Calidad de la dieta, sobrepeso y obesidad en estudiantes universitarios

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Evaluation des liens entre l’indice de la qualité alimentaire globale C-HEI, des paramètres nutritionnels et anthropométriques et des indicateurs de santé dans la cohorte «NuAge»

Introduction: Plusieurs indices de qualité alimentaire globale ont été élaborés en misant sur la consommation de certains nutriments ou aliments, ou des groupes d’aliments. Les indices de la qualité alimentaire globale sont en mesure d’évaluer de manière intégrée les aspects recherchés d’une bonne alimentation. C’est dans ce cadre que le Canadian Healthy Eating Index (C-HEI) a été développé pour évaluer le degré auquel les apports alimentaires des individus rencontrent les consignes du guide alimentaire canadien et les Recommandations nutritionnelles canadiennes. Objectif: Evaluer les liens entre l’indice de la qualité alimentaire globale C-HEI calculé à partir de la moyenne de trois rappels alimentaires de 24 heures et des paramètres nutritionnels, anthropométriques et des indicateurs de santé au recrutement (T1) dans l’étude longitudinale québécoise sur la nutrition et le vieillissement réussi (NuAge). Méthodologie: Des analyses bivariées (coefficients de corrélation, tableaux croisés et la statistique khi deux) ont été réalisées afin de déterminer les associations entre le score total C-HEI et certaines variables nutritionnelles, anthropométriques et le nombre de maladies chroniques. Résultats et discussion: Les participants ont rencontré ou dépassé la plupart de leurs apports nutritionnels de référence. Le C-HEI n’a pas été fortement corrélé aux nutriments individuels (rs= 0,14-0,52, p<0,01). Le C-HEI total était significativement associé aux recommandations canadiennes pour l’apport en fibres (rs= 0,51), le % d’énergie provenant des lipides (rs=-0,60) et des acides gras saturés (rs= -0,59), p<0,01. De plus, la suffisance en protéines et en énergie est augmentée lorsqu’on passait du Q1 (plus faible) à Q4 (plus élevé) du C-HEI (p<0,05). De même, les proportions des sujets ayant des mesures anthropométriques associées aux risques accrus pour la santé sont diminuées en passant du Q1 au Q4 (p<0,05), témoignant ainsi des liens entre une alimentation de bonne qualité et la protection des risques de santé associés à l’embonpoint et à l’obésité. Conclusion : Les résultats de cette recherche ont fourni des preuves additionnelles sur le lien entre le score C-HEI et certains paramètres nutritionnels et anthropométriques d’intérêt, et ce, provenant des données alimentaires quantitatives colligées au sein d’une population âgée vivant dans la communauté.

Avaliação da alimentação de gestantes mediante aplicação do índice de qualidade da dieta adaptado

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Effects of oat bran and nutrition counseling on the lipid and glucose profile and anthropometric parameters of hypercholesterolemia patients

Background: In order to prevent chronic, non communicable disease, it is essential that lifestyle is modified to include a diet high in fiber. Aim: To assess the effect oat bran (OB) in conjunction with nutrition counseling (NC) have on lipid and glucose profile, anthropometric parameters, quality of diet, and ingestion of ultraprocessed foods (UPF) and additives in hypercholesterolemia sufferers. Method: This was a 90-day, double-blind, placebo-controlled, block-randomized trial undertaken on 132 men and women with LDL-c ≥ 130 mg/dL. The participants were sorted into two groups: OB Group (OBG) and Placebo Group (PLG), and were given NC and 40g of either OB or rice flour, respectively. Lipid and glucose profile were assessed, as were the anthropometric data, quality of diet (Diet Quality Index revised for the Brazilian population - DQI-R) and whether or not UPF or additives were consumed. Results: Both groups showed a significant decrease in anthropometric parameters and blood pressure, as well as a significant reduction in total and LDL cholesterol. There was also an improvement in DQI-R in both groups and a decrease in consumption of UPF. Blood sugar, HOMA-IR and QUICKI values were found to be significantly lower only in the OBG. Conclusion: Our findings in lipid profile and anthropometric parameters signify that NC has a beneficial effect, which is attributable to the improved quality of diet and reduced consumption of UPF. Daily consumption of 40 g of OB was found to be of additional benefit, in decreasing insulin-resistance parameters.

Seasonal changes in pasture quality and diet selection and their relationship with liveweight gain of steers grazing tropical grass and grass-legume pastures in northern Australia.

