VERUSKA MAGALHAES SCABIM
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
LIM/38 - Laboratório de Epidemiologia e Imunobiologia, Hospital das Clínicas, Faculdade de Medicina
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- Very low-calorie diet in candidates for bariatric surgery: change in body composition during rapid weight loss(2019) SERAFIM, Marcela Pires; SANTO, Marco Aurelio; GADDUCCI, Alexandre Vieira; SCABIM, Veruska Magalhaes; CECCONELLO, Ivan; CLEVA, Roberto deOBJECTIVE: To analyze the changes in the body composition of morbidly obese patients induced by a very low-calorie diet. METHODS: We evaluated 120 patients selected from a university hospital. Body composition was assessed before and after the diet provided during hospitalization, and changes in weight, body mass index, and neck, waist and hip circumferences were analyzed. Bioimpedance was used to obtain body fat and fat-free mass values. The data were categorized by gender, age, body mass index and diabetes diagnosis. RESULTS: The patients consumed the diet for 8 days. They presented a 5% weight loss (without significant difference among groups), which represented an 85% reduction in body fat. All changes in body circumference were statistically significant. There was greater weight loss and a greater reduction of body fat in men, but the elderly showed a significantly higher percentage of weight loss and greater reductions in body fat and fat-free mass. Greater reductions in body fat and fat-free mass were also observed in superobese patients. The changes in the diabetic participants did not differ significantly from those of the non-diabetic participants. CONCLUSIONS: The use of a VLCD before bariatric surgery led to a loss of weight at the expense of body fat over a short period, with no significant differences in the alteration of body composition according to gender, age, body mass index and diabetes status.
- Adesão ao seguimento nutricional ambulatorial pós-cirurgia bariátrica e fatores associados(2012) SCABIM, Veruska Magalhaes; ELUF-NETO, Jose; TESS, Beatriz HelenaObjective This study estimated the prevalence of adherence to outpatient postoperative nutritional follow-up after bariatric surgery and analyzed the association between adherence and selected factors. Methods A total of 241 records of female and male adults who underwent Roux-en-Y gastric bypass between 2006 and 2008 were reviewed for this retrospective cohort study. The data included the preoperative and postoperative periods. Individuals were considered compliant when they attended four or more nutritional appointments in the first 12 months after surgery. Prevalence ratios were calculated for estimating the association between adherence to postoperative nutritional follow-up and factors such as age, gender, marital status, education level, employment status, distance between home and hospital, weight loss strategies used during the preoperative period, body mass index immediately before surgery, presence of comorbidities and duration of hospital stay after surgery, and the Poisson multiple regression was used for adjusted analysis. Results Adherence prevalence was 56.0% (CI95% 49.7-62.3). Women composed 80.9% of the population; the mean age of the sample was 44.4 years (SD=11.6) and mean preoperative body mass index was 47.2kg/m(2) (SD=6.2). Among the study factors, only duration of postoperative hospital stay was significantly associated with adherence after adjustment for age and gender (PR=1.46 CI95% 1.15-1.86). Conclusion The adherence prevalence of this population was similar to those of foreign studies, but below the minimum prevalence of 75% considered reference. The greater adherence of individuals with longer postoperative hospital stays may have stemmed from their prolonged interaction with the multidisciplinary team, which may have increased their awareness of disease severity and need of long-term health care.
- Modified body adiposity index for body fat estimation in severe obesity(2017) BERNHARD, A. B.; SCABIM, V. M.; SERAFIM, M. P.; GADDUCCI, A. V.; SANTO, M. A.; CLEVA, R. deBackgroundThe body adiposity index (BAI) comprises a simple method for estimating body fat (BF) that needs to be validated in patients with severe obesity. The present study aimed to determine BAI accuracy with respect to the determination BF in patients with severe obesity. MethodsA cross-sectional prospective study comparing two methods for BF estimation was conducted in 433 patients with severe obesity between August 2012 to December 2014. BF was estimated by bioelectrical impedance analysis (BIA) with specific equations developed for BF estimation in patients with severe obesity and BAI. The BF estimation in 240 patients with severe obesity (Group 1: G1) was used to evaluate BAI limitations and to develop a specific equationin this population. The new equationproposed was validated in another 158 patients with severe obesity (Group 2: G2). ResultsThere was a significant difference between BF determination by BIA and BAI (P=0.039). The mean (SD) BF in G1 was 52.3%(6.1%) determined by BIA and 51.6%(8.1%) determined by BAI. Sex, waist-hip ratio (WHR) and obesity grade determined significant errors on BF estimation by BAI. A new equation(modified body adiposity index; MBAI) was developed by linear regression to minimise these errors [MBAI%=23.6+0.5x(BAI); add 2.2 if body mass index50kgm(-2) and 2.4 if WHR1.05]. The new equationreduced the difference [1.2% (5.9%), P<0.001 to 0.4%(4.12%), P=0.315] and improved the correlation (0.6-0.7) between methods. ConclusionsBAI present significant limitations in severe obesity and MBAI was effective for BF estimation in this population.
- Obese patients lose weight independently of nutritional follow-up after bariatric surgery(2015) TESS, Beatriz Helena; SCABIM, Veruska Magalhães; SANTO, Marco Aurélio; PEREIRA, Júlio César R.Summary Objective: to examine the association between preoperative body weight, adherence to postsurgical nutritional follow-up, length of postoperative period, and weight loss during the first 18 months among adults who have undergone bariatric surgery. Methods: a retrospective cohort study was conducted on 241 consecutive patients who underwent open Roux-en-Y gastric bypass (RYGBP) from January 2006 to December 2008, in a teaching hospital in São Paulo (Brazil). Data were collected through hospital records review and the variables analyzed included sex, age, immediate preoperative weight, adherence to postsurgical nutritional visits and length of postoperative period. Proportional body weight reductions during the 18-month follow-up period were examined using generalized estimating equations. Results: 81% (n=195) of participants were female, with overall mean age of 44.4 ± 11.6 years, mean preoperative weight of 123.1± 21.2 kg and mean preoperative body mass index of 47.2± 6.2 kg/m2. The overall adherence to postoperative follow- up schedule was 51% (95%CI: 44.5-57.5%). Preoperative body weight and adherence were not associated with proportional weight reduction (Wald’s test p > 0.18). Weight loss leveled off at the end of the 18-month follow-up period for both compliant and non-compliant patients (Wald’s test p = 0.00). Conclusions: our study showed that weight loss occurred steadily over the first 18 months after RYGBP, leveling off at around 40% weight reduction. It was associated with neither presurgical weight, nor nutritional follow-up and it may be primarily dependent on the surgical body alterations themselves. This finding may have implications for intervention strategies aimed at motivating patients to comply with early postsurgical and life-long follow-up.