Effect of reducing saturated fat intake on cardiovascular disease in adults: an umbrella review.

Introduction: Our objective was to explore the effect of the reduction of saturated fat (SAF) intake on cardiovascular disease, mortality and other health-related outcomes in adults. Methods: We conducted an umbrella review, searching Medline, Scopus, EMBASE, Cochrane Library, and LILACS databases for systematic reviews from December 1, 2012, to December 1, 2022. We have included meta-analyses of randomized controlled trials (RCTs) and cohort studies. We extracted effect sizes (95%CI), heterogeneity (I 2), and evidence quality rating based on the population, intervention, comparator, and outcomes. Results: 21 meta-analyses were included (three were from RCTs, and 18 were from cohort studies). Among meta-analyses of RCTs, 15 of the 45 associations were significant. The effect of reduction in SAF intake on combined cardiovascular events (RR 0.79, 95%CI 0.66-0.93) was graded as having moderate certainty of evidence. We found no effect on all-cause mortality, cardiovascular mortality, cancer deaths, and other cardiovascular events. Among meta-analyses of cohort studies, five of the 19 associations were significant. There was an increase in coronary heart disease mortality (HR 1.10, 95% CI 1.01-1.21) and breast cancer mortality (HR 1.51, 95% CI 1.09-2.09) in participants with higher SFA intake compared to reduced SFA. We found no effect on all-cause mortality, cardiovascular mortality, and other cardiovascular events. Conclusion: This umbrella review found the reduction in SAF intake probably reduces cardiovascular events and other health outcomes. However, it has little or no effect on cardiovascular mortality and mortality from other causes. More high-quality clinical trials with long-term follow-up are needed.Systematic review registration: CRD42022380859.

Pre-exercise meal on oxidation of energy substrates during maximal exercise test in non-trained individuals.

Objective: This study aimed to compare the influence of a high carbohydrate meal versus high-fat meal on the oxidation of substrates during an exercise incremental test. Materials and methods: Ten untrained male subjects underwent two days of the protocol. Randomly, they received a high carbohydrate meal or a high-fat meal, receiving the other one in the next protocol. On both days, they performed an incremental treadmill test, with heart rate and maximal oxygen consumption to estimate the oxidation of substrates. Results: The high-fat meal showed an increase in the absolute amount of oxidized fat along with the incremental test (P < 0.05; effect size = 0.9528), and a reduction in the respiratory exchange ratio at low intensities (P < 0.05; effect size = 0.7765). Conclusion: The meals presented no difference when compared to maximum oxidation point of substrates, the oxidation rate of substrates over time, and heart rate. A pre-test high-fat meal in untrained individuals was shown to be a modulating factor of total oxidized fats throughout the exercise, although it did not exert a significant effect on the rate of this oxidation over time.

Industrially produced trans fat and saturated fat content of food products in Jamaica.

Objective: To estimate industrially produced trans and saturated fatty acid levels in foods within the Jamaican food system. Methods: A total of 308 commonly consumed foods were selected for analysis based on their potential to contain trans fatty acids. Samples were collected from supermarkets, convenience stores, and fast-food restaurants. Official methods of gas chromatography for the analysis of fats were used. The results were expressed as grams of fatty acid per 100 g of food sample and percentage of total fatty acids. Results: Total fat was found to exceed United Kingdom National Health Service (NHS) limits in 27.3% (n = 84/308) of food samples. About one-third (33.8%; n = 104/308) of commonly consumed foods in Jamaica contained varying levels of industrially produced trans fatty acids, while 7.8% exceeded the Pan American Health Organization limit of 2% of total fat. Industrially produced trans fatty acids were found in food categories such as canned meats, baked goods, cooking oils, condiments, breakfast cereals, desserts, dairy, spreads, snacks, and confectionery. The subcategories coconut oils and burgers had the highest mean content. Canned food, infant food, and pasta categories had no trans fat present. Saturated fats were found in almost all foods. Importantly, 32.5% (n = 100/308) of the foods had saturated fat concentrations higher than the NHS limit of 5 g per 100 g of food. Most of the food items with high levels of industrially produced trans fatty acids also contained high levels of saturated fats. Conclusions: Food products in Jamaica contain varying levels of fats that exceeded recommendations which support healthy consumption. Further exploration and reformulation efforts are needed to ensure that nutritional qualities are improved.

Industrially produced trans fat and saturated fat content of food products in Jamaica / Contenido de ácidos grasos trans y grasas saturadas producidos industrialmente en productos alimenticios en Jamaica / Teor de ácidos graxos trans de produção industrial e ácidos graxos saturados em produtos alimentícios na Jamaica

