Editorial

Caros Congressistas, autores e leitores, Como Editora-chefe do International Journal of Nutrology agradeço a participação de todos no nosso evento científico anual e é com muita satisfação que publicamos os Anais do XXII Congresso Brasileiro de Nutrologia, promovido pela Associação Brasileira de Nutrologia ABRAN. Convido todos a aproveitarem o nosso evento e lerem os trabalhos científicos publicados nesses Anais. Ótima leitura a todos

The New Face of the Brazilian Journal of Nutrology

Dear authors and readers, The Brazilian Journal of Nutrology is facing changes on the editorial board to accomplish the international demands for higher indexations of the journal. This is a challenge for the new editorial board that will follow the new trends in science publications preserving the peer review process and keeping up with the high quality of the published manuscripts. It was undoubtedly a great challenge to contribute to the most important scientific journal of Nutrology in South America. Several actions have been planned to speed up the article review process of our journal and make it more attractive to authors. With the constant progress of science and of its outreach channels, the Brazilian Journal of Nutrology needs to be prepared to keep up with these changes and innovations. In this editorial, we would like to thank our peers and colleagues, who have manifested sincere and total support to our work. We are pleased to present Professor Moacir Fernandes de Godoy, who will assume the role of Editor-in-Chief of the Brazilian Journal of Nutrology. In his professional activities, Godoy interacted with over 300 employees in the coauthorship of scientific papers. He also works in medicine as cardiologist and hemodynamicist, received his medical training at the Universidade Federal de São Paulo (Unifesp), state of São Paulo, Brazil, and is lecturer-professor at the Faculdade de Medicina de São José do Rio Preto (FAMERP, in the Portuguese acronym) in São José do Rio Preto, state of São Paulo, Brazil, in the Department of Cardiology and Cardiovascular Surgery. Afterwards, he occupied a prominent position of Deputy Head and Former Deputy Director of Education at FAMERP. He has been serving the scientific community as a professional since 1971. He has experience in medicine, focusing on cardiology, acting on the following subjects: heart rate variability, nonlinear dynamics, cardiovascular surgery, atherosclerosis, oxidative stress, myocardial revascularization, heart failure, and congenital heart disease. We are sure that the future of our Brazilian Journal of Nutrology is brilliant and will continue to merge with the history of Brazilian Nutrology. However, some things never change, and the “good science” and the relevance of the articles continue to depend on traditional scientific aspects, such as the changes in the clinical practice and the generation of new knowledge on the scientific mechanisms, efficacy, and safety of dietary interventions in the context of disease prevention and health benefits. It was a great honor and privilege to have served as the Editor-in-chief of this publication. Finally, but most important, we would like to thank the herculean job done by the previous editors with the editorial board, who worked very hard to keep our journal running well and smoothly up to date

Failure of a single nutrition counseling session for climacteric women

Background: Due to the alarming growth of obesity over the world, strategies of nutritional guidance are necessary for the treatment and prevention of this disease. Thus, the objective of the present study was to provide a single session of nutritional counseling to a group of climacteric women and to assess the efficacy of this procedure 2 years later and to calculate the concordance between methods that evaluate body composition. Methods: Anthropometric, dietary and physical activity data were collected from the volunteers studied, who were then counseled about correct eating habits and the importance of physical activity during a single visit lasting 120 minutes. Two years later, the same women were reevaluated on the basis of the same criteria as used for the initial evaluation. Body composition and energy expenditure were assessed by bioelectrical impedance, DXA and indirect calorimetry, and food intake was calculated. Anthropometric measurements were made and laboratory tests were also performed. The initial and final analyses were compared statistically by the Wilcoxon test for paired samples and the St. Laurent test was applied to determine the concordance of the methods for the determination of body composition. Results: Ten women were followed up during the study period and their mean (±SD) age was 54 ± 8 years at the beginning of the study. The dietary history of the subjects studied showed deficient intake of calcium, vitamins, zinc and fibers both at the beginning and at the end of the study. A greater intake of cholesterol and carbohydrates occurred at the end of the study. The anthropometric measurements and all other body composition measurements remained constant, with concordance between the anthropometric and DXA measurements regarding body mass. Conclusion: The data show the inefficiency of a single visit or counseling session regarding a change of nutritional habits in these patients, despite the limited number of participants

