A educação alimentar e nutricional como estratégia no tratamento dos transtornos alimentares / Food and nutrition education as a strategy in the treatment of eating disorders

Os transtornos alimentares são doenças de fundo psiquiátricos, que promovem danos relacionados a comportamentos alimentares, implicando em graves distorções na imagem corporal, as quais provocam severas alterações nos comportamentos alimentares como compulsão e/ou inanição, podendo levar à morte ou causar morbidades. Objetivou-se, com essa pesquisa, demonstrar a aplicação da Educação Alimentar e Nutricional como estratégia no tratamento nos Transtornos do Comportamento Alimentar. Trata-se de uma revisão bibliográfica de caráter exploratório e qualitativo, por meio da consulta nas bases de dados: Scielo, PubMed e Google Acadêmico, utilizando os descritores: Educação Alimentar e Nutricional e Transtornos Alimentares. Incluíram-se artigos entre os anos 1997 a 2018 que continham pelo menos um dos descritores selecionados, excluindo da pesquisa dissertações, teses, monografias, artigos em outros idiomas, exceto português e inglês, e estudos que não tratavam especificamente do tema. Totalizam-se 10 artigos utilizados. Teoricamente a pesquisa está embasada em: ALVARENGA(2017), LATTERZA(2004), GOUGLIN(2016), GREENWOOD; FONSECA(2016) e AMERICA PSYCHIATRIC ASSOCIATION(2006). Os resultados apontam no sentido de que, por se tratar de uma patologia que se destaca pelo seu caráter multifatorial, ao envolver causas genéticas, psicológicas, familiares, socioculturais, biológicas e nutricionais, o tratamento requer a atuação de equipe multiprofissional formada por médicos, psicólogos e, em especial, por nutricionistas, por envolver alterações profundas no consumo, padrões e comportamentos alimentares do paciente, bem como os estudos asseveram que a utilização de ferramentas como a Educação Alimentar e Nutricional e a Técnica do Comportamento-cognitivo demonstrou ser eficaz na reparação do estado de nutricional e da redução ou da cessação de comportamentos inadequados para a saúde, quando utilizadas em conjunto com outros tratamentos desenvolvidos por membros da equipe multidisciplinar, não sendo, portanto, eficaz para o tratamento quando utilizada de forma isolada. Como se observa, por se tratar de uma pesquisa que visa demonstrar o uso da ferramenta Educação Alimentar e Nutricional no tratamento dos transtornos alimentares, torna-se de extrema relevância para a comunidade acadêmica

Recurrent solid ameloblastoma of the maxillary sinus: A case report

Introduction. Ameloblastomas are clinically the most important type of odontogenic tumors. Solid or multicystic form most commonly affects mandible, it is highly aggressive and shows high rates of recurrence. The aim was to report aggressive behavior of a rare maxillary solid ameloblastoma, emphasizing the clinical, tomographic and histological aspects. Case Report. A young and asymptomatic patient, presenting a solid ameloblastoma initially located in the maxillary sinus with rapid spreading to the adjacent tissues, had early recurrence despite radical surgical approach. Conclusion. Multicystic or solid ameloblastoma has lower incidence in maxilla and extremely aggressive behavior, justifying careful follow-up of the patients

First determination of mineral composition of the leaf Chicory (Cichorium intybus L.) used in human nourishment in the Midwest of Brazil and comparasion with dietary reference intakes for children and adults

