IMPACT OF ADHERENCE TO A HIGH-PROTEIN DIET IN CLINICAL TRIALS: METHODOLOGICAL CONSIDERATIONS IN ELDERLY GROUPS

Background/objectives: several randomized clinical trials (ECRs) showed no consistent responses of dietary treatments to clinical outcomes. It is speculated that it is due to low adherence to dietary guidelines. It is aimed at identifying the proportion of samples that joined the protein-rich diet and the effect of adhesion in different health outcomes in postmenopausal women. Methods: it was performed in 52 women participating in a physical activity program, all with a protein -rich diet for 12 weeks, with nutritional follow -up. The prescribed diet contained 1.3-1.6g/kg/day of protein, minimum intake of 1.2g/kg/day was considered adhesion. Eight 24 -hour memories were performed by participant. Adhesion was also analyzed in the urinary excretion of urea and uric acid. The effect was analyzed in anthropometric and cardiometabolic parameters. The analysis of unilateral variance was used. Results: Despite significant increase in protein intake, only 38.5% reached the desired intake. A significant increase in urea was observed only in the high protein group (1.16 x 2.57, p <0.05). Women who joined the protein -rich diet (n = 20) had significant clinical results in body mass index, plasma cholesterol and urea levels, both with p <0.05. Conclusion: postmenopausal women showed low adherence to the protein-rich diet, according to metabolite analysis and statistics by unilateral variance analysis. Thus, in ECRs it is essential to consider nutrient intake and not just prescription, also highlighting the importance of food and nutritional education actions to stimulate adherence to the proposed

Assistência nutricional em tempos de pandemia: relato de experiência de nutricionistas residentes multiprofissionais / Nutritional assistance in times of pandemic: experience report from multiprofessional resident nutritionists

Introdução: A Organização Mundial da Saúde declarou em março de 2020 a pandemia do novo coronavírus, o que resultou no estabelecimento de medidas a fim de evitar a propagação da Covid-19. Nesse âmbito, o Conselho Federal de Nutricionistas deliberou por meio de resolução a modalidade de assistência nutricional remota e assim novos desafios para os profissionais nutricionistas. Material e métodos: Trata-se de um relato de experiência de nutricionistas residentes sobre à assistência nutricional prestada a pacientes diagnosticados com Covid-19, internados em Unidade de Terapia Intensiva e Enfermaria de um hospital universitário localizado em Aracaju/SE. O acompanhamento foi realizado por meio de prontuário eletrônico e dados complementares foram coletados por contato telefônico com a equipe de enfermagem. Por meio das informações coletadas definia-se a conduta nutricional pertinente a cada caso, após alta hospitalar era encaminhado ao paciente orientações nutricionais específicas para continuidade do cuidado, assim como realizado contato com paciente e/ou familiar/cuidador com o intuito de fornecer explicações e sanar dúvidas quanto a terapia nutricional. Resultados e Discussão: Novos desafios surgiram com a nova modalidade para a prática assistencial, entre eles a impossibilidade de avaliação física do paciente, a dependência da evolução médica para atualização do caso e dificuldade de contato com a equipe de enfermagem devido sobrecarga da mesma. Apesar das limitações, a assistência nutricional ao paciente acometido por Covid-19 é fundamental para uma melhor recuperação do mesmo. Conclusão: Diante dos obstáculos encontrados na assistência nutricional remota aos pacientes acometidos por Covid-19, torna-se essencial que esses profissionais adaptem suas práticas a nova realidade, garantindo assim qualidade do atendimento prestado e contribuição para ampla recuperação dos assistidos.

IMPACT OF ADHERENCE TO A HIGH-PROTEIN DIET IN CLINICAL TRIALS: METHODOLOGICAL CONSIDERATIONS IN ELDERLY GROUPS

Background/objectives: several randomized clinical trials (ECRs) showed no consistent responses of dietary treatments to clinical outcomes. It is speculated that it is due to low adherence to dietary guidelines. It is aimed at identifying the proportion of samples that joined the protein-rich diet and the effect of adhesion in different health outcomes in postmenopausal women. Methods: it was performed in 52 women participating in a physical activity program, all with a protein -rich diet for 12 weeks, with nutritional follow -up. The prescribed diet contained 1.3-1.6g/kg/day of protein, minimum intake of 1.2g/kg/day was considered adhesion. Eight 24 -hour memories were performed by participant. Adhesion was also analyzed in the urinary excretion of urea and uric acid. The effect was analyzed in anthropometric and cardiometabolic parameters. The analysis of unilateral variance was used. Results: Despite significant increase in protein intake, only 38.5% reached the desired intake. A significant increase in urea was observed only in the high protein group (1.16 x 2.57, p <0.05). Women who joined the protein -rich diet (n = 20) had significant clinical results in body mass index, plasma cholesterol and urea levels, both with p <0.05. Conclusion: postmenopausal women showed low adherence to the protein-rich diet, according to metabolite analysis and statistics by unilateral variance analysis. Thus, in ECRs it is essential to consider nutrient intake and not just prescription, also highlighting the importance of food and nutritional education actions to stimulate adherence to the proposed

ELABORAÇÃO E VALIDAÇÃO DE PROTOCOLO EM TELENUTRIÇÃO

Introduction: Due to all the restrictions imposed by the Covid-19 pandemic, the need for the elaboration of teleconsultation protocols for the continuity of nutritional assistance was highlighted. Objective: To develop, validate and evaluate the effectiveness of the protocol for online nutritional counseling in improving dietary practices. Method: In order to develop the protocol, aspects of in-person care and the Protocol for Use of the Dietary Guidelines for the Brazilian Population aimed at adults were considered. The development, discussion, adjustments and validation of the telenutrition protocol was carried out in meetings between experts and members of the research group, in which all items and stages were evaluated. A pilot study was also conducted, proposing an online nutritional program with two distinct groups: the multicomponent group - which received the protocol composed of multiple combined strategies, and the traditional group, which received only the nutrition teleconsultations. Effectiveness was assessed by evaluating the score of the dietary practices scale, applied at the beginning and at the end of the study. Results: The development of a telecare protocol in nutrition for nutritional monitoring of patients over a period of 12 weeks, as well as the 11 educational materials that accompany it. In addition, there was also accomplished the validation, which achieved maximum agreement of all items in the protocol. In the pilot study, before the intervention, the multicomponent group had an average score of 43 ± 13.2 points, and after the program, scored 54 ± 5.6 on the scale, indicating an improvement in dietary practices. The traditional group also improved after the follow-up, but to a lesser extent, progressing from 43.3 ± 8.6 to 50.8 ± 6.3 points. Conclusion: an effective teleconsultation protocol in nutrition was developed, which is a crucial tool in improving dietary habits, enabling the organization of care actions through telenutrition and contributing to health promotion.Introdução: com as restrições ocasionadas pela pandemia de Covid-19 evidenciaram-se a necessidade da construção de protocolos de teleconsulta para continuidade da assistência nutricional. Objetivo: elaborar, validar e avaliar a efetividade de um protocolo para aconselhamento nutricional on-line na melhoria das práticas alimentares. Método: para elaboração do protocolo, foram considerados os aspectos do atendimento presencial e o “Protocolo de Uso do Guia Alimentar para a População Brasileira” voltado ao público adulto. A elaboração, discussões, adequações e a validação do protocolo de teleconsulta em nutrição se deu nas reuniões cientificas, onde foram avaliados todos os itens do protocolo. Foi também realizado o estudo piloto, sendo proposto um programa nutricional on-line com dois grupos distintos: o multicomponente – que recebeu o protocolo composto pelas estratégias múltiplas combinadas; e o tradicional, que recebeu apenas a teleconsulta em nutrição. A efetividade foi avaliada por meio da avaliação do escore da escala de práticas alimentares, aplicada no início e ao final do estudo. Resultados: destaca-se a elaboração do protocolo de teleatendimento em nutrição para acompanhamento nutricional dos pacientes, por um período de 12 semanas, além dos 11 materiais educativos. Além disso, houve também a validação que atingiu a concordância máxima de todos os itens do protocolo. No estudo piloto, antes da intervenção, o grupo multicomponente apresentava média de 43,0 (13,2) pontos, após o programa pontuou 54,0 (5,6) no escore, evidenciando melhora das práticas alimentares. O grupo tradicional também melhorou após o acompanhamento, porém em menor expressão, evoluindo de 43,3 (8,6) para 50,8 (6,3) pontos.  Conclusão: houve a elaboração de um protocolo efetivo de teleconsulta em nutrição, sendo este uma ferramenta crucial na melhora dos hábitos alimentares, viabilizando a organização das ações assistenciais através da telenutrição e contribuindo na promoção da saúde