It is well established that replacing dietary saturated fatty acids with unsaturated fatty acids reduces cardiovascular disease (CVD) risk. Although epidemiological and clinical evidence indicate health benefits of consuming various fatty acid classes including n-9, n-6, and short- and longer-chain n-3 fatty acids, current dietary recommendations fall short of providing the optimal amounts of these fatty acids in daily diets. In addition, significant knowledge gaps remain in our understanding of the effects of, and mechanisms underpinning the action of, the various fatty acid classes on risk factors for CVD. The objective of this research was to contribute to the evaluation of health benefits of using different dietary oils, and determine how these benefits may play a role in improving public health and decreasing CVD risk. Additionally, this research examined effects of diet-gene interactions, endogenous fatty acid ethanolamides (FAEs) on body fat mass distribution as well as changes in the composition of gut microbiota following consumption of dietary oil treatments. The Canola Oil Multicenter Intervention Trial (COMIT) was conducted as a 5-phase randomized, controlled, double-blind, cross-over clinical trial. Each 4-wk treatment period was separated by 4-wk washout intervals. A total of 130 volunteers with abdominal obesity consumed each of 5 identical weight-maintaining, fixed-composition diets with one of the following treatment oils (60 g/3000 kcal) in the form of beverages: 1) conventional canola oil (Canola; n-9 rich), 2) high–oleic acid canola oil with docosahexaenoic acid (CanolaDHA; n-9 and n-3 rich), 3) a blend of corn and safflower oil (25:75) (CornSaff; n-6 rich), 4) a blend of flax and safflower oils (60:40) (FlaxSaff; n-6 and short-chain n-3 rich), and 5) high–oleic acid canola oil (CanolaOleic; highest in n-9). At endpoints, plasma fatty acid levels reflected the differences in fatty acid composition of five dietary treatments. All diets lowered total cholesterol (TC) compared with baseline. TC was lowest after the FlaxSaff phase and highest after CanolaDHA. The CanolaDHA treatment improved HDL-C, triglycerides, and blood pressure thereby reducing Framingham risk scores compared with other oils varying in unsaturated fatty acid composition. Homozygotes minor allele carriers of rs174583 (TT) on FADS2 gene showed lower (P<0.01) plasma EPA and DPA levels across all diets, but no differences were observed in DHA concentrations after the CanolaDHA feeding. In addition, plasma FAE levels were positively associated with plasma fatty acid profiles. Minor allele A carriers of rs324420 of FAAH gene showed a higher (P<0.05) plasma FAE levels compared with major allele C carriers across all diets, and showed higher (P=0.0002) docosahexaenoylethanolamide levels in response to the CanolaDHA diet. Impacts of consuming 60 g of five dietary oil treatments on gut microbiota composition were relatively minor at the phylum level and mainly at the genus level, while BMI contributed to a significant shift at the phylum level. In conclusion, consumption of a novel DHA-enriched canola oil improved blood lipid profile and largely reduced CVD risk. Diet-gene interactions might help identify sub-populations who appear to benefit from increased consumption of DHA and oleic acid. The metabolic and physiological responses to dietary fatty acids may be influenced via circulating FAEs, while the altered microbiota profile by shifts in MUFA and/or PUFA may be associated with specific physiological effect. Personalized diets varying in unsaturated fatty acids composition based on specific lifestyles, environmental factors, psychosocial factors, and genetic make-ups will become the future “healthy eating” recommendations to prevent CVD risk. / May 2016

Although typical clinical onset does not occur until adulthood, cardiovascular disease (CVD) may have a long natural history with accumulation of risks beginning in early life and continuing through childhood and into adolescence and adulthood. Therefore, it is important to adopt a life-course approach to explore accumulation of risks, as well as identifying age-defined windows of susceptibility, from early life to disease onset. This thesis examines characteristics in adolescence and adulthood linked with subsequent risk of CVD. One area is concerned with physical and psychological characteristics in adolescence, which reflects inherited and acquired elements from childhood, and their association with occurrence and outcome of subsequent stroke and coronary heart disease many years later. The second area focuses on severe infections and subsequent delayed risk of CVD. Data from several Swedish registers were used to provide information on a general population-based cohort of men. Some 284 198 males, born in Sweden from 1952 to 1956 and included in the Swedish Military Conscription Register, form the basis of the study cohort for this thesis. Our results indicate that characteristics already present in adolescence may have an important role in determining long-term cardiovascular health. Stress resilience in adolescence was associated with an increased risk of stroke and CHD, working in part through other CVD factors, in particular physical fitness. Stress resilience, unhealthy BMI and elevated blood pressure in adolescence were also associated with aspects of stroke severity among survivors of a first stroke. We demonstrated an association for severe infections (hospital admission for sepsis and pneumonia) in adulthood with subsequent delayed risk of CVD, independent of risk factors from adolescence. Persistent systemic inflammatory activity which could follow infection, and that might persist long after infections resolve, represents a possible mechanism. Interventions to protect against CVD should begin by adolescence; and there may be a period of heightened susceptibility in the years following severe infection when additional monitoring and interventions for CVD may be of value.

