Introduction: CV risk in women increases dramatically with menopause when unfavorable changes in body composition are observed. Recently, several scientific societies have underlined the importance of CV disease prevention in women, but there are few studies on the role of changing dietary habits on CV risk factors in post-menopausal women. Our intervention study aims to evaluate the medium-term efficacy of a balanced low-calorie diet in reducing the prevalence and progression of CV diseases in women. Materials and methods: the participant were women in both natural and surgery with a BMI between 24 and 39 kg/m2 and with at least one other CV risk factor. Each is followed up with a quarterly follow-up for one year at the Cardiovascular Risk Clinic of the UOC of Dietetics and Clinical Nutrition, where detailed questionnaires were administered on lifestyle, near and distant pathological history, physical activity and food. In addition, anthropometric measurements including circumferences, plicometry with evaluation of body composition, vectorial bioimpedance analysis (BIVA), handgrip, PA, heart rate were obtained. At enrolment, a balanced low-calorie dietary pattern with quantitative advice or one of 4 dietary patterns (Mediterranean, DASH, Low Carb and Low Fat) was provided. Results: The analysis was performed on 52 participants with complete one-year data with balanced low-calorie diet plan with quantitative advice. There were significant reductions (p<0.01) in weight (Δ= -4.3 Kg), in BMI (Δ= -1.6 Kg/m2), in the prevalence of obese people (-21.1% with BMI≥30 Kg/m2), in waist circumferences (Δ= -4.1 cm) and hips (Δ= -3.0 cm), the percentage of women with abdominal obesity (-10%), the thickness of the subscapular folds (Δ= -5.2 mm), suprailiac (Δ= - 2.9 mm) and triceps (Δ= -4.5 mm) with a 9.6% reduction in patients with truncular obesity, in arm adipose area (AFA) (Δ=-6.4 cm2), in MG obtained from plicometry (Δ= - 4.2 kg) and of the MG obtained from the BIVA (Δ= -2.5 kg) and of the MM obtained with the BIVA (Δ= -1.8 kg). Significant positive correlations were observed between the change in weight at one year and the change in waist and hip circumferences and in the thicknesses of the subscapularis and triceps folds and in AFA. From a nutritional point of view, at one year, significant reductions were observed in the basal metabolic rate (Δ= -45.7 Kcal/day, p <0.0001) which correlates positively with the change in weight at one year and in the daily caloric intake (Δ = -99.8 Kcal/day, p= 0.04), due to the reduction in fat intake from 36.6% to 33.6% which correlates positively with the change in weight at one year, in particular of saturated fatty acids from 12 to 10.8% and of cholesterol (Δ = -23.1 mg/day) with maintenance of the average level of physical activity. From the Low Fat and Mediterranean adherence questionnaires and from the FFQ questionnaire, there were significant reductions (p<0.01) in the consumption of animal and processed meats with the elimination of visible fat and a reduction in the consumption of sweets and baked goods as well as a reduction in olive oil. Conclusions: the present nutritional intervention study underlines the medium-term (one year) utility of a balanced low-calorie diet in menopausal women on CV risk factors including anthropometric parameters, visceral adiposity indexes and BP. It is also highlighted how the adherence questionnaires can be a versatile and easy to administer tool compared to the FFQ questionnaire, able to guide the dietitian in a correct counseling in these patients.
Introduzione: il rischio CV nella donna incrementa drasticamente con la menopausa in cui si osservano modificazioni sfavorevoli nella composizione corporea. Recentemente diverse società scientifiche hanno sottolineato l’importanza della prevenzione delle malattie CV nelle donne, ma pochi sono gli studi sul ruolo del cambiamento delle abitudini alimentari sui fattori di rischio CV nelle donne in post-menopausa. Il nostro studio d’intervento si propone di valutare l’efficacia a medio termine di una dieta ipocalorica equilibrata nel ridurre la prevalenza e la progressione delle malattie CV nelle donne.Materiali e metodi: si sono reclutate in modo random donne in menopausa sia naturale che chirurgica con un BMI compreso tra 24 e 39 kg/mq e con almeno un altro fattore di rischio CV. Ognuna viene seguita con un follow-up trimestrale per un anno presso l’UOC di Dietetica e Nutrizione Clinica, dove si sono somministrati questionari dettagliati su stile di vita, anamnesi patologica prossima e remota, attività fisica e alimentare. Inoltre, si sono ottenute misurazioni antropometriche comprensive di circonferenze, plicometria con valutazione della composizione corporea, analisi bioimpedenziometrica vettoriale (BIVA), handgrip, PA, frequenza cardiaca. All’arruolamento è stato fornito uno schema dietetico ipocalorico equilibrato con consigli quantitativi o uno dei 4 pattern dietetici (Mediterranea, DASH, Low Carb e Low Fat).Risultati: L’analisi è stata effettuata su 52 partecipanti con dati completi ad un anno con schema dietetico ipocalorico equilibrato con consigli quantitativi. Si sono evidenziate riduzioni significative (p<0.01) del peso (Δ= -4.3 Kg), del BMI (Δ= -1.6 Kg/m2), della prevalenza di obesi (-21.1% con BMI≥30 Kg/m2), delle circonferenze vita (Δ= -4.1 cm) e fianchi (Δ= -3.0 cm), della percentuale di donne con obesità addominale (-10%), degli spessori delle pliche sottoscapolare (Δ= -5.2 mm), soprailiaca (Δ= -2.9 mm) e tricipitale (Δ= -4.5 mm) con una riduzione del 9.6% di pazienti con obesità tronculare, dell’area adiposa del braccio (AFA) (Δ=-6.4 cm2), della MG ottenuta dalla plicometria (Δ= -4.2 kg) e della MG ottenuta dalla BIVA (Δ= -2.5 kg) e della MM ottenuta con la BIVA (Δ= -1.8 kg). Si sono osservate correlazioni positive significative fra variazione di peso ad un anno e variazione delle circonferenze vita e fianchi e degli spessori delle pliche sottoscapolare e tricipitale e di AFA. Dal punto di vista nutrizionale, ad un anno, si sono osservate riduzioni significative del metabolismo basale (Δ= -45.7 Kcal/die, p <0.0001) che correla positivamente con la variazione di peso ad un anno e dell’introito calorico giornaliero (Δ= -99.8 Kcal/die, p= 0.04), da ricondurre alla riduzione dell’introito lipidico dal 36.6% al 33.6% che correla positivamente con la variazione di peso ad un anno, in particolare degli acidi grassi saturi dal 12 al 10.8% e del colesterolo (Δ =-23.1 mg/die) con mantenimento del livello medio di attività fisica. Dai questionari di aderenza Low Fat e Mediterranea e dal questionario FFQ, si sono evidenziati riduzione significative (p<0.01) del consumo di carni animali e processate con eliminazione del grasso visibile e riduzione del consumo di dolci e prodotti da forno oltre che riduzione dell’olio d’oliva. Conclusioni: il presente studio di intervento nutrizionale sottolinea l’utilità a medio termine (un anno) di una dieta ipocalorica equilibrata nelle donne in menopausa sui fattori di rischio CV comprensivi di parametri antropometrici, indici di adiposità viscerale e PA. Altresì viene messo in evidenza come i questionari di aderenza possano essere uno strumento versatile e di facile somministrazione rispetto al questionario FFQ, in grado di guidare il dietista in un corretto counseling in questi soggetti.
Ruolo benefico delle modifiche dietetiche a medio termine in menopausa
FAVARO, AURORA
2021/2022
Abstract
Introduction: CV risk in women increases dramatically with menopause when unfavorable changes in body composition are observed. Recently, several scientific societies have underlined the importance of CV disease prevention in women, but there are few studies on the role of changing dietary habits on CV risk factors in post-menopausal women. Our intervention study aims to evaluate the medium-term efficacy of a balanced low-calorie diet in reducing the prevalence and progression of CV diseases in women. Materials and methods: the participant were women in both natural and surgery with a BMI between 24 and 39 kg/m2 and with at least one other CV risk factor. Each is followed up with a quarterly follow-up for one year at the Cardiovascular Risk Clinic of the UOC of Dietetics and Clinical Nutrition, where detailed questionnaires were administered on lifestyle, near and distant pathological history, physical activity and food. In addition, anthropometric measurements including circumferences, plicometry with evaluation of body composition, vectorial bioimpedance analysis (BIVA), handgrip, PA, heart rate were obtained. At enrolment, a balanced low-calorie dietary pattern with quantitative advice or one of 4 dietary patterns (Mediterranean, DASH, Low Carb and Low Fat) was provided. Results: The analysis was performed on 52 participants with complete one-year data with balanced low-calorie diet plan with quantitative advice. There were significant reductions (p<0.01) in weight (Δ= -4.3 Kg), in BMI (Δ= -1.6 Kg/m2), in the prevalence of obese people (-21.1% with BMI≥30 Kg/m2), in waist circumferences (Δ= -4.1 cm) and hips (Δ= -3.0 cm), the percentage of women with abdominal obesity (-10%), the thickness of the subscapular folds (Δ= -5.2 mm), suprailiac (Δ= - 2.9 mm) and triceps (Δ= -4.5 mm) with a 9.6% reduction in patients with truncular obesity, in arm adipose area (AFA) (Δ=-6.4 cm2), in MG obtained from plicometry (Δ= - 4.2 kg) and of the MG obtained from the BIVA (Δ= -2.5 kg) and of the MM obtained with the BIVA (Δ= -1.8 kg). Significant positive correlations were observed between the change in weight at one year and the change in waist and hip circumferences and in the thicknesses of the subscapularis and triceps folds and in AFA. From a nutritional point of view, at one year, significant reductions were observed in the basal metabolic rate (Δ= -45.7 Kcal/day, p <0.0001) which correlates positively with the change in weight at one year and in the daily caloric intake (Δ = -99.8 Kcal/day, p= 0.04), due to the reduction in fat intake from 36.6% to 33.6% which correlates positively with the change in weight at one year, in particular of saturated fatty acids from 12 to 10.8% and of cholesterol (Δ = -23.1 mg/day) with maintenance of the average level of physical activity. From the Low Fat and Mediterranean adherence questionnaires and from the FFQ questionnaire, there were significant reductions (p<0.01) in the consumption of animal and processed meats with the elimination of visible fat and a reduction in the consumption of sweets and baked goods as well as a reduction in olive oil. Conclusions: the present nutritional intervention study underlines the medium-term (one year) utility of a balanced low-calorie diet in menopausal women on CV risk factors including anthropometric parameters, visceral adiposity indexes and BP. It is also highlighted how the adherence questionnaires can be a versatile and easy to administer tool compared to the FFQ questionnaire, able to guide the dietitian in a correct counseling in these patients.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/39909