RESUMO

RESUMO A pandemia de Covid-19 gerou grande impacto sobre a sociedade e a economia, desnudando as faces da desigualdade no Brasil e traçando um caminho em direção à fome e à insegurança alimentar e nutricional. Desde fevereiro de 2020, com notificação do primeiro caso no País, as medidas de isolamento social e lockdown aumentaram as taxas de desemprego e desalento, assim como o fechamento de feiras locais, que concediam acesso aos alimentos frescos às periferias, elevando o preço dos gêneros in natura e aumentando o consumo de produtos industrializados. Essas questões trazem a reflexão da fragilidade das cadeias de produção e consumo, que são longas, dependentes de insumos externos e de infraestrutura para o transporte. Na perspectiva de subsidiar estratégias de enfretamento da fome, acesso à comida e mudanças na lógica da produção alimentícia, foi realizada uma revisão da literatura científica e de textos jornalísticos do período pandêmico. Este texto disserta sobre políticas de proteção social e de Segurança Alimentar e Nutricional (SAN), relacionando com a potencialidade das práticas agroecológicas nesse contexto, entendendo que a agroecologia tem em seus princípios a liberdade, a autonomia e a saúde, dialogando com os conceitos de soberania alimentar e da luta pela equidade.

ABSTRACT The Covid-19 pandemic had a major impact on society and the economy, stripping the faces of inequality in Brazil, and tracing a path towards hunger and food and nutritional insecurity. Since February 2020, with the notification of the first case in the country, social isolation and lockdown measures have increased unemployment and discouragement rates, as well as the closing of local fairs, which granted access to fresh food to the peripheries, raising the price of unprocessed food and increasing the consumption of industrialized products. These issues reflect on the fragility of the production and consumption chains, which are dependent on external inputs and transport infrastructure. A review of the scientific literature and journalistic texts of the pandemic period was carried out with the perspective of subsidizing strategies to fight hunger, access to food, and changes in the logic of food production. This text discusses policies of social protection and Food and Nutritional Security, relating the potential of agroecological practices in this context, understanding that agroecology has in its principles freedom, autonomy, and health, dialoguing with the concepts of food sovereignty and the struggle for equity.

RESUMO

This systematic review of longitudinal studies aimed to evaluate the effect of enteral feeding of critically ill adult and pediatric patients in the prone position on gastric residual volume and other clinical outcomes. A literature search was conducted in the databases PubMed, Scopus and Embase using terms related to population and intervention. Two independent reviewers analyzed the titles and abstracts, and data collection was performed using a standardized form. Discrepancies were resolved by a third reviewer. The methodological quality of the studies was evaluated considering the potential for systematic errors, and the data were qualitatively analyzed. Four studies with adult patients and one with preterm patients were included. The gastric residual volume was evaluated as the main outcome: three studies did not show differences in the gastric residual volume between the prone and supine positions (p > 0.05), while one study showed a higher gastric residual volume during enteral feeding in the prone position (27.6mL versus 10.6mL; p < 0.05), and another group observed a greater gastric residual volume in the supine position (reduction of the gastric residual volume by 23.3% in the supine position versus 43.9% in the prone position; p < 0.01). Two studies evaluated the frequency of vomiting; one study found that it was higher in the prone position (30 versus 26 episodes; p < 0.001), while the other study found no significant difference (p > 0.05). The incidence of aspiration pneumonia and death were evaluated in one study, with no difference between groups (p > 0.05). The literature on the administration of enteral feeding in the prone position in critically ill patients is sparse and of limited quality, and the results regarding gastric residual volume are contradictory. Observational studies with appropriate sample sizes should be conducted to support conclusions on the subject.

Assuntos

RESUMO

RESUMO Esta revisão sistemática de estudos longitudinais objetivou avaliar o efeito da administração da dieta enteral em pacientes críticos adultos e pediátricos em posição prona no volume residual gástrico e em outros desfechos clínicos. A busca da literatura foi conduzida nas bases de dados PubMed®, Scopus e Embase, a partir de termos relacionados à população e à intervenção. Dois revisores independentes analisaram os títulos e resumos, e a coleta dos dados foi realizada a partir de uma ficha padronizada. Discrepâncias foram resolvidas por um terceiro revisor. A qualidade metodológica dos estudos foi avaliada considerando o potencial para erros sistemáticos e os dados analisados qualitativamente. Quatro estudos com pacientes adultos e um com pacientes pré-termos foram incluídos. O volume residual gástrico foi avaliado como principal desfecho: três não diferiram no volume residual gástrico entre as posições prona e supina (p > 0,05), enquanto um estudo demonstrou maior volume residual gástrico durante a administração da dieta em posição prona (27,6mL versus 10,6mL; p < 0,05), e outro apresentou maior volume residual gástrico na posição supina (redução do volume residual gástrico de 23,3% na posição supina versus 43,9% na posição prona; p < 0,01). Dois estudos avaliaram a frequência de vômitos, sendo maior na posição prona em um estudo (30 versus 26 episódios; p < 0,001) e sem diferença significativa em outro (p > 0,05). Incidência de pneumonia aspirativa e de óbito foram avaliadas por um estudo, não sendo observada diferença entre os grupos (p > 0,05). A literatura acerca da administração de dieta enteral em pacientes críticos em posição prona é escassa e de qualidade limitada, e os resultados sobre volume residual gástrico são contraditórios. Estudos observacionais com tamanho amostral apropriado deveriam ser conduzidos para fundamentar conclusões sobre o tema.

ABSTRACT This systematic review of longitudinal studies aimed to evaluate the effect of enteral feeding of critically ill adult and pediatric patients in the prone position on gastric residual volume and other clinical outcomes. A literature search was conducted in the databases PubMed, Scopus and Embase using terms related to population and intervention. Two independent reviewers analyzed the titles and abstracts, and data collection was performed using a standardized form. Discrepancies were resolved by a third reviewer. The methodological quality of the studies was evaluated considering the potential for systematic errors, and the data were qualitatively analyzed. Four studies with adult patients and one with preterm patients were included. The gastric residual volume was evaluated as the main outcome: three studies did not show differences in the gastric residual volume between the prone and supine positions (p > 0.05), while one study showed a higher gastric residual volume during enteral feeding in the prone position (27.6mL versus 10.6mL; p < 0.05), and another group observed a greater gastric residual volume in the supine position (reduction of the gastric residual volume by 23.3% in the supine position versus 43.9% in the prone position; p < 0.01). Two studies evaluated the frequency of vomiting; one study found that it was higher in the prone position (30 versus 26 episodes; p < 0.001), while the other study found no significant difference (p > 0.05). The incidence of aspiration pneumonia and death were evaluated in one study, with no difference between groups (p > 0.05). The literature on the administration of enteral feeding in the prone position in critically ill patients is sparse and of limited quality, and the results regarding gastric residual volume are contradictory. Observational studies with appropriate sample sizes should be conducted to support conclusions on the subject.

Assuntos

RESUMO

In Brazil, at least 30% of the total financial resources provided by the federal government for school feeding should be used to buy products from family farming. The present study examines the profile of the purchase of these products in municipalities of the state of Rio Grande do Sul (RS), south Brazil, in 2014. A cross-sectional descriptive study was carried out with information obtained through a questionnaire sent to the municipalities and filled by respondents. Of the 371 participating municipalities, 367 acquired products from family farming, and 86.8% of these municipalities achieved the minimum percentage required. Nutritionists and farmers were the main components involved in the articulation of this process. Difficulties faced by these individuals included the lack of organization of the producers, failure to meet the demand, and lack of interest. More than 80% of the municipalities bought food from the “Vegetables”, “Cereals, Breads, Pasta, and Tubers” and “Fruits” groups. Only 8% purchased products from socio-biodiversity. There was a great diversity of food purchased, most of which were in natura, despite the low acquisition of socio-biodiversity products. Results of this study indicated the concern and tendency of the Brazilian municipalities to support the local economy with incentives to consumption and production of regional foods.(AU)

No Brasil, no mínimo 30% do total dos recursos financeiros repassados pelo governo federal para a alimentação escolar devem ser utilizados na compra de produtos da agricultura familiar. Este estudo analisa o perfil da aquisição desses produtos em municípios do Rio Grande do Sul (RS), em 2014. Foi realizado estudo transversal descritivo com informações obtidas de um questionário encaminhado aos municípios. Dos 371 municípios participantes, 367 adquiriram produtos da agricultura familiar, sendo que 86,8% deles atingiram o percentual mínimo exigido. Os nutricionistas e os agricultores foram os principais envolvidos na articulação do processo e, dentre as dificuldades enfrentadas estão a falta de organização dos produtores, a impossibilidade de cumprirem com a demanda e o desinteresse. Mais de 80% dos municípios compraram dos grupos “Hortaliças, legumes e verduras”, “Cereais, pães, massas e tubérculos” e “Frutas”, embora apenas 8% adquiriam produtos da sociobiodiversidade. Verificou-se uma grande diversidade de alimentos adquiridos, sendo a maior parte produtos in natura, apesar da baixa aquisição de produtos da sociobiodiversidade. Os resultados indicam a tendência dos municípios em fomentar a economia local, com incentivo ao consumo e produção de alimentos regionais.(AU)

RESUMO

ABSTRACT: In Brazil, at least 30% of the total financial resources provided by the federal government for school feeding should be used to buy products from family farming. The present study examines the profile of the purchase of these products in municipalities of the state of Rio Grande do Sul (RS), south Brazil, in 2014. A cross-sectional descriptive study was carried out with information obtained through a questionnaire sent to the municipalities and filled by respondents. Of the 371 participating municipalities, 367 acquired products from family farming, and 86.8% of these municipalities achieved the minimum percentage required. Nutritionists and farmers were the main components involved in the articulation of this process. Difficulties faced by these individuals included the lack of organization of the producers, failure to meet the demand, and lack of interest. More than 80% of the municipalities bought food from the "Vegetables", "Cereals, Breads, Pasta, and Tubers" and "Fruits" groups. Only 8% purchased products from socio-biodiversity. There was a great diversity of food purchased, most of which were in natura, despite the low acquisition of socio-biodiversity products. Results of this study indicated the concern and tendency of the Brazilian municipalities to support the local economy with incentives to consumption and production of regional foods.

RESUMO: No Brasil, no mínimo 30% do total dos recursos financeiros repassados pelo governo federal para a alimentação escolar devem ser utilizados na compra de produtos da agricultura familiar. Este estudo analisa o perfil da aquisição desses produtos em municípios do Rio Grande do Sul (RS), em 2014. Foi realizado estudo transversal descritivo com informações obtidas de um questionário encaminhado aos municípios. Dos 371 municípios participantes, 367 adquiriram produtos da agricultura familiar, sendo que 86,8% deles atingiram o percentual mínimo exigido. Os nutricionistas e os agricultores foram os principais envolvidos na articulação do processo e, dentre as dificuldades enfrentadas estão a falta de organização dos produtores, a impossibilidade de cumprirem com a demanda e o desinteresse. Mais de 80% dos municípios compraram dos grupos "Hortaliças, legumes e verduras", "Cereais, pães, massas e tubérculos" e "Frutas", embora apenas 8% adquiriam produtos da sociobiodiversidade. Verificou-se uma grande diversidade de alimentos adquiridos, sendo a maior parte produtos in natura, apesar da baixa aquisição de produtos da sociobiodiversidade. Os resultados indicam a tendência dos municípios em fomentar a economia local, com incentivo ao consumo e produção de alimentos regionais.

RESUMO

PURPOSE: Previously showed that dietary trans fatty acids (TFAs) may cause systemic inflammation and affect the central nervous system (CNS) in Wistar rats by increased levels of cytokines in the cerebrospinal fluid (CSF) and serum (Longhi et al. Eur J Nutr 56(3):1003-1016, 1). Here, we aimed to clarifying the impact of diets with different TFA concentrations on cerebral tissue, focusing on hippocampus and cortex and behavioral performance. METHODS: Wistar rats were fed either a normolipidic or a hyperlipidic diet for 90 days; diets had the same ingredients except for fat compositions, concentrations, and calories. We used lard in the cis fatty acid (CFA) group and PHSO in the TFA group. The intervention groups were as follows: (1) low lard (LL), (2) high lard (HL), (3) low partially hydrogenated soybean oil (LPHSO), and (4) high partially hydrogenated soybean oil (HPHSO). Mitochondrial parameters, tumor necrosis factor alpha (TNF-α), 2'7'-dichlorofluorescein (DCFH) levels in brain tissue, and open field task were analyzed. RESULTS: A worse brain tissue response was associated with oxidative stress in cortex and hippocampus as well as impaired inflammatory and mitochondrial parameters at both PHSO concentrations and there were alterations in the behavioral performance. In many analyses, there were no significant differences between the LPHSO and HPHSO diets. CONCLUSIONS: Partially hydrogenated soybean oil impaired cortical mitochondrial parameters and altered inflammatory and oxidative stress responses, and the hyperlipidic treatment caused locomotor and exploratory effects, but no differences on weight gain in all treatments. These findings suggest that quality is more important than the quantity of fat consumed in terms of CFA and TFA diets.

Assuntos

RESUMO

PURPOSE: Recent data regarding trans fatty acids (TFAs) have implicated these lipids as particularly deleterious to human health, causing systemic inflammation, endothelial dysfunction and possibly inflammation in the central nervous system (CNS). We aimed to clarify the impact of partially hydrogenated soybean oil (PHSO) with different TFA concentrations on cerebrospinal fluid (CSF), serum and hepatic parameters in adult Wistar rats. METHODS: Wistar rats (n = 15/group) were fed either a normolipidic diet or a hyperlipidic diet for 90 days. The normolipidic and hyperlipidic diets had the same ingredients except for fat compositions, concentrations and calories. We used lard in the cis fatty acid group and PHSO in the trans fatty acid group. The intervention groups were as follows: (1) low lard (LL), (2) high lard (HL), (3) low partially hydrogenated soybean oil (LPHSO) and (4) high partially hydrogenated soybean oil (HPHSO). Body weight, lipid profiles and the inflammatory responses in the CSF, serum and liver tissue were analyzed. RESULTS: Surprisingly, with the PHSO diet we observed a worse metabolic response that was associated with oxidative stress in hepatic tissue as well as impaired serum and CSF fluid parameters at both PHSO concentrations. In many analyses, there were no significant differences between the LPHSO and HPHSO diets. CONCLUSIONS: Dietary supplementation with PHSO impaired inflammatory parameters in CSF and blood, induced insulin resistance, altered lipid profiles and caused hepatic damage. Overall, these findings suggest that fat composition is more important than the quantity of fat consumed in terms of cis and trans fatty acid diets.

Assuntos