Prehrana kod celijakije

Celijakija je nasljedni, imunosno posredovani poremećaj koji obilježava trajna nepodnošljivost glutena, bjelančevine pšenice, ječma, raži i zobi. Trenutačno, jedini znanstveno dokazano učinkoviti tretman za oboljele od celijakije jest striktna i doživotna bezglutenska dijeta. Bezglutenska dijeta znači izbjegavanje najmanjih količina glutena u prehrani. Kako bi se liječila celijakija, nužno je iz prehrane isključiti svu hranu koja sadržava pšenicu, ječam, raž i zob i njihove derivate. Potpuno uklanjanje glutena iz prehrane oboljelih od celijakije rezultirat će simptomatskom, serološkom i histološkom remisijom kod većine pacijenata

Percepcija tijela i učestalost ortoreksije nervoze u mladih osoba u Hrvatskoj

The prevalence of eating disorders in young people is steadily increasing, which brings orthorexia nervosa into focus, especially in pandemic and stress-related periods. Therefore, the aim of this study was to determine the prevalence of orthorexia nervosa in young people and relate it to anthropometric parameters, eating habits and perception of body appearance. This study included 191 participants aged 18-24 years, of which 85,9 % females. Data on body mass and height were collected, from which body mass index was calculated, while their eating attitudes were evaluated by using 5-point scale. The prevalence of orthorexia nervosa was assessed using the ORTO-15 questionnaire, while the Physical Appearance Comparison Scale - Revised (PACS-R) was used to assess participant’s appearance comparison tendencies with other people. It was found that 38.2% of the respondents had orthorexia nervosa. There were no statistically significant differences in the body mass index between the participants with or without the diagnosis of orthorexia (p=0.276). Nevertheless, in the group of participants not diagnosed with orthorexia, those with adequate body weight predominated (89.9%), while among subjects diagnosed with orthorexia the proportions of undernourished (8.2%) and overweight participants (15.1%) were higher. Participants with orthorexia found a healthy diet more important than subjects without orthorexia (p=0.001), while there were no statistically significant differences in self-rated diet quality between the two groups (p=0.815). Furthermore, there was a statistically significant negative correlation between the results of PACS-R and ORTO-15 (p<0.01). Ultimately, there was a statistically significant difference in the results of PACS-R between participants with or without the diagnosis of orthorexia (p=0.032). High share of participants was diagnosed with orthorexia nervosa. Even though young people who developed orthorexia nervosa mostly had normal body weight, they had a greater tendency to compare their physical appearance to the appearance of others, what indicated distorted perception of their own body image. This brings to attention the importance of educating young people, especially female, about healthy diet, and confirms the necessity of an interdisciplinary approach in treating orthorexia nervosa, including psychological support.Prevalencija poremećaja hranjenja u mladih ljudi u stalnom je porastu, što dovodi u fokus ortoreksiju nervozu, osobito u razdobljima pandemije i stresa. Stoga je cilj ovog istraživanja bio utvrditi prevalenciju ortoreksije nervoze u mladih ljudi i povezati je s antropometrijskim parametrima, prehrambenim navikama i percepcijom tjelesnog izgleda. Ovo istraživanje uključivalo je 191 ispitanika u dobi od 18-24 godine, od čega je 85,9 % ženskog spola. Prikupljeni su podaci o tjelesnoj masi i visini ispitanika iz kojih je izračunat indeks tjelesne mase. Prevalencija ortoreksije nervoze procijenjena je pomoću upitnika ORTO-15, dok je upitnik PACS-R (eng. Physical Appearance Comparison Scale – Revised) korišten za procjenu tendencije usporedbe tjelesnog izgleda ispitanika s drugim osobama. Utvrđeno je da 38,2 % ispitanika ima ortoreksiju nervozu. Nije bilo statistički značajnih razlika u indeksu tjelesne mase između ispitanika s obzirom na ortoreksiju nervozu (p=0,276). Ipak, u skupini ispitanika bez utvrđene ortoreksije prevladavali su oni s adekvatnom tjelesnom masom (89,9 %), dok je među ispitanicima s utvrđenom ortoreksijom bio veći udio pothranjenih ispitanika (8,2 %) i onih s prekomjernom tjelesnom masom (15,1 %). Ispitanicima s ortoreksijom pravilna prehrana je važnija nego ispitanicima bez ortoreksije (p=0,001), dok statistički značajne razlike u samoprocjeni kvalitete prehrane nije bilo (p=0,815). Nadalje, utvrđena je statistički značajna negativna korelacija između rezultata PACS-R i ORTO-15 (p<0,01). U konačnici, postojala je statistički značajna razlika u rezultatima PACS-R između ispitanika obzirom na utvrđenu ortoreksiju (p=0,032). Ortoreksija nervoza utvrđena je kod velikog broja ispitanika. Iako su mlade osobe koje su razvile ortoreksiju nervozu uglavnom adekvatne tjelesne mase, imaju veću sklonost uspoređivati svoj fizički izgled s izgledom drugih, što upućuje na iskrivljenu percepciju vlastitog tijela. Ovime se skreće pozornost na važnost educiranja mladih osoba o pravilnoj prehrani, posebice žena, te se potvrđuje važnost interdisciplinarnog pristupa u liječenju ortoreksije nervoze, koja bi trebala uključivati i psihološku podršku

