International Journal of Nutrology
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Relationship between gut microbiota, probiotics, and obesity in the cellular and molecular mechanisms for the activation of regulatory t cells and control of inflammatory processes: a systematic review
Get PDFIntroduction: Obesity represents a pandemic represented as a long-term chronic imbalance between calorie intake and energy expenditure, resulting in more than 30% of the world's population (over two billion people) being overweight or obese. Studies show that Tregs regulate inflammatory cells such as macrophages and T lymphocytes by reducing the production of cytokines IL-6, IL-10, etc., and microRNAs can regulate the gene expression of inflammatory cells. Probiotics have been increasingly studied for modulating the gut microbiota. Objective: It was to develop a systematic review to describe the main considerations of the relationship between gut microbiota, probiotics, and obesity, to list the cellular and molecular mechanisms for the activation of regulatory T cells and control of inflammatory processes. Methods: The PRISMA Platform systematic review rules were followed. The search was carried out from March to May 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 instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found, and 40 articles were evaluated in full and 24 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 25 studies with a high risk of bias and 22 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=78.7%>50%. It was concluded that probiotic therapy proved to be an important strategy associated with a nutritional change to improve the composition of the gut microbiota. In this context, the probiotics L. paracasei shirota, Akkermansia muciniphila, and Lactobacillus reuteri V3401 stand out, which are responsible for reducing inflammatory markers. Modulation of the gut microbiota through physical exercise, type of nutrients, and use of prebiotics, and/or probiotics have a positive effect on reducing inflammatory markers. Some miRNAs have been implicated in the control of body weight gain, glucose homeostasis, insulin resistance, and lipid metabolism, with crosstalk with the gut microbiota. Furthermore, an association was found between B. eggerthi abundance, miR-183-5p expression, and adiponectin levels. Expression of miR-15a-5p was found to be associated with H. parainfluenzae abundance and insulin levels
Main considerations of off-label drugs in patients with excessive adipose tissue and obesity: a systematic review
Get PDFIntroduction: The rise of the obesity pandemic has been underestimated since most assessments do not include perhaps up to 2.7 billion patients with excessive stores of adipose tissue and calories. A variety of classes of anti-obesity drugs approved for other indications have been used off-label in attempts to promote weight loss. Objective: It was to discuss the main off-label drugs for treating excess fatty tissue and obesity through clinical studies and consensus among world societies. Methods: The PRISMA Platform systematic review rules were followed. The research was carried out from September to October 2023 in the Web of Science, 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 115 articles were found, 30 articles were evaluated in full, and 22 were included and developed in the present systematic review study, out of a total of 24 (2 references are on the website and were not included) Considering the Cochrane tool for risk of bias, the overall evaluation resulted in 18 studies with high risk of bias and 27 studies that did not meet GRADE and AMSTAR-2. Most studies showed homogeneity in their results, with X2=58.6%>50%. It was concluded that the current paradigm for the diagnosis and treatment of obesity is for those with high BMI, however, the paradigm is flawed for patients with lower BMI in the early stages of abnormal adipose tissue accumulation, who are often ignored and left without treatment. This promotes the continuation of obesity worldwide, allowing early-stage patients to accumulate increasingly greater amounts of adipose tissue. Thus, the use of off-label antiobesity drugs has accumulated scientific evidence for a safe and effective treatment. However, it is still necessary to promote more observational studies and medical reports to corroborate the findings so far present in randomized studies
Nutrology and molecular state of art in muscle recovery and sports performance: a systematic review
Get PDFIntroduction: Nutrition makes it possible to recover from the negative impact of an injury induced by physical exercise. Recent progress has been made regarding gut microbiota, regenerative nutrition, and skeletal muscle metabolism. MicroRNAs (miRs) have emerged as critical regulators of numerous biological processes, modulating gene expression at the post-transcriptional level. Objective: It was to carry out a systematic review to elucidate the main considerations of nutrology and molecular state of art through exosomes, microRNAs, and nutrients in muscle recovery and sports performance. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from April to June 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 237 articles were found. A total of 107 articles were evaluated in full and 52 were included and developed in this systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 47 studies with a high risk of bias and 70 studies that did not meet GRADE. Based on the findings, it was concluded that dietary manipulations and metabolites may affect tissue stem cell fate decisions. Self-renewal and differentiation of mesenchymal stem cells can be regulated by manipulating vitamin C, A, or D levels and valine restriction. miRs play an important role as regulatory molecules during the muscle healing process. Myoblasts are known to secrete exosomes enriched with miRs into the inflammatory environment, whereby miR-224 is transferred to macrophages to inhibit M2 polarization. Additional data demonstrate that WNT-9a may be a direct target of miR224 for macrophage polarization. The results showed that miR-122 and myogenic markers were down-regulated in C2C12 cells after TGF-β stimulation, and overexpression of miR-122 can restore myogenesis inhibited by TGF-β. Evidence suggests that the exosome derived from mesenchymal stem cells exhibits functions similar to mesenchymal stem cells with low immunogenicity and without tumorization. High rates of intestinal self-renewal are enabled by intestinal stem cells (LGR5+) at the base of intestinal crypts. LGR5+ activity, including proliferation and differentiation rates, is affected by large shifts in nutrient availability, as occurs on a high-fat diet or fasting. The practice of physical activity, endogenous metabolites, and dietary nutrients can directly influence epigenetic enzymes
