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1.
Artigo em Inglês | MEDLINE | ID: mdl-32152146

RESUMO

OBJECTIVE: Obesity is associated with metabolic abnormalities, including insulin resistance and dyslipidemias. Previous studies demonstrated that genistein intake modifies the gut microbiota in mice by selectively increasing Akkermansia muciniphila, leading to reduction of metabolic endotoxemia and insulin sensitivity. However, it is not known whether the consumption of genistein in humans with obesity could modify the gut microbiota reducing the metabolic endotoxemia and insulin sensitivity. RESEARCH DESIGN AND METHODS: 45 participants with a Homeostatic Model Assessment (HOMA) index greater than 2.5 and body mass indices of ≥30 and≤40 kg/m2 were studied. Patients were randomly distributed to consume (1) placebo treatment or (2) genistein capsules (50 mg/day) for 2 months. Blood samples were taken to evaluate glucose concentration, lipid profile and serum insulin. Insulin resistance was determined by means of the HOMA for insulin resistance (HOMA-IR) index and by an oral glucose tolerance test. After 2 months, the same variables were assessed including a serum metabolomic analysis, gut microbiota, and a skeletal muscle biopsy was obtained to study the gene expression of fatty acid oxidation. RESULTS: In the present study, we show that the consumption of genistein for 2 months reduced insulin resistance in subjects with obesity, accompanied by a modification of the gut microbiota taxonomy, particularly by an increase in the Verrucomicrobia phylum. In addition, subjects showed a reduction in metabolic endotoxemia and an increase in 5'-adenosine monophosphate-activated protein kinase phosphorylation and expression of genes involved in fatty acid oxidation in skeletal muscle. As a result, there was an increase in circulating metabolites of ß-oxidation and ω-oxidation, acyl-carnitines and ketone bodies. CONCLUSIONS: Change in the gut microbiota was accompanied by an improvement in insulin resistance and an increase in skeletal muscle fatty acid oxidation. Therefore, genistein could be used as a part of dietary strategies to control the abnormalities associated with obesity, particularly insulin resistance; however, long-term studies are needed.

2.
J Clin Immunol ; 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32040803

RESUMO

PURPOSE: Chronic granulomatous disease (CGD) is a primary immunodeficiency characterized by an inability of phagocytes to produce reactive oxygen species, impairing their killing of various bacteria and fungi. We summarize here the 93 cases of CGD diagnosed in Mexico from 2011 to 2019. METHODS: Thirteen Mexican hospitals participated in this study. We describe the genetic, immunological, and clinical features of the 93 CGD patients from 78 unrelated kindreds. RESULTS: Eighty-two of the patients (88%) were male. All patients developed bacterial infections and 30% suffered from some kind of fungal infection. Fifty-four BCG-vaccinated patients (58%) presented infectious complications of BCG vaccine. Tuberculosis occurred in 29%. Granulomas were found in 56% of the patients. Autoimmune and inflammatory diseases were present in 15% of patients. A biological diagnosis of CGD was made in 89/93 patients, on the basis of NBT assay (n = 6), DHR (n = 27), and NBT plus DHR (n = 56). The deficiency was complete in all patients. The median age of biological diagnosis was 17 months (range, 0-186 months). A genetic diagnosis was made in 83/93 patients (when material was available), corresponding to CYBB (n = 64), NCF1 (n = 7), NCF2 (n = 7), and CYBA (n = 5) mutations. CONCLUSIONS: The clinical manifestations in these Mexican CGD patients were similar to those in patients elsewhere. This cohort is the largest in Latin America. Mycobacterial infections are an important cause of morbidity in Mexico, as in other countries in which tuberculosis is endemic and infants are vaccinated with BCG. X-linked CGD accounted for most of the cases in Mexico, as in other Latin American countries. However, a significant number of CYBA and NCF2 mutations were identified, expanding the spectrum of known causal mutations.

3.
Metabolism ; 103: 154048, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31843339

RESUMO

OBJECTIVE: Angiotensin-(1-7) [Ang-(1-7)], a component of the renin angiotensin system, is a vasodilator that exerts its effects primarily through the Mas receptor. The discovery of the Mas receptor in white adipose tissue (WAT) suggests an additional role for this peptide. The aim of the present study was to assess whether Ang-(1-7) can induce the expression of thermogenic genes in white adipose tissue and increase mitochondrial respiration in adipocytes. MATERIALS/METHODS: Stromal Vascular fraction (SVF)-derived from mice adipose tissue was stimulated for one week with Ang-(1-7), then expression of beige markers and mitochondrial respiration were assessed. Mas+/+ and Mas-/- mice fed a control diet or a high fat-sucrose diet (HFSD) were exposed to a short or long term infusion of Ang-(1-7) and body weight, body fat, energy expenditure, cold resistance and expression of beige markers were assessed. Also, transgenic rats overexpressing Ang-(1-7) were fed with a control diet or a high fat-sucrose diet and the same parameters were assessed. Ang-(1-7) circulating levels from human subjects with different body mass index (BMI) or age were measured. RESULTS: Incubation of adipocytes derived from SVF with Ang-(1-7) increased the expression of beige markers. Infusion of Ang-(1-7) into lean and obese Mas+/+mice also induced the expression of Ucp1 and some beige markers, an effect not observed in Mas-/- mice. Mas-/- mice had increased body weight gain and decreased cold resistance, whereas rats overexpressing Ang-(1-7) showed the opposite effects. Overexpressing rats exposed to cold developed new thermogenic WAT in the anterior interscapular area. Finally, in human subjects the higher the BMI, low circulating concentration of Ang-(1-7) levels were detected. Similarly, the circulating levels of Ang-(1-7) peptide were reduced with age. CONCLUSION: These data indicate that Ang-(1-7) stimulates beige markers and thermogenesis via the Mas receptor, and this evidence suggests a potential therapeutic use to induce thermogenesis of WAT, particularly in obese subjects that have reduced circulating concentration of Ang-(1-7).

