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1.
Food Chem ; 334: 127436, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-32711262

RESUMO

Milk samples (150 cow and 217 camel milk samples) were analyzed for protein, fat, lactose and total solids by near and mid-infrared transmission spectroscopy. Excellent positive correlations between the two methods were obtained for both types of milk (p < 0.001); for protein (r ≥ 0.96), fat (r ≥ 0.99), lactose (r = 0.82) and total solids (r = 0.90). The mean of the relative difference ((MIR values - NIR values)/0.5 (MIR values + NIR values) × 100%) for cow and camel milk were, for protein (+8.2 & +13.4%), fat (-9.3 & +0.9%), lactose (-5.4 &-0.7%) and total solids (-2.2 &-3.4%), respectively. The difference between the two methods may be due to the effects of differences in milk homogeneity, especially with respect to casein micelles and fat globules.


Assuntos
Análise de Alimentos/métodos , Lactose/análise , Proteínas do Leite/análise , Leite/química , Espectrofotometria Infravermelho/métodos , Animais , Calibragem , Camelus , Caseínas/análise , Bovinos , Gorduras na Dieta/análise , Feminino , Reprodutibilidade dos Testes
2.
Washington, D.C.; OPS; 2020-11-11. (OPS/NMH/RF/20-0033).
Não convencional em Espanhol | PAHO-IRIS | ID: phr-53013

RESUMO

La hipertensión, la hiperglucemia en ayunas (medida como el nivel de glucosa en plasma en ayunas) y el sobrepeso o la obesidad son los tres factores de riesgo más asociados con la mortalidad en la Región de las Américas. La mala alimentación guarda una estrecha relación con estos tres factores principales de riesgo en la Región, debido en gran parte a la ingesta excesiva de azúcares, grasas totales, grasas saturadas, grasas trans y sodio. La ingesta excesiva de estos nutrientes es resultado, en gran medida, de la amplia disponibilidad, asequibilidad y promoción de productos alimentarios procesados y ultraprocesados, que contienen cantidades excesivas de azúcares, grasas y sodio. Por consiguiente, gran parte de la solución consiste en la aplicación de leyes y regulaciones que reduzcan la demanda y la oferta de productos que contienen cantidades excesivas de nutrientes críticos. Uno de los instrumentos clave de política para regular esos productos con el objeto de prevenir el desequilibrio en la alimentación es la utilización de etiquetas en el frente del envase que indiquen a los consumidores que el producto contiene cantidades excesivas de azúcares, grasas totales, grasas saturadas, grasas trans y sodio. Para ayudar a la población de la Región a cumplir con las recomendaciones de la Organización Mundial de la Salud (OMS) y protegerla contra los principales factores de riesgo que perjudican su salud y desarrollo, el objetivo regulatorio del etiquetado frontal debe ser que los consumidores puedan identificar correcta, rápida y fácilmente los productos que contienen cantidades excesivas de azúcares, grasas totales, grasas saturadas, grasas trans y sodio. Esta publicación resume la evidencia sobre los resultados obtenidos con sistemas de etiquetado en el frente del envase en el cumplimiento de este objetivo y proporciona un listado de preguntas frecuentes sobre el sistema de advertencias nutricionales.


Assuntos
Fatores de Risco , Açúcares da Dieta , Gorduras na Dieta , Doença Crônica , Doenças não Transmissíveis , América
3.
PLoS One ; 15(10): e0235875, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33022003

RESUMO

The oral lipid tolerance test (OLTT) has been known to assess intestinal fat metabolism and whole-body lipid metabolism, but rodent models for OLTT are not yet established. Differences in OLTT methodology preclude the generation of definitive results, which may cause some confusion about the anti-hypertriglyceridemia effects of the test materials. To standardize and generate more appropriate methodology for the OLTT, we examined the effects of mice strain, dietary lipid sources, fasting period, and gender on lipid-induced hypertriglyceridemia in mice. First, lipid-induced hypertriglyceridemia was more strongly observed in male ddY mice than in C57BL/6N or ICR mice. Second, the administration of olive and soybean oils remarkably represented lipid-induced hypertriglyceridemia. Third, fasting period before the OLTT largely affected the plasma triglyceride elevation. Fasting for 12 h, but less than 48 h, provoked lipid-induced hypertriglyceridemia. Fourth, we explored the suppressive effects of epigallocatechin gallate (EGCG), a green tea polyphenol, on lipid-induced hypertriglyceridemia. The administration of 100 mg/kg of EGCG suppressed lipid-induced hypertriglyceridemia and intestinal lipase activity. Fifth, EGCG-induced suppressive effects were observed after lipid-induced hypertriglyceridemia was observed in male mice, but not in female mice. Lastly, lipid-induced hypertriglyceridemia could be more effectively induced in mice fed a high-fat diet for 1 week before the OLTT. These findings indicate that male ddY mice after 12 h fasting displayed marked lipid-induced hypertriglyceridemia in response to soybean oil. Hence, the defined experiment condition may be a more appropriate OLTT model for evaluating lipid-induced hypertriglyceridemia.


