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1.
Nutrients ; 12(10)2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33065991

RESUMO

The COVID-19 quarantine has caused significant changes in everyday life. This study aimed to evaluate the effect of the quarantine on dietary, physical activity and alcohol consumption habits of Lithuanians and the association between health behaviours and weight changes. An online cross-sectional survey was carried out among individuals older than 18 years in April 2020. The self-administered questionnaire included health behaviour and weight change data. Altogether 2447 subjects participated in the survey. Almost half of the respondents (49.4%) ate more than usual, 45.1% increased snacking, and 62.1% cooked at home more often. Intake of carbonated or sugary drinks, fast food and commercial pastries decreased, while consumption of homemade pastries and fried food increased. A decrease in physical activity was reported by 60.6% of respondents. Every third (31.5%) respondent, more often those already with overweight, gained weight. Multivariate logistic regression analysis showed that the higher odds of weight gain were associated with females, older age, increased consumption of sugary drinks, homemade pastries and fried food, eating more than usual, increased snacking, decreased physical activity and increased alcohol consumption. Our data highlighted the need for dietary and physical activity guidelines to prevent weight gain during the period of self-isolation, especially targeting those with overweight and obesity.


Assuntos
Infecções por Coronavirus , Ingestão de Energia , Comportamento Alimentar , Comportamentos Relacionados com a Saúde , Pandemias , Pneumonia Viral , Isolamento Social , Ganho de Peso , Adolescente , Adulto , Betacoronavirus , Índice de Massa Corporal , Peso Corporal , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Estudos Transversais , Fast Foods , Feminino , Humanos , Estilo de Vida , Lituânia/epidemiologia , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Quarentena , Lanches , Adulto Jovem
2.
Ther Umsch ; 77(7): 302-311, 2020 Sep.
Artigo em Alemão | MEDLINE | ID: mdl-32996430

RESUMO

Which diet is appropriate for patients with diabetes mellitus? Abstract. What is considered a balanced diet for the general population is in principle also true for people with diabetes. The scarce scientific evidence does not justify a dogmatic attitude with strict rules and bans on nutrients or foods. Rather, all macronutrient groups are represented in a balanced diet, whereby a reduction in calorie intake can be equally successful via carbohydrates or fats. Ideal are products of high quality and with low and gentle processing, such as starch products rich in fibre and cold-pressed vegetable oils. The benefits of increased protein intake in terms of diabetes management and weight control are becoming increasingly clear. However, plant-based or dairy products should be used as sources rather than red or processed meat. The Mediterranean diet and concepts with a comparable scientific basis are most likely to meet the criteria of a "suitable" diet for diabetes patients. Although alcohol is dense with empty calories, there is no reason not to tolerate the consumption embedded in such a diet. In view of the individually different metabolic reactions to the same foods and taking into account the scarce evidence, a personalised approach is more appropriate than ever.


Assuntos
Diabetes Mellitus , Dieta Mediterrânea , Ingestão de Energia , Humanos
3.
Rev Saude Publica ; 54: 89, 2020 Sep 04.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32901754

RESUMO

OBJECTIVE: To analyze the nutritional composition of ultra-processed foods consumed by children that attend basic health units. METHODS: This is a cross-sectional study with a representative probabilistic sample of 536 children aged between 6 and 59 months treated at a health unit in the city of Rio de Janeiro. Nutritional information was extracted from labels of the ultra-processed foods referred to in a 24-hour recall. The 351 foods mentioned were divided into 22 groups and 38 subgroups according to the type of product, and they were characterized according to the averages of the values for energy, total fats, saturated fats, trans fats and sodium in 100 grams of the product, in addition to presence, number, and type of "other sweeteners". The nutritional Profile Model of the Pan American Health Organization was applied for each food and for the average of nutrient content obtained for each group to examine the occurrence of critical nutrients excess. RESULTS: Ultra-processed foods contained high energy value and high levels of total fats, saturated fats, trans fats, and sodium. Out of the total of ultra-processed foods, 66% presented excess of at least one critical nutrient, with emphasis on requeijões and ultra-processed cheeses, instant noodles, and industrialized and sausage-like meats, which presented 100% of foods with excess of total fats, saturated fats and sodium. Out of the 21 groups, the following exceeded the limit established by the Pan American Health Organization: for total fats, 10 groups; for saturated fats, 11; for trans fats, 3; and sodium, 13. Requeijões and ultra-processed cheeses; industrialized and sausage-like meats; and biscuits exceeded this limit in all parameters. Out of the set of ultra-processed foods analyzed, 13.4% contained "other sweeteners" (eight different types). CONCLUSIONS: The ultra-processed foods analyzed presented unbalanced nutritional profile, and two thirds presented excess of at least one critical nutrient. Educational actions and regulatory measures are necessary to better inform the population and to discourage its consumption.


