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1.
Nutrients ; 12(5)2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32438620

RESUMO

The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. Global public health bodies and governments have ignited strategies and issued advisories on various handwashing and hygiene guidelines, social distancing strategies, and, in the most extreme cases, some countries have adopted "stay in place" or lockdown protocols to prevent COVID-19 spread. Notably, there are several significant risk factors for severe COVID-19 infection. These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. In this review, we discuss some of the anti-inflammatory therapies that are currently under investigation intended to dampen the cytokine storm of severe COVID-19 infections. Furthermore, nutritional status and the role of diet and lifestyle is considered, as it is known to affect patient outcomes in other severe infections and may play a role in COVID-19 infection. This review speculates the importance of nutrition as a mitigation strategy to support immune function amid the COVID-19 pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.


Assuntos
Anti-Inflamatórios/administração & dosagem , Betacoronavirus , Infecções por Coronavirus/terapia , Inflamação/terapia , Terapia Nutricional/métodos , Estado Nutricional , Pneumonia Viral/terapia , Infecções por Coronavirus/sangue , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Citocinas/sangue , Dieta/métodos , Humanos , Inflamação/imunologia , Estado Nutricional/imunologia , Pandemias , Pneumonia Viral/sangue , Pneumonia Viral/imunologia , Pneumonia Viral/virologia
2.
Nutrients ; 12(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252338

RESUMO

The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.


Assuntos
Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Terapia Nutricional , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Vitamina D/fisiologia , Vitamina D/uso terapêutico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/mortalidade , Suplementos Nutricionais , Humanos , Influenza Humana/epidemiologia , Influenza Humana/mortalidade , Influenza Humana/prevenção & controle , Pneumonia Viral/epidemiologia , Pneumonia Viral/mortalidade , Fatores de Risco , Estações do Ano , Deficiência de Vitamina D/epidemiologia , Deficiência de Vitamina D/prevenção & controle
3.
Einstein (Sao Paulo) ; 18: eAE4799, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32215466

RESUMO

The Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplantation: Graft- versus -host disease was approved by Sociedade Brasileira de Transplante de Medula Óssea , with the participation of 26 Brazilian hematopoietic stem cell transplantation centers. It describes the main nutritional protocols in cases of Graft- versus -host disease, the main complication of hematopoietic stem cell transplantation.


Assuntos
Conferências de Consenso como Assunto , Doença Enxerto-Hospedeiro/dietoterapia , Doença Enxerto-Hospedeiro/etiologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Terapia Nutricional/normas , Necessidades Nutricionais , Brasil , Congressos como Assunto , Gastroenteropatias/dietoterapia , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Doença Enxerto-Hospedeiro/fisiopatologia , Humanos , Terapia Nutricional/métodos , Índice de Gravidade de Doença
4.
PLoS One ; 15(2): e0229396, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32092109

RESUMO

OBJECTIVE: This study is aimed at determining the preoperative nutritional status of patients with hepatic alveolar echinococcosis (HAE), and subsequently establish a concise and reasonable nutritional evaluation indicator. The established evaluation method could be used for clinical preoperative risk assessment and prediction of post-operation recovery. METHODS: The basic patient information on height, body weight, BMI and hepatic encephalopathy of 93 HAE patients were examined. Subsequently, abdominal ultrasonography, blood coagulation and liver function tests were done on the patients. Liver function was assessed using the Child-Pugh improved grading method while nutritional status was evaluated using the European Nutrition Risk Screening 2002 (NRS 2002) method. Additional parameters including hospitalization time, the hemoglobin (HGB) level on the 3rd day after the operation, and the number of postoperative complications of HAE patients were also recorded. RESULTS: The NRS 2002 score was negatively correlated with body weight, body mass index (BMI)and albumin (ALB) (P<0.01), and positively correlated with the transverse and longitudinal diameters of the lesions (P<0.01). A worse grading of liver function was associated with a low ALB and a high NRS 2002 score (P<0.01). Results of the NRS 2002 score indicate that the hospitalization time of the normal nutrition group was significantly shorter than that of the malnourished group (P < 0.05). The HGB level of the control group on the 3rd day after the operation was significantly higher than that of the malnourished group (P < 0.05), and the number of postoperative complications was lower than that of malnutrition group (P < 0.05). CONCLUSION: Malnutrition is common in HAE patients. The nutritional status of HAE patients is related to many clinical factors, such as Child-Pugh classification of liver function, size of the lesion, and ALB among others. Although both BMI and ALB can be used as primary screening indicators for malnutrition in HAE patients, NRS 2002 is more reliable and prudent in judging malnutrition in HAE patients. Therefore, BMI and ALB are more suitable for preoperative risk assessment and prediction of postoperative recovery.


Assuntos
Equinococose Hepática/diagnóstico , Equinococose Hepática/cirurgia , Avaliação Nutricional , Estado Nutricional , Complicações Pós-Operatórias/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Equinococose Hepática/complicações , Equinococose Hepática/dietoterapia , Feminino , Hepatectomia/efeitos adversos , Hepatectomia/reabilitação , Humanos , Testes de Função Hepática , Masculino , Desnutrição/diagnóstico , Desnutrição/dietoterapia , Desnutrição/etiologia , Desnutrição/cirurgia , Pessoa de Meia-Idade , Terapia Nutricional , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/métodos , Período Pré-Operatório , Prognóstico , Recuperação de Função Fisiológica , Medição de Risco , Adulto Jovem
5.
Einstein (Sao Paulo) ; 18: AE4530, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32049129

RESUMO

The nutritional status of patients submitted to hematopoietic stem cell transplant is considered an independent risk factor, which may influence on quality of life and tolerance to the proposed treatment. The impairment of nutritional status during hematopoietic stem cell transplant occurs mainly due to the adverse effects resulting from conditioning to which the patient is subjected. Therefore, adequate nutritional evaluation and follow-up during hematopoietic stem cell transplant are essential. To emphasize the importance of nutritional status and body composition during treatment, as well as the main characteristics related to the nutritional assessment of the patient, the Brazilian Consensus on Nutrition in Hematopoietic Stem Cell Transplant: Adults was prepared, aiming to standardize and update Nutritional Therapy in this area. Dietitians, nutrition physicians and hematologists from 15 Brazilian centers thar are references in hematopoietic stem cell transplant took part.


Assuntos
Transplante de Células-Tronco Hematopoéticas/normas , Terapia Nutricional/normas , Estado Nutricional , Adulto , Antropometria , Brasil , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Humanos , Avaliação Nutricional , Terapia Nutricional/métodos , Nutrição Parenteral/métodos , Nutrição Parenteral/normas , Condicionamento Pré-Transplante
6.
Endocrinol. diabetes nutr. (Ed. impr.) ; 67(1): 4-12, ene. 2020. tab
Artigo em Inglês | IBECS | ID: ibc-186141

RESUMO

Introduction: Lifestyle changes in medical nutrition therapy (MNT) are associated to HbA1c decreases ranging from 0.3 to 2%. Evidence shows that people with barriers are less likely to adhere to a long-term nutritional plan. Little information is available on the barriers that prevent the implementation of a healthy nutritional plan, and the strategies used to overcome them. Objective: To report the longitudinal changes in perceptions of barriers to adherence to a nutritional plan in T2DM. Methods: A prospective cohort study with intervention. Follow-up was assessed at two years, and all patients received comprehensive care according to the CAIPaDi model. A questionnaire was used to detect the most common barriers to adherence to a nutritional plan at baseline and at 3 months and 1 and 2 years of follow-up. The analysis included data from 320 patients with complete evaluations from baseline to 2 years. Patients with T2DM aged 53.8 ± 9.1 years (55.9% women), BMI 29.2 ± 4.4 kg/m2, and time since the diagnosis 1 (0-5) years were included in the study. Results: At baseline, 78.4% of patients reported any barrier that limited adherence to a nutritional plan. The most common were "Lack of information on an adequate diet" (24.7%), "I eat away from home most of the time" (19.7%), and “Denial or refusal to make changes in my diet” (14.4%). After a structured nutritional intervention including strategies to eliminate each barrier, a 37% reduction (p < 0.001) was seen in barriers at 2 years of follow-up. Patients with persistent barriers at two years had a greater proportion of HbA1c values >7% (24.7%) and triglyceride levels >150 mg/dL (27.5%) out of the control range as compared to those with no barriers (11.6% and 14.4% respectively, p < 0.05). Conclusions: Identification of barriers to adherence to a nutritional plan may allow healthcare professionals design interventions with the specific behavioral components needed to overcome such barrier, thus improving adherence to the nutritional plan with the resultant long-term changes


Introducción: Los cambios en el estilo de vida en la terapia médica nutricional (TMN), se asocian con una disminución en la hemoglobina glucosilada A1c (HbA1c) del 0,3–2%. La evidencia muestra que las personas con barreras tienen menos probabilidades de adherirse a un plan nutricional a largo plazo. Hay información limitada sobre las barreras que impiden la implementación de un plan nutricional saludable y sobre las estrategias utilizadas para superarlas. Objetivo: Describir los cambios longitudinales en las percepciones de las barreras para la adherencia a un plan nutricional con diabetes tipo 2 (T2D). Métodos: Estudio prospectivo de cohorte con intervención, se evaluó el seguimiento a 2 años, todos los pacientes recibieron atención integral de acuerdo con el estudio CAIPaDi. Se utilizó un cuestionario para detectar las barreras más comunes para realizar un plan nutricional al inicio del estudio a los 3 meses, uno y 2 años de seguimiento. El análisis incluyó datos de 320 pacientes que tenían evaluaciones completas desde el basal hasta 2 años. Se incluyeron pacientes con T2D de 53,8 ± 9,1 años, 55,9% mujeres, IMC 29,2 ± 4,4 kg/m2 y tiempo desde el diagnóstico de 1 (0-5) año. Resultados: Al inicio del estudio, el 78,4% de los pacientes refirieron alguna barrera que limita la adherencia a un plan nutricional. Las barreras más frecuentes fueron «Falta de información sobre una dieta correcta» (24,7%), «Como fuera de casa la mayor parte del tiempo» (19,7%) y «Negación o rechazo a hacer cambios en mi dieta» (14,4%). Después de una intervención nutricional estructurada, que incluyó estrategias para reducir cada barrera, observamos un porcentaje de reducción del 37% (p < 0,001). Los sujetos que presentaban barreras persistentes a los 2 años de seguimiento, muestran una mayor proporción fuera del rango de control para la HbA1c el 24,7% (>7%) y triglicéridos el 27,5% (>150 mg/dl) en comparación con aquellos sin barreras (11,6 y 14,4%, respectivamente) p < 0,05. Conclusiones: La identificación de las barreras para la adherencia a un plan de alimentación puede permitir a los profesionales de la salud diseñar intervenciones con los componentes de comportamiento específicos necesarios para superar dicha barrera, mejorando la adherencia al plan de alimentación con cambios sostenidos a largo plazo


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Barreiras ao Acesso aos Cuidados de Saúde , Planejamento Alimentar/organização & administração , Diabetes Mellitus Tipo 2/complicações , Terapia Nutricional , Planejamento Alimentar/economia , Planejamento Alimentar/normas , Estudos Prospectivos , Inquéritos e Questionários , Antropometria
7.
Rev Assoc Med Bras (1992) ; 66Suppl 1(Suppl 1): s59-s67, 2020 Jan 13.
Artigo em Inglês | MEDLINE | ID: mdl-31939537

RESUMO

A healthy diet is an essential requirement to promote and preserve health, even in the presence of diseases, such as chronic kidney disease (CKD). In this review, nutritional therapy for CKD will be addressed considering not only the main nutrients such as protein, phosphorus, potassium, and sodium, which require adjustments as a result of changes that accompany the reduction of renal functions, but also the benefits of adopting dietary patterns associated with better outcomes for both preventing and treating CKD. We will also emphasize that these aspects should also be combined with a process of giving new meaning to a healthy diet so that it can be promoted. Finally, we will present the perspective of an integrated approach to the individual with CKD, exploring the importance of considering biological, psychological, social, cultural, and economic aspects. This approach has the potential to contribute to better adherence to treatment, thus improving the patient's quality of life.


Assuntos
Terapia Nutricional , Insuficiência Renal Crônica/dietoterapia , Dieta/classificação , Proteínas na Dieta , Ingestão de Energia , Comportamento Alimentar , Humanos , Fósforo , Potássio , Qualidade de Vida , Sódio
9.
GMS J Med Educ ; 36(6): Doc68, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31844640

RESUMO

Objective: The aim of the teaching project "Interprofessional Nutrition Management in Inpatient and Home Care" of the Medical Faculty of the Heinrich Heine University (HHU) and the Fliedner University of Applied Sciences Düsseldorf (FFH) was to test an interprofessional training session on the topic of malnutrition using the method of research-based learning to evaluate feasibility. Method: In the teaching project for medical and nursing students, research-based learning was applied in a case-based cross-sector setting. The teaching project was assessed quantitatively by the participating students through questionnaires and four newly-developed scales. The modeling and reliability of the scales (from 1 to 5) was confirmed by an exploratory factor analysis and Cronbach's alpha. The scales were evaluated descriptively and through inferential statistics. Results: The medical (n=21) and nursing students (n=25) rated the teaching project positively. Across all professional groups, the social context between the students (M=4.6) and the relevance of the topic (M=4.47) were rated very highly. The use of research-based learning (M=3.9) and the final assessment of the training session (M=3.9) were rated as satisfactory. Conclusions: The method of research-based learning proved to be very suitable for interprofessional education, as it enabled situations which encouraged the health professionals to learn from one another, about one another and with one another. Through the interdisciplinary discussion of malnutrition, cooperation skills and initial competences in nutritional management can be cultivated in future doctors and nursing staff even during training.


Assuntos
Educação Médica/métodos , Educação em Enfermagem/métodos , Terapia Nutricional/métodos , Currículo , Humanos , Desnutrição/terapia , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários
10.
Presse Med ; 48(12): 1496-1501, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31757727

RESUMO

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with obesity and insulin resistance. There is currently no pharmacological treatment validated in steatosis. The combination of weight loss and adequate physical activity can improve liver steatosis. In randomized trials and cohort studies, a weight loss of at least 7% and a diet approaching the Mediterranean diet have been associated with an improvement in hepatic fat content, an improvement in hepatic biomarkers, and regression of histological signs of steatosis. Bariatric surgery by losing weight can lead to an improvement in hepatic fat content.


Assuntos
Fígado Gorduroso/dietoterapia , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Terapia Nutricional/métodos , Cirurgia Bariátrica/métodos , Exercício Físico/fisiologia , Fígado Gorduroso/cirurgia , Humanos , Hepatopatia Gordurosa não Alcoólica/cirurgia , Perda de Peso/fisiologia
12.
Rev Col Bras Cir ; 46(4): e2238, 2019 Sep 09.
Artigo em Português, Inglês | MEDLINE | ID: mdl-31508735

RESUMO

OBJECTIVE: to compare the effects of the hydroalcoholic extract from the peel of Camu-Camu, a fruit plant belonging to the Myrtaceae family, widely distributed in the Amazon basin, with those of sleeve gastrectomy, on the weight and glycemia of Wistar rats. METHODS: twenty-four Wistar rats underwent obesity induction through a hyperlipid diet for eight weeks (fat period), and were randomized into three groups: Control Group (CG), Camu-Camu Group (CCG) and Bariatric Surgery Group (BSG). After this period, all animals returned to a normal diet and the intervention period began: CG did not undergo any intervention beyond diet change; CCG animals underwent gavage procedure for administration of Camu-Camu hydroalcoholic extract, 1g/kg/day, for four weeks; and the BSG was submitted to the surgical procedure of sleeve gastrectomy. We followed all animals for four weeks. RESULTS: there was only one loss in BSG due to a gastric fistula. We observed significant variations in the animals' mean weight: the CG evolved with weight gain even after the withdraw of the hypercaloric diet, while the other two groups presented weight reduction. BSG presented a significant reduction of weight and BMI (p<0.05); CCG achieved a significant reduction only of the BMI (p<0.05). There were no statistically significant changes in the glycemic levels. CONCLUSION: in spite of reducing weight, the crude hydroalcoholic extract of the Camu-Camu peel was not able to be as efficient as sleeve gastrectomy in the control of body weight in Wistar rats.


Assuntos
Cirurgia Bariátrica , Myrtaceae/química , Obesidade/dietoterapia , Obesidade/cirurgia , Perda de Peso , Animais , Suplementos Nutricionais , Modelos Animais de Doenças , Frutas/química , Masculino , Terapia Nutricional , Obesidade/etiologia , Ratos , Ratos Wistar
15.
Nutrients ; 11(9)2019 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-31540227

RESUMO

The Diabetes and Nutrition Study Group (DNSG) of the European Association for the Study of Diabetes (EASD) conducted a review of existing systematic reviews and meta-analyses to explain the relationship between different dietary patterns and patient-important cardiometabolic outcomes. To update the clinical practice guidelines for nutrition therapy in the prevention and management of diabetes, we summarize the evidence from these evidence syntheses for the Mediterranean, Dietary Approaches to Stop Hypertension (DASH), Portfolio, Nordic, liquid meal replacement, and vegetarian dietary patterns. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was used to assess the quality of evidence. We summarized the evidence for disease incidence outcomes and risk factor outcomes using risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs), respectively. The Mediterranean diet showed a cardiovascular disease (CVD) incidence (RR: 0.62; 95%CI, 0.50, 0.78), and non-significant CVD mortality (RR: 0.67; 95%CI, 0.45, 1.00) benefit. The DASH dietary pattern improved cardiometabolic risk factors (P < 0.05) and was associated with the decreased incidence of CVD (RR, 0.80; 95%CI, 0.76, 0.85). Vegetarian dietary patterns were associated with improved cardiometabolic risk factors (P < 0.05) and the reduced incidence (0.72; 95%CI: 0.61, 0.85) and mortality (RR, 0.78; 95%CI, 0.69, 0.88) of coronary heart disease. The Portfolio dietary pattern improved cardiometabolic risk factors and reduced estimated 10-year coronary heart disease (CHD) risk by 13% (-1.34% (95%CI, -2.19 to -0.49)). The Nordic dietary pattern was correlated with decreased CVD (0.93 (95%CI, 0.88, 0.99)) and stroke incidence (0.87 (95%CI, 0.77, 0.97)) and, along with liquid meal replacements, improved cardiometabolic risk factors (P < 0.05). The evidence was assessed as low to moderate certainty for most dietary patterns and outcome pairs. Current evidence suggests that the Mediterranean, DASH, Portfolio, Nordic, liquid meal replacement and vegetarian dietary patterns have cardiometabolic advantages in populations inclusive of diabetes.


Assuntos
Diabetes Mellitus/dietoterapia , Dieta , Terapia Nutricional/métodos , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/mortalidade , Doenças Cardiovasculares/prevenção & controle , Complicações do Diabetes/epidemiologia , Complicações do Diabetes/prevenção & controle , Dieta Mediterrânea , Dieta Vegetariana , Abordagens Dietéticas para Conter a Hipertensão , Humanos , MEDLINE , Metanálise como Assunto , Doenças Metabólicas/epidemiologia , Doenças Metabólicas/prevenção & controle , Fatores de Risco , Países Escandinavos e Nórdicos , Revisões Sistemáticas como Assunto
16.
Arch. prev. riesgos labor. (Ed. impr.) ; 22(3): 129-133, jul.-sept. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-186415

RESUMO

Se presenta el caso de un profesor de 47 años, no fumador, con riesgo-cardiovascular (RCV) moderado (2%) según HeartScore: obesidad (Índice-masa-muscular: 32,8 kg/m2); índice cintura-cadera: 1,08, tensión-arterial alta: 150/101mmHg, hipercolesterolemia: 223 mg/dl. La anamnesis-alimentaria inicial (2016) muestra consumo: 2100 kcal/día (distribuidas en 24% proteínas, 45% grasas, 31% carbohidratos) y, potasio (51%) y vitamina-D (42%) bajos; consume 2 bebidas-alcohólicas/semana. El tratamiento dietético consistió en 2500kcal/día (distribuidas en 14% proteína, 32% grasas, 51% carbohidratos) y aumento vitamina-D (10,50 μg/día), basado en directrices de la Guía Europea de Prevención Cardiovascular. Después de 1 año de tratamiento se mostraron cambios favorables: Índice-masa-muscular (30,5 kg/m2), índice cintura-cadera (0,98), tensión-arterial (128/90mmHg) evidenciados por datos bioquímicos y dietéticos. Este artículo presenta aspectos relevantes de una intervención dietético-nutricional individualizada de factores de RCV en el ámbito laboral y destacan las competencias del dietista-nutricionista y la coordinación del Servicio-Prevención-universitario como activos de salud comunitarios, para revertir parámetros de RCV especialmente antropométricos y tensión-arterial


We present the case of a 47 year old nonsmoking university professor with moderate cardiovascular risk (CVR) (2%) according to HeartS-core: obesity (body mass index, 32.8kg/m2); waist-to-hip ratio: 1.08; high blood pressure, 150/101 mmHg; and hypercholesterolemia: 223 mg/dL). The initial food inventory (2016) showed a consumption pattern of 2100 kcal/day (24% proteins, 45% fats, 31% carbohydrates); low intake of potassium (51%) and vitamin-D (42%); consumption of two alcoholic drinks/ per week. Dietary treatment consisted of 2500 kcal/day (distributed as 14% protein, 32% fat, 51% carbohydrates), and increased vitamin D intake (10.50 μg/day), following the European Cardiovascular Prevention Guide. Favorable changes were apparent after one year of treatment: body mass index (30.5kg/m2), waist-to-hip ratio (0.98), blood pressure (128/90mmHg), supported by laboratory and dietary data. This article presents relevant aspects of an individualized nutritional intervention targeting CVR factors in the workplace. It highlights the competencies of the dietitian and the coordination of the university-based occupational health service as community health assets, to revert CVR parameters, especially anthropometric and blood pressure data


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/dietoterapia , Doenças Cardiovasculares/dietoterapia , Doenças Cardiovasculares/prevenção & controle , Terapia Nutricional/métodos , Serviços de Saúde do Trabalhador , Fatores de Risco
17.
Nutrients ; 11(8)2019 Aug 02.
Artigo em Inglês | MEDLINE | ID: mdl-31382527

RESUMO

Personalised nutrition approaches provide healthy eating advice tailored to the nutritional needs of the individual[...].


Assuntos
Terapia Nutricional/métodos , Medicina de Precisão/métodos , Comportamento , Comportamento Alimentar , Humanos , Necessidades Nutricionais
18.
Rev Assoc Med Bras (1992) ; 65(7): 952-958, 2019 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-31389504

RESUMO

PURPOSE: In this prospective observational study, we aimed to investigate the role of the maximum compressed (MC) and uncompressed (UC) thickness of the quadriceps femoris muscle (QFMT) measured by ultrasonography (USG) in the detection of nutritional risk in intensive care patients (ICPs) with different volume status. METHODS: 55 patients were included. Right, left, and total ucQFMT and mcQFMT measurements were obtained by a standard USG device within the first 48 hours after ICU admission. Clinical examination and the USG device were used to determine the volume status of the patients. SOFA, APACHE II, modified NUTRIC scores, and demographic data were collected. RESULTS: There was a significant difference between the nutritional risk of patients in terms of left, right, and total mcQFMT measurements (p=0.025, p=0.039; p=0.028, respectively), mechanical ventilation requirement (p=0.014), presence of infection (p=0.019), and sepsis (p=0.006). There was no significant difference between different volume statuses in terms of mcQFMT measurements. In the multi-variance analysis, mcQFMT measurements were found to be independently associated with high nutritional risk (p=0.019, Exp(B)=0.256, 95%CI=0.082-0.800 for modified NUTRIC score ≥ 5), and higher nutritional risk (p=0.009, Exp(B)=0.144, 95%CI=0.033-0.620 for modified NUTRIC score ≥ 6). a Total mcQFMT value below 1.36 cm was a predictor for higher nutritional risk with 79% sensitivity and 70% specificity (AUC=0.749, p=0.002, likelihood ratio=2.04). CONCLUSION: Ultrasonographic measurement of total mcQFMT can be used as a novel nutritional risk assessment parameter in medical ICPs with different volume statuses. Thus, patients who could benefit from aggressive nutritional therapy can be easily identified in these patient groups.


Assuntos
Estado Nutricional/fisiologia , Músculo Quadríceps/diagnóstico por imagem , Músculo Quadríceps/patologia , Ultrassonografia/métodos , APACHE , Idoso , Idoso de 80 Anos ou mais , Estado Terminal , Feminino , Humanos , Unidades de Terapia Intensiva , Tempo de Internação , Modelos Logísticos , Masculino , Desnutrição/diagnóstico por imagem , Desnutrição/patologia , Desnutrição/fisiopatologia , Pessoa de Meia-Idade , Avaliação Nutricional , Terapia Nutricional/métodos , Estudos Prospectivos , Músculo Quadríceps/fisiopatologia , Valores de Referência , Respiração Artificial/efeitos adversos , Medição de Risco , Sensibilidade e Especificidade
20.
Artigo em Inglês | MEDLINE | ID: mdl-31398932

RESUMO

Obese children are exposed to short and long-term health consequences, such as dyslipidemia, hypertension and diabetes mellitus. For these reasons, the prevention and treatment of obesity in the pediatric population is a challenge for health care professionals. The aim of this study was to evaluate whether an intensive intervention based on diet and physical activity has a better impact on the auxological and biochemical parameters than standard care (intervention). The study included 20 children (six boys, 14 girls), of the mean age 8.9 (SD 1.4) before puberty. The participants were randomly assigned to two groups: Group I (starting treatment with intensive intervention), and II (starting treatment with standard intervention). After three months, the groups were switched. The comparison of the two interventions in the study group indicates a better effectiveness of intensive intervention in the improvement of anthropometric parameters and majority of biochemical ones (except for insulin concentration, HOMA IR index and LDL cholesterol). As the result of intensive intervention, the mean % of weight-to-height excess and hip circumference decreased significantly (p < 0.005). Our results confirm that complex intervention based on systematic control visits, including personalized dietitian counselling and physician care, during the weight reduction process is more effective than a one-off standard visit.


Assuntos
Terapia Comportamental/métodos , Exercício Físico/fisiologia , Terapia Nutricional/métodos , Obesidade Pediátrica/prevenção & controle , Puberdade/fisiologia , Maturidade Sexual/fisiologia , Perda de Peso/fisiologia , Índice de Massa Corporal , Tamanho Corporal , Criança , Feminino , Humanos , Masculino , Polônia
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