RCAAP Repository

ABSTRACT Objective: To compare the quality of life between patients with alcoholic chronic pancreatitis and controls, and between diabetic and non-diabetic patients, correlating clinical, sociodemographic, and nutritional factors with their quality of life scores. Methods: Forty-three outpatients of the pancreas and biliary tract clinic diagnosed with alcoholic chronic pancreatitis were assessed. Quality of life was measured by the Brazilian version of the Short Form-36. The control group consisted of 43 healthy companions. Nutritional status was classified according to body mass index and triceps, biceps, suprailiac, and subscapular skinfold thicknesses, using the appropriate methods. The percentage of body fat was given by adding the four skinfold thicknesses and by bioelectrical impedance analysis. The statistical tests included the Chi-square, Mann-Whitney, and Spearman's correlation tests, with the significance level set at p<0.05. Results: The sociodemographic variables of the case and control groups did not differ. Quality of life was lower in alcoholic chronic pancreatitis patients than in controls. The only quality of life domain that differed between diabetics and non-diabetics was functional capacity, lower in diabetics (p=0.022). Smoking duration, alcohol intake in grams, and time since pancreatic surgery correlated negatively with the quality of life of alcoholic chronic pancreatitis patients. Old age, skinfold thicknesses, and percentage of body fat correlated positively with quality of life. Conclusion: Quality of life is low in alcoholic chronic pancreatitis patients because of the negative influence of certain factors, such as smoking duration, amount of alcohol consumed, and time since pancreatic surgery.

ABSTRACT Objective: To evaluate the stages of behavior change related to fat and fruit/vegetable intakes and the factors associated with misperceived eating behavior (pseudo-maintenance). Methods: This cross-sectional study collected sociodemographic, socioeconomic, health, and food intake data from obese individuals (n=103) aged ≥20 years. Stages of behavior change according to the Transtheoretical Model were measured for fat and fruit/vegetable intakes. The pseudo-maintenance stage was reclassified in subjects in the action/maintenance stage who had inappropriate food habits. Multiple logistic regression models were proposed to assess the factors associated with misperceptions. Results: The prevalences of pseudo-maintenance for fat and fruit/vegetable intakes were 23.3 and 19.4%, respectively. The factors associated with misperceived fat intake were overconsumption of saturated fatty acids (OR=3.84; 1.18-12.56) and age (OR=1.06; 1.02-1.11), and with fruit and vegetable intake, income (OR=0.99; 0.98-0.99). Conclusion: The results reveal that perceived eating behavior and actual food intake diverge from anthropometric and health data, signaling the need of different intervention strategies to raise awareness in this group for the need of modifications.

ABSTRACT Objective: To investigate the association between various chronic diseases, multimorbidity, and handgrip strength in community dwelling older adults in Southern Brazil. Methods: A cross-sectional study carried out with 477 older adults (60 years and older) who resided in Antônio Carlos, Santa Catarina state. Subjects aged 60-79 years were selected by probability sampling (n=343) and all subjects aged 80 years or older (n=134) were evaluated. Chronic diseases were identified by self-report. A mechanical dynamometer verified handgrip strength (i.e., the outcome). Adjustments variables were age, literacy, living arrangement, smoking, body mass index, cognitive function, and comorbid chronic diseases. Sex-stratified analyses were conducted with simple and multiple linear regression. Results: A total of 270 women (73.2±8.8 years) and 207 men (73.3±9.0 years) were assessed. In the adjustment analysis, cancer (β=-3.69; 95%CI=-6.97 to -0.41) and depression (β=-1.65; 95%CI=-3.20 to -0.10) were associated with lower handgrip strength in women. For men, diabetes (β=-5.30; 95%CI=-9.64 to -0.95), chronic lung disease (β=-4.74; 95%CI=-7.98 to -1.50), and coronary heart disease (β=-3.07; 95%CI=-5.98 to -0.16) were associated with lower handgrip strength values. There was an inverse trend between number of diseases and handgrip strength for men only. Conclusion: The results showed an independent association between chronic diseases and handgrip strength. As such, handgrip strength is a valid measure to use for prevention or intervention in chronic disease and multimorbidity.

ABSTRACT Objective: To analyze the growth rate of premature infants in the first weeks of life and factors associated with extrauterine growth restriction. Methods: This is a cross-sectional study of 254 premature infants in a neonatal intensive care unit conducted from January 1, 2008 to December 31, 2010. Infants who died or had malformations incompatible with life were excluded. Median weight curves according to gestational age were constructed for the first four weeks of life. The Fenton growth chart calculations provided the weight Z-scores. Extrauterine growth restriction was defined as corrected weight-for-age Z-score ≤-2. Perinatal, morbidity, and health care variables were analyzed. The Poisson regression model yielded the prevalenceratios . Associations between extrauterine growth restriction and the perinatal, morbidity, and care variables were investigated. Poisson regression controlled possible confounding factors. Results: The frequency of extrauterine growth restriction was 24.0%. Most (85.0%) small-for-gestational-age infants developed extrauterine growth restriction; 55.3% of extrauterine growth restriction cases involved small-for-gestational-age infants. Premature infants with gestational age >32 weeks did not recover the median birth weight until the third week of life and had a higher frequency of small-for-gestational-age. The Z-scores of non-small-for-gestational-age infants decreased more after birth than those of small-for-gestational-age infants. extrauterine growth restriction was associated with small-for-gestational-age (PR=6.14; 95%CI=3.33-11.33;p <0.001) and time without enteral diet (PR=1.08; 95%CI=1.04-1.13; p =0.010). Conclusion: Extrauterine growth restriction occurs in premature infants of all gestational age. The participation of small-for-gestational-age and nutritional practices in its genesis is noteworthy. We suggest prospective studies of all premature infants. The implementation of best care practices, individualized for small-for-gestational-age infants, to improve nutrient supply can minimize the problem.

ABSTRACT Objective: To evaluate changes in food intake after adolescents attended a food and nutrition education program at a non-profit institution. Methods: Fifty-four adolescents aged 16 to 19 years, of low socioeconomic level, enrolled in an non-governmental organization in São Paulo, underwent a nutritional intervention of six months consisting of six meetings with dieticians, as well as strategic communication and relationship actions. Body weight, height, body mass index, questionnaire on knowledge on nutrition and feeding practices, 24-hour recall, and diet quality assessment using the Diet Quality Index associated with the Digital Food Guide were collected at baseline and after the intervention. Dietary pattern improvement was defined as an increase of at least 5 points in Diet Quality Index associated with the Digital Food Guide. Results: Understanding of food labels increased, and the dietary patterns on weekdays and weekends improved by 33 and 37%, respectively. The intake of legumes, milk, dairy products, fruits, and vegetables increased (adequacy components). However, intakes of nuts and whole grains were low, and intake of moderation components was high. Conclusion: The program improved the dietary patterns of adolescents, making it a viable and inexpensive method to prevent disease and improve health and quality of life. In addition, the Diet Quality Index associated with the Digital Food Guide has proven to be a good nutritional tool for assessing changes in food intake and for guiding future counseling and nutritional intervention actions for this population.

ABSTRACT Objective: To develop and evaluate the effectiveness of a nutrition education program to enable adolescents with type 1 diabetes to count carbohydrates without the parents' help. Methods: Nineteen adolescents with type 1 diabetes from a diabetes center participated in four fortnightly meetings of one hour, with lectures and discussions about healthy nutrition, importance of nutrients for blood glucose, portion sizes, food replacements, and carbohydrate counting therapy. All meetings ended with exercises to check the learning. Adolescents were followed for one year after the intervention. Results: All participants were 100% successful in all the steps of the program and started carbohydrate counting in the main meals. Nutritional status and total daily insulin doses before and after the study did not differ. After 12 months, 68% of the adolescents counted carbohydrates at all times, 16% did so in extra snacks, and 16% were suspended from the new therapy. Eighty percent of the parents were satisfied with the program, believing teenagers were trained in the new therapy. Conclusion: A short nutrition education program successfully trained adolescents to count carbohydrates without the parents' help.

RESUMO Objetivo: Investigar barreiras e fatores promotores do consumo de frutas e hortaliças entre usuários do Programa Academia da Saúde. Métodos: Estudo qualitativo conduzido em seis polos do Programa Academia da Saúde em Belo Horizonte, Minas Gerais. Foram realizadas entrevistas semiestruturadas com 62 usuários. A análise de conteúdo foi desenvolvida com auxílio dosoftware NVivo10. Resultados: As principais barreiras identificadas foram: comércio inadequado, baixo poder aquisitivo, preço, carência de iniciativas públicas, falta de tempo, preguiça, fruta ser considerada apenas uma alternativa alimentar e não realizar o jantar. Os fatores promotores mais citados foram: saúde, prevenção/controle de doenças, gostar, hortaliça ser considerada como parte da refeição, criação e origem familiar, melhoria da situação financeira, comércio próximo e estratégias de compra. Conclusão: É necessário ampliar o acesso às frutas e às hortaliças por meio do fortalecimento das iniciativas públicas para aumento da produção e diminuição dos preços desses alimentos e ampliação do comércio local. As intervenções educativas devem focar a construção de outros sentidos para o consumo que não se restrinjam ao discurso saúde-doença e soluções viáveis que facilitem o consumo de frutas e hortaliças no cotidiano, seja pela proposição de estratégias de aquisição de frutas e hortaliças ou pela ampliação de habilidades culinárias para preparações mais práticas.

RESUMEN Objetivo: Evaluar los menús ofertados en los colegios públicos, privados y concertados de la ciudad de Sevilla (España) para los diferentes grupos de edad escolar. Métodos: Se consideró un total de 86 colegios, incluyendo centros públicos, privados y concertados, representando a todos los distritos de la ciudad. Cuatro colegios disponían de cocina propia, mientras el resto tenían contratado un catering. Los menús iban dirigidos a escolares de entre 3 a 16 años. Se evaluó el grado de cumplimiento de las recomendaciones respecto a la frecuencia mensual de los distintos grupos de alimentos, repetición de recetas, variabilidad de técnicas culinarias y equilibrio nutricional. Para el tratamiento estadístico se utilizó el programa Statistica 7. Resultados: En la mayoría de comedores escolares la oferta de frutas, verduras y legumbres era deficitaria a diferencia de los postres lácteos, carnes y patatas. Se observaron diferencias significativas entre los tres tipos de colegio respecto a la frecuencia mensual de alimentos, siendo los públicos los que más se ajustaban a las recomendaciones. La mayoría de los comedores evaluados no aportaban menús suficientemente detallados así como se observó falta de variedad de técnicas culinarias. La energía no se ajustaba a las necesidades de todos los grupos de edad y la distribución de macronutrientes sólo era adecuada en el 50% de los menús. Conclusión: Aunque se ha observado una evolución favorable de los menús respecto a estudios anteriores hay que seguir trabajando en aumentar la oferta de frutas y verduras, disminuir el aporte de lípidos y proteínas, así como adaptar la energía de los menús a los diferentes grupos de edad.

RESUMO Objetivo: Avaliar a percepção dos gestores quanto à atenção nutricional ao pré-natal e ao puerpério na rede básica de município da Baixada Santista, São Paulo, segundo estrutura e processo. Métodos: Realizou-se censo das 28 unidades básicas da área insular por meio de entrevistas com gestores. Avaliou-se a atenção nutricional segundo infraestrutura, processo de trabalho e vigilância alimentar e nutricional. Resultados: A inserção do nutricionista foi o principal componente insuficiente da dimensão estrutura, interferindo negativamente na atenção nutricional para 60% dos gestores. Encontrou-se baixa conformidade para as seguintes variáveis da dimensão processo: cálculo do índice de massa corporal (35%), acompanhamento do estado nutricional na curva índice de massa corporal/semana gestacional (46%) e realização de aconselhamento nutricional individualizado no pré-natal (14%). Conclusão: A atenção nutricional pré-natal e puerperal é insatisfatória para alcançar a integralidade do cuidado. Faz-se necessário sensibilizar gestores locais e capacitar equipes de saúde para assegurar a efetividade de tais ações em Santos.