Introduction: Radicchio (Cichorium intybus L.) is a leaf chicory and is grown as a leaf vegetable which usually has white-veined red or purple leaves and it belongs to the Asteraceae family. In several countries is consumed mainly as salad, but no studies on their elemental composition  has been done, principally in Brazil. Objective: The aim of present work was to measure the macroelements (Na, K, Ca, Mg and P) and microelements (Cr, Cu, Fe, Mn, Mo, Zn, Al, Cd, Ni, Co and Si) in the leaf Chicory used as human nourishment in the Campo Grande, State of Mato Grosso do Sul, Brazil. Method: Chemical digests of samples were prepared using HNO3 and H2O2 and then placed in the microwave digestion system. After digestion, the concentrations of the elements in Leaf Chicory were determined by the technique of Inductively Coupled Plasma - Optical Emission Spectrometer (ICP–OES, Thermo Scientific - iCAP 6000 Series). Results obtained of the concentrations of leaf chicory were compared with the dietary reference intakes. Results: Detected concentration of macroelements in leaf Chicory decreases in the order: K > P > Ca > Mg > Na. As well as the concentration of microelements decreases in the order: Fe > Al > Si > Mn > Zn > Cu > Cr > Ni > Cd > Mo > Co. Leaf Chicory is excellent source of K, Ca, Mg, P, Cr, Cu, Fe, Mn, Mo and Zn for children and adults. On the other hand, leaf chicory is not considered a source of sodium for children and adults. Concentration of K, Cr, Fe, and Al are above the limit recommended limit by FAO/WHO (1984) and others countries. Conclusions: Leaf Chicory has macro and microelements in ample amount; it can be used as an important part of people's diets. Since it not exceed allowable limits set by WHO and FAO, RDA/AI and UL. Competent organs have not evaluated concentrations of elements as Al, Cd, Ni, Co and Si in order to establish a tolerable upper intake level or RDA/AI for human. The lack of studies of adverse effects following excess intake of a nutrient does not mean that adverse effects do not occur. Keywords: Leaf Chicory; Radicchio; Inductively Coupled Plasma Mass Spectrometry (ICP-OES)

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Catálogo Taxonômico da Fauna do Brasil: setting the baseline knowledge on the animal diversity in Brazil

The limited temporal completeness and taxonomic accuracy of species lists, made available in a traditional manner in scientific publications, has always represented a problem. These lists are invariably limited to a few taxonomic groups and do not represent up-to-date knowledge of all species and classifications. In this context, the Brazilian megadiverse fauna is no exception, and the Catálogo Taxonômico da Fauna do Brasil (CTFB) (http://fauna.jbrj.gov.br/), made public in 2015, represents a database on biodiversity anchored on a list of valid and expertly recognized scientific names of animals in Brazil. The CTFB is updated in near real time by a team of more than 800 specialists. By January 1, 2024, the CTFB compiled 133,691 nominal species, with 125,138 that were considered valid. Most of the valid species were arthropods (82.3%, with more than 102,000 species) and chordates (7.69%, with over 11,000 species). These taxa were followed by a cluster composed of Mollusca (3,567 species), Platyhelminthes (2,292 species), Annelida (1,833 species), and Nematoda (1,447 species). All remaining groups had less than 1,000 species reported in Brazil, with Cnidaria (831 species), Porifera (628 species), Rotifera (606 species), and Bryozoa (520 species) representing those with more than 500 species. Analysis of the CTFB database can facilitate and direct efforts towards the discovery of new species in Brazil, but it is also fundamental in providing the best available list of valid nominal species to users, including those in science, health, conservation efforts, and any initiative involving animals. The importance of the CTFB is evidenced by the elevated number of citations in the scientific literature in diverse areas of biology, law, anthropology, education, forensic science, and veterinary science, among others

Heterogeneous contributions of change in population distribution of body mass index to change in obesity and underweight NCD Risk Factor Collaboration (NCD-RisC)

From 1985 to 2016, the prevalence of underweight decreased, and that of obesity and severe obesity increased, in most regions, with significant variation in the magnitude of these changes across regions. We investigated how much change in mean body mass index (BMI) explains changes in the prevalence of underweight, obesity, and severe obesity in different regions using data from 2896 population-based studies with 187 million participants. Changes in the prevalence of underweight and total obesity, and to a lesser extent severe obesity, are largely driven by shifts in the distribution of BMI, with smaller contributions from changes in the shape of the distribution. In East and Southeast Asia and sub-Saharan Africa, the underweight tail of the BMI distribution was left behind as the distribution shifted. There is a need for policies that address all forms of malnutrition by making healthy foods accessible and affordable, while restricting unhealthy foods through fiscal and regulatory restrictions

