Ana Maria Cervato

Dieta habitual e fatores de risco para doenças cardiovasculares

INTRODUCTION A survey by sampling in a county of the State of S. Paulo in 1990 sought, by means of home interviews, to analyse the habitual diet and risk factors for cardiovascular disease of people over 20 years of age. METHODOLOGY Of the sub-specimen of a comprehensive study population, 557 individuals, aged between 20 and 88, were interviewed. The habitual diet, characterized by the dietary history, was compared with the recommendations on energy and nutrients of the WHO and the risk factors (obesity, lipemic disorders and diabetes mellitus) diagnosed by the Body Mass Index and biochemical measurements. RESULTS AND CONCLUSIONS It was observed that 60% of the population consume a diet with total energy below the estimated need and that the caloric contribution of carbohydrates was of 56%, of the lipids 29% and of the proteins 15%. However, by percentile analysis, the caloric contribution of lipids and of proteins was far above the recommended levels to the detriment of the carbohydrates. Energy, caloric distribution and quantity of cholesterol were satisfactory in only 5% of diets. Among the risk factors for the cardiovascular disease studied, obesity was found to be present in 38% of individuals, lipemic disorders in 26% and diabetes mellitus in 5%. Preponderantly light physical activity together with unsatisfactory diet, both in qualitative as in quantitative terms, aggravated this scenario still further.INTRODUCAO: Estudo descritivo por amostragem em municipio do Estado de Sao Paulo, Brasil, em 1990, com objetivo de analisar, mediante entrevistas domiciliares, a dieta habitual e fatores de risco para doencas cardiovasculares em individuos maiores de 20 anos. METODOLOGIA: Foram entrevistados 557 individuos, de idade entre 20 e 88 anos, que fazem parte de subamostra de um estudo global na regiao. A dieta habitual, identificada pelo historico alimentar foi comparada as recomendacoes da OMS e os fatores de risco estudados (obesidade, dislipidemias, diabetes melito) diagnosticados pelo Indice de Massa Corporea e dosagens bioquimicas. RESULTADOS E CONCLUSOES: Observou-se que 60% da populacao consome dieta com energia total abaixo da estimativa das necessidades e que a contribuicao calorica dos carboidratos foi de 56%, dos lipidios de 29% e das proteinas de 15%. Entretanto, na analise por percentil, a contribuicao calorica dos lipidios e das proteinas encontra-se muito acima dos padroes recomendados em detrimento dos carboidratos. A energia, distribuicao calorica e quantidade de colesterol foi adequada em apenas 5% das dietas. Dentre os fatores de risco para doencas cardiovasculares estudados observou-se a prevalencia de obesidade em 38% dos individuos, de dislipidemias em 26% e de diabetes melito em 5%. A atividade fisica leve preponderante com dieta inadequada, tanto em termos de qualitativos quanto quantitativos, agravam ainda mais esse quadro.

Relationship between stature, overweight and central obesity in the adult population in São Paulo, Brazil

OBJECTIVE: To test association between overweight, central obesity and stature.DESIGN: Cross-sectional study carried-out between 1990–1991.SUBJECTS: 951 adults (387 male and 564 female) aged 20–64 y, resident in the metropolitan area of São Paulo, Brazil.MEASUREMENTS: Anthropometry, blood lipid concentrations (total, high density lipoprotein (HDL) and low density lipoprotein (LDL)-cholesterol, triglycerides (TGs) and blood glucose. Body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference were used to identify overweight (BMI >25 kg/m2), obdominal obesity (WHR tertile 3 and waist circumference tertile 3), respectively. The subjects were categorised as those of short stature (women <150 cm, men <162 cm) and those of normal stature (women ≥150 cm, men ≥162 cm).RESULTS: Prevalence of short stature was 19.6% and 15.4% in men and women, respectively. Short stature women had higher serum concentrations of total cholesterol, LDL-cholesterol, TGs and glucose than those of normal stature. Among men, this difference was not observed, except for glucose concentrations. Short stature women had high BMI and WHR means in some age categories, compared with those of normal stature. Both overweight and high WHR frequencies were greater in short stature women than in those of normal ones. In multivariate analysis, adjusted by age, income, marital status, education, physical activity and tobacco use, only women group with short stature compared with normal stature had significantly risk of overweight an high WHR. In the same group there was no association with waist circumference. Among the men there was significant opposite association with waist circumference.CONCLUSION: Short stature in women can potentially be an independent risk factor for overweight and high WHR.

