Kátia Cristina Portero McLellan

Ten-week lifestyle changing program reduces several indicators for metabolic syndrome in overweight adults.

We aim to investigate the effectiveness of a 10-week lifestyle intervention focusing on physical activity and high fiber intake for reducing indicators for metabolic syndrome in overweight-obese individuals. A prospective study of 50 overweight (OW) adults (22 in the general educational group - G1; 28 in the high fiber nutrition group - G2) was performed. Both groups were offered dietary counseling and supervised exercise. Clinical, anthropometric, dietary and plasma biochemical tests were performed at baseline - time 0 (T0) and after 10 weeks - time 1 (T1). Both groups improved their dietary quality, but only G2 presented higher intake of fruit and vegetables (servings/day), higher plasma β-carotene levels and a 24% reduction of MetS incidence. Additionally G2 showed greater reductions in body fat (4%), and waist circumference (7%), obesity class III (2%) and obesity class II (14%) rate. Lifestyle intervention, including a high dietary fiber intake, improved healthy eating index and decreased body fat composition and plasma lipid concentrations leading to MetS incidence reduction.

Dietary factors associated with metabolic syndrome in Brazilian adults

BackgroundMetabolic Syndrome (MS) is defined as the association of numerous factors that increase cardiovascular risk and diet is one of the main factors related to increase the MS in the population. This study aimed to evaluate the association of diet on the presence of MS in an adult population sample.Methodology305 adults were clinically screened to participate in a lifestyle modification program. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m2) and muscle-mass index (MMI kg/m2). Dietary intake was estimated by 24 h dietary recall. Fasting blood was used for biochemical analysis. MS was diagnosed using NCEP-ATPIII (2001) criteria with adaptation for glucose (≥ 100 mg/dL). Logistic regression (Odds ratio) was performed in order to determine the odds ratio for developing MS according to dietary intake.ResultsAn adequate intake of fruits, OR = 0.52 (CI:0.28-0.98), and an intake of more than 8 different items in the diet (variety), OR = 0.31 (CI:0.12-0.79) showed to be a protective factor against a diagnosis of MS. Saturated fat intake greater than 10% of total caloric value represented a risk for MS diagnosis, OR = 2.0 (1.04-3.84).ConclusionRegarding the dietary aspect, a risk factor for MS was higher intake of saturated fat, and protective factors were high diet variety and adequate fruit intake.

Consumo de frutas, verduras e legumes associado à Síndrome Metabólica e seus componentes em amostra populacional adulta

A sindrome metabolica (SM) aumenta o risco de eventos cardiovasculares e o consumo adequado de frutas, verduras e legumes (FVL) esta relacionado a sua prevencao. Objetivo: Identificar o consumo de FVL e sua relacao com a SM e seus componentes em amostra populacional adulta. Estudo prospectivo de corte transversal com 636 individuos adultos, no periodo de 2004 a 2008. Foram realizadas avaliacoes antropometrica, clinica, dietetica e bioquimica com todos participantes. A SM foi classificada pelo NCEP ATP-III, modificada para a glicose >100mg/dl. A regressao logistica foi utilizada para verificar a razao de chance entre o consumo de FVL com a SM e seus componentes, e o nivel de significância adotado foi de 5%. O consumo de frutas adequado se mostrou protetor para obesidade abdominal (OR: 0,77; IC: 0,38-0,93), hipertrigliceridemia (OR: 0,76; IC: 0,35-0,96) e presenca de SM (OR: 0,78; IC: 0,39-0,96), e o consumo adequado de FVL apresentou efeito protetor para a presenca de SM (OR: 0,79; IC: 0,41-0,95). A analise isolada do consumo adequado de verduras e legumes nao mostrou efeitos de protecao/risco para a presenca de SM e de seus componentes. O consumo adequado de FVL apresentou efeito protetor para a presenca de SM e o consumo adequado de frutas exerceu efeito protetor tanto para a presenca de SM e como de seus componentes.

