RESUMO
Prebiotics can alter the gastrointestinal environment, favoring the growth of health-promoting bacteria. Although yacon is a functional food, with prebiotic properties (fructooligosaccharides), its effects on the intestinal microbiota have not been investigated yet. The objective of this study was to evaluate the effects of yacon flour consumption and energy-restricted diet in the intestinal microbiota in adults with excess body weight. Twenty-one adults with excess body weight were included in this randomized, parallel, double-blind, placebo-controlled, 6-week clinical trial. Subjects daily consumed at breakfast a drink containing 25 g of yacon flour (n = 11) or not containing yacon (n = 10) and received the prescription of energy-restricted diets. Fecal samples were collected on the first and on last day of the study. 16S rRNA sequencing was assessed to evaluate the effect of yacon fermentation on intestinal microbiota bacterial composition. There was an increase in the genera Bifidobacterium, Blautia, Subdoligranulum, and Streptococcus after the consumption of yacon and energy-restricted diet. In the yacon group, we also observed a positive correlation between the concentrations of short-chain fatty acids versus the genera Coprococcus and Howardella, besides a negative correlation between the concentrations of advanced glycation end products and early glycation products versus the genera Ruminococcus and Prevotella, respectively. Consumption of yacon flour and energy-restricted diet selectively changed the intestinal microbiota composition in adults with excess body weight. TRIAL REGISTRATION: Register number: RBR-6YH6BQ. Registered 23 January, 2018.
Assuntos
Farinha , Prebióticos , Humanos , Adulto , RNA Ribossômico 16S , Obesidade , Fezes , DietaRESUMO
BACKGROUND: Food insecurity is a public health concern that affects health and quality of life, but its association with cardiometabolic risk is not well established. Thus, this systematic review evaluated the association between food insecurity and cardiometabolic risk factors in adults and the elderly. METHODS: Search was conducted according to the PRISMA protocol using Scielo, LILACS and PubMed databases. We included original articles published in Portuguese, English, and Spanish, which assessed the association between food insecurity and cardiometabolic risk factors in adults and the elderly. The search identified 877 articles but only 11 were included in the review. RESULTS: Food insecurity was directly associated with cardiometabolic risk (excess weight, hypertension, dyslipidemias, diabetes, and stress) after adjusting for interfering factors. A limitation of the cross-sectional study design is that the cause-effect relation between food insecurity and cardiometabolic risk cannot be established. CONCLUSIONS: We conclude that food insecurity has a direct relationship with cardiometabolic risk factors, especially excess weight, hypertension, and dyslipidemias. The identification of food insecurity as health problems can contribute to the implementation of efficient public policies for the prevention and control of chronic diseases. PROTOCOL REGISTRATION: This review was registered on PROSPERO-International Prospective Register of Systematic Reviews - CRD4201911549.
Assuntos
Fatores de Risco Cardiometabólico , Insegurança Alimentar , Adulto , Idoso , Estudos Transversais , Feminino , Abastecimento de Alimentos , Humanos , Qualidade de Vida , Estados UnidosRESUMO
ABSTRACT Objectives Yacon flour is rich in bioactive compounds (phenolic compounds and fructooligosaccharides (FOS)), and may therefore reduce the risk of diseases associated with excess body weight. However, its effect on fecal short chain fatty acids (SCFA), intestinal permeability, oxidative stress and inflammation markers has not been studied in adult humans with excess body weight. Thus, we evaluated the effect of the consumption of yacon flour on these variables. Materials and methods Twenty-six excess body weight (30.4 ± 2.4 kg/m2) adults (31.3 ± 8.5y) were randomized to one of two groups (yacon flour or control; n = 13) on a double blind clinical trial. Subjects received a breakfast drink containing or not yacon flour (25g) associated with an energy restricted diet, for six weeks. The flour chemical characterization, FOS and total phenolics contents were evaluated. Antioxidant capacity was evaluated in vitro and in vivo (plasma). Intestinal permeability, fecal SCFA, oxidative stress and inflammatory markers also were evaluated in vivo. Results Yacon flour was well tolerated. It presented an in vitro and in vivo antioxidant capacity, increased plasma total antioxidant capacity (ΔYAC: 49.16 (-4.20; 156.63)) and reduced protein carbonyl concentrations (ΔYAC: -0.98 (-1.54; -0.42)). A reduction in SCFAs was observed in both groups (Δacetic: -3.16 (-5.07; -0.95) vs. -1.05 (-2.65; 1.11); Δpropionic: -1.05 (-2.60;-0.38) vs. -0.41 (-2.08; 0.09); Δbutyric: -0.75 (-1.38; -0.04) vs. -0.28 (-0.98; 0.11), for YAC and CON, respectively). Other variables did not change. Conclusion The yacon flour increased the plasma antioxidant capacity, decreased oxidative stress and SCFAs in adults with obesity or overweight.
