Résumé : Introduction: Chez les aînés, la perte de dents et les difficultés masticatoires peuvent entraîner une réduction de la qualité de la diète et une perte de poids. Objectifs: Dans une population âgée vivant à domicile, nous voulons déterminer la cohérence interne et la validité de critère d’un questionnaire sur la perception de l’efficacité masticatoire. Nous désirons aussi vérifier la relation entre l’efficacité masticatoire et l’alimentation, notamment l’apport protéinique, l’apport en vitamine C et folate ainsi que la consommation de fruits et légumes. Méthodologie: Une analyse secondaire des données recueillies à l’entrée de l’Étude longitudinale québécoise sur la nutrition comme déterminant d’un vieillissement réussi (NuAge) a été réalisée. NuAge est une étude observationnelle (2003-2008) de 1793 hommes et femmes âgés de 68-82 ans, généralement en bonne santé lors du recrutement. L'échantillon total (n=1789) a été utilisé pour déterminer la cohérence interne puis un sous-échantillon (n=94), dont les participants ont passé un test clinique de l'efficacité masticatoire, a été utilisé pour mesurer la validité de critère du questionnaire. Le questionnaire contient 7 questions tirées du Oral Health Impact Profile (échelle de Likert, score total= 28 points). Le test clinique (Swallowing Threshold Test Index, score 0 à 100%) a été utilisé pour mesurer l'efficacité masticatoire. Pour ces deux instruments, un score élevé indique une bonne efficacité masticatoire (perçue ou mesurée). Les apports habituels de protéines, de vitamine C, de folate et de fruits/légumes ont été calculés à partir de 3 rappels alimentaires de 24 heures non-consécutifs. Résultats: Les scores moyens obtenus au questionnaire sont élevés [H:25.3;IC(24.7-25.9); F:24.3;IC(23.7-25.0)], indiquant une bonne efficacité masticatoire perçue. Les participants du sous-échantillon (50H, 63F) ont des scores moyens au test masticatoire de 60.8% [H:IC(57.3-64.2)] et de 61.2% [F:IC(57.7-64.7)]. La cohérence interne du questionnaire est considérée «satisfaisante» (Alpha de Cronbach= 0.803). Aucune relation significative n’a été observée entre l'efficacité masticatoire perçue et mesurée (r= -0.14; p= 0.22). Une prévalence élevée (78,9%) d'apports alimentaires insuffisants en fruits et en légumes (<7 portions/jour), se traduit par des niveaux élevés (53,9%) d'apports insuffisants en folate chez les femmes (<320μg/j). Après ajustement pour l'âge, le sexe, la scolarité et le revenu, le score d'efficacité masticatoire n'est pas significativement associé aux apports alimentaires. Conclusion: Malgré la bonne cohérence interne du questionnaire et la validité reconnue du test, il semble que les résultats de l'efficacité masticatoire perçue ne réflètent pas la «vraie» efficacité masticatoire mesurée avec le test. De plus, on n'observe aucune relation significative entre l'efficacité masticatoire et les apports alimentaires. Des tests masticatoires adaptés aux aînés et intégrant les impacts sur la déglutition et sur la digestion seraient à développer. // Abstract : Introduction: Among seniors, loss of teeth and chewing difficulties can cause diet's quality reduction and weight loss. Objectives: Among generally healthy seniors, we want to determine internal consistency and criterion validity of a questionnaire assessing the perception of masticatory efficiency. We also want to assess the relationship between masticatory efficiency and food intake (protein, Vitamine C, folic acid and fruits/vegetables). Methodology: This is a secondary cross-sectional analysis of the baseline data from the NuAge Study (Québec Longitudinal Study on Nutrition and Successful Aging). NuAge is a 5-year (2003-2008) observational study of 1793 men and women aged 68-82 years in good general health at recruitment. The total sample (n=1789) was used to determine internal consistency of the questionnaire. A subsample (n=94) of the cohort who underwent a clinical test measuring directly masticatory efficiency was used to determine criterion validity of the questionnaire. The questionnaire was a subset of the Oral Health Impact Profile (Likert-scale, total score= 28 points). Assessment of masticatory efficiency was carried out using a clinical test measuring the ability to chew a raw carrot, (Swallowing Threshold Test Index, score from 0 to 100%). For both measures (perceived or measured) a higher score indicates a better masticatory efficiency. Usual protein, Vitamin C, folic acid and fruits/vegetables intakes are calculated from 3 nonconsecutive 24h dietary recalls. Results: Internal consistency of the questionnaire was deemed «satisfactory» (Cronbach’s Alpha= 0.803). Mean scores of the questionnaire were generally high [M:25.3;IC(24.7-25.9); W:24.3;IC(23.7-25.0)], indicating a good perceived masticatory efficiency. In contrast, mean scores of the masticatory performance test were rather low [M:60.8%;IC(57.3-64.2); W:61.2%;IC(57.7-64.7)]. No significant relationship between perceived and measured masticatory efficiency has been observed (r= -0.14; p= 0.22). A high prevalence (78.9%) of inadequate dietary intake of fruits and vegetables (<7 servings/day), resulting in high levels (53,9%) of inadequate folate intake for women (<320μg/d). After adjusting for age, sex, education and income, the masticatory efficiency score was not significantly associated with food intake Discussion/Conclusion: Despite a good internal consistency of the questionnaire, and the recognized validity of the test, it seems that people's perception of their masticatory efficiency does not reflect "real" efficiency as measured by the test. Furthermore, no relationship was observed between masticatory efficiency and food intake. New masticatory tests, more related to impact on swallowing and digestion, should be developed.

