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Objective: To characterize the situation of breastfeeding and the adequacy of prescription of infant formulas to infants assisted by a secondary care program of the Public Health System. Methods: This is a cross-sectional study with analysis of medical records of 350 infants from zero to 6 months, followed up between February to April 2019. Results: The possibility of breastfeeding was present in 97.0% of mothers and no infant presented an acceptable medical condition for proscription of breastfeeding. Despite this, only 47.2% of cases were on exclusive breastfeeding before being referred to the program. Regarding the reasons for the introduction of infant formulas, complementation to breast milk was the most present (75.8%), followed by mothers returning to the job market (20.1%). The general rates of inadequacy of those prescribed were 65% before arriving at the program, increasing to 69% (standard formulas) and 80% (formulas for special purposes) during follow-up. Conclusion: The low rate of exclusive breastfeeding and the indiscriminate prescription of infant formulas are a concern for damage to maternal-child healthcare and sound finances of the Public Health System. RESUMO Objetivo: Caracterizar a situação de aleitamento materno e da adequação de prescrição de fórmulas infantis a lactentes assistidos por um programa de Atenção Secundária do Sistema Único de Saúde. Métodos: Trata-se de estudo transversal pela análise de prontuários de 350 lactentes de zero a 6 meses, acompanhados entre fevereiro a abril de 2019. Resultados: A possibilidade de aleitamento materno esteve presente em 97,0% das mães, e nenhum lactente apresentou condição médica aceitável para a proscrição do aleitamento materno. Apesar disso, apenas 47,2% dos casos estavam em aleitamento materno exclusivo antes do encaminhamento ao programa. Em relação aos motivos da introdução das fórmulas infantis, a complementação ao leite materno foi o mais presente (75,8%), seguido da volta da mãe ao mercado de trabalho (20,1%). As taxas gerais de inadequação dentre os prescritos foram de 65% antes da chegada ao programa, passando para 69% (fórmulas padrão) e 80% (fórmulas para fins especiais) durante o acompanhamento. Conclusão: A baixa taxa de aleitamento materno exclusivo e a prescrição indiscriminada de fórmulas infantis são preocupantes por causar prejuízos à saúde maternoinfantil e financeira do Sistema Único de Saúde.

Obesity is a serious global health problem that is directly related to various morbidities manifestation. Intestinal dysbiosis has been implicated on obesity pathogenesis. Diet composition can alter gut microbiota, regardless of energy intake. Dietary fatty acids quality may affect gut microbiota composition, which in turn may affect host metabolic health. The mechanisms by which the different type of FFA modulate gut microbiota is yet poor elucidate and there is a lack of studies regard to this. Fatty acids may act in cell membrane, interfere with energy production, inhibit enzymatic activities, impair nutrient absorption and generate toxic compounds to cells, leading to growth inhibition or even bacterial death. The beneficial effect of the consumption of n-3 polyunsaturated fatty acids (PUFA) and conjugated linoleic acid (CLA) on microbiota, unlike n-6 PUFA and saturated fatty acids has been suggested. n-3 PUFA consumption promotes desirable changes on obese intestinal microbiota making it similar to that of normal weight individuals. More studies are needed to better understand the effect of CLA on microbiota and host health. Long term human controlled clinical trials must be conducted to allow us to understand the complex interaction between dietary fat, intestinal microbiota and obesity.

Previous studies suggest that the type of dietary fatty acid may modulate the intestinal bacterial ecosystem. However, this effect is still inconclusive. Thus, the aim of this study was to investigate the effect of the intake of vegetable oils rich in different types of fatty acids, associated with energy-restricted normofat diets, on the composition of intestinal microbiota and permeability, on LPS concentrations, and fecal short chain fatty acids and pH. This was a 9 consecutive weeks (±5 days), randomized, parallel, double-blind clinical trial. Overweight women received daily breakfast containing 25 mL of one of the test oils: soybean oil (n = 17), extra virgin olive oil (n = 19) or coconut oil (n = 16). Blood, fecal and urine samples were collected on the first and last day of the experiment for the analysis of the variables of interest. The consumption of the three oils did not affect the diversity and relative abundance of intestinal bacteria. We observed an increase in bacterial richness estimated by the Chao 1 index, and a reduction in the concentration of isovaleric fatty acid in the group that ingested soybean oil. Paracellular and transcellular permeability increased after the ingestion of extra virgin olive oil and coconut oil. However, LPS concentrations remained unchanged. The intake of different types of fatty acids associated with the energy-restricted normofat diet modestly affected the intestinal microbiota and permeability, without resulting in metabolic endotoxemia in overweight women.

Evidence shows that excessive sugar consumption may impair the quality of feeding affecting negatively on health. The objective of this study was evaluated the intake of macronutrients and adequacy of sugar consumption by healthcare students of Federal University of Vicosa, Brazil. The study included 157 women and 30 men, aged 21.3 ± 3.4 years, with mean body mass index (BMI) of 22.03 ± 4.03 kg m-2 and waist circumference (WC) of 72.95 ± 8.96 cm. Semi-structured questionnaires were administered and proceeded to anthropometric and dietary assessments of individuals. The results revealed high average daily intake of added sugar (69.21 ± 5.25 g) which consequently increased the fructose content of feeding (36.22 ± 29.78 g), and a low intake of fiber (15.51 ± 7.30 g). It was found that the average intake of added sugar was significantly (p

Introduction. Many consumers buy organic foods because of their alleged greater nutritional benefits. However, studies investigating the effect of the agricultural farming system on minerals and toxic elements content are scarce. This study compared the content of minerals (P, Ca, Mg, Na and K) and trace elements (Fe, Mn, Cu, Cr, Se, Zn, Mo, Ni, Cd and Al) of four organically and conventionally grown fruits in Brazil. Materials and methods. Mango (Mangifera indica L., var. Palmer), persimmon (Diospyros kaki L., var. Rama Forte), acerola (Malpighia punicifolia L., var. Olivier) and strawberry (Fragaria vesca L., var. Oso Grande) were produced by organic and conventional farming in the same geographic region, under the same climatic conditions and same type of soil. Mineral analysis was performed by inductively coupled plasma atomic emission spectrometry (ICP-AES). Results and discussion. Organic mango contained higher amounts of Mg and K, and Cr content was higher in conventionally grown mangos. Organic persimmon contained higher amounts of Cu and Zn, and Mg, P, Na, and K concentration was higher in conventional persimmon. Conventionally grown acerola contained higher amounts of Ca, Fe, Mn, Mo, Al, and Ni than the organic acerola. The concentrations of Mo and Al were higher in organic strawberry when compared to conventional strawberry. Conclusion. Organic farming did not result in a clear superiority of the mineral quality of fruit nor did it provide fruit free of toxic elements.

Dietary fat strongly affects human health by modulating gut microbiota composition and low-grade systemic inflammation. High-fat diets have been implicated in reduced gut microbiota richness, increased Firmicutes to Bacteroidetes ratio, and several changes at family, genus and species levels. Saturated (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) and conjugated linolenic fatty acids share important pathways of immune system activation/inhibition with gut microbes, modulating obesogenic and proinflammatory profiles. Mechanisms that link dietary fat, gut microbiota and obesity are mediated by increased intestinal permeability, systemic endotoxemia, and the activity of the endocannabinoid system. Although the probiotic therapy could be a complementary strategy to improve gut microbiota composition, it did not show permanent effects to treat fat-induced dysbiosis. Based upon evidence to date, we believe that high-fat diets and SFA consumption should be avoided, and MUFA and omega-3 PUFA intake should be encouraged in order to regulate gut microbiota and inflammation, promoting body weight/fat control.

Despite the fact that extra virgin olive oil (EVOO) is widely used in obese individuals to treat cardiovascular diseases, the role of EVOO on weight/fat reduction remains unclear. We investigated the effects of energy-restricted diet containing EVOO on body composition and metabolic disruptions related to obesity. This is a randomized, double-blinded, placebo-controlled clinical trial in which 41 adult women with excess body fat (mean ± SD 27.0 ± 0.9 year old, 46.8 ± 0.6% of total body fat) received daily high-fat breakfasts containing 25 mL of soybean oil (control group, n = 20) or EVOO (EVOO group, n = 21) during nine consecutive weeks. Breakfasts were part of an energy-restricted normal-fat diets (−2090 kJ, ~32%E from fat). Anthropometric and dual-energy X-ray absorptiometry were assessed, and fasting blood was collected on the first and last day of the experiment. Fat loss was ~80% higher on EVOO compared to the control group (mean ± SE: −2.4 ± 0.3 kg vs. −1.3 ± 0.4 kg, P = 0.037). EVOO also reduced diastolic blood pressure when compared to control (–5.1 ± 1.6 mmHg vs. +0.3 ± 1.2 mmHg, P = 0.011). Within-group differences (P < 0.050) were observed for HDL-c (−2.9 ± 1.2 mmol/L) and IL-10 (+0.9 ± 0.1 pg/mL) in control group, and for serum creatinine (+0.04 ± 0.01 µmol/L) and alkaline phosphatase (−3.3 ± 1.8 IU/L) in the EVOO group. There was also a trend for IL-1β EVOO reduction (−0.3 ± 0.1 pg/mL, P = 0.060). EVOO consumption reduced body fat and improved blood pressure. Our results indicate that EVOO should be included into energy-restricted programs for obesity treatment.