Estado nutricional de grupamentos sociais da área metropolitana de São Paulo, Brasil

This paper focuses on prevalence of nutritional status (Body Mass Index, BMI) in social groups in greater metropolitan São Paulo, in Southeastern Brazil. The population was stratified in four socioeconomic groups. Prevalence of malnutrition (BMI<18.5kg/m2), low body mass (BMI<20.0kg/m2), and overweight (BMI>25.0kg/m2) and obesity (BMI(30.0kg/m2) were calculated. Prevalence of malnutrition was 3.9% in men and 6.2% in women. Prevalence of overweight ranged from 27.5% to 34.1% in men and from 25.8% to 43.6% in women. Obesity ranged from 2.5% to 11.1% in men and from 7.1% to 20.5 in women. Prevalence of overweight and obesity was greater among women than men (p<0.01). In relation to excess weight (BMI>25.0kgm/2), the study showed that prevalence in men was 43, 51, 35, and 30% for strata I, II, III, and IV, respectively. Among women, prevalence was 12, 61, 55 and 46% for strata I, II, III, and IV, respectively. In women there were an abrupt increase in excess weight just before 40 years of age. A high percentage of overweight and obesity was observed in all population groups.

Índices dietéticos na avaliação da qualidade global da dieta

Feeding can act in the prevention of some diseases as well as in the treatment of others. The analysis of food consumption provides information to assess nutritional needs and improve nutrition education programs. Few studies have been carried out in order to perform a global dietary assessment. The dietary indexes have been studied as an alternative to perform this assessment. The objective of this paper is to show some dietary indexes: Nutrient Index, Diet Variety Score, Diet Diversity Score, Diet Quality Index, Healthy Eating Index and Diet Quality Index Revised. These indexes have fundamental importance in the summarization of distinct dietary components in a single variable.

Alimentação institucionalizada e suas representações sociais entre moradores de instituições de longa permanência para idosos em São Paulo, Brasil

This study analyzed social representations of institutional eating and nutritional patterns among residents of long-term homes for the elderly, in order to identify conditioning factors for eating behavior that may interfere in their nutritional status. A qualitative exploratory study was performed in five homes for the elderly in Sao Paulo, Brasil, including 40 elderly participants of both sexes, without cognitive disorders, residing in these institutions for at least six months. The study selected 20 subjects who were undernourished or at risk of malnutrition and 20 without risk of malnutrition. Semi-structured interviews were conducted, and the data were analyzed according to the collective subject discourse technique. As perceived by these elderly, the institutional eating routine, the routine menus, and insufficient supply of fruits and vegetables have a negative interference on their eating. They also recognize that balanced nutrition improves health and quality of life. They report that lack of appetite among some residents is related to unpleasing meals, health problems, and inadequate help during meals. This study identified psychological and social factors that may lead to malnutrition among the elderly in institutions.

Consumo alimentar de vitaminas e minerais em adultos residentes em area metropolitana de Sao Paulo, Brasil

OBJETIVO: Propos-se calcular a composicao quantitativa e a densidade nutricional de vitaminas e sais minerais da dieta habitual, em relacao ao sexo e idade, em populacao de adultos residentes no Municipio de Cotia, Estado de Sao Paulo, SP, Brasil. MATERIAL E METODO: Foi realizado inquerito atraves do historico alimentar em populacao de adultos residentes em area metropolitana de Sao Paulo, Municipio de Cotia. A partir de uma subamostra de 548 individuos, com idades compreendidas entre 20 e 88 anos. Foi calculado o consumo de nutrientes da dieta habitual. As porcoes consumidas, obtidas em medidas caseiras, foram convertidas em gramas de alimentos para o calculo da concentracao de nutrientes. RESULTADOS E CONCLUSOES: a) O consumo de tiamina, riboflavina, niacina, calcio e ferro foi maior em individuos do sexo masculino (p < 0,001); b) nao houve diferencas significativas no consumo de vitamina A e de vitamina C entre os sexos; c) a populacao de idosos apresentou menor consumo de vitaminas e minerais e nao houve diferencas associadas a idade com relacao ao consumo de vitamina C; d) a dieta habitual, dessa populacao, apresenta-se inadequada e com baixa densidade nutricional em vitamina A e calcio.