Association of coffee intake and its polyphenols with mammographic findings in women who visited the Brazilian Public Health Service.

Introduction: Objective: this study aimed to evaluate if there is an association of intake of coffee and its polyphenols with mammographic findings in women treated at a breast care service unit of the Unified Health System (SUS), Brazil. Research methods and procedures: this was a cross-sectional study with 532 women treated at a health service. The participants were divided according to their mammographic reports into two groups: without and with altered findings. Two 24-h dietary recalls were applied and coffee consumption was categorized into three groups (less than 1 cup, 1 to 3 cups, and more than 3 cups). Phenolic acids were determined using the Phenol Explorer program. The intake of polyphenols was calculated by adding the values obtained from the total amount of coffee consumed during the day. The Multiple Source Method (MSM) was applied to analyze the usual intake. Results: of the 532 women, 178 (33.5 %) had altered mammographic findings. The participants' average daily coffee intake was 193.4 mL. No significant association was found between coffee consumption and mammographic findings. However, it was found that the second tertile of polyphenols was a protective factor for breast changes. Conclusion: Coffee polyphenols are protective against breast changes in the group evaluated and, thus, can help prevent breast cancer.

Introducción: Objetivo: este estudio tuvo como objetivo evaluar si existe una asociación de la ingesta de café y sus polifenoles con los hallazgos mamográficos de mujeres tratadas en una unidad de patología mamaria del Sistema Unificado de Salud (SUS), Brasil. Métodos y procedimientos de investigación: este fue un estudio transversal con 532 mujeres tratadas en un servicio de salud. Las participantes se dividieron de acuerdo con sus informes mamográficos en dos grupos: sin y con hallazgos alterados. Se aplicaron dos registros dietéticos de 24 horas y el consumo de café se clasificó en tres grupos (menos de 1 taza, 1 a 3 tazas y más de 3 tazas). Los ácidos fenólicos se determinaron utilizando el programa Phenol Explorer. La ingesta de polifenoles se calculó sumando los valores obtenidos de la cantidad total de café consumido durante el día. Se aplicó el método de fuentes múltiples (MSM) para analizar la ingesta habitual. Resultados: de las 532 mujeres, 178 (33,5 %) tenían hallazgos mamográficos alterados. La ingesta diaria promedio de café de los participantes fue de 193,4 ml. No se encontró una asociación significativa entre el consumo de café y los hallazgos mamográficos. Sin embargo, se encontró que el segundo tercil de polifenoles era un factor protector para los cambios mamarios. Conclusión: los polifenoles del café son protectores contra los cambios mamarios en el grupo evaluado y, por lo tanto, podrían ayudar a prevenir el cáncer de mama.

Yacon syrup reduces postprandial glycemic response to breakfast: A randomized, crossover, double-blind clinical trial.

Yacon is a root rich in fructooligosaccharides (FOS), which act as prebiotics. Numerous studies have shown promising results in the technological aspects of producing yacon syrup. However, uncertainties exist concerning whether yacon syrup can modulate postprandial glucose and lipid profiles. In order to assess the effect of yacon syrup on postprandial glucose, insulin and triglyceride (TG) responses, a randomized, crossover, double-blind clinical intervention with 40 women (20 normal weight and 20 grade I obese) was performed. Participants underwent two-arms of intervention with at least a one-week wash-out period between visits. On each intervention day, after 12 h of fasting, an aliquot of blood was collected. For intervention A, volunteers consumed breakfast +40 g of placebo, whereas for intervention B, participants consumed breakfast +40 g of yacon syrup (14 g of FOS). Blood samples were drawn at 15, 30, 45, 60, 90, and 120 min. Glucose and insulin concentrations were lowered after yacon syrup intake as compared to placebo at following times: 30 min for glucose and 15, 30 and 45 min for insulin. In conclusion, yacon syrup has a postprandial decreasing effect glucose and insulin concentrations in adult women. This effect was not evident for triglyceride concentration. Clinical trial registry: RBR-33wf46. Available in: http://www.ensaiosclinicos.gov.br/rg/RBR-33wf46/.

Nutrition in Multiple Sclerosis: An integrative review of scientific publications from the last 5 years / Nutrición en la Esclerosis Múltiple: Revisión integrativa de las publicaciones científicas en los últimos 5 años

ABSTRACT This study analyzed the profile of scientific production related to the nutritional aspects of the etiology and/or progress of Multiple Sclerosis (MS). We conducted an integrative review that analyzed 64 works published in English, Spanish or Portuguese between 2012 and 2017 on the relationship between nutrition and MS. There was a predominance of studies in humans (54.0%, n= 34) and randomized clinical trials (38.3%, n= 13). The association between vitamin D and etiology progression and/or development of disabilities resulting from MS was the most studied aspect (30.2%, n= 19), followed by studies that evaluated the importance of fat concentration and/or types for MS risk (22.2%, n= 14), and research that analyzed the role of antioxidant vitamins (19.0%; n= 12) in the disease development and/ or evolution. The study showed that most research involves small samples and that a healthy diet contributes to the prevention and mitigation of disease evolution. However, this affirmation cannot be made with regards to dietary supplements. Further research is necessary, from cross-sectional studies to randomized clinical trials considering the wide knowledge gap on this subject.

RESUMEN El presente estudio buscó plantear el perfil de las producciones científicas que relacionan aspectos nutricionales con la etiología y/o progresión de la Esclerosis Múltiple (EM). Fue una revisión integrativa que analizó 63 trabajos publicados en el idioma inglés, español y portugués, entre 2012 a 2017, sobre la relación entre los aspectos nutricionales y la EM. Predominaron estudios con seres humanos (54,0%, n= 34), del tipo ensayo clínico randomizado (38,3%, n= 13). La asociación de la vitamina D con la etiología, progresión y/o desarrollo de incapacidades consecuentes de la EM fue la más estudiada (30,2%, n= 19), seguida de los estudios que evaluaron la importancia de la concentración y/o de los tipos de gordura para el riesgo o progresión de la EM (22,2%, n= 14), y de estudios que analizaron el papel de las vitaminas antioxidantes (19,0%; n= 12) en el desencadenamiento y/o evolución de la enfermedad. La mayoría de los estudios incluyó muestras pequeñas y una dieta saludable que aporta con la prevención y atenuación de la evolución de la enfermedad. No se pueó hacer esta afirmación para los suplementos dietéticos. Son necesarios más estudios, dada la enorme laguna de conocimiento que envuelve el tema.

Fructo-oligosaccharide effects on blood glucose: an overview.

PURPOSE: To identify the current status of scientific knowledge in fructo-oligosaccharides (FOS), non-conventional sugars that play an important role in glycemia control. METHODS: We performed a search for scientific articles in MEDLINE and LILACS databases, from January 1962 to December 2011, using English/Portuguese key words: "blood glucose/glicemia", "prebiotics/prebióticos" and "dietary fiber/fibras na dieta". From an initial number of 434 references, some repeated, 43 references published from 1962 to 2011 were included in this study. The selected texts were distributed in three topics: (1) metabolism of FOS, (2) FOS and experimental studies involving glucose and (3) human studies involving glucose and FOS. RESULTS: Five studies have shown that the use of FOS reduces the fecal content and increases intestinal transit time. Experimental studies have shown that dietary supplementation with high doses (60 g/Kg) of propionate, a short-chain fatty acid decreased glycemia. The use of lower doses (3 g/kg) did not produce the same results. Study in subjects with diabetes type II showed that the addition of 8 grams of FOS in the diet for 14 days, caused a reduction in serum glucose. In another study with healthy subjects, there were no changes in glycemic control. CONCLUSIONS: This review demonstrates that consumption of FOS has a beneficial influence on glucose metabolism. The controversies appear to be due to inadequate methodological designs and/or the small number of individuals included in some studies.

Fructo-oligosaccharide effects on blood glucose: an overview / Efeitos dos fruto-oligossacarídeos no controle glicêmico: revisão

PURPOSE: To identify the current status of scientific knowledge in fructo-oligosaccharides (FOS), non-conventional sugars that play an important role in glycemia control. METHODS: We performed a search for scientific articles in MEDLINE and LILACS databases, from January 1962 to December 2011, using English/Portuguese key words: "blood glucose/glicemia", "prebiotics/prebióticos" and "dietary fiber/fibras na dieta". From an initial number of 434 references, some repeated, 43 references published from 1962 to 2011 were included in this study. The selected texts were distributed in three topics: (1) metabolism of FOS, (2) FOS and experimental studies involving glucose and (3) human studies involving glucose and FOS. RESULTS: Five studies have shown that the use of FOS reduces the fecal content and increases intestinal transit time. Experimental studies have shown that dietary supplementation with high doses (60 g/Kg) of propionate, a short-chain fatty acid decreased glycemia. The use of lower doses (3 g/kg) did not produce the same results. Study in subjects with diabetes type II showed that the addition of 8 grams of FOS in the diet for 14 days, caused a reduction in serum glucose. In another study with healthy subjects, there were no changes in glycemic control. CONCLUSIONS: This review demonstrates that consumption of FOS has a beneficial influence on glucose metabolism. The controversies appear to be due to inadequate methodological designs and/or the small number of individuals included in some studies.

OBJETIVO: Conhecer o estado atual do conhecimento científico em fructooligossacarídeos (FOS), açúcares não-convencionais que desempenham um papel importante no controle da glicemia. MÉTODOS: Realizamos uma busca de artigos científicos nas bases de dados MEDLINE e Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), a partir de janeiro 1962 a dezembro de 2011, usando como descritores termos Português/Inglês: "glicemia/blood glucose, "prebióticos/prebiotics" e "fibras na dieta/dietary fiber. A partir de um número inicial de 434 referências, algumas repetidas, 43 referências foram consideradas adequadas para a finalidade deste estudo e foram, portanto, selecionadas para análise. Os textos selecionados foram distribuídos em três tópicos: (1) metabolismo de FOS (2), FOS e estudos experimentais envolvendo glicose e (3) estudos em humanos envolvendo glicose e FOS. RESULTADOS: Cinco trabalhos mostraram que o uso de FOS diminui o conteúdo fecal e aumenta o tempo do transito intestinal. Estudos experimentais demonstraram que a suplementação dietética com altas doses (60 g/Kg) de propionato, um ácido graxo de cadeia curta, diminuiu a glicemia. A utilização de doses menores (3 g/Kg) não produziu os mesmos resultados. Em indivíduos diabéticos tipo II a adição de 8 g de FOS na dieta, durante 14 dias, induziu uma redução da glicemia. Em indivíduos sadios, não ocorreram alterações da glicemia. CONCLUSÕES: Essa revisão mostra que o consumo de FOS exerce influência benéfica no metabolismo glicêmico. As controvérsias evidenciadas parecem estar mais ligadas a desenhos metodológicos inadequados e/ou ao número reduzido de indivíduos incluídos em alguns estudos.

A dieta do paleolítico na prevenção de doenças crônicas / Paleolithic diet in the prevention of chronic diseases

The search for healthy nutritional standards to prevent chronic diseases has led researchers to investigate the diet of our ancestors, mainly of the Paleolithic age. The aim of this study was to examine the current knowledge about the Paleolithic diet and the extent to which it can be applied to the prevention of chronic diseases. The research was based on data from several English, Spanish and Portuguese articles found at Medline and Lilacs databases. The Paleolithic diet consisted of only 3 basic foodstuffs: meat, vegetables and fruit and was thus rich in fibers (46 g), vitamins, minerals and phytochemicals having a high amount of potassium and low sodium content. The intake of calcium was satisfactory since this was obtained from forage and deer meat. The meat available from wild animals was low in fat and contained omega-3 fatty acids. The results of recent studies have been promising and suggest the diet can help in the reductionof chronic diseases. Further in-depth enquiries are needed into both the potential risks and benefits of the paleolithic diet as, if there are no collateral risks, its introduction could lead to significant changes in the feeding habits of the western world. However, health professionals should adopt a critical point of view to this issue, and should not be swayed by its growing popularappeal; their principal concern must always be the health of the population.

La búsqueda por modelos de alimentación saludables que prevengan enfermedades crónicas, ha llevado a los investigadores a mirarlas respuestas en la dieta de nuestros antepasados, particularmente del paleolítico. El objetivo de esta investigación fue revisar el conocimiento actual de la dieta del paleolítico, su aplicabilidady su utilidad en la prevención de enfermedades crónicas. Por medio de las bases de datos Medline y Lilacs fue realizada una búsqueda de artículos en inglés, español y portugués. La dieta del paleolítico estaba compuesta por sólo tres grupos alimenticios: carnes, hortalizas y frutas.Esa composición propiciaba un contenido ricoen fibras (46g), vitaminas, minerales y fotoquímicos, abundante en potasio y pobre ensodio; la ingestión de calcio era satisfactoria, provista por forrajeras y carne de ciervo. La carne disponible, de animales salvajes, era pobre en grasas y contenía ácido graso omega-3. Sepercibe que esta dieta contiene varias recomendaciones actuales para disminuir el riesgo de enfermedades crónicas. Los pocos estudios que intentaron adaptarla a nuestros días muestran resultados prometedores. Frentea su potencial, parece relevante profundizar en las investigaciones acerca de los riesgos y beneficios asociados a una actualización de la dieta del paleolítico, sin embargo resaltamos quesi los beneficios son definitivamente comprobados y que no hay riesgos asociados, la utilización deese modelo dietético exigirá profundos cambiosen los hábitos alimenticios del mundo occidental. El profesional de la salud necesita adoptar unposicionamiento crítico frente a esta temática,sin dejarse seducir por el creciente apelo popular favoreciendo la salud de la población.

A busca de padrões alimentares saudáveis, preventivos de doenças crônicas tem levado pesquisadores a procurarem respostas na dietados nossos ancestrais, particularmente da era paleolítica. O objetivo do presente estudo foirevisar o conhecimento atual sobre a dieta do paleolítico, sua aplicabilidade e sua utilidade na prevenção de doenças crônicas. Para tanto foi realizada, nas bases de dados Medline e Lilacs, uma busca de artigos publicados em inglês, espanhol e português. A dieta do paleolítico era composta por apenas 3 grupos alimentares: carnes, hortaliças e frutas. Tal composição propiciava uma dieta rica em fibras(46g), vitaminas, minerais, e fitoquímicos, sendo ainda elevada em potássio e pobre em sódio; a ingestão de cálcio era satisfatória, propiciada por plantas forrageiras e carne de cervo. A carne disponível, de animais selvagens, era pobre em gordura e continha ácido graxo ômega-3. Percebe-se que esta dieta contempla várias das recomendações atuais para reduzir o risco de doenças crônicas. Dentre os poucos estudos que tentaram adaptá-la para os dias de hoje, os resultados parecem promissores. Face ao seu potencial, parece relevante aprofundar pesquisas sobre riscos e benefícios associados a uma atualização da dieta do paleolítico. Deve ser destacado, no entanto, que caso seus benefícios sejam definitivamente comprovados e não haja riscos associados, a utilização deste modelo dietético irá requerer amplas mudanças nos hábitos alimentares do mundo ocidental. O profissional de saúde necessita adotar um posicionamento crítico frente a esta temática, sem se deixar seduzir pelo apelo popular crescente, favorecendo a saúde da população.