International Journal of Nutrology

Enteral nutrition and congestive heart failure: a systematic review

Laís Lopes Mascarenhas de Lacerda — 2023-03-22

Introduction: Congestive heart failure (CHF) is a serious and growing public health problem worldwide. Approximately 23 million people are carriers of this disease and two million new cases are diagnosed each year. The clinical evolution of patients with CHF is moving towards variable malnutrition, making it necessary to adhere to enteral nutrition (EN). This picture can occur due to inadequate intake, altered metabolism, proinflammatory state, increased oxidative stress, and greater loss of nutrients, even due to drug interactions. Objective: It was to carry out a systematic review of the main clinical outcomes that demonstrate the importance of enteral nutrition in patients with congestive heart failure. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 122 articles were found. A total of 87 articles were evaluated and 28 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 7 studies with a high risk of bias and 8 studies that did not meet GRADE. There is moderate scientific evidence of the effectiveness of enteral nutrition in increasing survival and reducing morbidity in patients with congestive heart failure, as there are few randomized clinical trials that have evaluated this issue, however, enteral nutrition is highly indicated in the attempt to mitigate weight loss in these patients.

Herbal medicine and climacteric: a systematic review of the main clinical outcomes

Fernanda Christie Batista — 2023-03-21

Introduction: The climacteric is the stage of life in which the transition from the productive or fertile period to the non-reproductive period occurs. Climacteric and menopause are intrinsically linked and may bring about various psychological and physiological changes. The use of medicinal plants (Herbal Medicine) is an important tool in an attempt to relieve symptoms. Objective: It was to develop a systematic review to present the main considerations and scientific evidence of the use of herbal medicines in climacteric and menopause to the reduction of symptoms and improvement of quality of life. Methods: The systematic review rules (PRISMA) were followed. The research was carried out from September to October 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, covering scientific articles from various eras to the present day. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 121 articles were found. A total of 32 articles were fully evaluated and 23 were included in this systematic review. Most studies showed homogeneity in their results, with I² =96.7% >50%. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 30 studies with a high risk of bias and 37 studies that did not meet GRADE. An asymmetrical funnel plot does not suggest a risk of bias among small sample-size studies. In search of symptom relief and based on knowledge of the side effects of hormone replacement therapy, many women resort to alternative therapy with herbal medicines. The main results support that supplementation with soy isoflavones as a natural source of phytohormones is associated with a reduction in the frequency and intensity of hot flashes, a recurrent symptom in the climacteric. The formulated blend of four herbal extracts (Glycine max, Cimicifuga racemosa, Vitex agnus-castus, and Oenothera biennis) supports skin health and antioxidant status in women of menopausal age. Furthermore, purified pollen cytoplasm can be considered an effective non-hormonal treatment alternative for the treatment of vasomotor symptoms, as well as mood and sleep disturbances in peri and post-menopause. Three clinical trials using the Danggui Buxue Tang herbal formula have been shown to alleviate menopausal syndrome, providing solid scientific evidence of its effectiveness.

Evidence from clinical studies of the nutrological modulation of the gut microbiota in inflammatory bowel diseases: a systematic review

Pedro Paulo Barbosa Nunes — 2023-03-20

Introduction: The main risk factor for inflammatory bowel disease (IBD) is a positive family history in 10-25% of patients. Crohn's disease (CD) can affect individuals from 15 to 40 years old and from 50 to 80 years old, more frequently in women. Ulcerative colitis (UC) can start at any age. The pathogenesis of IBD is linked to genetically susceptible individuals, dysregulated gut microbiota (dysbiosis), chronic inflammation, and poor dietary patterns. Diet plays an important role in modulating the gut microbiota and can be applied as a therapeutic tool to improve the course of the disease. Objective: To carry out a systematic review of the main interactions between dietary therapy, gut microbiota, and inflammatory bowel disease, to elucidate the main clinical outcomes after nutrological treatment. Methods: The present study followed the international model of systematic review (PRISMA). Clinical studies were included, involving randomized controlled, prospective, and retrospective studies published from 2010 to 2022. Results: It was founded 87 studies on diet modulation in the control of IBD. These studies showed reductions in persistent intestinal symptoms, improvement of gut microbiota, reduction of inflammation markers, and improvement in quality of life, with p<0.05 (95% CI). The studies were homogeneous (X² = 98.9%), which increases the reliability of the clinical results on the dietary importance in the modulation of IBD. Conclusion: The important role of diet modulation in the control and even in the remission of IBD was evidenced.

Major influences of the gut microbiota on thyroid metabolism: a concise systematic review

Rildo Guilherme de Oliveira Gomes — 2023-03-17

The objective was to discuss the influence of the gut microbiota on the functions of the thyroid gland, elucidating the main aspects of rebalancing intestinal function and its importance in the regulation of thyroid functions. The present study followed a systematic review of the literature in periodicals published between 2010 and 2023. The microbiota of the healthy gastrointestinal system presents around 800 species of bacteria, and a hundred of these microorganisms together with bacteriophage viruses and fungi species characterize each human being, with maximum concentration in the colon. In the presence of dysbiosis, the malfunction of the epithelial barrier leads to intestinal and systemic disorders, mainly immunological and metabolic. The functions of the gut microbiota are fundamental and determinant in the metabolism of nutrients, drugs, and hormones, including exogenous and endogenous iodothyronines, as well as micronutrients involved in thyroid homeostasis. The state of the art of effects of the gut microbiota on the regulation of thyroid functions has not been fully elucidated. The intestinal tract is of great importance for the balance of exogenous and endogenous thyroid hormones, but the analysis of the composition of the microbiota is not an easy task. A recent study revealed that individuals with hyperthyroidism had significantly lower levels of Bifidobacteria and Lactobacilli and significantly higher levels of Enterococcus species compared to healthy controls.

