Paula Martins Horta

Aconselhamento sobre alimentação e atividade física: prática e adesão de usuários da atenção primária

O presente estudo objetivou verificar o conteudo do aconselhamento de profissionais de saude direcionado a usuarios da atencao primaria, assim como as dificuldades de adesao destes acerca do que foi orientado, por meio de delineamento transversal. Foram entrevistados 499 usuarios de uma Unidade Basica de Saude, sendo a pratica do aconselhamento referido por 59,3% dos usuarios, que a vincularam especialmente aos medicos (93,6%) e a pratica de uma alimentacao saudavel associada a atividade fisica (48,9%). O aconselhamento foi mais frequente entre os usuarios com maior numero de morbidades (p=0,001) e apresentou como principais barreiras a sua adesao a falta de tempo (27,5%) e a necessidade de mudanca de habitos (23%). Identificou-se que o aconselhamento ainda e incipiente na atencao primaria, tornando-se necessario que profissionais de saude, especialmente o enfermeiro da Equipe de Saude da Familia, atuem mais nesse processo, tendo como foco preponderante a promocao da saude.

Efetividade de uma intervenção nutricional associada à prática de atividade física

The nutritional transition in Brazil demands the development of contexts and environments of healthy lifestyles promotion. This study aimed to evaluate the effectiveness of a nutritional intervention associated with physical activity practice among individuals from a Health Promotion Service of Belo Horizonte (MG). The intervention was carried out in six months with normal weight or overweight adults and normal weight elderly. Socio-demographic and economic condition was evaluated before and after this period in addition to health profile, food consumption (eating habits and food frequency questionnaire) and anthropometry. The sample included 20 subjects, 95% women, 75% adults, 52.0±12.9 years. Initially, evaluation revealed occurrence of inadequate eating habits and 30% of overweight among participants. After the nutritional intervention period, there were no differences regarding eating habits, but an increase in the adequacy of processed meats consumption was verified (p=0.016). Furthermore, a reduction in body weight (62.6±8.2 versus 61.7±8.8, p=0.032), waist circumference (82.5±8.2 versus 78.9±6.2; p=0.002) and waist-to-hip ratio (0.82±0.07 versus 0.79±0.05, p=0.016). The intervention was effective for anthropometry changes and reduction in processed meats consumption, highlighting the importance of these services for the population health promotion.

Qualidade de vida entre mulheres com excesso de peso e doenças crônicas não transmissíveis

O estudo objetivou identificar a qualidade de vida e os fatores a ela associados entre mulheres com excesso de peso e doencas cronicas nao transmissiveis. Tratou-se de estudo transversal com uma amostra de conveniencia formada por 50 usuarias adultas e idosas de uma academia da cidade de Belo Horizonte(MG), Brasil. Para a avaliacao da qualidade de vida, utilizou-se instrumento WHOQOL-bref. Realizou-se analise descritiva e regressao linear uni e multivariada. “Relacoes sociais” foi o dominio que mais contribuiu para a qualidade de vida, seguido do dominio “fisico”. Associaram-se a pior qualidade de vida a presenca autorreferida de gastrite/ulcera (s=-11,890; p=0,011), uso de medicamentos (s=-7,730, p=0,035), maior consumo per capita de acucar (s=-0,092; p=0,045), valores elevados de indice de massa corporal (s=-1,218; p=0,048) e maior consumo de carboidratos (s=-0,382; p=0,042). Concluiu-se que muitos sao os fatores relacionados a qualidade de vida, que devem ser considerados nos programas de saude.

The dietary profile of socially vulnerable participants in health promotion programs in a brazilian metropolis

OBJECTIVES To analyze the dietary profile of participants who used two health promotion services located in socially vulnerable areas in a Brazilian metropolis. METHODS A cross-sectional comparative study was conducted with participants (n = 370) aged ≥ 20 years who joined two services of the Academias da Cidade program in Belo Horizonte, Minas Gerais, Brazil. The study participants engaged in physical activity and nutritional education actions directed by the services from 2009 to 2010. The sociodemographic and economic conditions and health and nutrition profiles of each individual were assessed. RESULTS Participants from a high social-risk who used the service did not demonstrate adequate intake of vegetables (54.6 versus 43.6%; p = 0.038), sweets (33.5 versus 23.2%; p = 0.030), soft drinks (28.5 versus 11.9%; p < 0.001), artificial juice (34.7 versus 22.6%; p = 0.011), and processed meat (48.8 versus 32.7; p = 0.002). However, in the other service, lower social vulnerability, a higher prevalence of abdominal adiposity (60.7 versus 43.0%; p = 0.004) and consumption of high-fat meat products (53.0 versus 36.5%; p = 0.002) was observed. CONCLUSION Participants who used both services demonstrated inadequate food intake compatible with the development of chronic disease profiles. However, the participants in each service were distinct from each other. This suggests that promotion of healthy eating should to contemplate the territory and its interface with people health.