Major nutrological approaches to macronutrients in the performance and body composition of highly trained athletes: a systematic review
Get PDFIntroduction: Findings around nutrient timing require appropriate context because factors such as age, gender, fitness level, previous fueling status, diet status, training volume, training intensity, program design, and time before upcoming training or competition can influence the extent to which timing can play a role in the adaptive response to exercise. Thus, nutrient timing is a feeding strategy that in almost all situations can be useful for promoting recovery and training adaptations. Objective: A systematic review was carried out to elucidate the importance of macronutrient consumption by highly trained athletes on performance and body composition. Methods: The present study followed a systematic review model (PRISMA). The search strategy was carried out in PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar databases, using scientific articles from 2009 to 2021. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: After the study eligibility process, a total of 42 scientifically favorable articles were found to compose the systematic review. Biases did not compromise the scientific basis of the studies. The amount depends on the mode and intensity of exercise, the quality of protein ingested, and the individual's energy and carbohydrate status. However, it should be noted that there is preliminary evidence that consuming much higher amounts of protein (>3 g/kg/d) may confer a benefit concerning body composition. Concerns that protein intake within this range is unhealthy are unfounded in healthy, exercising individuals. One should try to consume whole foods that contain high-quality protein sources. Timing of protein intake in the period spanning the exercise session can provide several benefits, including improved recovery and greater gains in lean body mass. Essential amino acids and leucine supplements are beneficial for the exercising individual by increasing muscle protein synthesis rates, decreasing muscle protein breakdown, and possibly aiding exercise recovery
Major considerations of cardiometabolic nutrients in heart failure: a systematic review
Get PDFIntroduction: Heart failure (HF) is one of the main causes of hospitalizations in the world. In Brazil, about 7.0 million Brazilians suffer from this syndrome. The clinical evolution of patients with HF evidence variable conditions of malnutrition. This can occur due to inadequate intake, altered metabolism, pro-inflammatory state, increased oxidative stress, and greater loss of nutrients, even due to drug interactions. Objective: It was to demonstrate, through a systematic review of the literature, the main considerations of cardiometabolic nutrients in heart failure. Methods: The present study followed a concise systematic review model (PRISMA). The literary search process was carried out from April to May 2023 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles until 2023. The low quality of evidence was attributed to case reports, editorials, and short communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 136 studies were found for eligibility analysis, and so 75 of a total of 84 studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with X2 =92.2% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in studies with smaller sample sizes. The presence of malnutrition is an important predictive factor for reduced survival in patients with HF, highlighting inadequate food intake, altered metabolism, pro-inflammatory state, increased oxidative stress, greater loss of nutrients, and drug interactions. Patients with HF have anabolism/catabolism imbalance. Providing nutritional support significantly increased dietary adherence above 90%. Therefore, malnutrition and inflammation are important predictors for assessing the prognosis of the disease in patients with HF
Major roles of the gut microbiota and microRNAs in cardiovascular disease events: a systematic review
Get PDFIntroduction: Gut microbiota (GM) is an essential mediator in the health of GM and has been identified as the origin of several diseases by influencing cell signaling and T cell receptor pathways in the central nervous system. Several microRNAs participate in signaling networks through GM intervention. The interaction between GM and miRNAs plays a crucial role in vascular dysfunction. GM can metabolize L-carnitine, choline, and phosphatidylcholine and produce vascular-toxic metabolites such as trimethylamine-Noxide (TMAO), which is associated with the atherosclerotic process. Nutrology and dietary therapy represent important strategies, especially with the use of plant-derived miRNAs to modify GM. Objective: To carry out a systematic review to highlight the main roles of the gut microbiota and microRNAs in cardiovascular disease events. Methods: The present study followed a concise systematic review model (PRISMA). The literary search process was carried out from March to May 2023 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2002 to 2022. The low quality of evidence was attributed to reports of cases, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The total of 126 studies were found for eligibility analysis, and then 42 of the 64 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with X2 =88.7%>50%. It was concluded that the gut microbiota can be influenced by diet, genetics, and environmental factors. Changes in the microbial population can lead to multiple diseases, including cardiovascular disease. miRNAs have been known as important regulators of several biological functions, and are also involved in the pathogenesis of cardiovascular diseases. There is evidence that disturbances in the gut microbiota and derived metabolites impair the development of atherosclerotic cardiovascular disease. Studies have shown that YRNAs belonging to extracellular vesicles and their fragments play important roles in the initiation, progression, and diagnosis of atherosclerosis
Major clinical approaches to macro and micronutrients in enteral therapy according to international guidelines and clinical studies: a systematic review
Get PDFIntroduction: In the context of Nutritional Therapy (NT), critically ill patients are associated with a state of catabolic stress and a systemic inflammatory response. Patients admitted to intensive care units (ICU) have a prevalence of malnutrition greater than 35%. The main objective of parenteral nutrition (PN) is to provide a nutrient mix closely related to requirements safely and avoid complications. However, PN poses a considerable risk of overfeeding, which can be just as harmful as underfeeding. Long-term survival data (expressed as 6-month survival) will also be considered a relevant outcome measure. Objective: It was performed a systematic review to evaluate the main clinical approaches of macro and micronutrients in enteral therapy according to international guidelines and clinical studies. Methods: The present study followed a concise systematic review model, following the systematic review rules (PRISMA). The literary search process was carried out from August to October 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2011 to 2022. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: It was found 118 studies that underwent eligibility analysis, and then 20 of the 22 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with I2 =97.7% >50%. Standard crystalline amino acid solutions, while devoid of side effects, remain incomplete regarding their composition (eg glutamine). Lipid emulsions have come a long way and are now included in bi- and tri-compartment feeding bags, allowing for true total PN as long as daily micronutrients are prescribed. The issue of exact individual needs for energy, macro, and micronutrients has not yet been resolved. Many complications attributed to total PN are the consequence of under or overfeeding. Total PN indications have evolved towards its use alone or in combination with enteral nutrition. The start time varies by country between admission (Australia and Israel), day 4 (Swiss), and day 7 (Belgium, USA). The most important issue may be an individualized and time-dependent prescription of the feeding pathway, energy, and substrates
Off-label pharmacological treatment of obesity: a systematic review of clinical studies
Get PDFIntroduction: There are 2.0 billion overweight and obese people in the world, and Brazil ranks fifth in the world. The World Health Organization (WHO) advises that the use of drugs to combat obesity is indicated for patients who have a body mass index (BMI) above 30 kg/m2 or when the BMI is 25 kg/m2 associated with comorbidities. that permeate excess weight. A variety of drug classes approved for other indications have been used off-label in an attempt to promote weight loss. Objective: It was to list and present the main off-label drugs for obesity in adults, as well as to show the scientific evidence of clinical studies. Methods: The present study followed a concise systematic review (PRISMA) model. The literary search process was carried out from July 2022 to September 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2002 to 2022. The low quality of evidence was attributed to reports of cases, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument using the Funnel Plot. Results and Conclusion: We found 98 studies that underwent eligibility analysis, and then 15 of the 12 total studies were selected. Most studies showed homogeneity in their results, with I2 =96.5% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in the studies. Off-label prescribing is very common among physicians who treat obesity. However, randomized controlled studies should be increasingly encouraged and increased to clearly present the scientific evidence and, thus, propose a scientific formalism for the safe and effective use of off-label anti-obesity drugs. Physicians, however, have adopted a more pragmatic approach, giving much greater credibility to shared clinical experience, particularly in situations where favorable outcomes have been consistently observed over decades. International medical bodies do not recommend the off-label use of drugs approved for the exclusive use of weight loss. In Brazil, the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) recommends that drugs approved for the treatment of obesity be prescribed preferentially over off-label treatments. In addition, the patient must be well informed and aware that the drug is not approved by Anvisa for this indication or chronic use
Major considerations of sarcopenia in the elderly: a concise systematic review
Get PDFThe present work aims to highlight throughout the contents presented the main aspects of sarcopenia in the elderly, promoting to readers an understanding of the diagnosis, possible treatments, and exams that are relevant for the identification of the disease. The general objective of the research is to describe the main aspects of sarcopenia in the elderly, regarding the specific objectives, are highlighting information about the elderly; assessing how sarcopenia develops; present procedures for the diagnosis and treatment of sarcopenia among the elderly. For a better foundation of the contents presented, a literature review was carried out, highlighting some of the main concepts and analyzes of renowned authors on sarcopenia, consolidating how this disease impacts the routines and quality of life of the elderly. It can be concluded that over the years some research has been developed and treatment methods have been developed seeking to give the elderly an opportunity to treat sarcopenia, especially with the practice of physical activities aimed at strengthening the limbs and joints
Evidence of the functions of vitamin D in pregnant women in COVID-19: a systematic review
Get PDFIntroduction: In the world, about 1 million people suffer from vitamin D deficiency. Vitamin D deficiency in pregnant women increases maternal mortality and morbidity rates. In the scenario of COVID-19, it is known that the immune response, inflammation, and coagulation are modulated by vitamin D activity. Objective: It was to analyze the main considerations of the effects of vitamin D on pregnant women and fetuses in the scenario of COVID-19, presenting the mechanisms of inflammatory and immunological processes in an attempt to mitigate the worsening of comorbidities and deaths. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 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 210 articles were found, 82 articles were evaluated and 32 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =98.9% >50%. There is a relationship between vitamin D status and the severity of COVID-19 in pregnant women. Vitamin D levels are low in pregnant women with COVID-19. Furthermore, there is a significant difference regarding the level of vitamin D and the severity of COVID-19 in pregnant women. Maintaining adequate vitamin D levels may be useful as an approach to preventing an aggressive course of inflammation induced by this novel coronavirus in pregnant women