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- Dietary acid load and relationship with albuminuria and glomerular filtration rate in individuals with chronic kidney disease at predialysis statePublication . Silva, Luísa; Moço, Sara Alegria; Antunes, Maria Da Luz; Ferreira, Andreia Sousa; Moreira, Ana CatarinaThe Western diet, characterized by excessive consumption of animal protein and reduced intake of vegetables and fruits, is also rich in sulfur, chlorine, and organic acids, which are the main sources of dietary acid load. A relationship between dietary acid load, renal function, and progression of chronic kidney disease has been demonstrated. Dietary modifications seem to contribute to a reduction in dietary acid load and are associated with improved outcomes in individuals with chronic kidney disease (CKD). The aim of this paper was to review the existing evidence concerning the association between dietary acid load and renal function in non-dialyzed individuals with CKD. A systematic review was conducted by gathering articles in electronic databases (MEDLINE/PubMed, Scopus, and Web of Science) from January 2018 to May 2021. Dietary acid load and GFR and/or albuminuria were analyzed. A total of 1078 articles were extracted, of which 5 met the inclusion criteria. Only one study found no statistically significant associations between the study variables. The remaining showed a negative association between dietary acid load and renal function. This systematic review confirmed the existence of an association between dietary acid load and renal function, with a high dietary acid load contributing to a decreased renal function.
- Qualidade de vida em doentes com excesso ponderalPublication . Esteves, Ana Sofia; Moreira, Ana CatarinaIntrodução: A obesidade está fortemente associada à morbidade e mortalidade, no entanto é menos claro o seu impacto na qualidade de vida relacionada com a saúde. Devido ao aumento da prevalência de excesso ponderal e suas consequências na saúde e qualidade de vida relacionada com a saúde torna-se importante proceder à sua avaliação. Objetivos: Avaliar a qualidade de vida relacionada com a saúde antes e após intervenção nutricional para redução ponderal. Metodologia: Estudo analítico longitudinal com intervenção nutricional para perda de excesso ponderal/adiposidade, numa amostra de 39 utentes. A qualidade de vida relacionada com a saúde foi avaliada pela aplicação dos questionários SF-36v2 e EQ-5D-3L. Resultados: O peso, a massa gorda e o índice de massa corporal iniciais encontraram-se negativamente associadas a pelo menos uma das dimensões avaliadas. No final da intervenção observou-se uma diminuição de medidas antropométricas e um aumento significativo na qualidade de vida relacionada com a saúde. Verificou-se um aumento do índice EQ-5D-3L com a redução do peso, de índice de massa corporal e de massa gorda. Conclusões: A redução ponderal de apenas 4,3% numa amostra de indivíduos com índice de massa corporal médio classificado em obesidade, embora borderline (30,6 Kg/m2), foi suficiente para se observarem alterações positivas na qualidade de vida relacionada com a saúde.
- Adesão ao padrão alimentar mediterrânico e estado nutricional dos doentes com enfarte agudo do miocárdioPublication . Rosado, Sandra; Raimundo, Graça; Aguiar, José; Moreira, Ana CatarinaIntrodução: As doenças cardiovasculares são a principal causa de morte em Portugal. Vários estudos referem o Padrão Alimentar Mediterrânico como protetor das doenças cardiovasculares. Objetivos: Aferir a adesão ao Padrão Alimentar Mediterrânico e caracterizar o estado nutricional de uma amostra de doentes internados no Hospital Espírito Santo de Évora, E.P.E. que sofreram enfarte agudo do miocárdio. Metodologia: Estudo transversal. Amostra composta por 42 doentes com enfarte agudo do miocárdio internados no Hospital Espírito Santo de Évora, E.P.E., entre fevereiro e abril de 2018. Aferiu-se a escolaridade e mediu-se o peso, a altura e o perímetro abdominal. Para aferir a adesão ao Padrão Alimentar Mediterrânico foi aplicado o MedDietScore e para caracterizar a alimentação foi aplicado um Questionário de Frequência Alimentar, previamente validado para a população adulta portuguesa. Resultados: A média de idades dos homens e mulheres foi de 65,3 anos±10,2 e de 70,5 anos±11,3, respetivamente. O índice de massa corporal da amostra teve uma média de 28,5 Kg/m2±4,6 (no caso das mulheres de 29,6 Kg/m2±5,4 e no caso dos homens de 28,0 Kg/m2±4,3). Dos 25 idosos, 64% apresentou excesso de peso e dos 17 adultos, 76,5% apresentou excesso de peso. A mediana do perímetro abdominal dos homens foi de 100,0 cm e a mediana do perímetro abdominal das mulheres foi de 102,0 cm. Foi encontrado um perímetro abdominal >88 cm em 100% das mulheres. Nos homens, 44,8% possuía um perímetro abdominal >102 cm e em 24,1% foi encontrado um perímetro abdominal >94 cm. Apenas 19,1% dos inquiridos apresentaram uma adesão elevada ao Padrão Alimentar Mediterrânico. O consumo de carne vermelha foi superior ao consumo de carne branca ou de peixe [64,3 (P25=17,13; P75=77,15) g/dia vs. 31,7(P25=12,0; P75=68,6) g/dia e 14,3(P25=6,9; P75=31,4) g/dia]. Conclusões: A maioria da amostra apresentou excesso de peso (69,0%), possuía um perímetro abdominal com risco de doenças cardiovasculares associado e 80,9% não apresentou uma elevada adesão ao Padrão Alimentar Mediterrânico.
- Adesão à dieta mediterrânica em adolescentes do 2º ciclo: que fatores são influenciadores?Publication . Timóteo, Sara; Costa, Vânia; Viegas, Cláudia; Moreira, Ana Catarina; Mendes, LinoOs hábitos alimentares adquiridos na adolescência perduram para a vida adulta, determinando a saúde do indivíduo. A dieta mediterrânica representa um estilo de vida saudável. Contudo, tem-se verificado uma diminuição da adesão a este padrão alimentar. A adoção de hábitos alimentares ocidentalizados pelos estudantes portugueses pode ter repercussões no estado nutricional e na saúde atual e futura. Objetivos do estudo: Avaliar a adesão à dieta mediterrânica e estudar a relação com fatores socioeconómicos e com o estado nutricional.
- Differences between four skinfold calipers in the assessment of adipose tissue in young adult healthy populationPublication . Esparza-Ros, Francisco; Moreira, Ana Catarina; Vaquero-Cristóbal, Raquel; Barrigas, Carlos; Albaladejo-Saura, Mario; Vieira, FilomenaBackground: The aim of this study was to analyze the validity of four different skinfold calipers, as well as to establish the differences between them in a healthy young adult population. Methods: The present study followed a cross-sectional design, including 138 participants, with 69 males (21.46 ± 2.52 years) and 69 females (22.19 ± 2.85 years). The measurement protocol included basic measurements of body mass and stretch stature and eight skinfolds with a Harpenden, Holtain, Slim Guide, and Lipowise. The ∑6 and ∑8 skinfolds and fat mass were calculated. The order in which the skinfold calipers were used was randomized. Results: No significant differences were found in either the Σ6 and Σ8 skinfolds or masses and fat percentages calculated with the skinfolds obtained with the different calipers (p > 0.05), and the inclusion of the covariates of sex, BMI, and hydration status of the participants showed no effect on the differences. The Bland–Altman test showed significant differences between the calipers (p < 0.001). Conclusion: It has been observed that the analyzed calipers have shown validity for the assessment of adiposity-related variables in a male and female sample of non-overweight, young healthy adults, but they are not interchangeable with each other when the assessment is meant to be compared over time or with other samples.
- Cardiovascular risk in HIV-infected individuals: a comparison of three risk prediction algorithmsPublication . Policarpo, Sara; Rodrigues, Teresa; Moreira, Ana Catarina; Valadas, EmíliaABSTRACT - Introduction: Cardiovascular (CV) risk is known to be increased in HIV-infected individuals. Our aim was to assess CV risk in HIV-infected adults. Methods: CV risk was estimated for each patient using three different risk algorithms: SCORE, the Framingham risk score (FRS), and DAD. Patients were classified as at low, moderate or high CV risk. Clinical and anthropometric data were collected. Results: We included 571 HIV-infected individuals, mostly male (67.1%; n=383). Patients were divided into two groups according to antiretroviral therapy (ART): naïve (7.5%; n=43) or under ART (92.5%; n=528). The mean time since HIV diagnosis was 6.7±6.5 years in the naive group and 13.3±6.1 years in the ART group. Metabolic syndrome (MS) was identified in 33.9% (n=179) and 16.3% (n=7) of participants in the ART and naïve groups, respectively. MS was associated with ART (OR=2.7; p=0.018). Triglycerides ≥150 mg/dl (OR=13.643, p<0.001) was one of the major factors contributing to MS. Overall, high CV risk was found in 4.4% (n=23) of patients when the SCORE tool was used, in 20.5% (n=117) using the FRS, and in 10.3% (n=59) using the DAD score. The observed agreement between the FRS and SCORE was 55.4% (k=0.183, p<0.001), between the FRS and DAD 70.5% (k=0.465, p<0.001), and between SCORE and DAD 72.3% (k=0.347, p<0.001). Conclusion: On the basis of the three algorithms, we detected a high rate of high CV risk, particularly in patients under ART. The FRS was the algorithm that classified most patients in the high CV risk category (20.5%). In addition, a high prevalence of MS was identified in this patient group.