Vitamin D (1,25(OH) 2 D 3 ) is a steroid hormone that has a range of physiological functions in skeletal and nonskeletal tissues, and can contribute to prevent and/or treat osteoporosis, obesity, and Type 2 diabetes mellitus (T2DM). In bone metabolism, vitamin D increases the plasma levels of calcium and phosphorus, regulates osteoblast and osteoclast the activity, and combats PTH hypersecretion, promoting bone formation and preventing/treating osteoporosis. This evidence is supported by most clinical studies, especially those that have included calcium and assessed the effects of vitamin D doses (≥800 IU/day) on bone mineral density. However, annual megadoses should be avoided as they impair bone health. Recent findings suggest that low serum vitamin D is the consequence (not the cause) of obesity and the results from randomized double-blind clinical trials are still scarce and inconclusive to establish the relationship between vitamin D, obesity, and T2DM. Nevertheless, there is evidence that vitamin D inhibits fat accumulation, increases insulin synthesis and preserves pancreatic islet cells, decreases insulin resistance and reduces hunger, favoring obesity and T2DM control. To date, there is not enough scientific evidence to support the use of vitamin D as a pathway to prevent and/or treat obesity and T2DM.

Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.Recentemente, a falta de artigos que visam fornecer orientação quanto ao uso do índice glicêmico foi apontada como causa de sua baixa utilização na educação nutricional. O objetivo do presente trabalho é oferecer suporte para o uso do índice glicêmico como ferramenta a ser adotada na educação nutricional, para estimular o consumo preferencial de alimentos que apresentem menores valores nesse indicador. Foram selecionados estudos publicados nos últimos doze anos, além de estudos clássicos referentes ao tema, indexados nos bancos de dados MedLine, ScienceDirect, SciELO e Lilacs, que exploraram a importância do índice glicêmico e os fatores que interferem em seu valor. A elaboração de listas agrupando os alimentos segundo o índice glicêmico deve ser feita com base nas informações encontradas em tabelas e sites específicos. Essa é uma estratégia interessante que deve ser conduzida de maneira criteriosa, considerando-se os hábitos alimentares do público assistido. Para resultar em resposta glicêmica pós-prandial mais baixa, os produtos de alto índice glicêmico devem ser ingeridos em associação com alimentos ricos em proteína e pobres em gordura, com óleos de boa qualidade, com alimentos menos processados por ricos em fibras, evitando-se os com alto teor em cafeína. O índice glicêmico deve ser considerado uma ferramenta adicional para a escolha de alimentos fonte de carboidratos, os quais devem ser incluídos em uma dieta nutricionalmente equilibrada, capaz de promover e/ou manter tanto o peso corporal adequado quanto a saúde.

Virgin coconut oil (VCO) is a medium-chain fatty acid source with popularly attributed benefits on obesity management. However, its role on obesity requires elucidation due to its saturated nature. In the study herein, we investigated acute effects of VCO consumption on energy metabolism, cardiometabolic risk markers, and appetitive responses in women with excess body fat. Fifteen adult women with excess body fat (37.43 ± 0.83%) participated in this randomized, crossover, controlled study. Two isocaloric mixed breakfasts containing 25 mL of VCO or control (extra-virgin olive oil-C) were evaluated. Resting energy expenditure (REE), fat oxidation rate (FOR), diet induced thermogenesis (DIT) and appetitive subjective responses were assessed at fasting and postprandial periods (up to 240 min). Cardiometabolic risk markers were assessed at fasting and up to 180 min postprandially. VCO did not affect REE, FOR, and DIT compared to C. In addition, VCO did not cause deleterious change in triglycerides, total cholesterol, HDL-c, LDL-c, triglycerides/HDL-c ratio, uric acid, glucose and Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR) (P time×treatment > 0.05). However, VCO suppressed less hunger (P time×treatment = 0.003), total satiety (P iAUC = 0.021) and total fullness (P iAUC = 0.035) responses than C. VCO consumption did not acutely change energy metabolism and cardiometabolic risk markers when added to a mixed breakfast but promoted less appetitive responses.

