Consumo de alimentos y factores relacionados con la variación de peso en pacientes con Enfermedad Hepática Grasa no Alcohólica durante la pandemia de COVID-19
DOI:
https://doi.org/10.33448/rsd-v10i16.24261Palabras clave:
Enfermedad Hepática Grasa no Alcohólica; Dieta; Consumo de Energía; Aumento de Peso; COVID-19.Resumen
Este estudio longitudinal investigó el consumo de alimentos longitudinal y factores relacionados con la variación de peso en 81 pacientes adultos con Enfermedad Hepática Grasa no Alcohólica (EHGNA) durante la pandemia COVID-19. Datos sociodemográficos, antropométricos, de actividad física y consumo alimentario fueron recogidos durante dos períodos: antes y durante la pandemia. Para el análisis, las variaciones de peso se dividieron en dos categorías: aumento de peso menor o igual a dos kilos y aumento de peso mayor que dos kilos. La prueba de Mann Whitey fue utilizada para verificar la diferencia entre las medianas, el coeficiente de correlación de Spearman para calcular correlaciones y prueba exacta de Fisher para evaluar asociaciones. El nivel de significancia adoptado en la decisión de las pruebas fue del 5%. Los resultados mostraron aumento en el consumo de alimentos procesados y ultraprocesados entre pacientes con EHGNA, junto con la reducción en el consumo de alimentos naturales o mínimamente procesados. Ambos hallazgos fueron más frecuentes entre pacientes que presentaron aumento de peso superior a dos kilogramos. Sin embargo, el análisis de la composición nutricional de las dietas de los pacientes reveló aumentos en el consumo de carbohidratos como el único factor significativamente correlacionado con el aumento de peso. Hubo un alto porcentaje de individuos que no practicaron ejercicio físico antes de la pandemia, y ese número fue exacerbado durante el aislamiento domiciliario. Por lo tanto, se observa que los pacientes con EHGNA tienen dificultades para mantener un estilo de vida saludable y estas dificultades empeoraron durante la pandemia, lo que refleja el aumento de peso. Por lo tanto, se sugiere que la asistencia nutricional especializada se dirija a los pacientes con EHGNA, ya que tienen un mayor riesgo de progresión hacia formas más graves de COVID-19.
Citas
Ammar, A., Brach, M., Trabelsi, K., Chtourou, H., Boukhris, O., Masmoudi, L. & Hoekelmann, A. (2020). Effects of COVID-19 Home Confinement on Eating Behaviour and Physical Activity: Results of the ECLB-COVID19 International Online Survey. Nutrients, 12(6), 1583. 10.3390/nu12061583
Aquino, E. M. L., Silveira, I. H., Pescarini, J. M., Aquino, R., Souza-Filho, J. A., Rocha, A. S. & Lima, R. T. R. S. (2020). Social distancing measures to control the COVID-19 pandemic: potential impacts and challenges in Brazil. Ciência e Saúde Coletiva 25(suppl 1), 1678-4561. 10.1590/1413-81232020256.1.10502020
Arab, J. P., Dirchwolf, M., Álvares-da-Silva M. R., Barrera, F., Benítez, C., Castellanos-Fernandez, M. & Arrese, M. (2020). Latin American Association for the study of the liver (ALEH) practice guidance for the diagnosis and treatment of non-alcoholic fatty liver disease. Annals of Hepatology, 19(6), 674-690. 10.1016/j.aohep.2020.09.006
Avelino, G. F., Previdelli, N. A., Castro, M. A., Marchioni, D. M. L., & Fisberg, R. M. (2014). Sub-relato da ingestão energética e fatores associados em estudo de base populacional. Cadernos de Saúde Pública, 30(3), 663-668. http://dx.doi.org/10.1590/0102-311X00073713
Bahrami, A., Teymoori, F., Eslamparast, T., Sohrab, G., Hejazi, E., Poustchi, H., & Hekmatdoost, A. (2019). Legume intake and risk of nonalcoholic fatty liver disease. Indian Journal Gastroenteroly, 38(1), 55-60. 10.1007/s12664-019-00937-8
Bezerra, A. C. V., da Silva, C. E. M., Soares, F. R. G. et al. (2020). Factors associated with people’s behavior in social isolation during the covid-19 pandemic. Ciência e Saúde Coletiva, 25(suppl 1), 2411-2421. 10.1590/1413-81232020256.1.10792020
Bischoff, S. C., Bernal, W., Dasarathy, S., Merli, M., Plank, L. D., Schütz, T., & Plauth, M. (2020). ESPEN practical guideline: Clinical nutrition in liver disease. Clinical Nutrition, 39(12), 3533-3562. 10.1016/j.clnu.2020.09.001
Brazilian Association for the Study of Obesity and Metabolic Syndrome (2016) Brazilian obesity guidelines. 4ed. São Paulo: ABESO. Available in: https://abeso.org.br/wp-content/uploads/2019/12/Diretrizes-Download-Diretrizes-Brasileiras-de-Obesidade-2016.pdf
Brazilian Ministry of Health (1996). National Institute of Food and Nutrition. Special Programs Secretariat. Photographic record for dietary surveys – utensils and servings. Brazilian Ministry of Health.
Brazilian Ministry of Health (2021). Coronavirus Panel [Internet]. Available in: https://covid.saude.gov.br/. Accessed: November 2021.
Buzzard, M. (1998). 24-hours dietary recall and food record methods. In: Willett WC. Nutritional Epidemiology. 2ed. Oxford: Oxford University Press.
Calder, P. C., Carr, A. C., Gombart, A. F., & Eggersdorfer, M. (2020). Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients, 12(4), 1181. 10.3390/nu12041181
Carvalho, A. M., Piovezan, L. G., Selem, S. S. C., Fisberg, R. M., & Marchioni, D. M. (2014) Validation and calibration of self-reported weight and height from individuals in the city of São Paulo. Revista Brasileira de Epidemiologia, 17(3), 735-46. 10.1590/1809-4503201400030013
Chalasani, N., Younossi, Z., Lavine, J. E., Charlton, M., Cusi, K., Rinella, M., Harrison, S.A., Brunt, E. M., & Arun, J. S. (2018). The diagnosis and management of nonalcoholic fatty liver disease: practice guidance from the American Association for the Study of Liver Diseases. Hepatology, 67(1), 328–357. 10.1002/hep.29367
Chen, S. M, Liu, C. Y., Li, S. R., Huang, H. T., Tsai, C. Y., & Jou, H. J. (2008). Effects of therapeutic lifestyle program on ultrasound-diagnosed nonalcoholic fatty liver disease. Journal of the Chinese Medical Association, 71(11), 551-558. 10.1016/S1726-4901(08)70168-0
Chenarides, L., Grebitus, C., Lusk, J. L., & Printezis, I. (2020). Food consumption behavior during the COVID-19 pandemic. Agribusiness, 37, 44-81. 10.1002/agr.21679
Chesnut, W. M., MacDonald, S., & Wambier, C. G. (2021). Could diet and exercise reduce risk of COVID-19 syndemic? Medical hypotheses, 148(110502). 10.1016/j.mehy.2021.110502
Costa, C. D. S., Steele, E. M., Leite, M. A., Rauber, F., Levy, R. B., & Monteiro, C. A. (2020). Body weight changes in the NutriNet Brasil cohort during the covid-19 pandemic. Revista de Saúde Pública, 55(1), 1518-8787. 10.11606/s1518-8787.2021055003457
De Carvalho, M. H. C. (2005). I Brazilian guideline for the diagnosis and treatment of metabolic syndrome. Arquivos brasileiros de cardiologia, 84(1), 1-28.