Major considerations and outcomes of clinical trials of vitamin D in athlete performance: a systematic review

Rildo Guilherme de Oliveira Gomes — 2023-03-17

Introduction: In addition to influencing physical performance, some studies verify the impact of vitamin D on body composition. It is known that their high levels favor the gain of fibers of fast contraction, favoring the increase of force due to the increase of muscular areas and it prevents loss of lean mass. Objective: It was present, through a systematic review, the main correlations and outcomes of clinical studies between vitamin D and physical exercise practitioners, analyzing the effects of vitamin D deficiency, sufficiency, and supplementation on sports performance. Methods: Following the criteria of literary search with the use of the Mesh Terms that were cited in the item below on "Search strategies", a total of 94 papers that were submitted to the eligibility analysis were collated and, after that, 65 studies were selected, following the rules of systematic review - PRISMA. The review protocol was based on literary search criteria using mesh terms in major databases such as PubMed, Scopus, Medline, Bireme, EBSCO, and Scielo. It followed the following steps: search for MeSH Terms: Vitamin D. Clinical trials. Physical exercises. Athletes. Quality of life. Conclusion: The present study aimed to present, through a systematic review, the main correlations and outcomes of clinical studies between vitamin D and physical exercise practitioners, analyzing the effects of vitamin D deficiency, sufficiency, and supplementation on sports performance.

Major evidence of clinical studies on the triad gut microbiota, ubiquinone and physical exercise: a systematic review

Fernanda Rossi Schmechel — 2023-03-17

Introduction: In the scenario of sports practices, the human gut microbiota is currently the focus of convergent interest in many diseases and sports performance. Sports performance studies have also shown interesting and promising results. Supplementation with certain antioxidants such as ubiquinone [Coenzyme Q10 (CoQ10)] is important for physically active individuals to speed recovery from fatigue and prevent exercise damage. Objective: It was to demonstrate the influence of the gut microbiota and ubiquinone on the performance of athletes. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 104 articles were found. A total of 54 articles were evaluated and 27 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 13 studies with a high risk of bias and 27 studies that did not meet GRADE. Most studies showed homogeneity in their results, with X 2 =97.2% >50%. The composition and activity of the gut microbiota are influenced by many different factors, such as diet and physical activity. Cumulative data indicate that gut bacteria are sensitive to modulation by physical activity, as demonstrated by studies using models of training and hypoactivity. Supplementation with the antioxidant Coenzyme Q10 is important for physically active individuals to accelerate recovery from fatigue and prevent damage caused by exercise, in addition to optimizing training and improving sports performance. Clinical studies have shown that in physical fatigue concerning physical exercise, patients have low plasma concentrations of Coenzyme Q10.

Consensus of the Brazilian Association of Nutrology on diagnosis, prophylaxis, and treatment of vitamin B12 deficiency

Carlos Alberto Nogueira-de-Almeida — 2023-03-06

Introduction: Vitamin B12 deficiency is quite prevalent in all age groups and all regions of the country, however, there is a need for standardization of clinical management recommendations. Objective: It was to achieve a consensus on the diagnosis, prophylaxis, and treatment of vitamin B12 deficiency. Methods: An integrative review of the scientific literature was carried out in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases and on governmental and regulatory websites. Results: According to the literary search carried out by the authors of this study, 84 scientific works were selected. Based on these findings, in the timeline from 1999 to 2022, randomized controlled clinical studies represented the majority, and prospective and retrospective studies with significant sample sizes were elucidated in this consensus on the vitamin B12 administration for all patient populations. The basis of this scientific evidence was determined by appropriate clinical trials, with additional endpoints including patient clinical symptoms and biochemical parameters in addition to serum and marginal B12 level. Conclusions: Based on the scientific literature, the recommendations of the Brazilian Association of Nutrology for diagnosis, prophylaxis, and treatment of vitamin B12 deficiency were presented.

Nutritional status of patients at the moment of primary cleft lip and palate surgery

Renan Canale Peres Montanher — 2023-02-07

Objective: This study aimed to analyze the nutritional status of patients with cleft lip and palate at the time of admission and time of performing primary lip and/or palate surgeries at the Hospital for Rehabilitation of Craniofacial Anomalies of Bauru, Universidade São Paulo. Methods: A retrospective observational study was conducted using medical records of individuals with cleft lip and/or palate who underwent primary lip and/or palate surgeries between 2011 and 2021. Anthropometric data were collected upon hospital admission and before primary lip and/or lip surgery. The Z-scores of the growth curves were calculated according to age and sex using the World Health Organization (WHO) Anthro and WHO AnthroPlus programs. Statistical analysis was performed using the Spearman, analysis of variance (ANOVA), and Student’s t-tests. Results: Of the 218 participants, 50.46% were men, and most of the patients originated from the southeast region (87.16%) with prevalence of cleft palate (52.75%). A correlation was found between weight/height and weight/age indices with the delay in performing primary lip surgery and height/age with the delay in primary palate and lip surgery (Student’s t-test, p < 0.05), and no correlation was found between the nutritional/nutrological status and socioeconomic profile (Spearman correlation test, p < 0.05) and with the place of origin (ANOVA test, p < 0.05). Conclusion: A correlation was found between the weight/height and height/age indices with the delay in performing primary lip surgery and height/age with the delay in primary surgery of the palate and lip.

Evidence of the functions of vitamin D in pregnant women in COVID-19: a systematic review

Sueli Tapigliani Baptista — 2023-02-02

Introduction: In the world, about 1 million people suffer from vitamin D deficiency. Vitamin D deficiency in pregnant women increases maternal mortality and morbidity rates. In the scenario of COVID-19, it is known that the immune response, inflammation, and coagulation are modulated by vitamin D activity. Objective: It was to analyze the main considerations of the effects of vitamin D on pregnant women and fetuses in the scenario of COVID-19, presenting the mechanisms of inflammatory and immunological processes in an attempt to mitigate the worsening of comorbidities and deaths. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to October 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 210 articles were found, 82 articles were evaluated and 32 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 28 studies with a high risk of bias and 28 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I² =98.9% >50%. There is a relationship between vitamin D status and the severity of COVID-19 in pregnant women. Vitamin D levels are low in pregnant women with COVID-19. Furthermore, there is a significant difference regarding the level of vitamin D and the severity of COVID-19 in pregnant women. Maintaining adequate vitamin D levels may be useful as an approach to preventing an aggressive course of inflammation induced by this novel coronavirus in pregnant women.

Sports nutrology and gut microbiota

Lucas Vasconcelos Lima Diniz — 2023-02-02

Introduction: Many of the established positive health benefits of exercise have been documented by historic discoveries in the field of exercise physiology. Regular physical training associated with nutritional health has broad health benefits for the gut microbiota, acting positively on almost all organ systems of the body. Objective: It was to analyze the main metabolic pathways modulated by nutrients, gut microbiota, and physical exercise in muscle regeneration and sports performance. Methods: The present study followed a systematic review model (PRISMA). The literary search process was carried out from July to September 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, with scientific articles from 2004 to 2022. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: We found 132 studies that underwent eligibility analysis, and then 31 of the 52 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with I2 =98.9% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in studies with a smaller sample size. A healthy gut microbiota and a positive interaction with the immune system, promoted by diligent nutrological care, can be crucial for the muscle-gut axis and can influence the maintenance of muscle mass and its functionality in athletes. However, dysbiosis resulting from a negative interaction with the immune system can influence muscle wasting disorders. These changes can promote systemic inflammation, with overproduction of the pro-inflammatory cytokines TNF-α, IL-1β, and IL-6. Future studies should clarify whether gut microbiota dysbiosis and nutrient depletion are pathophysiologically associated with muscle wasting disorders and whether exercise can positively influence this supposed gut-muscle axis.

Effect of glutamine supplementation in elderly people with emphasis on sarcopenia, immunity and hypertrophy: a concise systematic review

Camilla Reis Fernandes Coelho — 2023-02-01

Currently, the aging of the population is no longer a forgotten subject for health professionals in Brazil. This is due to the decrease in the birth rate in the country and the improvement in quality of life, this first factor was boosted after the ease of access to information on contraceptive methods and their distribution by the health system. As a result, the Nutrition area has been studying more diligently ways to provide elderly people with methods that contribute to a more comfortable, healthy, and long-lasting life. The nutritionist is essential to identify the deficits and disharmonization of the body of the elderly caused naturally over the years in people's lives, such as loss of muscle mass, and lack of nutrients, among others. Given this scenario, this work will be focused on showing that the use of oral Glutamine supplementation contributes to the gain of muscle mass in the elderly since this natural amino acid present mainly in the muscle tissue of the human body is greatly reduced due to loss of mass skin and body weight gain caused by the slow metabolism found in older people. In this way, supplementation along with a well-designed nutritional table and an exercise routine will promote less chance of injury to the elderly due to a lack of nutrients and greater physical resistance. To reinforce and prove this study, we will use the literature review method distributed in topics.

Developmental origins of health and disease (DOHaD) and its impacts on children's health: a systematic review

Mayra Jazmila Ramirez Leguizamon — 2022-12-23

The general objective of this study is to elucidate how studies linked to the Developmental Origins of Health and Diseases (DOHaD) relate to pregnancy, children's health, and the possibility of developing non-communicable diseases (NCDs). The research method chosen for its scope was based on bibliographic, qualitative, and descriptive research. Among the results obtained, it was possible to show that since the 1980s when the first studies within the DOHaD scope were published to the present, numerous advances have been consolidated and there is still a vast field of study to be developed. It is concluded that the external environment can affect the development of the fetus in the intrauterine environment, increasing vulnerability to the development of non-communicable diseases (NCDs) in adult life, such as type II diabetes, malnutrition, and obesity, among countless other problems. that can manifest in adulthood. Therefore, it is essential that the pregnant woman has specialized care from the first months, at birth, and then as the child grows and develops.

