Adherence to a nutritional counseling program for adults with excess weight and comorbidities

Objetivo: Investigar adesão a programa de aconselhamento nutricional em grupo para indivíduos com excesso de peso e comorbidades. Métodos: Estudo analítico de intervenção controlada e aberta. Oitenta adultos, de ambos os sexos, com índice de massa corporal entre 25 e 35kg/m², portadores de dois ou mais fatores de risco cardiovascular associados foram alocados aleatoriamente em dois grupos para acompanhamento por três meses. O grupo de intervenção com aconselhamento nutricional em grupo recebeu atendimento individual e participou de seis reuniões grupais para discussão sobre alimentação saudável e atividade física, com dinâmicas e método participativo. O grupo-controle, com atendimento padrão individual, foi assistido em três consultas ambulatoriais. Consideraram-se repercussões dietéticas antes e após a intervenção e assiduidade às reuniões como parâmetros de adesão ao tratamento. Resultados: Trinta e três participantes concluíram o estudo. Do total inicial, 45,8% e 40,7% do grupo de intervenção com aconselhamento nutricional em grupo e do grupo-controle com atendimento padrão individual, respectivamente, atingiram nível ótimo de assiduidade. Os fatores mais citados como barreiras à adesão ao tratamento foram fazer refeições fora de casa (46,7% - grupo-controle com atendimento padrão individual) e dificuldade em aplicar os conhecimentos na prática, principalmente em eventos sociais (33,3% - grupo de intervenção com aconselhamento nutricional em grupo). Verificou-se aumento significativo do percentual médio do uso de temperos naturais e do número de refeições ao dia nos dois grupos após a intervenção. Porém, não houve diminuição significativa do consumo energético intra ou entre os grupos. Conclusão: Apesar da abrangência do conteúdo e do emprego de um método participativo no grupo de intervenção, a adesão foi insuficiente para alterar significativamente os principais parâmetros dietéticos estudados. O aprofundamento da abordagem comportamental, continuada e ultiprofissional deve ser objeto de mais investigações. _______________________________________________________________________________________________________________ ABSTRACTObjective: The objective of this study was to verify adherence to a nutritional group counseling program for patients with excess weight and comorbidities. Methods: This was an analytical, open, controlled, intervention study. Eighty adults from both genders with a body mass index ranging from 25 to 35kg/m² with two or more associated cardiovascular risk factors were randomly allocated to two groups for a three-month follow-up. The intervention group with nutritional group counseling received personalized care and participated in six group meetings to discuss healthy eating and physical activity, with group dynamics and participatory method. The control group was given standard personalized care in three outpatient visits. The parameters of adherence to treatment were the dietary repercussions before and after the intervention and attendance to the meetings. Results: Thirty-three participants concluded the study. In all, 45.8% and 40.7% of intervention group and control group, respectively, had excellent attendance. The main barriers to adherence to treatment were the need of eating out (46.7% - control group) and the difficulty of putting their knowledge to use, especially in social occasions (33.3% - intervention group). There was a significant increase in the mean percentage use of natural seasonings and in the number of daily meals of both groups after the intervention. However, there was no significant decrease in energy intake within groups or between groups. Conclusion: Despite the breadth of the content and the use of a participatory method in the intervention group, adherence was not enough to change the main dietary parameters significantly

Aconselhamento nutricional em grupo para adultos com excesso de peso e co-morbidades : adesão, repercussões clínicas e metabólicas

Dissertação (mestrado)—Universidade de Brasília, Faculdade de Ciências da Saúde, Departamento de Nutrição, 2006.Apesar da forte evidência entre dieta inadequada e sedentarismo com o aumento da prevalência das doenças crônicas não transmissíveis, e com as taxas elevadas de morbimortalidade por doença cardiovascular, observam-se benefícios modestos associados às intervenções nutricionais conservadoras. A baixa adesão tem sido apontada como fator determinante desse processo. O objetivo deste estudo foi verificar os efeitos de um Programa de Aconselhamento Nutricional em grupo para pacientes adultos portadores de excesso de peso e co-morbidades. Oitenta indivíduos foram considerados elegíveis para o estudo e foram alocados aleatoriamente em dois grupos: Grupo Controle (acompanhamento nutricional ambulatorial mensal) e Experimental (além do atendimento ambulatorial, participação em um programa de aconselhamento nutricional em grupo). Após 3 meses de acompanhamento, apenas trinta e três participantes concluíram o estudo. Foram analisados, antes e depois da intervenção, consumo alimentar, parâmetros antropométricos, pressão arterial de consultório e dados bioquímicos (glicemia de jejum e perfil lipídico). Não houve mudanças significativas intra e entre os grupos em relação aos parâmetros estudados, com exceção da circunferência da cintura e HDL colesterol. Nestes, as diferenças entre os níveis de antes e depois da intervenção foram observadas somente no grupo em que houve aconselhamento nutricional em grupo. Não houve diminuição significativa do consumo energético em ambos os grupos. As principais barreiras à adesão ao tratamento foram realizar as refeições fora de casa e a dificuldade na aplicação dos conhecimentos em situações especiais. Apesar da utilização de uma metodologia participativa, não foi possível conseguir resultados satisfatórios. Sugere-se que é preciso ampliar a atuação multiprofissional nos programas de aconselhamento e prolongar o período de intervenção. ___________________________________________________________________________________________ ABSTRACTIn spite the strong evidence demonstrating the link between an inadequate diet and a sedentary way of life with the increase for the prevalence of non-transmissible chronic disease, and with the high rates of morbid mortality, due to cardiovascular disease, one may observe modest benefits associated to the conservative nutritional interventions. The low adhesion has been pointed out as a decisive factor of that process. The objective of this study was to check the effects of a Nutritional Counseling Program in a group of adult patients bearing weight excess and comorbidity. Eighty individuals were considered eligible for the study and were allocated into two groups following a randomized controlled trial: a Control Group (monthly ambulatory care, nutritional attendance) and an Experimental Group (in addition to the ambulatory care, the participation in a special nutritional education program). After 3 months of attendance, only thirty-three participants concluded the study. Food consumption, anthropometric parameters, clinic blood pressure and biochemical data (glycaemia when fastening and lipid profile) were analyzed, before and after the intervention. There were not significant changes within and between the groups in relation to the studied parameters, except for the circumference of the waist and the HDL cholesterol. Concerning these aspects, the differences among the levels before and after the intervention were only observed in the group, in which there was group nutritional counseling. There was no significant decrease of energy consumption in both groups. The main barriers to the adhesion to the treatment were: the need of having meals out and the difficulty in the application of knowledge in special situations. In spite of the use of a participatory methodology, it was not possible to get satisfactory results. The need of the expansion a multi professional performance in the counseling programs is suggested in order to prolong the intervention period

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora