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1.
Food Chem ; 455: 139867, 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38823127

RESUMEN

Reducing the content of quickly absorbed carbohydrates and saturated fats in snack formulations while increasing the consumption of high-quality proteins are effective strategies to prevent obesity in childhood. Thus, the nutritional value, digestibility, and functionality of fava beans (Vicia faba L.) fermented with Pleurotus ostreatus were examined as potential ingredients for food design. Solid-state fermentation enhanced the protein content by 16% with a rise in essential (25%) and non-essential (15%) amino acids while decreasing total carbohydrate content and tannin levels. Moreover, fermentation modified the amino acid profile released during digestion, increasing amino acids such as valine, isoleucine, and threonine, which are vital for health and development in childhood. Furthermore, the bioaccessible fraction of the fermented bean showed a 60% of ACE inhibition and improved magnesium bioaccessibility. Consequently, fava beans fermented with Pleurotus ostreatus emerged as a new ingredient in the development of new protein-rich snacks tailored for children and adolescents.

2.
Food Funct ; 2024 May 28.
Artículo en Inglés | MEDLINE | ID: mdl-38804915

RESUMEN

Children with Cystic Fibrosis (CF) are more likely to have intestinal dysbiosis due to recurrent antibiotic therapy and the conventional hypercaloric diet administered to them. This study aimed at evaluating the effect of isolated prebiotic components and probiotic strains, and their combinations as potential synbiotics, on the intestinal microbiota of CF children. A static in vitro colonic fermentation model was used by colonizing vials with faecal inoculum, a culture medium, and the substrates to be tested. Post treatment, aliquots were taken to determine ammonium, lactate, and short-chain fatty acids production and to profile the microbiota composition by 16s rRNA sequencing. At genus level, Escherichia-Shigella decreased (15.8%) with the treatment pectin + L. rhamnosus, followed by the beta-glucan + L. salivarius (15.5%). Inversely, the most increase in Bacteroides (44%) was obtained by the treatment with Pectin + L. reuteri. Lactate and acetic acid production was significantly increased with prebiotics and their combinations with L. rhamnosus and L. salivarius. In conclusion, the use of beta-glucan and pectin in combination with probiotic strains from the Lactobacillaceae family suggest potential to modulate dysbiosis and metabolic activity on CF colonic microbiota, encouraging further studies in animal studies or clinical settings to confirm the findings in vivo.

3.
Pediatr Res ; 2024 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-38778229

RESUMEN

BACKGROUND: Fat malabsorption in children with cystic fibrosis (CF) leads to poor nutritional status and altered colonic microbiota. This study aimed at establishing the faecal lipid profile in children with CF, and exploring associations between the faecal lipidome and microbiota. METHODS: Cross-sectional observational study with children with CF and an age-matched control group. Faecal lipidome was analysed by UHLC-HRMS and microbiota profiling by 16S rRNA amplicon sequencing. RESULTS: Among 234 identified lipid species, five lipidome clusters (LC) were obtained with significant differences in triacylglycerols (TG), diacylglycerols (DG), monoacylglycerols (MG) and fatty-acids (FA): LC1 subjects with good digestion and absorption: low TG and low MG and FA; LC2 good digestion and poor absorption: low TG and high MG and FA; LC3 Mild digestion and poor absorption: intermediate TG and high MG and FA; LC4 poor digestion and absorption: high TG and high MG and FA; LC5 outliers. Bacteroidota and Verrucomicrobiota decreased over LC1-LC4, while Proteobacteria increased. Nutritional status indicators were significantly higher in LC1 and decreased over LC2-LC4. CONCLUSION: Assessing faecal lipidome may be relevant to determine how dietary lipids are digested and absorbed. This new evidence might be a method to support targeted nutritional interventions towards reverting fat maldigestion or malabsorption. IMPACT: Lipidomic analysis enabled the identification of the lipid species related to maldigestion (triglycerides) or malabsorption (monoglycerides and fatty acids). Children with cystic fibrosis can be grouped depending on the faecal lipidome profile related to dietary fat maldigestion or malabsorption. The lipidome profile in faeces is related to the composition of microbiota and nutritional status indicators.

