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Study of the effectiveness of multidisciplinary intervention in overweight adolescents at the Nutrition Education and recovery center - health multipliers project - phase 2

Grant number: 18/04164-1
Support type:Regular Research Grants
Duration: December 01, 2018 - November 30, 2020
Field of knowledge:Health Sciences - Nutrition
Principal Investigator:Ana Lydia Sawaya
Grantee:Ana Lydia Sawaya
Home Institution: Centro de Recuperação e Educação Alimentar (CREN). Núcleo Interdepartamental de Segurança Alimentar e Nutricional (NISAN). Universidade Federal de São Paulo (UNIFESP). São Paulo , SP, Brazil
Assoc. researchers:Vinicius José Baccin Martins

Abstract

Overweight has become a global pandemic and the main problem for global public health. His treatment has revealed a complex reality with attenuating and aggravating as yet little known. For example, increasing evidence suggests that hyper-palatable foods, or some ingredients in these foods, may be able to trigger an additive process that aggravates the disease picture. In addition, there is evidence that overweight individuals present changes in the hypothalamic-pituitary-thyroid axis and energy balance that may also hamper nutritional recovery. Moreover, there is strong evidence that individuals with short stature, a marker of chronic malnutrition, are at greater risk of gaining weight and of related co-morbidities when living in an obesogenic environment in relation to individuals without short stature. This project represents Phase 2 of a treatment protocol entitled "Study of the effectiveness of multidisciplinary intervention in overweight children and adolescents at the Center for Nutrition Education and Recovery - Multipliers of Health Project" (FAPESP, number 2014 / 22501-2) . E aims to investigate the permanence of the improvement of the nutritional status after 24 months of the end of the treatment (follow-up), and factors that may interfere in the recovery process, namely: the consumption profile and presence of food addiction in follow-up, changes in the hypothalamic-pituitary-thyroid axis at the beginning and at the end of treatment and the effect of short stature. For the study of thyroid function, a group of students with short stature and excess weight will be included. The hypotheses underlying these analyzes are: the students who underwent intervention for weight loss maintained the improvement or continued to improve their nutritional status, the food consumption profile, and further reduced the prevalence of food addiction after the end of the intervention ; the treatment allowed to reverse possible changes in the hypothalamic-pituitary-thyroid axis (PTH). Furthermore, we hypothesize that height, being an important predictor of thyroid function, may help to explain the differences described in the literature on the concentration of HPT axis hormones in overweight individuals. To do so, the questionnaires of addiction and food consumption will be reapplied, and the weight and height of the students who participated in the protocol will be checked. For the investigation of the thyroid function will be carried out the analysis of the hormones with the frozen serum of the students (pre and post treatment for weight loss). In addition, in a group of students paired by sex, age, overweight and with short stature of João Pessoa will be carried out, in collaboration with Prof. Vinicius Martins da UFPB, the evaluation of lipidemia, insulinemia, glycemia, TSH, T3 and T4. The reason for this collaboration is the higher prevalence of students with short stature and excess weight in the Northeast. (AU)