Maria Luiza Ferreira Stringhini

Reproducibility and validity of a food-frequency questionnaire for use among low-income Brazilian workers.

OBJECTIVES To assess the reproducibility and validity a 127-item, habitual intake, food-frequency questionnaire (FFQ), developed for low-income and low-literacy Brazilian workers, by comparison with a 24-hour dietary recall (24-HDR). DESIGN The FFQ and 24-HDR were interviewer-administered at the local workplace to each subject twice, with a period of 6 months between estimates; and four 24-HDRs were conducted during the 4-month period between the two FFQs (FFQ1 and FFQ2). Reproducibility was tested by comparing mean nutrient intakes from the two FFQs. Validity was determined by comparing the mean nutrient intakes from the FFQs with the corresponding averages of the six 24-HDRs (reference method). SETTING Goiânia City, in Central West Brazil. SUBJECTS The study was based on 104 (62 women and 42 men) subjects, aged 18 to 60 years, who were randomly selected. RESULTS Dietary intake from the FFQ was higher than from the 24-HDR. Reproducibility was assessed by Pearson correlation coefficients for nutrients from FFQ1 and FFQ2, and ranged from 0.23 for retinol to 0.69 for total energy (mean 0.52). Intra-class coefficients for nutrients averaged by the 24-HDRs ranged from 0.29 for vitamin C to 0.76 for total energy; retinol was not significant. In the validation study, correlation between the FFQ and the 24-HDR ranged between 0.21 for vitamin C and 0.70 for total energy (mean 0.50). Adjusting for total energy lowered the coefficients, except for calcium, retinol and vitamin C. Coefficients increased with attenuation, ranging from 0.35 for carbohydrate to 0.65 for calcium. CONCLUSIONS Results indicate that this questionnaire had satisfactory reproducibility and reasonable validity.

Fatores socioeconômicos, demográficos, nutricionais e de atividade física no controle glicêmico de adolescentes portadores de diabetes melito tipo 1

OBJECTIVE To identify the association of socioeconomic, demographic, nutritional and of physical activity factors in the glycemic control of adolescents with T1DM. SUBJECTS AND METHODS Sectional study of 71 adolescents with type 1 diabetes. Socioeconomic, demographic and anthropometric data were obtained. The glycemic control was classified by the index of glycated hemoglobin (A1C). Four 24-hours recalls of food consumption and physical activity were applied. RESULTS The A1C was inadequate for the majority of the adolescents. The low educational level of the caregivers influenced the inadequate glycemic control. Patients with lower insulin dose presented better glycemic control. The food consumption was high of fat and poor of carbohydrate. Most of the patients were sedentary. CONCLUSION Factors related to education, insulin and food consumption influenced the glycemic control.

ESTADO NUTRICIONAL DE CRIANÇAS E ADOLESCENTES HOSPITALIZADOS: COMPARAÇÃO ENTRE DUAS FERRAMENTAS DE AVALIAÇÃO NUTRICIONAL COM PARÂMETROS ANTROPOMÉTRICOS

ABSTRACT Objective: Verify the association between anthropometric indicators and the Subjective Global Assessment of Nutritional Status (SGA) and the Screening of Risk for Nutritional Status and Growth (STRONGkids) scales. Methods: A cross-sectional study with patients from 0 to 18 years admitted in the Hospital das Clínicas, Goiânia (GO), between August and November 2015. Children and adolescents admitted in up to 48 hours were included. Patients who required specific instruments for assessing their nutritional status and those hospitalized in Intensive Care were excluded. Identification and anthropometric data was collected and applied to the SGA and STRONGkids. We performed an analysis comparing proportions and did an agreement assessment, where p<0.05 was significant. Results: 71 patients were evaluated, of whom 9.6% had low or very low birth weight/age, 9.7% had thinness or accentuated thinness according to the weight/height index, 16.9% had a height impairment, 7% were thin according to the body mass index/age, and 32.4% were malnourished with regard to arm muscle circumference. The STRONGkids detected that 69% of the sample had a moderate or high nutritional risk. According to the SGA, malnutrition prevalence was 38.1%. There was an association between the SGA and body mass index/age (p=0.022), height/age (p<0.001) and arm muscle circumference (p=0.014). There was no association between the STRONGkids and anthropometric indicators. A correlation was found between: high nutritional risk versus severe malnutrition and low nutritional risk x the well-nourished (p<0.001), but the agreement was weak (k=0.255). Conclusions: It is recommended to use the STRONGkids as a screening instrument because it has a higher sensitivity for diagnosing patients with a nutritional risk. The SGA should be applied to nutritional assessment due to its association with anthropometry.

Carbohydrate counting, nutritional status and metabolic profil eof adolescents with type 1 diabetes mellitus