Estimation of milk, dairy products and calcium intake in nutrition of the celiac patients

Celijakija je bolest probavnog sustava pri kojoj dolazi do oštećenja tankog crijeva i problema s apsorpcijom hranjivih sastojaka. Oboljeli ne podnose protein gluten koji se nalazi u pšenici, ječmu, raži i zobi. Najmanja količina glutena u hrani oštećuje tanko crijevo oboljelih. U Hrvatskoj postoji vrlo malo podataka o prehrani i prehrambenim navikama ove vrlo osjetljive populacije. Jedini je lijek za oboljele od celijakije bezglutenska prehrana, tj. izbjegavanje najmanjih količina glutena u prehrani. Mlijeko i mliječni proizvodi su najvažniji izvor kalcija, a ova je populacija, zbog malapsorptivnog sindroma osobito osjetljiva te sklona oboljenjima koja nastaju kao posljedica nedovoljnog unosa kalcija (osteoporoza, osteopenija). Stoga je svrha ovog istraživanja bila odrediti udio mlijeka i mliječnih proizvoda u prehrani oboljelih od celijakije, s posebnim osvrtom na unos kalcija. Unos mlijeka, mliječnih proizvoda i kalcija utvrđen je trodnevnim dnevnikom prehrane (3DD) i upitnikom za utvrđivanje prosječnog prehrambenog unosa kalcija (FFQ) kod 15 oboljelih od celijakije. Energetski udio mlijeka i mliječnih proizvoda bio je u prosjeku 11,82 % kJ, što je gotovo dvostruko manje od preporuka. Prosječan dnevni unos kalcija također je bio manji od preporuka (62,64 % DRI), a 67 % ispitanika nije zadovoljilo niti 2/3 dnevnih potreba za kalcijem. Iz skupine namirnica mlijeko i mliječni proizvodi oboljeli koriste najviše mlijeko i puding, a nešto manje su zastupljeni jogurt i voćni jogurt. Potrebno je povećati unos kalcija osobito namirnicama iz skupine mlijeko i mliječni proizvodi koji su najbolji izvor ovog nutrijenta.Celiac disease is a digestive disease that damages the small intestine and interferes with absorption of nutrients from food. People who have celiac disease cannot tolerate a protein called gluten, which is found in wheat, rye, barley and possibly oats. The smallest amount of gluten in food damages the small intestine of these patients. In Croatia there is no data about nutrition and dietary habits of people with celiac disease. In celiac disease there is one and only cure: a gluten-free diet. Milk and dairy products are major source of calcium, and this population, because of malapsorptive syndrome is especially sensitive and predisposed for osteoporosis and osteopenya. Therefore, the purpose of this research was to establish milk, dairy products and calcium intake in celiac patients nutrition. Milk and dairy products was determined by using 3-day-dietary record (3DD) combined with food frequency questionnaire (FFQ) in 15 celiac patients. Energy share of milk and dairy products were 11,82 % kJ, twice less than recommendation. Average daily intake of calcium was also below the recommendation (62,64 % DRI), and 67 % of examinees did not achieve neither 2/3 of daily recommendation intake (DRI) for calcium. From milk and dairy group examinees use milk and pudding the most, yoghurt and fruit yoghurt less. It is necessary to increase intake of calcium from milk and dairy products group because they are the best source of this nutrient

Breastfeeding: Health benefits and dietary recommendations

Dojenje je prirodan način hranjenja novorođenčeta jer mu pruža sve neophodne hranjive tvari potrebne za odgovarajući rast i razvoj. Također, dojenje je osjetljivo razdoblje kada se stvara emocionalna i tjelesna veza između majke i djeteta, pružajući djetetu osjećaj sigurnosti, opuštenosti i nježnosti. U skladu s navedenim, posvećenost institucija i raznih udruga za podizanje društvene i zdravstvene svijesti te promicanje važnosti dojenja neprestano rastu. Svjetska zdravstvena organizacija (SZO) preporučuje isključivo dojenje tijekom prvih šest mjeseci djetetovog života, što djetetu pruža brojne kratkoročne i dugoročne koristi. Kada se govori o koristima dojenja, naglasak se stavlja prvenstveno na dobrobit djeteta, dok bi potrebe dojilja trebale biti od jednake važnosti. Razdoblje laktacije i dojenja zahtijeva veći majčin energijski unos u usporedbi s razdobljem posljednjeg tromjesečja trudnoće kako bi se zadovoljile sve potrebe majke i djeteta za mikro- i makronutrijentima. Količina i sastav mlijeka, odnosno kvaliteta prehrane dojenčeta, dijelom ovisi o kvaliteti majčine prehrane, a dijelom o majčinim tjelesnim zalihama iz kojih se nadoknađuju hranjive tvari u slučaju nedovoljnog prehrambenog unosa. Kako bi se izbjegli negativni učinci laktacije i dojenja na prehrambeni i zdravstveni status majke u nadolazećim životnim razdobljima, presudno je posvetiti posebnu pozornost raznovrsnoj, uravnoteženoj i energijski zadovoljavajućoj prehrani. Iako je primarni cilj postići preporučeni unos svih esencijalnih hranjivih sastojaka prehranom, u slučajevima neuravnotežene prehrane, zdravstvenih problema ili prakticiranja restriktivne dijete, potrebna je primjena dodataka prehrani. Zbog povećanih bioloških potreba i utvrđenih deficita, u dodacima prehrani za trudnice često se mogu naći željezo, kalcij, cink, jod, folat te vitamini B12, C i D

Bezglutenski proizvodi namijenjeni osobama s celijakijom nisu dobar izvor folata i vitamina B12

The gluten-free diet, the only treatment in coeliac disease, can be nutritionally unbalanced and deficient in several nutrients. Gluten-free products contain much lower levels of B vitamins, especially lower folate concentrations than their gluten-containing counterparts. Folate intake is considered as a major dietary determinant of plasma homocysteine concentration in healthy population. Elevated homocysteine is an independent risk factor for cardiovascular disease and has been associated with osteoporotic fractures, which are an increased risk factor in coeliac disease. The aim of this study is to determine dietary folate intake and plasma homocysteine concentration as metabolic markers of suboptimal intake of folate and B12 in Croatian coeliac patients living on a gluten-free diet. Subjects were 52 coeliac patients (83 % female, age 35±13) adhering to a gluten-free diet. Blood samples were analyzed for plasma homocysteine, serum and red blood cell folate and serum B12. Quantitative food frequency questionnaire was used to measure dietary folate intake. Mean dietary folate intake was 206 mg of dietary folate equivalents (DFE), which was far below the national recommendation of 400 µg of DFE (or 200 μg of folic acid). Mean homocysteine was (9±2) μmol/L (range from 5.42 to 13.90 μmol/L), while elevated homocysteine concentrations (>10 μmol/L) were found in 34 % of subjects. In conclusion, coeliac patients adhering to gluten-free diet included in this study showed low folate intake and suboptimal folate and vitamin B12 status, possibly due to low folate content in gluten-free products. Therefore, folate fortification or enrichment of gluten-free products could be beneficial for coeliac patients and it would be of great interest for the food industry.Bezglutenska prehrana, jedini lijek za oboljele od celijakije, može biti neuravnotežena zbog nedostataka nekih hranjivih tvari. Bezglutenski proizvodi sadrže manju količinu vitamina B, osobito folata, nego slični proizvodi koji sadrže gluten. U zdravih osoba koncentracija homocisteina u plazmi uglavnom ovisi o prehrambenom unosu folata. Povećana vrijednost homocisteina u posljednje se vrijeme povezuje s osteoporozom koja je učestala u osoba s celijakijom. Svrha je ovoga rada utvrditi unos folata i status homocisteina kao metaboličkoga biljega suboptimalnog unosa folata i vitamina B12 u osoba s celijakijom na području Republike Hrvatske. U istraživanju su sudjelovale 52 osobe s celijakijom koje su na bezglutenskoj prehrani (83 % žena, dobi 35±13 godina). Analizom krvi utvrđena je koncentracija homocisteina, folata u serumu i eritrocitima te vitamina B12 u serumu. Kvantitativni je upitnik za procjenu unosa hrane i pića upotrijebljen radi utvrđivanja prehrambenog unosa folata. Prosječni je unos folata bio 206 µg ekvivalenata folata (eng. dietary folate equivalents-DFE), što je kudikamo manje od nacionalne preporuke koja navodi 400 µg DFE odnosno 200 µg folne kiseline. Prosječna vrijednost homocisteina iznosila je 9±2 µmol/L (raspon 5,42-13,90 µmol/L). Povećana vrijednost homocisteina (>10 µmol/L) utvrđena je u 34 % ispitanika. Može se zaključiti da osobe s celijakijom koje se pridržavaju bezglutenske prehrane, a sudjelovale su u ovom istraživanju, imaju mali unos folata i suboptimalan status folata i vitamina B12, vjerojatno zbog unosa folatom siromašnih bezglutenskih proizvoda. Stoga bi obogaćivanje ili dodatak folata u bezglutenske proizvode mogao povoljno utjecati na osobe s celijakijom, te predstavljati izazov prehrambenoj industriji

Milk and dairy products in hospital diets of pregnant women with diabetes mellitus

Svrha ovoga rada bila je odrediti udjel mlijeka i mliječnih proizvoda u prehrani trudnica oboljelih od šećerne bolesti zbog važnosti koje ova skupina namirnica ima u prehrani ove populacije. Analizirani su bolnički obroci pripremani isključivo za trudnice oboljele od šećerne bolesti. Rezultati su obrađeni matematički i statistički, te uspoređeni s važećim preporukama. Petnaestodnevnim praćenjem dnevnih jelovnika hospitaliziranih trudnica oboljelih od šećerne bolesti može se zaključiti da trudnice dobivenim obrocima nisu u potpunosti zadovoljile energetske potrebe određene RDA standardima. Unutar obroka udjel mlijeka i mliječnih proizvoda bio je zadovoljavajući, što se također odnosi i na unos minerala (kalcij, fosfor) i vitamina (riboflavin) čiji su mlijeko i mliječni proizvodi glavni nosioci. Radi li se o trudnicama koje imaju povećanu tjelesnu masu, preporuča se odabir manje masnih i nemasnih mlijeka i jogurta, te smanjivanje udjela visokomasnih polutvrdih sireva u dnevnom obroku.The aim of this work was to determine the milk and dairy products share in hospital diets of pregnant women with Diabetes Mellitus, due to special importance for this population. Hospital meals for this population were therefore mathematically and statistically analysed and compared with valuable recommendations. Meals were prepared exclusively for hospitalised pregnant women with Diabetes Mellitus. Results showed that meals were energetically lower than they should be. Milk and dairy products share as well as share of minerals (calcium, phosphorus) and vitamins (riboflavin) in hospital daily diets were suitable. If pregnant women have higher body mass that they should, they should have in there diets more low-fat and non-fat milk and yogurt, and less high-fat cheese in their daily diets

DIETARY HABITS AND USE OF DIETARY SUPPLEMENTS AMONG FEMALE CANCER PATIENTS

Cancer is one of the leading causes of death globally. Breast cancer has the highest incidence and mortality rate among female population in the world and in Croatia. There are many factors believed to affect cancer prevention and development, one of important is lifestyle including diet and dietary habits. The aim of this work was to determine dietary habits and dietary supplements intake among female cancer patients. For this purpose, dietary questionnaire was designed and conducted among 190 women, cancer patients, members of the Association of women affected by cancer EVERYTHING for HER. Most women surveyed had breast cancer (86%), average age 52.9 ± 0.9 years. According to body mass index, 40.5% of the patients were overweight while 8.4% were obese, and 2.1% undernourished. Dietary habits improvement after cancer diagnosis reported 85.3% of surveyed patients what was self-assessed by the patients and specially referred to fruit, vegetable and red meat intake. After the diagnosis, 77.9% patients consumed fruits, with 41.9% consuming more than 2 servings, and 98.4% consumed vegetables, with 72.1% consuming more than 2 servings, every day. Red meat was consumed by 22.6% of patients consuming meat while only 4.7% of patients stopped eating meat after diagnosis. Dietary supplements were used by 76.3% of patients, mainly probiotics, vitamin D and C, with boosting of the immune system as the main reason for use

Milk and dairy products in socially imperiled seniors\u27 all day meals

Cilj rada bio je utvrditi udjel mlijeka i mliječnih proizvoda u strukturi cjelodnevnog obroka socijalno ugroženih starijih osoba, kojima se dostavlja jedan topli obrok (ručak) na dan. Dijetetičkim istraživanjem bili su obuhvaćeni štićenici jednog većeg zagrebačkog naselja te analizirani obroci koji se dostavljaju. Prema dobivenim rezultatima prosječna energetska vrijednost obroka koji se dostavljaju iznosi 2848 kJ, što je 29-35 % od preporuka za dnevni unos (RDA) energije u starijih osoba. Udjel proteina u tim obrocima bio je 30-55 g ili 20-42% od RDA za proteine. Udjel minerala i vitamina bio je promjenjiv. Od minerala najlošije je zastupljen kalcij (19.3 % RDA), a vitamin B2 (45.7 % RDA for men and 53.3 % RDA for women) od vitamina. Prosječni dnevni udjel mlijeka i mliječnih proizvoda u dostavljanim obrocima bio je vrlo nizak. U njima, je mlijeko jedini zastupljeni proizvod i to manje od 1 dL na tjedan. Cjelodnevnim obrokom 90 % ispitanika konzumira 1.5 dL do 2.0 dL mlijeka na dan. Osim mlijeka, svega 5 % ispitanika konzumira jogurt i polutvrdi sir jedan do dva puta na tjedan. Prema utvrđenim podacima u obroke koji se dostavljaju trebalo bi uvrstiti mlijeko i mliječne proizvode (osobito nemasni jogurt i svježi kravlji sir). Time bi se povećao udjel kalcija ali i poboljšala prehrambena vrijednost obroka.The aim of this study was to determine share of milk and dairy products in all-day meals socially imperiled independent-living elders who had organized one meal (lunch) on wheels daily. Dietetic monitoring was made in one subarea of Zagreb and meals on wheels were analized. According to results average energetic value of meals on the wheels was 2848 kJ, what was 29-35 % of recommended daily intake (RDA). Protein content in those meals was 30-55 g or 20-42 % of RDA for proteins. Content of minerals and vitamins was very fluctuating. Of minerals the lowest content was for calcium (19.3 % RDA) as well as for vitamin B2 (45.7 % RDA for men and 53.3 % RDA for women) of vitamins. Average daily share of milk and dairy products in meals on wheels was very low. Milk was the only present product in those meals and frequency was once per week in quantity less than 1 dL. By all-day meals 90 % examinees consumed 1.5 dL to 2.0 dL milk per day. Except the milk, only 5 % examinees consumed yogurt or semihard cheese once or twice per week. According to results some dairy products (as non-fat yogurt and fresh soft cheese) should be include in the meals on wheels. That would increase the share of calcium as well as nutritive value of the meals on wheels