Major clinical approaches to macro and micronutrients in enteral therapy according to international guidelines and clinical studies: a systematic review

Darwin dos Santos Ribeiro — 2023-01-31

Introduction: In the context of Nutritional Therapy (NT), critically ill patients are associated with a state of catabolic stress and a systemic inflammatory response. Patients admitted to intensive care units (ICU) have a prevalence of malnutrition greater than 35%. The main objective of parenteral nutrition (PN) is to provide a nutrient mix closely related to requirements safely and avoid complications. However, PN poses a considerable risk of overfeeding, which can be just as harmful as underfeeding. Long-term survival data (expressed as 6-month survival) will also be considered a relevant outcome measure. Objective: It was performed a systematic review to evaluate the main clinical approaches of macro and micronutrients in enteral therapy according to international guidelines and clinical studies. Methods: The present study followed a concise systematic review model, following the systematic review rules (PRISMA). The literary search process was carried out from August to October 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2011 to 2022. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: It was found 118 studies that underwent eligibility analysis, and then 20 of the 22 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with I2 =97.7% >50%. Standard crystalline amino acid solutions, while devoid of side effects, remain incomplete regarding their composition (eg glutamine). Lipid emulsions have come a long way and are now included in bi- and tri-compartment feeding bags, allowing for true total PN as long as daily micronutrients are prescribed. The issue of exact individual needs for energy, macro, and micronutrients has not yet been resolved. Many complications attributed to total PN are the consequence of under or overfeeding. Total PN indications have evolved towards its use alone or in combination with enteral nutrition. The start time varies by country between admission (Australia and Israel), day 4 (Swiss), and day 7 (Belgium, USA). The most important issue may be an individualized and time-dependent prescription of the feeding pathway, energy, and substrates.

Clinical, cellular and molecular approaches to oxidative stress in athletes' bodies: a systematic and integrative review

Islaine Cristina Assunção Toledo — 2023-01-31

Introduction: Frequent physical exercises can cause a state of transient fatigue, thus increasing the regenerative capacity of the body and inducing an overcompensation of the biological systems involved. The state resulting from overtraining has negative consequences not only for physical performance but also for health and when this state occurs, reactive oxygen species (ROS) are synthesized in the body. Objective: It was to carry out a systematic and integrative review of the main clinical, cellular and molecular approaches to oxidative stress in athletes' bodies, as well as the main functions of antioxidants in mitochondria. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from October to December 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found, and a total of 67 articles were fully evaluated and 57 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 7 studies at high risk of bias and 25 studies that did not meet the GRADE. Studies have shown that free radicals play important roles as regulators in muscle signaling processes. Oxidative stress reflects an imbalance between the production of reactive oxygen species and adequate antioxidant defense. The relationship between exercise and oxidative stress is extremely complex, depending on the mode, intensity, and duration of exercise. High levels of reactive oxygen species produced in skeletal muscle during exercise have been associated with muscle damage and impaired muscle function. Antioxidant supplementation may be warranted under specific conditions when athletes are exposed to high oxidative stress or do not meet dietary antioxidant requirements. Continuous aerobic exercise under moderate-intensity or high-intensity interval training can be recommended to increase the body's ability to maintain redox balance, especially for unhealthy individuals.

Use of GLP-1 analogs in the treatment of obesity: an integrative and systematic review

Giulia Biagi Furlan — 2023-01-31

Obesity is the global epidemic of the 21st century: about 1.5 billion adults worldwide are overweight, and among them, about 200 million men and 300 million women are obese. The prevalence of overweight and obesity is also increasing in children and adolescents in developed (about 25%) and developing countries (about 13%). Obesity has been associated with many comorbidities, including type 2 diabetes mellitus (T2DM), nonalcoholic fatty liver disease (NAFLD), hypertension, chronic kidney disease, cardiovascular disease (CVD), and malignancies, leading to increased mortality observed in obese individuals. Overweight and obesity were estimated to be associated worldwide with 3.4 million deaths, which could also be expressed as 4% of disability-adjusted life-years lost (DALYs). It is also alarming that children with severe obesity are apparently at in- creased risk of premature death. Managing obesity is hard and usually disappointing for both patients and physicians. Weight loss is difficult to achieve and even more difficult to sustain in the long term. When lifestyle modifications fail to achieve the predefined target, anti-obesity medications may be added on, as recommended by all relevant guidelines, including those of the Endocrine Society and recent guidelines for obese with diabetes. Glucagon-like peptide 1 (GLP-1) is an incretin secreted by L-cells in the intestinal mucosa and has been shown to act in the brain and periphery to cause effective weight loss. GLP-1 release is stimulated by food intake and its agonist, exenatide, is the first from the incretin family approved for weight-loss therapy by the Food and Drug Administration (FDA). In overweight and obese adults, it is concluded that the GLP-1 analogs and the Phentermine/Topiramate association proved to be among the best for the effects on weight reduction. Regarding childhood obesity, the FDA recently approved the use of Liraglutide. Schizophrenic patients, a target of studies due to risk factors, benefited from treatment with GLP-1 analogs.

