Livro Nutrição e Estética- Enviar

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Nutrição em Estética e Nutricosméticos Uma abordagem abordagem práti p rática ca Mariana Braga Neves 1ª Edição

2012

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EXPEDIENTE Produção Editorial e Revisão Final  Adel son Marq ues Canudo Assistência Assistênc ia Editorial  Adria na Lopes Peixoto CRN9 - 9521 Capa e Produção Gráfica Peter Pereira da Silva Edição Ortográfica e Textual  Jornalista  Jorna lista Éverton Oliveira Ol iveira Coordenação de Projeto para mídia digital Rafa el da Si Silva lva Carrasco Carrasco Coordenação Geral  Adel son Marq ues Canudo Luiz Lu iz Eduardo Eduard o Ferreira Font Fontes es

Todos os direitos reservados. Nenhuma parte deste livro eletrônic eletrôn icoo poderá ser reproduzida reproduzida total ou parci pa rcial al ment mentee sem autorização prévia da A.S. Sistemas.

Nutriçãoo em Estética e Nutricosméticos Nutriçã Nutricosméticos – Uma U ma abordagem abordag em prática ISBN nº: 978-85-65880-07-7 Mariana Braga Neves CRN99 - 2000100325 CRN 200010 0325 A.S. Sistemas Rua Professor Professor Carlos Schlottfeld Sch lottfeld,, casa c asa 10 – Cléli C léliaa Bernardes – Viçosa – MG – CEP 36570-000 Tel el:: (31) 3892 3 892 7700 7 700 site: www.assistemas.com.br

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INTRODUÇÃO Nutrição em Estética e Nutricosméticos – uma abordagem prática destina-se a profissionais e estudantes de nutrição, medicina, fisioterapia, cosmetologia e a empreendedores do ramo da beleza. A nutrição em estética é uma área em crescente expansão e seu conteúdo soma-se à medicina, à cirurgia plástica, à educação física e à fisioterapia dermatofuncional para que conhecimentos científicos sejam transformados em conselhos cons elhos práticos na busca b usca da beleza bele za e da qualidade qualidade de vida. vida. Com este livro digital, objetiva-se capacitar o leitor a atuar em nutrição em estética. Busca-se ainda fornecer informações sobre os nutrientes relevantes em estética e sobre as principais condutas nutricionais no tratamento do sobrepeso, magreza, acne, flacidez, lipodistrofia ginoide e nos cuidados da pele, unhas e cabelos. cabe los.

Mariana Braga Neves

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  Sumário Módulo 1

1 Considerações sobre a beleza 2 Atuação em estética Módulo 2

3 Nutrientes Nutrientes relevantes r elevantes em estética estética 4 Hidratação Hidratação 5 Envelhecimento Envelhecimento Módulo 3 Módulo  3

6 Nutrição Nutriçã o no em emagreci agrecim mento 7 Nutrição no ganho de peso Mód Mó dulo 4

8 Nutrição na cirurgia na cirurgia plástica 9 Nu Nutrição na flacidez flacide z Mód Mó dulo 5

10 Nutrição 10 Nu trição e saúde dos cabelos cabelos,, das unhas unhas e no no controle controle das estrias e da gordura localizada locali zada 11 Nutrição na lipodis l ipodistrofia trofia ginoide ginoide Módulo 6 Módulo  6

12 Nutrição Nutrição e acne 13 Aliment Alimentos os fu funcion ncionais, ais, sinais do tem tempo po e fot fotoproteção oproteção Mód Mó dulo 7

14 Cuidado Cuidado nutricional nutricional associado ass ociado aos procedimen pr ocedimentos tos estéticos 15 Avalia valiação ção bioquím bioquímica, ica, fitoterapia  fitoterapia aplicada e situações vivenciadas em consultório Mód Mó dulo 8

16 Atualidades Atualid ades em nut nutr  r ição ição em estética estética e oportu oportun nidades de trabalho trabal ho 17 Nu 17  Nutricosm tricosméticos éticos 18 Glossário 19 Apêndice 1 20 Apêndice 2

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Módulo 1 A nutrição nutrição em e m estética e stética

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1 Considerações sobre a beleza A beleza be leza é uma preocupação constante de grande parte da população. Essa Essa busca b usca por uma boa aparência não é um privilégio dos séculos XX e XXI. Estudos mostram que, há muitos anos, ser belo sempre esteve na lista de prioridades da população. Entretanto, com o passar do tempo, o padrão de beleza foi sofrendo s ofrendo alterações. No século XVII, o excesso de peso era considerado uma referência de beleza. Corpos torneados e com excesso de gordura corporal representavam não somente uma figura mais bela, como também significavam mais saúde e fertilidade. Nas artes barrocas, é possível perceber a presença da lipodistrofia ginoide, a popular “celulite”, registrada em  boa  b oa parte das peças. peças . No fim do último século e especialmente neste, percebemos que a beleza está ligada à saúde. Com o aumento das doenças crônico-degenerativas, preocupar-se com o peso corporal, por exemplo, torna-se uma questão de saúde. Pessoas que buscam o peso saudável e que, para isso, alimentam-se de forma mais saudável e praticam uma atividade física regular se mostram mais atentas à qualidade de vida e preocupadas com a longevidade. A beleza também está ligada ao bem-estar, à autoestima. Pessoas que se cuidam são mais seguras e têm maiores chances de sucesso em suas relações afetivas, profissionais e sociais por se mostrarem mais confiantes em suas possibilidades. Em uma época na qual o mercado de trabalho apresenta-se cada vez mais competitivo, pessoas bem cuidadas e com boa aparência representam trabalhadores preocupados com a saúde e que podem significar melhores rendimentos para as empresas e menores riscos de se ausentarem de suas ocupações. Por tudo isso, percebe-se a importância dos profissionais ligados aos cuidados estéticos no sentido de orientarem seus clientes na busca saudável pela beleza. É importante que esse assunto fique bem claro, porque a busca desenfreada pela beleza é