The variation in liveweight gain in grazing beef cattle as influenced by pasture type, season and year effects has important economic implications for mixed crop-livestock systems and the ability to better predict such variation would benefit beef producers by providing a guide for decision making. To identify key determinants of liveweight change of Brahman-cross steers grazing subtropical pastures, measurements of pasture quality and quantity, and diet quality in parallel with liveweight were made over two consecutive grazing seasons (48 and 46 weeks, respectively), on mixed Clitoria ternatea/grass, Stylosanthes seabrana/grass and grass swards (grass being a mixture of Bothriochloa insculpta cv. Bisset, Dichanthium sericeum and Panicum maximum var. trichoglume cv. Petrie). Steers grazing the legume-based pastures had the highest growth rate and gained between 64 and 142 kg more than those grazing the grass pastures in under 12 months. Using an exponential model, green leaf mass, green leaf %, adjusted green leaf % (adjusted for inedible woody legume stems), faecal near infrared reflectance spectroscopy predictions of diet crude protein and diet dry matter digestibility, accounted for 77, 74, 80, 63 and 60%, respectively, of the variation in daily weight gain when data were pooled across pasture types and grazing seasons. The standard error of the regressions indicated that 95% prediction intervals were large (+/- 0.42-0.64 kg/head.day) suggesting that derived regression relationships have limited practical application for accurately estimating growth rate. In this study, animal factors, especially compensatory growth effects, appeared to have a major influence on growth rate in relation to pasture and diet attributes. It was concluded that predictions of growth rate based only on pasture or diet attributes are unlikely to be accurate or reliable. Nevertheless, key pasture attributes such as green leaf mass and green leaf% provide a robust indication of what proportion of the potential growth rate of the grazing animals can be achieved.

Efetividade de um ensaio randomizado de base escolar envolvendo familiares e professores para redução do ganho excessivo de peso em adolescentes

Esta tese é composta por três artigos que veiculam os resultados da realização e análise de uma intervenção de base escolar com o objetivo de reduzir o ganho de peso excessivo em adolescentes. O ensaio, denominado PAPPAS (Pais, Alunos e Professores Pela Alimentação Saudável), foi conduzido com alunos do 5 ano de vinte escolas públicas do município de Duque de Caxias, Rio de Janeiro. As atividades desenvolvidas durante o ano letivo de 2010 desencorajaram o consumo de bebidas adoçadas e biscoitos e estimularam o consumo de feijão e frutas. Pais/ responsáveis e professores receberam informação e material de divulgação sobre os mesmos temas abordados em sala de aula. O consumo de alimentos foi avaliado por meio de um questionário de frequência alimentar aplicado ao início e ao final do estudo. A aferição do peso e da estatura se deu em três momentos: na linha de base, na metade do ano letivo e ao fim do estudo. Para as análises longitudinais, empregou-se modelos generalizados lineares mistos, que levam em conta tanto os dados faltantes quanto o efeito de conglomerado. No primeiro artigo é apresentado o efeito da intervenção no Índice de Massa Corporal (IMC) dos estudantes. Análise por intenção de tratamento revelou que a alteração no IMC dos adolescentes ao longo do tempo não foi estatisticamente diferente entre os grupos intervenção e controle. Observou-se redução estatisticamente significativa no consumo de bebidas adoçadas e biscoitos e aumento no consumo de frutas nos participantes do grupo intervenção quando comparados aos do grupo controle. Pôde-se concluir que estratégias baseadas exclusivamente na qualidade da dieta podem não levar à alterações no peso corporal de adolescentes. No segundo artigo verificou-se a influência do estágio de prontidão para modificação dos hábitos alimentares dos adolescentes na alteração do consumo de refrigerantes, biscoitos e frutas. Observou-se maior alteração no consumo dentre os participantes do grupo intervenção que se encontravam nos estágios de ação na linha de base (relataram já ter alterado seus hábitos alimentares), sugerindo que essa estratégia pode auxiliar em estudos de intervenção visando à alteração do comportamento. O terceiro artigo revisou evidências do ajuste inadequado para características da linha de base, em análises de ensaios randomizados de base escolar que objetivaram alteração no estado nutricional de adolescentes. Foram avaliados 37 estudos e 35% apresentaram desbalanceamento estatisticamente significativo para o IMC na linha de base. Concluiu-se que o ajuste para o IMC na linha de base é frequente em ensaios comunitários randomizados, porém, esta prática força um balanço, que pode levar à resultados espúrios sobre o efeito do tratamento. Os resultados dos artigos 2 e 3 permitem explicar, ao menos em parte, as inconsistências nos resultados de estudos de intervenções voltadas para alteração de hábitos alimentares em escolares.

