The dietary inflammatory index is associated with anti- and pro-inflammatory adipokines in Brazilian schoolchildren.

PURPOSE: To investigate the relationship of Children's Dietary Inflammatory Index (C-DII™) scores with body fat distribution and serum adipokines in Brazilian schoolchildren. METHODS: This population-based cross-sectional study enrolled 378 schoolchildren aged 8 and 9 years from Viçosa, Minas Gerais, Brazil. Food consumption was assessed using three 24-h dietary recalls from which C-DII scores were calculated. Serum adipokines [adiponectin, leptin, retinal-binding protein 4 (RBP4), and chemerin] were analyzed in blood samples. Sociodemographic characteristics and sedentary behavior were assessed using a semi-structured questionnaire. Total, truncal, android and gynoid body fat were evaluated by dual-energy X-ray absorptiometry (DXA). We compared the distributions of adiposity measures and serum adipokines by C-DII categories with linear regression, adjusting for potential confounders. RESULTS: The mean sample C-DII was 0.59 ± 0.94 and ranged from - 2.16 to + 2.75. The C-DII was not associated with central and total body fat. However, the C-DII was modestly inversely associated with adiponectin and RBP4, and modestly directly associated with chemerin. These results remained significant after adjusting for body fat. Every 1 SD of C-DII was related, respectively, to a - 0.8 (- 1.5, - 0.03) and to a - 0.1 (- 0.2, - 0.05) units lower mean of adiponectin and RBP4, and to 7.2 (0.3, 14.1) units higher of chemerin. CONCLUSION: Higher C-DII score was modestly inversely and directly associated with anti- and pro-inflammatory adipokines, respectively, in Brazilian children. The development of public health policies is needed to promote healthy eating habits during childhood to prevent the early onset of systemic inflammation and ill health effects later in life.

Dietary total antioxidant capacity is positively associated with muscular strength in cirrhotic outpatients: a cross-sectional study.

BACKGROUND: Cirrhosis is the end-stage of progressive fibrosis, in which oxidative stress and inflammation-related pathways can modulate the cellular and tissue events involved in the pathogenesis of liver fibrosis. Dietary intake of antioxidants has been suggested to protect against oxidative damage and related clinical complications. The present study aimed to investigate the potential association of the dietary total antioxidant capacity (dTAC) with anthropometric, functional and biochemical markers, as well as the severity of the disease, in cirrhotic outpatients. METHODS: Sixty-two outpatients (38 men and 24 women) with a mean (SD) age of 59.1 (9.9) years were evaluated. Dietary TAC was estimated from a food frequency questionnaire. Aetiology and severity of liver cirrhosis, lifestyle characteristics, occurrence of comorbidities and oedema, and anthropometric, functional and biochemical markers were all assessed. RESULTS: Cirrhotic outpatients with higher dTAC also had higher values of the hand-grip strength (P = 0.029) and arm muscle area (P = 0.027). After adjusting by sex, age, smoking and alcohol intake, the addition of 1 mmol day-1 of dTAC contributed to increase 0.552 kg f-1 in hand-grip strength (P < 0.05). The addition of one mmol day-1 of dTAC contributed to an arm muscle area increase 0.565 cm2 (P < 0.05) on average. CONCLUSIONS: The dTAC was positively associated with hand-grip strength and arm muscle area in cirrhotic outpatients. The implications of the present study are important in clinical practice because a diet rich in antioxidants may be an ally in the control of excessive reactive oxygen species production in cirrhotic outpatients with repercussion on muscle mass and strength.

Implementation of a Brazilian Cardioprotective Nutritional (BALANCE) Program for improvement on quality of diet and secondary prevention of cardiovascular events: A randomized, multicenter trial

Background Complex percutaneous coronary intervention (PCI) is associated with higher ischemic risk, which can be mitigated by long-term dual antiplatelet therapy (DAPT). However, concomitant high bleeding risk (HBR) may be present, making it unclear whether short- or long-term DAPT should be prioritized. Objectives This study investigated the effects of ischemic (by PCI complexity) and bleeding (by PRECISE-DAPT [PRE dicting bleeding Complications in patients undergoing stent Implantation and Sub sequent Dual Anti Platelet Therapy] score) risks on clinical outcomes and on the impact of DAPT duration after coronary stenting. Methods Complex PCI was defined as ≥3 stents implanted and/or ≥3 lesions treated, bifurcation stenting and/or stent length >60 mm, and/or chronic total occlusion revascularization. Ischemic and bleeding outcomes in high (≥25) or non-high (<25) PRECISE-DAPT strata were evaluated based on randomly allocated duration of DAPT. Results Among 14,963 patients from 8 randomized trials, 3,118 underwent complex PCI and experienced a higher rate of ischemic, but not bleeding, events. Long-term DAPT in non-HBR patients reduced ischemic events in both complex (absolute risk difference: −3.86%; 95% confidence interval: −7.71 to +0.06) and noncomplex PCI strata (absolute risk difference: −1.14%; 95% confidence interval: −2.26 to −0.02), but not among HBR patients, regardless of complex PCI features. The bleeding risk according to the Thrombolysis In Myocardial Infarction scale was increased by long-term DAPT only in HBR patients, regardless of PCI complexity. Conclusions Patients who underwent complex PCI had a higher risk of ischemic events, but benefitted from long-term DAPT only if HBR features were not present. These data suggested that when concordant, bleeding, more than ischemic risk, should inform decision-making on the duration of DAPT. (AU)

Comparison between direct and indirect methods to diagnose malnutrition and cardiometabolic risk in haemodialisys patients.

BACKGROUND: The present study aimed to evaluate the nutritional status of patients undergoing haemodialysis (HD) by comparing nutritional risk scores with biochemical, anthropometric and body composition variables. METHODS: Eighty-five individuals [65.9% male, mean (SD) age 62 (14) years] participated in a cross-sectional study. Global Objective Assessment (GOA) and Modified Global Subjective Assessment (mGSA) scores, as well as biochemical, anthropometric and body composition data, were collected using standardised procedures. RESULTS: The prevalence of malnutrition ranged from 20.0% (% body fat by electrical bioimpedance) to 95.3% (by GOA), depending on the indicator or score used. According to the waist circumference, 61.2% of the individuals presented abdominal obesity and visceral adipose tissue was excessive in 20% of them. Malnutrition diagnosis by GOA showed the relationship between the anthropometric and body composition indicators, as assessed by the extent that the ratings of risk nutritional/mild malnutrition and mainly moderate malnutrition were accompanied by a significant decrease in nutritional status and body composition variables. However, with respect to categories of mGSA, no statistically significant differences were observed for nutritional status and body composition variables. In the receiver operator characteristic curve analyses, mGSA and GOA were good indicators for diagnosing malnutrition because both achieved an AUC > 0.5. CONCLUSIONS: mGSA and GOA were more sensitive with respect to identifying individuals at nutritional risk compared to the isolated anthropometric indicators, thus indicating their utility in diagnostic malnutrition. However, individuals at high nutritional risk also presented cardiometabolic risk, as diagnosed mainly by central fat indicators, suggesting the application of both malnutrition and cardiometabolic risk markers in HD patients.

Consumption of Branched-Chain Amino Acids Is Inversely Associated with Central Obesity and Cardiometabolic Features in a Population of Brazilian Middle-Aged Men: Potential Role of Leucine Intake.

OBJECTIVE: To assess the potential associations of branched-chain amino acids (BCAA) consumption with central obesity (CObesity) and cardiometabolic risk factors in a population of Brazilian middle-aged men. Special attention was given to leucine intake. DESIGN: Cross-sectional study. SETTING: Universidade Federal de Viçosa, Viçosa, Brazil. PARTICIPANTS: Two-hundred ninety-six middle-aged men (Age: 50.5 ± 5.0 years; Body mass index: 25.8 ± 3.5 kg/m2). MEASUREMENTS: Anthropometry, lifestyle features, blood biochemical parameters were assessed and dietary intake was estimated by a food frequency questionnaire. Participants were classified by the occurrence of CObesity, hypertriglyceridemia (HTG), hypertriglyceridemic waist phenotype (HWP) and metabolic syndrome (MetS). RESULTS: Subjects in the BCAA highest tertile (≥0.17 g/kg/d) presented lower occurrence of CObesity (36.0% vs 72.4%, P<0.01, z=-5.10), HTG (17.0% vs 30.6% P<0.032, z=-2.32), HWP (23.0% vs 46.9%, P<0.01, z=-3.57) and MetS (19.0% vs 34.7%, P<0.01, z=-2.57). They also exhibited lower values for Castelli index (total cholesterol:HDL-c) and triglycerides: HDL-c ratio than those in the first tertile, regardless of interfering factors (i.e. habitual physical activity, work position, smoking habit, and energy intake). Interestingly, leucine consumption showed similar associations with cardiometabolic risk factors, as compared to BCAA consumption (P<0.05). CONCLUSION: BCAA consumption was cross-sectionally and negatively associated with relevant cardiometabolic risk factors in a population of Brazilian middle-aged men. The content of leucine in BCAA consumption may have contributed to such relationship.

Carotenoid consumption is related to lower lipid oxidation and DNA damage in middle-aged men.

The present cross-sectional study assessed the potential relationships of carotenoid intake with lipid and oxidative stress markers in middle-aged men. A total of 296 apparently healthy middle-aged men (mean age 50.5 (SD 5.0) years, BMI 25.8 (SD 3.5) kg/m(2)) were recruited to participate in the study. Dietary intake, anthropometry, blood pressure, lifestyle features, blood and urine biomarkers were assessed using validated procedures. The lipid markers included NEFA, Castelli index, and TAG:HDL ratio; oxidative stress markers included urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG), 8-iso-PGF2α and plasma oxidised-LDL (ox-LDL). We observed a significant inverse association (P < 0.05) between NEFA concentrations and consumption of lutein plus zeaxanthin, ß-carotene, α-carotene and total carotenoid, while Castelli index was negatively associated with daily intake of lycopene, ß-carotene and total carotenoids. Regarding oxidative stress biomarkers, urinary 8-OHdG and ox-LDL concentrations were also inversely associated (P < 0.05) with consumption of lycopene, lutein plus zeaxanthin, ß-carotene, α-carotene and total carotenoids, regardless of confounding variables. Moreover, there was a negative association of urinary 8-iso-PGF2α concentration with dietary lutein plus zeaxanthin (ß - 0.135, 95% CI - 0.268, - 0.001), ß-carotene (ß - 0.156, 95% CI - 0.277, - 0.034) and with the sum of all carotenoids (ß - 0.189, 95% CI - 0.333, - 0.046). In conclusion, total daily carotenoid intake based on five investigated carotenoid types (ß-cryptoxanthin, lycopene, lutein plus zeaxanthin, ß-carotene and α-carotene) was inversely associated with relevant lipid and oxidative stress markers in middle-aged men, with emphasis on ß-carotene that was negatively associated with five of the six lipid and oxidative stress markers evaluated in the present study.

Metabolomics identifies changes in fatty acid and amino acid profiles in serum of overweight older adults following a weight loss intervention.

The application of metabolomics in nutritional research may be a useful tool to analyse and predict the response to a dietary intervention. The aim of this study was to examine metabolic changes in serum samples following exposure to an energy-restricted diet (-15% of daily energy requirements) over a period of 8 weeks in overweight and obese older adults (n = 22) using a gas chromatography/mass spectrometry (GC/MS) metabolomic approach. After 8 weeks, there were significant reductions in weight (7%) and metabolic improvement (glucose and lipid profiles). Metabolomic analysis found that total saturated fatty acids (SFAs), including palmitic acid (C16:0) and stearic acid (C18:0) and monounsaturated fatty acids (MUFAs), were significantly decreased after the 8-week intervention. Furthermore, palmitoleic acid (C16:1) was found to be a negative predictor of change in body fat loss. Both the total ω-6 and ω-3 polyunsaturated fatty acids (PUFAs) significantly decreased, although the overall total amounts of PUFAs did not. The branched chain amino acid (BCAA) isoleucine significantly decreased in the serum samples after the intervention. In conclusion, this study demonstrated that the weight loss intervention based on a hypocaloric diet identified changes in the metabolic profiles of serum in overweight and obese older adults, with a reduction in anthropometric and biochemical parameters also found.

Glycemia and insulinemia evaluation after high-sucrose and high-fat diets in lean and overweight/obese women.

The study investigates the effect of weight-maintaining high-sucrose (HSD) and high-fat (HFD) diets on plasma glucose and insulin concentrations in lean and obese women, and verifies the correlation between insulin profile and body composition. Lean (G1 group, n=6, BMI= 21.4 (20.2-22.8) kg/m2) and overweight/obese (G2 group, n=6, BMI 28.6 (25.1-32.1) kg/m2) women participated in the study. HSD (59% total carbohydrate with 23% sucrose; 28% lipid) or HFD (42% total carbohydrate with 1.3% sucrose; 45% lipid) diets were consumed under free-living conditions for 14 days. Anthropometry and body composition were assessed before and after HSD and HFD diets following-up. Fasting and postprandial (at 30, 60, 180 and 240 min) glucose and insulin were determined. HOMA-IR and QUICK index were also calculated. Fasting and postprandial glucose and insulin concentration did not differ significantly between groups or diets. However, there was a positive and significant correlation between plasma fasting and postprandial insulin concentrations and BMI, percentage of total body fat (% TBF) and HOMA-IR index. In addition, carbohydrate and sucrose intake presented a positive and significant correlation with insulin concentration and HOMA-IR at 180 min postprandial, after adjusting for energy intake and % TBF (p<0.05). These results suggest that altering the profile of the macronutrients in the diet can modify glycemia and insulinemia homeostasis, regardless of energy intake and adiposity. On the other hand, the overweight/obese women can maintain a stable metabolic profile with the habitual diet.