Objective. To compare energy balance and nutrient intake of elite and non-elite school-aged gymnasts, as well as to evaluate their nutritional knowledge and eating attitude and its effect on dietary intake and practices. Methods. Demographic information, anthropometric measurements, menstrual status, sources of nutritional information, nutritional habits as well as supplement use was documented. Eating attitudes were measured by the EAT26 test and nutritional knowledge by a standardised questionnaire. Dietary intake and practices were determined with a 3-day weighed food record, while energy expenditure was measured with an Actical® accelerometer (Mini Mitter Co., Inc. Bend, OR, USA). Results. The total daily energy intake (non-elite = 6 944.37 ± 1 272.28 kJ vs. elite = 6 543.01 ± 2 570 kJ) in both groups was similar to their daily energy expenditure values (non-elite = 6 393.77 ± 1 244.19 kJ vs. elite = 6 696.09 ± 1 676.58 kJ). Elite gymnasts tended to have higher protein (21.37 vs. 15.4% total energy intake (TE), small effect size, d = 0.1) and lower fat (28.9 vs. 33.6% TE, medium effect size, d = - 0.6) intakes. More non-elite gymnasts (n = 7, 88.88%) used micronutrient supplements than elite gymnasts (n = 4, 45.45%, medium effect size, d = 0.45). Most of the gymnasts (55%) ate snacks during the day, which consisted mostly of refined carbohydrates. In the total group of gymnasts the most frequently used source of nutritional information was the coach (60%). There was no difference in nutritional knowledge between the groups (elite = 61.8% vs. non-elite = 62.8% respectively). Lastly, elite gymnasts had a practically significantly higher risk than non-elite gymnasts to follow a diet (large effect size, d = 1.32), while non-elite gymnasts exercised practically significantly more self-control over their food intake com pared to elite gymnasts (large effect size, d = - 1.03). Conclusions. South African elite gymnasts do not differ from non-elite gymnasts in terms of energy-, carbohydrate-, protein-, or fat intake. There is also no difference in energy expenditure or risk in developing an eating disorder, probably due to less competitiveness compared to other international gymnasts. / Thesis (M.Sc. (Dietetics))--North-West University, Potchefstroom Campus, 2005.

Abstract Background There is a great need for improved dietary assessment methods that give valid intake data and are more user friendly than traditional methods. Objectives The aim of this thesis was to develop, implement, and evaluate dietary assessment methods using new approaches and technologies in young populations, and to investigate variables that are important for reporting accuracy. Another aim was to investigate day-of-the-week effects on assessed energy and sugar intakes among children and adolescents. Methods This thesis is based on data collected as part of four different studies on the implementation of the following dietary assessment methods: the short dietary questionnaire (SDQ), a food record (FR) with either a digital camera or smartphone, and a computer-based 24-hour recall. Young pregnant and non-pregnant women with different weight statuses completed the SDQ. Children with overweight and obesity used digital cameras to complete FRs, and adolescents used the smartphone application FR. Parents of 2‒9-year-old European children completed the computer-based 24-hour recall and the results of sugar intake of the children on weekdays and weekends were analysed. The SDQ was evaluated against doubly labelled water (DLW) and a more extensive food frequency questionnaire (FFQ). The two FRs were evaluated against data from a SenseWear Armband (SWA), and the smartphone FR was further compared to a web-based FR. Results The new approaches and technologies used in the dietary assessment methods in this thesis captured between 70% and 79% of the energy intake (EI) of children, adolescents and young women, and the ranking according to EI was generally low with all methods. The negative effect on reporting accuracy with increasing BMI/weight status that has been observed previously was confirmed in our studies. In children and adolescents, a weekend day in the FR emerged as a factor that was positively associated with reporting accuracy. Assessed sugar intake in children and adolescents was high in general and highest on weekends, although EI did not differ between weekdays and weekends. Conclusions FRs using technology should focus on simplifying the recording of consumed foods and amounts to a greater extent, for example, by automatizing these steps as much as possible. The SDQ could be further adapted for testing among other groups than young women, and could be adapted for specific objectives. Factors influencing reporting accuracy need to be taken into consideration and further explored when assessing dietary intake. In order to make it possible to evaluate sugar intake in relation to nutritional recommendations, information about added sugar in foods needs to be incorporated into food composition databases. Further development and research is needed to obtain dietary assessment methods with improved accuracy and user friendliness. / Sammanfattning Bakgrund Traditionella kostundersökningsmetoder är krävande och har flera felkällor, vilket ofta leder till att energiintaget (EI) från insamlade kostdata är lägre än individens uppmätta totala energiförbrukning (TEE). Det finns ett stort behov av kostundersökningsmetoder som ger valida resultat och är användarvänliga. Syfte Syftet med avhandlingen var att vidareutveckla kostundersökningsmetoder och att im plementera och utvärdera dem bland barn, ungdomar och unga kvinnor. Syftet var också att undersöka faktorer med betydelse för en korrekt rapportering av kostintaget. Vidare var syftet att undersöka skillnader i EI och intag av socker under vardagar och helger bland barn och ungdomar. Metod Avhandlingen baseras på data från fyra olika studier där olika nyutvecklade kostundersökningsmetoder användes. I en studie användes en kort kostenkät (SDQ) på unga gravida och icke-gravida kvinnor med olika viktstatus. Rapporterat EI jämförde s med TEE uppmätt med dubbelmärkt vatten-metoden, och rapporterat intag av näringsämnen och livsmedel jämfördes med en mer omfattande kostenkät (FFQ). I en annan studie samlades kostdata in för 2 ‒ 9-åringar från åtta europeiska länder med hjälp av en datoriserad 24-timmars recall som besvarades av föräldrarna. Barnens socker- och energiintag jämfördes mellan måndag ‒ torsdag, fredag och helg. I en tredje studie genomförde 8 ‒ 12-åringar med övervikt eller fetma en kostregistrering med hjälp av digitalkamera vid upprepade tillfällen. I en fjärde studie utvecklades och anvä ndes en smartphoneapplikation för kostregistrering bland 15-åringar, som också använde en webb-baserad kostregistrering. Rapporterat EI med kostregistreringarna utvärderades i jämförelse med TEE mätt med SenseWear Armband, och EI och sockerintag under vardagar och helger undersöktes. Resultat SDQ underskattade EI med 30 % bland de icke-gravida kvinnorna och en signifikant högre underskattning skedde bland kvinnorna med övervikt eller fetma. SDQ underskattade EI med 21 % bland de gravida kvinnorna. SDQ kunde dock rangordna EI bland kvinnorna med övervikt eller fetma och gav ett högre estimerat intag av flera näringsämnen och de flesta livsmedel jämfört med FFQ bland de icke-gravida kvinnorna. De nyutvecklade kostregistreringsmetoderna underskattade EI bland barn med 24 % och bland ungdomar med 29 %. Digitalkamerametoden visade god reproducerbarhet för de olika mättillfällena bland barn. Smartphoneapplikationen kunde uppskatta ungdomars TEE och pojkars fysiska aktivitetsnivå med en fråga om den dagliga fysiska aktiviteten. Underskattning av EI ökade med BMI och var lägre när en helgdag fanns med i kostregistreringen för både barn och ungdomar. Bland barnen iv underskattades EI mer bland flickor än pojkar och underskattningen ökade med åldern. Det fanns ingen signifikant skillnad i intagsmängd av näringsämnen och livsmedel när de mättes med smartphoneapplikationen jämfört med den webb-baserade kostregistreringen, och flera näringsämnen och livsmedel var signifikant korrelerade mellan de båda metoderna. EI hos barn i Europa skilde sig inte åt mellan vardagar och helger, men det totala intaget av mono- och disackarider och/eller livsmedel med hög andel tillsatt socker eller sackaros var generellt högre på helgerna. Sockerintaget på fredagar var ett mellanting mellan intaget under vardagar och helger hos de europeiska barnen. Konklusion De nyutvecklade kostundersökningsmetoderna fångade i genomsnitt mellan 70 % och 79 % av EI bland barn, ungdomar och unga kvinnor, och förmågan att rangordna EI var generellt låg med metoderna. Liksom i tidigare studier underskattades EI i högre grad hos de med övervikt/fetma eller högre BMI i alla grupperna, och bland barn och ungdomar framkom att validiteten ökade med en helgdag i kostregistreringen som en ny påverkande faktor. Barns och ungdomars sockerintag var generellt högt och som högst under helgen. Det finns ett stort behov av fortsatt forskning för att förbättra kostundersökningsmetoders validitet och användarvänlighet. För kostregistreringsmetoder som använder sig av teknik bör fokus i vidareutvecklingen vara på att göra det enklare för användaren att registrera konsumerade livsmedel och portionsstorlekar, till exempel genom att automatisera dessa steg i så hög grad som möjligt. SDQ kan anpassas och utvärderas även i andra grupper och för olika syften. Faktorer med betydelse för en korrekt rapportering av kost intaget bör tas i beaktande även fortsättningsvis samt undersökas vidare. För att göra det möjligt att utvärdera intaget av socker i jämförelse med näringsrekommendationer bör information om mängden tillsatt socker i livsmedel inkluderas i livsmedelsdatabaser.

Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / INTRODUCTION: The objective of this research study was to analyze previously collected dietary intake data using multiple 24-hour dietary recalls and semiquantitative food frequency questionnaires (FFQ’s) in a group of HIV-positive and HIV-negative breastfeeding women from a rural region in KwaZulu-Natal in order to compare the intake of selective micronutrients obtained with the two instruments. Identifying the pattern of food intake and the contribution of different foods to the micronutrient intake in this population group will contribute to possible recommendations aimed at dietary changes to improve dietary micronutrient intake. This study was designed as a sub-study of a longitudinal prospective cohort study and subjects (N=108) were lactating mothers enrolled in a cohort which investigated the combined effect of HIV-infection and breastfeeding on women’s nutritional status. METHOD: A locally constructed FFQ and 24h-recall were used to collect dietary intake data from 108 subjects on three occasions, (~6 weeks, 14- and 24-weeks post partum). Analysis was done using the Food Finder Program™2. Micronutrients under investigation were iron, zinc, copper, selenium, vitamin A, B6, C, D and E, thiamin, riboflavin and folic acid and were selected on their relevance in HIV (AIDS). Descriptive statistics was used to determine the consumption of food items as percentage of all food items consumed and to calculate mean, mode, median and range of serving sizes for the ten food items most frequently consumed (measured with the 24h and FFQ respectively). Data was not normally distributed (indicated by the paired t-test and confirmed with a RM ANOVA nonparametric test). The F-value was determined (using Wilcoxon matched pairs test) and the significance of the difference between the micronutrient intakes measured with the two instruments (p<0.05) calculated. To investigate the strength of the correlation between the two dietary intake measures, Spearman’s correlation coefficients were determined for the nutrients under investigation. The significance level for these measurements was 95% (p<0.05). RESULTS: Both methods identified maize meal and mahewu, bread, chicken, dried beans, cabbage, onion, bananas, oranges and green leaves as the foods most often consumed. Bread, dried beans, maas, pilchards, mango and green wild leaves were the foods that contributed the most to the micronutrients under investigation. Although maize meal (in the form of phutu or mahewu) was the food item most frequently consumed in large portions, it was not in the top ten food items for any micronutrient contribution, except for selenium. Correlation coefficients (unadjusted for energy) in this study were very poor, ranging from 0.038 for vitamin B12 up to 0.48 for iron. All correlations (except vitamin B12) were poor but significant (p<0.05). CONCLUSION: There was some agreement found in the type of foods most frequently consumed and their contribution to the micronutrient intake of this population group, when using three 24h-recalls and FFQ’s and therefore in describing the habitual food intake of the population group. There was however no agreement between the micronutrient intake measured with three 24h-recalls and three FFQ’s (p<0.05). Further analysis of the data and comparisons with the biochemical results reported in another study, is recommended.

