Comparison of the Effects of Brazil Nut Oil and Soybean Oil on the Cardiometabolic Parameters of Patients with Metabolic Syndrome: A Randomized Trial.

Recent evidence suggests that replacing saturated fat with unsaturated fat is beneficial for cardiovascular health. This study compared the effects of Brazil nut oil (BNO) and soybean oil (SO) supplementation for 30 days on anthropometric, blood pressure, biochemical, and oxidative parameters in patients with metabolic syndrome (MS). Thirty-one patients with MS were randomly allocated to receive 30 sachets with 10 mL each of either BNO (n = 15) or SO (n = 16) for daily supplementation. Variables were measured at the beginning of the study and after 30 days of intervention. No change in anthropometric and blood pressure variables were observed (p > 0.05). Total (p = 0.0253) and low-density lipoprotein (p = 0.0437) cholesterol increased in the SO group. High-density lipoprotein cholesterol decreased (p = 0.0087) and triglycerides increased (p = 0.0045) in the BNO group. Malondialdehyde levels decreased in the BNO group (p = 0.0296) and total antioxidant capacity improved in the SO group (p = 0.0110). Although the addition of oils without lifestyle interventions did not affect anthropometric findings or blood pressure and promoted undesirable results in the lipid profile in both groups, daily supplementation of BNO for 30 days decreased lipid peroxidation, contributing to oxidative stress reduction.

Interactions between dietary inflammatory index, nutritional state and Multiple Sclerosis clinical condition.

BACKGROUND & AIMS: The Dietary Inflammatory Index (DII) consists of a tool that assesses dietary inflammatory potential based on the assignment of an inflammatory score to a variety of nutrients, seasonings and bioactive compounds. Pro-inflammatory diets are associated to weight and abdominal fat excess. High Body Mass Index (BMI) and Waist Circumference (WC) seem to contribute to a worse prognosis in Multiple Sclerosis (MS) patients. Therefore, this study seeks to investigate the relation between anthropometric indexes and body adiposity with the clinical condition and the Dietary Inflammatory Index of MS individuals. METHODS: This is a cross-sectional, analytical study that included 137 MS patients residing in the Brazilian northeast. Through a structured questionnaire and medical records consultation, we collected data on demographics, nutritional state, arterial pressure, clinical and dietary variables. Clinical variables included the MS type, number of pulse therapies and attack rate in the last two years, number of days of most recent pulse therapy and muscular strength assessment scores (MRC) and most recent disability level (EDSS). The nutritional state was evaluated based on BMI, WC, waist-hip ratio (WHR), Body Roundness Index (BRI), Body Shape z score Index (ABSIz) and body fat percentage (%BF). The DII was calculated according to a validated methodology. RESULTS: The ABSIz presented a positive correlation with regards to the EDSS score (r = 0.294. p = 0.001). WC and WHR presented a negative correlation in relation to the number of pulse therapy days (r = -0.255. p = 0.022 and r = -0.251. p = 0.024). BMI and %BF were not correlated to clinical variables (p > 0.05). The DII was positively correlated to the BMI in people with progressive MS (r = 0.556. p = 0.025). CONCLUSIONS: The DII may interfere in the nutritional state of MS patients and the nutritional state may affect disability levels but it is necessary to establish which nutritional indicator can better predict the relation between DII and the clinical condition of MS patients.

Zinco e risco cardiovascular de pacientes nefropatas em tratamento de hemodiálise / Zinc and cardiovascular risk in nephropathic patients undergoing hemodialysis treatment / Zinc y riesgo cardiovascular de pacientes con enfermedad del riñón en tratamiento de hemodiálisis

Objetivo: Investigar a relação entre concentração de zinco e risco cardiovascular em pacientes com insuficiência renal crônica em hemodiálise. Métodos: Estudo analítico, retrospectivo e transversal, realizado em Fortaleza, Ceará, em 2012, do qual participaram 43 adultos com insuficiência renal crônica em hemodiálise (grupo HD) e 35 saudáveis (CO - controle). Coletaram-se dados socioeconômicos e bioquímicos (colesterol total - CT, lipoproteína de baixa densidade - LDL, lipoproteína de muito baixa densidade - VLDL, lipoproteína de alta densidade - HDL e triglicerídeos - TG); determinou-se zinco plasmático por espectrometria de emissão óptica com plasma acoplado; coletou-se perfil lipídico do grupo HD do prontuário e do grupo CO por meio de kit Bioclin®. Obteve-se colesterol não-HDL pela fórmula: não-HDL = CT ­ HDL-c. Calculou-se risco cardiovascular pela razão TG/HDL, considerando risco quando >3,8. Análises por meio de testes t de Student, Pearson ou Spearman. Resultados: O zinco do grupo HD encontrou-se abaixo da referência e menor (p<0,001) em relação ao controle (68,40µg/dL e 85,53µg/dL, respectivamente). HDL no grupo HD mostrou-se abaixo da recomendação (39,64±11,58). VLDL (29,02±14,03mg/dL) do grupo HD foi maior (p<0,001) que no CO (15,47±10,65mg/dL). LDL do grupo HD maior que no CO (p=0,05) e o TG no grupo HD (145,14±70,15mg/dL) maior (p<0,001) que no CO (77,35±53,25mg/dL). Encontrou-se razão TG/HDL no grupo HD de 4,02±2,60 (p=0,04), indicando maior risco cardiovascular. Pacientes com maior relação TG/HDL apresentaram menores níveis de zinco (p=0,011). Conclusão: Os pacientes em hemodiálise apresentaram deficiência de zinco e possuíam elevado risco cardiovascular, porém sem correlação entre zinco e perfil lipídico.

