Certain food groups are often rejected during chemotherapy (CT) due to the side effects of treatment, which may interfere with adequate diet and nutritional status. The aim of this study was to evaluate the treatment impact on the diet and nutritional status of women with breast cancer (BC). In this prospective longitudinal study, conducted in 2014–2015, 55 women diagnosed with BC, with a mean age 51.5±10.1 years, were followed and data were collected at three different times. Anthropometric and dietary assessments were performed, the latter by applying nine 24h dietary recalls, by using the Brazilian Healthy Eating Index Revised (BHEI-R), and calculating the prevalence of inadequacy by the EAR cut-off point method. Regarding the BHEI-R analysis, the majority of women had a “diet requires modification’, both at the beginning (T0, 58.2%, n = 32) and during treatment (T1, 54.5%, n = 30). However, after the end of the CT, the greater percentage of patients (T2, 49.1%, n = 27) were classified as having an "inadequate diet", since the Total Fruit consumption as well as the Dark Green and Orange Vegetable and Legume consumption decreased significantly during treatment (p = 0.043 and p = 0.026, respectively). There was a significant reduction in the intake of macro and micronutrients, with a high prevalence of inadequacy, of up to 100%, for calcium, iron, phosphorus, magnesium, niacin, riboflavin, thiamin, vitamin B6, vitamin C and zinc. Assessment of the nutritional status indicated that 56% (n = 31) of patients were overweight at these three different times. Weight, BMI and Waist Circumference increased significantly, indicating a worse nutritional status, and there was a correlation between poor diet quality and higher values for BMI, Waist-Hip Ratio and Waist-to-Height Ratio. Chemotherapy interferes in the patients’ diet generating a negative impact on the quality and intake of micro and macronutrients, as well as an impact on their nutritional status, with an increase in anthropometric measurements.
This study evaluated the reproducibility and relative validity of the Food Frequency Questionnaire (FFQ) used in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (n = 281) completed the FFQ and three food records on two occasions during a 12-month period. Energy and nutrient values from food records were disattenuated and log-transformed. Reproducibility and validity were assessed by the intra-class correlation coefficient (ICC). Agreement between the two methods was evaluated by classification in tertiles. In the evaluation of reproducibility, ICC estimated ranged from 0.55 to 0.83 for protein and vitamin E, respectively. On relative validity, ICC ranged from 0.20 to 0.72 for selenium and calcium, respectively. Exact and adjacent agreement between methods varied from 82.9% for vitamin E to 89% for lipids and calcium (mean 86%). Average disagreement was 13.6%. In conclusion, this FFQ showed satisfactory reliability for all nutrients and reasonable validity, especially for energy, macronutrients, calcium, potassium, and vitamins E and C.
This study aimed to evaluate changes in dietary and lifestyle habits during the period of confinement due to the first wave of the COVID-19 pandemic in Ibero-American countries. A cross-sectional investigation was conducted with 6,325 participants of both genders (68% women), over 18 years of age and from five countries: Brazil (N = 2,171), Argentina (N = 1,111), Peru (N = 1,174), Mexico (N = 686), and Spain (N = 1,183). Data were collected during the year 2020, between April 01 and June 30 in Spain and between July 13 and September 26, in the other countries studied using a self-administered online survey designed for the assessment of sociodemographic, employment, physical activity, health status, and dietary habits changes. Most participants (61.6%), mainly those from Spain, remained constant, without improving or worsening their pattern of food consumption. Among those who changed, a pattern of better eating choices prevailed (22.7%) in comparison with those who changed toward less healthy choices (15.7%). Argentina and Brazil showed the highest proportion of changes toward a healthier pattern of food consumption. Peruvians and Mexicans were less likely to make healthy changes in food consumption (OR: 0.51; 95% CI: 0.4–0.6 and OR: 0.69; 95% CI: 0.4–0.8, respectively), when compared to Argentinians. Most respondents did not change their pattern of meal consumption, but those who did reduced their consumption of main meals and increased intake of small meals and snacks. Although most participants affirmed to be doing physical activity at home, about one-half reported perception of weight gain. Individuals with alterations in sleep pattern (either by increasing or decreasing sleep time) were more likely to change their diets to a healthier pattern. In contrast, individuals with confirmed diagnosis of COVID-19 and those who reported feeling anxious were more likely to perform changes to a less healthy eating pattern (OR: 1.72; 95% CI: 1.2–2.3 and OR: 1.21; 95% CI: 1.1–1.4, respectively). In conclusion, although most participants remained constant in their eating habits, lifestyle changes and anxiety feelings were reported. Among those who changed patterns of food consumption, healthier choices prevailed, with differences between countries. However, there were alterations in the distribution of meals, with higher consumption of snacks and small meals. These results can be used to guide policies to prevent deleterious consequences that may affect the incidence of chronic diseases.
