Whey Protein, Vitamins C and E Decrease Interleukin-10 in Chronic Hemodialysis Patients: A Pioneer, Randomized, Double-Blind Pilot Trial.

OBJECTIVE: To evaluate the effects of supplementation with whey protein combined with vitamins C and E on inflammatory markers in hemodialysis (HD) patients. DESIGN AND METHODS: This was a pioneer, randomized and double-blinded study. Patients were randomized into two groups and stratified by HD frequency. The supplementation group received 20 g of whey protein, 250 mg of vitamin C, and 600 IU of vitamin E; the placebo group, 20 g of rice flour, and microcrystalline cellulose capsules. The interventions were given after HD, 3 times a week, for 8 weeks. The inflammatory markers were assessed: interleukin (IL) IL-12p70, IL-10, IL-6, IL-8, and tumor necrosis factor alpha. For statistical analysis, the χ2 test, Student's t-test, Mann-Whitney test, analysis of variance for repeated two-way measurements, paired t test, and Wilcoxon test were performed. P < .05 was considered statistically significant. RESULTS: Twenty-three patients completed the study. No significant differences were found in inflammatory markers when comparing the groups postintervention. In the intragroup was a decrease in IL-10 in the supplementation group after 8 weeks (P = .0382). IL-6 tended to decrease by 810.95% in the supplementation group and increased by 732.8% (nonsignificant) in the placebo group. CONCLUSION: Whey protein combined with vitamins C and E significantly reduced IL-10 in the supplementation group and could be beneficial to reduce IL-6 in HD patients. Future studies are suggested with a larger sample size, different supplementation doses, and longer interventions.

Severe obesity increases the prevalence but not the incidence of depressive symptoms in the elderly-population-based cohort in Southern Brazil.

BACKGROUND: The relation between body weight status and depressive symptoms in the elderly differs according to age and country of origin. The goal of this study was to analyze the cross-sectional and longitudinal relationship between body mass index (BMI), waist circumference (WC) and depressive symptoms in the elderly. METHODS: A population-based cohort study of 1,702 elderly individuals (70.6+8.0 years) in Southern Brazil evaluated in 2009/10 and 2013/14 was accessed. The body weight status was assessed using measured data of BMI and WC. The Geriatric Depression Scale (GDS-15) was used to determine depressive symptoms. Logistic regression analysis adjusted for sociodemographic and behavioral variables was performed. RESULTS: The prevalence of depressive symptoms in 2009/10 was 23.3% (95% CI 20.3-26.6) and the cumulative incidence in the 4-years period was 10.9% (95% CI 8.7-13.6). Elderly people with obesity class II-III and WC in the highest quartile had higher prevalence odds ratio of being depressed than individuals with normal weight or WC in the lower quartile (OR 2.34; 95% CI 1.42-3.87 and OR 1.73; 95% CI 1.13-2.65, respectively). Meanwhile, intermediary values of BMI and WC were associated with a lower prevalence. When evaluating the incidence of depressive symptoms, overweight individuals and those in the second quartile of WC had a lower risk (58% and 57%, respectively), but severely obese individuals had the same risk compared to those with normal BMI/WC. CONCLUSIONS: Severely obese individuals presented a similar incidence of depressive symptoms compared to those with normal BMI/WC, but higher prevalence. Intermediary values of body weight status decrease the risk of depressive symptoms.

Effects of supplementation with vegetable sources of alpha-linolenic acid (ALA) on inflammatory markers and lipid profile in individuals with chronic kidney disease: A systematic review and meta-analysis.

BACKGROUND AND AIMS: Inflammation and dyslipidemia are traditional risk factors and well-known causes of morbidity and mortality in chronic kidney disease (CKD). Alpha-linolenic acid (ALA), an essential fatty acid mainly found in vegetable sources, has been associated with anti-inflammatory effects and improving lipid profile. This systematic review and meta-analysis investigate the effects of supplementation with vegetable sources of ALA on inflammatory marker and lipid profile in individuals with CKD. METHODS: This review included studies with adult or elderly patients with CKD, including those receiving dialysis, using oral supplementation or food or combined interventions containing vegetable sources of ALA. All studies were randomized trials and The Cochrane Collaboration's tool was use for assessing risk of bias. RESULTS: 19 studies provided data for meta-analyses. ALA had significant effect on reducing C-reactive protein (CRP) after supplementation (WMD: -1.32; 84.5% CI, -2.35 to -0.29, P = 0.012), on the other hand, had no significant effect on total cholesterol (WMD: -2.85; 90.1% CI, -14.43 to 8.73, P = 0.629), high density lipoprotein (WMD: 1.09; 92.4% CI, -1.82 to 3.99, P = 0.463), low density lipoprotein (WMD: -3.87; 86.7% CI, -12.62 to 4.89, P = 0.387) and triglycerides (WMD: -16.42; 87.7% CI, -47.83 to 14.98, P = 0.305). CONCLUSION: Vegetables sources of ALA showed beneficial effects on reducing inflammatory marker CRP in CKD patients but had no effect on lipid profile. Future well-designed studies are needed to investigate the effectiveness of vegetables sources of ALA, particularly in CKD.

Mate tea (Ilex paraguariensis) improves glycemic and lipid profiles of type 2 diabetes and pre-diabetes individuals: a pilot study.

OBJECTIVES: Yerba mate (Ilex paraguariensis) infusions have been shown to reduce plasma glucose in animals and serum lipids in humans. The aim of this study was to evaluate the effects of roasted mate tea consumption, with or without dietary counseling, on the glycemic and lipid profiles of individuals with type 2 diabetes mellitus (T2DM) or pre-diabetes. METHODS: Twenty-nine T2DM and 29 pre-diabetes subjects were divided into 3 groups: mate tea, dietary intervention, and mate tea and dietary intervention. Individuals drank 330 mL of roasted mate tea 3 times a day and/or received nutritional counseling over 60 days. Blood samples were collected and food intake was assessed at baseline and after 20, 40, and 60 days of treatments. RESULTS: Mate tea consumption decreased significantly the levels of fasting glucose (25.0 mg/dL), glycated hemoglobin A(1c) (HbA(1c)) (0.85%), and low-density lipoprotein cholesterol (LDL-c) (13.5 mg/dL) of T2DM subjects (p < 0.05); however, it did not change the intake of total energy, protein, carbohydrate, cholesterol, and fiber. In pre-diabetes individuals, mate tea consumption combined with nutritional counseling diminished significantly the levels of LDL-c (11 mg/dL), non-high-density lipoprotein cholesterol (HDL-c) (21.5 mg/dL), and triglycerides (53.0 mg/dL) (p < 0.05). Individuals of this group decreased significantly their consumption of total fat (14%), cholesterol (28%), and saturated (23.8%) and monounsaturated (28.0%) fatty acids, and increased their fiber intake by 35% (p < 0.05). CONCLUSIONS: Mate tea consumption improved the glycemic control and lipid profile of T2DM subjects, and mate tea consumption combined with nutritional intervention was highly effective in decreasing serum lipid parameters of pre-diabetes individuals, which may reduce their risk of developing coronary disease.

Vitamin C decreases reduced glutathione in chronic haemodialysis patients: a pilot, randomised, double-blind trial.

PURPOSE: Whey protein has antioxidant properties through its amino acid cysteine, which enhances the biosynthesis of glutathione, the most abundant antioxidant non-protein in mammalians. Glutathione influences vitamin C recycling and increases its protective effect on oxidative stress (OS). The aim of this study was to analyse the effect of whey protein and vitamin C supplementation on OS biomarkers in chronic haemodialysis (HD) patients. METHODS: This pioneer trial was a randomised, double-blind, pilot study in patients from a dialysis clinic. Patients were randomised into three groups (1:1:1) and stratified by HD frequency (2 or 3 times/week). Sachets containing protein powder (20.0 g) with/without vitamin C (0.25 g) or placebo (20.0 g of white rice flour) with vitamin C (0.25 g) were supplemented after each HD session, 3 times/week for 8 weeks. Blood samples were collected at the baseline period and after 8 weeks for the measurement of reduced glutathione (GSH), oxidised glutathione (GSSG), the GSH:GSSG ratio, malondialdehyde, vitamin C, and glutathione peroxidase-1. RESULTS: Twenty-two patients were enrolled, of which 18 concluded the trial, 6 per group (18.2%, n = 4 losses during follow-up). The vitamin C group presented decreased GSH levels after supplementation (p = 0.053) and a decreasing tendency in the GSH:GSSG ratio (non-statistically significant), while MDA levels significantly decreased only in the whey protein-supplemented groups (p ≤ 0.05). CONCLUSION: The results suggest a pro-oxidant effect of 0.25 g of vitamin C alone in chronic HD patients. CLINICAL TRIAL REGISTRATION: https://ensaiosclinicos.gov.br/ , RBR-65b8f4.

