EDITORIAL

Nuno Borges;
Abstract

No presente número da Acta Portuguesa de Nutrição encontram-se trabalhos científcos que abordam temas muito diversos da área da alimentação e nutrição. Estes trabalhos resultam da experiência de terreno de diversos investigadores e vão desde a desnutrição à obesidade, passando por patologias com grau elevado de especifcidade técnica como a paralisia cerebral ou a artrite reumatóide. Muito tem sido o valioso trabalho de campo na área da alimentação e nutrição que poderia (e deveria) ser publicado em revistas científcas da especialidade e, por isso, lançamos novamente o apelo para quem estiver em condições de o fazer, o faça. O exercício de refexão que a escrita de um trabalho científco propicia é uma indiscutível mais-valia para a prática profssional, permitindo não raras vezes um espaço de autocrítica difícil de conseguir na exigente rotina diária. A este propósito, destacamos ainda o recente e relevantíssimo apoio à investigação nas ciências da nutrição propiciado pelos European Economic Area (EEA) Grants. Este mecanismo de fnanciamento europeu, com fundos provenientes da Noruega, Islândia e Liechtenstein, contemplou vários projetos dedicados exclusivamente à nutrição e alimentação, bem como outros em que esta importante área aparece associada a outros campos do saber. Trata-se de um dos mais importantes estímulos alguma vez feitos à investigação científca em Portugal, quer pela dimensão dos projetos quer pela relevância dos temas abordados. Destaca-se, pelo impacto potencial dos seus resultados, a possibilidade de termos, quase 40 anos depois, um novo inquérito alimentar nacional, que irá certamente permitir um olhar muito mais preciso sobre os hábitos alimentares dos Portugueses, possibilitando um conjunto de intervenções com um nível de fundamentação científca impossível de ter até à data. A Acta Portuguesa de Nutrição orgulha-se de ter no seu corpo editorial muitos dos investigadores envolvidos neste notável esforço coletivo de investigação, aguardando com grande expectativa os resultados que se irão obter.

TERAPÊUTICA NUTRICIONAL NA ARTRITE REUMATOIDE

NUTRITIONAL APPROACH OF RHEUMATOID ARTHRITIS
Joana Pinheiro
Abstract

ABSTRACT

Rheumatoid arthritis is a chronic autoimmune disease characterized by extensive synovitis resulting in erosion of articular cartilage and marginal bone that lead to joint destruction. It’s common to patients with rheumatoid arthritis to have poor nutritional status. Furthermore, some of the drugs used in its treatment can increase the requirements of some nutrients in some cases or reduce their absorption in other cases. The objective of this paper is to review the scientifc information of the importance of dietary patterns and the main nutrients recommended as complement for the treatment of rheumatoid arthritis in the reduction of symptomatology, the progression of the disease and the side efects associated to the drugs recommended. Although there is some evidence of the nutrition utility as complement of rheumatoid arthritis therapy, more studies are needed to determine the best nutritional needs in this disease, as well as to prove the benefts of nutritional supplements use.

KEYWORDS

n-3 polyunsaturated fatty acids, Dietary patterns, Antioxidants, Rheumatoid arthritis, Probiotics

A IMPORTÂNCIA DA ALIMENTAÇÃO EM PARALISIA CEREBRAL

THE IMPORTANCE OF FEEDING IN CEREBRAL PALSY
Joana Sampaio; Maria Antónia Campos; Cláudia Afonso;
Abstract

ABSTRACT

One of the most recent defnitions of cerebral palsy describes it as a group of permanent changes, but not unchangeable, of the movement and posture, causing limitations in activity, that are attributed to non-progressive damage occurring in the immature brain and under development. In this population feeding difculties are common. These can result from oral-motor disability (chewing and/or swallowing difculties), dysphagia and sensory impairment, with or without behavioral disorders. These feeding difculties may also be associated with common health problems, such as aspiration and lung infections, gastroesophageal refux and constipation. Low water intake, or even dehydration, the increase in the time to take a meal and insufcient intake (which can lead to low weight) are other consequences of feeding problems. On other hand, there are situations where it is common overweight for various reasons (for example, sedentary lifestyle). Dietary/nutritional intervention is essential to improve the individual’s quality of life. It is also primordial that caregivers are provided with all the information and motivation to address their specifcities, so that the meals are as pleasant and safe as possible. In this population, food can be our greatest ally.

