Effectiveness of nutritional intervention in overweight women in Primary Health Care

Ferreira, Nathália Luíza; Mingoti, Sueli Aparecida; Jaime, Patrícia Constante; Lopes, Aline Cristine Souza

doi:10.1590/1415-52732014000600003

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Sumário

Artigos Originais • Rev. Nutr. 27 (6) • Nov-Dec 2014 • https://doi.org/10.1590/1415-52732014000600003 copy

Effectiveness of nutritional intervention in overweight women in Primary Health Care

Efetividade de intervenção nutricional em mulheres com excesso de peso na Atenção Primária à Saúde

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective:

To assess the effectiveness of nutritional intervention in overweight women undergoing Primary Health Care.

Methods:

An intervention study was conducted with overweight adult and elderly women aged 20 years or older (body mass index ≥25.0 kg/m² and ≥27.0 kg/m², respectively) who were subjected to 12 months of individual nutritional monitoring. The effectiveness of the intervention was assessed by dietary, health, and anthropometric indicators.

Results:

Most of the 71 individuals were adults with a low income and poor level of education. After the intervention, there was an increase in number of meals and in the frequency of breakfasting. Moreover, there were more fruits and vegetables consumed, in addition to a decrease in household availability of salt, sugar, oil, and fried foods consumption. An improvement in health and weight self-perception was observed, as well as a decrease in body mass and abdominal adiposity, in particular among those participating in several consultations (n >9).

Conclusion:

The proposed nutritional intervention was effective and viable for improving the care of overweight individuals and those suffering from destabilized comorbidities, and may be extended to other contexts.

Variables	n*	Descriptive measurements
Sociodemographic
Age (years)**	71	52.5 ± 10.7
Age classification (%)
Adults Elderly	47 24	66.2 33.8
Monthly income per capita (minimum wage)
Up to ½ ½ to 1 1 to 1 and ½ 1 and ½ to 2 Education (years)***	18 35 8 6 71	26.9 52.2 11.9 09.0 5.0 (4.0; 10.0)
Professional occupation (%)
Without fixed wage**** With fixed wage	45 26	63.4 36.6
Associated morbidity
Systemic Arterial Hypertension (%) Dyslipidemias (%) Diabetes Mellitus (%)	36 25 10	51.4 36.8 14.3

Variables	Baseline		After 12 months		p-value
Variables	Variables	n*	Descriptive measurements	n*	p-value	Descriptive measurements
Use of medication (%)	57	80.3	56	78.9	1.0001
Self-perception of health (%)					0.0431
Very good/Good	38	54.3	50	70.4
Reasonable/bad/very bad	32	45.7	21	29.6
Good quality of sleep (%)	55	77.5	60	84.5	0.3021
Time spent watching television or	71	180.0 (60.0; 240.0)	71	120.0 (60.0; 240.0)	0.6232
using the computer (minutes)**
Self-perception of the body (%)					<0.0011
Lean/normal	1	1.4	15	21.1
Fat	69	98.6	56	78.9
Physical exercise (%)	67	94.4	59	84.3	0.1181

Variables	Baseline		After 12 months		p-value
Variables	n*	Descriptive measurements	n*	Descriptive measurements	p-value
Eating habits
Daily meals§	71	4.0 (3.0; 5.0)	71	5.0 (4.0; 6.0)	<0.001¹
Frequency of breakfasting per week^§	71	7.0 (7.0; 7.0)	71	7.0 (7.0; 7.0)	0.035¹**
Proper food chewing (%)	43	60.6	49	69.0	0.263²
Liquid consumption during meals (%)	28	39.4	18	25.4	0.041²
Daily food availability per capita
Salt (g)^§	70	5.6 (4.2; 8.3)	70	4.2 (3.2; 5.6)	0.001¹
Sugar (g)^§	71	44.4 (33.3; 83.3)	71	33.3 (20.8; 55.6)	<0.001¹
Oil (mL)^§	71	20.0 (15.0; 30.0)	71	15.0 (10.0; 22.5)	<0.001¹
Food consumption
Fruit (%)
≥4 times/week	42	60.0	52	78.8	0.024²
<4 times/week	28	40.0	14	21.2
Leafy vegetables (%)
Daily	20	28.6	37	54.4	<0.001²
Other***	50	71.4	31	45.6
Other vegetables (%)
Daily	29	41.4	40	58.8	0.043²
Other	41	58.6	28	41.2
Milk (%)
Daily	37	52.9	41	60.3	0.210²
Other	33	47.1	27	39.7
Fried food (%)
Daily	15	21.7	3	4.5	0.001²
Other	54	78.3	64	95.5
Soft drink (%)
Daily	11	15.9	6	9.0	0.267²
Other	58	84.1	61	91.0
Sweets (%)
Daily	9	13.0	2	3.0	0.070²
Other	60	87.0	64	97.0
Animal fat (%)
Daily	5	7.2	1	1.5	0.500²
Other	64	92.8	66	98.5

	Baseline		After 12 months		Delta percentage§**	p-value
	n*	Descriptive measurements	n*	Descriptive measurements	Delta percentage§**	p-value
Body weight (kg)	70	80.4 ± 11.0†	70	77.8 ± 12.1†	-2.9 (-6.4; -0.1)	<0.001¹
BMI (kg/m²)	70	33.2 (31.7; 35.1)§	70	32.0 (29.4; 35.0)§	-2.6 (-6.3; -0.2)	<0.0012
Classification of BMI - adults (%)
Eutrophy	0	0.0	1	2.1	-	-
Overweight	5	10.4	15	31.9
Obesity	43	89.6	31	66.0
Classification of BMI - elderly (%)
Eutrophic	0	0.0	1	4.3	-	-
Overweight	23	100.0	22	95.7
WC (cm)	70	97.2 ± 7.8†	70	93.4 ± 9.6†	-3.2 (-6.7; -0.3)	<0.001¹
Risk of metabolic complications - WC (%)
No risk	1	1.4	5	7.1	-	0.036³
High risk	8	11.3	15	21.4
Very high risk	62	87.3	50	71.4
WHR	70	0.63 ± 0.06†	70	0.60 ± 0.06†	-3.1 (-6.9; 0.0)	<0.001¹
High coronary risk - WHR (%)
No risk	1	1.4	2	2.9	-	1.000³
With Risk	70	98.6	68	97.1
C Index	70	1.24 ± 0.07†	70	1.21 ± 0.07†	-1.6 (-3.9; 0.8)	<0.001¹
High coronary risk - conicity index
No risk	25	35.2	31	44.3	-	0.286³
Risk	46	64.8	39	55.7

Delta percentages^§*	Number of sessions over 12 months		p-value
Delta percentages^§*	Variables	≤9 (57.4%)	p-value	>9 (42.6%)
Weight Body mass index Waist circumference Waist-height ratio Conicity index	-1.7 (-5.8; 0.4) -1.1 (-4.7; 0.3) -2.4 (-5.1; 0.0) -2.2 (-4.9; 0.0) -1.9 (-5.4; 0.8)	-5.3 (-7.7; -0.9) -4.1 (-8.4; -1.4) -6.8 (-10.6; -1.8) -6.9 (-10.6; -1.6) -3.4 (-5.6; -0.8)	0.069 0.009 0.002 0.001 0.007

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[1] CONTRIBUTORS NL FERREIRA collected, analyzed, and interpreted the data, and wrote the article. SA MINGOTI contributed to the analysis and interpretation of the data, the critical and intellectual revision, and the approval of the final version. PC JAIME contributed to the critical and intellectual revision, and the approval of the final version. ACS LOPES contributed to the conception and delineation of the study, the acquisition of data, participation in analysis and interpretation of the data, the critical and intellectual revision, the approval of the final version, and also helped obtain financial support.