Educación alimentaria en pacientes en dialisis / Nutritional education in dialysis patients

La enfermedad renal crónica terminal aumenta el riesgo cardiovascular y puede ocasionar defectos en la mineralización ósea. Para prevenir esto, se debe mantener el fósforo plasmático normal, que depende de la diálisis, los quelantes y la ingesta de fósforo, principalmente de origen inorgánico, incorporado mediante aditivos alimentarios. Las intervenciones nutricionales son pilares en el tratamiento de estos pacientes. El objetivo es facilitar estrategias alimentarias a un grupo de pacientes pediátricos en diálisis, mediante educación alimentaria nutricional, para aumentar el consumo de alimentos naturales, disminuyendo la ingesta de fósforo inorgánico especialmente de los productos cárnicos procesados. Materiales y métodos: se estudió una población pediátrica en diálisis. Se preparó un programa educativo con atención personalizada, instrucción alimentaria y seguimiento mensual, seguido de un taller. Resultados: n: 17 pacientes, edad decimal media de 12,3, 53% sexo masculino, 88% en hemodiálisis. Previo a la intervención el 64,7% consumía productos cárnicos procesados. Luego del taller el 58,8% disminuyó su consumo, el 41,2% aumentó la ingesta de preparaciones caseras, el 53% incorporó nuevos condimentos, de los cuales el 89% presentó al incorporarlos, mejor aceptación a las preparaciones. Conclusiones: la hiperfosfatemia está presente en alrededor del 50% de los pacientes en diálisis asociándose a un incremento entre 20% al 40% del riesgo de mortalidad. La presencia de fósforo oculto en los alimentos y la falta de adherencia hacen prioritario trabajar en programas educativos que favorezcan el aprendizaje colaborativo, centralizados en prácticas culinarias, para brindar herramientas que faciliten una alimentación natural, disminuyendo el consumo de ultraprocesados (AU)

Chronic end-stage renal disease increases the risk of cardiovascular disease and may lead to defects in bone mineralization. In order to prevent these risks, normal plasma phosphorus levels should be maintained. Achieving this goal depends on dialysis, chelators, and phosphorus intake, mainly of inorganic origin, incorporated through food supplements. Nutritional interventions are crucial in the treatment of these patients. The objective is to facilitate nutritional strategies to a group of pediatric dialysis patients, through food education, to increase the consumption of natural foods, decreasing the intake of inorganic phosphorus, especially from processed meat products. Materials and methods: a pediatric population undergoing dialysis was studied. An educational program was prepared with personalized care, nutritional instruction, and monthly follow-up visits, followed by a workshop. Results: n: 17 patients, mean age 12.3 years, 53% male, 88% on hemodialysis. Prior to the intervention, 64.7% consumed processed meat products. After the workshop, 58.8% decreased their consumption, 41.2% increased the intake of homemade food, 53% incorporated new seasonings, of whom 89% reported better acceptance of the preparations when they were incorporated. Conclusions: hyperphosphatemia is observed in around 50% of patients undergoing dialysis and is associated with a 20% to 40% increased risk of mortality. The presence of hidden phosphorus in food and the lack of adherence point to the need for the development of educational programs that promote collaborative learning, focusing on food-preparation practices. These programs should provide tools that facilitate a natural diet, reducing the consumption of ultra-processed food (AU)

Microbiota intestinal y cólicos infantiles: ¿hay lugar para los prebióticos, probióticos y posbióticos? / Gut Microbiota and Infant Colic: is there a Place for Prebiotics, Probiotics, and Postbiotics?