Estudo do nível sérico de ácido úrico em pacientes coronariopatas

Estudos em nosso meio que tenham avaliado a prevalência da hiperuricemia em pacientes portadores de doença arterial coronariana, para o nosso conhecimento são escassos. Desta maneira, o objetivo do presente estudo foi avaliar a prevalência de níveis séricos de ácido úrico elevados (maior que 6,0 mg/dl) nos pacientes atendidos pelo ambulatório de Cardiopatia Isquêmica da Divisão de Cardiologia, da FMRP-USP e buscar uma correlação estatística entre a hiperuricemia e o maior número de artérias acometidas ao cateterismo

Urinary calcium excretion in short bowel syndrome patients receiving cyclic parenteral nutrition: Case report

Total parenteral nutrition is essential for the survival of short bowel syndrome patients. However, in the long term it is associated with complications such as metabolic bone disease. This complication has been attributed, among other causes, to an increased urinary calcium loss, which might be related to the amount of aminoacids, glucose and calcium present in the parenteral nutrition solution. Two case reports are here presented showing normal calciuria in short bowel syndrome adults, receiving parenteral nutrition for up to 5 years after extensive bowel resection

Gasto energético após 2 ou 3 horas de cirurgia eletiva

Energy expenditure was measured by indirect calorimetry in 17 adult patients (8 women and 9 men) before surgery, 4 hours immediately after surgery , and 24 hours late after surgery in patients undergoing elective surgery of small-to-medium scope. MATERIAL AND METHODS: The total duration of surgery ranged from 2 to 3 hours. Repeated measures were performed on the same patient, so that each patient was considered to be his/her own control. All patients received a 5% dextrose solution (2000 mL/day) throughout the postoperative period. RESULTS: Men showed a reduction in CO2 production during the immediately after surgery period (257±42 mL/min) compared to before surgery (306±48 mL/min) and late after surgery (301±45 mL/min); this reduction was not observed in women. Energy expenditure was also lower in men during immediately after surgery (6.6 kJ/min). None of the other measurements, including substrate oxidation, showed significant differences. CONCLUSION: Therefore, elective surgery itself cannot be considered an important trauma that would result in increased energy expenditure. According to this study, it is not necessary to prescribe an energy supply exceeding basal expenditure during the immediate after-surgery period. The present results suggest that the energy supply prescribed during the postoperative period after elective surgery of small-to-medium scope should not exceed 5-7 kJ/min, so the patient does not receive a carbohydrate overload from energy supplementation.A resposta metabólica ao trauma cirúrgico ocorre imediatamente após a cirurgia e recomenda-se que a oferta calórica, nesta situação, seja igual ao metabolismo basal acrescido de 20-30%, considerado fator de injúria. No entanto, níveis elevados de glicemia e aumento na produção de CO2 são freqüentemente observados nestas ocasiões . OBJETIVO: O principal objetivo do presente estudo foi medir o gasto energético basal, o gasto energético imediatamente e 24 horas após cirurgia eletiva; comparar o gasto e consumo energético entre estes diferentes períodos, assim como, procurar diferenças entre o homem e a mulher. MATERIAL E MÉTODO: O método utilizado para avaliar o gasto energético de 17 pacientes adultos (8 mulheres e 9 homens) foi por meio de calorimetria indireta, nos períodos basal, imediatamente após cirurgia e 24 horas após cirurgia . O tempo cirúrgico variou entre 2 e 3 horas. Este foi um estudo pareado , sendo portanto cada paciente considerado controle de si próprio. RESULTADOS: Todos os pacientes receberam no período pós-cirúrgico solução de dextrose a 5% (2000 mL/dia).Os resultados encontrados nos homens mostraram diminuição da produção de CO2 no período imediatamente após cirurgia (257±42 mL/min) quando comparado ao gasto energético basal (306±48 mL/min) e 24horas após a cirurgia (301±45 mL/min). O mesmo não ocorreu com as mulheres. O gasto energético dos homens também foi menor no imediatamente após a cirurgia (6,6 kJ/min). Todas outras medidas, incluindo oxidação do substrato, não mostraram diferenças significativas. CONCLUSÃO: Desta maneira, a cirurgia eletiva não pode ser considerado trauma importante que resulte em aumento do gasto energético. Conclui-se que a prescrição energética no pós-cirúrgico, de cirurgias eletivas de médio e pequeno porte, seja equivalente 5-7 kJ/min, evitando desta maneira que o paciente receba sobregarca de hidratos de carbono

