Increased low-density lipoprotein cholesterol on a low-carbohydrate diet in adults with normal but not high body weight: A meta-analysis.

BACKGROUND: Low-density lipoprotein (LDL) cholesterol change with consumption of a low-carbohydrate diet (LCD) is highly variable. Identifying the source of this heterogeneity could guide clinical decision-making. OBJECTIVES: To evaluate LDL cholesterol change in randomized controlled trials involving LCDs, with a focus on body mass index (BMI) in kg/m2. METHODS: Three electronic indexes (Pubmed, EBSCO, and Scielo) were searched for studies between 1 January, 2003 and 20 December, 2022. Two independent reviewers identified randomized controlled trials involving adults consuming <130 g/d carbohydrate and reporting BMI and LDL cholesterol change or equivalent data. Two investigators extracted relevant data, which were validated by other investigators. Data were analyzed using a random-effects model and contrasted with results of pooled individual participant data. RESULTS: Forty-one trials with 1379 participants and a mean intervention duration of 19.4 wk were included. In a meta-regression accounting for 51.4% of the observed variability on LCDs, mean baseline BMI had a strong inverse association with LDL cholesterol change [ß = -2.5 mg/dL/BMI unit, 95% confidence interval (CI): -3.7, -1.4], whereas saturated fat amount was not significantly associated with LDL cholesterol change. For trials with mean baseline BMI <25, LDL cholesterol increased by 41 mg/dL (95% CI: 19.6, 63.3) on the LCD. By contrast, for trials with a mean of BMI 25-<35, LDL cholesterol did not change, and for trials with a mean BMI ≥35, LDL cholesterol decreased by 7 mg/dL (95% CI: -12.1, -1.3). Using individual participant data, the relationship between BMI and LDL cholesterol change was not observed on higher-carbohydrate diets. CONCLUSIONS: A substantial increase in LDL cholesterol is likely for individuals with low but not high BMI with consumption of an LCD, findings that may help guide individualized nutritional management of cardiovascular disease risk. As carbohydrate restriction tends to improve other lipid and nonlipid risk factors, the clinical significance of isolated LDL cholesterol elevation in this context warrants investigation. This trial was registered at PROSPERO as CRD42022299278.

Metabolic effects of milk fatty acids: A literature review.

Milk and dairy products are known to have a significant role in human development and tissue maintenance due to their high nutritional value. With the higher incidence of obesity and metabolic diseases, nutrition and public health authorities have recommended the intake of fat-free or low-fat dairy due to the saturated fatty acid content of whole-fat products and their effect on serum cholesterol levels. However, recent studies have questioned the association between milk fat consumption and cardiometabolic risk. This literature review aims to compile the scientific evidence of the metabolic effects of milk fatty acids in clinical and basic research studies, as well as their relationship with metabolic disorders and gut microbiota composition. Research shows that various milk fatty acids exert effects on metabolic alterations (obesity, type 2 diabetes and cardiovascular diseases) by modifying glucose homeostasis, inflammation and lipid profile-related factors. Additionally, recent studies have associated the consumption of milk fatty acids with the production of metabolites and the promotion of healthy gut microbiota. From mainly observational studies, evidence suggests that milk and dairy fatty acids are not directly linked to cardiometabolic risk, but further controlled research is necessary to clarify such findings and to assess whether dietary recommendations to choose low-fat dairy foods are necessary for the population for the prevention of obesity and cardiometabolic disease.

Physiologic Adaptation to Macronutrient Change Distorts Findings from Short Dietary Trials: Reanalysis of a Metabolic Ward Study.

An influential 2-wk cross-over feeding trial without a washout period purported to show advantages of a low-fat diet (LFD) compared with a low-carbohydrate diet (LCD) for weight control. In contrast to several other macronutrient trials, the diet order effect was originally reported as not significant. In light of a new analysis by the original investigative group identifying an order effect, we aimed to examine, in a reanalysis of publicly available data (16 of 20 original participants; 7 female; mean BMI, 27.8 kg/m2), the validity of the original results and the claims that trial data oppose the carbohydrate-insulin model of obesity (CIM). We found that energy intake on the LCD was much lower when this diet was consumed first compared with second (a difference of -1164 kcal/d, P = 3.6 × 10-13); the opposite pattern was observed for the LFD (924 kcal/d, P = 2.0 × 10-16). This carry-over effect was significant (P interaction = 0.0004) whereas the net dietary effect was not (P = 0.4). Likewise, the between-arm difference (LCD - LFD) was -320 kcal/d in the first period and +1771 kcal/d in the second. Body fat decreased with consumption of the LCD first and increased with consumption of this diet second (-0.69 ± 0.33 compared with 0.57 ± 0.32 kg, P = 0.007). LCD-first participants had higher ß-hydroxybutyrate levels while consuming the LCD and lower respiratory quotients while consuming LFD when compared with LFD-first participants on their respective diets. Change in insulin secretion as assessed by C-peptide in the first diet period predicted higher energy intake and less fat loss in the second period. These findings, which tend to support rather than oppose the CIM, suggest that differential (unequal) carry-over effects and short duration, with no washout period, preclude causal inferences regarding chronic macronutrient effects from this trial.

Randomization to a Provided Higher-Complex-Carbohydrate Versus Conventional Diet in Gestational Diabetes Mellitus Results in Similar Newborn Adiposity.

