RESUMO
Edible insects are recognized as promising food sources due to their nutritional composition. Some species, such as Gryllus assimilis, contain proteins, lipids, and carbohydrates of high biological value, which regulate several metabolic functions, including the Renin-Angiotensin System (RAS). In this context, the present study aimed to assess the effects of dietary supplementation with whole Gryllus assimilis powder on the metabolism of malnourished mice. Thirty-two male Swiss mice were used and divided into four treatment groups. The groups were identified as (AIN93-M); AIN93-M + Gryllus assimilis diet (AIN93-M + GA); AIN93-M + Renutrition diet (AIN93-M + REN) and AIN93-M + Renutrition diet + Gryllus assimilis (AIN93-M + REN + GA). The results showed that whole Gryllus assimilis powder inclusion promotes recovery from protein-energy malnutrition, reduces adiposity, and improves glucose tolerance and insulin sensitivity. It also reduces total cholesterol, triglycerides, VLDL, and adipocyte area. We also observed a significant increase in the expression of RAS-related genes, such as ACE2 and MasR, followed by a reduction in Angiotensinogen and ACE. The main findings of the present study suggest the use of black cricket as a viable strategy for the prevention and treatment of protein-energy malnutrition, as well as the reduction of adiposity, and improvement of lipid and glycemic parameters, with antihypertensive potential.
Assuntos
Tecido Adiposo , Suplementos Nutricionais , Gryllidae , Desnutrição Proteico-Calórica , Sistema Renina-Angiotensina , Animais , Sistema Renina-Angiotensina/efeitos dos fármacos , Masculino , Camundongos , Desnutrição Proteico-Calórica/metabolismo , Desnutrição Proteico-Calórica/dietoterapia , Tecido Adiposo/metabolismo , Adiposidade , Resistência à InsulinaRESUMO
Nutritional recovery of early malnutrition with a soybean diet reduces liver glycogen stores in the fed state and produces liver insulin resistance. We investigated whether nutritional recovery on a soybean flour diet alters hepatic gluconeogenesis in the adult offspring of rats deprived of protein during pregnancy and lactation. Male rats from mothers that were fed either 17% (C) or 6% (L) protein during pregnancy and lactation were maintained on a 17% casein (CC, n = 16 and LC, n = 17), 17% soybean flour (CS, n = 10 and LS, n = 10), or 6% casein (LL, n = 10) diet after weaning. The soybean diet reduced basal serum glucose (soybean diet, 5.6 ± 0.6 mmol/L vs. casein diet, 6.2 ± 0.6 mmol/L; p < 0.05) but increased alanine aminotransferase mRNA/GAPDH (soybean diet, 0.062 ± 0.038 vs. casein diet, 0.024 ± 0.011; p < 0.01), phosphoenolpyruvate carboxykinase mRNA/GAPDH (soybean diet, 1.53 ± 0.52 vs. casein diet, 0.95 ± 0.43; p < 0.05), and glycerokinase protein content (soybean diet, 0.86 ± 0.08 vs. casein diet, 0.75 ± 0.11; p < 0.05). The serum glucose concentration (recovered groups, 5.6 ± 0.5 mmol/L vs. control groups, 6.2 ± 0.7 mmol/L; p < 0.05) and phosphoenolpyruvate carboxykinase activity (recovered groups, 2.8 ± 0.6 µU/mg vs. control groups, 3.6 ± 0.6 µU/mg; p < 0.05) were decreased in rats subjected to protein restriction in early life. The glucose area under the curve during the pyruvate tolerance test did not differ among groups, whereas glucose area under the curve after glucagon infusion was reduced by early malnutrition (recovered groups, 4210 ± 572 mg/dL·40 min vs. control groups, 4493 ± 688 mg/dL·40 min; p < 0.001) and by the soybean diet (soybean diet, 3995 ± 500 mg/dL·40 min vs. casein diet, 4686 ± 576 mg/dL·40 min; p < 0.05). Thus, the soybean diet impaired the response to glucagon but did not alter gluconeogenesis.
Assuntos
Ração Animal , Glucagon/metabolismo , Gluconeogênese , Glycine max/metabolismo , Fígado/metabolismo , Efeitos Tardios da Exposição Pré-Natal , Desnutrição Proteico-Calórica/dietoterapia , Fatores Etários , Animais , Dieta com Restrição de Proteínas , Modelos Animais de Doenças , Feminino , Regulação Enzimológica da Expressão Gênica , Gluconeogênese/genética , Lactação , Fígado/enzimologia , Masculino , Estado Nutricional , Gravidez , Fenômenos Fisiológicos da Nutrição Pré-Natal , Desnutrição Proteico-Calórica/genética , Desnutrição Proteico-Calórica/metabolismo , Desnutrição Proteico-Calórica/fisiopatologia , Ratos WistarRESUMO
BACKGROUND: The use of enteral formulas with immunonutrients in patients with gastrointestinal malignancies susceptible to surgery can reduce postoperative morbidity, at the expense of reduced infectious complications, with the consequent reduction in hospital stay and health care costs. MATERIAL AND METHODS: Prospective randomized study. 84 patients operated on a scheduled basis for resectable colorectal cancer were recruited. In the group YES IN Impact © Oral was administered for 8 days (3 sachets a day), compared with the NOT IN group who did not receive it. RESULTS: 40.5% (17) patients without immunonutrition suffered infectious complications vs. 33.3% (14) of YES IN. In patients with rectal cancer NOT IN, 50% (8) suffered minor infectious complications (p=.028). In each group (YES IN, NOT IN, colon and rectal cancer) when infectious complications were observed, the variables total hospital stay and costs doubled, with significant differences. These variables showed higher values in the group NOT IN compared with those who received immunonutrition, although these differences were not statistically significant. CONCLUSIONS: NOT IN patients suffered infectious complications more frequently than YES IN, with significant results in the subgroup of patients with rectal cancer. The total hospital stay and costs were slightly higher in the group not supplemented, doubling in each category significantly (YES IN, NOT IN, colon and rectal cancer), when infectious complications were observed.
Assuntos
Adenocarcinoma/cirurgia , Neoplasias Colorretais/cirurgia , Nutrição Enteral , Custos de Cuidados de Saúde/estatística & dados numéricos , Cuidados Pré-Operatórios/métodos , Adenocarcinoma/complicações , Adenocarcinoma/economia , Adenocarcinoma/imunologia , Idoso , Idoso de 80 Anos ou mais , Neoplasias Colorretais/complicações , Neoplasias Colorretais/economia , Neoplasias Colorretais/imunologia , Proteínas Alimentares/administração & dosagem , Nutrição Enteral/economia , Feminino , Humanos , Tempo de Internação/economia , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios/economia , Estudos Prospectivos , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/dietoterapiaRESUMO
This study investigated the effects of pre- and postnatal conditions of protein deficiency followed to nutritional rehabilitation in the morphology of skeletal muscle. Twelve Wistar male rats were distributed in two groups: nourished (N), with normal protein diet and undernourished (U), with low protein diet. The respective diet was maintained until animals completed 21 days of life. After that, part of group U (n = 4) received normal protein diet, forming a third group, renourished group (R). Forty-two-day-old animals were euthanized and we performed histopathological and morphometric analysis of the soleus muscle. Analysis stained in hematoxylin and eosin (H&E) of the group N revealed polygonal and equidistant muscle fibers, with normal distribution in muscle fascicles. However, D group had rounded and disorganized fibers with different distances between them in muscle fascicles. R group presented muscle fibers with several formats, polygonal and rounded, and some muscle fascicles starting the reorganization process. In N group, analysis of the connective tissue showed predominance of type I collagen and a lower amount collagen type III, both well organized. Whereas U group had a predominance of disorganized type III collagen, in R group, there was return of type I collagen, but partially organized. Muscle fiber area of U (163.18 ± 52.55 µm2) and R (381.79 ± 26.62 µm2) groups was smaller than N (1229.2 µm2 ± 61.12 µm2). Muscle fibers density of groups U (3369 ± 1226 fibers/mm2) and R (1979 ± 28 fibers/mm2) was larger than N (830 ± 113 fibers/mm2). The nutritional rehabilitation in the present study showed an attempt of reorganization of the muscle tissue.
Assuntos
Dieta com Restrição de Proteínas/efeitos adversos , Proteínas Alimentares/administração & dosagem , Fibras Musculares Esqueléticas/patologia , Músculo Esquelético/patologia , Desnutrição Proteico-Calórica/patologia , Animais , Masculino , Fibras Musculares Esqueléticas/metabolismo , Músculo Esquelético/anatomia & histologia , Músculo Esquelético/metabolismo , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/metabolismo , Ratos , Ratos WistarRESUMO
We assessed the biological value of an okara diet and its effects on the hormonal and metabolic profile of rats submitted to protein restriction during intra-uterine life and lactation and recovered after weaning. Male rats from mothers fed either 17% or 6% protein during pregnancy and lactation were maintained on 17% casein (CC, LC), 17% okara (CO, LO) or 6% casein (LL) diets over 60 d. The nutritional quality of the okara protein was similar to that of casein. The okara diet was effective in the nutritional recovery of rats in growing that were malnourished in early life. Furthermore, the okara diet reversed the hypercholesterolemia and the hepatic steatosis observed in the malnutrition and prevented glucose intolerance in an animal model prone to diabetes mellitus.
Assuntos
Dieta , Fígado Gorduroso/prevenção & controle , Intolerância à Glucose/prevenção & controle , Hipercolesterolemia/prevenção & controle , Fenômenos Fisiológicos da Nutrição Materna , Proteínas de Plantas/uso terapêutico , Polissacarídeos/uso terapêutico , Desnutrição Proteico-Calórica/metabolismo , Animais , Caseínas/farmacologia , Diabetes Mellitus/etiologia , Diabetes Mellitus/metabolismo , Dieta com Restrição de Proteínas , Proteínas Alimentares/administração & dosagem , Proteínas Alimentares/metabolismo , Modelos Animais de Doenças , Fígado Gorduroso/etiologia , Fígado Gorduroso/metabolismo , Feminino , Intolerância à Glucose/etiologia , Intolerância à Glucose/metabolismo , Hipercolesterolemia/etiologia , Hipercolesterolemia/metabolismo , Masculino , Valor Nutritivo , Proteínas de Plantas/farmacologia , Polissacarídeos/farmacologia , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/dietoterapia , Ratos Wistar , Alimentos de Soja , Proteínas de Soja/farmacologia , Proteínas de Soja/uso terapêutico , Glycine maxRESUMO
RATIONAL: Among the alternatives to reverse chronic hemodialysis protein-energy malnutrition is the enhancement of intradialytic oral nutritional therapy. Although foods of animal origin are a source of nutrients and represent a feasible diet, there is uncertainty about their health consequences. OBJECTIVES: We assessed the relationship of intradialytic high-protein red meat snack supplementation with patient inflammatory status and protein losses (nitrogen) during this supplementation. Fourteen patients submitted to low-flux chronic hemodialysis for one month were divided into two groups receiving 2 g (group 1) and 29 g (group 2) of oral intradialytic protein during the initial phase, respectively. In the subsequent phase, group 1 was supplemented with 27 g protein (a red meat snack) for a total of 29 g per dialysis. Group 2 continued to receive 29 g protein. Nutritional status, total nitrogen losses through the dialysate and acute inflammatory phase protein (CRP) were assessed before and after dialysis. Reuse of the dialyzer was also determined on each occasion. MAIN FINDINGS: Red meat supplementation did not interfere with CRP, nitrogen loss through the dialysate (18 ± 7 to 19 ± 4 g in group 1, ns, and 20 ± 7 to 21 ± 4 g in group 2, ns) or with nutritional status. However, the data showed a positive correlation between pre- and post-hemodialysis CRP values (r = 0.84, p < 0.01) in both groups, suggesting an increase of the values after ultrafiltration. Reuse of the dialyzer was not correlated with CRP values. PRINCIPLE CONCLUSIONS: The results suggest that snacks were not acutely correlated with increased inflammatory levels and indicated that a protein-rich red meat snack may be beneficial for chronic hemodialysis patients.
Assuntos
Falência Renal Crônica/terapia , Carne , Estado Nutricional , Desnutrição Proteico-Calórica/dietoterapia , Diálise Renal , Adulto , Proteína C-Reativa/metabolismo , Feminino , Humanos , Inflamação/sangue , Inflamação/dietoterapia , Inflamação/patologia , Falência Renal Crônica/sangue , Masculino , Carne/efeitos adversos , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Desnutrição Proteico-Calórica/sangue , Diálise Renal/efeitos adversos , Adulto JovemRESUMO
Advances in the nutritional support of hospitalized patients in the early 1970s led to the recognition that tools were needed to evaluate the nutritional status of patients. The observation that malnutrition in patients receiving dialysis was associated with increased morbidity and mortality prompted many expert groups to develop nutritional scoring systems to be applied in these patients. Given the diverse and confusing terminologies that emerged from these publications, the International Society of Renal Nutritional and Metabolism convened an expert panel to recommend a new nomenclature and preferred methods to evaluate the nutritional status of patients with chronic kidney disease (CKD). The new and inclusive term protein-energy wasting (PEW) refers to a systematically defined condition based on certain criteria and reflects malnutrition and wasting caused not only by inadequate nutrient intake but also by depletion resulting from the inflammatory and noninflammatory conditions that prevail in this population. Serial assessment of nutritional status for detection and management of PEW is recommended using old and new scoring tools, including the Subjective Global Assessment (SGA), malnutrition inflammation score (MIS), Geriatric Nutritional Risk Index (GNRI), and PEW definition criteria. These tools, which are reliable methods and predictors of outcomes, are reviewed in this article.
Assuntos
Avaliação Nutricional , Desnutrição Proteico-Calórica/diagnóstico , Diálise Renal/efeitos adversos , Proteínas Alimentares/administração & dosagem , Ingestão de Energia , Humanos , Estado Nutricional , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/etiologia , Insuficiência Renal Crônica/complicações , Insuficiência Renal Crônica/dietoterapia , Insuficiência Renal Crônica/fisiopatologiaRESUMO
Introducción: algunos investigadores consideran que la malnutrición proteico energética es la complicación más frecuente en el paciente cirrótico y que constituye un elemento predictor independiente de supervivencia. Objetivos: determinar el estado nutricional y su relación con la causa, el tiempo de evolución y la ingesta calórica en pacientes con cirrosis hepática compensada. Métodos: se realizó un estudio observacional descriptivo de todos los pacientes gaboneses de ambos sexos, entre 15 y 60 años, con este diagnóstico. Se halló predominio de las mujeres y del grupo entre 45 y 54 años, con una edad media de 45 años (± 7,6). Prevalecieron la causa mixta y el grupo A de la clasificación de Child-Pugh-Turcotte. Todos tenían menos de 1 año desde el diagnóstico de la enfermedad y según el índice de masa corporal, la malnutrición proteico-energética se observó en 75 por ciento de los casos, predominó la delgadez moderada. La circunferencia del brazo se afectó con menor frecuencia e intensidad que el índice de masa corporal. En la medida que disminuyó el número de comidas al día aumentó el porcentaje de pacientes con malnutrición proteico-energética. Conclusiones: la frecuencia de malnutrición de la población cirrótica compensada fue elevada, con mayor índice de malnutrición en los casos de causa mixta, además, se comprobó que el estado nutricional del paciente cirrótico no puede ser valorado al margen de factores dietéticos
Introduction: some researchers believe that protein energy malnutrition is the most common complication in cirrhotic patients and it is an independent predictor of survival element. Objectives: to determine the nutritional status and its relationship to the cause, time of evolution and caloric intake in patients with compensated liver cirrhosis. Methods: a descriptive study of all Gabonese patients of both sexes, between the ages 15 and 60 years, with this diagnosis. Women and the group between 45 and 54 years was found predominant (mean age 45 years (± 7.6)). Additionally, mixed cause and group A in Child-Pugh-Turcotte widely existed. All patients had diagnosis of this disease for less than a year and according to their body mass index, protein-energy malnutrition was observed in 75 percent of cases; moderate thinness predominated. The arm circumference was less frequently and intensively affected than the body mass index. To the extent that the number of meals reduced per day, the percentage of patients with protein-energy malnutrition increased. Conclusions: the frequency of malnutrition of compensated cirrhotic population was high, with the highest rate of malnutrition in cases of mixed causes; it also was proved that the nutritional status of cirrhotic patient cannot be valued regardless of dietary factors
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Pessoa de Meia-Idade , Cirrose Hepática/complicações , Cirrose Hepática/terapia , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/prevenção & controle , Ingestão de Energia/fisiologia , Epidemiologia Descritiva , Estado Nutricional/fisiologia , Estudos Observacionais como AssuntoRESUMO
Proteinenergy malnutrition (PEM) causes a significant impairment of the immune system, the thymus being one of the most affected organs. It has been demonstrated that the administration of probiotic fermented milk (PFM) recovered the intestinal barrier, histological alterations and mucosal and systemic immune functions in a non-severe malnutrition model using BALB/c mice. The aim of the present study was to evaluate, in the same model of malnutrition, the effect of a PFM added to a re-nutrition diet on the recovery of the thymus, analysing histological and functional alterations caused by malnutrition. Mice were undernourished and divided into three groups according to the dietary supplement received during re-nutrition: milk, PFM or its bacterial-free supernatant (BFS). They were compared with well-nourished and malnourished mice. PFM was the most effective re-nutrition supplement to improve the histology of the thymus, decreasing cellular apoptosis in this organ and recovering the percentage of CD4þ/CD82 single-positive thymocytes. Immature doublepositive thymocytes were increased in the malnourished control (MC). The production of different cytokines in the thymus was increased in mice given PFM, compared with the mice that received other dietary supplements and MC. Mice given the BFS presented an improvement in the thymus similar to those that received milk. We demonstrated the importance of the whole PFM supplementation on the histological and functional recovery of the thymus in a non-severe PEM model.
Assuntos
Citocinas/metabolismo , Suplementos Nutricionais , Leite/microbiologia , Probióticos/uso terapêutico , Desnutrição Proteico-Calórica/dietoterapia , Timócitos/efeitos dos fármacos , Timo/efeitos dos fármacos , Animais , Apoptose/efeitos dos fármacos , Antígenos CD4/metabolismo , Feminino , Fermentação , Microbiologia de Alimentos , Proteína Kangai-1/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Desnutrição Proteico-Calórica/imunologia , Desnutrição Proteico-Calórica/metabolismo , Índice de Gravidade de Doença , Timócitos/metabolismo , Timo/citologia , Timo/imunologia , Timo/metabolismoRESUMO
Infantile malnutrition is known to be associated with cognitive and behavioral impairment during childhood and adolescence. Data pertaining to longer-term effects on behavioral outcomes in adulthood are limited. In this study, we report associations between infantile malnutrition and attention problems in adults at midlife. Attention problems were assessed by the Conners Adult ADHD Rating Scales (CAARS) and the Conners Continuous Performance Test (CPT) in 145 Barbadian adults (aged 37-43 y) who had been followed longitudinally since childhood. Previously malnourished participants (n = 80) had experienced moderate to severe protein-energy malnutrition in the first year of life and were successfully rehabilitated thereafter. They were compared with healthy adults (n = 65) who were former classmates of the index cases and who had been matched for age, sex, and handedness in childhood. Multiple regression analyses showed persisting effects of childhood malnutrition on both the CAARS and the CPT, independent of effects of household standard of living assessed in childhood. The malnutrition effect on the CAARS ratings was independent of IQ, whereas this effect was attenuated for the CPT after adjustment for IQ. Teacher-reported attention problems in childhood predicted attention problems in adulthood, indicating continuity over the life span. Infantile malnutrition may have long-term effects on attentional processes nearly 40 y after the episode, even with excellent long-term nutritional rehabilitation and independent of socioeconomic conditions in childhood and adolescence. This finding has major public health implications for populations exposed to early childhood malnutrition.
Assuntos
Transtorno do Deficit de Atenção com Hiperatividade/etiologia , Transtornos da Nutrição do Lactente/fisiopatologia , Desnutrição Proteico-Calórica/fisiopatologia , Transtorno do Deficit de Atenção com Hiperatividade/complicações , Barbados , Transtornos Cognitivos/complicações , Transtornos Cognitivos/etiologia , Estudos de Coortes , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Lactente , Transtornos da Nutrição do Lactente/dietoterapia , Transtornos da Nutrição do Lactente/psicologia , Transtornos da Nutrição do Lactente/reabilitação , Estudos Longitudinais , Masculino , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/psicologia , Desnutrição Proteico-Calórica/reabilitação , Escalas de Graduação Psiquiátrica , Análise de Regressão , Autorrelato , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Children with edematous severe acute malnutrition (SAM) produce less cysteine than do their nonedematous counterparts. They also have marked glutathione (GSH) depletion, hair loss, skin erosion, gut mucosal atrophy, and depletion of mucins. Because GSH, skin, hair, mucosal, and mucin proteins are rich in cysteine, we hypothesized that splanchnic extraction and the efficiency of cysteine utilization would be greater in edematous than in nonedematous SAM. OBJECTIVE: We aimed to measure cysteine kinetics in childhood edematous and nonedematous SAM. DESIGN: Cysteine flux, oxidation, balance, and splanchnic uptake (SPU) were measured in 2 groups of children with edematous (n = 9) and nonedematous (n = 10) SAM at 4.4 ± 1.1 d after admission (stage 1) and at 20.5 ± 1.6 d after admission (stage 2) when they had replenished 50% of their weight deficit. RESULTS: In comparison with the nonedematous group, the edematous group had slower cysteine flux at stage 1 but not at stage 2; furthermore, they oxidized less cysteine at both stages, resulting in better cysteine balance and therefore better efficiency of utilization of dietary cysteine. Cysteine SPU was not different between groups but was â¼45% in both groups at the 2 stages. CONCLUSION: These findings suggest that children with edematous SAM may have a greater requirement for cysteine during early and mid-nutritional rehabilitation because they used dietary cysteine more efficiently than did their nonedematous counterparts and because the splanchnic tissues of all children with SAM have a relatively high requirement for cysteine. This trial was registered at clinicaltrials.gov as NCT00069134.
Assuntos
Cisteína/metabolismo , Dieta , Edema/metabolismo , Transtornos do Crescimento/metabolismo , Transtornos da Nutrição do Lactente/metabolismo , Desnutrição Proteico-Calórica/metabolismo , Aumento de Peso/fisiologia , Cisteína/uso terapêutico , Edema/etiologia , Feminino , Transtornos do Crescimento/dietoterapia , Transtornos do Crescimento/etiologia , Humanos , Lactente , Transtornos da Nutrição do Lactente/complicações , Transtornos da Nutrição do Lactente/dietoterapia , Masculino , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/dietoterapiaRESUMO
BACKGROUND: In 2007, the Hospital Infantil Los Ángeles (HILA) in Colombia implemented a slightly-modified version of the WHO guidelines for the diagnosis and management of malnutrition during childhood. OBJECTIVE: To evaluate the efficacy of the WHO-HILA protocol in children hospitalized with severe, chronic marasmus and kwashiorkor malnutrition (MS-KWK) in 2007 and 2008. MATERIAL AND METHODS: In this descriptive retrospective study the records of 100 children hospitalized with MSKWK were initially evaluated. Of these, 30 fulfilled the inclusion criteria: children of both sexes with a primary diagnosis of MS-KWK. Patients with any chronic disease liable to cause malnutrition were excluded. Anthropometric parameters, clinical signs and biochemical indicators of malnutrition were assessed upon admission and again at discharge following application of the WHO guidelines. Univariate analysis was performed for each study variable; serum hemoglobin and albumin levels on admission and at discharge were compared, and data were subjected to bivariate analysis. RESULTS: Marasmus was diagnosed in 23.3% of children, kwashiorkor in 73.3% and marasmic kwashiorkor in 3.3%. The major clinical findings were: edema (70%), emaciation (40%), "flag sign" hair (42.86%), low serum albumin (93%) and anemia (80%). Thirteen children following the WHO-HILA protocol showed a significant nutritional status improvement (p<0.05), whereas no improvement was noted in the 17 children not treated according to the protocol. CONCLUSIONS: Application of the WHO-HILA protocol was associated with reduced morbimortality in children with marasmus-kwashiorkor malnutrition. Implementation of this protocol should therefore be considered in all children´s hospitals in countries where this disease is prevalent.
Assuntos
Kwashiorkor/dietoterapia , Desnutrição/dietoterapia , Desnutrição Proteico-Calórica/dietoterapia , Adolescente , Algoritmos , Anemia/etiologia , Peso Corporal/fisiologia , Criança , Pré-Escolar , Protocolos Clínicos , Colômbia , Feminino , Guias como Assunto , Cabelo/fisiologia , Hemoglobinas/análise , Humanos , Lactente , Kwashiorkor/complicações , Masculino , Desnutrição/complicações , Desnutrição Proteico-Calórica/complicações , Estudos Retrospectivos , Albumina Sérica/análise , Classe Social , Aumento de Peso , Organização Mundial da SaúdeRESUMO
The objective of this study was to analyze the aerobic capacity, through the maximal lactate steady-state (MLSS) protocol, of rats subjected to fetal protein malnutrition and recovered with a fructose-rich diet. Pregnant adult Wistar rats that were fed a balanced (17% protein) diet or a low-protein (6% protein) diet were used. After birth, the offspring were distributed into groups according to diet until 60 days of age: balanced (B), balanced diet during the whole experimental period; balanced-fructose (BF), balanced diet until birth and fructose-rich diet (60% fructose) until 60 days; low protein-balanced (LB), low-protein diet until birth and balanced diet until 60 days; and low protein-fructose (LF), low protein diet until birth and fructose-rich diet until 60 days. It was verified that the fructose-rich diet reduced body growth, mainly in the BF group. There was no difference among the groups in the load corresponding to the MLSS (B, 7.5+/-0.5%; BF, 7.4+/-0.6%; LB, 7.7+/-0.4%; and LF, 7.7+/-0.6% relative to body weight). However, the BF group presented higher blood lactate concentrations (4.8+/-0.9 mmol.L(-1)) at 25 min in the load corresponding to the MLSS (B, 3.2+/-0.9 mmol.L(-1); LB, 3.4+/-0.9 mmol.L(-1); and LF, 3.2+/-1.0 mmol.L(-1)). Taken together, these results indicate that the ability of young rats to perform exercise was not altered by intrauterine malnutrition or a fructose-rich diet, although the high fructose intake after the balanced diet in utero increased blood lactate during swimming exercises in rats.
Assuntos
Fenômenos Fisiológicos da Nutrição Animal , Dieta com Restrição de Proteínas/efeitos adversos , Sacarose Alimentar/administração & dosagem , Tolerância ao Exercício , Transtornos da Nutrição Fetal/dietoterapia , Fenômenos Fisiológicos da Nutrição Materna , Efeitos Tardios da Exposição Pré-Natal , Desnutrição Proteico-Calórica/dietoterapia , Fatores Etários , Animais , Glicemia/metabolismo , Peso Corporal , Proteínas Alimentares/sangue , Modelos Animais de Doenças , Feminino , Transtornos da Nutrição Fetal/metabolismo , Transtornos da Nutrição Fetal/fisiopatologia , Glicogênio/metabolismo , Cinética , Ácido Láctico/sangue , Fígado/metabolismo , Masculino , Gravidez , Desnutrição Proteico-Calórica/metabolismo , Desnutrição Proteico-Calórica/fisiopatologia , Ratos , Ratos Wistar , Recuperação de Função Fisiológica , Albumina Sérica/metabolismo , NataçãoRESUMO
OBJECTIVE: To investigate the effect of nutritional recovery with rice bran on energy balance, leptin and insulin levels. METHODS: Weaned Wistar rats were fed on a 17% (Control - C) or 0.5% (Aproteic - A) protein diet for 12d. After this, rats were kept on a C diet (C) or recovered with control (Recovered Control - RC) or control plus recovered rice bran diet (Recovered Rice Bran - RRB). RESULTS: Despite the increased food intake, group A exhibited lower carcass fat associated to low serum leptin. RRB and RC groups showed lower carcass weight and energy intake and expenditure. Energy expenditure was positively associated with food intake and carcass weight. Negative correlations between HOMA-IR and energy expenditure and energy intake were observed. CONCLUSION: Nutritional recovery with rice bran did not modify energy balance, leptin and insulin levels.
Assuntos
Fibras na Dieta/administração & dosagem , Ingestão de Energia/fisiologia , Insulina/metabolismo , Leptina/metabolismo , Oryza , Desnutrição Proteico-Calórica/dietoterapia , Animais , Animais Recém-Nascidos , Peso Corporal/fisiologia , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Masculino , Distribuição Aleatória , Ratos , Ratos WistarRESUMO
This article summarizes thirty years of intensive clinical metabolic and therapeutic studies of the consequences of severe protein deficiency relative to calories, which results in kwashiorkor, and of a balanced deficiency of protein and calories that results in marasmus. Evidence is provided that these are two different metabolic diseases, but kwashiorkor is usually superimposed on some degree of chronic marasmus and hence most cases studied were marasmic kwashiorkor. The value of the creatinine/height index to indicate the degree of lean body cell mass with any disease is demonstrated.
Assuntos
Academias e Institutos/história , Kwashiorkor/história , Desnutrição Proteico-Calórica/história , Estatura , América Central/epidemiologia , Creatinina/urina , História do Século XX , Humanos , Kwashiorkor/dietoterapia , Kwashiorkor/etiologia , Kwashiorkor/fisiopatologia , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/etiologia , Desnutrição Proteico-Calórica/fisiopatologia , Índice de Gravidade de DoençaRESUMO
This Special Issue summarizes the results of several studies aimed at providing information on a series of questions related to the adequate protein and energy intakes that allow adequate growth and function in children and work performance and productivity in adults. The effect of different sources of protein on nitrogen balance and the requirements of essential amino acids in young children were also explored in fully recovered, previously malnourished children housed in the Metabolic Ward of the Biomedical Division of INCAP. The following are the main results of these investigations: Animal experiments and studies in children recovering from protein-energy malnutrition (PEM) strongly suggest that even when requirements of all nutrients are satisfied, inactivity reduces the rate of linear growth and physical activity improves it as well as lean body mass repletion. The effects of different energy intakes on nitrogen balance demonstrated how energy intake modifies the need to ingest different amounts of protein to satisfy protein requirements. Insensible nitrogen losses in preschool children and their relation to protein intake was demonstrated. The quality of even "good protein sources" modifies the amount needed to satisfy nitrogen requirements, and corn and bean-based diets can satisfy protein needs for health and even growth of young children. Essential amino acid requirements of 2-year-old children was assessed by diverse measurements of nitrogen metabolism and amino acid levels in blood, and were found lower than those recommended by FAO-WHO. In rural adult populations the relationship between energy and protein intake, productivity and body composition, and the impact of environmental hygiene on nitrogen balance was demonstrated and measured.
Assuntos
Academias e Institutos/história , Aminoácidos/metabolismo , Proteínas Alimentares/metabolismo , Metabolismo Energético , Desnutrição/história , Adulto , Animais , Composição Corporal , América Central , Criança , Desenvolvimento Infantil , Pré-Escolar , História do Século XX , Humanos , Desnutrição/fisiopatologia , Atividade Motora , Política Nutricional/história , Necessidades Nutricionais , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/história , Desnutrição Proteico-Calórica/fisiopatologia , Análise e Desempenho de TarefasRESUMO
Anemia is highly prevalent, especially in poorly nourished populations living in unsanitary conditions. Studies of the Central American population showed that iron was the predominant deficient hematopoietic micronutrient and that correction of nutrient deficiencies led to hematological normality as defined by WHO. The bioavailability of diverse iron compounds added to the mostly vegetable diets of such populations showed the superior absorption of chelated iron (NaFeEDTA) and its strong effectiveness in correcting iron deficiency when added to sugar. The consequences on development and mental behavioral functions as well as on work capacity of iron deficiency and anemia in infants, children and adults, and the positive effects of their correction was demonstrated. In protein-energy malnourished (PEM) children, the deficit in active tissue mass (basal oxygen consumption) and in total hemoglobin content were closely related. This relationship persisted as the rates of active tissue mass repletion was modified by levels of protein intake. This demonstrated the strong adaptive nature of hemoglobin content in response to oxygen needs in PEM and during recovery. Gastrointestinal functions in PEM and in populations demonstrated the bacterial invasion of the upper GI tract and how this resulted in secondary bile acids that are toxic to the intestinal mucosal cells impairing their absorptive functions. Environmental hygiene in populations reversed gut bacterial migration and improved GI function.
Assuntos
Academias e Institutos/história , Anemia Ferropriva/história , Trato Gastrointestinal/fisiopatologia , Infecções/história , Desnutrição Proteico-Calórica/história , Anemia Ferropriva/epidemiologia , Anemia Ferropriva/fisiopatologia , Anemia Ferropriva/prevenção & controle , América Central/epidemiologia , Sacarose Alimentar , Ácido Edético/administração & dosagem , Ácido Edético/uso terapêutico , Compostos Férricos/administração & dosagem , Compostos Férricos/uso terapêutico , Alimentos Fortificados/história , História do Século XX , Humanos , Higiene , Infecções/complicações , Infecções/fisiopatologia , Política Nutricional/história , Inquéritos Nutricionais , Desnutrição Proteico-Calórica/complicações , Desnutrição Proteico-Calórica/dietoterapia , Desnutrição Proteico-Calórica/fisiopatologiaRESUMO
There is evidence suggesting an association between fructose consumption and the development of metabolic syndrome. In turn, protein malnutrition in utero is proposed to "program" the fetal tissues, making them more susceptible to nutritional associated disorders. To test this hypothesis, the present study was designed to analyze body growth and metabolic aspects of rats subjected to fetal protein malnutrition and subsequently fed a fructose-rich diet. Wistar rats were distributed into 4 groups: balanced (B) diet-B diet offered the entire experimental period; balanced diet/fructose-B diet until birth and fructose-rich diet (F-60% fructose) until adulthood; low-protein (L) diet/balanced-L diet until birth and B diet until adulthood; low-protein diet/fructose (F)-L diet until birth and F diet until adulthood. After nutritional recovery, there was a restoration of serum glucose, total protein, and albumin concentrations, which were reduced by fetal malnutrition, and a restoration of the liver glycogen and lipids contents, which were increased by fetal malnutrition. This restoration was independent of the diet adopted after birth. It was verified that the high fructose diet arrested body growth of the rats independently of the nutritional state during fetal life and was associated with weight reduction and decrease of the adipose in some regions of the body (P < .05). Moreover, the serum concentrations of triglycerides and total cholesterol, which are indicators of metabolic syndrome, rose in the rats that ingested the fructose-rich diet (P < .05). In summary, high consumption of fructose impairs body growth and alters the circulating lipids independently of the protein nutrition in utero.
Assuntos
Sacarose Alimentar/administração & dosagem , Transtornos da Nutrição Fetal/fisiopatologia , Frutose/farmacologia , Crescimento/efeitos dos fármacos , Metabolismo dos Lipídeos , Desnutrição Proteico-Calórica/fisiopatologia , Aumento de Peso/efeitos dos fármacos , Albuminas/metabolismo , Animais , Glicemia , Dieta com Restrição de Proteínas , Feminino , Desenvolvimento Fetal/efeitos dos fármacos , Transtornos da Nutrição Fetal/dietoterapia , Glicogênio Hepático/metabolismo , Masculino , Gravidez , Efeitos Tardios da Exposição Pré-Natal , Desnutrição Proteico-Calórica/dietoterapia , Proteínas/metabolismo , Ratos , Ratos WistarRESUMO
OBJECTIVE: To investigate the effect of nutritional recovery with rice bran on energy balance, leptin and insulin levels. METHODS: Weaned Wistar rats were fed on a 17 percent (Control - C) or 0.5 percent (Aproteic - A) protein diet for 12d. After this, rats were kept on a C diet (C) or recovered with control (Recovered Control - RC) or control plus recovered rice bran diet (Recovered Rice Bran - RRB). RESULTS: Despite the increased food intake, group A exhibited lower carcass fat associated to low serum leptin. RRB and RC groups showed lower carcass weight and energy intake and expenditure. Energy expenditure was positively associated with food intake and carcass weight. Negative correlations between HOMA-IR and energy expenditure and energy intake were observed. CONCLUSION: Nutritional recovery with rice bran did not modify energy balance, leptin and insulin levels.
OBJETIVO: Investigar o efeito da recuperação nutricional com farelo de arroz sobre o balanço energético e níveis de leptina e insulina. MÉTODOS: Ratos Wistar recém-desmamados foram alimentados com 17 por cento (Controle - C) ou 0,5 por cento (Aproteico - A) de proteína (caseína) durante 12 dias. Em seguida, ratos permaneceram com dieta controle (C) ou foram recuperados com controle (Recuperados Controle - RC) ou controle mais 5 por cento de farelo de arroz (Recuperados com Farelo de Arroz - RFA) durante 21 dias. RESULTADOS: Apesar de a ingestão alimentar ter sido maior em A, a gordura na carcaça foi reduzida, sendo associada com menor nível de leptina. Os grupos RFA e RC tiveram redução no peso da carcaça, no gasto e ingestão de energia. O gasto energético foi correlacionado com a ingestão de alimentos e o peso da carcaça fresco. Foi observada correlação negativa entre HOMA-IR com gasto energético e com ingestão de energia. CONCLUSÃO: A recuperação nutricional com farelo de arroz não modificou o balanço energético, nem os níveis de leptina e insulina.
Assuntos
Animais , Masculino , Ratos , Fibras na Dieta/administração & dosagem , Ingestão de Energia/fisiologia , Insulina/metabolismo , Leptina/metabolismo , Oryza , Desnutrição Proteico-Calórica/dietoterapia , Animais Recém-Nascidos , Peso Corporal/fisiologia , Modelos Animais de Doenças , Ingestão de Alimentos/fisiologia , Distribuição Aleatória , Ratos WistarRESUMO
Although studying the effect of supplementation on maternal health or the outcome of pregnancy was not a primary goal of the Institute of Nutrition of Central America and Panama Oriente Longitudinal Study, many important findings in these areas were produced. As part of the study, a food supplementation program was implemented. Two villages received Atole, a gruel containing protein and energy, and 2 matched villages received a refreshing, low-energy drink containing no protein. Both drinks contained micronutrients. Some women did not choose to consume the supplements and those who did consumed widely varying amounts. More volume of Fresco was consumed than Atole. The energy in the supplements improved birthweight, with no apparent additional benefit from protein or micronutrients. Researchers identified several groups of women who benefited from supplementation more than others by having babies with higher birthweights, including those with poorer current nutritional status and those who consumed high amounts of the supplement continuously from one pregnancy to the next. Results from the study provided an early indication that supplementation might increase the duration of gestation and, thus, reduce preterm birth. On the other hand, maternal supplementation did not substantially alter the duration of postpartum amenorrhea once concurrent infant supplementation was taken into account. Finally, findings from this study provided evidence of a biological trade-off between maintenance of maternal nutritional status and increasing fetal size that was responsive to both current maternal nutritional status and supplement intake but not to the mother's nutritional status earlier in life.