4.
J Am Heart Assoc ; 8(17): e012401, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31451009

RESUMO

Background Metabolic syndrome (MetS) is a serious health problem over the world; thus, the aim of the present work was to develop a lifestyle intervention to decrease the dysbiosis of gut microbiota and reduce the biochemical abnormalities of MetS. Methods and Results The prevalence of MetS was evaluated in 1065 subjects of Mexico City, Mexico, and the gut microbiota in a subsample. Subjects with MetS were selected for a pragmatic study based on a lifestyle intervention with a low-saturated-fat diet, reduced-energy intake, with functional foods and physical activity, and a second group was selected for a randomized control-placebo study to assess the gut microbiota after the dietary intervention. Prevalence of MetS was 53%, and the higher the body mass index, the higher the gut microbiota dysbiosis. The higher the Homeostatic Model Assessment for Insulin Resistance, the lower the high-density lipoprotein cholesterol concentration. The pragmatic study revealed that after 15 days on a low-saturated-fat diet, there was a 24% reduction in serum triglycerides; and after a 75-day lifestyle intervention, MetS was reduced by 44.8%, with a reduction in low-density lipoprotein cholesterol, small low-density lipoprotein particles, glucose intolerance, lipopolysaccharide, and branched-chain amino acid. The randomized control-placebo study showed that after the lifestyle intervention, there was a decrease in the dysbiosis of the gut microbiota associated with a reduction in the Prevotella/ Bacteroides ratio and an increase in the abundance of Akkermansia muciniphila and Faecalibacterium prausnitzii. Conclusions A lifestyle intervention significantly decreased MetS components, small low-density lipoprotein particle concentration, gut microbiota dysbiosis, and metabolic endotoxemia, reducing the risk of atherosclerosis. Clinical Trial Registration URL: https://www.clinicaltrials.gov. Unique identifier: NCT03611140.

5.
J Nutr ; 149(7): 1116-1121, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31070756

RESUMO

BACKGROUND: Dietary intervention (DI) is a primary strategy to attenuate some of the metabolic abnormalities associated with metabolic syndrome (MetS), including low HDL cholesterol. There is no biomarker that can identify individuals who respond to DI by increasing HDL cholesterol. OBJECTIVE: The aim of this study was to assess the predictive power of a genetic predisposition score (GPS) in Mexican adults with MetS to identify HDL cholesterol responders to DI. METHODS: This study followed a prospective cohort design. Sixty-seven Mexican adults aged 20-60 y (21% men) with BMI ≥25 and ≤39.9 kg/m², who had at least 3 of 5 positive criteria for MetS, were included. Participants consumed a low saturated fat diet for 2.5 mo (<7% energy as saturated fat, <200 mg of cholesterol/d) and reduced their usual diet by ∼440 kcal/d, a reduction in total energy intake of about 25%. Anthropometry and serum biochemical markers, including HDL cholesterol, were measured before and after DI. A multilocus GPS was constructed using previously reported genetic variants associated with response to diet in subjects with MetS. GPS values, designed to predict the response of HDL cholesterol to the DI, were computed for each individual as the sum of the number of effect alleles across 14 SNPs. RESULTS: Individuals were dichotomized as high and low GPS according to median GPS (-2.12) and we observed a difference in HDL cholesterol changes on DI of +3 mg/dL (6.3%) in subjects with low GPS, whereas those with high GPS had HDL cholesterol decreases of -3 mg/dL (-7.9%) (P = 0.04). CONCLUSIONS: Individuals with low GPS showed greater increases in their HDL cholesterol than those with high GPS. Therefore, the GPS can be useful for predicting the HDL cholesterol response to diet.

6.
Nutr Clin Pract ; 34(4): 589-596, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30071151

RESUMO

BACKGROUND: The use of malnutrition screening tools (MSTs) among hospitalized pediatric patients is a simple practice that may allow the identification of patients at nutrition risk. There are different tools developed in the English language, but there are limited data available on their validity when translated into other languages. The aim of this study was to construct a Spanish version (SV) of the STRONGkids MST and determine its validity and reliability in a pediatric population. METHODS: The translation and cross-cultural adaptation of the tool was performed, followed by the reliability, feasibility, and validity of the SV of the STRONGkids MST. Anthropometric assessment was used as the reference standard to evaluate the criterion validity of the MST. The length of hospital stay was used to determine predictive validity. RESULTS: A total 400 children were included in the study, 90 of whom took part in the reliability phase. The interrater agreement between dietitians and nursing staff was kappa (κ) = 0.67, while the intrarater agreement among dietitians was κ = 0.82. The feasibility of the MST was adequate for clinical use. The results for criterion validity between STRONGkids and anthropometric assessment was κ = 0.56, and the criterion validity between STRONGkids and length of hospital stay was κ = 0.20. The sensitivity of the MST was 86% and the specificity was 72%. CONCLUSIONS: The SV of the MST showed good reliability and feasibility. The validity is moderate, and the MST could be considered a useful resource for early detection of malnutrition risk.


Assuntos
Transtornos da Nutrição Infantil/diagnóstico , Programas de Rastreamento/normas , Avaliação Nutricional , Antropometria , Criança , Estudos de Viabilidade , Feminino , Humanos , Linguagem , Tempo de Internação/estatística & dados numéricos , Masculino , Programas de Rastreamento/métodos , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Espanha , Traduções
8.
Clin Nutr ; 37(6 Pt A): 2198-2205, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-29169857

