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1.
Nutrients ; 14(10)2022 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-35631198

RESUMO

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.


Assuntos
Dietoterapia , Dispepsia , Dieta com Restrição de Carboidratos , Dieta Livre de Glúten , Intolerância Alimentar , Humanos , Qualidade de Vida
2.
BMC Endocr Disord ; 22(1): 63, 2022 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-35287643

RESUMO

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.


Assuntos
Dietoterapia , Hipoglicemiantes/uso terapêutico , Hepatopatia Gordurosa não Alcoólica , Vitamina E/uso terapêutico , Redução de Peso , Humanos , Hepatopatia Gordurosa não Alcoólica/metabolismo , Hepatopatia Gordurosa não Alcoólica/patologia , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Hepatopatia Gordurosa não Alcoólica/terapia
4.
PLoS One ; 17(2): e0262893, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35196317

RESUMO

INTRODUCTION: Truck driving is the most common vocation among males internationally with a high proportion overweight/obese due to a combination of work and lifestyle factors leading to health complications. With limited studies in this area, this systematic review aimed to identify and describe interventions addressing weight reduction in truck drivers. METHODS: Five electronic databases were searched, January 2000 to June 2020 (CINAHL, Cochrane Library, Embase, Ovid MEDLINE, Scopus). Inclusion criteria: experimental primary studies, long-distance (≥500 kms) truck drivers, peer reviewed publications in English. Weight loss interventions included physical activity, diet, behavioral therapy, or health promotion/education programs. Exclusions: non-interventional studies, medications or surgical interventions. Two independent researchers completed screening, risk of bias (RoB) and data extraction with discrepancies managed by a third. Study descriptors, intervention details and outcomes were extracted. RESULTS: Seven studies (two RCTs, five non-RCTs,) from three countries were included. Six provided either counselling/coaching or motivational interviewing in combination with other components e.g. written resources, online training, provision of exercise equipment. Four studies demonstrated significant effects with a combined approach, however, three had small sample sizes (<29). The effect sizes for 5/7 studies were medium to large size (5/7 studies), indicating likely clinical significance. RoB assessment revealed some concerns (RCTs), and for non-RCTs; one moderate, two serious and two with critical concerns. Based on the small number of RCTs and the biases they contain, the overall level of evidence in this topic is weak. CONCLUSION: Interventions that include a combination of coaching and other resources may provide successful weight reduction for truck drivers and holds clinical significance in guiding the development of future interventions in this industry. However, additional trials across varied contexts with larger sample populations are needed.


Assuntos
Condução de Veículo , Veículos Automotores , Obesidade/epidemiologia , Obesidade/terapia , Doenças Profissionais/epidemiologia , Doenças Profissionais/terapia , Redução de Peso , Programas de Redução de Peso/métodos , Adolescente , Adulto , Terapia Cognitivo-Comportamental/métodos , Dietoterapia/métodos , Terapia por Exercício/métodos , Seguimentos , Educação em Saúde/métodos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Circunferência da Cintura , Adulto Jovem
5.
Immunity ; 55(2): 210-223, 2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35139351

RESUMO

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.


Assuntos
Dietoterapia , Imunidade , Envelhecimento/imunologia , Restrição Calórica , Humanos , Inflamação , Corpos Cetônicos/biossíntese , Corpos Cetônicos/imunologia , Desnutrição/imunologia , Microbiota/imunologia , Fenômenos Fisiológicos da Nutrição/imunologia
6.
Int J Mol Sci ; 23(4)2022 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-35216170

RESUMO

Macroautophagy is a "cell cleansing" process that rids cells of protein aggregates and damaged organelles that may contribute to disease pathogenesis and the dysfunctions associated with aging. Measures which boost longevity and health span in rodents typically up-regulate macroautophagy, and it has often been suggested that safe strategies which can promote this process in humans may contribute to healthful aging. The kinase ULK1 serves as a trigger for autophagy initiation, and the transcription factors TFEB, FOXO1, ATF4 and CHOP promote expression of a number of proteins which mediate macroautophagy. Nutraceutical or dietary measures which stimulate AMPK, SIRT1, eIF5A, and that diminish the activities of AKT and mTORC1, can be expected to boost the activities of these pro-autophagic factors. The activity of AMPK can be stimulated with the phytochemical berberine. SIRT1 activation may be achieved with a range of agents, including ferulic acid, melatonin, urolithin A, N1-methylnicotinamide, nicotinamide riboside, and glucosamine; correction of ubiquinone deficiency may also be useful in this regard, as may dietary strategies such as time-restricted feeding or intermittent fasting. In the context of an age-related decrease in cellular polyamine levels, provision of exogenous spermidine can boost the hypusination reaction required for the appropriate post-translational modification of eIF5A. Low-protein plant-based diets could be expected to increase ATF4 and CHOP expression, while diminishing IGF-I-mediated activation of AKT and mTORC1. Hence, practical strategies for protecting health by up-regulating macroautophagy may be feasible.


Assuntos
Autofagia , Dietoterapia/métodos , Suplementos Nutricionais , Animais , Humanos , Sirtuínas/genética , Sirtuínas/metabolismo , Regulação para Cima
7.
ScientificWorldJournal ; 2022: 3547266, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35132308

RESUMO

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.


Assuntos
Grão Comestível/normas , Desnutrição/prevenção & controle , Musa/química , Valor Nutritivo , Soja/química , Zea mays/química , Pré-Escolar , Dietoterapia/métodos , Proteínas na Dieta/análise , Grão Comestível/química , Humanos , Micronutrientes/análise
8.
JAMA ; 327(2): 138-150, 2022 01 11.
Artigo em Inglês | MEDLINE | ID: mdl-35015037

RESUMO

Importance: Phase 3 trials have not compared semaglutide and liraglutide, glucagon-like peptide-1 analogues available for weight management. Objective: To compare the efficacy and adverse event profiles of once-weekly subcutaneous semaglutide, 2.4 mg, vs once-daily subcutaneous liraglutide, 3.0 mg (both with diet and physical activity), in people with overweight or obesity. Design, Setting, and Participants: Randomized, open-label, 68-week, phase 3b trial conducted at 19 US sites from September 2019 (enrollment: September 11-November 26) to May 2021 (end of follow-up: May 11) in adults with body mass index of 30 or greater or 27 or greater with 1 or more weight-related comorbidities, without diabetes (N = 338). Interventions: Participants were randomized (3:1:3:1) to receive once-weekly subcutaneous semaglutide, 2.4 mg (16-week escalation; n = 126), or matching placebo, or once-daily subcutaneous liraglutide, 3.0 mg (4-week escalation; n = 127), or matching placebo, plus diet and physical activity. Participants unable to tolerate 2.4 mg of semaglutide could receive 1.7 mg; participants unable to tolerate 3.0 mg of liraglutide discontinued treatment and could restart the 4-week titration. Placebo groups were pooled (n = 85). Main Outcomes and Measures: The primary end point was percentage change in body weight, and confirmatory secondary end points were achievement of 10% or more, 15% or more, and 20% or more weight loss, assessed for semaglutide vs liraglutide at week 68. Semaglutide vs liraglutide comparisons were open-label, with active treatment groups double-blinded against matched placebo groups. Comparisons of active treatments vs pooled placebo were supportive secondary end points. Results: Of 338 randomized participants (mean [SD] age, 49 [13] years; 265 women [78.4%]; mean [SD] body weight, 104.5 [23.8] kg; mean [SD] body mass index, 37.5 [6.8]), 319 (94.4%) completed the trial, and 271 (80.2%) completed treatment. The mean weight change from baseline was -15.8% with semaglutide vs -6.4% with liraglutide (difference, -9.4 percentage points [95% CI, -12.0 to -6.8]; P < .001); weight change with pooled placebo was -1.9%. Participants had significantly greater odds of achieving 10% or more, 15% or more, and 20% or more weight loss with semaglutide vs liraglutide (70.9% of participants vs 25.6% [odds ratio, 6.3 {95% CI, 3.5 to 11.2}], 55.6% vs 12.0% [odds ratio, 7.9 {95% CI, 4.1 to 15.4}], and 38.5% vs 6.0% [odds ratio, 8.2 {95% CI, 3.5 to 19.1}], respectively; all P < .001). Proportions of participants discontinuing treatment for any reason were 13.5% with semaglutide and 27.6% with liraglutide. Gastrointestinal adverse events were reported by 84.1% with semaglutide and 82.7% with liraglutide. Conclusions and Relevance: Among adults with overweight or obesity without diabetes, once-weekly subcutaneous semaglutide compared with once-daily subcutaneous liraglutide, added to counseling for diet and physical activity, resulted in significantly greater weight loss at 68 weeks. Trial Registration: ClinicalTrials.gov Identifier: NCT04074161.


Assuntos
Peso Corporal/efeitos dos fármacos , Peptídeos Semelhantes ao Glucagon/administração & dosagem , Hipoglicemiantes/administração & dosagem , Liraglutida/administração & dosagem , Sobrepeso/tratamento farmacológico , Diabetes Mellitus , Dietoterapia , Esquema de Medicação , Exercício Físico , Feminino , Peptídeos Semelhantes ao Glucagon/efeitos adversos , Humanos , Hipoglicemiantes/efeitos adversos , Injeções Subcutâneas , Liraglutida/efeitos adversos , Masculino , Pessoa de Meia-Idade , Obesidade/tratamento farmacológico , Obesidade/terapia , Razão de Chances , Sobrepeso/terapia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Placebos/administração & dosagem , Resultado do Tratamento , Estados Unidos , Redução de Peso
9.
Oxid Med Cell Longev ; 2022: 6457318, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35082970

RESUMO

BACKGROUND: Oxidative stress is crucial in stroke pathogenesis. Many cohort-based studies suggested that the intake of exogenous antioxidants originated from food may prevent stroke. However, the corresponding randomized controlled trials did not show diet-derived antioxidants have a protective effect on stroke. OBJECTIVES: To examine the association of genetically proxied diet-derived antioxidants with stroke risk using Mendelian randomization. METHODS: We performed a two-sample Mendelian randomization (MR) analysis to evaluate the causal effect of diet-derived antioxidants on stroke risk. For exposure data, we extracted genetic variants as instrumental variables (IVs) that are strongly associated with frequently used diet-derived antioxidants, including vitamin C, vitamin E (α-tocopherol, γ-tocopherol), carotene, retinol, zinc, and selenium, from a large-scale genome-wide association study (GWAS). We obtained IVs' corresponding effect estimates on the risk of total stroke and ischemic stroke from a GWAS meta-analysis with 40,585 cases and 406,111 controls. Finally, we applied five types of Mendelian randomization analysis to obtain preliminary MR results and performed four three kinds of sensitivity analysis to verify them. RESULTS: According to the primary MR estimations and further sensitivity analyses, we established two robust associations after Bonferroni correction: genetically proxied circulating γ-tocopherol was causally associated with total stroke [odds ratio (OR) = 0.68, 95% confidence interval (CI) (0.52-0.88), p = 3.78E - 03] and ischemic stroke [OR = 0.66, 95% CI (0.51-0.86), p = 2.34E - 03]. There was no evidence to support the causal effect of other diet-derived antioxidants on the risk of total stroke and ischemic stroke. CONCLUSION: Our study revealed a protective impact of genetic susceptibility to high circulating γ-tocopherol levels on stroke risk, providing new information on the potential therapeutic targets for primary stroke prevention.


Assuntos
Antioxidantes/uso terapêutico , Dietoterapia/métodos , Análise da Randomização Mendeliana/métodos , Estresse Oxidativo/efeitos dos fármacos , Acidente Vascular Cerebral/prevenção & controle , Antioxidantes/farmacologia , Humanos , Fatores de Risco
10.
Int J Mol Sci ; 23(2)2022 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-35055025

RESUMO

The severe impairment of bone development and quality was recently described as a new target for unbalanced ultra-processed food (UPF). Here, we describe nutritional approaches to repair this skeletal impairment in rats: supplementation with micro-nutrients and a rescue approach and switching the UPF to balanced nutrition during the growth period. The positive effect of supplementation with multi-vitamins and minerals on bone growth and quality was followed by the formation of mineral deposits on the rats' kidneys and modifications in the expression of genes involved in inflammation and vitamin-D metabolism, demonstrating the cost of supplementation. Short and prolonged rescue improved trabecular parameters but incompletely improved the cortical parameters and the mechanical performance of the femur. Cortical porosity and cartilaginous lesions in the growth-plate were still detected one week after rescue and were reduced to normal levels 3 weeks after rescue. These findings highlight bone as a target for the effect of UPF and emphasize the importance of a balanced diet, especially during growth.


Assuntos
Desenvolvimento Ósseo , Osso e Ossos/metabolismo , Dietoterapia , Dieta , Fast Foods , Animais , Biomarcadores , Osso e Ossos/diagnóstico por imagem , Cálcio/administração & dosagem , Cálcio/metabolismo , Cobre/administração & dosagem , Cobre/metabolismo , Suplementos Nutricionais , Fast Foods/efeitos adversos , Lâmina de Crescimento/diagnóstico por imagem , Lâmina de Crescimento/metabolismo , Humanos , Imuno-Histoquímica , Rim/metabolismo , Rim/patologia , Minerais/análise , Nutrientes/análise , Ratos , Vitaminas/análise
11.
PLoS One ; 17(1): e0261446, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34986194

RESUMO

AIM: To study the possible effects of a dietary intervention with minimal and unprocessed foods, high in natural saturated fats on the lipid profile and body mass index of children. METHOD: This study combines three intervention studies; one non-randomized retrospective cohort study and two randomized controlled trials, to a pooled analysis. The intervention group received a dietary intervention of minimal and unprocessed foods for three to six months, consisting of five times per week green vegetables, three times per week beef, daily 200-300 mL whole cow's milk (3.4% fat) and whole dairy butter (80% fat) on each slice of bread. The control group continued their usual dietary habits. Raw data of the three intervention studies where combined into one single dataset for data analysis, using mixed effects analysis of covariance to test the effects of the dietary advice on the main study outcomes, which are measurements of the lipid profile. RESULTS: In total, 267 children aged 1 to 16 years were followed. 135 children were included in the intervention group and 139 children in the control group. Characteristics (age, gender and follow-up period) were equally distributed between the groups at baseline. In the intervention group HDL-cholesterol increased significantly from 1.22 mmol/L, 95% confidence interval (CI) 1.14-1.32 to 1.42 mmol/L 95% CI 1.30-1.65 (p = 0.007). The increase over time in HDL cholesterol in the intervention group was significantly different compared to the increase in the control group (from 1.26 mmol/L, 95% CI 1.19-1.35, to 1.30 mmol/L, 95% CI 1.26-1.37) (p = 0.04). Due to the increased HDL concentration in the intervention group, the total cholesterol/HDL cholesterol ratio decreased significantly from 3.70 mmol/L, 95% CI 3.38-3.87, to 3.25 mmol/L, 95% CI 2.96-3.31 (p = 0.05). CONCLUSION: Consumption of minimal and unprocessed foods (high in natural saturated fats) has favourable effects on HDL cholesterol in children. Therefore, this dietary advice can safely be recommended to children.


Assuntos
HDL-Colesterol/metabolismo , Dietoterapia/métodos , Gorduras na Dieta/efeitos adversos , Adolescente , Índice de Massa Corporal , Criança , Pré-Escolar , LDL-Colesterol/metabolismo , Estudos de Coortes , Dieta/efeitos adversos , Dietoterapia/psicologia , Ingestão de Energia , Ácidos Graxos , Comportamento Alimentar , Feminino , Humanos , Lactente , Metabolismo dos Lipídeos/fisiologia , Lipidômica/métodos , Lipídeos/fisiologia , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos
12.
J Neuromuscul Dis ; 9(1): 53-71, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34511508

RESUMO

BACKGROUND: GNE myopathy (GNEM) is a rare, adult-onset, inclusion body myopathy that results from mutations in the GNE gene. GNE encodes UDP-GlcNAc epimerase/ManNAc-6 kinase, a protein with two enzymatic activities that comprise the committed step in biosynthesis of sialic acid (SA), an essential glycan that appears on the terminal positions of many extracellular oligosaccharide chains. These GNE mutations can cause a reduction of SA in many tissues, although pathology is restricted to skeletal muscles through a poorly understood mechanism. OBJECTIVE: Despite recent advances in the field, it remains unclear which therapeutic avenue is most promising for the restoration of SA level in skeletal muscle affected by GNEM. Our objective was to assess dietary and gene therapy strategies for GNEM in Cmah-deficient GNED207VTgGne-/- mice, a model that allows for the visualization of orally delivered N-glycolylneuraminic acid (Neu5Gc), one of the two predominant SA forms in muscle. METHODS: Methods included in situ physiology studies of the tibialis anterior muscle, studies of ambulation and limb grip strength, and muscle staining using MAA, SNA, and anti-Neu5Gc antibody, along with qPCR, qRT-PCR, western blot, and HPLC studies to assess virally introduced DNA, GNE gene expression, GNE protein expression, and SA expression. RESULTS: We found that a diet enriched in Neu5Gc-containing glycoproteins had no impact on Neu5Gc immunostaining in muscles of GNEM model mice. Delivery of a single high dose oral Neu5Gc therapy, however, did increase Neu5Gc immunostaining, though to levels below those found in wild type mice. Delivery of a single dose of GNE gene therapy using a recombinant Adeno Associated Virus (rAAV) vector with a liver-specific or a muscle-specific promoter both caused increased muscle Neu5Gc immunostaining that exceeded that seen with single dose monosaccharide therapy. CONCLUSIONS: Our findings indicate that dietary loading of Neu5Gc-containing glycoproteins is not effective in increasing muscle Neu5Gc expression, while single dose oral Neu5Gc monosaccharide or GNE gene therapy are. Neu5Gc immunostaining, however, showed greater changes than did lectin staining or HPLC analysis. Taken together, these results suggest that Neu5Gc immunostaining may be more sensitive technique to follow SA expression than other more commonly used methods and that liver expression of GNE may contribute overall muscle SA content.


Assuntos
Dietoterapia , Miopatias Distais/terapia , Terapia Genética , Complexos Multienzimáticos/genética , Músculo Esquelético/metabolismo , Ácido N-Acetilneuramínico/metabolismo , Animais , Modelos Animais de Doenças , Miopatias Distais/genética , Miopatias Distais/metabolismo , Humanos , Camundongos , Camundongos Transgênicos
14.
Dig Dis Sci ; 67(2): 481-491, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-33939147

RESUMO

BACKGROUND AND AIMS: Lifestyle modification is the main treatment for nonalcoholic fatty liver disease (NAFLD), but remains challenging to implement. The aim of this pilot was to assess the acceptability and feasibility of a mobile-technology based lifestyle program for NAFLD patients. METHODS: We enrolled adult patients with NAFLD in a 6-month mobile-technology based program where participants received a FitBit with weekly tailored step count goals and nutritional assessments. Anthropometrics, hepatic and metabolic parameters, Fibroscan, physical function and activity, and health-related quality of life measures were obtained at enrollment and month 6. Semi-structured exit interviews were conducted to assess patient's experience with the program. RESULTS: 40 (63%) eligible patients were enrolled. Median age was 52.5 with 53% males, 93% whites, 43% with diabetes and median BMI 33.9. On baseline Fibroscan, 59% had F0-2 fibrosis and 70% had moderate-severe steatosis. 33 patients completed the study. Median percentage of days with valid FitBit data collection was 91. 4 patients increased and maintained, 19 maintained, and 8 increased but subsequently returned to baseline weekly step count. 59% of patients reported Fitbit was easy to use and 66% felt step count feedback motivated them to increase their activity. Roughly 50% of patients had reduction in weight, triglycerides and Fibroscan liver stiffness, and 75% had improvement in controlled attenuation parameter and physical function. CONCLUSIONS: A 6-month mobile-technology based pilot lifestyle intervention was feasible and acceptable to NAFLD patients. The program promoted physical activity and was associated with improvement in clinical parameters in some patients.


Assuntos
Dietoterapia , Exercício Físico , Hepatopatia Gordurosa não Alcoólica/terapia , Comportamento de Redução do Risco , Adulto , Técnicas de Imagem por Elasticidade , Estudos de Viabilidade , Feminino , Monitores de Aptidão Física , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/diagnóstico por imagem , Projetos Piloto , Triglicerídeos/sangue , Redução de Peso
15.
Arch Physiol Biochem ; 128(2): 558-567, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32569480

RESUMO

We aimed to firstly examine the effects of nutrition and exercise training on irisin, Sema-3E, biochemical and inflammatory parameters in obese patients. This study was conducted using 37 individuals were divided into three groups according to body mass index (BMI) as non-obese, 1nd degree and 2nd degree obese individuals. Nutrition and exercise training were applied to groups for eight weeks. Insulin resistance decreased in non-obese and 1st degree obese subjects. HsCRP values decreased only in the second degree obese individuals. Adiponectin values were significantly decreased in all three groups. There was a negative correlation between serum adiponectin and plasma irisin levels both before and after treatment. Sema-3E levels increased significantly in only the first degree obese individuals, whereas plexin-D1 values did not change significantly in any group. Our findings indicate that nutrition and exercise training we apply improved both anthropometric measurements and biochemical parameters in obese and non-obese individuals.


Assuntos
Fibronectinas , Obesidade , Semaforinas , Índice de Massa Corporal , Dietoterapia , Exercício Físico , Fibronectinas/metabolismo , Humanos , Obesidade/terapia , Semaforinas/metabolismo
16.
Gynecol Endocrinol ; 38(1): 55-62, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34636710

RESUMO

AIM: The objective of this study was to determine the effectiveness of system-based intervention in reducing the incidence of diabetes and to improve the postnatal metabolic profiles among women with gestational diabetes mellitus (GDM). MATERIALS AND METHODS: For women in the intervention arm (n = 130), they received one session of individualized health education at 36 gestational weeks, a booklet of diabetes prevention, five-session of postpartum booster educational program which were conducted including 1 session of dietary and exercise counseling by dietician and physiotherapist at 6 weeks postpartum. For women in the control group (n = 168), standard treatment whereby they had received group therapy on diet and physical activity modification by dietician and staff nurses during the antenatal period. RESULTS: There were no significant differences in baseline characteristics between groups for most of the variables examined except for educational level which the control group had a higher education than the intervention group. The women assigned to system-based intervention have a significant difference to GDM women who were assigned to the control group for LDL and HDL but not in anthropometric measurements, blood pressure, glucose index, total cholesterol, and triglyceride. In addition, it was found that the incidence of Type 2 diabetes mellitus (T2DM) 2 years after delivery was 20% in the intervention arm compared to 17% in the control arm. CONCLUSION: The system-based intervention was not statistically superior to the control intervention as there is no difference in terms of incidence of T2DM between the intervention and control group. We, therefore, suggested that more intensive interventions are needed to prevent GDM from developing into T2DM.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Diabetes Gestacional/terapia , Aconselhamento , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Gestacional/fisiopatologia , Dietoterapia , Exercício Físico , Feminino , Idade Gestacional , Educação em Saúde , Humanos , Metaboloma , Nutricionistas , Educação de Pacientes como Assunto , Fisioterapeutas , Período Pós-Parto , Gravidez
17.
Rheumatol Int ; 42(2): 285-290, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34677651

RESUMO

Polymyalgia rheumatica (PMR) is common. The mainstay of treatment, glucocorticoids, are associated with significant adverse effects and many patients remain on high doses for a number of years. Little is known about the use of other, non-pharmacological therapies as adjuncts in PMR. The PMR Cohort Study is an inception cohort study of patients diagnosed with PMR in primary care. This analysis presents data on the use and perceived impact of non-pharmacological therapies from a long-term follow-up survey. Non-pharmacological treatments were classified as either diet, exercise, or complementary therapies. Results are presented as adjusted means, medians, and raw counts where appropriate. One hundred and ninety-seven participants completed the long-term follow-up questionnaire, of these 81 (41.1%) reported using non-pharmacological therapy. Fifty-seven people reported using a form of complementary therapy, 35 used exercise and 20 reported changing their diet. No individual non-pharmacological therapy appeared to be associated with long-term outcomes. The use of non-pharmacological therapies is common amongst PMR patients, despite the paucity of evidence supporting their use. This suggests that people perceive a need for treatment options in addition to standard glucocorticoid regimens. Further research is needed to understand patients' aims when seeking additional treatments and to strengthen the evidence base for their use so that patients can be guided towards effective options.


