Composição Nutricional de Dietas para Emagrecimento Divulgadas em Revistas não Científicas

Introdução: Com o aumento mundial do excesso de peso e preocupação com emagrecimento entre os adultos, é crescente o surgimento de dietas populares divulgadas em revistas não científicas.Objetivo: Comparar a composição nutricional de dietas para emagrecimento encontradas em revistas femininas de circulação nacional com as recomendações dietéticas atuais de macro- e micronutrientes preconizadas para mulheres adultas jovens.Métodos: Foram selecionadas revistas publicadas em 2007. A composição nutricional das dietas foi calculada (Nutwin®) e comparada com recomendações atuais para macronutrientes (NCEP ATP III) e micronutrientes [cálcio, ferro, vitamina C e folato (DRIS,IOM)]. Biodisponibilidade de ferro do almoço e jantar também foi calculada. As dietas foram divididas em dois grupos: de grande restrição calórica [(GRC); 800-1200 kcal] ou de restrição calórica leve [(RCL); >1200 kcal] e comparadas.Resultados: Foram analisadas 86 dietas (17 exemplares; duas editoras) com aporte calórico de 709-1822 kcal/dia. Mais da metade das dietas analisadas tinh

Nutritional breakdown of weight loss diet advertised in non-scientific publications

Introdução: Com o aumento mundial do excesso de peso e preocupação com emagrecimento entre os adultos, é crescente o surgimento de dietas populares divulgadas em revistas não científicas. Objetivo: Comparar a composição nutricional de dietas para emagrecimento encontradas em revistas femininas de circulação nacional com as recomendações dietéticas atuais de macro- e micronutrientes preconizadas para mulheres adultas jovens. Métodos: Foram selecionadas revistas publicadas em 2007. A composição nutricional das dietas foi calculada (Nutwin®) e comparada com recomendações atuais para macronutrientes (NCEP ATP III) e micronutrientes [cálcio, ferro, vitamina C e folato (DRIS,IOM)]. Biodisponibilidade de ferro do almoço e jantar também foi calculada. As dietas foram divididas em dois grupos: de grande restrição calórica [(GRC); 800-1200 kcal] ou de restrição calórica leve [(RCL); >1200 kcal] e comparadas. Resultados: Foram analisadas 86 dietas (17 exemplares; duas editoras) com aporte calórico de 709-1822 kcal/dia. Mais da metade das dietas analisadas tinha 1200 kcal] and compared [Student t test, chi-square (SPSS ®)]. Results: Eighty-six diets were analyzed (17 magazines, two publishers), with daily calorie intake of 1154 (709-1822) kcal. More than half of the diets tested had less than 50% of calories from carbohydrates. A higher proportion of HER diets was classified as inadequate, according to recommendations for calcium (30.2% vs.11.6%, P=0.025), iron (46.5% vs.16.3%, P=0.010) and folate (93.0% vs.72.%, P=0.035), when compared to MER diets. A higher proportion of the HER diets group had low iron bioavailability only at lunch, when compared to MER diets (27.6% vs. 9.3%, P=0.013). Conclusion: A higher proportion of HER diets was inadequate to the micronutrient recommendations for women of childbearing age, compared to MER diets. The results suggest that it is necessary to make better use of these magazines to inform the population about diets

Papel da Ingestão de Soja na Nefropatia Diabética

O papel específico das modificações da dieta no tratamento da nefropatia diabética (ND) ainda não está elucidado. A substituição de proteína de origem animal por soja em pacientes com Diabete Melito (DM) poderia ser benéfica para a função renal. O objetivo do presente manuscrito foi revisar criticamente as evidências acerca do papel da soja na ND. Foram selecionados seis ensaios clínicos randomizados conduzidos em pacientes com DM, dentre os quais cinco demonstraram melhora de pelo menos um marcador de função renal com a dieta com soja. Os mecanismos através dos quais essas dietas promoveriam melhora da ND não foram elucidados, assim como não está estabelecido ainda se há distinção no efeito benéfico aos rins dos diferentes produtos à base de soja disponíveis no mercado. Novos estudos são necessários para que tais questões possam ser elucidadas e para que os benefícios da soja na ND possam ser confirmados

Safer glycemic control using a fructose-based enteral formula : a randomized crossover clinical trial

Introduction: Glycemic variability during nutritional therapy in critically ill patients is associated with morbidity and mortality. A low-carbohydrate diet can be help avoid glycemic oscillation in patients under enteral nutrition; however, it is unclear whether the presence of fructose interferes with glycemic variability. Aim: Our study aimed to evaluate the effect of two diabetes-specific diets (fructose-based versus maltodextrin-based) on the glycemic variability of critically ill patients. Methods: This was a randomized, active-controlled, double-blinded crossover clinical trial comparing diabetes-specific enteral formula with fructose versus without fructose. Patients under enteral nutrition who developed hyperglycemia during their intensive care unit stay were included. Patients were randomized to receive one of two diets for 2 days before switching to the other diet. A capillary blood sample was taken every 4 h, and glycemic variability was defined as the difference between each time point. Results: Twenty-five patients completed both formulas. Patients that underwent the fructose- based diet reduced their glycemic variability by 6.30 mg/dL relative to those that received the maltodextrin-based diet (95%CI -13.86 to 1.26 mg/dL, p = 0.101 for between-group differences). This effect was seen without any complications. Conclusion: A diabetes-specific enteral formula with fructose had no difference in glycemic variability in critically ill patients versus a diabetes-specific enteral formula without fructose

Diet quality and therapeutic targets in patients with type 2 diabetes : evaluation of concordance between dietary indexes

Background: This study aimed to evaluate the concordance between two dietary indexes, the Healthy Eating Index (HEI) and the Diabetes Healthy Eating Index (DHEI), in evaluating diet quality and its possible association with therapeutic targets in patients with type 2 diabetes. Methods: Cross-sectional study of outpatients with type 2 diabetes mellitus treated at a university hospital. Dietary information was obtained from a quantitative food frequency questionnaire (previously validated for use in patients with type 2 diabetes) and converted into daily intakes. Diet quality was assessed using two dietary indexes: HEI (12 components, nine food groups and three moderation components) and DHEI (10 components, six food groups, three nutrient groups, and one for variety of diet). In both indexes, the sum of the scores for each component yields an overall score converted on a scale from 0 to 100%; diet quality is subsequently ranked as low (80%). Patients underwent clinical and laboratory assessment. Those with fasting blood glucose values 70–130 mg/dL, A1c < 7%, total cholesterol <200 mg/dL, LDL-cholesterol <100 mg/dL, and triglycerides <150 mg/dL were considered to meet therapeutic targets. All analyses were conducted in PASW Statistics 18.0, and p < 0.05 deemed significant. Results: We analyzed 148 patients with type 2 diabetes (73% white, mean age 63.2 ± 9.4 years, median diabetes duration 10 [IQR 5–19] years, mean A1c% 8.4 ± 2.0%, and mean BMI 30.5 ± 4.2 kg/m2). Mean energy intake was 2114 ± 649 kcal/day. DHEI scores were 17.0 (95%CI -6.8 to 41.0) points lower than HEI scores (55.9 ± 14.2% vs. 72.9 ± 10.7%, respectively; P < 0.001), suggesting there is no agreement (Bland-Altman method), and the Pearson correlation coefficient was 0.55 (P < 0.001). More patients were classified as having a low-quality diet by the DHEI than by the HEI (38.5% vs. 1.4%; P < 0.001). A higher proportion of patients (35.7%) with out-of-target total cholesterol levels had a low-quality diet evaluated by the DHEI (P = 0.03). We did not find associations between overall score of HEI and therapeutic targets. Conclusions: In its intended population of patients with type 2 diabetes, the DHEI seems to be a more rigorous tool to evaluate association between diet quality and changes in metabolic parameters

Fatty acid composition and cholesterol content of beef and chicken meat in Southern Brazil

O objetivo do presente estudo foi analisar a composição de ácidos graxos e conteúdo de colesterol de cortes de carne de gado e frango mais consumidos pela população de pacientes com diabete melito tipo 2 atendidos no Sul do Brasil: para gado, cortes de semimembranosus e biceps femoris; e para frango, coxa e sobrecoxa. Os conteúdos de umidade (gravimetria), proteína (procedimento de Kjeldahl), colesterol (HPLC ou método enzimático), lipídeos (método gravimétrico) e composição de ácidos graxos (cromatografia gasosa) foram analisados em amostras cruas de três diferentes procedências de cada corte em duplicata. Os resultados foram comparados com dados extraídos da tabela de composição de alimentos disponibilizada pelo Departamento de Agricultura dos Estados Unidos (USDA) e tabelas brasileiras (TACO-UNICAMP, TBCAUSP 4.1). Carne de frango possui menor proporção de ácidos graxos saturados (36,4&plusmn;3,6%; PThe aim of the present study was to analyze the fatty acid composition and cholesterol content of the beef and chicken meat most often consumed by a population of type 2 diabetic patients in Southern Brazil: for beef, semimembranosus and biceps femoris; and for chicken, drumstick and thigh. The moisture content (gravimetrically), protein content (Kjeldahl procedure), cholesterol content (HPLC or enzymatic methods), lipid content (gravimetric method) and fatty acid composition (gas chromatography) were analyzed in three different brands of these raw cuts in duplicate. The results were compared with data extracted from the United States Department of Agriculture (USDA) Handbook and Brazilian tables (TACO-UNICAMP and TBCAUSP 4.1). Chicken meat had a lower proportion of saturated (36.4&plusmn;3.6%;

Physical activity level and hypoglycemia in type 1 diabetes patients

Introduction: The recommended management for individuals with type 1 diabetes (T1D) includes an intensive treatment with insulin therapy and the practice of regular exercise. However, this association is related with hypoglycemia episodes. Objective: The aim of this study was to perform a cross-sectional evaluation of the association between the physical activity (PA) level and hypoglycemia episodes reported in patients with T1D. Methods: Adult outpatients with T1D had their PA level assessed by the International Physical Activity Questionnaire (long form), considering the intensity of the physical activity (vigorous, moderate and/or walks) in daily activities, such as at work, means of transport, domestic activities and at leisure, and answered questions about self‑care and hypoglycemia episodes. Results: The study included 126 patients who presented the following characteristics: mean age of 35 (28-47) years old and 16 (11-24) years of diabetes duration, 55% women, HbA1c=9.3 ± 2.1%, and body mass index = 25.0 ± 4.2 kg/m2. Very active patients had lower values of glucose and LDL-cholesterol when compared with the less active group. A greater proportion of active (48.1%) and very active patients (66.7%) reported practicing exercise regularly when compared with the less active subjects (13.3%; P=0.003). Less active patients had a three-fold chance of reporting hypoglycemia episodes when compared with very active patients (OR=3.49; CI 95%: 1.26-9.70; P=0.016). Conclusions: Less active adults with T1D presented more hypoglycemia, probably due to the practice of informal moderate and/or vigorous activities without specific self-care

Body adiposity markers and insulin resistance in patients with type 1 diabetes

Objectives: Body composition changes are associated with adverse effects such as increased insulin resistance (IR) in individuals with diabetes mellitus. This study aims to evaluate the association between different body adiposity markers and IR in adults with type 1 diabetes (T1D). Subjects and methods: The cross-sectional study included outpatient adults with T1D from a university public hospital in southern Brazil. The body adiposity markers studied were waist circumference (WC), waist-height ratio (WHtR), body mass index (BMI), conicity index (CI), lipid accumulation product (LAP) and body adiposity index (BAI). IR was calculated using an Estimated Glucose Disposal Rate (EGDR) equation (analyzed in tertiles), considering an inverse relation between EGDR and IR. Poisson regression models were used to estimate the odds ratio (OR) and 95% CIs of association of adiposity markers with IR. Results: A total of 128 patients were enrolled (51% women), with a median EGDR of 7.2 (4.4-8.7) mg.kg-1.min-1. EGDR was negatively correlated with WC (r = -0.36, p < 0.01), WHtR (r = -0.39, p < 0.01), CI (r = -0.44, p < 0.01), LAP (r = -0.41, p < 0.01) and BMI (r = -0.24, p < 0.01). After regression analyses, WC (OR = 2.07; CIs: 1.12-3.337; p = 0.003), WHtR (OR = 2.77; CIs: 1.59-4.79; p < 0.001), CI (OR = 2.59; CIs: 1.43-4.66; p = 0.002), LAP (OR = 2.27; CIs: 1.25-4.11; p = 0.007) and BMI (OR = 1.78; CIs: 1.09-2.91; p = 0.019) remained associated with IR. Conclusions: The authors suggest using the studied adiposity markers as a routine since they were shown to be suitable parameters in association with IR