RESUMO

BACKGROUND & AIMS: Accurate predictive equations of resting energy expenditure (REE) are crucial in devising nutritional strategies to manage overweight/obesity, especially in countries where these are highly prevalent. REE is the most common measurement used to estimate energy requirements in the nutritional context; the most accurate method of measuring REE is indirect calorimetry (IC). However, this method is costly and often rarely feasible in many clinical settings. The objective of the present study was to develop and validate a new equation for predicting REE in adults with overweight and obesity. METHODS: This was a cross-sectional study including 410 men and women with overweight and obesity (20-60 y). Participants were randomly assigned; the development group included 200 subjects and the validation group 210 subjects. The new predictive equation was derived using stepwise multiple linear regression analysis. The accuracy of the new equation was compared to several existing predictive equations (PEs). The accuracy rate was calculated as the percentage of subjects whose REE-PE was within ±10% of the REE-IC. REE was measured by IC and anthropometric measurements. RESULTS: One predictive equation was developed (NEQ) in which weight was the strongest predictor of REE. Compared with others predicted equations already using, the new designed equation showed the less mean bias (Kj/day): NEQ: 25.7, Valencia:129, WHO/FAO/United Nations University: 270, Mifflin-St Jeor: 308, Owen: -808, Carrasco: -1097, Korth: -36.4, Johnstone: -375, Livingstone: -315, De Lorenzo: -28.3, Lazzer: -123, Muller: -145, Huang: -399 and Bernstein: -1335. CONCLUSIONS: The present equation had the highest predictive accuracy in subjects with overweight or obesity compared with the previous equations derived from different populations. Thus, these new equation can be used to assist the nutritional management of these subjects.


Assuntos
Metabolismo Energético/fisiologia , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Adulto , Índice de Massa Corporal , Calorimetria Indireta , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Adulto Jovem
9.
Nutr. clín. diet. hosp ; 38(1): 90-96, 2018. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-175409

RESUMO

Introducción: Los pacientes diagnosticados con cáncer son susceptibles a diferentes enfermedades nutricionales, como la desnutrición, la sarcopenia y la caquexia, que tienen valores pronósticos. Objetivo: El objetivo del presente estudio es evaluar la prevalencia de alteraciones nutricionales en sujetos con cáncer. Métodos: Se realizó un estudio con diseño transversal. Pacientes adultos de ambos sexos fueron seleccionados y luego fueron sometidos a evaluaciones médicas y nutricionales en el servicio de oncología ambulatoria. Se realizó el diagnóstico nutricional, así como el diagnóstico de sarcopenia o caquexia de acuerdo a criterios internacionales. Resultados: Se incluyeron a un total de 119 sujetos, el 57,1% eran mujeres. La edad fue de 55,9 ± 14,2 años, y el índice de masa corporal (IMC) promedio fue de 25,0 ± 4,88 kg / m2. De la población total estudiada, el 25,2% tenía cáncer de mama, el 17,6% de cáncer gastrointestinal y el 16,8% de cáncer hematológico y otras neoplasias. De acuerdo a la clasificación de la OMS, el 14% de los sujetos tenían bajo peso, el 40% tenían peso normal, el 30% tenían sobrepeso y el 16% obesidad. La prevalencia de sarcopenia fue del 26,1%. Se observó que los voluntarios masculinos tenían un mayor riesgo de presentar sarcopenia [OR 13,1 (IC 95% 4,5-37,9, p <0,001)] y 47,6% de estos pacientes tenían cáncer gastrointestinal [OR 3,3 (IC 95% 1,3-8,9) p <0,05] Finalmente, el 12% de todos los sujetos fueron diagnosticados con caquexia. Conclusión: La prevalencia de malnutrición, sarcopenia y caquexia son altas en pacientes oncológicos atendidos en el servicio ambulatorio, especialmente en hombres y en aquellos diagnosticados con cáncer gastrointestinal


Introduction: Patients who are diagnosed with cancer are subjected to different nutritional maladies, such as malnutrition, sarcopenia, and cachexia that have prognostic values. Objective: The aim of the present study is to evaluate the prevalence of nutritional alterations in subjects with cancer. Methods: The study has a cross-sectional design. Adult volunteers of both sexes were recruited and then underwent medical and nutritional assessments at the ambulatory oncology service. Diagnoses of sarcopenia and cachexia were made according to international criteria. Results: A total of 119 subjects were recruited, 57.1% were women. The mean age was 55.9 ± 14.2 years, and the mean body mass index was 25.0 ± 4.88 kg/m2. Of the total population studied, 25.2% had breast cancer, 17.6% gastrointestinal cancer, and 16.8% hematologic cancer and other neoplasms. According to the WHO guidelines for body mass index, 14% of subjects were underweight, 40% had normal weight, 30% were overweight and 16% were obese. The prevalence of sarcopenia was 26.1%; we observed that male volunteers had a higher risk of presenting sarcopenia [OR 13.1 (IC 95% 4.5-37.9, p<0.001)] and 47.6% of those subjects had gastrointestinal cancer [OR 3.3 (IC 95% 1.3-8.9, p<0.05)]. Finally, 12% of all of the subjects were diagnosed with cachexia. Conclusion: The prevalence of malnutrition, sarcopenia, and cachexia are high in oncological patients treated in the ambulatory service, especially in men and in those diagnosed with gastrointestinal cancer


Assuntos
Humanos , Masculino , Feminino , Neoplasias/complicações , Desnutrição/epidemiologia , Caquexia/epidemiologia , Sarcopenia/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Atenção Terciária à Saúde/estatística & dados numéricos , Fatores de Risco , Avaliação Nutricional , Estado Nutricional , Antropometria/métodos , Estudos Transversais
10.
Nutr. clín. diet. hosp ; 38(2): 16-21, 2018. ilus, graf
Artigo em Inglês | IBECS | ID: ibc-175473

RESUMO

Cancer is one of the leading causes of morbidity and mortality worldwide according to the WHO. Strong evidence suggests that food and nutrition are important in modification of cancer process. There is increased evidence that specific dietary patterns or constituents such as n-3 PUFAs, may be associated with reduced risk of BC. Female athymic nude mice were fed since weaning to adulthood with a DHA+EPA (4%w/w) diet or with standard diet during 14-week. At week- 7, tumor cell implantation with MDA-MB-231cell line took place, each mice received 5x106 tumor cells. When tumors became palpable, maximum length, width, and diameters were measured twice a week. Incidence of tumor development was observed in all mice (n=4, 100%) in the control diet group; instead, the n-3 PUFAs diet group, only two mice developed tumor (n=2, 50%), and the development time was longer compared to the control group. These differences were significant (p < 0.001). This study establish the potential effect as a preventive measure to BC. This evidence is consentient with epidemiological data about high n-3 PUFAs diet patterns in some populations may lower risk of BC, highlighting the importance of these components in our diet since childhood to promote the preventive effect. Being thus necessary, setting up recommendations for n-3 PUFAs supplementation from fish oil or, for a minimal dietary fatty fish intake/week, in order to attempt modulate carcinogenesis in populations at high risk, particularly those with a high prevalence of obesity


El cáncer es una de las principales causas de morbilidad y mortalidad en todo el mundo según la OMS. Una fuerte evidencia sugiere que la alimentación y la nutrición son importantes en la modificación de proceso de cáncer. Existe una alta evidencia de que patrones dietéticos específicos constituidos por AGPI n-3, pueden estar asociados con riesgo reducido de BC. Ratones atímicos desnudos femeninos fueron alimentados desde el destete hasta la etapa adulta con una dieta con DHA + EPA (4% p / p) o con una dieta estándar durante 14 semanas. En la semana 7, tuvo lugar la implantación de células tumorales de la línea celular MDA-MB-231 y cada ratón recibió 5x106 células tumorales. Cuando los tumores se hicieron palpables, y de longitud, ancho y diámetros máximos, se midieron dos veces por semana. La incidencia del desarrollo tumoral se observó en todos los ratones (n = 4, 100%) en el grupo de la dieta control ; en cambio, en el grupo de dieta de AGPI n-3, solo dos ratones desarrollaron un tumor (n = 2, 50%), y el tiempo de desarrollo fue más largo en comparación con el grupo de control. Estas diferencias fueron significativas (p <0.001). Este estudio establece el efecto potencial como una medida preventiva para BC. Esta evidencia se corrobora con datos epidemiológicos sobre patrones dietéticos altos en AGPI n-3 que en algunas poblaciones puede disminuir el riesgo de BC, destacando la importancia de estos componentes en nuestra dieta desde la infancia para promover el efecto preventivo. Siendo así necesario, establecer recomendaciones para la suplementación con AGPI n-3 del aceite de pescado o, para una ingesta dietética mínima de pescado / semana para intentar modular la carcinogénesis en poblaciones de alto riesgo, particularmente aquellos con una alta prevalencia de obesidad


Assuntos
Animais , Ratos , Ácidos Graxos Insaturados/administração & dosagem , Ácidos Graxos Ômega-3/administração & dosagem , Alimentos Fortificados , Carga Tumoral , Neoplasias da Mama/patologia , Ácido Eicosapentaenoico/farmacocinética , Ácidos Docosa-Hexaenoicos/farmacocinética , Modelos Animais de Doenças , Proliferação de Células , Fatores de Risco , Fatores de Proteção , Estudos de Casos e Controles
11.
Front Biosci (Landmark Ed) ; 22: 1655-1681, 2017 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-28410138

RESUMO

Overweight and obesity are highly prevalent conditions worldwide, linked to an increased risk for death, disability and disease due to metabolic and biochemical abnormalities affecting the biological human system throughout different domains. Biomarkers, defined as indicators of biological processes in health and disease, relevant for body mass excess management have been identified according to different criteria, including anthropometric and molecular indexes, as well as physiological and behavioural aspects. Analysing these different biomarkers, we identified their potential role in diagnosis, prognosis and treatment. Epigenetic biomarkers, cellular mediators of inflammation and factors related to microbiota-host interactions may be considered to have a theranostic value. Though, the molecular processes responsible for the biological phenomenology detected by the other analysed markers, is not clear yet. Nevertheless, these biomarkers possess valuable diagnostic and prognostic power. A new frontier for theranostic biomarkers can be foreseen in the exploitation of parameters defining behaviours and lifestyles linked to the risk of obesity, capable to describe the effects of interventions for obesity prevention and treatment which include also behaviour change strategies.


Assuntos
Biomarcadores/metabolismo , Epigenômica/métodos , Obesidade/genética , Obesidade/metabolismo , Epigênese Genética , Microbioma Gastrointestinal/fisiologia , Regulação da Expressão Gênica , Humanos , Estilo de Vida , MicroRNAs/genética , Músculo Esquelético/fisiologia
12.
Obesity (Silver Spring) ; 24(7): 1454-63, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27221771

RESUMO

OBJECTIVE: To evaluate the efficacy of an orlistat-resveratrol (O-R) combination in subjects with obesity over a 6-month period. METHODS: This study was a double-blind, parallel, randomized controlled clinical trial. Patients fulfilling the selection criteria (age from 20 to 60 years and body mass index (BMI) ≥30 and ≤39.9 kg/m(2) ) consumed an energy-reduced diet with 500 fewer calories than their usual diet for 2 weeks. Then the participants were randomly assigned to four groups, placebo, resveratrol, orlistat, or O-R, and they consumed the energy-reduced diet for 6 months. The study consisted of seven visits. During each visit, a 24-h recall was performed, along with measurements of anthropometric and serum biochemical parameters. RESULTS: A total of 161 participants were selected. Of these, 84 participants completed the study. A significant weight loss of -6.82 kg (95% CI -8.37 to -5.26) was observed in the O-R group compared with -3.50 kg (-5.05 to -1.95, P = 0.021) in the placebo group. In contrast, the -6.02 kg (-7.68 to -4.36) orlistat and -4.68 kg (-6.64 to -2.71) resveratrol monotherapy losses did not significantly differ from the placebo. Significant decreases in BMI, waist circumference, fat mass, triglycerides, leptin, and leptin/adiponectin ratio were observed with the O-R combination. CONCLUSIONS: The O-R combination was the most effective weight loss treatment.


Assuntos
Fármacos Antiobesidade/uso terapêutico , Lactonas/administração & dosagem , Obesidade/tratamento farmacológico , Estilbenos/administração & dosagem , Perda de Peso , Adulto , Idoso , Antropometria , Índice de Massa Corporal , Restrição Calórica , Dieta , Método Duplo-Cego , Quimioterapia Combinada , Ingestão de Energia/efeitos dos fármacos , Feminino , Humanos , Lactonas/uso terapêutico , Leptina/sangue , Masculino , México , Pessoa de Meia-Idade , Obesidade/sangue , Orlistate , Placebos , Resveratrol , Estilbenos/uso terapêutico , Resultado do Tratamento , Triglicerídeos/sangue
13.
Nutr Hosp ; 32(5): 2105-10, 2015 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-26545666

RESUMO

BACKGROUND: currently, there is an increase in the incidence of obesity in the pediatric population, which is associated with an increase in metabolic syndrome (MetS). Thus, an early diagnosis of MetS is needed in this population to improve the prevention of cardiovascular disease and type 2 diabetes in adulthood. OBJECTIVE: the aim of this study was to explore the ability of health professionals to identify the main criteria for MetS in children, which is required for establishing the conditions for early diagnosis and timely treatment. METHODS: a cross-sectional study was conducted using a survey and conducted in two states of the republic (Aguascalientes and Hidalgo) and in the Federal District from January to December 2014. RESULTS: the questionnaire was applied to 274 health professionals. Most of these professionals (61.7%) reported knowledge of the criteria for MetS diagnosis in children and adolescents. Additionally, it was observed that 63.1% of professionals did not perform the needed measurements the waist of circumference in preschool children and that 46.4% did not measure them in school children. However, 64.6% of professionals performed the measurements in adolescents. CONCLUSIONS: this study found that health professionals providing care to pediatric patients do not know the parameters and cutoff points for MetS diagnosis. They do not conduct a deliberate search for MetS risk factors, which is a major limitation for diagnosis and early treatment. Therefore, we suggest a systematic approach for maintaining the standards of health professionals and to make determining the criteria for proper diagnosis of MetS a target of clinical practice.


Assuntos
Síndrome Metabólica/diagnóstico , Recursos Humanos em Hospital , Adolescente , Criança , Pré-Escolar , Competência Clínica , Estudos Transversais , Diagnóstico Precoce , Feminino , Pesquisas sobre Serviços de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , México , Enfermeiras e Enfermeiros , Médicos , Fatores de Risco , Inquéritos e Questionários
14.
Nutr. hosp ; 32(5): 2105-2110, nov. 2015. tab, graf
Artigo em Inglês | IBECS | ID: ibc-145537

RESUMO

Background: currently, there is an increase in the incidence of obesity in the pediatric population, which is associated with an increase in metabolic syndrome (MetS). Thus, an early diagnosis of MetS is needed in this population to improve the prevention of cardiovascular disease and type 2 diabetes in adulthood. Objective: the aim of this study was to explore the ability of health professionals to identify the main criteria for MetS in children, which is required for establishing the conditions for early diagnosis and timely treatment. Methods: a cross-sectional study was conducted using a survey and conducted in two states of the republic (Aguascalientes and Hidalgo) and in the Federal District from January to December 2014. Results: the questionnaire was applied to 274 health professionals. Most of these professionals (61.7%) reported knowledge of the criteria for MetS diagnosis in children and adolescents. Additionally, it was observed that 63.1% of professionals did not perform the needed measurements the waist of circumference in preschool children and that 46.4% did not measure them in school children. However, 64.6% of professionals performed the measurements in adolescents. Conclusions: this study found that health professionals providing care to pediatric patients do not know the parameters and cutoff points for MetS diagnosis. They do not conduct a deliberate search for MetS risk factors, which is a major limitation for diagnosis and early treatment. Therefore, we suggest a systematic approach for maintaining the standards of health professionals and to make determining the criteria for proper diagnosis of MetS a target of clinical practice (AU)


Introducción: actualmente se ha producido un aumento en la incidencia de obesidad en la población pediátrica, y con ello un incremento del Síndrome Metabólico (SM) por lo que es necesario realizar un diagnóstico oportuno del SM en esta población, así se propiciará la prevención de la enfermedad cardiovascular y la diabetes tipo 2 en la edad adulta. Objetivo: explorar la capacidad de los profesionales de la salud para identificar los principales criterios de SM en niños, requisito para poder establecer las condiciones para el diagnóstico temprano y su tratamiento oportuno. Material y métodos: se realizó un estudio transversal de investigación a través de una encuesta para identificar el conocimiento y la capacidad técnica de los profesionales de la salud en la atención y detección de niños y adolescentes con SM. Se llevó a cabo en dos Estados de la República (Aguascalientes e Hidalgo) y en el Distrito Federal en los meses de enero a diciembre de 2014. Resultados: el cuestionario se aplicó a 274 profesionales de la salud dentro de los cuales se encontraban licenciados en nutrición, médicos generalistas, médicos pediatras, licenciados en enfermería y licenciados en enfermería con especialidad pediátrica. El 61,7% de los encuestados refirieron conocer los criterios de diagnóstico de SM en esta población, sin embargo solo el 32,8% contestó de manera correcta a estos. Por otro lado se observó que el 63,1% del total de los profesionales no miden la circunferencia de cintura en preescolares y el 46,4% en escolares; no obstante, el 64,6% sí realiza esta medición en adolescentes. Por otro lado, el 72,6% de los encuestados no mide la presión arterial en edad preescolar y el 64,6% en edad escolar; sin embargo, el 52,2% sí la mide en adolescentes. Conclusión: en el estudio observamos que los profesionales de la salud que dan atención a los pacientes pediátricos no conocen los parámetros y puntos de corte para diagnosticar el SM; no realizan una búsqueda intencionada de esos factores de riesgo y, por lo tanto, esto se considera una gran limitación para realizar el diagnóstico y tratamiento temprano. Por lo que sugerimos un acercamiento sistemático para mantener los estándares de los profesionales de la salud y establecer como objetivo de la práctica el determinar los criterios de SM para realizar el diagnóstico adecuadamente (AU)


Assuntos
Criança , Humanos , Síndrome Metabólica/diagnóstico , Programas de Nutrição/organização & administração , Vigilância Nutricional , Avaliação Nutricional , Qualidade da Assistência à Saúde/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Competência Profissional/estatística & dados numéricos
15.
Arch Med Res ; 46(5): 408-26, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26031780

RESUMO

Cardiovascular disease (CVD) is a universal problem in modern society. Atherosclerosis is the leading cause of CVD resulting in high rate of mortality in the population. Nutrition science has focused on the role of essential nutrients in preventing deficiencies, at the present time, the nutritional strategies are crucial to promote health and intervene with these global noncommunicable diseases. In many cases, diet is a major driving force, which is much easier to change and follow than other factors. It is important to establish that the first strategy to treat atherosclerosis is to modify lifestyle habits, focusing on the beneficial properties of specific nutrients. In the last decades, epidemiological, clinical and experimental studies have demonstrated that diet plays a central role in the prevention of atherosclerosis. In this review we will focus on the effect of specific foods, nutrients and bioactive compounds, including epidemiological facts, potential mechanisms of action and dietary recommendations to reduce the risk of atherosclerosis. In particular, we include information about fiber, plant sterols and stanols, niacin, taurine, olive oil, omega 3 fatty acids, antioxidants, minerals, methyl nutrients and soy. In addition, we also show that dysbiosis of the intestinal microbiota associated with a consumption of certain animal food sources can generate some metabolites that are involved in the development of atherosclerosis and its consequences on CVD. According to the epidemiological, clinical and experimental studies we suggest a recommendation for some dietary foods, nutrients and bioactive compounds to support the complementary clinical management of patients with atherosclerosis.


Assuntos
Aterosclerose/epidemiologia , Dieta , Animais , Antioxidantes/uso terapêutico , Aterosclerose/etiologia , Aterosclerose/prevenção & controle , Aterosclerose/terapia , Dieta Mediterrânea , Alimentos , Humanos , Estado Nutricional
16.
Nutr. hosp ; 31(2): 552-558, feb. 2015. tab, graf
Artigo em Inglês | IBECS | ID: ibc-133440

RESUMO

Background: The early introduction of food is consistent with a significant increase in the prevalence of overweight and obesity, particularly in children, partly because of the resulting changes in feeding patterns. The purpose of this study was to describe the complementary feeding practices of Mexican children younger than two years of age. Methods: Medline, Lilacs and manual methods were used to search for studies that assessed feeding practices in children younger than two years of age in Mexico. The following terms were used: complementary feeding, supplementary feeding, Mexico and weaning. Data on complementary feeding practices, including the age of nitiation, the type of foods eaten, the frequency of food intake and the reasons for starting complementary feeding, were collected. The information gathered was subjected to qualitative analysis, and the data are presented as proportions in the tables. Results: The seven studies included in this evaluation revealed that children were introduced to complementary feeding before the age of 6 months. Although fruits were the foods most commonly provided when complementary feeding began, processed juices, soft drinks and fried snacks were also offered. The intake of these products increased as the children grew older and coincided with a low intake of foods containing high-biological value protein, particularly red meats. Conclusions: The results of the included studies showed that during complementary feeding, infants receive high-energy density foods, whereas the intake of foods that provide animal protein and iron in particular is low. In addition, common conditions associated with complementary feeding include overweight, obesity, malnutrition, and anemia, which may contribute to health problems (AU)


Antecedentes: El inicio de la alimentación complementaria temprana coincide con un aumento significativo en la prevalencia de sobrepeso y obesidad especialmente en los niños, lo cual se debe entre otras causas a los cambios en los patrones de alimentación que se han experimentado. El objetivo del estudio fue describir las prácticas de alimentación complementaria en niños mexicanos. Métodos: Se realizó una búsqueda de los estudios que evaluaron las prácticas alimentarias en menores de 2 años en México en Medline, Lilacs y de forma manual con los siguientes términos: alimentación complementaria, alimentación suplementaria, México, ablactación y destete. Se recabó la edad de inicio de la alimentación complementaria, tipo de alimento consumido, frecuencia de consumo de los alimentos y motivo por el que iniciaban la alimentación complementaria. Se realizó un análisis cualitativo de la información recolectada y los datos en las gráficas son mostrados como proporciones. Resultados: Se incluyeron 7 estudios que mostraron que los niños inician la alimentación complementaria antes de los 6 meses predominantemente con frutas, aunque también consumieron jugos industrializados, refrescos y frituras. El consumo de estos productos aumenta con el crecimiento de los niños, aunado a un bajo consumo de alimentos con proteína de alto valor biológico, especialmente las carnes rojas. Conclusiones: Los resultados de los estudios incluidos mostraron que los menores reciben alimentos con alta densidad energética, mientras que es bajo el consumo de aquellos que aportan proteína animal y hierro en particular, lo que puede contribuir a problemas de salud como sobrepeso, obesidad, desnutrición y anemia (AU)


Assuntos
Humanos , Pré-Escolar , Lactente , Comportamento Alimentar , Obesidade Pediátrica/complicações , Desnutrição/epidemiologia , México , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Proteínas na Dieta , Fenômenos Fisiológicos da Nutrição do Lactente
17.
Nutr Hosp ; 30(4): 749-55, 2014 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-25335657

