Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 36.718
Filtrar
1.
An Acad Bras Cienc ; 92(3): e20180989, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32876141

RESUMO

An 8-week experiment was carried out to assess the impact of supplemental dietary pyridoxine (PY), protease (PR), zinc (Zn) and their mixture (MIX) with low protein diet (LP; 14.76% CP) or high protein diet (HP; 18.53% CP) on rabbit growth, feed utilization, and nutrients digestibility. Rabbits were divided into ten similar groups in a 2 (protein level) ×5 (treatments) factorial design. Treatments included a control group (without any additives), 5 mg PY/kg of diet, 100 mg Zn/kg of diet, 500 mg PR/kg of diet or a mixture of all tested feed additive with the same doses. Results indicated that growth performance, feed utilization, and nutrients digestibility indicators were retarded significantly with reduction of dietary crude protein. Growth performance and feed conversion were significantly enhanced as a result of PY, PR, Zn, and MIX supplementation. All feed supplements had significantly improved the digestibility of crude protein and digestible crude protein. No change in carcass traits was recorded in response to protein level and tested feed supplements. It is concluded that the growing rabbit responded positively to PY, Zn, PR, and MIX (particularly PY) supplemental of LP or HP diets, in terms of growth performance, feed conversion, and nutrient digestibility.


Assuntos
Ração Animal , Fenômenos Fisiológicos da Nutrição Animal , Animais , Proteínas na Dieta , Suplementos Nutricionais , Digestão , Peptídeo Hidrolases , Piridoxina , Coelhos , Zinco
2.
Cochrane Database Syst Rev ; 9: CD000433, 2020 09 23.
Artigo em Inglês | MEDLINE | ID: mdl-32964431

RESUMO

BACKGROUND: Preterm infants require high protein intake to achieve adequate growth and development. Although breast milk feeding has many benefits for this population, the protein content is highly variable, and inadequate to support rapid infant growth. This is a 2020 update of a Cochrane Review first published in 1999. OBJECTIVES: To determine whether protein-supplemented human milk compared with unsupplemented human milk, fed to preterm infants, improves growth, body composition, cardio-metabolic, and neurodevelopmental outcomes, without significant adverse effects. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search Cochrane Central Register of Controlled Trials (CENTRAL 2019, Issue 8) in the Cochrane Library and MEDLINE via PubMed on 23 August 2019. We also searched clinical trials databases and the reference lists of retrieved articles for randomised controlled trials and quasi-randomised trials. SELECTION CRITERIA: Published and unpublished RCTs were eligible if they used random or quasi-random methods to allocate hospitalised preterm infants who were being fed human milk, to additional protein supplementation or no supplementation. DATA COLLECTION AND ANALYSIS: Two review authors independently abstracted data, assessed risk of bias and the quality of evidence at the outcome level, using GRADE methodology. We performed meta-analyses, using risk ratio (RR) for dichotomous data, and mean difference (MD) for continuous data, with their respective 95% confidence intervals (CIs). We used a fixed-effect model and had planned to explore potential causes of heterogeneity via subgroup or sensitivity analyses. MAIN RESULTS: We included six RCTs, involving 204 preterm infants. The risk of bias for most methodological domains was unclear as there was insufficient detail reported. Low-quality evidence showed that protein supplementation of human milk may increase in-hospital rates of growth in weight (MD 3.82 g/kg/day, 95% CI 2.94 to 4.7; five RCTs, 101 infants; I² = 73%), length (MD 0.12 cm/wk, 95% CI 0.07 to 0.17; four RCTs, 68 infants; I² = 89%), and head circumference (MD 0.06 cm/wk, 95% CI 0.01 to 0.12; four RCTs, 68 infants; I² = 84%). Protein supplementation may lead to longer hospital stays (MD 18.5 days, 95% CI 4.39 to 32.61; one RCT, 20 infants; very low-quality evidence). Very low quality evidence means that the effect of protein supplementation on the risk of feeding intolerance (RR 2.70, 95% CI 0.13 to 58.24; one RCT, 17 infants), or necrotizing enterocolitis (RR 1.11, 95% CI 0.07 to 17.12; one RCT, 76 infants) remains uncertain. No data were available about the effects of protein supplementation on neurodevelopmental outcomes. AUTHORS' CONCLUSIONS: Low-quality evidence showed that protein supplementation of human milk, fed to preterm infants, increased short-term growth. However, the small sample sizes, low precision, and very low-quality evidence regarding duration of hospital stay, feeding intolerance, and necrotising enterocolitis precluded any conclusions about these outcomes. There were no data on outcomes after hospital discharge. Our findings may not be generalisable to low-resource settings, as none of the included studies were conducted in these settings. Since protein supplementation of human milk is now usually done as a component of multi-nutrient fortifiers, future studies should compare different amounts of protein in multi-component fortifiers, and be designed to determine the effects on duration of hospital stay and safety, as well as on long-term growth, body composition, cardio-metabolic, and neurodevelopmental outcomes.


