International Journal of Nutrology
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Enteral nutrition and congestive heart failure: a systematic review
Get PDFIntroduction: Congestive heart failure (CHF) is a serious and growing public health problem worldwide. Approximately 23 million people are carriers of this disease and two million new cases are diagnosed each year. The clinical evolution of patients with CHF is moving towards variable malnutrition, making it necessary to adhere to enteral nutrition (EN). This picture can occur due to inadequate intake, altered metabolism, proinflammatory state, increased oxidative stress, and greater loss of nutrients, even due to drug interactions. Objective: It was to carry out a systematic review of the main clinical outcomes that demonstrate the importance of enteral nutrition in patients with congestive heart failure. 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 122 articles were found. A total of 87 articles were evaluated and 28 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 7 studies with a high risk of bias and 8 studies that did not meet GRADE. There is moderate scientific evidence of the effectiveness of enteral nutrition in increasing survival and reducing morbidity in patients with congestive heart failure, as there are few randomized clinical trials that have evaluated this issue, however, enteral nutrition is highly indicated in the attempt to mitigate weight loss in these patients
Effect of glutamine supplementation in elderly people with emphasis on sarcopenia, immunity and hypertrophy: a concise systematic review
Get PDFCurrently, the aging of the population is no longer a forgotten subject for health professionals in Brazil. This is due to the decrease in the birth rate in the country and the improvement in quality of life, this first factor was boosted after the ease of access to information on contraceptive methods and their distribution by the health system. As a result, the Nutrition area has been studying more diligently ways to provide elderly people with methods that contribute to a more comfortable, healthy, and long-lasting life. The nutritionist is essential to identify the deficits and disharmonization of the body of the elderly caused naturally over the years in people's lives, such as loss of muscle mass, and lack of nutrients, among others. Given this scenario, this work will be focused on showing that the use of oral Glutamine supplementation contributes to the gain of muscle mass in the elderly since this natural amino acid present mainly in the muscle tissue of the human body is greatly reduced due to loss of mass skin and body weight gain caused by the slow metabolism found in older people. In this way, supplementation along with a well-designed nutritional table and an exercise routine will promote less chance of injury to the elderly due to a lack of nutrients and greater physical resistance. To reinforce and prove this study, we will use the literature review method distributed in topics
Consensus of the Brazilian Association of Nutrology on diagnosis, prophylaxis, and treatment of vitamin B12 deficiency
Get PDFIntroduction: Vitamin B12 deficiency is quite prevalent in all age groups and all regions of the country, however, there is a need for standardization of clinical management recommendations. Objective: It was to achieve a consensus on the diagnosis, prophylaxis, and treatment of vitamin B12 deficiency. Methods: An integrative review of the scientific literature was carried out in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases and on governmental and regulatory websites. Results: According to the literary search carried out by the authors of this study, 84 scientific works were selected. Based on these findings, in the timeline from 1999 to 2022, randomized controlled clinical studies represented the majority, and prospective and retrospective studies with significant sample sizes were elucidated in this consensus on the vitamin B12 administration for all patient populations. The basis of this scientific evidence was determined by appropriate clinical trials, with additional endpoints including patient clinical symptoms and biochemical parameters in addition to serum and marginal B12 level. Conclusions: Based on the scientific literature, the recommendations of the Brazilian Association of Nutrology for diagnosis, prophylaxis, and treatment of vitamin B12 deficiency were presented
Major clinical approaches to proper nutrition and lifestyle change during pregnancy: a systematic review
Get PDFHaving a healthy pregnancy with the birth of a healthy child is the goal of the entire process that involves this phase. Nutrology is important in this context to reduce the risk of future chronic diseases in the child and unfavorable outcomes for the pregnant woman and the fetus. Lifestyle change generates a positive impact on every phase of life in which it is carried out. But it is known that changes in parents at least 3 months before conception, during pregnancy, and breastfeeding are related to the improvement in the quality of gametes and the expression of healthy genes. Food consumption is increasingly far from ideal. There was an increase in the consumption of ultraprocessed foods and a decrease in natural foods. Thus, the recommended dietary intake is not achieved by a large part of the Brazilian population. Therefore, it is necessary to supplement mainly during pregnancy due to increased needs. Therefore, the present study carried out a concise systematic review to list the main clinical approaches to the effects of adequate nutrition and lifestyle changes in human pregnancy
Major approaches to the skin-gut microbiota axis under the light of the nutrology of probiotics and prebiotics: a systematic review
Get PDFIntroduction: Skin conditions contributed with about 2.0% to the global burden of 306 diseases and injuries in recent years. The microbiota compositions of lesional skin in atopic dermatitis and psoriasis showed distinct differences compared to healthy skin, as well as healthy skin presented a healthy gut microbiota in the light of nutrology. Objective: It was to analyze, through a systematic review, the main considerations on the Skin-Gut microbiota axis, presenting the importance of intestinal health through nutrology, probiotics and prebiotics. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to October 2022 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: A total of 255 articles were found. A total of 76 articles were evaluated in full and 20 articles were included. Current scientific evidence reveals the existence of an important Skin-Gut microbiota axis in the presence of nutrients responsible for this, highlighting the management of dermatoses through probiotics and prebiotics, as well as changes in lifestyle. Conclusion: Management of aesthetically healthy skin includes manipulation of bowel function. Treatments that augment or repair a leaky gut barrier may become important as adjunctive therapy in the management of inflammatory skin conditions and may help to enhance the effectiveness of standard dermal therapy
Major influences of the gut microbiota on thyroid metabolism: a concise systematic review
Get PDFThe objective was to discuss the influence of the gut microbiota on the functions of the thyroid gland, elucidating the main aspects of rebalancing intestinal function and its importance in the regulation of thyroid functions. The present study followed a systematic review of the literature in periodicals published between 2010 and 2023. The microbiota of the healthy gastrointestinal system presents around 800 species of bacteria, and a hundred of these microorganisms together with bacteriophage viruses and fungi species characterize each human being, with maximum concentration in the colon. In the presence of dysbiosis, the malfunction of the epithelial barrier leads to intestinal and systemic disorders, mainly immunological and metabolic. The functions of the gut microbiota are fundamental and determinant in the metabolism of nutrients, drugs, and hormones, including exogenous and endogenous iodothyronines, as well as micronutrients involved in thyroid homeostasis. The state of the art of effects of the gut microbiota on the regulation of thyroid functions has not been fully elucidated. The intestinal tract is of great importance for the balance of exogenous and endogenous thyroid hormones, but the analysis of the composition of the microbiota is not an easy task. A recent study revealed that individuals with hyperthyroidism had significantly lower levels of Bifidobacteria and Lactobacilli and significantly higher levels of Enterococcus species compared to healthy controls
Herbal medicine and climacteric: a systematic review of the main clinical outcomes
Get PDFIntroduction: The climacteric is the stage of life in which the transition from the productive or fertile period to the non-reproductive period occurs. Climacteric and menopause are intrinsically linked and may bring about various psychological and physiological changes. The use of medicinal plants (Herbal Medicine) is an important tool in an attempt to relieve symptoms. Objective: It was to develop a systematic review to present the main considerations and scientific evidence of the use of herbal medicines in climacteric and menopause to the reduction of symptoms and improvement of quality of life. Methods: The systematic review rules (PRISMA) were followed. The research was carried out from September to October 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, covering scientific articles from various eras to the present day. 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 121 articles were found. A total of 32 articles were fully evaluated and 23 were included in this systematic review. Most studies showed homogeneity in their results, with I2 =96.7% >50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 37 studies that did not meet GRADE. An asymmetrical funnel plot does not suggest a risk of bias among small sample-size studies. In search of symptom relief and based on knowledge of the side effects of hormone replacement therapy, many women resort to alternative therapy with herbal medicines. The main results support that supplementation with soy isoflavones as a natural source of phytohormones is associated with a reduction in the frequency and intensity of hot flashes, a recurrent symptom in the climacteric. The formulated blend of four herbal extracts (Glycine max, Cimicifuga racemosa, Vitex agnus-castus, and Oenothera biennis) supports skin health and antioxidant status in women of menopausal age. Furthermore, purified pollen cytoplasm can be considered an effective non-hormonal treatment alternative for the treatment of vasomotor symptoms, as well as mood and sleep disturbances in peri and post-menopause. Three clinical trials using the Danggui Buxue Tang herbal formula have been shown to alleviate menopausal syndrome, providing solid scientific evidence of its effectiveness
Major considerations of nutrological aspects, gut microbiota, and regulation (down or up-regulation) of microRNAs/exosomes in inflammatory bowel diseases: a systematic review
Get PDFIntroduction: Inflammatory bowel diseases (IBD) are multifactorial, chronic, continuous, relapsing, and immune-mediated diseases of the gastrointestinal tract. The pathogenesis of IBD is linked to genetically susceptible individuals, dysregulated gut microbiota (dysbiosis), chronic inflammation, and poor dietary patterns. Diet and microRNAs/exosomes play an important role in modulating the intestinal microbiota, and can be applied as a therapeutic tool to improve the course of IBD. Objective: It was to carry out a systematic review of the main considerations of nutrological aspects, intestinal microbiota, and the regulation (Down or Up-regulation) and modulation of microRNAs/exosomes in inflammatory bowel diseases. Methods: The present study followed the international model of systematic review and meta-analysis (PRISMA). Clinical studies were included, involving randomized controlled, prospective, and retrospective studies, as well as pre-clinical studies, published in previous years as gold standard articles until 2023. Results and Conclusion: A total of 154 articles were found. A total of 78 articles were fully evaluated and 55 were included in this systematic review. Considering the Cochrane tool for risk of bias, 22 studies with a high risk of bias and 24 studies that did not meet the GRADE were removed. Most studies showed homogeneity in their results, with X2 =93.5% >50%. The present study analyzed the main interactions between dietary therapy, intestinal microbiota, microRNAs, exosomes, and inflammatory bowel disease, elucidating the main clinical outcomes of the disease after nutrological treatment. As a corollary, important randomized controlled clinical studies were found in the last ten years that showed the important role of diet modulation in the control and even in the remission of inflammatory bowel disease, revealing important reductions in persistent intestinal symptoms, in the balance of the intestinal microbiota, in the regulatory role of microRNAs, reducing inflammation markers and improving quality of life. Recognition of the need for additional data from clinical trials, the inherent uncertainty of efficacy for all inflammatory bowel disease therapies, and the potential for benefit with dietary interventions will help guide progress toward a better understanding of the usefulness of dietary therapy for individuals with inflammatory bowel disease
Obesity and comorbidities in COVID-19: a longitudinal observational retrospective study of the main relationships of life risk
Get PDFIntroduction: Currently, around 30% of the world's population is overweight or obese. By 2030, it is estimated that more than 60% of the world's population will be overweight or obese. The COVID19 pandemic has resulted in the worsening of obesity comorbidities. The primary increase in the inflammatory response in obese patients functions as a predictor for the hyperinflammatory state observed in COVID-19. Therefore, this primary increase can be amplified by SARS-CoV-2 infection, increasing the production of cytokines such as TNF-α, IL-1, and IL-6. Objective: It was to carry out a retrospective longitudinal observational study to quantitatively analyze how cardiovascular comorbidities such as diabetes, hypertension, obesity, smoking, and compromised immunity contribute to the increased risk of life of participants affected by COVID-19. Methods: This study followed a longitudinal observational retrospective design (STROBE). A total of 45 public and official documents from Brazil (ANVISA), WHO (World Health Organization), Pan American Health Organization (PAHO), EASO (The European Association for the Study of Obesity - The European Commission/ National Information on COVID-19, Lancet Resource Centre) and scientific articles were subjected to eligibility analysis and, after that, 32 documents dated from 2019 to 2022 were selected. Results: In total, 3,993,857 participants were found from 32 documents. The highest incidence of deaths occurred in participants who were smokers, had compromised immunity, had diabetes, and were obese. The greatest risk of death was observed among participants who smoke (HR=2.5) and those with compromised immunity (HR=2.1). Despite this, other comorbidities such as diabetes, obesity, and hypertension also presented statistically significant results for the risk of life. It was observed that only the difference between the means of the comorbidities “obesity” and “diabetes” was not statistically significant, with p<0.05, that is, both comorbidities have similar impacts on the worsening and death of participants in the presence of COVID-19. Conclusion: Cardiovascular comorbidities such as diabetes, hypertension, obesity, smoking, and compromised immunity contributed to the increased risk of life in participants affected by COVID-19, especially in those of an older age. The endothelial dysfunction caused by SARS-CoV-2 explains why participants with comorbidities related to blood vessels such as cardiovascular disease, hypertension, diabetes, and obesity are more likely to develop severe COVID-19, even deat
Metabolic effects of coenzyme Q10, magnesium and vitamin D in cardiovascular diseases: a systematic review
Get PDFIntroduction: Cardiovascular diseases (CVD) are the main causes of death in the population. According to data from the World Health Organization for 2020, of the 20.8 million deaths from these diseases, 9.2 million are due to atherosclerotic coronary disease. In this context, the beneficial metabolic effects of magnesium, vitamin D, and coenzyme Q10 can be highlighted. Objective: It was to scientifically analyze, through clinical and experimental studies, the influence of the three elements Magnesium, Vitamin D, and Coenzyme Q10 concerning cardiovascular diseases and metabolic syndrome, highlighting the improvement of metabolic disorders and heart failure. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 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 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 =95.7% >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