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Dos Santos ALS, Santos BC, Frazão LN, Miranda AL, Fayh APT, Silva FM, Gonzalez MC, Correia MITD, Souza NC, Anastácio LR, Maurício SF. Validity of the GLIM criteria for the diagnosis of malnutrition in patients with colorectal cancer: A multicenter study on the diagnostic performance of different indicators of reduced muscle mass and disease severity. Nutrition 2024; 119:112324. [PMID: 38215671 DOI: 10.1016/j.nut.2023.112324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 11/27/2023] [Accepted: 12/03/2023] [Indexed: 01/14/2024]
Abstract
OBJECTIVES To assess the concurrent and predictive validity of different combinations of Global Leadership Initiative on Malnutrition (GLIM) criteria in patients with colorectal cancer considering different indicators of reduced muscle mass (MM) and the effects of the disease. METHODS A secondary analysis with patients with colorectal cancer. The reduced MM was assessed by arm muscle area, arm muscle circumference, calf circumference, fat-free mass index, skeletal muscle index (SMI) and skeletal muscle. Cancer diagnosis or disease staging (TNM) was considered for the etiologic criterion referred to as the effect of the disease. The other phenotypic and etiologic criteria were also evaluated, and we analyzed 13 GLIM combinations. Concurrent validity between GLIM criteria and Patient-Generated Subjective Global Assessment was evaluated. Logistic and Cox regression were used in the predictive validation. RESULTS For concurrent validity (n = 208), most GLIM combinations (n = 6; 54.5%) presented a moderate agreement with Patient-Generated Subjective Global Assessment and none showed satisfactory sensitivity and specificity (>80%). Reduced MM evaluated by SMI and SMI were present in the GLIM combinations associated with postoperative complications (odds ratio, ≥2.0), independent of other phenotypic and etiologic criteria. The combinations with reduced MM considering any method and fixed phenotypic criteria and TNM were associated with mortality (hazard ratio, ≥2.0). CONCLUSIONS Satisfactory concurrent validity was not verified. The GLIM diagnosis of malnutrition was associated with postoperative complications and mortality.
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Affiliation(s)
| | - Bárbara Chaves Santos
- Universidade Federal de Minas Gerais, Postgraduate Program in Food Science, Belo Horizonte, Brazil
| | | | - Ana Lúcia Miranda
- Universidade Federal do Rio Grande do Norte, Postgraduate Program in Health Sciences, Health Sciences Center, Natal, Brazil
| | - Ana Paula Trussardi Fayh
- Universidade Federal do Rio Grande do Norte, Postgraduate Program in Health Sciences, Health Sciences Center, Natal, Brazil
| | - Flávia Moraes Silva
- Universidade Federal de Ciências da Saúde de Porto Alegre, Department of Nutrition, Porto Alegre, Brazil
| | - Maria Cristina Gonzalez
- Postgraduate Program in Food and Nutrition, Federal University of Pelotas, Rio Grande do Sul, Pelotas, Brazil
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Moraes GV, Santos BC, Anastácio LR, Santos NTO, Maltos AL, Barata CH, Castro SDS. Validation of the Global Leadership Initiative on Malnutrition criteria for diagnosis of malnutrition and mortality prediction for people living with HIV or AIDS. Nutrition 2024; 117:112224. [PMID: 37939455 DOI: 10.1016/j.nut.2023.112224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVES To validate the Global Leadership Initiative on Malnutrition (GLIM) criteria to diagnose malnutrition in hospitalized people living with HIV or AIDS (HA) considering different combinations, using the Subjective Global Assessment (SGA) as the semi-gold standard, and to assess the predictive effects of malnutrition according to the GLIM criteria on hospital length of stay and mortality. METHODS Retrospective observational study including hospitalized people living with HA aged >18 y. Forty GLIM combinations were obtained by combining the different phenotypic and etiologic criteria. The concurrent validity was assessed according to the sensitivity and specificity values, and the agreement with the SGA was tested using κ values. Multivariate logistic and Cox regression models were used to test the independent predictors for longer length of stay (LOS) and mortality, respectively. RESULTS The sample comprised 320 patients (mean age, 44.6 ± 12.1 y; 69.1% were men, and 68.4% were malnourished, according to the SGA). The prevalence of malnutrition, according to GLIM, varied from 10.3% to 69.1%. The combination of any phenotypic criteria with the etiologic criteria of low food intake and the combination of any phenotypic criteria with the etiologic criteria of disease severity were independent predictors for mortality (Hazard Ratio: 2.09 [95% CI, 1.15-3.77] and 2.09 [95% CI, 1.25-3.51], respectively). The combination of low body mass index and reduced absorption was independently associated with LOS higher than the median value (Oodds Ratio; 2.57; 95% CI, 1.21-5.45). CONCLUSIONS Nine GLIM combinations had satisfactory sensitivity and specificity values to determine concurrent validity, all of them including weight loss and low weight; two combinations were independent predictors of mortality (any phenotypic criteria and low food intake or opportunistic infections), and one combination predicted longer LOS. Combining any phenotypic criteria with low food intake resulted in adequate concurrent and predictive validity.
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Affiliation(s)
- Giselle Vanessa Moraes
- Graduate Program in Health Care, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil.
| | - Bárbara Chaves Santos
- Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Núbia Tomain Otoni Santos
- Graduate Program in Health Care, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - André Luiz Maltos
- Department of Clinical Pathology, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Cristina Hueb Barata
- Medical Clinic Department, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
| | - Sybelle de Souza Castro
- Graduate Program in Health Care, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil
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Guimarães TCM, Taranto DODL, Couto CA, Nardelli MJ, Cândido AL, Hott CDA, Anastácio LR, Reis FM, Rocha ALL, Faria LC. Dietary pattern in women with polycystic ovary syndrome with and without associated non-alcoholic fatty liver disease: A cross-sectional study. Clinics (Sao Paulo) 2023; 78:100288. [PMID: 38052105 PMCID: PMC10746390 DOI: 10.1016/j.clinsp.2023.100288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/14/2023] [Accepted: 09/26/2023] [Indexed: 12/07/2023] Open
Abstract
INTRODUCTION Women with Polycystic Ovary Syndrome (PCOS) have a higher prevalence of Nonalcoholic Fatty Liver Disease (NAFLD) than the general population. PCOS and NAFLD have common metabolic risk factors, however, the role of diet in NAFLD development is still uncertain in PCOS women. OBJECTIVE To evaluate and compare the dietary patterns and nutritional intake in patients with PCOS with and without NAFLD. METHOD Cross-sectional study that included patients with PCOS diagnosed according to Rotterdam criteria. All participants were submitted to abdominal ultrasound to investigate liver steatosis. Dietary profile was assessed by 24-hour food recall (24hR), and Food Frequency Questionnaire (FFQ). Diet quality was assessed by the Healthy Eating Index (HEI) adapted for the Brazilian population. Physical activity practice was also assessed. RESULTS 87 participants were included (average age 35.2 ± 5.7 years), among whom, 67 (77%) had NAFLD. The group with PCOS and NAFLD presented higher body mass index (BMI) (34.9 ± 4.5 vs. 30.4 ± 4.9 kg/m2; p = 0.001), Waist Circumference (WC) (103 [97‒113] vs. 95 [87.5‒100] cm; p < 0.001) and were considered physically active less frequently than those without NAFLD (34.3% vs. 60%; p = 0.04). Food intake and dietary patterns assessed by 24hR, FFQ and HEI presented no difference between the groups. CONCLUSIONS PCOS women with coexistent NAFLD had higher BMI, WC and were less physically active than those without NAFLD. Dietary evaluation showed that PCOS women with NAFLD had no significant difference in macro and micronutrients or food group intake and diet quality in comparison to those without NAFLD.
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Affiliation(s)
| | - Daniela Oliveira de Lima Taranto
- Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Serviço de Diagnóstico por Imagem do Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Claudia Alves Couto
- Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Ambulatório de Doença Hepática Gordurosa Não Alcoólica, Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mateus Jorge Nardelli
- Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Lucia Cândido
- Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Ambulatório de Doença Hepática Gordurosa Não Alcoólica, Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Cristina de Almeida Hott
- Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucilene Rezende Anastácio
- Departamento de Alimentos, Faculdade de Farmácia da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Fernando M Reis
- Ambulatório de Hiperandrogenismo, Serviço de Endocrinologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ana Luiza Lunardi Rocha
- Ambulatório de Hiperandrogenismo, Serviço de Endocrinologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Departamento de Ginecologia e Obstetrícia, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Luciana Costa Faria
- Pós-Graduação em Ciências Aplicadas à Saúde do Adulto, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Departamento de Clínica Médica, Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Ambulatório de Doença Hepática Gordurosa Não Alcoólica, Instituto Alfa de Gastroenterologia, Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Fonseca ALF, Santos BC, Anastácio LR, Pereira RG, Correia MITD, Lima AS, Mizubuti YGG, Ferreira SC, Ferreira LG. Global Leadership Initiative on Malnutrition criteria for the diagnosis of malnutrition and prediction of mortality in patients awaiting liver transplant: A validation study. Nutrition 2023; 114:112093. [PMID: 37437417 DOI: 10.1016/j.nut.2023.112093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/02/2023] [Accepted: 05/21/2023] [Indexed: 07/14/2023]
Abstract
OBJECTIVES The Global Leadership Initiative on Malnutrition (GLIM) is a framework aiming to standardize malnutrition diagnosis. However, it still needs to be validated, in particular for patients with chronic liver disease. This study aimed to validate the GLIM criteria in patients with liver cirrhosis awaiting liver transplant (LTx). METHODS This was a retrospective observational study carried out with adult patients on the waiting list for LTx, consecutively evaluated between 2006 and 2021. The phenotypic criteria were unintentional weight loss, low body mass index, and reduced muscle mass (midarm muscle circumference [MAMC]). The etiologic criteria were high Model for End-Stage Liver Disease (MELD) and MELD adjusted for serum sodium (MELD-Na) scores, the Child-Pugh score, low serum albumin, and low food intake and/or assimilation. Forty-three GLIM combinations were tested. Sensitivity (SE), specificity (SP), positive and negative predictive values, and machine learning (ML) techniques were used. Survival analysis with Cox regression was carried out. RESULTS A total of 419 patients with advanced liver cirrhosis were included (median age, 52.0 y [46-59 y]; 69.2% male; 68.8% malnourished according to the Subjective Global Assessment [SGA]). The prevalence of malnutrition by the GLIM criteria ranged from 3.1% to 58.2%, and five combinations had SE or SP >80%. The MAMC as a phenotypic criterion with MELD and MELD-Na as etiologic criteria were predictors of mortality. The MAMC and the presence of any phenotypic criteria associated with liver disease parameters and low food intake or assimilation were associated with malnutrition prediction in ML analysis. CONCLUSIONS The MAMC and liver disease parameters were associated with malnutrition diagnosis by SGA and were also predictors of 1-y mortality in patients with liver cirrhosis awaiting LTx.
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Affiliation(s)
| | - Bárbara Chaves Santos
- Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Ramon Gonçalves Pereira
- Computer Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Agnaldo Soares Lima
- Surgery PostGraduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Lívia Garcia Ferreira
- Nutrition and Health Graduate Program, Universidade Federal de Lavras, Lavras, Brazil.
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de Faria NC, Andrade GMDP, Ruas CM, Claro RM, Braga LVM, Nilson EAF, Anastácio LR. Impact of implementation of front-of-package nutrition labeling on sugary beverage consumption and consequently on the prevalence of excess body weight and obesity and related direct costs in Brazil: An estimate through a modeling study. PLoS One 2023; 18:e0289340. [PMID: 37566577 PMCID: PMC10420370 DOI: 10.1371/journal.pone.0289340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/18/2023] [Indexed: 08/13/2023] Open
Abstract
RATIONALE Intake of sugary beverages has been associated with obesity and chronic non-communicable diseases, thereby increasing the direct health costs related to these diseases. Front-of-package nutrition labeling (FoPNL) aims to help consumers understand food composition, thereby improving food choices and preventing the development of such diseases. OBJECTIVE To estimate, over five years, the impact of implementing FoPNL in Brazil on the prevalence of excess body weight and obesity in adults who consume sugary beverages and the direct costs related to such problems. METHODS A simulation study to performed to estimate the effect of FoPNL implementation on the prevalence of excess body weight and obesity. The VIGITEL research database (2019), published in the 2020 report, was used in this study (the final sample consisted of 12,471 data points representing 14,380,032 Brazilians). The scenarios were considered: base (trend in sugary beverage intake); 1 (base scenario associated with the changes in energy content of the purchased beverages observed after the first phase of the Chilean labeling law (-9.9%); and 2 (scenario 1 associated with reformulation of beverages, total energy reduction of -1.6%). Changes in body weight were estimated using the simulation model of Hall et al. (2011) over five years. A linear trend in the prevalence of obesity and excess body weight in the Brazilian population was considered. The impact of the prevalence of obesity and excess body weight on body mass index was estimated. In addition, the direct health costs related to obesity were estimated. RESULTS Energy consumption from sugary beverages after FoPNL implementation is expected to be reduced by approximately 28 kcal/day (95% CI, -30 to -27) considering scenario 1. In scenarios 1 and 2, without FoPNL, the prevalence of obesity and excess body weight over five years was estimated to be 25.3% and 25.2%, and 64.4% and 64.2%, respectively. By extrapolating the results to the entire Brazilian population, it was observed that the implementation of FoPNL may reduce the prevalence of obesity by -0.32 percentage points and -0.35 percentage points (scenario 1 and 2, respectively) and excess body weight by -0.42 percentage points and -0.48 percentage points (scenarios 1 and 2, respectively) in five years. It is estimated that after five years of implementation, it will be possible to save approximately US$ 5,5 millions (95% CI 4,7 to 8,8) in scenario 1, reaching approximately US$ 6,1 millions (95% CI 5,3 to 9,8) in scenario 2. CONCLUSION The results of this modeling study indicate that FoPNL may reduce prevalence of excess body weight and obesity, representing strategic public policies for obesity prevention.
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Affiliation(s)
- Natália Cristina de Faria
- Post-Graduate Program in Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | | | - Cristina Mariano Ruas
- Department of Social Pharmacy, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Rafael Moreira Claro
- Department of Nutrition, School of Nursing, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
- Centre for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
| | - Luíza Vargas Mascarenhas Braga
- Post-Graduate Program in Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Eduardo Augusto Fernandes Nilson
- Centre for Epidemiological Research in Nutrition and Health (NUPENS), University of Sao Paulo, Sao Paulo, Brazil
- Oswaldo Cruz Foundation (Fiocruz) Brasília, Brasilia, Brazil
| | - Lucilene Rezende Anastácio
- Post-Graduate Program in Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil
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Ferreira SC, Souza NPD, Amado LRDN, Melo JOF, Reis IA, Anastácio LR. THE EFFECT OF BETA-HYDROXY-BETA-METHYLBUTYRATE (HMB) WITH NUTRITIONAL INTERVENTION ON ANTHROPOMETRIC MUSCLE MASS MARKERS, STRENGTH, FUNCTIONALITY, AND QUALITY OF LIFE IN PATIENTS ON THE WAITING LIST FOR LIVER TRANSPLANTATION: A DOUBLE-BLIND STUDY. Nutrition 2023; 110:112021. [PMID: 37099902 DOI: 10.1016/j.nut.2023.112021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/18/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
OBJECTIVE Patients on the waiting list for liver transplantation (LTx) usually lose muscle mass. Supplementation with β-hydroxy β-methylbutyrate (HMB) may have a promising effect on this clinical condition. This study aimed to evaluate the effects of HMB on muscle mass, strength, functionality, and quality of life in patients on the LTx waiting list. METHODS A double-blind, randomized study was conducted of 3g supplementation of HMB or 3g supplementation of maltodextrin (active control) with nutritional counselling for 12 wk in patients >18 y, evaluated at five points or timepoints. Body composition and anthropometric data (resistance, reactance, phase angle, weight, body mass index, arm circumference [AC], arm muscle area, and adductor pollicis muscle thickness) were collected, and muscle strength was assessed through dynamometry and muscle function by the frailty index (FI). Quality of life was assessed. RESULTS A total of 47 patients were enrolled (HMB: 23 and active control: 24). There was a significant difference in both groups for AC (P = 0.03), dynamometry (P = 0.02), and FI (P = 0.01). There was an increase in dynamometry between weeks 0 and 12 in both groups (HMB [Δdynamometry: 10.1% ± 16.4%; P < 0.05] and active control [Δdynamometry: 23.0% ± 70.3%; P < 0.05]). The AC increased in both groups between weeks 0 and 4 (HMB [ΔAC: 0.9% ± 2.8%; P < 0.05] and active control [ΔAC: 1.6% ± 3.6%; P < 0.05]) and between weeks 0 and 12 (HMB [ΔAC: 3.2% ± 6.7%; P < 0.05] and active control [ΔAC: 2.1% ± 6.6%; P < 0.05]). The FI decreased in both groups, between weeks 0 and 4 (HMB [ΔFI: -4.2% ± 6.9%; P < 0.05) and active control [ΔFI: -3.2% ± 9.6%; P < 0.05]) and between weeks 0 and 12 (HMB ΔFI: -4.4% ± 11.2%; P < 0.05] and active control [ΔFI: -5.5% ± 11.3%; P < 0.05]). The other variables did not change (P > 0.05). CONCLUSIONS Nutritional counselling with supplementation with HMB or active control in patients on the LTx waiting list improved AC, dynamometry, and the FI in both groups.
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Affiliation(s)
- Samanta Catherine Ferreira
- Food Science Department, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Júlio Onésio Ferreira Melo
- Department of Exact and Biological Sciences, Universidade Federal de São João del-Rei, São João del-Rey, Brazil
| | - Ilka Afonso Reis
- Department of Statistics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucilene Rezende Anastácio
- Food Science Department, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Silva ARCS, Braga LVM, Anastácio LR. Coexistence of high content of critical nutrients and claims in food products targeted at Brazilian children. Rev paul pediatr 2023; 41:e2021355. [DOI: 10.1590/1984-0462/2023/41/2021355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 02/27/2022] [Indexed: 12/23/2022]
Abstract
ABSTRACT Objective: This study aimed to evaluate food labels targeted at children and identify the concomitant presence of claims and high levels of critical nutrients and/or the presence of sweeteners. As a secondary objective, it aimed to list different types of claims and check which marketing strategies are most used. Methods: We collected 409 products, from 8 popular food groups targeted at children, in Brazilian market (i.e., fruit drinks, dairy drinks, sandwich cookies, cakes, breakfast cereals, jellies, corn snacks, and yogurts). The contents of critical nutrients (e.g., sugar, total fat, saturated fat, and trans-fat, and sodium) and presence/absence of sweetener were calculated, considering Pan American Health Organization (PAHO) parameters. Then, we verified the presence and types of claims in these products. Results: Overall, 265 (64.7%) labels presented claims. In three of the eight categories (i.e., breakfast cereals, dairy drinks, and yogurt), all products with claims (50, 34, and 34 products, respectively) had one or more nutrients in harmful concentrations (critical nutrients above PAHO’s nutritional profile and/or presence of sweeteners). In the other categories, only one product (of 63 sandwich cookies and 26 breakfast cereals with claims) and three products (of 22 cakes and 28 jellies with claims) had no nutrient in critical concentration. The presence of claims, like “rich/source” of micronutrient, was predominant in seven of the eight food groups. Conclusion: In the present study, there was a high presence of claims, of different types, in foods targeted at children, which, for the most part, also have excess of at least one critical nutrient, according to PAHO.
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Silva ARCS, Ni Mhurchu C, Anastácio LR. Corrigendum: Comparison of two front-of-pack nutrition labels for Brazilian consumers using a smartphone app in a real-world grocery store: A pilot randomized controlled study. Front Nutr 2022; 9:1040011. [PMID: 36313080 PMCID: PMC9610831 DOI: 10.3389/fnut.2022.1040011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Lucilene Rezende Anastácio
- Department of Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil,*Correspondence: Lucilene Rezende Anastácio
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Souza TCDM, Goston JL, Martins-Costa HC, Minighin EC, Anastácio LR. Can Anthocyanins Reduce Delayed Onset Muscle Soreness or Are We Barking Up the Wrong Tree? Prev Nutr Food Sci 2022; 27:265-275. [PMID: 36313058 PMCID: PMC9585400 DOI: 10.3746/pnf.2022.27.3.265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Exercise-induced muscular overload can trigger delayed onset muscle soreness (DOMS). DOMS is related to the indiscriminate use of analgesics and nonsteroidal anti-inflammatory drugs without proper guidance, decreased physical exercise adherence and degenerating sports performance, increased risk of injury, and reduced muscle strength and function. Dietary anthocyanins have been extensively studied as potential natural treatments for DOMS, but the indication, dosage, and form of use remain highly variable. Therefore, this review aims to synergize and present evidence relating to the effect of anthocyanins on DOMS in clinical studies. Notably, the results of anthocyanin supplementation for DOMS were found to be inconclusive. The use of protocols with lower anthocyanin doses yielded better results than those with high-dose supplements, suggesting that anthocyanin-rich foods are more accessible as therapeutic tools, leading to the conclusion that these foods could be used to prevent and treat DOMS. However, consumption protocols for this purpose are not yet well established, and the answer is dependent on the methodological quality of future studies.
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Affiliation(s)
| | - Janaina Lavalli Goston
- Department of Physical Education, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG 30535-610, Brazil
| | - Hugo César Martins-Costa
- Department of Physical Education, Pontifical Catholic University of Minas Gerais, Belo Horizonte, MG 30535-610, Brazil
| | - Elaine Carvalho Minighin
- Department of Food Science, Federal University of Minas Gerais, Belo Horizonte, MG 31270-901, Brazil
| | - Lucilene Rezende Anastácio
- Department of Food Science, Federal University of Minas Gerais, Belo Horizonte, MG 31270-901, Brazil,
Correspondence to Lucilene Rezende Anastácio, E-mail:
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Prates SMS, Reis IA, Rojas CFU, Spinillo CG, Anastácio LR. Influence of nutrition claims on different models of front-of-package nutritional labeling in supposedly healthy foods: Impact on the understanding of nutritional information, healthfulness perception, and purchase intention of Brazilian consumers. Front Nutr 2022; 9:921065. [PMID: 36211521 PMCID: PMC9539030 DOI: 10.3389/fnut.2022.921065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Nutrition claims are positive information about foods, which are widely used as a marketing strategy on labels. On the contrary, front-of-package nutritional labeling (FoPNL) aims to make it easier for consumers to understand the nutritional composition of foods and favor healthy food choices. However, the concomitant presence of nutrition claims and FoPNL may hinder the understanding, judgment, and choices of consumers at the moment of purchase. Therefore, the objective of this study was to evaluate the influence of nutrition claims on the efficacy of FoPNL models in the understanding of nutritional information, healthfulness perception, and purchase intention of Brazilian consumers. It was an experimental cross-sectional study carried out using an online questionnaire, with a total of 720 participants randomly divided into four FoPNL conditions: control, octagon, triangle, and magnifying glass. Each participant looked at 12 food packages, which were produced following the factorial design: (i) food category (cereal bar, whole grain cookies, and snacks); (ii) product type (containing one critical nutrient × containing two critical nutrients); and (iii) nutrition claims (present × absent). The comprehension of nutritional information was evaluated through the identification of excessive nutrients, and the healthfulness perception and purchase intention were evaluated using a seven-point scale. The results indicated that the presence of FoPNL increased the understanding of the information and reduced healthfulness perception and purchase intention. The presence of nutrition claims influenced the three outcomes, decreasing the probability of understanding information about food composition by 32% (OR 0.68, 95% confidence interval 0.58–0.78, p < 0.01) and significantly increasing (p < 0.05) average health scores (1.95–2.02) and purchase intention (2.00–2.05). Nonetheless, the interaction “FoPNL × claims” was not significant, which indicated that claims act independently. All FoPNL models were more effective than the control. For the least healthful type of product (two nutrients in excess), the octagon and triangle models were superior to the magnifying glass, regarding the outcome of healthfulness perception. The results prove the efficacy of FoPNL in consumer understanding and judgment. Despite the positive effects of FoPNL, it did not cancel the positivity bias generated by the claims.
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Affiliation(s)
- Sarah Morais Senna Prates
- Food Science Post-Graduation Program, Department of Food Science, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ilka Afonso Reis
- Department of Statistics, Institute of Exact Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carlos Felipe Urquizar Rojas
- Laboratory of Information System Design, Design Post-Graduation Program, Department of Design, Universidade Federal do Paraná, Curitiba, Brazil
| | - Carla Galvão Spinillo
- Laboratory of Information System Design, Design Post-Graduation Program, Department of Design, Universidade Federal do Paraná, Curitiba, Brazil
| | - Lucilene Rezende Anastácio
- Food Science Post-Graduation Program, Department of Food Science, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- *Correspondence: Lucilene Rezende Anastácio,
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Tomaz LA, Pereira CG, Braga LVM, Prates SMS, Silva ARCS, Soares APDC, de Faria NC, Anastácio LR. From the most to the least flexible nutritional profile: Classification of foods marketed in Brazil according to the Brazilian and Mexican models. Front Nutr 2022; 9:919582. [PMID: 36204372 PMCID: PMC9531871 DOI: 10.3389/fnut.2022.919582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Nutrient profiling is the science of classifying or ranking foods according to their nutritional composition, for reasons related to disease prevention and health promotion. To be effective, policies such as front-of-pack nutrition labeling (FoPNL) must have an adequate nutritional profile model, since it will determine which products will be eligible to receive a FoPNL. This study aimed to determine the percentage of packaged food and drink products available in Brazil that would be subject to FoPNL under two different legislations: Brazilian and Mexican. This is a cross-sectional study in which we collected information on food products (photos of the ingredients list, the front label, the barcode, and the nutrition facts table) from one of the largest stores of a supermarket chain in the city of Belo Horizonte-MG, Brazil, from March to May 2021 (~6 months after the publication of the Brazilian legislation about FoPNL and a year and a half before the legislation came into force). The products were classified in relation to the BNPM (added sugars, saturated fats, and sodium) and the MNPM (energy, free sugars, saturated fats, trans fats, sodium, non-sugar sweeteners, and caffeine). A total of 3384 products were collected and, after applying the exclusion criteria, 3,335 products were evaluated. Of these, 2,901 would be eligible to receive FoPNL in Brazil and 2,914 would be eligible to receive FoPNL in Mexico. According to the BNPM, 56.7% (95% CI 54.9; 58.5%) of the products were “high in” critical nutrients, 27.1% (95% CI 25.5; 28.7%) of the products in added sugars, 26.7% (95% CI 25.2; 28.4%) of the products in saturated fats, and 21.4% (95% CI 19.9; 22.9%) of the products in sodium. As for the MNPM, 96.8% (95% CI 96.1; 97.4%) of them were “high in” up to five critical nutrients and up to two warning rectangles (caffeine and non-sugar sweeteners), 45.8% (95% CI 44.0; 47.6%) of them in free sugars, 43.7% (95% CI 41.9; 45.5%) of them in saturated fats, and 47.9% (95% CI 46.1; 49.7%) of them in sodium. We concluded that the eligibility to receive FoPNL by BNPM and MNPM was relatively similar between products; however, almost all products would have at least one FoPNL and/or warning rectangles according to Mexican legislation, and nearly half of them would have at least one FoPNL, considering BNPM. The MNPM is much more restrictive than the BNPM. The Nutrient Profile Model (NPM) that regulates FoPNL, and other health policies, must be carefully defined to ensure that foods are properly classified according to their healthiness.
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Silva ARCS, Ni Mhurchu C, Anastácio LR. Comparison of two front-of-pack nutrition labels for Brazilian consumers using a smartphone app in a real-world grocery store: A pilot randomized controlled study. Front Nutr 2022; 9:898021. [PMID: 35990330 PMCID: PMC9389176 DOI: 10.3389/fnut.2022.898021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 07/08/2022] [Indexed: 11/21/2022] Open
Abstract
One of the suggestions for improving the understanding of food labels is implementing front-of-pack nutrition labeling (FoPNL), where nutritional information is objectively made available to consumers. Scientific data on the best FoPNL model to be adopted for the Brazilian population is still emerging, especially in real-world purchase situations. This study aims to evaluate/compare the proposed Brazilian and Mexican FoPNL systems, on different outcome measures, using an application, in dairy foods available in a supermarket aisle. This pilot randomized controlled trial in a real-world purchase situation was conducted in June/July 2021. A total of 230 participants were randomly allocated to one of the three study arms (Mexican and Brazilian FoPNL systems or control—nutritional information table and ingredients list). Using a smartphone, the participants scanned a product barcode and received the allocated FoPNL (with information about excessive added sugars, sodium, and/or saturated fat content) or the control. After, they answered questions related to our primary outcome (decision to buy or not to buy a product) and secondary outcomes (perceived healthiness, facilitation of a quick purchase decision, and identification of excess nutrients). The Mexican FoPNL system performed better in the primary outcome (3.74 ± 1.34) and “facilitation of a quick purchase decision” (3.59 ± 1.31), compared to the control (3.28 ± 1.45;p = 0.043 and 3.11 ± 1.42; p = 0.029). The Mexican FoPNL system performed better in supporting consumers to identify dairy foods, among the selected sample in this study, high in added sugars than the control (82.2% and 63.5% of correct answers, respectively; p = 0.009). For saturated fats, the Brazilian FoPNL resulted in 93.1% of correct answers against 48.2% for the control and 58.9% for the Mexican system (p ≤ 0.001). The Mexican FoPNL system facilitated consumer decision-making on when to buy or not to buy a selected dairy product and in helping to quickly decide which dairy products to buy, among the selected sample in this study, compared to the control. Considering the right answers of critical nutrients in excess or not, both models of FoPNL, delivered by a smartphone app, performed well.
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Affiliation(s)
| | - Cliona Ni Mhurchu
- National Institute for Health Innovation, University of Auckland, Auckland, New Zealand
| | - Lucilene Rezende Anastácio
- Department of Food Science, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Soares APDC, de Faria NC, Graciano GF, Dos Santos ALS, Valenzuela VDC, Toulson Davisson Correia MI, Cosenza GP, Anastácio LR. Cinnamon Infusion Reduces Satiety and Increases Energy Intake: A Randomized Crossover Trial. Ann Nutr Metab 2022; 78:265-272. [PMID: 35830848 DOI: 10.1159/000525949] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 07/01/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND/AIMS This study aimed to evaluate the effects of the intake of a single dose of cinnamon infusion on energy metabolism, appetite responses and food intake in healthy individuals. METHODS This was an open randomized crossover clinical trial, with a minimum washout of seven days, which was conducted in which two standardized breakfasts were served randomly: one with cinnamon infusion (2g, Cinnamomum sp.) And one with water (control). The study included 21 healthy volunteers. Energy expenditure (EE), diet-induced thermogenesis (DIT), respiratory quotient (RQ), substrate oxidation and appetite responses were evaluated, as well as prospective food intake. RESULTS Ingestion of cinnamon infusion did not alter EE, DIT, RQ or substrate oxidation. The incremental area under the curve for hunger, satiety and desire to eat did not differ between the treatment with cinnamon infusion and water, however, there was a reduction in the feeling of satiety (p=0.021) compared to the control treatment. The energy consumption of the first meal after treatment was higher (p=0.05) in the treatment with cinnamon infusion than in the control treatment. Regarding macronutrients or food intake throughout the day, there was no difference between treatments. CONCLUSIONS Although it did not affect energy metabolism, consuming a single dose of cinnamon infusion promoted less feeling of satiety and increased energy intake in the first meal after treatment. The study protocol was registered at the Brazilian Clinical Trials Registry Platform (RBR-5ftg3z).
