Interactions between drugs and drug-nutrient in enteral nutrition: a review based on evidences

Introduction: Enteral nutrition (EN) provides calories, macronutrients and micronutrients in adequate quantity and quality to meet the patient's needs. Some drugs when crushed and diluted may have their properties altered, including the reduction of bioavailability causing the reduction of the serum concentration of the drug; tube obstruction; drug-drug interaction or drug-nutrient interaction. Methods: The study was conducted through review of submitted articles in the databases of the Virtual Health Library (VHL): MEDLINE (National Library of Medicine, USA), Lilacs (Latin American and Caribbean Literature on Health Sciences) PUBMED - NCBI (National Center for Biotechnology Information) and COCHRANE. Results: For this survey, 42 articles were identified during database searching. After applying the inclusion and exclusion criteria, 08 articles were selected, obtained from the MEDLINE and Lilacs. Discussion: Some interactions were found such as the aluminium hydroxide and lactulose with the enteral nutrition, which may result in a precipitation and reduction of drug bioavailability. Mineral oil will alter the absorption of fat-soluble vitamins and reduces the tube light. Others results were found as phenytoin, warfarin, captopril and furosemide with enteral nutrition may reduce the maximum serum concentration. Conclusion: Drug interactions are more common in day-to-day activities than health professionals may suppose. Knowledge on the matter may also assist in reducing cases of obstruction of tubes, through which enteral nutrition and medications are administered. Thus, the multidisciplinary team, acting together, may have more beneficial effects to the patient.

The most significant deficiencies in macro and micro nutrients in adolescents living with HIV/AIDS in antiretroviral therapy

Objective: To evaluate macro and micronutrients intake of adolescents living with HIV/AIDS in use of antiretroviral therapy and compare it to the Dietary Reference Intakes. Methodology: Cross-sectional study conducted with adolescents of both genders with HIV/AIDS, assessing the dietary composition of macro and micronutrients, using the 24h dietary recall. Results: 39 adolescents, average age of 15 years, 51.3% males. The participants intake of total calories, total fiber (g/d), liposoluble vitamins (A, D, E, K), vitamin B5 (mg/d), vitamin B9 (mg/d), vitamin C (mg/d), calcium (mg/d), phosphorus (mg/d), potassium (mg/d), and magnesium (mg/d) was lower than recommended. The percentages of intake lower than recommended were 79.5% for calories, 82.1% for total fibers, 89.7% for vitamin A, 100% for vitamin D, 87.2% for vitamin E, 100% for vitamin K, 71.8% for vitamin B5, 82.1% for vitamin B9, 76.9% for vitamin C, 92.3% for calcium, 61.5% for phosphorus, 97.4% for potassium, and 76.9% for magnesium. The participants ingested more carbohydrates (g), proteins (g), vitamins B2 (mg/d), B3 (mg/d), B8 (mg/d) and sodium (g/d) than recommended, the percentages above the recommendations being 92.3% for carbohydrates, 64.1% for proteins and vitamin B2, 56.4% for vitamin B3, 82.1% for vitamin B8, and 59% for sodium. The remaining nutrients were within the amounts recommended by the DRIs. Conclusion: Food intake was inadequate as compared to the recommendations of the International Nutrition Guidelines.

Compliance in food consumption of young and long-lived elderly of a city in southern Brazil

Introduction: Life expectancy is increasing and becoming a characteristic phenomenon of developed countries and, increasingly, of developing countries, such as Brazil. The aging process causes changes of some physiological functions such as loss of smell, taste, loss of appetite, among other things that end up changing the food intake of these individuals. Objectives: This study aimed to assess food consumption of the young and long-lived elderly in a city in southern Brazil. Methods: A cross-sectional survey conducted through home visits in Palmeira das Missões - RS, Brazil. The sociodemographic, anthropometrical and dietary data were collected through questionnaires and 24-hour recall. The adequacy of nutrients was assessed according to the Dietary Reference Intakes. Data were analyzed using SPSS 18.0 software. Results: The study included 424 older adults, 84,4% (n = 358) aged less than 80 years old and 15,6% (n = 66) older than 80. The intake of energy and protein was insufficient for both young elderly and the oldest. The consumption of vitamins and minerals has been insufficient in all seniors except for iron, which presented an excessive intake. There was a statistically significant difference between the elderly and oldest only for the consumption of lipids and vitamin B12. Conclusion: The majority of studies with elderly corroborate the results found in this article. An inadequate intake of nutrients can develop nutritional deficiencies, and consequently it can result in physiological and pathological changes which would compromise the functional capacity of the elderly. Energy consumption was insufficient and macronutrients were inadequate, both for the young elderly as for the oldest. Additionally, the consumption of vitamins and minerals was insufficient to everyone except the iron, which presented excessive intake for young and oldest elderly.

Nutritional assessment of the most frequently consumed dishes in a slum in Iquitos, Peruvian Amazon

Introduction: Large nutritional surveys in Peru have identified the magnitude and location of the different types of malnutrition. The chronic type is the most prevalent one. However, although rates may be considered as alarming (even more in rural areas), only one of these studies contains information about intake characteristics, using 24-hour recalls (R24). That is, it lacks some other systems, adapted to the gastronomical characteristics of their regions and to the bioavailability of food in each area, in order to locate the origin of this situation and, thus, propose truly effective and efficient solutions. Aim: To determine the nutritional value of the main dishes consumed by the residents of a slum in Peruvian Amazon. Methods: Ninety-eight participants completed three 24-h recalls. Based on these data, we selected the 25 most commonly eaten dishes and evaluated their nutritional composition. We took note of the homemade recipes, weights and measures. In addition, we observed preparation and cooking. The mean nutritional composition of each dish was calculated per 100 g using the Nutriplato 4.6. software. We also calculated gains or losses resulting from culinary treatments. Results: Within those which include milk, the highest energy density is the mingado de arroz. In the group of fish, the most energetic is pescado frito, while within meat-based recipes tallarín con pollo, res asada and chancho frito are the most energetic ones. Regarding prepared dishes, the juane is the highest energy density of all recipes. Inside garnish, using bananas as the main ingredient, plátano frito and madurito are the most energetic. Fats are higher in fried dishes and those which contribute most fat ratio. The same thing happens with garnish as 100 grams of plátano frito or madurito contain more than 70% of the RDA. Res asada and juane present the highest sodium level. Conclusions: If we wish to offer healthier dishes, it is necessary to change their composition and/or cooking methods, reducing the consumption of fried foods. Sodium intake should also be reduced. Two foods could be important to that aim: menudencia de pollo, rich in B vitamins and low in fat, and frijol hervido, which is rich in vegetable protein and, with rice dishes ubiquitous in this area, increases the biological value of ingested proteins.

To eat or not to eat meat: that is the question

Meat is a well accepted food with appreciable appealing. Due to its high nutritional value it plays a central role in human development. Meat/meat derivates are important sources of proteins, minerals and vitamins. Their nutritional importance is paralleled to their economic impact. Paying attention to the social alarm originated by a recent publication of WHO about the relationship between red and/or processed meat consumption and cancer, this paper reviews the following aspects: a) the present consumption of meat/meat products in Spain; b) the contribution of their macro/micronutrients to the recommended dietary allowances; c) the obliged use of additives (e.g. nitrites and nitrates) to warrant the food safety, and their daily intake. In addition health risks derived from a high consumption, as well as the most appropriate culinary uses in order to reduce the formation of toxic products (e.g. N-nitrosocompounds) are commented. Due to the huge variety of available meat products, this paper concludes that any generalization should be avoided. We also emphasize about the advantages of consuming meat/meat products in the frame of a Mediterranean diet, rich in vegetables, fruits, and bioactive compounds.