2182-7230 2182-7230 S2182-72302012000400004 00 12 2012 00 12 2012 15 14 18

ARTIGO DE REVISÃO


Azeite e Saúde

Olive Oil and Health

 

Marina Rodrigues1*; Marta Rocha1*; Ana Ferreira1*; Patrícia Padrão2

1Estudante de Ciências da Nutrição, Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto 2Docente, Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto

Endereço para correspondência

 

RESUMO

Na bacia do Mediterrâneo, o azeite, juntamente com os hortofrutícolas e o pescado, é um componente-chave da alimentação desta região, sendo considerado importante na preservação da saúde da população. Os dados epidemiológicos sugerem que a Alimentação Mediterrânica pode ter efeitos protectores contra várias doenças, sendo argumentado que são os polifenóis, o esqualeno e o ácido oleico, que conferem ao azeite as suas propriedades de promoção da saúde. O consumo de azeite virgem tem sido associado a uma diminuição da probabilidade de ocorrência de cancro, doenças cardiovasculares, obesidade e diabetes.

]]> Palavras-Chave: Azeite, Alimentação Mediterrânica, Saúde

 

 

ABSTRACT
In Mediterranean countries, olive oil, along with fruit, vegetables and fish, is a key component of diet in this region, being considered important for the preservation of health of the population. Epidemiological data suggest that the Mediterranean diet can have protective effects against various diseases, being argued that are the polyphenols, the squalene and oleic acid, that give to olive oil its health-promoting properties. The consumption of virgin olive oil has been associated with a decrease of likelihood of cancer, cardiovascular disease, obesity and diabetes.

keywords: Olive oil, Mediterranean Diet, Health

 

 

