Influência da restrição do período alimentar e dieta hipocalórica sobre o perfil metabólico e composição corporal de mulheres com obesidade em vulnerabilidade social

Abstract

Given the prevalence of obesity in the socially vulnerable population and the growing search for strategies that facilitate adherence to obesity treatment, this dissertation was developed based on a randomized clinical trial in which two results articles were produced. The first article is an observational study based on baseline data from the clinical trial entitled “Agreement between equations-estimated resting metabolic rate and indirect calorimetry-estimated resting metabolic rate in low-income obese women”, the objective of this study was to determine the predictive equation of resting metabolic rate that shows the highest agreement with the resting metabolic rate obtained by indirect calorimetry in obese Brazilian women living in social vulnerability. Among the analyzed equations, none satisfactorily estimated the resting metabolic rate by indirect calorimetry; however, the Harris-Benedict equation presented greater agreement and the Henry-Rees equation had higher precision, which can be considered in the absence of specific equations. The second article deals with the clinical trial entitled as “Acute effects of time-restricted feeding in low-income women with obesity submitted to hypoenergetic diets: a randomized trial”, the objective of this study was to evaluate the acute effects of dietary restriction in obese women in social vulnerability submitted to the same energy deficit diet. Weight loss was considered as the primary outcome, while secondary outcomes involved: body composition (bioimpedance), vital signs (temperature, blood pressure, and heart rate), appetite, thyroid hormone dosage, leptin, insulin, and glycemia. The latter is used to determine insulin sensitivity before and after 21 days of intervention. Through a mixed ANOVA, significant group x time interactions were observed only at the axillary temperature (-0,4°C; IC95% [-0,7 – -0,1]°C; p = 0,01) and in body fat percentage (0,75%; IC95% [0,0 – 1,4]%; p < 0,05), where the time restricted-feeding induced the maintenance of axillary temperature and the reduction in body fat percentage compared to the hypoenergetic diet, and may be considered a supporting strategy in the treatment of obesity in socially vulnerable women. Given the above, we highlight the difficulty in determining energy expenditure through predictive equations for the obese population and the relevance of the present study to assist in nutritional interventions efficiently. As we also consider that the time-restricted feeding was a strategy that can contribute to the treatment of obesity of women in social vulnerability by contributing to treatment without implying higher costs for the insertion of new foods that do not correspond to the dietary pattern of this population.