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BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional condition, which main symptoms of pain, discomfort and abdominal distension, constipation, diarrhea, altered fecal consistency and sensation of incomplete evacuation can be influenced by the presence of dietary fiber and fermentable carbohydrates (FODMAPs). This study aimed to assess the relationship between the quantity of fermentable carbohydrates (FODMAP) and fiber consumed by individuals diagnosed with IBS, and their classification according to the Rome III criteria. METHODS: A transversal study was carried out in the Intestinal Outpatient Clinic of the Gastroenterology Discipline of UNIFESP. The nutrients of interest for the study were: fiber, general carbohydrates and FODMAPs, with intake quantity measured in grams, analyzed through portions consumed. A nutrition log was used, along with a semi-quantitative questionnaire of consumption frequency. RESULTS: The sample included 63 adult patients; 21 with constipated IBS, 21 with diarrhea IBS, and 21 with mixed IBS. Carbohydrate intake was suboptimal in 55.6% of patients in all groups; excessive consumption was identified in 38.1% of the diarrhea group, 14.3% of the mixed group and 38.1% of the constipated group. Low consumption of carbohydrates was found in 28.6% of diarrhea patients and 47.6% of the mixed group. A mean intake of 23 g of fiber per day was identified, lower than recommended. CONCLUSION: The study identified a number of inadequacies in the consumption of different nutrients, excessive carbohydrate intake, especially FODMAPs, identified by the respondents as responsible for a worsening of their conditions. By contrast, other food groups such as meat, eggs and dairy were consumed by the sample population in insufficient quantities.

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ABSTRACT BACKGROUND: Irritable bowel syndrome (IBS) is a chronic functional condition, which main symptoms of pain, discomfort and abdominal distension, constipation, diarrhea, altered fecal consistency and sensation of incomplete evacuation can be influenced by the presence of dietary fiber and fermentable carbohydrates (FODMAPs). This study aimed to assess the relationship between the quantity of fermentable carbohydrates (FODMAP) and fiber consumed by individuals diagnosed with IBS, and their classification according to the Rome III criteria. METHODS: A transversal study was carried out in the Intestinal Outpatient Clinic of the Gastroenterology Discipline of UNIFESP. The nutrients of interest for the study were: fiber, general carbohydrates and FODMAPs, with intake quantity measured in grams, analyzed through portions consumed. A nutrition log was used, along with a semi-quantitative questionnaire of consumption frequency. RESULTS: The sample included 63 adult patients; 21 with constipated IBS, 21 with diarrhea IBS, and 21 with mixed IBS. Carbohydrate intake was suboptimal in 55.6% of patients in all groups; excessive consumption was identified in 38.1% of the diarrhea group, 14.3% of the mixed group and 38.1% of the constipated group. Low consumption of carbohydrates was found in 28.6% of diarrhea patients and 47.6% of the mixed group. A mean intake of 23 g of fiber per day was identified, lower than recommended. CONCLUSION: The study identified a number of inadequacies in the consumption of different nutrients, excessive carbohydrate intake, especially FODMAPs, identified by the respondents as responsible for a worsening of their conditions. By contrast, other food groups such as meat, eggs and dairy were consumed by the sample population in insufficient quantities.