Assuntos
Gorduras na Dieta/efeitos adversos , Hipertrigliceridemia/sangue , Lipídeos/efeitos adversos , Chá/química , Triglicerídeos/sangue , Animais , Hipertrigliceridemia/tratamento farmacológico , Hipertrigliceridemia/etiologia , Lipídeos/administração & dosagem , Lipídeos/sangue , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Endogâmicos ICR , Ratos , Ratos Sprague-Dawley , Ratos Wistar
4.
Wei Sheng Yan Jiu ; 49(4): 554-560, 2020 Jul.
Artigo em Chinês | MEDLINE | ID: mdl-32928354

RESUMO

OBJECTIVE: To investigate the nutritional composition of fatty acids in freshwater products in Hunan Province. METHODS: The edible parts of freshwater products were detected by gas chromatography, and fatty acid fingerprints were obtained by statistical analysis. RESULTS: A total of 18 freshwater products were monitored and 14-26 fatty acids were detected in each freshwater product. Among them, 12 were saturated fatty acids(SFA), ranging from 0. 74 to 3143 mg/100 g, 9 were monounsaturated fatty acids(MUFA), ranging from 1. 23 to 2790 mg/100 g, and 10 were polyunsaturated fatty acids(PUFA), ranging from 1. 75 to 2832 mg/100 g. The ratio of n-6 to n-3 in polyunsaturated fatty acids ranged from 0. 24∶1 to 15. 7∶1. CONCLUSION: The composition of fatty acids in freshwater products in Hunan Province is mainly unsaturated fatty acids. Most freshwater products are rich in n-3 PUFA, and the ratio of n-6 PUFA to n-3 PUFA is less than 6, which is beneficial to the nutritional balance. The composition and content of fatty acids have ideal nutritional value.


Assuntos
Gorduras na Dieta/análise , Ácidos Graxos , Ácidos Graxos Monoinsaturados , Ácidos Graxos Insaturados , Água Doce
5.
PLoS Med ; 17(9): e1003282, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32903262

RESUMO

BACKGROUND: Endothelial dysfunction is a crucial step in atherosclerosis development, and its severity is determinant for the risk of cardiovascular recurrence. Diet may be an effective strategy to protect the endothelium, although there is no consensus about the best dietary model. The CORonary Diet Intervention with Olive oil and cardiovascular PREVention (CORDIOPREV) study is an ongoing prospective, randomized, single-blind, controlled trial in 1,002 coronary heart disease (CHD) patients, whose primary objective is to compare the effect of 2 healthy dietary patterns (low-fat versus Mediterranean diet) on the incidence of cardiovascular events. Here, we report the results of one secondary outcome of the CORDIOPREV study: to evaluate the effect of these diets on endothelial function, assessed by flow-mediated dilation (FMD) of the brachial artery. METHODS AND FINDINGS: From the total participants taking part in the CORDIOPREV study, 805 completed endothelial function study at baseline and were randomized to follow a Mediterranean diet (35% fat, 22% monounsaturated fatty acids [MUFAs], and <50% carbohydrates) or a low-fat diet (28% fat, 12% MUFAs, and >55% carbohydrates), with endothelial function measurement repeated after 1 year. As secondary objectives and to explore different underlying mechanisms in the modulation of endothelial function, we quantified endothelial microparticles (EMPs) and endothelial progenitor cells (EPCs) and evaluated, in 24 preselected patients, in vitro cellular processes related to endothelial damage (reactive oxygen species, apoptosis, and senescence) and endothelial repair (cell proliferation and angiogenesis), as well as other modulators (micro-RNAs [miRNAs] and proteins). Patients who followed the Mediterranean diet had higher FMD (3.83%; 95% confidence interval [CI]: 2.91-4.23) compared with those in the low-fat diet (1.16%; 95% CI: 0.80 to 1.98) with a difference between diets of 2.63% (95% CI: 1.89-3.40, p = 0.011), even in those patients with severe endothelial dysfunction. We observed higher EPC levels (group difference: 1.64%; 95% CI: 0.79-2.13, p = 0.028) and lower EMPs (group difference: -755 EMPs/µl; 95% CI: -1,010 to -567, p = 0.015) after the Mediterranean diet compared with the low-fat diet in all patients. We also observed lower intracellular reactive oxygen species (ROS) production (group difference: 11.1; 95% CI: 2.5 to 19.6, p = 0.010), cellular apoptosis (group difference: -20.2; 95% CI: -26.7 to -5.11, p = 0.013) and senescence (18.0; 95% CI: 3.57 to 25.1, p = 0.031), and higher cellular proliferation (group difference: 11.3; 95% CI: 4.51 to 13.5, p = 0.011) and angiogenesis (total master segments length, group difference: 549; 95% CI: 110 to 670, p = 0.022) after the Mediterranean diet than the low-fat diet. Each dietary intervention was associated with distinct changes in the epigenetic and proteomic factors that modulate biological process associated with endothelial dysfunction. The evaluation of endothelial function is a substudy of the CORDIOPREV study. As in any substudy, these results should be treated with caution, such as the potential for false positives because of the exploratory nature of the analyses. CONCLUSIONS: Our results suggest that the Mediterranean diet better modulates endothelial function compared with a low-fat diet and is associated with a better balance of vascular homeostasis in CHD patients, even in those with severe endothelial dysfunction. CLINICAL TRIAL REGISTRATION: URL, http://www.cordioprev.es/index.php/en. clinicaltrials.gov number NCT00924937.


