Karine Anusca Martins

Comparação de métodos de avaliação da gordura corporal total e sua distribuição

OBJECTIVE To compare two methods for evaluating total body fat and its distribution. METHODS Cross-sectional, cohort-nested study. Sixty-two women received a nutritional status evaluation which included total body fat (BF) obtained through the sum of skinfolds (ΣSF) and bioimpedance (BIA). Visceral fat distribution was measured using ultrasonography (USG) (intra-abdominal fat thickness) (IAT) and waist circumference (WC). The concordance correlation coefficient (CCC) and the determination coefficient (r²) were calculated. RESULTS Mean patient age was 48.19 (8.99) years. Thirty-six women (58.06%) had a very large WC and 42 (67.74%) had high body fat. There was moderate concordance (r² = 0.42; CCC = 0.59; p < 0.01) between the methods for determining body fat (%) and optimal concordance (r² = 0.90; CCC = 0.91; p < 0.01) for body fat (kg) determined by BIA and ΣSF. The comparison between WC and IAT (USG) showed moderate concordance (r² = 0.49; p < 0.01) between the methods. CONCLUSIONS Moderate concordance in determining total body fat (%) and optimal concordance in determining body fat (kg) were found between the methods. Moderate concordance was found between the methods for determining body fat distribution.

Overweight in Goiás'quilombola students and food insecurity in their families

Objective: To characterize the nutritional status of quilombola students and determine the food security status of their households. Methods: This is a cross-sectional study with students aged six to nineteen years from quilombola communities in twelve municipalities of Goias categorized by age, gender, school location (urban/rural), and nutritional status based on the World Health Organizations height-for-age and body mass index for-age charts. The Brazilian Food Insecurity Scale was used for measuring food (in)security in their families. Descriptive and association analyses were conducted using the Chi-square test at a significance level of 5% (p<0.05). Results: In a sample of 226 students, overweight (17.2%) was more common than malnutrition (1.3%), especially in students attending urban schools (28.2%) (p<0.05). Most (75.2%) quilombola families experienced food insecurity, especially mild. Conclusion: The apparent contradiction of excess weight and food insecurity occurring simultaneously indicates the need of revising the study instruments and the causal network that identify poverty.

Alterações venosas e linfáticas em mulheres com linfedema após linfadenectomia axilar no tratamento do câncer de mama

PURPOSE To evaluate changes in the venous axillary-subclavian and lymphatic systems of women with lymphedema after axillary lymphadenectomy for breast cancer treatment. METHODS This was a case series involving 11 women with unilateral upper limb lymphedema after axillary lymphedenectomy for the treatment of breast cancer. The study was carried out in the Mastology Program of the Clinical Hospital of the Federal University of Goiás, Goiânia, GO, during the period between March 2010 and March 2011. Doppler velocimetry ultrasonography was used to detect the presence of venous changes in the subclavian and axillary veins. Lymphatic changes were evaluated by lymphoscintigraphy in both upper limbs. Fishers exact test was used for the comparison between limbs. RESULTS Subclavian vein flow volume in the upper limb with lymphedema was significantly different from that in the contralateral limb (p<0.001), 54.6% of the women had increased flow. In the axillary vein, 45.4% had increased flow and 45.4% had decreased flow, with a statistically significant difference (p<0.01) between limbs. Compared to the contralateral limb, significant lymphatic changes (p<0.05) were also found in the vessel route (not visualized), number of lymphatic vessels (none), axillary lymph nodes (absent) and dermal reflux (present). In the contralateral upper limb without lymphedema, no venous or lymphatic alterations were encountered. CONCLUSION The women subjected to axillary lymphadenectomy for the treatment of breast cancer presented both venous and lymphatic changes in the upper limb with lymphedema.

Insegurança alimentar na área de abrangência do Núcleo de Apoio à Saúde da Família em Itumbiara, Goiás

OBJETIVO:estimar a prevalencia de inseguranca alimentar (IA) e fatores associados na populacao da area de abrangencia do Nucleo de Apoio a Saude da Familia (NASF) em Itumbiara-GO.METODOS:realizou-se estudo transversal; utilizou-se a Escala Brasileira de Inseguranca Alimentar e questionario padronizado; calcularam-se razoes de prevalencia (RP) e respectivos intervalos de confianca de 95% (IC95%) pela regressao de Poisson.RESULTADOS:avaliaram-se 356 domicilios, a prevalencia de IA foi de 51,4% (36,2% com IA leve; 11,3% moderada; e 3,9% grave); a IA esteve associada a (i) residir em moradia com acabamento incompleto (RP=1,3; IC95% 1,0-1,5), (ii) ter mais de cinco moradores por domicilio (RP=1,3; IC95% 1,1-1,6), (iii) pertencer as classes economicas C (RP=1,6; IC95% 1,0-2,5) e D/E (RP=2,1; IC95% 1,3-3,2) e (iv) ser beneficiario do Programa Bolsa Familia (RP=1,3; IC95% 1,1-1,6).CONCLUSAO:a prevalencia de inseguranca alimentar foi elevada e maior nas familias maiores e mais pobres.

Alimentação escolar nas comunidades quilombolas: desafios e potencialidades

O Programa Nacional de Alimentacao Escolar (PNAE) e uma estrategia de Seguranca Alimentar e Nutricional (SAN) para estudantes de escolas publicas. Este artigo tem por objetivos discutir os desafios e as potencialidades da alimentacao escolar nas comunidades quilombolas e relatar a experiencia do Centro Colaborador em Alimentacao e Nutricao do Escolar da Universidade Federal de Goias e Regiao Centro-Oeste (CECANE UFG/Centro-Oeste). Relato de experiencia associado a sistematizacao da literatura sobre o PNAE, SAN e outras politicas. O acesso permanente e adequado as politicas sociais e um desafio para as comunidades quilombolas. Identificam-se na execucao do PNAE entraves de ordem economica, estrutural e social. Neste contexto, a Lei 11.947/2009 incentiva o desenvolvimento local, por meio da aquisicao de alimentos da regiao e determina valor per capita diferenciado, traduzido em cardapio com alimentos da cultura negra e que atenda no minimo 30% das necessidades nutricionais diarias. O CECANE UFG/Centro-Oeste no projeto alimentacao, saude e qualidade de vida de escolares quilombolas realiza acoes em SAN. O campo da alimentacao escolar mostra-se sensivel as necessidades locais e apoia o desenvolvimento e a promocao da qualidade de vida.

Produção e potencial agrícolas de alimentos destinados à alimentação escolar em Goiás e no Distrito Federal, na Região Centro-Oeste do Brasil

OBJECTIVE: This study investigated the production and production potential of vegetables, fruits and native Cerrado fruits in Goias and Distrito Federal, for their inclusion in the school menu as determined by the Law 11.947/2009. METHODS: A descriptive, quantitative study was done in 2009 in five mesoregions of Goias and in Distrito Federal. The agricultural production was determined using data from the Brazilian Institute of Geography and Statistics and production estimates from 2003-2007. The estimated agricultural potential was based on the mean annual temperature of each mesoregion and optimal temperature ranges for each culture. The selected foods were classified according to production scale (small, average or high) and agricultural potential (excellent, average or low). RESULTS: The production of fruits and vegetables occurred mainly in the central, southern and eastern regions of the state, while the northeast and northern regions were less exploited. The most common cultures were lime, lettuce, mango, banana and cashew. The production potential of the Distrito Federal was less exploited than that of three mesoregions of Goias (without correcting the index for the actual cultivated area). Also, there is a scarcity of official data on Cerrado fruits. CONCLUSION: This study showed the differences in regional production of viable foods for the school menu and highlighted the productive potential of the region, taking sustainable development into account.

