Evolução da ingestão alimentar e do estado nutricional de crianças após a interrupção da dieta isenta de leite de vaca por teste negativo de desencadeamento oral
Data
2021-09-10
Autores
Faria, Dayane Pêdra Batista de [UNIFESP]
Orientadores
Morais, Mauro Batista de [UNIFESP]
Tipo
Tese de doutorado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Objetivo: avaliar a evolução da ingestão alimentar e do estado nutricional de crianças
após a interrupção da dieta isenta de leite de vaca por teste negativo de
desencadeamento oral.
Método: estudo longitudinal, prospectivo, não controlado que incluiu 80 crianças com
idade inferior a 5 anos que apresentaram teste negativo de desencadeamento oral
aberto para leite de vaca. Ingestão alimentar e estado nutricional foram avaliados no
dia do teste e após 30 dias. Ingestão alimentar foi comparada com as Dietary
Reference Intakes (DRIs). Peso e estatura foram mensurados de acordo com as
normas da Organização Mundial da Saúde no dia do teste e após 30 dias.
Resultados: a média de idade dos pacientes foi 18,7±12,4 meses, sendo 58,7% do
sexo masculino (47/80). Após interrupção da dieta de exclusão as crianças
apresentaram aumento do consumo diário de energia (897,7 e 961,9 kcal; p<0,001),
proteínas (35,5, e 41,1 g; p<0,001), carboidratos (125,7 e 130,3 g; p=0,042), cálcio
dos alimentos (495,2 e 712,6 mg; p<0,001), cálcio dos alimentos e suplementos (516,2
e 722,9 mg; p<0,001), fósforo (463,1 e 680,5 mg; p<0,001) e vitamina D (7,6 e 8,8 mg;
p=0,006). A proporção de pacientes com ingestão adequada de cálcio (alimentos e
suplemento) segundo às DRIs aumentou de 50,0% para 66,3% (p=0,012). Os escores
Z (n=76) no dia do teste e 30 dias após, foram, respectivamente, para peso/idade: -
0,6 e -0,4 (p<0,001), estatura/idade: -1,1 e -0,8 (p<0,001) e peso-estatura: -0,1± 1,1 e
-0,1±1,0 (p=0,793). Os escores Z de peso- estatura e IMC-idade não apresentaram
variação estatisticamente significante.
Conclusão: a liberação das proteínas do leite de vaca na dieta promoveu aumento
da ingestão de energia, proteínas, carboidratos, cálcio, fósforo e vitamina D, além de
aumento nos escores Z de peso/idade e estatura/idade.
Objective: to evaluate the evolution of food intake and nutritional status of children after discontinuation of a cow's milk-free diet after a negative oral food challenge. Methods: longitudinal, prospective, uncontrolled study that included 80 children under 5 years of age had a negative open oral challenge test for cow's milk. Food intake and nutritional status were evaluated on the test day and after 30 days. Food intake was compared with Dietary Reference Intakes (DRIs). Weight and height were measured according to World Health Organization guidelines on the test day and after 30 days. Results: the mean age of patients was 18.7±12.4 months, with 58.7% male (47/80). After discontinuation of the elimination diet, the children showed daily consumption increase in energy (897.7 and 961.9 kcal; p<0.001), proteins (35.5, and 41.1 g; p<0.001), carbohydrates (125.7) and 130.3 g; p=0.042), calcium from foods (495.2 and 712.6 mg; p<0.001), calcium from foods and supplements (516.2 and 722.9 mg; p<0.001), phosphorus (463.1 and 680.5 mg; p<0.001) and vitamin D (7.6 and 8.8 mg; p=0.006). The proportion of patients with adequate calcium intake (food and supplement) according to DRIs increased from 50.0% to 66.3% (p=0.012). The Z scores (n=76) on the test day and 30 days after were, respectively, for weight-for-age: -0.6 and -0.4 (p<0.001), height-for-age: -1.1 and -0.8 (p<0.001) and weight-for-height: -0.1±1.1 and -0.1±1.0 (p=0.793). The Z scores for weight-height and BMI-age did not present a statistically significant variation. Conclusion: the release of cow's milk proteins in the diet promoted an increase in the intake of energy, proteins, carbohydrates, calcium, phosphorus, and vitamin D in addition to an increase in the Z-scores for weight-for-age and height-for-age.
Objective: to evaluate the evolution of food intake and nutritional status of children after discontinuation of a cow's milk-free diet after a negative oral food challenge. Methods: longitudinal, prospective, uncontrolled study that included 80 children under 5 years of age had a negative open oral challenge test for cow's milk. Food intake and nutritional status were evaluated on the test day and after 30 days. Food intake was compared with Dietary Reference Intakes (DRIs). Weight and height were measured according to World Health Organization guidelines on the test day and after 30 days. Results: the mean age of patients was 18.7±12.4 months, with 58.7% male (47/80). After discontinuation of the elimination diet, the children showed daily consumption increase in energy (897.7 and 961.9 kcal; p<0.001), proteins (35.5, and 41.1 g; p<0.001), carbohydrates (125.7) and 130.3 g; p=0.042), calcium from foods (495.2 and 712.6 mg; p<0.001), calcium from foods and supplements (516.2 and 722.9 mg; p<0.001), phosphorus (463.1 and 680.5 mg; p<0.001) and vitamin D (7.6 and 8.8 mg; p=0.006). The proportion of patients with adequate calcium intake (food and supplement) according to DRIs increased from 50.0% to 66.3% (p=0.012). The Z scores (n=76) on the test day and 30 days after were, respectively, for weight-for-age: -0.6 and -0.4 (p<0.001), height-for-age: -1.1 and -0.8 (p<0.001) and weight-for-height: -0.1±1.1 and -0.1±1.0 (p=0.793). The Z scores for weight-height and BMI-age did not present a statistically significant variation. Conclusion: the release of cow's milk proteins in the diet promoted an increase in the intake of energy, proteins, carbohydrates, calcium, phosphorus, and vitamin D in addition to an increase in the Z-scores for weight-for-age and height-for-age.
Descrição
Citação
FARIA, D. P. B. Evolução da ingestão alimentar e do estado nutricional de crianças após a interrupção da dieta isenta de leite de vaca por teste negativo de desencadeamento oral. São Paulo, 2021. 125 f. Tese (Doutorado em Nutrição) – Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, 2021.