Estimates of resting energy expenditure and total energy expenditure using predictive equations in adults with overweight and obesity: a systematic review with meta-analysis.

CONTEXT: Energy expenditure predictive equations can generate inaccurate estimates for overweight or obese individuals. OBJECTIVE: The objective of this review was to determine which predictive equations for resting energy expenditure (REE) and total energy expenditure (TEE) have the lowest bias and the highest precision in adults with overweight and obesity. DATA SOURCES: Searches were performed in January 2022 in MEDLINE, Web of Science, Scopus, CENTRAL, and the gray literature databases. DATA EXTRACTION: Meta-analyses were performed with equations included in more than 1 study. The DerSimonian and Laird random-effects model and the I2 statistic were used to quantify heterogeneity in the quantitative analyses. The Egger test was performed to assess potential publication biases, and metaregressions were conducted to explore the heterogeneity. Findings were presented separated by participants' body mass index classification (overweight and obesity). DATA ANALYSIS: Sixty-one studies were included. The FAO/WHO/UNU (1985) equation, which uses only body weight in its formula, showed the lowest bias in estimating REE (mean difference [MD] = 8.97 kcal; 95% CI = -26.99; 44.94). In the subgroup analysis for individuals with obesity, the Lazzer (2007) equation showed the lowest bias (MD = 4.70 kcal; 95% CI = -95.45; 104.86). The Harris-Benedict equation (1919) showed the highest precision values for individuals with overweight (60.65%) and for individuals with obesity (62.54%). Equations with body composition data showed the highest biases. The equation proposed by the Institute of Medicine (2005) showed the lowest bias (MD = -2.52 kcal; 95% CI = -125.94; 120.90) in estimating the TEE. Most analyses showed high heterogeneity (I2 > 90%). There was no evidence of publication bias. CONCLUSION: For individuals with overweight, the FAO/WHO/UNU (1985) and the Harris-Benedict equations (1919) showed the lowest bias and the highest precision in predicting the REE, respectively. For individuals with obesity, the Harris-Benedict equation (1919) showed the highest precision and the Lazzer equation (2007) showed the lowest bias. More studies are needed on predictive equations to estimate the TEE. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no. CRD42021262969.

Prevalence of iron deficiency anemia in Brazilian women of childbearing age: a systematic review with meta-analysis.

BACKGROUND: Iron deficiency anemia (IDA) is among the most common micronutrient deficiencies in women of childbearing age and may affect children's development. Brazil has several national programs to tackle this condition, such as food fortification and supplementation for pregnant women, but IDA prevalence in this population has not been systematically reviewed. We sought to determine the prevalence of IDA in Brazilian women of childbearing age through a systematic review with metanalysis. METHODOLOGY: A protocol was previously published on the PROSPERO platform under the code CRD42020200960. A panel of the National Council for Scientific and Technological Development (CNPq) approved the protocol of this study under the public call number 26/2019. The main databases searched were MEDLINE, Web of Science, Scopus, Lilacs, and SciELO. In gray literature, the Brazilian Digital Library of Theses and Dissertations and the annals of the Brazilian Congress of Epidemiology and the Brazilian Congress of Public Health were accessed. The search strategy involved terms related to the condition (IDA) and the age group of the population of interest (teenagers and adults). Studies that had assessed the prevalence of IDA in Brazilian women of childbearing age (10-49 years) were included. Three independent reviewers read all titles and abstracts and extracted data from the included studies. Random effects meta-analyses using the Freeman-Tukey arcsine transformation were carried out with prevalence data, and meta-regression was conducted to test for subgroup differences. The quality of the studies was assessed using the Newcastle-Ottawa Scale. RESULTS: From 21,210 unique records screened, 237 full-texts were retrieved, of which 91 were included in the qualitative synthesis, and 83 were included in the meta-analysis. The overall IDA prevalence was 25% (95% CI [23-28], 83 studies). The subgroup of studies that used random sampling showed a prevalence of 22% (95% CI [17-27], 22 studies), whereas in those with non-random sampling, the prevalence was 27% (95% CI [23-30], 61 studies), without significant differences between subgroups in the metaregression (P = 0.13). High prevalence of IDA were found in the subgroups of studies conducted in the North and Northeast regions (30%; 95% CI [24-37]; seven studies, and 30%; 95% CI [26-34]; 27 studies, respectively), in studies conducted with indigenous population (53%; 95% CI [27-78], four studies), and with studies that had their collections after 2015 (28%; 95% CI [23-34], nine studies). CONCLUSIONS: IDA in women of childbearing age remains a public health problem in Brazil, especially in the North and Northeast region. The national programs should be strengthened and more thoroughly supervised to decrease this condition nationally.

Prevalence of food addiction determined by the Yale Food Addiction Scale and associated factors: A systematic review with meta-analysis.

OBJECTIVE: To determine, through a systematic review with meta-analysis, the prevalence of food addiction (FA) using the Yale Food Addiction Scale (YFAS) and its derivatives exploring possible factors associated with the prevalence of FA in several contexts. METHODS: The following databases were searched: MEDLINE, ScienceDirect, LILACS, PsycArticles, CENTRAL, Greylit.org, and OpenGrey.eu. Studies that assessed FA using YFAS were included. Two independent reviewers assessed the eligibility of each report. Random-effects meta-analysis was performed to calculate the weighted prevalence of FA. Subgroup analyses and meta-regression were conducted to explore sources of heterogeneity. RESULTS: Of the 6425 abstracts reviewed, 272 studies were included. The weighted mean prevalence of FA diagnosis was 20% (95% CI: 18%; 21%). The prevalence of FA was higher in individuals with clinical diagnosis of binge eating (55%; 95% CI 34%; 75%). The prevalence in clinical samples was higher compared to non-clinical samples. Two studies included children only and no studies included only elderly people. CONCLUSIONS: Food addiction is a topic in which there has been a significant growth in studies. The highest prevalence was found in the group of participants with eating disorders and weight disorders. More studies with children and the elderly are needed.

Impact of Infant Milk-Type and Childhood Eating Behaviors on Functional Constipation in Preschool Children.

OBJECTIVE: To investigate the association between functional constipation, infant feeding in early infancy and eating behavior in preschool children. METHODOLOGY: A cross-sectional study was undertaken in public and private schools in the state of Sergipe (Northeast of Brazil). The sample calculation was based on a 25% estimate of constipation prevalence in Brazilian children, resulting in a sample size of 1051 children. Functional constipation was assessed using Rome IV criteria. Eating behavior was assessed using the Children's Eating Behavior Questionnaire. Adjusted odds ratios were estimated using a multivariate model. RESULTS: The prevalence of functional constipation was 23%. After adjusting for water intake, children with food fussiness were >6 times likely to have constipation (odds ratio [OR] = 6.65; 95% confidence interval [CI] 5.19-8.52). Children who were fed with cow's milk in the first 6 months of age were up to 15.2 times more likely to have functional constipation. Bottle feeding at 0-6 months of age increased the risk of functional constipation at preschool age (whole cow's milk: OR = 17.02; 95% CI 7.33-39.51, infant formula: OR = 6.35; 95% CI 3.42-11.79, mixed breastfeeding: OR = 10.83; 95% CI 4.57-25.69). CONCLUSION: Food fussiness and the use of cow's milk-based feeding bottles at 0-6 months of age were associated with functional constipation in preschool children.

Effects of time-restricted feeding on body weight, body composition and vital signs in low-income women with obesity: A 12-month randomized clinical trial.

BACKGROUND & AIMS: Time-restricted feeding (TRF) studies usually are of short-term, involving heterogeneous populations, without a control group with similar energy restriction. Besides, it seldom assess vital signs such as body temperature and heart rate, which may be influenced by the fasting state. In this investigation, we assessed the long-term effects of TRF on body weight, body composition and vital signs of low-income women with obesity undergoing diets with the same energy deficit. METHODS: Low-income women with obesity were randomly allocated to a group with a hypoenergetic diet and 12 h of TRF or to a group with only a hypoenergetic diet, for 12 months. Body fat and waist circumference were estimated using a tetrapolar electrical bioimpedance and an inelastic measuring tape, respectively, at baseline and after 4, 6 and 12 months of intervention. Systolic and diastolic blood pressure, heart rate, and axillary temperature were measured at baseline and 12 months of intervention. The energy content of the diets was determined based on the women's resting metabolic rate (by indirect calorimetry) and level of physical activity (by triaxial accelerometers). Effects were analyzed using an intention-to-treat approach. RESULTS: Fifty-eight women were randomized and 31 (53.44%) were lost to follow-up at 12 months. Dropout rates were similar between groups. In the intention-to-treat analysis, there were no significant changes in the body weight after 12 months (Differences in changes from baseline between groups: -0.05 95%CI [-2.34; 2.24] Kg; p = 0.96). An increase in axillary temperature (0.40 °C, 95% CI [-0.14; 0.67]°C, p < 0.01), a reduction in the percentage of body fat (-1.64%, 95% CI [-3.08; -0.19]%, p = 0.02) and waist circumference (-2.57 cm, 95% CI [-5.73; 0.58] cm, p = 0.03 in the mixed model involving 4 measurements) were observed in the intervention group, when compared to the control group. CONCLUSIONS: TRF showed no effects on weight loss. Nevertheless the findings on waist circumference and body fat, although not clinically meaningful, suggest that this strategy may help in the long-term management of obesity in this population, since it is an easy to apply intervention. Axillary temperature findings warrants further investigation. Registered under www.ensaiosclinicos.gov.br Identifier no. RBR-387v6v. TRIAL REGISTRATION: http://www.ensaiosclinicos.gov.br/rg/RBR-387v6v/.

Identification of neck circumference cut-off points for insulin resistance as a marker in adolescents / Identificação de pontos de corte da circunferência do pescoço como marcador da resistência à insulina em adolescentes

ABSTRACT Objective To identify cut-off points of neck circumference measurement to predict insulin resistance in adolescents. Methods Cross-sectional analysis with data derived from the Study of Cardiovascular Risks in Adolescents, nationwide, multicenter, school-based survey. We evaluated 901 adolescents, aged 12 to 17, from public and private schools in two cities of Sergipe state in Brazil. We measured demographic, anthropometric, and biochemical data, and insulin resistance using Homeostasis Model Assessment-Insulin Resistance. We used multiple linear regression and logistic analysis to evaluate the association between dependent variables (biochemical) and independent variables (anthropometric) controlled by body mass index, age, gender, and Tanner's stage. We used the Receiver operating characteristic curve to determine cut-off points of neck circumference that can identify insulin resistance. Results The multiple linear regression analysis showed a positive association between neck circumference measurement with fasting glycemia and glycated hemoglobin (p<0.001) and a negative association with insulin (p<0.024). Furthermore, in logistic regression, the measurement of neck circumference was the only anthropometric indicator positively correlated with homeostasis model assessment-insulin resistance. The cut-off points of neck circumference for predicting insulin resistance were: 30.55cm for female pubertal and 32.10cm for post-pubertal adolescents; 35.90cm for male pubertal adolescents and 36.65cm for post-pubertal adolescents. Conclusions The measurement of neck circumference is a simple, practical anthropometric indicator and can be used as a screening tool to identify insulin resistance in adolescents.

RESUMO Objetivo Identificar pontos de corte da medida da circunferência do pescoço que possam predizer a resistência à insulina em adolescentes. Métodos Estudo transversal com uma subamostra do Estudo de Riscos Cardiovasculares em Adolescentes, um estudo multicêntrico nacional. Avaliaram-se 901 adolescentes de 12 a 17 anos de duas cidades do estado de Sergipe, Brasil. Fatores demográficos, antropométricos e bioquímicos e a resistência à insulina pelo homeostasis model assessment-insulin resistance foram mensurados. A associação entre as variáveis dependentes (bioquímicas) e independentes (antropométricas), controladas pelo índice de massa corporal, idade, sexo e estadiamento de Tanner, foi avaliada pela análise de regressão linear múltipla e logística, e a curva característica de operação do receptor foi utilizada para determinar os pontos de corte da circunferência do pescoço na predição da resistência à insulina. Resultados A análise de regressão linear múltipla mostrou uma associação positiva entre a medida da circunferência do pescoço com a glicemia de jejum e a hemoglobina glicada (p<0,001) e negativa com a insulina (p<0,024). Na regressão logística, a medida da circunferência do pescoço foi o único indicador antropométrico que se correlacionou positivamente com o Homeostasis Model Assessment-Insulin Resistance. Os pontos de corte da circunferência do pescoço para predição da resistência à insulina em adolescentes foram: 30,55cm feminino púberes e 32,10cm feminino pós-púberes; 35,90cm masculino púberes e 36,65cm masculino pós-púberes. Conclusão A medida da circunferência do pescoço é um indicador antropométrico simples e prático e pode ser utilizada como instrumento de triagem para identificar a resistência à insulina em adolescentes.

Associação da lesão renal aguda com desfechos clínicos de pacientes em unidade de terapia intensiva / Asociación de la lesión renal aguda con resultados clínicos de pacientes en unidad de terapia intensiva / Association of acute kidney injury with clinical outcomes of patients in intensive care unit

RESUMO Objetivo: avaliar a associação da Lesão Renal Aguda com os desfechos clínicos dos pacientes em Unidade de Terapia Intensiva. Método: trata-se do recorte de dados de coorte com visão prospectiva, realizada em uma unidade intensiva privada na capital sergipana entre outubro de 2018 e julho de 2019. A amostra foi por conveniência e não probabilística. Os dados foram analisados com os testes de Kolmogorov-Sminorv; exato de Fisher e t-Student através do Statistical Package for the Social Sciences. Resultados: participaram do estudo 100 pacientes, 29% apresentaram Lesão Renal Aguda, sendo 62,1% destes do sexo masculino e com 70±16 anos. Foi evidenciada associação da injúria com infecção (p=0,018), ventilação mecânica por mais de 48 horas (p=0,016), morte (p=0,010) e lesão por pressão (p=0,037). Conclusão: O estudo contribuirá para identificação precoce da lesão renal, promovendo auxílio no planejamento do plano para reduzir as complicações da doença.

RESUMEN Objetivo: evaluar la asociación entre la Lesión Renal Aguda y los resultados clínicos de los pacientes en Unidad de Terapia Intensiva. Método: se hizo una selección de datos de cohorte con visión prospectiva que se realizó en una unidad intensiva particular en la capital de Sergipe entre octubre de 2018 y julio de 2019. La muestra se hizo por conveniencia y no probabilística. Se analizaron los datos con pruebas de Kolmogorov-Sminorv; exacto de Fisher y t-Student por medio del Statistical Package for the Social Sciences. Resultados: 100 pacientes participaron del estudio: 29% presentaron Lesión Renal Aguda, siendo el 62,1% de estos del sexo masculino y edad de 70±16 años. Se evidenció asociación del agravio con infección (p=0,018), ventilación mecánica por más de 48 horas (p=0,016), muerte (p=0,010) y lesión por presión (p=0,037). Conclusión: El estudio ayudará en la identificación precoz de la lesión renal, contribuyendo al planeamiento para reducir las complicaciones de la enfermedad.

ABSTRACT Objective: evaluar la asociación entre la Lesión Renal Aguda y los resultados clínicos de los pacientes en Unidad de Terapia Intensiva. Method: se hizo una selección de datos de cohorte con visión prospectiva que se realizó en una unidad intensiva particular en la capital de Sergipe entre octubre de 2018 y julio de 2019. La muestra se hizo por conveniencia y no probabilística. Se analizaron los datos con pruebas de Kolmogorov-Sminorv; exacto de Fisher y t-Student por medio del Statistical Package for the Social Sciences. Results: 100 pacientes participaron del estudio: 29% presentaron Lesión Renal Aguda, siendo el 62,1% de estos del sexo masculino y edad de 70±16 años. Se evidenció asociación del agravio con infección (p=0,018), ventilación mecánica por más de 48 horas (p=0,016), muerte (p=0,010) y lesión por presión (p=0,037). Conclusion: El estudio ayudará en la identificación precoz de la lesión renal, contribuyendo al planeamiento para reducir las complicaciones de la enfermedad.

Acute effects of time-restricted feeding in low-income women with obesity placed on hypoenergetic diets: Randomized trial.

OBJECTIVE: The aim of this study was to evaluate the acute effects of time-restricted feeding in obese women living in social vulnerability who were placed on diets with the same energy deficit. METHODS: Fifty-eight obese women (19-44 y of age) were randomized to a group with a hypoenergetic diet and 12 h of fasting daily or to a group with only a hypoenergetic diet for 21 d, with body weight and waist circumference monitoring up to 81 d of intervention. The determination of the individual's energy content of the diets was based on their resting metabolic rate (by indirect calorimetry) and physical activity level (by triaxial accelerometers). Body composition, temperature, blood pressure, appetite, adhesion difficulty, thyroid axis hormones, leptin, glucose concentration, and insulin were measured before and after 21 d of intervention. A mixed analysis of variance test was performed. RESULTS: The women had a mean age of 31 y and mean body mass index of 33 kg/m². Significant interaction between group × time was observed only in axillary temperature (0.44°C; 95% confidence interval [CI], 0.17-0.74°C; P < 0.01), which increased in the experimental group and in body fat (-0.75%; 95% CI, -1.43% to -0.07%; P = 0.02) decreased in the experimental group. Also, there was a significant decrease in waist circumference in the time-restricted feeding group after 81 d. There were no differences in hormonal profile, resting metabolic rate, reported appetite, or adherence difficulty. CONCLUSION: Time-restricted feeding may be considered an alternative strategy for treating obesity in socially vulnerable women.

Metabolomic fingerprinting of Cissampelos sympodialis Eichler leaf extract and correlation with its spasmolytic activity.

ETHNOPHARMACOLOGICAL RELEVANCE: Cissampelos sympodialis Eichler (Menispermaceae) is popularly used in northeastern Brazil for the treatment of respiratory diseases such as bronchitis and asthma. Despite many pre-clinical pharmacological studies, the compounds mediating the anti-asthma activity of polar extracts of Cissampelos sympodialis leaves have not been definitively identified. AIM OF THE STUDY: Aim of the study: The aim of the study was to investigate the correlation between the bioactivity of polar extracts prepared from the leaves of C. sympodialis and the chemical composition using a 1H-NMR-based metabolomics approach. MATERIAL AND METHODS: The metabolic profile of the leaf polar extract during different phenological stages of the plant was investigated using 1H NMR spectroscopy while simultaneously screening for spasmolytic activity using guinea-pig tracheal preparations. The content of the alkaloids previously implicated in the bioactivity of Cissampelos sympodialis was determined by HPLC. RESULTS: PCA analysis of the 1H NMR data discriminated the extracts from different plant phenological stages. The contents of the major alkaloids decrease (from 2 ± 0.32 µg/mL for warifteine and 1 ± 0.14 µg/mL for methylwarifteine) to undetectable levels from 90 (CsL90 extract) and 120 (CsL120) days onwards for warifteine and methylwarifteine, respectively. All six extracts relaxed the trachea pre-contracted with carbachol, but the CsF210 extract was more potent (EC50 = 74.6 ± 7.9 µg/mL) compared to both CsL90 extracts and CsL180 in the presence of functional epithelium. PLS regression analysis of 1H-NMR spectral data demonstrated that the spasmolytic activity was better correlated with signals for flavonol derivatives. CONCLUSIONS: Our data challenge the idea that warifteine and methylwarifteine mediate the spasmolytic activity of the polar extract of C. sympodialis leaves.

Agreement between the total energy expenditure calculated with accelerometry data and the BMR yielded by predictive equations v. the total energy expenditure obtained with doubly labelled water in low-income women with excess weight.

Low-income women are the group with the highest levels of obesity worldwide. In low-income settings, the use of predictive equations, which yield a measure of the individuals' BMR, is a feasible approach to estimate the individuals' total energy expenditure (TEE), using the factorial method (calculated-TEE = BMR × physical activity level), an important step of the obesity nutritional care. The present study aimed to identify the predictive equation that, in conjunction with metabolic equivalents of tasks (MET) data from accelerometers, yields the calculated-TEE with better agreement compared with the TEE measured by doubly labelled water (TEE-DLW). Forty-five women aged 19-45 years, with excess weight and mothers of undernourished children, were included. They received DLW to determine TEE (14 d); at the same time, they used triaxial accelerometers (7 d) to estimate their MET. The Bland-Altman method, paired-sample t tests, concordance correlation coefficient and root-mean-square error were used to assess the agreement. Maximum allowed differences were defined as 24 %, based on the within-variance coefficient of the energy intake of the sample. Eleven equations were studied. The calculated-TEE obtained by five equations showed non-significant bias: Dietary Reference Intake (Institute of Medicine (2005) Dietary Reference Intakes for Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids), FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series), Harris & Benedict ((1919) Proc Natl Acad Sci USA4, 370-373), Henry & Rees ((1991) Eur J Clin Nutr45, 177-185) and Schofield ((1985) Hum Nutr Clin Nutr39, 5-41). The mean percentage differences were -1·5, -0·8, 2·2, -2·2 and 2·0 %, respectively. Considering all parameters, FAO/WHO/UNU ((2001) Food and Nutrition Technical Report Series) equation performed slightly better than the others; nevertheless, no equation in conjunction with the estimated-MET showed a calculated-TEE with its CI for the Bland-Altman limits of agreement inside the pre-defined acceptable range.

Experiencia inicial en la adaptación del instrumental del tratamiento video asistido modificado de las fistulas perianales complejas (VAMAFT) / Initial experience in the adaptation of the instruments of the modified assisted video treatment of complex perianal fistulas (VAMAFT)

Introducción: Las fístulas perianales tienen dos problemas fundamentales, la tasa de recurrencia y de incontinencia fecal postoperatoria, complicaciones que varían en frecuencia dependiendo de varios factores como el tipo de fistula, la técnica quirúrgica usada y la experiencia del cirujano. Debido a esto existen técnicas quirúrgicas no conservadoras y conservadoras de esfínteres donde se incluye el tratamiento video asistido que aparece desde el año 2006 y en la cual se utiliza un sistema de video endoscopio sofisticado y de alto valor económico el cual hemos adaptado a nuestro medio. Pacientes y método: De septiembre del 2015 al 2017 en la Unidad de Coloproctología del Hospital Domingo Luciani IVSS se realizó un estudio prospectivo experimental, donde se incluyeron 18 pacientes con fístulas perianales complejas diagnosticadas previamente con Ecofistulografía 3D y los cuales se operaron con un sistema adaptado usando citoscopio pediátrico de 4 mm y energía láser. Se evaluaron parámetros referentes a la técnica así como la tasa de éxito y riesgo de incontinencia. Resultados: Tiempo quirúrgico de 40 a 80 minutos, con tasa de éxito de 89%, recidiva en 2 pacientes, con tiempo de seguimiento entre 12 a 36 meses y sin cambios en la escala de incontinencia pre y post quirúrgica. Conclusión: El tratamiento video asistido modificado para fistulas anales (VAMAFT) es una técnica innovadora y factible de realizar al adaptar algunos instrumentos, con una tasa de éxito adecuada y sin riesgo de incontinencia, pero más trabajos aleatorizados con mayor números de pacientes deben ser realizados.

Introduction: Anal fistulas have two basic problems, rate of recurrence and postoperative anal incontinence. These complications vary according to several factors such as type of anal fistula, surgical technique and the surgeon´s experience. For each cases there are different surgical techniques with and without conservation of anal sphincters like conservative video assisted anal fistula treatment, described in 2006, this technique uses a sophisticated and expensive endoscope system but that we modified to use in our hospitals. Patients and method: Between September 2015 to 2017 in the Unit of Coloproctology of Domingo Luciani Hospital, was perfomed a prospective and experimental trial in 18 patients with anal complex fistulas previously diagnosed using tridimensional anal ultrasound and operated with a modified system consisting of pediatric cystoscope of 4 mm and laser energy. Some parameters were evaluated including surgical technique, recurrence and anal incontinence rate. Results: Surgical times were between 40 to 80 minutes, success rate of 89%, recurrence in two patients with follow up of 12 to 36 months and no changes in pre and post surgical anal incontinence scale. Conclusion: Video assited modified anal fistula treatment (VAMAFT) is an innovative and feasible surgical technique to do adapting some instruments, with suitable success rate and without anal incontinence risk but many randomized research with more patients have to be perfomed.

Curcumin or combined curcuminoids are effective in lowering the fasting blood glucose concentrations of individuals with dysglycemia: Systematic review and meta-analysis of randomized controlled trials.

Curcuminoids have received considerable attention as therapeutical adjuvants in the treatment of dysglycemia. The purpose of this meta-analysis was to evaluate whether the supplementation of turmeric extract, curcuminoids and/or isolated curcumin is more effective than placebo in decreasing fasting blood glucose (FBG) in adults. MEDLINE, CENTRAL, ScienceDirect and gray literature databases were searched. Randomized controlled trials with the following criteria were included: (1) studied individuals older than 18 years, supplemented with curcumin, curcuminoids and/or turmeric extract (2) had a follow-up ≥4 weeks (3) used a placebo group. Titles and abstracts were screened and potentially eligible articles were retrieved. The primary outcome was FBG. The secondary outcomes were HbA1c and HOMA-IR. Eleven studies were included. In the overall analysis, turmeric, curcuminoids and curcumin supplementation led to a decrease in FBG (-8.88, 95% CI: [-5.04 to -2.72] mg/dL, p = 0.005). Supplementation of curcuminoids and/or curcumin decreased the concentrations of HbA1c (-0.54, 95% CI: [-1.09 to -0.002] %, p = 0.049) but were not able to decrease HOMA-IR (-1.26, 95% CI: [-3.71 to -1.19], p = 0.31). Sensitivity analyses revealed that baseline FBG was an important covariate. Heterogeneity was high in the overall analyses and there was evidence of publication bias. Supplementation of isolated curcumin or combined curcuminoids were both effective in lowering the FBG concentrations of individuals with some degree of dysglycemia, but not in non-diabetic individuals. Isolated curcumin lead to significant decreases of the HbA1c compared to placebo.

Consumption of minimally processed food is inversely associated with excess weight in adolescents living in an underdeveloped city.

BACKGROUND: The consumption of ultra-processed foods may be associated with the development of chronic diseases, both in adults and in children/adolescents. This consumption is growing worldwide, especially in low and middle-income countries. Nevertheless, its magnitude in small, poor cities from the countryside is not well characterized, especially in adolescents. This study aimed to assess the consumption of minimally processed, processed and ultra-processed foods by adolescents from a poor Brazilian city and to determine if it was associated with excess weight, high waist circumference and high blood pressure. METHODS: Cross-sectional study, conducted at a public federal school that offers technical education together with high school, located in the city of Murici. Adolescents of both sexes and aged between 14-19 years old were included. Anthropometric characteristics (weight, height, waist circumference), blood pressure, and dietary intake data were assessed. Associations were calculated using Poisson regression models, adjusted by sex and age. RESULTS: At total, 249 adolescents were included, being 55.8% girls, with a mean age of 16 years-old. The consumption of minimally processed foods was inversely associated with excess weight (Adjusted Prevalence Ratio: 0.61, 95% Confidence Interval: [0.39-0.96], P = 0.03). Although the consumption of ultra-processed foods was not associated with excess weight, high blood pressure and high waist circumference, 46.2% of the sample reported eating these products more than weekly. CONCLUSION: Consumption of minimally processed food is inversely associated with excess weight in adolescents. Investments in nutritional education aiming the prevention of chronic diseases associated with the consumption of these foods are necessary.

Adesão ao tratamento dietético e evolução nutricional e clínica de pacientes com diabetes mellitus tipo 2 / Adherence to the nutrition treatment and clinical evolution of patients with type 2 diabetes mellitus

O Diabetes Mellitus (DM) acomete pessoas em todo o mundo. O conhecimento acerca das características da doença e sobre a adesão ao tratamento nutricional em pacientes ambulatoriais é fundamental para um melhor controle da patologia. Esse estudo teve como objetivo avaliar a adesão ao tratamento dietético e a evolução do estado nutricional e clínico de pacientes diabéticos assistidos pelo Ambulatório de Nutrição do Hospital Universitário de Sergipe. Participaram do estudo 30 pacientes, sendo avaliados os momentos da primeira consulta e segunda consulta depois de 6 ± 2 meses de tratamento nutricional. Foram coletados dos protocolos de atendimento do ambulatório de nutrição dados antropométricos, bioquímicos, história clínica dos mesmos e da adesão ao consumo alimentar. Analisou-se peso, IMC, colesterol total e frações, glicemia de jejum, glicemia pós-prandial, triglicérides, prevalência de comorbidades e percentual de adesão à dieta. Foi encontrada uma prevalência de 40% de pacientes obesos. As comorbidades mais prevalentes no estudo foram hipertensão (80%) e dislipidemia (36%). Quanto ao tratamento nutricional, observou-se que apenas 13,3% da amostra aderiram ao plano alimentar proposto e que não houve evolução significativa do perfil antropométrico e bioquímico dos pacientes participantes do estudo.

Development and validation of a method for the determination of folic acid in different pharmaceutical formulations using derivative spectrophotometry

ABSTRACT Folic acid is a B complex water-soluble vitamin that is essential to humans, and its deficiency can cause problems including congenital malformations in the fetus as well as heart disease. Most countries affected by diseases associated with a lack of folic acid now supplement foods with the vitamin. There is therefore a need for the development of new analytical procedures able to determine folic acid present in different matrices. This work describes the development of zero order and first order derivative spectrophotometric methods for the determination of folic acid in different pharmaceutical formulations, using 0.1 mol L-1 NaOH as solvent. The methods are shown to be simple, selective, and robust. Good linearity was achieved, with correction coefficients ≥0.9996 and limits of detection and quantification ranging from 0.64 to 0.75 and from 1.80 to 2.85 mg L-1, respectively. Recoveries of 98-104% were obtained in accuracy tests, and precision (as RSD) was between 0.2 and 4.8%. The methods can be used in routine analyses for quality control purposes, offering an alternative to the procedures already reported in the literature

Comments to article: Dietary intake of AIN-93 standard diet induces fatty liver with altered hepatic fatty acid profile in Wistar rats / Comentarios del artículo: La ingesta de la dieta estándar AIN-93 induce esteatosis hepática con aletración del perfil de ácidos grasos en ratones Wistar

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HEPATIC FATTY ACID PROFILE OF RATS FED A TRIHEPTANOIN-BASED KETOGENIC DIET.

OBJECTIVE: the aim of this study was to evaluate the influence of consumption of a ketogenic diet supplemented with triheptanoin, a medium-chain anaplerotic triacylglycerol, on the liver fatty acid profile of Wistar rats. METHODS: three groups of male Wistar rats (n = 10) were submitted to an AIN-93 control diet, a triheptanoin- based ketogenic diet, or a soybean oil-based ketogenic diet for 60 days. Excised livers were subjected to lipid extraction and methylation to obtain fatty acids methyl esters, which were subjected to gas chromatography- mass spectrometry. RESULTS AND DISCUSSION: compared to the rats fed the control diet, those fed ketogenic diets showed a significant reduction in the concentrations of 9-hexadecenoic and 9-octadecenoic acids, whereas those fed triheptanoin showed increased levels of octadecanoic acid. CONCLUSION: changes in the liver fatty acid profiles of the rats fed a triheptanoin-based or a soybean oil-based ketogenic diet did not seem to be related to the dietary fat source, but rather to the characteristics of the ketogenic diets themselves.

Objetivo: el objetivo de este estudio fue evaluar la influencia del consumo de una dieta cetogénica complementada con triheptanoína, un triacilglicerol de cadena media y anaplerótico, en el perfil de ácidos grasos del hígado de ratones Wistar. Métodos: tres grupos de ratones Wistar machos (n = 10) fueron sometidos durante 60 días a una dieta AIN-93 de control, una dieta cetogénica basada en triheptanoína o una dieta cetogénica a base de aceite de soja. Los hígados fueron escindidos y sometidos a extracción de lípidos y metilación para obtener los ésteres metílicos de ácidos grasos, que se sometieron a cromatografía de gas-espectrometría de masa. Resultados y discusión: en comparación con los ratones alimentados con la dieta de control, los de ambas dietas cetogénicas mostraron una reducción significativa en las concentraciones de los ácidos grasos 9-hexadecenoico y 9-octadecenoico, mientras que los alimentados con triheptanoína mostraron niveles de ácido octadecenoico aumentados. Conclusión: los cambios en los perfiles de ácidos grasos del hígado de los ratones alimentados con dietas cetogénicas no están relacionados con la fuente de grasa de la dieta (triheptanoína o aceite de soja), sino más bien con la concentración total de lípidos.