Perfil nutricional e consumo alimentar de alcoolistas em uma unidade de internação em adição

O uso de substâncias psicoativas (SPA), especialmente o álcool, pode acarretar diversas modificações na vida do indivíduo, como familiares, psicológicas, sociais e, também, relacionadas ao estado nutricional. Perda de peso pode estar presente no momento de uso ativo da SPA, já o ganho rápido de peso pode ser observado durante internação para tratamento do transtorno por uso de substâncias (TUS). Este trabalho teve o objetivo de verificar o estado nutricional dos pacientes usuários de álcool no momento da baixa hospitalar e após 15 dias de internação. Buscou-se conhecer os hábitos alimentares dos usuários, padrão de consumo de álcool e os psicofármacos utilizados durante o período de internação. Trata-se de um estudo longitudinal, quantitativo, com coleta de dados na baixa hospitalar e após 15 dias de internação. Foram realizadas medidas antropométricas e análise da composição corporal na baixa hospitalar a após 15 dias de internação, bem como foi aplicado questionário de frequência alimentar em até dois dias após a baixa para verificar hábitos alimentares prévios. Participaram do estudo 26 usuários de álcool com média de idade de 49,3 ± 7,3 anos. Observou-se uma diferença estatisticamente significativa no índice de massa corporal (IMC) e circunferência da cintura (CC) inicial e final da amostra (P<0,05). A avaliação corporal dos pacientes por bioimpedância elétrica demonstrou um aumento significativo de massa magra e água corporal total. Foi possível notar que 30,7% da amostra fez uso de algum tipo de antidepressivo, mas os antipsicóticos foram os mais utilizados pelos indivíduos (51,1%). Dentre as características do consumo de álcool, notou-se que o tipo de bebida alcoólica mais consumida foi a cachaça (84,6%), a frequência do consumo mais relatada foi diária (92,3%) e o padrão de ingestão mais referido foi de 1000 ml. Em relação à frequência alimentar, notou-se consumo elevado de carboidratos simples. Porém, identificou-se um consumo não habitual de fontes proteicas, sendo a frequência diária consumida pela população estudada de: leite (46,2%), queijo (30,8%), ovos (19,2) e carnes (7,6%). Alto consumo de embutidos foi observado (50% dos indivíduos consumiam, pelo menos, cinco vezes na semana). O consumo de óleos (especialmente margarina) foi elevado, 73,1% da amostra consumiam diariamente. Observou-se um consumo diário abaixo do esperado de hortaliças (30,7%) e de frutas (42,3%) pelos participantes. O consumo de café e de suco artificial foi diário, em torno de 54% da amostra. No período de internação dos usuários de álcool, o acompanhamento e orientação nutricional são fundamentais para evitar possíveis complicações causadas pelas mudanças no estado nutricional, como observado no trabalho. Portanto, a nutrição é fundamental no processo de recuperação e tratamento de usuários de álcool, contribuindo para a promoção da saúde e bem estar dos indivíduos.The use of psychoactive substances (SPA), especially alcohol, can cause several changes in the individual's life, such as family, psychological, social and also related to nutritional status. Weight loss may be present at the time of active use of SPA, while rapid weight gain may be observed during hospitalization for treatment of substance use disorder (TUS). This study aimed to verify the nutritional status of alcohol users at the time of hospital discharge and after 15 days of hospitalization. We sought to know the eating habits of users, the pattern of alcohol consumption and the psychotropic drugs used during the hospitalization period. This is a longitudinal, quantitative study, with data collection at hospital discharge and after 15 days of hospitalization. Anthropometric measurements and body composition analysis were performed at hospital discharge after 15 days of hospitalization, and a food frequency questionnaire was applied within two days after discharge to verify previous eating habits. Twenty-six alcohol users with a mean age of 49.3 ± 7.3 years participated in the study. A statistically significant difference was observed in the initial and final sample body mass index (BMI) and waist circumference (WC) (P <0.05). Body assessment of patients by electrical bioimpedance showed a significant increase in lean body mass and total body water. It was noted that 30.7% of the sample used some type of antidepressant, but antipsychotics were the most used by individuals (51.1%). Among the characteristics of alcohol consumption, it was noted that the most consumed type of alcohol was cachaça (84.6%), the frequency of most reported consumption was daily (92.3%) and the most reported drinking pattern was 1000 ml. Regarding eating frequency, it was noted high consumption of simple carbohydrates. However, an unusual consumption of protein sources was identified, and the daily frequency consumed by the studied population of: milk (46.2%), cheese (30.8%), eggs (19.2) and meat (7, 6%). High consumption of sausages was observed (50% of individuals consumed at least five times a week). The consumption of oils (especially margarine) was high, 73.1% of the sample consumed daily. There was a lower than expected daily consumption of vegetables (30.7%) and fruits (42.3%) by the participants. Coffee and artificial juice consumption was daily, around 54% of the sample. During the period of hospitalization of alcohol users, nutritional monitoring and guidance are essential to avoid possible complications caused by changes in nutritional status, as observed in the study. Therefore, nutrition is fundamental in the process of recovery and treatment of alcohol users, contributing to the health and well-being of individuals

Eating habits and nutritional status of alcohol users admitted to a hospital unit / Hábitos alimentares e estado nutricional de alcoolistas internados em uma unidade hospitalar

Aims: To verify eating habits prior to hospitalization and the nutritional status of alcoholic patients during the period of abstinenceMethods: This is a longitudinal, quantitative study, with data collection at hospitalization and 15 days after the first evaluation. Anthropometric measures were taken and a food frequency questionnaire was applied to assess eating habits prior to hospitalization.Results: Twenty-six alcoholics participated in the study, aged 49.3 ± 7.3 years. At hospitalization, 65% of individuals were overweight or obese and, after treatment, had significantly increased weight (2.7 ± 2.1 kg; P&lt;0.001), body mass index and waist circumference (P&lt;0.05). Regarding the food frequency data, high consumption of simple carbohydrates and low protein were identified, with the following frequency of daily consumption: milk (23.1% of patients), cheese (15.4%), eggs (19.2) and meat (7.6%). Half of the individuals consumed sausages almost daily. The daily consumption of vegetables (30.7%) and fruits (42.3%) were below recommendations.Conclusions: The significant increase in weight, body mass index and waist circumference after treatment and the inadequate eating habits, when compared to recommendations, demonstrated a necessity for interventions in these patients’ lifestyle in order to avoid the development of chronic non-communicable diseases. 

Hábitos alimentares e estado nutricional de alcoolistas internados em uma unidade hospitalar

Aims: To verify eating habits prior to hospitalization and the nutritional status of alcoholic patients during the period of abstinence Methods: This is a longitudinal, quantitative study, with data collection at hospitalization and 15 days after the first evaluation. Anthropometric measures were taken and a food frequency questionnaire was applied to assess eating habits prior to hospitalization. Results: Twenty-six alcoholics participated in the study, aged 49.3 ± 7.3 years. At hospitalization, 65% of individuals were overweight or obese and, after treatment, had significantly increased weight (2.7 ± 2.1 kg; P<0.001), body mass index and waist circumference (P<0.05). Regarding the food frequency data, high consumption of simple carbohydrates and low protein were identified, with the following frequency of daily consumption: milk (23.1% of patients), cheese (15.4%), eggs (19.2) and meat (7.6%). Half of the individuals consumed sausages almost daily. The daily consumption of vegetables (30.7%) and fruits (42.3%) were below recommendations. Conclusions: The significant increase in weight, body mass index and waist circumference after treatment and the inadequate eating habits, when compared to recommendations, demonstrated a necessity for interventions in these patients’ lifestyle in order to avoid the development of chronic non-communicable diseases.Objetivos: Verificar os hábitos alimentares anteriores à internação hospitalar e o estado nutricional de pacientes alcoolistas durante o período de abstinência. Metodos: Estudo longitudinal, quantitativo, com coleta de dados na internação e 15 dias após a primeira avaliação. Foram realizadas medidas antropométricas e aplicado questionário de frequência alimentar para avaliar hábitos alimentares anteriores à internação. Resultados: Participaram do estudo 26 alcoolistas, com idade de 49,3 ± 7,3 anos. Na internação, 65% dos indivíduos apresentavam sobrepeso ou obesidade e, após o tratamento, apresentaram aumento significativo de peso (2,7 ± 2,1 kg; P <0,001), índice de massa corporal e circunferência abdominal (P<0,05). Em relação aos dados de frequência alimentar, identificou-se alto consumo de carboidratos simples e baixo teor de proteína, com a seguinte frequência de consumo diário: leite (23,1% dos pacientes), queijo (15,4%), ovos (19,2) e carnes (7,6%). Metade dos indivíduos consumia embutidos quase diariamente. O consumo diário de hortaliças (30,7%) e frutas (42,3%) foi abaixo do recomendado. Conclusões: O aumento significativo do peso corporal, índice de massa corporal e circunferência da cintura após o tratamento e os hábitos alimentares inadequados, quando comparados às recomendações, demonstraram a necessidade de intervenções no estilo de vida desses pacientes, a fim de evitar o desenvolvimento de doenças crônicas não transmissíveis

Association of Subjective Global Assessment and adductor pollicis muscle thickness with the Sarcopenia in older patients with type 2 diabetes

