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1.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(1): 43-52, ene. 2020. tab
Artigo em Espanhol | IBECS | ID: ibc-186146

RESUMO

Antecedentes y objetivos: El alelo de riesgo (G) de la variante rs10830963 en el gen del receptor de melatonina 1 B (MTNR1B) se relaciona con la obesidad. En este trabajo evaluamos el efecto de este SNP sobre los factores de riesgo cardiovascular y la pérdida de peso secundaria a 2 dietas hipocalóricas. Métodos: Trescientos sesenta y un sujetos obesos fueron asignados aleatoriamente durante 3 meses (dieta M: dieta hipocalórica alta en grasas monoinsaturadas vs. dieta P: dieta hipocalórica alta en grasas poliinsaturadas). Se midieron los parámetros antropométricos, glucemia en ayunas, proteína C reactiva, concentración de insulina, resistencia a la insulina (HOMA-IR), perfil de lípidos y los niveles de adipocitoquinas. Se evaluó el genotipo del polimorfismo del gen MTNR1B (rs10830963). Resultados: Todos los parámetros antropométricos, la presión arterial sistólica y los niveles de leptina disminuyeron en todos los sujetos después de ambas dietas. Esta mejora de los parámetros antropométricos fue mayor en los no portadores del alelo G que en los portadores del alelo G. Tras la intervención con dieta M (CC vs. CG + GG), el colesterol total (delta: -10,4 ± 2,1 mg/dl vs. -6,4 ± 1,2 mg/dl: p < 0,05), colesterol LDL (delta: -7,1 ± 0,9 mg/dl vs. –2,8 ± 0,8 mg/dl: p < 0,05), insulina (delta: -3,0 ± 0.8 UI/l vs. -2,0 ± 1,0 UI/l: p < 0,05) y HOMA IR (delta: -3,4 ± 1,0 unidades vs. -2,9 ± 0,9 unidades: p < 0,05) mejoraron en los no portadores del alelo G. Tras la dieta P, en el grupo de sujetos sin alelo G, los niveles de insulina (delta: -2,9 ± 1,0 UI/l vs. -0,6 ± 0,2 UI/l: p < 0,05) y HOMA-IR (delta [CC vs. CG + GG]: -0,8 ± 0,2 unidades vs. -0,4 ± 0,3 unidades: p < 0,05) también disminuyeron. Conclusiones: Nuestro estudio detectó una relación de la variante rs10830963 de MTNR1B con la pérdida de peso corporal y la modificación de la resistencia a la insulina inducida por 2 dietas hipocalóricas diferentes. Solo la dieta hipocalórica enriquecida en grasa monoinsaturada y los no portadores del alelo G mostraron un efecto significativo sobre las lipoproteínas


Background & aims: The risk allele (G) of rs10830963 in the melatonin receptor 1 B (MTNR1B) gene presents an association with obesity. We study the effect of this SNP on cardiovascular risk factors and weight loss secondary to 2hypocaloric diets. Methods: 361 obese subjects were randomly allocated during 3 months (Diet M - high monounsaturated fat hypocaloric diet vs. Diet P – high polyunsaturated fat hypocaloric diet). Anthropometric parameters, fasting blood glucose, C-reactive protein (CRP), insulin concentration, insulin resistance (HOMA-IR), lipid profile and adipocytokines levels were measured. Genotype of MTNR1B gene polymorphism (rs10830963) was evaluated. Results: All anthropometric parameters, systolic blood pressure and leptin levels decreased in all subjects after both diets. This improvement of anthropometric parameters was higher in non G allele carriers than G allele carriers. After dietary intervention with Diet M, (CC vs. CG + GG); total cholesterol (delta: -10.4 ± 2.1 mg/dl vs. -6.4 ± 1.2 mg/dl: P <.05), LDL-cholesterol (delta:-7.1 ± 0.9 mg/dl vs. -2.8 ± 0.8 mg/dl: P <.05), insulin (delta:-3.0 ± 0.8 UI/L vs. -2.0 ± 1.0 UI/L: P<.05) and HOMA-IR (delta:-3.4 ± 1.0 units vs. -2.9 ± 0.9 units: P<.05) improved in no G allele carriers. After Diet P, in the group of subjects without G allele CC, insulin levels (delta: -2.9 ± 1.0 UI/L vs. -0.6 ± 0.2 UI/L: P <.05) and HOMA-IR (delta (CC vs. CG + GG): -0.8 ± 0.2 units vs. -0.4 ± 0.3 units: P <.05) decreased, too. Conclusions: Our study detected a relationship of rs10830963 MTNR1B SNP with body weight loss and insulin resistance modification induced by 2 different hypocaloric. Only monounsaturated enriched hypocaloric diet and in no-G allele carriers showed a significant effect on lipoproteins


Assuntos
Humanos , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Polimorfismo Genético , Gorduras na Dieta/uso terapêutico , Resistência à Insulina , Perda de Peso/efeitos dos fármacos , Obesidade/dietoterapia , Fatores de Risco , Gorduras na Dieta/metabolismo , Doenças Cardiovasculares , Antropometria , Glicemia , Composição Corporal , Relação Cintura-Quadril , Radioimunoensaio/métodos
2.
Rev Gastroenterol Peru ; 39(1): 78-80, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31042241

RESUMO

Primary intestinal lymphangiectasia is a rare clinical condition of unknown etiology. The common age of presentation is during the first 3 years of life, but cases in adults have also been reported. It has a variable symptomatology, but the main clinical manifestation is edema, also diarrhea and weight loss can occur. The loss of lymph fluid into the gastrointestinal tract also leads to hypoproteinemia and lymphopenia. Diagnosis is based on clinical manifestations, laboratory and endoscopic findings, and is confirmed on histopathological examination of biopsy. The main treatment is a protein rich, low in fat and medium chain triglyceride diet. We present the case of a 1-year-old male patient who presents with generalized edema, predominantly in lower limbs, and diarrhea. Laboratory findings show the presence of marked hypoproteinemia. Then an endoscopy and a duodenal biopsy are performed, and the histopathological study confirms the diagnosis of primary intestinal lymphangiectasia. The patient is treated and after a satisfactory evolution, is discharged.


Assuntos
Linfangiectasia Intestinal/diagnóstico , Corticosteroides/uso terapêutico , Terapia Combinada , Diarreia/etiologia , Gorduras na Dieta/uso terapêutico , Proteínas na Dieta/uso terapêutico , Diuréticos/uso terapêutico , Edema/etiologia , Hemodinâmica , Humanos , Hipoproteinemia/dietoterapia , Hipoproteinemia/etiologia , Lactente , Linfangiectasia Intestinal/complicações , Linfangiectasia Intestinal/epidemiologia , Linfangiectasia Intestinal/terapia , Masculino , Peru/epidemiologia , Venezuela/etnologia
3.
Nutrients ; 11(4)2019 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-31010058

RESUMO

We examined the effect of high fat oral nutritional supplement (HFS) on the nutritional status, oral intake, and serum metabolites of postoperative pancreaticobiliary cancer patients. Pancreaticobiliary cancer patients were voluntarily recruited. The HFS group received postoperative oral high fat supplementation (80% of total calories from fat; n = 12) until discharge; the control group (non-HFS; n = 9) received none. Dietary intake, anthropometry, blood chemistry, nutritional risk index (NRI), and serum metabolites analyzed by liquid chromatography tandem mass spectrometry were evaluated. Overall, cumulative caloric supply via parental and oral/enteral routes were not different between groups. However, oral fat intake, caloric intake, and NRI scores of the HFS group were higher than those of the non-HFS group with increased oral meal consumption. Oral caloric, fat, and meal intakes correlated with NRI scores. Metabolomics analysis identified 195 serum metabolites pre-discharge. Oral fat intake was correlated with 42 metabolites relevant to the glycerophospholipid pathway. Oral high fat-specific upregulation of sphingomyelin (d18:1/24:1), a previously reported pancreatic cancer-downregulated metabolite, and lysophosphatidylcholine (16:0) were associated with NRI scores. Provision of HFS in postoperative pancreatic cancer patients may facilitate the recovery of postoperative health status by increasing oral meal intake, improving nutritional status, and modulating serum metabolites.


Assuntos
Gorduras na Dieta/uso terapêutico , Suplementos Nutricionais , Desnutrição/prevenção & controle , Metaboloma , Estado Nutricional , Pancreatectomia , Neoplasias Pancreáticas/cirurgia , Administração Oral , Idoso , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/sangue , Gorduras na Dieta/farmacologia , Ingestão de Energia , Comportamento Alimentar , Feminino , Humanos , Lisofosfatidilcolinas/sangue , Masculino , Desnutrição/sangue , Desnutrição/etiologia , Metaboloma/efeitos dos fármacos , Pessoa de Meia-Idade , Necessidades Nutricionais , Pancreatectomia/efeitos adversos , Neoplasias Pancreáticas/sangue , Complicações Pós-Operatórias/sangue , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Esfingomielinas/sangue
4.
Clin Exp Dermatol ; 44(4): 363-369, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30706549

RESUMO

This review is part of a series of annual updates summarizing the evidence base for atopic eczema (AE). It provides a summary of key findings from 28 systematic reviews that were published or indexed during 2016 with a focus on treatment and prevention of AE. There is reasonable evidence of benefit for topical corticosteroids, calcineurin inhibitors, a glycyrrhetinic acid-containing preparation (Atopiclair® ), oral ciclosporin, oral azathioprine, narrowband ultraviolet B radiation and education programmes. Overall, there is evidence that topical corticosteroids and calcineurin inhibitors have similar efficacy and that both can prevent AE flares when used twice weekly as maintenance therapy. However, topical calcineurin inhibitors are costlier and have more adverse reactions, thus topical corticosteroids should remain the standard of care for patients with AE. There is no evidence that multiple applications are better than once-daily application of topical corticosteroid. There is inconsistent evidence to support omalizumab and specific allergen immunotherapy use in AE. There is some evidence that vitamin D supplementation and synbiotics reduce AE severity, although the margin of improvement may not be clinically meaningful. There is little evidence to support the use of wet wraps or of complementary/alternative medicine (including Chinese herbal medicine). There is some evidence to suggest that a diet high in fish in infancy may be preventative for AE, but other dietary interventions for the prevention of AE show little promise. This review provides a succinct guide for clinicians and patients wishing to remain up to date with the latest evidence for the treatment and prevention of AE.


Assuntos
Corticosteroides/uso terapêutico , Inibidores de Calcineurina/uso terapêutico , Dermatite Atópica/tratamento farmacológico , Dermatite Atópica/prevenção & controle , Administração Oral , Administração Tópica , Corticosteroides/administração & dosagem , Antialérgicos/uso terapêutico , Azatioprina/administração & dosagem , Azatioprina/uso terapêutico , Inibidores de Calcineurina/administração & dosagem , Pré-Escolar , Terapias Complementares , Ciclosporina/administração & dosagem , Ciclosporina/uso terapêutico , Dermatite Atópica/radioterapia , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/uso terapêutico , Ácido Glicirretínico/administração & dosagem , Ácido Glicirretínico/uso terapêutico , Humanos , Imunossupressores/uso terapêutico , Lactente , Recém-Nascido , Omalizumab/administração & dosagem , Omalizumab/uso terapêutico , Extratos Vegetais/administração & dosagem , Extratos Vegetais/uso terapêutico , Terapia Ultravioleta/métodos , Vitamina D/uso terapêutico
5.
Stroke ; 50(2): 274-282, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30602356

RESUMO

Background and Purpose- We hypothesized that total marine n-3 polyunsaturated fatty acids (PUFA), in particular eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the diet and in adipose tissue (biomarkers of long-term intake and endogenous exposure) were inversely associated with the risk of ischemic stroke and its subtypes. Methods- The Diet, Cancer and Health cohort consisted of 57 053 participants aged 50 to 65 years at enrolment. All participants filled in a food frequency questionnaire and had an adipose tissue biopsy taken at baseline. Information on ischemic stroke during follow-up was obtained from The Danish National Patient Register, and all cases were validated. Cases and a random sample of 3203 subjects from the whole cohort had their fatty acid composition of adipose tissue determined by gas chromatography. Results- During 13.5 years of follow-up 1879 participants developed an ischemic stroke. Adipose tissue content of EPA was inversely associated with total ischemic stroke (hazard ratio [HR], 0.74; 95% CI, 0.62-0.88) when comparing the highest with the lowest quartile. Also, lower rates of large artery atherosclerosis were seen with higher intakes of total marine n-3 PUFA (HR, 0.69; 95% CI, 0.50-0.95), EPA (HR, 0.66; 95% CI, 0.48-0.91) and DHA (HR, 0.72; 95% CI, 0.53-0.99), and higher adipose tissue content of EPA (HR, 0.52; 95% CI, 0.36-0.76). Higher rates of cardioembolism were seen with higher intakes of total marine n-3 PUFA (HR, 2.50; 95% CI, 1.38-4.53) and DHA (HR, 2.12; 95% CI, 1.21-3.69) as well as with higher adipose tissue content of total marine n-3 PUFA (HR, 2.63; 95% CI, 1.33-5.19) and DHA (HR, 2.00; 95% CI, 1.04-3.84). The EPA content in adipose tissue was inversely associated with small-vessel occlusion (HR, 0.69; 95% CI, 0.55-0.88). Conclusions- EPA was associated with lower risks of most types of ischemic stroke, apart from cardioembolism, while inconsistent findings were observed for total marine n-3 PUFA and DHA.