RESUMO CONTEXTO: A síndrome do intestino irritável é um distúrbio funcional crônico, no qual a dieta, principalmente o teor de fibra dietética e presença de carboidratos fermentativos (FODMAPs) podem influenciar nos principais sintomas: dores, desconforto e/ou distensão abdominal, constipação, diarreia, alteração na consistência das fezes, sensação de evacuação incompleta. OBJETIVO: Este estudo teve como objetivo avaliar as quantidades de carboidratos fermentativos (FODMAP) e fibras consumidas por indivíduos com o diagnóstico de síndrome do intestino irritável e relacionar com seu modelo da classificação, segundo os critérios Roma III. MÉTODOS: Estudo transversal, realizado no Ambulatório de Doenças Intestinais da Disciplina de Gastroenterologia/UNIFESP. Os nutrientes de interesse para o estudo foram: fibras, carboidratos em geral e FODMAPs, calculando-se suas quantidades em gramas, analisadas através das porções consumidas. Os instrumentos de pesquisa utilizados: ficha de acompanhamento nutricional e questionário de frequência alimentar semi-quantitativo. RESULTADOS: A amostra incluiu 63 pacientes adultos, com síndrome do intestino irritável constipado (21), diarreico (21) e misto (21). O consumo de carboidratos mostrou-se inadequado em 55,6% dos indivíduos em todos os grupos; os que tinham alto consumo (38,1%) pertenciam ao grupo diarreia, 14,3% ao misto e 38,1 % ao constipado. Baixo consumo deste nutriente foi 28,6% nos casos de diarreia e 47,6% do misto. Observamos uma ingestão média de fibras equivalente à 23 g/dia, nos três grupos, inferior ao recomendado. CONCLUSÃO: O estudo permitiu reconhecer várias inadequações no consumo dos diferentes grupos de alimentos, particularmente excesso de carboidratos, incluindo os classificados como FODMAPs, identificados pelos doentes como responsáveis pela piora das suas queixas. Em contrapartida, nutrientes fundamentais, como carnes, ovos, leite e derivados estiveram referidos em níveis abaixo do recomendado.

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The objective of the Food and Nutrition Surveillance System (SISVAN) is to monitor the food intake of individuals attended by the Brazilian Unified Health System (SUS). The objective of this research was to identify the feeding practices of children under 24 months of age who were attended at Primary Healthcare Units (UBS), using SISVAN, and to assess the relationship with maternal sociodemographic profiles. A cross-sectional study was conducted in order to evaluate 350 children using the Food Consumption Marker Form of SISVAN, and maternal demographic data to identify sociodemographic profiles by exploratory factor analysis. Of the children assessed, 41.1% were under 6 months of age and 98.7% of those between 6 and 23 months had an inadequate intake. Two sociodemographic profiles were found: Profile 1 (mothers with lower income, less education, and recipients of the 'Bolsa Família' conditional family grant program) associated with the consumption of water/tea, cow's milk and salty baby food; and Profile 2 (older mothers with many children and with a larger number of residents in the household) associated with breast milk consumption (p = 0.048). The use of SISVAN made it possible to identify that children had inadequate feeding practices, and Profile 1 appears to be a risk profile for weaning.

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The objective of the Food and Nutrition Surveillance System (SISVAN) is to monitor the food intake of individuals attended by the Brazilian Unified Health System (SUS). The objective of this research was to identify the feeding practices of children under 24 months of age who were attended at Primary Healthcare Units (UBS), using SISVAN, and to assess the relationship with maternal sociodemographic profiles. A cross-sectional study was conducted in order to evaluate 350 children using the Food Consumption Marker Form of SISVAN, and maternal demographic data to identify sociodemographic profiles by exploratory factor analysis. Of the children assessed, 41.1% were under 6 months of age and 98.7% of those between 6 and 23 months had an inadequate intake. Two sociodemographic profiles were found: Profile 1 (mothers with lower income, less education, and recipients of the 'Bolsa Família' conditional family grant program) associated with the consumption of water/tea, cow's milk and salty baby food; and Profile 2 (older mothers with many children and with a larger number of residents in the household) associated with breast milk consumption (p = 0.048). The use of SISVAN made it possible to identify that children had inadequate feeding practices, and Profile 1 appears to be a risk profile for weaning.

O Sistema de Vigilância Alimentar e Nutricional (SISVAN) objetiva monitorar as características do consumo alimentar de indivíduos atendidos pelo Sistema Único de Saúde. O objetivo deste estudo foi identificar as práticas alimentares de crianças menores de 24 meses que frequentam Unidades Básicas de Saúde (UBS), utilizando o SISVAN, e avaliar a relação com perfis sociodemográficos maternos. Estudo transversal que avaliou 350 crianças utilizando-se o Formulário de Marcadores de Consumo Alimentar do SISVAN, e dados sociodemográficos maternos para a identificação dos perfis a partir da análise fatorial exploratória. Das crianças avaliadas, 41,1% das menores de 6 meses e 98,7% daquelas entre 6 e 23 meses apresentaram consumo inadequado. Foram encontrados 2 perfis sociodemográficos: Perfil 1 (mães com menor renda, menor escolaridade e beneficiárias do Programa Bolsa Família) associado com o consumo de água/chá, leite de vaca e papa salgada; e Perfil 2 (mães com mais idade, com maior número de filhos e com maior número de residentes no domicílio) associado com o consumo de leite materno (p= 0,048). A utilização do SISVAN possibilitou identificar que as crianças apresentaram práticas alimentares inadequadas, e o Perfil 1 parece ser um perfil de risco para o desmame.

