Cost and energy density of diet in Brazil, 2008-2009

This study aimed to evaluate the relationship between the cost and energy density of diet consumed in Brazilian households. Data from the Brazilian Household Budget Survey (POF 200812009) were used to identify the main foods and their prices. Similar items were grouped, resulting in a basket of 67 products. Linear programming was applied for the composition of isoenergetic baskets, minimizing the deviation from the average household diet. Restrictions were imposed on the inclusion of items and the energy contribution of the various food groups. A reduction in average cost of diet was applied at intervals of R$0.15 to the lowest possible cost. We identified an inverse association between energy density and cost of diet (p < 0.05), and at the lowest possible cost we obtained the maximum value of energy density Restrictions on the diet's cost resulted in the selection of diets with higher energy density, indicating that cost of diet may lead to the adoption of inadequate diets in Brazil.

Low-Cost Ultra-Wide Genotyping Using Roche/454 Pyrosequencing for Surveillance of HIV Drug Resistance

Background: Great efforts have been made to increase accessibility of HIV antiretroviral therapy (ART) in low and middle-income countries. The threat of wide-scale emergence of drug resistance could severely hamper ART scale-up efforts. Population-based surveillance of transmitted HIV drug resistance ensures the use of appropriate first-line regimens to maximize efficacy of ART programs where drug options are limited. However, traditional HIV genotyping is extremely expensive, providing a cost barrier to wide-scale and frequent HIV drug resistance surveillance. Methods/Results: We have developed a low-cost laboratory-scale next-generation sequencing-based genotyping method to monitor drug resistance. We designed primers specifically to amplify protease and reverse transcriptase from Brazilian HIV subtypes and developed a multiplexing scheme using multiplex identifier tags to minimize cost while providing more robust data than traditional genotyping techniques. Using this approach, we characterized drug resistance from plasma in 81 HIV infected individuals collected in Sao Paulo, Brazil. We describe the complexities of analyzing next-generation sequencing data and present a simplified open-source workflow to analyze drug resistance data. From this data, we identified drug resistance mutations in 20% of treatment naive individuals in our cohort, which is similar to frequencies identified using traditional genotyping in Brazilian patient samples. Conclusion: The developed ultra-wide sequencing approach described here allows multiplexing of at least 48 patient samples per sequencing run, 4 times more than the current genotyping method. This method is also 4-fold more sensitive (5% minimal detection frequency vs. 20%) at a cost 3-5 x less than the traditional Sanger-based genotyping method. Lastly, by using a benchtop next-generation sequencer (Roche/454 GS Junior), this approach can be more easily implemented in low-resource settings. This data provides proof-of-concept that next-generation HIV drug resistance genotyping is a feasible and low-cost alternative to current genotyping methods and may be particularly beneficial for in-country surveillance of transmitted drug resistance.

Endurance exercise training increases APPL1 expression and improves insulin signaling in the hepatic tissue of diet-induced obese mice, independently of weight loss

Hepatic insulin resistance is the major contributor to fasting hyperglycemia in type 2 diabetes. The protein kinase Akt plays a central role in the suppression of gluconeogenesis involving forkhead box O1 (Foxo1) and peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PGC-1a), and in the control of glycogen synthesis involving the glycogen synthase kinase beta (GSK3 beta) in the liver. It has been demonstrated that endosomal adaptor protein APPL1 interacts with Akt and blocks the association of Akt with its endogenous inhibitor, tribbles-related protein 3 (TRB3), improving the action of insulin in the liver. Here, we demonstrated that chronic exercise increased the basal levels and insulin-induced Akt serine phosphorylation in the liver of diet-induced obese mice. Endurance training was able to increase APPL1 expression and the interaction between APPL1 and Akt. Conversely, training reduced both TRB3 expression and TRB3 and Akt association. The positive effects of exercise on insulin action are reinforced by our findings that showed that trained mice presented an increase in Foxo1 phosphorylation and Foxo1/PGC-1a association, which was accompanied by a reduction in gluconeogenic gene expressions (PEPCK and G6Pase). Finally, exercised animals demonstrated increased at basal and insulin-induced GSK3 beta phosphorylation levels and glycogen content at 24?h after the last session of exercise. Our findings demonstrate that exercise increases insulin action, at least in part, through the enhancement of APPL1 and the reduction of TRB3 expression in the liver of obese mice, independently of weight loss. J. Cell. Physiol. 227: 29172926, 2012. (C) 2011 Wiley Periodicals, Inc.

Effect of the classic ketogenic diet on the treatment of refractory epileptic seizures

Objective The ketogenic diet is used as a therapeutic alternative for the treatment of epilepsy in patients with refractory epilepsy. It simulates biochemical changes typical of fasting. The present study verified the nutritional impact of the ketogenic diet on children with refractory epilepsy. Methods Nutritional status data (dietary, biochemical and anthropometric measurements), seizure frequency, and adverse events were collected from the medical records and during outpatient clinic visits of children over a period of 36 months. Results Of the 29 children who initiated the ketogenic diet, 75.8% presented fewer seizures after one month of treatment. After six months, 48.3% of the patients had at least a 90.0% decrease in seizure frequency, and 50.0% of these patients presented total seizure remission. At 12 months, eight patients continued to show positive results, and seven of these children remained on the ketogenic diet for 24 months. There was an improvement of the nutritional status at 24 months, especially in terms of weight, which culminated with the recovery of proper weight-for-height. There were no significant changes in biochemical indices (total cholesterol and components, triglycerides, albumin, total protein, creatinine, glycemia, serum aspartate transaminase and serum alanine transaminase). Serum cholesterol levels increased significantly in the first month, fell in the following six months, and remained within the normal limits thereafter. Conclusion In conclusion, patients on the classic ketogenic diet for at least 24 months gained weight. Moreover, approximately one third of the patients achieved significant reduction in seizure frequency, and some patients achieved total remission.

Cost-effectiveness of conventional and modified supervised toothbrushing in preventing caries in permanent molars among 5-year-old children

The cost-effectiveness of a modified supervised toothbrushing program was compared to a conventional program. A total of 284 five-year-old children presenting at least one permanent molar with emerged/sound occlusal surface participated. In the control group, oral health education and dental plaque dying followed by toothbrushing with fluoride dentifrice was carried outfour times per year. With the test group, children also underwent professional cross-brushing on surfaces of first permanent molar rendered by a dental assistant five times per year. Enamel/dentin caries were recorded on buccal, occlusal and lingual surfaces of permanent molars for a period of 18 months. The incidence density (ID) ratio was estimated using Poisson's regression model. The ID was 50% lower among boys in the test group (p = 0.016). The cost of the modified program was US$ 1.79 per capita. The marginal cost-effectiveness ratio among boys was US$ 6.30 per avoided carie. The modified supervised toothbrushing program was shown to be cost-effective in the case of boys.

Quality of diet of working college students

Considering the scarcity of studies with young workers and the role of diet in the prevention of chronic diseases, the objective of the study was to assess the quality of diet of working college students. The present study investigated 43 university students, aged between 18 and 25 years old who had systematically being involved in a working activity in the past 6 months, paid or unpaid, at least 6 hours daily, five days a week. Dietary intake measured by seven dietary records covering every day of the week was used to calculate the Brazilian Healthy Eating Index Revised (B-HEIR). It was observed a low B-HEIR score (53.43,+/- 7.81) indicating a risk of a poor quality of diet, with high intake of sodium and sugar and low consumption of fruits and whole grains. This poor quality of diet can result in an inadequate nutritional status that may increase the risk of obesity and chronic diseases.

New Protein Sources in Adults Diet for Mass-rearing of Anastrepha fraterculus (Diptera: Tephritidae)

The aim of this study was to find alternatives to reduce the cost of mass production of the South American fruit fly (A. fraterculus) by looking for locally available products as protein source in the diet of adults to replace the imported product without changing the quality parameters. Two yeast from a Brazilian company were evaluated. The quality parameters showed that the imported hydrolyzed yeast used in the adult diet could be perfectly replaced by the local products tested, with a reduction of over 80% of the cost of the diet. The quality of the produced insects remained the same and there were improvements in some quality parameters such as the volume of eggs produced, number of adults flying and longevity under the stress.

Results obtained with a low cost software-based audiometer for hearing screening

Introduction: The implementation of hearing screening programs can be facilitated by reducing operating costs, including the cost of equipment. The Telessaúde (TS) audiometer is a low-cost, software-based, and easy-to-use piece of equipment for conducting audiometric screening. Aim: To evaluate the TS audiometer for conducting audiometric screening. Methods: A prospective randomized study was performed. Sixty subjects, divided into those who did not have (group A, n = 30) and those who had otologic complaints (group B, n = 30), underwent audiometric screening with conventional and TS audiometers in a randomized order. Pure tones at 25 dB HL were presented at frequencies of 500, 1000, 2000, and 4000 Hz. A "fail" result was considered when the individual failed to respond to at least one of the stimuli. Pure-tone audiometry was also performed on all participants. The concordance of the results of screening with both audiometers was evaluated. The sensitivity, specificity, and positive and negative predictive values of screening with the TS audiometer were calculated. Results: For group A, 100% of the ears tested passed the screening. For group B, "pass" results were obtained in 34.2% (TS) and 38.3% (conventional) of the ears tested. The agreement between procedures (TS vs. conventional) ranged from 93% to 98%. For group B, screening with the TS audiometer showed 95.5% sensitivity, 90.4% sensitivity, and positive and negative predictive values equal to 94.9% and 91.5%, respectively. Conclusions: The results of the TS audiometer were similar to those obtained with the conventional audiometer, indicating that the TS audiometer can be used for audiometric screening.

Mass-rearing of Mediterranean fruit fly using low-cost yeast products produced in Brazil

Ceratitis capitata is one of the most important pests of fruits for exportation, and Sterile Insect Technique (SIT) has been the most efficient and environmental friendly technique used to control fruit fly populations around the world. A key goal in achieving a successful SIT program is a mass rearing system producing high quality insects at low cost. Providing adults with an artificial diet containing hydrolysed protein has been the major obstacle for bio-production facilities in Brazil, because it is expensive and has to be imported. Two other commercial products, autolysed yeast (AY) and yeast extract (YE), of domestic origin and low cost, were tested as substitutes of the imported hydrolyzed protein. To compare their efficiency we observed the female fecundity, adult survival and egg viability of flies raised on diets containing one of each of the different protein products. Flies reared on the domestic yeast products had equivalent or superior performance to the flies reared on imported protein. Both AY and YE can be a possible substitute for imported hydrolyzed protein for C. capitata mass-rearing, as they are cheaper and are readily available in the national market.

New protein sources in adults diet for mass-rearing of Anastrepha fraterculus (Diptera:Tephritidae)

The aim of this study was to find alternatives to reduce the cost of mass production of the South American fruit fly (A. fraterculus) by looking for locally available products as protein source in the diet of adults to replace the imported product without changing the quality parameters. Two yeast from a Brazilian company were evaluated. The quality parameters showed that the imported hydrolyzed yeast used in the adult diet could be perfectly replaced by the local products tested, with a reduction of over 80% of the cost of the diet. The quality of the produced insects remained the same and there were improvements in some quality parameters such as the volume of eggs produced, number of adults flying and longevity under the stress.