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OBJECTIVE: Mental illness is an important public health concern, often starting early in life and particularly impacting children from low-and middle-income countries. Our aims were to 1) determine, in a representative sample of public preschool 4- to 5-year old children in Brazil, the prevalence of internalizing and externalizing disorders and socioemotional development delays; and 2) to identify modifiable risk factors associated with mental, behavioral, or developmental disorders (MBDD), such as microsystem (i.e., parent-child relationship), mesosystem (social support), and macrosystem contextual factors (neighborhood disadvantage). METHODS: A random sample of public preschool children was recruited in the city of Embu das Artes (São Paulo metropolitan area) (n=1,292 from 30 public preschools). Six-month prevalence of MBDD was measured using the Child Behavior Checklist (CBCL) and the Ages and Stages Questionnaires: Social-Emotional (ASQ:SE). RESULTS: Six-month prevalence estimates were 25.4% for internalizing disorders, 12.1% for externalizing disorders, and 30.3% for socioemotional development delays. MBDD prevalence estimates were higher in families with stressful relationships and parental depression or anxiety, and in families with lower social capital. CONCLUSION: At least 25% of preschool children living in an urban area in Brazil presented a mental health disorder. These mental disorder were associated with modifiable factors such as stressful family relationships and lower social capital. Prevention and intervention measures such as family therapy are needed to decrease such high prevalence.
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Transtornos do Comportamento Infantil , Transtornos Mentais , Ansiedade , Brasil/epidemiologia , Criança , Desenvolvimento Infantil , Pré-Escolar , Humanos , Prevalência , Fatores de RiscoRESUMO
Excessive screen media use exposure is a robust childhood predictor of sedentary behavior. The association between excessive exposure to sedentary behaviors (e.g., screen media use) and motor skills and how this association differs across sociodemographic strata is an important knowledge gap that needs to be addressed. The study aims to investigate the association of motor skills and screen media use in preschool children, taking into account sociodemographic variables, physical activity, and sleep profile. A cross-sectional survey of 926 children from 27 preschools was performed. The main outcome was defined as motor skills assessed using the general motor quotient (GMQ). Independent variables included sociodemographic variables, screen media use, screen habits, physical activity, and sleep duration. Logistic regression models were used to estimate the associations between the children's motor skills and each exposure factor. More than 55 percent of the children ate while watching television and 28 percent spent a long time watching television, playing video games, or using a computer, tablet, or cell phone. Excessive screen media use increased the risk of a low GMQ by 72 percent and inactivity in children increased the odds by 90 percent; sleep duration at night decreased the odds of a low GMQ by 51 percent and daytime sleep decreased the odds by 33 percent. Excessive screen media use has been associated with poor motor skills and increased physical inactivity in children, especially among those with prolonged exposure. Our findings can alert parents to the consequences of excessive screen media use and can motivate policymakers to encourage sports and other health-promotion strategies.
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Meios de Comunicação/estatística & dados numéricos , Exercício Físico/psicologia , Destreza Motora , Tempo de Tela , Comportamento Sedentário , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Masculino , Pais , SonoRESUMO
OBJECTIVE: To evaluate the complementary feeding practices for infants, focusing on the main pureed baby foods, and verify adherence to the guidelines adopted in Brazil. METHODS: Through cross-sectional study, aspects of complementary feeding of 404 healthy infants between 4 and 9 months of age (São Paulo, Curitiba and Recife) were evaluated. Socio-demographic data, history and food habits were collected. Mothers described three recipes (preparations) usually used in key baby foods. The findings were compared with those recommended by the Brazilian Society of Pediatrics. RESULTS: The average age was 6.9 ± 1.6 months. Among infants, 241/404 (59.6%) were still breastfeeding. Among those who received another type of milk, 193/368 (52.4%) received whole cow's milk, while 151/368 (41.0%) drank infant or follow-on formulas. Regarding baby food recipes salted reported by mothers, it was seen that 30% and 60% contained meat and vegetables, respectively. The percentages less suitable for feeding in general were observed for use of cow's milk and added sugar, chocolate and cereal in feeding bottles; 79% and 80.5% of the families interviewed would adopted such practices. CONCLUSION: The early termination of exclusive/predominant breastfeeding and the practice of an inadequate transition diet have shown a picture of quantitatively and qualitatively inadequate feeding, with the risk of causing serious nutritional problems in later ages, such as anemia and vitamin A deficiency, or excess of nutrients, leading to obesity, diabetes and dyslipidemias.
Assuntos
Comportamento Alimentar/etnologia , Alimentos Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Animais , Alimentação com Mamadeira , Brasil/epidemiologia , Bovinos , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Leite Humano , Política Nutricional/tendências , Inquéritos Nutricionais , Cooperação do Paciente , Guias de Prática Clínica como Assunto , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
Objective: to evaluate the complementary feeding practices for infants, focusing on the main pureed baby foods, and verify adherence to the guidelines adopted in Brazil. Methods: through cross-sectional study, aspects of complementary feeding of 404 healthy infants between 4 and 9 months of age (São Paulo, Curitiba and Recife) were evaluated. Socio-demographic data, history and food habits were collected. Mothers described three recipes (preparations) usually used in key baby foods. The findings were compared with those recommended by the Brazilian Society of Pediatrics. Results: the average age was 6.9±1.6 months. Among infants, 241/404 (59.6%) were still breastfeeding. Among those who received another type of milk, 193/368 (52.4%) received whole cow's milk, while 151/368 (41.0%) drank infant or follow-on formulas. Regarding baby food recipes salted reported by mothers, it was seen that 30% and 60% contained meat and vegetables, respectively. The percentages less suitable for feeding in general were observed for use of cow's milk and added sugar, chocolate and cereal in feeding bottles; 79% and 80.5% of the families interviewed would adopted such practices. Conclusion: the early termination of exclusive/predominant breastfeeding and the practice of an inadequate transition diet have shown a picture of quantitatively and qualitatively inadequate feeding, with the risk of causing serious nutritional problems in later ages, such as anemia and vitamin A deficiency, or excess of nutrients, leading to obesity, diabetes and dyslipidemias. .
Objetivo: avaliar as práticas relacionadas à alimentação complementar de lactentes, com ênfase nas papas principais, e verificar a concordância com as recomendações atualmente adotadas no Brasil. Métodos: por meio de estudo transversal, foram avaliados os aspectos da alimentação complementar de 404 lactentes saudáveis entre 4 e 9 meses de vida (São Paulo, Recife e Curitiba). Coletaram-se dados sociodemográficos de antecedentes e hábitos alimentares. As mães descreveram três receitas (preparações) que costumam utilizar nas papas principais. Os achados foram comparados ao preconizado pela Sociedade Brasileira de Pediatria. Resultados: a média de idade foi de 6,9±1,6 meses. Cerca de 241 lactentes (59,6%) permaneciam em aleitamento materno. Entre os que recebiam outro tipo de leite, 193 dos 368 (52,4%) recebiam leite de vaca integral, e 151 dos 368 (41%), fórmulas infantis ou de seguimento para lactentes. Em relação às receitas de papas salgadas relatadas pelas mães, foi possível observar que 30 e 60% delas continham leguminosas e carnes, respectivamente. Os piores percentuais de adequação na alimentação, em geral, foram observados para uso de leite de vaca e adição de açúcar, achocolatado e cereais em mamadeiras; 79 e 80,5% das famílias entrevistadas adotavam essas práticas. Conclusão: o abandono precoce do aleitamento materno exclusivo/predominante e a prática de uma dieta de transição inadequada têm mostrado um quadro de consumo quantitativa e qualitativamente inapropriado, com riscos de acarretar graves problemas nutricionais nas faixas etárias posteriores, como anemia e hipovitaminose A, ou excessos de nutrientes, como obesidade, diabete e dislipidemias. .
Assuntos
Animais , Bovinos , Feminino , Humanos , Lactente , Masculino , Comportamento Alimentar/etnologia , Alimentos Infantis/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Alimentação com Mamadeira , Brasil/epidemiologia , Estudos Transversais , Leite Humano , Política Nutricional/tendências , Inquéritos Nutricionais , Cooperação do Paciente , Guias de Prática Clínica como Assunto , Inquéritos e Questionários , Fatores SocioeconômicosRESUMO
OBJECTIVE: To evaluate the presence of dyslipidemia and plasma concentrations of homocysteine (Hcy) and cysteine (Cys) in adolescents with juvenile systemic lupus erythematosus (SLE) and relate these findings to disease activity (Systemic Lupus Erythematosus Disease Activity Index, SLEDAI) and cardiovascular risk factors. METHODS: A cross-sectional controlled study including 26 female adolescents with SLE and 26 healthy controls was conducted. We evaluated SLEDAI, medications, anthropometric data, dietary intake, lipid profile, proteinuria, Hcy, Cys, folic acid, vitamin B12, and high-sensitivity C-reactive protein levels. RESULTS: Dyslipidemia was observed in 46.2% of the patients and in 19.2% of the controls. The SLE group had a higher Cys concentration and a lower high-density lipoprotein cholesterol concentration compared with the controls. In the multivariate analysis only Hcy was significantly and independently associated with the presence of dyslipidemia in the juvenile SLE group; an increase of 1 µmol/l in the Hcy concentration doubled the chance of dyslipidemia (OR: 2.1; 95% CI: 1.1-4.9; p = 0.030). The Cys concentration was correlated with Hcy, total cholesterol, low-density lipoprotein cholesterol, and triglyceride concentrations. CONCLUSION: We observed the presence of cardiovascular risk factors in adolescents with juvenile SLE. The early identification of biochemical alterations allows the development of intervention strategies that may lower the risk of cardiovascular disease.
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Cisteína/sangue , Dislipidemias/sangue , Homocisteína/sangue , Lúpus Eritematoso Sistêmico/sangue , Adolescente , Corticosteroides/administração & dosagem , Adulto , Índice de Massa Corporal , Proteína C-Reativa/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Estudos de Casos e Controles , Criança , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Dislipidemias/complicações , Dislipidemias/epidemiologia , Ingestão de Energia , Feminino , Ácido Fólico/sangue , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/epidemiologia , Análise Multivariada , Estado Nutricional , Puberdade/fisiologia , Fatores de Risco , Triglicerídeos/sangue , Vitamina B 12/sangue , Circunferência da Cintura , Adulto JovemRESUMO
This study aims to evaluate the body composition (BC) of female children and adolescents with juvenile idiopathic arthritis (JIA). A cross-sectional, controlled study was performed to compare the BC between 42 JIA girls and 35 healthy controls, matched for age and gender. Weight and height were used to calculate body mass index (BMI), classified as a Z-score (Z-BMI). BC was evaluated by dual-energy X-ray absorptiometry (DXA; DPX-L, Lunar). The fat mass index (FMI) was calculated as the ratio between total fat mass and height squared (kilograms per square metre). The lean mass index (LMI) was calculated as the ratio between total lean mass and height squared (kilograms per square metre). In JIA patients, the median of age was 13 years (6-19) and median disease duration was 84 months (10.0-215.0). The main disease subtype was polyarticular arthritis (54.8%). We observed that 61.9% of patients had normal Z-BMI. JIA girls had higher median Z-BMI scores (0.17 vs. -0.48, p = 0.034), total body fat percentages (26.5% vs. 16.4%, p = 0.001), truncal fat (4.52 vs. 2.32, p = 0.011) and FMI (4.83 vs. 2.23, p < 0.001). For LMI, there was no difference between JIA girls and controls (13.45 vs. 12.45, p = 0.212). We did not find association between FMI and age, disease subtype, number of limited and/or active joints, months since diagnosis and use of corticosteroids or methotrexate. BC changes found in JIA girls, such as fatness and adiposity, indicate a potentially greater risk for developing hypertension, diabetes mellitus and cardiovascular diseases. These findings emphasise the importance of evaluating nutritional status and body composition to minimise the emergence of chronic diseases later in life.
Assuntos
Tecido Adiposo/patologia , Adiposidade , Artrite Juvenil/complicações , Obesidade/complicações , Absorciometria de Fóton/métodos , Adolescente , Adulto , Fatores Etários , Artrite Juvenil/fisiopatologia , Composição Corporal , Índice de Massa Corporal , Criança , Estudos Transversais , Feminino , Humanos , Obesidade/fisiopatologia , RiscoRESUMO
Objetivo: Avaliar as práticas e o consumo alimentar de lactentes saudáveis de três metrópoles do Brasil. Métodos: Por meio de estudo prospectivo, analisaram-se registros alimentares de 7 dias consecutivos de amostra intencional, por cotas e ponderada, das cidades de Curitiba, São Paulo e Recife, de 179 lactentes saudáveis, entre 4 e 12 meses, que não se encontravam em aleitamento materno (AM) exclusivo. As mães receberam orientação verbal e escrita, por nutricionista, visando a uniformização da anotação do registro alimentar. Para o cálculo de ingestão, utilizou-se o Programa de Apoio à Nutrição (NutWin). Resultados: A mediana de idade dos lactentes foi de 6,8 meses (4,0-12,6 meses). Observou-se que 50,3% jánão recebiam AM. Destes, 12,0 e 6,7% dos menores e maiores de 6 meses, respectivamente, utilizavam fórmulas infantis em substituição ao leite materno. A maioria dos lactentes, portanto, recebia leite de vaca integral. A diluição da fórmula infantil foi correta em apenas 23,8 e 34,7% das crianças menores e maiores de 6 meses, respectivamente. Em relação à alimentação complementar, observou-se que a mediana de idade foi de 4 meses para sua introdução e de 5,5 meses para a alimentação da família. Verificou-se elevada inadequação quantitativa na ingestão de micronutrientes para lactentes de 6 a 12 meses que não recebiam AM, destacando-se as de zinco (75%) e ferro (45%). Conclusão: O presente estudo mostrou elevada frequência de práticas e consumo alimentar inadequados em lactentes muito jovens. É possível que essas práticas levem a aumento no risco de desenvolvimento futuro de doenças crônicas.
Objective: To assess feeding practices and dietary in-take of healthy infants in three Brazilian municipalities. Methods: By means of a prospective study, we analyzed the food record of 7 consecutive days of an intentional sample (quota and weighted sampling) of 179 healthy infants, aged between 4 and 12 months, from the municipalities of Curitiba, São Paulo, and Recife, who were not being exclusively breastfed. Mothers received oral and written information provided by a nutritionist with the purpose of standardizing the feeding data. The computer program NutWin was used to calculate the dietary intake. Results: The median of the infants' age was 6.8 months (4.0-12.6 months). We found that 50.3% of the infants were no longer being exclusively breastfed. Of these, 12.0 and 6.7% among the infants younger and older than 6 months, respectively, were fed with infant formulae instead of breast milk. Therefore, most infants received whole cow's milk. Infant formula dilution was correct in only 23.8 and 34.7% of the infants younger and older than 6 months old, respectively. With regards to complementary feeding, we found that the median age was 4 months for its introduction and 5.5 months for the introduction of family diet. There was high quantitative inappropriateness of micronutrient intake for infants between 6 and 12 months old who were not exclusively breastfed, mainly in terms of zinc (75%) and iron (45%). Conclusion: The present study showed a high frequency of inappropriate feeding practices and dietary intake in very young infants. These practices may lead to an increased risk of development of chronic diseases in the future.
