[Effects of the composite of buckwheat-oat-pea on blood glucose in diabetic rats].

OBJECTIVE: To study the effects of buckwheat-oat-pea (BOP) composite flour [buckwheat ∶ oats ∶ peas=6 ∶ 1 ∶ 1 (quality ratio)] on blood glucose in diabetic rats. METHODS: In this study, 64 male Sprague-Dawley rats were divided into 8 groups by fasting blood glucose (FBG) and body weight: normal control group, model control group, metformin group, buckwheat group, oats group, BOP low-dose group (BOP-L), medium-dose group (BOP-M), and high-dose group (BOP-H). The rats in the normal control group were fed with normal diet, the rats in the model control group and metformin group were fed with a high-fat diet (HFD), and the rats in the buckwheat group, oats group, and BOP-L, BOP-M, BOP-H groups were fed with HFD containing 10% buckwheat flour, 10% oat flour, 3.3% BOP, 10% BOP, 30% BOP, respectively. The HFD in all the groups had the same percentage of energy from fat (45%). After 30 days, the rats fed with HFD received intraperitoneal injection of streptozotocin (30 mg/kg, once a week for two weeks) to establish diabetes mellitus. After the model was successful established, the rats were fed for another 28 days. During the study, the body weight, food intake/body weight (FI/BW) and water intake/body weight (WI/BW), food utilization rate, 24 h urine volume, FBG, glucose area under curve (GAUC) of oral glucose tolerance test were measured regularly. At the end of the study, the fasting serum glucose and insulin were measured, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. RESULTS: With the inducing of HFD and streptozotocin, compared with the normal control group, the rats in the model control group had higher FI/BW, WI/BW, 24 h urine volume, FBG, GAUC, HOMA-IR (P < 0.05), and lower body weight, food utilization rate (P < 0.05). Compared with the model control group, the rats in the three BOP groups all had higher body weight, food utilization rate (P < 0.05), and lower WI/BW, HOMA-IR (P < 0.05); the rats in the BOP-L and BOP-M groups had lower FI/BW, 24 h urine volume, FBG (P < 0.05), and the rats in the BOP-M group also had lower GAUC (P < 0.05). After the establishment of diabetes, there was no significant difference in blood glucose and the other indicators between the rats in the three BOP groups and the buckwheat group or the oats group (P>0.05). CONCLUSION: The BOP had the effects of reducing blood glucose, insulin resistance and diabetic symptoms on diabetic rats, and had the value for further development and utilization.

Effects of the composite of buckwheat-oat-pea on blood glucose in diabetic rats / 北京大学学报(医学版)

OBJECTIVE@#To study the effects of buckwheat-oat-pea (BOP) composite flour [buckwheat ∶ oats ∶ peas=6 ∶ 1 ∶ 1 (quality ratio)] on blood glucose in diabetic rats.@*METHODS@#In this study, 64 male Sprague-Dawley rats were divided into 8 groups by fasting blood glucose (FBG) and body weight: normal control group, model control group, metformin group, buckwheat group, oats group, BOP low-dose group (BOP-L), medium-dose group (BOP-M), and high-dose group (BOP-H). The rats in the normal control group were fed with normal diet, the rats in the model control group and metformin group were fed with a high-fat diet (HFD), and the rats in the buckwheat group, oats group, and BOP-L, BOP-M, BOP-H groups were fed with HFD containing 10% buckwheat flour, 10% oat flour, 3.3% BOP, 10% BOP, 30% BOP, respectively. The HFD in all the groups had the same percentage of energy from fat (45%). After 30 days, the rats fed with HFD received intraperitoneal injection of streptozotocin (30 mg/kg, once a week for two weeks) to establish diabetes mellitus. After the model was successful established, the rats were fed for another 28 days. During the study, the body weight, food intake/body weight (FI/BW) and water intake/body weight (WI/BW), food utilization rate, 24 h urine volume, FBG, glucose area under curve (GAUC) of oral glucose tolerance test were measured regularly. At the end of the study, the fasting serum glucose and insulin were measured, and homeostasis model assessment of insulin resistance (HOMA-IR) was calculated.@*RESULTS@#With the inducing of HFD and streptozotocin, compared with the normal control group, the rats in the model control group had higher FI/BW, WI/BW, 24 h urine volume, FBG, GAUC, HOMA-IR (P < 0.05), and lower body weight, food utilization rate (P < 0.05). Compared with the model control group, the rats in the three BOP groups all had higher body weight, food utilization rate (P < 0.05), and lower WI/BW, HOMA-IR (P < 0.05); the rats in the BOP-L and BOP-M groups had lower FI/BW, 24 h urine volume, FBG (P < 0.05), and the rats in the BOP-M group also had lower GAUC (P < 0.05). After the establishment of diabetes, there was no significant difference in blood glucose and the other indicators between the rats in the three BOP groups and the buckwheat group or the oats group (P>0.05).@*CONCLUSION@#The BOP had the effects of reducing blood glucose, insulin resistance and diabetic symptoms on diabetic rats, and had the value for further development and utilization.

Avaliação dos custos diretos com terapia nutricional enteral em um hospital público / Assessment of direct costs with enteral nutritional therapy in a public hospital

Introdução: A desnutrição representa um alto custo hospitalar, decorrente de gastos com medi� camentos, exames e terapia nutricional em maior tempo de internação. Nos hospitais públicos, o Sistema Único de Saúde (SUS) repassa um valor diário por paciente para subsidiar os custos com nutrição enteral (NE). O objetivo do trabalho foi descrever os custos diretos com NE em pacientes hospitalizados e avaliar o percentual desses custos em relação ao repasse do SUS. Método: Estudo transversal e descritivo desenvolvido no Setor de Terapia Nutricional de um hospital público. Os custos diretos foram quantificados de acordo com consumo e custo diário de fórmulas enterais, frascos e equipos, número de pacientes por dia em uso de nutrição enteral (NE): por sonda e por suplementação nutricional oral (SNO). Os valores obtidos foram utilizados para avaliar o percentual de cobertura do valor padrão repassado pelo SUS. Resultados: No período avaliado, foram quantificadas 2066 solicitações de NE para pacientes (69,4% com NE por sonda e 30,6% com SNO). O custo médio diário por paciente em uso de NE por sonda foi de R$ 23,89 (60,0% referente à fórmula, 30,2% ao equipo, 7,7% ao frasco e 2,1% ao módulo proteico) e em uso de SNO foi de R$ 6,17 (95,7% referente à fórmula, 3,3% do frasco e 1,0% do módulo proteico). Isso representou uma cobertura do valor repassado pelo SUS de, respectivamente, 79,6% e 20,2%. Na NE por sonda, os custos estimados diários com fórmulas foram: semielementares (R$ 22,65), especializadas (R$ 19,58), hipercalórica/hiperproteica (R$ 13,13) e normocalórica/hiperproteica (R$ 10,26). Na SNO, foram de hipercalóricos/hiperproteicos (R$ 6,12), semielementares (R$ 5,80), especializados (R$ 5,43) e normocalóricos/hiperproteicos (R$ 3,51). Conclusões: Observa-se no estudo que o valor repassado pelo SUS com terapia nutricional enteral provavelmente se mostra insuficiente, principalmente para cobrir os custos com NE por sonda.

Japanese physicians' attitudes towards enteral nutrition treatment for pediatric patients with Crohn's disease: a questionnaire survey.

BACKGROUND/AIMS: Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices. METHODS: Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011. RESULTS: A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days. CONCLUSIONS: EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.

Japanese physicians' attitudes towards enteral nutrition treatment for pediatric patients with Crohn's disease: a questionnaire survey

BACKGROUND/AIMS: Enteral nutrition (EN) is recommended for the treatment of pediatric Crohn's disease (CD) in Japan. However, the indications and treatment protocols for EN vary among hospitals. In the present study, we aimed to determine how EN was administered to pediatric patients and whether physicians followed treatment guidelines in their practices. METHODS: Two types of questionnaires were administered to 32 physicians who were involved in the treatment of pediatric CD. The consensus questionnaire evaluated the physicians' attitudes towards EN, whereas the efficacy questionnaire collected data on patients with CD, aged <17 years, who had undergone induction therapy between 2006 and 2011. RESULTS: A total of 23 physicians responded to the questionnaires. The results of the consensus questionnaire indicated that 82% and 59% of study participants recommended EN treatment for all newly diagnosed pediatric patients with CD and all relapsed patients, respectively. Exclusive EN (EEN) and elemental formula were recommended by 84% and 85% of physicians, respectively. The efficacy questionnaire revealed that 57 of the 58 patients received EN. Elemental formula was used in 39 of 40 patients who were treated with EEN. Of these 40 patients, 27 were treated with EEN alone; of these, 22 (81%) achieved remission without any other treatment. The mean duration of EEN was 15.9 days. CONCLUSIONS: EN is widely recommended by physicians treating pediatric CD in Japan. In contrast to Western countries, clinicians used elemental formula more often and with a shorter EEN treatment duration.

Comparação energética e de micronutrientes entre dietas enterais fornecidas pelo Sistema Único de Saúde / Comparison between energy and enteral micro diets provided by the Unified Health System

A Nutrição Enteral é considerada como um alimento utilizado para fins especiais, com a ingestão controlada de nutrientes, na forma isolada ou combinada, de composição definida, especialmente formulada e elaborada para uso por sondas ou via oral, industrializado ou não. O objetivo desse estudo foi analisar os rótulos de alimentos de Nutrição Enteral comparando energia e micronutrientes entre dietas alimentares especiais fornecidas pelo Sistema Único de Saúde de Guarapuava, Paraná. A pesquisa foi realizada na Secretaria de Saúde do município, e foram analisados 15 rótulos de embalagens de fórmulas de NE. Foram analisadas fórmulas enterais indicadas para via oral e sonda e avaliados os valores de energia macronutrientes (carboidratos, proteína e lipídios) além de vitaminas (A, C e B12) e minerais (cálcio e ferro). A padronização dos nutrientes está de acordo com 100 gramas do produto e também no total diário, de acordo com o fabricante considerando, 6 refeições ao dia, com cerca de 35g do produto reconstituído em água. Seis produtos (40%) eram fórmulas completas, e somente uma (6,7%) era especializada, para distúrbios renais. Ainda, observa-se que a frequência maior de produtos era de módulos (46,7%). Quanto ao custo, observou-se que a diferença aproximadamente entre o mínimo e máximo é de R$50,00 para cada produto. Quando há comparação entre as fórmulas enterais em termos de vitaminas e minerais obtém-se diferença estatística entre todos os micronutrientes avaliados. Para a vitamina A média foi de 490,70mg, para a vitamina C 51,27mg, para a vitamina B12 a média foi 1,52mg, para o ferro foi 7,63mg, e por fim o cálcio com a média 418,25mg. Quando consideradas apenas as fórmulas completas, a média de calorias diárias foi diferente entre as fórmulas analisadas (867,2±270,5 Kcal) (p<0,05). O mesmo ocorreu com os carboidratos, proteínas e lipídios (p<0,05). Vale ressaltar que poucas fórmulas conseguem suprir as necessidades de pacientes que necessitam de dieta especializada e com valores especiais de calorias diárias com melhoria de nutrientes.

Enteral Nutrition is all food for special purposes, with controlled nutrients intake, alone or in combination, defined composition, specially formulated and designed for use by probes or oral, industrialized or not. The aim of this study was to analyze the Enteral Nutrition food labels comparing energy and micronutrients between special diets provided by the Brazilian Unit health care system (SUS) at Guarapuava, Paraná, Brazil. It Were analyzed 15 labels Enteral Nutrition formulas packaging and it was analyzed energy and micronutrient composition. Enteral formulas given orally and probe were analyzed. They evaluated the energy values macronutrients (carbohydrates, protein and lipids) as well as vitamins (A, B12 and C) and minerals (calcium and iron). Nutrients standardization is in accordance with 100 grams per product and also the total daily according to the manufacturer 6 meals a day, about 35g of the reconstituted product in water. Six (40%) were complete formulas and only one (6.7%) was specialized, for kidney disorders. Thus, it is observed that the higher frequency products were modules (46.7%). As for the cost it was observed that the difference approximately between the minimum and maximum is R$50.00 for each product. When no comparison between the enteral formulas in terms of vitamins and minerals obtained statistical difference between all micronutrient, vitamin A the average was 490.70mg, as the vitamin C 51.27mg, vitamin B12 average was 1.52 mg, since iron was 7.63 mg, and finally with calcium media was 418.25mg. When considering only the complete formulas, the average daily calorie was different among the formulas analyzed (867.2±270.5kcal) (p<0.05). The same happened with carbohydrates, proteins and lipids (p <0.05). It can be seen that formulas few can meet the needs of patients requiring specialized diet and daily calorie special values with improved nutrients.

Qualidade nutricional e microbiológica de dietas enterais artesanais padronizadas preparadas nas residências de pacientes em terapia nutricional domiciliar / Nutritional and microbiological quality of standardized homemade enteral diets for patients in home nutritional therapy

OBJETIVO: Avaliar as propriedades físico-químicas, microbiológicas e nutricionais de dietas enterais artesanais padronizadas preparadas nos domicílios de pacientes em terapia nutricional domiciliar. MÉTODOS: Foram desenvolvidas duas formulações de dietas enterais (F1=1,2kcal/mL e F2=1,5kcal/mL), elaboradas com maltodextrina (155/155g), concentrado proteico de soro de leite (30/15g) e óleos vegetais (30/60g) dissolvidos em água (q.s.p.1000mL). Os cuidadores receberam os ingredientes e as medidas padrão e foram orientados quanto ao preparo e às boas práticas de manipulação. O estudo teve duração de quatro meses, e amostras das dietas preparadas nos domicílios de 33 pacientes foram coletadas e analisadas no início e no final deste período. As amostras foram avaliadas quanto à sua adequação percentual em relação aos valores prescritos de macronutrientes e energia, bem como aos padrões microbiológicos estabelecidos pela legislação vigente. RESULTADOS: As dietas formuladas (Formulação 1/Formulação 2) apresentaram os seguintes teores de macronutrientes, energia e osmolalidade: água - 73,5/70,0%; proteína - 4,4/6,0%; lipídeo - 4,3/6,6%; carboidrato - 16,9/16,4%; energia - 120/150kcal/100mL; osmolalidade - 440/450mOsm/kg.H2O. As variações nas adequações percentuais das amostras domiciliares foram menores que 20,0% tanto na primeira quanto na última amostragem. As proporções de amostras em desacordo com os padrões legais foram significantemente menores nas amostras finais, 24,0% e 36,0% para bactérias mesófilas e coliformes, respectivamente. CONCLUSÃO: O preparo das dietas nos domicílios apresentou boa reprodutibilidade; no entanto, a qualidade microbiológica ainda permanece uma questão preocupante, exigindo uma atuação cuidadosa do profissional de saúde nos domicílios.

OBJECTIVE: This study assessed the physical, chemical, microbiological and nutritional properties of standardized enteral diets prepared at the homes of patients receiving nutritional therapy. METHODS: Two enteral diet formulations were developed (F1=1.2kcal/mL and F2=1.5kcal/mL) containing maltodextrin (155/155g), whey protein concentrate (30/15g) and vegetable oils (30/60g) dissolved in water (q.s.p.1000mL). The ingredients and measuring devices were given to the caregivers, along with preparation instructions and advice on good handling practices. The study lasted four months and the diets prepared at the homes of 33 patients were collected at baseline and endline for analysis. The samples were analyzed to determine the compliance of their macronutrient and energy contents with the prescription and their microbiological contents with the legislation. RESULTS: The study diets (Formulation 1/Formulation 2) contained the following macronutrient and energy contents and osmolality: water - 73.5/70.0%; protein - 4.4/6.0%; lipids - 4.3/6.6%; carbohydrate - 16.9/16.4%; energy - 120/150kcal/100mL; osmolality - 440/450mOsm/kg.H2O. The percent adequacy of the homemade diets did not vary by more than 20.0% at baseline or end of study. The percentages of samples that did not meet the legal standards were significantly lower at the end of the study: 24.0% and 36.0% for mesophilic bacteria and coliforms, respectively. CONCLUSION: Homemade diets presented good reproducibility but their microbiological quality remains a matter of concern, indicating that health professionals must be careful when working at home.