853 resultados para nutritional indicators


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Background/Aims: Patients with chronic liver disease undergoing liver transplantation have reduced body fat and muscle mass. The extent to which nutritional indicators and Child-Pugh class are predictive of postoperative outcome in adults is unclear. The aims of this study were to determine in adult patients undergoing transplant 1) the influence of preoperative Child-Pugh class and nutritional indicators on early transplant outcomes and one-year survival, 2) the relationship between nutritional indicators and Child-Pugh class and disease type. This study included 80 patients (1990-1994). Methodology: The nutritional indicators utilized were grip strength, triceps skinfold thickness and uncorrected mid-arm muscle area. Measured outcomes were ventilator time, intensive care stay, postoperative hospital stay and one-year survival. Results: Early morbidity was determined in survivors. Child-Pugh class C patients required longer ventilation and spent more time in the intensive care unit than Child-Pugh classes A and B. No significant relationships were found length of hospital stay. Relationships between the nutritional indicators (when controlled for Child-Pugh class) and early morbidity could not be determined due;to insufficient data. No relationship was established between one-year survival and Child-Pugh class or the nutritional indicators. Grip strength and mid-arm muscle area were lower in the patients in Child-Pugh:classes B and C. Parenchymal liver disease was associated with lower grip strength and mid-arm muscle area when compared to cholestatic disease. Conclusions: Child-Pugh class C is associated with greater early postoperative morbidity. Advanced Child-Pugh class is also associated with diminished muscle status and parenchymal disease.

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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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This study aimed at learning about the nutritional profile of HIV-positive individuals undergoing antiretroviral therapy and at comparing the performance of nutritional-state indicators. A transversal study was performed on 94 patients attending the Tropical Diseases Outpatient Hospital of Botucatu Medical School (FMB)-UNESP. The body mass index (BMI) and the classification by Papini-Berto (PB) were used to evaluate nutritional state, aiming at detecting malnutrition and obesity. The waist-to-hips ratio (W/HR) and waist circumference (WC) were adopted for identification of abdominal obesity and lipodystrophy. According to BMI, most of the individuals were eutrophic, followed by 30.9% overweight and 6.4% malnourished. By using the PB classification, the frequency of malnourished increased (22.3%). The analysis of the PB classification in relation to BMI indicated that the former presented high sensitivity and good specificity for malnutrition diagnosis, namely 100% and 83%, respectively. The prevalence of abdominal obesity was 7.44% according to WC, and a higher prevalence (38.3%) was observed when taking W/HR into account. There was significant positive association between nutritional diagnosis according to PB and T CD4(+) lymphocyte. The results support the use of PB classification for malnutrition detection as well as that of BMI and W/HR for overweight and fat redistribution.

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Background: Few data is available on long-term secular trends in height and weight in children in countries in transition. We assessed the secular trends in height and weight among representative samples of children and adolescents from the Seychelles (African region). Methods: Weight and height data from all students of all schools in four selected school grades (kindergarten, 4th, 7th and 10th years) were collected by cross-sectional surveys for periods 1998-9 (3,676 boys, 3,715 girls) and 2005-6 (4,867 boys, 4,846 girls). Data from 1956-7 was extracted from a previously published report. Results: Height increased, in boys, by 1.6 cm/decade for the period 1956-7 to 1998- 9, and 1.1 cm/decade for the period 1998-8 to 2005-6; in girls, the corresponding figures were 0.9 cm/decade and 1.8 cm/decade. At age 15.5 years, boys/girls were taller by 10/13 cm in 2005-6 than in 1956-7. Weight increased, in boys, by 1.4 kg/decade for the period 1956-7 to 1998-9, and by 2.2 kg/decade for the subsequent period; the corresponding figures in girls were 1.1 kg/decade and 2.5 kg/decade. Conclusion: Marked upward secular trends in body height and weight were documented in children and adolescents aged <16 years in the Seychelles, consistent with large changes in socio-economic and nutritional indicators in the considered 50- year interval. However, indirect evidence suggests that the secular height gain reflects accelerated growth during childhood over time with less than commensurate impact on adult height. Conversely, the largely steeper secular increase in weight than height is consistent with a pediatric obesity epidemic.

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BACKGROUND: Height of individuals has long been considered as a significant index of nutrition and health of a population; still, there is little information regarding the trends of height and weight among developing or transitional countries. We assessed the secular trends in height and weight in children of the Seychelles, a rapidly developing island state in the Indian Ocean (African region). METHODS: Height and weight were measured in all students of all schools in four selected school grades (kindergarten, 4th, 7th and 10th grades) for the periods 1998-9 (6391 children) and 2005-6 (8582 children). Data for 1956-7 was extracted from a previously published report. RESULTS: At age 15.5 years, boys/girls were on average 10/13 cm taller and 15/9 kg heavier in 2005-6 than in 1956-7. Height increased in boys/girls by 1.62/0.93 cm/decade between 1956-7 and 1998-9 and by 1.14/1.82 cm/decade between 1998-9 and 2005-6. For weight, the linear increase in boys/girls was 1.38/1.10 kg/decade between 1956-7 and 1998-9 and 2.21/2.50 kg/decade between 1998-9 and 2005-6. Overall, the relative increase in weight between 1956-7 and 2005-6 was 5-fold higher than the relative increase in height. CONCLUSION: Height and weight increased markedly over time in children aged <16 years in the Seychelles, consistent with large changes in socio-economic and nutritional indicators in the considered 50-year interval. The markedly steeper increase in weight than height over time is consistent with an epidemic of overweight and obesity.

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Introducción: La desnutrición infantil es una importante preocupación en países en desarrollo y se relaciona con condiciones de pobreza. Metodología: Estudio secundario de una muestra de 1.232 datos de menores de cinco años con diagnóstico nutricional obtenido en forma retrospectiva en la evaluación del SISVAN año 2009 para Bogotá. Se utilizó para el procesamiento de la información Epi Info 6.04 y SPSS 17.0. Resultados: Se encontró que el 37.2% de los menores está en riesgo de desnutrición, el 27.3% tiene desnutrición aguda y el 7.2% desnutrición crónica. Fontibón y Chapinero presentan la mayor desnutrición aguda y crónica respectivamente. Los menores con reducidos ingresos familiares, de estrato uno, con madres que estudian y trabajan, divorciadas o viudas, o que sean desplazados actuales presentan mayor riesgo de desnutrición. La desnutrición aguda es mayor en los niños con desplazamientos mayores de un año o con esquemas de vacunación incompleto. Cuando se presentan inadecuadas condiciones de saneamiento, peso al nacer inferior a 2000 gramos, madres con escolaridad primaria o grupos etáreos entre 3 y 5 años se observa mayor desnutrición crónica. Quienes reciben lactancia materna exclusiva presentan menor desnutrición aguda y crónica. Conclusiones: En la población estudiada, el riesgo de desnutrición está por encima de la desnutrición aguda y crónica. Los resultados sugieren que la desnutrición y el riesgo de desnutrición pueden ser reducidos mejorando educación materna, saneamiento, prolongando la lactancia y cumpliendo esquemas de vacunación.

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Na passagem para o século XX, a agricultura sofreu transformações no modelo de produção. Atualmente, a maior parte dos alimentos são produzidos no modelo da agricultura convencional baseada na utilização intensiva de insumos químicos e alta produtividade, em contraponto, a agricultura orgânica está alicerçada na independência de insumos externos e na qualidade dos alimentos. O morango (Fragaria x Ananassa Duch), reconhecido por suas vitaminas e compostos quimioprotetores, tais como o ácido ascórbico e licopeno, é uma cultura produzida tanto no sistema orgânico, quanto no convencional. Entretanto, não existem informações sobre os tipos de sistemas existentes dentro destas duas formas de fazer agricultura e nem dados sobre os conteúdos de ácido ascórbico e de licopeno. Os objetivos deste trabalho foram: tipificar os sistemas de cultivo praticados e identificar as características básicas da produção de morango em Porto Alegre; quantificar os indicadores nutricionais licopeno e ácido ascórbico em morangos cv. Vila Nova, oriundos de diferentes sistemas de cultivo e avaliar a possibilidade dessas substâncias servirem como descritores da qualidade biológica dos frutos produzidos nestas diferentes formas de fazer agricultura. Foram escolhidos cinco sistemas de produção de morangos no bairro Lami, Porto Alegre/RS, sendo duas propriedades orgânicas (OJ, OS) e três convencionais (CN, CP, CB) Para a tipificação foi usada à observação participativa com registro dos dados sobre a intensidade dos componentes de cultivo (manejos, adubação, controle fitossanitário, técnicas de irrigação) e sócio-econômicos. Para medir os teores de licopeno e ácido ascórbico foram cultivados morangos cv. Vila Nova, os quais foram colhidos maduros e analisados. Dentro do sistema convencional existe uma intensidade variada na utilização de insumos. No sistema orgânico um foi tipificado como agroecológico e outro como em final de transição para o orgânico. Os sistemas convencionais têm alta demanda por produtos externos, principalmente em relação à adubação (adubos minerais de alta solubilidade), irrigação (mangueiras, etc) e controle fitossanitário (produtos químicos de síntese) e os sistemas orgânicos apresentam uma baixa dependência externa em relação ao controle fitossanitários, irrigação e manejo. Eles apresentaram dependência de adubos orgânico de origem animal. Os resultados demonstraram que o conteúdo de licopeno variou de 0,033 a 0,063 mg/100g de peso fresco e que ele não foi eficiente como descritor da qualidade hortícola de morangos cultivados em sistemas orgânicos e convencionais. O conteúdo de ácido ascórbico foi de 30,05 a 69,39 mg/100g de peso fresco. Esta vitamina não discrimina diferenças entre os sistemas, e não pode ser considerada como um descritor de qualidade biológica de morangos cultivados em sistemas orgânicos e convencionais.

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Pós-graduação em Bases Gerais da Cirurgia - FMB

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No presente estudo foram analisados possíveis fatores bio-sócio-ambientais interferentes na exposição ao mercúrio em crianças ribeirinhas. Participaram 103 crianças das regiões do rio Tapajós, rio Acará e ilha do Marajó. O tipo de estudo foi seccional analítico. Foram colhidas amostras de cabelo para análise dos teores de Hgtotal, de sangue (análise de hemoglobina e hematócrito) e fezes. Foram utilizados índices antropométricos na análise do crescimento das crianças. Na avaliação do desenvolvimento neuropsicomotor foi aplicado o teste de triagem Denver II modificado. A maior média dos teores de Hgtotal em amostras de cabelo das crianças foi na região do Tapajós (5,58 μg/g) e 0,65 μg/g nas demais localidades. A prevalência de Hgtotal >10 μg/g foi 25% e 7,5% em São Luiz do Tapajós e Barreira. O consumo diário de peixes pelas famílias das crianças quando relacionado com teores de Hgtotal p(valor) foi < 0,05. A prevalência do tempo de amamentação das crianças nos grupos com menos de 12 meses e maior de 6 meses para as localidades do rio Tapajós, quando relacionadas com teores de Hgtotal no cabelo das crianças apresentou p(valor) <0,05. A prevalência de anemia nas crianças da região Tapajós era de 46,7% e quando relacionada com teores de Hgtotal p(valor) <0,0001.Os exames coproscópicos indicaram que 68,3% eram poliparasitadas, quando relacionadas com Hgtotal p(valor) <0,05. O perfil do crescimento observado através dos indicadores do estado nutricional era 82,6% com peso adequado para idade e 14,5% com peso muito baixo e baixo. O desempenho neuropsicomotor examinado pelo teste de triagem Denver II modificado apresentou cinco crianças como suspeitas de atraso no desenvolvimento. Concluiu-se que localidades no entorno de atividades garimpeira as crianças ribeirinhas são expostas ao risco de contaminação mercurial. Fatores bio-sócio-ambientais interferentes na exposição ao mercúrio tais como consumo diário de peixes, tempo de amamentação, anemia, enteroparasitoses apresentaram relações estatísticas significativas com o Hgtotal no cabelo das crianças.

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The authors show the relations among arm circumference, arm muscle and arm fat areas with or without menarche, by carrying out an anthropometric study in 717 adolescents in the municipality of Botucatu. It must be emphasized that those adolescents who had already menstruated presented significantly higher nutritional indicators than those who had not menstruated yet. There was an increase in fat tissue and lean body mass in those adolescents who had already menstruated. Body changes might be expressed by calculating muscle and arm fat areas using triceps skinfold and arm circumference.

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El interés creciente en encontrar alimentos precocinados congelados que se asemejen a productos naturales, capaces de superar un procesado con el menor daño, ha generado un aumento en el estudio de nuevos productos en este campo de la investigación. Las características de cada matriz alimentaria, la composición y estructura de los ingredientes, así como el efecto de las interacciones entre ellos, modifica la textura, estructura y las propiedades físicas y sensoriales del alimento, así como su aceptación por el consumidor. En este contexto, la investigación realizada en esta tesis doctoral se ha llevado a cabo en puré de patata considerado como una matriz alimentaria semisólida y se ha centrado en analizar los efectos de la concentración y modificación de la composición en las propiedades reológicas y de textura, en las propiedades físico-químicas y estructurales, así como en los atributos sensoriales de los purés de patata cuando a estos se le añaden diferentes ingredientes funcionales como fibra de guisante, inulina, aceite de oliva, aislado de proteína de soja, ácidos grasos omega 3 y/o sus mezclas. Para ello, se han realizado cuatro estudios donde se determinan las propiedades reológicas mediante ensayos dinámicos oscilatorios y en estado estacionario, los parámetros instrumentales de textura mediante ensayos de extrusión inversa y de penetración cónica, además de los cambios estructurales a través de cromatografía iónica con detector de pulsos amperométrico, cromatografía de gases con detector de ionización de llama y microscopía electrónica de barrido. Conjuntamente, se han evaluado los atributos sensoriales de los diferentes purés generando los descriptores que mejor definen la calidad sensorial del producto, utilizando un panel de jueces entrenados y valorándose la aceptación global de los nuevos productos mediante un panel de consumidores. En un primer estudio, el puré de patata natural congelado elaborado con crioprotectores se enriqueció con fibra dietética insoluble (fibra de guisante), fibra dietética soluble (inulina) y sus mezclas. La fibra de guisante influyó significativa y negativamente en la textura del puré de patata, percibiéndose en el producto un incremento de la dureza y de la arenosidad, mientras que la inulina produjo un ablandamiento del sistema. En un segundo estudio, el puré de patata natural fresco y congelado/descongelado elaborado con y sin crioprotectores, se enriqueció con fibra dietética soluble (inulina), aceite de oliva virgen extra y sus mezclas. La adición de estos dos ingredientes generó un ablandamiento de la matriz del sistema, produciéndose, sin embargo, un efecto sinérgico entre ambos ingredientes funcionales. La inulina tuvo un efecto más significativo en la viscosidad aparente del producto, mientras que el aceite de oliva virgen extra afectó más significativamente a la pseudoplasticidad, al índice de consistencia y a la viscosidad plástica del mismo. El proceso de congelación y descongelación utilizado favoreció la reducción del tamaño de las partículas de inulina haciéndolas imperceptibles al paladar, obteniéndose productos más cremosos y con mayor aceptabilidad global que sus homólogos frescos. En un tercer estudio, el puré de patata natural fresco y congelado/descongelado elaborado con crioprotectores se enriqueció con mezclas de fibra dietética soluble (inulina) y aislado de proteína de soja. Los resultados demostraron que el ciclo de congelación y descongelación realizado no afecta el grado de polimerización de la inulina. La estructura química de la inulina tampoco se vio afectada por la incorporación de la soja. El proceso de congelación/descongelación, así como la adición de concentraciones altas de inulina y bajas de aislado de proteína de soja, favorecen la disminución de la contribución de la componente viscosa en las propiedades viscoelásticas del puré de patata. La cremosidad fue el único atributo sensorial que presentó una correlación lineal significativa entre las puntuaciones otorgadas por panelistas entrenados y no entrenados. Por último, se elaboró un puré de patata natural fresco y congelado/descongelado optimizado con crioprotectores y enriquecido con la suma de ácido docosahexaenoico (DHA, C22:6 n-3) y ácido eicosapentaenoico (EPA, C20:5 n-3) y con ácido α-linolénico (ALA, C18:3 n-3) microencapsulados. El ciclo de congelación y descongelación no afectó al perfil de ácidos grasos del puré de patata. La adición de omega 3 procedente de aceites de lino y pescado microencapsulados mejora los indicadores nutricionales que definen la calidad de la grasa, obteniéndose un producto más saludable. ABSTRACT The growing interest in finding frozen precooked products that are like a natural product and capable of withstanding initial processing with minimum damage and remaining stable during preservation and reheating prior to consumption has generated an increase in studies of new products in this field of research. The characteristics of each food matrix, the composition and structure of the ingredients and the effect of interactions between them alter the texture, structure and physical and sensory properties of the food product and its acceptance by the consumer. In this context, the research conducted in this doctoral thesis was carried out on mashed potato, considered as a semi-solid food matrix, and focused on analysing the effects of concentration and modification of the composition of the mashed potato matrix on the rheological and textural properties, physicochemical and structural properties and sensory attributes of mashed potato when various functional ingredients are added to it, such as pea fibre, inulin, olive oil, soy protein isolate, omega 3 fatty acids and/or mixtures of these ingredients. Four studies were conducted for this purpose. Rheological properties were determined by oscillatory dynamic tests and stationary state tests, and instrumental texture parameters by backward extrusion and cone penetration tests. Structural changes were studied by ion chromatography with pulsed amperometric detector, gas chromatography with flame ionisation detector and scanning electron microscopy. The sensory attributes of the various mashed potato mixtures were evaluated by generating the descriptors that best defined the sensory quality of the products and using a panel of trained judges, and overall acceptance of the new products was evaluated by a panel of consumers. In the first study, frozen natural mashed potato incorporating cryoprotectants was enriched with insoluble dietary fibre (pea fibre), soluble dietary fibre (inulin) and mixtures of the two. Pea fibre had a significant negative influence on the texture of the mashed potato, producing an increase in hardness and granularity, whereas inulin produced a softening of the system. In the second study, fresh and frozen/thawed natural mashed potato prepared with and without cryoprotectants was enriched with soluble dietary fibre (inulin), extra virgin olive oil and mixtures of the two. The addition of these two ingredients generated softening of the matrix of the system, but a synergic effect between the two functional ingredients was produced. Inulin had a more significant effect on the apparent viscosity of the product, whereas extra virgin olive oil had a more significant effect on its pseudoplasticity, consistency index and plastic viscosity. The freezing and thawing process that was used contributed to a reduction in the size of the inulin particles, making them imperceptible to the palate and producing creamier products with greater overall acceptability than their fresh equivalents. In the third study, the fresh and frozen/thawed natural mashed potato incorporating cryoprotectants was enriched with mixtures of soluble dietary fibre (inulin) and soy protein isolate. The results showed that the freezing and thawing process that was performed did not affect the degree of polymerisation of the inulin. The chemical structure of the inulin was also not affected by the incorporation of soy. The freezing and thawing process and the addition of high concentrations of inulin and low concentrations of soy protein isolate favoured a decrease in the contribution of the viscous component to the viscoelastic properties of the mashed potato. Creaminess was the only sensory attribute that presented a significant linear correlation between the scores given by trained and untrained panellists. Lastly, fresh and frozen/thawed natural mashed potato optimised with cryoprotectants was prepared and enriched with the sum of docosahexaenoic acid (DHA, C22:6 n-3) and eicosapentaenoic acid (EPA, C20:5 n-3) and with α-linolenic acid (ALA, C18:3 n-3), microencapsulated. The freezing and thawing process did not affect the fatty acid profile of the mashed potato. The addition of omega 3 obtained from microencapsulated linseed and fish oils improved the nutritional indicators that define the quality of the fat, producing a healthier product.

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This study aimed to verify the correlation among the nutritional composition of the food consumed in the work environment, the energy expenditure and the nutritional status of workers from different sectors (administration and production) in different industries. The anthropometric data, in addition to the energy expenditure and food intake at lunch were evaluated for 292 workers, all of them included in the Brazilian Worker Food Program (also called PAT). The food consumption was assessed from the direct observation of the meal, for five consecutive days. The obtained data were analyzed by Pearson correlation test and by a Principal Components Analysis. Prevalence of overweight was detected in the studied population, according to the Body Mass Index (BMI). A statistically significant difference was found in terms of the energy expenditure of physical activity and daily energy expenditure in relation to gender and the working sector. The obtained results indicate that there is significant positive correlation (p < 0.01) between the following variables: body weight and BMI (r = 0.84), weight and daily energy expenditure (DEE) (r = 0.52), BMI and DEE (r = 0.27), DEE and energy (r = 0.38), and energy and lipid intake (r = 0.50). These findings seems to indicate the importance of ensuring an adequate balance of nutrients at meals, due to the heterogeneity of workers, in particular in the case of those workers who perform tasks or functions requiring less energy expenditure.

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Introduction: The high prevalence of disease-related hospital malnutrition justifies the need for screening tools and early detection in patients at risk for malnutrition, followed by an assessment targeted towards diagnosis and treatment. At the same time there is clear undercoding of malnutrition diagnoses and the procedures to correct it Objectives: To describe the INFORNUT program/ process and its development as an information system. To quantify performance in its different phases. To cite other tools used as a coding source. To calculate the coding rates for malnutrition diagnoses and related procedures. To show the relationship to Mean Stay, Mortality Rate and Urgent Readmission; as well as to quantify its impact on the hospital Complexity Index and its effect on the justification of Hospitalization Costs. Material and methods: The INFORNUT® process is based on an automated screening program of systematic detection and early identification of malnourished patients on hospital admission, as well as their assessment, diagnoses, documentation and reporting. Of total readmissions with stays longer than three days incurred in 2008 and 2010, we recorded patients who underwent analytical screening with an alert for a medium or high risk of malnutrition, as well as the subgroup of patients in whom we were able to administer the complete INFORNUT® process, generating a report for each.

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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.