El consumo de probióticos, prebióticos y posbióticos, o su combinación, puede contribuir a mantener una microbiota intestinal saludable ya que permite la regulación de su disbiosis en el caso de algunas enfermedades o trastornos, principalmente en los trastornos gastrointestinales funcionales (TGIF). El microbioma intestinal es protagonista esencial en la fisiopatología de los TGIF a través de sus funciones metabólicas y nutricionales, el mantenimiento de la integridad de la mucosa intestinal y la regulación de la respuesta inmunitaria. Las investigaciones realizadas hasta la fecha indican que los probióticos, prebióticos y posbióticos pueden tener efectos inmunomoduladores directos y clínicamente relevantes. Existen pruebas del uso de esta familia de bióticos en individuos sanos para mejorar la salud general y aliviar los síntomas en una serie de enfermedades como los cólicos infantiles. La colonización y establecimiento de la microbiota comienza en el momento del nacimiento; los primeros 2-3 años de vida son fundamentales para el desarrollo de una comunidad microbiana abundante y diversa. Diversos estudios científicos realizados mediante técnicas tradicionales dependientes de cultivo y más recientemente por técnicas moleculares han observado diferencias en las poblaciones bacterianas de bebés sanos y aquellos que sufren TGIF, estos últimos caracterizados por un aumento de especies patógenas y una menor población de bifidobacterias y lactobacilos, en comparación con los primeros. En tal contexto, se considera que la microbiota intestinal como protagonista en el desarrollo de esos trastornos, entre ellos los cólicos infantiles, a través de sus funciones metabólicas, nutricionales, de mantenimiento de la integridad de la mucosa intestinal y regulación de la respuesta inmunitaria. Esto ha abierto la puerta al estudio de la utilización de prebióticos, probióticos y posbióticos en el tratamiento y/o prevención de los TGIF infantiles. El parto vaginal y de término así como la lactancia son fundamentales en la constitución de una microbiota saludable. Como herramientas de apoyo, existen estudios de eficacia que sustentan la administración de esta familia de bióticos, principalmente en los casos en que la lactancia no sea posible o esté limitada. (AU)

The consumption of probiotics, prebiotics, and postbiotics, or a combination of them, can contribute to maintaining a healthy intestinal microbiota as it allows the regulation of its dysbiosis in the case of some diseases or disorders, mainly in functional gastrointestinal disorders (FGIDs). The gut microbiome is an essential player in the pathophysiology of FGIDs through its metabolic and nutritional functions, the maintenance of intestinal mucosal integrity, and the regulation of the immune response. Research results thus far indicate that probiotics, prebiotics, and postbiotics may have direct and clinically relevant immunomodulatory effects. There is evidence regarding the prescription of this family of biotics in healthy individuals to improve overall health and alleviate symptoms in many conditions like infantile colic. The colonization and microbiota establishment begins at birth; the first 2-3 years of life are critical for developing an abundant and diverse microbial community. Several scientific studies performed by traditional culture-dependent techniques and more recently by molecular techniques have observed differences in the bacterial populations of healthy infants and those suffering from FGIDs, the latter characterized by an increase in pathogenic species and a lower population of bifidobacteria and lactobacilli, compared to the former. In this context, the intestinal microbiota plays a leading role in the onset of these disorders, including infantile colic, through its metabolic and nutritional functions, maintenance of the integrity of the intestinal mucosa, and regulation of the immune response. That has opened the door to the study of prebiotics, probiotics, and postbiotics usage in the treatment and or prevention of infantile FGIDs. Vaginal and term delivery and breastfeeding are fundamental in the constitution of a healthy microbiota. As supportive tools, there are efficacy studies that support the administration of this family of biotics, mainly in cases where lactation is not possible or is limited.

Síndrome urémico hemolítico del adulto / Adult hemolytic uremic syndrome

El síndrome urémico hemolítico (SUH), descripto en 1955, se caracteriza por la tríada de anemia hemolítica no inmunomediada, trombocitopenia y lesión renal aguda. En su patogenia interviene la toxina Shiga, producida con mayor frecuencia por E. coli O157:H. Puede manifestarse a cualquier edad, aunque es infrecuente en adultos, y se desarrolla en forma esporádica o en brote. Se presenta con un cuadro de dolor abdominal, diarrea, fiebre y vómitos. Puede afectar el sistema nervioso central, pulmones, páncreas y corazón. En adultos, el síndrome evoluciona tras un período de incubación de 1 semana posterior a la diarrea y tiene alta morbimortalidad, a diferencia de los casos pediátricos. Presentamos el caso de una paciente adulta, que cursó internación por síndrome urémico hemolítico. (AU)

Hemolytic uremic syndrome (HUS), described in 1955, is characterized by the triad of non-immune mediated hemolytic anemia, thrombocytopenia, and acute kidney injury. Shiga toxin, produced most frequently by E coli O157:H, is involved in its pathogenesis. Hus can manifest at any age, although it is rare in adults and develops sporadically or in outbreaks. HUS presents with a picture of abdominal pain, diarrhea, fever and vomiting. It can affect the central nervous system, lungs, pancreas, and heart.In adults, the syndrome evolves after an incubation period of 1 week after diarrhea, with high morbidity and mortality, unlike pediatric cases.We present the case of an adult patient who was hospitalized for hemolytic uremic syndrome. (AU)

Effects of balanced diet associated with sports on the health of obese university students / Análise dos efeitos da dieta balanceada associada aos esportes na saúde dos estudantes universitários obesos / Análisis de los efectos de la dieta equilibrada asociada al deporte en la salud de estudiantes universitarios obesos

ABSTRACT Introduction The student, when entering university, is subject to new cycles and major changes in his routine, which includes exercise and nutritious habits. Objective Explore the effect of a balanced diet and physical exercise on the health of university students. Methods Through literature studies, a questionnaire was developed where the physical condition, nutritional habits, dietary structure, and exercise practice of obese college students were investigated and analyzed. Results The BMI index of those investigated exceeded the standard limit of BMI > 25. The longer the time of physical exercise, the more evident the difference between male and female students in terms of physical endurance factor. The body weight, BMI, and body fat index of both groups showed a downward trend after the intervention. Six weeks of aerobic exercise combined with a proper diet can significantly improve body mass index, body mass index, and physiological and biochemical indices of obese college students. Conclusion Balanced diet and exercise positively affect the health of obese college students. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O estudante, ao ingressar na universidade, está sujeito a novos ciclos e grandes mudanças em sua rotina, que inclui os hábitos de exercício e alimentares. Objetivo Explorar o efeito de uma dieta balanceada e exercícios físicos na saúde de estudantes universitários. Métodos Através de estudos da literatura, elaborou-se um questionário onde foram investigadas e analisadas a condição física, os hábitos alimentares, a estrutura alimentar e a prática de exercícios nos universitários com obesidade. Resultados o índice de IMC dos investigados ultrapassou o limite padrão de IMC > 25. Quanto maior o tempo de exercício físico, mais evidente é a diferença entre estudantes do sexo masculino e feminino no fator da resistência física. O peso corporal, IMC e índice de gordura corporal dos dois grupos apresentaram tendência de queda após a intervenção. Seis semanas de exercícios aeróbicos combinados com dieta razoável podem melhorar significativamente o índice de massa corporal, índice de massa corporal e índices fisiológicos e bioquímicos de estudantes universitários obesos. Conclusão Dieta balanceada e exercício físico possuem um efeito positivo sobre a saúde dos estudantes universitários obesos. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El estudiante, al entrar en la universidad, se ve sometido a nuevos ciclos y a grandes cambios en su rutina, que incluye el ejercicio y los hábitos alimenticios. Objetivo Explorar el efecto de una dieta equilibrada y el ejercicio físico en la salud de los estudiantes universitarios. Métodos A través de estudios bibliográficos, se elaboró un cuestionario en el que se investigó y analizó la condición física, los hábitos alimentarios, la estructura de la dieta y la práctica de ejercicio en estudiantes universitarios con obesidad. Resultados El índice de IMC de los investigados superaba el límite estándar de IMC > 25. Cuanto mayor es el tiempo de ejercicio físico, más evidente es la diferencia entre los alumnos y las alumnas en el factor de resistencia física. El peso corporal, el IMC y el índice de grasa corporal de ambos grupos mostraron una tendencia a disminuir después de la intervención. Seis semanas de ejercicios aeróbicos combinados con una dieta razonable pueden mejorar significativamente el índice de masa corporal, el índice de masa corporal y los índices fisiológicos y bioquímicos de los estudiantes universitarios obesos. Conclusión La dieta equilibrada y el ejercicio tienen un efecto positivo en la salud de los estudiantes universitarios obesos. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

El consumo de dos kiwis diarios podría mejorar el hábito intestinal en personas con estreñimiento crónico / Daily consumption of two kiwifruits could improve bowel habits in people with chronic constipation

A partir del caso de una paciente con síndrome de intestino irritable a predominio de estreñimiento cuyos síntomas mejoraron con el consumo regular de kiwi, el médico de familia se planteó la pregunta de si el kiwi podría mejorar los síntomas asociados a constipación crónica en comparación con el tratamiento habitual. Tras realizar una búsqueda de estudios que analizaran los efectos del consumo de kiwi sobre el hábito intestinal, fueron seleccionados tres artículos que permiten concluir que el consumo de esta fruta tiene una eficacia superior al placebo y comparable al psyllium y las pasas de ciruela para mejorar los síntomas de personas con estreñimiento crónico. (AU)

Based on the case of a patient with constipation-predominant irritable bowel syndrome whose symptoms improved with regular consumption of kiwi, the family doctor wondered if kiwi could improve symptoms associated with chronic constipation compared to usual treatment. After conducting a search for studies that analyzed the effects of kiwi consumption on intestinal habit, three articles were selected that allow us to conclude that the consumption of this fruit has an efficacy superior to placebo and comparable to psyllium and plum raisins to improve the symptoms of people with chronic constipation. (AU)

Relación entre fibromialgia y sarcopenia: el papel del abordaje nutricional / Fibromyalgia and sarcopenia relation: the role of nutritional approach

Introducción: la fibromialgia (FM) es un síndrome caracterizado por la presencia de dolor musculoesquelético crónico y generalizado, de origen no articular, que puede llegar a ser invalidante y afectar la esfera biológica, psicológica y social del paciente. Estado del arte: no se han publicado recomendaciones nutricionales específicas para las personas con FM y también existe un vago conocimiento acerca de los parámetros relacionados con la evaluación de la composición corporal (masa musculoesquelética, masa grasa, agua corporal, etc.) y la alteración en la fuerza muscular (p. ej., dinapenia, por dinamometría de mano, flexión de la rodilla, entre otras), así como la evaluación en términos de sarcopenia. Discusión: pocos estudios publicados hasta el momento describen en profundidad la composición corporal de las personas con FM. La mayoría se centran casi exclusivamente en la descripción del peso y el índice de masa corporal (IMC), por lo que existe poco conocimiento acerca de otros parámetros de relevancia, como por ejemplo aquellos relacionados con masa y fuerza muscular o masa grasa. La alimentación se menciona en varias publicaciones, pero no existen guías o pautas específicas de recomendaciones nutricionales para esta población. Algunos pacientes adoptan diversas dietas, estrategias o planes alimentarios sin ningún tipo de orientación de los profesionales de la salud, e incluso a veces, siguiendo fuentes de información no fiables, poniendo en riesgo su salud. Las publicaciones científicas no evalúan la asociación o el impacto del estado nutricional y la inadecuada alimentación en la calidad de vida. Conclusiones: en las personas con FM, conocer el estado nutricional, más allá del peso, determinando la composición corporal y la prevalencia de dinapenia o sarcopenia o ambas permitiría realizar un abordaje nutricional más adecuado. Este conocimiento podría ser coadyuvante en la terapéutica, logrando una mejoría en su desempeño físico y una mejor calidad de vida. (AU)

Introduction: fibromyalgia (FM) is a syndrome charcaterized by the presence of chronic, and generalized musculoskeletal pain, not articular in origin, which can become disabling and affect the biological, psychological, and social sphere of the patient. State of the art: no specific nutritional recommendations have been published for people with FM and there is also a vague knowledge regarding parameters related to body composition assessment (skeletal muscle mass, body fat mass, water, etc.) and loss of muscle strength (for example, dynapenia, by handgrip, knee flexion, among others), as well as assessment in terms of sarcopenia. Discussion: there are few studies published so far that completely describe the body composition in people with FM. Most of them focus almost exclusively on weight and body mass index (BMI), so there is a lack of knowledge about other descriptive parameters, such as those related to muscle mass and strength or fat mass. Diet is mentioned in several publications, but there are no specific guidelines for nutritional recommendations for this population. Some patients follow several diets, strategies or eating plans without health care professionals' guidance, and sometimes even following unreliable sources of information, putting themselves at risk. Scientific publications do not evaluate the association or impact of nutritional status and inadequate nutrition on quality of life in FM. Conclusions: in people with FM, knowledge of the nutritional status, beyond weight, determining body composition and the prevalence of dynapenia and/or sarcopenia would allow a more accurate nutritional approach. This knowledge could be helpful for the treatment, achieving an improvement in their physical performance and a better quality of life. (AU)

Evaluación de la técnica de conteo de grasas y ajuste de enzimas pancreáticas en un grupo de pacientes con insuficiencia pancreática secundaria a fibrosis quística con seguimiento en un hospital de alta complejidad / Evaluation of the fat counting technique and pancreatic enzyme adjustment in a group of patients with pancreatic insufficiency secondary to cystic fibrosis followed-up in a tertiary-level hospital

Objetivo: evaluar la efectividad de la técnica de conteo de grasas y ajuste de enzimas pancreáticas en un grupo de pacientes con insuficiencia pancreática secundaria a fibrosis quística (FQ). Materiales y métodos: En un grupo de pacientes con FQ, sin otra patología asociada, mayores de 1 año, con >10 000 UKD (unidades por kilo por día) de lipasa; se realizó educación y aplicación de técnica de conteo de grasas con ajuste enzimático, solicitando Van de Kamer y registro alimentario de 5 días durante la recolección de la muestra con un intervalo de 3 meses entre ambas determinaciones. Se evaluó la efectividad de la misma y las dosis de enzimas utilizadas mediante el porcentaje de excreción grasa (PEG), así como las variaciones en la cantidad de enzimas utilizadas y la ganancia de peso. Los datos se registraron en RED Cap (Research Electronic Data Capture) y se analizaron mediante Stata 12. Resultados: De un total de 21 pacientes, 16 completaron la intervención. El 50% presentó un índice de masa corporal (IMC) mayor del Plo 25 antes y después, un 87% alcanzó adecuación calórica mayor del 120% de la ingestas diarias recomendadas (RDA) al final, logrando un aumento promedio de z score de peso de 0,28 con una media inicial de 17 kg y final de 18,2 kg. En cuanto a la media del requerimiento enzimático fue de 14 800 UKD antes y 10 145 UKD después (z=0,002), asimismo el porcentaje de excreción grasa (PEG) tuvo una disminución del 38% (p=0,1705). Conclusiones: La implementación de la técnica de conteo de grasas y ajuste enzimático, podría ser una estrategia válida para aquellos pacientes con FQ que tienen dosis altas de enzimas e inadecuada ganancia de peso (AU)

Objective: To evaluate the effectiveness of the fat counting technique and pancreatic enzyme adjustment in a group of patients with pancreatic insufficiency secondary to cystic fibrosis (CF). Materials and methods: A group of patients with CF without other associated diseases, older than 1 year of age, lipase dose >10 000 UKD (units per kilo per day), received education on the fat counting technique with enzyme adjustment followed by its implementation of the intervention. Van de Kamer was requested and a 5-day food record was kept during the sample collection with an interval of 3 months between both measurements. The effectiveness of the technique and the enzyme doses used were evaluated based on the percentage of fat excretion (PFE), as well as the variations in the amount of enzymes used and weight gain. Data were recorded in RED Cap (Research Electronic Data Capture) and analyzed using Stata 12. Results: Of a total of 21 patients, 16 completed the intervention. Fifty percent had a body mass index (BMI) greater than Plo 25 before and after the intervention; 87% had achieved a caloric increase greater than 120% of the recommended daily intake (RDA) at the end of the study and an average increase in weight z score of 0.28 with an initial mean of 17 kg and a final mean of 18.2 kg. Mean enzyme requirement was 14 800 UKD before and 10 145 UKD after the intervention (z=0.002). PFE decreased by 38% (p=0.1705). Conclusions: The implementation of the technique of fat counting and enzyme adjustment may be a valid strategy for CF patients with high enzyme doses and inadequate weight gain. (AU)

Situación nutricional y acciones implementadas en niños internados en salas de cuidados intermedios y moderados de un hospital pediátrico de alta complejidad de la ciudad de Buenos Aires / Nutritional status and actions implemented in children admitted to intermediate and moderate care wards of a tertiary-care pediatric hospital in the city of Buenos Aires

Introducción: La malnutrición es un estado de deficiencia o exceso de nutrientes que provoca efectos nocivos y puede alterar el crecimiento aumentando la morbi-mortalidad. Materiales y métodos: estudio retrospectivo, descriptivo. Incluyó niños/as de 1-18 años hospitalizados entre 2016-2018. Se obtuvieron datos de caracterización de la muestra y antropométricos. La herramienta de tamizaje nutricional pediátrico (HTNP) se utilizó para detectar riesgo nutricional y en este subgrupo se analizó: variación de peso, intervención nutricional, complicaciones infecciosas y estadía hospitalaria. El análisis de variables se realizó con SPSS Statistics 20. Resultados: Se evaluaron 745 pacientes, 373 niñas (50,1%). Mediana de edad 7,3 años. Estancia hospitalaria media de 4 días (1-123). Se observó 5,9% emaciados, 56,4% eutróficos, 16,8% sobrepeso y 20,9% obesidad. Con baja talla 13%. Se detectó riesgo nutricional con HTNP en 50,7% de los ingresos. Las patologías de base más frecuentes fueron cardiopatías y neoplasias. En pacientes con riesgo nutricional: estadía hospitalaria media de 5 días, 13,5% cursó con infecciones intrahospitalarias, 68% mantuvo o aumentó de peso durante la internación, 13,5% requirió apoyo nutricional (más utilizado el gavage en 59%). Conclusiones: El niño hospitalizado se encuentra en una situación de vulnerabilidad, por lo que el tamizaje y evaluación nutricional resultan acciones claves para prevenir el deterioro nutricional. En los niños con malnutrición las acciones llevadas a cabo por el Nutricionista Clínico como integrante del equipo de atención, revisten un rol clave para promover y garantizar el derecho de los pacientes a la alimentación adecuada y así mejorar su condición nutricional. (AU)

