RESUMO
BACKGROUND: The aim of the study was to investigate oxidative stress, muscle damage, enzymatic antioxidant defense and body composition in senior adults who have performed different lifelong physical activity practices. METHODS: Twenty-three healthy senior men (60±1.88 years old) were divided into three groups according to their lifelong physical activity practice as follows: A) sedentary (N.=7); B) recreational (N.=9); and C) amateur (N.=7). Blood sampling was performed at rest to analyze plasma malondialdehyde (MDA) by TBARs-assay, nuclear DNA-damage in peripheral lymphocytes using Comet-Assay, the plasma enzymatic activity of glutathione peroxidase by spectrophotometry and serum alpha-actin release as skeletal muscle damage marker through western blot. Body composition was evaluated using anthropometric assessments by the ISAK protocol through skinfold thickness. RESULTS: The lowest value of MDA was shown in the amateur group. Nuclear DNA-damage was significantly lower in the recreational group than in sedentary and amateur groups (MD=5.53±1.70; P=0.013. MD=5.61±1.62; P=0.008), respectively. The amateur group showed trends toward higher glutathione peroxidase enzymatic activity than recreational and sedentary groups. Alpha-actin levels were significantly higher in the amateur compared with recreational (MD=4.34±0.46; P<0.001) and sedentary groups (MD=4.89±0.46; P<0.001). The sedentary group showed significantly lower muscle mass (MD=3.67±1.10; P=0.011) and higher fat mass (MD=4.19±0.98; P=0.001) than amateur group. CONCLUSIONS: The results described above suggest that the lifelong amateur endurance practice seems to improve oxidative stress response and strengthens hypertrophy mechanisms that might preserve muscle mass in senior adults.
Assuntos
Exercício Físico/fisiologia , Estresse Oxidativo/fisiologia , Resistência Física/fisiologia , Síndrome de Emaciação/prevenção & controle , Antioxidantes , Biomarcadores/sangue , Dano ao DNA , Glutationa Peroxidase/sangue , Humanos , Masculino , Malondialdeído/sangue , Pessoa de Meia-Idade , Oxirredução , Comportamento de Redução do RiscoRESUMO
BACKGROUND: Nutrition rehabilitation centers (NRCs) have shown mixed results in reducing morbidity and mortality among undernourished children in the developing world. Follow-up on children after leaving these programs remains undocumented. OBJECTIVE: To assess the nutritional improvement of children attending the Centro de Rehabilitación Infantil Nutricional (CRIN), a residential NRC in rural Bolivia, from entrance to exit and to a household follow-up visit 1 month to 6 years later, and to identify factors associated with nutritional improvement. METHODS: A retrospective analysis was conducted of clinical records collected by CRIN staff from 135 children under 3 years of age attending CRIN in rural Cochabamba, Bolivia, from 2003 to 2009, and of clinical records of household follow-up measurements on a subset of 26 children that were taken between 1 month and 6 years postexit. Nutritional status was evaluated by calculating z-scores for weight-for-height (WHZ), weight-for-age (WAZ), and height-for-age (HAZ). Children with z-scores < -2 were considered to be wasted, underweight, or stunted, respectively. RESULTS: The prevalence of wasting decreased significantly, while the prevalence of stunting did not change significantly between entrance and exit from the program. From entrance to exit, the mean changes in WHZ (0.79) and WAZ (1.08) were statistically significant, while the mean change in HAZ (-0.02) was not significant. Linear regression analysis suggested that nutritional status and diarrhea at entrance had the greatest effect on WHZ and HAZ changes between entrance and exit. Children maintained their nutritional gains from the program between exit and follow-up and showed statistically significant improvement in WAZ (but not HAZ). CONCLUSIONS: CRIN is effective at rehabilitating nutritional deficits associated with wasting, but not those associated with stunting.
Assuntos
Desnutrição/reabilitação , Estatura , Peso Corporal , Bolívia , Pré-Escolar , Centros Comunitários de Saúde , Feminino , Humanos , Lactente , Masculino , Desnutrição/mortalidade , Estado Nutricional , Estudos Retrospectivos , População Rural , Resultado do Tratamento , Síndrome de Emaciação/prevenção & controleRESUMO
Addressing malnutrition in all its forms represents an integrated agenda addressing the root causes of malnutrition at all stages of the life course. The issue is not about choosing between addressing undernutrition in the poor versus overnutrition in the affluent. We must recognize that the interventions required to address stunting are different from those needed to reduce underweight and wasting. In most developing regions, there is a coexistence between underweight and stunting in infants and children, while in the adult population it may be overweight and stunting. Malnutrition in all its forms refers to both underweight and overweight. Underweight is defined by a low weight-for-age, a child is underweight because of wasting (low weight-for-height) or stunting (low length-for-age). Stunting refers to low height-for-age independent of their weight-for-age, some stunted children may have excess weight for their stature length. Overweight is excess weight-for-length/-height or high-BMI-for-age. The prevention of nutrition-related chronic diseases is a life-long process that starts in fetal life and continues throughout infancy and later stages of life. It requires promoting healthy diets and active living at each stage. The agenda requires that we tackle malnutrition in all its forms.
Assuntos
Índice de Massa Corporal , Efeitos Psicossociais da Doença , Promoção da Saúde , Desnutrição , Estado Nutricional , Obesidade , Magreza , Adulto , Estatura , Criança , Doença Crônica/prevenção & controle , Transtornos do Crescimento/dietoterapia , Transtornos do Crescimento/etiologia , Transtornos do Crescimento/prevenção & controle , Humanos , Lactente , Desnutrição/complicações , Desnutrição/dietoterapia , Desnutrição/prevenção & controle , Obesidade/dietoterapia , Obesidade/etiologia , Obesidade/prevenção & controle , Sobrepeso/dietoterapia , Sobrepeso/etiologia , Sobrepeso/prevenção & controle , Magreza/dietoterapia , Magreza/etiologia , Magreza/prevenção & controle , Síndrome de Emaciação/dietoterapia , Síndrome de Emaciação/etiologia , Síndrome de Emaciação/prevenção & controleRESUMO
A common observation in sickle cell disease is growth retardation, in particular, wasting. Wasting is associated with increased hospitalization and possibly poorer clinical outcomes. Therefore understanding the mechanism of wasting is crucial and reducing the degree of wasting by improving the nutritional status, holds the potential for modifying the course of the disease.
Assuntos
Anemia Falciforme/complicações , Desnutrição/prevenção & controle , Síndrome de Emaciação/etiologia , Adulto , Anemia Falciforme/metabolismo , Anemia Falciforme/fisiopatologia , Anorexia/etiologia , Anorexia/fisiopatologia , Regulação do Apetite/fisiologia , Metabolismo Basal , Composição Corporal , Criança , Ingestão de Energia , Metabolismo Energético , Feminino , Hemólise/fisiologia , Humanos , Mediadores da Inflamação/fisiologia , Masculino , Desnutrição/etiologia , Atividade Motora , Estado Nutricional , Síndrome de Emaciação/prevenção & controle , Adulto JovemRESUMO
The integration of nutrition support for infants of HIV-infected mothers is a recognized need; however, the evidence for effective programmatic solutions is weak. The objective of our study was to implement and evaluate a new infant feeding support intervention for HIV-exposed, uninfected, non-breast-fed infants 6-12 mo of age attending the Groupe Haïtien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) pediatric clinic in Port-au-Prince, Haiti. The 24-wk intervention included a lipid-based nutrient supplement, education, promotion of existing clinical services, and social support. We compared growth outcomes among intervention participants (n = 73) at start (wk 0) and end (wk 24) of intervention to a historical control group of HIV-exposed infants seen at the GHESKIO in the year prior to the intervention who would have met the intervention entrance criteria (n = 294). The intervention and historical control groups did not differ significantly at age 6 mo (wk 0). At age 12 mo (wk 24), the intervention group had a lower prevalence of underweight and stunting than the historical control group (weight-for-age Z-score < -2 SD: 6.8 vs. 20.8%, P = 0.007; length-for-age Z-score < -2 SD: 9.6 vs. 21.2%, P = 0.029). Wasting tended to be lower in the intervention group than the historical control (weight-for-length Z-score < -2 SD: 2.9 vs. 8.9%, P = 0.11). Implementation of the intervention was associated with reduced risk of growth faltering in HIV-exposed uninfected children from 6 to 12 mo of age. This is a promising intervention model that can be adapted and scaled-up to other HIV care contexts.
Assuntos
Desenvolvimento Infantil , Suplementos Nutricionais , Transtornos do Crescimento/prevenção & controle , Soropositividade para HIV , Magreza/prevenção & controle , Síndrome de Emaciação/prevenção & controle , Instituições de Assistência Ambulatorial , Estatura , Peso Corporal , Estudos Transversais , Suplementos Nutricionais/análise , Feminino , Serviços de Alimentação , Alimentos Fortificados/análise , Transtornos do Crescimento/epidemiologia , Transtornos do Crescimento/etiologia , Soropositividade para HIV/fisiopatologia , Haiti/epidemiologia , Humanos , Lactente , Masculino , Prevalência , Risco , Magreza/epidemiologia , Magreza/etiologia , Saúde da População Urbana , Síndrome de Emaciação/epidemiologia , Síndrome de Emaciação/etiologiaRESUMO
Public health interventions aimed at children in Mexico have placed the country among the seven countries on track to achieve the goal of child mortality reduction by 2015. We analysed census data, mortality registries, the nominal registry of children, national nutrition surveys, and explored temporal association and biological plausibility to explain the reduction of child, infant, and neonatal mortality rates. During the past 25 years, child mortality rates declined from 64 to 23 per 1000 livebirths. A dramatic decline in diarrhoea mortality rates was recorded. Polio, diphtheria, and measles were eliminated. Nutritional status of children improved significantly for wasting, stunting, and underweight. A selection of highly cost-effective interventions bridging clinics and homes, what we called the diagonal approach, were central to this progress. Although a causal link to the reduction of child mortality was not possible to establish, we saw evidence of temporal association and biological plausibility to the high level of coverage of public health interventions, as well as significant association to the investments in women education, social protection, water, and sanitation. Leadership and continuity of public health policies, along with investments on institutions and human resources strengthening, were also among the reasons for these achievements.
Assuntos
Causas de Morte , Mortalidade da Criança/tendências , Pobreza , Saúde Pública/tendências , Síndrome de Emaciação/epidemiologia , Adolescente , Adulto , Pré-Escolar , Escolaridade , Feminino , Hidratação/tendências , Humanos , Lactente , Recém-Nascido , Sarampo/epidemiologia , Sarampo/mortalidade , Sarampo/prevenção & controle , México/epidemiologia , Pessoa de Meia-Idade , Estado Nutricional , Prevalência , Síndrome de Emaciação/prevenção & controle , Síndrome de Emaciação/terapiaRESUMO
OBJECTIVE: To estimate the effect of supplementary feeding on the prevention of wasting in preschool children in a rural area of Guatemala with a high prevalence of malnutrition. METHODS: Children aged 6-48 months, with a weight-for-length exceeding 90% of that of the median NCHS/WHO/CDC reference population, received either Atole, a drink with a high protein and moderate energy content, or Fresco, a drink with no protein and a low energy content. Children consuming amounts of Atole equivalent to more than 10% of the age-adjusted recommended dietary intake for energy were termed "supplemented." A comparable group of children consuming Fresco was termed "non-supplemented". The energy intake in the supplemented group was higher than that in the non-supplemented group by 16-18% of the recommended daily intake. The corresponding difference in protein intake was 45-80% of the recommended daily intake. The children were followed up at intervals of three or six months in order to evaluate their weight-for-length development. The difference between supplemented and non-supplemented children in the proportions maintaining their weight-for-length category at the end of the study intervals represented the prevention of wasting attributable to supplementary feeding (attributable prevention). Households were used as units of analysis in order to avoid cluster effects. FINDINGS: The attributable prevention in children aged 6-24 months with weight-for-length between 90% and 99.9% of the reference population at entry ranged from 0.21 to 0.26 and was statistically significant after three and six months of supplementation. However, it was not significant in children at or above 100% weight-for-length or in older children. Children above 100% weight-for-length did not become overweight as a result of supplementation. CONCLUSION: Supplementary feeding of children aged 6-24 months in populations with inadequate dietary intakes can prevent the onset of wasting in a large proportion of children.
Assuntos
Fenômenos Fisiológicos da Nutrição Infantil , Suplementos Nutricionais/estatística & dados numéricos , Alimentos Fortificados , Fenômenos Fisiológicos da Nutrição do Lactente , Distúrbios Nutricionais/dietoterapia , Síndrome de Emaciação/prevenção & controle , Peso Corporal , Pré-Escolar , Proteínas Alimentares/administração & dosagem , Doenças Endêmicas , Guatemala/epidemiologia , Humanos , Lactente , Distúrbios Nutricionais/complicações , Distúrbios Nutricionais/epidemiologia , Estado Nutricional , Fatores de Tempo , Resultado do Tratamento , Síndrome de Emaciação/dietoterapia , Síndrome de Emaciação/etiologiaRESUMO
The key analytical challenge presented by longitudinal data is that observations from one individual tend to be correlated. Although longitudinal data commonly occur in medicine and public health, the issue of correlation is sometimes ignored or avoided in the analysis. If longitudinal data are modelled using regression techniques that ignore correlation, biased estimates of regression parameter variances can occur. This bias can lead to invalid inferences regarding measures of effect such as odds ratios (OR) or risk ratios (RR). Using the example of a childhood health intervention in Brazil, we illustrate how ignoring correlation leads to incorrect conclusions about the effectiveness of the intervention.