Cessação tabágica em pacientes com múltiplas condições crônicas: estratégias nutricionais para auxiliar no tratamento

Abstract

A nutritional intervention in smoking cessation can aid in dietary choices, control of craving and excessive weight gain. The objective of this study was to evaluate the impacts of the nutritional education intervention for patients with multiples chronic conditions being treated by the Comprehensive Smoking Assistance Unit of the Minas Gerais Foundation Institute of Nephrology Studies and Research. There were three moments of nutritional education intervention and initial assessments of smoking history, degree of dependence and stage of motivation. Craving degree was evaluated weekly during the first month. Anthropometric and biochemical evaluations were conducted at baseline, after 1 month and after 3 months. Dietary intake was assessed by the “How is your diet?” questionnaire. Statistical analysis was performed with Shapiro Wilk normality test, paired T-Test or Wilcoxon and U-Mann Whitney. Significance level were set at ≤0.05. The sample consisted mostly of women (66.7%), heavy smokers (72.2%) and in people the preparation stage of motivation at the beginning of the follow-up (55.6%). In the intervention group, most people had a high degree of smoking dependence (55.6%), while in the control group the frequency were 22.2%. Craving degree decreased significantly after 1 month of treatment (p= 0.017). After 3 months, the groups presented mean body weight positive variation. However, the percentage of mean body weight change was below 3%. Increase in fruit consumption was observed only in the intervention group (62.5%). Higher percentage of participants increased fat consumption in the control group (33.3%) than in the intervention group (12.5%). In both groups, half of the sample increased the consumption of processed and fried foods. Blood glucose and HOMA-IR in the intervention group showed a significant increase (p= 0.015 and p= 0.050, respectively). Cortisol showed a more significant increase during the intensive approach. The intervention group had lower average weight gain and positive dietary changes. In both groups, the average percentage of weight gain was below 3%, indicating that having nutritionists during the implementation of INCA’s protocol for smoking cessation can help controlling weight gain. Biochemical parameters indicate urgency in smoking cessation to assist with proper control of their pathologies.