EFEITOS DA INTERVENÇÃO MULTIDISCIPLINAR NA QUALIDADE DE VIDA E PARÂMETROS BIOQUÍMICOS DE ADULTOS E CRIANÇAS COM EXCESSO DE PESO.

Abstract

In children and adults obesity is normally associated with an inadequate diet, low physical activity and environmental or genetic factors. Individuals in this condition have a higher prevalence of cardiovascular risk factors, shown by their clinical history, physical exams or biochemical parameters, in addition to loss of quality of life. Ten multidisciplinary intervention sessions were conducted, involving 26 overweight families, chosen from an elementary school in Goiânia, Brazil. This investigation was divided in three studies. The first and second studies evaluate the quality of life of caregivers and children, the effect of the intervention on the Body Mass Index (BMI) and on the quality of life (QL), and the relationship between the QL and the BMI. The third study investigated the biochemical parameters of the 10 families with the higher BMIs before the multidisciplinary intervention, and the relationship between the results for caregivers and children. The children had average scores of 53.15 in the QV AUQEI scale before the intervention, with 15.38% having decreased QL. The effect of the intervention on the children s BMI ranged from 23.38 to 22.97kg/m² (p=0.07). Though all domains of the AUQEI improved after the intervention, there was no statistically significant change before and after the intervention (52.23 and 54.38). Significant correlations between the BMI and the QL were not found. In the caregivers, the obese had smaller averages before the interventions in the QL domains (functional capacity, general state of health and mental health), comparing to the caregivers with overweight in the SF-36. After the multidisciplinary intervention the caregivers showed statistical improvement in the QL domains (SF-36): vitality, social aspects and mental health. A statistical improvement was also found in the environmental domain through the WHOQOL-BREF tool. The relationship between QL and BMI showed that the psychological domain stood out, in which obese caregivers had lower averages than the overweight caregivers. The biochemical parameters measured were: glucose, insulin, reactive ultrasensitive protein C (PCR-US), lipidogram and hepatic transaminases. As result, 95% of the caregivers and children showed at least one alteration, with PCR-US and the HOMA/IR index being the most altered, calculated from glucose and basal insulin. The PCR-US was increased in 85% of the caregivers and children, and the HOMA/IR was above normality in 35% of the sample, emphasizing that an increase in the PCR-US levels were increased in 95% of the participants. 90% of caregivers had an increase in the abdominal circumference, 20% in the blood pressure and 10% in metabolic syndrome. No statistically significant relationships between the biochemical alterations of the caregivers with the children were found; though an increase in the PCR-US was found in 70% of the families in which the caregiver and the child had increased. We conclude that the multidisciplinary intervention contributed with a reasonable improvement in the QL of the participants, and the biochemical alterations signaled that the family unity is an indispensable tool for acquiring better habits and potential beneficial changes.