Comparison of Body Mass Index, Skinfold Thickness, and Bioelectrical Impedance Analysis With Dual-Energy X-Ray Absorptiometry in Hemodialysis Patients.

BACKGROUND: Malnutrition is a consistent finding in hemodialysis (HD) patients and is associated with high mortality. The aim was to compare nutrition status indicators using dual-energy x-ray absorptiometry (DXA) as reference in HD patients. METHODS: Observational cross-sectional study with 42 patients, 55.8 years (±14.6) old, 60% male, HD 2-3 times per week for ≥3 months. HD ranged from 3 months to 28 years (median, 17.3; interquartile range, 8.73-39.0). We used body mass index (BMI) and fat mass (FM) by skinfold thickness (SFT), bioelectrical impedance analysis (BIA), and DXA. Statistical analyses used Bland-Altman plots, Lin's concordance correlation coefficient, the paired t-test, and Pearson or Spearman correlation. P < .05 was significant. RESULTS: SFT and DXA presented the lowest prevalence of malnutrition (2.4%) and BMI the highest (28.6%). BMI, BIA FM, and SFT FM presented strong positive correlations with DXA FM (r = 0.915; r = 0.976; r = 0.910, P < .001, respectively). BIA FM and fat-free mass (FFM) demonstrated substantial agreement with DXA values (ρ = 0.974 and 0.960, P < .001). Thus, the measurement procedures used, SFT and BIA, underestimated %FM (-4.65% and -2.13%) and overestimated FFM (3.12 kg and 1.0 kg) according to DXA. No differences were found between mean values of BIA FM and DXA (P = .178). CONCLUSIONS: Compared with DXA, BIA was the most appropriate nutrition indicator for measuring body composition.

Apple intake improves antioxidant parameters in hemodialysis patients without affecting serum potassium levels.

Oxidative stress (OS) is associated with increased morbidity and mortality in hemodialysis (HD) patients, and the consumption of fruits seems to improve OS due to their antioxidant properties. Therefore, we hypothesized that Fuji apple intake improves OS markers in HD patients due to its polyphenolic compounds without increasing serum potassium levels. This trial was a 1-group, pre- and posttest comparison between 16 patients who had been on hemodialysis for at least 3 months without any acute illness or hyperkalemia. Each volunteer consumed 2 Fuji apples (~360 g) per day for 1 week. Blood samples were collected at the baseline period and after 8 days for the measurement of total antioxidant status, ascorbic acid, catalase, glutathione peroxidase, superoxide dismutase, reduced glutathione, total oxidant status, oxidative stress index, potassium, phosphorus, uric acid, glucose, and fructosamine. For tolerance evaluation, participants were asked about their bowel habits. Apple intake increased glutathione peroxidase (P = .006) and superoxide dismutase activities (P = .006) and ascorbic acid levels (P = .002). No significant changes were observed in uric acid, potassium, phosphorus, glucose, and fructosamine levels. Additionally, there was a decrease in the catalase activity (P = .021) and in the total antioxidant status values (P = .004). However, increased total oxidant status (P = .003) and oxidative stress index (P = .033) levels were observed after apple intake. In conclusion, the intake of 2 Fuji apples per day for 1 week was well tolerated and improved antioxidant parameters in HD patients without affecting serum potassium levels.

Consumption of green tea favorably affects oxidative stress markers in weight-trained men.

OBJECTIVE: This study investigated the effects of the consumption of green tea (GT) for 7 d on biomarkers of oxidative stress in young men undergoing resistance exercise. METHODS: Fourteen subjects performed a bench press exercise (four sets, 10 to 4 repetitions) after undergoing a period without (control group) or with the intake of GT (GT group; 2 g of leaves in 200 mL of water, three times per day). Blood samples were obtained before and after exercise and analyzed for total antioxidant capacity (ferric reducing ability of plasma [FRAP]), total polyphenols, reduced glutathione (GSH), lipid hydroperoxide (LH) and thiobarbituric acid-reactive substances, creatine kinase (CK), aspartate aminotransferase (AST), xanthine oxidase (XO), hypoxanthine, and uric acid (UA). RESULTS: In the control group, exercise did not affect the values of LH, thiobarbituric acid-reactive substances, and FRAP, although it did reduce the levels of GSH (P < 0.05). In addition, exercise increased CK, AST, and XO activities, although it did not change the values for hypoxanthine or UA. Green tea reduced the postexercise concentration of LH and increased the values of total polyphenols, GSH, and FRAP. GT also inhibited a significant rise in CK and XO activities induced by exercise. Furthermore, GT decreased the AST activity and hypoxanthine and UA concentrations before and after exercise. The assessment of food consumption revealed that the participants had an unbalanced diet, particularly in relation to vitamin E and carotenoids. CONCLUSION: Consumption of GT, a beverage rich in polyphenols, may offer protection against the oxidative damage caused by exercise, and dietary guidance for sports participants should be emphasized.

Diagnostic Accuracy of Bioelectrical Impedance Analysis Parameters for the Evaluation of Malnutrition in Patients Receiving Hemodialysis.

BACKGROUND: In the absence of a gold standard technique for assessing nutrition status in patients receiving hemodialysis (HD), we aimed to determine the diagnostic accuracy of single-frequency (50 kHz) bioelectrical impedance analysis parameters, resistance/height (R/H), reactance/height (Xc/H), and impedance/height (Z/H), and their cutoff points for malnutrition. METHODS: The reference standards, Subjective Global Assessment (SGA), Malnutrition Inflammation Score, and Nutritional Risk Screening 2002, were performed at baseline and then once a year for 2 years. At least 2 assessments for each reference standard were performed during the monitoring period, and those patients who were assessed as malnourished on at least 2 consecutive occasions were classified as malnourished. RESULTS: A total 101 patients receiving HD were evaluated. R/H and Z/H demonstrated low to moderate accuracy to diagnose malnutrition in men and low accuracy in women, whereas the accuracy of Xc/H was uncertain. The cutoff points of bioelectrical impedance vector analysis (BIVA) parameters, determined based on the SGA to maximize sensitivity and specificity simultaneously, were: R/H ≥330.05 and ≥420.92 ohms/m for men and women, respectively; Z/H ≥332.71 and ≥423.19 ohms/m for men and women, respectively. In men, sensitivity based on the cutoff points of R/H and Z/H together ranged from 73% to 89% and specificity ranged from 49% to 50%. In women, sensitivity ranged from 58% to 80% and specificity from 48% to 55%. CONCLUSION: BIVA parameters demonstrated low to moderate accuracy in men and low accuracy in women for the diagnosis of malnutrition.

Association of hyperhydration evaluated by bioelectrical impedance analysis and mortality in patients with different medical conditions: Systematic review and meta-analyses.

BACKGROUND AND AIMS: Fluid retention is a risk factor for mortality in several medical conditions. However, the accurate and fast assessment of hydration status remains a challenge in the clinical practice. Bioelectrical impedance analysis (BIA) could be an alternative to assess volume status. This systematic review aimed to evaluate the use of BIA to identify hydration status in patients with different medical conditions and to verify the association of hyperhydration, assessed by BIA, with mortality. METHODS: This systematic review and meta-analyses included 29 studies conducted from 2002 to 2017 among different medical conditions in adults. Eligible studies were randomized and non-randomized clinical trials, prospective and retrospective observational studies. For quality assessment of studies, Effective Public Health Practice Project (EPHPP) was used. RESULTS: Twelve studies provided data eligible for meta-analyses. A direct association between hyperhydration and mortality was observed (Odds Ratio [OR] 4.38; Confidence interval 95% [95% CI] 2.76-6.94), even when stratified for medical condition (OR 4.37; 95% CI 1.15-6.92) and BIA device (OR 4.37; 95% CI 2.75-6.92). CONCLUSION: Hyperhydration, evaluated by BIA, was positive associated with mortality. Therefore, the prognostic impact of hyperhydration may be properly assessed by a bedside tool such as BIA.

Do sociodemographic, behavioral or health status variables affect longitudinal anthropometric changes in older adults? Population-based cohort study in Southern Brazil.

AIM: To assess the influence of sociodemographic, behavioral and health status variables on longitudinal changes in height, weight, and waist circumference in older adults. METHODS: This is a population-based cohort study in Southern Brazil (EpiFloripa Study) investigating 1702 individuals aged 70.6 ± 8.0 years (62.5% women). Height, weight and waist circumference were measured in 2009/10 and 2013/14 (n = 1197). Linear mixed regression models were used to estimate age-related changes in anthropometric measurements according to the explanatory variables. RESULTS: Unmarried individuals, with higher education level or household income, with excessive alcohol consumption, former smokers and positives for some chronic disease were heavier than their counterparts. Similar associations were observed for waist circumference in terms of marital status, smoking and the presence of chronic diseases. Height was higher among the wealthiest, in former smokers and those physically active. Only in men were a lower education level and being unmarried associated with higher weight loss after the age of 75 years, but not with waist circumference reduction. CONCLUSIONS: Despite their association with current height, weight and waist circumference, neither behavioral variables nor the presence of chronic diseases influenced the anthropometric changes. Less educated and unmarried men lose weight at a higher rate, showing a higher risk of sarcopenia. Geriatr Gerontol Int 2017; 17: 2074-2082.

Nutrition Status Parameters and Hydration Status by Bioelectrical Impedance Vector Analysis Were Associated With Lung Function Impairment in Children and Adolescents With Cystic Fibrosis.

BACKGROUND: (1) To compare nutrition and hydration status between a group of children/adolescents with cystic fibrosis (CFG; n = 46; median age, 8.5 years) and a control group without cystic fibrosis (CG). (2) To examine the association of nutrition and hydration status with lung function in the CFG. MATERIAL AND METHODS: A cross-sectional study. Nutrition screening, anthropometric parameters, and bioelectrical impedance analysis (BIA) were assessed. The z scores for body mass index for age, height for age, mid upper arm circumference, triceps and subscapular skinfold thickness, mid upper arm muscle area, resistance/height, and reactance/height were calculated. Bioelectrical impedance vector analysis was conducted. Forced expiratory volume in 1 second <80% was considered lung function impairment. An adjusted logistic regression was applied (P < .05). RESULTS: In the CFG, lung function impairment was observed in 51.1%. All anthropometric parameters were lower, and the mean z-resistance/height and z-reactance/height were higher in the CFG (P < .05) compared with the CG. In the CFG, 43% were severely/mildly dehydrated, while none were in the CG (P = .007). In the CFG, there was an association between high nutrition risk-via nutrition screening (odds ratio [OR], 22.28; P < .05), lower values of anthropometric parameters, higher z-resistance/height (OR, 2.23; P < .05) and z-reactance/height (OR, 1.81; P < .05), and dehydration (OR, 4.94; P < .05)-and lung function impairment. CONCLUSIONS: The CFG exhibited a compromised nutrition status assessed by anthropometric and BIA parameters. Nutrition screening, anthropometric and BIA parameters, and hydration status were associated with lung function.

Conjunctural hunger and structural obesity in the global scenario: reflections on what Covid-19 masks reveal / Fome conjuntural e obesidade estrutural no cenário global: reflexões sobre o que revelam as máscaras da Covid-19

ABSTRACT This essay is a reflection on the interconnection of the Covid-19 pandemic, social inequality, food insecurity and obesity in the global scenario. The pandemic health crisis is bound to an economic and social crisis marked by an increase in unemployment and a decrease in income with a consequent growth of food and nutritional insecurity. The impacts are felt worldwide, although the situation in each country, with regard to the conditions of social inequality and access to food, influences the magnitude of the pandemic consequences. At the same time, we are aware that food and nutritional insecurity is associated with low food quality and higher rates of obesity, which impairs the immune response and predisposes to worse prognosis. Thus, more economically vulnerable populations must face poorer disease outcome, besides the worsening of the economic situation and food and nutritional insecurity and the increase in obesity rates.

RESUMO Este ensaio traz uma reflexão sobre a inter-relação da pandemia da doença causada pelo novo coronavírus com a desigualdade social, a insegurança alimentar e a obesidade no cenário global. A crise sanitária oriunda da pandemia está atrelada a uma crise econômica e social, marcada pelo aumento do desemprego e pela diminuição da renda, com consequente acréscimo da insegurança alimentar e nutricional. Os impactos devem ser sentidos em todo o mundo, embora a situação de cada país, no que diz respeito às condições de desigualdade social e acesso à alimentação, influencie na magnitude dos efeitos da pandemia. Paralelamente, sabe-se que a insegurança alimentar e nutricional está associada à baixa qualidade alimentar e a maiores índices de obesidade, o que prejudica a resposta imunológica e predispõe a piores prognósticos. Dessa forma, populações mais economicamente vulneráveis devem encarar piores desfechos da doença, além do agravamento da situação econômica, da piora da IAN e do aumento dos índices de obesidade.

The predictive value of composite methods of nutritional assessment on mortality among haemodialysis patients.

BACKGROUND & AIMS: Several parameters might indicate protein-energy wasting in patients undergoing haemodialysis (HD), and such depletion has been associated with the survival of these patients. Our aim was to identify the parameters that are associated with an increased risk of death among HD patients. METHODS: This was a prospective study with at least 13 months follow-up three times per week of 138 HD patients; 61.6% of the patients were men, 28.9% had diabetes mellitus, and 81.9% had hypertension. The associations of the survival rates based on by Kaplan-Meier analysis with the following nutritional parameters were verified: albumin, lymphocytes, % fat mass (% FM), mid-arm muscle circumference (MAMC), subjective global assessment (SGA), malnutrition-inflammation score (MIS), and nutritional risk screening 2002 (NRS 2002). Cox proportional hazard analysis was used to identify the patients' risk of death (hazard proportional ratio - HR). RESULTS: The nutritional parameters of lymphocytes and % FM were not associated with the risk of patient death. The patients who were classified as malnourished based on MAMC had a greater risk of death than did those considered nourished, but this difference was not statistically significant. The parameters of serum albumin, SGA, MIS, and NRS 2002 were associated with the risk of patient death (HR = 2.77 P = 0.042, HR = 1.88 P = 0.202, HR = 4.47 P = 0.011, HR = 3.13 P = 0.022, respectively), and the latter two parameters were significantly associated with a high risk among malnourished. CONCLUSIONS: The scores for the MIS and NRS 2002 composite methods of nutritional assessment were associated with the highest mortality risk values; thus, in conditions similar to those of our study, we suggest that the use of these parameters should be preferred.

Influence of drugs acting on nitric oxide-dependent pathways on ethanol tolerance in rats.

RATIONALE: Our previous studies have shown that the inhibition of nitric oxide (NO) synthesis with drugs administered either by systemic or ICV routes blocks the development of tolerance to some of the effects of ethanol. OBJECTIVES: The aim of this study was to further investigate the role of NO-dependent pathways in tolerance to the incoordinating effect of ethanol through ICV administration of drugs that activate or interfere with NO-dependent pathways. METHODS: Male Wistar rats were pretreated with IP ethanol (2.7 g/ kg) or saline before receiving ICV injections of the soluble guanylyl cyclase (sGC) inhibitors methylene blue (30 nmol), 6(phenylamino)-5,8-quinolinedione (LY83583, 10 nmol), 1H-(1,2,4)-oxodiazolo (4,3-a)quinoxalin-1-one (ODQ, 1 nmol), and 4H-8-bromo-1,2,4-oxadiazolo (3,4-d)benz(b)(1,4)oxazin-1-one (NS2028, 10 nmol), or the respective control solutions. The animals were tested on the tilt plane apparatus. Tolerance was assessed 24 h after the first ethanol injection, by administering ethanol to all animals and re-testing them on the tilt plane. The effects of the cyclic guanylate 3',5'-monophosphate (cGMP) analogue, 8-bromo-cGMP (40 nmol or 80 nmol) and of the NO donors S-nitroso-N-acetylpenicillamine (SNAP, 40 or 80 nmol) and sodium nitroprusside (SNP, 40 or 80 nmol) were also studied. RESULTS: All sGC inhibitors significantly blocked rapid tolerance, whereas SNP (40 nmol) and 8-bromo-cGMP (80 nmol) increased the magnitude of ethanol tolerance (ANOVA+Tukey's test). CONCLUSIONS: The present results suggest that activation or inhibition of NO-dependent pathways increases or blocks rapid tolerance, respectively. These results give additional support to the hypothesis that brain NO plays a role in the development of tolerance to ethanol, but it remains to be confirmed if the same basic cellular mechanisms are also applicable to tolerance to other behavioural and/or physiological effects of this drug.

Effects of intracerebroventricular administration of 7-nitroindazole on tolerance to ethanol.

Previous studies have shown that nitric oxide (NO) is involved in the development of rapid tolerance to the motor incoordination produced by ethanol. In order to further investigate this involvement, three experiments were undertaken using the tilt-plane and the hypothermia tests. The first demonstrated that 7-nitroindazole (7-NI), a preferential neuronal NO synthase (nNOS) inhibitor, injected by intracerebroventricular (i.c.v.) route, blocked the development of rapid tolerance to ethanol-induced motor incoordination. This effect was prevented by i.c.v. injection of L-arginine. The second experiment showed that D-arginine did not influence the blockade of tolerance produced by 7-NI. The third experiment revealed that i.c.v. injection of 7-NI also blocked the development of tolerance to the hypothermic effect of ethanol. These results support the hypothesis that nNOS-derived NO participates in the development of rapid tolerance to ethanol.

Comparison between nutritional risk tools and parameters derived from bioelectrical impedance analysis with subjective global assessment.

BACKGROUND: Nutritional risk and malnutrition are highly prevalent among hospitalized patients. As a result, several methods have been developed to produce an adequate nutritional diagnosis. OBJECTIVE: We aimed to assess the relationship between nutritional risk tools and parameters derived from bioelectrical impedance analysis with a Subjective Global Assessment (SGA). DESIGN: A cross-sectional study was conducted from April to September 2010. PARTICIPANTS/SETTING: The study included 124 patients admitted to the Surgical Clinic I, University Hospital, Federal University of Santa Catarina, Florianópolis, Brazil, to undergo elective surgery. MAIN OUTCOME MEASURES: We utilized SGA and Nutritional Risk Screening 2002 (NRS 2002), Nutritional Risk Index (NRI), Fat-Free Mass Index (FFMI), Fat Mass Index (FMI), body cell mass as a percentage of the total weight (%BCM), and standardized phase angle (SPA). STATISTICAL ANALYSIS PERFORMED: The agreement was tested by κ coefficient, while bivariate associations were tested by Mann-Whitney U test. RESULTS: Prevalence of nutritional risk by NRS 2002 and NRI or malnutrition by SGA, FFMI, FMI, %BCM, and SPA was 19.3%, 69.5%, 35.5%, 12.9%, 8.1%, 46.8%, and 4.8%, respectively. The best agreement was between SGA and NRS 2002 (κ=.490), possibly because they constitute similar instruments. Patients identified as malnourished by SGA (B+C) showed considerably lower values of FFMI, FMI, BCM, and SPA. CONCLUSIONS: The results suggest that the NRS 2002 and parameters derived from bioelectrical impedance analysis identify patients with impaired nutritional status.

Green tea extract reverses endothelial dysfunction and reduces atherosclerosis progression in homozygous knockout low-density lipoprotein receptor mice.

The aim of this study was to evaluate the effects of green tea extract (GTE) administration on vascular reactivity and atherosclerosis progression in low-density lipoprotein receptor knockout mice. We hypothesized that GTE intake may ameliorate atherosclerosis by improving endothelial dysfunction. Animals (n = 12 per group) were fed a hypercholesterolemic diet and received either water or GTE at a dose of 50, 100, or 300 mg/kg once a day by gavage (100 µL/10 g weight). After 4 weeks, atherosclerosis extension and vascular reactivity were evaluated in the aorta, and the levels of lipids, monocyte chemotactic protein-1 (MCP-1), and tumor necrosis factor α were measured in the plasma. Administration of GTE at a dose of 50 mg/kg significantly decreased the area of atherosclerotic lesions by 35%, improved the vascular reactivity in the isolated thoracic aorta, and lowered the plasma levels of both MCP-1 and triglycerides. Delivery of 100 mg/kg of GTE only promoted vasocontraction and vasorelaxation (P < .05), whereas a dose of 300 mg/kg was ineffective. Maximum contraction and relaxation negatively correlated with the lesion area (r = -0.755 and -0.767, respectively), whereas the plasma levels of MCP-1 and triglycerides positively correlated with plaque size (r = 0.549 and 0.421, respectively). In summary, our results supported the hypothesis that administration of GTE at low doses may contribute to a decrease in atherosclerosis progression by reversing endothelial dysfunction.

Association of mate tea (Ilex paraguariensis) intake and dietary intervention and effects on oxidative stress biomarkers of dyslipidemic subjects.

OBJECTIVE: To evaluate the effect of long-term ingestion of mate tea, with or without dietary intervention, on the markers of oxidative stress in dyslipidemic individuals. METHODS: Seventy-four dyslipidemic volunteers participated in this randomized clinical trial. Subjects were divided into three treatment groups: mate tea (MT), dietary intervention (DI), and mate tea with dietary intervention (MD). Biochemical and dietary variables were assessed at the beginning of the study (baseline) and after 20, 40, 60, and 90 d of treatment. Participants in the MT and MD groups consumed 1 L/d of mate tea. Those in the DI and MD groups were instructed to increase their intake of fruit, legumes and vegetables and decrease their consumption of foods rich in cholesterol and saturated and trans-fatty acids. Biomarkers of oxidative stress such as antioxidant capacity of serum (ferric reducing antioxidant potential assay), uric acid, reduced glutathione, paraoxonase-1 enzyme, lipid hydroperoxide (LOOH), and protein carbonyl were analyzed. RESULTS: Participants in the DI group showed a significant decrease in total fat and saturated fatty acid intakes. Those in the DI and MD groups presented a significant increase in vitamin C consumption. For all groups, there was a significant increase in ferric reducing antioxidant potential and reduced glutathione concentrations but no significant changes in LOOH, protein carbonyl, and paraoxonase-1 values. The reduced glutathione concentration was positively correlated with the consumption of monounsaturated fatty acids, fiber, and vitamin C, whereas levels of LOOH were inversely correlated with intakes of vitamin C and fiber. In addition, LOOH correlated positively with low-density lipoprotein cholesterol and inversely with high-density lipoprotein cholesterol, which had a positive association with paraoxonase-1. CONCLUSION: The ingestion of mate tea independently of the dietary intervention increased plasma and blood antioxidant protection in patients with dyslipidemia.

Associação entre o escore de desnutrição- inflamação e indicadores do estado nutricional em pacientes submetidos à hemodiálise / Association between the malnutrition-inflammation score and parameters of nutritional status in hemodialyzed patients

Introdução: O conhecimento e caracterização do estado nutricional de pacientes com doença renal crônica (DRC) em hemodiálise (HD) são fundamentais para a prevenção da desnutrição e para propiciar a intervenção nos pacientes em risco nutricional ou desnutridos. Objetivo: Verificar a associação entre o Malnutrition-Inflammation Score (MIS) e os indicadores: albumina sérica, índice de massa corporal, circunferência muscular do braço, força do aperto da mão, Avaliação Subjetiva Global (ASG) e Nutritional Risk Screening 2002 (NRS 2002). Método: Estudo transversal analítico, realizado na Unidade de Terapia Dialítica do Hospital Universitário da Universidade Federal de Santa Catarina, de junho a agosto de 2013. Realizada avaliação nutricional após sessão de hemodiálise. Foram utilizados os testes qui quadrado, t de Student ou Mann Whitney. Resultados: A amostra foi constituída de 25 pacientes e a prevalência de desnutrição variou de 21,7 a 96%, conforme o indicador nutricional utilizado. Conclusões: O MIS foi o indicador nutricional composto que identificou maior prevalência de desnutrição e foi associado com a ASG e o NRS 2002.(AU)

Introduction: The knowledge and characterization of the nutritional status of patients with chronic kidney disease (CKD) on hemodialysis (HD) are essential for the prevention of malnutrition and to provide intervention in patients at nutritional risk or malnourished. Objective: To investigate the association between Malnutrition-Inflammation Score (MIS) and indicators: serum albumin, body mass index, arm muscle circumference, hand grip strength, Subjective Global Assessment (SGA) and Nutritional Risk Screening 2002 (NRS 2002). Methods: A cross-sectional study conducted in Dialytic Care Unit of the University Hospital of the Federal University of Santa Catarina, from June to August 2013. Nutritional assessment was held after hemodialysis session. Chi-square test, Student's t test or Mann-Whitney test were used. Results: The sample consisted of 25 patients and the prevalence of malnutrition varied from 21.7 to 96% as the nutritional indicator used. Conclusions: The MIS was the nutritional indicator compound identified higher prevalence of malnutrition and was associated with SGA and NRS 2002.(AU)