Estudo da capacidade de absorção intestinal de ferro e zinco em indivíduos com obesidade grave, antes e após cirurgia bariátrica

A obesidade é uma doença crônica, multifatorial e de prevalência crescente tanto nos países desenvolvidos como nos em desenvolvimento. Atualmente, têm sido realizadas diferentes técnicas cirúrgicas como tratamento da obesidade e tem-se verificado desenvolvimento de carências nutricionais em diferentes tempos de seguimento pós-cirúrgico. Apesar de o ferro e o zinco estarem incluídos entre as deficiências de nutrientes, pouco se sabe sobre alterações na absorção intestinal desses minerais em indivíduos submetidos à cirurgia bariátrica. Assim, o presente estudo teve como objetivo verificar alterações na resposta plasmática de ferro e zinco em indivíduos com obesidade grave, em pré e pós-operatório de cirurgia bariátrica, após administração, por via oral, de ferro e zinco. Para isso foram avaliados 9 indivíduos com obesidade grave, do sexo feminino, com idade média de 41l12 anos e IMC médio de 51l9 Kg/m2. Antes e três meses após serem submetidos a cirurgia bariátrica, foram realizados: avaliação nutricional (anamnese alimentar, avaliação antropométrica e bioquímica, impedância bioelétrica e calorimetria indireta), determinação do nitrogênio urinário e o teste de absorção. Em cada momento, após jejum noturno de 8 horas, as voluntárias receberam uma cápsula de sulfato ferroso (15 mg de Fe elementar) e uma cápsula de sulfato de zinco (15 mg de Zn elementar) em doses únicas, em conjunto. A determinação das curvas de ferro e zinco plasmáticos foram realizadas a partir de cinco amostras de cada voluntária: uma basal (antes da administração das cápsulas) e as outras a cada 1 hora num período de 4 horas após a administração. As análises plasmáticas foram realizadas pelo método de espectrometria de absorção atômica e a comparação entre pré e pós-operatório avaliada...Obesity is a chronic and multifactorial disease with increasing prevalence both in developed and in developing countries. Recently, bariatric surgery became one option for obesity treatment and studies have described nutritional deficiencies after this surgery, including iron and zinc deficiencies. Little is known about intestinal absorption of these minerals in patients submitted to bariatric surgery. Therefore, the aim of this study was to verify plasma iron and zinc response in severe obese patients, before and three months after bariatric surgery, subsequent to oral administration of iron and zinc. Nine female severe obese patients (BMI 51l9 Kg/m2) aged 41l12 years old were evaluated. It was carried out: iron and zinc absorption test, urinary nitrogen determination and nutritional assessment which included dietary, anthropometric and biochemical evaluation, bioelectrical impedance and indirect calorimetry. After 8 hours fasting, patients received ferrous sulphate (15 mg elementary Fe) and zinc sulphate (15 mg elementary Zn) single dose at the same time. For determination of plasma iron and zinc curves, it was collected five samples from each patient. Blood was collected immediately before and 1, 2, 3 and 4 hours after oral dose administration. Plasma analyses were carried out by atomic absorption spectrometry and the area under the curve used to compare before and after operative results. It was verified no statistical differences on iron plasma concentration when the five samples were compared, before and after surgery, as well as in the area under the curve measurement. Concerning the zinc, it was verified statistical difference (p<0,05) only before surgery when basal plasma zinc concentration ... (Complete abstract click electronic access below)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Creatine supplementation decreased homocysteine plasma levels in rats but not humans: A critical review with meta-analysis

AbstractBackgroundIncreasing evidence has shown that an elevated a level of homocysteine (Hcy) in the blood is related to several diseases. Over the last few years, studies have demonstrated creatine (Cr) synthesis and Hcy formation are metabolically connected; and Cr supplementation can decrease Hcy blood levels in different situations. This data however is inconsistent and still controversial.ObjectiveThe aim of this critical review with meta-analysis was to discuss and ascertain the effects of Cr supplementation on blood Hcy levels.MethodA review was conducted according to the PRISMA guidelines using PubMed Discuss and Scielo online databases to identify relevant studies through November 2015. RevMan was used to calculate the effect size of the change in Hcy plasma/serum concentration from baseline to post-supplementation with Cr vs. placebo groups. Weighted mean differences were calculated using random effect models.ResultsCr supplemented trials were divided into two subgroups according to whether the experimental design included animals or humans participants. Overall, 14 studies were included in the meta-analysis. The six rodent included studies reported decreased plasma Hcy concentration after Cr supplementation with a mean effect size equal to −2.43 μmol/l (95% CI: 3.60, −1.26, P < 0.01). The humans studies involved 483 participants (242 Cr and 241 placebo supplemented subjects) and indicated no changes in plasma Hcy concentration after Cr supplementation compared to placebo (0.09 μmol/l, 95% CI: −0.47, 0.66, P = 0.18).ConclusionsOur data demonstrated Cr supplementation is effective in decrease Hcy blood concentration in rats; the same effect however, is not demonstrated humans studies. Human and rats particularities in Hcy metabolism and poorly controlled humans studies may contribute to the divergence of results

Evidence of zinc deficiency in competitive swimmers

Objective: The aim of this study was to assess the nutritional zinc (Zn) status of elite swimmers during different training periods. Methods: A longitudinal paired study was performed at the University of Sao Paulo in eight male swimmers 18 to 25 y old who had been swimming competitively at the state and national levels for at least 5 y. The swimmers were evaluated over a total period of 14 wk: before the basic and specific preparatory period (BSPP-baseline), at the end of the basic and specific preparatory period (post-BSPP), and at the end of the polishing period (PP). Levels of Zn were determined in the plasma, erythrocyte, urine, and saliva by atomic absorption spectrophotometry. Anthropometric measurements and a 3-d food record were also evaluated. Results: The median plasma Zn concentration was below the reference value in all training periods (BSPP-baseline 59 mu g/dL, post-BSPP 55.9 mu g/dL, after PP 58.8 mu g/dL, P &gt; 0.05), as were threshold values for erythrocytes (BSPP-baseline 36.5 mu g of Zn/g of hemoglobin, post-BSPP 42 mu g of Zn/g of hemoglobin, after PP 40.7 mu g of Zn/g of hemoglobin, P &gt; 0.05), urinary Zn (BSPP-baseline 280 mu g/24 h, post-BSPP 337 mu g/24 h, after PP 284 mu g/24 h, P &gt; 0.05), and salivary Zn (BSPP-baseline 66.1 mu g/L, post-BSPP 54.1 mu g/L, after PP 79.7 mu g/L, &gt; 0.05). Salivary Zn did not correlate with plasma and erythrocyte Zn levels. Conclusion: The results suggest that the elite swimmers studied presented a possible Zn deficiency and that salivary Zn was not adequate to evaluate the Zn nutritional status. (C) 2012 Elsevier Inc. All rights reserved

Amino acids in squamous cell carcinomas and adjacent normal tissues from patients with larynx and oral cavity lesions

Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (Fapesp) [2006/56010-0

Calibration of the food list and portion sizes of a food frequency questionnaire applied to free-living elderly people

Objective: To calibrate the food list and relative portion sizes of a food frequency questionnaire (FFQ) for application to a free-living, healthy, elderly population.Methods: Cross-sectional study. One hundred free-living, healthy participants, aged from 60 to 75 y, randomly selected from among individuals in the area served by the Family Health Program, School of Medicine of Ribeirao Preto, University of São Paulo. A Food Frequency Questionnaire (FFQ) and a Diet History Questionnaire (DH) were applied by trained dietitians. Each food item of the FFQ had its portion size recalculated according to the percentiles referenced by the volunteers in the DH (25th = small, 50th = medium, and 75th = large). the list of foods and portion sizes of the original FFQ and those obtained by the application of the DH were compared. the percent contribution of energy, protein, fat, carbohydrate, folic acid, vitamin C, calcium, and fiber of each food item mentioned in the FFQ was determined from the data obtained by the application of the DH.Results: FFQ as compared with the DH, provided good estimation of the intake of protein, calcium, folic acid, and fiber (paired t test P < 0.05). Portion sizes of the FFQ differed from those obtained by the application of the DH (-23% to 300%).Conclusions: Adjustments to the FFQ in particular, new portion sizes and a reduction of the food list were found to be appropriate for application to healthy, urban, free-living elderly people in Ribeirao Preto, Brazil. (C) 2013 Elsevier Inc. All rights reserved