Nutrición e hiperuricemia / Nutrition and hyperuricemia

El aumento de la incidencia y prevalencia de hiperuricemia asintomática, la que está fuertemente asociada a los factores de riesgo cardiovasculares clásicos y la dificultad para definir su tratamiento con drogas ha jerarquizado al tratamiento dietético, a los efectos de identificar los alimentos que pueden tener efectos protectores sobre el nivel de ácido úrico plasmático (AU). Los niveles del AU dependen de la producción endógena (10%), disminución de la excreción (90%) o de ambas. La producción del AU depende de la ingesta de purina, sin embargo, una dieta rica en purina sería responsable solo de un aumento en 1 a 2 mg / dl del AU sérico. La pérdida < 5 kg disminuye hasta un 45% el riesgo de aumentar el AU, mientras que pérdidas superiores reducirían al menos el 60% del riesgo. De igual manera, el descenso del peso máximo y la estabilidad del peso disminuyen el riesgo de hiperuricemia. Se sugiere que este descenso no sea brusco para evitar el catabolismo muscular que puede conducir a sarcopenia con pérdida de la fuerza y debilidad muscular y aumento concomitante del AU. Reducen los niveles séricos de AU: leche, yogur y quesos blancos, las frutas ricas en vitamina C, huevos, frutas secas sin sal, legumbres (incluidas la soja) y pollo, salmón, bacalao y langosta. Debe limitarse las carnes rojas (cerdo, ternera, cabrito), y evitarse mariscos, pescados (trucha, atún, palometa, vieir

The increase of incidence and prevalence of asymptomatic hyperuricemia, closely related to the traditional cardiovascular risk factors, and the difficulty to establish a drug therapy for this condition have attached importance to dietary treatment; the aim is to identify foods which can prevent plasma uric acid (UA) concentrations from reaching abnormally high levels. UA level depends on endogenous production (10%), reduced excretion (90%) or both. Although UA production depends on the consumption of purine, a diet rich in purines is believed to be responsible only for a serum UA increase of 1 to 2 mg/dL. Losing < 5 kg reduces the risk of UA increase by up to 45%, whereas higher losses could lead to a risk at least 60% lower. In the same way, maximum weight loss and weight stability minimize the risk of hyperuricemia. Weight loss, however, should not be sudden so as to avoid muscle catabolism, which may cause loss of muscle mass and strength (sarcopenia) and a concomitant UA increase. The following foods can help reduce serum UA levels: milk, yogurt, fresh cheese, vitamin C-rich fruits, eggs, unsalted nuts, legumes (including soy), chicken, salmon, codfish and lobster. Red meat intake (pork, beef, goat meat) should be limited, and seafood, fish (trout, tuna, pompano, scallop, anchovy, herring, sardine and tuna in oil), bacon, viscera, turkey and lamb should be avoided.

Regurgitation and Gastroesophageal Reflux Disease in Six to Nine Months Old Indonesian Infants / 대한소아소화기영양학회지

PURPOSE: Regurgitation is known to peak at the age of 3-4 months, with a sharp decrease around the age of 6 months. Little is known about the natural evolution of infants who still regurgitate after the age of 6 months. METHODS: Hundred thirty-one infants older than 6 months regurgitating more than once a day were followed for a period of 3 months. RESULTS: According to our data, gastroesophageal reflux disease (GERD) is seldom at this age. Most of the infants regurgitated 3 or more times/day and spit up an estimated volume of more than 15 mL. Eighty-five parents were educated regarding frequency of feeding. There were only 6 infants that still had frequent regurgitation (>3 times/day) despite an appropriate feeding schedule. The Infant GER Questionnaire score reached a score of 0 in 50% of the infants after one month of follow-up and in 81.9% at the third month of follow-up. There was an increase of the "weight for age z-score" trends in infants that still regurgitated at the end of follow-up and a declining z-score in infants that no longer regurgitated. An explanation may be that infants that regurgitate drink larger volumes than infants who do not regurgitate. Conservative treatment (reassurance, dietary treatment, behavioral advice) resulted in a significant better outcome than natural evolution. CONCLUSION: Regurgitation that persisted after the age of 6 months, strongly decreased during a 3-month follow-up with conservative treatment. GERD is rare in this age group; therefore, anti-reflux medication is only seldom needed.

Importância da gordura alimentar na prevenção e no controle de distúrbios metabólicos e da doença cardiovascular: [revisão] / Importance of the dietary fat on the prevention and control of metabolic disturbances and cardiovascular disease: [review]

A Organização Mundial da Saúde (OMS) reiterou recentemente que o consumo de dietas inadequadas e a inatividade física estão entre os dez principais fatores de mortalidade. Diversos ensaios aleatorizados demonstram que intervenções alimentares adequadas podem diminuir ou prevenir significativamente o aparecimento de várias doenças crônicas não transmissíveis. Neste contexto, o papel da dieta vem sendo exaustivamente avaliado em estudos clínicos e epidemiológicos. Assim, já foi bem estabelecido na literatura que a quantidade e o tipo de gordura alimentar exercem influência direta sobre fatores de risco cardiovascular, tais como a concentração de lípides e de lipoproteínas plasmáticas, bem como sua associação a processos inflamatórios. Os ácidos graxos participam de complexos sistemas de sinalização intracelular, função que vem sendo bastante explorada. Os ácidos graxos poli-insaturados não somente influenciam a composição das membranas, metabolismo celular e sinais de tradução, mas também modulam a expressão de genes, regulando a atividade e a produção de diversos fatores de transcrição. A proposta deste artigo é rever tópicos relevantes referentes ao metabolismo de lípides e os relacionar a terapias nutricionais que possam contribuir para a prevenção e o tratamento de doenças associadas.

The World Health Organization (WHO) has recently reinforced the fact that inadequate diets, along with physical inactivity, are among the ten main determinant factors of mortality. Several randomized trials demonstrated that dietary interventions may lower or even prevent the occurrence of several non-communicable diseases. In this context, the role of diet has been exhaustively evaluated in several clinical and epidemiological studies. Thus, it is well established in literature that the amount and type of dietary fat have a direct influence on cardiovascular risk factors, such as lipids and plasma lipoprotein concentration, as well as their association with inflammatory processes. Fatty acids also participate in complex intracellular signaling systems, a function which has been currently investigated. Dietary polyunsaturated fatty acids (PUFA) act not only by altering membrane lipid composition, cellular metabolism and signal transduction, but also modulating gene expression by regulating the activity and/or production of different nuclear transcription factors. The aim of this article is to review important topics regarding the lipids metabolism and correlate them with nutritional therapies that may contribute to the prevention and treatment of related diseases.