Carga glicêmica e rotulagem nutricional no manejo da hipertensão em indivíduos em tratamento em serviço especializado

Abstract

Esta dissertação tem como objetivos avaliar a carga glicêmica (CG) da dieta e utilização do rótulo dos alimentos para controle de sal, por indivíduos hipertensos. Realizou-se revisão sistemática da literatura, de ensaios clínicos, para avaliar a evidência de associação da CG com a PA e duas análises secundárias, transversais, de dados primários de um ensaio clínico de avaliação de intervenção educativa nutricional. Calculou-se IG e CG a partir de três recordatórios alimentares de 24 horas, com intervalo de dois meses. Cerca de doze meses após o ensaio clínico, aplicou-se instrumento de avaliação do uso da informação nutricional apresentada na embalagem, por telefone. A metanálise (três ensaios clínicos) mostrou associação direta da CG com PA diastólica. Dos 120 participantes do ensaio clínico, 85 foram incluídos nas análises transversais. A maioria eram mulheres (64,7%) com 62,6±9,2 anos. A PA de 24h na MAPA da última visita, ajustada para sexo e renda, mostrou PA diastólica menor no grupo CG ≤80 comparado com CG >80; não houve associação com PA sistólica. Responderam ao questionário, 85 participantes e 84,7% lê o rótulo. Desses, 89,2% atenta-se para a data de validade e 17,6%, para a composição. A maioria considerou os rótulos pouco legíveis e entende parcialmente as informações. A PA não diferiu entre os que leem e não leem o rótulo. Conclui-se que a PAD está diretamente associada com CG e que a maioria lê os rótulos, mas os considera pouco legíveis e entende parcialmente as informações.

More and more non-pharmacological strategies are currently used to control blood pressure (BP). Among them, healthy eating guidance. The dietary glycemic index (GI) can contribute to the sequence of events that lead to chronic diseases, such as systemic hypertension (SH). Thus, the present work aims to evaluate nutritional aspects related to SAH, specifically the dietary control of salt and glycemic load (GL). Secondary data analysis was performed from a clinical trial designed to evaluate an educational intervention to reduce dietary salt consumption were analyzed. Anthropometrics, BP measurements, demographic data, 24-hour food recall (R24h) were collected. The GI and GL were calculated from three recalls filled out in the six-month interval. About twelve months after the end of the clinical trial, telephone interviews were conducted with the application of an instrument to assess the use of nutritional information fromfood labels. 116 individuals participated in this study, and 85 answered the complete questionnaire. Most were women (64.7%) aged 64 ± 9.58 years. The closing SBP was 122.24 ± 19.83mmHg; DBP 72.72 ± 13.51mmHg in the intervention group (IG) and SBP 125.42 ± 20.20mmHg; PAD 74.58 ± 15.49mmHg in the control. The reading of the label was more frequent in the CG (92.5%) than in the IG (77.8%). Participants who did not have the habit of reading nutritional information in the CG had a mean SBP (117.00mmHg ± 26.87) lower than the participants who did not read the IG labels (120.43mmHg ± 17.54). The same happened with the BMI, being lower in the CG and in those who did not read the labels (29.21 kg / m² ± 3.56). When assessing GL in both groups, only 18.96% of participants were classified as average (GL between 81 and 119) or high (> 119). However, most women (73.4%) were classified as low GL, and men (59.1%) in the medium or high GL group. The mean SBP was 121.24 ± 14.71 mmHg (p-value 0.386) and the DBP was 71.60 ± 10.86 mmHg (p-value 0.044) in the low GL group. The habit of reading the label can serve as a good educational action strategy for the 12 control of hypertension, help patients to make healthier choices, foods with less sodium content and diets with lower GL.