The quality of deliberation in Northern Ireland's district policing partnerships

This study uses theoretical based deliberative democratic dimensions to measure the deliberative quality of Northern Ireland’s District Policing Partnership (DPP) meetings in public. The study combines Habermasian, and Young’s deliberative concepts to create an Augmented Discourse Quality Index. This Augmented DQI is employed by this research as am empirical instrument to establish the true deliberative nature of these DPP meetings in public. The overall goal of this study is two-fold. First; to gain an in-depth understanding of Northern Ireland’s DPPs in relation to deliberative democratic theory, specifically regarding how these policing/public partnerships stand up under a deliberative democratic lens. The second goal is to provide a possible framework by which deliberative quality can be more accurately measured. In that frameworks which are designed to measure deliberative quality should include not only the dimensions for rational participation, but also include broader terms of communication such as greeting, rhetoric and story-telling.

Childhood obesity in Ireland: recent trends and modifiable determinants

Background: Childhood obesity is a global epidemic posing a significant threat to the health and wellbeing of children. To reverse this epidemic, it is essential that we gain a deeper understanding of the complex array of driving factors at an individual, family and wider ecological level. Using a social-ecological framework, this thesis investigates the direction, magnitude and contribution of risk factors for childhood overweight and obesity at multiple levels of influence, with a particular focus on diet and physical activity. Methods: A systematic review was conducted to describe recent trends (from 2002-2012) in childhood overweight and obesity prevalence in Irish school children from the Republic of Ireland. Two datasets (Cork Children’s Lifestyle [CCLaS] Study and the Growing Up in Ireland [GUI] Study) were used to explore determinants of childhood overweight and obesity. Individual lifestyle factors examined were diet, physical activity and sedentary behaviour. The determinants of physical activity were also explored. Family factors examined were parental weight status and household socio-economic status. The impact of food access in the local area on diet quality and body mass index (BMI) was investigated as an environmental level risk factor. Results: Between 2002 and 2012, the prevalence of childhood overweight and obesity in Ireland remained stable. There was some evidence to suggest that childhood obesity rates may have decreased slightly though one in four Irish children remained either overweight or obese. In the CCLaS study, overweight and obese children consumed more unhealthy foods than normal weight children. A diet quality score was constructed based on a previously validated adult diet score. Each one unit increase in diet quality was significantly associated with a decreased risk of childhood overweight and obesity. Individual level factors (including gender, being a member of a sports team, weight status) were more strongly associated with physical activity levels than family or environmental factors. Overweight and obese children were more sedentary and less active than normal weight children. There was a dose response relationship between time spent at moderate to vigorous physical activity (MVPA) and the risk of childhood obesity independent of sedentary time. In contrast, total sedentary time was not associated with the risk of childhood obesity independent of MVPA though screen time was associated with childhood overweight and obesity. In the GUI Study, only one in five children had 2 normal weight parents (or one normal weight parent in the case of single parent families). Having overweight and obese parents was a significant risk factor for overweight and obesity regardless of socio-economic characteristics of the household. Family income was not associated with the odds of childhood obesity but social class and parental education were important risk factors for childhood obesity. Access to food stores in the local environment did not impact dietary quality or the BMI of Irish children. However, there was some evidence to suggest that the economic resources of the family influenced diet and BMI. Discussion: Though childhood overweight and obesity rates appear to have stabilised over the previous decade, prevalence rates are unacceptably high. As expected, overweight and obesity were associated with a high energy intake and poor dietary quality. The findings also highlight strong associations between physical inactivity and the risk of overweight and obesity, with effect sizes greater than what have been typically found in adults. Important family level determinants of childhood overweight and obesity were also identified. The findings highlight the need for a multifaceted approach, targeting a range of modifiable determinants to tackle the problem. In particular, policies and interventions at the shared family environment or community level may be an effective mean of tackling this current epidemic.

Dietary quality is associated with diabetes and cardio-metabolic risk factors1–3

In this study, our aim was to investigate the associations between diet quality and newly diagnosed diabetes, prediabetes, and cardio-metabolic risk factors. The analysis was based on 7441 participants of the Australian Diabetes, Obesity and Lifestyle study, a cross-sectional study of adults aged 25 y involving a 75-g oral glucose tolerance test. Diet quality was assessed via a dietary guideline index and FFQ data. Associations between diet quality and diabetes, prediabetes (impaired fasting glycemia, impaired glucose tolerance), and cardiovascular risk factors were investigated using linear and logistic regression adjusted for age, education, smoking, physical activity, sedentary behavior, and BMI. Higher diet quality was significantly associated with lower systolic and diastolic blood pressure among men, lower fasting plasma glucose among men and women, and lower systolic blood pressure, fasting plasma insulin, and 2-h plasma glucose and greater insulin sensitivity among women. Diet quality was inversely associated with abdominal obesity [odds ratio (OR) for top quartile: 0.68, 0.48–0.96], hypertension (OR: 0.50, 0.31–0.81), and type 2 diabetes (OR: 0.38, 0.18–0.80) among men. Lack of compliance with established dietary guidelines was associated with type 2 diabetes and cardio-metabolic risk factors. Further work is required to determine whether this dietary index has predictive validity for health in longitudinal studies.

Involvement of young Australian adults in meal preparation : cross-sectional associations with abdominal obesity and body mass index

Previous research has shown that involvement in meal preparation is positively associated with better diet quality. However, it is unclear whether there is an association between involvement in meal preparation and being overweight or obese. This study investigated whether the level of involvement in meal preparation was associated with objectively measured weight status in young adults. During 2004-2006, a national sample of 1,996 Australian adults aged 26 to 36 years completed a self-administered questionnaire including questions on sociodemographic characteristics, diet, and physical activity. Participants were asked to report who usually prepared the main meal on working days and responses were categorized as “myself,” “shared,” or “someone else.” Waist circumference, weight, and height were measured by trained staff. Moderate abdominal obesity was defined as waist circumference >94 cm for men and >80 cm for women. Overweight was defined as body mass index (calculated as kg/m2) >25. Prevalence ratios were calculated using log binomial regression. After adjusting for age, education, and leisure time physical activity, men who shared the meal preparation had a slightly lower prevalence of moderate abdominal obesity (prevalence ratio=0.92; 95% confidence interval [CI]: 0.86 to 0.99) than those whose meals were usually prepared by someone else. There was no association with having sole responsibility (prevalence ratio=0.99; 95% CI: 0.92 to 1.06). There were no associations between level of involvement in meal preparation and being overweight (shared responsibility prevalence ratio=0.99; 95% CI: 0.92 to 1.07; sole responsibility prevalence ratio=0.98; 95% CI: 0.91 to 1.05). For women, level of involvement was not associated with moderate abdominal obesity (shared responsibility prevalence ratio=0.93; 95% CI: 0.84 to 1.03; sole responsibility prevalence ratio=0.94; 95% CI: 0.86 to 1.03) or being overweight (shared responsibility prevalence ratio=0.93; 95% CI: 0.84 to 1.02; sole responsibility prevalence ratio=0.93; 95% CI: 0.85 to 1.02). In this sample of young adults, level of involvement in meal preparation was not strongly related to weight status.

Scores on the dietary guideline index for children and adolescents are associated with nutrient intake and socio-economic position but not adiposity 1-3

Diet quality indices reflect overall dietary patterns better than single nutrients or food groups. The study aims were to develop a measure of adherence with dietary guidelines applicable to child and adolescent populations in Australia and determine the association between index scores and food and nutrient intake, socio-demographic characteristics, and measures of adiposity. Data were analyzed from 4- to 16-y-old participants of the 2007 Australian Children’s Nutrition and Physical Activity Survey (n = 3416). The Dietary Guideline Index for Children and Adolescents (DGI-CA) comprises 11 components: 5 core food groups, wholegrain bread, reduced-fat dairy foods, extra foods (nutrient poor and high in fat, salt, and added sugar), healthy fats/oils, water, and diet variety (possible score of 100). The index criteria were age specific. The mean DGI-CA score was low (53.6 ± 0.4), similar between boys and girls, and differed by age; the youngest children scored higher than the oldest children (P < 0.0001). Higher DGI-CA scores were associated with lower energy intake, energy density, total and saturated fat, and sugar intake; higher protein, carbohydrate, fiber, calcium, iron, vitamin C, vitamin A, folate, phosphorous, magnesium, zinc, and iodine intakes; and a higher polyunsaturated:saturated fat ratio (P < 0.0001). DGI-CA scores were associated with socio-economic characteristics and measures of family circumstance. Weak positive associations were observed between DGI-CA score and BMI or waist circumference Z-scores in the 4- to 10-y and 12- to 16-y age groups only. This index is the first validated index in Australia and one of the few international indices to describe the diet quality of children and adolescents.

