RESUMO
BACKGROUND: The study of the effects of bariatric surgery on quality of life in patients of different socioeconomic levels (SEL) is worthwhile. AIM: To study quality of life (QoL), eating behavior, depressive symptoms and sexuality in patients subjected to a gastric bypass (GBP) more than 1 year before. MATERIAL AND METHODS: The sample was composed of 33 GPB patients (19 high SEL and 14 low SEL), and 27 non-operated women (18 high SEL and 9 low SEL) of similar weight and age, as controls. Assessment included medical history anthropometry radiological densitometry. Eating behavior was assessed using the three factor eating questionnaire, quality of life using SF-36 and the Bariatric Analysis of Reporting Outcome System (BAROS) depressive symptoms were assessed using the Beck scale version II and sexual behavior using the female sexual function index (FSFI). RESULTS: QoL was lower in operated patients from low SEL, especially when compared to high SEL control women. Operated patients had a predominantly restrictive pattern of eating behavior Eating behavior disorders were detected in 5 of 33 operated patients versus 4 of 27 controls (p =ns). Sexual function was absent or dysfunctional in 22 operated versus 8 controls (p =0,02). No significant differences were observed for depressive symptoms, between operated patients and controls. CONCLUSIONS: In the long term, QoL of bariatric patients, especially those from low SEL, is inferior to control women and Chilean general population. Operated patients have restrictive eating patterns and lower sexual satisfaction indexes. Frequency of depressive symptoms was high both in bariatric and control women.
Assuntos
Derivação Gástrica/psicologia , Obesidade Mórbida/cirurgia , Qualidade de Vida/psicologia , Estudos de Casos e Controles , Depressão/psicologia , Comportamento Alimentar/psicologia , Feminino , Humanos , Pessoa de Meia-Idade , Obesidade Mórbida/psicologia , Comportamento Sexual/psicologia , Classe Social , Fatores SocioeconômicosRESUMO
Background: The study of the effects of bariatric surgery on quality of life in patients of different socioeconomic levels (SEL) is worthwhile. Aim: To study quality of life (QoL), eating behavior, depressive symptoms and sexuality in patients subjected to a gastric bypass (GBP) more than 1 year before. Material and methods: The sample was composed of 33 GPB patients (19 high SEL and 14 low SEL), and 27 non-operated women (18 high SEL and 9 low SEL) of similar weight and age, as controls. Assessment included medical history anthropometry radiological densitometry. Eating behavior was assessed using the three factor eating questionnaire, quality of life using SF-36 and the Bariatric Analysis of Reporting Outcome System (BAROS) depressive symptoms were assessed using the Beck scale version II and sexual behavior using the female sexual function index (FSFI). Results: QoL was lower in operated patients from low SEL, especially when compared to high SEL control women. Operated patients had a predominantly restrictive pattern of eating behavior. Eating behavior disorders were detected in 5 of 33 operated patients versus 4 of 27 controls (p =ns). Sexual function was absent or dysfunctional in 22 operated versus 8 controls (p =0,02). No significant differences were observed for depressive symptoms, between operated patients and controls. Conclusions: In the long term, QoL of bariatric patients, especially those from low SEL, is inferior to control women and Chilean general population. Operated patients have restrictive eating patterns and lower sexual satisfaction indexes. Frequency of depressive symptoms was high both in bariatric and control women.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Derivação Gástrica/psicologia , Obesidade Mórbida/cirurgia , Qualidade de Vida/psicologia , Estudos de Casos e Controles , Depressão/psicologia , Comportamento Alimentar/psicologia , Obesidade Mórbida/psicologia , Comportamento Sexual/psicologia , Classe Social , Fatores SocioeconômicosRESUMO
Background: Roux-en-Y gastric bypass (RYGBP) has had a positive impact on co-morbidities associated with obesity. However, in the long-term it can induce micronutrient deficiencies. Aim: To perform a complete nutritional assessment in a group of women previously operated of RYGBP, from different socioeconomic levéis (SEL). Patients and Methods: Thirty three women (19 high SEL and 14 low SEL), were assessed by dietary recalls, anthropometric measurements, muscle strength, bone mineral density, routine clinical laboratory, serum levéis of vitamin B12, 250H-vitamin D, Mate, calcium, ferritine, ceruloplasmin and indicators ofbone turnover (parathohormone, osteocalcin and urinary pyridinolines). Their valúes were compared to those of 30 control women (18 high SEL and 12 low SEL). Results: Low SEL operated women consumed fewer vitamin and mineral supplements compared with their high SEL pairs. No cases of vitamin B12, folie acid or copper deficiencies were detected. Frequency of iron deficieney was similar in patients and controls. Vitamin D insufficieney was higher amongpatients than in controls (p =0,04 7), regardless SEL. Patients had also a higher frequency of high serum PTH and osteocalcin and urinary pyridinoline levéis. However, no differences in bone mineral density were observed between operated women and controls. Conclusions: Vitamin and mineral deficiencies were lower than expected among operated women. However, problems associated with vitamin D deficieney were highly prevalent among patients operated of RYGBP, irrespective SEL. These alterations were only detectable through speciñe markers at this stage, because they did not transíate into lower bone mineral density (BMD) of surgicalpatients, probably due to the higher pre-operative BMD of these morbidobese patients.