In recent years there has been growing interest in the role of gut hormones in regulating appetite, energy balance and weight control. Prominent among these hormones is the hunger hormone ghrelin which is the only circulating hormone currently known to stimulate appetite. A variety of hormones are known to suppress appetite and notable among these is peptide YY (PYY). Both ghrelin and PYY exist in more than one form with acylated ghrelin and PYY3-36 representing the biologically active forms of these hormones i.e. the form of each hormone with the most potent effects on appetite. Many studies have investigated ghrelin responses to exercise in male participants and some studies have also examined PYY responses. Far fewer studies have examined ghrelin and PYY responses in female participants and this was the primary purpose of the studies reported here. This thesis comprises four main experimental chapters which collectively sought to clarify whether there is any evidence to support the hypothesis that appetite, gut hormone and food intake responses differ in female compared with male participants. A total of 123 participants took part in the studies reported in this thesis. The first of these studies was cross-sectional in nature and compared fasting appetite, plasma acylated ghrelin and dietary restraint questionnaire values (among other variables) in 34 males and 33 females. No significant differences were observed between sexes for any of these variables. In the second study, appetite, plasma acylated ghrelin and ad libitum food intake responses to cycling exercise were examined in 13 female participants taking the oral contraceptive pill in both the luteal and follicular phases of the menstrual cycle. Although fasting hunger and prospective food consumption values were higher in the follicular than the luteal phase there was no difference in appetite, plasma acylated ghrelin and food intake responses to exercise between menstrual cycle phases. In the third study, appetite, plasma acylated ghrelin, plasma PYY3-36 and food intake responses to energy deficits created via diet and exercise were compared in 13 young, healthy female participants who completed three separate trials (control, exercise deficit and food deficit) in a random order. The findings revealed that, as with male participants, females experience compensatory appetite, gut hormone and food intake responses to dietary induced energy deficits but not to exercise induced energy deficits (over the course of a nine hour observation period). The final study reported in this thesis compared appetite, plasma acylated ghrelin and ad libitum food intake responses to a one hour run in 10 male and 10 female participants. Suppressions of both hunger and plasma acylated ghrelin were noted during exercise but there was no significant difference in the responses of males and females during or after exercise. Collectively, the studies reported here suggest: 1) that fasting appetite and plasma acylated ghrelin concentrations do not differ between male and female participants; 2) that appetite, ghrelin and food intake responses to cycling exercise do not differ according to the phase of the menstrual cycle in females; 3) that dietary restriction is more likely to elicit compensatory feeding responses than elevated exercise levels in females and 4) that males and females do not differ in their acute appetite, ghrelin and food intake responses to an acute bout of running exercise. Hence the studies reported here do not support the hypothesis that exercise will be less effective for controlling appetite and food intake in females than in males.

Leptin is an adipokine that acts centrally to regulate feeding behaviour, energy expenditure and autonomic function via activation of its receptor (ObRb) in nuclei in the central nervous system (CNS). This thesis investigates the involvement of two sensory circumventricular organs (CVOs), the subfornical organ (SFO) and area postrema (AP), in mediating the central effects of leptin using a variety of experimental approaches. We first show that acute electrical stimulation of the SFO elicits feeding in satiated rats, supporting a role for this specialized CNS structure in the control of food intake. We then demonstrate, using RT-PCR, the presence of ObRb mRNA in SFO and, using whole cell current clamp electrophysiology, reveal that leptin influences the excitability of individual SFO neurons, causing both excitatory and inhibitory responses. Furthermore, we find that leptin activates the same SFO neurons activated by amylin. Given the association between obesity and hypertension and the well-established role of the SFO in cardiovascular regulation, we show that leptin microinjection into the SFO decreases blood pressure in young rats, effects that are abolished in leptin-resistant, diet induced obese rats, suggesting that leptin-insensitivity in the SFO of obese, leptin-resistant, individuals may contribute to obesity-related hypertension. Our studies also show that the medullary AP expresses ObRb and that leptin influences the excitability of AP neurons. Furthermore, we show that leptin and amylin act on the same subpopulation of neurons in the AP. Finally, our preliminary AP/SFO lesion studies reveal that animals with these lesions exhibit a profound decrease in body weight and food intake and no longer exhibit decreases in body weight in response to peripheral leptin administration. In summary, the data presented in this thesis suggest the SFO and AP to be important in body weight homeostasis and in mediating the central effects of leptin. In addition, these areas appear to be important in the integration of multiple signals derived from peripheral sources. Furthermore, the fact that the SFO appears to be involved in leptin effects on both energy balance and cardiovascular regulation attest to the integrative nature of the SFO in the control of diverse physiological functions. / Thesis (Ph.D, Physiology) -- Queen's University, 2012-10-15 14:57:15.387

O hormônio do crescimento (GH) age sobre tecidos periféricos e está relacionado com várias funções do organismo como, o controle do metabolismo, crescimento somático e processos celulares. Existem evidências que o GH pode exercer efeitos sobre o sistema nervoso central (SNC). Neurônios que co-expressam o neuropeptideo Y (NPY) e a proteína relacionada agouti (AgRP) estão localizados na parte ventromedial do núcleo arqueado do hipotálamo (ARH). Com intuito de estudar a ação do GH especificamente em neurônios NPY/AgRP, iremos utilizar o sistema Cre-LoxP que permite a manipulação gênica de maneira tecido-específica. Sendo assim, inativamos o receptor de GH em neurônios NPY/AgRP em animais fêmeas (GHR/AgRP KO). Como já é bem sabido, essa população de neurônios é conhecida como um potente estimulador do apetite, objetivamos verificar se a falta do receptor de GH (GHR), pode impactar fatores metabólicos. Na validação do modelo observamos que os neurônios NPY/AgRP são responsivos ao GH. As fêmeas GHR/AgRP KO não apresentam diferença no peso corporal. Além disso, não foram observadas diferenças na avaliação metabólica, como, tolerância à glicose, sensibilidade à insulina ou na resposta à leptina. Assim como não observamos diferenças significativa no gasto energético. Quando desafiadas à restrição alimentar, as fêmeas GHR/AgRP KO apresentam maior dificuldade de sustentar a glicemia e perdem mais peso que as fêmeas controles. Por outro lado, a resposta contra regulatória à hipoglicemia é similar entre os animais GHR/AgRP KO e os controles. Ainda, quando expostas ao estresse por contenção, as fêmeas GHR/AgRP KO apresentaram consumo alimentar similar aos animais do grupo controle. Um segundo grupo foi gerado com o intuito de analisarmos o equilíbrio energético e homeostase da glicose durante a gestação e lactação. Os grupos responderam de forma similar tanto ao que se refere ao equilíbrio energético, quanto em relação a glicemia. Por fim, após os aspectos relacionados ao metabolismo energético, utilizando a técnica de ensaio de flexão de três pontos, que analisa parâmetros relacionados ao metabolismo ósseo, observamos que o grupo controle e GHR/AgRP KO não apresentaram diferenças significantes nos parâmetros ósseos analisados. Nossos resultados sugerem que o GH exerce efeito sobre o metabolismo via neurônios NPY/AgRP apenas durante situações de estresse crônico como por exemplo, em situação de privação alimentar. / Growth hormone (GH) acts on peripheral tissues and is related to various functions of the organism such as metabolism control, somatic growth and cellular processes. There is evidence that GH may exert effects on the central nervous system (CNS). Neurons co-expressing the neuropeptide Y (NPY) and related protein agouti (AgRP) are located in the ventromedial part of the arcuate nucleus of the hypothalamus (ARH). In order to study the action of GH specifically on NPY/AgRP neurons, we will use the Cre-LoxP system that allows a genetic manipulation in a tissue-specific manner. Thus, we inactivate the GH receptor in NPY/AgRP neurons in female animals (GHR/AgRP KO). It is well established that this population of neurons is known as a potent stimulator of appetite, so we aim to verify if the lack of the GH receptor (GHR) can