Assuntos
Humanos , Adulto , Asteraceae , Farinha , Permeabilidade , Estresse Oxidativo , Dieta , Sobrepeso , Ácidos Graxos Voláteis , Inflamação , ObesidadeRESUMO
We assessed the effects of increased Ca consumption from fat-free milk in an energy-restricted diet and educational activities in the metabolic control of overweight type 2 diabetes mellitus (T2DM) patients. Fourteen subjects with T2DM (BMI 29·4 (sd 4·5) kg/m2, low habitual Ca consumption (<600 mg/d)) were included in this randomised, crossover clinical trial. Subjects were randomly allocated to one of the two interventions: drink containing 700 mg of Ca (DAIR) or drink containing 0 mg of Ca (CONT) for ninety consecutive days each. Energy-restricted diets (-500 kcal/d; -2092 kJ/d), containing 800 mg of Ca from dietary sources/d, were prescribed for both groups. Questionnaires were applied at baseline and at the end of the study to assess the subjects' knowledge on the disease and on self-care, biochemical variables and physical activity. Blood pressure, food intake, body composition and anthropometry were assessed at baseline, days 45 and 90. There was a higher reduction of body fat %, waist circumference, hip circumference, neck circumference, waist:hip ratio, sagittal abdominal diameter, diastolic/systolic blood pressure and an increase in fat-free mass % in DAIR than in CONT. Uric acid, fasting glucose, Hb1Ac, parathyroid hormone and alanine aminotransferase concentrations reduced and vitamin D concentration increased after 90 d in DAIR compared with CONT. The consumption of energy-restricted diet containing 1200 mg Ca/d seems to favour metabolic control in subjects with T2DM. The educational activities increased the knowledge on the disease care.
Assuntos
Cálcio da Dieta/administração & dosagem , Restrição Calórica/métodos , Diabetes Mellitus Tipo 2/dietoterapia , Dieta para Diabéticos/métodos , Sobrepeso/dietoterapia , Educação de Pacientes como Assunto/métodos , Adulto , Animais , Glicemia/análise , Composição Corporal , Peso Corporal , Estudos Cross-Over , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/psicologia , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Leite/química , Sobrepeso/complicações , Sobrepeso/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Autocuidado/métodos , Autocuidado/psicologia , Resultado do Tratamento , Circunferência da Cintura , Relação Cintura-QuadrilRESUMO
We evaluated the effects of high-Ca fat-free milk v. low-Ca control diet on adiposity and on glycaemic control. Fourteen subjects with type 2 diabetes (aged 49·5 (sd 8·6) years, BMI 29·4 (sd 4·5) kg/m2, low habitual Ca consumption (<600 mg/d)) were included in this randomised, crossover clinical trial. Subjects participated in two 12-week experimental sessions (high-Ca fat-free milk (HC) or low-Ca control (LC)) separated by 8-week washout. Subjects daily consumed in the laboratory a breakfast shake containing 700 mg (HC) or 6·4 mg (LC) of Ca. Energy-restricted diets containing 800 mg of dietary Ca/d were prescribed. Dietary records data indicated the consumption of 1200 mg of Ca/d during HC and of 525 mg of Ca/d during LC. There was a greater reduction in body weight, body fat mass, waist circumference and waist:hip ratio after HC. Serum 25-hydoxyvitamin D and homeostatic model assessment-2 ß-cell function (HOMA2-%B) increased, and serum uric acid, parathormone (PTH) and glycated Hb (HbA1c) concentrations reduced after HC. In addition, changes from baseline in terms of serum uric acid, glucose, HbA1c and PTH concentrations were lower, and those of HOMA2-%B, serum Ca and 25-hydoxyvitamin D were higher after the HC than after LC. The consumption of approximately three servings of fat-free milk and 1200 mg of dietary Ca/d enhanced weight loss, improved body composition and promoted glycaemic control in subjects with type 2 diabetes and low habitual Ca consumption (<600 mg/d).
Assuntos
Cálcio da Dieta/administração & dosagem , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/dietoterapia , Hiperglicemia/sangue , Leite/química , Adulto , Animais , Composição Corporal , Índice de Massa Corporal , Peso Corporal , Estudos Cross-Over , Dieta , Método Duplo-Cego , Exercício Físico , Feminino , Homeostase , Humanos , Células Secretoras de Insulina/citologia , Masculino , Pessoa de Meia-Idade , Nutrientes/administração & dosagem , Hormônio Paratireóideo/sangue , Inquéritos e Questionários , Ácido Úrico/sangue , Vitamina D/análogos & derivados , Vitamina D/sangue , Circunferência da Cintura , Adulto JovemRESUMO
Obesity is a serious global health problem that is directly related to various morbidities manifestation. Intestinal dysbiosis has been implicated on obesity pathogenesis. Diet composition can alter gut microbiota, regardless of energy intake. Dietary fatty acids quality may affect gut microbiota composition, which in turn may affect host metabolic health. The mechanisms by which the different type of FFA modulate gut microbiota is yet poor elucidate and there is a lack of studies regard to this. Fatty acids may act in cell membrane, interfere with energy production, inhibit enzymatic activities, impair nutrient absorption and generate toxic compounds to cells, leading to growth inhibition or even bacterial death. The beneficial effect of the consumption of n-3 polyunsaturated fatty acids (PUFA) and conjugated linoleic acid (CLA) on microbiota, unlike n-6 PUFA and saturated fatty acids has been suggested. n-3 PUFA consumption promotes desirable changes on obese intestinal microbiota making it similar to that of normal weight individuals. More studies are needed to better understand the effect of CLA on microbiota and host health. Long term human controlled clinical trials must be conducted to allow us to understand the complex interaction between dietary fat, intestinal microbiota and obesity.
Assuntos
Gorduras na Dieta , Microbioma Gastrointestinal , Obesidade/microbiologia , Disbiose , HumanosRESUMO
The metabolic effects of cranberry and blueberry consumption on glycemic control have been evaluated in vitro and in animal models as well as in human studies, although findings have not been systematically reviewed yet. Therefore, a systematic review was carried out of relevant randomized clinical trials (RCTs) in order to assess the effect of berries (blueberry and cranberry) consumption on type 2 diabetes (T2DM) glycemic control. Some evidences were also discussed on the anti-diabetic mechanisms exerted by berries polyphenols. Studies were identified by searching electronic databases: LILACS, PubMed/MEDLINE, Scopus, The Cochrane Library and Web of Science. Three authors independently searched and extracted RCTs in which the effect of berries (cranberry or blueberry) consumption on T2DM glycemic control was assessed. A total of 7 RCTs, involving 270 adults with type 2 diabetes were included. Despite the heterogeneity of the administration forms (in natura, dried, extract, preparations - juice), dosage, duration of the intervention and type of population of the studies involving these two berries some studies highlight the potential benefit of berries, especially of blueberry, on glucose metabolism in T2DM subjects. Daily cranberry juice (240 mL) consumption for 12 weeks and blueberry extract or powder supplementation (9.1 to 9.8 mg of anthocyanins, respectively) for 8 to 12 weeks showed a beneficial effect on glucose control in T2DM subjects. Those results indicate a promising use of these berries in T2DM management; although more studies are required to better understand the mechanisms involved.
Assuntos
Glicemia/efeitos dos fármacos , Mirtilos Azuis (Planta)/química , Diabetes Mellitus Tipo 2/dietoterapia , Frutas/química , Vaccinium macrocarpon/química , Animais , Antocianinas/uso terapêutico , Terapias Complementares , Bases de Dados Factuais , Diabetes Mellitus Tipo 2/prevenção & controle , Suplementos Nutricionais , Humanos , Fitoterapia , Extratos Vegetais/farmacologia , Polifenóis/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Dietary fat strongly affects human health by modulating gut microbiota composition and low-grade systemic inflammation. High-fat diets have been implicated in reduced gut microbiota richness, increased Firmicutes to Bacteroidetes ratio, and several changes at family, genus and species levels. Saturated (SFA), monounsaturated (MUFA), polyunsaturated (PUFA) and conjugated linolenic fatty acids share important pathways of immune system activation/inhibition with gut microbes, modulating obesogenic and proinflammatory profiles. Mechanisms that link dietary fat, gut microbiota and obesity are mediated by increased intestinal permeability, systemic endotoxemia, and the activity of the endocannabinoid system. Although the probiotic therapy could be a complementary strategy to improve gut microbiota composition, it did not show permanent effects to treat fat-induced dysbiosis. Based upon evidence to date, we believe that high-fat diets and SFA consumption should be avoided, and MUFA and omega-3 PUFA intake should be encouraged in order to regulate gut microbiota and inflammation, promoting body weight/fat control.
Assuntos
Dieta Hiperlipídica/efeitos adversos , Disbiose/etiologia , Endotoxemia/etiologia , Enterite/etiologia , Medicina Baseada em Evidências , Intestinos/imunologia , Obesidade/etiologia , Animais , Disbiose/dietoterapia , Disbiose/microbiologia , Disbiose/fisiopatologia , Endotoxemia/imunologia , Endotoxemia/microbiologia , Endotoxemia/prevenção & controle , Enterite/imunologia , Enterite/microbiologia , Enterite/prevenção & controle , Microbioma Gastrointestinal , Humanos , Intestinos/microbiologia , Intestinos/fisiopatologia , Obesidade/imunologia , Obesidade/microbiologia , Obesidade/fisiopatologia , Permeabilidade , Probióticos/uso terapêutico , Simbióticos/administração & dosagem , Aumento de PesoRESUMO
PURPOSE: Glycaemic control is essential to prevent the manifestation of diabetes in predisposed individuals and the development of associated comorbidities. It is believed that sorghum may modulate the glucose response. In this study, we investigated the effect of extruded sorghum consumption, and the profile of bioactive compounds, on postprandial glycaemia of a subsequent meal in normal weight and normoglycaemic subjects. METHODS: This was a randomized, single-blind, crossover designed study. After a 12 h overnight fasting, ten subjects reported to the laboratory to participate in four experimental sessions, and consumed one of three sorghum test drinks: sorghum P 3-DXAs (with proanthocyanidins-P and rich in 3-deoxyanthocyanidins-3-DXAs); 3-DXAs (without proanthocyanidins and rich in 3-DXAs); and control (low in 3-DXAs and without proanthocyanidins); or a non-sorghum drink. 30 min later, the subjects consumed a glucose solution (25 g glucose). Glycaemic response was monitored at times 0 (before glucose solution), 15, 30, 45, 60, 90, 120 min (after glucose solution consumption). The incremental areas under the glycaemic curve (iAUC) were calculated by the trapezoidal method. RESULTS: Intake of P 3-DXAs drink before the glucose solution resulted in a postprandial iAUC lower than the other sorghum test drinks. Sorghum drinks minimized the postprandial glycaemia peak. CONCLUSION: Sorghum drinks consumption, especially the P 3-DXAs drink, 30 min before the glucose solution resulted in lower iAUC compared to the non-sorghum drink, leading to a lower glycaemic response.