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os períodos de dietas são intercalados com episódios de vômitos provocados após episódios de comer compulsivo, compulsivo, seguido de culpa. Alguns também tamb ém fazem uso de laxantes laxantes e diuréticos. Assim, bulimia é um transtorno alimentar no qual as principais características são os episódios de compulsão alimentar seguidos de comportamentos compensatórios para evitar o ganho de peso. As pessoas que sofrem de bulimia vivem em um círculo vicioso de compulsão-purgação. O culto excessivo ao corpo também tem aumentado os casos de vigorexia. O transtorno tem início quando a intensidade de exercício praticado por um indivíduo excede a sua capacidade de recuperação, o que se soma ao fato de que geralmente apresenta uma auto-imagem um tanto tant o distorcida. Tais transtornos são considerados multicausais, mas têm nas dietas sem orientação e na busca pela forma física ideal, seus principais agravantes. Assim, na tentativa de atingirem o padrão físico idealizado, jovens utilizam recursos como uso sem prescrição de drogas para emagrecer, laxantes, diuréticos e excessos de suplementos e anabolizantes, colocando em risco à saúde, sem contar nos inúmeros transtornos psicológicos gerados. Cabe ao profissional de saúde atuante em estética, orientar o seu cliente a buscar o  bem-est  b em-estar ar e a b oa forma física, físi ca, preserv prese rvando ando a saúde e garantindo garanti ndo aumento aumen to da autoestima.

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2 Atuação em estética Como falamos, nos dias de hoje, sentir-se bem com o corpo, pele e cabelo é uma necessidade neces sidade e uma condição valorizad valorizada, a, inclusive inclusive nos n os ambientes amb ientes corporativos. corporativos. O mercado da beleza está aquecido e é fundamental que o profissional de saúde faça uso da ciência a seu favor, transformando conhecimentos científicos em conselhos práticos. Até há algumas décadas, a nutrição em estética era carente em estudos capazes de comprovar a eficácia de nutrientes nos diversos tratamentos estéticos. Devido a esse problema, muitas das informações da nutrição em estética eram precárias e sem comprovação. Com o aumento do número de pesquisas na área, foi possível conhecer mais sobre o papel dos nutrientes para a beleza. Foi possível também mostrar que os cuidados cuidados estéticos es téticos exigem exigem a interação in teração de diversos diversos profissionais profis sionais de saúde. Podemos dizer que os principais profissionais ligados à estética são: s ão: Médico – especialmente o endocrinologista e o especialista em cirurgia plástica; Nutricionista – responsável pelo planejamento alimentar de acordo com cada procedimento estético; Fonoaudiólogo – principalmente o que atua na área da fonoaudiologia estética, especialidade ligada à melhora, por exemplo, do tônus da pele e na diminuição das linhaças de ex e xpressão; Fisioterapeuta – especialmente o que atua na área da fisioterapia dermatofuncional; Dentista Dent ista – o que promove promove uma melhor melh or saúde bucal que atua na ortodontia; Esteticista – não somente o que atua na área dos procedimentos corporais, mas também o que oferece serviços ligados à saúde da pele, pés e cabelos; Educador físico – atuantes no emagrecimento, hipertrofia ou melhora do tônus muscular.

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• 30% Indicação Indicação de fami familliares, amig amigos e conhecidos; conhecidos; • 20% Indicação Indicação de outros outros profi profissi ssionais onais da da área de de saúde; saúde; • 15% Internet, Internet, planos planos de saúde, saúde, catálogos, catálogos, propag propaganda, anda, outros. outros. No caso da nutrição em estética, a atuação do nutricionista pode ocorrer nas seguintes áreas:

• Emagrecimento  – controlando sobrepeso, obesidade e oferecendo assessoria para o emagrecimento emagrecimento saudáv sa udável el,, cont c ontínuo ínuo e duradouro; • Nutrição esportiva   – auxiliando o cliente não somente no planejamento de acordo com a atividade física como também na diminuição do percentual de gordura, aumento do tônus muscular, ganho anh o de massa magra; • Saúde da pele e do cabelo   – a nutrição adequada garante melhor aspecto da pele, facilita a hidratação, pode evitar o envelhecimento precoce e atua no arsenal antiacne. Pode ainda nutrir o indivíduo, diminuindo as marcas de expressão e evitando a queda de cabelo, muitas vezes reflexo de uma má nutrição; • Saúde do corpo  – a escolha adequada do cardápio e a manutenção de um peso saudável está envolvida no processo de prevenção de estrias, flac flacidez idez e lipodistro lipodistrofi fiaa gi gino noide; ide; • Pré e pós-operatório – especialmente conciliada à cirurgia plástica,

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promoção da boa apresentação.

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Módulo 2 Nutrientes Nutrientes relevantes em e m estética, e stética, hidratação hidratação e envelhecimento envelhecimento

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3 Nutrientes relevantes em estética Antes de falarmos sobre os principais nutrientes relevantes em estética, cabe conceituar as principais alterações alte rações para as quais a conduta nutricional pode pode ser eficaz. e ficaz. Lipodistrofia ginoide   – também chamada de celulite. Pode aparecer em diferentes graus, sedo que, nos casos mais graves, há nódulos e dor. Trata-se de um transtorno muti fatorial, que envolv envolvee a predisposição genética, gené tica, associada ao efeito efeit o hormonal e a alterações da microcirculação da composição corporal, de modo que as células adipócitas incham muito a ponto de dificultar a drenagem linfática. Isso provoca a retenção de líquido, toxinas e excesso de gordura. Além disso, outras alterações hormonais podem piorar o quadro, quadro, como no período pe ríodo menstrual e gravidez, gravidez, além do uso de pílulas anticoncepcionais ant iconcepcionais e, eventualmente, no caso de ocorrerem alterações da tireoide. Outros fatores implicados nas causas de celulite são o estresse, sedentarismo, cigarro, consumo frequente de refrigerantes e comidas gordurosas. Acne  – trata-se de uma doença inflamatória da pele. A sua frequência é maior na adolescência, quando o nível elevado de hormonas sexuais causa o aumento da secreção de sebo pelas glândulas sebáceas, provocando o aparecimento de espinhas, bolhas e pontos negros, principalmente no rosto, costas, peito e ombros. Flacidez - alteração da elasticidade da pele e dos músculos, devido a transtornos nos fibroblastos, as células encarregadas de fabricar colágeno e elastina.

