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- ItemSomente MetadadadosAvaliação da qualidade nutricional de planos dietéticos para perda de peso publicados em revistas não científicas voltadas para o público feminino no primeiro semestre de 2014(Universidade Federal de São Paulo (UNIFESP), 2015-10-31) Martininghi, Mayara [UNIFESP]; Silva, Edina Mariko Koga da Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Introduction: emotional and genetic factors associated with the increase in global energy consumption and sedentary behavior make overweight and obesity examples of the main current public health problems worldwide. They are also related to an increase in chronic diseases (NCDs) and mortality rates. In Brazil, the prevalence of overweight and obesity is 50.8% and 17.5%, respectively. As well as the increase in the prevalence of obesity there is an increase in the "cult of the body" and the multiplication of popular diet plans that promise quick and easy loss of weight. Most of these plans do not correspond to the fundamental principle of change and practice of healthy eating habits, being effective only in the short run and having questionable nutritional quality. In Brazil, non scientific magazines play an important role in the providing information on topics such as food, nutrition, health and desirable physical condition. Women in particular are encouraged to lose weight, whether necessary or not, being much more motivated by fashion than by awareness of the risks that overweight and obesity bring to health. Developing interventions for the pursuit of healthy eating habits is a complex process and due to considering different variables for the individual, it should be individualized. Due to ubiquitous diet plans served weekly and monthly by non scientific magazines all over Brazil, it is important to evaluate the quality of these plans in different aspects, in order to provide people with guidance, especially women, about the quality of the information disseminated, in order to maintain their quality of life and health. Objective: To evaluate the quality of diet plans for weight loss published in non scientific national magazines aimed at women. Methods: Cross-sectional descriptive study. One hundred thirty-six issues of six non scientific magazines aimed at female readers, published in the first half of 2014, were selected. Recognized by often displaying diet plans calls for weight loss in their covers. At this step, data from Mídia Dados 2014 and Associação Nacional de Editores de Revista (ANER) [National Association of Magazine Editors] have been used. Forty-one issues were excluded and 95 analyzed. The calculation of the total calorie content and nutritional composition of the diet plans of each issue included was performed by a second researcher through DIETPRÓ PROFISSIONAL software, with the help of the data bank of the AVANUTRI software and the Brazilian Table of Food Composition (TACO). Quantitative analysis of the adequacy of diet plans was made by comparing the values of carbohydrates, proteins, lipids, saturated fatty acids, fiber, Calcium, Iron, Sodium and vitamin C, found after calculating those with nutritional recommendations of the World Health Organization (WHO) and the Dietary Reference Intakes for females aged 19-50 years. It was checked if there were, in any of the pages which contained diet plans and information related to these, instructions for the total energy value of the proposed diet plan, appropriate daily water consumption, practice of physical activity concomitant with the adoption of a proposed diet plan and a qualified professional responsible for the plan and further information therein. Furthermore, after the calculation of the total energy of diet plans which provided those values, the consistency of all the information provided was verified, being deemed as consistent, values between 90 and 110% of the specified in the proposed diet plan. The results were presented using descriptive statistics. Results: The quantitative analysis of the level of adequacy of carbohydrates, proteins, lipids and saturated fatty acids, showed that 83.1% of the plans which were analyzed showed carbohydrates values below recommended, 97.8% of the plans presented values for protein above recommended, 66.3% of the plans presented suitable values for lipids according to recommended and 95.7% of the plans presented values for saturated fatty acids above recommended. In relation to fibers, calcium, iron, sodium, and vitamin C, the quantitative analysis of the level of adequacy showed that 83.1% of the plans which were analyzed showed values for fibers below recommended, 88.4% of the plans analyzed presented values for calcium below recommended, 98.9% of the analyzed plans presented values for iron below recommended, 51.5% of the plans presented appropriate values for sodium as recommended and 89.4% of the plans presented suitable values for vitamin according to recommendation. Only 30 plans analyzed specify the amount of total energy supplied therein, and among those, 53.3% presented different information after the calculation thereof. Twenty percent of the plans had no information concerning the adequate daily water consumption, 35.7% of the plans provided no information regarding the encouragement to practising of concurrent physical activity when adhering to ae proposed diet plan and 96.8% of the plans presented advice or comments by professionals. Conclusion: The results of this study strengthen the hypothesis that diet plans published in non scientific magazines are inadequate about different qualitative aspects.
- ItemSomente MetadadadosDietary Medium-Chain Triacylglycerols versus Long-Chain Triacylglycerols for Body Composition in Adults: Systematic Review and Meta-analysis of Randomized Controlled Trials(Routledge Journals, Taylor & Francis Ltd, 2015-03-04) Bueno, Nassib B. [UNIFESP]; Melo, Ingrid V. de; Florencio, Telma T.; Sawaya, Ana Lydia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Fed AlagoasObjective: To assess the effect of replacing dietary long-chain triacylglycerols (LCTs) with medium-chain triacylglycerols (MCTs) on body composition in adults.Methods: We conducted a meta-analysis of randomized controlled trials (RCTs), to determine whether individuals assigned to replace at least 5g of dietary LCTs with MCTs for a minimum of 4 weeks show positive modifications on body composition. We systematically searched, through July 2013, the CENTRAL, EMBASE, LILACS, and MEDLINE databases for RCTs that investigated the effects of MCT intake on body composition in adults. Two authors independently extracted data and assessed risk of bias. Weighted mean differences (WMDs) were calculated for net changes in the outcomes. We assessed heterogeneity by the Cochran Q test and I-2 statistic and publication bias with the Egger's test. Prespecified sensitivity analyses were performed.Results: in total, 11 trials were included, from which 5 presented low risk of bias. in the overall analysis, including all studies, individuals who replaced dietary LCT with MCT showed significantly reduced body weight (WMD, -0.69kg; 95% confidence interval [CI], -1.1 to -0.28; p = 0.001); body fat (-0.89kg; 95% CI, -1.27 to -0.51; p < 0.001), and WC (-1.78cm; 95% CI, -2.4 to -1.1; p < 0.001). the overall quality of the evidence was low to moderate. Trials with a crossover design were responsible for the heterogeneity.Conclusion: Despite statistically significant results, the recommendation to replace dietary LCTs with MCTs must be cautiously taken, because the available evidence is not of the highest quality.
- ItemAcesso aberto (Open Access)Eficácia de uma intervenção psicológica no estilo de vida para redução do risco coronariano(Sociedade Brasileira de Cardiologia - SBC, 2007-10-01) Pugliese, Rita [UNIFESP]; Zanella, Maria Teresa [UNIFESP]; Blay, Sergio Luis [UNIFESP]; Plavinik, Frida [UNIFESP]; Andrade, Marco Antonio [UNIFESP]; Galvão, Roberto [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To evaluate the efficacy of a program of lifestyle change through psychological intervention, combined with pharmacological therapy, for coronary risk reduction in uncontrolled hypertensive patients with overweight and dyslipidemia over 11 months of follow-up. METHODS: A randomized controlled trial with 74 patients assigned to three different treatment programs. One group (CT) only received conventional pharmacological treatment. Another group (OG) received pharmacological treatment and participated in a guidance program to control cardiovascular risk factors. A third group (LSPI) received pharmacological treatment and participated in a brief psychological intervention program for reduction of estresse levels and changing of eating behavior. The main measure was the Framingham risk index. RESULTS: CT patients presented an average reduction of 18% (p = 0.001) in coronary risk; OG patients elevated the risk by 0.8% (NS) and the LSPI group showed an average reduction of 27% on the Framingham risk index (p = 0.001). CONCLUSION: Pharmacological treatment combined with psychological intervention for reduction of estresse level and changing of eating behavior resulted in additional benefits in coronary risk reduction.
- ItemAcesso aberto (Open Access)Emerging drugs for obesity therapy(Sociedade Brasileira de Endocrinologia e Metabologia, 2009-03-01) Zanella, Maria Teresa [UNIFESP]; Ribeiro Filho, Fernando Flexa [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Fundação Oswaldo Ramos Clinical Research Center of Hypertension and Cardiovascular MetabologyCentral obesity have an important impact on the development of risk factors for coronary heart disease, including dislipidemia, glucose intolerance, insulin resistance and hypertension. These factors contribute to building cardiovascular (CV) disease as a major cause of death. The approach to obesity therapy should be designed to reduce CV risk and mortality. Diet and lifestyle changes remain the cornerstones of therapy for obesity, but the resultant weight loss is often small and long-term success is uncommon and disappointing. Drug therapy is considered for individuals with a body mass index greater than 30 kg/m² or ranging from 25 to 30 kg/m² if they have comorbid conditions. Antiobesity agents can be helpful to some patients in achieving and maintaining meaningful weight loss, but yet our pharmaceutical tools are of limited effectiveness considering the magnitude of the problem. At the present, only two drugs, orlistat and sibutramine, are approved for long-term treatment of obesity and promote no more than 5 to 10% of weight loss. Rimonabant, a cannabinoid-1 receptor antagonist, was withdrawn from the market because of concerns about its safety, including risk of suicidal and seizures, although very effective in promoting clinically meaningful weight loss, reduction in waist circumference, and improvements in several metabolic risk factors, rimonabant, a cannabinoid-1 receptor antagonist was withdrawn from the market because it concerns about its safety, including risk of suicidal and seizures. Fortunately, recent fundamental insights into the neuroendocrine mechanisms regulating body weight provide an expanding list of molecular targets for novel, rationally designed antiobesity drugs. In this review, the therapeutic potential of some antiobesity molecules in the development will be analyzed based on an understanding of energy homeostasis.
