Cadmium and lead levels consumed by patients with oral hospital diets prescriptions.

INTRODUCTION: The levels of cadmium (Cd) and lead (Pb) in foods should be monitored as a function of health risks. OBJECTIVE: To evaluate Cd and Pb levels in oral hospital diets and in an oral food complement (OFC) according to their respective consumption by patients, and to estimate the patient's exposition risk. METHODS: The levels of Cd and Pb were determined by ICP-OES in samples of regular, blend, soft and renal diets and OFC, collected on 6 weekdays. About 14.3% of the diets and OFC served were analyzed. RESULTS AND DISCUSSION: 163 patients participated, with mean weights and ages of 62.7 kg and 56.5 years, respectively, the majority being men (59.5%). The mean Cd content consumed was greater for men fed the regular and blend diets and similar amongst the sexes for the soft diet. The consumption of Cd (max. 21.02 µg/day) was below the provisional tolerable monthly intake (PTMI). The mean Pb ingested (max. 199.49 µg/day) was similar amongst the sexes. The soft diet showed the highest Pb content in September/2010, whereas the other showed no variation according to season. In September/2010 and January/2011, the soft and regular diets associated with the OFC offered 207.50 and 210.50 µg/day of Pb, respectively. CONCLUSIONS: The combination of the diet with the OFC increased the risk of an excessive ingestion of Pb, and the vulnerability of the patients to an excessive exposition to Pb could be greater due to water and medications. It was concluded that whereas the calculated ingestion of Cd conformed to the PTMI, the Pb level and ingestion represented a risk to the health of the patients.

Consumption of oral hospital diets and percent adequacy of minerals in oncology patients as an indicative for the use of oral supplements.

BACKGROUND & AIMS: Deficiencies in the consumption of foods and nutrients favor malnutrition in patients. Considering the recommendations for the ingestion of minerals, the content, consumption and percent adequacy of the minerals (Ca, Cu, Fe, Mg, Mn, K, P, Na, Zn and Se) were evaluated amongst oncology patients who received oral diets isolated or associated with an oral food complement (OFC), evaluating the need and composition of an oral supplement. METHODS: The mineral composition as determined by ICP-OES, and the food consumption of the patients served regular, bland and soft diets, were evaluated on six non-consecutive weekdays. Patients with increased nutritional needs received OFC. The consumptions were calculated by deducting the weight of the leftovers from the value served. RESULTS: A total of 163 patients took part of which 59.5% were men, the mean age was 57 ± 15 years old, and 126 (77.3%), 27 (16.6%) and 10 (6.1%) were served the regular, bland and soft diets, respectively, with (23.0%), 8 (30.7%) and 4 (40.0%) receiving the OFC. Patient consumption was lower when the regular (74.2 vs 79.7%) and soft (68.9 vs 74.2%) diets were combined with OFC. For all diets, less was consumed at the lunch (61.2%-65.7%) and dinner (39.9%-62.8%) meals. Patients that received the OFC showed reduced meal consumption and higher Ca ingestion. The mineral contents of the diets were inadequate, with 66.8% of the patients ingesting Na above the UL and K below the nutritional recommendation (100%). CONCLUSION: The diet consumption, isolated or associated with OFC was insufficient, and hence the exclusion of OFC and the inclusion of a mineral supplement (without P and Na) was indicated to adequate ingestion to the nutritional recommendations.

Evaluation of iron, zinc, copper, manganese and selenium in oral hospital diets.

BACKGROUND & AIMS: Many trace elements are nutrients essential to humans, acting in the metabolism as constituents or as enzymatic co-factors. The iron, zinc, copper, manganese and selenium contents of hospital diets (regular, blend and soft) and of oral food complement (OFC) were determined, evaluating the adequacy of each element in relation to the nutritional recommendations (DRIs) and the percent contribution alone and with OFC. METHODS: Duplicate samples were taken of six daily meals and of the OFC on two non-consecutive days from a hospital in Belo Horizonte (MG, Brazil) in May and September of 2010 and January of 2011. The elements were determined by ICP OES. RESULTS: Of the diets, the soft diet showed the highest elements content. Offering the OFC was insufficient to provide adequate levels of the trace elements. CONCLUSION: The oral hospital diets were inadequate in relation to the RDAs for the trace elements studied and the use of the OFCs was insufficient to compensate the values.