4.
Food Res Int ; 180: 114080, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38395555

RESUMEN

Consumption of essential amino acids responsible for muscle protein synthesis is important in preventing sarcopenia among older individuals. This population may experience gastrointestinal disorders that inhibit protein digestibility, making it crucial to address. Therefore, solid-state fermentation (SSF) using Pleurotus ostreatus and air drying has been suggested as a means of improving the protein digestibility of lentils and quinoa. SSF combined with air drying at 70 °C resulted in a slight increase in protein hydrolysis compared to unfermented samples. SSF was found to boost the proportion of small peptides to 35 %. Following digestion, SSF and drying yielded bioactive peptides of 1400 and 450 Da, with a range of 11 % to 28 %, respectively, and peptides < 190 Da making up 60 % of the total. SSF promoted valine, leucine, and isoleucine generation; however, hot air drying reduced free amino acids due to the amino acid-reducing sugar bonding but was never lower than the initial content of its unfermented counterpart. Furthermore, SSF and drying at 70 °C improved the release of hydrophobic amino acids (>70 mg/g dry basis) and negatively charged amino acids (>20 mg/g dry basis) in lentils during digestion. The SSF samples exhibited lower angiotensin converting enzyme (ACE) inhibitory activity, ≤35 %, compared to unfermented flours after digestion. However, the ACE inhibitory activity increased in SSF-dried samples, in part because of melanoidins generated during drying. Finally, lower values of protein digestibility and thus smaller peptides, amino acid profile, and ACE inhibitory activity of fermented flours were found in the older adult digestion model.


Asunto(s)
Inhibidores de la Enzima Convertidora de Angiotensina , Péptidos , Humanos , Anciano , Inhibidores de la Enzima Convertidora de Angiotensina/química , Péptidos/química , Hidrólisis , Aminoácidos , Harina
5.
Breast Cancer Res Treat ; 203(1): 173-179, 2024 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-37733187

RESUMEN

PURPOSE: The incidence of breast cancer in young women (BCYW) has increased in recent decades. Malignant disease in this subset is characterized by its aggressiveness and poor prognosis. Ovarian function suppression (OFS) in these patients improves survival especially in hormone receptor-positive (HR +) cases. The Regan Composite Risk (RCR) is a prognostic tool to identify high-risk HR + BC candidates for OFS. Our study sought to characterize a Chilean cohort of early HR + BCYW assessing the use of OFS and its related prognosis and the utility of RCR in our patients. METHODS: This was a retrospective population cohort study that included ≤ 35-year-old early HR + /human epidermal growth factor receptor 2 -negative (HER2-) BC patients treated between 2001 and 2021. Analysis included clinical-pathological characteristics, treatment strategies, and survival. Also, we evaluated the association between RCR and survival. RESULTS: A total of 143 patients were included into our study, representing 2.9% of all early BC cases in our registry. Median age was 31 years old (range: 19-35). Most patients (93%) received endocrine therapy (ET). Of these, 18% received OFS. No survival differences were observed among treatment strategies. Median RCR score for patients treated with CT plus ET was significantly higher vs. ET alone (2.95 vs. 1.91; p = 0.0001). Conversely, patients treated with tamoxifen alone had significantly lower RCR scores vs. OFS (2.72 vs. 3.14; p = 0.04). Higher RCR scores were associated with poorer overall survival. CONCLUSION: Less than 20% of very young women with early HR + /HER2-BC in our cohort received OFS, in most cases, this involved surgical oophorectomy. RCR score was higher in patients that underwent CT and OFS and was associated with survival, regardless of treatment. We confirm the RCR score as a valuable prognostic tool to identify high-risk BC patients who could benefit from OFS.