- ItemAcesso aberto (Open Access)Fatores de risco para perda ponderal de crianças frequentadoras de berçários em creches do município de São Paulo(Sociedade de Pediatria de São Paulo, 2009-03-01) Toloni, Maysa Helena de Aguiar [UNIFESP]; Konstantyner, Tulio [UNIFESP]; Taddei, Jose Augusto de Aguiar Carrazedo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE: To identify and quantify risk factors related to the aggravation of nutritional condition from birth until the date of the study. METHODS: Cross-sectional study with 270 children attending nurseries of eight public and non-for-profit daycare centers in the city of São Paulo, Brazil. Ponderal loss was considered when children presented negative difference of Z score for weight-for-age (W/A) from birth until the date of the present inquiry. Chi-square was used to test associations and considered significant if p<0.05. Multivariate logistic regression model adjusted Odds Ratio estimates for confounding variables and/or covariables. RESULTS: Anthropometric analysis showed 7.1% prevalence of malnutrition (W/A<-2 Z score) at birth and 4.4% by the time of measurement. Ponderal evolution with unfavorable Z score was present in 50.7% of studied children (n=137). In the bivariate analyses, the variables: birth weight (OR=5.35; p<0.001), anemia (OR=1.81; p=0.019) and age less than 19 months (OR=1.67; p=0.036) were statistically significant. CONCLUSIONS: Ponderal loss in Z score during the first months of life has not been often used in epidemiological studies. However, future researches might identify weight loss as an indicator of risk for sociobiological vulnerability. Development of health programs in order to reduce the prevalence of nutritional aggravation targeting the younger population with anemia is strongly recommended.
- ItemAcesso aberto (Open Access)Fluoxetina: indícios de uso inadequado(Instituto de Psiquiatria da Universidade Federal do Rio de Janeiro, 2009-01-01) Carlini, Elisaldo Araujo [UNIFESP]; Noto, Ana Regina [UNIFESP]; Nappo, Solange Aparecida [UNIFESP]; Sanchez, Zila van der Meer [UNIFESP]; Franco, Vera Lúcia da Silva; Silva, Luiz Carlos Franco; Santos, Vilmar Ezequiel dos; Alves, Décio de Castro; Universidade Federal de São Paulo (UNIFESP); Prefeitura Municipal de Santo André Secretaria da Saúde Departamento de Assistência à SaúdeOBJECTIVE: Investigate the use of fluoxetine in Santo André city, SP, by collecting and analyzing special prescriptions (SP) issued by physicians and filed in compounding pharmacies and drugstores of that city. METHODS: Special prescriptions were collected during August 2005 to July 2006 in 13 compounding pharmacies and 27 drugstores, in different regions of Santo André. Each prescription has been examined for the presence of fluoxetine, in combination or not with other active ingredients, and sex (a) patient was noted. RESULTS: We examined 39,782 SP; 16,124 of them were collected from compounding pharmacies and 23,658 from drugstores. Of these totals, 10,919 prescriptions contained fluoxetine as follows: 9,259 from the compounding pharmacies (84.8%) and only 1,660 (15.2%) from drugstores. Fluoxetine was manly prescribed for women (79.8%). In the vast majority of SP, fluoxetine was prescribed in combination with a large number of other active substances reaching more than ten others in almost half of the prescriptions. CONCLUSION: It is suggested that the large use of fluoxetine possibily aims to an aesthetic objective (to lose weight) and not as a therapeutic aim (treatment of depression). This work discusses the risk/benefit of this use which could be described as inappropriate, given the known adverse reactions of fluoxetine and its interference with the cytochrome P450 system.