Assuntos
Isquemia Encefálica/prevenção & controle , Ácidos Graxos Ômega-3/uso terapêutico , Comportamento Alimentar , Óleos de Peixe/uso terapêutico , Gordura Subcutânea/química , Doença Aguda , Idoso , Antropometria , Isquemia Encefálica/classificação , Isquemia Encefálica/epidemiologia , Isquemia Encefálica/metabolismo , Cromatografia Gasosa , Dinamarca/epidemiologia , Registros de Dieta , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/uso terapêutico , Ácidos Docosa-Hexaenoicos/farmacologia , Ácidos Docosa-Hexaenoicos/uso terapêutico , Ácido Eicosapentaenoico/farmacologia , Ácido Eicosapentaenoico/uso terapêutico , Ácidos Graxos Ômega-3/farmacologia , Feminino , Óleos de Peixe/administração & dosagem , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Amostragem , Inquéritos e Questionários
6.
Crit Rev Food Sci Nutr ; 59(10): 1619-1644, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-29359954

RESUMO

Dietary fat has been implicated in the rise of obesity due to its energy density, palatability and weak effects on satiety. As fat is a major contributor to overall energy intake, incorporating fat with satiating properties could potentially reduce energy intake. This review outlines the potential mechanisms, as far as we know, by which Medium-Chain Triglycerides (MCT), Conjugated Linoleic Acid (CLA), Short-Chain Fatty Acids (SCFA), Diacylglycerol (DAG), n-3 PUFA, and Small Particle Lipids, exerts their satiating effects. The evidence suggests that the lipid with the most potential to enhance satiety is MCT. SCFA can also promote satiety, but oral administration has been linked to poor tolerability rather than satiety. Data on the appetite effects of CLA is limited but does suggest potential. Research comparing these lipids to each other is also lacking and should be explored to elucidate which of these 'functional lipids' is the most beneficial in enhancing satiety.


Assuntos
Gorduras na Dieta/administração & dosagem , Saciação , Apetite/fisiologia , Gorduras na Dieta/uso terapêutico , Digestão , Diglicerídeos , Ingestão de Energia , Ácidos Graxos Ômega-3 , Ácidos Graxos Voláteis , Esvaziamento Gástrico , Hormônios , Humanos , Leptina , Ácidos Linoleicos Conjugados , Metabolismo dos Lipídeos , Lipídeos , Obesidade/prevenção & controle , Oxirredução , Triglicerídeos
7.
Nutrition ; 57: 154-161, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30170304

RESUMO

OBJECTIVES: Olive oil has health benefits for the correction of metabolic diseases. We aimed to evaluate the effect of olive oil consumption on the severity of fatty liver and cardiometabolic markers in patients with non-alcoholic fatty liver disease. METHODS: This randomized, double-blind, clinical trial was conducted on 66 patients with non-alcoholic fatty liver disease. Patients were divided to receive either olive or sunflower oil, each 20 g/d for 12 wk. A hypocaloric diet (-500 kcal/d) was recommended to all participants. Fatty liver grade, liver enzymes, anthropometric parameters, blood pressure, serum lipid profile, glucose, insulin, malondialdehyde, total antioxidant capacity, and interleukin-6 were assessed pre- and postintervention. RESULTS: Fatty liver grade, weight, waist circumference, and blood pressure significantly decreased in both groups. Sunflower oil significantly reduced serum aspartate and alanine aminotransferases and olive oil only decreased serum aspartate aminotransferase. Fat-free mass and skeletal muscle mass significantly reduced after the consumption of sunflower oil and serum triacylglycerols and fat mass significantly declined after the ingestion of olive oil. Among these variables, only changes in fatty liver grade (-0.29 ± 0.46 in sunflower oil versus -0.75 ± 0.45 in olive oil; P < 0.001), skeletal muscle mass (-0.71 ± 1.36 in sunflower oil versus +0.45 ± 2.8 in olive oil; P = 0.04), and body fat percentage (+0.38 ± 5.2% in sunflower oil versus -3.4 ± 5.5% in olive oil; P = 0.04) were significantly different between the groups. CONCLUSIONS: Olive oil may alleviate the severity of fatty liver independent of correcting cardiometabolic risk factors. Low-calorie diets may benefit patients with non-alcoholic fatty liver disease additionally through mitigation of obesity, blood pressure, and liver enzymes.


Assuntos
Tecido Adiposo/metabolismo , Doenças Cardiovasculares/etiologia , Fígado/efeitos dos fármacos , Hepatopatia Gordurosa não Alcoólica/tratamento farmacológico , Olea , Azeite de Oliva/uso terapêutico , Índice de Gravidade de Doença , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Pressão Sanguínea/efeitos dos fármacos , Restrição Calórica , Doenças Cardiovasculares/metabolismo , Dieta Redutora , Gorduras na Dieta/farmacologia , Gorduras na Dieta/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Fígado/enzimologia , Fígado/patologia , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/efeitos dos fármacos , Hepatopatia Gordurosa não Alcoólica/metabolismo , Obesidade/complicações , Obesidade/dietoterapia , Obesidade/metabolismo , Azeite de Oliva/farmacologia , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura
8.
J Nutr ; 148(10): 1556-1563, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-30204921

