Breastfeeding in infants seen in private pediatric practices and its relation with type of delivery and history of prematurity

Abstract Objective: To describe the type of milk used to feed infants seen in private pediatric practices in Brazil. To evaluate the relationship between breastfeeding, type of delivery, and history of prematurity. Methods: This is a cross-sectional and observational study that included 4929 infants in the first year of life seen in private pediatric practices in the five geographic regions of Brazil. Mothers provided information about the type of milk used by their infant, the type of delivery (vaginal or cesarean), and whether the birth was premature. Results: Breastfeeding was the only source of milk for 56.1% (1546/2755) of infants in the first six months of life and 32.9% (716/2174) in the second. Of the infants who received other types of milk besides breastfeeding, there was a predominance of infant formula in 98.6% and 93.8% of the infants, respectively, in the first and in the second six months of life. Whole cow's milk was used by 0.7% (20/2755) of infants in the first six months and by 4.1% (90/2174) of infants in the second (p < 0.001). In the first six months of life, breastfeeding as the only type of milk was associated with vaginal delivery (OR = 1.79; p < 0.001) and not having a history of prematurity (OR = 2.48; p < 0.001). Conclusion: Breastfeeding was the only milk source for more than half of infants before 180 days of life. Birth by cesarean section and history of prematurity were negatively associated with breastfeeding as the only source of milk used in infant feeding.

Prevalence of Functional Gastrointestinal Disorders in Brazilian Infants Seen in Private Pediatric Practices and Their Associated Factors.

OBJECTIVES: To assess the prevalence of the most frequent functional gastrointestinal disorders (FGIDs) in Brazilian infants seen in private pediatric clinics and their relationship with cesarean delivery, breastfeeding, and history of prematurity. METHODS: This cross-sectional study enrolled 5080 infants under 12 months old with routine visits in private pediatric clinics in Brazil. The mothers answered questions about the type of delivery, type of feeding (breast milk, infant formula, cow milk, mixed feeding), history of prematurity, and gastrointestinal symptoms. Rome IV criteria were used to diagnose FGIDs. RESULTS: The prevalence of infant regurgitation was 10.7% (487/4560); infant colic, 6.1% (131/2162); infant dyschezia, 4.0% (157/3895); functional constipation, 7.6% (341/4506); and functional diarrhea, 0.09% (2/2186). Prematurity was associated ( P < 0.05) with infant regurgitation (odds ratio [OR] = 1.41; 95% confidence interval [CI]: 1.05, 1.90), infant colic (OR = 1.97; 95% CI: 1.19, 3.24), infant dyschezia (OR = 1.64, 95% CI: 1.02, 2.64), and functional constipation (OR = 1.44; 95% CI: 1.02, 2.02). Prematurity was associated ( P < 0.001) with two or more FGIDs between 21 days and 150 days of age (OR = 3.06; 95% CI: 1.74, 5.37). CONCLUSION: FGIDs are common in infants seen in the private pediatric practice in Brazil. History of prematurity was associated with infant regurgitation, infant colic, functional dyschezia, and functional constipation.

Breastfeeding in infants seen in private pediatric practices and its relation with type of delivery and history of prematurity.

OBJECTIVE: To describe the type of milk used to feed infants seen in private pediatric practices in Brazil. To evaluate the relationship between breastfeeding, type of delivery, and history of prematurity. METHODS: This is a cross-sectional and observational study that included 4929 infants in the first year of life seen in private pediatric practices in the five geographic regions of Brazil. Mothers provided information about the type of milk used by their infant, the type of delivery (vaginal or cesarean), and whether the birth was premature. RESULTS: Breastfeeding was the only source of milk for 56.1% (1546/2755) of infants in the first six months of life and 32.9% (716/2174) in the second. Of the infants who received other types of milk besides breastfeeding, there was a predominance of infant formula in 98.6% and 93.8% of the infants, respectively, in the first and in the second six months of life. Whole cow's milk was used by 0.7% (20/2755) of infants in the first six months and by 4.1% (90/2174) of infants in the second (p < 0.001). In the first six months of life, breastfeeding as the only type of milk was associated with vaginal delivery (OR = 1.79; p < 0.001) and not having a history of prematurity (OR = 2.48; p < 0.001). CONCLUSION: Breastfeeding was the only milk source for more than half of infants before 180 days of life. Birth by cesarean section and history of prematurity were negatively associated with breastfeeding as the only source of milk used in infant feeding.

A new Kunitz trypsin inhibitor from Erythrina poeppigiana exhibits antimicrobial and antibiofilm properties against bacteria.

Erythrina poeppigiana belongs to Fabaceae family (subfamily Papillionoideae) and is commonly found in tropical and subtropical regions in Brazil. Herein, we described the purification and characterization of a new Kunitz-type inhibitor, obtained from E. poeppigiana seeds (EpTI). EpTI is composed by three isoforms of identical amino-terminal sequences with a molecular weight ranging from 17 to 20 kDa. The physicochemical features showed by EpTI are common to Kunitz inhibitors, including the dissociation constant (13.1 nM), stability against thermal (37-100 °C) and pH (2-10) ranging, and the presence of disulfide bonds stabilizing its reactive site. Furthermore, we investigated the antimicrobial, anti-adhesion, and anti-biofilm properties of EpTI against Gram-positive and negative bacteria. The inhibitor showed antimicrobial activity with a minimum inhibitory concentration (MIC, 5-10 µM) and minimum bactericidal concentration (MBC) of 10 µM for Enterobacter aerogenes, Enterobacter cloacae, Klebsiella pneumoniae, Staphylococcus aureus, and Staphylococcus haemolyticus. The combination of EpTI with ciprofloxacin showed a marked synergistic effect, reducing the antibiotic concentration by 150%. The increase in crystal violet uptake for S. aureus and K. pneumoniae strains was approximately 30% and 50%, respectively, suggesting that the bacteria plasma membrane is targeted by EpTI. Treatment with EpTI at 1x and 10 x MIC significantly reduced the biofilm formation and prompted the disruption of a mature biofilm. At MIC/2, EpTI decreased the bacterial adhesion to polystyrene surface within 2 h. Finally, EpTI showed low toxicity in animal model Galleria mellonella. Given its antimicrobial and anti-biofilm properties, the EpTI sequence might be used to design novel drug prototypes.

Conhecimento de adolescentes e jovens sobre questões relacionadas ao sexo, em uma escola pública de Monte Alegre do Piauí-PI / Knowledge of adolescents and young people on issues related to sex, in a public school in Monte Alegre do Piauí-PI

O presente estudo objetivou avaliar o conhecimento de adolescentes e jovens sobre questões relacionadas ao sexo, na cidade de Monte Alegre do Piauí (PI). Para isso, utilizou-se o método descritivo quantitativo por meio de questionário semiestruturado aplicado a 81 estudantes, com idade entre 16 a 23 anos, da escola Ginásio Estadual Senador Chagas Rodrigues. A coleta de dados evidenciou que 97,5% (n=79) dos participantes já haviam praticado sexo, tendo iniciado com idade média de 15,5 anos. O preservativo foi o método contraceptivo mais conhecido, no entanto, observou-se que os adolescentes e jovens não se preveniram em todas as relações sexuais, mesmo cientes das consequências da não prevenção. Percebeu-se fragilidade dialógica entre os indivíduos, família e escola; a conversação sobre o assunto no âmbito familiar e escolar ainda era receosa e pouco atrativa. Como conclusão deste estudo, sugere-se como necessário a implementação eficaz de políticas públicas que envolvam de forma educativa a escola, os jovens, seus familiares e amigos.

This present study aimed to assess the knowledge of adolescents and young people on issues related to sex, in the city of Monte Alegre do Piauí (PI). For this, the quantitative descriptive method was used through a semi-structured questionnaire applied to 81 students, aged between 16 and 23 years old, from the school Ginásio Estadual Senador Chagas Rodrigues. The data collection showed that 97.5% (n = 79) of the participants had already had sex, having started with an average age of 15,5 years. The condom was the most known contraceptive method; however, it was observed that adolescents and young people did not prevent themselves in all sexual intercourse, even though they were aware of the consequences of non-prevention. Dialogical fragility was noticed among individuals, family and school; the conversation on the subject in the family and school environment was still fearful and unattractive. As a conclusion of this study, it is suggested as necessary the effective implementation of public policies that involve the school, young people, their families and friends in an educational way.