Assuntos
Doença das Coronárias/dietoterapia , Endotélio/metabolismo , Idoso , Doenças Cardiovasculares/prevenção & controle , Dieta com Restrição de Gorduras , Dieta Mediterrânea , Gorduras na Dieta , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Azeite de Oliva , Estudos Prospectivos , Proteômica , Método Simples-Cego
6.
Cochrane Database Syst Rev ; 9: CD012415, 2020 09 11.
Artigo em Inglês | MEDLINE | ID: mdl-32914461

RESUMO

BACKGROUND: Overweight and obesity are increasing worldwide and are considered to be a major public health issue of the 21st century. Introducing taxation of the fat content in foods is considered a potentially powerful policy tool to reduce consumption of foods high in fat or saturated fat, or both. OBJECTIVES: To assess the effects of taxation of the fat content in food on consumption of total fat and saturated fat, energy intake, overweight, obesity, and other adverse health outcomes in the general population. SEARCH METHODS: We searched CENTRAL, Cochrane Database of Systematic Reviews, MEDLINE, Embase, and 15 other databases and trial registers on 12 September 2019. We handsearched the reference lists of all records of included studies, searched websites of international organizations and institutions (14 October 2019), and contacted review advisory group members to identify planned, ongoing, or unpublished studies (26 February 2020). SELECTION CRITERIA: In line with Cochrane Effective Practice and Organisation of Care Group (EPOC) criteria, we included the following study types: randomized controlled trials (RCTs), cluster-randomized controlled trials (cRCTs), non-randomized controlled trials (nRCTs), controlled before-after (CBA) studies, and interrupted time series studies. We included studies that evaluated the effects of taxes on the fat content in foods. Such a tax could be expressed as sales, excise, or special value added tax (VAT) on the final product or an intermediary product. Eligible interventions were taxation at any level, with no restriction on the duration or the implementation level (i.e. local, regional, national, or multinational). Eligible study populations were children (zero to 17 years) and adults (18 years or older) from any country and setting. We excluded studies that focused on specific subgroups only (e.g. people receiving pharmaceutical intervention; people undergoing a surgical intervention; ill people who are overweight or obese as a side effect, such as those with thyroiditis and depression; and people with chronic illness). Primary outcomes were total fat consumption, consumption of saturated fat, energy intake through fat, energy intake through saturated fat, total energy intake, and incidence/prevalence of overweight or obesity. We did not exclude studies based on country, setting, comparison, or population. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods for all phases of the review. Risk of bias of the included studies was assessed using the criteria of Cochrane's 'Risk of bias' tool and the EPOC Group's guidance. Results of the review are summarized narratively and the certainty of the evidence was assessed using the GRADE approach. These steps were done by two review authors, independently. MAIN RESULTS: We identified 23,281 records from searching electronic databases and 1173 records from other sources, leading to a total of 24,454 records. Two studies met the criteria for inclusion in the review. Both included studies investigated the effect the Danish tax on saturated fat contained in selected food items between 2011 and 2012. Both studies used an interrupted time series design. Neither included study had a parallel control group from another geographic area. The included studies investigated an unbalanced panel of approximately 2000 households in Denmark and the sales data from a specific Danish supermarket chain (1293 stores). Therefore, the included studies did not address individual participants, and no restriction regarding age, sex, and socioeconomic characteristics were defined. We judged the overall risk of bias of the two included studies as unclear. For the outcome total consumption of fat, a reduction of 41.8 grams per week per person in a household (P < 0.001) was estimated. For the consumption of saturated fat, one study reported a reduction of 4.2% from minced beef sales, a reduction of 5.8% from cream sales, and an increase of 0.5% to sour cream sales (no measures of statistical precision were reported for these estimates). These estimates are based on a restricted number of food types and derived from sales data; they do not measure individual intake. Moreover, these estimates do not account for other relevant sources of fat intake (e.g. packaged or processed food) or other food outlets (e.g. restaurants or cafeterias); hence, we judged the evidence on the effect of taxation on total fat consumption or saturated fat consumption to be very uncertain. We did not identify evidence on the effect of the intervention on energy intake or the incidence or prevalence of overweight or obesity. AUTHORS' CONCLUSIONS: Given the very low quality of the evidence currently available, we are unable to reliably establish whether a tax on total fat or saturated fat is effective or ineffective in reducing consumption of total fat or saturated fat. There is currently no evidence on the effect of a tax on total fat or saturated fat on total energy intake or energy intake through saturated fat or total fat, or preventing the incidence or reducing the prevalence of overweight or obesity.


Assuntos
Gorduras na Dieta/administração & dosagem , Obesidade/prevenção & controle , Impostos , Adolescente , Adulto , Criança , Comércio/estatística & dados numéricos , Dinamarca , Humanos , Análise de Séries Temporais Interrompida , Sobrepeso/prevenção & controle
7.
Washington, D.C.; PAHO; 2020-09-25. (PAHO/NMH/RF/20-0033).
Não convencional em Inglês | PAHO-IRIS | ID: phr-52740

RESUMO

High blood pressure, high fasting blood sugar levels (measured as fasting plasma glucose), and overweight/obesity are the top three risk factors for mortality in the Americas. Unhealthy eating is closely linked to these top three risk factors in the Americas, driven largely by excess intake of sugars, total fats, saturated fats, trans fats, and sodium. The excess intake of these nutrients has been driven largely by the widespread availability, affordability, and promotion of processed and ultra-processed food products that are excessive in sugars, fats, and sodium. As such, an essential part of the solution requires the use of laws and regulations to reduce the demand for and offer of products that contain excessive amounts of critical nutrients. One of the key policy tools to regulate such products to prevent them from unbalancing diets is the use of front-of-package labeling (FOPL) to indicate to consumers which products contain excessive amounts of sugars, total fats, saturated fats, trans fats, and sodium. To support populations in the Americas in their efforts to meet the World Health Organization recommendations and protect them from the top risk factors harming their health and development, the regulatory objective of a FOPL system should aim at allowing consumers to correctly, quickly, and easily identify products that contain excessive amount of sugars, total fats, saturated fats, trans fats, and sodium. This technical brief summarizes the evidence on the performance of FOPL systems in meeting this purpose and provides a list of frequently asked questions about the nutrition warning system.


Assuntos
Fatores de Risco , Açúcares da Dieta , Gorduras na Dieta , Doença Crônica , Doenças não Transmissíveis , América
8.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32943535

RESUMO

Potential long-lasting adverse effects of child maltreatment have been widely reported, although little is known about the distinctive long-term impact of differing types of maltreatment. Our objective for this special article is to integrate findings from the Mater-University of Queensland Study of Pregnancy, a longitudinal prenatal cohort study spanning 2 decades. We compare and contrast the associations of specific types of maltreatment with long-term cognitive, psychological, addiction, sexual health, and physical health outcomes assessed in up to 5200 offspring at 14 and/or 21 years of age. Overall, psychological maltreatment (emotional abuse and/or neglect) was associated with the greatest number of adverse outcomes in almost all areas of assessment. Sexual abuse was associated with early sexual debut and youth pregnancy, attention problems, posttraumatic stress disorder symptoms, and depression, although associations were not specific for sexual abuse. Physical abuse was associated with externalizing behavior problems, delinquency, and drug abuse. Neglect, but not emotional abuse, was associated with having multiple sexual partners, cannabis abuse and/or dependence, and experiencing visual hallucinations. Emotional abuse, but not neglect, revealed increased odds for psychosis, injecting-drug use, experiencing harassment later in life, pregnancy miscarriage, and reporting asthma symptoms. Significant cognitive delays and educational failure were seen for both abuse and neglect during adolescence and adulthood. In conclusion, child maltreatment, particularly emotional abuse and neglect, is associated with a wide range of long-term adverse health and developmental outcomes. A renewed focus on prevention and early intervention strategies, especially related to psychological maltreatment, will be required to address these challenges in the future.


