Efeitos do ômega 3 na prevenção e tratamento da doença de Alzheimer / Effects of omega 3 in prevention and treatment of Alzheimer's disease

A doença de Alzheimer constitui o principal tipo de demência existente, sendo uma doença crônica neurodegenerativa decorrente de danos nas células do sistema nervoso, constituindo um distúrbio por deficiência progressiva de memória, linguagem, raciocínio e outras funções cognitivas. Na nutrição, diversos nutrientes específicos e seus efeitos vêm sendo estudados na Doença de Alzheimer, incluindo os ácidos graxos ômega 3. O objetivo deste estudo foi revisar sistematicamente a literatura, sobre os efeitos do ômega 3 na prevenção e tratamento do Alzheimer. Para a busca dos artigos da presente revisão, foi utilizado a base de dados Medline, por meio do PubMed. A princípio, foram encontrados 669 artigos, dos quais foram selecionados 11 após o processo de seleção. Os resultados mostraram que a suplementação de ômega 3 parece ter mais efeitos positivos (como melhora na memória e em sintomas depressivos e de agitação, menor declínio cognitivo, retardo na atrofia do hipocampo e diminuição da proteína beta amiloide no cérebro) em indivíduos com chances de desenvolver a doença de Alzheimer ou nos estágios iniciais da doença, do que em pacientes em estágios mais avançados.

Alzheimer's disease is the main type of existing dementia, it is a chronic neurodegenerative disease resulting from damage to the cells of the nervous system, constituting a disorder due to progressive impairment of memory, language, reasoning and other cognitive functions. In nutrition, several specific nutrients and their effects fueled in Alzheimer's Disease, including omega 3 fatty acids. The aim of this study was to systematically review the literature on the effects of omega 3 in the prevention and treatment of Alzheimer's disease. Medline database was used through PubMed search engine to search for articles to make up this review. At first, 669 articles were found and 11 were selected after the selection process and the results showed that omega 3 supplementation appears to have more positive effects (improvement in memory and in depressive and agitation symptoms, less cognitive decline, delayed hippocampal atrophy and decreased beta amyloid protein in the brain) in individuals with a chance of developing Alzheimer's disease or in the early stages of the disease than in patients in advanced stages.

Consumption of nutritional supplements by teenagers attending gyms supplements and exercise in teenagers / Consumo de suplementos nutricionais por adolescentes frequentadores de academias

ABSTRACT Objective: To describe the supplements used by adolescents in gyms in the city of São Paulo and the factors related to their use. Methods: Participants were 1,012 adolescents of both sexes, aged between 13 and 18 years old, all of them regular regulars at gyms in the city of São Paulo. For data collection, a questionnaire was used to identify the main supplements consumed by adolescents. The chi-square test was used to verify possible associations with a significance of p<0.05. Results: The use of supplements was more frequent in the age group between 16 and 18 years, in the socioeconomic level B, and the use of these supplements was higher as the time of exercise in the gym was longer (>12 months). The amount of exercise modalities practiced in the gym was inversely associated with the use of supplements. Male adolescents consumed significantly more supplements than females, and Physical Education professionals, friends and parents were the ones who most influenced adolescents to use supplements. The main supplements used by the boys were carbohydrate gel (90.9%) and hypercaloric (94.5%). In girls it was fat burner (55.0%) and vitamins and minerals (50.0%). Conclusion: The use of supplements was common among adolescents who exercise in gyms in São Paulo and the indication was made by physical education professional.

RESUMO Objetivo: Descrever os suplementos utilizados por adolescentes em academias da cidade de São Paulo e os fatores relacionados à sua utilização. Métodos: Participaram 1.012 adolescentes de ambos os sexos, com idade variando entre 13 e 18 anos, sendo todos frequentadores regulares de academias de ginástica na cidade de São Paulo. Para coletada de dados, foi utilizado um questionário com objetivo de identificar os principais suplementos consumidos pelos adolescentes. Utilizou-se o teste Qui Quadrado para verificar possíveis associações com significância de p<0,05. Resultados: O uso de suplementos foi mais frequente na faixa etária entre 16 e 18 anos, no nível socioeconômico B, e, o uso desses suplementos foi mais alto a medida que o tempo de prática de exercício na academia foi maior (>12 meses). A quantidade de modalidades de exercício praticada na academia esteve inversamente associada ao uso de suplementos. Adolescentes do sexo masculino consumiram significativamente mais suplementos do que o sexo feminino, e, os profissionais de Educação Física, amigos e pais foram os que mais influenciaram os adolescentes para o uso de suplementos. Os principais suplementos utilizados pelos meninos foram o gel de carboidrato (90,9%) e hipercalóricos (94,5%). Nas meninas foram o fat burner (55,0%) e vitaminas e minerais (50,0%). Conclusão: O uso de suplementos foi comum entre adolescentes praticantes de exercícios em academias de São Paulo e a indicação foi feita basicamente por profissionais de educação física.

Gastrostomia endoscópica percutânea em crianças e adolescentes: 15 anos de experiência em um hospital terciário / Percutaneous endoscopic gastrostomy in children and adolescents: 15-years' experience of a tertiary center

ABSTRACT BACKGROUND: Percutaneous endoscopic gastrostomy (PEG) is an important option for enteral nutrition for both children and adults. It is considered a safe, effective, and advantageous technique in comparison to other complementary feeding routes. It allows continuous feeding, the feeding of patients with swallowing disorders due to neurological causes or others, and the administration of non-palatable diets or medications, all with low rates of complications and mortality. OBJECTIVE: This study aimed to evaluate the main indications and complications of PEG in pediatric patients. In addition, the impact on the nutritional status of patients undergoing PEG was also compared with weight, body mass index (BMI), and height according to references from the World Health Organization. METHODS: This observational and retrospective study included 152 children and adolescents who underwent PEG between January/2003 and December/2018. Patients up to 18 years of age at the time of the procedure were included. Complications related to the procedure were classified as minor or major. Patients with PEG indication for nutritional supplementation were evaluated for weight gain, height, and BMI, using the Z score at the day of the procedure and six months, 1 year, and 2 years after the procedure. RESULTS: Indications for PEG were: swallowing disorder of neurological cause (67.1%), need for nutritional supplementation (25%), swallowing disorder of mechanical origin (6.6%), and indication of gastric decompression (1.3%). Minor complications occurred in 57.8% of patients and major complications in 9.8% of patients. The traction technique corresponded to 92.1% and puncture to 7.9%. The death rate was 1.3%. Thirty-eight patients had an indication for nutritional supplementation. In these patients, there was a gradual increase in both BMI and weight, reaching statistically significant differences (P=0.0340 and P= 0.0105, respectively). These differences were more evident in chronic renal disease patients. Height did not vary significantly (P=0.543). CONCLUSION: PEG proved to be an advantageous option as an auxiliary feeding method in pediatric patients. Dysphagia of neurological origin was the main indication followed by the need for nutritional supplementation. PEG has low frequency of major complications and mortality. This study also showed the importance of PEG in patients who need nutritional supplementation, as it enabled patients to move from undernutrition to normal weight ranges.

RESUMO CONTEXTO: A gastrostomia endoscópica percutânea (GEP) é uma importante opção de nutrição enteral para crianças e adultos, sendo considerada uma técnica segura, eficaz e vantajosa em comparação às outras vias de alimentação complementar. Permite a alimentação contínua, a alimentação em pacientes com distúrbios de deglutição de causa neurológica ou outros, a administração de dietas ou medicamentos não palatáveis, todos com baixos índices de complicações e mortalidade. OBJETIVO: Avaliar as principais indicações e complicações de pacientes pediátricos submetidos à GEP e o impacto no estado nutricional de pacientes submetidos à GEP para suplementação nutricional, comparando peso, índice de massa corporal (IMC) e estatura com referências da Organização Mundial de Saúde. MÉTODOS: Estudo observacional e retrospectivo de 152 crianças e adolescentes submetidos à GEP, no período de janeiro/2003 a dezembro/2018. Foram incluídos pacientes até 18 anos de idade na época do procedimento. As complicações relacionadas ao procedimento foram divididas em menores e maiores. Pacientes com indicação de GEP para suplementação nutricional foram avaliados quanto ao ganho de peso, altura e IMC, por meio do escore Z no dia do procedimento e 6 meses; 1 ano; e 2 anos após o procedimento. RESULTADOS: As indicações para GEP foram distúrbio de deglutição de causa neurológica (67,1%), necessidade de suplementação nutricional (25%), distúrbio de deglutição de origem mecânica (6,6%), e indicação de descompressão gástrica (1,3%). Complicações menores ocorreram em 57,8% dos pacientes e complicações maiores em 9,8%. A técnica de tração correspondeu a 92,1% e a punção, 7,9%. A taxa de mortalidade foi de 1,3%. Trinta e oito pacientes tinham indicação de suplementação nutricional. Nestes, houve aumento gradativo tanto do IMC quanto do peso, com variação estatisticamente significativa da mediana P=0,0340 e P=0,0105, respectivamente, mais evidente nos pacientes renais crônicos. A altura não variou significativamente (P=0,543). CONCLUSÃO: A GEP mostrou-se uma opção vantajosa como forma auxiliar de alimentação em pacientes pediátricos, tendo como principais indicações a disfagia de causa neurológica e a necessidade de suplementação nutricional, com baixa prevalência de complicações maiores e mortalidade. Este estudo também mostrou a importância da GEP em pacientes com necessidade de suplementação nutricional, possibilitando a passagem dos pacientes desnutridos para escores nutricionais de peso adequados à idade.

SEROTONIN ROLE IN FIBROMYALGIA

Fibromyalgia (FM) is a musculo-skeletal disorder and tiredness which results in diffuse myalgia, localized pain, weakness, lower pain thresholds and non-restorative sleep. Multiple sources of evidence supporting the view of decreased flux via the serotonin pathway in FM patients. Supplementation with serotonin substrates, through L- tryptophan or 5-Hydroxytryptophan (5-HTP) significantly improves depression symptoms, anxiety, fatigue and poor sleep in FM patients. Advances in fibromyalgia recognition have helped to increase the therapy choices for FM patients. New medications, nutritional supplements, and nutritional / pharmacological improvement of deep-stage sleep are all being studied by researchers that emphasizes awareness, exercise, and serotonin substrate / receptor regulation.

Comparación de la digestibilidad de tres especies forrajeras estimada mediante diferentes técnicas / Comparison of the digestibility of three forage species estimated by different techniques / Comparação da digestibilidade de três espécies forrageiras estimadas por diferentes técnicas

Resumen Esta investigación se realizó en el municipio de Villavicencio, en la Universidad de los Llanos, cuyo objetivo fue determinar la digestibilidad de tres forrajes para bovinos mediante cuatro técnicas diferentes: una in situ y tres in vitro (inoculación con líquido ruminal, producción de gas, y enzimática) con el fin de validar las técnicas y los equipos que se están usando para estos procedimientos; se evaluaron las especies forrajeras y arbóreas: Pennisetum purpureum (PP), Hibiscus rosa-sinensis (HR) y Gliricidia sepium (GS), además se valoró en todas las técnicas, la curva y tasa de degradación de la materia seca (MS), fibra detergente neutro (FDN) y proteína cruda (PC) (0 a 72 horas). Se utilizó un diseño completamente al azar con arreglo de medidas repetidas, bajo el cual se realizó el análisis de varianza para determinar los rangos de desviación entre las técnicas y así establecer la tendencia de los datos; las variables evaluadas fueron las digestibilidades de la MS, FDN y PC de los tres forrajes de las cuatro técnicas; luego de verificar las diferencias entre las varianzas de las digestibilidades, y comprobar el supuesto de esfericidad con el test de Mauchly, se realizó la comparación múltiple con la prueba de Bonferroni. La digestibilidad de la MS, FDN y PC varió entre 39.89-44.22, 54.18-64.26 y 47.54-57.05%; 79.29-84.18, 76.30-86.95 y 72.81-89.03%; 32.52-62.14, 69.12-76.52 y 42.00-66.54% respectivamente en los forrajes PP, HR y GS, en función de la técnica empleada para su estimación. A pesar de encontrar diferencias estadísticamente significativas entre varias de las comparaciones realizadas en las técnicas de digestibilidad, se encontró un alto coeficiente de determinación y alta correlación entre las estimaciones in vitro: inoculación con líquido ruminal, producción de gas y enzimática con respecto a la estimación in situ.

Abstract This research was conducted in the Villavicencio city, at the Universidad de los Llanos, whose objective was to determine the digestibility of three forages for cattle through four different techniques: one in situ and three in vitro (inoculation with ruminal fluid, gas production, and enzymatic), in order to validate the techniques and equipment that are being used for these procedures; the forage species were evaluated: Pennisetum purpureum, Hibiscus rosa-sinensis y Gliricidia sepium, in addition it was evaluated both in all techniques: the curve and rate of degradation of dry matter (DM), neutral detergent fiber (NDF) and crude protein (PC) (0 to 72 hours). A repeated measures design was used, under which the analysis of variance was performed to determine the ranges of deviation between the techniques and thus establish the trend of the data; the variables evaluated were the digestibilities of DM, NDF and PC of the three forages of the four techniques; after verifying the differences between the variances of the digestibilities, and check the assumption of sphericity with the Mauchly test, the multiple comparison was performed with the Bonferroni test. The digestibility of DM, NDF and PC varied between 39.89-44.22, 54.18-64.26 and 47.54-57.05%; 79.29-84.18, 76.30-86.95 and 72.81-89.03%; 32.52-62.14, 69.12-76.52 and 42.00-66.54% respectively in the PP, HR and GS forages, depending on the technique used for their estimation. Despite finding statistically significant differences among several of the comparisons made in the techniques of digestibility, it was found a high determination coefficient and correlation between estimates in vitro: inoculation with ruminal fluid, gas production and enzymatic with respect to the in situ estimate.

Resumo Esta pesquisa foi realizada na cidade de Villavicencio, na Universidad de los Llanos, cujo objetivo foi determinar a digestibilidade de três forragens em bovinos através de quatro técnicas in vitro diferentes: um in situ e três in vitro (inoculação com fluido ruminai, produção de gás, e enzimática), com a fim de validar as técnicas e equipamentos que estão sendo usados para estes procedimentos; foram avaliadas espécies forrageiras e árvore: Pennisetum purpureum (PP), Hibiscus rosa-sinensis (HR) y Gliricidia sepium (GS), além disso foi avaliado em todas as técnicas: curva e a taxa de degradação de matéria seca (MS), fibra em detergente neutro (FDN) e proteína bruta (PB) (0 a 72 horas). Utilizou-se um desenho de medidas repetidas, sob as quais foi realizado o análise de variância para determinar as gamas de desvio entre as técnicas e assim estabelecer a tendência dos dados; as variáveis avaliadas foram a digestibilidade da MS, FDN e PB dos três forragens das quatro técnicas; depois de verificar as diferenças entre as variâncias de digestibilidade, e verificar a hipótese de esfericidade com o teste de Mauchly, foi realizado a comparação múltipla com o teste de Bonferroni. A digestibilidade de MS, FDN e PB variou entre 39,89-44,22, 54,18-64,26 e 47,54-57,05%; 79,29-84,18, 76,30-86,95 e 72,81-89,03%; 32,52-62,14, 69,12-76,52 e 42,00-66,54%, respectivamente nas forragens PP, HR e GS, dependendo da técnica utilizada para sua estimação. Apesar de encontrar diferenças estatisticamente significativas entre varios das comparações realizadas nas técnicas de digestibilidade, foi encontrado un alto coeficiente de determinação y uma elevada correlação entre as estimativas in vitro: inoculação líquido ruminal, produção de gás e enzimática com respeito à estimativa in situ.

Comparing Compliance and Efficacy of Isocaloric Oral Nutritional Supplementation Using 1.5 kcal/mL or 1 kcal/mL Sip Feeds in Mildly to Moderately Malnourished Indonesian Children: A Randomized Controlled Trial / 대한소아소화기영양학회지

PURPOSE: This study set out to evaluate the compliance to, and efficacy of oral supplementation, using a 1.5 kcal/mL or 1 kcal/mL sip feed, in children with mild to moderate malnutrition. METHODS: This was a parallel, randomized, controlled open-label trial in children aged 3 to 6 years with a weight for height Z (WHZ) score <−1 and ≥−3, who were randomized to receive a total of 600 kcal/day from either a 1.5 kcal/mL or a 1.0 kcal/mL pediatric sip feed for 28 days. Assessments included daily study product intake, body weight, tolerance and dietary intake from solid food. RESULTS: Of 110 children recruited, 98 (mean±standard deviation of age 49±7 months) completed the study. Both sip feeds were well tolerated, with high compliance (80±24% and 81±22% of prescribed volume in 1.5 kcal/mL and 1.0 kcal/mL groups respectively, p=0.79). Both study groups gained similar weight during the 28 days intervention period (0.42±0.40 kg in 1.5 kcal/mL group vs. 0.49±0.49 kg in 1.0 kcal/mL group, p=0.43). There were no significant differences between the groups in weight gain and in the change in WHZ score over the intervention period. Dietary analysis at the end of the study did not show replacement of solid food by the oral nutritional supplements. CONCLUSION: In children with mild to moderate malnutrition, both 1.5 kcal/mL and 1 kcal/mL pediatric sip feeds had high compliance and were well tolerated, and were equally effective in promoting weight gain in the 28 days study period.

Undernutrition & tuberculosis in India: Situation analysis & the way forward.

Undernutrition and tuberculosis (TB) are linked and have a bidirectional relationship. Undernutrition increases the risk of TB which in turn, can lead to malnutrition. Undernutrition not only is a risk factor for progression of latent TB infection to active disease, but also increases the risk of drug toxicity, relapse and death once TB develops. The dietary intake of TB patients in the country is inadequate. Nutritional supplementation in patients with TB is associated with faster sputum conversion, higher cure and treatment completion rates, significant gain in body weight and body composition as well as better performance status. The Government of India has various social support schemes (including nutrition supplementation schemes) and policies, at the Centre as well as State levels. Here we discuss some successful examples and suggest a few solutions to address this gap; like considering TB patients as a vulnerable group for “Targeted Public Distribution System” and providing extra rations for the duration of treatment. Recommendations for the research community, civil societies, government organizations, non-governmental and corporate sector on the actions needed to achieve the goals of the End TB Strategy are also provided. Ultimately, reduction of TB burden in India and its elimination will require improving the nutritional status of the community as a whole.

Sugarcane straw as a feedstock for xylitol production by Candida guilliermondii FTI 20037

Abstract Sugarcane straw has become an available lignocellulosic biomass since the progressive introduction of the non-burning harvest in Brazil. Besides keeping this biomass in the field, it can be used as a feedstock in thermochemical or biochemical conversion processes. This makes feasible its incorporation in a biorefinery, whose economic profitability could be supported by integrated production of low-value biofuels and high-value chemicals, e.g., xylitol, which has important industrial and clinical applications. Herein, biotechnological production of xylitol is presented as a possible route for the valorization of sugarcane straw and its incorporation in a biorefinery. Nutritional supplementation of the sugarcane straw hemicellulosic hydrolyzate as a function of initial oxygen availability was studied in batch fermentation of Candida guilliermondii FTI 20037. The nutritional supplementation conditions evaluated were: no supplementation; supplementation with (NH4)2SO4, and full supplementation with (NH4)2SO4, rice bran extract and CaCl2·2H2O. Experiments were performed at pH 5.5, 30 °C, 200 rpm, for 48 h in 125 mL Erlenmeyer flasks containing either 25 or 50 mL of medium in order to vary initial oxygen availability. Without supplementation, complete consumption of glucose and partial consumption of xylose were observed. In this condition the maximum xylitol yield (0.67 g g-1) was obtained under reduced initial oxygen availability. Nutritional supplementation increased xylose consumption and xylitol production by up to 200% and 240%, respectively. The maximum xylitol volumetric productivity (0.34 g L-1 h-1) was reached at full supplementation and increased initial oxygen availability. The results demonstrated a combined effect of nutritional supplementation and initial oxygen availability on xylitol production from sugarcane straw hemicellulosic hydrolyzate.

Suplementação com creatina associada ao treinamento resistido não altera as funções renal e hepática / Creatine supplementation associated with resistance training does not alter renal and hepatic functions

A creatina é o suplemento nutricional mais popular utilizado para melhorar o desempenho em atividades que envolvem exercícios de curta duração e alta intensidade. Porém, as possíveis intercorrências advindas do seu uso não estão totalmente elucidadas. O objetivo do estudo foi avaliar os efeitos de duas dosagens de suplementação com creatina nas funções renal e hepática de adultos saudáveis durante oito semanas de treinamento de musculação. Exames bioquímicos foram realizados em 35 praticantes de musculação distribuídos aleatoriamente em três grupos, placebo (PLA, n = 12), creatina (CRE1, n = 12) e creatina 2 (CRE2, n = 11), antes e após oito semanas de treinamento com exercícios resistidos. Em desenho duplo-cego, os voluntários foram suplementados (20g/dia) com creatina (CRE1 e CRE2) ou placebo (PLA) por sete dias e nos 53 dias subsequentes com 0,03g/kg de massa corporal de creatina (CRE1) e placebo (PLA) e com 5g/dia o grupo CRE2. Não houve intervenção na composição de suas dietas, que foram registradas e analisadas. Os resultados dos exames bioquímicos realizados permaneceram dentro das faixas de normalidade. Os valores de creatinina aumentaram 12,2 por cento no grupo CRE1 e 9,0 por cento, no CRE2, enquanto que no grupo PLA diminuiu 4,7 por cento, entretanto, esses valores não ultrapassaram os índices de normalidade. Os valores dos exames da função hepática diminuíram em quase todas as frações, em todos os tratamentos, contudo, sem significância estatística. Conclui-se que a suplementação com creatina nas dosagens utilizadas (0,03g/kg e 5g/dia) para indivíduos saudáveis por oito semanas não altera a função hepática ou renal, sendo assim, nas condições deste estudo, foi considerada segura.

Creatine is the most popular nutritional supplement widely used to improve performance in activities that involve exercise of short duration and high intensity. However, the complications arising from its use are not fully elucidated. The aim of this study was to evaluate the effects of two doses of creatine supplementation on renal and hepatic function in healthy adults during eight weeks of resistance exercise training. Biochemical tests were performed on 35 athletes randomly distributed into three groups, placebo (PLA, n = 12), creatine (CRE1, n = 12) and creatine2 (CRE2, n = 11) before and after eight weeks of resistance training. In a double-blind design, the volunteers were supplemented (20 g/day) with creatine (CRE1, CRE2) or placebo (PLA) for seven days and at the 53 subsequent days with 0.03g/kg of body weight of each supplement (CRE1, PLA) and 5g/day for CRE2. There was no intervention in the composition of their diets, which were recorded and analyzed. The results of biochemical tests conducted remained within normal ranges. Creatinine values increased by 12.2 percent for CRE1 and 9.0 percent for CRE2, whereas decreased by 4.7 percent in PLA; however, these values did not exceed normal rates. The values of liver function tests declined in nearly all fractions in all treatments, not being statistically significant, though. It is concluded that creatine supplementation at the dosages used (0.03g/kg and 5g/day) for healthy subjects during eight weeks does not alter hepatic or renal function, hence under the conditions of this study, creatine was considered safe.

Manejo nutricional en los programas de rehabilitación respiratoria de los pacientes con enfermedad pulmonar obstructiva crónica / Nutritional management in pulmonary rehabilitation programs for patients with chronic obstructive pulmonary disease

It is estimated that at least one third of patients with moderate to severe Chronic Obstructive Pulmonary Disease (COPD) have a significant alteration of their body composition, which is associated with deleterious clinical effects and higher mortality. However, there is a lack of evidence to support that dietary, pharmacological or both nutritional interventions have significant clinical benefits in COPD patients who are participating in a pulmonary rehabilitation program. At the present time the recommendation is to establish a nutritional diagnosis of the COPD patients from the beginning of the pulmonary rehabilitation program using the measurement of body mass index (BMI) and the estimation of the nutritional risk, which means a significant weight loss during a given period of time, followed by an individualized dietary and educational supplementation guide during at least 12 weeks.

Se estima que al menos un tercio de los pacientes con enfermedad pulmonar obstructiva crónica moderada y severa tienen una alteración significativa en su composición corporal, lo cual se asocia con efectos clínicos deletéreos y con una mayor mortalidad. Sin embargo, hay evidencia insuficiente para respaldar que los pacientes que participan en un programa de rehabilitación respiratoria se beneficien en forma significativa de las intervenciones nutricionales dietarias, farmacológicas o la asociación de ambas, aunque aparentemente los últimos estudios publicados parecen sugerirlo. La recomendación actual es establecer desde que el paciente ingresa a un programa de rehabilitación respiratoria tanto el diagnóstico nutricional mediante la determinación del índice de masa corporal como el riesgo nutricional que corresponde a una baja involuntaria significativa de peso en determinado intervalo de tiempo, entregando al paciente un plan de alimentación y educación individualizado que debiera tener una duración mínima de 12 semanas.

Suplementação crônica de leucina não reduz efeitos deletérios do destreinamento em ratos / Chronic leucine supplementation does not reduce the deleterious effects of detraining in rats

Diferentes condições podem alterar as características fisiológicas, metabólicas, nutricionais e morfológicas. Assim, o objetivo desse estudo foi analisar o efeito do treinamento físico, destreinamento e especialmente destreinamento combinado com a suplementação de leucina sobre o peso corporal, composição corporal, homeostase glicêmica e expressão e fosforilação da via de sinalização da proteína alvo da rapamicina em mamíferos (mTOR). Quarenta e seis ratos Wistar adultos machos foram divididos em 4 grupos: 31 ratos foram treinados em esteira por 8 semanas e 15 foram usados como controle (ratos sedentários). Destes, 15 ratos foram eutanasiados imediatamene após o treinamento (grupo treinado = 8 e grupo controle =7), 8 continuaram treinando, 16 foram mantidos sem exercícios (grupo destreinado = 8 e grupo destreinado suplementado com leucina = 7), e os 7 ratos restantes foram usados como controle (ratos sedentários) por mais 6 semanas antes de serem eutanasiados. Os animais do grupo destreinado foram alimentados com uma dieta contendo ~18% de proteínas, suplementados ou não com 5% de leucina. A composição corporal, o consumo alimentar, o volume de adipócitos, a glicose de jejum, o teste oral de tolerância à glicose (TOTG), o teste oral de tolerância à insulina (TTI), a atividade da citrato sintase, as concentrações séricas de leptina, adiponectina, aminoácidos e ácidos graxos não esterificados (AGNE) e a expressão e fosforilação da proteína mTOR foram avaliados. Os resultados de peso corporal, gordura corporal, coxins adiposos epididimal e retroperitoneal, volume de adipócitos, consumo alimentar, concentração sérica de leptina e TOTG foram significantemente menores nos animais treinados do que nos sedentários e destreinados (P < 0,05). Nenhuma diferença significante foi observada nos valores de glicemia de jejum, TTI e AGNE entre os três grupos (P > 0,05). Por outro lado, o grupo treinado apresentou valores significantemente mais altos para a atividade da citrato sintase do que os grupos sedentário e destreinado (P < 0,05). Nenhuma diferença significante (P > 0,05) foi identificada na comparação entre os grupos destreinados (com ou sem suplementação de leucina), incluindo a expressão e fosforilação da proteína mTOR. O exercício moderado exerce um efeito protetor sobre a composição corporal e a homeostase glicêmica, enquanto que a interrupção do treinamento físico teve um efeito negativo sobre essas variáveis. Os resultados sugerem que a suplementação crônica de leucina parece não reduzir os efeitos deletérios do destreinamento

Different conditions may alter physiological, metabolic, nutritional, and morphological characteristics. Thus, the aim of this study was to analyze the effects of training, detraining, and especially detraining combined with leucine supplementation on body weight, body composition, glicemic homeostasis and expression and phosphorylation of mammalian target of rapamycin (mTOR) protein-signaling pathway in epididymal adipose tissue in rats. Fourty-seven male adult Wistar rats were divided into 4 groups: 32 rats were trained on a treadmill for 8 weeks and 15 were used as controls (untrained rats). Of these, 15 rats were euthanized immediately after training (trained group = 8 and control group = 7), 8 continued in training, 16 were caged without exercise (detrained group = 8 and detrained group plus leucine supplementation = 7), and the remaining 7 rats were used as controls (untrained rats) for more 6 weeks before being euthanized. Animals of the detrained groups were fed with a ~18% protein diet supplemented or not with 5% leucine. Body composition, food intake, adipocytes size, fasting glucose, oral glucose tolerance test (OGTT), insulin tolerance test (ITT), citrate synthase activity (CS), serum leptin, adiponectin, amino acids and non-esterified fatty acids (NEFA) concentrations and expression and phosphorylation of mammalian target of rapamycin (mTOR) protein were measured. Body weight, body fat, epididymal and retroperitoneal fats depots, adipocytes size, food intake, serum leptin concentration and OGTT were significantly lower in trained animals than in untrained and detrained (P < 0.05). No significant differences in the fasting glucose, ITT and NEFA among the three groups were observed (P > 0.05). On the other hand, the trained group showed a significantly higher score in the citrate synthase activity than both untrained and detrained groups (P < 0.05). No significant differences (P > 0.05) were identified in the comparisons between detrained groups (with and without leucine supplementation), including of the mTOR protein expression and phosphorylation. Moderate exercise exerted a protective effect on the body composition and glucose homeostasis while sudden discontinuation of physical training had a negative effect on such variables. Our results suggest that chronic leucine supplementation not seems to decrease the deleterious effects caused by detraining

Evolução antropométrica e sintomas gastrointestinais em pacientes que receberam suplementos nutricionais ou nutrição enteral / Anthropometric evolution and gastrointestinal complaints in oral nutritional supplementation and enteral nutritional therapy

OBJETIVO: Em pacientes hospitalizados, comparar a evolução de variáveis antropométricas e a ocorrência de efeitos adversos relacionados ao consumo de suplementos nutricionais e infusão de nutrição enteral. MÉTODOS: 10 pacientes que recebiam suplementos nutricionais (Grupo SN) e 20 em nutrição enteral (Grupo NE), pareados para o gênero, idade (50 ± 21 vs 49 ± 23 anos) e afecções de base foram submetidos à avaliação antropométrica ao início e término da terapêutica. Diariamente, foi aplicado um questionário semi-estruturado referente às queixas gastrointestinais. Determinaram-se as diferenças estatísticas obtidas entre o início e o final da terapêutica (teste t para amostras dependentes) e entre os grupos de estudo (teste t para amostras independentes). RESULTADOS: A circunferência muscular do braço aumentou nos pacientes do Grupo NE (80 ± 15 vs 85 ± 15 por cento de adequação, p = 0,009) e diminuiu no Grupo SN (96 ± 14 vs 92 ± 14 por cento de adequação, p = 0,04). Náuseas e vômitos foram mais frequentes no Grupo SN (60 vs 10 por cento, p = 0,01) e as queixas relacionadas ao sabor dos produtos ocorreram em 30 por cento dos casos. CONCLUSÃO: Os pacientes que receberam suplementos nutricionais apresentaram maior ocorrência de queixas gastrointestinais e evolução desfavorável dos parâmetros antropométricos. Os dados obtidos no estudo não evidenciam o benefício da suplementação nutricional de rotina em pacientes hospitalizados.

OBJECTIVE: To compare the evolution of anthropometric variables and the occurrence of adverse effects related to the ingestion of nutritional food supplements and enteral diet administration in hospitalized patients. METHODS: The study was performed in the Clinical Medicine wards of the Hospital of the School of Medicine of Ribeirão Preto, USP, with 10 patients receiving nutrition supplements, and 20 patients under enteral nutrition therapy, paired by gender, age (50 ± 21 vs 49 ± 23 years) and basic afflictions. All were volunteers submitted to anthropometric evaluation at the beginning and end of nutritional therapy, utilizing standard techniques. A semi-structured questionnaire was applied daily referring to gastrointestinal complaints. Statistical differences between onset and final results (t-test for dependent samples) and between-group differences (t-test for independent samples) were estimated. RESULTS: Arm muscle circumference increased in patients receiving enteral nutrition therapy (80 ± 15 vs 85 ± 15 percent adequacy, p = 0.009) and decreased in those receiving nutritional supplements (96 ± 14 vs 92 ± 14 percent adequacy, p = 0.04). Nausea and vomiting were more frequent in the latter (60 vs 10 percent, p = 0.01); complaints about taste of the products were reported by 30 percent of the cases. CONCLUSION: Patients who received oral nutrition supplements reported gastrointestinal complaints and had a less favorable anthropometric evolution. Study data did not disclose the benefit of routine nutrition supplements for hospitalized patients.

Nutritional Assessment and Management in Liver Cirrhosis / 대한간학회지

No abstract available.

Effects of Nutritional Supplementation on Nutirtional Status in Patients with Nonalcoholic Liver Cirrhosis

Severe protein-calorie malnutrition, common in patients with advanced liver disease, can seriously undermine the capacity for regeneration and functional restoration of liver. Nutritional supplementation for these patients can improve biochemical and hormonal abnormalities. However, these effects were not identified in patient with nonalcoholic liver cirrhosis. To determine effects of nutritional supplementation in patients with nonalcoholic liver cirrhosis, 77 subjects aged 29 to 69 years participated in this study for 12 weeks and were subdivided into three groups; normal diet group (Control group, n=16), branched-chain amino acid supplementation group (BCAA group, n=31), nutritional supplementation group (NS group, n=30). Anthropometric parameters, hemoglobin, hematocrit, blood cell counts, serum levels of lipids, vitamins, minerals and fatty acid composition, and plasma amino acids were examined. The mean values of age and height, and the initial values of weight and body mass index (BMI) were not different among all groups. After 12 weeks, there were no significant changes in these values in Control group. Only NS group showed significant increases in weight, lean body mass, midarm circumference, triceps skinfold thickness. Serum transferrins were increased both in BCAA and NS groups. Plasma levels of branched-chain amino acids, urea amino acids and glutamic acid were also significantly increased in these groups, but plasma levels of ammonia, serum LDL cholesterol and atherogenic index were decreased. However, there were no significant changes in serum levels of vitamin and mineral and composition of fatty acids in phospholipids in these groups. These results showed that the nutritional supplementation for patients with nonalcoholic liver cirrhosis can more improve nutritional status in these people together with increases of weight, body fat and lean body mass, compared to only BCAA supplementation. To ascertain and investigate the appropriate nutritional supplementation for patients with nonalcoholic liver cirrhosis, further studies are necessary.

The effect of the nutritional supplementation in eliminating sport fatigue / 肠外与肠内营养

Sport fatigue affects exercise ability of human being.A number of experiments of animals and humans have proved that the rational usage of nutritional supplementation will eliminate the fatgue caused by over-exerise,and improve exerise ability.This review is about the effect of the nutritional supplementation in eliminating sport fatigue.