Maria da Conceição Monteiro da Silva

Perfil antropométrico e consumo alimentar de adolescentes de Teixeira de Freitas - Bahia

OBJECTIVE: The objective was to describe the anthropometric profile and food intake in adolescents from public schools in a municipality of Bahia, Brazil. METHODS: A cross-sectional experimental design was employed with a random conglomerate sample of 354 adolescents, 17 to 19 years old, from a total of 1.678 students enrolled in 23 eligible schools of the municipality. Qualitative data on the frequency of food consumption and anthropometric indicators were collected. Body weight/ height index, triceps skeletal muscle and sub-scapular skinfold measurements, were carried out according to World Health Organization. Bivariate and stratified analyses were then carried out, and statistical significance at the 5% level verified using chi-square (c2) and the exact Fischer test. RESULTS: An analysis of the anthropometric indicators showed prevalence for overweight and obesity in 5.1% of the females and prevalence for underweight in 6.4% of the males. Growth deficiency was noted in 25.0% of the adolescents; the deficiency being classified as moderate in 15.0% and severe in 10.0% of the adolescents. The usual food intake consisted of cooked rice, beans, manioc flour, wheat bread, butter, coffee and sugar. A low consumption of dairy products, fruits, vegetables and greens was observed. 96.6% of the adolescents had three meals per day, which were consumed at home by 80.0% of those interviewed. CONCLUSION: The results point to a need to implement preventive strategies for nutritional problems, recommending appropriate food intake and healthier life styles. Furthermore, possible factors inhibiting growth in the adolescents should be studied.

Fatores associados a excesso de peso e concentração de gordura abdominal em adultos na cidade de Salvador, Bahia, Brasil

O objetivo foi identificar os fatores associados ao excesso de peso e concentracao de gordura abdominal em adultos de ambos os sexos. Um estudo transversal envolvendo amostra representativa de 570 adultos de Salvador, Bahia, Brasil. A regressao de Poisson foi utilizada na analise, adotando-se o indice de massa corporal (IMC) e a circunferencia da cintura como variaveis dependentes. Para as mulheres, a inadequacao do IMC e da circunferencia da cintura ocorreu com o aumento da idade e entre as que faziam dieta no momento do estudo, a historia familiar de obesidade associou-se apenas com o IMC elevado. Para os homens, o IMC elevou-se na faixa etaria de 30 a 39 e 50 a 59 anos. A circunferencia da cintura elevou-se com a realizacao de tres ou menos refeicoes-dia, com a hipertensao arterial, uso de bebida alcoolica e diminuiu entre mulatos e negros. Tanto IMC quanto circunferencia da cintura elevaram-se com a historia familiar de infarto. Portanto sao distintos os fatores que se associam ao excesso de peso e da gordura abdominal em homens e mulheres. Mas muitos deles podem ser modificados com a adocao do estilo de vida saudavel.

O Programa Saúde da Família: contribuições para uma reflexão sobre a inserção do nutricionista na equipe multidisciplinar

Brazil is presently experiencing the implementation of a differentiated model to provide health basic care, conduced by a multidisciplinary action directed towards an intervention aiming at then population health promotion, consolidated on the Brazilian Family Health Program. The objective of promotion, consolidated on the specially in Brazil, will not be achieved unless effective action in the area of food health monitoring system. Thus, this paper reflects on the epidemiologic transition being experienced in Brazil and discusses the food and nutritional problems in this process. Some basic proposals of Family Health Program and Food and Nutrition National Policy area also emphasized. This article still argues that the nutritionist can contribute yo the necessary transformation, acting on the practices and results of this new model of intervention. Finally, the authors focus on the impossibility of effective transformation of health basic care without the support of professionals who have been studding and practicing the food and nutrition surveillance and the dietary assistance to the populations.

Longterm contraception by subcutaneous silasticR capsules containing megestrol acetate

Abstract Contraceptive effectiveness and acceptability of subcutaneous silastic capsules containing Megestrol Acetate (M.A.) were evaluated in 188 women of childbearing age. The patients were observed for a minimum of 2 and a maximum of 18 months. A total of 1,448 cycles were recorded. In patients bearing 4 implants eleven pregnancies were reported during 1,076 months of use. No pregnancies occurred in the group of patients bearing 5 capsules, during 372 months of use. Data are presented which suggest that in most patients in both groups conception is prevented without inhibition of ovulation.