INTRODUÇÃO
Aceita-se ]]> A Alimentação Mediterrânica (AM) tradicional baseia-se no consumo de alimentos de origem vegetal, inclusão de pequenas quantidades de alimentos de origem animal (sob a forma de pescado e produtos lácteos), consumo moderado (3) de bebidas ]]> No século XX, Keys e colaboradores publicaram um conjunto de trabalhos decorrentes do “Seven Countries Study”, tendo evidenciado uma possível associação entre a AM e uma menor incidência de doenças crónicas (9-11). A evidência científica é crescente no que respeita à associação entre a adopção da AM (12) como padrão de alimentação e a diminuição do risco de doenças cardiovasculares (DCV), obesidade, diabetes tipo 2, cancro, artrite reumatóide, bem como o ]]> Composição do Azeite
É importante referir que a composição nutricional do azeite não é fixa: depende da variedade da azeitona usada, do ano de produção, da região de onde provém e ]]> No fabrico do azeite, as azeitonas são primeiramente esmagadas para criar um bagaço que, depois de ser homogeneizado, é pressionado para produzir óleo. O primeiro óleo extraído é o azeite virgem de alta qualidade – obtido usando apenas métodos físicos, o que permite a preservação de muitos dos seus componentes (2, 25).
A qualidade do azeite vai ser determinada pela região onde é produzido, a variedade, a idade, o estado sanitário e o grau de maturação das azeitonas, o ]]> O azeite é constituído na sua quase totalidade por lípidos (≈99%), sendo que a maior fracção (78,6%) corresponde a ácidos gordos monoinsaturados (AGM) – nomeadamente o ácido oleico, um dos maiores componentes bioactivos do azeite - e possui numerosos componentes com capacidade antioxidante (vitamina E, carotenos, compostos fenólicos, entre outros) (27).
Inicialmente, ]]> Azeite e Efeitos Fisiológicos
Actividade Antioxidante
Os principais componentes que contribuem para os vários benefícios atribuídos ao azeite (ácido oleico, compostos fenólicos e esqualeno), inibem o stress oxidativo (25). Ao contrário dos ácidos gordos ]]> Entre os compostos fenólicos do azeite, o hidroxitirosol e a oleuropeína são considerados potentes agentes antioxidantes visto que são capazes de eliminar radicais livres e oxidantes e de inibir a oxidação das LDL (25, 32-35). É sabido que o excesso de radicais livres leva a danos oxidativos, aumentando o risco de desenvolver numerosas ]]> De facto, a oxidação das LDL é considerada o maior factor de risco no desenvolvimento de aterosclerose e DCV, já que induz o desenvolvimento de placas ateromatosas nas paredes arteriais. Outros estudos têm corroborado os ]]> Actividade Anti-inflamatória
É reconhecido que a fisiopatologia de várias doenças como o cancro, DCV, artrites e doenças neurodegenerativas se associa com a inflamação crónica (46-49). A evidência científica actual sugere que os compostos fenólicos encontrados no azeite virgem possuem uma capacidade anti-inflamatória considerável, sendo por isso capazes de reduzir o risco de desenvolvimento de doenças crónicas inflamatórias (50-52).
A ]]> Actividade Antimicrobiana
Alguns compostos fenólicos do azeite parecem encerrar propriedades antimicrobianas que se pensam traduzir na inibição do crescimento de microrganismos, cooperando no tratamento terapêutico de algumas doenças infecciosas (58), embora a maioria da evidência científica existente provenha de estudos realizados in vitro.
Azeite e Patologias
Cancro ]]> De uma forma geral, a literatura científica mais recente sobre a associação entre AM e ocorrência de cancro, atribui propriedades preventivas ao rácio equilibrado de ácido gordos n-6 e n-3 e à elevada quantidade de fibra, antioxidantes e polifenóis presentes nos hortofrutícolas, no azeite e no vinho (7). Relativamente ao azeite, e conforme discutido em vários trabalhos, parece existir uma relação inversa entre o seu consumo e diversos tipos de cancro (63-68), embora os mecanismos subjacentes não estejam completamente esclarecidos (59, 69). Entre os componentes que podem explicar estes possíveis efeitos benéficos do azeite está o ácido oleico ]]> Owen e colaboradores sugeriram ainda que os polifenóis do azeite são capazes de eliminar os radicais livres produzidos na matriz fecal, o que poderá contribuir para explicar os possíveis efeitos quimioprotetores do azeite sobre o cólon (25). Acresce o facto de o azeite parecer capaz de diminuir a expressão de COX-1 e BCL-2, duas proteínas presentes na carcinogénese colorectal (87). ]]> No que respeita ao cancro da mama, estudos caso-controlo com mulheres de vários países do Mediterrâneo têm descrito uma relação inversa entre o consumo de azeite e a ocorrência deste tipo de cancro (88, 89). Solanas e colaboradores sugeriram ainda que o azeite virgem exerce efeitos moduladores no cancro da mama através de uma combinação de diferentes vias de sinalização Ras, resultando num cenário de apoptose celular (90). Apesar dos potenciais efeitos protectores do azeite contra o cancro da mama, estes não se parecem reflectir numa menor mortalidade por esta patologia (91).
Artrite Reumatóide ]]> Na origem do processo inflamatório característico da artrite reumatóide estão, entre outros, as espécies reactivas de oxigénio (ROS) (92). Parece que o azeite, dado o seu efeito antioxidante (capacidade de redução das ROS), é capaz de reduzir a inflamação. Por outro lado, há autores que defendem que o ácido oleico pode substituir os ácidos gordos polinsaturados n-6 no que respeita ao metabolismo celular, o que contribui para diminuir a produção do leucotrieno A4, eicosanóide pró-inflamatório. Assim, reduzindo a competição entre n-6 e n-3 (via ácido oleico), aumentaria a incorporação e utilização de n-3 (aumentando a produção de eicosanóides anti-inflamatórios como o leucotrieno A5). Além disto, é de notar que o ácido oleico ]]> Síndrome Metabólica
A investigação desenvolvida no âmbito da Síndrome Metabólica (SM) tem apontado ]]> Diabetes: Os estudos têm revelado uma menor frequência de diabetes conforme aumenta a adesão à AM (96), tanto em pessoas saudáveis (97) como em pessoas que sofreram enfarte do miocárdio (12). Neste sentido, tem-se colocado a questão sobre qual será a melhor fonte energética (Hidratos de carbono (HC) ou AGM) para substituir os ácidos gordos saturados (AGS) e, da comparação destes dois padrões alimentares numa meta-análise, observou-se um controlo glicémico e ]]> Obesidade: Estudos recentes relataram que a adesão à AM se associou a uma menor proporção de gordura abdominal e, consequentemente a um menor perímetro da cintura. Contudo, os autores sugerem cautela na interpretação dos resultados devido à heterogeneidade dos mesmos entre os países participantes (102, 103). Em relação ao Índice de Massa Corporal (IMC), a relação com a AM não tem sido conclusiva (102, 104), embora haja resultados que apontem para a inexistência de relação entre o consumo de azeite e o aumento do IMC (105). Foi inclusivamente observada uma associação inversa entre o consumo de azeite e a ocorrência de obesidade em crianças do sul a Europa, onde a estimativa da prevalência de obesidade é mais ]]> Risco Cardiovascular: Os estudos epidemiológicos sugerem que a AM tem capacidade para reduzir a frequência de doença coronária (110, 111), podendo o azeite ter um papel relevante neste efeito, nomeadamente no que respeita à protecção contra o enfarte do miocárdio (112). Foi observada uma associação inversa entre o consumo de azeite e o risco cardiovascular na coorte espanhola do estudo EPIC (113), tendo sido apontados como factores decisivos do azeite no risco cardiovascular tanto o conteúdo lipídico como os seus componentes minoritários (114-116). ]]> Trombogénese: O azeite vem sendo referenciado como detentor de propriedades antiagregantes, efeito que aparece aumentado quando se duplica a quantidade de AGS substituídos por AGM (117). É sugerido que o consumo de azeite é acompanhado por uma diminuição do risco cardiovascular tanto pela diminuição de factores de coagulação como de agregação plaquetária (118).
Aterosclerose: Tem sido estudada a possível capacidade de redução do colesterol sanguíneo pelo esqualeno, embora os estudos não reportem resultados consistentes (119). Tem sido, por outro lado, sugerido que os polifenóis presentes no azeite, principalmente o hidroxitirosol, ]]> Hipertensão arterial: A adesão à AM tem sido associada a uma redução da incidência de hipertensão arterial (122, 123), bem como à capacidade de reduzir a dose de fármacos anti-hipertensivos (2). Embora o mecanismo pelo qual o azeite possa ser capaz de reduzir a pressão arterial seja desconhecido, várias teorias têm sido discutidas, tais como a capacidade do azeite actuar como um antagonista dos canais de cálcio (mimetização dos efeitos de fármacos ]]> Em ]]>

