Efetividade de uma estratégia para tratamento da obesidade infantil baseada no Guia Alimentar para a População Brasileira: um ensaio randomizado

• Ano de defesa: 2022
• Autor(a) principal: Brandão, Joana Maia
• Outros Autores: [e-mail]
• Orientador(a): Sichieri, Rosely
• Banca de defesa: Paravidino, Vítor Barreto, Canella, Daniela Silva, Ribas, Simone Augusta, Pereira, Rosângela
• Tipo de documento: Tese
• Tipo de acesso: Acesso embargado
• Idioma: por
• Instituição de defesa: Universidade do Estado do Rio de Janeiro
• Programa de Pós-Graduação: Programa de Pós-Graduação em Saúde Coletiva
• Departamento: Centro Biomédico::Instituto de Medicina Social Hesio Cordeiro
• País: Brasil
• Palavras-chave em Português: Obesidade infantil; Ensaio clínico; Guias alimentares; Alimentos ultraprocessados
• Palavras-chave em Inglês: Childhood obesity; Clinical trial; Dietary guidelines; Ultraprocessed-food
• Área do conhecimento CNPq: CIENCIAS DA SAUDE::SAUDE COLETIVA
• Link de acesso: http://www.bdtd.uerj.br/handle/1/18185

The Dietary Guidelines for the Brazilian Population (DGBP) rely its recommendation on the of extent and purpose that occurred in food and suggests that the reducing the consumption of ultra-processed foods (UPF) improves diet quality and consequent weight loss. Although some studies have observed an important impact on the quality of the diet, there is no evidence that the reduction in the consumption of UPF is accompanied by a reduction in total energy consumption. Thus, the goal of this study is to evaluate the effectiveness of an intervention proposal for the treatment of obesity in children based on the DGBP. A randomized clinical trial was carried out with children between 7 and 12 years old, referred by the National Regulatory System (SISREG) to the nutrition outpatient clinic of University Hospital Pedro Ernesto (HUPE) are evaluated. Participants in the Control Group (CG) and Intervention Group (IG) participated in 6 standardized educational activities contextualized with the 10 Steps of DGBP. In the IG, an individualized food plan was prescribed, based on nutritional recommendations. Intent-to-treat analysis were performed to assess the rate of change of primary (body mass index (BMI)) and secondary (waist circumference (WC) and weight) outcomes between IG and CG, based on mixed-effects models. These analyzes were also applied to measure food consumption, assessed by the rate of change of grams of AUP. Additionally, the BMI results were compared with growth curves, developed by the LMS method, which represents the BMI evolution of the study population without intervention. Of the 101 participants, 51 were allocated to the IG. At the end of the study, BMI declined in the IG (Δ = -0.27 kg/m2) in relation to the CG (Δ = + 0.53 kg/m2), with a statistically significant difference between the groups (p=0.0002). When comparing the GC with the LMS curve, a greater increase in BMI was observed in the LMS group (Δ = + 1.02 kg/m2; p<0.0001). For weight change, the increase was greater in the CG (Δ= +5.51), compared to the IG (Δ= +3.7, p=<0.0001). And there was no significant difference in the trajectory of WC between groups. Both groups showed a decline in grams of UPF until the fourth month and a gradual increase in the following months, with no statistically significant difference (p=0.77). The combination of a qualitative approach based on the DGBP with energy restriction advice through the food plan proved to be effective in reducing childhood obesity. Educational activities had an impact on UPF consumption, however, there is a difficulty in maintaining behavioral changes over long periods. Since the consumption of these foods can impair the treatment of childhood obesity, strategies are needed to reduce UPF consumption over time.