Percepção do peso corporal e dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos / Perception of body weight and difficulties encounteredby people with visual impairment in acquiring, preparing and consuming food

Objetivo: investigar a percepção do peso corporal e as dificuldades encontradas pelas pessoas com deficiência visual na aquisição, na preparação e no consumo dos alimentos. Metodologia: estudo observacional transversal, com adultos e idosos com deficiência visual em Pelotas/RS, realizado no período de abril a maio de 2023. Foi utilizado um questionário composto de 42 itens. Os dados coletados foram analisados por análise descritiva e analítica, e apresentados como média ± desvio padrão ou percentual. Resultados: a amostra contou com 20 pessoas, predominantemente do sexo feminino e idosas. Em relação ao consumo alimentar, 50% dos participantes consomem feijão, 75% frutas e hortaliças, 50% bebidas adoçadas, biscoitos recheados e doces. Referente à percepção do peso corporal, percebeu-se que a maior parte do grupo sente que está acima do peso adequado e se sentem "insatisfeitos(as)". Sobre as dificuldades encontradas, 85% dos participantes relataram dificuldade extrema para identificar a validade dos alimentos, 70% para comprar alimentos frescos e perecíveis e 40% para usar a faca para cortar e descascar os alimentos. Conclusão: verificou-se que a maior parte do grupo sente que está acima do peso adequado e estão "insatisfeitos(as)" em relação ao peso corporal. Além disso, dependem de outra pessoa para escolher os alimentos a serem comprados, saber o prazo de validade, preparar alimentos que precisam ser porcionados, servir refeições no prato, cortar carnes, descascar vegetais e frutas, utilizar faca, entre outros. Esta dependência pode influenciar diretamente no seu consumo alimentar quando essas pessoas se encontram sozinhas, optando por consumir alimentos industrializados de fácil preparo ou prontos.

Objective: to investigate the perception of body weight and the difficulties encountered by people with visual impairments in acquiring, preparing and consuming food. Methodology: cross-sectional observational study, with adults and elderly people with visual impairment in Pelotas/RS, carried out from April to May 2023. A questionnaire composed of 42 items was used. The collected data were analyzed using descriptive and analytical analysis, and presented as mean ± standard deviation or percentage. Results: the sample included 20 people, predominantly female and elderly. Regarding food consumption, 50% of participants consume beans, 75% fruits and vegetables, 50% sweetened drinks, stuffed cookies and sweets. Regarding the perception of body weight, it was noticed that the majority of the group feels that they are overweight and feel "dissatisfied". Regarding the difficulties encountered, 85% of participants reported extreme difficulty in identifying the expiration date of food, 70% in purchasing fresh and perishable foods and 40% in using a knife to cut and peel food. Conclusion: it was found that the majority of the group feels that they are overweight and are "dissatisfied" with their body weight. Furthermore, they depend on someone else to choose the food to be purchased, know the expiration date, prepare food that needs to be portioned, serve meals on the plate, cut meat, peel vegetables and fruits, use a knife, among others. This dependence can directly influence their food consumption when these people are alone, choosing to consume easily prepared or ready-made processed foods.

Existem diferenças entre homens e mulheres quanto aos fatores associados à ingestão de cálcio? / Are there differences between men and women with respect to the factors associated with calcium intake?

Resumo O objetivo do artigo é verificar se existem diferenças entre os sexos quanto aos fatores que se associam à ingestão de cálcio. Estudo realizado com dados de inquérito de saúde, em amostra de 1.640 indivíduos de 20 anos ou mais residentes no município de Campinas-SP. A ingestão de cálcio foi obtida por meio de um recordatório de 24 horas (R24h) e analisada segundo variáveis sociodemográficas, de comportamentos de saúde, frequência de refeições e índice de massa corporal (IMC); a presença de associações foi verificada por meio de testes de regressão linear múltipla. O perfil de fatores associados à ingestão de cálcio diferiu entre os sexos. A prática de atividade física no contexto de lazer só se associou ao consumo de cálcio no sexo masculino, enquanto cor da pele, tabagismo, renda, excesso de peso e frequência do café da manhã mostraram associação apenas no sexo feminino. Escolaridade e realização de lanches intermediários mostraram-se associadas à ingestão de cálcio em ambos os sexos. A análise aponta segmentos da população feminina e masculina em que a importância da ingestão de cálcio precisa ser mais enfatizada; além disso, alerta para a importância do desenvolvimento de análises de saúde estratificadas por sexo em decorrência de diferentes padrões comportamentais que prevalecem entre os sexos.

Abstract The scope of this article is to verify if there are differences in factors associated with calcium intake between men and women. It is based on a study conducted with data from a health survey in a sample of 1641 individuals aged 20 years or more living in the urban area of the city of Campinas, in the State of São Paulo. Calcium intake was obtained from a 24-hour recall (24hr recall method) and analyzed according to sociodemographic variables, health behavior, frequency of meals and body mass index (BMI). The existence of associations was verified by multiple linear regression tests, and it was detected that the profile of associated factors differed between genders. Physical exercise in the leisure context was only associated with calcium intake in males, while skin color, smoking, income, overweight/obesity, and frequency of having breakfast only revealed an association in females. Schooling and having snacks were associated with calcium intake in both sexes. The analysis of the associated factors indicates segments of the female and male population in which the importance of calcium intake needs to be more closely examined. Furthermore, it highlights the importance of conducting health analyses stratified by sex due to the different behavioral patterns that prevail between the sexes.

Effects of glyphosate herbicide ingestion on kidney function in rats on a balanced diet / Efeitos da ingestão do herbicida glifosato na função renal de ratos em uma dieta balanceada

Abstract Introduction: Glyphosate is the most widely used herbicide worldwide and in Brazil. There is currently increasing concern about the effects of glyphosate on human health. The Brazilian Institute for Consumer Protection showed data on the presence of glyphosate in some of Brazil's most consumed ultra-processed products. Currently, regulations on the upper limit for these residues in ultra-processed foods have yet to be established by the National Health Surveillance, and ultra-processed food consumption is independently associated with an increased risk of incident chronic kidney disease. Methods: Since an unbalanced diet can interfere with kidney function, this study aims to investigate the effect of daily intake of 5 mg/kg bw glyphosate in conjunction with a balanced diet and the possible impact on renal function in rats. Kidney function, kidney weight, markers of renal injury, and oxidative stress were evaluated. Results: There was a decrease in kidney weight. The main histopathological alterations in renal tissues were vacuolation in the initial stage and upregulation of the kidney injury marker KIM-1. Renal injury is associated with increased production of reactive oxygen species in mitochondria. Conclusion: This study showed changes in the kidney of rats exposed to a balanced diet with glyphosate, suggesting a potential risk to human kidney. Presumably, ultra-processed food that contain glyphosate can potentiate this risk. The relevance of these results lies in drawing attention to the need to regulate glyphosate concentration in ultra-processed foods in the future.

RESUMO Introdução: O glifosato é o herbicida mais utilizado no mundo e no Brasil. Atualmente, há uma preocupação crescente com os efeitos do glifosato na saúde humana. O Instituto Brasileiro de Defesa do Consumidor apresentou dados sobre a presença de glifosato em alguns dos produtos ultraprocessados mais consumidos no Brasil. Atualmente, as regulamentações sobre o limite máximo desses resíduos em alimentos ultraprocessados ainda não foram estabelecidas pela Vigilância Sanitária Nacional, e o consumo de alimentos ultraprocessados está indepen­dentemente associado a um risco maior de doença renal crônica incidente. Métodos: Como uma dieta desbalanceada pode interferir na função renal, este estudo tem como objetivo investigar o efeito da ingestão diária de 5 mg/kg pc de glifosato em conjunto com uma dieta equilibrada e o possível impacto na função renal em ratos. Foram avaliados função renal, peso dos rins, marcadores de lesão renal e estresse oxidativo. Resultados: Houve redução no peso dos rins. As principais alterações histopatológicas nos tecidos renais foram vacuolização no estágio inicial e regulação positiva do marcador de lesão renal KIM-1. A lesão renal está associada à produção aumentada de espécies reativas de oxigênio nas mitocôndrias. Conclusão: Esse estudo mostrou alterações nos rins de ratos expostos a uma dieta balanceada com glifosato, sugerindo um risco potencial ao rim humano. Presumivelmente, alimentos ultraprocessados que contenham glifosato podem potencializar esse risco. A relevância desses resultados está no fato de chamar a atenção para a necessidade de regulamentar a concentração de glifosato em alimentos ultraprocessados no futuro.

Adequação Alimentar de Indivíduos com Doença Cardiovascular Conforme Diretrizes Clínicas no Programa Alimentar Brasileiro Cardioprotetor / Dietary Adequacy of Individuals with Cardiovascular Disease According to Clinical Guidelines in the Brazilian Cardioprotective Nutritional (BALANCE)

Resumo Fundamento Alcançar as metas nutricionais estabelecidas pelas sociedades científicas é um desafio constante e nem sempre alcançado. Objetivo Investigar a adequação alimentar de indivíduos com doença cardiovascular (DCV), participantes do Programa Alimentar Brasileiro Cardioprotetor residentes da região Nordeste do Brasil, segundo as recomendações da Sociedade Brasileira de Cardiologia (SBC). Métodos Análise transversal com dados do estudo de implementação da Dieta Cardioprotetora Brasileira (DICA BR) que avaliou indivíduos com DCV, atendidos em centros especializados em saúde cardiovascular em oito estados do Nordeste. O consumo alimentar foi obtido por recordatório alimentar de 24 horas e a adequação da dieta seguiu as recomendações da SBC. Foram considerados significantes valores de p < 0,05. Resultados Foram estudados 647 pacientes, com média (desvio padrão) de idade de 63,1 (9,4) anos, sendo 50,2% do sexo feminino. Na avaliação da ingestão alimentar, observou-se baixa adequação de carboidratos (52,3%), proteínas (70,9%), lipídios (38,8%) e fibras (22,4%). Observou-se que a maioria das mulheres consumia dieta hipoproteica (59,2%) e idosos tinham maior inadequação no consumo de carboidratos (52,6%). Em relação a ingestão de sódio, os homens apresentaram maior ingestão (72,9%), enquanto os idosos apresentaram redução de 13%. Além disso, foi demonstrado que os homens ingeriam mais fibras (28,1%) e indivíduos com maior escolaridade tinham um consumo elevado de ácidos graxos saturados (70,5%). Conclusões A maioria dos indivíduos não alcançou as metas dietoterápicas preconizadas para prevenção cardiovascular secundária. Os achados do presente estudo reforçam a necessidade de implementação de estratégias estruturadas, a fim de estimular hábitos alimentares saudáveis nesses indivíduos.

Abstract Background Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. Objective To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). Methods Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. Results 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). Conclusions Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals.

"It's a bit exasperating to be locked up"- an exploration of Mexican adolescents' perceived barriers and facilitators for physical activity and healthy eating / "É um pouco irritante estar preso" - uma exploração das barreiras e facilitadores percebidos pelos adolescentes mexicanos para a prática de atividade física e alimentação saudável

Mexican adolescents' diet and physical activity levels fall short of recommendations for health. The aim of this study was to explore Mexican adolescents' perceived barriers and facilitators of physical activity and healthy eating. Twelve single-sex focus groups were conducted in six secondary schools in Mexico City during three months from October 2016. Data were analysed via inductive thematic analysis. Three themes were identified, namely: understanding the health-behaviour link, the impact of a restricted life, and social support. Participants understood how physical activity contributes to multiple dimensions of health, and how diet contributes to physical health. They also identified so-cialising, having fun, and stress relief as facilitators of PA, and knowledge and the desire for healthy food as facilitators for healthy eating. Barriers included inadequate facilities, insufficient time within current school structures, and inadequate social support from teachers. Context-specific physical activity barriers of neighbourhood safety concerns, and limited family support were also reported. Participants had a basic knowledge of healthy eating but showed little motivation to improve their diet. In conclusion, the findings of this study suggest that improvement of opportunities for safe outdoor time, social support, and availability of healthy food would be useful to explore to promote the health behaviours of Mexican adolescents.

A dieta e os níveis de atividade física dos adolescentes mexicanos estão aquém das recomendações para a saú-de. O objetivo deste estudo foi explorar as barreiras percebidas por adolescentes mexicanos e facilitadores da atividade física e da alimentação saudável. Doze grupos focais unissexuais foram realizados em seis escolas secundárias na Cidade do México durante três meses a partir de outubro de 2016. Os dados foram analisados por meio da Análise Temática Indutiva. Foram identificados três temas: compreensão do nexo saúde-comportamento, impacto da restrição de vida e apoio social. Os participantes compreenderam como a atividade física contribui para múltiplas dimensões da saúde e como a dieta contribui para a saúde física. Identificaram a socialização, a diversão e o alívio do estresse como facilitadores da atividade física, e o conhecimento e o desejo por alimentos saudáveis como facilitadores para uma alimentação saudável. As barreiras incluíram instalações inadequadas, tempo insuficiente dentro das estruturas escolares atuais e apoio social inadequado dos professores. Barreiras de atividade física específicas do contexto de preocupações com a segurança da vizinhança e suporte familiar limitado também foram relatados. Os participantes tinham um conhecimento básico sobre alimentação saudável, mas mostraram pouca motivação para melhorar sua dieta. Em conclusão, os resultados deste estudo sugerem que a melhoria das oportunidades de tempo seguro ao ar livre, apoio social e disponibilidade de alimentos saudáveis seria útil para explorar para promover os comportamentos de saúde de adolescentes mexicanos.

Association between diet quality, nutritional status, and sarcopenia in people aged 80 years or older

Objective: To investigate the association between diet quality, nutritional status, and sarcopenia in a sample of the oldest old. Methods: Using a cross-sectional design, individuals aged ≥ 80 years were enrolled. To determine their energy and macronutrient intake, 24-hour dietary recall was used to calculate the Healthy Eating Index. Nutritional status was categorized based on Mini Nutritional Assessment (MNA) scores. Sarcopenia was diagnosed using both the 2010 and 2018 EWGSOP criteria. Electrical bioimpedance was used to calculate the muscle mass index. Muscle strength was measured through handgrip dynamometry, and muscle performance was determined with a 4-m gait speed test. To test the association between the HEI with sarcopenia, means of HEI scores were compared between sarcopenic and non-sarcopenic participants using indendent t-tests. Prevalence rate ratios were calculated using a Poisson Regression model with robust estimation of standard errors. Results: The study population consisted of 119 participants, predominantly women (n = 67; 56.3%), with a mean age of 83.4 (SD, 3.0) years. The prevalence of sarcopenia varied significantly according to the classification criteria, being higher according to EWGSOP 2010 than EWGSOP 2018 criteria (46.7 vs. 17.6%), as expected. Female participants and those categorized as malnourished presented higher prevalence of sarcopenia. Nutrition quality, estimated by the Healthy Eating Index, was not associated with the outcome. Reduced total energy and high protein intake were independently associated with both sarcopenia and severe sarcopenia, regardless of the diagnostic criteria. Conclusions: The Health Eating Index was not associated with sarcopenia in this sample of older adults ≥80 years. Sarcopenia prevalence, as defined by the EWGSOP 2018 criteria, was higher in those with MNA≤24 and with reduced daily total energy comsumption independently of age, sex and education attainment. Higher protein intake, oposed to expected, was indenpendently associated with sarcopenia, possibly due to protopathic bias. Large longitudinal studies are still required to investigate the relationship between nutrition quality and Sarcopenia in 80+ aged adults. (AU)

O Treinamento Resistido Atenua a Remodelação Cardíaca Induzida por uma Dieta Hiperlipídica em Roedores: Uma Revisão Sistemática / Resistance Exercise Training Mitigates Cardiac Remodeling Induced by a High-Fat Diet in Rodents: A Systematic Review

Resumo Fundamento A obesidade está associada ao desenvolvimento de doenças cardiovasculares e constitui um grave problema de saúde pública. Em modelos animais, a alimentação com uma dieta hiperlipídica (DH) compromete a estrutura e a função cardíaca e promove estresse oxidativo e apoptose. O treinamento resistido (TR), entretanto, tem sido recomendado como coadjuvante no tratamento de doenças cardiometabólicas, incluindo a obesidade, porque aumenta o gasto energético e estimula a lipólise. Objetivo Na presente revisão sistemática, nosso objetivo foi avaliar os benefícios do TR no coração de ratos e camundongos alimentados com DH. Métodos Foram identificados estudos originais por meio de busca nas bases de dados PubMed, Scopus e Embase de dezembro de 2007 a dezembro de 2022. O presente estudo foi conduzido de acordo com os critérios estabelecidos pelo PRISMA e registrado no PROSPERO (CRD42022369217). O risco de viés e a qualidade metodológica foram avaliados pelo SYRCLE e CAMARADES, respectivamente. Os estudos elegíveis incluíram artigos originais publicados em inglês que avaliaram desfechos cardíacos em roedores submetidos a mais de 4 semanas de TR e controlados por um grupo controle sedentário alimentado com DH (n = 5). Resultados Os resultados mostraram que o TR atenua o estresse oxidativo cardíaco, a inflamação e o estresse do retículo endoplasmático. Também modifica a atividade de marcadores de remodelamento estrutural, apesar de não alterar parâmetros biométricos, parâmetros histomorfométricos ou a função contrátil dos cardiomiócitos. Conclusão Nossos resultados indicam que o TR parcialmente neutraliza o remodelamento cardíaco adverso induzido pela DH, aumentando a atividade dos marcadores de remodelamento estrutural; elevando a biogênese mitocondrial; reduzindo o estresse oxidativo, marcadores inflamatórios e estresse do retículo endoplasmático; e melhorando os parâmetros hemodinâmicos, antropométricos e metabólicos.