Thesis (MNutr)--Stellenbosch University, 2011. / ENGLISH ABSTRACT: INTRODUCTION: Immigration, especially to countries with a higher prevalence of overweight and obesity, has been found to exacerbate these conditions in immigrants. This study investigated the change in dietary intake, physical activity and body mass index (BMI) of South African immigrants in Hobart, Australia. OBJECTIVES: The objectives were to determine the change in BMI, the current and usual dietary intakes and perceived dietary changes and the current physical activity levels and perceived changes in physical activity since immigration of South African immigrants residing in the Greater Hobart Area. DESIGN: This study had descriptive, cross-sectional as well as analytical components. SAMPLING: Forty seven participants were recruited by contacting known immigrants, postings in newspapers, contacting immigrant social groups, contacting the Department of Economic Development as well as using the social networking program, “Facebook”. All participants had to be between the ages of 20 and 50 and have lived in Australia for longer than six months, but shorter than five years. Thirty participants completed the study with a mean age of 37.17 years. METHODS: Participants were required to complete a self-administered sociodemographic questionnaire, a 3-day diet record, physical activity questionnaire and quantified food frequency questionnaire (QFFQ). The investigator administered a weight change questionnaire. Anthropometric measurements included weight, height and waist circumference measurements. RESULTS: There was no significant difference between the BMIs of participants preand post-immigration (p=0.06), but the percentage of overweight female participants increased from 24% (n=4) to 29% (n=5) and the percentage of overweight male participants increased from 46% (n=6) to 69% (n=9). The percentage of obese female participants increased from 6% (n=1) to 12% (n=2) post-immigration with the male participants showing no increased prevalence of obesity. Participants appeared aware of their weight classifications with 60% (n=18) reporting that they considered themselves overweight. Mean waist circumference values of male and female participants were classified as action level 1. Forty one percent (n=7) of female participants and 31% (n=4) of male participants had waist circumference values classified as action level 2. Carbohydrate intakes were below the Nutrient Reference Values (NRV) recommendations for 84% (n=25) and 62% (n=19) of participants as indicated by the QFFQ and diet records respectively and the mean carbohydrate intake values of male and female participants (QFFQ and diet records) were below the NRV recommendations as well. Fibre intakes were below the NRV recommendations for 76% (n=23) and 82% (n=25) of participants as indicated by the QFFQ and food records respectively. Saturated fat and sodium intakes were high. Folate, calcium and potassium were consumed in lower than recommended amounts by a large proportion of participants. Sixty seven percent (n=20) of participants reported an increase in physical activity post-immigration and 70% (n=21) of participants anticipated a future increase in physical activity levels. CONCLUSION: The study population experienced an increase in weight. A number of other risk factors for cardiovascular and other chronic diseases were also identified including high waist circumference values, high saturated fat and sodium intakes and low fibre, folate, calcium and potassium intakes. Interventions aimed at decreasing the risk of South African immigrants in Hobart becoming overweight/obese and developing chronic diseases should probably be aimed at lower saturated and total fat intake, higher carbohydrate and fibre intake and plenty of dietary variation and should further encourage physical activity, but this needs to be confirmed by larger prospective studies. / AFRIKAANSE OPSOMMING: INLEIDING: Daar is gevind dat immigrasie, veral na lande met ‘n hoër prevalensie van oorgewig en vetsugtigheid, hierdie toestande in immigrante kan vererger. Hierdie studie het die veranderinge in dieetinname, fisiese aktiwiteit en liggaamsmassa-indeks (LMI) van Suid-Afrikaanse immigrante in Hobart, Australië ondersoek. DOELWITTE: Die doelwitte was om die verandering in LMI na immigrasie, die huidige en gewoontelike dieetinname en gerapporteerde dieet veranderinge na immigrasie asook die huidige fisiese aktiwiteit en gerapporteerde fisiese aktiwiteit veranderinge van Suid-Afrikaanse immigrante, wat in die groter Hobart area woon, te ondersoek. ONTWERP: Die studie het beskrywende asook analitiese komponente gehad. STEEKPROEFTREKKING: Respondente is gewerf deur alle bekende immigrante te kontak, koerant boodskappe te plaas, sosiale groepe vir immigrante te kontak, die Department van Ekonomiese Ontwikkeling te kontak asook deur die sosiale netwerk program, “Facebook”, te gebruik. Alle respondente moes tussen die ouderdomme van 20 en 50 wees en moes langer as ses maande, maar korter as vyf jaar in Australië woon. METODES: Respondente het ‘n sosio-demografiese vraelys asook ‘n drie dag voedselrekord, ‘n voedselfrekwensie vraelys en ‘n fisiese aktiwiteit vraelys voltooi. Die navorser het ‘n gewigsverandering vraelys afgeneem. Antropometriese metings het gewig, lengte en middelomtrek ingesluit. RESULTATE: Daar was nie ‘n betekenisvolle verskil tussen die LMI waardes van respondente voor en na immigrasie nie (p=0.06), maar die persentasie oorgewig vroulike respondente het toegeneem van 24% (n=4) na 29% (n=5) en die persentasie oorgewig manlike respondente het toegeneem van 46% (n=6) na 69% (n=9). Die persentasie vetsugtige vroulike respondente het toegeneem van 6% (n=1) na 