Papers by Thais Steemburgo
Objective To examine the association between nutritional status and dietary factors in children a... more Objective To examine the association between nutritional status and dietary factors in children and adolescents with cystic fibrosis that are carriers of delta F508 mutation. Methods Cross-sectional study of cystic fibrosis children and adolescents. Nutritional status (body mass index percentile) and dietary intake (3-day diet records presented as a percentage of estimated energy requirement) were assessed. Results Thirty six patients (median of 8.6; interquartile range 6.8-12.5 years; 50% male). The Poisson regression analysis showed that the carriers for delta F508 mutation had 60% lower prevalence ratio of body mass index ≥25° (PR=0.4; 95%IC=0.2-0.8) and 90% lower prevalence ratio (PR=0.1; confidence interval 95%IC=0.02-0.3) of ≥150% of estimated energy requirement when compared with non-delta F508 mutation carriers. The model was adjusted for lung function, estimated energy requirement, and body mass index. Conclusion Carriers for delta F508 mutation showed lower body mass index...
Lifestyle Genomics, 2021
Introduction: Single nucleotide polymorphisms (SNP) in the fat mass and obesity-associated (FTO) ... more Introduction: Single nucleotide polymorphisms (SNP) in the fat mass and obesity-associated (FTO) gene have been associated with type 2 diabetes (T2D) and its complications. The aim of the present research was to investigate which and how (directly or indirectly) clinical and metabolic variables mediate the association between fat mass and the FTO gene and early chronic kidney disease (CKD) in individuals with T2D. Methods: This cross-sectional study was conducted in a sample of 236 participants with T2D (53.4% women, mean age 60 ± 10 years). DNA samples were genotyped for the rs7204609 polymorphism (C/T) in the FTO gene. Clinical, anthropometric, and metabolic data were collected. Path analysis was used to evaluate the associations. Results: Of the sample, 78 individuals with T2D had CKD (33%). Presence of the risk allele (C) was higher among participants with CKD (21.8 vs. 10.8%; p = 0.023). This polymorphism was positively associated with higher waist circumference, which in turn ...
Scientific Reports, 2020
Observational and experimental data reinforce the concept that vitamin D is associated with the p... more Observational and experimental data reinforce the concept that vitamin D is associated with the pathogenesis of arterial hypertension. We investigated the effect of a single dose of 100,000 IU of cholecalciferol, in office blood pressure (BP), and 24-h ambulatory blood pressure monitoring (ABPM) in patients with type 2 diabetes mellitus (DM), hypertension, and hypovitaminosis D. Forty-three patients were randomized to a placebo or cholecalciferol group. BP was assessed by office measurements and 24-h ABPM, before and after intervention. At week 8, a greater decrease in median ABPM values was observed in cholecalciferol supplementation than in the placebo group for systolic 24-h (− 7.5 vs. − 1; P = 0.02), systolic daytime (− 7 vs. − 1; P = 0.007), systolic nighttime (− 7.0 vs. 3; P = 0.009), diastolic 24-h (− 3.5 vs. − 1; P = 0.037), and daytime DBP (− 5 vs. 0; P = 0.01). Office DBP was also reduced after vitamin D supplementation. A single dose of vitamin D3 improves BP in patients ...
Background Evaluation of the resting energy expenditure (REE) is essential to ensure an appropria... more Background Evaluation of the resting energy expenditure (REE) is essential to ensure an appropriate dietary prescription for patients with type 2 diabetes. The aim of this study was to evaluate the accuracy of predictive equations for REE estimation in patients with type 2 diabetes, considering indirect calorimetry (IC) as the reference method.Methods A cross-sectional study was conducted in 62 patients (31 men and 31 women) with type 2 diabetes. Clinical and laboratory variables were evaluated, as well as body composition by electrical bioimpedance. The REE was measured by IC (QUARK RMR, Cosmed, Rome, Italy) and estimated by predictive equations. Data were analyzed using Bland–Altman plots, paired t-tests, and Pearson’s correlation coefficients.Results Patients in the sample had a mean age of 63.1 ± 5.2 years, median diabetes duration of 11 (1–36) years, and mean A1C of 7.6 ± 1.2%. Body composition analysis revealed a mean fat free mass of 35.2 ± 11.8 kg and fat mass of 29.1 ± 8.8 ...
