101 research outputs found
Desnutrição: conseqüências em longo prazo e efeitos da recuperação nutricional
POVERTY and malnutrition are still very high in slums. This condition is associated with poor sanitation and stunting. Studies in adolescents with stunting showed, high susceptibility to gain central fat, lower fat oxidation, lower energy expenditure, higher blood pressure and impaired insulin production, all factors linked with cronic diseases later in life. Adequate nutritional recovery in nutritional rehabilitation centres can revert the alterations in body composition.POBREZA e desnutrição estão presentes em alta prevalência em favelas. Essa situação está associada a condições insalubres de moradia e baixa estatura. Estudos em adolescentes com baixa estatura mostraram suscetibilidade aumentada a ganho de gordura na região central do corpo, diminuição da oxidação de gordura corporal e do gasto energético e aumento da pressão sangüínea, assim como alterações no metabolismo da glicose e da insulina, todos fatores associados à ocorrência de doenças crônicas na vida adulta. Recuperação nutricional adequada, realizada em centros de recuperação nutricional, pode reverter as alterações observadas na composição corporal
Baixa estatura nutricional e risco de obesidade futura: principais mecanismos fisiológicos
There is a fair amount of epidemiological evidence showing that nutritional stunting causes increased risks of obesity. Obesity is increasing dramatically not only in developed countries but also in developing countries, such as Brazil, especially among the poorer. The mere coexistence of undernutrition and obesity among poor people has a great impact, as the burden in the social, economic, and health care systems is remarkable. In addition, an increasing number of studies have shown that nutritional stunting causes a series of important long-lasting changes such as lower energy expenditure, higher susceptibility to the effects of high-fat diets, lower fat oxidation, and impaired regulation of food intake. These findings suggest that a broader and more detailed understanding of the long-lasting effects of early undernutrition, direct cause of nutritional stunting, is needed. Within this context, we present data of some physiological mechanisms that substantiate the association between previous undernutrition and future obesity.Existe uma quantidade significativa de evidências epidemiológicas mostrando que a baixa estatura nutricional aumenta o risco de obesidade futura. A obesidade vem aumentando dramaticamente, não apenas nos países desenvolvidos, mas também nos países em desenvolvimento, como o Brasil, especialmente entre indivíduos mais pobres. A mera coexistência de desnutrição e obesidade na população pobre tem um grande impacto, gerando enorme sobrecarga para o sistema de saúde e a estrutura sócio-econômica. Além disso, um número cada vez maior de estudos tem mostrado que a baixa estatura nutricional causa uma série de mudanças a longo prazo, como menor gasto energético, maior susceptibilidade aos efeitos de dietas com alto teor de gorduras, menor oxidação de gorduras e prejuízo na regulação da ingestão alimentar. Esses achados sugerem a necessidade de um entendimento mais amplo e detalhado dos efeitos tardios da desnutrição no início da vida, causa direta da baixa estatura para a idade. Dentro desse contexto, apresentamos alguns dados relacionados aos mecanismos fisiológicos subjacentes à associação entre desnutrição e obesidade futura.Universidade Federal de São Paulo (UNIFESP) Departamento de FisiologiaAging at Tufts University Human Nutrition Research CenterUNIFESP, Depto. de FisiologiaSciEL
Abra a felicidade? Implicações para o vício alimentar
Nearly two billion people are overweight. This eating disorder is affecting more and more children/teenagers. Although it is a multifactorial disease, there is strong evidence of the influence of advertising and the obesogenic environment in changing dietary habits. Industry/commerce food techniques can generate excessive consumption by developing flavors, images and techniques of persuasion, and by the production of foods high in sugar, salt and fat which are rewarding nutrients. This article focuses on the influence of the consumption of palatable food in the functional neuroanatomy of pleasure and its implication for food addiction. It also discusses the transtheoretical model as a tool for intervention in the treatment of obesity.Quase dois bilhões de pessoas tem excesso de peso. Esse distúrbio alimentar vem acometendo cada vez mais crianças/adolescentes. Embora seja uma doença multicausal, há forte evidência da influência da propaganda e do ambiente obesogênico na mudança dos hábitos alimentares. As indústrias/comércio de alimentos desenvolveram técnicas capazes de gerar consumo excessivo através do desenvolvimento de sabores, imagens e técnicas de persuasão, e da produção de alimentos ricos em açúcar, sal e gordura que são nutrientes recompensadores e podem gerar vício alimentar. Este artigo debruça-se sobre a influência do consumo de alimentos palatáveis na neuroanatomia funcional do prazer e sua implicação para o vício alimentar. Discute ainda o Modelo Transteórico como ferramenta para intervenção no tratamento da obesidade.Universidade Federal de São Paulo (UNIFESP) Departamento de FisiologiaUniversidade Federal de São Paulo (UNIFESP) Programa de Pós-Graduação em PediatriaUNIFESP, Depto. de FisiologiaUNIFESP, Programa de Pós-Graduação em PediatriaSciEL
Índice de masa corporal de adolescentes: comparación entre distintas referencias
