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1.
Adv Neurobiol ; 24: 573-586, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32006374

RESUMO

Autism is a developmental disorder that affects communication and behavior. Although autism can be diagnosed at any age, it is said to be a "developmental disorder" because symptoms generally appear in the first 2 years of life. The primary cause of autism is still not clear and therapy is currently restricted to controlling behavioral abnormalities. However, emerging studies have shown a link between mitochondrial dysfunction and autism. Dietary supplements that promote mitochondrial biogenesis and inhibit the production of oxidative stress have been used to treat autism patients. Dietary adjustments in treating autism is a novel approach to suppress autistic symptoms. Supplementation with antioxidants has been found to not only inhibit cognitive decline but also improve behavioral symptoms in autism. Dietary supplements fortified with vitamins should only be given under the supervision of a physician. A wide range of nutraceuticals are under clinical trials to understand whether they physiologically target mitochondrial pathways and improve the quality of life in autism.


Assuntos
Transtorno Autístico/dietoterapia , Dietoterapia , Proteínas na Dieta/uso terapêutico , Transtorno Autístico/metabolismo , Transtorno Autístico/patologia , Suplementos Nutricionais , Humanos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/metabolismo , Mitocôndrias/patologia , Estresse Oxidativo/efeitos dos fármacos , Qualidade de Vida
2.
Nutr Hosp ; 36(Spec No3): 49-52, 2019 Aug 27.
Artigo em Espanhol | MEDLINE | ID: mdl-31368339

RESUMO

Introduction: Introduction: frailty and sarcopenia are prevalent conditions in older adults which diagnosis and treatment often overlap. Objective: to analyze the nutritional problematic related to frailty and sarcopenia in older adults. Methods: a literature review, about particularities of frailty and sarcopenia, diagnosis and nutritional treatment, has been carried out. Results: frailty is a geriatric syndrome that can be identified by at least three of the following criteria: weight loss, exhaustion, reduced physical activity, increased walk time, low grip strength. Sarcopenia is a muscular disease characterized by low muscle mass and reduced muscle strength as the main determinant. Both conditions can benefit from adequate protein intake (1-1.5 g/kg/day) and regular physical activity. Conclusion: identification, prevention, monitoring and nutritional treatment of frailty and sarcopenia in older adults is important because of its high prevalence. The main goal is to maintain the muscular integrity and minimize muscle loss in older adults. A healthy aging includes regular physical activity and the fulfillment of the protein requirements of this population.


Assuntos
Idoso Fragilizado , Fragilidade/dietoterapia , Fragilidade/diagnóstico , Sarcopenia/dietoterapia , Sarcopenia/diagnóstico , Idoso , Idoso de 80 Anos ou mais , Proteínas na Dieta/uso terapêutico , Fenômenos Fisiológicos da Nutrição do Idoso , Exercício , Fadiga/etiologia , Feminino , Força da Mão , Humanos , Masculino , Debilidade Muscular/etiologia , Necessidades Nutricionais , Velocidade de Caminhada , Perda de Peso
3.
Vopr Pitan ; 88(3): 23-31, 2019.
Artigo em Russo | MEDLINE | ID: mdl-31265772

RESUMO

The review considers some issues of obtaining, as well as physic-chemical, organoleptic, immunochemical (residual antigenicity) characteristics of enzymatic hydrolysates from food proteins (EHFP) that are widely used in food products for various purposes, as well as assessing their biological activity. The results of experimental works and patents, which describe the most widely used approaches to the production of EHFP with desired properties (hydrolysates for therapeutic and prophylactic products), as well as assessments of biological activity and immunochemical properties are given. The use of various enzyme preparations (of bacterial, fungal and animal origin), as well as one- and two-stage hydrolysis schemes and options for instrumentation of fermentolysis processes are considered. It is concluded that in order to achieve the required reduction in antigenicity for hydrolysates used as part of therapeutic (hypoallergenic) foods (to values not higher than 10-5 relative to the antigenicity of the original protein) membrane ultrafiltration stages are necessary. The main disadvantage of such hydrolysates is their unsatisfactory organoleptic properties (bitterness and high osmolarity) that can be improved using a number of additional technological approaches. The use of partial hydrolysates (or hydrolysates with an average degree of hydrolysis, with a residual antigenicity of 10-4 to 10-5) with significantly better organoleptic properties compared with deep hydrolysates in therapeutic foods is considered. Of considerable interest are the issues of immunomodulatory, antioxidant and hypoallergenic properties of EHFP. It has been suggested that soybean and chicken egg hydrolysates may be promising as functional ingredients with antimicrobial, antihypertensive and immunomodulatory effects in various specialized foods, as well as in cases of food intolerance only to cow milk proteins.