Background: Evaluation of the resting energy expenditure (REE) is essential to ensure an appropri... more Background: Evaluation of the resting energy expenditure (REE) is essential to ensure an appropriate dietary prescription for patients with type 2 diabetes. The aim of this record was to evaluate the accuracy of predictive equations for REE estimation in patients with type 2 diabetes, considering indirect calorimetry (IC) as the reference method.Methods: A cross-sectional study was performed in outpatients with type 2 diabetes. Clinical, body composition by electrical bioimpedance and, laboratory variables were evaluated. The REE was measured by IC (QUARK RMR, Cosmed, Rome, Italy) and estimated by eleven predictive equations. Data were analyzed using Bland–Altman plots, paired t-tests, and Pearson’s correlation coefficients.Results: 62 patients were evaluated [50% female; mean age 63.1 ± 5.2 years; diabetes duration of 11 (1-36) years, and mean A1C of 7.6 ± 1.2%]. There was a wide variation in the accuracy of REE values predicted by equations when compared to IC REE measurement. In ...
Revista de Nutrição, 2020
Objective To evaluate the agreement between the modified version of the Nutritional Risk in the C... more Objective To evaluate the agreement between the modified version of the Nutritional Risk in the Critically Ill Score (without Interleukin-6) and a variant composed of C-Reactive Protein as well as its capacity to predict mortality. Methods A prospective cohort study was carried out with 315 patients in an Intensive Care Unit of a university hospital from October 2017 to April 2018. The agreement between the instruments was evaluated using the Kappa test. The predictive capacity for estimating mortality was assessed with the Receiver Operating Characteristic curve. Results The critical patients involved in the study had a mean age of 60.8±16.3 years and 53.5% were female. Most patients had C-Reactive Protein levels ?10mg/dL (n=263, 83.5%) and their admission in the Intensive Care Unit was medical (n=219, 69.5%). The prevalence of mortality was observed in 41.0% of the evaluated patients. The proportions at high nutritional risk according to Nutritional Risk in the Critically Ill with...
Revista Brasileira de Terapia Intensiva, 2019
O elevado risco nutricional está associado a desfechos desfavoráveis em pacientes internados na u... more O elevado risco nutricional está associado a desfechos desfavoráveis em pacientes internados na unidade de terapia intensiva ARTIGO ORIGINAL INTRODUÇÃO A desnutrição é uma condição frequente em pacientes hospitalizados. (1,2) Ela é ainda mais prevalente em pacientes críticos admitidos a unidades de terapia intensiva (UTIs), considerando que estes frequentemente se encontram em estado hipermetabólico provocado por trauma ou estresse pela enfermidade aguda. (3,4) Sabe-se que a desnutrição se associa a desfechos clínicos desfavoráveis, como aumento da morbidade e mortalidade, maior tempo de permanência no hospital e complicações clínicas, que resultam em aumento dos custos para os sistemas de saúde. (2,5) Uma das estratégias mais eficazes para cuidar de pacientes em alto risco nutricional é a implantação de intervenções nutricionais especializadas. (6-10) Em tais pacientes, o quanto antes o risco nutricional for identificado, garante-se o
Revista de Nutrição, 2018
Objective To evaluate the nutritional status and functional capacity of hospitalized adult patien... more Objective To evaluate the nutritional status and functional capacity of hospitalized adult patients. Methods Cross-sectional study of adult oncology patients at Hospital de Clínicas de Porto Alegre. Patients were evaluated according to Solid Tumors and Hematologic Tumors. The nutritional status was obtained using Patient Generated Subjective Global Assessment, and the functional capacity was evaluated by Handgrip Strength using a Jamar® dynamometer – and the Performance Index of the Eastern Cooperative Oncology Group. Results This study evaluated 76 patients (56±17 years old, 35.5% female), 63.2% with Solid Tumors and 36.8% with Hematologic Tumors. According to the Patient Generated Subjective Global Assessment, 53.9% of the patients were moderately and severely malnourished and demonstrated functional capacity, according to the Handgrip Strength and Performance Index of the Eastern Cooperative Oncology Group, of 47.9% and 32.2%, respectively. The functional capacity instruments sho...
Current Developments in Nutrition, 2019
Objectives To evaluate in Brazilian patients with type 2 diabetes which of the seven predictive e... more Objectives To evaluate in Brazilian patients with type 2 diabetes which of the seven predictive equations selected to estimate basal metabolic rate (BMR) is the best alternative considering calorimetry indirect (CI) as a reference method. Methods A cross-sectional study was conducted with 62 patients (31 men and 31 women) with type 2 diabetes. Clinical and laboratorial variables were evaluated as well as body composition by electrical bioimpedance. The BMR was measured by IC (Analisador MedGraphics Cardiorespiratory Diagnostic Systems, model CCM Express®) and estimated by prediction equations. Dietary intake was evaluated by a food frequency questionnaire (FFQ). Data were analyzed using Bland–Altman plots, paired t-tests, and Pearson's correlation coefficients. Results Our patients were aged 63.1 ± 5.2 years, had diabetes duration of 11 (1–36) years and A1C test 7.6 ± 1.2%. The body composition contained a fat free mass of 35.2 ± 11.8 kg and a fat mass of 29.1 ± 8.8 kg. The ener...
Archives of Endocrinology and Metabolism, 2018
Objective: The present investigation sought to evaluate the potential association between dietary... more Objective: The present investigation sought to evaluate the potential association between dietary fiber intake and blood pressure (BP) in adult patients with type 1 diabetes (T1D). Subjects and methods: A cross-sectional study was carried out in 111 outpatients with T1D from Porto Alegre, Brazil. Patients were predominantly male (56%) and white (88%), with a mean age of 40 ± 10 years, diabetes duration of 18 ± 9 years, BMI 24.8 ± 3.85 kg/m 2 , and HbA1c 9.0 ± 2.0%. After clinical and laboratory evaluation, dietary intake was evaluated by 3-day weighed-diet records, whose reliability was confirmed by 24-h urinary nitrogen output. Patients were stratified into two groups according to adequacy of fiber intake in relation to American Diabetes Association (ADA) recommendations: below recommended daily intake (< 14g fiber/1000 kcal) or at/above recommended intake (≥ 14g/1000 kcal). Results: Patients in the higher fiber intake group exhibited significantly lower systolic (SBP) (115.9 ± 12.2 vs 125.1 ± 25.0 mmHg, p = 0.016) and diastolic blood pressure (DBP) (72.9 ± 9.2 vs 78.5 ± 9.3 mmHg, p = 0.009), higher energy intake (2164.0 ± 626.0 vs 1632.8 ± 502.0 kcal, p < 0.001), and lower BMI (24.4 ± 3.5 vs 26.2 ± 4.8, p = 0.044). Linear regression modelling, adjusted for age, energy intake, sodium intake, and BMI, indicated that higher fiber intake was associated with lower SBP and DBP levels. No significant between-group differences were observed with regard to duration of diabetes, glycemic control, insulin dosage, or presence of hypertension, nephropathy, or retinopathy. Conclusion: We conclude that fiber consumption meeting or exceeding current ADA recommendations is associated with lower SBP and DBP in patients with T1D.
Archives of Endocrinology and Metabolism, 2019
Objectives: The aims of this study are to investigate which of the seven selected predictive equa... more Objectives: The aims of this study are to investigate which of the seven selected predictive equation for estimating basal metabolic rate (BMR) is the best alternative to indirect calorimetry (IC) and to evaluate the dietary energy intake in patients with type 2 diabetes. Subjects and methods: Twentyone patients with type 2 diabetes participated in this diagnostic test study. Clinical and laboratorial variables were evaluated as well as body composition by absorptiometry dual X-ray emission (DXA) and BMR measured by IC and estimated by prediction equations. Dietary intake was evaluated by a quantitative food frequency questionnaire. Data were analyzed using Bland-Altman plots, paired t-tests, and Pearson's correlation coefficients. Results: Patients were 62 (48-70) years old, have had diabetes for 8 (2-36) yeas, and 52.4% were females. The mean body composition comprised a fat-free mass of 49.8 ± 9.4 kg and a fat mass of 28.3 ± 7.2 kg. The energy intake was 2134.3 ± 730.2 kcal/day and the BMR by IC was 1745 ± 315 kcal/day. There was a wide variation in the accuracy of BMR values predicted by equations when compared to IC BMR measurement. Harris-Benedict, Oxford, FAO/WHO/ UNO equations produced the smallest differences to IC, with a general bias of < 8%. The FAO/WHO/ UNO equation provided the best BMR prediction in comparison to measured BMR. Conclusion: In patients with type 2 diabetes, the equation of the FAO/WHO/UNO was the one closest to the BMR values as measured by IC.
Fatores dietéticos têm sido associados positivamente[ácidos graxos(AG)saturados]ou negativamente[... more Fatores dietéticos têm sido associados positivamente[ácidos graxos(AG)saturados]ou negativamente[carne de peixe, AG poliinsaturados(AGPI)]com nefropatia diabética. O objetivo deste estudo foi avaliar associações entre dieta usual e microalbuminúria em pacientes com DM2:119pacientes normoalbuminúricos(NORMO;EUA<20mg/min)e 62microalbuminúricos(MICRO;EUA20-199mg/min)através de registros alimentares-3d com pesagem de alimentos(expressos % energia total).Foram avaliados:IMC, cintura, estilo de vida, perfil glicêmico, lipídico e níveis pressóricos.MICRO tiveram maior idade(60, 9±9, 7vs57, 7±10, 7anos;P<0, 05)e proporção de hipertensão(90%vs73%;P<0, 01)do que NORMO.A proporção de mulheres, duração DM2, estilo de vida, IMC, cintura, níveis pressóricos, perfil glicêmico e lipídico não foram diferentes.Os MICRO apresentaram maior ingestão de proteína(ptn)total(20, 5±4, 4vs19, 0±3, 5%;P=0, 01)com menor ingestão de ptn vegetais(30, 1±8, 7vs34, 1±9, 9%ptn total;P<0, 01), menor consumo de AGPI(8, 6±2, 9vs9, 7±3, 3%;P<0, 03)e de óleos vegetais[0, 20(0, 04-0, 67)vs0, 26(0, 05-0, 94)ml/kg peso/d;P=0, 02]do que NORMO.VET, carboidratos, lipídeos, AG saturados, monoinsaturados, fibras, carnes, leguminosas e lacticínios não foram diferentes entre MICRO e NORMO.Em modelos de regressão logística múltipla(ajuste para idade, sexo, hipertensão e glicemia de jejum)a ingestão de ptn total(OR1,
(orient.) (UFRGS). A Síndrome Metabólica (SM) ocorre em 85% dos pacientes com Diabete Melito tipo... more (orient.) (UFRGS). A Síndrome Metabólica (SM) ocorre em 85% dos pacientes com Diabete Melito tipo 2 (DM2) e está associada à elevada morbimortalidade cardiovascular. O objetivo deste estudo foi avaliar a associação de fatores dietéticos e SM em 214 pacientes com DM2 (60±10 anos, duração do DM 11, 5±8, 2 anos). Foram realizadas avaliações clínica, laboratorial, nutricional e registros alimentares com pesagem de alimentos em 3 dias, cuja adequacidade foi confirmada pela ingestão protéica estimada por uréia urinária de 24h. A composição da dieta foi analisada através do Nutribase 98 Clinical Nutritional Manager V.1. A SM foi definida de acordo com critérios do IDF (International Diabetes Federation, 2005). Pacientes com SM (n=176) tiveram maior proporção de mulheres (55, 1vs.
Diabetology & Metabolic Syndrome, 2015
Revista de Nutrição, 2015
Objective To examine the association between nutritional status and dietary factors in children a... more Objective To examine the association between nutritional status and dietary factors in children and adolescents with cystic fibrosis that are carriers of delta F508 mutation. Methods Cross-sectional study of cystic fibrosis children and adolescents. Nutritional status (body mass index percentile) and dietary intake (3-day diet records presented as a percentage of estimated energy requirement) were assessed. Results Thirty six patients (median of 8.6; interquartile range 6.8-12.5 years; 50% male). The Poisson regression analysis showed that the carriers for delta F508 mutation had 60% lower prevalence ratio of body mass index ≥25° (PR=0.4; 95%IC=0.2-0.8) and 90% lower prevalence ratio (PR=0.1; confidence interval 95%IC=0.02-0.3) of ≥150% of estimated energy requirement when compared with non-delta F508 mutation carriers. The model was adjusted for lung function, estimated energy requirement, and body mass index. Conclusion Carriers for delta F508 mutation showed lower body mass index...
Revista Brasileira de Terapia Intensiva, 2015
Objective: To systematically review the main methods for nutritional risk assessment used in crit... more Objective: To systematically review the main methods for nutritional risk assessment used in critically ill cancer patients and present the methods that better assess risks and predict relevant clinical outcomes in this group of patients, as well as to discuss the pros and cons of these methods according to the current literature. Methods: The study consisted of a systematic review based on analysis of manuscripts retrieved from the PubMed, LILACS and SciELO databases by searching for the key words "nutritional risk assessment", "critically ill" and "cancer". Results: Only 6 (17.7%) of 34 initially retrieved papers met the inclusion criteria and were selected for the review. The main outcomes of these studies were that resting energy expenditure was associated with undernourishment and overfeeding. The high Patient-Generated Subjective Global Assessment score was significantly associated with low food intake, weight loss and malnutrition. In terms of biochemical markers, higher levels of creatinine, albumin and urea were significantly associated with lower mortality. The worst survival was found for patients with Conflicts of interest: None.
British Journal of Nutrition, 2011
The role of each Dietary Approaches to Stop Hypertension (DASH) diet component in blood pressure ... more The role of each Dietary Approaches to Stop Hypertension (DASH) diet component in blood pressure (BP) of patients with diabetes is still uncertain. The aim of the present study was to evaluate possible associations of the recommended food groups of the DASH diet eating plan with BP values in patients with type 2 diabetes. In the present cross-sectional study, 225 patients with type 2 diabetes (age 61·1 (sd10·4) years; diabetes duration 13·1 (sd9·1) years; males 48·4 %; BMI 28·5 (sd4·3) kg/m2; HbA1c 7·1 (sd1·3) %; systolic BP 136·7 (sd20·0) mmHg; diastolic BP 78·4 (sd11·8) mmHg) without dietary counselling during the previous 6 months had their dietary intake assessed by 3 d weighed-diet records. Patients were divided into two groups according to BP tertiles: LOW BP (first tertile) and HIGH BP (second plus third tertiles). Multivariate logistic regression models demonstrated that the daily intake of 80 g of fruits per 4184 kJ (1000 kcal) (OR 0·781; 95 % CI 0·617, 0·987;P = 0·039) or ...
British Journal of Nutrition, 2013
A diet rich in fibre seems to protect against the metabolic syndrome (MetS), but there is scarce ... more A diet rich in fibre seems to protect against the metabolic syndrome (MetS), but there is scarce information about the role of fibre intake in patients with the MetS and diabetes. The aim of the present study was to evaluate the effects of soluble fibre from partially hydrolysed guar gum (PHGG) on the MetS and cardiovascular risk factors in patients with type 2 diabetes. In the present randomised controlled clinical trial, forty-four patients with type 2 diabetes (males 38·6 %, age 62 (sd9) years, diabetes duration 14·2 (sd9·6) years) and the MetS underwent clinical, laboratory and dietary evaluations at baseline, 4 and 6 weeks. All patients followed their usual diet and the intervention group (n23) received an additional 10 g/d of PHGG. In the intervention group, waist circumference (WC), glycated Hb (HbA1c), 24 h urinary albumin excretion (UAE) and serumtrans-fatty acids (FA) were reduced in comparison with baseline after 4 and 6 weeks: WC 103·5 (sd9·5) to 102·1 (sd10) to 102·3 (s...
Journal of Renal Nutrition, 2012
Single nucleotide polymorphisms (SNPs) in the fat mass and obesity-associated (FTO) gene, especia... more Single nucleotide polymorphisms (SNPs) in the fat mass and obesity-associated (FTO) gene, especially the common rs9939609 (A/T) SNP, are associated with body mass index (BMI), diabetes, and metabolic syndrome (MetS). MetS is highly prevalent in patients with type 2 diabetes and has been associated with chronic diabetic complications. Therefore, the aim of this study was to evaluate possible associations of the scarcely investigated rs7204609 (C/T) polymorphism, as well as the rs9939609 (A/T) polymorphism, with MetS and chronic diabetic complications in type 2 diabetic patients from Southern Brazil. This was a cross-sectional study. A total of 236 patients with type 2 diabetes (age: 60.0 ± 10.3 years; diabetes duration: 12.7 ± 8.2 years; 53.4% women) were genotyped for the FTO rs7204609 and rs9939609 polymorphisms (ABI PRISM 7000 Real-Time PCR System). Patients underwent clinical, laboratory, and nutritional evaluation. MetS was defined according to the 2009-Joint Interim Statement. Carriers of C allele of the rs7204609 polymorphism (CT/CC genotypes, n = 35) were at increased risk for the presence of MetS (odds ratio [OR] = 4.56; 95% CI: 1.04 to 19.9), elevated waist circumference (OR = 8.66; 95% CI: 1.12 to 66.7), BMI: ≥ 30 kg/m(2) (OR = 3.71; 95% CI: 1.71 to 8.02), and microalbuminuria (OR = 2.30; 95% CI: 1.08 to 4.88), adjusted for gender and diabetes duration (P…
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Papers by Thais Steemburgo