BRASPEN Journal
https://braspenjournal.org/article/doi/10.37111/braspenj.2017.32.4.03
BRASPEN Journal
Artigo Original

Associação entre o consumo alimentar e o nível de atividade física com o risco cardiometabólico em crianças e adolescentes portadores de diabetes mellitus tipo 1  

Association between food consumption and the level of physical activity, with the cardiometabolic risk in children and adolescents carried out of diabetes mellitus type 1

Camilla Kapp Fritz, Marcia Regina Messaggi Gomes Dias, Suzana Nesi França, Luis Paulo Mascarenhas, Andreia Araújo Porchat de Leão.

Downloads: 0
Views: 244

Resumo

Introdução: O diabetes tipo 1 é uma doença crônica, caracterizada pela destruição das células beta pancreáticas que leva a uma deficiência de insulina. É a segunda doença crônica mais frequente da infância e sua incidência vem aumentando nas últimas décadas. O processo aterosclerótico é uma das complicações da doença, inicia-se na infância e sua extensão relaciona-se com o número e a gravidade dos fatores de risco cardiovascular encontrados. Objetivos: Investigar a influência do padrão da ingesta alimentar e do nível de exercício físico realizado por crianças e adolescentes portadores de diabetes mellitus tipo 1 com o risco cardiometabólico. Método: Estudo transversal de caráter descritivo, com crianças e adolescentes, idades entre 9 e 17 anos, portadores de diabetes mellitus tipo 1. Foram avaliados parâmetros antropométricos (peso corporal, altura, circunferência da cintura (CC), cálculos de índice de massa corporal (IMC), escore Z (E/I) e (IMC/I), aferição da pressão arterial, exames bioquímicos e determinação do estágio puberal, além de questionário para avaliação do nível de atividade física e um diário alimentar de 3 dias. Após dados obtidos, foi realizado a classificação dos pacientes, quanto portadores ou não de síndrome metabólica (SM). Resultados: A amostra compreendeu 31 pacientes (14 masculino e 17 feminino). Destes, 8 crianças e adolescentes apresentavam mais de 3 fatores de risco, sendo classificados como portadores de SM. O consumo alimentar foi considerado inadequado conforme o preconizado, em 90,32% dos avaliados. O consumo de calorias (p=0,039), proteínas (p=0,001) e colesterol (p=0,009) foi significativamente maior no sexo masculino. Tanto o grupo portador de SM como o sem SM apresentaram alimentação inadequada e sedentarismo instalado. Conclusão: Crianças e adolescentes com diabetes tipo 1 tendem a apresentar uma elevação no risco cardiovascular, devido aos fatores de risco presentes com frequência. Não se pode relacionar com a qualidade da alimentação e nível de atividade física.

Palavras-chave

Nutrição. Diabetes Mellitus Tipo 1. Doenças Cardiovasculares. Síndrome X Metabólica.

Abstract

Introduction: Type 1 diabetes is a chronic disease, characterized by the destruction of pancreatic beta cells that lead to insulin deficiency. It is the second most frequent chronic disease of childhood, and its incidence has been increasing in the last decades. The atherosclerotic process is one of the complications of the disease, which begins in childhood and its extension is related to the number and severity of the cardiovascular risk factors found. Objective: To investigate the influence of the dietary intake pattern and the level of physical exercise performed by children and adolescents with type 1 diabetes mellitus with cardiometabolic risk. Methods: Descriptive cross-sectional study with children and adolescents, ages 9 to 17 years, with type 1 diabetes mellitus. The study also evaluated anthropometric parameters (body weight, height, waist circumference (WC), body mass index (BMI), Z score (E / I) and (BMI / I), blood pressure measurement, biochemical tests and determination of the pubertal stage, and included a questionnaire to assess the level of physical activity and a food diary of 3 days. After the data were obtained, the classification of patients, whether or not with metabolic syndrome (MS), was performed. Results: The sample consisted of 31 patients (14 male and 17 female). Of these, 8 children and adolescents had more than 3 risk factors, being classified as having MS. Food intake was considered inadequate according to what was recommended in 90.32% of the patients evaluated. Calorie consumption (p=0.039), protein (p=0.001) and cholesterol (p=0.009) were significantly higher in males. Both the SM and non-SM groups presented inadequate diet and sedentary lifestyle. Conclusion: Children and adolescents with type 1 diabetes frequently tend to present an elevation in cardiovascular risk due to present risk factors. It can not be related to the quality of the diet and level of physical activity.

Keywords

Nutrition. Diabetes Mellitus, Type 1. Cardiovascular Diseases. Metabolic Syndrome X

Referências

1. Standards of Medical Care in Diabetes – 2015. Diabetes Care. 2015;38(Suppl 1).

2. Guelfi KJ, Jones TW, Fournier PA. Intermittent high-intensity exercise does not increase the risk of early post exercise hypoglycemia in individuals with type 1 diabetes. Diabetes Care. 2005;28(2):416-8.

3. Albuquerque IZ, Stringhini MLF, Marques RMB, Mundim CA, Rodrigues MLD, Campos MRH. Contagem de carboidratos, estado nutricional e perfil metabólico em adolescentes com diabetes mellitus tipo 1. Sci Med. 2014;24(4):343-52.

4. Donovan A, Finner N, O'Connor C, Quinn A, O'Gorman CS. Review of cardiometabolic risk factors in a cohort of paediatric type 1 diabetes mellitus patients. Ir J Med Sci. 2017;186(2):427-32.

5. Kautzky-Willer A, Stich K, Hintersteiner J, Kautzky A, Kamyar MR, Saukel J, et al.Sex-specific-differences in cardiometabolic risk in type 1 diabetes: a cross-sectional study. Cardiovasc Diabetol. 2013;12:78.

6. Smart CE, Annan F, Bruno LP, Higgins LA, Acerini CL; International Society for Pediatric and Adolescent Diabetes. ISPAD Clinical Practice Consensus Guidelines 2014. Nutritional management in children and adolescents with diabetes. Pediatr Diabetes.2014;Suppl 20:135-53.

7. Kenneth R, Riddell MC, Guinhouya BC, Adolffsson P, Hanas R; Exercise in children and adolescents with diabetes.ISPAD Clinical Practice Consensus Guidelines 2014 Compendium. Pediatric Diabetes. 2014;15(Suppl. 20):203-23.

8. World Health Organization - WHO. Global recommendations on physical activity for health 2010. [acessado 2016 Set 23].Disponível em: http://www.who.int/dietphysicalactivity/ factsheet_recommendations/en/

9. Fernández JR, Redden DT, Pietrobelli A, Allison DB. Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents. J Pediatr. 2004;145(4):439-44.

10. Tanner JM. Normal growth and techniques of growth assessment. Clin Endocrinol Metab. 1986;15(3):411-51.

11. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. The fourth report on the diagnosis, evaluation, and treatment of high blood pressure in children and adolescents. Pediatrics. 2004;114(2 Suppl):555-76.

12. Leite N, Milano GE, Cieslak F, Lopes WA, Rodacki A, Randominski RB. Effects of physical exercise and nutritional guidance on metabolic syndrome in obese adolescents. Rev Bras Fisioter. 2009;13(1):73-81.

13. Bouchard C, Tremblay A, Leblanc C, Lortie G, Savard R, Thériault G. A method to assess energy expenditure in children and adults. Am J Clin Nutr. 1983;37(3):461-7.

14. Krishnan S, Short KR. Prevalence and significance of cardiometabolic risk factors in children with type 1 diabetes. J Cardiometab Syndr. 2009;4(1):50-6.

15. Davison KA, Negrato CA, Cobas R, Matheus A, Tannus L, Palma CS, et al.; Brazilian Type 1 Diabetes Study Group (BrazDiab1SG). Relationship between adherence to diet, glycemic control and cardiovascular risk factors in patients with type 1 diabetes: a nation wide survey in Brazil. Nutr J.2014;13:19.

16. Nansel T, Haynie D, Lipsky L, Mehta S, Laffel L. Little variation in diet cost across wide ranges of overall dietary quality among youth with type 1 diabetes. J Acad Nutr Diet. 2015;115(3):433-9.

17. Wajchenberg BL, Rassi N, Feitosa ACR, Lerário AC, Betti RTB. Doença cardiovascular no diabetes melito tipo 1. Arq Bras Endocrinol Metab. 2008;52(2):387-97.

18. Jaacks LM, Crandell J, Mendez MA, Lamichhane AP, Liu W, Ji L, et al. Dietary patterns associated with HbA1c and LDL cholesterol among individuals with type1 diabetes in China. J Diabetes Complications. 2015;29(3):343-9.


Submetido em:
13/08/2017

Aceito em:
24/10/2017

63e28e8ea9539528e56b2b32 braspen Articles
Links & Downloads

BRASPEN Journal

Share this page
Page Sections