impact metabolic factors. In the validation of the model we observed that NPY/AgRP neurons are responsive to GH. GHR/AgRP KO females shown no difference in body weight. In addition, no differences were observed in metabolic evaluation, such as glucose tolerance, insulin sensitivity or leptin response. As well as we didn\'t observe significant differences in energy expenditure. When challenged with dietary restriction, GHR/AgRP KO females presented greater difficulty in sustaining glycemia and lost more weight than control females. On the other hand, the counter-regulatory response to hypoglycemia is similar between the GHR/AgRP KO and control animals. Also, when exposed to containment stress, the GHR/AgRP KO females presented similar food consumption to the control animals. A second group was generated with the purpose of analyzing the energy balance and glucose homeostasis during pregnancy and lactation. The groups responded similarly to both energy balance and glycemia. Finally, after the aspects related to energy metabolism, using the three-point flexural test technique, which analyzes parameters related to bone metabolism, we observed that the control and GHR/AgRP KO groups didn\'t present significant differences in the analyzed bone parameters. Our results suggest that GH exerts an effect on the metabolism via NPY/AgRP neurons only during situations of chronic stress such as food deprivation.

Thesis advisor: Gorica Petrovich / Thesis advisor: Christina Reppucci / Previously our lab has shown that food-deprived male and female rats will inhibit food consumption when presented with a conditioned stimulus that signals danger, and that this effect persists much longer in females than in males. The current experiment is part of a larger study that has two aims: 1) delineate the brain areas associated with fear-cue induced anorexia and 2) determine whether there are sex-differences in brain activation patterns. Female rats previously conditioned in an aversive paradigm inhibited food intake compared to female rats in the control group during three extinction tests, while experimental males only inhibited intake compared to male controls during test one. Following the third test, rats were sacrificed and brain tissue processed to assess activation patterns via Fos-expression within the central nucleus of the amygdala (CEA). We found that males had higher activation than females during test 3 in the CEA. / Thesis (BS) — Boston College, 2013. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Psychology Honors Program. / Discipline: Psychology.

Introdução - Há evidências de que o aumento do consumo de carboidratos esteja associado à sonolência. Quando realizado à noite, o consumo de carboidratos parece ser um fator que afeta o desempenho no trabalho. Paradoxalmente, o trabalho noturno levaria ao aumento da ingestão de alimentos ricos em carboidratos como consequência da privação de sono. Objetivo - Verificar a existência de correlação entre a sonolência e consumo de carboidratos entre motoristas de caminhão. Métodos - Participaram da primeira etapa do estudo 71 motoristas de caminhão com idade média de 41 anos (DP=9,5), divididos em dois grupos: transferência (turno irregular de trabalho) e distribuição (turno diurno). Esta etapa consistiu na aplicação de um questionário com questões sociodemográficas, hábitos de vida, consumo alimentar e questões relacionadas ao trabalho. Na segunda etapa 49 motoristas (24 da transferência com idade média de 41 anos DP=8,3 e 25 da distribuição com idade média de 39 anos DP=11,4) responderam ao recordatório alimentar de 24h em dois dias de trabalho e um de folga, à escala de sonolência de Karolinska (KSS), o protocolo de atividade diária e usaram actimetros por 10 dias consecutivos. Resultados - Cerca de 70 por cento dos motoristas encontravam-se sobrepesos ou obesos. O teste de Kruskal Wallis demonstrou que os motoristas da transferência apresentaram uma média significativamente maior de consumo de carboidratos (91,8 g DP=53,7) na refeição anterior ao início do trabalho em relação aos motoristas da distribuição (51,3g DP=32,6) (p<0,05). A ANOVA de medidas repetidas que analisou a sonolência segundo área de trabalho revelou um efeito do horário (p<0,001) e uma interação entre horário e área de trabalho (p<0,05). O teste de correlação de Spearman entre o consumo de carboidratos na refeição anterior ao início do trabalho e a medida de KSS imediatamente após esta refeição não foi estatisticamente significante para nenhuma das duas áreas de trabalho. Conclusões - Embora não tenha sido possível estabelecer associação entre o consumo de carboidratos e a sonolência dos motoristas estudados, observou-se que os motoristas da transferência consomem mais carboidratos na refeição que antecede o início do trabalho em comparação aos do turno diurno. De modo geral, pode-se dizer que os motoristas apresentam padrões distintos de sonolência, cuja manifestação parece variar em função da pressão social dos horários de trabalho / Introduction - There is evidence that increased consumption of carbohydrates is associated with sleepiness. When performed at night, carbohydrate intake might be a factor that affects alertness. Paradoxically, night work could lead to increased intake of carbohydrate-rich foods as a result of sleep deprivation. Objective - To verify whether there is a correlation between carbohydrate intake and sleepiness in truck drivers. Methods -The first phase of this study included 71 truck drivers with a mean age of 41 years (SD = 9.5), divided into two groups: long haul drivers (irregular shift work) and short haul drivers (day shift). In