RESUMO
To prepare a nutritional supplement using silkworm pupae oil (SPO) as a feedstock, a microfluidic reactor with a smart hydrogel immobilized lipase was first constructed to reduce the relative content of palmitic acid at sn-1,3 and improve the nutritional function. The effects of flow rate, reaction temperature, and substrate molar ratio were investigated. In vitro digestion and pH-stat models were employed to analyze the digestion feature after the modification of SPO, while HPLC-ELSD, zeta potential, DSC, and TGA were used to evaluate the nutritional function. The relative content of "OOO" and "OPO" type triglycerides was increased by 49.48% and 107.67%, and that of palmitic acid at sn-1,3 was decreased by 49.61% in 10 s. After the verification of the in vitro digestion model, the fatty acid release rate of the modified SPO was significantly improved by 22.07%, indicating the nutritional function improvement of SPO. Therefore, the nutritional function of SPO has been improved successfully by the application of a microchannel reactor with photo-immobilized lipase, which could set a reference for the utilization of insect oil resources.
Assuntos
Bombyx/química , Hidrogéis/química , Lipase/química , Óleos/química , Pupa/química , Animais , Catálise , Cromatografia Líquida de Alta Pressão/métodos , Suplementos Nutricionais , Enzimas Imobilizadas/química , Ácidos Graxos/análise , Humanos , Concentração de Íons de Hidrogênio , Microscopia Eletrônica de Varredura/métodos , Ciências da Nutrição/métodos , Ácido Palmítico/análise , Termodinâmica , Triglicerídeos/análiseAssuntos
Enteropatias/dietoterapia , Enfermeiros Clínicos/tendências , Ciências da Nutrição/métodos , Consultores , Feminino , Gastrostomia/métodos , História do Século XXI , Humanos , Enteropatias/fisiopatologia , Enfermeiros Clínicos/ética , Terapia Nutricional/métodos , Nutrição Parenteral/métodosRESUMO
The field of 'nutritional psychiatry' has evolved with rapidity over the past several years, with an increasing amount of dietary or nutrient-based (nutraceutical) intervention studies being initiated, and more preclinical and epidemiological data being available. This emergent paradigm involves the clinical consideration (where appropriate) of prescriptive dietary modification/improvement, and/or the select judicious use of nutrient-based supplementation to prevent or manage psychiatric disorders. In the last several years, significant links have increasingly been established between dietary quality and mental health (although not all data are supportive). Maternal and early-life nutrition may also affect the mental health outcomes in offspring. In respect to nutraceutical research, like with many recent conventional drug studies, results are fairly mixed across the board, and in many cases there is not emphatic evidence to support the use of nutraceuticals in various psychiatric disorders. This may in part be due to a preponderance of recent studies within the field revealing marked placebo effects. Due to current indicators pointing towards mental disorders having an increasing burden of disease, bold and innovative approaches on a societal level are now required. In light of the widespread use of nutrient supplements by those with and without mental disorders, it is also critical that scientifically rigorous methodologies be brought to bear on the assessment of the efficacy of these supplements, and to determine if, or what dose of, a nutrient supplement is required, for whom, and when, and under what circumstances. More simple studies of additional isolated nutrients are not of great benefit to the field (unless studied in supra-dosage in an individualised, biomarker-guided manner), nor, based on recent data, is the research of 'shotgun' formulations of nutraceuticals. The next critical step for the field is to design psychiatric interventional studies for both dietary modification and nutraceuticals, based on more of a personalised medicine approach, using biomarkers (e.g. nutrient deficiencies, inflammatory cytokine levels, genomic assessment, microbiome analysis) and a person's dietary patterns and individual macro/micronutrient requirements.
Assuntos
Comportamento Alimentar/fisiologia , Transtornos Mentais/terapia , Saúde Mental , Ciências da Nutrição/métodos , Psiquiatria/métodos , Dieta Saudável , Suplementos Nutricionais , Comportamento Alimentar/psicologia , Humanos , Transtornos Mentais/psicologia , Ciências da Nutrição/tendências , Psiquiatria/tendênciasRESUMO
BACKGROUND: In 2011, we launched the Smarter Pregnancy mobile health (mHealth) coaching program, which has shown to effectively improve inadequate nutrition and lifestyle behaviors in women before and during pregnancy. It is known that in deprived neighborhoods, risk factors for adverse pregnancy outcomes like inadequate nutrition and lifestyle behaviors accumulate. However, it has not yet been investigated whether the Smarter Pregnancy program is equally effective in women living in deprived neighborhoods. OBJECTIVE: This paper aimed to study the associations between neighborhood deprivation and improvement of inadequate nutrition and lifestyle behaviors of women who were either contemplating pregnancy or already pregnant and subscribed to the Smarter Pregnancy program. METHODS: We performed an additional analysis on data from women who used the Smarter Pregnancy program from 2011 to 2016. The program comprised 24 weeks of coaching on 5 nutrition and lifestyle behaviors, of which adequate intakes or lifestyle behaviors were defined as an intake of 200 grams or above of vegetables, 2 pieces of fruit, daily folic acid supplement use of 400 µg per day, and no smoking or alcohol consumption. Neighborhood deprivation was determined according to the status scores of the Netherlands Institute for Social Research. Logistic regression analyses and generalized estimating equation models were used to assess the associations between the neighborhood status score (NSS) and the improvement of inadequate nutrition and lifestyle behaviors, taking into account the behaviors at baseline. We adjusted the analyses for maternal age, body mass index, geographic origin, pregnancy status, and participation as a couple. RESULTS: Of the 2554 women included, 521 participated with their male partner. Overall, daily vegetable intake was most frequently inadequate at the start of the program (77.72, 1985/2554). Women with a higher NSS (ie, nondeprived neighborhood) smoked less often (adjusted odds ratio [OR] 0.85; 95% CI 0.77-0.93), consumed alcohol more often (adjusted OR 1.14, 95% CI 1.04-1.24), and were less likely to complete the 24 weeks of coaching (OR 0.91, 95% CI 0.88-0.95) compared with women who lived in a neighborhood with a low NSS (ie, deprived). In the total group, the relative improvement of inadequate nutrition and lifestyle behaviors after 24 weeks of coaching was between 26% and 64%. NSS was negatively associated with this improvement, indicating that women with a higher NSS were less likely to improve inadequate nutrition and lifestyle behaviors, especially vegetable intake (adjusted OR 0.89, 95% CI 0.82-0.97). CONCLUSIONS: The Smarter Pregnancy mHealth coaching program empowers women to improve inadequate nutrition and lifestyle behaviors. Unexpectedly, the program seemed more effective in women living in deprived neighborhoods. It is important to unravel differences in needs and behaviors of specific target groups to further tailor the mHealth program on the basis of demographic characteristics like neighborhood deprivation.
Assuntos
Tutoria/normas , Ciências da Nutrição/educação , Cuidado Pré-Concepcional/métodos , Telemedicina/normas , Adulto , Feminino , Humanos , Tutoria/métodos , Países Baixos , Ciências da Nutrição/métodos , Razão de Chances , Cuidado Pré-Concepcional/normas , Gravidez , Desenvolvimento de Programas/métodos , Características de Residência/estatística & dados numéricos , Inquéritos e Questionários , Telemedicina/métodos , População Urbana/estatística & dados numéricosRESUMO
BACKGROUND: Dietitians in countries across the world have been implementing the Nutrition Care Process (NCP) and Terminology (NCPT) during the past decade. The implementation process has been evaluated in specific countries and in smaller international studies; however, no large international study comparing implementation between countries has been completed. OBJECTIVE: The aim of this study was to describe and compare the level of NCP/NCPT implementation across 10 countries. METHODS: A previously tested web-based survey was completed in 2017 by 6,719 dietitians across 10 countries. Participants were recruited through e-mail lists, e-newsletters, and social media groups for dietitians. Nondietitians were excluded through screening questions and targeted dissemination channels. MAIN OUTCOME MEASURES AND STATISTICAL ANALYSIS: The main outcome of interest was the level of implementation of each of the four NCP steps. Differences in implementation between the NCP (process) and NCPT (terminology) were also measured. Differences between groups were assessed using Kruskal-Wallis test and Mann-Whitney U test. Multiple linear regression was used to assess relationships between the main outcomes and respondent demographic information. RESULTS: Australia, New Zealand, and the United States had higher implementation rates compared with other countries surveyed. Awareness of the NCP was high in most countries (>90%) but lower in Greece (50%). All countries had a higher implementation level of the NCP (process) compared with the NCPT (terminology). Dietitians working with inpatients reported the highest implementation levels while those working in public health reported the lowest. CONCLUSIONS: Dietitians in countries with more experience in NCP/NCPT implementation and a clear implementation strategy had higher levels of implementation. To achieve a successful NCP/NCPT implementation among dietitians, there is a need to promote the value of a standardized dietetic language together with the more easily implemented process. There is also a need to promote NCP/NCPT for all areas of practice, and develop strategic plans for implementation of the NCP and NCPT.
Assuntos
Implementação de Plano de Saúde/estatística & dados numéricos , Terapia Nutricional/normas , Ciências da Nutrição/normas , Avaliação de Processos em Cuidados de Saúde/estatística & dados numéricos , Terminologia como Assunto , Estudos de Coortes , Humanos , Ciências da Nutrição/métodos , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Euryale ferox Salisb. (Makhana) is a rooted macro-hydrophyte, grown as a crop in north Bihar wetlands, India. Makhana refers to yummy pops prepared through mechanical smacking of the baked seeds of E. ferox. New techniques have been evolved to produce pops from seeds at a brisk pace. OBJECTIVE: It is specially associated with marital rituals possibly in view of its spermatogenic properties. It has a high amino acid index but a low glycemic value. The plant carries medicinal values against cardiovascular and diabetes-related diseases. Makhana pops with a high volume to mass ratio, is developed as a reliable system for drug delivery in the recent times. RESULTS: There is a fair prospect of raising multi-faceted industry based on Makhana culture, harvest, post-harvest safety, preparation of pops and various types of food products therefrom and marketing in areas where water-logging is considered as a curse. It may generate employment and strengthen regional economy propping check on population migration primarily due to non-employment and poverty. CONCLUSION: Active research is required to harness this macro-hydrophyte along with co-culture of compatible fish varieties and other hydrophytes into a sustainable livelihood and economic prosperity.
Assuntos
Aquicultura/métodos , Ciências da Nutrição/métodos , Nymphaeaceae/química , Extratos Vegetais/química , Sementes/química , Animais , Aquicultura/tendências , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/epidemiologia , Humanos , Índia/epidemiologia , Ciências da Nutrição/tendências , Nymphaeaceae/fisiologia , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/uso terapêutico , Sementes/fisiologiaRESUMO
There is a rapid increase in the percentage of elderly people in Europe. Consequently, the prevalence of age-related diseases will also significantly increase. Therefore, the main goal of MediHealth, an international research project, is to introduce a novel approach for the discovery of active agents of food plants from the Mediterranean diet and other global sources that promote healthy ageing. To achieve this goal, a series of plants from the Mediterranean diet and food plants from other origins are carefully selected and subjected to in silico, cell-based, in vivo (fly and mouse models), and metabolism analyses. Advanced analytical techniques complement the bio-evaluation process for the efficient isolation and identification of the bioactive plant constituents. Furthermore, pharmacological profiling of bioactive natural products, as well as the identification and synthesis of their metabolites, is carried out. Finally, optimization studies are performed in order to proceed to the development of innovative nutraceuticals, dietary supplements or herbal medicinal products. The project is based on an exchange of researchers between nine universities and four companies from European and non-European countries, exploiting the existing complementary multidisciplinary expertise. Herein, the unique and novel approach of this interdisciplinary project is presented.
Assuntos
Produtos Biológicos/química , Dieta Mediterrânea , Suplementos Nutricionais/análise , Envelhecimento Saudável/efeitos dos fármacos , Compostos Fitoquímicos/isolamento & purificação , Plantas Comestíveis/química , Animais , Disponibilidade Biológica , Produtos Biológicos/farmacocinética , Produtos Biológicos/farmacologia , Drosophila melanogaster/efeitos dos fármacos , Drosophila melanogaster/fisiologia , Envelhecimento Saudável/fisiologia , Humanos , Comunicação Interdisciplinar , Cooperação Internacional , Camundongos , Camundongos Endogâmicos C57BL , Ciências da Nutrição/instrumentação , Ciências da Nutrição/métodos , Compostos Fitoquímicos/química , Plantas Medicinais/químicaRESUMO
The Metabolically Optimized Brain study explored nutritional science believed to be ready to place into practice to help improve US service members' cognitive performance and, thereby, optimize mission-readiness. A transparent, step-wise, research approach was used for informing evidence-based decisions among and for various, diverse stakeholders. A steering committee and subject-matter experts convened to devise the protocol and independent systematic reviews were performed to determine the quality of the evidence for nutritional science in 4 areas relevant to military populations: (1) caffeinated foods and beverages; (2) omega-3 polyunsaturated fatty acids; (3) plant-based foods and beverages or their phytochemical constituents; and (4) whole dietary patterns. A research expert panel was asked to then recommend future research directions and solutions likely to benefit warfighters. An implementation expert panel further considered how to apply sound nutritional science in a cost-effective manner. This article summarizes the methodological processes, high-level results, global research recommendations, and priorities for implementation. Specific results of the individual dietary interventions, as well as recommendations for moving this field of research and practice forward, are detailed throughout the current supplement.
Assuntos
Dieta , Prática Clínica Baseada em Evidências , Medicina Militar , Militares , Ciências da Nutrição/métodos , Cafeína , Cognição/fisiologia , Análise Custo-Benefício , Suplementos Nutricionais , Ácidos Graxos Ômega-3 , Humanos , Compostos Fitoquímicos/administração & dosagem , Plantas ComestíveisRESUMO
Dietary guidelines in many countries include a recommendation to consume oily fish, mainly on the basis of evidence from prospective cohort studies that fish consumption is cardioprotective. However, average intakes are very low in a large proportion of the UK population. Some groups, such as vegans and vegetarians, purposely omit fish (along with meat) from their diet resulting in zero or trace intakes of long chain (LC) n-3 PUFA. Although the efficacy of dietary fish oil supplementation in the prevention of CVD has been questioned in recent years, the balance of evidence indicates that LC n-3 PUFA exert systemic pleiotropic effects through their influence on gene expression, cell signalling, membrane fluidity and by conversion to specialised proresolving mediators; autacoid lipid mediators that resolve inflammatory events. The long-term impact of reduced tissue LC n-3 PUFA content on cardiovascular health is surprisingly poorly understood, particularly with regard to how low proportions of LC n-3 PUFA in cell membranes may affect cardiac electrophysiology and chronic inflammation. Randomised controlled trials investigating effects of supplementation on prevention of CHD in populations with low basal LC n-3 PUFA tissue status are lacking, and so the clinical benefits of supplementing non-fish-eating groups with vegetarian sources of LC n-3 PUFA remain to be determined. Refocusing dietary LC n-3 PUFA intervention studies towards those individuals with a low LC n-3 PUFA tissue status may go some way towards reconciling results from randomised controlled trials with the epidemiological evidence.
Assuntos
Doença das Coronárias/prevenção & controle , Dieta Saudável , Suplementos Nutricionais , Ácidos Graxos Ômega-3/uso terapêutico , Peixes , Alimentos Marinhos , Animais , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Congressos como Assunto , Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Deficiências Nutricionais/dietoterapia , Deficiências Nutricionais/etiologia , Deficiências Nutricionais/fisiopatologia , Deficiências Nutricionais/prevenção & controle , Dieta Vegetariana/efeitos adversos , Dietética/métodos , Dietética/tendências , Ácidos Graxos Ômega-3/deficiência , Humanos , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Estado Nutricional , Risco , Sociedades Científicas , Reino Unido/epidemiologiaRESUMO
The role of vitamin D in supporting the growth and maintenance of the skeleton is robust; with recent research also suggesting a beneficial link between vitamin D and other non-skeletal health outcomes, including immune function, cardiovascular health and cancer. Despite this, vitamin D deficiency remains a global public health issue, with a renewed focus in the UK following the publication of Public Health England's new Dietary Vitamin D Requirements. Natural sources of vitamin D (dietary and UVB exposure) are limited, and thus mechanisms are needed to allow individuals to achieve the new dietary recommendations. Mandatory or voluntary vitamin D food fortification may be one of the mechanisms to increase dietary vitamin D intakes and subsequently improve vitamin D status. However, for the food industry and public to make informed decisions, clarity is needed as to whether vitamins D2 and D3 are equally effective at raising total 25-hydroxyvitamin D (25(OH)D) concentrations as the evidence thus far is inconsistent. This review summarises the evidence to date behind the comparative efficacy of vitamins D2 and D3 at raising 25(OH)D concentrations, and the potential role of vitamin D food fortification as a public health policy to support attainment of dietary recommendations in the UK. The comparative efficacy of vitamins D2 and D3 has been investigated in several intervention trials, with most indicating that vitamin D3 is more effective at raising 25(OH)D concentrations. However, flaws in study designs (predominantly under powering) mean there remains a need for a large, robust randomised-controlled trial to provide conclusive evidence, which the future publication of the D2-D3 Study should provide (BBSRC DRINC funded: BB/I006192/1). This review also highlights outstanding questions and gaps in the research that need to be addressed to ensure the most efficacious and safe vitamin D food fortification practices are put in place. This further research, alongside cost, availability and ethical considerations (vitamin D3 is not suitable for vegans), will be instrumental in supporting government, decision-makers, industry and consumers in making informed choices about potential future vitamin D policy and practice.
Assuntos
Colecalciferol/uso terapêutico , Ergocalciferóis/uso terapêutico , Medicina Baseada em Evidências , Alimentos Fortificados , Saúde Global , Prática de Saúde Pública , Deficiência de Vitamina D/prevenção & controle , Animais , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Colecalciferol/administração & dosagem , Colecalciferol/efeitos adversos , Congressos como Assunto , Dietética/métodos , Dietética/tendências , Ergocalciferóis/administração & dosagem , Ergocalciferóis/efeitos adversos , Alimentos Fortificados/efeitos adversos , Humanos , Política Nutricional/tendências , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Sociedades Científicas , Deficiência de Vitamina D/dietoterapiaRESUMO
It is postulated that knowledge of genotype may be more powerful than other types of personalised information in terms of motivating behaviour change. However, there is also a danger that disclosure of genetic risk may promote a fatalistic attitude and demotivate individuals. The original concept of personalised nutrition (PN) focused on genotype-based tailored dietary advice; however, PN can also be delivered based on assessment of dietary intake and phenotypic measures. Whilst dietitians currently provide PN advice based on diet and phenotype, genotype-based PN advice is not so readily available. The aim of this review is to examine the evidence for genotype-based personalised information on motivating behaviour change, and factors which may affect the impact of genotype-based personalised advice. Recent findings in PN will also be discussed, with respect to a large European study, Food4Me, which investigated the impact of varying levels of PN advice on motivating behaviour change. The researchers reported that PN advice resulted in greater dietary changes compared with general healthy eating advice, but no additional benefit was observed for PN advice based on phenotype and genotype information. Within Food4Me, work from our group revealed that knowledge of MTHFR genotype did not significantly improve intakes of dietary folate. In general, evidence is weak with regard to genotype-based PN advice. For future work, studies should test the impact of PN advice developed on a strong nutrigenetic evidence base, ensure an appropriate study design for the research question asked, and incorporate behaviour change techniques into the intervention.
Assuntos
Dieta Saudável , Suplementos Nutricionais , Medicina Baseada em Evidências , Conhecimentos, Atitudes e Prática em Saúde , Nutrigenômica/métodos , Cooperação do Paciente , Medicina de Precisão , Pesquisa Biomédica/educação , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Comportamento de Escolha , Congressos como Assunto , Comportamento Alimentar , Humanos , Nutrigenômica/tendências , Ciências da Nutrição/educação , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Sociedades CientíficasRESUMO
In vitro techniques are essential in elucidating biochemical mechanisms and for screening a wide range of possible bioactive candidates. The number of papers published reporting in vitro bioavailability and bioactivity of flavonoids and flavonoid-rich plant extracts is numerous and still increasing. However, even with the present knowledge on the bioavailability and metabolism of flavonoids after oral ingestion, certain inaccuracies still persist in the literature, such as the use of plant extracts to study bioactivity towards vascular cells. There is therefore a need to revisit, even question, these approaches in terms of their biological relevance. In this review, the bioavailability of flavonoid glycosides, the use of cell models for intestinal absorption and the use of flavonoid aglycones and flavonoid-rich plant extracts in in vitro bioactivity studies will be discussed. Here, we focus on the limitations of current in vitro systems and revisit the validity of some in vitro approaches, and not on the detailed mechanism of flavonoid absorption and bioactivity. Based on the results in the review, there is an apparent need for stricter guidelines on publishing data on in vitro data relating to the bioavailability and bioactivity of flavonoids and flavonoid-rich plant extracts.
Assuntos
Absorção Fisiológica , Suplementos Nutricionais , Flavonoides/metabolismo , Absorção Intestinal , Extratos Vegetais/metabolismo , Animais , Pesquisa Biomédica/educação , Pesquisa Biomédica/métodos , Pesquisa Biomédica/normas , Pesquisa Biomédica/tendências , Congressos como Assunto , Glicosídeos/metabolismo , Guias como Assunto , Humanos , Técnicas In Vitro/normas , Técnicas In Vitro/tendências , Ciências da Nutrição/educação , Ciências da Nutrição/métodos , Ciências da Nutrição/normas , Ciências da Nutrição/tendências , Publicações Periódicas como Assunto/normas , Sociedades CientíficasRESUMO
Immunosenescence during ageing is a major challenge which weakens the ability of older individuals to respond to infection or vaccination. There has been much interest in dietary strategies to improve immunity in older people, but there is an assumption that modulation of the immune response in older people will be based on the same principles as for younger adults. Recent evidence suggests that ageing fundamentally alters the impact of nutrition on immune function. As a result, interpretation of data from studies investigating the impact of diet on immune function is highly dependent on subject age. Study design is critically important when investigating the efficacy of dietary components, and most studies involving older people include rigorous inclusion/exclusion criteria based on medical history, laboratory tests, general health status and often nutritional status. However, immunological status is rarely accounted for, but can vary significantly, even amongst healthy older people. There are several clear examples of age-related changes in immune cell composition, phenotype and/or function, which can directly alter the outcome of an intervention. This review uses two case studies to illustrate how the effects of n-3 PUFA and probiotics differ markedly in young v. older subjects. Evidence from both suggests that baseline differences in immunosenescence influence the outcome of an intervention, highlighting the need for detailed immunological characterisation of subjects prior to interventions. Finally, future work elucidating alterations in metabolic regulation within cells of the immune system as a result of ageing may be important in understanding the impact of diet on immune function in older people.
Assuntos
Imunidade Adaptativa , Doença Crônica/prevenção & controle , Dieta Saudável , Fenômenos Fisiológicos da Nutrição do Idoso , Imunidade Inata , Imunossenescência , Idoso , Idoso de 80 Anos ou mais , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Congressos como Assunto , Suplementos Nutricionais , Dietética/métodos , Dietética/tendências , Ácidos Graxos Ômega-3/uso terapêutico , Microbioma Gastrointestinal/imunologia , Humanos , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Probióticos/uso terapêutico , Sociedades Científicas , Linfócitos T/imunologia , Linfócitos T/metabolismoAssuntos
Dietética/educação , Micronutrientes/metabolismo , Ciências da Nutrição/métodos , Nutricionistas/educação , Biotina/metabolismo , Eletroforese , Ensaio de Imunoadsorção Enzimática , Humanos , Ferro/metabolismo , Magnésio/metabolismo , Niacina/metabolismo , Ciências da Nutrição/educação , Fósforo/metabolismo , Reação em Cadeia da Polimerase , Riboflavina/metabolismo , Selênio/metabolismo , Espectrofotometria , Zinco/metabolismoRESUMO
In observational studies, treatment assignment is a nonrandom process and treatment groups may not be comparable in their baseline characteristics, a phenomenon known as confounding. Propensity score (PS) methods can be used to achieve comparability of treated and nontreated groups in terms of their observed covariates and, as such, control for confounding in estimating treatment effects. In this article, we provide a step-by-step guidance on how to use PS methods. For illustrative purposes, we used simulated data based on an observational study of the relation between oral nutritional supplementation and hospital length of stay. We focused on the key aspects of PS analysis, including covariate selection, PS estimation, covariate balance assessment, treatment effect estimation, and reporting. PS matching, stratification, covariate adjustment, and weighting are discussed. R codes and example data are provided to show the different steps in a PS analysis.
Assuntos
Pesquisa Biomédica/métodos , Ciências da Nutrição/métodos , Pontuação de Propensão , Projetos de Pesquisa/estatística & dados numéricos , Benchmarking , Suplementos Nutricionais , Humanos , Tempo de Internação , Estudos Observacionais como Assunto , Projetos de Pesquisa/normasRESUMO
Limiting the saturated fatty acid (SAFA) consumption forms the basis of dietary fat recommendations for heart health, despite several meta-analyses demonstrating no link between dietary SAFA and the risk of cardiovascular disease (CVD). Three experts on dietary fat and health discussed the evidence of reducing SAFA intake at a symposium of the Federation of European Nutrition Societies in Berlin, Germany, October 23, 2015. Ronald P. Mensink, Maastricht University, the Netherlands, discussed the evidence linking dietary fatty acids and CVD risk. He emphasized the importance of the replacement nutrient(s) when SAFA intake is reduced. Julie Lovegrove, University of Reading, UK, addressed the question of whether higher intakes of unsaturated fatty acids are beneficial. She discussed the replacement of SAFA by polyunsaturated fatty acids (PUFA) and monounsaturated fatty acids (MUFA), noting the reduction in CVD risk with PUFA replacement and in CVD risk markers with MUFA replacement of SAFA. Ursula Schwab, University of Eastern Finland, Kuopio, Finland, discussed the importance of dietary patterns in achieving reduced risk of CVD, observing that several dietary patterns following the principles of a health-promoting diet and adapted to local customs, food preferences and seasonality are effective in reducing the risk of CVD, type 2 diabetes and other chronic diseases. This paper summarizes the symposium presentations.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Dieta Saudável , Gorduras na Dieta/administração & dosagem , Medicina Baseada em Evidências , Ácidos Graxos Monoinsaturados/uso terapêutico , Ácidos Graxos/administração & dosagem , Biomarcadores/sangue , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Congressos como Assunto , Dieta com Restrição de Gorduras/efeitos adversos , Dieta Hiperlipídica/efeitos adversos , Gorduras na Dieta/efeitos adversos , Ácidos Graxos/efeitos adversos , Humanos , Internacionalidade , Pessoa de Meia-Idade , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Fatores de Risco , Sociedades CientíficasRESUMO
In contrast to the spectacular advances in the first half of the twentieth century with micronutrient-related diseases, human nutrition science has failed to stem the more recent rise of obesity and associated cardiometabolic disease (OACD). This failure has triggered debate on the problems and limitations of the field and what change is needed to address these. We briefly review the two broad historical phases of human nutrition science and then provide an overview of the main problems that have been implicated in the poor progress of the field with solving OACD. We next introduce the field of nutritional ecology and show how its ecological-evolutionary foundations can enrich human nutrition science by providing the theory to help address its limitations. We end by introducing a modeling approach from nutritional ecology, termed nutritional geometry, and demonstrate how it can help to implement ecological and evolutionary theory in human nutrition to provide new direction and to better understand and manage OACD.
Assuntos
Doenças Cardiovasculares/prevenção & controle , Medicina Ambiental/história , Síndrome Metabólica/prevenção & controle , Ciências da Nutrição/história , Estado Nutricional , Obesidade/prevenção & controle , Animais , Regulação do Apetite , Evolução Biológica , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/terapia , Medicina Ambiental/métodos , Medicina Ambiental/tendências , Guias como Assunto , Transição Epidemiológica , História do Século XX , História do Século XXI , Humanos , Estudos Interdisciplinares/tendências , Síndrome Metabólica/etiologia , Síndrome Metabólica/terapia , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Obesidade/etiologia , Obesidade/terapia , Prática de Saúde Pública , Meio Social , Biologia de Sistemas/métodos , Biologia de Sistemas/tendências , Pesquisa Translacional Biomédica/métodos , Pesquisa Translacional Biomédica/tendênciasRESUMO
Accurate measurements of the secondary metabolites in natural products and plant foods are critical for establishing relations between diet and health. There are as many as 50,000 secondary metabolites that may influence human health. Their structural and chemical diversity presents a challenge to analytical chemistry. With respect to flavonoids, putative identification is accessible, but positive identification and quantification are limited by the lack of standards. Quantification has been tested with use of both nonspecific and specific methods. Nonspecific methods, which include antioxidant capacity methods, fail to provide information on the measured components, suffer from numerous interferences, are not equatable, and are unsuitable for health research. Specific methods, such as LC with diode array and mass spectrometric detection, require the use of internal standards and relative molar response factors. These methods are relatively expensive and require a high level of expertise and experimental verification; however, they represent the only suitable means of relating health outcomes to specific dietary components.