Obesity, assessed by body mass index (BMI), is considered a major public health problem worldwide. Studies in people without CVD, have shown that BMI between 22.5 to 24.9 kg/m2 is associated with the lowest risk of death in healthy non-smoker populations. However, studies in patients with acute coronary syndrome (ACS) have shown that overweight and obese patients have better survival than those in the normal BMI range. This phenomenon has been called the “obesity paradox”. This thesis has two main components: a systematic review with meta-analysis of the current literature of BMI and ACS, and an individual patient data meta-analysis from 8 randomized trials whose data base was accessible at the PHRI involving ACS patients. The study-level systematic review (35 studies) and meta-analysis (19 studies) demonstrates that there is a statistically significant adjusted 20% risk lower mortality among overweight and obese participants considered normal weight. Nevertheless, there was moderate to high heterogeneity of pooled estimates that could not be explained in subgroup analyses. Also, the systematic review detected major limitations in the current literature, including missing BMI and covariates data, lost to follow-up, enough number of events in high BMI categories, warranting more research in the area. The second component, the individual patient data meta-analysis (n = 81,553), confirmed a 20% lower mortality risk in the overweight and type I obesity categories, compared to the normal the BMI range. This lower risk was robust and remained consistent within several sensitivity analyses. Analysis of secondary outcomes suggests that a reduced risk of bleeding, and probably a reduced risk of ischemia and heart failure related deaths, are the responsible mechanisms. Given the limitations of observational research, prospective randomized interventional trials are required to clarify the optimal range of BMI in those with ACS. / Thesis / Master of Health Sciences (MSc)

No description available.

O estilo de vida adotado pela população como má alimentação, sedentarismo e poucas horas de sono podem contribuir para o aumento de peso e consequentemente para o aparecimento de doenças crônicas não transmissíveis. O objetivo deste estudo foi avaliar o estado nutricional e identificar o estilo de vida da população adulta usuária da Estratégia de Saúde da Família (ESF) de um município paulista. Foi conduzido um inquérito com emprego de questionário aplicado pelo pesquisador em entrevistas individualizadas, com 381 pessoas maiores de vinte anos em onze ESF do município de Bebedouro-SP. A coleta de dados foi realizada no prazo de oito meses (Outubro de 2016 a Maio de 2017), com participantes que encontravam presentes no local, nos dias visitados, até atingir a cota amostral prevista para a unidade. Foram realizadas medidas antropométricas (peso, altura e IMC) e aplicado os questionários sobre estilo de vida e o socioeconômico e demográfico em todos os participantes. Observou-se predomínio dos participantes da faixa etária 20 - 39 anos (33,9%), do sexo feminino (74,5%), com ensino médio completo/superior incompleto (38,6%), classe econômica D-E (59,5%) hábito de sono menor que 6 horas/dia (41,5%) e sedentários (66,9%). Em relação ao consumo alimentar, a maioria consumia feijão todos os dias (33,6%), com diferença estatística significante entre adultos e idosos (limite inferior: 0,59 e limite superior: 0,03) e também na comparação do estado nutricional de sobrepeso e obesidade (limite inferior: 0,21 e limite superior: 1,37). Quanto ao estado nutricional, classificado de acordo com o índice de massa corporal, verificou-se que a maioria dos adultos apresentavam obesidade (43,5%) e sobrepeso (37,4%) e a maioria dos idosos (61,8%) sobrepeso. Em resumo, a população que mais frequenta as unidades de ESF do município estudado era do sexo feminino, da faixa etária dos 20 aos 39 anos, com vida sedentária, entretanto não faz ingestão de álcool e tabaco. O excesso de peso predominou nos adultos e idosos. / The lifestyle adopted by the population as poor diet, sedentary lifestyle and few hours of sleep can contribute to weight gain and consequently for the occurrence of chronic non-communicable diseases. The aim of this study was to evaluate the nutritional status and identify the lifestyle of the adult population using the family health strategy in a municipality of the countryside of São Paulo State. A survey was conducted using a questionnaire applied by the researcher in individualized interviews, with 381 individuals aged twenty years or more, in eleven Family Health Strategies in the municipality of Bebedouro-SP. Data collection was carried out within eight months (October 2016 to May 2017), with participants who were present in the site, on the visited days, until to complete the sampling quota of the unit. Anthropometric measurements (weight, height and BMI) were performed, and a lifestyle and socioeconomic and demographic questionnaires were applied to all participants. Among participants, there was predominance of the categories age group 20 - 39 years old (33.9%), female (74.5%), married (50.9%), incomplete high school (38.6%), economic class D and E (59.5%), having a sleep habit of less than 6 hours / day (41.5%) and sedentary (66.9%). In relation to food consumption, most of the participants consumed beans every day 33.6%) with significant statistical difference between adults and the elderly (lower limit: 0.59 and upper limit: 0.03) and also in the comparison of the nutritional status of overweight and obesity (lower limit: 0.21 and upper limit superior: 1,37). In relation to the nutritional status, classified according to body mass index, the majority of adults were obese (43.5%) and overweight (37.4%) and the majority of elderly (61.8%) were overweight. In summary, the population that most visit the ESF units of the studied municipality was female, from the age group of 20 to 39 years old, with a sedentary life, but does not consume alcohol and tobacco. Excess weight predominated in adults and elderly.

