Cálcio na regulação da adiposidade corporal de adolescentes e adultos: revisão sistemática

Objective: Describe the results of the influence of calcium, supplemented or dietary, derived or not from dairy products, in the regulation of weight and body fat in adolescents (13 to 17 years old) and adults (18 to 64 years old). Method: Systematic review of the literature performed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) method on the databases LILACS, PubMed, SciELO e Google Scholar, using the descriptors: (adolescents OR adults) AND (calcium OR dairy products OR calcium supplement OR dietary calcium) AND (body weight OR body composition OR overweight OR obesity ORadiposity), on October 2019, without restrictions on language, date or publication status. The review protocol was registered on the International Prospective Register of Systematic Reviews (PROSPERO) platform (CRD42020150838). Results: Twenty-two studies were selected, which met the criteria for inclusion in the review, published between 2003 and 2017. The majority had a low risk of bias, following the procedures of the National Heart, Lung, and Blood Institute (NHLBI). All nine cross-sectional studies and four of the 13 longitudinal showed results suggestive of an inverse relationship between calcium consumption in weight regulation and some anthropometric indicator of obesity and/or a constituent of body composition. Conclusion: Calcium intake can facilitate significant weight loss/ body fat in adolescents and adults. Sufficient food consumption of this micronutrient should be encouraged to help minimize the impact of overweight/ obesity.Objetivo: Descrever os resultados da influência do cálcio, suplementado ou dietético, derivado ou não de laticínios, na regulação do peso e da gordura corporal em adolescentes (13 a 17 anos de idade) e adultos (18 a 64 anos de idade). Método: Revisão sistemática da literatura realizada pelo método Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) nas bases de dados LILACS, PubMed, SciELO e Google Scholar, usando os descritores: (“adolescentes” OR “adults”) AND (“calcium” OR “dairy products” OR “calcium supplement” OR “dietary calcium”) AND (“body weight” OR “body composition” OR “overweight” OR “obesity” OR “adiposity”), em outubro de 2019, sem restrições de idioma, data ou status de publicação. O protocolo da revisão foi registrado na plataforma International Prospective Register of Systematic Reviews (PROSPERO) (CRD42020150838). Resultados: Vinte e dois estudos foram selecionados, que atingiram os critérios para inclusão na revisão, publicados entre os anos de 2003 e 2017. A maioria apresentou risco baixo de viés, seguindo os procedimentos da National Heart, Lung, and Blood Institute (NHLBI). Todos os nove estudos transversais e quatro dos 13 longitudinais mostraram resultados sugestivos de relação inversa entre o consumo de cálcio na regulação do peso e algum indicador antropométrico de obesidade e/ou constituinte da composição corporal. Conclusão: O consumo de cálcio pode facilitar a perda significativa de peso/ adiposidade corporal, em adolescentes e adultos. O consumo alimentar suficiente desse micronutriente deve ser encorajado para ajudar a minimizar o impacto do sobrepeso/ obesidade

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background: Appropriate dietary recommendations represent a key part of secondary prevention in cardiovascular disease (CVD). We evaluated the effectiveness of the implementation of a nutritional program on quality of diet, cardiovascular events, and death in patients with established CVD. Methods: In this open-label, multicenter trial conducted in 35 sites in Brazil, we randomly assigned (1:1) patients aged 45 years or older to receive either the BALANCE Program (experimental group) or conventional nutrition advice (control group). The BALANCE Program included a unique nutritional education strategy to implement recommendations from guidelines, adapted to the use of affordable and regional foods. Adherence to diet was evaluated by the modified Alternative Healthy Eating Index. The primary end point was a composite of all-cause mortality, cardiovascular death, cardiac arrest, myocardial infarction, stroke, myocardial revascularization, amputation, or hospitalization for unstable angina. Secondary end points included biochemical and anthropometric data, and blood pressure levels. Results: From March 5, 2013, to Abril 7, 2015, a total of 2534 eligible patients were randomly assigned to either the BALANCE Program group (n = 1,266) or the control group (n = 1,268) and were followed up for a median of 3.5 years. In total, 235 (9.3%) participants had been lost to follow-up. After 3 years of follow-up, mean modified Alternative Healthy Eating Index (scale 0-70) was only slightly higher in the BALANCE group versus the control group (26.2 ± 8.4 vs 24.7 ± 8.6, P <.01), mainly due to a 0.5-serving/d greater intake of fruits and of vegetables in the BALANCE group. Primary end point events occurred in 236 participants (18.8%) in the BALANCE group and in 207 participants (16.4%) in the control group (hazard ratio, 1.15; 95% CI 0.95-1.38; P =.15). Secondary end points did not differ between groups after follow-up. Conclusions: The BALANCE Program only slightly improved adherence to a healthy diet in patients with established CVD and had no significant effect on the incidence of cardiovascular events or death. © 2019 The Author