Ayuno intermitente: efectos en diversos escenarios clínicos / Intermittent fasting: effects in diverse clinical settings

Introducción: los esquemas de ayuno intermitente (AI) proponen limitar la ingestión de alimentos durante periodos específicos. Se han propuestocomo estrategia dietoterapéutica para tratar distintas condiciones metabólicas en diversos padecimientos, sin embargo, la heterogeneidad entrecada contexto de ayuno intermitente pudiera generar diferentes resultados en parámetros metabólicos.Objetivo: evaluar la aplicación clínica del ayuno intermitente y discernir si ofrece ventajas sobre otras estrategias tradicionales.Métodos: se formularon preguntas estructuradas (PICO) y la metodología se apegó a las guías establecidas por la declaración PRISMA 2020.Se realizó una búsqueda de literatura científica en las plataformas de PubMed, Cochrane Library y Google Scholar.Resultados: se encontraron 3.962 artículos, de los cuales se incluyeron finalmente 56, eliminando 3.906 trabajos que no contestaban directao indirectamente las preguntas estructuradas.Conclusiones: frente a las dietas convencionales, los diversos esquemas de AI no generan ventajas ni desventajas en cuanto a pérdida de pesoo perfil lipídico, aunque en la variante a días alternos se producen mayores reducciones de insulina a las observadas en la restricción energéticacontinua. La heterogeneidad de las intervenciones y poblaciones estudiadas, así como los comparadores, los desenlaces y el tipo de diseñoimposibilitan extrapolar los efectos a todos los escenarios clínicos y generalizar las recomendaciones.(AU)

Introduction: intermittent fasting plans propose to limit food intake during specific periods as nutritional therapeutic strategies to treat differentmetabolic conditions in various clinical entities. However, the heterogeneity between each context of intermittent fasting could generate differentresults in metabolic parameters.Objective: to evaluate the clinical application of intermittent fasting and to discern whether it offers advantages over other traditional strategies.Methods: structured questions were formulated (PICO), and the methodology followed the guidelines established by the PRISMA 2020 statement.The search was conducted in different databases (PubMed, Cochrane Library and Google Scholar).Results: we found 3,962 articles, of which 56 were finally included; 3,906 articles that did not directly or indirectly answer the structuredquestions were excluded.Conclusions: compared to conventional diets, the various AI schemes do not generate advantages or disadvantages in terms of weight loss andlipid profile, although in the alternate-day variant there are greater insulin reductions than those observed in the continuous energy restriction. Theheterogeneity of the interventions, the populations studied, the comparators, the results, and the type of design make it impossible to extrapolatethe effects found in all clinical scenarios and generalize the recommendations.(AU)

Da medicalização da comida à gourmetização do medicamento: análise da campanha publicitária que transformou um comprimido efervescente em febre nacional / From the medicalization of food to the gourmetization of medicines: analysis of the advertising campaign that turned an effervescent tablet into a national fever / De la medicalización de los alimentos a la gourmetización de los medicamentos: análisis de la campaña publicitaria que convirtió un comprimido efervescente en fiebre nacional

O aumento da longevidade humana veio acompanhado de uma maior preocupação com os hábitos alimentares e de uma banalização das dietas prescritas, favorecendo um contexto de medicalização da comida, no qual a fronteira entre alimento e medicamento fica imprecisa. Isto tem sido usado mercadologicamente pelas indústrias alimentícias, farmacêuticas e de suplementos alimentares. Este artigo visa discutir como o ecossistema publicitário contemporâneo e a ciberpublicidade são utilizados para naturalizar a presença de suplementos e medicamentos na dieta cotidiana. Usou-se como estudo de caso uma campanha publicitária vietnamita, em que um comprimido foi posicionado como ingrediente culinário. A partir de outros casos descritos na literatura, discutem-se os resultados encontrados no contexto ocidental. Nas considerações finais, apresentam-se alguns desafios regulatórios; apontam-se perspectivas para pesquisas futuras; e defende-se a educação como elemento fundamental para a construção de uma sociedade em que a saúde seja valorizada e exigida como bem coletivo e direito de todos

As human longevity increases, a greater concern with eating habits is visible. Furthermore, the number of people who trivialize prescribed diets increases. This context favors the medicalization of food, in which the boundary between food and medicine is blurred. Industries take advantage of this situation to promote several products. This article discusses how the contemporary advertising ecosystem and the cyber advertising techniques are used to naturalize the presence of supplements and medications in the daily diet. We used as a case study a Vietnamese campaign, in which a tablet was positioned as a culinary ingredient. Based on other cases described in the literature, the results found in the Western context are discussed. In the last section, some regulatory challenges are presented, prospects for future research are pointed out, and education is defended as fundamental for the development of citizens who value Public Health as a collective good and a right of all

El aumento de la longevidad humana ha venido acompañado de una mayor preocupación por los hábitos alimentarios y de una banalización de las dietas prescritas, favoreciendo un contexto de medicalización de la alimentación, en el que la frontera entre alimento y medicamento se esfuma. Esto viene siendo utilizado comercialmente por industrias alimentarias, farmacéuticas y de complementos alimenticios. Este artículo tiene el objetivo de discutir como el ecosistema publicitario contemporáneo y la publicidad cibernética son usados para naturalizar la presencia de suplementos y medicamentos en la dieta diaria. Se utilizó como estudio de caso una campaña publicitaria vietnamita, en la que se posicionó un comprimido como ingrediente culinario. Con base en otros casos descritos en la literatura, se discuten los resultados encontrados en el contexto occidental. En las reflexiones finales, se presentan algunos desafíos regulatorios; se señalan perspectivas para futuras investigaciones; y la educación es defendida como elemento fundamental para la construcción de una sociedad en la que se valore y exija la salud como bien colectivo y derecho de todos.

Predicting insulin use among women with gestational diabetes diagnosed in oral glucose tolerance test.

BACKGROUND: Gestational diabetes mellitus (GDM) is one of the most common complications affecting pregnant women. While most women will achieve adequate glycemic levels with diet and exercise, some will require pharmacological treatment to reach and maintain glucose levels between the desired thresholds. Identifying these patients early in pregnancy could help direct resources and interventions. METHODS: This retrospective cohort of women with GDM diagnosed with an abnormal 75g-OGTT presents data from 869 patients (724 in the diet group and 145 in the insulin group). Univariate logistic regression was used to compare the groups, and multivariable logistic regression was used to identify independent factors associated with the need for insulin. A log-linear function was used to estimate the probability of requiring pharmacological treatment. RESULTS: Women in the insulin group had higher pre-pregnancy BMI index (29.8 vs 27.8 kg/m2, odds ratio [OR] 1.06, 95% confidence interval [CI] 1.03-1.09), more frequent history of previous GDM (19.4% vs. 7.8%, OR 2.84, 95% CI 1.59-5.05), were more likely to have chronic hypertension (31.7% vs. 23.2%, OR 1.54, 95% CI 1.04-2.27), and had higher glucose levels at all three OGTT points. Multivariable logistic regression final model included age, BMI, previous GDM status, and the three OGTT values as predictors of insulin requirement. CONCLUSIONS: We can use regularly collected data from patients (age, BMI, previous GDM status, and the three OGTT values) to calculate the risk of a woman with GDM diagnosed in OGTT needing insulin. Identifying patients with a greater risk of requiring pharmacological treatment could help healthcare services to better allocate resources and offer closer follow-up to high-risk patients.

New approaches to diet therapy for eosinophilic esophagitis.

PURPOSE OF REVIEW: An empiric step-up (2-4-6) elimination diet remains the most common dietary approach in clinical practice when treating eosinophilic esophagitis (EoE). However, research in this field has fallen behind pharmacological therapy. This review aims to summarize novel approaches to dietary therapy for EoE. RECENT FINDINGS: A first prospective multicenter study in 41 pediatric patients (mean age 9 years) has evaluated the efficacy of a cow's milk elimination diet. This dietary approach led to histological remission in 51% of patients, albeit a caveat is that up to 80% of patients were receiving concomitant therapy with proton pump inhibitors. In a series of 18 adult patients with documented milk-induced EoE, ingestión of 400 ml of sterilized milk (boiled for up to 20 min) daily for 8 weeks did not induce histologic relapse in two-thirds of patients. SUMMARY: Milk elimination diet is effective in one-half of pediatric EoE patients and should likely be the first choice in children with EoE (within a step-up dietary approach). Promising data on tolerance of sterilized milk in adults with milk-induced EoE (66%) merit further replication in children, which may radically improve quality of life for patients and their caregivers.

[Controversy 2: What should diet therapy provide?] / Controversia 2. ¿Qué aportar desde la dietoterapia?

Introduction: Controversy 2: What should diet therapy provide?

Introducción: Controversia 2. ¿Qué aportar desde la dietoterapia?

Behavior Change Effectiveness Using Nutrition Apps in People With Chronic Diseases: Scoping Review.

BACKGROUND: Cardiovascular disease, cancer, diabetes mellitus, and obesity are common chronic diseases, and their prevalence is reaching an epidemic level worldwide. As the impact of chronic diseases continues to increase, finding strategies to improve care, access to care, and patient empowerment becomes increasingly essential. Health care providers use mobile health (mHealth) to access clinical information, collaborate with care teams, communicate over long distances with patients, and facilitate real-time monitoring and interventions. However, these apps focus on improving general health care concerns, with limited apps focusing on specific chronic diseases and the nutrition involved in the disease state. Hence, available evidence on the effectiveness of mHealth apps toward behavior change to improve chronic disease outcomes is limited. OBJECTIVE: The objective of this scoping review was to provide an overview of behavior change effectiveness using mHealth nutrition interventions in people with chronic diseases (ie, cardiovascular disease, diabetes mellitus, cancer, and obesity). We further evaluated the behavior change techniques and theories or models used for behavior change, if any. METHODS: A scoping review was conducted through a systematic literature search in the MEDLINE, EBSCO, PubMed, ScienceDirect, and Scopus databases. Studies were excluded from the review if they did not involve an app or nutrition intervention, were written in a language other than English, were duplicates from other database searches, or were literature reviews. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, the systematic review process included 4 steps: identification of records through the database search, screening of duplicate and excluded records, eligibility assessment of full-text records, and final analysis of included records. RESULTS: In total, 46 studies comprising 256,430 patients were included. There was diversity in the chronic disease state, study design, number of participants, in-app features, behavior change techniques, and behavior models used in the studies. In addition, our review found that less than half (19/46, 41%) of the studies based their nutrition apps on a behavioral theory or its constructs. Of the 46 studies, 11 (24%) measured maintenance of health behavior change, of which 7 (64%) sustained behavior change for approximately 6 to 12 months and 4 (36%) showed a decline in behavior change or discontinued app use. CONCLUSIONS: The results suggest that mHealth apps involving nutrition can significantly improve health outcomes in people with chronic diseases. Tailoring nutrition apps to specific populations is recommended for effective behavior change and improvement of health outcomes. In addition, some studies (7/46, 15%) showed sustained health behavior change, and some (4/46, 9%) showed a decline in the use of nutrition apps. These results indicate a need for further investigation on the sustainability of the health behavior change effectiveness of disease-specific nutrition apps.

Transtornos alimentares: vivências de mulheres acima de 30 anos / Eating disorders: experiences of women aged over 30 years / Trastornos alimentarios: experiencias de mujeres de más de 30 años

O objetivo deste estudo foi compreender como mulheres adultas (acima de 30 anos) diagnosticadas com transtornos alimentares (TAs) vivenciam o adoecer. Trata-se de um estudo qualitativo, descritivo e exploratório, desenvolvido com base no referencial teórico-metodológico da Análise Fenomenológica Interpretativa (AFI). Participaram seis mulheres, com idades entre 34 e 65 anos, atendidas em um serviço especializado. Os dados foram coletados por meio de entrevista aberta, de inspiração fenomenológica, na modalidade remota. As entrevistas foram audiogravadas, transcritas e analisadas seguindo os passos da AFI. Duas categorias temáticas foram identificadas: "Vivendo antes do adoecer" e "Encontrando-se doente." Constatou-se que os sintomas tiveram início anteriormente à vida adulta e que houve dificuldade na confirmação do diagnóstico. Na perspectiva das participantes, conviver com a sintomatologia ficou mais complicado em função de particularidades de manejo dos sintomas na vida adulta, e a idade é percebida como um fator que impacta e dificulta ainda mais a recuperação. As participantes relataram desesperança em relação ao futuro, apesar de a maioria reconhecer melhoras no quadro clínico ao longo do tempo e de valorizar a relação de confiança estabelecida com a equipe multiprofissional.(AU)

This study aimed to understand the experience of illness of adult women (over 30 years) diagnosed with eating disorders (ED). This is a qualitative, descriptive, and exploratory study, using Interpretative Phenomenological Analysis (IPA) as theoretical and methodological framework. A sample of six women aged 34-64 years, assisted in a specialized service, were recruited to complete a phenomenological in-depth open interview. The data were remotely collected. Interviews were audio-recorded, transcribed and analyzed following the IPA. Two thematic categories were identified: "Living before the illness" and "Finding about the illness." It was found that the symptoms started before adulthood and that there was difficulty establishing the diagnosis. Living with the symptoms became more complicated due to particularities of symptom management in adulthood and age is perceived as a factor that impacts recovery and makes it even more difficult. The participants reported hopelessness about the future, although most recognized improvements in the clinical condition over time and valued the trusting relationship they established with the multiprofessional team.(AU)

El objetivo de este estudio fue comprender las experiencias de las mujeres adultas (mayores de 30 años) diagnosticadas con trastornos alimentarios (TA) respecto a la enfermedad. Se trata de un estudio cualitativo, descriptivo y exploratorio, desarrollado a partir del marco teórico y metodológico del Análisis Fenomenológico Interpretativo (AFI). Participaron seis mujeres, con edades de entre 34 y 65 años, atendidas en un servicio especializado. Los datos se recogieron mediante entrevistas abiertas, de inspiración fenomenológica, en la modalidad a distancia. Las entrevistas fueron grabadas en audio, transcritas y analizadas siguiendo los pasos del AFI. Se identificaron dos categorías temáticas: "Vivir antes de enfermar" y "Encontrarse enfermo." Se constató que los síntomas comenzaron antes de la edad adulta y que hubo dificultades de establecer el diagnóstico. La convivencia con síntomas se complicó debido a las particularidades del manejo de los síntomas en la vida adulta y la edad se percibe como un factor que influye y dificulta aún más la recuperación. Los participantes manifestaron desesperanza sobre el futuro, aunque reconocieron mejoras en el cuadro clínico con el paso del tiempo y valoraron la relación de confianza establecida con el equipo multiprofesional.(AU)

Ezetimibe increases resistance to oxidative stress and extends lifespan mimicking dietary restriction in Caenorhabditis elegans

Ezetimibe is an approved drug for lowering plasma LDL (low-density lipoprotein) level via inhibition of cholesterol absorption. Derivatives of ezetimibe reduce inflammatory response and oxidative stress. In the present study, we investigated the effect of dietary supplementation with ezetimibe in response to environmental stressors and found that ezetimibe increases resistance to oxidative stress and ultraviolet irradiation. Ezetimibe also significantly extended lifespan accompanying reduced fertility, which is a common trade-off for longevity in C. elegans. Cellular level of reactive oxygen species was increased and the expression of stress-responsive genes, hsp-16.2 and sod-3, was induced by dietary supplementation with ezetimibe, suggesting a hormetic effect on oxidative stress response and lifespan. Ezetimibe also significantly prevented amyloid beta-induced toxicity and completely reversed increased mortality by high-glucose diet. Nuclear localization of DAF-16 required for the prevention of amyloid beta-induced toxicity was enhanced by ezetimibe supplementation. Lifespan assay using known long-lived mutants, age-1, clk-1, and eat-2, revealed that lifespan extension by ezetimibe specifically overlapped with that of eat-2 mutants, which are genetic models of dietary restriction. Effect of ezetimibe on lifespan of worms fed with diluted bacteria suggested that ezetimibe mimics the effect of dietary restriction on lifespan. These findings suggest that ezetimibe exhibits anti-oxidative and anti-aging effects through hormesis and works as a dietary-restriction mimetic on lifespan extension.