Perfil epidemiológico e conhecimento de gestantes sobre aleitamento materno em um município do nordeste brasileiro / Epidemiological profile and knowledge of pregnant women regarding breastfeeding in a city in northeastern Brazil

O aleitamento materno exclusivo propicia saúde ao recém-nascido e à mulher, fortalece o vínculo mãe e filho e leva à redução na mortalidade infantil. Objetivo: Identificar o perfil e os conhecimentos sobre aleitamento materno de gestantes atendidas em Unidades Básicas de Saúde, durante o pré-natal, no município de Gilbués, Piauí, Brasil. Material e Métodos: Trata-se de um estudo descritivo e abordagem quantitativa, com coleta de dados por meio de um formulário sobre as características sociodemográficas e conhecimentos em relação ao aleitamento materno. O estudo foi realizado com 40 gestantes nas Unidades Básicas de Saúde dos bairros São José e Santo Antônio. Resultados: Das gestantes, 75% estavam na segunda gestação ou mais e 47,5% no segundo trimestre gestacional. A maioria apresentou idade entre 18 e 30 anos, era solteira, possuía o ensino fundamental, não exercia atividade profissional e possuía renda familiar de até um salário mínimo. Quanto aos conhecimentos sobre aleitamento materno, houve orientação no pré-natal, porém, com pouca incorporação acerca dos benefícios que essa prática pode proporcionar à mãe. Apontaram-se, ainda, dúvidas e/ou inseguranças das gestantes sobre a quantidade de leite produzido e sua capacidade de nutrição, surgimento de fissuras na mama e transmissão de doenças por meio da amamentação. Conclusão: As atividades de educação em saúde no pré-natal são fundamentais para a saúde da criança e da mulher, promovendo estratégias de promoção, apoio e incentivo ao aleitamento materno.

Exclusive breastfeeding provides health to both the newborn and the mother, strengthening the bond between mother and child and leading to a reduction in infant mortality. Objective: Identify the profile and knowledge about breastfeeding of pregnant women attended at the Basic Health Units during prenatal care in the city of Gilbués, Piauí, Brazil. Methodology: This is a descriptive study, with a quantitative approach collected through a form on sociodemographic characteristics and knowledge regarding breastfeeding. The study was performed considering 40 pregnant women seen at the UBSs in the São José and Santo Antônio neighborhood. Results: Among the patients, 75% were in their second pregnancy or more, and 47.5% in the second gestational trimester. Most of them were aged between 18 and 30 years old, single, had only elementary education, did not work, and had family income up to a minimum wage. Regarding the knowledge about breastfeeding, they received guidance in the prenatal care, but with little emphasis on the benefits that exclusive breastfeeding can also provide to the mother. The doubts and/or insecurities of pregnant women were related to the amount of milk produced and its nutritional capacity, the appearance of cracks on the breast, and the transmission of diseases through breastfeeding. Conclusions: Prenatal health education activities are essential for the health of the child and the pregnant woman by providing strategies to promote, support, and encourage breastfeeding.

Gut Microbiota of Young Children Living in Four Brazilian Cities.

Recent studies have demonstrated that gut microbiota development is influenced by human biogeographic factors such as race, ethnicity, diet, lifestyle or culture-specific variations, and other environmental influences. However, biogeographic variation in gut microbiota assembly remains largely unexplored in Latin America. In this paper, we compared food recall information and microbiota composition of toddlers living in geographically separated urban populations within four states of Brazil. 16S RNA gene sequencing revealed that alpha diversity was similar between the four different populations. Gut microbiota compositions were dominated by members of the phyla Firmicutes and Bacteroidetes, resembling a more adult-like microbiota as compared with those of Western European toddlers of similar age. These findings suggest that inter-individual and nutrition-induced differences were apparent in the fecal microbiota. We conclude that urban dietary pattern plays a larger role in influencing the gut microbiota composition than do biogeographic factors.

Bio-synthesized sardine oil concentrate alters the composition of hepatic lipids in rats: A lipidomic approach.

Both preventive and curative therapies have created a considerable demand for n-3 PUFAs (polyunsaturated fatty acids) from fish oil, such as eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, for human use. Bio-synthesized sardine oil (bioSO) concentrate containing an acylglycerols mixture with 50% n-3 PUFAs was obtained by Candida cylindracea lipase hydrolysis and subsequently used for in vivo tests in animals. Wistar rats received, by gavage, a dose of 0.2 g/kg/day of bioSO or unmodified sardine oil (unSO) or saline solution (control) for three consecutive days and the liver tissue was evaluated by a selective and sensitive lipidomic approach based on ultra-performance liquid chromatography-quadruple time-of-flight mass spectrometry (UPLC-QTOF-MSE) and gas chromatography (GC). In addition, antioxidant parameters, response of oxidative stress marker and estimated fatty acid desaturase indexes were determined. The use of bioSO led to an increase in Cer d18:1/16:0, PE-Cer d14:2/18:0 and highly unsaturated phosphatylcholines (PC 38:4, PC 40:6 and PC 42:8) in the hepatic tissue membranes. There was also an increase in DHA incorporation in animals that received bioSO in comparison with the control animals. No differences in superoxide dismutase and catalase activity levels were observed between the groups, and malondialdehyde levels and delta 5-desaturase activity were higher in animals supplemented with bioSO. These results indicate that bioSO increase the hepatic incorporation of DHA, especially those esterified as PCs, and are probably absorbed and transported more effectively than the unSO. Enzymatically hydrolyzed compounds containing antioxidants may be a viable alternative for obtaining n-3 PUFA-enriched functional lipids.

A Mixture of Polyunsaturated Fatty Acids ω-3 and ω-6 Reduces Melanoma Growth by Inhibiting Inflammatory Mediators in the Murine Tumor Microenvironment.

BACKGROUND: Although it has been previously demonstrated that acute inflammation can promote the tumor growth of a sub-tumorigenic dose of melanoma cells through of 5-lipoxygenase inflammatory pathway and its product leukotriene B4, and also that the peritumoral treatment with eicosapentaenoic acid and its product, leukotriene B5, reduces the tumor development, the effect of the treatment by gavage with omega-3 and omega-6 in the tumor microenvironment favorable to melanoma growth associated with acute inflammation has never been studied. METHODS: C57BL/6 mice were coinjected with 1 × 106 apoptotic cells plus 1 × 103 viable melanoma cells into the subcutaneous tissue and treated by gavage with omega-3-rich fish oil or omega-6-rich soybean oil or a mixture of these oils (1:1 ratio) during five consecutive days. RESULTS: The treatment by gavage with a mixture of fish and soybean oils (1:1 ratio) both reduced the melanoma growth and the levels of leukotriene B4 (LTB4), prostaglandin E2 (PGE2), PGE2/prostaglandin E3 (PGE3) ratio, and CXC ligand 1 (CXCL1) and increased the levels of interleukin 10 (IL-10) to IL-10/CXCL1 ratio in the melanoma microenvironment. CONCLUSION: The oral administration of a 1:1 mixture of fish oil and soybean oil was able to alter the release of inflammatory mediators that are essential for a microenvironment favorable to the melanoma growth in mice, whereas fish oil or soybean oil alone was ineffective.

Evidence for Involvement of IL-9 and IL-22 in Cows' Milk Allergy in Infants.

Although allergic inflammation is characterized by a T helper (Th) 2-dominant immune response, the discovery of a role for new T cell subsets in inflammatory diseases has added an additional layer of complexity to the understanding of the pathogeneses of allergic diseases. We evaluated plasma cytokine profiles in infants with cows' milk allergy (CMA), who were being treated with an elimination diet. In a prospective, randomized and controlled study, infants (aged 8.4 ± 3.9 months) with CMA were treated with an elimination diet for 120 days, which replaced cows' milk with a hydrolysed soy protein formula (n = 26) or a free amino acid formula (n = 20). Blood samples were collected before treatment during active disease (T0) and after 120 days, when symptoms were absent (T1). Plasma cytokine concentrations were measured. Infants with CMA had higher plasma concentrations of interleukin (IL)-4 and IL-13 and lower concentrations of IL-9, IL-17A and interferon-γ, compared with healthy breast-fed infants. At T0, there was a positive correlation between blood eosinophil numbers and plasma concentrations of IL-4, IL-9, IL-17A and IL-22. Treatment with a cows' milk elimination diet resulted in a decrease in plasma IL-4, IL-9, IL-13 and IL-22 and an increase in plasma IL-17A. We conclude that IL-4 and IL-13 are elevated in active CMA. The association of IL-9 and IL-22 with eosinophilia, and the decrease in these two cytokines with cows' milk elimination, suggests that they both play a role in the symptoms observed in CMA and may be important targets for future interventions.

Self-esteem and resilience in people with type 2 diabetes mellitus / Autoestima e resiliência em pessoas com Diabetes mellitus tipo 2

Diabetes mellitus type 2 (T2DM) is a disease that requires drastic changes in lifestyle, resulting from feelings of incapacity,lack of motivation and appearance of stressors, making glycemic control difficult. However, individuals with T2DM, whodevelop high self-esteem and resilience, manage to maintain a good quality of life. Self-esteem concerns self-image, whileresilience is the ability to overcome adversity. This study was based on the assumption that self-confident and resilientindividuals with T2DM face adversities more positively. The objective was to identify the self-esteem and resilience ofindividuals with DM2, in order to understand their coping abilities in the face of the disease. The study is a cut of themacro project entitled “Effects of Health Promotion Practices on People with Type 2 Diabetes mellitus”. It is a crosssectional,exploratory-descriptive, quantitative approach, conducted in the Petrópolis neighborhood of Manaus, AM,with 27 diabetic individuals (100% of the sample) followed by the Pastoral Health Care, with a margin of error of 5%and coefficient of confidence of 95%. The Rosenberg Self-Esteem Scale (RSES) was used. The data were presented intables of simple (fi) and relative (%) absolute frequencies, calculating mean, median and standard deviation (SD). Theresults showed a mean / SD of 61.3 ± 11.19 years; 100% of the individuals reached a self-esteem and resilience patternabove the cut level (20 points), with a mean / SD of 33.25 ± 3,799 points. We conclude that there was a high level ofself-esteem and resilience in the individuals in the studied group

O Diabetes mellitus tipo 2 (DM2) é uma doença que exige mudanças drásticas no estilo de vida, advindos daísentimentos de incapacidade, desmotivação e aparecimento de fatores estressores, dificultando o controle glicêmico.Porém, indivíduos com DM2, que desenvolvem alta autoestima e resiliência, conseguem manter boa qualidade devida. A autoestima diz respeito à imagem que se tem de si, enquanto a resiliência é a capacidade de superação dasadversidades. Esse estudo partiu do pressuposto que indivíduos com DM2 autoconfiantes e resilientes enfrentam maispositivamente as adversidades. O objetivo foi identificar a autoestima e a resiliência de indivíduos com DM2, a fimde compreender suas capacidades de enfrentamento diante da doença. O estudo é um recorte do macro projetointitulado “Efeitos das Práticas de Promoção de Saúde em pessoas com Diabetes tipo 2”. É um estudo transversal,do tipo exploratório-descritivo, de abordagem quantitativa, realizado no bairro de Petrópolis em Manaus (AM), com27 indivíduos diabéticos (100% do universo) acompanhados pela Pastoral da Saúde, com margem de erro de 5% ecoeficiente de confiança de 95%. Utilizou-se a Escala de Autoestima de Rosenberg (EAR). Os dados foram apresentadosem tabelas de frequências absolutas simples(fi) e relativas(%), calculando-se média, mediana e desvio-padrão (DP).Os resultados mostraram média/DP de 61,3 ±11,19 anos; 100% dos indivíduos alcançaram padrão de autoestimae resiliência acima no nível de corte (20 pontos), com média/DP de 33,25±3,799 pontos. Concluimos que houvepresença em alto nível de autoestima e resiliência nos indivíduos do grupo estudado

Brazilian infant and preschool children feeding: literature review / Alimentação do lactente e do pré-escolar brasileiro: revisão da literatura

Abstract Objective To assess the feeding profile of Brazilian infants and preschool children aged 6 months to 6 years, based on the qualitative and quantitative analysis of food and nutrient intake. Data source This review analyzed studies carried out in Brazil that had food survey data on infants and preschool children. The search was limited to publications from the last 10 years included in the LILACS and MEDLINE electronic databases. Data summary The initial search identified 1480 articles, of which 1411 were excluded after the analysis of abstracts, as they were repeated or did not meet the inclusion criteria. Of the 69 articles assessed in full, 31 articles contained data on food survey and were selected. Only three studies concurrently assessed children from different Brazilian geographical regions. Of the assessed articles, eight had qualitative data, with descriptive analysis of food consumption frequency, and 23 had predominantly quantitative data, with information on energy and nutrient consumption. Conclusions The articles assessed in this review showed very heterogeneous results, making it difficult to compare findings. Overall, the feeding of infants and preschool children is characterized by low consumption of meat, fruits, and vegetables; high consumption of cow's milk and inadequate preparation of bottles; as well as early and high intake of fried foods, candies/sweets, soft drinks, and salt. These results provide aid for the development of strategies that aim to achieve better quality feeding of Brazilian infants and preschoolers.

Resumo Objetivo Verificar o perfil alimentar do lactente e do pré-escolar brasileiro, na faixa de 6 meses a 6 anos, a partir da análise qualitativa e quantitativa do consumo de alimentos e nutrientes. Fontes de dados Nesta revisão foram analisados estudos feitos no Brasil que apresentavam dados de inquéritos alimentares de lactentes e pré-escolares. A busca foi limitada às publicações dos últimos dez anos, incluídas nas bases de dados eletrônicas Lilacs e Medline. Síntese dos dados Na pesquisa inicial foram identificados 1.480 artigos, 1.411 foram excluídos após análise dos resumos, por ser repetidos ou não preencher os critérios de inclusão. Dos 69 artigos avaliados na íntegra, foram selecionados 31 que continham dados sobre alimentação. Apenas três trabalhos avaliaram concomitantemente crianças de diferentes regiões geográficas brasileiras. Dos artigos analisados, oito apresentavam informações qualitativas, com análise descritiva da frequência de consumo alimentar, e 23 informações predominantemente quantitativas, com dados de consumo energético e de nutrientes. Conclusões Os artigos analisados na presente revisão apresentaram resultados bastante heterogêneos, o que dificultou a comparação dos achados. De um modo geral, a alimentação do lactente e do pré-escolar é caracterizada pelo baixo consumo de carnes, frutas, legumes e verduras, por elevado consumo de leite de vaca e inadequação no preparo de mamadeiras, além de precoce e elevado consumo de frituras, doces, refrigerantes e sal. Nossos resultados constituem subsídios para a elaboração de estratégias que visem a melhorar a qualidade da alimentação do lactente e do pré-escolar brasileiro.

Protective effect of soybean oil- or fish oil-rich diets on allergic airway inflammation.

BACKGROUND: The increased prevalence of asthma and allergic diseases in westernized societies has been associated with increased intake of diets rich in n-6 fatty acids (FAs) and poor in n-3 FAs. This study aimed to analyze the prophylactic effects of treatment with a soybean oil-rich diet (rich in n-6) or fish oil (rich in n-3) in an allergic airway inflammation model on lung inflammation score, leukocyte migration, T-helper cell (Th)-2 (interleukin [IL]-4, IL-5) and Th1 (interferon [IFN]-γ, tumor necrosis factor-α) cytokines, lipoxin A4, nitric oxide, bradykinin, and corticosterone levels in bronchoalveolar lavage (BAL) or lungs. METHODS: Male Wistar rats fed with soybean oil- or fish oil-rich diet or standard rat chow were sensitized twice with ovalbumin-alumen and challenged twice with ovalbumin aerosol. The BAL and lungs were examined 24 hours later. RESULTS: Both diets, rich in n-6 or n-3 FAs, impaired the allergic lung inflammation and reduced leukocyte migration, eosinophil and neutrophil percentages, and IL-4/IL-5/bradykinin levels in BAL and/or lungs, as well as increased the nitric oxide levels in BAL. The soybean oil-rich diet additionally increased the levels of lipoxin A4 and corticosterone in the lungs. CONCLUSION: Data presented demonstrated that the n-6 FA-rich diet had protective effect upon allergic airway inflammation and was as anti-inflammatory as the n-3 FA-rich diet, although through different mechanisms, suggesting that both diets could be considered as complementary therapy or a prophylactic alternative for allergic airway inflammation.

Brazilian infant and preschool children feeding: literature review.

OBJECTIVE: To assess the feeding profile of Brazilian infants and preschool children aged 6 months to 6 years, based on the qualitative and quantitative analysis of food and nutrient intake. DATA SOURCE: This review analyzed studies carried out in Brazil that had food survey data on infants and preschool children. The search was limited to publications from the last 10 years included in the LILACS and MEDLINE electronic databases. DATA SUMMARY: The initial search identified 1480 articles, of which 1411 were excluded after the analysis of abstracts, as they were repeated or did not meet the inclusion criteria. Of the 69 articles assessed in full, 31 articles contained data on food survey and were selected. Only three studies concurrently assessed children from different Brazilian geographical regions. Of the assessed articles, eight had qualitative data, with descriptive analysis of food consumption frequency, and 23 had predominantly quantitative data, with information on energy and nutrient consumption. CONCLUSIONS: The articles assessed in this review showed very heterogeneous results, making it difficult to compare findings. Overall, the feeding of infants and preschool children is characterized by low consumption of meat, fruits, and vegetables; high consumption of cow's milk and inadequate preparation of bottles; as well as early and high intake of fried foods, candies/sweets, soft drinks, and salt. These results provide aid for the development of strategies that aim to achieve better quality feeding of Brazilian infants and preschoolers.

Antimicrobial Activity of ILTI, a Kunitz-Type Trypsin Inhibitor from Inga laurina (SW.) Willd.

Over the last few years, a growing number of proteinase inhibitors have been isolated from plants and particularly from seeds and have shown antimicrobial activity. A 20,000 Da serine peptidase inhibitor, named ILTI, was isolated from Inga laurina seeds and showed potent inhibitory enzymatic activity against trypsin. The aim of this study was to determine the effects of ILTI on the growth of pathogenic and non-pathogenic microorganisms. We observed that ILTI strongly inhibited in particular the growth of Candida tropicalis and Candida buinensis, inducing cellular agglomeration. However, it was ineffective against human pathogenic bacteria. We also investigated the potential of ILTI to permeabilize the plasma membrane of yeast cells. C. tropicalis and C. buinensis were incubated for 24 h with the ILTI at different concentrations, which showed that this inhibitor induced changes in the membranes of yeast cells, leading to their permeabilization. Interestingly, ILTI induced the production of reactive oxygen species (ROS) in C. tropicalis and C. buinensis cells. Finally, ILTI was coupled with fluorescein isothiocyanate, and subsequent treatment of C. tropicalis and C. buinensis with DAPI revealed the presence of the labeled protein in the intracellular spaces. In conclusion, our results indicated the ability of peptidase inhibitors to induce microbial inhibition; therefore, they might offer templates for the design of new antifungal agents.

Adequado crescimento, aus�ncia de ganho de peso excessivo e de altera��o no padr�o evacuat�rio em lactentes com refluxo gastroesof�gico recebendo f�rmula infantil espessada com goma jata� / Adequate growth, absence of excessive weight gain and no changing in feces consistency in infants with gastroesophageal reflux receiving carob bean gum-thickened infant formula

Introdu��o: O tratamento do refluxo gastroesof�gico (RGE) com f�rmulas espessadas com goma jata� tem se mostrado eficaz na redu��o dos epis�dios de refluxo e regurgita��o. Neste estudo, n�s comparamos o tratamento cl�nico, evolu��o p�ndero-estatural e padr�o das fezes, de lactentes com RGE em aleitamento materno ou recebendo f�rmula infantil antirregurgita��o com goma jata�. Material e m�todos: Analisamos um total de 42 prontu�rios m�dicos de lactentes menores de 1 ano com RGE atendidos em uma cl�nica de gastroenterologia pedi�trica. Os pacientes foram divididos em Grupo AME- aleitamento materno (n=17); e Grupo FAR- f�rmula antirregurgita��o com goma jata� (n=17). Dados antropom�tricos, uso de medica��o antirrefluxo, padr�o evacuat�rio e evolu��o do ganho p�ndero-estatural foram avaliados em 4 consultas consecutivas. Resultados: Observamos maior prescri��o de medicamentos antirrefluxo no grupo AME quando comparado ao FAR (p=0.08). N�o houve diferen�a entre os grupos no c�lculo do z-escore P/E e E/I, nem nos epis�dios de diarreia e/ou constipa��o intestinal ao longo dos 4 tempos de acompanhamento (p>0.05). Conclus�o: O uso da f�rmula espessada com goma jata� foi eficaz e segura para garantir crescimento adequado, com bom ganho p�ndero-estatural, n�o ocasionando sobrepeso, al�m de n�o interferir no padr�o das evacua��es.

Pharmaconutrition: acute fatty acid modulation of circulating cytokines in elderly patients in the ICU.

BACKGROUND: Enteral supply of ω-3 polyunsaturated fatty acids has been used in an attempt to modulate inflammation and improve outcome in critically ill patients. However, enteral administration may be slow to change membrane composition and therefore may not be the best route to supply these fatty acids in patients with acute conditions. This study evaluated the effects of short-term intravenous (IV) administration of fish oil-based lipid emulsion (FLE) as pharmaconutrition on cytokine levels in critically ill elderly patients. METHODS: Enterally fed patients (n = 40; aged 60-80 years) were recruited in the first 48 hours of intensive care unit (ICU) admission. Fifteen patients received IV FLE (0.2 g/kg body weight) over 6 hours for 3 consecutive days, and 25 patients did not receive IV lipid (control). Samples were collected before and 24 hours and 72 hours after the third FLE infusion. Nutrient intakes, clinical parameters, and serum cytokine concentrations were measured. RESULTS: Compared with the control, FLE resulted in higher energy intake, lower serum tumor necrosis factor-α and interleukin (IL)-8 concentrations, and higher serum IL-10. These differences occurred around 7-9 days of ICU stay at the time of the patient's extubation. ICU stay, mortality, and markers of coagulation and liver function did not differ between groups. CONCLUSIONS: Short-term IV FLE modulates some inflammatory markers in critically ill elderly patients receiving enteral nutrition (EN), suggesting an anti-inflammatory effect. This may be a benefit and suggests a role for FLE administration as a supplement in elderly ICU patients receiving standard EN.

Fatty acids in plasma, white and red blood cells, and tissues after oral or intravenous administration of fish oil in rats.

BACKGROUND & AIMS: The importance of route of administration of omega-3 (n-3) polyunsaturated fatty acids (PUFA) (oral vs intravenous (iv)) is not clear. We determined the relative concentrations of fatty acids in plasma phosphatidylcholine (PC), red blood cells (RBC), white blood cells (WBC) and several tissues after short-term oral or iv administration of soybean oil (SO) or fish oil (FO). METHODS: Wistar rats (n = 6/group) received saline, FO, or SO by gavage or saline, FO based-lipid emulsion (FLE), or SO based-lipid emulsion (SLE) iv. The oils were provided at 0.2 g/kg/day for three consecutive days. The animals were sacrificed 24 h after the last administration, blood was collected for plasma, WBC and RBC separation and tissues removed. Fatty acids were analysed by gas chromatography. RESULTS: FO resulted in higher eicosapentaenoic acid (EPA) in plasma PC and liver than the control. FLE resulted in higher EPA, docosahexaenoic acid (DHA) and total n-3 PUFA in plasma PC, WBC and liver than both the control and SLE groups. EPA, DHA and total n-3 PUFA were higher in the heart with FLE compared with SLE. Individual and total n-3 PUFA were higher in plasma PC, WBC, liver and heart with FLE than with FO given by gavage. CONCLUSION: Short-term iv administration of n-3 PUFA appears to be more effective at increasing EPA and DHA status in plasma, WBC, liver and heart than oral administration. This might be important for rapid treatment with n-3 PUFA.