Consumo de frutas e hortaliças e as condições de saúde de homens e mulheres atendidos na atenção primária à saúde

This cross-sectional study sought to analyze the associations between health conditions and the inadequate consumption of fruit and vegetables (FV) of 1,255 men and women attended in Primary Healthcare Units in Belo Horizonte (State of Minas Gerais). Data collection included FV consumption, socioeconomic status and health conditions. Results are presented by prevalence ratio (PR) with a confidence interval of 95% (CI 95%). A 77.5% (CI 95%: 75.1%-79.8%) of inadequacy of consumption (< 5 daily servings) was found and it was more prevalent among men (83.8%, CI 95%: 79.0%-88.5% than among women: 76.0%, CI 95%: 73.4%-78.6%). For women, the inadequate consumption of FV was higher among those with poor perception of health quality (PR: 1.37; CI 95%: 1.19-1.59) and among those who consider their dietary habits as being unhealthy (PR: 1.15; CI 95%: 1.07-1.24). For men, the inadequate consumption was higher between individuals that reported 2 to 4 visits to the doctor in the year prior to the interview (PR: 1.21; CI 95%: 1.06-1.21). The conclusions showed that the consumption of FV among the population under study is below the recommendations and the health conditions are associated differently for each gender.This cross-sectional study sought to analyze the associations between health conditions and the inadequate consumption of fruit and vegetables (FV) of 1,255 men and women attended in Primary Healthcare Units in Belo Horizonte (State of Minas Gerais). Data collection included FV consumption, socioeconomic status and health conditions. Results are presented by prevalence ratio (PR) with a confidence interval of 95% (CI 95%). A 77.5% (CI 95%: 75.1%-79.8%) of inadequacy of consumption (< 5 daily servings) was found and it was more prevalent among men (83.8%, CI 95%: 79.0%-88.5% than among women: 76.0%, CI 95%: 73.4%-78.6%). For women, the inadequate consumption of FV was higher among those with poor perception of health quality (PR: 1.37; CI 95%: 1.19-1.59) and among those who consider their dietary habits as being unhealthy (PR: 1.15; CI 95%: 1.07-1.24). For men, the inadequate consumption was higher between individuals that reported 2 to 4 visits to the doctor in the year prior to the interview (PR: 1.21; CI 95%: 1.06-1.21). The conclusions showed that the consumption of FV among the population under study is below the recommendations and the health conditions are associated differently for each gender.

Atualizações em guias alimentares para crianças e adolescentes: uma revisão

OBJECTIVES: to conduct a review of dietary guides for children and adolescents. METHODS: a systematic review of the Medline and Lilacs databases and institutional sites, covering documents published between 2000 and 2010. RESULTS: seventeen dietary guides published were identified worldwide, including ten in Latin America, three in North America, two in Europe and two in Asia/Oceania. The guides differ in terms of structure. Some contain nutritional guidelines, others graphics and some both. The content of the nutritional guidelines, as well as the number of food groups and graphics used in the manual also varied according to the dietary culture of the population. Sixteen guides focus on food rather than nutrients. The Japanese guide, for example, contains recommendations on how to consume and prepare dishes and is easier to understand. All the dietary guides identified for children aged under two years (n=5) were from Latin America, and three were found whose guidelines were aimed at health professionals, suggesting a need for training and retraining of these. CONCLUSION: the study demonstrates the importance of dietary guides when dealing with children and adolescents, providing a theoretical basis for health professionals and institutions.

Fatty acid intake and metabolic syndrome among overweight and obese women

OBJECTIVE To examine relations between fatty acids intake and metabolic syndrome (MetS) status among overweight and obese women (n = 223). METHODS This was a cross-sectional study. The physical and laboratory tests included anthropometry, body composition evaluation and measurements of blood pressure, fasting blood glucose, insulinemia and lipid profiles. A three-day food diary was used to evaluate fatty acids consumption. Statistical analysis included χ2 test and odds ratio measurements. RESULTS The women had 35.2 (6.9) years old and 15.2% presented MetS. Women with MetS presented higher serum levels of very low-density lipoprotein cholesterol, triglycerides, glucose and insulin in addition to higher diastolic blood pressure in comparison to women without MetS. Overweight women with MetS consumed higher amounts of monounsaturated fatty acids - 24.3 g (24.7 - 36.4) versus overweight women without MetS - 23.9 g (23.8 - 26.8), polyunsaturated fatty acids - 16.7 g (14.6 - 21.1) versus overweight women without MetS - 13.6 g (13.8 - 15.8) and linoleic fatty acids - 15.9 g (6.5) versus overweight women without MetS - 13.1 g (5.1). Among obese women with MetS, higher intake of linoleic fatty acids was also noted - 17.6 g (6.1) versus obese women without MetS - 14.3 g (6.6) in addition to higher consumption of trans fatty acids - 4.7 g (4.8 - 6.3) versus obese women without MetS - 3.9 g (2.9 - 4.6). Increased quartiles of monounsaturated, polyunsaturated, linoleic and trans fatty acid intake were significantly associated with a greater occurrence of MetS. CONCLUSION Lipid intake may be related to MetS, although other factors also need to be considered, such as lifestyle, genetics and metabolism.

Qualidade da dieta entre mulheres com excesso de peso atendidas em uma Academia da Cidade de Belo Horizonte, Minas Gerais

ObjectiveTo characterize dietary quality and its associated factors among overweight women attended in an ‘Academia da Cidade’ in Belo Horizonte, Minas Gerais state, Brazil.MethodsIt is a cross-sectional study in which the socioeconomic condition, health profile and dietary quality were evaluated; the latter was obtained through the Brazilian healthy eating index revised (BHEI-R). The influence of socioeconomic information and health profile on dietary quality was investigated.ResultsOne hundred forty women aged 53.7±11.4 years were interviewed. Dietary quality evaluation reached 57.2 (P25: 48.8; P75: 66.1) points at the BHEI-R score. Only two women (1.4%) presented adequacy on dietary quality, and 30.7% and 67.9% presented inadequate dietary quality and diet that needs improvement, respectively. The referred presence of hypertension and the use of medicine were inversely correlated with dietary quality.ConclusionThe women under study presented low dietary quality, and the identification of this profile can help define intervention actions in this and other health promotion services, as the recently proposed ‘Academia da Cidade’ health clubs.

A higher number of school meals is associated with a less‐processed diet

OBJECTIVE To compare the participation of food groups - fresh and minimally processed, processed, and ultra-processed - in the diet of students (n=1357) from Belo Horizonte, MG, Brazil, in accordance with the number of school meals consumed daily. METHODS Four groups were defined: children that did not consume school meals and children that consumed one, two, or three school meals daily. Food groups participation, in g/1000kcal, was obtained using two 24-hour recalls. Three linear regression models were analyzed, in which the consumption of each of the food groups was the dependent variable, the number of school meals was the independent variable, and sociodemographic data (gender, age, health vulnerability) and overweight condition were the control variables. RESULTS Children that consumed 2 or 3 school meals daily showed, respectively, 7.3% and 10.5% higher ingestion of fresh and minimally processed food in comparison to children that did not consume school meals. Moreover, ultra-processed food participation was 18.0% lower among students that consumed two school meals and 26.0% lower among children that consumed three meals daily, in comparison to students that did not consume school meals. CONCLUSION The study showed a possible dose-response effect in childrens daily diets with two or three school meals and highlighted the relevance of the prolonged stay at school for healthy eating promotion in children.

Effectiveness of high-intensity nutritional interventions for overweight Brazilian women

Excess weight and obesity are important epidemiological conditions that affect 35% and 12%, respectively, of adults and elderly adults worldwide. In Brazil, high rates of these disorders are also observed, with 49% and 14.8% of people reported as being overweight or obese, respectively. In response to this scenario, health organisations have proposed actions focussing on changes in individual behaviours and lifestyle intervention programs have been associated with weight losses of 5e10%, in addition to reductions in cardiometabolic risks and morbidity/mortality. These results are more pronounced when nutritional interventions are associated with supervised exercises and are conducted in group and at a high intensity level. Intervention intensity can be understood as the number of meetings between the subjects and health professionals and high-intensity interventions are defined as more than one contact per month in the first three months of the program.