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Affiliation(s)
- Ana Paula da Costa Soares
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Natália Cristina de Faria
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Guilherme Fonseca Graciano
- Postgraduate Program in Sciences Applied to Adult Health, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Luiza Soares Dos Santos
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Gustavo Pereira Cosenza
- Food Science Department, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lucilene Rezende Anastácio
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Food Science Department, Pharmacy School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Oliveira LA, Della Lucia CM, Rezende FAC, Ferreira LG, Anastácio LR, Souza TCDM, Daniel MM, Liboredo JC. Food Craving and Its Associated Factors during COVID-19 Outbreak in Brazil. American Journal of Health Education 2022. [DOI: 10.1080/19325037.2022.2071360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Daniel MM, Liboredo JC, Anastácio LR, Souza TCDM, Oliveira LA, Della Lucia CM, Ferreira LG. Incidence and Associated Factors of Weight Gain During the Covid-19 Pandemic. Front Nutr 2022; 9:818632. [PMID: 35284434 PMCID: PMC8908378 DOI: 10.3389/fnut.2022.818632] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 01/31/2022] [Indexed: 12/12/2022] Open
Abstract
Introduction and Aims The behavioral changes that arose from quarantine due to the COVID-19 pandemic may have impacted the weight of people. This study aims to investigate the incidence and predictors of weight gain during the quarantine period. Methods An online survey was performed five months after the social distance measures implementation. Participants recorded their current and usual weight before lockdown. A multivariate logistic regression model was performed. Results Data on 1334 participants were evaluated (33.6y, 79.8% females), and 58.8% have gained weight (3.0 kg; 0.1 to 30.0 kg). Predictors of weight gain were increased food intake (OR = 5.40); snacking (OR = 2.86); fast food (OR = 1.11); canned products (OR = 1.08); and in physical activity (OR = 0.99) concerning the period before the pandemic; also time spent at work, including household chores (OR = 1.58); evening snack (OR = 1.54); higher frequency of alcoholic beverage intake (OR = 1.59) and dose of alcoholic beverage (OR = 1.11); uncontrolled eating (OR = 1.01), and vegetable intake (OR = 0.92) during the quarantine and physical activity before pandemic period (OR = 0.99). Conclusion Most participants have gained weight during the pandemic because of working changes, lifestyle, eating habits changes, and uncontrolled eating behavior. These results can be useful to encourage changes during future quarantine periods to prevent weight gain.
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Affiliation(s)
- Marina Martins Daniel
- Graduate Program in Nutrition and Health, Department of Nutrition, Universidade Federal de Lavras, Lavras, Brazil
| | | | | | | | - Lívya Alves Oliveira
- Graduate Program in Nutrition Science, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Ceres Mattos Della Lucia
- Graduate Program in Nutrition Science, Department of Nutrition and Health, Universidade Federal de Viçosa, Viçosa, Brazil
| | - Lívia Garcia Ferreira
- Graduate Program in Nutrition and Health, Department of Nutrition, Universidade Federal de Lavras, Lavras, Brazil
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Cristina de Faria N, Paula da Costa Soares A, Graciano GF, Toulson Davisson Correia MI, Valenzuela VDCT, Anastácio LR. Acute green tea infusion ingestion effect on energy metabolism, satiety sensation and food intake: a randomized crossover trial. Clin Nutr ESPEN 2022; 48:63-67. [DOI: 10.1016/j.clnesp.2022.01.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 01/21/2022] [Accepted: 01/27/2022] [Indexed: 11/27/2022]
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Santos BC, Fonseca ALF, Ferreira LG, Ribeiro HS, Correia MITD, Lima AS, Penna FGCE, Anastácio LR. Different combinations of the GLIM criteria for patients awaiting a liver transplant: Poor performance for malnutrition diagnosis but a potentially useful prognostic tool. Clin Nutr 2022; 41:97-104. [PMID: 34864459 DOI: 10.1016/j.clnu.2021.11.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/03/2021] [Accepted: 11/06/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND & AIMS Studies using the Global Leadership Initiative on Malnutrition (GLIM) criteria for patients with liver cirrhosis are limited. This study aimed to assess the impact of malnutrition according to the GLIM criteria on the outcomes of patients awaiting a liver transplant (LTx) and compare these criteria with Subjective Global Assessment (SGA). METHODS This retrospective observational study included adult patients awaiting LTx. Patient clinical data, nutritional status according to various tools including SGA, and resting energy expenditure were assessed. The distinct phenotypic and etiologic criteria provided 36 different GLIM combinations. The GLIM criteria and SGA were compared using the kappa coefficient. The variables associated with mortality before and after the LTx and with a longer length of stay (LOS) after LTx (≥18 days) were assessed by Cox regression and logistic regression analyses, respectively. RESULTS A total of 152 patients were included [median age 52.0 (interquartile range: 46.5-59.5) years; 66.4% men; 63.2% malnourished according to SGA]. The prevalence of malnutrition according to the GLIM criteria ranged from 0.7% to 30.9%. The majority of the GLIM combinations exhibited poor agreement with SGA. Independent predictors of mortality before and after LTx were presence of ascites or edema (p = 0.011; HR:2.58; CI95%:1.24-5.36), GLIM 32 (PA-phase angle + MELD) (p = 0.026; HR:2.08; CI95%:1.09-3.97), GLIM 33 (PA + MELD-Na≥12) (p = 0.018; HR:2.17; CI95%:1.14-4.13), and GLIM 34 (PA + Child-Pugh) (p = 0.043; HR:1.96; CI95%:1.02-3.77). Malnutrition according to GLIM 28 (handgrip strength + Child-Pugh) was independently associated with a longer LOS (p = 0.029; OR:7.21; CI95%:1.22-42.50). CONCLUSION The majority of GLIM combinations had poor agreement with SGA, and 4 of the 36 GLIM combinations were independently associated with adverse outcomes.
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Affiliation(s)
- Bárbara Chaves Santos
- Food Science Post-Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Ana Luisa Ferreira Fonseca
- Nutrition and Health Post-Graduate Program, Universidade Federal de Lavras, Lavras, Minas Gerais, Brazil
| | - Lívia Garcia Ferreira
- Nutrition and Health Post-Graduate Program, Universidade Federal de Lavras, Lavras, Minas Gerais, Brazil
| | - Helem Sena Ribeiro
- Surgery Post-Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Isabel Toulson Davisson Correia
- Surgery Post-Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Alfa Institute of Gastroenterology, Hospital das Clínicas-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Agnaldo Soares Lima
- Surgery Post-Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Santos BC, Ferreira LG, Ribeiro HS, Correia MITD, Lima AS, Penna FGCE, Anastácio LR. Bioelectrical impedance vector analysis in patients on the waiting list for liver transplant: Associated factors and prognostic effects. Nutrition 2021; 94:111528. [PMID: 34891107 DOI: 10.1016/j.nut.2021.111528] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVES The aim of this study was to assess patients on the waiting list for liver transplant (LTx) according to bioelectrical impedance vector analysis (BIVA), as well as to verify the association between the placement of the vectors on the graph with clinical outcomes and identify the predictors to vector placement in quadrant 4 (Q4; indicating more hydration and less cellularity). METHODS This was a retrospective observational study including 129 patients ≥20 y of age awaiting LTx. Patients' nutritional status was assessed by using different tools, including single-frequency bioelectrical impedance analysis and the Subjective Global Assessment (SGA). Clinical data were registered. The BIVA was evaluated by comparing the individual vectors plotted for all patients to the tolerance ellipses of 50%, 75%, and 95% of the reference healthy population. The quadrant of the vector for each patient was registered. RESULTS The majority of the vectors were placed in Q1 (n = 54; 41.9%) and Q4 (n = 39; 30.2%). The presence of ascites or edema (hazard ratio [HR], 2.43; 95% confidence interval [CI], 1.15-5.12; P = 0.019) and the BIVA vector placed in Q4 in any ellipse (HR, 2.10; 95% CI, 1.07-4.09; P = 0.029) were independent predictors for mortality on the waiting list or ≤1 y after LTx. BIVA was not associated with longer hospital length of stay. The predictors of vector placement in Q4 were higher age, malnutrition according to SGA, and presence of ascites or edema. CONCLUSION Patients on the waiting list for LTx with BIVA vectors placed in Q4, in the 50%, 75%, or 95% tolerance ellipses, presented a worse prognosis.
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Affiliation(s)
- Bárbara Chaves Santos
- Food Science Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lívia Garcia Ferreira
- Nutrition and Health Graduate Program, Universidade Federal de Lavras, Lavras, Minas Gerais, Brazil
| | - Helem Sena Ribeiro
- Surgery Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria Isabel Toulson Davisson Correia
- Surgery Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil; Alfa Institute of Gastroenterology, Hospital das Clínicas-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Agnaldo Soares Lima
- Surgery Graduate Program, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Faria NCD, Soares APDC, Graciano GF, Correia MITD, Pires MC, Valenzuela VDCT, Anastácio LR. Hibiscus sabdariffa tea affects diet-induced thermogenesis and subjective satiety responses in healthy men, but not in women: a randomized crossover trial. Appl Physiol Nutr Metab 2021; 47:429-438. [PMID: 34370964 DOI: 10.1139/apnm-2021-0051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to investigate the effect of Hibiscus sabdariffa tea on energy expenditure, satiety response and food intake. This is an open-label, crossover, randomized clinical trial (RBR-5HZ86T), including 21 subjects (11 women, 10 men). The individuals were evaluated at acute moments (fasting and after eating standardized breakfast accompanied by water or Hibiscus sabdariffa tea). Resting energy expenditure was measured by indirect calorimetry, subjective satiety responses were evaluated with a visual analogue scale and food intake was assessed by using food records. The volunteers who drank the Hibiscus sabdariffa tea had lower perception of hunger (p=0.002) and greater feeling of satiety (p=0.010) and fullness (p=0.009) compared to control. Men who ingested the Hibiscus sabdariffa tea had an increase in nitrogen energy expenditure (water: 1501±290.7kcal, Hibiscus sabdariffa tea: 1619±288.9kcal; p=0.029). In comparison to control, men presented less perception of hunger (p=0.003) and desire to eat (p=0.016), increased satiety (p=0.021) and fullness (p=0.010), and women oxidized more fat (p=0.034) when they drank Hibiscus sabdariffa tea. There was no difference between treatments regarding the energy and macronutrient intake from the first meal and throughout the day (p>0.050) for all participants. The Hibiscus sabdariffa tea only affected energy expenditure and satiety responses in men. Clinical trial registry: ReBEC Platform of the Brazilian Clinical Trials Registry - RBR-5HZ86T Novelty bullets • Hibiscus sabdariffa tea promoted an increase in energy expenditure and caused less perception of hunger/desire to eat in men. • Hibiscus sabdariffa tea intake increased postprandial fat oxidation in women.
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Affiliation(s)
- Natália Cristina de Faria
- Universidade Federal de Minas Gerais, 28114, Departamento de Alimentos, 6627 Antônio Carlos Avenue, Pampulha Campus, Belo Horizonte, Minas Gerais, Brazil, 31270-901;
| | | | | | | | - Magda Carvalho Pires
- Universidade Federal de Minas Gerais, Department of Statistics; Institute of Exact Sciences, Belo Horizonte, Minas Gerais, Brazil;
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Liboredo JC, Anastácio LR, Ferreira LG, Oliveira LA, Della Lucia CM. Quarantine During COVID-19 Outbreak: Eating Behavior, Perceived Stress, and Their Independently Associated Factors in a Brazilian Sample. Front Nutr 2021; 8:704619. [PMID: 34381806 PMCID: PMC8349978 DOI: 10.3389/fnut.2021.704619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/24/2021] [Indexed: 12/29/2022] Open
Abstract
The study aimed to assess the eating behavior [uncontrolled eating (UE), emotional eating (EE), and cognitive restraint (CR)], the perceived stress, and independently associated factors among Brazilians during the COVID-19 pandemic. An online survey was conducted and data about 1,368 participants were evaluated. Multivariate logistic regression models were performed to identify factors independently associated (socioeconomic, lifestyle, and eating habits data) with eating behaviors and perceived stress. Working in the COVID-19 frontline (OR = 2.19), increased food delivery (OR = 1.49), increased food intake (OR = 1.48), increased number of meals (OR = 1.13), and EE (OR = 1.05) were factors independently associated with UE. Variables that were independently associated with EE were: increased food intake (OR = 2.57), graduation in a non-health-related course (OR = 1.78), perceived stress (OR = 1.08), UE (OR = 1.07), and CR (OR = 1.02). Reduced snacking (OR = 2.08), female gender (OR = 1.47), having a higher degree (OR = 1.44), increased homemade meals (OR = 1.31), the higher difference in the frequency of instant meals and snacks intake (OR = 0.91), EE (OR = 1.01), not increased alcohol dose intake (OR = 0.57), and increased physical activity (OR = 0.54) were independently associated with CR. Perceived stress was independently associated with changes in the way of working or studying (OR = 2.48), worse sleep quality (OR = 2.22), younger age (OR = 1.06), and EE (OR = 1.02). This study indicates that socioeconomic variables, lifestyle, and eating habits were independently associated with the eating behaviors of Brazilians and perceived stress during the quarantine.
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Affiliation(s)
| | - Lucilene Rezende Anastácio
- Graduate Program in Food Science, Food Science Department, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lívia Garcia Ferreira
- Graduate Program in Nutrition and Health, Universidade Federal de Lavras, Lavras, Brazil
| | - Lívya Alves Oliveira
- Graduate Program in Nutrition Science, Universidade Federal de Viçosa, Viçosa, Brazil
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Silva I, de Faria NC, Ferreira ÁRS, Anastácio LR, Ferreira LG. Risk factors for critical illness and death among adult Brazilians with COVID-19. Rev Soc Bras Med Trop 2021; 54:e0014 2021. [PMID: 33950121 PMCID: PMC8083890 DOI: 10.1590/0037-8682-0014-2021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 03/25/2021] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION Severe acute respiratory syndrome coronavirus 2 has infected more than 9,834,513 Brazilians up to February 2021. Knowledge of risk factors of coronavirus disease among Brazilians remains scarce, especially in the adult population. This study verified the risk factors for intensive care unit admission and mortality for coronavirus disease among 20-59-year-old Brazilians. METHODS A Brazilian database on respiratory illness was analyzed on October 9, 2020, to gather data on age, sex, ethnicity, education, housing area, and comorbidities (cardiovascular disease, diabetes, and obesity). Multivariate logistic regression analysis was performed to identify the risk factors for coronavirus disease. RESULTS Overall, 1,048,575 persons were tested for coronavirus disease; among them, 43,662 were admitted to the intensive care unit, and 34,704 patients died. Male sex (odds ratio=1.235 and 1.193), obesity (odds ratio=1.941 and 1.889), living in rural areas (odds ratio=0.855 and 1.337), and peri-urban areas (odds ratio=1.253 and 1.577) were predictors of intensive care unit admission and mortality, respectively. Cardiovascular disease (odds ratio=1.552) was a risk factor for intensive care unit admission. Indigenous people had reduced chances (odds ratio=0.724) for intensive care unit admission, and black, mixed, East Asian, and indigenous ethnicity (odds ratio=1.756, 1.564, 1.679, and 1.613, respectively) were risk factors for mortality. CONCLUSIONS Risk factors for intensive care unit admission and mortality among adult Brazilians were higher in men, obese individuals, and non-urban areas. Obesity was the strongest risk factor for intensive care unit admission and mortality.
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Affiliation(s)
- Isabela Silva
- Universidade Federal de Lavras, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Lavras, MG, Brasil
| | - Natália Cristina de Faria
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Alimentos, Programa de Pós-Graduação em Ciência de Alimentos, Belo Horizonte, MG, Brasil
| | - Álida Rosária Silva Ferreira
- Universidade Federal de Minas Gerais, Ciências Econômicas, Programa de Pós-Graduação em Demografia, Belo Horizonte, MG, Brasil
| | - Lucilene Rezende Anastácio
- Universidade Federal de Minas Gerais, Faculdade de Farmácia, Departamento de Alimentos, Programa de Pós-Graduação em Ciência de Alimentos, Belo Horizonte, MG, Brasil
| | - Lívia Garcia Ferreira
- Universidade Federal de Lavras, Departamento de Nutrição, Programa de Pós-Graduação em Nutrição e Saúde, Lavras, MG, Brasil
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Silva ARCS, Braga LVM, Anastácio LR. A comparison of four different Nutritional Profile models in their scoring of critical nutrient levels in food products targeted at Brazilian children. NUTR BULL 2021. [DOI: 10.1111/nbu.12490] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Dos Santos ALS, Anastácio LR. The impact of L-branched-chain amino acids and L-leucine on malnutrition, sarcopenia, and other outcomes in patients with chronic liver disease. Expert Rev Gastroenterol Hepatol 2021; 15:181-194. [PMID: 32993404 DOI: 10.1080/17474124.2021.1829470] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Metabolic and hormonal disorders resulting from chronic liver diseases culminate in increased proteolysis and decreased protein synthesis, which contributes to the development and progression of malnutrition and, consequently, sarcopenia. Nutritional management of sarcopenia in liver cirrhosis is a continuously evolving field and data on essential amino acid supplementation in chronic liver diseases is scarce. AREAS COVERED This review encompasses the current literature on oral amino acids supplementation in patients with chronic liver disease or patients with liver cirrhosis to try to elucidate the possible effects of L-branched-chain amino acids and isolated L-leucine as a therapeutic approach to malnutrition and sarcopenia. EXPERT COMMENTARY To ensure an optimal nutritional status and to reduce sarcopenia, it is necessary to assess nutritional status in all patients with liver cirrhosis and to apply nutritional interventions accordingly. The supply of calories, proteins, and essential amino acids is necessary for the maintenance of muscle mass and function. Although supplementation of L-branched-chain amino acids plays an important role in liver disease, L-leucine has been described as the main amino acid involved in protein turnover, reducing proteolysis, and stimulating protein synthesis.
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Affiliation(s)
- Ana Luiza Soares Dos Santos
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
| | - Lucilene Rezende Anastácio
- Food Science Post-Graduation Program, Pharmacy School, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
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Santos BC, Correia MITD, Anastácio LR. Energy Expenditure and Liver Transplantation: What We Know and Where We Are. JPEN J Parenter Enteral Nutr 2020; 45:456-464. [DOI: 10.1002/jpen.1985] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 12/17/2022]
Affiliation(s)
- Bárbara Chaves Santos
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Maria Isabel Toulson Davisson Correia
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Brazil
- Surgery Department Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Lucilene Rezende Anastácio
- Food Science Post Graduation Program Universidade Federal de Minas Gerais Belo Horizonte Brazil
- Food Science Department Universidade Federal de Minas Gerais Belo Horizonte Brazil
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Ferreira SC, de Oliveira Penaforte FR, Cardoso A, da Silva MVT, Lima AS, Correia MITD, Anastácio LR. Association of food cravings with weight gain, overweight, and obesity in patients after liver transplantation. Nutrition 2019; 69:110573. [PMID: 31585257 DOI: 10.1016/j.nut.2019.110573] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Revised: 08/13/2019] [Accepted: 08/18/2019] [Indexed: 11/17/2022]
Abstract
OBJECTIVE After liver transplantation (LTx), patients often gain weight and many become overweight or obese; however, the association between LTx and food craving (FC) is unknown. The aim of this study was to describe FC among patients after LTx and verify its association with weight gain and obesity. METHODS This was a cross-sectional study that assessed 301 patients who underwent LTx (55.1 ± 12.7 y of age; time since LTx 6.6 ± 4.4 y; 64.1% men). Pregnant or nursing women were excluded. Patients were interviewed once either in the outpatient clinic or by completing the online questionnaire, from August 2016 to February 2017. RESULTS The median weight variation after Ltx was 8 kg (ranging from -16 to +41 kg). At evaluation, 62.5% (n = 188) of the patients presented excessive weight and 22.3% (n = 67) presented with obesity. The average score on the Food Craving Questionnaire-State (FCQ-S) was 33.4 ± 9 and for the Food Craving Questionnaire-Trait (FCQ-T) the median score was 68 (39-163). The FCQ-T dimensions of lack of control, preoccupation, emotion, environmental triggers/stimuli, and guilt correlated positively with weight gain (P < 0.05). The desire dimension on the FCQ-S was significantly associated with overweight in post-LTx patients (P < 0.05) and the FCQ-T dimensions [negative reinforcement (P = 0.013), lack of control (P = 0.016), emotion (P = 0.009), environmental triggers/stimuli (P = 0.029), and guilt (P = 0.007)] were associated with obesity. CONCLUSION Lack of control, preoccupation, emotion, trigger, and guilt were positively correlated with weight gain. Desire was significantly associated with overweight. Negative reinforcement, lack of control, emotion, environmental triggers/stimuli, and guilt were associated with obesity.
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Affiliation(s)
- Samanta Catherine Ferreira
- Food Science Post Graduation Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Amanda Cardoso
- Nutrition Course, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Agnaldo Silva Lima
- Surgery Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | | | - Lucilene Rezende Anastácio
- Food Science Post Graduation Program, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil; Food Science Department, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
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Anastácio LR, Ferreira LG, Ribeiro HS, Diniz KGD, Lima AS, Correia MITD, Vilela EG. SARCOPENIA, OBESITY AND SARCOPENIC OBESITY IN LIVER TRANSPLANTATION: A BODY COMPOSITION PROSPECTIVE STUDY. Arq Bras Cir Dig 2019; 32:e1434. [PMID: 31038559 PMCID: PMC6488274 DOI: 10.1590/0102-672020190001e1434] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 01/17/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Sarcopenia is prevalent before liver transplantation, and it is considered to be a risk factor for morbidity/mortality. After liver transplantation, some authors suggest that sarcopenia remains, and as patients gain weight as fat, they reach sarcopenic obesity status. AIM Prospectively to assess changes in body composition, prevalence and associated factors with respect to sarcopenia, obesity and sarcopenic obesity after transplantation. METHODS Patients were evaluated at two different times for body composition, 4.0±3.2y and 7.6±3.1y after transplantation. Body composition data were obtained using bioelectrical impedance. The fat-free mass index and fat mass index were calculated, and the patients were classified into the following categories: sarcopenic; obesity; sarcopenic obesity. RESULTS A total of 100 patients were evaluated (52.6±13.3years; 57.0% male). The fat-free mass index decreased (17.9±2.5 to 17.5±3.5 kg/m2), fat mass index increased (8.5±3.5 to 9.0±4.0; p<0.05), prevalence of sarcopenia (19.0 to 22.0%), obesity (32.0 to 37.0%) and sarcopenic obesity (0 to 2.0%) also increased, although not significantly. The female gender was associated with sarcopenia. CONCLUSION The fat increased over the years after surgery and the lean mass decreased, although not significantly. Sarcopenia and obesity were present after transplantation; however, sarcopenic obesity was not a reality observed in these patients.
