Editorial

Prezados colegas e participantes do XXII Congresso Brasileiro de Nutrologia, Esse espaço científico tem como objetivo promover a troca de conhecimentos médicos nutricionais entre profissionais da área de nutrição e que pesquisam com bases científicas sólidas a realização de experimentos dentro do contexto da Nutrologia e das ciências nutricionais no presente momento. Esta é a XXII edição do Congresso Brasileiro de Nutrologia, que juntamente com a XXII Conferência sobre Obesidade e Síndrome Metabólica, visa trazer conhecimentos científicos, observando-se nessas últimas edições, um aumento significativo da presença de colegas interessados na área de Nutrologia, de nutrição médica, das ciências nutricionais. A congregação de todos esses profissionais e estudantes na realização de trabalhos científicos, cujo conteúdo aqui está publicado, efetivamente traz ainda mais aprendizagem e atualização com o objetivo de transmitir esses conhecimentos aos seus respectivos pacientes e outros experimentos científicos. Desejo que aproveitem a grandiosidade dos anais do XXII Congresso Brasileiro de Nutrologia para que toda a população possa ter algum grau de contribuição para uma melhoria da profilaxia e tratamento das enfermidades nutroneurometabólicas. A Associação Brasileira de Nutrologia, especialidade médica do Conselho Federal de Medicina e Associação Médica Brasileira, muito agradece a gentil e honrosa participação de todos que direta ou indiretamente contribuíram para a realização desses trabalhos científicos e consequente publicação desses anais. Uma ótima leitura a todos

Medical nutrition therapeutic approach of non-alcoholic fatty liver: diet, nutraceuticals, phytotherapy and probiotics

Although the genetic and pharmacological research of the non-alcoholic fatty liver disease (NAFLD), the commonest liver disease in the world, affecting more than a quarter of the population, shows a promising future, the non-pharmacological therapy continues to be an important approach of this concerning public health issue. The present study focused on the therapeutical potential of the diet and mainly the phytotherapy, nutraceuticals, and probiotics use, employing the literature review methodology by a selection of recent (last 5-10 years) national and international articles from the PubMed and Google Scholar databases. The conclusion was that the non-pharmacological medical nutrition approach could be considered as a first-line therapeutical option for NAFLD due to its low cost, few adverse effects, and a mainly positive impact on an individual's health and life quality

Liraglutideas Adjunct Therapy in the Management of Obesity

The obesity epidemic has reached a new level with some impressive numbers recently published in the United States of America. Even more alarming is the rapid increase in childhood obesity, which has been universally documented over the past few decades. The reasons underlying the problem of obesity can be simplified into three categories: i) routine consumption of bigger portion size meals; ii) confusing messages from food industry to consumers; and iii) physical inactivity is the “new normal”. Considering that the medical consequences of obesity are serious and directly affect morbidity and mortality, it has become necessary to act concomitantly to prevent and treat the increase in body weight and fat excess accumulation. The prevention of obesity is a formidable task that can only be accomplished with a concerted effort put together by several governmental agencies, especially those interested in agriculture, health and education, the food industry and health care providers, including physicians and nutrition specialists. Treatment of obesity with behavioral management, nutritional manipulations (“diets”) and, even bariatric surgery has had some success, but these strategies are accompanied by limited benefits and only to a select group of individuals. More importantly, the overall impact of these on the growing obesity pandemic is disappointing, at best. Some dietary recommendations with caloric restriction and adjustments in nutrient intake combined to pharmacotherapy have expanded our ability to manage obese patients.The recent approval by the U.S. Food and Drug Administration (FDA) agency of the Glucagon-Like-Peptide-1 (GLP-1) receptor analog liraglutide, at the dose of 3.0 mg once daily, has provided us with an additional tool to combat the disease and minimize its complications. In this particular study, a significant reduction in the conversion ratesfrom pre-diabetes to diabetes was also shown and represents an important findingof the trial. Despite the fact that nausea, vomiting and diarrhea were frequently reported during the 1-year period of observation, tolerance was acceptable and most subjects completed the study.These data clearly indicate that combination drug therapy with dietary adjustments can be successful in promoting weight reduction and further support routine utilization of adjuvant pharmacotherapy in the management of obesity