- Effects of the ketogenic diet in the treatment of gliomas: a systematic reviewPublication . Sargaço, Beatriz; Oliveira, Patrícia; Antunes, Maria Da Luz; Moreira, Ana CatarinaThe ketogenic diet (KD) is a restrictive therapeutic diet, distinguished by being hyperlipidic, normoproteic, and hypoglucidic. This diet stimulates biochemical changes related to fasting periods to achieve systemic ketosis. The metabolic particularities of glioma tumors motivated the rise in investigations and nutritional strategies, such as KD, to modulate the glycemic response as a treatment. This systematic review followed the PRISMA recommendations and was published in PROSPERO, with the identification CRD42021264173. The databases used were EMBASE, PubMed/Medline, Scopus, and Web of Science, and the studies were analyzed using the web-based application Rayyan. To analyze the risk of bias, Cochrane RevMan 5 software was used. For the analysis and treatment of statistical data, Microsoft® Excel® was used. A total of nine original articles were included. Data on survival, symptomology, and quality of life were collected. Mean overall survival was 15.9 months. Constipation and fatigue were the most reported symptoms. In 44.4% of the studies, an improvement in the quality of life was found. The KD is supported by most published studies as an effective therapy in the treatment of malignant gliomas due to its positive effects on patient survival. It was not possible to conclude the effectiveness of KD on quality of life.
- Development of RisObIn.Com, a screening tool for risk of childhood obesity in the communityPublication . Moreira, Ana Catarina; Oliveira, Patrícia Almeida; Borrego, Rute; Nogueira, Telma; Ferreira, Raquel; Virella, DanielThe prevalence of childhood overweight has increased considerably in the past three decades and there is evidence that childhood obesity can persist into adulthood. A simple tool to identify relevant risk factors may alert families and prevent overweight and obesity. This study aims to develop a preschool screening tool to assess the risk of childhood obesity. Child anthropometric measurements and several risk factors for childhood obesity factors were obtained. The effect of the variables on the outcome of obesity (defined as increased anthropometry-estimated adiposity) was assessed by binary logistic regression analyses. The identified variables were submitted for expert panel validation and combined for the tool development. A total of 304 children were included. Eight items were included in the tool. A higher score of the tool indicates a greater risk for obesity in childhood with the cutoff point set at 0. The tool sensitivity for obesity was 95%, specificity was 74.4%, the positive predictive value was 37.3%, and the negative predictive value was 98.9%. The Risk of childhood Obesity In the Community (RisObIn.Com) tool is proposed to be a comprehensive tool to identify children at high risk for late childhood obesity at admission to primary school. Further studies are needed to assess the performance of the tool.
- Excesso ponderal e pressão arterial em crianças do 1º CicloPublication . Moreira, Ana Catarina; Borrego, Rute; Machado, Margarida; Pombo, André; Costa, Vânia; Almeida, Ana Maria; Tavares, Ana Sofia; Sá, Cristina; Cordovil, R.; Luz, CarlosIntrodução: Portugal é o 6.° país da União Europeia cuja prevalência de excesso de peso e obesidade ultrapassa os 30%. As crianças obesas apresentam risco mais elevado para hipertensão arterial do que crianças não obesas, risco que aumenta com o aumento do IMC e não apenas na classificação de obesidade. A hipertensão arterial é um dos principais factores de risco modificável de doenças cardiovasculares. A sua incidência e prevalência em crianças tem aumentado nas últimas décadas, principalmente, nos países desenvolvidos. Crianças com hipertensão arterial tendem a ser adultos hipertensos com elevado número de morbilidades associadas. Como tal, a sua prevenção deve iniciar-se o mais precocemente possível. Métodos: Estudo transversal em crianças do 1º ciclo, com avaliação nutricional por parâmetros antropométricos e de pressão arterial. A avaliação nutricional incluiu peso e altura para cálculo do índice de massa corporal (IMC), prega cutânea tricipital e prega subescapular para cálculo da percentagem de massa gorda (%MG) através da equação de Slaughter, e o perímetro da cintura para a razão cintura/altura. Para a medição da pressão arterial foi utilizado um tensiómetro de braço, OMRON® M6, realizadas duas medições da pressão arterial sistólica e a pressão arterial diastólica com um intervalo de alguns minutos e classificada de acordo com o percentil de altura (National High Blood Pressure Education Program, 2004). A análise estatística foi efectuada com programa IBM SPSS (Statistical Package for the Social Sciences). Resultados: Foram incluídos 181 crianças, 90 (49,7%) do sexo masculino, entre os 5 e os 10 anos com idade, média 7,4n1,2 anos. De acordo com o IMC, a maioria (61,9%) apresentava eutrofia, 38 (21%) excesso ponderal e 29 (16%) obesidade. A razão perímetro da cintura/altura foi superior ao percentil 90, em 62 (32,4%) crianças. A classificação da %MG foi superior ao percentil 91 em 47 (26,3%) e destes, 21 (11,6%) foram classificados com percentil superior a 98. A pressão arterial sistólica estava elevada (>Percentil 90) em 6 (3,3%) crianças, enquanto a diastólica estava elevada em 44 (24,3%) crianças, das quais 25 (13,8%) acima do Percentil 95. Verificou-se uma correlação positiva entre a pressão arterial sistólica e diastólica e o Z-Score de IMC (r=0,328; p<0,000) e (r=0,263; p<0,000) ; e entre a %MG (r=0,271; p<0,000) e (r=0,187; p<0,000), enquanto apenas a sistólica mostrou correlação fraca com a razão cintura/altura (r=0,181; p=0,015). As crianças eutróficas apresentavam valores de pressão arterial inferiores aos das crianças com excesso ponderal e obesidade (sistólica: 88,5n10,0 vs 93,6n9,7; p=0,050) (diastólica: 61,7n9,3 vs 64,7n7,4; P=0,024). Conclusão: Estes dados confirmam a elevada prevalência de excesso de peso e pressão arterial elevada em crianças no 1º ciclo, bem como a sua associação. Cerca de 1/3 das crianças apresentava excesso ponderal e ¼ tinha valores de pressão arterial elevados. Apesar de num estudo transversal não serem avaliados factores de causalidade, a correlação observada entre a pressão arterial e excesso de peso, indica que futuras intervenções devem focar não apenas a obesidade, mas igualmente a pressão arterial, especialmente em crianças com excesso de peso.
- Is motor competence a key factor in children’s body composition, independent of the method used for measuring it?Publication . Pombo, André; Rodrigues, Luis Paulo; Moreira, Ana Catarina; Borrego, Rute; Machado, Margarida; Costa, Vânia; Almeida, Ana; Tavares, Ana Sofia; Sá, Cristina; Luz, CarlosThe increase in sedentary behaviors and a decrease in children's physical activity (PA) observed in the last decades led to an increase in the prevalence of overweight and obesity in children worldwide. Most of the investigation in this field focus on components of physical fitness (PF) (cardiovascular fitness and upper body strength), however Motor Competence (MC) has been associated with childhood obesity in several studies. An adequate level of MC is a prerequisite for PF and its development can impact lifelong PA habits therefore it’s important to understand how these variables behave in different measures of body composition (BC). The aim of this study is to understand if the association of MC and childhood obesity is similar in different measures of BC (Body mass index (BMI), Skinfold, and Fat mass in kg) and to determine the role of the different motor skills components (MC, cardiovascular fitness and upper body strength) in this relationship. 181 children with a mean age of 7,93 years (SD = 1.28) were evaluated in MC (MCA instrument), cardiovascular fitness (PACER test), upper body strength (handgrip), BMI, skinfold thickness (Slaughter equation) and fat mass weight (value obtained in the slaughter equation converted in kg). Pearson correlations were used to understand the associations between MC and the BC variables, also separate multiple standard regressions were performed to explore the effect of motor skills components in the different measures of BC. MC, cardiovascular fitness, and upper body strength were used as independent variables (predictors), and BMI, skinfold thickness, and fat mass weight dependent variables. Overall, the results showed that MC is weak to moderately associated with childhood obesity independently of the measure used for BC (range between -.285 and -.316, p < .01). Furthermore, only upper body strength and MC were significant predictors (p < .001), discarding cardiovascular fitness, independently of the method used for BC. Our results indicate that MC seems to have similar behavior, in different methods that evaluate BC.