Relationship between diet and mental health in children and adolescents: a systematic review

We systematically reviewed 12 epidemiological studies to determine whether an association exists between diet quality and patterns and mental health in children and adolescents; 9 explored the relationship using diet as the exposure, and 3 used mental health as the exposure. We found evidence of a significant, cross-sectional relationship between unhealthy dietary patterns and poorer mental health in children and adolescents. We observed a consistent trend for the relationship between good-quality diet and better mental health and some evidence for the reverse. When including only the 7 studies deemed to be of high methodological quality, all but 1 of these trends remained. Findings highlight the potential importance of the relationship between dietary patterns or quality and mental health early in the life span.

Diet and bipolar disorder: a review of its relationship and potential therapeutic mechanisms of action

OBJECTIVES: It is well accepted that diet quality has an important role in the prevention and treatment of several physical diseases. However, its influence on mental health has received far less attention, although there is increasing evidence to support a relationship with depression. In this narrative review, investigations into the relationship between diet and bipolar disorder are examined and the potential implications in the management and treatment of bipolar disorder are reviewed. METHODS: The authors provide a narrative review of the relevant information. RESULTS: Research is limited, although there are preliminary findings to suggest a relationship between diet and bipolar disorder. Findings from cross-sectional research suggest that people with bipolar disorder consume an unhealthier dietary pattern. This has significant treatment implications as bipolar disorder has a high comorbidity with several physical diseases. In addition, diet also influences several biological processes that are dysregulated in bipolar disorder, namely monoaminergic activity, immune/inflammatory processes, oxidative stress, mitochondrial activity, and neuroprogression. CONCLUSIONS: The role of diet in bipolar disorder requires further attention in research as it presents as a factor that may contribute to the worsening course of this condition and may potentially enhance current treatment outcomes.

Psoriasis: correlation between severity index (PASI) and quality of life index (DLQI) in patients assessed before and after systemic treatment

BACKGROUND: Psoriasis is a chronic inflammatory disease of the skin that affects patients of all ages and both genders. The impact of the disease on quality of life is greater among patients with moderate to severe psoriasis. OBJECTIVE: to establish a correlation between the psoriasis area and severity index (PASI) and the Dermatology Life Quality Index (DLQI) based on a quality of life questionnaire adapted to the Brazilian context for patients with plaque psoriasis before and after systemic treatment. METHODS: This was a cross-sectional, descriptive study of psoriasis patients who did not undergo treatment or who manifested clinical activity of the disease. Patients were evaluated according to the PASI and the quality of life questionnaire adapted to the Brazilian context before and 60 days after systemic treatment. RESULTS: Thirty-five patients participated in the study. Twenty-six were men, with a mean age of 46 years. There was no correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context, but there was a correlation between the PASI and some items of the quality of life questionnaire adapted to the Brazilian context, such as jobs involving public contact. CONCLUSION: The non-correlation between the PASI and the quality of life questionnaire adapted to the Brazilian context in this work may be associated with a history of chronic disease, which implies greater acceptance of the illness, or may be related to the low income and social status of the patients studied. The correlation observed among patients with careers involving public contact suggests that some professions are more impacted by the disease. It may be necessary to adapt the quality of life questionnaire to patients with a low income and cultural and social limitations. The small sample size (n=35 patients) and the short follow-up period of 60 days were some of the limitations of this work.

Quality of life index in autoimmune bullous dermatosis patients

Background: Autoimmune bullous dermatoses are complex diseases triggered by autoantibodies action against epidermal antigens or the dermoepidermal junction. Blisters and vesicles that evolve with erosion areas characterize them. Although rare, they present high morbidity, affecting the quality of life of patients.Objectives: To assess the magnitude of autoimmune bullous dermatoses on life quality of patients treated in a public university service in countryside of Brazil. Methods: This cross-sectional study was based on an inquiry with autoimmune bullous dermatoses patients assisted at outpatient university referral service. Elements related to quality of life were evaluated by the Dermatology Life Quality Index, as well as clinical and demographic data. Results: The study evaluated 43 patients with pemphigus foliaceus, 32 with pemphigus vulgaris, 6 with bullous pemphigoid and 3 with dermatitis herpetiformis. The average age was 48 +/- 16 years and 34 (40%) were female. The median score (p25-p75) of the Dermatology Life Quality Index was 16 (9-19), classified as "severe impairment" of life quality, in which the greater impact was related to symptoms and feelings, daily and leisure activities. Conclusions: Autoimmune bullous dermatoses inflict severe impairment of quality of life for patients followed by a public outpatient clinic in the countryside of Brazil.