Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 111
Filtrar
1.
Mol Cell ; 78(6): 1034-1044, 2020 06 18.
Artigo em Inglês | MEDLINE | ID: mdl-32504556

RESUMO

Malignant cells remodel their metabolism to meet the demands of uncontrolled cell proliferation. These demands lead to differential requirements in energy, biosynthetic precursors, and signaling intermediates. Both genetic programs arising from oncogenic events and transcriptional programs and epigenomic events are important in providing the necessary metabolic network activity. Accumulating evidence has established that environmental factors play a major role in shaping cancer cell metabolism. For metabolism, diet and nutrition are the major environmental aspects and have emerged as key components in determining cancer cell metabolism. In this review, we discuss these emerging concepts in cancer metabolism and how diet and nutrition influence cancer cell metabolism.


Assuntos
Dietoterapia/métodos , Neoplasias/dietoterapia , Neoplasias/metabolismo , Carcinogênese/metabolismo , Proliferação de Células/genética , Dieta/tendências , Dietoterapia/tendências , Metabolismo Energético/genética , Humanos , Redes e Vias Metabólicas/genética , Redes e Vias Metabólicas/fisiologia , Neoplasias/genética , Terapia Nutricional/métodos , Transdução de Sinais/genética
2.
Nutr. hosp ; 36(4): 898-904, jul.-ago. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184716

RESUMO

Introducción: las estrictas restricciones dietéticas que imponemos en la enfermedad renal crónica avanzada (ERCA) tienen un impacto negativo en la calidad de vida. Objetivo: determinar si estas restricciones están justificadas y si un programa de educación nutricional mejoraría los parámetros de calidad de vida relacionada con la salud (CVRS). Material y métodos: realizamos un ensayo clínico de intervención educativa, unicéntrico, randomizado y controlado en los pacientes de la consulta ERCA de Albacete. Se incluyeron 75 pacientes, 35 en el grupo control y 40 en el de intervención. Se realizó la valoración nutricional mediante valoración global subjetiva (VGS) e índice de masa corporal (IMC). Para medir la CVRS se empleó el cuestionario de salud SF-36. En el grupo intervención se realizó la intervención nutricional individual, colectiva y por recuerdo telefónico, adaptando a cada paciente el consejo dietético y ajustando las restricciones de forma personalizada. Resultados: la malnutrición medida por VGS fue del 20% en el grupo control y del 29,3% en el grupo intervención, donde mejoró aunque no fue significativo. El IMC mostró sobrepeso con una media de 28,83 (DE: 5,4) y 26,96 kg/m2 (DE: 4,09) respectivamente, sin cambios a lo largo del estudio. La intervención nutricional supuso una mejoría en las puntuaciones de todas las subescalas excepto en el dolor corporal. Además, los componentes físico y mental también mejoraron sus puntuaciones en el grupo intervención y empeoraron significativamente (p < 0,001) en el control. Conclusiones: la calidad de vida se puede mejorar en los pacientes con ERCA aplicando un programa de educación nutricional


Introduction: the strict dietary recommendations we impose on patients with advanced chronic kidney disease (ACKD) have negative impact on quality of life. Objective: determine whether such restrictions are justified and if an educational program can improve health-related quality of life (HRQL) parameters. Methods: we carried out an educational intervention, single center, randomized, controlled clinical trial on ACKD outpatients in Albacete. Seventy-five patients were included, 35 in the control group and 40 in the intervention group. Nutritional assessment was based on the Subjetive Global Assessment (SGA) and body mass index (BMI). We used the SF-36 health questionnaire to measure HRQL. In the intervention group we carried out individual, collective and telephone nutritional interventions, adapting diet advice and restrictions in a personalized way. Results: malnutrition measured by Subjective Global Assessment (SGA) in the control group was 20%; meanwhile, in the intervention group it was 29.3% and it improved at the end of the study, but not significantly. BMI showed overweight with a mean of 28.83 kg/m² (DE: 5.4) and 26.96 kg/m² (DE: 4.09), respectively, and did not change throughout the study. The nutritional intervention improved the score in all the subscales except for body pain score. Besides, mental and physical components also improved their scores in the intervention group and worsened them in the control group (p < 0.001). Conclusions: quality of life can be improved in ACKD patients applying an educational nutrition program


Assuntos
Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Educação Alimentar e Nutricional , Dietoterapia/métodos , Dietoterapia/tendências , Qualidade de Vida , Insuficiência Renal Crônica/dietoterapia , Desnutrição/epidemiologia , Valor Nutritivo , Análise Estatística , Inquéritos e Questionários , Modelos Lineares
3.
Physiol Res ; 67(Suppl 3): S525-S530, 2018 11 28.
Artigo em Inglês | MEDLINE | ID: mdl-30484679

RESUMO

The paper presents the results of our effort to reveal objective parameters for evaluation of the spa treatment for patients with anxiety-depressive disorders. The study was based on our previous experience with neuroactive steroids and neurosteroids, which play a crucial role in the psychological well-being of patients by maintaining balance of the organism. A total number of 94 steroids were determinated in a group of 70 female patients diagnosed with anxiety-depressive disorders. Patients underwent a month spa treatment while maintaining unchanged medication dosing with SSRI (selective serotonin reuptake inhibitors). The other investigated factors contributing to improving the health of treated subjects were amino-acid homocysteine and serotonin. The blood samples were collected at the beginning and the end of the spa treatment. Serotonin in all patients increased by a relative 23 % (results given as relative differences in percent), while homocysteine decreased by 17.1 %. Statistically significant increases were found in 21 steroids, which indicate activation of the adrenal cortex. It can be assumed, that the overall improvement in the mental condition of patients, which was proved by questionnaire from Knobloch and Hausner, the increase in immune suppressive substances and anti-autoimmune responses, will maintain for a longer time after the spa treatment.


Assuntos
Transtornos de Ansiedade/sangue , Transtorno Depressivo/sangue , Dietoterapia/tendências , Hormônios/sangue , Massagem/tendências , Terapia de Relaxamento/tendências , Transtornos de Ansiedade/terapia , Transtorno Depressivo/terapia , Feminino , Humanos , Pessoa de Meia-Idade , Inibidores de Captação de Serotonina/sangue , Inibidores de Captação de Serotonina/uso terapêutico , Resultado do Tratamento
4.
J Neurol Sci ; 391: 104-108, 2018 08 15.
Artigo em Inglês | MEDLINE | ID: mdl-30103955

RESUMO

INTRODUCTION: Tuberous sclerosis complex (TSC) is a rare congenital disorder often associated with epilepsy. However, real-world treatment patterns for epilepsy in patients with TSC are not yet well categorized. METHODS: This study included patients with TSC and epilepsy from fifteen clinics in the United States and one in Belgium who were enrolled in the TSC Natural History Database (2006-2014). Patient demographics and epilepsy treatment patterns, including the use of anti-epileptic drugs (AEDs), epilepsy surgeries, and dietary therapies were assessed. RESULTS: Of the 1328 patients with TSC in the database, 1110 (83.6%) were diagnosed with epilepsy. The median age of epilepsy diagnosis was 0.7 years. Of those who received treatment for epilepsy (92.3%), 99.5% were prescribed AEDs, 25.3% underwent surgery, 7.9% were prescribed special diets, and 1% were prescribed mammalian target of rapamycin (mTOR) inhibitors. Of the patients receiving AEDs, over half (64.5%) used ≥3 different AEDs, and 22.5% underwent surgical treatment following AED initiation. Of the patients who underwent surgery, 35.1% had subsequent surgery. CONCLUSION: The use of multiple AEDs and surgical interventions may indicate a need for new therapies to reduce the treatment burden among patients with TSC and epilepsy.


Assuntos
Epilepsia/complicações , Epilepsia/terapia , Esclerose Tuberosa/complicações , Esclerose Tuberosa/terapia , Adolescente , Anticonvulsivantes/uso terapêutico , Criança , Pré-Escolar , Dietoterapia/tendências , Epilepsia/epidemiologia , Epilepsia/genética , Feminino , Seguimentos , Humanos , Masculino , Procedimentos Neurocirúrgicos/tendências , Estudos Retrospectivos , Resultado do Tratamento , Esclerose Tuberosa/epidemiologia , Esclerose Tuberosa/genética , Adulto Jovem
5.
World J Gastroenterol ; 24(25): 2673-2685, 2018 Jul 07.
Artigo em Inglês | MEDLINE | ID: mdl-29991873

RESUMO

Inflammatory bowel disease (IBD) is a serious health concern among western societies. The disease is also on the rise in some East Asian countries and in Australia. Health professionals and dietitians around the world are facing an unprecedented challenge to prevent and control the increasing prevalence of IBD. The current therapeutic strategy that includes drugs and biological treatments is inefficient and are associated with adverse health consequences. In this context, the use of natural products is gaining worldwide attention. In vivo studies and clinical evidence suggest that well-planned dietary regimens with specific nutrients can alleviate gastrointestinal inflammation by modulating inflammatory cytokines, such as tumor necrosis factor α (TNF-α), interleukin 1 (IL-1), IL-6, IL-1ß, and IL-10. Alternatively, the avoidance of high-fat and high-carbohydrate diets is regarded as an effective tool to eliminate the causes of IBD. Many functional foods and bioactive components have received attention for showing strong therapeutic effects against IBD. Both animal and human studies suggest that bioactive functional foods can ameliorate IBD by downregulating the pro-inflammatory signaling pathways, such as nuclear factor κB, STAT1, STAT6, and pro-inflammatory cytokines, including IL-1ß, IL-4, IL-6, COX-2, TNF-α, and interferon γ. Therefore, functional foods and diets have the potential to alleviate IBD by modulating the underlying pathogenic mechanisms. Future comprehensive studies are needed to corroborate the potential roles of functional foods and diets in the prevention and control of IBD.


Assuntos
Terapias Complementares/métodos , Dietoterapia/tendências , Suplementos Nutricionais , Alimento Funcional , Doenças Inflamatórias Intestinais/terapia , Animais , Produtos Biológicos/uso terapêutico , Terapias Complementares/tendências , Citocinas/metabolismo , Dietoterapia/métodos , Fármacos Gastrointestinais/efeitos adversos , Humanos , Mediadores da Inflamação/metabolismo , Doenças Inflamatórias Intestinais/etiologia , Resultado do Tratamento
6.
Ostomy Wound Manage ; 64(5): 18-29, 2018 05.
Artigo em Inglês | MEDLINE | ID: mdl-29847308

RESUMO

Little is known about the nutritional status and dietary habits of persons with an intestinal stoma, and no specific dietary guidelines have been established. A cross-sectional study was conducted among patients of a Stoma Patient Health Care Service in Juiz de Fora, Brazil, to compare the nutritional status of persons with an ileostomy or colostomy and to evaluate which foods are avoided most frequently and why. Anthropometric measurements (weight, height, arm circumference, and triceps and subscapular skinfold thickness) and body fat were assessed. Habitual dietary intake (energy, protein, carbohydrate, fiber, fat, calcium, iron, sodium, potassium, thiamin, riboflavin, vitamin B6, vitamin B3 [niacin], and vitamin B12) was assessed using a validated quantitative food frequency questionnaire. Foods avoided and reasons for avoidance (increased odor, increased gas, increased output, constipation, appliance leakage, and feelings regarding leaving home) were assessed. All data were collected without personal identifiers and stored in electronic files. Data were analyzed descriptively, and the Student's t test or Mann-Whitney test was used to compare the groups. Chi-squared analysis with Yates' continuity correction or Fisher's exact test was employed to examine the differences in the frequency of avoided foods by reasons for avoidance between the 2 groups. Of the 103 participants (52 [50.5%] men, 51 [49.5%] women; mean age 60.5 ± 12.9 years); 63 (61.2%) had a colostomy and 40 (38.8%) had an ileostomy. For both groups combined, time since surgery ranged from 1 to 360 months. Anthropometric measurements and body composition did not suggest nutritional deficiencies and did not differ significantly between groups. Persons with an ileostomy had a significantly lower fat and niacin intake than persons with a colostomy (P <.05). No other dietary intake differences were observed. Avoiding foods due to appliance leakage was more common among participants with an ileostomy (8, 20%) than a colostomy (3, 4.8%), and vegetables and fruits were reported as the most problematic foods. None of the other cited reasons was significantly different. The results of this study confirm that many persons with a stoma adjust their dietary intake and avoid certain foods which, especially in persons with an ileostomy, may increase their risk for nutritional deficiencies. Additional research to assess dietary intake and nutritional status variables as well as patient needs is needed to facilitate the development of specific nutritional status monitoring and dietary recommendations for persons with an ileostomy or colostomy.


Assuntos
Colostomia/métodos , Dietoterapia/tendências , Ileostomia/métodos , Estado Nutricional , Adulto , Idoso , Idoso de 80 Anos ou mais , Antropometria/métodos , Brasil , Estudos Transversais , Dieta/métodos , Dieta/normas , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Inquéritos e Questionários
7.
Ageing Res Rev ; 46: 42-59, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29803716

RESUMO

Growing evidence suggests chronic low-grade inflammation (LGI) as a possible mechanism underlying the aging process. Some biological and pharmaceutical compounds may reduce systemic inflammation and potentially avert functional decline occurring with aging. The aim of the present meta-analysis was to examine the association of pre-selected interventions on two established biomarkers of inflammation, interleukin-6 (IL-6), and C-reactive protein (CRP) in middle-age and older adults with chronic LGI. We reviewed the literature on potential anti-inflammatory compounds, selecting them based on safety, tolerability, acceptability, innovation, affordability, and evidence from randomized controlled trials. Six compounds met all five inclusion criteria for our systematic review and meta-analysis: angiotensin II receptor blockers (ARBs), metformin, omega-3, probiotics, resveratrol and vitamin D. We searched in MEDLINE, PubMed and EMBASE database until January 2017. A total of 49 articles fulfilled the selection criteria. Effect size of each study and pooled effect size for each compound were measured by the standardized mean difference. I2 was computed to measure heterogeneity of effects across studies. The following compounds showed a significant small to large effect in reducing IL-6 levels: probiotics (-0.68 pg/ml), ARBs (-0.37 pg/ml) and omega-3 (-0.19 pg/ml). For CRP, a significant small to medium effect was observed with probiotics (-0.43 mg/L), ARBs (-0.2 mg/L), omega-3 (-0.17 mg/L) and metformin (-0.16 mg/L). Resveratrol and vitamin D were not associated with any significant reductions in either biomarker. These results suggest that nutritional and pharmaceutical compounds can significantly reduce established biomarkers of systemic inflammation in middle-age and older adults. The findings should be interpreted with caution, however, due to the evidence of heterogeneity across the studies.


Assuntos
Envelhecimento/metabolismo , Dietoterapia/tendências , Sistemas de Liberação de Medicamentos/tendências , Medicina Baseada em Evidências/tendências , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/efeitos dos fármacos , Envelhecimento/patologia , Dietoterapia/métodos , Sistemas de Liberação de Medicamentos/métodos , Medicina Baseada em Evidências/métodos , Humanos , Inflamação/metabolismo , Inflamação/patologia , Inflamação/terapia , Pessoa de Meia-Idade
8.
Enferm. glob ; 17(50): 153-163, abr. 2018. tab
Artigo em Espanhol | IBECS | ID: ibc-173552

RESUMO

Objetivo: Investigar los efectos de la asistencia telefónica en la adhesión a la práctica de una dieta saludable de los pacientes con diabetes mellitus tipo 2. Métodos: Se realizó un ensayo clínico que involucró a 63 pacientes con diabetes mellitus tipo 2, 36 pacientes asignados al grupo de intervención (G1) y 27 en el grupo control (G2). Para el G1 se llevó a cabo una intervención de asistencia telefónica que correspondía a cuatro llamadas telefónicas que abordan: la planificación de comidas, tipos y porciones de comida y la comida sana. Para G2, se llevó a cabo la atención habitual en sus unidades. Los efectos de la asistencia telefónica en la dieta sana se midieron al inicio del estudio (T1) y después de la intervención (T2) en cuatro meses. Resultados: En G1, 16 (44,44%) pacientes se unieron en T1, disminuyendo para 14 (38.88%) en T2. En el G2, 08 (29,62%) pacientes se unieron en T1 y aumentó a 09 (33,33%) en T2. Hubo un aumento del consumo de frutas y verduras, reducción el consumo de alimentos ricos en grasas y alta en la tasa de azúcar, así como un aumento en el fraccionamiento de las comidas después de la intervención en G1. Hubo una diferencia significativa en la reducción de los niveles de glucosa en ayuno en los pacientes no adherentes y em la reducción de Hb1Ac entre los pacientes adherente G1. Conclusión: Los efectos de la asistencia telefónica después de la intervención de cuatro meses resultó insuficiente para aumentar la adherencia a una alimentación sana, pero observó un aumento del consumo de frutas y verduras y la disminución del consumo de alimentos ricos en grasas y alto contenido de azúcar y refrescos


Objetivo: Verificar os efeitos do suporte telefônico na adesão á prática de uma alimentação saudável de pacientes com diabetes mellitus tipo 2. Métodos: Tratou-se de um ensaio clínico do qual participaram 63 pacientes com diabetes mellitus tipo 2, sendo 36 pacientes alocados para o grupo intervenção (G1) e 27 para o grupo controle (G2). Para o G1, foi conduzida uma intervenção de suporte telefônico que correspondeu a quatro ligações telefônicas abordando: planejamento alimentar, tipos e porções de alimentos e alimentos saudáveis. Para o G2, foi conduzido o cuidado usual em sua unidade de saúde. Os efeitos do suporte telefônico na alimentação saudável foram medidos no início (T1) e após a intervenção (T2) em quatro meses. Resultados: No G1, 16 (44,44%) pacientes aderiram no T1, diminuindo para 14 (38,88%) no T2. No G2, 08 (29,62%) pacientes aderiram no T1 e aumentou para 09 (33,33%) no T2. Houve aumento do consumo de frutas, verduras e legumes, redução do consumo de alimentos gordurosos e ricos em açúcar além de aumento no fracionamento das refeições após a intervenção no G1. Observou-se diferença significativa na redução da glicemia de jejum entre os pacientes não aderentes e na redução da Hb1Ac entre os pacientes aderentes do G1. Conclusão: Os efeitos do suporte telefônico após a intervenção de quatro meses mostrou-se insuficiente para aumentar a adesão à alimentação saudável, porém observamos o aumento de consumo de frutas, verduras e legumes e diminuição do consumo de alimentos gordurosos e ricos em açúcar e refrigerantes


Objective: To verify the effects of telephone support on adherence to healthy eating practices among patients with type 2 diabetes mellitus. Methods: This was a clinical trial with 63 patients with type 2 diabetes mellitus; 36 patients were allocated to the intervention group (G1) and 27 patients to the control group (G2). For G1, telephone support was provided, consisting of four telephone calls addressing food planning, types and portions of food, and healthy foods. For G2, normal care was given in their health facility. The effects of telephone support on healthy eating were measured at baseline (T1) and at four months after the intervention (T2). Results: In G1, 16 (44.44%) patients joined at T1, which dropped to 14 (38.88%) by T2. In G2, 8 (29.62%) patients started at T1 and the number rose to 9 (33.33%) by T2. After the G1 intervention, there was an increase in the consumption of fruits and vegetables, a reduction in the consumption of fatty foods and foods high in sugar, and an increase in meal frequency. A significant difference was noted in reduced fasting blood glucose among non-adherent patients and reduced Hb1Ac among adherent patients from G1. Conclusion: The four-month intervention using telephone support proved insufficient to increase adherence to healthy eating. However, there was an increase in consumption of fruits and vegetables and a decrease in the consumption of fatty foods, foods high in sugar, and soft drinks


Assuntos
Humanos , Masculino , Feminino , Adulto , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/enfermagem , Cuidados de Enfermagem , Educação Alimentar e Nutricional , Telefone , Dietoterapia/tendências
9.
Artigo em Inglês | MEDLINE | ID: mdl-29094792

RESUMO

BACKGROUND: Functional gastrointestinal symptoms in irritable bowel syndrome (IBS) and quiescent inflammatory bowel disease (IBD) cause significant morbidity and a reduction in quality of life. Multiple dietary therapies are now available to treat these symptoms, but supporting evidence for many is limited. In addition to a further need for studies demonstrating efficacy and mechanism of action of dietary therapies, the risk of nutritional inadequacy, alterations to the microbiome and changes in quality of life are key concerns requiring elucidation. Identifying predictors of response to dietary therapy is an important goal as management could be tailored to the individual to target specific dietary components, and thereby reduce the level of dietary restriction necessary. PURPOSE: This review discusses the available dietary therapies to treat symptoms in patients with IBS and patients with quiescent IBD suffering from IBS symptoms, with the aim to understand where current dietary evidence lies and how to move forward in dietary research in this field.


Assuntos
Dietoterapia/métodos , Doenças Inflamatórias Intestinais/dietoterapia , Síndrome do Intestino Irritável/dietoterapia , Animais , Dietoterapia/tendências , Humanos , Qualidade de Vida , Resultado do Tratamento
10.
Ageing Res Rev ; 41: 1-17, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29081381

RESUMO

Type 2 diabetes mellitus (T2DM) is characterised by chronic low-grade inflammation, recently referred to as 'metaflammation', a relevant factor contributing to the development of both diabetes and its complications. Nonetheless, 'canonical' anti-inflammatory drugs do not yield satisfactory results in terms of prevention of diabetes progression and of cardiovascular events, suggesting that the causal mechanisms fostering metaflammation deserve further research to identify new druggable targets. Metaflammation resembles ageing-induced low-grade inflammation, previously referred to as inflammageing, in terms of clinical presentation and the molecular profile, pointing to a common aetiology for both conditions. Along with the mechanisms proposed to fuel inflammageing, here we dissect a plethora of pathological cascades triggered by gluco- and lipotoxicity, converging on candidate phenomena possibly explaining the enduring pro-inflammatory program observed in diabetic tissues, i.e. persistent immune-system stimulation, accumulation of senescent cells, epigenetic rearrangements, and alterations in microbiota composition. We discuss the possibility of harnessing these recent discoveries in future therapies for T2DM. Moreover, we review recent evidence regarding the ability of diets and physical exercise to modulate selected inflammatory pathways relevant for the diabetic pathology. Finally, we examine the latest findings showing putative anti-inflammatory mechanisms of anti-hyperglycaemic agents with proven efficacy against T2DM-induced cardiovascular complications, in order to gain insights into quickly translatable therapeutic approaches.


Assuntos
Senescência Celular/fisiologia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/terapia , Dietoterapia/métodos , Exercício Físico/fisiologia , Animais , Sistema Cardiovascular/imunologia , Sistema Cardiovascular/metabolismo , Diabetes Mellitus Tipo 2/imunologia , Dietoterapia/tendências , Humanos , Inflamação/imunologia , Inflamação/metabolismo , Inflamação/terapia , Estresse Oxidativo/fisiologia
11.
Ageing Res Rev ; 42: 40-55, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29248758

RESUMO

BACKGROUND: Ageing is a highly complex process marked by a temporal cascade of events, which promote alterations in the normal functioning of an individual organism. The triggers of normal brain ageing are not well understood, even less so the factors which initiate and steer the neuronal degeneration, which underpin disorders such as dementia. A wealth of data on how nutrients and diets may support cognitive function and preserve brain health are available, yet the molecular mechanisms underlying their biological action in both normal ageing, age-related cognitive decline, and in the development of neurodegenerative disorders have not been clearly elucidated. OBJECTIVES: This review aims to summarise the current state of knowledge of vulnerabilities that predispose towards dysfunctional brain ageing, highlight potential protective mechanisms, and discuss dietary interventions that may be used as therapies. A special focus of this paper is on the impact of nutrition on neuroprotection and the underlying molecular mechanisms, and this focus reflects the discussions held during the 2nd workshop 'Nutrition for the Ageing Brain: Functional Aspects and Mechanisms' in Copenhagen in June 2016. The present review is the most recent in a series produced by the Nutrition and Mental Performance Task Force under the auspice of the International Life Sciences Institute Europe (ILSI Europe). CONCLUSION: Coupling studies of cognitive ageing with studies investigating the effect of nutrition and dietary interventions as strategies targeting specific mechanisms, such as neurogenesis, protein clearance, inflammation, and non-coding and microRNAs is of high value. Future research on the impact of nutrition on cognitive ageing will need to adopt a longitudinal approach and multimodal nutritional interventions will likely need to be imposed in early-life to observe significant impact in older age.


Assuntos
Envelhecimento Cognitivo/fisiologia , Envelhecimento Cognitivo/psicologia , Dietoterapia/métodos , Estado Nutricional/fisiologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Animais , Encéfalo/metabolismo , Cognição/fisiologia , Transtornos Cognitivos/dietoterapia , Transtornos Cognitivos/metabolismo , Transtornos Cognitivos/psicologia , Dietoterapia/tendências , Humanos , Nutrientes/administração & dosagem , Nutrientes/metabolismo , Obesidade/dietoterapia , Obesidade/metabolismo , Obesidade/psicologia
12.
BMC Nephrol ; 18(1): 368, 2017 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-29262858

RESUMO

BACKGROUND: The most commonly used glomerular filtration rate estimating equations for drug dosing are Cockcroft-Gault (CG), Modification of Diet in Renal Disease (MDRD), Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations. However there is still a concern about whether to use MDRD and CKD-EPI interchangeably with CG for drug dosage adjustment. METHODS: The study was initiated to determine the concordance between MDRD, CKD-EPI and CG equations and associated factors in patients with chronic kidney disease at Saint Paul's Hospital Millennium Medical College (SPHMMC). This was a cross sectional study which involved patient chart review and physicians self-administered questionnaire. Serum creatinine level ≥ 1.2 mg/dL was used as a cutoff point in pre-selection of patients. The correctness of the drug dose prescribed for the level of renal function were compared to the drug database (Lexi-Comp) available through Up-to-date version 21.2. RESULTS: Among the total of 422 patients, 249 (59%) were males. Mean age of patients was 46.09 years. The use of MDRD equation for drug dose adjustment by physicians working in the renal clinic of SPHMMC was six out of nine physicians. The Pearson correlation coefficient between the CG with MDRD and CKD-EPI equations was r = 0.94, P < 0.001 and r = 0.95, P < 0.001, respectively. The concordance between the CG with MDRD and CKD-EPI equations for FDA assigned kidney function categories was 73.7%, Kappa = 0.644 and 74.9%, Kappa = 0.659, respectively. Concordance between the CG with MDRD and CKD-EPI equations for the drug dosing recommendation was 89.6%, kappa = 0.782 and 92%, kappa = 0.834, respectively. Age > 70 years was associated with discordance between CG and MDRD equations for drug dosing recommendation whereas serum creatinine 1.2-3.5 mg/dL, weight < 61 Kg and age > 70 years were associated with discordance between the CG with MDRD and CKD-EPI equations for FDA assigned kidney function categories. However, none of the factors associated with discordance between CG and CKD-EPI for drug dosing. CONCLUSION: MDRD equation can be used interchangeably with CG equation for drug dosing recommended in all adult patients between the age of 18 and 70 years. CKD-EPI can be used interchangeably with CG in all adult Ethiopian patients with CKD.


Assuntos
Dietoterapia/tendências , Hospitais Privados/tendências , Insuficiência Renal Crônica/dietoterapia , Insuficiência Renal Crônica/epidemiologia , Adulto , Idoso , Estudos Transversais , Dietoterapia/métodos , Etiópia/epidemiologia , Feminino , Taxa de Filtração Glomerular/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Insuficiência Renal Crônica/diagnóstico
13.
Proc Nutr Soc ; 76(3): 203-212, 2017 08.
Artigo em Inglês | MEDLINE | ID: mdl-28629483

RESUMO

High-quality placebo-controlled evidence for food, nutrient or dietary advice interventions is vital for verifying the role of diet in optimising health or for the management of disease. This could be argued to be especially important where the benefits of dietary intervention are coupled with potential risks such as compromising nutrient intake, particularly in the case of exclusion diets. The objective of the present paper is to explore the challenges associated with clinical trials in dietary research, review the types of controls used and present the advantages and disadvantages of each, including issues regarding placebos and blinding. Placebo-controlled trials in nutrient interventions are relatively straightforward, as in general placebos can be easily produced. However, the challenges associated with conducting placebo-controlled food interventions and dietary advice interventions are protean, and this has led to a paucity of placebo-controlled food and dietary advice trials compared with drug trials. This review appraises the types of controls used in dietary intervention trials and provides recommendations and nine essential criteria for the design and development of sham diets for use in studies evaluating the effect of dietary advice, along with practical guidance regarding their evaluation. The rationale for these criteria predominantly relate to avoiding altering the outcome of interest in those delivered the sham intervention in these types of studies, while not compromising blinding.


Assuntos
Dietoterapia/métodos , Ensaios Clínicos Controlados Aleatórios como Assunto , Pesquisa Biomédica/educação , Pesquisa Biomédica/métodos , Pesquisa Biomédica/tendências , Congressos como Assunto , Dietoterapia/efeitos adversos , Dietoterapia/tendências , Método Duplo-Cego , Guias como Assunto , Humanos , Ciências da Nutrição/educação , Ciências da Nutrição/métodos , Ciências da Nutrição/tendências , Educação de Pacientes como Assunto , Placebos , Ensaios Clínicos Controlados Aleatórios como Assunto/normas , Projetos de Pesquisa/normas , Projetos de Pesquisa/tendências , Método Simples-Cego , Sociedades Científicas
14.
Clin. transl. oncol. (Print) ; 19(6): 682-694, jun. 2017. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-162825

RESUMO

The relationship between obesity and cancer is clear and is present at all times during course of the disease. The importance of obesity in increasing the risk of developing cancer is well known, and some of the most prevalent tumours (breast, colorectal, and prostate) are directly related to this risk increase. However, there is less information available on the role that obesity plays when the patient has already been diagnosed with cancer. Certain data demonstrate that in some types of cancer, obese patients tolerate the treatments more poorly. Obesity is also known to have an impact on the prognosis, favouring lower survival rates or the appearance of secondary tumours. In this consensus statement, we will analyse the scientific evidence on the role that obesity plays in patients already diagnosed with cancer, and the available data on how obesity control can improve the quality of daily life for the cancer patient (AU)


No disponible


Assuntos
Humanos , Obesidade/complicações , Obesidade/patologia , Conferências de Consenso como Assunto , Sociedades Médicas/organização & administração , Sociedades Médicas/normas , Neoplasias/terapia , Qualidade de Vida , Comorbidade , Recidiva Local de Neoplasia/complicações , Medição de Risco/métodos , Taxa de Sobrevida , Cirurgia Bariátrica/tendências , Apoio Social , Dietoterapia/tendências
15.
Am J Prev Med ; 53(1): 9-16, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28365089

RESUMO

INTRODUCTION: In 2007 and 2010, Expert Committee and U.S. Preventive Services Task Force guidelines were released, respectively, urging U.S. practitioners to deliver preventive obesity counseling for children. This study determined the frequency and evaluated predictors of receiving counseling for diet and physical activity among a national sample of children from 2002 to 2011. METHODS: Children aged 6-17 years were used from the 2002-2011 Medical Expenditure Panel Surveys and analyzed in 2016. Parental report of two questions assessed whether children received both dietary and exercise counseling from the provider. Children were grouped by weight category. Bivariate analyses compared the frequency of receiving counseling; logistic regression evaluated predictors of receiving counseling. RESULTS: The sample included 36,114 children; <50% of children received counseling. Across all time periods, children were more likely to receive counseling with increasing weight. Logistic regression models showed that obese children had greater odds of receiving counseling versus normal-weight children, even after adjusting for covariates. Additional significant positive correlates of receiving counseling were Hispanic ethnicity, living in an urban setting, and being in the highest income stratum. Being uninsured was associated with lower odds of counseling. Years 2007-2009 and 2010-2011 were associated with increased counseling versus the benchmark year category in the multivariable model. CONCLUSIONS: Counseling appears more likely with greater weight and increased after both guidelines in 2007 and 2010. Overall counseling rates for children remain low. Future work should focus on marginalized groups, such as racial and ethnic minorities and rural populations.


Assuntos
Aconselhamento/tendências , Dietoterapia/tendências , Terapia por Exercício/tendências , Obesidade/prevenção & controle , Serviços Preventivos de Saúde/tendências , Adolescente , Peso Corporal , Criança , Aconselhamento/normas , Aconselhamento/estatística & dados numéricos , Dietoterapia/estatística & dados numéricos , Terapia por Exercício/estatística & dados numéricos , Feminino , Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Hispano-Americanos/estatística & dados numéricos , Humanos , Masculino , Pessoas sem Cobertura de Seguro de Saúde/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Serviços Preventivos de Saúde/métodos , Serviços Preventivos de Saúde/normas , Serviços Preventivos de Saúde/estatística & dados numéricos , População Rural , Fatores Socioeconômicos , População Urbana
16.
Nutrients ; 9(4)2017 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-28394304

RESUMO

The history of dialysis and diet can be viewed as a series of battles waged against potential threats to patients' lives. In the early years of dialysis, potassium was identified as "the killer", and the lists patients were given of forbidden foods included most plant-derived nourishment. As soon as dialysis became more efficient and survival increased, hyperphosphatemia, was identified as the enemy, generating an even longer list of banned aliments. Conversely, the "third era" finds us combating protein-energy wasting. This review discusses four questions and four paradoxes, regarding the diet-dialysis dyad: are the "magic numbers" of nutritional requirements (calories: 30-35 kcal/kg; proteins > 1.2 g/kg) still valid? Are the guidelines based on the metabolic needs of patients on "conventional" thrice-weekly bicarbonate dialysis applicable to different dialysis schedules, including daily dialysis or haemodiafiltration? The quantity of phosphate and potassium contained in processed and preserved foods may be significantly different from those in untreated foods: what are we eating? Is malnutrition one condition or a combination of conditions? The paradoxes: obesity is associated with higher survival in dialysis, losing weight is associated with mortality, but high BMI is a contraindication for kidney transplantation; it is difficult to limit phosphate intake when a patient is on a high-protein diet, such as the ones usually prescribed on dialysis; low serum albumin is associated with low dialysis efficiency and reduced survival, but on haemodiafiltration, high efficiency is coupled with albumin losses; banning plant derived food may limit consumption of "vascular healthy" food in a vulnerable population. Tailored approaches and agreed practices are needed so that we can identify attainable goals and pursue them in our fragile haemodialysis populations.


Assuntos
Dietoterapia/efeitos adversos , Medicina Baseada em Evidências , Comunicação Interdisciplinar , Assistência Centrada no Paciente , Diálise Renal/efeitos adversos , Insuficiência Renal Crônica/dietoterapia , Insuficiência Renal Crônica/terapia , Terapia Combinada/efeitos adversos , Terapia Combinada/tendências , Contraindicações , Dietoterapia/tendências , Progressão da Doença , Humanos , Falência Renal Crônica/complicações , Falência Renal Crônica/etiologia , Falência Renal Crônica/prevenção & controle , Falência Renal Crônica/cirurgia , Transplante de Rim/efeitos adversos , Transplante de Rim/tendências , Necessidades Nutricionais , Obesidade/complicações , Assistência Centrada no Paciente/tendências , Desnutrição Proteico-Calórica/etiologia , Desnutrição Proteico-Calórica/prevenção & controle , Diálise Renal/tendências , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/fisiopatologia
17.
EBioMedicine ; 17: 24-29, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28242200

RESUMO

The nascent field of 'Nutritional Psychiatry' offers much promise for addressing the large disease burden associated with mental disorders. A consistent evidence base from the observational literature confirms that the quality of individuals' diets is related to their risk for common mental disorders, such as depression. This is the case across countries and age groups. Moreover, new intervention studies implementing dietary changes suggest promise for the prevention and treatment of depression. Concurrently, data point to the utility of selected nutraceuticals as adjunctive treatments for mental disorders and as monotherapies for conditions such as ADHD. Finally, new studies focused on understanding the biological pathways that mediate the observed relationships between diet, nutrition and mental health are pointing to the immune system, oxidative biology, brain plasticity and the microbiome-gut-brain axis as key targets for nutritional interventions. On the other hand, the field is currently limited by a lack of data and methodological issues such as heterogeneity, residual confounding, measurement error, and challenges in measuring and ensuring dietary adherence in intervention studies. Key challenges for the field are to now: replicate, refine and scale up promising clinical and population level dietary strategies; identify a clear set of biological pathways and targets that mediate the identified associations; conduct scientifically rigorous nutraceutical and 'psychobiotic' interventions that also examine predictors of treatment response; conduct observational and experimental studies in psychosis focused on dietary and related risk factors and treatments; and continue to advocate for policy change to improve the food environment at the population level.


Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/prevenção & controle , Depressão/prevenção & controle , Dietoterapia/métodos , Dieta , Animais , Transtorno do Deficit de Atenção com Hiperatividade/dietoterapia , Transtorno do Deficit de Atenção com Hiperatividade/epidemiologia , Depressão/dietoterapia , Depressão/epidemiologia , Dietoterapia/tendências , Suplementos Nutricionais , Humanos
19.
Nat Rev Clin Oncol ; 13(8): 504-15, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-26951041

RESUMO

Despite the potentially important roles of diet and nutrition in cancer prevention, the evidence to support these roles is widely perceived by the public and health professionals as being inconsistent. In this Review, we present the issues and challenges in conducting and interpreting diet-cancer research, including those relating to the design of epidemiological studies, dietary data collection methods, and factors that affect the outcome of intervention trials. Approaches to improve effect estimates, such as the use of biomarkers to improve the accuracy of characterizing dietary exposures, are also discussed. Nutritional and dietary patterns are complex; therefore, the use of a reductionist approach to investigations, by focusing on specific nutrients, can produce misleading information. The effects of tumour heterogeneity and the failure to appreciate the nonlinear, U-shaped relationship between micronutrients and cancer in both observational studies and clinical trials are discussed. New technologies and investigational approaches are enabling the exploration of complex interactions between genetic, epigenetic, metabolic, and gut-microbial processes that will inform our knowledge of the diet-cancer relationship. Communicating the status of the evolving science in the context of the overall scientific evidence base, and evidence-based dietary recommendations for cancer prevention, should be emphasized in guidance for the public and for individual patients.


Assuntos
Dieta , Neoplasias/prevenção & controle , Estado Nutricional , Pesquisa Biomédica/tendências , Dietoterapia/tendências , Dieta Saudável , Métodos Epidemiológicos , Exercício Físico/fisiologia , Alimentos , Previsões , Humanos
20.
Rev. toxicol ; 33(1): 20-30, 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-153970

RESUMO

Al declarar la acrilamida como un probable carcinógeno en humanos, diferentes trabajos han tratado de esclarecer si la exposición dietética en humanos puede constituir un riesgo para la salud, no obstante, las publicaciones sobre la población española han sido englobadas en macroestudios no específicos o se refieren exclusivamente a población infantil. El objetivo del presente trabajo fue realizar una evaluación del riesgo de exposición dietética a la acrilamida en la población española y valenciana. A partir de la revisión de la información sobre la toxicidad de acrilamida y su presencia en alimentos se calculó la exposición dietética al tóxico a través del método determinista. Los alimentos que presentan mayor contribución al consumo diario de acrilamida son el pan, el pan tostado, las galletas, las patatas crisps y los cereales de desayuno, seguidos del café tostado y la cerveza. La población adulta española duplica la exposición estimada por el estudio europeo EPIC. La población más expuesta es la infantil seguida de la femenina. La población valenciana está menos expuesta que la española aunque ambas se encuentran en el mismo nivel que la población europea. Los adultos españoles presentan el mismo riesgo de neurotoxicidad y menor riesgo de tumores mamarios que el calculado a nivel internacional en 2011 por la FAO/OMS. En cambio la población infantil presenta un riesgo de neurotoxicidad cuatro veces menor. El principio de precaución debe prevalecer en tanto no se obtengan datos más concluyentes de toxicidad (AU)


As a result of declaring acrylamide as a probable human carcinogen, different studies attempted to clarify whether dietary exposure in humans can establish a health risk. However, the literature concerning Spanish population has been subsumed in non-specific macro studies or it refers exclusively to children. The aim of this study was to make a risk assessment of dietary exposure to acrylamide in the Spanish and Valencian population. Based on reviewing the information about the toxicity of acrylamide and its presence in food, dietary exposure to the toxic substance was calculated by a deterministic method. Foods that have a higher contribution to daily intake of acrylamide are bread, toasted bread, biscuits, crisps and breakfast cereals, followed by roasted coffee and beer. The Spanish adult population doubles the exposure estimated by the EPIC study. The most exposed population is children followed by the female one. The Valencian population is less exposed than the Spanish as a whole though both are on the same level, as the European population. Spanish adults have the same risk of neurotoxicity and lower risk of mammary tumors than the international value calculated in 2011 by the FAO/WHO. However the child population has a risk of neurotoxicity four times lower. The precautionary principle must prevail while more conclusive toxicity data is not achieved (AU)


Assuntos
Humanos , Masculino , Feminino , Acrilamida/uso terapêutico , Nutrição de Grupos de Risco , Medição de Risco/métodos , Medição de Risco , Dietoterapia/métodos , Dietoterapia/tendências , Dietética/métodos , Dietética/tendências , Dieta/instrumentação , Dieta/métodos , Dieta , Fatores de Risco , Síndromes Neurotóxicas/complicações
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA