Ritmo intestinal e fatores associados, durante o distanciamento social devido à pandemia da COVID-19, e a influência da microbiota intestinal na gênese da obesidade.

Abstract

The intestinal microbiota has a number of beneficial and essential functions for the human organism. The intestine is a fundamental organ for immunity and also works as a trigger for the appearance of several pathologies, such as obesity, which is related to the onset of chronic non- communicable diseases, which can worsen the prognosis of COVID-19. In clinical practice, assessment of intestinal transit and bowel function using tools such as the Bristol Stool Consistency Scale (EBCF) has been widely used by healthcare professionals, due to its easy application and low cost. In this context, the objective of this dissertation was to evaluate the intestinal rhythm and associated factors, during social distance due to the pandemic of COVID- 19, as well as to evaluate the influence of the microbiota in the genesis of obesity, according to literature review data. Article I presents the results obtained from the analysis of the rhythm of intestinal transit of adults, during social isolation due to the pandemic of COVID-19, associated with sex, age, physical activity, nutritional status, water intake and frequency to feed. The data were obtained through an online questionnaire. Pearson's chi-square test (χ2) or Fisher's exact test was used to assess the association between variables, considering a significance level of p <0.05. Our results showed that, among the 142 individuals evaluated, the majority had an adequate intestinal rhythm (72.5%) during the period of social isolation. It was observed that the inadequate intestinal rhythm was higher among women, when compared to men (64.1% vs 35.9%); inadequacy was also greater in individuals up to 40 years old compared to individuals over 40 years old (74.4% vs 25.6%); and, the percentage of adequacy of the intestinal rhythm was higher for eutrophic individuals compared to individuals with overweight and obesity (64.7% vs 35.3%). When associated with the presence of fast or slow intestinal rhythm with the associated factors, a higher prevalence of slow intestinal rhythm was found by individuals who frequently consumed simple carbohydrates (63%, p = 0.032). Article II presents the results obtained from a literature review on the influence of the intestinal microbiota on the genesis of obesity, between the years 2005 to 2020. Bibliographic compilations of original scientific articles on animal experimentation and clinical trials were carried out, based on Pubmed and Google academic data, using, in various combinations, the following search terms: “Obesity”, “Firmicutes”, “Bacteroidetes” and “Gastrointestinal Microbioma”, excluding duplicate articles and unrelated to the topic. The results showed that some studies identify increased proportions of Firmicutes when compared to Bacteroidetes in the intestinal microbiota of obese individuals, and authors also report that there is a relationship between obesity and the type of diet ingested, also influencing changes in the proportions of phyla (Firmicutes and Bacteroidetes), but this evidence is deconstructed by other authors. It can be concluded that, during social distance due to the pandemic of COVID-19, most individuals had an adequate intestinal rhythm; women had a higher prevalence of inadequate intestinal rhythm and a slow intestinal rhythm was associated with frequent consumption of simple carbohydrates. From the bibliographic compilations, it is observed that some studies identify increased proportions of the phylum Firmicutes in relation to the phylum Bacteroidetes in the obsessional microbiota; they also identify which diets influence changes in the proportions of the phyla (Firmicutes and Bacteroidetes), however other authors disregard such evidence. It is suggested that further research be carried out, which can elucidate the effect of the diet on the intestinal microbiota and identify which proportions of the phyla Firmicutes and Bacteroidetes are associated with obesity, since the relationship between obesity and the human intestinal microbiota is highly complex and difficult to be interpreted.