Highlights of three metabolites HDL and reduction in blood pressure values after dietary fiber supplementation in overweight and obese normotensive women: a metabolomic study.

INTRODUCTION: The prevalence of hypertension and obesity are a worldwide concern. OBJETIVES: Assess the metabolites profile after intervention with mixed dietary fiber in overweight and obese normotensive women. METHODS: This is a randomized double blind placebo-controlled study. Through a simple randomization process, two groups were allocated, with eleven women (group 1) receiving 12 g of mixed dietary fiber and thirteen women (group 2) receiving 12 g of placebo (corn starch) for eight weeks. Anthropometric and biochemical tests and lifestyle were analyzed. As for evaluation metabolomics, used a 1H NMR. The data matrix generated 96 samples and 225 variables, which was exported in the ASCII format for the "The Unscrumbler" statistics software (version 9.7, CAMO Process). RESULTS: After the intervention with mixed dietary fiber, significant differences were observed between the main types of metabolites, referring to the increase in the relative peak areas of in three HDL metabolites 4.94 ppm (0.0086*), HDL 1.28 ppm (0 .0337*), HDL 0.88 ppm (0.0224*) and an α-glucose metabolite 4.90 ppm (0.0106) and the reduction in systolic blood pressure (SBP) (0.0292*) of 7 mmHg in the reference range and in the placebo group there was a reduction in SBP (0.0118*) of 4 mmHg and of a choline metabolite 3.65 ppm (0.0266*), which does not call into question the validity of these results in the literature. CONCLUSION: The synergism of the functions of these statistically highlighted metabolites contributed to prevention the increase in SBP after fiber intervention in overweight and obese normotensive women.

Food Intervention with Folate Reduces TNF-α and Interleukin Levels in Overweight and Obese Women with the MTHFR C677T Polymorphism: A Randomized Trial.

Methylenetetrahydrofolate reductase (MTHFR) C677T polymorphism associated with body fat accumulation could possibly trigger an inflammatory process by elevating homocysteine levels and increasing cytokine production, causing several diseases. This study aimed to evaluate the effects of food intervention, and not folate supplements, on the levels of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and interleukin-1ß (IL-1ß) in overweight and obese women with the MTHFR C677T polymorphism. A randomized, double-blind eight-week clinical trial of 48 overweight and obese women was conducted. Participants were randomly assigned into two groups. They received 300 g of vegetables daily for eight weeks containing different doses of folate: 95 µg/day for Group 1 and 191 µg/day for Group 2. MTHFR C677T polymorphism genotyping was assessed by digestion with HinfI enzyme and on 12% polyacrylamide gels. Anthropometric measurements, 24-h dietary recall, and biochemical analysis (blood folic acid, vitamin B12, homocysteine (Hcy), TNF-α, IL-1ß, and IL-6) were determined at the beginning and end of the study. Group 2 had a significant increase in folate intake (p < 0.001) and plasma folic acid (p < 0.05) for individuals with the cytosine-cytosine (CC), cytosine-thymine (CT), and thymine-thymine (TT) genotypes. However, only individuals with the TT genotype presented reduced levels of Hcy, TNF-α, IL-6, and IL-1ß (p < 0.001). Group 1 showed significant differences in folate consumption (p < 0.001) and folic acid levels (p < 0.05) for individuals with the CT and TT genotypes. Food intervention with folate from vegetables increased folic acid levels and reduced interleukins, TNF-α, and Hcy levels, mainly for individuals with the TT genotype.

Functioning and Disability Profile of Children with Microcephaly Associated with Congenital Zika Virus Infection.

INTRODUCTION: The increase in the number of cases of microcephaly in Brazil and its association with the Zika virus (ZIKV) is a global public health problem. The International Classification of Functioning Disability and Health (ICF) model is a powerful tool and extremely relevant in managing disability. OBJECTIVE: Describe the functioning profile of children with microcephaly associated with ZIKV in two states of northeastern Brazil. METHODS: This is a descriptive cross-sectional study. The sociodemographic characteristics, head circumference, and other clinical data were collected from medical charts, physical examinations, measuring instruments, and interviews with the children and their parents. The Brazilian Portuguese version of the Brief Common ICF Core Set for cerebral palsy (CP) was used. Each ICF category was assigned a qualifier, which ranged from 0 to 4 (no problem, mild problem, moderate problem, severe problem, complete problem). For environmental factors, 0 represents no barrier and 4 represents complete barrier; +0, no facilitator and +4, complete facilitator. RESULTS: A total of 34 children with microcephaly caused by ZIKV were recruited (18 girls and 16 boys) at four rehabilitation facilities in Rio Grande do Norte and Paraíba states, Brazil. The average age of the participants was 21 months, monthly income was ≈USD 300.00, and head circumference z-scores ranged between 0.92 and -5.51. The functioning profile revealed complete disability in most of the body function categories (b). The activity and participation areas (d) were highly impacted, particularly in mobility-related categories. With respect to environmental factors (e), most of the sample reported a complete facilitator for the immediate family, friends, and health services, systems, and policies, as well as a complete barrier to societal attitudes. CONCLUSION: This is the first study that describes the functioning profile of children with microcephaly associated with ZIKV, using a tool based on the ICF in Brazil. Our findings reinforce the need to maximize health care and access to information, based on the ICF, for multiprofessional teams, administrators, family members, and children.

Alta frequência de síndrome metabólica e sua relação com o baixo consumo alimentar de proteínas em mulheres com diagnóstico de diabetes gestacional prévio / High frequency of metabolic syndrome and its relation to low dietary intake of protein in women with previous gestational diabetes

Introdução: Nesta pesquisa, examinou-se a ocorrência de síndrome metabólica, diabetes mellitus e obesidade e as suas relações com o consumo habitual de macro e micronutrientes e grupos de alimentos, em mulheres com antecedentes de diabetes mellitus gestacional (DMG). Método: O estudo envolveu 110 pacientes atendidas no ambulatório de diabetes gestacional de um hospital universitário localizado em uma cidade do Nordeste do Brasil, das quais 49 completaram todas as etapas da investigação. No período pós-parto entre 6 meses e 4 anos, as pacientes recrutadas para uma primeira consulta responderam questionários acerca dos seus antecedentes clínicos, hábitos alimentares e do nível de atividade física e submeteram-se à aferição do peso e altura, realização de exame de bioimpedância e exames laboratoriais, a serem apresentados na segunda consulta. Resultados: A prevalência de síndrome metabólica foi elevada, totalizando 49% das pacientes; a de diabetes mellitus foi de 16%; e de disglicemias de 65%, porcentagens próximas àquelas encontradas em estudos realizados durante cinco anos após a gestação ou por períodos mais longos. Do total das pacientes, 45% estavam com sobrepeso e 28% obesas. Após análise estatística, observou-se relação entre a prevalência de síndrome metabólica e menor ingestão de proteínas (p=0,05), quando os macro e micronutrientes foram ajustados pelo peso. Conclusão: Não houve relação entre o consumo alimentar habitual e a ocorrência de diabetes mellitus e obesidade e a frequência de síndrome metabólica nas pacientes com diagnóstico prévio de DMG foi elevada, sendo sua ocorrência associada à menor ingestão de proteínas.

Atenção profissional à criança com paralisia cerebral e sua família / Professional care for children with cerebral palsy and their families / Atención profesional al niño con parálisis cerebral y a su familia

Objetivo: analisar a atenção dos profissionais de saúde no cuidado à família e à criança com paralisia cerebral. Método: pesquisa qualitativa, descritiva, realizada com sete familiares de crianças com paralisia cerebral atendidas há mais de 6 meses em uma clínica escola de João Pessoa, Paraíba. Os dados foram coletados nos meses de março a abril de 2009, por meio de entrevista semiestruturada, e submetidos à análise temática. Resultados: vínculo forte constituiu-se como aspecto relevante na construção de projeto terapêutico adequado para o emponderamento das famílias dessas crianças no processo de superação das dificuldades e adaptação ambiental, desfavorecido pela rotatividade dos profissionais da equipe de saúde. Conclusão: a atenção longitudinal dos profissionais de saúde é primordial, pois no cotidiano, com o passar do tempo, novas demandas surgem e a família necessita do apoio dos profissionais para superá-las e desempenhar satisfatoriamente seu papel, com adoção de postura ativa frente ao processo de cuidar.

Objective: to examine health professionals' role in care for children with cerebral palsy and their families. Method: this qualitative, descriptive study was conducted with seven relatives of children with cerebral palsy in care for more than six months at a teaching clinic in João Pessoa, Paraíba. Data were collected in March and April 2009, by semi-structured interviews, and subjected to thematic analysis. Results: strong bonding ­ impaired by high personnel turnover in the care team ­ emerged as crucial in constructing a therapeutic plan designed to empower these children's families for the process of coping and overcoming environmental difficulties. Conclusion: longitudinal care by health care personnel is of prime importance, because the family needs professional support in order to meet the new demands that arise from day to day, and to play its role satisfactorily and take an active role in the care process.

Objetivo: analizar la atención de los profesionales de salud en el cuidado de la familia y del niño con parálisis cerebral. Método: investigación cualitativa, descriptiva, cuyos sujetos fueron siete familiares de niños con parálisis cerebral atendidos hace más de seis meses en una clínica escuela de João Pessoa, Paraíba. La recolección de datos se llevó a cabo entre marzo y abril de 2009, utilizando como instrumento entrevistas semiestructuradas y sometidos al análisis temático. Resultados: un vínculo fuerte constituyó un aspecto relevante en la construcción del proyecto terapéutico adecuado para el empoderamiento de las familias de esos niños en el proceso de superación de las dificultades y adaptación ambiental, desfavorecido por la rotación de los profesionales del equipo de salud. Conclusión: la atención longitudinal de los profesionales de salud es primordial pues, en el cotidiano, con el tiempo, nuevas demandas surgen y la familia necesita el apoyo de los profesionales para superarlas y desempeñar satisfactoriamente su rol adoptando postura activa ante el proceso del cuidar.