Assuntos
Bebidas/análise , Glicemia/análise , Refeições , Sorghum , Antocianinas/administração & dosagem , Índice de Massa Corporal , Estudos Cross-Over , Feminino , Glucose/administração & dosagem , Humanos , Masculino , Período Pós-Prandial , Proantocianidinas/administração & dosagem , Método Simples-CegoRESUMO
Objetivo: Analisar o perfil nutricional, demográfico e clínico de indivíduos hospitalizados com indicação de terapia nutricional, assim como verificar as variáveis que se relacionam à ocorrência de desnutrição e óbito. Método: Estudo transversal retrospectivo, realizado em um hospital filantrópico de Minas Gerais, com os dados dos pacientes adultos e idosos que receberam terapia nutricional enteral e/ou parenteral entre 2011 e 2014. Resultados: Foram analisados os dados de 688 indivíduos, com idade média de 69 anos (DP=17,5 anos). Dos pacientes avaliados, 55,5% apresentavam algum grau de desnutrição, segundo a Avaliação Subjetiva Global, sendo 22,5% desnutridos graves. A maioria (81,5%) atingiu a meta nutricional e 56,6% foram a óbito. Ter 60 anos ou mais, estar em Unidade de Terapia Intensiva (UTI) e o atendimento pelo Sistema Único de Saúde foram fatores que se associaram à maior frequência de desnutrição e ao óbito. Conclusão: É preocupante a frequência de indivíduos que já iniciam a terapia nutricional com algum grau de desnutrição, ressaltando-se a necessidade da intervenção nutricional precoce. Idosos e pacientes em UTI foram grupos potencialmente mais vulneráveis à desnutrição e ao óbito e, requerem, portanto, atenção especial.(AU)
Objective: To analyze the nutritional status, demographic and clinical profile of hospitalized patients with nutritional support indication, as well as check the variables that relate to the occurrence of malnutrition and death. Methods: A retrospective cross-sectional study in a philanthropic hospital in Minas Gerais, with data from adults and elderly patients who received enteral and/or parenteral nutrition between the years 2011 to 2014. Results: Data of 688 individuals were analyzed, with mean age of 69 years (SD: 17.5 years). Among the patients, 55.5% had some degree of malnutrition according to the Subjective Global Assessment, and 22.5% were severely malnourished. Most of patients (81.5%) reached the nutritional goal and 56.6% died. Be 60 years or older, be in the Intensive Care Unit (ICU) and the attendance by the Unified Health System were factors that were associated with higher frequency of malnutrition and death. Conclusion: It is worrying the high frequency of individuals who already begin to nutritional support with some degree of malnutrition, emphasizing the need for early nutritional intervention. Elderly and patients in ICU were potentially most vulnerable to malnutrition and death, and therefore require special attention.(AU)
Assuntos
Estado Nutricional , Desnutrição/dietoterapia , Desnutrição/mortalidade , Terapia Nutricional/instrumentação , Estudos Transversais , Inquéritos e Questionários , Estudos RetrospectivosRESUMO
ABSTRACT Objective The aim of this study was to verify the effects of glycemic index (GI) on body composition, and on inflammatory and metabolic markers concentrations in patients with type 2 diabetes. Subjects and methods In this randomized controlled parallel trial, twenty subjects (aged 42.4 ± 5.1 years, BMI 29.2 ± 4.8 kg.m-2) were allocated to low GI (LGI) (n = 10) or high GI (HGI) (n = 10) groups. Body composition, inflammatory and metabolic markers were assessed at baseline and after 30 days of intervention. Food intake was monitored during the study using three-day food records completed on two non-consecutive weekdays and on a weekend day. Results Body fat reduced after the LGI intervention compared with baseline (P = 0.043) and with the HGI group (P = 0.036). Serum fructosamine concentration (P = 0.031) and TNF-α mRNA expression (P = 0.05) increased in the HGI group. Serum non-esterified fatty acids were greater in the HGI than in the LGI group (P = 0.032). IL-6 mRNA expression tended to decrease after the consumption of the LGI diet compared to baseline (P = 0.06). Conclusion The LGI diet reduced body fat and prevented the negative metabolic and inflammatory responses induced by the HGI diet.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Tecido Adiposo/metabolismo , Índice Glicêmico/fisiologia , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/metabolismo , Valores de Referência , Fatores de Tempo , Glicemia/metabolismo , Composição Corporal , Fibras na Dieta/análise , Antropometria , Reprodutibilidade dos Testes , Interleucina-6/sangue , Fator de Necrose Tumoral alfa/sangue , Resultado do Tratamento , Estatísticas não Paramétricas , Frutosamina/sangue , Ingestão de Alimentos/fisiologia , Reação em Cadeia da Polimerase em Tempo Real , Inflamação/metabolismoRESUMO
Abstract Fortification of food constitutes an important strategy for the control of micronutrient deficiency and has advantages such as high population coverage and maintenance of eating habits. This study aimed to assess the impact of using fortified rice (Ultra Rice® - UR®) on the nutritional status of preschoolers. Ninety-nine children enrolled in two philanthropic preschools participated of the study. Children of one of the preschools were offered UR® mixed with polished rice, as part of school meals (test group) and the children of another preschool were offered pure polished rice (control group). Biochemical evaluations were performed before and after 4 months of intervention. Dietary assessment and sensory evaluation of UR® mixed with polished rice were performed during the study. The fortified rice improved the concentrations of zinc (p < 0.001), thiamine (p < 0.001), folic acid (p = 0.003), mean corpuscular hemoglobin (p < 0.001) and mean corpuscular hemoglobin concentration (p < 0.001). The fortified rice showed good acceptability among preschoolers. This study demonstrated the effectiveness of using rice fortified with iron, zinc, thiamine and folic acid on the nutritional status of children.