KEYWORDS

Feeding, Feeding problems and difculties, Dietary and/or nutritional intervention, Cerebral palsy

INDIVIDUO: INTERVENÇÃO NUTRICIONAL DIRECIONADA AOS ESTILOS DE VIDA EM INDIVÍDUOS COM OBESIDADE

INDIVIDUO: LIFEST YLE-ORIENTED NUTRICIONAL INTERVENTION IN INDIVIDUALS WITH OBESITY
José Camolas; Osvaldo Santos; Mário Mascarenhas; Pedro Moreira; Isabel do Carmo;
Abstract

ABSTRACT

Obesity treatment paradigm challenges both professionals and patients to engage on shared clinical decisions. Adopting a new food consumption pattern is contingent with multiple behavior changes, usually proposed by the health professional, which may negatively afect patients’ health-related quality of life, therefore compromising adherence and maintenance. This paper presents INDIVIDUO, a nutritional intervention procedure, which integrates nutritional strategies with patient-centered counseling, targeting to sustainable weight control. We also present the protocol for assessing the efectiveness (a controlled clinical trial) of this structured intervention, designed for obesity surgery candidates in a specialized multidisciplinary outpatient clinic. We expect intervened individual to engage in sustained behavior changes and to see signifcant clinical improvements in the intervention group, namely at weight loss, metabolic control and health-related quality of life.

KEYWORDS Patient-centered care, Clinical trial, Nutrition, Severe obesity, Protocol

ADEQUAÇÃO NUTRICIONAL EM CRIANÇAS SUBNUTRIDAS DOS 6 AOS 59 MESES, EM CANTAGALO (SÃO TOMÉ E PRÍNCIPE)

NUTRITIONAL ADEQUACY IN UNDERNOURISHED CHILDREN FROM 6 TO 59 MONTHS OF AGE, IN CANTAGALO (SÃO TOMÉ E PRÍNCIPE)
Ana Pisco; Rui Poínhos; Elisabete Catarino;
Abstract

ABSTRACT

INTRODUCTION: Undernutrition in children is considered a public health issue, especially in developing countries, and its relation to an inadequate dietary intake is highly recognized. The lack of data concerning to São Tomé e Príncipe in this area makes it imperious to evaluate these children’s nutritional adequacy and to do more similar studies.

OBJECTIVES: To know the diferences between energetic and macronutrient intake and nutritional recommendations in undernourished children from 6 to 59 months of age in Cantagalo, São Tomé e Príncipe. To assess the relationship between nutritional adequacy and undernutrition type and severity, age, breastfeeding and reported difculties in access to enough food.

METHODOLOGY: In this descriptive study, a survey was applied to 118 caregivers of children from 6 to 59 months of age. Anthropometric and sociodemographic data were collected and a 24 hour recall was applied to assess children’s energy and macronutrient intake. Nutritional adequacy was determined by comparison with the DRI (non-breastfed children) and Dewey and Brown’s recommendations (for breastfed children).

RESULTS: From the sample of undernourished children, 72.9%, 59.3% and 74.6% presented values below the recommendations for energy, carbohydrates and lipids, respectively. For protein, only 14.4% were below the reference values. Older and non-breastfed children tended to be out of the recommendation. Children with moderate chronic undernutrition, comparatively to those with severe chronic undernutrition, showed a higher prevalence of energetic intake inferior to recommendations, but no signifcant diferences were found in terms of macronutrients.

CONCLUSIONS: Most of the evaluated undernourished children do not reach energetic and macronutrient recommendations, with protein being an exception. This is worse for older and non-breastfed children.

  KEYWORDS Nutritional adequacy, Energetic and macronutrient intake, São Tomé e Príncipe, Acute undernutrition, Chronic undernutrition