Clinical and nutritional status of surgical patients with and without malignant diseases: cross-sectional study

CONTEXT Malnutrition is frequently observed in inpatients with malignant diseases and may contribute to longer hospital stays. OBJECTIVE To compare the nutritional status, lymphocyte count, hemoglobin values and length of hospital stay of patients with and without malignant diseases. METHODS This comparative study assessed indicators of nutritional status, namely body mass index, recent weight loss, lymphocyte count, hemoglobin and length of hospital stay, of 928 surgical patients with and without malignant diseases (50.2% females and 49.8% males). The chi-square test was used to compare proportions and the Mann-Whitney test was used to compare continuous measurements between two groups. The significance level was set at 5%. RESULTS Patients with malignant diseases had longer hospital stays (P<0.0001), furthermore, a higher percentage of patients with malignant diseases had body mass index <18.5 (P<0.0001) and experienced recent weight changes (P<0.0002). Lymphocyte count also differed statistically between the groups (P = 0.0131), which lower levels were identified among patients with malignant diseases. CONCLUSION The lymphocyte count, hemoglobin values and weight loss are important findings of nutritional depletion in patients with malignant diseases.

Higher dietary quality and muscle mass decrease the odds of low phase angle in bioelectrical impedance analysis in Brazilian individuals

Aim Phase angle is a bioimpedance parameter that is suggested as an indicator of cellular death and membrane integrity. Studies have shown an association between phase angle and nutritional status in many diseases, but little is known about its association with body composition and diet in free-living individuals. The present study investigated potential associations of dietary and anthropometric parameters with phase angle. Methods This cross-sectional study included 493 individuals (97 men and 396 women), older than 18 years, clinically screened for a lifestyle modification program from 2005 to 2011. All participants were assessed for body composition, anthropometric and dietary data, and were divided in two groups according to the cut-off point of phase angle determined by the median value (6.35°). Statistical comparisons were undertaken between groups and logistic regression was performed to evaluate the odds ratio (OR) and 95% CI for the potential predictors of phase angle. Results Participants with phase angle of 6.35° or below were older, had lower body mass index, waist circumference, muscle mass index, energy intake and Healthy Eating Index (HEI) score. After adjustments for confounding factors, higher muscle mass index (OR: 0.425; 95% CI: 0.204–0.887) and higher HEI score (OR: 0.357; 95% CI: 0.190–0.672) showed lower odds for low phase angle. Conclusions Higher dietary quality and muscle mass decreased the odds for low phase angle.

Resting energy expenditure and carbohydrate oxidation are higher in elderly patients with COPD: a case control study

BackgroundElderly patients with chronic obstructive pulmonary disease (COPD) usually have a compromised nutritional status which is an independent predictor of morbidity and mortality. To know the Resting Energy Expenditure (REE) and the substrate oxidation measurement is essential to prevent these complications. This study aimed to compare the REE, respiratory quotient (RQ) and body composition between patients with and without COPD.MethodsThis case–control study assessed 20 patients with chronic obstructive pulmonary disease attending a pulmonary rehabilitation program. The group of subjects without COPD (control group) consisted of 20 elderly patients attending a university gym, patients of a private service and a public healthy care. Consumption of oxygen (O2) and carbon dioxide (CO2) was determined by indirect calorimetry and used for calculating the resting energy expenditure and respiratory quotient. Body mass index (BMI) and waist circumference (WC) were also measured. Percentage of body fat (%BF), lean mass (kg) and muscle mass (kg) were determined by bioimpedance. The fat free mass index (FFMI) and muscle mass index (MMI) were then calculated.ResultsThe COPD group had lower BMI than control (p = 0.02). However, WC, % BF, FFMI and MM-I did not differ between the groups. The COPD group had greater RQ (p = 0.01), REE (p = 0.009) and carbohydrate oxidation (p = 0.002).ConclusionsElderly patients with COPD had higher REE, RQ and carbohydrate oxidation than controls.

The increase of dairy intake is the main dietary factor associated with reduction of body weight in overweight adults after lifestyle change program

This study evaluated which was the main nutritional change associated with weight reduction of overweight adult participants of a lifestyle change program. It was hypothesized that increases in dairy intake could be an important nutrition intervention in a lifestyle change program. 117 individuals, male (19.5%) and female (80.5%), with a minimum age of 36 years (54.2 ± 10.4). All study participants were enrolled in a lifestyle change program consisting of nutritional counseling and physical activity during 20 weeks. All participants were grouped in three groups according to Body Mass Index (BMI) delta median (-0.87 kg/m2) of individuals that showed weight loss: G1 - lost more than 0.87 kg/m2 of BMI (n = 38); G2 - lost 0 to 0.87 kg/m2 of BMI (n = 36); and G3 - increased BMI (n = 43). G1 increased dairy, fruit and vegetables intake and after forward stepwise multiple regression analysis, it was noted that an increase in dairy product intake of 0.40 servings per day had an impact of 9.6% on the loss of one kg/m2 of BMI. In conclusion, an increase in dairy product intake was the main dietary factor associated with reductions in body weight in overweight adults after 20 weeks of lifestyle change program.

Dietary Intake Association with IFG and Responses of a Lifestyle Changing Protocol in a Community-B based Adult Cohort

Objective: Investigate the association of diet on Impaired Fasting Glucose (IFG) and response of a lifestyle changing protocol (LISC) on a community sample of adults. Methods: A cross sectional study of LISC was conducted with 1004 subjects. From those, 264 adults individuals participated in a 20-week intervention based on physical exercises and dietary counseling and were divided in three groups, normoglycemic, IFG, and T2DM. Evaluations were done at baseline (M0) and after a 20-week intervention (M1). The analyses were performed by using SAS, version 9.2., and results were discussed based on the level of significance of p<0.05. Results: At baseline, the three groups differed for plasma triglycerides, and number of altered metabolic syndrome (MetS) components. T2DM differed from normoglicemic by presenting higher intake of meat, lower of sugar, and less dietary variety, along with higher plasma levels of uric acid. After 20-week intervention, normoglicemics, IFG and T2DM responded similarly to LISC. Both genders increased body fatness. Men increased fasting plasma insulin, saturated fatty acid intake, along with a decrease of vegetable oil intake while women showed a significant increase in HEI and dietary fiber intake and a trend to higher sugar and protein intake and lower vegetable oil intake. Overall T2DM decreased 68% from M0 (9.5%) to M1 (6.4%) of LISC. Conclusion: Our data showed a significant difference in food composition on altered plasma glucose, and its further normalization with lifestyle intervention was independent of significant body weight and body fat changes.

Prevention of Diabetes: Effects of a Lifestyle Intervention

Lifestyle is directly related to the incidence of type 2 diabetes mellitus (DM2), a risk dramatically elevated by obesity and inactivity. Sedentary lifestyle, inadequate eating habits, aging, educational backgrounds and the increased life expectancy observed in Brazil suggested to be the main culprits for the increased prevalence of DM2 seen in this country. Therefore, many epidemiologists have been emphasizing the importance of primary prevention for obesity and DM in Brazil (Sartorelli & Franco, 2003). Some studies have shown that people consuming a diet rich in whole grains (Salmeron et al. 1997a; Salmeron et al. 1997b) and polyunsaturated fatty acids (Salmeron et al. 2001), combined with low intake of trans fatty acids and foods with low glycemic index (Salmeron et al. 1997a; Salmeron et al. 1997b; Salmeron et al. 2001; Burani L Tuomilehto et al. 2001; Knowler et al. 2002). The Finnish Diabetes Prevention Study showed that lifestyle counseling can be effective and feasible in routine health care (Tuomilehto et al. 2001; Lindstron et al. 2003; Absetz et al. 2009). Brazilian studies evaluating the impact of DM2 on primary care or “at risk” populations are still scarce. Preliminary data from an intervention study for DM2 prevention among adults suggests that these programs are not only viable in Primary Public Health Care (Sartorelli et al. 2004) but also help to improve the health of the population. Since DM2 is one of the biggest problems in public health worldwide, it should receive special attention from health-related government entities. In order to identify the effects of a 12-month nutritional education and lifestyle intervention program in a Brazilian urban community, on metabolic improvement, body composition and eating behavior, we evaluated subjects recruited primarily through 2 Diabetes Prevention Campaigns, carried out in November 2002 and November 2003 in a small urban Brazilian community. A total of 2043 individuals were screened for capillary glucose levels and among them 142 people presented fasting plasma glucose above 100mg/dL and also 2 risk factors for developing DM2 and cardiovascular disease (CVD). Fasting plasma glucose

WITHDRAWN: The increase of dairy intake is the main dietary factor associated with reduction of body weight in overweight adults after lifestyle change program.

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