Lowering Low-Density Lipoprotein Cholesterol Concentration with Plant Stanol Esters to Reduce the Risk of Atherosclerotic Cardiovascular Disease Events at a Population Level: A Critical Discussion

Atherosclerotic cardiovascular diseases (ASCVDs) cause every fifth death worldwide. However, it is possible to prevent the progression of ASCVDs by reducing circulating concentrations of low-density lipoprotein cholesterol (LDL-C). Recent large meta-analyses demonstrated that by reducing the dietary intake of saturated fat and cholesterol, it is possible to reduce the risk of ASCVD events. Plant stanols, as fatty-acid esters, were developed as a dietary adjunct to reduce LDL-C levels as part of a heart-healthy diet. They reduce cholesterol absorption so that less cholesterol is transported to the liver, and the expression of LDL receptors is upregulated. Ultimately, LDL-C concentrations are reduced on average by 9–12% by consuming 2–3 g of plant stanol esters per day. In this review, we discuss recent information regarding the prevention of ASCVDs with a focus on dietary means. We also present new estimates on the effect of plant stanol ester consumption on LDL-C levels and the risk of ASCVD events. Plant stanol esters as part of a heart-healthy diet plausibly offer a means to reduce the risk of ASCVD events at a population level. This approach is not only appropriate for subjects with a high risk of ASCVD, but also for subjects at an apparently lower risk to prevent subclinical atherosclerosis

EGGS IN THE HUMAN DIET - FACTS AND CHALLENGES

Eggs are a good source of balanced nutritional and biologically active substances - proteins, lipids, some irreplaceable nutritional components such as amino acids, polyunsaturated fatty acids, vitamins, macro- and microelements, etc. It is identified as the cheapest animal source of proteins, lipids, vitamins A, B12, riboflavin, choline, iron, zinc, phosphorus and calcium. At the same time, the dangers to human health that eggs can carry are also taken into account. Material/Methods: The literature used is based on databases PubMed, Embase and as well as data from own studies. Review Results: In the present review, we provide data on the importance of the composition of eggs in human nutrition are presented and the risk of their use is evaluated. Conclusions: The high biological and nutritional value of eggs are grounds for their use in the daily life of healthy people, without additional restrictions of cardiovascular diseases. There is a risk of food poisoning, which can be limited to acceptable levels by following good hygiene practices

El índice de calidad de la nutrición en las residencias de ancianos (QUINN). Una nueva herramienta para evaluar la calidad de la dieta en las residencias de ancianos

