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Ingestão nutricional em prevenção cardiovascular
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Advisor(s)
Abstract(s)
Em Portugal e noutros países economicamente mais desenvolvidos, as doenças
cardiovasculares representam a principal causa de mortalidade por doenças
transmissíveis. A sua etiologia é multifatorial mas pensa-se que os estilos de vida,
nomeadamente uma alimentação saudável seja fundamental para a prevenção primária e
secundária das doenças cardiovasculares.
Este trabalho reviu a literatura científica sobre o efeito da ingestão nutricional com efeito
na saúde cardiovascular e realçou as atuais recomendações nutricionais para a prevenção
cardiovascular primária e secundária. Foi feita uma revisão bibliográfica da literatura a
partir das bases de dados da PubMed e ScienceDirect, complementada por pesquisa
manual, e também por pesquisas em revistas científicas e sites da internet.
No contexto de prevenção cardiovascular, o consumo de sal deve de ser inferiro a 5g/dia.
Preconiza-se também que o consumo de gorduras totais não ultrapasse os 30% do valor
energético diário assim como deve ser feita uma redução no consumo de ácidos gordos
trans. A evidência para os ácidos gordos saturados é ainda controversa, com base em
resultados de uma meta-análise de estudos de coorte prospetivos. Deve ser dada
preferência ao consumo de ácidos gordos insaturados tais como os monoinsaturados e os
polinsaturados, nomeadamente os ácidos gordos ómega 3 dado os seus efeitos antiinflamatórios
e anti-trombóticos. Os indivíduos saudáveis deverão consumir 500 mg/dia
de ácidos gordos ómega 3 e os indivíduos com história de doença cardiovascular devem
consumir 800 mg/dia, pelo que as recomendações diferem em prevenção primária e
secundária. Destaca-se ainda, que a relação ómega 6 versus ómega 3 deve de estar
equilibrada, sendo o equilíbrio ideal de 3:1. O papel do colesterol alimentar na doença
cardiovascular não está totalmente esclarecido, sendo necessários futuramente mais
estudos. No entanto, as recomendações alertam que este consumo não deve ser superior
a 300 mg/dia para indivíduos saudáveis e a 200 mg/dia para indivíduos com histórico de
doença cardiovascular. O consumo de 200 a 400 mg/dia de fitoesterois apresenta efeitos
benéficos nas concentrações de colesterol total. O consumo moderado de álcool, isto é 10
g/dia para as mulheres e 20 g/dia para os homens, apresenta benefícios na prevenção
cardiovascular e este efeito pode ser independente do tipo e bebida alcoólica. O consumo
de proteínas também deve de ser moderado, dando preferência ao consumo de proteínas
de origem vegetal, como por exemplo as proteínas da soja. Deve-se privilegiar uma dieta
rica em produtos hortofrutícolas, grãos integrais e soja para a manutenção dos níveis
ideias de fibras. A suplementação em antioxidantes não está recomendada em prevenção cardiovascular, sendo que é de privilegiar uma alimentação rica em frutas e hortícolas
como fontes de grandes quantidades de antioxidantes tais como a vitamina E, vitamina
C, carotenoides e flavonoides devido ao seu elevado efeito protetor na prevenção
cardiovascular. É de salientar ainda que, a Dieta Mediterrânica e a Dieta DASH são
atualmente reconhecidas pela evidência científica como padrões alimentares a seguir para
a prevenção primária e secundária da doença cardiovascular.
Este trabalho concluiu que uma alimentação saudável que garanta o consumo adequado
de macronutrientes e micronutrientes é a base fundamental para a prevenção das doenças
cardiovasculares.