Resumo A fortificação de alimentos constitui importante estratégia para o controle da deficiência de micronutrientes e apresenta como vantagens a alta cobertura populacional e o fato de não alterar hábitos alimentares. O presente estudo teve como objetivo avaliar o impacto do uso de arroz fortificado (Ultra Rice® - UR®) sobre o estado nutricional de pré-escolares. Noventa e nove crianças matriculadas em duas creches filantrópicas participaram do estudo. Para crianças de uma creche foi oferecido UR® misturado com arroz polido, como parte das refeições escolares (grupo teste) e para as da outra foi oferecido somente arroz polido (grupo controle). Avaliações bioquímicas foram realizadas antes e após 4 meses de intervenção. Avaliações dietética e sensorial do UR® misturado com arroz polido foram realizadas durante o estudo. O arroz fortificado melhorou as concentrações de zinco (p < 0,001), tiamina (p < 0 ,001), ácido fólico (p = 0,003), hemoglobina corpuscular média (p < 0,001) e hemoglobina corpuscular média (p < 0,001). O arroz fortificado mostrou boa aceitação entre os pré-escolares. Este estudo demonstrou a eficácia do uso de arroz fortificado com ferro, zinco, tiamina e ácido fólico sobre o estado nutricional das crianças.
RESUMO
OBJECTIVE: The aim of this study was to verify the effects of glycemic index (GI) on body composition, and on inflammatory and metabolic markers concentrations in patients with type 2 diabetes. SUBJECTS AND METHODS: In this randomized controlled parallel trial, twenty subjects (aged 42.4 ± 5.1 years, BMI 29.2 ± 4.8 kg.m-2) were allocated to low GI (LGI) (n = 10) or high GI (HGI) (n = 10) groups. Body composition, inflammatory and metabolic markers were assessed at baseline and after 30 days of intervention. Food intake was monitored during the study using three-day food records completed on two non-consecutive weekdays and on a weekend day. RESULTS: Body fat reduced after the LGI intervention compared with baseline (P = 0.043) and with the HGI group (P = 0.036). Serum fructosamine concentration (P = 0.031) and TNF-α mRNA expression (P = 0.05) increased in the HGI group. Serum non-esterified fatty acids were greater in the HGI than in the LGI group (P = 0.032). IL-6 mRNA expression tended to decrease after the consumption of the LGI diet compared to baseline (P = 0.06). CONCLUSION: The LGI diet reduced body fat and prevented the negative metabolic and inflammatory responses induced by the HGI diet.
Assuntos
Tecido Adiposo/metabolismo , Diabetes Mellitus Tipo 2/dietoterapia , Diabetes Mellitus Tipo 2/metabolismo , Índice Glicêmico/fisiologia , Adulto , Antropometria , Glicemia/metabolismo , Composição Corporal , Fibras na Dieta/análise , Ingestão de Alimentos/fisiologia , Feminino , Frutosamina/sangue , Humanos , Inflamação/metabolismo , Interleucina-6/sangue , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase em Tempo Real , Valores de Referência , Reprodutibilidade dos Testes , Estatísticas não Paramétricas , Fatores de Tempo , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangueRESUMO
There is a growing mortality related to co-morbidities associated with diabetes mellitus. Intake of polyunsaturated fatty acids (PUFA) has been associated with low cardiometabolic risk and reduction of inflammatory process. The objective of this paper is to review the impact of PUFA intake on glycemic control in diabetic patients as well as to elucidate the possible mechanisms involved. Medline/PubMed electronic database was searched to identify studies published within last five years regarding the effect of PUFA intake on glucose metabolism in type 2 diabetics. The search terms used were "polyunsaturated fatty acid(s)," "PUFA," and "diabetes." We included only interventional studies that assessed the effects of PUFA intake on glucose metabolism - fasting glucose, serum insulin, HbA1c, and HOMA-IR assessment- in type 2 diabetics. Initially, 48 articles were identified, of which one was not available and 41 did not match the inclusion criteria. Within the selected studies, three articles showed an improvement in fasting blood glucose, two showed an increase in fasting glycemia, and there was no effect of intervention in one article only. Based on the analyzed clinical interventional studies, supplementation of 0.42-5.2-g PUFA/day for at least eight weeks may become an alternative treatment for type 2 diabetes mellitus, particularly in Asian subjects.
Assuntos
Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/tratamento farmacológico , Ácidos Graxos Insaturados/uso terapêutico , Diabetes Mellitus Tipo 2/metabolismo , Jejum , Ácidos Graxos Ômega-3/uso terapêutico , HumanosRESUMO
OBJECTIVE: Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects. MATERIALS AND METHODS: Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study. RESULTS: Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals. CONCLUSION: The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect.
Assuntos
Índice Glicêmico/fisiologia , Refeições/fisiologia , Obesidade/metabolismo , Obesidade/prevenção & controle , Adulto , Antropometria , Glicemia/análise , Composição Corporal/fisiologia , Ingestão de Energia/fisiologia , Metabolismo Energético/fisiologia , Jejum/metabolismo , Feminino , Humanos , Masculino , Período Pós-Prandial/fisiologia , Distribuição Aleatória , Valores de Referência , Método Simples-Cego , Estatísticas não Paramétricas , Fatores de Tempo , Adulto JovemRESUMO
Introdução: a adoção de hábitos alimentares adequados, fundamental para o controlemetabólico da criança com diabetes mellitus tipo 1 (DM1), necessita do envolvimentoe participação efetiva da família e pode implicar mudanças nos padrões alimentares jáestabelecidos. Objetivo: avaliar o perfil alimentar de crianças e adolescentes com DM1e sua adequação às recomendações atuais. Casuística e métodos: foram estudadas146 pessoas com idade entre sete e 19 anos e no mínimo um ano de diagnóstico deDM1, atendidos na Divisão de Endocrinologia Pediátrica do Hospital das Clínicas daUniversidade Federal de Minas Gerais. A dieta foi avaliada por meio de questionárioquantitativo de frequência alimentar, testado e validado previamente em projeto-piloto.Resultados: o percentual médio de calorias ingeridas como proteínas e gordurapoli-insaturada estava dentro das recomendações adotadas; o de gordura saturadae colesterol superou a recomendação em toda a população estudada. A ingestão degordura monoinsaturada e a de carboidratos nos indivíduos com até 14 anos de idadenão atingiu a recomendação adotada. Adolescentes entre 15 e 19 anos ingeriram altopercentual de calorias provenientes de carboidratos, enquanto as crianças entre sete e10 anos de idade ingeriram mais gorduras e proteínas. Os adolescentes de 15 a 19 anosapresentaram hábitos alimentares mais inadequados. Conclusão: constituem motivode preocupação a dieta com perfil lipídico insatisfatório e hábitos alimentares inapropriados,inadequações nutricionais que contribuem para o mau controle de DM1.
Introduction: adopting proper eating habits is crucial for the metabolic control of diabetesmellitus type 1 (DM1) in children and requires the involvement and effective participationof the family implying in changes in established eating patterns. Objective: toevaluate the dietary profile of children and adolescents with DM1 and their adaptation tocurrent recommendations. Patients and methods: we studied 146 individuals aged betweenseven and 19 years old with at least one year of DM1 diagnosis and treated at theDivision of Pediatric Endocrinology of the General Hospital, Federal University of MinasGerais. The diet was assessed by a quantitative food frequency questionnaire, previouslytested and validated in a pilot project. Results: the average percentage of ingestedcalories as protein and polyunsaturated fat was within the adopted recommendations;that of saturated fat and cholesterol exceeded the recommendation in the entire studypopulation. The monounsaturated fat and carbohydrates intake in individuals under 14years of age did not reach the adopted recommendation. Adolescents between 15 and19 years old ingested a high percentage of calories from carbohydrates while childrenbetween seven and ten years old ingested more fat and protein. Adolescents between15 and 19 years old presented the most inadequate eating habits. Conclusion: a diet with poor lipid profile, inappropriate eating habits, andnutritional inadequacies that contribute to poor controlof DM1 are of concern.
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Objective Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects.Materials and methods Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study.Results Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals.Conclusion The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect. Arch Endocrinol Metab. 2015;59(3):245-51.
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Proteínas de Bactérias/química , Escherichia coli/enzimologia , Proteínas de Membrana/química , Fenilalanina/química , Motivos de Aminoácidos , Sequência de Aminoácidos , Proteínas de Bactérias/genética , Proteínas de Bactérias/metabolismo , Quimiotaxia , Sequência Conservada , Dimerização , Escherichia coli/química , Escherichia coli/genética , Escherichia coli/fisiologia , Dados de Sequência Molecular , Proteínas de Membrana/genética , Proteínas de Membrana/metabolismo , Conformação Proteica , Fenilalanina/genética , Fenilalanina/metabolismoRESUMO
PURPOSE: A meal replacement may be an effective strategy in the management of obesity to increase antioxidant intake, attenuating oxidative stress and inflammation. In the present study, we investigated the efficacy of a new nutritional supplement to reduce metabolic risk parameters in obese women. METHODS: In a randomized controlled crossover study (2 × 2), 22 women (percentage body fat 40.52 ± 3.75%; body mass index-BMI 28.72 ± 2.87 kg/m²; 35.04 ± 5.6 years old) were allocated into two treatments: hypocaloric diet and drink containing "Human Ration" (HR) consumption (CRHR), and hypocaloric diet and control drink consumption (CR). The study consisted of 2 periods of 5 weeks with 1 week of washout in two orders (CR â CRHR and CRHR â CR). Caloric restriction was 15%, based on estimated energy requirement. Anthropometric, clinical and metabolic risk parameters were assessed at baseline and at the end of each period. RESULTS: Some metabolic risk factors were favorably modulated in both interventions: reduction in body weight (CR -0.74 ± 1.27 kg; p = 0.01; CRHR -0.77 ± 1.3 kg; p = 0.02), body mass index (BMI) (CR -0.27 ± 0.51 kg/m²; p = 0.02; CRHR -0.30 ± 0.52 kg/m²; p = 0.01) and HOMA-IR (CR -0.35 ± 0.82; p = 0.02, CRHR -0.41 ± 0.83; p = 0.03). However, CRHR reduced waist circumference (-2.54 ± 2.74 cm; p < 0.01) and gynoid fat (-0.264 ± 0.28 g; p < 0.01), and increased HDL-c levels (0.08 ± 0.15 mmol/l; p = 0.04). CONCLUSION: Associated with hypocaloric diet, the intake of a nutritional supplement rich in phytochemicals as a breakfast substitute for 5 weeks had no additional effect on weight reduction than caloric restriction alone, but increased central lipolysis and improved the lipoprotein profile.
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Bebidas , Desjejum , Dieta Redutora/métodos , Alimentos Especializados , Resistência à Insulina , Síndrome Metabólica/prevenção & controle , Obesidade/dietoterapia , Adiposidade , Adulto , Antioxidantes/uso terapêutico , Índice de Massa Corporal , Brasil/epidemiologia , HDL-Colesterol/sangue , Estudos Cross-Over , Feminino , Humanos , Síndrome Metabólica/epidemiologia , Síndrome Metabólica/etiologia , Obesidade/sangue , Obesidade/metabolismo , Obesidade/fisiopatologia , Estresse Oxidativo , Compostos Fitoquímicos/uso terapêutico , Fatores de Risco , Método Simples-Cego , Circunferência da Cintura , Redução de PesoRESUMO
Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.
Recentemente, a falta de artigos que visam fornecer orientação quanto ao uso do índice glicêmico foi apontada como causa de sua baixa utilização na educação nutricional. O objetivo do presente trabalho é oferecer suporte para o uso do índice glicêmico como ferramenta a ser adotada na educação nutricional, para estimular o consumo preferencial de alimentos que apresentem menores valores nesse indicador. Foram selecionados estudos publicados nos últimos doze anos, além de estudos clássicos referentes ao tema, indexados nos bancos de dados MedLine, ScienceDirect, SciELO e Lilacs, que exploraram a importância do índice glicêmico e os fatores que interferem em seu valor. A elaboração de listas agrupando os alimentos segundo o índice glicêmico deve ser feita com base nas informações encontradas em tabelas e sites específicos. Essa é uma estratégia interessante que deve ser conduzida de maneira criteriosa, considerando-se os hábitos alimentares do público assistido. Para resultar em resposta glicêmica pós-prandial mais baixa, os produtos de alto índice glicêmico devem ser ingeridos em associação com alimentos ricos em proteína e pobres em gordura, com óleos de boa qualidade, com alimentos menos processados por ricos em fibras, evitando-se os com alto teor em cafeína. O índice glicêmico deve ser considerado uma ferramenta adicional para a escolha de alimentos fonte de carboidratos, os quais devem ser incluídos em uma dieta nutricionalmente equilibrada, capaz de promover e/ou manter tanto o peso corporal adequado quanto a saúde.