Acknowledgements: the authors would like to thank the cooperation of the personnel of this institution — Yolanda Velasco, Alfredo Zapatero-Llanos, Carolina Calderon-Niño, and Lidia Peña-Rampérez, and all the residents of the center who participated in the study. The authors would like to thank Verónica Casanova- Muñoz for her constructive comments on some aspects of this manuscript.Background: the assessment of diet quality (DQ) is fundamental to the study of disease-diet associations, and it is necesary to implement an easy to-apply tool in nursing homes (NHs). Our objective was to propose and apply a novel diet quality indicator (DQIn) using an a priori approach for NHs. Methods: the QUality Index for Nutrition in Nursing homes (QUINN) was implemented in a public NH located in Valladolid, Spain, during a 5-week period (n = 137 subjects). The choice of the QUINN components was based on a rapid review. The QUINN was based on 15 dietary components — 12 were basic (vegetables, fruits, legumes, olive oil, cereals, dairy, white fish and seafood, white-meat, eggs/positive; other fats, red and processed meat, and sweets/negative), and 3 were supplementary (fruits and vegetables variety, oily-fish, and whole-grains/positive). Each component was classified into 4-categories (0, 1, 2 o 3 points; range: 0-45 points). Results: the QUINN was tested on a menu offered by a NH giving a result of 34 points (good diet). The components with the highest scores were related to the Mediterranean diet (high consumption of legumes, olive oil, white fish and shellfish; low intake of other fats; and a wide variety of fruits and vegetables), together with cereals, white meat, dairy, and eggs. The components that required a major change were red- and processed-meats, sweets, and whole grains. Conclusion: the menu of this Spanish NH showed a good DQ according to the QUINN. The assessment of the DQ in NHs using QUINN will allow the proposal of interventions aimed at improving their diet.Antecedentes: la valoración de la calidad de la dieta es fundamental para el estudio de las asociaciones enfermedad-dieta, y es necesario implantar una herramienta de fácil aplicación en las residencias de ancianos. Nuestro objetivo fue proponer y aplicar un nuevo indicador de calidad de la dieta (diet quality indicator, DQIn) utilizando un enfoque a priori para su utilización en residencias de ancianos. Métodos: el Índice de Calidad Nutricional en Residencias de Ancianos (QUality Index for Nutrition in Nursing homes, QUINN) se aplicó en una residencia pública de Valladolid durante un periodo de 5 semanas (n = 137 sujetos). La elección de los componentes del QUINN se basó en una revisión rápida. En el QUINN se consideraron 15 componentes dietéticos, 12 básicos (verduras, frutas, legumbres, aceite de oliva, cereales, lácteos, pescado blanco y marisco, carnes blancas, huevos/positivos; otras grasas, carnes rojas y procesadas, y dulces/negativos) y 3 adicionales (variedad de frutas y verduras, pescado azul, y cereales integrales/positivos). Cada componente se clasificó en 4 categorías (0, 1, 2 o 3 puntos; rango: 0-45 puntos). Resultados: el QUINN se aplicó en el menú ofertado por una residencia de ancianos dando un resultado de 34 puntos (dieta de buena calidad). Los componentes con mayor puntuación estaban relacionados con la dieta mediterránea (alto consumo de legumbres, aceite de oliva, pescado blanco y marisco, bajo consumo de otras grasas y variedad de frutas y verduras), junto con los cereales, las carnes blancas, los lácteos y los huevos. Los componentes que requerían un cambio importante fueron las carnes rojas y procesadas, los dulces y los cereales integrales. Conclusión: el menú de esta residencia de ancianos situada en España mostró una calidad de la dieta buena según el QUINN. La evaluación de la calidad de la dieta en las residencias de ancianos mediante el QUINN permitirá proponer intervenciones para mejorar la dieta

Suggestions for Chinese Dietary Lipids Reference Intakes in the New Period

With the rapid development of economy and society, the dietary pattern of Chinese residents has undergone obvious transition. The recommendation of dietary lipids intake has a significant influence on the improvement of dietary pattern and on the achievement of Healthy China goals in the new period. We put forward some suggestions on the revision of dietary lipids reference intake for Chinese residents. (1) The upper limit of acceptable macronutrient distribution range (U-AMDR) of percent of energy (%E) from fat for residents aged 18 years and above in China is 30%E, lower than that in countries of European Union and North America, which is 35%E. Some scholars suggest raising the U-AMDR of dietary fat for Chinese adults, but there is still insufficient evidence for modification. However, considering the characteristics of high-energy and nutrient-dense diets required by the elderly, increasing the U-AMDR of dietary fat in the elderly should be considered. (2) Some studies have shown that the ratio of n-6/n-3 polyunsaturated fatty acids (n-6/n-3PUFA) is closely related to the risk of multiple chronic non-communicable diseases. The average dietary n-6/n-3 PUFA ratio of Chinese residents is 8.6, and even higher in some populations. Therefore, it is recommended that the recommended values of dietary n-6/n-3PUFA ratio be included in the new dietary lipid reference intake recommendations. (3) Despite numerous investigations, the relationship between dietary cholesterol intake and the outcomes of several chronic diseases, such as cardiovascular disease, remains unclear. The average daily cholesterol intake was in the normal range, 264.0 mg in urban residents while 168.8 mg in rural residents. Based on current research evidence, it is still inappropriate to set dietary cholesterol limits for the general adult population. For patients with chronic diseases such as cardiovascular and cerebrovascular diseases, it is suggested to refer to the recommendations on dietary cholesterol intake in the guidelines of control and prevention for corresponding diseases

Importância e benefícios do consumo de ovos de galinha enriquecidos com selénio: uma narrativa de revisão

Selenium has been shown to have beneficial effects on human health, such as strengthening of the immune system, anti-inflammatory effects and decreased lipoxidation. Moreover, its deficiency can cause diseases such as Keshan disease and Kashin-Beck disease, which have a mortality of approximately 50%. The objective of this article is to identify and summarize the functions and advantages of consuming selenium-enriched egg on human health.El selenio ha demostrado poseer efectos benéficos sobre la salud humana, entre los que destacan el fortalecimiento del sistema inmune, efectos antiinflamatorios y disminución de la lipoxidación. Además, su deficiencia puede ocasionar enfermedades como la enfermedad de Keshan y de Kashin-Beck, ambas con una mortalidad del 50 %, aproximadamente. El objetivo de este artículo es identificar y sintetizar las funciones y ventajas del consumo de huevo enriquecido con selenio en la salud humana.O selênio tem demonstrado ter efeitos benéficos na saúde humana, entre os quais destaca-se o fortalecimento do sistema imunológico, efeitos antiinflamatórios e diminuição da lipoxidação. No entanto, sua deficiência pode causar doenças como a doença de Keshan e a doença de Kashin-Beck, ambas com mortalidade de aproximadamente 50%. O objetivo deste artigo é identificar e sintetizar as funções e vantagens do consumo de ovo enriquecido com selênio

Desmistificar com Ciência

Outubro 2020 © Laboratório de Nutrição FMULinfo:eu-repo/semantics/publishedVersio

Consumo de diferentes tipos de carne e de ovos em pacientes transplantados renais