State of the art and major clinical outcomes of the use of essential oils in the performance of athletes: a systematic review

Patrícia Perla da Fonseca — 2023-01-30

Introduction: Essential oils (EOs) has been around for years and studies show that they are useful in treating various diseases and improving health. According to the United States OEs Handbook, OEs are a vital part of complementary and alternative medicine and the positive findings of OEs are now becoming a trend in sports performance research for athletes. Objective: It was to list the main scientific findings of clinical studies on the effectiveness of essential oils in improving the health and sports performance of athletes. Methods: A total of 195 articles were found involving clinical studies of the influence of essential oils on human health. After this process, 42 articles were included and 32 were discussed in this study. The present study was prepared following the systematic review guidelines – PRISMA. Results and Conclusion: Essential oils have been used in medicine for decades and have been proven to eliminate toxins from the body. They are also shown to improve the body's ability to absorb essential vitamins and nutrients. In this sense, the application of these oils not only helps to prevent and heal sports injuries but also to stimulate and relax the mind and body, leading to higher levels of fitness. Because of these inherent properties of EOs, there is growing interest in using them to tone the body and mind in a variety of ways, such as musculoskeletal preparation, injury prevention, and improving mood and performance to achieve a higher success rate in sports. sports and fitness, as well as post-exertion recovery. They can be used as an aid to make recovery faster, reducing the effect of fatigue and raising the energy level of the mind and body.

Major considerations of sarcopenia in the elderly: a concise systematic review

Kleber Reinert — 2023-01-30

The present work aims to highlight throughout the contents presented the main aspects of sarcopenia in the elderly, promoting to readers an understanding of the diagnosis, possible treatments, and exams that are relevant for the identification of the disease. The general objective of the research is to describe the main aspects of sarcopenia in the elderly, regarding the specific objectives, are highlighting information about the elderly; assessing how sarcopenia develops; present procedures for the diagnosis and treatment of sarcopenia among the elderly. For a better foundation of the contents presented, a literature review was carried out, highlighting some of the main concepts and analyzes of renowned authors on sarcopenia, consolidating how this disease impacts the routines and quality of life of the elderly. It can be concluded that over the years some research has been developed and treatment methods have been developed seeking to give the elderly an opportunity to treat sarcopenia, especially with the practice of physical activities aimed at strengthening the limbs and joints.

Metabolic effects of coenzyme Q10, magnesium and vitamin D in cardiovascular diseases: a systematic review

Marcos Alberto Pires Meira Júnior — 2023-01-27

Introduction: Cardiovascular diseases (CVD) are the main causes of death in the population. According to data from the World Health Organization for 2020, of the 20.8 million deaths from these diseases, 9.2 million are due to atherosclerotic coronary disease. In this context, the beneficial metabolic effects of magnesium, vitamin D, and coenzyme Q10 can be highlighted. Objective: It was to scientifically analyze, through clinical and experimental studies, the influence of the three elements Magnesium, Vitamin D, and Coenzyme Q10 concerning cardiovascular diseases and metabolic syndrome, highlighting the improvement of metabolic disorders and heart failure. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 154 articles were found, and 80 articles were evaluated and 78 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 18 studies with a high risk of bias and 26 studies that did not meet GRADE. Most studies showed homogeneity in their results, with I2 =95.7% >50%. It was concluded that magnesium plays a fundamental role in glucose metabolism, insulin, and glycemic homeostasis, in the synthesis of adenosine triphosphate, proteins, and nucleic acids. However, further studies are needed to better clarify the role of magnesium in the prevention and treatment of cardiovascular diseases, especially concerning higher concentrations and increased treatment time. Vitamin D plays important roles in innate and adaptive immune responses, cell cycle, and metabolic processes, evidenced by the reported relationship between its deficiency and the prevalence of immune-mediated disorders, cancer, and cardiometabolic diseases. Coenzyme Q10 exerts an important protective antioxidant action. Clinical studies carried out showed that pathologies such as acute myocardial infarction, arterial hypertension, myopathies induced by statins, physical fatigue inherent to physical exercise, male infertility, pre-eclampsia, Parkinson's disease, periodontal diseases, and migraines had low plasma concentrations of Q10. In addition, Coenzyme Q10 reduces the amount of lipid peroxide found in atherosclerotic lesions. Thus, Q10 protects the lipids present in cell membranes, as well as plasma lipoproteins.

Investigation of hypovitaminosis D in patients infected with SARS-CoV-2 and its relationship with clinical worsening: a cross-sectional observational retrospective clinical study

Mariana Argente Caetano Vilela — 2023-01-27

Numerous studies have demonstrated the profile of infection and symptoms related to COVID-19 that occur with pulmonary manifestations (such as Acute Respiratory Syndrome), digestive symptoms, anosmia, and ageusia. Many comorbidities have been associated with deaths and severe cases of the disease, such as diabetes, hypertension, obesity, and heart disease. However, many questions remain unanswered, especially the association of disease severity with hypovitaminosis D. Vitamin D deficiency is widely found in patients in Intensive Care Units, and recent studies have shown that it has been suggested that patients with severe manifestations of COVID-19 have hypovitaminosis D. Therefore, the present study aims to associate the presence of hypovitaminosis D in patients with the acute respiratory syndrome, positive for SARS-COV-2, admitted to the José Alencar Regional Hospital in Uberaba/Brazil and the evolution of the disease (days of hospitalization, hospitalization in the ICU, discharge and death) through the analysis of vitamin D (25(OH)D) hospitalized patients clinical records. The incidence of hypovitaminosis D among the patients was also assessed. The results may contribute to the understanding of the disease, as well as the need for vitamin supplementation.

Off-label pharmacological treatment of obesity: a systematic review of clinical studies

Keysse Ribeiro — 2023-01-27

Introduction: There are 2.0 billion overweight and obese people in the world, and Brazil ranks fifth in the world. The World Health Organization (WHO) advises that the use of drugs to combat obesity is indicated for patients who have a body mass index (BMI) above 30 kg/m2 or when the BMI is 25 kg/m2 associated with comorbidities. that permeate excess weight. A variety of drug classes approved for other indications have been used off-label in an attempt to promote weight loss. Objective: It was to list and present the main off-label drugs for obesity in adults, as well as to show the scientific evidence of clinical studies. Methods: The present study followed a concise systematic review (PRISMA) model. The literary search process was carried out from July 2022 to September 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2002 to 2022. The low quality of evidence was attributed to reports of cases, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument using the Funnel Plot. Results and Conclusion: We found 98 studies that underwent eligibility analysis, and then 15 of the 12 total studies were selected. Most studies showed homogeneity in their results, with I2 =96.5% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in the studies. Off-label prescribing is very common among physicians who treat obesity. However, randomized controlled studies should be increasingly encouraged and increased to clearly present the scientific evidence and, thus, propose a scientific formalism for the safe and effective use of off-label anti-obesity drugs. Physicians, however, have adopted a more pragmatic approach, giving much greater credibility to shared clinical experience, particularly in situations where favorable outcomes have been consistently observed over decades. International medical bodies do not recommend the off-label use of drugs approved for the exclusive use of weight loss. In Brazil, the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO) recommends that drugs approved for the treatment of obesity be prescribed preferentially over off-label treatments. In addition, the patient must be well informed and aware that the drug is not approved by Anvisa for this indication or chronic use.

Obesity: a view on treatment

Luca Campassi Bonini — 2023-01-20

Obesity is a disease stigmatized by society in general. Many tend not to consider it a disease, which makes it difficult to treat and worsens the pandemic generated by this condition. Considering the seriousness with which health professionals must face this problem, a form was applied to 511 Brazilian academic medical students, to understand how these students see this disease and how to treat it. The results showed that there is a tendency for incoming students to opt for diet therapy associated with physical exercises, while students further on consider the use of drugs associated with diet therapy and physical exercises the best strategy. This shows the importance of medical schools providing solid information about obesity and its treatment, showing that in certain cases it is not enough for the patient to follow a diet and exercise. This change in the view of health professionals, therefore, would be a way to fight the pandemic in question.

The role of leucine in the activation of cellular metabolism: a large integrative review

Amir Salomão Gebrin — 2022-11-23

This review addressed the signaling of cellular activation by leucine, discussed the risks of excessive signaling by proteins in the Western diet, and explored the potential of leucine stimulation in tissue regeneration. As result, amino acids are, in addition to building blocks of macromolecules, cellular activation signals. Essential amino acids are not produced by animals and leucine appears to be the main signaling amino acid. Mammals adjusted the cell activation and growth rate of their young by the leucine concentration of the milk produced. Several studies demonstrate the benefits of leucine supplementation in preventing sarcopenia, improving muscle and liver performance, as well as a possible neuroprotective role in head trauma and dementia. However, its excess, so common in the Western diet, is related to obesity, type II diabetes, neurodegenerative diseases, and cancer. The mTORC1 kinase integrates cellular activation stimuli from macro protein synthesis to epigenetic regulation. Controlling mTORC1 activity by consuming leucine can prevent, treat, or cause disease. A greater understanding of the regulatory effects of leucine and mTOR in unstable tissues such as tumors or fragile tissues such as the CNS are areas of great relevance and with extensive fields still to be explored.

Relationship between nutrology and oral health: a systematic review of major clinical findings

Vivian Teixeira Martins Yamaguchi — 2022-11-14

Introduction: Food and nutrition are fundamental in maintaining the general and oral health of populations. Health status can be affected by nutrient deficiency and vice versa. Dietary guidelines were developed to provide evidence-based food and beverage recommendations to populations to promote a diet that meets nutritional needs and prevents diet-related illness. Objective: Aimed to carry out a concise systematic review to elucidate through clinical studies the real relationship between nutrition and oral health. Methods: The rules of the Systematic Review-PRISMA Platform. The research was carried out from August to October 2022 and developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 2005 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 125 articles were found. In total, 75 articles were fully evaluated and 35 were included and evaluated in this systematic review. It was concluded that food and nutrition are fundamental in maintaining the general and oral health of populations. Health status can be affected by nutrient deficiency and vice versa. Nutrology can promote a diet that meets nutritional needs and prevent diet-related diseases such as tooth decay. It was evidenced that malnutrition can significantly affect oral health and vice versa. A diet lacking in nutrients can lead to the progression of oral cavity disease by altering tissue homeostasis, reducing resistance to microbial biofilm, and decreasing tissue healing. It can also affect the development of the oral cavity.

Major approaches to melatonin and nutrients regulation in the bone regeneration process with exosomes and microRNAs: a systematic review

Danillo Gomes Leite — 2022-10-31

Introduction: Bone diseases comprise a large group of common diseases, including fractures, osteoporosis, and osteoarthritis that affect a large number of individuals. Without intervention, the prevalence of osteopenia is projected to increase to 64.3 million Americans and that of osteoporosis to 11.9 million by the year 2030. Melatonin exerts numerous physiological effects, including the induction of anti-inflammatory and antioxidants, resetting circadian rhythms, and promoting wound healing and tissue regeneration, participating in the maintenance and regenerative processes of bones and cartilage. Objective: A systematic review was carried out to present the state of the art of melatonin regulation, mesenchymal stem cells, exosomes, microRNAs, and nutrients in the bone regeneration process. Methods: The systematic review rules (PRISMA) were followed. The search was carried out from July to September 2022 in the Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases, using scientific articles from 2019 to 2022. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 126 articles were found. A total of 59 articles were fully evaluated and 46 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 9 studies at high risk of bias and 24 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =97.8%>50%. The symmetrical funnel plot does not suggest a risk of bias between small sample-size studies. Based on the results, melatonin has important functions in regulating the regenerative activities of mesenchymal stem cells that modulate, together with nutrients, the activities of exosomes and microRNAs in the bone regeneration process.

Nutrological and metabolic approaches to the action of the some special micronutrients in heart failure and metabolic syndrome: a systematic review

Vanessa Piovesan Freitas Assumpção — 2022-10-28

Introduction: In the heart disease scenario, heart failure (HF) is the leading cause of hospitalizations in the United States in patients over 65 years of age, and there is evidence that this pathology affects 26 million people worldwide. Dietary guidance for patients with HF has focused on sodium restriction and fluid intake, but diet quality is often poor in HF patients and can contribute to morbidity and mortality. Restrictive diets can lead to inadequate intake of macro and micronutrients by patients with HF, highlighting deficiencies in calcium, magnesium, coenzyme Q10, zinc, iron, thiamine, vitamins D, E, and K, and folate. Objective: Through a systematic literature review, the main nutrological approaches to the action of the micronutrients magnesium, coenzyme Q10, and vitamin D in heart failure and metabolic syndrome were evidenced. Methods: The present study followed a concise systematic review model (PRISMA). The literary search process was carried out from August 2022 to September 2022 and was developed based on Scopus, PubMed, Science Direct, Scielo, and Google Scholar, using scientific articles from 1998 to 2022. The low quality of evidence was attributed to reports of cases, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: The total of 136 studies were found for eligibility analysis, and then 75 of the 84 total studies were selected for this systematic review. According to the GRADE instrument, most studies showed homogeneity in their results, with I2 =98.7% >50%. The Funnel Plot showed a symmetrical behavior, not suggesting a significant risk of bias in studies with smaller sample sizes. Studies have shown that magnesium deficiency or changes in its metabolism are related to the pathophysiology of heart failure, hypertension, arrhythmias, preeclampsia, insulin resistance, and diabetes. Vitamin D plays an important role in innate and adaptive immune responses, cell cycle, and metabolic processes, evidenced by the reported relationship between its deficiency and the prevalence of immunity-mediated disorders, cancer, and cardiometabolic diseases. The VDR results in β cells, endothelium, cardiac myocytes, and renin production suggesting a role for vitamin D in these diseases. Coenzyme Q10 is part of the electron transport chain and is found in large concentrations in the mitochondrial, especially in the muscles, brain, and heart. Clinical studies have shown that pathologies such as acute myocardial infarction, arterial hypertension, and myopathies induced by statins, physical fatigue inherent in physical exercise, male infertility, preeclampsia, Parkinson's disease, periodontal disease, and migraine had low plasma concentrations of coenzyme Q10.

Major evidence of nutrological regulation in obese patients with meta-inflammation: a systematic review

Paulo Mageste Lessa — 2022-10-25

Introduction: Obesity stands out as a multifactorial disease that can cause several public health problems. There are 2.0 billion overweight and obese people in the world, and Brazil ranks fifth in the world. A healthy nutritional status promotes immune function and can prevent the onset of a serious inflammatory process and severe infections, especially in times of a pandemic such as COVID-19. Objective: It was to highlight the main clinical considerations of nutrological and dietary regulation in obese patients with marked inflammatory processes and meta-inflammation through a systematic review. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from August to September 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 127 articles were found. A total of 74 articles were fully evaluated and 29 were included and developed in the present systematic review study. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 32 studies at high risk of bias and 25 studies that did not meet the GRADE. Research has shown that unbalanced dietary patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, and saturated and trans fatty acids, lead to chronic inflammatory responses, increased fat deposits, and future comorbidities associated with overweight and obesity. Caloric restriction decreased polymerase chain reaction (PCR) in obese patients and diet administration over 12 weeks had a beneficial effect. Furthermore, obese patients with antioxidant supplementation had lower values of BMI, waist circumference, fasting blood glucose level, and insulin resistance homeostasis model assessment when compared to the placebo group, as well as lower total cholesterol levels, triglycerides, LDL, malondialdehyde and tumor necrosis factor-alpha. Supplementation of n-3 PUFA can significantly reduce serum PCR, tumor necrosis factor α (TNFα), and interleukin 6 (IL-6) concentrations.