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Índice Glicêmico , Educação Alimentar e NutricionalRESUMO
The aim of this study was to evaluate the change stages of dietary behavior (consumption of fruits and vegetables ? FV) and physical activity, as well as their impacts on the biochemical and anthropometrical profiles of type 2 Diabetes mellitus patients by means of intervention strategies based on the Transtheoretical Model (TTM). To this end, we studied thirty-one type 2 diabetic individuals (8 men and 23 women), aged 41 to 75, from the municipality of Ponte Nova, State of Minas Gerais, Brazil. The stages of the TTM behavior changes in the FVL and physical activity were identified. Body mass index (BMI) and waist to hip (W/H) ratio were calculated. Percentage of fat was measured by bipolar bioelectric impedance analysis. The following blood parameters were analyzed: complete blood count, fasting plasma glucose, glycated hemoglobin, total cholesterol and its fractions, and triglycerides. All the evaluations were performed before and after a six-month period of interventions based on the TTM. Once a month, the patients received individual dietary orientation to maintain or lose weight and control biochemical alterations; those who did not practice physical activities were advised to walk 50 min a day, three days a week. After the interventions, there was a move to the action stage concerning the dietary behavior, while the maintenance stage was preserved regarding the physical activity behavior of patients. Body weight, BMI, fasting plasma glucose, glycated hemoglobin, total cholesterol and LDL ? Low Density Lipoprotein fraction showed significant reduction (p<0.05). Waist to hip ratio and percentage of fat presented no change. In conclusion, interventions based on the MTT promoted the move of type 2 diabetic patients to the action stage regarding the FVL; preserved the maintenance stage in respect to the physical activity; and had a positive impact on the biochemical and anthropometrical profiles of these individuals.
El objetivo del presente estudio fue evaluar las etapas de cambio en los hábitos alimentarios (consumo de frutas y hortalizas ? FH) y en la actividad física, así como los impactos sobre el perfil bioquímico y antropométrico de las personas con Diabetes mellitus (DM) tipo 2, mediante estrategias de intervención basadas en el Modelo Transteórico (MTT). Se estudiaron 3 sujetos (8 hombres y 23 mujeres) con diabetes tipo 2, de edades comprendidas entre 41 y 75 años, en el municipio de Ponte Nova, Minas Gerais. Se identificaron etapas de cambio de comportamiento del MTT para el FH y para la actividad física. Se calculó el índice de masa corporal (IMC) y la relación cintura/cadera (RC/C). El porcentaje de grasa corporal se calculó por bioimpedancia eléctrica bipolar. Se analizaron los parámetros sanguíneos: hemograma completo, glucosa en ayunas, hemoglobina glicosilada, colesterol total y parcial y triglicéridos. Las evaluaciones fueron realizadas antes y después de seis meses a partir de las intervenciones, como en el MTT Se realizó una intervención por mes y los sujetos recibieron individualmente: orientación dietética destinada a mantener o perder masa corporal y controlar los cambios bioquímicos; y a aquellos que no practicaban actividad física se les aconsejó caminar 50 minutos al día, tres veces por semana. Después de la intervención, se observaron cambios de conducta del FVL hacia la etapa de acción, y la actividad física se mantuvo en la etapa de mantenimiento. El IMC, la glucosa en ayunas, la hemoglobina glicosilada, el colesterol total y el LDL ? Liproteínas de Baja Densidad disminuyeron significativamente (p<0,05). La RC/C y la grasa corporal no se vieron afectadas. Se concluye que las intervenciones basadas en el MTT promovieron: un movimiento de los portadores de DM 2 em la etapa de preparación hacia la etapa de acción en el FH; conservación de la etapa de estabilidad en la práctica de actividad física; e impacto positivo sobre los perfiles bioquímicos y antropométricos de los sujetos.
O objetivo do presente estudo foi avaliar os estágios de mudança nos comportamentos alimentar (consumo de frutas, verduras e legumes ? FVL) e de atividade física e os impactos sobre o perfil bioquímico e antropométrico de indivíduos portadores de Diabetes mellitus (DM) tipo 2, mediante estratégias de intervenção com base no Modelo Transteórico (MTT). Trinta e um indivíduos (8 homens e 23 mulheres) portadores de DM tipo 2, com idade entre 41 e 75 anos, no município de Ponte Nova, MG, foram estudados. Estágios de mudança de comportamento do MTT para o FVL e para a prática de atividade física foram identificados. Foram calculados o índice de massa corporal (IMC) e a relação cintura/ quadril (RC/Q). O percentual de gordura foi obtido por meio da bioimpedância elétrica bipolar. Os parâmetros sanguíneos: hemograma completo, glicemia de jejum, hemoglobina glicada, colesterol total e frações e triglicerídeos foram analisados. As avaliações foram feitas antes e após seis meses de intervenções, baseadas no MTT. Uma intervenção por mês foi realizada e os sujeitos recebiam individualmente: orientação dietética visando à manutenção ou perda de massa corporal e controle de alterações bioquímicas; e aqueles que não praticavam atividade física foram orientados a caminhar 50 minutos diários, três vezes por semana. Depois das intervenções, observou-se movimentação do FLV para o estágio de ação; na prática de atividade física foi conservado o estágio de manutenção. A massa corporal, o IMC, a glicemia de jejum, a hemoglobina glicada, o colesterol total e o LDL ? Lipoproteínas de Baixa Densidade reduziram significativamente (p<0,05). A RC/Q e o percentual de gordura não foram afetados. Conclui-se que as intervenções baseadas no MTT promoveram: movimentação dos portadores de DM tipo 2 do estágio de preparação para o estágio de ação no FVL; conservação do estágio de manutenção na prática de atividade física; e impacto positivo sobre os perfis bioquímico e antropométrico dos sujeitos.