ABSTRACT Objective: To develop a natural dietary product with functional benefits for diabetic patients. Whey protein concentrate was obtained through the separation membrane processes and sweetened with rebaudioside A. This product was submitted to sensory testing in humans and used to evaluate possible functional properties in male Wistar rats models with diabetesMellitus induced by streptozotocin. Methods: Two concentrates were produced. Only the second showed protein content of 74.3 and 17.3% of lactose was used as supplementation in induced diabetic rats. This concentrate was obtained from the concentration by reverse osmosis system (180 k Daltons), followed by nanofiltration in a 500 k Daltons membrane and spray drying at 5.0% solution of the first concentrate developed. The concentrate was sweetened with rebaudioside A (rebaudioside A 26 mg/100 g concentrate). All procedures were performed at the Center for Studies in Natural Products, at the Universidade Estadual de Maringá. Three experimental groups were established (n=6): two groups of diabetic animals, one control group and one supplemented group; and a control group of normal mice (non-diabetic). The supplemented group received concentrates sweetened with rebaudioside A in a dose of 100 mg/kg bw/day by an esophageal tube for 35 days. Fasting, the fed state and body weight were assessed weekly for all groups. At the end of the supplementation period, the following were analyzed: plasma parameters of glucose, total cholesterol, triglycerides and fructosamine; the serum levels of aspartate aminotransferase and alanine aminotransferase, water and food intake. Organs and tissues were removed and weighed to assess mass and anatomical changes. Results: The product presented 74% of proteins and 17% of lactose and showed satisfactory sensory testing by the addition of 26 mg of rebaudioside A/100 g concentrate. Supplementation of the product reduced hyperglycemia, plasma fructosamine levels, triglycerides and total cholesterol, and improved body weight gain of streptozotocin-induced diabetic rats. Conclusion: Whey protein concentrate with substantial content of protein (above 70%) and low lactose was obtained through the membrane separation processes. The addition of rebaudioside A at the concentration of 26 mg/100 g rebaudioside A proved to be as sweet as sucralose with satisfactory sensory testing, which indicates that this is a non-caloric natural sweetener that can replace artificial sweeteners. The product (whey protein concentrate sweetened with rebaudioside A) presented important functional properties and reduced the metabolic disorders caused by the syndrome.

ABSTRACT Objective: To evaluate the profile of academic production of undergraduates in Nutrition courses in the state of Rio Grande do Norte, Brazil. Methods: The bibliometric study was conducted with undergraduate final research projects from five courses in Nutrition in the state of Rio Grande do Norte during 2013 and 2014. The following variables were collected: institution, title of project, number of authors, academic degree of the advisor, study design, area of study interest, type of study, study setting, submission to the ethics committee, and keywords. Pearson's Chi-square test was used to assess the variable area of study interest with a significance level at p≤0.05 and 95% confidence interval. Results: Of the 195 projects analyzed, 79.0% were developed at universities. We found a higher frequency of academic articles (68.2%) developed by a single student (65.6%), advised by a professor with a Masters degree (57.9%), with a cross-sectional study design (48.2%), and without submission to the research ethics committee (49.2%). The mean adequacy of keywords was 50.0%. Conclusion: The quantitative approach was the most predominant characteristic of the final research projects and the most frequently researched area of knowledge was public health. The methodological approaches of the research projects were considered weak, which suggests the need to improve the quality of scientific methodology during undergraduate studies, considering the important benefits derive from researches as an active methodology.

