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BACKGROUND: Adhering to a diet adequate in macronutrients is crucial for the secondary prevention of cardiovascular diseases. OBJECTIVE: To assess the prevalence of adherence to recommendations for the consumption of dietary fatty acids for the prevention and treatment of cardiovascular diseases and to estimate whether the presence of certain cardiovascular risk factors would be associated with adherence. METHODS: Cross-sectional study using baseline data from 2,358 participants included in the "Brazilian Cardioprotective Nutritional Program Trial". Dietary intake and cardiovascular risk factors were assessed. Adequate intake of polyunsaturated fatty acids (PUFA) was considered as ≥10% of total daily energy intake; for monounsaturated fatty acids (MUFA), 20%; and for saturated fatty acids (SFA), <7% according to the Brazilian Society of Cardiology. A significance level of 5% was considered in the statistical analysis. RESULTS: No participant adhered to all recommendations simultaneously, and more than half (1,482 [62.9%]) did not adhere to any recommendation. Adherence exclusively to the SFA recommendation was the most prevalent, fulfilled by 659 (28%) participants, followed by adherence exclusively to the PUFA (178 [7.6%]) and MUFA (5 [0.2%]) recommendations. There was no association between the number of comorbidities and adherence to nutritional recommendations (p = 0.269). Participants from the Brazilian Northeast region showed a higher proportion of adherence to SFA consumption recommendations (38.42%) and lower adherence to PUFA intake (3.52%) (p <0.001) compared to other regions. CONCLUSIONS: Among the evaluated sample, there was low adherence to nutritional recommendations for dietary fatty acid consumption.
FUNDAMENTO: A adesão à uma alimentação adequada em macronutrientes é fundamental para a prevenção secundária de doenças cardiovasculares. OBJETIVO: Avaliar a prevalência de adesão às recomendações de consumo de ácidos graxos para prevenção e tratamento de doenças cardiovasculares, e estimar se a presença de determinados fatores de risco cardiovascular estaria associada à adesão. MÉTODOS: Estudo transversal com os dados de linha de base de 2358 participantes do estudo "Brazilian Cardioprotective Nutritional Program Trial". Dados de consumo alimentar, e fatores de risco cardiovascular foram avaliados. Foi considerada, de acordo com a Sociedade Brasileira de Cardiologia, uma ingestão adequada de ácidos graxos poli-insaturados (AGPI) ≥10% do consumo total de energia diária, para ácidos graxos monoinsaturados (AGM), 20% e para ácidos graxos saturados (AGS), <7%. Na análise estatística foi considerando nível de significância de 5%. RESULTADOS: Nenhum participante aderiu a todas as recomendações de forma simultânea e mais da metade (1482 [62,9%]) não aderiu a nenhuma recomendação. A adesão exclusivamente à recomendação de AGS foi a mais prevalente, sendo cumprida por 659 (28%) dos participantes, seguida da adesão exclusivamente à recomendação de AGP (178 [7,6%]) e de AGM (5 [0,2%]). Não houve associação entre o número de comorbidades e a adesão às recomendações nutricionais (p =0,269). Os participantes da região Nordeste do país apresentaram maior proporção de adesão às recomendações para consumo de AGS (38,42%), e menor para ingestão de AGPI (3,52%) (p <0,001) em comparação às demais. CONCLUSÕES: Na amostra avaliada, evidenciou-se baixa adesão às recomendações nutricionais para consumo de ácidos graxos.
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Enfermedades Cardiovasculares , Ácidos Grasos , Humanos , Grasas de la Dieta , Enfermedades Cardiovasculares/etiología , Prevención Secundaria , Estudios Transversales , Ácidos Grasos Insaturados , Ácidos Grasos MonoinsaturadosRESUMEN
OBJECTIVE: The objective was to evaluate the psychometric properties of the Mindful Eating Questionnaire (MEQ) in Brazilian subjects with type 2 diabetes mellitus (T2DM) and validate a Brazilian version of the MEQ for adults with T2DM (MEQ-DM). METHODOLOGY: Baseline data from the multicentre Nutritional Strategy for Glycaemic Control in Patients with Type 2 Diabetes Mellitus (NUGLIC) trial were used. Construct validity was assessed using exploratory factor analysis (EFA). The root mean square error of approximation (RMSEA), comparative fit index (CFI) and TuckerâLewis index (TLI) fit indices indicated the adequacy of the model. The reliability of the questionnaire was evaluated considering the different factor loadings. Criterion validity was tested by correlating the MEQ-DM with sociodemographic variables, body mass index (BMI) and physical activity levels. RESULTS: A total of 370 participants were included, who were mostly female (60.8 %) and had a median age of 61 (54-67) years. The EFA results supported the two-factor structure of the 25-item MEQ-DM: disinhibition and awareness. The results of the fit indices (RMSEA = 0.04; CFI = 0.95 and TLI = 0.94) and composite reliability (disinhibition = 0.84 and awareness = 0.81) were consistent. The criterion validity analysis indicated a significant association between MEQ-DM scores and age, sex, civil status, education level, BMI and physical activity (p < 0.05). CONCLUSION: When explored with Brazilian adults with T2DM, the MEQ-DM presented a factorial model with two dimensions: disinhibition and awareness. This model must be confirmed in future studies with Brazilians with T2DM.
