Evolution and Therapy of Brain by Foods Containing Unsaturated Fatty Acids

About 6 million years ago, our ancestors had experienced a tremendous brain growth, widely viewed as a “major adaptive shift” in human evolution. Half of human brain composition is fat and 20% of its dry weight is long‐chain polyunsaturated fatty acids (LCPUFA). Consequently, improvements in consumption of dietary fat were necessary condition for promoting encephalization. Dietary fat quantity and quality have been subjected to tremendous change over the past 10,000 years with the introduction of industrially produced trans fatty acids and reduced intakes of ω‐3 fatty acids. The absolute human brain size reached its peak of approximately 90,000 years ago and has decreased by 11% since 35,000 years ago, most of it (8%) coming in the last 10,000 years. The shortfall in consumption of animal foods since the late Paleolithic and mainly consequent shortfall in consumption of preformed LCPUFA would be the plausible hypothesis for the brain size decreasing. Genetically, we are still adapted to the East African ecosystem on which our genome evolved, with some adaptations since the Out‐of‐Africa Diaspora. Dietary fat quantity and quality change has caused a conflict with our slowly adapting genome and this mismatch is likely to be at the basis of “typically Western” diseases. Many recommendations for the intakes of EPA + DHA have been issued, notably for prevention. However, the ultimate goal might be to return to the fat quality of our ancient diet on which our genes have evolved during the past million years of evolution

Implantação dos Procedimentos Operacionais Padronizados (POPs) de higienização e desinfecção dos equipamentos e utensílios em uma Unidade de Alimentação e Nutrição Hospitalar

In a hospital UFNs, an outbreak of food poisoning can have disastrous consequences and aggregate risk of death for patients. Thus, the training of food handlers is critical to ensuring the quality of the food that is produced. The aim of this study was to implement the SOPs related to sanitation and disinfection of equipment and utensils, by means of a training, containing illustrative figures and everyday issues on the subject; and evaluate the daily practice of sanitation and disinfection activities before and after the intervention with employees of UFN. We developed and implemented a guidefor inspection of best practices in sanitation of equipment and utensils at two different times, before and after the intervention with the food handlers. The results showed a significant improvement in the situation of this unit in terms of practice, frequency and fulfillment of stages related to sanitation and disinfection of equipment and utensils. We concluded that the implementation of SOPs for sanitation and disinfection was carried out successfully, and that empowering employees with dynamic and interactive training allows them a greater understanding of the importance of hygiene practices in the daily routine of UFN.Em Unidades de Alimentação e Nutrição hospitalar (UAN), um surto de toxi-infecção alimentar pode trazer consequências desastrosas e agregar riscos de morte aos pacientes. Desta forma, a capacitação dos manipuladores de alimentos é fundamental para a garantia da qualidade das refeições produzidas. O objetivo do presente estudo foi implantar os POPs referentes à higienização e desinfecção dos equipamentos e utensílios, através de um treinamento contendo figuras ilustrativas e questões cotidianas sobre o tema; e avaliar a prática diária das atividades de higienização e desinfecção, antes e após a intervenção com os colaboradores da UAN. Foi elaborado e aplicado um roteiro de inspeção das boas práticas na higienização dos equipamentos e utensílios em dois momentos distintos, antes e depois da intervenção com os manipuladores de alimentos. Os resultados demonstraram uma relevante melhora na situação desta unidade quanto à prática, frequência e cumprimento das etapas referentes à higienização e desinfecção dos equipamentos e utensílios. Conclui-se que a implantação dos POPs de higienização e desinfecção foi efetivada com sucesso, e que a capacitação dos funcionários com treinamento dinâmico e interativo permite aos colaboradores um maior entendimento sobre a importância das práticas de higiene na rotina diária da UAN

The lifestyle modification effectiveness in reducing Hypertension in a Brazilian Community: From the epigenetic basis of Ancestral Survival to the Contemporary Lifestyle and Public Health Initiatives

High blood pressure (HBP) is a strong, independent and etiologically relevant risk factor for cardiovascular and therefore, the leading cause of preventable deaths worldwide. Hypertension has high medical and social costs. Due to its many associated complications, the use of medical services create high costs with medications which represent almost half of the estimated direct expenses. Free distribution of more than 15 medications for HyPERtension and DIAbetes (HIPERDIA program) clearly shows the important role of drugs in the Brazilian Government’s effort to tackle these two diseases. Notwithstanding, the prevalence of HBP is rising in parallel with other NCDs. It is known that HBP results from environmental and genetic factors, and interactions among them. Our ancestors were often faced with survival stresses, including famine, water and sodium deprivation. As results of natural selection, the survival pressures drove our evolution to shape a thrifty genotype, which favored/promoted energy-saving and sodium/water preservation. However, with the switch to a sodium- and energy-rich diets and sedentary lifestyle, the thrifty genotype and ancient frugal alleles, are no longer advantageous, and may be maladaptive to disease phenotype, resulting in hypertension, obesity and insulin resistance syndrome. Low-grade chronic inflammation and oxidative stress would be the underlying mechanisms for these diseases. HBP is often associated with unhealthy lifestyles such as consumption of high fat and/or high-salt diets and physical inactivity. Therefore, alternatively to medicine drugs, lifestyle and behavioral modifications are stressed for the prevention, treatment, and control of hypertension. A lifestyle modification program (LSM) involving dietary counseling and regularly supervised physical activity (“Move for Health”) has been used for decades, in our group, for NCDs primary care. Retrospective (2006-2016) data from 1317 subjects have shown the top quartile of blood pressure(142.2/88.5mmHg) differing from the lower quartile (120.6/69.2mmHg) by being older, with lower schooling, lower income and, lower physical activity and aerobic capacity. Additionally, the P75 showed higher intake of CHO, saturated fat and sodium along with lower-diet quality score with a more processed foods. They showed higher body fatness and prevalence of metabolic syndrome along with higher pro-inflammatory and peroxidative activities and insulin resistance. In this free-demand sample, the HBP rate was 51.2% for SBP and 42.7% for DBP. The rate of undiagnosed HBP was 9.8% and only 1/3 of medicated patients were controlled for HBP. After 10 weeks of LSM the HBP normalization achieved 17.8% for SBP and 9.3% for DBP with a net effectiveness of 8.5% and 2.4%, respectively. The reduction of HBP by LSM was followed by increased aerobic conditioning and reduced intake of processed foods along with decreased values of BMI, abdominal fatness, insulin resistance, pro-inflammatory and peroxydative activities. Importantly, once applied nationwide this LSM would save HBP medication for 3.1 million of hypertensives at an economic saving costs of US$ 1.47 billion a year