Gastrointestinal genetic reprogramming of vitamin A metabolic pathways in response of Roux-en-Y gastric bypass.

Roux-en-Y gastric bypass (RYGB) is one of the most performed bariatric surgical techniques. However, RYGB commonly results, as side effects, in nutritional deficiencies. This study aimed to examine changes in the expression of vitamin A pathway encoding genes in the gastrointestinal tract (GI) and to evaluate the potential mechanisms associated with hypovitaminosis A after RYGB. Intestinal biopsies were obtained through double-balloon endoscopy in 20 women with obesity (age 46.9±6.2 years; body mass index [BMI] 46.5±5.3 kg/m2 [mean±SD]) before and three months after RYGB (BMI, 38.2±4.2 kg/m2). Intestinal mucosal gene microarray analyses were performed in samples using a Human GeneChip 1.0 ST array (Affymetrix). Vitamin A intake was assessed from 7-day food records and serum retinol levels were evaluated by electrochemiluminescence immunoassay. Our results showed the following genes with significant downregulation (p≤0.05): LIPF (-0.60), NPC1L1 (-0.71), BCO1 (-0.45), and RBP4 (-0.13) in duodenum; CD36 (-0.33), and ISX (-0.43) in jejunum and BCO1 (-0.29) in ileum. No significant changes in vitamin A intake were found (784±694 retinol equivalents [RE] pre-operative vs. 809±753 RE post-operative [mean±SD]). Although patients were routinely supplemented with 3500 international units IU/day (equivalent to 1050 µg RE/day) of oral retinol palmitate, serum concentrations were lower in the post-operative when compared to pre-operative period (0.35±0.14 µg/L vs. 0.52±0.33 µg/L, respectively - P=0.07), both within the normal range. After RYGB, the simultaneous change in expression of GI genes, may impair carotenoid metabolism in the enterocytes, formation of nascent chylomicrons and transport of retinol, resulting in lower availability of vitamin A.

Qualitative Analysis of the "Healthy Growing at School Program" - Vision of Health Professionals, School Community and Family / Análise Qualitativa do Programa Crescer Saudável na Escola - Visão dos Profissionais de Saúde, da Comunidade Escolar e da Família

INTRODUCTION: At present, school institutions exert a great influence on the diet of their pupils, since they usually remain for a long time in these places. The Food and Nutrition Education can help in the creation of healthy eating habits among children. OBJECTIVE: To analyze the results of the Healthy Growing in School Program with regard to encouraging healthy eating habits among preschoolers at a school in São Paulo (São Paulo, Brazil). METHODS: The Program lasted 1 academic year. The sample consisted of 108 children of both sexes, aged 4 to 6 years. A questionnaire was applied to those responsible for characterization and questions to measure the level of knowledge about balanced eating (score 0-37 points) at the beginning and end of the Program. Eighteen play activities were carried out with the children, and two with the parents. This study was approved by the Ethics Committee of the São Camilo University Center (No.2,450,931). RESULTS: Most of the parents or guardians have a high school education, receive from 1-3 minimum salaries and have a nutritional diagnosis of eutrophic. The average score of the food knowledge questionnaire was 27.0±2.5 at the beginning of the Program and did not show a significant difference at the end (p=0,322). From the development of educational activities, it was possible to observe that the preschoolers acquired more knowledge about the fruits, vegetables and vegetables most commonly consumed in São Paulo. The vision of the school community and families was positive about the Program. CONCLUSION: The Program provided has increased interest in healthy eating practices among children.

INTRODUÇÃO: Atualmente, as instituições escolares exercem grande influência na alimentação dos alunos, pois, geralmente, permanecem longo período nestes locais. A Educação Alimentar e Nutricional pode auxiliar numa possível criação de hábitos alimentares saudáveis entre as crianças. OBJETIVO: Analisar os resultados do Programa Crescer Saudável na Escola no que se refere ao estímulo de hábitos alimentares saudáveis entre os pré-escolares em uma escola municipal em São Paulo (SP, Brasil). MÉTODO: O Programa teve duração de 1 ano letivo. A amostra foi composta por 108 crianças de ambos os sexos, com idade de 4 a 6 anos. Foi aplicado um questionário aos responsáveis para caracterização e medir o nível de conhecimento sobre alimentação equilibrada (0-37 pontos) no início e no final do Programa. Foram realizadas dezoito atividades com as crianças, e duas com os pais. Este estudo foi aprovado pelo Comitê de Ética. RESULTADOS: A maioria dos pais tem ensino médio, recebem de 1-3 salários mínimos e apresentam diagnóstico nutricional de eutrofia. A pontuação média do questionário foi de 27,0±2,5 no início do Programa, e não apresentou diferença significativa no final (p=0,322). A partir do desenvolvimento das atividades educativas foi possível observar que os pré-escolares adquiriram maior conhecimento sobre frutas, verduras e legumes mais comumente consumidos em SP. As percepções da comunidade escolar e das famílias foram positivas. CONCLUSÃO: O Programa proporcionou aumento do interesse sobre práticas alimentares saudáveis entre as crianças.

Fatores que influenciam os responsáveis pela seleção dos alimentos para crianças da educação infantil: uma reflexão bioética num estudo exploratório / Influencing factors in caretakers selection of food for children of early childhood education: bioethical analysis within in exploratory study

A análise ética torna-se fundamental ao relacionar o papel da família no desenvolvimento dos hábitos alimentares de seus filhos. Neste estudo, efetuou-se uma contextualização bioética sobre a propaganda que influencia os responsáveis quanto à aquisição e seleção dos alimentos oferecidos às crianças da educação infantil. A população de estudo foi composta por 162 responsáveis das crianças, matriculadas em escola municipal de ensino infantil em 2013, e os dados obtidos por meio do retorno dos questionários enviados na agenda das crianças. O fator saudabilidade do gênero alimentício foi destacado pelos entrevistados como determinante para a aquisição do gênero (77,2%), ao passo que a mídia foi relatada como o fator de menor influência na compra (63%). O presente estudo mostrou que existe certa preocupação por parte dos responsáveis nas escolhas dos alimentos a serem comprados e oferecidos às crianças. Os aspectos éticos devem ser sempre considerados frente a interesses econômicos e outros secundários como o status social.

An ethical analysis is crucial for the role of the family in the development of eating habits of their children. This study covers a bioethical contextualization about the influence of advertisement in caretakers as to the purchase and selection of food offered for children of early childhood education. The study population was composed of 162 caretakers of children, enrolled in municipal schools of childhood education in 2013, and the data was collected by means of questionnaires sent in children's agenda. Interviewees highlighted the healthiness of the food as decisive factor for the purchase of food (77.2%), whereas the media was reported as the minor influencing factor in the purchase of food (63%). This study demonstrates that caretakers do have concerns as to the choice of foods to be purchased and offered to children. The ethical aspects must always come ahead of economic and other secondary interests such as social status.

Kinin B1 receptor deficiency leads to leptin hypersensitivity and resistance to obesity.

OBJECTIVE: Kinins mediate pathophysiological processes related to hypertension, pain, and inflammation through the activation of two G-protein-coupled receptors, named B(1) and B(2). Although these peptides have been related to glucose homeostasis, their effects on energy balance are still unknown. RESEARCH DESIGN AND METHODS: Using genetic and pharmacological strategies to abrogate the kinin B(1) receptor in different animal models of obesity, here we present evidence of a novel role for kinins in the regulation of satiety and adiposity. RESULTS: Kinin B(1) receptor deficiency in mice (B(1)(-/-)) resulted in less fat content, hypoleptinemia, increased leptin sensitivity, and robust protection against high-fat diet-induced weight gain. Under high-fat diet, B(1)(-/-) also exhibited reduced food intake, improved lipid oxidation, and increased energy expenditure. Surprisingly, B(1) receptor deficiency was not able to decrease food intake and adiposity in obese mice lacking leptin (ob/ob-B(1)(-/-)). However, ob/ob-B(1)(-/-) mice were more responsive to the effects of exogenous leptin on body weight and food intake, suggesting that B(1) receptors may be dependent on leptin to display their metabolic roles. Finally, inhibition of weight gain and food intake by B(1) receptor ablation was pharmacologically confirmed by long-term administration of the kinin B(1) receptor antagonist SSR240612 to mice under high-fat diet. CONCLUSIONS: Our data suggest that kinin B(1) receptors participate in the regulation of the energy balance via a mechanism that could involve the modulation of leptin sensitivity.

High- or low-salt diet from weaning to adulthood: effect on body weight, food intake and energy balance in rats.

OBJECTIVE: To get some additional insight on the mechanisms of the effect of salt intake on body weight. DESIGN AND METHODS: Rats were fed a low (LSD), normal (NSD), or high (HSD) salt diet. In a first set, body weight, tail-cuff blood pressure, fasting plasma thyroid-stimulating hormone, triiodothyronine, L-thyroxine, glucose, insulin, and angiotensin II were measured. Angiotensin II content was determined in white and brown adipose tissues. Uncoupling protein 1 expression was measured in brown adipose tissue. In a second set, body weight, food intake, energy balance, and plasma leptin were determined. In a third set of rats, motor activity and body weight were evaluated. RESULTS: Blood pressure increased on HSD. Body weight was similar among groups at weaning, but during adulthood it was lower on HSD and higher on LSD. Food intake, L-thyroxine concentration, uncoupling protein 1 expression and energy expenditure were higher in HSD rats, while non-fasting leptin concentration was lower in these groups compared to NSD and LSD animals. Plasma thyroid-stimulating hormone decreased on both HSD and LSD while plasma glucose and insulin were elevated only on LSD. A decrease in plasma angiotensin II was observed in HSD rats. On LSD, an increase in brown adipose tissue angiotensin II content was associated to decreased uncoupling protein 1 expression and energy expenditure. In this group, a low angiotensin II content in white adipose tissue was also found. Motor activity was not influenced by the dietary salt content. CONCLUSIONS: Chronic alteration in salt intake is associated with changes in body weight, food intake, hormonal profile, and energy expenditure and tissue angiotensin II content.