Dietary intake in individuals with phenylketonuria: an integrative review.

Introduction: Introduction: the dietary intake of individuals with phenylketonuria (PKU) may vary widely according to different cultural eating habits, lifestyle, access to multidisciplinary team, and metabolic formulas available. Thus, knowing the dietary intake of this population makes it possible to tailor nutritional treatment strategies to impact their health. Objective: to analyze the evidence on the dietary intake of individuals with PKU. Methods: an integrative literature review was conducted on the dietary intake of individuals with PKU in the databases PUBMED, BIREME and Science Direct. Original articles that addressed the energy and macronutrient food intake of children, adolescents and/or adults with PKU were included in the study, without time restriction, in any language. A total of 384 articles were found and 27 articles were selected and analyzed. Results: evidence about the nutritional composition of their diet showed that individuals with PKU consume between 1160-2721 kcal of energy -7.2-17.4 % (32.4-76.9 g) of energy as protein, 45.9-69.2 % of energy as carbohydrates, 16.6-39 % of energy as lipids- and between 7.6 and 20 g of fiber. Conclusion: most individuals with PKU have low energy, protein and fiber intake, adequate lipid intake, and high carbohydrate intake. Metabolic control of the disease is still a challenge in all countries. Nutritional strategies to improve dietary nutritional composition and phenylalanine blood levels in individuals with PKU remain an urgent issue.

Introducción: Introducción: la ingesta dietética de los individuos con fenilcetonuria (PKU) puede variar ampliamente debido a los diferentes hábitos culturales de alimentación, el estilo de vida, el acceso al equipo multidisciplinar y las fórmulas metabólicas disponibles. Por ello, conocer la ingesta dietética de esta población permite adaptar las estrategias de tratamiento nutricional para incidir en su salud. Objetivo: analizar la evidencia sobre la ingesta dietética de individuos con PKU. Métodos: se realizó una revisión bibliográfica integradora sobre la ingesta dietética de las personas con PKU en las bases de datos PUBMED, BIREME y Science Direct. El estudio incluyó artículos originales que abordaran la ingesta alimentaria de energía y macronutrientes de niños, adolescentes y/o adultos con PKU, sin restricción de tiempo, en cualquier idioma. Se encontraron 384 artículos y se seleccionaron y analizaron 27. Resultados: la evidencia de la composición nutricional de la dieta mostró que los individuos con PKU consumen entre 1160 y 2721 kcal de energía ­7,2-17,4 % (32,4-76,9 g) de la energía en forma de proteínas, 45,9-69,2 % de la energía en carbohidratos, 16,6-39 % de la energía en lípidos­ y entre 7,6 y 20 g de fibra. Conclusiones: la mayoría de los individuos con PKU tienen una ingesta baja de energía, proteínas y fibra, una ingesta adecuada de lípidos y una ingesta alta de hidratos de carbono. El control metabólico de la enfermedad sigue siendo un reto en todos los países. Siguen siendo urgentes las estrategias nutricionales para mejorar la composición nutricional de la dieta y los niveles de fenilalanina en sangre de los individuos con PKU.

Adults with early diagnosis of phenylketonuria have higher resting energy expenditure than adults with late diagnosis.

INTRODUCTION: To date, there is a gap regarding resting energy expenditure (REE) in adults with phenylketonuria (PKU), whether PKU type and time of diagnosis interfere with REE, and whether the available predictive equations are valid in this population. OBJECTIVE: To compare the REE of adult subjects with PKU with healthy subjects and secondarily, examine the REE of adults with PKU according to type and time of diagnosis, and check the agreement of commonly used predictive equations of REE. METHODS: Concordance study with adults with PKU and a comparison group (CG) with healthy adults. Anthropometric and body composition assessments and REE assessment by indirect calorimetry (IC) were performed. The results obtained by IC were compared with predictive equations. RESULTS: Sixty-nine adults were evaluated (PKU: 36; CG: 33). The REE of adults with mild and classic PKU is similar (p>.05) and similar to CG (p>.05). The REE of individuals with early diagnosis is higher (p < .05) than the REE of individuals with late diagnosis. The REE obtained by IC differed (p < .05) from all estimated REE. CONCLUSION: Late diagnosis of PKU showed lower REE compared to individuals with early diagnosis. The REE of adults with PKU does not differ in relation to the type of PKU, nor does it differ from the CG. Predictive equations overestimate REE.

Does the nutritional composition and category of administered enteral nutrition affect the nutritional status of patients receiving home nutritional therapy?