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Affiliation(s)
| | - Lívia Garcia Ferreira
- Nutrition and Health Post-Graduation Program, Universidade Federal de Lavras, Lavras, MG
| | - Helem Sena Ribeiro
- Instituto de Ensino e Pesquisa, Santa Casa de Belo Horizonte, Belo Horizonte,MG
| | - Kiara Gonçalves Dias Diniz
- Adult Health Post-Graduation Program, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG
| | - Agnaldo Soares Lima
- Surgery Post-Graduation Program, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
| | | | - Eduardo Garcia Vilela
- Surgery Post-Graduation Program, Faculty of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, MG Brazil
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Penaforte FRDO, Minelli MCS, Anastácio LR, Japur CC. Anxiety symptoms and emotional eating are independently associated with sweet craving in young adults. Psychiatry Res 2019; 271:715-720. [PMID: 30791346 DOI: 10.1016/j.psychres.2018.11.070] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 11/19/2018] [Accepted: 11/30/2018] [Indexed: 12/12/2022]
Abstract
Sweet craving (SC), defined as a strong desire for sweet foods, seems to be closely related to negative emotions, such as anxiety and unhealthy eating behaviors. The objective was to investigate factors that are associated with SC and to assess the relationships among SC, anxiety symptoms, and eating behavior in university students. This was a cross-sectional study involving 300 students of both sexes (20.5 ± 4.4 years) who were freshmen in a Brazilian public university. Eating behavior was evaluated using the Three Factor Eating Questionnaire, anxiety symptoms were assessed using the Beck Anxiety Inventory, SC was identified by a yes/no question ("Have you had a very strong desire to eat sweet food over the last three months?"), and characterized by the Questionnaire for Assessment of Sweet Substance Dependence. Individuals with SC scored significantly higher for uncontrolled eating (UE), emotional eating (EE), and anxiety symptoms. Logistic regression analysis revealed that anxiety symptoms are independently associated with SC. In conclusion, negative emotions, like anxiety, and eating guided by these emotions can contribute to the SC phenomenon.
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Affiliation(s)
- Fernanda Rodrigues de Oliveira Penaforte
- Department of Nutrition/PostGraduate Program in Psychology, Universidade Federal do Trângulo Mineiro, Av. Frei Paulino, 30. Bairro Abadia, CEP 38025-180 Uberaba, MG, Brazil; Laboratory of Eating Practices and Behavior (PratiCA), Universidade de São Paulo, Av. Bandeirantes, 3900. Bairro Monte Alegre, CEP 14049-900 Ribeirão Preto, SP, Brazil.
| | - Maria Clara Santos Minelli
- Department of Nutrition/PostGraduate Program in Psychology, Universidade Federal do Trângulo Mineiro, Av. Frei Paulino, 30. Bairro Abadia, CEP 38025-180 Uberaba, MG, Brazil.
| | - Lucilene Rezende Anastácio
- Department of Food Sciences, Faculty of Pharmacy, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627. Campus Pampulha, CEP 31270-901 Belo Horizonte, MG, Brazil.
| | - Camila Cremonezi Japur
- Division of Nutrition and Metabolism, Department of Health Sciences. Ribeirão Preto Medical Scholl. Universidade de São Paulo. Av. Bandeirantes, 3900. Bairro Monte Alegre, CEP 14049-900 Ribeirão Preto, SP, Brazil; Laboratory of Eating Practices and Behavior (PratiCA), Universidade de São Paulo, Av. Bandeirantes, 3900. Bairro Monte Alegre, CEP 14049-900 Ribeirão Preto, SP, Brazil.
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Abstract
PURPOSE OF REVIEW Nutritional status of patients after liver transplantation is affected by dietary intake and this, in turn, is affected by eating behavior. The present review will highlight recent studies on these topics after liver transplantation. RECENT FINDINGS Malnutrition drops significantly after liver transplantation. Recovery of weight lost during liver disease occurs within 1 year. Liver transplantation recipients gain weight up to the second or third year, often becoming overweight and obese. Muscle mass may not recover completely, and sarcopenia could increase within 1 year after liver transplantation. Some studies, but not all, demonstrated modifications of food intake before and after liver transplantation. A positive energy balance was found in the first year, and a greater energy intake along time after liver transplantation, although some authors mentioned potential underreporting of the true consumption, mainly among people overweight/obese. Dietary survey methods are unable to detect eating behavior, resulting in a lack of data. Weight gain and obesity were related to higher scores for patterns of eating behaviors after liver transplantation. Food deprivation in the pretransplantation period and psychological factors could affect eating behavior and consequently food intake and nutritional status of liver transplantation patients. SUMMARY Understanding eating behavior after liver transplantation could be key knowledge regarding dietary intake and its impact on nutritional modifications occurring after liver transplantation.
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Affiliation(s)
- Lucilene Rezende Anastácio
- Post-Graduation Program of Food Science, Food Science Department, Pharmacy School, Universidade Federal de Minas Gerais, Brazil
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Ribeiro HS, Oliveira MC, Anastácio LR, Generoso SV, Lima AS, Correia MI. PREVALENCE AND RISK FACTORS OF HYPERKALEMIA AFTER LIVER TRANSPLANTATION. ACTA ACUST UNITED AC 2018; 31:e1357. [PMID: 29947691 PMCID: PMC6050000 DOI: 10.1590/0102-672020180001e1357] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 02/08/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND There is a lack of data regarding hyperkalemia after liver transplantation. AIM To evaluate the prevalence of hyperkalemia after liver transplantation and its associated factors. METHODS This retrospective cohort study evaluated 147 consecutive post-transplant patients who had at least one year of outpatient medical follow up. The data collection included gender, age, potassium values, urea, creatinine, sodium and medication use at 1, 6 and 12 months after. Hyperkalemia was defined as serum potassium concentrations higher than 5.5 mEq/l. RESULTS Hiperkalemia was observed in 18.4%, 17.0% and 6.1% of patients 1, 6 and 12 months after tranplantation, respectively. Older age (p=0.021), low creatinine clearance (p=0.007), increased urea (p=0.010) and hypernatremia (p=0.014) were factors associated with hyperkalemia, as well as the dose of prednisone at six months (p=0.014). CONCLUSION Hyperkalemia was prevalent in less than 20% of patients in the 1st month after liver transplantation and decreased over time. Considering that hyperkalemia does not affect all patients, attention should be paid to the routine potassium intake recommendations, and treatment should be individualized.
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Affiliation(s)
- Helem Sena Ribeiro
- Postgraduate Program in Applied Sciences for Surgery, Faculty of Medicine
| | | | | | | | - Agnaldo Soares Lima
- Hospital das Clínicas, Alpha Institute of Gastroenterology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maria Isabel Correia
- Hospital das Clínicas, Alpha Institute of Gastroenterology, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Anastácio LR, de Oliveira MC, Diniz KG, Ferreira AMV, Lima AS, Correia MITD, Vilela EG. Adipokines, inflammatory mediators, and insulin-resistance parameters may not be good markers of metabolic syndrome after liver transplant. Nutrition 2015; 32:921-7. [PMID: 27189907 DOI: 10.1016/j.nut.2015.12.038] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Revised: 12/21/2015] [Accepted: 12/27/2015] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The role of adipokines in liver transplantation (LTx) recipients who have metabolic syndrome (MetS) has seldom been assessed. The aim of this study was to investigate the concentrations of adipokines, inflammatory mediators, and insulin-resistance markers in liver recipients with MetS and its components. METHODS Serum samples from 34 patients (55.9% male; 54.9 ± 13.9 y; 7.7 ± 2.9 y after LTx; 50% presented with MetS) were assessed for adiponectin, resistin, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1, interleukin (IL)-6, C-reactive protein (CRP), homeostatic model assessment-insulin resistance (HOMA-IR) and free fatty acid (FFA) levels. The dosages were uni- and multivariate analyzed to cover MetS (using the Harmonizing MetS criteria), its components, and dietary intake. RESULTS A higher concentration of adiponectin (P < 0.05) was observed among patients with MetS (5.2 ± 3.2 μg/mL) compared with those without MetS (3.2 ± 1.2 μg/mL), as well as those with MetS components versus those without them: abdominal obesity (4.6 ± 2.6 μg/mL versus 2.6 ± 0.6 μg/mL), high triacylglycerols (TGs; 5.6 ± 3.1 μg/mL versus 3 ± 0.9 μg/mL) and low high-density lipoprotein (HDL; 6.1 ± 2.7 μg/mL versus 3.3 ± 1.9 μg/mL). Increased TNF-α and HOMA-IR values were seen in patients with abdominal obesity. Patients with high TGs also had greater FFA values. Independent predictors for adiponectin were waist-to-hip ratio, low HDL and high TGs. High TGs and fasting blood glucose were independent predictors for HOMA-IR. Independent predictors could not be identified for CRP, TNF-α, MCP-1, IL-6, or FFA. CONCLUSIONS MetS and its components are related to an increased HOMA-IR concentration and FFA. Adiponectin, resistin, and inflammatory markers, such as TNF-α, IL-6, MCP-1, and CRP, were not associated with MetS in this sample of post-LTx patients.
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Affiliation(s)
| | | | - Kiara Gonçalves Diniz
- Nutrition Department, Universidade Federal do Triângulo Mineiro, Minas Gerais, Brazil
| | | | - Agnaldo Soares Lima
- Alpha Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Maria Isabel Toulson Davisson Correia
- Alpha Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Minas Gerais, Brazil; Surgery Post Graduation Program, Medical School, Universidade Federal de Minas Gerais, Minas Gerais, Brazil
| | - Eduardo Garcia Vilela
- Alpha Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Minas Gerais, Brazil; Internal Medicine Department, Faculty of Medicine, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.
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Ribeiro HDS, Anastácio LR, Ferreira LG, Lagares EB, Lima AS, Correia MITD. Prevalence and factors associated with dyslipidemia after liver transplantation. Rev Assoc Med Bras (1992) 2015; 60:365-72. [PMID: 25211421 DOI: 10.1590/1806-9282.60.04.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Accepted: 01/13/2014] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE to determine the prevalence of abnormal total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein (HDL) and triglycerides in patients undergoing liver transplantation (LTx) and to identify predictors of these disorders. METHODS cross-sectional study to assess the prevalence of dyslipidemia in patients undergoing LTx. Demographic, socioeconomic, clinical, anthropometric and dietetic data were collected to determine the association with dyslipidemia using univariate and multivariate statistical analysis. RESULTS 136 patients were evaluated, 68.1% of which had at least one type of dyslipidemia. The triglyceride level was high in 32.4% of cases, with low HDL in 49.3% of patients and high LDL levels in only 8.8%. High total cholesterol was observed in 16.2% of the study population and was associated with the recommendation for transplantation due to ethanolic cirrhosis (OR = 2.7) and a greater number of hours slept per night (OR = 1.5). CONCLUSION many patients presented dyslipidemia after transplantation, demonstrating the need for interventions in relation to modifiable factors associated with dyslipidemias that can mitigate or prevent these disorders.
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Affiliation(s)
- Hélem de Sena Ribeiro
- Postgraduate Program in Food Science, Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucilene Rezende Anastácio
- Postgraduate Program in Adult Health, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lívia Garcia Ferreira
- Postgraduate Program in Sciences applied to Surgery and Ophthalmology, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Agnaldo Soares Lima
- Alfa Institute of Gastroenterology, Hospital das Clínicas, Faculty of Medicine, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
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Anastácio LR, Ribeiro HDS, Ferreira LG, Lima AS, Vilela EG, Toulson Davisson Correia MI. Incidence and risk factors for diabetes, hypertension and obesity after liver transplantation. NUTR HOSP 2014; 28:643-8. [PMID: 23848083 DOI: 10.3305/nh.2013.28.3.6193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
AIM Metabolic disorders are widely described in patients after liver transplantation (LTx). MATERIAL AND METHODS Arterial hypertension, diabetes mellitus and obesity incidence and risk factors were assessed in 144 post-LTx patients at least one year after transplantation (59% male; median age 54 y; median time since transplantation 4 y). Risk factors were assessed using logistic regression analysis according to demographic, socioeconomic, lifestyle, clinical, anthropometric and dietetic variables. RESULTS The incidence of hypertension was 18.9%; diabetes, 14.0% and obesity, 15.9%. Risk factors for the incidence of hypertension were abdominal obesity (OR: 2.36; CI: 1.02-5.43), family history of hypertension (OR: 2.75; CI: 1.06-7.19) and cyclosporine use (OR: 3.92; CI: 1.05-14.70). Risk factor for incidence of diabetes were greater fasting glucose levels (mg/dL) pre-LTx (OR: 1.04; CI: 1.01-1.06) and on the diagnosis of alcoholic cirrhosis as an indication of LTx (OR: 2.54; CI: 0.84-7.72). The incidence of obesity after LTx was related to lower milk consumption (mL) (OR: 1.01; CI: 1.001-1.01; P < 0.05), greater donor BMI (kg/m(2)) (OR: 1.34; CI: 1.04-1.74; P < 0.05), greater BMI prior to liver disease (kg/m(2)) (OR: 1.79; CI: 1.36-2.36; P < 0.01) and a per capita income twice the minimum wage (OR: 5.71; CI: 4.51-6.86; P < 0.05). CONCLUSION LTx was associated with significantly increased rates of hypertension, diabetes and obesity. Furthermore, the incidences of these disorders were related to immunosuppressive therapy and have risk factors that are common in the general population.
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Affiliation(s)
- Lucilene Rezende Anastácio
- Adult Health Post Graduate Program, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
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Ferreira LG, Anastácio LR, Lima AS, Touslon Davisson Correia MI. Predictors of mortality in patients on the waiting list for liver transplantation. NUTR HOSP 2014; 28:914-9. [PMID: 23848119 DOI: 10.3305/nh.2013.28.3.6333] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND AND AIM The demand for liver transplantation (LTx) increases every year, which is in contrast to the stagnation in the number of donors. This phenomenon has given rise to longer waiting times, which results in higher pre-transplantation mortality. Thus, our aim for this study was to identify risk factors, including nutritional variables, for mortality for patients who are on the waiting list for LTx. METHODS Patients on the waiting list were assessed to identify risk factors for mortality. Data related to demographic, socioeconomic, and etiologic factors, liver disease severity, complications, medications, and biochemical tests related to disease, nutritional status, diet intake, and physical activity were collected. RESULTS There were 159 patients followed, and 47.8% (76) were transplanted. The mortality rate while on the waiting list was 25.7% patient-years, and 40 patients died (28.0%). Variables associated with mortality during this period (p < 0.05) were the following: severe malnutrition (OR 2.5/CI: 1.2-5.3), low serum sodium values (OR: 1.1/CI: 1.01-1.2), and cryptogenic cirrhosis (OR: 2.2/CI: 1.1-4.6). CONCLUSIONS Special attention should be given to patients with low serum sodium, those who are diagnosed with cryptogenic cirrhosis and the severely malnourished. An early diagnosis of malnutrition and an appropriate nutritional intervention is mandatory in such patients.
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Affiliation(s)
- Lívia Garcia Ferreira
- Surgery Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Brazil.
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Ferreira LG, Ferreira Martins AI, Cunha CE, Anastácio LR, Lima AS, Correia MITD. Negative energy balance secondary to inadequate dietary intake of patients on the waiting list for liver transplantation. Nutrition 2014; 29:1252-8. [PMID: 24012087 DOI: 10.1016/j.nut.2013.04.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 04/04/2013] [Accepted: 04/07/2013] [Indexed: 02/08/2023]
Abstract
OBJECTIVES The aim of this study was to evaluate the energy balance (EB) of patients on the waiting list for liver transplantation, using total energy expenditure (TEE) assessment and total caloric intake (TCI). METHODS We analyzed nutrient adequacy and factors associated with it. EB was obtained by subtracting the TCI (obtained by 3-d food record) from TEE, which was measured as resting energy expenditure and physical activity factor calculation. Socioeconomic and clinical data also were evaluated. Univariate and multiple linear regressions were used (P < 0.05). Seventy-three patients were included. RESULTS The TEE was 2318.5 kcal, and the TCI was 1485.1 kcal, with 81.6% of patients presenting with negative EB. There was no significant association between TCI and socioeconomic variables, medications, and encephalopathy (P > 0.05). Women, less-educated patients, those with ascites, and those who were malnourished presented with lower TCI (P < 0.05). Severity of disease, by Child-Pugh and Model for End-Stage Liver Disease scores were associated with EB (P < 0.05). Child-Pugh remained significant after multivariate analyses. Energy inadequacy was observed in 91.8% of patients, and protein inadequacy in 72.6% of patients. Polyunsaturated fatty acid (64.4%) and monounsaturated fatty acid (91.8%) and fiber (94.5%) inadequacies also were high. The percentage of adequate intake was less than 10% for vitamins B5 and D, calcium, folic acid, and potassium, and higher percentages of adequate intake (>80%) were found for iron and vitamins B1 and B12. Moreover, 54.8% and 16.4% of the patients had excessive sodium and cholesterol intakes, respectively. CONCLUSION Negative EB was highly prevalent among patients on the waiting list for liver transplantation, and was associated with the severity of liver disease. Negative EB was primarily affected by low food intake. The food intake data were characterized by low overall energy and protein intake and inadequate composition of the patient's diet plan, which tended to be characterized by specific nutrient deficiencies and excesses.
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Affiliation(s)
- Lívia Garcia Ferreira
- Surgery Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, MG, Brazil.
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Anastácio LR, Pereira MCDA, Vilela EG, Lima AS, Correia MITD. Overweight in liver transplant recipients. Rev Col Bras Cir 2014; 40:502-7. [PMID: 24573630 DOI: 10.1590/s0100-69912013000600014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/25/2012] [Indexed: 12/31/2022] Open
Abstract
This review aims to describe the incidence and prevalence of overweight and obesity after liver transplantation and the consequences associated with it. Literature review consultation was conducted in Medline / PubMed, SciELO, EMBASE and LILACS, with the combination of the following keywords: liver transplantation, overweight, obesity, weight gain. Overweight is incident on more than 60% of patients undergoing liver transplantation and obesity rates exceed 20% in the first year after surgery, during which occurs the largest relative weight gain. Studies have shown that between 60% and 70% of patients undergoing liver transplantation are overweight after the third year, 90% with abdominal obesity. Associated factors are, among others, advanced age, family history of overweight and excess weight prior to liver disease. The contribution of immunosuppressive medication remains controversial. Some of the consequences of overweight are liver steatosis, steatohepatitis, diabetes mellitus, hypertension, dyslipidemia, cardiovascular disease and death.
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Ferreira LG, Santos LF, Silva TRND, Anastácio LR, Lima AS, Correia MITD. Hyper- and hypometabolism are not related to nutritional status of patients on the waiting list for liver transplantation. Clin Nutr 2013; 33:754-60. [PMID: 24238850 DOI: 10.1016/j.clnu.2013.10.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2013] [Revised: 10/18/2013] [Accepted: 10/25/2013] [Indexed: 12/28/2022]
Abstract
BACKGROUND & AIMS Metabolic disorders and malnutrition are well known conditions reported in patients with liver disease (LD), but the relationship between them are underexplored. So, the aim of this study was to assess the resting energy expenditure (REE) of these patients, identifying the prevalence of hyper- and hypometabolism. In addition, to evaluate whether malnutrition and clinical variables were associated with REE and metabolic disorders. METHODS The REE was measured by indirect calorimetry and predicted by the Harris and Benedict formula (REEHB). Nutritional status was assessed by different methods. The etiology, severity and complications of LD were also evaluated. RESULTS A total of 81 patients were assessed. The measured REE was 1587.5 ± 426.6 kcal. The REE was overestimated by the REEHB (REE:REEHB <0.8) in 7.4% and underestimated (REE:REEHB >1.2) in 24.7% of the patients. The REE was lower in malnourished patients (p < 0.05). However, hyper- and hypometabolism were not associated with nutritional status (p > 0.05). The REE and hypermetabolism were not associated with LD, but hypometabolic patients had a higher prevalence of Child C, and had higher values for MELD, INR and total bilirubin (p < 0.05). After multiple regression analyses, the REE was significantly associated (p < 0.05) with intracellular body water, arm muscle area and serum glucose. Serum glucose was only significantly associated (p < 0.05) with hypermetabolism, and INR with hypometabolism. CONCLUSION Changes in resting metabolism are present but not universal. The hypermetabolism was associated with extrahepatic factors, and hypometabolism with the severity of LD. Under these conditions in the clinical setting, calculated energy requirements using the HB formula should be adjusted.
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Affiliation(s)
- Lívia Garcia Ferreira
- Surgery Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Brazil.
| | | | | | | | - Agnaldo Soares Lima
- Surgery Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Brazil; Alfa Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Brazil
| | - Maria Isabel Toulson Davisson Correia
- Surgery Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Brazil; Alfa Institute of Gastroenterology, Hospital of Clinics, Medical School, Universidade Federal de Minas Gerais, Brazil
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Lagares ÉB, Santos KDF, Mendes RC, Moreira FA, Anastácio LR. Excesso de Peso em Mulheres com Diagnóstico de Câncer de Mama em Hormonioterapia com Tamoxifeno. Rev Bras Cancerol 2013. [DOI: 10.32635/2176-9745.rbc.2013v59n2.525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Introdução: O ganho de peso excessivo é frequentemente relatado em pacientes com câncer de mama em hormonioterapia com tamoxifeno. Objetivos: Descrever a prevalência de excesso de peso em mulheres submetidas à hormonioterapia com tamoxifeno e fatores associados. Método: Trata-se de estudo descritivo e transversal realizado em mulheres com diagnóstico de câncer de mama submetidas à hormonioterapia com tamoxifeno. Foram coletadas informações referentes ao estado nutricional usando parâmetros antropométricos como Índice de Massa Corporal (IMC), circunferência da cintura e percentual de gordura corporal pela bioimpedanciometria. Características demográficas, socioeconômicas, estilo de vida e variáveis clínicas (peso, estatura, circunferência de cintura, dobras cutâneas e pressão arterial) e dietéticas (recordatório 24 horas) foram coletadas. Resultados: Foram avaliadas 24 pacientes na faixa etária de 36 a 73 anos, com tempo medio de uso do tamoxifeno de 16,6 meses (variando de 4 a 60 meses). Considerando-se a classificação de IMC, 52,4% (n=10) das pacientes foram diagnosticadas com sobrepeso, 45,8% (n=11) com obesidade e 1,8% (n=3) com eutrofia. Quanto ao percentual de gordura corporal, duas (8,3%) possuíam sobrepeso e 22 (91,7%), obesidade. Além disso, 87,5% (n=21) foram classificadas como tendo algum grau de obesidade abdominal. Conclusão: Houve predomínio de sobrepeso e obesidade nas mulheres em hormonioterapia com tamoxifeno avaliadas. Assim, as pacientes, principalmente aquelas que ja apresentam histórico de excesso de peso, devem receber orientações nutricionais, desde o início da hormonioterapia, que promovam a manutenção do peso saudável, e devem ser estimuladas a se engajar em programas de mudanças no estilo de vida.
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Liboredo JC, Anastácio LR, Pelúzio MDCG, Valente FX, Penido LCP, Nicoli JR, Correia MITD. Effect of probiotics on the development of dimethylhydrazine-induced preneoplastic lesions in the mice colon. Acta Cir Bras 2013; 28:367-72. [DOI: 10.1590/s0102-86502013000500008] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2013] [Accepted: 04/16/2013] [Indexed: 01/01/2023] Open
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Anastácio LR, Ferreira LG, Ribeiro HDS, Lima AS, Vilela EG, Correia MITD. Weight loss during cirrhosis is related to the etiology of liver disease. Arq Gastroenterol 2013; 49:195-8. [PMID: 23011241 DOI: 10.1590/s0004-28032012000300005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 03/26/2012] [Indexed: 11/22/2022]
Abstract
CONTEXT Malnutrition is widely described in patients waiting for liver transplantation (LTx). However, risk factors associated with weight loss during liver disease have not yet been well studied. OBJECTIVES The aim of this study was to assess weight loss and its risk factors during liver disease and up to the first appointment after transplantation. Patients who underwent LTx were retrospectively assessed for weight loss during liver disease while on the waiting list for LTx. The usual weight of the patients before disease and their weight on the first outpatient appointment after transplant were considered. Demographic, socioeconomic, lifestyle and clinical variables were collected to assess risk factors using a linear regression analysis. We retrospectively evaluated 163 patients undergoing LTx between 1997 and 2008. RESULTS Patients lost in average 7.7 ± 12.4 kg while ill. Variables independently associated with weight loss by multiple linear regression analyses were as follows: former smoker (P = 0.03), greater body mass index (P<0.01), overweight before liver disease (P = 0.02) and indication for LTx (P = 0.01). Among these indications, patients with alcoholic cirrhosis had lost significantly more weight (P<0.01), and those with hepatitis C virus (P = 0.01) and autoimmune hepatitis (P = 0.02) had lost significantly less weight. CONCLUSIONS Patients experienced weight loss during liver disease independent of age, sex, schooling and income; however, the etiology of liver disease was related to weight loss.
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Affiliation(s)
- Lucilene Rezende Anastácio
- Adult Health Post-Graduate Program, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil.
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Fantuzzi E, Anastácio LR, Nicoli JR, de Paula SO, Arantes RME, Vanetti MCD. Evaluation of Royal Sun Agaricus, Agaricus brasiliensis S. Wasser et al., aqueous extract in mice challenged with Salmonella enterica serovar Typhimurium. Int J Med Mushrooms 2012; 13:281-8. [PMID: 22135880 DOI: 10.1615/intjmedmushr.v13.i3.80] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study investigated the effects of Agaricus brasiliensis S. Wasser et al. (=Agaricus blazei Murrill sensu Heinem.) aqueous extract on small intestinal sIgA levels, serum TNF-alpha, IFN-gamma and IL-10 levels, splenic index, bacterial translocation, and histology of small intestine, spleen, and liver from mice orally challenged with 10(6) CFU of Salmonella enterica serovar Typhimurium (SEST). Splenic index values as well as sIgA, TNF-alpha, IFN-gamma, and IL-10 levels were not affected by either A. brasiliensis aqueous extract treatment or by pathogenic challenge. Typical colonies of SEST were recovered from liver, spleen, and mesenteric lymph nodes of challenged animals, but there was no significant difference in this translocation between groups treated or not with A. brasiliensis aqueous extract. Translocation was confirmed by histopathological analysis in mice challenged with SEST, which showed small and diffuse foci of mixed inflammatory infiltrate in hepatic parenchyma. In conclusion, A. brasiliensis aqueous extract as tested in the present study did not influence any of the variables selected to evaluate in vivo its immunomodulatory effect suggested in the literature.
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Affiliation(s)
- Elisabete Fantuzzi
- Departamento de Produção Vegetal, Centro de Ciências Agrárias, Universidade Federal do Espírito Santo, ES, Brasil.
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de Sena Ribeiro H, Anastácio LR, Ferreira LG, Soares Lima A, Toulson Davisson Correia MI. Cardiovascular risk in patients submitted to liver transplantation. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1016/s0104-4230(12)70206-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Sena Ribeiro HD, Anastácio LR, Ferreira LG, Lima AS, Davisson Correia MIT. Risco cardiovascular em pacientes submetidos ao transplante hepático. Rev Assoc Med Bras (1992) 2012. [DOI: 10.1590/s0104-42302012000300016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Ribeiro HDS, Anastácio LR, Ferreira LG, Lima AS, Correia MITD. Cardiovascular risk in patients submitted to liver transplantation. Rev Assoc Med Bras (1992) 2012; 58:348-354. [PMID: 22735228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 01/13/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine the prevalence of cardiovascular risk in patients undergoing liver transplantation according to the Framingham score, and to evaluate possible associations with traditional and non-traditional risk factors. METHODS Cross-sectional study in which patients undergoing liver transplantation were stratified by cardiovascular risk according to the Framingham score. Demographic, socioeconomic, clinical, and anthropometric variables were collected to assess the association with cardiovascular risk factors using univariate and multivariate statistical analyses. RESULTS A total of 115 patients were evaluated, of which 46.1% showed medium or high risk for the occurrence of cardiovascular events over ten years. The mean percentage risk of evaluated patients was of 9.5 ± 7.8%. Male gender (OR: 4.97; CI: 1.92-12.85; p < 0.01), older age (OR: 1,09; CI: 1.04-1.13; p < 0.01), and higher BMI at the moment of assessment (1.09; CI: 0.99-1.20; p = 0.03) were factors associated with medium and high cardiovascular risk. A higher percentage of cardiovascular risk was also associated with cyclosporine use (p = 0.01). CONCLUSION The probability of occurrence of cardiovascular events in the assessed patients undergoing liver transplantation was higher than that in the Brazilian population. Special attention should be paid to this population, especially in relation to potentially modifiable factors associated to higher BMI and cyclosporine use.
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Anastácio LR, Ferreira LG, Ribeiro HDS, Liboredo JC, Lima AS, Correia MITD. Metabolic syndrome after liver transplantation: prevalence and predictive factors. Nutrition 2011; 27:931-7. [PMID: 21621388 DOI: 10.1016/j.nut.2010.12.017] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Revised: 12/17/2010] [Accepted: 12/20/2010] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Metabolic syndrome (MetS) is a disorder in which obesity, insulin resistance, high blood pressure and dyslipidemia coexist. This study assessed the prevalence of MetS and its associated factors in patients who underwent orthotopic liver transplantation (OLTx). METHODS Post-OLTx patients were assessed for the presence of MetS according to the diagnostic criteria proposed by the International Diabetes Federation (IDF) and National Heart, Lung, and Blood Institute/American Heart Association (NHLBI/AHA). Demographic, socioeconomic, lifestyle, clinical, anthropometric, and dietary variables were collected to identify predictors for MetS using logistic regression analysis. RESULTS Among the 148 patients assessed, the prevalence of MetS was 50% (IDF criteria) and 38.5% (NHLBI/AHA criteria). For both the IDF and the NHLBI/AHA classifications, the independent factors associated with MetS were older age, shorter time since transplantation, and history of excessive weight prior to OLTx. Other predictors for MetS by IDF criteria were alcohol abuse as the indication for OLTx, physical activity reduction as the cause of weight gain after transplantation, and calcium intake below recommended levels. The presence of MetS (NHLBI/AHA) was also associated with decreased intake of potassium, fiber, and folic acid. CONCLUSIONS MetS is highly prevalent among post-OLTx patients and it is predicted by older age, shorter time since transplantation, alcohol abuse as the cause of cirrhosis, excessive weight prior to OLTx, and some potentially modifiable factors such as physical activity reduction after OLTx and low intake of calcium, potassium, fiber, and folic acid.
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Affiliation(s)
- Lucilene Rezende Anastácio
- Adult Health Postgraduate Program, Medical School, Universidade Federal de Minas Gerais, Itauna, Minas Gerais, Brazil.
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Ferreira LG, Anastácio LR, Lima AS, Correia MITD. [Malnutrition and inadequate food intake of patients in the waiting list for liver transplant]. Rev Assoc Med Bras (1992) 2010; 55:389-93. [PMID: 19750303 DOI: 10.1590/s0104-42302009000400011] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 02/03/2009] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE Nutritional status of patients in the waiting list for liver transplant must be assessed due to the many risk factors associated with nutritional deficiencies. This was the aim of the study. METHODS Throughout a period of 13 months, patients on the waiting list for liver transplantation were nutritionally assessed by the Subjective Global Assessment (SGA) and food intake was assessed by using the 24 hour recall instrument. RESULTS 159 patients were included, mean age 50.5 +10.6 years and 71.1% were men. Overall malnutrition according to SGA was 74.7%, with 28% of patients considered severely malnourished. Malnutrition was associated with Child-Pugh score, presence of ascites and/or edema, previous episodes of encephalopathy and use of three or more medications and lower levels of physical activity. Socio-economic aspects, etiology of the disease and MELD score did not affect the nutritional status (p = NS). Calorie needs were not reached by 90.7% of patients and 75.7% of them did not reach protein requirements. CONCLUSIONS In conclusion, malnutrition is highly prevalent amongst patients on the waiting list for liver transplantation and most do not meet nutritional requirements which certainly contribute to the vicious cycle leading to a deranged nutritional status.
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Affiliation(s)
- Lívia Garcia Ferreira
- Faculdade de Farmácia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Liboredo JC, Anastácio LR, Mattos LV, Nicoli JR, Toulson Davisson Correia MI. Impact of probiotic supplementation on mortality of induced 1,2-dimethylhydrazine carcinogenesis in a mouse model. Nutrition 2010; 26:779-83. [DOI: 10.1016/j.nut.2010.01.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 01/05/2010] [Accepted: 01/09/2010] [Indexed: 01/01/2023]
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