Abstract Background Obesity is associated with the development of cardiovascular diseases and is a serious public health problem. In animal models, high-fat diet (HFD) feeding impairs cardiac structure and function and promotes oxidative stress and apoptosis. Resistance exercise training (RT), however, has been recommended as coadjutant in the treatment of cardiometabolic diseases, including obesity, because it increases energy expenditure and stimulates lipolysis. Objective In this systematic review, we aimed to assess the benefits of RT on the heart of rats and mice fed HFD. Methods Original studies were identified by searching PubMed, Scopus, and Embase databases from December 2007 to December 2022. This study was conducted in accordance with the criteria established by PRISMA and registered in PROSPERO (CRD42022369217). The risk of bias and methodological quality was evaluated by SYRCLE and CAMARADES, respectively. Eligible studies included original articles published in English that evaluated cardiac outcomes in rodents submitted to over 4 weeks of RT and controlled by a sedentary, HFD-fed control group (n = 5). Results The results showed that RT mitigates cardiac oxidative stress, inflammation, and endoplasmic reticulum stress. It also modifies the activity of structural remodeling markers, although it does not alter biometric parameters, histomorphometric parameters, or the contractile function of cardiomyocytes. Conclusion Our results indicate that RT partially counteracts the HFD-induced adverse cardiac remodeling by increasing the activity of structural remodeling markers; elevating mitochondrial biogenesis; reducing oxidative stress, inflammatory markers, and endoplasmic reticulum stress; and improving hemodynamic, anthropometric, and metabolic parameters.

Percepção e satisfação corporal de estudantes universitários vegetarianos / Perception and body satisfaction of vegetarian students / Percepción y satisfacción corporal de los estudiantes vegetarianos

INTRODUÇÃO: A percepção e satisfação corporal têm sido amplamente estudadas em diversos públicos, principalmente em estudantes universitários; porém, existem poucas investigações com vegetarianos, sendo assim, torna-se necessário avaliar se o padrão alimentar vegetariano está relacionado com os fenômenos inerentes à imagem corporal. OBJETIVO: Avaliar a percepção e a satisfação corporal entre estudantes universitários vegetarianos. MÉTODO: Trata-se de um estudo transversal com 123 participantes, no qual foram aplicados o Questionário de Imagem Corporal - BSQ (Body Shape Questionnaire) e a Escala de Silhuetas de Stunkard. RESULTADOS: Os dados mostraram que 86,2% dos participantes eram eutróficos (IMC=22,4±3,3), sendo o score obtido no BSQ foi de 84,6 pontos (±36,0) correspondente à leve insatisfação com a imagem corporal. Cerca de 82,1% dos estudantes se mostravam insatisfeitos com a silhueta, dentre estes, 61,4% desejavam diminuí-la. CONCLUSÃO: O padrão alimentar (ovolactovegetariano, lactovegetariano, vegetariano estrito e vegano) não se relacionou com a insatisfação corporal, mas sim o desejo de ter silhuetas magras que são valorizadas pelo padrão de beleza vigente.

INTRODUCTION: For Body perception and satisfaction have been widely studied among different publics, especially among college students; however, there are few investigations with vegetarians. Therefore, it is necessary to evaluate whether the vegetarian eating pattern is related to the phenomena inherent to body image. OBJECTIVE: To evaluate body perception and body satisfaction among vegetarian college students. METHOD: This is a cross-sectional study with 123 participants, in which the Body Image Questionnaire (BSQ) and the Stunkard Silhouette Scale were applied. RESULTS: The data showed that 86.2% of the participants were eutrophic (BMI=22.4±3.3), and the score obtained in the BSQ was 84.6 points (±36.0) corresponding to a mild dissatisfaction with body image. About 82.1% of the students were dissatisfied with their silhouette, and 61.4% of them wanted to reduce it. CONCLUSION: Dietary patterns (ovolactovegetarian, lactovegetarian, strict vegetarian, and vegan) were not related to body dissatisfaction, but rather the desire to have thin silhouettes that are valued by the prevailing beauty standard.

INTRODUCCIÓN: La percepción y satisfacción corporal han sido ampliamente estudiadas entre diferentes públicos, especialmente entre estudiantes universitarios; sin embargo, existen pocos estudios sobre vegetarianos, por lo que es necesario evaluar si el patrón alimentario vegetariano está relacionado con los fenómenos inherentes a la imagen corporal. OBJETIVO: Evaluar la percepción corporal y la satisfacción corporal entre estudiantes universitarios vegetarianos. MÉTODO: Se trata de un estudio transversal con 123 participantes, en el que se aplicaron el Cuestionario de Imagen Corporal - BSQ (Body Shape Questionnaire) y la Escala de Siluetas de Stunkard. RESULTADOS: Los datos mostraron que el 86,2% de los participantes eran eutróficos (IMC=22,4±3,3), y la puntuación obtenida en el BSQ fue de 84,6 puntos (±36,0) correspondiente a una insatisfacción leve con la imagen corporal. Alrededor del 82,1% de los estudiantes estaban insatisfechos con su silueta, entre ellos, el 61,4% deseaba reducirla. CONCLUSIÓN: El patrón alimentario (ovolactovegetariano, lactovegetariano, vegetariano estricto y vegano) no estaba relacionado con la insatisfacción corporal, sino con el deseo de tener siluetas delgadas que son valoradas por el estándar de belleza vigente.

Use of neutropenic diet in the nutritional care of pediatric cancer patients with neutropenia: a scoping review

Abstract Objective: to carry out a scoping review with the purpose of mapping the scientific evidence on the use of the neutropenic diet in neutropenic pediatric cancer patients. Source of data: The scoping review protocol was prepared in accordance with the PRISMA-ScR and the checklist before the literature search was performed. Articles on nutritional management in adults or on the treatment of other diseases, and articles that were not in Portuguese or English and published before the year 2000, were excluded. Data were extracted based on the Cochrane Consumer and Communication Review Group form. Summary of the findings: Three hundred and forty scientific articles were identified, with the final sample of this review consisting of nine studies. Although the neutropenic diet has been part of the nutritional management of pediatric cancer patients for more than 20 years, there is still great variation in the criteria for indicating use and starting and discontinuing it, as well as in the nutritional composition of the diet. Furthermore, there is no consensus on the impact of using a neutropenic diet on different clinical and nutritional outcomes. Conclusion: In the absence of guidelines that standardize the use of a neutropenic diet in pediatric patients with neutropenia, there are heterogeneous approaches reported in the literature, even within the same institution. The available literature presents an absence of evidence on the use, viability, and effectiveness of the neutropenic diet in oncological children with neutropenia. More studies are needed to identify the real impact of the neutropenic diet on clinical and nutritional outcomes.

Value of precision nutrition in the inflammatory control of systemic lupus erythematosus

Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies directed against endogenous antigens causing various clinical manifestations, chronic inflammation and tissue damage. Although the pathophysiology of SLE remains unknown, it is recognized that genetic, epigenetic, environmental and neuroendocrine factors are involved in the development of the disease and its complications. A notable proportion of patients with SLE also present obesity, and this dysmetabolic profile can cause renal, musculoskeletal and/or respiratory deterioration, fatigue, various pathophysiological alterations and functional deterioration. In this context, precision nutrition emerges as a promising tool in the inflammatory control of SLE, especially in patients with associated obesity. Various studies demonstrate the beneficial influence of balanced dietary patterns in macronutrients with foods rich in fiber, vitamins, minerals, antioxidants and polyphenols on the inflammatory control of SLE and the most diverse pathologies, highlighting the Mediterranean diet and plant-based diets. Finally, the intestinal microbiota may play a relevant role in this clinical scenario, since dysbiosis is associated with inflammatory processes and immune deregulation. It is believed that precision nutrition can modulate inflammatory profiles and immune dysfunctions to ensure better quality of life and metabolic well-being of SLE patients with the support of precision omics technologies.

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune caracterizada por la producción de autoanticuerpos dirigidos contra antígenos endógenos causando diversas manifestaciones clínicas, inflamación crónica y daño tisular. Aunque la fisiopatología del LES sigue siendo desconocida, se reconoce que factores genéticos, epigenéticos, ambientales y neuroendocrinos están implicados en el desarrollo de la enfermedad y sus complicaciones. Una proporción notable de pacientes con LES presenta también obesidad, y este perfil dismetabólico puede producir deterioro renal, musculoesquelético y/o respiratorio, fatiga, diversas alteraciones fisiopatológicas y deterioro funcional. En este contexto, la nutrición de precisión emerge como una herramienta prometedora en el control inflamatorio del LES, especialmente en pacientes con obesidad asociada. Diversos estudios demuestran la influencia beneficiosa de patrones dietéticos equilibrados en macronutrientes con alimentos ricos en fibra, vitaminas, minerales, antioxidantes y polifenoles en el control inflamatorio del LES y de las más diversas patologías, destacando la dieta Mediterránea y las dietas basadas en plantas/vegetales. Por último, la microbiota intestinal puede tener un papel relevante en este escenario clínico, ya que la disbiosis se asocia con procesos inflamatorios y desregulación inmune. Se cree que con la nutrición de precisión se pueden modular los perfiles inflamatorios y las disfunciones inmunitarias para garantizar una mejor calidad de vida y el bienestar metabólico de los pacientes con LES con el apoyo de las tecnologías de precisión ómicas.

Alimentación basada en plantas: la nueva tendencia nutricional / Plant-based diets: the new nutritional trend

En la actualidad cada vez más familias optan por seguir una alimentación basada en plantas (ABP). Es fundamental que pediatras y agentes de salud conozcan estos tipos de patrones alimentarios para asesorar adecuadamente a sus pacientes y derivarlos oportunamente a especialistas capacitados con el objetivo de garantizar un adecuado crecimiento y desarrollo principalmente en la edad pediátrica, evitando posibles consecuencias negativas sobre la salud. La mayoría de las sociedades científicas del mundo considera a las dietas vegetarianas apropiadas para todas las etapas de la vida si están correctamente planificadas, suplementadas y con un seguimiento adecuado por especialistas capacitados. Con respecto a las dietas veganas existen controversias por parte de las distintas sociedades con respecto a si son adecuadas o no en pediatría. Recientemente se han revisado las descripciones respecto a las tipificaciones de una ABP y se ha propuesto una definición estándar de estos tipos de dieta. Los riesgos más significativos asociados a la mala planificación de estas dietas son las deficiencias de calcio, vitamina D y vitamina B12, aunque también se debe tener en cuenta el estado del zinc, selenio, yodo y los ácidos grasos Omega 3. Es importante la planificación diaria de un plato nutricionalmente completo y es incuestionable que quienes siguen estos patrones alimentarios reciban suplementos con vitamina B12 adecuados para cada etapa de la vida. Se requieren más estudios en pediatría para evaluar los efectos de las distintas ABP sobre la ingesta de nutrientes, el estado nutricional, el crecimiento, desarrollo y la prevención de enfermedades no transmisibles (AU)

Currently, an increasing number of families are choosing to follow a plant-based diet (PBD). It is essential that pediatricians and healthcare agents know these types of dietary patterns in order to properly advise their patients and refer them to trained specialists to ensure adequate growth and development, especially in the pediatric age, avoiding possible negative health consequences. Most of the world's scientific societies consider vegetarian diets appropriate for all stages of life if they are adequately planned, supplemented and monitored by trained specialists. However, there is controversy among different societies regarding the appropriateness of vegan diets for children. Recently, there has been a review of descriptions concerning the characteristics of a plant-based diet, leading to a proposed standard definition for these types of diets. The most significant risks associated with poorly planned diets are calcium, vitamin D, and vitamin B12 deficiencies, although zinc, selenium, iodine and omega-3 fatty acid status should also be considered. The daily planning of a nutritionally complete meal is important and it is imperative that those who follow these dietary patterns receive vitamin B12 supplementation appropriate for each stage of life. Further studies in children are needed to evaluate the effects of different PBDs on nutrient intake, nutritional status, growth, development, and prevention of noncommunicable diseases (AU)

Construcción de la alimentación en trayectorias vitales de personas mayores

Introducción: La alimentación se construye a partir de experiencias y significados adquiridos en el curso de la vida. Las personas mayores tienen un acervo importante que informa de valores y prácticas culturales aplicadas a la alimentación. El objetivo del estudio fue interpretar los significados que entregan personas mayores a la construcción de su alimentación en trayectorias del curso de vida. Métodos: La investigación utilizó un enfoque cualitativo de alcance exploratorio, utilizando el método de teoría fundamentada de Strauss y Corbin. Para la recolección de datos se aplicó una entrevista semiestructurada entre julio de 2021 y junio de 2022. El tipo de muestreo fue teórico y el análisis de los datos cualitativos respondió al proceso de codificación abierta, axial y selectiva. Resultados: Participaron 54 personas mayores (72% mujeres) con edad promedio de 68,6 años (6,9 años). Las personas mayores construyeron su alimentación con un alto significado a las comidas caseras, con influencia de género femenino durante la niñez y adolescencia. En la adultez, se reconstruye la alimentación al ingresar al mundo laboral. En la actualidad, cimentan la alimentación con un enfoque de cuidados para su salud. Reconocen transiciones y puntos de inflexión en la alimentación provocados por terremotos, pandemia por COVID-19, situación política en el país, embarazos o el diagnóstico de alguna enfermedad crónica. Discusión: Las personas mayores reconocen diversas vivencias en trayectorias vitales que han marcado sus patrones alimentarios. Estas experiencias de vida pueden ser la base de estrategias o acciones en la práctica clínica que aporten a su bienestar.

Introduction: Food is intricately woven into the fabric of our experiences and the meanings accumulated throughout life. Older people possess a rich cultural heritage that shapes the values and practices surrounding food.The aim of the study was to interpret the meanings attributed to older people to the construction of their feeding in life course trajectories. Methods: The research employed a qualitative exploratory approach, utilizing the Grounded Theory method developed by Strauss and Corbin. Data collection took place through semi-structured interviews conducted between July 2021 and June 2022. The sampling method employed was theoretical, and the analysis of qualitative data followed the open, axial, and selective coding process. Results: A total of 54 older individuals (72% women), with an average age of 68.6 years (6,9 years), participated in the study. These individuals constructed their relationship with food, assigning significant value to homemade meals, influenced by gender roles during childhood and adolescence. In adulthood, the relationship with food transformed with entry into the workforce. Currently, their feeding are guided by a health-centric approach. They recognize transitions and turning pointsin food provoked by earthquakes, pandemic by COVID-19, political situation in the country, pregnancies or the diagnosis of a chronic disease. Discussion: Older people recognize a multitude of life experiences that have left imprints on their eating patterns. These life experiences can be the basis for strategies or actions in clinical practice that contribute to their well-being.

Plant-based diets and their effects on the metabolism and survival of chronic renal patients undergoing conservative treatment

Diet therapy in conservative treatment of chronic kidney disease involves protein restriction, but there is not enough evidence to recommend a particular type of protein, whether animal or plant based. However, studies suggest that plant-based diets help reduce the consumption of total and animal protein, reduce the need for nephroprotective drugs, improve complications and bring advantages in terms of disease progression and patient survival. The article considers up-to-date data on the effects of this diet and observed that when low in protein, primarily vegetable and in some cases supplemented with ketoanalogues, it can result in positive clinical outcomes, such as: delay in the decrease in the glomerular filtration rate, lower concentrations of urea, reduction of serum creatinine and phosphorus concentrations, lower metabolic acidosis, higher insulin sensitivity and lower systemic inflammation. As a whole, this dietary pattern may be able to postpone the start of dialysis with less progression of renal insufficiency. Additional research is needed to better characterize this dietary pattern.

La dietoterapia en el tratamiento conservador de la enfermedad renal crónica implica la restricción de proteínas, pero aún no hay pruebas suficientes para recomendar un tipo concreto de proteínas, ya sean animales o vegetales. Sin embargo, los estudios sugieren que las dietas basadas en plantas ayudan a reducir la ingesta de proteínas totales y animales, disminuyen la necesidad de fármacos nefroprotectores, mejoran las complicaciones y presentan ventajas con respecto a la progresión de la enfermedad y la supervivencia de los pacientes. En este artículo se consideran datos actualizados sobre los efectos de esta dieta y se observa que, cuando es hipoproteica, principalmente vegetal y en algunos casos se complementa con cetoanálogos, puede dar lugar a resultados clínicos positivos, como una disminución retardada de la tasa de filtración glomerular, concentraciones más bajas de urea, concentraciones reducidas de creatinina y fósforo séricos, menor acidosis metabólica, mayor sensibilidad a la insulina y menor inflamación sistémica. En conjunto, este patrón dietético tiene el potencial de retrasar el inicio de la diálisis con una menor progresión de la insuficiencia renal. Es necesario seguir investigando para caracterizar mejor este patrón dietético.

Rol de las masculinidades en la transmisión alimentaria / Role of masculinities in food transmission

Introducción. Las masculinidades representan roles sociales diversos y un estereotipo masculino que limita el desarrollo de tareas domésticas, entre otras, el estar a cargo de la alimentación familiar. Objetivo. Interpretar los relatos de personas mayores sobre el rol de las masculinidades en la transmisión alimentaria familiar. Materiales y Métodos. Estudio exploratorio con enfoque cualitativo utilizando la metodología de la Teoría Fundamentada de Strauss y Corbin. Participaron personas mayores de género masculino, a los que se les aplicó entrevista semiestructurada. Los datos fueron analizados a través de codificación abierta, axial y selectiva, lo que permitió identificar las categorías centrales que fueron la base del levantamiento de teoría que responde al objeto de estudio. La investigación fue avalada por comité de ética científica. Resultados. Se reconoce una cesión social de hábitos, patrones y costumbres alimentarias familiares en este grupo de personas, en especial, en etapas nóveles de su trayectoria vital. Como personas mayores, las masculinidades se adaptan a los cuidados y necesidades de sus respectivos hogares, ayudando en las compras de alimentos, elaborando preparaciones culinarias o reconociendo miembros masculinos de sus familias en el traspaso intergeneracional de saberes alimentarios. Conclusión. Desde los relatos de personas mayores participantes, las masculinidades presentan una dinámica familiar que comienza a desmitificar el rol de género femenino en el traspaso cultural de la alimentación.

Introduction. masculinities represent diverse social roles and a male stereotype that limits the development of domestic tasks, among others, be in charge of family feeding. Objective. to interpret the stories of older people about the role of masculinities in the family food transmission. Material and methods. exploratory study with qualitative approach using the methodology of the Grounded Theory of Strauss and Corbin. Elderly male participants participated, to whom a semi-structured interview was applied. The data were analyzed through open, axial and selective coding, which allowed identifying the central categories that were the basis of the theory survey that responds to the object of study. The research was endorsed by the scientific ethics committee. Results. a social transfer of family eating habits, patterns and customs is recognized in this group of people, especially in the new stages of their life trajectory. As older people, masculinities adapt to the care and needs of their respective homes, in particular, in new stages of their life trajectory. As older people, masculinities adapt to the care and needs of their respective homes, assisting in food purchases, preparing culinary preparations or recognizing male members of their families in the intergenerational transfer of food knowledge. Conclusion. From the stories of elderly participants, masculinities present a family dynamic that begins to demystify the female gender role in the cultural transfer of food.

Factores que influyen en la adherencia al tratamiento nutricional en pacientes hipertensos, Paraguay 2021 / Factors that influence adherence to nutritional treatment in hypertensive patients, Paraguay 2021

Introducción: el tratamiento nutricional está afectado por la conducta de los sujetos para generar adherencia. Objetivo: determinar factores que influyen en la no adherencia al tratamiento nutricional en pacientes hipertensos que acuden al Hospital Regional de Coronel Oviedo, 2021. Metodología: estudio descriptivo transversal. La población estuvo comprendida por pacientes registrados en el Programa de hipertensión arterial/Departamento cardiovascular del Hospital Regional de Coronel Oviedo. Se estudiaron los datos sociodemográficos, los factores de tratamiento nutricional y el grado de adherencia al tratamiento nutricional. Resultados: participaron del estudio 206 sujetos, el 53,4 % poseía 55 años o menos y el 81,1 % fue del sexo femenino. Se pudo hallar que solo el 3,8 % de los pacientes se adhieren al tratamiento. La no adherencia al factor conocimiento estuvo relacionado con el bajo nivel educativo (p=0,032), al factor equipo de salud con provenir del área rural y tener un bajo nivel educativo (p=0,006, p=0,002), al factor paciente con provenir del área rural (p=0.002), ser de bajo nivel educativo (p=0,008) y poseer obesidad grado II y III (p=0,036). La no adherencia global estuvo relacionada a estar casado (p=0.001) y realizar trabajos domésticos (p=0,009). Conclusiones: la adherencia al tratamiento es baja en la población de estudio.

Introduction: nutritional treatment is affected by the behavior of the subjects to generate adherence. This study was carried out to determine factors that influence non-adherence to nutritional treatment in hypertensive patients who attend the Coronel Oviedo Regional Hospital, 2021. Methodology: this was a cross-sectional descriptive observational study. The population was comprised of patients registered in the hypertension department of the Coronel Oviedo Regional Hospital. Sociodemographic data, nutritional treatment factors and the degree of adherence to nutritional treatment were studied. Results: 206 subjects participated in the study, 53.4 % were 55 years old or younger and 81.1 % were female. We found that only 3.8 % of patients adhere to treatment. Non-adherence due to the knowledge factor was related to low educational level (p=0.032), to the health team factor with coming from a rural area and having a low educational level (p=0.006, p=0.002), to the patient factor with coming from a rural area (p=0.002), to have a low educational level (p=0.008) and to have obesity grade II and III (p=0.036). Global non-adherence was related to being married (p=0.001) and doing housework (p=0.009). Conclusions: adherence to treatment is low in the study population.

Nicho trófico y bioclimático de dos especies andinas cercanamente emparentadas de Liolaemus (Squamata, Liolaemidae) en el sur del Perú / Trophic and bioclimatic niche of two closely related Andean species of Liolaemus (Squamata, Liolaemidae) in southern Peru

Resumen En el presente estudio, los nichos trófico y bioclimático de Liolaemus annectens y L. etheridgei son evaluados. Ambas especies se distribuyen en la región andina del sur del Perú. La comparación interespecífica del nicho trófico reveló a Lygaeidae (Hemiptera) como presa fundamental de L. etheridgei, mientras que las presas fundamentales en la dieta de L. annectens fueron larvas de Lepidoptera, Araneae, Curculionidae (Coleoptera) y Lygaeidae. Asimismo, se observó un importante consumo de material vegetal en ambas especies, por lo que pueden considerarse omnívoras. Ambas especies presentaron una baja amplitud de nicho trófico, con una tendencia especialista de consumo de presas, y un bajo solapamiento de nicho trófico. En cuanto al nicho Grinnelliano, la evaluación y comparación de modelos de nichos ecológicos, permitieron identificar las áreas de mayor idoneidad para la sobrevivencia de estas especies. Estas se encuentran en áreas de Arequipa, Moquegua y Tacna para L. etheridgei y en Arequipa, Puno, y Cusco para L. annectens. Ambas especies mostraron una baja superposición de nicho ecológico, rechazando la hipótesis de que ocupan nichos idénticos.

Abstract In the present study, the trophic and bioclimatic niches of Liolaemus annectens and L. etheridgei are evaluated. Both species are distributed in the Andean region of southern Peru. Interspecific comparison of the trophic niche revealed Lygaeidae (Hemiptera) as a fundamental prey for L. etheridgei, while the fundamental preys in the diet of L. annectens were Lepidoptera larvae, Araneae, Curculionidae (Coleoptera), and Lygaeidae. Additionally, a significant consumption of plant material was observed in both species, indicating an omnivorous diet. Both species exhibited a narrow trophic niche breadth, with a specialist tendency in prey consumption and low trophic niche overlap. Regarding the Grinnellian niche, evaluation and comparison of ecological niche models allowed the identification of areas of highest suitability for the survival of these species. These include some areas in Arequipa, Moquegua and Tacna for L. etheridgei, and some areas in Arequipa, Puno and Cusco for L. annectens. Both species showed low ecological niche overlap, rejecting the hypothesis of identical niches.

Risk assessment of cadmium exposure of Shanghai residents based on different dietary exposure assessment methods / 上海预防医学

ObjectiveTo conduct comprehensive assessment of internal and external cadmium exposure and health risks for Shanghai residents. MethodsCadmium levels in food samples were calculated by employing two dietary exposure assessment methods， total diet study （TDS） and food frequency questionnaire （FFQ）， to estimate the daily dietary cadmium exposure of Shanghai residents. The provisional tolerable monthly intake （PTMI） of cadmium set by joint food and agriculture organization/WHO expert committee on food additives （JECFA） was applied to evaluate the health risk. Differences in dietary and urinary cadmium were compared by rank-sum test among different regions， age， gender， smoking status， and BMI groups， and the association between internal and external cadmium exposure was investigated by correlation analysis. ResultsThe mean value of urinary cadmium for 1 300 respondents was 0.542 μg·L-1. Urinary cadmium was higher in the population in central urban and urban-rural fringe areas than in the suburban area， higher in the older age group than in the younger age group， and higher in the smoking group than in the non-smoking group （all P<0.01）. The two assessment methods showed that the mean values of daily dietary cadmium exposure for Shanghai residents were 0.306 and 0.090 μg·kg-1， with 3.69% and 0.85% of Shanghai residents exceeding the PTMI， respectively. Correlation analyses showed that dietary exposure to cadmium based on the FFQ method was positively correlated with the urinary cadmium level when smoking status， age， gender， and BMI were adjusted. ConclusionDietary exposure to cadmium of Shanghai residents is mainly derived from vegetables， aquatic products， cereals and potatoes， and is overall at a low-risk level. Dietary exposure assessment based on FFQ and risk monitoring data can effectively estimate long-term cadmium exposure.

Trend and age-period-cohort analysis of heart disease deaths and DALY attributable to high-salt diets in Chinese residents in 1990 -2019 / 公共卫生与预防医学

Objective To understand the trends of the mortality and DALY of ischemic heart disease (IHD) caused by high-salt diets，as well as their age-period-cohort effects among Chinese residents from 1990 to 2019. Methods Using the 2019 Global Burden of Disease Study (GBD 2019) data on IHD deaths and DALY attributed to high-salt diets among Chinese residents from 1990 to 2019, an age-period-cohort (APC) model was applied to explore the age-period-cohort effect. Results Among the 13 major risk factors for ischemic heart disease (IHD) in China in 1990 and 2019, age-standardized mortality and age-standardized DALY rates attributable to risk factors of high-salt diets led the way. Age-standardized mortality and age-standardized DALY rates were attributabled to high-salt diets showed a decreasing trend in both China and globally in 1990-2019, but were consistently higher in China than in the world. The results of the APC model show that from 1990 to 2019, the mortality rate and DALY rate of IHD attributed to a high-salt diet in China showed an increasing trend with age; over time, the risk of death and the risk of DALY for males showed a decreasing trend from 1990-1994 to 1995-1999, and an increasing trend from 1995-1999 to 2010-2014, and reached its peak in 2010-2014 (RR=1.17,95% CI: 1.12-1.21), followed by a decreasing trend. For males with a later birth cohort have a higher risk of death and DALY, while for females with a later birth cohort have a lower risk of death and DALY. Conclusion The burden of IHD disease attributed to a high-salt diet in China is still relatively heavy, and it is necessary to strengthen protection for high-risk populations such as young males and the elderly population to reduce the burden of IHD disease in China.

Research progress on inducement and pathogenesis of euglycemic diabetic ketoacidosis / 重庆医学

Euglycemic diabetic ketoacidosis(euDKA)is a rare acute metabolic disorder syndrome,its characteristics include metabolic acidosis with a high anion gap,positive ketones in blood or urine,and blood glucose＜13.9 mmol/L.Due to low blood sugar level,euDKA is easy to be missed or delayed treatment in clinical work,resulting in serious consequences.In recent years,many cases of euDKA have been reported,but its inducements and pathogenesis are not fully understood.This article reviews the common inducements and pathogenesis of euDKA.