Background and Aim: Sarcopenia is prevalent in older patients and increases the risk for negative outcomes during hospitalization and after hospital discharge. In patients with type 2 diabetes (T2D) this association may be even worse. Upon hospital admission, it is often difficult to identify sarcopenia, so the objective of this study was to assess whether the subjective global assessment (SGA), the European Society for Clinical Nutrition and Metabolism (ESPEN) and Global Leadership Initiative on Malnutrition (GLIM) criteria and/or usual anthropometric measures can predict sarcopenia. A secondary objective, to evaluate the accuracy of variables in the prediction of sarcopenia. Methodology: Patients 60 years old and with T2D were included. Malnutrition was evaluated in accordance with the guidelines of ESPEN and GLIM, and SGA. Anthropometric measurements were performed by Mid-arm circumference (MAC), mid-upper arm muscle circumference (MUAMC), and adductor pollicis muscle thickness (APMT) was performed. The sarcopenia was evaluated by handgrip strength, timed Up and Go (TUG) test and muscle mass by measuring the calf circumference (CC). Logistic regression was performed to assess the association of variables with Sarcopenia. Results: A total of 311 patients were included. The prevalence of malnutrition in accordance to ESPEN, GLIM and SGA was 18 (5.8%), 65 (21%) and 15 (4%), respectively. The MAC and MUAMC showed a negative relationship with sarcopenia (HR: 0.92 CI95% 0.85-0.99). However, patients with overweight had a 66% reduction in the risk of sarcopenia (HR: 0.34 CI95% 0.19-0.59). After adjustments, malnourished patients according to the SGA had a risk of HR: 5.65 (CI95% 1.64-19.38) of sarcopenia, similarly to patients with APMT <5 th HR: 2.81 (CI95% 1.53-5.13), ESPEN and GLIM criteria presented HR:3.10 (CI95%1.12-8.22) and HR:2.94 (CI95%1.64-5.27), respectively. The interaction between SGA and APMT after adjusting the model has been significant (HR: 7.23 CI95% 2.98-17.67). In the area under the curve (ROC), only SGA and APMT showed greater accuracy in the prediction of sarcopenia (AUC: 0.713 CI95% 0.650-0.803). Conclusion: In our sample, it was possible to predict sarcopenia through the malnutrition criteria of ESPEN and GLIM, SGA, MAC and APMT. Measures such as APMT associated with the SGA tool seem to better predict sarcopenia in older patients with T2D

O impacto da abstinência nos níveis séricos de leptina e no perfil nutricional de alcoolistas

Introduction: Alcohol use disorder (AUD) is associated with changes in metabolism and in the nutritional profile. Food-seeking behaviors and psychoactive substances share common biological pathways that activate the reward system and leptin is a modulator of this system. Objective: To measure serum leptin levels and nutritional status of individuals with before their detoxification and then 15 days later. Material and Methods: In total, 38 men diagnosed with AUD and admitted to a detoxification unit were analyzed. Serum leptin levels, Body Mass Index (BMI), Waist Circumference (WC) and body composition were assessed by Bioelectrical Impedance Analysis (BIA) within the first 48 hours of hospital admission and again 15 days after the first assessment. Results: Weight, BMI and WC increased significantly during detoxing (p<0.001), but body fat and leptin levels percentages remained similar. At admission, leptin levels were positively correlated with body fat (0.607), WC (0.696), and BMI (0.357). After 15 days, only leptin and BMI were significantly correlated (0.462). Conclusion: Our results reinforce the relationship between leptin and nutritional parameters related to body weight. It is essential to educate about nutrition and to encourage healthy eating behaviors so individuals with AUD can reduce weight gain during the recovery period.Introdução: O transtorno por uso de álcool (TUA) está associado a alterações metabólicas e perfil nutricional. Comportamento de busca de alimentos e substâncias psicoativas compartilham vias biológicas comuns ativando o sistema de recompensa e a leptina modula esse sistema. Objetivo: Avaliar níveis séricos de leptina e estado nutricional de indivíduos antes e 15 dias após a desintoxicação. Materiais e Métodos: Foram analisados 38 homens com diagnóstico de TUA internados em unidade de desintoxicação. Níveis séricos de leptina, Índice de Massa Corporal (IMC), Circunferência da Cintura (CC) e composição corporal foram avaliados por Bioimpedância Elétrica (BIA) nas primeiras 48 horas de internação e 15 dias após a primeira avaliação. Resultados: Peso, IMC e CC aumentaram significativamente durante a desintoxicação (p<0,001), mas os percentuais de gordura corporal e níveis de leptina permaneceram semelhantes. Na admissão, os níveis de leptina foram positivamente correlacionados com a gordura corporal (0,607), CC (0,696) e IMC (0,357). Após 15 dias, apenas leptina e IMC foram significativamente correlacionados (0,462). Conclusão: Os resultados reforçam a relação entre leptina e parâmetros nutricionais relacionados ao peso corporal. A educação nutricional e o incentivo ao comportamento alimentar saudável são essenciais para que indivíduos com TUA reduzam o ganho de peso na desintoxicação