Patrícia de S. Genaro

Cálcio dietético: estratégias para otimizar o consumo

RESUMO O calcio e um nutriente essencial necessario em diversas funcoes biologicas. Estudos tem demonstrado a associacao entre o baixo consumo de calcio e doencas cronicas, entre elas osteoporose, câncer de colon, hipertensao arterial e obesidade. Entretanto, grande parte da populacao brasileira apresenta consumo de calcio abaixo do recomendado. Este artigo objetiva revisar os fatores endogenos (idade e estado hormonal) e exogenos (fitatos, oxalatos, sodio, compostos bioativos e vitamina D) que influenciam a absorcao do calcio, bem como as principais metodologias utilizadas para avaliar a absorcao e biodisponibilidade desse nutriente. discorre-se sobre os possiveis fatores para o baixo consumo de calcio: 1) Habito alimentar – substituicao de leite por bebidas com baixo teor de calcio como o refrigerante, refeicoes realizadas fora de casa e a nao realizacao de refeicoes como o cafe da manha; 2) Alto custo dos alimentos fontes de calcio. Alem disso, este artigo discute as estrategias para otimizar o consumo do calcio, que incluem: 1) Aumentar o conhecimento sobre a importância do consumo de calcio para a saude e as principais fontes alimentares desse nutriente; 2) Aumentar a disponibilidade de alimentos fortificados com calcio; 3) Uso de suplementos em grupos especificos – quando e como administrar os sais de calcio. Palavras-chave: calcio, absorcao, biodisponibilidade, consumo, sais de calcio.

Antioxidant intake among Brazilian adults--the Brazilian Osteoporosis Study (BRAZOS): a cross-sectional study.

BackgroundAntioxidant nutrient intake and the lesser formation of free radicals seem to contribute to chronic diseases. The aim of the present study was to evaluate the intake profile of the main dietary antioxidants in a representative sample of the adult Brazilian population and discuss the main consequences of a low intake of these micronutrients on overall health.MethodsThe sample comprised 2344 individuals aged 40 years or older from 150 cities and was based on a probabilistic sample from official data. The research was conducted through in-home interviews administered by a team trained for this purpose. Dietary intake information was obtained through 24-h recall. The Nutrition Data System for Research software program was used to analyze data on the intake of vitamins A, C and E, selenium and zinc, which was compared to Dietary Reference Intakes (DRIs). Differences in intake according to sex, anthropometrics, socioeconomic status and region were also evaluated. The SPSS statistical package (version 13) was used for the statistical analysis. P-values < 0.05 were considered significant.ResultsHigher proportions of low intake in relation to recommended values were found for vitamin E (99.7%), vitamin A (92.4%) and vitamin C (85.1%) in both genders. Intake variations were found between different regions, which may reflect cultural habits.ConclusionThese results should lead to the development of public health policies that encourage educational strategies for improving the intake of micronutrients, which are essential to overall health and prevention of non-communicable diseases.

Higher prevalence of morphometric vertebral fractures in patients with recent coronary events independently of BMD measurements

Cardiovascular disease and osteoporosis are important causes of morbi-mortality in the elderly and may be mutually related. Low bone mineral density (BMD) may be associated with increased risk of cardiovascular events. We investigated the prevalence of low bone mass and fractures in metabolic syndrome patients with acute coronary events. A case-control study was conducted with 150 individuals (30-80years-old) with metabolic syndrome. Seventy-one patients had had an acute coronary syndrome episode in the last 6months (cases) and the remaining 79 had no coronary event (controls). Cases and controls were matched for gender, BMI and age. DXA measurements and body composition were performed while spine radiographs surveyed for vertebral fractures and vascular calcification. Biochemical bone and metabolic parameters were measured in all patients. No statistically significant difference in BMD and the prevalence of osteopenia, osteoporosis and non-vertebral fractures was observed between cases and controls. The prevalence of vertebral fractures and all fractures was higher in the cases (14.1 versus 1.3%, p=0.003 and 22.5versus7.6%, p=0.010, respectively). Male gender (OR=0.22 95% CI 0.58 to 0.83, p=0.026) and daily intake of more than 3 portions of dairy products (OR=0.19 95% CI 0.49 to 0.75, p=0.017) were associated with lower prevalence of fractures. Cases had higher risk for fractures (OR=4.97, 95% CI 1.17 to 30.30, p=0.031). Bone mass and body composition parameters were not associated with cardiovascular risk factors or bone mineral metabolism. Patients with fragility fractures had higher OPG serum levels than those without fractures (p<0.001). Our findings demonstrated that patients with recent coronary events have a higher prevalence of vertebral fractures independently of BMD.