RESUMO
Introducción: La Universidad de Antioquia desarrolla, en el Urabá antioqueño, el programa de Tecnología en Regencia de Farmacia (TRF), orientado a formar en promoción de la salud y prevención de la enfermedad. Objetivo: Caracterizar la pertinencia social y laboral del programa de TRF en la región de Urabá, y su efecto en la promoción de la salud y prevención de la enfermedad. Materiales y métodos: Estudio descriptivo de corte trasversal, en el cual se diseñaron cuatro instrumentos, orientados a egresados, empleadores, establecimientos y comunidad de la región, para ser aplicados por estudiantes del programa en la región, durante un periodo de seis meses. Resultados: De 52 egresados encuestados, 51 eran de la región, y 48 de ellos estaban laborando, 42 en la región. Los empleadores valoraron los aportes del TRF, como bueno y excelente, en un 69.6%, 78.2% y 78.3%, para los desempeños institucional, procesos administrativos y asistenciales, respectivamente. En cuanto a la comunidad, 212 de los 369 encuestados, identificaron la existencia del TRF en farmacias/droguerías y esperan que le brinde información sobre el uso de los medicamentos. La pertinencia social fue valorada como pertinente y muy pertinente, en un 77.4%, resultado que fue similar para la pertinencia laboral. Conclusiones: El estudio identifica un alto de grado de satisfacción con las funciones del TRF en los servicios farmacéuticos y de aceptación e identificación del TRF por la comunidad. El programa de TRF es pertinente en la región, sus egresados están ubicados en la región, desempeñando funciones acordes con su formación.
Introduction: University of Antioquia develops, in the Urabá region of Antioquia (Colombia), the program of Technology in Regency of Pharmacy (TRP), aimed at training in health promotion and disease prevention. Objective: To characterize the social relevance of the TRP program in the Urabá region, and its effect in health promotion and disease prevention. Materials and methods: cross-sectional study with descriptive metodology, in which four instruments were designed and aimed at graduates, employers, institutions and community in the region, to be applied by the students of the program in the region, for a period of six months. Results: Of 52 graduates surveyed, 51 were graduates of the region, and 48 of them were working, 42 in the region. Employers valued the contributions of the TRP, as good and excellent, in a 69.6%, 78.2% and 78.3%, for institutional performance, administrative and welfare, respectively. Related to the community, 212 of the 369 respondents identified the existence of the TRP in pharmacies/drugstores and they expected that she/he would give you information about the use of drugs. The social relevance was assessed as relevant and very relevant, in a 77.4%, a result that was similar to the relevance related to work. Conclusions: The study identifies a high degree of satisfaction with the functions of the TRP in pharmaceutical services and acceptance and identification of the TRF for the community. The TRP program is relevant in the region; its graduates are working in the region, performing duties commensurate with their training.
Assuntos
Humanos , Serviço de Farmácia Hospitalar , Farmácia , Meio Social , Características de Residência , Saúde Ocupacional , Educação de Pós-GraduaçãoRESUMO
In recent times, nutrition analysts have been emphasizing the fact that the most critical nutritional unfulfilled need in underdeveloped countries is energy or quantity of food. This has prompted some leading food economist and agricultural policy makers to promote the extensive cultivation of high field inexpensive staples, including starchy roots and tubers. A typical example is cassava in many African countries and Indonesia. These foods not only have very little and poor quality protein, but also lack other essential nutrients. Interestingly, underdeveloped populations seem to select the nutritionally poorest staples under condition of extreme economic constraints, for example cassava or sorghum. But as their economic level improves they switch to nutritionally better staples, like wheat or rice. The people seem to be able to <
Assuntos
Agricultura/tendências , Proteínas Alimentares/metabolismo , Manihot/química , Política Nutricional/tendências , Animais , Pré-Escolar , Dieta/normas , Humanos , Renda , Lisina/análise , Manihot/metabolismo , Política Nutricional/economia , Necessidades Nutricionais , Valor Nutritivo , Ratos , Fatores SocioeconômicosRESUMO
Nutrification of wheat flour with at least ten micronutrients has proven to be technologically feasible and nutritionally effective. Some criteria must be satisfied in order to determine if the food is appropriate as a carrier for nutrification in a country or in a particular region. The most important aspect however, is that to be sure that it is consumed by the population in need of preventive actions and control of specific vitamin and mineral deficiencies. In view of the fact that Latinamerican countries may greatly differ in this respect, such a question deserves careful scrutiny. The preliminary efforts and previous large scale trials in some countries, illustrate the most frequent problem: the main obstacle against successful achievement of many nutrification programs in the developing world has been, not the lack of technological and economical feasibility but he failure to take key decisions at political levels.
Assuntos
Farinha , Alimentos Fortificados , Micronutrientes , Triticum , Conservação de Alimentos , Política de Saúde , Índia , Jordânia , América Latina , Legislação sobre Alimentos , Necessidades NutricionaisRESUMO
The list of vitamins recognized as essential in human nutrition is extensive. Only some of them, however, are attributed an important role in public health. The present paper deals with three of these selected because their deficiencies still prevail in important sectors of population in the Latin American Region: vitamin A, vitamin C and vitamin D. For each vitamin the paper discusses the scientific bases for their requirements, as well as pragmatic considerations to be taken into account for the derivation of recommended dietary intakes. Reference is made to the logic of applying the concepts of nutrient density when developing guidelines for the design of diets for the family and the community. Adequate nutrient density means that when a diet is consumed in sufficient amounts to satisfy energy requirements, the needs for essential nutrients are also being met. For the above reasons, the principle of expressing the recommended levels of intake of vitamin A and C per 1,000 kilocalories has been followed. This is not the case with vitamin D which, in view of its special feature of being synthesized endogenously, is not really a vitamin in the strict sense of the term and, therefore, a rational and consistent relationship with the energy of the diet cannot be established.
Assuntos
Deficiência de Ácido Ascórbico/epidemiologia , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina D/epidemiologia , Adolescente , Adulto , Ácido Ascórbico/metabolismo , Deficiência de Ácido Ascórbico/etiologia , Deficiência de Ácido Ascórbico/terapia , Criança , Pré-Escolar , Dieta , Feminino , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente , América Latina/epidemiologia , Masculino , Necessidades Nutricionais , Gravidez , Deficiência de Vitamina A/etiologia , Deficiência de Vitamina A/terapia , Vitamina D/fisiologia , Deficiência de Vitamina D/etiologia , Deficiência de Vitamina D/terapiaRESUMO
There is no evidence of any nutritional benefit derived from the consumption of vitamin supplements in excess of the daily intakes recommended by the various international and national expert committees. Furthermore, in the case of certain of the vitamins such as vitamin A and vitamin D, excessive intakes result in toxic effects. To a lesser extent this is also the case for vitamin C and nicotinic acid. In addition, the use of high supplements or megadoses of any vitamin results in a wasteful misuse of economic resources. This reduces the capacity to acquire foods which would have clear nutritional benefits for the whole family. Consequently, the indiscriminate use of these megadoses must be discouraged. Their application is exclusively justified in clinical situations under direct medical supervision.
Assuntos
Terapia Ortomolecular , Transtornos Relacionados ao Uso de Substâncias , Vitaminas , Adulto , Criança , Feminino , Humanos , Recém-Nascido , Masculino , Necessidades Nutricionais , Gravidez , Automedicação , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Vitaminas/administração & dosagem , Vitaminas/efeitos adversosRESUMO
The effect of improvement in vitamin A nutriture on biochemical indicators of iron nutrition during national vitamin A fortification of sugar was investigated longitudinally. Four "paired-comparison-subgroups" of preschoolers were studied before fortification (survey I) and, respectively, at 6 months (survey I versus II), at 1 yr (survey I versus III), at 1 1/2 yr (survey I versus IV), and at 2 yr (survey I versus V) after fortification began. Comparing I versus II gave a positive correlation (p less than 0.001) between changes in serum retinol or retinol-binding protein and changes in iron, total iron binding capacity, and percentage transferrin saturation. In contrast, changes in serum ferritin correlated negatively (p less than 0.05). Comparing V with I, retinol, retinol-binding protein, iron, and percentage transferritin saturation increased, but ferritin also increased (p less than 0.05). Consequently, the distribution of serum iron and ferritin values of the children improved (p less than 0.05). Because dietary iron did not change through the study period, the results suggest that vitamin A fortification had a favorable effect on iron metabolism and nutritional status.
Assuntos
Alimentos Fortificados , Ferro/metabolismo , Vitamina A/administração & dosagem , Pré-Escolar , Carboidratos da Dieta , Guatemala , Humanos , Lactente , Ferro/sangue , Estudos Longitudinais , Vitamina A/sangueRESUMO
The distribution of the protein energy ratio indicators (Pe%), amino acid score and protein value (NDpCal%) in the three daily meals (breakfast, lunch and dinner) of the diet of pregnant women from Santa María Cauqué, Guatemala, was studied. The results were compared with those obtained for the total daily food intake. The differences observed were not significant, confirming the validity of the determination of amino acid score, Pe% and NDpCal% in the foods consumed during the whole day in this type of populations. It also reflects the nutritional benefit of the food pattern, since protein utilization would not be decreased by a different distribution of protein quality and concentration throughout the three daily meals. The variability among individuals of Pe% intake, amino acid score and NDpCal% gave the following values: 16.0, 9.3 and 15.6, respectively. It is noteworthy to add that the variability of Pe% observed is similar to that reported for populations of developed countries.
Assuntos
Dieta , Proteínas Alimentares , Ingestão de Energia , Gravidez , Aminoácidos/análise , Comportamento Alimentar , Feminino , Guatemala , Humanos , Nitrogênio/metabolismoAssuntos
Distúrbios Nutricionais/epidemiologia , Fenômenos Fisiológicos da Nutrição , América Central , Criança , Pré-Escolar , Deficiências Nutricionais/epidemiologia , Transtornos do Crescimento/epidemiologia , Humanos , Lactente , Mortalidade , Distúrbios Nutricionais/complicações , Inquéritos Nutricionais , Panamá , Desnutrição Proteico-Calórica/epidemiologia , Fatores SocioeconômicosRESUMO
Based on the Guatemalan program of vitamin A fortification of sugar, a longitudinal evaluation on serum retinol levels of preschool-aged children was performed. Five consecutive surveys executed every 6 months were examined, considering only children who were surveyed more than once. Thus, the changes in their serum retinol after the intervention were evaluated. Natural dietary vitamin A remained unchanged throughout. Addition of retinyl palmitate to sugar increased significantly the intake (p < 0.001). After 1 yr of fortification 76% of the children experienced an elevation of retinol. All those with initial values < 20 microgram/dl showed an increase. Mean values increased significantly, particularly for children below 20 microgram/dl whose levels changed from 16.2 +/- 2.9 to 30.2 +/- 9.7 (P < 0.00001). Those between 20 to 29 microgram/dl increased from 24.9 +/- 3.2 to 30.1 +/- 8.1 (p < 0.0003). Similar results were obtained after 2 yr. The results indicated the effectiveness of the program in raising serum retinol levels.
Assuntos
Sacarose , Vitamina A/análogos & derivados , Vitamina A/sangue , Pré-Escolar , Diterpenos , Alimentos Fortificados , Guatemala , Humanos , Palmitatos/farmacologia , Ésteres de Retinil , Vitamina A/farmacologiaRESUMO
Se estudio la distribucion de los indicadores Pe%, puntaje (score) aminoacidico y NDpCal% en los tres tiempos de comida (desayuno, almuerzo y cena) en la dieta de embarazadas de Santa Maria Cauque, Guatemala. No se observaron diferencias significativas al compararlos con los valores obtenidos en la alimentacion del dia entero. Este hecho valida, en este tipo de poblaciones, la determinacion del score aminoacidico, Pe% y NDpCal%, considerando los alimentos consumidos durante el dia Refleja tambien un patron alimentario beneficioso, pues no habria deterioro de la utilizacion proteinica de haber una diferente distribucion de la calidad y concentracion de la proteina en los tres diferentes tiempos de comida. La variabilidad interindividual de la ingesta de Pe%, score de aminoacidos y NDpCal% dio los siguientes valores: 16.0, 9.3 y 15.6, respectivamente. Cabe subrayar el hecho de que la variabilidad observada en el Pe% es similar a la notificada para poblaciones de paises desarrollados
Assuntos
Proteínas Alimentares , Ingestão de Energia , GravidezRESUMO
The main purpose of the present study was to determine the qualitative and quantiative effect of various infectious epsiodes on the blood serum levels of retinol and retinol-binding protein (RBP). Twenty-four children and 30 adult subjects were studied. The infections studied included chickenpox (n = 7); bronchitis (n = 9) upper respiratory infection (n = 30); tonsillitis (n = 2); diarrhea (n = 2) and one case each of: febrile stomatitis, nonspecific gastrointestinal alteration, urinary infection and shigellosis. In addition to retinol and RBP, the study determined changes in serum carotene, proteins, albumin and globulins. The results clearly demonstrate the marked depressing effect of infections on serum retinol, with a magnitude which in many cases reached more than 20 micrograms/dl, and in others more than 30 micrograms/dl. The RBP levels were significantly correlated with retinol, decreasing proportionally with infection. Serum albumin also decreased in most instances; and the globulin levels of the children, but not of the adults, were significantly higher during the infections. Carotene did not show important variations. The effects were more intense when fever accompanied the infectious episodes. These results are considered of great public health significance, in view of the large majorities, mainly children, who ordinarily subsist with very low serum retinol levels in the underdeveloped regions of the world. As infections attack these underpriviledged children, their serum retinol and RBP levels will likely drop a magnitude similar to that observed in the subjects of this study. They may then reach even more critically deficient retinol levels and be in serious danger of developing a severe acute state of clinical vitamin A deficiency.
Assuntos
Infecções/sangue , Infecções Respiratórias/sangue , Proteínas de Ligação ao Retinol/sangue , Vitamina A/sangue , Adolescente , Adulto , Proteínas Sanguíneas/metabolismo , Carotenoides/sangue , Carotenoides/metabolismo , Criança , Pré-Escolar , Feminino , Alimentos Fortificados , Humanos , Lactente , Infecções/metabolismo , Masculino , Pessoa de Meia-Idade , Infecções Respiratórias/metabolismo , Proteínas de Ligação ao Retinol/metabolismo , Vitamina A/administração & dosagem , Vitamina A/metabolismo , Deficiência de Vitamina A/sangueRESUMO
The protein-calorie (Po/o) and the protein value (NDpCalo/o) have been proposed as indices to evaluate the potentiality of diets to meet protein and calorie needs of a given population. The fat-calorie to protein-calorie ratio (G/P) is presented as a complementary index, considering the possibility that the values of Po/o and NDpCalo/o can be adequate but that the energy density of the diets is too low, as might be the case in many rural communities of the developing countries. On the basis of the evidence discussed in this paper, the G/P ratio estimated as adequate is 2.5, and values lower than 2 can be considered as nutritionally unacceptable.
Assuntos
Dieta , Gorduras na Dieta/normas , Proteínas Alimentares/normas , Ingestão de Energia , Metabolismo Energético , Pré-Escolar , Gorduras na Dieta/administração & dosagem , Proteínas Alimentares/administração & dosagem , Guatemala , Humanos , Deficiência de Proteína/dietoterapia , População Rural , Fatores SocioeconômicosRESUMO
In order to investigate the role of vitamin A nutriture in the prevalence of anemia in Central America, a retrospective evaluation of the data of the six Institute of Nutrition of Central Americal and Panama/Office for International Research nutrition surveys of Central America and Panama has been made. Three groups of children; 1 to 4, 5 to 8, and 9 to 12 years old, living between 0 and 2,5000 feet above sea level were studeid. Several biochemical and dietary parameters related to anemia were corrleated with plasma levels of retinol. Children between the ages of 5 and 12 years showed a significant positive correlation between hemoglobin and plasma retinol. Children aged 1 to 4 years did not show a similar correlation. In children of all age groups there were positive correlations between plasma retinol and serum iron. Percent saturation of transferrin was also found to be lower when plasma retinol levels were low. Children with an adequate intake of iron, as classified by both dietary information and socioeconomic level, showed a significant positive correlation between plasma retinol levels and iron in their serum. In contrast, no correlation was found when dietary iron was low. In the light of these findings, a possible relationship between vitamin A deficiency and anemia is suggested.
Assuntos
Anemia/etiologia , Deficiências Nutricionais/etiologia , Deficiência de Vitamina A/complicações , Fatores Etários , Altitude , Anemia/epidemiologia , Proteínas Sanguíneas/metabolismo , América Central , Criança , Pré-Escolar , Hemoglobinas/metabolismo , Humanos , Lactente , Ferro/sangue , Ligação Proteica , Fatores Socioeconômicos , Transferrina/metabolismo , Vitamina A/sangue , Deficiência de Vitamina A/epidemiologiaRESUMO
Nutrition during pregnancy is recognized as of great importance in public health, not only for the woman herself, but also for the impact that it may have on the present and future of the born child. The pregnant state represents additional nutritional needs which have been estimated by expert groups, in a nutrient-independent manner. The percent increase in nutrient specific recommendations due to pregnancy varies with each nutrient. This would mean that the recommended dietary "pattern" for the pregnant women differs markedly from that of the non-pregnant woman, but this matter needs further study and careful consideration. In areas like Central America and Panama, where malnutrition is prevalent, pregnant women suffer from the same nutritional deficits as the general population. The main nutritional deficits are calories, protein, vitamin A, riboflavin, iron and folates. In some instances like in the case of iron and calories, the deficit seems greater in the pregnant women than in the population at large. The studies give evidence that the new born children of malnourished mothers reflect in some aspects the biochemical changes found in the pregnant women.
Assuntos
Fenômenos Fisiológicos da Nutrição , Gravidez , América Central , Deficiências Nutricionais/epidemiologia , Inquéritos sobre Dietas , Feminino , Humanos , Inquéritos Nutricionais , Necessidades Nutricionais , Panamá , Fatores SocioeconômicosRESUMO
During the nutrition survey carried out in Central America and Panama in 1965-1967, information was obtained on the diets and nutrient intake of the rural populations, and on their anthropometric and nutritional-biochemical characteristics. Simultaneously, data were collected for each family studied, which permitted their categorization according to a scale of socioeconomic index. The findings of these studies demonstrate a direct relationship between the socioeconomic level of the families and their dietary and nutritional characteristics. The different types of data, that is, dietary, biochemical, anthropometric and socioeconomic, were all collected at the same time in order to avoid seasonal differences as a confounding factor. Restriction of the sample studied to the rural area of the six countries makes each population rather homogeneous with respect to environmental, genetic and cultural characteristics. Under these conditions, the direct association found between the socioeconomic index of the families and nutritional status acquires more meaning. The design of the study does not permit to determine the direction of a cause-effect relationship, that is, which is the cause of the other. Nevertheless, the findings lend themselves to interesting speculation in this regard.
Assuntos
Inquéritos Nutricionais , População Rural , América Central , Feminino , Humanos , Masculino , Fatores SocioeconômicosRESUMO
The present study constitutes an analysis of the diets of children of low socioeconomic level in the rural area of two Central American countries to specifically determine whether these typical diets are deficient in their content of biologically utilizable protein. The study confirmed that the calorie deficit is of a greater magnitude than that of protein. The estimates of NDpCal%, that is, of the biologically utilizable protein expressed as percent of the total calories, allow to conclude that when these diets, bases predominantly on a combination of a cereal and a legume seed, are consumed in sufficient amounts to meet calorie requirements, there is no protein problem. It is proposed that the approaches to improve the calorie-protein nutritional status be based on previous analysis similar to the one undertaken in the present work. The costly supplementation of diets with "protein-rich" foods or the adoption of similar measures, are not justified except when diets have an unduly low NDpCal%. In the case of the populations studied, the recommended action is to increase the consumption of the existing diets as such, or even a predominantly calorie supplementation when their NDpCal% is higher than needed. These last measures would seem more feasible and less costly. The fact that the increased losses of nutrients due to infection cannot be compensated solely with protein is also stressed.