Metabolic syndrome and associated factors in children and adolescents of a Brazilian municipality.

BACKGROUND the risk factors associated to metabolic syndrome (MS) have been extensively studied in adults, but in children and adolescents it is poorly explored. OBJECTIVE To identify the prevalence of MS and associated factors in children and adolescents. METHODS A cross-sectional study with 540 children and adolescents from 7 to 14 years of age. The socioeconomic, demographic and lifestyle data and the family history of chronic diseases were reported by the individual and/or guardian and recorded in a structured questionnaire. Biochemical tests (fasting blood glucose, triacylglycerols, reduced high-density lipoprotein, very-low-density lipoprotein, homocysteine and cysteine), an anthropometric assessment and a blood pressure measurement were performed. MS was defined according to the criteria of The National Cholesterol Education Program Adult Treatment Panel III adapted by Ferranti. A Poisson regression was used to identify the factors statistically associated with MS. RESULTS The MS prevalence was 12.8%, in which the most frequent component was a decreased high-density lipoprotein level (58.2%), followed by hypertriglyceridemia (41.8%), elevated blood pressure (29.1%), increased waist circumference (26.7%) and hyperglycemia (7.2%). Associations between metabolic syndrome and overweight [prevalence ratio (PR): 2.2 (1.22-3.95)], father education [PR: 2.19 (1.10-4.37)], serum very low-density lipoprotein concentration [PR: 1.08 (1.04-1.11)] and concomitantly increased serum homocysteine and cysteine concentrations [PR: 2.58 (1.32-5.04)] were observed. CONCLUSIONS The MS prevalence is high in children and adolescents and it is increased in patients with overweight, higher father education, increased serum very-low-density lipoprotein concentrations and a concomitant serum homocysteine and cysteine high levels.

Mudança nos parâmetros antropométricos: a influência de um programa de intervenção nutricional e exercício físico em mulheres adultas

Obesity prevalence is increasing worldwide, with inadequate nutrition and physical inactivity as the main risk factors. The objective was to evaluate the impact of a nutritional intervention and physical activity program on body mass index (BMI) and waist circumference (WC) in adult women. This quasi-experimental study, lasting 12 months, enrolled 69 adult women that reported physical activity three times a week, besides receiving nutritional counseling and lectures on healthy living, evaluated at baseline and at 6 and 12 months of follow-up. Lower levels of physical activity and higher intake of high-risk foods were associated with a 2.28cm increase in mean WC, has compared to higher physical activity and lower intake of high-risk foods (p < 0.01). Lower levels of physical activity associated with high intake of protective foods increased the mean BMI by 0.68kg/m2, as compared to higher physical activity and high intake of protective foods. The intervention was positively associated with the target parameters.

Projeto pedagógico do programa de graduação em nutrição da Escola de Nutrição da Universidade Federal da Bahia: uma proposta em construção

The pedagogical project principles are based on eight educational issues: professional profile, competency, educational strategies, topic issues, curriculum organization, learning assessment system and course evaluation. The fundamental aim of these issues is the integration of knowledge(s), in order to overcome dichotomies such as those of the biological versus the social, the theory versus practice, the basic cycle versus the professional, and the individual approach versus the collective and the multiprofessional practices. The searches for curricular flexibility and methodological innovation imply a new way of learning which is based on the autonomy and independence of the students. Incorporated in the project, as its central elements, are the scientific and pedagogical training of teachers and the course evaluation process. The proposal intends to socialize the discussion, thus contributing to improve the education of nutrition professionals in Brazil.

