J. E. dos Santos

Health in early adulthood: the contribution of the 1978/79 Ribeirão Preto birth cohort.

The increase in non-communicable chronic diseases of adults is due to demographic changes and changes in the risk factors related to physical activity, smoking habits and nutrition. We describe the methodology for the evaluation of persons at 23/25 years of age of a cohort of individuals born in Ribeirão Preto in 1978/79. We present their socioeconomic characteristics and the profile of some risk factors for chronic diseases. A total of 2063 participants were evaluated by means of blood collection, standardized questionnaires, anthropometric and blood pressure measurements, and methacholine bronchoprovocation tests. The sexes were compared by the chi-square test, with alpha = 0.05. Obesity was similar among men and women (12.8 and 11.1%); overweight was almost double in men (30.3 vs 17.7%). Weight deficit was higher among women than among men (8.6 and 2.6%). Women were more sedentary and consumed less alcohol and tobacco. Dietary fat consumption was similar between sexes, with 63% consuming large amounts (30 to 39.9 g/day). Metabolic syndrome was twice more frequent among men than women (10.7 vs 4.8%), hypertension was six times more frequent (40.9 vs 6.4%); altered triglyceride (16.1 vs 9.8%) and LDL proportions (5.4 vs 2.7%) were also higher in men, while women had a higher percentage of low HDL (44.7 vs 39.5%). Asthma and bronchial hyper-responsiveness were 1.7 and 1.5 times more frequent, respectively, among women. The high prevalence of some risk factors for chronic diseases among young adults supports the need for investments in their prevention.

Impact of marked weight loss induced by bariatric surgery on bone mineral density and remodeling

Data about the impact of bariatric surgery (BS) and subsequent weight loss on bone are limited. The objective of the present study was to determine bone mineral density (BMD), bone remodeling metabolites and hormones that influence bone trophism in premenopausal women submitted to BS 9.8 months, on average, before the study (OGg, N = 16). The data were compared to those obtained for women of normal weight (CG, N = 11) and for obese women (OG, N = 12). Eight patients in each group were monitored for one year, with the determination of BMD, of serum calcium, phosphorus, magnesium, parathyroid hormone, 25-hydroxyvitamin D, insulin-like growth factor-I (IGF-I) and osteocalcin, and of urinary calcium and deoxypyridinoline. The biochemical determinations were repeated every three months in the longitudinal study and BMD was measured at the end of the study. Parathyroid hormone levels were similar in the three groups. IGF-I levels (CG = 332 +/- 62 vs OG = 230 +/- 37 vs OGg = 128 +/- 19 ng/mL) were significantly lower in the operated patients compared to the non-operated obese women. Only OGg patients presented a significant fall in BMD of 6.2% at L1-L4, of 10.2% in the femoral neck, and of 5.1% in the forearm. These results suggest that the weight loss induced by BS is associated with a significant loss of bone mass even at sites that are not influenced by weight overload, with hormonal factors such as IGF-I being associated with this process.

Association of apolipoprotein E polymorphism in late-onset Alzheimer's disease and vascular dementia in Brazilians

The genetic basis for dementias is complex. A common polymorphism in the apolipoprotein E (APOE) gene is considered to be the major risk factor in families with sporadic and late-onset Alzheimers disease as well as in the general population. The distribution of alleles and genotypes of the APOE gene in late-onset Alzheimers disease (N = 68), other late-life dementias (N = 39), and in cognitively normal controls (N = 58) was determined, as also was the risk for Alzheimers disease associated with the epsilon4 allele. Peripheral blood samples were obtained from a total of 165 individuals living in Brazil aged 65-82 years. Genomic DNA was amplified by the polymerase chain reaction and the products were digested with HhaI restriction enzyme. APOE epsilon2 frequency was considerably lower in the Alzheimers disease group (1%), and the epsilon3 allele and epsilon3/epsilon3 genotype frequencies were higher in the controls (84 and 72%, respectively) as were the epsilon4 allele and epsilon3/epsilon4 genotype frequencies in Alzheimers disease (25 and 41%, respectively). The higher frequency of the epsilon4 allele in Alzheimers disease confirmed its role as a risk factor, while epsilon2 provided a weak protection against development of the disease. However, in view of the unexpectedly low frequency of the epsilon4 allele, additional analyses in a more varied Brazilian sample are needed to clarify the real contribution of apolipoprotein E to the development of Alzheimers disease in this population.

