Supplementation of Ocean-Based Advance Protein Powder (APP) for Restoration of Body Growth, Bone Development and Immune Functions in Protein Malnourished Mice: Implications for Preventing Child Malnutrition.

Child malnutrition is a global public health challenge. A protein malnutrition (PM) model in young mice was established in this study. The efficacy of an ocean-based protein (APP) extracted from by-catch fish as compared to casein and soy on restoring body weight, bone growth, and immunity of PM mice was evaluated. Results show that supplementation of APP increases body weight, lean muscle mass, bone area, mineral content and density. APP supplementation increases spleen, thymus weight, and interlukin-6 production. In conclusion, APP is an alternative source of protein to effectively restore body weight, bone growth and immune function of PM mice.

A Novel Concept of Amino Acid Supplementation to Improve the Growth of Young Malnourished Male Rats.

BACKGROUNDS/AIMS: This study was aimed at understanding the relationship between plasma amino acids and protein malnutrition and at determining whether amino acid supplementation associated with malnutrition and growth improves linear growth in growing rats. METHODS: Body length and plasma amino acids were measured in young male rats that were fed the following diet for 3 weeks, mimicking a low and imbalanced protein diets based on maize, a major staple consumed in developing countries: a 70% calorically restricted cornmeal-based diet (C), C + micronutrients (CM), CM + casein (CMC), CM + soy protein (CMS) or CMS + 0.3% lysine. RESULTS: A correlation analysis of linear growth and plasma amino acids indicated that lysine, tryptophan, branched-chain amino acids, methionine, and phenylalanine significantly correlated with body length. Supplementation with these 5 amino acids (AA1) significantly improved the body length in rats compared to CMC treatment whereas, nitrogen-balanced amino acid supplemented controls (AA2) did not (CM +1.2 ± 0.2, CMC +2.7 ± 0.3, CMS +2.1 ± 0.3, AA1 +2.8 ± 0.2, and AA2 +2.5 ± 0.3 cm). CONCLUSION: With securing proper amino acid balance, supplementing growth-related amino acids is more effective in improving linear growth in malnourished growing male rats. Analysis of the correlation between plasma amino acids and growth represents a powerful tool to determine candidate amino acids for supplementation to prevent malnutrition. This technology is adaptable to children in developing countries.

The effects of a high-protein, high-calorie, fiber- and fructo-oligosaccharide-enriched enteral formula on nutritional status, bowel habits and tolerance: Safety and Effectiveness of Enteral Nutrition in elderly Spanish patients (SENS Study) / Fórmula enteral hiperproteica e hipercalórica, enriquecida en fibra y en fructooligosacáridos: efecto sobre el estado nutricional, hábitos gastrointestinales y tolerancia en pacientes ancianos españoles (Estudio SENS)

Background: Enteral nutrition (EN) is an effective nutritional intervention for patients at risk of malnutrition or malnourished. However, complications such as gastrointestinal intolerance, hyperglycemia or refeeding syndrome can be triggered by EN. Aim: To investigate the effects of a tube feeding formula (TFF) on patients' nutritional status, biochemical status, bowel habits and safety. Methodology: Observational, prospective and multicenter study. Patients ≥ 18 years, undernourished or at nutritional risk, who were prescribed a high-calorie, high-protein, fiber-fortified TFF were included. Patients were evaluated over a period of eight weeks (baseline [V1], four weeks [V2] and eight weeks [V3]). Results: A statistically significant increase in weight (1.5 kg), body mass index (0.6 kg/m2) and nutritional intake (59.7 kcal/day) was observed between V1 and V2. Between V1 and V3, there was a statistically significant decrease in the percentage of individuals with abnormal biochemical markers for glucose, potassium, total protein and albumin. The number of patients’ bowel movements remained stable throughout the study with a mean of 1.1 daily bowel movements. Conclusion: The TFF was safe and well tolerated, improving patients’ nutritional status without altering patients' bowel habits (AU)

Introducción: la nutrición enteral es una intervención efectiva para pacientes desnutridos o en riesgo de sufrir desnutrición. Sin embargo, puede desencadenar complicaciones como intolerancia gastrointestinal, hiperglicemia o síndrome de realimentación. Objetivo: investigar los efectos de una fórmula de nutrición enteral por sonda en el estado nutricional y bioquímico, hábitos gastrointestinales y seguridad de los pacientes. Metodología: estudio observacional, prospectivo y multicéntrico. Se incluyeron pacientes ≥ 18 años, desnutridos o en riesgo de desnutrición, tributarios de recibir una fórmula de nutrición enteral hipercalórica, hiperproteica, y rica en fibra y fructooligosacáridos. Los pacientes fueron evaluados durante 8 semanas en 3 visitas (V1, inicial; V2, 4 semanas; V3, 8 semanas). Resultados: entre V1 y V2 se observó un incremento estadísticamente significativo en peso (1,5 kg), índice de masa corporal (0,6 kg/m2) e ingesta calórica (59,7 kcal/día). Entre V1 y V3, existió un descenso en el porcentaje de pacientes con valores anormales de glucosa, potasio, proteína total y albúmina. Los hábitos intestinales se mantuvieron estables durante el estudio (1,1 deposiciones diarias de media). Conclusión: la fórmula fue segura, tolerada, y mejoró el estado nutricional del paciente sin alterar los hábitos intestinales (AU)

Evaluación de tecnologías sanitarias aplicada a la selección de un módulo de proteína para uso hospitalario / Health technology assessment applied to the selection of a protein module for hospital use

Introducción: La evaluación de tecnologías en salud aplicadas a la selección de un módulo de proteína para uso hospitalario, tiene como finalidad servir de apoyo en la elección de productos costo efectivos y seguros, con el fin de favorecer la toma de decisiones a los diferentes agentes que participan en la elección de alternativas terapéuticas, recomendadas en pacientes con necesidades elevadas de proteínas, como es el caso de la presente investigación. Objetivo: Aplicar un método matemático - multicriterio que permita evaluar los módulos de proteína disponibles en el mercado para la terapia nutricional institucional. Métodos: Se establecieron dos fases, una revisión de la literatura para establecer y priorizar los criterios de evaluación técnica de las diferentes ofertas de módulos de proteína, y dos se realizó una aplicación de un modelo matemático con el fin de considerar el modulo proteico para uso dentro de las instituciones hospitalarias, el cual consistió en la asignación de un valor a cada una de las variables mediante una escala diferencial semántica establecida, que permitieron calcular el peso porcentual de cada una de las variables, cuya sumatoria arrojo la calificación porcentual de cada alternativa. Resultados: Respecto a la búsqueda de criterios de evaluación técnica para las diferentes ofertas de módulos de proteína, en la literatura se identificaron las siguientes variables para evaluación, la naturaleza o equivalencia, condiciones de administración y uso, seguridad, y eficacia. La naturaleza se evaluó mediante la calificación del cómputo químico de aminoácidos corregido por digestibilidad proteica (PDCAAS) con un peso en la evaluación del 39.05%, en referencia a las condiciones de administración y uso se tuvo en cuenta factores incluidos en los sistemas de distribución por dosis unitaria con un peso del 27.61%, la eficacia fue definida por la tasa de eficiencia proteica (PER) la cual impacta el 19.53% de la calificación y finalmente, el criterio de seguridad con un 13.81% referente al empaque y etiquetado. Conclusiones: Al realizar la evaluación de cuatro alternativas de módulos de proteína, ofertadas por las diferentes casas farmacéuticas, la mayor puntuación correspondiente a las alternativas con una calificación superior al 90%, la obtuvieron dos alternativas de módulos de proteína para uso hospitalario, las cuales contienen proteínas del suero ('Whey') y aminoácidos en combinaciones (AU)

Introduction: The evaluation of health technologies applied to the selection of a module of protein for hospital use, aims to provide support in choosing products cost effective and safe, in order to facilitate decision making to the different actors involved in the choice of therapeutic alternatives recommended in patients with elevated protein needs, as is the case in this investigation. Aims: To apply a mathematical method - to evaluate multi-protein modules available on the market for institutional nutritional therapy. Methods: Two phases are established, a review of the literature to establish and prioritize technical evaluation criteria of different modules offers protein, and two application of a mathematical model was developed to consider the protein module for use within hospital institutions, which consisted of assigning a value to each of the variables through an established semantic differential scale, which allowed calculating the percentage weight of each of the variables whose sum throw percentage score for each alternative. Results: Regarding the search for technical evaluation criteria for different protein modules deals in the following literature, nature or equivalence conditions of administration and use, safety, and efficacy were identified. Nature is self assessed by rating the chemical amino acid score corrected for protein digestibility (PDCAAS) weighing in assessing 39.05%, referring to the terms of use and management took into account factors included in the distribution systems unit dose with a weight of 27.61%, the efficiency was defined by the protein efficiency ratio (PER) which impacts the 19.53% of the grade and ultimately the safety criterion 13.81% with respect to packaging and labeling. Discussion: There is agreement with that reported in the literature concerning the technical evaluation criteria relevant to the quality of the protein, and the criteria of administration, safety and efficacy. Similarly to conduct triage criteria using the mathematical model in order to consider the protein module for use within hospital facilities, the measure PDCAAS nature, remains the most important when choosing a protein module. However, the total protein content and solubility are similar in all the tested products. Conclusions: When evaluating four alternative protein modules, offered by different pharmaceutical companies, the highest score corresponding to the alternative with a higher rating than 90%, the obtained two alternative protein modules for use in hospitals, which contain whey protein and amino acids in combinations (AU)

[Development of a high content protein beverage from Chilean mesquite, lupine and quinoa for the diet of pre-schoolers]. / Desarrollo de una bebida de alto contenido proteico a partir de algarrobo, lupino y quinoa para la dieta de preescolares.

This research was aimed at developing a high content protein beverage from the mixture of liquid extracts of a pseudocereal, quinoa (Chenopodium quinoa Willd) and two legumes: mesquite (Prosopis chilensis (Mol.) Stunz) and lupine (Lupinus albus L.), native from the Andean highlands of the Chilean northern macro-zone, flavored with raspberry pulp, to help in the feeding of children between 2 and 5 years of lower socioeconomic status with nutritional deficiencies. The formulation was defined by linear programming, its composition was determined by proximate analysis and physical, microbiological and sensory acceptance tests were performed. After 90 days of storage time, the beverage got a protein content of 1.36%, being tryptophan the limiting amino acid; for its part, the chromaticity coordinates of CIEL*a*b* color space showed no statistical significant differences (p < 0.05) maintaining the "dark pink" tonality, the viscosity and the sensory evaluation were acceptable for drinking.

Taurine supplementation restored the changes in pancreatic islet mitochondria in the fetal protein-malnourished rat.

Intra-uterine growth retardation has been linked to the development of type 2 diabetes in later life. Mitochondrial changes have been suggested as a link between fetal malnutrition and adult insulin resistance. Taurine has been implicated in this process. We investigated whether protein malnutrition in early life alters mitochondria of the pancreatic islets in adulthood, and whether taurine supplementation restores these changes. Male offspring of rats fed a control diet, a low-protein diet or a low-protein diet supplemented with taurine during pregnancy and lactation were weaned onto the control diet. In each group, at 20 weeks of age, intravenous glucose tolerance tests, euglycaemic-hyperinsulinaemic clamp studies, morphometric analysis of the pancreatic islets and ultra-structural analysis of the mitochondria of the ß-cells were performed. The expressions of cytochrome c oxidase (COX) I and mitochondrial respiratory chain complex II were also measured. Fetal protein-malnourished rats showed decreased pancreatic islet mass and reduced insulin-secretory responses to a glucose load. These rats also showed reduced mitochondrial DNA-encoded COX I gene expression in the islets. Electron microscopic examination showed abnormal mitochondrial shapes in the ß-cells of fetal protein-malnourished rats. Taurine supplementation to the low-protein diet restored all these changes. Our findings indicate that a maternal protein-restriction diet causes long-lasting mitochondrial changes that may contribute to the development of type 2 diabetes later in life. The lack of taurine may be a key causative factor for these dysfunctional mitochondrial changes.

A low-protein diet supplemented with ketoacids plays a more protective role against oxidative stress of rat kidney tissue with 5/6 nephrectomy than a low-protein diet alone.

Dietary protein restriction is one major therapy in chronic kidney disease (CKD), and ketoacids have been evaluated in CKD patients during restricted-protein diets. The objective of the present study was to compare the efficacy of a low-protein diet supplemented with ketoacids (LPD+KA) and a low-protein diet alone (LPD) in halting the development of renal lesions in CKD. 5/6 Nephrectomy Sprague-Dawley rats were randomly divided into three groups, and fed with either 22 % protein (normal-protein diet; NPD), 6 % protein (LPD) or 5 % protein plus 1 % ketoacids (LPD+KA) for 24 weeks. Sham-operated rats were used as controls. Each 5/6 nephrectomy group included fifteen rats and the control group included twelve rats. Proteinuria, decreased renal function, glomerular sclerosis and tubulointerstitial fibrosis were found in the remnant kidneys of the NPD group. Protein restriction ameliorated these changes, and the effect was more obvious in the LPD+KA group after 5/6 nephrectomy. Lower body weight and serum albumin levels were found in the LPD group, indicating protein malnutrition. Lipid and protein oxidative products were significantly increased in the LPD group compared with the LPD+KA group. These findings indicate that a LPD supplemented with ketoacids is more effective than a LPD alone in protecting the function of remnant kidneys from progressive injury, which may be mediated by ketoacids ameliorating protein malnutrition and oxidative stress injury in remnant kidney tissue.

Efetividade da multimistura como suplemento de dietas deficientes em vitaminas e/ou minerais na recuperação ponderal de ratos submetidos à desnutrição pós-natal / The effectiveness of the multi-mixture as supplement to mineral and/or vitamin deficient diets, promoting weight gain in rats submitted to post-natal under-nourishment

OBJETIVO: Avaliar a efetividade da "multimistura", usada como suplemento de dietas deficientes em vitaminas, deficientes em minerais, ou deficientes em vitaminas e minerais, na recuperacão ponderal de ratos desnutridos. MÉTODOS: Após o desmame, 56 ratos Wistar, submetidos à desnutricão pós-natal, foram aleatoriamente distribuídos em 7 grupos diferenciados segundo o tipo de dieta oferecida: controle, dietas deficientes em vitaminas, deficientes em minerais, deficientes em vitaminas e minerais e os grupos cujas dietas deficientes eram suplementadas com a "multimistura" (dietas deficientes em vitaminas + "multimistura", deficientes em minerais + "multimistura" e deficientes em vitaminas e minerais + "multimistura"). A "multimistura" (pó de casca de ovo, pó de folha de mandioca e farelo de trigo, na proporção de 1:1.8) foi adicionada ao nível de 4 por cento. O ganho ponderal e os Coeficientes de Eficiência Protéica ou alimentar foram usados como indicadores da efetividade da "multimistura" como suplemento de vitaminas e/ou minerais. RESULTADOS: Após 28 dias, todos os grupos apresentaram valores de ganho ponderal, coeficientes de eficiência protéica, e coeficientes de eficiência alimentar, inferiores aos do grupo controle (p<0,05), exceto aquele que recebeu dietas deficientes em vitaminas + "multimistura". O grupo que recebeu dieta deficiente em minerais apresentou os piores resultados. A suplementação dessa dieta com a "multimistura" determinou a obtenção de valores significantemente superiores, mas aquém daqueles observados no grupo controle. CONCLUSÃO: Esses resultados sugerem que a suplementação de dietas pouco nutritivas com a "multimistura", fornece as necessidades de vitaminas de ratos desnutridos e supre apenas parte das necessidades de minerais desses animais.

Valoración del estado nutricional en niños y adolescentes con trastorno psicomotor / Evaluation of the nutritional state in children and teen-agers with psychomotrical troubles

Si en cualquier paciente es importante la valoración de su estado nutricional, ésta se hace imprescindible en niños y adolescentes con Trastorno Psicomotor. Se sabe que un déficit de energía, proteínas y micronutrientes, interfiere con el crecimiento, desarrollo y función neuromuscular de niños y adolescentes sanos. En los que padecen trastorno psicomotor es mayor el riesgo de presentar estos déficits, lo cual se convierte en factor de agresión añadido a su estado general que puede tener graves consecuencias. Por su importancia e interés clínico en beneficio de los pacientes con trastorno psicomotor, se presenta este planteamiento de Evaluación Nutricional, que si bien tiene como base los valores estándar para individuos sanos, de edad y sexo similares, aporta algunas especificaciones útiles para la valoración de quienes presentan trastorno psicomotor. Esta evaluación será provechosa, siempre que se realice de modo sistemático y con una periodicidad determinada (AU)

Effect of nutritional rehabilitation of undernourished rats on serum insulin-like growth factor (IGF)-I and IGF-binding proteins

El propósito del presente trabajo fue estudiar el efecto de la rehabilitación nutricia con dietas que contenían diferente concentración de proteína (6, 18 o 50 por ciento) en ratas previamente desnutridas sobre los niveles del factor de crecimiento semejante a la insulina (IGF-I) y de las proteínas que unen al factor semejante a la insulina (IGFBPs). La desnutrición se indujo alimentando ratas en crecimiento con 0.5 por ciento de caseína por cinco semanas. En este periodo, el crecimiento, las proteínas totales en el suero, las concentraciones de IGF-I en suero y la relación IGFBP-3/IGFBP-2 se encontraron significativamente disminuidas comparados con el grupo con libre acceso a una dieta con 18 por ciento de caseína. La rehabilitación nutricia por 21 días con 6 por ciento de caseína no cambió ninguno de estos parámetros. La rehabilitación nutricia con una dieta con 18 o 50 por ciento de caseína por un día no inició el restablecimiento de las concentraciones de IGF-I y la relación IGFBP-3/IGFBP-2. Sin embargo, después de 10 días con dietas al 18 o 50 por ciento de caseína por un día no inició el restablecimiento de las concentraciones de IGF-I y la relación IGFBP-3/IGFBP-2. Sin embargo, después de 10 días con dietas al 18 o 50 por ciento de caseína, las ratas aumentaron 12 veces las concentraciones de IGF-I y siete veces la relación IGFBP-3/IGFBP-2. Finalmente, la rehabilitación por 21 días con 18 o 50 por ciento de caseína produjo un incremento de 21 y 16 veces en las concentraciones de IGF-I y 6.1 y 14.5 veces en la relación IGFBP-3/IGFBP-2 respectivamente. Estos resultados sugieren que la rehabilitación nutricia con 18 por ciento o 50 por ciento de caseína son más efectivas que dietas que contienen 6 por ciento de caseína para restablecer el peso corporal. Las concentraciones de IGF-I e IGFBP-3 fueron indicadores sensibles de la evolución del estado nutricio dependiendo de la concentración de proteína en la dieta

Estimation of optimum amino acid supplements to triticale.

Based on the nitrogen balance (NB) data and the efficiency of amino acid utilization, optimum supplements of limiting amino acids (AA) to triticale were calculated and their effect on true N digestibility (TD), biological value of protein (BV) and net protein utilization (NPU) of a triticale-based diet was evaluated. To determine if AA balance must be considered in the calculation of the optimum supplements, the effect of a 20% or 40% excess of essential AA in lysine-, methionine-, threonine- or tryptophan-deficient diets was also studied. The AA excess had no significant effect on NB in diets deficient in lysine, methionine or threonine. However, NB in rats fed on the tryptophan-deficient diet increased as the AA excess increased. BV of the diet containing the optimized supplements of lysine, threonine, methionine and valine was comparable to that of lactalbumin or to the diet supplemented with all essential AA. The deletion of valine from the optimized supplement caused an insignificant decrease in BV. Due to the lower TD, NPU of diets containing the optimized AA supplements was lower than that of the diet containing all essential AA or of the lactalbumin-based diet.

Reduction of methotrexate toxicity with improved nutritional status in tumor-bearing animals.

The administration of chemotherapy in clinical situations is limited frequently because of the associated toxicity to normal bone marrow cells, gastrointestinal epithelium, and other host tissues. Although nutritional support has been advocated to reduce chemotherapy-related toxicity in cancer patients, few studies substantiate this clinical impression. The current study was performed to determine the role of nutritional status and enteral nutrient intake as determinants of methotrexate (MTX) toxicity in a well-controlled, tumor-bearing animal model. After subcutaneous mammary tumor (AC-33) inoculation, 56 female Lewis/Wistar rats were assigned randomly to one of the following two nutritional regimens for 14 days: (1) protein-depleted chow (PC) (0.03% protein; 4.27 kcal/g) or (2) standard chow (RC) (22.0% protein; 3.50 kcal/g). After 7 days of dietary control, all animals received one of three weight-adjusted doses of MTX (5, 10, or 20 mg/kg intramuscularly [IM] ) or placebo. All animals received leucovorin rescue (0.6 mg IM) at 6 and 24 hours after MTX injection. Improved nutritional status was associated with a significant reduction in objective measures of MTX-related morbidity and mortality. At low doses of MTX (5 and 10 mg/kg), the mean duration of clinical signs of toxicity (i.e., hair loss, lethargy, and diarrhea) and severity of leukopenia were greater in protein-depleted (PD) animals. With high-dose MTX (20 mg/kg), mortality was increased significantly in PD animals (100%) compared with well-nourished animals (0%). Equivalent tumor response was observed in PD and well-nourished animals. Thus, improved nutritional status by enteral nutrition reduced the morbidity and mortality associated with MTX significantly in this tumor-bearing animal model.

Protein metabolism in cystic fibrosis: responses to malnutrition and taurine supplementation.

Increased protein breakdown has been cited as an important cause of nutrient loss in cystic fibrosis (CF). Taurine deficiency, which is common in CF, may contribute to the increased breakdown. The occurrence of and the benefit of taurine supplementation to abnormal protein metabolism in apparently optimally treated CF were assessed using a 12-mo double-blind crossover technique in 14 well-nourished and seven mildly-moderately malnourished infection-free preadolescent CF children. Muscle protein breakdown (urinary 3-methylhistidine technique) was significantly decreased in well-nourished (1.35% degraded/24 h +/- 0.15, p less than 0.05) and malnourished (1.24 +/- 0.11, p less than 0.001) CF children compared with controls (1.50 +/- 0.17, n = 13). Whole-body protein flux, synthesis, and catabolism ([15N]-glycine technique) were similar in all groups. Net protein gain was greater in CF children, particularly those who were well-nourished (0.55 g/(kg X 10 h) +/- 0.35, p less than 0.01) compared with controls (0.16 +/- 0.26). Taurine supplementation did not significantly affect any of the indices. In the absence of infection, protein metabolism in CF children responds appropriately to malnutrition.

Increased formation and keeping of ribosomes during dietary recovery of mouse kidney.

In the kidney of 5-day protein-depleted mice there is a decrease of 23% in the rRNA mass. When these animals are fed with a complete diet, rRNA content is restored to its normal value after 24 h of refeeding. The mechanisms that underlie this phenomenon were studied. It was found that the activity of rRNA polymerase I in the nuclei of kidneys from refed mice showed an increase of about twofold compared with the activity in normal and protein-depleted nuclei. The in vivo incorporation of a large dose (nontrace) of [14C]orotic acid into rRNA was also twofold enhanced in kidneys from refed mice. Ribosome degradation (measured by the disappearance of radioactivity from either ribosomal proteins or rRNA previously labeled by the injection of NaH14CO3 and [14C]orotic acid to the mice, respectively) stopped during the 1st day after refeeding. The estimation of the difference between the rRNA synthesis rate and the net rRNA increase also demonstrated a decrease in the rRNA degradation rate in refed mice.

Nutritional deficiencies in the neonate.

This article reviews common nutritional deficiencies that have been identified in newborn infants, including deficiencies of protein; vitamins A, D, K, C, and E; calcium and phosphorus; folate; zinc; and copper. The etiology, clinical presentation, diagnosis, and treatment of these nutritional deficiencies are discussed.

Effects of nutritional rehabilitation on the content and lipid composition of brain gray and white matter of neonatally undernourished rats.

Neonatal undernutrition affects the content and lipid concentrations of gray and white matter. Nutritional rehabilitation reverses the deficit observed in gray matter. In the case of white matter the lipid concentration but not the content comes back to normal.

[The influence of the quality of proteins in fluoride bone fixation]. / Influencia da qualidade da proteina na fixacao ossea do fluor.

45 rats Wistar, 30 days old, were divided into five groups, receiving different diets: casein, bean and wheat flour. The last two diets were supplemented or not by D-L Methionine and D-L Lysine, respectively. Diets and fluoridated water (25 ppm) were given "ad libitum" for 28 days. After this period of experience, the animals were sacrificed and the mandible and the tibias removed for analyses of fluoride, calcium, phosphorus and ash. The A.A. main conclusions are the following: The fixation of fluorides in bones is significantly increased with the supplement of the limitant factor to dificients diets. In this condition, the mandible shows smaller fixation of fluorides than tibias. The level of calcium, phosphorus and ash shows to be similar in the diferentes groups. This data suggests interaction of the protein quality and the percentual fixation of fluorides, and the necessity of further studies about this problem.