International Journal of Nutrology
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Developmental origins of health and disease (DOHaD) and its impacts on children's health: a systematic review
Get PDFThe general objective of this study is to elucidate how studies linked to the Developmental Origins of Health and Diseases (DOHaD) relate to pregnancy, children's health, and the possibility of developing non-communicable diseases (NCDs). The research method chosen for its scope was based on bibliographic, qualitative, and descriptive research. Among the results obtained, it was possible to show that since the 1980s when the first studies within the DOHaD scope were published to the present, numerous advances have been consolidated and there is still a vast field of study to be developed. It is concluded that the external environment can affect the development of the fetus in the intrauterine environment, increasing vulnerability to the development of non-communicable diseases (NCDs) in adult life, such as type II diabetes, malnutrition, and obesity, among countless other problems. that can manifest in adulthood. Therefore, it is essential that the pregnant woman has specialized care from the first months, at birth, and then as the child grows and develops
Leptin Levels, Basal Metabolic Rates, and Insulin Resistance in Obese Pubertal Children
Get PDFIntroduction: Obesity in children and adolescents is considered a serious public health problem. The consequences of overweight can last for life. It is extremely important to have formulas to calculate the basal metabolic rate (BMR) that are truly reliable in relation to the individual caloric expenditure. Objectives: To investigate the association of serum levels of leptin, lipid profile, and insulin resistance (insuline resistance by Homeostatic Model Assessment [HOMA] index) with the body mass index (BMI) z-score of pubertal obese children. In addition, to compare the basal metabolic rate (BMR) evaluation carried out using bioimpedance (BIA) with the Food and Agricultural Organization/World Health Organization (FAO/WHO) equation. Methods: Cross-sectional study including 37 pubertal obese children (aged 7 to 12 years old) seen for the first time in the outpatient care unit specialized in child obesity between June 2013 and April 2014. The participants were assessed regarding anthropometric data, body composition (fat mass) by BIA 310 bioimpedance analyzer (Biodynamic Body Composition Analyser, model 310 - Biodynamics Corporation, Seattle, EUA), and blood pressure. Blood samples were collected to measure glucose, insulin, lipid profile, triglycerides, and leptin. The stage of sexual maturity was determined by self-assessment according to the Tanner scale. Results: Higher leptin levels were found in the severe obesity group (p = 0.007) and, as expected, higher BMI (p < 0.001), and fat mass (p = 0.029). The groups did not differ in relation to insulin, insulin resistance (HOMA-IR), triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and blood pressure. The BMR measured by bioimpedance was lower as compared to the measure by the FAO/WHO equation (p < 0.001). Conclusions: These results suggest that severely obese children may present leptin resistance in this early stage of life, (since this hormone is higher in these children). It is suggested that health professionals prioritize the calculation of BMR by bioimpedance, since the FAO/WHO equation seems to overestimate the caloric values
Caring for Overweight Children and Adolescents at a Reference Clinic in Nutrology: Habits and Attendance
Get PDFIntroduction: The global obesity epidemic has mobilized health services to offer care at all levels, with reference outpatient clinics playing a prominent role in cases of greater complexity. Objectives: The present study aimed to identify soft drinks consumption and physical activity habits among children and adolescents diagnosed with overweight and obesity during the first visit at a secondary level nutrology outpatient clinic, and to verify attendance at follow-up visits in a 2-year period from the first visit. Materials and Methods: This is a retrospective, descriptive study based on data collection from medical records of overweighted or obese patients receiving first care at the Nutrology Clinic of the Municipal Health Secretariat from Ribeirão Preto, São Paulo, Brazil. The study population included children and adolescents aged between 2 and 18 years old cared for from January 2, 2013 to December 30, 2017. Age, weight, height, soft drinks consumption, physical activity, and attendance in scheduled follow-up visits during a 2-year period were analyzed. Results: During the study period, 316 patients were registered, including 302 (95.5%) diagnosed with obesity. Of these, 112 (35.4%) were children and 204 (64.6%) were adolescents. Only 2.0% of the children and adolescents did not consume soft drinks, while 23.5 and 26.2% of the children and adolescents, respectively, consumed them daily. Physical inactivity was reported by 31.8% of the children and by 35.8% of the adolescents. Among those who practiced some type of physical activity, 81.3% of the children and 78.2% of the adolescents did not meet the recommendation of moderate to vigorous activity for 60 minutes per day. Dropout rates within the 1st year were of 41.9% for children and of 34.3% for adolescents, increasing to 76.9% and 73.8%, respectively, within the 2nd year. Conclusion: There was a high consumption of soft drinks and low adherence to physical activity among patients who started outpatient follow-up. A small adherence to the follow-up program was also identified, with high dropout rates within the 2-year period following the first visit
Bioelectrical Impedance Phase Angle: Utility in clinical practice
Get PDFThe choice of the best nutrition assessment method in hospitalized patients remains a challenge. The aim of this study was to review the use of phase angle (PA) in clinical practice. PA is a parameter obtained from bioelectrical impedance analysis, being a derived measure from the relationship between resistance and reactance. Because PA is dependent on body cell mass (BCM) and cell membrane functions, it has been considered a prognostic marker in several clinical conditions. BCM reflects the cellular components responsible for energy transfer and biochemical activity and is considered an excellent reference for expressing the rates of physiological processes, such as energy expenditure and proteolysis. Low PA values suggest cell death or decreased cell integrity, whereas higher PA values suggest a large amount of intact cell membranes, with a consequently better prognosis. The literature lacks studies determining PA reference values, which has prevented its use in routine clinical practice. Reference values are therefore necessary to properly evaluate possible deviations from the population mean
Revisão das principais deficiências de micronutrientes no pós-operatório do Bypass Gástrico em Y de Roux
Get PDFIntroduction: Obesity is a chronic disorder that is increasing worldwide. Nowadays, bariatric surgery is the only effective treatment for morbid obesity that consistently achieves and maintains a sustained weight loss, decreases the incidence and severity of obesity-related comorbidities, and improves overall quality of life and survival. The United States is the champion in number of surgeries performed, followed by Brazil. Roux-en-Y gastric bypass (RYGB) is a safe and effective technique of bariatric surgery, comprising about 70 to 75% of all bariatric procedures worldwide. Objectives: Address key nutritional deficiencies in the population subjected to RYGB and its clinical consequences. Methods: Literature review of articles published in the past decade related to major nutritional deficiencies observed postoperatively in RYGB. Results: Approximately 30% of bariatric surgery patients will develop a macro and / or micronutrients deficiences. In the RYGB, the major nutritional complications of micronutrients includes iron, calcium, folic acid and vitamin B12. In cases where there is presence of a very long-limb, patients have increased risk of deficiency of fat- soluble vitamins (A, D, E, K), essential fatty acids, copper and zinc. Conclusion: All bariatric surgery patients should make vitamins and minerals supplementation on a daily basis. There is still no consensus on the dose needed to avoid such deficiencies. Some complications arise micronutrient months postoperatively, while others may occur even years after bariatric surgery. Therefore, there is a need for clinical and nutritional status of patients and monitoring of possible nutritional deficiencies for life
Crianças com paralisia cerebral: como podemos avaliar e manejar seus aspectos nutricionais
Get PDFIntroduction: The population of children with cerebral palsy (CP) has grown over the years. It is estimated that has 30,000 to 40,000 new cases per year in Brazil. In this sense, health professionals must be prepared to serve this population. The classification of nutritional status appropriate for the population of PC, optimizes an appropriate nutritional intervention. And, it is important to consider at the time of nutritional assessment, children with CP have characteristics such as swallowing disorders and motor deficits should not be evaluated the same way as healthy children. In this sense the objective of this study is to review the literature on methods of nutritional assessment and nutritional therapy used in children and adolescents with cerebral palsy. Data Sources: Articles indexed in MEDLINE, SCIELO, and classical references. The words used were “cerebral palsy”, “nutrition assessment”, “growth curves” and “nutritional therapy”. Conclusions: It is observed that is not clear which methods should be used in nutritional assessment of patients with CP. In this sense, is being highlighted important aspects of nutritional care for children with CP
Hábito alimentar nos lanches intermediários de crianças pré-escolares brasileiras: estudo em amostra nacional representativa
Get PDFObjetivo: Descrever os hábitos alimentares das crianças pré-escolares brasileiras, relacionados à ingestão dos lanches intermediários, e verificar o aporte nutricional dos mesmos. Metodologia: Análise secundária de questionário estruturado respondido por 3 dias, pelas mães de 1.391 crianças de 4 a 6 anos, de todas as regiões do país, sobre os alimentos consumidos nos lanches e suas quantidades. Resultados: 98,20% das crianças brasileiras realizam os lanches intermediários e, em média, são compostos por 2,9 grupos de alimentos. Qualitativamente, as composições dos lanches da manhã e da tarde foram semelhantes, em sua maioria contendo os mesmos grupos alimentares: frutas em geral, biscoitos em geral e iogurtes em geral. O lanche da tarde se mostrou mais calórico e com consumo mais frequente de alimentos variados e com alto teor de açúcares de adição (como balas, sorvetes e chocolates). O consumo de açúcar de adição, somadas as quantidades de açúcares do lanche da manhã e da tarde, se aproximou do limite recomendado para a dieta. O consumo do grupo das frutas em geral foi frequente em 98,8% das composições de lanches estudadas. Conclusão: As crianças pré-escolares brasileiras têm o hábito de realizar os lanches intermediários. A composição dos lanches é de suma importância, uma vez que são oportunidades para o preenchimento dos requerimentos nutricionais desta faixa etária, que por estarem em período de crescimento e desenvolvimento, precisam de aporte nutricional adequado
A ferritina sérica é bom marcador de deficiência de ferro em adolescentes obesos?
Get PDFThe aim of the present study was to verify the ferritin as an inflammatory marker and its association with components of metabolic syndrome in a children and youth obese population. Obese and adolescents users of Childhood Obesity Clinic of a tertiary hospital in southern Brazil were included. The variables obtained were: anthropometric variables, metabolic syndrome components (blood pressure, waist circumference, lipid profile), hemoglobin and serum ferritin. The determination of iron deficiency anemia was according to the criterion of the World Health Organization. A total of 101 children and adolescents were analyzed, the age was 10.0 (QI: 2.9 -17.0) years, serum ferritin was 63.9 (QI: 11.7 - 298.6) ng/dl. There was a weak correlation of ferritin with waist circumference (r=0.324, p=0.001) and triglycerides (r=0.30, p=0.08). There was no association of serum ferritin with the components of metabolic syndrome in obese children and adolescents
Influência do sobrepeso sobre a Estrutura de Sustentação Osteomuscular
Get PDFIn this century, among the numerous chronic diseases, we highlight obesity and osteoporosis as a result of the growing and high prevalence which are now considered epidemic and two major public health problems. There is little multidisciplinary research related to musculoskeletal clinical symptoms in patients with overweight and simultaneously evaluating the state of the musculoskeletal support structure and bone composition. The New Biology Bone, from an early age enables to trace the two bone matrix (protein and inorganic) that make up the support structure of the entire musculoskeletal system. Nowadays you can trace comprehensively bone protein matrix and detect early changes resulting from the habits, drugs, idleness, hormone deficiencies, obesity, chronic diseases among others. The old understanding that obesity exerts protective action to fractures was commuted by research in molecular level, which found that adipocytes and osteoblasts share the same progenitor cell. Objective: To trace the two bone matrix and compare the pattern of bone support structure in healthy young adults and on overweight. Result: The comparison showed that both qualitative tools accused significant difference at p <0.001. Stratification of UBPI tool revealed bone quality was poor in 7.7% of the patients with overweight and none in the control group. Stratification Profile Biophysical Bone (PBO) detected in 43.1% of overweight with Inverse Profile and none in the control group. Regarding quantitative tool (T-score) we didn´t detect differences in its three stratifications. Conclusion: In patients with overweight an early analysis of two bone-qualitative tools (PBO and UBPI) provide important information about the musculoskeletal support structure and enables the clinical nutrition specialist to develop preventive actions in the short term
Dinâmica entre a alimentação habitual, anemia e segurança alimentar entre estudantes de Saúde no Amazonas
Get PDFThe aim of this work was to approach the dynamic between the usual food habit and the presence of iron deficiency anemia in students of health courses (Medicine, Dentistry and Nursing) from the Universidade do Estado do Amazonas (UEA), future professionals that deal with health education. At the beginning of the study, subjects were submitted to a questionnaire about their food habits (24-hour feeding recall and food frequency), use of medications, health history and demographic factors, and blood was collected for hemoglobin and iron study, and anthropometric data. 22 out of the 114 enrolled students have completed the survey - 64% females and 36% males; the mean age 19.8 and 26.2 years, respectively; anemia was detected in 18.2% of participants. Understanding of nutrition education is an essential, important and decisive factor for health and food safety