Caracterização da dieta de pacientes pós infarto agudo do miocárdio frente a um guideline europeu e escore da deita mediterrânea: subestudo DICANUTS
Caracterização da dieta de pacientes pós infarto agudo do miocárdio frente a um guideline europeu e escore da deita mediterrânea: subestudo DICANUTS
Data
2024
Autores
Oliveira, Rodrigo Damasceno de
Journal Title
Journal ISSN
Volume Title
Publisher
Instituto Nacional de Cardiologia
Resumo
Objetivo: Caracterizar e avaliar a dieta de pacientes que sofreram infarto agudo do miocárdio recente entre 60 e 180 dias utilizando um escore de dieta mediterrânea, analisando a pontuação de adesão ao escore e verificar adequações frente a diretriz da Sociedade Europeia de Cardiologia ESC 2021.Métodos:Trata-se de um estudo transversal realizado com amostra de participantes adultos brasileiros que sofreram infarto agudo do miocárdio recente (até 180 dias). A ingestão alimentar foi avaliada através de um questionário de frequência alimentar e aplicado o escore de dieta mediterrânea de 17 pontos. Através do software Nutriquanti foram calculados o valor calórico total, fibras, colesterol, macronutrientes e micronutrientes. O consumo de nutrientes foi comparado com as recomendações nutricionais da diretriz da Sociedade Europeia de Cardiologia ESC 2021 e foi analisada a adesão a dieta mediterrânea de acordo com a pontuação do escore utilizado. As análises foram realizadas realizada utilizando o Stata Data Analysis and Statistical Software (STATA) versão 13.1. Os valores foram considerados estatisticamente significativos quando o p-valor <0,05. Resultados: Após a aplicação do escore de dieta mediterrânea, foi identificada uma moderada adesão ao padrão alimentar mediterrâneo de acordo com a análise de pontos do escore. No que diz respeito aos grupos de alimentos da dieta mediterrânea, o grupo de vegetais, peixes e cereais obtiveram baixa adesão. Tratando-se de micronutrientes, o consumo de fibras, zinco, cálcio, vitaminas do complexo B e cobre foi abaixo do recomendado. A ingestão de carboidratos se manteve dentro das recomendações, com ingestão acima do recomendado de proteínas, no entanto, baixo consumo de carne vermelha. A ingestão de gorduras totais foi adequada, no entanto, houve um consumo acima das recomendações de ácidos graxos saturados. A adequação as recomendações da diretriz ESC 2021 foram parecidas com as pontuações pelos grupos de alimentos do escore da dieta mediterrânea. O consumo de fibras foi baixo. Foram encontrados fatores associados a pontuações do escore e do ESC 2021.Ter idade >=60 anos [Odds Ratio -OR (IC 95%) = 1,63 (1,18-2,24)], nunca ter fumado [OR (IC 95%) = 2,58 (1,41 - 4,72) ou ser ex fumante [OR (IC 95%) = 2,17 (1,21 - 3,88), foram fatores que permaneceram diretamente associados no modelo múltiplo ao aumento do escore da ingestão de frutas. Sobre a pontuação do escore do grupo de vegetais, Ser do sexo feminino [OR (IC 95%) = 1,68 (1,12 - 2,52) e com maior escolaridade [OR (IC 95%) =1,94 (1,33 - 2,82) foram fatores diretamente associados ao aumento do escore da ingestão de vegetais. O consumo de peixes teve maior razão de chance quando os participantes tinham cor da pele não branca [OR (IC 95%) = 1,82 (1,23 - 2,70); nunca fumaram [OR (IC 95%) = 2,71 (1,19 - 6,13) ou eram ex fumantes [OR (IC 95%) = 3,31 (1,54-7,57). A pontuação do grupo de álcool foi maior nos participantes que tinham idade igual ou acima de 60 anos [OR (IC 95%) = 2,01 (1,20 - 3,36); do sexo feminino [OR (IC 95%) = 2,54 (1,31 - 5,13) e nunca fumaram [OR (IC 95%) = 2,82 (1,28 - 6,21). Sobre os lácteos, aqueles que possuíam idade igual ou acima de 60 anos tiveram mais chances de pontuação no escore [OR (IC 95%) = 0,62 (0,44 - 0,98). Sobre os cereais, ter idade maior ou igual a 60 anos foi inversamente associada a maior pontuação do escore de cereais [OR (IC 95%) = 0,22 (0,08-0,60). No grupo das leguminosas, nenhuma variável foi associada a uma maior pontuação. Conclusão: A dieta de indivíduos que sofreram IAM recente no Brasil tem característica mediterrânea moderada, com baixa ingestão de grupos de alimentos e micronutrientes que fazem parte da proteção cardiovascular como fibras, cereais, peixes, vegetais, cálcio, vitaminas do complexo B, cobre, selênio e zinco. Estes indivíduos ainda não se enquadram nas recomendações de diretrizes para a prevenção cardiovascular, necessitando de mais estudos e orientações nesta população no Brasil.
Palavras chave: Dieta mediterrânea; Infarto agudo do miocárdio; Escore da dieta mediterrânea; Brasil
ABSTRACT Objective: To characterize and evaluate the diet of patients who have recently experienced acute myocardial infarction using a Mediterranean diet score, analyzing adherence scores and assessing compliance with the 2021 European Society of Cardiology (ESC) guidelines. Methods: This is a cross-sectional study conducted with a sample of Brazilian adult participants who recently suffered acute myocardial infarction (within 180 days). Dietary intake was assessed through a food frequency questionnaire, and the 17-point Mediterranean diet score was applied. Using the Nutriquanti software, total caloric value, fiber, cholesterol, macronutrients, and micronutrients were calculated. Nutrient consumption was compared with the nutritional recommendations of the 2021 ESC guidelines, and adherence to the Mediterranean diet was analyzed based on the score. Analyses were performed using Stata Data Analysis and Statistical Software (STATA) version 13.1. Values were considered statistically significant when the p-value <0.05. Results: After applying the Mediterranean diet score, moderate adherence to the Mediterranean dietary pattern was identified based on the score analysis. Regarding food groups in the Mediterranean diet, the vegetable, fish, and cereal groups showed low adherence. In terms of micronutrients, the consumption of fiber, zinc, calcium, B vitamins, and copper was below recommended levels. Carbohydrate intake remained within recommendations, with protein intake exceeding recommendations, but there was low red meat consumption. Total fat intake was adequate; however, there was an excessive consumption of saturated fatty acids. Adherence to the 2021 ESC guidelines was similar to scores for food groups in the Mediterranean diet. Fiber intake was low. Factors associated with scores from both the Mediterranean diet score and ESC 2021 were identified. Being aged >=60 years [Odds Ratio -OR (95% CI) = 1.63 (1.18-2.24)], never smoking [OR (95% CI) = 2.58 (1.41-4.72), or being an ex-smoker [OR (95% CI) = 2.17 (1.21-3.88) were factors directly associated in the multiple model with increased fruit intake scores. Concerning the vegetable intake score, being female [OR (95% CI) = 1.68 (1.12-2.52)] and having higher education [OR (95% CI) = 1.94 (1.33-2.82)] were factors directly associated with increased vegetable intake scores. Fish consumption had a higher odds ratio when participants had non-white skin color [OR (95% CI) = 1.82 (1.23-2.70)], never smoked [OR (95% CI) = 2.71 (1.19-6.13), or were ex-smokers [OR (95% CI) = 3.31 (1.54-7.57). The alcohol group score was higher in participants aged 60 years or older [OR (95% CI) = 2.01 (1.20-3.36), females [OR (95% CI) = 2.54 (1.31-5.13), and never smokers [OR (95% CI) = 2.82 (1.28-6.21). Regarding dairy, those aged 60 years or older were more likely to score higher [OR (95% CI) = 0.62 (0.44-0.98). Concerning cereals, being aged 60 years or older was inversely associated with a higher cereal score [OR (95% CI) = 0.22 (0.08-0.60). No variables were associated with a higher score in the legumes group. Conclusion: The diet of individuals who have recently experienced myocardial infarction in Brazil exhibits moderate Mediterranean characteristics, with low intake of food groups and micronutrients that are part of cardiovascular protection, such as fiber, cereals, fish, vegetables, calcium, B vitamins, copper, selenium, and zinc. These individuals do not yet meet the recommendations of cardiovascular prevention guidelines, necessitating further studies and guidance in this population in Brazil. Keywords: Mediterranean diet, acute myocardial infarction, Mediterranean diet score, Brazil.
ABSTRACT Objective: To characterize and evaluate the diet of patients who have recently experienced acute myocardial infarction using a Mediterranean diet score, analyzing adherence scores and assessing compliance with the 2021 European Society of Cardiology (ESC) guidelines. Methods: This is a cross-sectional study conducted with a sample of Brazilian adult participants who recently suffered acute myocardial infarction (within 180 days). Dietary intake was assessed through a food frequency questionnaire, and the 17-point Mediterranean diet score was applied. Using the Nutriquanti software, total caloric value, fiber, cholesterol, macronutrients, and micronutrients were calculated. Nutrient consumption was compared with the nutritional recommendations of the 2021 ESC guidelines, and adherence to the Mediterranean diet was analyzed based on the score. Analyses were performed using Stata Data Analysis and Statistical Software (STATA) version 13.1. Values were considered statistically significant when the p-value <0.05. Results: After applying the Mediterranean diet score, moderate adherence to the Mediterranean dietary pattern was identified based on the score analysis. Regarding food groups in the Mediterranean diet, the vegetable, fish, and cereal groups showed low adherence. In terms of micronutrients, the consumption of fiber, zinc, calcium, B vitamins, and copper was below recommended levels. Carbohydrate intake remained within recommendations, with protein intake exceeding recommendations, but there was low red meat consumption. Total fat intake was adequate; however, there was an excessive consumption of saturated fatty acids. Adherence to the 2021 ESC guidelines was similar to scores for food groups in the Mediterranean diet. Fiber intake was low. Factors associated with scores from both the Mediterranean diet score and ESC 2021 were identified. Being aged >=60 years [Odds Ratio -OR (95% CI) = 1.63 (1.18-2.24)], never smoking [OR (95% CI) = 2.58 (1.41-4.72), or being an ex-smoker [OR (95% CI) = 2.17 (1.21-3.88) were factors directly associated in the multiple model with increased fruit intake scores. Concerning the vegetable intake score, being female [OR (95% CI) = 1.68 (1.12-2.52)] and having higher education [OR (95% CI) = 1.94 (1.33-2.82)] were factors directly associated with increased vegetable intake scores. Fish consumption had a higher odds ratio when participants had non-white skin color [OR (95% CI) = 1.82 (1.23-2.70)], never smoked [OR (95% CI) = 2.71 (1.19-6.13), or were ex-smokers [OR (95% CI) = 3.31 (1.54-7.57). The alcohol group score was higher in participants aged 60 years or older [OR (95% CI) = 2.01 (1.20-3.36), females [OR (95% CI) = 2.54 (1.31-5.13), and never smokers [OR (95% CI) = 2.82 (1.28-6.21). Regarding dairy, those aged 60 years or older were more likely to score higher [OR (95% CI) = 0.62 (0.44-0.98). Concerning cereals, being aged 60 years or older was inversely associated with a higher cereal score [OR (95% CI) = 0.22 (0.08-0.60). No variables were associated with a higher score in the legumes group. Conclusion: The diet of individuals who have recently experienced myocardial infarction in Brazil exhibits moderate Mediterranean characteristics, with low intake of food groups and micronutrients that are part of cardiovascular protection, such as fiber, cereals, fish, vegetables, calcium, B vitamins, copper, selenium, and zinc. These individuals do not yet meet the recommendations of cardiovascular prevention guidelines, necessitating further studies and guidance in this population in Brazil. Keywords: Mediterranean diet, acute myocardial infarction, Mediterranean diet score, Brazil.
Description
Palavras-chave
Dieta mediterrânea, Infarto agudo do miocárdio, Escore da dieta mediterrânea, Brasil, Mediterranean diet, Acute myocardial infarction, Mediterranean diet score, Brazil
Citação
Oliveira RD. Caracterização da dieta de pacientes pós infarto agudo do miocárdio frente a um guideline europeu e escore da deita mediterrânea: subestudo DICANUTS. Rio de Janeiro. dissertação [Mestrado Profiossional em Ciências Cardiovasculares] Instituto Nacional de Cardiologia - INC; 2024.