RESUMO

Background: Few trials have examined the effects of coconut oil consumption in comparison with polyunsaturated fatty acid-rich oils such as corn oil. Objective: This trial assessed the effects of consuming foods made with corn oil compared with coconut oil on lipids, glucose homeostasis, and inflammation. Methods: This was a preliminary randomized crossover study of men (n = 12) and women (n = 13) with a mean age of 45.2 y, mean body mass index (in kg/m2) of 27.7, fasting LDL cholesterol ≥115 mg/dL and <190 mg/dL, and triglycerides (TGs) ≤375 mg/dL. Subjects consumed muffins and rolls providing 4 tablespoons (∼54 g) per day of corn oil or coconut oil as part of their habitual diets for 4 wk, with a 3-wk washout between conditions. Fasting plasma lipids and high-sensitivity C-reactive protein (hs-CRP) and glucose metabolism were assessed via an intravenous glucose tolerance test at baseline and 15 and 29 d of treatment. Responses were compared between treatments by ANCOVA. Results: Median baseline concentrations of LDL cholesterol, non-HDL cholesterol, total cholesterol (total-C), HDL cholesterol, total-C:HDL cholesterol, and TGs were 123, 144, 188, 46.0, 4.21, and 92.5 mg/dL, respectively. Changes from baseline for corn oil and coconut oil conditions, respectively, were: LDL cholesterol (primary outcome; -2.7% compared with +4.6%), non-HDL cholesterol (-3.0% compared with +5.8%), total-C (-0.5% compared with +7.1%), HDL cholesterol (+5.4% compared with +6.5%), total-C:HDL cholesterol (-4.3% compared with -3.3%), and TGs (-2.1% compared with +6.0%). Non-HDL cholesterol responses were significantly different between corn and coconut oil conditions (P = 0.034); differences between conditions in total-C and LDL cholesterol approached significance (both P = 0.06). Responses for hs-CRP and carbohydrate homeostasis parameters did not differ significantly between diet conditions. Conclusions: When incorporated into the habitual diet, consumption of foods providing ∼54 g of corn oil/d produced a more favorable plasma lipid profile than did coconut oil in adults with elevated cholesterol. This trial was registered at clinicaltrials.gov as NCT03202654.


Assuntos
Colesterol/sangue , Óleo de Coco/farmacologia , Óleo de Milho/uso terapêutico , Gorduras na Dieta/uso terapêutico , Comportamento Alimentar , Hipercolesterolemia/dietoterapia , Triglicerídeos/sangue , Adolescente , Adulto , Idoso , Análise de Variância , Pão/análise , Proteína C-Reativa/metabolismo , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Óleo de Coco/uso terapêutico , Cocos/química , Óleo de Milho/farmacologia , Estudos Cross-Over , Dieta , Gorduras na Dieta/farmacologia , Feminino , Humanos , Hipercolesterolemia/sangue , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Zea mays/química
9.
Int J Mol Sci ; 19(7)2018 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-30002281

RESUMO

Lifestyle is the primary prevention of diabetes, especially type-2 diabetes (T2D). Nutritional intake of olive oil (OO), the key Mediterranean diet component has been associated with the prevention and management of many chronic diseases including T2D. Several OO bioactive compounds such as monounsaturated fatty acids, and key biophenols including hydroxytyrosol and oleuropein, have been associated with preventing inflammation and cytokine-induced oxidative damage, glucose lowering, reducing carbohydrate absorption, and increasing insulin sensitivity and related gene expression. However, research into the interaction of OO nutraceuticals with lifestyle components, especially physical activity, is lacking. Promising postprandial effects have been reported when OO or other similar monounsaturated fatty acids were the main dietary fat compared with other diets. Animal studies have shown a potential anabolic effect of oleuropein. Such effects could be further potentiated via exercise, especially strength training, which is an essential exercise prescription for individuals with T2D. There is also an evidence from in vitro, animal, and limited human studies for a dual preventative role of OO biophenols in diabetes and cancer, especially that they share similar risk factors. Putative antioxidative and anti-inflammatory mechanisms and associated gene expressions resulting from OO biophenols have produced paradoxical results, making suggested inferences from dual prevention T2D and cancer outcomes difficult. Well-designed human interventions and clinical trials are needed to decipher such a potential dual anticancer and antidiabetic effects of OO nutraceuticals. Exercise combined with OO consumption, individually or as part of a healthy diet is likely to induce reciprocal action for T2D prevention outcomes.


Assuntos
Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/prevenção & controle , Suplementos Nutricionais , Iridoides/uso terapêutico , Estilo de Vida , Azeite de Oliva/uso terapêutico , Álcool Feniletílico/análogos & derivados , Diabetes Mellitus Tipo 2/patologia , Gorduras na Dieta/uso terapêutico , Humanos , Álcool Feniletílico/uso terapêutico
10.
J Nutr ; 148(8): 1380-1386, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29982544

RESUMO

Background: Combined omega-3 fatty acid and vitamin D supplementation may improve multiple sclerosis (MS) by correcting metabolic abnormalities and attenuating oxidative stress and inflammation. Objective: This study aimed to determine the effects of ω-3 fatty acid and vitamin D cosupplementation on the disability score and metabolic status of patients with MS. Methods: This was a randomized, placebo-controlled clinical trial with Expanded Disability Status Scale (EDSS) score and inflammation as primary outcomes and oxidative stress biomarkers and metabolic profile as secondary outcomes. Patients, aged 18-55 y, were matched for disease EDSS scores, gender, medications, BMI, and age (n = 53) and randomly received a combined 2 × 1000 mg/d ω-3 fatty acid and 50,000 IU/biweekly cholecalciferol supplement or placebo for 12 wk. The placebos were matched in colour, shape, size, packaging, smell, and taste with supplements. Fasting blood samples were collected at baseline and end of intervention to measure different outcomes. Multiple linear regression models were used to assess treatment effects on outcomes adjusting for confounding variables. Results: Patients taking ω-3 fatty acid plus vitamin D supplements showed a significant improvement in EDSS (ß -0.18; 95% CI: -0.33, -0.04; P = 0.01), compared with placebo. Serum high-sensitivity C-reactive protein (ß -1.70 mg/L; 95% CI: -2.49, -0.90 mg/L; P < 0.001), plasma total antioxidant capacity (ß +55.4 mmol/L; 95% CI: 9.2, 101.6 mmol/L; P = 0.02), total glutathione (ß +51.14 µmol/L; 95% CI: 14.42, 87.87 µmol/L; P = 0.007), and malondialdehyde concentrations (ß -0.86 µmol/L; 95% CI: -1.10, -0.63 µmol/L; P < 0.001) were significantly improved in the supplemented group compared with the placebo group. In addition, ω-3 fatty acid and vitamin D cosupplementation resulted in a significant reduction in serum insulin, insulin resistance, and total/HDL-cholesterol, and a significant increase in insulin sensitivity and serum HDL-cholesterol concentrations. Conclusion: Overall, taking ω-3 fatty acid and vitamin D supplements for 12 wk by patients with MS had beneficial effects on EDSS and metabolic status. This trial was registered at the Iranian website (www.irct.ir) for registration of clinical trials as IRCT2017090133941N20.