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Diabetes Mellitus Tipo 2 , Ingestión de Alimentos , Atención Plena , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Brasil , Psicometría , Reproducibilidad de los Resultados , Pueblos Sudamericanos , Encuestas y Cuestionarios , Ingestión de Alimentos/psicologíaRESUMEN
Obesity is a chronic disease resulting from multifactorial causes mainly related to lifestyle (sedentary lifestyle, inadequate eating habits) and to other conditions such as genetic, hereditary, psychological, cultural, and ethnic factors. The weight loss process is slow and complex, and involves lifestyle changes with an emphasis on nutritional therapy, physical activity practice, psychological interventions, and pharmacological or surgical treatment. Because the management of obesity is a long-term process, it is essential that the nutritional treatment contributes to the maintenance of the individual's global health. The main diet-related causes associated with excess weight are the high consumption of ultraprocessed foods, which are high in fats, sugars, and have high energy density; increased portion sizes; and low intake of fruits, vegetables, and grains. In addition, some situations negatively interfere with the weight loss process, such as fad diets that involve the belief in superfoods, the use of teas and phytotherapics, or even the avoidance of certain food groups, as has currently been the case for foods that are sources of carbohydrates. Individuals with obesity are often exposed to fad diets and, on a recurring basis, adhere to proposals with promises of quick solutions, which are not supported by the scientific literature. The adoption of a dietary pattern combining foods such as grains, lean meats, low-fat dairy, fruits, and vegetables, associated with an energy deficit, is the nutritional treatment recommended by the main international guidelines. Moreover, an emphasis on behavioral aspects including motivational interviewing and the encouragement for the individual to develop skills will contribute to achieve and maintain a healthy weight. Therefore, this Position Statement was prepared based on the analysis of the main randomized controlled studies and meta-analyses that tested different nutrition interventions for weight loss. Topics in the frontier of knowledge such as gut microbiota, inflammation, and nutritional genomics, as well as the processes involved in weight regain, were included in this document. This Position Statement was prepared by the Nutrition Department of the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), with the collaboration of dietitians from research and clinical fields with an emphasis on strategies for weight loss.
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The Western diet can negatively affect the gut microbiota and is associated with metabolic disorders. Kombucha, a tea fermented by a symbiotic culture of bacteria and yeast (SCOBY), is known for its bioactive properties and has become popular in the last years. In this study, we evaluated the effects of regular kombucha consumption on the gut microbiota and on outcomes related to the intestinal health of Wistar rats fed a high-fat high-fructose diet. After eight weeks receiving a standard diet (AIN-93M) (n = 10) or a high-fat and high-fructose diet (HFHF) (n = 30) to induce metabolic disorders, the animals were subdivided into four groups: AIN-93M (n = 10); HFHF (n = 10); GTK (HFHF + green tea kombucha (n = 10); and BTK (HFHF + black tea kombucha; n = 10) for 10 weeks. Although body composition did not differ among the groups, the HFHF diet was associated with metabolic alterations, and stimulated the growth of gram-negative bacteria such as Proteobacteria and Bacteroides. Kombucha ingestion could somewhat modulate the gut microbiota, attenuating the effects of a Western diet by increasing propionate production and favoring the growth of beneficial bacteria, such as Adlercreutzia in the GTK group. Our results suggest that regular kombucha consumption may be beneficial to intestinal health, which can be mostly attributed to its high content and diversity of phenolic compounds.
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Camellia sinensis , Microbioma Gastrointestinal , Ratas , Animales , Té/microbiología , Ratas Wistar , Fructosa/farmacología , Polifenoles/farmacología , Dieta Alta en Grasa/efectos adversosRESUMEN
Evidence suggests antioxidant and anti-inflammatory properties of omega-3 polyunsaturated fatty acids (n-3 PUFA). However, the effect of supplementation of this fatty acid profile on the telomere length and the telomerase enzyme activity was not revised yet. The PubMed and Embase® databases were used to search for clinical trials. A total of six clinical trials were revised. Omega-3 PUFA supplementation did not statistically affect telomere length in three out of three studies but affected telomerase activity in two out of four studies. The supplementation increased telomerase enzyme activity in subjects with first-episode schizophrenia. Besides, it decreased telomerase enzyme activity without modulating the effects of Pro12Ala polymorphism on the PPARγ gene in type 2 diabetes subjects. The methodological differences between the studies and the limited number of studies on the theme suggest that further studies are needed to elucidate the effects of n-3 PUFA supplementation on telomere length and telomerase enzyme activity in humans.
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Diabetes Mellitus Tipo 2 , Ácidos Grasos Omega-3 , Telomerasa , Ensayos Clínicos como Asunto , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Suplementos Dietéticos , Ácidos Grasos Omega-3/farmacología , Ácidos Grasos Omega-3/uso terapéutico , Humanos , Telomerasa/genética , Telomerasa/metabolismo , TelómeroRESUMEN
Nuts consumption has been associated with a protective effect against cardiovascular diseases and oxidative stress-related disorders. We aimed to perform a systematic review with clinical trials to assess the impact of chronic nuts consumption on oxidative stress and the possible mechanisms involved. Studies were identified by searching in three electronic databases: PubMed/MEDLINE, Scopus, and LILACS, and selected following PRISMA guidelines. Two authors perform searching and data extraction. A total of 16 articles were included (12 randomized clinical trials and 4 one or two-arm clinical trials). Nut doses were generally high (> 30 g/d), except for Brazil nuts (5-13 g/d). The follow-up time ranges between four weeks and six months, and the oxidized low-density lipoprotein (ox-LDL) was the most assessed biomarker. Eight articles reported improvement in oxidative stress biomarkers after nuts supplementation. Pathways regulated by selenium (e.g. glutathione peroxidase activity and nuclear factor-E2-related factor 2 (Nrf2) regulation), monounsaturated fatty acids (e.g. reduction of LDL oxidation), and bioactive compounds (e.g. antioxidant activity) were described as mechanisms involved in these beneficial effects. No studies reported harmful effects of nut consumption, even in high doses. The chronic consumption of nuts seemed to be effective to change some oxidative stress biomarkers, however, this topic remains controversial because the benefits depends on nut type, nut dose, and population characteristics.
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Enfermedades Cardiovasculares , Selenio , Antioxidantes , Humanos , Nueces , Estrés OxidativoRESUMEN
BACKGROUND AND AIMS: Hypertension (HTN) is a chronic non-communicable disease influenced by non-modifiable risk factors, such as sex and age, as well as modifiable risk factors such as lifestyle, including diet and smoking. Moreover, diet quality among smokers is worse than that of non-smokers, mainly in terms of antioxidant content. Thus, the current study aimed to investigate whether dietary total antioxidant capacity (dTAC) influences the association between smoking and HTN. METHODS AND RESULTS: This cross-sectional study included 4303 graduates (69.35% women) from the Cohort of Minas Gerais Universities (CUME) project. An online food frequency questionnaire was administered to participants, and dTAC was estimated using the ferric reducing antioxidant power method. In the questionnaires, individuals reported smoking status, systolic and diastolic blood pressure values, previous HTN diagnosis, and use of antihypertensive drugs. Logistic regression models were used to estimate the odds ratio and 95% confidence interval between smoking and HTN, stratified by the median dTAC. Current and former smokers had higher dTAC values despite their lower fruit intake. Moreover, coffee was the main contributor to dTAC among them. Smoking was associated with a higher likelihood of HTN, mainly among individuals with a higher dTAC. However, after exclusion of coffee antioxidant capacity, there was an association between only smoking and HTN in individuals with lower dTAC. CONCLUSIONS: The controversial association between higher dTAC and HTN can result from high coffee intake. Higher dTAC without coffee intake may mitigate the association between smoking and HTN in this population.