Objective: To assess the relationship between zinc concentration and cardiovascular risk in patients with chronic renal failure on hemodialysis. Methods: Analytical retrospective cross-sectional study carried out in Fortaleza, Ceará, Brazil, in 2012 with 43 adult patients with chronic renal failure on hemodialysis (HD group) and 35 healthy individuals (control group). Socioeconomic and biochemical (total cholesterol - TC, low density lipoprotein - LDL, very low density lipoprotein - VLDL, high density lipoprotein - HDL and triglycerides - TG) were collected. Plasma zinc was determined using coupled plasma optical emission spectrometry. HD group' lipid profile was collected from medical records, and the controls' lipid profile was analyzed using the Bioclin® kit. Non-HDL cholesterol was = CT ­ HDL-C. Cardiovascular risk was assessed using the TG/HDL ratio, with risk when >3.8. Student's t test, Pearson's test or Spearman's test were used. Results: Zinc was below the recommended and lower (p<0.001) in the HD group (68.40µg/dL and 85.53µg/dL, respectively). HDL-c in the HD group was below the recommended (39.64±11.58). VLDL (29.02±14.03 mg/dL) in HD patients was higher (p<0.001) than in controls (15.47±10.65 mg/dL). LDL was higher in the HD group than in controls (p=0.05) and TG in the HD group (145.14±70.15 mg/dL) was higher (p<0.001) than in controls (77.35±53.25 mg/dL). The TG/HDL ratio in the HD group was 4.02±2.60 (p=0.04), indicating a higher cardiovascular risk. Individuals with higher TG/HDL had lower zinc (p=0.011). Conclusion: Patients on hemodialysis presented with zinc deficiency and high cardiovascular risk, but there was no correlation between zinc levels and lipid profile.

Objetivo: Investigar la relación entre la concentración de zinc y el riesgo cardiovascular de pacientes con insuficiencia renal crónica en hemodiálisis. Métodos: Estudio analítico, retrospectivo y transversal realizado en Fortaleza, Ceará, en 2012, en el cual participaron 43 pacientes adultos con insuficiencia renal crónica en hemodiálisis (grupo HD) y 35 saludables (grupo CO - control). Se recogieron los datos socioeconómicos y bioquímicos (colesterol total - CT, lipoproteína de baja densidad - LDL, lipoproteína de muy baja densidad - VLDL, lipoproteína de alta densidad - HDL y triglicéridos - TG); se determinó el zinc plasmático por la espectrometría de emisión óptica por el plasma de acoplamiento inductivo; se recogió el perfil lipídico del grupo HD del historial clínico y el del grupo control a través del kit Bioclin®. Se obtuvo el colesterol no-HDL por la fórmula: no-HDL = CT ­ HDL-c. Se calculó el riesgo cardiovascular por la razón TG/HDL considerando riesgo cuando ≥3,8. Los análisis fueron a través de la prueba t de Student, Pearson o Spearman. Resultados: El zinc del grupo HD fue menor y abajo de la referencia (p<0,001) en comparación con el control (68,40µg/dL y 85,53µg/dL, respectivamente). La HDL del grupo HD se mostró abajo de la recomendación (39,64±11,58). El VLDL (29,02±14,03mg/dL) del grupo HD ha sido mayor (p<0,001) que en el CO (15,47±10,65mg/dL). La LDL del grupo HD ha sido mayor que en el CO (p=0,05) y el TG en el grupo HD (145,14±70,15mg/dL) mayor (p<0,001) que en el CO (77,35±53,25mg/dL). Se encontró la razón TG/HDL en el grupo HD de 4,02±2,60 (p=0,04) con menores niveles de zinc (p=0,011). Conclusión: Los pacientes en hemodiálisis presentaron deficiencia de zinc y tenían elevado riesgo cardiovascular, sin embargo, sin relación entre el zinc y el perfil lipídico.

NUTRITIONAL STATUS, DIET AND NON-ALCOHOLIC FATTY LIVER DISEASE IN ELDERS.

OBJECTIVE: evaluate the inter-relations between non-alcoholic fatty liver disease (NAFLD) and dietary factors in a population of hypertensive elders. METHODS: 229 hypertensive elder patients were evaluated, from June to December 2009. All the patients that accepted to participate in the study signed a free consent term. An anthropometric evaluation was carried out and the body composition was evaluated. The diagnosis of NAFLD was determined by the American guidelines. The regular food intake was estimated through a 24 hour questionnaire. RESULTS: the weighted excess, by the body mass index and excess of abdominal fat, were associated with NAFLD (p < 0.001). An inverse profile was found with the diet variables. CONCLUSION: the studied group presents a health risk situation, considering the nutritional status markers. The regular diet appeared to be inadequate, showing excess of sodium and low fiber and vegetables intake.

Objetivo: evaluar las interrelaciones entre enfermedad grasa no alcohólica del hígado (HGNA) y factores dietéticos en una población de ancianos hipertensos. Métodos: 229 pacientes ancianos hipertensos fueron evaluados desde junio a diciembre del 2009. Todos los pacientes que aceptaron participar en el estudio firmaron un consentimiento libre e informado. Fueron realizadas evaluaciones antropométricas y de composición corporal. El diagnóstico de HGNA fue determinado por el American Guidelines. El consumo alimenticio regular fue estimado a través de una encuesta alimentaria de recordatorio de 24 horas. Resultados: el exceso de peso, ponderado por el índice de masa corporal y el exceso de grasa abdominal, fueron asociados con HGNA (p < 0,001). Un perfil inverso fue encontrado con las variables dietéticas. Conclusión: el grupo estudiado presentó una situación de riesgo para la salud, considerando los marcadores del estado nutricional. La dieta regular pareció ser inadecuada, mostrando exceso de sodio bajo consumo de fibras y vegetales.

[Relationship between dietary glycemic index and glycemic load and nonalcoholic fatty liver disease in elderly]. / Associação entre índice glicêmico e carga glicêmica dietéticos e doença hepática gordurosa não alcoólica em idosos.

OBJECTIVE: To investigate if there is an association between glycemic index (GI) and glycemic load (GL) of the diet and the presence of nonalcoholic fatty liver disease (NAFLD) in the elderly. METHODS: Retrospective study, composed of 229 patients seen at the Outpatient Clinic of Arterial Hyperten- sion in a public hospital, 103 carriers and 126 noncarriers of NAFLD. Food intake was analyzed to GI and GL. RESULTS: We found a high prevalence of inadequate dietary GI, with an average of 62.0 +/- 6.3 among patients with NAFLD and 62.5 +/- 6.5 among patients without NAFLD. The same occurred with the GL, 101.7 +/- 33.3 and 101.4 +/- 40.2, respectively, between carriers and noncarriers of the disease. There was no statistical difference between the values of GI and GL found in the diet of patients with and without NAFLD. CONCLUSION: In the evaluated group there was no association between GI and GL dietetic with NAFLD, but the findings put all of the patients at higher risk for the development of chronic diseases.

AssociaþÒo entre índice glicÛmico e carga glicÛmica dietéticos e doenþa hepática gordurosa nÒo alcoólica em idosos. / [Relationship between dietary glycemic index and glycemic load and nonalcoholic fatty liver disease in elderly].

OBJECTIVE: To investigate if there is an association between glycemic index (GI) and glycemic load (GL) of the diet and the presence of nonalcoholic fatty liver disease (NAFLD) in the elderly. METHODS: Retrospective study, composed of 229 patients seen at the Outpatient Clinic of Arterial Hyperten- sion in a public hospital, 103 carriers and 126 noncarriers of NAFLD. Food intake was analyzed to GI and GL. RESULTS: We found a high prevalence of inadequate dietary GI, with an average of 62.0 +/- 6.3 among patients with NAFLD and 62.5 +/- 6.5 among patients without NAFLD. The same occurred with the GL, 101.7 +/- 33.3 and 101.4 +/- 40.2, respectively, between carriers and noncarriers of the disease. There was no statistical difference between the values of GI and GL found in the diet of patients with and without NAFLD. CONCLUSION: In the evaluated group there was no association between GI and GL dietetic with NAFLD, but the findings put all of the patients at higher risk for the development of chronic diseases.

AssociaþÒo entre índice glicÛmico e carga glicÛmica dietéticos e doenþa hepática gordurosa nÒo alcoólica em idosos / [Relationship between dietary glycemic index and glycemic load and nonalcoholic fatty liver disease in elderly].

OBJECTIVE: To investigate if there is an association between glycemic index (GI) and glycemic load (GL) of the diet and the presence of nonalcoholic fatty liver disease (NAFLD) in the elderly. METHODS: Retrospective study, composed of 229 patients seen at the Outpatient Clinic of Arterial Hyperten- sion in a public hospital, 103 carriers and 126 noncarriers of NAFLD. Food intake was analyzed to GI and GL. RESULTS: We found a high prevalence of inadequate dietary GI, with an average of 62.0 +/- 6.3 among patients with NAFLD and 62.5 +/- 6.5 among patients without NAFLD. The same occurred with the GL, 101.7 +/- 33.3 and 101.4 +/- 40.2, respectively, between carriers and noncarriers of the disease. There was no statistical difference between the values of GI and GL found in the diet of patients with and without NAFLD. CONCLUSION: In the evaluated group there was no association between GI and GL dietetic with NAFLD, but the findings put all of the patients at higher risk for the development of chronic diseases.