O estilo de vida adotado pela população como má alimentação, sedentarismo e poucas horas de sono podem contribuir para o aumento de peso e consequentemente para o aparecimento de doenças crônicas não transmissíveis. O objetivo deste estudo foi avaliar o estado nutricional e identificar o estilo de vida da população adulta usuária da Estratégia de Saúde da Família (ESF) de um município paulista. Foi conduzido um inquérito com emprego de questionário aplicado pelo pesquisador em entrevistas individualizadas, com 381 pessoas maiores de vinte anos em onze ESF do município de Bebedouro-SP. A coleta de dados foi realizada no prazo de oito meses (Outubro de 2016 a Maio de 2017), com participantes que encontravam presentes no local, nos dias visitados, até atingir a cota amostral prevista para a unidade. Foram realizadas medidas antropométricas (peso, altura e IMC) e aplicado os questionários sobre estilo de vida e o socioeconômico e demográfico em todos os participantes. Observou-se predomínio dos participantes da faixa etária 20 - 39 anos (33,9%), do sexo feminino (74,5%), com ensino médio completo/superior incompleto (38,6%), classe econômica D-E (59,5%) hábito de sono menor que 6 horas/dia (41,5%) e sedentários (66,9%). Em relação ao consumo alimentar, a maioria consumia feijão todos os dias (33,6%), com diferença estatística significante entre adultos e idosos (limite inferior: 0,59 e limite superior: 0,03) e também na comparação do estado nutricional de sobrepeso e obesidade (limite inferior: 0,21 e limite superior: 1,37). Quanto ao estado nutricional, classificado de acordo com o índice de massa corporal, verificou-se que a maioria dos adultos apresentavam obesidade (43,5%) e sobrepeso (37,4%) e a maioria dos idosos (61,8%) sobrepeso. Em resumo, a população que mais frequenta as unidades de ESF do município estudado era do sexo feminino, da faixa etária dos 20 aos 39 anos, com vida sedentária, entretanto não faz ingestão de álcool e tabaco. O excesso de peso predominou nos adultos e idosos. / The lifestyle adopted by the population as poor diet, sedentary lifestyle and few hours of sleep can contribute to weight gain and consequently for the occurrence of chronic non-communicable diseases. The aim of this study was to evaluate the nutritional status and identify the lifestyle of the adult population using the family health strategy in a municipality of the countryside of São Paulo State. A survey was conducted using a questionnaire applied by the researcher in individualized interviews, with 381 individuals aged twenty years or more, in eleven Family Health Strategies in the municipality of Bebedouro-SP. Data collection was carried out within eight months (October 2016 to May 2017), with participants who were present in the site, on the visited days, until to complete the sampling quota of the unit. Anthropometric measurements (weight, height and BMI) were performed, and a lifestyle and socioeconomic and demographic questionnaires were applied to all participants. Among participants, there was predominance of the categories age group 20 - 39 years old (33.9%), female (74.5%), married (50.9%), incomplete high school (38.6%), economic class D and E (59.5%), having a sleep habit of less than 6 hours / day (41.5%) and sedentary (66.9%). In relation to food consumption, most of the participants consumed beans every day 33.6%) with significant statistical difference between adults and the elderly (lower limit: 0.59 and upper limit: 0.03) and also in the comparison of the nutritional status of overweight and obesity (lower limit: 0.21 and upper limit superior: 1,37). In relation to the nutritional status, classified according to body mass index, the majority of adults were obese (43.5%) and overweight (37.4%) and the majority of elderly (61.8%) were overweight. In summary, the population that most visit the ESF units of the studied municipality was female, from the age group of 20 to 39 years old, with a sedentary life, but does not consume alcohol and tobacco. Excess weight predominated in adults and elderly.

Thesis (M.S.P.H.)--University of South Florida, 2009. / Title from PDF of title page. Document formatted into pages; contains 137 pages. Includes bibliographical references.

Aim: Negative attitudes towards people with obesity are common even in health care settings. So far, the attitudes and causal beliefs of dietitians and nutritionists have not been investigated systematically. The aim of this article was to review the current state of quantitative research on weight-related stigma by dietitians and nutritionists. Method: A systematic literature review was conducted in 2014 using PubMed, PsycINFO, Web of Science and Cochrane Library. Results: Eight studies were found that differ in regard to study characteristics, instruments and the origin of the sample. Six out of eight studies reported weight stigma expressed by dietitians and nutritionists. Their believed causes of obesity indicated a defined preference for internal factors rather than genetics or biology. Discussion: Results of studies were not homogenous. The degree of negative attitudes by dietitians and nutritionists towards people with obesity appeared to be slightly less pronounced compared to the general public and other health care professionals. Stigma and its consequences should be included into educational programs to optimally prepare dietitians and nutritionists.

No description available.

Submitted by SBI Biblioteca Digital (sbi.bibliotecadigital@puc-campinas.edu.br) on 2017-04-04T13:35:20Z No. of bitstreams: 1 KAINARA SILVA DA CUNHA.pdf: 4382186 bytes, checksum: 5903094e0138ceaa973c86523ff0f8d9 (MD5) / Made available in DSpace on 2017-04-04T13:35:20Z (GMT). No. of bitstreams: 1 KAINARA SILVA DA CUNHA.pdf: 4382186 bytes, checksum: 5903094e0138ceaa973c86523ff0f8d9 (MD5) Previous issue date: 2017-02-06 / Conselho Nacional de Pesquisa e Desenvolvimento Cient?fico e Tecnol?gico - CNPq / Pontif?cia Universidade Cat?lica de Campinas ? PUC Campinas / Child overweight and obesity have been growing at a significant rate, and studies point towards family participation as crucial to reach an efficient treatment, by its virtue as the main influence on the child. This study analyzed a few parental variables related to adherence to overweight/obesity (OOB) treatment of children between 5 and 11 years, such as the family?s psychosocial risk, feeding control standards, the stressors and the strategies for coping with Pediatrics and Endocrinology outpatient treatment of a university teaching hospital. There were 19 participants, most of them mothers of children with obesity. The participants had 37 years on average, and most were married or in a stable relationship, and also presented obesity. They individually answered these instruments: Research Participant Characterization Form, Psychosocial Assessment Tool (PAT2.0), Comprehensive Feeding Practices Questionnaire (CPFQ), and Parental Coping Protocol for Child Overweight/Obesity, specially elaborated for the study, based on Coping Motivational Theory. For weight and height measurements, the instruments used were a portable scale and a stadiometer. The results show that all families are at psychosocial risk, especially the single mothers. Most families were forwarded to professional interventions, such as Targeted (52,6%) and Clinical (21,1%). The biggest risk set families apart at the average PAT2.0 score and especially with regards to social support, problems in family structure and resources, and problems in the family and with the child. A positive, moderate-to-high relation between the mother?s physical activity and the child?s was observed. Reported parental practice of feeding control was one of incitement towards experimentation and healthy consumption, and towards quantitative and qualitative restriction of food choices; although families at ?clinical? psychosocial risk use food as reward more often. The bigger the psychosocial risk, the less the child is involved in family meals. The most common stressor is feeding control. Those guardians deal with child obesity with more adaptive coping strategies, such as: Self-Confidence, Support-Seeking, Information-Seeking and Problem Resolution. However, significant correlations between higher psychosocial risk and maladaptive Opposition coping were observed, such as a reaction to a perceived threat to the guardian?s need for autonomy. The most common emotional reactions are sadness and fear, with correlations between reactions of anger and sadness, indicating that negative affect is the coping basis of the guardians, making problem resolution and adherence to treatment more difficult. All sample participants are at psychosocial risk, but set apart by risk, indicating a necessity of specific interventions. The