Combining hand grip strength with nutritional screening tools in elderly patients with chronic kidney disease

Malnutrition in vulnerable patient populations must be rapidly detected using techniques that are easy to incorporate into everyday clinical practice. The new recommendations defined the 7-point Subjective Global Assessment (SGA) as optimal for nutritional assessment in chronic kidney disease (CKD), while Geriatric Nutrition Risk Index (GNRI) demands additional examination in elderly. This study aimed to determine the accuracy of several concise tools used in the clinical practice and the correlation of this tools with functional method hand grip strength (HGS) in elderly patients with CKD. In this cross-sectional study, anthropometric and functional data for 50 elderly hemodialysis patients were analyzed using numerous survey-based tools for screening nutritional status (Malnutrition Screening Tool – MST, Nutritional Risk Screening 2002 - NRS2002, Malnutrition Universal Screening Tool - MUST, Mini Nutritional Assessment - MNA, GNRI), which we compared to the standard 7-point SGA nutritional assessment tool. The sensitivity, specificity, and accuracy of these tools for detecting malnutrition were compared with the standard by using receiver operating characteristic (ROC) curve analysis. 7-point SGA classified 36.6% of participants as well nourished, and 63.4% as mildly to moderately malnourished, while the simplest alternative methods showed lower accuracy, classifying much higher proportions of participants as well nourished (MST, 92.0%; NRS2002, 80.4%). MNA had the highest accuracy based on receiver operating characteristic curves. HGS correlated moderately with 7-point SGA (r = 0.331), MNA (r = 0.410), and GNRI (r = 0.320). Our small study suggests that MNA is the best tool for malnutrition risk screening in elderly with CKD. Combining HGS with concise tools, such as GNRI, may provide better results and unburden healthcare professionals

Potential Application of Yeast β-Glucans in Food Industry

Different β-glucans are found in a variety of natural sources such as bacteria, yeast, algae, mushrooms, barley and oat. They have potential use in medicine and pharmacy, food, cosmetic and chemical industries, in veterinary medicine and feed production. The use of different β-glucans in food industry and their main characteristics important for food production are described in this paper. This review focuses on beneficial properties and application of β-glucans isolated from different yeasts, especially those that are considered as waste from brewing industry. Spent brewer’s yeast, a by-product of beer production, could be used as a raw-material for isolation of β-glucan. In spite of the fact that large quantities of brewer’s yeast are used as a feedstuff , certain quantities are still treated as a liquid waste. β-Glucan is one of the compounds that can achieve a greater commercial value than the brewer’s yeast itself and maximize the total profitability of the brewing process. β-Glucan isolated from spent brewer’s yeast possesses properties that are benefi cial for food production. Therefore, the use of spent brewer’s yeast for isolation of β-glucan intended for food industry would represent a payable technological and economical choice for breweries