RESUMEN
BACKGROUND: Palm olein is used in infant formula fat blends in order to match the fatty acid profile of human milk. While the effects on fatty acid balance have been evaluated, the use of palm olein in combination with palm kernel oil and supplementation with docosahexaenoic acid (DHA) and arachidonic acid (ARA) has not been similarly assessed in infants. This study evaluated the effects of infant formulas containing different fat compositions on the balance of fat, fatty acids, and calcium. METHODS: In this randomized, crossover, double-blinded study, 33 healthy term infants (68-159 ± 3 days of age at enrollment) were fed two formulas for 14 days in a tolerance period, followed by a 4-day metabolic balance period in 17 of the male subjects. The study compared two commercially available milk-based powdered formulas in Brazil; the PALM formula contained palm olein (44%), kernel palm oil (21.7%), and canola oil (18.5%) as the predominant fats, whereas the NoPALM formula contained other fat sources. RESULTS: Fat absorption (%) was greater for NoPALM versus PALM-fed infants (96.55 and 95.50%, respectively; p = 0.023). The absorption percentage of palmitic acid (C16:0) did not differ significantly between formulas (p > 0.05), but this acid was excreted at significantly higher concentrations in the PALM (29.42 mg/kg/day) than in the NoPALM (12.28 mg/kg/day) formula groups. DHA and ARA absorption percentages were also higher in NoPALM-fed infants. Calcium absorption was higher in NoPALM-fed infants (58.00%) compared to those fed PALM (40.90%), but the difference was not significant (p = 0.104) when calcium intake was used as a covariate. However, calcium retention was higher in NoPALM-fed infants compared to that in PALM-fed infants with or without calcium intake as a covariate. Adverse events did not differ between groups (p > 0.05). CONCLUSIONS: The absorption of essential fatty acids was similar for both formulas; however, long-chain polyunsaturated fatty acids (DHA and ARA) were better absorbed from the NoPALM formula. Fat absorption and calcium retention were lower in term infants fed the PALM-based formula. CLINICAL TRIAL REGISTRATION: Clinicaltrial.gov # NCT00941564 .
Asunto(s)
Ácido Araquidónico/administración & dosificación , Grasas de la Dieta/administración & dosificación , Ácidos Docosahexaenoicos/administración & dosificación , Glicéridos/administración & dosificación , Fórmulas Infantiles/análisis , Aceites de Plantas/administración & dosificación , Aceite de Brassica napus/administración & dosificación , Ácido Araquidónico/orina , Brasil , Calcio/orina , Estudios Cruzados , Grasas de la Dieta/orina , Ácidos Docosahexaenoicos/orina , Método Doble Ciego , Heces/química , Absorción Gastrointestinal/fisiología , Glicéridos/orina , Humanos , Lactante , Recién Nacido , Masculino , Leche Humana/química , Leche Humana/metabolismo , Aceite de Palma , Ácido Palmítico/orina , Aceites de Plantas/metabolismo , Aceite de Brassica napus/metabolismoRESUMEN
OBJECTIVE: To describe and compare maternal perception and the self-perception of children/adolescents of their nutritional status, identifying factors associated with incorrect perceptions. METHODS: Cross-sectional study carried out in Salvador, BA, Brazil with 1,741 students aged 6 to 19 years, classified according to body mass index (BMI) percentiles as underweight (BMI < p5), well-nourished (p5 = BMI < p85), at risk of overweight (p85 = BMI < p95) or overweight (BMI >/= p95). Students and their mothers answered questions on perception of weight, patterns of physical exercise and dieting. By means of multivariate analysis, factors associated with incorrect maternal and self- perceptions were analyzed. RESULTS: Self-perceptions were correct in 64.7% of cases and 75.3% of maternal perceptions were correct. The principal factor associated with incorrect self-perception was age between 6 and 9 years (OR = 1.59; 95%CI 1.15-2.20). Among girls, being overweight and practicing physical exercise were characteristics associated with better perception. For boys, the presence of overweight resulted in an increased risk of incorrect self-perception. Among mothers, having an overweight child (OR = 3.02; 95%CI 2.05-4.46) and a child aged from 6 to 9 years (OR = 1.88; 95%CI 1.28-2.76) were associated with incorrect perception. CONCLUSIONS: A failure to correctly perceive weight was very frequent among children and their mothers, especially when children were overweight. These factors could represent obstacles to correctly recognizing nutritional abnormalities.
Asunto(s)
Madres , Estado Nutricional , Obesidad/psicología , Percepción , Autoimagen , Adolescente , Adulto , Índice de Masa Corporal , Brasil/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Masculino , Obesidad/epidemiología , Instituciones Académicas , Encuestas y CuestionariosRESUMEN
Objetivos: Avaliar o consumo alimentar de crianças e adolescentes com mucopolissacaridose.Métodos: Série de casos de mucopolissacaridose acompanhados regularmente em um serviço de referência da cidade de Salvador, Bahia, no período de janeiro a abril de 2012. Foram considerados para inclusão pacientes de ambos os sexos, entre dois e 18 anos de idade, com ingestão alimentar por via oral, sem complicações clínicas. Foi aplicada anamnese estruturada contemplando informações socioeconômicas, clínicas e avaliação da ingestão alimentar. Dados de consumo alimentar foram obtidos através do recordatório alimentar de 24 horas e registro alimentar de três dias. Foram avaliadas as possíveis inadequações alimentares através das recomendações da Dietary Reference Intakes, 2005. Os dados foram tabulados no Epidata 3.1 e analisados no pacote estatístico R.Resultados: Foram estudados oito meninos e duas meninas, com idade mediana de 10 anos (intervalo interquartil 6,4 anos, mínima 3, máxima 16 anos). O tipo mais frequente da doença foi a mucopolissacaridose VI (60%). Seis pacientes necessitavam de auxílio para se alimentar, nove apresentaram baixa ingestão de calorias e seis apresentaram baixa ingestão de lipídios. Todos os pacientes apresentavam insuficiente ingestão de fibras e consumo adequado de carboidratos e proteínas. O consumo de todos os micronutrientes apresentou inadequação.Conclusões: Detectou-se alta frequência de inadequação no consumo alimentar de crianças e adolescentes com mucopolissacaridose. Algumas limitações osteoarticulares causadas pela doença acarretam problemas na ingestão de alimentos, tendo muitos pacientes necessidade de auxílio no ato de se alimentar. A conduta nutricional especializada poderá auxiliar na qualidade de vida e no prognóstico desses indivíduos...
AIMS: To assess the dietary intake of children and adolescents with mucopolysaccharidosis.METHODS: Series of cases of mucopolysaccharidosis regularly followed in a referral center in Salvador, Bahia state, Brazil, in January-April 2012. Patients of both sexes aged between 2 and 18 years with food intake by mouth and without clinical complications were considered to inclusion. Structured anamnesis was applied contemplating socioeconomic, clinical, and dietary intake information. The food consumption data were obtained from 24-hour dietary recall and food record of three days. Possible dietary inadequacies were evaluated facing the recommendations of the Dietary Reference Intakes, 2005. Data were tabulated in 3.1 Epidata and analyzed by the statistical package R.RESULTS: Eight boys and two girls, with a median age of 10 years (interquartile range 6.4 years, minimum 3, maximum 16 years) were studied. The most common type of the disease was Mucopolysaccharidosis VI (60 %) and less frequent mucopolysaccharidosis I (10%). Six patients needed assistance to feed, nine had low calorie intake, and six had low intake of lipids. All patients had insufficient intake of fiber and adequate intake of carbohydrates and proteins. The intake of all micronutrients had impairments.CONCLUSIONS: There was a high frequency of inadequate dietary intake in children and adolescents with mucopolysaccharidosis. Some osteoarticular limitations caused by the disease lead to problems in food intake, and many patients need assistance in the act of eating. A specialized nutritional intervention may assist in quality of life and prognosis of these individuals...
Asunto(s)
Humanos , Dieta , Ingestión de Alimentos , Estudios Transversales , MucopolisacaridosisRESUMEN
OBJETIVO:Descrever as características clínicas e demográficas dos pacientes com diagnóstico de hiperfenilalaninemia acompanhados no Serviço de Referência em Triagem Neonatal da Bahia. MÉTODOS: Estudo transversal de 99 famílias (111 afetados) com fenótipo bioquímico de hiperfenilalaninemia, com coleta de dados em prontuários e em banco de dados laboratorial, incluindo aspectos demográficos e clínicos. RESULTADOS: A incidência de hiperfenilalaninemia na Bahia foi de um caso a cada 16.334 nascidos vivos, com cobertura de 91 por cento. Dentre os pacientes acompanhados, 82 por cento foram diagnosticados pela triagem neonatal e, em 11 famílias, havia mais de um caso. O fenótipo clássico da fenilcetonúria foi diagnosticado em 63 (57 por cento) pacientes. Entre os triados, a mediana de idade na primeira consulta foi 39,5 dias e, deles, 34 por cento apresentavam sintomatologia nesse momento; nenhum com atraso no desenvolvimento neuropsicomotor. A consanguinidade foi descrita em 32 por cento dos casos e houve predomínio de pacientes classificados como brancos (63 por cento). Os pais tinham baixa escolaridade e baixa renda. Dos 417 municípios da Bahia, 15 por cento apresentavam pelo menos um caso, com concentração na região nordeste (10 por cento) e na capital do Estado (14 por cento). CONCLUSÕES: Os resultados evidenciaram idade tardia ao início do tratamento, o que pode comprometer os resultados do programa. Observou-se também presença de consanguinidade e recorrência familiar, reforçando a importância da investigação familiar para diagnosticar indivíduos com deficiência mental de etiologia não esclarecida que podem se beneficiar de tratamento.
OBJECTIVE:To describe demographic and clinical characteristics of patients with hyperphenylalaninemia followed at the Neonatal Screening Reference Service of Bahia, Brazil. METHOD:Cross-sectional study including 99 families (111 affected individuals) with biochemical phenotype of hyperphenylalaninemia by chart review and laboratory database that include demographic and clinical features. RESULTS: The incidence of hyperphenylalaninemia in Bahia was one case per 16,334 live births, covering 91 percent of them. Among patients followed, 82 percent were diagnosed by newborn screening and, in 11 families, there were more than one case. The classic phenotype of phenylketonuria was diagnosed in 63 (57 percent) patients. Among those screened, the median age at first consultation was 39.5 days. Among the patients, 34 percent had symptoms at the first medical consultation, none of them with delayed neurodevelopment. Consanguinity was reported in 32 percent of patients. Affected individuals were predominantly classified as white (63 percent). The parents had low education and low income. Among the 417 municipalities of Bahia, 15 percent had at least one case, with a concentration in the Northeast (10 percent) and in the capital of the State (14 percent). CONCLUSIONS: The results showed elevated age at the beginning of the treatment, which may compromise the program results. Presence of consanguinity and familial recurrence were also noted. Careful investigation of families searching for individuals with mental retardation of unknown etiology that would benefit from the treatment is important.
Asunto(s)
Humanos , Fenilcetonurias/epidemiología , Tamizaje NeonatalRESUMEN
OBJETIVO: Descrever e comparar a percepção materna e a autopercepção da criança/adolescente do seu estado nutricional, identificando fatores associados a erro na percepção. MÉTODOS: Estudo transversal realizado em Salvador (BA) com 1.741 estudantes entre 6 e 19 anos, classificados de acordo com os percentis do índice de massa corporal (IMC) em baixo peso (IMC < p5), eutróficos (p5 ≤ IMC < p85), risco para sobrepeso (p85 ≤ IMC < p95) e sobrepeso (IMC > p95). Perguntas acerca da percepção do peso, padrão de atividade física e realização de dieta foram respondidas por alunos e genitoras. Foram avaliados, através de análise multivariada, fatores associados a erro na autopercepção e percepção materna. RESULTADOS: Houve acerto de 64,7 por cento para a autopercepção e de 75,3 por cento para a percepção das genitoras. O principal fator associado a erro na autopercepção foi a faixa etária entre 6 e 9 anos (OR = 1,59; IC95 por cento 1,15-2,20). Entre as meninas, ter excesso de peso e fazer atividade física foram as características associadas à melhor percepção. Para os meninos, a presença de excesso de peso resultou em maior risco de erro na autopercepção. Entre as genitoras, filho com excesso de peso (OR = 3,02; IC95 por cento 2,05-4,46) e faixa etária de 6 a 9 anos (OR = 1,88; IC95 por cento 1,28-2,76) foram os fatores associados a erro na percepção. CONCLUSÃO: A falta de percepção adequada do peso ocorreu com muita freqüência entre as crianças e suas genitoras, em especial quando havia excesso de peso, fatores que podem representar obstáculos ao correto reconhecimento de alterações nutricionais.
OBJECTIVE: To describe and compare maternal perception and the self-perception of children/adolescents of their nutritional status, identifying factors associated with incorrect perceptions. METHODS: Cross-sectional study carried out in Salvador, BA, Brazil with 1,741 students aged 6 to 19 years, classified according to body mass index (BMI) percentiles as underweight (BMI < p5), well-nourished (p5 ≤ BMI < p85), at risk of overweight (p85 ≤ BMI < p95) or overweight (BMI > p95). Students and their mothers answered questions on perception of weight, patterns of physical exercise and dieting. By means of multivariate analysis, factors associated with incorrect maternal and self- perceptions were analyzed. RESULTS: Self-perceptions were correct in 64.7 percent of cases and 75.3 percent of maternal perceptions were correct. The principal factor associated with incorrect self-perception was age between 6 and 9 years (OR = 1.59; 95 percentCI 1.15-2.20). Among girls, being overweight and practicing physical exercise were characteristics associated with better perception. For boys, the presence of overweight resulted in an increased risk of incorrect self-perception. Among mothers, having an overweight child (OR = 3.02; 95 percentCI 2.05-4.46) and a child aged from 6 to 9 years (OR = 1.88; 95 percentCI 1.28-2.76) were associated with incorrect perception. CONCLUSIONS: A failure to correctly perceive weight was very frequent among children and their mothers, especially when children were overweight. These factors could represent obstacles to correctly recognizing nutritional abnormalities.
Asunto(s)
Adolescente , Adulto , Niño , Preescolar , Femenino , Humanos , Masculino , Madres , Estado Nutricional , Obesidad/psicología , Percepción , Autoimagen , Índice de Masa Corporal , Brasil/epidemiología , Estudios Transversales , Obesidad/epidemiología , Instituciones Académicas , Encuestas y CuestionariosRESUMEN
OBJETIVOS: descrever as características clínicas dos pacientes com hiperfenilalaninemia acompanhados no Serviço de Referência em Triagem Neonatal (SRTN) do estado da Bahia. MÉTODOS: estudo descritivo transversal, tendo como amostra todos os pacientes com diagnóstico conhecido de Hiperfenilalaninemia residentes no estado da Bahia e acompanhados no SRTN até setembro de 2005. Tal população é composta de 46 famílias, num total de 51 pacientes. A análise dos dados foi descritiva, incluindo medidas de tendência central e dispersão. RESULTADOS: houve discreto predomínio do gênero feminino (52,9 por cento). A maioria dos pacientes (78,4 por cento) teve seu diagnóstico estabelecido através da triagem neonatal, tendo, portanto, tratamento precoce. Consangüinidade foi registrada em 32,6 por cento das famílias. A média de início do tratamento entre os pacientes diagnosticados pela triagem neonatal foi de 56,6 37,8 dias, enquanto que entre os pacientes com diagnóstico tardio, foi de 7,1 anos. CONCLUSÕES: o estudo descreve um grupo de pacientes representativo de uma patologia incluída no Programa Nacional de Triagem Neonatal (PNTN), sendo, portanto, de relevância para a saúde pública. Entre os dados clínicos, chama a atenção a média de idade do início do tratamento, superior ao recomendado na literatura, alertando para a necessidade de um maior enfoque no diagnóstico precoce.