BACKGROUND & AIMS: Home enteral nutrition is a nutritional intervention that can help in the recovery of health after hospital discharge. The objectives of this study were to evaluate the nutritional composition of different categories of enteral nutrition administered to patients at home, the relationship with their nutritional status, and to compare the nutritional recommendations to the nutritional content provided by the different categories of enteral nutrition. METHODS: 111 samples of homemade enteral preparations (HEP), blended enteral preparations (BEP) and commercial enteral formulas (CEF) were collected from patients' homes. Physicochemical analyses were performed on the enteral formulations, and anthropometric and body composition evaluations were performed on the patients. Comparisons between the infused and prescribed nutritional content were performed. Shapiro-Wilk, Wilcoxon, and Kruskal-Wallis tests with post hoc DMS were conducted. RESULTS: The enteral nutrition categories demonstrated adequacy in relation to the physical analyses. The energy content was similar among the evaluated categories. The BEP and CEF presented higher levels of total solids, proteins, lipids, caloric density and non-protein calories; they also had a lower volume of infused/day content, and both were classified as normocaloric. The HEP were classified as hypocaloric. Regarding the infused content in relation to the recommended content, the HEP presented lower levels of protein and lipids; the CEF showed lower lipid and carbohydrate content, and the BEP presented adequacy in all nutrients. Most of the evaluated anthropometric parameters did not differ between the enteral nutrition categories. The anthropometric indicator of arm circumference (cm and %) was higher in patients receiving CEF and BEP, and the triceps skin fold (mm) was higher in patients receiving CEF and HEP. CONCLUSIONS: It is recommended to review the macronutrient content in nutritional prescriptions, regardless of the enteral nutrition category used. Most anthropometric parameters did not differ between the categories of enteral nutrition administered, especially those that were indicative of lean body mass.

Nutritional composition and cost of home-prepared enteral tube feeding.

BACKGROUND & AIMS: To aid in dietary prescription and contribute to the promotion of food and nutritional safety of individuals, this study's objective was to compare the nutritional composition and cost of homemade preparations, blended preparations, and commercial enteral formula prescribed for adults and elderly people at hospital discharge. METHODS: All hospitals in a Brazilian city that prescribed the three types of enteral formulations provide information about enteral formulations prescribed for home use. Enteral formulations were estimated in relation to energy content, macronutrients, micronutrients, and cost. RESULTS: Homemade diets, blended and commercial enteral formulations showed, on average, normoproteic, normoglicidic and normolipidic features, with average daily costs (US$/2000 kcal) of US$ 29.77, 50.56 and 154.44, respectively. The cost was higher in the commercial enteral formulas (P < .001); vitamin and mineral content were poorer in homemade preparations. CONCLUSIONS: The homemade and blended enteral preparations cost less, but were generally lower in micronutrients, calling for more adequate dietary prescription.

Nutritional and metabolic parameters of children and adolescents with phenylketonuria.

BACKGROUND AND AIMS: Considering that phenylalanine-poor diets may be monotonous and compromise the development and nutritional status of children and adolescents with phenylketonuria, the aim of this study was to evaluate the anthropometric and biochemical characteristics of children and adolescents with this condition. METHODS: Retrospective study with anthropometric and biochemical data collection from patients with phenylketonuria in the age group 2-19.9 years. Nutritional status was classified according to the World Health Organization. Biochemical tests were compared to current recommendations. RESULTS: A total of 84 patients (71.8%) were eligible, with a median age of 10.7 years (2.4-19.9 years). There was predominance of adequate (n = 58, 69%) with presence of overweight and obesity in 24 (28.5%) patients. The biochemical tests revealed hyperphosphatemia in 46 (55%), hypertriglyceridemia in 27 (50%), vitamin B12 elevated in 34 (41.2%), selenium deficiency in 10 (13.7%), insufficient zinc in 7 (8.9%), low globulin in 21 (26.9%), low HDL in 35 (59.3%) and elevated phenylalanine level in 28 (34.5%) patients in the sample. Overweight and obesity were correlated with low HDL (p = 0.04) and lowest adequate frequency of LDL (p = 0.09). Higher phosphorus values were associated with lower body weight (r = -0.72) and age (r = -0.75), as well as vitamin B12 in the same parameters (r = -0.67 and r = -0, 68). A positive correlation of phenylalanine with body weight and age (r = 0.62 and r = 0.66) was observed. CONCLUSION: Most patients presented adequate according to anthropometric parameters and appropriate biochemical tests, except HDL, and moderate metabolic control of the disease. However, attention should be paid to the presence of overweight and need for biochemical monitoring of triglycerides, selenium, zinc, HDL, and phenylalanine.

Efeito da redução de peso em pacientes submetidos à técnica do Bypass Gástrico em Y-de-Roux / Effects of weight reduction in patients submitted to the technique of Gastric Bypass in Y-en-Roux

Objetivo Identifi car o impacto da cirurgia bariátrica sobre o perfi l metabólico de indivíduos submetidos ao Bypass Gástrico em Y-de Roux. Métodos Análise retrospectiva do período pré- e pós-operatório de cinquenta e três pacientes submetidos à técnica cirúrgica Bypass Gástrico em Y-de-Roux, com idade entre 18 e 63 anos, atendidos em um Centro de Saúde Preventiva do Município de Curitiba, Paraná. Foram coletados dados antropométricos e laboratoriais de Low Density Lipoproteins, High Density Lipoproteins, triglicérides, glicose de jejum e insulina de jejum no período pré- e pós-operatório (6 meses, 12 meses e 24 meses) de prontuários médicos. Resultados Entre os pacientes, 94,34% (n=50) eram mulheres com idade média de 45,04±9,17 anos. Foi observada redução significativa do peso e índice de massa corporal, assim como concentrações inferiores de glicose sérica. O colesterol total (192,19±38,66 vs 162,38±30,42, p=<0,05), low density lipoproteins (119,81±31,68 vs 95,10±22,77), e Triglicérides (153,11±84,10 vs 80,64±35,52, p<0,01) quando comparados os períodos pré-operatório e pós-operatório (24 meses). No pós-operatório de 24 meses foi observada remissão da hipertensão arterial, diabetes Mellitus e dislipidemia, sendo a obesidade mais comum no pós-operatório de 2 anos estando presente em 21,00% dos pacientes. Conclusão O Bypass Gástrico em Y-de-Roux mostrou ser um procedimento eficaz na melhora do perfil metabólico de indivíduos com obesidade mórbida, com resultados consistent

Objective To identify the impact of bariatric surgery on the metabolic profile of individuals submitted to Roux-en-Y gastric bypass. Methods Retrospective analysis of the pre and postoperative period of 53 patients submitted to the Roux-en-Y gastric bypass surgical technique, aged 18 to 63 years, attended at a Preventive Health Center of the Municipality of Curitiba, Paraná. Anthropometric and laboratory data Low Density Lipoproteins, High Density Lipoprotein, triglycerides, fasting glucose and fasting insulin were collected in the pre and postoperative period (6 months, 12 months and 24 months) of medical records. Results Among the patients, 94.34% (n=50) were women with a mean age of 45.04±9.17 years. A significant reduction in body weight and body mass index was observed, as well as lower serum glucose concentrations. Total cholesterol (192.19±38.66 vs 162.38±30.42, p=<0.05), Low Density Lipoproteins (119.81±31.68 vs 95.10±22.77), and triglycerides (153.11±84.10 vs 80.64±35.52, p<0.01) when comparing the preoperative and postoperative periods (24 months). In the 24-month postoperative period, remission of arterial hypertension, diabetes Mellitus and dyslipidemia was observed, with obesity being more common in the postoperative period of 2 years and being present in 21.00% of the patients Conclusion Roux-en-Y gastric bypass has been shown to be an effective procedure in improving the metabolic profile of morbidly obese individuals, with consistent results in weight loss and remission of major comorbidities associated with obesity

Content of Poorly Absorbed Short-Chain Carbohydrates (FODMAP) in Enteral Homemade Diets.

BACKGROUND: Recent studies have shown that commercial enteral formulas with low FODMAP (FO, fermentable oligosaccharides; D, disaccharides; M, monosaccharides; AP, and polyols) content decrease diarrhea of individuals receiving enteral nutrition therapy (ENT). There is no information, however, regarding the content of FODMAP in homemade enteral formula. The objective of this study was to assess energy and macronutrient content, and to quantify the amount of FODMAP content in homemade enteral formula, commonly prescribed for home use after hospital discharge. METHODS: Recipes of homemade enteral formula were requested from all hospitals and healthcare centers in a Brazilian city, totaling 24 recipes. The diets were quantified in relation to their energy content, macronutrients, and FODMAP content. RESULTS: Of the 19 hospitals, 68.4% prescribe only commercial enteral formulas at the time of hospital discharge, and 31.6% prescribe homemade enteral formula, both conventional and commercial. The homemade enteral formula showed a variation from 700 to 3000 kcal/d. The macronutrient levels of carbohydrates, proteins, and fats were 49.0% ± 6.8%, 17.4% ± 3.1%, and 33.5% ± 6.2%, respectively. On average, homemade enteral formula had 58.5% of high FODMAP content, 7.1% of moderate content, and 34.5% of low FODMAP content, considering that milk is the main food responsible for the high content of FODMAP. CONCLUSIONS: Homemade enteral formula presented adequate nutrition characteristics and is rich in FODMAP. It is important to consider FODMAP in enteral diets prescribed for individuals intolerant to these carbohydrates by individualizing the diet prescription.

Relação entre eficiência da hemodiálise e estado nutricional em pacientes com doença renal crônica / Relationship between dialytic efficiency and nutritional status of patients with chronic kidney disease on hemodialysis

OBJETIVOS: Verificar as relações entre índice de eficiência dialítica (Kt/V) e parâmetros de estado nutricional de indivíduos com doença renal crônica em hemodiálise. MÉTODOS: Foi realizado um estudo retrospectivo em um instituto de hemodiálise. Foram coletados dados dos prontuários sobre sexo, idade, exames bioquímicos, peso seco, altura, circunferência do braço (CB) e prega cutânea tricipital (PCT). Foram calculados índice de risco nutricional (IRN), índice de massa corporal (IMC), circunferência muscular do braço (CMB), área muscular do braço corrigida (AMBc), Kt/V e taxa de redução da ureia (urea reduction rate ­ URR). Para a análise estatística foram empregados o teste de Mann-Whitney e a Correlação de Spearman, sendo considerados significativos valores de p<0,05. RESULTADOS: Foram avaliados 164 pacientes, com média de idade de 58±14,4 anos, sendo 96 (59%) do sexo masculino. A mediana do tempo em que os pacientes se encontravam em hemodiálise foi 35,0 (5-234) meses. Entre os 164 pacientes, 60 (37%) apresentavam risco nutricional. Na avaliação do estado nutricional, os valores médios obtidos foram de 25,0±4,5kg/m2 para o IMC, 99,0±12,3% para a adequação da CB, 86,7±14,5% para a adequação da CMB, 122,9±66,8% para a adequação da AMBc e 1,4±0,4 para o Kt/V. A mediana de adequação para PCT foi de 107,8% (11,5%-305,4%). Observou-se ausência de correlação do Kt/V com albumina sérica, CB, CMB, AMBc e IRN. O Kt/V apresentou correlação positiva baixa com o tempo em hemodiálise (r=0,2197) e correlação negativa baixa com a PCT (r=-0,1692) e com o IMC (r=-01970). A correlação entre Kt/V e peso seco foi negativa moderada (r=-0,3710) e entre Kt/V e URR foi positiva forte (r=0,81129). CONCLUSÕES: Verificou-se adequada eficiência dialítica e bom estado nutricional na maioria da amostra avaliada, com correlações significativas entre eficiência dialítica e parâmetros de avaliação do estado nutricional.

AIMS: To verify the relationships between the dialysis adequacy index (Kt/V) and nutritional parameters of individuals with chronic renal disease on hemodialysis. METHODS: A retrospective study was performed at a hemodialysis institute. Data on sex, age, biochemical tests, dry weight, height, arm circumference (AC) and triceps skin fold (TSF) were collected from the medical charts. Nutritional risk index (NRI), body mass index (BMI), arm muscle circumference (AMC), corrected arm muscle area (AMAc), Kt/V and urea reduction rate (URR). The Mann-Whitney test and the Spearman correlation were used for the statistical analysis, and a p<0.05 was considered significant. RESULTS: A total of 164 patients were evaluated, with a mean age of 58±14.4 years, of which 96 (59%) were male. The median time on hemodialysis was 35.0 (5-234) months. Among the 164 patients, 60 (37%) presented nutritional risk. In the evaluation of nutritional status, the mean values obtained were 25.0±4.5 kg/m2 for BMI, 99.0±12.3% for CB adequacy, 86.7±14.5% for WBC adequacy, 122.9±66.8% for CBA adequacy and 1.4±0.4 for Kt/V. The median adequacy for PCT was 107.8% (11.5%-305.4%). There was no correlation of Kt/V with serum albumin, CB, CMB, AMAc and NRI. Kt/V had a low positive correlation with time on hemodialysis (r=0.2197) and a low negative correlation with PCT (r=-0.1692) and with BMI (r=-01970). The correlation between Kt/V and dry weight was moderate and negative (r=-0.3710) and between Kt/V and URR the correlation was strongly positive (r=0.81129). CONCLUSIONS: Adequate dialysis efficiency and good nutritional status were observed in most patients of the evaluated sample, with significant correlations between dialysis adequacy and parameters of nutritional status assessment.

Hematological parameters and body composition of soccer players / Parâmetros hematológicos e composição corporal de atletas de futebol / Parámetros hematológicos y composición corporal de atletas de fútbol

ABSTRACT Introduction: Soccer players may experience hematological changes that could be detrimental to their health status. In addition, inadequate body composition may impair performance. Objective: To assess body composition and hematological changes over a year in soccer players. Methods: A retrospective observational study was conducted. Age, weight, height, body composition, blood count, serum iron, serum ferritin, serum transferrin and total iron binding capacity data were collected from the athletes' medical records in the months of January, May and August of 2015 and January of 2016. Body mass index was also calculated. For the statistical analyses, the Anova and post-hoc Tukey's post-hoc tests were used for the quantitative variables and the Chi-square test for the qualitative variables. The significance level adopted was p<0.05. Results: Data were evaluated for 51 athletes with a mean age of 23.53 ± 3.11 years, 77.10 ± 6.56 kg, 1.80 ± 0.07 and 15.6 ± 2.89% body fat (BF). We observed significant (p<0.05) changes in mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, cell size and eosinophils during the period evaluated. Among the athletes, 21.6% had decreased hematocrit levels and 3.9% had hemoglobin levels below the reference range. A BF% greater than 16% was significantly related to serum iron depletion (p = 0.01). Conclusion: Small significant hematological changes during the competitive year were observed, but without significant changes in body composition. Level of Evidence III; Study of nonconsecutive patients; without consistently applied reference ''gold'' standard.

RESUMO Introdução: Os atletas de futebol podem apresentar alterações hematológicas que podem comprometer o seu estado de saúde. Além disso, a composição corporal inadequada pode prejudicar o respectivo desempenho. Objetivo: Avaliar a composição corporal e as alterações hematológicas ao longo de um ano em atletas de futebol. Métodos: Realizou-se um estudo observacional retrospectivo. Foram coletados dos prontuários dos atletas dados referentes à idade, peso, estatura, composição corporal, hemograma, ferro sérico, ferritina sérica, transferrina sérica e capacidade total de ligação do ferro nos meses de janeiro, maio e agosto de 2015 e janeiro de 2016. O índice de massa corporal também foi calculado. Para as análises estatísticas foram utilizados o teste Anova e o teste post-hoc Tukey para as variáveis quantitativas e o teste de Qui-quadrado para as variáveis qualitativas. O nível de significância adotado foi de p<0,05. Resultados: Foram avaliados os dados de 51 atletas, com média de idade de 23,53 ± 3,11 anos, 77,10 ± 6,56 kg, 1,80 ± 0,07 m e 15,6 ± 2,89% de gordura corporal (GC). Observou-se alteração significativa (p<0,05) do volume corpuscular médio, da hemoglobina corpuscular média, da concentração de hemoglobina corpuscular média, do tamanho celular e dos eosinófilos durante o período avaliado. Dentre os atletas, 21,6% apresentaram hematócrito diminuído e 3,9% apresentaram hemoglobina abaixo dos valores de referência. A % de GC maior que 16% se correlacionou significativamente com a depleção de ferro sérico (p=0,01). Conclusão: Pequenas alterações hematológicas significativas durante o ano de competição esportiva foram observadas, mas sem alterações significativas sobre a composição corporal. Nível de Evidência III; Estudo de pacientes não consecutivos; sem padrão de referência "ouro" aplicado uniformemente.

RESUMEN Introducción: Los atletas de fútbol pueden presentar alteraciones hematológicas que pueden comprometer su estado de salud. Además, la composición corporal inadecuada puede perjudicar el respectivo rendimiento. Objetivo: Evaluar la composición corporal y las alteraciones hematológicas a lo largo de un año en atletas de fútbol. Métodos: Se realizó un estudio observacional retrospectivo. Fueron colectados de los prontuarios de los atletas datos referentes a la edad, peso, estatura, composición corporal, hemograma, hierro sérico, ferritina sérica, transferrina sérica y capacidad total de unión del hierro en los meses de enero, mayo y agosto de 2015 y enero de 2016. El índice de masa corporal también fue calculado. Para los análisis estadísticos fueron utilizados el test Anova y el test post-hoc Tukey para las variables cuantitativas y el test de Qui-cuadrado para las variables cualitativas. El nivel de significancia adoptado fue de p<0,05. Resultados: Fueron evaluados los datos de 51 atletas, con un promedio de edad de 23,53 ± 3,11 años, 77,10 ± 6,56 kg, 1,80 ± 0,07 m y 15,6 ± 2,89% de grasa corporal (GC). Se observó alteración significativa (p <0,05) del volumen corpuscular promedio, de la hemoglobina corpuscular promedio, de la concentración de hemoglobina corpuscular promedio, del tamaño celular y de los eosinófilos durante el período evaluado. Entre los atletas, 21,6% presentaron hematocrito disminuido y 3,9% presentaron hemoglobina por debajo de los valores de referencia. El % de GC superior a 16% se correlacionó significativamente con la depleción de hierro sérico (p = 0,01). Conclusión: Se observaron pequeñas alteraciones hematológicas significativas durante el año de competición deportiva, pero sin cambios significativos sobre la composición corporal. Nivel de Evidencia III; Estudio de pacientes no consecutivos; sin estándar de referencia "oro" aplicado uniformemente.

Conhecimento e uso de plantas medicinais por usuários de Unidades Básicas de Saúde na Região de Colombo, PR / The knowledge and use of medicinal plants by users of primary healthcare facilities in Colombo, PR

Objetivo: Avaliar o conhecimento sobre a utilização de plantas medicinais pela população frequentadora de Unidades Básicas de Saúde (UBS) em Colombo, PR. Material e Métodos: Por meio de um questionário de pesquisa estruturado, foram entrevistados usuários adultos de ambos os sexos, de quatro UBS, entre os meses de maio e junho de 2016. Resultados: Foram entrevistados 101 usuários de UBS. Destes, 72,28% utilizavam plantas medicinais, sendo a maioria do sexo feminino, com idade média de 39 anos. A espécie vegetal mais citada pela população foi a camomila (Matricaria chamomilla L.), seguida da hortelã (Mentha spicata L.) e do capim limão (Cymbopogon citratus L.), sendo que a indicação mais referida pelos entrevistados foi calmante, seguida das afecções estomacais. Aproximadamente 70% dos entrevistados que fazem uso de plantas medicinais relataram que cultivam as próprias plantas para consumo e o entendimento da finalidade terapêutica é proveniente do conhecimento familiar. Dentre as 30 plantas citadas pelos entrevistados, grande parte estão listadas na Relação Nacional de Plantas Medicinais de Interesse ao SUS (RENISUS), no Formulário Fitoterápico e no Memento Fitoterápico da Farmacopeia Brasileira. Conclusão: A partir dos resultados obtidos, conclui-se que os usuários entendem que as plantas medicinais auxiliam na terapêutica como um complemento no tratamento das mais diversas enfermidades.(AU)

Objective: To evaluate the knowledge on the use of medicinal plants by frequent users of Primary Healthcare Facilities (PHF) in Colombo, PR. Material and Methods: Adult users of both sexes from four PHF were interviewed using a structured questionnaire between May and June 2016. Results: A total of 101 PHF users were interviewed. Of these, 72.28% reported using medicinal plants, most of them being female, with a mean age of 39 years. The plant species most frequently cited were chamomile (Matricaria chamomilla L.), followed by mint (Mentha spicata L.) and lemon grass (Cymbopogon citratus L.), and the most common indications were soothing, followed by stomach disorders. Approximately 70% of the respondents who use medicinal plants reported that they cultivate the plants themselves for consumption, and that the knowledge of the therapeutic purpose comes from the family. Among the 30 plants cited by respondents, most of them are listed in the National List of Medicinal Plants of Interest to the Brazilian Healthcare System (SUS, RENISUS); in the Phytotherapic Form; and in the Phytotherapic Memento of the Brazilian Pharmacopoeia. Conclusion: It is concluded that users understand that medicinal plants help in therapy as an adjunct in the treatment of several diseases.(AU)

Determinação do índice glicêmico e da carga glicêmica de dietas hospitalares servidas para diabéticos / Determination of glycemic index and glycemic load of hospital diets served for diabetics

OBJETIVOS: Determinar o índice glicêmico e a carga glicêmica de dietas habitualmente oferecidas nos hospitais para pacientes com diabetes mellitus. MÉTODOS: Um estudo transversal avaliou cardápios servidos para pacientes diabéticos internados em hospitais da cidade de Curitiba, Paraná, Brasil. Analisando os cardápios, determinou-se teor energético, de macronutrientes, índice glicêmico e carga glicêmica das refeições ofertadas aos pacientes. RESULTADOS: Participaram do estudo cinco hospitais gerais da cidade e foram avaliados 10 cardápios de dieta para diabetes. A estrutura dos cardápios diferenciou-se principalmente na oferta quantitativa de frutas e leite. As dietas variaram entre 1317,6 a 2013,2 kcal, com 18,9 a 27,6% de proteínas, 21,9 a 29,4% de lipídios, 48,2 a 53,3% de carboidratos e 24,7 a 33,6 g de fibras. O índice glicêmico diário variou de 47 a 57% e a carga glicêmica diária entre 81 e 109%. CONCLUSÕES: Todas as dietas ofertadas foram hiperproteicas, normolipídicas e normoglicídicas. ntretanto, observaram-se níveis inadequados de carga glicêmica em todos os cardápios avaliados, embora com níveis adequados de índice glicêmico. Faz-se necessária a revisão dos planos alimentares elaborados para diabéticos, visando o melhor tratamento dietoterápico a essa população.

AIMS: To determine the glycemic index and the glycemic load of diets usually offered by hospitals to patients with diabetes mellitus. METHODS: A cross-sectional study evaluated menus served to diabetic inpatients of hospitals in the city of Curitiba, Parana, Brazil. Analyzing the menus, we determined the energy content, macronutrients, glycemic index and glycemic load of the meals offered to the patients. RESULTS: Five general hospitals of the city participated in the study and 10 menus for diabetes were evaluated. The structure of the menus was different mainly in the quantitative supply of fruits and milk. Diets ranged from 1317.6 to 2013.2 kcal, with 18.9 to 27.6% of proteins, 21.9 to 29.4% of lipids, 48.2 to 53.3% of carbohydrates and 24.7 to 33.6 g of fibers. Daily glycemic index ranged from 47 to 57% and daily glycemic load from 81 to 109%. CONCLUSIONS: All offered diets were hyperproteic, normolipid and normoglicidic. However, inadequate levels of glycemic load were observed in all the evaluated menus, although with adequate levels of glycemic index. It is necessary to review the diet plans elaborated for diabetics, aiming at the best dietary treatment for this population

Consumo alimentar de praticantes de musculação de uma academia em Curitiba, PR / Dietary intake of practitioners of resistance training at a gym in Curitiba, PR

Introdução: O estudo do consumo alimentar de uma população é capaz de gerar informa- ções que refletem a sua organização social e de saúde, possibilitando otimizar estratégias de melhoria nos variados aspectos. Objetivo: Avaliar o consumo alimentar de praticantes de musculação de uma academia em Curitiba, PR. Método: Estudo observacional transversal, com coleta de dados sobre idade, gênero, Índice de Massa Corporal (IMC), objetivando a prática de musculação e avaliação do consumo alimentar por meio de recordatório 24 horas. Resultados: Foram avaliados 22 indivíduos, sendo 45,5% (n=10) do sexo feminino e 54,5% (n=12) do sexo masculino. A média de idade foi de 30,6±10,34 anos para o sexo feminino e 28,1±6,18 anos para o sexo masculino. O IMC médio encontrado foi de 22,6±2,18 kg/m2 para o sexo feminino e 25,9±3,99 kg/m2 para o sexo masculino. Observou-se que 45% dos avaliados buscam hipertrofia muscular. A característica da dieta encontrada é hipocalórica, hiperproteica, hipoglicídica, normolipídica e carente em micronutrientes, com elevado consumo de suplemento hiperproteico. Conclusão: Esses dados indicam a necessidade de intervenção focada no controle de peso e comportamentos alimentares para um bom desempenho esportivo e de saúde.(AU)

Introduction: The study of food consumption of a population can generate information that reflect the social organization and health, allowing optimize improvement strategies in various aspects. Objective: To evaluate the dietary intake of practitioners of resistance training at gym in Curitiba, PR. Methods: Cross-sectional observational study with collect data on age, gender, body mass index (BMI), the aim of the practice of strength and evaluation of food consumption by 24-hour recall. Results: Twenty-two individuals were evaluated, 45.5% (n=10) were female and 54.5% (n=12) were male. The mean age was 30.6±10.34 years for females and 28.1±6.18 years for males. The mean BMI was found 22,6±2,18 kg/m2 for women and 25,9±3,99 kg/m2 for males. It was observed that 45% of the individuals seeking muscle hypertrophy. The feature is found hypocaloric diet, high-protein, low-carbohydrate, normolipidic and lacking in micronutrients, with high protein supplement consumption. Conclusion: These data indicate the need for an intervention focused on weight control and eating behavior for a good sports performance and health.(AU)

Fatores de risco para recidiva de peso no pós-operatório tardio de cirurgia bariátrica / Risk factors for weight regain in the late postoperative of bariatric surgery

OBJETIVOS: Avaliar os fatores de risco para a recidiva de peso em indivíduos submetidos à cirurgia bariátrica. MÉTODOS: Estudo transversal utilizando-se questionário autoaplicável online. O questionário abordou fatores que poderiam estar associados à recidiva de peso após cirurgia bariátrica. Foram registrados peso, altura, sexo, idade, escolaridade, renda e assiduidade às consultas nutricionais no pré e no pós-operatório. Foram avaliados índice de massa corporal, perda de peso e perda do excesso de peso no pós-operatório imediato e após seis, 12 e 24 meses de pós-operatório, assim como no momento em que o participante respondeu ao questionário. O reganho de peso foi avaliado a partir do menor peso obtido após a cirurgia. O questionário Three Factor Eating Questionnaire-21 foi utilizado para classificar o comportamento alimentar em Alimentação Emocional, Restrição Cognitiva ou Descontrole Alimentar. RESULTADOS: Foram respondidos 46 questionários por indivíduos que realizaram cirurgia bariátrica, com média de idade de 38±8,78 anos e mediana de três anos de pós-operatório. Quarenta e três (93,5%) participantes eram do sexo feminino. As médias de perda do excesso de peso e a perda de peso atual foram de 78,56±16,12% e 35,24±8,19%, respectivamente. A média do índice de massa corporal atual era de 27,35±3,98 kg/m2 . Alimentação Emocional foi encontrada em 18 (39,13%), Restrição Cognitiva em 24 (52,17%) e Alimentação Emocional associada à Restrição Cognitiva em 4 (8,69%) dos entrevistados. A recidiva de peso ocorreu em 18 (39%) dos indivíduos, a partir principalmente dos 12 meses após a cirurgia. Observou-se que a renda familiar mensal superior a 4000 reais e a frequência a consultas com nutricionista inferior a três vezes no pré-operatório estiveram associadas a maior chance de recidiva de peso. CONCLUSÕES: Nessa amostra, a baixa assiduidade às consultas nutricionais no pré-operatório, bem como a renda familiar elevada foram fatores de risco para recidiva de peso no pós-operatório tardio de cirurgia bariátrica.

AIMS: To evaluate risk factors for weight regain in patients undergoing bariatric surgery. Methods: Cross sectional study using self-administered online questionnaire. The questionnaire asked about factors that can be associated with weight regain after bariatric surgery. Weight, height, sex, age, education, income, and nutrition appointment attendance before and after surgery were registered. Body mass index, weight loss, and loss of excess weight in the immediate postoperative period and at 6, 12, and 24 months postoperatively, as well as at the time of completing the questionnaire, were evaluated. Weight regain was evaluated according to the lowest weight achieved since surgery. The Three Factor Eating Questionnaire 21 was used to classify eating behavior into Emotional Eating, Cognitive Dietary Restraint, or Uncontrolled Eating. RESULTS: The questionnaire was answered by 46 individuals who underwent bariatric surgery, with a mean age of 38±8.78 years and a median of three postoperative years. Forty-three (93.5%) patients were female. The mean loss of excess weight and current weight loss were 78.56±16.12% and 35.24±8.19%, respectively. The current body mass index was 27.35±3.98 kg/m2 . Emotional eating was observed in 18 (39.13%), cognitive restraint in 24 (52.17%), and emotional eating associated with cognitive restraint in 4 (8.69%) of the respondents. Eighteen individuals (39%) regained weight, especially after 12 months. A monthly family income greater than 4000 Brazilian Reals and nutrition appointments fewer than three in the preoperative period were associated with a larger probability of weight regain. CONCLUSIONS: In this sample, low nutrition appointment attendance in the preoperative period and a high family income were risk factors for weight regain in the late postoperative period of bariatric surgery.

Qualidade físico-química e atividades biológicas de caseinofosfopeptídeos obtidos por hidrólise tríptica de caseinato de sódio sob diferentes condições / Physico-chemical quality and biological activities of Casein phosphopeptides obtained by sodium caseinate tryptic hydrolysis under different conditions

Muitos métodos têm sido empregados na produção de peptídeos bioativos para a promoção da saúde. O objetivo deste estudo foi produzir caseinofosfopeptídeos por hidrólise tríptica do caseinato de sódio usando diferentes temperaturas (37 e 50 °C) e tempos de reação (2 e 4 h), caracterizá-los e analisar sua influência nas atividades citotóxica, antimicrobiana e antioxidante. Caseinofosfopeptídeos foram caracterizados através da composição centesimal, eletroforese em gel de poliacrilamida, Espectrometria de Massas e Cromatografia Líquida de Alta Eficiência. Toxicidade para leucócitos humanos, atividade antimicrobiana utilizando o teste de microdiluição em caldo e determinação da capacidade antioxidante pelo método de espécies reativas ao ácido tiobarbitúrico foram os ensaios biológicos realizados. Os resultados mostraram que as quatro frações peptídicas obtidas apresentaram-se com baixo peso molecular e elevados teores proteico e mineral; quanto ao perfil aminoacídico, apresentaram elevadas e diferenciadas quantidades de ácido glutâmico e serina, que pouco variaram de acordo com o processo de obtenção; não se mostraram tóxicos para leucócitos humanos; demonstraram atividade antimicrobiana para Escherichia coli e Salmonella Enteritidis e elevada capacidade antioxidante. Os resultados físico-químicos das frações de caseinofosfopeptídeos demonstraram elevada composição nutricional em termos de proteína e, principalmente, cálcio. O conjunto de dados indicou que alterações no tempo e na temperatura de reação para a obtenção dos hidrolisados não interferem nas suas qualidades biológicas, mostrando serem seguros para a promoção da saúde e para a aplicação em situações especiais, que envolvem pacientes desnutridos, imunossuprimidos, com comprometimento ósseo ou gastrintestinal decorrentes de inflamações e infecções.

Several methods have been employed for the production of bioactive peptides for health promotion. The aim of this study was to produce and characterize Casein phosphopeptides obtained by sodium caseinate tryptic hydrolysis under different temperatures (37 and 50 °C) and reaction times (2 and 4 h), and evaluate their biological capabilities. They have been characterized by assessing their centesimal composition, by polyacrylamide gel electrophoresis, Mass Spectrometry, and High-Performance Liquid Chromatography. The biological activities tested included toxicity for human leukocytes, antimicrobial assay using the microdilution test, and determination of the antioxidant capacity by the thiobarbituric acid reactive species method. The results showed that the four fractions obtained were of low molecular weight with high protein and mineral contents; their amino acid profile showed high and differentiated amounts of glutamic acid and serine independent of the methodological procedures. The results also showed no toxicity for human peripheral leukocytes, demonstrated antimicrobial activity against Escherichia coli and Salmonella Enteritidis as well as high antioxidant capacity. The results of the physicochemical Casein phosphopeptides' fractions showed high nutritional composition in terms of protein and, particularly, calcium. The biological assays indicated that time and temperature changes in the process for obtaining casein hydrolysates have not interfered with their biological qualities. In addition, they have proven safe in promoting health in special conditions involving malnourished and/or, immunocompromised patients or those with bone and/or gastrointestinal impairment due to inflammations and infections.

Uso de plantas medicinais e satisfação de consumidores de lojas de produtos naturais do Mercado Municipal de Curitiba, PR / Use of medicinal plants and satisfaction of consumers of health food stores Municipal Market Curitiba, PR

Este trabalho teve como objetivo conhecer a prevalência de consumo e as indicações de plantas medicinais de consumidores de lojas de produtos naturais. Estudo observacional transversal, com coleta de dados realizada no Mercado Municipal de Curitiba, PR, por meio de um questionário abordando o uso de plantas medicinais, modo, frequência, tempo e finalidade de uso, identificação do prescritor dessa planta, efeito(s) colateral(is), satisfação com o uso de plantas medicinais e avaliação de consumo de medicamentos concomitantemente. Entre os consumidores abordados, 82,69% utilizam plantas medicinais frequentemente, principalmente a erva cidreira (Melissa officinalis L.). O principal objetivo de uso é com função digestiva e a forma de preparo mais utilizada é a infusão com 73,08%. Observou-se 63,46% dos entrevistados afirmam fazer uso das plantas desde a infância, 75% as utilizam por influência dos pais e familiares e ainda, 46,15% fazem uso das plantas medicinais concomitantemente com medicamentos. Dos entrevistados, 98,07% demonstraram estar satisfeitos com os resultados obtidos. Concluiu-se que o uso de plantas medicinais por parte dos consumidores é bastante difuso e frequente, principalmente pelo conhecimento acumulado ao longo de gerações. Portanto, se faz necessária maior atenção a esse aspecto de utilização, visando evitar possíveis interações medicamentosas.(AU)

This study aimed to assess the prevalence of consumption and indications of medicinal plants of consumers of natural products hops. Cross-sectional observational study, data collection was performed at the Municipal Market Curitiba, PR, through a questionnaire addressing the use of medicinal plants, addressing which plants used, method of use, frequency and duration of use, purpose, prescriber identification of this plant, effect ID (s) side (s), satisfaction with the use of herbal and dietary intake assessment concomitant medications. Among the topics consumers, 82.69% use medicinal plants often including lemon balm (Melissa officinalis L.). The main purpose of use is with digestive function and how to most commonly used preparation is infused with 73.08%. There was 63.46% of respondents claim to make use of plants from childhood, 75% use them for influence of parents and family and also 46.15% make use of medicinal plants with medicines. Of the respondents, 98.07% reported being satisfied with the results. It was found that the use of medicinal plants by consumers is very diffuse and often, therefore, is needed more attention to this aspect of use, in order to avoid possible drug interactions, since a large part of the population makes use of concomitant medications.(AU)