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OBJETIVO: Avaliar as práticas e o consumo alimentar de lactentes saudáveis de três metrópoles do Brasil. MÉTODOS: Por meio de estudo prospectivo, analisaram-se registros alimentares de 7 dias consecutivos de amostra intencional, por cotas e ponderada, das cidades de Curitiba, São Paulo e Recife, de 179 lactentes saudáveis, entre 4 e 12 meses, que não se encontravam em aleitamento materno (AM) exclusivo. As mães receberam orientação verbal e escrita, por nutricionista, visando a uniformização da anotação do registro alimentar. Para o cálculo de ingestão, utilizou-se o Programa de Apoio à Nutrição (NutWin). RESULTADOS: A mediana de idade dos lactentes foi de 6,8 meses (4,0-12,6 meses). Observou-se que 50,3 por cento já não recebiam AM. Destes, 12,0 e 6,7 por cento dos menores e maiores de 6 meses, respectivamente, utilizavam fórmulas infantis em substituição ao leite materno. A maioria dos lactentes, portanto, recebia leite de vaca integral. A diluição da fórmula infantil foi correta em apenas 23,8 e 34,7 por cento das crianças menores e maiores de 6 meses, respectivamente. Em relação à alimentação complementar, observou-se que a mediana de idade foi de 4 meses para sua introdução e de 5,5 meses para a alimentação da família. Verificou-se elevada inadequação quantitativa na ingestão de micronutrientes para lactentes de 6 a 12 meses que não recebiam AM, destacando-se as de zinco (75 por cento) e ferro (45 por cento). CONCLUSÃO: O presente estudo mostrou elevada frequência de práticas e consumo alimentar inadequados em lactentes muito jovens. É possível que essas práticas levem a aumento no risco de desenvolvimento futuro de doenças crônicas.
OBJECTIVE: To assess feeding practices and dietary intake of healthy infants in three Brazilian municipalities. METHODS: By means of a prospective study, we analyzed the food record of 7 consecutive days of an intentional sample (quota and weighted sampling) of 179 healthy infants, aged between 4 and 12 months, from the municipalities of Curitiba, São Paulo, and Recife, who were not being exclusively breastfed. Mothers received oral and written information provided by a nutritionist with the purpose of standardizing the feeding data. The computer program NutWin was used to calculate the dietary intake. RESULTS: The median of the infants' age was 6.8 months (4.0-12.6 months). We found that 50.3 percent of the infants were no longer being exclusively breastfed. Of these, 12.0 and 6.7 percent among the infants younger and older than 6 months, respectively, were fed with infant formulae instead of breast milk. Therefore, most infants received whole cow's milk. Infant formula dilution was correct in only 23.8 and 34.7 percent of the infants younger and older than 6 months old, respectively. With regards to complementary feeding, we found that the median age was 4 months for its introduction and 5.5 months for the introduction of family diet. There was high quantitative inappropriateness of micronutrient intake for infants between 6 and 12 months old who were not exclusively breastfed, mainly in terms of zinc (75 percent) and iron (45 percent). CONCLUSION: The present study showed a high frequency of inappropriate feeding practices and dietary intake in very young infants. These practices may lead to an increased risk of development of chronic diseases in the future.
Assuntos
Adulto , Animais , Feminino , Humanos , Lactente , Masculino , Alimentação com Mamadeira/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Fenômenos Fisiológicos da Nutrição do Lactente , Fórmulas Infantis/administração & dosagem , Leite/química , Brasil , Aleitamento Materno/estatística & dados numéricos , Fórmulas Infantis/química , Valor Nutritivo , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
OBJECTIVE: To assess feeding practices and dietary intake of healthy infants in three Brazilian municipalities. METHODS: By means of a prospective study, we analyzed the food record of 7 consecutive days of an intentional sample (quota and weighted sampling) of 179 healthy infants, aged between 4 and 12 months, from the municipalities of Curitiba, São Paulo, and Recife, Brazil, who were not being exclusively breastfed. Mothers received oral and written information provided by a nutritionist with the purpose of standardizing the feeding data. The computer program NutWin was used to calculate the dietary intake. RESULTS: The median of the infants' age was 6.8 months (4.0-12.6 months). We found that 50.3% of the infants were no longer being exclusively breastfed. Of these, 12.0 and 6.7% among the infants younger and older than 6 months, respectively, were fed with infant formulae instead of breast milk. Therefore, most infants received whole cow's milk. Infant formula dilution was correct in only 23.8 and 34.7% of the infants younger and older than 6 months old, respectively. With regards to complementary feeding, we found that the median age was 4 months for its introduction and 5.5 months for the introduction of family diet. There was high quantitative inappropriateness of micronutrient intake for infants between 6 and 12 months old who were not exclusively breastfed, mainly in terms of zinc (75%) and iron (45%). CONCLUSION: The present study showed a high frequency of inappropriate feeding practices and dietary intake in very young infants. These practices may lead to an increased risk of development of chronic diseases in the future.
