Regime Alimentar Simpósio Modificações do Estilo de Vida Regime Alimentar João Vieira, José...

Simpósio Modificações do Estilo de Vida

Regime AlimentarRegime Alimentar

João Vieira, José CamolasNutricionistasSEDM, HSM

Risco muitoaumentado

Risco aumentado

Risco ligeiramenteaumentado

DM 2 DC Cancro (mama, endométrio, cólon)

D. Vesícula HTA Alt. H. Sexuais

Dislipidemia

Resist. Insulina

Dif. respiratórias

SAOS

Osteoartrite

Hiperuricémia

e Gota

SOP

Alt. Fertilidade

Lombalgia

Anomalias Fetais

Risco anestésico

Because the risks of diabetes,

cardiovascular disease and hypertension

rise continuously with increasing weight,

there is much overlap between the

prevention of obesity and the

prevention of a variety of chronic

diseases.WHO, 2003.

Mulheres

(n=4320),

%

Homens

(n=3796),

%

Total

(N=8116),

%

Baixo Peso

Peso Normal

Pre-obesidade

Obesidade I

Obesidade II

Obesidade III

3,4

48,9

34,4

10,2

2,4

0,8

0,9

38,9

45,2

13,2

1,6

0,2

2,2

44,2

39,4

11,6

2,0

0,6

Obesidade 13,4 15,0 14,2

Adaptado: Lowe MR, Obesity Research, 2003.



3 a 5 porções/dia

1 a 3 porções/dia

1 a 2 porções/dia

1,5 a 4,5 porções/dia

2 a 3 porções/dia

3 a 5 porções/dia

4 a 11 porções/dia

Água:1,5 a 3 litros dia



Comparing with prevalence rates from 1995-1998

survey, there is an increase of 4 percentual

points in the overall pre-obesity/obesity

prevalence.

Carmo I. et al, aguarda publicação.



Typically reported weight losses remaining

after 4-5 years are about 3% to 6% of initial

body weight.

Anderson JW et al, 2001.



Cancro do cólon

Cancro da mama

Cancro do endométrio

Diabetes Tipo 2

Hiperlipidémia

Obesidade

Doença hipertensiva

D. Sist. Circulatório

Doenças da vesícula

Artropatias

Total

Obesidade

Número de consultas médicas atribuíveis à obesidade por patologia

Pereira, J., C. Mateus e M.J. Amaral, 'Direct costs of obesity in Portugal' Value in Health, Vol. 3, pp. 64-65, 2000.Pereira, J., C. Mateus e M.J. Amaral, 'Custos da obesidade em Portugal' Associação Portuguesa de Economia da Saúde, Documento de Trabalho 4/99, Lisboa, 1999. disponível em: http://www.apes.pt/files/dts/dt_041999.pdf



http://www.apes.pt/files/dts/dt_041999.pdf






DIETASDIETAS……

Jornal Metro, 11 de Abril de 2007.



REGIME

s.m. acto ou modo de reger; sistema político de um país; modo de viver; direcção; regimento; dieta; trato; procedimento; complemento. (Do lat. «direcção»).

DIETA

s.f. regime especial de alimentação; privação total ou parcial de certos alimentos; assembleia legislativa, em certos países; assembleia dos capítulos de certas ordens religiosas, para tratar de assuntos disciplinares. (Do gr. díaita, «género de vida», pelo lat. diaeta-, «dieta»)

Dicionário de Língua Portuguesa, 6ª Ed., Porto Editora



Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004;79:6–16.

Evidence is provided to support the following points:

First, the highest rates of obesity occur among population groups with the highest poverty rates and the least education.



Baptista F, Brito MJ, Lázaro MJ et al. Obesidade e pobreza.

Endocrinologia, Metabolismo & Nutrição. 2005; 14: 163-68.

Relação entre rendimento e obesidade – Resultados

preliminares de um estudo em Lisboa:

…o nível de rendimento condiciona a obesidade,

sendo a doença mais prevalente nos grupos de

rendimento inferior.



Drewnowski A, Specter SE. Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004;79:6–16.

Evidence is provided to support the following points:

Second, there is an inverse relation between energy density (MJ/kg) and energy cost ($/MJ), such that energy-dense foods composed of refined grains, added sugars, or fats may represent the lowest-cost option to the consumer.



Berteus Forslund H et al. Snacking frequency in relation to energy intake and food choices in obese men and women compared to a reference population. Int J Obes (Lond). 2005 Jun;29(6):711-9.

Obese subjects were more frequent snackers than

reference subjects and women were more frequent

snackers than men.