study results provide information for an intervention directed by social, emotional and coping characteristics of the families? obesity treatment. / O sobrepeso e a obesidade infantil v?m crescendo de forma significativa, e estudos apontam ? participa??o da fam?lia como crucial para atingir um tratamento eficaz, pelo fato da mesma ser a principal fonte de influ?ncia da crian?a. Este estudo analisou algumas vari?veis parentais relacionadas ? ades?o ao tratamento do sobrepeso/obesidade (SOB) dos filhos com idade entre cinco e 11 anos, como os riscos psicossociais da fam?lia, o padr?o de controle alimentar, os estressores e as estrat?gias de enfrentamento do tratamento ambulatorial de Pediatria e Endocrinologia de um hospital universit?rio. Participaram 19 familiares, a maioria m?es de crian?as com obesidade. Os participantes tinham 37 anos, em m?dia, sendo a maioria casada ou em rela??o est?vel, e apresentavam tamb?m obesidade. Responderam individualmente os instrumentos: Ficha de Caracteriza??o do Participante para Pesquisa; Instrumento de Avalia??o Psicossocial (PAT 2.0), Question?rio de Pr?ticas Alimentares (CFPQ) e Protocolo de Enfrentamento Parental do Sobrepeso/Obesidade Infantil, especialmente elaborado para o estudo, com base na Teoria Motivacional do Coping. Para medidas de peso e altura, foram usados uma balan?a port?til e estadi?metro. Os resultados mostram que todas as fam?lias est?o em risco psicossocial, especialmente as m?es solteiras. A maioria das fam?lias foi indicada para interven??o profissional, como Alvo (52,6%) e Cl?nico (21,1%). O maior risco diferenciou as fam?lias na m?dia geral do PAT 2.0 e especialmente em rela??o ao suporte social, problemas na estrutura familiar e recursos, problemas na fam?lia e com a crian?a. Constatou-se uma rela??o positiva e moderada-alta entre a atividade f?sica da m?e e do filho. A pr?tica parental de controle da alimenta??o relatada ? de incentivo ? experimenta??o e consumo saud?vel, e ? restri??o de escolha quantitativa e qualitativa de alimentos; mas fam?lias em risco psicossocial ?cl?nico? usam mais a comida como recompensa. Quanto maior o risco psicossocial, menor ? o envolvimento da crian?a com as refei??es em fam?lia. Os estressores mais frequentes s?o o controle alimentar. Esses cuidadores lidam com a obesidade do filho com estrat?gias enfrentamento mais adaptativas, como: Autoconfian?a, Busca de Suporte, Busca de Informa??o e Resolu??o de Problemas. Contudo, observou-se correla??es significativas entre maior risco psicossocial e coping mal adaptativo de Oposi??o, como uma rea??o a uma percep??o de amea?a ? necessidade de autonomia do cuidador. As rea??es emocionais mais comuns s?o de tristeza e medo, havendo correla??es entre rea??es de raiva e tristeza, indicando que o afeto negativo ? a base do enfrentamento dos cuidadores, dificultando a resolu??o do problema e a ades?o ao tratamento. Todos os participantes da amostra est?o em risco psicossocial familiar, mas diferenciados quanto ao risco, indicativo da necessidade de interven??es espec?ficas. Os resultados do estudo fornecem subs?dios para uma interven??o direcionada ?s caracter?sticas psicossociais, emocionais e de enfrentamento do tratamento da obesidade pelas fam?lias.

The obesity is a main factor in expansions of cardiovascular diseases, diabetes type 2, musculoskeletal diseases and some of the tumour illnesses. Study is dealing with the effect of movement activities during 3-months individual program on body mass reduction and changes of composition in human body. The program was held in VSTJ Medicina Praha, z.s. from April 2018 to January 2019. Included the group of 37 participants. Only 19 of them completed the program. This group undertook the body analysis, using bioimpedant machine "Tantia MC-780 MA". Components of evaluation were body mass, BMI and body fat in kg and %. In application "Time for Health" nutritional Intervention diet was monitored and evaluated during consultations. Physical activity using Pedometer "Garmin Vivofit" was recorded as a number of steps. Aim of this study was to obtain a collection data of changes in the body mass and body composition of the participants, based on input and output analysis as well as other biological parameters. Comparison of the compliance and program was based on recorded number of diet days. Statistically important differences between input and output data were compared and average decrease in body mass was 3.5 kg (SD ± 3.22), body fat 2.3 kg (SD ± 2.63) and BMI 1.17 kg (SD ±1.11). On average participants...

Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008. / Title from first page of PDF file (viewed July 11, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 67-76).