Introdução: As taxas de sobrepeso e obesidade vêem aumentando nos últimos anos e esta tendência se reflete também nos trabalhadores. O ambiente de trabalho é um local estratégico para ações de incentivo a adoção de estilos de vida saudáveis, através da alimentação, atividade física e controle de peso. Objetivo: Avaliar o impacto de uma intervenção nutricional no local de trabalho sobre a qualidade da dieta de trabalhadores adultos no município de São Paulo. Métodos: Trata-se de um ensaio comunitário controlado que teve duração de 6 meses, envolvendo 279 trabalhadores de 4 empresas da cidade de São Paulo. A intervenção foi baseada no automonitoramento de peso com apoio de um programa de computador denominado Programa Peso Saudável, em que o trabalhador enviava seu peso, via e-mail, e recebia um gráfico de acompanhamento com mensagens de estímulos a comportamentos saudáveis de alimentação e atividade física. A dieta foi avaliada por meio de recordatório alimentar de 24h e a Qualidade Global da Dieta foi avaliada pelo Índice de Qualidade da Dieta (IQDa) adaptado para ajuste energético. Este índice é composto por 10 componentes (1-Cereais e tubérculos; 2- Verduras e legumes; 3- Frutas; 4- Leite e produtos lácteos; 5- Carnes e ovos e 6- Leguminosas; 7- Gordura total; 8- Gordura saturada; 9- Sódio e 10- Variedade), itens que receberam pontuação de 0 (consumo inadequado) a 10 (consumo dentro do recomendado). Para avaliar o impacto da intervenção foi utilizada a média do consumo energético, o IQDa total e seus componentes antes e após intervenção e o delta da variação entre os grupos para avaliar o efeito bruto do impacto da intervenção. O impacto foi ajustado pelas variáveis sexo, estado civil, escolaridade e idade. Resultados: A intervenção resultou em melhora no impacto bruto do componente cereais e tubérculos. Em relação ao IQDa observou-se piora no grupo controle, enquanto que o grupo intervenção não sofreu diferença significativa. Observou-se efeito positivo da intervenção entre os participantes que apresentaram pior qualidade da dieta no início do estudo (+6,38 pontos no IQDa). Conclusão: A intervenção apesar de não ter sido efetiva na promoção da melhora da qualidade global da dieta, resultou em melhora do componente cereais, raízes e tubérculos do IQDa, com incremento de 0,73 ponto após a intervenção. O efeito mais expressivo da intervenção foi observado entre os trabalhadores que tinham, inicialmente, a pior qualidade da dieta, com um impacto superior a 6 pontos no IQDa / Introduction: The rates of overweight and obesity have increased in recent years and this trend also reflect in the workers. The workplace is a strategic point for actions to encourage the adoption of healthy lifestyles through nutrition, physical activity and weight control. Objective: To evaluate the impact of a nutritional intervention at the workplace on the quality of adult workers diet. Methods: This is a randomized community trial and it ran for 6 months, involving 279 employees of four companies in the city of São Paulo. Intervention was based on self-monitoring of weight with the help of software Healthy Weight Program, where a worker sent the weight, by email, and received an accompanying graph with messages of encourage to healthy behaviors of diet and physical activity. Diet was assessed by 24h dietary recall and overall diet quality was assessed by the Diet Quality Index (DQIa) adapted to energy requirements. This index is composed of 10 components (1-Cereals and tubers; 2- Vegetables and legumes, 3- Fruit 4- Milk and dairy products; 5- Meat and eggs 6- Beans; 7- Total Fat: 8- Saturated Fat , 9- Sodium and 10- Variety), items that received scores of 0 (inadequate intake) to 10 (recommended intake). To evaluate the impact of the intervention was used a mean of energy consumption, the DQIa total and its components before and after intervention and the difference between groups to determine the effect of raw impact of the intervention. The impact was adjusted for sex, marital status, education and age. Results: The intervention resulted in improvement in the raw impact of the component grains and tubers. After the intervention there was a decrease in the DQIa in the control group, while the intervention group had no significant difference. Observed positive effect of intervention among participants who had a poorer quality of diet at baseline (+6.38 points in DQIa). Conclusion: The intervention was not effective in promoting the improvement of overall diet quality, resulted in improved component cereals and tubers of DQIa, an increase of 0,73 point after the intervention. The expressive effect of the intervention was observed among workers who were initially the worst quality of the diet, with an impact of more than 6 points in DQIa

Orientador: Helena Maria André Bolini / Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Engenharia de Alimentos / Made available in DSpace on 2018-08-19T01:17:22Z (GMT). No. of bitstreams: 1 Mauricio_AngelicaAparecida_D.pdf: 2435386 bytes, checksum: 5945d9533cc0ccfd4509978a82ba8f53 (MD5) Previous issue date: 2011 / Resumo: As mudanças no processamento e a crescente exigência do consumidor por alimentos que apresentem, além da alta qualidade sensorial e nutricional, benefícios associados à saúde, fazem surgir à necessidade de novos produtos que possam atender a essas exigências do mercado. O presente trabalho teve como principal objetivo o desenvolvimento e a caracterização de um bolo de cenoura sem glúten e diet, avaliar a aceitação por consumidores e determinar a intenção de compra. Para dar início a pesquisa, primeiramente, desenvolveu-se um mix de farinhas sem glúten a fim de identificar as características do bolo produzido com o mix e compará-las aos 2 tipos de bolo produzidos com glúten, mas com diferentes tipos de gordura. As formulações de bolo isentos de glúten (BIG) produzidos com MIX -1 e MIX +1, bolo com glúten e óleo de milho (BGOM) e bolo com glúten e óleo de palma (BGOP) 80 e 100g, foram avaliadas quanto ao seu valor nutricional, preferência e intenção de compra. Os bolos BIG MIX-1 e BGOP 80g apresentaram valor nutricional, preferência e intenção de compra comparáveis ao da formulação padrão. Portanto, o MIX-1 isento de glúten e o óleo de palma podem ser utilizados como ingredientes de bolo de cenoura, fornecendo produtos com características que atendem às exigências do mercado consumidor. Para dar continuidade à pesquisa, o novo objetivo traçado foi a partir do mix isento de glúten, que buscou desenvolver e padronizar novas fórmulas de bolo de cenoura sem glúten e avaliar sua aceitação. Para tal, devido ao grande número de variáveis, optou-se por utilizar somente o mix de farinhas isenta de glúten e o óleo de milho, deixando assim a sugestão de novos experimentos com óleo de palma. Para o delineamento experimental com 12 ensaios, foram elaborados três diferentes mix de quatro farinhas sem glúten. Os atributos dos bolos preparados com esses mix foram comparados com os atributos do bolo padrão com glúten. Os resultados foram analisados por ANOVA, Teste de Tukey (p<0,05) e Análise de Cluster. Houve três ensaios que não diferiram significativamente do bolo padrão. As melhores formulações obtiveram razão de massa entre seis e quatro. As fórmulas sem glúten obtiveram notas de aceitação global entre 7,55 e 6,80 e a padrão, 7,15. Os atributos dureza, fraturabilidade, adesividade e gomosidade interferiram negativamente na aceitação e, maciez, elasticidade, coesividade e atividade de água interferiram positivamente. Dessa forma, é possível afirmar que é viável substituir a farinha de trigo por farinhas isentas de glúten na produção de bolo de cenoura mantendo suas características sensoriais. Depois de ter chegado a resultados que apontaram que a razão da massa entre seis e quatro foram as que sugeriram melhor resposta sensorial e instrumental, optou-se por dar continuidade à pesquisa padronizando as formulações isentas de glúten em relação à formulação padrão com glúten e também se inseriu um novo mix de farinhas isento de glúten e sem fubá uma vez que alguns consumidores comentaram detectar sabor de fubá nos bolos sem glúten. Além disso, elaborouse a versão diet (sem sacarose) das fórmulas sem glúten. Sendo assim, deu-se continuidade a pesquisa com o objetivo de avaliar o perfil sensorial e temporal e o índice de aceitação global das sete diferentes fórmulas de bolos de cenoura, com e sem glúten diet ou com sacarose. As fórmulas foram então submetidas aos testes descritivos de Análise Descritiva Quantitativa (ADQ) com 12 provadores treinados, e Análise de Tempo-Intensidade (TI) com 13 provadores treinados. Os resultados foram analisados por ANOVA, teste de Tukey (p<0,05) e Análise de componentes Principais (ACP). Para complementar as análises, aplicou-se teste de Aceitação Global (120 consumidores) analisado por ANOVA, Tukey (p<0,05) e Mapa de Preferência Externo (MPREFE) que permitiu conhecer os atributos descritivos preferidos pelo público consumidor a fim de garantir a aceitação do produto. Foram definidos 16 termos descritores para o estudo de ADQ e, somente o atributo gosto doce passou por estudo temporal. Observou-se que as amostras que continham fubá em sua fórmula apresentaram-se mais quebradiças, arenosas, aparentemente mais secas, menos macias e menos elásticas quando comparadas as fórmulas sem fubá. Em contrapartida, as fórmulas sem fubá mostraram-se mais adesivas, porém, com melhor sabor e aroma de cenoura, enquanto que a amostra padrão, com glúten e sacarose, caracterizou-se por ser a mais macia, devido à presença de glúten. Quanto ao estudo temporal de gosto doce, as amostras não apresentaram diferença significativa entre si. As diferenças observadas pela equipe treinada de ADQ não foram detectadas pelos consumidores, que demonstraram boa aceitação para todas as amostras sem diferença. Além disso, pelo MPREFE, foi possível concluir que os consumidores esperam que bolo de cenoura seja mais macio e úmido, além de poroso e com aroma adocicado, mesmo esses dois últimos atributos sendo esperados em menor intensidade. Concluiu-se, portanto, que a substituição de farinha de trigo e sacarose em bolo de cenoura é possível e atende as expectativas dos consumidores. Para finalizar a pesquisa, fez-se novamente a análise de aceitação das sete fórmulas de bolo de cenoura, padrão e sem glúten, com e sem sacarose, com objetivo de avaliar os atributos aparência, aroma, sabor, textura e impressão global com 120 consumidores de bolo de cenoura por utilização de escala hedônica linear de 9 cm. Os dados foram analisados por ANOVA, teste de medias de Tukey (p<0,05), Mapa de Preferência Interno e Dendograma. Alem disso, dados de parâmetros de textura como dureza, adesividade, gomosidade, mastigabilidade, coesividade, fraturabilidade, maciez e elasticidade, atividade de água e cor das amostras foram analisados por Partial Least Square (PLS) para que fosse possível determinar a influência desses parâmetros instrumentais na aceitação hedônica dos consumidores. Observou-se que todos os bolos foram bem aceitos, exceto a amostra Sem Glúten Diet elaborada com mix +1 (SGD+1) uma vez que esta amostra deixou o consumidor em dúvida e foi a que obteve menores porcentagens para o aspecto avaliado de doçura ideal e intenção de compra e a que se apresentou com sabor mais acentuado de fubá. Quanto aos aspectos instrumentais analisados, coesividade e elasticidade influenciaram positivamente na aceitação dos produtos. Os demais parâmetros não foram considerados parâmetros relevantes pelos consumidores nas análises de aceitação dos bolos. Finalmente, obteve-se resultados de intenção de compra para as amostras por meio de escala de atitude estruturada de 5 pontos. Os provadores indicaram ter interesse em adquirir os bolos, com exceção da amostra SGD+1, caso estivessem disponíveis para compra / Abstract: Changes in food process and the higher demand for foods that have health benefits, besides high sensory and nutritional quality, make new-products development necessary. This study aimed to develop different formulas of glutenfree carrot cake with maize oil and traditional carrot cakes with wheat flour and maize oil or palm oil. Acceptance by consumers, their purchase intention and the nutritional facts of the formulas were also goals of this research. Firstly, a mix of gluten-free flours was suggested in order to replace wheat flour in cakes. Glutenfree cake was compared to two types of cake made with wheat flour (gluten) and with different types of fat. The gluten-free cake (BIG) produced with MIX -1, the cake with gluten and maize oil (BGOM) and the cake with gluten and palm oil (BGOP) with 80 and 100g were assessed for their nutritional values, preference and purchase intent. BIG MIX-1 and BGOP 80g had nutritional values, preference and purchase intent comparable to standard formulation. Therefore, the glutenfree-flour mix (MIX-1) and palm oil can be used as ingredients for carrot cake, providing products with features that meet the requirements of the consumer market. Secondly, a new goal was drawn and new gluten-free formulas were developed and standardized from the first suggested gluten-free-flour mix. Acceptance rates were one more time evaluated. For this purpose and due to the large number of variables, mix of gluten-free flours and maize oil were the only two variables chosen. Thus, we left the suggestion of new experiments with palm oil. For the 12-essays-experimental design, three gluten-free mixes with four different gluten-free flours were developed. The attributes of the cakes made with these mixes were compared with the attributes of the standard cake, with gluten. The results were analyzed by ANOVA, Tukey test (p<0.05) and Cluster Analysis. Three trials did not differ significantly from standard cake. The best formulas have obtained mass ratio between six and four. Overall linking of the gluten-free formulas was scored between 7.55 and 6.80 and the standard, gained 7.15. Hardness, fracturability, gumminess and Adhesiveness interfered negatively in the acceptance, while Softness, resilience, cohesiveness and water activity interfered in a positive way. Thus, it can be said that it is feasible to substitute wheat flour for gluten-free flours in the production of carrot cake and keep its sensory characteristics. Once we have reached results that showed that the ratio of mass between six and four presented the best sensory and instrumental responses we decided to continue the research by standardizing the gluten-free formulations and also suggested a new mix of gluten-free flour, but at this time, without corn meal once some consumers commented that cakes with that flour tasted like cornmeal cake. In addition, we elaborated the diet version (without sucrose) of gluten-free formulas. So, the novel goal was to assess the sensory and temporal profiles and the overall acceptance rate of the new seven different formulas of carrot cakes. The formulas were then evaluated by Descriptive Quantitative Analysis (QDA) with 12 trained panelists and by Time-Intensity Analysis (TI) with 13 trained panelists. The results were analyzed by ANOVA, Tukey test (p<0.05) and Principal Component Analysis (PCA). In order to complement the analysis, Global Acceptance was carried out with 120 consumers and its results were analyzed by ANOVA, Tukey (p <0.05) and External Preference Mapping (MPREFE) which informed the descriptive attributes most preferred by the consumers in order to ensure acceptance of the products. Sixteen descriptor terms were defined during QDA study, and only sweet taste attribute underwent temporal study. It was observed that the samples that contained corn meal in its formula were more brittle, sandy, apparently drier, less elastic and less soft. In contrast, the formulas without cornmeal were more adhesive, but with better taste and flavor of carrots, while the standard sample, with gluten and sucrose, was said as being the softest, due to the presence of gluten. Cake samples showed no significant difference for the temporal profile of their sweet taste. The differences observed by the QDA trained panelists were not detected by consumers, who showed good acceptance for all samples with no difference. Furthermore, MPREFE shows that, for consumers, carrot cakes are supposed to be moist and soft, porous and smell sweet. Therefore, it was concluded that the replacement of wheat flour and sucrose in carrot cake is possible and meets consumer expectations. Finally, acceptance of appearance, aroma, flavor, texture and overall liking of the seven samples was evaluated by 120 consumers of carrot cake using the 9cm-linear scale. Data were analyzed by ANOVA, Tukey test (p <0.05), internal preference mapping and dendogram. Furthermore, data of texture parameters such as hardness, adhesiveness, gumminess, chewiness, cohesiveness, fracturability and resilience, water activity and color of the samples were analyzed by Partial Least Square (PLS) in order to determine the influence of instrumental parameters on consumers' hedonic acceptance. It was observed that all the cakes were well accepted, except the SGD 1, which sweetness seemed to be questionable. As for the instrumental aspects, cohesiveness and elasticity have influenced the acceptance of products. The other parameters were not relevant to the panelists. Finally, we obtained results for purchase intention using the 5-point-attitude scale. Panelists indicated an interest in buying the cakes, except for the SGD 1 sample / Doutorado / Consumo e Qualidade de Alimentos / Doutor em Alimentos e Nutrição

Submitted by Biblioteca da Faculdade de Farmácia (bff@ndc.uff.br) on 2017-04-25T19:05:47Z No. of bitstreams: 1 Silva, Zoraide Nascimento da [Dissertação, 2013].pdf: 1185323 bytes, checksum: 946daa9635e7e35265240f551b7b7d5e (MD5) / Made available in DSpace on 2017-04-25T19:05:47Z (GMT). No. of bitstreams: 1 Silva, Zoraide Nascimento da [Dissertação, 2013].pdf: 1185323 bytes, checksum: 946daa9635e7e35265240f551b7b7d5e (MD5) / Uma das dietas mais procuradas para perda de peso é a dieta Atkins, caracterizada como hiperproteica, hiperlipídica e hipoglicídica. O consumo em excesso de proteínas leva a produção de ácidos provenientes do metabolismo protéico e para manter a homeostase sanguínea são recrutados íons, principalmente o cálcio proveniente do osso, levando ao comprometimento deste tecido. Este trabalho teve como objetivo avaliar o efeito da dieta hiperproteica no tecido ósseo em ratas Wistar. O estudo teve duração de 60 dias. Animais com 90 dias de idade foram divididas em 4 grupos (n=7); Grupo controle Caseína 1 (C1) e Caseína 2 (C2), Grupo Hiperproteico 1 (HP1) e Hiperproteico 2 (HP 2). O grupo C2 e HP2 foram submetidos a 30% de restrição alimentar. O experimento teve a duração de 60 dias. O peso e a ingestão hídrica eram verificados uma vez por semana. Utilizando absorciometria por dupla emissão de raios X (DXA) foi avaliada a densidade mineral óssea (DMO g/cm2), o conteúdo mineral ósseo (CMO g), a Área (cm2), tecido gordo total e do tronco. A análise densitométrica foi realizada no início e ao final do experimento com o animal anestesiado. Após o sacrifício foram coletadas amostras de sangue e o fêmur direito. No fêmur foi realizado densitometria óssea, biometria e com as cinzas ósseas análises de cálcio, magnésio e fósforo. Do sangue coletado foi obtido o soro e analisados cálcio, magnésio, fósforo, insulina, osteocalcina e paratormônio. Os resultados são apresentados com média e erro padrão. Os animais com alimentação em livre demanda apresentaram maior ganho de massa corporal do que os animais com restrição calórica. Os grupos hiperproteicos apresentaram maior ingestão hídrica, quando comparados com o grupo C1 (P<0,05). Na ingestão alimentar, os grupos experimentais consumiram quantidades similares e menor em comparação com o Controle 1 (P<0,05). As concentrações de cálcio sérico foram menores entre os grupos experimentais e C2 (P<0,05). Os valores da osteocalcina sérica foram menores nos grupos hiperproteicos (P<0,05). A insulina foi significativamente menor no grupo HP2 (P<0,05), e sem diferença significativa entre os grupos controles e HP1, sendo que o grupo C2 apresentou redução de mais de 50% em relação ao grupo C1. Houve redução da largura do ponto médio da diáfise do fêmur nos grupos experimentais quando comparados com seus respectivos grupos controle. As concentrações de cálcio ósseo foram menores nos grupos hiperproteicos (P<0,05). No geral, os resultados densitométricos ósseos total, da pelve e da coluna vertebral foram semelhantes entre os grupos com consumo em livre demanda e entre os grupos com restrição alimentar. A DMO do fêmur do grupo HP2 foi menor (P<0,05). O tecido gordo do tronco nos grupos com consumo em livre demanda foi maior e o tecido magro total desses grupos foram similares. A dieta da proteína não promoveu maior perda de peso que a dieta controle. Os grupos hiperproteicos apresentaram redução da largura do ponto médio da diáfise do fêmur, diminuição do cálcio ósseo e sérico e da osteocalcina, sendo que o grupo HP2 apresentou também diminuição na concentração sérica de insulina / One of the most sought diet for weight loss is the Atkins’, characterized as a high protein, lipid and low glycemic diet. The excessive intake of proteins leads to the production of acids from it’s metabolism. In order to maintain homeostasis, blood ions are recruited, mainly calcium from the bone, leading to impairment of the tissue. The objective of the present study was to evaluate the effect of a high protein diet on the bone tissue in Wistar rats. 90-day-old animals were divided into 4 groups (n = 7): Casein 1 group control (C1), Casein 2 (C2), High Protein 1 (HP1) and High Protein 2 (HP 2). Groups C2 and HP2 were subjected to 30% of food restriction ( 60 days). Weight and water intake were checked once a week. Bone mineral density (BMD g/cm2), bone mineral content (BMC g), total fat tissue and area (cm2) of the thorax were determined by Dual Emission X-rays (DXA). Anesthetized animals were subjected to densitometric analysis at the beginning and at the end of the experiment with anesthetized animals. Then the animals were terminated, and the blood and right femur collected. Femur densitometry and biometrics were made. Calcium, magnesium and phosphorus were determined from bone ashes. Serum calcium, magnesium, phosphorus, insulin, PTH and osteocalcin were measured. Results are presented as mean and standard error. Animals fed ad libitum gained more body weight than the animals on restricted diet. High protein groups had higher (P <0.05) water intake when compared with C1. Food intake in experimental groups was similar and lower (P <0.05) when compared with C1. Serum calcium concentration were lower (P <0.05) between the high protein groups and C2. Values of serum osteocalcin were low (P <0.05) in high protein groups. Insulin was significantly low (P <0.05) in group HP2. C2 group insulin was reduced by over 50% compared to C1. Groups HP1 and control were statistically similar. High protein groups showed a width at the midpoint of the diaphysis when compared with their respective control groups. Bone calcium concentrations were low (P <0.05) in high protein groups. Overall, the results of bone, pelvis and spine densitometries were similar between groups ad libitum and with restricted diets. HP2 group femurs exhibited reduced bone mass density (BMD). Trunk fat and lean tissues in ad libitum groups were higher (P<0.05) and similar, respectively. The protein diet did not promote greater weight loss than the restricted diet. High protein groups showed a width reduction at the midpoint of the diaphysis, decreased bone and serum calcium and osteocalcin. HP2 group also showed lower serum insulin

Bakgrund: Kost och fysisk aktivitet ligger till grund för elevers psykiska, fysiska och sociala välmående. Skolsköterskors främsta uppgift är att arbeta hälsofrämjande och förebyggande i skolan.Syfte: Syftet med studien är att belysa hur skolsköterskor arbetar hälsofrämjande på olika nivåer i skolan fokuserat på kost och fysisk aktivitet.Metod: Kvalitativ studie där fem skolsköterskor intervjuats och datamaterialet har analyserats med innehållsanalys.Resultat: Vikten av att ha hälsofrämjande visioner i skolan. Att arbeta hälsofrämjande med elever i grupp. Att skapa relation med elever.Konklusion: För att nå fram till elever med olika förutsättningar behöver skolsköterskors hälsofrämjande arbete fokuserat på kost och fysisk aktivitet kombineras på organisatorisk, grupp och individnivå. / Background: Diet and physical activity form the basis for students' mental, physical and social well-being. The primary task of school nurses is to promote health promotion and prevention in the school.Purpose: The aim of the study is to explore how school nurses work with health promotion at different levels in the school focused on diet and physical activity.Method: A qualitative study in which five school nurses were interviewed and the data material was analyzed with content analysis.Result: Importance of having health-promoting visions in school. To work health promotion with students in a group. Creating relationships with students.Conclusion: In order to reach students with different conditions, school nurses' health promotion work focused on diet and physical activity need to be combined at organizational, group and individual levels.

