Gut microbiota and probiotics: Focus on diabetes mellitus.

The characterization of gut microbiota has become an important area of research in several clinical conditions, including type 2 diabetes (T2DM). Changes in the composition and/or metabolic activity of the gut microbiota can contribute to human health. Thus, this review discusses the effects of probiotics and gut microbiota on metabolic control in these individuals. Relevant studies were obtained from electronic databases such as PubMed/Medline and ISI Web of Science. The main probiotics used in these studies belonged to the genera Lactobacillus and Bifidobacterium. The authors found seven randomized placebo-controlled clinical trials and 13 experimental studies directly related to the effect of probiotics on metabolic control in the context of T2DM. The hypothesis that gut microbiota plays a role in the development of diabetes indicates an important beginning, and the potential of probiotics to prevent and reduce the severity of T2DM is better observed in animal studies. In clinical trials, the use of probiotics in glycemic control presented conflicting results, and only few studies have attempted to evaluate factors that justify metabolic changes, such as markers of oxidative stress, inflammation, and incretins. Thus, further research is needed to assess the effects of probiotics in the metabolism of diabetic individuals, as well as the main mechanisms involved in this complex relationship.

Meal replacement based on Human Ration modulates metabolic risk factors during body weight loss: a randomized controlled trial.

PURPOSE: A meal replacement may be an effective strategy in the management of obesity to increase antioxidant intake, attenuating oxidative stress and inflammation. In the present study, we investigated the efficacy of a new nutritional supplement to reduce metabolic risk parameters in obese women. METHODS: In a randomized controlled crossover study (2 × 2), 22 women (percentage body fat 40.52 ± 3.75%; body mass index-BMI 28.72 ± 2.87 kg/m²; 35.04 ± 5.6 years old) were allocated into two treatments: hypocaloric diet and drink containing "Human Ration" (HR) consumption (CRHR), and hypocaloric diet and control drink consumption (CR). The study consisted of 2 periods of 5 weeks with 1 week of washout in two orders (CR → CRHR and CRHR → CR). Caloric restriction was 15%, based on estimated energy requirement. Anthropometric, clinical and metabolic risk parameters were assessed at baseline and at the end of each period. RESULTS: Some metabolic risk factors were favorably modulated in both interventions: reduction in body weight (CR -0.74 ± 1.27 kg; p = 0.01; CRHR -0.77 ± 1.3 kg; p = 0.02), body mass index (BMI) (CR -0.27 ± 0.51 kg/m²; p = 0.02; CRHR -0.30 ± 0.52 kg/m²; p = 0.01) and HOMA-IR (CR -0.35 ± 0.82; p = 0.02, CRHR -0.41 ± 0.83; p = 0.03). However, CRHR reduced waist circumference (-2.54 ± 2.74 cm; p < 0.01) and gynoid fat (-0.264 ± 0.28 g; p < 0.01), and increased HDL-c levels (0.08 ± 0.15 mmol/l; p = 0.04). CONCLUSION: Associated with hypocaloric diet, the intake of a nutritional supplement rich in phytochemicals as a breakfast substitute for 5 weeks had no additional effect on weight reduction than caloric restriction alone, but increased central lipolysis and improved the lipoprotein profile.

The addition of whole soy flour to cafeteria diet reduces metabolic risk markers in wistar rats.

BACKGROUND: Soybean is termed a functional food because it contains bioactive compounds. However, its effects are not well known under unbalanced diet conditions. This work is aimed at evaluating the effect of adding whole soy flour to a cafeteria diet on intestinal histomorphometry, metabolic risk and toxicity markers in rats. METHODS: In this study, 30 male adult Wistar rats were used, distributed among three groups (n = 10): AIN-93 M diet, cafeteria diet (CAF) and cafeteria diet with soy flour (CAFS), for 56 days. The following parameters were measured: food intake; weight gain; serum concentrations of triglycerides, total cholesterol, HDL-c, glycated hemoglobin (HbA1c), aspartate (AST) and alanine (ALT) aminotransferases and Thiobarbituric Acid Reactive Substances (TBARS); humidity and lipid fecal content; weight and fat of the liver. The villous height, the crypt depth and the thickness of the duodenal and ileal circular and longitudinal muscle layers of the animals were also measured. RESULTS: There was a significant reduction in the food intake in the CAF group. The CAFS showed lower serum concentrations of triglycerides and serum TBARS and a lower percentage of hepatic fat, with a corresponding increase in thickness of the intestinal muscle layers. In the CAF group, an increase in the HbA1c, ALT, lipid excretion, liver TBARS and crypt depth, was observed associated with lower HDL-c and villous height. The addition of soy did not promote any change in these parameters. CONCLUSIONS: The inclusion of whole soy flour in a high-fat diet may be helpful in reducing some markers of metabolic risk; however, more studies are required to clarify its effects on unbalanced diets.

Fish oil improves the lipid profile and reduces inflammatory cytokines in Wistar rats with precancerous colon lesions.

A fatty diet is regarded as one of the most important risk factors related to the etiology of colorectal cancer, and this effect is linked to the quantity and principal types of fatty acids consumed. In this study, the chemopreventive effects of different oils on rats were investigated. Forty Wistar rats received 1,2-dimetilhidrazine (DMH) and were divided into 4 groups fed normal lipid diets to which 4% olive, fish, flaxseed, or soybean oils (control) were added. The group fed with fish oil presented higher levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid in hepatic tissue and greater levels of linolenic acid and EPA in adipose tissue compared to the other treatments. In the proximal portion of the colon, lower levels of aberrant crypt foci were found in the fish and flaxseed oil groups; however, this behavior was not observed in the middle and distal regions. Via a benchmarking method, the fish oil group showed a greater transforming growth factor ß expression and lower interleukin-8 expression in relation to the other treatments. Fish oil in a normal lipid diet demonstrated a limited protective effect on the colonic precancerous mucosa in carcinogen-treated rodents, whereas it had a beneficial effect on inflammatory modulation.

In vivo protein quality of new sorghum genotypes for human consumption.

The in vivo protein qualities were evaluated in flours from raw sorghum grains (RF) and flours from sorghum grains subjected to heat treatment in an oven (HTF) from the hybrids BRS 305, BRS 309 and BRS 310, developed by the Brazilian Agricultural Research Corporation (Embrapa). There were no differences in feed efficiency ratios among experimental groups. Heat-treated flour from BRS 309 and BRS 310 genotypes had higher protein efficiency ratios and net protein ratio values; however, they did not differ from those of flour from raw grain of BRS 310 genotype. Effects of heat treatment were observed in the BRS 309 genotype. Heat treatment did not affect true digestibility observed for the RF and HTF of the three genotypes. Lysine was the first limiting amino acid of the three sorghum genotypes. The HTF BRS 305 showed the lowest protein digestibility-corrected amino acid score value. Heat treatment improved the protein quality of genotype BRS 309; however, no differences were observed among the other genotypes.

Heat-treated hull flour does not affect iron bioavailability in rats.

In this study the chemical composition and iron bioavailability of hull and hull-less soybean flour from the new cultivar UFVTN 105AP was evaluated. The hemoglobin depletion-repletion method was used in Wistar rats. Soybean hull flour presented 37% more total dietary fiber and higher content of iron than hull-less soybean flour. The phytate:iron molar ratio, however, was 2-fold lower in the soybean hull flour in compared to the hull-less soybean flour. Animals fed soybean hull flour presented hemoglobin gains similar to those of the control diet group (p > 0.05). The Relative Biological Values of hull and hull-less soybean flour were 68.5% and 67.1%, respectively, compared to the control group. Heat-treated soybean hull flour (150 degrees C/30 minutes) showed high content of iron and low phytate, which favors the iron bioavailability. Thus, the soybean hull flour is a better source of dietary fiber and iron than hull-less soybean flour at comparable bioavailabilities.

Eating habits, lifestyle and intestinal constipation in children aged four to seven years.

INTRODUCTION: Objective: to investigate the association between intestinal constipation, lifestyle and eating habits in four to seven year old children. Methods: a cross-sectional study with a sample of 152 children aged four to seven years old. Intestinal constipation was characterized according to the Rome IV criteria. Excess weight was classified by the body mass index. Variables that could be associated with constipation, such as maternal constipation, lifestyle, food and water intake, were selected. In the analysis, the prevalence ratio using Poisson regression, with a robust variance and statistical significance was set at p < 0.05. Results: the prevalence of intestinal constipation was 32.2% (n = 49), of which 34.7% (n = 17) of the children were overweight. As for lifestyle, 73% of the children did not practice any regular physical activities and approximately 60% spent more than two hours a day in sedentary activities, such as watching television or playing electronic games. A statistically significant association was found between constipation and daily school time equal to or greater than 4.5 hours (p = 0.007), non-consumption of fruits (p = 0.003) and greens (p = 0.007) and regular intake of fried food (p = 0.003). Conclusion: an association between intestinal constipation and unhealthy habits, such as non-consumption of fruits and vegetables, and regular consumption of fried food was observed. Preventing intestinal constipation requires changes in the lifestyle and eating habits of the children and family.

INTRODUCCIÓN: Objetivo: investigar la asociación entre estreñimiento intestinal, estilo de vida y hábitos alimentarios en niños de cuatro a siete años. Métodos: estudio transversal con muestra de 152 niños de cuatro a siete años. El estreñimiento intestinal se caracterizó según los criterios de Roma IV. El exceso de peso fue clasificado por el índice de masa corporal. Se seleccionaron variables que podrían estar asociadas al estreñimiento, como el estreñimiento materno, el estilo de vida, los hábitos alimentarios y el consumo de agua. En los análisis, la razón de prevalencia mediante regresión de Poisson con una varianza robusta y significación estadística se estableció < 0,05. Resultados: la prevalencia de estreñimiento intestinal fue del 32,2%, de la cual el 34,7% presentaba un exceso de peso. En cuanto al estilo de vida, el 71% de los niños no practicaba actividad física regular y aproximadamente el 60% pasaba más de dos horas diarias realizando actividades sedentarias, como ver la televisión y jugar a videojuegos. Se pudo constatar una asociación estadísticamente significativa entre el estreñimiento y un tiempo diario en la escuela igual o superior a 4,5 horas (p = 0,007), escaso consumo de frutas (p = 0,003) y verduras (p = 0,007) y consumo regular de frituras (p = 0,003). Conclusiones: se pudo observar una relación directa entre el estreñimiento intestinal y los hábitos no saludables, como no consumir frutas y verduras y el consumo regular de frituras. La prevención del estreñimiento intestinal requiere cambios en el estilo de vida y los hábitos alimentarios del niño y la familia.

Clinical-nutritional, inflammatory and oxidative stress predictors in hemodialysis mortality: a review.

The evaluation of clinical-nutrition status is essential to increase life quality and improve clinical outcomes of patients in hemodialysis (HD). In the absence of a gold standard, the goal of this integrative review was to present and discuss the latest scientific literature on the ability of clinical-nutritional indicators and inflammatory and oxidative stress markers to predict morbidity and mortality in HD. In this context, the lean and fat mass indexes have become good predictors of mortality in HD individuals, regardless of BMI. Subjective scoring systems have been more sensitive to malnutrition, and altogether anthropometric indicators may result in an early detection of mortality risk in this population. On the other hand, inflammation in HD, as assessed by C-reactive protein, is not only related to cardiometabolic alterations, but it is also one of the key-points in the development of malnutrition, exacerbated by the state of oxidative stress, which has been identified in this group by the increase of the serum levels of gamma-glutamyl transferase and malondialdehyde.

Anti-obesity effects of tea from Mangifera indica L. leaves of the Ubá variety in high-fat diet-induced obese rats.

Due to the high content of bioactive compounds, herbal teas are being investigated as adjuvant in chronic disease management. Studies have shown that mango leaf tea contain mangiferin, total phenolics and antioxidants, compounds with many functional properties. Therefore, this study aims to evaluate the anti-obesity effects of tea from Mangifera indica L. leaves, Ubá variety (TML), in obese rats fed a high-fat diet (HFD). For this, adult male Wistar rats were divided into three groups (n=8): the control group (fed AIN-93 diet), obese group (fed a HFD) and treated group (fed a HFD and supplemented with TML for 8 weeks). We analysed biometric measures and serum biochemical parameters of metabolic control, inflammation and oxidative stress biomarkers, histomorphometry of visceral adipose tissue and mRNA expression of peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PPAR-γ), lipoprotein lipase (LPL) and fatty acid synthase (FAS). The consumption of TML (24.7±2.1mL/day) exerted antioxidant and anti-inflammatory effects, increasing total antioxidant capacity and interleukin-10 serum concentrations, reduced abdominal fat accumulation, upregulated PPAR-γ and LPL and downregulated FAS expression. Our data suggest that TML has therapeutic potential in treating obesity and related diseases through regulating the expression of transcriptional factors and enzymes associated with adipogenesis.

[Measurements of location of body fat distribution: an assessment of colinearity with body mass, adiposity and stature in female adolescents]. / Medidas de localização da gordura corporal: uma avaliação da colinearidade com massa corporal, adiposidade e estatura em adolescentes do sexo feminino.

OBJECTIVE: To verify the correlation between body fat location measurements with the body mass index (BMI), percentage of body fat (%BF) and stature, according to the nutritional status in female adolescents. METHODS: A controlled cross sectional study was carried out with 113 adolescents (G1: 38 eutrophic, but with high body fat level, G2: 40 eutrophic and G3: 35 overweight) from public schools in Viçosa-MG, Brazil. The following measures have been assessed: weight, stature, waist circumference (WC), umbilical circumference (UC), hip circumference (HC), thigh circumference, waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), waist-to-thigh ratio (WTR), conicity index (CI), sagittal abdominal diameter (SAD), coronal diameter (CD), central skinfolds (CS) and peripheral (PS). The %BF was assessed by tetrapolar electric bioimpedance. RESULTS: The increase of central fat, represented by WC, UC, WSR, SAD, CD and CS, and the increase of peripheral fat indicated by HC and thigh were proportional to the increase of BMI and %BF. WC and especially the UC showed the strongest correlations with adiposity. Weak correlation between WHR, WTR, CI and CS/PS with adiposity were observed. The stature showed correlation with almost all the fat location measures, being regular or weak with waist. CONCLUSIONS: The results indicate colinearity between body mass and total adiposity with central and peripheral adipose tissue. We recommend the use of UC for assessing nutritional status of adolescents, because it showed the highest ability to predict adiposity in each group, and also presented regular or weak correlation with stature.

Modulators of erythrocyte glutathione peroxidase activity in healthy adults: an observational study.

The aim of this study was to investigate the potential modulators of erythrocyte glutathione peroxidase (GPx) activity in young and apparently healthy individuals. One hundred one individuals (53 women and 48 men) were evaluated for anthropometric measurements, biochemical markers, clinical, dietary, and endogenous and exogenous components of the antioxidant defense system. Statistical analysis was performed to detect differences among subjects by the median of GPx activity. A linear regression model and Spearman correlation coefficients were used to screen the associations between GPx activity and interest variables. Individuals with higher GPx enzymatic activity were older and higher circulating levels of oxidized low-density lipoprotein (ox-LDL) values, but conversely lower nail concentrations of selenium and copper (P < 0.05). The GPx activity was positively correlated to truncal fat percentage values (r = 0.24, P = 0.016), circulating levels of ox-LDL (r = 0.28, P = 0.004), and daily vitamin C intake (r = 0.28, P = 0.007), and negatively correlated to the nail concentration of selenium (r = -0.24, P = 0.026). Interesting, it was noticed that the truncal fat percentage and circulating levels of ox-LDL explained 5.9 and 7.4% of the GPx enzymatic activity. Thus, preventive measures such as adequate antioxidant intake and proper fat percentage would be a priority in the nutritional care of young and apparently healthy individuals.

Low energy and carbohydrate intake associated with higher total antioxidant capacity in apparently healthy adults.

OBJECTIVES: The aim of this study was to investigate the associations between plasma total antioxidant capacity (TAC) and anthropometric, biochemical, clinical, and dietary measurements in young and apparently healthy individuals. METHODS: We evaluated 156 individuals (91 women and 65 men; ages 23.1 ± 3.5 y; body mass index 22 ± 2.9 kg/m(2)) for anthropometrics, biochemical markers, clinical, dietary, and some components of the antioxidant defense system, including the plasma TAC. Statistical analyses were performed to detect differences between individuals with TAC higher and lower than the mean value and to screen the associations between TAC and variables of interest. A linear regression model was fitted to identify TAC predictors. RESULTS: Daily caloric intake and macronutrient consumption were lower in individuals who exhibited the highest TAC values (P < 0.05). Linear regression analysis showed that daily calories and carbohydrate intake was a possible negative TAC predictor (P < 0.05). Nevertheless, there was no difference in the values of oxidized low-density lipoprotein in the individuals separated by means of TAC. In contrast, individuals whose plasma TAC values were above the mean showed higher low-density lipoprotein cholesterol concentrations, total cholesterol/high-density lipoprotein cholesterol values, and selenium in nails (P < 0.05). CONCLUSIONS: In physiological conditions, the caloric intake level seems to be an important factor to act in the modulation of plasma TAC, before establishing anthropometric impairments of body or metabolic composition, or both. Additionally, the plasma TAC increase may be able to act as a compensatory mechanism.

[Insulin resistance and components of metabolic syndrome, analysis by gender and stage of adolescence]. / Resistência à insulina e componentes da síndrome metabólica, análise por sexo e por fase da adolescência.

OBJECTIVE: To analyze the influence of metabolic syndrome components in insulin resistance, by gender and adolescence phase. SUBJECTS AND METHODS: We evaluated biochemical, clinical, lifestyle and body composition data of 800 adolescents from 10 to 19 years old, from both genders, from Viçosa, MG/Brasil, and there was the division by stage: early (10 to 13 years), intermediate (14 to 16 years) and late (17 to 19 years). RESULTS: 10.3 and 3.4% had, respectively, insulin resistance and metabolic syndrome. In the initial phase there was a higher prevalence of dyslipidemia and intermediate hyperuricemia and excess body fat. Females had a higher prevalence of dyslipidemia, excess body fat and insulin resistance and higher male prevalence of low HDL, hyperuricemia and blood pressure changes. Those from the initial phase had higher levels of total cholesterol, LDL, HDL, triglycerides, fasting glucose and waist/hip ratio, stayed less time sitting and had more meals (p < 0.05) in relation to other phases. The final model, adjusted for gender, was different for each phase of adolescence. CONCLUSIONS: Insulin resistance is associated with inadequate body composition, in biochemical levels and lifestyle, being the factors associated different in each phase of adolescence.

Markers of healthy eating habits, water intake, and constipation in children between 4 and 7 years of age / Marcadores de alimentação saudável, ingestão de água e constipação intestinal em crianças de 4 a 7 anos de idade

ABSTRACT Objective To evaluate the association between diet and constipation in children between four and seven years of age. Methods A cross-sectional study with 152 children between 4 and 7 years of age residing in Viçosa, Brazil. Constipation was defined in accordance with the Rome IV diagnostic criteria. Dietary habits were evaluated based on the frequency of food intake using a food diary for three days. Dietary analysis considered foods deemed healthy and unhealthy which could be associated with constipation, as well as the children's consumption of fruits and vegetables. The amounts of fiber and water consumed were also rated as adequate or inadequate. As part of the analyses, Student's t-test and the chi-square test were performed with a significance level of p<0.05. Results The prevalence of constipation was 32.2%. Constipation was more common among children who did not consume fruits (p=0.020) or greens (p=0.002), as well as among children who consumed "instant" chocolate drinks (p=0.033). An association was found between the frequent consumption of fried food (p=0.020), a daily water intake lower than 600mL, and constipation (p=0.028). Conclusion Unhealthy eating habits among children, such as the lack of fruit and greens intake and the consumption of "instant" chocolate drinks and fried foods, were found to be positively correlated with constipation. The low fruit and vegetable consumption observed herein reflects the need for changes in children's eating habits and the implementation of measures to promote the intake of healthy foods.

RESUMO Objetivo O estudo visa avaliar a associação do consumo alimentar de crianças de quatro a sete anos de idade com constipação intestinal. Métodos Foi realizado estudo transversal com 152 crianças de 4 a 7 anos, residentes em Viçosa, Minas Gerais, Brasil. A constipação intestinal foi identificada de acordo com os critérios de Roma IV. Avaliou-se o consumo alimentar por meio da frequência de consumo de alimentos e do registro alimentar de três dias. Na análise do consumo alimentar selecionaram-se os alimentos marcadores de alimentação saudável e não saudável que poderiam estar associados à constipação, além do consumo agrupado de frutas, verduras e legumes. Verificou-se ainda adequação do consumo de fibras e ingestão de água. Nas análises, foram realizados os testes t-Student e qui-quadrado, considerando-se como significância estatística p<0,05. Resultados A prevalência de constipação foi de 32,2%, sendo maior entre as crianças que não consumiam frutas (p=0,020) e verduras (p=0,002) e consumiam achocolatados (p=0,033). Houve associação entre a constipação (p=0,028) e o consumo frequente de frituras (p=0,020), ingestão diária de água inferior a 600mL. Conclusão Hábitos não saudáveis das crianças, como a baixa ingestão de frutas e verduras, e o consumo de achocolatado e frituras, contribuíram para a associação positiva com a constipação. O baixo consumo de frutas, verduras e legumes revela a necessidade de alteração dos hábitos alimentares das crianças, bem como da implantação de ações para incentivo ao consumo de alimentos saudáveis.

[The promotion of health and integrated prevention of risk factors for cardiovascular diseases]. / A promoção da saúde e a prevenção integrada dos fatores de risco para doenças cardiovasculares.

Cardiovascular diseases are currently the most common causes of morbimortality worldwide. In the context of disease prevention, actions creating favorable health environments and promoting healthy choices prove fundamental. Intervention programs with a community basis have been introduced in different countries since the beginning of the 1970s, aiming to modify cardiovascular risk factors and decrease morbidity and mortality due to cardiovascular diseases. In such experiences, the importance of public policies and cardiovascular risk vigilance systems needs to be stressed, permitting a more accurate assessment of the magnitude of the problem and the development of more cost-effective actions. The scope of this bibliographical study was to describe community-geared experiences in many countries in the campaign against cardiovascular diseases through health promotion and primary prevention of risk factors, as well as to identify in Brazil the vigilance actions of the risk factors of non-transmissible chronic diseases, stressing the strategic challenges facing the Family Health Program in tackling cardiovascular diseases.

Effect of dry coffee residues fermented with Monascus ruber on the metabolism of Apo E mice.

BACKGROUND: Atherosclerosis is a chronic inflammatory disease of multifactorial origin, which occurs in response to endothelial injury. The fungus Monascus ruber has hypocholesterolemic activity, and the polyphenols present in coffee residue have an antioxidant activity and can help prevent cardiovascular diseases. Coffee residue has a significant amount of fermentable sugars, being an adequate substrate for growing fungi. OBJECTIVE: The objective of this study was to assess the effect of dry coffee residue fermented with Monascus ruber on the lipid metabolism of ApoE knockout mice. METHODS: The biological assay was performed with 30 ApoE knockout mice, divided into five groups and undergoing different treatments. The phytochemical prospection and quantification of phenolic compounds of the fermented and non-fermented coffee residues were performed. The sera of the animals were analyzed by using enzyme kits, and the aortic tissue was embedded in paraffin and stained with hematoxylin and eosin to undergo histopathological analysis. RESULTS: Comparing with the control group, the group receiving 2% non-fermented coffee residue showed a reduction of 42% in the serum levels of triacylglycerols and of approximately 41% in VLDL-c. The groups receiving 10% non-fermented coffee residue and 2% fermented coffee residue showed reductions in the lesion areas of 10.5% and 15.4%, respectively, as compared with the control group. The fermented coffee residue showed a higher content of phenolic compounds as compared with the non-fermented coffee residue. CONCLUSION: The present study showed that coffee residue fermentation has a potentially beneficial effect on cardiovascular diseases, especially atherosclerosis.

Nutritional status variation and intestinal and extra intestinal symptomatology in patients with celiac disease and non-celiac gluten sensitivity given specialized dietary advice / Evolução do estado nutricional e sintomatologia intestinal e extra intestinal em pacientes com doença celíaca e sensibilidade ao glúten não celíaca submetidos à orientação dietética especializada

ABSTRACT Objective: To investigate the nutritional status variation and symptomatology of patients with celiac disease and non-celiac gluten sensitivity after specialized dietary advice Methods: This prospective study included 80 patients with celiac disease and non-celiac gluten sensitivity. Clinical, metabolic, and nutritional variables were collected from medical records, and the symptomatology was investigated by the Metabolic Screening Questionnaire. The variables were assessed on two occasions (T1 - before dietary advice and T2 - after dietary advice) with an interval of three months between T1 and T2 Results: The median age was 42 years. The prevalences of celiac disease and non-celiac gluten sensitivity were 66.2% and 33.8%, respectively. Normal weight prevailed at T1 (58.8%) and T2 (56.3%), but 30.0% of the patients at T1 and 34.9% of the patients at T2 had excess weight. The two conditions had similar symptomatology. The most frequent signs and symptoms on both occasions involved the gastrointestinal tract, followed by energy/activity and emotions. All symptoms decreased significantly after the introduction of a proper diet Conclusion: The patients were normal weight on both study occasions (T1 and T2), and the symptoms improved after dietary advice. Thus, we reinforce the importance of proper dietary management in both clinical conditions to make dietary adjustments that improve these individuals' symptomatology.

RESUMO Objetivo: Investigar a evolução do estado nutricional e a sintomatologia de pacientes com doença celíaca e sensibilidade ao glúten não celíaca após orientação dietética especializada Métodos: O estudo prospectivo foi realizado com 80 pacientes portadores da doença celíaca e de sensibilidade ao glúten não celíaca. A coleta das variáveis clínicas, metabólicas e nutricionais foi feita por análise dos prontuários, enquanto a sintomatologia foi investigada por meio de Questionário de Rastreamento Metabólico. As variáveis foram avaliadas em dois momentos (T1 - antes da orientação dietética e T2 - após orientação dietética), com intervalo de 3 meses entre T1 e T2 Resultados: A mediana de idade foi de 42 anos. A prevalência de doença celíaca e de sensibilidade ao glúten não celíaca foi de 66,2% e 33,8%, respectivamente. A eutrofia prevaleceu como estado nutricional de T1 (58,8%) e T2 (56,3%), porém 30,0% dos pacientes em T1 e 34,9% em T2 apresentaram excesso de peso. A sintomatologia foi similar entre as duas enfermidades. Os sinais e sintomas mais frequentes nos dois tempos foram os do trato digestório, seguido pelos relacionados à energia/atividade e às emoções. Todos os sintomas diminuíram significativamente após a introdução da dieta Conclusão: Os pacientes apresentaram estado nutricional de eutrofia nos dois momentos avaliados (T1 e T2) e houve redução dos sintomas após as orientações nutricionais. Dessa forma, reitera-se a importância do manejo dietético adequado para ambas as enfermidades clínicas a fim de adequar a dieta que favoreça a melhora da sintomatologia apresentada por esses indivíduos.

Perfil nutricional e fatores associados ao baixopeso e à redução do consumo alimentar emcrianças hospitalizadas / Nutritional profile and factors associaed with low body weight andreduction of food intake in hospitalized children

A avaliação do estado nutricional de crianças hospitalizadas assume um papel fundamental na identificação precocede riscos nutricionais. Assim, é de grande relevância identificar variáveis que exercem impacto no estado nutricional ena aceitação dos alimentos no ambiente hospitalar. O objetivo do trabalho foi avaliar o perfil nutricional de criançasinternadas em um hospital e analisar as variáveis que exercem influência no diagnóstico nutricional e no consumoalimentar durante a hospitalização. O estado nutricional foi avaliado por meio da aferição de peso, comprimento/estatura,cálculo do Índice de Massa Corporal e avaliação dos índices antropométricos. A avaliação bioquímica foi realizadaa partir das informações disponíveis no prontuário clínico. Os dados socioeconômicos, alimentares, de aleitamentomaterno e avaliação da aceitação das refeições oferecidas foram coletados por meio de aplicação de um questionárioao responsável pela criança. Participaram do estudo 208 crianças, sendo 61,5% do sexo masculino e mediana deidade de 21,5(6-59) meses. Quanto ao estado nutricional, 80% das crianças foram classificadas como eutróficas, 10%apresentavam magreza e 10% excesso de peso. As crianças com baixo peso tiveram mais linfocitopenia (p=0,038)e também foram as que apresentaram menor tempo de aleitamento materno exclusivo (p=0,015). As crianças queapresentaram concentrações elevadas de PCR e leucócitos apresentaram baixa aceitação da dieta oferecida (p=0,034e p=0,040, respectivamente). Foram identificados fatores que se associaram ao baixo peso e a menor aceitação dasrefeições pelas crianças. Assim, atenção específica deve ser dada àquelas com alteração do estado inflamatório e commenor tempo de aleitamento materno exclusivo.

The evaluation of nutritional status in hospitalized children plays a critical role in the early identification of nutritionalrisk. Thus, it is of great importance to identify variables that have an impact on nutritional status and acceptance of foodin the hospital environment. The objective of this work to evaluate the nutritional status of hospitalized children, thevariables that influence the nutritional diagnosis and food intake during hospitalization. Nutritional status was evaluatedby measurement of weight, length / height, body mass index and anthropometric indices. The biochemical evaluationwas performed based on the information available in the medical record. Socioeconomic, dietary and breastfeedingdata and, evaluation of the acceptance of meals offered were obtained through a questionnaire to the responsable forthe children. The study included 208 children, predominantly male (61.5%) and median age of 21.5 (6-59) months. Inrelation to nutritional status, 80% of children were classified eutrophic, 10% were thinness and 10% overweight. Childrenwith low weight had more cases of lymphocytopenia (p = 0.038) and were also those who had shorter time of exclusivebreastfeeding (p = 0.015). Children with elevated concentrations of PCR and leukocytes showed low acceptance of theoffered diet (p = 0.034 and p = 0.040, respectively). Factors associated with low weight and lower acceptance of mealsby children were identified. Particular attention should be given to children with altered inflammatory status and shortertime of exclusive breastfeeding.

Avaliação da estabilidade da capacidade antioxidante e de parâmetros físico-químicos de néctares de frutas caseiros / Assessment of the antioxidant capacity and of the physicalchemicals parameters stability in homemade fruit nectars

Este estudo avaliou a capacidade antioxidante e os indicadores físico-químicos de néctares caseiros de laranja, manga e maracujá, mantidos sob refrigeração (5 ± 2 o C) por 24 horas. Os néctares foram preparados em laboratório e mantidos sob refrigeração, simulando as condições domésticas. As análises foram realizadas após o preparo (T0) e durante o acondicionamento sob refrigeração (1 h, 4 h e 24 h). Os sólidos solúveis, pH e cor foram determinados respectivamente por refratometria, potenciometria e colorimetria. Carotenoides e ácido ascórbico foram analisados por cromatografia líquida de alta eficiência; a concentração de compostos fenólicos foi determinada utilizando-se o reagente de Folin Ciocalteau e a atividade antioxidante pelo teste do DPPH. Ácido ascórbico, β-caroteno e compostos fenólicos foram identificados em todos os néctares. Foram encontrados α-caroteno e β-criptoxantina no néctar de laranja e licopeno no néctar de manga. Durante 24 horas de refrigeração, os compostos analisados e a atividade antioxidante mantiveram-se estáveis. De forma geral, os parâmetros físico-químicos também se mantiveram estáveis durante o período avaliado. Em conclusão, sob as condições utilizadas no presente estudo, os néctares não apresentaram alteração da capacidade antioxidante, podendo ser considerados fontes de carotenoides e vitamina C, mesmo se consumidos após 24 horas de preparo.

The objective of the study was to evaluate the antioxidant capacity and the physical-chemical indicators of homemade nectars of orange, mango and passion fruit, kept under refrigeration (5 ± 2 °C) for 24 hours. The nectars were prepared in laboratory and kept under refrigeration simulating the domestic conditions. The samples analyses were performed after their preparations (T0) and during the refrigerated storage (1 h, 4 h and 24 h). Soluble solids, pH and color were determined by refractometry, colorimetry and potentiometry, respectively. Carotenoids and ascorbic acid were analyzed by high performance liquid chromatography, the concentration of phenolic compounds were determined by using Folin Ciocalteau reagent, and the antioxidant activity by the DPPH test. Ascorbic acid, β-carotene and phenolic compounds were identified in all of the analyzed nectars samples. The α-carotene and β-cryptoxanthin were found in orange nectar and the lycopene in mango nectar samples. During the refrigeration for 24 hours, the analyzed compounds and the antioxidant activity remained stable. In general, the physical-chemicals parameters also remained stable during the storage for 24 hours. In conclusion, under the conditions used in this study, the nectars might be considered as antioxidant sources, even if consumed after being prepared 24 hours before.

Avaliação da estabilidade da capacidade antioxidante e de parâmetros físico-químicos de néctares de frutas caseiros / Assessment of the antioxidant capacity and of the physicalchemicalsparameters stability in homemade fruit nectars

Este estudo avaliou a capacidade antioxidante e os indicadores físico-químicos de néctares caseirosde laranja, manga e maracujá, mantidos sob refrigeração (5 ± 2 oC) por 24 horas. Os néctaresforam preparados em laboratório e mantidos sob refrigeração, simulando as condições domésticas.As análises foram realizadas após o preparo (T0) e durante o acondicionamento sob refrigeração(1 h, 4 h e 24 h). Os sólidos solúveis, pH e cor foram determinados respectivamente por refratometria,potenciometria e colorimetria. Carotenoides e ácido ascórbico foram analisados por cromatografialíquida de alta eficiência; a concentração de compostos fenólicos foi determinada utilizando-seo reagente de Folin Ciocalteau e a atividade antioxidante pelo teste do DPPH. Ácido ascórbico,β-caroteno e compostos fenólicos foram identificados em todos os néctares. Foram encontradosα-caroteno e β-criptoxantina no néctar de laranja e licopeno no néctar de manga. Durante 24 horasde refrigeração, os compostos analisados e a atividade antioxidante mantiveram-se estáveis. De formageral, os parâmetros físico-químicos também se mantiveram estáveis durante o período avaliado.Em conclusão, sob as condições utilizadas no presente estudo, os néctares não apresentaramalteração da capacidade antioxidante, podendo ser considerados fontes de carotenoides e vitamina C,mesmo se consumidos após 24 horas de preparo.

The objective of the study was to evaluate the antioxidant capacity and the physical-chemicalindicators of homemade nectars of orange, mango and passion fruit, kept under refrigeration(5 ± 2 °C) for 24 hours. The nectars were prepared in laboratory and kept under refrigerationsimulating the domestic conditions. The samples analyses were performed after their preparations(T0) and during the refrigerated storage (1 h, 4 h and 24 h). Soluble solids, pH and color weredetermined by refractometry, colorimetry and potentiometry, respectively. Carotenoids andascorbic acid were analyzed by high performance liquid chromatography, the concentrationof phenolic compounds were determined by using Folin Ciocalteau reagent, and the antioxidantactivity by the DPPH test. Ascorbic acid, β-carotene and phenolic compounds were identified inall of the analyzed nectars samples. The α-carotene and β-cryptoxanthin were found in orangenectar and the lycopene in mango nectar samples. During the refrigeration for 24 hours,the analyzed compounds and the antioxidant activity remained stable. In general, thephysical-chemicals parameters also remained stable during the storage for 24 hours. In conclusion,under the conditions used in this study, the nectars might be considered as antioxidant sources,even if consumed after being prepared 24 hours before.