Diet adherence in elderly patients with metabolic syndrome treated by the Family Health Strategy: frequency and association with depression
DOI:
https://doi.org/10.15448/1980-6108.2016.3.22956Keywords:
elderly, metabolic syndrome X, feeding behavior, depression, primary health care.Abstract
Aims: To describe diet adherence and to analyze its association with depression in elderly patients with metabolic syndrome treated by the Family Health Strategy.
Methods: Cross-sectional study including elderly patients with metabolic syndrome diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria who participated in the Epidemiological and Clinical Study of Elderly Individuals Treated by the Family Health Strategy in Porto Alegre, Brazil. A questionnaire developed by the researchers based on the recommendations of the I Brazilian Guideline for Metabolic Syndrome was used to evaluate compliance with eight possible dietary guidelines provided by health professionals (intake of "whole foods", "sweets", "sugar", "fruits/vegetables/legumes", "salt", "fatty foods/fried foods", "processed foods" and "fish"). Diet adherence was considered when an individual followed all dietary guidelines (regardless of their number, which ranged from one to eight). The diagnosis of depression was based on the Mini International Neuropsychiatric Interview instrument, used by psychiatrists.
Results: A total of 109 elderly patients were included in the study, most of whom were female (67.9%). The mean age was 68.4±6.6 years (61-90 years). Thirty-seven elderly patients (33.9%) were considered adherent to the diet. Lower salt intake was the dietary guidance with greater adherence (89.1%) while the consumption of whole foods exhibited less adherence (59.7%). There was no association of diet adherence with sociodemographic and clinical parameters and with metabolic syndrome components. The frequency of adherence to the recommendation against the consumption of sugar and sweets was significantly lower among individuals with depression (43.9% and 34.9%, respectively; p = 0.001).
Conclusions: Diet adherence occurred in one third of elderly patients with metabolic syndrome treated at the primary health care level. There was lower adherence to the recommendation against the consumption of sweets and sugar in individuals diagnosed with depression.
Downloads
References
World Health Organization. Global status report on noncommunicable diseases. [Internet]. Geneva: WHO; 2014 [cited 2016 Jan 18]. Available from: http://apps.who.int/iris/bitstream/10665/148114/1/9789241564854_eng.pdf
Ferro MA. Major depressive disorder, suicidal behaviour, bipolar disorder, and generalized anxiety disorder among emerging adults with and without chronic health conditions. Epidemiol Psychiatr Sci. 2015 Sep 8:1-13. http://dx.doi.org/10.1017/S2045796015000700
Rodrigues GHP, Gebara OCE, Gerbi CCS, Pierri P, Wajngarten M. Depressão como determinante clínico de dependência e baixa qualidade de vida em idosos cardiopatas. Arq Bras Cardiol. 2015;104(6):443-9.
I Diretriz Brasileira de Diagnóstico e Tratamento da Síndrome Metabólica. Arq Bras Cardiol. 2005;84(Supl 1):1-28. http://dx.doi.org/10.1590/S0066-782X2005000100001
Grundy SM. Metabolic syndrome update. Trends Cardiovasc Med. [In Press] Dallas; 2015 [cited 2016 Jan 18]. Available from: http://www.sciencedirect.com/science/article/pii/S1050173815002492
Soares TS, Haas C, Gustavo AS, Macagnan FE, Bodanese LC, Feoli AMP. Hábitos alimentares, atividade física e Escore de Risco Global de Framingham na síndrome metabólica. Arq Bras Cardiol. 2014;102(4):374-82. http://dx.doi.org/10.5935/abc.20140029
World Health Organization. Defining Adhrence. In: World Health Organization. Adhrence to long-term therapies: evidence for action. Geneva: WHO; 2003. p. 192-4.
Organización Mundial de La Salud. Delimitación del problema In: Organización Panamericana de La Salud. Adherencia a lós tratamentos a largo plazo: pruebas para la acción. Washington: OMS; 2004. p. 3-47.
