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2.
Int J Clin Pract ; 74(7): e13505, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32239620

RESUMO

BACKGROUND: We aimed to investigate the effect of a low-protein intake on all-cause mortality in subjects with an estimated glomerular filtration rate (eGFR) ≧60 mL/min/1.73 m2 with or without albuminuria using data from the National Health and Nutrition Examination Survey (NHANES). METHODS: We analysed participants in the NHANES from 2003 to 2010. We excluded participants with an eGFR less than 60 mL/min/1.73 m2 from the analyses. Low-protein intake was defined as a protein intake of less than 0.8 g/kg/day. The Healthy Eating Index 2010 was used to assess diet quality. The vital status of all participants in the NHANES was determined by linking to the National Death Index through the end of 2011. The hazard ratios (HRs) for the association of low-protein intake and mortality were determined using weighted Cox proportional hazards regression models. RESULTS: A total of 7730 participants were included in the analyses. After a median follow up of 4.7 years, 462 participants died. A low-protein intake was associated with a higher risk of mortality (HRs 1.394, 95% CI 1.121-1.734, P = .004) with adjustment for diet quality and relevant risk factors. The higher risk of mortality associated with a low-protein intake was consistent in subjects with or without albuminuria (P interaction .280). CONCLUSION: A protein intake of less than 0.8 g/kg/day was associated with a higher risk of mortality in subjects with an eGFR ≧60 mL/min/1.73 m2 , irrespective of whether they had albuminuria.


Assuntos
Albuminúria/mortalidade , Proteínas na Dieta/uso terapêutico , Taxa de Filtração Glomerular , Inquéritos Nutricionais , Deficiência de Proteína/prevenção & controle , Adulto , Idoso , Albuminúria/complicações , Albuminúria/prevenção & controle , Dieta/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Deficiência de Proteína/etiologia , Risco , Fatores de Risco , Fatores de Tempo
3.
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
4.
J Nutr Health Aging ; 24(2): 223-229, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32003415

RESUMO

OBJECTIVES: The aim of this study was to examine the association of dietary protein intake and protein sources with cognitive function in population aged 60 years and older. DESIGN: Cross-sectional study. SETTING: The National Health and Nutrition Examination Survey (NHANES) 2011-2014. PARTICIPANTS: Non-institutionalized US adults aged 60 years and older. MEASUREMENTS: Cognitive functions were assessed by a series of cognitive tests. Dietary protein intake was assessed by two 24-hour dietary recall interviews. Linear regression analyses were used to assess the associations between quartiles of dietary protein intake and cognitive function. RESULTS: Protein intake was positively associated with cognitive function. In full-adjusted model, the significant association between dietary protein intake and Recall Test score was observed (quartile (Q) 2 versus Q1, ß=0.24, 95%CI: 0.01 to 0.47); the association between protein intake and Animal Fluency test was significant (Q2 versus Q1, ß=1.40, 95%CI: 0.51 to 2.29; Q4 versus Q1, ß=1.42, 95%CI: 0.37 to 2.48); the positive associations with DSST score and Composite z-score were observed both in Q2 versus Q1 and Q3 versus Q1 of protein intake. Protein intake from total animal, total meat, eggs and legumes were associated with a better performance on certain cognitive tests. However, an adverse association between higher protein intake from milk and milk products and cognitive function was observed. CONCLUSIONS: We found the positive associations of dietary protein intake and protein intake from total animal, total meat, eggs and legumes with cognitive function in adults aged 60 years and older, while higher milk and milk products were negatively associated with cognitive function.


Assuntos
Cognição/fisiologia , Dieta/métodos , Proteínas na Dieta/uso terapêutico , Estado Nutricional/fisiologia , Animais , Estudos Transversais , Proteínas na Dieta/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
Gastroenterol Hepatol ; 43(3): 142-154, 2020 Mar.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32089375

RESUMO

Post-operative morbidity of pancreatectomies occurs in up to 40-50% of patients, even in modern series. There is a need to find a simple scale in order to identify patients with increased risk of developing major post-operative complications after pancreatic resections. Many studies have been published on sarcopenia and surgical outcomes. Aspects of sarcopenia are presented, along with a systematic review using PRISMA guidelines, in order to search for articles about sarcopenia and pancreatic surgery. The impact of sarcopenia on morbidity and mortality in pancreatic resections is still unclear. The studies presented have been carried out over long periods of time, and many of them compare patients with different diseases. There are also different definitions of sarcopenia, and this can influence the results, as some of the reviewed articles have already shown. It is necessary to unify criteria, both in the definition and in the cut-off values. Prospective studies and consensus on sarcopenia diagnosis should be achieved.


Assuntos
Pancreatectomia , Pancreaticoduodenectomia , Complicações Pós-Operatórias/etiologia , Sarcopenia/complicações , Terapia Combinada , Proteínas na Dieta/uso terapêutico , Terapia por Exercício , Humanos , Desnutrição/complicações , Músculo Esquelético/diagnóstico por imagem , Músculo Esquelético/patologia , Terapia Neoadjuvante , Transplante de Pâncreas , Pancreatectomia/mortalidade , Neoplasias Pancreáticas/complicações , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/cirurgia , Pancreaticoduodenectomia/mortalidade , Pancreatite Crônica/complicações , Pancreatite Crônica/cirurgia , Complicações Pós-Operatórias/mortalidade , Risco , Sarcopenia/diagnóstico por imagem , Sarcopenia/patologia , Sarcopenia/terapia , Tomografia Computadorizada por Raios X
6.
Trials ; 20(1): 763, 2019 Dec 23.
Artigo em Inglês | MEDLINE | ID: mdl-31870451

RESUMO

BACKGROUND: A 2014 Cochrane review evaluating the effect of anabolic steroids after hip fracture concluded that the quality of the studies was insufficient to draw conclusions on the effects and recommended further high-quality trials in the field. Therefore, the aim of this pilot trial is to determine the preliminary effect and feasibility of a 12-week multimodal intervention consisting of physiotherapy (with strength training), protein-rich nutritional supplement and anabolic steroid on knee-extension muscle strength and function 14 weeks after hip fracture surgery. METHODS: We plan to conduct a randomized, placebo-controlled pilot trial with 48 patients operated for acute hip fracture. The patients are randomized (1:1) to either (1) physiotherapy with protein-rich nutritional supplement plus anabolic steroid or (2) physiotherapy with protein-rich nutritional supplement plus placebo. Outcome assessments will be carried out blinded at baseline (3-10 days after surgery) and at 14 weeks after entering the trial. Primary outcome is the change from baseline to follow-up in maximal isometric knee-extension muscle strength in the fractured limb. Secondary outcomes are physical performance test, patient-reported outcomes, and measures of body composition. DISCUSSION: If the trial is found feasible and the results show an indication of anabolic steroid being a relevant addition to further enhance the recovery of muscle strength and function in an enhanced recovery after surgery program, this trial will constitute the basis of a larger confirmatory trial. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03545347. Preregistered on 4 June 2018.


Assuntos
Anabolizantes/uso terapêutico , Proteínas na Dieta/uso terapêutico , Suplementos Nutricionais , Fraturas do Quadril/reabilitação , Força Muscular , Decanoato de Nandrolona/uso terapêutico , Modalidades de Fisioterapia , Treinamento de Resistência/métodos , Idoso , Estudos de Viabilidade , Fraturas do Quadril/cirurgia , Humanos , Pessoa de Meia-Idade , Procedimentos Ortopédicos/reabilitação , Medidas de Resultados Relatados pelo Paciente , Desempenho Físico Funcional , Projetos Piloto , Músculo Quadríceps
8.
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 Físico , Fadiga/etiologia , Feminino , Força da Mão , Humanos , Masculino , Debilidade Muscular/etiologia , Necessidades Nutricionais , Velocidade de Caminhada , Perda de Peso
9.
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
10.
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
11.
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
12.
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
13.
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
14.
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
15.
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
16.
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 , Proteínas Animais da Dieta/administração & dosagem , Proteínas Animais da Dieta/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
17.
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
18.
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
19.
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 , Dieta Saudável , 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
20.
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
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