Conhecimento do controle dietético de hipertensos e diabéticos quilombolas de Bequimão, Maranhão, Brasil

Abstract

Introduction: Arterial hypertension and diabetes mellitus are more prevalent in the country's black population. The implications of food regarding the control of these diseases give nutritional knowledge the possibility of preventing or controlling them. Objective: To investigate knowledge about dietary control in arterial hypertension and diabetes mellitus among quilombolas in the municipality of Bequimão, Maranhão, Brazil. Methods: Crosssectional study carried out with 115 hypertensive and diabetic quilombolas, in 2021, in the municipality of Bequimão, Maranhão, Brazil. Through a face-to-face interview, a form was applied at the participants' homes, collecting socioeconomic, clinical and lifestyle characteristics; as well as knowledge about dietary control in arterial hypertension and diabetes mellitus. To verify the association between the study variables, the chi-square or Fisher's exact test (p<0.05) was used. Results: Of the surveyed quilombolas, 65.22% were hypertensive, 9.57% were diabetic and 25.22% had high blood pressure associated with diabetes mellitus. Most were female (65.22%), aged ≥ 60 years (76.52%), with some education (68.70%), black/brown/black (64.35%), of social class D or E (97.39%), diagnosed with arterial hypertension for more than five years (62.61%) and with diabetes mellitus for five or less years (71.30%). Hypertensive and/or diabetic Quilombola women lived with a lower per capita monthly income than men (p = 0.021) and were less alcoholic (p=0.027). It was known by 77.39% of the studied population that the diet plays a therapeutic role on the investigated diseases, with diabetics being the ones who most had this understanding (p=0.009). Body weight was understood as a factor that influences blood pressure and blood sugar levels for 71.30% of the studied quilombolas. For 53.04% of the quilombolas, food influences the values of routine exams. Most quilombolas share common knowledge about the dietary components of sodium, fats, fibers, carbohydrates and table sugars and unfounded knowledge about coffee and protein-rich foods. Most know about the correct use of sweeteners. For 35.65% of respondents, the adoption of all dietary practices considered appropriate for their illnesses is unfeasible, due to the marketing away from the quilombola areas of food considered adequate (46.31%), the taste (pleasant or not) food (36.52%) and the lowest financial resources they have (9.75%). Most of the quilombolas studied lack knowledge or certainty about the quality of fat, the presence of cholesterol and the salt content of certain foods, as well as about the glycemic increase capacity of different food combinations and unrefined table sugars. Conclusion: Hypertensive and diabetic quilombolas understood that there is a relationship between the diet followed and the control of their diseases. However, there are gaps to be filled in the nutritional knowledge of this racial group. There is a presence of food selectivity and an uninterrupted panorama of socio-spatial marginalization and adverse economic reality remains installed in these communities, which make it difficult to experiment with food practices that are more adequate to the health demands of the studied quilombolas.