Iron, calcium and phosphorus mineral profile in chronic renal patients on hemodialysis

The main goal of this study was to verify the association between serum and dietary concentrations of calcium, phosphorus and iron, and to determinate whether patients with kidney disease undergoing hemodialysis had inadequacy in dietary intake. We conducted a descriptive cross-sectional study that evaluated 40 patients undergoing hemodialysis. Food consumption was determined by the 24-hour recall. The optical technology method was used to obtain hemoglobin and hematocrit concentrations. Serum levels of iron, calcium and phosphorus were determined by dry chemistry. We observed insufficient consumption of energy, macronutrients and minerals. Energy intake of patients with longer hemodialysis was higher. The sample presented hypocalcemia, hyperphosphatemia (except in the group ≥8 years of hemodialysis), higher iron concentrations and lower hemoglobin and hematocrit values. The serum levels of minerals were not affected by dietary intake. There was a significant correlation between dietary phosphorus and calcium in patients undergoing hemodialysis for more than 8 years, those over 60 years old and, between calcium and phosphorus normal levels in patients over 60 years old. Hemoglobin, hematocrit and mineral serum levels were similar regardless of age and hemodialysis time. It was concluded that inadequacies of minerals reflected deregulation among metabolism and the pathophysiological changes inherent to Chronic Kidney Disease.

El objetivo principal de este estudio fue verificar la asociación entre las concentraciones séricas y dietéticas de calcio, fósforo y hierro, y determinar su ingesta dietética inadecuada en pacientes con enfermedad renal sometidos a hemodiálisis. Se trató de un estudio descriptivo transversal que evaluó a 40 pacientes en hemodiálisis. El consumo de alimentos se determinó mediante el recordatorio de 24 horas. Se utilizó el método de tecnología óptica para obtener concentraciones de hemoglobina y hematocrito. Los niveles séricos de hierro, calcio y fósforo se determinaron mediante química seca. El estudio mostró un consumo insuficiente de energía, macronutrientes y minerales. La ingesta energética de los pacientes con hemodiálisis más prolongada fue mayor. La muestra presentó hipocalcemia, hiperfosfatemia (excepto en el grupo ≥8 años de hemodiálisis), mayor concentración de hierro y menores valores de hemoglobina y hematocrito. Los niveles séricos de minerales no se vieron afectados por su ingesta dietética. Hubo una correlación significativa entre el fósforo dietético y el calcio en los pacientes en hemodiálisis durante más de 8 años y los mayores de 60 años y, también, entre los niveles normales de calcio y fósforo en los pacientes mayores de 60 años. Los niveles séricos de hemoglobina, hematocrito y minerales fueron similares independientemente de la edad y el tiempo de hemodiálisis. Se concluyó que las deficiencias de los minerales parecen reflejarse en la desregulación de su metabolismo y los cambios fisiopatológicos inherentes a la Enfermedad Renal Crónica.

Protein intake and its influence on the lipid and anthropometric profiles of patients with chronic kidney disease

ABSTRACT Introduction: Recent studies highlight Chronic Kidney Disease (CKD) as responsible for severe damage to clinical-nutritional status and for changes in the lipid profile of its patients, which, together, contribute to the increase in deaths and hospitalization time for these patients. Therefore, this study aimed to determine the protein intake and its association with the lipid and anthropometric profile of chronic renal patients. Methods: Data came from a cross-sectional survey conducted with 95 patients with CKD on dialysis treated at Renal Therapy Centers in the State of Piauí. Anthropometric variables were determined. Protein consumption was obtained by applying two 24hr dietary recalls. Lipid fractions were determined according to the calorimetric enzymatic method and specific calculations. Data were analyzed with Stata®, v.12 software (Statacorp, College Station, Texas, USA), with significance level set at p<0.05. The research received ethical approval, nº 2.527.329. Results: The final sample consisted of 95 patients, with a predominance of male participants (67.4%) and the average age of the total population was 40.8±10.7 years. There was no association between protein consumption and anthropometric variables. However, there was a significant, but negative, correlation between protein intake and total cholesterol concentrations (p= 0.017) and LDL-c (p= 0.025). Conclusion: The mean protein intake identified, 1.30±0.83 g/kg/day, despite meeting the recommendation for chronic renal patients did not appear to influence the anthropometric status, but had significant effects on specific lipid parameters of patients with CKD of this study.

RESUMEN Introducción: Estudios recientes destacan a la enfermedad renal crónica (ERC) como responsable del daño severo en el estado clínico-nutricional y de cambios en el perfil lipídico de sus pacientes, que, en conjunto, contribuyen al aumento del tiempo de hospitalización y mortalidad de estos pacientes. Por tanto, este estudio tuvo como objetivo determinar la ingesta proteica y su asociación con el perfil lipídico y antropométrico de pacientes renales crónicos. Métodos: Se analizaron los datos de la encuesta transversal realizada a 95 pacientes con ERC en diálisis tratados en Centros de Terapia Renal del Estado de Piauí. Se determinaron variables antropométricas. El consumo de proteínas se obtuvo aplicando dos encuestas de alimentación 24HR. Las fracciones lipídicas se determinaron según el método enzimático calorimétrico y cálculos específicos. Los datos se analizaron en Software Stata 12, y se adoptaron como nivel de significancia p<0.05. La investigación recibió la aprobación ética, bajo la opinión del número 2.527.329. Resultados: La muestra final estuvo conformada por 95 pacientes, con predominio de varones (67,4%) y la edad promedio de la población total fue de 40,8±10,7 años. No hubo asociación entre el consumo de proteínas y las variables antropométricas de los pacientes. Sin embargo, hubo una correlación significativa, pero negativa, entre la ingesta de proteínas y las concentraciones de CT (p= 0.017) y LDL-c (p= 0.025). Conclusión: Se concluyó que la ingesta media de proteínas identificada, 1,30±0,83 g/kg/día, a pesar de cumplir con la recomendación para pacientes renales crónicos, no pareció influir en el estado antropométrico, pero tuvo efectos significativos sobre parámetros lipídicos específicos de pacientes con ERC de este estudio.

Crianças e adolescentes que consomem alimentos ultraprocessados possuem pior perfil lipídico? Uma revisão sistemática / Do children and adolescents who consume ultra-processed foods have a worse lipid profile? A systematic review

Resumo O aumento da participação de alimentos ultraprocessados na alimentação de crianças e adolescentes está relacionado ao desenvolvimento de agravos não transmissíveis, como dislipidemia. Objetivou-se realizar uma revisão sistemática da literatura sobre a relação do consumo de alimentos ultraprocessados e o perfil lipídico de crianças e adolescentes. Realizou-se uma busca nas bases de dados PubMed, Scopus, Cochrane e LILACS por estudos com desenhos transversais e longitudinais, com ou sem intervenção; em crianças e/ou adolescentes aparentemente saudáveis, que tivessem a ingestão de alimento ultraprocessado como variável de exposição e o perfil lipídico como desfecho. Após triagem, 14 estudos foram incluídos, destes, nove demonstraram que o consumo de ultraprocessados estava relacionado com o aumento do LDL-c, colesterol total, triglicerídeos e diminuição do HDL-c. Três estudos não encontraram nenhuma relação e dois demonstraram que a maior ingestão de cereais prontos estava relacionada com a diminuição de colesterol total e LDL-c. Observou-se elevado consumo de alimentos ultraprocessados e relação positiva com lipídios sanguíneos em crianças e adolescentes o que chama atenção para a realização de intervenções, como educação nutricional, com vistas a reduzir a ingestão desses alimentos.

Abstract The increase in the input of ultra-processed ingredients in the food of children and adolescents is related to the development of noncommunicable diseases such as dyslipidemia. The scope of this study was to conduct a systematic review of the literature on the relationship of consumption of ultra-processed foods in the lipid profile of children and adolescents. A search in the PubMed, Scopus, Cochrane and LILACS databases was carried out to locate cross-sectional and longitudinal studies, with or without intervention, in apparently healthy children and/or adolescents, who had the intake of ultra-processed food as an exposure variable and the lipid profile as an outcome. After screening, 14 studies were included, of which nine demonstrated that ultra-processed food consumption was related to increased LDL-c, total cholesterol, triglycerides and a reduction in HDL-c. Three studies found no relationship and two demonstrated that the increased intake of ready-to-eat cereals was related to the decrease in total cholesterol and LDL-c. There was a high consumption of ultra-processed foods and positive relation with blood lipids among children and adolescents, which calls attention to interventions, such as nutritional education, with a view to reducing the intake of these foods.

Associations between taste sensitivity, preference for sweet and salty flavours, and nutritional status of adolescents from public schools / Associação entre sensibilidade gustativa, preferência aos sabores doce e salgado e estado nutricional de adolescentes

ABSTRACT Objective This study aimed to investigate the associations between taste sensitivity, preference for sweet and salty flavours, and nutritional status of adolescents in public schools. Methods We used a cross-sectional study involving 1,036 adolescents of both sexes, aged 10-19 years. Preference for sweet or salty flavours and preference for foods high in sugar or sodium were evaluated. Measurements of body mass index and taste flavour intensity recognition were conducted. Results Most participants were unable to identify the flavours and/or intensities, and only 18.0% of participants were able to correctly identify both the flavour and intensity of the samples. Most participants (82.1%) preferring sweet foods had low sensitivity to this taste, just as a large proportion of individuals preferring saltiness (82.3%) were less sensitive to salt (p<0.001). Preference for saltiness was associated with pre-obesity. Conclusion We found an association between a preference for sweet or salty flavours and nutritional status, highlighting the importance of poor food choices in the development of obesity and other chronic diseases.

RESUMO Objetivo Este estudo teve como objetivo investigar a associação entre a sensibilidade gustativa, a preferência pelos sabores doce e salgado e o estado nutricional de adolescentes em escolas públicas. Métodos Estudo de natureza transversal, envolvendo 1.036 adolescentes de ambos os sexos, com idade entre 10 e 19 anos. A preferência pelos sabores doce e salgado e por alimentos ricos em açúcar ou sódio foi avaliada. Medidas do índice de massa corporal e testes de reconhecimento de gosto-intensidade foram conduzidos. Resultados A maioria dos participantes foi incapaz de identificar os sabores e/ou intensidades e somente 18,0% dos participantes foram capazes de identificar corretamente o sabor e intensidade das amostras. A maioria dos participantes (82,1%) preferiram alimentos doces e tiveram baixa sensibilidade a esse gosto, bem como uma grande proporção de indivíduos que preferem salgado (82,3%) eram menos sensíveis ao sal (p<0,001). A preferência pelo gosto salgado foi associada com excesso de peso. Conclusão Foi encontrada uma associação entre a preferência pelos sabores doce e salgado e o estado nutricional, destacando a importância de escolhas alimentares pobres no desenvolvimento de obesidade e outras doenças crônicas.