Annie Seixas Bello Moreira

Trans fatty acids in maternal milk lead to cardiac insulin resistance in adult offspring

OBJECTIVE Trans fatty acids (TFAs) are derived from vegetable oil hydrogenation and can be found in most manufactured food products. Our main objective was to evaluate the effects of TFA consumption by lactating dams on cardiac glucose metabolism of adult offspring by analyzing glucose transporter-4 in the left ventricle. To investigate the energy homeostasis, insulin sensitivity and hepatic glycogen content were also measured. METHODS Lactating Wistar rats were divided into a control group or a TFA group. The control group received a diet containing soybean oil, and the TFA group received a diet containing partially hydrogenated vegetable oil (total trans concentration of about 10.58 mg/g, 11.75%, of total fat) throughout the lactation period. At weaning, pups from both groups received a standard chow until 60 d of age, at which time the quantity of glucose transporter-4 in the left ventricle and hepatic glycogen were measured. Moreover, insulin sensitivity was analyzed by assessing the insulin/glucose ratio and the homeostatic model assessment index. RESULTS TFA consumption by the pups during lactation led to a significant decrease in the cardiac content of glucose transporter-4 (P < 0.05) and in the hepatic content of glycogen (P < 0.05). Moreover, we observed impaired insulin sensitivity in the TFA group (insulin/glucose ratio and homeostatic model assessment index, P < 0.05) in adulthood. CONCLUSION Our data suggest that the consumption of hydrogenated fat, rich in TFAs, by the mothers during the lactation period caused cardiac insulin resistance in the adult progeny, thus reinforcing the hypothesis that early adaptations may cause deleterious consequences later in life.

A COCONUT EXTRA VIRGIN OIL-RICH DIET INCREASES HDL CHOLESTEROL AND DECREASES WAIST CIRCUMFERENCE AND BODY MASS IN CORONARY ARTERY DISEASE PATIENTS.

INTRODUCTION saturated fat restriction has been recommended for coronary arterial disease, but the role of coconut oil (Cocos nucifera L.) extra virgin, lauric acid source in the management of lipid profile remains unclear. OBJECTIVE to evaluate the effect of nutritional treatment associated with the consumption of extra virgin coconut oil in anthropometric parameters and lipid profile. METHODS we conducted a longitudinal study of 116 adults of both sexes presenting CAD. Patients were followed in two stages: the first stage (basal-3 months), intensive nutritional treatment. In the second stage (3-6 months), the subjects were divided into two groups: diet group associated with extra virgin coconut oil consumption (GDOC) and diet group (DG). Held monthly anthropometric measurements: body mass, waist circumference (WC), neck circumference (PP), body mass index (BMI). Gauged to collected blood pressure and blood samples were fasted for 12 hours, for total cholesterol analysis and fractions apoproteins (Apo A-1 and B), glucose, glycated hemoglobin (HbA1C), insulin (I). Comparing the averages at the beginning and end of the study employing the paired Student t-independent. And set the diastolic blood pressure by BMI using ANOVA. Analyses were performed using the SPSS statistical package, being significant p < 0.05. RESULTS the mean age of the population was 62.4 ± 7.7 years, 63.2% male, 70% elderly, 77.6% infarcted, 52.6% with angina, hypertension and dyslipidemia 100%. In the first stage the nutritional treatment reduced body weight, WC, BMI and PP and insulin concentrations, HbA1C, HOMA-IR and QUICK, without changing the other parameters. In the second stage of the study, it was observed that the GDOC maintained the reduction of body mass, BMI, WC, with a significant difference between groups for DC (-2.1 ± 2,7 cm; p < 0.01). In addition, there was an increase in HDL-C concentrations, Apo A, with significant difference in GD, only for HDL-C (3.1 ± 7.4 mg/dL; p = 0.02). CONCLUSION it was observed that the nutritional treatment associated with extra virgin coconut oil consumption reduced the CC and increased HDL-C levels in patients with CAD.