Philosophiae Doctor - PhD / Given the devastating and debilitating impact of spinal cord injuries (SCI) globally and the effects on any population, its impact extends far beyond just the victim to people and institutions surrounding them and supporting them post-injury. Of growing concern is the increased risk that individuals with SCI have been seen to have a three-fold greater risk of developing cardio-vascular disease (CVD) than their able-bodied counterparts. Prevention strategies to curtail the onset of CVD in the SCI population is limited, and often developed for individuals from developed countries. The overall aim of this study was to assess and explore the need to implement CVD prevention programmes in a regional South African population with individuals after sustaining a traumatic spinal cord injury (TSCI). The study employed a mixed methods approach and was conducted in four (4) phases. Permission and ethics clearance were obtained from the Research Ethics Committee at the University of the Western Cape (UWC) and the Western Cape Department of Health. Phase One of the study utilized a questionnaire to collect TSCI incidence data of which 108 of the eligible 132 cases consented to take part in the study. The demographic findings of this study indicated that a person sustaining a TSCI in the Cape Metropolitan area in South Africa is most likely to be a male, young (20 to 29 years of age), from a Black African or Coloured race group and living in the Cape Flats suburbs. The male to female ratio was 6.2:1. The main cause of TSCI was assault at 58.33% (n=63) with males accounting for the majority of cases (88.89%, n=65). According to the AIS classification, ASIA A and D were the most common classification seen in 38.89% (n=42) and 39.81% (n=43) of the cohort respectively. Phase Two utilized a questionnaire and looked at CVD risk factors of the original cohort. A large portion of the cohort was engaged in high-risk behaviours, i.e. smoking and alcohol consumption. A low number of individuals reported a baseline history of hypertension diagnosis prior to their TSCI (5.56%, n=6). Phase Three of the study emplored semi-structured interviews and a focus group discussion to explore the experiences of persons with a TSCI regarding their ability to be physically active once reintegrated back into the community. Despite understanding the associated benefits of physical activity, several barriers to being physically active were reported; factors within their homes, access within their community, and transportation. The present study’s findings illustrated a growing concern among the SCI population for increased risk for developing CVD due to decreased physical activity. Phase Four of the study utilised a scoping review to identify CVD prevention programmes for individuals with a TSCI. Physical activity has been shown to have numerous health benefits of which reducing the risk of CVD is one. Engaging in physical activity, whether it be structured, unstructred or through a sporting activity can play a major role in combating the onset of CVD. Other tools used in reducing the onset of CVD were seen to be self-management strategies of which contrayer views were seen both for and against their use. Conclusion: Better education during the rehabilitation phase might be a key component to individuals with TSCI injury making more informed decisions about prioritising physical activity as they attempt to reintegrate back into their respective communities. The removal of socio-environmental barriers could allow motivated TSCI individuals better access to choosing how to increase their physical activity levels.

Background: Smoking is the cause of the deaths of up to 7,000,000 people worldwide and can be referred to as a global pandemic. There are 25% of the adult population smoke in the Czech Republic and it is estimated that there are currently 2.4 million active daily smokers. Cardiovascular disease (CVD) is the most common cause of death in the Czech Republic and approximately 50,000 people die every year. In all these deaths, smoking accounts for 26% of men and 12% of women. According to available studies, smoking is directly related to CVD and is a major risk factor for this disease. Both of them, tobacco use and chronic CVD are thought to have a significant impact on the deterioration in quality of life. Aims : The main goal of the diploma thesis was to assess the subjective perception of the quality of life of smokers in connection with the decision to quit smoking in the acute phase of cardiovascular disease and with a three- month interval to find possible connections between tobacco use and quality of life. Methods: The research was based on a quantitative approach, in the form of a questionnaire survey. A set of 34 respondents was selected according to predetermined criteria. These were patients III. Department of Internal Medicine - Cardiology Clinic, University Hospital Královské Vinohrady,...

