Nutritional Education in the Midwife's Consultation Room.

Evidence of the importance of maternal nutrition during pregnancy is growing, and midwives are the healthcare professionals in charge of monitoring pregnancy. In the present review, the aim is therefore to look at the relevant contributions on midwifery and the role of midwifery in the provision of nutritional education. Searches were conducted on three databases-Medline, PubMed Central, and Web of Science-using two key search terms ("nutrition" and "midwives") and their synonyms, for an extensive set of results. The final selection consisted of 27 original papers, most of which concerned the nutritional knowledge of midwives, their training, and their views, attitudes, and practices within the field of nutrition. According to the findings, although the midwives considered nutritional education to be part of their role and they agreed on the importance of nutrition during pregnancy, their knowledge of this topic was poor, perhaps due to inadequate nutritional education during their midwifery training. Academic programs on midwifery must therefore be reviewed, so as to increase the workload of nutrition-related subjects, in order to reinforce the corresponding knowledge bases of future midwives. In addition, based on the success of the nutritional interventions discussed in the present review, these sorts of initiatives could be of utmost importance to improve the knowledge of practicing midwives. In any case, it must be highlighted that the available evidence discussed in this review was drawn from only a few countries around the world. Further studies involving midwives of varied origins are therefore needed. Such research would be of immense assistance in the design of the corresponding nutritional interventions in the field, so as to improve the health of pregnant women.

The Impact of In Vitro Digestion on the Polyphenol Content and Antioxidant Activity of Spanish Ciders.

Various factors can influence the polyphenol content and the antioxidant capacity of ciders, such as the apple variety, its degree of maturity, apple farming and storage conditions, and the cider-fermentation method, all of which explains why ciders of different origin present different values. In addition, digestive processes could have some effects on the properties of cider. Hence, the objective of this study is to characterize Spanish ciders in terms of their polyphenol content and antioxidant capacity and to ascertain whether those same properties differ in digested ciders. In total, 19 ciders were studied from three different zones within Spain: Asturias (A) (10), the Basque Country (BC) (6), and Castile-and-Leon (CL) (3). A range of assays was used to determine the total polyphenol content and the antioxidant capacity of the ciders. In addition, a digestive process was simulated in vitro, assessing whether the use of amylase might influence the recovery of bioactive compounds after digestion. The Basque Country ciders presented higher total polyphenol contents (830 ± 179 GAE/L) and higher antioxidant capacities (DPPH: 5.4 ± 1.6 mmol TE/L; ABTS: 6.5 ± 2.0 mmol TE/L; FRAP: 6.9 ± 1.6 mmol TE/L) than the other ciders that were studied. The in vitro digestion process, regardless of the use of amylase, implied a loss of phenolic compounds (598 ± 239 mg GAE/L undigested samples; 466 ± 146 mg GAE/L digested without amylase samples; 420 ± 115 mg GAE/L digested with amylase samples), although the variation in antioxidant activity depended on the assay chosen for its determination.

Multiple reaction monitoring for identification and quantification of oligosaccharides in legumes using a triple quadrupole mass spectrometer.

Raffinose family oligosaccharides are non-digestible compounds considered as dietary prebiotics with health-related properties. Hence, it is important to develop highly specific methods for their determination. An analytical method is developed in this study for oligosaccharide identification and quantification using liquid chromatography-tandem mass spectrometry equipped with a triple quadrupole analyser operating in Multiple Reaction Monitoring mode. Raffinose, stachyose and verbascose are separated in a 10-minute run and the method is validated over a broad concentration range, showing good linearity, accuracy, precision and high sensitivity. A low-cost, short eco-friendly procedure for oligosaccharide extraction from legumes, with a high recovery rate extraction, good repeatability and reproducibility is also proposed. No plant-matrix effects were demonstrated. The method applied to the screening of 28 different legumes revealed species-related traits for oligosaccharide distribution, highlighting Pisum sativum (9.22 g/100 g) as the richest source of these prebiotics and its suitability as a functional food ingredient.

Relationship between color and betalain content in different thermally treated beetroot products.

Several health benefits are currently attributed to natural pigments that give fruit and vegetables their inherently colorful properties. Color measurements might therefore serve as quick indicators of the potential health-promoting properties of such foods. Nevertheless, the relationship between color and pigment content depends on the type of matrix and pigment, as well as the factors affecting their interaction, which calls for further investigation. Hence, the aim of the present study is to investigate the relationship between color parameters and betalain content in three commonly consumed beetroot products (beetroot juice, beetroot puree and whole beetroot), subjected to thermal treatment. Our results showed a negative correlation between the total betalain content and the color parameters L*, a*, b*, chroma, and hue angle in beetroot juice, beetroot puree and whole beetroot. Two chromatic parameters, a* and chroma, are proposed as the best descriptors for the betalain concentrations of these products. Likewise, the tristimulus L/ab combination for the juice is also suggested as a good descriptor. Our findings highlighted that the relationship between color and total betalain content depended on the beetroot product under assessment, with the strongest correlations found for the juice. Squeezed beetroot was therefore suggested as an alternative to improve this relationship in more complex matrices such as whole cooked beetroots. Useful information from color determination sheds light on the relationship between color and betalain pigments in beetroot, suggesting that color determination could be used as an indicator of betalain content.

Biological activity and photocatalytic properties of a naphthyl-imidazo phenanthroline (HNAIP) ligand and its [Ir(ppy)2(HNAIP)]Cl and [Rh(ppy)2(HNAIP)]Cl complexes.

The synthesized 2-(hydroxy-1-naphtyl)imidazo-[4,5-f][1,10]phenanthroline (HNAIP) ligand and its new iridium ([Ir(ppy)2(HNAIP)]Cl) and rhodium ([Rh(ppy)2(HNAIP)]Cl) complexes, being ppy = 2-phenylpiridinate, show cytotoxic effects in SW480 (colon adenocarcinoma) and A549 (epithelial lung adenocarcinoma) cells. They all are cytotoxic in the tested cell lines. HNAIP and [Rh(ppy)2(HNAIP)]+ are the most cytotoxic, whereas [Ir(ppy)2(HNAIP)]+ displays negligible cytotoxicity towards A549 cells and moderate activity towards SW480. The interaction of all three compounds with Bovine Serum Albumin (BSA), l-glutathione reduced (GSH), nicotinamide adenine dinucleotide (NADH) and DNA was studied to explain the differences found in terms of cytotoxicity. None of them are able to interact with BSA, thus excluding bioavailability due to plasma protein interaction as the possible differentiating factor in their biological activity. By contrast, small differences have been observed regarding DNA interaction. In addition, taking advantage of the emission properties of these molecules, they have been visualized in the cytoplasmic region of A549 cells. Inductively coupled plasma mass spectrometry (ICP-MS) experiments show, in turn, that the internalization ability follow the sequence [Rh(ppy)2(HNAIP)]+ > [Ir(ppy)2(HNAIP)]+ > cisplatin. Therefore, it seems clear that the cellular uptake by tumour cells is the key factor affecting the different cytotoxicity of the metal complexes and that this cellular uptake is influenced by the hydrophobicity of the studied complexes. On the other hand, preliminary catalytic experiments performed on the photo-oxidation of GSH and some amino acids such as l-methionine (Met), l-cysteine (Cys) and l-tryptophan (Trp) provide evidence for the photocatalytic activity of the Ir(III) complex in this type of reactions.

Effect of oleic acid on store-operated calcium entry in immune-competent cells.

PURPOSE: To study the mechanism by which oleic acid (OA) (C18:1) exerts its beneficial effects on immune-competent cells. Since store-operated Ca2+ entry (SOCE) is a Ca2+ influx pathway involved in the control of multiple physiological processes including cell proliferation, we studied the effect of OA in Ca2+ signals of Jurkat T cells and THP-1 monocytes, paying particular attention to SOCE. METHODS: Changes in [Ca2+]i were measured using the Fura-2 fluorescence dye. Mn2+ uptake was monitored as a rate of quenching of Fura-2 fluorescence measured at the Ca2+-insensitive wavelengths. Thapsigargin was used to induce SOCE in Fura-2-loaded cells. RESULTS: We showed a clear dose-dependent SOCE-inhibitory effect of OA in both cell lines. Such an inhibitory effect was PKC independent and totally restored by albumin, suggesting that OA exerts its effect somewhere in the membrane. We also demonstrated that OA induces increases in [Ca2+]i partly mediated by an extracellular Ca2+ influx through econazole-insensitive channels. Finally, we compared the effect of OA with stearic acid (C18:0), assuming the emerged evidence concerning the link between saturated fats and inflammation disorders. Stearic acid failed to inhibit SOCE, independently on the concentration tested, thus intensifying the physiological relevance of our findings. CONCLUSION: We suggest a physiological pathway for the beneficial effects of OA in inflammation.

[Effect of refeeding on the body composition of females with restrictive anorexia nervosa; anthropometry versus bioelectrical impedance]. / Efecto de la realimentación en la composición corporal de mujeres con anorexia nerviosa restrictiva; antropometría frente a impedancia bioeléctrica.

OBJECTIVE: To assess the body composition in a group of malnourished patients with anorexia nervosa as compared to healthy controls, before and after nutritional support, by means of anthropometry and bioimpedance. METHODS: Prospective observational study. Complete anthropometry was performed as well as bioimpedance analysis in 12 women (24.5 years) with restrictive anorexia nervosa at hospital admission and weekly thereafter during re-feeding. The control group was formed by 24 healthy women (21 years). The Student's t test, the Mann-Whitney U test, the Student's t test for repeated measurements, and the Wilcoxon's test were applied. The level of agreement between anthropometry and BIA was calculated by the interclass correlation coefficient and the Bland-Altman s test. RESULTS: The patients had significant improvements in all indexes of body composition throughout their hospital staying although their values at discharge still were lower than those of the control subjects. The average weight gain was 5.22 kg (SD: 1.42), of which 51.4% was fat mass, preferentially centrally distributed. In the control subjects, the BIA equation that correlated the best with anthropometrics was Sun s equation (CCI = 0.896); in the patients, the level of agreement was weaker, both at hospital admission and at hospital discharge. CONCLUSIONS: Re-feeding produces weight gain, essentially at the expense of fat mass, which is centrally distributed; the nutritional status is not reestablished. The level of agreement between anthropometry and bioimpedance for studying body composition is acceptable, especially in healthy subjects. In those cases with severe changes in body composition and/or water balance, anthropometry is recommended when vectorial BIA or some other gold standard method are not available for the analysis of body composition.

Objetivo: Evaluar la composición corporal en un grupo de pacientes desnutridas con anorexia nerviosa, respecto de controles sanas, antes y después del soporte nutricional, mediante antropometría y bioimpedancia. Métodos: Estudio observacional prospectivo. Se realizó una antropometría completa y un análisis de bioimpedancia a 12 mujeres con anorexia nerviosa restrictiva (24,5 años) al ingreso hospitalario y semanalmente durante la realimentación. El grupo control estuvo formado por 24 mujeres sanas (21 años). Se aplicaron los test t-Student, U-Mann-Whitney, t-Student para medidas repetidas o Wilcoxon. La concordancia entre antropometría y BIA se analizó mediante el coeficiente de correlación intraclase y Bland-Altman. Resultados: Las pacientes mejoraron significativamente todos los índices de composición corporal a lo largo de la estancia hospitalaria, aunque sus valores al alta siguieron siendo menores que los de las controles. La media de peso ganado fue 5,22 kg (DE: 1,42), de los que el 51,4% fueron masa grasa, con distribución central preferentemente. En las controles la ecuación de BIA que mejor concuerda con antropometría es la de Sun (CCI = 0,896); en las pacientes la concordancia fue más débil, al ingreso y al alta. Conclusiones: La realimentación produce una ganancia ponderal, fundamentalmente a expensas de masa grasa, con distribución central; no se consigue restablecer el estado nutricional. La concordancia entre antropometría y bioimpedancia para el estudio de la composición corporal es aceptable, especialmente en sujetos sanos. Se recomienda emplear antropometría, si no se dispone de BIA vectorial o algún método gold estandard para el análisis de la composición corporal, en casos de alteraciones importantes en la composición corporal y/o el balance hídrico.

Effect of nutritional support on mitochondrial complex I activity in malnourished patients with anorexia nervosa.

Previous studies have shown a reduction in lymphocyte mitochondrial complex I activity (CIA) in malnourished patients, which is restored after refeeding. Our aim was to evaluate the usefulness of CIA as an indicator of nutritional status in anorexia nervosa patients. Twelve malnourished anorexia nervosa females (mean age, 24.5 years) were admitted to the Eating Disorders Unit. Basal and weekly anthropometrics, bioelectric impedance (BIA), body composition, and CIA were performed until discharge. Patients were matched to 25 healthy females and refeeding was adjusted according to the Unit's protocol. Statistics were used as appropriated and significance was reached at p < 0.05. Patients showed a significant reduction in body mass index, fat mass and fat free mass (FFM), triceps skinfold, and waist circumference on admission as compared with the control group. Parameters improved during hospitalization, but they failed to reach normal values at discharge. Compared with controls, CIA was significantly lower in patients on admission (2.16 vs. 5.68 nmol·min(-1)·mg protein(-1)). Refeeding and weight gain did not restore CIA. A positive association (r(2) = 0.69) was found between FFM and CIA in patients at discharge. Malnourished females with anorexia nervosa have lower CIA than controls that is not recovered after refeeding. This could be because of a low FFM exacerbated by physical inactivity while in hospital.

Diacylglycerol-containing oleic acid induces increases in [Ca(2+)](i) via TRPC3/6 channels in human T-cells.

Though most of the studies have focused on the effects of free fatty acids on T-cell activation, fatty acids incorporated into plasma membrane phospholipids may also affect cell signaling via diacylglycerol (DAG), generally produced by phospholipid hydrolysis. In the present study, we have synthesized a DAG-containing oleic acid and studied its implication in the modulation of calcium signaling in human Jurkat T-cells. 1-palmitoyl-2-oleoyl-sn-glycerol (POG) induced a dose-dependent increase in [Ca(2+)](i). This effect was due to the presence of oleic acid at the sn-2 position as no differences were observed between POG and 1-stearoly-2-oleoyl-sn-glycerol (SOG). However, the substitution of oleic acid with arachidonic acid at the sn-2 position of the DAG moiety exerted a different response on the increases in [Ca(2+)](i) in these cells. POG-evoked increases in [Ca(2+)](i) were not due to its metabolites. Furthermore, POG-induced increases in [Ca(2+)](i) were due to the opening of TRPC3/TRPC6 channels as silencing of TRPC3 and TRPC6 genes by shRNA abolished calcium entry. Moreover, disruption of lipid rafts with methyl-ß-cyclodextrin completely abolished POG-evoked increases in [Ca(2+)](i). In conclusion, our results demonstrate that oleic acid can influence T-lymphocyte functions, in the conjugated form of DAG, via opening TRPC3/6 channels.

Oleic acid inhibits store-operated calcium entry in human colorectal adenocarcinoma cells.

AIMS: Much evidence indicates the association between dietary fat and colorectal cancer risk. However, most of the studies focus on polyunsaturated fatty acids, and little is known about the role of monounsaturated ones and their precise mechanism of action. Being store-operated Ca²âº entry (SOCE) a Ca²âº influx pathway involved in the control of multiple cellular and physiological processes including cell proliferation, we studied the effect of oleic acid in Ca²âº signals of colorectal cancer cells, paying particular attention to SOCE. METHODS: Carbachol was used to induce SOCE in Fura 2-loaded HT29 cells. We tested a saturated fatty acid to compare the physiological relevance of our results. RESULTS: We show that oleic acid is a potent inhibitor of SOCE. By contrast, stearic acid failed to have a SOCE-inhibitory effect. The SOCE-inhibition induced by oleic acid was protein kinase C-independent and restored by albumin. We also demonstrated that oleic acid induced increases in [Ca²âº](i). The novelty of our report is that little variability in the concentration could end in a large different physiological effect. CONCLUSIONS: In conclusion, we suggest a physiological pathway for the beneficial effect of oleic acid in colon carcinoma cells.

Activation of human neutrophils by oleic acid involves the production of reactive oxygen species and a rise in cytosolic calcium concentration: a comparison with N-6 polyunsaturated fatty acids.

BACKGROUND: There is a growing body of evidence showing that dietary constituents and lipids in particular, influence the function of the human immune system. However, although the beneficial effects of oleic acid (OA) are clear, its mechanism of action at the molecular level is poorly understood. AIMS: To evaluate neutrophil activation under the influence of OA and compare this with several n-6 PUFAs. METHODS: Two key aspects of neutrophil activation were investigated: oxygen radical (ROS) production and intracellular Ca(2+) signaling. RESULTS: OA and the n-6 PUFA arachidonic acid (AA) both induced ROS production in a dose-dependent manner, although AA was the more potent stimulus. When looking for the mechanisms behind these effects, we found that both FA induce increases in cytosolic calcium concentration [Ca(2+)](i)), but whereas OA-induced ROS production is totally mediated through Ca2+ signaling, this is not the case for AA since ROS generation by AA is only partly inhibited in BAPTA-treated cells. We also found evidence for the involvement of protein kinase C (PKC) in the OA-induced ROS generation; by contrast, other enzymes apart from PKC seem to be implicated in n-6 PUFA-induced ROS production. In addition, our results argue against the involvement of a pertussis toxin-sensitive receptor activated by OA. CONCLUSIONS: OA differs from the n-6 PUFA AA in the activation of human neutrophils and these differences may be related to their distinct inmunomodulatory properties.

Oleic acid versus linoleic and α-linolenic acid. different effects on Ca2+ signaling in rat thymocytes.

BACKGROUND: Oleic acid is the principal fatty acid of olive oil composition and is reported to play a crucial role in its healthy aspects. However, the detailed mechanism of action is poorly understood. AIMS: This study aims to elucidate the role of oleic acid in calcium signaling in rat thymocytes, in comparison to linoleic and linolenic acid. METHODS: Fatty acids were applied to thymocytes isolated from wistar rats and loaded with Fura-2 to measure calcium signals. RESULTS: The main results showed a concentration-dependent increase in [Ca(2+)](i) induced by the 3 fatty acids. Raising the number of unsaturations resulted in greater increases. Two different pathways contributed to the increase induced by the polyunsaturated fatty acids: an IP(3)- independent release from the thapsigargin-sensitive stores and an extracellular calcium entry by econazole and nifedipine-insensitive channels. However, the OA-induced increases in [Ca(2+)](i) seemed to be due mostly to the Ca(2+) recruited from the intracellular stores. CONCLUSION: This study demonstrates that the fatty acids tested induce increases in [Ca(2+)](i) in rat thymocytes, with differences in close relation to the degree of unsaturation. Such differences could be responsible for their different physiological action.