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Abstract(s)
Introdução: As Doenças Cardiovasculares (DCV) representam um conjunto de doenças que afetam os vasos sanguíneos e o coração, encontrando-se relacionadas com o processo de aterosclerose que contribui para a ocorrência de Enfarte Agudo do Miocárdio (EAM). Identificam-se vários fatores de risco cardiovascular (FRCV), como a dislipidemia (DL), hipertensão arterial (HTA), diabetes mellitus, pré-obesidade/obesidade, aumento do perímetro abdominal (PA), sedentarismo, hábitos alimentares desadequados e hábitos tabágicos. O EAM é um evento cardíaco que se define por uma lesão do miocárdio com indícios de necrose e consequente isquémia miocardial, identificando-se como um dos métodos de tratamento a terapêutica farmacológica, mas com maior ênfase na modificação do estilo de vida, nomeadamente de hábitos alimentares e atividade física. Pelo impacto da intervenção multidisciplinar nestes indivíduos após EAM, surgiram os Programas de Reabilitação Cardíaca (PRC), de modo a disponibilizar um conjunto de atividades que auxiliem no controlo dos FRCV. Objetivos e Metodologia: O presente estudo prospetivo observacional e descritivo, apresentou como objetivo principal caracterizar os hábitos alimentares que possam estar implicados na ocorrência de EAM, assim como o estado nutricional atual, sendo incluídos indivíduos da Fase 1 do PRC do Centro Hospitalar Universitário do Algarve (CHUA). A recolha de dados consistiu na aplicação de um questionário referente à avaliação clínica, bioquímica e antropométrica e um questionário de frequência alimentar semi-quantitativo (QFA). Posteriormente, os dados foram tratados com recurso ao SPSS versão 24.0. Resultados: Dos FRCV avaliados observou-se uma maior prevalência de HTA (74,5%), seguida por pré-obesidade/obesidade (67,9%) e DL (67%). Verificou-se uma associação forte entre o Índice de Massa Corporal (IMC), o PA e a Pressão Arterial Sistólica (PAS) com a ocorrência de EAM. Ao avaliar o perfil lipídico e calculando o ratio triglicéridos/colesterol HDL, obteve-se um valor de 3,7, associado a maior risco cardiovascular. No que se refere ao QFA, destaca-se que 47,6% consumia carnes vermelhas, 2 a 4 vezes por semana, 46,6% consumia carnes processadas, pelo menos, 1 vez por dia, 54,4% referiu ingerir bacalhau, pelo menos, 1 vez por semana, 68% confirmou o consumo de pão branco, pelo menos, 2 vezes por dia, 82,5% utilizava o azeite, pelo menos, 1 vez por dia e 55,5% da amostra referiu nunca consumir ou consumir menos de 1 vez por mês hortaliças. Conclusão: Identificou-se uma associação forte entre o IMC, o PA e a PAS com a ocorrência de EAM, sendo parâmetros a intervir para redução do risco cardiovascular. O QFA mostrou elevada ingestão de alimentos industrializados, em particular de carnes processadas, alimentos salgados e com baixo teor de fibra, associados ao aumento do risco de DCV. Sugerem-se estudos futuros com metodologias adequadas que permitam investigar mais detalhadamente o efeito do consumo de diferentes grupos de alimentos na ocorrência de EAM.