12% (n=2) na immigrasie en die manlike respondente het geen toename in vetsugtigheid getoon nie. Dit het voorgekom asof respondente bewus was van hulle gewigsklassifikasies met 60% (n=18) wat gerapporteer het dat hulle hulself as oorgewig beskou. Die gemiddelde middelomtrek waardes van die manlike en vroulike respondente was geklassifiseer as aksie vlak 1. Een en veertig persent (n=7) van die vroulike respondente en 31% (n=4) van die manlike respondente het middelomtrek waardes getoon wat as aksie vlak 2 geklassifiseer was. Koolhidraat inname was laer as the nutrient verwysingswaardes vir 84% (n=25) en 62% (n=19) van die respondente soos aangedui deur die voedselfrekwensie lys en 3-dag voedselrekord. Vesel inname was laer as the nutrient verwysingswaardes vir 76% (n=23) en 82% (n=25) van die respondente soos aangedui deur die voedselfrekwensie lys en 3-dag voedselrekord. Die gemiddelde waardes vir koolhidraat en vesel inname vir manlike en vroulike respondente (voedselfrekwensie lys en 3-dag voedselrekord) was laer as die nutrient verwysingswaardes. Versadigde vet en natrium innames was hoog. Folaat, kalsium en kalium innames van ‘n groot proporsie respondente was laer as die aanbevelings. Sewe en sestig persent (n=20) van die respondente het gerapporteer dat hulle fisiese aktiwiteitsvlakke toegeneem het na immigrasie en 70% (n=21) van die respondente het verwag dat hulle fisiese aktiwiteitsvlakke sou verhoog. AANBEVELINGS: Die studie populase het ‘n toename in gewig en LMI ondervind. ‘n Aantal verdere risikofaktore vir kroniese en kardiovaskulêre siektes was geïdentifiseer, byvoorbeeld hoë middelomtrek waardes, hoë versadigde vet en natrium innames en lae vesel, folaat, kalsium en kalium innames. Programme wat fokus op die voorkoming van oorgewig/vetsug in Suid-Afrikaanse immigrante in Hobart, Australië moet moontlik gemik wees op laer totale en versadigde vet inname, hoër vesel en koolhidraat inname asook variasie in diet en fisiese aktiwiteit moet ook verder aangemoedig word. Sodanige aanbevelings moet egter bevestig word deur groter prospektiewe studies.

p. 1-91 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-30T19:25:01Z No. of bitstreams: 5 TeseCompleta.pdf: 487668 bytes, checksum: 0cbd119285e19d904247614a45fbc4b1 (MD5) TeseCap02.pdf: 67224 bytes, checksum: 77a8daf7dd37cd014cebede8dc9c3b7d (MD5) TeseCap01.pdf: 132759 bytes, checksum: 5ba4ec7ffc38816101f5c9c624aa5415 (MD5) cap04_Lista_de_Tabelas.pdf: 75027 bytes, checksum: 4e5c9bbb159afdd1bac1994c3460c9bc (MD5) CAP03_SUM_RIO.pdf: 57213 bytes, checksum: d944160e0fd7fdcef66e3257c2b69c27 (MD5) / Approved for entry into archive by Maria Creuza Silva(mariakreuza@yahoo.com.br) on 2013-05-04T17:39:11Z (GMT) No. of bitstreams: 5 TeseCompleta.pdf: 487668 bytes, checksum: 0cbd119285e19d904247614a45fbc4b1 (MD5) TeseCap02.pdf: 67224 bytes, checksum: 77a8daf7dd37cd014cebede8dc9c3b7d (MD5) TeseCap01.pdf: 132759 bytes, checksum: 5ba4ec7ffc38816101f5c9c624aa5415 (MD5) cap04_Lista_de_Tabelas.pdf: 75027 bytes, checksum: 4e5c9bbb159afdd1bac1994c3460c9bc (MD5) CAP03_SUM_RIO.pdf: 57213 bytes, checksum: d944160e0fd7fdcef66e3257c2b69c27 (MD5) / Made available in DSpace on 2013-05-04T17:39:11Z (GMT). No. of bitstreams: 5 TeseCompleta.pdf: 487668 bytes, checksum: 0cbd119285e19d904247614a45fbc4b1 (MD5) TeseCap02.pdf: 67224 bytes, checksum: 77a8daf7dd37cd014cebede8dc9c3b7d (MD5) TeseCap01.pdf: 132759 bytes, checksum: 5ba4ec7ffc38816101f5c9c624aa5415 (MD5) cap04_Lista_de_Tabelas.pdf: 75027 bytes, checksum: 4e5c9bbb159afdd1bac1994c3460c9bc (MD5) CAP03_SUM_RIO.pdf: 57213 bytes, checksum: d944160e0fd7fdcef66e3257c2b69c27 (MD5) Previous issue date: 2006 / Estudos realizados nos países em desenvolvimento demonstram que é freqüente a coexistência de ingestão inadequada de vários nutrientes entre pré-escolares. O objetivo deste estudo é investigar a associação entre anemia e o consumo alimentar inadequado de ferro biodisponível isolado ou combinado à inadequação no consumo alimentar de cobre e/ou vitamina A. Trata-se de um estudo transversal, realizado em dez municípios do Estado da Bahia, Brasil, desenvolvido com 1.551 pré-escolares. Foram obtidos dados sobre idade, sexo, condições sócio-ambientais (utilizou-se questionário estruturado), níveis de hemoglobina (utilizou-se o hemoglobinômetro portátil) e consumo alimentar (inquérito recordatório de 24 horas). A associação entre consumo alimentar e a anemia foi verificada inicialmente por análise bivariada e posteriormente utilizando-se o modelo de regressão log-binomial. Verificou-se que o consumo inadequado de ferro biodisponível esteve significativamente associado à anemia quando ocorreu simultaneamente à inadequação de outros micronutrientes: cobre e vitamina A RP 2.0 (95% CI 1.3 ? 3.0); cobre ou vitamina A RP 1.6 (95% CI 1.1 ? 2.2), mas não quando a inadequação ocorreu apenas para ferro biodisponível RP 1.1 (95% CI 0.6 ? 2.1), quando comparados ao consumo adequado de ferro biodisponível. Observou-se proporção de consumo significativamente maior de: vegetais e frutas para os não anêmicos; leite e cereais para os anêmicos. Entre as refeições principais, mostrou-se que no jantar a ingestão de ferro biodisponível e cobre foi significativamente maior no grupo de não anêmicos, mesmo após ajuste por idade e sexo. É possível supor que entre os pré-escolares com consumo inadequado de ferro biodisponível existe diferenciais de risco importante à medida que se agregam deficiências no consumo alimentar de micronutrientes, como cobre e vitamina A. / Salvador

