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Kennedy Maia Dos Santos IMAGEM CORPORAL, ÍNDICE DE MASSA

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Kennedy Maia Dos Santos IMAGEM CORPORAL, ÍNDICE DE MASSA Kennedy Maia dos Santos IMAGEM CORPORAL, ÍNDICE DE MASSA CORPORAL, PERÍMETRO DA CINTURA, ALTERAÇÃO DA PRESSÃO ARTERIAL E INTOLERÂNCIA À GLICOSE ENTRE OS POVOS INDÍGENAS DO XINGU, BRASIL Tese apresentada à Universidade Federal de São Paulo - Escola Paulista de Medicina, para a obtenção do título de Doutor em Ciências. São Paulo 2016 Kennedy Maia dos Santos IMAGEM CORPORAL, ÍNDICE DE MASSA CORPORAL, PERÍMETRO DA CINTURA, ALTERAÇÃO DA PRESSÃO ARTERIAL E INTOLERÂNCIA À GLICOSE ENTRE OS POVOS INDÍGENAS DO XINGU, BRASIL Tese apresentada à Universidade Federal de São Paulo - Escola Paulista de Medicina, para a obtenção do título de Doutor em Ciências. Orientadora: Prof.ª Titular Suely Godoy Agostinho Gimeno Coorientadora: Prof.ª Adjunta Luciana Yuki Tomita São Paulo 2016 i Santos, Kennedy Maia dos Imagem corporal, índice de massa corporal, perímetro da cintura, alteração da pressão arterial e intolerância à glicose entre os povos indígenas do Xingu, Brasil / Kennedy Maia dos Santos, 2016. —São Paulo, 2016. xix, 174f. Tese (Doutorado) – Universidade Federal de São Paulo. Escola Paulista de Medicina. Programa de Pós-graduação em Saúde Coletiva. Body image, body mass index, waist circumference, abnormal blood pressure and glucose intolerance among the indigenous peoples of the Xingu, Brazil. 1. Intolerância à glicose; 2. Hipertensão Arterial; 3. Índice de Massa Corporal; 4. Perímetro da Cintura; 5. Imagem corporal; 6. Indígenas ii Universidade Federal de São Paulo Escola Paulista de Medicina Departamento de Medicina Preventiva Programa de Pós-graduação em Saúde Coletiva Chefe do Departamento: Profª Titular Rebeca de Souza e Silva Coordenador(a) do programa: Profª Titular Suely Godoy Agostinho Gimeno iii Kennedy Maia dos Santos IMAGEM CORPORAL, ÍNDICE DE MASSA CORPORAL, PERÍMETRO DA CINTURA, ALTERAÇÃO DA PRESSÃO ARTERIAL E INTOLERÂNCIA À GLICOSE ENTRE OS POVOS INDÍGENAS DO XINGU, BRASIL Presidente da banca: Profª. Titular Suely Godoy Agostinho Gimeno BANCA EXAMINADORA _______________________________________ Profª. Titular Suely Godoy Agostinho Gimeno ______________________________________________ Dra. Lenise Mondini ______________________________________________ Profª. Dra. Marselle Bevilacqua Amadio _______________________________________________ Profº. Dr. Pedro Paulo Gomes Pereira _______________________________________________ Profº. Titular José Maria Pacheco de Souza iv Dedicatória Dedico a realização deste sonho a toda minha família, em especial a minha esposa Raquel, que é minha carne e por isso sente tudo que eu sinto e é meu orgulho, aos meus filhos Salmon e Guilherme, que são meus estímulos para que eu continue aprendendo, minha mãe Nelcy Maia (in memoriam) e meu pai Raimundo Mendes, que me ensinaram valores vitais, aos Khisêdjê, pela generosidade e acolhimento inesquecível e a Deus, sem o qual nada disso seria possível. v AGRADECIMENTOS A Deus. Obrigado Pai pelo amor e graça imerecida. Por permitir que eu chegasse até aqui e em muitos momentos me “carregar nos braços”. Por acreditar em mim quando eu duvidei que conseguiria realizar este sonho. O Senhor é o meu Ebenézer (pedra de ajuda), pois “até aqui nos ajudou o Senhor” (1Samuel 7: 12). MUITO OBRIGADO PAI QUERIDO! A minha esposa Raquel. Nesses quase quinze anos você sempre fez parte dos melhores e mais importantes momentos da minha vida até então. É quem sonha, se alegra e até chora comigo. Me ajuda em tudo, inclusive nesta tese. É exemplo de esposa, filha, mãe e profissional. Você me inspira, é o meu presente dos céus. Amo Você! A minha orientadora Professora Dra. Suely Gimeno. Agradeço a generosidade, paciência, dedicação, comprometimento, responsabilidade e carinho que sempre dedicou a mim e aos seus orientandos que tive o privilégio de conviver. Sou privilegiado em tê-la como minha orientadora. Tenho absoluta certeza que não foi o “acaso” que fez você abrir meu e-mail e aceitar me entrevistar ainda para o mestrado. Muito obrigado por tudo. A minha Coorientadora Professora Dra. Luciana Yuki Tomita pelas contribuições de fundamental importância no alinhamento desse estudo, paciência e carinho sempre. Muito obrigado por tudo. Aos povos do Xingu pela oportunidade de realizar este estudo e por termos sido tão bem recebidos quando estivemos entres os Khisêdjê. Sou extremamente grato por tudo que tive a oportunidade de vivenciar e receber de vocês. Sou devedor. Aos amigos: Lalucha, Mario, Patrícia que durante todo o período que estive em São Paulo foram minha família. Muito obrigado pela amizade e ajuda em todas as etapas da realização desta conquista. Vocês são especiais para mim e Raquel. Aos pastores Celson Costa e Agostinho Gonçalves pelo apoio e cobertura em oração. Vocês são bênçãos. vi