Assuntos
Dietoterapia , Proteínas na Dieta/uso terapêutico , Alimentos Especializados , Hidrolisados de Proteína/uso terapêutico , Anti-Infecciosos/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Antioxidantes/uso terapêutico , Humanos , Fatores Imunológicos/uso terapêutico
4.
Neurology ; 93(5): e485-e496, 2019 07 30.
Artigo em Inglês | MEDLINE | ID: mdl-31278117

RESUMO

OBJECTIVE: We evaluated the efficacy of muscle-targeted nutritional support on the functional outcomes of multidisciplinary intensive rehabilitation treatment (MIRT) in patients with Parkinson disease (PD) or parkinsonism. METHODS: We conducted a pragmatic, bicentric, randomized (1:1), assessor-blind controlled trial (Protein, Leucine and Vitamin D Enhancing Rehabilitation [PRO-LEADER]; April 2017 to January 2018) in cognitively intact patients with PD or parkinsonism and undergoing a 30-day MIRT. Patients (n = 150) received a standard hospital diet with or without a whey protein-based nutritional supplement enriched with leucine and vitamin D twice daily. The primary efficacy endpoint was the increase in the distance walked during a 6-minute walking test (6MWT). Secondary endpoints were changes in 4-meter walking speed, Timed Up and Go test (TUG), Berg balance scale, handgrip strength, Self-assessment Parkinson's Disease Disability Scale, body weight, and skeletal muscle mass (SMM). RESULTS: Nutritional support resulted in greater increase in the distance walked during 6MWT (mean 69.6 meters [95% confidence interval (CI) 60.7-78.6]) than no support (51.8 meters [95% CI 37.0-66.7]): center-adjusted mean difference, 18.1 meters (95% CI 0.9-35.3) (p = 0.039). Further adjustment for changes in dopaminergic therapy and SMM yielded consistent results: mean difference, 18.0 meters (95% CI 0.7-35.2) (p = 0.043). A meaningful effect was also found for the following secondary endpoints: 4-meter walking speed (p = 0.032), TUG (p = 0.046), SMM, and SMM index (p = 0.029). Six patients discontinued the nutritional therapy due to mild side effects. CONCLUSION: The consumption of a whey protein-based nutritional formula enriched with leucine and vitamin D with MIRT improved lower extremity function and preserved muscle mass in patients with PD or parkinsonism.Clinicaltrials.gov IDENTIFIER: NCT03124277. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that for patients with parkinsonism undergoing intensive rehabilitation, a whey protein-based nutritional formula enriched with leucine and vitamin D increased distance walked on the 6MWT.


Assuntos
Leucina/uso terapêutico , Músculo Esquelético , Apoio Nutricional/métodos , Doença de Parkinson/reabilitação , Desempenho Físico Funcional , Vitaminas/uso terapêutico , Proteínas do Soro do Leite/uso terapêutico , Idoso , Aminoácidos Essenciais/uso terapêutico , Peso Corporal , Colecalciferol/uso terapêutico , Proteínas na Dieta/uso terapêutico , Suplementos Nutricionais , Feminino , Alimentos Fortificados , Humanos , Masculino , Pessoa de Meia-Idade , Doença de Parkinson/fisiopatologia , Transtornos Parkinsonianos/fisiopatologia , Transtornos Parkinsonianos/reabilitação , Resultado do Tratamento , Teste de Caminhada , Velocidade de Caminhada
5.
Geriatr Psychol Neuropsychiatr Vieil ; 17(2): 137-143, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31162116

RESUMO

Minimum levels of protein intake are essential for the preservation of muscle mass and function, which is a major preventive issue of successful aging. Epidemiological studies suggest strong associations between protein intake and the different elements of sarcopenia, namely maintenance of lean mass and muscle strength. Most often, protein intakes among older patients are below requirements, independently from situations of under nutrition. This opens the path for nutritional interventions to prevent the consequences of sarcopenia in older patients. Isolated amino-acids such as leucine have shown positive effects in the short term only. The positive effects of protein supplementations on muscle strength and function are currently not established in the absence of concomitant exercise training. The highest level of evidence supports interventions combining exercise and nutrition.


Assuntos
Proteínas na Dieta/uso terapêutico , Suplementos Nutricionais , Idoso Fragilizado , Fragilidade/prevenção & controle , Força Muscular/efeitos dos fármacos , Músculo Esquelético/anatomia & histologia , Idoso , Idoso de 80 Anos ou mais , Proteínas na Dieta/administração & dosagem , Humanos , Músculo Esquelético/efeitos dos fármacos , Músculo Esquelético/crescimento & desenvolvimento , Sarcopenia/prevenção & controle
6.
Nutrients ; 11(6)2019 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-31181771

RESUMO

Sarcopenic obesity (SO) is referred to as the combination of obesity with low skeletal muscle mass and function. However, its definition and diagnosis is debated. SO represents a sizable risk factor for the development of disability, possibly with a worse prognosis in women. The present narrative review summarizes the current evidence on pharmacological, nutrition and exercise strategies on the prevention and/or treatment of SO in middle-aged and older-aged women. A literature search was carried out in Medline and Google Scholar between 29th January and 14th March 2019. Only controlled intervention studies on mid-age and older women whose focus was on the prevention and/or treatment of sarcopenia associated with obesity were included. Resistance training (RT) appears effective in the prevention of all components of SO in women, resulting in significant improvements in muscular mass, strength, and functional capacity plus loss of fat mass, especially when coupled with hypocaloric diets containing at least 0.8 g/kg body weight protein. Correction of vitamin D deficit has a favorable effect on muscle mass. Treatment of SO already established is yet unsatisfactory, although intense and prolonged RT, diets with higher (1.2 g/kg body weight) protein content, and soy isoflavones all look promising. However, further confirmatory research and trials combining different approaches are required.


