The action of phytochemicals present in cocoa in the prevention of vascular dysfunction and atherosclerosis

BACKGROUND

Chronic non-communicable diseases, including cardiovascular diseases (CVDs), have caused many deaths worldwide. Atherosclerotic plaque formation is common in individuals with CVDs. Thus, antioxidant and anti-inflammatory nutritional strategies can be used to prevent or inhibit this process. Due to its higher concentrations of cocoa, dark chocolate is considered a functional food due to the presence and action of phytochemical compounds, with anti-inflammatory and antioxidant actions. However, the recommended amounts of these compounds to prevent atherosclerosis have not yet been fully elucidated.

AIM

The aim of the studywas to review the effects of cocoa and dark chocolate intake on the prevention of cardiovascular dysfunction and atherosclerosis.

METHODS

This narrative review was based on a search of PubMed and Lilacs. The search was conducted from September 2021 to February 2022 using the following keywords: flavonoids, cocoa, atherosclerosis, oxidative stress, and inflammation. The inclusion criteria were original articles, meta-analyses, and experimental and clinical studies published between 2002 and 2022 in English, focusing on the subject addressed. The exclusion criteria were the title and abstract reading and duplication of articles in the databases.

RESULTS

The antioxidant and anti-inflammatory functions of phytochemicals in cocoa and dark chocolate are related to the modulation of nitric oxide through activation/phosphorylation and acting as a vasodilator. Furthermore, these phytochemicals reduce the formation of reactive oxygen species and activate antioxidant enzymes. The anti-inflammatory activities are related to the modulation of nuclear factor kappa B in the reduction of inflammatory markers, such as tumor necrosis factor-alpha, C-reactive protein, and pro-inflammatory cytokines, as well as in the reduction of adhesion molecules in the wall of the vases.

CONCLUSION

The main phytochemicals present in cocoa and dark chocolates are catechins and their epicatechin isomers, which are responsible for improving inflammatory, metabolic, and antioxidant profiles. Its consumption can be encouraged, but with caution, owing to the caloric supply and forms of chocolate production, as these factors can reduce the presence of flavonoids in its composition.

RELEVANCE FOR PATIENTS

The antioxidant and anti-inflammatory functions of the phytochemicals in cocoa and dark chocolate are responsible for modulating nitric oxide via activation/phosphorylation and acting as a vasodilator. Reducing the formation of reactive oxygen species, as well as activating antioxidant enzymes. As for the anti-inflammatory activities, they modulate the nuclear factor kappa B, reducing inflammatory markers, thus improving the antioxidant and inflammatory profile of these patients.

Tobacco cessation in patients with multiple chronic conditions: nutritional strategies as an additional tool in treatment

OBJECTIVE

To evaluate the impacts of a nutritional education intervention for patients with multiple chronic conditions during smoking cessation.

METHODS

The non-probabilistic sample comprised 18 adults and seniors of both sexes recruited from a smoking cessation treatment group. At the beginning of treatment, smoking history, degree of dependence, and stage of motivation were assessed. Degree of craving was evaluated weekly for the 1st month. Anthropometric and biochemical assessments were conducted at baseline, at 1 month, and at 3 months. Dietary intake was assessed with the "How is your diet?" questionnaire. The nutritional intervention was delivered in three sessions. The themes covered were energy balance and physical activity, healthy eating, and the importance of fruit and vegetables in the diet. Statistical analysis was conducted with the Shapiro Wilk test of normality, the paired t test, and the Wilcoxon or Mann-Whitney U tests (significance ≤ 0.05).

RESULTS

Most people (55.6%) in the intervention group had a high degree of smoking dependence, while the frequency in the control group was 22.2%. Degree of craving decreased significantly after 1 month of treatment (p = 0.017). After 3 months, both groups had a positive variation in mean body weight, although below 3%. In both groups, the average percentage of weight gain was less than 3%, suggesting that delivery of the nutritional education sessions and the nutritionist's use of the protocol proposed by the Instituto Nacional de Câncer (INCA) helped to control weight gain. Blood glucose and homeostasis model assessment-insulin resistance (HOMA-IR) both increased significantly in the intervention group (p = 0.15 and p = 0.50, respectively).

CONCLUSION

Greater proximity and more frequent intervention by a nutritionist assists and encourages healthy eating practices during the smoking cessation process, which can benefit individuals' control of chronic diseases over the long term.

Gastrointestinal parasites in captive and free-living wild birds in Goiania Zoo

Helminths are endoparasites that infect a variety of bird species. Endoparasite infections can cause severe diseases, including kill captive avian hosts and represents a problem to maintenance and conservation. The eggs and larval forms of these parasites are usually eliminated in the host feces. The main interest of this study is to report the occurrence of eggs and oocysts in feces from captive wild birds in Goiânia Zoo and free-living birds in its surroundings. The fecal samples were subjected to parasitological examination to identify the presence of helminths and to classify their eggs based on morphological characteristics. Eggs of nematode parasites (Positive/N) were identified as Ascaridia spp. in Brotogeris chiriri (2/2), Dromaius novaehollandiae (1/1) and Rhea americana (2/2); Ascarididae in Pavo cristatus nigripensis (1/1); Capillaria spp. in Ara chloropterus (1/1) and Penelope jacucaca (1/1); Capillaria plagiaticia in Anodorhynchus hyacinthinus (1/2) and Ara spp. (2/2); Capillaria venusta in Rhamphastus tucanus (1/2); and unidentified nematode eggs from Amazona amazonica (2/2). Eimeria spp. oocyst was founded in feces from A. hyacinthinus (1/2). Considering free-living birds, Diphyllobothrium spp. eggs were founded in Ardea alba (2/2) and Nycticorax nycticorax (2/3). Co-infection of Eustrongylides spp. was founded in A. alba (1/2). This is the first occurrence of: Ascaridia spp. parasitizing B. chiriri; and C. venusta parasitizing R. tucanus. In conclusion, the helminth eggs found in the abovementioned host bird species are consistent with those reported in the literature, and treatment and control protocols were based on their identification.