Selection of an intact casein or casein hydrolysate diet by rats submitted to protein deprivation and bowel resection.

The feeding preference of normal rats (n = 14), malnourished rats (n = 14), and enterectomized rats (n = 16) was determined in a situation of free choice of three complete solid diets which only differed in extent of protein polymerization: intact casein, casein hydrolysate, and an amino acid mixture with a composition similar to that of casein. The animals were housed in metabolic cages for 30 days and allowed to freely choose among the three diets presented simultaneously. All three groups showed an initial preference for the intact casein diet. The control group maintained this preference, whereas the malnourished and enterectomized groups reduced the ingestion of the intact casein diet and increased the ingestion of the amino acid diet. The nitrogen balance, which was always positive in all three groups, was constant in the control group (1.51 +/- 0.26 g) initially higher (1.77 +/- 0.19 g) in the malnourished group, with a subsequent fall (1.13 +/- 0.24 g), and lower in the enterectomized group (0.83 +/- 0.32 g). Although total intake was similar for the control and malnourished groups, the malnourished group presented a higher weight recovery (130.2%). In contrast, the food intake of the enterectomized group was much lower, with a small weight gain. After treatment that impairs the digestive tract, intact casein was the initially preferred nitrogen source, which later tended to be replaced with free amino acids. This change was accompanied by an improvement in nitrogen balance and body weight, especially after protein malnutrition. These data may suggest that, in clinical practice, the use of enteral diets containing fully hydrolyzed protein may be of benefit in terms of the recovery of malnourished patients and of patients with short bowel syndrome.

Six years of treatment with the HELP system of a patient with familial hypercholesterolemia

The purpose of the present report is to demonstrate the long-term efficacy and safety of heparin-induced extracorporeal lipoprotein precipitation (HELP) of LDL-c and fibrinogen in the management of familial hypercholesterolemia. From June 1992 to June 1998 a 22-year-old young male patient with familial hypercholesterolemia (double heterozygote for C660X and S305C) resistant to medication and diet and with symptomatic coronary artery disease (angina) was treated weekly with 90-min sessions of the HELP system. The patient had also been previously submitted to right coronary artery angioplasty. The efficacy of the method was evaluated by comparing the reduction of total cholesterol, LDL-c and fibrinogen before and after the sessions and before and after initiation of the study (data are reported as averages for each year). During the study, angina episodes disappeared and there were no detectable adverse effects of the treatment. Total cholesterol (TC), fibrinogen, and LDL-c decreased significantly after each session by 59.6, 66.1 and 64%, respectively. HDL-c showed a nonsignificant reduction of 20.4%. Comparative mean values pre- and post-treatment values in the study showed significant differences: TC (488 vs 188 mg/dl), LDL-c (416.4 vs 145 mg/dl), and fibrinogen (144.2 vs 57.4 mg/dl). There was no significant change in HDL-c level: 29.4 vs 23 mg/dl. These data show that the HELP system, even for a long period of time, is a safe and efficient mode of treatment of familial hypercholesterolemia and is associated with disappearance of angina symptoms.