Objective : To evaluate sociodemographic inequalities in the diet quality of the urban population of the city of Campinas, São Paulo, Brazil. Methods: A population-based, cross-sectional study was performed using data from a health survey conducted in the city of Campinas in 2008-2009. Diet quality was evaluated using the Brazilian Healthy Eating Index Revised. A total of 3,382 individuals aged 10 years old and older were analyzed. Results : Brazilian Healthy Eating Index Revised scores increased with age and education level. Women consumed more vegetables, fruits, and milk, and less sodium, meat and eggs, oils, saturated and solid fats, alcohol, and added sugars than men. Scores for whole grains, vegetables, and fruits also increased with age and education level. Conclusion: These findings point to sociodemographic segments that are more vulnerable to an inappropriate diet and identify the need of strategies to increase the consumption of whole grains, dark green vegetables, fruits, and milk, and decrease the consumption of sodium, solid fats, alcohol, and added sugar.

Objective: This study assessed the validity of a Food Frequency Questionnaire used to assess food intake in adolescents in Salvador, Bahia, Brazil. Methods: Seventy adolescents enrolled in public schools aged 11 to 17 years participated in this study. The dietary intake of the adolescents was assessed using the Food Frequency Questionnaire and the mean value of three-day food record, used as the reference method. The mean (and standard deviation) energy and nutrient intakes estimated from the Food Frequency Questionnaire and food records were calculated. The paired Student's t test was used to determine differences between the data. Results: Pearson's correlation coefficient and Kappa statistics were used to measure the strength of the association between the two instruments. There was variation in the crude unadjusted (r=0.61-0.73) and deattenuated (r=0.33-0.99) Pearson correlation coefficients. After adjusting for energy, the crude and deattenuated coefficients ranged from r=0.53-0.81 and r=0.27-0.99, respectively. The intake of energy and most nutrients were found to be adequate, except for fiber (r=0.27) and calcium (r=0.33), which showed a weak correlation. Kappa statistics showed good correlation between all values varying from r=0.47 to 0.73. Conclusion: It is considered that an average r value greater than 0.40 indicates a good correlation, the results obtained indicate the good ability of the Food Frequency Questionnaire to assess individuals according to their usual intake of most nutrients.

Objective: To analyze whether psychosocial factors and physical activity are predictors of fruit and vegetable intake in young adults attending college. Methods: This cross-sectional study included a representative sample of students from a public university in the Brazilian Northeast (n=717). Fruit and vegetable intake was measured by a Food Frequency Questionnaire containing 21 items. The psychosocial factors for behavior change, measured by a questionnaire, were: behavior change strategy, self-efficacy, perceived barriers and facilitators in decision making, and social support. The level of physical activity was measured by the International Physical Activity Questionnaire. Multiple linear regression was the intake prediction model using a significance level of 5% (p<0.05). Results: The median fruit and vegetable intake was 2.0 servings/day. In adjusted analysis, behavior change strategy (R²=0.31), self-efficacy (R²=0.03), friends' support (R²=0.02), and physical activity (R²=0.03) explained 39% of the fruit and vegetable intake variance in men. Behavior change strategy (R²=0.03), self-efficacy (R²=0.13), perceived barriers (R²=0.08), and physical activity (R²=0.02) explained 26% of the fruit and vegetable intake variance in women. Fruit and vegetable intake would increase by one serving for every extra 35 and 47 minutes of physical activity men and women, respectively, practice a day. Conclusion: The main predictors of fruit and vegetable intake are behavior change strategies, self-efficacy, and physical activity.

Abstract This study investigated the correlations and the possible deficits in reading, phonemic awareness, and executive functions among students with developmental dyslexia. A total of 28 students participated in the study, between 9 and 11 years old, 14 with developmental dyslexia and 14 without reading difficulties. Specific instruments were used to assess reading, phonemic awareness, and executive functions. The Spearman test indicated moderate and very significant correlations between performance in tasks of phonemic awareness and reading (recognition and comprehension) and tasks that assessed cognitive functioning involving the following executive functions: cognitive flexibility, working memory, inhibitory control, and orthographic verbal fluency. No correlation was found between the reading and phonemic awareness assessments and the results of the planning done with the Tower of London instrument. The results allowed the researchers to hypothesize that an intervention planned for the development of phonemic awareness and executive functions may have an effect in improving the reading performance of dyslexics.