Introduction: Malnutrition is a state of nutrient deficiency or excess that causes harmful effects and can alter growth increasing morbidity and mortality. Materials and methods: retrospective, descriptive study. Children aged 1-18 years admitted to the hospital between 2016-2018 were included. Sample characterization and anthropometric data were collected. The pediatric nutritional screening tool (PNST) was used to identify nutritional risk and in this subgroup we analyzed: weight variation, nutritional intervention, infectious complications, and length of hospital stay. The analysis of variables was performed with SPSS Statistics 20. Results: 745 patients were evaluated, 373 were girls (50.1%). Median age was 7.3 years. Mean hospital stay was 4 days (1- 123). Among the patients, 5.9% were emaciated, 56.4% eutrophic, 16.8% overweight, and 20.9% obese. Thirteen percent of the patients had short stature. Nutritional risk was detected using HTNP in 50.7% of the admitted patients. The most frequent underlying diseases were heart disease and cancer. In patients at nutritional risk: mean hospital stay was 5 days, 13.5% had hospital-acquired infections, 68% maintained or gained weight during the hospital stay, 13.5% required nutritional support (gavage was the most frequently used in 59%). Conclusions: Hospitalized children are in a vulnerable situation, therefore nutritional screening and evaluation are key actions to prevent nutritional deterioration. In children with malnutrition, the Clinical Nutritionist, as a member of the health care team, plays a key role in promoting and guaranteeing the right of patients to adequate food and thus improve their nutritional condition (AU)

Lifestyle Intervention in Reducing Cardiometabolic Risk Factors in Students with Dyslipidemia and Abdominal Obesity: A Randomized Study

Abstract Background The long incubation periods of cardiovascular diseases offer opportunities for controlling risk factors. In addition, preventive interventions in childhood are more likely to succeed because lifestyle habits become ingrained as they are repeated. Objective To investigate the effects of recreational physical activities, in combination or not with a qualitative nutritional counseling, in cardiometabolic risk factors of students with dyslipidemia and abdominal obesity. Methods Students (8-14 years old) were randomly divided into three groups (n=23 each): i ) Control; ii ) PANC, students undergoing Physical Activity and Nutritional Counseling, and iii ) PA, students submitted to Physical Activity, only. Blood samples (12-h fasting) were collected for biochemical analysis and anthropometric markers were also assessed. Two-Way RM-ANOVA and Holm-Sidak's test, and Friedman ANOVA on Ranks and Dunn's test were applied. P ≤ 0.05 was considered significant. Effect sizes were evaluated by Hedges' g and Cliff's δ for normal and non-Gaussian data, respectively. Results Compared to the control group and to baseline values, both interventions caused significant average reductions in total cholesterol (11%; p <0.001), LDL-c (19%; p=0.002), and non-HDL-c (19%; p=0.003). Furthermore, students in the PANC group also experienced a significant decrease in body fat compared to baseline (p=0.005) and to control (5.2%; g=0.541). Conclusions The proposed strategies were effective to reduce cardiometabolic risk factors in children and adolescents. The low cost of these interventions allows the implementation of health care programs in schools to improve the students' quality of life.

The beneficial effects of virgin olive oil against oxidative stress induced by hypercholesterolemia in rats

Cardiovascular disease(CVD) remains the major cause of mortality in the world, typically claiming a third of all deaths. The primary cause of CVD is atherosclerosis. Therefore, timely prevention and therapy of atherosclerosis are able to reduce the risk of the development of its clinical manifestations. Anti-atherosclerotic activity of medicinal plants mainly appears in their multiple effects.This study was carried out to evaluate the hypolipidemic activity of virgin olive oil in experimentally induced hyperlipemic Wistar. A total of 24 rats were randomly allocated to 4 equal groups and treated as follows for 50 days: (1) Normal control (NC); that were fed with a standart diet; (2) High Cholesterol Diet Control (HCD); which received high cholesterol diet for 50 days; (3) Animals receiving high cholesterol diet for 50 days, after this period the animals are fed for eight days by the standard foodand receiving by gavage virgin olive oil (HCD+VOO) and(4) Animals fed for eight days with the standard food and receiving by gavage olive oil (VOO). High Cholesterol Diet containing yolk egg and coconut oil. Results showed that olive oil caused a significant (p < 0.01) reduction in serum levels of Total Cholesterol (TC), Triglycerides (TG), Low­Density Lipoprotein Cholesterol (LDL) and Atherogenic Index Serum (AIS). The results also demonstrated a significant (p < 0.01) increase in High­Density Lipoprotein Cholesterol (HDL). Moreover, virgin olive oil induced a significant reduction in liver lipid content. On the other hand, a High cholesterol diet induced oxidative stress was measured by estimating reduced glutathione level and amount of thiobarbituric acid reactive substances (TBARS) formed as an index of lipid peroxidation in a liver and a heart. Virgin olive oil supplementation attenuated all these variations. Our observations of the study indicate that the virgin olive oil has a significant antihyperlipidemic potential.

Neuroprotective role of Tinospora cordifolia extract in streptozotocin induced neuropathic pain

Abstract Diabetic Neuropathy (DN) is one of the prevailing micro vascular complications of diabetes which can be characterized by neuropathic pain. Streptozotocin (STZ) induced diabetes in the rat has been increasingly used as a model of painful diabetic neuropathy. STZ injection leads to neurotoxicity of peripheral nerves that leads to development of Peripheral Diabetic Neuropathy in rat model. The present study was aimed at exploring the protective role of Tinospora cordifolia extract in STZ induced neurotoxicity and evaluating mechanisms responsible for attenuating neuropathic pain. Neuropathic pain markers like hyperalgesia, allodynia and motor deficits were assessed before STZ injection and after the treatment with 250 mg/kg and 500 mg/kg dose of Tinospora cordifolia. Oxidative stress markers, NGF expression in sciatic nerve were observed after seven weeks treatment. Our results demonstrated that seven weeks treatment with Tinospora cordifolia leaf extract significantly relieved thermal hyperalgesia and allodynia by increasing the antioxidant enzyme levels, decreasing the lipid peroxidation and by increasing the Nerve growth factor (NGF) expression in diabetic rat sciatic nerves. Our findings highlighted the beneficial effects of oral administration of Tinospora cordifolia extract in attenuating diabetic neuropathic pain, possibly through a strong antioxidant activity and by inducing NGF m RNA in sciatic nerves.

O aluno com diabetes: avaliação dos pais sobre o ambiente escolar / The student with diabetes: parental assessment of the school environment

Introdução: O diabetes mellitus tipo 1 (DM1) é uma das doenças crônicas mais comuns da infância. O adequado controle do DM1 engloba uma ação multidisciplinar e envolve ambientes nos quais as crianças passam grande parte do tempo do seu dia, as escolas. Objetivos: Identificar a realidade vivenciada pelo aluno com diabetes no ambiente escolar sob a visão dos pais ou responsáveis. Métodos: Aplicado um questionário a 200 pais ou responsáveis por alunos com diabetes matriculados na educação infantil, nos ensinos fundamental e médio de escolas públicas e privadas de Belo Horizonte, compreendidos entre a faixa etária dos quatro aos dezoito anos. Resultados: A escolha da escola pelos pais foi influenciada pelo fato da criança ter diabetes em 16,5% dos casos. Houve negação inicial de matrícula. Foram necessárias explicações sobre o DM1 para os professores em 67,5% dos casos. Para 74,5% dos pais, os professores das escolas envolvidas não possuem o conhecimento necessário sobre diabetes. A maioria das crianças tem a permissão para realizar a glicemia capilar em sala de aula. Cerca de 54,5% dos alunos com diabetes fazem o uso de insulina na escola, entretanto, grande parte delas não oferecem um local específico para tal procedimento. A merenda escolar foi considerada inadequada. Houve relato de bullying. Alguns foram impedidos de participarem de excursões e até mesmo da educação física. Conclusão: Os alunos com DM1 vivenciam uma realidade inadequada no ambiente escolar. A maioria das escolas não está preparada do ponto de vista técnico e estrutural para receber estas crianças.

Introduction: Type 1 diabetes mellitus (DM1) is one of the most common chronic diseases in childhood. Proper control of DM1 encompasses a multidisciplinary action and involves environments in which children spend much of their day, such as schools. Objectives: To identify the reality experienced by students with diabetes in the school environment from the perspective of parents or guardians. Methods: A questionnaire was applied for 200 parents or guardians of students with diabetes enrolled in early childhood education, in the elementary and high schools of public and private schools in Belo Horizonte, in the age group of four to eighteen years. Results: The parents' choice of school was influenced by the fact that the child had diabetes in 16.5% of cases. There was an initial denial of registration on school. Explanations about DM1 were needed for teachers in 67.5% of cases. For 74.5% of parents, school teachers do not have the necessary knowledge about diabetes. Most children are allowed to take capillary blood glucose in the classroom. About 54.5% of students with diabetes use insulin at school, however, in most of them there are not a specific place for such procedure. The school meal was considered inadequate. There was a bullying relationship. Some students were prevented from getting involved in extracurricular activities such as excursions and in physical education. Conclusion: Students with DM1 experience an inadequate reality in the school environment. Most schools are not technically and structurally prepared to receive these children.

Pretreatment with water kefir reduces the development of acidified ethanol-induced gastric ulcers

Abstract To evaluate the gastroprotective and antioxidant effects of pretreatment with water kefir on ulcers induced with HCl/ethanol. All pretreatments lasted 14 days. Male mice were separated into five groups: the control (C) group received vehicle without ulcer induction; the ulcerated (U) group received vehicle; the lansoprazole (L) group received 30 mg/kg/day lansoprazole; the water kefir (WK15 and WK30) groups received WK at a dose of 0.15 or 0.30 ml/kg/day, respectively. Gastroprotection was measured by ulcer area, ulcer index and ulcer reduction percentage. Antioxidant effects were quantified by measuring advanced oxidized protein products (AOPPs), superoxide dismutase (SOD), and catalase activity in the stomach. Pretreatment with WK at both doses promoted gastroprotection against HCl/ethanol-induced ulcers much like the pretreatment with lansoprazole. In addition, WK decreased protein oxidation while increasing SOD and catalase activity. We concluded that pretreatment with water kefir increases the activity of antioxidant enzymes, preventing gastric lesions induced by HCl/ethanol by maintaining the antioxidant performance in gastric tissue.

Avaliação do consumo de frutas em pacientes com diabetes mellitus tipo 2 / Fruit consumption in patients with type 2 diabetes mellitus

Introdução: O impacto do consumo de frutas sobre a saúde de pacientes com diabetes mellitus tipo 2 (DM2) requer investigações. O objetivo deste estudo foi avaliar o consumo de frutas em pacientes com DM2 e identificar a sua associação com parâmetros de controle glicêmico.Métodos: Foram incluídos 197 pacientes ambulatoriais com DM2, submetidos à avaliação clínica, sociodemográfica, antropométrica, laboratorial e de consumo alimentar. A ingestão alimentar total e o consumo de frutas foram avaliados por questionário quantitativo de frequência alimentar. Os pacientes com menor e maior consumo de frutas (de acordo com a mediana) foram comparados.Resultados: A média do consumo de frutas foi de 593,66 ± 330,74 g/dia. Entre os menores e maiores consumidores de frutas, os valores de glicemia (169,42 ± 70,83 vs. 158,62 ± 64,56 mg/dL; p = 0,273) e hemoglobina glicada (8,39 ± 1,68 vs. 8,68 ± 2,38%; p = 0,319) não foram diferentes, assim como as demais variáveis. Os pacientes com maior consumo de frutas apresentaram maior ingestão de energia (p < 0,001), carboidratos (p < 0,001) e fibras (p = 0,006) e uma menor ingestão de proteínas (p = 0,015), lipídeos totais (p = 0,040) e seus tipos. O grupo que mais consumiu frutas apresentou uma maior ingestão de vitamina C (p < 0,001) e potássio (p < 0,001) e um menor consumo de sódio (p = 0,001). Foi observado ainda uma correlação negativa entre o consumo de frutas e o índice glicêmico da dieta (p = 0,05).Conclusão: Não houve diferença na glicemia em jejum e no valor de hemoglobina glicada entre os pacientes com DM2 com maior e menor consumo de frutas.

Introduction: The impact of fruit consumption on the health of patients with type 2 diabetes mellitus (T2DM) warrants investigation. The aim of this study was to evaluate fruit consumption in patients with T2DM and to identify its association with glycemic control parameters.Methods: We included 197 outpatients with T2DM who underwent clinical, sociodemographic, anthropometric, laboratory, and food consumption assessments. A food frequency questionnaire was used to assess total food intake and fruit consumption. Patients with lower and higher fruit consumption (according to the median) were compared.Results: Average fruit consumption was 593.66 ± 330.74 g/day. Blood glucose (169.42 ± 70.83 vs. 158.62 ± 64.56 mg/dL; p = 0.273) and glycated hemoglobin (8.39 ± 1.68% vs. 8.68 ± 2.38%; p = 0.319) levels did not differ between the lower and higher fruit consumption groups, nor did the other variables. Patients with higher fruit consumption had a higher intake of energy (p < 0.001), carbohydrates (p < 0.001), and fibers (p = 0.006) but a lower intake of proteins (p = 0.015) and total and different types of lipids (p = 0.040). The higher consumption group had higher vitamin C (p < 0.001) and potassium (p < 0.001) intake and lower sodium intake (p = 0.001). We identified a negative correlation between fruit consumption and the diet's glycemic index (p = 0.05).Conclusion: Fasting blood glucose and glycated hemoglobin levels did not differ between the higher and lower fruit consumption groups.