In Portugal and other economically developed countries, cardiovascular diseases represent the leading cause of mortality by non-communicable diseases. Its etiology is multifactorial, but it is believed that lifestyles, particularly a healthy is essential for primary and secondary prevention of cardiovascular diseases. This paper reviewed the scientific literature on the effect of nutritional intake on cardiovascular health effect and highlighted the current nutritional recommendations for primary and secondary cardiovascular prevention. A bibliographical review was conducted based on PubMed and ScienceDirect databases, complemented by a manual search, as well as other scientific journals and websites. For cardiovascular prevention, salt intake should be less than 5 g/day. It is also recommended that the consumption of total fat does not exceed 30% of the total daily energy intake, as well as a reduction in the consumption of trans fatty. Evidence for saturated fatty acids is still controversial based on evidence from a meta-analysis of prospective cohort studies. In general, the consumption of unsaturated fatty acids such as monounsaturated and polyunsaturated ones should be preferred, namely omega-3, given its anti-inflammatory and anti-thrombotic effects. Healthy subjects should consume 500 mg/day of omega-3 fatty acids and individuals with a history of cardiovascular disease should consume 800 mg/day, and thus recommendations differ in primary and secondary prevention. It should also be noted that the omega-6 versus omega-3 ratio must be balanced, with the ideal balance being of 3: 1. The role of dietary cholesterol in cardiovascular diseases is not fully understood, leading to the need of more studies in the future. However, the recommendations warn that this consumption should not exceed 300 mg/day for healthy subjects and 200 mg/day for individuals with a history of cardiovascular disease. The consumption of 200 to 400 mg/day of phytosterols has beneficial effects on total cholesterol concentrations. Moderate alcohol consumption (10 g/day for women and 20 g/day for men) has benefits in cardiovascular prevention, and this effect may be independent of the type of alcoholic beverage. Protein consumption should also be moderate, giving preference to the consumption of proteins of plant origin, such as soy proteins. A diet rich in fruit and vegetables, whole grains and soybeans should be privileged to maintain the optimal levels of fibers. Supplementation with antioxidants is not recommended in cardiovascular prevention, as it is preferable to eat a rich diet of fruit and vegetables as sources of large amounts of antioxidants such as vitamin E, vitamin C, carotenoids and flavonoids due to their high protective effect in cardiovascular prevention. It should also be noted that the Mediterranean Diet and the DASH Diet are currently recognized by the scientific evidence as dietary patterns to follow for primary and secondary prevention of cardiovascular disease. This study concluded that a healthy diet which guarantees an adequate consumption of macronutrients and micronutrients is the fundamental basis for the prevention of cardiovascular diseases.
In Portugal and other economically developed countries, cardiovascular diseases represent the leading cause of mortality by non-communicable diseases. Its etiology is multifactorial, but it is believed that lifestyles, particularly a healthy is essential for primary and secondary prevention of cardiovascular diseases. This paper reviewed the scientific literature on the effect of nutritional intake on cardiovascular health effect and highlighted the current nutritional recommendations for primary and secondary cardiovascular prevention. A bibliographical review was conducted based on PubMed and ScienceDirect databases, complemented by a manual search, as well as other scientific journals and websites. For cardiovascular prevention, salt intake should be less than 5 g/day. It is also recommended that the consumption of total fat does not exceed 30% of the total daily energy intake, as well as a reduction in the consumption of trans fatty. Evidence for saturated fatty acids is still controversial based on evidence from a meta-analysis of prospective cohort studies. In general, the consumption of unsaturated fatty acids such as monounsaturated and polyunsaturated ones should be preferred, namely omega-3, given its anti-inflammatory and anti-thrombotic effects. Healthy subjects should consume 500 mg/day of omega-3 fatty acids and individuals with a history of cardiovascular disease should consume 800 mg/day, and thus recommendations differ in primary and secondary prevention. It should also be noted that the omega-6 versus omega-3 ratio must be balanced, with the ideal balance being of 3: 1. The role of dietary cholesterol in cardiovascular diseases is not fully understood, leading to the need of more studies in the future. However, the recommendations warn that this consumption should not exceed 300 mg/day for healthy subjects and 200 mg/day for individuals with a history of cardiovascular disease. The consumption of 200 to 400 mg/day of phytosterols has beneficial effects on total cholesterol concentrations. Moderate alcohol consumption (10 g/day for women and 20 g/day for men) has benefits in cardiovascular prevention, and this effect may be independent of the type of alcoholic beverage. Protein consumption should also be moderate, giving preference to the consumption of proteins of plant origin, such as soy proteins. A diet rich in fruit and vegetables, whole grains and soybeans should be privileged to maintain the optimal levels of fibers. Supplementation with antioxidants is not recommended in cardiovascular prevention, as it is preferable to eat a rich diet of fruit and vegetables as sources of large amounts of antioxidants such as vitamin E, vitamin C, carotenoids and flavonoids due to their high protective effect in cardiovascular prevention. It should also be noted that the Mediterranean Diet and the DASH Diet are currently recognized by the scientific evidence as dietary patterns to follow for primary and secondary prevention of cardiovascular disease. This study concluded that a healthy diet which guarantees an adequate consumption of macronutrients and micronutrients is the fundamental basis for the prevention of cardiovascular diseases.
Description
Trabalho Complementar apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de licenciada em Ciências da Nutrição
Keywords
Doenças cardiovascular Alimentação Prevenção primária Prevenção secundária Revisão da literatura Cardiovascular disease Diet Primary prevention Secondary prevention Literature review