Vitis vinifera L. grape skin extract activates the insulin-signalling cascade and reduces hyperglycaemia in alloxan-induced diabetic mice

Objectives  This study examined the effect of Vitis vinifera grape skin extract (ACH09) on hyperglycaemia and the insulin‐signalling cascade in alloxan‐treated mice.

Effects of Dietary Supplementation with Brazil Nuts on Microvascular Endothelial Function in Hypertensive and Dyslipidemic Patients: A Randomized Crossover Placebo-Controlled Trial

To investigate the effects of dietary supplementation with GBNs on microvascular endothelial function in hypertensive and dyslipidemic patients.

Dietary intake and nutritional status in cancer patients: comparing adults and older adults

OBJECTIVE Evaluate the nutrient intake and nutritional status of food in cancer patients admitted to a university hospital, with comparison of adult and older adult age category. METHODS Cross-sectional study. This study involved cancer patients admitted to a hospital in 2010. Dietary habits were collected using a Brazilian food frequency questionnaire. Participants were divided in two groups: adults or older adults and in 4-cancer category: hematologic, lung, gastrointestinal and others. Body Mass Index evaluated nutritional status. RESULTS A total of 86 patients with a mean age of 56.5 years, with 55% males and 42% older adults were evaluated. The older adult category had a higher frequency of being underweight (24.4% vs 16.3%, p < 0.01) and a lower frequency of being overweight (7% vs. 15.1%, p < 0.01) than adults. Both, adult and older adults had a high frequency of smoking, alcohol consumption and physical inactivity. The older adults had lower consumption of calories, intake of iron and folic acid. Inadequacy of vitamin intake was observed in both groups; respectively, 52%, 43%, 95%, 76% and 88% for Vitamin A, C, D, E and folic acid. The older adults had a higher folic acid and calcium inadequacy than the adults (97% vs 82%, p <0.01; 88% vs 72%, p < 0.01). There was no association of micronutrient intake with cancer, nor with nutritional status. CONCLUSION The food intake, macro and micronutrients ingestion is insufficient among cancer individuals. Food intake of older adults was inferior, when compared to the adult category. There was a high prevalence of BMI excess in the adult group and a worst nutritional status in the older adult category.

The effect of dietary intake of sesame (Sesamumindicum L.) derivatives related to the lipid profile and blood pressure: a systematic review

ABSTRACT In this systematic review, we discuss the scientific evidence about the effect of dietary intake of seeds and sesame derivatives on lipid profile and blood pressure (BP) of hypertensive and dyslipidemic individuals. Clinical trials published in English, Portuguese or Spanish were searched on the following databases: Lilacs, PubMed, Isi Web of Knowledge, Cochrane Library, Scopus, Trip Data Base and Scielo. The bibliographic search period was started in September 2013 and ended in January 2014. The biases of risk analysis were carried out considering 6 of the 8 criteria of the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1. Of the 7 clinical trials included, five evaluating individuals with hypertension observed a significant reduction in systolic and/or diastolic blood pressure. The two articles that evaluated individuals with dyslipidemia showed improvement in lipid profile. The mechanisms of action are still being studied. Regarding the bias risk analysis, clinical trials included showed few descriptions of the methods applied. There are few studies about sesame ingestion, and it was observed high risk for bias in the selected studies. More standardized methods with attention to the design of studies are needed to improve the level of the evidence.

Insulin-like growth factor-1 in early-onset coronary artery disease: Insights into the pathophysiology of atherosclerosis.