Estes, C., Razavi, H., Loomba, R., Younossi, Z., & Sanyal, A. J. (2018). Modeling the epidemic of nonalcoholic fatty liver disease demonstrates an exponential increase in burden of disease. Hepatology, 67(1), 23–133. 10.1002/hep.29466
Hall, K. D., Ayuketah, A., Brychta, R., Cai, H., Cassimatis, T., Chen, K. Y. & Zhou, M. (2019). Ultra-Processed Diets Cause Excess Calorie Intake and Weight Gain: An Inpatient Randomized Controlled Trial of Ad Libitum Food Intake. Cell Metabolism, 30(1), 67-77. 10.1016/j.cmet.2019.05.008.
Harttig, U., Haubrock, J., Knüppel, S., Boeing, H.; & EFCOVAL Consortium. (2011). The MSM program: web-based statistics package for estimating usual dietary intake using the Multiple Source Method. European Journal of Clinical Nutrition, 65 Suppl 1:S87-9. 10.1038/ejcn.2011.92
Hegyi, P. J., Váncsa, S., Ocskay, K., Dembrovszky, F., Kiss, S., Farkas, N. & Pár, G. (2021). Metabolic Associated Fatty Liver Disease Is Associated With an Increased Risk of Severe COVID-19: A Systematic Review With Meta-Analysis. Frontiers in medicine, 8, 626425. 10.3389/fmed.2021.626425
Huang, R., Zhu, L., Wang, J., Xue, L., Liu, L., Yan, X. & Wu, C. (2020). Clinical features of patients with COVID-19 with nonalcoholic fatty liver disease. Hepatology Communications, 4(12), 1758–1768. https://doi.org/10.1002/hep4.1592
Iaccarino Idelson, P., Rendina, D., Strazzullo, P. (2021). Nutrition and the Covid-19 pandemic: Three factors with high impact on community health. Nutrition, metabolism, and cardiovascular diseases, 31(3), 756–761. https://doi.org/10.1016/j.numecd.2020.12.001
Institute of Medicine of the National Academics. (2000). Dietary Reference Intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington DC: National Academy Press.
Institute of Medicine of the National Academics. (2001). Dietary Reference Intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington DC: National Academy Press.
Institute of Medicine of the National Academics. (2005). Dietary references intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein, and amino acids. Journal of the American Dietetic Association, 102(11), 1621–1630. https://doi.org/10.1016/s0002-8223(02)90346-9
Institute of Medicine of the National Academics. (2011). Dietary Reference Intakes for calcium and vitamin D. Washington DC: National Academy Press.
Izar, M., Lottenberg, A. M., Giraldez, V., Santos Filho, R., Machado, R. M., Bertolami, A. & Machado, V. A. (2021) Position Statement on Fat Consumption and Cardiovascular Health. Arquivos brasileiros de cardiologia, 116(1), 160–212. https://doi.org/10.36660/abc.20201340
Johns Hopkins University (2021). Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU) https://coronavirus.jhu.edu/map.html.
Kaya, S., Uzdil, Z., & Cakiroğlu, F.P. (2021) Evaluation of the effects of fear and anxiety on nutrition during the COVID-19 pandemic in Turkey. Public health nutrition, 24(2), 282–289. https://doi.org/10.1017/S1368980020003845
Lohman, T. G., Roche, A. F., & Martorell, R. (1988). Anthropometric standardization reference manual. Human Kinetics Books.
Mahady, S. E., & George, J. (2018). Predicting the future burden of NAFLD and NASH. Journal of hepatology, 69(4), 774–775. https://doi.org/10.1016/j.jhep.2018.06.025
Malta, D. C., Szwarcwald, C. L., Barros, M., Gomes, C. S., Machado, Í. E., Souza Júnior, P. & Gracie, R. (2020). The COVID-19 Pandemic and changes in adult Brazilian lifestyles: a cross-sectional study, 2020. Epidemiologia e serviços de saúde: revista do Sistema Único de Saúde do Brasil, 29(4), e2020407. https://doi.org/10.1590/S1679-49742020000400026
Marty, L., de Lauzon-Guillain, B., Labesse, M., & Nicklaus, S. (2021). Food choice motives and the nutritional quality of diet during the COVID-19 lockdown in France. Appetite, 157, 105005. https://doi.org/10.1016/j.appet.2020.105005
Maynard, D. C., Anjos, H. D., Magalhães, A. V. Grimes, L. N., Costa, M. G. O., & Santos, R. B. (2020). Food consumption and anxiety among the adult population during the COVID-19 pandemic in Brazil. Research, Society and Development, 9(11), e4279119905. 10.33448/rsd-v9i11.9905.