Introdução: As doenças cardiovasculares (DCV) são a principal causa de morte no mundo, sendo a doença arterial coronária (DAC) a mais comum das DCV, juntamente com acidente vascular cerebral. O cálcio das artérias coronárias é um marcador da DAC subclínica (assintomática) e é preditivo de eventos coronários futuros. Vários fatores de risco cardiovascular contribuem para o desenvolvimento da calcificação da artéria coronária (CAC). Adicionalmente, os fatores dietéticos podem influenciar no processo de aterosclerose e CAC. Objetivo: Avaliar a CAC e sua associação com fatores de risco cardiovascular e ingestão dietética em homens assintomáticos vivendo em comunidade. Métodos: Estudo transversal. A amostra consistiu de 150 homens assintomáticos com idades entre 50 e 70 anos (idade média 58,2 ± 5,3 anos), que foram submetidos à tomografia computadorizada multidetectores (TCMD). A aterosclerose subclínica foi avaliada pela CAC de acordo com o método de Agatston, sendo os escores de cálcio classificados como ≤10 (sem evidência e CAC mínima) e >10 (CAC moderada e aumentada). A ingestão dietética foi avaliada através do Registro de Consumo Alimentar (RCA). O modelo multivariado de Regressão de Modified Poisson foi utilizado para avaliar os fatores de risco cardiovascular independentemente associados com a CAC moderada/aumentada, sendo estimados os efeitos do consumo de diversos nutrientes na prevalência de CAC moderada/aumentada ajustado para ingestão calórica e fatores de risco para CAC, através da razão de prevalências e intervalo de 95% de confiança. Resultados: A presença de CAC (escore de cálcio >0) foi identificada em 59,3% dos participantes. Na análise multivariada, os fatores independentemente associados com a CAC moderada/aumentada foram a história familiar (HF) de DAC prematura (RP=1,39; IC95% 1,03-1,88, p=0,029) e a atividade física (AF) <150 minutos/semana (RP=1,40; IC95% 1,01-1,93; p=0,045). O consumo de alguns nutrientes, também, mostrou-se associado à CAC moderada/aumentada, como o menor consumo de carboidratos (p=0,021) e o maior consumo de lipídeos (p=0,006), após o ajuste do modelo para a quantidade de calorias. Com a inclusão no modelo dos fatores de risco cardiovascular e escolaridade, os nutrientes associados à prevalência da CAC moderada/aumentada foram: carboidratos percentual (RP=0,98; IC95% 0,96-0,99; p=0,040), lipídeos percentual (RP=1,04; IC95% 1,01-1,07; p=0,005) e ácidos graxos saturados (AGS) percentual (RP=1,08; IC95% 1,02-1,14; p=0,013). Conclusões: Nesta amostra de adultos e idosos assintomáticos vivendo em comunidade, fatores de risco cardiovascular como HF de DAC prematura e baixa intensidade de AF estiveram associados, de forma independente, com a calcificação coronária moderada a aumentada. Analisando os fatores dietéticos, uma maior ingestão de lipídeos totais e de gorduras saturadas mostraram-se associadas com escores mais elevados de CAC, enquanto que a ingestão maior de carboidratos, em detrimento aos lipídeos, associou-se com escores mais baixos de CAC. Nossos resultados sugerem que esses fatores de risco devem ser mais considerados na avaliação clínica do risco cardiovascular global do paciente. / Introduction: Cardiovascular diseases (CVD) are the main cause of death in the world, being the coronary artery disease (CAD) the most common CVD. The calcium of the coronary arteries is a marker for subclinical (asymptomatic) CAD, and is predictive of future coronary events. A number of cardiovascular risk factors account for coronary artery calcification (CAC). In addition, dietary factors may influence the process of atherosclerosis and CAC. Goal: To assess CAC and its association with cardiovascular risk factors and dietary intake in community-dwelling asymptomatic men. Method: Cross-sectional study. The sample included 150 asymptomatic men with age ranging between 50 and 70 years (mean age 58.2 ± 5.3 years) submitted to multidetector computed tomography (MDCT). Subclinical atherosclerosis was measured by CAC in accordance with the Agatston method, with the scores classified as ≤10 (no evidence of, or mild CAC) and >10 (moderate and severe CAC). Dietary intake was assessed according to the Food consumption Register (RCA) method. The multivariate Modified Poisson regression model was used to assess cardiovascular risk associated with moderate/severe CAC and the effects of the intake of different nutrients were estimated for the prevalence of moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals. Results: CAC (calcium score >0) was present in 59.3% of the subjects. In the multivariate analysis, factors independently associated with moderate/severe CAC included family history (FH) of early CAD (PR=1.39; 95%CI 1.03-1.88, p=0.029) and physical activity (PA) <150 minutes/week (PR=1.40; 95%CI 1.01-1.93; p=0.045). The intake of some nutrients was also associated with moderate/severe CAC, such as lower carbohydrate intake (p=0.021) and higher lipid intake (p=0.006), after model adjustment for the amount of calories. Once the cardiovascular risk factors and schooling were included in the model, the nutrients associated with the prevalence of moderate/severe CAC were: percentage of carbohydrates (PR=0.98; 95%CI 0.96-0.99; p=0.040), percentage of lipids (PR=1.04; 95%CI 1.01-1.07; p=0.005), and percentage of saturated fatty acids (SFA) (PR=1.08; 95%CI 1.02-1.14; p=0.013). Conclusions: In the sample of community-dwelling asymptomatic adults and older persons, cardiovascular risk factors such as FH of early CAD, and low-intensity PA were independently associated with moderate to severe coronary calcification. Analysis of dietary factors showed that higher intake of total lipids and saturated fats were associated with higher CAC scores, whereas higher intake of carbohydrates over lipids was associated with lower CAC scores. Our results indicate that these risk factors should be considered in the cardiovascular assessment of the patient.

Orientador: Maria Rita Marques de Oliveira / Banca: Maria Rita Marques de Oliveira / Banca: Maria Jacira Silva Simões / Banca: Rozangela Verlengia / Resumo: A obesidade é uma doença estreitamente relacionada ao desenvolvimento da síndrome metabólica (SM) e é fundamentalmente um problema de balanço energético que se desenvolve quando a ingestão de energia proveniente dos alimentos é maior que o gasto energético total. O gasto energético total compreende a taxa metabólica de repouso, o efeito térmico dos alimentos e os gastos com atividade física e pode ser medido pela calorimetria indireta. O objetivo deste trabalho foi estudar a relação da taxa metabólica de repouso (TMR) em mulheres obesas com os componentes da SM e fatores relacionados. O grupo de estudo foi constituído por 35 mulheres com idade entre 18 e 40 anos, que apresentavam um índice de massa corporal (IMC) maior ou igual a 30 kg/m². Foram excluídas as mulheres portadoras de diabetes mellitus, hipotireoidismo, gestantes, lactantes e aquelas em tratamento (medicamentoso ou não) para obesidade e dislipidemias, além das portadoras de doenças graves. Foram aplicados um questionário para obtenção de dados sócio-demográficos, três recordatórios de 24 horas em dias não consecutivos sendo um final de semana e três diários de atividade física, aplicados no mesmo dia dos recordatórios. O comportamento alimentar foi avaliado pela escala de compulsão alimentar periódica (ECAP). Dentre as variáveis antropométricas foram avaliadas peso, estatura, circunferência de cintura, quadril e braço. A composição corporal (percentual de gordura e massa magra) foi avaliada pela bioimpedância elétrica e a TMR foi avaliada por meio do analisador de gases VO2000 MedGraphicsÒ. Foram ainda dosados em sangue o colesterol total e frações, glicose, insulina, proteína C reativa e triglicérides. As mulheres foram agrupadas quanto à presença ou não de SM e em tercil de TMR ajustada para a massa corporal (TMR/MC)... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: It is known that obesity, a disease closely related to the development of the metabolic syndrome (MS), is basically a problem of energy balance and develops when energy intake exceeds total energy expenditure. Total energetic expenditure includes basal metabolic rate, the thermogenic effect of food and expenditures with physical activity and can be determined by indirect calorimetry. The objective of this study was to relate the basal metabolic rate (BMR) of obese women with MS components and related factors. The studied group included 35 women aged 18 to 40 years with a body mass index equal to or above 30 kg/m². Women with diabetes mellitus, hypothyroidism, severe diseases, women being treated for obesity and dyslipidemias and pregnant and lactating women were excluded from this study. A questionnaire to obtain sociodemographic data, three 24-hour dietary recalls in non-consecutive days one being during the weekend and three physical activity diaries administered on the same day as the 24-hour recalls were administered. Eating behavior was assessed by the binge eating scale (BES). The following anthropometric variables were assessed: weight, height and waist, hip and arm circumferences. Body composition (percentage of fat and lean mass) was determined by electrical bioimpedance and the basal metabolic rate was assessed by the gas exchange testing system MedGraphics VO2000®. The women were divided into groups with and without the MS and in BMR terciles adjusted for body mass (BMR/BM). The results showed that there was no significantly statistical difference between the groups with and without the MS regarding income, physical activity, presence of binge eating disorder, dietary macronutrient and micronutrient composition, energy intake, BMR, respiratory quotient (RQ), BMR/BM or MBR/LM. When the women were divided into BMR/BM terciles, BMR/BM was not associated with MS components... (Complete abstract click electronic access below) / Mestre

Made available in DSpace on 2014-06-11T19:29:33Z (GMT). No. of bitstreams: 0 Previous issue date: 2010-02-12Bitstream added on 2014-06-13T20:19:24Z : No. of bitstreams: 1 barim_em_me_botfm.pdf: 1395312 bytes, checksum: 8b3645d190436f35ecd09f4f548b221f (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A alimentação inadequada e o consumo insuficiente de frutas, verduras e legumes estão relacionadas à maior prevalência de doenças e agravos crônicos não transmissíveis, como diabetes, obesidade, doenças cardiovasculares e alguns tipos de cânceres. A complexidade dos determinantes relacionados a essa situação tem exigido o desenvolvimento de investigações que ampliem o conhecimento científico sobre os diferentes aspectos envolvidos. As doenças e agravos crônicos não transmissíveis são de etiologia multifatorial e compartilham vários fatores de riscos modificáveis entre eles a alimentação inadequada, com destaque para a ingestão insuficiente de frutas, verduras e legumes. Considerando a importância desse grupo alimentar para a saúde em geral e redução das doenças e agravos crônicos não transmissíveis, o presente estudo visou descrever o consumo de frutas, verduras e legumes e identificar os fatores associados a esse consumo em uma população adulta, usuária de um serviço público de atenção primária à saúde. Para descrever o consumo de frutas, verduras e legumes foi utilizado recordatório alimentar de 24 horas e realizado método de ajuste pelo consumo energético. Para a obtenção das informações socioeconômicas, antropométricas e sobre os fatores potencialmente associados ao consumo de frutas, verduras e legumes foi utilizado um formulário, construído para o presente estudo, guiado por um modelo teórico de determinação do comportamento alimentar de indivíduos adultos. A população estudada foi formada, predominantemente, por mulheres de meia idade e baixa escolaridade, com excesso de peso corporal e alta prevalência de doenças crônicas. O consumo diário médio de frutas, verduras e legumes, ajustado por energia, foi igual a 281,3 gramas... / Inadequate diet and insufficient intake of fruit, vegetables and legumes are related to higher prevalence of non-transmittable chronic diseases and aggravations, such as diabetes, obesity, cardiovascular diseases and some cancer types. The complexity of determinants related to this situation has required the development of investigations that can expand scientific knowledge concerning the different aspects involved. Non-transmittable chronic diseases and aggravations have multifactor etiology and share various changeable risk factors, among which is inadequate diet, with distinction to insufficient intake of fruit, vegetables and legumes. Considering the importance of this food group to general health and to the reduction of non-transmittable chronic diseases and aggravations, the present study aimed at describing the intake of fruit, vegetables and legumes and at identifying the factors associated with such intake in an adult population of users of a public primary health care service. In order to describe the intake of fruit, vegetables and legumes, a 24-hour recall was used, and a method of adjustment for energetic intake was performed. A form specifically designed for the present study, guided by a theoretical model for determination of individual adults’ dietary behavior, was used to collect socioeconomic and anthropometric data as well as information concerning the factors potentially associated with the intake of fruit, vegetables and legumes. The studied population predominantly consisted of poorly educated middleaged overweight women with a high prevalence of chronic diseases. The mean daily intake of fruit, vegetables and legumes, adjusted for energy, was equal to 281.3 grams, and the mean percentage of energy in the diet provided by this dietary group was equal to 8.7%. Of the evaluated... (Complete abstract click electronic access below)

Resumo: A alimentação inadequada e o consumo insuficiente de frutas, verduras e legumes estão relacionadas à maior prevalência de doenças e agravos crônicos não transmissíveis, como diabetes, obesidade, doenças cardiovasculares e alguns tipos de cânceres. A complexidade dos determinantes relacionados a essa situação tem exigido o desenvolvimento de investigações que ampliem o conhecimento científico sobre os diferentes aspectos envolvidos. As doenças e agravos crônicos não transmissíveis são de etiologia multifatorial e compartilham vários fatores de riscos modificáveis entre eles a alimentação inadequada, com destaque para a ingestão insuficiente de frutas, verduras e legumes. Considerando a importância desse grupo alimentar para a saúde em geral e redução das doenças e agravos crônicos não transmissíveis, o presente estudo visou descrever o consumo de frutas, verduras e legumes e identificar os fatores associados a esse consumo em uma população adulta, usuária de um serviço público de atenção primária à saúde. Para descrever o consumo de frutas, verduras e legumes foi utilizado recordatório alimentar de 24 horas e realizado método de ajuste pelo consumo energético. Para a obtenção das informações socioeconômicas, antropométricas e sobre os fatores potencialmente associados ao consumo de frutas, verduras e legumes foi utilizado um formulário, construído para o presente estudo, guiado por um modelo teórico de determinação do comportamento alimentar de indivíduos adultos. A população estudada foi formada, predominantemente, por mulheres de meia idade e baixa escolaridade, com excesso de peso corporal e alta prevalência de doenças crônicas. O consumo diário médio de frutas, verduras e legumes, ajustado por energia, foi igual a 281,3 gramas... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Inadequate diet and insufficient intake of fruit, vegetables and legumes are related to higher prevalence of non-transmittable chronic diseases and aggravations, such as diabetes, obesity, cardiovascular diseases and some cancer types. The complexity of determinants related to this situation has required the development of investigations that can expand scientific knowledge concerning the different aspects involved. Non-transmittable chronic diseases and aggravations have multifactor etiology and share various changeable risk factors, among which is inadequate diet, with distinction to insufficient intake of fruit, vegetables and legumes. Considering the importance of this food group to general health and to the reduction of non-transmittable chronic diseases and aggravations, the present study aimed at describing the intake of fruit, vegetables and legumes and at identifying the factors associated with such intake in an adult population of users of a public primary health care service. In order to describe the intake of fruit, vegetables and legumes, a 24-hour recall was used, and a method of adjustment for energetic intake was performed. A form specifically designed for the present study, guided by a theoretical model for determination of individual adults' dietary behavior, was used to collect socioeconomic and anthropometric data as well as information concerning the factors potentially associated with the intake of fruit, vegetables and legumes. The studied population predominantly consisted of poorly educated middleaged overweight women with a high prevalence of chronic diseases. The mean daily intake of fruit, vegetables and legumes, adjusted for energy, was equal to 281.3 grams, and the mean percentage of energy in the diet provided by this dietary group was equal to 8.7%. Of the evaluated... (Complete abstract click electronic access below) / Orientador: Elen Rose Lodeiro Castanheira / Coorientador: Maria Antonieta de Barros Leite Carvalhaes / Banca: Regina Mara Fisberg / Banca: Antonio de Pádua Pithon Cyrino / Mestre

Introdução: As doenças cardiovasculares (DCV) são a principal causa de morte no mundo, sendo a doença arterial coronária (DAC) a mais comum das DCV, juntamente com acidente vascular cerebral. O cálcio das artérias coronárias é um marcador da DAC subclínica (assintomática) e é preditivo de eventos coronários futuros. Vários fatores de risco cardiovascular contribuem para o desenvolvimento da calcificação da artéria coronária (CAC). Adicionalmente, os fatores dietéticos podem influenciar no processo de aterosclerose e CAC. Objetivo: Avaliar a CAC e sua associação com fatores de risco cardiovascular e ingestão dietética em homens assintomáticos vivendo em comunidade. Métodos: Estudo transversal. A amostra consistiu de 150 homens assintomáticos com idades entre 50 e 70 anos (idade média 58,2 ± 5,3 anos), que foram submetidos à tomografia computadorizada multidetectores (TCMD). A aterosclerose subclínica foi avaliada pela CAC de acordo com o método de Agatston, sendo os escores de cálcio classificados como ≤10 (sem evidência e CAC mínima) e >10 (CAC moderada e aumentada). A ingestão dietética foi avaliada através do Registro de Consumo Alimentar (RCA). O modelo multivariado de Regressão de Modified Poisson foi utilizado para avaliar os fatores de risco cardiovascular independentemente associados com a CAC moderada/aumentada, sendo estimados os efeitos do consumo de diversos nutrientes na prevalência de CAC moderada/aumentada ajustado para ingestão calórica e fatores de risco para CAC, através da razão de prevalências e intervalo de 95% de confiança. Resultados: A presença de CAC (escore de cálcio >0) foi identificada em 59,3% dos participantes. Na análise multivariada, os fatores independentemente associados com a CAC moderada/aumentada foram a história familiar (HF) de DAC prematura (RP=1,39; IC95% 1,03-1,88, p=0,029) e a atividade física (AF) <150 minutos/semana (RP=1,40; IC95% 1,01-1,93; p=0,045). O consumo de alguns nutrientes, também, mostrou-se associado à CAC moderada/aumentada, como o menor consumo de carboidratos (p=0,021) e o maior consumo de lipídeos (p=0,006), após o ajuste do modelo para a quantidade de calorias. Com a inclusão no modelo dos fatores de risco cardiovascular e escolaridade, os nutrientes associados à prevalência da CAC moderada/aumentada foram: carboidratos percentual (RP=0,98; IC95% 0,96-0,99; p=0,040), lipídeos percentual (RP=1,04; IC95% 1,01-1,07; p=0,005) e ácidos graxos saturados (AGS) percentual (RP=1,08; IC95% 1,02-1,14; p=0,013). Conclusões: Nesta amostra de adultos e idosos assintomáticos vivendo em comunidade, fatores de risco cardiovascular como HF de DAC prematura e baixa intensidade de AF estiveram associados, de forma independente, com a calcificação coronária moderada a aumentada. Analisando os fatores dietéticos, uma maior ingestão de lipídeos totais e de gorduras saturadas mostraram-se associadas com escores mais elevados de CAC, enquanto que a ingestão maior de carboidratos, em detrimento aos lipídeos, associou-se com escores mais baixos de CAC. Nossos resultados sugerem que esses fatores de risco devem ser mais considerados na avaliação clínica do risco cardiovascular global do paciente. / Introduction: Cardiovascular diseases (CVD) are the main cause of death in the world, being the coronary artery disease (CAD) the most common CVD. The calcium of the coronary arteries is a marker for subclinical (asymptomatic) CAD, and is predictive of future coronary events. A number of cardiovascular risk factors account for coronary artery calcification (CAC). In addition, dietary factors may influence the process of atherosclerosis and CAC. Goal: To assess CAC and its association with cardiovascular risk factors and dietary intake in community-dwelling asymptomatic men. Method: Cross-sectional study. The sample included 150 asymptomatic men with age ranging between 50 and 70 years (mean age 58.2 ± 5.3 years) submitted to multidetector computed tomography (MDCT). Subclinical atherosclerosis was measured by CAC in accordance with the Agatston method, with the scores classified as ≤10 (no evidence of, or mild CAC) and >10 (moderate and severe CAC). Dietary intake was assessed according to the Food consumption Register (RCA) method. The multivariate Modified Poisson regression model was used to assess cardiovascular risk associated with moderate/severe CAC and the effects of the intake of different nutrients were estimated for the prevalence of moderate/severe CAC, adjusted for calorie intake and CAC risk factors by means of prevalence ratios and 95% confidence intervals. Results: CAC (calcium score >0) was present in 59.3% of the subjects. In the multivariate analysis, factors independently associated with moderate/severe CAC included family history (FH) of early CAD (PR=1.39; 95%CI 1.03-1.88, p=0.029) and physical activity (PA) <150 minutes/week (PR=1.40; 95%CI 1.01-1.93; p=0.045). The intake of some nutrients was also associated with moderate/severe CAC, such as lower carbohydrate intake (p=0.021) and higher lipid intake (p=0.006), after model adjustment for the amount of calories. Once the cardiovascular risk factors and schooling were included in the model, the nutrients associated with the prevalence of moderate/severe CAC were: percentage of carbohydrates (PR=0.98; 95%CI 0.96-0.99; p=0.040), percentage of lipids (PR=1.04; 95%CI 1.01-1.07; p=0.005), and percentage of saturated fatty acids (SFA) (PR=1.08; 95%CI 1.02-1.14; p=0.013). Conclusions: In the sample of community-dwelling asymptomatic adults and older persons, cardiovascular risk factors such as FH of early CAD, and low-intensity PA were independently associated with moderate to severe coronary calcification. Analysis of dietary factors showed that higher intake of total lipids and saturated fats were associated with higher CAC scores, whereas higher intake of carbohydrates over lipids was associated with lower CAC scores. Our results indicate that these risk factors should be considered in the cardiovascular assessment of the patient.