Background and aim Malnutrition is common in patients with cancer, and its early diagnosis can reduce or prevent further complications and improve the clinical and nutritional prognosis. Adductor Pollicis Muscle Thickness (APMT) and Handgrip Strength have been explored in this population to identify a reduction in strength and muscle mass prior to the use of conventional methods. We aimed to correlate APMT and Handgrip Strength with conventional anthropometric variables in cancer patients and verify their association with nutritional status as determined by the Patient-Generated Subjective Global Assessment (PG-SGA). Methods A cross-sectional study was conducted with 80 patients diagnosed with cancer who were candidates for surgery. Nutritional status was obtained from the PG-SGA. Conventional anthropometric measurements were taken, as well as APMT and Handgrip Strength. Pearson’s correlation analysis and multivariate linear regression were applied to detect the influence of variables on APMT and HGS. A significance level of 5.0% was considered. Results A high prevalence of malnutrition and the need for dietotherapic intervention was found, identified by the PG-SGA. Correlations between APMT and Handgrip Strength with anthropometric variables and with the PG-SGA score were observed. After regression adjustments, the variables that interacted with APMT were TSF and AC, and the PG-SGA score, corrected Muscle Arm Area (CAMA), and age interacted with Handgrip Strength. Conclusion Correlations between anthropometric measurements and the PG-SGA score with APMT and Handgrip Strength were observed, even after adjusting for age and sex. These associations demonstrate that APMT and Handgrip Strength can be used with criterion in patients with cancer as complementary methods to evaluate nutritional risk and the need for nutritional intervention.
Introducción: Evaluar el consumo de alimentos no saludables y prácticas de estilo de vida en mexicanos durante el confinamiento por SARS-CoV-2 (COVID-19).Material y métodos: Estudio transversal realizado durante parte del confinamiento en México. La recolección de datos fue realizada a través de una encuesta digital. Fueron evaluados aspectos de alimentación, bienestar y estilo de vida (consumo de alcohol y tabaco, actividad física y sueño), además de variables sociodemográficas. Para los análisis estadísticos fueron utilizadas la prueba χ2 para comparar diferencias entre género, con significancia estadística del 5%, utilizando el software SPSS 23.0.Resultados: Fueron analizadas 1084 encuestas. La edad promedio fue de 35,5±13,9 años y el 66,5% (n=721) fueron mujeres. En relación a la alimentación antes del confinamiento, 69,8% (n=757) consideraban su alimentación saludable, 6,5% (n=99) muy saludable y 23,7% (n=228) poco saludable, y el 2,3% (n=26) ha mejorado su alimentación, a pesar de esto el 17,1% (n=186) de las personas dice que en estos días come todo el tiempo. En relación al sueño, las mujeres duermen menos durante el periodo del confinamiento (p=0,002) y despiertan más durante la noche cuando se compara con los hombres (p<0,001).Conclusiones: Factores como la alimentación y el sueño presentaron alteraciones en ese período del confinamiento. Es importante destacar la relevancia de esos factores pues una buena alimentación y el descanso contribuyen para un mejor/fortalecimiento del sistema inmunológico.
Background and aim Nutrition impact symptoms (NIS) are common in cancer patients and the negative impacts on nutritional status indicate the need for research, diagnosis and nutritional intervention in order to reduce the risk of malnutrition. We aimed to verify the presence of malnutrition, the need for nutritional intervention, NIS and their influence on the nutritional status of surgical patients with cancer. Methods This cross-sectional study was carried out in a public tertiary hospital, from March 2017 to October 2019. Nutritional status, the need for nutritional intervention and NIS were assessed through the Patient-Generated Subjective Global Assessment (PG-SGA) in the first 48 hours of hospital admission. Results Among the 135 patients evaluated, 55.6% were elderly and 51.1% were male; patients had a median age of 62 years and a predominance of cancer located in the lower gastrointestinal tract (35.6%). Malnutrition and the need for nutritional intervention were identified in 60.0% and 90.4% of cases, respectively. The presence of three or more NIS was reported by 51.9% of patients. Significant differences in NIS were observed according to sex, PG-SGA classification and PG-SGA score. After logistic regression analysis, it was determined that the symptoms that increased the chances of malnutrition were anorexia, constipation, strange taste, mouth sores and others (depression, dental or financial problems). Conclusion Malnutrition, the need for nutritional intervention and the presence of three or more NIS were elevated in the patients evaluated. Malnutrition was associated with the presence of NIS, indicating the need for attention and care in antineoplastic treatment.
BackgroundAlthough the effects of physical activity (PA) on health and wellness are well-established, incorporating sedentary behaviours in the daily lives of populations from high- and medium-income countries is becoming increasingly common. Regardless of other factors, the area of residence can influence the physical activity level and sedentary behaviours. The aim of this study was to identify and analyse active and sedentary behaviours and factors associated with physical activity in two different geographical areas in south-eastern Brazil.Methods1.770 schoolchildren aged 7-10 years old were studied. Parents or caregivers completed a validated questionnaire on PA and sedentary behaviours. Screen time (ST) was calculated from the time spent watching television, playing video games and using the computer. The level of active PA (>300 minutes per week) was identified and compared between the areas of study. Parametric and non-parametric tests and Poisson regression model with robust variance were used for statistical analysis.ResultsCompared to schoolchildren from the urban area, those from the rural area showed a higher percentage of compliance with the PA recommendations (87 vs. 69.7%) and screen time <2 h (34.8 vs. 18.8%) and less participation in supervised PA. Active commuting to school was more common among schoolchildren from urban areas, although using a bicycle was more common in rural areas. The characteristics of children who do not meet the recommended weekly PA are as follows: being female, living in urban areas, being overweight, not using video games or performing supervised PA. Total ST as well as daily use of television and the computer was not associated with physical activity level in the present sample. Participation in supervised physical activities in both areas was found to increase the prevalence of being active in the areas studied.ConclusionsThe results of the present study suggest that while schoolchildren from rural areas are more active and spend less time on sedentary activities than those from the urban area, the time spent in sedentary behaviors, such as watching television, playing video games and using the computer, is high in both contexts, and it is not associated with physical activity recommendation compliance.
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