Assuntos
Proteínas na Dieta , Suplementos Nutricionais , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido Prematuro/crescimento & desenvolvimento , Leite Humano , Viés , Estatura , Enterocolite Necrosante/epidemiologia , Cabeça/crescimento & desenvolvimento , Humanos , Recém-Nascido , Tempo de Internação/estatística & dados numéricos , Leite Humano/química , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
3.
Adv Exp Med Biol ; 1265: 1-20, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32761567

RESUMO

Dietary protein digestion is an efficient process resulting in the absorption of amino acids by epithelial cells, mainly in the jejunum. Some amino acids are extensively metabolized in enterocytes supporting their high energy demand and/or production of bioactive metabolites such as glutathione or nitric oxide. In contrast, other amino acids are mainly used as building blocks for the intense protein synthesis associated with the rapid epithelium renewal and mucin production. Several amino acids have been shown to support the intestinal barrier function and the intestinal endocrine function. In addition, amino acids are metabolized by the gut microbiota that use them for their own protein synthesis and in catabolic pathways releasing in the intestinal lumen numerous metabolites such as ammonia, hydrogen sulfide, branched-chain amino acids, polyamines, phenolic and indolic compounds. Some of them (e.g. hydrogen sulfide) disrupts epithelial energy metabolism and may participate in mucosal inflammation when present in excess, while others (e.g. indole derivatives) prevent gut barrier dysfunction or regulate enteroendocrine functions. Lastly, some recent data suggest that dietary amino acids might regulate the composition of the gut microbiota, but the relevance for the intestinal health remains to be determined. In summary, amino acid utilization by epithelial cells or by intestinal bacteria appears to play a pivotal regulator role for intestinal homeostasis. Thus, adequate dietary supply of amino acids represents a key determinant of gut health and functions.


Assuntos
Aminoácidos/metabolismo , Saúde , Intestinos/fisiologia , Proteínas na Dieta/metabolismo , Microbioma Gastrointestinal , Humanos
4.
Oecologia ; 193(4): 827-842, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32857190

RESUMO

Hydrogen isotope (δ2H) analysis has been routinely used as an ecological tracer for animal movement and migration, yet a biochemical understanding of how animals incorporate this element in the synthesis of tissues is poorly resolved. Here, we apply a new analytical tool, amino acid (AA) δ2H analysis, in a controlled setting to trace the influence of drinking water and dietary macromolecules on the hydrogen in muscle tissue. We varied the δ2H of drinking water and the proportions of dietary protein and carbohydrates with distinct hydrogen and carbon isotope compositions fed to house mice among nine treatments. Our results show that hydrogen in the non-essential (AANESS) and essential (AAESS) AAs of mouse muscle is not readily exchanged with body water, but rather patterns among these compounds can be described through consideration of the major biochemical pathway(s) used by organisms to synthesize or route them from available sources. Dietary carbohydrates contributed more hydrogen than drinking water to the synthesis of AANESS in muscle. While neither drinking water nor dietary carbohydrates directly contributed to muscle AAESS, we did find that a minor but measurable proportion (10-30%) of the AAESS in muscle was synthesized by the gut microbiome using hydrogen and carbon from dietary carbohydrates. δ2H patterns among individual AAs in mice muscle are similar to those we previously reported for bacteria, which provides additional support that this approach may allow for the simultaneous analysis of different AAs that are more influenced by drinking water (AANESS) versus dietary (AAESS) sources of hydrogen.


Assuntos
Aminoácidos , Água , Animais , Isótopos de Carbono , Proteínas na Dieta , Hidrogênio , Camundongos , Isótopos de Nitrogênio
5.
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
6.
Anim Sci J ; 91(1): e13438, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32761765

RESUMO

The objective was to investigate the influence of crude protein (CP) content in a fattening diet on feed intake, body weight gain, nitrogen excretion, and carcass traits in Holstein steers. Steers (initial body weight 241 ± 26 kg) consumed feed with the following CP content: (a) 17.7% during the early period (from 7 to 10 months of age) and 13.9% during the late period (from 11 to 18 months of age) (HIGH, n = 3), and (b) 16.2% during the early period and 12.2% during the late period (LOW, n = 4). The CP intake was lower in the LOW than the HIGH group. Urinary and total nitrogen excretion in the late period tended to be lower (p < .10) in the LOW than the HIGH group. However, growth performance and carcass traits were not affected by dietary CP content. Free histidine and total amino acid contents in the longissimus thoracis muscle tended to be higher (p < .10) in the HIGH than the LOW group, however, the CP contents were not affected by dietary CP content. The results of this experiment suggest that decreasing dietary CP to 16% (early period) or 12% (late period) of dry matter would reduce nitrogen excretion from Holstein fattening farms without affecting productivity.


Assuntos
Ração Animal/análise , Fenômenos Fisiológicos da Nutrição Animal , Bovinos/metabolismo , Bovinos/fisiologia , Dieta/veterinária , Proteínas na Dieta/análise , Nitrogênio/metabolismo , Ganho de Peso , Animais , Masculino
7.
PLoS One ; 15(8): e0236212, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32797100

RESUMO

Although an impact of processing on immunogenicity of food proteins has clearly been demonstrated, the underlying mechanisms are still unclear. We applied 3 different processing methods: wet heating (60 °C) and low- or high-temperature (50 °C or 130 °C, respectively) dry-heating in absence or presence of reducing sugars, to ß-lactoglobulin (BLG), lysozyme and thyroglobulin, which represent dietary proteins with different pI or molecular weight. Uptake of the soluble fraction of the samples was tested in two types of, genetically homogeneous, antigen-presenting cells (macrophages and dendritic cells derived from THP-1 monocytes). This revealed a strong correlation between the uptake of the different protein samples by macrophages and dendritic cells, and confirmed the key role of hydrophobicity, over aggregation, in determining the uptake. Several uptake routes were shown to contribute to the uptake of BLG by macrophages. However, cytokine responses following exposure of macrophages to BLG samples were not related to the levels of uptake. Together, our results demonstrate that heat-treatment-induced increased hydrophobicity is the prime driving factor in uptake, but not in cytokine production, by THP-1 macrophages.


Assuntos
Citocinas/metabolismo , Células Dendríticas/imunologia , Proteínas na Dieta/imunologia , Macrófagos/imunologia , Receptores de Superfície Celular/metabolismo , Culinária , Células Dendríticas/metabolismo , Proteínas na Dieta/química , Proteínas na Dieta/metabolismo , Temperatura Alta , Humanos , Interações Hidrofóbicas e Hidrofílicas , Macrófagos/metabolismo , Peso Molecular , Células THP-1
8.
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
9.
Nutr Hosp ; 34(3): 622-630, 2020 Jul 13.
Artigo em Espanhol | MEDLINE | ID: mdl-32603180

RESUMO

Introduction: The current COVID-19 pandemic mainly affects older people, those with obesity or other coexisting chronic diseases such as type-2 diabetes and high blood pressure. It has been observed that about 20 % of patients will require hospitalization, and some of them will need the support of invasive mechanical ventilation in intensive care units. Nutritional status appears to be a relevant factor influencing the clinical outcome of critically ill patients with COVID-19. Several international guidelines have provided recommendations to ensure energy and protein intake in people with COVID-19, with safety measures to reduce the risk of infection in healthcare personnel. The purpose of this review is to analyze the main recommendations related to adequate nutritional management for critically ill patients with COVID-19 in order to improve their prognosis and clinical outcomes.


Assuntos
Betacoronavirus , Infecções por Coronavirus/dietoterapia , Cuidados Críticos/métodos , Estado Terminal , Desnutrição/dietoterapia , Pandemias , Pneumonia Viral/dietoterapia , Doenças Cardiovasculares/epidemiologia , Comorbidade , Infecções por Coronavirus/complicações , Infecções por Coronavirus/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Proteínas na Dieta/administração & dosagem , Nutrição Enteral/efeitos adversos , Nutrição Enteral/métodos , Gastroenteropatias/complicações , Humanos , Inflamação/epidemiologia , Inflamação/fisiopatologia , Desnutrição/diagnóstico , Desnutrição/etiologia , Desnutrição/prevenção & controle , Metanálise como Assunto , Micronutrientes/administração & dosagem , Avaliação Nutricional , Necessidades Nutricionais , Apoio Nutricional , Obesidade/epidemiologia , Pneumonia Viral/complicações , Pneumonia Viral/epidemiologia , Guias de Prática Clínica como Assunto , Síndrome da Realimentação/prevenção & controle , Respiração Artificial , Sarcopenia/epidemiologia
10.
Cochrane Database Syst Rev ; 7: CD011378, 2020 07 17.
Artigo em Inglês | MEDLINE | ID: mdl-32677037

RESUMO

BACKGROUND: Foot ulcers in people with diabetes are non-healing, or poorly healing, partial, or full-thickness wounds below the ankle. These ulcers are common, expensive to manage and cause significant morbidity and mortality. The presence of a wound has an impact on nutritional status because of the metabolic cost of repairing tissue damage, in addition to the nutrient losses via wound fluid. Nutritional interventions may improve wound healing of foot ulcers in people with diabetes. OBJECTIVES: To evaluate the effects of nutritional interventions on the healing of foot ulcers in people with diabetes. SEARCH METHODS: In March 2020 we searched the Cochrane Wounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting. SELECTION CRITERIA: We included randomised controlled trials (RCTs) that evaluated the effect of nutritional interventions on the healing of foot ulcers in people with diabetes. DATA COLLECTION AND ANALYSIS: Two review authors, working independently, assessed included RCTs for their risk of bias and rated the certainty of evidence using GRADE methodology, using pre-determined inclusion and quality criteria. MAIN RESULTS: We identified nine RCTs (629 participants). Studies explored oral nutritional interventions as follows: a protein (20 g protein per 200 mL bottle), 1 kcal/mL ready-to-drink, nutritional supplement with added vitamins, minerals and trace elements; arginine, glutamine and ß-hydroxy-ß-methylbutyrate supplement; 220 mg zinc sulphate supplements; 250 mg magnesium oxide supplements; 1000 mg/day omega-3 fatty acid from flaxseed oil; 150,000 IU of vitamin D, versus 300,000 IU of vitamin D; 250 mg magnesium oxide plus 400 IU vitamin E and 50,000 IU vitamin D supplements. The comparator in eight studies was placebo, and in one study a different dose of vitamin D. Eight studies reported the primary outcome measure of ulcer healing; only two studies reported a measure of complete healing. Six further studies reported measures of change in ulcer dimension, these studies reported only individual parameters of ulcer dimensions (i.e. length, width and depth) and not change in ulcer volume. All of the evidence identified was very low certainty. We downgraded it for risks of bias, indirectness and imprecision. It is uncertain whether oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements, increases the proportion of ulcers healed at six months more than placebo (risk ratio (RR) 0.80, 95% confidence interval (CI) 0.42 to 1.53). It is also uncertain whether arginine, glutamine and ß-hydroxy-ß-methylbutyrate supplement increases the proportion of ulcers healed at 16 weeks compared with placebo (RR 1.09, 95% CI 0.85 to 1.40). It is uncertain whether the following interventions change parameters of ulcer dimensions over time when compared with placebo; 220 mg zinc sulphate supplement containing 50 mg elemental zinc, 250 mg magnesium oxide supplement, 1000 mg/day omega-3 fatty acid from flaxseed oil supplement, magnesium and vitamin E co-supplementation and vitamin D supplementation. It is also uncertain whether 150,000 IU of vitamin D, impacts ulcer dimensions when compared with 300,000 IU of vitamin D. Two studies explored some of the secondary outcomes of interest for this review. It is uncertain whether oral nutritional supplement with 20 g protein per 200 mL bottle, 1 kcal/mL, nutritional supplement with added vitamins, minerals and trace elements, reduces the number of deaths (RR 0.96, 95% CI 0.06 to 14.60) or amputations (RR 4.82, 95% CI 0.24 to 95.88) more than placebo. It is uncertain whether arginine, glutamine and ß-hydroxy-ß-methylbutyrate supplement increases health-related quality of life at 16 weeks more than placebo (MD -0.03, 95% CI -0.09 to 0.03). It is also uncertain whether arginine, glutamine and ß-hydroxy-ß-methylbutyrate supplement reduces the numbers of new ulcers (RR 1.04, 95% CI 0.71 to 1.51), or amputations (RR 0.66, 95% CI 0.16 to 2.69) more than placebo. None of the included studies reported the secondary outcomes cost of intervention, acceptability of the intervention (or satisfaction) with respect to patient comfort, length of patient hospital stay, surgical interventions, or osteomyelitis incidence. One study exploring the impact of arginine, glutamine and ß-hydroxy-ß-methylbutyrate supplement versus placebo did not report on any relevant outcomes. AUTHORS' CONCLUSIONS: Evidence for the impact of nutritional interventions on the healing of foot ulcers in people with diabetes compared with no nutritional supplementation, or compared with a different dose of nutritional supplementation, remains uncertain, with eight studies showing no clear benefit or harm. It is also uncertain whether there is a difference in rates of adverse events, amputation rate, development of new foot ulcers, or quality of life, between nutritional interventions and placebo. More research is needed to clarify the impact of nutritional interventions on the healing of foot ulcers in people with diabetes.


Assuntos
Pé Diabético/dietoterapia , Cicatrização , Arginina/administração & dosagem , Proteínas na Dieta/administração & dosagem , Suplementos Nutricionais , Ácidos Graxos Ômega-3/administração & dosagem , Feminino , Glutamina/administração & dosagem , Humanos , Magnésio/administração & dosagem , Óxido de Magnésio/administração & dosagem , Masculino , Pessoa de Meia-Idade , Minerais/administração & dosagem , Ensaios Clínicos Controlados Aleatórios como Assunto , Oligoelementos/administração & dosagem , Valeratos/administração & dosagem , Vitaminas/administração & dosagem , Sulfato de Zinco/administração & dosagem
11.
Cochrane Database Syst Rev ; 6: CD003959, 2020 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-32573771

RESUMO

BACKGROUND: The ideal quantity of dietary protein for formula-fed low birth weight infants is still a matter of debate. Protein intake must be sufficient to achieve normal growth without leading to negative effects such as acidosis, uremia, and elevated levels of circulating amino acids. OBJECTIVES: To determine whether higher (≥ 3.0 g/kg/d) versus lower (< 3.0 g/kg/d) protein intake during the initial hospital stay of formula-fed preterm infants or low birth weight infants (< 2.5 kilograms) results in improved growth and neurodevelopmental outcomes without evidence of short- or long-term morbidity. Specific objectives were to examine the following comparisons of interventions and to conduct subgroup analyses if possible. 1. Low protein intake if the amount was less than 3.0 g/kg/d. 2. High protein intake if the amount was equal to or greater than 3.0 g/kg/d but less than 4.0 g/kg/d. 3. Very high protein intake if the amount was equal to or greater than 4.0 g/kg/d. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2019, Issue 8), in the Cochrane Library (August 2, 2019); OVID MEDLINE Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid MEDLINE(R) Daily, and Ovid MEDLINE(R) (to August 2, 2019); MEDLINE via PubMed (to August 2, 2019) for the previous year; and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (to August 2, 2019). We also searched clinical trials databases and the reference lists of retrieved articles for randomized controlled trials (RCTs) and quasi-randomized trials. SELECTION CRITERIA: We included RCTs contrasting levels of formula protein intake as low (< 3.0 g/kg/d), high (≥ 3.0 g/kg/d but < 4.0 g/kg/d), or very high (≥ 4.0 g/kg/d) in formula-fed hospitalized neonates weighing less than 2.5 kilograms. We excluded studies if infants received partial parenteral nutrition during the study period, or if infants were fed formula as a supplement to human milk. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures expected by Cochrane and the GRADE approach to assess the certainty of evidence. MAIN RESULTS: We identified six eligible trials that enrolled 218 infants through searches updated to August 2, 2019. Five studies compared low (< 3 g/kg/d) versus high (3.0 to 4.0 g/kg/d) protein intake using formulas that kept other nutrients constant. The trials were small (n = 139), and almost all had methodological limitations; the most frequent uncertainty was about attrition. Low-certainty evidence suggests improved weight gain (mean difference [MD] 2.36 g/kg/d, 95% confidence interval [CI] 1.31 to 3.40) and higher nitrogen accretion in infants receiving formula with higher protein content (3.0 to 4.0 g/kg/d) versus lower protein content (< 3 g/kg/d), while other nutrients were kept constant. No significant differences were seen in rates of necrotizing enterocolitis, sepsis, or diarrhea. We are uncertain whether high versus low protein intake affects head growth (MD 0.37 cm/week, 95% CI 0.16 to 0.58; n = 18) and length gain (MD 0.16 cm/week, 95% CI -0.02 to 0.34; n = 48), but sample sizes were small for these comparisons. One study compared high (3.0 to 4.0 g/kg/d) versus very high (≥ 4 g/kg/d) protein intake (average intakes were 3.6 and 4.1 g/kg/d) during and after an initial hospital stay (n = 77). Moderate-certainty evidence shows no significant differences in weight gain or length gain to discharge, term, and 12 weeks corrected age from very high protein intake (4.1 versus 3.6 g/kg/d). Three of the 24 infants receiving very high protein intake developed uremia. AUTHORS' CONCLUSIONS: Higher protein intake (≥ 3.0 g/kg/d but < 4.0 g/kg/d) from formula accelerates weight gain. However, limited information is available regarding the impact of higher formula protein intake on long-term outcomes such as neurodevelopment. Research is needed to investigate the safety and effectiveness of protein intake ≥ 4.0 g/kg/d.


Assuntos
Desenvolvimento Infantil/fisiologia , Proteínas na Dieta/administração & dosagem , Fórmulas Infantis/química , Recém-Nascido de Baixo Peso/crescimento & desenvolvimento , Proteínas na Dieta/efeitos adversos , Cabeça/crescimento & desenvolvimento , Humanos , Recém-Nascido , Criança Pós-Termo , Nitrogênio/metabolismo , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
12.
Am J Clin Nutr ; 112(1): 84-95, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32520344

RESUMO

BACKGROUND: Protein intake recommendations advise ≥0.8 g/kg body weight (BW)/d, whereas experts propose a higher intake for older adults (1.0-1.2 g/kg BW/d). It is unknown whether optimal protein intake differs by sex or race. OBJECTIVES: We examined the shape of sex- and race-specific associations of dietary protein intake with 3- and 6-y changes in appendicular lean mass (aLM) and gait speed and also 6-y incidence of mobility limitation in community-dwelling older men and women. METHODS: We used data on men (n = 1163) and women (n = 1237) aged 70-81 y of the Health, Aging, and Body Composition Study. Protein intake was assessed using an FFQ (1998-1999). aLM and gait speed were measured at baseline and at 3 and 6 y. Difficulty walking one-quarter mile or climbing stairs was measured every 6 mo over 6 y. Prospective associations were evaluated with linear and Cox regression models, comparing fit of models with and without spline functions. All analyses were stratified by sex and additionally by race. RESULTS: Mean ± SD protein intake was 0.94 ± 0.36 g/kg adjusted body weight (aBW)/d in men and 0.95 ± 0.36 g/kg aBW/d in women. There were no strong indications of nonlinear associations. In women, higher protein intake was associated with less aLM loss over 3 y (adjusted B per 0.1 g/kg aBW/d: 39.4; 95% CI: 11.6, 67.2), specifically in black women, but not over 6 y or with gait speed decline. In men, protein intake was not associated with changes in aLM and gait speed. Higher protein intake was associated with a lower risk of mobility limitation in men (adjusted HR per 1.0 g/kg aBW/d: 0.55; 95% CI: 0.34, 0.91) and women (adjusted HR: 0.56; 95% CI: 0.33, 0.94), specifically white women. CONCLUSIONS: Associations between protein intake and physical outcomes may vary by sex and race. Therefore, it is important to consider sex and race in future studies regarding protein needs in older adults.


Assuntos
Envelhecimento/metabolismo , Proteínas na Dieta/metabolismo , Idoso , Idoso de 80 Anos ou mais , Biomassa , Composição Corporal , Peso Corporal , Feminino , Humanos , Vida Independente , Masculino , Desenvolvimento Muscular , Força Muscular , Músculos/fisiologia , Estudos Prospectivos , Fatores Sexuais
13.
Nat Commun ; 11(1): 2894, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32518324

RESUMO

Dietary protein dilution (DPD) promotes metabolic-remodelling and -health but the precise nutritional components driving this response remain elusive. Here, by mimicking amino acid (AA) supply from a casein-based diet, we demonstrate that restriction of dietary essential AA (EAA), but not non-EAA, drives the systemic metabolic response to total AA deprivation; independent from dietary carbohydrate supply. Furthermore, systemic deprivation of threonine and tryptophan, independent of total AA supply, are both adequate and necessary to confer the systemic metabolic response to both diet, and genetic AA-transport loss, driven AA restriction. Dietary threonine restriction (DTR) retards the development of obesity-associated metabolic dysfunction. Liver-derived fibroblast growth factor 21 is required for the metabolic remodelling with DTR. Strikingly, hepatocyte-selective establishment of threonine biosynthetic capacity reverses the systemic metabolic response to DTR. Taken together, our studies of mice demonstrate that the restriction of EAA are sufficient and necessary to confer the systemic metabolic effects of DPD.


Assuntos
Aminoácidos Essenciais/deficiência , Ração Animal , Proteinúria/metabolismo , Animais , Proteínas na Dieta/metabolismo , Feminino , Fatores de Crescimento de Fibroblastos/metabolismo , Hormônios Gastrointestinais/metabolismo , Hepatócitos/metabolismo , Homeostase , Fígado/metabolismo , Masculino , Metaboloma , Camundongos , Camundongos Endogâmicos C57BL , Obesidade/metabolismo , Fenótipo , Treonina/deficiência , Triptofano/deficiência
14.
Anim Sci J ; 91(1): e13403, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32557958

RESUMO

The effects of inclusion of persimmon peel (PP) in total mixed ration (TMR) silage on its nutrient composition, tannin content, and in vitro ruminal fermentation were studied. Four types of TMR silages containing 0, 50, 100, and 150 g/kg of PP on a dry matter basis were prepared. The dietary contents of non-fiber carbohydrate (NFC) decreased, while soluble protein fraction increased after ensiling of the TMR. In the TMR silages, the content of insoluble tannin increased (p < .05) with increasing PP level. The fraction of soluble protein decreased linearly (p < .01), while that of neutral detergent insoluble protein increased linearly (p < .01) with increasing the PP level in the TMR silages. The total gas and methane yields from the in vitro rumen fermentation of the TMR silages were lower (p < .01) than those of pre-ensiled TMR and declined linearly (p < .01) with increasing PP level. These results indicate that adding PP to TMR silage may resist the breakdown of dietary protein during the ensiling process, although the ruminal fermentability of TMR possibly decreased after ensiling due to the loss of NFC.


Assuntos
Diospyros , Fermentação , Rúmen/fisiologia , Silagem/análise , Taninos/análise , Animais , Biocombustíveis/análise , Carboidratos/análise , Proteínas na Dieta/análise , Técnicas In Vitro , Metano/análise , Solubilidade
15.
Nat Med ; 26(6): 964-973, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32528151

RESUMO

Metabolic responses to food influence risk of cardiometabolic disease, but large-scale high-resolution studies are lacking. We recruited n = 1,002 twins and unrelated healthy adults in the United Kingdom to the PREDICT 1 study and assessed postprandial metabolic responses in a clinical setting and at home. We observed large inter-individual variability (as measured by the population coefficient of variation (s.d./mean, %)) in postprandial responses of blood triglyceride (103%), glucose (68%) and insulin (59%) following identical meals. Person-specific factors, such as gut microbiome, had a greater influence (7.1% of variance) than did meal macronutrients (3.6%) for postprandial lipemia, but not for postprandial glycemia (6.0% and 15.4%, respectively); genetic variants had a modest impact on predictions (9.5% for glucose, 0.8% for triglyceride, 0.2% for C-peptide). Findings were independently validated in a US cohort (n = 100 people). We developed a machine-learning model that predicted both triglyceride (r = 0.47) and glycemic (r = 0.77) responses to food intake. These findings may be informative for developing personalized diet strategies. The ClinicalTrials.gov registration identifier is NCT03479866.


Assuntos
Glicemia/metabolismo , Microbioma Gastrointestinal , Insulina/metabolismo , Nutrientes , Período Pós-Prandial , Triglicerídeos/metabolismo , Adolescente , Adulto , Idoso , Peptídeo C/metabolismo , Carboidratos da Dieta , Gorduras na Dieta , Fibras na Dieta , Proteínas na Dieta , Feminino , Variação Genética , Teste de Tolerância a Glucose , Voluntários Saudáveis , Humanos , Individualidade , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Medicina de Precisão , Adulto Jovem
17.
Water Res ; 181: 115909, 2020 Aug 15.
Artigo em Inglês | MEDLINE | ID: mdl-32492592

RESUMO

Single cell protein (SCP), has been proposed as alternative to effectively upgrade and recycle organics and nutrients from wastewater. Biomass recovery is a critical issue, and recovery as a biofilm is effective in comparison with sedimentation of suspended biomass. This study aims to determine the applicability of purple phototrophic bacteria (PPB) biofilm on infra-red irradiated, submerged surfaces for the treatment of pre-settled red meat processing wastewater, and SCP generation. PPB removed up to 66% of COD and 42% of TN and TP during batch operation with total areal productivities between 15 and 20 gVS m-2 d-1 achieved. More than 60% of the total biomass grew attached (as biofilm) with the remainder being suspended. The biofilm can be harvested at around 160 gTS L-1 with high protein (>96 g L-1) and low ash contents (>4.0% compared to >30% in the wastewater). The compositions of attached and suspended biomass differed significantly, where the suspended fraction resembled the wastewater composition (e.g. in terms of inert components). The PPB community was similar in the suspended and biofilm fractions while the biofilm had higher relative abundance of PPB representatives (57% vs 43%). A consistent product composition is highly relevant for the manufacturer and ultimately determines the value as feed, feed additive, or supplement.


Assuntos
Fotobiorreatores , Proteobactérias , Bactérias , Biofilmes , Biomassa , Reatores Biológicos , Proteínas na Dieta , Eliminação de Resíduos Líquidos , Águas Residuárias
18.
Zhonghua Wei Chang Wai Ke Za Zhi ; 23(6): 566-571, 2020 Jun 25.
Artigo em Chinês | MEDLINE | ID: mdl-32521976

RESUMO

Objective: To evaluate the effect of oral nutritional supplementation (ONS) on the nutritional status and quality of life in patients with colorectal cancer and postoperative adjuvant chemotherapy. Methods: This study was registered in the Chinese Clinical Trial Registry (ChiCTR-TRC-13003798). A multi-center randomized controlled trial was conducted. Colorectal cancer patients who underwent radical surgery and postoperative adjuvant chemotherapy, and had nutritional risk (nutrition risk screening 2002 score ≥3) when discharge from hospital in six hospitals (Beijing Hospital, Peking University Third Hospital, Guangzhou Nanfang Hospital, Shanghai Xinhua Hospital, Shanghai Ruijin Hospital, and Shanghai The Sixth People's Hospital) from June 2013 to August 2015 were prospectively enrolled. These patients were randomly divided into the ONS group and control group. Patients in the ONS group received dietary guidance and oral nutritional supplements (2092 kJ/day, whole protein enteral nutrition) for 90 days after discharge from hospital, while patients in the control group only received dietary guidance. Anthropometric measurements (body weight, body mass index [BMI], upper arm circumference, gripping power of the dominant hand, triceps skin fold), nutrition-related laboratory tests (hemoglobin, albumin, prealbumin, total cholesterol, triglyceride), gastrointestinal function scores and quality of life (evaluated by EuroQol five dimensions questionnaire) were collected and compared at baseline (at discharge), and at 30-day, 60-day and 90-day after discharge. Results: A total of 90 patients were included into this multi-center study, of whom 5 patients dropped out, 43 patients were assigned to the ONS group and 42 patients to the control group. Compared with baseline, the body weight of patients in the ONS group increased by (1.523±0.525) kg at 60-day and (1.967±0.661) kg at 90-day, which were significantly higher than those of patients in the control group [60-day: (-0.325±0.518) kg, P=0.015; 90-day: (-0.224±0.705) kg, P=0.027, respectively]. A similar pattern was observed for BMI, the ONS group increased by (0.552±0.203) kg/m(2) at 60-day and (0.765±0.205) kg/m(2) at 90-day, which were significantly higher than those of patients in control group [60-day: (-0.067±0.202) kg/m(2), P=0.034; 90-day: (0.022±0.210) kg/m(2), P=0.013]. No significant differences of other anthropometric measurements and nutrition-related laboratory tests were found between the two groups (all P>0.05). Furthermore, there were no significant differences of improvement in gastrointestinal function and quality of life between two groups (all P>0.05). Conclusion: Oral nutritional supplements can improve the body weight and BMI of colorectal cancer patients with nutritional risk receiving postoperative adjuvant chemotherapy, though it does not improve the quality of life.


Assuntos
Neoplasias Colorretais/terapia , Proteínas na Dieta/administração & dosagem , Nutrição Enteral/métodos , Administração Oral , Antineoplásicos/administração & dosagem , Quimioterapia Adjuvante , China , Suplementos Nutricionais , Procedimentos Cirúrgicos do Sistema Digestório , Humanos , Estado Nutricional , Período Pós-Operatório , Estudos Prospectivos , Qualidade de Vida
19.
Curr Diabetes Rev ; 16(6): 619-627, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32552634

RESUMO

BACKGROUND: There is no data available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and protein-containing food, as often the case during social happenings or "happy hours". INTRODUCTION: This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif ("Spritz" and chips). METHODS: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated- measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting. RESULTS: After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected. CONCLUSION: Therefore, a personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on the psycho-affective dimension. Further studies are mandatory to confirm such preliminary results.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Educação de Pacientes como Assunto , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/psicologia , Glicemia/análise , Estudos Cross-Over , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/psicologia , Carboidratos da Dieta/análise , Gorduras na Dieta/análise , Proteínas na Dieta/análise , Feminino , Humanos , Sistemas de Infusão de Insulina , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Qualidade de Vida , Adulto Jovem
20.
PLoS One ; 15(6): e0228758, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32497052

RESUMO

Nutritional Programming (NP) has been studied as a means of mitigating the negative effects of dietary plant protein (PP), but the optimal timing and mechanism behind NP are still unknown. The objectives of this study were: 1) To determine whether zebrafish (Danio rerio) can be programmed to soybean meal (SBM) through early feeding and broodstock exposure to improve SBM utilization; 2) To determine if NP in zebrafish affects expression of genes associated with intestinal nutrient uptake; 3) To determine if early stage NP and/or broodstock affects gene expression associated with intestinal inflammation or any morphological changes in the intestinal tract that might improve dietary SBM utilization. Two broodstocks were used to form the six experimental groups. One broodstock group received fishmeal (FM) diet (FMBS), while the other was fed ("programmed with") SBM diet (PPBS). The first ((+) Control) and the second group ((-) Control) received FM and SBM diet for the entire study, respectively, and were progeny of FMBS. The last four groups consisted of a non-programmed (FMBS-X-PP and PPBS-X-PP) and a programmed group (FMBS-NP-PP and PPBS-NP-PP) from each of the broodstocks. The programming occurred through feeding with SBM diet during 13-23 dph. The non-control groups underwent a PP-Challenge, receiving SBM diet during 36-60 dph. During the PP-Challenge, both PPBS groups experienced significantly lower weight gains than the (+) Control group. NP in early life stages significantly increased the expression of PepT1 in PPBS-NP-PP, compared to PPBS-X-PP. NP also tended to increase the expression of fabp2 in the programmed vs. non-programmed groups of both broodstocks. The highest distal villus length-to-width ratio was observed in the dual-programmed group, suggesting an increase in surface area for nutrient absorption within the intestine. The results of this study suggest that NP during early life stages may increase intestinal absorption of nutrients from PP-based feeds.


Assuntos
Dieta , Proteínas na Dieta/metabolismo , Absorção Intestinal/efeitos dos fármacos , Plantas/química , Animais , Regulação da Expressão Gênica/efeitos dos fármacos , Proteínas de Vegetais Comestíveis , Fatores de Tempo , Peixe-Zebra/genética , Peixe-Zebra/crescimento & desenvolvimento , Peixe-Zebra/metabolismo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA