Maria Izabel Siqueira de Andrade

Excessive weight – muscle depletion paradox and cardiovascular risk factors in outpatients with inflammatory bowel disease

BACKGROUND Evidence suggests a nutritional transition process in patients with inflammatory bowel disease. Obesity, which was once an uncommon occurrence in such patients, has grown in this population at the same prevalence rate as that found in the general population, bringing with it an increased risk of cardiovascular disease. Objective The aim of the present study was to determine the nutritional status and occurrence of cardiovascular risk factors in patients with inflammatory bowel disease. METHODS A case-series cross-sectional study was conducted involving male and female adult outpatients with inflammatory bowel disease. Data were collected on demographic, socioeconomic, clinical and anthropometric variables as well as the following cardiovascular risk factors: sedentary lifestyle, excess weight, abdominal obesity, medications in use, comorbidities, alcohol intake and smoking habits. The significance level for all statistical tests was set to 5% (P< 0.05). RESULTS The sample comprised 80 patients with inflammatory bowel disease, 56 of whom (70.0%) had ulcerative colitis and 24 of whom (30.0%) had Crohns disease. Mean age was 40.3±11 years and the female genre accounted for 66.2% of the sample. High frequencies of excess weight (48.8%) and abdominal obesity (52.5%) were identified based on the body mass index and waist circumference, respectively, in both groups, especially among those with ulcerative colitis. Muscle depletion was found in 52.5% of the sample based on arm muscle circumference, with greater depletion among patients with Crohns disease (P=0.008). The most frequent risk factors for cardiovascular disease were a sedentary lifestyle (83.8%), abdominal obesity (52.5%) and excess weight (48.8%). CONCLUSION The results of the complete anthropometric evaluation draw ones attention to a nutritional paradox, with high frequencies of both - muscle depletion, as well as excess weight and abdominal obesity.

Anemia e fatores associados em mulheres de idade reprodutiva de um município do Nordeste brasileiro

OBJECTIVE To identify the prevalence of iron-deficiency anemia and associated factors in women at reproductive age in the city of Vitoria de Santo Antão, Pernambuco. METHODS Cross-sectional study with a representative sample of 322 women aged between 15 and 49 years. Anemia was diagnosed by measuring hemoglobin below 12 g/dL. The independent variables were: demographic and socioeconomic conditions (age, race/color, education, literacy, presence of children aged < 5 years in the household, regime of residence occupation, ownership of assets, and per capita income), housing conditions (number of people in the household, number of bedrooms, and basic sanitation), food and nutrition security and womens health conditions (menarche, number of pregnancies, history of miscarriages, body mass index, and ferritin). Poisson regression was used to analyze the factors associated with anemia. RESULTS The mean age of women surveyed was 31.1 ± 6.61 years old (standard deviation - SD) and the prevalence of anemia was 18.6% (95%CI 14.7 - 23.3). After multivariate analysis, anemia was significantly associated with age ≤ 19 years and low ferritin. CONCLUSION The prevalence of anemia is characterized as a mild public health problem and follows the world trend in developing countries.RESUMO: Objetivo: Determinar a prevalencia de anemia e seus fatores associados em mulheres em idade reprodutiva do municipio de Vitoria de Santo Antao, Pernambuco. Metodos: Estudo transversal com amostra representativa de 322 mulheres, com idade entre 15 e 49 anos. A anemia foi diagnosticada pela dosagem de hemoglobina abaixo de 12 g/dL. As variaveis independentes foram: condicoes demograficas e socioeconomicas (idade, raca/cor, escolaridade, alfabetizacao, presenca de criancas com idade < 5 anos no domicilio, regime de ocupacao de residencia, posse de bens e renda familiar per capita), condicoes de moradia (numero de pessoas no domicilio, numero de dormitorios e condicoes de saneamento basico), seguranca alimentar e nutricional e condicoes de saude das mulheres (menarca, numero de gestacoes, passado de abortos, indice de massa corporal e ferritina). A regressao de Poisson foi utilizada para a analise dos fatores associados a anemia. Resultados: A media de idade das mulheres investigadas foi de 31,1 ± 6,61 anos (desvio padrao - DP) e a prevalencia de anemia, de 18,6% (IC95% 14,7 - 23,3). Apos analise multivariavel, a anemia apresentou associacao significativa com idade ≤ 19 anos e com baixo indice de ferritina. Conclusao: A prevalencia de anemia encontrada se caracteriza como um problema de saude publica de grau leve e segue a tendencia mundial de paises em desenvolvimento.

Excesso de peso em adolescentes e estado nutricional dos pais: uma revisão sistemática

Resumo O objetivo do presente estudo e verificar a associacao entre o excesso de peso em adolescentes e o estado nutricional dos pais e identificar possiveis fatores determinantes. A pesquisa foi realizada nas bases de dados Pubmed, Lilacs, Scielo e Biblioteca Virtual de Saude (BVS), considerando-se o periodo de 2004 a 2014. Os descritores usados foram: “Adolescente”, “Fatores de risco”, “Obesidade”, “Pais” e “Sobrepeso”. Dos 366 artigos encontrados, apenas 07 atenderam a todos os criterios de elegibilidade. Notou-se nos adolescentes prevalencia de sobrepeso mais elevada nos estudos realizados no Brasile na Grecia, enquanto a prevalencia de obesidade foi maior nos estudos conduzidos nos Estados Unidos. Foram verificadas maiores prevalencias de excesso de peso em adolescentes do sexo masculino. Todos os trabalhos mostraram que a presenca de sobrepeso ou obesidade no pai ou na mae aumenta o risco dos adolescentes desenvolverem excesso de peso, e esse risco e ainda maior quando ambos os pais sao obesos. A grande associacao entre excesso de peso nos adolescentes e estado nutricional dos pais esta relacionada com inumeros fatores, dessa forma, a presenca de um fator de risco, como, por exemplo, a predisposicao genetica, pode ser amenizada por um fator de protecao, como habitos alimentares saudaveis.