Mariana Carvalho de Menezes

Intervention based on Transtheoretical Model promotes anthropometric and nutritional improvements - a randomized controlled trial.

OBJECTIVE To analyze the effects of an intervention based on the Transtheoretical Model on anthropometric and dietetic profile among women in the Primary Health Care in Brazil. DESIGN AND METHODS Randomized controlled trial. The control group participated in physical activity and open group-education regarding nutrition of usual care. The intervention group participated in 10 workshops based on the Transtheoretical Model. RESULTS Seventy-one women completed the study, with a mean age of 57.9±11.7years. Participants in the intervention group showed an improved body perception, reduced weight and body mass index post-intervention, and lower consumption of calories and foods high in fat. Significant weight reduction in the intervention group was associated with higher per capita income, reduced consumption of protein, reduced consumption of lipids, and the removal of visible fat from red meat and skin from chicken. CONCLUSION An intervention based on the Transtheoretical Model promoted reduction in consumption of foods high in calories and fat, with positive effects on weight and body perception. These results provide evidence of the applicability and benefit of the Transtheoretical Model within primary care.

Eating behavior toward oil and fat consumption versus dietary fat intake

Objective: To analyze whether the stages of change of the Transtheoretical Model are in accordance with the fat consumption of members of the Academia da Cidade of Belo Horizonte, Minas Gerais. Methods: This cross-sectional study included a simple random sample of users aged ≥20 years frequenting an Academia da Cidade. Eating behavior toward oil and fat consumption was evaluated by the transtheoretical model and compared with fat intake adequacy, obtained through mean fat intake was investigated by three 24-hour recalls. Anthropometric and sociodemographic data were also collected. Additionally, the stages of change were verified, after reclassification the stages of change agreed with the consumption of fatty foods, fats, and fractions. Results: A total of 131 women with a mean age of 53.9±12.1 had an average fatty acid consumption of 556.0 mL. Some participants consumed high-fat foods, lipids (20.6%), saturated (31.3%) and polyunsaturated (38.2%) fatty acids, and cholesterol (16.0%) in excess. The stages of eating behavior were significantly different after reclassification. The number of women in action and maintenance decreased in a way that in the end, 4.6% were in precontemplation, 19.8% were in contemplation, 26.0% were in preparation, 28.2% were in action, and 21.4% were in maintenance. The consumption of chicken skin; fatty salad dressing; bread, doughnuts or cake with butter/margarine; and fats, saturated fatty acids, and monounsaturated fatty acids was lower in the final stages of the transtheoretical model. Conclusion: After reclassification the algorithm is in agreement with the ingestion of high-fat foods, which denotes its applicability for the evaluation of eating behavior and for providing data to food and nutrition education actions.

Interventions directed at eating habits and physical activity using the Transtheoretical Model: a systematic review.

INTRODUCTION The multi-behavioral Transtheoretical Model (TTM) addresses multiple behaviors and it is a promising strategy to control multifactorial morbidities, such as chronic diseases. The results obtained using the TTM are positive, but are not consistently methodical. OBJECTIVES The aim of this study was to systematically review the effectiveness of the Transtheoretical Model in multi-behavioral interventions for changing eating habits and levels of physical activity. METHODS A search on PubMed and SciELO databases was performed with inclusion criteria set for intervention studies before 2016 using the Transtheoretical Model for more than one behavior, including eating habits and/or engaging in physical activity. RESULTS AND CONCLUSION Eighteen studies were identified; there was a predominance of randomized clinical trials, studies conducted in the United States, and the use of the Internet and/or telephone. The selected studies were aimed at changing eating behaviors; five of the studies did not address physical activity. The main results were reduction of fat consumption, an increase in the consumption of fruit and vegetables, and increases in physical activity, which are progressions in the stages of change and weight loss identified by the Transtheoretical Model. However, the studies showed methodological weaknesses, including high participant loss and the omission of information about randomization and blinding.

Fatores associados ao excesso de peso entre mulheres

Resumen The objective is to characterize the users of a public health promotion service (HPS) and identify factors associated with excess weight among these users. It’s cross-sectional study among all women in a HPS. It was used anthropometric variables, food consumption and dietary habits, and reports of morbidity. Descriptive analysis and multiple linear regressions were performed (p<0,05). A high prevalence of excess weight (78,7%) and inadequate dietary characteristics were found among the 262 interviewees. The increase of body mass index correlated with inadequate food mastication (b=2,780; p<0,001); insufficient vitamin C intake (b=-2,700; p=0,039); risk of cardiovascular diseases (b=2,840; p<0,001) and dyslipidemia (b=2,292; p=0,003); and doing diets over the last six months (b=2,216; p=0,006). Conclusion: The high rates of excess weight and associated factors show that there is a need to implement strategies for health promotion and recovery, focusing on comprehensive care for individuals and communities, even if at HPS.

Local food environment and fruit and vegetable consumption: An ecological study

Ecological studies are essential for understanding the environment-diet relationship. The purpose of this study was to describe environmental conditions and their relationship with fruit and vegetable (FV) consumption among Brazilian public health service users in the city of Belo Horizonte. We evaluated food stores contained within 1600 m buffer zones at 18 Health Academy Programme sites, from 2013 to 2014. Variables at the community (density, proximity and type) and the consumer (sectional location of FV; availability, quality, variety, price and advertising of FV and ultra-processed foods) nutrition environment were measured by direct observation, while aggregate data from users (income and FV consumption) were obtained by interview. Data were analysed using the Kernel intensity estimator, average nearest neighbour value and Local Morans Index for local spatial autocorrelation. We interviewed 3414 users and analysed 336 food stores. Major geographical variations in the FV consumption were identified. Average consumption was higher (site 2A: 410.5 ± 185.7 g vs. site 4B: 311.2 ± 159.9 g) in neighbourhoods with higher income and concentration of food stores, and better index of access to healthy foods. Sites with poor FV consumption had the most stores with poor access to healthy foods (index in the first tertile, ≤ 10). In conclusion, negative characteristics of the food environment, as seen in the present study, may contribute to low FV consumption, suggesting the need for the development and consolidation of public policies aimed at creating healthy environments through built environment interventions that increase access to and consumption of healthy foods like FV.

Promoting fruit and vegetable consumption: Methodological protocol of a randomized controlled community trial

This study aimed to develop community educational activities in Brazilian primary health care settings. A randomized controlled community trial was conducted to encourage fruit and vegetable consumption (FV-RCT) in a representative sample of consumers aged 20 years or older in a Brazilian city. The fruit and vegetable consumption was classified according to the transtheoretical models stages of change, reflecting different degrees of readiness for change. The educational activities were based on the transtheoretical model and a problematizing-dialogic pedagogy, planned by an interdisciplinary team, using information collected in a qualitative pilot study. The actions were conducted over seven months, and baseline data were collected from 1483 participants. The educational strategies included workshops interspersed with motivational messages conveyed via postcard, interactive environment-based activities, and informative material. In the workshops, different techniques were used - conversation circles, image theatre, self-portraits, cooking and art as experience. The applied intervention based on the chosen theories implied in a refinement of the intervention, but, nevertheless, proved to be feasible for large population groups and to the scenario of health services. Thus, this interdisciplinary FV-RCT study represents an effort to advance methodological issues and provide theoretical subsidies for actions.

An Optimal Method for Measuring Body Fat in Overweight Individuals in Clinical Practice

Background: Excess body fat is associated with increased morbidity and mortality. Accordingly, it is important to choose reliable, simple and straightforward methods for measuring body composition in clinical practice. The aim of this study was to verify the concordance between body composition obtained by Skinfold Thickness (SF) and Bioelectrical Impedance Analysis (BIA) as well as their correlation with anthropometric indices. Methods: The study was conducted from August 2007 to July 2009 among the adults and elderly patients (n = 85) receiving nutritional counseling at a primary health care unit in a Brazilian city. It was investigated all patients seen in the period. The following indices were used for comparison: Body Mass index (BMI), Waist Circumference (WC), Waist-Hip Ratio (WHR) and body composition evaluated by BIA and the sum of skinfolds (tricipital, bicipital, subscapular and suprailiac). The statistical analyses included the Kolmogorov-Smirnov test, Student’s t-test, Wilcoxon signed-rank test, the Pearson and Spearman correlation tests and the Bland-Altman method. Results: Eighty-five individuals were evaluated, predominantly women (91.8%) and overweight individuals (92.8% adults, 89.7% elderly), with a mean age of 51.8 ± 13.0 years (22;85). The percentage of body fat estimated by SF was significantly higher than that estimated by BIA (42.8%; 95% CI: 12.6-49.2 vs. 40.4%; 95% CI: 21.0-51.2; p<0.001). However, a moderate correlation (r = 0.58; p<0.001) and strong concordance [0.9797 (LC95%= -8.0519; 10.0113)] were observed between the two methods. Significant correlations were found between BMI and WC, but not WHR, with respect to body fat estimated by BIA and SF (r = 0.453 to 0.707; p<0.05). BIA presented stronger correlations with BMI and WC (r = 0.707 and 0.605, respectively) compared with SF (r = 0.493 and 0.453, respectively). Conclusion: Strong concordance and a significant correlation were observed between BIA and SF, suggesting their validity in measuring body fat among overweight individuals. However, BIA appears to present better results when considering its higher correlation with the anthropometric indicators used. *Corresponding author: Mariana Carvalho de Menezes, 359 Andre Cavalcanti ave, apt 22. Belo Horizonte, MG 30430-110, Brazil, Tel: 55-31-8644-4344; Fax: 55-31-3409-9860; E-mail: marysnut@gmail.com Received January 12, 2012; Accepted May 15, 2012; Published May 18, 2012 Citation: de Menezes MC, Souza Lopes AC, Cunha LP, Jansen AK, dos Santos LC (2012) An Optimal Method for Measuring Body Fat in Overweight Individuals in Clinical Practice. Endocrinol Metab Synd S2:002. doi:10.4172/2161-1017.S2-002 Copyright:

Factors associated to overweight among women

Resumen The objective is to characterize the users of a public health promotion service (HPS) and identify factors associated with excess weight among these users. It’s cross-sectional study among all women in a HPS. It was used anthropometric variables, food consumption and dietary habits, and reports of morbidity. Descriptive analysis and multiple linear regressions were performed (p<0,05). A high prevalence of excess weight (78,7%) and inadequate dietary characteristics were found among the 262 interviewees. The increase of body mass index correlated with inadequate food mastication (b=2,780; p<0,001); insufficient vitamin C intake (b=-2,700; p=0,039); risk of cardiovascular diseases (b=2,840; p<0,001) and dyslipidemia (b=2,292; p=0,003); and doing diets over the last six months (b=2,216; p=0,006). Conclusion: The high rates of excess weight and associated factors show that there is a need to implement strategies for health promotion and recovery, focusing on comprehensive care for individuals and communities, even if at HPS.

Factores asociados al exceso de peso entre mujeres

Resumen The objective is to characterize the users of a public health promotion service (HPS) and identify factors associated with excess weight among these users. It’s cross-sectional study among all women in a HPS. It was used anthropometric variables, food consumption and dietary habits, and reports of morbidity. Descriptive analysis and multiple linear regressions were performed (p<0,05). A high prevalence of excess weight (78,7%) and inadequate dietary characteristics were found among the 262 interviewees. The increase of body mass index correlated with inadequate food mastication (b=2,780; p<0,001); insufficient vitamin C intake (b=-2,700; p=0,039); risk of cardiovascular diseases (b=2,840; p<0,001) and dyslipidemia (b=2,292; p=0,003); and doing diets over the last six months (b=2,216; p=0,006). Conclusion: The high rates of excess weight and associated factors show that there is a need to implement strategies for health promotion and recovery, focusing on comprehensive care for individuals and communities, even if at HPS.

Fatores associados ao diabetes Mellitus em participantes do Programa 'Academia da Cidade' na Região Leste do Município de Belo Horizonte, Minas Gerais, Brasil, 2007 e 2008

Endereco para correspondencia: Departamento de Enfermagem Materno-Infantil e Saude Publica, Escola de Enfermagem, Universidade Federal de Minas Gerais. Avenida Professor Alfredo Balena, 190, 4o andar, Sala 420. Santa Efigenia, Belo Horizonte-MG, Brasil. CEP: 30130-100 E-mail: marysnut@gmail.com Mariana Carvalho de Menezes Grupo de Pesquisa em Intervencoes em Nutricao, Universidade Federal de Minas Gerais, Belo Horizonte-MG, Brasil