Assuntos
Dieta , Força Muscular , Músculo Esquelético , Obesidade/terapia , Desempenho Físico Funcional , Treinamento de Resistência , Sarcopenia/terapia , Tecido Adiposo/metabolismo , Envelhecimento , Proteínas na Dieta/administração & dosagem , Proteínas na Dieta/uso terapêutico , Feminino , Humanos , Isoflavonas/uso terapêutico , Músculo Esquelético/metabolismo , Obesidade/complicações , Obesidade/metabolismo , Obesidade/prevenção & controle , Sarcopenia/complicações , Sarcopenia/prevenção & controle , Soja/química , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/terapia
7.
Rev Gastroenterol Peru ; 39(1): 78-80, 2019.
Artigo em Espanhol | MEDLINE | ID: mdl-31042241

RESUMO

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


Assuntos
Linfangiectasia Intestinal/diagnóstico , Corticosteroides/uso terapêutico , Terapia Combinada , Diarreia/etiologia , Gorduras na Dieta/uso terapêutico , Proteínas na Dieta/uso terapêutico , Diuréticos/uso terapêutico , Edema/etiologia , Hemodinâmica , Humanos , Hipoproteinemia/dietoterapia , Hipoproteinemia/etiologia , Lactente , Linfangiectasia Intestinal/complicações , Linfangiectasia Intestinal/epidemiologia , Linfangiectasia Intestinal/terapia , Masculino , Peru/epidemiologia , Venezuela/etnologia
8.
Am J Clin Nutr ; 109(5): 1310-1318, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31051510

RESUMO

BACKGROUND: Data on the relationship between protein intake and the risk of type 2 diabetes are conflicting. OBJECTIVE: We studied prospective associations between the intake of total, plant-based, and animal protein and the risk of pre-diabetes and diabetes in 4 population-based studies included in the PREVIEW project. METHODS: Analyses were conducted with the use of data from 3 European cohorts and 1 Canadian cohort, including 78,851 participants. Protein intake was assessed through the use of harmonized data from food-frequency questionnaires or 3-d dietary records. Cohort-specific incidence ratios (IRs) were estimated for pre-diabetes and diabetes, adjusting for general characteristics, lifestyle and dietary factors, disease history, and body mass index (BMI) and waist circumference; results were pooled based on a random-effects meta-analysis. RESULTS: Higher total protein intake (g · kg-1 · d-1) was associated with lower incidences of pre-diabetes and diabetes (pooled IRs: 0.84; 95% CI: 0.82, 0.87 and 0.49; 95% CI: 0.28, 0.83, respectively); plant-based protein intake was the main determinant (pooled IRs: 0.83; 95% CI: 0.81, 0.86 and 0.53; 95% CI: 0.36, 0.76, respectively). Substituting 2 energy percentage (E%) protein at the expense of carbohydrates revealed increased risks of pre-diabetes and diabetes (pooled IRs: 1.04; 95% CI: 1.01, 1.07 and 1.09; 95% CI: 1.01, 1.18, respectively). Except for the associations between intakes of total protein and plant-based protein (g · kg-1 · d-1) and diabetes, all other associations became nonsignificant after adjustment for BMI and waist circumference. CONCLUSIONS: Higher protein intake (g · kg-1 · d-1) was associated with a lower risk of pre-diabetes and diabetes. Associations were substantially attenuated after adjustments for BMI and waist circumference, which demonstrates a crucial role for adiposity and may account for previous conflicting findings. This study was registered at ISRCTN as ISRCTN31174892.


Assuntos
Diabetes Mellitus Tipo 2/prevenção & controle , Proteínas na Dieta/uso terapêutico , Ingestão de Energia , Comportamento Alimentar , Estado Pré-Diabético/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Canadá , Diabetes Mellitus Tipo 2/etiologia , Registros de Dieta , Inquéritos sobre Dietas , Proteínas na Dieta/administração & dosagem , Europa (Continente) , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Proteínas de Vegetais Comestíveis/administração & dosagem , Proteínas de Vegetais Comestíveis/uso terapêutico , Estado Pré-Diabético/etiologia , Estudos Prospectivos , Circunferência da Cintura , Adulto Jovem
9.
Nutr Hosp ; 36(1): 238-241, 2019 03 07.
Artigo em Inglês | MEDLINE | ID: mdl-30834767