Asunto(s)
Neoplasias de la Mama , Femenino , Humanos , Adulto , Neoplasias de la Mama/terapia , Neoplasias de la Mama/tratamiento farmacológico , Antineoplásicos Hormonales/uso terapéutico , Estudios Retrospectivos , Estudios de Cohortes , Quimioterapia Adyuvante , Premenopausia , Receptor ErbB-2/metabolismo
6.
Pediatr Res ; 2023 Dec 13.
Artículo en Inglés | MEDLINE | ID: mdl-38092964

RESUMEN

BACKGROUND: Children with cystic fibrosis (CF) present with gut dysbiosis, and current evidence impedes robust recommendations on the use of prebiotics. This study aimed at establishing the prebiotic potential of a commercial beta-glucan on the in vitro colonic microbiota of a child with CF compared to a healthy counterpart (H). METHODS: A dynamic simulator of colonic fermentation (twin-SHIME® model) was set up including the simulation of the proximal (PC) and distal colon (DC) of the CF and the H subjects by colonizing the bioreactors with faecal microbiota. During two weeks the system was supplied with the beta-glucan. At baseline, during treatment and post-treatment, microbiota composition was profiled by 16 S rRNA and short-chain fatty acids (SCFA) production was determined by GS-MS. RESULTS: At baseline, Faecalibacterium, was higher in CF' DC than in the H, along higher Acidaminococcus and less Megasphaera and Sutterella. Beta-glucan supplementation induced increased microbiota richness and diversity in both subjects during the treatment. At genus level, Pseudomonas and Veillonella decreased, while Akkermansia and Faecalibacterium increased significantly in CF. CONCLUSION: The supplementation with beta-glucan suggests positive results on CF colonic microbiota in the in vitro context, encouraging further research in the in vivo setting. IMPACT: Current evidence supports assessing the effect of prebiotics on modifying cystic fibrosis microbiota. The effect of beta-glucan supplementation was evaluated in a controlled dynamic in vitro colonic ecosystem. Beta-glucan supplement improved diversity in cystic fibrosis colonic microbiota. The treatment showed increased abundance of Faecalibacterium and Akkermansia in cystic fibrosis. New evidence supports the use of prebiotics in future clinical studies.

7.
Nutrients ; 15(24)2023 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-38140272

RESUMEN

A "high-fat, high-energy diet" is commonly recommended for children with cystic fibrosis (CF), leading to negative consequences on dietary patterns that could contribute to altered colonic microbiota. The aim of this study was to assess dietary intake and to identify possible associations with the composition of faecal microbiota in a cohort of children with CF. A cross-sectional observational study was conducted, including a 3-day food record simultaneously with the collection of faecal samples. The results showed a high fat intake (43.9% of total energy intake) and a mean dietary fibre intake of 10.6 g/day. The faecal microbiota was characterised at the phylum level as 54.5% Firmicutes and revealed an altered proportion between Proteobacteria (32%) and Bacteroidota (2.2%). Significant associations were found, including a negative association between protein, meat, and fish intake and Bifidobacterium, a positive association between lipids and Escherichia/Shigella and Streptococcus, a negative association between carbohydrates and Veillonella and Klebsiella, and a positive association between total dietary fibre and Bacteroides and Roseburia. The results reveal that a "high-fat, high-energy" diet does not satisfy dietary fibre intake from healthy food sources in children with CF. Further interventional studies are encouraged to explore the potential of shifting to a high-fibre or standard healthy diet to improve colonic microbiota.


Asunto(s)
Fibrosis Quística , Microbiota , Niño , Animales , Humanos , Dieta , Estudios Transversales , Fibras de la Dieta/análisis , Dieta Alta en Grasa , Ingestión de Alimentos
8.
Molecules ; 28(21)2023 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-37959717

RESUMEN

The growing number of older adults necessitates tailored food options that accommodate the specific diseases and nutritional deficiencies linked with ageing. This study aims to investigate the influence of age-related digestive conditions in vitro on the phenolic profile, antioxidant activity, and bioaccessibility of minerals (Ca, Fe, and Mg) in two types of unfermented, fermented, and fermented dried quinoa and lentils. Solid-state fermentation, combined with drying at 70 °C, significantly boosted the total phenolic content in Castellana and Pardina lentils from 5.05 and 6.6 to 10.5 and 7.5 mg gallic acid/g dry weight, respectively, in the bioaccessible fraction following the standard digestion model, compared to the unfermented samples. The phenolic profile post-digestion revealed elevated levels of vanillic and caffeic acids in Castellana lentils, and vanillic acid in Pardina lentils, while caffeic acids in Castellana lentils were not detected in the bioaccessible fraction. The highest antioxidant potency composite index was observed in digested fermented dried Castellana lentils, with white quinoa samples exhibiting potency above 80%. Mineral bioaccessibility was greater in fermented and fermented dried samples compared to unfermented ones. Finally, the digestive changes that occur with ageing did not significantly affect mineral bioaccessibility, but compromised the phenolic profile and antioxidant activity.


Asunto(s)
Chenopodium quinoa , Lens (Planta) , Antioxidantes , Fenoles , Minerales , Digestión , Ácidos Cafeicos
9.
Nutrients ; 15(17)2023 Sep 03.
Artículo en Inglés | MEDLINE | ID: mdl-37686878

RESUMEN

Cystic Fibrosis-related gut dysbiosis (CFRGD) has become a recognised complication in children with this condition, and current evidence remains insufficient to guide the selection of probiotic strains for supplementation treatments. The aim of this study was to characterise the effect of three probiotic strains on CFRGD by means of a dynamic in vitro simulation of the colonic fermentation (SHIME®). The configuration of the system included three bioreactors colonised with the faecal inoculum of a child with cystic fibrosis. For 20 days, each bioreactor was supplied daily with either Lacticaseibacillus rhamnosus GG (ATCC 53103 TM), Limosilactobacillus reuteri (DSM 17938) or Lactiplantibacillus plantarum (DSM 22266). The baseline microbiota was characterised by a high abundance of Prevotella, Faecalibacterium and Acidaminococcus genera. After 20 days of supplementation, L. rhamnosus and L. plantarum reduced Prevotella significantly, and the three strains led to increased Faecalibacterium and Bifidobacterium and decreased Acidaminococcus, with some of these changes being maintained 10 days after ceasing supplementation. The metabolic activity remained unaltered in terms of short-chain fatty acids, but branched-chain fatty acids showed a significant decrease, especially with L. plantarum. Additionally, ammonia decreased at 20 days of supplementation, and lactate continuously increased with the three strains. The effects on colonic microbiota of L. rhamnosus, L. reuteri or L. plantarum were established, including increased beneficial bacteria, such as Faecalibacterium, and beneficial metabolites such as lactate; and on the other hand, a reduction in pathogenic genera, including Prevotella or Acidaminococcus and branched-chain fatty acids, overall supported their use as probiotics in the context of CFRGD.


Asunto(s)
Fibrosis Quística , Limosilactobacillus reuteri , Microbiota , Niño , Humanos , Lactobacillaceae , Ácido Láctico , Disbiosis , Faecalibacterium , Ácidos Grasos
10.
Pharmaceutics ; 15(6)2023 Jun 18.
Artículo en Inglés | MEDLINE | ID: mdl-37376211

RESUMEN

Acute and chronic bone infections, especially those caused by methicillin-resistant Staphylococcus aureus (MRSA), remains a major complication and therapeutic challenge. It is documented that local administration of vancomycin offers better results than the usual routes of administration (e.g., intravenous) when ischemic areas are present. In this work, we evaluate the antimicrobial efficacy against S. aureus and S. epidermidis of a novel hybrid 3D-printed scaffold based on polycaprolactone (PCL) and a chitosan (CS) hydrogel loaded with different vancomycin (Van) concentrations (1, 5, 10, 20%). Two cold plasma treatments were used to improve the adhesion of CS hydrogels to the PCL scaffolds by decreasing PCL hydrophobicity. Vancomycin release was measured by means of HPLC, and the biological response of ah-BM-MSCs growing in the presence of the scaffolds was evaluated in terms of cytotoxicity, proliferation, and osteogenic differentiation. The PCL/CS/Van scaffolds tested were found to be biocompatible, bioactive, and bactericide, as demonstrated by no cytotoxicity (LDH activity) or functional alteration (ALP activity, alizarin red staining) of the cultured cells and by bacterial inhibition. Our results suggest that the scaffolds developed would be excellent candidates for use in a wide range of biomedical fields such as drug delivery systems or tissue engineering applications.