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OBJECTIVE: To identify the dietary patterns of individuals with metabolic syndrome and determine associations with sociodemographic, lifestyle, anthropometric and biochemical features. METHODS: We analyzed data of individuals with metabolic syndrome attending the nutrition outpatient clinic at a public university in São Paulo, from 2008 to 2011. We assessed food intake by 24-hour dietary recall and identified the dietary patterns using principal components analysis. Multivariate multiple linear regression models were applied to investigate possible associations between dietary patterns and the independent variables. We applied Pearson's correlations to evaluate possible associations between dietary patterns and biochemical and anthropometric variables. RESULTS: Of the 166 outpatients enrolled, 65.7% (109) were women; 63.0% (103) were adults (21-59 years) and 37.0% were elderly (60-79 years). Most people were married, sedentary and obese, with incomplete primary education, non-smoking and non- alcoholic. We identified nine dietary patterns. There was a positive association between the "traditional Brazilian" dietary pattern (rice, beans and red meat) with men and a negative association with age, and the "prudent" (whole grains, soups) with women. There was a positive correlation between the "traditional Brazilian", "compensatory" (snacks, sweeteners, light products) and "mixed" (refined grains, fruits, oils) patterns with fasting glucose, and negative correlation between the "healthy" (vegetables and oilseeds) and waist circumference. CONCLUSION: The results of this study indicate that these individuals with metabolic syndrome have dietary patterns characterized by the presence of refined foods, fats, red meat and alcohol, associated with biochemical disturbance, as impaired fasting glucose and hypertriglyceridemia

OBJETIVO: Caracterizar o padrão alimentar de indivíduos com síndrome metabólica e averiguar associações com dados sociodemográficos, estilo de vida, antropométricos e bioquímicos. MÉTODOS: Analisaram-se dados de indivíduos com síndrome metabólica em acompanhamento ambulatorial de nutrição de uma universidade pública na cidade de São Paulo, atendidos de 2008 a 2011. O consumo alimentar foi obtido por meio do Recordatório Alimentar de 24 horas. A identificação dos padrões alimentares se deu por análise fatorial por componentes principais com rotação varimax. Utilizaram-se modelos de regressão linear múltipla multivariada para verificar a relação entre os escores dos padrões alimentares e as variáveis independentes. Avaliaram-se as associações entre os padrões alimentares e variáveis bioquímicas e antropométricas por correlações de Pearson. RESULTADOS: Do total de 166 indivíduos incluídos, 65,7% (109) eram do sexo feminino; 63,0% (103) eram adultos (21 a 59 anos) e 37% eram idosos (60 a 79 anos). A maioria dos indivíduos era casada, sedentária e obesa, tinha ensino fundamental incompleto, não fumante e não etilista. Foram identificados nove padrões alimentares. Encontrou-se associação positiva entre o padrão "tradicional brasileiro" (arroz, feijão e carne vermelha) com o sexo masculino e negativa com a idade, e o padrão "prudente" (cereais integrais, sopas) com o sexo feminino. Observou-se correlação positiva entre os padrões "tradicional brasileiro", "compensatório" (lanches, adoçantes, produtos light) e "misto" (cereais refinados, frutas, óleos) com glicemia de jejum, e correlação negativa entre o padrão "saudável" (verduras e legumes e oleaginosas) e circunferência da cintura. CONCLUSÃO: Os resultados do presente estudo indicam que estes indivíduos com SM apresentam padrões alimentares caracterizados pela presença de alimentos refinados, gorduras, carnes vermelhas e bebida alcoólica, associados às alterações bioquímicas da SM, como glicemia de jejum alterada e hipertrigliceridemia

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The objective of this study was to investigate wellbeing in a random sample of nutritionists, using body image, and social and personal variables as causal factors, in an exploratory, crosssectional study. Statistical treatments included descriptive analyses, t-tests, ANOVAs, and linear regressions. The 242 participants perceived themselves frequently in a wellbeing state at work (M=3.8); 25.6

a severely distorted body image. Social and personal variables, such as having children and the level of personal income, were associated with wellbeing. Body image had a significant negative impact of 3.2

O objetivo deste estudo foi pesquisar sobre o bem-estar dos nutricionistas, utilizando a imagem corporal e as variáveis sociais e pessoais como fatores causais, em um estudo exploratório e transversal de uma amostra aleatória de nutricionistas. O trabalho estatístico incluiu análisedescritiva, provas-t, ANOVAs e regressão linear. Os 242 participantes manifestaram gozar de bem-estar no trabalho com frequência (M=3,8); 25,6

apresentaram uma imagem corporal levemente distorcida; 14,5

moderadamente distorcida e 7,5

seriamente distorcida. As variáveis sociais e pessoais —ter filhos, ingressos pessoais, campo de trabalho, grupo etário e atividade física regular— se associaram com o bem-estar. A imagem corporal tem um impacto significativamente negativo sobre o bem-estar...

O objetivo deste estudo foi pesquisar sobre o bem-estar dos nutricionistas, utilizando a imagem corporal e as variáveis sociais e pessoais como fatores causais, em um estudo exploratório e transversal de uma amostra aleatória de nutricionistas. O trabalho estatístico incluiu análise descritiva, provas-t, ANOVAs e regressão linear. Os 242 participantes manifestaram gozar de bem-estar no trabalho com frequência (M=3,8); 25,6% apresentaram uma imagem corporal levemente distorcida; 14,5% moderadamente distorcida e 7,5% seriamente distorcida. As variáveis sociais e pessoais - ter filhos, ingressos pessoais, campo de trabalho, grupo etário e atividade física regular - se associaram com o bem-estar. A imagem corporal tem um impacto significativamente negativo sobre o bem-estar...

a moderately distorted body image, and 7.5

on wellbeing...

The objective of this study was to investigate wellbeing in a random sample of nutritionists, using body image, and social and personal variables as causal factors, in an exploratory, crosssectional study. Statistical treatments included descriptive analyses, t-tests, ANOVAs, and linear regressions. The 242 participants perceived themselves frequently in a wellbeing state at work (M=3.8); 25.6% of participants presented a mildly distorted body image, 14.5% a moderately distorted body image, and 7.5% a severely distorted body image. Social and personal variables, such as having children and the level of personal income, were associated with wellbeing. Body image had a significant negative impact of 3.2 % on wellbein...

El objetivo de este estudio fue investigar el bienestar en una muestra aleatoria de nutricionistas, utilizando la imagen corporal y las variables sociales y personales como factores causales, en un estudio exploratorio y transversal. El trabajo estadístico incluyó análisis descriptivos, pruebas t, ANOVAs y regresión lineal. Los 242 participantes manifestaron gozar frecuentemente de bienestar en el trabajo (M=3.8); el 25,6

presentó una imagen corporal levemente distorsionada; el 14,5

moderadamente distorsionada y el 7,5

severamente distorsionada. Las variables sociales y personales, como tener hijos y los ingresos personales, se asociaron con el bienestar. La imagen corporal tuvo un impacto significativamente negativo sobre el 3.2

del bienestar...

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A validity test of a Food Frequency Questionnaire was carried out using 50 students of health occupation in São Paulo, Brazil. Therefore, a three day dietary record was used as reference method and variables such as energy, macronutrients and dietary fiber were analyzed. The accordance between the Food Frequency Questionnaire and average data from dietary record was tested with kappa statistics and intra-class correlation coefficients (ICC). Limits of agreement were estimated by the Bland-Altman's method. Better results were found for calories (ICC 0.43; 95%CI 0.17 - 0.63) and non-energy-adjusted nutrients, except dietary fiber (ICC 0.34; 95%CI 0.07 - 0.56). The percentage of individuals classified in the same category of consumption was nearly half (49.8%), while only 16% of them were classified in opposite categories. With the exception of lipids, other analyzed variables tended to be overestimated by the Food Frequency Questionnaire. The Food Frequency Questionnaire is recommended as a method of assessing food intake of university students in studies which focuson calorie estimates and also intend to classify groups into intake categories.