OBJECTIVE: Nutrition therapy for gestational diabetes mellitus (GDM) has conventionally focused on carbohydrate restriction. In a randomized controlled trial (RCT), we tested the hypothesis that a diet (all meals provided) with liberalized complex carbohydrate (60%) and lower fat (25%) (CHOICE diet) could improve maternal insulin resistance and 24-h glycemia, resulting in reduced newborn adiposity (NB%fat; powered outcome) versus a conventional lower-carbohydrate (40%) and higher-fat (45%) (LC/CONV) diet. RESEARCH DESIGN AND METHODS: After diagnosis (at ∼28-30 weeks' gestation), 59 women with diet-controlled GDM (mean ± SEM; BMI 32 ± 1 kg/m2) were randomized to a provided LC/CONV or CHOICE diet (BMI-matched calories) through delivery. At 30-31 and 36-37 weeks of gestation, a 2-h, 75-g oral glucose tolerance test (OGTT) was performed and a continuous glucose monitor (CGM) was worn for 72 h. Cord blood samples were collected at delivery. NB%fat was measured by air displacement plethysmography (13.4 ± 0.4 days). RESULTS: There were 23 women per group (LC/CONV [214 g/day carbohydrate] and CHOICE [316 g/day carbohydrate]). For LC/CONV and CHOICE, respectively (mean ± SEM), NB%fat (10.1 ± 1 vs. 10.5 ± 1), birth weight (3,303 ± 98 vs. 3,293 ± 81 g), and cord C-peptide levels were not different. Weight gain, physical activity, and gestational age at delivery were similar. At 36-37 weeks of gestation, CGM fasting (86 ± 3 vs. 90 ± 3 mg/dL), 1-h postprandial (119 ± 3 vs. 117 ± 3 mg/dL), 2-h postprandial (106 ± 3 vs. 108 ± 3 mg/dL), percent time in range (%TIR; 92 ± 1 vs. 91 ± 1), and 24-h glucose area under the curve values were similar between diets. The %time >120 mg/dL was statistically higher (8%) in CHOICE, as was the nocturnal glucose AUC; however, nocturnal %TIR (63-100 mg/dL) was not different. There were no between-group differences in OGTT glucose and insulin levels at 36-37 weeks of gestation. CONCLUSIONS: A ∼100 g/day difference in carbohydrate intake did not result in between-group differences in NB%fat, cord C-peptide level, maternal 24-h glycemia, %TIR, or insulin resistance indices in diet-controlled GDM.

Evidence for the carbohydrate-insulin model in a reanalysis of the Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial.

BACKGROUND: The Diet Intervention Examining The Factors Interacting with Treatment Success (DIETFITS) trial demonstrated that meaningful weight loss can be achieved with either a "healthy low-carbohydrate diet" (LCD) or "healthy low-fat diet" (LFD). However, because both diets substantially decreased glycemic load (GL), the dietary factors mediating weight loss remain unclear. OBJECTIVES: We aimed to explore the contribution of macronutrients and GL to weight loss in DIETFITS and examine a hypothesized relationship between GL and insulin secretion. DESIGN: This study is a secondary data analysis of the DIETFITS trial, in which participants with overweight or obesity (aged 18-50 y) were randomized to a 12-mo LCD (N = 304) or LFD (N = 305). RESULTS: Measures related to carbohydrate intake (total amount, glycemic index, added sugar, and fiber) showed strong associations with weight loss at 3-, 6-, and 12-mo time points in the full cohort, whereas those related to total fat intake showed weak to no associations. A biomarker of carbohydrate (triglyceride/HDL cholesterol ratio) predicted weight loss at all time points (3-mo: ß [kg/biomarker z-score change] = 1.1, P = 3.5 × 10-9; 6-mo: ß = 1.7, P = 1.1 × 10-9; and 12-mo: ß = 2.6, P = 1.5 × 10-15), whereas that of fat (low-density lipoprotein cholesterol + HDL cholesterol) did not (all time points: P = NS). In a mediation model, GL explained most of the observed effect of total calorie intake on weight change. Dividing the cohort into quintiles of baseline insulin secretion and GL reduction revealed evidence of effect modification for weight loss, with P = 0.0009 at 3 mo, P = 0.01 at 6 mo, and P = 0.07 at 12 mo. CONCLUSIONS: As predicted by the carbohydrate-insulin model of obesity, weight loss in both diet groups of DIETFITS seems to have been driven by the reduction of GL more so than dietary fat or calories, an effect that may be most pronounced among those with high insulin secretion. These findings should be interpreted cautiously in view of the exploratory nature of this study. TRIAL REGISTRATION: ClinicalTrials.gov (NCT01826591).

Plan de alimentación para hipertensos / Eating plan for hypertensives

La presente publicación describe un enfoque dietético para mantener la presión arterial normal, realizado por el profesional nutricionista basado en el aumento de frutas, verduras y lácteos bajos en grasa e incluye cereales integrales,pescado, aves. menestras y frutas secas. El material ayuda al profesional nutricionista a desarrollar actividades educativas para enseñar al paciente con hipertensión arterial o a personas diagnosticadas con hipertensión arterial a comer más sano, lo que permitirá que disminuya la presión y el colesterol malo elevado, por tratarse de una dieta baja en grasas saturadas, total, colesterol y sodio a la misma vez que es alta en minerales como potasio, magnesio y calcio

Effect of inclusion levels of low-fat dried distillers grains in finishing diets on protein and energy intake and retention and estimation of protein and energy requirements of young Nellore bulls fed with high concentrate diets.