this phase, a questionnaire about sociodemographic aspects, lifestyle, food intake and work was filled out. In the second phase, 49 drivers (24 long haul drivers with a mean age of 41 years SD = 8.3 and 25 short haul drivers with a mean age of 39 years SD = 11.4) responded to a 24hr food intake recall (for two working days and one day off) and the Karolinska Sleepiness Scale (KSS). The workers also filled out an activity diary and wore actigraphs for 10 consecutive days. Results - About 70 per cent of the drivers were overweight or obese. The Kruskal Wallis test showed that long haul drivers had a mean consumption of carbohydrates in the meal preceding the work onset (91.8 g ; SD = 53.7) significantly higher than the short haul drivers (mean = 51.3 g ; SD = 32.6) (p <0.05). A repeated measurement ANOVA, revealed an effect of time (p <0.001) and an interaction effect of time and work area (p <0.05) on sleepiness. The Spearman correlation test, between the consumption of carbohydrates in the meal prior to work onset and the sleepiness levels immediately after this meal, was not significant for both groups. Conclusions - Although it was not possible to establish an association between carbohydrate intake and sleepiness, it was observed that, the long haul drivers consume more carbohydrates than the short haul drivers. This occurs in the meal that precedes the work onset. In conclusion, truck drivers have distinct patterns of sleepiness, whose expression seems to vary according to the social pressure of working hours

Objetivo. Verificar a existência de associações entre a insegurança alimentar e nutricional e padrões alimentares, a participação em programas sociais, dentre outros fatores em adolescentes de escolas públicas de Piracicaba (SP). Métodos. Este estudo foi conduzido em amostra probabilística de 488 escolares da 5ª série do ensino fundamental da rede pública de Piracicaba. Foram coletadas informações demográficas, antropométricas, bioquímicas e de pressão arterial, sobre a adesão à alimentação escolar, e de consumo alimentar a partir de Questionário de Frequência Alimentar Simplificado para Adolescentes (QFASA). Também foram obtidas informações sobre situações de insegurança alimentar e nutricional (IAN), participação em programas de transferência de renda e informações socioeconômicas. Foram realizadas análises descritivas, testes de Qui-quadrado de Pearson, t de Student e U de Mann Whitney. Padrões alimentares foram definidos a partir de Análise de Componentes Principais. A análise de regressão logística avaliou a influência de múltiplas variáveis na presença de IAN (variável dependente dicotômica). O estudo foi aprovado pelo Comitê de Ética da Faculdade de Saúde Pública. Resultados. De 308 escolares da amostra final, 54,5 por cento eram meninas. Mais de 40 por cento dos lares de escolares entrevistados apresentaram algum nível de IAN. Observaram-se elevadas proporções de adesão à alimentação escolar (70 por cento ) e de excesso de peso (39 por cento ). O principal padrão alimentar observado contou com maior participação de doces, massas, carnes, salgados, pães, frutas e hortaliças. Conclusão. A insegurança alimentar e nutricional determinou a participação no Programa Nacional de Alimentação Escolar e em programas de transferência de renda. Quando se observa um adolescente que pratica o padrão alimentar descrito, que reconhece a importância da alimentação escolar para o desenvolvimento físico e que cujo domicílio tem mais pessoas ocupadas, a probabilidade de tratar-se de um indivíduo que está em situação de IAN é menor. / Objective . To verify possible associations between food insecurity and food patterns, participation in social programs and other factors among adolescents enrolled in public schools of Piracicaba (SP). Methods . This study was conducted in a representative sample of 488 students enrolled in the fifth grade of public schools of Piracicaba. Data about demographic, anthropometric, biochemical, blood pressure, school feeding and food intake information were collected using computerized questionnaires and a Food Frequency Questionnaire Simplified for Adolescents (QFASA). Information about food insecurity, socioeconomic characteristics, and participation in Conditional Cash Transfer Programs were also obtained. Descriptive analysis, Chi-squared test to categorical variables, and t-Student and Mann-Whitney U test in order to compare means between groups were performed. Food patterns were predicted from food intake data, using the Principal Component Analysis method. These food patterns were transformed in variables and were used in logistic regression analysis. Food insecurity was the dependent variable. The study was approved by the Ethical Committee of the School of Public Health. Results. Out of the total 308 scholars of the final sample, 55 per cent were girls. More than 40 per cent of adolescents households presented some level of food insecurity. High proportions of students who consumed the school feeding (70 per cent ) and that were overweight (39 per cent ) were observed. The main dietary pattern observed was composed of higher participation of sweets, pasta, meats, pastries breads, fruits and vegetables. Conclusion. Food and nutrition insecurity (FNI) in scholars enrolled in public schools of Piracicaba determined their participation in the National School Feeding Program and in the Conditional Cash Transfer Programs. A teenager who practices the described eating pattern, who recognizes the importance of the school feeding for the physical development and whose home has more people employed, is less likely to be in a FNI status.

Introdução: A síndrome metabólica (SM) é frequente em idosos. A alimentação influencia a prevalência, constituindo uma das variáveis de risco modificáveis, com impacto positivo no controle da doença. Objetivo: Verificar a associação entre SM e padrões alimentares de indivíduos idosos do município de São Paulo. Métodos: Estudo transversal que utilizou os dados do Estudo SABE: epidemiológico, de coortes e de base domiciliar. A população deste estudo incluiu idosos ( 60 anos), de ambos os sexos, selecionados por amostra probabilística, e entrevistados em 2010, pertencentes a três coortes A/2000 (n=630), B/2006 (n=214) e C/2010 (n=311). As variáveis de estudo foram: a) referidas: sexo, idade, escolaridade, ingestão de bebida alcoólica, tabagismo, atividade física e número de doenças crônicas não transmissíveis; b) mensuradas: SM, identificada segundo os critérios do National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII) sendo circunferência da cintura > 102 cm, para homens, e > 88 cm, para mulheres; pressão arterial 130 e/ou 85 mmHg (obtidas por entrevistadores previamente treinados); triacilgliceróis 150 mg/dL; High Density Lipoprotein (HDL) colesterol < 40 mg/dL, para homens e < 50 mg/dL, para mulheres; glicemia de jejum >100 mg/dL (por meio de amostra sanguínea); obesidade, classificada pelo índice de massa corporal 30kg/m2. Os dados de alimentação foram obtidos por meio de entrevista domiciliar registrando-os em formulário específico, com 107 alimentos, classificados em 18 grupos de alimentos. Os padrões alimentares foram determinados pela análise fatorial exploratória por componentes principais. Foram utilizados teste de qui-quadrado de Rao & Scott para amostragem complexa, bem como regressão logística múltipla, com nível de significância de 5 por cento . O programa estatístico STATA 13.1 foi adotado para os cálculos. Resultados: 1.155 indivíduos foram estudados e a prevalência de SM foi de 57,9 por cento . Quatro padrões alimentares foram identificados: padrão 1, composto por: frituras, embutidos, enlatados, doces, tubérculos, temperos/molhos industrializados e ovos, denominado inadequado; padrão 2, laticínios desnatados, cereais e pães integrais e alimentos light, diet ou zero, denominado padrão modificado; padrão 3, óleos vegetais, arroz, cereais refinados e pão branco, carnes e leguminosas, denominado padrão tradicional brasileiro; e, padrão 4, frutas, verduras e legumes e tubérculos, denominado benéfico. O padrão modificado foi associado positivamente à SM. Idosos do 4º quartil do padrão modificado aumentaram em 60 por cento o risco da presença de SM. O padrão benéfico foi associado negativemente à SM, em idosos 70 anos (coorte A). Os padrões inadequado e tradicional brasileiro não foram associados significativamente à SM. Conclusão: O padrões alimentares modificado e benéfico estiveram associados a SM. Indivíduos do padrão modificado apresentaram aumento do risco de SM, e do padrão benéfico redução do risco para idosos mais velhos. A associação ao padrão modificado pode ser devido à mudanças alimentares implementadas no dia a dia dos indivíduos idosos, após diagnóstico de anormalidades metabólicas. / Introduction: Metabolic syndrome (MS) is common in elderly people. The feeding influences its prevalence constituting one of the modifiable risk factor, with positive impact on the disease control. Objective: To investigate the association between MS and dietary patterns of older adults from São Paulo city. Methods: Cross-sectional study that used data from the SABE survey: epidemiological, cohort based and home-dweling. The study population included elderly individuals ( 60 years old), both sexes, selected by probability sampling, and interviewed in 2010, belonging to three cohorts A/2000 (n = 630), B/2006 (n = 214) and C / 2010 (n = 311). The study variables were: a) referred: gender, age, education, alcohol consumption, smoking, physical activity, number of chronic noncommunicable diseases; b) measured: MS, identified according to the criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATPIII): waist circumference > 102 cm for men, and > 88 cm for women; blood pressure 130 and/or 85 mmHg (obtained by trained interviewers); triglycerides 150 mg/dL; high density lipoprotein cholesterol < 40 mg/dL for men, and < 50 mg/dL for women; fasting glucose > 100 mg/dL (through blood samples); obesity, c classified by body mass index 30 kg/m2. The feeding data were obtained by one specific food frequency questionnaire with 107 foods, classified into 18 food groups. Dietary patterns were determined by exploratory factor analysis of principal components. Rao & Scott and multiple logistic regression for complex sample were used, with 5 per cent significance level. The statistical software STATA 13.1 was adopted for calculations. Results: 1155 subjects were studied. The prevalence of MS was 57.9 per cent . Four dietary patterns were identified: pattern 1, composed by fried foods, sausages, canned foods, sweets, tubers, spices/sauces and processed eggs, called inappropriated; pattern 2, composed by low-fat dairy products, whole grain cereals and breads, and light, diet or zero food, called modified; pattern 3, composed by vegetable oils, rice, refined cereals and white bread, meat and legumes, called Brazilian traditional pattern; and pattern 4, fruits, vegetables and tubers, called beneficial. The modified pattern was positively associated to MS. 4th quartile modified pattern older adults had increased in 60 per cent the risk of MS. The beneficial pattern was negatively associated to MS, in the older individuals ( 70 y, cohort A). The inappropriated and Brazilian traditional patterns were not significantly associated to MS. Conclusion: The modified and beneficial dietary patterns were associated to MS. Modified individuals pattern showed increased risk of MS. Beneficial pattern reduced the risk to the oldest older individuals. The modified pattern could be due to dietary changes implemented in the older adults daily life after diagnosis of metabolic abnormalities. .

O presente estudo analisou aspectos nutricionais e hábitos alimentares de idosos, de ambos os sexos (69,8 por cento mulheres e 30,2 por cento homens), matriculados em ambulatório geriátrico, com idade variando de 60 a 100 anos (média e mediana igual a 74 anos). As variáveis sangüíneas, analisadas para 127 idosos, quando comparadas com valores de referência, mostraram que a albumina, a HDL-C, a VLDL-C e os triglicérides apresentaram valores normais quanto à média para ambos os sexos, mas as duas primeiras ficaram abaixo desses valores e as duas últimas acima, em certo percentual de idosos quando consideradas segundo o sexo. A glicose, o colesterol e a LDL-C apresentaram valores acima dos de referência tanto na média quanto em certo número de idosos, quando separados por sexo. As medidas antropométricas, realizadas por nutricionistas treinadas, de acordo com metodologias previamente estabelecidas, foram analisadas também para 127 idosos e os resultados foram comparáveis aos de outros autores para peso e altura. A circunferência do braço apresentou-se excepcionalmente mais elevada nas mulheres do que nos homens. A prega cutânea triciptal e o índice de Quetelet são indicativos de obesidade, especialmente nas mulheres. O perfil de morbidade, estabelecido para 308 idosos, a partir dos diagnósticos registrados nos prontuários, revelou que a doença hipertensiva foi a mais prevalente, acometendo 49 por cento dos indivíduos, seguida pelas doenças do sistema osteomuscular e tecido conjuntivo e pelas doenças endócrinas e metabólicas. A dieta habitual obtida em entrevista por nutricionistas treinadas, também em 308 idosos, mostrou que a freqüência de alimentos construtores e energéticos parece adequada, mas não a de reguladores e que os hábitos alimentares devem estar influenciando para a alteração de algumas variáveis sangüíneas. / The present study analised the nutritional aspects and food habits of elderly persons, of both sexes (69.8 per cent women and 30.2 per cent men), registered at the geriatric out-patient service, with ages varying from 60 to 100 years (mean and median equal 74 years). The blood variables, analised for 127 elderly persons, when compared with reference values, showed that albumin, HDL-C, VLDL-C and triglycerides presented normal values regarding the mean for both sexes, but the first and the second were below these values, and the remainder were over the reference values for a certain percentual of elderly persons, when considered according to sex. Glucose, cholesterol and LDL-C were over the reference values both the global mean and age and sex specific mean in certain number of aged. The anthropometric measurements, carried out by trained nutritionists, according to previously established methodologies, were analised, too, for 127 elderly persons and the results for weight and height were comparable to the results of others authors. Arm circunference was greater in women than in men which is an exception. The triciptal skinfold and the Quetelet index are indicatives of obesity, especially in the women. The morbidity profile, established for 308 elderly persons, from diagnoses registered, reveled that hipertensive disease was the most prevalent, present in 49 per cent of individuals, followed by diseases of osteomuscular system and conjuntive tissue and endocrine and metabolic diseases. The habitual diet obtained from interview by trained nutritionists, also for 308 elderly persons, showed that the frequency of constructor and energetic foods seemed to be adequate, but regulatory foods did not seem so. Food habits probably exert an influence on the alteration observed in some blood variables.

Introdução: Os adolescentes são considerados vulneráveis do ponto de vista nutricional, pois tendem a omitir refeições e não realizá-las com a família. Refeições em família propiciam oportunidade de socializar o adolescente e ensiná-lo sobre nutrição e bons hábitos alimentares. Objetivos Verificar associação entre freqüência de refeições em família com o consumo de alimentos e estado nutricional de adolescentes. Metodologia: Foram estudados adolescentes do ensino médio de 12 escolas técnicas da região metropolitana de São Paulo, com amostragem aleatória simples. Os adolescentes responderam dois questionários, sendo um sobre atitude alimentar e outro sobre a freqüência alimentar. Foi realizada mensuração antropométrica e calculado o Índice de Massa Corporal (IMC) para analisar o estado nutricional, utilizando-se o IMC/ idade. Para a análise dos dados foram utilizados os testes Qui-quadrado e a Análise de Variância e também comparações múltiplas quando houve diferenças significativas entre médias. Resultados: Foram avaliados 1167 adolescentes, sendo 51por centomeninos e 49por centomeninas. A média de IMC para ambos os gêneros foi de 22,28kg/m2 (±3,9) e observou-se baixa ingestão de verduras, legumes, frutas e leite. Verificou-se que aproximadamente 70por centodos adolescentes informaram realizar pelo menos 3 vezes/ semana refeições junto com a família. Detectou-se que realizar pelo menos 1 vez por dia refeições em família está associado com maior ingestão de verduras, legumes e frutas e há a tendência de ingerir maior quantidade de carnes e ovos. Não foi observada associação entre freqüência de refeições em família e estado nutricional. Conclusão: Foi verificado que a maioria dos adolescentes realizava pelo menos 3 refeições em família por semana e aqueles que faziam com maior freqüência ingeriam maior quantidade de verduras, legumes e frutas. Não houve diferença estatisticamente significante para o estado nutricional / Introduction: By the nutritional point of view, the adolescent are considered vulnerable, because they run to omit and not to perform the meals with the family. Family meals create the opportunity of socialize the adolescent and teach them nutrition and good food habits. Objectives: Checking the associations between the frequency of family meals and the food intake and adolescent nutritional status. Methods: This study was made with high school adolescents of 12 technical schools of São Paulo city, using simple random sampling. These adolescents answered two questionnaires; the first attended the food attitude, and the second attended the food frequency. The anthropometric measurements were made and the Body Mass Index (BMI) was computed to analyze the nutritional status, supported by the BMI/ age. For this study were used the Chi-square and ANOVA as well the multiple confrontation was made when significant differences between averages were detected. Results: There were assessed 1167 adolescent, being 51 per cent boys and 49 per cent girls, and the BMI average was 22,28kg/m2 (±3,9) for both. There were observed the low intake of vegetables, fruits and milk. And it as clear that close 70 per cent of adolescent told they have at least 3 meals with the family. It was observed that perform at least one daily family meal is related with higher intake of vegetables, fruits and there is the tendency of consume more quantity of the meat and eggs. It wasnt found the association between the family meals and nutritional status. Conclusion: It was observed that the most of adolescent performed at least 3 meals per week with their family, and for those that got it with more frequency consumed more vegetables and fruits. There wasnt any statistically significant difference to the nutritional status