Aos amigos do Projeto Xingu e UNIFESP: Anabele, Vanessa, Juliana, Bruna, Danielle, Vânia, Sofia, Douglas, Glória e muitos outros amigos que tive o prazer de conviver. Muito obrigado pela generosa amizade e apoio sempre. A secretária do Programa de Pós-graduação em Saúde Coletiva, Sandra Fagundes, que sempre nos ajudou, fazendo muito mais que suas atribuições no programa. Muito obrigado Sandra. Aos professores da UNIFESP e FSP/USP, em especial os professores: Pedro Paulo, Wilza Vilella, Luiz Francisco Marcopito, Luiz Cecílio, Elizeu Waldman e Denise Coviello com quem tive o privilégio de estudar e aprender conteúdos inestimáveis. A todos, o meu muito obrigado pela rica contribuição que vocês deram à minha formação acadêmica e humana. Aos meus familiares, irmãos, irmãs, tios, primos e sobrinhos que aqui não mencionarei o nome de todos pois são muitos, no entanto, não poderia deixar de mencionar alguns para representá-los: José Raci, AJ, Neide, Neurides, Yana, Raquel, Radi, Vlad, Laires, Pedro, Rocilda, Cosmo, (...). Muito obrigado a todos (as) pelas orações, incentivo e apoio sempre. Amo vocês! Aos amigos de Rio Branco e Cruzeiro do Sul no Acre pelo cuidado, paciência, incentivo, apoio e oração, que me fizeram acreditar que a realização deste projeto era possível. Quem tem amigos como vocês é “rico”, pois a maior riqueza que alguém pode cultivar é a amizade. Muito obrigado sempre. A Universidade Federal de São Paulo, ao Projeto Xingu, a Fundação de Amparo à Pesquisa do Estado de São Paulo e ao Governo do Estado do Acre pela oportunidade ímpar e por tornar tudo isso possível. A todos (as), muito obrigado. vii Valores - “Pigrytxi”, fala Mario querendo começar uma conversa. - “Sim, Mario”, responde Pigrytxi. - “Alguma vez já aconteceu de alguém da aldeia fazer algo errado lá fora ou aqui dentro?”, pergunta Mario. - “Já sim...mas faz tempo”, fala Pigrytxi. - “Mas o que vocês fizeram com a pessoa?”, pergunta Mario. - “Nós conversamos com ele pra ele não fazer de novo”, responde Pigrytxi, de forma simples. - “Mas se a pessoa voltar a fazer algo de errado, o que é feito?”, insiste Mario. - “Nós falamos de novo pra ele não fazer aquilo”, responde Pigrytxi. - “Sim, mas se ele voltar a fazer o que vocês já haviam dito duas ou três vezes para ele não fazer, vocês mandam ele ir embora da aldeia?”, questiona Mario, ainda com dúvidas sobre o que poderia acontecer com quem quebrasse as regras da comunidade Khisêdjê. - “Não, por que nós faríamos isso se aqui é a casa dele?”, replica Pigrytxi demonstrando não entender o motivo da última pergunta de Mario, “nós continuamos conversando com ele”. (Diálogo entre Pigrytxi Khisêdjê e Mario Tsutsui e eu como observador na aldeia Ngôjhwêrê em setembro de 2011). viii SUMÁRIO 1. CONSIDERAÇÕES INICIAIS ................................................................................................ 1 2. HISTÓRIA DOS POVOS INDÍGENAS NO BRASIL .......................................................... 3 2.1. IDENTIDADE INDÍGENA ............................................................................................................. 3 2.2. POVOS INDÍGENAS DO BRASIL ................................................................................................ 4 2.2.1. Parque Indígena do Xingu e suas Populações ......................................................... 7 3. CULTURA CORPORAL ................................................................................................... 29 3.1. IMAGEM CORPORAL............................................................................................................... 31 3.1.1. Imagem Corporal e Condição Nutricional .................................................................... 33 3.1.2. Uso de Escalas de Silhuetas para Avaliação da Imagem Corporal ........................ 35 3.1.3. Imagem Corporal entre Indígenas ................................................................................ 36 4. PERFIL DE MORBIMORTALIDADE DOS POVOS INDÍGENAS NO BRASIL ................. 38 4.1. MORTALIDADE DOS POVOS INDÍGENAS NO BRASIL ................................................................ 39 4.2. MORBIDADE POR DOENÇAS INFECCIOSAS E PARASITÁRIAS .................................................. 43 4.3. MORBIDADE POR DCNTS ......................................................................................................... 46 4.3.1. Hipertensão Arterial ........................................................................................................ 47 4.3.2. Intolerância à Glicose e Diabetes Mellitus................................................................... 48 4.3.3. Distúrbios Nutricionais .................................................................................................... 49 5. ATIVIDADE FÍSICA E DCNTS ..........................................................................................
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