Beneficios en la microbiota intestinal después de la suplementación con inulina y la goma guar parcialmente hidrolizada: un ensayo clínico aleatorizado en mujeres con estreñimiento

Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation.Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids.Methods: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d I-PHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively.Results: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile.Conclusions: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut rnicrobiota by decreasing the amount of pathological bacteria of the Clostridium genera.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Univ São Paulo, Fac Med, Sch Med, Dept Gastroenterol,Surg Gastroenterol Discipline, BR-01246903 São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biociences, Santos, BrazilGANEP Nutr Humana, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Biociences, Santos, BrazilFAPESP: 07/58600-2Web of Scienc

Selection of Top 10 Quality Indicators for Nutrition Therapy

Background: The identification of useful quality indicators for nutrition therapy (QINTs) is of great interest and a challenge. This study attempted to identify the 10 QINTs that best suit the practice of quality control in nutrition therapy (NT) by evaluating the opinion of experts in NT with the use of psychometric techniques and statistical tools. Methods: Thirty-six QINTs available for clinical application in Brazil were assessed in 2 distinct phases. In phase 1, 26 nutrition experts ranked QINTs by scoring 4 attributes (utility, simplicity, objectivity, low cost) to assess each QINT on a 5-point Likert scale. The top 10 QINTs were identified from the 10 best scores obtained, and the reliability of expert opinion for each indicator was assessed by Cronbach's alpha. In phase 2, experts provided feedback regarding the selected top 10 QINTs by answering 2 closed questions. Results: The top 10 QINTs, in descending order, are the frequency of nutrition screening of hospitalized patients, diarrhea, involuntary withdrawal of enteral feeding tubes, feeding tube obstruction, fasting longer than 24 hours, glycemic dysfunction, estimated energy expenditure and protein needs, central venous catheter infection, compliance of NT indication, and frequency of application of subjective global assessment. Opinions were consistent among the interviewed experts. During feedback, 96% of experts were satisfied with the top 10 QINTs, and 100% had considered them in accordance with their previous opinion. Conclusion: The top 10 QINTs were identified according to their usefulness in clinical practice by obtaining adequate agreement and representativeness of opinion of nutrition experts. (Nutr Clin Pract. 2012;27:261-267

Diseño de indicadores de calidad para terapia nutricional oral

sem informaçãoObjective: quality indicators in nutritional therapy (NT) have been proposed as useful tools to improve clinical NT. This study was conducted to develop feasible quality indicators in oral nutritional therapy (QIONTs) to aid quality control. Methods: a Clinical Nutrition Task Force composed of Brazilian NT experts from the International Life Science Institute (ILSI) developed QIONTs. In an internet-based psychometric survey, 40 independent Brazilian NT practitioners assessed four attributes (simplicity, utility, objectivity, and low cost) of each QIONT using a five-point Likert scale. Results: independent NT experts consistently classified all 12 QIONTs developed by the ILSI team as good (mean Cronbach's alpha = 0.84). In ranked order, the QIONTs enable assessment of the frequency of nutritional screening, oral nutritional supplementation (ONS) prescription to malnourished patients receiving an oral diet, ONS prescription to patients receiving an oral diet but at risk of malnutrition, nutritional assessment, adhesion to ONS regime, hospitalized patients with insufficient oral dietary intake and ONS prescription, ICU patients with insufficient oral dietary intake and ONS prescription, oral intake assessment in ICU patients, oral intake assessment in ward patients, oral supplement volume intolerance due to inappropriate offering time, ONS flavor intolerance, and ONS volume intolerance. Conclusion: twelve potentially feasible new QIONTs were developed and approved for clinical practice by experts.Quality indicators in nutritional therapy (NT) have been proposed as useful tools to improve clinical NT. This study was conducted to develop feasible quality indicators in oral nutritional therapy (QIONTs) to aid quality control. Methods: a Clinical Nutr31626922695sem informaçãosem informaçãosem informaçãosem informaçãoObjetivo: los indicadores de calidad en la terapia nutricional han sido propuestos como herramientas útiles para mejorar la terapia nutricional (TN). Este estudio pretende diseñar indicadores de calidad de terapia nutricional oral (ICTNO) factibles en e

