Avaliação do consumo de alimentos e ingestão de ferro em adultos com anemia falciforme

• Autor(a) principal: Teixeira, Tamara Vilhena
• Data de Publicação: 2020
• Outros Autores: [e-mail]
• 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/1/17463
• topic: Hierro; Sobrecarga de hierro; Consumo alimentario; Clasificación NOVA; Sickle cell anemia; Iron; Iron overload; Food consumption; NOVA classification; Nutrição; Anemia falciforme; Ferro; Sobrecarga de ferro; Consumo de alimentos; Classificação NOVA; CIENCIAS DA SAUDE::NUTRICAO::ANALISE NUTRICIONAL DE POPULACAO

Introduction: Sickle Cell Anemia (SCA) is caused by homozygous hemoglobin S (HbSS) inheritance. It is characterized by chronic hemolytic anemia and vascular occlusion, resulting in chronic inflammation. In order to minimize and prevent the disease's symptoms aggravation, treatment with transfusion therapy is commonly required. When transfusion is done continuously, it can cause iron overload (IOL). Also in this scenario, in order to reduce the possible damage from excess iron, it is common for health care professionals to recommend restricting food sources of iron as well as reducing the consumption of food sources of vitamin C. These can result in the worsening of the overall quality of the diet and represent a risk of less consumption and absorption of iron. On the other hand, iron consumption above the recommendations may pose a risk of aggravation or development of IOL in people with SCA. To date, the food intake of a representative sample of adults with SCA is unknown, in addition, there are no studies in the literature to assess the iron consumption of these individuals. Therefore, the aim of this study was to evaluate food consumption, as well as iron intake in adults with SCA in the city of Rio de Janeiro. Methods: A cross-sectional study conducted between January and December 2019 with adults with SCA living in Rio de Janeiro city. Information on food consumption was collected through a 24-hour recall per participant. Socioeconomic and clinical data were obtained through a questionnaire. Food quantities consumed were converted into energy and in milligrams of iron and vitamin C through the table of nutritional composition of food consumed in Brazil. In addition, the foods consumed were grouped according to the NOVA classification. The prevalence of inadequate iron consumption was calculated by using the EAR method as a cutoff point, according to gender and age group of participants. Results: A total of 215 individuals were evaluated, 58.6% female with mean age of 36.6±11.5 years and 41.4% male with mean age of 33±10.6 years. The prevalence of inadequate iron intake was estimated at 40% among women within reproductive age, 8% among women over 50 years of age, and 2.8% among men. Iron intake above the tolerable limit was 0.8% among women and 3.4% among men. The intake of vitamin C below the EAR was observed in 61.4% of individuals. The largest portion of the iron intake came from natural or minimally processed foods (72.7%), especially meat (31%) and beans (23.5%), while intake from ultra-processed foods represented 23.5% of total iron intake. Corn and wheat flour-based foods contributed 17.5% of the total iron intake in the diet. The evaluation of iron intake in the different socioeconomic classes showed that classes A+B1+B2 and C1 had the highest median iron intake, while class C2 and class D-E had the lowest intake values. Conclusion: The risk of excessive iron consumption does not seem to be a serious problem in the population studied. Therefore, recommendations for iron and vitamin C restriction should be reassessed. It is important to emphasize that for a better understanding of the risks that iron intake offers to the population with SCA, it is necessary to also know the absorptive capacity of these people. These findings point to the need for better clinical, food and nutritional monitoring of patients with SCA as they may be more vulnerable to iron deficiency, especially women of reproductive age and people belonging to the lower socioeconomic classes.