McClave, S. A, Taylor, B. E, Martindale, R. G, Warren, M. M, Johnson, D. R, Braunschweig, C., & Mckeever, L. (2016). American Society for Parenteral and Enteral Nutrition. Guidelines for the Provision and Assessment of Nutrition Support Therapy in the Adult Critically Ill Patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.). Journal of Parenteral and Enteral Nutrition, 40(2), 159-211. 10.1002/jpen.2267
Mirizzi, A., Franco, I., Leone, C.M., Bonfiglio, C., Cozzolongo, R., Notarnicola, M. & Osella, (2019). A. R. Effects of Some Food Components on Non-Alcoholic Fatty Liver Disease Severity: Results from a Cross-Sectional Study. Nutrients, 11(11), 2744. 10.3390/nu11112744. PMID: 31726714.
Monteiro, A. C., Pfrimer, K., Tremeschin, M. H., Molina, M. C., Chiarello, P., & Vannucchi, H. (2007). Consumo Alimentar: Visualizando Porções. 1ed. Rio de Janeiro: Guanabara Koogan.
Monteiro, C. A., Cannon, G., Moubarac, J. C., Levy, R. B., Louzada, M. L. C., & Jaime, P. C. (2018). The UN Decade of Nutrition, the NOVA food classification and the trouble with ultra-processing. Public Health Nutrition, 21(1), 5-17. https://doi.org/10.1017/S1368980017000234
Moreb, N. A., Albandary, A., Jaiswal, S., & Jaiswal, A. K. (2021). Fruits and Vegetables in the Management of Underlying Conditions for COVID-19 High-Risk Groups. Foods, 10(2), 389. https://doi.org/10.3390/foods10020389
Moshfegh, A. J., Rhodes, D. G., Baer, D. J., Murayi, T., Clemens, J. C., Rumpler, W. V. & Cleveland, L. E. (2008). The US Department of Agriculture Automated Multiple-Pass Method reduces bias in the collection of energy intakes. The American Journal of Clinical Nutrition, 88(2), 324-332. 10.1093/ajcn/88.2.324
Murphy, B., Benson, T., McCloat, A., Mooney, E., Elliott, C., Dean, M., & Lavelle, F. (2020). Changes in Consumers' Food Practices during the COVID-19 Lockdown, Implications for Diet Quality and the Food System: A Cross-Continental Comparison. Nutrients, 13(1), 20. https://doi.org/10.3390/nu13010020
Natividade, M., Bernardes, K., Pereira, M., Miranda, S. S., Bertoldo, J., Teixeira, M., Livramento, H. L., & Aragão, E. (2020). Social distancing and living conditions in the pandemic COVID-19 in Salvador-Bahia, Brazil. Ciência & saúde coletiva, 25(9), 3385–3392. https://doi.org/10.1590/1413-81232020259.22142020
Oliveira, L. P. M., Queiroz, V. A. O., Silva, M. C. M. P., Pitangueira, J. C. D., Costa, P. R. F., Demétrio, F., Anjos, M. C. G., & Assis, A. M. O. (2012). Validity of the body mass index calculated from self-reported values for the classification of anthropometric status in adults: validation study with residents in the municipality of Salvador, state of Bahia, Brazil. Epidemiologia e Serviços de Saúde, 21(2), 325-332. https://dx.doi.org/10.5123/S1679-49742012000200015
