Jane Bandeira Dichi

Comparison of ω-3 fatty acids and sulfasalazine in ulcerative colitis

Fish oil omega-3 fatty acids exert antiinflammatory effects on patients with ulcerative colitis. However, a comparative study in patients with mild to moderate ulcerative colitis receiving only sulfasalazine or omega-3 fatty acids has not been performed. We sought to detect changes in the inflammatory disease activity with the use of either fish oil omega-3 fatty acids or sulfasalazine in patients with ulcerative colitis. Ten patients (five male, five female; mean age = 48 +/- 12 y) with mild to moderate active ulcerative colitis were investigated in a randomized cross-over design. They received either sulfasalazine (2 g/d) or omega-3 fatty acids (5.4 g/d) for 2 m.o. Disease activity was assessed by clinical and laboratory indicators, sigmoidoscopy, histology, and whole-body protein turnover (with 15N-glycine). Treatment with omega-3 fatty acids resulted in greater disease activity as detected by a significant increase in platelet count, erythrocyte sedimentation rate, C-reactive protein, and total fecal nitrogen excretion. No major changes in protein synthesis and breakdown were observed during either treatment. In conclusion, treatment with sulfasalazine is superior to treatment with omega-3 fatty acids in patients with mild to moderate active ulcerative colitis.

Influence of uric acid and γ-glutamyltransferase on total antioxidant capacity and oxidative stress in patients with metabolic syndrome

OBJECTIVE Metabolic syndrome (MS) is a cluster of risk factors for cardiovascular disease related mainly to insulin resistance, but also to oxidative stress. Uric acid and gamma-glutamyltransferase (GGT) levels are also associated with MS and oxidative stress. This study was undertaken to assess the role of GGT and uric acid in adult patients with MS and its relation to oxidative stress and antioxidant defense. METHODS A total of 88 adults (67 with MS and 21 controls) were selected among ambulatory patients and workers of the University Hospital of Londrina, Paraná, Brazil. Oxidative stress was assessed by determination of thiobarbituric acid-reactive substances and tert-butyl hydroperoxide-initiated chemiluminescence and antioxidant defenses by total radical-trapping antioxidant parameter. RESULTS The MS group presented higher significant results (P < 0.0001) than the control group in all parameters of MS and uric acid and GGT levels and significant lower values (P < 0.0001) in high-density lipoprotein cholesterol levels. Thiobarbituric acid-reactive substances and total radical-trapping antioxidant parameter did not show statistically significant differences between groups. However, lipid hydroperoxides, evaluated by tert-butyl hydroperoxide-initiated chemiluminescence, showed higher significant results in the MS group (P = 0.045) than in the control group. Total antioxidant capacity did not decrease and thiobarbituric acid-reactive substances did not increase, probably due to increased uric acid (r = 0.239, P = 0.04) in the MS group. CONCLUSION The present study confirmed that GGT is a strong predictor of MS and that lipid peroxide measured by tert-butyl hydroperoxide-initiated chemiluminescence and GGT activity are reliable markers of oxidative stress in this syndrome.

Association between soy and green tea (Camellia sinensis) diminishes hypercholesterolemia and increases total plasma antioxidant potential in dyslipidemic subjects

OBJECTIVE To evaluate the hypolipemic and antioxidant effects of soy and green tea alone and/or in association in dyslipidemic subjects. METHODS One hundred dyslipidemic individuals were allocated into four groups. The soy group ingested 50 g of soy (kinako) daily, and the green tea group ingested 3 g of green tea in 500 mL of water per day. A third group ingested 50 g of soy and 3 g of green tea daily, and the control group had a hypocholesterolemic diet. Evaluations were performed at baseline and after 45 and 90 d. Plasma levels of total cholesterol, high-density lipoprotein, and triacylglycerols were evaluated by automated methods. Low-density lipoprotein (LDL) cholesterol was calculated using the Friedewald equation. LDL was isolated by ultracentrifugation. Total plasma antioxidant capacity and plasma levels of total lipid hydroperoxides and those linked to LDL were evaluated by chemiluminescence. The results were expressed as median values and their 25th to 75th percentiles, with a 5% level of significance. RESULTS No significant difference occurred in LDL, high-density lipoprotein cholesterol, and triacylglycerol levels across groups. However, a statistically significant difference in total cholesterol occurred within the soy/green tea group 45 and 90 d after intervention. No statistically significant difference occurred in plasma levels of lipid hydroperoxides or those linked to LDL in any of the groups studied. All the groups that used soy and/or green tea presented increased total plasma antioxidant potential. CONCLUSION Soy and green tea, alone or in combination, increased the total antioxidant potential of hypercholesterolemic patients, whereas only the combination decreased total cholesterol levels.

Evaluation of Agaricus blazei in vivo for antigenotoxic, anticarcinogenic, phagocytic and immunomodulatory activities.

The development of various types of cancer results from the interaction among endogenous, environmental and hormonal factors, where the most notable of these factors is diet. The aim of the present study was to determine the antigenotoxic, anticarcinogenic, phagocytic and immunomodulatory activities of Agaricus blazei. The test antigenotoxicity (Comet Assay) and anticarcinogenic (Test of Aberrant Crypt Foci) assess changes in DNA and/or intestinal mucosa that correlate to cancer development. Tests of phagocytosis in the spleen and differential count in blood cells allow the inference of modulation of the immune system as well as to propose a way of eliminating cells with DNA damage. Supplementation with the mushroom was carried out under pre-treatment, simultaneous treatment, post-treatment and pre-treatment+continuous conditions. Statistical analysis demonstrated that the mushroom did not have genotoxic activity but showed antigenotoxic activity. Supplementation caused an increase in the number of monocytes and in phagocytic activity, suggesting that supplementation increases a proliferation of monocytes, consequently increasing phagocytic capacity especially in the groups pre-treatment, simultaneous and pre-treatment+continuous. The data suggest that A. blazei could act as a functional food capable of promoting immunomodulation which can account for the destruction of cells with DNA alterations that correlate with the development of cancer, since this mushroom was demonstrated to have a preventive effect against pre-neoplastic colorectal lesions evaluated by the aberrant crypt foci assay. According to these results and the literature, it is believed that supplementation with A. blazei can be an efficient method for the prevention of cancer as well as possibly being an important coadjuvant treatment in chemotherapy.

Effect of Long-term Fortification of Whey Drink With Ferrous Bisglycinate on Anemia Prevalence in Children and Adolescents From Deprived Areas in Londrina, Paraná, Brazil☆

OBJECTIVE Fortification of food with iron is considered the best sustainable way of preventing iron deficiency when an appropriate diet is not available. The most difficult challenge is to find the ideal combination of iron fortification compound and food vehicle. We investigated the effect of cheese whey drink with 15% of frozen strawberry fortified with ferrous bisglycinate on hemoglobin values in children and adolescents. METHODS The assessed population participates in Public Educational Centers in Londrina, Paraná (southern Brazil), which assist families living in precarious socioeconomic conditions (annual income < 500.00 US dollars per capita). Hemoglobin was measured for 1 y with a Hemocue portable photometer. Anemia was defined as hemoglobin values below 12 g/dL. Thus, hemoglobin was verified in 467 (7 to 14 y) individuals (249 boys and 218 girls). RESULTS Although anemia prevalence did not decrease after 3 mo, there was a statistically significant decrease from 41.9% at the beginning of the study to 26.4% after 6 mo (P < 0.001) and to 9.6% after 1 y (P < 0.001). Statistically significant changes (mean +/- standard deviation) were observed between children and adolescents with hemoglobin values below 11 g/dL (increase of 2.2 +/- 1.03) and above 12 g/dL (increase of 0.35 +/- 1.07; P < 0.0001). CONCLUSION There was a marked reduction in the prevalence of anemia in children and adolescents after long-term fortification of whey drink with ferrous bisglycinate.

Comparison of ferrous sulfate and ferrous glycinate chelate for the treatment of iron deficiency anemia in gastrectomized patients

OBJECTIVES Postgastrectomy iron deficiency anemia has a variable prevalence and occurs in 20-50% of patients. Food fortification reports examining ferrous glycinate chelate have shown that it can be 2.5-3.4 times more bioavailable than ferrous sulfate, with minimal gastrointestinal symptoms. The present study was designed as a controlled experimental study including 18 gastrectomized patients with iron deficiency anemia to compare the effects of ferrous sulfate and ferrous glycinate chelate in the treatment of anemia and to evaluate the presence of side effects. METHODS Patients were divided in two groups: group 1 received ferrous sulfate (200 mg twice a day, corresponding to 80 mg of elemental iron) and group 2 received ferrous glycinate chelate (250 mg/d, corresponding to 50 mg of elemental iron) for 4 mo. Laboratory measurements were performed at baseline and after 2 and 4 mo. RESULTS Group 1 showed an apparent recovery in laboratory parameters, with increases in medium corpuscular hemoglobin (P = 0.02), serum iron (P = 0.02), and ferritin (P = 0.04), and a decrease in transferrin (P = 0.002) after 4 mo. Individualized analysis showed that only one patient using ferrous sulfate had anemia at the end of the study in contrast to six patients using ferrous glycinate. In addition, ferritin levels increased above 20 microg/L at the end of the study in seven patients using ferrous sulfate in contrast to one patient using ferrous glycinate. CONCLUSION Patients with iron deficiency anemia after gastrectomy treated with ferrous sulfate had better results in hematologic laboratory parameters than those who used ferrous glycinate chelate.

CONSEQÜÊNCIAS NUTRICIONAIS DAS ALTERAÇÕES METABÓLICAS DOS MACRONUTRIENTES NA DOENÇA HEPÁTICA CRÔNICA

Liver chronic pathologies often courses with metabolic abnormalities of macronutrients leading to or aggravating a protein-energy malnutrition status. This review raised the major pathophysiological mechanisms related to the protein-energy malnutrition in chronic liver patients. By large the reduced dietary intake is the most accepted cause particularly among alcoholic patients. Moreover during the treatment prevails the iatrogenic anorexia by unpalatable (restricted) diets interpolated with long-lasting fastings of hospitalized patients. Intestinal fat malabsorption is a common finding whereas hypermetabolism can be found associated with an acute alcoholism. Hypoglycemia or insulin resistance, hypertriglyceridemia and liver steatosis are common findings as well as lower plasma proteins along with higher levels of ammonia, aromatic and sulphur amino acids leading to neurological outcomes. The knowledge of these metabolic changes allow proper dietary interventions toward reduced morbi-mortality of those patients.Liver chronic pathologies often courses with metabolic abnormalities of macronutrients leading to or aggravating a protein-energy malnutrition status. This review raised the major pathophysiologycal mechanisms related to the protein-energy malnutrition in chronic liver patients. By large the reduced dietary intake is the most accepted cause particularly among alcoholic patients. Moreover during the treatment prevails the iatrogenic anorexia by unpalatable (restricted) diets interpolated with long-lasting fastings of hospitalyzed patients. Intestinal fat malabsorption is a common finding whereas hypermetabolism can be found associated with an acute alcoholism. Hipoglycemia or insulin resistance, hypertriglyceridemia and liver steatosis are common findings as well as lower plasma proteins along with higher levels of ammonia, aromatic and sulfer amino acids leading to neurological outcomes. The knowledge of these metabolic changes allow proper dietary interventions toward reduced morbi-mortality of those patients.Liver chronic pathologies often courses with metabolic abnormalities of macronutrients leading to or aggravating a protein-energy malnutrition status. This review raised the major pathophysiologycal mechanisms related to the protein-energy malnutrition in chronic liver patients. By large the reduced dietary intake is the most accepted cause particularly among alcoholic patients. Moreover during the treatment prevails the iatrogenic anorexia by unpalatable (restricted) diets interpolated with long-lasting fastings of hospitalyzed patients. Intestinal fat malabsorption is a common finding whereas hypermetabolism can be found associated with an acute alcoholism. Hipoglycemia or insulin resistance, hypertriglyceridemia and liver steatosis are common findings as well as lower plasma proteins along with higher levels of ammonia, aromatic and sulfer amino acids leading to neurological outcomes. The knowledge of these metabolic changes allow proper dietary interventions toward reduced morbi-mortality of those patients.

Nitric oxide enhancement and blood pressure decrease in patients with metabolic syndrome using soy protein or fish oil.

OBJECTIVE To verify the effects of fish oil and soy on nitric oxide (NO) and blood pressure in patients with metabolic syndrome (MS). SUBJECTS AND METHODS Sixty women with MS were investigated in a parallel randomized design study. The first group maintained their usual diet; the second group received 25 g/day of soy; the third group received 3 g/day of n-3 fatty acids, and the fourth group the same amount previously cited of n-3 fatty acids and soy. RESULTS Serum nitric oxide metabolites showed significant increase after 90 days in the fish oil and soy groups. Systolic pressure reduced after 45 days of treatment with fish oil, whereas diastolic pressure decreased significantly throughout the study in the soy group. CONCLUSIONS NO increase and blood pressure reduction with fish oil or soy protein reinforce the importance of the influence of NO on blood pressure in patients with MS.

Increased oxidative stress, decreased total antioxidant capacity, and iron overload in untreated patients with chronic hepatitis C.

The aim of this study was to determine oxidative stress in patients with untreated chronic hepatitis C (CHC), relating the obtained results with iron status and disease activity markers. Two groups (CHC patients and controls) were studied. CHC patients presented significantly higher values than the control group in some parameters: ALT, AST, GGT, iron, ferritin, and transferrin saturation, and also in tert-butyl hydroperoxide initiate chemiluminescence and thiobarbituric acid-reactive substances (TBARS) as well as lower values in total radical-trapping antioxidant parameter (TRAP). TBARS showed a significant correlation with serum AST and with transferrin saturation, whereas TRAP correlated inversely with serum albumin. Serum ferritin correlated with ALT and GGT, whereas serum iron did so with GGT. In conclusion, lower antioxidant capacity, higher levels of pro-oxidants activity, and iron overload occur in untreated patients with CHC. This greater oxidative activity could play an important role in pathogenesis and evolution of hepatitis C and thus further investigations.

Repercussão da perda de peso sobre parâmetros nutricionais e metabólicos de pacientes obesos graves após um ano de gastroplastia em Y-de-Roux

OBJECTIVE To assess nutritional and metabolic evolution and inflammatory activity in severe obese patients submitted to bariatric surgery. METHODS This prospective study evaluated 56 patients (50 female and 6 male), mean age 40 + or - 9,9 years, submitted to RYGB. Nutritional, metabolic, and inflammatory parameters were assessed prior to and 12 months postsurgery. RESULTS It was verified significant decreases in weight loss in relation to baseline values from 138 + or - 28,8 to 90 + or - 19,5 kg (p< 0,0001), glucose levels from 116 + or - 47,3 to 84 + or - 9,8 mg/dL (p< 0,0001), triacylglycerol levels from 137 + or - 61,4 to 84 + or - 38,6 mg/dL (p< 0,0001), and also in total cholesterol from 189 + or - 41,6 to 166 + or - 36,4 mg/dL (p< 0,0001) and LDL-cholesterol from 119 + or - 36,1 to 104 + or - 30,7 mg/dL (p< 0,0005). C-reactive protein levels reduced from 11,33 + or - 10,82 to 3,62 + or - 4,49 mg/dL (p< 0,0001). Although maintenance of iron levels was verified after one year, there was a significant decrease in hemoglobin from 13 + or - 1,3 to 12 + or - 1,4 g/dL (p< 0,01), and reduction in ferritin levels, especially in women who showed a decrease from 101,2 + or - 123,3 to 85,0 + or - 101,9 (p< 0,03). CONCLUSION Therefore, weigh loss in patients with severe obese after RYGB showed improvement in both metabolic and inflammatory status and may reduce substantially co-morbidities associated with increased cardiovascular risk.