- ItemSomente MetadadadosGlucocorticoids are not responsible for paradoxical sleep deprivation-induced memory impairments(Amer Acad Sleep Medicine, 2008-04-01) Tiba, Paula Ayalko [UNIFESP]; Menezes Oliveira, Maria Gabriela [UNIFESP]; Rossi, Vanessa Contatto [UNIFESP]; Tufik, Sergio [UNIFESP]; Suchecki, Deborah [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Study Objectives: To evaluate whether paradoxical sleep deprivation-induced memory impairments are due to release of glucocorticoids, by means of corticosterone inhibition with metyrapone.Design: The design was a 2 (Groups [control, paradoxical sleep-deprived]) x 2 (Treatments [vehicle, metyrapone]) study, performed in 2 experiments: Acute treatment (single injection given immediately after 96 hours of sleep deprivation) and chronic treatment (8 injections, twice per day, throughout the sleep-deprivation period). Animals were either paradoxical sleep-deprived or remained in their home cages for 96 hours before training in contextual fear conditioning and received intraperitoneal injections of a corticosterone synthesis inhibitor, metyrapone. Memory performance was tested 24 hours after training.Subjects: Three-month old Wistar male rats.Measurements: Freezing behavior was considered as the conditioning index, and adrenocorticotropic hormone and corticosterone plasma levels were determined from trunk blood of animals sacrificed in different time points. Animals were weighed before and after the paradoxical sleep-deprivation period.Results: Acute metyrapone treatment impaired memory in control animals and did not prevent paradoxical sleep deprivation-induced memory impairment. Likewise, in the chronic treatment, paradoxical sleep-deprived animals did not differ from control rats in their corticosterone or adrenocorticotropic hormone response to training, but still did not learn as well, and did not show any stress responses to the testing. Chronic metyrapone was, however, effective in preventing the weight loss typically observed in paradoxical sleep-deprived animals.Conclusions: Our results suggest that glucocorticoids do not mediate memory impairments but might be responsible for the weight loss induced by paradoxical sleep deprivation.
- ItemSomente MetadadadosX-PERT: weight reduction with orlistat in obese subjects receiving a mildly or moderately reduced-energy diet. Early response to treatment predicts weight maintenance(Blackwell Publishing, 2005-11-01) Toplak, H.; Ziegler, O.; Keller, U.; Hamann, A.; Godin, C.; Wittert, G.; Zanella, M. T.; Zuniga-Guajardo, S.; Van Gaal, L.; Med Univ; CHU Nancy; Univ Basel Hosp; Univ Heidelberg Hosp; CHU Sherbrooke; Univ Adelaide; Universidade Federal de São Paulo (UNIFESP); Clin Cuauhtemoc & Famosa; Fac Med; Univ Hosp; Univ AntwerpAim: To determine the effect of two different levels of energy deficit on weight loss in obese patients treated with orlistat.Methods: Patients (n = 430) were randomized in a 1-year, multicentre, open-label, parallel group study conducted at 23 hospital centres and university medical departments worldwide. Obese outpatients (body mass index 30-43 kg/m(2)) aged 18-70 years with a body weight of >= 90 kg and a waist circumference of >= 88 cm (women) or >= 102 cm (men) were treated with orlistat 120 mg three times daily plus a diet that provided an energy deficit of either 500 or 1000 kcal/day for 1 year. Orlistat treatment was discontinued in patients who did not achieve >= 5% weight loss after assessment at 3 and 6 months. the primary outcome measure was change in body weight from baseline at week 52.Results: Reported mean difference in energy intake between the two groups (500-1000 kcal/day deficit) at weeks 24 and 52 was actually 111 and 95 kcal/day respectively. of the 430 patients involved in the study, 295 achieved >= 5% weight loss at both 3 and 6 months. in this population, at week 52, weight loss from baseline was similar for patients randomized to either the 500 or the 1000 kcal/day deficit diet (-11.4 kg vs. -11.8 kg, respectively; p = 0.778). After 12 months of treatment with orlistat, 84% (n = 118/141) and 85% (n = 131/154) of patients in the 500 and 1000 kcal/day deficit groups, respectively, achieved >= 5% weight loss, and 50% (n = 70/141) and 53% (n = 82/154) of patients, respectively, achieved >= 10% weight loss. Patients in both the diet treatment groups showed similar significant improvements in blood pressure, lipid levels and waist circumference at week 52.Conclusions: Treatment with orlistat was associated with a clinically beneficial weight loss, irrespective of the prescribed dietary energy restriction (-500 or -1000 kcal/day). Patients who achieved >= 5% weight loss at 3 months achieved long-term, clinically beneficial weight loss with orlistat plus either diet. Therefore, identifying patients who lose at least 5% weight after 3 months and who maintain this weight loss up to 6 months is a valuable treatment algorithm to select patients who will benefit most from orlistat treatment in combination with diet.