Suplementos vitamínicos (Vit. C, D) y Zinc en infección por COVID-19 / Vitamin supplements (Vit. C, D) and Zinc in COVID-19 infection

CONTEXTO CLÍNICO: La enfermedad por el Coronavirus 2019 (COVID-19), por su sigla en inglés Coronavirus Disease 2019) es una enfermedad respiratoria de humanos por un nuevo Coronovirus identificado con la sigla SARS-CoV-2. TECNOLOGÍA: La vitamina C o ácido ascórbico es una vitamina soluble en agua con una función conocida sobre la síntesis de colágeno en tejidos conectivos y actúa como antioxidante. La vitamina D no solo es un nutriente sino también una hormona, que puede sintetizarse en nuestro cuerpo con la ayuda de la luz solar. El zinc es un oligoelemento dietético y es importante para el mantenimiento y el desarrollo de las células inmunes del sistema inmunitario innato y adaptativo. La deficiencia de Zinc resulta en la disfunción de la inmunidad humoral y mediada por células y aumenta la susceptibilidad a enfermedades infecciosas. OBJETIVO: El objetivo del presente informe es evaluar la evidencia disponible acerca de la eficacia, seguridad y aspectos relacionados a las políticas de cobertura del uso de suplementos vitamínicos (Vit. C, D) y Zinc en la infección por COVID-19. MÉTODOS: Se realizó una búsqueda en las principales bases de datos bibliográficas, en buscadores genéricos de internet, financiadores de salud. Se priorizó la inclusión de revisiones sistemáticas (RS), ensayos clínicos controlados aleatorizados (ECAs), evaluaciones de tecnologías sanitarias (ETS), evaluaciones económicas, guías de práctica clínica (GPC) y recomendaciones de diferentes organizaciones de salud. RESULTADOS: Se incluyeron una RS con MA, un protocolo de RS, un estudio observacional retrospectivo y ocho recomendaciones de sociedades científicas. No se hallaron estudios que evalúen la suplementación con vitaminas C y D para la prevención o tratamiento de la infección por COVID-19. Para Zinc, se halló un solo estudio que lo utiliza combinado con tratamientos discontinuados para esta patología por alertas en su seguridad. CONCLUSIONES: No hallaron estudios que evalúen la suplementación con las vitaminas C y D, solas o combinadas con otros tratamientos, en la prevención o tratamiento de la infección por COVID-19. Tampoco se encontraron estudios preventivos que evaluén el uso de Zinc. En el caso de su uso terapéutico, evidencia de muy baja calidad no permite determinar los efectos de la suplementación con Zinc en pacientes hospitalizados por COVID-19. Aunque se desconoce el efecto preventivo en relación al COVID-19, se halló evidencia de alta calidad de estudios realizados durante la era pre- COVID-19 que muestra que, en población general, la suplementación con vitamina D reduce el riesgo de infecciones respiratorias agudas. La incertidumbre actual podría reducirse a corto o mediano plazo debido a que se encuentran en curso aproximadamente 90 estudios que evaluarán el efecto de la administración C y D, y Zinc, solas o en combinación con otros tratamientos, para la prevención o tratamiento de la infección por COVID-19.

Nutrientes y alimentos en la esclerosis múltiple / Nutrients and foods in multiple sclerosis. Abstract

La alimentación influye en la mejora de la sintomatología de cualquier enfermedad, incluida la esclerosis múltiple (EM),la cual, se caracteriza por un proceso inflamatorio crónico, autoinmune del sistema nervioso central generando situaciones como inflamación, alteraciones; digestivas y mentales, discapacidad, y fatiga. El propósito de la presente revisión fue identificar la evidencia científica sobre los aspectos nutricionales que mejoran la progresión de EM. La metodología consistió en la búsqueda de literatura, en bases de datos electrónicas, referente a nutrición y esclerosis múltiple, principalmente entre los años 2015-2020. Entre los resultados de los aspectos nutricionales que mostraron eficacia en mejorar la progresión de EM, se encuentran el zinc, vitamina D, fibra, probióticos, aceite de pescado y de oliva, cacao, cúrcuma, y salmón. Existen evidencias del papel inmunomodulador del Zn y de la vitamina D en la inhibición de la producción de citocinas proinflamatorias. Niveles bajos de ambos componentes se asocian con mayor riesgo de padecer EM. Otros componentes de interés nutricional son la fibra y probióticos; producen ácidos grasos de cadena corta, con propiedades antiinflamatorias. La primera se conoce por su papel en la motilidad gastrointestinal y los segundos por su acción celular y molecular en procesos inflamatorios, y modulación del microbioma, por mencionar algunos. Los aspectos nutricionales antes mencionados pueden contribuir a modular la inflamación y mejorar la fatiga. Finalmente, este documento genera un panorama importante para continuar con la investigación referente a la influencia de la alimentación en pacientes con EM(AU)

Diet influences the improvement of the symptoms of any disease, including multiple sclerosis (MS), which is characterized by a chronic, autoimmune inflammatory process of the central nervous system generating situations such as inflammation, mental and digestive alterations, disability and fatigue. The aim of this review was to identify the scientific evidence on the nutritional aspects that improve the progression of MS. The methodology consisted of searching literature, in electronic databases, referring to nutrition and multiple sclerosis, mainly between the years 2015-2020. The results of the nutritional aspects that showed effectiveness in improving the progression of MS, are zinc, vitamin D, fiber, probiotics, fish oil and olive oil, cocoa, turmeric and salmon. There is evidence of the immunomodulatory role of Zn and vitamin D in inhibiting the production of proinflammatory citokines. Low levels of both components are associated with an increased risk of MS. Other components of nutritional interest are fiber and probiotics; they produce short chain fatty acids, with anti-inflammatory properties. The first is known for its role in gastrointestinal motility and the second one for its cellular and molecular actions in inflammatory processes and the microbiome modulation, to name a few. The nutrition aspects mentioned above, can contribute to modulate inflammation and improve fatigue. Finally, this paper creates an important perspective to continue the investigation concerning the influence of diet in MS patients(AU)

Performance, carcass yield, and meat quality of broilers supplemented with organic or inorganic zinc / Desempenho, rendimento e qualidade da carne de frangos de corte suplementados com zinco orgânico ou inorgânico

A total of 640 one-day-old Cobb broiler chicks, half male and half female, were reared up to 49 days of age. A completely randomized 2 × 4 factorial design was used. Experimental treatments consisted of four levels of organic zinc supplementation and one control (inorganic zinc supplementation) and two levels of sex (female and male), with four replicates of 16 birds per experimental plot. Animal performance, carcass and cut yields, and meat quality were evaluated. Feed intake increased with zinc supplementation. Broilers that received the lowest level of organic zinc showed better feed conversion than those fed an equivalent level of inorganic zinc. Increased levels of organic zinc reduced the abdominal fat content in females but impaired the oxidative stability of meat. The results showed that male broilers have better performance, carcass yield, and meat quality than females and that organic zinc improves broiler feed conversion and reduces abdominal fat but increases lipid oxidation in meat.(AU)

Foram alojados 640 pintainhos de corte, sendo metade de machos e metade de fêmeas, da linhagem Cobb, de um a 49 dias de idade. Foi adotado um delineamento inteiramente ao acaso, em esquema fatorial 2 × 4. Os tratamentos experimentais consistiram em quatro níveis de suplementação de zinco orgânico e um controle inorgânico, e diferentes sexos, com quatro repetições de 16 aves por parcela experimental. Foram avaliados o desempenho, a característica da carcaça e dos cortes, bem como a qualidade de carne dos frangos. O aumento dos níveis de zinco elevou o consumo de ração dos frangos. Os frangos que receberam zinco orgânico na exigência mínima apresentaram melhor conversão alimentar comparados àqueles que receberam ração de fonte inorgânica. O aumento nos níveis de zinco orgânico proporcionou redução no teor de gordura abdominal para fêmeas, mas níveis de zinco orgânico prejudicaram a estabilidade oxidativa da carne. Conclui-se que frangos machos apresentam melhor desempenho, carcaça e qualidade de carne em relação às fêmeas, e que o zinco orgânico melhora a conversão alimentar dos frangos, reduz a gordura abdominal, porém eleva a oxidação lipídica da carne.(AU)

Relação zinco cobre em dietas de codornas japonesas em postura / Zinc copper ratio of Japanese quails diets posture

Objetivou-se verificar o efeito da suplementação de diferentes relações de zinco orgânico e de cobre inorgânico, bem como comparar os resultados com a dieta controle de codornas japonesas, sobre o desempenho produtivo e a qualidade dos ovos. Foram realizados dois experimentos na área experimental da Universidade Federal do Espírito Santo: variando os níveis de zinco orgânico e mantendo os de cobre recomendados e outro variando os níveis de cobre inorgânico. O período experimental foi de 84 dias, divididos em períodos de 21 dias. Foram usadas cinco pré-misturas minerais. Foram analisadas variáveis de desempenho e qualidade dos ovos. Foi observado primeiramente que as variáveis avaliadas não foram afetadas de forma significativa pelas diferentes relações dos minerais, exceto para pesos relativo e absoluto da casca. No segundo ensaio, não houve interação entre os níveis de zinco e de cobre nem entre estes e a dieta controle, para nenhuma das variáveis observadas; quando analisadas as médias individuais, foi observada diferença significativa para taxa de postura, relação ovos comerciais e totais, consumo de ração e na unidade Haugh. Pode-se concluir que a relação de 35mg/kg de zinco orgânico e a de 3,5mg/kg de cobre inorgânico atenderam as necessidades nutricionais dos animais para desempenho e qualidade de ovos.(AU)

The objective of this study was to verify the effect of the supplementation of different organic zinc and inorganic copper ratios and to compare the results with the Japanese quail control diet on the productive performance and egg quality. Two experiments were carried out in the experimental area of the Federal University of Espírito Santo, varying the levels of organic zinc and maintaining the recommended copper and the other varying levels of inorganic copper. The experimental period was 84 days. Five mineral premixes were used. Performance and egg quality variables were analyzed. It was first observed that the evaluated variables were not affected significantly by the different mineral relations, except for relative and absolute weight of the bark. In the second test, there was no interaction between the zinc and copper levels, neither between the control and the control diet, for any of the variables observed, when analyzing the individual means, a significant difference was observed for posture rate, commercial and total eggs ratio, feed intake, and in the Haugh Unit. It can be concluded that the ratio of 35mg/kg organic zinc and 3,5mg/kg of inorganic copper met the nutritional requirements of the animals for performance and egg quality.(AU)

Determinantes dietéticos del consumo de zinc en menores de cinco años con retardo del crecimiento en comunidades mayas de Guatemala / Dietetic Determinants of Zinc Consumption in Stunted Children Under Five in Maya Communities From Guatemala

RESUMEN El objetivo del estudio fue identificar elementos del patrón alimentario que influyen en la ingesta y biodisponibilidad de zinc en niños con retardo del crecimiento (RC) entre 1-5 años en comunidades maya de la localidad de Huehuetenango, Guatemala. Estudio descriptivo, transversal aplicado en 138 niños de entre 1-5 años con RC. Se realizó un inventario de disponibilidad alimentaria de fuentes de zinc, se construyó un cuestionario frecuencia de consumo de alimentos, un cuestionario de condiciones de vida, prácticas alimentarias, antropometría, y se recolectó información acerca de enfermedades infecciosas. Hubo disponibilidad de 28 alimentos fuentes de zinc (54% de baja y 7% de alta biodisponibilidad). El consumo de alimentos de alta biodisponibilidad fue bajo y el de alimentos antagonistas, alto. Los niños consumían 3 mg de zinc al día (IC95% 2,65-3,35). Solo el 14,5% alcanzaba los requerimientos de zinc, y el 2,9% alcanzaba la recomendación diaria. La ocurrencia de diarrea e infecciones, en los quince días previos, fue del 29,71 y 45,65%, respectivamente. Concluimos que la mayoría de niños con RC tuvo un bajo consumo de fuentes de zinc, alto consumo de alimentos antagonistas.

ABSTRACT The objective of the study was to identify the elements from feeding patterns that influence the intake and bioavailability of zinc in stunted children (SC) 1-5 years from Maya communities living in Huehuetenango, Guatemala. This descriptive, cross-sectional study was performed in 138 stunted children aged 1-5 years. It was applied: an inventory of zinc food sources availability, a Food Frequency Questionnaire, a questionnaire about living conditions. anthropometrics measurements and information on food intake habits, and information about disease prevalence. Twenty-eight food sources of zinc were available for consumption (54% low and 7% high zinc bioavailability). The consumption of foods with high bioavailability was low, while the antagonistic foods were high. On average the daily zinc consumption in diet 3 mg (95% CI: 2.65-3.35). Only 14.5% of the children met the zinc requirements, and 2.9% reached the daily recommendation. Episodes of diarrhea and respiratory infections were observed 15 days before the visit, in 29.71% and 45.6% of children, respectively. Most of children have a diet that does not cover the daily requirement.

Efeito metafilático do zinco injetável sobre parâmetros metabólicos e oxidativos de ovelhas no pós-parto imediato / Metaphylactic effect of injectable zinc on metabolic and oxidative parameters of sheep in the immediate postpartum

The aim of this study was to evaluate a new source of injectable organic zinc (zinc edetate) on the energy and oxidative profile in sheep during the immediate postpartum period. Twenty-six Texel breed animals were previously identified and divided into two experimental groups: the treated group (TG; n= 13) that comprised the animals that received a subcutaneous (SC) injection of 100 mg of zinc edetate (2 mL) fifteen days before the parturition expected date and the control group (CG; n=13) that comprised the animals that received 2mL of physiological solution at the same date of TG. Blood samples were collected on the parturition day for the assessment of serum fructosamine, cholesterol and triglycerides, insulin-like growth factor type 1 (IGF-1), the oxidative stress index (OSi) and blood zinc concentration. In addition to these parameters, the measurement of zinc was made in food given to the animals. There was no difference in metabolic parameters and OSi between the experimental groups (P>0.05), as well as in blood zinc concentrations (P>0.05). The parenteral zinc edentate does not change the energy and oxidative profile of sheep in immediate postpartum.(AU)

Effect of supplementary zinc on orthodontic tooth movement in a rat model

ABSTRACT Introduction: Osteoclasts and osteoblasts are responsible for regulating bone homeostasis during which the trace element zinc has been shown to exert a cumulative effect on bone mass by stimulating osteoblastic bone formation and inhibiting osteoclastic bone resorption. Objective: The aim of the present study was to investigate the effects of zinc (Zn) on orthodontic tooth movement (OTM) in a rat model. Material and Methods: A total of 44 male Wistar rats were divided into four groups of 11 animals each and received 0, 1.5, 20 and 50 ppm Zn in distilled water for 60 days. In the last 21 days of the study, nickel-titanium closed coil springs were ligated between maxillary right incisors and first molars of all rats, and tooth movement was measured at the end of this period. Histological analysis of hematoxylin/eosin slides was performed to assess root resorption lacunae, osteoclast number and periodontal ligament (PDL) width. Results: Mean OTM was calculated as 51.8, 49.1, 35.5 and 45 µm in the 0, 1.5, 20 and 50 ppm zinc-receiving groups, respectively. There were no significant differences in neither OTM nor histological parameters among the study groups (p > 0.05). Conclusion: According to the results obtained in the current investigation, increase in supplementary zinc up to 50 ppm does not affect the rate of OTM neither bone and root resorption in rats.

RESUMO Introdução: os osteoclastos e os osteoblastos são responsáveis por regular a homeostase óssea, processo no qual o oligoelemento zinco tem demonstrado exercer um efeito cumulativo sobre a massa óssea, estimulando a formação óssea osteoblástica e inibindo a reabsorção óssea osteoclástica. Objetivo: o objetivo do presente estudo foi investigar os efeitos do zinco (Zn) sobre a movimentação dentária ortodôntica (MDO) em ratos. Métodos: um total de 44 ratos Wistar machos foi dividido em quatro grupos de 11 animais cada, os quais receberam 0; 1,5; 20 e 50ppm de zinco diluído em água destilada, durante 60 dias. Nos últimos 21 dias do estudo, molas helicoidais fechadas de níquel-titânio foram instaladas entre os incisivos direitos e os primeiros molares superiores de todos os ratos, e a movimentação dentária foi medida ao final desse período. Foi realizada análise histológica de cortes corados por hematoxilina-eosina, para avaliar as lacunas de reabsorção radicular, o número de osteoclastos e a espessura do ligamento periodontal. Resultados: as médias da MDO foram estimadas em 51,8; 49,1; 35,5 e 45µm no grupos que receberam, respectivamente, 0; 1,5; 20 e 50ppm de zinco. Não houve diferença significativa entre os grupos experimentais, nem quanto à MDO, nem quanto aos parâmetros histológicos (p > 0,05). Conclusão: segundo os resultados obtidos na presente investigação, verificou-se que um aumento na dose de suplementação com zinco para 50ppm não afeta nem o índice de MDO, nem a reabsorção óssea ou radicular em ratos.