Assuntos
Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Adolescente , Comportamento do Adolescente , Asma/epidemiologia , Transtornos de Deficit da Atenção e do Comportamento Disruptivo/epidemiologia , Austrália/epidemiologia , Estatura , Criança , Cognição , Estudos de Coortes , Gorduras na Dieta/administração & dosagem , Escolaridade , Feminino , Humanos , Inteligência , Estudos Longitudinais , Transtornos Mentais/epidemiologia , Gravidez , Gravidez na Adolescência/estatística & dados numéricos , Qualidade de Vida , Comportamento Sexual , Transtornos do Sono-Vigília/epidemiologia , Evasão Escolar/estatística & dados numéricos , Desemprego/estatística & dados numéricos , Adulto Jovem
9.
Life Sci ; 260: 118415, 2020 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-32918974

RESUMO

AIMS: Previous studies have shown the effect of niacin on dairy cow production, but no study on the role of niacin in milk fat synthesis has been performed. Therefore, the purpose of this study was to examine the effect of niacin on milk fat synthesis and its specific mechanism in BMECs. MAIN METHODS: In this study, 0.5 mM niacin, a GPR109A-inhibiting plasmid, and an AMPK inhibitor were added to BMECs. Milk fat was measured by a triglyceride kit and BODIPY staining. The protein expression of GPR109A, FASN, SREBP1, AMPK, ACC, mTOR and S6K was measured by Western blotting. The gene expression of GPR109A, FASN, and SREBP1 was analysed by RT-PCR. KEY FINDINGS: Our results showed that 0.5 mM niacin could significantly reduce milk fat synthesis in BMECs and activate the AMPK/ACC signalling pathway by stimulating GPR109A, reducing the protein expression of p-mTOR and p-S6K, and reducing the expression of SREBP1 and FASN in BMECs. SIGNIFICANCE: The present study clarified the effect of niacin on milk fat synthesis. The results show that niacin inhibits the synthesis of milk fat in BMECs through the downstream signalling pathway mediated by GPR109A. The function of niacin has been expanded, and knowledge of the new mechanism and signalling pathway will help improve the biosynthesis of milk fat.


Assuntos
Gorduras na Dieta/metabolismo , Células Epiteliais/metabolismo , Glândulas Mamárias Animais/metabolismo , Leite/metabolismo , Niacina/farmacologia , Receptores Acoplados a Proteínas-G/metabolismo , Animais , Bovinos , Células Epiteliais/efeitos dos fármacos , Feminino , Hipolipemiantes/farmacologia , Glândulas Mamárias Animais/efeitos dos fármacos , Leite/efeitos dos fármacos , Receptores Acoplados a Proteínas-G/genética
10.
PLoS Med ; 17(8): e1003234, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32764760

RESUMO

BACKGROUND: In common with many other low- and middle-income countries (LMICs), rural to urban migrants in India are at increased risk of obesity, but it is unclear whether this is due to increased energy intake, reduced energy expenditure, or both. Knowing this and the relative contribution of specific dietary and physical activity behaviours to greater adiposity among urban migrants could inform policies for control of the obesity epidemic in India and other urbanising LMICs. In the Indian Migration Study, we previously found that urban migrants had greater prevalence of obesity and diabetes compared with their nonmigrant rural-dwelling siblings. In this study, we investigated the relative contribution of energy intake and expenditure and specific diet and activity behaviours to greater adiposity among urban migrants in India. METHODS AND FINDINGS: The Indian Migration Study was conducted between 2005 and 2007. Factory workers and their spouses from four cities in north, central, and south of India, together with their rural-dwelling siblings, were surveyed. Self-reported data on diet and physical activity was collected using validated questionnaires, and adiposity was estimated from thickness of skinfolds. The association of differences in dietary intake, physical activity, and adiposity between siblings was examined using multivariable linear regression. Data on 2,464 participants (median age 43 years) comprised of 1,232 sibling pairs (urban migrant and their rural-dwelling sibling) of the same sex (31% female) were analysed. Compared with the rural siblings, urban migrants had 18% greater adiposity, 12% (360 calories/day) more energy intake, and 18% (11 kilojoules/kg/day) less energy expenditure (P < 0.001 for all). Energy intake and expenditure were independently associated with increased adiposity of urban siblings, accounting for 4% and 6.5% of adiposity difference between siblings, respectively. Difference in dietary fat/oil (10 g/day), time spent engaged in moderate or vigorous activity (69 minutes/day), and watching television (30 minutes/day) were associated with difference in adiposity between siblings, but no clear association was observed for intake of fruits and vegetables, sugary foods and sweets, cereals, animal and dairy products, and sedentary time. The limitations of this study include a cross-sectional design, systematic differences in premigration characteristics of migrants and nonmigrants, low response rate, and measurement error in estimating diet and activity from questionnaires. CONCLUSIONS: We found that increased energy intake and reduced energy expenditure contributed equally to greater adiposity among urban migrants in India. Policies aimed at controlling the rising prevalence of obesity in India and potentially other urbanising LMICs need to be multicomponent, target both energy intake and expenditure, and focus particularly on behaviours such as dietary fat/oil intake, time spent on watching television, and time spent engaged in moderate or vigorous intensity physical activity.


Assuntos
Adiposidade/fisiologia , Dieta/tendências , Ingestão de Energia/fisiologia , Exercício Físico/fisiologia , População Rural/tendências , Migrantes , População Urbana/tendências , Adulto , Índice de Massa Corporal , Estudos Transversais , Dieta/efeitos adversos , Gorduras na Dieta/efeitos adversos , Metabolismo Energético/fisiologia , Feminino , Humanos , Índia/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Autorrelato
11.
PLoS One ; 15(8): e0237210, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32790725

RESUMO

BACKGROUND: Chronic childhood malnutrition, or stunting, remains a persistent barrier to achieve optimal cognitive development, child growth and ability to reach full potential. Almost half of children under-five years of age are stunted in the province of Sindh, Pakistan. OBJECTIVE: The primary objective of this study was to test the hypothesis that the provision of lipid-based nutrient supplement-medium-quantity (LNS-MQ) known as Wawamum will result in a 10% reduction in risk of being stunted at the age of 24 months in the intervention group compared with the control group. DESIGN: A cluster randomized controlled trial was conducted in Thatta and Sujawal districts of Sindh province, Pakistan. A total of 870 (419 in intervention; 451 in control) children between 6-18 months old were enrolled in the study. The unit of randomization was union council and considered as a cluster. A total of 12 clusters, 6 in each study group were randomly assigned to intervention and control group. All children received standard government health services, while children in the intervention group also received 50 grams/day of Wawamum. RESULTS: Children who received Wawamum were found to have a significantly reduced risk of stunting (RR = 0.91, 95% CI; 0.88-0.94, p<0.001) and wasting (RR = 0.78, 95% CI; 0.67-0.92, p = 0.004) as compared to children who received the standard government health services. There was no evidence of a reduction in the risk of underweight (RR = 0.94, 95% CI; 0.85-1.04, p = 0.235) in the intervention group compared to the control group. Statistically significant reduction in anaemia in the intervention group was also found as compared to the control group (RR = 0.97, 95% CI; 0.94-0.99, p = 0.042). The subgroup analysis by age, showed intervention effect is significant in reduction of risk of stunting in younger children of aged 6-12 month (RR = 0.83, 95% CI; 0.81-0.86, p = <0.001) and their older peers aged 13-18 month- (RR = 0.90, 95% CI; 0.83-0.97, p = 0.008). The mean compliance of Wawamum was 60% among children. CONCLUSIONS: The study confirmed that the provision of Wawamum to children 6-23 months of age is effective in reducing the risk of stunting, wasting and anaemia. This approach should be scaled up among the most food insecure areas/households with a high prevalence of stunting to achieve positive outcomes for nutrition and health. This study was registered at clinicaltrials.gov as NCT02422953. Clinical Trial Registration Number: NCT02422953.


Assuntos
Anemia Ferropriva/prevenção & controle , Gorduras na Dieta/administração & dosagem , Suplementos Nutricionais , Fórmulas Infantis , Transtornos da Nutrição do Lactente/prevenção & controle , Síndrome de Emaciação/prevenção & controle , Anemia Ferropriva/dietoterapia , Gorduras na Dieta/uso terapêutico , Feminino , Humanos , Lactente , Transtornos da Nutrição do Lactente/dietoterapia , Masculino , Paquistão , Síndrome de Emaciação/dietoterapia
12.
Cochrane Database Syst Rev ; 8: CD000341, 2020 08 25.
Artigo em Inglês | MEDLINE | ID: mdl-32842164

RESUMO

BACKGROUND: As preterm infants do not experience the nutrient accretion and rapid growth phase of the third trimester of pregnancy, they are vulnerable to postnatal nutritional deficits, including of fat. Consequently, they require higher fat intakes compared to their full term counterparts to achieve adequate growth and development. Human milk fat provides the major energy needs of the preterm infant and also contributes to several metabolic and physiological functions. Although human milk has many benefits for this population, its fat content is highly variable and may be inadequate for their optimum growth and development. This is a 2020 update of a Cochrane Review last published in 2000. OBJECTIVES: To determine whether supplementation of human milk with fat compared with unsupplemented human milk fed to preterm infants improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes without significant adverse effects. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL 2019, Issue 8) in the Cochrane Library and MEDLINE via PubMed on 23 August 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Published and unpublished randomised controlled trials were eligible if they used random or quasi-random methods to allocate preterm infants fed human milk in hospital to supplementation or no supplementation with additional fat. DATA COLLECTION AND ANALYSIS: No new randomised controlled trials matching the selection criteria were found but we extracted data from the previously included trial due to changes in review outcomes from when the protocol was first published. Two reviewers independently abstracted data, assessed trial quality, and the quality of evidence at the outcome level using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) criteria. We planned to perform meta-analyses using risk ratio (RR) for dichotomous data and mean difference (MD) for continuous data, with their respective 95% confidence intervals (CIs). We planned to use a fixed-effect model and to explore potential causes of heterogeneity via sensitivity analyses. MAIN RESULTS: One randomised trial involving 14 preterm infants was included. There was no evidence of a clear difference between the fat-supplemented and unsupplemented groups in in-hospital rates of growth in weight (MD 0.6 g/kg/day, 95% CI -2.4 to 3.6; 1 RCT, n = 14 infants, very low-quality evidence), length (MD 0.1 cm/week, 95% CI -0.08 to 0.3; 1 RCT, n = 14 infants, very low-quality evidence) and head circumference (MD 0.2 cm/week, 95% CI -0.07 to 0.4; 1 RCT n = 14 infants, very low-quality evidence). There was no clear evidence that fat supplementation increased the risk of feeding intolerance (RR 3.0, 95% CI 0.1 to 64.3; 1 RCT, n = 16 infants, very low-quality evidence). No data were available regarding the effects of fat supplementation on long-term growth, body mass index, body composition, neurodevelopmental, or cardio-metabolic outcomes. AUTHORS' CONCLUSIONS: The one included trial suggests no evidence of an effect of fat supplementation of human milk on short-term growth and feeding intolerance in preterm infants. However, the very low-quality evidence, small sample size, few events, and low precision diminishes our confidence that these results reflect the true effect of fat supplementation of human milk in preterm infants, and no long-term outcomes were reported. Further high-quality research should evaluate the effect on short and long-term growth, neurodevelopmental and cardio-metabolic outcomes in the context of the development of multicomponent fortifiers. Optimal dosage, adverse effects, and delivery practices should also be evaluated.


Assuntos
Gorduras na Dieta/administração & dosagem , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Humanos , Recém-Nascido
13.
Am J Kidney Dis ; 76(3 Suppl 1): S1-S107, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32829751

RESUMO

The National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) has provided evidence-based guidelines for nutrition in kidney diseases since 1999. Since the publication of the first KDOQI nutrition guideline, there has been a great accumulation of new evidence regarding the management of nutritional aspects of kidney disease and sophistication in the guidelines process. The 2020 update to the KDOQI Clinical Practice Guideline for Nutrition in CKD was developed as a joint effort with the Academy of Nutrition and Dietetics (Academy). It provides comprehensive up-to-date information on the understanding and care of patients with chronic kidney disease (CKD), especially in terms of their metabolic and nutritional milieu for the practicing clinician and allied health care workers. The guideline was expanded to include not only patients with end-stage kidney disease or advanced CKD, but also patients with stages 1-5 CKD who are not receiving dialysis and patients with a functional kidney transplant. The updated guideline statements focus on 6 primary areas: nutritional assessment, medical nutrition therapy (MNT), dietary protein and energy intake, nutritional supplementation, micronutrients, and electrolytes. The guidelines primarily cover dietary management rather than all possible nutritional interventions. The evidence data and guideline statements were evaluated using Grading of Recommendations, Assessment, Development and Evaluation (GRADE) criteria. As applicable, each guideline statement is accompanied by rationale/background information, a detailed justification, monitoring and evaluation guidance, implementation considerations, special discussions, and recommendations for future research.


Assuntos
Terapia Nutricional/normas , Insuficiência Renal Crônica/terapia , Dieta com Restrição de Proteínas , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais , Eletrólitos/administração & dosagem , Ingestão de Energia , Medicina Baseada em Evidências , Ácidos Graxos Ômega-3/administração & dosagem , Humanos , Micronutrientes/administração & dosagem , Avaliação Nutricional , Apoio Nutricional/métodos , Insuficiência Renal Crônica/dietoterapia , Vitaminas/administração & dosagem
15.
Cochrane Database Syst Rev ; 8: CD011737, 2020 08 21.
Artigo em Inglês | MEDLINE | ID: mdl-32827219

RESUMO

BACKGROUND: Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES: To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS: We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA: Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS: We included 15 randomised controlled trials (RCTs) (16 comparisons, 56,675 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 17% (risk ratio (RR) 0.83; 95% confidence interval (CI) 0.70 to 0.98, 12 trials, 53,758 participants of whom 8% had a cardiovascular event, I² = 67%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 53. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS: The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Gorduras na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Adulto , Doenças Cardiovasculares/mortalidade , Causas de Morte , Colesterol/sangue , Carboidratos da Dieta/administração & dosagem , Gorduras Insaturadas na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Masculino , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/prevenção & controle
16.
Nutr Metab Cardiovasc Dis ; 30(10): 1673-1678, 2020 09 24.
Artigo em Inglês | MEDLINE | ID: mdl-32736955

RESUMO

BACKGROUND AND AIMS: The present study analyzes the relation between diet and all-cause mortality in a cohort of Italian men residing in different regions of Italy. METHODS AND RESULTS: The cohort was established using the members of the Associazione Nazionale Alpini, a voluntary organization that enlists individuals who have served in the Alpine troup; a mountain warfare infantry corps of the Italian Army. For the purpose of these analyses a total of 5049 participants were followed for an average of seven years. At baseline information was collected regarding age, education, life style habits, with special emphasis on diet (with the use of a validated dietary questionnaire), smoking and alcohol use. A total of 190 deaths were ascertained. In multivariate analyses the consumption of a Mediterranean type diet was inversely associated with mortality. Additional findings of relevance include: an inverse association between mortality and intake of vegetable fats and proteins, monounsaturated (MUFA) fats of vegetable origins, starch and folic acid. Positive association were evident between mortality and intake of animal fats, MUFA of animal origins and sugar. CONCLUSIONS: This study, focusing on a homogenous cohort characterized by a varied intake and high intake of monounsaturated fats, confirms the inverse association between a Mediterranean type diet and mortality and points out that the nature of the MUFA may be relevant for their effects on health. In addition, the study confirms that fats of animal origins and dietary sugar are associated with an overall deleterious effect on mortality.


Assuntos
Causas de Morte , Dieta Saudável , Dieta Mediterrânea , Comportamento Alimentar , Adulto , Inquéritos sobre Dietas , Gorduras na Dieta/efeitos adversos , Açúcares da Dieta/efeitos adversos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Saúde Militar , Fatores de Proteção , Medição de Risco , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Adulto Jovem
17.
mBio ; 11(4)2020 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-32703911

RESUMO

There is high mortality in coronavirus disease 2019 (COVID-19)-infected individuals with chronic inflammatory diseases, like obesity, diabetes, and hypertension. A cytokine storm in some patients after infection contributes to this mortality. In addition to lungs, the intestine is targeted during COVID-19 infection. The intestinal membrane serves as a barrier to prevent leakage of microorganisms and their products into the bloodstream; however, dietary fats can affect the gut microbiome and may increase intestinal permeability. In obese or diabetic individuals, there is an increase in the abundance of either Gram-negative bacteria in the gut or their product, endotoxin, in systemic circulation. We speculate that when the COVID-19 infection localizes in the intestine and when the permeability properties of the intestinal membrane are compromised, an inflammatory response is generated when proinflammatory endotoxin, produced by resident Gram-negative bacteria, leaks into the systemic circulation. This review discusses conditions contributing to inflammation that are triggered by microbially derived factors from the gut.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gorduras na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Pneumonia Viral/complicações , Animais , Síndrome da Liberação de Citocina/etiologia , Microbioma Gastrointestinal/fisiologia , Humanos , Inflamação/etiologia , Camundongos , Pandemias
19.
Adv Nutr ; 11(4): 1043-1044, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32666111
20.
Food Chem ; 332: 127344, 2020 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-32619937

RESUMO

There is a contentious need for robust and rapid methodologies for maintaining the authenticity of foods and food additives. The current paper presented a new Raman spectroscopy-based methodology for detection and quantification of lard in butter. Hierarchical cluster analysis (HCA) and principal component analysis (PCA) were successfully performed for the classification and discrimination of butter and lard-adulterated samples. Strong discrimination pattern was observed in the HCA analysis. Also, partial least squares regression and principal component regression (R2 = 0.99) were applied for quantification of lard in butter samples. Quite favorable prediction capabilities were observed in the cross-validation of PLS and PCR analysis for the adulteration levels between 0% and 100% lard fat (w/w). Raman spectroscopy coupled chemometrics was employed effectively for quantification of lard fat in butter fat samples with easy, robust, effective, low-cost and reliable application in the quality control of butter.


Assuntos
Manteiga/análise , Gorduras na Dieta/análise , Informática , Análise Espectral Raman , Análise por Conglomerados , Contaminação de Alimentos/análise , Fraude/prevenção & controle , Análise dos Mínimos Quadrados , Análise de Componente Principal
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