Avaliação e adequação de receitas com restrição proteica, postadas em redes sociais para pacientes com erros inatos do metabolismo
Data
2022
Autores
Frangipani, Beatriz Jurkiewicz [UNIFESP]
Orientadores
Oliveira, Fernanda Luisa Ceragioli [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Os Erros Inatos do Metabolismo (EIM) causam as doenças metabólicas hereditárias (DMH) que resultam da falta de atividade de uma ou mais enzima ou defeito no transporte de proteínas. As doenças de interesse neste estudo são as aminoacidopatias, acidúrias orgânicas e defeitos do ciclo da ureia, cuja terapêutica principal é o tratamento nutricional por meio de dieta restrita em proteínas. O tratamento consiste em implementar uma dieta hipoproteica de forma a controlar o acúmulo de metabólitos tóxicos. Faz parte da dietoterapia a suplementação com fórmula de aminoácidos, alimentos especiais com baixo teor de proteína e controle quantitativo de frutas, vegetais, outros alimentos naturais, alimentos manufaturados e preparações/receitas com baixa proteína. Os objetivos deste estudo foi avaliar e adequar receitas com restrição proteica divulgadas nas redes sociais (Facebook e Instagram de todo o Brasil) para pacientes com Erros Inatos do Metabolismo e caracterizar por meio de questionário o perfil do paciente ou familiar que divulga receitas hipoproteicas nas redes sociais. Dos participantes da pesquisa 53% tinham diagnóstico de fenilcetonúria. Entre todos os participantes da amostra, 51% eram procedentes da região sudeste do país. Em relação as receitas hipoproteicas postadas nas redes sociais todos os participantes (100%) concordaram com a importância de apresentarem composição nutricional. Obtivemos 65 receitas enviadas pelos participantes e 95 captadas nas redes sociais com autorização prévia, totalizando 160 receitas. Destas, foram excluídas 48 por complexidade de reprodução. Foram testadas 112 preparações e 14 excluídas por não conterem características organolépticas (apresentação visual/ textura/sabor) adequadas. Todas foram analisadas quantitativamente e 1 excluída por conter valor de proteína mais elevado comparada as demais receitas, assim, restaram 97 receitas para compor o ebook. Todas as receitas que farão parte do ebook (97) foram analisadas quanto a composição de macronutrientes e aminoácidos específicos (leucina, fenilalanina, tirosina e metionina), que foram apresentadas como média (DP), mediana (IQ25,75) e variação mínima e máxima. Apenas 16% das preparações apresentaram valor de proteína ≤ 0,5g/100g e poderiam ser consumidas sem controle quantitativo como parte do tratamento dietético dos erros inatos do metabolismo proteico. As receitas foram categorizadas por grupos de similaridade de preparação e ingredientes. Os grupos que apresentaram menor valor de proteína e aminoácidos foram “bebidas e cremes” (7) e “biscoitos e bolachas” (10) e o grupo com maior teor proteína com 34 receitas foram “pratos principais e vegetais”. As receitas aprovadas quanto às características organolépticas serão disponibilizadas em forma de ebook para pacientes, que realizam dieta com restrição de proteína. Assim, os resultados deste estudo poderão contribuir para maior precisão no cálculo da dieta, de acordo com as necessidades individuais e, portanto, melhor controle dietético e prevenção dos possíveis riscos de descompensação metabólica nestes pacientes com erro inato do metabolismo proteico.
Inborn Errors of Metabolism (IEM) cause the inherited metabolic diseases (IMD) that result from the lack of activity of one or more enzymes or defect in protein transport. The diseases of interest in this study are aminoacidopathies, organic aciduria, and urea cycle defects, the main therapy for which is nutritional treatment by means of a protein-restricted diet. The treatment consists of implementing a low-protein diet to control the accumulation of toxic metabolites. Supplementation with specific amino acid mixture, special low protein foods, and quantitative control of fruits, vegetables, other natural foods, manufactured foods, and low protein preparations/recipes are part of the diet therapy. The objectives of this study were to evaluate and adapt recipes with protein restriction disseminated on social networks (Facebook and Instagram from all over Brazil) for patients with Inborn Errors of Metabolism and to characterize by means of a questionnaire the profile of the patient or family member who disseminates hypoprotein recipes on social networks. Of the research participants, 53% were diagnosed with phenylketonuria. Among all participants in the sample, 51% were from the southeastern region of the country. Regarding the hypoprotein recipes posted on social networks, all participants (100%) agreed with the importance of having a nutritional composition. We obtained 65 recipes sent by the participants and 95 captured on social networks with prior authorization, totaling 160 recipes. Of these, 48 were excluded for complexity of reproduction. We tested 112 preparations and 14 were excluded for not having adequate organoleptic characteristics (visual presentation/texture/taste). All were analyzed quantitatively and 1 was excluded for containing higher protein value compared to the other recipes, thus, 97 recipes remained to compose the ebook. All recipes that will be part of the ebook (97) were analyzed for the composition of macronutrients and specific amino acids (leucine, phenylalanine, tyrosine, and methionine), which were presented as mean (SD), median (IQ25.75) and minimum and maximum variation. Only 16% of the preparations had a protein value ≤ 0.5g/100g and could be consumed without quantitative control as part of the dietary treatment of inborn errors of protein metabolism. The recipes were categorized by preparation and ingredient similarity groups. The groups with the lowest protein and amino acid values were "drinks and creams" (7) and "cookies and crackers" (10) and the group with the highest protein content with 34 recipes were "main dishes and vegetables". The recipes approved for organoleptic characteristics will be made available as an ebook for patients on a protein-restricted diet. Thus, the results of this study may contribute to greater accuracy in calculating the diet according to individual needs and, therefore, better dietary control and prevention of possible risks of metabolic decompensation in patients with inborn error of protein metabolism.
Inborn Errors of Metabolism (IEM) cause the inherited metabolic diseases (IMD) that result from the lack of activity of one or more enzymes or defect in protein transport. The diseases of interest in this study are aminoacidopathies, organic aciduria, and urea cycle defects, the main therapy for which is nutritional treatment by means of a protein-restricted diet. The treatment consists of implementing a low-protein diet to control the accumulation of toxic metabolites. Supplementation with specific amino acid mixture, special low protein foods, and quantitative control of fruits, vegetables, other natural foods, manufactured foods, and low protein preparations/recipes are part of the diet therapy. The objectives of this study were to evaluate and adapt recipes with protein restriction disseminated on social networks (Facebook and Instagram from all over Brazil) for patients with Inborn Errors of Metabolism and to characterize by means of a questionnaire the profile of the patient or family member who disseminates hypoprotein recipes on social networks. Of the research participants, 53% were diagnosed with phenylketonuria. Among all participants in the sample, 51% were from the southeastern region of the country. Regarding the hypoprotein recipes posted on social networks, all participants (100%) agreed with the importance of having a nutritional composition. We obtained 65 recipes sent by the participants and 95 captured on social networks with prior authorization, totaling 160 recipes. Of these, 48 were excluded for complexity of reproduction. We tested 112 preparations and 14 were excluded for not having adequate organoleptic characteristics (visual presentation/texture/taste). All were analyzed quantitatively and 1 was excluded for containing higher protein value compared to the other recipes, thus, 97 recipes remained to compose the ebook. All recipes that will be part of the ebook (97) were analyzed for the composition of macronutrients and specific amino acids (leucine, phenylalanine, tyrosine, and methionine), which were presented as mean (SD), median (IQ25.75) and minimum and maximum variation. Only 16% of the preparations had a protein value ≤ 0.5g/100g and could be consumed without quantitative control as part of the dietary treatment of inborn errors of protein metabolism. The recipes were categorized by preparation and ingredient similarity groups. The groups with the lowest protein and amino acid values were "drinks and creams" (7) and "cookies and crackers" (10) and the group with the highest protein content with 34 recipes were "main dishes and vegetables". The recipes approved for organoleptic characteristics will be made available as an ebook for patients on a protein-restricted diet. Thus, the results of this study may contribute to greater accuracy in calculating the diet according to individual needs and, therefore, better dietary control and prevention of possible risks of metabolic decompensation in patients with inborn error of protein metabolism.