Thesis (M. Sc.(Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

Thesis (M. Sc. (Physiology)) -- University of Limpopo, 2019 / Aim: The purpose of this study was to assess the prevalence and risk factors associated with malnutrition and nutritional status of rural and urban primary school children aged 6–9 years. Literature background: Malnutrition is one of the leading causes of childhood morbidity and mortality in developing countries, affecting 10.9% of people globally, particularly in Southern Asian (15.7%) and sub-Saharan African (23.2%) countries undergoing urbanisation. Urbanisation affects diet, physical activity levels, body fatness, body composition and socio-economic factors. There is currently a shortage of information on the effect of urbanisation on nutritional status, especially in poor areas such as the Limpopo Province of South Africa. It is important to understand the effects that body fatness and associated risk factors have on stunting, wasting, underweight, and overweight/obesity in urban and rural children. Subjects and design: This was a cross-sectional study including rural (n=106) and urban (n=68) primary school children aged 6–9 years. Anthropometric (weight and height) and skinfold measurements were taken and a 24-hour recall dietary assessment was conducted twice to include a week day and a weekend day. A questionnaire was used to gather demographic, health, dietary and physical activity information. Results: The prevalence of stunting, wasting, underweight, and overweight/obese children in this population was 14%, 6%, 20%, and 26% respectively. Furthermore, the prevalence stunting, wasting, and underweight were higher in rural areas compared to urban areas. Meanwhile, the prevalence of overweight/obesity was higher in urban areas as compared to rural areas. Gender, area (urban/rural) (p=0.0001), birthweight, time spent on sedentary activities, monthly household income (p=0.0210), mode of transport to school, and breastfeeding (p=0.0560) were all found to be significantly associated with malnutrition. Weekday dietary intake of Vitamins A and D was significally associated with BF%, whereas weekend consumption of energy, protein, calcium, iron, phosphorus, and zinc were not significantly associated with BF%. The mean energy and calcium intake between the urban and rural vi population only differed significantly over weekends and not during the week, while vitamin D differed significantly between urban and rural populations during the week only. Conclusions: The current study demonstrates that children in rural areas were significantly more wasted than those residing in urban areas, while those residing in urban areas were significantly more overweight/obese compared to rural areas. All indicators used for undernutrition were associated significantly with gender and the prevalence were higher males compared to females, but this significance disappeared for overnutrition. Families with a higher income tended to have children who were overweight or obese compared to families with a lower income. Children spending a lot of time on sedentary activities were more likely to be overweight or obese, and breastfeeding seemed to protect children from becoming overweight or obese, while low birth weight was associated with stunting. The weekaday and week-end diets indicate that school feeding schemes in the rural areas may be effective in increasing total energy intake in children and this should be further investigated. In this population, stunting, wasting, and underweight were not limited to rural areas, and should still be a health concern in urban areas, despite the fact that overweight/obesity is also prevalent in urban areas. Thus, overweight/obesity in this population can be prevented by promoting breastfeeding and physical activity, while at the same time discouraging children from partaking in too many sedentary activities. / National Research Foundation (NRF)

Thesis (M. Tech. (Biomedical Technology)) -- Central University of Technology, Free State, [2014] / Pica is the habitual eating of non-food substances by humans and animals. It has different subgroups and these are defined by the ingested substance. Moreover, geophagia is a type of pica that refers to the consistent eating of mostly earth and earth-like substances such as clay and soil. It is observed in both sexes, all age groups and in different ethnic groups around the world. There are many reasons people give for the practice of geophagia, such as culture, hunger and health being the most prominent. Geophagic materials differ in texture, colour and taste. Soil colour classification according to the Munsell soil classification, which uses hues, values