Introducao: A resistencia a insulina (RI) e frequentemente associada ao diabetes tipo 2 (DM2), quese apresenta como uma morbidade de importante impacto devido as suas possiveis complicacoes.Objetivos: Identificar individuos com RI e DM2 e avaliar as possiveis diferencas em suas caracteristicassociodemograficas, antropometricas e de composicao corporal, clinicas e de comportamento alimentar.Materiais e metodos: Trata-se de um estudo transversal observacional. Participaram do estudo 68pacientes atendidos em um programa de intervencao nutricional visando a prevencao e ao tratamentode doencas cardiovasculares. Os dados foram coletados de prontuarios referentes a primeira consulta.Para identificacao de individuos com RI utilizou-se o indice HOMA-IR>2,7. Resultados: Vinte e seteindividuos foram classificados como grupo controle, 21 com RI e nao diabeticos e 20 com DM2. Tanto osresistentes a insulina quanto os diabeticos tiveram maiores valores de IMC (p=00001), gordura corporal(p=0,001), perimetro da cintura (p=0,001) e do quadril (p=0,002) quando comparados ao grupo controle.Foi observada maior prevalencia de hipertensao arterial (70%) nos diabeticos. Os resistentes a insulinativeram menores valores de HDL (p=0,009) e maiores de acido urico (p=0,033), em comparacao ao grupocontrole, e maiores de LDL (p=0,031), quando comparados aos diabeticos. Esses tambem relatarammaior uso de banha animal (15,8%) e mudancas de habitos alimentares nos finais de semana (84,2%).Conclusoes: Os resultados deste estudo ressaltam a importância da deteccao precoce da RI e de programasde intervencao nutricional, visando ao controle de peso corporal e combate a hipertensao arterial tanto emdiabeticos como em resistentes a insulina.

Introducao: O consumo adequado de hortalicas e importante para a manutencao do bom estadonutricional e prevencao de doencas cronicas nao transmissiveis. Objetivo: Avaliar o impacto do uso depublicidade social em nutricao no consumo e na aceitacao de saladas por usuarios de um restauranteuniversitario. Materiais e metodos: Tratou-se de um estudo de intervencao do tipo teste-controle deamostragem representativa (n=1.518, 11,40%), onde foram elaborados nove banners com forte apelovisual e informacoes nutricionais objetivas. A intervencao consistiu na exposicao dos banners duranteo almoco em quatro dias nao consecutivos no grupo teste. As porcoes de saladas eram padronizadaspreviamente e avaliadores observavam o resto-ingesta dos primeiros usuarios que devolviam suas bandejasem intervalos regulares de tempos nos grupos teste e controle. A analise dos resultados foi feita mediantea conversao dos valores individuais para valores totais de resto-ingesta e consumo. O teste z (softwareSigmaPlot, v11.0) foi adotado para verificar diferencas entre os tratamentos (P

