High-dose Vitamin C supplementation in the treatment of patients with COVID-19: A systematic review

Introduction: Vitamin C supplementation has been seen as a supportive treatment to control and prevent complications of COVID-19 by enhancing the immune response against infection. However, the effects of high doses of this vitamin are not yet fully understood. Objective: To analyze the effects of high-dose vitamin C in patients with COVID-19. Methods: This was a systematic review, using original studies published from April 2020 to November 2022 in PubMed, ScienceDirect, Scopus and Web of Science databases. The combination of descriptors registered in Medical Subject Headings (MeSH) used to search for articles were: (("vitamin C" OR "ascorbic acid") AND ("COVID-19" OR "SARS-CoV-2" OR "coronavirus")). Original articles of clinical trials conducted with patients diagnosed with COVID-19 and submitted to high-dose vitamin C supplementation were included. Results: Eligible studies included patients in intensive care units, wards, or outpatient clinics, who were given doses of vitamin C, ranging from 6,000 to 8,000 mg/day, with an average duration of 6.25 days of supplementation and mostly intravenous administration. A reduction in fever and myalgia was observed, as well as an improvement in oxygen saturation and lung impairment rate. Conclusion: The role of high-dose vitamin C in patients affected by COVID-19 requires further study, however, to date, the results have been promising for symptom reduction and improvement in lung function and oxygenation.

Introducción: La administración de suplementos de vitamina C se ha considerado un tratamiento de apoyo para controlar y prevenir las complicaciones del COVID-19 al mejorar la respuesta inmunitaria contra la infección. Sin embargo, los efectos de dosis elevadas de esta vitamina aún no se conocen en su totalidad. Objetivo: Analizar los efectos de altas dosis de vitamina C en pacientes con COVID-19. Métodos: Se trata de un estudio de revisión sistemática, utilizando artículos originales publicados desde abril de 2020 hasta noviembre de 2022 en las bases de datos PubMed, ScienceDirect, Scopus y Web of Science. Para la búsqueda de los artículos se utilizó la combinación de descriptores registrados en Medical Subject Headings (MeSH): (("vitamin C" OR "ascorbic acid") AND ("COVID-19" OR "SARS-CoV-2" OR "coronavirus")). Se incluyeron artículos originales de tipo ensayo clínico realizados con pacientes diagnosticados con COVID-19 y sometidos a suplementación con altas dosis de vitamina C. Resultados: Los estudios elegibles se realizaron con pacientes ingresados en unidades de cuidados intensivos, salas o ambulatorios, a los que se administraron dosis de vitamina C que oscilaban entre 6.000 y 8.000 mg/día, con una duración media de 6,25 días de suplementación y vía de administración mayoritariamente intravenosa. Se observó una reducción de la fiebre y las mialgias, además de una mejoría de la saturación de oxígeno y de la tasa de compromiso pulmonar. Conclusión: El papel de las dosis altas de vitamina C en pacientes afectados por COVID-19 requiere más estudios; sin embargo, hasta la fecha, los resultados han sido prometedores en cuanto a la reducción de los sintomas, y la mejora de la función pulmonar y la oxigenación.

IMPACT OF FEAR ON DEMOGRAPHY PROFILE AND EDUCATION TOWARDS THE PURCHASE OF NUTRITIONAL SUPPLEMENTS DURING COVID19 PANDEMIC

Every human being, from birth to death, is inevitably accompanied by the dominant emotion of fear. It starts when we perceive a physical or emotional threat to our life that poses a variety of risks. The customer was structurally exposed to the dread that is present in the possibility of impending infection, per the research findings at the period of "lockdown" (average score = 4.26; standard deviation = 0.865; relative standard deviation = 22.3%). Evidently, all people have a deep-seated dread of COVID-19 infection, which manifests as conscious and unconscious anxieties and phobias that influence purchases, but it can also be a helpful defence mechanism that prevents us from dying before our time. According to respondents, existential insecurity and imbalance are the root causes of fear during a pandemic (average score = 4.57, standard deviation = 1.41, and relative deviation = 21.8%). Additionally, fear was defined for the purposes of this study as an unpleasant, uncomfortable feeling related to a current or potential COVID-19 threat that increases intake in both men and women. Because the specific elements of the threat affect the emotional reaction, the perception of risk and danger, and the consumption of dietary supplements, it is crucial to consider the peculiarities of the threat of coronavirus infection. This is confirmed by the finding that 75% of respondents reported their use of dietary supplements has increased since the pandemic's beginning

Study of influence of anti-dementia drugs and nutritional supplements in elderly patients with mental decline

Background: Malnutrition is a common condition among elderly people with dementia and is associated with low nutrient and calorie intake. There are no data about efficacy of intervention with nutritional supplements in addition to medication in cognitive decline people. Aims and Objectives: we aimed to find out the nutritional status of patients with cognitive decline and to ascertain the effects of nutritional supplements with medication in such patients. Materials and Methods: This observational study was conducted for 12 months. All patients admitted with cognitive decline as per the mini-mental state examination score were included after informed consent. The demographic details, clinical features, treatment given, and response to treatment were noted and tabulated as mean ± and SD and analyzed statistically. Results: Maximum patients were found to be of moderate degree cognitive decline and were at risk of malnutrition. There was significant improvement in cognitive status and behavioral symptoms after 12 months of treatment with nutritional supplements and drugs in our study population. Conclusions: Addition of nutritional supplements to drug therapy does provides significant advantages in cognition and neuropsychiatric symptoms. They did add a lot in rectifying the deficiency of different nutritional parameters and thereby improving the domains such as nutritional functions and activity of daily living.

Avaliação nutricional de pacientes cirúrgicos com câncer gastrointestinal em uso de suplemento alimentar / Nutritional evaluation of surgical patients with gastrointestinal cancer using food supplements

Objetivo: Avaliar a nutrição de pacientes cirúrgicos com neoplasia no trato gastrointestinal em uso de suplemento alimentar. Método: Trata-se de uma revisão sistemática de literatura realizada nas bases de dados Google Scholar, PubMed, Scielo e Web of Science, no período de maio a junho de 2021, sem recorte temporal ou restrição de idioma, através dos descritores: "enteral nutrition e immunenutrition", "cancerpatients e gastriccancerpatients", "preoperative, perioperative e postoperative". Resultados: Foram selecionados 8 estudos, destes, a maioria identificou benefícios na utilização da suplementação em razão da diminuição de células TNF-a, do cortisol e da transferrina, diminuindo o tempo de internação e melhora no estado funcional dos participantes suplementados. Conclusão: Os achados foram positivos, no entanto, houve algumas limitações como a heterogeneidade em abordagens terapêuticas e perda de pacientes durante o estudo, apesar de apresentarem baixo risco de viés, ainda há a necessidade de mais estudos.(AU)

Objective: To evaluate the nutrition of surgical patients with neoplasia in the gastrointestinal tract using food supplements. Method: This is a systematic literature review carried out in Google Scholar, PubMed, Scielo and Web of Science databases, from May to June 2021, without time frame or language restriction, using the descriptors: "enteral nutrition and immunenutrition", "cancerpatients and gastriccancerpatients", "preoperative, perioperative and postoperative". Results: Eight studies were selected, most of which identified benefits in the use of supplementation due to the decrease in TNF-a cells, cortisol and transferrin, reducing the length of hospital stay and improving the functional status of supplemented participants. Conclusion: The findings were positive, however, there were some limitations such as heterogeneity in therapeutic approaches and loss of patients during the study, despite having a low risk of bias, there is still a need for further studies(AU)

Objetivo: Evaluar la nutrición de pacientes quirúrgicos con neoplasia en el tracto gastrointestinal utilizando suplementos alimenticios. Método: Se trata de una revisión sistemática de la literatura realizada en las bases de datos Google Scholar, PubMed, Scielo y Web of Science, de mayo a junio de 2021, sin franja horaria ni restricción de idioma, utilizando los descriptores: "nutrición enteral e inmunonutrición", "pacientes oncológicos y pacientes con cáncer gástrico", "preoperatorio, perioperatorio y postoperatorio". Resultados: Se seleccionaron ocho estudios, la mayoría de los cuales identificaron beneficios en el uso de la suplementación por la disminución de células TNF-a, cortisol y transferrina, reduciendo la estancia hospitalaria y mejorando el estado funcional de los participantes suplementados. Conclusión: Los hallazgos fueron positivos, sin embargo, hubo algunas limitaciones como la heterogeneidad en los enfoques terapéuticos y la pérdida de pacientes durante el estudio, a pesar de tener un bajo riesgo de sesgo, aún existe la necesidad de realizar más estudios(AU)

Avaliação nutricional de pacientes cirúrgicos com câncer gastrointestinal em uso de suplemento alimentar / Evaluación nutritional de pacientes quirúrgicos con cáncer gastrointestinal utilizando complementos alimentarios / Nutritional evaluation of surgical patients with gastrointestinal cancer using food supplements

Objetivo: Avaliar a nutrição de pacientes cirúrgicos com neoplasia no trato gastrointestinal em uso de suplemento alimentar. Método: Trata-se de uma revisão sistemática de literatura realizada nas bases de dados Google Scholar, PubMed, Scielo e Web of Science, no período de maio a junho de 2021, sem recorte temporal ou restrição de idioma, através dos descritores: "enteral nutrition e immunenutrition", "cancerpatients e gastriccancerpatients", "preoperative, perioperative e postoperative". Resultados: Foram selecionados 8 estudos, destes, a maioria identificou benefícios na utilização da suplementação em razão da diminuição de células TNF-a, do cortisol e da transferrina, diminuindo o tempo de internação e melhora no estado funcional dos participantes suplementados. Conclusão: Os achados foram positivos, no entanto, houve algumas limitações como a heterogeneidade em abordagens terapêuticas e perda de pacientes durante o estudo, apesar de apresentarem baixo risco de viés, ainda há a necessidade de mais estudos.(AU)

Objective: To evaluate the nutrition of surgical patients with neoplasia in the gastrointestinal tract using food supplements. Method: This is a systematic literature review carried out in Google Scholar, PubMed, Scielo and Web of Science databases, from May to June 2021, without time frame or language restriction, using the descriptors: "enteral nutrition and immunenutrition", "cancerpatients and gastriccancerpatients", "preoperative, perioperative and postoperative". Results: Eight studies were selected, most of which identified benefits in the use of supplementation due to the decrease in TNF-a cells, cortisol and transferrin, reducing the length of hospital stay and improving the functional status of supplemented participants. Conclusion: The findings were positive, however, there were some limitations such as heterogeneity in therapeutic approaches and loss of patients during the study, despite having a low risk of bias, there is still a need for further studies.(AU)

Objetivo: Evaluar la nutrición de pacientes quirúrgicos con neoplasia en el tracto gastrointestinal utilizando suplementos alimenticios. Método: Se trata de una revisión sistemática de la literatura realizada en las bases de datos Google Scholar, PubMed, Scielo y Web of Science, de mayo a junio de 2021, sin franja horaria ni restricción de idioma, utilizando los descriptores: "nutrición enteral e inmunonutrición", "pacientes oncológicos y pacientes con cáncer gástrico", "preoperatorio, perioperatorio y postoperatorio". Resultados: Se seleccionaron ocho estudios, la mayoría de los cuales identificaron beneficios en el uso de la suplementación por la disminución de células TNF-a, cortisol y transferrina, reduciendo la estancia hospitalaria y mejorando el estado funcional de los participantes suplementados. Conclusión: Los hallazgos fueron positivos, sin embargo, hubo algunas limitaciones como la heterogeneidad en los enfoques terapéuticos y la pérdida de pacientes durante el estudio, a pesar de tener un bajo riesgo de sesgo, aún existe la necesidad de realizar más estudios.(AU)

Application progress on perioperative oral nutritional supplements / 中国实用护理杂志

Patients in the perioperative period are often at risk of malnutrition due to the disease itself, surgical trauma, stress, and fasting. Oral nutritional supplementation is widely used in the perioperative period as the first choice for nutritional therapy. This article summarizes the effects, usage, adverse reactions and coping methods of oral nutritional supplementation during perioperative period, aiming to understand the current status of oral nutritional supplementation in perioperative period, and provide reference for subsequent application research of oral nutritional supplementation in perioperative period.

Copos temáticos na aceitação de suplementos hiperproteicos orais para crianças e adolescentes com câncer / Thematic cups and the acceptance of high-protein oral supplements for children and adolescents with cancer

A intervenção nutricional precoce em crianças com câncer, associada com o uso de suplementos nutricionais hiperproteicos orais (SO), é de extrema importância. Quando se trata de um público infantil, é importante destacar a relevância da apresentação dos utensílios oferecidos nas refeições. A melhor aceitação de SO, quando ofertado em copo temático, pode contribuir para melhora do estado nutricional e melhor prognóstico do tratamento. O objetivo desse estudo foi avaliar a aceitação do suplemento mix artesanal fortificado, sob apresentação de duas formas diferentes: copos descartáveis versus copos temáticos, para crianças e adolescentes em tratamento oncológico. Trata-se de uma pesquisa prospectiva realizada com crianças e adolescente em tratamento oncológico. Na 1a etapa do estudo, os pacientes receberam o suplemento em copos temáticos e na 2a etapa receberam em copo descartável. A aceitação foi avaliada através da escala hedônica e numérica. 44 crianças e adolescentes fizeram uso do copo descartável e 36 do copo temático. A oferta de diferentes copos não interferiu na aceitação do suplemento (p>0,3). Entretanto, a escala numérica apresentou maior média da pontuação na apresentação do copo temático (p<0,005), onde 90% das crianças e adolescentes que aceitaram ≥ 50% relataram "gostei" e "adorei" (p<0,005), obtendo também diferença na pontuação para as variáveis: cor, sabor, textura e odor (p<0,005). Os dados obtidos nesse estudo mostraram que o copo temático não influenciou no aumento do consumo do suplemento, porém reforçou que a apresentação de utensílios temáticos utilizados nas refeições de crianças e adolescentes pode ser uma estratégia benéfica para a diminuição de desnutrição em pacientes com câncer.

Early nutritional intervention in children with cancer, associated with the use of high-protein oral nutrition supplements (OS), is of utmost importance. When it comes to children, it is important to highlight the relevance of the presentation of the utensils offered in the meals. The better acceptance of OS, when offered in a themed cup, can contribute to an improvement in the nutritional status and a better prognosis of the treatment. The objective of this study was to evaluate the acceptance of the fortified artisanal supplement mix, presented in two different ways: disposable cups versus themed cups, for children and adolescents undergoing cancer treatment. This is a prospective study carried out with children and adolescents undergoing cancer treatment. In the 1st stage of the study, the patients received the supplement in themed cups and in the 2nd stage they received the supplement in a disposable cup. Acceptance was assessed using the hedonic and numerical scales. 44 children and adolescents used the disposable cup and 36 the themed cup. The offer of different cups did not interfere with the acceptance of the supplement (p>0.3). However, the numerical scale presented a higher average score in the presentation of the themed cup (p<0.005), where 90% of children and adolescents who accepted ≥ 50% reported "liked" and "loved" (p<0.005), also obtaining a difference. As for the score for the variables: color, taste, texture, and odor (p<0.005). The data obtained in this study showed that the themed cup did not influence the increase in the consumption of the supplement but reinforced that the presentation of thematic utensils used for the meals of children and adolescents can be a beneficial strategy to reduce malnutrition in cancer patients.

Valores de hemoglobina en niños y niñas de 2 a 5 años, que viven a una altura de 3073 m.s.n.m. y consumieron chispitas nutricionales en marzo 2018 / Hemoglobin values in infants 2-5 year olds, who got nutritional supplements chispitas, and live at a height of 3073 meters above sea level, march 2018

La anemia es la disminución de la concentración de la hemoglobina por debajo de los límites inferiores considerados como normales de acuerdo a la edad, sexo y el contexto de la altitud. La prevalencia de Anemia en menores de 5 años en Bolivia, departamento La Paz es de 60,3%, constituyéndose en la principal barrera para lograr el desarrollo social y económico. La presente investigación contribuye al cumplimiento de uno de los Objetivos de Desarrollo Sostenible para la trasformación de nuestro mundo, que es Poner fin al hambre, lograr la seguridad alimentaria y la mejora de la nutrición. OBJETIVO: determinar valores de hemoglobina en niños y niñas de 2 a 5 años, que viven a una altura de 3073 m.s.n.m. que consumieron Chispitas nutricionales en marzo 2018. METODOLOGÍA: fue un estudio cuantitativo, descriptivo de tipo trasversal, con una muestra de 43 entre niños y niñas que cumplieron los criterios de inclusión. MÉTODO: se utilizó el sistema portátil Fotómetro B Hemoglobin HemoCue, para procesar las muestras de sangre capilar y medir los niveles de concentración de hemoglobina. Para determinar el punto de corte de los niveles de hemoglobina a una altura de 3073 m.s.n.m. y se utilizó el factor de corrección para la altura de 1.9 g/dL Se considera 11.5 a 9.5 g/dL anemia leve; 9.5 a 7,5 g/dL anemia moderada y menor a 7,5 g/dL anemia severa. RESULTADOS: en niños y niñas menores de 5 años que viven a una altura de 3073 m.s.n.m. la prevalencia de anemia ferropénica es de 74%, los niveles de hemoglobina se incrementan según la edad (p < 0.05) y no se asocia al consumo de chispitas nutricionales con un (p > 0.05). CONCLUSIONES: los niveles de hemoglobina se incrementan según la edad y no así con el consumo de chispitas nutricionales. También se evidencia el promedio de hemoglobina no ajustada en ambos sexos, con una leve similitud entre los mismos, femenino 12,43 g/dL y masculino 12,46 g/dL; valores muy por debajo de umbrales óptimos para definir anemia a gran altitud.

The anemy is the decrease of hemoglobine under the normal limits considered healthy acording to the age, gender and the sea level context. The prevalence of the anemia in children under 5 years in La Paz department in Bolivia is 60,3%, so, it is one of the main impediments to achieve the social and economic development. This research contributes to achieve one of the world's substantiable development objectives, which is to end hunger, to achieve the food security and improve nutrition. OBJECTIVE: to determine the values of hemoglobin in infants 2-5 years old who got nutritional supplements chispitas, and lived in a height of 3073 meters above sea level, March 2018. METODOLOGY: it was a quantitative descriptive cross sectional research, a sample of 43 infants who had all the requirements to the research. METHOD: it was used the photometric system B Hemoglobin HemoCue to process and to determine the hemoglobin levels of the capillary blood samples. At a height of 3073 meters above sea level, the cut-off point of hemoglobin with a cross-correlation figure of 1.9 is the following: from 11.5 to 9.5mg/dL mild anemia, from 9.5 to 7,5 mg/dL moderate anemia and less of 7,5mg/dL severe anemia. RESULTS: in infants under 5 year olds who lived at 3073 meters over sea level, the prevalence of iron deficiency anemia is 74%, the hemoglobin levels increases according to the age (p< 0,05) and not to the use of the nutritional supplements Chispitas (p > 0,05). CONCLUSIONS: the hemoglobin levels increase according to age and not to the use of nutritional supplements Chispitas. The average hemoglobin in both sexes is also evidenced, slightly similar between them, female 12.43 g/dL and male 12.46 g/dL; values below normal limits considered healthy in order to define anemia at high altitude.

Can oral nutritional supplements increase energy and protein intake among hospitalized patients? / ¿Los suplementos nutricionales orales pueden aumentar la energía y la proteína en pacientes hospitalizados?

ABSTRACT Background: Oral nutritional supplements aim at offsetting dietary deficits and helping to meet energy and protein targets. Due to the absence of data about their role in food intake, it is necessary to evaluate the contribution of these products to the estimated needs of hospitalized patients. Methods: This is a prospective longitudinal study with hospitalized patients over 18 years of age, admitted to a public university hospital, who were given oral nutritional supplements, according to clinical guidelines. Food intake was quantified throughout the period such products were prescribed. Results: 805-day food intake follow-up and record of 128 patients, who took supplements for 6.4 days on average. The use of nutritional supplements demonstrated a significant contribution to the input of both energy (1576 kcal/day versus 1263 kcal/day, p<0.001) and protein (68.7 g/day versus 50.3 g/day, p<0.001). Conclusions: Nutritional supplements help increase food intake and achieve nutritional goals when prescribed in a hospital setting.

RESUMEN Antecedentes: los suplementos nutricionales orales tienen como objetivo compensar los déficits dietéticos y ayudar a cumplir los objetivos de energía y proteínas. Debido a la ausencia de datos sobre su papel en la ingesta de alimentos, es necesario evaluar la contribución de estos productos a las necesidades estimadas de los pacientes hospitalizados. Métodos: Este es un estudio longitudinal prospectivo con pacientes hospitalizados mayores de 18 años, ingresados en un hospital universitario público, que recibieron suplementos nutricionales orales, según la derivación clínica. La ingesta de alimentos se cuantificó durante todo el período en que se prescribieron dichos productos. Resultados: seguimiento de la ingesta alimentaria de 805 días y registro de 128 pacientes, que tomaron suplementos durante 6,4 días en promedio. El uso de suplementos nutricionales demostró una contribución significativa al aporte de energía (1576 kcal/día versus 1263 kcal/día, p< 0,001) y proteína (68,7 g/día versus 50,3 g/día, p<0,001). Conclusiones: los suplementos nutricionales ayudan a aumentar la ingesta de alimentos y alcanzar objetivos nutricionales cuando se prescriben en un entorno hospitalario.

Biochemical and liver histological changes in rats exposed to sub-lethal dose of Uproot-pesticide and the protective potentials of nutritional supplements

This study determined the therapeutic potentials of vitamin C, glutathione, and garlic on the hepatic andhistological changes induced by uproot-pesticide on albino Wistar rats. All animal groups (except normalcontrol) received intraperitoneally 50 mg/kg body weight of uproot-pesticide (a commercially formulatedglyphosate-based herbicide) on alternate days and daily oral administration (except Uproot control) of 20 mg/kg body weight of glutathione, vitamin C, and garlic as nutritional supplements singly and in combination for28 days. Liver function and oxidative stress parameters of the liver were determined using blood and liversamples. Histological studies were done on the liver tissue. The values obtained showed significant variationof measured parameters in Uproot control compared to groups administered nutritional supplements and thecontrol. These variations indicated oxidative liver damage and significant therapeutic potential of the nutritionalsupplements. Other observed significant and non-significant changes were discussed.

Consumption of nutritional supplements among the residents aged eighteen years and below in Tongzhou District / 预防医学

Objective@#To understand the consumption of nutritional supplements among the residents aged eighteen years and below in Tongzhou District of Beijing,so as to provide reference for supplements exposure assessment and health education.@* Methods@# A hundred people aged 18 years and below were selected from each of the eight neighborhood committees of Tongzhou Town,Tongzhou District,Beijing. The questionnaire for the Nutritional Supplements Guidelines for Chinese Residents Study was used to collect the rate of taking nutritional supplements,influencing factors,types and frequency. @*Results@#The rate of taking nutritional supplements was 44.16%. The rates of taking nutritional supplements in people aged 0-5 years,6-12 years and 13-18 years were 45.56%,42.86% and 41.00%,respectively,without statistically significant difference among them （P>0.05）. The rates of taking nutritional supplements in males and females were 44.82% and 43.49%,without statistically significant difference between them （P>0.05）. The Results of multivariate logistic regression analysis showed that annual per capita household income of more than 50 000 yuan （OR=1.688,95%CI: 1.171-2.435） and parents taking nutritional supplements （OR=4.104,95%CI: 3.023-5.573） were the promoting factors for the intake of nutritional supplements in people aged 18 years and below. The rates of taking calcium,vitamin D and multivitamin were 26.10%,21.56% and 8.31%,respectively. There were 272 （80.00%） people taking 1-2 kinds of supplements,and 200 （58.82%） people taking them daily. @*Conclusions@#In Tongzhou District,44.16% of the population aged 18 years and below takes nutritional supplements,mainly calcium and vitamin D. Family income and whether their parents taking or not are determinants.

Dietary supplements in fitness centers: body management and health risks / Suplementos alimentares em academias de ginástica: gerenciamentos do corpo e riscos à saúde

ABSTRACT The purpose of this study was to explore the meanings of supplement use among those who engage in physical activity in fitness centers. A qualitative study was carried out based on 67 questionnaires answered on the internet by practitioners of physical training. There was also an observation of the groups in the Facebook, the dynamic and other aspects such as discussions, messages, profiles and images. It was detected that physical activity practitioners care more about the quantity of substances ingested than any other factor that may lead them to suffer certain health risks. They believe that so-called "excesses" may cause diseases to the internal organs. Although the participants believe that their own consumption of supplements does not compromise their health, a biomedical authority is crucial for them to recognize whether or not they are at risk. The consumption of supplements can vary depending on what is understood to be excessive and which risks may compromise the body. There are many motivations for managing these substances. Health risks should not be analyzed solely from a biomedical perspective, but also addressed by the socio-cultural logic of the perceptions and meanings attributed by the subjects to the body and the management thereof.

RESUMO O objetivo deste estudo foi explorar os significados do uso de suplementos entre aqueles que praticam atividade física em academias de ginástica. Um estudo qualitativo foi realizado com base em 67 questionários respondidos na internet por praticantes de atividade física. Houve também uma observação dos grupos na Facebook, a dinâmica e outros aspectos como discussões, mensagens, perfis e imagens. Foi detectado que os praticantes de atividade física se importam mais com a quantidade de substâncias ingeridas do que com qualquer outro fator que possa levá-los a sofrer certos riscos à saúde. Eles acreditam que os chamados "excessos" podem causar doenças aos órgãos internos. Embora os participantes acreditem que seu próprio consumo de suplementos não compromete a saúde, a autoridade biomédica é crucial para que eles reconheçam se estão ou não em risco. O consumo de suplementos pode variar dependendo do que se entende ser excessivo e quais os riscos que podem comprometer o corpo. Existem muitas motivações para gerenciar essas substâncias. Os riscos para a saúde não devem ser analisados apenas a partir de uma perspectiva biomédica, mas também abordados pela lógica sociocultural das percepções e significados atribuídos pelos sujeitos ao corpo e ao seu gerenciamento.

Tratamiento nutricional en úlceras por presión y úlceras venosas / Nutritional treatment in pressure and venous ulcers

RESUMEN Las úlceras por presión (UPP) y úlceras venosas (UV) son frecuentes en adultos y adultos mayores. En Chile un 70% de las heridas crónicas corresponden a UV y la prevalencia de UPP en pacientes hospitalizados es de 28%. El objetivo de esta revisión es analizar la evidencia disponible respecto al tratamiento nutricional de individuos con UPP y UV. Estas úlceras tienen diferentes etiologías, pero ambas provocan un aumento de requerimientos energéticos, proteicos y de micronutrientes. La cicatrización de heridas depende de varios factores como: el tipo de úlcera, estado nutricional, patologías presentes, el tipo de curación y el tratamiento médico. La terapia nutricional establece en la mantención o aumento de peso de estos pacientes, administración adecuada de proteínas y suplementación de energía, proteínas o micronutrientes cuando se presente déficit.

ABSTRACT Pressure and venous ulcers are common in adults and the elderly. In Chile, 70% of chronic wounds correspond to venous ulcers and the prevalence of pressure ulcers in hospitalized patients is 28%. The aim of this review was to analyze the available evidence regarding the nutritional treatment of individuals with pressure and venous ulcers. These ulcers have different etiologies, but both produce an increase in energy, protein, and micronutrient requirements. The healing of wounds depends on several factors such as the type of ulcer, nutritional status, current co-morbidities, healing type and medical treatment. Nutritional therapy should be based on weight maintenance or gain of these patients, adequate administration of proteins and energy supplementation, or protein or micronutrients when a deficiency occurs.

Efect of vitamin A suplementation: a systematic review / Efeito da suplementação de vitamina A: uma revisão sistemática

Abstract To evaluate the effect of vitamin A supplementation in postpartum infants and women on serum retinol levels and breast milk. The databases Medline, PubMed, Lilacs and SciELO were consulted. The descriptors used were vitamin A, dietary supplement, child, postpartum period, infant and nutrition programs policies. Search found 7432 articles. After elimination of duplicity and application of eligibility criteria, 8 studies remained. All evaluated the effect of vitamin A supplementation on immediate postpartum, five studies used retinyl palmitate supplementation, one with retinyl palmitate and two did not specify the form of supplementation. Six studies evaluated colostrum and two included supplementation of children. It was found that supplementation in the puerperium increases the concentrations of serum retinol and breast milk, however, this result was in the short term and was relevant when the previous concentrations of the mother were low. When maternal serum concentrations are adequate, the retinol content in milk does not change, with little relevance for children. Further studies should be performed to evaluate the effect of megadoses supplementation on serum concentrations of children.

Resumo Avaliar o efeito da suplementação de vitamina A, em lactentes e mulheres no pós-parto, nos níveis de retinol sérico e no leite materno. Foram consultadas as bases de dados Medline, PubMed, Lilacs e SciELO. Os descritores utilizados foram: vitamin A, dietary supplement, child, postpartum period, infant e nutrition programs policies. A busca identificou 7432 artigos. Após eliminação da duplicidade e aplicação dos critérios de elegibilidade permaneceram 8 estudos. Todos avaliaram o efeito da suplementação de vitamina A no pós parto imediato, cinco estudos utilizaram a suplementação com retinil palmitato, um com palmitato de retinila e dois não especificaram a forma de suplementação. Seis estudos avaliaram o colostro e dois incluíram a suplementação de crianças. Encontrou-se que a suplementação no puerpério aumenta as concentrações de retinol sérico e do leite materno, no entanto, este resultado foi a curto prazo e foi relevante quando as concentrações prévias da mãe eram baixas. Quando as concentrações séricas maternas encontram-se adequadas, pouco se altera o teor de retinol no leite, tendo pouco relevância para as crianças. Mais estudos devem ser realizados para avaliar o efeito da suplementação com megadoses nas concentrações séricas de crianças.

Biofloc production in activated sludge system treating shrimp farming effluent / Produção de bioflocos em sistema de lodos ativados tratando efluente de carcinicultura

ABSTRACT The release of wastewater and the shrimp feed cost are the main challenges faced by the shrimp farming industry. An alternative solution to both problems is biofloc production in a unit external to the farm, in an activated sludge system for effluent treatment. The treatment system's influent was composed of the shrimp farm wastewater supplemented with urea and sugarcane molasses. The results show that the average removal of chemical oxygen demand was 71% and the average biofloc production in the reactor was approximately 1.5g.L-1. Adding molasses to the influent contributed to the increase in the quantity and diversity of existing microorganisms that are beneficial to cultured shrimp. The mass balance of nitrogen compounds confirmed that nitrification occurred in the system. Therefore, the use of the activated sludge system is a viable and environmentally suitable alternative to produce bioflocs and shrimp farming effluent treatment.

RESUMO A geração de efluentes e o custo com a alimentação do camarão são os principais desafios enfrentados pela carcinicultura. Uma solução conjunta para ambos os problemas é a produção de bioflocos em um sistema de lodo ativado para tratamento de efluentes. Neste trabalho, o afluente ao sistema estudado era composto pelas águas residuais do cultivo de camarão suplementadas com ureia e melaço de cana-de-açúcar. Os resultados mostraram que a remoção média de demanda química de oxigênio foi de 71% e a produção média de bioflocos no reator foi de aproximadamente 1,5 g.L-1. A adição de melaço ao afluente contribuiu para o aumento da quantidade e da diversidade de microrganismos benéficos para a produção de camarão. Houve remoção de amônia e nitrificação confirmada pelo balanço de massa. Portanto, a utilização do sistema de lodos ativados é uma alternativa viável e ambientalmente adequada para produzir bioflocos e tratar efluentes de cultivo de camarão.

Nutritional management for Alzheimer ' s disease in all stages: mild, moderate, and severe

Alzheimer's disease corresponds to 50­70% of all dementia syndromes, classified as a progressive neurodegenerative disease showing diffuse cortical atrophy with three stages of evolution: mild, moderate, and severe. Behavioral symptoms and memory loss are major manifestations of the disease. Non-pharmacological interventions are essential to improve the quality of life of these patients. Interdisciplinary assistance is essential throughout the disease course. Regarding nutrition for patients with Alzheimer's disease, weight loss and behavioral changes related to food are major objects of scientific study, as they trigger deterioration of the quality of life of patients and caregivers. Knowing which nutritional guidelines should be used helps in clinical decisions. The study of nutrition in dementia is, therefore, critical for patient management.

Suplementos nutricionales como modificadores de morbimortalidad en pacientes con cáncer / Nutritional supplements as modifiers of morbidity and mortality in cancer patients

La caquexia, un síndrome multifactorial caracterizado por la pérdida de masa muscular con o sin pérdida de tejido adiposo que no puede ser revertido con soporte nutricional convencional, es frecuente en pacientes con enfermedades crónicas como cáncer, en quienes empeora notablemente su estado de salud. El objetivo de esta revisión fue estudiar el impacto que tienen los suplementos nutricionales en la morbimortalidad de los pacientes con caquexia secundaria a cáncer. Se realizó una búsqueda de literatura en las bases de datos Embase y Medline (Pubmed), sobre los suplementos y desenlaces clínicos en pacientes con caquexia secundaria a cáncer. Se excluyeron revisiones de literatura no sistemáticas, y aquellos que se centraran en otros desenlaces. Se seleccionaron 42 artículos, y se revisó su versión en texto completo. Se encontró que los ácidos grasos poliinsaturados aumentan el peso corporal; los antioxidantes podrían reducir la progresión del cáncer; selenio, zinc, hierro y cobre mejorarían el sistema inmunológico; y las proteínas y suplementos calóricos podrían reducir la lipólisis y proteólisis. Dentro de las limitaciones del estudio se encuentra la referencia a múltiples tipos de cáncer, con diferencias significativas en el tratamiento y el pronóstico de los pacientes. Se concluye que el soporte con suplementos nutricionales que contengan ácidos grasos poliinsaturados (EPA y DHA), micronutrientes (Fe, Cu, Zn, Se, vitamina E y C) y aminoácidos (l-arginina, l-glutamina, y b hidrometilbutirato), puede mejorar la morbimortalidad y por lo tanto la calidad de vida en pacientes con caquexia secundaria a cáncer(AU)

Cachexia, a multifactorial syndrome characterized by the loss of skeletal muscle mass with or without loss of fat mass that cannot be reversed by conventional nutrition support, is frequently present in patients with chronic diseases such as cancer, in whom the health status deteriorates markedly. The objective of this review was to study the impact of nutritional supplements on morbidity and mortality of patients with cachexia secondary to cancer. A literature search was conducted (Embase and Medline-Pubmed) looking for references that described associations between supplements and morbidity or mortality in patients with cachexia secondary to cancer. Non-systematic literature reviews, or studies with other non-clinical outcomes were excluded. A total of 42 articles were selected, and their full text version reviewed. We found that polyunsaturated fatty acids increase body weight; antioxidants reduce cancer progression; selenium, zinc, iron and copper improve the immune system and proteins and caloric supplements prevent lipolysis and proteolysis. Within the limitations of the study is the reference to multiple types of cancer, which in themselves present significant differences in treatment and prognosis of patients. As a conclusion, nutritional support with nutritional supplements containing polyunsaturated fatty acids (EPA-DHA), micronutrients (Zn, Se, Cu, Fe, vitamins C and E) and amino acids (l-arginine, l-glutamine and b hidroxymethylbutyrate), can improve morbimortality and therefore quality of life in patients with cachexia secondary to cancer(AU)

Nutritional aspects and the use of nutritional supplements by women who underwent gastric bypass / Aspectos nutricionais e o uso de suplementos alimentares em mulheres submetidas ao bypass gástrico

ABSTRACT Background: Bariatric surgery is deemed one of the most effective procedures for the treatment of obesity and it aims at the reduction and maintenance of weight loss in long term, as the control of the related comorbidities. Aim: Quantify the occurrence of alterations of the gastrointestinal tract, suggestive signs of nutritional deficiencies and the use of supplements in a group of women undergoing bariatric surgery. Methods: The sample consisted of women aged 20-65 years submitted to Roux-en-Y gastric bypass with monitoring equal to or higher than 24 months. For the qualitative analysis, the Feeding Frequency Questionnaire was used. Results: In the postoperative period, alopecia was the most reported (79.3%), followed by changes in the texture of the nails, both considered predictive of nutritional deficiencies. Changes in the gastrointestinal tract were described in 86.2%, and episodes of dumping were reported in 65.5%. Qualitative analysis has shown reduced daily consumption of sources of animal and plant proteins. Conclusion: After bariatric surgery can occur flatulence, vomiting and dumping syndrome as the most frequent representative symptoms of digestive functional disorders. Alopecia and nail changes are the most important signs of nutritional deficiency. The use of dietary supplements in the postoperative period is scarce and sporadic.

RESUMO Racional: A cirurgia bariátrica é considerada um dos procedimentos mais eficazes para tratamento da obesidade e objetiva a redução e manutenção da perda de peso em longo prazo, assim como, o controle das comorbidades associadas. Objetivo: Quantificar a ocorrência de alterações funcionais do trato gastrointestinal, sinais sugestivos de carências nutricionais e o uso de suplementos em um grupo de mulheres submetidas à cirurgia bariátrica. Métodos: A amostra foi constituída por mulheres com idades entre 20-65 anos submetidas ao bypass gástrico em Y-de-Roux com seguimento igual ou superior a 24 meses. Para análise qualitativa foi utilizado o Questionário de Frequência Alimentar. Resultados: No período pós-operatório a alopecia foi a mais relatada (79,3%), seguida de alteração na textura das unhas, ambas consideradas preditivos de carências nutricionais. As alterações do trato gastrointestinal foram descritas por 86,2%, e os episódios de dumping foram relatados em 65,5%. Na análise qualitativa foi observado consumo diário reduzido de fontes de proteínas animal e vegetal. Conclusão: Após a cirurgia bariátrica pode ocorrer flatulência, vômitos e síndrome de dumping como sintomas representativos mais frequentes das alterações funcionais digestivas. Alopecia e alterações ungueais são os sinais mais relevantes de carência nutricional. O uso de suplementos alimentares no pós-operatório é escasso e esporádico.

Knowledge and Attitude Related to Nutritional Supplements and Risk of Doping among National Elite Athletes in Malaysia

Introduction: Often considered a legitimate strategy to enhance health and performance, the consumption of nutritional supplements (NS) has become a common practice which frequently results in unintentional doping among athletes. Despite a probable association between NS and doping, there are limited studies on this topic in developing countries such as Malaysia. Thus, this study aimed to identify the prevalence of NS usage among national elite athletes and assess their knowledge and attitude regarding its use and doping. Methods: This was a cross-sectional study conducted at the Malaysian National Sports Institute among national elite athletes (n=50) recruited via convenience sampling. The athletes completed a self-administered questionnaire documenting their demographic characteristics, training information, NS consumption, knowledge and attitude related to supplement-doping. The total knowledge and attitude scores were compared according to demography, training information, and NS consumption. Results: The prevalence of NS use among the athletes was 72%. NS usage was significantly associated with training duration (p=0.029), source of nutrition information (p=0.047) and self-exploration on supplements (p=0.045). Supplement-doping knowledge was significantly higher among athletes with tertiary level education (p=0.027), NS users (p=0.044), those obtaining information from nutritionists (p=0.048) and those who had attended nutrition workshops (p<0.001). The attitude score was significantly higher among males (p=0.021), professional athletes (p=0.041), athletes with lower training hours (p=0.010), those obtaining information from nutritionists (p=0.035) and those who had attended nutrition workshops (p=0.005). Conclusion: A demographic- and training-specific education on NS should be provided by qualified nutritionists to reduce the risk of doping amongst athletes.

Clinical study on nutriti0nal interventi0n in patients with Alzheimer(s) disease / 肠外与肠内营养

Objective:To explore the effects of nutritional intervention on the nutritional status,cognitive function and activities of daily living (ADL) in patients with Alzheimer's Disease (AD).Methods:90 AD patients were randomly divided into the control group and the intervention group,with 45 cases in each group.Patients in the control group received anti-dementia drugs,and patients in the intervention group additionally received TPF-T as the oral nutritional supplement.The nutritional status and nutritional biochemical indicators,cognitive function and ADL of two groups were evaluated when enrolled and 6 months later after the treatment.Results:After 6 months'treatment,the nutritional status,MMSE,ADL scores and nutritional indicators of patients in the intervention group were significantly improved compared to the control group (P ＜ 0.05).Conclusion:Nutritional intervention can effectively improve the nutritional status,cognitive function and ADL of patients with dementia.