Assuntos
Alimentação com Mamadeira/estatística & dados numéricos , Conhecimentos, Atitudes e Prática em Saúde , Fórmulas Infantis/administração & dosagem , Fenômenos Fisiológicos da Nutrição do Lactente , Leite/química , Adulto , Animais , Brasil , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Lactente , Fórmulas Infantis/química , Masculino , Valor Nutritivo , Estudos Prospectivos , Fatores SocioeconômicosRESUMO
Pacientes com imunodeficiência primária (IOP) que necessitam de reposição regular de imunoglobulinas podem cursar com distúrbios inflamatórios, endócrinos e com exacerbação do estresse oxidativo, resultando em alterações do estado nutricional (EN) e maior risco de desenvolvimento de outras doenças crônicas. Objetivou-se nesse estudo descrever o EN de pacientes com agamaglobulinemia congênita ligada ao X (XLA), imunodeficiência comum variável (ICV) e deficiência de anticorpo a antígenos polissacarídeos (DAAP). Foram avaliados pacientes em uso regular de imunoglobulina, atendidos na Universidade Federal de São Paulo em 2009. O diagnóstico de IOP seguiu os critérios do PAGID-ESID. Avaliou-se o estado nutricional através do índice de massa corporal (IMC) e índice de estatura por idade (E/I), adotando-se os pontos de corte propostos pela Sociedade Brasileira de Pediatria (crianças e adolescentes) e Organização Mundial da Saúde (adultos). Foram avaliados 52 pacientes, sendo 14 com XLA, 33 com ICV e 5 DAAP; 63,5% do sexo masculino e 61,5% (32/50) com menos de 20 anos. A mediana de idade foi de 14 anos (1,6 - 53). Nos adultos, observou-se 20% de desnutrição e 25% excesso de peso e nas crianças e adolescentes, 21,8%, 15,6% e 25% de desnutrição, excesso de peso e baixa estatura grave, respectivamente. Observou-se comprometimento pulmonar em 45% dos adultos e 34% entre crianças e adolescentes. O grupo estudado demonstrou alta frequência de inadequação do EN, ressaltando-se a desnutrição em adultos e desnutrição e baixa estatura em crianças e adolescentes. A desnutrição e a baixa estatura, crianças e adolescentes, apresentou relação com o comprometimento pulmonar.
Patients with primary immunodeficiency (PIO) receive immunoglobulin replacement therapy, and as with other chronic diseases, may present inflammatory and endocrine complications and exacerbation of oxidative stress leading to an altered nutritional status (NS) and to a greater risk of developing other chronic diseases. This study aimed to describe the NS in patients with congenital X-linked agammaglobulinemia (XLA), common variable immunodeficiency (CVIO) and antibody deficiency to polysaccharide antigens (DAAP). We assessed patients with regular use of immunoglobulin, attended at Federal São Paulo University in 2009. These diseases were classified according to the PAGID-ESID criteria. Nutritional status was evaluated by body mass index and height for age. The values were expressed in z score and the cutoff points for diagnosis were adopted according to World Health Organization and Brazilian Society of Pediatrics. We evaluated 52 patients (63.5% male, median age= 14 years, age range= 1,6-53 years, 61.5% (32/50) with less than 20 years), 14 with XLA, 33 with CVIO and 5 DAAP. In adults, there was 20% for malnutrition and 25% and overweight, and in children and adolescents, 21.8%, 15.6% and 25% of malnutrition, overweight and severe short stature, respectively. Pulmonary sequel was observed in 45% of adults and in 34% of children and adolescents. We observed a high frequency of inadequate nutritional status, especialIy malnutrition in adults and malnutrition and severe short stature in children and adolescents. Malnutrition and severe short stature.