RESUMO

BACKGROUND: The prevalence of overweight and obesity in Mexico is approximately 70%; thus, obtaining a reliable measurement of the resting energy expenditure (REE) in these patients is of extreme importance. The aim of the study was to obtain a prediction equation of REE in overweight or obese outpatients in the Mexican population. METHODS: The study was conducted at The National Institute for Medical Sciences and Nutrition Salvador Zubiran (Mexico, D.F.). Consecutive outpatients (18-70 years old) at the Clinical Nutrition were evaluated between March 2010 and August 2012 after being diagnosed with overweight or obesity (body mass index [BMI] ≥ 25 kg/m2). Patients with any disease that could affect the measurement of gas exchange were excluded. Participants were evaluated by indirect calorimetry (IC), bioelectrical impedance analysis (BIA) and anthropometric measurements to design the REE prediction equation. Two groups were evaluated: one group for derivation and another group for validation. The REE was also estimated using the equations of Harris-Benedict, Mifflin St-Jeor, Ireton-Jones, Carrasco, Kleiber and Owen, assessing current weight, ideal weight and adjusted weight. A REE equation was obtained by multiple linear regression based on the evaluated variables, and those that gave the best precision to the model were selected. The real REE and the estimated REE were then compared using Student's t-test. To highlight differences, pairs of measurements were further analyzed using the Bland & Altman plot. Pearson correlation coefficients and coefficients of determination between REE values measured by IC and REE values estimated using various formulas were calculated. RESULTS: A total of 77 patients were included in the derivation group: 38 men (49.4%) and 39 women (50.6%). The mean age was 48.5 ± 13.9 years, and the mean BMI was 34.7 ± 5.7 kg/m2. A total of 50 participants were included in the validation group: 16 men (32%) and 34 women (68%). The mean age was 48.5 ± 15.5 years, and the mean BMI was 34.2 ± 5.2 kg/m2. The baseline characteristics of both groups were homogeneous. IC reported an average of 2001 ± 552 kcal, with a respiratory quotient (RQ) of 0.75 ± 0.04. The new REE equation that resulted from the statistical model had an R2 = 0.52 and a bias of ± 3.39 kcal. When the REE obtained from IC was compared with the REE estimated by the new formula, there was no significant difference between the results, and the correlation for all participants was 0.71 (p. <0.0001). When the equations were analyzed using the Bland-Altman method, the difference between the new formula and the REE measurement by IC was a bias of 3.39 ± 384 kcal.Furthermore, a correlation was obtained between the real and estimated REE values using different equations; the most accurate correlation with the new formula was Owen's formula (r=0.712). CONCLUSION: The new formula had an acceptable correlation with IC REE measurement in overweight and obese patients in the Mexican population. This equation may represent a useful tool for health care professionals who do not have access to IC equipment for the estimation of REE.


Assuntos
Metabolismo Energético , Obesidade/metabolismo , Sobrepeso/metabolismo , Adolescente , Adulto , Idoso , Feminino , Previsões , Humanos , Masculino , Conceitos Matemáticos , México , Pessoa de Meia-Idade , Adulto Jovem
18.
Nutr. hosp ; 30(4): 749-755, oct. 2014. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-134900

RESUMO

Background: The prevalence of overweight and obesity in Mexico is approximately 70%; thus, obtaining a reliable measurement of the resting energy expenditure (REE) in these patients is of extreme importance. The aim of the study was to obtain a prediction equation of REE in overweight or obese outpatients in the Mexican population. Methods: The study was conducted at The National Institute for Medical Sciences and Nutrition Salvador Zubirán (Mexico, D.F.). Consecutive outpatients (18-70 years old) at the Clinical Nutrition were evaluated between March 2010 and August 2012 after being diagnosed with overweight or obesity (body mass index [BMI] ≥ 25 kg/m2). Patients with any disease that could affect the measurement of gas exchange were excluded. Participants were evaluated by indirect calorimetry (IC), bioelectrical impedance analysis (BIA) and anthropometric measurements to design the REE prediction equation. Two groups were evaluated: one group for derivation and another group for validation. The REE was also estimated using the equations of Harris-Benedict, Mifflin St-Jeor, Ireton-Jones, Carrasco, Kleiber and Owen, assessing current weight, ideal weight and adjusted weight. A REE equation was obtained by multiple linear regression based on the evaluated variables, and those that gave the best precision to the model were selected. The real REE and the estimated REE were then compared using Student’s t-test. To highlight differences, pairs of measurements were further analyzed using the Bland & Altman plot. Pearson correlation coefficients and coefficients of determination between REE values measured by IC and REE values estimated using various formulas were calculated. Results: A total of 77 patients were included in the derivation group: 38 men (49.4%) and 39 women (50.6%). The mean age was 48.5 ± 13.9 years, and the mean BMI was 34.7 ± 5.7 kg/m2. A total of 50 participants were included in the validation group: 16 men (32%) and 34 women (68%). The mean age was 48.5 ± 15.5 years, and the mean BMI was 34.2 ± 5.2 kg/m2. The baseline characteristics of both groups were homogeneous. IC reported an average of 2001 ± 552 kcal, with a respiratory quotient (RQ) of 0.75 ± 0.04. The new REE equation that resulted from the statistical model had an R2 = 0.52 and a bias of ± 3.39 kcal. When the REE obtained from IC was compared with the REE estimated by the new formula, there was no significant difference between the results, and the correlation for all participants was 0.71 (p <0.0001). When the equations were analyzed using the Bland-Altman method, the difference between the new formula and the REE measurement by IC was a bias of 3.39 ± 384 kcal. Furthermore, a correlation was obtained between the real and estimated REE values using different equations; the most accurate correlation with the new formula was Owen’s formula (r=0.712). Conclusion: The new formula had an acceptable correlation with IC REE measurement in overweight and obese patients in the Mexican population. This equation may represent a useful tool for health care professionals who do not have access to IC equipment for the estimation of REE (AU)


Antecedentes: La prevalencia de sobrepeso y obesidad en México se sitúa aproximadamente en el 70%; así, la obtención de una medición fiable del gasto energético en reposo (GER) en estos pacientes tiene una importancia crucial. El objetivo del estudio consistió en obtener una ecuación de predicción de GER en pacientes ambulatorios con sobrepeso u obesidad en la población mexicana. Métodos: El estudio fue realizado en el Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (México, D.F.). Se evaluó a pacientes ambulatorios consecutivos (18-70 años) en el servicio de Nutriología Clínica entre marzo de 2010 y agosto 2012 tras un diagnóstico de sobrepeso u obesidad (índice de masa corporal [IMC] ≥ 25 kg/ m2). Los pacientes con cualquier enfermedad que pudiera afectar la medición de intercambio de gases fueron excluidos. Los participantes fueron evaluados mediante calorimetría indirecta (CI), análisis de impedancia bioeléctrica (AIB) y mediciones antropométricas para diseñar la ecuación de predicción de GER. Fueron evaluados dos grupos: un grupo para diseño y otro para validación. El GER también fue calculado empleando las ecuaciones de Harris-Benedict, Mifflin St-Jeor, Ireton-Jones, Carrasco, Kleiber y Owen, calculando el peso actual, el peso ideal y un peso ajustado. Se obtuvo una ecuación GER mediante regresión lineal múltiple basada en las variables evaluadas, y fueron seleccionadas aquellas que aportaron la mayor precisión al modelo. Luego se compararon el GER real y el GER estimado, utilizando la prueba de t de student. Para destacar las diferencias entre pares de mediciones se utilizo el método de Bland & Altman. Se calcularon los coeficientes de correlación de Pearson y los coeficientes de determinación entre valores GER medidos mediante valores de CI y GER con diversas fórmulas. Resultados: Un total de 77 pacientes fueron incluidos en el grupo de diseño: 38 hombres (49.4%) y 39 mujeres (50.6%). La edad media fue 48.5 ± 13.9 años, y el IMC medio fue 34.7 ± 5.7 kg/m2. Un total de 50 participantes fueron incluidos en el grupo de validación: 16 hombres (32%) y 34 mujeres (68%). La edad media fue 48.5 ± 15.5 años, y el IMC medio fue 34.2 ± 5.2 kg/m2. Las características iniciales de ambos grupos eran homogéneas. La CI indicó una media de 2001 ± 552 kcal, con un cociente respiratorio (CR) de 0.75 ± 0.04. La nueva ecuación de GER resultante del modelo estadístico presentó un R2 = 0.52 y una desviación de ± 3.39 kcal. Al comparar el GER obtenido de CI con el GER calculado mediante la nueva fórmula, no se apreció diferencia significativa entre los resultados, y la correlación para todos los participantes fue 0.71 (p <0.0001). Al comparar las ecuaciones usando el método Bland-Altman, la diferencia entre la nueva fórmula y la medición GER mediante CI mostró una desviación de 3.39 ± 384 kcal. Además, se obtuvo una correlación entre los valores reales y calculados de GER usando diferentes ecuaciones; la correlación más precisa con la nueva fórmula fue la fórmula de Owen (r = 0.712). Conclusión: La nueva fórmula tuvo una correlación aceptable con medición CI de GER en pacientes con sobrepeso y obesidad en la población mexicana. Esta ecuación podría suponer una útil herramienta para los profesionales de la salud que no tienen acceso a equipos de CI para el cálculo del GER (AU)


Assuntos
Humanos , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Metabolismo Energético/fisiologia , Calorimetria Indireta/métodos , Descanso/fisiologia , Previsões/métodos
19.
Nutr Hosp ; 30(3): 671-7, 2014 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-25238846

RESUMO

Dyslipidemia is a major public health problem, and therefore, it is important to develop dietary strategies to diminish the prevalence of this disorder. It was recently reported that diet may play an important role in triggering insulin resistance by interacting with genetic variants at the CAPN10 gene locus in patients with metabolic syndrome. Nonetheless, it remains unknown whether genetic variants of genes involved in the development of type 2 diabetes are associated with variations in high-density lipoprotein cholesterol (HDL-C). The study used a single-center, prospective, cohort design. Here, we assessed the effect of four variants of the CAPN10 gene on HDL-C levels in response to a soy protein and soluble fiber dietary portfolio in subjects with dyslipidemia. In 31 Mexican dyslipidemic individuals, we analyzed four CAPN10 gene variants (rs5030952, rs2975762, rs3792267, and rs2975760) associated with type 2 diabetes. Subjects with the GG genotype of the rs2975762 variant of the CAPN10 gene were better responders to dietary intervention, showing increased HDL-C concentrations from the first month of treatment. HDL-C concentrations in participants with the wild type genotype increased by 17.0%, whereas the HDL-C concentration in subjects with the variant genotypes increased by only 3.22% (p = 0.03); the low-density lipoprotein cholesterol levels of GG carriers tended to decrease (-12.6%). These results indicate that Mexican dyslipidemic carriers of the rs2975762-GG genotype are better responders to this dietary intervention.


Assuntos
Calpaína/genética , HDL-Colesterol/sangue , Fibras na Dieta , Dislipidemias/sangue , Dislipidemias/genética , Variação Genética , Proteínas de Soja , Adulto , Diabetes Mellitus Tipo 2 , Dislipidemias/dietoterapia , Feminino , Genótipo , Humanos , Masculino , México , Estudos Prospectivos
20.
Genes Nutr ; 9(6): 431, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25260659

RESUMO

Obesity is a complex disorder caused by several factors. Thus, the aim of the present study was to assess whether the expression of genes in the omental white adipose tissue (AT) of subjects with insulin resistance (IR) or metabolic syndrome (MetS) is associated with an elevation in serum branched-chain amino acids (BCAAs) and whether this response depends on specific genetic variants. Serum BCAA concentration, the adipocyte area, and gene variants of PPARγ, ABCA1, FTO, TCF7L2, GFOD2, BCAT2, and BCKDH were determined in 115 Mexican subjects. The gene expression in the AT and adipocytes of BCAT, BCKDH E1α, C/EBPα, PPARγ2, SREBP-1, PPARα, UCP1, leptin receptor, leptin, adiponectin, and TNFα was measured in 51 subjects. Subjects with IR showed higher values for the BMI, HOMA-IR, and adipocyte area and higher levels of serum glucose, insulin, leptin, and C-reactive protein, as well as an elevation of the AT gene expression of SREBP-1, leptin, and TNFα and a significant reduction in the expression of adiponectin, BCAT2, and BCKDH E1α, compared with non-IR subjects. The presence of MetS was associated with higher HOMA-IR as well as higher serum BCAA concentrations. Subjects with the genetic variants for BCAT2 and BCKDH E1 α showed a lower serum BCAA concentration, and those with the ABCA1 and FTO gene variant showed higher levels of insulin and HOMA-IR than non-IR subjects. AT dysfunction is the result of a combination of the presence of some genetic variants, altered AT gene expression, the presence of MetS risk factors, IR, and serum BCAA concentrations.

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