ABSTRACT Objective. To estimate industrially produced trans and saturated fatty acid levels in foods within the Jamaican food system. Methods. A total of 308 commonly consumed foods were selected for analysis based on their potential to contain trans fatty acids. Samples were collected from supermarkets, convenience stores, and fast-food restaurants. Official methods of gas chromatography for the analysis of fats were used. The results were expressed as grams of fatty acid per 100 g of food sample and percentage of total fatty acids. Results. Total fat was found to exceed United Kingdom National Health Service (NHS) limits in 27.3% (n = 84/308) of food samples. About one-third (33.8%; n = 104/308) of commonly consumed foods in Jamaica contained varying levels of industrially produced trans fatty acids, while 7.8% exceeded the Pan American Health Organization limit of 2% of total fat. Industrially produced trans fatty acids were found in food categories such as canned meats, baked goods, cooking oils, condiments, breakfast cereals, desserts, dairy, spreads, snacks, and confectionery. The subcategories coconut oils and burgers had the highest mean content. Canned food, infant food, and pasta categories had no trans fat present. Saturated fats were found in almost all foods. Importantly, 32.5% (n = 100/308) of the foods had saturated fat concentrations higher than the NHS limit of 5 g per 100 g of food. Most of the food items with high levels of industrially produced trans fatty acids also contained high levels of saturated fats. Conclusions. Food products in Jamaica contain varying levels of fats that exceeded recommendations which support healthy consumption. Further exploration and reformulation efforts are needed to ensure that nutritional qualities are improved.

RESUMEN Objetivo. Calcular los niveles de ácidos grasos trans y grasas saturadas producidos industrialmente en alimentos del sistema alimentario de Jamaica. Métodos. Se seleccionó un total de 308 alimentos de consumo común para su análisis en función de la posibilidad de que contuvieran ácidos grasos trans. Se recolectaron muestras de supermercados, tiendas de víveres y restaurantes de comida rápida. Para el análisis de las grasas, se utilizaron métodos oficiales de cromatografía de gases. Se expresaron los resultados en gramos por muestra de alimento y grasa total. Resultados. Se concluyó que la grasa total excedía los límites del Servicio Nacional de Salud del Reino Unido (NHS, por su sigla en inglés) en el 27,3% (n = 84/308) de las muestras de alimentos. Alrededor de un tercio (33,8%; n = 104/308) de los alimentos de consumo común en Jamaica contenían niveles variables de grasas trans producidas industrialmente, mientras que el 7,8% excedía el límite de 2% de grasa total de la Organización Panamericana de la Salud. Se encontraron grasas trans producidas industrialmente en categorías de alimentos como carnes enlatadas, productos de repostería, aceites de cocina, condimentos, cereales para el desayuno, postres, lácteos, untables, bocadillos o snacks y dulces. Las subcategorías aceite de coco y hamburguesas mostraron el contenido medio más elevado. Las categorías alimentos enlatados, alimentos infantiles y pasta no presentaron grasas trans. Se encontraron grasas saturadas en casi todos los alimentos. Es importante destacar que el 32,5% (n = 100/308) de los alimentos mostraron concentraciones de grasas saturadas superiores al límite del NHS (5 g por cada 100 g de producto). La mayoría de los alimentos con niveles elevados de ácidos grasos trans producidos industrialmente también contenían altos niveles de grasas saturadas. Conclusiones. Los productos alimentarios en Jamaica contienen niveles variables de grasas que excedieron las recomendaciones relativas a un consumo saludable. Es necesario incrementar los esfuerzos de exploración y reformulación para garantizar una mejora de las cualidades nutricionales.

RESUMO Objetivo. Estimar o teor de ácidos graxos trans de produção industrial e ácidos graxos saturados em produtos alimentícios consumidos no sistema alimentar jamaicano. Métodos. Trezentos e oito gêneros alimentícios amplamente consumidos foram selecionados para análise, com base em seu potencial para conter ácidos graxos trans. As amostras foram coletadas em supermercados, lojas de conveniência e restaurantes de fast-food. Foram utilizados métodos oficiais para análise de ácidos graxos, à base de cromatografia gasosa. Os resultados foram expressos em gramas por gordura total e por amostra de alimento. Resultados. Verificou-se que o teor de gordura total excedeu os limites do Serviço Nacional de Saúde do Reino Unido (NHS) em 27,3% (n = 84/308) das amostras de alimentos. Cerca de um terço (33,8%; n = 104/308) dos alimentos comumente consumidos na Jamaica continham níveis variados de ácidos graxos trans de produção industrial, enquanto 7,8% excediam o limite de 2% de gordura total recomendado pela Organização Pan-Americana da Saúde. Ácidos graxos trans de produção industrial foram encontrados em diferentes categorias de alimentos, como carnes enlatadas, pães e doces, óleos de cozinha, condimentos, cereais matinais, sobremesas, laticínios, pastas, salgadinhos e confeitos. As subcategorias "óleos de coco" e "hambúrgueres" apresentaram o maior teor médio. As categorias "alimentos enlatados", "alimentos infantis" e "massas" não continham gordura trans. Ácidos graxos saturados foram encontrados em quase todos os alimentos. Cabe notar que 32,5% (n = 100/308) dos alimentos tinham teor de gordura saturada superior ao limite preconizado pelo NHS (5 g por 100 g de alimento). A maioria dos alimentos com alto teor de ácidos graxos trans de produção industrial também continha alto teor de gorduras saturadas. Conclusões. Os produtos alimentícios na Jamaica contêm níveis variados de gorduras, excedendo as recomendações que apoiam o consumo saudável. Mais esforços de exploração e reformulação são necessários para garantir que a qualidade nutricional dos alimentos seja melhorada.

Pre-exercise meal on oxidation of energy substrates during maximal exercise test in non-trained individuals

ABSTRACT Objective: This study aimed to compare the influence of a high carbohydrate meal versus high-fat meal on the oxidation of substrates during an exercise incremental test. Materials and methods: Ten untrained male subjects underwent two days of the protocol. Randomly, they received a high carbohydrate meal or a high-fat meal, receiving the other one in the next protocol. On both days, they performed an incremental treadmill test, with heart rate and maximal oxygen consumption to estimate the oxidation of substrates. Results: The high-fat meal showed an increase in the absolute amount of oxidized fat along with the incremental test (P < 0.05; effect size = 0.9528), and a reduction in the respiratory exchange ratio at low intensities (P < 0.05; effect size = 0.7765). Conclusions: The meals presented no difference when compared to maximum oxidation point of substrates, the oxidation rate of substrates over time, and heart rate. A pre-test high-fat meal in untrained individuals was shown to be a modulating factor of total oxidized fats throughout the exercise, although it did not exert a significant effect on the rate of this oxidation over time.

Ruminant and industrial trans-fatty acids consumption and cardiometabolic risk markers: A systematic review.

The development of cardiometabolic diseases is related to conditions such as obesity, abdominal fat, insulin resistance, diabetes mellitus, elevated blood pressure and changes in lipid profile. The whole of Trans Fatty Acid (TFA) intake is associated with the increase of cardiometabolic risk factors. There are two main sources of TFA, the ruminant TFA (rTFA) which are produced by biohydrogenation in animal's rumen, and the industrial TFA (iTFA), produced by hydrogenation of vegetable oils, the individual effect of each group is still controversial. The aim of this study was to analyze the effect of industrially and ruminants TFA intake on cardiometabolic risk in adults. It was carried out a systematic search of the literature in October 2019 and two independent authors selected and extracted data from articles. After the selection process, nine clinical trials were included, and summary tables were constructed to present data for all outcomes. The results showed that both sources of TFA can increase cardiometabolic risk parameters, especially lipid profile. At levels up to 1.5%-7% of energy, the effect of rTFA seems to be greater than iTFA and it seems to be greater in women. However, rTFA seems to be less harmful than iTFA for High Density Lipoprotein cholesterol, although for total cholesterol and Low density Lipoprotein cholesterol it may be worse. In summary, both sources of TFA can increase cardiometabolic risk parameters, especially lipid profile. However, the dose of TFA and the whole composition of the food must be considered.

Relationship between Dietary Fatty Acid Intake with Nonalcoholic Fatty Liver Disease and Liver Fibrosis in People with HIV.

We aimed to evaluate the relationship between food intake of lipids with nonalcoholic fatty liver disease (NAFLD) and/or liver fibrosis in people living with HIV/AIDS (PLWHA). In this cross-sectional study, transient elastography was used to detect the presence of NAFLD and/or liver fibrosis. The dietary intake of fats and fatty acids (FA) were assessed by two 24 h dietary recalls (24-HDR) (n = 451). Multivariate logistic regression models were performed. Participants with higher intake of total fat were associated with higher odds for NAFLD compared to those with lower consumption [adjusted odds ratio (aOR) = 1.91 (95% confidence interval (95% CI) 1.06-3.44)]. Furthermore, participants with intermediate intake of n6-PUFA (n6-poly-unsaturated FA) and lauric FA had lower odds for NAFLD, respectively aOR = 0.54 (95% CI 0.3-0.98) and aOR = 0.42 (95% CI 0.22-0.78). Additionally, a higher intake of myristoleic FA (fourth quartile) was a significant protective factor for NAFLD [aOR = 0.56 (95% CI 0.32-0.99)]. Participants with higher intake of lauric FA [0.38 (95% CI 0.18-0.80)], myristic FA [0.38 (0.17-0.89)], palmitoleic FA [0.40 (0.19-0.82)] and oleic FA [0.35 (0.16-0.79)] had positively less odds of having liver fibrosis. On the other hand, higher intake of n-6 PUFA was significantly associated with fibrosis [aOR = 2.45 (95% CI 1.12-5.32)]. Dietary assessment of total fat and FA should be incorporated into HIV care as a tool for preventing NAFLD and fibrosis in PLWHA.

A better quality of maternal dietary fat reduces the chance of large-for-gestational-age infants: A prospective cohort study.

OBJECTIVES: We sought to investigate the relationship between the usual intake of fatty acids and indices of dietary fat quality in pregnant women and the birth-weight categories of their newborns. METHODS: This prospective cohort study was conducted with 734 mother-infant pairs in Brazil. Dietary intake was estimated through 24-h dietary recalls. Secondary data on birth weight, sex of the newborn, and pregnancy duration were obtained. The relationship of fatty acids and indices with birth-weight categories were investigated using logistic regression models adjusted for confounding factors. We considered P values < 0.05 significant. RESULTS: The median (interquartile range) maternal age was 27 (23-31) y; 46.2% of the pregnant women had pregestational body mass index ≥ 25 kg/m2, 18.1% had gestational diabetes mellitus, and 11.2% had hypertension. Regarding the newborns, 68 (9.3%) were classified as small for gestational age, 545 (74.2%) as appropriate size for gestational age, and 121 (16.5%) as large for gestational age. In adjusted logistic regression models, a lower chance of being large for gestational age was observed among the children of women classified in the third tertile (versus the first tertile) for intake of polyunsaturated fatty acids (odds ratio [OR], 0.52; 95% confidence interval [CI], 0.31-0.89; P = 0.02), ω-3 fatty acids (OR, 0.48; 95% CI, 0.28-0.80; P = 0.005), and ω-6 fatty acids (OR, 0.56; 95% CI, 0.33-0.96; P = 0.04) and for ratios of polyunsaturated to saturated fatty acids (OR, 0.54; 95% CI, 0.32-0.92; P = 0.03) and hypocholesterolemic to hypercholesterolemic fatty acids (OR, 0.51; 95% CI, 0.30-0.87; P = 0.01). CONCLUSIONS: The data suggest that better-quality fat in the maternal diet can reduce the chance of a large-for-gestational-age newborn.

Análisis del perfil de ácidos grasos y propiedades fisicoquímicas del aceite de palma de mil pesos (Oenocarpus Bataua) / Analysis of the Fatty Acid Profile and Physicochemical Properties of Oil from the Thousand Peso Palm (Oenocarpus Bataua)

Resumen Antecedentes: la palma de mil pesos (Oenocarpus bataua) es una especie promisoria, tanto por sus frutos ricos en aceite de excelente condición como por su especial adaptación a suelos pobres. Objetivo: analizar el perfil de ácidos grasos y propiedades fisicoquímicas del aceite de palma de mil pesos. Materiales y métodos: se analizaron las propiedades fisicoquímicas, el porcentaje de saturación con técnicas del AOAC y el perfil de ácidos grasos mediante cromatografía líquida de gases con detector de ionización de llama (CG-FID). Resultados: el aceite analizado tiene un perfil de ácidos grasos parecido al del aceite de oliva, con la siguiente distribución porcentual de ácidos grasos: palmítico (11,9±1,1), oleico (76,1±1), linoleico (3±0,4), α-linolénico (1,9±0,3), con predominio de grasas monoinsaturadas (77,0±1,0 %), moderado aporte de saturadas (18,1±1,2 %) y bajo de poliinsaturadas (4,9±0,6 %), esto último sería la única limitante para utilizarlo como única fuente de grasa para la preparación de alimentos, por lo demás cumple con la norma colombiana para el aceite de palma alto oleico en cuanto al perfil de ácidos grasos y sus características físicoquímicas. Conclusiones: el aceite estudiado es potencialmente comercializable para el consumo humano y tiene beneficios para la salud cardiovascular de los consumidores.

Abstract Background: The thousand peso palm tree (Oenocarpus bataua) is a promising species, both for its oil-rich fruits of excellent properties and for its unique adaptation to poor soils. Objective: Analyze the fatty acid profile and physicochemical properties of oil from the thousand peso palm tree. Materials and Methods: The physicochemical properties and the percentage of saturation ere found using AOAC techniques, and the fatty acid profile was analyzed by liquid gas chromatography with flame ionization detector (GC-FID). Results: The oil analyzed had a fatty acid profile similar to olive oil, with the following percentage distribution of fatty acids: palmitic (11.9±1.1), oleic (76.1±1), linoleic (3±0.4), α-linolenic (1.9±0.3), with a predominance of monounsaturated fats (77.0±1.0%), moderate contribution of saturated (18.1±1.2%) and low polyunsaturated (4.9±0.6%). Only the polyunsaturated profile would constitute a limitation for use as a sole source of fat for food preparation, otherwise thousand peso palm oil complies with the Colombian standard for high oleic palm oil in terms of the fatty acid profile and its physicochemical characteristics. Conclusions: The oil studied is potentially marketable for human consumption and has cardiovascular health benefits for consumers.

Is there any association between overweight, physical activity, fat and fiber intake with functional constipation in adolescents?

Objectives: To assess the prevalence of functional constipation and its association with overweight, physical activity and the estimation of fat and fiber intake in adolescents.Methods: In all, 386 adolescents aged 14-19 years from the city of Maceió (Alagoas, Northeast Brazil) were included in this study. Participants responded to standardized questionnaires that assessed bowel habits, physical activity and the estimation of fat and dietary fiber intake. Functional constipation was defined according to the Rome criteria. Weight and height were measured using standard methods. Body mass index (BMI) was used to evaluate whether a participant was overweight.Results: The prevalence of constipation was 24.9%. The median BMI was higher in female adolescents with constipation (22.6) compared with female adolescents without constipation (20.0; p = .001). Physical inactivity (fewer than 300 min of physical activity per week) was more frequent in females (62.7%; 126/201) than in males (42.2%; 78/185; p = .000). No association was observed between physical inactivity and functional constipation. Excessive intake of fat in the diet was found in 45.3% (175/386) of participants, while poor dietary fiber intake was found in 84.2% (325/386) of participants. No association was found between a fat-rich diet and constipation. Low dietary fiber intake was associated with constipation in female adolescents (odds ratio = 3.42, 95% confidence interval: 1.08 and 12.06).Conclusions: The prevalence of constipation was high among this group of adolescents. Constipation was not associated with physical inactivity but was associated with a low dietary fiber intake and higher BMI values in female adolescents.

High-Lard and High-Cholesterol Diet, but not High-Lard Diet, Leads to Metabolic Disorders in a Modified Dyslipidemia Model / Dieta Rica em Banha e Colesterol, mas não Dieta Rica em Banha, Leva a Distúrbios Metabólicos em um Modelo Modificado de Dislipidemia

Abstract Background: In view of the increased global prevalence of cardiovascular and hepatic diseases, the diet lipid content and its relationship with the accumulation of fat in hepatocytes have been investigated as key factors in preventing these diseases. Objective: To evaluate the metabolic effects of a high-lard diet supplemented or not with cholesterol on a modified dyslipidemia model. Methods: We divided 24 adult male Wistar rats into three groups: standard diet (STD - 4% lipids), high-lard diet (HLD - 21% lard), and high-lard and high-cholesterol diet (HL/HCD - 20% lard, 1% cholesterol, 0.1% cholic acid). After six weeks of treatment, blood and liver were collected for biochemical (serum lipid profile and liver enzymes) and morphological analyses. Statistical analysis included one-way analysis of variance (ANOVA), followed by Tukey test for mean comparisons, and a 5% probability was considered statistically significant. Results: Animals fed HL/HCD showed increased total cholesterol, triacylglycerol, LDL-c, non-HDL-c, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) serum levels compared to those fed STD. In addition, the HL/HCD animals presented higher relative liver weight, with moderate macrovesicular hepatic steatosis and inflammatory infiltrate. Conclusion: A high-fat diet with lard (20%) and cholesterol (1%) triggered dyslipidemia with severe liver damage in rats in a shorter experimental time than the previously reported models. The high-lard diet without supplementation of cholesterol led to body weight gain, but not to dyslipidemia.

Resumo Fundamento: Tendo em vista o aumento da prevalência global de doenças cardiovasculares e hepáticas, o conteúdo lipídico da dieta e sua relação com o acúmulo de gordura nos hepatócitos têm sido investigados como fatores-chave na prevenção dessas doenças. Objetivo: Avaliar os efeitos metabólicos de uma dieta rica em banha suplementada com colesterol ou não, em um modelo modificado de dislipidemia. Métodos: Foram divididos 24 ratos Wistar machos adultos em três grupos: dieta padrão (DP - 4% de lipídios), dieta rica em banha (DRB - 21% de banha) e dieta rica em banha e colesterol (DRB/RC - 20% de banha, 1% de colesterol e 0,1% de ácido cólico). Após seis semanas de tratamento, o sangue e o fígado foram coletados para análises bioquímicas (perfil lipídico sérico e enzimas hepáticas) e morfológicas. A análise estatística incluiu análise de variância unidirecional (ANOVA), seguida do teste de Tukey para comparações de médias. Uma probabilidade de 5% foi considerada estatisticamente significativa. Resultados: Animais alimentados com DRB/RC apresentaram um aumento nos níveis séricos de colesterol total, triacilglicerol, LDL-c, não-HDL-c, alanina aminotransferase (ALT) e aspartato aminotransferase (AST) em comparação com aqueles alimentados com DP. Além disso, os animais tratados com DRB/RC apresentaram um peso relativo do fígado maior, com esteatose hepática macrovesicular moderada e infiltrado inflamatório. Conclusão: Uma dieta rica em gordura com banha (20%) e colesterol (1%) desencadeou dislipidemia com danos graves ao fígado em ratos em um tempo experimental menor do que os modelos previamente relatados. A dieta rica em banha sem suplementação de colesterol levou ao ganho de peso corporal, mas não à dislipidemia.

Impacto da dieta usual no risco de doença hepática gordurosa não alcoólica (DHGNA) / Impact of current diet at the risk of non-alcoholic fatty liver disease (nafld)

ABSTRACT The nonalcoholic fatty liver disease (NAFLD) affects approximately 20%-30% of general population and is even more prevalent among obese individuals. The risk factors mainly associated with NAFLD are diseases related to the metabolic syndrome, genetics and environment. In this review, we provide a literature compilation evaluating the evidence behind dietary components, including calories intake, fat, protein, fibers and carbohydrate, especially fructose which could be a trigger to development and progression of the NAFLD. In fact, it has been demonstrated that diet is an important factor for the development of NAFLD and its association is complex and extends beyond total energy intake.

RESUMO A doença hepática gordurosa não alcoólica (DHGNA) afeta aproximadamente de 20% a 30% da população geral sendo prevalente entre os indivíduos obesos. Os fatores de risco associados à DHGNA são: doenças relacionadas à síndrome metabólica, fatores genéticos e meio ambiente. Nesta revisão, fornecemos uma compilação bibliográfica avaliando como as evidências relacionadas aos componentes da dieta, incluindo ingestão calórica, de gorduras, de proteínas, de fibras e de carboidratos, especialmente a frutose, poderiam ser um estímulo para o desenvolvimento e progressão da DHGNA. Foi demonstrado que a dieta é um fator importante para o desenvolvimento da DHGNA e sua associação se estende além do consumo total de calorias.

Stress and Food Consumption Relationship in Hypertensive Patients / Estresse e Consumo Alimentar em Pacientes Hipertensos

Abstract Background: Stress is a state of threat to the balance of the organism, which can cause biological and psychological changes. In hypertensive patients, stress can interfere with blood pressure levels, influence on food choices and neglect of the diet. Objective: This study aims to describe the relationship between stress and dietary intake of hypertensive patients. Methods: A transversal study was carried out at the Arterial Hypertension Clinic of the Cardiology Institute of Rio Grande do Sul, Brazil. The participants were aged ≥ 18 years and hypertensive. Blood pressure, food consumption and anthropometric measurements were collected. The variables related to stress were evaluated by the Lipp's Stress Symptoms Inventory (LSSI) for adults. Significance level of 5% has been considered for all analyzed data. Results: The number of participants was 100. There was a higher prevalence of the female sex (67%), the mean age of the study population was 55.87 ± 12.55 years. Among the participants, 86% were classified in some of the stress phases, on which 57% were in the resistance phase. It was observed that there was no correlation between the presence of stress (as well as their actions), pressure levels and food consumption. The consumption of foods rich in lipids and individuals with a prevalence of psychological symptoms of stress displayed a significant association. Conclusions: Rich in fat dietary has been the first choice in patients with psychological symptoms of stress. Further studies regarding remodeled dietary intake and blood pressure levels in relation to the stress phases are suggested. These findings are important to contribute to the development of prevention and treatment strategies for cardiovascular diseases.

Resumo Fundamento: O estresse é um estado de ameaça ao equilíbrio do organismo, podendo causar alterações biológicas e psicológicas. No paciente hipertenso o estresse pode interferir nos níveis pressóricos e gerar influência nas escolhas alimentares e negligência da dieta. Objetivo: Este estudo tem como objetivo descrever a relação entre o estresse e consumo alimentar de pacientes hipertensos. Métodos: Estudo transversal, desenvolvido no Ambulatório de Hipertensão Arterial do Instituto de Cardiologia do Rio Grande do Sul. Participaram da pesquisa indivíduos hipertensos com idade > 18 anos. Foram coletados dados de pressão arterial, consumo alimentar e medidas antropométricas. As variáveis relacionadas ao estresse foram avaliadas pelo inventário de sintomas de stress para adultos de Lipp (ISSL). Em todas as análises foi considerando um nível de significância 5% (p < 0,05). Resultados: O número de participantes foi de 100. Houve maior prevalência no sexo feminino (67%), a idade média da população estudada foi 55,87 ± 12,55 anos. Dos participantes, 86% se classificaram em alguma das fases do estresse, sendo que destes, 57% estavam na fase de resistência. Observou-se que não houve correlação entre a presença de estresse (bem como suas fases), níveis pressóricos e consumo alimentar. O consumo de alimentos ricos em lipídios em hipertensos com sintomas de estresse apresentou significância estatística. Conclusão: Os alimentos ricos em gordura prevaleceram entre as escolhas alimentares nos pacientes com sintomas psicológicos de estresse. Sugere-se mais estudos em relação a alteração do consumo alimentar e níveis pressóricos em relação às fases do estresse.

Contenido de ácidos grasos saturados y trans en materias primas grasas empleadas en algunas panaderías de Medellín / Content of Saturated and Trans Fatty Acids in Margarines Used in Some Bakeries in Medellín

Resumen Antecedentes: estudios previos reportan la presencia de grasas saturadas y grasas trans en productos de panadería, relacionadas con enfermedades crónicas no transmisibles. Sin embargo, se desconoce la procedencia y calidad de las materias primas grasas utilizadas por los panaderos en Medellín. Objetivo: caracterizar las materias primas grasas utilizadas para la preparación de productos de panadería. Materiales y métodos: estudio descriptivo transversal, de tipo exploratorio, con 24 muestras. Por cada muestra se realizó una encuesta a los panaderos para evaluar la calidad de las grasas y un análisis por cromatografía de gases para cuantificar 17 grasas saturadas y grasas trans. Resultados: el promedio de grasas trans en las materias primas grasas fue de 0,46 g en 100 g, mientras la normatividad permite 5 g en 100 g (Resolución 2508 de 2012, del Ministerio de Salud y Protección Social); el 42,1 % del contenido graso proviene de grasas saturadas; y algunas materias primas grasas no cumplen con la normatividad vigente para el etiquetado de alimentos envasados, pues no tienen rotulado nutricional. Conclusiones: en ninguna de las 24 materias primas grasas evaluadas cromatográficamente se cuantificó un contenido de grasas trans superior a lo permitido por la Resolución 2508, lo cual evidencia el esfuerzo de la industria de alimentos. Es necesario mantener la vigilancia del etiquetado para asegurar su cumplimiento.

Abstract Background: Previous studies have reported the presence of saturated and trans fatty acids in bakery products, which are related with chronic non-communicable diseases. Currently, the origin and quality of the primary fat ingredients and products used by bakers in the city of Medellin is currently unknown. Objective: The aim of this paper is to characterize the primary fat ingredients used for the preparation of bakery products. Materials and Methods: An exploratory transversal descriptive study, with 24 bakery samples belonging to three groups according to socioeconomic level. For each sample, a survey was conducted to evaluate the quality of fat and an analysis by gas chromatography was done to quantify 17 saturated and trans fatty acids was. Results: The average trans fatty acid content in the margarines is 0.46 g per 100 g, however regulatory entities allow 5 g per 100 g (Resolución 2508 de 2012, del Ministerio de Salud y Protección Social); 42.1% of fat content comes from saturated fatty acids and some primary fat ingredients do not comply with current regulations for packaged foods. Conclusions: None of the 24 fat ingredient chromatographic evaluations was quantified with trans fatty acids content higher than that allowed by Resolution 2508. This proves the effort of the food industry, however it is necessary to maintain the surveillance of the labeling to ensure compliance.

n-3 Ingestion may modulate the severity of periodontal disease? Systematic review.

The aim of this study was to determine the effects of n-3 ingestion on periodontal disease. Besides, we also investigated the relationship between plasma concentrations of eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and/or aracdonic acid (AA), and periodontal disease. An electronic search was performed in several databases with the following keywords: "n-3," DHA, EPA and polynsaturated fatty acids (PUFA) in combination with the term "periodontal disease" (PD). Only studies conducted with humans, involving clinical parameters of PD assessment and use of n-3 were selected, without restriction to the date of publication. The search has returned 1368 articles, 11 of which were selected. The results were separated according to the type of n-3 ingestion: supplementation or n-3 content in normal diet. In the studies where n-3 has been supplemented, there was no significant difference in the clinical severity of PD compared to the control subjects. However, in patients where levels of n-3 were evaluated in a usual diet, a lower disease severity was reported. We have detected a preventive effect related to plasma levels of EPA and DHA against PD progression. Thus, n-3 ingestion may beneficially interfere in PD progression, depending on the duration and dosage of consumption.

Efecto de una dieta alta en grasas en el proceso de formación de cálculos biliares de colesterol / Effect of a high-fat diet on cholesterol gallstone formation

Background: It is known that some nutrients play an important role in the development of cholelithiasis. Cholesterol is carried by micelles and vesicles in the bile. During the first stage of gallstone formation, cholesterol crystals derive from thermodynamically unstable vesicles. Aim: To determine the effect of a high fat diet on blood lipids and bile composition, and its implication in the formation of gallstones. Material and Methods: Two groups of 15 BALB/c mice each, coming from the same litter, were treated with a control or with a high-fat diet (64% fat and 0.14% cholesterol). After two months, the animals were sacrificed, blood and bile samples were obtained. Serum glucose and the corresponding lipid profiles were measured. In bile samples, cholesterol and phospholipid levels were analyzed, and cholesterol transporters (vesicles and micelles) were separated by gel filtration chromatography. Results: Treated animals showed an 87% increase in serum total cholesterol (p < 0.01), a 97% increase in HDL-cholesterol (p < 0.05) and a 140% increase in LDL-cholesterol (p < 0.05). No changes in serum triglycerides or glucose were observed. In bile, a 13% increase in biliary cholesterol (p < 0.05) was observed but no change in biliary phospholipids. Also, an increase in biliary vesicular transporters and an increase of cholesterol/phospholipid ratio in vesicular transporters were observed. Conclusions: A high fat diet may contribute to the formation of gallstones in our experimental model.

Fenótipo da cintura hipertrigliceridêmica e fatores nutricionais: um estudo com participantes do ELSA-Brasil / Hypertriglyceridemic waist phenotype and nutritional factors: a study with participants of ELSA-Brasil

RESUMO: Objetivo: Investigar a associação entre consumo de gorduras e fibras e o fenótipo da cintura hipertrigliceridêmica (FCH). Métodos: Pesquisa de corte transversal conduzida a partir da linha de base do Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). Foi realizada avaliação antropométrica e calculado o Índice de Massa Corporal (IMC). Os participantes foram classificados segundo presença do FCH quando circunferência da cintura ≥ 102 e ≥ 88 cm, respectivamente, em homens e mulheres, e triglicerídeos ≥ 150 mg/dL. O consumo de gorduras e fibras foi avaliado a partir de um Questionário de Frequência Alimentar validado e as variáveis socioeconômicas, demográficas e características comportamentais foram coletadas por meio de questionário. Foram realizados testes do χ2, Mann-Whitney e regressão de Poisson com significância de 5%. Resultados: Homens apresentaram menor prevalência do FCH (RP = 0,959; IC95% 0,948 - 0,969). Maiores prevalências de FCH foram observadas em indivíduos com atividade física fraca (RP = 1,039; IC95% 1,021-1,057), histórico de tabagismo (RP = 1,044; IC95% 1,031-1,057), menor renda per capita (IRR = 1,035; IC95% 1,022-1,049) e obesidade (RP = 1,32; IC95% 1,305-1,341). Consumo de gorduras e fibras não foi associado ao FCH. Conclusão: Maior prevalência do FCH foi encontrada em obesos, porém não foi observada associação entre o consumo de gorduras e fibras e o fenótipo.

ABSTRACT: Objective: To investigate the association between fat and fiber intakes and the hypertriglyceridemic waist phenotype (HWP). Methods: Cross-sectional survey conducted from the baseline of Brazilian Longitudinal Study of Health Adult (ELSA-Brasil). Anthropometric measurements were conducted and the body mass index was calculated (BMI). Participants were classified according to the presence of HWP when waist circumference ≥ 102 and ≥ 88 cm, respectively, in men and women, and triglycerides ≥ 150 mg/dL. Fat and fiber intakes were assessed using a validated food frequency questionnaire, and socioeconomic, demographic and behavioral variables were collected through a questionnaire. The χ² test, Mann-Whitney and Poisson regression were performed with significance level of 5%. Results: There was no association between fiber and fat intakes with HWP. A lower prevalence of HWP among men was observed (IRR = 0.959; 95%CI 0.948 - 0.969). A higher prevalence of HWP was observed in participants with low physical activity (OR = 1.039, 95%CI 1.021 - 1.057), smoking history (OR = 1.044, 95%CI 1.031 - 1.057), lower per capita income (IRR = 1.035; 95%CI 1.022 - 1.049) and obesity (OR = 1.32, 95%CI 1.305 - 1.341). Fat and fiber intakes were not associated with HWP. Conclusion: A higher prevalence of HWP was found in obese, but no association was found between intake of fat and fiber and phenotype.

The role of dietary fatty acid intake in inflammatory gene expression: a critical review / O papel da ingestão dos ácidos graxos da dieta na expressão de genes inflamatórios: uma revisão crítica

ABSTRACT CONTEXT AND OBJECTIVE: Diet is an important modifiable factor involved in obesity-induced inflammation. We reviewed clinical trials that assessed the effect of consumption of different fatty acids on the expression of inflammation-related genes, such as cytokines, adipokines, chemokines and transcription factors. DESIGN AND SETTING: Narrative review study conducted at a research center. METHODS: This was a review on the effect of fat intake on inflammatory gene expression in humans. RESULTS: Consumption of saturated fatty acids (SFAs) was related to postprandial upregulation of genes associated with pro-inflammatory pathways in peripheral blood mononuclear cells (PBMCs), in comparison with monounsaturated fatty acid (MUFA) or polyunsaturated fatty acid (PUFA) intake. In addition, acute intake of a high-SFA meal also induced a postprandial pro-inflammatory response for several inflammatory genes in subcutaneous adipose tissue. Both high-MUFA and high-PUFA diets showed anti-inflammatory profiles, or at least a less pronounced pro-inflammatory response than did SFA consumption. However, the results concerning the best substitute for SFAs were divergent because of the large variability in doses of MUFA (20% to 72% of energy intake) and n3 PUFA (0.4 g to 23.7% of energy intake) used in interventions. CONCLUSIONS: The lipid profile of the diet can modulate the genes relating to postprandial and long-term inflammation in PBMCs and adipose tissue. Identifying the optimal fat profile for inflammatory control may be a promising approach for treating chronic diseases such as obesity.

RESUMO CONTEXTO E OBJETIVO: A dieta é um importante fator modificável envolvido na inflamação induzida pela obesidade. Nós revisamos ensaios clínicos que avaliaram o efeito do consumo de diferentes ácidos graxos sobre a expressão de genes relacionados com a inflamação, tais como citocinas, adipocitocinas, quimiocinas e fatores de transcrição. TIPO DE ESTUDO E LOCAL: Estudo de revisão narrativa realizado em um centro de pesquisa. MÉTODOS: Revisão do efeito da ingestão de gordura sobre a expressão de genes envolvidos com inflamação em seres humanos. RESULTADOS: O consumo do ácido graxo saturado (AGS) foi relacionado com a regulação favorável pós-prandial de genes associados com vias pró-inflamatórias nas células mononucleares de sangue periférico (CMSP), em comparação com a ingestão do ácido graxo monoinsaturado (AGMI) ou do ácido graxo poli-insaturado (AGPI). Além disso, o consumo agudo de uma dieta com alto conteúdo de AGS também induziu uma resposta pró-inflamatória pós-prandial para vários genes da inflamação no tecido adiposo subcutâneo. Ambas as dietas com alto conteúdo de AGMI e AGPI apresentaram perfil anti-inflamatório ou, pelo menos, menor resposta pró-inflamatória em relação ao consumo de AGS. Contudo, os resultados são controversos acerca do melhor substituto para o AGS, devido à grande variabilidade na dose de AGMI (20% a 72% da ingestão energética) e AGPI n3 (0,4 g para 23,7% da ingestão energética) utilizados nos estudos de intervenção. CONCLUSÕES: O perfil lipídico da dieta pode modular os genes relacionados com inflamação pós-prandial e a longo prazo em CMSP e no tecido adiposo. Identificar o perfil lipídico ideal no controle inflamatório pode ser uma abordagem promissora para o tratamento de doenças crônicas como a obesidade.