Evaluation of premenstrual syndrome and its relationship with changes in food consumption during the luteal phase in a university center in northwest paulista: a prospective observational cross-sectional study

Beatriz Rosa Meneghesso — 2022-10-07

Introduction: The menstrual cycle is a natural phenomenon that occurs in two phases: follicular and luteal. Several hormonal, physical and psychological changes occur during this period, which influence the female diet. These changes and consequences are felt mainly in the luteal phase, that is between 1 to 5 days before the menstrual flow, characterizing the premenstrual syndrome (PMS) or premenstrual tension (PMS). Objective: This article aims to evaluate food intake and dietary changes in adult women of reproductive age during the luteal phase of the menstrual cycle. Methods: Quali-quantitative descriptive exploratory study, carried out with 207 female students, between 18 and 41 years of age, from all courses at a University Center in northwestern São Paulo. An online questionnaire was applied via Google Forms with closed and open questions that characterized the sample regarding the participants' personal and dietary aspects in the luteal phase. The work complied with Resolution 466/12 of the National Health Council and was approved by the Ethics Committee and all participants signed the Informed Consent Term. Results: It was observed that there was a predominance of women aged between 19 and 22 years (64.25%). With regard to physical symptoms in the luteal phase, 95.65% of women reported having at least one symptom, such as swollen and/or painful breasts (67.7%) and colic (55.1%). Regarding the intensity of food craving, 5.3% of the women reported no changes, 10.6% had low intensity (mild), 50.7% had moderate intensity, 27.5% had high intensity (high) and 5, 8% very high intensity (severe). According to the change in dietary pattern, among the foods presented, 85% of the participants claimed to have a higher consumption of sugars and sweets during this period and 38.6% higher consumption of carbohydrates, representing most of the responses collected. It was found that food cravings among the participants occurred with high frequency in 91.78% of the cases, with emphasis on the high craving for sweets (87%) and fast food (33.8%). The increase in food consumption in the luteal phase was significant, as it was present in 70.5% of women. Conclusion: The luteal phase interferes with the pattern and intensity of food craving, as well as with the increased intake of macronutrients, especially carbohydrates, sugars and sweets.

Anais XXVI Congresso Brasileiro de Nutrologia - n. 26, v. 1, 2022

Carlos Alberto Nogueira-de-Almeida — 2022-10-07

O XXVI Congresso Nacional de Nutrologia é o maior evento de nutrologia da América Latina e, em 2022, tem como objetivo geral transmitir conhecimentos científicos e atuais com palestrantes de renome nacional e internacional.
Além disso, promove o envolvimento de acadêmicos, médicos, nutricionistas, psicólogos na elaboração e apresentação de trabalhos científicos, visando fomentar a produção científica na nossa área.
Desejamos que todo o conteúdo aqui apresentado seja de grande utilidade na aplicação do seu trabalho, no dia a dia, contribuindo para a honra dos princípios da Nutrologia, que é promover saúde e bem-estar.

The role of intestinal and vaginal dysbiosis in endometrial cancer: an integrative review

Patrícia Alves de Oliveira Ferreira Sbragi — 2022-09-30

The increase in the incidence of endometrial neoplasms in the female population is associated with increased life expectancy and the lifestyle adopted in our daily lives. The way we eat influences the profile of our bacterial flora and the production of substances that can work as suppressor tumors or oncogenic. Dysbiosis leads to changes in the intestinal and vaginal bacterial barrier and promotes chronic inflammation and metabolic and hormonal changes that influence the carcinogenesis of gynecological tumors. Chemotherapy treatments can also change the composition of the intestinal microbiota and influence the efficacy and toxic effects, as well as the quality of life of these patients. The use of prebiotics, probiotics, or fecal transplantation can be useful both in prevention and in obtaining better results with chemotherapy treatment and better quality of life. The objective of this review is to provide further elucidation about the interaction mechanisms between the intestinal microbiota and the gynecological tract and assess future perspectives through the modification of the feeding pattern, use of prebiotics, probiotics, and fecal transplant both in the prevention and during the treatment of carrier patients of endometrial neoplasm.

Pseudohipoaldosteronism Type 1: a case report supported by a literature review

Natália Cavalheiro Braz Fernandes — 2022-09-30

In the neonatal period, hydro electrolytic disorders with dehydration and metabolic acidosis can cause admission to an intensive care unit and become a diagnostic challenge. Among such disorders, hyponatremia and hyperkalemia become diagnostic challenges with hormonal involvement, including aldosterone. Pseudohypoaldosteronism (PHA) resulting from the lack of response to aldosterone in target cells can be classified into three types and its suspected diagnosis in cases of hyponatremia, hyperkalemia with an elevation of serum aldosterone, can be confirmed by exome sequencing with identification of a potentially pathogenic. This study was based on the case report of a newborn of consanguineous parents who, after birth, evolved in the first week of life with shock, hyponatremia, hyperkalemia, and metabolic acidosis. An initial investigation ruled out congenital adrenal hyperplasia. The presence of hyperaldosteronism with increased plasma renin activity, associated with hyperkalemia and hyponatremia difficult to control with electrolyte replacement, led to a molecular investigation that confirmed PHA type 1 by a mutation in the SCCN1A gene. In neonates with severe hyponatremia that is difficult to resolve with conventional treatment and elevation of serum aldosterone, this pathology must be remembered and investigated, avoiding high morbidity and mortality.