Heat and cold stress increases the risk of paroxysmal supraventricular tachycardia.

Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in adults. Its occurrence depends on the presence of the reentry circuit and the trigger of the paroxysm. Stress, emotional factors, and comorbidities favour the occurrence of such an episode. We hypothesized that the occurrence of PSVT follows extreme thermal episodes. The retrospective analysis was based on the data collected from three hospital emergency departments in Poland (Olsztyn, Radom, and Wroclaw) involving 816 admissions for PSVT in the period of 2016-2021. To test the hypothesis, we applied the Universal Climate Thermal Index (UTCI) to objectively determine exposure to cold or heat stress. The risk (RR) for PSVT increased to 1.37 (p = 0.006) in cold stress and 1.24 (p = 0.05) in heat stress when compared to thermoneutral conditions. The likelihood of PSVT during cold/heat stress is higher in women (RR = 1.59, p< 0.001 and RR = 1.36, p = 0.024, respectively) than in men (RR = 0.64 at p = 0.088 and RR = 0.78, p = 0.083, respectively). The susceptibility for PSVT was even higher in all groups of women after exclusion of perimenopausal group of women, in thermal stress (RR = 1.74, p< 0.001, RR = 1.56, p = 0.029, respectively). Females, particularly at the perimenopausal stage and men irrespective of age were less likely to develop PSVT under thermal stress as compared to thermoneutral conditions. Progress in climate change requires searching for universal methods and tools to monitor relationships between humans and climate. Our paper confirms that the UTCI is the universal tool describing the impact of thermal stress on the human body and its high usefulness in medical researches.

Nutritional Status, Selected Nutrients Intake, and Metabolic Disorders in Bariatric Surgery Patients.

Bariatric surgery is the most effective treatment for obesity and its complications. However, failure to adhere to dietary recommendations can result in both unsatisfactory weight loss and metabolic disorders. The aim of this study was to evaluate the effects of bariatric surgery on the anthropometric parameters and selected nutrient intake. A total of 12 months postoperatively, percent excess weight loss (%EWL) was significantly higher after laparoscopic Roux-en-Y gastric bypass (LRYGB) than laparoscopic sleeve gastrectomy (LSG) and laparoscopic adjustable gastric banding (LAGB) (93.78% vs. 56.13% and 55.65%, p < 0.001). The same was true for waist-to-hip ratio (WHR) (p = 0.017) and waist-to-height ratio (WHtR) changes (p = 0.022). There was a significant decrease in total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels after RYGB. A significant decrease (p < 0.05) in daily intake was found for energy (4278.4 kcal vs. 1355.17 kcal), sucrose (122.23 g vs. 38.22 g), dietary fiber (30.90 g vs. 14.20 g), eicosapentaenoic fatty acid and docosahexaenoic acid (EPA+DHA) (142.46 mg vs. 52.90 mg) and % energy from fats (42.43% vs. 35.17%), saturated fatty acids (SAFAs) (19.96% vs. 14.11%) and alpha-linolenic fatty acid (ALA) (0.87% vs. 0.69%). Energy intake and energy % from fats positively correlated with body weight (BW), waist circumference (WC), WHR, and WHtR, and negatively with %EWL. The percentage of unsaturated fatty acids positively correlated with WC and WHR. Energy intake correlated positively with serum triglycerides (TGs) and energy % from fats and carbohydrates. Despite significant weight loss, the patient's diet deviated from recommendations and may have contributed to metabolic disorders.

Higher Muscle Mass and Higher Serum Prealbumin Levels Are Associated with Better Survival in Hemodialysis Patients during a Five-Year Observation Period.

BACKGROUND: Dialysis is the most commonly used renal replacement therapy in patients with end-stage renal disease. The mortality rate of hemodialysis patients is 15-20%, with cardiovascular complications being the most common. There is an association between the severity of atherosclerosis and both the development of protein-calorie malnutrition and inflammatory mediators. The aim of this study was to assess the relationship between biochemical markers of nutritional status, body composition and survival in hemodialysis patients. METHODS: Fifty-three hemodialysis patients were included in the study. Serum albumin, prealbumin, and IL-6 levels were measured, as well as body weight, body mass index, fat content and muscle mass. The five-year survival of patients was calculated using Kaplan-Meier estimators. The long-rank test was used for univariate comparison of survival curves, and the Cox proportional hazards model was used for multivariate analysis of survival predictors. RESULTS: There were 47 deaths, 34 of which were due to cardiovascular disease. The hazard ratio (HR) for age in the middle-aged group (55-65 years) was 1.28 (confidence interval [CI] 0.58, 2.79) and 5.43 (CI 2.1, 14.07; statistically significant) for the oldest age group (over 65 years). A prealbumin level above 30 mg/dl was associated with an HR of 0.45 (CI 0.24, 0.84). Serum prealbumin (odds ratio [OR] = 5.23; CI 1.41, 19.43; p = 0.013) and muscle mass (OR = 7.5; CI 1.31, 43.03; p = 0.024) were significant predictors of all-cause mortality. CONCLUSIONS: Prealbumin level and muscle mass were associated with increased mortality risk. Identification of these factors may improve the survival of hemodialysis patients.

Nutritional Status, Selected Nutrients Intake and Their Relationship with the Concentration of Ghrelin and Adiponectin in Patients with Diabetic Nephropathy.

BACKGROUND: Overnutrition is one of the risk factors of chronic kidney disease (CKD). The factors related to both obesity and CKD are adiponectin and ghrelin. The aim of the study was to assess if there is a link of nutritional status and selected nutrients intake with adiponectin and ghrelin in patients with diabetic nephropathy (DN). METHODS: The study involved 55 patients diagnosed with DN in the pre-dialysis period (two groups: GFR < 30 and >30 mL/min/1.73 m2). In all participants standard blood tests, total ghrelin and total adiponectin plasma concentrations and anthropometric measurements (BMI, WHR- waist-hip ratio, body composition analysis) were performed. The evaluation of energy and nutrient intakes was made using the three-day food record method. RESULTS: Excessive body weight was found in 92.80% patients. The average daily energy intake was 1979.67 kcal/day (14.45% protein energy, 28.86% fat, and carbohydrates 56.89%). In the group with eGFR < 30 mL/min/1.73 m2 the analysis showed a negative relationship between ghrelin and WHR value, and the creatine and albumin concentrations. There was a positive correlation between ghrelin concentration and the consumption of carbohydrates and sucrose. In the group of patients with eGFR > 30 mL/min/1.73 m2, a positive correlation was found between the concentration of ghrelin and the consumption of vegetable protein, carbohydrates, and glucose. CONCLUSIONS: The study confirms the high prevalence of obesity in patients with DN-Excessive supply of protein was found in the patients' diets, which may contribute to the deterioration of the course of the disease and its prognosis. In patients with eGFR < 30 there was a negative correlation between ghrelin concentration and nutritional status, and in patents with eGFR > 30 between ghrelin concentration and some nutrients intake.

Nutritional Status and Dietary Patterns in Adults with Severe Obstructive Sleep Apnea.