Assuntos
Colecalciferol/uso terapêutico , Suplementos Nutricionais , Avaliação da Deficiência , Ácidos Graxos Ômega-3/uso terapêutico , Inflamação/tratamento farmacológico , Esclerose Múltipla/tratamento farmacológico , Estresse Oxidativo/efeitos dos fármacos , Adulto , Analgésicos/farmacologia , Analgésicos/uso terapêutico , Antioxidantes/metabolismo , Antioxidantes/farmacologia , Antioxidantes/uso terapêutico , Proteína C-Reativa/metabolismo , Colecalciferol/farmacologia , Colesterol/sangue , HDL-Colesterol/sangue , Gorduras na Dieta/farmacologia , Gorduras na Dieta/uso terapêutico , Pessoas com Deficiência , Ácidos Graxos Ômega-3/administração & dosagem , Ácidos Graxos Ômega-3/sangue , Ácidos Graxos Ômega-3/farmacologia , Feminino , Glutationa/sangue , Humanos , Inflamação/sangue , Insulina/sangue , Resistência à Insulina , Malondialdeído/sangue , Esclerose Múltipla/complicações , Esclerose Múltipla/metabolismo , Vitaminas/farmacologia , Vitaminas/uso terapêutico
11.
Aliment Pharmacol Ther ; 48(1): 15-34, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-29722430

RESUMO

BACKGROUND: Butyrate, propionate and acetate are short chain fatty acids (SCFA), important for maintaining a healthy colon and are considered as protective in colorectal carcinogenesis. However, they may also regulate immune responses and the composition of the intestinal microbiota. Consequently, their importance in a variety of chronic inflammatory diseases is emerging. AIMS: To review the physiology and metabolism of SCFA in humans, cellular and molecular mechanisms by which SCFA may act in health and disease, and approaches for therapeutic delivery of SCFA. METHODS: A PubMed literature search was conducted for clinical and pre-clinical studies using search terms: 'dietary fibre', short-chain fatty acids', 'acetate', 'propionate', 'butyrate', 'inflammation', 'immune', 'gastrointestinal', 'metabolism'. RESULTS: A wide range of pre-clinical evidence supports roles for SCFA as modulators of not only colonic function, but also multiple inflammatory and metabolic processes. SCFA are implicated in many autoimmune, allergic and metabolic diseases. However, translating effects of SCFA from animal studies to human disease is limited by physiological and dietary differences and by the challenge of delivering sufficient amounts of SCFA to the target sites that include the colon and the systemic circulation. Development of novel targeted approaches for colonic delivery, combined with postbiotic supplementation, may represent desirable strategies to achieve adequate targeted SCFA delivery. CONCLUSIONS: There is a large array of potential disease-modulating effects of SCFA. Adequate targeted delivery to the sites of action is the main limitation of such application. The ongoing development and evaluation of novel delivery techniques offer potential for translating promise to therapeutic benefit.


Assuntos
Ácidos Graxos Voláteis/uso terapêutico , Gastroenteropatias/dietoterapia , Inflamação/dietoterapia , Animais , Gorduras na Dieta/uso terapêutico , Fibras na Dieta/metabolismo , Fibras na Dieta/uso terapêutico , Gastroenteropatias/epidemiologia , Microbioma Gastrointestinal/efeitos dos fármacos , Microbioma Gastrointestinal/imunologia , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/imunologia , Trato Gastrointestinal/microbiologia , Humanos , Inflamação/epidemiologia
12.
Adv Nutr ; 9(3): 193-206, 2018 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-29767701

RESUMO

The Mediterranean diet pattern is increasingly associated with improved metabolic health. Two mechanisms by which consuming a Mediterranean diet pattern may contribute to improved metabolic health are modulation of the gastrointestinal (GI) microbiota and reduction of metabolic endotoxemia. Metabolic endotoxemia, defined as a 2- to 3-fold increase in circulating levels of bacterial endotoxin, has been proposed as a cause of inflammation during metabolic dysfunction. As the largest source of endotoxins in the human body, the GI microbiota represents a crucial area for research on strategies for reducing endotoxemia. Diets high in saturated fat and low in fiber contribute to metabolic endotoxemia through several mechanisms, including changes in the GI microbiome and bacterial fermentation end products, intestinal physiology and barrier function, and enterohepatic circulation of bile acids. Thus, the Mediterranean diet pattern, rich in unsaturated fats and fiber, may be one dietary strategy to reduce metabolic endotoxemia. Preclinical studies have demonstrated the differential effects of dietary saturated and unsaturated fats on the microbiota and metabolic health, but human studies are lacking. The role of dietary fiber and the GI microbiome in metabolic endotoxemia is underinvestigated. Clinical research on the effects of different types of dietary fat and fiber on the GI microbiota and GI and systemic inflammation is necessary to determine efficacious dietary strategies for reducing metabolic endotoxemia, inflammation, and subsequent metabolic disease.


Assuntos
Dieta Mediterrânea , Gorduras na Dieta/farmacologia , Fibras na Dieta/farmacologia , Endotoxemia/complicações , Ácidos Graxos Insaturados/farmacologia , Microbioma Gastrointestinal , Inflamação , Dieta Hiperlipídica , Gorduras na Dieta/efeitos adversos , Gorduras na Dieta/uso terapêutico , Fibras na Dieta/uso terapêutico , Disbiose/complicações , Endotoxinas/sangue , Ácidos Graxos Insaturados/uso terapêutico , Comportamento Alimentar , Microbioma Gastrointestinal/efeitos dos fármacos , Humanos , Inflamação/sangue , Inflamação/etiologia , Inflamação/prevenção & controle , Mucosa Intestinal/microbiologia , Mucosa Intestinal/patologia
13.
Int J Dermatol ; 57(4): 480-487, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29431228

RESUMO

Proven as effective acne scar treatment, ablative fractional carbon dioxide (AFCO2 ) laser requires post-laser wound healing care. MAS063DP is a multicomponent nonsteroidal anti-inflammatory moisturizer for effective post-laser treatment. This study compares the efficacy of MAS063DP and 0.02% triamcinolone acetonide (TA) lotion for post-laser wound healing and complications. A split-face, triple-blinded, clinical study was performed in 16 patients, aged 20-50 years, receiving AFCO2 on both sides of the face, with MAS063DP on one side and 0.02% TA on the other side for 7 days twice daily. Digital photography, hemoglobin, and melanin index at baseline were obtained immediately after laser treatment and then at days 3, 5, 7, and 30. Erythema, edema, crusting, adverse effects, and post-inflammatory hyperpigmentation (PIH) were followed every visit. Sixteen patients, mean age 38.6 (8.4) years, with moderate-severe atrophic scar and skin phototype III-IV completed the study. Clinical improvement of edema, erythema, crusting, and hyperpigmentation was observed from day 3 to day 30 (P < 0.001), with no statistically significant difference in both groups. There was also no statistical difference of hemoglobin, melanin index, and texture at days 3, 5, 7, and 30. Melanin index at day 30 was significantly less than baseline in both MAS063DP and 0.02% TA. With PIH in 50% of cases, both treatments demonstrated good safety profiles and no serious adverse reactions. MAS063DP could be an effective treatment for post-laser wound healing and complications, compatible to 0.02% TA.


Assuntos
Anti-Inflamatórios/uso terapêutico , Cicatriz/terapia , Fármacos Dermatológicos/uso terapêutico , Gorduras na Dieta/uso terapêutico , Ácido Glicirretínico/uso terapêutico , Extratos Vegetais/uso terapêutico , Triancinolona Acetonida/uso terapêutico , Cicatrização/efeitos dos fármacos , Acne Vulgar/complicações , Adulto , Anti-Inflamatórios/farmacologia , Cicatriz/etiologia , Técnicas Cosméticas/efeitos adversos , Fármacos Dermatológicos/farmacologia , Gorduras na Dieta/farmacologia , Edema/tratamento farmacológico , Edema/etiologia , Eritema/tratamento farmacológico , Eritema/etiologia , Feminino , Ácido Glicirretínico/farmacologia , Humanos , Hiperpigmentação/tratamento farmacológico , Hiperpigmentação/etiologia , Lasers de Gás/efeitos adversos , Masculino , Pessoa de Meia-Idade , Extratos Vegetais/farmacologia , Creme para a Pele/uso terapêutico , Triancinolona Acetonida/farmacologia
14.
Eur J Clin Nutr ; 72(10): 1364-1372, 2018 10.
Artigo em Inglês | MEDLINE | ID: mdl-29382923

RESUMO

BACKGROUND/OBJECTIVES: The aim of this study was to assess the effects of a fish oil-based lipid emulsion on intestinal failure-associated liver disease (IFALD) in children. SUBJECTS/METHODS: From January 2014 through June 2017, we enrolled 32 children with IF on long-term parenteral nutrition (PN). When the levels of any three of seven liver indicators (TBA, alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase, gamma glutamyl transferase (γ-GT), total bilirubin (TB), or direct bilirubin (DB)) were two times higher than normal levels, we switched a 50:50 mix of soybean oil and medium-chain triglycerides (MCT) lipid emulsion (with an average dose of 1.30 g/kg/day) to a fish oil-based lipid emulsion (1 g/kg/day) and measured liver function in the children. Meanwhile, inflammation and oxidative stress-related markers were also measured. RESULTS: The average fish oil therapy duration was 26 ± 21 days, and the median duration of PN support was 84 days. With fish oil therapy, levels of TBA, ALT, AST, γ-GT, TB, and DB all significantly decreased. Enteral nutrition was introduced following fish oil resulting in higher energy intake (99.88 ± 31.06 kcal/kg/day) compared with before fish oil (67.90 ± 27.31 kcal/kg/day, P = 0.001). No significant difference was found in average PN energy (P = 0.147). In addition, levels of inflammatory indicators like tumor necrosis factor-alpha (TNF-α), C-reactive protein (CRP), and white blood cell (WBC) significantly decreased. CONCLUSIONS: Fish oil therapy alleviates IFALD in children.


Assuntos
Gorduras na Dieta/uso terapêutico , Emulsões Gordurosas Intravenosas/uso terapêutico , Óleos de Peixe/uso terapêutico , Enteropatias/complicações , Hepatopatias/tratamento farmacológico , Fígado/efeitos dos fármacos , Nutrição Parenteral , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Bilirrubina/sangue , Criança , Pré-Escolar , Gorduras na Dieta/administração & dosagem , Emulsões Gordurosas Intravenosas/química , Emulsões Gordurosas Intravenosas/farmacologia , Feminino , Óleos de Peixe/administração & dosagem , Óleos de Peixe/farmacologia , Humanos , Lactente , Recém-Nascido , Inflamação/sangue , Inflamação/tratamento farmacológico , Fígado/enzimologia , Fígado/patologia , Hepatopatias/etiologia , Masculino , Óleos Vegetais/uso terapêutico , Triglicerídeos/uso terapêutico , gama-Glutamiltransferase/sangue
15.
J Eur Acad Dermatol Venereol ; 32(7): 1180-1187, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-29419920

RESUMO

BACKGROUND: Emollients are considered as a first-line therapy for the treatment of atopic dermatitis (AD). However, evidence-based proof that the regular use of emollients reduces AD severity is lacking. OBJECTIVE: To assess whether the regular use of emollients results in a reduction in AD severity in children with AD. METHODS: In this multicentre randomized, parallel group, open-label study, children with mild-to-moderate AD were recruited during a flare. After flare resolution with a topical corticosteroid, patients were randomized to V0034CR emollient, reference emollient or no emollient (1:1:1 ratio), for 12 weeks. AD severity was assessed regularly by physicians [Scoring for Atopic Dermatitis (SCORAD) and subcomponents, IGA] and by parents (PO-SCORAD and POEM). RESULTS: A total of 335 patients were randomized to V0034CR (n = 111), reference emollient (n = 116) or no emollient (n = 108). After 12 weeks of treatment, SCORAD score was reduced by 5.28 points in the V0034CR group and by 3.36 points in the reference emollient group compared with the no emollient group (+4 points; P < 0.001 in both emollient groups vs. no emollient group). In a similar manner, PO-SCORAD score was reduced by 4.88 and 2.67 points in the V0034CR and reference emollient groups, respectively, but increased by 2.90 points in the no emollient group (P < 0.001). Similar results were observed for POEM. A continuous decrease in all scores was observed over the 12-week treatment period. At the end of the study, the percentage of patients in complete remission (i.e. without a new flare over the treatment period) was higher in the V0034CR (59.5%) and reference emollient (44.3%) groups than in the no emollient group (29.8%; P < 0.001). CONCLUSION: These results demonstrate that the regular use of emollients in children with mild-to-moderate AD reduces the severity of symptoms and, therefore, support their use as a first-line treatment for these patients.


Assuntos
Dermatite Atópica/tratamento farmacológico , Gorduras na Dieta/uso terapêutico , Emolientes/uso terapêutico , Glicerol/uso terapêutico , Ácido Glicirretínico/uso terapêutico , Parafina/uso terapêutico , Extratos Vegetais/uso terapêutico , Pré-Escolar , Dermatite Atópica/complicações , Combinação de Medicamentos , Feminino , Humanos , Masculino , Prurido/etiologia , Índice de Gravidade de Doença , Transtornos do Sono-Vigília/etiologia , Avaliação de Sintomas , Exacerbação dos Sintomas , Resultado do Tratamento
16.
Clin Nutr ; 37(4): 1193-1201, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-28606702

RESUMO

BACKGROUND & AIM: Regular intake of nuts improves lipid profile and thus reduces the cardiovascular (CV) risk associated with hyperlipidemia. The aim of the study was to investigate the effect of a dietary intervention with hazelnuts (HZNs, 15-30 g/day, depending on patient weight) on serum lipid profile, anthropometric parameters and fatty acids (FAs) composition of erythrocyte phospholipids in children and adolescents with primary hyperlipidemia. METHODS: Eight-week randomized, single blind, controlled, three-arm, parallel-group study. Sixty-six subjects were enrolled and randomized in 3 groups receiving: 1) hazelnuts with skin (HZN+S); 2) hazelnuts without skin (HZN-S); 3) dietary advices for hyperlipidemia only (controls). Before and after intervention, clinical parameters were measured and blood samples were collected for the evaluation of serum lipid levels and phospholipid FA composition of erythrocytes. RESULTS: Two-way ANOVA showed a significant effect of time on serum low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C)/LDL-C ratio and non-HDL-C (p ≤ 0.001), but not of treatment and time × treatment interaction. In particular, HZN+S and HZN-S significantly reduced the concentrations of LDL-C and increased HDL-C/LDL-C ratio. HZNs also had a favorable impact on FAs composition of erythrocyte phospholipids, as demonstrated by time × treatment interaction, with a significant increase of monounsaturated fatty acids (MUFAs) (p = 0.008) and MUFAs/saturated fatty acids (SFAs) ratio (p = 0.002) with respect to the control group. CONCLUSIONS: For the first time, we documented a positive effect of HZN consumption on lipid profile and FA composition of erythrocyte phospholipids in children with primary hyperlipidemia. Further studies are encouraged to better define HZN impact on the markers of CV risk in this population. The trial was registered under ISRCTN.com, ID no. ISRCTN12261900.


Assuntos
Corylus , Gorduras na Dieta/uso terapêutico , Eritrócitos/efeitos dos fármacos , Hiperlipidemias/dietoterapia , Lipídeos/sangue , Adolescente , Criança , Gorduras na Dieta/farmacologia , Ácidos Graxos/análise , Ácidos Graxos Ômega-3/sangue , Feminino , Humanos , Hiperlipidemias/metabolismo , Masculino , Fosfolipídeos/química
17.
J Nutr Sci Vitaminol (Tokyo) ; 64(6): 412-424, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30606964

RESUMO

The present study aims to determine the most suitable dietary balance of energy-producing nutrients for recovery from starvation. Rats were fed their standard high- carbohydrate diet (HCD, carbohydrate energy : protein energy : fat energy=71 : 18 : 11) for 7 d and then deprived of food for 3 d (short-term starvation) or 8 d (long-term starvation). The starved rats were then fed the HCD, a high-protein diet (HPD, 31 : 57 : 12), or a high-fat diet (HFD, 34 : 14 : 52) for 8 d. Rats had ad libitum access to drinking water throughout the experimental period, including the starvation period. The reference group was allowed free access to the HCD throughout the experimental period. Characteristically, increased drinking, increased urea nitrogen in the plasma and urine, and hypertrophy of the kidneys, were observed in the HPD group. Furthermore, the recovery of plasma glucose level was insufficient in this group. Therefore, administration of a HPD was contraindicated in recovery from starvation. The recovery of body weight after starvation was excellent in the HFD group. No effect on the metabolism of B-group vitamins involved in energy metabolism was found with the administration of any diet. The effects of HCD and HFD administration on recovery from starvation were investigated in further detail. No adverse effects were observed on the tissue to body weight mass ratios or biochemical parameters in blood in the HFD group. From the above findings, it is hypothesized that a HFD is most suitable for quickly reversing the influence of starvation.


Assuntos
Dieta Hiperlipídica , Dieta Rica em Proteínas , Gorduras na Dieta/uso terapêutico , Proteínas na Dieta/efeitos adversos , Ingestão de Energia , Estado Nutricional , Inanição/dietoterapia , Animais , Glicemia/metabolismo , Composição Corporal , Peso Corporal , Dieta Rica em Proteínas/efeitos adversos , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Masculino , Ratos Wistar
18.
BMJ Open ; 7(9): e018360, 2017 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-28947468

RESUMO

INTRODUCTION: Preterm birth accounts for more than 85% of all perinatal complications and deaths. Seventy-five per cent of early preterm births (EPTBs) occur spontaneously and without identifiable risk factors. The need for a broadly applicable, effective strategy for primary prevention is paramount. Secondary outcomes from the docosahexaenoic acid (DHA) to Optimise Mother Infant Outcome trial showed that maternal supplementation until delivery with omega-3 (ω-3) long chain polyunsaturated fatty acid (LCPUFA), predominantly as DHA, resulted in a 50% reduction in the incidence of EPTB and an increase in the incidence of post-term induction or post-term prelabour caesarean section due to extended gestation. We aim to determine the effectiveness of supplementing the maternal diet with ω-3 LCPUFA until 34 weeks' gestation on the incidence of EPTB. METHODS AND ANALYSIS: This is a multicentre, parallel group, randomised, blinded and controlled trial. Women less than 20 weeks' gestation with a singleton or multiple pregnancy and able to give informed consent are eligible to participate. Women will be randomised to receive high DHA fish oil capsules or control capsules without DHA. Capsules will be taken from enrolment until 34 weeks' gestation. The primary outcome is the incidence of EPTB, defined as delivery before 34 completed weeks' gestation. Key secondary outcomes include length of gestation, incidence of post-term induction or prelabour caesarean section and spontaneous EPTB. The target sample size is 5540 women (2770 per group), which will provide 85% power to detect an absolute reduction in the incidence of preterm birth of 1.16% (from 2.45% to 1.29%) between the DHA and control group (two sided α=0.05). The primary analysis will be based on the intention-to-treat principle. TRIAL REGISTRATION NUMBER: Australia and New Zealand Clinical Trial Registry Number: 2613001142729; Pre-results.


