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1.
Nutrients ; 13(8)2021 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-34445046

RESUMO

BACKGROUND: As a result of tumor location and treatment that is aggressive, head and neck cancer (HNC) survivors experience an array of symptoms impacting the ability and desire to eat termed nutrition impact symptoms (NISs). Despite increasing cancer survival time, the majority of research studies examining the impact of NISs have been based on clinical samples of HNC patients during the acute phase of treatment. NISs are often chronic and persist beyond the completion of treatment or may develop as late side effects. Therefore, our research team examined chronic NIS complications on HNC survivors' functional status, quality of life, and diet quality. METHODS: This was a cross-sectional study of 42 HNC survivors who were at least 6 months post-radiation. Self-reported data on demographics, NISs, quality of life, and usual diet over the past year were obtained. Objective measures of functional status included the short physical performance battery and InBody© 270 body composition testing. NISs were coded so a lower score indicated lower symptom burden, (range 4-17) and dichotomized as ≤10 vs. >10, the median in the dataset. Wilcoxon rank sum tests were performed between the dichotomized NIS summary score and continuous quality of life and functional status outcomes. Diet quality for HNC survivors was calculated using the Healthy Eating Index 2015 (HEI-2015). Wilcoxon rank sum tests examined the difference between the HNC HEI-2015 as compared to the National Health and Nutrition Examination Survey (NHANES) data calculated using the population ratio method. RESULTS: A lower NIS score was statistically associated with higher posttreatment lean muscle mass (p = 0.002). A lower NIS score was associated with higher functional (p = 0.0006), physical (p = 0.0007), emotional (p = 0.007), and total (p < 0.0001) quality of life. Compared to NHANES controls, HNC survivors reported a significantly lower HEI-2015 diet quality score (p = 0.0001). CONCLUSIONS: Lower NIS burden was associated with higher lean muscle mass and functional, physical, emotional, and total quality of life in post-radiation HNC survivors. HNC survivors reported a significantly lower total HEI-2015 as compared to healthy NHANES controls, providing support for the hypothesis that chronic NIS burden impacts the desire and ability to eat. The effects of this pilot study were strong enough to be detected by straight forward statistical approaches and warrant a larger longitudinal study. For survivors most impacted by NIS burden, multidisciplinary post-radiation exercise and nutrition-based interventions to manage NISs and improve functional status, quality of life, and diet quality in this survivor population are needed.


Assuntos
Estado Funcional , Neoplasias de Cabeça e Pescoço/complicações , Transtornos Nutricionais/fisiopatologia , Qualidade de Vida , Lesões por Radiação/fisiopatologia , Idoso , Sobreviventes de Câncer , Doença Crônica , Estudos Transversais , Dieta Saudável , Feminino , Neoplasias de Cabeça e Pescoço/fisiopatologia , Neoplasias de Cabeça e Pescoço/radioterapia , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/etiologia , Inquéritos Nutricionais , Estado Nutricional , Projetos Piloto , Lesões por Radiação/etiologia
3.
Int J Med Sci ; 18(3): 593-603, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33437194

RESUMO

Sleep disturbances often result from inappropriate lifestyles, incorrect dietary habits, and/or digestive diseases. This clinical condition, however, has not been sufficiently explored in this area. Several studies have linked the circadian timing system to the physiology of metabolism control mechanisms, energy balance regulation, and nutrition. Sleep disturbances supposedly trigger digestive disorders or conversely represent specific clinical manifestation of gastrointestinal (GI) diseases. Poor sleep may worsen the symptoms of GI disorders, affecting the quality of life. Conversely, short sleep may influence dietary choices, as well as meal timing, and the circadian system drives temporal changes in metabolic patterns. Emerging evidence suggests that patients with inappropriate dietary habits and chronic digestive disorders often sleep less and show lower sleep efficiency, compared with healthy individuals. Sleep disturbances may thus represent a primary symptom of digestive diseases. Further controlled trials are needed to fully understand the relationship between sleep disturbances, dietary habits, and GI disorders. It may be also anticipated that the evaluation of sleep quality may prove useful to drive positive interventions and improve the quality of life in a proportion of patients. This review summarizes data linking sleep disorders with diet and a series of disease including gastro-esophageal reflux disease, peptic disease, functional gastrointestinal disorders, inflammatory bowel diseases, gut microbiota alterations, liver and pancreatic diseases, and obesity. The evidence supporting the complex interplay between sleep dysfunction, nutrition, and digestive diseases is discussed.


Assuntos
Gastroenteropatias/complicações , Doenças Negligenciadas/complicações , Transtornos Nutricionais/complicações , Transtornos do Sono-Vigília/complicações , Ritmo Circadiano/fisiologia , Digestão/fisiologia , Gastroenteropatias/fisiopatologia , Humanos , Doenças Negligenciadas/fisiopatologia , Transtornos Nutricionais/fisiopatologia , Qualidade de Vida , Sono/fisiologia , Transtornos do Sono-Vigília/fisiopatologia
4.
Nutrients ; 12(12)2020 Nov 24.
Artigo em Inglês | MEDLINE | ID: mdl-33255334

RESUMO

Chronic kidney disease (CKD) is increasing in sub-Saharan Africa. Undernutrition has been prevalent amongst end stage CKD patients, with limited data on the prevalence of obesity. The aim of this study was to assess the nutritional status of CKD patients using various methods sensitive to over and under-nutrition. Stage 3 to 5 CKD patients (glomerular filtration rate (GFR) < 60 mL/min/1.73 m2) attending a pre-dialysis clinic in Cape Town, were enrolled. Exclusion criteria included infectious and autoimmune conditions. Sociodemographic, clinical and biochemical data were collected, and anthropometric measurements were performed. Dietary intake was measured with a quantified food frequency questionnaire (FFQ). Statistical Package for the Social Sciences (SPSS) version 26 was used for statistical analysis. Seventy participants, with mean age of 41.8 ± 11.8 years, 52.9% females and 47.1% males were enrolled. Participants enrolled mainly had stage 5 kidney failure. Thirty percent were overweight (21) and 25 (36%) were obese, 22 (60%) of females were overweight and obese, while 13 (39.4%) of males were predominantly normal weight. Abdominal obesity was found in 42 (60%) of participants, mainly in females. Undernutrition prevalence was low at 3%. Dietary assessment showed a high sugar and protein intake. There was a high prevalence of overweight, obesity and abdominal obesity in CKD stage 35 patients, with unhealthy dietary intake and other nutritional abnormalities.


Assuntos
Estado Nutricional , Obesidade/epidemiologia , Obesidade/fisiopatologia , Insuficiência Renal Crônica/epidemiologia , Insuficiência Renal Crônica/fisiopatologia , Adulto , África ao Sul do Saara/epidemiologia , Comorbidade , Estudos Transversais , Diálise , Feminino , Humanos , Masculino , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/fisiopatologia
5.
Clin Nucl Med ; 45(10): 781-783, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32796238

RESUMO

A 7-year-old boy presented with diffuse bone pain. FDG PET/CT was performed to find the possible underlying malignant cause of hypercalcemia. The images demonstrated multiple foci of abnormal FDG activity at the sites of periosteal reaction. In addition, calcium deposit was noted in the basal ganglia, stomach, and the colon. History taking revealed that the patient had routinely taken an over-the-counter "supplement" that contains a high dose of vitamin D. One week after calcitonin therapy and stopping the supplement, the patient became symptom free. This case suggests that hypervitaminosis D might cause hypermetabolic periosteal reaction on FDG PET/CT imaging.


Assuntos
Fluordesoxiglucose F18/metabolismo , Transtornos Nutricionais/diagnóstico por imagem , Transtornos Nutricionais/fisiopatologia , Osteogênese , Periósteo/fisiopatologia , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Artefatos , Transporte Biológico , Criança , Humanos , Masculino , Transtornos Nutricionais/metabolismo , Osteogênese/efeitos dos fármacos , Periósteo/efeitos dos fármacos , Vitamina D/farmacologia
6.
Surg Clin North Am ; 100(4): 695-705, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32681870

RESUMO

Wound healing is affected by several factors. Preexisting diagnoses may significantly alter, delay, or inhibit normal wound healing. This is most commonly seen with chronic disorders, such as diabetes and renal failure, but also occurs secondary to aging and substance abuse. Less commonly, genetic or inflammatory disorders are the cause of delayed wound healing. In some cases, it is not the illness, but the treatment that can inhibit wound healing. This is seen in patients getting chemotherapy, radiation, steroids, methotrexate, and a host of other medications. Understanding these processes may help treat or avoid wound healing problems.


Assuntos
Falência Renal Crônica/fisiopatologia , Cicatrização/fisiologia , Ferimentos e Lesões/fisiopatologia , Fatores Etários , Antineoplásicos/efeitos adversos , Doenças Autoimunes/complicações , Doenças Autoimunes/fisiopatologia , Doença Crônica , Doenças Genéticas Inatas/complicações , Doenças Genéticas Inatas/fisiopatologia , Humanos , Infecções/complicações , Infecções/fisiopatologia , Falência Renal Crônica/complicações , Transtornos Nutricionais/complicações , Transtornos Nutricionais/fisiopatologia , Lesões por Radiação/complicações , Lesões por Radiação/fisiopatologia , Pele/efeitos da radiação , Dermatopatias/complicações , Dermatopatias/fisiopatologia , Fumar/efeitos adversos , Fumar/fisiopatologia , Ferimentos e Lesões/complicações
7.
Artigo em Inglês | MEDLINE | ID: mdl-31958295

RESUMO

OBJECTIVE: Balanced nutrition is important for patients with diabetes, and nutrition might well influence diabetes-related complications, although there is limited evidence for this supposition at present. Consequently, we investigate the association between dietary behaviors and renal function decline among patients with diabetes. RESEARCH DESIGN AND METHODS: From 2011 to 2013, a total of 2797 patients with type 2 diabetes participated in the Diabetes Shared Care Program at Chang Gung Memorial Hospital. All received nutritional consulting by dieticians and an eight-item list of unhealthy dietary behaviors, which included the excessive intake of carbohydrates, fats, protein, fruit, pickled foods, dessert and alcohol, as well as inadequate dietary vegetable. Estimated glomerular filtration rate (eGFR) decline ≥40% was defined as a surrogate end point for kidney damage. Independent dietary risk factors predicting poor renal outcomes were assessed. RESULTS: Stable mean glycated hemoglobin (A1c) (7.78% to 7.75%, p=0.151), improved cholesterol (174.04 to 170.13 mg/dL, p<0.001) and low-density lipoprotein (104.19 to 98.07 mg/dL, p<0.001) were found in patients throughout 2 years of therapy. However, significant eGFR decline was noted (94.20 to 88.08 mL/min/1.73 m2, p<0.001). A total of 125 subjects had eGFR decline ≥40% and 2672 had stable renal progression.In regression analysis, 625 stable renal patients (selected via propensity score matching) and 125 subjects with eGFR decline ≥40% demonstrated excessive pickled foods to be predictive of poor renal outcomes (OR 1.861, 95% CI 1.230 to 2.814, p=0.003). CONCLUSIONS: Our study suggests that excessive pickled foods deteriorate renal function more than other unhealthy dietary behaviors in patients with diabetes.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Nefropatias Diabéticas/etiologia , Dieta/efeitos adversos , Comportamento Alimentar , Transtornos Nutricionais/fisiopatologia , Insuficiência Renal Crônica/etiologia , Biomarcadores/análise , Glicemia/análise , Progressão da Doença , Feminino , Seguimentos , Hemoglobina A Glicada/análise , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Insuficiência Renal Crônica/patologia , Fatores de Risco
8.
Eur J Clin Nutr ; 73(10): 1422-1430, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31285552

RESUMO

BACKGROUND: Most body composition techniques assume constant properties of fat free mass (FFM) (hydration and density) regardless of nutritional status, which may lead to biased values. AIM: To evaluate the interactive associations of age and body mass index (BMI) with hydration and density of FFM. METHODS: Data from subjects aged between 4 and 22 years old from several studies conducted in London, UK were assessed. Hydration (HFFM) and density (DFFM) of FFM obtained from the four-component model in 936 and 905 individuals, respectively, were assessed. BMI was converted in to z-scores, and categorised into five groups using z-score cut-offs (thin, normal weight, overweight, obese, and severely obese). Linear regression models for HFFM and DFFM were developed using age, sex, and BMI group as predictors. RESULTS: Nearly 30% of the variability in HFFM was explained by models including age and BMI groups, showing increasing HFFM values in heavier BMI groups. On the other hand, ∼40% of variability in DFFM was explained by age, sex, and BMI groups, with DFFM values decreasing in association with higher BMI group. CONCLUSION: Nutritional status should be considered when assessing body composition using two-component methods, and reference data for HFFM and DFFM is needed for higher BMI groups to avoid bias. Further research is needed to explain intra-individual variability in FFM properties.


Assuntos
Fatores Etários , Composição Corporal , Índice de Massa Corporal , Água Corporal , Adolescente , Água Corporal/fisiologia , Peso Corporal , Criança , Pré-Escolar , Feminino , Humanos , Londres , Masculino , Transtornos Nutricionais/fisiopatologia , Estado de Hidratação do Organismo , Adulto Jovem
9.
Nutr Metab Cardiovasc Dis ; 29(4): 319-324, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30782507

RESUMO

AIMS: The nutritional management of renal transplant recipients (RTR) represents a complex problem either because the recovery of renal function is not complete and for the appearance of "unavoidable" metabolic side effects of immunosuppressive drugs. Nevertheless, it remains a neglected problem, whereas an appropriate dietary intervention could favorably affect graft survival. DATA SYNTHESIS: Renal transplantation is associated with steroids and calcineurin inhibitors administration, liberalization of diet after dialysis restrictions, and patients' better quality of life. These factors predispose, from the first months after surgery, to body weight gain, enhanced post transplant diabetes, hyperlipidemia, metabolic syndrome, with negative consequences on graft outcome. Unfortunately, specific guidelines about this topic and nutritional counseling are scarce; moreover, beyond the low adherence of patients to any dietary plan, there is a dangerous underestimation of the problem by physicians, sometimes with inadequate interventions. A prompt and specific nutritional management of RTR can help prevent or minimize these metabolic alterations, mostly when associated with careful and repeated counseling. CONCLUSIONS: A correct nutritional management, possibly tailored to enhance patients' motivation and adherence, represents the best preventive maneuver to increase patients' life and probably improve graft survival, at no cost and with no side effects.


Assuntos
Sobrevivência de Enxerto , Transplante de Rim , Transtornos Nutricionais/prevenção & controle , Terapia Nutricional/métodos , Estado Nutricional , Dieta Saudável , Humanos , Imunossupressores/efeitos adversos , Transplante de Rim/efeitos adversos , Transtornos Nutricionais/etiologia , Transtornos Nutricionais/fisiopatologia , Qualidade de Vida , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
Eur J Dermatol ; 29(6): 619-626, 2019 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-31903952

RESUMO

BACKGROUND: The possible impact of nutritional status on healing and course of disease in patients with chronic wounds is widely suggested, however, most data are based on small groups of patients with no control group and minor afflictions. Clear diagnostic strategies are missing. OBJECTIVES: To analyse in detail the nutritional status of chronic wound patients relative to healthy controls based on a large patient population. MATERIAL AND METHODS: We screened a group of 50 patients for their nutritional status based on body mass index (BMI), the Mini-Nutritional Assessment (MNA), and Nutritional Risk Screening (NRS), as well as additional laboratory investigations. Twenty-five patients suffered from chronic venous leg ulcers and were compared with a matching control group of 25 patients with acute surgical wounds. RESULTS: Patients with chronic venous leg ulcers showed significantly higher BMI, hyperhomocysteinaemia, and higher levels of serum copper but significantly lower levels of vitamin B6, B9 and C, as well as a significantly lower level of zinc. Vitamin D deficiency was present in both groups, however, severe vitamin D deficiency was present only in the leg ulcer group. Mobility was significantly reduced in patients with leg ulcers. CONCLUSION: Ulcer patients are often obese but suffer from qualitative malnutrition, including a lack of vitamin D, which might be explained by reduced mobility and being housebound. Hypoalbuminaemia, as a sign of protein deficiency, was observed significantly more often in patients with chronic leg ulcers, irrespective of wound area or wound duration.


Assuntos
Deficiências Nutricionais/fisiopatologia , Úlcera da Perna/fisiopatologia , Transtornos Nutricionais/fisiopatologia , Estado Nutricional/fisiologia , Ferida Cirúrgica/fisiopatologia , Cicatrização/fisiologia , Doença Aguda , Idoso , Doença Crônica , Estudos Transversais , Feminino , Humanos , Hipoalbuminemia/fisiopatologia , Masculino , Avaliação Nutricional
11.
East Mediterr Health J ; 24(3): 302-310, 2018 Jun 10.
Artigo em Inglês | MEDLINE | ID: mdl-29908026

RESUMO

Background: Growth faltering in early life can adversely affect health in later childhood and adulthood. Growth monitoring of children can provide evidence to help formulate effective strategies to address growth problems but such information on Palestinian children is lacking. Objectives: This study aimed to determine the growth patterns of children under 2 years in Gaza, Palestine. Methods: This retrospective cohort study was conducted in 2014 in 10 randomly selected primary health care clinics in 5 governorates of Gaza. Weight and length data were obtained from the health cards of children born in 2012, and z-scores were calculated and compared with the WHO Growth Standard (2006). Results: A total of 2 632 children's cards were included at the beginning of the study. Weight-for-age and weight-forlength decreased from birth to 6 months to about -0.40 SD but increased afterwards to -0.11 SD and 0.34 SD at 24 months respectively. Length-for-age declined after 6 months, reaching -0.85 SD at 24 months. At 6 months, the prevalence of underweight and stunting were 5% and 9% but at 24 months, the prevalence was 4% and 20% respectively. Wasting was highest at 6 months (10%) but decreased to 3% at 24 months. Significantly more girls were stunted at 9, 12 and 18 months (P < 0.001), underweight at 24 months (P < 0.05) and wasted at 12 months (P < 0.05). Early life faltering in length was more pronounced than weight, with stunting occurring in one fifth of boys and girls by 2 years of age. Conclusions: Preventive strategies are urgently needed to address early life causes of undernutrition, particularly stunting, in Palestinian children in Gaza.


Assuntos
Desenvolvimento Infantil , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/fisiopatologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Oriente Médio/epidemiologia , Estudos Retrospectivos
12.
Maturitas ; 111: 61-68, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29673833

RESUMO

Peak bone mass is the maximum bone mass that accrues during growth and development. Consolidation of peak bone mass normally occurs during early adulthood. Low peak bone mass results from failure to achieve peak bone mass genetic potential, primarily due to bone loss caused by a variety of conditions or processes occurring at younger ages than usual. Recognized causes of low peak bone mass include genetic causes, endocrine disorders, nutritional disorders, chronic diseases of childhood or adolescence, medications, and idiopathic factors.


Assuntos
Densidade Óssea , Osso e Ossos/patologia , Osso e Ossos/fisiopatologia , Doenças do Sistema Endócrino/complicações , Transtornos Nutricionais/complicações , Osteoporose/etiologia , Densidade Óssea/genética , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/complicações , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/fisiopatologia , Doenças do Sistema Endócrino/fisiopatologia , Feminino , Humanos , Transtornos Nutricionais/fisiopatologia , Tamanho do Órgão , Osteoporose/genética
13.
J Intern Med ; 284(1): 37-49, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29706028

RESUMO

Understanding the physiological and metabolic underpinnings that confer individual differences in responses to diet and diet-related chronic disease is essential to advance the field of nutrition. This includes elucidating the differences in gene expression that are mediated through programming of the genome through epigenetic chromatin modifications. Epigenetic landscapes are influenced by age, genetics, toxins and other environmental factors, including dietary exposures and nutritional status. Epigenetic modifications influence transcription and genome stability are established during development with life-long consequences. They can be inherited from one generation to the next. The covalent modifications of chromatin, which include methylation and acetylation, on DNA nucleotide bases, histone proteins and RNA are derived from intermediates of one-carbon metabolism and central metabolism. They influence key physiological processes throughout life, and together with inherited DNA primary sequence, contribute to responsiveness to environmental stresses, diet and risk for age-related chronic disease. Revealing diet-epigenetic relationships has the potential to transform nutrition science by increasing our fundamental understanding of: (i) the role of nutrients in biological systems, (ii) the resilience of living organisms in responding to environmental perturbations, and (iii) the development of dietary patterns that programme physiology for life-long health. Epigenetics may also enable the classification of individuals with chronic disease for specific dietary management and/or for efficacious diet-pharmaceutical combination therapies. These new emerging concepts at the interface of nutrition and epigenetics were discussed, and future research needs identified by leading experts at the 26th Marabou Symposium entitled 'Nutrition, Epigenetics, Genetics: Impact on Health and Disease'. For a compilation of the general discussion at the marabou symposium, click here http://www.marabousymposium.org/.


Assuntos
Doença Crônica/terapia , Epigenômica/métodos , Transtornos Nutricionais/genética , Terapia Combinada , Humanos , Individualidade , Transtornos Nutricionais/dietoterapia , Transtornos Nutricionais/fisiopatologia , Prognóstico
15.
Food Res Int ; 104: 4-13, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29433782

RESUMO

Socio-economic dynamics determine the transition from diets characterized by the risk of famine, to those characterized by the risk of diet-related non-communicable disease (DR-NCD). This transition is of particular concern in Sub-Saharan Africa (SSA) in which key socio-economic interactions that influence diet include economic growth and rapid urbanization; inequality and a growing middle class; and obesogenic food environments and an increasing prevalence of DR-NCD. In each case, countries in SSA are among those experiencing the most rapid change in the world. These interactions, styled as 'keystones', affect the functioning of other components of the food system and the diets that result. Data from the wealthiest quartile of countries in SSA suggest that these keystones may be increasing the risk of DR-NCD, widening inequalities in health outcomes due to unbalanced diets. To address this, new consumer and government capabilities that address these keystones are required. Food sensitive urban planning, supporting food literacy and fiscal management of consumption are examples.


Assuntos
Dieta Saudável , Abastecimento de Alimentos , Doenças não Transmissíveis/prevenção & controle , Transtornos Nutricionais/prevenção & controle , Comportamento de Redução do Risco , Determinantes Sociais da Saúde , África ao Sul do Saara/epidemiologia , Dieta Saudável/economia , Comportamento Alimentar , Abastecimento de Alimentos/economia , Disparidades nos Níveis de Saúde , Humanos , Doenças não Transmissíveis/economia , Doenças não Transmissíveis/epidemiologia , Transtornos Nutricionais/economia , Transtornos Nutricionais/epidemiologia , Transtornos Nutricionais/fisiopatologia , Estado Nutricional , Valor Nutritivo , Prevalência , Fatores de Proteção , Recomendações Nutricionais , Medição de Risco , Fatores de Risco , Determinantes Sociais da Saúde/economia , Fatores Socioeconômicos , Urbanização
16.
Nutrients ; 10(1)2018 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-29304025

RESUMO

Surveys in high-income countries show that inadequacies and deficiencies can be common for some nutrients, particularly in vulnerable subgroups of the population. Inadequate intakes, high requirements for rapid growth and development, or age- or disease-related impairments in nutrient intake, digestion, absorption, or increased nutrient losses can lead to micronutrient deficiencies. The consequent subclinical conditions are difficult to recognize if not screened for and often go unnoticed. Nutrient deficiencies can be persistent despite primary nutrition interventions that are aimed at improving dietary intakes. Secondary prevention that targets groups at high risk of inadequacy or deficiency, such as in the primary care setting, can be a useful complementary approach to address persistent nutritional gaps. However, this strategy is often underestimated and overlooked as potentially cost-effective means to prevent future health care costs and to improve the health and quality of life of individuals. In this paper, the authors discuss key appraisal criteria to consider when evaluating the benefits and disadvantages of a secondary prevention of nutrient deficiencies through screening.


Assuntos
Deficiências Nutricionais/economia , Deficiências Nutricionais/prevenção & controle , Países Desenvolvidos/economia , Renda , Programas de Rastreamento/economia , Transtornos Nutricionais/economia , Transtornos Nutricionais/prevenção & controle , Estado Nutricional , Prevenção Secundária/economia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Redução de Custos , Análise Custo-Benefício , Deficiências Nutricionais/diagnóstico , Deficiências Nutricionais/fisiopatologia , Feminino , Custos de Cuidados de Saúde , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Transtornos Nutricionais/diagnóstico , Transtornos Nutricionais/fisiopatologia , Gravidez , Medição de Risco , Fatores de Risco , Prevenção Secundária/métodos , Resultado do Tratamento , Adulto Jovem
17.
J Steroid Biochem Mol Biol ; 180: 81-86, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-28734988

RESUMO

Vitamin D is a fat-soluble hormone that has endocrine, paracrine and autocrine functions. Consumption of vitamin D-supplemented food & drugs have increased significantly in the last couple of decades due to campaign and awareness programs. Despite such wide use of artificial vitamin D supplements, serum level of 25 hydroxyvitamin D does not always reflect the amount of uptake. In contrast to the safe sunlight exposure, prolonged and disproportionate consumption of vitamin D supplements may lead to vitamin D intoxication, even without developing hypervitaminosis D. One of the reasons why vitamin D supplementation is believed to be safe is, it rarely raises serum vitamin D levels to the toxic range even after repeated intravenous ingestion of extremely high doses of synthetic vitamin D analogs. However, prolonged consumption of vitamin D supplementation may induce hypercalcemia, hypercalciuria and hyperphosphatemia, which are considered to be the initial signs of vitamin D intoxication. It is likely that calcium and phosphorus dysregulation, induced by exogenous vitamin D supplementation, may lead to tissue and organ damages, even without developing hypervitaminosis D. It is needed to be emphasized that, because of tight homeostatic control of calcium and phosphorus, when hypercalcemia and/or hyperphosphatemia is apparent following vitamin D supplementation, the process of tissue and/or organ damage might already have been started.


Assuntos
Suplementos Nutricionais , Hipercalcemia/etiologia , Hipercalciúria/etiologia , Hiperfosfatemia/etiologia , Transtornos Nutricionais/fisiopatologia , Vitamina D/efeitos adversos , Vitaminas/efeitos adversos , Humanos , Vitamina D/administração & dosagem , Vitaminas/administração & dosagem
18.
Adv Exp Med Biol ; 1010: 281-293, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-29098678
19.
Int J Dev Neurosci ; 62: 25-31, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28760641

RESUMO

The expression of different behavioral components in the adult rat depends on a number of early influences, including age, hormones, manipulations of sensory cues, and perinatal undernutrition, all of which impact the development of brain areas underlying adaptive processes, maternal behavior, and the response to novelty. The current study investigates the effects of pre- and neonatal undernutrition on various components of maternal behavior of dams exposed to the challenge of an unfamiliar home cage on days 4, 8, and 12 of lactation. Food restriction was initiated from gestational day (G) G6 to G19 when dams received 50-70% of the normal balanced diet, followed by 100% from G20 to G21. After birth, pups were underfed by alternating every 12h between two lactating dams, one of which, had ligated nipples. Weaning was at 25days of age followed by an ad libitum diet until postpartum day 90, when females were mated, and subsequently tested for maternal behavior in an unfamiliar cage. The results indicated that in early underfed mothers the frequency of handling wood shavings and of, approaching, licking, crouching, and grasping pups for retrieval was significantly reduced. Moreover, self-grooming increased substantially in the underfed dams, but the frequency of rearing was reduced. Additionally, the body weight of pups nursed by early underfed dams was significantly lower than that of control pups. These findings suggest a relation between early food restriction and the deficient maternal care observed when these dams were challenged by exposure to an unfamiliar home cage.


Assuntos
Comportamento Materno/fisiologia , Privação Materna , Transtornos Nutricionais/fisiopatologia , Complicações na Gravidez/fisiopatologia , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Animais , Animais Recém-Nascidos , Peso Corporal , Feminino , Asseio Animal , Masculino , Gravidez , Ratos , Ratos Wistar
20.
Semin Pediatr Neurol ; 24(1): 70-80, 2017 02.
Artigo em Inglês | MEDLINE | ID: mdl-28779868

RESUMO

Vitamins and minerals have essential functions in the body, from signal transduction to acting as cofactors for numerous enzymatic processes. Nutritional deficiencies and excess of certain vitamins and minerals can have profound effects on the central and peripheral nervous systems from early development into adulthood. This article summarizes the role of various nutritional factors in the nervous system and the neurological symptoms that can arise from deficiency or excess.


Assuntos
Doenças do Sistema Nervoso/complicações , Transtornos Nutricionais/complicações , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Humanos , Micronutrientes/deficiência , Micronutrientes/toxicidade , Doenças do Sistema Nervoso/diagnóstico por imagem , Doenças do Sistema Nervoso/fisiopatologia , Transtornos Nutricionais/diagnóstico por imagem , Transtornos Nutricionais/fisiopatologia , Medula Espinal/diagnóstico por imagem , Medula Espinal/fisiopatologia
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