Luzia Jaeger Hintze

Validação interna do questionário de estágio de prontidão para mudança do comportamento alimentar e de atividade física

Objective: To translate into Portuguese the contents of the questionnaire for adaptation assessment of dietary and physical activity changes proposed by Sutton et al, to be used with adolescents; and to verify the internal consistency and reliability of this tool. Methods: The content validation was accomplished by a multidisciplinary group, which was consulted after the translation and back translation of the instrument in order to generate a coherent version, followed by the cultural adaptation performed using a Likert’s scale, from which adolescents assessed clarity and relevance of each statement. The reliability and internal consistency of the tool were assessed by a questionnaire applied to 32 obese adolescents of both genders from a multiprofessional program for obesity treatment. They had, on average, 13.5±1.59 years old and 86.1±18.8kg. The Cronbach’s alpha coefficient was used to assess the internal consistency, as well as Pearson, Spearman and intraclass correlation coefficients. Also the t-test was used to assess reliability. Results: The results of test and retests revealed the high reliability of the tool. Internal consistency showed good reliability rates for all areas, with all values higher than or near to 0.70. Conclusions: The questionnaire presented good internal consistency and reliability in obese adolescents. However, it

The effects of sleep restriction and altered sleep timing on energy intake and energy expenditure

Experimental evidence suggests that sleep restriction increases energy intake (EI) and may alter energy expenditure (EE). However, it is unknown whether the timing of a sleep restriction period impacts EI and EE the following day. Hence, we examined the effects of sleep restriction with an advanced wake-time or delayed bedtime on next day EI and EE. Twelve men and 6 women (age: 23±4years, body fat: 18.8±10.1%) participated in 3 randomized crossover sessions: control (habitual bed- and wake-times), 50% sleep restriction with an advanced wake-time and 50% sleep restriction with a delayed bedtime. Outcome variables included sleep architecture (polysomnography), EI (food menu), total EE and activity times (accelerometry). Carbohydrate intake was greater on day 2 in the delayed bedtime vs. control session (1386±513 vs. 1579±571kcal; P=0.03). Relative moderate-intensity physical activity (PA) time was greater in the delayed bedtime session vs. control and advanced wake-time sessions on day 1 (26.6±19.9 vs. 16.1±10.6 and 17.5±11.8%; P=0.01), whereas vigorous-intensity PA time was greater following advanced wake-time vs. delayed bedtime on day 1 (2.7±3.0 vs. 1.3±2.4%; P=0.004). Greater stage 1 sleep (β=110kcal, 95% CI for β=42 to 177kcal; P=0.004), and a trend for lower REM sleep (β=-20kcal, 95% CI for β=-41 to 2kcal; P=0.07), durations were associated with greater EI between sleep restriction sessions. These findings suggest that the timing of a sleep restriction period impacts energy balance parameters. Additional studies are needed to corroborate these findings, given the increasing prevalence of shift workers and incidences of sleep disorders and voluntary sleep restriction.

Impact of readiness to change behavior on the effects of a multidisciplinary intervention in obese Brazilian children and adolescents

The obesity epidemic is a global challenge that requires evidence-based intervention to slow the emergence of weight-related illness in children and adolescents. Thus, effective treatments are urgently needed. This study aimed to analyze whether there is relationship between the initial stage of readiness for behavior change (SRBC) and the results obtained through participation in a multidisciplinary program of obesity treatment (MPOT). The study included 113 overweight or obese children and adolescents who participated in an intervention for 16 weeks, in which the categorical variable was the SRBC. The dependent variables included: anthropometric measures of body composition, hemodynamic parameters (e.g., blood pressure values), and health-related physical fitness. Although stages 1 and 2 had greater improvements in flexibility than those in stage 5, and stage 1 had greater percentage changes in abdominal strength than those in stage 5, children and adolescents in the highest stage had greater percentage changes for anthropometric, hemodynamic and cardiorespiratory fitness, suggesting an impact of the stage of change on the effects of a MPOT. This study suggests that SRBC plays a role in obesity treatment in Brazilian children and adolescents and warrants consideration when enrolling patients to intervention.

Weight Loss and Appetite Control in Women

Purpose of ReviewThe aim of this review is to describe and discuss weight loss-induced variations in appetite in women and factors responsible for these changes.Recent FindingsStudies have shown postweight loss increases in fasting and postprandial appetite in individuals engaged in weight loss trials, especially in women. Similarly, appetite-related peptides associated to the homeostatic control of feeding, such as leptin, ghrelin and peptide YY, were also found to be altered in way that promotes increased appetite after weight loss interventions. Sustained caloric deficits also drive increases in the frequency and strength of food cravings, food reward and seem to enhance oro-sensory sensations in women who lost weight. The menstrual cycle has also been to shown to influence caloric intake in women, more specifically food cravings. On the other hand, caloric restriction seems to increase cognitive restraint, decrease habitual disinhibition and susceptibility to hunger among women engaged in weight loss trials. Neural analysis corroborates these results, showing increased activation in brain areas involved in food reward and self-control processing.SummaryIn conclusion, evidence supports that weight loss increases appetite sensations, and promotes changes in homeostatic and non-homeostatic control of feeding, which collectively seem to upregulate appetite in women.

Estágio de prontidão para mudança de comportamento de adolescentes interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade

OBJETIVO: Avaliar o estagio de prontidao para mudanca do comportamento (EPMC) alimentar e de atividade fisica de adolescentes e verificar a associacao entre as variaveis genero, faixa etaria e classificacao do indice de massa corporea (IMC) com o EPMC. METODOS: Foram avaliados 145 adolescentes entre dez e 18 anos interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade (PMTO). As avaliacoes incluiram, alem dos EPMC, parâmetros antropometricos. A analise estatistica envolveu a aplicacao do teste t de Student para amostras independentes e do teste de Mann-Whitney na comparacao entre os grupos. O teste do qui-quadrado de tendencia foi utilizado para verificar se houve ou nao associacao entre as variaveis do estudo, sendo significante p<0,05. RESULTADOS: Em relacao ao comportamento alimentar (quantidade e tamanho das porcoes), verificou-se associacao entre IMC e o EPMC. Tambem foi observado que os adolescentes mais velhos apresentaram EPMC mais avancado em relacao ao consumo de frutas e verduras. O mesmo se verificou em relacao a pratica habitual de atividade fisica. CONCLUSOES: Ha associacao entre IMC e o EPMC relacionado ao comportamento alimentar (quantidade e tamanho das porcoes), do mesmo modo que entre a idade e o EPMC relacionado ao consumo de frutas e vegetais e pratica habitual de atividade fisica. Recomenda-se a realizacao de estudos experimentais a fim de verificar se o EPMC tem poder preditivo em programas de intervencao destinados ao tratamento do excesso de peso

A one-year resistance training program following weight loss has no significant impact on body composition and energy expenditure in postmenopausal women living with overweight and obesity

Resistance training (RT) has been shown to decrease fat mass (FM), and increase fat-free mass (FFM), which can be a useful for weight loss maintenance. OBJECTIVE To examine the effects of a 1-year RT intervention on weight loss maintenance following a 6-month dietary weight loss intervention. DESIGN Following a 6-month dietary weight loss intervention (-6% ± 5.8; 5.05 kg ± 4.45), 70 postmenopausal women living with overweight or obesity were randomized to a control group (n = 34) or a RT group (n = 36) (3×/week first 6 months, 2×/week last 6 months, 70-80% of 1-repetition maximum). Body composition (DXA), abdominal visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) (CT scan), resting energy expenditure (EE) (indirect calorimetry), physical activity EE and total daily EE were measured (doubly-labelled water). RESULTS A total of 54 participants completed the study (control group n = 29; RT group n = 25) and compliance to the RT program was on average 64%. Significant regains were noted for body weight 0.98 (3.71) kg vs. 1.33 (3.94) kg and FM regain 1.32 (2.69) kg vs. 0.81 (3.26) kg in control and RT groups after the 1-year weight maintenance phase. No group differences were noted. Resting EE and total daily EE did not change after the weight maintenance phase, and no differences were observed between groups. Both groups had significantly greater than predicted decrease in resting EE after the 6-month dietary intervention and at the end of the 1-year weight-loss maintenance phase. CONCLUSIONS Our results suggest that a 1-year RT intervention following a 6-month dietary weight loss intervention does not improve weight loss maintenance, body composition or EE in post-menopausal women living with overweight or obesity.

Stage of readiness to change of behavior in adolescents interested in joining the Multiprofessional Obesity Treatment Program

OBJETIVO: Avaliar o estagio de prontidao para mudanca do comportamento (EPMC) alimentar e de atividade fisica de adolescentes e verificar a associacao entre as variaveis genero, faixa etaria e classificacao do indice de massa corporea (IMC) com o EPMC. METODOS: Foram avaliados 145 adolescentes entre dez e 18 anos interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade (PMTO). As avaliacoes incluiram, alem dos EPMC, parâmetros antropometricos. A analise estatistica envolveu a aplicacao do teste t de Student para amostras independentes e do teste de Mann-Whitney na comparacao entre os grupos. O teste do qui-quadrado de tendencia foi utilizado para verificar se houve ou nao associacao entre as variaveis do estudo, sendo significante p<0,05. RESULTADOS: Em relacao ao comportamento alimentar (quantidade e tamanho das porcoes), verificou-se associacao entre IMC e o EPMC. Tambem foi observado que os adolescentes mais velhos apresentaram EPMC mais avancado em relacao ao consumo de frutas e verduras. O mesmo se verificou em relacao a pratica habitual de atividade fisica. CONCLUSOES: Ha associacao entre IMC e o EPMC relacionado ao comportamento alimentar (quantidade e tamanho das porcoes), do mesmo modo que entre a idade e o EPMC relacionado ao consumo de frutas e vegetais e pratica habitual de atividade fisica. Recomenda-se a realizacao de estudos experimentais a fim de verificar se o EPMC tem poder preditivo em programas de intervencao destinados ao tratamento do excesso de peso

Estadio de prontitud para cambio de comportamiento de adolescentes interesados en ingresar en el Programa Multiprofesional de Tratamiento de la Obesidad

OBJETIVO: Avaliar o estagio de prontidao para mudanca do comportamento (EPMC) alimentar e de atividade fisica de adolescentes e verificar a associacao entre as variaveis genero, faixa etaria e classificacao do indice de massa corporea (IMC) com o EPMC. METODOS: Foram avaliados 145 adolescentes entre dez e 18 anos interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade (PMTO). As avaliacoes incluiram, alem dos EPMC, parâmetros antropometricos. A analise estatistica envolveu a aplicacao do teste t de Student para amostras independentes e do teste de Mann-Whitney na comparacao entre os grupos. O teste do qui-quadrado de tendencia foi utilizado para verificar se houve ou nao associacao entre as variaveis do estudo, sendo significante p<0,05. RESULTADOS: Em relacao ao comportamento alimentar (quantidade e tamanho das porcoes), verificou-se associacao entre IMC e o EPMC. Tambem foi observado que os adolescentes mais velhos apresentaram EPMC mais avancado em relacao ao consumo de frutas e verduras. O mesmo se verificou em relacao a pratica habitual de atividade fisica. CONCLUSOES: Ha associacao entre IMC e o EPMC relacionado ao comportamento alimentar (quantidade e tamanho das porcoes), do mesmo modo que entre a idade e o EPMC relacionado ao consumo de frutas e vegetais e pratica habitual de atividade fisica. Recomenda-se a realizacao de estudos experimentais a fim de verificar se o EPMC tem poder preditivo em programas de intervencao destinados ao tratamento do excesso de peso