Major Considerations of Celiac Disease: A Narrative Review

Celiac disease (CD) is an autoimmune disease. Whoever has it cannot eat foods that have gluten in their composition. The only treatment available is a diet in which all products containing gluten are removed from the dietary routine of patients with CD, which requires that their patients have determination. It is of utmost importance that the maximum amount of information is provided to the patient, so that the patient has a wide awareness of the conditions and limitations to be respected, as well as of the possible harmful changes to health caused by the non-adherence of the gluten-free diet

Nutrological Management in Bariatric Surgery: A Narrative Review

Nutrology based on the analysis of benefits and harms generated by the ingestion of nutrients and assessing individual organic needs promotes the maintenance of health and the reduction of disease risk, as well as the treatment of manifestations of deficiency or excess. Obesity is defined by a body mass index greater than 30 kg/m². Its manifestation is the sum of genetic and environmental factors, this through sedentary lifestyle and caloric intake greater than energy consumption. There are many ways to deal with obesity, from behavioral changes such as a balanced diet and physical exercises, pharmacological and even surgical measures of different modalities, with Roux-en-Y gastric bypass surgery being the most used technique in Brazil. The most common postoperative nutritional deficiencies are iron, protein, calcium, folate, thiamine, zinc, copper, and vitamins D, B12, A, C, and K. In this case, we present the importance of nutrology in monitoring patients after bariatric surgery. This research made use of a bibliographic survey, giving priority to articles dated from the last 5 years, using the databases Lilacs, Medline, bireme, where articles, dissertations, and theses were consulted, in search of the following keywords, obesity, bariatric surgery, and nutritional deficiency, post-bariatric feeding

Major Approaches to the Dosage of Vitamin D in the Elderly: A Systematic Review

Introduction: In the scenario of vitamin D deficiency, this incident is prevalent and with risks to public health in the world, reaching approximately 90% of individuals. Hypovitaminosis D can cause, mainly in the elderly, lower bone mineral density, fractures, muscle weakness, falls, and acute respiratory infection. Objective: To evaluate the main clinical results on vitamin D levels in the elderly, as well as to analyze which daily or weekly dose of vitamin D is most effective in the elderly in reducing the number of falls and fractures. Methods: The present study developed a systematic review, addressing randomized clinical studies, diverse clinical studies, systematic reviews, meta-analysis, and the latest international consensus, following the rules of PRISMA. Results and Conclusion: A total of 152 articles were found involving the dosage and the impact of vitamin D in the elderly. In total, 72 articles were evaluated in full and 30 were included. According to the main literary findings, vitamin D deficiency implies problems with mineralization and bone mineral density, causing fractures and an increase in the number of elderly falls. In this sense, SBEM recommends maintaining vitamin D concentrations above 30 ng/mL. Also, vitamin D deficiency points to the occurrence of neurological diseases such as cognitive decline, risk of Alzheimer's disease, and depression. In the current scenario of the pandemic, vitamin D points as an important modulator of the immune system, and its deficiency promotes the unregulated release of cytokines, leading to complications in patients with COVID-19

Facing the BANI World

We have already passed through the VUCA World. We must now face the BANI World. In VUCA World, the pillars were Volatility, Unpredictability, Complexity, and Ambiguity. In more recent times, especially with the Covid-19 Pandemic, we live in what the anthropologist, historian, and futurologist Jamais Cascio called BANI World, an acronym for the terms Brittle, Anxiety, Non-Linearity and Incomprehensible. IJN is aware of this change and has sought to bring in its publications, current concepts, and rules of procedure in line with this new vision. And this, we Editors consider being extremely relevant because we want everyone to be able to assimilate the advance of knowledge that grows in a fast and non-linear way, without the wear and tear of anxiety and in the most understandable way possible. We look forward to your contributions by sending your studies and research for publication. Good reading The Editor