Avaliação da Ingestão Alimentar de Idosos em Hemodiálise.

O número de pacientes idosos iniciando tratamento dialítico aumentou de maneira importante nas últimas duas décadas. Por esse motivo, é importante conhecer sobre aspectos nutricionais desse segmento de pacientes. Poucos trabalhos até o momento investigaram a ingestão alimentar de pacientes idosos em hemodiálise (HD) com foco na qualidade da dieta. Dessa forma, o objetivo deste estudo é investigar o padrão alimentar de idosos em HD, verificar se o dia de tratamento dialítico pode alterar o padrão alimentar, avaliar se o padrão alimentar se associa com marcadores do estado nutricional e averiguar se o padrão alimentar de pacientes idosos em HD difere do de idosos sem doença renal crônica (DRC). Métodos: Este trabalho tem desenho observacional e transversal. Foram avaliados 153 pacientes idosos (> 60 anos) em tratamento crônico de HD (Grupo Estudo: 70,8 7,2 anos) e 47 idosos sem DRC (Grupo Controle: 73,2 7,9 anos). A avaliação do estado nutricional, no Grupo Estudo, foi feita por medidas antropométricas, impedância bioelétrica, força de preensão manual, albumina sérica e avaliação subjetiva global de 7 pontos. O consumo alimentar foi avaliado a partir do registro alimentar de 3 dias, sendo 1 dia do final de semana sem diálise (FS), 1 dia da semana com diálise (HD) e 1 dia da semana sem diálise (SHD) para o Grupo Estudo; e 1 dia do final de semana (FS) e um dia da semana (dia 1) para o Grupo Controle. O padrão alimentar foi avaliado pelo índice de qualidade da dieta revisado (IQD-R), com 12 componentes e pontuação máxima de 100 pontos, indicando melhor qualidade da dieta. Para avaliar o consumo de alimentos ultraprocessados, os alimentos foram categorizados em três grupos (in natura, ingredientes de adição e ultraprocessados). Resultados: Não houve diferença estatística na pontuação total do IQD-R entre os três dias avaliados no Grupo Estudo. No entanto, observou-se diferença quando avaliado os componentes do IQD-R. Notou-se menor consumo de frutas integrais (2,66 0,18 vs. 3,28 0,18 pontos), vegetais verde-escuros e alaranjados (2,99 0,19 vs. 3,55 0,16 pontos) no dia HD comparado ao dia SHD, respectivamente. Quanto ao consumo de alimentos ultraprocessados, apenas no dia HD a contribuição energética desse grupo alimentar (41,6 17,6%) foi similar à de alimentos in natura (41,7 15,9%), enquanto nos dias FS e SHD a contribuição de alimentos in natura foi maior. Não foram observadas associações clinicamente significantes entre a pontuação total do IQD-R e parâmetros nutricionais no Grupo Estudo. Ao comparar o Grupo Estudo com o Grupo Controle, notou-se que a pontuação total do IQD-R foi menor no Grupo Estudo em todos os três dias avaliados e as maiores diferenças foram encontradas no dia HD. O mesmo se repete quanto à contribuição energética dos alimentos ultraprocessados, que foi maior no dia HD (41,6 17,6%) quando comparado ao dia 1 do Grupo Controle (33,4 15,9%). Essa diferença não foi observada quando o dia 1 do Grupo Controle foi comparado ao dia SHD. Conclusão: Pacientes idosos em HD apresentam pior padrão alimentar no dia HD e pior do que de idosos sem DRC. Fica clara a importância de rever as orientações alimentares voltadas a esse grupo de pacientes, de forma a favorecer um padrão alimentar compatível com uma boa saúde.

Assessment of the carp seeds value chain in southern Bangladesh (final draft)

The Aquaculture for Income and Nutrition (AIN) project implemented by World Fish and funded by USAID, aims at increasing aquaculture production in 20 districts of Southern Bangladesh (Greater Khulna, Greater Barisal, Greater Jessore and Greater Faridpur) to reduce poverty and enhance nutritional status. As part of its initial scoping activities World Fish commissioned this value chain assessment on the market chains of carp fish seed (spawn, fry and fingerlings) in the southern region of Bangladesh. The purpose of this study is to obtain a clearer understanding of the volumes of fish produced and consumed in Southern Bangladesh and their origin (by system and location), their destination (by type of market, type of consumer and location), and to gain a clearer understanding of potential market based solutions to farmer’s problems, which the project could implement.

Nutritive value of the crab Podophthalmus vigil (Fabricius)

Among the edible crabs, Podophthalmus vigil occupies a distinct position in Porto Novo coast. Though the fishery is seasonal, P. vigil supports an additional crab fishery from august to october. An attempt has been made to evaluate the nutritional status of different size groups of P. vigil. It has been observed that protein and moisture values are more in smaller crabs, corresponding with a drop in carbohydrate and fat. In bigger size groups, the values of fat and carbohydrate are found to be higher, while protein and moisture contents decreased slightly. The total meat content varies in different crabs of the same size group and the average value of the total consumable part is found to be only less than 30% of the total weight of the animal.

Effect of water washing on biochemical and gel characteristics of minced meat from croaker fish (Johnius gangeticus)

Quality of analog fishery products invariably depends on the gel characteristics and nutritional status of minced meat. With an objective to find out the effect of water washing on kamaboko gel, the minced meat from Croaker fish was washed for four times (5 minutes each) using chilled water at a temperature of 8-10°C. Results reflected noticeable improvement in folding test and SSN% of kamaboko with essential decrease in fat content, water soluble proteins, expressible water and quality parameters like NPN, VBN, TMA, FFA and PV denoting superior gel quality than control sample after repeated washing. The results indicated that there was a definite improvement in functional properties such as gel forming ability, expressible water content of the croaker minced meat essential decrease in fat content, water soluble proteins, expressible water and quality parameters after each wash, but two washes of 5 minutes duration each was necessary to achieve satisfactory results.

Effect of dietary linolenic acid/linoleic acid ratio on growth performance, hepatic fatty acid profiles and intermediary metabolism of juvenile yellow catfish Pelteobagrus fulvidraco

The present study aimed to evaluate the effect of dietary linolenic acid (LNA)linoleic acid (LA) ratio on growth performance, hepatic fatty acid profile and intermediary metabolism of juvenile yellow catfish Pelteobagrus fulvidraco. Six isonitrogenous and isolipidic diets were formulated to contain incremental levels of LNA from 0 to 5% at the expense of corn oil (rich in LA), resulting in six dietary treatments with LNA to LA ratios ranging from 0.35 to 14.64. The experiment continued for 7 weeks. Best growth and feed intake were obtained in the fish fed the diets containing the LNA/LA ratios of 1.17 and 2.12 (P<0.05). In contrast, feed conversion ratio was the lowest for fish fed the diets containing the LNA/LA ratios of 1.17 and 2.12 (P<0.05). Dietary LNA to LA ratios significantly influenced viscerosomatic index and hepatosomatic index (P<0.05), but not condition factor (P>0.05). Body composition was also significantly influenced by dietary LNA to LA ratios (P<0.05). Generally, liver FA compositions reflected dietary FA profiles. Declining LA and increasing LNA contents in liver were observed with the increasing dietary LNA/LA ratios (P<0.05). Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) increased with the increasing LNA to LA ratios, suggesting that yellow catfish could elongate and desaturate C18 polyunsaturated fatty acids into highly unsaturated fatty acids. As a consequence, the n-6 fatty acids (FA) declined, and total n-3 FA and n-3/n-6 ratios increased with the dietary ratios of LNA/LA (P<0.05). Dietary LNA to LA ratios significantly influenced several enzymatic activities involved in liver intermediary metabolism (P<0.05), such as lipoprotein lipase, hepatic lipase, pyruvate kinase, succinate dehydrogenase, malic dehydrogenase and lactate dehydrogenase, suggesting that dietary LNA/LA ratios had significant effects on nutrient metabolism in the liver. To our knowledge this is the first demonstration of the effects of dietary LNA to LA ratios on the enzymatic activities of liver in fish, which provides information on diet quality and utilization, and can also be used as an indicator of the nutritional status of this fish. (C) 2009 Elsevier B.V. All rights reserved.

RESPONSES OF Elodea nuttallii AND Ceratophyllum demersum TO HIGH TEMPERATURE

There were large losses of exotic species Elodea nuttallii during summer in eutrophic lakes of the middle and lower reaches of the Yanatze River, China. To investigate the main causes, the heat tolerance of E. nuttallii was studied and compared with that of native species Ceratopkyllum demersum by using an aquaria system in the laboratory. Under 4500 lx light intensity and 12-h L/12-h D cycle, E. nuttallii cultured in 1/5 Hoaglands solution at 39 degrees C showed a positive growth rate during the first 15 days, and the growth rate was higher than that at 35 degrees C. But after 15 days, the growth rates became negative for those cultured both at 39 and 35 degrees C. However, the growth rate was positive for more than 20 days for those cultured at 25 degrees C. Under the same conditions, the growth rate, productivity and chlorophyll content of E. nuttallii were significantly higher than that of C. demersum. Heat tolerance of E. nuttallii was also stronger than that of C. demersum. The optimal temperature for the growth of the two plants depended on the experimental period: both plants grew at an optimal rate at higher temperature if the experimental period was short; nevertheless the plants achieved optimal growth at a lower temperature if the experiment was conducted for a longer period. At the same light intensity, the heat tolerance of C. demersum in tap water with sediment was markedly stronger than that of E. nuttallii at 39 degrees C. Average growth rate of C. demersum was 4.5 times higher than that of E. nuttallii within 25 days. The positive growth period lasted for less than 25 days for E. nuttallii and for more than 25 days for C. demersum. When they were cultured in 1/5 Hoaglands solution and in tap water with sediment, the growth rate of C. demersum increased from 0.4 to 79.4 mg/d.g fresh weight (FW) within 20 days. E. nuttallii increased from 8.3 to 24.4 mg/d-g FW within 20 days. Both grew better in tap water with sediment than in 1/5 Hoaglands solution. The results demonstrated that the nutritional status of the water other than the high temperature affected the heat tolerance of E. nuttallii during summer. E. nuttallii has great ecological safe risk in China.

Influence of Potamogeton crispus growth on nutrients in the sediment and water of Lake Tangxunhu

An incubation experiment was performed on Potamogeton crispus (P. crispus) using sediment collected from Lake Tangxunhu in the center of China, in order to determine the effects of plant growth on Fe, Si, Cu, Zn, Mn, Mg, P, and Ca concentrations in the sediments and overlying waters. After 3 months of incubation, Ca, Mg, and Si concentrations in the water column were significantly lower, and P and Cu concentrations were significantly higher than in unplanted controls. The effect of P. crispus growth on sediment pore waters and water-extractable elements varied. Concentrations of Ca, Mg, Si, Fe, Cu, and Zn were significantly higher, and P was significantly lower, than in pore waters of the control. Water-extracted concentrations of Fe, Mg, and Si in the sediments were lower, and P was higher, than in the control. Presence of P. crispus generally enhanced concentration gradients of elements between pore waters and overlying waters but not for P. The growth of P. crispus was associated with an increase in water pH and formation of root plaques, resulting in complex effects on the sediment nutritional status.

Feeding, morphological changes and allometric growth during starvation in miiuy croaker larvae

We investigated the effects of the timing of first feeding (larvae in F0, F1, F2, F3 and S were first fed on day 3, 4, 5, 6 days after hatching (DAH) and unfed, respectively) on feeding, morphological changes, survival and growth in miiuy croaker larvae at 24A degrees C. The fed larvae initiated feeding on 3 DAH and reached point of no return (PNR) on 6 DAH. Larvae in F0 and F1 groups survived apparently better than F2 group at the end of the experiment on 36 DAH. High larval mortality occurred from 3 to 7 DAH in all feeding groups, accounting for 40% (F0, F1 and F2 groups) to 90% (F3 and S groups) of the total mortality. Larvae in F0 and F1 groups grew better than F2 group throughout the experiment. Eye diameter, body height, head height and mouth gape of the first feeding larvae were more sensitive to starvation than other morphometrics and could be used as indicators for evaluating their nutritional status. Results indicated that delayed first feeding over 1 day after yolk exhaustion could lead to poor larval survival and growth. To avoid starvation and obtain good growth in culturing, larvae feeding should be initiated within 1 day after yolk exhaustion at 24A degrees C.

Nutrição Artificial nos Serviços Farmacêuticos Hospitalares

Projeto de Pós-Graduação/Dissertação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências Farmacêuticas

Variations in total and differential milk somatic cell counts and plasmin levels and their role in proteolysis and quality of milk and cheese

Increased plasmin and plasminogen levels and elevated somatic cell counts (SCC) and polymorphonuclear leucocyte levels (PMN) were evident in late lactation milk. Compositional changes in these milks were associated with increased SCC. The quality of late lactation milks was related to nutritional status of herds, with milks from herds on a high plane of nutrition having composition and clotting properties similar to, or superior to, early-mid lactation milks. Nutritionally-deficient cows had elevated numbers of polymorphonuclear leucocytes (PMNs) in their milk, elevated plasmin levels and increased overall proteolytic activity. The dominant effect of plasmin on proteolysis in milks of low SCC was established. When present in elevated numbers, somatic cells and PMNs in particular had a more significant influence on the proteolysis of both raw and pasteurised milks than plasmin. PMN protease action on the caseins showed proteolysis products of two specific enzymes, cathepsin B and elastase, which were also shown in high SCC milk. Crude extracts of somatic cells had a high specificity on αs1-casein. Cheeses made from late lactation milks had increased breakdown of αs1-casein, suggestive of the action of somatic cell proteinases, which may be linked to textural defects in cheese. Late lactation cheeses also showed decreased production of small peptides and amino acids, the reason for which is unknown. Plasmin, which is elevated in activity in late lactation milk, accelerated the ripening of Gouda-type cheese, but was not associated with defects of texture or flavour. The retention of somatic cell enzymes in cheese curd was confirmed, and a potential role in production of bitter peptides identified. Cheeses made from milks containing high levels of PMNs had accelerated αs1-casein breakdown relative to cheeses made from low PMN milk of the same total SCC, consistent with the demonstrated action of PMN proteinases. The two types of cheese were determined significantly different by blind triangle testing.

Cancer associated malnutrition: prevalence of cachexia, sarcopenia and impact on treatment outcomes, survival and health related quality of life

Malnutrition, sarcopenia and cancer cachexia (CC) are prevalent among cancer patients and can have detrimental effects on clinical outcomes such as quality of life (QoL) and overall survival. Cachexia is associated with lower tolerance for chemotherapy, which limits the total dose that can be delivered, the number of symptomatic responses and any survival advantage that might be accrued. Moreover, for the majority who do not respond, cachexia may be exacerbated by systemic chemotherapy, thus increasing the net symptom burden experienced by patients. The multitude of interactions between cancer location, treatments, nutritional status and QoL has never been thoroughly explored in an Irish cancer cohort. The objectives of this thesis were to further understand nutritional status, especially body composition in ambulatory cancer patients and determine the relationship between nutritional status using different assessment criteria and QoL, chemotherapy toxicity and survival among cancer patients undergoing chemotherapy. Results aimed to identify baseline factors that may be predictive of poor outcome, toxicities to chemotherapy and disease-free and overall survival. This thesis broadly divides into two sections. The first section (Chapters 3 & 4) focuses on improving our knowledge of the nutritional status of Irish cancer outpatients using a cross sectional study design. A study of 517 patients referred for chemotherapy was conducted using computed tomography (CT) imaging (body composition) and a survey that documented oncologic data, weight loss (WL) data and QoL data. We revealed that a significant proportion of Irish cancer patients undergoing chemotherapy experience unintentional WL over the previous 6 months (62%), sarcopenia (45%) and CC (43%), and the distribution of WL and nutritional risk were associated with site of primary tumour and treatment intent. Patients that had sarcopenia, nutritional risk, or CC had significantly reduced functional abilities, more symptoms and adverse global QoL. In the second section of this thesis (Chapters 5 & 6) the potential link between developing toxicity to antineoplastic regimens in patients with sarcopenia was conducted by way of retrospective studies. A retrospective serial CT analysis defined the prevalence of sarcopenia in patients with metastatic renal cell carcinoma (mRCC) and metastatic castrate resistant prostate cancer (mCRPC), which was then correlated with dose limiting toxicities of sunitinib and docetaxel respectively. Sarcopenia was prevalent in patients with mRCC and mCRPC, was an occult condition in patients with normal/high BMI, was associated with less treatment days, was a significant predictor of DLT in patients receiving sunitinib and a significant predictor of neutropenia and neurosensory toxicities in patients receiving docetaxel. This thesis attempted to address the underlying research deficiencies in Irish oncology nutritional data at national level. The findings from this thesis have implications for the planning of cancer care interventions and indicate that further research is required to improve nutritional screening, in particular for CC and sarcopenia, in the hope that timely intervention can improve both patient-centered and oncologic outcomes.

Mycobacteriosis in Chesapeake Bay Striped Bass (Morone saxatilis): The Interaction of Nutrition and Disease

Field and laboratory studies were conducted from 1998 - 2005 to examine the relationship between nutritional status and mycobacteriosis in Chesapeake Bay striped bass (Morone saxatilis). A review of DNA from archived tissue blocks indicated that the disease has been present since at least 1984. Field surveys and feeding trials were conducted from 1998-1999 to determine the nutritional condition of striped bass and the association with disease state. Proximate composition revealed elevated moisture (~ 80%) and low storage lipids (< 0.5% ww), characteristic of a poorly nourished population. These findings were not consistent with data collected in 1990-1991, or with experimentally fed fish. Mycobacteriosis explained little of the variance in chemical composition (p > 0.2); however elevated moisture and low lipid concentration were associated with fish with ulcerative lesions (p < 0.05). This suggests that age 3 and 4 striped bass were in poor nutritional health in 1998-1999, which may be independent from the disease process. Challenge studies were performed to address the hypothesis that disease progression and severity may be altered by nutritional status of the host. Intraperitoneal inoculation of 104 CFU M. marinum resulted in high mortality, elevated bacterial density, and poor granuloma formation in low ration (0.15% bw/d) groups while adequately fed fish (1% bw/d) followed a normal course of granulomatous inflammation with low mortality to a steady, equilibrium state. Further, we demonstrated that an active inflammatory state could be reactivated in fish through reductions in total diet. The energetic demand of mycobacteriosis, was insignificant in comparison to sham inoculated controls in adequately fed fish (p > 0.05). Declines in total body energy were only apparent during active, inflammatory stages of disease. Overall, these findings suggest that: 1) mycobacteriosis is not a new disease of Chesapeake Bay striped bass, 2) the disease has little energetic demand in the normal, chronic progression, and 3) poor nutritional health can greatly enhance the progression and severity, and reactivation of disease. The implications of this research are that management strategies focused on enhancing the nutritional state of striped bass could potentially alter the disease dynamics in Chesapeake Bay.

Intake, digestibility, and passage of a commercially designed diet by two Propithecus species.

The digestibility and passage of an experimental diet was used to compare the digestive physiology of two Propithecus species: P. verreauxi and P. tattersalli. Though both animals have a similar feeding ecology, the captive status of P. verreauxi is considered more stable than that of P. tattersalli. The test diet included a local tree species, Rhus copallina, at 15% of dry matter intake (DMI) and Mazuri Leafeater Primate Diet at 85% of DMI. The chemical composition of the diet (dry matter basis) was 25% crude protein, 34% neutral detergent fiber (NDF), and 22% acid detergent fiber (ADF) with a gross energy of 4.52 kcal/g. After a 6 week acclimation to the experimental diet, animals were placed in research caging. After a 7 day adjustment period, animals were dosed with chromium mordant and Co-EDTA as markers for digesta passage and all feed refusals and feces were collected at timed intervals for 7 days. Digestibility values, similar for both species, were approximately 65% for dry matter, crude protein, and energy, and 40% and 35% respectively, for NDF and ADF. Transit times (17-18.5 hr) and mean retention times (31-34 hr) were not significantly different between species, and there was no difference between the chromium mordant and Co-EDTA. Serum values for glucose, urea, and non-esterified fatty acids (NEFA) were obtained during four different time periods to monitor nutritional status. While there was no change in serum glucose, serum urea increased over time. The NEFAs increased across all four time periods for P. verreauxi and increased for the first three periods then decreased in the last period for P. tattersalli. Results obtained indicate no difference in digestibility nor digesta passage between species, and that both Propithecus species were similar to other post-gastric folivores.

Role of T cells in malnutrition and obesity.

Nutritional status is critically important for immune cell function. While obesity is characterized by inflammation that promotes metabolic syndrome including cardiovascular disease and insulin resistance, malnutrition can result in immune cell defects and increased risk of mortality from infectious diseases. T cells play an important role in the immune adaptation to both obesity and malnutrition. T cells in obesity have been shown to have an early and critical role in inducing inflammation, accompanying the accumulation of inflammatory macrophages in obese adipose tissue, which are known to promote insulin resistance. How T cells are recruited to adipose tissue and activated in obesity is a topic of considerable interest. Conversely, T cell number is decreased in malnourished individuals, and T cells in the setting of malnutrition have decreased effector function and proliferative capacity. The adipokine leptin, which is secreted in proportion to adipocyte mass, may have a key role in mediating adipocyte-T cell interactions in both obesity and malnutrition, and has been shown to promote effector T cell function and metabolism while inhibiting regulatory T cell proliferation. Additionally, key molecular signals are involved in T cell metabolic adaptation during nutrient stress; among them, the metabolic regulator AMP kinase and the mammalian target of rapamycin have critical roles in regulating T cell number, function, and metabolism. In summary, understanding how T cell number and function are altered in obesity and malnutrition will lead to better understanding of and treatment for diseases where nutritional status determines clinical outcome.

Leptin metabolically licenses T cells for activation to link nutrition and immunity.

Immune responses are highly energy-dependent processes. Activated T cells increase glucose uptake and aerobic glycolysis to survive and function. Malnutrition and starvation limit nutrients and are associated with immune deficiency and increased susceptibility to infection. Although it is clear that immunity is suppressed in times of nutrient stress, mechanisms that link systemic nutrition to T cell function are poorly understood. We show in this study that fasting leads to persistent defects in T cell activation and metabolism, as T cells from fasted animals had low glucose uptake and decreased ability to produce inflammatory cytokines, even when stimulated in nutrient-rich media. To explore the mechanism of this long-lasting T cell metabolic defect, we examined leptin, an adipokine reduced in fasting that regulates systemic metabolism and promotes effector T cell function. We show that leptin is essential for activated T cells to upregulate glucose uptake and metabolism. This effect was cell intrinsic and specific to activated effector T cells, as naive T cells and regulatory T cells did not require leptin for metabolic regulation. Importantly, either leptin addition to cultured T cells from fasted animals or leptin injections to fasting animals was sufficient to rescue both T cell metabolic and functional defects. Leptin-mediated metabolic regulation was critical, as transgenic expression of the glucose transporter Glut1 rescued cytokine production of T cells from fasted mice. Together, these data demonstrate that induction of T cell metabolism upon activation is dependent on systemic nutritional status, and leptin links adipocytes to metabolically license activated T cells in states of nutritional sufficiency.