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Humanos , Criança , Adolescente , Adulto , Imunodeficiência de Variável Comum , Educação Alimentar e Nutricional , Imunoglobulinas , Síndromes de Imunodeficiência , Métodos , Pacientes , MétodosRESUMO
OBJETIVOS: Avaliar o consumo alimentar de crianças e adolescentes com artrite idiopática juvenil (AIJ) e lúpus eritematoso sistêmico (LES) por recordatório de 24 horas e relacioná-lo com características clínicas e antropométricas e com os medicamentos empregados. MÉTODOS: Em estudo transversal, avaliamos os recordatórios de 24 horas de pacientes ambulatoriais. O estado nutricional foi classificado pelo CDC, 2000. Para o cálculo da ingestão, utilizamos o software NutWin UNIFESP-EPM. Para a análise quantitativa e qualitativa, adotamos as Recommended Dietary Allowances e a pirâmide alimentar brasileira. RESULTADOS: A mediana de idade foi 12 na AIJ e 16,5 anos no LES. Na AIJ, 37,5 por cento dos pacientes estavam em atividade de doença, e, no LES, 68,2 por cento tinham Systemic Lupus Erythematosus Disease Activity Index > 4. Foi encontrada desnutrição em 8,3 e 4,5 por cento dos pacientes com AIJ e com LES, respectivamente, e obesidade, em 16,7 e 18,2 por cento. Na AIJ, o consumo excessivo de energia, proteína e lipídios foi de 12,5, 75 e 31,3 por cento, respectivamente. No LES, o consumo excessivo de energia, proteína e lipídios foi de 13,6, 86,4 e 36,4 por cento, respectivamente. Consumo deficiente de ferro, zinco e vitamina A foi observado em 29,2 e 50, 87,5 e 86,4 e 87,5 e 95,2 por cento dos pacientes com AIJ e LES, respectivamente. Não houve relação significante entre consumo, atividade da doença e estado nutricional. CONCLUSÃO: Pacientes com doenças reumáticas apresentam inadequação do consumo alimentar. Ressaltamos a ingestão excessiva de lipídios e proteínas e a ingestão insuficiente de micronutrientes.
OBJECTIVES: To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients clinical and anthropometric characteristics and to the drugs used in their treatment. METHODS: By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis. RESULTS: Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5 percent had active disease, and among the JSLE patients, 68.2 percent showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5 percent of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2 percent. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3 percent, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4 percent, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2 percent of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. CONCLUSION: Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients.
Assuntos
Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Adulto Jovem , Artrite Juvenil/fisiopatologia , Ingestão de Alimentos/fisiologia , Lúpus Eritematoso Sistêmico/fisiopatologia , Antropometria , Métodos Epidemiológicos , Ingestão de Energia/fisiologia , Micronutrientes/deficiência , Estado Nutricional/fisiologia , Adulto JovemRESUMO
OBJECTIVES: To evaluate the dietary intake of children and adolescents with juvenile idiopathic arthritis (JIA) and juvenile systemic lupus erythematosus (JSLE) using a 24-hour diet recall and relating it to the patients' clinical and anthropometric characteristics and to the drugs used in their treatment. METHODS: By means of a cross-sectional study, we assessed the 24-hour diet recalls of outpatients. Their nutritional status was classified according to the CDC (2000). The computer program NutWin UNIFESP-EPM was used for food intake calculation. The Recommended Dietary Allowances and the Brazilian food pyramid were used for quantitative and qualitative analysis. RESULTS: Median age was 12 years for JIA patients and 16.5 years for JSLE patients. Among the JIA patients, 37.5% had active disease, and among the JSLE patients, 68.2% showed Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) > 4. Malnutrition was found in 8.3 and 4.5% of the JIA and JSLE patients, respectively, and obesity was present in 16.7 and 18.2%. For JIA patients, the excessive intake of energy, protein, and lipids was 12.5, 75, and 31.3%, respectively. For JSLE patients, the excessive intake of energy, protein, and lipids was 13.6, 86.4, and 36.4%, respectively. Low intake of iron, zinc, and vitamin A was found in 29.2 and 50, 87.5 and 86.4, and 87.5 and 95.2% of the JIA and JSLE patients, respectively. There was not a significant association between intake, disease activity, and nutritional status. CONCLUSION: Patients with rheumatic diseases have inadequate dietary intake. There is excessive intake of lipids and proteins and low intake of micronutrients.