59 resultados para Nutritional Assessment
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The beneficial effects derived from the nutritional support in human patients and experimental animal models include the improvement of immune function, repair of wounds, answer to the treatment, time of recovery and survival. In front of these benefits, we end up alienating the nutritional needs of hospitalized patients, especially those with clinical or surgical affections threatening. The objective of the nutritional support is to indicate the importancea and the proportions of energy and nutrients that the patient can use with the maximum effectiveness. The majority of hospitalized patients do not have voluntary food intake adequate to meet even the minimal nutritional needs. It is often perceived that lack of adequate food intake, will have serious impact on the patient’s clinical outcome. The nutritional assessment will help determine which route of feeding will be the safest, most effective and best tolerated by the patient. Diet choice is based on which of the patient’s problems can and should be addressed with nutrition and the feeding access available
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Free radicals are produced during aerobic cellular metabolism and have key roles as regulatory mediators in signaling processes. Oxidative stress reflects an imbalance between production of reactive oxygen species and an adequate antioxidant defense. This adverse condition may lead to cellular and tissue damage of components, and is involved in different physiopathological states, including aging, exercise, inflammatory, cardiovascular and neurodegenerative diseases, and cancer. In particular, the relationship between exercise and oxidative stress is extremely complex, depending on the mode, intensity, and duration of exercise. Regular moderate training appears beneficial for oxidative stress and health. Conversely, acute exercise leads to increased oxidative stress, although this same stimulus is necessary to allow an up-regulation in endogenous antioxidant defenses (hormesis). Supporting endogenous defenses with additional oral antioxidant supplementation may represent a suitable noninvasive tool for preventing or reducing oxidative stress during training. However, excess of exogenous antioxidants may have detrimental effects on health and performance. Whole foods, rather than capsules, contain antioxidants in natural ratios and proportions, which may act in synergy to optimize the antioxidant effect. Thus, an adequate intake of vitamins and minerals through a varied and balanced diet remains the best approach to maintain an optimal antioxidant status. Antioxidant supplementation may be warranted in particular conditions, when athletes are exposed to high oxidative stress or fail to meet dietary antioxidant requirements. Aim of this review is to discuss the evidence on the relationship between exercise and oxidative stress, and the potential effects of dietary strategies in athletes. The differences between diet and exogenous supplementation as well as available tools to estimate effectiveness of antioxidant intake are also reported. Finally, we advocate the need to adopt an individualized diet for each athlete performing a specific sport or in a specific period of training, clinically supervised with inclusion of blood analysis and physiological tests, in a comprehensive nutritional assessment. (C) 2015 Elsevier Inc. All rights reserved.
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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Pós-graduação em Ciências da Motricidade - IBRC
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Pós-graduação em Fisiopatologia em Clínica Médica - FMB
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CONTEXTO E OBJETIVO: Portadores de insuficiência renal crônica em diálise apresentam alta prevalência de desnutrição proteico-energética. Não existe ainda um método uniforme para avaliar o estado nutricional desses pacientes. Recomenda-se a aplicação de um conjunto de métodos subjetivos e objetivos para se chegar aos diagnósticos nutricionais adequados. O objetivo deste estudo é traçar o perfil nutricional de pacientes submetidos a hemodiálise. TIPO DE ESTUDO E LOCAL: Estudo transversal descritivo realizado na Unidade de Tratamento Dialítico de Araraquara, São Paulo, Brasil, em 2008. MÉTODOS: 48 pacientes tiveram seus indicadores antropométricos e bioquímicos caracterizados, sendo também submetidos ao questionário Avaliação Global Subjetiva modificada (SGAm), verificando-se possíveis correlações entre esses indicadores. RESULTADOS: A frequência de desnutrição moderada e grave variou de 22% a 54%, de acordo com o parâmetro utilizado. Com relação à adequação do peso ideal, 29% da amostra estavam com porcentagem de adequação abaixo do percentil 75, classificados como portadores de desnutrição moderada e grave. As correlações mais significativas foram observadas entre índice de massa corporal (IMC) e adequações de prega triciptal (PCT), circunferência do braço (CB) e circunferência muscular do braço (CMB); e entre o SGAm e adequações de CB e CMB. CONCLUSÃO: A desnutrição apresentou grande variabilidade de frequência entre os pacientes de acordo com o critério escolhido para avaliação. O acompanhamento nutricional de rotina e a validação de métodos que avaliem a composição corporal desses pacientes são de extrema importância para diagnosticar precocemente a desnutrição e assim prevenir complicações e reduzir as taxas de morbimortalidade nesta população.
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Assessment of vitamin A status in chronic obstructive pulmonary disease patients and healthy smokers
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Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
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Background and aims. Dementia weakens older people and can lead to malnutrition; therefore, the objective of this study was to assess the association between indicators of dementia and biochemical indicators, anthropometric indicators and food intake in institutionalised older people. Methods. A total of 150 older people of both genders participated in this study. Nutritional status was determined by body mass index and other anthropometric variables, and biochemical indicators were used to analyse the differences between individuals with and without dementia. Energy and nutrient intakes were determined by food records, and dementia was investigated with the Mini-Mental State Examination. The data were analysed by the chi-square test, Student's t-test and Mann-Whitney tests. Results. Of the 150 individuals studied, 48% were men with a mean age of 73±10years and 52% were women with a mean age of 80±9years. Thirty-six per cent had some degree of malnutrition and 48% presented dementia, which was more prevalent in women (59%). The nutritional status of men and women individuals with and without dementia differed significantly (P<0.001 for men and women). The only variables that presented a significant difference between individuals with and without dementia were those associated with muscle mass in men. There were no differences in energy and nutrient intakes between individuals with and without dementia except for vitamin C intake, which differed among women (P=0.032). Conclusion. In the conditions of the present study, dementia was associated with nutritional status, but not with energy and nutrient intakes, suggesting that older people with dementia may have higher nutritional requirements. Implications for practice. Investigation of dementia may contribute to the nutritional status assessment of older people and energy expenditure and immobility should be investigated for a more complete assessment. © 2012 Blackwell Publishing Ltd.
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PURPOSE: Malnutrition is prevalent in patients with advanced liver disease (LD) related to multifactorial causes. Fluid retention can underestimate the nutritional status based on anthropometric measures. We evaluated nutritional indicators and body composition (BC) in patients with liver cirrhosis and correlated them with LD severity. METHODS: Forty three patients with LD enrolled for liver transplantation were evaluated by Anthropometric measures, subjective evaluation (Global Assessment of Nutritional Status - SGA) and biochemical indicators. Single-frequency electrical bioimpedance (SFE-BIA) was used to evaluate body composition (BC). It measured resistance (R), reactance (Xc) and the phase angle (PA). LD severity was estimated by Child-Pugh and Meld criteria (Model for End-Stage Liver Disease). RESULTS: Child-Pugh index between patients was 7.11±1.70 and Meld was 12.23±4.22. Arm Circumference, Arm Muscle Circumference and Arm Muscle Area, SGA, hemoglobin, hematocrit and albumin showed better correlation with disease severity. Xc and PA showed correlation both with Meld and Child-Pugh score when BC were evaluated. PA was depleted in 55.8% of the patients. CONCLUSIONS: Diagnosis of malnutrition varied according to the method. Global assessment of nutritional status showed better correlation with disease severity than with objective methods. Single-frequency electrical bioimpedance for body composition analysis in cirrhotic patients must be cautiously used; however, primary vectors seems to be valid and promising in clinical practice.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)