Impact of income on nutrient intakes: implications for undernourishment and obesity

The relationship between income and nutrient intake is explored. Nonparametric, panel, and quantile regressions are used. Engle curves for calories, fat, and protein are approximately linear in logs with carbohydrate intakes exhibiting diminishing elasticities as incomes increase. Elasticities range from 0.10 to 0.25, with fat having the highest elasticities. Countries in higher quantiles have lower elasticities than those in lower quantiles. Results predict significant cumulative increases in calorie consumption which are increasingly composed of fats. Though policies aimed at poverty alleviation and economic growth may assuage hunger and malnutrition, they may also exacerbate problems associated with obesity.

Influence of age on the development of immunological lung response in intrauterine undernourishment

Objective: We investigated the effect of intrauterine undernourishment on some features of asthma using a model of allergic lung inflammation in rats. The effects of age at which the rats were challenged (5 and 9 wk) were also evaluated. Methods: Intrauterine undernourished offspring were obtained from dams that were fed 50% of the nourished diet of counterparts and were immunized at 5 and 9 wk of age. They were tested for immunoglobulin E anti-ova titers (by passive cutaneous anaphylaxis), cell count in the bronchoal-veolar fluid, leukotriene concentration, airway reactivity, mucus production, and blood corticosterone and leptin concentrations 21 d, after immunologic challenge. Results: Intrauterine undernourishment significantly reduced the antigen-specific immunoglobulin E production, inflammatory cell infiltration into airways, mucus secretion, and production of leukotrienes B-4/C-4 in the lungs in both age groups compared with respective nourished rats. The increased reactivity to methacholine that follows antigen challenge was not affected by intrauterine undernourishment. Corticosterone levels increased with age in the undernourished rats` offspring, but not in the nourished rats` offspring. Undernourished offspring already presented high levels of corticosterone before inflammatory stimulus and were not modified by antigen challenge. Leptin levels increased with challenge in the nourished rats but not in the undernourished rats and could not be related to corticosterone levels in the. undernourished rats. Conclusion: Intrauterine undernourishment has a striking and age-dependent effect on the off spring, reducing lung allergic inflammation. (C) 2008 Elsevier Inc. All rights reserved.

Intrauterine Undernourishment Alters TH1/TH2 Cytokine Balance and Attenuates Lung Allergic Inflammation in Wistar Rats

IL-4 produced by Th2 cells can block cytokine production by Th1 cells, and Th1 IFN-gamma is known to counterregulate Th2 immune response, inhibiting allergic eosinophilia. As intrauterine undernutrition can attenuate lung inflammation, we investigated the influence of intrauterine undernourishment on the Th1/Th2 cytokine balance and allergic lung inflammation. Intrauterine undernourished offspring were obtained from dams fed 50% of the nourished diet of their counterparts and were immunized at 9 weeks of age. We evaluated the cell counts and cytokine protein expression in the bronchoalveolar lavage, mucus production and collagen deposition, and cytokine gene expression and transcription factors in lung tissue 21 days after ovalbumin immunization. Intrauterine undernourishment significantly reduced inflammatory cell airway infiltration, mucus secretion and collagen deposition, in rats immunized and challenged. Intrauterine undernourished rats also exhibited an altered cytokine expression profile, including higher TNF-alpha and IL-1 beta expression and lower IL-6 expression than well-nourished rats following immunization and challenge. Furthermore, the intrauterine undernourished group showed reduced ratios of the IL-4/IFN-gamma and the transcription factors GATA-3/T-Bet after immunization and challenge. We suggest that the attenuated allergic lung inflammation observed in intrauterine undernourished rats is related to an altered Th1/Th2 cytokine balance resulting from a reduced GATA-3/T-bet ratio. Copyright (C) 2012 S. Karger AG, Basel

Differential effects of undernourishment on the differentiation and maturation of rat enteric neurons

The colocalization, number, and size of various classes of enteric neurons immunoreactive (IR) for the purinergic P2X2 and P2X7 receptors (P2X2R, P2X7R) were analyzed in the myenteric and submucosal plexuses of control, undernourished, and re-fed rats. Pregnant rats were exposed to undernourishment (protein-deprivation) or fed a control diet, and their offspring comprised the following experimental groups: rats exposed to a normal diet throughout gestation until postnatal day (P)42, rats protein-deprived throughout gestation and until P42, and rats protein-deprived throughout gestation until P21 and then given a normal diet until P42. Immunohistochemistry was performed on the myenteric and submucosal plexuses to evaluate immunoreactivity for P2X2R, P2X7R, nitric oxide synthase (NOS), choline acetyltransferase (ChAT), calbindin, and calretinin. Double-immunohistochemistry of the myenteric and submucosal plexuses demonstrated that 100% of NOS-IR, calbindin-IR, calretinin-IR, and ChAT-IR neurons in all groups also expressed P2X2R and P2X7R. Neuronal density increased in the myenteric and submucosal plexuses of undernourished rats compared with controls. The average size (profile area) of some types of neurons in the myenteric and submucosal plexuses was smaller in the undernourished than in the control animals. These changes appeared to be reversible, as animals initially undernourished but then fed a normal diet at P21 (re-feeding) were similar to controls. Thus, P2X2R and P2X7R are present in NOS-positive inhibitory neurons, calbindin- and calretinin-positive intrinsic primary afferent neurons, cholinergic secretomotor neurons, and vasomotor neurons in rats. Alterations in these neurons during undernourishment are reversible following re-feeding

Phenotypic characterization of Schistosoma mansoni adult wormsrecovered from undernourished mice: a morphometric study focusing on the reproductive system

A morphometric study focusing on some features of the reproductive system of Schistosoma mansoni adult worms was performed, aiming to complete previously reported data concerning the effects of undernourishment of the host on the parasites. Male worms were significantly affected (p<0.05) regarding the testicular lobes.

Evolução, a curto prazo, do perfil do estado de nutrição no transplante hepático, em adultos : contributo para otimização da abordagem clínica e nutricional

RESUMO:Contexto: A avaliação do estado de nutrição do doente com indicação para transplante hepático (TH) deve ser abrangente, considerando o amplo espetro de situações clínicas e metabólicas. As alterações metabólicas relacionadas com a doença hepática podem limitar a aplicação de métodos de avaliação nutricional, subestimando a desnutrição. Após o TH, é expectável a reversão dos distúrbios metabólicos da doença hepática, pela melhoria da função do fígado. No entanto, algumas complicações metabólicas podem surgir após o TH, relacionadas com a má-nutrição, a desnervação hepática e o uso prolongado de imunossupressão, comprometendo os resultados clínicos a longo-prazo. A medição longitudinal e confiável do metabolismo energético e dos compartimentos corporais após o TH, avaliada em conjunto com fatores influentes no estado de nutrição, pode identificar precocemente situações de risco e otimizar e individualizar estratégias clínicas e nutricionais com vantagens no prognóstico. Objetivo: Avaliar longitudinalmente, a curto prazo, o estado de nutrição após o TH em doentes com insuficiência hepática por doença crónica e identificar os fatores, para além da cirurgia, que determinam diferentes evoluções do metabolismo energético e da composição corporal. Métodos: Foi estudada uma coorte de indivíduos com indicação para TH por doença hepática crónica, admitidos consecutivamente para TH ortotópico eletivo, durante 2 anos. Foram programados 3 momentos de avaliação: na última consulta pré-TH (T0), logo que adquirida autonomia respiratória e funcional após o TH (T1) e um mês após o TH (T2). Nesses momentos, foram medidos no mesmo dia: o suprimento nutricional por recordatório das últimas 24 horas, o estado de nutrição por Avaliação Subjetiva Global (ASG), o gasto energético em repouso (GER) por calorimetria indireta, a antropometria, a composição corporal por bioimpedância elétrica tetrapolar multifrequências e a força muscular por dinamometria de preensão palmar. O índice de massa magra (IMM) e a massa celular corporal (MCC) foram usados como indicadores do músculo esquelético e a percentagem de massa gorda (%MG) e o índice de massa gorda (IMG) como indicadores de adiposidade. O GER foi comparado com o estimado pelas fórmulas de Harris-Benedict para classificação do estado metabólico em:hipermetabolismo (GER medido >120% do GER estimado), normometabolismo (GER medido entre 80 e 120% do GER estimado) e hipometabolismo (GER medido <80% do GER estimado). Foi utilizada análise multivariável: por regressão logística, para identificar variáveis associadas à possibilidade (odds ratio – OR) de pertencer a cada grupo metabólico pré-TH; por regressão linear múltipla, para identificar variáveis associadas à variação dos compartimentos corporais no período pós-TH; e por modelos de efeitos mistos generalizados, para identificar variáveis associadas à evolução do GER e dos compartimentos corporais entre o período pré- e pós-TH. Resultados: Foram incluídos 56 indivíduos com idade, média (DP), 53,7 (8,5) anos, 87,5% do sexo masculino, 23,2% com doença hepática crónica de etiologia etanólica. Após o TH, em 60,7% indivíduos foi administrado regime imunossupressor baseado no tacrolimus. Os indivíduos foram avaliados [mediana (AIQ)] 90,5 (P25: 44,2; P75: 134,5) dias antes do TH (T0), 9,0 (P25: 7,0; P75: 12,0) dias após o TH (T1) e 36,0 (P25: 31,0; P75: 43,0) dias após o TH (T2). Após o TH houve melhoria significativa do estado de nutrição, com diminuição da prevalência de desnutrição classificada pela ASG (37,5% em T0, 16,1% em T2, p<0,001). Antes do TH, 41,1% dos indivíduos eram normometabólicos, 37,5% hipometabólicos e 21,4% hipermetabólicos. A possibilidade de pertencer a cada grupo metabólico pré-TH associou-se à: idade (OR=0,899, p=0,010) e desnutrição pela ASG (OR=5,038, p=0,015) para o grupo normometabólico; e índice de massa magra (IMM, OR=1,264, p=0,049) e etiologia viral da doença hepática (OR=8,297, p=0,019) para o grupo hipermetabólico. Não se obteve modelo múltiplo para o grupo de hipometabólico pré-TH, mas foram identificadas associações univariáveis com a história de toxicodependência (OR=0,282, p=0,047) e com a sarcopénia pré- TH (OR=8,000, p=0,040). Após o TH, houve normalização significativa e progressiva do estado metabólico, indicada pelo aumento da prevalência de normometabolismo (41,1% em T0, 57,1% em T2, p=0,040). Foram identificados diferentes perfis de evolução do GER após o TH, estratificado pelo estado metabólico pré-TH: no grupo hipometabólico pré-TH, o GER (Kcal) aumentou significativa e progressivamente (1030,6 em T0; 1436,1 em T1, p=0,001; 1659,2 em T2, p<0,001); no grupo hipermetabólico pré-TH o GER diminuiu significativa e progressivamente (2097,1 em T0; 1662,5 em T1, p=0,024; 1493,0 em T2, p<0.001); no grupo normometabólico não houve variações significativas. Os perfis de evolução do GER associaram-se com: peso corporal (β=9,6, p<0,001) e suprimento energético (β=13,6, p=0,005) na amostra total; com peso corporal (β=7,1, p=0,018) e contributo energético dos lípidos (β=18,9, p=0,003) no grupo hipometabólico pré-TH; e com peso corporal (β=14,1, p<0,001) e desnutrição pela ASG (β=-171,0, p=0,007) no grupo normometabólico pré-TH.Houve redução transitória dos compartimentos corporais entre T0 e T1, mas a maioria destes recuperou para valores semelhantes aos pré-TH. As exceções foram a água extracelular, que diminuiu entre T0 e T2 (média 18,2 L e 17,8 L, p=0,042), a massa gorda (média 25,1 Kg e 21,7 Kg, p<0,001) e o IMG (média 10,6 Kg.m-2 e 9,3 Kg.m-2, p<0,001) que diminuíram entre T1 e T2. Relativamente à evolução dos indicadores de músculo esquelético e adiposidade ao longo do estudo: a evolução do IMM associou-se com força de preensão palmar (β=0,06, p<0,001), creatininémia (β=2,28, p<0,001) e número total de fármacos administrados (β=-0,21, p<0,001); a evolução da MCC associou-se com força de preensão palmar (β=0,16, p<0,001), creatininémia (β=4,17, p=0,008) e número total de fármacos administrados (β=-0,46, p<0,001); a evolução da %MG associou-se com força de preensão palmar (β=-0,11, p=0,028), história de toxicodependência (β=-5,75, p=0,024), creatininémia (β=-5,91, p=0,004) e suprimento proteico (β=-0,06, p=0,001); a evolução do IMG associou-se com história de toxicodependência (β=- 2,64, p=0,019), creatininémia (β=-2,86, p<0,001) e suprimento proteico (β=-0,02, p<0,001). A variação relativa (%Δ) desses compartimentos corporais entre T1 e T2 indicou o impacto da terapêutica imunossupressora na composição corporal: o regime baseado na ciclosporina associou-se positivamente com a %Δ do IMM (β=23,76, p<0,001) e %Δ da MCC (β=26,58, p<0,001) e negativamente com a %Δ MG (β=-25,64, p<0,001) e %Δ do IMG (β=-25,62, p<0,001), relativamente ao regime baseado no tacrolimus. Os esteróides não influenciaram a evolução do GER nem com a dos compartimentos corporais. Conclusões: O estado de nutrição, avaliado por ASG, melhorou significativamente após o TH, traduzida pela diminuição da prevalência de desnutrição. O normometabolismo pré-TH foi prevalente e associou-se à menor idade e à desnutrição pré- TH. O hipometabolismo pré-TH associou-se à história de toxicodependência e à sarcopénia pré-TH. O hipermetabolismo pré-TH associou-se ao maior IMM e à etiologia viral da doença hepática. Após o TH, houve normalização progressiva do estado metabólico. Foram identificados três perfis de evolução do GER, associando-se com: peso corporal e suprimento energético na amostra total; peso corporal e contributo energético dos lípidos no grupo hipometabólico pré- TH; e peso corporal e desnutrição pela ASG no grupo normometabólico pré-TH. Foram identificados diferentes perfis de evolução da composição corporal após TH. A evolução do músculo esquelético associou-se positivamente com a força de preensão palmar e a creatininémia e negativamente com o número total de fármacos administrados. A evolução da adiposidade (%MG e IMG) associou-se inversamente com a história de toxicodependência, a creatininémia e o suprimento proteico; adicionalmente, a %MG associou-se inversamente com a força de preensão palmar. O regime baseado na ciclosporina associou-se independentemente com diminuição da adiposidade e aumento do músculo esquelético, comparativamente ao regime baseado no tacrolimus.---------------------------ABSTRACT:Background: The assessment of nutritional status in patients undergoing liver transplantation (LTx) should be comprehensive, accounting for the wide spectrum of the clinical and metabolic conditions. The metabolic disturbances related to liver disease may limit the precision and accuracy of traditional nutritional assessment methods underestimating the undernourishment. After LTx, it is expected that many metabolic derangements improve with the recovery of liver function. However, some metabolic complications arising after LTx, related to nutritional status, hepatic denervation, and prolonged immunosuppression, may compromise the longterm outcome. A reliable longitudinal assessment of both energy metabolism and body compartments after LTx, combined with assessments of other factors potentially affecting the nutritional status, may enable a better interpretation on the relationship between the metabolic and the nutritional status. These reliable assessments may precociously identify nutritional risk conditions and optimize and customize clinical and nutritional strategies improving the prognosis. Objective: To assess longitudinally the nutritional status shortly after orthotopic LTx in patients with chronic liver disease, and identify factors, beyond surgery, determining different energy metabolism and body composition profiles.Methods: A cohort of consecutive patients who underwent LTx due to chronic liver disease was studied within a period of two years. The assessments were performed in three occasions: at the last visit before LTx (T0), after surgery as soon as respiratory and functional autonomy was established (T1), and approximately one month after surgery (T2). On each occasion all assessments were performed on the same day, and included: the dietary assessment by 24- hour dietary recall, nutritional status by the Subjective Global Assessment (SGA), the resting energy expenditure (REE) by indirect calorimetry, anthropometry, body composition by multifrequency bioelectrical impedance analysis, and muscle strength by handgrip strength. Both the lean mass index (LMI) and body cell mass (BCM) were used as surrogates of skeletal muscle, and both the percentage of fat mass (%FM) and fat mass index (FMI) of adiposity. The REE was predicted according to the Harris and Benedict equation. Hypermetabolism was defined as a measured REE more than 120% of the predicted value; normometabolism as a measured REE within 80-120% of the predicted value; and hypometabolism as a measured REE less than 80% of the predicted value. Multiple regression analysis was used: by logistic regression to identify variables associated with odds of belong each pre-LTx metabolic groups; by linear multiple regression analysis to identify variables associated with body compartments relative variations (%Δ) in the post-LTx period; and by mixed effects models to identify variables associated with the REE and body compartments profiles pre- and post-LTx. Results: Fifty six patients with a mean (SD) of 53.7 (8.5) years of age were included, 87.5% were men and 23.2% with alcoholic liver disease. After LTx 60.7% individuals were assigned to tacrolimus-based immunosuppressive regimen. The patients were assessed at a median time (inter-quartil range) of 90.5 (P25 44.2; P75 134.5) days before LTx (T0), at a median time of 9.0 (P25 7.0; P75 12.0) (T1) and 36 (P25 31.0; P75 43.0) (T2) days after LTx. After LTx the nutritional status significantly improved: the SGA-undernourishment decreased from 37.5% (T0) to 16.1% (T2) (p<0.001). Before LTx, 41.1% patients were normometabolic, 37.5% hypometabolic, and 21.4% hypermetabolic. The predictors of each pre-LTx metabolic group were: age (OR=0.899, p=0.010) and SGA-undernourishment (OR=5.038, p=0.015) for the normometabolic group; and LMI (OR=1.264, p=0.049) and viral etiology of liver disease (OR=8.297, p=0.019) for the hypermetabolic group. No multiple model was found for the pre-LTx hypometabolic group, but univariate association was found with history of drug addiction (OR=0.282, p=0.047) and pre- LTx sarcopenia (OR=8.000, p=0.040). After LTx a significant normalization of the metabolic status occurred, indicated by the increase in the prevalence of normometabolic patients (from T0: 41.1% to T2: 57.1%, p=0.040). Different REE profiles were found with REE stratified by preoperative metabolic status: in the hypometabolic group a significant progressive increase in mean REE (Kcal) was observed (T0: 1030.6; T1: 1436.1, p=0.001; T2: 1659.2, p<0.001); in the hypermetabolic group, a significant progressive decrease in mean REE (Kcal) was observed (T0: 2097.1; T1: 1662.5, p=0.024; T2: 1493.0, p<0.001); and in the normometabolic group, no significant differences were found. The REE profiles were associated with: body weight (β- estimate=9.6, p<0.001) and energy intake (β-estimate=13.6, p=0.005) in the whole sample; with body weight (β-estimate=7.1, p=0.018) and %TEV from lipids (β-estimate=18.9, p=0.003) in the hypometabolic group; and with body weight (β-estimate=14.1, p<0.001), and SGAundernourishment (β-estimate=-171, p=0.007) in the normometabolic group. A transient decrease in most body compartments occurred from T0 to T1, with subsequent catch-up to similar preoperative values. Exceptions were the extracellular water, decreasing from T0 to T2 (mean 18.2 L to 17.8 L, p=0.042), the fat mass (mean 25.1 Kg to 21.7 Kg, p<0.001) and FMI (mean 10.6 Kg.m-2 to 9.3 Kg.m-2, p<0.001), decreasing from T1 to T2. Significant predictors of skeletal muscle and adiposity profiles were found: LMI evolution was associated with handgrip strength (β-estimate=0.06, p<0.001), serum creatinine (β- estimate=2.28, p<0.001) and number of medications (β-estimate=-0.21, p<0.001); BCM evolution was associated with handgrip strength (β-estimate=0.16, p<0.001), serum creatinine (β-estimate=4.17, p<0.001) and number of medications (β-estimate=-0.46, p<0.001); the %FM evolution was associated with handgrip strength (β-estimate=-0.11, p=0.028), history of drug addiction (β-estimate=-5.75, p=0.024), serum creatinine (β-estimate=-5.91, p=0.004) and protein intake (β-estimate=-0.06, p=0.001); and FMI evolution was associated with history of drug addiction (β-estimate=-2.64, p=0.019), serum creatinine (β-estimate=-2.86, p<0.001) and protein intake (β-estimate=-0.02, p<0.001). The %Δ of the aforementioned body compartments from T1 to T2 indicated the influence of immunosuppressive agents on body composition: the cyclosporine-based regimen, compared with tacrolimus-based regimen, was positively associated with %Δ LMI (β-estimate=23.76, p<0.001) and %Δ BCM (β- estimate=26.58, p<0.001), and inversely associated with %Δ FM (β-estimate=-25.64, p<0.001) and %Δ FMI (β-estimate=-25.62, p<0.001). No significant changes in REE or body composition were observed associated with dose or duration of steroid therapy. Conclusions: The SGA-assessed nutritional status improved shortly after LTx, with significant decrease in prevalence undernourished individuals. XXI Preoperative normometabolism was prevalent and was associated with younger age and SGAundernourishment before LTx. Preoperative hypometabolism was associated with history of drug addiction and pre-LTx sarcopenia. Preoperative hypermetabolism was associated with higher LMI and viral etiology of liver disease. A significant normalization of the metabolic status was observed after LTx. The REE profiles were positively predicted by body weight and energy intake in the whole sample, by body weight and percentage of energy intake from lipids in the preoperative hypometabolic patients, and by body weight and SGA–undernourishment in the preoperative normometabolic patients. Different body composition profiles were found after LTx. Skeletal muscle profile was positively associated with handgrip strength and serum creatinine, and inversely with the number of medications. The adiposity profile was inversely associated with history of drug addiction, serum creatinine and protein intake. Additionally, the %FM evolution was inversely associated with handgrip strength. The cyclosporine-based regimen, compared with tacrolimus-based regimen, was independently associated with skeletal muscle increase and adiposity decrease.

Acute respiratory infections in children living in two low income communities of Rio de Janeiro, Brazil

Community studies of non-hospitalized children are essential to obtain a more thorough understanding of acute respiratory infections (ARI) and provide important information for public health authorities. This study identified a total ARI incidence rate (IR) of 4.5 per 100 child-weeks at risk and 0.78 for lower respiratory tract infections (LRI). Disease duration averaged less than one week and produced a total time ill with ARI of 5.8% and for LRI 1.2%. No clear seasonal variation was observed, the sex-specific IR showed a higher proportion of boys becoming ill with ARI and LRI and the peak age-specific IR occurred in infants of 6-11 months. Correlation with risk factors of the child (breastfeeding, vaccination, diarrheal disease, undernourishment) and the environment (crowding, living conditions, maternal age and education) showed marginal increases in the rate ratios, making it difficult to propose clear-cuts targets for action to lower the ARI and LRI morbidity. The importance of an integral maternal-child health care program and public education in the early recognition of LRI is discussed.

The postmortem diagnosis of alcoholic ketoacidosis.

AIMS: The aim of this article is to review the forensic literature covering the postmortem investigations that are associated with alcoholic ketoacidosis fatalities and report the results of our own analyses. METHODS: Eight cases of suspected alcoholic ketoacidosis that had undergone medico-legal investigations in our facility from 2011 to 2013 were retrospectively selected. A series of laboratory parameters were measured in whole femoral blood, postmortem serum from femoral blood, urine and vitreous humor in order to obtain a more general overview on the biochemical and metabolic changes that occur during alcoholic ketoacidosis. Most of the tested parameters were chosen among those that had been described in clinical and forensic literature associated with alcoholic ketoacidosis and its complications. RESULTS: Ketone bodies and carbohydrate-deficient transferrin levels were increased in all cases. Biochemical markers of generalized inflammation, volume depletion and undernourishment showed higher levels. Adaptive endocrine reactions involving insulin, glucagon, cortisol and triiodothyronine were also observed. CONCLUSIONS: Metabolic and biochemical disturbances characterizing alcoholic ketoacidosis can be reliably identified in the postmortem setting. The correlation of medical history, autopsy findings and biochemical results proves therefore decisive in identifying pre-existing disorders, excluding alternative causes of death and diagnosing alcoholic ketoacidosis as the cause of death.

Influence of the test situation on pup retrieval behavior of normal and undernourished lactating rats

Undernutrition of dams and pups disrupts the retrieval efficiency of mothers. However, if the mothers are assessed in their home cages, they spend more time with their litters. In the present study the effect of test conditions on pup retrieval behavior of mothers receiving a 25% (well-nourished group) and 8% casein diet (undernourished group) was examined. In agreement with previous studies, undernourished mothers spent more time with their litters than well-nourished dams as lactation proceeded. Pup retrieval behavior varied with test conditions. In the first experiment, the maternal behavior of dams was assessed by the standard procedure (pups were separated from their mother and scattered over the floor of the home cage). The mother was then returned and the number of retrieved pups was recorded. From day 3 to 8, the retrieval efficiency of undernourished dams decreased, while the retrieval efficiency of well-nourished mothers did not vary. In the second experiment, mothers were subjected to a single retrieval test (on day 9 of lactation) using the procedure described for experiment 1. No difference between well-nourished and undernourished mothers was observed. In the third experiment, seven-day-old pups were separated from the mothers and returned individually to a clean home cage. Dietary treatment did not affect the retrieval efficiency. However, undernourished dams reconstructed the nest more slowly than did well-nourished dams. Taken together, these results suggest that pup retrieval behavior of the undernourished mother is not impaired by dietary restriction when the maternal environment is disturbed minimally.

Antinutrients in the cassava (Manihot esculenta Crantz) leaf powder at three ages of the plant

In Brazil, the cassava leaf meal (CLM) has been used to strive against undernourishment because it is a high source of vitamins and minerals. However, the wide variation in the chemical composition of the different cultivars, as well as their antinutritional substances may be a restriction to their uses. The levels of some antinutrients in CLM from five cultivars at three ages of the plant (TAP) were investigated, in order to select the cultivars and plant ages that would be more appropriate for human consumption. The lowest contents of antinutrients were observed in the 12-month old plants, except for nitrate and hemagglutinin from which the lowest contents were found for the 17 month old ones. The cultivar IAC 289-70 had the lowest antinutrient levels, except for saponin and oxalate. Thus, the cultivar IAC 289-70 at 12 months is the most appropriate for human consumption.

Contribution à l’élaboration d’un guide alimentaire béninois : approche par la programmation linéaire et validation sur le terrain

Contexte: Le Bénin est atteint par le double fardeau nutritionnel : dans le même pays, et parfois dans le même ménage, il y a des personnes malnutries et d’autres aux prises avec des maladies chroniques. Ces conditions, au moins pour partie, peuvent être prévenues si la population est sensibilisée à de bonnes habitudes alimentaires. Pour ce faire, les professionnels de la santé ont besoin d’outils comme un guide alimentaire (GA) pour faciliter l’apprentissage de bonnes pratiques alimentaires. Ce dernier nécessite plusieurs étapes à son élaboration, dont la définition des groupes alimentaires, la présentation visuelle et la quantification des portions d'aliments. Objectif : Ce travail a eu pour but de proposer et d’homologuer des portions quotidiennes d’aliments dans chaque groupe alimentaire pour différents groupes d’âge de Béninois. Méthode : Elle consiste à : 1) Caractériser la consommation alimentaire locale; 2) Optimiser le profil moyen de consommation alimentaire quotidienne à l’aide de la programmation linéaire (PL); 3) Traduire les résultats en termes de nombre et taille de portions d’aliments de chaque groupe à consommer quotidiennement; 4) Illustrer les recommandations au moyen d’exemples de menus journaliers; 5) Homologuer le prototype du GA avec des experts béninois. La PL a permis de déterminer les choix d’aliments et quantités optimales à recommander à partir des enquêtes transversales récentes et des recommandations nutritionnelles de l’OMS. Résultats : Les quantités et portions d'aliments recommandées à la consommation ont été déterminées. Les résultats ont été partagés avec les personnes-ressources en nutrition au Bénin. Le premier prototype du GA a été développé pour restitution subséquente aux autorités du Bénin.

Contradictions within the Modern Food System: Nutritional Disbalance across the Globe, Its Main Drivers and Possible Ways Out

Contemporary food production, given the degree of technology being applied in it and the present state of scientific knowledge, should be able to feed the world. Corresponding statistics show that in fact the volumes of modern food production confirm this statement. Yet, the present nutritional situation across the globe leaves much to be desired: on the one hand the numbers of undernourished and malnourished people are still high and even growing in some regions, and on the other hand there is an increasing number of overweight and obese people who are experiencing (or are at risk of) adverse health impacts as consequences. The question arises how this situation is possible given the present state of food production and knowledge, and also in terms of nutrition basics when talking about the latter. When arguing about the main causes of the present situation with nutrition across the globe, it is the modern food system with its distortions that is often criticised with emphasis placed on inappropriate food distribution as one of the key problems. However it is not only food distribution that shapes inequalities in terms of food availability and accessibility – there is a number of other factors contributing to this situation including political influences. Each of the drivers of the present situation might affect more than one part and have outcomes in different dimensions. Therefore it makes sense to apply a holistic approach when viewing the modern food system, embracing all the elements and existing relationships between them for this will facilitate taking appropriate actions in order to target the desired outcome in the best possible way. Applying a systematic approach and linking various elements with corresponding interactions among them allows for picturing all the possible outcomes and hence finding the way for a better solution on global level – a solution to the present problem with nutritional disbalance across the globe.

Atendimento ambulatorial versus programa de educação infantil : qual oferece mais mudança de hábito?

De acordo com um recente relatório da Organização Mundial de Saúde, a obesidade atingiu proporções epidêmicas em todo o mundo. Hoje a obesidade é muito comum e está começando a substituir a desnutrição e as doenças infecciosas. A obesidade está relacionada com doenças crônico-degenerativas e com sérias conseqüências psicológicas para o indivíduo. A obesidade é uma doença complexa e heterogênea, influenciada por diversos genes, no entanto, a combinação dos genes envolvidos no desenvolvimento de formas de obesidade ainda não foi definitivamente determinada (REILLY et al, 2002). A obesidade, ou o aumento da adiposidade, é geralmente atribuída a um desequilíbrio entre a energia ingerida (padrão alimentar) e a energia gasta (atividade física e metabolismo basal). Assim, o manejo da obesidade consiste em tornar esse balanço energético negativo, sendo o exercício considerado um dos aspectos principais, associado com mudanças alimentares e de estilo de vida saudáveis (ESCRIVÃO & LOPEZ, 1998). Dietas são, na maioria das vezes, transitórias. Então, a mudança de hábito alimentar e de atividade física são os aspectos principais, especialmente na criança, uma vez que a manutenção de peso irá proporcionar uma melhora dramática da composição corporal, já que o crescimento linear ainda existe. Mas, qualquer mudança de hábito necessita da colaboração da família (HILL et al, 1993). Assim, o presente estudo teve como objetivo principal comparar um programa de educação em obesidade infantil com o atendimento ambulatorial para manejo de obesidade infantil quanto a mudanças de hábitos alimentares e de atividade física e aquisição de conhecimentos em dieta saudável. Foi desenvolvido inicialmente um programa de educação em obesidade infantil e posteriormente comparado com o atendimento ambulatorial habitual. O presente estudo constou de um ensaio clínico randomizado entre crianças e adolescentes com idade entre 7 e 13 anos incompletos que tivessem IMC compatível para obesidade, de acordo com a idade e sexo, segundo classificação de COLE et al (2002). Os sujeitos foram aleatoriamente distribuídos em dois grupos. Cada grupo foi acompanhado por oito meses, sendo que o primeiro e o oitavo encontro serviram para responder questionários que avaliavam aspectos gerais, hábitos alimentares e de atividade física, conhecimentos gerais sobre dieta saudável e avaliação corporal. O grupo ambulatorial teve atendimento mensal com aferição de peso e orientações gerais quanto alimentação e atividade física. O grupo programa tinha encontro mensal, em grupo, seus participantes assistiam a uma aula expositiva e, posteriormente, eram divididos em grupos para atividades monitoradas, e os pais e/ou responsáveis ficavam discutindo suas dificuldades e como mudar hábitos. As 38 crianças inicialmente apresentavam algumas diferenças quanto a atividade física, mas após a intervenção elas se assemelharam, apresentando ambas tendência a desfechos favoráveis. O grupo programa passou a fazer mais atividade física e caminhar, e reduziu sedentarismo. O grupo programa foi mais efetivo em reduzir colesterol total. Houve também uma melhora do hábito alimentar do grupo programa, com menor consumo de massa + arroz, bebida láctea + leite, leite, salsicha + frios e sanduíche + bauru. Assim, conclui-se que as intervenções foram semelhantes e de sucesso, podendo-se aplicar mais o programa, que pode envolver menos profissionais, mais sujeitos e ser realizado em qualquer local, especialmente nas escolas, que são, na realidade, o local de mudança.

Desnutrição e aprendizagem: uma abordagem sobre a controvertida relação

Este estudo versa sobre a controvertida relação elitre a desnutrição e a aprendizagem procurando identificar os pontos em comum, ou não, entre essas duas áreas. O objetivo deste trabalho é contribuir com fundamentos teóricos e práticos que possibilitem a análise e reflexão do tema apresentado. Observamos que há diferentes abordagens sobre a relação desnutrição e aprendizagem e, p~ ra cada dimensão do problema estudado, procuramos oferecer as reflexões necessárias ao processo ensino-aprendizagem. O trabalho apresenta, também, alguns dados provenientes de uma pesquisa de campo realizada pela autora com professores e orientadores educacionais de diversas escolas do Município do Rio de Janeiro. Embora a pesquisa, em si, não tenha sido o fio condutor deste estudo, seus resultados, entretanto, poderão servir como colaboração e subsídio aocontextualmente, a partir de sua própria realidade. Sem ter a pretensio de ter esgotado ~odo o referencial teórico sobre o assunto, esse estudo teve, também, a finalidade àe provocar o debate sobre'o tema, oferecer subsídio aos professores, assim como propiciar meios novas pesquisas nesta área. para Há que ressaltar que o problema da desnutriçio envolve variáveis de outros setores tais como: social, poli tica, econômica e cultural, portanto, ele nao pode ser analisado isoladamente; e seu estudo requer, por conseguinte, aprofundamento também nas outras áreas. As duas suposições de trabalho, levantadas no iní cio do estudo, continuam em aberto porque, apesar da desnutriçio nao ser a única responsável pelo fracasso escolar, ela,.a desnutriçio, provavelmente, será u~ dos fatores prejudiciais ao desempenho satisfatório do aluno. tema estudado.em trabalhos posteriores. De acordo como levantamento teórico, podemos con cluir que não existe um consenso a respeito da relação desnu trição e aprendizagem, pois, os próprios autores, nao excluem de suas análises os pontos referenciais das outras abordagens. Observa-se, então, que este tema, tão rico e tão polêmico, ainda não oferece uma dimensão única sobre seus resultados, devendo o educador, por isso mesmo, trabalhá-lo,

The influence of initial feeding on muscle development and growth in pacu Piaractus mesopotamicus larvae

The effects of different feeding schemes on pacu Piaractus mesopotamicus early development were evaluated with respect to growth, survival, muscle development, and differential gene expression of MyoD and myogenin. The pacu larvae (4 days post hatch-dph, 0.77 mg wet weight) were given six feeding treatments intentionally designed to cause variations in the larvae growth rate: (A) only artemia nauplii; (CD) only a commercial diet; (ED) only a semi-purified experimental diet; (ACD) and (AED) two treatments that involved weaning; and (S) starvation. Early weaning from artemia nauplii to the formulated diets (ACD and AED) affected growth and survival of the pacu larvae compared with the exclusive use of artemia (A). Starvation (S) and the commercial diet (CD) caused total mortality in pacu larvae at 18 dph. The experimental diet (ED) assured low fish survival and growth. The skeletal muscle morphology was not affected by the delay in somatic growth from early weaning onto the formulated diets. Three distinct muscle compartments were observed throughout the larval development in treatments A, ACD and AED: superficial, deep and intermediate, accompanied by muscle thickening. Severe undernourishment caused drastic differences in growth and in the morphology of the muscle fibers. Pacu larvae fed only formulated diets (CD and ED) showed muscle characteristics similar to the larvae in starvation (S) during the first 15 dph. At 27 and 35 dph, a slight increase in epaxial muscle mass was noted in larvae fed only the experimental diet (ED). At 35 dph, we observed a high frequency of fibers >= 40 mu m in the larvae that were weaned onto the formulated diets (ACD and AED), indicative of hypertrophy. In contrast, the larvae fed only artemia nauplii (A) displayed a larger number of fibers with diameters <= 20 mu m, which is indicative of hyperplasia. The expression of the MyoD and myogenin genes in pacu larvae at 35 dph was not affected by initial feeding (p>0.05). In conclusion, the formulated diets used impaired pacu larvae growth and survival; therefore, they were inadequate for pacu, at least at the times they were introduced. Artemia nauplii were the most adequate food source during first feeding of the pacu, and they produced bigger fish upon completion of the experiment. Moreover, the contribution of hyperplasia to the skeletal muscle growth appeared higher in fast- than in slow-growing pacu larvae. (C) 2011 Elsevier By. All rights reserved.