Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica

Detalhes bibliográficos
Autor(a) principal: Gapanowicz, Débora Pinto
Data de Publicação: 2019
Outros Autores: debora.gapanowicz@gmail.com
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/18129
Resumo: Objective: To evaluate the effects of an orientation and eating behavior change program on quality of life (QoL) in patients diagnosed with heterozygous familial hypercholesterolemia (FH). Methods: A two-arm, prospective, randomized-controlled trial was conducted with patients diagnosed with FH for six months. Those in the POMAR group received an intensive follow-up through one-on-one visits, group counseling sessions, and text messages via a smartphone app. Control group (CG) received usual care. Constructs of the social cognitive theory and the health belief model were employed to design the intervention and support lifestyle change. . The Medical Outcomes Short-Form Health Survey (SF-36) and Brief Illness Perception Questionnaire (B-IPQ) were applied.Anthropometric measures, biochemical profile and food intake were also evaluated at the beginning and after 6-month follow-up. Results: Thirty patients diagnosed with FH (POMAR=15 e CG=15) were selected, mean age 48 years old, majority being women (80%). After the intervention, POMAR group showed a general improvement in QoL, with a significant increase in physical functional (p = 0.042), role physical (p = 0.007), general health (p = 0.001), vitality (p = 0.002) and role emotional (p = 0.039). A raise was also seen in the score of the individual control (p = 0.006) and treatment control (p =0.004) of disease perception. With regard to dietary consumption. a reduction of sodium consumption (p = 0.004) and trans fat (p = 0.006) were identified, promoting an improvement in body composition, with a reduction in BMI (p = 0.033) and body fat area (p <0.001).Conclusion: These results indicate the positive impact of an intensive lifestyle intervention on food intake, illness perception and quality of life. In addition, this multimodal approach program represents an innovative and affordable health promotion and prevention strategy, which should not only be applied to other FH and high-risk groups, but also in the primary care.
id UERJ_782d201468b2c3beebd9ebaa1a1cb8b7
oai_identifier_str oai:www.bdtd.uerj.br:1/18129
network_acronym_str UERJ
network_name_str Biblioteca Digital de Teses e Dissertações da UERJ
repository_id_str 2903
spelling Moreira, Annie Seixas Bellohttp://lattes.cnpq.br/6785913715818890Huguenin, Grazielle Vilas Bôashttp://lattes.cnpq.br/4524969597289041Klein, Márcia Regina Simas Torreshttp://lattes.cnpq.br/8755810383117085http://lattes.cnpq.br/8519219011830691Gapanowicz, Débora Pintodebora.gapanowicz@gmail.com2022-08-01T13:47:54Z2019-07-10GAPANOWICZ, Débora Pinto. Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica. 2019. 189 f. Dissertação (Mestrado em Alimentação, Nutrição e Saúde) - Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2019.http://www.bdtd.uerj.br/handle/1/18129Objective: To evaluate the effects of an orientation and eating behavior change program on quality of life (QoL) in patients diagnosed with heterozygous familial hypercholesterolemia (FH). Methods: A two-arm, prospective, randomized-controlled trial was conducted with patients diagnosed with FH for six months. Those in the POMAR group received an intensive follow-up through one-on-one visits, group counseling sessions, and text messages via a smartphone app. Control group (CG) received usual care. Constructs of the social cognitive theory and the health belief model were employed to design the intervention and support lifestyle change. . The Medical Outcomes Short-Form Health Survey (SF-36) and Brief Illness Perception Questionnaire (B-IPQ) were applied.Anthropometric measures, biochemical profile and food intake were also evaluated at the beginning and after 6-month follow-up. Results: Thirty patients diagnosed with FH (POMAR=15 e CG=15) were selected, mean age 48 years old, majority being women (80%). After the intervention, POMAR group showed a general improvement in QoL, with a significant increase in physical functional (p = 0.042), role physical (p = 0.007), general health (p = 0.001), vitality (p = 0.002) and role emotional (p = 0.039). A raise was also seen in the score of the individual control (p = 0.006) and treatment control (p =0.004) of disease perception. With regard to dietary consumption. a reduction of sodium consumption (p = 0.004) and trans fat (p = 0.006) were identified, promoting an improvement in body composition, with a reduction in BMI (p = 0.033) and body fat area (p <0.001).Conclusion: These results indicate the positive impact of an intensive lifestyle intervention on food intake, illness perception and quality of life. In addition, this multimodal approach program represents an innovative and affordable health promotion and prevention strategy, which should not only be applied to other FH and high-risk groups, but also in the primary care.Objetivo: Avaliar o efeito de um programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica (HFHe). Métodos: Trata-se de um ensaio clínico randomizado, prospectivo, com grupo controle em paralelo e duração de seis meses, com pacientes diagnosticados com HF no Rio de Janeiro. Os pacientes alocados no grupo intervenção (POMAR) recebem um tratamento intensivo, composto por 3 consultas individuais, 5 consultas em grupo mensais e recebimento de mensagens de texto semanais, via aplicativo de smartphone. Já o grupo controle (GC) recebeu o acompanhamento ambulatorial habitual. O POMAR foi desenvolvido baseado nos constructos da teoria social cognitiva e o modelo de crença em saúde. Foram aplicados os questionários de qualidade de vida relacionada à saúde (SF-36), percepção da doença (B- IPQ) e consumo alimentar (registro alimentar de três dias), realização de medidas antropométricas e análises laboratoriais ao início e após os 6 meses de acompanhamento. Resultados: Trinta pacientes diagnosticados com HFHe (POMAR= 15 e GI= 15), com média de idade de 48 anos e em sua maioria mulheres (80%). Após a intervenção, o G-POMAR apresentou uma melhora geral na QV, com um aumento significativo nos domínios como capacidade funcional (p=0,042), aspectos físicos (p=0,007), estado geral de saúde (p=0,001), vitalidade (p=0,002) e aspectos emocionais (p=0,039). Identificou-se ainda um aumento significativo no escore dos domínios controle individual (p=0,006) e controle do tratamento (p=0,004) de percepção da doença e redução do consumo de sódio (p=0,004), e gordura trans (p=0,006), promovendo uma melhora na composição corporal, com redução do IMC (p=0,033) e da área de gordura corporal (p<0,001). Conclusão: Esses resultados indicam a efetividade de uma intervenção intensiva no estilo de vida e melhora da qualidade de vida, percepção da doença, consumo alimentar e composição corporal. Esses achados trazem evidências sobre a viabilidade e benefícios desse tipo de abordagem multimodal e sugerem a sua aplicação não só em outras populações com HF ou em alto risco cardiovascular, como também na população em geral atendida nas unidades básicas de saúde.Submitted by Mariangela CEH/A (marianfig.uerj@gmail.com) on 2022-08-01T13:47:54Z No. of bitstreams: 2 Dissertação - Débora Pinto Gapanowicz - 2019 - Completa.pdf: 7201026 bytes, checksum: e53e29239e46b05cd90f1aace6fe2ea2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5)Made available in DSpace on 2022-08-01T13:47:54Z (GMT). No. of bitstreams: 2 Dissertação - Débora Pinto Gapanowicz - 2019 - Completa.pdf: 7201026 bytes, checksum: e53e29239e46b05cd90f1aace6fe2ea2 (MD5) license_rdf: 0 bytes, checksum: d41d8cd98f00b204e9800998ecf8427e (MD5) Previous issue date: 2019-07-10Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESapplication/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Alimentação, Nutrição e SaúdeUERJBrasilCentro Biomédico::Instituto de Nutriçãohttp://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessFamilial HypercholesterolemiaQuality of LifeDietary IntakeHealth BehaviorLifestyle Change ProgramNutriçãoHipercolesterolemia FamiliarQualidade de VidaHipercolesterolemia FamiliarQualidade de VidaConsumo AlimentarComportamento de SaúdePrograma de Mudança De Estilo de VidaCIENCIAS DA SAUDE::NUTRICAO::DIETETICAImpacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigóticaImpact of the orientation and eating behavior change program (POMAR) on the quality of life in patients diagnosed with heterozygous familial hypercholesterolemiainfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALDissertação - Débora Pinto Gapanowicz - 2019 - Completa.pdfDissertação - Débora Pinto Gapanowicz - 2019 - Completa.pdfapplication/pdf7201026http://www.bdtd.uerj.br/bitstream/1/18129/5/Disserta%C3%A7%C3%A3o+-+D%C3%A9bora+Pinto+Gapanowicz+-+2019+-+Completa.pdfe53e29239e46b05cd90f1aace6fe2ea2MD55CC-LICENSElicense_urllicense_urltext/plain; charset=utf-849http://www.bdtd.uerj.br/bitstream/1/18129/2/license_url4afdbb8c545fd630ea7db775da747b2fMD52license_textlicense_texttext/html; charset=utf-80http://www.bdtd.uerj.br/bitstream/1/18129/3/license_textd41d8cd98f00b204e9800998ecf8427eMD53license_rdflicense_rdfapplication/rdf+xml; charset=utf-80http://www.bdtd.uerj.br/bitstream/1/18129/4/license_rdfd41d8cd98f00b204e9800998ecf8427eMD54LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/18129/1/license.txte5502652da718045d7fcd832b79fca29MD511/181292024-02-23 16:32:25.407oai:www.bdtd.uerj.br:1/18129Tk9UQTogTElDRU7Dh0EgUkVERSBTSVJJVVMKRXN0YSBsaWNlbsOnYSBkZSBleGVtcGxvIMOpIGZvcm5lY2lkYSBhcGVuYXMgcGFyYSBmaW5zIGluZm9ybWF0aXZvcy4KCkxJQ0VOw4dBIERFIERJU1RSSUJVScOHw4NPIE7Dg08tRVhDTFVTSVZBCgpDb20gYSBhcHJlc2VudGHDp8OjbyBkZXN0YSBsaWNlbsOnYSwgdm9jw6ogKG8gYXV0b3IgKGVzKSBvdSBvIHRpdHVsYXIgZG9zIGRpcmVpdG9zIGRlIGF1dG9yKSBjb25jZWRlIMOgIFVuaXZlcnNpZGFkZSAKZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBvIGRpcmVpdG8gbsOjby1leGNsdXNpdm8gZGUgcmVwcm9kdXppciwgIHRyYWR1emlyIChjb25mb3JtZSBkZWZpbmlkbyBhYmFpeG8pLCBlL291IApkaXN0cmlidWlyIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAoaW5jbHVpbmRvIG8gcmVzdW1vKSBwb3IgdG9kbyBvIG11bmRvIG5vIGZvcm1hdG8gaW1wcmVzc28gZSBlbGV0csO0bmljbyBlIAplbSBxdWFscXVlciBtZWlvLCBpbmNsdWluZG8gb3MgZm9ybWF0b3Mgw6F1ZGlvIG91IHbDrWRlby4KClZvY8OqIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSwgc2VtIGFsdGVyYXIgbyBjb250ZcO6ZG8sIHRyYW5zcG9yIGEgc3VhIHRlc2Ugb3UgZGlzc2VydGHDp8OjbyAKcGFyYSBxdWFscXVlciBtZWlvIG91IGZvcm1hdG8gcGFyYSBmaW5zIGRlIHByZXNlcnZhw6fDo28uCgpWb2PDqiB0YW1iw6ltIGNvbmNvcmRhIHF1ZSBhIFVFUkogcG9kZSBtYW50ZXIgbWFpcyBkZSB1bWEgY8OzcGlhIGEgc3VhIHRlc2Ugb3UgCmRpc3NlcnRhw6fDo28gcGFyYSBmaW5zIGRlIHNlZ3VyYW7Dp2EsIGJhY2stdXAgZSBwcmVzZXJ2YcOnw6NvLgoKVm9jw6ogZGVjbGFyYSBxdWUgYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIMOpIG9yaWdpbmFsIGUgcXVlIHZvY8OqIHRlbSBvIHBvZGVyIGRlIGNvbmNlZGVyIG9zIGRpcmVpdG9zIGNvbnRpZG9zIApuZXN0YSBsaWNlbsOnYS4gVm9jw6ogdGFtYsOpbSBkZWNsYXJhIHF1ZSBvIGRlcMOzc2l0byBkYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIG7Do28sIHF1ZSBzZWphIGRlIHNldSAKY29uaGVjaW1lbnRvLCBpbmZyaW5nZSBkaXJlaXRvcyBhdXRvcmFpcyBkZSBuaW5ndcOpbS4KCkNhc28gYSBzdWEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvIGNvbnRlbmhhIG1hdGVyaWFsIHF1ZSB2b2PDqiBuw6NvIHBvc3N1aSBhIHRpdHVsYXJpZGFkZSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMsIHZvY8OqIApkZWNsYXJhIHF1ZSBvYnRldmUgYSBwZXJtaXNzw6NvIGlycmVzdHJpdGEgZG8gZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzIHBhcmEgY29uY2VkZXIgw6AgVUVSSiBvcyBkaXJlaXRvcyBhcHJlc2VudGFkb3MgbmVzdGEgbGljZW7Dp2EsIGUgcXVlIGVzc2UgbWF0ZXJpYWwgZGUgcHJvcHJpZWRhZGUgZGUgdGVyY2Vpcm9zIGVzdMOhIGNsYXJhbWVudGUgCmlkZW50aWZpY2FkbyBlIHJlY29uaGVjaWRvIG5vIHRleHRvIG91IG5vIGNvbnRlw7pkbyBkYSB0ZXNlIG91IGRpc3NlcnRhw6fDo28gb3JhIGRlcG9zaXRhZGEuCgpDQVNPIEEgVEVTRSBPVSBESVNTRVJUQcOHw4NPIE9SQSBERVBPU0lUQURBIFRFTkhBIFNJRE8gUkVTVUxUQURPIERFIFVNIFBBVFJPQ8ONTklPIE9VIApBUE9JTyBERSBVTUEgQUfDik5DSUEgREUgRk9NRU5UTyBPVSBPVVRSTyBPUkdBTklTTU8gUVVFIE7Dg08gU0VKQSBFU1RBClVOSVZFUlNJREFERSwgVk9Dw4ogREVDTEFSQSBRVUUgUkVTUEVJVE9VIFRPRE9TIEUgUVVBSVNRVUVSIERJUkVJVE9TIERFIFJFVklTw4NPIENPTU8gClRBTULDiU0gQVMgREVNQUlTIE9CUklHQcOHw5VFUyBFWElHSURBUyBQT1IgQ09OVFJBVE8gT1UgQUNPUkRPLgoKQSBVbml2ZXJzaWRhZGUgZG8gRXN0YWRvIGRvIFJpbyBkZSBKYW5laXJvIChVRVJKKSBzZSBjb21wcm9tZXRlIGEgaWRlbnRpZmljYXIgY2xhcmFtZW50ZSBvIHNldSBub21lIChzKSBvdSBvKHMpIG5vbWUocykgZG8ocykgCmRldGVudG9yKGVzKSBkb3MgZGlyZWl0b3MgYXV0b3JhaXMgZGEgdGVzZSBvdSBkaXNzZXJ0YcOnw6NvLCBlIG7Do28gZmFyw6EgcXVhbHF1ZXIgYWx0ZXJhw6fDo28sIGFsw6ltIGRhcXVlbGFzIApjb25jZWRpZGFzIHBvciBlc3RhIGxpY2Vuw6dhLgo=Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-23T19:32:25Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
dc.title.alternative.eng.fl_str_mv Impact of the orientation and eating behavior change program (POMAR) on the quality of life in patients diagnosed with heterozygous familial hypercholesterolemia
title Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
spellingShingle Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
Gapanowicz, Débora Pinto
Familial Hypercholesterolemia
Quality of Life
Dietary Intake
Health Behavior
Lifestyle Change Program
Nutrição
Hipercolesterolemia Familiar
Qualidade de Vida
Hipercolesterolemia Familiar
Qualidade de Vida
Consumo Alimentar
Comportamento de Saúde
Programa de Mudança De Estilo de Vida
CIENCIAS DA SAUDE::NUTRICAO::DIETETICA
title_short Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
title_full Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
title_fullStr Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
title_full_unstemmed Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
title_sort Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica
author Gapanowicz, Débora Pinto
author_facet Gapanowicz, Débora Pinto
debora.gapanowicz@gmail.com
author_role author
author2 debora.gapanowicz@gmail.com
author2_role author
dc.contributor.advisor1.fl_str_mv Moreira, Annie Seixas Bello
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/6785913715818890
dc.contributor.referee1.fl_str_mv Huguenin, Grazielle Vilas Bôas
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/4524969597289041
dc.contributor.referee2.fl_str_mv Klein, Márcia Regina Simas Torres
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/8755810383117085
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/8519219011830691
dc.contributor.author.fl_str_mv Gapanowicz, Débora Pinto
debora.gapanowicz@gmail.com
contributor_str_mv Moreira, Annie Seixas Bello
Huguenin, Grazielle Vilas Bôas
Klein, Márcia Regina Simas Torres
dc.subject.eng.fl_str_mv Familial Hypercholesterolemia
Quality of Life
Dietary Intake
Health Behavior
Lifestyle Change Program
topic Familial Hypercholesterolemia
Quality of Life
Dietary Intake
Health Behavior
Lifestyle Change Program
Nutrição
Hipercolesterolemia Familiar
Qualidade de Vida
Hipercolesterolemia Familiar
Qualidade de Vida
Consumo Alimentar
Comportamento de Saúde
Programa de Mudança De Estilo de Vida
CIENCIAS DA SAUDE::NUTRICAO::DIETETICA
dc.subject.por.fl_str_mv Nutrição
Hipercolesterolemia Familiar
Qualidade de Vida
Hipercolesterolemia Familiar
Qualidade de Vida
Consumo Alimentar
Comportamento de Saúde
Programa de Mudança De Estilo de Vida
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::NUTRICAO::DIETETICA
description Objective: To evaluate the effects of an orientation and eating behavior change program on quality of life (QoL) in patients diagnosed with heterozygous familial hypercholesterolemia (FH). Methods: A two-arm, prospective, randomized-controlled trial was conducted with patients diagnosed with FH for six months. Those in the POMAR group received an intensive follow-up through one-on-one visits, group counseling sessions, and text messages via a smartphone app. Control group (CG) received usual care. Constructs of the social cognitive theory and the health belief model were employed to design the intervention and support lifestyle change. . The Medical Outcomes Short-Form Health Survey (SF-36) and Brief Illness Perception Questionnaire (B-IPQ) were applied.Anthropometric measures, biochemical profile and food intake were also evaluated at the beginning and after 6-month follow-up. Results: Thirty patients diagnosed with FH (POMAR=15 e CG=15) were selected, mean age 48 years old, majority being women (80%). After the intervention, POMAR group showed a general improvement in QoL, with a significant increase in physical functional (p = 0.042), role physical (p = 0.007), general health (p = 0.001), vitality (p = 0.002) and role emotional (p = 0.039). A raise was also seen in the score of the individual control (p = 0.006) and treatment control (p =0.004) of disease perception. With regard to dietary consumption. a reduction of sodium consumption (p = 0.004) and trans fat (p = 0.006) were identified, promoting an improvement in body composition, with a reduction in BMI (p = 0.033) and body fat area (p <0.001).Conclusion: These results indicate the positive impact of an intensive lifestyle intervention on food intake, illness perception and quality of life. In addition, this multimodal approach program represents an innovative and affordable health promotion and prevention strategy, which should not only be applied to other FH and high-risk groups, but also in the primary care.
publishDate 2019
dc.date.issued.fl_str_mv 2019-07-10
dc.date.accessioned.fl_str_mv 2022-08-01T13:47:54Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/masterThesis
format masterThesis
status_str publishedVersion
dc.identifier.citation.fl_str_mv GAPANOWICZ, Débora Pinto. Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica. 2019. 189 f. Dissertação (Mestrado em Alimentação, Nutrição e Saúde) - Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2019.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/18129
identifier_str_mv GAPANOWICZ, Débora Pinto. Impacto do programa de orientação e mudança alimentar (POMAR) na qualidade de vida de pacientes diagnosticados com hipercolesterolemia familiar heterozigótica. 2019. 189 f. Dissertação (Mestrado em Alimentação, Nutrição e Saúde) - Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2019.
url http://www.bdtd.uerj.br/handle/1/18129
dc.language.iso.fl_str_mv por
language por
dc.rights.driver.fl_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
info:eu-repo/semantics/openAccess
rights_invalid_str_mv http://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Alimentação, Nutrição e Saúde
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Centro Biomédico::Instituto de Nutrição
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
dc.source.none.fl_str_mv reponame:Biblioteca Digital de Teses e Dissertações da UERJ
instname:Universidade do Estado do Rio de Janeiro (UERJ)
instacron:UERJ
instname_str Universidade do Estado do Rio de Janeiro (UERJ)
instacron_str UERJ
institution UERJ
reponame_str Biblioteca Digital de Teses e Dissertações da UERJ
collection Biblioteca Digital de Teses e Dissertações da UERJ
bitstream.url.fl_str_mv http://www.bdtd.uerj.br/bitstream/1/18129/5/Disserta%C3%A7%C3%A3o+-+D%C3%A9bora+Pinto+Gapanowicz+-+2019+-+Completa.pdf
http://www.bdtd.uerj.br/bitstream/1/18129/2/license_url
http://www.bdtd.uerj.br/bitstream/1/18129/3/license_text
http://www.bdtd.uerj.br/bitstream/1/18129/4/license_rdf
http://www.bdtd.uerj.br/bitstream/1/18129/1/license.txt
bitstream.checksum.fl_str_mv e53e29239e46b05cd90f1aace6fe2ea2
4afdbb8c545fd630ea7db775da747b2f
d41d8cd98f00b204e9800998ecf8427e
d41d8cd98f00b204e9800998ecf8427e
e5502652da718045d7fcd832b79fca29
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
MD5
repository.name.fl_str_mv Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)
repository.mail.fl_str_mv bdtd.suporte@uerj.br
_version_ 1792352363637374976