Snacks were positively related to energy intake,

irrespective of physical activity.

Sweet, fatty food groups were associated with snacking

and contributed considerably to energy intake.

Snacking needs to be considered in obesity

treatment, prevention and general dietary

recommendations.



Nasser J. Taste, food intake and obesity. Obesity Reviews. 2001; 2:213-218.

Taste contributes to food palatability, which promotes

intake, and to thermic effect of a meal and sensory

specific satiety, which promote termination of intake.

Reduced sensitivity to these sensory-based

termination signals, coupled with possible increased

incentive salience of food stimuli and decreased

activation of food reward circuits, may contribute to

the over-consumption of energy that leads to

obesity.



Bellisle F, McDevitt R, Prentice AM. Meal frequency and energy balance. Br J Nutr. 1997 Apr;77 Suppl 1:S57-70.

...a 'nibbling' meal pattern may help in the avoidance

of obesity... some short-term studies suggest that the

thermic effect of feeding is higher when an

isoenergetic test load is divided into multiple small

meals, other studies refute this, and most are neutral…

… studies using whole-body calorimetry and doubly-

labelled water to assess total 24 h energy expenditure

find no difference between nibbling and gorging…



Bellisle F, McDevitt R, Prentice AM. Meal frequency and energy balance. Br J Nutr. 1997 Apr;77 Suppl 1:S57-70.

… there is no evidence that weight loss on

hypoenergetic regimens is altered by meal

frequency. We conclude that any effects of meal pattern

on the regulation of body weight are likely to be mediated

through effects on the food intake side of the

energy balance equation.



Fisher J., Rolls B., Birch L. Children's bite size and intake of an entree are greater with large portions than with age-appropriate or self-selected portions. Am J Clin Nutr 2003; 77: 1164-70.

Large entree portions may constitute an "obesigenic"

environmental influence for preschool-aged children by

producing excessive intake at meals.

Children with satiety deficits may be most susceptible

to large portions.

Allowing children to select their own portion size may

circumvent the effects of exposure to large portions on

children's eating.



““Tentativas Frustradas de Perda de Peso”Tentativas Frustradas de Perda de Peso”

It has been suggested that weight cycling is associated

with negative health outcomes, makes future weight

loss more difficult and results in a decrease in lean-to-

fat tissue ratio.

Lissner L et al. Int J Obes. 1990; 14: 373-383.

Some studies have shown histories of greater weight

fluctuation or weight cycling in obese binge eaters

compared with nonbingers, but others have not.Kuehnel RH, Wadden TA. Int J Eat Disord. 1994;15:321-329.



The evidence available at the time was that the increased risk was not sufficient to outweigh the potential benefits of moderate weight loss in obese patients.

National Task Force on the Prevention and Treatment of Obesity. JAMA. 1994; 272: 1196-1202.

Attempted weight loss is associated with lower all-cause mortality, independent of weight change. Self-reported intentional weight loss is associated with lower mortality rates, and weight loss is associated with higher mortality rates only if it is unintentional.

Gregg EW, Gerzoff RB, Thompson TJ, Williamson DF. Ann Intern Med. 2003 Mar 4;138(5):383-9.



Joint WHO/FAO Expert Consultation. WHO 2003.

Actividade Física Regular

Plano Alimentar Adequado

VCT ajustado

Distribuição nutrientes

Polifraccionado

Variedade de Alimentos



Algumas estratégias…Algumas estratégias…

Coma Sentado.Sirva a comida num prato mais pequeno.Não leve recipientes com comida para a mesa (tachos,

travessas, ...). Divida as porções. Coma devagar e saboreie a comida.Pouse os talheres. Converse durante a refeição.Deixe um pouco de comida no prato.Deixe a mesa logo que acabe a refeição.



Algumas estratégias…Algumas estratégias…

Não combine alimentação com outras actividades, tais como ler ou ver televisão.Planeie as suas refeições. Faça as compras após uma refeição completa, utilize uma lista e limite o dinheiro que vai gastar.Negoceie com a família não comer alimentos inapropriados.Evite ter alimentos desaconselhados em casa.Guarde os alimentos nas prateleiras que não são facilmente visíveis.Procure ocupações que evitem os snacks.



OBRIGADO !!!OBRIGADO !!!

Regime Alimentar Simpósio Modificações do Estilo de Vida Regime Alimentar João Vieira, José...

Documents

Transcript of Regime Alimentar Simpósio Modificações do Estilo de Vida Regime Alimentar João Vieira, José...