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RESUMO

A validity test of a Food Frequency Questionnaire was carried out using 50 students of health occupation in São Paulo, Brazil. Therefore, a three day dietary record was used as reference method and variables such as energy, macronutrients and dietary fiber were analyzed. The accordance between the Food Frequency Questionnaire and average data from dietary record was tested with kappa statistics and intra-class correlation coefficients (ICC). Limits of agreement were estimated by the Bland-Altman's method. Better results were found for calories (ICC 0.43; 95%CI 0.17 - 0.63) and non-energy-adjusted nutrients, except dietary fiber (ICC 0.34; 95%CI 0.07 - 0.56). The percentage of individuals classified in the same category of consumption was nearly half (49.8%), while only 16% of them were classified in opposite categories. With the exception of lipids, other analyzed variables tended to be overestimated by the Food Frequency Questionnaire. The Food Frequency Questionnaire is recommended as a method of assessing food intake of university students in studies which focus on calorie estimates and also intend to classify groups into intake categories.

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OBJETIVO: Identificar o estado nutricional, o consumo alimentar e a qualidade da dieta de nutrizes em amamentação exclusiva. MÉTODOS: Estudo transversal realizado com nutrizes em aleitamento exclusivo a partir do 28º dia pós-parto. Foram utilizados instrumentos padronizados e foram avaliados o índice de massa corporal, consumo alimentar e qualidade da dieta. RESULTADOS: As nutrizes apresentaram sobrepeso, consumo energético abaixo do recomendado, porcentagens de macronutrientes adequadas exceto para proteína, que foi elevada. A dieta foi classificada como "precisando de melhorias", conforme o Índice de Alimentação Saudável. CONCLUSÃO: Os resultados mostraram que o sobrepeso associado a uma qualidade inadequada da dieta, indicou possíveis carências de micronutrientes.

OBJECTIVE: Identifying the nutritional status, dietary intake and diet quality of nursing mothers on exclusive breastfeeding. METHODS: Cross-sectional study carried out with nursing mothers on exclusive breastfeeding from day 28 postpartum. Standardized instruments were used, and body mass index, food consumption and diet quality were evaluated. RESULTS: The nursing mothers were overweight, presented energy consumption below the recommended and adequate percentage of macronutrients, except for protein, which was elevated. The diet was classified as "needs improvement" according to the Healthy Eating Index (HEI). CONCLUSION: The results show that the overweight associated with a diet of poor quality indicated possible deficiencies of micronutrients.

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INTRODUCTION: The Nutrition Committee of the Brazilian Society of Nephrology (SBN) held in 2010 the first Brazilian Nutrition Census in hemodialysis patients. Multicenter data contribute to clinical development and nutritional intervention. OBJECTIVE: To describe epidemiological and nutritional aspects of hemodialysis patients. METHOD: Cross-sectional study in 36 dialysis clinics and 2,622 randomly selected participants. Socio-demographical, clinical, biochemical and anthropometric records were collected. RESULTS: 60.45% of the patients lived in the Brazilian Southeast. 13.53% came from Northeast region, while 12.81% from South, 10.33% from Midwest and 2.86% from North regions. Approximately 58% were male and 63.1% were below 60 years old. 58.5% of patients were married or in cohabitation. Around 80% of them depended on the government Unified Health System. Smoking showed a difference between gender and age. Presumptive etiologies were Hypertensive Nephrosclerosis (26.4%), Diabetic Nephropathy (24.6%), unknown/undiagnosed causes (19.9%), Glomerulopathies (13.6%) and others (11.2%). Both Hypertension and Diabetes Mellitus affect approximately 30% of patients, especially over 60 years. Body Mass Index did not differ between genders, although it differed between age groups and when used different evaluation criteria. Men and women average waist circumference were respectively 90.5 and 88.0 cm. Lipid profile did not differ between age groups, but it did between genders. Albumin values were lower in women and in patients older than 60 years. CONCLUSION: This study characterized Brazilian hemodialysis patients in 2010, and may support further studies to monitor nutrition and epidemiological transitions of the population.

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