Aims: To evaluate the effect of a carbohydrate counting program on the anthropometric measurements, body composition, biochemical parameters anddietary intake of adolescentswithtype 1 diabetes mellitususing insulin. Methods: A randomized clinical trial included adolescents between 10 and 19 years in treatment for type 1 diabetes with association of fast- acting insulin (regular) and intermediate-acting insulin (Neutral Protamine Hagedorn). The participants received nutritional counseling and were followed for four months, being divided into intervention group (IG), with carbohydrate counting, and control group (CG), without carbohydrate counting. At the beginning and end of the program, patients were evaluated for body mass index, waist circumference, body fat percentage and biochemical parameters: glycated hemoglobin, fasting glucose, postprandial glucose and lipid levels. Dietary intake was assessed every two weeks through the 24-hour recall. For intragroup comparison T-paired and Wilcoxon tests were used, and for intergroup comparison Student t and Mann-Whitney tests were used. The significance level was 5%. Results: The study included 28 adolescents, 14 in each group. The IG significantly decreased glycated hemoglobin (p=0.002) and lipid intake (p=0.002), and increased carbohydrate intake (p=0.005). The CG increased glycated hemoglobin (p=0.024). The IG showed lower fasting glucose value (p=0.033) and glycated hemoglobin (p<0.001) compared to the CG. Both groups decreased caloric intake. Anthropometric parameters were stable and there was no difference between groups. Conclusions: Carbohydrate counting together with Neutral Protamine Hagedorn and Regular insulins favored glycemic control, allowed flexibility in carbohydrate intake, decreased caloric intake, and had no effect on body composition.AIMS: To evaluate the effect of a carbohydrate counting program on the anthropometric measurements, body composition, biochemical parameters anddietary intake of adolescentswithtype 1 diabetes mellitususing insulin. METHODS: A randomized clinical trial included adolescents between 10 and 19 years in treatment for type 1 diabetes with association of fast-acting insulin (regular) and intermediate-acting insulin (Neutral Protamine Hagedorn). The participants received nutritional counseling and were followed for four months, being divided into intervention group (IG), with carbohydrate counting, and control group (CG), without carbohydrate counting. At the beginning and end of the program, patients were evaluated for body mass index, waist circumference, body fat percentage and biochemical parameters: glycated hemoglobin, fasting glucose, postprandial glucose and lipid levels. Dietary intake was assessed every two weeks through the 24-hour recall. For intragroup comparison T-paired and Wilcoxon tests were used, and for intergroup comparison Student t and Mann-Whitney tests were used. The significance level was 5%. RESULTS: The study included 28 adolescents, 14 in each group. The IG significantly decreased glycated hemoglobin (p=0.002) and lipid intake (p=0.002), and increased carbohydrate intake (p=0.005). The CG increased glycated hemoglobin (p=0.024). The IG showed lower fasting glucose value (p=0.033) and glycated hemoglobin (p <0.001) compared to the CG. Both groups decreased caloric intake. Anthropometric parameters were stable and there was no difference between groups. CONCLUSIONS: Carbohydrate counting together with Neutral Protamine Hagedorn and Regular insulins favored glycemic control, allowed flexibility in carbohydrate intake, decreased caloric intake, and had no effect on body composition.

Omega-3 fatty acid supplementation, nutritional status and quality of life in patients with gastrointestinal cancer: double-blind, placebo-controlled, randomized study

Introduction: Cancer cachexia is characterized by weight loss, immunosuppression and is associated with worse prognosis and quality of life. Objectives: To evaluate the effect of ω-3 supplementation on nutritional status, functional capacity and quality of life of patients with gastrointestinal cancer. Methods: the placebo group (P) (n = 10) received seven 1,000 mg capsules of soybean oil and the supplement group (S) (n = 11) seven 1,000 mg capsules of fish oil and flaxseed containing 214.3 mg of eicosapentaenoic acid and 113.5 mg of docosahexaenoic acid daily for 14 days. We evaluated weight, body composition, inflammatory and immunological markers, functional capacity and quality of life. Results: The average weight variation of the P group before and after treatment was -0.44 ± 2.7 kg and of S group was 0.07 ± 1.4 kg, with no statistical difference. The average BMI of the sample was 20.5 ± 3.4 kg / m 2. There was a significant reduction of total serum protein (p = 0.005) and albumin (p = 0.011) in the P group; and an increase in levels of C-reactive protein (CRP) (p = 0.005) and decrease in total lymphocyte count (p = 0.037). An increase in serum transfer

Avaliação retrospectiva do serviço ambulatorial em dietoterapia do Hospital das Clínicas da Universidade Federal de Goiás

A proposta deste estudo foi fazer uma retrospectiva sobre o atendimento do Servico Ambulatorial de Nutricao do Hospital das Clinicas da Universidade Federal de Goias de 1991 a 1995. A finalidade do ambulatorio e prestar orientacao nutricional a individuos sadios e enfermos da comunidade bem como aos funcionarios e estudantes da Universidade. O atendimento e feito com base em registros em fichas individuais, com um rigoroso controle de medidas de peso e altura, alem de um recordatorio alimentar de 24 horas e um registro de frequencia de ingestao. A partir dai, faz-se a prescricao de dieta, que e individualizada, levando-se em conta as condicoes socioeconomicas e culturais do cliente. Na analise retrospectiva foram consultados os prontuarios nutricionais e avaliados os dados referentes a idade, ao sexo, a classificacao do estado nutricional, ao diagnostico medico, a doencas associadas e ao numero de consultas de retorno. No periodo foram atendidos 646 pacientes sendo 26,2% do sexo masculino e 73,8% do sexo feminino, dos quais 24,7% se encontravam na faixa etaria de 19 a 35 anos. As principais doencas encontradas foram obesidade (50,8%) e diabetes (33,3%). Quanto a classificacao do estado nutricional, 33,9% dos individuos diabeticos apresentavam sobrepeso e 30,2% eram eutroficos. Entre os pacientes cuja queixa principal era obesidade, 68,3% eram realmente classificados como obesos. Obsevou-se que 40,9% dos clientes diabeticos possuiam outras doencas associadas sendo este numero de 44,5% entre os obesos. Entretanto, 61 % dos pacientes atendidos nao retornaram as consultas. Portanto, nao se deve esquecer da importância de uma avaliacao constante do servico de nutricao ambulatorial que e oferecido a comunidade, a fim de melhorar a eficiencia do tratamento e oferecer subsidios para o planejamento de novas atividades.