Parabenizamos os autores pela publicação do artigo publicado nesta revista (Arq Bras Cardiol. 2007; 89 (4): 237-44).
A obesidade está claramente associada ao aumento de doenças cardiovasculares. Muito desse risco se deve ao aumento de outros fatores de risco, como hipertensão, diabete melito e dislipidemias. Os hábitos alimentares também estão envolvidos nos fatores de risco cardiovasculares. Com isso, várias dietas vêm sendo propostas, e a que demonstrou maior benefício cardiovascular, atualmente, foi a dieta do mediterrâneo, composta principalmente por frutas, grãos, vegetais e óleos insaturados1-4.
Esse estudo observacional concluiu que a alimentação onívora desbalanceada implica um maior risco cardiovascular. Os dados apresentados na tabela 1 evidenciaram no grupo da dieta onívora índices maiores de IMC, RCQ, colesterol total, LDL, VLDL, glicose, uréia, Na/K.
Vale, no entanto, ressaltar que o IMC como índice isolado é diferente nos dois grupos, já que a média do grupo vegetariano (22,6) foi menor que a obtida no grupo de onívoros (26,7). Essa diferença pode ser resultado do aumento dos valores dos lipídios e da glicose evidenciados no estudo, o que eleva o risco cardiovascular.
Outro ponto a ser salientado é o tipo de carne bovina brasileira, que é diferente daquela mencionada na literatura internacional, em que o gado é confinado e criado com rações.
A "carne verde", como é conhecida no Brasil, é produzida principalmente na Região Sul do país, em um tipo de pecuária em que o animal fica solto no pasto, utilizando como fonte alimentar capim e sais minerais, o que torna essa carne mais ecológica. Ela é rica em ácidos graxos poliinsaturados de cadeia curta como linoléico5.
Além disso, as pessoas vegetarianas acabam estabelecendo um "projeto de vida", possuindo hábitos alimentares mais saudáveis, combatendo o estresse, fazendo atividade física e praticando a religiosidade. Em razão disso, acabam surgindo novos fatores imensuráveis, que dificultam qualquer conclusão.
Eduardo Maffini da Rosa
Ronei Pacheco Scatola
Ricardo Possa
Universidade de Caxias do Sul
Liga Acadêmica de Estudos e Ações em Cardiologia
Caxias do Sul, RS - Brasil
E-mail:
Agradecemos o seu interesse por nosso estudo e pelo fato de levantar questões para o debate.
Concordamos com suas observações no que diz respeito às questões relacionadas à nutrição e às doenças cardiovasculares. Um dos aspectos levantados, e que merece nossa atenção, é o fato de indivíduos onívoros apresentarem IMC mais elevado que vegetarianos, contribuindo, assim, para aumentar o risco cardiovascular. Em nosso estudo publicado em 2006 - "Estado nutricional e estilo de vida em vegetarianos e onívoros" (Rev Bras Epidemiol 2006; 9 (1): 131-43), podem-se observar, além desse, outros resultados que certamente contribuirão para essa análise.
Vale ressaltar, no entanto, que o objetivo desse estudo foi descrever e analisar o risco cardiovascular de acordo com o algoritmo de Framingham em dois grupos de indivíduos (vegetarianos e onívoros). Segundo esse algoritmo, independentemente do IMC e tipo de alimentação, os indivíduos são classificados segundo um conjunto determinado de critérios. Não foi nosso objetivo comprovar que a dieta vegetariana reduz o risco cardiovascular, independentemente de outras condições. Assim sendo, nossa conclusão é a de que uma alimentação desbalanceada, como a dieta ocidental, tipicamente onívora, pode estar, em grande parte, envolvida no desencadeamento das doenças crônicas.
Colocamo-nos, mais uma vez, à disposição para maiores esclarecimentos.
Obrigada pela atenção.
Maria del Carmen Bisi Molina
Universidade Federal do Espírito Santo (UFES)
Vitória, ES - Brasil
Email:
We congratulate the authors on the publication of their article in this journal (Arq Bras Cardiol. 2007; 89 (4): 237-44).
Obesity is clearly associated with an increased incidence of cardiovascular diseases. Much of this risk is due to the increase in other risk factors such as hypertension, diabetes mellitus and dyslipidemias. Eating habits are also implicated in cardiovascular risk factors. Thus, several diets have been proposed, and the one that currently shows the greatest cardiovascular benefit is the Mediterranean diet, which consists mainly of fruits, grains, vegetables, and unsaturated fat1-4.
This observational study concluded that the unbalanced omnivorous diet implies a greater cardiovascular risk. Data presented in Table 1 showed higher values of BMI, WHR, total cholesterol, LDL, VLDL, glucose, urea, and Na/K in the omnivorous diet group.
However, it is worth pointing out that BMI considered alone variesbetween the two groups; the mean BMI in the vegetarian group (22.6) was lower than that of the omnivorous group (26.7). This difference may be related to the increased levels of lipids and glucose found in the study, thus increasing the cardiovascular risk.
Also worth pointing out is the type of Brazilian beef which is different from the beef used in other studies of the international literature in that the latter comes from feedlot cattle raised on feed. The "green beef", as we call the Brazilian beef, is produced especially in the Southern region of the country, in a type of livestock farming where the animals roam at large in the pasture, and use mainly grass and mineral salts as their feed source, thus being produced in a more ecological manner. It is therefore rich in short-chain polyunsaturated fatty acids such as the linoleic acid5.
Additionally, vegetarian individuals establish a "life project"; they not only have good eating habits, but also fight stress, are engaged in physical activities, practice religion, so that there are many other non-measurable factors that make it difficult to reach any conclusion.
Eduardo Maffini da Rosa
Ronei Pacheco Scatola
Ricardo Possa
Universidade de Caxias do Sul
Liga Acadêmica de Estudos e Ações em Cardiologia
Caxias do Sul, RS - Brasil
E-mail:
We appreciate your interest in our study, as well as in raising questions for debate.
We agree with your arguments regarding the issues related to nutrition and cardiovascular diseases. One of the noteworthy issues addressed is the fact that omnivorous individuals have higher BMI than vegetarians, thus contributing to increase the cardiovascular risk. In our study published in 2006 -
However, it is worth pointing out that the objective of this study was to describe and analyze the cardiovascular risk based on the Framingham algorithm in two groups of individuals (vegetarians and omnivores). According to this algorithm, regardless of BMI and type of food, the individuals are classified as per a determined set of criteria. Our purpose was not to prove that the vegetarian diet reduces the cardiovascular risk independent of other conditions. Thereby, our conclusion is that an unbalanced diet, such as the Western diet which is typically omnivorous, may be implicated, to a great extent, in the development of chronic diseases.
Please contact us for any further explanations.
Thank you for your attention.
Maria del Carmen Bisi Molina
Universidade Federal do Espírito Santo (UFES)
Vitória, ES - Brasil
Email:
We congratulate the authors on the publication of their article in this journal (Arq Bras Cardiol. 2007; 89 (4): 237-44).
Obesity is clearly associated with an increased incidence of cardiovascular diseases. Much of this risk is due to the increase in other risk factors such as hypertension, diabetes mellitus and dyslipidemias. Eating habits are also implicated in cardiovascular risk factors. Thus, several diets have been proposed, and the one that currently shows the greatest cardiovascular benefit is the Mediterranean diet, which consists mainly of fruits, grains, vegetables, and unsaturated fat1-4.
This observational study concluded that the unbalanced omnivorous diet implies a greater cardiovascular risk. Data presented in Table 1 showed higher values of BMI, WHR, total cholesterol, LDL, VLDL, glucose, urea, and Na/K in the omnivorous diet group.
However, it is worth pointing out that BMI considered alone variesbetween the two groups; the mean BMI in the vegetarian group (22.6) was lower than that of the omnivorous group (26.7). This difference may be related to the increased levels of lipids and glucose found in the study, thus increasing the cardiovascular risk.
Also worth pointing out is the type of Brazilian beef which is different from the beef used in other studies of the international literature in that the latter comes from feedlot cattle raised on feed. The "green beef", as we call the Brazilian beef, is produced especially in the Southern region of the country, in a type of livestock farming where the animals roam at large in the pasture, and use mainly grass and mineral salts as their feed source, thus being produced in a more ecological manner. It is therefore rich in short-chain polyunsaturated fatty acids such as the linoleic acid5.
Additionally, vegetarian individuals establish a "life project"; they not only have good eating habits, but also fight stress, are engaged in physical activities, practice religion, so that there are many other non-measurable factors that make it difficult to reach any conclusion.
Eduardo Maffini da Rosa
Ronei Pacheco Scatola
Ricardo Possa
Universidade de Caxias do Sul
Liga Acadêmica de Estudos e Ações em Cardiologia
Caxias do Sul, RS - Brasil
E-mail:
1. Sociedade Brasileira de Cardiologia. IV Diretriz sobre Dislipidemias e Prevenção da Aterosclerose. Arq Bras Cardiol. 2007; 88 (supl. 1): 2-19.
2. Jackson E, Ockene IS. Obesity, weight reduction, and cardiovascular disease. [access 2007 Dec 10]. Available in:
3. Kaplan NM, Rose BD. Diet in treatment and prevention of hypertension. [access 2007 Dec 10]. Available in:
4. Tangney CC, Rosenson RS. Lipid Lowering with diet or dietary supplements. [access 2007 Dec 10]. Available in:
5 Silva CC, Zanine AM, Lirio VS. Análise do desempenho brasileiro no mercado internacional de carne bovina. Revista Eléctronica de Veterinária. 2005; 6 (11): 1-23.
We appreciate your interest in our study, as well as in raising questions for debate.
We agree with your arguments regarding the issues related to nutrition and cardiovascular diseases. One of the noteworthy issues addressed is the fact that omnivorous individuals have higher BMI than vegetarians, thus contributing to increase the cardiovascular risk. In our study published in 2006 -
However, it is worth pointing out that the objective of this study was to describe and analyze the cardiovascular risk based on the Framingham algorithm in two groups of individuals (vegetarians and omnivores). According to this algorithm, regardless of BMI and type of food, the individuals are classified as per a determined set of criteria. Our purpose was not to prove that the vegetarian diet reduces the cardiovascular risk independent of other conditions. Thereby, our conclusion is that an unbalanced diet, such as the Western diet which is typically omnivorous, may be implicated, to a great extent, in the development of chronic diseases.
Please contact us for any further explanations.
Thank you for your attention.
Maria del Carmen Bisi Molina
Universidade Federal do Espírito Santo (UFES)
Vitória, ES - Brasil
Email: