Uso de vitaminas e/ou minerais entre adultos e idosos em áreas urbanas no Brasil: prevalência e fatores associados / Use of vitamins and/or minerals among adults and the elderly in urban areas of Brazil: prevalence and associated factors

Resumo O objetivo do estudo foi estimar a prevalência do uso de vitaminas e/ou minerais na população brasileira urbana com idade maior ou igual a 20 anos e identificar os fatores associados ao uso. Foram analisados os dados da Pesquisa Nacional sobre Acesso, Utilização e Promoção do Uso Racional de Medicamentos no Brasil (PNAUM), estudo transversal de base populacional, com amostra probabilística, realizada nas áreas urbanas das cinco regiões geográficas do país entre setembro de 2013 e fevereiro de 2014. A prevalência do uso estimada foi de 4,8% (IC95% 4,3-5,3), maior no sexo feminino, 6,4% (IC95% 5,7-7,1), e na população idosa, 11,6% (IC95% 10,5-12,8). O uso de vitaminas e/ou minerais mostrou-se associado aos fatores: sexo feminino, 60 anos ou mais, classe econômica A/B, apresentar doença(s) crônica(s) e autopercepção de saúde regular e muito ruim/ruim. Os multivitamínicos e multiminerais obtiveram maior frequência de uso, 24,5% (IC95% 20,1-29,4), seguido de cálcio e vitamina D, 23,4% (IC95% 19,7-27,5). Os dados sugerem que mulheres idosas devam ser o público referencial para ações de promoção do uso racional. Recomenda-se que os inquéritos epidemiológicos de abrangência nacional possam ampliar a observação desses produtos para possibilitar a análise de tendências.

Abstract The purpose of the present study was to estimate the prevalence of vitamin and/or mineral use among urban Brazilian populations aged 20 years and over and to identify associated factors. Data from the National Survey on Access, Use and Promotion of the Rational Use of Medicines in Brazil (PNAUM) were analyzed and a population-based cross-sectional study with probability sampling was performed in urban areas of Brazil's five geographic regions from September 2013 to February 2014. The estimated prevalence of vitamin and/or mineral use was 4.8% (95%CI: 4.3-5.3), higher in women 6.4% (95%CI: 5.7-7.1) and in the elderly population 11.6% (95%CI: 10.5-12.8). Vitamin and/or mineral use was associated with the following factors: women, 60 years of age or older, economic class A/B, chronic disease(s) and self-perceived health held as average and very poor/poor. Multivitamins and multiminerals were the most used ones with 24.5% (95%CI 20.1-29.4), followed by calcium and vitamin D with 23.4% (95%CI 19.7-27.5). Data suggest that elderly women should be the reference public for actions aimed at promoting rational use. Nationwide epidemiological surveys should increase monitoring of these products to support the analysis of trends.

Dietary Immunomodulators - An Organic Boom in the Management of Chronic Diseases

Immunology involves all the defence mechanisms occurring in the body after the invasion of any infectious agent and the ability to resist this infection. The micronutrients like essential proteins, essential amino acids, vitamins (A, B6, B12, C, D, E and folic acid), fatty acids, minerals (iron, selenium, zinc and copper) and certain phytochemicals are of prime importance towards healthy immune system. In addition to these nutritional components, intestinal microflora and certain bacteria (probiotic bacteria) also play an important role in the modulation of healthy immune system. There is an ongoing trend of usage of immunomodulators to combat various chronic diseases like viral diseases, cancers, inflammatory and autoimmune diseases. This review focuses on various immunomodulators available in daily dietary meals, its positive and negative effects on immune system and its role in management of chronic illness as an adjunct to other modalities to achieve positive health benefits with minimal side effects.

The Efficacy and Safety of a Combination of Amino Acids, Vitamins and Probiotics in PROM and PPROM

The prevalence and severity of prelabor rupture of the membranes (PROM)/preterm PROM (PPROM) are a worldwide public health concern. PROM is the result of a cascade of events involving matrix metalloproteinase (MMP)-9, tissue inhibitor of metalloproteinases 1 (TIMP1), cytokines and proapoptotic genes, which is initiated by several factors such as infection, genotoxic agents or some unknown etiology. In PROM, there is an increased expression and activation of MMP-2, MMP-3 and MMP-9 and a reduction of TIMP1. p53 and tumor necrosis factor (TNF)-? mediate the major apoptotic pathway of PROM. p53 can transactivate some MMP genes, resulting in the overexpression of MMPs. This leads to apoptosis. MMP-2 and MMP-9 degrades type-IV collagen, which is the major structural component of chorioamnion. Understanding the fundamental pathology at the molecular level, it appears necessary to adjust the biologically protective mechanism to prevent spontaneous preterm labor. Our findings show that the novel combination of arginine, ascorbic acid, folic acid, glutamine, glutathione, thiamine, lactic acid bacillus spores, vitamin E acetate and pyridoxine is safe and effectively prevents PROM and PPROM (97% patients) and prolongs pregnancy term.

Safety and Efficacy of a Combination of Amino Acids in Insufficient Lactating Mothers

Milk production of the mammary gland is mainly determined by the milk synthesis and proliferation abilities of mammary epithelial cells (MECs). The availability of amino acids is critical for the production of milk. Amino acids enhance milk protein synthesis and mammary gland development through the mechanistic target of rapamycin (mTOR) pathway. Taurine enhances lactation by increasing prolactin secretion. Vitamins such as Thiamine and Pyridoxine are essential for maintaining and growing maternal and child health. However, there is a paucity of data regarding the safety and efficacy of amino acids and vitamins combination in lactating mothers with insufficient lactation. Hence, a prospective study was conducted to assess the safety and efficacy of a novel amino acids and vitamins combination. The results showed that with the intervention of this combination, 62% of participants showed onset of lactation within 45 minutes to 2 hours. The study suggests clinicians should consider this novel combination to improve lactation in insufficient lactating mothers

Effect of Thermal Treatments on Selected Minerals and Water Soluble Vitamins of Chicken Breast Meat

The study was conducted to ascertain the effect of thermal treatments on selected minerals (Ca, K, Mg, Na, P, Fe and Zn) and water soluble vitamins (B1, B2, B3, B6, B9, B12 and C) contents of chicken breast meat. Industrial skinless chicken breast meat samples were purchased, transported to Bioprocess laboratory in cool conditions, frozen and sliced into dimensions and thawed. The samples were cooked by air frying (AF), baking (BK), deep fat frying (DF) and grilling (GR) at 170, 180 and 1900C for 0, 4, 8 and 12 min for minerals and 0, 8 and 16 min for vitamins. Thereafter, cooked and raw samples were wet acid digested overnight and 5 h digested on a block digester on slowly increased temperature to 1200C, cooled and deionized. The mineral elements were analysed by Optima 4300DV inductivity coupled plasma optical emission spectrometry (ICP-OES) and inductivity coupled plasma mass spectrometry (ICP-MS). These mineral elements were extrapolated through a calibration curve between intensity and concentration, while the vitamins were ascertained by measurement of absorbance of filtrates of the samples dissolved in their respective solvents in the Spectrophotometer against their blank samples at different wavelengths. The results showed that cooking methods decreased significantly (p < 0.05) the mineral elements with an exception of Zn cooked by grilling (GR) that increased by 19.92% and Mg that increased in the cooking methods. The ascending percentage reduction of minerals in cooked chicken breast were Zn, P, K, Fe, Na and Ca. Samples cooked by DF had significantly (p < 0.05) higher percentage reduction of 45.06% in Ca, 27.74% in Na and 18.85% in Zn and higher percentage increases of 14.96% in Mg contents than other methods. Also samples cooked by DF had higher percentage reductions of 55.10%, 37.93%, 37.11%, 34.44% and 30.99% in vitamins B1, C, B2, B9 and B6 Whereas higher percentage reductions of 41.67% and 37.84 % in vitamins B12 and B3 occurred in baking (Bk) and grilling (GR) treated samples. Cooking at 1900C had higher percent reduction in the Ca, Na, Fe, K, P and Zn as well as B1, B12, B2, C, B3, B9 and B6. Cooking methods, temperatures and times decreased significantly (p < 0.05) vitamins and minerals contents of chicken breast meat with an exception of Mg. Samples cooked at 1700C for 4 min and 1700C for 8 min had lower losses of minerals and vitamins compared to similar samples cooked at 1800C and 1900C. The AF cooking method had the least percent reduction of 22.50% than other cooking methods BK (26.88%), DF (36.04%) and GR (30.69%) in vitamin contents.

Characterization of micronutrient supplements use by Brazilian children 6-59 months of age: Brazilian National Survey on Child Nutrition (ENANI-2019) / Caracterização do uso de suplementos de micronutrientes por crianças brasileiras de 6-59 meses de idade: Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019) / Caracterización del uso de suplementos de micronutrientes por niños brasileños de 6-59 meses de edad: Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019)

This study aimed to characterize micronutrient supplements use among Brazilian children 6-59 months of age included in the Brazilian National Survey on Child Nutrition (ENANI-2019; n = 12,598). Micronutrient supplements use at the time of the interview and the 6 months prior to it was evaluated using a structured questionnaire. The following indicators were included: micronutrient supplement use; supplements containing a single micronutrient; supplements of the Brazilian National Iron Supplementation Program (PNSF); multivitamin supplements with or without minerals; multivitamin supplements with minerals; multivitamin supplements without minerals. The estimates and their respective 95% confidence intervals (95%CI) were calculated for Brazil and according to macroregion, educational level of the mother or caregiver, and type of health care service used, considering the sampling plan, weights, and calibration. In Brazil, the prevalence of micronutrient supplements use was 54.2% (95%CI: 50.5; 57.8), with the highest prevalence in the North Region (80.2%; 95%CI: 74.9; 85.6) and among children 6-23 months of age (69.5%; 95%CI: 65.7; 73.3). The prevalence of the use of supplements containing exclusively iron and exclusively vitamin A in Brazil was 14.6% (95%CI: 13.1; 16.1) and 23.3% (95%CI: 19.4; 27.1), respectively. The prevalence of the use of multivitamin with or without minerals in Brazilian children 6-59 months of age was 24.3% (95%CI: 21.4; 27.2). These results may help to understand the practice of supplements use among Brazilian children and support the proposal of national public policies for the prevention and control of micronutrient deficiencies.

O objetivo deste estudo foi caracterizar o uso de suplementos de micronutrientes entre crianças brasileiras de 6-59 meses de idade incluídas no Estudo Nacional de Alimentação e Nutrição Infantil (ENANI-2019; n = 12.598). O uso de suplementos de micronutrientes no momento da entrevista e nos seis meses anteriores foi avaliado por meio de um questionário estruturado. Foram incluídos os seguintes indicadores: uso de suplemento de micronutrientes; suplementos contendo um único micronutriente; suplemento do Programa Nacional de Suplementação de Ferro (PNSF); suplementos multivitamínicos com ou sem minerais; suplementos multivitamínicos com minerais; suplementos multivitamínicos sem minerais. As estimativas pontuais e seus respectivos intervalos de 95% de confiança (IC95%) foram calculados para o Brasil e de acordo com a macrorregião, a escolaridade da mãe ou cuidadora e o tipo de serviço de saúde utilizado, considerando o plano, os pesos e a calibração amostral. No Brasil, a prevalência de uso de suplemento de micronutrientes foi de 54,2% (IC95%: 50,5; 57,8), com maior prevalência na Região Norte (80,2%; IC95%: 74,9; 85,6) e entre crianças de 6-23 meses de idade (69,5%; IC95%: 65,7; 73,3). A prevalência do uso de suplementos contendo apenas ferro e apenas vitamina A no Brasil foi de 14,6% (IC95%: 13,1; 16,1) e 23,3% (IC95%: 19,4; 27,1), respectivamente. A prevalência de uso de multivitamínicos com ou sem minerais em crianças brasileiras de 6-59 meses de idade foi de 24,3% (IC95%: 21,4; 27,2). Esses resultados podem auxiliar na compreensão da prática do uso de suplementos entre crianças brasileiras e apoiar a proposta de políticas públicas nacionais de prevenção e controle de deficiências de micronutrientes.

