A carregar...
Publicação
Educação para a saúde e redução de obesidade em ambulatório
Orientador(es)
Resumo(s)
RESUMO - Introdução: a prevalência da obesidade (ob) — excesso de
massa gorda — tem vindo a aumentar em adultos, segundo
recentes estudos epidemiológicos. O índice de massa corporal
(IMC) será o método diagnóstico mais adaptado para
estudos de base populacional. A relação entre o perímetro
periumbilical/perímetro bitrocanteriano (R) é também
importante. Como factores etiológicos citam-se (a) alimentares,
(b) genéticos, (c) sócio-económicos, (d) psicológicos e
(e) doenças congénitas, sendo as alimentares as mais prevalentes.
A ob aumenta o risco de morte por qualquer causa,
e por doença cárdio-vascular em adultos, sendo tal risco
mais marcado nos indivíduos mais novos e menos acentuado
a partir dos 75 anos. A correcção da ob implica
(a) conhecimento do obeso sobre a ob, (b) transformações
sustentadas do estilo de vida e (c) adequada escolha dos
objectivos a atingir. Em 1997 a Sociedade Portuguesa para
o Estudo da Obesidade editou um relatório, dirigido ao
obeso, que serviu de base à elaboração de «ensino» que foi
aplicado a obesos após completa validação e treino de aplicação.
Objectivos: determinar (a) a prevalência de ob em ambulatório,
(b) a influência do «ensino» na redução da ob medida
pelo IMC e R aos dias 30 e 60 e (c) a prevalência de factores
de risco associados à ob.
Material: amostra aleatória estratificada por sexos de 25%
da população (idade ≥ a 5 anos) de ficheiro de clínica geral,
segundo o peso por sexos e idades do censo de 1991 para
a Região Centro. Ensino original e validado.
Metodologia: excesso de peso/obesidade (caso) IMC >
25 kg/m2, por graus. Estudo de R. Para jovens até aos 14
anos ob quando IMC em p > 90 em tabela de percentis.
Aplicação de ensino a obesos de acordo com tabela aleatória.
Estudo de IMC e R aos dias 30 e 60 após ensino.
Resultados: estudados 396 indivíduos — idade média
42,5 ± 21,2 anos, máximo 85, mínimo 5 —, sendo 185
(46,7%) do sexo masculino e 211 (53,3%) do sexo feminino.
Efectuados 223 (56,4% do total) diagnósticos — idade
média 48 ± 19,8 — máximo e mínimo de 85 e 6 anos, 108
(584,%) do sexo masculino e 125 (54,5%) do feminino.
O ensino não originou redução significativa dos valores de
IMC e R nos diferentes tempos. Como principais patologias
associadas identificadas: alterações metabólicas e
patologia cárdio-vascular.
ABSTRACT - The prevalence of obesity (ob) — defined as fatty mass excess — is increasing in adults as stated by recent epidemiologic studies. Body mass index (BMI) is the more suitable diagnostic measure in epidemiologic studies. The relation between the peri-umbilical diameter and the peri by-trochanterian perimeter (R) is also important. Obesity may have several causes such as (a) dietary errors, (b) genetics, (c) socio-economical factors, (d) psichological disturbances, (e) congenital diseases, the more prevalent beeing the dietary ones. Ob increases the risk of death by any cause and by cardiovascular disease in adults, the risk beeing greater in young adults and reduced for ages greater than 75 years. Correction of ob implies (a) self-knowledge about obesity, (b) sustained changes in life style and (c) correct choice of the goals to be reached by the obese and his treating team. In 1997 the Portuguese Society for the Study of Obesity, has launched a report, directed to the obese patient, that we used as a basis for a teaching course that was applied to the obese patients after it was fully validated. Objectivs: to determine (a) the prevalence of ob in an ambulatory population of a GP surgery, (b) the reduction obtained in ob prevalence by the use of the teaching course, measured by the decrease in BMI at days 30 and 60 after the teaching course and (c) the prevalence of risk factors associated with ob. Material: a stratified random population corresponding to 25% of the total one of a GP list of patients older than 5 years according to the weight by sexes and ages of the population of the Center of Portugal was studied. Application of a original validated teaching course. Methodology: excess weight/obesity (case) BMI > 25 kg/m2, in obesity degrees. For ages < 15 years ob defined as p > 90 in specific tables of BMI percentils. Random application of the teaching course to the obese patients. Study of BMI and R at days 30 and 60 after the teaching course. Results: 396 patients were studied — mean age 42,5 ± 21,2 years, between 5 and 85 years —, 185 (46,7%) males and 211 (53,3%) female. 223 (56,4% of the total population studied) patients were considered obese — mean age 48 ± 19,8 years between ages 6 and 85 —, 108 (58,4%) in males and 125 (54,5%) in females. The teaching course did not produce any significative change in BMI and R at the different times of the study. The more prevalent pathologies aasociated with obesity were metabolic abnormalities and cardio-vascular pathologies.
ABSTRACT - The prevalence of obesity (ob) — defined as fatty mass excess — is increasing in adults as stated by recent epidemiologic studies. Body mass index (BMI) is the more suitable diagnostic measure in epidemiologic studies. The relation between the peri-umbilical diameter and the peri by-trochanterian perimeter (R) is also important. Obesity may have several causes such as (a) dietary errors, (b) genetics, (c) socio-economical factors, (d) psichological disturbances, (e) congenital diseases, the more prevalent beeing the dietary ones. Ob increases the risk of death by any cause and by cardiovascular disease in adults, the risk beeing greater in young adults and reduced for ages greater than 75 years. Correction of ob implies (a) self-knowledge about obesity, (b) sustained changes in life style and (c) correct choice of the goals to be reached by the obese and his treating team. In 1997 the Portuguese Society for the Study of Obesity, has launched a report, directed to the obese patient, that we used as a basis for a teaching course that was applied to the obese patients after it was fully validated. Objectivs: to determine (a) the prevalence of ob in an ambulatory population of a GP surgery, (b) the reduction obtained in ob prevalence by the use of the teaching course, measured by the decrease in BMI at days 30 and 60 after the teaching course and (c) the prevalence of risk factors associated with ob. Material: a stratified random population corresponding to 25% of the total one of a GP list of patients older than 5 years according to the weight by sexes and ages of the population of the Center of Portugal was studied. Application of a original validated teaching course. Methodology: excess weight/obesity (case) BMI > 25 kg/m2, in obesity degrees. For ages < 15 years ob defined as p > 90 in specific tables of BMI percentils. Random application of the teaching course to the obese patients. Study of BMI and R at days 30 and 60 after the teaching course. Results: 396 patients were studied — mean age 42,5 ± 21,2 years, between 5 and 85 years —, 185 (46,7%) males and 211 (53,3%) female. 223 (56,4% of the total population studied) patients were considered obese — mean age 48 ± 19,8 years between ages 6 and 85 —, 108 (58,4%) in males and 125 (54,5%) in females. The teaching course did not produce any significative change in BMI and R at the different times of the study. The more prevalent pathologies aasociated with obesity were metabolic abnormalities and cardio-vascular pathologies.
Descrição
Palavras-chave
Contexto Educativo
Citação
Santiago, Luiz Miguel; Mesquita, Eugénia Paula - Educação para a saúde e redução de obesidade em ambulatório = Education for health and reduction of obesity in ambulatory care. Revista Portuguesa de Saúde Pública. ISSN 0870-9025. Vol. 17, Nº 1 (Janeiro/Junho 1999), p. 53-63
Editora
Universidade Nova de Lisboa, Escola Nacional de Saúde Pública