ABSTRACT - Introduction: Cardiovascular Diseases (CVD) represent a set of diseases that affect the blood vessels and the heart, being related to the process of atherosclerosis that contributes to the occurrence of Acute Myocardial Infarction (AMI). Several cardiovascular risk factors (CVRF), such as dyslipidemia (DL), hypertension (HT), diabetes mellitus, pre-obesity/obesity, increased abdominal circumference (AC), sedentary lifestyle, inadequate eating habits, and smoking habits are identified. The AMI is a cardiac event that is defined by a myocardial injury with signs of necrosis and consequent myocardial ischemia. One of the methods of treatment is pharmacological treatment, but the modification of the lifestyle, namely food habits and physical activity, has a major impact on cardiac outcomes. Because of the impact of the multidisciplinary intervention in these individuals after AMI, the Cardiac Rehabilitation Programs (CRP) appeared, in order to provide a set of activities that help in the control of CVRF. Objectives and Methodology: A prospective observational and descriptive study aimed to characterize the eating habits that may be implicated in the occurrence of AMI, as well as the current nutritional status, including phase 1 CRP subjects of the University Hospital of Algarve (CHUA). Data collection consisted of the application of a questionnaire regarding clinical, biochemical, and anthropometric evaluation and a semi-quantitative food frequency questionnaire (FFQ). Subsequently, the data were treated using SPSS version 24.0. Results: A higher prevalence of HT was observed (74.5%), followed by pre-obesity/obesity (67.9%) and DL (67%). There was a strong association between Body Mass Index (BMI), AC, and Systolic Blood Pressure (SBP) with the occurrence of AMI. When assessing the lipid profile and calculating the ratio triglycerides/HDL cholesterol, a value of 3.7 was obtained, associated with a higher cardiovascular risk. With regard to FFQ, 47.6% of the sample consumed red meat, 2 to 4 times a week, 46.6% consumed processed meat at least 1 time per day, 54.4% reported ingesting cod (dried and salted), at least once a week, 68% confirmed white bread consumption at least 2 times a day, 82.5% used olive oil at least 1 time a day and 55.5% of the sample stated never consume or consume less than 1 time per month vegetables. Conclusion: It was identified a strong association between BMI, AC, and SBP with the occurrence of AMI, being parameters identified to be changed in the way to reduce cardiovascular risk. The FFQ showed a high intake of processed foods, particularly processed meats, salty foods, and low fiber, associated with an increased risk of CVD. It is suggested future studies with adequate methodologies allow us to investigate in more detail the effect of the consumption of different food groups on the occurrence of AMI.
ABSTRACT - Introduction: Cardiovascular Diseases (CVD) represent a set of diseases that affect the blood vessels and the heart, being related to the process of atherosclerosis that contributes to the occurrence of Acute Myocardial Infarction (AMI). Several cardiovascular risk factors (CVRF), such as dyslipidemia (DL), hypertension (HT), diabetes mellitus, pre-obesity/obesity, increased abdominal circumference (AC), sedentary lifestyle, inadequate eating habits, and smoking habits are identified. The AMI is a cardiac event that is defined by a myocardial injury with signs of necrosis and consequent myocardial ischemia. One of the methods of treatment is pharmacological treatment, but the modification of the lifestyle, namely food habits and physical activity, has a major impact on cardiac outcomes. Because of the impact of the multidisciplinary intervention in these individuals after AMI, the Cardiac Rehabilitation Programs (CRP) appeared, in order to provide a set of activities that help in the control of CVRF. Objectives and Methodology: A prospective observational and descriptive study aimed to characterize the eating habits that may be implicated in the occurrence of AMI, as well as the current nutritional status, including phase 1 CRP subjects of the University Hospital of Algarve (CHUA). Data collection consisted of the application of a questionnaire regarding clinical, biochemical, and anthropometric evaluation and a semi-quantitative food frequency questionnaire (FFQ). Subsequently, the data were treated using SPSS version 24.0. Results: A higher prevalence of HT was observed (74.5%), followed by pre-obesity/obesity (67.9%) and DL (67%). There was a strong association between Body Mass Index (BMI), AC, and Systolic Blood Pressure (SBP) with the occurrence of AMI. When assessing the lipid profile and calculating the ratio triglycerides/HDL cholesterol, a value of 3.7 was obtained, associated with a higher cardiovascular risk. With regard to FFQ, 47.6% of the sample consumed red meat, 2 to 4 times a week, 46.6% consumed processed meat at least 1 time per day, 54.4% reported ingesting cod (dried and salted), at least once a week, 68% confirmed white bread consumption at least 2 times a day, 82.5% used olive oil at least 1 time a day and 55.5% of the sample stated never consume or consume less than 1 time per month vegetables. Conclusion: It was identified a strong association between BMI, AC, and SBP with the occurrence of AMI, being parameters identified to be changed in the way to reduce cardiovascular risk. The FFQ showed a high intake of processed foods, particularly processed meats, salty foods, and low fiber, associated with an increased risk of CVD. It is suggested future studies with adequate methodologies allow us to investigate in more detail the effect of the consumption of different food groups on the occurrence of AMI.
Description
Mestrado em Nutrrição Clínica
Keywords
Doença cardiovascular Enfarte agudo do miocárdio Reabilitação cardíaca Estado nutricional Fator alimentar Fator nutricional Cardiovascular disease Acute myocardial infarction Cardiac rehabilitation Nutritional status Food factor Nutritional factor
Citation
Miranda MI. Estado nutricional e padrão alimentar dos doentes admitidos em programa de reabilitação cardíaca [dissertation].Lisboa: Escola Superior de Tecnologia da Saúde de Lisboa/Instituto Politécnico de Lisboa; Faculdade de Medicina de Lisboa; 2018.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa