Fruit intake and obesity Fruit and vegetables consumption and obesity in Brazil

Introduction: Obesity affects more than half of the adult population and correlates with the development of chronic and psychosocial diseases. The consumption of fruits and vegetables (FV) is a protective factor for obesity, but their consumption is often below the recommendations. Objective: To identify the level of fruit consumption in human development cycles, as well as the data on the association of fruit consumption with excess weight in Brazil. Methods: A non-systematic literature review on the Virtual Health Library (VHL) databases for the period 2005 to 2015. A total of 23 studies were selected in the English and Portuguese languages, according to the study design and population group. Only cohorts and cross sections studies in Brazil were selected. Appropriate FV consumption was considered to be 400 g/day or a frequency of 5 servings/day (3 servings/day of fruits), and overweight was evaluated according to each age group and development cycle. Results: The average consumption for pregnant women was found to be 350 g/day; an inverse relationship was found between total fi bre consumption and gestational weight gain. The average consumption of FV for children and adolescents has remained between 30% and 40%, consumption falling with increasing age. Vigitel data between 2006 and 2014 shows an increase in the prevalence of adequate consumption of FV for adults and seniors according to gender, age and education. Appropriate consumption tripled during this period. There was an association between fruit consumption and weight loss, increased risk of obesity, abdominal obesity, hypertriglyceridemia and presence of metabolic syndrome (SM). Conclusions: The prevalence of adequate consumption of FV is low in all regions of Brazil and among all age groups, the highest prevalence is among women and increases with the advance of age, higher education level and higher socioeconomic status. Adequate fruit consumption correlates to weight loss and/or weight gain control of individuals

Growth of very low birth weight infants fed with milk from a human milk bank selected according to the caloric and protein value

OBJECTIVE: To describe growth and clinical evolution of very low birth weight infants fed during hospital stay with milk from a human milk bank according to the caloric-protein value. METHOD: Forty very low birth weight infants were included: 10 were fed milk from their own mothers (GI), and 30 were fed human milk bank &gt; 700 cal/L and 2 g/dL of protein. Growth curves were adjusted using nonlinear regression to the measured growth parameters. RESULTS: full enteral diet was reached in 6.3 days by GI and in 10.8 by GII; a weight of 2 kg was reached in 7.3 weeks for GI and in 7.8 for GII. In GI, 3/10 (33.3%) and in GII, 7/30 (23.3%) developed sepsis. Necrotizing enterocolitis did not occur in GI, but in 3/30 (10.0%) in GII. GI presented with urinary calcium &gt; 4 mg/L in 1/10 (10.0%), urinary phosphorus (Pu) <1 mg/L in 10/10 (100%), and Ca/Cr &gt;0.6 ratio in 1/10 (10.0%) of the cases; in GII, no children presented alterations of the urinary calcium or the Ca and Cr ratio, and Pu was <1 mg/L in 19/30 (63.3%). In terms of growth the 50th percentile for GI was a weight gain of 12.1 g/day (GI) vs. 15.8 g/day (GII), a length gain of 0.75 cm/week (GI) vs. 1.02 cm/week (GII), and a head circumference gain of 0.74 cm/week (GI) vs. 0.76 cm/week (GII). CONCLUSIONS: Human milk bank allowed a satisfactory growth and good clinical evolution for very low birth weight infants

Growth of very low birth weight infants fed with milk from a human milk bank selected according to the caloric and protein value

OBJECTIVE: To describe growth and clinical evolution of very low birth weight infants fed during hospital stay with milk from a human milk bank according to the caloric-protein value. METHOD: Forty very low birth weight infants were included: 10 were fed milk from their own mothers (GI), and 30 were fed human milk bank &gt; 700 cal/L and 2 g/dL of protein. Growth curves were adjusted using nonlinear regression to the measured growth parameters. RESULTS: full enteral diet was reached in 6.3 days by GI and in 10.8 by GII; a weight of 2 kg was reached in 7.3 weeks for GI and in 7.8 for GII. In GI, 3/10 (33.3%) and in GII, 7/30 (23.3%) developed sepsis. Necrotizing enterocolitis did not occur in GI, but in 3/30 (10.0%) in GII. GI presented with urinary calcium &gt; 4 mg/L in 1/10 (10.0%), urinary phosphorus (Pu

Farmacocinética da vancomicina em neonatos pré-termo

OBJETIVE: The objective of the present study was to evaluate the kinetic disposition of vancomycin in preterm infants with emphasis on the apparent volume of distribution, biological half-life, and total body clearance as well as whether their variations cause significant modification of the trough plasma concentration of the drug, depending on the postconceptional age (PCA) and the postnatal age (PNA). MATERIAL AND METHOD: Twenty-five selected patients were distributed into 2 groups which differed significantly in terms of mean PCA (31.2-32.3 weeks in group 1, n = 13; 33.5-34.1 weeks in group 2, n = 12: CI95%, P < .001) and PNA (group 1, 12.0-18.5 days; group 2, 18.0-34.0 days, CI95%, P < .05). The parents were informed and signed a written consent for participation of the infants in the protocol that had been previously approved by the Ethics Committee of the hospital. RESULTS: Apparent volume of distribution was significantly increased in group 1 compared with patients of group 2 (0.85 vs. 0.56 L/kg, respectively; P = .01,). Additionally multiple linear regression revealed a good linear correlation (r = 0.85) of trough plasma concentration of vancomycin with the apparent volume of distribution and also with the biological half-life in patients of group 1, while a good correlation (r = 0.91) was obtained for the trough plasma concentration with total body clearance in infants of group 2. The influence of these kinetic parameters on the trough concentration of vancomycin in preterm infants seems to vary according to PCA and PNA. CONCLUSION: In conclusion, the trough plasma concentration of vancomycin depends on the pharmacokinetics, and multiple linear correlation indicates that it varies according to the postconceptional and postnatal age of preterm infants.OBJETIVO: O objetivo do presente estudo foi investigar a farmacocinética da vancomicina em neonatos pretermo, considerando a idade pós-conceptual e também a idade pós-natal para determinar se as alterações no volume aparente de distribuição, meia-vida biológica e depuração plasmática causam variação significativa no vale plasmático da vancomicina. MATERIAL E MÉTODO: Os vinte e cinco pacientes selecionados foram distribuídos em dois grupos, que diferiram significativamente em termos de idade pós-conceptualgrupo 1, n=13: 31,2-32,3 semanas; grupo 2, n=12: 33,5-34,1 semanas, IC95%,

Monitorização da terapêutica com vancomicina em recém-nascidos de termo com sepse, utilização e importância clínica

Foi realizado um estudo prospectivo para verificar se as doses habituais de vancomicina determinam concentrações séricas adequadas em 25 recém - nascidos de termo com sepse. OBJETIVOS: Avaliou-se a resposta terapêutica da sepse neonatal por Staphylococcus sp., tratada com vancomicina, monitorizando além de sua concentração sérica, o poder bactericida do soro (PBS) e a concentração inibitória mínima (MIC). MÉTODO: Os níveis séricos do antibiótico foram obtidos através do imunoensaio por fluorescência polarizada, o MIC através de micro-difusão em ágar, e o PBS foi obtido por macro-diluição em caldo. RESULTADOS: Concentrações séricas no pico de vancomicina adequadas (20-40 mg/mL) ocorreram em 59,1% dos casos e um recém-nascido apresentou potencial risco de ototoxicidade (>;40 mg/mL). Em 48% dos pacientes ocorreram vales séricos adequados (5-10 mg/mL) e 28% dos pacientes apresentaram potencial risco de nefrotoxicidade (>;10mg/mL). Não houve concordância significante entre a normalidade determinada pelo pico e vale de vancomicina no método (prova de McNemar: p=0,7905). A concentração sérica no pico de vancomicina foi comparada com a evolução clínica dos recém-nascidos com sepse neonatal, não havendo diferença estatisticamente significante entre os picos séricos dos pacientes que apresentaram boa e má evolução (U=51,5; p=0,1947). Também não houve diferença estatisticamente significante entre os vales séricos dos pacientes que apresentaram boa e má evolução clínica ( U= 77,0; p=0,1710). Todos os MICs obtidos demonstraram sensibilidade à vancomicina. Metade dos pacientes que apresentou PBS no vale adequado (1/8), também tiveram concentração sérica de vancomicina adequada e boa evolução clínica. CONCLUSÕES: A recomendação de doses de vancomicina para recém-nascidos de termo deve ser baseada no peso e na idade pós-conceptual apenas para dar início à terapia antimicrobiana na sepse neonatal, não existindo um padrão de doses ideal. Logo, a dose deve ser individualizada. A utilização desses dados laboratoriais com a clínica favorecem a elucidação da provável causa da má evolução do paciente, facilitando o ajuste da droga e a menor chance de efeitos tóxicos ou sub-terapêuticos.A prospective study was conducted to determine if standardized vancomycin doses could produce adequate serum concentrations in 25 term newborn infants with sepsis. Purpose: The therapeutic response of neonatal sepsis by Staphylococcus sp. treated with vancomycin was evaluated through serum concentrations of vancomycin, serum bactericidal titers (SBT), and minimum inhibitory concentration (MIC). METHOD: Vancomycin serum concentrations were determined by the fluorescence polarization immunoassay technique , SBT by the macro-broth dilution method, and MIC by diffusion test in agar . RESULTS: Thirteen newborn infants (59.1%) had adequate peak vancomycin serum concentrations (20--40 mg/mL) and one had peak concentration with potential ototoxicity risk (>;40 µg/mL). Only 48% had adequate trough concentrations (5--10 mg/mL), and seven (28%) had a potential nephrotoxicity risk (>;10 µg/mL). There was no significant agreement regarding normality for peak and trough vancomycin method (McNemar test : p = 0.7905). Peak serum vancomycin concentrations were compared with the clinical evaluation (good or bad clinical evolution) of the infants, with no significant difference found (U=51.5; p=0.1947). There was also no significant difference between the patients' trough concentrations and good or bad clinical evolution (U = 77.0; p=0.1710). All Staphylococcus isolates were sensitive to vancomycin according to the MIC. Half of the patients with adequate trough SBT (1/8), also had adequate trough vancomycin concentrations and satisfactory clinical evolution. CONCLUSIONS: Recommended vancomycin schedules for term newborn infants with neonatal sepsis should be based on the weight and postconceptual age only to start antimicrobial therapy. There is no ideal pattern of vancomycin dosing; vancomycin dosages must be individualized. SBT interpretation should be made in conjunction with the patient's clinical presentation and vancomycin serum concentrations. Those laboratory and clinical data favor elucidation of the probable cause of patient's bad evolution, which would facilitate drug adjustment and reduce the risk of toxicity or failing to achieve therapeutic doses

Characteristics of the clinical development of a newborn with gastroschisis in an intensive care unit in latin america

Introduction: Congenital malformations are major diseases observed at birth. They are the second most common cause of death in the neonatal population, the fi rst one being prematurity. Objective: To characterise the clinical outcome of newborns with gastroschisis (GS) in a neonatal intensive care unit. Methods: A retrospective observational clinical study in 50 infants with GS using the association of intestinal abnormalities, impossibility of primary closure of the abdominal defect and reoperation necessity as classifi cation criteria for the disease. The signifi cance level was p &lt; 0.05. Results: The hospitalisation to primary surgery occurred with a median age of 2 hours. Fourteen percent of children were subjected to a primary silo interposition and 24% had associated intestinal malformation. Nineteen newborns (NB) required more than one surgery. The median length of stay was 33 days, higher in patients with complex GS (56 days). All NB recovered from urine output 48 hours after surgery and 40% had hyponatraemia and oligoanuria in this period. There was no difference between the natraemia and fasting time (p = 0.79). Weight gain was similar in both groups with total parenteral nutrition and became signifi cantly higher in patients with simple GS after enteral feeding (p = 0.0046). These NB evolved 2.4 times less cholestasis. Late-onset sepsis occurred in 58% of patients and was related to the infection of the central venous catheter in 37.9% of cases. Mortality was higher in infants infected with complex GS and the overall mortality rate was 14%. Conclusion: Clinical characterisation of newborns with gastroschisis depends on the complexity and the knowledge and conduct of morbidities to reduce mortality

AVALIAÇÃO ANTROPOMÉTRICA E POR BIOIMPEDÂNCIA DE UM PROGRAMA DE EDUCAÇÃO NUTRICIONAL PARA ESCOLARES NA FAIXA ETÁRIA DE 7-14 ANOS DURANTE O PERÍODO DE 10 MESES

Over the past several decades, an increasing prevalence of excessive weight has been observed among children. Considering the importance of schools in promoting health, the implementation of individualized educational interventions in a school setting is necessary. The present study aimed to determine the influence of a nutritional education program in promoting the healthy eating habits and nutritional status of school-aged students. A total of 416 children and adolescents between 7 and 14 years of age who were enrolled in 2 complementary public schools were evaluated. A 10- month intervention in one of the schools was based on a nutritional education program targeting the students, legal guardians and school staff and involved substantial changes in the school meal menu. Weight, height, BMI, lean mass and body fat mass were evaluated in both the intervention (school 1) and the control (school 2) groups. At the beginning of the study, both school 1 and 2 exhibited a prevalence of overweight (34.0% and 28%, respectively) and obese students (16.9% and 10.4%, respectively); obesity was significantly reduced by the end of the study (p = 0.001). The growth of the students was considered normal for the age range in both schools, although it was slightly larger in school 1 (p = 0.04). Measurements of body composition, which were collected using bioelectrical impedance, indicated an increase in lean mass in both schools (p &lt; 0.01) with an increase in body fat mass being observed only in school 2 (p = 0.01). These results, which are related to a significant reduction of the BMI, a change in bodily proportions and an increase in height growth for the students of school 1, indicate the beneficial aspects of the adopted diet.[N

Rest energy expenditure is decreased during the acute as compared to the recovery phase of sepsis in newborns

<p>Abstract</p> <p>Background</p> <p>Little is known with respect to the metabolic response and the requirements of infected newborns. Moreover, the nutritional needs and particularly the energy metabolism of newborns with sepsis are controversial matter. In this investigation we aimed to evaluate the rest energy expenditure (REE) of newborns with bacterial sepsis during the acute and the recovery phases.</p> <p>Methods</p> <p>We studied nineteen neonates (27.3 ± 17.2 days old) with bacterial sepsis during the acute phase and recovery of their illness. REE was determined by indirect calorimetry and VO₂and VCO₂measured by gas chromatography.</p> <p>Results</p> <p>REE significantly increased from 49.4 ± 13.1 kcal/kg/day during the acute to 68.3 ± 10.9 kcal/kg/day during recovery phase of sepsis (P < 0.01). Similarly, VO₂(7.4 ± 1.9 <it>vs </it>10 ± 1.5 ml/kg/min) and VCO₂(5.1 ± 1.7 <it>vs </it>7.4 ± 1.5 ml/kg/min) were also increased during the course of the disease (P < 0.01).</p> <p>Conclusion</p> <p>REE was increased during recovery compared to the sepsis phase. REE of septic newborns should be calculated on individualized basis, bearing in mind their metabolic capabilities.</p