Vera Lúcia Morais Antonio de Salvo

Reprodutibilidade e validade do questionário de freqüência de consumo de alimentos

OBJECTIVE: Methods to evaluate food consumption still need improvement. A study was conducted to verify the reproducibility and validity of a food frequency questionnaire (FFQ) among overweight adults. METHODS: The study was carried out in a private university in Sao Paulo, Brazil. The study sample consisted of 146 individuals of both sex with body mass index =25 kg/m2 and age between 18 and 60 years old. For reproducibility the FFQ was applied by trained interviewers at two different instances with a mean interval time of 47 days. For validity, data collected from the FFQ were compared with those obtained from the average of 3 different daily records of a 24-hour dietary recall (mean interval time: 15 days). Validity and reproducibility of data on calories and macronutrients consumption was assessed using pondered kappa statistics and intraclass correlation coefficient. RESULTS: A higher variability in the reporting of regular food consumption was seen among obese than overweight individuals. Concerning reproducibility, kappa statistical values varied from 0.23 (carbohydrates and fats) to 0.40 (calories), and intraclass correlation coefficients ranged from 0.28 (protein) to 0.54 (total calories). For FFQ validity, the highest kappa value was 0.25 (calories), and the intraclass correlation coefficient was 0.21 (protein). CONCLUSIONS: Food consumption reports of overweight individuals tend to be underestimated. Despite its limitations, FFQ could be used in epidemiological studies to assess the regular food consumption of overweight individuals.

Perfil metabólico e antropométrico dos Suyá: Parque Indígena do Xingu, Brasil Central

OBJETIVO: Descrever o perfil metabolico e antropometrico de indios Suya que vivem no Parque Indigena do Xingu (Mato Grosso). METODO: Neste estudo transversal foram avaliados 86 indios Suya com idade de > 20 anos, de ambos os sexos. Durante o exame fisico foram obtidos os valores de pressao arterial, peso, altura, perimetros corporais e dobras cutâneas. Amostras de sangue foram coletadas para dosagem de lipoproteinas, glicemia e acido urico. Na analise dos dados foram utilizados os testes estatisticos qui-quadrado (para proporcoes) ou t de Student (para valores medios) nas comparacoes das distribuicoes das variaveis relativas ao estado nutricional e perfil metabolico, segundo sexo e faixa etaria dos sujeitos. RESULTADOS: As mulheres, quando comparadas aos homens, apresentaram valores medios estatisticamente menores das variaveis antropometricas (peso, indice de massa corporal, perimetro de cintura, do braco e dobras cutâneas), de pressao arterial, triglicerides, VLDL e acido urico. Foram encontrados, entre os Suya, 46,5%, com excesso de peso, 12,8% com obesidade generalizada, 38,4% com obesidade central, 26,7%, apresentaram alteracoes pressoricas, 4% glicemia de jejum alterada, 63,9% dislipidemia e 21,9% sindrome metabolica. CONCLUSAO: Foram observadas alteracoes metabolicas e antropometricas entre os indios Suya. Intervencoes educativas devem ser implementadas para resgatar habitos e estilo de vida tradicionais a fim de conter o avanco deste quadro.

Impacto de um programa de intervenção sobre o estilo de vida nos perfis metabólico, antropométrico e dietético em nipo-brasileiros com e sem síndrome metabólica

OBJETIVO: Avaliar as mudancas nos perfis metabolico e nutricional de nipo-brasileiros com e sem sindrome metabolica, apos dois anos de participacao em programa de intervencao. MATERIAIS E METODOS: Trata-se de estudo experimental nao controlado. A pesquisa incluiu tres momentos de avaliacao clinico-laboratorial: basal (2005), apos o primeiro ano de intervencao (2006) e ao final do segundo ano (2007). Na presente analise, utilizaram-se informacoes de 360 individuos examinados nos tres momentos. RESULTADOS: Ambos os grupos apresentaram melhora no perfil metabolico e antropometrico, apos o segundo ano de intervencao. Observaram-se diminuicao na ingestao de gorduras totais, acidos graxos saturados, colesterol e aumento de fibras totais nos homens sem sindrome metabolica. No sexo feminino sem sindrome metabolica, observou-se reducao de gordura total (p = 0,003) e acido graxo monoinsaturado (p = 0,002). CONCLUSAO: Os resultados encontrados mostraram impacto positivo do programa de intervencao nos perfis metabolico e nutricional dos nipo-brasileiros com e sem sindrome metabolica.

Consumo alimentar e doença macrovascular em nipo-brasileiros: um estudo transversal

OBJECTIVE: To describe the food intake of Japanese-Brazilians with and without macrovascular disease (MVD). METHODS: MVD was defined, for 1,165 Japanese-Brazilians, by scores attributed to the health historical, electrocardiogram and ankle-brachial index values. The usual dietary intake was determined using a food frequency questionnaire. RESULTS: The MVD prevalence was of 3.2%, being similar among genders. Statistically higher frequencies of individuals with MVD were observed among those of first generation, with age > 60 years, tobacco user, with hypertension, hypertriglyceridemia and diabetes. Subjects with MVD were older, with smaller hip circumference, and higher systolic blood pressure levels, triglycerides and glycemia concentration; they informed higher consumption of iron source food and smaller of grains fibers. Statistically significant difference was found to saturated fat (crude analysis: second tercile versus first tercile). CONCLUSIONS: Programs of nutritional education should be stimulated in this group with high prevalence of non-communicable chronic diseases.

Mindfulness as a complementary intervention in the treatment of overweight and obesity in primary health care: study protocol for a randomised controlled trial

BackgroundMindfulness has been applied in the United States and Europe to improve physical and psychological health; however, little is known about its feasibility and efficacy in a Brazilian population. Mindfulness may also be relevant in tackling obesity and eating disorders by decreasing binge eating episodes—partly responsible for weight regain for a large number of people—and increasing awareness of emotional and other triggers for overeating. The aim of the present study protocol is to evaluate and compare the feasibility and efficacy of two mindfulness-based interventions (MBIs) addressing overweight and obesity in primary care patients: a general programme called Mindfulness-Based Health Promotion and a targeted mindful eating protocol called Mindfulness-Based Eating Awareness Training.Methods/designA randomised controlled trial will be conducted to compare treatment as usual separately in primary care with both programmes (health promotion and mindful eating) added to treatment as usual. Two hundred forty adult women with overweight and obesity will be enrolled. The primary outcome will be an assessment of improvement in eating behaviour. Secondary outcomes will be (1) biochemical control; (2) anthropometric parameters, body composition, dietary intake and basal metabolism; and (3) levels of mindfulness, stress, depression, self-compassion and anxiety. At the end of each intervention, a focus group will be held to assess the programme’s impact on the participants’ lives, diet and health. A feasibility study on access to benefits from and importance of MBIs at primary care facilities will be conducted among primary care health care professionals and participants. Monthly maintenance sessions lasting at least 1 hour will be offered, according to each protocol, during the 3-month follow-up periods.DiscussionThis clinical trial will result in more effective mindfulness-based interventions as a complementary treatment in primary care for people with overweight and obesity. If the findings of this study confirm the effectiveness of mindfulness programmes in this population, it will be possible to improve quality of life and health while optimising public resources and reaching a greater number of people. In addition, on the basis of the evaluation of the feasibility of implementing this intervention in primary care facilities, we expect to be able to suggest the intervention for incorporation into public policy.Trial registrationClinicalTrials.gov, NCT02893150. Registered retrospectively on 30 March 2017.

Study protocol of a multicenter randomized controlled trial of mindfulness training to reduce burnout and promote quality of life in police officers: the POLICE study

BackgroundPolice officers experience a high degree of chronic stress. Policing ranks among the highest professions in terms of disease and accident rates. Mental health is particularly impacted, evidenced by elevated rates of burnout, anxiety and depression, and poorer quality of life than the general public. Mindfulness training has been shown to reduce stress, anxiety, burnout and promote quality of life in a variety of settings, although its efficacy in this context has yet to be systematically evaluated. Therefore, this trial will investigate the efficacy of a mindfulness-based intervention versus a waitlist control in improving quality of life and reducing negative mental health symptoms in police officers.MethodsThis multicenter randomized controlled trial has three assessment points: baseline, post-intervention, and six-month follow-up. Active police officers (n = 160) will be randomized to Mindfulness-Based Health Promotion (MBHP) or waitlist control group at two Brazilian major cities: Porto Alegre and São Paulo. The primary outcomes are burnout symptoms and quality of life. Consistent with the MBHP conceptual model, assessed secondary outcomes include perceived stress, anxiety and depression symptoms, and the potential mechanisms of resilience, mindfulness, decentering, self-compassion, spirituality, and religiosity.DiscussionFindings from this study will inform and guide future research, practice, and policy regarding police offer health and quality of life in Brazil and globally.Trial registrationClinicalTrials.gov NCT03114605. Retrospectively registered on March 21, 2017.

Estresse percebido em profissionais da Estratégia Saúde da Família

Objective: To evaluate the perceived stress (PS) of professionals in Primary Health Care and its association with the characteristics of the teams in the Family Health Program (FHP). The association between PS and self-referred morbidity was also investigated. Methods: This is a cross-sectional study conducted with 450 employees from 60 teams in 12 Basic Health Units (BHUs) in a region of São Paulo. The differences in the total score in the Perceived Stress Scale were evaluated through multiple linear regression models. Results: Higher levels of PS were observed in those who had been working for one year or more in the same team, in the categories of doctors, nurses and community health workers, females, non-religious, and in BHU professionals in incomplete teams (absence of a physician). Lower perceived stress was found in widowers. It was observed that individuals with higher levels of PS have higher chances of reporting chronic health problems. Conclusion: It can be concluded that the perception of stress in this population is associated with individual, professional factors, and the composition of teams in healthcare units.