Transcultural Diabetes Nutrition Algorithm: Brazilian Application.
The prevalence of obesity, pre-diabetes, and type 2 diabetes (T2D) is increasing worldwide, especially in the developing nations of South America. Brazil has experienced an exponential increase in the prevalence of these chronic non-communicable diseases. The rising prevalence is probably due to changing eating patterns, sedentary living, and a progressive aging of the population. These trends and their underlying causes carry untoward consequences for all Brazilians and the future of Brazilian public health and the healthcare system. Lifestyle changes that include healthy eating (nutrition therapy) and regular physical activity (structured exercise) represent efficient inexpensive measures to prevent and/or treat the aforementioned disorders and are recommended for all afflicted patients. Regrettably, the implementation of lifestyle changes is fraught with clinical and personal challenges in real life. The transcultural Diabetes Nutrition Algorithm (tDNA) is a therapeutic tool intended to foster implementation of lifestyle recommendations and to improve disease-related outcomes in common clinical settings. It is evidence-based and amenable to cultural adaptation. The Brazilian Diabetes Association, Society of Cardiology and Ministry of Health guidelines for nutrition therapy and physical exercise were considered for the Brazilian adaptation. The resultant tDNA-Brazil and its underlying recommendations are presented and explained.
Endocrinology and Metabolism Department, University of Pernambuco, Recife, Pernambuco 50100-130, Brazil. fmoura.pe@gmail.com.
Fabio
F
Moura
Endocrine Unit, Department of Internal Medicine, Santa de Sao Paulo Medical School, Sao Paulo 04119-010, Brazil. jensalles@yahoo.com.br.
João
J
Salles
Joslin Diabetes Center, Harvard University, Boston, MA 02215, USA. osama.hamdy@joslin.harvard.edu.
Osama
O
Hamdy
Department of Endocrinology, Catholic University, Rio de Janeiro 22211-340, Brazil. wcoutinho@globo.com.
Walmir
W
Coutinho
Department of Nutrition, Federal University of Parana, Curitiba, Parana 04566-905, Brazil. deiseregina@ufpr.br.
Deise Regina
DR
Baptista
State Institute of Diabetes and Endocrinology, Rua Moncorvo Filho, 90, Centro, Rio de Janeiro 20211-340, Brazil. alexanderbenchimol@rjnet.com.br.
Alexander
A
Benchimol
Department of Preventive Medicine and Community Health, Rutgers New Jersey Medical School, Newark, NJ 07101, USA. albertmarchetti@yahoo.com.
Albert
A
Marchetti
Research and Development, Abbott Nutrition, Columbus, OH 43219, USA. refaat.hegazi@abbott.com.
Refaat A
RA
Hegazi
Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA. jeffreymechanick@gmail.com.
Jeffrey I
JI
Mechanick
D000465:Algorithms; D001938:Brazil; D015897:Comorbidity; D003466:Cultural Characteristics; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology / Q000517:prevention & control; D004032:Diet / Q000208:ethnology; D015444:Exercise; D006801:Humans; D008019:Life Style / Q000208:ethnology*; D015596:Nutrition Assessment; D009752:Nutritional Status / Q000208:ethnology*; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology / Q000517:prevention & control; D011236:Prediabetic State / Q000175:diagnosis / Q000208:ethnology* / Q000503:physiopathology / Q000517:prevention & control; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D040242:Risk Reduction Behavior
Brazil; algorithm; chronic non-communicable disease; diabetes; nutrition therapy; obesity; physical exercise; prediabetes; transcultural