Relationship between dietary intake and use of protease inhibitors with anthropometric and biochemical parameters of lipodystrophy in people living with hiv.

The lipodystrophy syndrome is characterized by redistribution of body fat and disorders of glicidic and lipid metabolism. Although its etiology is related to infection and drug therapy, there is little evidence regarding the nutritional disturbances on this association. This study aimed to assess the relationship between dietary intake and use of protease inhibitors (PIs) with anthropometric and biochemical parameters in HIV positive patients. The study included 50 patients. A questionnaire about socioeconomic status, lifestyle and infection history was taken. In addition, it was conducted the evaluation of dietary intake (frequency questionnaire), anthropometric parameters (body mass index, waist circumference, triceps skinfold, corrected arm muscle area) and biochemistry tests (glycemia and lipid profile). Only 37% of the sample was classified as "good food consumption", 54% were overweight or obese and 66% presented high waist circumference. The group with good food consumption had higher HDL-C (p=0.04) levels than the group with poor food consumption. Patients taking PIs presented VLDL-C (p=0.023) and triglycerides (p=0.024) levels significantly higher. These results indicated the necessity for continuous monitoring of HIV-positive patients and non-pharmacological interventions such as nutrition education and practice of physical exercises.

La lipodistrofia se caracteriza por la redistribución de la grasa corporal y los trastornos de la glucosa y el metabolismo de los lípidos. Su etiología está relacionada con la infección y la terapia de drogas, sin embargo, hay poca evidencia sobre el papel de la nutrición en estos cambios . Este estudio tuvo como objetivo evaluar la relación entre el consumo alimenticio y el uso de inhibidores de la proteasa con parâmetros antropométricos y bioquímicos en las personas que viven con el VIH. La muestra estuvo constituida por 50 pacientes. Se recogieron Preguntas sobre la situación socioeconómica, el estilo de vida, y antecedentes de infección. Además, se celebró evaluar el consumo de alimentos (cuestionario de frecuencia), antropométricos (índice de masa corporal, circunferencia de la cintura, espesor del pliegue cutáneo del tríceps y el área muscular del brazo corregida) y bioquímicos (niveles de glucosa y lípidos). Sólo el 37 % de la muestra se clasifica como buena consumo de alimentos, 54 % tenían sobrepeso o eran obesos y 66 % tienen alta circunferencia de la cintura. El grupo de consumo de alimentos clasificados como " buenos" presentaram mejores valores de HDLc cuando comparados com el grupo clasidicado del "malo" del los pacientes que usan IP mostró valores de VLDL -C y triglicéridos significativamente más altos. Estos resultados indican la necesidad de un seguimiento continuado de estos pacientes y las intervenciones no farmacológicas, como la educación en nutrición y ejercicio físico.

Protocolo diferenciado para terapia nutricional na esclerose lateral amiotrófica / Special protocol to nutritional therapy in amyotrophic lateral sclerosis

OBJETIVO: Discutir a terapia nutricional na Esclerose Lateral Amiotrófica (ELA), compartilhando um protocolo elaborado e utilizado em ambulatório especializado. MATERIAL E MÉTODOS: A fundamentação teórica desse artigo foi baseada na literatura científica publicada nas bases de dados PubMed e ISI Web of Science, utilizando os descritores "amyrotrophic lateral sclerosis" and "nutrition". RESULTADOS E DISCUSSÃO: Em síntese, a ELA é uma doença neurodegenerativa rara, com prognóstico desfavorável e tratamento paliativo. A desnutrição é bastante frequente nessa doença e aumenta o risco de morte dos pacientes. Assim, a terapia nutricional é imprescindível e deve estar integrada a uma assistência multidisciplinar. O monitoramento nutricional é recomendado pelo menos a cada três meses, incluindo avaliação nutricional e prescrição de dieta hipercalórica e hiperproteica, com adequada quantidade hídrica e de fibras. Em adição, os micronutrientes, sobretudo os antioxidantes, devem atingir a Ingestão Diária Recomendada. Modificações na consistência da dieta para tratar a disfagia são indicadas e a nutrição enteral deve ser desmistificada entre os pacientes e cuidadores. Esses pacientes são candidatos potenciais para uso da nutrição enteral, a qual deve ser indicada em casos de disfagia significativa ou prejuízo da função respiratória associada com baixa ingestão alimentar, índice de massa corporal menor que 18,5 ou 22,0 kg/m2 (para adultos e idosos, respectivamente) e/ou perda de peso acima de 10%. CONCLUSÃO: Sugere-se a padronização da terapia nutricional na ELA e a instituição de protocolo diferenciado na prática clínica. Com isso, a desnutrição pode ser evitada ou minimizada, contribuindo para melhor qualidade de vida e sobrevida desses pacientes

OBJECTIVE: To discuss the nutritional therapy in Amyotrophic Lateral Sclerosis (ALS), sharing a protocol performed and used by a specialized ambulatory care service. MATERIAL AND METHODS: The theoretical foundation of this paper was based on the literature published in both PubMed and ISI Web of Science, using "amyrotrophic lateral sclerosis" and "nutrition" as keywords. RESULTS AND DISCUSSION: In brief, ALS is a rare neurodegenerative disease with poor prognosis and palliative treatment. Malnutrition is very common in these patients and increases the risk of death among them. Nutritional therapy is essential and must be integrated into a multidisciplinary care. Nutritional monitoring is recommended at least once every three months. Nutritional assessment, high-calorie and highprotein diet with an adequate amount of water and fiber are recommended. In addition, micronutrients, especially antioxidants, must reach the Recommended Dietary Allowances. A diet texture modification for dysphagia is indicated and enteral nutrition should be demystified to patients and care givers during the follow-up care. ALS patients are potential candidates to use enteral nutrition, which should be indicated in cases of significant dysphagia or impaired respiratory function associated with low food intake, body mass index less than 18.5 or 22.0 kg/m² (for adults or elderlies, respectively), and/or body weight loss above 10%. CONCLUSION: We suggest the standardization of nutritional therapy in ALS and the establishment of a distinct protocol in clinical practice. Thus, malnutrition can be avoided or minimized, contributing to a better quality of life and survival of these patients

Oral zinc supplementation may improve cognitive function in schoolchildren.

Zinc is an important micronutrient for humans, and zinc deficiency among schoolchildren is deleterious to growth and development, immune competence, and cognitive function. However, the effect of zinc supplementation on cognitive function remains poorly understood. The purpose of our study was to evaluate the effect of oral zinc supplementation (5 mg Zn/day for 3 months) on the Full Scale Intelligence Quotient (FSIQ), Verbal Intelligence Quotient (VIQ), and Performance Intelligence Quotient (PIQ) using a Wechsler Intelligence Scale for Children (WISC-III). We studied 36 schoolchildren aged 6 to 9 years (7.8 ± 1.1) using a nonprobability sampling method. The baseline serum zinc concentrations increased significantly after zinc supplementation (p < 0.0001), with no difference between sexes. Tests were administered under basal conditions before and after zinc supplementation, and there was no difference in FSIQ according to gender or age. The results demonstrated that zinc improved the VIQ only in the Information Subtest (p = 0.009), although the supplementation effects were more significant in relation to the PIQ, as these scores improved for the Picture Completion, Picture Arrangement, Block Design, and Object Assembly Subtests (p = 0.0001, for all subtests). In conclusion, zinc supplementation improved specific cognitive abilities, thereby positively influencing the academic performance of schoolchildren, even those without marginal zinc deficiency.

Influence of basal energy expenditure and body composition on bone mineral density in postmenopausal women.

BACKGROUND: The aim of this study was to investigate the influence of body mass index, body weight, lean mass, fat mass, and basal energy expenditure on bone mineral density in postmenopausal women. METHODS: This was a cross-sectional, descriptive study of a sample of 50 women, with minimum time since menopause between 1 and 10 years. Bone mineral density was assessed at the lumbar spine (L2-L4), femoral neck, Ward's triangle, and trochanter using dual-energy X-ray absorptiometry. Body mass index, lean mass, fat mass, and basal energy expenditure were measured by bioimpedance. RESULTS: The mean age of the women was 51.49 ± 3.86 years and time since menopause was 3.50 ± 2.59 years. Significant negative correlations were found between chronological age and lumbar spine, femoral neck, Ward's triangle, and trochanteric bone mineral density. In regard to time since menopause, we also observed significant negative correlations with bone mineral density at the lumbar spine and Ward's triangle. The following significant positive correlations were recorded: body mass index with bone mineral density at the femoral neck and trochanter; fat mass with bone mineral density at the femoral neck and trochanter; lean mass with bone mineral density at the lumbar spine, femoral neck, and trochanter; and basal energy expenditure with bone mineral density at all sites assessed. On the other hand, the multiple linear regression model showed that: 20.2% of bone mineral density variability at the lumbar spine is related to lean mass and time since menopause; 22.3% of bone mineral density variability at the femoral neck is related to body weight and age; 18.9% of bone mineral density variability at Ward's triangle is related to age and basal energy expenditure; and 39% of bone mineral density variability at the trochanter is related to body mass index, age, and menarche. CONCLUSION: Changes in bone mineral density, specific for each skeletal site, are influenced by age, time since menopause, body weight, body mass index, lean mass, and basal energy expenditure. Lean mass and basal energy expenditure positively influenced bone mineral density at the lumbar spine and Ward's triangle, with a predominance of trabecular bone.

Kinetics of zinc status and zinc deficiency in Berardinelli-Seip syndrome.

Berardinelli-Seip syndrome (BSS) is a very rare disorder characterized by near-complete absence of adipose tissue from birth or early infancy, hypoleptinemia, hypertriglyceridemia, insulin resistance, diabetes mellitus, and other clinical signals. It is caused by mutations in AGPAT2 or Gng3lg. We evaluated 10 BSS patients and 10 healthy subjects. A single dose of 382.43 µmol zinc was administered intravenously before and after 3 months of oral zinc supplementation. Blood samples were collected from the contralateral arm at 0, 30, 60, 90, and 120 min after zinc injection. Plasma and serum were obtained to measure hematological and biochemical parameters. Urine was collected to measure creatinine, protein, and zinc. Basal serum zinc levels were similar in controls and BSS patients. However, serum zinc profiles were significant reduced in BSS patients in comparison with controls. The change in total-body zinc clearance was more significant in BSS patients, indicating that these patients had suboptimum zinc deficiency.

Positive effects of zinc supplementation on growth, GH, IGF1, and IGFBP3 in eutrophic children.

Zinc is an essential micronutrient for growth and development. Its deficiency causes growth retardation in children and adolescents. The present study analyzes the effect of zinc on growth hormone (GH) secretion, insulin-like growth factor 1 (IGF1), and insulin-like growth factor-binding protein 3 (IGFBP3) in normal children before puberty. Thirty normal children were studied, 15 boys and 15 girls, aged 6-9 years. They were orally supplemented with 5 mg Zn/day for 3 months and 0.06537 mg Zn/kg body weight was injected before and after oral supplementation. Dietary intake and anthropometric measurements were assessed at baseline and end of study. Plasma GH levels increased during intravenous zinc administration and IGF1 and IGFBP3 increased after oral zinc supplementation. There was a positive correlation between the areas under the curves of GH and zinc after oral supplementation. Zinc supplementation was possibly effective in improving the body zinc status of the children, secretory levels of IGF1 and IGFBP3, GH potentialization, and height.

Lipoic acid and moderate swimming improves the estrous cycle and oxidative stress in Wistar rats.

The generation of reactive oxygen species resulting from physical activity may trigger adaptive processes at the reproductive level and in the antioxidant defense system itself. The objective of this study was to investigate the effects of moderate daily swimming and lipoic acid (LA) supplementation on estrous cycle duration and pro-oxident and antioxidant markers in young Wistar rats. Animals were submitted to daily swimming (for 1 h) for 30 days, between 1300 h and 1400 h. The following study groups were formed: group 1, sedentary; group 2, submitted to swimming; group 3, sedentary supplemented with 100 mg·kg(-1)·day(-1) of LA; and group 4, submitted to swimming and supplementation with 100 mg·kg(-1)·day(-1) of LA. The estrous cycle of the animals was evaluated daily, and the following oxidative stress markers were measured: plasma thiobarbituric acid reactive substances (TBARS) and glutathione (GSH), erythrocyte superoxide dismutase (SOD), GSH peroxidase (GPx) and catalase (CAT) activity. The exercise protocol increased estrous cycle duration in group 2, especially in the diestrous phase. There was also a decrease in lipoperoxidation, with enhanced antioxidant activity of SOD and GPx. Group 4 showed no alteration in estrous cycle duration and maintained the beneficial effects on the antioxidant system observed in group 2. The increase in estrous cycle duration and improved oxidative stress markers may be an adaptive response to moderate exercise. LA impeded any exercise-induced alteration in the cycle but preserved improvements in the antioxidant system.

Comparação de três programas computacionais utilizados na avaliação de recordatórios alimentares 24 horas / Comparison of three softwares used for evaluating of 24-hour food recall / Comparación de tres programas de ordenador usados en la evaluación de recordatorios 24 h

A avaliação do consumo alimentar tem um papel importante na área de Nutrição e Saúde. Para tanto, são necessários métodos apropriados para estimar a ingestão de alimentos e nutrientes. O mercado da informática vem desenvolvendo diversos programas computacionais especializados em nutrição clínica. No entanto, a escolha do programa mais adequado tem sido uma decisão difícil em função das características operacionais disponíveis em cada um. Este estudo objetivou comparar três programas computacionais (Dietwin® profissional, Dietpro® 5i e Avanutri® revolution) utilizados na análise química nutricional de dez Recordatórios Alimentares de 24 horas oriundos de pacientes com Esclerose Lateral Amiotrófica, atendidos no Hospital Universitário da UFRN. Não houve diferença estatística entre os programas computacionais, com relação à energia, macronutrientes e micronutrientes. Todavia, foram detectadas divergências entre as gramaturas estipuladas para medidas caseiras de alguns alimentos. Além disso, observou-se quantificação equivocada do teor de ferro e cobre em dois alimentos. Conclui-se que é preciso ter cautela na escolha de um programa computacional especializado em nutrição clínica, pois poderá superestimar ou subestimar valores de energia ou nutrientes numa dieta prescrita ou consumida. Em adição, cuidado especial deve ser dado à origem das informações que alimentam o banco de dados desses programas, devendo ser as mais fidedignas possíveis.

Food intake assessment has an important role in nutrition research and health. For this purpose, right methods are needed to estimate appropriate intake of food and nutrients. The informatics market has developed several specialized computer programs in clinical nutrition . However, choosing the most appropriate program has been a difficult decision due all of operational features available in each one. This study aimed to compare three computer programs (Dietwin ® professional DietPro ® 5i and Avanutri Revolution ®) used in chemical analysis of ten 24-hour food recall from ten Amyotrophic Lateral Sclerosis patients, attending in by specific Multidisciplinary Team at Federal University of Rio Grande do Norte. There was no statistical difference between the three computer programs related to energy, macronutrients and micronutrients. Despite this, some differences were detected like measure portion food sizes. Moreover, there was wrong quantification of iron and copper content in two foods. We conclude that care should be taken to choose a computer program in clinical nutrition, because it can overestimate or underestimate values of calories and nutrients in a specific diet. In addition, it is necessary to be especially careful in the information sources that will feed the database of these programs. They should be as reliable as possible.

La evaluación de la ingesta alimentaria tiene un papel importante en la investigación en nutrición y salud. Para evaluar la ingesta de alimentos de un individuo se requieren métodos adecuados para la estimación de la ingesta de alimentos y nutrientes. El mercado de la informática ha desarrollado varios programas informáticos especializados en nutrición clínica. Sin embargo, elegir el programa más apropiado ha sido una decisión difícil a la luz de las características disponibles operativo. Este estudio tuvo por objetivo comparar los tres programas de ordenador (Dietwin ® profesional DietPro ® 5i y Avanutri Revolución ®) utilizados en el análisis químico de de recordatorios 24 h de pacientes con Esclerosis Amiotrófica Lateral. No hubo diferencia estadística entre los programas de ordenador, con respecto a la energía, macronutrientes y micronutrientes. Sin embargo, se detectaron diferencias entre los pesos fijados para tamaños de las porciones de algunos alimentos. Además, el contenido de hierro y el cobre se equivocaron en dos alimentos. El estudio demostró que se debe tener cuidado al elegir el mejor programa en la nutrición clínica, ya que puede sobreestimar o subestimar los valores de las calorías y nutrientes de una dieta prescrita o consumido. Además, la atención especial se debe dar a la fuente de la información introducida en la base de datos de estos programas debe ser lo más fiable posible.

Sensitivity of zinc kinetics and nutritional assessment of children submitted to venous zinc tolerance test.

OBJECTIVE: The purposes of this study were to investigate the kinetics of zinc in schoolchildren between the ages of 6 and 9 years, of both sexes, and to verify its sensitivity in detecting alterations in body zinc status. METHODS: Nutritional assessment was performed by body mass index. Food intake, venous zinc tolerance test, and zinc kinetics were carried out before and after 3-month oral zinc supplementation. RESULTS: Of the 42 children studied, 76.2% had healthy weight. Only energy, calcium, and fiber intake were suboptimal before and after oral zinc supplementation. Serum zinc and total-body zinc clearance, although at normal levels, increased significantly after zinc supplementation. CONCLUSION: We concluded, therefore, that kinetics is a sensitive tool for detecting changes in body zinc status, even in children without a deficiency of this mineral. Furthermore, kinetics showed a positive response to supplementation and may be a sensitive parameter for evaluating the efficacy of this therapy.