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No grupo dos nutrientes antioxidantes, a vedete é a vitamina C. Esse nutriente atua na formação das fibras musculares, é importante para a formação do colágeno e confere fotoproteção. Estudos mostram ação anti-inflamatória e pró-cicatrizante. Assim como a vitamina A, a C também costuma ser usada pela população sem critério. É importante ressaltar que excessos excessos de vitamina vitamina C podem elevar elevar o risco de formação de cálculos renais ren ais em pessoas já susceptíveis. A suplementação é desnecessária, uma vez que o equilíbrio é facilmente conseguido com a inclusão de frutas cítricas, tomate, pimentão. O uso da vitamina E é conhecido quando se trata da prevenção do envelhecimento precoce. Entretanto, estudos mostram que esse antioxidante melhora a microcirculação no couro cabeludo, facilitando o crescimento cresciment o capilar e a nutrição dos fios. A vitamina B6 evita a retenção de líquido, tendo assim aplicação em casos de edema comum na tensão pré-menstrual, no linfoedema e na lipodistrofia ginoide, destacando-se pelo seu papel no metabolismo de aminoácidos, o que contribui para o excelente reparo dos tecidos. O poderoso selênio , cujo cuj o equilíbrio equilíb rio pode ser facilment facilm entee conseguido cons eguido a partir da inclusão da castanha-do-pará no cardápio, além de ser um antioxidante potente, tem se mostrado eficaz na tonicidade dos tecidos, o que faz com que o nutriente seja indispensável nas dietas antiflacidez.  Já  J á o magnésio atua na renovação celular, crescimento dos cabelos, vitalidade da pele e melhora melh ora o bem-estar bem -estar.. Deve receber atenção aten ção especial na dieta, no período pré-menstrual,

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tem atuação na contração muscular, o que faz com que haja a necessidade de atenção especial para as dietas de combate comb ate à flacidez e de ganho de massa mass a muscular. muscular. Como sabemos, a tireoide é a glândula que tem a função de regular a velocidade das reações orgânica e o iodo faz parte da estrutura do hormônio da tireoide . Assim, uma dieta adequada em iodo é fundamental para a manutenção do bom metabolismo, o que significa uma melhor melh or chance de manter mante r o peso saudável saudável e a contribuição contrib uição na prevenção prevenção da constipação intestinal, por exemplo. Especula-se ainda o papel do iodo na prevenção do acúmulo da gordura localizada. Nenhum nutriente ganhou tanto destaque como o ômega 3 , encont enc ontrado rado em peixes de águas geladas, algumas oleaginosas e na linhaça. Entre suas principais funções estão:

• Ação anti-i anti-inf nfllamatór amatóriia; • Mel Melhora hora da competê competênci nciaa imune imune;; • Mel Melhora hora da circu circullação; • O ffato ato de estudos estudos mostrarem mostrarem um mel melhor hor control cont rolee da pel pele acneica quando a dieta é associada à suplementação de ômega 3. Quando o assunto é alimentação, não faltam novidades. Estamos em uma época na qual as enzimas presentes nos alimentos também são alvo de estudos. No caso da área

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• Acelera Acelera o metaboli metabolismo smo levem evemente. ente.  Já  J á o chá br branco anco tem atributos atrib utos ainda melhore mel horess que o chá-verde chá-verde por ser menos men os processado e ter maior concentração dos nutrientes. Uma ressalva deve ser feita em relação à quantidade de cafeína, que é maior do que a do verde. Por tal motivo, o consumo deve ser criterioso em condições como hipertensão e gastrite. O consumo de proteínas costuma ser abusivo quando há uma preocupação maior com a estética. De certo, o nutriente é fundamental para o tônus muscular e para a síntese de colágeno. No entanto, excessos de proteínas são danosos e podem levar à sobrecarga dos rins e do fígado. A orientação nutricional personalizada é fundamental. Sobre a proteína, são papéis relevantes:

• For Fortal taleci ecim mento ento muscul muscular; ar; • Fi Firm rmez ezaa e el elasticidade asticidade da pele pele;; • Mel Melhora hora da competê competênci nciaa imune imune;; • Sínte Síntese se de de colág colágen eno. o. Além dos cuidados mencionados, vale frisar que as fontes proteicas de animais muitas vezes são fontes de gordura, o que pode elevar taxas de colesterol e aumentar o

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• O org organism anismoo tem um um ggasto asto cal ca lórico órico para processá-los processá-los e, com isso, isso, há uma contribuição para o emagrecimento; • São exemp exempllos: pimenta, pimenta, cacau, c acau, gengi gengibre, mostarda, mostarda, vi vinagre nagre de maçã, guaraná; • A inclusão na dieta dieta deve deve ser cautelosa, já que são contraind con traindicados icados para gestantes e a prescrição para idosos, hipertensos e crianças deve ser avaliada cuidadosamente.

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4 Hidratação A hidratação adequada adequada é fundamental para o bom b om funcionamento funcioname nto do organismo. organism o. Um corpo bem hidratado não somente funciona melhor como também mantém melhor aparência. As principais contribuições da água no nosso corpo são:

• Favore Favorecim cimento ento das funções funções org orgânicas; ânicas; • Manut Manuteenção met metabó abóllica; • Tônus Tônus da da pel pele e dos múscul músculos. os. A ingestão adequada de água favorece a absorção dos nutrientes necessários ao equilíbrio da pele e garante a sua s ua hidratação.

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É importante ressaltar que, em atividades físicas aeróbicas de baixa intensidade, a hidratação, embora dependente do clima, pode ser feita com água até 50 minutos após o início da atividade. Após esse tempo, as bebidas que contêm carboidratos e eletrólitos são mais indicadas. Para esses casos, a recomendação não é de 1 ml por caloria, ou seja, durante durante a atividade atividade utiliza-se utiliza-se de 150 a 250 ml de água a cada 15 ou 20 minutos de prática. Como foi dito, algumas situações, além da atividade física, exigem uma maior necessidade neces sidade de água, água, como:

• Consti Constipação pação intesti intestinal nal – mai maiss 40%; 40%; • Procedime Procedimentos ntos estéticos estéticos capazes c apazes de de fav favorecer orecer a di diurese, urese, como a drenagem linfática; • Infe nfecç cçõe õess;

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5 Envelhec Env elhecimento imento Passamos por um período de transição demográfica. O Brasil caminha para a maturidade maturidade de forma que a nossa n ossa pirâmide tem t em mudado de configuração. Na década de 50, as pessoas padeciam com as doenças infectocontagiosas e morriam com pouca idade. Com Com todos os avanços avanços da medicina e da imunologia, essas doenças não nos afligem mais. Entretanto, convivemos agora com as doenças crônico-degenerativas. Por um lado, aumentam os casos de doenças como hipertensão, diabetes, câncer. Por outro, cresce a preocupação da população com a qualidade de vida. Melhora o acesso da população aos serviços de saúde. Aumenta a conscientização da população sobre a importância do controle médico. Esses fatores somados ao fato de que a terceira idade tem se engajado em projetos sociais, tem buscado participar de grupos para socialização e tem se mostrado cada vez

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ocorre por volta volta dos 30 anos, ou sej a, passamos a maior parte de nossa vida vida envelhecendo e todas as espécies passam por esse processo. Bons hábitos de vida diminuem a velocidade desse processo e a função dos profissionais de saúde é de sempre incentiválos. O corpo do idoso passa por alterações na sua composição que englobam basicamente o aumento dos estoques de gordura, a diminuição da massa magra total e a queda da densidade óssea. Além dessas alterações, existem as mudanças psicológicas e a deterioração do desempenho físico. Alterações hormonais também ocorrem, sendo que a principal é a diminuição da ação da insulina. Sobre a composição corporal:

• Pessoas idosas idosas tendem tendem a pesar 25% mais mais do que adultos adultos jovens; jovens; • Ocorre Ocorre menor menor síntese síntese protei proteica;

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• Acompanhar a ativi atividade físi física, ca, de modo modo a dar condições de de aumento do tônus muscular; • Inclui Incluirr nu nutri trientes entes funcionai uncionais; s; • Cui Cuidar da saúde saúde tire tireoi oidi diana. ana.

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Módulo 3 Nutrição e composição corporal

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6 Nutrição no emagrecimento Os nutrientes podem ser divididos em energéticos e não energéticos. No grupo dos energéticos, temos os carboidratos, proteínas, lipídios e o álcool. Já no grupo dos não energéticos são incluídas as vitaminas, os minerais, as fibras e os nutrientes funcionais, ou seja, sej a, aqueles capazes de promover promover saúde, além da função básica b ásica de nutrir. nutrir. Com o aumento das doenças crônico-degenerativas, a manutenção do peso saudável

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• Estat tatura; • Peso; • Percentual ercentual de gordur orduraa corporal corporal;; • Dados da da rotina rotina de diár diáriia – ocupação, ocupaçã o, fformas ormas de locomoção, estil estilo

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Assim, Assim , a nutrição aplicada aplicada ao emagrecimento emagreciment o e o profissional profission al devem: devem:

• Permi ermitir o adequado adequado fracionamento fracionamento das ref refeições; eições; • Capacitar Capacitar o cliente cliente ao adequad adequadoo porcioname porcionamento; nto; • Fornecer infor informações mações sobre grupos grupos de de ali alimentos mentos para que o cliente cliente seja treinado a substituir um gênero por outro sem comprometer o

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• Selênio: atua em conjunto com a vitamina E. São fontes de selênio castan ca stanhas, has, nozes, frutos do mar, carne verme vermelha lha e frango; frango; • Manganês: possui papel ativo no funcionamento da mitocôndria, além de ser importante na formação dos ossos e das cartilagens articulares. Cereais, grãos, frutas e sais minerais são ótimas fontes desse mineral. • Zinco:  atua nas membranas celulares e proteínas estruturais. Os alimentos ricos em zinco são carnes vermelhas, peixes, aves, leite e derivados derivados e cereais; c ereais; • Magnésio:  importante constituinte da membrana celular. Cereais integrais, castanhas, vegetais e frutas, sementes e leguminosas são  boass fontes  boa font es desse nutrient n utriente. e. Para a prescrição de fitoterápicos, é importante que o profissional seja preparado e que tome conhecimento dos ativos que o nutricionista pode prescrever. Também é importante a busca de informações sobre efeitos colaterais, indicações, contraindicações. O nutricionista está habilitado à prescrição, mas esta deve conter informações completas, como dosagem, tempo de uso, horário, forma de uso. Os fitoterápicos com relevância em estética são basicamente:

• Os que promovem promovem aceleração aceleração do metaboli metabolismo e, assim, assim, ajudam no emagrecimento – como exemplo, o Citrus aurantium, o chá-verde e o branco; • O que promov promovem em saciedade saciedade – evi evitando o consumo excessi excessivvo de alimentos. alimentos. Como exempl exemplo, o, temos t emos o Glu G luco comanan manan;; • Os que que evi evitam a compulsão compulsão por doces – como exem exempl plo, o, temos a Garcíni Garc íniaa camboja c amboja e Ginmena silvestre; silvestre; • Os que que dimi diminuem nuem a absorção de nutrientes nutrientes especí específi ficos cos como co mo a gordura e o carboidrato – são exemplos a faseolamina e a

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manipulado, os fruto-oligossacarídeos e os pró-bióticos. Os dois últimos ajudam na saúde do intestino e, por isso, são excelentes para controle da disbiose, envolvida na etiologia da celulite. Também ambé m podem ser se r prescritos ativos ativos como licopeno, l icopeno, resveratrol, ômega 3, todos com aplicação, por exemplo, exemplo, na prevenção prevenção do env en velhecimento elhecime nto precoce.