Obstructive sleep apnea (OSA) is associated with daytime sleepiness, obesity, and lifestyle and dietary changes. The potential role of diet in OSA has been largely unexplored. The aim of the study was to assess nutritional status and dietary patterns in OSA patients. The study was conducted in 137 adult patients (48 women and 89 men) aged 31-79 suffering from OSA. The following diagnostic procedures were undertaken: polysomnography, anthropometric measurements, and a dietary pattern questionnaire. We found that 128 (93.4%) patients were overweight or obese with the mean body mass index (BMI) of 33.2 ± 6.1 kg/m2 and weight of 98.0 ± 20.2 kg. The mean percentage of total body fat was 45.0 ± 5.5% in women and 32.5 ± 5.5% in men. Obesity was associated with the severity of OSA, expressed by apnea/hypopnea index. We further found that the waist-to-hip ratio in women, but the neck circumference or percentage of body fat in men, characterizes best the OSA patients. Referring to dietary habits, half of the patients consumed white bread on a daily basis, 35.8% of them had whole grain bread in the diet, and only 16.8% consumed fish at least two portions a week. A third of patients used butter as a spread for bread or a source of fat for cooking, 2.9% of them used soft margarine, and 20.4% used olive or canola oil. Fruits and vegetables were consumed by 60% and 38% of patients, respectively. Refined sugar and sweets were used by 31.4% of patients every day. We conclude that excessive body weight, which may portend the development of OSA, is characterized by different anthropometric variables in men and women. Further, improper dietary habits seem conducive to the gain in body weight and thus may be at play in the pathogenesis of OSA.

Body Composition and Biochemical Markers of Nutrition in Non-dialysis-Dependent Chronic Kidney Disease Patients.

The aim of this study was to examine the body composition in stages 3b to 5 of chronic kidney disease. There were 149 patients included in the study, with the mean age of 65.5 ± 16.5 years, body mass index (BMI) of 29.4 ± 5.6 kg/m2, and estimated glomerular filtration rate (eGFR) of 23.2 ± 9.3/min/1.73m2. They remained with dialysis. Body composition was measured using bioimpedance spectroscopy, and handgrip strength was measured with a hydraulic dynamometer. The main biochemical markers assessed consisted of serum protein, albumin, prealbumin, high-sensitivity C-reactive protein (hsCRP), and interleukin (IL)-6 content. We found that 39% of patients were overweight and 41% were obese. Obesity was more prevalent in stage 3b of chronic kidney disease than in stages 4-5 in women and in patients older than 60 years of age. Thirty-eight percent of the study population were sarcopenic, of whom 20% presented a sarcopenic obesity phenotype. There were significant associations between lean tissue index (LTI) and serum prealbumin content and handgrip strength. Fat tissue index (FTI) was associated and hsCRP, serum protein, body mass index (BMI), waist-hip ratio, and waist-to-height ratio. There were inverse associations between FTI-LTI and LTI-age. We conclude that the prevalence of obesity in non-dialysis-dependent patients with chronic kidney disease is higher than that in the general population. Earlier stages of chronic kidney disease are associated with a higher prevalence of obesity.

Applicability of the universal thermal climate index for predicting the outbreaks of respiratory tract infections: a mathematical modeling approach.

Respiratory tract infections (RTI) are one of the most frequent reasons for medical consultations. As air temperature decreases, but also in connection with other meteorological parameters, evident seasonal fluctuations in the number of consultations for RTI can be observed. The Universal Thermal Climate Index (UTCI) is a complex meteorological index derived from an analysis of human thermal balance that depends on air temperature, air humidity, and wind speed. Our aims were to check if this index, although never used before for that purpose, is an adequate tool for forecasting seasonal increases in RTI prevalence. This study is a retrospective analysis of patients' consultations with general practitioners in the period of 2012-2015 (453,674 records) recorded in the city of Olsztyn (Poland), which is characterized by a cold climate type (Dfb). The values of air temperature, atmospheric pressure, relative air humidity, wind speed, and UTCI were used for a statistical analysis and a mathematical analysis of curve fitting in order to determine correlations between analyzed meteorological parameters and a number of medical consultations for RTI. Analysis of the number of medical consultations for RTI revealed an evident seasonal pattern in a 4-year observation period, with a strong inverse correlation between the number of patients with RTI and the UTCI. A statistically significant increase in the number of patients with RTI appeared when the UTCI decreased, especially when it reached the classes of strong cold stress and very strong cold stress. In conclusion, the UTCI is a valuable predictive parameter for forecasting seasonal increases in RTI cases. Its decrease may initiate a seasonal increased prevalence. This effect is strongest about the 10th day following a change in the thermal climate conditions and is not continuous. A larger number of consultations for RTI after weekends and holidays (the Monday effect) may blur the results of statistical analyses.

Dietary and Pharmacological Treatment of Nonalcoholic Fatty Liver Disease.

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the developed world. Simple hepatic steatosis is mild, but the coexistence of steatohepatitis (NASH) and fibrosis increases the risk of hepatocellular carcinoma. Proper dietary and pharmacological treatment is essential for preventing NAFLD progression. The first-line treatment should include dietary intervention and increased physical activity. The diet should be based on the food pyramid, with a choice of products with low glycemic index, complex carbohydrates in the form of low-processed cereal products, vegetables, and protein-rich products. Usage of insulin-sensitizing substances, pro- and prebiotics, and vitamins should also be considered. Such a therapeutic process is intended to support both liver disease and obesity-related pathologies, including insulin resistance, diabetes, dyslipidemia, and blood hypertension. In the pharmacological treatment of NAFLD, apart from pioglitazone, there are new classes of antidiabetic drugs that are of value, such as glucagon-like peptide 1 analogs and sodium/glucose cotransporter 2 antagonists, while several other compounds that target different pathogenic pathways are currently being tested in clinical trials. Liver biopsies should only be considered when there is a lack of decline in liver enzymes after 6 months of the abovementioned treatment. Dietary intervention is recommended in all patients with NAFLD, while pharmacological treatment is recommended especially for those with NASH and showing significant fibrosis in a biopsy.

Fructose Consumption and Lipid Metabolism in Obese Children and Adolescents.

Inappropriate dietary habits influence the development of excessive body weight. The role of added sugars, including fructose, notably is significant in this process. It is estimated that fructose intake has increased many times over the past two centuries. The aim of the study was to define the effect of fructose consumption on anthropometric indices and lipid metabolism in obese (body mass index (BMI) >30 kg/m2) children and adolescents. The study included 84 patients (47 girls and 37 boys) aged 7-18 years, divided into prepubertal, pubertal, and post-pubertal age groups. Aside from BMI, the assessment comprised waist circumference, body composition estimated with bioelectrical impedance (BIA), plasma lipid profile, fructose intake consumption based on a 3-day menu analysis, and a number of calculated atherogenic indices. The major findings were that total daily fructose intake was high, on average, ranging from 19 to 26 g, with no appreciable relation to age. A higher fructose intake from beverages is significantly associated with the percentage of body fat, waist circumference, waist-to-height ratio, and also with the content of total cholesterol, triglycerides, and the level of atherogenic indices. In conclusion, fructose appears a particularly unfavorable component in children's diet as it is conducive to visceral obesity and atherogenic lipid profile. However, inadequate proportions of other macronutrients may also be at play in the development of metabolic diet-related disorders.

Content of fatty acids in a diet and the homocysteine levels in women with fertility disorders.

OBJECTIVES: Assessment of the effects of consumption of fatty acids on the homocysteine levels in women with fertility disorders. METHODS AND RESULTS: The study included 286 women at the age between 23 and 46 years (the mean 33.13±4.21 years) with a fertility disorders. We measured: levels of homocysteine [µmol/L] (n=171), body weight and height (n=286). Body mass index (BMI) was calculated. A diet was assessed by 3-day dietary food records method including one day of the weekend. The mean homocysteine (Hcy) levels were 10.02±2.98 µmol/L. Body weight excess was observed in 29.3% of subjects. The percentage of fatty acids in the total energy [%E] it was demonstrated that the mean rate of MUFAs and PUFAs was statistically significantly lower in diets of women with the homocysteine levels >15 µmol/L compared to the group with the Hcy <10 µmol/L. Based on the results of a correlation between the homocysteine levels and consumption of n-6 fatty acids and n-3 fatty acids it is possible to conclude that there are negative correlations observed indicating that higher consumption of these acids is associated with lower levels of homocysteine. CONCLUSION: Increased consumption of PUFAs, including α-linoleic acid, in a diet seems to be an important factor preventing from hyperhomocysteinemia.

Stress as a factor contributing to obesity in patients qualified for bariatric surgery - studies in a selected group of patients (a pilot study).

INTRODUCTION: Recently, the incidence of obesity, especially extreme obesity, has significantly increased. It is connected with inappropriate lifestyle, including a high calorie diet, psychological and genetic factors, some medications, diseases or infectious factors. Nowadays, the consumption of food is not only to satisfy a physiological need, but also fulfils psychological needs. The most effective method of morbid obesity treatment is metabolic surgery. Moreover, food is considered to be a reward and method of coping with stress. In order to improve the efficiency of the surgical treatment, it seems significant to assess the effects of psychological factors on eating behaviours. AIM: To evaluate the effects of stress on eating habits that increase the risk of extreme obesity. MATERIAL AND METHODS: The study included 50 subjects qualified for bariatric surgery. The authors' own questionnaire and standardised PSS-10 questionnaire by Cohen, Kamarcki and Mermelstein adapted by Juczynski and Oginska-Bulik were used. RESULTS: These questionnaires indicated that patients felt a moderate levels of stress but with a tendency for high levels. The majority of respondents declared an increased appetite due to stress-causing factors. Reasons for snacking most frequently included negative emotions and feeling like eating something. Consumption of additional snacks was a way of coping with stress. Most frequently the subjects ate sweets and salty snacks, but also sandwiches, nuts, fruit and alcohol beverages. CONCLUSIONS: Psychological support may help morbidly obese people both to change nutritional habits and to cope with stress.

[Dietetary recommendation for non-alcoholic fatty liver disease]. / Zalecenia zywieniowe dla chorych z niealkoholowa stluszczeniowa choroba watroby.

Non-alcoholic Fatty Liver Disease (NAFLD) is currently the most common chronic liver disease in the developed world. Nowadays, in the adult population of Europe it is estimated at 14% to 21%. Its most important risk factors are obesity and metabolic syndrome. Introducing lifestyle changes such as: dietary intervention and increased physical activity are the first-line treatment and are intended to support not only NAFLD but also associated diseases such as obesity, insulin resistance, diabetes and dyslipidemia. Dietary management focuses on weight reduction of overweight or obese people by decreasing energy in diet. It is recommended to limit the intake of saturated fats and trans fatty acids as well as cholesterol. Instead, it is important to increase the proportion of polyunsaturated fatty acid diets, mainly from the n-3 family, which exhibit anti-inflammatory activity. It is also beneficial to eat nuts, despite their high energy value, as a source of alpha linolenic acid, which lowers LDL cholesterol. It is important to increase the share of vegetable protein (eg. soya) and limit the intake of fat meat, milk and the dairy products. A key role in the treatment and prevention of NAFLD is also a reduction of simple sugars and total exclusion of added sugar in the diet. The rise of NAFLD in developed countries is analogous to the increase of fructose consumption, which high intake is directly indicated as the main cause of the disease. Choosing foods with high fiber content, low glycemic index and meals composed with low glycemic load, is conducive to weight reduction. An important role in supporting NAFLD treatment is also attributed to vitamin D, C and E supplementation and some probiotic bacteria, as well as cinnamon and turmeric, which improve insulin sensitivity. Daily physical activity is strongly recommended as the supplement of healthy lifestyle.

Fight against malnutrition (FAM): Selected results of 2006-2012 nutrition day survey in Poland.

BACKGROUND: Prevalence of malnutrition among hospitalized patients is a common issue increasing the morbidity and mortality rate. In response to the aforementioned problem the European Society for Clinical Nutrition and Metabolism (ESPEN) stated an action plan to fight malnutrition and created in 2004 the global health project named NutritionDay (nD) - a single-day, population based, standardized, multinational cross-sectional audit which is performed worldwide in hospitals and nursing homes. OBJECTIVES: To present selected NutritionDay (nD) results from Poland describing the nutritional situation of hospitalized patients in 2006 - 2012 compared to other countries participating in nD study. MATERIAL AND METHODS: Data were collected in nD study through voluntary participation all over the world during seven years - from 2006 to 2012. Data collection was performed on ward level by staff members and patients using standardized questionnaires. The data were analyzed by the Vienna coordinating centre using the Structured Query Language ("my SQL") - an open source relational database management system as well as the Statistical Analysis System version 9.2 (SAS). RESULTS: In Poland 2,830 patients were included in the study during a 7-year survey, while 5,597 units recruited 103,920 patients in the world (nD reference). About 45% of the patients had a weight loss within the last 3 months prior to admission (same for nD references); 58.34% reported a decrease in eating during last week (54.85% in case of nD references). Food intake at nD illustrated that 60.55% of the patients ate half to nothing of the served meal (58.37% in the case of nD references). For both Poland and other countries participated in audit at the time of detection of malnutrition on the half of hospital wards wasn't reported any action aimed at combating this phenomenon. CONCLUSIONS: Malnutrition of hospitalized patients in Poland was found comparable to the rest of the world. These results reflects the fact that malnutrition is a common issue among hospitalized patients all over the world and it would be recommended to continue the action plan to fight against malnutrition commenced by the European Society for Clinical Nutrition and Metabolism (ESPEN) on international and national level. KEY WORDS: malnutrition, disease-related malnutrition, fight against malnutrition.

Evaluation of conducting a screening assessment of nutritional status of hospitalized patients. Presentation of main goals and objectives of the global health project "NutritionDay".

INTRODUCTION: European Society for Clinical Nutrition and Metabolism (ESPEN) commenced in 2004 a global health project named "NutritionDay" aiming to promote awareness of proper nutritional status of hospitalized patients and to draw attention to the need for early detection of malnutrition among patients. Under the Polish law--pursunat to the regulation of the Minister of Health dated September 15, 2011 (amendment as of 27.12.2013)--a nutritional status of each patient should be assessed at the time of a hospital admission. THE AIM: of this study was to analyze the fulfilment of the mandatory questionnaire assessment of nutritional status at selected wards of one of Warsaw's clinical hospitals. MATERIAL AND METHODS: The study included an analysis of medical records of patients hospitalized within 6 months (n = 26375). The correct fulfilment of screening questionnaire assessing nutritional status (NRS 2002 survey) and the information about patients' body weight as well as the results assessment of nutritional status were subject to the analysis. RESULTS: NRS 2002 questionnaire was present in only 67,14% medical records of patients, however 49.24% of them were unfilled. CONCLUSIONS: The obtained results confirming low degree of NRS 2002 questionnaires' fulfilment in one of the Warsaw clinical hospitals draws attention to the need for education of hospital personnel in the field of significance of screening of nutritional assessment and its regulations. The "NutritionDay" project is an interesting form to attract attention of the aforementioned problem and its global extent additionally encourage medical units to participate in the project.

Nutrition and Immune System in Children with Simple Obesity.

The purpose of this study was to evaluate dietary factors in nutrition influencing the immune system of children and teenagers suffering from simple obesity. The study involved 100 children and teenagers aged 7-18 with simple obesity. Nutritional data were obtained from 3-day food records. The consumed nutrients, including immunomodulators and immunostimulants, were estimated based on the nutrition interview. The results were compared with the nutritional norms. On average, the proportion of n-6:n-3 fatty acids equalled 10:1. Among the amino acids, the highest intake values in the diet were observed for glutamine (13,694.6 mg/day). The study demonstrates inadequate intake levels of iron (73% of recommended dietary allowance, RDA), vitamin C (65% of RDA), and vitamin D (11% of RDA) taking into account the median values for the entire study group. The median daily intake of other nutrients exceeded the RDA values. The diets of the participants in this study were not properly balanced with respect to immunomodulators, which may contribute to the occurrence of immunological disorders and immunodeficiency in this group of patients.

[The relationship between selected fluid intake and the risk of diabetes]. / Zwiazek miedzy spozyciem wybranych plynów a ryzykiem zachorowania na cukrzyce.