O “peso” da insulina

INTRODUCTION: The decline of β cell function during type 2 diabetes mellitus natural course determines, in the majority of patients, the need of insulin therapy. A moderate weight gain is usual after insulin treatment begins, sometimes acting as a barrier to modification of the treatment regimen. Suggested risk factors for weight gain with insulin treatment (IT) are: higher HbA1c levels at baseline, low initial BMI and younger ages. OBJECTIVES: To measue the variation (Δ) of weight in a sample of diabetic outpatients when IT is started and the identification of factors related to weight gain change. MATERIAL AND METHODS: 50 patients that started treatment with insulin were retrospectively analysed. The Δ of weight and the Δ of HbA1c during the first year of IT was calculated related to sex, type of insulin administered, metformin concomitant intake, 3 levels of physical activity and number of daily meals. The correlation of the Δ of weight with the value of HbA1c, BMI and age was analyzed at the beginning of the IT. RESULTS: Of the analysed patients, 62% were male, the mean (±SD) age was 63.34±11.19 years, and the mean (±SD) initial BMI was 29.61±4.54 kg/m2. With the onset of IT, within a year, there was a statistically significant weight gain, (p<0.001), of 3.16±4.18 kg (mean±SD). There was also a decrease of HbA1c of -1.27±1.81% (mean±SD) (p<0.001). It wasn’t found any statistical relation between the Δ of weight and the Δ of HbA1c by sex, type of insulin (most prevalent insulin, glargine: 42%), metformin concomitant intake (32%), levels of physical activity (74% with no physical activity) or number of daily meals (most prevalent number, 5 meals/day: 34%). There was not significant correlation between the Δ of weight, baseline HbA1c or age of patients. Only the correlation between the Δ of weight and initial BMI was statistically significant (p=0.002) with an inverse relationship (r=-0.431). DISCUSSION: An inverse correlation between patients initial BMI and the Δ of weight was verified after the first year of insulin treatment, without detecting any significant correlation between the Δ of weight, baseline HbA1c or patients age. Therefore, patients with lower BMI’s offered to start insulin treatment, should be targeted for a more rigorous weight awareness and more intensive nutritional and exercise management plans.INTRODUÇÃO: O declínio da função das células β no decurso natural da diabetes tipo 2 determina, em grande parte dos doentes, a necessidade de insulinoterapia (IT). Um aumento moderado de peso é usual após o início do tratamento, actuando por vezes como barreira à modificação do regime terapêutico. Têm sido apontados como factores de risco para aumento ponderal com a IT os níveis de HbA1c mais elevados no início do tratamento, baixo IMC inicial, e idades mais precoces. OBJECTIVOS: Avaliar a variação (Δ) de peso de uma amostra de doentes da consulta de diabetologia com o início da IT e identificar factores associados com o aumento de peso. MATERIAL E MÉTODOS: Foram analisados retrospectivamente os processos de 50 doentes insulinotratados. Foram calculadas a Δ de peso e a Δ de HbA1c no primeiro ano de IT. Avaliou-se a Δ de peso e a Δ de HbA1c por sexo, tipo de insulina, toma concomitante de metformina, três níveis de actividade física e número de refeições diárias. Verificou-se a correlação da Δ de peso com o valor de HbA1c, IMC e idade no início da IT. RESULTADOS: Dos processos analisados, 62% foram do sexo masculino, a média (±DP) das idades foi 63.34±11.19 anos, e a média (±DP) do IMC inicial foi de 29.61±4.54 kg/m2. Com o início da IT, no período de um ano houve um aumento, estatisticamente significativo (p<0.001), em média (±DP) de peso de 3.16±4.18 kg. Houve também uma diminuição da HbA1c de -1.27±1.81 % com significado estatístico (p<0.001). Não foi encontrada qualquer significância estatística entre a Δ de peso e a Δ HbA1c por sexo, tipo de insulina (insulina mais prevalente, glargina: 42%), toma concomitante de metformina (32%), níveis de actividade física (74% sem actividade física) ou número de refeições diárias (nº mais prevalente, 5 ref./dia: 34%). Não houve correlação estatisticamente significativa entre a Δ de peso e a HbA1c inicial, assim como com a idade dos doentes. A correlação entre a Δ de peso e o IMC inicial mostrou-se estatisticamente significativa (p=0.002) no sentido inverso (r=-0.431). DISCUSSÃO: Nesta análise retrospectiva foi identificada uma correlação inversa entre o IMC inicial dos doentes e a Δ de peso verificada após o primeiro ano de IT, não se confirmando uma correlação significativa da Δ de peso com a HbA1c inicial ou a idade dos pacientes. Assim, os doentes de mais baixo IMC propostos para início de IT, deverão ser alvo de uma vigilância ponderal ainda mais rigorosa e de um plano nutricional e de exercício físico mais intensivo

O “peso” da insulina

INTRODUÇÃO: O declínio da função das células &#946; no decurso natural da diabetes tipo 2 determina, em grande parte dos doentes, a necessidade de insulinoterapia (IT). Um aumento moderado de peso é usual após o início do tratamento, actuando por vezes como barreira à modificação do regime terapêutico. Têm sido apontados como factores de risco para aumento ponderal com a IT os níveis de HbA1c mais elevados no início do tratamento, baixo IMC inicial, e idades mais precoces. OBJECTIVOS: Avaliar a variação (&#916;) de peso de uma amostra de doentes da consulta de diabetologia com o início da IT, e a identificação de factores associados com o aumento de peso. MATERIAL E MÉTODOS: Foram analisados retrospectivamente os processos de 50 doentes insulinotratados. Foram calculadas a &#916; de peso e a &#916; de HbA1c no primeiro ano de IT. Avaliou-se a &#916; de peso e a &#916; de HbA1c por sexo, tipo de insulina, três níveis de actividade física, e número de refeições diárias. Verificou-se a correlação da &#916; de peso com o valor de HbA1c, IMC e idade no início da IT. RESULTADOS: Dos processos analisados, 62% foram do sexo masculino, a média (±DP) das idades foi 63.34±11.19 anos, e a média (±DP) do IMC inicial foi de 29.61±4.54 kg/m2. Com o início da IT, no período de um ano houve um aumento, estatisticamente significativo (p<0.001), em média (±DP) de peso de 3.16±4.18 kg. Houve também uma diminuição da HbA1c de -1.27±1.81 % com significado estatístico (p<0.001). Não foi encontrada qualquer significância estatística entre a &#916; de peso e a &#916; HbA1c por sexo, tipo de insulina (insulina mais prevalente, glargina: 42%), níveis de actividade física (74% sem actividade física), ou número de refeições diárias (nº mais prevalente, 5 ref./dia: 34%). Não houve correlação estatisticamente significativa entre a &#916; de peso e a HbA1c inicial, assim como com a idade dos doentes. A correlação entre a &#916; de peso e o IMC inicial mostrou-se estatisticamente significativa (p=0.005) no sentido inverso (r = -0.392). DISCUSSÃO: O ganho ponderal, a par dos episódios de hipoglicémia, é o efeito secundário mais significativo da IT. Assim, a identificação de factores de risco associados ao aumento de peso, nos doentes que iniciam insulina, poderá trazer benefícios no controlo da doença ao pôr em evidência os indivíduos que irão necessitar de vigilância ponderal ainda mais rigorosa e de um plano nutricional e de exercício físico mais intensivo

Radiographic study of patients with ectodermal dysplasia and partial

Aim: To investigate the association between gender and type of cleft with hypodontia and to verify if the presence of the cleft interferes with hypodontia of one or more type of teeth in patients with ectodermal dysplasia attending the Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of Sγo Paulo (USP). Materials and Methods: Panoramic radiographs of 54 patients of both genders (29 males, 25 females), from the files of the oral radiology sector of HRCA/USP, presenting with ectodermal dysplasia and cleft lip and/or palate were evaluated by radiographic observation of hypodontia of one or more types of teeth. Statistical Analysis: We performed descriptive statistics and statistical analysis by Fisher test. Results: Hypodontia was observed in 50% of females and 50.88% of males; 50% for cleft palate and 50.59% for complete cleft lip and palate. Only 22.22% of patients with cleft palate and 6.67% with complete cleft lip and palate presented with hypodontia of one type of teeth, whereas 77.78% of cases with cleft palate and 93.33% with complete cleft lip and palate displayed hypodontia of more than one type of teeth. Conclusion: Based on the present methodology, there were no statistically significant differences in hypodontia of one or more types of teeth between genders or types of cleft