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1.
JAMA ; 322(15): 1486-1499, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31613346

RESUMO

Importance: High-quality dietary patterns may help prevent chronic disease, but limited data exist from randomized trials about the effects of nutritional and behavioral interventions on dietary changes. Objective: To assess the effect of a nutritional and physical activity education program on dietary quality. Design, Setting, and Participants: Preliminary exploratory interim analysis of an ongoing randomized trial. In 23 research centers in Spain, 6874 men and women aged 55 to 75 years with metabolic syndrome and no cardiovascular disease were enrolled in the trial between September 2013 and December 2016, with final data collection in March 2019. Interventions: Participants were randomized to an intervention group that encouraged an energy-reduced Mediterranean diet, promoted physical activity, and provided behavioral support (n = 3406) or to a control group that encouraged an energy-unrestricted Mediterranean diet (n = 3468). All participants received allotments of extra-virgin olive oil (1 L/mo) and nuts (125 g/mo) for free. Main Outcomes and Measures: The primary outcome was 12-month change in adherence based on the energy-reduced Mediterranean diet (er-MedDiet) score (range, 0-17; higher scores indicate greater adherence; minimal clinically important difference, 1 point). Results: Among 6874 randomized participants (mean [SD] age, 65.0 [4.9] years; 3406 [52%] men), 6583 (96%) completed the 12-month follow-up and were included in the main analysis. The mean (SD) er-MedDiet score was 8.5 (2.6) at baseline and 13.2 (2.7) at 12 months in the intervention group (increase, 4.7 [95% CI, 4.6-4.8]) and 8.6 (2.7) at baseline and 11.1 (2.8) at 12 months in the control group (increase, 2.5 [95% CI, 2.3-2.6]) (between-group difference, 2.2 [95% CI, 2.1-2.4]; P < .001). Conclusions and Relevance: In this preliminary analysis of an ongoing trial, an intervention that encouraged an energy-reduced Mediterranean diet and physical activity, compared with advice to follow an energy-unrestricted Mediterranean diet, resulted in a significantly greater increase in diet adherence after 12 months. Further evaluation of long-term cardiovascular effects is needed. Trial Registration: isrctn.com Identifier: ISRCTN89898870.


Assuntos
Restrição Calórica , Dieta Mediterrânea , Exercício , Síndrome Metabólica/dietoterapia , Cooperação do Paciente , Idoso , Doenças Cardiovasculares/prevenção & controle , Inquéritos sobre Dietas , Feminino , Educação em Saúde , Humanos , Modelos Lineares , Lipídeos/sangue , Masculino , Síndrome Metabólica/terapia , Pessoa de Meia-Idade , Obesidade/dietoterapia , Fatores de Risco , Espanha
2.
J Agric Food Chem ; 67(46): 12675-12684, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31661963

RESUMO

Metabolic syndrome (MSyn) constitutes a litany of pathophysiological conditions, such as central adiposity, hypertension, dyslipidemia, and hyperglycemia. As a result of the epidemic levels of MSyn, several efforts have been made to identify the etiologies of the condition and develop methods by which to reduce its prevalence. The attenuation of the gut microflora ratio of Firmicutes/Bacteroidetes through bioactive compounds found in the Mediterranean diet, dietary polysaccharides, and pre- and probiotics can be used as functional foods to improve derangements in cardiometabolic markers correlated with the development of MSyn. Although more studies are needed to understand the role of manipulating the gut microbiota in health and disease in human models, this review based on current data from epidemiologic studies and clinical trials will serve as a review to elucidate the role nutrition plays in attenuating the gut microbiota in preventing and managing MSyn.


Assuntos
Bactérias/isolamento & purificação , Microbioma Gastrointestinal , Síndrome Metabólica/dietoterapia , Síndrome Metabólica/microbiologia , Animais , Bactérias/química , Bactérias/classificação , Dieta , Humanos , Prebióticos/análise
3.
Nutr. hosp ; 36(4): 826-833, jul.-ago. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184707

RESUMO

Background: metabolic syndrome (MetS) has been diagnosed in adolescents. However, it remains uncertain which determinants of lifestyle are independently associated with its occurrence. Objective: to verify the association between lifestyle determinants (physical activity, sedentary behavior and food consumption) and MetS, by controlling demographic indicators and anthropometric nutritional status in a sample of adolescents from the southern region of Brazil. Subjects and methods: a school-based cross-sectional study involving 1,035 adolescents (565 girls and 470 boys) aged 12 to 20 years. Anthropometric measurements were performed and a questionnaire was applied with structured questions. MetS was identified according to criteria proposed by the International Diabetes Federation. The data were treated using bivariate analysis and hierarchical multiple regression. Results: the overall prevalence of MetS was equivalent to 4.5% (95% CI: 3.8 to 5.4). Multivariate analysis showed a significant association between MetS and age (OR = 1.34 [95% CI, 1.09 to 1.80]) and economic class (OR = 1.35 [95% CI: 1.08 to 1.86]). Among the determinants of lifestyle, high recreational screen time (OR = 1.32 [95% CI: 1.07 to 1.94]) and low fruit/vegetable intake (OR = 1.23 [95% CI: 1.01 to 1.87]) were independently associated with MetS. Likewise, obesity (OR = 1.62 [95% CI: 1.28 to 2.47]) was significantly associated with the outcome. Conclusion: in view of the significant association with MetS, intervention strategies should be designed to reduce recreational screen time and encourage fruit/vegetable consumption, especially among older adolescents, with a high economic class and obesity status


Introducción: el síndrome metabólico (SMet) se ha diagnosticado en adolescentes, sin embargo, sigue siendo incierto qué determinantes del estilo de vida se pueden asociar de forma independiente con su aparición. Objetivo: verificar la asociación entre determinantes del estilo de vida (actividad física, comportamiento sedentario y consumo de alimentos) y SMet mediante el control de indicadores demográficos y el estado nutricional antropométrico en una muestra de adolescentes de la región sur de Brasil. Sujetos y métodos: estudio transversal con 1.035 adolescentes (565 chicas y 470 chicos) de 12 a 20 años. Se midieron valores antropométricos y se aplicó un cuestionario con preguntas estructuradas. El SMet se identificó de acuerdo con los criterios propuestos por la International Diabetes Federation. Los datos fueron tratados mediante análisis bivariado y regresión múltiple jerarquizada. Resultados: la prevalencia general de SMet fue del 4,5% [IC 95%: 3,8-5,4]. El análisis multivariado mostró una asociación significativa entre SMet y edad (OR = 1,34 [IC 95%: 1,09-1,80]) y clase económica (OR = 1,35 [IC 95%: 1,08-1,86]). Entre los determinantes del estilo de vida, el alto tiempo de pantalla en actividad recreativa (OR = 1,32 [IC 95%: 1,07-1,94]) y la baja ingesta de frutas/vegetales (OR = 1,23 [IC 95%: 1,01-1,87]) se asociaron de forma independiente con el SMet. Del mismo modo, la obesidad (OR = 1,62 [IC 95%: 1,28-2,47]) se asoció significativamente con el SMet. Conclusión: en vista de la asociación significativa con el SMet, las estrategias de intervención deben diseñarse para reducir el tiempo de pantalla recreativo y fomentar el consumo de frutas y verduras, especialmente entre los adolescentes mayores, de clase económica más alta y obesos


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Síndrome Metabólica/diagnóstico , Estilo de Vida , Comportamento Alimentar , Estado Nutricional , Síndrome Metabólica/dietoterapia , Síndrome Metabólica/epidemiologia , Atividade Motora , Estudos Transversais , Comportamento Sedentário , Inquéritos e Questionários , Epidemiologia Descritiva , Modelos Logísticos , Brasil
4.
Nutrients ; 11(8)2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31344950

RESUMO

Our purpose was to study the relationship of adherence to the Mediterranean diet (MedDiet) with urinary factors that favor the formation of renal calcium and uric acid stones in overweight and obese participants who had metabolic syndrome. This cross-sectional study examined 267 participants. A well-known MedDiet score (range 0-9) was calculated for each patient, and patients were then categorized has having low (≤3), medium (4-5), or high (≥6) adherence to the MedDiet. Baseline characteristics and urinary parameters were also analyzed. High calcium salt urinary crystallization risk (CaUCR) and high uric acid urinary crystallization risk (UrUCR) were calculated from urinary parameters using pre-defined criteria. More than half of patients with MedDiet scores ≤3 had high UrUCR (55.4%) and high CaUCR (53.8%). In contrast, fewer patients with high adherence (≥6) to the MedDiet had high UrUCR (41.2%) and high CaUCR (29.4%). Relative to those with low adherence, individuals with high adherence had a prevalence ratio (PR) of 0.77 for a high UrUCR (95% CI: 0.46-1.12; p for trend: 0.069) and a PR of 0.51 for a high CaUCR (95% CI: 0.26-0.87; p for trend: 0.012) after adjusting for age, sex, body mass index, type 2 diabetes, and total energy intake. Our findings indicate that greater adherence to the MedDiet was associated with a reduced CaUCR and a reduced UrUCR. This suggests that adequate dietary management using the MedDiet patterns may prevent or reduce the incidence and recurrence of calcium salt and uric acid renal stones.


Assuntos
Dieta Mediterrânea , Síndrome Metabólica/dietoterapia , Sobrepeso/dietoterapia , Cooperação do Paciente , Urolitíase/prevenção & controle , Idoso , Biomarcadores/urina , Estudos Transversais , Comportamento Alimentar , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/urina , Pessoa de Meia-Idade , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Sobrepeso/urina , Prevalência , Fatores de Proteção , Ensaios Clínicos Controlados Aleatórios como Assunto , Recidiva , Medição de Risco , Fatores de Risco , Espanha/epidemiologia , Fatores de Tempo , Resultado do Tratamento , Urolitíase/diagnóstico , Urolitíase/epidemiologia , Urolitíase/urina
5.
Nutrients ; 11(7)2019 Jul 16.
Artigo em Inglês | MEDLINE | ID: mdl-31315213

RESUMO

Carica papaya L. is a well-known fruit worldwide, and its highest production occurs in tropical and subtropical regions. The pulp contains vitamins A, C, and E, B complex vitamins, such as pantothenic acid and folate, and minerals, such as magnesium and potassium, as well as food fibers. Phenolic compounds, such as benzyl isothiocyanate, glucosinolates, tocopherols (α and δ), ß-cryptoxanthin, ß-carotene and carotenoids, are found in the seeds. The oil extracted from the seed principally presents oleic fatty acid followed by palmitic, linoleic and stearic acids, whereas the leaves have high contents of food fibers and polyphenolic compounds, flavonoids, saponins, pro-anthocyanins, tocopherol, and benzyl isothiocyanate. Studies demonstrated that the nutrients present in its composition have beneficial effects on the cardiovascular system, protecting it against cardiovascular illnesses and preventing harm caused by free radicals. It has also been reported that it aids in the treatment of diabetes mellitus and in the reduction of cholesterol levels. Thus, both the pulp and the other parts of the plant (leaves and seeds) present antioxidant, anti-hypertensive, hypoglycemic, and hypolipidemic actions, which, in turn, can contribute to the prevention and treatment of obesity and associated metabolic disorders.


Assuntos
Carica , Suplementos Nutricionais , Síndrome Metabólica/dietoterapia , Frutas , Humanos , Valor Nutritivo , Compostos Fitoquímicos
6.
Nutrients ; 11(7)2019 06 29.
Artigo em Inglês | MEDLINE | ID: mdl-31261967

RESUMO

Background: The effect of dietary fat intake on the metabolic syndrome (MetS) and in turn on cardiovascular disease (CVD) remains unclear in individuals at high CVD risk. Objective: To assess the association between fat intake and MetS components in an adult Mediterranean population at high CVD risk. Design: Baseline assessment of nutritional adequacy in participants (n = 6560, men and women, 55-75 years old, with overweight/obesity and MetS) in the PREvención con DIeta MEDiterránea (PREDIMED)-Plus randomized trial. Methods: Assessment of fat intake (total fat, monounsatured fatty acids: MUFA, polyunsaturated fatty acids: PUFA, saturated fatty acids: SFA, trans-fatty acids: trans-FA, linoleic acid, α-linolenic acid, and ω-3 FA) using a validated food frequency questionnaire, and diet quality using 17-item Mediterranean dietary questionnaire and fat quality index (FQI). Results: Participants in the highest quintile of total dietary fat intake showed lower intake of energy, carbohydrates, protein and fiber, but higher intake of PUFA, MUFA, SFA, TFA, LA, ALA and ω-3 FA. Differences in MetS components were found according to fat intake. Odds (5th vs. 1st quintile): hyperglycemia: 1.3-1.6 times higher for total fat, MUFA, SFA and ω-3 FA intake; low high-density lipoprotein cholesterol (HDL-c): 1.2 higher for LA; hypertriglyceridemia: 0.7 lower for SFA and ω-3 FA intake. Conclusions: Dietary fats played different role on MetS components of high CVD risk patients. Dietary fat intake was associated with higher risk of hyperglycemia.


Assuntos
Doenças Cardiovasculares/epidemiologia , Gorduras na Dieta/efeitos adversos , Dislipidemias/epidemiologia , Hiperglicemia/epidemiologia , Síndrome Metabólica/epidemiologia , Idoso , Biomarcadores/sangue , Glicemia/análise , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/prevenção & controle , Estudos Transversais , Dieta Mediterrânea , Gorduras na Dieta/administração & dosagem , Dislipidemias/sangue , Dislipidemias/diagnóstico , Dislipidemias/dietoterapia , Feminino , Humanos , Hiperglicemia/sangue , Hiperglicemia/diagnóstico , Hiperglicemia/dietoterapia , Lipídeos/sangue , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/dietoterapia , Pessoa de Meia-Idade , Medição de Risco , Fatores de Risco , Espanha/epidemiologia , Resultado do Tratamento
7.
Nutrients ; 11(7)2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31336561

RESUMO

Linseed is a dietary source of plant-based ω-3 fatty acids along with fiber as well as lignans including secoisolariciresinol diglucoside (SDG). We investigated the reversal of signs of metabolic syndrome following addition of whole linseed (5%), defatted linseed (3%), or SDG (0.03%) to either a high-carbohydrate, high-fat or corn starch diet for rats for the final eight weeks of a 16-week protocol. All interventions reduced plasma insulin, systolic blood pressure, inflammatory cell infiltration in heart, ventricular collagen deposition, and diastolic stiffness but had no effect on plasma total cholesterol, nonesterified fatty acids, or triglycerides. Whole linseed did not change the body weight or abdominal fat in obese rats while SDG and defatted linseed decreased abdominal fat and defatted linseed increased lean mass. Defatted linseed and SDG, but not whole linseed, improved heart and liver structure, decreased fat vacuoles in liver, and decreased plasma leptin concentrations. These results show that the individual components of linseed produce greater potential therapeutic responses in rats with metabolic syndrome than whole linseed. We suggest that the reduced responses indicate reduced oral bioavailability of the whole seeds compared to the components.


Assuntos
Dieta Hiperlipídica/efeitos adversos , Linho/química , Síndrome Metabólica/induzido quimicamente , Animais , Humanos , Intestino Delgado/efeitos dos fármacos , Masculino , Síndrome Metabólica/dietoterapia , Distribuição Aleatória , Ratos , Ratos Wistar
8.
Nutrients ; 11(6)2019 Jun 02.
Artigo em Inglês | MEDLINE | ID: mdl-31159504

RESUMO

BACKGROUND: In the treatment of obesity/metabolic syndrome, dietary measures traditionally focus on reducing carbohydrate/fat-related caloric intake. The possibility that changes in potassium consumption may be related to the achieved weight loss has not been previously explored. METHODS: Sixty-eight participants, with a mean age of 51.6 ± 11.0 years (F/M-30/38), who fulfilled the ATPIII criteria for the metabolic syndrome (MS) were enrolled into a 1-year intensive multidisciplinary program. Nutritional recommendation consisted of a moderate low calorie/high protein Mediterranean diet. Baseline assessment included clinical and biochemical profiling, and body composition. Nutritional components were registered over 7 days before and at the end of 1 year of treatment. RESULTS: Mean baseline body mass index (BMI) was 35 ± 4 kg/m², which declined by 9.4 ± 0.1% after one year of combined intervention. Linear stepwise regression analysis revealed that 45% of the predicted variance of the % decline in BMI was related to increased consumption of dietary potassium (ß = -0.865) and caproic acid (ß = -0.423) and reduction in the consumption of dietary vitamin B6 (ß = 0.542), calcium (ß = 0.335), total carbohydrates (ß = 0.239) and total caloric intake (ß = 0.238; p < 0.001). Notably, the strongest correlate of the decline in BMI was the increase in dietary potassium intake (ß = -0.865). Subjects whose achieved decrease in BMI was above the average (n = 30) increased potassium intake by 25% as compared to an increase in dietary potassium intake of only 3% by those whose decline in BMI was below the average (n = 36; p < 0.05). The change in dietary potassium was related to the percent increase in dietary protein (r = 0.433; p < 0.001). CONCLUSION: An increase in dietary potassium consumption is a previously unrecognized predictor of the achieved reduction in BMI in a weight-loss-oriented multidisciplinary intervention in obesity/MS. Prospective trials are underway to confirm this post-hoc finding.


Assuntos
Síndrome Metabólica/dietoterapia , Potássio na Dieta/administração & dosagem , Perda de Peso/efeitos dos fármacos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
9.
Nutrients ; 11(7)2019 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-31247933

RESUMO

BACKGROUND: Metabolic syndrome increases the risk of cardiovascular disease (CVD) over and above that related to type 2 diabetes. The optimal diet for the treatment of metabolic syndrome is not clear. MATERIALS AND METHODS: A review of dietary interventions in volunteers with metabolic syndrome as well as studies examining the impact of dietary fat on the separate components of metabolic syndrome was undertaken using only recent meta-analyses, if available. RESULTS: Most of the data suggest that replacing carbohydrates with any fat, but particularly polyunsaturated fat, will lower triglyceride(TG), increase high density lipoprotein (HDL) cholesterol, and lower blood pressure, but have no effects on fasting glucose in normal volunteers or insulin sensitivity, as assessed by euglycemic hyperinsulinemic clamps. Fasting insulin may be lowered by fat. Monounsaturated fat (MUFA) is preferable to polyunsaturated fat (PUFA) for fasting insulin and glucose lowering. The addition of 3-4 g of N3 fats will lower TG and blood pressure (BP) and reduce the proportion of subjects with metabolic syndrome. Dairy fat (50% saturated fat) is also related to a lower incidence of metabolic syndrome in cohort studies.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/dietoterapia , Dieta com Restrição de Carboidratos , Gorduras na Dieta/administração & dosagem , Síndrome Metabólica/dietoterapia , Valor Nutritivo , Biomarcadores/sangue , Glicemia/metabolismo , Pressão Sanguínea , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , HDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Dieta com Restrição de Carboidratos/efeitos adversos , Gorduras na Dieta/efeitos adversos , Humanos , Incidência , Insulina/sangue , Resistência à Insulina , Metanálise como Assunto , Síndrome Metabólica/sangue , Síndrome Metabólica/epidemiologia , Resultado do Tratamento , Triglicerídeos/sangue
10.
Nat Commun ; 10(1): 2700, 2019 06 20.
Artigo em Inglês | MEDLINE | ID: mdl-31221967

RESUMO

Pathological obesity can result from genetic predisposition, obesogenic diet, and circadian rhythm disruption. Obesity compromises function of muscle, which accounts for a majority of body mass. Behavioral intervention that can counteract obesity arising from genetic, diet or circadian disruption and can improve muscle function holds untapped potential to combat the obesity epidemic. Here we show that Drosophila melanogaster (fruit fly) subject to obesogenic challenges exhibits metabolic disease phenotypes in skeletal muscle; sarcomere disorganization, mitochondrial deformation, upregulation of Phospho-AKT level, aberrant intramuscular lipid infiltration, and insulin resistance. Imposing time-restricted feeding (TRF) paradigm in which flies were fed for 12 h during the day counteracts obesity-induced dysmetabolism and improves muscle performance by suppressing intramuscular fat deposits, Phospho-AKT level, mitochondrial aberrations, and markers of insulin resistance. Importantly, TRF was effective even in an irregular lighting schedule mimicking shiftwork. Hence, TRF is an effective dietary intervention for combating metabolic dysfunction arising from multiple causes.


Assuntos
Transtornos Cronobiológicos/dietoterapia , Jejum/fisiologia , Síndrome Metabólica/dietoterapia , Músculo Esquelético/fisiopatologia , Obesidade/dietoterapia , Animais , Animais Geneticamente Modificados , Transtornos Cronobiológicos/etiologia , Transtornos Cronobiológicos/fisiopatologia , Ritmo Circadiano/fisiologia , Dieta Hiperlipídica/efeitos adversos , Modelos Animais de Doenças , Drosophila melanogaster , Metabolismo Energético/fisiologia , Feminino , Humanos , Masculino , Síndrome Metabólica/etiologia , Síndrome Metabólica/patologia , Síndrome Metabólica/fisiopatologia , Músculo Esquelético/patologia , Obesidade/etiologia , Obesidade/patologia , Obesidade/fisiopatologia , Sarcômeros/patologia , Jornada de Trabalho em Turnos/efeitos adversos , Resultado do Tratamento
11.
Nutrients ; 11(5)2019 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-31091691

RESUMO

Long-chain polyunsaturated fatty acids, n-3 series (n-3 LC-PUFA), are known for their preventive effects against cardiovascular disease. In an unfavourable economic and environmental context of fish oil production, marine microalgae could be an alternative source of n-3 LC-PUFA and are of interest for human nutrition. The aim of this study was to evaluate the effects of P. tricornutum, a microalga rich in eicosapentaenoic acid and used as a food supplement, on the metabolic disorders associated with metabolic syndrome and obesity development. Three male Wistar rat groups (n = 6) were submitted for eight weeks to a standard diet or high-fat diet (HF) with 10% fructose in drinking water, supplemented or not with 12% of P. tricornutum (HF-Phaeo). Supplementation led to n-3 LC-PUFA enrichment of lipids in the liver, plasma and erythrocytes. Plasma transaminases showed no difference between the HF and HF-Phaeo groups. Body weight, fat mass, inflammatory markers and insulinemia decreased in HF-Phaeo rats versus the HF group. Plasma total cholesterol, triacylglycerols and leptine diminished in HF-Phaeo rats, while HDL-cholesterol increased. In conclusion, this study highlights the beneficial effects of P. tricornutum in reducing the metabolic disorders associated with metabolic syndrome.


Assuntos
Suplementos Nutricionais , Síndrome Metabólica/prevenção & controle , Microalgas , Ração Animal/análise , Animais , Peso Corporal , Dieta/veterinária , Dieta Hiperlipídica , Ácidos Graxos Insaturados/química , Ácidos Graxos Insaturados/farmacologia , Masculino , Síndrome Metabólica/dietoterapia , Ratos , Ratos Wistar , Fatores de Risco
12.
Medicina (Kaunas) ; 55(5)2019 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-31108986

RESUMO

Background and Objectives: Cerebral palsy (CP) is a set of permanent disorders that limit physical activity and increase the risk of developing other diseases, such as metabolic syndrome (MS). Adequate nutrition can contribute to the prevention of associated symptoms. The main objective of this study is to evaluate the nutritional status and the prevalence of cardiometabolic risk factors in adults with CP and Gross Motor Function Classification System (GMFCS) levels between IV and V. Materials and Methods: A sample of 41 adults with CP and GMFCS levels from IV to V were studied. The variables used in the study were age, sex, weight, height, mean age, and GMFCS level range. To evaluate nutritional status, body mass index and the Mini Nutritional Assessment (MNA), a nutritional screening tool, were used. To assess cardiometabolic risk, data on obesity, central obesity, blood pressure, fasting plasma glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides were collected. Results: More than 80% of the population studied was malnourished or at risk of malnutrition, according to the MNA tool classification ranges, and around 35% of the studied population was within the underweight range. Regarding cardiometabolic risk factors, only one adult with CP was diagnosed with MS. Conclusions: The studied population of adults with CP and GMFCS levels between IV and V is not a population at risk of MS; however, the high prevalence of malnutrition, as well as some of the most prevalent cardiovascular risk factors, should be taken into consideration.


Assuntos
Paralisia Cerebral/dietoterapia , Síndrome Metabólica/complicações , Estado Nutricional , Adolescente , Adulto , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Institucionalização/estatística & dados numéricos , Masculino , Síndrome Metabólica/dietoterapia , Pessoa de Meia-Idade , Fatores de Risco , Estatísticas não Paramétricas
13.
Plant Foods Hum Nutr ; 74(2): 235-240, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30993530

RESUMO

Metabolic syndrome, characterized by obesity, low-grade inflammation, insulin resistance, hyperglycemia, dyslipidemia and hypertension, is a major risk factor for cardiovascular mortality. Preclinical studies on recently discovered classes of lipids - fatty acid esters of hydroxy fatty acids (FAHFA) have revealed their anti-inflammatory and insulin-sensitizing potential. The FAHFA levels are significantly decreased in insulin-resistant individuals, their application exhibited anti-inflammatory effects and restoring the glucose-insulin homeostasis. The aim of our research was to analyze the overall FAHFA composition in a common diet, as only a partial FAHFA composition has been revealed so far (only the PAHSA subclass was analyzed in a few foods). A new approach to the FAHFAs analysis includes nano-LC and post-column modifier followed by negative ion mass spectrometry, in order to obtain maximum sensitivity. Analysis of different foods - oat (whole grain, coarse flakes and fine flakes), apple, clementine, lemon, strawberry, blueberry, mango, kiwi, avocado, pineapple, banana, onion, garlic, cherry tomato, carrot, parsley root, pepper and radish - exhibited wide inter-food variation in the FAHFA profiles. Sixteen analyzed FAHFAs (palmitic, oleic, palmitoleic and stearic hydroxy-esters) showed microgram to low nanogram levels (0.165 ng/g - 32 µg/g FW), with the highest abundancy in oat, clementine, garlic and pineapple. Stearic acid hydroxy stearic acid (SAHSA) was the most abundant FAHFA, especially in the food with antioxidative, anti-inflammatory and beneficial metabolic effects. In contrary, the PAHSA - previously proven to have the strongest antihyperglycemic and insulin-sensitizing effects, was not present in some foods (radish, avocado, mango, lemon, cherry tomato, kiwi). Our study proves the importance of overall FAHFA analysis in food (especially in a functional food), because of their potential metabolic benefits and possible future incorporation in special diets.


Assuntos
Anti-Inflamatórios/análise , Ésteres/análise , Ácidos Graxos/análise , Alimento Funcional , Lipídeos/análise , Síndrome Metabólica/dietoterapia , Plantas/química , Análise de Alimentos , Humanos , Insulina/metabolismo , Espectrometria de Massas
14.
Oxid Med Cell Longev ; 2019: 9089035, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30937145

RESUMO

Despite the increase in cognitive deficit following stroke in metabolic syndrome (MetS) condition, the therapeutic strategy is still limited. Since oxidative stress and neuroinflammation play the crucial roles on the pathophysiology of aforementioned conditions, the cognitive enhancing effect of the combined extract of Oryza sativa and Anethum graveolens was considered based on their antioxidant, anti-inflammation, and neuroprotective effects together with the synergistic effect concept. Male Wistar rats weighing 180-220 g were induced metabolic syndrome-like condition by using a high-carbohydrate high-fat diet (HCHF diet). Then, reperfusion injury following cerebral ischemia was induced by the occlusion of right middle cerebral artery and treated with the combined extract of O. sativa and A. graveolens (OA extract) at doses of 0.5, 5, and 50 mg/kg BW once daily for 21 days. Spatial memory was assessed every 7 days throughout the experimental period. At the end of the study, neuron and glial fibrillary acidic protein- (GFAP-) positive cell densities, the oxidative stress status, AChE, and the expression of proinflammatory cytokines (TNF-α, IL-6) in the hippocampus were determined. The results showed that OA extract at all doses used in this study significantly improved memory together with the reductions of MDA, TNF-α, IL-6, AChE, and density of GFAP-positive cell but increased neuron density in the hippocampus. Taken together, OA is the potential cognitive enhancer in memory impairment following stroke in MetS condition. The possible underlying mechanism may occur partly via the reductions of oxidative stress status, GFAP-positive cell density, and neuroinflammatory cytokines such as TNF-α and IL-6 together with the suppression of AChE activity in the hippocampus. This study suggests that OA is the potential functional ingredient to improve the cognitive enhancer. However, further clinical research is required.


Assuntos
Anethum graveolens/química , Disfunção Cognitiva/dietoterapia , Síndrome Metabólica/dietoterapia , Oryza/química , Acidente Vascular Cerebral/complicações , Animais , Humanos , Masculino , Ratos , Ratos Wistar
15.
Nutrients ; 11(2)2019 Feb 22.
Artigo em Inglês | MEDLINE | ID: mdl-30813286

RESUMO

This editorial discusses and analyses the role of dietary interventions in the management of chronic conditions in recognition of the global increase of these diseases, the rise in the ageing population, and the significant cost to health services around the world. Evidence has shown that low-glycaemic index (GI) and low-carbohydrate diets are effective in the management of type 2 diabetes, and the role of unsaturated fatty acids, vitamins, and bioactive compounds in chronic disease management have been the subject of intense research. However, although multidimensional approaches are important in the management of these chronic conditions, nutritional interventions are critical and central to these strategies.


Assuntos
Doenças Cardiovasculares/dietoterapia , Transtornos Cognitivos/dietoterapia , Diabetes Mellitus Tipo 2/dietoterapia , Dieta/normas , Síndrome Metabólica/dietoterapia , Estado Pré-Diabético/dietoterapia , Doença Crônica , Índice Glicêmico , Humanos
16.
Nutrients ; 11(3)2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30889891

RESUMO

The Mediterranean Diet (MedDiet) has been promoted as a means of preventing and treating cardiodiabesity. The aim of this study was to answer a number of key clinical questions (CQs) about the role of the MedDiet in cardiodiabesity in order to provide a framework for the development of clinical practice guidelines. A systematic review was conducted to answer five CQs formulated using the Patient, Intervention, Comparison, and Outcome (PICO) criteria. Twenty articles published between September 2013 and July 2016 were included, adding to the 37 articles from the previous review. There is a high level of evidence showing that MedDiet adherence plays a role in the primary and secondary prevention of cardiovascular disease (CVD) and improves health in overweight and obese patients. There is moderate-to-high evidence that the MedDiet prevents increases in weight and waist circumference in non-obese individuals, and improves metabolic syndrome (MetS) and reduces its incidence. Finally, there is moderate evidence that the MedDiet plays primary and secondary roles in the prevention of type 2 diabetes mellitus (T2DM). The MedDiet is effective in preventing obesity and MetS in healthy and at-risk individuals, in reducing mortality risk in overweight or obese individuals, in decreasing the incidence of T2DM and CVD in healthy individuals, and in reducing symptom severity in individuals with T2DM or CVD.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Diabetes Mellitus Tipo 2/prevenção & controle , Dieta Mediterrânea , Comportamento Alimentar , Síndrome Metabólica/prevenção & controle , Obesidade/prevenção & controle , Doenças Cardiovasculares/dietoterapia , Diabetes Mellitus Tipo 2/dietoterapia , Humanos , Síndrome Metabólica/dietoterapia , Obesidade/dietoterapia , Sobrepeso , Prevenção Secundária , Circunferência da Cintura , Ganho de Peso
17.
Lipids Health Dis ; 18(1): 66, 2019 Mar 18.
Artigo em Inglês | MEDLINE | ID: mdl-30885221

RESUMO

BACKGROUND: Nutraceuticals represent a new therapeutic frontier in the treatment of metabolic syndrom (MetS) and related cardiovascular risk factors. The aim of this study was to evaluate the potential beneficial effects of Armolipid Plus (AP) (berberine 500 mg, red yest rice, monacolin K 3 mg and policosanol 10 mg) on insulin resistance, lipid profile, particularly on small and dense LDL cholesterol (sdLDL-C), representing the most atherogenic components, as well as its effects on high sensitivity C-reactive protein, a notable marker of cardiovascular risk, blood pressure and cardiac remodeling in subjects affected by MetS, with left ventricular hypertrophy. METHODS: The study was a prospective, multi-center, randomized, double blind, placebo-controlled trial. One hundred and fifty eight patients, aged between 28 and 76 years old, were enrolled and randomized to receive either one tablet of AP or placebo (PL) once daily for 24 weeks. Anthropometric and vital parameters, total cholesterol (tot-C), low-density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglyceridemia (TG), non-HDL cholesterol (NHDL-C) and sdLDL-C were evaluated. RESULTS: After 24 weeks of treatment, the analysis performed on 141 subjects (71 in AP arm and 70 in PL arm), showed a significant improvement of lipid profile in the AP group, with reduction in tot-C (- 13.2 mg/dl), LDL-C (- 13.9 mg/dl) and NHDL-C (- 15.3 mg/dl) and increase in HDL-C (+ 2.0 mg/dl). These changes were equally significant compared with placebo (tot-C: AP - 13.2 mg/dL vs PL + 2.7 mg/dL, p < 0.01; LDL-C: AP -13.9 mg/dl vs PL + 1.5 mg/dl, p < 0.01; NHDL-C: AP -15.3 mg/dl vs PL + 2.8 mg/dl, p < 0.01), Although no significant difference was observed between the two arms in the reduction of HDL-C nevertheless it increased significantly in the AP group (AP + 2 mg/dL p < 0.05, PL 0.13 mg/dL). CONCLUSION: The results of this study, applicable to a specific local population show that, in a population of subjects affected by MetS, treatment with AP improves the lipid profile and the most atherogenic factors, thus suggesting a reduction in the risk of development and progression of atherosclerosis, particularly in subjects with high atherogenic risk, due to the presence of sdLDL-C.


Assuntos
Suplementos Nutricionais , Metabolismo dos Lipídeos/efeitos dos fármacos , Síndrome Metabólica/dietoterapia , Adulto , Idoso , Berberina/uso terapêutico , LDL-Colesterol/sangue , Método Duplo-Cego , Álcoois Graxos/uso terapêutico , Feminino , Humanos , Hipertrofia Ventricular Esquerda/dietoterapia , Resistência à Insulina , Lovastatina/uso terapêutico , Masculino , Síndrome Metabólica/metabolismo , Pessoa de Meia-Idade , Placebos , Resultado do Tratamento
18.
Int J Vitam Nutr Res ; 89(5-6): 227-237, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30829137

RESUMO

The present randomized, double-blind, placebo controlled study aimed to evaluate the effect of vitamin D supplementation on matrix metalloproteinases-2, -9 (MMP-2 and MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) in subjects with metabolic syndrome. Forty-six eligible subjects were randomly assigned to either vitamin D or placebo groups for 16 weeks. The participants were asked to take 50,000 IU vitamin D or matching placebo every week. Metabolic and anthropometric indices, serum MMP-2, MMP-9, TIMP-1 and high-sensitivity C-reactive protein (hsCRP) were assessed before and after intervention. Moreover, dietary intake, sun exposure and physical activity were also determined. The trial was registered at http://www.irct.ir (No. IRCT201409033140N14). Participants were 40.20 ± 4.60 y and 45.50% males. Compared to the baseline values, MMP-9 and TIMP-1 concentrations were decreased after 16 weeks in the intervention group (p = 0.03 and p = 0.04, respectively). However, the changes of MMP-2, MMP-9, TIMP-1 and hsCRP in the intervention group were not significant compared to the placebo group (p > 0.05). Furthermore, the metabolic or anthropometric indices between two study groups remained unchanged (p > 0.05). The findings of the present study demonstrated no effect of vitamin D supplementation on MMP-2, MMP-9 and TIMP-1 concentrations in subjects with metabolic syndrome. However, there is a need for more longitudinal trials to investigate the role of vitamin D on atherosclerosis and cardiovascular diseases in subjects with metabolic syndrome.


Assuntos
Síndrome Metabólica , Adulto , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Humanos , Masculino , Metaloproteinase 2 da Matriz , Metaloproteinase 9 da Matriz , Síndrome Metabólica/dietoterapia , Projetos Piloto , Inibidor Tecidual de Metaloproteinase-1 , Vitamina D
19.
J Med Food ; 22(5): 538-541, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30864849

RESUMO

Nopal is used in Mexico as both food and traditional medicine for metabolic diseases. Our aim was to analyze the effect of the chronic administration of mucilage fiber extracted from nopal (Opuntia ficus indica; 500 mg/kg body weight per day) on male Wistar rats on a high-fructose diet (HFD). After which three groups were administered one of the following for 30 days: whole-fresh nopal mixed in water, mucilage, and control. Metabolic and hemodynamic parameters (triglycerides, cholesterol, fasting glucose, oral glucose tolerance test, blood pressure, and abdominal circumference) were determined. Rats administered nopal and mucilage had lower levels of triglycerides and diastolic arterial pressure than control, but only nopal had significant differences. Furthermore, systolic and diastolic pressure were higher in the control group. Thus, whole nopal and mucilage improve metabolic parameters in rats fed a HFD.


Assuntos
Fibras na Dieta/metabolismo , Frutose/efeitos adversos , Síndrome Metabólica/dietoterapia , Opuntia/química , Extratos Vegetais/metabolismo , Animais , Glicemia/metabolismo , Colesterol/metabolismo , Frutose/metabolismo , Teste de Tolerância a Glucose , Humanos , Masculino , Síndrome Metabólica/etiologia , Síndrome Metabólica/metabolismo , Ratos , Ratos Wistar , Triglicerídeos/metabolismo
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