Assuntos
Gorduras na Dieta/uso terapêutico , Ácidos Graxos Ômega-3/uso terapêutico , Nascimento Prematuro/prevenção & controle , Adulto , Estudos de Casos e Controles , Protocolos Clínicos , Suplementos Nutricionais , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez
19.
J Nutr ; 147(9): 1624-1630, 2017 09.
Artigo em Inglês | MEDLINE | ID: mdl-28768838

RESUMO

Background: Premature infants are deprived of prenatal accumulation of brain docosahexaenoic acid [DHA (22:6n-3)], an omega-3 fatty acid [ω-3 FA (n-3 FA)] important for proper development of cognitive function. The resulting brain DHA deficit can be reversed by ω-3 FA supplementation.Objective: The objective was to test whether there is a critical period for providing ω-3 FA to correct cognitive deficits caused by developmental ω-3 FA deprivation in mice.Methods: Twelve timed-pregnant mice [embryonic day 14 (E14), C57/BL6NCr] were fed an ω-3 FA-deficient diet containing 0.04% α-linolenic acid [ALA (18:3n-3)], and their offspring were fed the same deficient diet (Def group) or changed to an ω-3 FA-adequate diet containing 3.1% ALA at 3 wk, 2 mo, or 4 mo of age. In parallel, 3 E14 pregnant mice were fed the adequate diet and their offspring were fed the same diet (Adeq group) throughout the experiment. Brain FA composition, learning and memory, and hippocampal synaptic protein expression were evaluated at 6 mo by gas chromatography, the Morris water maze test, and western blot analysis, respectively.Results: Maternal dietary ω-3 FA deprivation decreased DHA by >50% in the brain of their offspring at 3 wk of age. The Def group showed significantly worse learning and memory at 6 mo than those groups fed the adequate diet. These pups also had decreased hippocampal expression of postsynaptic density protein 95 (43% of Adeq group), Homer protein homolog 1 (21% of Adeq group), and synaptosome-associated protein of 25 kDa (64% of Adeq group). Changing mice to the adequate diet at 3 wk, 2 mo, or 4 mo of age restored brain DHA to the age-matched adequate concentration. However, deficits in hippocampal synaptic protein expression and spatial learning and memory were normalized only when the diet was changed at 3 wk.Conclusion: Developmental deprivation of brain DHA by dietary ω-3 FA depletion in mice may have a lasting impact on cognitive function if not corrected at an early age.


Assuntos
Encéfalo/efeitos dos fármacos , Cognição/efeitos dos fármacos , Deficiências Nutricionais/tratamento farmacológico , Ácidos Docosa-Hexaenoicos/administração & dosagem , Recém-Nascido Prematuro , Aprendizagem em Labirinto/efeitos dos fármacos , Memória/efeitos dos fármacos , Animais , Animais Recém-Nascidos , Encéfalo/crescimento & desenvolvimento , Encéfalo/metabolismo , Deficiências Nutricionais/complicações , Dieta , Gorduras na Dieta/administração & dosagem , Gorduras na Dieta/farmacologia , Gorduras na Dieta/uso terapêutico , Proteína 4 Homóloga a Disks-Large , Ácidos Docosa-Hexaenoicos/deficiência , Ácidos Docosa-Hexaenoicos/farmacologia , Ácidos Docosa-Hexaenoicos/uso terapêutico , Feminino , Guanilato Quinases/metabolismo , Proteínas de Arcabouço Homer/metabolismo , Humanos , Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido Prematuro/metabolismo , Fenômenos Fisiológicos da Nutrição Materna , Proteínas de Membrana/metabolismo , Camundongos , Gravidez , Proteína 25 Associada a Sinaptossoma/metabolismo , Fatores de Tempo
20.
Public Health Nutr ; 20(16): 2998-3007, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28789712

RESUMO

OBJECTIVE: To determine the effects of lipid-based nutrient supplements (LNS) on children's Hb, linear growth and development, compared with supplementation with micronutrient powder (MNP). DESIGN: The study was a two-arm parallel-group randomized controlled trial, where participants received either LNS or MNP for daily consumption during 6 months. Supplements were delivered by staff at government-run health centres. Hb, anthropometric, motor development, language development and problem-solving indicators were measured by trained research assistants when children were 12 months of age. SETTING: The study was conducted in five rural districts in the Province of Ambo in the Department of Huánuco, Peru. SUBJECTS: We enrolled 6-month-old children (n 422) at nineteen health centres. RESULTS: Children who received LNS had a higher mean Hb concentration and lower odds of anaemia than those who received MNP. No significant differences in height-for-age, weight-for-height or weight-for-age Z-score, or stunting and underweight prevalence, were observed. Provision of LNS was associated with a higher pre-verbal language (gestures) score, but such effect lost significance after adjustment for covariates. Children in the LNS group had higher problem-solving task scores and increased odds of achieving this cognitive task than children in the MNP group. No significant differences were observed on receptive language or gross motor development. CONCLUSIONS: LNS between 6 and 12 months of age increased Hb concentration, reduced anaemia and improved cognitive development in children, but showed no effects on anthropometric indicators, motor or language development.


Assuntos
Deficiências do Desenvolvimento/prevenção & controle , Gorduras na Dieta/uso terapêutico , Suplementos Nutricionais , Transtornos da Nutrição do Lactente/prevenção & controle , Fenômenos Fisiológicos da Nutrição do Lactente , Micronutrientes/uso terapêutico , Saúde da População Rural , Desenvolvimento Infantil , Deficiências do Desenvolvimento/epidemiologia , Método Duplo-Cego , Feminino , Seguimentos , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Transtornos da Nutrição do Lactente/epidemiologia , Análise de Intenção de Tratamento , Desenvolvimento da Linguagem , Perda de Seguimento , Masculino , Peru/epidemiologia , Prevalência , Resolução de Problemas , Risco , Serviços de Saúde Rural , Magreza/epidemiologia , Magreza/prevenção & controle
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