The effect of dietary supplements on healing of alloplastic bone grafted defects in rat tibia / Efecto de los suplementos dietarios sobre la cicatrización de defectos injertados con hueso aloplástico en la tibia de ratas

The aim of this investigation was to evaluate the potential effects of the systemically delivered combination of calcium, zinc and vit-d supplementation of the locally applied alloplastic bone graft. 28 male Wistar albino rats were used in this study. In each animal, bone defects (10 mm length ¥ 3 mm width ¥ 2 mm depth) were created in the tibias. The animals were divided into four groups. In Group 1 (Control Group) rats were fed with standard rat diet. In Group 2 (Calcium Group) rats received calcium carbonate (15 mg/kg body weight) suspended in saline. In Group 3 (Calcium/Zinc Group) rats received calcium carbonate (15 mg/kg body weight) and zinc sulfate (4 mg/kg body weight) suspended in saline. In Group 4 (Calcium/Vitamin D Group) rats received calcium carbonate (15 mg/kg body weight) and Vitamin D (500 IU/kg body weight) suspended in olive oil. Histopathological analysis of samples was performed to evaluate the process of osteoblastic activity, matrix formation, trabecular bone formation and myeloid tissue in bone defects. Total amounts of osteoblastic activity, matrix formation, trabecular bone formation and myeloid yissue in Ca Group (p= 0.002), Ca/Zinc Group (p= 0.002), and Ca/Vit.D Group (p= 0.001) were significantly higher than in Control Group. The total amounts of Ca/Vit.D Group were significantly different than Control Group and Ca Group. The results of the present study indicated that the oral calcium carbonate supplementation combination with zinc may have systemic effects on accelerating bone regeneration in alloplastic bone grafted tibial defects. Further human studies involving long-term follow up and different type of bone grafts should be conducted.

El objetivo de esta investigación fue evaluar los efectos potenciales de la combinación sistémica de calcio, zinc y vitamina D como suplemento de la aplicación local de un injerto óseo aloplástico. Fueron utilizadas 28 ratas Wistar albinas (machos). En cada animal, se crearon defectos óseos en las tibias (cuyas medidas fueron: 10 mm de longitud x 3 mm de ancho x 2 mm de profundidad). Los animales fueron divididos en cuatro grupos. En el Grupo 1 (control) las ratas fueron alimentadas con una dieta estándar. En el Grupo 2 (grupo de calcio) las ratas recibieron carbonato de calcio (15 mg/kg de peso corporal) suspendido en solución salina. En el Grupo 3 (grupo de calcio/zinc) las ratas recibieron carbonato de calcio (15 mg/kg de peso corporal) y sulfato de zinc (4 mg/kg de peso corporal) suspendido en solución salina. El Grupo 4 (calcio/vitamina D) recibió carbonato de calcio (15 mg/kg de peso corporal) y vitamina D (500 UI/kg de peso corporal) suspendidos en aceite de oliva. Se realizó un análisis histopatológico de las muestras para evaluar el proceso de actividad osteoblástica, formación de la matriz, hueso trabecular y tejido mieloide en defectos óseos. Las cantidades totales de actividad osteoblástica, formación de matriz, de hueso trabecular y tejido mieloide en los grupos Calcio (p= 0,002), Calcio/Zinc (p= 0,002), y Calcio/Vitamina D (p= 0,001) fueron significativamente mayores que en el grupo de control. Las cantidades totales de Calcio/Vitamina D Grupo fueron significativamente diferentes de los grupos Control y Calcio. Los resultados del presente estudio indican que lacombinación de suplementos de carbonato de calcio por vía oral con zinc puede tener efectos sistémicos sobre la aceleración de la regeneración ósea en defectos tibiales con injertos aloplásticos. Deben llevarse a cabo otros estudios en humanos, que involucren un largo plazo de seguimiento y también diferentes tipos de injertos óseos.

Asociación entre los niveles de zinc intracelular y el estado nutricional de los niños infectados por el virus de la inmunodeficiencia humana (VIH) y los niños expuestos al virus no infectados / Association between Intracellular zinc levels and nutritional status in HIV-infected and uninfected children exposed to the virus

Introducción: Desnutrición, retardo en el crecimiento e infecciones oportunistas sobrevienen a alteraciones metabólicas, inmunológicas y gastrointestinales que produce el virus de la inmunodeficiencia humana (VIH). La deficiencia de zinc se ha asociado con deterioro nutricional, falla en el crecimiento y riesgo de infecciones. El objetivo de este estudio fue asociar los niveles de zinc en células mononucleares de sangre periférica (PBMC) con el estado nutricional en niños infectados por el VIH y en niños no infectados expuestos al virus. Pacientes y Método: Estudio analítico observacional, transversal, en 17 niños infectados y 17 expuestos, entre 2 y 10 años de edad. Se realizó valoración antropométrica, historia clínica-nutricional, recordatorio de 24 horas, medición de actividad física y determinación de zinc en PBMC por citometría de fiujo. Resultados: La talla para la edad, el consumo de energía, y la adecuación de energía, proteínas y zinc alimentario fueron significativamente mayores en los niños expuestos comparados con los niños infectados (p < 0,05). No se hallaron diferencias significativas en el índice de masa corporal, los niveles de zinc en monocitos, linfocitos CD4+ y CD4- entre los dos grupos de estudio (p > 0,05); sin embargo, la mediana de los niveles de zinc en monocitos de pacientes infectados fue mayor (218,6) comparado con el grupo control (217,0). No se encontró asociación entre consumo de zinc y niveles de zinc intracelular. Conclusiones: El deterioro del estado nutricional y el retardo en el crecimiento en niños estuvo asociado al VIH, pero no a los niveles de zinc intracelular. El consumo alimentario de este nutriente no se asoció a niveles de zinc en monocitos y linfocitos CD4+ y CD4-.

Introduction: Malnutrition, growth retardation and opportunistic infections outlast the metabolic, immune and gastrointestinal disorders produced by HIV. Zinc deficiency has been associated with deteriorating nutritional status, growth failure, and risk of infection. The aim of this study is to determine the association between zinc levels in peripheral blood mononuclear cells (PBMC) and the nutritional status of HIV-infected and uninfected children exposed to the virus. Patients and Methods: An analytical, observational, cross-sectional study was conducted on 17 infected and 17 exposed children, aged 2-10 years. Anthropometric measurements, clinical and nutritional history, 24 h recall, measurement of physical activity, and zinc in PBMC by fiow cytometry analysis were recorded. Results: Height according to age, energy consumption and adequacy of energy, protein and dietary zinc were significantly higher in children exposed to the virus compared to those infected with HIV (P < 0.05). No significant differences were found in BMI, levels of zinc in monocytes, CD4+ and CD4- lymphocytes between the two study groups (P > 0.05). However, the median levels of zinc in monocytes of infected patients was higher (218.6) compared to the control group (217.0). No association was found between zinc intake and levels of intracellular zinc. Conclusions: The deterioration of nutritional status and growth retardation in children were associated with HIV, but not with the levels of intracellular zinc. The dietary intake of this nutrient was not associated with levels of zinc in monocytes or CD4+ and CD4- lymphocytes.

Intake of antioxidants in patients with rheumatoid arthritis / Consumo de antioxidantes em portadores de artrite reumatoide

Objective: to investigate dietary intake of antioxidants in patients with rheumatoid arthritis. Methods: this is a cross-sectional case series study with 53 women accompanied at the Rheumatology Outpatient Clinic, Hospital das Clínicas/UFPE, from January to October 2012. Demographic and anthropometric parameters (weight, height, body mass index, weight change) were collected by means of a form. The assessment of food consumption was conducted using a semi-quantitative food frequency survey, analyzed according to a food composition table. Database construction and statistical analysis were performed using Excel and SPSS version 18.0, using chi-squared test, Anova, and Student’s t-test, at a confidence level of 5%. Results: the sample was composed of 53 women with a mean age of 54.51 ± 4.24 years and BMI of 25.97 ± 5.94 kg/m². In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant. Conclusion: the sample was composed of 53 women with a mean age of 54.51 ± 4.24 years and BMI of 25.97 ± 5.94 kg/m². In the sociodemographic variables, statistically significant differences in origin, occupation, and income were observed. Daily consumption showed significance for vitamins A, C, and zinc. In adults, vitamins A and C were in accordance with recommendations, while in the elderly a low intake of vitamin E and selenium was observed. The relation between vitamin E and origin was significant. .

Objectivo: investigar o consumo alimentar de antioxidantes em pacientes portadores de artrite reumatoide. Métodos: estudo transversal do tipo série de casos com 53 mulheres acompanhadas no Ambulatório de Reumatologia do Hospital das Clínicas da Universidade Federal de Pernambuco (HC-UFPE), de janeiro a outubro de 2012. Por meio de formulário, foram coletados parâmetros sociodemográficos e antropométricos (peso, estatura, índice de massa corpórea [IMC], alteração ponderal). A avaliação do consumo alimentar foi realizada por questionário de frequência alimentar semiquantitativo, analisado por tabela de composição de alimentos. A construção do banco de dados e a análise estatística foram realizadas por Excel e SPSS versão 18.0, com aplicação de testes Qui-quadrado, Anova e t-Student, com nível de confiança de 5%. Resultados: demonstrou-se que os pacientes apresentaram baixo consumo de vitaminas A, C e zinco. Portanto, ressalta-se a importância de maior consumo de alimentos fontes em antioxidantes, a fim de contribuir para a prevenção da lesão articular e a perda da função reumática, melhorando a qualidade de vida do paciente. Conclusão: demonstrou-se que os pacientes apresentaram baixo consumo de vitaminas A, C e zinco. Portanto, ressalta-se a importância de maior consumo de alimentos fontes em antioxidantes, a fim de contribuir para a prevenção da lesão articular e a perda da função reumática, melhorando a qualidade de vida do paciente. .

Effects of glutamine alone or in combination with zinc and vitamin A on growth, intestinal barrier function, stress and satiety-related hormones in Brazilian shantytown children

OBJECTIVE: To determine the impact of supplemental zinc, vitamin A, and glutamine alone or in combination on growth, intestinal barrier function, stress and satiety-related hormones among Brazilian shantytown children with low median height-for-age z-scores. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in children aged two months to nine years from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for testing (a total of 120 children) were as follows: (1) glutamine alone, n = 38; (2) glutamine plus vitamin A plus zinc, n = 37; and a placebo (zinc plus vitamin A vehicle) plus glycine (isonitrogenous to glutamine) control treatment, n = 38. Leptin, adiponectin, insulin-like growth factor (IGF-1), and plasma levels of cortisol were measured with immune-enzymatic assays; urinary lactulose/mannitol and serum amino acids were measured with high-performance liquid chromatography. ClinicalTrials.gov: NCT00133406. RESULTS: Glutamine treatment significantly improved weight-for-height z-scores compared to the placebo-glycine control treatment. Either glutamine alone or all nutrients combined prevented disruption of the intestinal barrier function, as measured by the percentage of lactulose urinary excretion and the lactulose:mannitol absorption ratio. Plasma leptin was negatively correlated with plasma glutamine (p = 0.002) and arginine (p = 0.001) levels at baseline. After glutamine treatment, leptin was correlated with weight-for-age (WAZ) and weight-for-height z-scores (WHZ) (p≤0.002) at a 4-month follow-up. In addition, glutamine and all combined nutrients (glutamine, vitamin A, and zinc) improved the intestinal barrier function in these children. CONCLUSION: Taken together, these findings reveal the benefits of glutamine alone or in combination ...

Prevalencia de deficiencia y consumo de hierro, zinc y cobre en mujeres chilenas en edad fértil / Prevalence of deficiency and dietary intake of iron, zinc and copper in Chilean childbearing age women

El objetivo del presente estudio es evaluar el estado nutricional e ingesta de hierro (Fe), zinc (Zn) y cobre (Cu) en mujeres chilenas en edad fértil. Se estudió una muestra de conveniencia de 86 mujeres entre 18 a 48 años de edad de la ciudad de Santiago, Chile. El estado nutricional de Fe se determinó a través de hemoglobina (Hb), volumen corpuscular medio, saturación de transferrina, zinc protoporfirina, ferritina sérica (FS), Zn y Cu séricos. La ingesta dietética fue evaluada con una encuesta de frecuencia de consumo. Un 4,7% de las mujeres presentó anemia por deficiencia de Fe, 21% deficiencia de Fe sin anemia, 26% depósitos depletados de Fe y un 48,3% estado nutricional normal de Fe. Las mujeres obesas presentaron mayores niveles de FS (p<0,01) al comparar con mujeres con peso normal. Además, presentaron niveles más altos de Hb (p<0,05) al comparar con mujeres con estado nutricional normal y sobrepeso. El 3,5% y 2,3% de las mujeres presentó deficiencia de Zn y Cu, respectivamente. El 95%, 94% y 99% cumplió el EAR para Fe, Zn y Cu, respectivamente. No se encontraron diferencias significativas en la ingesta de micronutrientes entre las mujeres al comparar por estado nutricional. En conclusión, un alto porcentaje de las mujeres presentó una ingesta adecuada de micronutrientes. Además existe una baja prevalencia de deficiencia de Zn, Cu y anemia. Sin embargo, un 47% presenta deficiencia de Fe en etapas anteriores a la de anemia.

The aim of the present study was to evaluate anemia, the biochemical status and dietary adequacy of iron (Fe), zinc (Zn) and copper (Cu), in Chilean childbearing age women. We studied a convenience sample of 86 women aged 18 to 48 years from Santiago, Chile. We determined anemia and the micronutrient status through hemoglobin (Hb) mean corpuscular volume, transferrin saturation, zinc protoporphyrin, serum ferritin (SF), serum Zn and Cu. Dietary adequacy was estimated using a food frequency questionnaire. Of all women, 4.7% had Fe deficiency (ID) anemia, 21 % ID without anemia, 26 % depleted Fe stores and 48.3% normal Fe status. Obese women had higher SF (p<0.01) compared with those classified as having normal BMI. Also, showed higher Hb (p<0.05) concentrations compared with overweight and normal weight women. Participants showed 3.5 % and 2.3 % of Zn and Cu deficiency, respectively. Also, 95 %, 94 % and 99 % had adequate intake of Fe, Zn and Cu respectively, according to EAR cut points. There were no significant differences in micronutrients intake across different nutritional status. There was a low prevalence of anemia, Fe, Zn and Cu deficiency. A high percentage of women reached micronutrient adequacy. However, 47% of women had ID without anemia and Fe depleted stores.

Efficacy of Zinc Supplementation as an Adjunct to Anti Tubercular Drug Therapy.

Zinc being a stronger electron acceptor than iron might replace iron from the critical thiol groups. So, Zinc supplementation in Tubercular Subjects might help the decompartmentalised state of iron in the body to revert back to normal compartmentalized state of iron. Again, Zinc inhibits the formation of superoxide radicals. Thus, Zinc supplementation might decrease the excess superoxide with simultaneous decrease in the formation of soluble oxygen made by dismutation reaction by the iron cofactored superoxide dismutase secreted extracellularly by the pathogenic M. tuberculosis. The study shows early and effective recovery with Zinc supplementation (50mgm. of elemental zinc orally / day for one month) along with anti - Tubercular drug therapy. This gets support by the significant changes in the serum level of three enzymes – Glutamine Synthetase, Superoxide Dismutase and Cholienesterase. Again, the dose of zinc supplementation instituted with a great benefit and without any toxic symptoms and signs, is below the Lowest Observed Adverse Effect Level (LOAEL) based on the superoxide dismutase activity in erythrocytes with zinc intake.

Review of Various Indicators for Assessment of Zinc Requirement and Effectiveness.

Zinc (Zn) has been shown to be an essential micronutrient for all organisms including plants, animals and human beings. Deprivation of zinc arrests growth and development and produces multiple system dysfunctions in all these organisms. Because of the involvement of this micronutrient in so many core areas of metabolism, it is common that the features of zinc defi ciency in humans are nonspecifi c with a wide range including growth retardation, alopecia, diarrhea, delayed sexual maturation and impotence, eye and skin lesions and even impaired appetite. Clinical features and laboratory criteria are not always consistent. Th is inconsistency poses a major diffi culty in the search to reliable yet sensitive clinical or functional indicator of zinc status for validation. Further, it has become clear now that the homeostatic mechanisms fall short of perfection and clinically important features of zinc defi ciency can occur with only modest degrees of zinc defi ciency. In this review article we try to look critically at the available tests and various indicators for assessment of zinc’s level for potential requirement and eff ectiveness and try to conclude about the effi cacy of each.

Valores de referencia de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles para la población venezolana / Reference values of iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols for the Venezuelan population

Esta revisión de las recomendaciones de energía y nutrientes para la población Venezolana presenta los valores de hierro, yodo, zinc, selenio, cobre, molibdeno, vitamina C, vitamina E, vitamina K, carotenoides y polifenoles. Se adoptan definiciones internacionales de Ingestas Dietéticas de Referencia (DRIs por Dietary Reference Intakes) que incluyen: Ingesta Dietética Recomendada (RDA), Requerimiento Promedio Estimado (EAR), Ingesta Adecuada (AI) y Niveles de Ingesta Máximos Tolerables (UL). Las RDA para hierro: 11 mg/día para < 1 año, 7-10 mg/día niños, 8-11 mg/día para hombres, 8-18 mg/día para mujeres y 27 mg/día para embarazadas. RDA Yodo: 110-130 mg/ día recién nacidos, 90-120 mg/día niños y adolescentes y 150 mg/ día adultos, 220 mg/día embarazo y 290 mg/día lactancia. RDA Zinc: 2-3 mg/día < 1 año, 3-5 mg/día niños, 8-11 mg/día adolescentes y hombres, 8-9 mg/día adolescentes y mujeres, 12 mg/ día para embarazadas y 13 mg/día durante la lactancia. RDA Vitamina C: 40-50 mg/día recién nacidos, 15-45 mg/día niños, 75 mg/día adolescentes masculinos, 65 mg/día adolescentes femeninas, 90 mg/día hombres y 75 mg/día mujeres, 80-85 mg/día embarazadas y lactancia 115-120 mg/día. También se presentan valores de cobre, selenio, molibdeno, vitaminas E, K, carotenoides y polifenoles. Estas recomendaciones contribuirán al diseño de políticas adecuadas y eficientes que puedan ayudar a evitar o a tratar las consecuencias derivadas de la deficiencia o el exceso de estos nutrientes.

The review on iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols recommendations for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). The RDA for iron: 11 mg/day for infants < 1 year of age, 7 - 10 mg/day for children, 8-11 mg/day for males, 8-18 mg/day for females and 27 mg/day during pregnancy. RDA for iodine: 110-130 mg/day for infants, 90-120 mg/ day for children and adolescents, 150 mg/day for adults, 220 mg/ day for pregnancy and 290 mg/day during lactation. RDA Zinc: 2-3 mg/day for infants, 3-5 mg/day for children, 8-11 mg/day for male adolescents and adults, 8-9 mg/day for female adolescents and adults, 12 mg/day during pregnancy and 13 mg/day for lactation. RDA Vitamin C: 40-50 mg/day for infants, 15-45 mg/ day for children, 75 mg/day for male adolescents, 65 mg/day for female adolescents, 90 mg/day for adult males, 75 mg/day for adult females, 80-85 mg/day during pregnancy and 115-120 mg/ day during lactation. Recommendations for copper, selenium, molybdenum, vitamins E, K, carotenoids and polyphenols are also presented. These recommendations will help to design adequate and efficient policies that could help to avoid or to treat the consequences derived from the deficiency or the excess of these nutrients.

Effect of Zinc Supplementation on Adenosine Deaminase Activity in Leprosy.

Serum Adenosine Deaminase (ADA) acts as marker of cellular immunity and its activity is found to be altered in various diseases in which there is a cell mediated immune response (CMI) including leprosy. The role of zinc is well established in the development and maintainence of immunocompetence and its supplementation activates the immune response in particular Tlymphocytes and monocytes in several ways. The aim of the study was planned to evaluate the effect of nutritional zinc supplementation on cell mediated immune response by investigating the pre and post intervention serum ADA levels after oral zinc sulphate supplementation in leprosy patients. A total of 49 cases, 30 Tuberculoid Leprosy (TT) and 19 Lepromatous Leprosy (LL) patients, within the age group of 25-60 years were enrolled in the study along with 30 age matched healthy controls. Serum ADA was estimated in all the subjects before and after (2 months and 4 months) oral zinc supplementation. Pre intervention serum ADA level was observed to be significantly increased in both the TT and LL (p<0.001) groups as compared to controls, revealing raised immunological activity in the patients. After oral zinc sulphate supplementation serum ADA re-evaluation was done in 38 cases. A highly significant (p < 0.001 ) rise in ADA level was registered in the post intervention period (4 months supplementation) in TT cases with a moderately significant (p< 0.05) increase in LL cases, indicating the ability of oral zinc therapy to affectively alter the cell mediated immune response in leprosy.

Foliar application of Zn at flowering stage improves plant’s performance, yield and yield attributes of black gram.

Black gram plants subjected to varying levels of Zn supply (0.01 to 10 µM Zn) showed optimum growth and dry matter yield in plants receiving 1 µM Zn. The dry matter yield of plants decreased in plants receiving 0.01 and 0.1 µM Zn (deficient) and excess levels of Zn (2 and 10 µM Zn). The plants grown with Zn deficient supply showed delayed flowering, premature bud abscission, reduced size of anthers, pollen producing capacity, pollen viability and stigma receptivity resulting in poor pod formation and seed yield. Providing Zn as a foliar spray at pre-flowering stage minimized the severity of Zn deficiency on reproductive structure development and enhanced the seed nutritional status by enhancing seed Zn density, seed carbohydrate (sugar and starch content) and storage proteins (albumins, globulins, glutenins, and prolamines).

Suplementação de zinco e outros micronutrientes através do uso de sprinkles: impacto na ocorrência de doença diarreica e infecções respiratórias em crianças institucionalizadas / Zinc and other micronutrients supplementation through the use of sprinkles: impact on the occurrence of diarrhea and respiratory infections in institutionalized children

OBJETIVO: Avaliar a incidência de doenças diarreicas (DA) e infecção respiratória aguda (IRA) em crianças submetidas à suplementação de zinco e outros micronutrientes através dos sprinkles, bem como a aceitação destes pelos participantes. MÉTODO: Ensaio clínico, duplo cego, randomizado, realizado com 143 crianças institucionalizadas, saudáveis, de seis a 48 meses. As mesmas foram randomizadas em dois grupos e receberam diariamente zinco + micronutrientes - grupo teste (sprinkles), ou apenas micronutrientes sem zinco - grupo controle. As crianças foram suplementadas por 90 dias e acompanhadas quanto aos desfechos de DA e IRA. RESULTADOS: Das crianças randomizadas, 52,45% pertenciam ao grupo teste e 47,55% ao controle. A incidência de DA no teste foi de 14,7%, e no controle, 19,1%. O grupo teste apresentou menor risco de desenvolver DA em relação ao controle, porém esse achado não foi estatisticamente significante (RR = 0,77 [0,37-1,6]; p = 0,5088). A IRA apresentou incidência elevada em ambos os grupos, sendo 60% no teste e 48,5% no controle, com risco maior de apresentar a doença no grupo teste, porém sem significância estatística (RR=1,24 [0,91-1,68]; p = 0,1825). Quanto à aceitação, o percentual médio de consumo, em dias, de todo conteúdo dos sachês contendo sprinkles foi 95,72% (DP = 4,9) e 96,4% (DP = 6,2), para o teste e controle, respectivamente. CONCLUSÕES: A suplementação de zinco através dos sprinkles não reduziu a incidência de DA ou IRA entre as crianças avaliadas. Os sprinkles foram bem aceitos por todos os participantes do estudo.

OBJECTIVE: To evaluate the incidence of diarrheal disease (DD) and acute respiratory infection (ARI) in children undergoing supplementation of zinc and other micronutrients through the use of sprinkles, as well as their acceptance by these participants. METHOD: This was a randomized double-blinded clinical trial of 143 healthy institutionalized children, aged 6 to 48 months. They were randomized into two groups and received daily zinc and micronutrients - test group (sprinkles), or micronutrients without zinc - control group. Children were supplemented for 90 days and followed regarding the outcomes of DD and ARI. RESULTS: Of the randomized children, 52.45% belonged to the test and 47.55% to the control group. The incidence of DD in the test group was 14.7% and was 19.1% in the control group. The test group showed a lower risk of developing DD when compared to controls, but this finding was not statistically significant (RR = 0.77 [0.37 to 1.6], p = 0.5088). ARI had high incidence in both groups, 60% in the test group and 48.5% in the control group, with an increased risk of developing the disease in the test group, but with no statistical significance (RR = 1.24 [0.91 to 1.68], p = 0.1825). Regarding acceptance, the mean percentage of consumption, in days, of the entire content of the sachets containing sprinkles was 95.72% (SD = 4.9) and 96.4% (SD = 6.2) for the test and control groups, respectively. CONCLUSIONS: Zinc supplementation through the use of sprinkles did not reduce the incidence of DD or ARI among the evaluated children. The sprinkles were well accepted by all study participants.

Zinc, vitamin A, and glutamine supplementation in Brazilian shantytown children at risk for diarrhea results in sex-specific improvements in verbal learning

OBJECTIVE: To identify the impact of supplemental zinc, vitamin A, and glutamine, alone or in combination, on long-term cognitive outcomes among Brazilian shantytown children with low median height-for-age z-scores. METHODS: A randomized, double-blind, placebo-controlled trial was conducted in children aged three months to nine years old from the urban shanty compound community of Fortaleza, Brazil. Demographic and anthropometric information was assessed. The random treatment groups available for cognitive testing (total of 167 children) were: (1) placebo, n = 25; (2) glutamine, n = 23; (3) zinc, n = 18; (4) vitamin A, n = 19; (5) glutamine+zinc, n = 20; (6) glutamine+vitamin A, n = 21; (7) zinc+vitamin A, n = 23; and (8) glutamine+zinc+vitamin A, n = 18. Neuropsychological tests were administered for the cognitive domains of non-verbal intelligence and abstraction, psychomotor speed, verbal memory and recall ability, and semantic and phonetic verbal fluency. Statistical analyses were performed using SPSS, version 16.0. ClinicalTrials.gov: NCT00133406. RESULTS: Girls receiving a combination of glutamine, zinc, and vitamin A had higher mean age-adjusted verbal learning scores than girls receiving only placebo (9.5 versus 6.4, p = 0.007) and girls receiving zinc+vitamin A (9.5 versus 6.5, p = 0.006). Similar group differences were not found between male study children. CONCLUSIONS: The findings suggest that combination therapy offers a sex-specific advantage on tests of verbal learning, similar to that seen among female patients following traumatic brain injury.