and chroma, sometimes differ with the soil colour being noticeable with the naked eye. However, geophagic clays from Qwa-Qwa are white and contain kaoline. Geophagic materials are believed to augment mineral deficiency, especially magnesium, calcium and iron. Geophagia is practised mainly by females, especially during their child bearing years. Females are more prone to iron deficiency anaemia due to their monthly menstruation cycle. Iron deficiency is the most common cause of anaemia and is classified as hypochromic microcytic anaemia (HMA). This study focused on the health aspect of geophagia. The research question seeks to explore whether there is an association between geophagia and the haematological parameters of iron deficiency anaemia. Geophagia seems to be linked with the occurrence of anaemia, but not iron deficiency anaemia, although it is implied. It is not known if the practice of geophagia causes iron deficiency anaemia or if it is because of iron deficiency anaemia that people practise geophagia. A pilot study was done in 2007, and the results of that study prompted that this study be performed on a bigger scale. The lack of information regarding the quantity, frequency and type of geophagic material consumed the impact of geophagia on haematological parameters and the iron status of the geophagists made it important that the primary existence of the iii relationship be investigated. In addition, research to establish whether there is a relationship between geophagia and haematological parameters of iron deficiency anaemia, has not been undertaken in South Africa, especially on non-pregnant women. Geophagia seems to always be accompanied by the subject of iron deficiency anaemia and especially its prevalence in females. The bigger geophagia project was therefore an ideal opportunity to do a specific survey on geophagic women. This was a cross-sectional study, consisting of 36 control women and 47 geophagic women, aged between 18-45 years. The participants completed a questionnaire to determine the geophagic practices, which included the colour of the clay, how frequent the clay was consumed, how much was consumed and for how long it has been consumed. Nutritional status was assessed using a food frequency questionnaire. Blood was drawn to assess the haematological and iron status of the participants. The participants of the study were within the required age range, with no significant difference between the groups (p-value=0.7914). The most consumed colour of clay was white and white clay contains kaoline, which has the ability to absorb iron in the duodenum. The majority of the participants consumed 40 grams of clay on a daily basis, with most of the participants having done so for 5 years. Diet was ruled out as the cause of iron deficiency. The haematological parameters indicated that the geophagic group (43%) were inclined to have hypochromic microcytic anaemia, while a small percentage of control groups (8%) had HMA; this was revealed by the red cell parameters and red cell indices. In addition, the odds ratio for the haematological results revealed that the probability of a geophagic person developing anaemia was two times greater than that of a non-geophagic person. Platelet results partially ruled out bleeding as a cause of anaemia. The median red cell distribution width indicated that the iv geophagic group was inclined to have anisocytosis. The geophagic group was found to have iron deficiency (75%), whilst the control group had a small percentage with iron deficiency (22%), which was validated by the serum ferritin, serum iron and saturated transferrin (chemical analysis). The odds ratio revealed that the probability of a geophagic person being iron deficient is 3 times greater than that of a non-geophagic person. The strongest association is seen with iron study findings, because being iron deficient showed the highest odd ratio than the association with red cell morphology and even haemoglobin. Thus, participants were more iron deficient than suffering from iron deficiency anaemia. Inflammatory and parasitic indicators proved that inflammation and infection was uncommon in both groups, and therefore did not compromise the credibility of the iron study results. Inflammatory indicators (white blood cells, erythrocyte sedimentation rate and C-reactive protein) ruled out inflammation, whilst eosinophil count showed no indication of parasitic infection for both geophagic and control groups. To conclude, the study found that an association exists between geophagia and haematological parameters of iron deficiency anaemia amongst geophagic women in Qwa-Qwa, in that geophagic material contributes to iron deficiency anaemia.

Devido ao constante aumento na prevalência de obesidade e doenças relacionadas é sugerido que indivíduos obesos sejam submetidos a programas educativos para redução da massa corporal. Objetivos: avaliar os efeitos de um programa de Educação em Saúde (Educação nutricional e Educação física) voltado a um grupo de mulheres obesas. Métodos: 50 mulheres obesas foram submetidas a um programa de quatro meses envolvendo educação nutricional (1 vez/semana) e exercício físico (aeróbio e contra-resistência - 3 vezes/semana). Foram avaliadas variáveis antropométricas, metabólicas e alimentares: peso, estatura, circunferência da cintura e do quadril, composição corporal por raios X de dupla energia (DEXA), teste ergoespirométrico e gasto energético de repouso (VO2000-Imbrasport&#174;), hemograma, leucograma, perfil lipídico, glicemia, leptina, IGF-1 (Fator de crescimento semelhante à insulina-1, TSH (Hormônio estimulante da tireóide), albumina e pré albumina, 3 diários alimentares e de atividade física. Para análise dos resultados, as participantes foram distribuídas em G1 (IMC inicial < IMC final) e G2 (IMC inicial &#8805; IMC final). Resultados: No G1 houve redução de: massa corporal, IMC, CC, CQ, RCQ, gordura corporal (kg), massa corporal magra (kg) e glicemia. No G2 não foram encontradas alterações significativas nestas variáveis. Não foram encontradas diferenças significativas no GER e ambos os grupos apresentaram aumento do VO2 pico, redução da leptina plasmática e da albumina sérica. Conclusões: O programa de perda de peso realizado neste estudo foi eficiente para resultar em redução da massa corporal em 50% das participantes, apresentando também melhoras em fatores de risco para doenças cardiovasculares. Independentemente da redução da massa corporal e na massa corporal magra, programas de exercício físico sem o controle individualizado da ingestão alimentar, principalmente de proteínas, pode resultar em prejuízos para o estado nutricional de mulheres obesas. / Because of the high prevalence of obesity and its associated comorbities all over the world, it is suggested to submmit obese people to edicational weight reduction programs. Objectives: to evaluate the effects of an educational program (nutrition and physical education) in obese women. Methods: 50 obese women were submitted to a four months program of nutritional education (once a week) and exercise training (aerobic and resistance -3 times/week). They were evaluated variables related to anthropometry, metabolic and eating behavior: weight, height, waist and hip circumferences, body composition by dual X-ray energy (DEXA), aerobic power and resting energy expenditure (VO2000-lmbrasport&#174;); hemogram, leucogram, lipid profile, glucose level, leptin, IGF-1 (Insulin like growth factor-1), TSH (Tireoid stimulating hormone), albumin and pré-albumin, 3 days of food and physical activity records. The participants were distributed into the follow groups for the analysis: G1 (initial BMI < final BMI) and G2 (initial BMI &#8805; final BMI). Results: In G1 they were reduced: body mass, body mass index (BMI), waist circumference, hip circumference, waist/hip relation, fat mass (kg), lean body mass (kg) and glucose. No statistical differences were found in these parameters in G2. No statistical differences were found in resting energy expenditure in both groups and there was an increase in VO2peak, decrease in leptin and albumin concentration in both groups. Conclusions: The weight reduction program realized in this study was efficient to result weight loss in 50% of the participants, with improvements in cardiovascular risk factors. Independent of reductions on body mass and lean body mass, exercise training programs without individualized control of protein intake, especially of proteins, can jeopardize nutritional status of obese women.

Urban agriculture is a strategy poor urban, informal settlement residents adopt to reduce poverty and improve food security and child nutrition. It is widely asserted in the literature and development circles that household vegetable gardens can provide a significant percentage of recommended dietary allowances of macro- and micro-nutrients in the diets of pre-school children. These children are vulnerable in terms of food access and nutrition. The first five years of a child’s life are crucial to psychological well-being. This study set out to determine the impact of home gardens on access to food, dietary diversity and nutrient intake of pre-school children in an informal settlement in Eatonside, in the Vaal Region, Johannesburg, South Africa. The home gardening project was undertaken in five phases, namely the planning phase; a baseline survey (including quantitative food intake frequencies, 24-hour recall, individual dietary diversity questionnaires and anthropometric measurements); a training programme on home gardens; planting and tending the gardens and evaluating the impact of home gardens on access to food, dietary diversity and nutrient intake of pre-school children. Children aged two to five years (n=40) were selected to participate in the study. The sample population consisted of 22 boys and 18 girls. The children were categorised into three groups at the start of the project: children of 24-35 months (four boys and one girl), 36-47 months (four boys and five girls) and 48-60 months (14 boys and 12 girls). All but 10 per cent of the children’s consumption of foods in the food groups increased. At the start of the project, low consumption rates were observed for white tubers and roots, vitamin A-rich fruit, other fruit and fish. After the gardening project, the number of children consuming vegetables increased considerably. There was an increase in the intake of food groups over the period of the project. The number of children consuming vitamin A-rich increased the most, with all children (45 per cent improvement) consuming vitamin A-rich vegetables at the end of the project, compared with just over half at the start of the project. The consumption of vegetables increased with 78 per cent of the children consuming beans and 33 per cent beetroot. Most children (95 per cent) consumed cabbage, carrots and spinach post-home gardening. Seventy eight percent of children consumed beans by the end of the project, but only a third of the children had consumed beetroot during the post-project survey period. Intakes of all nutrients considered in the study improved by the end of the project, except for energy and calcium, which dropped marginally, but both remained at around 50 per cent below requirements. Twenty five percent of boys (24-35 months) were underweight and below the 50th percentile at the pre- and post-project stages. The same boys were severely stunted (on average -4.41 standard deviations below the third percentile). Of the boys aged 36-47 months, 25 per cent were stunted pre-project, but by the end of the project, this number had decreased to 50 per cent. Twenty one per cent of the older boys (48-60 months) were within their normal height for age. Twenty five per cent of girls were underweight (36-47 months). A slight change was observed in the 36-47 month group, where the mean changed from -0.14 standard deviations (below 50th percentile) pre-project to -0.5 (below 50th percentile) post-project. All girls aged 24-35 months were below -2 standard deviations pre-project. After the home gardening project, the figure dropped to 50 per cent. For girls aged 36-47 months, 25 per cent were below -3 standard deviations after the project, compared with 20 per cent pre-project. Height-for- age for girls aged 36-47 months dropped by 10 per cent below -2 standard deviation post-home gardening. Girls from 24 to 35 months were severely stunted [-3.02 (below 3rd percentile) pre- and -2.31 (below 5th percentile) post-project]. Stunting was observed in 36-47 months girls who had means of -2.39 (below 3rd percentile) and 1.86 (below 25th percentile) both pre-and post-gardening respectively and were at risk of malnutrition. The older girls were well nourished with means of height-for-age at -0.88 (below 50th percentile) pre-project and -0.92 (below 50th percentile) post-project. Home-gardening improved food access, dietary diversity, energy, protein, carbohydrate, fat, fibre, vitamin A and iron intakes, but did not make a significant impact on the malnutrition of the children in the project or ensure adequate intakes. Home gardens had a positive impact on height-for-age scores; but had no significant impact on mean weight-for-age and height-for-weight z-scores of the pre-school children. Increases in carbohydrate and fat intakes were shown to have the only significant impact on the children’s nutritional status and only with regard to improving height-for-age scores. The results show that the gardens did not have the expected impact on children’s nutrition, but confirm that increases in incomes from gardening are likely to have a greater impact through savings from consuming produce grown and selling produce to buy energy-dense foods for the children. This needs to be considered in nutrition interventions. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

The aim of this study was to assess the dietary intake, diet-related knowledge and metabolic control in children with Type 1 Diabetes Mellitus between the ages of 6-10 years attending the Paediatric Diabetic Clinics at Grey’s Hospital, Pietermaritzburg and Inkosi Albert Luthuli Central Hospital, Durban, KwaZulu-Natal. This was a cross sectional observational study that was carried out in a total of 30 subjects out of a possible 35 subjects that qualified for inclusion in the study from both the Grey’s Hospital clinic (n=8) and IALCH clinic (n=22). The dietary intake was assessed in a total of 25 subjects using a three day dietary record (n=20) and a 24 hour recall of the third day of the record (n=16). Diet-related knowledge was assessed using a multiple choice questionnaire. Metabolic control was assessed using the most recent HbA1c and the mean HbA1c results over the previous 12 months from the date of data collection. Height and weight measurements were also carried out. Information on socioeconomic status and education status of the caregivers was obtained from 22 caregivers through follow-up phone calls. All measurements except for dietary intake were obtained from all subjects participating in the study. The mean percentage contribution of macronutrients to total energy was very similar to the International Society for Pediatric and Adolescent Diabetes (ISPAD) Consensus Guidelines (2002). The mean percentage contribution of macronutrients to total energy from the 3 day dietary records and the 24 hour recalls were as follows: carbohydrate (52% and 49%); sucrose (2% and 2%); protein (16% and 17%); fat (32% and 34%). Micronutrient intake was adequate for all micronutrients except for calcium and vitamin D which showed low intakes. The mean diet-related knowledge score for the sample was 67% with significantly higher scores in children older than 8 years of age. The latest HbA1c for the sample was 9.7% and the mean HbA1c over the previous 12 months from the date of data collection was 9.6%. There was a significant positive correlation between age of the participant and the latest HbA1c (r = 0.473; p=0.008) and a significant negative correlation between the education level of the caregivers and the latest HbA1c (r = - 0.578; p=0.005) and the mean HbA1c over 12 months (r = - 0.496; p=0.019). Significant differences were found between African and Indian children respectively for HbA1c, with higher values in African children. There was no correlation between BMI for age and latest HbA1c (r = 0.203, p=0.282) or mean HbA1c over 12 months (r = 0.101, p=0.594). Z score for BMI for age was also not correlated with latest HbA1c (r = 0.045, p=0.814) or mean HbA1c over 12 months (r = - 0.012, p=0.951). Children from the Grey’s Hospital Clinic were found to have higher HbA1c values (p=0.001) and lower diet-related knowledge scores as compared to the children from the IALCH Clinic (p=0.038). It should be noted that the ethnic and racial composition of the children attending these two clinics differed. In conclusion the macronutrient intake in this sample was found to be similar to the ISPAD Consensus Guidelines (2002) while calcium and vitamin D intakes were low. Overall this sample displayed good diet-related knowledge while metabolic control was found to be poor. / Thesis (M.Sc.)-University of KwaZulu-Natal, Pietermaritzburg, 2007.

The Integrated Nutrition Programme (INP) was implemented in 1995 to target child malnutrition in South Africa. This study assessed the impact of the INP on child malnutrition by province and age group using secondary data. Data from three national nutrition surveys, conducted in 1994, 1999 and 2005, were used to describe trends in child stunting, underweight, wasting, vitamin A deficiency and iron deficiency. The relationship between the prevalence of the human immunodeficiency virus (HIV) in prenatal women and child nutritional status; challenges and constraints to implementing the INP at provincial level; and government responses to nutrition recommendations by lead experts in the 1994 and 1999 surveys were also investigated. Child nutritional status varied across provinces. In some provinces such as the Northern Cape, stunting, underweight and wasting remained consistently high. Stunting decreased in the Eastern Cape, but rates of wasting increased between 1994 and 2005. On the other hand, Gauteng and the Western Cape generally had lower rates of malnutrition compared to the other provinces. This may be due to these provinces being the most economically active in the country thus more opportunities for employment and higher purchasing power of foods rich in micronutrients. By 2005, vitamin A deficiency had doubled in most provinces despite mandatory food fortification being implemented in 2003. KwaZulu-Natal had the highest rates of vitamin A deficiency, while Limpopo had the highest rates of iron deficiency. By 2005, malnutrition had decreased in children aged seven to nine years, but had increased in those aged one to three years. There was a significant positive correlation (p<0.01) between the prevalence of HIV in prenatal women and vitamin A deficiency nationally. The prevalence of HIV in prenatal women was positively correlated (p<0.05) with rates of wasting in children aged one to three years. Limited skills, inadequate monitoring and evaluation, and limited infrastructure were common challenges and constraints to implementing the INP at provincial level. The effect of HIV on human resources and the higher demands of HIV infected patients also posed a challenge to provinces as they implemented the INP. Government responded to most recommendations made by nutrition experts. Supplementation,food fortification, growth monitoring and nutrition promotion programmes were implemented. Based on the data, it would appear that INP activities targeted at school-going children were more effective than those targeting children under-five. Although food fortification was implemented in 2003, the vitamin A content of fortified products might not have met legislative requirements. Additionally, because vitamin A is unstable to heat and light, if vitamin A fortified foods are cooked or stored this may also influence the bioavailability of vitamin A. Maternal HIV status might have attenuated child nutrition outcomes due to the negative effect of HIV on related health conditions such as child caring and feeding practices. Some of the challenges and constraints at provincial level might have negatively affected the implementation of the INP and consequently its impact. Although government responded to most recommendations made by nutrition experts, ongoing monitoring and evaluation of child nutritional status were not adequately done, which might have also negatively affected INP outcomes. In addition, factors in the macro-environment such as food inflation and access to basic sanitation, could have lessened the impact of the INP on child malnutrition. Interventions directed at malnutrition in children under-five need to be prioritised. There needs to be rigorous monitoring of micronutrient content, especially vitamin A, of fortified foods. Future studies need to include assessment of nutritional status in HIV affected and infected children to help identify specific needs and develop appropriate policies. Frequent nutrition surveillance to assess key child malnutrition indicators is required. / Thesis (M.Sc.) - University of KwaZulu-Natal, Pietermaritzburg, 2009.