OBJECTIVE: Cardiovascular disease (CVD) remains the leading cause of death globally. Reducing high blood cholesterol, which is a dominant risk factor for CVD events, is an essential goal of medical treatment. Statins are known as first‐choice agents. However, clinical trials report that some statins increased the risk for type 2 diabetes (T2D). Our objective was to investigate the effect of different statins on insulin secretion and content from pancreatic β-cells after chronic and acute exposure and determine the underlying mechanisms. METHODS: The effects of simvastatin, lovastatin and pitavastatin on GSIS and content were studied in clonal pancreatic β-cells (INS-1 832/13) cultured in high glucose (12 mM). Insulin content and secretion were measured after chronic and acute incubation of statins using homogenous time-resolved fluorescence (HTRF) insulin assay kit (Cisbio). Intracellular Ca2+ was measured using fura-2 AM (Invitrogen). RESULTS: Simvastatin (25-200 nM) and lovastatin (50-200 nM) significantly inhibited GSIS and depleted insulin content in a dose-dependent manner after 72-hour exposure. When the secretion level was normalized for content, the inhibitory effect was not observed. Simvastatin (200 nM) also increased the amplitude of intracellular Ca2+ oscillations at low glucose, but this was not reflected in the amplitude of oscillatory insulin release. In contrast, pitavastatin (25-200 nM) did not affect GSIS and only decreased insulin content at the highest dose tested. CONCLUSION: Inhibition of GSIS by simvastatin and lovastatin could be due to depletion of insulin content. Decreased Ca2+ sensitivity may also contribute to inhibition of GSIS by simvastatin. Pitavastatin had less inhibitory effect on GSIS and insulin content as compared to simvastatin and lovastatin indicating that not all lipophilic statins have a detrimental impact on GSIS. We suggest that statins may have differential mechanistic effects on β-cells some of which may contribute to the risk of T2D.

Student No. 0107750D M.Sc(Med) Research Report / The prescription habits of general practitioners are continually under the scrutiny of ethical critics. There are numerous factors that influence a practitioner’s decision as to which antihypertensive agents to prescribe for the treatment of hypertension. As outlined in various international and national guidelines for the management of hypertension, the recommended treatment depends on ethnicity, current life-style, diet, smoking, age, gender, family history and possible underlying or secondary conditions such as diabetes mellitus, heart failure, isolated systolic hypertension, myocardial infarction, pregnancy, and evidence of coronary artery disease (CAD), stroke or peripheral vascular disease. Currently the control of blood pressure in patients with hypertension is far from optimal with over 70% of hypertensive patients being reported as having imperfect control. A number of factors related to the patient, the practitioner or the medication may explain the high incidence of inadequate blood pressure control. One possible explanation for the poor control of blood pressure may be that practitioners fail to comply with the guidelines. Hence the aim of my study was firstly to determine whether a practitioner’s decision as to which medication to prescribe in the treatment of hypertension is influenced by the Southern African Hypertension Society Guidelines. Secondly, in an attempt to assess the validity of the results of the primary analysis, the actual prescription habits (MediCross® database) were assessed and compared to the general practitioner’s recall of their prescription habits. Questionnaires were distributed to 320 MediCross® practitioners and prescription habits were identified and substantiated by the screening of an existing MediCross® database. I chose as my sample MediCross® general practitioners, as they are demographically representative of all major urban areas in South Africa; likely to be open-minded to supporting research and answering questionnaires (as MediCross® is part of a Clinical Research Site Management Organisation); and I had access to the database of the prescriptions made by MediCross® practitioners hence enabling me to fulfil my second objective. However, it must be kept in mind that these practitioners are representative of general practitioners in urban areas only (as the title of my research report indicates). My results show that 33.1% adhere to the guidelines (when a non-conservative definition of diuretics is used); 27% have heard of the guidelines and have a copy of them. When asked to give their own opinion however, 39% thought they adhered to the guidelines. The results also show that ACE inhibitors are the most commonly prescribed drug class for uncomplicated hypertension but a comparison to a MediCross® database, of which the quality is questionable, does not support this. As the response rate to the questionnaires was only 24.7%, these results are only a pilot study; however they suggest that few general practitioners use the guidelines or even have a copy of the guidelines. This pilot study suggests that the guidelines need to be distributed more widely. Furthermore the general practitioners that responded to the questionnaire indicated that the management of hypertension is difficult in that there is no single treatment regimen appropriate for all populations and each different patient. It was also their view that clinical guidelines for the management of hypertension should more accurately reflect the uncertainty of when to initiate treatment and individual variation if they are going to take these guidelines seriously and comply with them.