C – Situações práticas prática s vivenciadas em consultório consultório O nutricionista deve estar apto a atender o cliente da nutrição em estética, de forma ampla, tratando concomitantemente alterações clínicas. A seguir, seguir, acompanhe algumas situações s ituações práticas e formas sugeridas para conduta: U. D, 31 anos, sexo feminino, procurou orientação alimentar para diminuir gordura localizada na região abdominal. Além do bom estado de saúde, apresenta apenas constipação intestinal. Realiza atividade física diariamente, de 08:00 às 09:00. Três vezes por semana, faz 60 minutos de corrida na esteira e por três vezes faz musculação. Avaliação antropométrica - 1,625 m, 63,2 Kg, 85 cm de abdômen, 33,2% de gordura, 45 cm de coxa. Avaliação alimentar: alime ntar:

• Café Café da manhã manhã – quatro quatro biscoi biscoitos tos tipo tipo água água e sal, sal, café com açúcar; • Intervalo Intervalo –café, salg salgadinho adinho e refri refriggerante; • Almoço Almoço – arroz, fei feijão, jão, macarrão, bife bife de carne bovi bovina e salada com maionese; • Lanche da da tarde – café, bomb bombom, om, suco suco de pó pó e biscoi biscoito to tipo tipo recheado; • Jantar – café, pi pizz zzaa ou macarronada macarronada e ref refri riggerante. Na situação apresentada, o cliente apresenta diversas falhas nutricionais que precisam ser corrigidas antes mesmo do controle estético específico. Entre elas, podemos citar o baixo consumo de cálcio, o elevado consumo de café, de refrigerante, a falta de frutas, etc. Sugere-se ainda que sejam passadas informações sobre as refeições pré e pós-

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• Dimi Diminui nuição ção do índi índice ce glicêm glicêmiicos das refei refeições; • Aumento Aumento do do teor de fibra da da dieta. dieta. Segundo momento – dieta termogênica, fitoterapia.  J,  J , M, Y, 36 anos, anos , sexo feminin fem inino, o, procurou orientação orien tação nutricional nutri cional com o ob objj etiv eti vo de reduzir os sinais de celulite. A cliente faz drenagem linfática, é sedentária e apresenta peso saudável. Além disso, é portadora da Síndrome do Intestino Irritável (SII). No caso apresentado, a SII pode ter a disbiose como um dos fatores etiológicos, assim como a celulite. Por esse motivo, sugere-se que o ponto de partida seja o equilíbrio da flora intestinal, feito, por exemplo, com a introdução de alimentos ricos em probióticos ou com a manipulação dessas bactérias. A hidratação deve ser estimulada, assim como a introdução de alimentos anti-inflamatórios.

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Módulo 8 Nutricosmésticos, atualidades em nutrição e estética, e oportunidades de trabalho na área

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16 Atualidades em nutrição em estética e oportunidades de trabalho A nutrição, de forma geral, é uma ciência na qual não faltam novidades. Muitos alimentos colocados na berlinda, em alguns momentos, têm seu consumo incentivado, em outros não. Assim, é importante que o profissional procure atualizações constantes para que acompanhe os estudos e para que possa dar ao seu cliente, informações úteis, seguras, confiáveis confiáveis e de ponta. Nas clínicas de estéticas e nos consultórios especializados, o termo “Síndrome da Desarmonia Corporal” tem sido bastante utilizado. Essa síndrome foi descrita pelo prof. dr. Miguel Francischelli Neto, com base em suas pesquisas sobre estética, e se caracteriza pela presença de celulite, alterações da gordura corporal e alterações musculares que aparecem frequentemente associadas. Pelo conteúdo abordado, percebe-se claramente o papel do nutricionista no controle dessa síndrome. Isso porque, é possível, com uma abordagem dietética associada aos procedimentos estéticos e à atividade física, amenizar essas alterações. Cabe ao profissional, indicar ao seu cliente a melhor alimentação para a solução do problema e orientá-lo a procurar os profissionais que poderão oferecer os tratamentos estéticos específicos. específicos. Curiosidade

A gordu gordura ra regionalizada é diferente diferen te da localizada porque porque se deposita homogeneamente debaixo da pele, sem projetar-se, ou seja, não cria os depósitos como o popular culote. Normalmente, os depósitos ocorrem no quadril, quadril, abdômen e cintura e pode estar associados ass ociados à celulite. O ideal é que o cuidado nutricional leve leve em consideração a composição da dieta, equilíbrio calórico e traga nutrientes específicos para tratamento da celulite. Fique ligado

A lipoaspiração é o procedimento esté estético tico mais m ais popular. popular. É realizado por meio de uma cirurgia com cânulas muito finas que retiram a

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trabalho. Recentemente, um estudo mostrou que a lactoferrina, encontrada no leite, conseguiu diminuir o aspecto da acne. Como a quantidade da lactoferrina no leite é pequena, a possibilidade possib ilidade de enriquecimento de alimentos aliment os deve ser avaliada. avaliada. Alimentos ricos em sulforesinato, como o brócolis, são capazes de elevar os níveis de enzimas que protegem contra a radiação ultravioleta. Essa substância ainda é estudada por induzir a detoxificação do organismo. Cada vez mais estudos mostram que o controle do açúcar total e, especialmente, do índice glicêmicos das refeições é fundamental. Isso porque o excesso desse nutriente na corrente sanguínea, além de prejudicar a saúde, é causa da glicação das proteínas da pele, que diminui a propriedade propriedade de elasticidad elast icidadee do colágeno. A dermatite atópica, um tipo de inflamação da pele, pode ser amenizada com o uso de probióticos devido devido à ação no reparo de de membranas. mem branas.