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Antioxidantes/administración & dosificación , Presión Sanguínea , Dieta/efectos adversos , Hipertensión/epidemiología , Valor Nutritivo , Fumar/efectos adversos , Adulto , Brasil/epidemiología , Café/efectos adversos , Estudios Transversales , Ex-Fumadores , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Masculino , No Fumadores , Prevalencia , Factores Protectores , Medición de Riesgo , Factores de Riesgo , Fumadores , Fumar/epidemiología , Cese del Hábito de FumarRESUMEN
Melatonin is an indolamine with a recognized chronobiotic role. In turn, the supplementation of melatonin through capsules has been shown to be efficient in the modulation of inflammatory markers, oxidative stress, as well as in the control of hypertension and metabolic syndrome. However, the science of nutrition is interested in the study of the food sources of this hormone and its possible therapeutic effects. Thus, this review aimed to identify and present scientific papers that quantified melatonin in foods and evaluated its application in intervention studies. In total, 278 studies were found, of which 17 were included in this review. The results show that meats, fish, eggs, cereals, tubers, oilseeds, mushrooms, fruits, vegetables, alcoholic and non-alcoholic beverages and dairy products had some items analyzed for their melatonin concentrations. The concentrations reported presented considerable amplitude among different foods and even within the same species, possibly due to differences in cultivation and different hormonal dosing techniques. Also, different concentrations of melatonin can be presented for the same food when submitted to processes such as cooking, roasting or fermentation. The intervention studies presented positive results regarding the consumption of foods rich in melatonin and clinical-metabolic indicators. However, in order to guide nutritional behavior, it is necessary to consult a composition table that makes melatonin concentrations available and considers the processes involved in the preparation of the food. With this table, it will be possible to analyze the real effect of habitual consumption of melatonin from food on health.
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Fenómenos Cronobiológicos/efectos de los fármacos , Análisis de los Alimentos , Melatonina/administración & dosificación , Melatonina/farmacología , Humanos , Melatonina/químicaRESUMEN
The accentuated increase in the use of medicinal plants by the population to treat diseases makes it necessary to carry out pharmacological studies in order to contribute to the scientific knowledge and clarify the mechanisms involved in the main compounds present in these plants. Due to the difficulty of combating antimicrobial-resistant microorganisms, plants become a low-cost and effective alternative. The stem, fruit, and leaves of plants are used to measure antioxidant and antimicrobial capacity and to combat the oxidative degradation of free radicals produced in the presence of xenobiotics. A systematic review is a powerful tool that incorporates the variability among the studies, providing an overall estimate of the use of plant extracts as antioxidants and antimicrobial activities. In view of the controversies in the literature regarding the use of compounds from plants or the isolation and purification of the main substances for the prevention of bacterial various therapeutic actions, the aim of this was to present a systematic review on the antimicrobial and antioxidant properties of cashew (Anacardium occidentale), cajui (Anacardium microcarpum), and pequi (Caryocar brasiliense). The following databases were analyzed: PubMed/Medline, Virtual Health Library (LILACS and SciELO), and Science Direct. Out of 425 articles, 33 articles have been used in this study, which were also represented in the Prisma Statement. In vitro antioxidant tests were conducted in 28 studies using different methodologies. Most of the tests involving the studied species demonstrated positive antioxidant potential and antimicrobial properties. The results provide important data and perspectives into the use of natural products that can contribute to the treatment of various diseases.
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Anacardium/química , Antiinfecciosos/uso terapéutico , Antioxidantes/uso terapéutico , Frutas/química , Extractos Vegetales/química , Antiinfecciosos/farmacología , Antioxidantes/farmacología , HumanosRESUMEN
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.
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Antioxidantes/metabolismo , Colesterol/sangre , Dieta , Carbohidratos de la Dieta/administración & dosificación , Ingestión de Energía , Estrés Oxidativo , Adulto , Biomarcadores/sangre , Índice de Masa Corporal , HDL-Colesterol/sangre , LDL-Colesterol/sangre , Carbohidratos de la Dieta/farmacología , Femenino , Humanos , Modelos Lineales , Lipoproteínas LDL/sangre , Masculino , Uñas/metabolismo , Valores de Referencia , Selenio/metabolismo , Adulto JovenRESUMEN
Vitamin D (1,25(OH)2D3) is a steroid hormone that has a range of physiological functions in skeletal and nonskeletal tissues, and can contribute to prevent and/or treat osteoporosis, obesity, and Type 2 diabetes mellitus (T2DM). In bone metabolism, vitamin D increases the plasma levels of calcium and phosphorus, regulates osteoblast and osteoclast the activity, and combats PTH hypersecretion, promoting bone formation and preventing/treating osteoporosis. This evidence is supported by most clinical studies, especially those that have included calcium and assessed the effects of vitamin D doses (≥800 IU/day) on bone mineral density. However, annual megadoses should be avoided as they impair bone health. Recent findings suggest that low serum vitamin D is the consequence (not the cause) of obesity and the results from randomized double-blind clinical trials are still scarce and inconclusive to establish the relationship between vitamin D, obesity, and T2DM. Nevertheless, there is evidence that vitamin D inhibits fat accumulation, increases insulin synthesis and preserves pancreatic islet cells, decreases insulin resistance and reduces hunger, favoring obesity and T2DM control. To date, there is not enough scientific evidence to support the use of vitamin D as a pathway to prevent and/or treat obesity and T2DM.
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Vitamina D/metabolismo , Densidad Ósea , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/patología , Humanos , Obesidad/metabolismo , Obesidad/patología , Osteoporosis/metabolismo , Osteoporosis/patología , Vitamina D/químicaRESUMEN
The low-grade inflammation has been recognized as the link between adiposity and the risk of chronic metabolic disorders. Thus, increased concentrations of inflammatory markers, such as interleukins and tumor necrosis factor alpha have been found in obese individuals. In turn, diet can positively or negatively influence on the risk of chronic metabolic diseases by modulating the inflammatory status. In this context, orange juice consumption can play a role in modulation of inflammatory markers through bioactive compounds, such as the flavonoids (hesperidin, naringenin). According to this review, orange juice appears to mediate the inflammatory response in plasma level and gene expression, and in postprandial and chronic (≥7 consecutive days) periods. The current findings suggest that orange juice could be a dietary feature for prevention and treatment of chronic diseases, although more studies are necessary to evaluate the physiological and molecular mechanisms involved.
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Antiinflamatorios/uso terapéutico , Bebidas , Citrus sinensis/química , Flavonoides/uso terapéutico , Frutas/química , Inflamación/prevención & control , Obesidad/dietoterapia , Antiinflamatorios/farmacología , Citocinas/metabolismo , Flavonoides/farmacología , Humanos , Inflamación/etiología , Obesidad/complicaciones , Obesidad/metabolismo , Fitoterapia , Preparaciones de Plantas/farmacología , Preparaciones de Plantas/uso terapéuticoRESUMEN
Recently, increased attention has been paid to the link between gut microbial composition and obesity. Gut microbiota is a source of endotoxins whose increase in plasma is related to obesity and insulin resistance through increased intestinal permeability in animal models; however, this relationship still needs to be confirmed in humans. That intestinal permeability is subject to change and that it might be the interface between gut microbiota and endotoxins in the core of metabolic dysfunctions reinforce the need to understand the mechanisms involved in these aspects to direct more efficient therapeutic approaches. Therefore, in this review, we focus on the emerging link between obesity and increased intestinal permeability, including the possible factors that contribute to increased intestinal permeability in obese subjects. We address the concept of intestinal permeability, how it is measured, and the intestinal segments that may be affected. We then describe 3 factors that may have an influence on intestinal permeability in obesity: microbial dysbiosis, dietary pattern (high-fructose and high-fat diet), and nutritional deficiencies. Gaps in the current knowledge of the role of Toll-like receptors ligands to induce insulin resistance, the routes for lipopolysaccharide circulation, and the impact of altered intestinal microbiota in obesity, as well as the limitations of current permeability tests and other potential useful markers, are discussed. More studies are needed to reveal how changes occur in the microbiota. The factors such as changes in the dietary pattern and the improvement of nutritional deficiencies appear to influence intestinal permeability, and impact metabolism must be examined. Also, additional studies are necessary to better understand how probiotic supplements, prebiotics, and micronutrients can improve stress-induced gastrointestinal barrier dysfunction and the influence these factors have on host defense. Hence, the topics presented in this review may be beneficial in directing future studies that assess gut barrier function in obesity.
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Absorción Intestinal , Mucosa Intestinal/metabolismo , Metagenoma , Obesidad/fisiopatología , Animales , Dieta Alta en Grasa , Modelos Animales de Enfermedad , Endotoxemia/microbiología , Endotoxemia/fisiopatología , Conducta Alimentaria , Fructosa/administración & dosificación , Humanos , Resistencia a la Insulina , Intestinos/microbiología , Intestinos/fisiopatología , Lipopolisacáridos/metabolismo , Desnutrición/microbiología , Desnutrición/fisiopatología , Permeabilidad , Proteínas de Uniones Estrechas/genética , Proteínas de Uniones Estrechas/metabolismoRESUMEN
JUSTIFICATIVA E OBJETIVOS: A sepse está entre as principais causas de êxito letal nas unidades de terapia intensiva (UTI) em todo o mundo. A adequada abordagem desta condição mórbida - incluindo os aspectos nutricionais - é de suma relevância para o sucesso terapêutico. Diante desta perspectiva, o escopo do presente manuscrito é apresentar elementos do suporte nutricional na sepse. Para isso procedeu-se revisão de literatura, com busca no Pubmed e no Scielo, utilizando-se as palavras chave, sepsis e nutrition. A busca realizada permitiu a obtenção de 320 citações, dentre as quais foram selecionados 33 artigos. A pesquisa bibliográfica foi complementada por textos acessórios, incluindo livros da área de nutrição, terapia intensiva, infectologia e diretrizes nacionais e estrangeiras. CONTEÚDO: A sepse cursa habitualmente com aumentodo metabolismo - caracterizando um estado hipercatabólico - destacando-se, em termos terapêuticos, a instituição de suporte nutricional efetivo como uma das medidas importantes para o tratamento dos enfermos. A via de administração - enteral (NE)ou parenteral (NP) - permanece como motivo de debate, devendo-se pontuar que a primeira tem se mostrado menos onerosa e mais fisiológica e segura, além de manter a função e a estrutura do trato gastrintestinal, ao passo que a NP resulta em melhor alcance das metas nutricionais, mas se associa ao maior risco de infecção. CONCLUSÃO: Apesar das controvérsias relativas à via de administração, é consensual que a terapia nutricional influencia positivamente o prognóstico dos enfermos com sepse.
BACKGROUND AND OBJECTIVES: Sepsis is the leading cause of morbidity and mortality in intensive care units (ICU) worldwide. The appropriate approach of this morbid condition - including the nutritional aspects - is very important for successful treatment. Thus, the objective of this paper is to introduce elements of nutritional support in sepsis. In this case we made are view of the literature, searching Pubmed and Scielo, using the keywords nutrition and sepsis. The search performed allowed the obtainment of 320 citations, of which 33 articles were selected. The literature search was supplemented by other sources, including books in the nutrition area, intensive care and infectious diseases and national and international guidelines. CONTENTS: Sepsis usually evolves with increased metabolism - featuring a hypercatabolic state - where, in therapeutic terms,the institution of effective nutritional support stands out as one of the important approaches for the treatment of the patients.The route of administration - enteral (EN) or parenteral (PN) - remains a subject of debate, and one should point out that the former has been less costly and more physiological and safe, and maintains the function and structure of the gastrointestinal tract, while the latter results in better achievement of nutritional goals, but is associated with increased risk of infection. CONCLUSION: Despite controversies regarding the route of administration, nutritional therapy positively influences the prognosis of the patient with sepsis.
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Humanos , Nutrición Enteral/métodos , Nutrición Parenteral/métodos , Sepsis , Terapia Nutricional/métodosRESUMEN
The aim of the present cross-sectional study was to assess the potential relationships between fruit and vegetable (FV) consumption and some oxidative stress markers in young adults, with particular emphasis on fibre and vitamin C intake. The study enrolled 246 healthy subjects (eighty-eight men and 158 women), with a mean age of 22 (sd 3) years and a mean BMI of 21·9 (sd 2·8) kg/m2. Dietary intake, anthropometry, blood pressure, lifestyle features and blood biochemical data were assessed with validated procedures. Those subjects in the highest tertile (T) of FV consumption ( ≥ 705 g/d) had statistically lower oxidised LDL (ox-LDL) concentrations as well as higher plasma total antioxidant capacity (TAC) and glutathione peroxidase (GPx) activity (P for trend <0·05), after adjusting for sex, age, energy intake, physical activity, smoking, BMI, vitamin supplement use and other confounding factors. Moreover, plasma ox-LDL concentrations showed a decreasing trend and TAC an increasing trend across tertiles of fibre (T3: ≥14 g/d) and vitamin C (T3: ≥150 mg/d) from FV intake, while GPx activity was positively associated with vitamin C intake (P for trend < 0·05). In conclusion, greater FV consumption was independently associated with reduced ox-LDL as well as increased TAC and GPx activity in healthy young adults, with dietary fibre and vitamin C from FV clearly being implicated in this beneficial relationship.
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Ácido Ascórbico/administración & dosificación , Fibras de la Dieta/administración & dosificación , Estrés Oxidativo/efectos de los fármacos , Adolescente , Adulto , Antioxidantes/administración & dosificación , Biomarcadores/sangre , Estudios Transversales , Femenino , Frutas , Glutatión Peroxidasa/sangre , Humanos , Lipoproteínas LDL/sangre , Masculino , Verduras , Adulto JovenRESUMEN
BACKGROUND: Dietary total antioxidant capacity (TAC) has been assumed as a useful tool to assess the relationship between the cumulative antioxidant food capacity and several chronic disorders. The aim of this cross-sectional study was to investigate the potential relationships of dietary TAC with adiposity, metabolic and oxidative stress markers in healthy young adults. METHODS: This study enrolled 266 healthy subjects (105 men/ 161 women; 22 ± 3 years-old; 22.0 ± 2.7 kg/m2). Dietary intake, anthropometry, blood pressure, lifestyle features, and biochemical data were assessed with validated procedures. RESULTS: In linear regression analyses, dietary TAC values were inversely associated with glycemia, total cholesterol:HDL-c ratio, triglycerides and oxidized-LDL concentrations, and positively associated with HDL-c concentrations, independently of gender, age, smoking status, physical activity, vitamin use supplement, waist circumference, energy intake, fatty acid intake. In addition, plasma TAC was negatively correlated with ox-LDL concentrations (r= -0.20, P = 0.003), independently of the assessed confounding variables. Finally, dietary TAC values were inversely related to waist circumference values (r= -0.17, P = 0.005) as well as to lower mild central obesity occurrence (waist circumference ≥ 80/ 94 cm for women/ men, respectively). CONCLUSION: Dietary TAC values are inversely associated with glucose and lipid biomarkers as well as with central adiposity measurements in healthy young adults, indicating dietary TAC as a useful tool to assess the health benefits of cumulative antioxidant capacity from food intake. In addition, the independent and inverse relationships of ox-LDL concentrations with dietary and plasma TAC respectively suggest a putative role of antioxidant rich-diet in the link between redox state and atherogenesis at early stage.
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BACKGROUND: Despite oxidized low density lipoprotein (ox-LDL) plays important roles in the pro-inflammatory and atherosclerotic processes, the relationships with metabolic and oxidative stress biomarkers have been only scarcely investigated in young adult people. Thus, the aim of this study was to assess plasma ox-LDL concentrations and the potential association with oxidative stress markers as well as with anthropometric and metabolic features in healthy young adults. METHODS: This study enrolled 160 healthy subjects (92 women/68 men; 23±4 y; 22.0±2.9 kg/m2). Anthropometry, body composition, blood pressure, lifestyle features, biochemical data, and oxidative stress markers were assessed with validated tools. Selenium, copper, and zinc nail concentrations were measured by atomic absorption spectrophotometry. RESULTS: Total cholesterol (TC), LDL-c and uric acid concentrations, TC-to-HDL-c ratio, and glutathione peroxidase (GPx) activity were positive predictors of ox-LDL concentrations, while nail selenium level (NSL) was a negative predictor, independently of gender, age, smoking status, physical activity. Those individuals included in the highest tertile of GPx activity (≥611 nmol/[mL/min]) and of NSL (≥430 ng/g of nail) had higher and lower ox-LDL concentrations, respectively, independently of the same covariates plus truncal fat or body mass index, and total cholesterol or LDL-c concentrations. CONCLUSIONS: Ox-LDL concentrations were significantly associated with lipid biomarkers, GPx activity, uric acid concentration, and NSL, independently of different assayed covariates, in young healthy adults. These findings jointly suggest the early and complex relationship between lipid profile and redox status balance.
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Salud , Lípidos/sangre , Lipoproteínas LDL/sangre , Estrés Oxidativo , Investigación Biomédica Traslacional , Adolescente , Adulto , Biomarcadores/sangre , Femenino , Glutatión Peroxidasa/metabolismo , Humanos , Estilo de Vida , Modelos Lineales , Masculino , Análisis Multivariante , Uñas/metabolismo , Selenio/metabolismo , Adulto JovenRESUMEN
The consumption of soy protein lowers blood cholesterol in humans and animals. Breeding may alter the physiological effects of soybeans, such as its cholesterol-lowering property. Our hypothesis is that breeding affects the hypocholesterolemic effect of soy by modulating the expression of key hepatic enzymes related to cholesterol and bile acid biosynthesis, as well as altering fecal neutral and acidic steroid excretion. Therefore the aim of this study was to evaluate the effect of a new Brazilian soybean cultivar (UFV-116), lacking lipoxygenases 2 and 3, compared with a commercial cultivar (OCEPAR-19), on 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGR) and cholesterol 7α-hydroxylase (CYP7A) mRNA expression and fecal steroid output in rats. Thirty-six male rats were fed UFV-116, OCEPAR-19, or casein as the protein source, with or without addition of dietary cholesterol (0.25%). Blood and liver cholesterol, HMGR and CYP7A mRNA abundance, and fecal excretion of steroids were measured. Blood and liver cholesterol levels were lowered by both soybean cultivars, with and without cholesterol, but UFV-116 was more effective when included in the cholesterol-free diet. Both soy diets promoted lower levels of HMGR mRNA, higher levels of CYP7A mRNA, and higher excretion of fecal secondary bile acids. There was higher fecal neutral steroid output when cholesterol was added to all diets. These data show that both soybean cultivars acted similarly in lowering serum and hepatic cholesterol; therefore, breeding did not affect the hypocholesterolemic effect of the new cultivar.
Asunto(s)
Anticolesterolemiantes/farmacología , Colesterol/sangre , Glycine max/química , Metabolismo de los Lípidos/efectos de los fármacos , Proteínas de Soja/farmacología , Animales , Ácidos y Sales Biliares/biosíntesis , Colesterol 7-alfa-Hidroxilasa/metabolismo , Colesterol en la Dieta/administración & dosificación , Dieta , Lipooxigenasa/metabolismo , Hígado/efectos de los fármacos , Hígado/enzimología , Masculino , ARN Mensajero/metabolismo , Ratas , Ratas Sprague-Dawley , Glycine max/clasificación , Esteroides/metabolismoRESUMEN
Patients who have undergone bariatric surgery are at increased risk of developing nutritional deficiencies from limited food intake and absorption of different nutrients. A systematic review of several database websites (PubMed and ISI Web of Science) was conducted from September 1983 to April 2010 to identify literature related to micronutrient deficiencies occurring after bariatric surgery. Keywords used individually or in various combinations in the search were bariatric surgery, obesity, vitamin/mineral deficiencies, protein deficiency, nutrient absorption and nutrient supplementation. Literature suggests that to prevent or treat nutritional deficiencies resulting from anatomical changes due to surgical techniques nutritional supplementation is usually necessary. The success of oral nutritional supplementation to correct or prevent nutritional deficiencies depends on several factors. Thus, to understand how nutrients can be administered is very important for clinical practice. This review aims to provide help for the best selection of nutrients to ensure an adequate replacement of nutrients in patients who have undergone bariatric surgery.
Asunto(s)
Cirugía Bariátrica , Suplementos Dietéticos , Desnutrición/prevención & control , Vitaminas/administración & dosificación , Humanos , Obesidad/cirugía , Guías de Práctica Clínica como AsuntoRESUMEN
Pacientes submetidos à cirurgia bariátrica apresentam maior risco de desenvolver deficiências nutricionais pela limitação na ingestão e absorção de diferentes nutrientes. Desta forma, realizamos uma revisão sistemática no PubMed e ISI Web of Science incluindo artigos de setembro de 1983 a abril de 2010 para identificar as principais deficiências nutricionais após a cirurgia bariátrica e de que forma ocorre o seu tratamento. As palavras-chave utilizadas individualmente ou em associação foram: cirurgia bariátrica, obesidade, deficiência de vitamina/mineral, deficiência de proteína, absorção de nutrientes e suplementação de nutrientes. A literatura sugere que para prevenir ou tratar as deficiências nutricionais decorrentes das alterações anatômicas provocadas pelas técnicas cirúrgicas é necessário o uso de suplementação nutricional. O sucesso da suplementação nutricional oral em corrigir ou prevenir as deficiências nutricionais depende de vários fatores. Assim, compreender as formas pelas quais os nutrientes podem ser administrados é muito importante na prática clínica. Essa revisão tem como objetivo auxiliar a melhor seleção de nutrientes de forma a garantir uma reposição adequada dos nutrientes em pacientes submetidos à cirurgia bariátrica.
Patients who have undergone bariatric surgery are at increased risk of developing nutritional deficiencies from limited food intake and absorption of different nutrients. A systematic review of several database websites (PubMed and ISI Web of Science) was conducted from September 1983 to April 2010 to identify literature related to micronutrient deficiencies occurring after bariatric surgery. Keywords used individually or in various combinations in the search were bariatric surgery, obesity, vitamin/mineral deficiencies, protein deficiency, nutrient absorption and nutrient supplementation. Literature suggests that to prevent or treat nutritional deficiencies resulting from anatomical changes due to surgical techniques nutritional supplementation is usually necessary. The success of oral nutritional supplementation to correct or prevent nutritional deficiencies depends on several factors. Thus, to understand how nutrients can be administered is very important for clinical practice. This review aims to provide help for the best selection of nutrients to ensure an adequate replacement of nutrients in patients who have undergone bariatric surgery.