RESUMO

Introduction: Malabsorptive bariatric techniques are associated with nutritional deficiencies. However, when patients do not respond to supplemental intensive treatments they should be closely followed because they can hide other pathological conditions. We present the case of a 47-year-old man with morbid obesity (body mass index [BMI]: 48 kg/m2) who underwent bariatric surgery. In 2016, he presented severe pneumonia and hospitalization at the Intensive Unit Care was required. After this episode, his nutritional state impaired, presenting 6-7 diarrhea/steatorrhea events per-day and requiring several hospitalizations due to the persistence of severe hypoproteinemia. He was given parenteral high-protein associated with low-fat oral diet. He presented a temporary biochemical improvement, but the hypoproteinemia recurred. Finally, tests revealed the presence of Tropheryma whipplei as protein-losing enteropathy. Whipple's disease (WD) is a rare cause of diarrhea and malnutrition, and these symptoms can be confused with the postoperative status of malabsorptive bariatric techniques. WD requires early diagnosis with prolonged antibiotic treatment to avoid severe complications.


Assuntos
Cirurgia Bariátrica , Síndromes de Malabsorção/complicações , Desnutrição/complicações , Complicações Pós-Operatórias/fisiopatologia , Doença de Whipple/etiologia , Antibacterianos/uso terapêutico , Dieta com Restrição de Gorduras , Proteínas na Dieta/uso terapêutico , Feminino , Humanos , Síndromes de Malabsorção/etiologia , Desnutrição/etiologia , Pessoa de Meia-Idade , Estado Nutricional , Obesidade Mórbida/cirurgia , Complicações Pós-Operatórias/etiologia , Tropheryma , Doença de Whipple/dietoterapia , Doença de Whipple/microbiologia
10.
Am J Clin Nutr ; 109(5): 1319-1327, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-30920607

RESUMO

BACKGROUND: The types of food in complementary feeding of infants and young children are important for growth and development. Food protein quality, as measured by the Digestible Indispensable Amino Acid Score (DIAAS), requires the determination of true ileal digestibility of indispensable amino acids (IAAs) in children. OBJECTIVES: First, the aim of this study was to measure the true ileal IAA digestibility of 4 (rice, finger millet, mung bean, and hen egg) commonly consumed complementary foods in children aged <2 y using the dual-isotope tracer method. Second, we calculated the DIAAS of complementary feeding diets and their relation to stunting in a representative Indian rural population. DESIGN: Rice, finger millet, and mung bean were intrinsically labeled with deuterium oxide (2H2O), whereas egg was labeled through oral dosing of hens with a uniformly 2H-labeled amino acid mixture. True ileal IAA digestibility was determined by the dual-isotope tracer technique. The DIAAS of complementary food protein was calculated in children aged 1-3 y from a nationally representative survey to evaluate its relation with stunting. RESULTS: True ileal IAA digestibility was lowest in mung bean (65.2% ± 7.1%), followed by finger millet (68.4 %± 5.3%) and rice (78.5% ± 3.5%), and was highest for egg (87.4% ± 4.0%). There was a significant inverse correlation of complementary food DIAAS with stunting in survey data (r = -0.66, P = 0.044). The addition of egg or milk to nationally representative complementary diets theoretically improved the DIAAS from 80 to 100. CONCLUSIONS: The true ileal IAA digestibility of 4 foods commonly consumed in complementary diets showed that the DIAAS was associated with stunting and reinforces the importance of including animal source food (ASF) in diets to improve growth. This trial was registered at http://ctri.nic.in/clinicaltrials/login.php as CTRI/2017/02/007921.


Assuntos
Dieta , Proteínas na Dieta/administração & dosagem , Digestão , Transtornos do Crescimento , Fenômenos Fisiológicos da Nutrição do Lactente , População Rural , Aminoácidos Essenciais/análise , /farmacocinética , Animais , Galinhas , Pré-Escolar , Proteínas na Dieta/farmacocinética , Proteínas na Dieta/normas , Proteínas na Dieta/uso terapêutico , Ovos , Feminino , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Íleo/metabolismo , Índia , Lactente , Isótopos , Masculino , Leite , Proteínas de Vegetais Comestíveis/administração & dosagem , Proteínas de Vegetais Comestíveis/farmacocinética , Poaceae , Inquéritos e Questionários , Vigna
11.
Nutr. hosp ; 36(1): 238-241, ene.-feb. 2019. ilus
Artigo em Inglês | IBECS | ID: ibc-183208

RESUMO

Malabsorptive bariatric techniques are associated with nutritional deficiencies. However, when patients do not respond to supplemental intensive treatments they should be closely followed because they can hide other pathological conditions. We present the case of a 47-year-old man with morbid obesity (body mass index [BMI]: 48 kg/m2) who underwent bariatric surgery. In 2016, he presented severe pneumonia and hospitalization at the Intensive Unit Care was required. After this episode, his nutritional state impaired, presenting 6-7 diarrhea/steatorrhea events per-day and requiring several hospitalizations due to the persistence of severe hypoproteinemia. He was given parenteral high-protein associated with low-fat oral diet. He presented a temporary biochemical improvement, but the hypoproteinemia recurred. Finally, tests revealed the presence of Tropheryma whipplei as protein-losing enteropathy. Whipple's disease (WD) is a rare cause of diarrhea and malnutrition, and these symptoms can be confused with the postoperative status of malabsorptive bariatric techniques. WD requires early diagnosis with prolonged antibiotic treatment to avoid severe complications


Las técnicas bariátricas malabsortivas suelen asociarse a deficiencias nutricionales. Sin embargo, cuando los pacientes no responden a tratamientos intensivos suplementarios, deben valorarse otras condiciones patológicas. Presentamos el caso de un hombre de 47 años, obeso mórbido (índice de masa corporal [IMC]: 48 kg/m2) sometido a cirugía bariátrica, que dos años más tarde presentó neumonía severa, por lo que requirió ingreso en la Unidad de Cuidados Intensivos. Posteriormente, el estado nutricional se deterioró, presentando 6-7 episodios de diarrea-esteatorrea/día y requiriendo varias hospitalizaciones por hipoproteinemia severa. Recibió infusión parenteral rica en proteínas asociada con una dieta baja en grasas y presentó mejoría analítica temporal. Finalmente, las pruebas revelaron la presencia de Tropheryma whipplei, una bacteria que genera enteropatía pierde-proteínas. La enfermedad de Whipple (EW) es una causa poco común de diarrea y malnutrición. Estos síntomas pueden confundirse con el posoperatorio de técnicas bariátricas malabsortivas. La EW requiere un diagnóstico precoz con un tratamiento antibiótico prolongado para evitar complicaciones graves


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Doença de Whipple/etiologia , Complicações Pós-Operatórias/fisiopatologia , Cirurgia Bariátrica , Desnutrição/complicações , Obesidade Mórbida/cirurgia , Doença de Whipple/dietoterapia , Doença de Whipple/microbiologia , Complicações Pós-Operatórias/etiologia , Antibacterianos/uso terapêutico , Dieta com Restrição de Gorduras , Proteínas na Dieta/uso terapêutico , Síndromes de Malabsorção/etiologia , Estado Nutricional
12.
Am J Clin Nutr ; 109(2): 478-486, 2019 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-30624598

RESUMO

Background: Dietary protein and micronutrients are important to the maintenance of bone health and may be an effective countermeasure to weight-loss-associated bone loss. Objectives: We aimed to determine the effect of a 6-mo hypocaloric, nutritionally complete, higher-protein meal plan on change in bone density and quality as compared with weight stability in older adults using a randomized post-test design. We hypothesized that participants randomly assigned to this meal plan would maintain similar bone density and quality to weight-stable controls, despite significant reductions in body mass. Methods: Ninety-six older adults (aged 70.3 ± 3.7 y, 74% women, 27% African American) with obesity [body mass index (kg/m2): 35.4 ± 3.3] were randomly assigned to a 6-mo hypocaloric, nutritionally complete, higher-protein meal plan targeting ≥1.0 g protein · kg body weight-1 · d-1 [weight-loss (WL) group; n = 47] or to a weight-stability (WS) group targeting 0.8 g protein · kg body weight-1 · d-1, the current Recommended Dietary Allowance (n = 49). The primary outcome was total hip bone mineral density (BMD), with femoral neck BMD, lumbar spine BMD, and lumbar spine trabecular bone score (TBS) as secondary outcomes, all assessed at baseline and 3 and 6 mo with dual-energy X-ray absorptiometry. Results: Baseline total hip, femoral neck, and lumbar spine BMDs were 1.016 ± 0.160, 0.941 ± 0.142, and 1.287 ± 0.246 g/cm2, respectively; lumbar TBS was 1.398 ± 0.109. Despite significant weight loss achieved in the WL group (6.6 ± 0.4 kg; 8.6% ± 0.4% of baseline weight), 6-mo regional BMD estimates were similar to those in the WS group (all P > 0.05). Lumbar spine TBS significantly increased at 6 mo in the WL group (mean: 1.421; 95% CI: 1.401, 1.441) compared with the WS group (1.390: 95% CI: 1.370, 1.409; P = 0.02). Conclusions: Older adults following a hypocaloric, nutritionally complete, higher-protein meal plan maintained similar bone density and quality to weight-stable controls. Our data suggest that adherence to this diet does not produce loss of hip and spine bone density in older adults and may improve bone quality. This trial was registered at clinicaltrials.gov as NCT02730988.


Assuntos
Densidade Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Restrição Calórica , Dieta Redutora , Proteínas na Dieta/farmacologia , Obesidade/dietoterapia , Perda de Peso , Idoso , Índice de Massa Corporal , Manutenção do Peso Corporal , Osso e Ossos/metabolismo , Proteínas na Dieta/administração & dosagem , Proteínas na Dieta/uso terapêutico , Ingestão de Energia , Feminino , Fêmur/efeitos dos fármacos , Fêmur/metabolismo , Quadril , Humanos , Vértebras Lombares/efeitos dos fármacos , Vértebras Lombares/metabolismo , Masculino , Refeições , Obesidade/metabolismo
13.
Nutrients ; 11(1)2019 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-30669313

RESUMO

Quality protein maize (QPM) varieties are biofortified, or nutritionally improved, to have higher lysine and tryptophan levels to increase quality protein intakes particularly among young children. This study assesses adequacy of children's protein intakes in Ethiopia, where QPM is being promoted, accounting for protein quality and seasonal dietary changes, and estimates potential increases in intakes if QPM replaced conventional maize in diets. Diets of randomly sampled children aged 12⁻36 months in rural southern Ethiopia (n = 218) were assessed after harvest during relative food security and 3⁻4 months later during relative food insecurity using 24-h weighed food records. Diets were analyzed for protein adequacy, accounting for protein quality using the protein digestibility corrected amino acid score (PDCAAS) method, and potential improvements from QPM substitution were estimated. Stunting was prevalent (38%) at the first assessment. Across seasons, 95⁻96% of children consumed maize, which provided 59⁻61% of energy and 51⁻55% of total protein in 24 h. Dietary intakes decreased in the food insecure season, though children were older. Among children no longer breastfeeding, QPM was estimated to reduce inadequacy of utilizable protein intakes from 17% to 13% in the food secure season and from 34% to 19% in the food insecure season. However, breastfed children had only 4⁻6% inadequate intakes of utilizable protein, limiting QPM's potential impact. Due to small farm sizes, maize stores from home production lasted a median of three months. Young Ethiopian children are at risk of inadequate quality protein intakes, particularly after breastfeeding has ceased and during food insecurity. QPM could reduce this risk; however, reliance on access through home production may result in only short-term benefits given the limited quantities of maize produced and stored.


Assuntos
Deficiências Nutricionais/prevenção & controle , Dieta , Proteínas na Dieta/administração & dosagem , Grão Comestível , Melhoramento Vegetal , Proteínas de Plantas/administração & dosagem , Zea mays/química , Aminoácidos/análise , Pré-Escolar , Deficiências Nutricionais/complicações , Proteínas na Dieta/análise , Proteínas na Dieta/normas , Proteínas na Dieta/uso terapêutico , Ingestão de Energia , Etiópia , Comportamento Alimentar , Feminino , Abastecimento de Alimentos , Jardinagem , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , Masculino , Estado Nutricional , Proteínas de Plantas/análise , Proteínas de Plantas/uso terapêutico , Avaliação de Programas e Projetos de Saúde , População Rural , Estações do Ano , Zea mays/classificação
14.
Ecol Food Nutr ; 58(2): 80-92, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30650991

RESUMO

This study evaluated an alternative ocean-based fish protein, Advanced Protein Powder (APP) as a feasible, environmentally sustainable protein source to reduce childhood malnutrition. We completed a rodent feeding study to evaluate growth and development in young growing mice on a purified diet containing APP as compared to mice-fed diets using other common protein sources - casein, whey, and soy. Results suggested APP to be an effective and safe protein source and ensured normal body growth, bone development, and brain function in APP diet-fed mice. Evidence provided in this study supports considering the use of APP to reduce malnutrition among children worldwide.


Assuntos
Densidade Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Cognição/efeitos dos fármacos , Dieta , Proteínas na Dieta/farmacologia , Proteínas de Peixes/farmacologia , Ganho de Peso/efeitos dos fármacos , Animais , Encéfalo/efeitos dos fármacos , Caseínas/farmacologia , Caseínas/uso terapêutico , Criança , Proteínas na Dieta/uso terapêutico , Proteínas de Peixes/uso terapêutico , Peixes , Humanos , Masculino , Memória/efeitos dos fármacos , Camundongos , Oceanos e Mares , Desnutrição Proteico-Calórica/prevenção & controle , Proteínas de Soja/farmacologia , Proteínas de Soja/uso terapêutico , Proteínas do Soro do Leite/farmacologia , Proteínas do Soro do Leite/uso terapêutico
15.
Mech Ageing Dev ; 177: 186-200, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30044947

RESUMO

Although the beneficial effects of calorie restriction (CR) on health and aging were first observed a century ago, the specific macronutrients and molecular processes that mediate the effect of CR have been heavily debated. Recently, it has become clear that dietary protein plays a key role in regulating both metabolic health and longevity, and that both the quantity and quality - the specific amino acid composition - of dietary protein mediates metabolic health. Here, we discuss recent findings in model organisms ranging from yeast to mice and humans regarding the influence of dietary protein as well as specific amino acids on metabolic health, and the physiological and molecular mechanisms which may mediate these effects. We then discuss recent findings which suggest that the restriction of specific dietary amino acids may be a potent therapy to treat or prevent metabolic syndrome. Finally, we discuss the potential for dietary restriction of specific amino acids - or pharmaceuticals which harness these same mechanisms - to promote healthy aging.


Assuntos
Aminoácidos Essenciais/uso terapêutico , Restrição Calórica , Proteínas na Dieta/uso terapêutico , Longevidade , Síndrome Metabólica/prevenção & controle , Modelos Biológicos , Animais , Humanos , Síndrome Metabólica/metabolismo , Síndrome Metabólica/patologia , Camundongos
16.
Nutr Clin Pract ; 34(1): 123-130, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30452094

RESUMO

BACKGROUND: In a previous audit, 81% of enteral protein prescriptions failed to meet protein guidelines. To address this, a very high-protein enteral formula and protein supplements were introduced, and protein prescriptions were adjusted to account for nonnutrition energy sources displacing enteral formula. This follow-up audit compared protein provision in critically ill adults requiring exclusive enteral nutrition (EN), first, with local and international guidelines, and second, after changes to practice, with the previous audit in the same intensive care unit (ICU). METHODS: Data were collected from 106 adults consecutively admitted to the ICU of a U.K. tertiary hospital and requiring exclusive EN ≥3 days. Protein targets based on local guidelines (1.25, 1.5, or 2.0 g/kg/d), nutrition prescription, and delivery were recorded for 24 hours between days 1-3, 5-7, 8-10, and 18-20 post-ICU admission. RESULTS: The proportion of day 1-3 protein prescriptions meeting protein targets increased from 19% in 2015 to 69% in 2017 (P < .0005, φ = 0.50). The median percentage of protein target delivered was lower than prescribed (79% vs 103%; (P < .0005; r = 0.53) and EN delivery only met the target of 22% of patients. The proportion of protein prescriptions meeting protein targets was similar for days 1-3 (69%), 5-7 (71%), and 8-10 (68%), but increased slightly by days 18-20 (74%). The proportion of patients for which EN delivery met protein targets increased with the number of days post-ICU admission (22%, 26%, 37%, and 53% for days 1-3, 5-7, 8-10, and 18-20, respectively). CONCLUSION: The proportion of protein prescriptions meeting guideline targets was higher after changes to practice.


Assuntos
Estado Terminal/terapia , Proteínas na Dieta/uso terapêutico , Nutrição Enteral/estatística & dados numéricos , Nutrição Enteral/normas , Adulto , Idoso , Auditoria Clínica , Feminino , Seguimentos , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Avaliação Nutricional , Guias de Prática Clínica como Assunto , Melhoria de Qualidade
17.
J Obstet Gynaecol Res ; 45(3): 592-599, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30484932

RESUMO

AIM: In this study, we aimed to investigate the protective effect of krill oil (KO) against ischemia-reperfusion (I/R) injury on rat ovary. METHODS: This study was conducted with 32 Wistar Albino rats. Rats were divided into four groups, with eight rats in each group-as follows: Sham group, I/R group, I/R + low dose KO group (50 mg) and I/R + high dose KO group (500 mg). The histopathological and follicle counts were performed on the right ovary. The total antioxidant status, total oxidant status and oxidative stress index were evaluated on the left ovary. And also serum N-thiol level, serum T-thiol level, serum disulfide (SDS) level, serum disulfide/N-thiol and serum disulfide/T-thiol ratios were evaluated too. RESULTS: A statistically significant difference was determined between the I/R group and all the other groups for all parameters. There was significant difference between KO groups and the Sham group for the parameters of serum N-thiol, serum T-thiol, SDS, serum disulfide/N-thiol and serum disulfide/T-thiol. SDS, total oxidant status and oxidative stress index were determined to be the highest in the I/R group and the lowest in the low dose KO group. The total antioxidant status values were found to be the highest in the high dose KO group and the lowest in the I/R group. Follicle counts and histological injury scores showed no significant difference between Sham and KO groups. CONCLUSION: This study demonstrated that KO has beneficial effects on decreasing the injury after I/R on rat ovary.


Assuntos
Proteínas na Dieta/uso terapêutico , Doenças Ovarianas/prevenção & controle , Ovário/efeitos dos fármacos , Substâncias Protetoras/uso terapêutico , Traumatismo por Reperfusão/prevenção & controle , Animais , Antioxidantes/farmacologia , Feminino , Doenças Ovarianas/patologia , Ovário/irrigação sanguínea , Ovário/patologia , Estresse Oxidativo/efeitos dos fármacos , Ratos , Traumatismo por Reperfusão/patologia
18.
Br J Gen Pract ; 69(678): e61-e69, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30510094

RESUMO

BACKGROUND: Recommendations for routine frailty screening in general practice are increasing as frailty prevalence grows. In England, frailty identification became a contractual requirement in 2017. However, there is little guidance on the most effective and practical interventions once frailty has been identified. AIM: To assess the comparative effectiveness and ease of implementation of frailty interventions in primary care. DESIGN AND SETTING: A systematic review of frailty interventions in primary care. METHOD: Scientific databases were searched from inception to May 2017 for randomised controlled trials or cohort studies with control groups on primary care frailty interventions. Screening methods, interventions, and outcomes were analysed in included studies. Effectiveness was scored in terms of change of frailty status or frailty indicators and ease of implementation in terms of human resources, marginal costs, and time requirements. RESULTS: A total of 925 studies satisfied search criteria and 46 were included. There were 15 690 participants (median study size was 160 participants). Studies reflected a broad heterogeneity. There were 17 different frailty screening methods. Of the frailty interventions, 23 involved physical activity and other interventions involved health education, nutrition supplementation, home visits, hormone supplementation, and counselling. A significant improvement of frailty status was demonstrated in 71% (n = 10) of studies and of frailty indicators in 69% (n=22) of studies where measured. Interventions with both muscle strength training and protein supplementation were consistently placed highest for effectiveness and ease of implementation. CONCLUSION: A combination of muscle strength training and protein supplementation was the most effective intervention to delay or reverse frailty and the easiest to implement in primary care. A map of interventions was created that can be used to inform choices for managing frailty.


Assuntos
Aconselhamento , Terapia por Exercício , Fragilidade/prevenção & controle , Terapia Nutricional , Atenção Primária à Saúde , Proteínas na Dieta/uso terapêutico , Estudos de Viabilidade , Fragilidade/diagnóstico , Fragilidade/terapia , Hormônios/uso terapêutico , Visita Domiciliar , Humanos , Programas de Rastreamento , Treinamento de Resistência
19.
Isr J Health Policy Res ; 7(1): 58, 2018 12 10.
Artigo em Inglês | MEDLINE | ID: mdl-30526654

RESUMO

BACKGROUND: Epidemiological studies have shown deterioration in dental health accompanying the ageing process. Tooth loss increases with age. Chewing ability is closely correlated with number of natural teeth present: there is a threshold of 20-21 teeth, below which chewing ability declines. The government of Israel is currently considering adding dental treatment for elderly to the basket of services of the National Health Insurance Law. Information on the influence of elderly's dental health on nutrition and general health status can contribute to the decision making process. METHODS: Secondary analysis of data collected on a subsample (N = 1776) of the cross-sectional Mabat Zahav - National Health and Nutrition Survey of the Elderly was done. Intakes of energy, fiber, protein, fruits and vegetables, associations with dental visits, dentures presence and functional ability were analyzed. Linear regression adjusted for confounders was performed. RESULTS: Statistically significant differences in dietary intake of energy, fiber, protein and vegetables were found between elderly who visited a dentist in the last year and those who did not. Elderly who possessed dentures had lower dietary intakes than their dentate counterparts. Elderly with functional problems such as impaired chewing had worse dietary intakes than the others. This was so after controlling for education, degree of interest in the relationship between nutrition and health and reading the nutrition label. CONCLUSIONS: The findings in our study suggest that those who visited a dentist in the last year, had natural teeth and no denture/s and reported no chewing problems had better dietary intake. The results emphasize the importance of maintaining adequate dental health, preserving natural teeth and regular dental visits in the elderly to assure adequate nutrient status in this age group.


Assuntos
Atividades Cotidianas , Comportamento Alimentar/psicologia , Saúde Bucal/normas , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Estudos Transversais , Fibras na Dieta/uso terapêutico , Proteínas na Dieta/uso terapêutico , Ingestão de Energia/fisiologia , Feminino , Frutas , Geriatria/legislação & jurisprudência , Geriatria/métodos , Geriatria/tendências , Humanos , Israel , Masculino , Saúde Bucal/tendências , Estatísticas não Paramétricas , Verduras
20.
Nutrients ; 10(12)2018 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-30518122

RESUMO

Aging poses a high risk of lean mass loss, which can be effectively improved through resistance exercise training (RET), or multicomponent exercise training (MET) as well as nutrition supplementation, such as protein supplementation (PS). This study investigated the effects of PS plus exercise training on frail older individuals. A comprehensive search of online databases was performed to identify randomized controlled trials (RCTs) that reported the efficacy of PS combined with RET or MET in frail older individuals. The included RCTs were analyzed through a meta-analysis and risk-of-bias assessment. We finally included 22 RCTs in the meta-analysis, with a mean (range/total) Physiotherapy Evidence Database score of 6.7 (4⁻9/10). PS plus exercise training significantly improved the frailty status (odds ratio = 2.77; p = 0.006), lean mass (standard mean difference (SMD) = 0.52; p < 0.00001), leg strength (SMD = 0.37; p < 0.00001), and walking speed (SMD = 0.32; p = 0.002). Subgroup analyses revealed that PS plus MET exert significant effects on frailty indices, whereas PS plus RET further improves lean mass. Our findings suggest that PS plus RET as well as MET is effective in improving frailty status, lean mass, muscle strength, and physical mobility in frail older individuals.


Assuntos
Composição Corporal , Proteínas na Dieta , Suplementos Nutricionais , Terapia por Exercício , Idoso Fragilizado , Idoso , Idoso de 80 Anos ou mais , Composição Corporal/efeitos dos fármacos , Composição Corporal/fisiologia , Proteínas na Dieta/farmacologia , Proteínas na Dieta/uso terapêutico , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados Aleatórios como Assunto
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