OBJECTIVE: To compare the performance of the references (National Health and Nutrition Examination Survey I, National Center for Health Statistics/2000, International Obesity Task Force and Pesquisa Nacional sobre Saúde e Nutrição) to assess the nutritional status of children and adolescents with the new reference of body mass index values proposed by the World Health Organization in 2007. METHODS: Cross-sectional study that enrolled a non-probabilistic sample of 5,122 children and adolescents of low socioeconomic status. In the matrix study, sample size was calculated in order to identify the association between blood pressure changes and stunting in different nutritional status. This interim report relates to the comparison among different references for assessment of nutritional status. Cochran's Q, McNemar, chisquare and Kappa statistics were used to compare the proportion of underweight and overweight by different references and the agreement among them. RESULTS: The five references used in this study showed differences between them. Both for boys as for girls, the estimated prevalence of underweight by the Brazilian reference is much smaller than with the other references. For overweight girls, a higher prevalence was detected by the Pesquisa Nacional sobre Saúde e Nutrição reference, followed by the World Health Organization/2007. There was an excellent agreement (k>0.75) between the references regarding overweight, but the agreement among them regarding underweight was weak (k0.75) entre la mayoría de las clasificaciones para exceso de peso analizadas. Sin embargo, la concordancia entre las clasificaciones para bajo peso se presentódébil (k0,75) entre a maioria das classificações para excesso de peso analisadas. Porém, a concordância entre as classificações para baixo peso apresentou-se fraca (k<0,40). CONCLUSÕES: A nova referência da Organização Mundial da Saúde é adequada para classificar os distúrbios nutricionais nos adolescentes brasileiros.Universidade Federal de São Paulo (UNIFESP)UNIFESPSciEL
Perfil socioeconômico, nutricional e de ingestão alimentar de beneficiários do Programa Bolsa Família
We studied beneficiaries of Bolsa Família Maceió - AL and found a high prevalence of malnutrition in children (18%) and adolescents (20%), but overweight in adults (51%). Women beneficiaries were 4 times more likely to have abdominal obesity compared to other adults. The vast majority of households (92%) had food insecurity (FI); severe FI was found in 33%. There was an association between FI and larger number of people in the house and unemployment. An increase in the consumption of foods rich in carbohydrates and lipids was found in obese women in comparison to other studies. It was found inadequate intake of calcium, folate, vitamin E, magnesium, vitamin C, zinc, riboflavin, thiamine and fiber. These findings demonstrate the need for integrated actions between education / health and income transfer programs.Foram estudados beneficiários do Programa Bolsa Família de Maceió (AL) e encontrada alta prevalência de desnutrição nas crianças (18%) e adolescentes (20%); mas excesso de peso nos adultos (51%). As mulheres beneficiárias tiveram quatro vezes mais chance de ter obesidade abdominal em relação aos outros adultos. A maioria das famílias (92%) apresentou Insegurança Alimentar (IA), sendo em 33% grave. Houve associação entre IA e maior número de pessoas na casa e desemprego. Entre as obesas houve aumento no consumo de alimentos ricos em carboidratos e lipídios em relação à outra população não beneficiária. Encontrou-se ingestão inadequada de cálcio, folato, vitamina E, magnésio, vitamina C, zinco, riboflavina, tiamina e fibra. Esses achados demonstram a necessidade de ações integradas entre políticas de educação/saúde e os programas de transferência de renda.Universidade Federal de Alagoas Faculdade de NutriçãoCentro de Recuperação e Educação NutricionalUniversidade Federal de São Paulo (UNIFESP) EPM Departamento de FisiologiaUNIFESP, EPM, Depto. de FisiologiaSciEL
Higher central fat and poor self-body image in short-stature overweight/obese women living in Brazilian shantytowns
Background: Short stature in adult life, a possible consequence of poor perinatal conditions, is associated with higher risk of mortality and social disabilities. We aimed to determine whether low-income, overweight/obese, short-stature (SS) women show alterations in body composition, self-body-image perception, and biochemical profile compared to their non-short (NS) counterparts. Methods: A cross-sectional study was conducted with women living in shantytowns and mother or relatives to undernourished children treated in a center for recuperation and nutritional education. Inclusion criteria were: (1) age, 19-45 years(2) stature 158.7 cmand (3) body mass index > 25 kg/m(2). Socioeconomic, anthropometric, biochemical, and body image data were collected. We analyzed 56 SS and 57 NS women. Results: The SS group showed a higher waist-to-height ratio (WHtR) (mean: 0.63standard deviation: 0.06 for SS and mean: 0.60standard deviation: 0.07 for the NS groupp = 0.02), and, in the adjusted analysis, showed lower fat-free mass (Estimated Marginal Mean for the SS group: 45.7 kg 95% confidence intervals (CI) (45.2-46.2) and for the NS group: 46.9 kg 95% CI (46.4-47.4)p < 0.01) and higher fat mass (Estimated Marginal Mean for the SS group: 32.5 95% CI (31.9-33.0) and for the NS group: 31.4 kg 95% CI (30.9-31.9)p < 0.01). Body mass index was a better predictor of current self-body-image perception for NS women. The SS coefficient values were beta = 0.141, SE = 0.059, and R-2-Nagelkerke = 0.107, and the NS coefficients values were beta = 0.307, SE = 0.058, and R-2 -Nagelkerke = 