 

Divulgação

Em primeiro lugar, cabe a você mapear em detalhes quem é seu cliente, conhecendo profundamente onde o mesmo se encontra e quais os melhores canais para se chegar até ele. A escolha do melhor canal de comercialização é o ponto que pode fazer o sucesso de qualquer qualquer negócio. n egócio. Muitas pessoas obtêm sucesso porque constroem um modelo de negócios que agrega valor para seu público-alvo e sabem como atingi-lo com competência. Nesse sentido, é preciso aplicar adequadamente o processo de tomada de decisão, com conhecimento profundo do do comportamento comportament o dos clientes e do mercado. A área de estética estét ica é uma excelente opção de trabalho trabalh o para o nutricionista. Os serviços serviços podem ser oferecidos em:

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divulgação. divulgação. Esse Esse material gráfico deve deve ser s er atrativo para o cliente. client e. Mostre para ele qual é o seu diferencial! Indicação –  apresentação do serviço a médicos, clínicas de estética, academias e educadores físicos. Sugira parcerias, mostre seu potencial para essas pessoas. Assim, será mais fácil obter indicações. Cartas de apresentação  – para os profissionais, administradores de condomínios, empresas, etc. Isso aumentará a sua clientela. Para a criação desses materiais de divulgação, o profissional poderá utilizar artigos científicos como base e transformá-lo em textos mais diretos e com linguagem adequada ao seu público. Ainda sobre sob re a divulgação divulgação do do trabalho, trab alho, ela poderá ser feita fe ita de diversas diversas formas como:

• Cri Criação de bl blog ogss e sites sites e rede redess de relacionamento relacionamento – não somente divulgam o serviço e passam informações de contato, como também são importantes para o profissional publicar matérias e textos; • Jornais Jorna is e rev revistas istas – escrever escrever matérias matérias para esses veí veículos culos é uma forma de o profissional tornar-se conhecido e de fazer com que os possíveis clientes vejam o quão atualizado ele está; • Cartas de de apresentação apresentação a outros profi profissionais ssionais – criar uma carta de de apresentação e anexar a ela cartão de visita e fôlder é uma forma de outros profissionais de saúde conhecerem os diversos serviços que o nutricionista pode oferecer na área de estética; • Criaç Criação ão de fôlder fôlder – detalhar os serviços serviços no fôlder fôlder e distri distribuí-l buí-los os em

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agendarem com você é maior. Como opção de trabalho, o profissional deve pensar também em opções não somente para o público feminino, como também para o masculino. Sabemos que o homem de hoje é mais preocupado com a estética, embora ainda precise dar maior atenção à saúde. O homem de hoje valoriza o corpo atlético, torneado e objetiva o ganho de massa magra. Muitas vezes os recursos usados para esse fim não são os mais saudáveis, o que faz com que o profissional tenha a possibilidade de oferecer serviços eficazes e saudá s audávveis.

M ontagem ontagem da tabela de honorários honorários O preço da consulta de nutrição em estética deve acompanhar o que é cobrado por uma avaliação clínica e antropométrica conciliada ao plano alimentar. Para a montagem do preço, sugere-se uma avaliação do mercado local, porque uma consulta pode variar de acordo com o tamanho da cidade ou a localidade do consultório em que será prestado o atendimento. Procure conhecer os preços sugeridos na tabela do CFN ou dos sindicatos de nutricionistas. A título de sugestão indicamos o valor de R$ 120,00. Contudo, pesquise antes de definir o preço de sua consulta. Monte sua ficha de avaliação No capítulo 19, na sessão “apêndice”, encontra-se uma ficha de atendimento que poderá ser utilizada como base para um modelo a ser aplicado no seu trabalho. Cabe lembrar que, por ser um modelo, a mesma deverá ser modificada de acordo com a necessidade neces sidade de cada profissional, profissional, relacionada relacion ada ao seu tipo de atuação.

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17 Nutricosméticos Sabemos que a nutrição ideal é aquela obtida com a ingestão de nutrientes capazes de produzir benefícios, sejam eles à saúde ou à beleza. Nessa linha, alguns ativos indicados para uso oral são indicados por produzirem efeitos desejáveis, melhorando a saúde e a aparência da pele, cabelos, unhas. As chamadas “pílulas da beleza” dividem o mercado de cosméticos com os cremes e têm a vantagem de conterem ativos que não somente contribuem para a parte estética, como produzem efeitos funcionais. Os nutricosméticos podem ser definidos como alimentos ou suplementos que possuem efeito preventivo ou reativo na pele, unhas e cabelos, contribuindo para o bemestar, saúde e beleza. Podem ser vitaminas, minerais, proteínas, fitoterápicos ou ativos funcionais em cápsula, pó ou na forma líquida e relacionam-se com fármacos, nutrição e cosmecêuticos, formando o que se conhece por nutrição personalizada. Nessa tríade que envolve nutrição, cosméticos e medicamentos, os nutricosméticos se propõem a ficar entre a nutrição e os cuidados pessoais, valendovalendo-se se preferencialment prefe rencialmente, e, de nutracêuticos, com a finalidade de melhorar a estrutura da pele e cabelos, prevenindo e retardando alterações estéticas como manchas, flacidez, fotodano, queda e fragilidade capilar, capilar, entre outros. No mercado brasileiro, existem diversos fabricantes que combinam vitaminas, aminoácidos, ativos funcionais e criam nutricosméticos. No mercado internacional, é possível encontrar alimentos com nutricosméticos associados. São produtos de fácil aceitação como sucos e barras de cereais ou chocolates, nos quais o fabricante associa ativos capazes de contribuir com a beleza. Trata-se de uma área de trabalho que traz ao nutricionista a possibilidade de desenvolver desenvolver até mesmo me smo produtos, associando-se a um engenheiro de alimentos. alime ntos. Para os profissionais que desejam associar a prescrição de nutricosméticos à dieta