Soybean products for feeding infants, children and adults under nutritional stress

This review points out the good quality of well-processed soya products. Normal infants, children and adults are able to utilize the protein and other nutrients present in the soya, when fed these products in amounts that will cover their needs. Under nutritional stress, such as in infant malnutrition, soya products such as soya-milk have been shown to help in the children’s recovery. Clinical and biochemical data show that their recovery is similar to that obtained with cow’s milk. Milk- or lactose-intolerant children and adults, who present a public health problem in some developing countries, could benefit from the high nutritive value and low cost of soy milk. Soya products have been shown to decrease cholesterol and other levels of blood lipids. Considering the availability of the several soya products in the market, this possibility has to be further explored. The utilization of soya products in preparing liquid formulas for oral or tube-feeding opens new fields for the treatment of several diseases, insuring at the same time adequate nutrition for the patients. From a practical point of view, in spite of all that is known about soybeans and soybean products, its use as human food, even in countries where it is produced in large quantities, is very low. It seems that local governments are not aware of the importance of soya for the solution to their serious food and nutrition problems. What is known on the subject has to leave the laboratories, research centers and universities and be transferred as food for the mouths of the needy populations. This has to be understood as an urgent duty of national governments. There is no doubt that soya is the cheapest and one of the best-quality foods available to help solve the present hunger problem of the world today.

Evaluation of the toxic activity of anorectic diethylpropion in Chinese hamster ovary cells.

Diethylpropion has been available in the market for treating obesity for over 50 years. Refined studies are lacking to fully elucidate its action spectrum. The aim of our study was to evaluate possible toxic effects of anorectic diethylpropion in Chinese hamster ovary (CHO) cells. Comet assay (detects breaks in the DNA strand), micronucleus test (detects clastogenic/aneugenic damage), and cell survival test (detects cytotoxic damage) were used to evaluate the toxic effects. In comet assay, we found that the damage scores with diethylpropion treatments at the concentrations of 20 and 40 μg/mL were more significant ( p < 0.05) than that of the negative control. When assessing the possible aneugenic and/or clastogenic damage caused by the drug in CHO cells, we found no difference ( p > 0.05) in the values of micronucleated cells when comparing different diethylpropion treatments and the negative control. Regarding the cell viability, for all the diethylpropion concentrations tested, higher values ( p < 0.05) of apoptosis were found compared with those of the negative control. In relation to the number of necrotic cells, no difference ( p > 0.05) was noted between the means of the three concentrations of diethylpropion evaluated and the negative control. In the experimental conditions, we conclude that diethylpropion has weak genotoxic and cytotoxic activities.

Effect of temperature and pre-incubation time of fibrolytic enzymes on in vitro degradability of Brachiaria (Brachiaria decumbens)

The ruminant production system in Brazil is based mostly on grazing and relies on native pastures and cultivated grass pastures. Improving forage digestibility is essential to overcome the energy loss and excessive nutrient excretion by livestock. Use of exogenous fibrolytic enzymes on tropical grasses has shown promise in increasing forage utilisation and productive efficiency of ruminants. The present study was taken up to evaluate the effect of temperature and pre-incubation time of cellulose-treated substrate (CTS) and xylanase-treated substrate (XTS) on in vitro degradability of Brachiaria decumbens substrate. Two commercial fibrolytic enzymes, cellulase and xylanase, were applied at the manufacturer’s recommended dose of 7.5 and 0.46 enzymatic units per 500 mg DM, respectively. Effect of temperature regimes of substrate exposure (18°C, 25°C and 32°C) and pre-incubation times with the enzymes (0, 12 and 24 h) were investigated in a complete factorial design. Three adult rumen-cannulated Santa Ines sheep served as inoculum donors. Substrates were incubated in vitro in semi-automatic gas production (GP) system and blanks were included for each inoculum. The GP was calculated, rumen degradability and volatile fatty acids (VFA) were determined. Interaction effect between temperature of substrate exposure and pre-incubation time with the enzyme was significant on degradable neutral detergent fibre (DNDF, g/kg) for both CTS (P = 0.01) and XTS (P = 0.04). Net gas production (GP, mL/g DNDF) of XTS (P = 0.06) differ on temperature versus pre-incubation time, whereas CTS were similar (P = 0.34). Partition factor, total VFA and acetate : propionate ratio were non-significant for both the enzymes. These findings highlight that Brachiaria may respond well to exogenous application of cellulase at all the environmental conditions studied and does not need any pre-incubation period.