El objetivo de este estudio fue caracterizar el uso de suplementos de micronutrientes entre niños brasileños con edades entre 6-59 meses incluidos en el Estudio Nacional de Alimentación y Nutrición Infantil (ENANI-2019; n = 12.598). El uso de suplementos de micronutrientes en el momento de la entrevista y en los seis meses anteriores se evaluó mediante un cuestionario estructurado. Se incluyeron los siguientes indicadores: uso de suplementos de micronutrientes; suplementos que contienen un solo micronutriente; suplemento del Programa Nacional de Suplementación con Hierro (PNSF); suplementos multivitamínicos con o sin minerales; suplementos multivitamínicos con minerales; suplementos multivitamínicos libres de minerales. Se calcularon las estimaciones puntuales para Brasil y sus respectivos intervalos del 95% de confianza (IC95%) de acuerdo con la macrorregión, el nivel educativo de la madre/cuidador y el tipo de servicio de salud utilizado, considerando el plan, los pesos y la calibración de la muestra. En Brasil, la prevalencia del uso de suplementos de micronutrientes fue del 54,2% (IC95%: 50,5; 57,8), con mayor prevalencia en la Región Norte (80,2%; IC95%: 74,9; 85,6) y entre niños con edades entre 6-23 meses (69,5%; IC95%: 65,7; 73,3). Las prevalencias del uso de suplementos que contienen solo hierro o solo vitamina A en Brasil fueron del 14,6% (IC95%: 13,1; 16,1) y del 23,3% (IC95%: 19,4; 27,1), respectivamente. La prevalencia de uso de multivitamínicos con o sin minerales en niños brasileños de 6-59 meses de edad fue del 24,3% (IC95%: 21,4; 27,2). Estos resultados pueden ayudar a comprender la práctica de uso de suplementos entre los niños brasileños y apoyar la propuesta de políticas públicas para la prevención y control de la carencia de micronutrientes.

Suplementación con vitaminas, minerales y otros micronutrientes durante el embarazo

Introducción: La adecuada nutrición en el embarazo depende no solo de la correcta ingesta de alimentos, sino también de una apropiada administración de vitaminas, minerales y otros nutrientes en forma de suplementos. Objetivo: Describir aspectos relacionados sobre la suplementación con ácido fólico, hierro, yodo, calcio, vitamina B12 y omega-3, durante el embarazo. Método: Se realizó una revisión sistemática entre mayo de 2022 y marzo de 2023 sobre la suplementación con algunas vitaminas y minerales durante el embarazo. Se revisaron bases de datos electrónicas de literatura científica biomédica como: UpToDate, Science Direct, SciELO y PUBMED, LILACS. Se realizó la búsqueda de artículos desde el 2016 hasta 2022. Los términos de búsqueda en las bases de datos fueron: suplementos "Vitaminas", "Micronutrientes", "Minerales", y "Embarazo", en inglés y en español. Resultados: Los requerimientos de vitaminas, minerales y diferentes nutrientes aumentan en el embarazo. Una apropiada alimentación y el consumo de micronutrientes en forma de suplementos son el soporte básico para un adecuado desarrollo de la madre y del feto; por otra parte, una nutrición adecuada reduce el riesgo de malformaciones congénitas, complicaciones obstétricas, fetales y perinatales. No todas las embarazadas necesitan la misma cantidad de suplementos, por lo que es necesario identificar aquellas con mayor riesgo de presentar alguna deficiencia. Conclusiones: La suplementación de vitaminas, minerales y otros micronutrientes durante el embarazo es muy importante para disminuir el riesgo de complicaciones obstétricas y anomalías fetales y perinatales.

Introduction: Adequate nutrition in pregnancy depends not only on a healthy diet, but also on the most effective way of taking vitamins, minerals and other nutrient supplementation. Objective: To describe aspects related to supplementation with folic acid, iron, iodine, calcium, vitamin B12 and omega-3 in pregnancy. Method: A systematic review was conducted between May 2022 and March 2023, concerning supplementation intake of vitamins and minerals in pregnancy. Electronic databases of biomedical scientific literature were reviewed such as: UpToDate, Science Direct, SciELO and PUBMED, LILACS. Searching was on articles published from 2016 to 2022. The key terms for searching in databases were as follow: supplements "Vitamins", "Micronutrients", "Minerals", and "Pregnancy", in English and Spanish. Results: A vitamin, minerals and different nutrients intake requirements has increased in pregnancy. An appropriate diet and the consumption of micronutrients in the form of supplements are the basic support for an adequate health status of the mother and the development the fetus; on the other hand, an adequate nutrition reduces the risk of congenital malformations, obstetric, fetal and perinatal complications. Not all pregnant women need the same amount of supplements, so it is necessary to identify those with a highest risk of presenting deficiency. Conclusions: Supplementation of vitamins, minerals and other micronutrients in pregnancy is very important to reduce the risk of obstetric complications and fetal or perinatal anomalies.

Introdução: a nutrição adequada durante a gravidez depende não só da ingestão correta de alimentos, mas também da administração adequada de vitaminas, minerais e outros nutrientes na forma de suplementos. Objetivo: descrever aspectos relacionados à suplementação com ácido fólico, ferro, iodo, cálcio, vitamina B12 e ômega 3, durante a gestação. Método: foi realizada uma revisão sistemática entre maio de 2022 e março de 2023 sobre a suplementação com algumas vitaminas e minerais durante a gravidez. Bases de dados eletrônicas de literatura científica biomédica como: UpToDate, Science Direct, SciELO e PUBMED, LILACS foram revisadas. A busca dos artigos foi realizada no período de 2016 a 2022. Os termos de busca nas bases de dados foram: suplementos "Vitamins", "Micronutrients", "Minerals" e "Pregnancy", nos idiomas inglês e espanhol. Resultados: as necessidades de vitaminas, minerais e diferentes nutrientes aumentam na gravidez. Uma dieta adequada e o consumo de micronutrientes na forma de suplementos são o suporte básico para um desenvolvimento adequado da mãe e do feto; por outro lado, uma nutrição adequada reduz o risco de malformações congênitas, complicações obstétricas, fetais e perinatais. Nem todas as gestantes precisam da mesma quantidade de suplementos, por isso é necessário identificar aquelas com maior risco de apresentar deficiência. Conclusões: a suplementação de vitaminas, minerais e outros micronutrientes durante a gravidez é muito importante para reduzir o risco de complicações obstétricas e anomalias fetais e perinatais.

Dietary supplement intakes among adults living in Kota Kinabalu during the COVID-19 pandemic: A crosssectional study

@#Introduction: During the coronavirus 2019 (COVID-19) pandemic, the public may seek a non-pharmacological approach, such as dietary supplements, to prevent or manage COVID-19. Therefore, this study aimed to evaluate the use of dietary supplements during the COVID-19 pandemic among adults in Kota Kinabalu. Methods: This cross-sectional study recruited 213 adults living in Kota Kinabalu through convenient sampling from October 2021 to March 2022. A validated questionnaire was used to evaluate their perception on the use of dietary supplements, and the types of dietary supplements consumed before and during the COVID-19 pandemic. Results: One-hundred sixty-one (75.6%) adults reported that they were told to consume dietary supplements during the COVID-19 pandemic, primarily from close family members (64.0%) and social media (58.4%). One-hundred and thirty-two (62%) adults were consuming dietary supplements and 46 (34.8%) of them only started taking them during the COVID-19 pandemic. The reasons for taking dietary supplements during the COVID-19 pandemic included enhancing the immune system (83.6%) and for prevention of COVID-19 infection (64.4%). The most common dietary supplements consumed during the COVID-19 pandemic were vitamin C (90.2%), followed by multi-vitamin and mineral (32.6%), and fish oil (25.8%). After adjusting for age, sex, education level, and income level, KadazanDusun adults were most likely to consume dietary supplements (adjusted odds ratio = 2.369, 95% CI: 1.070 - 5.248, p=0.034). Conclusion: There was an increase in the number of adults consuming dietary supplements during the COVID-19 pandemic, which was likely driven by information sharing via family members and social media.

Nutritional Contents of Two Varieties of Sweet Potatoes (Ipomoea batatas (L.) Lam ) Cultivated IN North Western Nigeria

Background and Objectives: Food shortages and nutritional imbalances are among the main food security problems in many countries around the world. In this study, the nutrients content of the yellow and red-fleshed sweet potatoes varieties cultivated in Nigeria were assessed. Materials and Methods: The proximate composition, mineral elements analysis, phytochemicals, and vitamins content of the red and yellow-fleshed sweet potatoes were determined using the standard methods of analysis. Results: The proximate analysis has shown that, the moisture (17.927%) and fat (2.703%) content of the yellow sweet potato were significantly (p<0.05) higher than in the red potato with a content of 16.68% and 1.693% respectively. The protein and fiber content of the red potato are 14.280% and 14.572% respectively, this is quite higher than in the yellow cultivar having 12.987% and 10.443% of the nutrients respectively. The ash and carbohydrate content were same in both. The red potato exhibits high level of sodium (11.420 mg/l), potassium (1.206 mg/l), and magnesium (8.468 mg/l) in contrast to the red potato containing 10.270 mg/l, 1.035 mg/l and 6.127 mg/l of the respective elements. Iron and zinc content were comparable in both cultivars while the calcium content (1.444 mg/l) of the yellow cultivar is significantly higher than in the red variety (1.144 mg/l). The vitamin A, B and E content of the red potato are 8.740 µmol/L, 2.977 mg/dl, and 13.267 mg/dl respectively. These values are significantly (p<0.05) higher than in the yellow potato containing 6.047 µmol/L, 1.680 mg/dl, and 11.110 mg/dl of the respective vitamins. There is no significant difference with respect to the vitamin C content of both yellow (11.850 mg/dl) and red potato (12.520 mg/dl). The phytochemicals: tannins, flavonoids, phenols, terpenes, and anthocyanins content of the red sweet potato are 0.967 mg/g, 1.577 mg/g, 1.867 mg/g, 6.590 mg/g and 2.660 mg/g respectively. Terpenes and anthocyanins were not found in the yellow cultivar. However, saponins (0.823 mg/g) were found in the yellow variety but not in the red potato. Amount of the tannins, flavonoids and phenols observed in the yellow-fleshed potato are 0.667 mg/g, 1.027 mg/g and 1.287 mg/g respectively. These values are lower than in the corresponding red potato. Conclusion: In this study, the nutritional contents of sweet potato varieties have been assessed which will immensely contribute to reducing the menace of malnutrition bedeviling the Northwestern part of Nigeria.

Determination of Vitamin Contents of Maize (Zea mays L) Produced and Stocked from Rural Conditions in Cote D’ivoire

Aims: Maize is prized for its richness in nutrient compounds. Despite its socio-economic importance, maize faces a quality problem that is sometimes very delicate. Indeed, maize during different production, post-harvest processing, storage and transport conditions is exposed to bio-aggressors that can alter the quality of this cereal. With this in mind, this study was conducted to determinate the vitamins contents of maize produced and stored in five maize-producing regions of Côte d’Ivoire. Study Design: A total of 1 500 samples of maize as grains, epis and spathes were collected at rate of 500 samples by region (Gbêkê, Poro, Hambol, Indénié-Djuablin and Gontougo) and sent to the laboratory for analysis of the vitamin contents. Place and Duration of Study: This study was carried out during March 2016 to January 2017. Then, the analyses of the collected sample took place at the Biotechnology, Agriculture and Valorisation of Biological Ressources Laboratory of the Félix Houphouët-Boigny’s University, Abidjan. Methodology: Vitamins determination was carried by High Performance Liquid Chromatography. A total of twelve vitamins were evaluated namely 9 water-soluble vitamins (thiamin, riboflavin, niacin, choline, pantothenic acid, pyridoxine, biotin, folic acid and cobalamin) and 3 fat-soluble vitamins (β-carotene, vitamin E and K). Results: Results show a significant difference between vitamins contents of the different maize forms and regions. The mean values ranged from 0.09 ± 0.04 to 557.24 ± 10.97 mg / kg for water-soluble vitamins and from 0.31±0.25 to 4.20±1.00 mg / kg for fat-soluble vitamins. Choline was the most abundant of the water-soluble vitamins while β-carotene and vitamin E were the most abundant of the fat-soluble vitamins. Maize grains and epis had the highest levels of these vitamins all of the regions. Maize spathes samples, especially those from Indénié-Djuablin and Gontougo, showed the lowest concentrations. Conclusion: A significant variability from one region to another can be noticed at level of vitamins regardless the type of maize. Maize vitamin contents seem to be related to maize form (grains, epis, spathes), maize variety, agronomic practices, post-harvest treatments and storage structure.

El rol de los suplementos vitamínicos en pacientes con depresión / The role of vitamin supplements in patients with depression

La depresión es un trastorno del estado de ánimo que se caracteriza por la existencia de un sentimiento de tristeza lo suficientemente intenso como para interferir en el desarrollo de las actividades habituales. A partir de un caso clínico real, en el que una paciente con depresión solicita a su médico de cabecera sumar un suplemento de vitaminas a su plan terapéutico, revisamos la evidencia disponible sobre el uso de estos micronutrientes para el tratamiento de la depresión, y encontramos que no existen pruebas robustas que avalen la suplementación vitamínica en pacientes con este problema de salud. (AU)

Depression is a mood disorder characterised by the existence of a feeling of sadness intense enough to interfere with the performance of normal activities. Based on a real clinical case, in which a patient with depression asked her family doctor to add a vitamin supplement to her therapeutic plan, we reviewed the available evidence on the use of these micronutrients for the treatment of depression and found that there is no robust evidence to support vitamin supplementation in patients with this health problem. (AU)

Suplementación de micronutrientes durante el embarazo: revisión narrativa de revisiones sistemáticas y metanálisis / Micronutrient supplementation during pregnancy: narrative review of systematic reviews and meta-analyses

Resumen OBJETIVO: Describir los efectos de la suplementación con vitamina B12, vitamina D, calcio, magnesio, zinc y múltiples micronutrientes asociados con complicaciones perinatales. METODOLOGÍA: Estudio retrospectivo, basado en la búsqueda bibliográfica de revisiones sistemáticas y metanálisis en la base de datos de Medline-PubMed, acerca de la suplementación con Vitamina B12, vitamina D, calcio, magnesio y zinc, además de la suplementación con múltiples micronutrientes en mujeres con embarazo único, sanas y con alteraciones metabólicas, de artículos publicados entre 2012 y 2022. RESULTADOS: Se incluyeron 51 revisiones y metanálisis. De acuerdo con los estudios, la suplementación con vitamina D reduce el riesgo de diabetes gestacional y preeclampsia, y posiblemente el riesgo de bajo peso al nacimiento y de pequeño para la edad gestacional. La suplementación con calcio disminuye el riesgo de hipertensión gestacional y preeclampsia en mujeres con alto riesgo y con bajo consumo de calcio. La suplementación con múltiples micronutrientes demostró un efecto en la reducción del bajo peso al nacimiento, pequeño para la edad gestacional, óbito y, posiblemente, parto pretérmino. Pocos estudios reportan que la suplementación con magnesio disminuye la hospitalización materna y mejora el control glucémico en mujeres con diabetes gestacional. Se requieren más estudios de suplementación con vitamina B12, zinc y magnesio. CONCLUSIÓN: No existe un esquema de referencia de suplementación con micronutrientes efectivo para todas las mujeres; el protocolo debe individualizarse en cuanto al tipo de nutrimento, dosis, características específicas, riesgos individuales y contexto de cada mujer, su consumo dietético y deficiencias, entre otros factores. La suplementación debe formar parte de los programas de salud gestacional, para garantizar la seguridad alimentaria y mejorar las condiciones de salud pública.

Abstract OBJECTIVE: To describe the effects of vitamin B12, vitamin D, calcium, magnesium, zinc and multiple micronutrient (MMS) supplementation on perinatal complications. METHODS: We performed a search of systematic reviews/meta-analyses of supplementation in healthy women, and/or with metabolic disorders, with a single pregnancy (Medline/PubMed; 2012-2022). RESULTS: 51 reviews/meta-analyses were included. Vitamin D supplementation appears to reduce the risk of gestational diabetes (GDM) and preeclampsia; and possibly the risk of low birth weight (LBW) and small for gestational age (SGA). Calcium supplementation reduces the risk of gestational hypertension, preeclampsia, in women at high risk and with low calcium intake. MMS showed an effect in reducing LBW, SGA, stillbirth, and possibly preterm birth. Few studies reported that magnesium supplementation could decrease maternal hospitalization and improve glycemic control in women with GDM. More studies on vitamin B12, zinc and magnesium supplementation are required. CONCLUSION: There is no single effective micronutrient supplementation scheme for all women; this must be individualized in terms of the type of nutrient, dose, specific characteristics, individual risks and context of each woman, her dietary intake/micronutrient deficiencies, among others. Supplementation should be part of a policy to improve gestational clinical care, ensure food security and improve public health conditions.

Vitamin and mineral levels during pregnancy

SUMMARY OBJECTIVE: Numerous physiological changes occur during pregnancy, which affect both the mother and the fetus. The objective of this study was to evaluate the magnesium, calcium, phosphate, parathormone (PTH), and vitamin D levels in each trimester of pregnancy. METHODS: In this study, 30 pregnant women in the first trimester, 30 pregnant women in the second trimester, 30 pregnant women in the third trimester, and 30 healthy, non-pregnant women (control) in the same age group were included. The serum magnesium, calcium, phosphate, PTH, and vitamin D levels were measured in all the participants. RESULTS: No statistically significant difference was found in the PTH and phosphate levels within the groups. In contrast, a significant difference was found in the vitamin D, calcium, and magnesium levels (p<0.001 for all). By analyzing the differences between the groups, the vitamin D, calcium, and magnesium levels were found to decrease with increase in the gestational weeks. CONCLUSION: For maintaining a healthy pregnancy and fetus, we recommend vitamin D, calcium, and magnesium levels to be included in routine follow-ups for each trimester and supplemented in case of deficiency.

Potentials of Immunonutrition in Wound Healing: A Review (Potensi Imunonutrisi dalam Penyembuhan Luka: Tinjauan) / Jurnal Sains Kesihatan Malaysia

@#A delayed wound healing process can lead to detrimental complications in chronic wound patients such as tissue necrosis and systemic infections. Application of immunonutrition (IN) in experimental animal models and chronic wound patients has shown promising and improved wound healing processes. IN restores the supply of essential nutrients that are critical for cell growth and tissue repair in the wounded subjects. Several commonly found nutrients in IN formulations include polyunsaturated fatty acids (PUFAs), essential amino acids, trace elements such as zinc and vitamins. Recently, some studies suggested the use of traditionally used herbs like curcumin in IN recipes due to its efficient wound healing properties. The roles and functions of IN in wound healing encompass recruitment of white blood cells, platelets and fibroblasts into the wounded area during the coagulation and inflammation phases, enhancement of fibroblast proliferation, collagen synthesis and neovascularization in the proliferation phase; and lastly, regulation of tissue re-epithelization for wound closure and recovery. In this review, the roles and functions of individual nutrients were deliberately discussed alongside their mechanisms of action in wound healing. This aims to provide a more holistic insight into the potentials of those nutrients when used as part of IN for major wound patients. Despite its remarkable effects in wound healing, several criteria should be considered in an IN formulation: the type and severity of wounds, administration timing and mode of administration, and concoction of immune-boosting nutrients in order to ensure the optimal wound healing effects.

The biochemical content and antioxidant capacities of endemic Tanacetum densum (Lab.) Schultz Bip. subsp. laxum, and Tanacetum densum (Lab.) Schultz Bip. subsp. amani Heywood growing in Turkey / O conteúdo bioquímico e as capacidades antioxidantes de Tanacetum densum endêmico (lab.) Schultz Bip. subsp. laxum e Tanacetum densum (lab.) Schultz Bip. subsp. amani Heywood que crescem na Turquia

Abstract Medicinal plants have a significant role in preventing and curing several diseases, and Tanacetum L. is one of these plants. The aim of the present study is to determine the fatty acid, lipid-soluble vitamin, sterol, phenolic content, and antioxidant capacity of Tanacetum densum subsp. laxum and Tanacetum densum subsp. amani, to compare the effect of altitude on the biochemical content and to compare systematically by using fatty acids and phenolics. This study showed that palmitic acid (C16:0) and stearic acid (C18:0) are major sources of saturated fatty acid and oleic acid (C18:1 n9), and linoleic acid (18:2 n6c) and a-linolenic acid (C18:3 n3) are the principal unsaturated fatty acids in the two endemic Tanacetum densum taxa. Also, this study found that the unsaturated fatty acid content (60.11±1.61%) of Tanacetum densum subsp. laxum was higher than the unsaturated fatty acid content (44.13±1.28%) of Tanacetum densum subsp. amani. And also, the ω6/ω3 ratio of Tanacetum densum subsp. laxum (1.74) and Tanacetum densum subsp. amani (1.60) was found to be similar. However, this study determined that the lipid soluble vitamin and sterol content of two endemic Tanacetum taxa are low except for stigmasterol. Present study showed that catechin is principal phenolic in the Tanacetum densum taxa. This study also found that Tanacetum densum subsp. laxum and Tanacetum densum subsp. amani had the highest levels of catechin, vanillic acid, and caffeic acid content though the phenolic amounts, particularly catechin and quercetin, were dissimilar in the T. densum taxa. This study suggested that ecological conditions such as altitude may affect the biochemical content of two endemic Tanacetum densum taxa. Furthermore, the current study determined that two endemic Tanacetum L. taxa had potent radical scavenging capacities and found a correlation between total phenolics and antioxidant activity.

Resumo As plantas medicinais têm um papel significativo na prevenção e cura de várias doenças, e Tanacetum L. é uma dessas plantas. O objetivo do presente estudo é determinar o conteúdo de ácido graxo, vitamina lipossolúvel, esterol, estrutura fenólica e capacidade antioxidante de Tanacetum densum subsp. laxum e Tanacetum densum subsp. amani, comparar o efeito da altitude sobre o conteúdo bioquímico e realizar uma comparação sistemática usando ácidos graxos e fenólicos. Esta pesquisa mostrou que o ácido palmítico (C16:0) e o ácido esteárico (C18:0) são as principais fontes de ácido graxo saturado e que o ácido oleico (C18:1 n9), o ácido linoleico (18:2 n6c) e o ácido a-linolênico (C18: 3 n3) são os principais ácidos graxos insaturados nos dois táxons endêmicos de Tanacetum densum. Além disso, este estudo descobriu que o conteúdo de ácidos graxos insaturados (60,11±1,61%) de Tanacetum densum subsp. laxum foi superior ao conteúdo de ácidos graxos insaturados (44,13±1,28%) de Tanacetum densum subsp. amani, e também que a razão ω6/ω3 de Tanacetum densum subsp. laxum (1,74) e Tanacetum densum subsp. amani (1,60) foi semelhante. No entanto, este trabalho determinou que o conteúdo de vitamina lipossolúvel e esterol de dois táxons endêmicos de Tanacetum é baixo, exceto o estigmasterol, além de descobrir que Tanacetum densum subsp. laxum e Tanacetum densum subsp. amani apresentaram os mais altos níveis de conteúdo de catequina, ácido vanílico e ácido cafeico, embora as quantidades fenólicas, especialmente catequina e quercetina, sejam diferentes nos táxons de T. densum. Este estudo sugere que condições ecológicas, como a altitude, podem afetar o conteúdo bioquímico de dois táxons endêmicos de Tanacetum densum. Ainda, esta pesquisa determinou que dois táxons de Tanacetum L. endêmicos possuíam potentes capacidades de sequestro de radicais e que houve correlação entre fenólicos totais e atividade antioxidante.

Consumo de micronutrientes durante el embarazo y la lactancia / Micronutrient intake during pregnancy and lactation

RESUMEN El estado nutricional adecuado de la mujer antes, durante y después del embarazo es fundamental para evitar complicaciones obstétricas y perinatales. Los micronutrientes son esenciales para el desarrollo materno y fetal. El embarazo tiene una demanda metabólica especial de nutrientes de alta calidad. Además, la ingesta adecuada de micronutrientes puede mejorar directamente la calidad de la leche materna. Los suplementos pueden satisfacer la creciente demanda de estos elementos durante el embarazo y la lactancia, reduciendo el riesgo de anomalías congénitas fetales, patologías obstétricas y desarrollo de enfermedades crónicas en la edad adulta. Sin embargo, existe información contradictoria sobre la eficacia y seguridad de los suplementos nutricionales durante el embarazo. Es importante que el personal médico pueda brindar consejos precisos y adecuados basados en evidencia sobre el consumo de suplementos durante el embarazo, ya que no todas las embarazadas necesitan utilizar suplementos en forma regular, pero es necesario identificar a las gestantes con riesgo de presentar alguna deficiencia. El objetivo de esta revisión fue analizar los efectos del consumo de micronutrientes en el embarazo y la lactancia.

ABSTRACT Adequate nutritional status of women before, during and after pregnancy is essential to avoid obstetric and perinatal complications. Micronutrients are essential for maternal and fetal development. Pregnancy has a special metabolic demand for high quality nutrients. In addition, adequate micronutrient intake can directly improve the quality of breast milk. Supplements can meet the increased demand for these elements during pregnancy and lactation, reducing the risk of fetal congenital anomalies, obstetric pathologies and development of chronic diseases in adulthood. However, there is conflicting information on the efficacy and safety of nutritional supplements during pregnancy. It is important that medical personnel can provide accurate and appropriate evidence-based advice on supplementation during pregnancy, as not all pregnant women need to use supplements on a regular basis, but it is necessary to identify pregnant women at risk for deficiency. The objective of this review was to analyze the effects of micronutrient intake in pregnancy and lactation.

Alegações nutricionais e o real benefício para o consumidor de biscoitos infantis / Nutritional claims and the real benefit for the child biscuit consumer

Atualmente, observa-se o aumento do consumo de biscoitos infantis que são acrescidos com micronutrientes. O objetivo desse artigo é avaliar o valor nutricional e seu benefício para esse público. Foram analisados 16 (dezesseis) rótulos de biscoitos infantis, contendo alegações de fonte de vitaminas e minerais. A avaliação foi baseada na Portaria nº 31/98 sobre Regulamento Técnico, referente a alimentos adicionados de nutrientes essenciais, e na Portaria nº 33/98, sobre a Ingestão Diária Recomendada para Lactantes e Crianças. Os dados tabulados foram divididos em três gráficos: primeiro para Conformidade dos Rótulos; segundo da Quantidade dos Micronutrientes de Acordo com a Portaria nº 33/98; e terceiro Análise da Porção de Acordo com IDR para Lactantes e Crianças da Portaria nº 33/98. Dos biscoitos analisados, 94% estavam em conformidade quanto às informações contidas nos rótulos. Em relação à quantidade dos micronutrientes, as vitaminas B1, B2 e B3 apresentaram valores superiores ao recomendado. Conclusão: Os rótulos dos biscoitos avaliados não apresentaram de forma clara as informações necessárias para o consumidor. É necessário construir normas mais específicas direcionadas às atribuições nutricionais nas rotulagens, com uma linguagem mais acessível para a sociedade.(AU)

Currently, there is an increase in the consumption of children's cookies that are added with micronutrients. The article's purpose is to assess the nutritional value and its benefit for this audience. 16 (Sixteen) children's biscuit labels were analyzed, holding claims from source of vitamins and minerals. The evaluation of this was based on Portaria nº 31/98 about Regulamento Técnico regarding foods added with essential nutrients and on Portaria nº 33/98 about Recommended Daily Intake for Lactants and Children. The charted data were divided into three graphs: First for Label Compliance; Second for Quantity of Micronutrients According to Portaria nº 33/98; And third Analysis from the Portion of Agreement with IDR for Lactating and Children of Portaria nº 33/98. From the analyzed cookies, 94% were in compliance with the information on the labels. Regarding to the amount of micronutrients, the vitamins B1, B2 and B3 showed higher values than recommended. Conclusion: The labels of the evaluated cookies did clearly present the necessary information for the consumer. It is necessary to build more specific norms directed to the nutritional attributions in the labels, with a language more accessible to society.(AU)

Vitamina B12 e homocisteína em pacientes com DHGNA: revisão sistemática e metanálise / Vitamin b12 and homocysteine levels in patients with nafld: a systematic review and metanalysis

ABSTRACT BACKGROUND: The vitamin B12 absorption can be affected in patients with nonalcoholic fatty liver disease (NAFLD), and low serum vitamin B12 levels has been related to the high homocysteine (HCY) levels and to the degree of NAFLD. OBJECTIVE: To carry out a systematic review and metanalysis of serum vitamin B12 and HCY levels in patients with NAFLD. METHODS: Original studies including serum vitamin B12 and HCY levels in humans with NAFLD were included. The searches were performed in four databases. RESULTS: 159 studies were identified, and after excluding the duplicates and non-eligible titles, eight original articles were included. Six out of eight showed higher B12 levels in NAFLD patients (404.9±136.2 pg/mL in relation to controls 353.91±117.3 pg/mL). Seven of the eight studies also showed higher HCY levels in NAFLD patients (14.2±3.44 umol/L in relation to controls 11.05±3.6 umol/L). The results for serum vitamin B12 and HCY levels were submitted to metanalysis, showing no difference in the vitamin B12 levels between patients with NAFLD and controls. However, the levels of Hcy were higher in NAFLD patients than in controls. CONCLUSION: There was no relashionship between the vitamin B12 levels and NAFLD. The levels of HCY were significantly higher in patients with NAFLD, suggesting this could be a potential marker for liver damage.

RESUMO CONTEXTO: A absorção de vitamina B12 pode ser afetada em pacientes com doença hepática gordurosa não alcoólica (DHGNA), e baixos níveis séricos de vitamina B12 têm sido relacionados a níveis elevados de homocisteína (HCI) ao grau de DHGNA. OBJETIVO: Realizar revisão sistemática e metanálise dos níveis séricos de vitamina B12 e de HCI em pacientes com DHGNA. MÉTODOS: Estudos originais que incluíssem avaliação dos níveis séricos de vitamina B12 e de HCI em humanos com DHGNA foram incluídos. As buscas foram realizadas em quatro bases de dados. RESULTADOS: Foram identificados 159 estudos e, após exclusão das duplicatas e dos não elegíveis, oito artigos originais foram incluídos. Seis dos oito artigos apresentaram níveis mais elevados de vitamina B12 nos pacientes com DHGNA (404,9±136,2 pg/mL) em relação aos controles (353,91±117,3 pg/mL). Sete dos oito estudos determinaram os níveis de HCI, estando aumentados em pacientes com DHGNA (14,2±3,44 umol/L) em relação aos controles (11,05±3,6 umol/L). Os resultados dos níveis séricos de vitamina B12 e HCI foram submetidos à metanálise, mostrando que não há diferença nos níveis de vitamina B12 entre os pacientes com DHGNA e os controles. No entanto, os níveis de HCI foram maiores nos pacientes com DHGNA do que nos controles. CONCLUSÃO: Não houve relação entre DHGNA e nível sérico de vitamina B12. Os níveis de HCI foram significativamente maiores em pacientes com DHGNA, sugerindo que esse poderia ser um potencial marcador de lesão hepática.

Tratamiento no hormonal del síndrome genitourinario de la menopausia / Non-hormonal treatment of genitourinary syndrome of menopause

El síndrome genitourinario de la menopausia (SGUM) describe los síntomas y signos vulvo-vaginales y del tracto urinario inferior, de carácter crónico y progresivo, secundario a un estado clínico de hipoestrogenismo que caracteriza a la postmenopausia. La presente revisión tiene como objetivo describir y analizar las diferentes alternativas terapéuticas no hormonales, con sus ventajas y desventajas, a fin de ofrecerle a los lectores una completa variedad de opciones a la hora de establecer el tratamiento en una mujer con SGUM. Se ha realizado una búsqueda en bases de datos, incluyendo investigaciones originales, consensos de expertos, revisiones sistemáticas y metaanálisis. Se ha revisado la evidencia actual para diversas modalidades terapéuticas farmacológicas y no farmacológicas (no hormonales), encontrando que los hidratantes y los lubricantes son la primera línea terapéutica para proporcionar alivio, a corto plazo, de la sequedad vaginal (leve a moderada) y la dispareunia; sin embargo, el tratamiento ha de ser individualizado. Existen numerosos tratamientos disponibles, cada uno con beneficios y limitaciones y se destacan las sustanciales lagunas, en la evidencia científica, de terapias seguras y efectivas, así como la necesidad de realizar investigaciones futuras..(Au)

The genitourinary syndrome of menopause (SGUM) describes the symptoms and signs of the vulvo-vaginal and lower urinary tract, of a chronic and progressive nature, secondary to a clinical state of hypoestrogenism that characterizes postmenopause. The present review aims to describe and analyze the different non-hormone therapeutic alternatives, with their advantages and disadvantages, in order to offer readers a full range of options when establishing treatment in a woman with SGUM. A database search, including original research, expert consensus, systematic reviews and meta-analysis. The current evidence for various pharmacological and non-pharmacological (non-hormonal) therapeutic modalities has been reviewed, finding that moisturizers and lubricants are the first line of therapy to provide short-term relief of vaginal dryness (mild to moderate) and dyspareunia; however, treatment must be individualized. It is concluded that there are numerous treatments available, each with benefits and limitations. Substantial gaps in the scientific evidence for safe and effective therapies are highlighted, as well as the need for future research..(Au)