Evolução dos estágios de mudança e do estado nutricional de mulheres mediante intervenção nutricional pautada no modelo transteórico para consumo de óleos e gorduras

Abstract

Introduction: Surveys indicate an increase in the levels of total and saturated fats in the diet, indicating the need for effective nutrition interventions that facilitate behavior change, such as those based on Transtheoretical Model (TM) for consumption of oils and fats. However, there are no reports of this kind of initiatives in Brazil. Objective: To analyze the evolution of stages of change (SOC) and nutritional status through nutritional intervention based on Transtheoretical Model for consumption of oils and fats in women of a Health Promotion Serviceof Belo Horizonte. Methods:This was a randomized controlled trial. The control group (CG, n=38) was composed of women who participated in routine interventions of the study site, including regular physical exercise and individual or collective nutritional intervention. The intervention group (IG, n=59), besides these interventions, participated in 10 specific workshops according to the classification of SOC for consumption of oils and fats (pre-action and action). The following tests were used: chi-square, Fisher exact, simple Student t and Mann-Whitney for intergroups; and McNemar, paired Student t, Wilcoxon for intragroups (p < 0.05). In addition, it was performed multiple linear regression in order to verify the factors associated with weight reduction. Results: Among the 97 subjects who initiated the study, 77 (79.4%) completed it. Men (n=6) were excluded in order to sample homogeneity, totaling 71 individuals (IG=40, CG=31). Those who drop out the study were younger and reported a higher prevalence of psychiatric treatment. At baseline, CG and IG had similar characteristics, differing only for the consumption of cholesterol. Most women were classified in the action group (CG: 54,8%; IG: 50,0%). After the intervention, the participants of IG improved their body perception, reduced weight and Body Mass Index (BMI), and decreased consumption of calories and foods high in fats. When the participants were evaluated according to the reclassification in pseudo-maintenance (PM) and non-reflective action, there was only a high prevalence of PM (46.5%). After the intervention, women in PM, compared to other members of the IG, showed progression in the SOC and reduced consumption of calories, weight and BMI. The decrease of body weight observed in the IG was associated with income (1=0.349, p=0.021), protein intake ( =-0.443, p=0.004), adequate intake of lipids (3=0.317, p=0.024) and habit of removing fat from meat and skin apparent chicken (4=0.298, p=0.038). Conclusion: The nutritional intervention based on TM promoted a reduction in the consumption of calories and foods high in fat, weight and BMI, as well as an improvement of body perception. Among the participants of the IG, those in PM showed more positive changes, highlighting the progression in SOC. The findings indicate the importance of this pioneering study in Brazil, confirming the need to develop nutritional interventions aiming to promote healthier eating habits, with a focus on reducing intake of oils and fats.