NUTRITIONAL STATUS IN CHILDREN WITH CANCER: COMPARISON OF DEUTERIUM OXIDE DILUTION WITH BIOELECTRIC IMPEDANCE ANALYSIS AND ANTHROPOMETRY.

OBJECTIVE: To explore changes in the nutritional status of pediatric cancer patients before and after chemotherapy and evaluate the correlation between deuterium oxide dilution, bioelectric impedance analysis, and anthropometry for assessment of body composition. METHODS: This study included 14 children (aged 5.6 to 13.6 years) and classified them as having hematologic or solid tumors. They had their body composition analyzed according to deuterium oxide, bioelectric impedance, and anthropometric measurements before the first chemotherapy cycle and after three and six months of therapy. RESULTS: The patients in the hematologic tumor group had an increase in weight, height, body mass index, waist, hip, and arm circumference, subscapular skinfold thickness, and fat mass with the isotope dilution technique during chemotherapy. In the solid tumor group, the children showed a reduction in fat-free mass when assessed by bioimpedance analysis. We found a positive correlation between the triceps skinfold thickness and fat mass determined by bioimpedance analysis and deuterium oxide. The arm muscle circumference correlated with the fat-free mass estimated by bioimpedance analysis and deuterium oxide. CONCLUSIONS: Patients with hematologic tumors had an increase in body weight, height, and fat mass, which was not identified in the solid tumor group. The positive correlation between anthropometry (triceps skinfold thickness and arm muscle circumference), deuterium oxide dilution, and bioelectric impedance analysis shows the applicability of anthropometry in clinical practice.

Nutritional status in children with cancer: comparison of deuterium oxide dilution with bioelectric impedance analysis and anthropometry / Estado nutricional em crianças com câncer: comparação entre diluição de deutério, impedância bioelétrica e antropometria

ABSTRACT Objective: To explore changes in the nutritional status of pediatric cancer patients before and after chemotherapy and evaluate the correlation between deuterium oxide dilution, bioelectric impedance analysis, and anthropometry for assessment of body composition. Methods: This study included 14 children (aged 5.6 to 13.6 years) and classified them as having hematologic or solid tumors. They had their body composition analyzed according to deuterium oxide, bioelectric impedance, and anthropometric measurements before the first chemotherapy cycle and after three and six months of therapy. Results: The patients in the hematologic tumor group had an increase in weight, height, body mass index, waist, hip, and arm circumference, subscapular skinfold thickness, and fat mass with the isotope dilution technique during chemotherapy. In the solid tumor group, the children showed a reduction in fat-free mass when assessed by bioimpedance analysis. We found a positive correlation between the triceps skinfold thickness and fat mass determined by bioimpedance analysis and deuterium oxide. The arm muscle circumference correlated with the fat-free mass estimated by bioimpedance analysis and deuterium oxide. Conclusions: Patients with hematologic tumors had an increase in body weight, height, and fat mass, which was not identified in the solid tumor group. The positive correlation between anthropometry (triceps skinfold thickness and arm muscle circumference), deuterium oxide dilution, and bioelectric impedance analysis shows the applicability of anthropometry in clinical practice.

RESUMO Objetivo: Verificar mudanças no estado nutricional de crianças com câncer antes e após o tratamento quimioterápico e avaliar a correlação entre diluição de óxido de deutério, análise de impedância bioelétrica (BIA) e dados antropométricos. Métodos: Quatorze crianças (entre 5,6 e 13,6 anos de idade) foram incluídas e classificadas como tendo tumores hematológicos ou sólidos. A composição corporal foi medida pelo óxido de deutério, impedância bioelétrica e medidas antropométricas antes da primeira quimioterapia e após três e seis meses de terapia. Resultados: Os pacientes do grupo de tumores hematológicos aumentaram o peso, a estatura, o índice de massa corporal, a circunferência da cintura, quadril e braço, dobra cutânea subescapular e a massa gorda com a técnica de diluição isotópica durante o tratamento quimioterápico. No grupo de tumores sólidos, as crianças mostraram uma redução na massa magra quando avaliadas por análise de impedância. Houve uma correlação positiva entre a dobra cutânea tricipital e a massa gorda determinadas pela análise de impedância e pelo óxido de deutério. A circunferência muscular do braço correlacionou-se com a massa magra estimada pela análise de impedância e pelo óxido de deutério. Conclusões: Pacientes com tumores hematológicos tiveram aumento no peso corporal, estatura e massa gorda, o que não foi observado naqueles com tumores sólidos. A boa correlação entre a antropometria (dobra cutânea tricipital e circunferência muscular do braço), a diluição do óxido de deutério e a análise da impedância bioelétrica mostra a aplicabilidade da antropometria na prática clínica.

Assessing Breastfeeding Practices Objectively Using Stable Isotope Techniques.

An objective method of assessing breastfeeding practices is required to evaluate progress toward the World Health Organization Global Target 2025: to increase exclusive breastfeeding (EBF) rates in the first 6 months to at least 50% by 2025. Currently, assessment of EBF at the population level is based on mother or caregiver reporting, which risks recall and social desirability bias. A more objective method is the deuterium oxide dose to mother (DTM) technique, in which lactating mothers are given a small amount of deuterium-labeled water. The infant receives deuterium during breastfeeding, and a compartmental model is used to determine the amount of human milk consumed by the infant, and the exclusivity of breastfeeding practices. If the amount of human milk consumed by an infant is determined using the DTM technique and the concentration of nutritional components or potentially toxic contaminants is measured, then the infant's intake of essential nutrients or environmental contaminants can be ascertained.

Applications of deuterium oxide in human health.

The main aim goal of this review was to gather information about recent publications related to deuterium oxide (D2O), and its use as a scientific tool related to human health. Searches were made in electronic databases Pubmed, Scielo, Lilacs, Medline and Cochrane. Moreover, the following patent databases were consulted: EPO (Espacenet patent search), USPTO (United States Patent and Trademark Office) and Google Patents, which cover researches worldwide related to innovations using D2O.

Deuterium equilibrium time in saliva of newborn infants.

UNLABELLED: There is an increasing interest about the use of stable isotopes for body composition analysis in pediatrics. To ensure the success of total body water analysis by the deuterium dilution method, it is fundamental to determine the equilibrium time (plateau) of deuterium in the body fluid studied. OBJECTIVES: We report here the equilibration time of deuterium oxide in the saliva of newborns after oral intake of the isotope. METHODS: Twenty healthy term newborn infants, 10 males and 10 females, were analyzed. Saliva was collected from each newborn before the oral administration of a 100 mg/kg dose of deuterium oxide (baseline sample) and then at 1-hour intervals for 5 hours after administration. Deuterium enrichment of saliva was determined by isotope ratio mass spectrometry according to the recommendations of the International Atomic Energy Agency. RESULTS: The plateau time of deuterium in saliva occurred 3 hours after oral administration of the stable isotope. CONCLUSION: These data are essential for further studies on the body composition of newborn infants. To the best of our knowledge, this is the first study regarding the equilibration time of deuterium in the saliva of term newborns.

Evaluación del consumo de leche humana por dilución con deuterio y detección por espectroscopia de infrarrojo / Assessment of human milk consumption by dilution with deuterium and detection by infrared spectroscopy

Objetivo. Adaptar la metodología de evaluación de ingestión de leche humana con isótopos estables utilizando un espectroscopio infrarrojo en lugar de un espectrómetro de masas. Material y métodos. Previo consentimiento informado, 12 mujeres que estaban amamantando recibieron 30 g de D2O por vía oral. a las 4 horas y 1, 3, 6, 9 y 14 días depués de la dosificación, se les tomó una muestra de saliva. Las muestras de saliva de los bebés se tomaron a los 1,2,5,6,13 y 14 días. Todas las muestras fueron preparadas por sublimación y centrifucación y la determinación de la concentración de D2O se determinó por espectroscopía de infrarrojo. Resultados. La recuperación del sistema de sublimación fue superior al 95 por ciento del volumen total tanto de agua sola como de saliva. Se encontró que con tres evaluaciones se alcanza la misma confiabilidad que con 5 evaluaciones. Los volúmenes de ingestión de leche humana fueron similares a los informados por otros autores