Portincasa, P., Krawczyk, M., Smyk, W., Lammert, F., & Di Ciaula, A. (2020). COVID-19 and non-alcoholic fatty liver disease: Two intersecting pandemics. uropean journal of clinical investigation, 50(10), e13338. https://doi.org/10.1111/eci.13338
Poti, J. M., Braga, B., & Qin, B. (2017). Ultra-processed Food Intake and Obesity: What Really Matters for Health-Processing or Nutrient Content? Current Obesity Reports, 6(4), 420-431. 10.1007/s13679-017-0285-4
Preuss, H. G., Kaats, G. R., Mrvichin, N., Swaroop, A., Bagchi, D., Clouatre, D., & Preuss, J. M. (2018). Examining the Relationship Between Nonalcoholic Fatty Liver Disease and the Metabolic Syndrome in Nondiabetic Subjects. Journal of the American College of Nutrition, 37(6), 457–465. https://doi.org/10.1080/07315724.2018.1443292
Ribeiro-Silva, R. C., Pereira, M., Campello, T., Aragão, É., Guimarães, J., Ferreira, A. J., Barreto, M. L., & Santos, S. (2020). Covid-19 pandemic implications for food and nutrition security in Brazil. Implicações da pandemia COVID-19 para a segurança alimentar e nutricional no Brasil. Ciência & saúde coletiva, 25(9), 3421–3430. https://doi.org/10.1590/1413-81232020259.22152020
Rodrigues, M. B., Matos, J. P., & Horta, P. M. (2021). The COVID-19 pandemic and its implications for the food information environment in Brazil. Public health nutrition, 24(2), 321–326. https://doi.org/10.1017/S1368980020004747
Ruiz-Roso, M. B., Knott-Torcal, C., Matilla-Escalante, D. C., Garcimartín, A., Sampedro-Nuñez, M. A., Dávalos, A., & Marazuela, M. (2020). COVID-19 Lockdown and Changes of the Dietary Pattern and Physical Activity Habits in a Cohort of Patients with Type 2 Diabetes Mellitus. Nutrients, 12(8), 2327. https://doi.org/10.3390/nu12082327
Salehi-Sahlabadi, A., Sadat, S., Beigrezaei, S., Pourmasomi, M., Feizi, A., Ghiasvand, R., Hadi, A., Clark, C., & Miraghajani, M. (2021). Dietary patterns and risk of non-alcoholic fatty liver disease. BMC gastroenterology, 21(1), 41. https://doi.org/10.1186/s12876-021-01612-z
Sanyal, A. J., Brunt, E. M., Kleiner, D. E., Kowdley, K. V., Chalasani, N., Lavine, J. E., Ratziu, V., & McCullough, A. (2011). Endpoints and clinical trial design for nonalcoholic steatohepatitis. Hepatology, 54(1), 344–353. 10.1002/hep.24376
Singh, A., Hussain, S., & Antony, B. (2021). Non-alcoholic fatty liver disease and clinical outcomes in patients with COVID-19: A comprehensive systematic review and meta-analysis. Diabetes & metabolic syndrome, 15(3), 813–822. https://doi.org/10.1016/j.dsx.2021.03.019
Steele, E. M., Rauber, F., Costa, C., Leite, M. A., Gabe, K. T., Louzada, M., Levy, R. B., & Monteiro, C. A. (2020). Dietary changes in the NutriNet Brasil cohort during the covid-19 pandemic. Revista de saúde pública, 54, 91. https://doi.org/10.11606/s1518-8787.2020054002950
Thomaz, P. M., Silva, E. F., & Costa, T. H. (2013). Validity of self-reported height, weight and body mass index in the adult population of Brasilia, Brazil. Brazilian journal of epidemiology, 16(1), 157–169.
Tutunchi, H., Saghafi-Asl, M., Asghari-Jafarabadi, M., & Ostadrahimi, A. (2021). Association between Dietary Patterns and Non-alcoholic Fatty Liver Disease: Results from a Case-Control Study. The Archives of Iranian Medicine, 24(1), 35-42. 10.34172/aim.2021.06
Verly Junior, E., Cesar, C. L., Fisberg, R. M., & Marchioni, D. M. (2013). Variância intrapessoal da ingestão de energia e nutrientes em adolescentes: correção de dados em estudos epidemiológicos. Revista Brasileira de Epidemiologia, 16(1), 170-177. https://doi.org/10.1590/S1415-790X2013000100016
Wang, C., Horby, P. W., Hayden, F. G., & Gao, G. F. (2020). A novel coronavirus outbreak of global health concern. Lancet, 395(10223), 470–473. https://doi.org/10.1016/S0140-6736(20)30185-9
Werneck, A. O., Silva, D. R., Malta, D. C., Gomes, C. S., Souza-Júnior, P. R., Azevedo, L. O., Barros, M. B., & Szwarcwald, C. L. (2021). Associations of sedentary behaviours and incidence of unhealthy diet during the COVID-19 quarantine in Brazil. Public health nutrition, 24(3), 422–426. https://doi.org/10.1017/S1368980020004188
Willett, W. C. & Stampfer, M. J. (1986). Total energy intake: implieations for epidemiologieal analyses. American Journal of Epidemiology, 124(1), 17-27. 10.1093/oxfordjournals.aje.a114366.
Williamson, E. J., Walker, A. J., Bhaskaran, K., Bacon, S., Bates, C., Morton, C. E. & Goldacre, B. (2020). Factors associated with COVID-19-related death using OpenSAFELY. Nature, 584(7821), 430–436. https://doi.org/10.1038/s41586-020-2521-4
World Health Organization [WHO] [Internet]. Emergency situation reports. WHO. Available in: https://www.who.int/emergencies/situation-reports. Accessed: November 2021.
Younossi, Z. M., Tacke, F., Arrese, M., Chander, S. B., Mostafa I, Bugianesi E. & Vos, M. B. (2019). Global Perspectives on Nonalcoholic Fatty Liver Disease and Nonalcoholic Steatohepatitis. Hepatology, 69(6), 2672-2682. 10.1002/hep.30251.
Younossi, Z. M., Koenig, A. B., Abdelatif, D., Fazel, Y., Henry, L., & Wymer, M. (2016). Global epidemiology of nonalcoholic fatty liver disease-meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology, 64(1), 73–84. 10.1002/hep.28431
Zhou, Y. J., Zheng, K. I., Wang, X. B., Yan, H. D., Sun, Q. F., Pan, K. H. & Zheng, M. H. (2020). Younger patients with MAFLD are at increased risk of severe COVID-19 illness: A multicenter preliminary analysis. Journal of hepatology, 73(3), 719–721. https://doi.org/10.1016/j.jhep.2020.04.027
Descargas
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2021 Laís Spíndola Garcêz; Carla de Magalhães Cunha ; André Castro Lyra; Rosangela Passos de Jesus; Lucivalda Pereira Magalhães de Oliveira
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
Los autores que publican en esta revista concuerdan con los siguientes términos:
1) Los autores mantienen los derechos de autor y conceden a la revista el derecho de primera publicación, con el trabajo simultáneamente licenciado bajo la Licencia Creative Commons Attribution que permite el compartir el trabajo con reconocimiento de la autoría y publicación inicial en esta revista.
2) Los autores tienen autorización para asumir contratos adicionales por separado, para distribución no exclusiva de la versión del trabajo publicada en esta revista (por ejemplo, publicar en repositorio institucional o como capítulo de libro), con reconocimiento de autoría y publicación inicial en esta revista.
3) Los autores tienen permiso y son estimulados a publicar y distribuir su trabajo en línea (por ejemplo, en repositorios institucionales o en su página personal) a cualquier punto antes o durante el proceso editorial, ya que esto puede generar cambios productivos, así como aumentar el impacto y la cita del trabajo publicado.