Diabetes mellitus is a chronic metabolic disease which affects more and more people. It is estimated that in Poland it affects about 2.6 million people, of which diagnosed and treated diabetes constitute only 60% cases. The increased incidences of diabetes and prediabetes, indicate the need for undertake prevention activities and forces for continuous analysis of lifestyle factors that may influence the risk of developing the disease. In the thesis it was described in detail the relationship between liquids intake such as coffee, tea, pure water and sugar-sweetened beverages and risk of the occurrence of type 2 diabetes. Much research proved that coffee reduces the risk of developing diabetes. An inverse relationship has been demonstrated in the case of consumption of sugar-sweetened beverages. In relation to tea and pure water due to the limited amount of data, there is a need to further research conducting, however, there are some evidence that people who consumed less than 0.5 liters of water a day should be covered by preventive treatment against diabetes.

[The use of low-calorie sweeteners]. / Zastosowanie niskokalorycznych substancji slodzacych.

The aim of this study was to determine the type of sweeteners and their impact on the human body. There have been described in details the sweeteners such as aspartame, acesulfame K, sugar alcohols, fructose, D-tagatose, steviol glycosides and maple syrup which are present in currently available food products. According to The European Food Safety Authority (EFSA), aspartame and steviol glycosides were found to be safe for consumption. Whereas fructose, a component representing a large number of component products, according to the Polish Diabetes Association from 2012, should not be consumed by diabetics. The increase of popularity of products containing sweeteners causes that the search for new resources is constantly current and is the subject of research.

[Assessment of dietary calcium intake on metabolic syndrome frequency in obese children and adolescents]. / Wplyw spozycia wapnia pokarmowego na wystepowanie zespolu metabolicznego u dzieci i mlodziezy z otyloscia prosta.

INTRODUCTION: High dietary calcium intake has an impact on reduction of adipose tissue, as in prevention and treatment of obesity and metabolic syndrome (MS). The aim of the study was to evaluate the influence of dietary calcium on appearance MS in children and adolescents. MATERIALS AND METHODS: The study included 150 patients in the age range of 7-18 years with obesity. In each child, the bioelectrical impedance analysis, waist circumference, blood pressure, lipids (enzymatic method), Oral Glucose Tolerance Test (OGTT) with marking of glucose, insulin blood levels (RIA method), and estimation of nutritional status had been made. The standard deviation score of body mass index (SDS BMI), waist to hip ratio (WHR), insulin resistance (HOMA-IR) was calculated. MS was recognized according Cook criteria. RESULTS: All patients had waist circumference greater than the 90 percentile. Boys had more often an abnormal lipids profile than girls. Both, high blood pressure and HOMA-IR >3 were found in over half of studied patients. The diet of many patients had too much fat and saccharose intaking. Only 20% of children consumed normal value of calcium. The observed intaking more than 20 mg of calcium per ideal body mass (i.b.m) per 24 hours had higher % FAT, SDS BMI, waist circumference, HOMA-IR, and insulin. MS was recognized more often in this group. CONCLUSIONS: Insufficient dietary calcium intake could have an effect on some parameters of metabolic syndrome.

Malnutrition, inflammation, atherosclerosis in hemodialysis patients.

Protein-energy malnutrition with muscle wasting occurs in a large proportion of patients with chronic renal failure and is, in addition to atherosclerosis, a strong risk factor for cardiovascular mortality in dialysis patients. There is evidence that a chronic inflammation with activation of C-reactive protein and proinfalammatory cytokines is associated with increased oxidative stress and endothelial dysfunction. Strong relations between malnutrition, inflammation and atherosclerosis in dialysis patients suggest the presence of a MIA (malnutrition, inflammation and atherosclerosis) syndrome, which is associated with high mortality rate. Thus, it could be speculated that suppression of the vicious cycle of malnutrition, inflammation and atherosclerosis would improve survival in dialysis patients.