Insulin secretion, insulin sensitivity, and hepatic insulin extraction in first-degree relatives of type 2 diabetic patients

To identify early metabolic abnormalities in type 2 diabetes mellitus, we measured insulin secretion, sensitivity to insulin, and hepatic insulin extraction in 48 healthy normal glucose-tolerant Brazilians, first-degree relatives of type 2 diabetic patients (FH+). Each individual was matched for sex, age, weight, and body fat distribution with a person without history of type 2 diabetes (FH-). Both groups were submitted to a hyperglycemic clamp procedure (180 mg/dl). Insulin release was evaluated in its two phases. The first was calculated as the sum of plasma insulin at 2.5, 5.0, 7.5, and 10.0 min after the beginning of glucose infusion, and the second as the mean plasma insulin level in the third hour of the clamp procedure. Insulin sensitivity index (ISI) was the mean glucose infusion rate in the third hour of the clamp experiment divided by the mean plasma insulin concentration during the same period of time. Hepatic insulin extraction was determined under fasting conditions and in the third hour of the clamp procedure as the ratio between C-peptide and plasma insulin levels. FH+ individuals did not differ from FH- individuals in terms of the following parameters [median (range)]: a) first-phase insulin secretion, 174 (116-221) vs 207 (108-277) µU/ml, b) second-phase insulin secretion, 64 (41-86) vs 53 (37-83) µU/ml, and c) ISI, 14.8 (9.0-20.8) vs 16.8 (9.0-27.0) mg kg-1 min-1/µU ml-1. Hepatic insulin extraction in FH+ subjects was similar to that of FH- ones at basal conditions (median, 0.27 vs 0.27 ng/µU) and during glucose infusion (0.15 vs 0.15 ng/µU). Normal glucose-tolerant Brazilian FH+ individuals well-matched with FH- ones did not show defects of insulin secretion, insulin sensitivity, or hepatic insulin extraction as tested by hyperglycemic clamp procedures.

Pediatric pain: prevalence, assessment, and management in a teaching hospital

The goal of this study was to examine the prevalence, assessment and management of pediatric pain in a public teaching hospital. The study sample consisted of 121 inpatients (70 infants, 36 children, and 15 adolescents), their families, 40 physicians, and 43 nurses. All participants were interviewed except infants and children who could not communicate due to their clinical status. The interview included open-ended questions concerning the inpatients’ pain symptoms during the 24 h preceding data collection, as well as pain assessment and pharmacological/non-pharmacological management of pain. The data were obtained from 100% of the eligible inpatients. Thirty-four children/adolescents (28%) answered the questionnaire and for the other 72% (unable to communicate), the family/health professional caregivers reported pain. Among these 34 persons, 20 children/adolescents reported pain, 68% of whom reported that they received pharmacological intervention for pain relief. Eighty-two family caregivers were available on the day of data collection. Of these, 40 family caregivers (49%) had observed their child’s pain response. In addition, 74% reported that the inpatients received pharmacological management. Physicians reported that only 38% of the inpatients exhibited pain signs, which were predominantly acute pain detected during clinical procedures. They reported that 66% of patients received pharmacological intervention. The nurses reported pain signs in 50% of the inpatients, which were detected during clinical procedures. The nurses reported that pain was managed in 78% of inpatients by using pharmacological and/or non-pharmacological interventions. The findings provide evidence of the high prevalence of pain in pediatric inpatients and the under-recognition of pain by health professionals.

Main food sources of carotenoids, according to the purpose and degree of processing, for beneficiaries of the 'Bolsa Família' in Brazil

The intake of carotenoids is associated with antioxidant properties and some of these substances have activity of pro-vitamin A. This study aimed to estimate the intake of carotenoids (average values) by the Brazilian population focusing on beneficiaries of the 'Bolsa Família' Program and identify the dietary sources, according to the purpose and degree of processing and the inclusion of food additives. The database used is the personal food consumption module of the Household Budget Survey of 2008-2009, conducted by the Brazilian Institute of Geography and Statistics. The content of carotenoids in foods was obtained primarily from a National data source. Food products were classified into three categories: 1) fresh and minimally processed foods; 2) processed foods (containing food additives, except for flavoring and coloring agents); and 3) highly processed foods (containing flavoring and coloring agents). Insufficient intakes were identified for the conditional cash transfer program beneficiaries (3,547.1 µg). Fresh and minimally processed foods supplied between 48.6% (for girls) and 65.7% (for male adults) of pro-vitamin carotenoids. Processed foods were sources of between 55.5% and 57.0% of lutein + zeaxanthin for elderly and between 58.0% and 67.8% of lycopene for adults. Highly processed foods contributed to less than 5.0% of total carotenoids.

Influence of the wheat flour extraction degree in the quality of bread made with high proportions of β-glucan

β-glucan is currently one of the most important bioactive substances. Hence, there is a growing interest in the production of various foods containing β-glucan. The study examines the influence of the degree of wheat flour extraction in the quality of breads with high β-glucan content. Rheological tests were conducted on dough. Volume, mass, color and texture of bread were measured after baking. We observed that increasing the degree of extraction caused an increase in the storage and loss modulus. All of the bread made from the different flours were smaller in volume after the addition of β-glucan, although the yield increased. The crumb color of β-glucan-added breads was darker than the control samples. Control samples were higher in textural parameters (firmness, gumminess and chewiness). β-glucan-added samples had decreased porosity. The results revealed that using very strong flour with a high protein content results in a high quality β-glucan bread with a higher nutritional value due to the high total dietary fiber and β-glucan content.

Influence of the degree of hydrolysis and type of enzyme on antioxidant activity of okara protein hydrolysates

Abstract The objective of this work was to evaluate the antioxidant activity of protein hydrolysates obtained by the enzymatic hydrolysis of okara using an endopeptidase (Alcalase) and exopeptidase (Flavourzyme). The reaction was monitored by the pH-stat procedure in which five aliquots were collected during the hydrolysis by each enzyme, corresponding to different degrees of hydrolysis (DH). The antioxidant activities of the aliquots were evaluated by the ABTS, DPPH and FRAP methods. For the hydrolysates obtained using Alcalase, the antioxidant activities increased from: 68.6 to 99.5% (ABTS), 14.5 to 17.7% (DPPH) and 222.6 to 684.9 µM Trolox (FRAP), when the DH varied from 0 to 33.6%. With respect to Flavourzyme, the results were: 67.2 to 88.2% (ABTS), 9.5 to 18.5% (DPPH) and 168.0 to 360.3 µM Trolox (FRAP), when the DH increased up to 5.8%. The results showed that the protein hydrolysates had antioxidant capacities, which were influenced by the degree of hydrolysis and the type of enzyme.