Existe a hipótese, dentro da medicina periodontal, de uma possível relação entre doença periodontal e doenças cardíacas. Talvez a doença periodontal possa agir como um fator desencadeante para o desenvolvimento da doença cardiovascular. Vinte e oito pacientes portadores de aterosclerose e periodontite crônica, submetidos à intervenção cirúrgica de revascularização cardíaca e endarterectomia coronariana, participaram do estudo, cujo objetivo foi avaliar nas placas de ateroma de artérias coronárias a presença dos periodontopatógenos do complexo vermelho: Porphyromonas gingivalis, Tannerella forsythia e Treponema denticola. O DNA genômico foi extraídos das amostras de ateromas e se constatou a presença das bactérias através da reação em cadeia da polimerase (PCR). Detectou-se nas 28 amostras de ateroma: P. gingivalis em 50%, T. forsythia em 7,1% e T. denticola em 3,6% respectivamente. Estes resultados ajudam a defender a hipótese de que a doença periodontal pode ser um dos muitos fatores envolvidos com o desenvolvimento da doença cardiovascular, sendo mais um motivo para ser precocemente diagnosticada, prevenida e tratada. / In the field of periodontal medicine there is the hypothesis of a possible connection between periodontal diseases and heart diseases. Maybe the periodontal disease may work as a triggering factor in the development of periodontal of cardiovascular diseases. Twenty-eight patients of atherosclerosis and cronical periodontitis patients were subjected to surgical intervention for cardiac revascularization and coronary endarterectomy, have made part of the study, whose objective was to evaluate the presence of periodontopathogens of the red complex in the atheroma platelets: Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Genomic DNA was extracted from atheroma samples, and the presence of bacteria was stated through polymerase chain reaction (PCR). In the 28 samples of atheroma were detected: P. gingivalis at 50%, T. forsythia at 7.1% and T. denticola at 3.6% respectively. These results help to sponsor the hypothesis that the periodontal disease can be one of several factors involved in the development of cardiovascular disease, being this another reason for its early diagnosis, prevention and treatment.

Trata-se de estudo descritivo com abordagem de análise quantitativa que tem por objetivo identificar o perfil de clientes portadores de angina pectoris instável atendidos numa instituição privada, de um município do interior paulista. O referencial teórico utilizado foi o modelo de “Campo de Saúde" de Lalonde que analisa elementos como a biologia humana, meio ambiente, estilo de vida e organização dos serviços de saúde diante da ocorrência de patologias. A amostra constituiu-se de 58 clientes, com idade entre 34 e 88 anos, de ambos os sexos, a maioria aposentados, que reinternaram na Unidade Coronariana da referida instituição, no período de 01 de setembro de 2002 a 31 de março de 2003. A coleta de dados se deu no domicílio dos clientes, através de entrevista semi-estruturada; aplicada pela pesquisadora. Quanto à biologia humana 32,7% clientes apresentaram obesidade; os pais destes tiveram como causa mortis o infarto agudo do miocárdio e angina pectoris com índices de 24,1% e 20,7%, respectivamente; os antecedentes familiares mais freqüentes quanto às patologias foram a ocorrência de infarto agudo do miocárdio em 22,4% dos pais e hipertensão arterial sistêmica em 41,3% dos parentes próximos; 84,4% clientes possuíam hipertensão arterial sistêmica; 46,5% eram hipercolesterolêmicos; 27,5% tiveram doença vascular periférica e 17,2% apresentaram quadro de acidente vascular cerebral; valores de PAS&#8805;140 mmHg e PAD&#8805;90 mmHg, identificados em 71,1% e 55,7% dos clientes, respectivamente; além de valores de glicemia de jejum >110 mg/dl apresentados por 34,5% da amostra. Com relação ao meio ambiente, 55,1% dos clientes possuíam 1º grau incompleto e 8,6% eram analfabetos; 82,7% dos clientes eram casados, 65,5% não exerciam atividade remunerada e tinham renda familiar entre 03 e 06 salários mínimos. No que concerne ao estilo de vida, 100% dos clientes relacionaram a doença com fatores de risco como a hipertensão arterial sistêmica, o estresse, história familiar, dieta inadequada, tabagismo e falta de atividade física; 24,1% referiram o consumo de bebida alcoólica; 55,2% eram ex-fumantes; 37,9% dos clientes realizavam atividade física; 48,3% referiram fatos ocorridos antes da dor anginosa; 55,2% dos clientes relataram alterações de sono; inatividade sexual em 43,1% dos clientes sendo que 88,0% das clientes já estavam na menopausa e apenas 13,6% faziam terapia de reposição hormonal. No tocante ao atendimento de saúde, todos os clientes eram conveniados mas apenas 13,8% dos clientes utilizavam o serviço de medicina preventiva disponibilizado pelo convênio para prevenir doenças; o serviço de saúde pública é referência para a amostra no tocante à aquisição de medicamentos. Os achados confirmaram a interferência dos elementos referenciados pelo modelo de “Campo de Saúde" na ocorrência das patologias e identificaram a necessidade de trabalhar a mudança no estilo de vida dos clientes, através da prevenção dos fatores de risco para as doenças cardiovasculares e promoção da saúde, em geral. / Descriptive study which was carried out in order to identify customer’s profiles with unstable pectoris angina attended in a Sao Paulo’s state’s town. The theoretical model used was the “Lalonde’s Health Field Model", which analyses elements like human biology, environment, lifestyle, and health services’ organization ahead diseases occurrences. The sample was composed by 58 customers, aged between 34 and 88 year old, masculine and feminine, most of them retired, which were readmitted in a the mentioned Coronary Unity’s institution. The data were collected at the customer’s residences and a semi- structured interview was used. Concerning about human biology, 32.7% male customers presented obesity; the parents died under acute infarct and pectoris angina and the percentual was 24,1% and 20,7%, respectively. The most common relatives’ diseases were related to the parent’s acute infarct (22,4%) and systemic arterial hypertension for the near relatives; 84.4% of the costumers suffered by systemic arterial hypertension; 46.5% had high cholesterol; 27.5% had peripheral vascular diseases and 17.2% demonstrated cerebral vascular accidents. Values like PAS&#8805;140mmHg and PAD&#8805;90 mmHg, identified in 71,1% and 55,7% among the customers, respectively; beyond glycemia’s values over 110mg/d, presented by 34,4% among the costumers. According to the environment, 55,1% customers didn’t study high school and 8,6% were illiterate; 82,7% were married and among them 65.5% didn’t have remunerate activity and their familiar remuneration was between 03 and 06 Brazil’s minimum salary. Related to the life style, 100% customers related the disease with risk factors’diseases as systemic arterial hypertension, stress, family history, inadequate diet, smoking and physical activity’s lack; 24,1% referred alcoholics drinks consume; 55,2% were ex-smokers; 37,9% practiced physical activity; 55.2% related sleeping problems; 43,1% related sexual inactivity and among them 88,0% female costumers already had menopause and only 13.6% were doing hormonal replacement therapy. About health services, all the costumers were had health policies but only 13.8% customers had used preventive medicine. The public health service is a reference in medicines’ acquisition. The data confirm the mentioned health field model elements in the happening of diseases and identify the need of working on changes in the costumers’ life style, through risk factors prevention for the cardiovascular diseases and health promotion.

Introdução: A doença cardiovascular é a principal causa de morbimortalidade precoce em todo o mundo, e responde por grande parte dos gastos dos recursos destinados aos programas de políticas públicas. Neste contexto, a dieta representa uma importante ferramenta na redução dos fatores de risco cardiovasculares. Tendo em vista que inúmeros estudos mostram que o consumo de ômega 9 ou alimento fonte modifica positivamente diversos fatores de risco cardiovascular clássicos, se torna importante avaliar seu efeito sobre propriedades físico-químicas da LDL e da HDL, marcadores cardiometabólicos e oxidativos em indivíduos brasileiros com diferentes níveis de risco cardiovascular. Objetivo: Avaliar o efeito do consumo de azeite de oliva sobre parâmetros cardiometabólicos clássicos e novos em indivíduos com diferentes níveis de risco cardiovascular. Métodos: O estudo foi do tipo clínico prospectivo, aleatorizado, placebo controlado, duplo cego baseado em intervenção nutricional. Indivíduos de ambos os sexos, distribuídos em grupos azeite de oliva (AO) e placebo (PL) receberam durante 8 semanas 3 g/d de azeite de oliva ou placebo. Todos os indivíduos foram classificados quanto ao risco cardiovascular, seguindo os critérios estabelecidos pelo Escore de Risco de Framingham (ERF). Nos momentos basal, T=4S e T=8S foram determinados o perfil clínico, antecedentes familiares de doenças, pressão arterial, consumo alimentar e nível de atividade física. A partir do plasma ou soro, obtidos após 12 h de jejum, foram determinados o perfil lipídico, as apolipoproteínas, o tamanho da HDL e da LDL, o conteúdo de LDL(-) e de NEFAS e atividade da paraoxonase. A aderência à intervenção foi monitorada por meios diretos (marcadores bioquímicos) e indiretos (registro de intercorrências). Resultados: O azeite de oliva foi efetivo em reduzir concentração de triacilglicerois dos indivíduos em alto risco cardiovascular (p=0,023 no T=4S e p=0,049 no T=8S) e a de LDL-C dos indivíduos com risco cardiovascular intermediário (p=0,045 no T=8S) no atual estudo. Observou-se também redução significativa na LDL(-), quando a amostra foi estratificada pelo ERF. Demais parâmetros permaneceram inalterados em função do tempo da intervenção e do ERF. Conclusão: Baixa suplementação (3 g/d) de azeite de oliva promoveu redução dos triacilglicerois, LDL-C e da LDL(-). Portanto, recomenda-se a incorporação de azeite de oliva na dieta brasileira ainda que em baixas doses. Sugere-se também que estudos adicionais usando doses maiores sejam realizados no sentido de identificar potenciais benefícios cardioprotetores adicionais associados ao consumo de azeite de oliva. / Introduction: Cardiovascular disease is the leading cause of premature morbidity and mortality worldwide, and accounts for a large part of the costs of resources devoted to public policy programs. In this context, the diet is an important tool in managing and reducing the risk of cardiovascular disease. Given that numerous studies show that consumption of omega 9 or food source changes positively several classical cardiovascular risk factors, it becomes important to evaluate its effect on physicochemical properties of LDL and HDL, cardiometabolic and oxidative markers in Brazilian individuals with different levels of cardiovascular risk. Objective: This study aimed to evaluate the effect of consuming olive oil on classical and new cardiometabolic properties in individuals with different levels of cardiovascular risk. Methods: It was a clinical, prospective, randomized, placebo controlled, double blind study based on nutritional intervention. Individuals of both sexes, divided into groups olive oil (AO) and placebo (PL) for 8 weeks received 3 g/d of olive oil or placebo. All subjects were classified for cardiovascular risk following the criteria established by the Framingham Risk Score (FRS). At baseline period, T = 4W and T = 8W the clinical profile, the family history of diseases, blood pressure, food consumption and physical activity level were determined. From plasma or serum obtained after 12 h of fasting lipid profile, apolipoproteins, the size of LDL and HDL, LDL (-) and NEFAS content, and activity of paraoxonase were determined. Adherence to the intervention was monitored by direct means (biochemical markers) and indirect (register of complications). Results: The olive oil was effective in reducing the concentration of triacylglycerol of individuals at high cardiovascular risk (p = 0.023 at T=4W and p=0.049 at T=8W) and LDL-C in individuals with intermediate cardiovascular risk (p=0.045 at T=8W) in the current study. It was also observed a significant reduction in LDL (-) when the sample was divided by the FRS. However, changes in other parameters were not detected when comparing the intervention group and the placebo group. Conclusion: Even at low dosage, olive oil has proved to be beneficial in reducing triglycerides, LDL-C and LDL (-).It is therefore recommended the incorporation of olive oil in the Brazilian diet even in low doses. It is suggested that future studies to use higher doses in order to check additional benefits associated with olive oil consumption.

Introdução: A obesidade é um problema de saúde pública, de etiologia multifatorial, relacionada à incidência de comorbidades, como as doenças cardiovasculares - causa número um de mortes, globalmente. Contudo, os tratamentos para reverter essa condição não surtem efeito em longo prazo, fazendo com que novas intervenções para seu tratamento sejam utilizadas, como a abordagem Health at Every Size® (HAES®), que ainda mostra resultados inconclusivos quanto à melhora no perfil lipídico relacionado às doenças cardiovasculares. Objetivo: Analisar os efeitos de uma nova intervenção interdisciplinar baseada na abordagem HAES®, sobre o perfil lipídico relacionado às doenças cardiovasculares em mulheres obesas. Métodos: Estudo quantitativo, baseado em ensaio clínico randomizado controlado com duração de sete meses. Noventa e sete participantes foram recrutadas, após aprovação nos critérios de inclusão e exclusão da amostra, e foram aleatoriamente dividas nos grupos \"Intervenção\" ou \"Controle\", cujas atividades conduzidas tiveram os princípios da abordagem HAES® como norteadores. Participantes do grupo \"Intervenção\" realizaram cinco oficinas filosóficas, aconselhamento nutricional quinzenalmente e atividade física três vezes por semana. Já as participantes do grupo \"Controle\" participaram bimestralmente de palestras relativas à filosofia, nutrição e atividade física. A coleta e análise foram realizadas antes e depois da intervenção para os seguintes parâmetros: triglicérides, colesterol total, colesterol não-HDL, colesterol-VLDL, colesterol-LDL e colesterol-HDL. Variáveis foram comparadas antes e depois da intervenção usando Teste T de Student. Resultados: Foram observadas reduções para colesterol total, colesterol LDL e colesterol NHDL em ambos os grupos. Já para colesterol VLDL e triglicerídeos, houve aumento nos níveis observados. Quanto ao colesterol HDL, o grupo \"Intervenção\" teve uma diminuição após o estudo, ao passo que o grupo \"Controle\" teve um aumento no mesmo. Contudo, para todas as variáveis observadas, não houveram diferenças estatisticamente significativas. Conclusão: a intervenção por si não foi suficientemente eficaz para provocar mudanças no perfil lipídico. / Introduction: Obesity is a public health problem, with multifactorial etiology, related to the incidence of comorbidities, such as cardiovascular diseases - the number-one cause of death globally. However, treatments to reverse this condition have no long-term effect, and new interventions to treat obesity are formulated, such as the Health at Every Size® (HAES®) approach, which still shows inconclusive results regarding the improvement in metabolic profile related to cardiovascular diseases. Objective: To analyze the effects of a new interdisciplinary intervention based on the HAES® approach on biochemical markers related to cardiovascular diseases in obese women. Methods: Prospective, quantitative study based on a randomized controlled clinical trial lasting seven months. Ninety-seven participants were recruited, after approval in the inclusion and exclusion criteria of the sample, and were randomly assembled into the \"Intervention\" or \"Control\" groups, whose activities had the principles of the HAES® approach as guides. Participants in the Intervention group held five philosophical workshops, nutritional counseling every two weeks and physical activity three times a week. The participants of the \"Control\" group participated bimonthly in lectures related to philosophy, nutrition and physical activity. Data collection and analysis were performed before and after the intervention for the following parameters: triglycerides, total cholesterol, non-HDL cholesterol, VLDL-cholesterol, LDL-cholesterol and HDL-cholesterol. Variables were compared before and after the intervention using Student\'s t-test. Results: Reductions were observed for total cholesterol, LDL cholesterol and NHDL-cholesterol in both groups. On the other hand, for VLDL-cholesterol and triglycerides, there was an increase in the levels observed. As for HDL-cholesterol, the \"Intervention\" group had a decrease after the study, whereas the \"Control\" group had an increase in the same. However, for all observed variables, there were no statistically significant differences. Conclusion: The intervention itself was not effective enough to cause changes in the lipid profile.