Nutritional Strategies for the Management of Type 2 Diabetes Mellitus: A Narrative Review.

BACKGROUND: Thinking about greater adherence to dietary planning, it is extremely important to be aware of all nutritional strategies and dietary prescriptions available in the literature, and of which of them is the most efficient for the management of T2DM. METHODS: A search was carried out in 2023 for randomized clinical trials, systematic reviews, meta-analyses, and guidelines in the following databases: Pubmed, Scielo, Web of Science, CrossRef and Google Scholar. In total, 202 articles were collected and analyzed. The period of publications was 1983-2023. RESULTS: There is still no consensus on what the best nutritional strategy or ideal dietary prescription is, and individuality is necessary. In any case, these references suggest that Mediterranean Diet may of greater interest for the management of T2DM, with the following recommended dietary prescription: 40-50% carbohydrates; 15-25% proteins; 25-35% fats (<7% saturated, 10% polyunsaturated, and 10% monounsaturated); at least 14 g of fiber for every 1000 kcal consumed; and <2300 mg sodium. CONCLUSIONS: Individuality is the gold standard for dietary prescriptions, however, the Mediterranean diet with low levels of carbohydrates and fats seems to be the most promising strategy for the management of T2DM.

Integrative Strategies for Preventing Nutritional Problems in the Development of Children in Brazil.

Child healthcare has been a priority subject in several programs and public policies developed over the decades. However, initiatives implemented seem insufficient to overcome the challenges regarding the integral development and improvement of the nutritional status of children in Brazil. The initial developmental stages of a child include pregnancy, breastfeeding, and complementary feeding, which are determinants in future aspects of health and nutritional status. Therefore, the strategies addressing problems during these three periods of life have the potential to positively impact the promotion of healthy eating habits and food security throughout life. Developing countries with huge dimensions and vast inequalities, like Brazil, are marked by differences in regional, cultural, and social contexts that may hinder the implementation of programs and policies with a broad scope. Extensive operational and professional costs, in addition to time-consuming activities that are necessary to apply, monitor, and evaluate interventions may jeopardize the proper assessment of programs and policy goals, generating the inefficiency and waste of resources in the health system. Thus, programs and policies aimed at creating and modifying habits should consider an intersectoral action within local contexts, involving health professionals, universities, policy managers, and the community. Therefore, this article aimed to discuss the preliminary conception of an integrated approach of decentralized strategies to promote healthy eating habits and food security of children in Brazil.

Principales Estrategias de Intervención Nutricional realizadas en Chile en el decenio 2010-2020: avances y desafíos / Main Nutritional Intervention Strategies carried out in Chile in the 2010-2020 decade: progress and challenges

La alta prevalencia de obesidad en Chile, y su tendencia al aumento, constituye un problema de Salud Pública por su asociación con enfermedades crónicas no transmisibles. Durante la década 2010-2020, el estado de Chile implementó estrategias de intervención nutricional dirigidas a mantener o disminuir la prevalencia de obesidad. Regulaciones como la ley 20.606 sobre composición nutricional de los alimentos y su publicidad para modificar los entornos alimentarios, sistema elige vivir sano como modelo de gestión intersectorial constituido por políticas, planes y programas elaborados y ejecutados por distintos organismos del Estado, destinados a contribuir a generar hábitos y estilos de vida saludable y a prevenir y disminuir los factores y conductas de riesgo asociados a las enfermedades no transmisibles. A pesar de todos los esfuerzos, las encuestas poblacionales han demostrado que la obesidad continúa en aumento a lo largo del ciclo vital, por lo que es necesario fortalecer las estrategias existentes, pero con enfoque de determinantes sociales y de salud en todas las políticas, y a su vez mejorar los sistemas de evaluación de las estrategias implementadas en la población, midiendo su impacto además de su ejecución.

The high prevalence of obesity in Chile, and its increasing trend, constitutes a Public Health problem due to its association with chronic non-communicable diseases. During the 2010-2020 decade, the state of Chile implemented nutritional intervention strategies aimed at maintaining or reducing the prevalence of obesity. Regulations such as Law 20.606 on the nutritional composition of food and its advertising to modify food environments, Sistema chooses to live healthy System "EVS" Choose Healthy lifestyles as an intersectoral management model made up of policies, plans and programs prepared and executed by different State agencies, intended to contribute to healthy habits and lifestyles and to prevent and reduce risk factors and behaviors associated with non-communicable diseases. Despite all efforts, population surveys have shown that obesity continues to increase throughout the life cycle, which is why it is necessary to strengthen existing strategies, but with a focus on social and health determinants in all policies, since in turn, improve the evaluation systems of the strategies implemented in the population, measuring their impact, in addition to their implementation.

Reverse Cholesterol Transport: Molecular Mechanisms and the Non-medical Approach to Enhance HDL Cholesterol.

Dyslipidemia (high concentrations of LDL-c and low concentrations of HDL-c) is a major cause of cardiovascular events, which are the leading cause of death in the world. On the other hand, nutrition and regular exercise can be an interesting strategy to modulate lipid profile, acting as prevention or treatment, inhibiting the risk of diseases due to its anti-inflammatory and anti-atherogenic characteristics. Additionally, the possibility of controlling different training variables, such as type, intensity and recovery interval, can be used to maximize the benefits of exercise in promoting cardiovascular health. However, the mechanisms by which exercise and nutrients act in the regulation of cholesterol and its fractions, such as reverse cholesterol transport, receptors and transcription factors involved, such as PPARs and their role related to exercise, deserve further discussion. Therefore, the objective of this review is to debate about non-medical approaches to increase HDL-c, such as nutritional and training strategies, and to discuss the central mechanisms involved in the modulation of lipid profile during exercise, as well as that can be controlled by physical trainers or sports specialists in attempt to maximize the benefits promoted by exercise. The search for papers was performed in the databases: Medline (Pubmed), Science Direct, Scopus, Sport Discus, Web of Science, Scielo and Lilacs until February 2016.

Comparison between linear and nonlinear systems of feed formulation for broilers

Two experiments were simultaneously carried out to compare feed formulation models: a linear model for minimum cost with a nonlinear model for maximum profitability for one-to 42-d-old broilers. One-d-old male or female Cobb 500 broilers (n=2368) were allocated to one of the two trials according to sex. The experiments were performed simultaneously in an experimental poultry farm. Two housing densities were used: high density (HDH), with 14 birds/m2, and low density (LDH), with 10 birds/m2. The following treatments were evaluated: linear feed formulation and LDH (LF10); nonlinear formulation and LDH (NF10); linear formulation and HDH (LF14); and nonlinear formulation and HDH (NF14). A completely randomized design with four treatments of eight replicates each was applied. Performance and cost per kg of poultry were evaluated. Both formulation systems promoted similar broiler performance. However, the high-density feed using linear formulation reduced body weight in 42-d-old males, but not when nonlinear formulation was used. The NF10 treatment yielded the worst feed conversion ratio (p 0.05) and the lowest cost/kg broiler (p 0.05) for both sexes. The results demonstrate that the nutritional program that yields the best performance is not always the most economical one.(AU)

Comparison between linear and nonlinear systems of feed formulation for broilers

Two experiments were simultaneously carried out to compare feed formulation models: a linear model for minimum cost with a nonlinear model for maximum profitability for one-to 42-d-old broilers. One-d-old male or female Cobb 500 broilers (n=2368) were allocated to one of the two trials according to sex. The experiments were performed simultaneously in an experimental poultry farm. Two housing densities were used: high density (HDH), with 14 birds/m2, and low density (LDH), with 10 birds/m2. The following treatments were evaluated: linear feed formulation and LDH (LF10); nonlinear formulation and LDH (NF10); linear formulation and HDH (LF14); and nonlinear formulation and HDH (NF14). A completely randomized design with four treatments of eight replicates each was applied. Performance and cost per kg of poultry were evaluated. Both formulation systems promoted similar broiler performance. However, the high-density feed using linear formulation reduced body weight in 42-d-old males, but not when nonlinear formulation was used. The NF10 treatment yielded the worst feed conversion ratio (p 0.05) and the lowest cost/kg broiler (p 0.05) for both sexes. The results demonstrate that the nutritional program that yields the best performance is not always the most economical one.