Assuntos
Ingestão de Energia , Fast Foods , Comportamento Alimentar , Valor Nutritivo , Brasil , Criança , Pré-Escolar , Estudos Transversais , Manipulação de Alimentos , Humanos , Lactente , Estados Unidos
4.
PLoS One ; 15(9): e0237969, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32870928

RESUMO

This systematic review aims to summarize the evidence regarding the effectiveness of interventions targeting energy balance-related behaviors in children from lower socioeconomic environments and the applied behavior change techniques. The literature search was conducted in Cochrane, Embase, Psycinfo and Pubmed. Articles had to be published between January 2000 and September 2019. Studies were included that i) targeted dietary behavior, physical activity and/or sedentary behavior; ii) had a controlled trial design; iii) included children aged 9-12 years old; iv) focused on lower socioeconomic environments; and v) took place in upper-middle or high income countries. Two independent researchers extracted data, identified behavior change techniques using the Behavior Change Technique Taxonomy v1, and performed a methodological quality assessment using the quality assessment tool of the Effective Public Health Practice Project. We included 24 studies, of which one received a high and three a moderate quality rating. Demonstration, practice and providing instructions on how to perform a behavior were the most commonly applied behavior change techniques. Seven studies reported significant beneficial intervention effects: five on physical activity, one on physical activity and sedentary behavior and one on dietary behavior. When comparing effective versus non-effective interventions, and comparing our review to previous reviews focusing on children from the general population, similar behavior change techniques were applied. More high quality research is needed to evaluate the effectiveness of interventions and their behavior change techniques targeting children of low socioeconomic environments. PROSPERO registration number: CRD42016052599.


Assuntos
Terapia Comportamental , Fenômenos Fisiológicos da Nutrição Infantil , Ingestão de Energia , Metabolismo Energético , Exercício Físico , Obesidade Pediátrica/prevenção & controle , Criança , Humanos , Obesidade Pediátrica/psicologia , Comportamento Sedentário , Fatores Socioeconômicos
5.
PLoS One ; 15(9): e0238050, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32903260

RESUMO

Many campaigns promote the preservation and consumption of leftover food items as a critical household strategy to accomplish national consumer food waste reduction goals. We fill a gap in knowledge about the consumption and creation of leftovers in the United States by analyzing data from a pilot study in which 18 subjects tracked food selection, intake, and plate waste across all eating occasions for about one week. Subjects noted which items selected for consumption were leftovers, i.e., previously prepared but uneaten items that were stored for future consumption, and which unfinished items were saved to become leftovers. We found that 12% of items selected for consumption were leftovers while 24% of selected items that were not fully consumed were kept to become a leftover. Leftovers were most frequently vegetables, cheeses, and meats, and most frequently selected on Mondays and for lunch. Regression analyses isolate significant dining patterns with respect to leftovers, including evidence that leftovers were less likely to be fully consumed than non-leftover items, and that larger meals led to more uneaten food. This suggests that strategies to reduce meal size may be most effective in reducing food waste by limiting the creation of leftovers in the first place. Strategies to make leftovers more attractive and appealing may also reduce food waste.


Assuntos
Comportamento de Escolha , Comportamento do Consumidor , Ingestão de Energia , Preferências Alimentares/psicologia , Serviços de Alimentação/normas , Eliminação de Resíduos/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estados Unidos
6.
Pediatrics ; 146(4)2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32913133

RESUMO

BACKGROUND: Despite the standardization of care, formula feeding varied across sites of the Ohio Perinatal Quality Collaborative (OPQC). We used orchestrated testing (OT) to learn from this variation and improve nonpharmacologic care of infants with neonatal abstinence syndrome (NAS) requiring pharmacologic treatment in Ohio. METHODS: To test the impact of formula on length of stay (LOS), treatment failure, and weight loss among infants hospitalized with NAS, we compared caloric content (high versus standard) and lactose content (low versus standard) using a 22 factorial design. During October 2015 to June 2016, OPQC sites joined 1 of 4 OT groups. We used response plots to examine the effect of each factor and control charts to track formula use and LOS. We used the OT results to revise the nonpharmacologic bundle and implemented it during 2017. RESULTS: Forty-seven sites caring for 546 NAS infants self-selected into the 4 OT groups. Response plots revealed the benefit of high-calorie formula (HCF) on weight loss, treatment failure, and LOS. The nonpharmacologic treatment bundle was updated to recommend HCF when breastfeeding was not possible. During implementation, HCF use increased, and LOS decreased from 17.1 to 16.4 days across the OPQC. CONCLUSIONS: OT revealed that HCF was associated with shorter LOS in OPQC sites. Implementation of a revised nonpharmacologic care bundle was followed by additional LOS improvement in Ohio. Despite some challenges in the implementation of OT, our findings support its usefulness for learning in improvement networks.


Assuntos
Ingestão de Energia , Fórmulas Infantis , Tempo de Internação/estatística & dados numéricos , Síndrome de Abstinência Neonatal/terapia , Feminino , Humanos , Recém-Nascido , Lactose/administração & dosagem , Metadona/administração & dosagem , Metadona/efeitos adversos , Morfina/administração & dosagem , Morfina/efeitos adversos , Ohio , Tratamento de Substituição de Opiáceos , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Melhoria de Qualidade/organização & administração , Ganho de Peso
7.
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
8.
Crit Rev Oncol Hematol ; 153: 103061, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32777729

RESUMO

This review aims to answer to two basic questions: a) Which substrates does a tumour utilize and is there a regimen that might potentially favour the host over the tumour? and b) Does nutritional intervention disproportionally affect tumour growth? Literature to date focuses on humans; although some references to molecular mechanisms regulating cancer cells metabolism derive from studies on experimental tumours and cell biology. Literature shows that some tumours, especially those of the brain and head/neck and lung, are glucose-dependent, and patients with these tumours could benefit from a normocaloric ketogenic diet provided these tumours exhibit high fluorodeoxyglucose (18F-FDG) captation. A high fat-protein, low carbohydrate diet appears to better fulfil the nutritional requirements of the cancer patient. Current evidence shows no improvement in tumoral response after restricting patients' caloric intake; whereas malnutrition is acknowledged as an important negative predictive and prognostic factor in all cancer patients.


Assuntos
Dieta Cetogênica , Neoplasias , Ingestão de Energia , Fluordesoxiglucose F18 , Humanos , Estado Nutricional
9.
Zhonghua Yu Fang Yi Xue Za Zhi ; 54(7): 742-746, 2020 Jul 06.
Artigo em Chinês | MEDLINE | ID: mdl-32842296

RESUMO

Objective: To explore the relationship between dietary quality and the risk of diabetes and prediabetes among urban women based on alternative healthy eating index-2010(AHEI-2010). Methods: From March to July 2016, a total of 1 061 female residents from 8 cities, Beijing, Guangzhou, Chengdu, Lanzhou, Xuchang, Jilin, Wuhu and Chenzhou in China, were selected by using the multi-stage sampling method. The basic characteristics of all participants were collected by using self-made questionnaire, and the dietary status of the subjects was collected by using 24-hour dietary recall method. AHEI-2010 scores were calculated and the diet was divided into low, medium and high dietary quality group according to the third quartile. All participants received physical examination, systolic blood pressure test, fasting blood glucose test and glycosylated hemoglobin test. Unconditional logistic regression model was used to analyze the relationship between dietary quality and the risk of diabetes and prediabetes. Results: The age of all participants was(48.0±17.5) years old. The median(P25, P75) of AHEI-2010 score was 46.52(40.04, 54.88). The prevalence of diabetes and prediabetes were 13.3%(141 cases) and 50.0%(530 cases), respectively. Unconditional logistic regression analysis showed that after adjusting for age, city, education, diet control, physical activity, energy intake and waist circumference, compared with the low diet quality group, the OR(95%CI) values of medium, high dietary quality group and diabetes risk were 0.96(0.57-1.62) and 0.63(0.36-1.09), respectively; the OR(95%CI) values of medium, high dietary quality group and prediabetes risk were 0.93(0.64-1.35) and 1.28(0.87-1.88), respectively. Conclusion: The dietary quality of urban women based on AHEI-2010 evaluation is not related to the risk of diabetes and prediabetes.


Assuntos
Estado Pré-Diabético/epidemiologia , Adulto , Idoso , Pequim , China/epidemiologia , Estudos Transversais , Dieta , Ingestão de Energia , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco
10.
PLoS Med ; 17(8): e1003256, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32853224

RESUMO

BACKGROUND: Ultra-processed food (UPF) consumption has increased drastically worldwide and already represents 50%-60% of total daily energy intake in several high-income countries. In the meantime, the prevalence of overweight and obesity has risen continuously during the last century. The objective of this study was to investigate the associations between UPF consumption and the risk of overweight and obesity, as well as change in body mass index (BMI), in a large French cohort. METHODS AND FINDINGS: A total of 110,260 adult participants (≥18 years old, mean baseline age = 43.1 [SD 14.6] years; 78.2% women) from the French prospective population-based NutriNet-Santé cohort (2009-2019) were included. Dietary intakes were collected at baseline using repeated and validated 24-hour dietary records linked to a food composition database that included >3,500 different food items, each categorized according to their degree of processing by the NOVA classification. Associations between the proportion of UPF in the diet and BMI change during follow-up were assessed using linear mixed models. Associations with risk of overweight and obesity were assessed using Cox proportional hazard models. After adjusting for age, sex, educational level, marital status, physical activity, smoking status, alcohol intake, number of 24-hour dietary records, and energy intake, we observed a positive association between UPF intake and gain in BMI (ß Time × UPF = 0.02 for an absolute increment of 10 in the percentage of UPF in the diet, P < 0.001). UPF intake was associated with a higher risk of overweight (n = 7,063 overweight participants; hazard ratio (HR) for an absolute increase of 10% of UPFs in the diet = 1.11, 95% CI: 1.08-1.14; P < 0.001) and obesity (n = 3,066 incident obese participants; HR10% = 1.09 (1.05-1.13); P < 0.001). These results remained statistically significant after adjustment for the nutritional quality of the diet and energy intake. Study limitations include possible selection bias, potential residual confounding due to the observational design, and a possible item misclassification according to the level of processing. Nonetheless, robustness was tested and verified using a large panel of sensitivity analyses. CONCLUSIONS: In this large observational prospective study, higher consumption of UPF was associated with gain in BMI and higher risks of overweight and obesity. Public health authorities in several countries recently started to recommend privileging unprocessed/minimally processed foods and limiting UPF consumption. TRIAL REGISTRATION: ClinicalTrials.gov NCT03335644 (https://clinicaltrials.gov/ct2/show/NCT03335644).


Assuntos
Índice de Massa Corporal , Ingestão de Energia/fisiologia , Fast Foods/efeitos adversos , Inquéritos Nutricionais/tendências , Valor Nutritivo/fisiologia , Sobrepeso/epidemiologia , Adulto , Estudos de Coortes , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/diagnóstico , Obesidade/epidemiologia , Sobrepeso/diagnóstico , Estudos Prospectivos , Fatores de Risco
11.
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
12.
PLoS One ; 15(8): e0237922, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32845924

RESUMO

BACKGROUND: Levels of cortisol, melatonin, ghrelin, and leptin are highly correlated with circadian rhythmicity. The levels of these hormones are affected by sleep, feeding, and general behaviors, and fluctuate with light and dark cycles. During the fasting month of Ramadan, a shift to nighttime eating is expected to affect circadian rhythm hormones and, subsequently, the levels of melatonin, cortisol, ghrelin, and leptin. The present study aimed to examine the effect of diurnal intermittent fasting (DIF) during Ramadan on daytime levels of ghrelin, leptin, melatonin, and cortisol hormones in a group of overweight and obese subjects, and to determine how anthropometric, dietary, and lifestyle changes during the month of Ramadan correlate with these hormonal changes. METHODS: Fifty-seven overweight and obese male (40) and female (17) subjects were enrolled in this study. Anthropometric measurements, dietary intake, sleep duration, and hormonal levels of serum ghrelin, leptin, melatonin, and salivary cortisol were assessed one week before the start of Ramadan fasting and after 28 days of fasting at fixed times of the day (11:00 am-1:00 pm). RESULTS: At the end of Ramadan, serum levels of ghrelin, melatonin, and leptin significantly (P<0.001) decreased, while salivary cortisol did not change compared to the levels assessed in the pre-fasting state. CONCLUSIONS: DIF during Ramadan significantly altered serum levels of ghrelin, melatonin, and serum leptin. Further, male sex and anthropometric variables were the most impacting factors on the tested four hormones. Further studies are needed to assess DIF's impact on the circadian rhythmicity of overweight and obese fasting people.


Assuntos
Ritmo Circadiano/fisiologia , Jejum/sangue , Grelina/sangue , Hidrocortisona/sangue , Melatonina/sangue , Obesidade/sangue , Obesidade/fisiopatologia , Adulto , Dieta , Ingestão de Energia , Feminino , Hemodinâmica , Humanos , Leptina/sangue , Lipídeos/sangue , Masculino , Estudos Prospectivos , Sono/fisiologia
13.
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
14.
Am J Physiol Regul Integr Comp Physiol ; 319(3): R347-R357, 2020 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-32755463

RESUMO

How low-level psychological stress and overnutrition interact in influencing cardiometabolic disease is unclear. Mechanistic overlaps suggest potential synergies; however, findings are contradictory. We test whether low-level stress and Western diet (WD) feeding synergistically influence homeostasis, mood, and myocardial ischemic tolerance. Male C57BL6/J mice were fed a control diet or WD (32%/57%/11% calories from fat/carbohydrates/protein) for 12 wk, with subgroups restrained for 30 min/day over the final 3 wk. Metabolism, behavior, tolerance of perfused hearts to ischemia-reperfusion (I/R), and cardiac "death proteins" were assessed. The WD resulted in insignificant trends toward increased body weight (+5%), glucose (+40%), insulin (+40%), triglycerides (+15%), and cholesterol (+20%) and reduced leptin (-20%) while significantly reducing insulin sensitivity [100% rise in homeostasis model assessment of insulin resistance (HOMA-IR), P < 0.05]. Restraint did not independently influence metabolism while increasing HOMA-IR a further 50% (and resulting in significant elevations in insulin and glucose to 60-90% above control) in WD mice (P < 0.05), despite blunting weight gain in control and WD mice. Anxiogenesis with restraint or WD was nonadditive, whereas anhedonia (reduced sucrose consumption) only arose with their combination. Neuroinflammation markers (hippocampal TNF-α, Il-1b) were unchanged. Myocardial I/R tolerance was unaltered with stress or WD alone, whereas the combination worsened dysfunction and oncosis [lactate dehydrogenase (LDH) efflux]. Apoptosis (nucleosome accumulation) and death protein expression (BAK, BAX, BCL-2, RIP-1, TNF-α, cleaved caspase-3, and PARP) were unchanged. We conclude that mild, anxiogenic yet cardio-metabolically "benign" stress interacts synergistically with a WD to disrupt homeostasis, promote anhedonia (independently of neuroinflammation), and impair myocardial ischemic tolerance (independently of apoptosis and death protein levels).


Assuntos
Dieta Hiperlipídica , Ingestão de Energia/fisiologia , Homeostase/fisiologia , Isquemia Miocárdica/fisiopatologia , Miocárdio/metabolismo , Animais , Coração/fisiopatologia , Resistência à Insulina/fisiologia , Camundongos Endogâmicos C57BL , Isquemia Miocárdica/metabolismo , Obesidade/fisiopatologia
15.
Nutrients ; 12(8)2020 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-32751721

RESUMO

AIM: to describe physical activity and ultra-processed foods consumption, their changes and sociodemographic predictors among adolescents from countries in Europe (Italy and Spain) and Latin America (Brazil, Chile, and Colombia) during the SARS-CoV-2-pandemic period. METHODS: Cross-sectional study via web survey. International Physical Activity Questionnaire (IPAQ) and weekly ultra-processed food consumption data were used. To compare the frequencies of physical activity status with sociodemographic variables, a multinomial logistic and a multiple logistic regression for habitual ultra-processed foods was performed. In final models, p < 0.05 was considered significant. RESULTS: Sample of 726 adolescents, mostly females (59.6%) aged 16-19 years old (54.3%). Adolescents from Latin America presented odds ratio (OR) 2.98 (CI 95% 1.80-4.94) of being inactive and those whose mothers had higher level of education were less active during lockdown [OR 0.40 (CI 95% 0.20-0.84)]. The habitual ultra-processed consumption was also high during this period in all countries, and more prevalent in Latin America. CONCLUSION: A higher prevalence of inactivity was observed in this population, but reductions of physical activity and habitual ultra-processed consumption during the pandemic were more pronounced in Latin America. Our findings reinforce the importance of promoting a healthy lifestyle, i.e., exercise and diet, during periods of social isolation.


Assuntos
Infecções por Coronavirus , Dieta , Exercício Físico , Fast Foods , Comportamento Alimentar , Pandemias , Pneumonia Viral , Comportamento Sedentário , Adolescente , Betacoronavirus , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Estudos Transversais , Ingestão de Energia , Europa (Continente) , Feminino , Estilo de Vida Saudável , Humanos , Modelos Logísticos , Masculino , Inquéritos Nutricionais , Obesidade/etiologia , Razão de Chances , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Isolamento Social , América do Sul , Adulto Jovem
17.
PLoS Med ; 17(7): e1003221, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32722682

RESUMO

BACKGROUND: In October 2019, Mexico approved a law to establish that nonalcoholic beverages and packaged foods that exceed a threshold for added calories, sugars, fats, trans fat, or sodium should have an "excess of" warning label. We aimed to estimate the expected reduction in the obesity prevalence and obesity costs in Mexico by introducing warning labels, over 5 years, among adults under 60 years of age. METHODS AND FINDINGS: Baseline intakes of beverages and snacks were obtained from the 2016 Mexican National Health and Nutrition Survey. The expected impact of labels on caloric intake was obtained from an experimental study, with a 10.5% caloric reduction for beverages and 3.0% caloric reduction for snacks. The caloric reduction was introduced into a dynamic model to estimate weight change. The model output was then used to estimate the expected changes in the prevalence of obesity and overweight. To predict obesity costs, we used the Health Ministry report of the impact of overweight and obesity in Mexico 1999-2023. We estimated a mean caloric reduction of 36.8 kcal/day/person (23.2 kcal/day from beverages and 13.6 kcal/day from snacks). Five years after implementation, this caloric reduction could reduce 1.68 kg and 4.98 percentage points (pp) in obesity (14.7%, with respect to baseline), which translates into a reduction of 1.3 million cases of obesity and a reduction of US$1.8 billion in direct and indirect costs. Our estimate is based on experimental evidence derived from warning labels as proposed in Canada, which include a single label and less restrictive limits to sugar, sodium, and saturated fats. Our estimates depend on various assumptions, such as the transportability of effect estimates from the experimental study to the Mexican population and that other factors that could influence weight and food and beverage consumption remain unchanged. Our results will need to be corroborated by future observational studies through the analysis of changes in sales, consumption, and body weight. CONCLUSIONS: In this study, we estimated that warning labels may effectively reduce obesity and obesity-related costs. Mexico is following Chile, Peru, and Uruguay in implementing warning labels to processed foods, but other countries could benefit from this intervention.


Assuntos
Bebidas , Ingestão de Alimentos , Rotulagem de Alimentos , Obesidade/prevenção & controle , Adulto , Índice de Massa Corporal , Ingestão de Energia , Feminino , Rotulagem de Alimentos/legislação & jurisprudência , Embalagem de Alimentos/legislação & jurisprudência , Custos de Cuidados de Saúde , Humanos , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Modelos Teóricos , Obesidade/economia , Obesidade/epidemiologia , Prevalência , Lanches
18.
PLoS Med ; 17(7): e1003220, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32722710

RESUMO

BACKGROUND: In June 2016, the first phase of the Chilean Food Labelling and Advertising Law that mandated front-of-package warning labels and marketing restrictions for unhealthy foods and beverages was implemented. We assess foods and beverages reformulation after this initial implementation. METHODS AND FINDINGS: A data set with the 2015 to 2017 nutritional information was developed collecting the information at 2 time periods: preimplementation (T0: January-February 2015 or 2016; n = 4,055) and postimplementation (T1: January-February 2017; n = 3,025). Quartiles of energy and nutrients of concern (total sugars, saturated fats, and sodium, per 100 g/100 mL) and the proportion of products with energy and nutrients exceeding the cutoffs of the law (i.e., products "high in") were compared pre- and postimplementation of the law in cross-sectional samples of products with sales >1% of their specific food or beverage groups, according to the Euromonitor International Database; a longitudinal subsample (i.e., products collected in both the pre- and postimplementation periods, n = 1,915) was also analyzed. Chi-squared, McNemar tests, and quantile regressions (simple and multilevel) were used for comparing T0 and T1. Cross-sectional analysis showed a significant decrease (T0 versus T1) in the proportion of product with any "high in" (from 51% [95% confidence interval (CI) 49-52] to 44% [95% CI 42-45]), mostly in food and beverage groups in which regulatory cutoffs were below the 75th percentile of the nutrient or energy distribution. Most frequent reductions were in the proportion of "high in" sugars products (in beverages, milks and milk-based drinks, breakfast cereals, sweet baked products, and sweet and savory spreads; from 80% [95% CI 73-86] to 60% [95% CI 51-69]) and in "high in sodium" products (in savory spreads, cheeses, ready-to-eat meals, soups, and sausages; from 74% [95% CI 69-78] to 27% [95% CI 20-35]). Conversely, the proportion of products "high in" saturated fats only decreased in savory spreads (p < 0.01), and the proportion of "high in" energy products significantly decreased among breakfast cereals and savory spreads (both p < 0.01). Quantile analyses showed that most of the changes took place close to the cutoff values, with only few exceptions of overall left shifts in distribution. Longitudinal analyses showed similar results. However, it is important to note that the nonexperimental nature of this study does not allow to imply causality of these findings. CONCLUSIONS: Our results show that, after initial implementation of the Chilean Law of Food Labelling and Advertising, there was a significant decrease in the amount of sugars and sodium in several groups of packaged foods and beverages. Further studies should clarify how food reformulation will impact dietary quality of the population.


Assuntos
Bebidas , Rotulagem de Alimentos/legislação & jurisprudência , Nutrientes , Publicidade/legislação & jurisprudência , Chile , Estudos Transversais , Laticínios , Ingestão de Energia , Fast Foods , Embalagem de Alimentos , Valor Nutritivo , Estudos Prospectivos , Açúcares
19.
PLoS One ; 15(7): e0236118, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32667943

RESUMO

The objective of this study was to evaluate whether pre-weaning heifer calves divergent for residual feed intake (RFI) or residual feed intake and body weight gain (RIG) exhibit differences in thermography, blood, and ruminal parameters. Thirty-two Gyr heifer calves were enrolled in a 63-d trial and classified into 2 feed efficiency (FE) groups based on RFI and RIG (mean ± 0.5 SD). The groups were classified as high efficiency (HE) RFI (HE RFI, n = 9), HE RIG (HE RIG, n = 10), low efficiency (LE) RFI (LE RFI, n = 10), and LE RIG (LE RIG, n = 11). The amount of whole milk provided for each calf was calculated based on their metabolic weight at birth (42% x BW0.75). The liquid diet was divided into two meals at 0700 and 1400 h. The total solid diet (TSD) was composed of 92% concentrate and 8% of Tifton 85 hay chopped in 5-cm lengths, as fed. Intake was measured daily. Blood concentrations of insulin, beta hydroxybutyrate, urea, and glucose, and ruminal pH, N-NH3, and volatile fatty acids (VFA) were evaluated at 14, 28, 42, 56, and 70 days of age. Thermal images of the calves were taken with an infrared camera (FLIR T420, FLIR Systems Inc., Wilsonville, OR) on d 56 (±3) at 0600 h, before the morning feeding. Total VFA concentration and propionate as % of total VFA were 24.2% and 22.2% lower in HE RFI compared to LE RFI calves, respectively. On the other hand, acetate as % of total VFA was 10.6% greater in HE RFI than LE RFI calves. Blood urea concentration tended to be greater in LE RFI than HE RFI calves. High efficiency HE RIG tended to have 6.8% greater acetate and 15.4% lower propionate as % of total VFA than LE RIG. Blood insulin concentration was greater and blood glucose tended to be greater for LE RIG than HE RIG group. Low efficiency RIG group had greater left rib, left flank, and anus surface temperature measured by infrared thermography than the HE RIG group. Differences in ruminal fermentation do not seem to be associated with pre-weaning calves efficiency, while differences in protein metabolism seem to affect RFI during this phase. Infrared thermography appears to be correlated to RIG in pre-weaning heifer calves.


Assuntos
Ração Animal/análise , Dieta/veterinária , Comportamento Alimentar/fisiologia , Termogênese , Desmame , Ganho de Peso , Animais , Células Sanguíneas/metabolismo , Bovinos , Ingestão de Energia , Ruminantes/metabolismo , Termografia
20.
Wei Sheng Yan Jiu ; 49(3): 392-396, 2020 May.
Artigo em Chinês | MEDLINE | ID: mdl-32693905

RESUMO

OBJECTIVE: To investigate the dietary nutrition status of lactating mothers in Beijing and the relationship between dietary nutrition level and breast milk composition. METHODS: Using convenient sampling, fifty-two lactating mothers were investigated and their breast milk was collected from May 2018 to July 2018. Dietary nutrient intake and the incidence of insufficiency nutrients intake were calculated. Dietary nutrient intake was compared with the dietary reference intake of Chinese residents. The relationship between dietary nutrition and breast milk composition was analyzed by multiple linear regression. RESULTS: The total energy intake was(1674. 15±655. 85) kcal, which was lower than the recommended value; protein(72. 77(45. 33, 92. 25)g), fat(66. 94(39. 26, 83. 83)g) and carbohydrates((208. 34±85. 77)g) were insufficient, of which the energy supply ratio of carbohydrates(49. 8%) was lower than the recommended value, while the protein(17. 39%) and fat(35. 99%) were higher than the recommended value. The insufficiency rate of vitamin A(73. 1%), folic acid(76. 9%), calcium(75. 0%) were also high. The ratio of energy produced by three meals was about 3∶4∶3, and the proportion of high-quality protein in dietary protein exceeded 50%. The fat(P=0. 007), dry matter(P=0. 006) and total energy(P=0. 006) in breast milk were affected by the protein in the diet, but protein(P=0. 283)and sugar(P=0. 307) in breast milk were not affected by dietary factors. CONCLUSION: The intakes of many nutrients of lactating mother are insufficient, especially energy and macronutrients. The fat, dry matter and total energy in breast milk are affected by the protein in the diet.


Assuntos
Leite Humano , Mães , Pequim , Dieta , Ingestão de Energia , Feminino , Humanos , Lactação
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