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1.
Pediatr Obes ; 16(5): e12741, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33089672

RESUMO

BACKGROUND: Increased intestinal permeability may be associated with certain disorders, such as obesity and small intestine bacterial overgrowth (SIBO). OBJECTIVE: This study aimed to investigate intestinal permeability and SIBO in excess weight adolescents. METHODS: This cross-sectional study included 67 adolescents with excess weight and 66 normal weight adolescents. Excess weight was defined as a body mass index for age (BMI/age) > +1 SD, which includes having excess body weight and obesity. SIBO was diagnosed by a breath test after the ingestion of lactulose according to the production of hydrogen and methane. Zonulin (haptoglobin) was considered an indicator of intestinal permeability. RESULTS: Adolescents with excess weight had a higher height/age Z-score (median [25th; 75th percentile]: +0.6 [-0.4; +1.0]) than those in the normal weight group (-0.1 [-0.6; +0.7]; P = .014). Zonulin (mg/mL) in the excess weight (2.3 [1.5; 3.8]) adolescents was higher than that in the normal weight (1.6 [1.0; 2.2]) adolescents (P < .001). SIBO was diagnosed in 23.3% (31/133) of the adolescents. The adolescents with SIBO had a lower (P < .05) BMI/age (+0.6 [-0.6; +1.9]) and height/age (-0.3 [-0.7; +0.3]) than the adolescents without SIBO (+1.3 [+0.1; +2.6] and +0.2 [-0.5; +1.0], respectively). No association was found between zonulin and SIBO. CONCLUSION: Excess weight is associated with increased intestinal permeability. No relationship was found between SIBO and intestinal permeability; however, SIBO was related to lower BMI and height for age Z-scores.


Assuntos
Intestino Delgado , Lactulose , Sobrepeso/microbiologia , Obesidade Infantil/microbiologia , Adolescente , Síndrome da Alça Cega , Testes Respiratórios , Estudos de Casos e Controles , Estudos Transversais , Humanos , Intestino Delgado/microbiologia , Permeabilidade
2.
J Pediatr Gastroenterol Nutr ; 71(4): e118-e123, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32960544

RESUMO

OBJECTIVE: A high prevalence of obesity is reported in children and adolescents with autoimmune hepatitis (AIH). Adipokines participate in inflammatory processes. The objective of this study was to examine the relationship between excess weight and systemic inflammation, adipokines, and ghrelin in adolescents with AIH. METHOD: This case-controlled study included 27 adolescents with AIH (13 with excess weight and 14 with normal weight) and a control group. Excess weight was defined by a body mass index/age Z score >+1 standard deviation. Adipokines (adiponectin, leptin, tumor necrosis factor alpha, interleukin 6 [IL-6], and IL-10) and ghrelin were measured with Luminex technology. RESULTS: Adiponectin (µg/mL) was higher (P < 0.001) in AIH adolescents with and without excess weight (median: 35.0 and 42.1, respectively) than in normal-weight (17.5) and excess-weight (17.0) controls. Leptin was higher (P < 0.001) in excess-weight AIH patients (18.0 ng/mL) and controls (19.8 ng/mL) than in normal-weight AIH (7.7 ng/mL) and control (7.0 ng/mL) adolescents. IL-6 levels were higher in excess-weight (3.8 pg/mL) and normal-weight (3.8 pg/mL) AIH patients than in excess-weight (1.1 pg/mL) and normal-weight (0.5 pg/mL) controls. IL-10 levels were higher (5.2 pg/mL) in normal-weight AIH patients than in excess-weight (1.8 pg/mL) and normal-weight (2.1 pg/mL) controls. Ferritin levels were lower in patients with AIH than in controls. CONCLUSIONS: Independent of body weight, AIH patients had higher levels of adipokines, especially adiponectin and IL-6. Leptin levels were associated with body weight and were not influenced by AIH. IL-10 levels were associated with lean tissue in AIH.


Assuntos
Adiponectina , Hepatite Autoimune , Adipocinas , Adolescente , Peso Corporal , Criança , Humanos , Leptina
3.
Rev. Nutr. (Online) ; 31(6): 535-546, Nov.-Dec. 2018. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1041292

RESUMO

ABSTRACT Objective This study evaluated the knowledge and practices of pediatricians and nutritionists about cow's milk protein allergy in infants, with an emphasis on issues related to the exclusion diet and nutritional status. Methods A cross-sectional, descriptive study was performed with a convenience sample of 204 pediatricians and 202 nutritionists randomly invited in scientific events in the city of São Paulo, from November 2014 to March 2016. Results Between 1.5% and 21.0% of respondents indicated inadequate products for the treatment of cow's milk protein allergy, including goat's milk, beverages or juices based on soy extract, lactose-free milk formula and partially hydrolyzed formula. The daily calcium recommendation for children between zero and 36 months of age was correctly indicated by 27.0% of pediatricians and 46.0% of nutritionists (p=0.001). Additionally, 96.1% of pediatricians and 82.7% of dietitians (p<0.001) provided guidance on about labels of industrialized products. Conclusion Pediatricians and nutritionists present gaps in knowledge about cow's milk protein allergy treatment in infants and educational strategies that increase the knowledge of the professionals are important for the management of cow's milk protein allergy.


RESUMO Objetivo Este estudo avaliou o conhecimento e práticas de pediatras e nutricionistas sobre alergia às proteínas do leite de vaca em lactentes, com ênfase em questões relacionadas à dieta de exclusão e ao estado nutricional. Métodos Estudo transversal, descritivo, realizado com uma amostra de conveniência de 204 pediatras e 202 nutricionistas, convidados aleatoriamente em eventos científicos na cidade de São Paulo, de novembro de 2014 a março de 2016. Resultados Entre 1,5% e 21,0% dos entrevistados indicaram produtos inadequados para o tratamento da alergia às proteínas do leite de vaca, incluindo leite de cabra, bebidas ou sucos à base de extrato de soja, fórmula de leite sem lactose e fórmula parcialmente hidrolisada. A recomendação diária de cálcio para crianças entre zero e 36 meses de idade foi corretamente indicada por 27,0% de pediatras e 46,0% de nutricionistas (p=0,001). Além disso, 96,1% dos pediatras e 82,7% dos nutricionistas (p<0,001) forneceram orientação sobre os rótulos dos produtos industrializados. Conclusão Pediatras e nutricionistas apresentam lacunas no conhecimento sobre o tratamento da alergia às proteínas do leite de vaca em lactentes. Estratégias educacionais que aumentam o conhecimento dos profissionais são importantes para o gerenciamento da alergia às proteínas do leite de vaca.


Assuntos
Humanos , Masculino , Feminino , Hipersensibilidade a Leite , Conhecimentos, Atitudes e Prática em Saúde , Estudos Transversais , Entrevista , Substitutos do Leite Humano , Nutricionistas , Pediatras , Lactente , Proteínas do Leite
5.
Rev. nutr ; 26(3): 301-311, May-June 2013. tab
Artigo em Português | LILACS | ID: lil-680217

RESUMO

OBJETIVO: Avaliar o estado nutricional e a ingestão de energia e de macronutrientes de pacientes com diagnóstico de doença celíaca que transgrediam ou não a dieta isenta de glúten. MÉTODOS: Foram estudados 63 pacientes com doença celíaca: 34 crianças e 29 adolescentes. Transgressão à dieta isenta de glúten foi caracterizada por meio da dosagem sérica do anticorpo antitransglutaminase tissular recombiante humana. O estado nutricional foi avaliado com base nos escores-Z de peso/idade, estatura/idade e no índice de massa corporal. A ingestão alimentar foi avaliada por meio do inquérito alimentar de 24 horas. RESULTADOS: A transgressão à dieta sem glúten foi constatada em 41,2% das crianças e em 34,5% dos adolescentes. Nas crianças com transgressão alimentar, a média do escore-Z de estatura/idade foi inferior à das crianças do grupo que não transgredia (p=0,024). Todavia, o grupo com transgressão apresentou maior escore-Z do índice de massa corporal em relação aos que não transgrediam (p=0,021). Os adolescentes que não transgrediam apresentaram maior índice de massa corporal quando comparados aos que transgrediam a dieta (p=0,037). Em relação à ingestão alimentar, não se observou diferença estatística entre os grupos. Todavia, cerca de 70,0% das crianças e adolescentes apresentaram consumo de energia acima de 120,0% da recomendação. CONCLUSÃO: As crianças que transgrediam a dieta apresentaram menor escore-Z de estatura/idade e maior escore-Z para índice de massa corporal do que crianças que seguem sem transgressões alimentares. Os adolescentes que não transgrediam a dieta apresentaram maior média de índice de massa corporal quando comparados aos que transgrediam a dieta. Consumo energético elevado foi observado tanto nas crianças quanto nos adolescentes.


OBJECTIVE: This study evaluated the nutritional status and intakes of energy and macronutrients of celiac disease patients compliant or not with a gluten-free diet. METHODS: We studied 63 patients with celiac disease, 34 children and 29 adolescents. Noncompliance with a gluten-free diet was characterized by detection of antibodies to tissue transglutaminase in serum by recombinant human tissue transglutaminase antigen. Nutritional status was classified according to the weight-for-age, height-for-age, and body mass index Z-scores. Dietary intake was assessed by a 24-hour recall. RESULTS: The percentages of children and adolescents noncompliant with a gluten-free diet were 41.2% and 34.5%, respectively. Noncompliant children had a lower mean height-for-age Z-score than compliant children (p=0.024). However, noncompliant children had higher mean body mass index Z-score than compliant children (p=0.021). On the other hand, compliant adolescents had higher BMI than noncompliant adolescents (p=0.037). The food intake between the groups did not differ, but the energy intakes of 70.0% of the children and adolescents exceeded 120.0% of their requirements. CONCLUSION: Children who do not comply with a gluten-free diet have lower height-for-age Z-scores and higher body mass index Z-scores than children who comply. Compliant adolescents have a higher mean body mass index than noncompliant adolescents. High energy intake was observed in both children and adolescents.


Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Adolescente , Adolescente , Ingestão de Alimentos , Criança , Doença Celíaca , Estado Nutricional
6.
J Clin Gastroenterol ; 44(3): 200-7, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-19826277

RESUMO

OBJECTIVE: To evaluate the food intake, anthropometry, body composition, and sexual maturity of children and adolescents with autoimmune hepatitis. METHODS: Thirty-seven children and adolescents with autoimmune hepatitis were studied. A questionnaire was given to evaluate food intake over a 24-hour period. Weight, height, and skin-fold thickness were measured. Electric impedance and skin-fold using Slaughter formula were used to evaluate body composition. Sexual maturity was evaluated using the Tanner stage method. Cumulative intake of corticosteroids was determined based on medical records. RESULTS: Most of the subjects were females (83.3%). Food intake did not meet recommended dietary intakes for energy, calcium, and vitamin A for 43.2%, 94.6%, and 59.4% of the patients, respectively. All subjects were in their respective pubertal developmental stage. A lower Z score for height-for-age (

Assuntos
Composição Corporal , Dieta , Hepatite Autoimune , Maturidade Sexual , Adolescente , Antropometria , Cálcio/administração & dosagem , Criança , Estudos Transversais , Ingestão de Alimentos , Impedância Elétrica , Ingestão de Energia , Feminino , Seguimentos , Glucocorticoides/administração & dosagem , Glucocorticoides/efeitos adversos , Glucocorticoides/uso terapêutico , Hepatite Autoimune/tratamento farmacológico , Hepatite Autoimune/fisiopatologia , Humanos , Masculino , Política Nutricional , Inquéritos e Questionários , Vitamina A/administração & dosagem , Adulto Jovem
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