Dietas pós BG e BIG: prós e contras

Obesity is a major public health problem. The failure of the treatment is very common. When we have individuals with morbid obesity, we find that many times diet, behavioral and pharmacological therapies are insufficient and ineffective, it is sometimes necessary to choose surgery. In this article we will consider the pros and cons of the diets for obese patients with gastric banding (GB) or intragastric balloon (IGB). Although BIG is not a surgical method, it is endoscopicaly performed but may also be an adjunct to the treatment of morbid obesity. Logically, the nutritional recommendations for the treatment of obesity are well defined, but in reality, this type of treatment, provided by specific hypo caloric diets in the order of 1200 kcal and 1500 kcal for women and for men, respectively to avoid nutritional deficiencies. With GB and IGB it is easier to control the intake, so diets are more easily accomplished, the weight losses are visible and self-esteem improves. On the other hand, these monotonous diets can lead to discouragement and abandonment of treatment, and there are many foods that are difficult to tolerate. In addition, GB and / or IGB can bring risks to health, including weight regain. A diet with a very low energy value can induce, micronutrient deficiencies, and vitamin and mineral supplementation may be necessary. In these treatments it is not possible to forget that obese people are particularly sensitive to sensory qualities of food, so forcing them to avoid to what they like to eat can be a barrier to a successful treatment. So, in addition to thinking about the advantages and disadvantages of the diet, it is essential to modify behaviors, to adapt the food plans to each patient individually and to create habits that allow them to have a healthy lifestyle with a healthy weight too.A Obesidade é um enorme problema de saúde pública. O insucesso do seu tratamento é muito frequente. Quando falamos de indivíduos com obesidade mórbida, verificamos que muitas vezes a terapêutica alimentar, comportamental e farmacológica são insuficientes e ineficazes, sendo por vezes necessário recorrer ao tratamento cirúrgico. Neste artigo serão abordados os prós e contras das dietas para obesos com banda gástrica ou balão intragástrico. Apesar de o BIG não ser um método cirúrgico, mas sim endoscópico, também pode ser um adjuvante para o tratamento de obesos mórbidos. Logicamente que as recomendações nutricionais para o tratamento da obesidade estão bem definidas, mas na realidade, neste tipo de tratamento específico as dietas fornecidas aos doentes devem ser hipoenergéticas, na ordem das 1200kcal para as mulheres e 1500kcal para o homens de forma a evitar deficiências nutricionais. Com a BG e BIG é mais fácil controlar a ingestão, logo as dietas são mais facilmente cumpridas, as perdas de peso são visíveis e a auto-estima melhora. Por outro lado, são dietas monótonas que podem conduzir à desmotivação e abandono do tratamento e existem muitos alimentos que são difíceis de tolerar. Além disto, a BG e/ou BIG podem trazer riscos associados para a saúde, incluído a recuperação do peso. Uma vez que a dieta tem um valor energético muito baixo, podem ocorrer deficiências de micronutrientes e por isso a suplementação vitamínica e mineral pode ser necessária. Nestes tratamentos não podemos esquecer o facto de os obesos serem particularmente sensíveis às qualidades sensoriais do alimentos e que o facto de srem obrigados a deixar de comer o que gostam pode ser um barreira para o sucesso do tratamento. Assim, além de pensar nas vantagens e desvantagens da dieta, é fundamental que se modifiquem comportamentos, se adaptem os planos individualmente a cada doente e se criem hábitos que lhes permitam ter um estilo de vida saudável com um peso também ele saudável

Barreiras ao cumprimento de um plano alimentar: O que mudou

[resumo][abstract

Dietary parameters in patients with drug allergy: Assessing dietary inflammatory index

Background Research on the increasing incidence of allergic diseases evidenced the role of diet as a potential key factor. Diet can modulate the low-grade systemic inflammation related to obesity and several diseases. There are no published data on drug allergy. Aim To investigate a potential association between diet, including dietary inflammatory index (DII), and drug allergy. Also, to evaluate correlations between diet and obesity, inflammatory and metabolic parameters in patients with drug allergy. Methods Ninety consecutive patients studied for suspected drug allergy were evaluated in terms of dietary parameters, anthropometric measurements, bioimpedance and biochemical analysis. DII was calculated based on information collected from a food frequency questionnaire. Results After diagnostic work-up, 39 patients had confirmed drug allergy and 45 excluded, representing the study group and the control group, respectively. The majority (79%) were female, with mean age of 39.58±13.3 years. The 84 subjects revealed an anti-inflammatory diet pattern. No significative difference was found in DII scores between drug allergic patients and controls (-3.37±0.95 vs -3.39±0.86, p = 0.985). However, the patients with drug allergy revealed higher obesity and inflammatory parameters. A significative negative correlation was found between DII and adiponectin levels, in the control group (r = -0.311, p = 0.040). In the patient group, a significative positive correlation was observed between DII and triglycerides (r = 0.359, p = 0.032). No other correlations were found between DII and the assessed parameters. Patients with drug allergy presented a significative higher intake of mono-unsaturated fatty-acids comparing to controls (19.8±3.7 vs 17.8 ± 4.0, p = 0.021). No other statistically significant differences were achieved in dietary parameters, between patients and controls. Conclusion The population assessed in this study revealed an anti-inflammatory diet profile. Although we have found in a previous work that the same patients with drug allergy revealed higher obesity and inflammatory parameters, the DII did not allow to distinguish between patients with drug allergy or controls. The DII scores correlated with triglycerides levels in the drug allergy patients and inversely with adiponectin levels in the control group. Larger studies are needed to clarify the potential role of the diet in drug allergy and its outcomes. (c) 2022 Dias de Castro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Avaliação antropométrica em doentes obesos após colocação de banda gástrica

[resumo][abstract