A restrição de alimentos lácteos é obrigatória para pacientes com doença inflamatória intestinal? Estudo transversal multinacional / Is dairy foods restriction mandatory for inflammatory bowel disease patients: a multinational cross-sectional study

ABSTRACT Background: The role of dairy foods in inflammatory bowel disease (IBD) has been controversial and it is debatable if patients with IBD should avoid milk and dairy products or not, as well as the relationship between these foods and symptoms among those population. Objective: This multi centric cross-sectional study designed to evaluate if it is really necessary to deprive IBD patients from consumption of dairy foods. Methods: A multicenter study with 12 gastroenterology referral centers in four countries was designed to evaluate gastrointestinal (GI) symptoms after consumption of dairy foods from all outpatients with IBD during 6 months and to compare patients treated at the same centers without IBD (non IBD cases). Results: Overall 1888 cases included (872 IBD patients and 1016 non IBD cases). 56.6% of participants were female with average age of 40.1 years. Racially 79.8% participants were Caucasians and originally they were citizens of 10 countries. Relative prevalence of IBD was higher in Africans and Indians and the most frequent prevalence of dairy foods intolerance was seen in Asians. Among IBD patients, 571 cases diagnosed as ulcerative colitis and 189 participants as Crohn's disease. Average duration of diagnosis as IBD was 6.8 years (from 2 months to 35 years). The most prevalent GI symptoms after consumption of all the dairy foods were bloating and abdominal pain. Totally, intolerance of dairy foods and lactase deficiency was more prevalent among IBD patients in comparison with non IBD cases (65.5% vs 46.1%, P=0.0001). But the rate of GI complains among IBD patients who had not any family history of lactase deficiency, history of food sensitivity or both were 59.91%, 52.87% & 50.33% respectively and similar to non IBD cases (P=0.68, 0.98 & 0.99 respectively). Conclusion: The rate of dairy foods intolerance among IBD patients without family history of lactase deficiency or history of food sensitivity is similar to non IBD cases and probably there is no reason to deprive them from this important source of dietary calcium, vitamin D and other nutrients.

RESUMO Contexto: O papel dos alimentos lácteos na doença inflamatória intestinal (DII) tem sido controverso e é discutível se os pacientes com DII devem ou não evitar leite e laticínios, bem como a relação entre esses alimentos e sintomas nesta população. Objetivo: Estudo transversal multicêntrico foi projetado para avaliar se é realmente necessário privar os pacientes com DII do consumo desta classe de alimentos. Métodos: Um estudo multicêntrico com 12 centros de referência em gastroenterologia de quatro países foi projetado para avaliar sintomas gastrointestinais após o consumo de alimentos lácteos em todos os ambulatórios de DII durante seis meses e comparar pacientes tratados nos mesmos centros sem DII. Resultados: No total, foram incluídos 1888 casos (872 pacientes com DII e 1016 casos sem DII. 56,6% dos participantes eram do sexo feminino com idade média de 40,1 anos. 79,8% dos participantes eram caucasianos e originalmente eram cidadãos de 10 países. A prevalência relativa de DII foi maior em africanos e indianos e a prevalência mais frequente de intolerância a alimentos lácteos observada nos asiáticos. Entre os pacientes com DII, 571 casos foram diagnosticados como colite ulcerativa e 189 participantes como doença de Crohn. A duração média do diagnóstico como DII foi de 6,8 anos (de 2 meses a 35 anos). Os sintomas de gastrointestinais mais prevalentes após o consumo de todos os alimentos lácteos foram inchaço e dor abdominal. No total, a intolerância aos alimentos lácteos e a deficiência de lactase foi mais prevalente entre os pacientes com DII em comparação com os casos sem DII (65,5% vs 46,1%, P=0,0001). A taxa de queixas gastrointestinais entre os pacientes com DII que não tinham histórico familiar de deficiência de lactase, histórico de sensibilidade alimentar ou ambos foram de 59,91%, 52,87% e 50,33% respectivamente e semelhantes aos casos sem DII (P=0,68, 0,98 e 0,99, respectivamente). Conclusão: A taxa de intolerância de alimentos lácteos entre pacientes com DII sem histórico familiar de deficiência de lactase ou histórico de sensibilidade alimentar é semelhante aos casos sem DII e provavelmente não há razão para privá-los dessa importante fonte de cálcio dietético, vitamina D e outros nutrientes.

Qualidade microbiológica de queijo ricota comercializado na região Noroeste do Rio Grande do Sul / Microbiological quality of ricotta cheese marketed in Rio Grande do Sul the Northwest region

O objetivo deste estudo foi analisar a qualidade microbiológica de quatro marcas de ricota comercializadas na região Noroeste do Rio Grande do Sul, sendo analisados cinco lotes de cada marca. Avaliou-se a presença de coliformes totais e termotolerantes, Escherichia coli, Staphylococcus coagulase positiva, bolores, leveduras, e de Salmonella spp., além da temperatura de armazenamento e pH. Constatou-se que, 85% das amostras apresentaram contaminação por coliformes totais e 75% por coliformes legislação brasileira, RDC nº 12 de 2001. Leveduras foram encontradas em 90% das amostras e Staphylococcus coagulase positiva e Salmonella spp. não foram detectados. 80% das amostras estavam armazenadas em temperaturas superiores a 8ºC, favorecendo o desenvolvimento microbiano e 25% apresentaram valores de pH ácido. Os resultados obtidos indicaram haver falhas no processamento que, quando aliadas ao mau armazenamento, promovem o desenvolvimento de micro-organismos, os quais aceleram a deterioração do produto e representam sério risco à saúde do consumidor. Maior controle por parte das indústrias e fiscalização pelos órgãos competentes são necessários, a fim de garantir o consumo de ricotas de qualidade.

The aim of this study was to analyze the microbiological quality of four trademarks of ricotta commercialized in the northwestern of Rio Grande do Sul The samples (five lots of each brand) were evaluated for the total and thermotolerant coliforms, Escherichia coli, coagulase-positive Staphylococcus, yeasts and molds, Salmonella, storage temperature and pH. Results showed contamination by total and thermotolerant coliforms in 85% and 75% of the samples, respectively, and 50% were inappropriate for human consumption according to the Brazilian legislation (RDC nº 12, 2001). Yeasts were found in 90% of samples, but coagulase-positive Staphylococcus and Salmonella were not identified. 80% of the samples were stored at temperatures above 8°C favoring microbial growth and 25% showed acid pH values, indicating the presence of fermenting microorganisms. The results showed flaws in the ricotta in the processing environment that, allied to inadequate storage at sale points, promote the growth of microorganisms and can accelerate the deterioration of the product, besides it is a risk to consumer health. Greater control by industries and supervision by the competent agencies are required to ensure the quality of ricotta consumption.

Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul

BACKGROUND/OBJECTIVES: The aim of this study was to examine differences in nutrient intake and food consumption by the presence of metabolic syndrome in Korean adults. SUBJECTS/METHODS: Study subjects in this cross-sectional study were recruited from four outpatient clinics in and near the Seoul metropolitan area of South Korea between 2006 and 2012. A total of 668 subjects (413 men and 255 women) aged > or = 30 y were included in the final data analyses. For each subject, daily nutrient intake and food consumption were calculated using three days of dietary intake data obtained from a combination of 24-hour recalls and dietary records. To evaluate food consumption, mean number of servings consumed per day and percentages of recommended number of servings for six food groups were calculated. Metabolic syndrome was defined using the National Cholesterol Education Program Adult Treatment Panel III criteria. The general linear model was performed to examine differences in nutrient intake and food consumption by sex and the presence of metabolic syndrome after adjustment for potential confounding variables. RESULTS: Nutrient intake did not differ by the presence of metabolic syndrome in both men and women. Men with metabolic syndrome had lower consumption and percentage of the recommendation for fruits compared with those without metabolic syndrome (1.6 vs. 1.1 servings/day, P-value = 0.001; 63.5 vs. 49.5%, P-value = 0.013). Women with metabolic syndrome showed lower consumption and percentage of the recommendation for dairy foods than those without metabolic syndrome (0.8 vs. 0.5 servings/day, P-value = 0.001; 78.6 vs. 48.9%, P-value = 0.001). CONCLUSIONS: Low intakes of fruits and dairy foods might be associated with the risk of having metabolic syndrome among Korean adults. Dietary advice on increasing consumption of these foods is needed to prevent and attenuate the risk of metabolic syndrome.

Estratégias competitivas e de desenvolvimento de produtos lácteos funcionais: estudos de caso em empresas agroindustriais da região Sul do Brasil / Competitive and product development strategies in functional dairy products: case studies in food processing industries from south Brazil

Esta pesquisa buscou compreender o motivo e o modo como as empresas agroindustriais brasileiras desenvolvem novos produtos e se orientam para o mercado no segmento de alimentos lácteos funcionais. Ela também examina o papel do sistema regulatório nesse processo. Foi utilizada a abordagem de estudos de caso para esclarecer as inter-relações sistêmicas e trade-offs entre os fatores relacionados à inovação. Foi escolhido um desenho de pesquisa com uma unidade de análise (empresas agroindustriais que, recentemente, lançaram novos produtos no mercado de lácteos funcionais) e estudos de caso múltiplos (três empresas agroindustriais da região Sul). Os resultados revelam que as empresas agroindustriais adotam estratégias seguidoras em relação às concorrentes multinacionais. Tradicionalmente, essa é uma estratégia considerada mais segura e exige menores investimentos em P&D e marketing. Contudo, ela corrói a imagem de marca e limita os retornos financeiros das inovações. O comportamento seguidor é resultado de um baixo grau de orientação para mercado e restrita cooperação com parceiros externos. Esse "ciclo vicioso" é reforçado pelas barreiras estabelecidas pelo sistema regulatório.

This multi-case study searched to understand why and how food processing industries develop new products and market orientates to compete in the Brazilian functional dairy market. It also examines the regulatory framework role in this process. We use case studies as an approach to give evidence of the systemic relations and the existent trade-offs among factors related to innovation. We chose a research design with one unity of analysis (food processors that recently launched new products in the functional dairy market) and multiple case studies (three Brazilian dairies of the southern region). The results reveal that the enterprises adopt a second-mover strategy vis-à-vis the multinational competitors. Traditionally, this strategy is considered safer and requires lower R&D and marketing investments. However, it erodes branding and also limits financial returns from innovations. The second-mover behavior is consequence of poor market orientation and restricted cooperation with external partners. This "vicious circle" is also enhanced by barriers established by the regulatory framework.

Using the Theory of Planned Behavior to Explain Dairy Food Consumption among University Female Students / 대한지역사회영양학회지

This study was designed to explain the intentions and consumption of dairy foods among university female students. The factors related to intentions of consumption or actual consumption of dairy foods were identified within the theory of planned behavior. The survey questionnaire, developed using open-ended questions (n = 35), was administered to university female students (n = 184). Subjects completed information regarding attitudes, subjective norms, perceived control, intentions and consumption of dairy foods. Correlation analysis and multiple regression were used to study the association of factors with intentions and consumption of dairy foods. Subjects showed relatively low intention to consume dairy foods (- 0.4 +/- 1.6 from a scale of - 4 ~ + 4). They ate 1.2 +/- 0.9 servings of dairy foods a day and 52.2% of subjects had less than a serving a day, showing inadequate consumption of dairy foods. All three factors, attitudes, subjective norms and perceived control were significantly correlated to the intentions to take dairy foods regularly (r = 0.26 - 0.27). Multiple regression results, however, revealed that subjective norms (p < 0.01) and perceived control (p < 0.05) contributed to the model of explaining intentions, while attitudes did not (model R2 = 0.154). To predict and explain actual consumption of dairy foods, two regression models were examined. In the first model, perceived control was significant in predicting dairy foods consumption, while attitudes and subjective norms were not. In the second model, intentions and perceived control were significantly related to actual consumption of dairy foods, providing the empirical evidence of the theory (model R2 = 0.121). These results suggest that perceived control was significant in explaining actual behavior as well as intentions. This study suggests that nutrition education to increase dairy foods consumption for young adults should focus on increasing perception of control and eliciting social support from respected others.