A obesidade vem crescendo gradativamente em locais anteriormente pouco prevalentes, inclusive naqueles de baixa renda. O presente estudo foi realizado em comunidades quilombolas com o objetivo de comparar a prevalência dos fatores de riscos para doenças cardiovasculares entre mulheres dessas comunidades e de dados retrospectivos de um grupo de mulheres adultas participantes do diagnóstico Materno-infantil do Estado de Alagoas, tido como grupo de referência. Participaram desse estudo, 1665 mulheres quilombolas de 41 comunidades cadastradas na Secretaria do Estado da Mulher, da Cidadania e dos Direitos Humanos e 1158 mulheres do grupo de referência. Analisou-se a massa corporal, a estatura, o índice de massa corporal (IMC), a circunferência da cintura (CC), a relação da cintura pelo quadril (RCQ) e o percentual de gordura como indicadores de risco a desenvolver doenças cardiovasculares. Para o tratamento dos dados, foi utilizada a estatística descritiva, medidas de prevalências, razão de prevalências (RP) ajustadas pelos quartis da idade e teste de diferença entre os grupos (p<0,05). Verificou-se uma maior prevalência de risco para os pontos de corte da CC e RCQ (CC 80 cm e RCQ 0,85) nas mulheres quilombolas do que nas mulheres de referência (CC:56,27% vs 34,45%; RCQ:51,3% vs 24,32%, respectivamente). Apesar das mulheres quilombolas apresentarem maior prevalência de sobrepeso (32,4% vs 30,29%) e obesidade (18,3% vs 13,77%) quando classificadas pelos valores de IMC, apenas o 4º quartil (sobrepeso) e 3º quartil (obesidade) apresentou razão de risco significativo quando ajustado pela idade (RP: 1,2; IC 95%: 1,04 a 1,39 para o 4º quartil; RP:1,43; IC95%: 1,01 a 2,0 para o 3º quartil). Não foram encontradas diferenças significativas entre os grupos para o percentual de gordura (p=0,98), e foi demonstrado fator de proteção para RP (0,29; 0,45; 0,67 e 0,96) com o ajustamento pela idade entre os grupos, respectivamente, no 1º, 2º, 3º e 4º quartil para este indicador. Observou-se também que a idade demonstrou ser um fator de risco associado com o aumento da idade quando comparada a RP entre o 4º e 1º quartis das mulheres quilombolas. Os resultados indicam que existem importantes evidências de que a população quilombola convive com uma considerável prevalência de indicadores de doenças cardiovasculares. Portanto, as prevalências encontradas apontam para a necessidade de iniciativas emergenciais para esse grupo, no sentido de reduzir as prevalências de sobrepeso/obesidade e, consequentemente, dos fatores de risco para desenvolvimento de doenças cardiovasculares.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A adoção do plano dietético Dietary Approaches to Stop Hypertension (DASH) tem sido enfatizado na população hipertensa como uma importante estratégia no controle dos níveis pressóricos elevados. O objetivo deste estudo foi analisar o consumo alimentar de macro e micronutrientes em pacientes hipertensos, em especial do sódio, cálcio, potássio e magnésio, e comparar com as recomendações dietéticas contidas no plano DASH. Estudo transversal envolvendo uma amostra de conveniência composta por 113 hipertensos entre 40 e 69 anos. A medida da pressão arterial (PA) foi determinada com aparelho eletrônico devidamente calibrado e a avaliação dietética obtida pelo questionário de freqüência do consumo alimentar. Os alimentos ingeridos foram convertidos em porções e distribuídos em diferentes grupos alimentares. A faixa de porções recomendadas pelo plano DASH foi determinada com base na média das necessidades energéticas desta amostra permitindo assim uma posterior comparação com o hábito alimentar dos hipertensos, utilizando um escore de pontos com pontuação máxima de 9 pontos. A amostra foi dividida em três grupos: grupo B que obteve 2,5 a 4,0 pontos (n=34; 30%), grupo M entre 4,5 a 5,0 pontos (n=43; 38%) e grupo A que obteve 5,5 a 8,0 pontos (n=36; 32%). Não foram observadas diferenças significativas na média da PA sistólica (14024 vs 13823 vs 13515 mmHg) e diastólica (8617 vs 8813 vs 8410 mmHg). Apesar do grupo A consumir mais proteínas e gordura monoinsaturada, foi detectado um excesso pronunciado na ingestão de gordura saturada, colesterol e das calorias totais, por este grupo de pacientes. No que tange a ingestão dos micronutrientes, o grupo A apresentou consumo significativamente maior de cálcio, potássio e magnésio, refletido pela maior ingestão de vegetais e frutas em comparação aos grupos B e M. A média de ingestão do sódio intrínseco foi significativamente maior no grupo A (4,12,0 vs 3,11,1 vs 2,71,1 g/dia). Foram detectadas, apenas no grupo A, correlações entre PA sistólica e o percentual de proteína (r = -0,5; p=0,002) e PA sistólica e o percentual de carboidrato (r = 0,4; p=0,02). Apenas um terço dos hipertensos avaliados apresentaram padrão alimentar mais concordante com o plano DASH e com maior ingestão de proteínas, gordura monoinsaturada, fibras, cálcio, potássio e magnésio. Entretanto, o consumo mais elevado de sódio, gordura saturada, colesterol e das calorias totais por este grupo de pacientes poderia restringir uma maior queda dos níveis pressóricos elevados. / The adoption of the Dietary Approaches to Stop Hypertension (DASH) plan has been emphasized in the hypertension population as an important strategy in the control of the raised blood pressure (BP). The objective of this study was to analyze the alimentary consumption of macro and micronutrients in hypertensive patients, especially of sodium, calcium, potassium and magnesium, and to compare with the dietary recommendations contained in DASH plan. Transversal study was conducted in a convenience sample of 113 hypertensive patients, between 40 and 69 years. The BP measurement was determined with calibrated electronic device and the dietary assessment was performed trough the semiquantitative food frequency questionnaire. For comparison with DASH plan, ingested foods were converted into portions and the magnitude of the portions recommended for DASH plan was determined on the basis of the mean energy requirements of this sample. Thereafter, cut-off points were established for food groups, the maximum number of points that a patient could reach was 9. The sample was divided in tertils: Group L with 2.5 4.0 points (n=34; 30%), Group I with 4.5 5.0 points (n=43; 38%) and Group H with 5.5 8.0 points (n=36; 32%). Systolic and diastolic BP were not significantly different among the groups (14024 vs 13823 vs 13515 mmHg/ 8617 vs 8813 vs 8410 mmHg). Group H consumed more proteins and monoinsaturated fat, a pronounced excess in the saturated fat, cholesterol and total calories intake was also detected in this group of patients. Regarding micronutrients intake, group H presented significantly higher consumption of calcium, potassium and magnesium, reflected for higher vegetable and fruits intake in comparison to the groups L and I. The average of intrinsic sodium intake was significantly higher in the group H (4.12.0 vs 3.11.1 vs 2.71.1 g/day). Negative correlation between the systolic BP and dietary protein percentage (r=-0.5, p=0.002) and a positive correlation between the systolic BP and the carbohydrate percentage (r=0.4, p=0.02) was verified only in group H. The present study showed that only one third of the hypertensive patients presented alimentary pattern more consistent with DASH plan, showing greater intake of protein, monounsaturated fat, fiber, calcium, potassium and magnesium. However, pronounced sodium, saturated fat and cholesterol intake and excess of total calories in these hypertensive patients could restrict a greater control of BP.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / A adoção do plano dietético Dietary Approaches to Stop Hypertension (DASH) tem sido enfatizado na população hipertensa como uma importante estratégia no controle dos níveis pressóricos elevados. O objetivo deste estudo foi analisar o consumo alimentar de macro e micronutrientes em pacientes hipertensos, em especial do sódio, cálcio, potássio e magnésio, e comparar com as recomendações dietéticas contidas no plano DASH. Estudo transversal envolvendo uma amostra de conveniência composta por 113 hipertensos entre 40 e 69 anos. A medida da pressão arterial (PA) foi determinada com aparelho eletrônico devidamente calibrado e a avaliação dietética obtida pelo questionário de freqüência do consumo alimentar. Os alimentos ingeridos foram convertidos em porções e distribuídos em diferentes grupos alimentares. A faixa de porções recomendadas pelo plano DASH foi determinada com base na média das necessidades energéticas desta amostra permitindo assim uma posterior comparação com o hábito alimentar dos hipertensos, utilizando um escore de pontos com pontuação máxima de 9 pontos. A amostra foi dividida em três grupos: grupo B que obteve 2,5 a 4,0 pontos (n=34; 30%), grupo M entre 4,5 a 5,0 pontos (n=43; 38%) e grupo A que obteve 5,5 a 8,0 pontos (n=36; 32%). Não foram observadas diferenças significativas na média da PA sistólica (14024 vs 13823 vs 13515 mmHg) e diastólica (8617 vs 8813 vs 8410 mmHg). Apesar do grupo A consumir mais proteínas e gordura monoinsaturada, foi detectado um excesso pronunciado na ingestão de gordura saturada, colesterol e das calorias totais, por este grupo de pacientes. No que tange a ingestão dos micronutrientes, o grupo A apresentou consumo significativamente maior de cálcio, potássio e magnésio, refletido pela maior ingestão de vegetais e frutas em comparação aos grupos B e M. A média de ingestão do sódio intrínseco foi significativamente maior no grupo A (4,12,0 vs 3,11,1 vs 2,71,1 g/dia). Foram detectadas, apenas no grupo A, correlações entre PA sistólica e o percentual de proteína (r = -0,5; p=0,002) e PA sistólica e o percentual de carboidrato (r = 0,4; p=0,02). Apenas um terço dos hipertensos avaliados apresentaram padrão alimentar mais concordante com o plano DASH e com maior ingestão de proteínas, gordura monoinsaturada, fibras, cálcio, potássio e magnésio. Entretanto, o consumo mais elevado de sódio, gordura saturada, colesterol e das calorias totais por este grupo de pacientes poderia restringir uma maior queda dos níveis pressóricos elevados. / The adoption of the Dietary Approaches to Stop Hypertension (DASH) plan has been emphasized in the hypertension population as an important strategy in the control of the raised blood pressure (BP). The objective of this study was to analyze the alimentary consumption of macro and micronutrients in hypertensive patients, especially of sodium, calcium, potassium and magnesium, and to compare with the dietary recommendations contained in DASH plan. Transversal study was conducted in a convenience sample of 113 hypertensive patients, between 40 and 69 years. The BP measurement was determined with calibrated electronic device and the dietary assessment was performed trough the semiquantitative food frequency questionnaire. For comparison with DASH plan, ingested foods were converted into portions and the magnitude of the portions recommended for DASH plan was determined on the basis of the mean energy requirements of this sample. Thereafter, cut-off points were established for food groups, the maximum number of points that a patient could reach was 9. The sample was divided in tertils: Group L with 2.5 4.0 points (n=34; 30%), Group I with 4.5 5.0 points (n=43; 38%) and Group H with 5.5 8.0 points (n=36; 32%). Systolic and diastolic BP were not significantly different among the groups (14024 vs 13823 vs 13515 mmHg/ 8617 vs 8813 vs 8410 mmHg). Group H consumed more proteins and monoinsaturated fat, a pronounced excess in the saturated fat, cholesterol and total calories intake was also detected in this group of patients. Regarding micronutrients intake, group H presented significantly higher consumption of calcium, potassium and magnesium, reflected for higher vegetable and fruits intake in comparison to the groups L and I. The average of intrinsic sodium intake was significantly higher in the group H (4.12.0 vs 3.11.1 vs 2.71.1 g/day). Negative correlation between the systolic BP and dietary protein percentage (r=-0.5, p=0.002) and a positive correlation between the systolic BP and the carbohydrate percentage (r=0.4, p=0.02) was verified only in group H. The present study showed that only one third of the hypertensive patients presented alimentary pattern more consistent with DASH plan, showing greater intake of protein, monounsaturated fat, fiber, calcium, potassium and magnesium. However, pronounced sodium, saturated fat and cholesterol intake and excess of total calories in these hypertensive patients could restrict a greater control of BP.