Daniela Saes Sartorelli

Tendências do diabetes mellitus no Brasil: o papel da transição nutricional

Prevalence of type 2 diabetes mellitus has increased rapidly and is expected to increase even further. In Latin America countries there is an upward trend among the younger age groups, with a major negative impact on the quality of life and burden of the disease for the health care system. Increasing rates of overweight and obesity associated with lifestyle changes and aging of the population are the main contributing factors to the increasing prevalence of type 2 diabetes. Dietary shifts in the Brazilian population (low frequency of fiber-rich foods and heavy consumption of saturated fatty acids and sugars) and sedentary lifestyle are the main risk factors for obesity, type 2 diabetes, and other chronic diseases. Diabetes prevention programs are being promoted in several countries with results showing improvement in quality of life.

The Costs of Type 2 Diabetes Mellitus Outpatient Care in the Brazilian Public Health System

OBJECTIVE The prevalence of type 2 diabetes has shown a significant increase in parallel with health care costs. The objective of the Brazilian Study on Diabetes Costs (ESCUDI study) was to estimate direct and indirect costs of type 2 diabetes outpatient care in the Brazilian Public Health Care System. METHODS Data were collected from different levels of health care in eight Brazilian cities in 2007. A total of 1000 outpatients were interviewed and had their medical records data analyzed. Direct medical costs included expenses with medications, diagnostic tests, procedures, blood glucose test strips, and office visits. Nonmedical direct costs included expenses with diet products, transportation, and caregivers. Absenteeism, sick leave, and early retirement were classified as indirect costs. RESULTS Total annual cost for outpatient care was US

High intake of fruits and vegetables predicts weight loss in Brazilian overweight adults

2108 per patient, out of which US

Validation of a food frequency questionnaire for assessing dietary nutrients in Brazilian children 5 to 10 years of age

1335 per patient of direct costs (63.3%) and US

Beneficial effects of short-term nutritional counselling at the primary health-care level among Brazilian adults

773 per patient of indirect costs (36.7%). Costs escalated as duration of diabetes and level of health care increased. Patients with both microvascular and macrovascular complications had higher costs (US

Intervenção nutricional e prevenção primária do diabetes mellitus tipo 2: uma revisão sistemática

3199 per patient) compared to those with either microvascular (US

Associação entre carboidratos da dieta habitual e diabetes mellitus tipo 2: evidências epidemiológicas

2062 per patient) or macrovascular (US

Rapid assessment of current infant feeding practices in São José do Rio Preto, São Paulo, Brazil

2517 per patient) complications only. The greatest portion of direct costs was attributed to medication (48.2%). CONCLUSIONS Diabetes treatment leads to elevated costs both to Brazilian Public Health Care System and society. Costs increased along with duration of disease, level of care and presence of chronic complications, which suggested a need to reallocate health resources focusing on primary prevention of diabetes and its complications.

Relative validation of a quantitative FFQ for use in Brazilian pregnant women

To determine whether changes in dietary intakes predict weight loss, we studied 80 overweight adults who attended a nutritional counseling program during 6 months of follow-up at a primary health care center in Brazil. Habitual diet was assessed using a validated food frequency questionnaire at baseline and after 6 months. The mean age (+/-SD) of the participants was 46.5 +/- 9.5 years, and their mean body mass index was 29 +/- 3 kg/m(2) at baseline. After 6 months, the differences in body weight and fruit/vegetable intake were -1.4 +/- 3 kg and +/-109 +/- 320 g daily, respectively. Using multiple linear regression models adjusted for age, sex, changes in walking time, and total energy intake, the increased intake of dietary fiber from fruits/vegetables was associated with a greater weight loss (beta1 [95% confidence interval (CI)] = -0.180 [-0.269, -0.091]) after 6 months of follow-up. Similar results were observed for increased intake of vegetables (beta1 [95% CI] = -0.00497 [-0.008, -0.002]) and fruits (beta1 [95% CI] = -0.00290 [-0.005, -0.001]) as predictors of weight loss. The increase of 100 g/d of vegetables and fruits represented a body weight loss of 500 and 300 g after 6 months, respectively (P < .05). Our findings support the relevance of increased intakes of fruits and vegetables that may help avoid weight gain in overweight adults.

Dietary fructose, fruits, fruit juices and glucose tolerance status in Japanese-Brazilians.

OBJECTIVE This study aimed to assess the relative validity of a food frequency questionnaire (FFQ), previously validated to measure usual intakes in adults, for measuring dietary intakes in children 5 to 10 y of age. METHODS Dietary intakes were measured using an FFQ and a 3-d dietary record. Healthy children, 5 to 10 y old (n = 151), were recruited from public schools and asked to answer the questions in the FFQ and to provide non-consecutive 3-d dietary records based on reported estimated portion sizes. Paired sample t tests and Pearsons correlation coefficients were conducted to determine whether the two instruments reported similar values for energy and nutrients. The agreement of quartile categorization between the two instruments was also examined. RESULTS Estimated energy and nutrient intakes derived from the FFQ were significantly higher than those derived from 3-d dietary records. As expected, Pearsons correlations increased after adjusting for residual measurement error, presumably due to exclusion of the high within-person variability in intake of these nutrients. Moderate to high (r > 0.50) correlation coefficients were verified for some nutrients such as calcium, folate, vitamin B2, vitamin A, and vitamin C. CONCLUSION This FFQ, originally developed for use in adults, appears to overestimate usual energy and nutrient intakes in children 5 to 10 y of age. Further work is necessary to conduct a calibration study to establish adequate portion sizes before instrument adoption in this population.