Avaliação metabólica sistêmica do tratamento dietético hipocalórico com predominância de alimentos de alto e baixo índice glicêmico associado à terapêutica com metformina em indivíduos com excesso de peso com ou sem alteração insulinêmica

AUTOR(ES)
DATA DE PUBLICAÇÃO

2008

RESUMO

Obesity is characterized by the excess of body fat and affects health and life quality. World Heath Organization recognizes obesity as a chronic disease that needs to be addressed by prolonged and continued treatments. The importance of the glycemic index (GI) of food has increased as a dietary treatment for obesity but its efficacy remains controversial. This study aims to assess the impact of energy restricted diets with predominance of low/high glycemic index food associated or not to metformin therapy into metabolic response of overweight subjects with/without insulinemic alterations during four months of clinical and nutritional treatment. This is a quasiexperimental, analytical, prospective and monoblind trial. Subjects were submitted to anthropometric, dietetic and biochemical evaluations at baseline and during 4 months follow-up. The glycemic and insulinemic profiles were assessed by the oral glucose tolerance test (OGTT) and also creatinin, urea, uric acid and lipids in blood samples. Metformin were prescribed to subjects with baseline OGTT glycemic value at 120 min over 140mg/dl. Dietary energy restriction was 25%-30% of individual estimate energy requirement from the IOM (2002) equations. Both men and women had significant reduction (p<0,05) in total body weight, body mass index (BMI), waist circumference and body fat mass. Decrease in energy consumption was also significant for both sexes. Men had significant reduction in the biochemical parameters of triglycerides and low-density lipoprotein (LDL), while women presented reductions in total serum cholesterol and also LDL. Only men presented significant changes in HOMA-R and the Cederholm Index (CI), which, respectively, measure insulin resistance and sensitivity. All subjects in dietary groups presented significant reductions in anthropometric parameters. HGI group presented decrease in HDL while LGI+MET group in HOMA b and fasting insulin. LGI group presented an increased CI and a significant reduction in triglycerides, VLDL and total serum cholesterol. In conclusion, both men and women had positive changes in anthropometric and dietetic parameters, especially percentage of fat, total body weight and intake of energy, fat and carbohydrate. Moreover, lipid profile showed favorable changes in both genders. The three dietetic groups showed significant reductions in anthropometric and dietetic parameters as body fat, energy, carbohydrate and cholesterol intakes. HGI group presented a negative change in HDL-c The LGI and LGI+MET groups showed positive change in the insulinemic profile. Only the LGI group showed favorable changes in lipid profile and insulin sensitivity.

ASSUNTO(S)

ciencias da saude índice glicêmico ttog metformina obesidade

ACESSO AO ARTIGO

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