Купить СНПЧ А7 Архангельск, оперативня доставка

crosscheckdeposited

Associação entre a Ingestão de Macronutrientes e a Obesidade Abdominal com a Doença Arterial Coronária

DOI: http://dx.doi.org/10.15602/1983-9480/cmrs.v12n23p45-53

https://www.metodista.br/revistas/revistas-ipa/index.php/RS/index 

downloadpdf

Magda A. Cammerer1 & Waldomiro C. Manfroi2

 

Resumo: A incidência da doença arterial coronária e uma das principais causas de morbidade e mortalidade em diversos países e o estudo dos fatores de risco tem grande importância na prevenção e no tratamento dessa enfermidade. Entre outros fatores, a obesidade corporal e a obesidade abdominal tem sido associadas com a maior incidência de doença arterial coronária (DAC). A ingestão diária de nutrientes também pode estar relacionada com essa doença, porém, uma vez que a alimentação e complexa e contém diversos nutrientes, ainda não foi possível elucidar o impacto da alimentação no risco das doenças cardiovasculares. Avaliar a relação entre o consumo alimentar diário, a presença de obesidade abdominal e achados angiográficos de obstrução arterial em pacientes, submetidos a cineangiocoronariográfica a por apresentarem sintomas compatíveis com cardiopatia isquêmica. Foi realizado um estudo transversal, com 284 pacientes submetidos a cateterismo cardíaco, da unidade de hemodinâmica de um hospital universitário. Foi avaliada a circunferência abdominal, o IMC, a ingestão alimentar diária através de um inquérito nutricional, a analise bioquímica do sangue e a avaliação do laudo do cateterismo cardíaco. Dos pacientes avaliados, 172 indivíduos (60,6%) apresentavam alterações em uma ou mais artérias coronárias. A ingestão media diária de calorias foi de 2450,56 kcal/dia. O consumo de proteínas foi em média 1,66 g/kg/dia, de carboidratos foi de 3,83 g/kg/dia e de lipídeos foi de 1,21 g/kg/dia. A idade, o sexo masculino, os níveis séricos de triglicerídeos, o consumo de álcool e a glicemia em jejum foram estatisticamente significativos na análise multivariada. Nos pacientes avaliados, o consumo diário de calorias encontra-se adequado, porem a ingestão de proteínas, carboidratos e lipídeos estão inadequados. Em relação aos fatores de risco para DAC, as mulheres apresentaram maior associação para desenvolver a doença arterial coronária do que os homens.

Palavras-chave: Obesidade abdominal - Consumo de alimentos - Fatores de risco - Doenças cardiovasculares.

 

Abstract: The incidence of coronary heart disease (CHD) remains the main cause of morbidity and mortality among adults, and the study of risk factors is important in the prevention and treatment of this disease. Between other factors, obesity and abdominal obesity have been associated with CHD. Daily intake of nutrients can be related with this disease, however, daily diet is complex and contains several nutrients and foods, and the specifi c impact of diet on the risk of coronary heart disease has not yet been accurately explained or quantifi ed. To evaluate the relation between daily intake, the abdominal obesity and angiography fi ndings of coronary obstruction in patients with isquemic cardiopatic, submitted to a cardiac catheterization. A cross study with 284 patients submitted a cardiac catheterization of the Hemodynamics Unit. It was evaluated the waist-rip-ratio, body mass index and daily intake and risk factors for CHD. Coronary obstruction was observed in 172 (60.6%) patients with abnormalities in one or more arteries. The analysis of macronutrient intake showed that mean protein intake was 1.66 } 0.65 g/kg/day, mean carbohydrate intake was 9.83 } 1.45 g/kg/day and mean lipid intake was 1.21 } 0.58 g/kg/day. Age, male sex, tryglicerides, alcohol intake and fasting glucose was statistically signifi cant in multivariate analysis. The energy intake is adjust, but the protein, carbohydrate and lipids are not. In relation to the others risk factors for CHD, the women were more signifi cantly associated with the risk to develop cardiovascular diesease than in men, which confi rmed fi ndings in other studies.

Key words: Abdominal obesity - Food consumption - Risk factors - Cardiovascular disease.

 

1 Nutricionista. Docente do Centro Universitário Metodista, do IPA
2 Médico Cardiologista. Universidade Federal do Rio Grande do Sul

 

Literatura Citada

APPEL, Lawrence J.; SACKS, Frank M.; CAREY, Vincent J. et al. Effects of protein, monounsaturated fat and carbohydrate intake on blood pressure and serum lipids. JAMA, v. 294, p. 2455-2464, 2005. doi

BJORNTORP, Per. Metabolic implications of body fat distribution. Diabetes Care, v. 14, n. 12, p.1132-1143, 1991. doi

CERVATO, AM; MAZZILLI, RN; MARTINS, IS; MARUCCI, MFN. Dieta habitual e fatores de risco para doencas cardiovasculares. Revista de Saúde Pública, v. 31, n. 3, p. 227-235, 1997. doi

DAHLOF, Bjorn. Cardiovascular disease risk factors: epidemiology and risk assessment. The American Journal of Cardiology, v. 105, p. 1A-9A, 2010.

