FRAIL scale as a screening tool and a predictor of mortality in non-dialysis dependent patients.

BACKGROUND: This study aimed to compare the diagnostic yield of the FRAIL scale with respect to the physical frailty phenotype measure and their association with mortality in non-dialysis-dependent patients. METHODS: In this prospective cohort study, non-dialysis dependent patients with chronic kidney disease (CKD) stages 3b-5 seen in the nephrology outpatient clinics of two university hospitals were included. The presence of frailty was evaluated by physical frailty phenotype measure and the FRAIL scale. Patients were evaluated for six months, and mortality was recorded. The Kappa test was used to evaluate the diagnostic properties between the methods, and logistic regression to test the association between frailty and mortality. RESULTS: One hundred fifty-three patients were evaluated; average age was 65 (56-70) years, 50.9% were women, and the all-cause mortality rate was 2.6%. Forty-six patients were classified as living with frailty according to the physical frailty phenotype while 36 patients were rated frail by the FRAIL scale. In adults < 60 years of age, the FRAIL scale showed good accuracy (84.9%) and specificity (93.2%) but had low sensitivity (41.3%) and moderate agreement (Kappa = 0.41; p < 0.001) compared to the definition of the physical frailty phenotype. The adjusted logistic regression model showed that the patients with frailty assessed by the FRAIL scale had a greater chance of mortality than the non-frail patients (OR: 6.8; CI95%:1.477-31.513; p = 0.014). CONCLUSION: Physical frailty phenotype identifies more patients as having pre-frailty and frailty in non-dialysis dependent patients as compared to the FRAIL scale. However, the FRAIL scale is a simple bedside tool that can be useful for screening for frailty and whose results were associated with mortality.

Oilseeds native to the Cerrado have fatty acid profile beneficial for cardiovascular health / Oleaginosas nativas do Cerrado apresentam perfis de ácidos graxos favoráveis à saúde cardiovascular

ABSTRACT Objective: To assess and compare the fatty acid composition of edible seeds and a nut native to the Cerrado (Brazilian savannah) to that of traditional oilseeds. Methods: Baru almonds, Cerrado cashew nuts, and pequi almonds were extracted from the fruits using appropriate equipment. All edible seeds and nuts were roasted, except for the Brazil nut. The sample lipids were extracted via cold pressing. The fatty acids were esterified, and the fatty acid esters were analyzed by gas chromatography. Results: The native and traditional edible seeds and nuts contain mostly monounsaturated fatty acids (42.72 g to 63.44 g/100 g), except for the Brazil nut, which showed predominance of polyunsaturated fatty acids (45.48 g/100 g). Pequi almond had the highest saturated fatty acid content (36.14 g/100 g). The fatty acids with the highest concentration were oleic and linoleic acids, and palmitic acid was also found in considerable concentration in the oilseeds studied. The Cerrado cashew nut and the traditional cashew nut have similar fatty acid profiles. As for the ratio of ω-6 to ω-3, the baru almond showed the highest ratio, 9:1, which was the closest to the recommended intake of these fatty acids. Conclusion: The fatty acid profile of the edible seeds and nuts native to the cerrado is similar to those of traditional oilseeds. We suggest the inclusion of native oilseeds in the diet aiming at reducing the risk of cardiovascular disease, especially the baru almond and the cerrado cashew nut, due to the fact they have high ratio of monounsaturated fatty acids to saturated fatty acids.

RESUMO Objetivo: Avaliar a composição de nozes e sementes comestíveis nativas do cerrado, no que diz respeito aos ácidos graxos, e comparar com oleaginosas tradicionais. Métodos: A amêndoa de baru, a castanha-de-caju-do-cerrado e a amêndoa de pequi foram extraídas dos frutos com equipamentos apropriados. Todas as nozes e sementes comestíveis foram torradas, exceto a castanha-do-brasil. Os lipídeos das amostras foram extraídos a frio, os ácidos graxos foram esterificados e os ésteres de ácidos graxos foram analisados por cromatografia gasosa. Resultados: As nozes e sementes comestíveis tradicionais e nativas possuem, predominantemente, ácidos graxos monoinsaturados (42,72 g a 63,44 g/100 g), exceto a castanha-do-brasil, que apresentou predominância de ácidos graxos poli-insaturados (45,48 g/100 g). A amêndoa de pequi apresentou o maior teor de ácidos graxos saturados (36,14 g/100 g). Os ácidos graxos encontrados em maior concentração nas oleaginosas foram o ácido oleico e o linoleico; o ácido palmítico foi também detectado em proporções consideráveis. O perfil de ácidos graxos da castanha-de-caju-do-cerrado é comparável ao da castanha-de-caju tradicional. Quanto à relação entre ácidos graxos w-6 e w-3, a amêndoa de baru apresentou o valor de 9:1, mais próximo ao recomendado para consumo. Conclusão: O perfil de ácidos graxos das nozes e sementes comestíveis nativas do cerrado se assemelha ao das tradicionais. Sugere-se, portanto, a inclusão das oleaginosas nativas em planos alimentares que visem a redução do risco de doenças cardiovasculares, sobretudo a amêndoa de baru e a castanha-de-caju-do-cerrado, por suas elevadas concentrações de ácidos graxos monoinsaturados em relação aos ácidos graxos saturados.

Eficiência alimentar e qualidade proteica das sementes de baru e pequi procedentes do Cerrado brasileiro / Food efficiency and protein quality of baru and pequi seeds from Brazilian savanna

Este trabalho avaliou a eficiência alimentar e a qualidade proteica das sementes de baru e pequi nativas do Cerrado brasileiro. Ratos Wistar machos, recém-desmamados (n = 24), distribuídos em quatro grupos,foram alimentados com diferentes dietas, contendo 10% de proteína: padrão (caseína, 7% de lipídios);controle (caseína, 15% de lipídios); baru (semente de baru, 15% de lipídios) e pequi (semente de pequi,15% de lipídios). Determinaram-se os teores proteicos e lipídicos e estimou-se o teor de fibra alimentar total das dietas. A eficiência alimentar foi avaliada pelo Fator de Conversão Alimentar (FCA), e o valor proteico, por meio do PER (Protein Efficiency Ratio). O FCA variou de 2,8 (dieta padrão) a 10,5 (dieta de semente de pequi); e a dieta de semente de baru (FCA = 5,17) foi mais eficiente do que a dieta de semente de pequi. O valor de PER da semente de baru (2,11) foi superior ao da semente de pequi (1,0), e os valores de RPER (qualidade proteica relativa) dessas sementes foram, respectivamente, de 70% e 30%. A semente de baru possui melhor eficiência alimentar e qualidade proteica do que a semente de pequi, e sua proteína pode ser classificada como de qualidade intermediária a boa.