Obesity and Type 2 diabetes may be controlled by foods capable of modulating food intake and blood glucose.We investigated whether the addition of food sources of fiber or phaseolamin to shakes can control food intake and reduce postprandial glycemia.This was a randomized, single blind, crossover design study (food intake: n=22; glycemia: n=10). Five liquid meals presenting similar amounts of macronutrients (C - control shake, OB - oat bran shake, F - flaxseed shake, WB - white bean extract shake, and UB - unripe banana flour shake) were consumed in five non-consecutive days. Participants kept dietary records during the subsequent 24 hours. Blood glucose was measured at 0 (immediately before), 15, 30, 45, 60, 90 and 120 minutes after the ingestion of each shake and the incremental areas under the curves (iAUC) were calculated.Compared to C, there was a significant increase in fiber intake after the consumption of OB (+17.9g), F (+19.1g), and UB (+12.6g), and in fat after the consumption of OB (+25,4g). There was a non-significant reduction of daily energy intake in F compared to C (1524kJ; P=0.10). There was a 43% reduction in the iAUC (P=0.03) in response to UB consumption.Unripe banana flour reduced postprandial glycemic response of shakes almost by half. The effect of oat bran and flaxseed on food intake needs further investigation in long-term studies.Introducción: Obesidad y diabetes de tipo 2 pueden ser controlados por alimentos capaces de modular la ingesta de alimentos y la glucemia. Objetivos: Se investigó si la adición de alimentos fuentes de fibra o fasolamina a batidos puede controlar la ingesta de alimentos y reducir la glucemia posprandial. Métodos: Estudio aleatorizado, simple ciego, de diseño cruzado (ingesta de alimentos:n=22; glucemia:n=10). Cinco batidos con cantidades similares de macronutrientes (C - control batido, SA - salvado de avena batido, L - linaza batido, FB - extracto de frijol blanco batido y PI - harina de plátano no maduro batido) fueron consumidos en cinco días no consecutivos. Las participantes registraron la ingesta de alimentos en las 24 horas subsiguientes. La glucosa en sangre se midió a 0 (inmediatamente antes), 15, 30, 45, 60, 90 y 120 minutos después de la ingestión de cada batido y se calcularon las áreas incrementales bajo las curvas (AIBC). Resultados: En comparación a C, hubo un aumento significativo en la ingesta de fibra después de que el consumo de SA(+17,9g), SL(+19,1g), y PI(+12,6g), y en la grasa después del consumo de SA(+25,4g). Se encontró una reducción no significativa de la ingesta diaria de energía en L (1524kJ, P=0,10) en comparación con C. Hubo una reducción del 43% en el AIBC (P=0,03) en respuesta al consumo PI. Conclusiones: Harina de plátano no maduro reduce la respuesta glucémica posprandial de batidos casi a la mitad. El efecto de salvado de avena y linaza en la ingesta de alimentos requiere mayor investigación en estudios a largo plazo.

Diabetes mellitus is a global epidemic affecting 346 million people in the world. The glycemic control is the key for diabetes prevention and management. Some proteins can stimulate insulin release and modulate glycemic response.To assess the effect of the consumption of different types of protein (whey protein, soy protein and egg white) on a second meal postprandial glycaemia in normal weight and normoglycemic subjects.Randomized crossover clinical trial. After an overnight fast of 12-hours, ten subjects attended the laboratory to drink one of the protein shakes (whey, soy or egg white) or the control drink. Thirty minutes later, the subjects consumed a glucose solution (25 g glucose). Glycemic response was monitored at times 0 (before glucose solution) and 15, 30, 45, 60, 90 and 120 min (after glucose solution consumption). Incremental area under the glycemic curve (iAUC) was calculated by the trapezoidal method. Furthermore, glycemic response was assessed by a new method using iG equation.Compared with control, whey and soy protein drinks reduced postprandial iAUC in 56.5% (p = 0.004) and 44.4% (p = 0.029), respectively. Whey protein was the only protein capable of avoiding great fluctuations and a peak in postprandial glycemia. The assessment of glycemic response by iG equation showed positive correlation with iAUC (Pearson 0.985, p0.05).The consumption of whey and soy protein 30 minutes before a glucose load resulted in lower iAUC compared with control drink. Whey protein maintained postprandial glycemia more stable.Introducción: La diabetes mellitus es una enfermedad epidémica que afecta a 346 millones de personas en el mundo. El control glicémico es la clave para la prevención y el control de la diabetes. Algunas proteínas pueden estimular la liberación de insulina y modular la respuesta glicémica. Objetivos: Evaluar el efecto del consumo de diferentes tipos de proteínas (proteína de suero de leche, proteína de soja y la clara de huevo) de la glicemia postprandial en una segunda comida en individuos de peso normal y normoglicémicos. Metodología: Este fue un ensayo clínico aleatorizado cruzado. Después de un ayuno nocturno de 12 horas, diez individuos asistieron al laboratorio para beber uno de los batidos de proteínas (suero de leche, soja o clara de huevo) o la bebida control. Treinta minutos más tarde, los individuos consumieron una solución de glucosa (25 g de glucosa). La respuesta glicémica fue monitorizada en los tiempos 0 (antes de solución de glucosa) y 15, 30, 45, 60, 90 y 120 min (después del consumo de la solución de glucosa). El área incrementada bajo la curva de glicemia (iAUC) fue calculada por el método trapezoidal. Por otra parte, la respuesta glicémica se evaluó mediante un nuevo método que utiliza la ecuación de iG. Resultados: En comparación con el control, las bebidas de suero de leche y de proteína de soja reducen iAUC postprandial en 56,5% (p = 0,004) y 44,4% (p = 0,029), respectivamente. La proteína de suero es la única proteína capaz de evitar grandes fluctuaciones y un pico de glicemia postprandial. La evaluación de la respuesta glicémica por la ecuación iG mostró correlación positiva con iAUC (Pearson 0,985, p0,05). Conclusión: El consumo de suero de leche y proteína de soja 30 minutos antes de una carga de glucosa resultó en menor iAUC en comparación con la bebida control. La proteína del suero mantiene la glucemia postprandial más estable.

It has been claimed that the appropriate consumption of dairy products can be beneficial for the prevention and treatment of type 2 diabetes mellitus (T2DM).The objective of this review is to critically analyze the main scientific evidence about this topic.MEDLINE, PubMEd, Science Direct, SCIELO and LILACS were searched for studies published over the past 12 years exploring the effects of the consumption of dairy products or its components (calcium, vitamin D and magnesium) on T2DM.Epidemiological studies indicate that consumption of at least three servings of low-fat dairy products per day as a part of a healthy diet is crucial to reduce the risk of developing T2DM. The majority of the analyzed intervention studies reported beneficial effects of increased calcium and vitamin D ingestion on insulin sensitivity improvement and T2DM prevention.Although the impact of dairy consumption to treat T2DM needs further investigation, the consumption of low-fat dairy products may be an important strategy to prevent and control T2DM.Introducción: Se ha afirmado que el consumo adecuado de los productos lácteos puede ser beneficioso para la prevención y el tratamiento de la diabetes mellitus tipo 2 (DMT2). Objetivos: El objetivo de esta revisión es analizar críticamente la principal evidencia científica sobre este tema. Métodos: MEDLINE, PubMed, Science Direct, SCIELO y LILACS fueron consultadas para estudios publicados en los últimos 12 años explorando los efectos del consumo de productos lácteos o sus componentes (calcio, vitamina D y magnesio) en la DMT2. Resultados y discusión: Los estudios epidemiológicos indican que el consumo de por lo menos tres porciones de productos lácteos bajos en grasa al día como parte de una dieta saludable, es crucial para reducir el riesgo de desarrollar DMT2. La mayoría de los estudios de intervención analizados reportaron efectos benéficos del aumento del calcio y de la ingestión de vitamina D en la mejora de la sensibilidad a la insulina y la prevención de DMT2. Conclusiones: Aunque el impacto del consumo de productos lácteos para tratar DMT2 necesita más investigación, el consumo de productos lácteos bajos en grasa puede ser una importante estrategia para prevenir y controlar la DMT2.

Recentemente, a falta de artigos que visam fornecer orientação quanto ao uso do índice glicêmico foi apontada como causa de sua baixa utilização na educação nutricional. O objetivo do presente trabalho é oferecer suporte para o uso do índice glicêmico como ferramenta a ser adotada na educação nutricional, para estimular o consumo preferencial de alimentos que apresentem menores valores nesse indicador. Foram selecionados estudos publicados nos últimos doze anos, além de estudos clássicos referentes ao tema, indexados nos bancos de dados MedLine, ScienceDirect, SciELO e Lilacs, que exploraram a importância do índice glicêmico e os fatores que interferem em seu valor. A elaboração de listas agrupando os alimentos segundo o índice glicêmico deve ser feita com base nas informações encontradas em tabelas e sites específicos. Essa é uma estratégia interessante que deve ser conduzida de maneira criteriosa, considerando-se os hábitos alimentares do público assistido. Para resultar em resposta glicêmica pós-prandial mais baixa, os produtos de alto índice glicêmico devem ser ingeridos em associação com alimentos ricos em proteína e pobres em gordura, com óleos de boa qualidade, com alimentos menos processados por ricos em fibras, evitando-se os com alto teor em cafeína. O índice glicêmico deve ser considerado uma ferramenta adicional para a escolha de alimentos fonte de carboidratos, os quais devem ser incluídos em uma dieta nutricionalmente equilibrada, capaz de promover e/ou manter tanto o peso corporal adequado quanto a saúde. Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.