Assuntos
Terapias Complementares/métodos , Dietoterapia/métodos , Terapia por Exercício/métodos , Polimialgia Reumática/terapia , Idoso , Estudos de Coortes , Terapia Combinada , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
18.
Scand J Immunol ; 95(2): e13111, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34709678

RESUMO

The mammalian lactoperoxidase system, consisting of lactoperoxidase and the H2 O2 -producing enzyme duox, is our first line of defence against airborne microbes. This system catalyses the production of hypoiodite and hypoiodous acid in the presence of sufficient iodine. These products are highly efficient at destroying the H1N1 virus and the respiratory syncytial virus (RSV). Japan has not been affected as much as other nations during the COVID-19 pandemic (death rate about 10% of the United States), and we think this is due to a diet high in iodine. With this in mind, we suggest four actions to prevent SARS-CoV-2 infections. First, health professionals should study the preventative effect of increasing iodine in the diets of the aged, institutionalized, diabetics andsmokers. Second, the recommended daily intake (RDI) for iodine should be significantly increased, to at least double, the current RDI. Governments should encourage the use and distribution of cheap iodized salts, kelp and seaweed. Third, more research should be done around the physiology and the protective effects of the lactoperoxidase system. Finally, the degradation products of the SARS-CoV-2 viral particle by hypoiodite and hypoiodous acid should be characterized; portions of the damaged particle are likely to elicit stronger immunity and better vaccines.


Assuntos
COVID-19/dietoterapia , COVID-19/prevenção & controle , Dietoterapia/métodos , Iodo/administração & dosagem , SARS-CoV-2/efeitos dos fármacos , COVID-19/epidemiologia , Dieta , Humanos , Imunomodulação/imunologia , Compostos de Iodo/metabolismo , Japão/epidemiologia , Lactoperoxidase/metabolismo
19.
Rio de Janeiro; s.n; 2022. 59 f p. tab.
Tese em Português | LILACS | ID: biblio-1393015

RESUMO

A adoção de uma alimentação saudável auxilia no controle e mortalidade por Doenças Crônicas não Transmissíveis (DCNT). Uma alimentação mais saudável pode ser alcançada pela prática de dietas especiais, que podem ser adotadas devido ao diagnóstico de algumas doenças. Conhecer o percentual de quem faz dietas especiais pode ser útil para o monitoramento do cuidado e enfrentamento das DCNT no Brasil. Assim, o presente trabalho objetivou estimar a prevalência do uso de dieta especial na população brasileira segundo tipos de dieta, variáveis sociodemográficas e estado nutricional. Trata-se de um estudo transversal e descritivo utilizando dados do Inquérito Nacional de Alimentação (INA) 2017/2018 (n=46.164 indivíduos com 10 anos ou mais de idade). Os participantes foram questionados se estavam fazendo alguma dieta especial, e para qual finalidade. Foram obtidas as prevalências de prática de dietas de acordo com características sociodemográficas, estado nutricional, uso de sal, açúcar e adoçante de adição, e suplementos nutricionais. Para o cálculo das estimativas, foi utilizado o Software R versão 4.1.0 considerando a complexidade da amostra e os fatores de expansão. Entre a população estudada (n=46.164 indivíduos), 14,3% afirmaram realizar algum tipo de dieta. Quando comparado por sexo, a prevalência foi maior entre as mulheres (17,8%) do que entre os homens (9,6%), sendo a dieta para pressão alta mais prevalente nos homens (3,7%) e a dieta para emagrecer mais prevalente nas mulheres (7,4%). O uso de dietas foi maior entre idosos (homens: 22,4%; mulheres: 31,2%) e obesos (homens: 13,2%; mulheres: 26,0%), para todos os tipos de dietas, e menor entre indivíduos de menor renda (homens: 4,3% vs. 20,4% maior renda; mulheres: 10% vs. 26,1% maior renda) e menor escolaridade (homens: 6,7% vs. 23,6% com maior escolaridade; mulheres: 11,9% vs. 23,9% com maior escolaridade). Os indivíduos que relataram realizar dieta, comparados com os que não relataram, apresentaram menor prevalência de consumo de sal (homens: 12,0% vs. 15,5%; mulheres: 9,6% vs. 12,6%) e açúcar de adição (homens: 53,1% vs. 85,4%; mulheres: 51,1% vs. 81,9%) e maior prevalência de consumo de suplementos nutricionais (homens: 32,2% vs. 13,7%; mulheres: 38,6% vs. 19,2%). O uso de dietas foi maior entre as mulheres, idosos e obesos, e menor entre indivíduos de menor renda e menor escolaridade para todos os tipos de dieta. Embora as DCNTs sejam mais frequentes entre os indivíduos de menor renda e menor escolaridade, o uso de dietas especiais foi menos frequente neste grupo.


The adoption of a healthy diet helps in the control and mortality from Chronic Non-Communicable Diseases (NCDs). A healthier diet can be achieved by the practice of special diets, which can be adopted due to the diagnosis of some diseases. Knowing the percentage of those on special diets can be useful for monitoring the care and coping with NCDs in Brazil. Thus, the present study aimed to estimate the prevalence of special diet use in the Brazilian population according to types of diet, sociodemographic variables and nutritional status. This is a cross-sectional and descriptive study using data from the National Food Survey (INA) 2017/2018 (n=46,164 individuals aged 10 years and over). Participants were asked if they were on a special diet, and for what purpose. Prevalence of diet practices were obtained according to sociodemographic characteristics, nutritional status, use of salt, sugar and added sweeteners, and nutritional supplements. To calculate the estimates, Software R version 4.1.0 was used, considering the complexity of the sample and the expansion factors. Among the population studied (n=46,164 individuals), 14.3% stated that they were on some type of diet. When compared by sex, the prevalence was higher among women (17.8%) than among men (9.6%), with the diet for high blood pressure being more prevalent in men (3.7%) and the diet for weight loss more prevalent in women (7.4%). Diet use was higher among the elderly (men: 22.4%; women: 31.2%) and obese (men: 13.2%; women: 26.0%), for all types of diets, and lower among individuals with lower income (men: 4.3% vs. 20.4% higher income; women: 10% vs. 26.1% higher income) and less educated (men: 6.7% vs. 23.6% with higher education; women: 11.9% vs. 23.9% with higher education). Individuals who reported dieting, compared with those who did not, had a lower prevalence of salt consumption (men: 12.0% vs. 15.5%; women: 9.6% vs. 12.6%) and sugar addiction (men: 53.1% vs. 85.4%; women: 51.1% vs. 81.9%) and a higher prevalence of consumption of nutritional supplements (men: 32.2% vs. 13.7% ; women: 38.6% vs. 19.2%). The use of diets was higher among women, elderly and obese, and lower among individuals with lower income and lower education for all types of diet. Although CNCDs are more frequent among individuals with lower income and lower education, the use of special diets was less frequent in this group.


Assuntos
Inquéritos Nutricionais , Estado Nutricional , Comportamento Alimentar , Brasil , Estudos Transversais , Dietoterapia , Alimentos
20.
Nutr Rev ; 80(4): 962-979, 2022 Mar 10.
Artigo em Inglês | MEDLINE | ID: mdl-34919715

RESUMO

CONTEXT: Public health nutrition interventions shown to be effective under optimal research conditions need to be scaled up and implemented in real-world settings. OBJECTIVES: The primary aim for this review was to assess the effectiveness of scaled-up public health nutrition interventions with proven efficacy, as examined in a randomized controlled trial. Secondary objectives were to: 1) determine if the effect size of scaled-up interventions were comparable to the prescale effect, and; 2) identify any adaptations made during the scale-up process. DATA SOURCES: Six electronic databases were searched and field experts contacted. STUDY SELECTION: An intervention was considered scaled up if it was delivered on a larger scale than a preceding randomized controlled trial ("prescale") in which a significant intervention effect (P ≤ 0.05) was reported on a measure of nutrition. DATA EXTRACTION: Two reviewers independently performed screening and data extraction. Effect size differences between prescale and scaled-up interventions were quantified. Adaptations to scale-up studies were coded according to the Adaptome model. RESULTS: Ten scaled-up nutrition interventions were identified. The effect size difference between prescale trials and scaled-up studies ranged from -32.2% to 222% (median, 50%). All studies made adaptations between prescale to scaled-up interventions. CONCLUSION: The effects of nutrition interventions implemented at scale typically were half that achieved in prior efficacy trials. Identifying effective scale-up strategies and methods to support retainment of the original prescale effect size is urgently needed to inform public health policy. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no.CRD42020149267.


Assuntos
Dietoterapia , Saúde Pública , Humanos
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