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• Antioxi Antioxidação – prevenção prevenção do envel envelhecim hecimento ento intrínseco, intrínseco, manchas; mancha s; • Fotoproteção Fotoproteção – evi evitando o fotodano, fotodano, já que a exposi exposição ção ao sol é o fator que mais contribui para o estrago da pele quando se trata de envelhecimento; • For Fortal taleci ecime mento nto de unhas, unhas, pel pele e cabel cabelo; • Pr Prev evenção enção da da flflacidez acidez;; • Auxíl Auxíliio ao a o controle c ontrole da lipodi lipodistrof strofiia ginoide; noide; • Prev Prevenção do envel envelhecim hecimento ento extrí extrínseco nseco - relaciona-se relaciona-se com alterações da superfície cutânea, provocadas, principalmente, pelo fotoenvelhecimento, como as modificações dos contornos e elasticidade da pele, que se manifestam por sulcos, dobras e rugas, associados assoc iados à flac flacid idez. ez. Na apresentação citada, também é possível encontrar citação de artigos científicos que contêm a aplicação de todos esses nutricosméticos. Como sabemos, a prescrição nutricional, seja de alimentos, nutrientes funcionais, fitoterápicos fitote rápicos ou nutricosméticos, nutricosméticos , deve deve ser personalizada. pers onalizada. A opção por uma dosagem maior ou menor deve levar em consideração a gravidade do problema, idade e o uso ou não de outros ativos.

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18 Glossário A Acne: Doença inflamatória da pele cuja frequência é maior na adolescência, quando o nível elevado de hormônios sexuais causa o aumento da secreção de sebo pelas glândulas sebáceas, provocando o aparecimento de espinhas, bolhas e pontos negros, principalmente principalmente no rosto, costas, peito e ombros. Alergias: Conjunto de reações desencadeadas pelo sistema imunitário em resposta a uma substância ou alimento, por exemplo, bolores, pólen, marisco, ovos, etc. Essa reação é responsável pelos sintomas da alergia, que podem ser atenuados pelos antihistamínicos, isto é, substâncias que bloqueiam a produção de histamina. Alimentação:  Processo biológico e cultural que se traduz na escolha, preparação e consumo de um ou vários vários alimentos. aliment os. Alimentação saudável: saudável: Usos, hábitos e costumes que definem padrões de consumo alimentar de acordo com conhecimentos científicos e técnicas de uma boa alimentação. Ver “orientação alimentar”, “composição dos alimentos” e “bem-estar nutricional”. Alimentos funcionais:   São alimentos que fornecem energia para o corpo e uma nutrição adequada, além de produzirem efeitos que proporcionam benefícios à saúde, auxiliando auxiliando na reduçã re duçãoo e prevenção prevenção de muitas doenças.  Unidades formadoras das proteínas. proteín as. Aminoácidos:  Unidades

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considerado. Botox: Técnica que usa a toxina botulínica em estética. É importante por ser capaz de impedir a contração dos músculos faciais que dão origem à ruga. Bulimia nervosa:  Na bulimia nervosa, os portadores são, na maioria das vezes,  jovens  j ovens com co m leve l eve sobrepes sob repesoo e habituados hab ituados a fazer faze r todo to do e qualquer tipo t ipo de dieta. Nesse Nes se tipo de transtorno, os períodos de dietas são intercalados com episódios de vômitos provocados provocados após episódios e pisódios de comer compulsiv com pulsivo, o, seguido de culpa. C Carência de nutrientes:   Situação em que uma deficiência de energia ou nutrientes resultam em danos para a saúde. saúde. CFN: Conselho Federal de Nutricionistas. Colágeno:  Abundante proteína. O colágeno tem uma série de funções no nosso corpo e em estética relaciona-se não somente com a flacidez, como também à saúde das unhas e da pele. D  D iminuição da quantidade de água corporal. Desidratação: Diminuição Dietas da moda:  Dietas adotadas por grande números de pessoas em um determinado tempo. Dislipidemia:  Termo que se refere às alterações, quase sempre por excessos, nos

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 Siste ma de classificação dos hidratos de carbono de acordo acordo com aos Índice glicêmico: Sistema seus efeitos ef eitos na n a glicemia. Forma como um carboidrato é capaz de elevar elevar a glicemia. L Lipoaspiração:  Procedimento estético realizado por meio de uma cirurgia realizada com cânulas muito finas que retiram a gordura localizada em determinadas regiões do corpo. Lipodistrofia ginoide:  Transtorno mutifatorial que envolve a predisposição genética, associada ao efeito hormonal e a alterações da microcirculação, da composição corporal, de modo que as células adipócitas incham demais a ponto de dificultar a drenagem linfática. M Metabolismo basal: Quantidade calórica ou energética que o corpo utiliza, durante o repouso, para o funcionamento de todos os órgãos. Micronutrientes:  Nutrientes demandados pelo organismo em quantidades muito pequena - miligramas ou microgramas – como é o caso de iodo, a vitamina A, o zinco e o ferro. O Ômega 3:  Uma das famílias dos ácidos gordos polinsaturados que se difere das restantes na configuração da molécula. Divide-se em não essenciais e essenciais, se são

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19 Apêndice 1 FICHA DE ATENDIMENTO 1 - identificação: Nome completo: Data de nascimento: Sexo: Convênio: E-mail: Endereço (preenchimento opcional): Telefone residencial: Telefone comercial: Telefone celular: Profissão: 2 - Por que você procurou o atendimento nutricional?   (marque uma ou mais opções) ( ) Emagrecimento ( ) Manter o peso

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( ) Anorexia/bulimia Anorexia/bulimia nerv ne rvosa osa ( ) Hipotireoidismo ( ) Prevenção ou controle de doenças cardiovasculares Outros: Outros : ............................... ............................................... ............................... .......................... ........... 3 - Você tem algum problema de saúde? Se sim, qual(is)? …............................... …............................................... ................................ ................................ .............................. .............. 4 - Você faz uso de algum medicamento? ( ) Não ( ) Sim. Quais? …........................... 5 - Você tem feito exames de sangue? ( ) Não ( ) Sim. Sim . Quando foi realizado o último exame?..... exame?.......... ........ ... 6 - Você já teve alguma destas alterações ou já passou por cirurgias? ( ) Colesterol elevado ( ) Triglicérides elevado ( ) Glicose elevada ( ) Anemia ( ) Cirurgia. Qual?.................. Quando?..................... 7 - Em sua família família (pais e irmãos), há casos cas os de: ( ) Diabetes ( ) Dislipidemia (colesterol/triglicérides elevado) ( ) Hipertensão arterial ( ) Doenças cardiovasculares cardiovasculares ( ) Câncer ( ) Hipo ou hipertireoidismo

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14 - Que alimentos você não gosta ou não te fazem bem? …............................... …............................................... ................................ ................................ ................................ .................. 15 – A que horas você acorda e a que horas você dorme? …............................... …............................................... ................................ ................................ ........................ ........ 16 - Com quem você mora? …............................... …........................................... ............ 17 - Você prepara os seus alimentos? ( ) Sim ( ) Não. Quem cozinha em sua casa?................................ 18 - Você: ( ) Estuda. De ........ ........ horas até at é ........ ........ horas. ( ) Trabalha. De …..... horas até.........horas.

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produtos para exercício)? Ingere água e outros líquidos?

Que quantidade por dia? dia? Cor da sua urina ( ) clara ( ) escura

Ingere: balas, chicletes, chocolates, bolos e  biscoitos, doces?

( ) M uito

Consome adoçantes? adoçantes?

Qual?

Consome laticínios? laticínios?

Quais?

( ) M oderado

Quantas vezes por dia? Consome café?

Quantas vezes por dia? Quantidade por cada vez?

Consome vegetais/ hortaliças?

Quantas vezes por dia?

Consome frutas?

Quantas por dia?

Consome carnes?

Que tipo?

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( ) flacidez ( ) estrias (citar cor) ( ) gordura localizada ( ) Manchas

3. Cel Celulite ( ) localização: ….................................. ( ) grau: ............................................ ................................................. ..... ( ) aumento nos últimos tempos

4. Unhas ( ) cor branca

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Peso habitual: ............. Altura:.................. Peso atual:................. Peso objetivo: ............. IMC:................PA:...................................... Circunferência: Circunferência: (cm) – data: .......... CC:.......... CQ:.............CB:................ Pregas cutâneas: (nesta etapa, o nutricionista deverá avaliar pregas e utilizar um  protocolo  protocol o para pa ra o cá l culo ul o do percentual de  gordura.  gordura . Caso o profissiona profi ssionall disponha disponh a de um aparelh apa relhoo de BIA, BIA, este poderá poderá ser usado ). Data:.............. Dat a:......................... ........... % Gordura: …................... ….......................... Gasto energético diário diário: ….......................... ….................................. Metabolismo basal: …................................ …................... Valor calórico ca lórico escolhido para o plano alimentar : …................... (Nesta parte o nutricionista deverá usar as fórmulas para o cálculo do gasto energético diário e escolh escolher er o val alóric al óricoo da dieta )

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20 Apêndice 2 ESTUDO DE CASO Simulação do atendimento NBM, sexo feminino, 32 anos, procurou atendimento nutricional para redução da flacidez, controle da constipação intestinal e melhora do aspecto da celulite. FICHA DE ATENDIMENTO 1 - Identificação Identificação Nome completo: NBM NBM Data  Data do atendimento: XXXXX Data de nascimento: 02/03/78. 02/03/78. Convênio:  Convênio: particular E-mail: XXXX Endereço (preenchimento opcional): XXXX Telefone residencial: XXXX XXXX Comercial:  Comercial: XXXX

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6 - Você já teve alguma destas alterações ou já passou por cirurgias? ( ) Colesterol elevado (x ( x) Triglicé Triglicérides rides elevado elevado ( ) Glicose elevada elevada ( ) Anemia ( ) Cirurgia. Qual?............................................ Quando?....................... 7 - Em sua famíl fam ília ia (pais (pais e irmãos), há casos de: ( ) Diabetes ( ) Dislipidemia (colesterol/triglicérides elevado) ( ) Hipertensão Hipertens ão arterial ( ) Doenças cardiovasculares cardiovasculares ( ) Câncer ( ) Hipo ou hipertireoidismo ( ) Outros pai: arritmia e mãe: litíase renal

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)escura Você Você ingere bala b alas, s, chicletes ch icletes,, chocolates, bolos X e bbiscoitos iscoitos,, doces? Usa adoçante? Usa laticínios?

( X ) M uito X

X

Qual? Quais? Leite, queijo, iogurte iogurte,, requeijão. Quantas vezes por dia? Duas vezes.

( ) M oderado

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( ) manchas 3. Celulite (x) localização.................. nádegas e perna (x) grau.......................... II (x) aumento nos últimos tempos 4. Unhas

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Circunferência (cm): Data

CC

CQ

CB

XX

72

98

27

etapa , o nutric nutricionista ionista deverá aval ava l iar pregas e utilizar util izar um protocolo protocolo Pregas cutâneas: (nesta etapa,

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pimenta, pimenta, sal, mostarda, maionese); • Fique Fique atenta à quantidade quantidade de sódio sódio dos alime alimentos ntos – evite evite excessos excessos desse nutriente nutriente e também t ambém de gorduras gorduras trans tran s e saturada; sat urada; • Consuma Consuma grande grande quantidade quantidade de de água água durante durante o dia, de de modo modo que, em horários de refeições, o líquido deve ser evitado (use 2,5 litros no

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(1 omelete omele te de

o + vegetais, ou 2 pedaços pequenos de frango assado ou cozido,

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Mix de fibras: 1 xícara de chá de farelo de trigo + 1 xícara de chá de aveia + 1 xícara de

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