Abstract:
In Portugal, the prevalence of pre-obesity is 34.8% and obesity is 22.3% (National Food and Physical Activity Survey, 2017). This prevalence is higher in the female population (24.3% vs. 20.1%). In the Algarve Region, the weighted prevalence of obesity is 30.4%. Around 322 million people live with depression, and it is even considered the most disabling disease (Baldini I., 2021). This pathology is more prevalent in female individuals (WHO, 2020). In Portugal, the 2019 mental health observatory reported anxiety disorders at 11% and depressive disorders at 7%. Intervention by a multidisciplinary team is required to achieve health gains (Hassapidou et al., 2023). Several approaches have proven effective in weight reduction and were associated with more consistent long-term behavioral changes: the Mediterranean diet, low-carbohydrate diet, vegetarian diet, Dietary Approaches to Stop Hypertension (DASH), and the Nordic diet (Kim Y., 2021). A prospective experimental clinical study was implemented with a sample of female individuals with pre-obesity and grade 1 obesity associated with a diagnosis of depression. A low-energy, low-carbohydrate, and high-protein diet is implemented, and its effect is evaluated over six months. The main objective is to evaluate the efficacy in reducing weight, Body Mass Index (BMI), body fat percentage, and visceral fat through the implementation of a low-energy, lowcarbohydrate, and high-protein diet in female individuals diagnosed with preobesity or grade 1 obesity associated with depression. As secondary objectives: to evaluate the association between weight loss and improvement in anxiety levels; the relationship between depression and diet compliance; and to evaluate the relationship between waist circumference and the reduction of visceral fat. For this purpose, a prospective experimental study was designed and conducted over a 6-month period. The sample will be representative of the female population with pre-obesity, grade 1 obesity, and depression from the Nutrition Consultation at ULS Algarve. Body composition assessment is performed via tetrapolar bioimpedance: weight, BMI, % body fat, % fat-free mass, total body water, visceral fat, and phase angle. Height and waist circumference will also be assessed. The Anxiety, Depression, and Stress Scale (EADS), validated for the Portuguese population, is applied (Ribeiro J. et al., 2004). Assessments take place during two moments: at the baseline and three months after. A total of 130 appointments were scheduled, of which 96 took place. There was a non-attendance rate of 26% (n=34). Among the evaluated participants, 70 meet the inclusion criteria and agreed to join the study. Currently, the clinical study is in the final stage of recruitment.
