Associação entre fatores nutricionais e a resposta frente à infecção por Leishmania chagasi

Leishmania chagasi infection presents a wide spectrum of clinical outcomes, ranging from asymptomatic self resolving infection to disease, visceral leishmaniasis (VL). The exact mechanisms that lead the evolution of infection to disease are not understood. It is believed that malnutrition is a risk factor associated with VL development, although there are few human studies in the area. We aimed to assess the nutritional factors associated with the response to L. chagasi infection in Rio Grande do Norte. The study was conducted from December 2006 to January 2008. 149 children were assessed: 20 active VL cases, 33 children with VL history, 40 DTH+ asymptomatic children and 56 DTH-. Nutritional status was assessed using z scores for Weight/Age, Weight/Height, Height/Age, Body Mass Index (BMI), and mid-upper arm circumference/height (MUAC/height). Vitamin A status was determined by serum retinol concentrations and the modified-relative-dose-esponse test (MRDR). Breastfeeding time and birth weight were also evaluated. VL children presented compromised nutritional status when compared to the other groups using BMI and MUAC/age, with means -1,53 ± 1,10 and -1,48 ± 1,28 z scores, respectively (ANOVA, p < 0,05). VL children also showed lower vitamin A levels: 43% presented serum retinol < 20 µg/dL and 15% MRDR > 0,060. Birth weight was inverserly associated with the risk to belong the VL group (β = -0,00; OR = 0,84; 95% CI 0,73 - 0,99; p = 0,047), whereas more breastfeeding time was directly associated with the risk to belong to the DTH+ group (β = 0,02; OD = 1,16; 95% CI 1,01 - 1,33; p = 0,036). The nutritional variables evaluated were associated with the response to the L. chagasi infection, with malnutrition and compromised vitamin A status as markers of children who present with VL. Higher birth weight was associated with protection to disease, and higher breastfeeding time was associated with increased likelihood of an asymptomatic infection. The results show that modifiable nutritional aspects in the study population are associated with the response to the L. chagasi infection

Promoção da alimentação saudável na atenção primária à saúde: contribuição para construção coletiva do saber-fazer

The recognition of the food as determinant and health-disease process etching requires new explanations and interventions of the food and nutrition policy action and demand health care model based on the completeness of the actions and focused on health promotion. This study, characterized as research-action of interventionist character, sought to develop strategies to support the transverse insertion of healthy eating promotion in professionals practices a core of support for the health of the family and a family health strategy Unit in the city of Natal, capital of Rio Grande do Norte, from the analysis of perceptions and work processes of these teams. Several methodological strategies were adopted: Dialectical Hermeneutical Circle, direct observation, reflective and Thematic Meetings Workshop "Rethinking the educational practices for promoting healthy eating". For data logging, search diaries - SD were used and moments. The analysis of procedural form occurred in conjunction with research participants, in constant movement of reflection-action-reflection, based on hermeneutics-dialectic. About the results, in relation to the promotion of health, showed the following insights: health promotion and disease prevention-related harms; health promotion related to quality of life and well-being, in its various dimensions; health promotion as a responsibility of the State; health promotion related to the actions of health education; health promotion as an expression of efficaciousness and accessibility to health services. Regarding healthy nutrition, predominated the perceptions relating to nutritional aspects. With regard to food and nutritional education - FNE, it was observed a predominance of perception of FNE as information, guidance and knowledge transfer for changes of dietary practices. As regards the working process, it was observed that among the actions for health promotion, educational activities predominate, such as lectures, conversations, groups that mostly occur in fragmentary form, without joint planning teams, varying according to the professionals and the moment of work in which they are carried out. The results pointed to the need for reorganization of the work processes, in the context of intra-and intersectoral coordination and the construction of new technologies, such as: Health project of the territory – HPT, Unique Therapeutic Project- UPT, Expanded Clinic and educational practices, Shared with active teaching and learning methodologies. From the results we believe that it is necessary to "thought reform", from changes in vocational training and strengthening of the permanent education spaces, whereas the complexity that involves feeding, food and nutrition education and health promotion. The reformation of thought must be articulate and closely tied to the production of knowledge and practices that encourage intersectoral approach, the transversality, dialogue and democratic and supportive attitude, based on the collective construction of know-how. We hope that this study can contribute with reflections and initiatives that encourage building practices that promote healthy eating in primary health care, in terms of completeness of the care and the attainment of food security and nutrition.

Estudo da reidratação do feijão verde (Vigna unguiculata L. Walp) desidratado por micro-ondas com e sem pré-tratamento osmótico

The green bean has organoleptic and nutritional characteristics that make it an important food source in tropical regions such as the Northeast of Brazil. It is a cheap source of protein and important for nutrition of rural population contributing significantly in subsistence farming of the families from Brazil s northeast. It is consumed in entire region and together with the dry meat and other products composes the menu of typical restaurants, being characterized as an important product for economy of Northeast. The green bean is consumed freshly harvested and has short cycle, being characterized as a very perishable food, which hampers your market. The drying method is an alternative to increase the lifetime and provide a reduction volume of this product making easier your transportation and storage. However is necessary to search ways of drying which keep the product quality not only from the nutritional standpoint but also organoleptic. Some characteristics may change with the drying process such as the coloring, the rehydration capacity and the grains cooking time. The decrease of drying time or of exposure of the grains to high temperature minimizes the effects related with the product quality loss. Among the techniques used to reduce the drying time and improve some characteristics of the product, stands out the osmotic dehydration, widely used in combined processes such as the pretreatment in drying food. Currently the use of the microwaves has been considered an alternative for drying food. The microwave energy generates heat inside of materials processed and the heating is practically instantaneous, resulting in shorter processing times and product quality higher to that obtained by conventional methods. Considering the importance of the green beans for the Northeast region, the wastefulness of production due to seasonality of the crop and your high perishability, the proposal of this thesis is the study of drying grain by microwaves with and without osmotic pretreatment, focusing on the search of conditions of processes which favor the rehydration of the product preserving your organoleptic characteristics. Based on the analysis of the results of osmotic dehydration and dielectric properties was defined the operating condition to be used in pretreatment of the green bean, with osmotic concentration in saline solution containing 12,5% of sodium chloride, at 40°C for 20 minutes. The drying of green bean by microwave was performed with and without osmotic pretreatment on the optimized condition. The osmotic predehydration favored the additional drying, reducing the process time. The rehydration of dehydrated green bean with and without osmotic pretreatment was accomplished in different temperature conditions and immersion time according to a factorial design 22, with 3 repetitions at the central point. According to results the better condition was obtained with the osmotically pretreated bean and rehydrated at a temperature of 60°C for 90 minutes. Sensory analysis was performed comparing the sample of the green bean in natura and rehydrated in optimized conditions, with and without osmotic pretreatment. All samples showed a good acceptance rate regarding the analyzed attributes (appearance, texture, color, odor and taste), with all values above 70%. Is possible conclude that the drying of green bean by microwave with osmotic pretreatment is feasible both in respect to technical aspects and rehydration rates and sensory quality of the product