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1.
Nutr Neurosci ; : 1-15, 2025 Jan 02.
Artigo em Inglês | MEDLINE | ID: mdl-39745496

RESUMO

OBJECTIVES: Maternal protein malnutrition alters brain functioning, impairing fetal development. Physical exercise during gestation benefits the fetal organism from maternal adaptive changes that may be neuroprotective. This study evaluated the effect of a low-protein diet associated with maternal voluntary physical activity (VPA) on rats' behavioral and brain electrophysiological parameters in the mother-pup dyad. METHODS: Female Wistar rats (n = 40) performed VPA on running wheels during a 30-day pre-mating period. Daily running distance, activity duration, and caloric expenditure enabled us to classify the dams as sedentary or exercised. During pregnancy, half of the mothers were fed a low-protein diet (8% protein from casein), and the other half was fed a standard diet with 17% protein from casein. After lactation, when the mothers reached 150-160 days and the pups aged 30-35, animals were tested to evaluate anxiety-like behaviors in the open field and the elevated plus maze, and assess object recognition memory in the open field apparatus. At 160-170 days of life (mothers) and 35-45 days (pups), the animals were subjected to a recording session of the excitability-related phenomenon known as cortical spreading depression (CSD). RESULTS: In the mother-pup dyad, malnutrition accelerated CSD, increased anxiety-like behavior, and impaired memory, whereas VPA produced the opposite effects. The greater impact of exercise was observed among the malnourished animals. DISCUSSION: Our results provide important evidence about the beneficial modulating role of perinatal VPA (before, during and up to 14 days after pregnancy) in reprograming the effects of protein malnutrition on the central nervous system.

2.
J Pediatr ; 276: 114288, 2025 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-39233117

RESUMO

OBJECTIVE: To evaluate predictive validity of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition Indicators to diagnose pediatric malnutrition (AAIMp) and the Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) in regard to pediatric patient outcomes in US hospitals. STUDY DESIGN: A prospective cohort study (Clinical Trial Registry: NCT03928548) was completed from August 2019 through January 2023 with 27 pediatric hospitals or units from 18 US states and Washington DC. RESULTS: Three hundred and forty-five children were enrolled in the cohort (n = 188 in the AAIMp validation subgroup). There were no significant differences in the incidence of emergency department visits and hospital readmissions, hospital length of stay (LOS), or health care resource utilization for children diagnosed with mild, moderate, or severe malnutrition using the AAIMp tool compared with children with no malnutrition diagnosis. The STRONGkids tool significantly predicted more emergency department visits and hospital readmissions for children at moderate and high malnutrition risk (moderate risk - incidence rate ratio 1.65, 95% CI: 1.09, 2.49, P = .018; high risk - incidence rate ratio 1.64, 95% CI: 1.05, 2.56, P = .028) and longer LOS (43.8% longer LOS, 95% CI: 5.2%, 96.6%, P = .023) for children at high risk compared with children at low risk after adjusting for patient characteristics. CONCLUSIONS: Malnutrition risk based on the STRONGkids tool predicted poor medical outcomes in hospitalized US children; the same relationship was not observed for a malnutrition diagnosis based on the AAIMp tool.


Assuntos
Avaliação Nutricional , Estado Nutricional , Humanos , Feminino , Masculino , Pré-Escolar , Estudos Prospectivos , Criança , Lactente , Estados Unidos , Criança Hospitalizada/estatística & dados numéricos , Tempo de Internação/estatística & dados numéricos , Transtornos da Nutrição Infantil/diagnóstico , Transtornos da Nutrição Infantil/epidemiologia , Readmissão do Paciente/estatística & dados numéricos , Medição de Risco , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Hospitalização/estatística & dados numéricos , Reprodutibilidade dos Testes , Valor Preditivo dos Testes
3.
Heliyon ; 10(23): e40362, 2024 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-39660206

RESUMO

Food insecurity, pollution, and malnutrition are some critical issues tackled by the modern world in the recent era. However, edible mushrooms are nutritionally, economically, and biotechnologically valuable groups of macro fungi. Besides being an essential source of edible food, it is also exploited in pharmacological industries as a potential source of anticancer, antioxidant and immunomodulating agents. Mushrooms are not only a rich nutritional source of functional food all over the world, but also have highly significant bioactive compounds that are considered nutraceuticals, cosmeceuticals, and mycotherapeutics across the globe. However, their cultivation is very low compared to their demand. Its cultivation consents the sustainable management of agro-industrial waste and generates decent income using low inputs. Additionally, the mushroom could also be used for the recirculation of forest waste by acting as a natural decomposer that in turn creates great opportunities for the development of economically miserable developing countries, like Pakistan. Mushroom farming is one of the promising approaches to explore such unwanted agro-waste materials from the environment and ensure food security. Mushroom farming is one of the cheapest sources to overcome the deficiency caused by malnutrition. Interestingly, it supports the local economy by offering more and more livelihood opportunities and significant income sources for local and national trade. The current review article emphasizes the prompt mushroom farming industries in Pakistan that can save lives by providing cheaper nutritional food and rich income sources.

4.
Clin Nutr ESPEN ; 2024 Dec 19.
Artigo em Inglês | MEDLINE | ID: mdl-39709095

RESUMO

BACKGROUND: Child overweight and obesity is associated with an increased risk of non-communicable diseases. The present work aimed to explain the global trends of overweight in children under 5 years during the last two decades in comparison to the global nutrition targets. METHODS: We analysed secondary data from the Global Nutrition Report 2020 report for the years 2000 to 2020 from 194 countries, distributed in 23 sub-regions to examine the changes in prevalence and trends of overweight and obesity in children under five years of age. We also analysed the number of countries with applied national policies on overweight and obesity and their progress against the global nutrition targets. RESULTS: The analysis from 194 countries showed that children under five years constituted 8% of the world population. In the last 20 years, the global prevalence of childhood overweight and obesity has risen from 5.4% to 5.7% since 2000 to 2022. North and South Africa, West, and East Asia, North and South America, Eastern and Northern Europe, Polynesia, Micronesia, Australia, and New Zealand are the subregions with the highest prevalence of overweight and obesity. Furthermore, regions with the highest number of children affected include Asia with more than 18 million (48%) and Africa with more than 10 million (27%). More than half of the countries for which data were available had not reached the global nutrition target for childhood overweight by 2020. CONCLUSION: The prevalence of childhood overweight in most of the regions of the world has been steadily increasing during the last two decades. Our findings indicate that if public health measures are not implemented, 2025 World Health Organization´s global nutrition targets and 2020 Sustainable Development Goals will not be reached.

5.
Public Health Chall ; 3(2)2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-39678003

RESUMO

Background: Malnutrition is prevalent throughout southwest Guatemala, where >40% of children suffer from chronic undernutrition. Evidence supports that assessing a community's awareness and readiness to address malnutrition is a critical first step in improving the success of a nutrition intervention program. The objective of this study was to apply the community readiness model (CRM) to assess community readiness to address childhood malnutrition in a rural southwest region of Guatemala. Methods: Thirteen key respondents of varied social roles and demographics residing in the region were interviewed. Interview questions related to addressing malnutrition were from the following predefined dimensions: Community Efforts, Community Knowledge of Efforts, Leadership, Community Climate, Community Knowledge, and Resources for Efforts. Interview recordings and notes were analyzed and scored according to the CRM guidelines, and a standardized analysis was conducted. Results: The overall community readiness score was 4.26 (preplanning: awareness of the issue). Community Efforts had a total score of 5 (Preparation: preparing to take action on the issue). Community Knowledge of Efforts, Community Climate, Community Knowledge, and Resources for Efforts Dimensions each had a total score of 4 (Preplanning: awareness of the issue). The overall score for the Leadership dimension was 2 (Denial/resistance: belief that the problem does not exist within the community). These scores demonstrate clear recognition for action to address childhood malnutrition as a problem. However, efforts to combat childhood malnutrition are not yet focused nor detailed for community action. Conclusions: This rural southwest region of Guatemala recognizes that childhood malnutrition is a problem. However, efforts to address malnutrition are not yet focused or detailed enough to have measurable impact in addressing this issue. For the region to advance the stage of community readiness, it is essential to enhance knowledge of dietary strategies aimed at improving nutrition for children and increase engagement from local leadership.

6.
BMC Glob Public Health ; 2(1): 15, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-39681951

RESUMO

BACKGROUND: Peru is facing a double burden of malnutrition (DBM), characterized by the co-existence of undernutrition and overnutrition. Double-duty actions that concurrently target common drivers of undernutrition and overnutrition, while ensuring no unintended side effects, are recommended to effectively address the DBM. To understand these complex common mechanisms and design context-specific double-duty actions, there is a need for participatory systems approaches. This paper provides a case study of applying a community-based system dynamics approach to capture stakeholder perspectives of food system drivers of the DBM in two regions in Peru. METHODS: We implemented a multi-stage community-based system dynamics approach, which included processes for research capacity building for systems approaches, and the designing, piloting, and implementation of stakeholder workshops. A total of 36 stakeholders, representing diverse perspectives, participated in five group model building workshops. Stakeholder views are presented in a causal loop diagram that showcases the feedback mechanisms between key food system drivers of overweight and stunting in Peru. RESULTS: The causal loop diagram highlights that prioritization of undernutrition over overnutrition in the policymaking process, due to Peru's historically high levels of undernutrition, may undermine action against the DBM. It also describes potential mechanisms of unintended impacts of undernutrition policies on the DBM in Peru, including impacts related to within-family distribution and quality of food provided through food assistance programs, and unintended impacts due to regional dynamics. CONCLUSIONS: This paper highlights the importance of a participatory approach to understand local needs and priorities when recommending double-duty actions in Peru and shares practical methodological guidance on applying participatory systems approaches in public health.

7.
Clin Nutr ESPEN ; 65: 324-330, 2024 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-39681165

RESUMO

BACKGROUND AND OBJECTIVES: Surgical resection is a first-line treatment for patients with cancer, but preoperative malnutrition is a risk factor for postoperative complications. This study aimed to evaluate the association between preoperative administration of an immunonutrition regimen and postoperative clinical outcomes in patients with cancer undergoing major abdominal surgery. METHODS: The Surgical Prehabilitation Multimodal Oncology (SUPREMO) retrospective cohort study, conducted from January 2021 to December 2023, included patients with cancer undergoing major abdominal surgery. Patients were categorized based on whether they received a complete immunonutrition regimen or an incomplete or no regimen. Demographic and clinical data were extracted from electronic health records for descriptive analysis. Logistic regression was used to assess the impact of immunonutrition on the risk of infectious complications, with clinical and demographic variables as explanatory factors. RESULTS: A total of 620 patients were included, with 49 % receiving a complete preoperative immunonutrition regimen. Bivariate analysis indicated that complete regimen administration was associated with lower intensive care unit (ICU) admission, invasive mechanical ventilation (IMV), and vasopressor support requirements (p = 0.005, p = 0.019, and p = 0.032, respectively). The logistic regression model showed a significant reduction in in-hospital infectious complications (odds ratio 0.54, 95 % confidence interval 0.31-0.98; p = 0.044). CONCLUSION: Administering a complete preoperative immunonutrition regimen may be associated with reduced infectious complications, ICU and IMV requirements, and vasopressor support use.

8.
Int J Epidemiol ; 53(6)2024 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-39545485

RESUMO

BACKGROUND: Examining trajectories of undernutrition and overnutrition separately limits understanding of the double burden of malnutrition. We investigated transitions between normal, stunting, overweight and concurrent stunting and overweight (CSO) and associations with sociodemographic factors in children and adolescents. METHODS: We used data from the Young Lives cohort in India, Peru and Vietnam, which follow children 1-15 (N = 5413) and 8-22 years (N = 2225) over five rounds between 2002 and 2016. We estimated transitions between nutritional states using a Markov chain model and estimated sociodemographic associations employing a logit parametrization. RESULTS: Transitions into stunting peaked in ages 1-5 years (India: 22.9%, Peru: 17.6%, Vietnam: 14.8%), while stunting reversal was highest during adolescence across all countries. Transitions into overweight peaked in ages 19-22, while overweight reversal increased in ages 1-5 and 12-15 years. Transitions away from stunting to overweight were rare; more commonly, stunted individuals developed overweight while remaining stunted, leading to a CSO state. In Peru, 20.2% of 19-year-olds who were stunted reached CSO by age 22, with 4% shifting from stunted to overweight. Reversion to a normal state is least likely for those in a CSO state. Household wealth gradually reduced the likelihood of transitioning into stunting [odds ratios (ORs) for wealthiest quartile in Peru: 0.29, 95% confidence interval (CI) 0.20-0.41; India: 0.43, 95% CI 0.32-0.57; Vietnam: 0.36, 95% CI 0.26-0.50), with stunting reversal only being more likely in the two wealthiest quartiles across all countries (ORs for wealthiest quartile in Peru: 2.39, 95% CI 1.57-3.65; India: 1.28, 95% CI 1.05-1.54; Vietnam: 1.89, 95% CI 1.23-2.91). In Vietnam, only the richest quartile was at higher risk of transitioning into overweight (OR 1.87, 95% CI 1.28-2.72), while in Peru and India, the risk gradually rose across all wealth quartiles (ORs for wealthiest quartile in Peru: 2.84, 95% CI 2.14-3.77; India: 2.99, 95% CI 1.61-5.54). CONCLUSIONS: Childhood and adolescence represent critical periods for prevention and reversal of stunting and overweight, thereby averting the development of CSO later in life. Context-specific interventions are crucial for preventing disparate transitions towards the double burden of malnutrition across socioeconomic groups.


Assuntos
Transtornos do Crescimento , Sobrepeso , Humanos , Peru/epidemiologia , Vietnã/epidemiologia , Índia/epidemiologia , Transtornos do Crescimento/epidemiologia , Adolescente , Masculino , Pré-Escolar , Feminino , Sobrepeso/epidemiologia , Adulto Jovem , Criança , Lactente , Estudos Longitudinais , Estado Nutricional , Cadeias de Markov , Fatores Socioeconômicos , Desnutrição/epidemiologia , Adulto
9.
Radiol Bras ; 57: e20240026, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39540014

RESUMO

The aim of the present study was to investigate whether nutritional status and changes in muscle and adipose tissue determined by computed tomography are predictors of mortality in hospitalized patients. This was a prospective cohort study involving patients ≥ 20 years of age hospitalized in a public hospital. Sociodemographic and clinical variables were collected from electronic medical records. Nutritional variables were determined. All patients were followed prospectively until the hospital outcome, which could be discharge or death. Body composition was defined from computed tomography images, with the identification of myopenia, myosteatosis, and myopenic obesity. The sample comprised 542 patients. The mortality rate was 10.7% (95% CI: 6.4-15.0%). The independent predictors of mortality were malnutrition, assessed with the subjective global assessment (hazard ratio: 4.18; 95% CI: 1.01-17.22; p = 0.047), and myopenic obesity (hazard ratio: 2.82; 95% CI: 1.11-7.20; p = 0.029). The findings of the present study add to the limited evidence in the literature that body composition is associated with outcomes in hospitalized patients.


O objetivo do presente estudo foi investigar se o estado nutricional e as alterações nos tecidos muscular e adiposo, determinados pela tomografia computadorizada, são preditores de mortalidade em pacientes hospitalizados. Foi realizado um estudo de coorte prospectivo envolvendo pacientes com idade ≥ 20 anos, internados em um hospital público. Variáveis sociodemográficas e clínicas foram coletadas do prontuário eletrônico e variáveis nutricionais foram aferidas. Todos os pacientes foram acompanhados prospectivamente até o desfecho hospitalar, que poderia ser alta ou óbito. A composição corporal foi definida com base em imagens de tomografia computadorizada, com determinação da presença de miopenia, mioesteatose e obesidade visceral miopênica. A amostra foi composta por 542 pacientes. A mortalidade foi encontrada em 10,7% (IC 95%: 6,4-15,0%). Os preditores independentes de mortalidade foram a desnutrição avaliada pela avaliação subjetiva global (risco relativo: 4,18; IC 95%: 1,01-17,22; p = 0,047) e a presença de obesidade visceral miopênica (risco relativo: 2,82; IC 95%: 1,11-7,20; p = 0,029). Os achados do presente estudo somam-se às limitadas evidências publicadas de que a composição corporal está associada a desfechos em pacientes hospitalizados.

10.
Artigo em Inglês | MEDLINE | ID: mdl-39546151

RESUMO

INTRODUCTION: Malnutrition in early childhood has long-term health consequences, including increased obesity risk due to catch-up growth in undernourished infants. While maternal perceptions and feeding practices affect infant malnutrition, limited evidence exists in middle-income countries like Mexico. This study examines the associations between maternal perceptions, feeding practices, and nutritional status in infants aged 6-12 months in northeastern Mexico. METHODS: A total of 192 mother-infant dyads were assed using questionnaires and anthropometric measurements. Maternal variables included perception of hunger and satiety, infant weight perception, feeding attitudes, self-efficacy, fatigue, and feeding practices. Infant nutritional status was determined using WHO Anthro, and multiple logistic regression identified associations between maternal and infant factors and nutritional status. RESULTS: 38% of infants were overweight/obese, and 7% were underweight. Low maternal self-efficacy, low perception of hunger and satiety signs, non-recommended feeding attitudes, and inaccurate perception of infant weight were identified. Maternal nocturnal sleep hours, type of feeding, and feeding frequency were associated to underweight. The maternal perception of infant weight was inaccurate for both underweight (mothers overestimate the weight) and overweight/obese (mothers underestimate the weight) infants. DISCUSSION: The main maternal perception influencing infant nutritional status was inaccurate weight perception. Mothers demonstrated limited knowledge and negative feeding practices with non-recommended feeding practices among Mexican mothers. Longer maternal sleep duration (> 8 h/night) was associated with underweight infants.

11.
Br J Nutr ; 132(7): 862-873, 2024 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-39391932

RESUMO

Several models of maternal undernutrition reveal impairment of testicular development and compromise spermatogenesis in male offspring. The expansion of the litter size model, valuable for studying the impact of undernutrition on early development, has not yet been used to evaluate the consequences of early undernutrition in the adult male reproductive system. For this purpose, pups were raised in either normal litter (ten pups/dam) or large litter (LL; sixteen pups/dam). On postnatal day 90, sexual behaviour was evaluated or blood, adipose and reproductive tissues were collected for biochemical, histological and morphological analysis. Adult LL animals were lighter and thinner than controls. They showed increased food intake, but decrease of retroperitoneal white adipose tissue weight, glycaemia after oral glucose overload and plasma concentration of cholesterol. Reproductive organ weights were not altered by undernutrition, but histopathological analysis revealed an increased number of abnormal seminiferous tubules and number of immature spermatids in the tubular lumen of LL animals. These animals also showed reduction in total spermatic reserve and daily sperm production in the testes. Undernutrition decreased the number of Sertoli cells, and testosterone production was increased in the LL group. Mitochondrial activity of spermatozoa remained unchanged between experimental groups, suggesting no significant impact on the energy-related processes associated with sperm function. All animals from both experimental groups were considered sexually competent, with no significant difference in the parameters of sexual behaviour. We conclude that neonatal undernutrition induces histological and physiological testicular changes, without altering sperm quality and sexual behaviour of animals.


Assuntos
Animais Recém-Nascidos , Tamanho da Ninhada de Vivíparos , Desnutrição , Ratos Wistar , Espermatogênese , Testículo , Animais , Masculino , Testículo/crescimento & desenvolvimento , Ratos , Feminino , Tamanho do Órgão , Testosterona/sangue , Espermatozoides , Comportamento Sexual Animal/fisiologia , Células de Sertoli/metabolismo
12.
Front Cell Dev Biol ; 12: 1460697, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39445334

RESUMO

Introduction: Genetic and environmental factors influence the risk of neural tube defects (NTD), congenital malformations characterized by abnormal brain and spine formation. Mouse embryos deficient in Scavenger Receptor Class B Type 1 (SR-B1), which is involved in the bidirectional transfer of lipids between lipoproteins and cells, exhibit a high prevalence of exencephaly, preventable by maternal vitamin E supplementation. SR-B1 knock-out (KO) embryos are severely deficient in vitamin E and show elevated reactive oxygen species levels during neurulation. Methods: We fed SR-B1 heterozygous female mice a high-fat/high-sugar (HFHS) diet and evaluated the vitamin E and oxidative status in dams and embryos from heterozygous intercrosses. We also determined the incidence of NTD. Results and discussion: HFHS-fed SR-B1 HET females exhibited altered glucose metabolism and excess circulating lipids, along with a higher incidence of embryos with developmental delay and NTD. Vitamin E supplementation partially mitigated HFHS-induced maternal metabolic abnormalities and completely prevented embryonic malformations, likely through indirect mechanisms involving the reduction of oxidative stress and improved lipid handling by the parietal yolk sac.

13.
Children (Basel) ; 11(10)2024 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-39457119

RESUMO

Malnutrition is a global problem that affects all countries in one or more of its forms, representing one of the greatest challenges worldwide. One of the key contributing factors is food insecurity, which must be evaluated in children with moderate and severe acute malnutrition, as they are at imminent risk of death. OBJECTIVE: Our objective was to assess food insecurity among children under 5 years old with moderate, and severe malnutrition from Valle del Cauca, a state located in the southwestern region of Colombia. METHODS: A descriptive observational study was conducted, including children whose weight-for-height (W/H) indicator was below 2 SD, as recorded on the World Health Organization (WHO) growth charts, or who exhibited severe malnutrition phenotypes such as marasmus or Kwashiorkor. Family and child food security were evaluated using the Latin American and Caribbean Food Security Scale (ELCSA). RESULTS: 58.6% of households with acutely malnourished children experienced food insecurity. A statistically significant relationship was found between food insecurity and children of Afro-Colombian and Indigenous descent. According to caregivers' perceptions, 30.2% of child malnutrition cases were related to poor feeding and caregiving practices. CONCLUSIONS: Not all children with acute malnutrition suffer from food insecurity. Therefore, the findings of this research suggest that governmental efforts should focus not only on ensuring food availability, but also on educating caregivers about the importance of a balanced and nutritious diet tailored to the specific characteristics of each region and promoting appropriate caregiving practices.

14.
Nutrition ; 128: 112567, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39366302

RESUMO

PURPOSE: Malnutrition is frequent in hospitalized patients and is related to functional decline and poorer clinical outcomes. The Patient-Generated Subjective Global Assessment (PG-SGA) is a globally implemented malnutrition tool. We aimed to perform a linguistic and content validation of the translation and cultural adaptation of the PG-SGA for the Spanish language setting. METHODS: This study was conducted in Mexico and Spain. Cancer patients and healthcare professionals (HCPs) of both countries were enrolled. We followed the 10 steps of the International Society for Pharmacoeconomics and Outcomes Research Principles. Patients and HCPs evaluated comprehensibility (Item: I-CI, Scale: S-CI) and difficulty (Item: I-DI, Scale: S-DI) of the Spanish version of the PG-SGA. HCPs also evaluated content validity (i.e., relevance) of the Spanish PG-SGA (Item: I-CVI, Scale: S-CVI). The data were collected by a questionnaire. RESULTS: The study enrolled 84 HCPs and 196 cancer patients from both countries. HCPs rated comprehensibility and difficulty of the professional component as excellent (S-CI = 0.95, S-DI = 0.92), and content validity of the full PG-SGA also as excellent. Patients rated comprehensibility (S-CI) and difficulty (S-DI) of the patient-generated component, that is, the PG-SGA Short Form, as "excellent" (S-CI = 0.98 and S-DI = 0.98). CONCLUSION: Translation and cultural adaptation of the PG-SGA to the Spanish setting according to the International Society for Pharmacoeconomics and Outcomes Research Principles resulted in an instrument perceived as clear and easy to complete by cancer patients and relevant by HCPs to assess the nutritional status.


Assuntos
Pessoal de Saúde , Idioma , Desnutrição , Neoplasias , Avaliação Nutricional , Traduções , Humanos , Neoplasias/complicações , Espanha , Feminino , Masculino , Reprodutibilidade dos Testes , Pessoa de Meia-Idade , México , Inquéritos e Questionários/normas , Desnutrição/diagnóstico , Idoso , Adulto , Linguística , Estado Nutricional , Compreensão
15.
Front Nutr ; 11: 1474616, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39439520

RESUMO

Background and Aims: Malnutrition increases post-operative risks like infections and prolonged stays. Pediatric assessment challenges require using anthropometric measurements and phase angle, which reflects body cell mass and health outcomes. Phase angle varies by maturation stages, making it crucial for pre-surgical evaluations alongside BMI. This study aimed to determine the relationship between nutritional status, phase angle, and postoperative complications in pediatric patients who underwent surgery. Methods: Prospective study with patients aged 3-17 undergoing major non-ambulatory surgery. Anthropometric measurements (weight, height, BMI Z-scores) hand grip strength, dietary intake and body composition via bioimpedance to assess phase angle were recorded. Postoperative complications were monitored, including surgical site infections, morbidity (pneumonia, inotropic support, infections, thromboembolism), and mortality. Surgical risks and pre- and postoperative conditions were documented. Results: After the application of the selection criteria, a total of 391 patients who underwent surgery were included; 60% (n = 235) were within the range of the preschool and school-age groups. During the follow-up period, 51 (13%) patients developed at least one postoperative complication, with surgical site infections being the most common. Moreover, as phase angle decreased, the length of stay (LOS) increased in all the participants. Among children aged ≤12 years old, malnutrition was a risk factor for complications [OR 3.86 (1.61-9.27 95%CI)], whereas among adolescents, phase angle served as a protective factor [OR 0.63 (0.42-0.94 95%CI)]. Conclusion: Significant associations were observed between nutritional status, by BMI z-score, and post-surgical complications in younger patients. Additionally, in adolescents, the phase angle emerged as a protective factor against these complications.

16.
Clin Nutr ESPEN ; 64: 16-20, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39251089

RESUMO

Apolipoprotein E (apoE) has a pivotal role in Alzheimer's Disease (AD) pathophysiology. APOE4 has been recognized as a risk factor for developing late-onset AD. Recently, APOE4 homozygosity was regarded as a new familial genetic trait of AD. In this opinion paper, we summarized the potential pleiotropic antagonism role of APOE4 in children living under early life adversity and afflicted with enteric infection/malnutrition-related pathogenic exposome. APOE4 was found to be neuroprotective early in life despite its increasing risk for AD with aging. We call for awareness of the potential burden this can bring to the public health system when APOE4 carriers, raised under adverse environmental conditions in early life and then aging with unhealthy lifestyles in later life may be at special risk for cognitive impairments and acquired AD. We postulate the importance of anti-senescence therapies to protect these individuals and remediate aging-related chronic illnesses.


Assuntos
Doença de Alzheimer , Apolipoproteína E4 , Nutrientes , Humanos , Envelhecimento , Doença de Alzheimer/prevenção & controle , Apolipoproteína E4/genética , Nutrientes/administração & dosagem , Fatores de Risco
17.
Nutr Clin Pract ; 39(6): 1509-1516, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-39257059

RESUMO

BACKGROUND: Acute malnutrition in children <5 years of age has a direct relationship with medical complications and mortality. We aimed to describe the etiologic factors in children with moderate and severe non-illness-related acute malnutrition who required hospitalization for treatment of malnutrition in two high-complexity hospital centers in Bogotá, Colombia. METHODS: This is a multicenter case series (December 2016 to December 2020) including patients aged 1-59 months with a weight/height indicator less than -2 SD. Electronic health records were reviewed, and demographic (sex, age, city of origin, and socioeconomic status) and clinical data (gestational age at birth, edema, and nutrition status) were collected. Descriptive analysis of information was performed. An exploratory bivariate analysis by diagnostic categories of moderate and severe acute malnutrition vs days of hospitalization was also performed. RESULTS: Forty-five patients were included, 62.2% of whom were male, with a median age of 14 months (Q1-Q3: 7-24). The main etiologic factors of malnutrition were related to problems with total food intake (33.3%), transition in consistency of feeding (31.1%), and breastfeeding technique (22.2%). Only 13.3% had problems related to food insecurity. There were no statistically significant differences between moderate (median: 7 days; Q1-Q3: 5-12) and severe (median: 8 days; Q1-Q3: 5-16) acute malnutrition when compared by days of hospitalization. CONCLUSIONS: The main etiologic factors of malnutrition in our study population were related to problems in the amount of food provided and transition in consistency of complementary feeding.


Assuntos
Hospitalização , Desnutrição Aguda Grave , Humanos , Lactente , Masculino , Feminino , Pré-Escolar , Colômbia/epidemiologia , Hospitalização/estatística & dados numéricos , Desnutrição Aguda Grave/terapia , Desnutrição Aguda Grave/epidemiologia , Desnutrição Aguda Grave/complicações , Estado Nutricional , Transtornos da Nutrição Infantil/epidemiologia , Transtornos da Nutrição Infantil/etiologia , Aleitamento Materno , Desnutrição/epidemiologia , Desnutrição/etiologia
18.
Mol Cell Endocrinol ; 592: 112348, 2024 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-39218056

RESUMO

The developmental origins of healthy and disease (DOHaD) concept has demonstrated a higher rate of chronic diseases in the adult population of individuals whose mothers experienced severe maternal protein restriction (MPR). Using proteomic and in silico analyses, we investigated the lung proteomic profile of young and aged rats exposed to MPR during pregnancy and lactation. Our results demonstrated that MPR lead to structural and immune system pathways changes, and this outcome is coupled with a rise in the PI3k-AKT-mTOR signaling pathway, with increased MMP-2 activity, and CD8 expression in the early life, with long-term effects with aging. This led to the identification of commonly or inversely differentially expressed targets in early life and aging, revealing dysregulated pathways related to the immune system, stress, muscle contraction, tight junctions, and hemostasis. We identified three miRNAs (miR-378a-3p, miR-378a-5p, let-7a-5p) that regulate four proteins (ACTN4, PPIA, HSPA5, CALM1) as probable epigenetic lung marks generated by MPR. In conclusion, MPR impacts the lungs early in life, increasing the possibility of long-lasting negative outcomes for respiratory disorders in the offspring.


Assuntos
Pulmão , MicroRNAs , Proteômica , Animais , Feminino , Pulmão/metabolismo , Masculino , Proteômica/métodos , Gravidez , MicroRNAs/genética , MicroRNAs/metabolismo , Ratos , Efeitos Tardios da Exposição Pré-Natal/metabolismo , Efeitos Tardios da Exposição Pré-Natal/genética , Dieta com Restrição de Proteínas , Transdução de Sinais , Serina-Treonina Quinases TOR/metabolismo , Serina-Treonina Quinases TOR/genética , Longevidade/genética , Ratos Wistar , Proteínas Proto-Oncogênicas c-akt/metabolismo , Proteoma/metabolismo , Fosfatidilinositol 3-Quinases/metabolismo , Fosfatidilinositol 3-Quinases/genética , Envelhecimento/metabolismo , Envelhecimento/genética , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 2 da Matriz/genética
19.
Front Public Health ; 12: 1435694, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-39290415

RESUMO

This mini review delves into the complex issue of mortality linked to malnutrition, highlighting its multifaceted nature beyond just biomedical factors, presenting it as an intricate intersectional phenomenon. Method: The mini-review methodology involved a systematic literature search across databases like PubMed and Scielo, focusing on malnutrition and infant mortality in Colombia. We used specific keywords and Boolean operators to identify relevant studies, emphasizing socio-economic, gender, and ethnic factors, while excluding non-peer-reviewed and outdated publications. Results: The relationship between gender and food/nutrition has deep historical and cultural roots. Patriarchal norms influence dietary habits based on gender roles, often placing undue responsibility on mothers for children's nutritional health, reflecting profound social intersections. Mortality due to malnutrition is most prevalent among indigenous and Afro-descendant children in rural, conflict-affected areas with limited access to healthcare. Unpaid domestic work restricts women's economic independence, intensifying challenges for single-parent households. Conclusion: A comprehensive understanding can shift institutional attitudes toward mothers, leading to more coherent policy strategies and effective interventions.


Assuntos
Mortalidade Infantil , Humanos , Colômbia/epidemiologia , Lactente , Mortalidade Infantil/tendências , Feminino , Desnutrição/mortalidade , Desnutrição/epidemiologia , Fatores Socioeconômicos , Masculino
20.
Arch Argent Pediatr ; : e202410452, 2024 Oct 03.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-39321388

RESUMO

Russell's diencephalic syndrome is a set of signs and symptoms characterized by extreme weight loss, with no impairment of height or head circumference, without changes in intake or appetite. It is due to hypothalamic dysfunction associated with space-occupying lesions in this region. It is a rare cause of malnutrition in pediatrics, so its diagnosis is often delayed. Here we describe the case of a 17-month-old male patient with weight loss for 3 months who was admitted to the pediatric inpatient ward due to suspected intestinal malabsorption syndrome. After ruling out the most common causes of malnutrition, the patient was diagnosed with pilomyxoid astrocytoma of the brainstem.


El síndrome diencefálico de Russel es un conjunto de signos y síntomas que se caracteriza por una pérdida de peso marcada, sin afección de la talla ni el perímetro cefálico, sin modificaciones en la ingesta ni el apetito. Se debe a una disfunción hipotalámica asociada a lesiones ocupantes de espacio en dicha región. Es una causa poco frecuente de desnutrición en pediatría, por lo que el diagnóstico suele retrasarse. Se presenta el caso de un paciente de 17 meses de edad, con pérdida de peso de 3 meses de evolución que ingresó al internado pediátrico por sospecha de síndrome de malabsorción intestinal. Tras descartar las causas más frecuentes de desnutrición, se realizó diagnóstico de astrocitoma pilomixoide cerebral.

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