0.491 (Z = 2.006p < 0.05). Considering the obese subgroup, six out of 32 (18.8%) SS women and 14 out of 33 (42.4%) NS women perceived themselves as obese (chi(2) = 4.27p = 0.03). This difference remained significant even after adjustment by age, schooling, and number of children (p = 0.04). Only the total thyroxin showed significant differences between groups, lower in SS women (p = 0.04). Discussion: Overweight/obese, low-income SS women have more central adiposity and impaired self-body image perception, and the body mass index is a weaker predictor of it, compared to NS women. Misperception about body size may be linked with an overestimation of health and underestimation of risk, which may lead to a lower utilization of the health care system and inadequate physician counseling. These features may account, at least partially, for the higher mortality risk seen in SS adults.Univ Fed Alagoas, Fac Nutr, Maceio, AI, BrazilUniv Fed Sao Paulo, Dept Fisiol, Sao Paulo, SP, BrazilDepartamento de Fisiologia, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, BrazilWeb of Scienc
Adolescents with Mild Stunting Show Alterations in Glucose and Insulin Metabolism
Purpose. To evaluate glucose and insulin profiles in adolescents with mild stunting and overweight in order to assess the possibility of increased predisposition to diabetes. Subjects and Methods. The study population consisted of 66 pubertal adolescents classified as mildly stunted (height-for-age z scores ≥−2 and <−1) or of normal stature, as well as overweight (body mass index ≥85th percentile) or normal weight. Beta-cell function and insulin resistance were evaluated according to the homeostasis model assessment (HOMA). Results. In the group with mild stunting, glucose, insulin, and HOMA-IR levels were significantly higher in overweight adolescents compared with those of normal weight, whereas HOMA-B levels were significantly lower. Adolescents with mild stunting showed significantly higher accumulations of body and abdominal fat than their normal stature counterparts. Conclusions. The presence of mild stunting was associated with higher levels of glucose and insulin, diminished function of beta cells, and increased insulin resistance. These results reinforce the need for intervention in adolescents with mild stunting
Violência em favelas e saúde
Drug trafficking has become the main factor in the escalation of violence and one of the greatest obstacles to the success of public health services in slums. Brazil ranks number one in the world as the country with the most years of life lost through violence. Brazilian slums emerged in the hills of Rio de Janeiro in the early 20th century and were built by former slaves. In the last decades, the speed of their growth has intensified. Between 2000 and 2010, the growth of slums was twelve times higher than the annual increase in Brazilian households. The number of people living in these conditions (61% Afro-Brazilians) increased from 6.5 million in 2000 to more than 14 million in 2010. São Paulo houses 27% of all the slums in Brazil. Since the 2000s, these communities have been occupied by poor workers (65% with work permits) who do not have a sufficient income to pay rent. Approximately 2 million people reside in the slums of São Paulo. These territories have the highest prevalence of malnutrition among children caused by unhealthy housing and the highest prevalence of adult obesity caused by the consumption of low-cost, ultraprocessed foods. The coexistence of these two diseases constitutes a double burden for health intervention and greatly increases the cost of implementing public policies. This article provides evidence that violence is increasing the negative neighborhood effects in Brazilian slums, a condition that implies more complex and targetet interventions in these territories.O tráfico de drogas tornou-se o principal fator para a crescente escalada da violência e um dos maiores obstáculos para o sucesso dos serviços públicos de saúde nas favelas. O Brasil ocupa o primeiro lugar no mundo como o país com mais anos de vida perdidos pela violência. As favelas brasileiras surgiram nas colinas do Rio de Janeiro no início do século XX e foram construídas por ex-escravos. Nas últimas décadas, a velocidade de seu crescimento se intensificou. Entre 2000 e 2010, o crescimento de favelas foi doze vezes maior que o aumento anual das famílias brasileiras. O número de pessoas vivendo nessas condições (61% afro-brasileiras) aumentou de 6,5 milhões em 2000 para mais de 14 milhões em 2010. São Paulo abriga 27% de todas as favelas no Brasil. Desde a década de 2000, essas comunidades foram ocupadas por trabalhadores pobres (65% com permissão de trabalho) que não têm renda suficiente para pagar o aluguel. Aproximadamente dois milhões de pessoas residem nas favelas de São Paulo. Esses territórios têm a maior prevalência de subnutrição entre as crianças causada por moradia insalubre e a maior prevalência de obesidade em adultos causada pelo consumo de alimentos ultraprocessados de baixo custo. A coexistência dessas duas doenças representa uma carga dupla para a intervenção na saúde e aumenta consideravelmente o custo de implementação de políticas públicas. Este artigo apresenta evidências de que a violência está aumentando os efeitos negativos da vizinhança nas favelas brasileiras, condição que implica intervenções mais complexas e específicas, direcionadas para esses territórios
Lowering of plasma triiodothyronine level and sympathetic activity does not alter hypoalbuminaemia in rats fed on a diet of low protein concentration
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