ANÁLISE CRÍTICA
O azeite parece contribuir para a baixa frequência de doenças crónicas nas populações que o consomem.
Desta forma, apesar de existirem estudos epidemiológicos que sugerem que o consumo do azeite, inserido numa alimentação equilibrada e num estilo de vida saudável, traga benefícios para a saúde, é necessário desenvolver mais investigação populacional que possibilite obter evidência científica convincente sobre o efeito do consumo de azeite na saúde. Só assim será possível avaliar a pertinência de serem estabelecidas recomendações neste domínio.

CONCLUSÕES
A investigação científica tem atribuído aos polifenóis, ao esqualeno e ao ácido oleico, presentes no azeite as suas propriedades de promoção da saúde. O consumo de azeite virgem, sobretudo como parte integrante da Alimentação Mediterrânica, tem sido associado a uma diminuição da probabilidade de ocorrência de alguns cancros, doenças cardiovasculares, obesidade e diabetes.

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Endereço para correspondência
Marina Rodrigues (A/C Patrícia Padrão)
Faculdade de Ciências da Nutrição e Alimentação da Universidade do Porto
Rua Dr. Roberto Frias s/n, 4200-465 Porto
marina.dfr@gmail.com

]]> Recebido a 13 de Agosto de 2012
Aceite a 13 de Dezembro de 2012

*Contributo semelhante para a realização deste estudo
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