Assuntos
Adulto , Feminino , Humanos , Pessoa de Meia-Idade , Composição Corporal , Densidade Óssea , Derivação Gástrica , Distúrbios Nutricionais/etiologia , Obesidade Mórbida/cirurgia , Estudos de Casos e Controles , Derivação Gástrica/efeitos adversos , Distúrbios Nutricionais/sangue , Distúrbios Nutricionais/diagnóstico , Fatores Socioeconômicos , Fatores de TempoRESUMO
BACKGROUND: Roux-en-Y gastric bypass (RYGBP) has had a posilive impact on co-mobidities associated with obesity. However, in the long-term it can induce micronutrient deficiencies. AIM: To petform a complete nutritional assessment in a group of women previously operated of RYGBP from different socioeconomic levels (SEL). PATIENTS AND METHODS: Thirtyy three women (19 high SEL and 14 low SEL), were assessed by dietary recalls, anthropometric measurements, muscle strength, bone mineral density, routine clinical laboratory, semm leeds of vitamin B12, 25OH-vitamin D, folate, calcium, ferritine ceruloplasmin and indicators of bone tutnoter (paratbohormone, osteocalcin and urinary pyridinolines). Their values were compared to those of 30 control women (18 high SEL and 12 low SEL). RESULTS: Low SEL operated women consumed fewer vitamin and mineral supplements compared with their high SEL pairs. No cases of vitamin B12, folic acid or copper deficiencies were detected. Frequency of iron deficiency was similar in patients and controls. Vitamin D insufficiency was higher among patients than in controls (p = 0.047), regardless SEL. Patients had also a higher frequency of high senum P771 and osteocakin and urinary pyridinoline levels. However, no differences in bone mineral density were obseived between operated women and controls. CONCLUSIONS: Vitamin and mineral deficiencies were lower than expected among operated women. However problems associated with vitamin D deficiency were highly prevalent among patients operated of RYGBP, irrespective SEL. These alterations were only detectable through specific markers at this stage, because they did not translate into lower bone mineral density (BMD) of sutgical patients, probably due to the higher pre-operative BMD of these moibid obese patients
Assuntos
Composição Corporal , Densidade Óssea , Derivação Gástrica , Distúrbios Nutricionais/etiologia , Obesidade Mórbida/cirurgia , Adulto , Estudos de Casos e Controles , Feminino , Derivação Gástrica/efeitos adversos , Humanos , Pessoa de Meia-Idade , Distúrbios Nutricionais/sangue , Distúrbios Nutricionais/diagnóstico , Fatores Socioeconômicos , Fatores de TempoRESUMO
OBJECTIVE: We assessed the value of height reduction, calculated using knee height measurement, as a risk factor or predictive sign for osteoporosis in healthy elderly women. METHODS: In 181 healthy women 76 +/- 5 y of age, height, weight, and knee height were evaluated. Femoral and spine bone mineral densities and body compositions were measured using dual-energy X-ray absorptiometry. In 76 young women 27 +/- 4 y of age, a regression equation to predict height, based on knee height, was derived. Using this equation, maximum attained height and height loss were calculated in elderly women, which was correlated to bone mineral density. RESULTS: The equation to predict height was height (cm) = knee height (cm) x 2.22 + 50.54. The calculated height loss in elderly women was -6.1 +/- 3.8 cm or -0.08 +/- 0.05 cm/y of age. Height loss and hip circumference were significant predictors of spine bone mineral density. In the case of femoral bone mineral density, to the same predictors, a negative effect of waist circumference was added. Women in the highest quintile of height reduction (>0.199 cm/y) had an odds ratio of 4.5 (95% confidence interval 1.56-13.3, P < 0.02) for femoral osteoporosis. CONCLUSION: Knee height can be used as an accurate measurement of height loss in the elderly, which is a significant predictor of femur and spine bone mineral densities, in addition to hip circumference.
Assuntos
Envelhecimento/fisiologia , Estatura/fisiologia , Densidade Óssea/fisiologia , Joelho , Osteoporose/epidemiologia , Absorciometria de Fóton , Adulto , Idoso , Envelhecimento/patologia , Composição Corporal , Estudos de Casos e Controles , Intervalos de Confiança , Feminino , Fêmur/patologia , Humanos , Razão de Chances , Osteoporose/diagnóstico , Osteoporose/patologia , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose Pós-Menopausa/patologia , Valor Preditivo dos Testes , Medição de Risco , Fatores de Risco , Coluna Vertebral/patologiaRESUMO
BACKGROUND: In acute illnesses, plasma glucose levels are often increased and generally parallel the severity of stress. Hyperglycemia caused by reduced insulin sensitivity and reduced insulin secretion is associated with increased susceptibility to infections. Maintaining blood glucose levels at or below 110 mg/dl reduces morbidity and mortality in critically ill patients. AIM: To measure the glucose and insulin responses of four commercially available enteral formulas compared with a standard meal reference product. MATERIAL AND METHODS: The glycemic index (GI) and the insulin index (II) were determined in a randomized, cross over protocol in 38 healthy volunteers between 18 and 46 years of age. Each subject underwent five tests: three with the standard meal (bread) and two with the study products. The enteral formulas were Clinutren HPR (whole protein of high protein value), Crucial (casein peptide based formula), Peptamen, (whey peptide based formula), Glytrol (formula for diabetics with whole protein with fiber). Each study product was evaluated 10 times. RESULTS: The diabetic formula and the high protein energy dense formulas induced a significantly lower GI (p <0.02) compared with the standard meal. The GI response did not appear to be due to enhanced insulin secretion. The other tested formulas had lower GI than the standard meal, but in addition they exhibited increased II The whey based peptide formulation produced the highest insulin response (p <0.03). CONCLUSIONS: Both GI and II are related to the concentration, form and type of protein contained in the enteral formula. The whey peptide formulation produced a low GI with the highest insulin index. Based on the low GI of these enteral products, all can be useful to provide nutritional support during metabolic stress, without adding an additional challenge to blood glucose management.
Assuntos
Glicemia/fisiologia , Nutrição Enteral , Alimentos Formulados/análise , Índice Glicêmico/fisiologia , Insulina/sangue , Adolescente , Adulto , Análise de Variância , Área Sob a Curva , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial/fisiologiaRESUMO
BACKGROUND AND AIMS: An accurate diagnosis of sarcopenia is required. The aim of this study is to correlate the results of two methods to define sarcopenia using cross sectional body composition data, with actual loss of fat free mass. METHODS: Healthy older subjects (926 females and 381 males aged 70 years or more) and healthy young adults (425 females and 151 males aged 20 to 40 years) were studied. Body composition was assessed by double beam X ray absorptiometry (DEXA). Among older subjects, a contemporary subsample of 148 females and 45 males had two or more measurements, separated by 4.8+/-1.5 years and loss of fat free mass per year was calculated. In the whole sample, total and appendicular lean body mass index were calculated as total or appendicular lean body mass/height. Using data from young people, sex specific t scores were obtained. In older subjects residuals were derived from a regression equation, using total or appendicular fat free mass as the dependent variable and height, fat free mass and age as independent variables. RESULTS: The concordance between residuals and t scores to define sarcopenia was 68 and 72%, respectively. Among subjects with two or more measurements, men and women lost a mean of 521+/-454 and 221+/-399 g/year of fat free mass, respectively. The odds ratio of losing more than 822 g lean body mass /year among men or 514 g lean body mass /year among women was 2.63 and 2.64 for subjects classified in the two lowest quintiles of sarcopenia, using t scores or residuals, respectively. CONCLUSIONS: Cross sectional body composition data can predict loss of fat free mass among older people.
Assuntos
Envelhecimento/patologia , Composição Corporal/fisiologia , Músculo Esquelético/patologia , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Estudos Longitudinais , Masculino , Músculo Esquelético/fisiopatologia , Análise de RegressãoRESUMO
Background: In acute illnesses, plasma glucose levels are often increased and generally parallel the severity of stress. Hyperglycemia caused by reduced insulin sensitivity and reduced insulin secretion is associated with increased susceptibility to infections. Maintaining blood glucose levels at or below 110 mg/dl reduces morbidity and mortality in critically ill patients. Aim: To measure the glucose and insulin responses of four commercially available enteral formulas compared with a standard meal reference product. Material and Methods: The glycemic index (GI) and the insulin index (II) were determined in a randomized, cross over protocol in 38 healthy volunteers between 18 and 46 years of age. Each subject underwent five tests: three with the standard meal (bread) and two with the study products. The enteral formulas were Clinutren HPR (whole protein of high protein value), Crucial® (casein peptide based formula), Peptamen®, (whey peptide based formula), Glytrol® (formula for diabetics with whole protein with fiber). Each study product was evaluated 10 times. Results: The diabetic formula and the high protein energy dense formulas induced a significantly lower GI (p <0.02) compared with the standard meal. The GI response did not appear to be due to enhanced insulin secretion. The other tested formulas had lower GI than the standard meal, but in addition they exhibited increased II The whey based peptide formulation produced the highest insulin response (p <0.03). Conclusions: Both GI and II are related to the concentration, form and type of protein contained in the enteral formula. The whey peptide formulation produced a low GI with the highest insulin index. Based on the low GI of these enteral products, all can be useful to provide nutritional support during metabolic stress, without adding an additional challenge to blood glucose management.
Assuntos
Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Glicemia/fisiologia , Nutrição Enteral , Alimentos Formulados/análise , Índice Glicêmico/fisiologia , Insulina/sangue , Análise de Variância , Área Sob a Curva , Período Pós-Prandial/fisiologiaRESUMO
The aim was to assess the effects of resistance training and vitamin D supplementation on physical performance of healthy elderly subjects. Ninety-six subjects, aged 70 years or more with 25 OH vitamin D levels of 16 ng/ml or less, were randomized to a resistance training or control group. Trained and control groups were further randomized to receive in a double blind fashion, vitamin D 400 IU plus 800 mg of calcium per day or calcium alone. Subjects were followed for nine months. Serum 25 OH vitamin D increased from 12.4+/-2.2 to 25.8+/-6.5 ng/ml among subjects supplemented with vitamin D. Trained subjects had significant improvements in quadriceps muscle strength, the short physical performance test and timed up and go. The latter improved more in trained subjects supplemented with vitamin D. At the end of the follow up, gait speed was higher among subjects supplemented with vitamin (whether trained or not) than in non-supplemented subjects (838+/-147 and 768+/-127 m/12 min, respectively, p=0.02). Romberg ratio was lower among supplemented controls than non-supplemented trained subjects (128+/-40% and 144+/-37%, respectively, p=0.05). In conclusion, vitamin D supplementation improved gait speed and body sway, and training improved muscle strength.
Assuntos
Suplementos Nutricionais , Exercício Físico , Força Muscular/efeitos dos fármacos , Deficiência de Vitamina D/tratamento farmacológico , Vitamina D/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Antropometria/métodos , Constituição Corporal , Densidade Óssea/efeitos dos fármacos , Cálcio/uso terapêutico , Terapia Combinada , Método Duplo-Cego , Quimioterapia Combinada , Feminino , Marcha , Força da Mão , Humanos , Masculino , Aptidão Física , Estudos Prospectivos , Deficiência de Vitamina D/fisiopatologiaRESUMO
OBJECTIVE: To study the effects of a special nutritional supplement on bone mineral density and bone turnover markers in Chilean elderly subjects with femoral osteoporosis. SETTING: Public primary health care clinics in Chile. SUBJECTS: Free living elderly subjects with femoral osteoporosis. INTERVENTIONS: Subjects were randomized to receive the usual nutritional supplement provided by the Chilean Ministry of Health or a special nutritional supplement providing, among other nutrients, 90 mg isoflavones, 800 mg calcium, 400 IU vitamin D, 60 ug vitamin K and 31 g proteins per day. MEASURES OF OUTCOME: At baseline, and after six and twelve months of supplementation, body composition, bone mineral density, serum 25 OH vitamin D, intact parathyroid hormone (iPTH), osteocalcin, decarboxylated osteocalcin, urinary aminoterminal telopeptide of type I collagen (NTX), deoxypyridoline cross links (Dpd) and equol were measured. Every month, urinary daidzein was measured in a morning urine sample. RESULTS: No differences between treatment groups were observed in body composition or bone mineral density changes. The group receiving the special supplement had a significant increase in serum 25 OH vitamin D and a significant decrease in serum iPTH and decarboxylated osteocalcin. No association between daidzein or equol excretion and changes in bone mineralization was observed. CONCLUSIONS: A special supplement delivered to elderly subjects with osteoporosis improved serum vitamin D and reduced serum iPTH and undercarboxylated osteocalcin levels but did not affect BMD.
Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Osso e Ossos/metabolismo , Osteoporose/tratamento farmacológico , Idoso , Análise de Variância , Cálcio/metabolismo , Cálcio/uso terapêutico , Chile , Suplementos Nutricionais , Feminino , Humanos , Isoflavonas/metabolismo , Isoflavonas/uso terapêutico , Masculino , Osteocalcina/sangue , Osteoporose/sangue , Hormônio Paratireóideo/sangue , Estudos Prospectivos , Resultado do Tratamento , Vitamina D/metabolismo , Vitamina D/uso terapêuticoRESUMO
BACKGROUND AND AIMS: Weight maintenance within normal standards is recommended for prevention of conditions associated with oxidative injury. To compare oxidative damage in a post mitotic tissue, between adults differing in long-term energy balance. METHODS: During hernia surgery, a sample of skeletal muscle was obtained in 17 non-obese adults. Subjects were divided into two groups according to their self-reported weight change: weight maintainers (WM) reported <4kg increase, and weight gainers (WG) reported >5kg increment. Muscle immunohistochemistry for 8-hydroxy-deoxyguanosine (8OHdG), 4-Hydroxy-2-nonenal (4HNE), and TNF-alpha, as markers of oxidative injury and inflammation, were performed. As known positive controls for oxidative injury, we included 10 elderly subjects (66-101yr). Anthropometric measures and blood samples for clinical laboratory and serum cytokines (TNF-alpha and IL-6) were obtained. RESULTS: 8OHdG was higher in WG compared with WM (149.1+/-16.2 versus 117.8+/-29.5, P=0.03), and was associated with anthropometric indicators of fat accumulation. 4HNE was similar in WG compared with WM (10.9+/-7.6 versus 9.8+/-6.3) but noticeably higher in elderly subjects (21.5+/-15.3, P=0.059). TNF-alpha protein in WG was higher compared with WM (114.0+/-41.7 versus 70.1+/-23.3, P=0.025), and was associated with weight increase. CONCLUSIONS: Moderate self-reported weight increase, and body fat accumulation, suggesting long-term positive energy balance is associated with muscle DNA oxidative injury and inflammation.
Assuntos
Dano ao DNA , Inflamação/metabolismo , Músculo Esquelético/metabolismo , Obesidade/metabolismo , Aumento de Peso/fisiologia , 8-Hidroxi-2'-Desoxiguanosina , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Envelhecimento/fisiologia , Aldeídos/metabolismo , Estudos de Casos e Controles , Desoxiguanosina/análogos & derivados , Desoxiguanosina/metabolismo , Humanos , Imuno-Histoquímica , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Fator de Necrose Tumoral alfa/metabolismoRESUMO
BACKGROUND: Infantile obesity is associated with metabolic disturbances (hyperinsulinism, impaired glucose, dyslipidemia) that determine a higher risk of type 2 diabetes, high blood pressure and atherosclerotic vascular disease in adulthood. Insulin resistance is a central mechanism of complications of obesity and is associated to body fat mass. AIM: To investigate insulin sensitivity and its association with anthropometric and metabolic variables in obese children. PATIENTS AND METHODS: We studied 314 children aged 6 to 15 years. Of these, 235 had a body mass index (BMI) over the 95 percentile for age and sex (classified as obese) and 79 had a normal body mass index; 161 were pre-pubescent and 153 were pubescent. Weight, height, percentage of total body fat (% TBF) using the sum of 4 skinfolds, blood pressure (BP), waist circumference (WC), basal glucose (Glu) and insulin (Ins) were measured. Insulin sensitivity (IS) was calculated with the homeostasis model assessment (HOMA) and QUICKI index. Serum lipids, postprandial Glu and Ins were measured only in obese children. RESULTS: BMI, WC and % TBF had an inverse and significant correlation with basal IS (p <0.001). Obese children had higher BP, basal Ins, and HOMA and a lower QUICKI index, compared to normal weight children. A low basal IS was present in 58% of obese children. Obese children with low IS had higher WC, % TBF, triglycerides, total/HDL-cholesterol ratio, basal and 2-h post glucose Gli and Ins and lower HDL-cholesterol than obese children with normal IS. In prepubescent children, the risk of a low IS was 2.43 times higher with a TBF over 33%. In pubescent children, it was 2.92 times higher with a TBF over 37%. CONCLUSIONS: Low IS in prepubescent and pubescent obese children is associated with central obesity and a higher cardiovascular.
Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Resistência à Insulina , Síndrome Metabólica/diagnóstico , Obesidade/complicações , Adolescente , Glicemia , Pressão Sanguínea , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/metabolismo , Estado Nutricional , Obesidade/metabolismo , Puberdade , Fatores de Risco , Fatores SexuaisAssuntos
Exercício Físico , Idoso , Índice de Massa Corporal , Chile , Tolerância ao Exercício , Feminino , Humanos , Masculino , Músculo Esquelético/fisiologia , Caminhada , Suporte de CargaRESUMO
BACKGROUND: Immune response is impaired in the elderly. Our aim was to study the effects of a special nutritional formula on the immune response and response to influenza and pneumococcal vaccination in elderly subjects. METHODS: Sixty healthy subjects aged > or = 70 years, with a Mini Mental score > or = 22 were studied. Half of the subjects received a special nutritional formula (in addition to the regular diet) providing, among other nutrients, 480 kcal, 31 g proteins, 120 IU vitamin E, 3.8 microg vitamin B12, 400 microg folic acid, 10(9) cfu Lactobacillus paracasei (NCC 2461), and 6 g of fructo-oligosaccharides. At 4 months of follow-up, subjects were vaccinated against influenza and pneumococcus. Lymphokine production by mononuclear cells (PBMC), lymphocyte subpopulations, and natural killer cell (NK) activity were measured at baseline and 4 months of follow-up (before vaccination). Antibodies against influenza and pneumococcal antigens and flu-stimulated production of interferon gamma and interleukin-2 by PBMC were measured at 4 and 6 months. Skin response to 7 recall antigens and body composition were assessed at baseline and at 4 and 12 months. All infections occurring during the study period were recorded. RESULTS: NK activity increased in supplemented subjects and decreased in nonsupplemented individuals. Interleukin-2 production by PBMC and the proportion of T cells with NK activity decreased in controls and did not change in supplemented subjects. Supplemented subjects reported less infections than nonsupplemented individuals (in 13% and 22% of scheduled visits, respectively; p = .02). CONCLUSIONS: This nutritional supplement increased innate immunity and protection against infections in elderly people.
Assuntos
Envelhecimento/imunologia , Citocinas/biossíntese , Alimentos Formulados , Imunidade Inata/imunologia , Vacinas contra Influenza/imunologia , Vacinas Pneumocócicas/imunologia , Idoso , Formação de Anticorpos/imunologia , Chile , Suplementos Nutricionais , Feminino , Seguimentos , Humanos , Imunidade Inata/efeitos dos fármacos , Células Matadoras Naturais/imunologia , Leucócitos Mononucleares/imunologia , Subpopulações de Linfócitos , MasculinoRESUMO
The mechanism by which homocysteine (Hcy) causes endothelial dysfunction is probably mediated by oxidative stress. The aim of this study was to evaluate the effect of oxidative stress on endothelial function in young and elderly hyperhomocysteinemic (HHcy) men. A total of 35 HHcy (Hcy > 15 micro mol/L), young (n = 15; 20-40 y) and elderly men (n = 20; > 65 y) and 33 normohomocysteinemic (NHcy; controls) young (n = 14) and elderly (n = 19) men (Hcy < 13 micro mol/L), without classic cardiovascular risk factors were recruited. Serum Hcy, folate, and vitamin B-12, whole-blood glutathione, plasma total antioxidants status, TBARS, and 8-F(2alpha) isoprostanes were determined. Noninvasive ultrasound measurements of endothelium-dependent (EDVR) and -independent dilatation (EIVR) were performed. EDVR, EIVR, and markers of oxidative stress did not differ among the groups. Folate concentrations were higher in elderly than in young men (P < 0.001), independent of Hcy concentrations. Vitamin B-12 concentrations were lower in HHcy than in NHcy elderly men (P < 0.045). EDVR was correlated with folate concentrations in young men (r = 0.40, P = 0.04) and negatively with BMI in elderly men (r = -0.52, P = 0.002). In the present study, HHcy with normal serum folate concentrations was not associated with poor EDVR or oxidative stress in healthy young and elderly men.
Assuntos
Envelhecimento/sangue , Ácido Fólico/sangue , Hiper-Homocisteinemia/complicações , Estresse Oxidativo , Vasodilatação , Adulto , Idoso , Antioxidantes/metabolismo , Endotélio Vascular/fisiologia , Humanos , MasculinoRESUMO
OBJECTIVE: Undernutrition is a frequent complication in patients with cystic fibrosis (CF). Elevated energy requirements have been found to be 4% to 33% higher than in controls in some studies. Whether or not this is caused by a primary defect or energy metabolism is still a matter of controversy. To this end, we assessed energy expenditure, nutrition status, and body composition of clinically stable CF outpatients. METHODS: Fifteen clinically stable CF patients, ages 2 to 15 y, were paired with 15 healthy control children. Measurements consisted of anthropometry and body composition. Plasma tocopherol, retinol, and hair zinc content were measured. Resting energy expenditure was determined by indirect calorimetry. Physical activity and dietary intake were recorded by recall methods. RESULTS: Two children were nutritionally at risk according to the weight/height index, eight were normal, three were overweight, and two were obese. Body composition was similar in both groups. Zinc, tocopherol, and retinol levels were low in three, two, and three patients, respectively. Resting energy expenditures were 4.7 MJ/d (1127 +/- 220 kcal/d) in CF children and 4.63 MJ/d (1108 +/- 191 kcal/d) in control children (P = not significant). Physical activity level was sedentary in 86.6% of CF patients; the rest had a light physical activity pattern. Energy intake represented 141% of the estimated daily energy expenditure. CONCLUSIONS: Non-oxygen-dependent CF children, without acute respiratory infection, had resting energy expenditures comparable to those of matched controls. Total energy expenditure was similar to or slightly lower than that in healthy children. Dietary recommendations for CF patients need to be reassessed.
Assuntos
Composição Corporal , Fibrose Cística/metabolismo , Metabolismo Energético/fisiologia , Necessidades Nutricionais , Estado Nutricional , Adolescente , Antropometria , Metabolismo Basal/fisiologia , Calorimetria Indireta , Estudos de Casos e Controles , Criança , Pré-Escolar , Fibrose Cística/sangue , Fibrose Cística/complicações , Ingestão de Energia/fisiologia , Exercício Físico/fisiologia , Feminino , Humanos , Masculino , Rememoração Mental , Micronutrientes/análise , Tocoferóis/sangue , Vitamina A/sangueRESUMO
OBJECTIVE: There is a seasonal variation in the incidence of diabetes mellitus and cardiovascular diseases. However, there is very little information about the seasonal variation in insulin sensitivity. We report the seasonal variation in insulin sensitivity in a group of elderly subjects followed for 1 y. METHODS: Healthy elderly (>/=70 y) subjects living independently were included. Fifty percent of subjects received a daily nutritional supplement that provided 400 kcal, 15 g of protein, and 50% of vitamin daily reference values (DRVs). Those receiving and not receiving supplements were randomly assigned to a resistance exercise training program. Every 6 mo (winter, summer, and winter), body composition was measured by dual-energy x-ray absorptiometry and blood samples were used to measure serum lipids, fasting and postprandial glucose, and insulin levels. RESULTS: One hundred eight subjects (31 supplemented and trained, 28 supplemented, 16 trained, and 33 without supplementation or training) completed the follow up. Higher homeostasis assessment of insulin sensitivity, postprandial insulin, and fasting triacylglycerol levels were observed during the summer than during the winter. Body fat increased steadily during the study period, and fat-free mass did not change. Serum low-density lipoprotein cholesterol decreased significantly in the supplemented and trained group and increased in the non-intervention group. CONCLUSIONS: In this group of elderly subjects, insulin resistance and triacylglycerol levels were higher during the summer. Nutritional supplementation and training had a positive effect on serum low-density lipoprotein cholesterol.
Assuntos
Envelhecimento/fisiologia , Doenças Cardiovasculares/sangue , Diabetes Mellitus Tipo 2/sangue , Exercício Físico/fisiologia , Insulina/metabolismo , Vitaminas/administração & dosagem , Absorciometria de Fóton , Idoso , Composição Corporal/efeitos dos fármacos , Composição Corporal/fisiologia , Doenças Cardiovasculares/epidemiologia , LDL-Colesterol/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Suplementos Nutricionais , Jejum , Feminino , Humanos , Incidência , Masculino , Período Pós-Prandial , Estudos Prospectivos , Estações do Ano , Triglicerídeos/sangueRESUMO
OBJECTIVE: The incidence of protein-calorie malnutrition in hospitalized adult patients can reach 30% to 50% and adversely affect clinical outcome. We evaluated the efficacy of muscle strength to predict functional derangement and detect early changes in nutrition status in hospitalized patients. METHODS: Patients hospitalized at medical and surgical wards from two different hospitals in Santiago, Chile, were studied during their hospital stay. Subjective Global Assessment of nutrition status and laboratory parameters were measured on admission. Anthropometric measures, handgrip dynamometry, and maximal inspiratory and expiratory pressures were measured on admission and discharge. The Karnofsky index was used to assess functional status. Twice weekly, caloric balance was calculated with indirect calorimetry and assessment of dietary intake. RESULTS: From the initial selection of patients (n = 70), 50 patients (26 men and 24 women) completed the study. Median hospital stay was 10 d. Subjective Global Assessment was associated with anthropometric data, handgrip dynamometry, and serum levels of total proteins. Patients in whom functional status declined during hospital stay, on admission had lower left handgrip strength, a worse Subjective Global Assessment classification, were older, and had lower fat mass. No association between caloric balance during hospital stay and changes in muscle strength was observed. CONCLUSIONS: Subjective Global Assessment, handgrip strength, and fat mass were good predictors for the decline in functional status during hospital stay. No association between caloric balance and changes in muscle strength was observed.
Assuntos
Hospitalização , Debilidade Muscular , Estado Nutricional , Adulto , Idoso , Antropometria , Feminino , Força da Mão , Humanos , Medidas de Volume Pulmonar , Masculino , Pessoa de Meia-Idade , Desnutrição Proteico-Calórica/diagnóstico , Desnutrição Proteico-Calórica/epidemiologia , Testes de Função RespiratóriaRESUMO
Se realizó una evaluación biológica de un instituto lácteo experimental, a base de harina de trigo cruda refinada sometida a hidrólisis enzimática, en comparación a un producto testigo basado en harina extruída y proteína de leche. El trabajo utilizó 35 escolares de un internado, con una edad promedio de 8.6 más o menos 0.6 años. Las niñas fueron alimentadas con dieta habitual durante dos períodos consecutivos de 14 y 12 días cada uno, reemplazando en forma aleatoria, mediante un estudio doble ciego cruzado, el sustituto lácteo en ese momento en uso en la institución, por los sustitutos testigo y experimental. Se evaluó la absorción aparente de proteína, energía, calcio y fósforo. La ingestión nitrogenada promedio fue significativamente más baja con el sustituto experimental (223 vs. 244 mg/Kg/día, p<0.0001), lo que reflejo menor nitrógeno absorbido (187 vs. 203 mg/Kg/día, p<0.0001). La ingestión energética y la excreción fecal fueron similares con ambos sustituto, observándose un 96 por ciento y 95 por ciento de absorción con el producto experimental y testigo respectivamente. La ingestión promedio de calcio fue significativamente inferior con el sustituto experimental (39.7 vs. 60.2 mg/Kg/día, p<0.0001), y el calcio absorbido fue de un 50 por ciento en relación al obtenido con el sustituto testigo (20.7 vs. 39.5 mg/Kg/día, p<0.0001). La ingestión de fósforo fue significativamente menor con el producto experimental (22.0 vs. 27.8 mg/Kg/día) y lo absorbido fue 13.1 vs. 16.5 mg/Kg/día respectivamente. Con ambos sustitutos se obtuvo una buena tolerancia. Concluimos, que las voluntarias que ingirieron el producto a base de harina de trigo cruda refinada, no presentaron diferencias importantes en la digestibilidad de las proteínas y energía en relación al testigo; sin embargo, la absorción de calcio y fósforo fue significativamente inferior al consumir el producto experimental, lo cual limita su uso en los programas de alimentación escolar.