Breastfeeding and maternal weight changes during 24 months post-partum: a cohort study

The relationship between breastfeeding and the loss of weight gained during pregnancy remains unclear. This study aimed to investigate the association between breastfeeding and maternal weight changes during 24 months post-partum. We studied a dynamic cohort comprising 315 women living in two cities in the state of Bahia, Brazil. The outcome variable was change in the post-partum weight; the exposure variable was the duration and intensity of breastfeeding. Demographic, socio-economic, environmental, reproductive and lifestyle factors were integrated in the analysis as covariates. The data were analysed using multiple linear regression and linear mixed-effects models. The average cumulative weight loss at 6 months post-partum was 2.561 kg (SD 4.585), increasing at 12 months (3.066 kg; SD 5.098) and decreasing at 18 months (1.993 kg; SD 5.340), being 1.353 kg (SD, 5.574) at 24 months post-partum. After adjustment, the data indicated that for every 1-point increase in breastfeeding score, the estimated average post-partum weight loss observed was 0.191 kg at 6 months (P = 0.03), 0.090 kg at 12 months (P = 0.043), 0.123 kg at 18 months (P < 0.001) and 0.077 kg at 24 months (P = 0.001). Based on these results, we concluded that despite the low expressiveness, the intensity and duration of breastfeeding was associated with post-partum weight loss at all stages of the study during the 24-month follow-up.

Prevalência e fatores associados ao excesso de peso em adolescentes de Salvador, Bahia, Brasil

OBJETIVO: Estimar a prevalencia e identificar fatores associados ao excesso de peso em adolescentes. METODOS: Trata-se de um estudo transversal. Foram selecionados 426 adolescentes de 10 a 18 anos, da cidade de Salvador, regiao Nordeste do Brasil, por um processo de amostragem por conglomerados, aleatoria em tres estagios. Os dados sobre a frequencia de consumo alimentar e atividade fisica, maturacao sexual, medidas antropometricas e covariaveis foram coletados. O estado nutricional foi classificado por meio dos pontos de corte baseados no indice de massa corporal de criancas e adolescentes brasileiros. As caracteristicas sexuais secundarias foram autorreferidas pelos avaliados. Os adolescentes que realizaram mais de 300 minutos de atividade fisica moderada por semana, foram considerados fisicamente ativos. A etnia foi classificada pela cor da pele e atributos fisicos. RESULTADOS: A prevalencia de excesso de peso para ambos os sexos foi de 14,3%. Estimou-se que a maturacao sexual precoce (Razao de Prevalencia ajustada = 2,12, IC95% = 1,10-4,05) e insuficientes niveis de atividade fisica (RP ajustada = 1,85, IC95% = 1,01-3,41), ajustados pela idade (RP ajustada = 1,77, IC95% = 0,97-3,24), sao associados, de forma independente, ao excesso de peso em adolescentes de Salvador. CONCLUSOES: O excesso de peso pode ser considerado elevado entre os adolescentes da cidade de Salvador. Consideram-se necessarias a adocao de politicas publicas de prevencao e combate precoce ao excesso de peso corporal que melhorem o estimulo, disponibilidade e acesso a pratica continuada e sistematica da atividade fisica em nivel populacional.

Effectiveness of the Brazilian Conditional Cash Transfer Program - Bolsa Alimentação - on the variation of linear and ponderal increment in children from northeast of Brazil

BACKGROUND Social programs can improve the conditions required for families provide sufficient care and attention for an adequate health and nutrition. OBJECTIVE This study evaluates the effectiveness of the Brazilians conditional cash transfer program - Bolsa Alimentacao (PBA) on children anthropometric status. METHODS A cohort of 1847 children, followed for 12 months: 1615 PBA children; 232 non-PBA. There were 316 (14.6%) missing children during the study. A quasi- experimental study adopting the before-after strategy was applied and the effectiveness approach was used to assess the impact of the program on children nutritional status. Multilevel analysis with three levels was used in the statistical analysis. The mean increment variations of height-for-age and weight-for-age were the outcome variables and the participation in the PBA was the exposition. Four participation groups were established: children not exposed to the program (internal control group); exposed to the program throughout the 12 months, exposed to the program only in the last 6 months; and exposed to the program only in the first 6 months. Repeated measures were obtained at baseline and at 12 months. RESULTS It was found that the exposure to the program was associated to a mean variation in weight-for-age of 0.34 Z-score (IC=-0.44; 0.63) and height-for-age of 0.38 (IC=0.05; 0.70) for children who were regular program beneficiaries during the follow-up. The exposure to the program in other periods was not statistically associated with a mean variation in the indicators. CONCLUSIONS Cash transfers direct to the family were associated to anthropometric deficits reduction in childhood.