Visceral adiposity increases the risk of breast cancer: a case-control study

INTRODUCTION in recent decades, lifestyle changes in women involving physical inactivity, insulin resistance and body fat distribution have been associated with an increase in breast cancer. OBJECTIVE to assess whether insulin resistance, lipid profile, and visceral adiposity are associated with increased risk of breast cancer. METHODS a hospital-based case control study was conducted with 116 women newly diagnosed with breast cancer and 226 controls. Body mass index, waist circumference, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), very-low-density lipoproteins (VLDL), triglycerides, glycated hemoglobin, HOMA-IR, HOMA-β, lipid accumulation product (LAP), and visceral adiposity index (VAI) were assessed. Logistic regression was adjusted for body mass index and age to quantify the association between breast cancer risk and insulinresistance, dyslipidemias, and visceral adiposity. RESULTS the case group had higher insulin resistance (p < 0.001), LAP (p = 0.012), and VAI (p = 0.004), and lower concentrations of HDL (p = 0.024) and HOMA-β(p = 0.010) compared to the control. Insulin resistance (OR = 3.00, 95% CI: 1.75-5.17, p < 0.001) and higher VAI (OR = 1.91, 95% CI: 1.17-3.13, p = 0.01) were associated with breast cancer, whereas the highest concentration of HDL reduces the chances of cancer by 53% (95% CI: 0.32-0.86, p = 0.026). In the multivariate analysis, only LAP and VAI were associated to breast cancer. CONCLUSIONS visceral fat accumulation increases the risk of breast cancer.

Abdominal Adiposity and Physical Inactivity Are Positively Associated with Breast Cancer: A Case-Control Study

Objective To examine whether breast cancer is associated with body composition and level of physical activity, considering the menstrual status. Methods This was a case-control study with 116 women recently diagnosed with breast cancer and 226 controls. Body composition was assessed by dual-energy X-ray absorptiometry, and cardiometabolic risk was assessed by conicity index and waist-to-height ratio. The short version of the International Physical Activity Questionnaire was used to estimate the level of physical activity. All analyses were adjusted for age and BMI. Results The total body fat percentage, android body fat, android-gynoid ratio, and waist circumference were positively associated (p < 0.05), whereas the percentage of lean body mass (p <0.05) and the level of physical activity (p < 0.01) were inversely associated with breast cancer in premenopausal women. Among postmenopausal women, physical activity decreased the chance of developing breast cancer by 49% (95% CI = 0.29 to 0.92, p = 0.02). Conclusion A low percentage of lean body mass and high abdominal adiposity in the premenopausal period increase the chances of developing breast cancer. Regular physical activity is inversely associated with breast cancer in pre- and postmenopausal women.

Feeding in full-time public schools: Do students adhere and accept?

Cross-sectional study with students of both sexes aged 6-14 years. Issues regarding the consumption of meals, food distribution, food eaten outside the school and socioeconomic data, including nutritional assessment of students, were investigated. Adherence to meals was defined as the consumption of school meals four to five times/week, and acceptance was defined as meal approval, using the facial hedonic scale.

Alteration of bone mineral density in breast cancer female survivors on chemotherapy treatment: an integrative review

Introdução: O uso de quimioterápicos para o tratamento de pacientes com câncer de mama tem aumentado a sobrevida dessa população. Entretanto, pode reduzir significativamente a densidade mineral óssea (DMO). Objetivo: Verificar a alteração da densidade mineral óssea em mulheres com câncer de mama submetidas a quimioterapia, assim como as características clínicas e os fatores de risco. Métodos: Revisão integrativa da literatura de artigos publicados no período de 2006 a 2016, realizada por meio de termos específicos nos bancos de dados da PubMed e da SciELO. Resultados: No período selecionado, foram identificados 898 artigos (897 na base PubMed e 1 na SciELO). Entre os seis artigos recuperados para leitura na íntegra, observou-se redução considerável na massa óssea na coluna lombar e no fêmur. Os principais tipos associados à redução foram os regimes doxorrubicina e ciclofosfamida (AC), ciclofosfamida, metotrexato e 5-fluorouracil (CMF) e ciclofosfamida, epirrubicina e 5-fluorouracil (FEC). Além disso, houve maior redução da DMO entre as mulheres com idade acima de 50 anos, caucasianas e que apresentaram falência ovariana precoce induzida pela quimioterapia. Conclusão: O uso de quimioterápicos para tratamento do câncer de mama pode acarretar perda de massa óssea, principalmente quando se utilizam os regimes AC, CMF e FEC em mulheres com idade acima de 50 anos e entre aquelas que apresentam menopausa precoce decorrente desse tratamento.