The objective was to evaluate the effect of including low-fat dried distillers grains (DDG) in finishing diets on protein and energy intake and retention and to estimate the protein and energy requirement of young Nellore bulls. Thirty-five animals were used: baseline (n = 4), maintenance (n = 4), and ad libitum intake (n = 27). Ad libitum animals were divided into four groups: diets with the inclusion of DDG at the levels of 0, 150, 300, and 450 g/kg (dry matter basis). At the end of the experiment, all animals were slaughtered. There was a linear reduction with increasing DDG levels in the total digestible nutrients intake (p = 0.008), metabolizable energy (ME) intake (p < 0.010), in total retained energy (p = 0.065), and in heat production (p < 0.001). Metabolizable protein (MP) intake increased linearly (p < 0.010) but retained protein did not differ (p = 0.499). Daily net energy and ME requirement for maintenance were 75.9 and 122 kcal/kg0.75 EBW, respectively. Daily MP for maintenance was 3.6 g/kg0.75 shrunk body weight. DDG inclusion in finishing diets reduces energy intake and deposition, and we recommend the equations of this study to estimate the requirements of young Nellore bulls.

The Cardiovascular Health Integrated Lifestyle Diet (CHILD) Lowers LDL-Cholesterol Levels in Brazilian Dyslipidemic Pediatric Patients.

OBJECTIVE: To analyze the impact of the CHILD-2 diet on the lipid profile of Brazilian children and adolescents with dyslipidemia. METHODS: This is a quasi-experimental study, where 149 participants (5-17 years) with mild-to-moderate hypercholesterolemia were divided into two groups (GI: low or normal weight; n = 58 and GII: overweight; n = 91). Both groups underwent the CHILD-2 diet, characterized by 25-30% total fat and less than 7% of low-saturated fat (SF) for 6 months. Changes from baseline in the lipid profile, including Total cholesterol (TC), LDL-C, triacylglycerols and glucose concentrations, dietary and anthropometric data were examined at 3 and 6 months. Longitudinal analyses were performed using linear mixed-effects models in SAS. RESULTS: Serum LDL-C concentrations reduced over time compared with baseline (Δ = -5.1 mg/dL; p < 0.01), with no difference between groups (p = 0.35). TC concentrations decreased by -2.0 mg/dL (p < 0.01); but no difference was observed between groups. We found no significant changes in body mass index/age Z scores after a dietary intervention compared with baseline in both groups (p = 0.94). CONCLUSION: Despite the modest reduction, our findings confirm that children with dyslipidemia can benefit from the CHILD-2 diet combined with a healthy lifestyle.

Obesidade em felinos domésticos: fatores de risco, impactos clínicos, metabólicos, diagnóstico e tratamento / Obesity in domestic cats: risk factors, clinical, metabolic impacts, diagnosis and treatment / Obesidad em felinos domésticos: factores de riesgo, impactos clínicos, metabólicos, diagnóstico y tratamento

O aumento da composição corporal pode promover alterações metabólicas e locomotoras, além de diminuir a expectativa de vida dos animais. Desse modo, o objetivo deste artigo é fornecer informações sobre a obesidade, elucidar os fatores de risco, diagnóstico, tratamento, assim como, ressaltar maneiras de enriquecimento ambiental e prevenção da obesidade. A obesidade possui origem multifatorial e pode contribuir para o surgimento de comorbidades. O diagnóstico baseia-se na avaliação nutricional e na identificação do grau de obesidade. Para isso existem algumas técnicas, como avaliação do peso, classificação do escore de condição corporal (ECC), índice de massa magra (IMM), raios-x de dupla energia (DEXA), tomografia computadorizada, ressonância magnética e em métodos que auxiliam a estimar o índice de massa corporal dos felinos e o percentual de gordura. O tratamento consiste no planejamento nutricional, para isso deve-se realizado a troca de dieta para um alimento para perda de peso com densidade energética reduzida, baixo teor de gorduras e alto teor de proteínas e fibras. É fundamental que haja o retorno quinzenal ou mensal do paciente para a verificação da velocidade de perda e caso seja necessário realizar ajustes na dieta. Acrescido a dieta é essencial a introdução de enriquecimento ambiental para aumentar a atividade física. Diante do exposto, é de grande importância...(AU)

The increase in body composition can promote metabolic and locomotor changes, in addition to decreasing the life expectancy of the animals. Thus, the objective of this article is to provide information about obesity, to elucidate risk factors, diagnosis, treatment, as well as to highlight ways of environmental enrichment and obesity prevention. Obesity has a multifactorial origin and can contribute to the emergence of comorbidities. The diagnosis is based on nutritional assessment and identification of the degree of obesity. For this there are some techniques, such as weight assessment, classification of the body condition score (ECC), lean mass index (IMM), dual energy x-rays (DEXA), computed tomography, magnetic resonance and methods that help to estimate the feline body mass index and fat percentage. The treatment consists of nutritional planning. To do this, the diet must be changed to a weight loss food with reduced energy density, low fat content and high protein and fiber content. It is essential that there is a fortnightly or monthly return of the patient to check the speed of loss and If it is necessary to make adjustments to the diet. In addition to the diet, it is essential to introduce environmental enrichment to increase physical activity. Given the above, it is of great importance to carry out the treatment for obesity, in addition to making tutors aware of the correct environmental and nutritional management, in order to promote quality of life for these animals.(AU)

El aumento de la composición corporal puede promover cambios metabólicos y locomotores, además de disminuir la esperanza de vida de los animales. Así, el propósito de este artículo es brindar información sobre la obesidad, dilucidar factores de riesgo, diagnóstico, tratamiento, así como resaltar formas de enriquecimiento ambiental y prevención de la obesidad. La obesidad tiene un origen multifactorial y puede contribuir a la aparición de comorbilidades. El diagnóstico se basa en la valoración nutricional y la identificación del grado de obesidad. Para ello existen algunas técnicas, como valoración de peso, clasificación de puntuación de condición corporal (ECC), índice de masa magra (IMM), rayos X de energía dual (DEXA), tomografía computarizada, resonancia magnética y métodos que ayudan a estimar el felino índice de masa corporal y porcentaje de grasa. El tratamiento consiste en una planificación nutricional, para lo cual se debe cambiar la dieta por un alimento para adelgazar con densidad energética reducida, bajo contenido en grasas y alto contenido en proteínas y fibras. Es fundamental que exista un retorno quincenal o mensual del paciente para comprobar la velocidad de pérdida y si es necesario realizar ajustes en la dieta. Además de la dieta, es fundamental introducir un enriquecimiento ambiental para incrementar la actividad física. Por lo anterior, es de gran importancia realizar el tratamiento de la obesidad, además de concienciar a los tutores del correcto manejo ambiental y nutricional, con el fin de promover la calidad de vida de estos animales.(AU)

Impact of different levels of low-fat dried distillers grains on performance of young Nellore bulls during the finishing phase.

This study evaluated the effect of including low-fat dried distillers grains (DDG) on young Nellore bulls performance, nutritional parameters, and nitrogen metabolism. Thirty-five Nellore cattle were randomly divided into four diets: without dried distillers grains (D0) or with the inclusion of DDG at 150 g/kg (D150), 300 g/kg (D300), or 450 g/kg (D450). The evaluation period lasted 126 days, and three periods of collection of feces and urine were carried out. Final body weight (P = 0.099) and average daily gain (P = 0.097) tended to decrease linearly; the digestibility of dry matter (P < 0.001), organic matter (P < 0.001), ether extract (P < 0.001) and nonfiber carbohydrates (P < 0.001), and intakes of total digestible nutrients (TDN, P < 0.001) decreased linearly. The increase in crude protein intake (P < 0.001) did not result in an increase in the amount of nitrogen retained (P = 0.540). We concluded that the inclusion of low-fat DDG in finishing diets up to the level of 450 g/kg tends to reduce animal performance and the intake of TDN.

Physical properties of UHT light cream: impact of the high-pressure homogenization and addition of hydrocolloids.

The beneficial effects of a healthy diet on the quality of life have prompted the food industry to develop low-fat variants, but fat content directly affects the physicochemical and sensory properties of food products. The utilization of high-pressure homogenization (HP) and incorporation of hydrocolloids have been suggested as strategies to improve the physical stability and rheological properties of light cream. Thus, this study aims to analyze the associated effect of high-pressure homogenization (80 MPa) and three different hydrocolloids: microcrystalline cellulose, locust bean gum and xanthan gum, on emulsion stability and rheological properties of ultra-high-temperature (UHT) light cream (ULC) with a 15% w/w fat content. The stability of ULC was determined by the ζ potential of oil droplets and emulsion stability percentage. Rheological characterization was based on flow behavior tests and dynamic oscillatory measurements, which were carried out in a rheometer. Results showed that the high-pressure homogenization process did not influence the emulsion stability of the treatments. Moreover, the hydrocolloids added to systems present weak interactions with milk proteins since all ULC showed macroscopical phase separation. The samples presented the same rheological behavior and were classified as pseudoplastic fluids (n < 1). ULC treated at 80 MPa was significantly (P ≤ 0.05) more consistent than the treatments at 20 MPa. All ULC showed a predominant elastic behavior (G' > G″), and a remarkable increase in both G' and G″ at 80 MPa. The results presented in this study highlight the potential of HP for altering some rheological characteristics of UHT light cream, for example, to increase its consistency. These results are important for the dairy industry and ingredient suppliers, in the standardization of UHT light cream and/or to develop low-fat products.

Dairy consumption and subclinical atherosclerosis: A cross-sectional study among middle-aged Mexican women.

BACKGROUND AND AIMS: Many dietary guidelines encourage low-fat dairy products; however, recent studies have found null and inverse associations between high-fat dairy intake and cardiovascular disease (CVD) risk. We examined the association between the intake of total dairy and different types of dairy and carotid intima-media thickness (IMT), a marker of subclinical atherosclerosis, in Mexican women. METHODS AND RESULTS: Dairy consumption was assessed using a validated food-frequency questionnaire (FFQ) in 1759 women in the Mexican Teachers' Cohort (MTC) study who were free of CVD or cancer. We categorized participants according to total dairy intake and consumption of four mutually exclusive dairy groups: high-fat, low-fat, yogurt, and dairy with added sugars. IMT and atherosclerotic plaque were measured by B-mode ultrasonography. Subclinical atherosclerosis was defined as an IMT ≥0.8 mm and/or the presence of plaque. Multivariable linear regression and logistic regression models were used to respectively assess the mean percentage difference of mean IMT and odds ratios (OR) for subclinical atherosclerosis across quantiles of dairy consumption. Mean (±SD) age was 45.4 ± 5.0 years and the median (interquartile range: IQR) total dairy consumption was 11.0 (6.6, 17.1) servings/week. After adjusting for lifestyle, clinical, and dietary factors, comparing the highest category of consumption, to the lowest, total dairy was associated with increased IMT (2.6%, 95% confidence interval (CI): 0.6, 4.3; p-trend<0.01). Moreover, yogurt consumption was associated with lower odds of subclinical atherosclerosis (OR = 0.65, 95% CI: 0.47, 0.91; p-trend = 0.01). CONCLUSIONS: While total dairy consumption was associated with carotid wall thickening, yogurt consumption was related to lower subclinical atherosclerosis.

Linfangiectasia intestinal en un paciente afectado de síndrome de Sanfilippo B / Intestinal lymphangiectasia in a patient with Sanfilippo B syndrome

La mucopolisacaridosis tipo III B es una enfermedad de depósito lisosomal causada por la deficiencia de la enzima N-acetil-alfa-d-glucosaminidasa, implicada en el catabolismo del heparán sulfato, que produce su acúmulo en diversos tejidos. Se presenta a un paciente de 8 años, afectado de mucopolisacaridosis tipo III B, con historia de diarrea crónica y hallazgos endoscópicos e histológicos compatibles con linfangiectasia intestinal. Tras tratamiento dietético con restricción de ácidos grasos de cadena larga y rica en triglicéridos de cadena media, presentó mejoría clínica, mantenida hasta la actualidad.La patogenia de la diarrea crónica en pacientes con mucopolisacaridosis tipo III B es aún desconocida. Debe investigarse la presencia de linfangiectasia intestinal en estos pacientes e iniciar, en caso de confirmarse, un tratamiento dietético adecuado para mejorar así su calidad de vida.

Mucopolysaccharidosis type IIIB is a lysosomal storage disease caused by a deficiency of the N-acetyl-alpha-d-glucosaminidase enzyme involved in the catabolism of heparan sulfate, causing its accumulation in various tissues. We present an 8-year-old patient with mucopolysaccharidosis type IIIB, with a history of chronic diarrhea and endoscopic and histological findings compatible with intestinal lymphangiectasia. After a dietary treatment with a low-fat diet supplemented with medium-chain triglyceride, our patient presents clinical improvement until today. The pathogenesis of chronic diarrhea in patients with mucopolysaccharidosis type IIIB is still unknown. The presence of intestinal lymphangiectasia in these patients should be investigated, and appropriate dietary treatment should be initiated, if confirmed, to improve their quality of life.

Obesidade em felinos domésticos: fatores de risco, impactos clínicos, metabólicos, diagnóstico e tratamento / Obesity in domestic cats: risk factors, clinical, metabolic impacts, diagnosis and treatment / Obesidad em felinos domésticos: factores de riesgo, impactos clínicos, metabólicos, diagnóstico y tratamento

O aumento da composição corporal pode promover alterações metabólicas e locomotoras, além de diminuir a expectativa de vida dos animais. Desse modo, o objetivo deste artigo é fornecer informações sobre a obesidade, elucidar os fatores de risco, diagnóstico, tratamento, assim como, ressaltar maneiras de enriquecimento ambiental e prevenção da obesidade. A obesidade possui origem multifatorial e pode contribuir para o surgimento de comorbidades. O diagnóstico baseia-se na avaliação nutricional e na identificação do grau de obesidade. Para isso existem algumas técnicas, como avaliação do peso, classificação do escore de condição corporal (ECC), índice de massa magra (IMM), raios-x de dupla energia (DEXA), tomografia computadorizada, ressonância magnética e em métodos que auxiliam a estimar o índice de massa corporal dos felinos e o percentual de gordura. O tratamento consiste no planejamento nutricional, para isso deve-se realizado a troca de dieta para um alimento para perda de peso com densidade energética reduzida, baixo teor de gorduras e alto teor de proteínas e fibras. É fundamental que haja o retorno quinzenal ou mensal do paciente para a verificação da velocidade de perda e caso seja necessário realizar ajustes na dieta. Acrescido a dieta é essencial a introdução de enriquecimento ambiental para aumentar a atividade física. Diante do exposto, é de grande importância...

The increase in body composition can promote metabolic and locomotor changes, in addition to decreasing the life expectancy of the animals. Thus, the objective of this article is to provide information about obesity, to elucidate risk factors, diagnosis, treatment, as well as to highlight ways of environmental enrichment and obesity prevention. Obesity has a multifactorial origin and can contribute to the emergence of comorbidities. The diagnosis is based on nutritional assessment and identification of the degree of obesity. For this there are some techniques, such as weight assessment, classification of the body condition score (ECC), lean mass index (IMM), dual energy x-rays (DEXA), computed tomography, magnetic resonance and methods that help to estimate the feline body mass index and fat percentage. The treatment consists of nutritional planning. To do this, the diet must be changed to a weight loss food with reduced energy density, low fat content and high protein and fiber content. It is essential that there is a fortnightly or monthly return of the patient to check the speed of loss and If it is necessary to make adjustments to the diet. In addition to the diet, it is essential to introduce environmental enrichment to increase physical activity. Given the above, it is of great importance to carry out the treatment for obesity, in addition to making tutors aware of the correct environmental and nutritional management, in order to promote quality of life for these animals.

