Ultra-processed food intake is associated with children and adolescents with congenital heart disease clustered by high cardiovascular risk factors.

The excessive intake of ultra-processed foods (UPF) is associated with an increase in cardiovascular risk. However, the effect of UPF intake on cardiovascular health in children and adolescents with congenital heart disease (CHD) is unknown. The aim of the present study was to describe UPF intake and evaluate associations with isolated cardiovascular risk factors and children and adolescents with CHD clustered by cardiovascular risk factors. A cross-sectional study was conducted involving 232 children and adolescents with CHD. Dietary intake was assessed using three 24-hour recalls. UPFs were categorized using the NOVA classification. The cardiovascular risk factors evaluated were central adiposity, elevated high-sensitivity C-reactive protein (hs-CRP) and subclinical atherosclerosis. The clustering of cardiovascular risk factors (waist circumference, hs-CRP and carotid intima-media thickness) was performed, allocating the participants to two groups (high versus low cardiovascular risk). UPFs contributed 40.69% (SD 6.21) to total energy intake. The main UPF groups were ready-to-eat and take-away/fast foods (22.2% energy from UPFs). The multivariable logistic regression revealed that an absolute increase of 10% in UPF intake (OR=1.90; 95% CI: 1.01;3.58) was associated with central adiposity. An absolute increase of 10% in UPF intake (OR=3.77; 95% CI: 1.80;7.87) was also associated with children and adolescents with CHD clustered by high cardiovascular risk after adjusting for confounding factors. Our findings demonstrate that UPF intake should be considered a modifiable risk factor for obesity and its cardiovascular consequences in children and adolescents with CHD.

An Update on the Biological Activities of Euterpe edulis (Juçara).

The palm tree Euterpe edulis, known as juçara, produces spherical and purple fruits, similar to those of the Euterpe oleracea and Euterpe precatoria palm trees, from which the common name açaí originates. Juçara fruit has been gaining prominence in the scientific world for its interesting nutritional composition, which is rich in antioxidants, and for its sustainable production model. Recently, relevant biological activities have been associated with the juçara fruit, and its use in alimentation has become an important nutritional, environmental, and economic alternative. The aim of this review is to compile recent scientific data about the phytochemical characterization and biological activities of E. edulis. A review of the literature was conducted in two electronic databases, Medline and Science Direct. The eligibility criteria were as follows: phytochemicals characterize of the E. edulis fruits and evaluate biological effects in vitro or in vivo with pulp, extract, juice, or product of juçara fruits. Investigations were excluded if they used other parts of the plant (seeds), did not assess biological activities, or have tested methodologies for compound extraction. From the identified reports, 25 articles were eligible for this study. The promotion of health benefits related to juçara fruits seems to have improved antioxidant activity in vivo, benefits to lipid and glycemic profiles, and modulation of inflammatory status in experimental studies in animals.

The effect of oral dietary interventions on nutritional status and treatment tolerance in patients with hematologic neoplasms receiving chemotherapy: a systematic review.

CONTEXT: Adverse events from chemotherapy treatment affect food intake, nutritional status, and treatment tolerance in cancer patients. However, the effect of nutritional intervention in patients with hematologic neoplasms receiving chemotherapy remains unknown. OBJECTIVE: The aim of this systematic review was to evaluate the evidence on nutritional interventions on nutritional status, treatment tolerance, inflammatory markers, quality of life, and mortality in patients with hematologic neoplasms receiving chemotherapy. DATA SOURCES: The MEDLINE, LILACS, CINAHL, Web of Science, Embase, ICTRP, CENTRAL, and ClinicalTrials.gov databases were searched. Additional literature and the bibliographies of identified articles were also considered. DATA EXTRACTION: Randomized controlled trials in individuals with hematologic neoplasms receiving chemotherapy along with nutritional counseling and oral nutritional supplementation, and intake of supplementary food products, alone or in combination, were assessed as criteria of interest. The data were extracted independently by 2 researchers. The risk of bias was assessed through the Cochrane risk-of-bias tool (RoB 2). DATA ANALYSIS: Ten studies were included up to August 15, 2022 (updated in November of 2022). With regard to the outcomes, 4 studies assessed nutritional status and 2 studies showed a positive result of the intervention on some of the markers. Seven studies assessed certain markers of treatment tolerance and only 2 studies showed improvement in the outcome after the intervention. CONCLUSION: The studies that found positive results are quite different from each other in terms of intervention, study time, and design. More randomized controlled trials are needed to test different dietary interventions using placebo and blinding, when possible, and with reduced sample variability in individuals with hematologic neoplasms receiving chemotherapy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42020196765.

EVALUATION OF DIET ACCEPTANCE BY PATIENTS WITH HAEMATOLOGICAL CANCER DURING CHEMOTHERAPEUTIC TREATMENT.

INTRODUCTION: a compromised nutritional status is one of the factors that may increase the morbidity and mortality of chemotherapy patients. The goal of this study was to evaluate acceptance of the diet by patients with haematological cancer throughout their hospital stay for chemotherapeutic treatment. METHOD: this was a cross-sectional, descriptive, quantitative study, carried out from February to October 2014 in adult patients of both genders diagnosed with lymphoma and leukaemia. Food intake was evaluated on a daily basis through a recording instrument designed by the author. ANOVA test for repeated measurements was employed. RESULTS: 32 patients were evaluated, with a mean age of 42 ± 11 years, the majority of whom were women (66%). We observed gastrointestinal disturbances in 72% of the patients, most commonly nausea (59%), followed by xerostomia (34%), vomiting (28%) and dysgeusia (25%). The percentage of leftover food was significant, varying from 23% to 35%. Lunch and dinner were the most frequently rejected meals. Light meals were more well-tolerated, having been accepted in 75% to 100% of the offers. CONCLUSION: The food records show that during chemotherapy cycles, patients present significant food rejection, specially with larger meals such as lunch and dinner, though light meals are better tolerated. Employing food options chosen by patients may be a strategy to improve dietary acceptance. More studies on this subject are necessary in order to improve nutritional care to this population, aiming to prevent and/or rehabilitate the nutritional status of these patients.

Introducción: el estado nutricional amenazado es uno de los factores que puede elevar la morbimortalidad de los pacientes sometidos a quimioterapia. El objetivo de este estudio fue evaluar la aceptación de la dieta por parte de pacientes con cáncer hematológico durante la internación para quimioterapia. Métodos: investigación transversal, descriptiva y cuantitativa llevada a cabo entre febrero y octubre de 2014 con pacientes adultos de ambos sexos diagnosticados de linfoma y leucemia. Se realizó la evaluación diaria del consumo alimentario mediante la utilización de herramientas para colección de datos preparado por el autor. Se utilizó ANOVA para medidas repetidas. Resultados: fueron evaluados 32 pacientes con edad promedio de 42 ± 11 años, siendo la mayoría mujeres (66%). Observamos trastornos gastrointestinales en el 72% de los pacientes, la mayoría de las molestias fueron náuseas (59%) además de xerostomía (34%), vómitos (28%), inapetencia (28%) y disgeusia (25%). El porcentaje de resto de ingesta alimentaria fue significativo, oscilando entre el 23% y el 35%. El mayor rechazo ocurrió en el almuerzo y la cena. Las meriendas fueron mejor aceptadas, con un porcentaje del 75% al 100%. Conclusión de la investigación: los registros de alimentos mostraron que durante los ciclos de quimioterapia se produjo un rechazo significativo de alimentos sobre todo en las comidas de mayor volumen, como el almuerzo y la cena, mientras que las comidas pequeñas, tales como aperitivos, son mejor toleradas. El uso de opciones de alimentos enumerados por los pacientes puede ser una estrategia para mejorar el cumplimiento de la dieta. Se necesitan más estudios sobre este tema para mejorar la atención a esta población, con el objetivo de prevenir y/o recuperar el estado nutricional de estos pacientes.

Brazilian healthy eating index revised (BHEI-R) of women before and during adjuvant treatment for breast cancer.

INTRODUCTION: Different therapeutic modalities for cancer trigger side effects that affect the selection of food by changing dietary patterns. AIMS: To evaluate changes in the diet quality of women in adjuvant treatment for breast cancer. METHODS: Sociodemographic, clinical and anthropometric data of 78 women were collected. The Brazilian Healthy Eating Index Revised and its components were obtained from food frequency questionnaire applied before and after the treatment. At baseline, participants were classified according to tertiles of diet quality. RESULTS AND DISCUSSION: The score of the Brazilian Healthy Eating Index Revised (BHEI-R) in the lowest tertile was 48.4 to 75.2 points, the second tertile was 75.7 to 81.8 points, and the upper tertile was 82.0 to 95.7 points. During treatment, of the women classified in the first tertile, 62% improved their diet score quality passing to the upper tertiles. Women classified in the second tertile, did not significantly alter the diet quality during the treatment, although 46% went to the third tertile. Patients classified in the third tertile significantly reduced the average score of the Index by 7.3 points during the treatment. Among these women, 38% and 20% decreased their score for the second and first tertiles respectively, where the reduction in the diet quality was due to reducing the score of components Total fruits, Total vegetables, Dark Green and orange vegetables and Legumes, Total grains and Solid fats, Alcohol and Added sugar. CONCLUSION: Dietary changes, which were observed after breast cancer diagnosis, significantly altered the quality of diet among the women participating in the study. Future nutrition interventions are important to aid in food choices during the treatment.

Introducción: Diferentes modalidades terapéuticas para los efectos secundarios de activación de cáncer que afectan a la selección de los alimentos por el cambio de los patrones dietéticos. Objetivo: Evaluar los cambios en la calidad de la dieta de mujeres en tratamiento adyuvante para cáncer de mama. Métodos: se obtuvieron datos sociodemográficos, clínicos y antropométricos de 78 mujeres. El Índice Brasileño de Alimentación Saludable y sus componentes se obtuvieron a partir de cuestionarios de frecuencia alimentar aplicados antes y al final del tratamiento. Los participantes fueron clasificados según terciles de calidad de la dieta con base en las informaciones del inicio del estudio. Resultados: Las puntuaciones del Índice de Calidad de la dieta en el tercil inferior fue 48,4-75,2 puntos, en el segundo tercil fue 75,7-81,8 puntos, y en el tercil superior 82,0-95,7 puntos. Durante el tratamiento, 62 % de las mujeres pertenecientes al primer tercil mejoraron su calidad, pasando para los terciles medio o superior. Las mujeres clasificadas en el segundo tercil no alteraron significativamente la calidad de la dieta durante el tratamiento, a pesar de que 46 % pasó para el tercil superior. Las pacientes pertenecientes al tercer tercil redujeron significativamente la puntuación promedio del Índice en 7,3 puntos durante el tratamiento. Entre estas mujeres, 38% y 20% disminuyeron su puntuación para el segundo y primer tercil, respectivamente. La reducción de la calidad de la dieta fue el resultado de la disminución en la puntuación de los componentes Frutas totales, Verduras totales, Verduras y legumbres de color verde oscuro y naranja, Cereales totales y grasas sólidas, Alcohol y Azúcar añadido. Conclusión: Los cambios observados en la alimentación después del diagnóstico de cáncer de mama alteró significativamente la calidad de la dieta de las mujeres participantes del estudio. Intervenciones nutricionales futuras son importantes para ayudar en la elección de alimentos durante el tratamiento.