Objetivo: Evaluar la calidad de la dieta por región natural del Perú en adolescentes y adultos. Materiales y métodos: El presente es un análisis secundario de la base de datos del Estudio Latinoamericano de Nutrición y Salud (ELANS). La muestra estuvo compuesta por 1113 sujetos de diferentes regiones del país (Lima, resto de costa, sierra y selva). Para medir la calidad de la dieta se calculó el HEI (Índice de Alimentación Saludable), a través de la información del consumo de alimentos por recordatorio de consumo de 24 horas de dos días no consecutivos. El HEI se clasificó en no saludable (<60 puntos HEI), medianamente saludable (60-79 puntos) y saludable (> 80 puntos). Resultados: La media del puntaje HEI fue 71.0 (DE: 10,0), las mujeres tuvieron mayor puntaje que los hombres (72,2 (DE: 10,0) vs 69,5 (DE: 9,7); p<0.001, respectivamente). El consumo de lácteos obtuvo un mayor puntaje en la Sierra y menor en la Selva (6,76 (DE: 4,53) vs 2,86 (DE: 4,24); p<0.001, respectivamente). Asimismo, las carnes tuvieron mayor puntaje en la Costa y Selva y menor en la Sierra (4,76 (DE: 0,89), 4,76 (DE: 0,84) vs 4,24 (DE: 1,49); p<0.001, respectivamente). La regresión lineal ajustada mostró que la Sierra tiene mayor puntaje de HEI (coef: 1.89 EE: 0.75; p=0.012) y la selva el menor puntaje (coef: -5.31, EE: 1.01; p<0.001) en relación a Lima y Resto de costa. Conclusión: El lugar de residencia afecta el índice de calidad, siendo la Sierra la que presenta un mayor índice de alimentación saludable y la selva el menor en comparación a las otras regiones. / Objective: To evaluate the diet quality in Peru by region in adolescents and adults. Materials and methods: This is a secondary analysis of the Latin American Nutrition and Health Study (ELANS) database. To measure diet quality, the HEI was calculated using information from a 24-hour food consumption reminder on two non-consecutive days. The HEI was classified as unhealthy (<60 HEI points), medium healthy (60-79 points) and healthy (>80 points). The sample was composed of 1113 subjects from four different regions of Peru: Lima Metropolitana, Costa, Sierra and Selva. A multiple linear regression was performed to analyze the effect of region, adolescents and adults. HEI score. Results: The mean HEI score was 71,0 (SD: 10,0), women scored higher than men (72,2 (10,0) vs 69,5 (9,7); p<0.001). Dairy products scored higher in the Sierra region and lower in the Selva region (6,76 (4,53) vs 2,86 (4,24); p<0. 001). Similarly, meats scored higher on the Costa region and the Jungle region and lower in the Sierra region (4,76 (0,89) vs. 4,76 (0,84) vs. 4,24 (1,49); p<0.001). The adjusted linear regression showed that the Sierra region has the highest HEI score (coef: 1.89, EE:0.75; p=0.012) and the Selva region the lowest score (coef: -5.31, EE:1.01; p<0.001). Conclusion: The region of residence affects the quality index, with the population of the Sierra having a higher index of healthy eating and the forest having the lowest score compared to the other regions. It is important to improve the quality of the population's diet across regions in Peru. / Tesis

Low carbohydrate diets have been studied for many years as nutritional therapy for treating patients with type 2 diabetes mellitus (T2DM). Type 2 diabetes is an inflammatory disease that is defined by high blood glucose and HbA1c, lipid levels, BMI, central adiposity, and cholesterol levels, are some among the many indicators that can signal risk for diabetes or help to diagnose diabetes. These indicators are used in studies to evaluate the effectiveness of the nutritional therapy in producing positive health outcomes. Many medications are available for the treatment of T2DM; however, they have a host of side effects, and nutritional therapy has been shown to at least help reduce the dosage of these medications needed by the patients. There are other forms of nutritional therapy besides low carbohydrate diets, and some controversy remains about low carbohydrate diets that in the long term, replacing carbohydrates with fats and proteins could result in increased cholesterol and lipid levels, creating an increased risk for cardiovascular disease. Although some studies have found that low carbohydrate diets, especially very low carbohydrate ketogenic diets (VLCK), do result in increased cholesterol, it is generally an increase in HDL, which is considered good cholesterol and not harmful. Overall weight loss benefits from reduced central adiposity, BMI, and reduced HbA1c levels outweigh the increase in HDL as a side effect. A few different variations of low carbohydrate diets are compared in this review, such as very low carbohydrate ketogenic diets, moderate carbohydrate calorie restricted diets, and moderate carbohydrate low (MCD) Glycemic Index (GI) diets. Due to the ability to exchange carbohydrates with high GI for carbohydrates with low GI, the MCD with low GI sounds promising for good adherence and positive health outcomes in the long run. Although very low carbohydrate ketogenic diets produce many positive health outcomes, the nutritional therapy must be very well designed and followed up, and care must be taken that fiber and nutrients are maintained in the diet. Adherence is a key part of the success of nutritional therapy and a study design plays a major role in that. Providing behavioral development classes, nutritional information classes, and intermittent classes focused on physical activity and healthy habit formation leads to overall increased positive affect which is better for the patient and thus, for the study as well. The easier the nutritionist or dietician can make the therapy transition for the participant, the more likely they are also to stay and try to stick with it. For example, in the studies where the study coordinator provided some small food provisions at the beginning or throughout the study seemed to be successful because the patients were less likely to fall to making their own choices poorly and being inconsistent. Although there were many diets that resulted in many positive health outcomes, ultimately a well-designed, adherence focused, very low carbohydrate ketogenic diet seemed to be the most effective at decreasing HbA1c and producing other positive health outcomes as well. In the long term however, a VLCKD, may be unsustainable for the patient and the body, given the extreme reduction in important carbohydrates.