Introdução: Pacientes com doença renal crônica tendem a modificar seu consumo alimentar após o transplante renal. A gama de escolha dos alimentos torna-se maior devido a menores restrições dietéticas. Dietas ricas em proteína são conhecidas por induzir alterações significativas na saúde renal. Entretanto, a literatura demonstra que não somente a proteína em si gera essas alterações, como também há diferenças entre o impacto de fontes distintas de proteína na função renal. Objetivo: avaliar o consumo de tipos de carne (carne vermelha, carne branca, carne processada) e de ovos em pacientes transplantados renais e sua associação com parâmetros antropométricos e laboratoriais, incluindo função renal, perfil lipídico e hemoglobina glicada. Metodologia: O consumo de tipos de carnes e ovos de pacientes transplantados renais foi estimado a partir de ao menos seis recordatórios de 24h coletados ao longo de um ano, iniciando no segundo mês pós transplante. Dados de peso e circunferência abdominal foram coletados mensalmente nos primeiros seis meses e a cada três meses no semestre subsequente. Para a avaliação de composição corporal foi realizada bioimpedância a cada três meses, bem como a avaliação bioquímica. Resultados: Cento e seis pacientes transplantados renais foram incluídos no estudo. A média de idade da amostra foi de 50 ± 13,4 anos, onde 64,15% eram do sexo masculino e 76,42% eram de etnia branca. A média de peso no momento do transplante foi de 72,55 ± 14,25 kg, IMC médio de 26,46 ± 4,49 kg/m². Em relação ao consumo alimentar, a média do consumo calórico diário foi de 1749,22 ± 33,76 kcal e a relação de kcal por quilo de peso teve uma média de 24,31 ± 0,68 kcal/kg. A ingestão proteica total e por quilo de peso foi de 88,67 ± 1,87 gramas e 1,22 ± 0,03 gramas, respectivamente. Quando avaliamos separadamente as fontes de proteína, observamos um consumo diário de carne vermelha de 67,22 (34,44 - 92,78) gramas e 77,78 (46,67- 124,31) gramas de carne branca. Em relação ao consumo de carnes processadas e ovos, o consumo foi 2,92 (0,00- 12,50) gramas e 15 (3,94 - 37,60) gramas, respectivamente. O consumo de carne vermelha apresentou correlação com peso corporal (0,101; p=0,027), circunferência de cintura (0,096; p=0,035), creatinina sérica (0,138; p=0,006), inversamente ao consumo de carne branca (-0,483; p=0,000) e ao consumo de ovos (-0158; p=0,000) e entre carnes processadas com valores de colesterol LDL (0,134; p=0,036) e inversamente com as fibras (-0,140; p=0,003) foram observadas. Já o consumo de ovos apresentou correlação positiva a massa corporal gorda (0,099; p=0,032) e inversamente à creatinina (-0,099; p=0,049), ao colesterol total (-0,103; p=0,043) e ao colesterol LDL (-0,128; p= 0,046). Conclusão: O consumo de carne vermelha e processada sugere um aumento do risco cardiovascular em pacientes transplantados renais, enquanto que o consumo de carnes brancas e ovos parece apresentar um efeito protetor. Mais estudos devem ser realizados a fim de avaliar as diversas fontes de carne juntamente com outras fontes de proteína animal, como laticínios e fontes de proteína vegetal.Introduction: Patients with chronic kidney disease tend to modify their food intake after kidney transplantation. The range of food choices is widened due to less dietary restrictions. Protein-rich diets are known to induce significant changes in kidney health. However, the literature demonstrates that does not the protein itself generate these changes, but there are also differences between the impact of different protein sources on renal function. Objective: to evaluate the consumption of types of meat (red meat, white meat, processed meat) and eggs in kidney transplant patients and their association with anthropometric and laboratory parameters, including renal function, lipid profile and glycated hemoglobin. Methodology: The consumption of differents sources of meat and eggs of 106 kidney transplant patients was estimated based on at least six 24-hour recalls collected over a year, starting in the second month after transplantation. Weight and waist circumference data were collected monthly in the first six months and every three months in the subsequent semester. For body composition assessment, bioimpedance was performed every three months, as well as biochemical assessment. Results: One hundred and six kidney transplant patients were included in the study. The mean age of the sample was 50 ± 13.4 years, where 64.15% were male and 76.42% were white. The average weight at the time of transplantation was 72.55 ± 14.25 kg, with an average BMI of 26.46 ± 4.49 kg / m². Regarding food consumption, the average daily caloric consumption was 1749.22 ± 33.76 kcal and the ratio of kcal per kilogram of weight had an average of 24.31 ± 0.68 kcal / kg. The total protein intake and per kilogram of weight was 88.67 ± 1.87 grams and 1.22 ± 0.03 grams, respectively. When assessing protein sources separately, we observed a daily consumption of red meat of 67.22 (34.44 - 92.78) grams and 77.78 (46.67- 124.31) grams of white meat. Regarding the consumption of processed meats and eggs, the consumption was 2.92 (0.00 - 12.50) grams and 15 (3.94 - 37.60) grams, respectively. The present study did not observe a directly significant impact of the consumption of different sources of meat with renal function, inflammation and other anthropometric and metabolic parameters in renal transplant patients. However, some weak correlations between the consumption of red meat with body weight (0,101; p=0,027) waist circumference (0,096; p= 0,035) and creatinine (0,138; p=0,006) and conversely to the consumption of white meat (-0,483; p=0,000) and eggs (-0158; p=0,000) between processed meats with LDL cholesterol (0,134; p=0,036) and conversely to the consumption of fiber (-0,140; p=0,003) were observed. The consumption of eggs showed a positive correlation with fat mass (0,099; p=0,032) and inversely proportional, with creatinine levels (-0,099; p=0,049), total cholesterol (-0,103; p=0,043) and LDL cholesterol (-0,128; p= 0,046). Conclusion: The consumption of red and processed meat suggests an increase in cardiovascular risk in kidney transplant patients, while the consumption of white meat and eggs seems to have a protective effect. Further studies should be carried out in order to evaluate the different sources of meat together with other sources of animal protein, such as dairy products and vegetable protein sources