11.
Food Res Int ; 169: 112874, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37254324

RESUMEN

Gastrointestinal (GI) functions deteriorate with age, primarily affecting protein digestion. The consumption of chia seeds may be helpful for the elderly because they offer a vegetable-based source of proteins, healthy lipids, fibre and micronutrients. The impact of common age-related GI deterioration on chia seed digestibility was assessed using in vitro digestion models. The goal was to study the potential of chia seeds as part of the diet of seniors. Deterioration in the oral, gastric and intestinal stages of digestion was cumulatively assessed in three digestion models: E1 (deterioration in oral conditions), E2 (deterioration in oral and gastric conditions) and E3 (deterioration in oral, gastric and intestinal conditions). Less efficient chewing (E1) decreased proteolysis, lipolysis and antioxidant capacity (p < 0.05). In contrast, deterioration in gastric functions seemed to affect only total polyphenolic content. Finally, in the model simulating the greatest deterioration in digestive functions (E3), all measured variables were negatively affected (proteolysis, lipolysis, amino acid release, total phenolic content, antioxidant capacity and calcium). Calcium bioaccessibility fell by 24 % with a decrease in pancreatic enzymes and bile secretion (E3). Age-related reduced digestive function did not affect the ratio of essential to non-essential amino acids in the digested samples in any case. However, under suboptimal GI conditions (E3), amino acids such as valine, leucine and isoleucine, which are important for sarcopenia prevention in the elderly, fell by 39 %, 49 % and 44 %, respectively. These findings might be helpful for further in vitro studies of chia seeds as a possible food ingredient. They may also be useful for the development of more targeted nutrition strategies in the elderly.


Asunto(s)
Antioxidantes , Calcio , Humanos , Anciano , Antioxidantes/metabolismo , Nutrientes , Aminoácidos
12.
Foods ; 12(5)2023 Feb 27.
Artículo en Inglés | MEDLINE | ID: mdl-36900516

RESUMEN

Solid-state fermentation (SSF) with Pleurotus ostreatus enhances the nutritional value of legumes. However, drying can cause significant changes in physical and nutritional properties of the final products. Thus, this work studies the impact of air-drying temperature (50, 60, and 70 °C) on relevant properties (antioxidant properties, ACE-inhibitory capacity, phytic acid, colour, and particle size) of two fermented lentils flour (Pardina and Castellana) using freeze-drying as a reference method. Castellana variety is a better substrate for Pleurotus, generating four times more biomass. In addition, an almost total reduction of phytic acid from 7.3 to 0.9 mg/g db is achieved in this variety. Air-drying significantly decreased the particle size and the final colour with ΔE > 20; nonetheless, the temperature does not play a crucial role. SSF decreased the total phenolic content and the antioxidant capacity regardless of the variety, however, drying at 70 °C increased total phenolic content (186%) in fermented Castellana flour. Comparing drying methods, freeze-drying implied a higher decrease in those parameters, reducing the TPC from 2.4 to 1.6 and from 7.7 to 3.4 mg gallic acid/g db in Pardina and Castellana dried flours. Finally, the flours inhibit the angiotensin I-converting-enzyme, and fermentation and drying increased their potential cardiovascular benefits.

13.
Curr Med Chem ; 30(14): 1667-1681, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-36082870

RESUMEN

INTRODUCTION: Opioid Free Anesthesia (OFA) is a relatively new technique that has been questioned due to the lack of evidence regarding its benefit-risk balance. METHODS: Four international databases were searched for clinical trials comparing OFA with opioid based anesthesia. The primary outcome was pain control and the secondary included postoperative nausea and vomiting (PONV), gastrointestinal recovery, respiratory depression, urinary retention, length of hospital stay, surgical complications, number of patients with cessation of the intervention and other side effects. RESULTS: Pain was better controlled in the OFA group in all the measurements made (VAS 1h: Md = -0.81, CI95% = -0.48- -1.14, VAS 24h: Md = -1.25, CI95% =-2.41- -0.1, VAS >24h: Md = -1.36, CI95% = -1.73- -1). In the opioid group there was an increase in the risk of nausea (RR=2.69, CI95% = 2-3.61) and vomiting (RR = 3.99, CI95% = 2.06-7.74), whilst in the OFA group, there was an increased risk of bradycardia (RR= 1.62, CI95% = 1.02-2.57). The rest of the variables showed no differences between groups or could not be analyzed. CONCLUSION: There is a clear benefit of OFA in pain control and PONV, but there is also a higher risk of bradycardia. This technique should be considered in patients with a special risk of difficult postoperative pain control or PONV. However, the best drug combination to perform OFA is still unknown, as well as the type of patient that benefits more with less risk.


Asunto(s)
Anestesia , Náusea y Vómito Posoperatorios , Humanos , Analgésicos Opioides/uso terapéutico , Bradicardia , Dolor
14.
Foods ; 11(3)2022 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-35159560

RESUMEN

Fermentation of plant-based substrates with edible fungi enhances the nutrient profile and digestibility, but it has been scarcely applied to edible seeds, which are rich in healthy lipids. In this study, chia and sesame seeds were solid-state fermented with Pleurotus ostreatus, followed by drying and milling. Fermentation led to increased content of lipid and protein in both seeds' products, and a change in fatty acid profile in favor of increased polyunsaturated fatty acids. Then, the samples were subjected to in vitro digestion. Lipolysis, determined by nuclear magnetic resonance, was higher in sesame than in chia products, and the fermented counterparts had increased values compared to the controls. In terms of physical properties, fermentation showed reduced particle size and increased matrix degradation and decreased viscosity of the digestion medium, which were related to increased lipolysis. In conclusion, applying solid-state fermentation on chia and sesame seeds could be a recommendable approach.

16.
J Agric Food Chem ; 69(15): 4402-4411, 2021 Apr 21.
Artículo en Inglés | MEDLINE | ID: mdl-33835800

RESUMEN

This study aimed to in vitro assess the impact of the cooking process of eggs (hard-boiled, poached, and omelet) on nutrients digestibility and vitamins A and D3 bioaccessibility under elderly gastrointestinal (GI) conditions. Three elderly digestion models were mimicked: oral (E1); oral and gastric (E2); and oral, gastric, and intestinal (E3), and a healthy adult model (C). Proteolysis extent reduced after digestion of omelet under the E3 model (p < 0.05) (up to 37% of reduction). Thus, hard-boiled and poached were more recommendable to enhance protein digestibility in elders. Altered GI conditions negatively influence neither the absorbable lipid fraction nor the cholesterol stability. Finally, vitamin A bioaccessibility was not affected but D3 slightly decreased with the elderly (E3). Hence, the digestion of nutrients was dependent on the resulting matrix, poached being the greater supplier of protein and lipid end-digestion products. Poached and omelet, however, offer a high net supply of bioaccessible vitamin D3 for elders.


Asunto(s)
Culinaria , Digestión , Adulto , Anciano , Disponibilidad Biológica , Huevos , Humanos , Nutrientes , Vitaminas
17.
Foods ; 10(1)2021 Jan 08.
Artículo en Inglés | MEDLINE | ID: mdl-33430041

RESUMEN

Food digestion is the key process for delivering nutrients and bioactive compounds to the body [...].

18.
Food Chem ; 342: 128387, 2021 Apr 16.
Artículo en Inglés | MEDLINE | ID: mdl-33097324

RESUMEN

Salmon is the main dietary source of omega-3 lipids and contains high-biological value protein. However, processing techniques could affect macronutrient digestibility. Also, altered intestinal conditions, particularly given in pancreatic insufficiency, could threaten digestibility. This study tested both hypotheses by subjecting raw, marinated and microwave-cooked salmon to static in vitro digestion under healthy (pH 7, bile concentration 10 mM) and altered (pH 6, bile 1 or 10 mM) intestinal conditions with different pancreatin concentrations. In the standard conditions, proteolysis was not affected by processing, but lipolysis decreased in marinated (46%) and raw salmon (57%) compared to the cooked matrix (67%). In altered conditions, proteolysis and lipolysis decreased to different extents depending on the treatment. Overall, processing affected proteolysis the most (f-ratio = 5.86), while intestinal conditions were the major determinants of lipolysis (f-ratio = 58.01). This study could set the ground to establish dietary recommendations of salmon for specific population groups.


Asunto(s)
Manipulación de Alimentos/métodos , Nutrientes/metabolismo , Salmón/metabolismo , Alimentos Marinos/análisis , Animales , Digestión , Concentración de Iones de Hidrógeno , Lipólisis , Espectroscopía de Resonancia Magnética , Pancreatina/análisis , Pancreatina/metabolismo , Proteolisis
19.
J Cyst Fibros ; 20(5): e33-e39, 2021 09.
Artículo en Inglés | MEDLINE | ID: mdl-33279468

RESUMEN

BACKGROUND: Patients with cystic fibrosis (CF) and pancreatic insufficiency need pancreatic enzyme replacement therapy (PERT) for dietary lipids digestion. There is limited evidence for recommending the adequate PERT dose for every meal, and controlling steatorrhea remains a challenge. This study aimed to evaluate a new PERT dosing method supported by a self-management mobile-app. METHODS: Children with CF recruited from 6 European centres were instructed to use the app, including an algorithm for optimal PERT dosing based on in vitro digestion studies for every type of food. At baseline, a 24h self-selected diet was registered in the app, and usual PERT doses were taken by the patient. After 1 month, the same diet was followed, but PERT doses were indicated by the app. Change in faecal fat and coefficient of fat absorption (CFA) were determined. RESULTS: 58 patients (median age 8.1 years) participated. Baseline fat absorption was high: median CFA 96.9%, median 2.4g faecal fat). After intervention CFA did not significantly change, but range of PERT doses was reduced: interquartile ranges narrowing from 1447-3070 at baseline to 1783-2495 LU/g fat when using the app. Patients with a low baseline fat absorption (CFA<90%, n=12) experienced significant improvement in CFA after adhering to the recommended PERT dose (from 86.3 to 94.0%, p=0.031). CONCLUSION: the use of a novel evidence-based PERT dosing method, based on in vitro fat digestion studies incorporating food characteristics, was effective in increasing CFA in patients with poor baseline fat absorption and could safely be implemented in clinical practice.


Asunto(s)
Fibrosis Quística/tratamiento farmacológico , Dieta , Terapia de Reemplazo Enzimático/métodos , Aplicaciones Móviles , Páncreas/enzimología , Niño , Europa (Continente) , Medicina Basada en la Evidencia , Femenino , Humanos , Masculino
20.
Food Res Int ; 137: 109454, 2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33233130

RESUMEN

This study aimed to evaluate the effect of some elderly in vitro gastrointestinal (GI) conditions on proteolysis and lipolysis extent, calcium, vitamins A and D bioaccessibility and lactose release in milk, yogurt, fresh and aged cheeses. To evaluate the impact of the some oral, gastric and intestinal disorders appearing with ageing on dairy digestion, three in-vitro elderly models were applied (E1 (oral altered conditions), E2 (oral and gastric altered conditions) and E3 (oral, gastric and intestinal altered conditions)) plus a healthy adult one as control. Proteolysis extent was significantly affected by elderly GI alterations (p < 0.05) (around 40% of reduction compared to control), being fresh and aged cheese proteolysis the most affected with an important descrease in leucine release (18 and 25%, respectively). Calcium, vitamins A and D3 bioaccesibility and lactose release seemed not to be highly compromised in these models of elderly conditions; however, the micronutrients bioaccessibility was very dependent on dairy matrix's structure. Finally, the amount of the lipid hydrolyzed fraction of cheeses is not influenced in the investigated models.


Asunto(s)
Queso , Anciano , Animales , Calcio de la Dieta , Humanos , Leche , Vitaminas , Yogur
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