Fernanda Camboim Rockett

Dietary aspects of migraine trigger factors.

The significance of dietary factors as triggers for migraines is controversial, and the assessment of this topic is complex and inconclusive. In order to evaluate the published evidence on dietary triggers, a critical review of the literature was performed by conducting a search for food item descriptors linked to migraines in the PubMed and SciELO databases. Reviews and relevant references cited within the articles that resulted from the search were also included. Of the 45 studies reviewed, 16 were population studies that involved the association between migraines and eating habits or the prevalence of related dietary factors; 12 involved interventions or analyzed observational prospective cohorts; and 17 were retrospective studies. Approximately 30 dietary triggers were explored in total, although only seven of these were addressed experimentally. In the prospective studies, patients were instructed to keep a diary; two of these studies involved dietary interventions. Conclusions that are based on nonpharmacological prophylactic strategies with a scientific basis and that show an association between certain dietary factors and the triggering of migraines are limited by the lack of prospective studies with clear experimental designs. Nevertheless, the high frequency of possible specific dietary triggers validates efforts to elucidate the involvement of food-related factors in precipitating migraines.

Body mass index, abdominal obesity, body fat and migraine features in women

BACKGROUND Studies seeking to establish an association between migraine and anthropometric parameters have thus far been inconclusive. Furthermore, drugs used for migraine prophylaxis may be associated with changes in body weight. OBJECTIVE To investigate the potential association of anthropometric parameters and body fat percentage with attack patterns and use of prophylactic medication in migraineurs. METHODS Cross-sectional study that assessed the body mass index, waist circumference, body fat percentage and related clinical variables (characteristics of attacks and the use of prophylactic medication) in female outpatients with migraine. RESULTS 166 female migraineurs aged ≥18 years (mean age, 45 ± 14 years) were included in the study. Migraine without aura was most prevalent (71.7%). Mean body mass index and body fat percentage were 27.8±6.0 kg/m² and 36.4 ± 8.3% respectively. Body mass index and waist circumference were weakly correlated with frequency of attacks over 6 months (rs = 0.162, p < 0.05 and rs = 0.187, p < 0.05 respectively). These correlations remains weak considering only premenopausal women, but disappear in the older women. Stratification of analysis by migraine type field shows a moderate correlation between migraine with aura and frequency of attacks over 6 months and body mass index (rs = 0.369, p < 0.05), as well as waist circumference (rs = 0.423, p < 0.01). Patients who were on prophylactic medication had higher body mass index, waist circumference, and body fat percentage values (p < 0.01, Student t-test). CONCLUSION This study revealed a potential, though tenuous association between migraine and anthropometric parameters and frequency of attacks, which does not reflect on the duration, severity, and disability of attacks, with patterns differing by migraine type, reproductive age and prophylactic medication.

Cardiovascular disease risk in women with migraine

BackgroundStudies suggest a higher prevalence of unfavourable cardiovascular risk factors amongst migraineurs, but results have been conflicting. The aim of this study was to investigate traditional and newly recognized risk factors as well as other surrogate markers of cardiovascular risk in obese and normal weight women with migraine.MethodsFifty-nine adult female probands participated in this case–control study. The sample was divided into normal weight and obese migraineurs and age- and body mass index-matched control groups. The following cardiovascular risk factors were analyzed: serum levels of lipids, fasting glucose, and insulin; insulin resistance; blood pressure; smoking (categorized as current, past or never); Framingham 10-year risk of general cardiovascular disease score; C-reactive protein; family history of cardiovascular disease; physical activity; sleep disturbances; depression; and bioelectrical impedance phase angle. The means of continuous variables were compared using Student’s t- test for independent samples or the Mann–Whitney U- test (for 2 groups) and ANOVA or the Kruskal-Wallis test (for 4 groups) depending on the distribution of data.ResultsAll migraineurs were sedentary irrespective of nutritional status. Migraineurs had higher depression scores and shorter sleep duration, and obese migraineurs, in particular, had worse sleep quality scores. Insulin resistance and insulinaemia were associated with obesity, and obese migraineurs had lower HDL-c than normal weight controls and migraineurs. Also, the Framingham risk score was higher in obese migraineurs.ConclusionThese findings suggest that female migraineurs experience marked inactivity, depression, and some sleep disturbance, that higher insulin resistance and insulinaemia are related to obesity, and that obesity and migraine probably exert overlapping effects on HDL-c levels and Framingham 10-year cardiovascular risk.

Estado nutricional, ingesta alimentaria y riesgo de enfermedad cardiovascular en individuos con esquizofrenia en el sur de Brasil: estudio de casos-controles

OBJECTIVES To verify food consumption patterns and presence of risk anthropometric parameters in schizophrenic patients, trying to assess some modifiable cardiovascular risk. METHOD Twenty-five schizophrenic outpatients, attended at the Hospital de Clínicas de Porto Alegre, Brazil, and 25 healthy controls matched by sex, age and body mass index (BMI) were included. Demographic (age, sex and socioeconomic status), anthropometric (weight, height and waist circumference), clinical (antipsychotics) and dietary consumption data (food frequency questionnaire) were obtained. RESULTS There was a 40% frequency of overweight and 40% of obesity as verified by BMI, and 80% of increased risk of metabolic complications as measured by waist circumference. Most of the patients (68%) used atypical antipsychotics and no association was found between the distribution of the nutritional status according to BMI and type of antipsychotic used. There was a higher intake of total calories, calories and protein per kilogram of body weight, percentage of carbohydrates, and lower intake of omega-6, phytosterols, vitamin A and α-tocopherol by cases. Cholesterol and sodium intake did not differ between groups (365 ± 152 mg of cholesterol in cases and 313 ± 146 mg in controls; (3499 ± 1695 mg sodium by cases and 2874 ± 800 by controls). CONCLUSION In this sample of schizophrenic patients there was a higher intake of calories and lower consumption of α-tocoferol and phitosterols, compared to controls. There was also elevated sodium, and cholesterol intake, and high frequency of overweight and central obesity.

Avaliação da inserção de alimentos orgânicos provenientes da agricultura familiar na alimentação escolar, em municípios dos territórios rurais do Rio Grande do Sul, Brasil

Organic food enables the promotion of Food and Nutritional Safety (FNS) and sustainable regional development. In this context, the National School Food Program (NSFD) seeks to comply with the requirements of FNS. This study evaluated the inclusion of organic food in school food in the municipalities of rural territories of the state of Rio Grande do Sul by means of interviews with local managers. Eight territories were visited, albeit of its 153 municipalities only 102 comprised the sample for this study. Of these, 20.58% said they buy organic produce from family farms. The Center South Territory revealed the highest percentage of purchase, in which 40% of the municipalities visited purchased organic produce, followed by the Center Mountain Territory with 33.3%, while the lowest percentage was 7.1% in the Countryside Territory. The study identified the need for intersectoral action to develop organic production, as well as stimulate the consumption of these foods in the school environment, in order to meet the requirements of FNS.

Risk and protective factors for the development of chronic diseases in a rural elderly population in Rio Grande do Sul

Objective: to verify risk and protective factors for the development of chronic diseases among elderly persons living in the rural area of Linha Senador Ramiro, in Nova Bassano, Rio Grande do Sul. Methods: a cross-sectional censitary-based study was conducted of 70 male and female subjects aged 60 years or over. The subjects were interviewed through a questionnaire and anthropometrically evaluated (weight, height and waist circumference (WC)). The risk factors considered were: smoking, excess weight, intake of saturated fat, physical inactivity and excessive alcohol consumption. The protective factors were: physical activity during leisure time, consumption of fruits and vegetables, and cancer prevention. Results: the population was composed of 70 elderly persons, with a mean age of 70.4 ± 7.8 years. A total of 65.7% of the sample were women, 57.1% considered their health “normal”, 72.3% said they were not sedentary and, among women, 78.3 and 47.8% performed mammography and Pap screening, respectively. The prevalence of excess weight was 55.9% and 76.5% of individuals were at increased risk of cardiovascular and metabolic diseases, according to waist circumference. Hypertension was the most prevalent chronic disease (64.3%). The prevalence of daily consumption of vegetables and fruit was 85.7% and 68.6%, respectively; wine, 54.3%, pork fat and queijo colonial (a local cheese) 75.7%, respectively, and homemade bread 87.1%. A total of 7.1% of the population said they smoked. Conclusions: the risk factors identified were high intake of saturated fat, excess weight and a high waist circumference. The protective factors were regular consumption of fruit and vegetables, low rates of physical inactivity and smoking, regular and moderate consumption of wine and preventive examinations. Further studies can assess the true association of these factors with the occurrence of cardiovascular and cerebrovascular events. http://dx.doi.org/10.1590/1809-9823.2015.14150

Risk factors for gestational diabetes mellitus in a sample of pregnant women diagnosed with the disease

Background The known risk factors for Gestational Diabetes Mellitus (GDM) are advanced age (≥35 yrs.), overweight or obesity, excessive gestational weight gain, excessive central body fat deposition, family history of diabetes, short stature (<1.50 m), excessive fetal growth, polyhydramnios, hypertension or preeclampsia in the current pregnancy, history of recurrent miscarriage, offspring malformation, fetal or neonatal death, macrosomia, GDM during prior pregnancies and polycystic ovary

Padrões alimentares de escolares: existem diferenças entre crianças e adolescentes?

Resumo Objetivo Identificar padroes alimentares de criancas e adolescentes de escolas publicas e verificar a associacao destes com a faixa etaria, o sexo, o municipio de residencia e a classe economica. Metodo Estudo transversal com escolares de cinco a 19 anos, de 10 escolas publicas. Aplicou-se o Formulario de Marcadores do Consumo Alimentar do Sistema de Vigilância Alimentar e Nutricional e a partir deste identificaram-se os padroes alimentares utilizando-se analise de cluster. Na analise estatistica, verificou-se a associacao dos padroes com faixa etaria, sexo, classe economica e municipio de residencia (teste qui-quadrado de Pearson). Consideraram-se significativos valores de p ≤ 0,05. Resultados A amostra final foi de 631 escolares. Identificaram-se cinco padroes alimentares: “feijao/leite/iogurte” representou o consumo de 23,3% (n = 147); “restrito” representou o de 22,7% (n = 143); “saudavel” representou o de 22,0% (n = 139); “industrializado brasileiro” representou o de 17,4% (n = 110) dos escolares; e “misto” representou o de 14,5% (n = 92). Os padroes nao se associaram as demais variaveis. Conclusoes Identificaram-se cinco padroes alimentares, sendo o saudavel associado as criancas e o restrito aos adolescentes.

Atuação do Nutricionista no Programa Nacional de Alimentação Escolar na Região Sul do Brasil

Resumo O objetivo deste estudo foi verificar a adequacao dos parâmetros numericos minimos de referencia com relacao as atribuicoes obrigatorias do nutricionista da regiao Sul do Brasil de acordo com a Resolucao do CFN 465/2010. Estudo transversal com amostra representativa de Responsaveis Tecnicos do PNAE que atuam na alimentacao escolar na regiao Sul do Brasil (PR, SC e RS). Os questionarios foram encaminhados por meio eletronico. Comparou-se o resultado obtido com o preconizado pela Resolucao CFN 465/2010, quanto a realizacao das atribuicoes obrigatorias e adequacao aos parâmetros numericos minimos definidos por esta legislacao. Os resultados apontam para a nao conformidade de 71,6% dos municipios da Regiao Sul no que tange o quantitativo de nutricionistas definido pelos parâmetros numericos minimos de referencia. Esta inadequacao se reflete no cumprimento das atribuicoes do nutricionista no PNAE. Essas inadequacoes reforcam a necessidade de formacao de parcerias e do trabalho intersetorial para o fortalecimento da execucao do PNAE, alem de ratificarem a necessidade de se garantir condicoes de trabalho para que o profissional possa exercer suas atividades conforme planejado.

Lifestyle, quality of life, nutritional status and headache in school-aged children

BACKGROUND Headache has been described as a factor with significant negative impact on the quality of life of school-aged children with a high risk of developing in chronic and persistent form in adulthood. Among other headache associated triggers or aggravating factors, lifestyle and obesity has been investigated, but results are still conflicting. OBJECTIVE To evaluate the prevalence of headache in school-aged children and its relationship to anthropometric characteristics, lifestyle, and quality of life. METHODS A cross-sectional study was conducted in six schools located in two cities in southern Brazil, involving 750 students aged 7 to 14 years. Information was collected on sociodemographic characteristics, clinical variables (presence of headache and menarche), anthropometric data, lifestyle, and quality of life. RESULTS A total of 185 (24.7%) students reported having headache crises in the last 3 months. Among students aged 10 to 14 years, presence of headache was associated with female sex, affecting 32.2% of girls vs. 23.3% of boys (p = 0.042, chi-square test). Anthropometric parameters (data on overweight/obesity) were consistent with national prevalence rates, and there was no association between Body Mass Index (BMI) and headache. Regarding lifestyle, 2.0% of students reported smoking and 1.6% consuming alcohol occasionally, and neither was associated with headache. Quality of life, especially aspects of social life, appeared to be affected by the presence of headache. CONCLUSION This study found a high prevalence of headache in school-aged children, which was associated with female students aged 10-14 years and quality of life.