DE LORGERIL, Michel; SALEN, Patricia; MARTIN, Jean-Louis, et al. Mediterranean diet, traditional risk factors, and the rate of cardiovascular complications after myocardial infarction: final report of the Lyon Diet Heart Study. Circulation, v. 99, p. 779-785, 1999.

ECKEL, Robert H; BAROUCH, Winifred W; ERSHOW, Abby G, et al. Report of National Heart, Lung, and Blood Institute-National Institute of Diabetes and Digestive and Kidney Diseases. Working group on the pathophysiology of obesity-associated cardiovascular disease. Circulation, v. 105, p. 2923-2928, 2002.

GRUNDY, Scott M; BALADY, Gary J; CRIQUI, Michael H, et al. Primary prevention of coronary heart disease: guidance from Framingham. A statement for healthcare professionals from the AHA task force on risk reduction. Circulation, v. 97, p. 1876-87, 1998.

GRUNDY, Scott M. Obesity, metabolic syndrome, and coronary atherosclerosis. Circulation, v. 105, p. 2696-2698, 2002. doi

GRUPO DE ESTUDIOS SOBRE DIETA, NUTRICION Y PREVENCION DE ENFERMIDADES NO TRANSMISSIBLES. Ginebra, 1989. Informe. Ginebra, Organización Mundial de la Salud, 1990. (OMS – Serie Informes Tecnicos, 797).

GUS, Iseu; FISCHMANN, Airton; MEDINA, Claudio. Prevalencia dos fatores de risco da doenca arterial coronariana no Estado do Rio Grande do Sul. Arquivos Brasileiros de Cardiologia, v. 78, p. 478-83, 2002.

LARSSON, B; SVARDSUDD, K; WELIN, L. Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913. BMJ, v. 288, p. 1401-1404, 1984. doi

LEAN, MEJ; HAN, TS; MORRISON, CE. Waist circumference as a measure for indicating need for weigth management. BMJ, v. 311, p. 158-161, 1995. doi

LEVY-COSTA, Renata Bertazzi; SICHIERI, Rosely; PONTES, Nezio dos Santos et al. Disponibilidade domiciliar de alimentos no Brasil: distribuicao e evolucao (1974-2003). Revista de Saúde Pública, v. 39, p. 530-540, 2005.

MCBRIDE, Patrick E.; RYAN, Gerald. Assessment and management of cardiovascular risk in men. Primary Care: Clinics in Offi ce Practice, v. 33, p. 75-91, 2006. doi

MCKEOWN, Nicola M; MEIGS, James B; LIU, Simin; et al. Whole-grain intake is favorably associated wthi metabolic risk factors for type 2 diabetes and cardiovascular disease in the Framingham Offspring Study. American Journal of Clinical Nutrition, v. 76, n. 2, p. 390-398, 2002.

REUNION CONSULTIVA CONJUNTA FAO/OMS/UNU DE EXPERTOS EM NECESSIDADES DE ENERGIA Y PROTEINAS, Roma, 1981. Informe. Ginebra, Organización Mundial de la Salud, 1985. (OMS – Serie de Informes Tecnicos, 724).

SCHENCK-GUSTAFSSON, Karin. Risk factors for cardiovascular disease in women. Maturitas, v. 63, p. 186-190, 2009. doi

SEIDELL, Jacob C; PERUSSE, Louis; DESPRES, Jean-Pierre; et al. Waist and hip circumferences have independent and opposite effects on cardiovascular disease risk factors: the Quebec Family Study. American Journal of Clinical Nutrition, v. 74, p. 315-21, 2001.

TRUSWELL, AS. Cereal grains and coronary heart disease. European Journal of Clinical Nutrition, v. 56, n. 1, p. 1-14, 2002. doi

VERSCHUREN, W.M. Monique; JACOBS, David R.; BLOEMBERG, Bennie P.M. et al. Serum total cholesterol and long-term coronary heart disease mortality in different cultures. Twenty-five-year follow up of the Seven Countries Study. JAMA, v.274, p. 131-135, 1995.

VRIES, Jeanne H.M. de; JANSSEN, Karin; HOLLMAN, Peter C.H. et al. Consumption of quercetin and kaempferol in free-living subjects eating a variety of diets. Cancer Letters, v. 114, p. 141-144, 1997.

YUSUF, S; HAWKEN, S; OUNPUU, S; et al. Effect of pontentially modifi able risk factors associated with myocardial infarction in 52 countries (The INTERHEART Study): case control study. Lancet, v. 364, p. 937-952, 2004. doi