Boas LCGV, Foss MC, Foss-Freitas MCF, Torres HC, Monteiro LZ, Pace AE. Adesão à dieta e ao exercício físico das pessoas com diabetes mellitus. Texto Contexto Enferm. 2011;20(2):272-9. http://dx.doi.org/10.1590/S0104-07072011000200008
Gillen MM, Markey CN, Markey PM. An examination of dieting behaviors among adults: links with depression. Eat Behav. 2012 Apr;13(2):88-93. http://dx.doi.org/10.1016/j.eatbeh.2011.11.014
Moraes AL, Almeida EC, Souza LB. Percepções de obesos deprimidos sobre os fatores envolvidos na manutenção da sua obesidade: investigação numa unidade do Programa Saúde da Família no município do Rio de Janeiro. Physis. 2013;23(2):553-72. http://dx.doi.org/10.1590/S0103-73312013000200012
Gomes I, Nogueira EL, Engroff P, Ely LS, Schwanke CHA, De Carli GA. The multidimensional study of the elderly in the family health strategy in Porto Alegre, Brazil (EMI-SUS). Pan Am J Aging Res. 2013;1(1):20-4.
Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001 May 16;285(19):2486-97. http://dx.doi.org/10.1001/jama.285.19.2486
Jacondino CB. Adesão ao tratamento medicamentoso e não medicamentoso em idosos portadores de síndrome metabólica acompanhados na Estratégia Saúde da Família [dissertação]. [Porto Alegre]: Pontifícia Universidade Católica do Rio Grande do Sul; 2013. 139 p.
Lipschitz DA. Screening for nutritional status in the elderly. Prim Care. 1994 Mar;21(1):55-67.
Sociedade Brasileira de Patologia Clínica. Recomendações da Sociedade Brasileira de Patologia Clínica. Medicina laboratorial para coleta de sangue venoso. 2ª ed. Barueri: Manole; 2009.
Sociedade Brasileira de Cardiologia. VI Diretrizes Brasileiras de Hipertensão. Arq Bras Cardiol. 2010;95(supl.1):1-51.
American Psychiatric Association Committee on Nomenclature and Statistics Diagnostics. Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). 4th ed. Washington DC; 1994.
Rodriguez GMJ, Castillo AF. Enfermeras y adherencia farmacológica: discurso y conducta. Index Enferm. 2011;20(3):160-4. http://dx.doi.org/10.4321/S1132-12962011000200005
Fuemmeler BF, Agurs-Collins T, McClernon FJ, Kollins SH, Garrett ME, Ashley-Koch AE. Interactions between genotype and depressive symptoms on obesity. Behav Genet. 2009 May;39(3):296-305. http://dx.doi.org/10.1007/s10519-009-9266-z
Mu-oz-Pareja M, León-Mu-oz LM, Guallar-Castillón P, Graciani A, López-García E, Banegas JR, Rodríguez-Artalejo F. The diet of diabetic patients in Spain in 2008-2010: accordance with the main dietary recommendations--a cross-sectional study. PLoS One. 2012;7(6):e39454. http://dx.doi.org/10.1371/journal.pone.0039454
Zanetti ML, Arrelias CCA, Franco RC, Santos MA, Rodrigues FFL, Faria HTG. Adesão às recomendações nutricionais e variáveis sócio demográficas em pacientes com diabetes mellitus. Rev Esc Enferm USP. 2015;49(4):619-25. http://dx.doi.org/10.1590/S0080-623420150000400012
Dourado CS, Costa KNF, Oliveira JS, Leadebal ODC, Silva LS. Adesão ao tratamento de idosos com hipertensão arterial em uma unidade básica de saúde de João Pessoa PB. Acta Sci Health. 2011;33(1):9-17.
Nolte AO. Associação entre hábitos saudáveis e alimentares, estado nutricional e percepção de saúde dos idosos [dissertação]. [Porto Alegre]: Pontifícia Universidade Católica do Rio Grande do Sul; 2011. 98p.
Tavares NUL, Bertoldi AD, Thume E, Facchini, LA, Franca GVA, Mengue, SS. Fatores associados a baixa adesão ao tratamento medicamentoso em idosos. Rev Saúde Publ. 2013;47(6):1092-101. http://dx.doi.org/10.1590/S0034-89102013000901092
Leão JM, Lisboa LCV, Pereira MAL, Freitas L, Lacerda KC, Elias MAR. Estágios motivacionais para mudança de comportamento em indivíduos que iniciam tratamento para perda de peso. J Bras Psiquiatr. 2015;64(2):107-14. http://dx.doi.org/10.1590/0047-2085000000065
Arruda DCJ, Eto FN, Velten APC, Morelato RL, Oliveira ERA. Fatores associados a não adesão medicamentosa entre idosos de um ambulatório filantrópico do Espírito Santo. Rev Bras Geriat Gerontol. 2015;18(2):327-37. http://dx.doi.org/10.1590/1809-9823.2015.14074
Pontieri FM, Bachion MM. Crenças de pacientes diabéticos acerca da terapia nutricional e sua influência na adesão. Ciên Saúde Colet. 2010;15(1):151-60 http://dx.doi.org/10.1590/S1413-81232010000100021
Koehnlein EA, Salado GA, Yamado, NA. Adesão à reeducação alimentar para a perda de peso: determinantes, resultados e a percepção do paciente. Rev Bras Nutr Clin. 2008;23(1):56-65.
Busnello FM, Bodanese LC, Pellanda LC, Santos ZEA. Intervenção nutricional e o impacto na adesão ao tratamento em pacientes com síndrome metabólica. Arq Bras Cardiol. 2011;97(3):217-24. http://dx.doi.org/10.1590/S0066-782X2011005000077
Vieira CM, Cordeiro SN; Magdaleno Júnior R, Turato ER. Significados da dieta e mudanças de hábitos para portadores de doenças metabólicas crônicas: uma revisão. Ciên Saúde Colet. 2011,16(7):3161-8. http://dx.doi.org/10.1590/S1413-81232011000800016
Jeffery RW, Linde JA, Simon GE, Ludman EJ, Rohde P, Ichikawa LE, Finch EA. Reported food choices in older women in relation to body mass index and depressive symptoms. Appetite. 2009 Feb;52(1):238-40. http://dx.doi.org/10.1016/j.appet.2008.08.008
Konttinen H, Männistö S, Sarlio-Lähteenkorva S, Silventoinen K, Haukkala A. Emotional eating, depressive symptoms and self-reported food consumption. A population-based study. Appetite. 2010 Jun;54(3):473-9. http://dx.doi.org/10.1016/j.appet.2010.01.014
Rahe C, Baune BT, Unrath M, Arolt V, Wellmann J, Wersching H, Berger K. Associations between depression subtypes, depression severity and diet quality: cross sectional findings from the BiDirect Study. BMC Psychiatry. 2015 Mar 4;15:38. http://dx.doi.org/10.1186/s12888-015-0426-9
Feijó FM, Bertolucci MC, Reis C. Serotonina e controle hipotalâmico da fome: uma revisão. Rev Assoc Med Bras. 2011;57(1):74–7. http://dx.doi.org/10.1590/S0104-42302011000100020
Jacondino CB, Gottlieb MGV. Oxytocin and chronic noncommunicable diseases: on overview of oxytocin receptor gene (OXTR) polymorphisms and the thrifty phenotype hypothesis. In: Anderson E, editors. Advances in oxytocin research: pharmacology - research, safety, testing and regulation. Nova York: Nova Science Publishers; 2015. p. 1-34.
Agurs-Collins T, Fuemmeler BF. Dopamine polymorphisms and depressive symptoms predict foods intake: results from a nationally representative sample. Appetite. 2011 Oct;57(2):339-48. http://dx.doi.org/10.1016/j.appet.2011.05.325
Bassi N, Karagodin I, Wang S, Vassallo P, Priyanath A, Massaro E, Stone NJ. Lifestyle modification for metabolic syndrome: a systematic review. Am J Med. 2014 Dec;127(12):1242.e1-10. http://dx.doi.org/10.1016/j.amjmed.2014.06.035
Durrani S, Irvine J, Nolan RP. Psychosocial determinants of health behaviour change in an counseling intervention for hypertension. Int J Hypertens. 2012;2012:191789.
Downloads
Published
How to Cite
Issue
Section
License
Copyright
The submission of originals to Scientia Medica implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Scientia Medica as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