Human Leukocyte Death After a Preoperative Infusion of Medium/Long-Chain Triglyceride and Fish Oil Parenteral Emulsions: A Randomized Study in Gastrointestinal Cancer Patients

Background: Parenteral lipid emulsions (LEs) can influence leukocyte functions. The authors investigated the effect of 2 LEs on leukocyte death in surgical patients with gastrointestinal cancer. Material and Methods: Twenty-five patients from a randomized, double-blind clinical trial (ID: NCT01218841) were randomly included to evaluate leukocyte death after 3 days of preoperative infusion (0.2 g fat/kg/d) of an LE composed equally of medium/long-chain triglycerides and soybean oil (MCTs/LCTs) or pure fish oil (FO). Blood samples were collected before (t0) and after LE infusion (t1) and on the third postoperative day (t2). Results: After LE infusion (t1 vs t0), MCTs/LCTs did not influence cell death; FO slightly increased the proportion of necrotic lymphocytes (5%). At the postoperative period (t2 vs t0), MCTs/LCTs tripled the proportion of apoptotic lymphocytes; FO maintained the slightly increased proportion of necrotic lymphocytes (7%) and reduced the percentage of apoptotic lymphocytes by 74%. In the postoperative period, MCT/LCT emulsion increased the proportion of apoptotic neutrophils, and FO emulsion did not change any parameter of apoptosis in the neutrophil population. There were no differences in lymphocyte or neutrophil death when MCT/LCT and FO treatments were compared during either preoperative or postoperative periods. MCT/LCTs altered the expression of 12 of 108 genes related to cell death, with both pro- and antiapoptotic effects; FO modulated the expression of 7 genes, demonstrating an antiapoptotic effect. Conclusion: In patients with gastrointestinal cancer, preoperative MCT/LCT infusion was associated with postoperative lymphocyte and neutrophil apoptosis. FO has a protective effect on postoperative lymphocyte apoptosis. (JPEN J Parenter Enteral Nutr. 2012; 36: 677-684)CNPqCNPqFAPESPFAPESP [08/00163-9]CAPESCAPE

BENEFICIOS EN LA MICROBIOTA INTESTINAL DESPUÉS DE LA SUPLEMENTACIÓN CON \ud INULINA Y LA GOMA GUAR PARCIALMENTE HIDROLIZADA – UN ENSAYO CLÍNICO \ud ALEATORIZADO EN MUJERES CON ESTREÑIMIENTO

Introduction: Prebiotics positively affect gut microbiota composition, thus improving gut function. These properties may be useful for the treatment of constipation. Objectives: This study assessed the tolerance and effectiveness of a prebiotic inulin/partially hydrolyzed guar gum mixture (I-PHGG) for the treatment of constipation in females, as well as its influence on the composition of intestinal microbiota and production of short chain fatty acids. Methods: Our study enrolled 60 constipated female health worker volunteers. Participants reported less than 3 bowel movements per week. Volunteers were randomized to treatment with prebiotic or placebo. Treatment consisted of 3 weeks supplementation with 15 g/d I-PHGG (fiber group) or maltodextrin (placebo group). Abdominal discomfort, flatulence, stool consistency, and bowel movements were evaluated by a recorded daily questionnaire and a weekly interview. Changes in fecal bacterial population and short chain fatty acids were assessed by real-time PCR and gas chromatography, respectively. Results: There was an increased frequency of weekly bowel movements and patient satisfaction in both the fiber and placebo groups with no significant differences. Total Clostridium sp significantly decreased in the fiber group (p = 0.046) and increased in the placebo group (p = 0.047). There were no changes in fecal short chain fatty acid profile. Conclusions: Consumption of I-PHGG produced clinical results comparable to placebo in constipated females, but had additional protective effects on gut rnicrobiota by decreasing the amount of pathological bacteria of the Clostridium genera.Introducción: Los prebióticos influyen positivamente en la composición de la microbiota intestinal, mejorando así la función intestinal. Estas propiedades pueden ser\ud útiles para el tratamiento del estreñimiento. Objetivos:Este estudio evaluó la tolerancia y la eficacia de una mezcla de prebiótico inulina con la goma guar parcialmente hidrolizada (I-PHGG) para el tratamiento de mujeres con estreñimiento, así como su influencia en la\ud composición de la microbiota intestinal y la producción de ácidos grasos de cadena corta. Métodos: Nuestro estudio contó con la participación de 60 mujeres voluntarias con estreñimiento y profesionales de la salud. Las participantes informaron tener menos de tres evacuaciones por semana y fueron asignadas aleatoriamente a tratamiento con prebióticos o placebo. El tratamiento consistió en 3 semanas de suplementación con 15 gd I-PHGG (grupo de fibras) o maltodextrina (grupo placebo). Malestar abdominal, flatulencia, consistencia de las heces, y los movimientos intestinales se evaluaron mediante un cuestionario de registro diario y una entrevista semanal. Cambios en la población de bacterias fecales y los ácidos grasos de cadena corta fueron evaluados por PCR en tiempo real y cromatografía de gases, respectivamente. Resultados: Hubo un aumento en la frecuencia de las evacuaciones intestinales por semana y la satisfacción del paciente, tanto en la fibra y el grupo placebo, sin diferencias significativas. El total de Clostridium sp disminuyó significativamente en el grupo de fibras (p = 0,046) y\ud aumentó en el grupo placebo (p = 0,047). No hubo cambios en el perfil fecal de ácidos grasos de cadena corta. Conclusiones: El consumo de I-PHGG ha producido resultados clínicos comparables a placebo en mujeres con estreñimiento, pero ofreció otros efectos protectores sobre la microbiota intestinal al disminuir la cantidad de bacterias patológicas de lo género Clostridium.Fundacao de Apoio a Pesquisa do Estado de Sao Paulo (FAPESP)Fundacao de Apoio a Pesquisa do Estado de Sao Paulo (Fapesp) [07/58600-2

<i>Megamonas funiformis,</i> Plasma Zonulin, and Sodium Intake Affect C3 Complement Levels in Inactive Systemic Lupus Erythematosus

The etiology of systemic lupus erythematosus (SLE) remains unclear, with both genetic and environmental factors potentially contributing. This study aimed to explore the relationship among gut microbiota (GM), intestinal permeability, and food intake with inflammatory markers in inactive SLE patients. A total of 22 women with inactive SLE and 20 healthy volunteers were enrolled, and dietary intake was assessed through 24-h dietary recalls. Plasma zonulin was used to evaluate intestinal permeability, while GM was determined by 16S rRNA sequencing. Regression models were used to analyze laboratory markers of lupus disease (C3 and C4 complement and C-reactive protein). Our results showed that the genus Megamonas was significantly enriched in the iSLE group (p p p = 0.016), and sodium intake was negatively associated with C3 and C4 levels (p p < 0.01). These findings suggest that increased Megamonas funiformis abundance, elevated plasma zonulin, and higher sodium intake may contribute to reduced C3 complement levels in women with inactive SLE

The SURMetaGIT study: Design and rationale for a prospective pan-omics examination of the gastrointestinal response to Roux-en-Y gastric bypass surgery

Objective: To describe the protocol of the SURgically induced Metabolic effects on the Human GastroIntestinal Tract (SURMetaGIT) study, a clinical pan-omics study exploring the gastrointestinal tract as a central organ driving remission of type 2 diabetes mellitus (T2DM) after Roux-en-Y gastric bypass (RYGB). The main points considered in the study's design and challenges faced in its application are detailed. Methods: This observational, longitudinal, prospective study involved collection of gastrointestinal biopsy specimens, faeces, urine, and blood from 25 obese women with T2DM who were candidates for RYGB (20 patients for omics assessment and 5 for omics validation). These collections were performed preoperatively and 3 and 24 months postoperatively. Gastrointestinal transcriptomics; faecal metagenomics and metabolomics; plasma proteomics, lipidomics, and metabolomics; and biochemical, nutritional, and metabolic data were assessed to identify their short- and long-term correlations with T2DM remission. Results: Data were collected from 20 patients before and 3 months after RYGB. These patients have nearly completed the 2-year follow-up assessments. The five additional patients are currently being selected for omics data validation. Conclusion: The multi-integrated pan-omics approach of the SURMetaGIT study enables integrated analysis of data that will contribute to the understanding of molecular mechanisms involved in T2DM remission after RYGB