Abstract This study aimed to evaluate the association between student characteristics and recruitment strategies in the adherence of college students to a web-based alcohol intervention. Participants were 46,329 Brazilian students aged from 18 to 30, who consumed alcohol during the past three months. Three recruitment strategies were implemented: open invitations, and personally-addressed invitations with or without non-monetary incentives. We evaluated the educational, sociodemographic, motivational, and alcohol consumption effects on adherence using logistic regression models. Women (aOR = 1.09 [1.04; 1.14]), students with higher income (aOR = 1.32 [1.21; 1.45]), and more motivated students (aOR = 1.04 [1.03; 1.05]) were more adherent to the intervention, as well as those reporting binge drinking (aOR = 1.26 [1.19; 1.33]) and alcohol hazardous use (aOR = 1.11 [1.05; 1.18]). The use of incentives was the main factor associated with adherence (aOR = 3.69 [2.46; 5.55]). Our results may help the development of future web-based interventions related to alcohol use.

Abstract Specific psychological treatments for depressive disorders delivered on the Internet have shown effectiveness and presented advantages over face-to-face treatments (potentially less expensive, flexible schedules, available in remote areas). This paper aims to describe the characteristics of those who sought help from an online self-guided intervention for depression and to explore hypotheses about predictors of enrollment to the program. Based on a sample of 282 of individuals who filled in screening questionnaires, we verified that the respondents were mainly female, were on average 34.36 years old, were primarily recruited through Facebook, had been previously diagnosed by mental health professionals, presented moderate self-efficacy perception, and had moderately severe symptoms of depression. Respondents who reported comorbid conditions were more likely to attend enrollment interviews, and being in treatment or not did not influence attendance. Such characterization may provide strategies to reach more people and to optimize the design of interventions targeting help-seeking depressed individuals in Brazil.

Abstract The aim of the article was to analyze the purposes in life of young Brazilians. A total of 560 students, aged 15-19 years, from the five geopolitical regions of Brazil, answered an open questionnaire developed by the Stanford Center on Adolescence and adapted to the specificities of the research. The data were analyzed using the Theory of Organizing Models of Thinking, which enabled us to identify six models of purposes. Most young people expressed their life purposes as a natural course of life or as an idealized dream; most of them also presented a self-centered view of their purposes, focused on their own accomplishments. The results reveal an association between life purposes and identity of young Brazilians in the interaction with collective values, particularly regarding the overcoming of economic difficulties and financial achievements.

Abstract The aim of this study was to investigate the possible relations between sibling care level and the areas of interest in adolescents’ life purposes. Participants were 113 adolescents. The instruments were a record of socio-demographic data, the household tasks and Sibling Care Questionnaire, and a written testimony on life purpose. We identified 347 life projects, which were grouped into the following categories: career, family, possessions, happiness, and generosity. The results of the Pearson’s correlations indicated positive associations between sibling care and generosity and career. Thus, there is a tendency that adolescents who take care of their younger siblings have more life projects related to assisting the family of origin and to professional development. These results suggest that taking care of younger siblings may influence the areas of interest of adolescents’ life purposes.

Abstract Adolescents undergo major biopsychosocial changes and having a life purpose can be a protection for positive development. This study analyzed the life purpose of 18 adolescents (15-20 years old, with an average family income of R$ 1,625.00), holders of scholarship from a social program in a Science & Technology Center. They answered the Scale of Life Purpose for Adolescents Questionnaire and participated in a focus group about the impact of this program in their life project. The responses were reviewed using the Software Interface de R pour les Analyses Multidimensionnelles de Textes et de Questionnaires, and were organized in two corpora – Life Project and Social Program. Ten-year projects are based on the Material, Study/Work, and Positive Aspiration dimensions. Adolescents show a life purpose connected to their community that can be caused by the fact of being a participant in a social program, enabling better access to education and a closer contact with the community.