percutaneous coronary intervention. Patients with acute coronary syndromes or coronary interventions in the previous 6 months were not considered eligible for the study. Controls were nondiabetic adults ≤45 years without cardiac symptoms or known CAD. Blood was collected after a 12-hour fast for glucose, total cholesterol, LDL and HDLcholesterol, triglycerides, IGF-1 and insulin measurements. IGF-1 was measured by chemiluminescent enzyme-labeled immunometric assays (Immulite 2000, Diagnostic Products Corporation, USA), and serum insulin was measured by radioimmunoassay (ImmuChemTM Coated Tube, MP Biomedicals, USA). CIMT measurement was performed with a 7.5-MHz ultrasound system (GE Healthcare, Wisconsin, USA) by 2 trained sonographers. Scans of the right and left last distal centimeter of common carotid arteries and bifurcation and of the first proximal centimeter of internal carotid arteries in 3 different projections (anterior, lateral, and posterior) were performed. Measurements were made on longitudinal scans by using the machines electronic caliper. Values for the 3 different projections and for right and left carotid arteries were averaged to obtain the mean maximum CIMT. For the analysis of agreement between observers, a Bland–Altman analysis was employed. There was good concordance between observers (0.73–0.91). The study complied with the Declaration of Helsinki. All participants gave informed written consent and study approval was obtained from the local ethics committee. Categorical variables were expressed as number and percentage and compared with a chi-square test. Continuous variables were expressed as mean ± SD or median and interquartile range and compared with the Students t test or Mann-Whitneys test according to their distribution (normal or skewed). Correlations between CIMT and candidate variables of interest were studied with the Pearsons test. Linear regression analysis was employed to evaluate variables independently associated with CIMT in the entire population; traditional risk factors were entered into the model, and IGF-1 and insulin were then separately entered to assess their contribution over and above the other risk factors. A value of p b 0.05 was considered statistically significant. Nineteen patients (84.2% with prior myocardial infarction, 26.3% with prior coronary artery bypass surgery and 68.4% with prior percutaneous coronary intervention) and 17 controls were studied. Table 1 depicts their characteristics. There was a small, statistically significant difference in age, which was not considered biologically important since patients remained at the “young for coronary artery disease” age range and very close to controls. Early-onset CAD patients had higher body mass index, fasting glucose and triglycerides and lower HDL-cholesterol. Of note, total cholesterol and LDL-cholesterol were not significantly

EFFECTIVENESS OF NUTRITIONAL TREATMENT ASSESSED BY THE QUALITY OF THE DIET IN PATIENTS WITH CHRONIC CORONARY ARTERY DISEASE.

The effectiveness of nutritional treatment is important protective factor for the prevention of recurrences of cardiovascular diseases. The goal of this study was to assess the effectiveness of nutritional treatment and to know the eating pattern and the quality of an adjuvant diet for optimized clinical treatment in patients with chronic coronary artery disease (CCAD). This is a clinical trial with a three-month duration conducted with 116 patients of both sexes with (CCAD) in secondary prevention. The patients underwent nutritional treatment and blood pressure, anthropometric, biochemical and dietetic (24-hour recall) measures were collected. The Brazilian Healthy Eating Index (BHEI-R) was calculated for assessing diet quality. The average age was 62.5 ± 7.8 years. The nutritional treatment reduced: weight -1.5 ± 2.3 kg; p < 0.01; body mass index -0.5 ± 0.9 kg/m2; p < 0.01; waist circumference -2.0 ± 0.1cm; p < 0.01; neck circumference -0.8 ± 0.1; p < 0.01 cm; concentrations of plasma insulin -1.3 ± 0.5mU/ mL p < 0.03, glycated hemoglobin -0.4 ± 0.1 mg/dL; p < 0.01 (- 0,004 mmol/L), and HOMA-IR (-0.8 ± 3.9; p < 0.03); and increased insulin sensitivity 6.64 ± 23,9 x10-3; p < 0.01. The nutritional treatment increased HDL-cholesterol concentrations in patients who adhered to the diet after BHEI-R control 1.7 ± 1.4 mg/dL; p = 0.04 (0,04 mmol/L). Three-month nutritional treatment promoted reduction of saturated fats consumption (-1.9 ± 0.5%; p=<0.01), cholesterol (-67.7 ± 18.6 mg/d; p < 0.01), and sodium(815.2 ± 146.5 mg/d; p < 0.01); and 20.7% of the patients finished the study with a healthy diet. The intensive nutritional treatment was effective in reducing anthropometric measures and improving glycemic control.

Microvascular Function and Endothelial Progenitor Cells in Patients with Severe Hypercholesterolemia and the Familial Hypercholesterolemia Phenotype

Objective: To evaluate endothelial progenitor cells (EPCs) and systemic microvascular function in patients with severe hypercholesterolemia, comparing patients with the definite familial hypercholesterolemia (FH) phenotype (DFH) or probable/possible FH phenotype (PFH). There is a large spectrum of atherosclerotic disease between these two clinical phenotypes of FH, and to acquire further knowledge of the pathophysiology of vascular disease in both is desirable. Methods: Subjects with severe hypercholesterolemia, defined as low-density lipoprotein cholesterol (LDL-C) >190 mg/dL, were classified as DFH or PFH and underwent measurement of the number of EPCs by flow cytometry and evaluation of cutaneous microvascular reactivity using a laser speckle contrast-imaging system with iontophoresis of acethylcholine (ACh) or sodium nitroprusside. EPCs were defined as CD45- or CD45low, CD34+CD133+CD309+ cells. Categorical variables were compared using Fisher test and continuous variables with Student t test or Mann-Whitney test, and a value of p < 0.05 was considered statistically significant. Results: Patients with DFH had higher LDL-C than those with PFH. There was no difference in the median number of EPCs between patients with DFH or PFH, but there was a significant reduction of endothelial-dependent, ACh-induced vasodilatation in the former. Conclusion: Patients with DFH have impaired microvascular endothelial-dependent vasodilatation compared to those with PFH, indicating more severe vascular disease in the former.

Paratireoidectomia na doença renal crônica: efeitos no ganho de peso e na melhora da qualidade de vida

Objective: to evaluate the benefit of parathyroidectomy in patients on hemodialysis, regarding nutritional and biochemical statuses, body composition and the health-related quality of life. Methods: this is a longitudinal study involving 28 hemodialysis adult patients with severe secondary hyperparathyroidism evaluated before and one year after surgery. Inclusion criteria: parathyroid hormone levels exceeding ten times the upper normal range and end-stage renal disease in hemodialysis program. We used the body mass index to classify the nutritional status and the biodynamics analyzer to evaluate the body composition. Biochemical analysis included markers of lipid and bone metabolism. We assessed quality of life with the SF36 (Short Form Health Survey) questionnaire. All individuals underwent total parathyroidectomy with a forearm implant. Results: there were significant gains in body weight (61.7 vs 66.0 kg, p<0.001), body cell mass (22.0 vs 24.5 kg/m2, p=0.05) and quality of life (p=0.001) after surgery. With respect to bone metabolism, intact PTH, calcium, phosphorus and alkaline phosphatase all stabilized and there were improvements in biochemical parameters such as albumin and hemoglobin. Conclusion: parathyroidectomy improves hemodialysis patient survival and is associated with weight and bone cell mass gain and improvement in health-related quality of life.Objective: to evaluate the benefit of parathyroidectomy in patients on hemodialysis, regarding nutritional and biochemical statuses, body composition and the health-related quality of life. Methods: this is a longitudinal study involving 28 hemodialysis adult patients with severe secondary hyperparathyroidism evaluated before and one year after surgery. Inclusion criteria: parathyroid hormone levels exceeding ten times the upper normal range and end-stage renal disease in hemodialysis program. We used the body mass index to classify the nutritional status and the biodynamics analyzer to evaluate the body composition. Biochemical analysis included markers of lipid and bone metabolism. We assessed quality of life with the SF36 (Short Form Health Survey) questionnaire. All individuals underwent total parathyroidectomy with a forearm implant. Results: there were significant gains in body weight (61.7 vs 66.0 kg, p<0.001), body cell mass (22.0 vs 24.5 kg/m2, p=0.05) and quality of life (p=0.001) after surgery. With respect to bone metabolism, intact PTH, calcium, phosphorus and alkaline phosphatase all stabilized and there were improvements in biochemical parameters such as albumin and hemoglobin. Conclusion: parathyroidectomy improves hemodialysis patient survival and is associated with weight and bone cell mass gain and improvement in health-related quality of life.