Monitorização da resposta orgânica ao trauma e à sepse

O hipermetabolismo causado pela sepse, pelo trauma, pela síndrome da resposta inflamatória sistêmica e pela síndrome da disfunção de múltiplos órgãos é o responsável pela alta mortalidade dos pacientes internados nas unidades de terapia intensiva. O desenvolvimento do hipermetabolismo, fator provavelmente associado ou, até mesmo, secundário à liberação de mediadores e subprodutos, tem, como resultante final, a alteração do metabolismo de vários órgãos. Por essas razões, dada a suma importância de compreender-se o metabolismo dos pacientes críticos, este artigo de revisão analisa os diversos aspectos envolvidos na monitorização dos parâmetros fisiológicos do paciente em estresse metabólico, tais como o consumo de oxigênio, o grau de perfusão esplâncnica e sua relação com o lactato sérico e a cinética protéica corpórea total, através da administração intravenosa de 13C-leucina.Sepsis, trauma, systemic inflammatory response syndrome and multiple organ dysfunction syndrome cause hypermetabolism, which is the principal factor for high mortality in critical ill intensive care unit patients. The hypermetabolism evolution, probably connected to the release of the mediators and metabolites, ends up impairing the metabolism of several organs. By the reasons mentioned above, and due to the extreme concern in understanding the metabolism in critical ill patients, this paper evaluates the different aspects in monitoring the physiological parameters in patients with metabolic stress. These aspects are the oxygen consumption, and the splanchnic perfusion, linked with the lactate plasma and the protein turnover by means of the intravenous infusion of 13 C-leucine (stable isotopes). &nbsp

Comparação entre fórmulas de estimativa do gasto energético em repouso com a calorimetria indireta em ciclistas amadores

Introduction and Objective: The increase in the practice of amateur physical activity, as well as the pursuit of performance by these individuals, aimed to evaluate whether the formulas indicated in the literature for the estimation of resting energy expenditure in athletes, accurately calculates the expenditure amateur cyclists when compared to what is measured by indirect calorimetry. Materials and Methods: Study approved by the Research Ethics Committee of the Unifafibe University Center, Bebedouro-SP. We collected data on weight, height, body mass index, waist and hip circumferences, fat mass and fat free mass by means of electrical bioimpedance, resting energy expenditure by indirect calorimetry and by formulas indicated in the literature. Statistical analysis: T test and Wilcoxon test. The agreement analysis between the indirect calorimetry and the formulas indicated in the literature were performed by means of Bland-Altmann. It was adopted p<.05. Results: Sample: twelve (12) volunteers, all male, with a mean age of 36.4 years (+ 6.4). The agreement analyzes between indirect calorimetry and Harris Benedict, FAO / WHO and Cunningham formulas, respectively, provided: r2 = 0.81, r2 = 0.65, r2 = 0.84. Discussion: Athlete formulas can be used in amateurs, making it a low-cost and reliable tool for professionals serving this growing public in nutrition offices. Conclusion: All formulas used in this study are indicated to calculate resting energy expenditure in amateur cyclists, being more accessible when compared to indirect calorimetry.Introdução e Objetivo: O aumento na prática de atividade física amadora, bem como a busca de performance por esses indivíduos, objetivou-nos a avaliar se as fórmulas indicadas na literatura para a estimativa do gasto energético de repouso em atletas, calcula com precisão o gasto de ciclistas amadores, quando comparado com àquilo que é aferido pela calorimetria indireta. Materiais e Métodos: Trabalho aprovado pelo Comitê de Ética em Pesquisa do Centro Universitário Unifafibe, Bebedouro-SP. Coletados dados de peso, estatura, índice de massa corporal, circunferências abdominal e do quadril, massa de gordura e massa livre de gordura por meio da bioimpedância elétrica, gasto energético de repouso por meio da calorimetria indireta e por fórmulas indicadas pela literatura. Análises estatísticas: teste t e teste de Wilcoxon. As análises de concordância entre a calorimetria indireta e as fórmulas indicadas na literatura foram realizadas por meio de Bland-Altmann.  Adotou-se p<0.05. Resultados: Amostra: doze (12) voluntários, todos do sexo masculino, com média de idade 36,4 anos (+ 6,4). As análises de concordância entre a calorimetria indireta e as fórmulas de Harris Benedict, FAO/OMS e Cunningham, forneceram, respectivamente: r2= 0,81, r2= 0,65, r2= 0,84. Discussão: Fórmulas indicadas para atletas podem ser utilizadas em amadores, o que se torna uma ferramenta de baixo custo e confiável para os profissionais que atendem esse público, cada vez mais crescente nos consultórios de Nutrição. Conclusão: Todas as fórmulas utilizadas neste estudo são indicadas para cálculo do gasto energético de repouso em ciclistas amadores, sendo mais acessíveis quando comparadas à calorimetria indireta