Bakgrund: Infertilitet är en sjukdom i reproduktionssystemet som definieras av att en klinisk graviditet inte uppnås efter 12 månader eller mer av regelbundet oskyddat samlag. Cirka tio procent av par i fertil ålder världen över drabbas av ofrivillig barnlöshet. Hos ungefär 30 % av paren finns ingen förklaring till infertiliteten. Ofrivillig barnlöshet kan leda till långvarig kris och psykisk ohälsa. En god kosthållning kan ge olika hälsofördelar. Att vägleda och hjälpa dessa par med kostråd skulle kunna leda till bättre psykisk och fysisk hälsa samt ekonomiska besparingar för samhället. Syfte: Belysa kostens betydelse för fertiliteten. Metod: En systematisk litteratursökning. Databassökning genomfördes i CINAHL och PubMed  som resulterade i sju vetenskapliga artiklar. Resultat: Hemlagad mat, Medelhavsdiet, frukt &amp; grönsaker, mjölkprodukter, kostfiber och omättat fett främjar fertiliteten. Socker, snabbmat och mättat fett är ogynnsamt för fertiliteten. Konklusion: Bevis har framkommit som tyder på att kosten har betydelse för kvinnors fertilitet. Implikation: En studie som finner ett resultat som påtalar att någon kost kan påverka fertiliteten kan utgöra grund för kostrådgivning som kan leda till färre fall av oönskad infertilitet och besparingar för samhället. Mer forskning inom området behövs. / Background: Infertility is a disease of the reproductive system defined by the fact that a clinical pregnancy is not achieved after 12 months or more of regular unprotected intercourse. Around ten percent of the fertile couples worldwide suffer involuntary infertility. In about 30 % of the cases there is no explanation for infertility. Involuntary infertility can lead to long-term crises and mental illness. A good diet can lead to better health. Helping these patients could lead to better mental health and physical health and economic savings for society. Purpose: To highlight the impact of the diet for fertility. Method: A systematic review. Database search was made in CINAHL and PubMed that resulted in seven scientific articles. Result: Homemade food, Mediterranean diet, fruits &amp; vegetables, diary, dietary fiber and unsaturated fats are promoting fertility. Sugar, fast food and saturated fat are unfavorable for fertility. Conclusion: Evidence has emerged that the diet is important for women's fertility. Implication: A study that would find that a particular diet would have an impact on fertility could be useful in diet counselling that could lead to less cases of  infertility and  savings for society. More research in this area is needed.

The composition of the gut microbiome can be affected by environmental factors, such as diet. The Western dietary pattern is associated with microbiome dysbiosis and adverse health outcomes, including obesity and metabolic disorders. The objective of this study was to examine the effect of gut microbiota from lean or obese human donors on metabolism and weight gain in recipient mice fed one of three basal diets: 1) the standard AIN93G diet, which promotes rodent health; 2) the total Western diet (TWD), which mimics the American dietary pattern and promotes inflammation-associated colorectal carcinogenesis; and 3) a 45% high fat diet-induced obesity (DIO) diet, which promotes excessive weight gain and symptoms of metabolic syndrome. We hypothesized that fecal microbiome transfer (FMT)from obese human donors would lead to an obese phenotype with symptoms of metabolic syndrome in recipient mice, and that consumption of TWD or DIO diets would further exacerbate the metabolic syndrome phenotype. The experiment design consisted of two main factors: body type of the human donor (obese or lean) and experimental diet (AIN, DIO or TWD), which was fed to mice for 22 weeks. Prior to FMT, the resident gut microbiome in mice was depleted using an established broad spectrum antibiotic/antifugal oral dosing regimen. Interestingly, human donor body type did not significantly affect final body weight or body composition in recipient

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