International Journal of Nutrology
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Individualized parenteral nutrition guideline: the challenge of trace elements
Get PDFParenteral nutrition (PN) is one of the pharmacological therapies that makes it possible to save lives previously condemned to death. PN entered clinical practice in the mid-1960s and was one of the most important advances in medicine after the discovery of anesthetics, antibiotics, and antisepsis methods. PN, however, is not without risks, as it is considered a high-alert medication that involves a significant risk of harm when used incorrectly. PN is the most complex existing pharmacological preparation with 20 to 40 active ingredients, the process of its application being transdisciplinary and its safety dependent on individual competence and reliable performance in each of its stages. The correct, individualized, and safe prescription of trace elements represents one of the biggest challenges in this process
Nutrological and pharmacological approaches to cancer cachexia: a systematic review
Get PDFIntroduction: Cancer cachexia (CC) is a multifactorial syndrome that is generally characterized by the continuous loss of skeletal muscle mass with or without fat loss, often accompanied by anorexia, weakness, and fatigue. Cancer cachexia is associated with poor tolerance to antitumor treatments, reduced quality of life, and a negative impact on survival. Unintentional weight loss has been associated with a negative impact on multiple outcomes in cancer patients, including survival and quality of life. Objective: It was to present the main evidence of the nutrological and pharmacological treatment of cancer cachexia through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from October a December 2023 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. A total of 67 articles were evaluated and 24 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 10 studies with a high risk of bias and 10 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X2=74.5%>50%. Based on the results, symptoms associated with cancer cachexia are thought to be caused by tumor-induced changes in host metabolism that result in systemic inflammation and abnormal neurohormonal responses. The sarcopenia seen in many patients with cancer cachexia is caused, in part, by increased activation of circulating proteolysis-inducing factor (PIF) and skeletal muscle protein breakdown by the ubiquitin-proteasome pathways. The nutritional consequences of cancer treatments must be identified early with screening and assessment of nutritional status. Nutritional intervention includes screening and appropriate nutritional assessment, which should begin early in the disease course to reduce or delay negative effects on therapy and quality of life. Liquid nutritional supplements may be useful to help increase caloric intake. Numerous investigations have reported orexigenic activity associated with progestational agents such as megestrol acetate and medroxyprogesterone. Megestrol acetate has received the most attention in randomized controlled trials of cancer patients. Also noteworthy was the use of corticosteroids and mirtazapine for weight gain and pain control
Major considerations of enteral nutritional therapy in patients with congestive heart failure: a systematic review
Get PDFIntroduction: Nutrition in the cardiovascular area has focused on improving lifestylerelated diseases such as hypertension, diabetes, dyslipidemia, obesity, and metabolic syndrome from the point of view of primary and secondary prevention, that is, “nutrition for weight loss ” and nutritional guidance has been required. Congestive heart failure (CHF) is a serious and growing public health problem worldwide. Approximately 25 million people are carriers of this disease and two million new cases are diagnosed each year, and enteral nutrition has been highlighted. Objective: It was to develop a systematic review of the main clinical outcomes that highlight the importance of enteral nutritional therapy in patients with congestive heart failure. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from October to November 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 143 articles were found. A total of 45 articles were evaluated and 34 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 21 studies with a high risk of bias and 17 studies that did not meet GRADE and AMSTAR-2. It was concluded enteral nutrition is highly recommended in an attempt to mitigate weight loss in these patients. Enteral diet therapy can be infused continuously or intermittently. Studies have shown that more debilitated and less active patients better accept the diet via continuous tube, slowly and for a long period, even in those with heart disease
Major types of diets in the management of metabolic syndrome and obesity: a systematic review
Get PDFIntroduction: Excessive weight gain generates comorbidities, many of which are characterized as metabolic syndrome (MS), in which the individual, to be diagnosed, must present three or more metabolic or anthropometric changes such as increased waist circumference, systemic arterial hypertension, hyperglycemia, hypertriglyceridemia, and reduced serum HDL levels. It is important to highlight the association of MS with cardiovascular diseases, increasing global mortality by approximately 1.5 times and cardiovascular mortality by approximately 2.5 times. In this sense, of the different types of diets such as the low-carb diet, very low-carb diet, and intermittent fasting diet, the traditional Brazilian diet, the DASH, and the Mediterranean diet stand out, as they present as the main therapeutic proposal in the treatment of MS. Objective: It was to carry out a systematic review to present the main types of diets in the management of metabolic syndrome, evaluating their effectiveness as a nutritional benefit in controlling health and quality of life. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from April to June 2024 in the Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE and AMSTAR-2 instrument and the risk of bias was analyzed appropriately. according to the Cochrane instrument. Results and Conclusion: 111 articles were found, and 30 were evaluated in full and included in this article, 21 of which were included in the systematic review. Considering the Cochrane tool for risk of bias, the global assessment resulted in 12 studies with a high risk of bias and 21 studies that did not reach GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=79.8%>50%. It was concluded that the traditional Brazilian diet, DASH, and the Mediterranean diet have in common the characteristics of plant-based diet varieties that incorporate natural foods and reduce ultra-processed foods. These diets have shown good results for human health through the prevention and treatment of obesity in its different life cycles, and there is also evidence of a reduction in the risk of cardiovascular diseases and cancer in individuals with obesity. Furthermore, these diets promote a decrease in low-grade inflammation that affects individuals with obesity, having beneficial effects in reducing metabolic syndrome, even more so when added to physical activities. It has been shown that dietary factors can play a fundamental role both in the individual components and in the prevention and control of metabolic syndrome. Recent data associate the presence of metabolic syndrome with lower consumption of whole grains, fruits, and vegetables
Health promotion through the adoption of the mediterranean diet as a therapeutic proposal in the treatment and prevention of metabolic syndrome: a systematic review
Get PDFIntroduction: Excessive weight gain generates comorbidities, many of which are characterized as metabolic syndrome (MetS). It is important to highlight the association of MetS with cardiovascular diseases, increasing global mortality by approximately 1.5 times and cardiovascular mortality by approximately 2.5 times. In this sense, the Mediterranean diet presents itself as the main therapeutic proposal in the treatment of MetS, as it corresponds to caloric limitations without altering the patient's adequate nutritional status. Objective: It was to investigate the effects of health promotion through the adoption of the Mediterranean diet as a therapeutic proposal in the treatment and prevention of metabolic syndrome, evaluating the nutritional benefit on quality of life. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from April to June 2024 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 157 articles were found. A total of 26 articles were evaluated in full and 21 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 29 studies with a high risk of bias and 28 studies that did not meet GRADE and AMSTAR-2. It was concluded that the studies showed the beneficial effects of the Mediterranean diet in reducing the prevalence of MetS. Furthermore, the dietary pattern described in the Mediterranean diet combined with physical activities can be used as a useful clinical tool in the treatment of metabolic syndrome. The suggested menu, with foods rich in fiber, is associated with reducing cardiovascular risk and, therefore, the Mediterranean diet is recognized as an agent for promoting health and preventing and treating obesity. In this sense, it appears that dietary factors can play a fundamental role both in the individual components and in the prevention and control of metabolic syndrome. Recent data associate the presence of MetS with lower consumption of whole grains, fruits, and vegetables. Therefore, there is a close relationship between these foods and dietary fiber, and, probably, soluble fiber is more directly related to these effects. A reduced prevalence of MetS was also observed in patients with systemic lupus erythematosus, a result of the good level of adherence to the Mediterranean diet. Furthermore, 25(OH)D status is associated with the composition, diversity, and functionality of the gut microbiota, and lifestyle intervention can modulate both the gut microbiota and 25(OH)D levels, potentially influencing metabolic pathways
Major outcomes in heart failure and cardiovascular diseases of the use of vitamin D, ubiquinone, and magnesium in nutrological cardiology: a systematic review
Get PDFIntroduction: Heart failure (HF) and cardiovascular diseases (CVD) are the main causes of death in the population. According to data from the World Health Organization for 2023, of the 21.5 million deaths from these diseases. The beneficial metabolic effects of magnesium, vitamin D, and ubiquinone (coenzyme Q10) can be highlighted. Objective: It was to scientifically analyze the influence of the three elements Magnesium, Vitamin D, and ubiquinone (Coenzyme Q10) concerning heart failure, cardiovascular diseases and metabolic syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from June to July 2024 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 154 articles were found, and 80 articles were evaluated and 78 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 18 studies with a high risk of bias and 26 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =96.8% >50%. It was concluded that magnesium plays a fundamental role in glucose metabolism, insulin, and glycemic homeostasis, in the synthesis of adenosine triphosphate, proteins, and nucleic acids. However, further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases, especially concerning higher concentrations and increased treatment time. Vitamin D plays important roles in innate and adaptive immune responses, cell cycle, and metabolic processes, evidenced by the reported relationship between its deficiency and the prevalence of immune-mediated disorders, cancer, and cardiometabolic diseases. Coenzyme Q10 exerts an important protective antioxidant action. Clinical studies carried out showed that pathologies such as acute myocardial infarction, arterial hypertension, myopathies induced by statins, physical fatigue inherent to physical exercise, male infertility, pre-eclampsia, Parkinson's disease, periodontal diseases, and migraines had low plasma concentrations of Q10. In addition, Coenzyme Q10 reduces the amount of lipid peroxide found in atherosclerotic lesions. Thus, Q10 protects the lipids present in cell membranes, as well as plasma lipoproteins
Anorexics and saints
Get PDFIn the Middle Ages, some Catholic saints fasted frequently. The specialized literature invariably has a critical bias, as if they suffered from a psychopathology. This article counters this view based on Theology, Catholic Doctrine, and Nutrology
Clinical studies and meta-analysis on the effects of collagen, vitamin, and nutrient supplementation for the rejuvenation of collagenic fibers: a systematic review
Get PDFIntroduction: Collagen prevails in connective tissues, constituting 80% of the dry weight of human skin. Aging induces a decline in enzymes involved in the post-translational processing of collagen, reducing the number of fibroblasts that synthesize collagen and the vessels that irrigate the skin. Oral ingestion of hydrolyzed collagen together with vitamins and nutrients (especially apple exosomes) increases the levels of collagenderived peptides in the bloodstream and improves skin properties. Objective: It was to carry out a systematic review to elucidate the main results of clinical studies and meta-analyses of clinical studies on the effects of supplementation of types of collagen, vitamins, and nutrients for the rejuvenation of collagen fibers. Methods: The search was carried out from October to December 2023 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found, and 12 articles were evaluated in full, and 07 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 20 studies with a high risk of bias and 26 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=62.4%>50%. Oral nutritional supplements containing collagen peptides can reduce skin vulnerability in the elderly and thus prevent conditions such as skin lesions. The direct effects of collagen peptides on fibroblasts, M2-like macrophages, and mechanisms related to oral tolerance are the possible mechanisms for the beneficial effects of collagen supplementation. Special collagen peptides together with acerola extract, vitamin C, vitamin E, biotin, and zinc showed a significant improvement in the skin's collagen structure. The proven positive nutritional effect on collagen structure was fully consistent with the quality of healthy skin. Finally, apple-derived nanovesicles (exosomes) also reduce the degradation of the extracellular matrix, increasing collagen synthesis (COL3A1, COL1A2, COL8A1, and COL6A1) and negatively regulating the production of metalloproteinases
Effectiveness of argon plasma coagulation in the treatment of weight regain after roux-y gastric bypass: a cross-sectional prospective observational study
Get PDFIntroduction: Roux-en-Y Gastric Bypass (RYGB) is one of the most commonly performed surgeries to treat obesity worldwide. However, approximately 20% of patients have a recurrence of obesity, and enlargement of the gastrojejunal anastomosis is one of the associated factors. Endoscopic treatment of anastomosis has been proposed for further weight loss. One of the most commonly used techniques for anastomotic narrowing is argon plasma coagulation (APC). However, no randomized controlled trials have proven that this technique is superior to multidisciplinary follow-up. Objective: To evaluate and investigate the efficacy and safety of the application of argon plasma in the gastrojejunal anastomosis in the relapse of obesity after Gastric Bypass. Methods: Transversal study. Thirty-two patients were selected. More than 50% of The excess body weight regained was lost. Ranging from 6 to 25 kg. Results: A loss of more than 50% of the excess weight regained was observed in 30 % patients. Ranging from 6 to 25 kg. Conclusion: The application of argon plasma coagulation was safe and effective in the treatment of obesity recurrence after gastric bypass
Major considerations of nutrological therapy in cancer patients: a systematic review
Get PDFIntroduction: Oncological malnutrition is a highly prevalent comorbidity in cancer, limiting patients' quality of life. International and national clinical guidelines recommend supportive nutrition and exercise therapy for cancer patients. Objective: It was to present the main approaches to nutritional therapy in cancer patients. Methods: The present study followed a concise systematic review model (PRISMA). The literary search process was carried out from August to October 2023 and developed based on Web of Science, Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2002 to 2023. The low quality of the evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. Results and Conclusion: A total of 81 studies were found that were subjected to eligibility analysis and, subsequently, 16 of the 22 final studies were selected. Most studies showed homogeneity in their results, with X2 =78.4% >50%. Current dietary guidelines for cancer patients fail to address adequate dietary intake of macro- and micronutrients that can improve patients' nutritional status. Clinical studies and meta-analyses have shown that there is an important impact of a personalized and specific diet on patients during and after anti-neoplastic treatment. Most studies indicate that cancer patients should receive a nutritional assessment immediately after diagnosis. You need to maintain a healthy body weight, with a body mass index of 20–24.9, preserving your lean mass and avoiding an increase in fat mass. Therefore, after diagnosing nutritional status, a conservative energy restriction of 500-1,000 kcal/day should be considered. Nutritional therapy should be based on the patient's nutritional status, eating habits, schedule, activities, and cultural preferences. Therefore, adequate dietary consumption of dietary macro and micronutrients rich in β-carotene and vitamins A, E, and C can prevent the deterioration of nutritional status, also improving the quality of life of cancer patients