El aumento de la composición corporal puede promover cambios metabólicos y locomotores, además de disminuir la esperanza de vida de los animales. Así, el propósito de este artículo es brindar información sobre la obesidad, dilucidar factores de riesgo, diagnóstico, tratamiento, así como resaltar formas de enriquecimiento ambiental y prevención de la obesidad. La obesidad tiene un origen multifactorial y puede contribuir a la aparición de comorbilidades. El diagnóstico se basa en la valoración nutricional y la identificación del grado de obesidad. Para ello existen algunas técnicas, como valoración de peso, clasificación de puntuación de condición corporal (ECC), índice de masa magra (IMM), rayos X de energía dual (DEXA), tomografía computarizada, resonancia magnética y métodos que ayudan a estimar el felino índice de masa corporal y porcentaje de grasa. El tratamiento consiste en una planificación nutricional, para lo cual se debe cambiar la dieta por un alimento para adelgazar con densidad energética reducida, bajo contenido en grasas y alto contenido en proteínas y fibras. Es fundamental que exista un retorno quincenal o mensual del paciente para comprobar la velocidad de pérdida y si es necesario realizar ajustes en la dieta. Además de la dieta, es fundamental introducir un enriquecimiento ambiental para incrementar la actividad física. Por lo anterior, es de gran importancia realizar el tratamiento de la obesidad, además de concienciar a los tutores del correcto manejo ambiental y nutricional, con el fin de promover la calidad de vida de estos animales.

Translation and cross-cultural adaptation of 14-item Mediterranean Diet Adherence Screener and low-fat diet adherence questionnaire.

BACKGROUND AND AIMS: The Mediterranean diet and the low-fat diet are recognized as cardioprotective dietary patterns, and the use of validated instruments that quickly identify adherence to these diets is very useful in the daily practice of the nutritionist. Our aim was to translate and cross-culturally adapt the 14-point Mediterranean Diet Adherence Screener (MEDAS) and a 9-item quantitative score of compliance with the low-fat diet (low-fat diet questionnaire) to the Brazilian Portuguese language. METHODS: The process of translation and cultural adaptation was conducted in six stages: initial translation, synthesis of translations, back-translation, proof of cross-cultural equivalence, pre-final version testing, and final evaluation of the cultural adaptation process. Interviews and assessments were administered to 30 nutritionists, and to 51 healthy participants and 50 individuals at cardiovascular risk. MEDAS ranges from 0 (minimum) to 14 (maximum) points and a total score ≥ 10 points was considered for high adherence to MedDiet. Low-fat diet questionnaire ranges from 0 (minimum) to 9 (maximum) points and a total score ≥ 6 points was considered for high adherence to a diet restricted in fat. RESULTS: MEDAS and low-fat diet questionnaire were translated, synthetized and then back-translated, and few grammatical and/or semantic changes were required. About 24 participants suggested at least one modification in low-fat diet questionnaire's questions/terms, and 28 participants suggested at least one change in MEDAS items. The process produced a valid version of both the MEDAS and low-fat diet questionnaire in the Brazilian Portuguese language. Participants showed an average MEDAS questionnaire of 5.3 ± 2.5 points, and an average low-fat diet questionnaire of 5.9 ± 1.9 points. Nutritionists showed higher means of low-fat diet scores when compared to healthy and at high cardiovascular risk individuals (7.1 ± 1.3, 5.6 ± 2 and 5.4 ± 1.9, respectively [P < 0.0001]) but not for MEDAS questionnaire. With a cutoff of ≥10 points, 2.3% (95% CI 0.78-6.52) of the participants showed high adherence to MedDiet based on MEDAS score, and with a cutoff of ≥6 points, 58% (95% CI 49.5-66.1) of the participants showed high adherence to a diet restricted in fat based on the low-fat diet questionnaire. CONCLUSIONS: MEDAS and low-fat diet questionnaire were successfully translated to the Portuguese language. Regarding the results from questionnaires applied to our sample, in general, poor adherence was found for both Mediterranean and low-fat diet.

Transient reductions in milk fat synthesis and their association with the ruminal and metabolic profile in dairy cows fed high-starch, low-fat diets.

Sub-acute ruminal acidosis (SARA) is sometimes observed along with reduced milk fat synthesis. Inconsistent responses may be explained by dietary fat levels. Twelve ruminally cannulated cows were used in a Latin square design investigating the timing of metabolic and milk fat changes during Induction and Recovery from SARA by altering starch levels in low-fat diets. Treatments were (1) SARA Induction, (2) Recovery and (3) Control. Sub-acute ruminal acidosis was induced by feeding a diet containing 29.4% starch, 24.0% NDF and 2.8% fatty acids (FAs), whereas the Recovery and Control diets contained 19.9% starch, 31.0% NDF and 2.6% FA. Relative to Control, DM intake (DMI) and milk yield were higher in SARA from days 14 to 21 and from days 10 to 21, respectively (P < 0.05). Milk fat content was reduced from days 3 to 14 in SARA (P < 0.05) compared with Control, while greater protein and lactose contents were observed from days 14 to 21 and 3 to 21, respectively (P < 0.05). Milk fat yield was reduced by SARA on day 3 (P < 0.05), whereas both protein and lactose yields were higher on days 14 and 21 (P < 0.05). The ruminal acetate-to-propionate ratio was lower, and the concentrations of propionate and lactate were higher in the SARA treatment compared with Control on day 21 (P < 0.05). Plasma insulin increased during SARA, whereas plasma non-esterified fatty acids and milk ß-hydroxybutyrate decreased (P < 0.05). Similarly to fat yield, the yield of milk preformed FA (>16C) was lower on day 3 (P < 0.05) and tended to be lower on day 7 in SARA cows (P < 0.10), whereas yield of de novo FA (<16C) was higher on day 21 (P < 0.01) in the SARA group relative to Control. The t10- to t11-18:1 ratio increased during the SARA Induction period (P < 0.05), but the concentration of t10-18:1 remained below 0.5% of milk fat, and t10,c12 conjugated linoleic acid remained below detection levels. Odd-chain FA increased, whereas branched-chain FA was reduced during SARA Induction from days 3 to 21 (P < 0.05). Sub-acute ruminal acidosis reduced milk fat synthesis transiently. Such reduction was not associated with ruminal biohydrogenation intermediates but rather with a transient reduction in supply of preformed FA. Subsequent rescue of milk fat synthesis may be associated with higher availability of substrates due to increased DMI during SARA.

Caloric restriction-induced weight loss with a high-fat diet does not fully recover visceral adipose tissue inflammation in previously obese C57BL/6 mice.

Caloric restriction (CR) reduces body weight and systemic inflammation, but the effects on adipose tissue under dietary lipid overload are controversial. We evaluated the effects of CR-induced weight loss with a high-fat diet on adipose tissue inflammation of obese mice. Male mice were assigned into low-fat diet (LF) and high-fat diet (HF) groups. After 8 weeks, the mice in the HF group were reassigned for another 7 weeks into the following 3 conditions: (i) kept in the HF condition; (ii) changed to low-fat diet ad libitum (LFAL); and (iii) changed to high-fat calorie-restricted (RHF) diet to reach LFAL body weight. Serum markers, adipocytokines, morphology, and inflammatory infiltrates in retroperitoneal adipose tissue (RAT) were accessed. The body weights of the LFAL and RHF groups were reduced, equaling the body weights of the LF group. The LFAL mice had restored almost all inflammatory markers as the LF mice, except tumor necrosis factor-alpha (TNF-α), monocyte chemoattractant protein-1 (MCP-1), and adiponectin. Compared with the HF group, the RHF group had lowered visceral adiposity, retroperitoneal adipocyte sizes, and RAT inflammatory cell infiltration, as well as TNF-α, interleukin-6, and hepatic and serum C-reactive protein, which were higher than that of the LFAL group; adiponectin and MCP-1 did not change. CR with high-fat diet reduced body weight and attenuated visceral adiposity but did not fully recover visceral tissue inflammation. Novelty Caloric restriction in a high-fat diet ameliorated visceral adiposity. Caloric restriction in a high-fat diet did not recover visceral adipose tissue inflammation.

Association between DASH diet (Dietary Approaches to Stop Hypertension) and hypertension in adolescents: A cross-sectional school-based study.

BACKGROUND & AIMS: The DASH diet (Dietary Approaches to Stop Hypertension) is considered a healthy dietary pattern, and is recommended for the control of arterial hypertension (AH). However, its role in the adolescent population needs to be better investigated and clarified. The aim of this study is to identify the association between AH and the DASH diet score in a representative sample of Brazilian adolescents. METHODS: A cross-sectional study using data from a national, multicenter and schoolbased probabilistic sample of 71,553 Brazilian adolescents who had their blood pressure (BP) measured and completed a 24-hour dietary recall (2013-2014). The components of the DASH score were assessed. Logistic regression models were used to evaluate the association between AH, anthropometric and sociodemographic variables, and the tertile of the DASH score. RESULTS: Approximately 11% of the adolescents who were in the 3rd tertile of the DASH score presented AH, 18% were overweight and 9% were obese. Among the components of the score, the highest intake was sugar-sweetened beverages (92.1%), legumes and oilseeds (68.2%), red and processed meat (64.5%) and the lowest were low-fat dairy (2.2%), whole grains (11.6%) and fruits (18.1%). Sodium intake was above the maximum recommended in all tertiles. CONCLUSIONS: A small proportion of Brazilian adolescents consume foods from the DASH diet. No associations were found between this dietary pattern and AH. Strategies to increase the intake of protective foods in adolescents must be investigated as well as the potential health benefits of the standard DASH diet for this age group over time.

Efeitos da restrição de carboidratos no manejo do diabetes mellitus: revisão de literatura científica / Effects of carbohydrate-restricted diets in the management of diabetes mellitus: review of scientific literature

O objetivo do presente estudo foi avaliar, por meio de uma revisão da literatura, evidências da utilização de dietas com restrição de carboidratos no manejo do diabetes mellitus (DM). As buscas eletrônicas e manuais foram até abril de 2019, e incluíram trabalhos publicados a partir de 2008. Foram excluídos estudos de pesquisas in vitro e em animais, revisões de literatura, livros, monografias, dissertações, teses, estudos de caso e relatos de caso. Os artigos remanescentes foram submetidos à análise de sua qualidade metodológica pela Escala JADAD cinco pontos. Um total de 19 estudos randomizados e com qualidade média de três pontos foram selecionados e analisados quanto aos tipos de dieta utilizadas, adesão, tipo de DM, tempo de intervenção, consumo reportado de carboidratos e resultados observados para os grupos controle e intervenção. Dentre os parâmetros escolhidos para mensurar os possíveis efeitos das dietas, destacaram-se alteração de peso e IMC, Hb1Ac, variabilidade ou controle glicêmico, perfil lipídico e alteração nas doses de insulina ou medicação utilizadas. Em quatro estudos não foram observadas vantagens significativas de uma dieta restrita em carboidratos, e 15 trabalhos relataram melhoras em um ou mais parâmetros. Tais resultados podem representar uma grande vantagem na adoção desta estratégia alimentar no manejo do DM e na prevenção de complicações da doença. Contudo, existem limitações nos estudos, que precisam ter suas hipóteses verificadas no longo prazo, e pesquisas adicionais devem ser realizadas para configurar uma estratégia oficial no controle do DM. (AU)

This study aimed to evaluate, through a literature review, evidence of the use of diets with carbohydrate restriction in the management of diabetes mellitus (DM). Electronic and manual searches were conducted until April 2019, including works published from 2008 onwards. Studies on in vitro and animal research, literature reviews, books, monographs, dissertations, theses, case studies and case reports were excluded. The remaining articles were submitted to analysis of their methodological quality by the five-point JADAD Scale. Nineteen randomized studies with an average quality of three points were selected and analyzed regarding the types of diet used, adherence, type of DM, time of intervention, reported consumption of carbohydrates and results observed for the control and intervention group. Among the parameters chosen to measure the possible effects of diets, weight and BMI changes, Hb1Ac, variability or glycemic control, lipid profile and changes in insulin doses or medication used stood out. In four studies, no significant advantages were observed from a carbohydraterestricted diet, and 15 studies reported improvements in one or more parameters. Such results can represent a great advantage in adopting this dietary strategy in the management of DM and in preventing complications of the disease. However, there are limitations in the studies, which need to have their hypotheses verified in the long term, and additional research must be carried out to configure an official strategy in the control of DM. (AU)

Effect of low-fat diets enriched with fruit purees on the biochemical markers of metabolic syndrome analogy induced-rats / Efecto de dietas bajas en grasa enriquecida con purés de frutas sobre marcadores bioquímicos en ratas inducidas con analogia a sindrome metabólico

Fruit purees can be added to diet as alternative sources of bioactive compounds for the prevention and/or improvement of the complications of metabolic syndrome. In this work we evaluated the effect of the intake of low-fat diets enriched with fruit purees (guava-strawberry, guava-blackberry, guava-soursop, guava-passion fruit) on the body weight and biochemical markers in metabolic syndrome analogy (MSA)-induced rats. The rats (n=6 for each treatment) were induced with a high fat diet and were injected with streptozotocin, one dose every week for 4 consecutive weeks after fasting overnight, then healthy rats were fed with standard diet and MS rats were fed with standard diet plus each of the fruit puree, for 4 weeks. As novel findings, the diet enriched with fruit purees was associated with a reduction in body weight (~13-21 %) and a control in the metabolism of glucose by decreasing plasma glucose (~5963 %). Also, there was a reduction in the total cholesterol, triacylglycerols, low-density lipoproteins, and low enzymatic activities of alanine aminotransferase, alkaline phosphatase and γ-glutamyl transferase, useful metabolites in the control of inflammatory processes in the liver. A notable improvement in the liver morphology was observed indicating that the treatments had a hepatoprotective effect. The diet enriched with guava-blackberry puree caused the best results on most biochemical markers of MS rats. Therefore, diets enriched with fruit purees can be an alternative for MS individuals for the control and improvement of the complications caused by this syndrome.

Los purés de frutas se pueden agregar a la dieta como fuentes alternativas de compuestos bioactivos para la prevención y / o mejora de las complicaciones del síndrome metabólico. En este trabajo evaluamos el efecto de la ingesta de dietas bajas en grasas, enriquecidas con purés de frutas (guayaba-fresa, guayaba-mora, guayaba-guanábana, guayaba-maracuyá) sobre el peso corporal y los marcadores bioquímicos en el síndrome metabólico (SM) inducido en ratas. Las ratas (n = 6 para cada tratamiento) fueron inducidas con una dieta alta en grasas y se les inyectó estreptozotocina, una dosis cada semana durante 4 semanas consecutivas después de ayunar durante la noche. Luego, las ratas sanas fueron alimentadas con una dieta estándar; y las ratas con SM fueron alimentadas con dieta estándar más cada uno de los purés de frutas, durante 4 semanas. Como hallazgos novedosos, la dieta enriquecida con purés de frutas se asoció con una reducción en el peso corporal (~ 13-21 %) y un control en el metabolismo de la glucosa al disminuir la glucosa en plasma (~ 59-63 %). Además, hubo una reducción en el colesterol total, triacilgliceroles, lipoproteínas de baja densidad, y bajas actividades enzimáticas de alanina aminotransferasa, fosfatasa alcalina y gama-glutamil transferasa, metabolitos útiles en el control de los procesos inflamatorios en el hígado. Se observó una mejora notable en la morfología del hígado, lo que indica que los tratamientos tuvieron un efecto hepatoprotector. La dieta enriquecida con puré de guayaba y mora causó los mejores resultados en la mayoría de los marcadores bioquímicos de las ratas con SM. Por lo tanto, las dietas enriquecidas con purés de frutas pueden ser una alternativa para las personas con SM, para el control y la mejora de las complicaciones causadas por este síndrome.