Quem é o comedor restritivo?: Modelos teóricos segundo variáveis do comportamento alimentar e a influência de redes sociais / Who is the restrained eater?: Theoretical models according to eating behaviour variables and the influence of social media

Introdução: O comer restritivo é relacionado à importantes questões de saúde pública, como obesidade e transtornos alimentares devido às relações com peso corporal; mas há divergência quanto a sua definição e variáveis relacionadas e são sugeridas particularidades para mulheres e homens em relação aos aspectos da imagem corporal, comportamento alimentar e susceptibilidade destes componentes à influência de redes sociais. Objetivo: Avaliar o comer restritivo e seus componentes [descontrole alimentar (DA), restrição cognitiva (RC) e comer emocional (CE)] em modelos teóricos que incluam insatisfação corporal, autoestima, índice de massa corporal e a influência da observação de perfis no Instagram® do tipo "fitness" entre mulheres e homens. Métodos: A partir de desenho experimental online (observação dos perfis de Instagram®), a pesquisa foi dividida em 3 etapas: 1) desenho intra sujeitos que utilizou análises de variância (ANOVAs) com medidas repetidas e covariáveis para comparar mulheres (vs. homens), que observaram perfis fitness no Instagram® (vs. perfis controle), antes (vs. após a intervenção) - distribuídos randomicamente entre os grupos respeitando sexo. A etapa avaliou o interesse por comidas indulgentes (versus não indulgentes) antes e após a intervenção experimental; 2) modelos de regressão linear múltipla para identificar a influência dos grupos experimentais (mulheres que observaram perfis fitness x perfis controle x homens que observaram perfis fitness x perfis controle), da insatisfação corporal, do comportamento de comer transtornado (CCT), da baixa autoestima, idade, renda, índice de massa corporal (IMC) e nível subjetivo de fome sobre os componentes do comer restritivo; 3) proposta de modelo teórico para o comer restritivo e componentes explicados pela insatisfação corporal e moderadores ou mediadores da relação: comportamento de comer transtornado, autoestima, IMC, nível subjetivo de fome e tipo de perfis de Instagram® observado (fitness x controle) por modelagem por equações estruturais (MEE). Resultados: A etapa 1 demonstrou que apenas os homens (H), apresentaram maior interesse por imagens de comidas doces e indulgentes após a observação de perfis fitness no Instagram® (p=0,04, d=0,45) e que tanto mulheres (M) como H apresentaram maior interesse por imagens de comidas doces e não indulgentes após observarem perfis fitness no Instagram® (M: p=0,001, d=0,68; H: p=0,001, d=0,67). A etapa 2 demonstrou que independentemente do perfil de Instagram® observado, mulheres apresentaram maior pontuação para DA, RC e CE. E para todos, a insatisfação corporal foi a variável mais explicativa [DE: ß = 0,25, p≤0,001; RC: ß= 0,26, p≤0,001; e CE: ß= 0,29, p≤0,001]. A etapa 3 revelou que entre a amostra de homens, o poder da teoria foi maior considerando a relação entre a insatisfação com a musculatura (e não para insatisfação geral com o corpo). O modelo para toda a amostra [CMIN =2,13, CFI=0,96, TLI = 0,94, RMSEA (90% IC) =0,06 (0,032-0,090)], apontou que entre as mulheres houve relações significativamente mais fortes entre insatisfação corporal total e comer restritivo (λ=0,54, p<0,001), IMC (λ= 0,28, p<0,001) e CCT (λ= 0,31, p<0,001) e relação significativa entre CCT e comer restritivo (λ=0,21, p<0,01). Porém houve relação significativamente mais forte para os homens entre IMC e comer restritivo (λ= 0,41, p<0,001). Houve moderação das outras variáveis do modelo na relação entre insatisfação corporal total e comer restrito. No entanto, para mulheres a presença das variáveis diminuiu a intensidade desta relação, ao passo que para homens a presença destas variáveis intensificou a relação. O comer emocional para mulheres e homens foi o constituinte mais relevante do comer restritivo nesta análise (M: λ=0,90, p<0,001; H: λ=0,87, p<0,001). Não houve influência dos tipos de perfis de Instagram® nesta etapa. Conclusão: O comedor restritivo foi melhor representado pelas mulheres, e cada sexo apresentou particularidades. Entre as mulheres a insatisfação corporal exerceu influência mais forte sobre o comer restritivo, principalmente afetando o comer emocional. Entre os homens a relação entre o aumento do IMC e maiores pontuações para comer restritivo foi a mais evidente, residindo na insatisfação corporal ligada à musculatura o principal elemento que explicou do comer restritivo entre eles. A autoestima não se revelou um moderador de destaque das relações estudadas e apesar da observação dos perfis fitness ter aumentado o interesse de M e H por imagens de comidas não indulgentes, mas não foi capaz de influenciar atributos duradouros dos indivíduos, como os avaliados nas variáveis pertencentes aos modelos teóricos propostos.

Introduction: Restrained eating is related to important public health issues, such as obesity and eating disorders related to body weight; but there is disagreement regarding its definition and related variables and particularities are suggested for women and men in relation to aspects of body image, eating behaviour and the susceptibility of these components to the influence of social networks. Objective: To evaluate restrained eating and its components [uncontrol eating (UE), cognitive restriction (CR) and emotional eating (EA)] in theoretical models that include body dissatisfaction, self-esteem, body mass index and the influence of observing profiles on Instagram® of the "fitness" type between women and men. Methods: Using an online experimental design (observation of Instagram® profiles), the research was carried out in 3 stages: 1) within-subjects design that used analyzes of variance (ANOVAs) with repeated measures and covariates to compare women (vs. men), who observed fitness profiles on Instagram® (vs. control profiles), before (vs. after the intervention) - randomly distributed between groups according to sex. The stage assessed interest in indulgent (versus non-indulgent) foods before and after the experimental intervention; 2) multiple linear regression models to identify the influence of experimental groups (women who observed fitness profiles x control profiles x men who observed fitness profiles x control profiles), body dissatisfaction, disordered eating behaviour (DEB), low self-esteem , age, income, body mass index (BMI) and subjective level of hunger on the components of restrictive eating; 3) proposed theoretical model for restrained eating and components explained by body dissatisfaction and moderators or mediators of the relationship: disordered eating behavior, self-esteem, BMI, subjective level of hunger and type of Instagram® profiles observed (fitness x control) by structural equation modeling (SEM). Results: Stage 1 demonstrated that only men (H) showed greater interest in images of sweet and indulgent foods after observing fitness profiles on Instagram® (p=0.04, d=0.45) and that both women (M) and H showed greater interest in images of sweet and non-indulgent foods after observing fitness profiles on Instagram® (M: p=0.001, d=0.68; H: p=0.001, d=0.67). Step 2 demonstrated that regardless of the Instagram® profile observed, women had higher scores for UE, RC and EA. And for everyone, body dissatisfaction was the most explanatory variable [DE: ß= 0.25, p≤0.001; RC: ß= 0.26, p≤0.001; and CE: ß= 0.29, p≤0.001]. Step 3 revealed that among the sample of men, the power of the theory was greater considering the relationship between dissatisfaction with musculature (and not general dissatisfaction with the body). The model for the entire sample [CMIN =2.13, CFI=0.96, TLI = 0.94, RMSEA (90% CI) =0.06 (0.032-0.090)], showed that among women there were significantly stronger between total body dis-satisfaction and restrained eating (λ=0.54, p<0.001), BMI (λ= 0.28, p<0.001) and DEB (λ= 0.31, p<0.001) and a significant relationship between DEB and restrictive eating (λ=0.21, p<0.01). However, there was a significantly stronger relationship for men between BMI and restrictive eating (λ= 0.41, p<0.001). There was moderation of the other variables in the model in the relationship between total body dissatisfaction and restrained eating, however, for women the presence of the variables decreased the intensity of this relationship while for men the presence of these variables intensified the relationship. Emotional eating for women and men was the most relevant constituent of restrictive eating in this analysis (M: λ=0.90, p<0.001; H: λ=0.87, p<0.001). There was no influence of the types of Instagram® profiles at this stage. Conclusion: The restrictive eater was best represented by women, and each sex had particularities. Among women, body dissatisfaction had a stronger influence on restrictive eating, mainly affecting emotional eating. Among men, the relationship between increased BMI and higher scores for restrictive eating was the most evident, with body dissatisfaction linked to musculature being the main element that explained restrictive eating among them. Self-esteem did not prove to be a prominent moderator of the relationships studied and although the observation of fitness profiles increased M and H's interest in images of non-indulgent foods, it was not able to influence lasting attributes of the individuals, such as those assessed in the variables belonging to the proposed theoretical models.

Determinants of disordered eating behaviors: Body mass index, emotional eating, dietary restriction, and motives for eating palatable foods / Determinantes de comportamentos alimentares desordenados: índice de massa corporal, alimentação emocional, restrição alimentar e motivos para comer alimentos palatáveis

ABSTRACT Objective: The study aimed to investigate the relationships between body mass index, reasons for consuming palatable foods, emotional eating, cognitive dietary restraint, and disordered eating behaviors in young adults. Methods: This study was conducted with 800 young adults, in Ankara, Türkiye. A questionnaire consisting of questions about socio-demographic characteristics, health status, and instruments including Eating Attitudes Test-26, Emotional Appetite Questionnaire, Palatable Eating Motives Scale, and The Three-Factor Eating Questionnaire were applied through face-to-face interviews. Results: According to the Eating Attitudes Test-26, 17.2% of males and 27.7% of females were at risk for disordered eating behaviors (χ2=9.750, p=0.002). The mean scores of the Three-Factor Eating Questionnaire-emotional eating, cognitive restraint subscales, and the positive and negative scores of the Emotional Appetite Questionnaire were higher in males than in females (p<0.05). The mean scores of the Palatable Eating Motives Scale-coping and reward enhancement motives were higher in females, while the mean score for the conformity motives was significantly higher in males. Body mass index, Three-Factor Eating Questionnaire-cognitive restraint subscale, Emotional Appetite Questionnaire-negative, and PEMS-conformity motives were found for predictors for Eating Attitudes Test-26 (all p<0.05). Conclusion: The results showed a high tendency for emotional eating, consumption of palatable foods, and cognitive dietary restraint in young adults, and these factors were considered determinants for eating disorders.

RESUMO Objetivo: O objetivo do estudo foi investigar as relações entre o índice de massa corporal, as razões para consumir alimentos palatáveis, o comer emocional, a restrição alimentar cognitiva e os comportamentos de desordem alimentar em jovens adultos. Métodos: Este estudo foi realizado com 800 jovens adultos, em Ancara, na Turquia. Foi aplicado um questionário composto por perguntas sobre características sociodemográficas, estado de saúde e instrumentos, incluindo o Eating Attitudes Test-26, o Emotional Appetite Questionnaire, a Palatable Eating Motives Scale e o The Three-Fator Eating Questionnaire, através de entrevistas presenciais. Resultados: De acordo com o Eating Attitudes Test-26, 17,2% dos homens e 27,7% das mulheres estavam em risco de desenvolver comportamentos alimentares desordenados (χ2=9,750, p=0,002). As pontuações médias do Three-Fator Eating Questionnaire-emotional eating, as subescalas de restrição cognitiva e as pontuações positivas e negativas do Emotional Appetite Questionnaire foram mais elevadas no sexo masculino do que no feminino (p<0,05). As pontuações médias da Palatable Eating Motives Scale - motivos de coping e de aumento da recompensa - foram mais elevadas no sexo feminino, enquanto a pontuação média para os motivos de conformidade foi significativamente mais elevada no sexo masculino. O índice de massa corporal, o Three-Fator Eating Questionnaire-subescala de contenção cognitiva, o Emotional Appetite Questionnaire-negativo e o PEMS-motores de conformidade foram encontrados como preditores do Eating Attitudes Test-26 (todos p<0,05). Conclusão: Os resultados mostraram uma elevada tendência para a alimentação emocional, o consumo de alimentos palatáveis e a restrição alimentar cognitiva em adultos jovens, sendo estes factores considerados determinantes para as perturbações alimentares.

“Out of the box” new therapeutic strategies for Crohn´s disease: moving beyond biologics

New treatment options beyond immunosuppression have emerged in recent years for patients with Crohn´s disease (CD), a chronic systemic condition affecting primarily the gut with great impact in the quality of life. The cause of CD is largely unknown, and a curative treatment is not yet available. In addition, despite the growing therapeutic armamentarium in recent years almost half of the patients don´t achieve a sustained response over time. Thus, new therapeutic strategies are urgently needed. In this review, we discuss the current state of promising new “out of the box” possibilities to control chronic inflammation beyond current pharmacological treatments, including: exclusive enteral nutrition, specific diets, cell therapies using T regs, hyperbaric oxygen, fecal microbiota transplantation, phage therapy, helminths, cannabis and vagal nerve stimulation. The exploration of original and novel therapeutic modalities is key to address their potential as main or complementary treatments in selected CD populations in order to increase efficacy, minimize side effects and improve quality of life of patients (AU)

Efectividad de la pauta de alimentación en la prevención y manejo de la preeclampsia en la actualidad. Revisión bibliográfica. / Effectiveness Of The Feeding Regimen In The Prevention And Management Of Preeclampsia Today. Bibliographic Review

La preeclampsia aparece entre el 2-10% de las gestaciones a partir de la vigésima semana de gestación y con más frecuencia en el embarazo a término, las medidas más importantes van encaminadas a la prevención. El objetivo de esta revisión bibliográfica es conocer la efectividad de la pauta de alimentación en la prevención y manejo de la preeclampsia. Se han revisado 18 publicaciones recientes de los últimos 5 años. En general, las gestantes suelen experimentar excesiva ganancia ponderal y bajo consumo de los principales minerales. Las grasas mono y poliinsaturadas y granos refinados pueden aumentar el riesgo de preeclampsia. Es necesario la valoración y educación nutricional en la mujer en edad fértil y especialmente en las gestantes con riesgo de preeclampsia. (AU)

Preeclampsia appears between 2-10% of pregnancies from the twentieth week of gestation and more frequently in term pregnancy, the most important measures are aimed at prevention. The objective of this bibliographical review is to know the effectiveness of the feeding regimen in the prevention and management of preeclampsia. 18 recent publications from the last 5 years have been reviewed. In general, pregnant women tend to experience excessive weight gain and low consumption of the main minerals. Monounsaturated and polyunsaturated fats and refined grains may increase the risk of preeclampsia. Nutritional assessment and education is necessary in women of childbearing age and especially in pregnant women at risk of preeclampsia. (AU)

Limiting amino acids supplementation in low crude protein diets and their impacts on growth performance and carcass composition in Labeo rohita (rohu) adult fish / Limitação da suplementação de aminoácidos em dietas com baixo teor de proteína bruta e seus impactos no desempenho de crescimento e composição da carcaça em peixes adultos Labeo rohita (rohu)

Ninety days study was conducted in hapas installed in earthen ponds. Fish of an average initial weight (220g) were evenly distributed in triplicate groups within fifteen hapas. Five experimental diets labeled as T1 (25% CP and NRC recommended amino acid level) as control diet, T2 (with 2% low protein and 5% amino acid supplementation), T3 (with 2% low protein and 10% amino acid supplementation), T4 (with 4% low protein and 10% amino acid supplementation) and T5 (with 4% low protein and 20% amino acid supplementation) were prepared. Fish were fed with @3% of their body weight twice a day at 10.00 & 16:00 hour. Significantly higher percent weight gain (420.18 ± 66.84a) and specific growth rate (13499.33±1273.54a) along with improved feed conversion ratio (1.29 ± 0.09b) and hundred percent survivals were recorded during the trial. Furthermore proximate analysis of meat showed significant improvement in the crude protein level (81.77 ± 0.19a) served with diet containing 20% limiting amino acids mixture. Therefore, limiting amino acids can be a source of cost effective feed and use safely in L. rohita diet.

O estudo de 90 dias foi realizado em hapas instalados em tanques de terra. Peixes com peso inicial médio (220 g) foram distribuídos uniformemente em grupos triplicados em 15 hapas. Cinco dietas experimentais rotuladas como T1 (25% de CP e NRC recomendado nível de aminoácidos) como dieta controle, T2 (com 2% de proteína baixa e 5% de suplementação de aminoácidos), T3 (com 2% de proteína baixa e 10% de suplementação de aminoácidos), T4 (com 4% de baixa proteína e 10% de suplementação de aminoácidos) e T5 (com 4% de baixa proteína e 20% de suplementação de aminoácidos) foram preparadas. Os peixes foram alimentados com 3% do seu peso corporal duas vezes por dia às 10h00 e 16h00. Ganho de peso significativamente maior (420,18 ± 66,84a) e taxa de crescimento específico (13499,33 ± 1273,54a) juntamente com taxa de conversão alimentar melhorada (1, 29 ± 0,09b) e sobrevivência de cem por cento foram registrados durante o ensaio. Além disso, a análise aproximada da carne mostrou melhora significativa no nível de proteína bruta (81,77 ± 0,19a) servida com dieta contendo 20% de mistura de aminoácidos limitantes. Portanto, a limitação de aminoácidos pode ser uma fonte de alimentação econômica e usada com segurança na dieta de L. rohita.

Orientação nutricional para prevenção do diabetes mellitus tipo 2 em comunidade rural: relato de experiência / Nutritional guidance for the prevention of type 2 diabetes mellitus in a rural community: experience report

Objetivo: Descrever a experiência vivenciada por meio da oferta de uma ação de orientação nutricional para prevenção do diabetes mellitustipo 2 em uma comunidade rural. Métodos: Relato de experiência de uma ação de orientação nutricional realizada em uma comunidade rural do Rio Grande do Norte. Para execução da ação, seguiu-se o fluxo: recepção e acolhimento dos usuários; triagem e explicação dos serviços que seriam ofertados; anamnese e avaliação de saúde pela equipe multiprofissional e; orientações nutricionais, conforme a necessidade dos participantes. Resultados: Dos 18 indivíduos que realizaram o teste de glicemia em jejum, seisapresentaram alterações glicêmicas significativas, sendo estes direcionados para a orientação nutricional individual para uma conduta mais específica. Asorientações foram realizadas de forma objetiva e acessível por umanutricionista, que explicouo que deveria ser evitado e o que escolher dentro da alimentação para que fosse alcançado o equilíbrio glicêmico, o controle e a manutenção da saúde. Conclusão: A experiência foi relevante para os usuários e a equipe de saúde local, que obteve um reforço no mapeamento de casos de doenças crônicas que agem, muitas vezes, de forma silenciosa. Também foi identificada a necessidade de um profissional de nutriçãoparaacontinuidade da assistência. Descritores: Diabetes Mellitus. Prevenção.Dietoterapia.Educação Alimentar e Nutricional.

Objective: To describe the experience lived through the provision of a nutritional guidance action for the prevention of type 2 diabetes mellitus in a rural community. Methods: Experience report of a nutritional guidance action carried out in a rural community in Rio Grande do Norte. To perform the action, the following flow was adopted: reception and welcoming of users; screening and explanation of the services that would be offered; anamnesis and health assessment by the multidisciplinary team and; nutritional guidelines, according to the needs of the participants. Results: Of the 18 individuals who underwent the fasting bloodglucose test, six showed significant glycemic changes, being them directed to individual nutritional guidance for a more specific conduct. The guidelines were carried out in an objective and accessible way by a nutritionist, who explained what should be avoided and what to choose in the diet so that glycemic balance, control and maintenance of health could be achieved. Conclusion: The experience was relevant for users and the local health team, who were given support in the mapping of cases of chronic diseases that often act silently. The need for a nutrition professional for continuity of care was also identified.Descriptors:Diabetes Mellitus.Prevention.Diet Therapy.Food and Nutrition Education.

Exclusion Diets in Functional Dyspepsia.

Functional dyspepsia represents one of the most common and prevalent disorders of the brain-gut interaction, with a large number of widespread risk factors being identified. With an intricate pathogenesis and symptomatology, it heavily impacts the quality of life and, due to the limited efficacy of traditional pharmacological agents, patients are likely to seek other medical and non-medical solutions to their problem. Over the last few years, significant research in this domain has emphasized the importance of various psychological therapies and nutritional recommendations. Nevertheless, a correlation has been established between functional dyspepsia and food intolerances, with more and more patients adopting different kinds of exclusion diets, leading to weight loss, restrictive eating behaviour and an imbalanced nutritional state, further negatively impacting their quality of life. Thus, in this systematic review, we aimed at analysing the impact and efficiency of certain exclusion diets undertook by patients, more precisely, the gluten-free diet and the low-FODMAP diet.

Dietary Patterns during Pregnancy and Gestational Weight Gain: A Systematic Review / Padrões alimentares durante a gravidez e ganho de peso gestacional: Uma revisão sistemática

Abstract The present systematic review (PROSPERO: CRD42020148630) hypothesizes the association of excessive weight gain during pregnancywith dietary patterns composed of ultraprocessed foods. Thus, the objective was to investigate the association between dietary patterns after analysis and weight gain during pregnancy. The search for articles was performed in nine databases. Two reviewers selected the articles in the databases and extracted from them the data used in the review. Two scales were used to evaluate the quality of the selected studies: New Castle-Ottawa Quality Assessment for cohort-based studies and Appraisal tool for Cross-Sectional Studies (AXIS) for cross-sectional-based studies. In total, 11 studies were identified with sample size variation (n=173-5,733). Women presenting more adherence to healthy and traditional patterns (fruits, vegetables, salads, nuts, and dairy) recorded less excessive gestational weight gain (GWG). Higher intake ofmixed patterns and western patterns rich in ultraprocessed foods were associated with a higher prevalence of excessive GWG (24.48- 55.20%). Gestational dietary patterns a posteriori-derived that have presented ultraprocessed components rich in fat and sugars presented association with high GWG; healthy and traditional dietary patterns were related to better mother-child health conditions, such as adequate GWG.

Resumo A presente revisão sistemática (PROSPERO: CRD42020148630) tem como hipótese que o ganho de peso excessivo durante a gravidez está associado aos padrões alimentares compostos por alimentos ultraprocessados. Desta forma, objetivou-se investigar a associação entre o padrão alimentar a posteriori e o ganho de peso durante a gestação. A busca de artigos foi realizada em nove bases de dados. Dois revisores selecionaram os artigos nestas bases e extraíram as informações utilizadas na revisão. Duas escalas foram utilizadas para avaliar a qualidade dos estudos selecionados: Escala de Avaliação da Qualidade de New Castle-Ottawa para estudos baseados em coortes e a Ferramenta de Avaliação de Estudos Transversais (escala AXIS) para estudos transversais. No total, foram identificados 11 trabalhos com variação do tamanho amostral (n=173-5.733). As mulheres que apresentaram maior adesão aos padrões alimentares saudáveis e tradicionais (frutas, hortaliças e vegetais, nozes e laticínios) apresentarammenor ganho de peso gestacional (GPG). A maior ingestão de padrões alimentares mistos e ocidentais ricos em alimentos ultraprocessados foi associada a uma maior prevalência de GPG excessivo (24,48-55,20%). Os padrões alimentares gestacionais derivados a posteriori que apresentaram componentes ultraprocessados ricos em gordura e açúcares apresentaram associação como maior GPG; os padrões alimentares saudáveis e tradicionais foram relacionados a melhores condições de saúde maternoinfantil, como GPG adequado.

Non-alcoholic fatty liver disease (NAFLD): a review of pathophysiology, clinical management and effects of weight loss.

Given the increasing prevalence of diabetes and obesity worldwide, the deleterious effects of non-alcoholic fatty liver disease (NAFLD) are becoming a growing challenge for public health. NAFLD is the most common chronic liver disease in the Western world. NAFLD is closely associated with metabolic disorders, including central obesity, dyslipidaemia, hypertension, hyperglycaemia and persistent abnormalities of liver function tests.In general NAFLD is a common denominer for a broad spectrum of damage to the liver, which can be due to hepatocyte injury, inflammatory processes and fibrosis. This is normally seen on liver biopsy and can range from milder forms (steatosis) to the more severe forms (non-alcoholic steatohepatitis (NASH), advanced fibrosis, cirrhosis and liver failure). In these patients, advanced fibrosis is the major predictor of morbidity and liver-related mortality, and an accurate diagnosis of NASH and NAFLD is mandatory. Histologic evaluation with liver biopsy remains the gold standard to diagnose NAFLD. Diagnosis of NAFLD is defined as presence of hepatic steatosis, ballooning and lobular inflammation with or without fibrosis. Weight loss, dietary modification, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established. Dietary recommendations and lifestyle interventions, weight loss, and the treatment of underlying metabolic syndrome remain the mainstays of therapy once the diagnosis is established with promising results but are difficult to maintain. Pioglitazone and vitamin E are recommended by guidelines in selected patients. This review gives an overview of NAFLD and its treatment options.

Control of immunity via nutritional interventions.

Nutrition affects all physiological processes including those linked to the development and function of our immune system. Here, we discuss recent evidence and emerging concepts supporting the idea that our newfound relationship with nutrition in industrialized countries has fundamentally altered the way in which our immune system is wired. This will be examined through the lens of studies showing that mild or transient reductions in dietary intake can enhance protective immunity while also limiting aberrant inflammatory responses. We will further discuss how trade-offs and priorities begin to emerge in the context of severe nutritional stress. In those settings, specific immunological functions are heightened to re-enforce processes and tissue sites most critical to survival. Altogether, these examples will emphasize the profound influence nutrition has over the immune system and highlight how a mechanistic exploration of this cross talk could ultimately lead to the design of novel therapeutic approaches that prevent and treat disease.

Therapeutic Food Development from Maize Grains, Pulses, and Cooking Banana Fruits for the Prevention of Severe Acute Malnutrition.

In children under five years of age, severe acute malnutrition is a complex and challenging problem, especially those living in poor communities. Therefore, this study aimed to formulate ready-to-use therapeutic foods from affordable, locally available cereals, pulses, and banana fruits to overcome the problem of severe acute malnutrition. Maize grains, pulses (soybeans), and cooking banana fruits were ingredients used in formulations of ready-to-use therapeutic foods (RUTF). A completely randomized design was done with two replicates. Data were analyzed using analysis of variance. A significant difference existed in the appearance and consistency for RUTF1, RUTF2, and RUTF3 samples (P < 0.05). The study findings revealed that the moisture content varied from 6.7 to 13.4%, energy from 513.2 to 642.41 kcal/100 g, protein from 13.9 to 19.34%%, and crude fat from 24.12 to 35.54%. The calcium content ranged from 225 to 302 g/100 mg, iron from 10.34 to 12.26 g/100 mg, and zinc from 10 to 20 g/100 mg. In this study, the phytate content varied from 314.74 to 369.3 µg/g and crude tannin, from 101.36 to 153.25 µg/g. This study concluded that the ingredients used in the RUTF1, RUTF2, and RUTF3 formulations met the standard ready-to-use therapeutic foods. Therefore, it is important to prescribe ready-to-use dietary supplements made from inexpensive, locally available, and culturally acceptable foods to prevent severe acute malnutrition in infants.