ABSTRACT Objectives Yacon flour is rich in bioactive compounds (phenolic compounds and fructooligosaccharides (FOS)), and may therefore reduce the risk of diseases associated with excess body weight. However, its effect on fecal short chain fatty acids (SCFA), intestinal permeability, oxidative stress and inflammation markers has not been studied in adult humans with excess body weight. Thus, we evaluated the effect of the consumption of yacon flour on these variables. Materials and methods Twenty-six excess body weight (30.4 ± 2.4 kg/m2) adults (31.3 ± 8.5y) were randomized to one of two groups (yacon flour or control; n = 13) on a double blind clinical trial. Subjects received a breakfast drink containing or not yacon flour (25g) associated with an energy restricted diet, for six weeks. The flour chemical characterization, FOS and total phenolics contents were evaluated. Antioxidant capacity was evaluated in vitro and in vivo (plasma). Intestinal permeability, fecal SCFA, oxidative stress and inflammatory markers also were evaluated in vivo. Results Yacon flour was well tolerated. It presented an in vitro and in vivo antioxidant capacity, increased plasma total antioxidant capacity (ΔYAC: 49.16 (-4.20; 156.63)) and reduced protein carbonyl concentrations (ΔYAC: -0.98 (-1.54; -0.42)). A reduction in SCFAs was observed in both groups (Δacetic: -3.16 (-5.07; -0.95) vs. -1.05 (-2.65; 1.11); Δpropionic: -1.05 (-2.60;-0.38) vs. -0.41 (-2.08; 0.09); Δbutyric: -0.75 (-1.38; -0.04) vs. -0.28 (-0.98; 0.11), for YAC and CON, respectively). Other variables did not change. Conclusion The yacon flour increased the plasma antioxidant capacity, decreased oxidative stress and SCFAs in adults with obesity or overweight.

ABSTRACT Objective To determine the prevalence of insufficient iodine intake in pregnant women. Materials and methods The search was performed in the electronic databases Medline (PubMed), Latin American and Caribbean Literature in Health Sciences (Lilacs) and Scopus. Review studies, experimental studies, those with adolescent pregnant women (< 20 years) and iodine supplementation were excluded. The selection followed the steps of identifying the articles in the databases, deleting the duplicates, and reading the titles, abstracts, and then the entire article. The search for the articles occurred in September 2017, using the descriptors “pregnant” and “iodine deficiency” NOT “supplementation” in English, Portuguese and Spanish. Results Thirteen articles were included, the deficiency prevalence ranged from 16.1% to 84.0%, and the median of iodine intake was insufficient in 75% of the studies. There is no classification for mild, moderate or severe levels of iodine deficiency in pregnant women, which makes it impossible to know the real dimension of the problem. Conclusion The high prevalence of insufficient iodine intake in pregnant women, observed worldwide, shows the need for a population classification in order to direct public policies. Arch Endocrinol Metab. 2019;63(3):306-11

Abstract Introduction: diet plays a decisive role in the prevention and treatment of diseases such as obesity, diabetes, allergies and inflammatory diseases. In addition to this, there are numerous investigations about the role of the microbiota in the genesis of metabolic diseases, especially obesity and its comorbidities. Objective: the aim of this review is to discuss the influence of high-fat diets on dysbiosis and metabolic endotoxemia. Results and conclusion: the intestinal microbial ecosystem has been shown to be essential in the performance of functions in the host organism, however, several factors can lead to an imbalance in the homeostasis of the microbiota, known as dysbiosis. High-fat diets are associated with a reduction in intestinal bacterial diversity, changes in membrane integrity, inducing increased permeability and increased lipopolysaccharide (LPS) translocation, changes in the immune system, and generation of low-intensity systemic inflammation. The installed endotoxemia can be considered as a causal factor of subclinical inflammation related to several chronic diseases, and as a result of this, it is essential to know the real impact of hyperlipidic diets on the intestinal microbiota. Thus, it becomes essential to identify dietary strategies that can minimize the inflammatory effects generated from changes in the intestinal microbiota.

Resumen Introducción: la dieta juega un papel determinante en la prevención y el tratamiento de enfermedades como la obesidad, la diabetes, las alergias y las enfermedades inflamatorias. Agregado a ello, son innumerables las investigaciones acerca del papel de la microbiota en la génesis de las enfermedades metabólicas, principalmente la obesidad y sus comorbilidades. Objetivo: el objetivo de esta revisión es analizar la influencia de las dietas ricas en grasas sobre la disbiosis y la endotoxemia metabólica. Resultados y conclusión: se ha demostrado que el ecosistema microbiano intestinal es esencial en el desempeño de funciones en el organismo del huésped, sin embargo, varios factores pueden conducir a un desequilibrio en la homeostasis de la microbiota, conocido como disbiosis. Las dietas ricas en grasas están asociadas a una reducción en la diversidad bacteriana intestinal, alteraciones en la integridad de la membrana que inducen un aumento de la permeabilidad y mayor translocación de lipopolisacáridos (LPS), alteraciones en el sistema inmunológico y generación de inflamación sistémica de baja intensidad. La endotoxemia instalada puede ser considerada un factor causal de la inflamación subclínica relacionada con diversas enfermedades crónicas y, en consecuencia, es imprescindible el conocimiento del impacto real de las dietas hiperlipídicas sobre la microbiota intestinal. Así, es esencial la identificación de estrategias dietéticas que puedan minimizar los efectos inflamatorios generados a partir de alteraciones en la microbiota intestinal.

Abstract Dysbiosis may favor the occurrence of inflammation and oxidative stress in chronic kidney disease (CKD). It has been suggested that the intake of pre/probiotics may control the progression of chronic kidney disease. Thus, the objective of this study was to systematically review the literature on the effects of pre/probiotic intake on the intestinal microbiota, control of nitrogen products, oxidative stress, and inflammation in CKD patients. The literature search was conducted on MEDLINE, LILACS, Cochrane Library of Clinical Trials, and Science Direct. After careful evaluation by the reviewers, ten potentially relevant articles were selected for this study. Based on previous studies, intake of prebiotics appears to have the following effects: increased bifidobacteria and lactobacillus counts; reduced formation of uremic toxin, p-cresol, and its serum concentrations; improved lipid profiles; reduced systemic inflammatory state and concentrations of oxidative stress markers. Similarly, consumption of probiotics can reduce blood urea and serum phosphate concentrations. Furthermore, an increase in fecal volume and intestinal Bifidobacterium and a reduction in p-cresol serum and blood urea concentrations were observed in response to symbiotic intake. These results suggest that consumption of pre/probiotics may modulate the intestinal microbiota, and promote the growth and metabolism of anaerobic bacteria by decreasing the production of uremic solutes, further causing oxidative stress and systemic inflammation in CKD patients.

Resumen La disbiosis puede favorecer la incidencia de inflamación y de estrés oxidativo en enfermedades renales crónicas. Se ha sugerido que el consumo de prebióticos y probióticos puede controlar la progresión de enfermedades renales crónicas. De este modo, el objetivo de este estudio es revisar sistemáticamente la literatura sobre los efectos del consumo de prebióticos y probióticos en la microbiota intestinal, el control de los productos de nitrógeno, el estrés oxidativo y la inflamación en enfermedades renales crónicas. La búsqueda bibliográfica fue realizada por medio de MEDLINE, LILACS, Cochrane Library of Clinical Trials y Science Direct. Diez artículos fueron incluidos en este estudio. Los prebióticos parecen aumentar las bifidobacterias y el recuento de lactobacillus, reducir la formación de toxina urémica, p-cresol y su concentración sérica; mejorar los perfiles lipídicos y reducir el estado de inflamación sistémica y la concentración de indicadores de estrés oxidativo. El consumo de probióticos puede reducir la urea en sangre y la concentración de fosfato sérico. Se verificó el aumento del volumen fecal y de las bifidobacterias intestinales y la reducción de la concentración sérica de p-cresol y de urea en sangre en respuesta a la ingesta de simbióticos. Estos resultados indican que los prebióticos y probióticos modulan la microbiota intestinal y promueven el crecimiento del metabolismo de bacterias anaerobias, disminuyendo la producción de solutos urémicos y la incidencia de estrés oxidativo e inflamación sistémica en pacientes portadores de enfermedades renales crónicas.

ABSTRACT Objective The aim of this study was to verify the effects of glycemic index (GI) on body composition, and on inflammatory and metabolic markers concentrations in patients with type 2 diabetes. Subjects and methods In this randomized controlled parallel trial, twenty subjects (aged 42.4 ± 5.1 years, BMI 29.2 ± 4.8 kg.m-2) were allocated to low GI (LGI) (n = 10) or high GI (HGI) (n = 10) groups. Body composition, inflammatory and metabolic markers were assessed at baseline and after 30 days of intervention. Food intake was monitored during the study using three-day food records completed on two non-consecutive weekdays and on a weekend day. Results Body fat reduced after the LGI intervention compared with baseline (P = 0.043) and with the HGI group (P = 0.036). Serum fructosamine concentration (P = 0.031) and TNF-α mRNA expression (P = 0.05) increased in the HGI group. Serum non-esterified fatty acids were greater in the HGI than in the LGI group (P = 0.032). IL-6 mRNA expression tended to decrease after the consumption of the LGI diet compared to baseline (P = 0.06). Conclusion The LGI diet reduced body fat and prevented the negative metabolic and inflammatory responses induced by the HGI diet.

Resumo A fortificação de alimentos constitui importante estratégia para o controle da deficiência de micronutrientes e apresenta como vantagens a alta cobertura populacional e o fato de não alterar hábitos alimentares. O presente estudo teve como objetivo avaliar o impacto do uso de arroz fortificado (Ultra Rice® - UR®) sobre o estado nutricional de pré-escolares. Noventa e nove crianças matriculadas em duas creches filantrópicas participaram do estudo. Para crianças de uma creche foi oferecido UR® misturado com arroz polido, como parte das refeições escolares (grupo teste) e para as da outra foi oferecido somente arroz polido (grupo controle). Avaliações bioquímicas foram realizadas antes e após 4 meses de intervenção. Avaliações dietética e sensorial do UR® misturado com arroz polido foram realizadas durante o estudo. O arroz fortificado melhorou as concentrações de zinco (p < 0,001), tiamina (p < 0 ,001), ácido fólico (p = 0,003), hemoglobina corpuscular média (p < 0,001) e hemoglobina corpuscular média (p < 0,001). O arroz fortificado mostrou boa aceitação entre os pré-escolares. Este estudo demonstrou a eficácia do uso de arroz fortificado com ferro, zinco, tiamina e ácido fólico sobre o estado nutricional das crianças.

Abstract Fortification of food constitutes an important strategy for the control of micronutrient deficiency and has advantages such as high population coverage and maintenance of eating habits. This study aimed to assess the impact of using fortified rice (Ultra Rice® - UR®) on the nutritional status of preschoolers. Ninety-nine children enrolled in two philanthropic preschools participated of the study. Children of one of the preschools were offered UR® mixed with polished rice, as part of school meals (test group) and the children of another preschool were offered pure polished rice (control group). Biochemical evaluations were performed before and after 4 months of intervention. Dietary assessment and sensory evaluation of UR® mixed with polished rice were performed during the study. The fortified rice improved the concentrations of zinc (p < 0.001), thiamine (p < 0.001), folic acid (p = 0.003), mean corpuscular hemoglobin (p < 0.001) and mean corpuscular hemoglobin concentration (p < 0.001). The fortified rice showed good acceptability among preschoolers. This study demonstrated the effectiveness of using rice fortified with iron, zinc, thiamine and folic acid on the nutritional status of children.

Resumo A fortificação de alimentos constitui importante estratégia para o controle da deficiência de micronutrientes e apresenta como vantagens a alta cobertura populacional e o fato de não alterar hábitos alimentares. O presente estudo teve como objetivo avaliar o impacto do uso de arroz fortificado (Ultra Rice® - UR®) sobre o estado nutricional de pré-escolares. Noventa e nove crianças matriculadas em duas creches filantrópicas participaram do estudo. Para crianças de uma creche foi oferecido UR® misturado com arroz polido, como parte das refeições escolares (grupo teste) e para as da outra foi oferecido somente arroz polido (grupo controle). Avaliações bioquímicas foram realizadas antes e após 4 meses de intervenção. Avaliações dietética e sensorial do UR® misturado com arroz polido foram realizadas durante o estudo. O arroz fortificado melhorou as concentrações de zinco (p < 0,001), tiamina (p < 0 ,001), ácido fólico (p = 0,003), hemoglobina corpuscular média (p < 0,001) e hemoglobina corpuscular média (p < 0,001). O arroz fortificado mostrou boa aceitação entre os pré-escolares. Este estudo demonstrou a eficácia do uso de arroz fortificado com ferro, zinco, tiamina e ácido fólico sobre o estado nutricional das crianças.

Abstract Fortification of food constitutes an important strategy for the control of micronutrient deficiency and has advantages such as high population coverage and maintenance of eating habits. This study aimed to assess the impact of using fortified rice (Ultra Rice® - UR®) on the nutritional status of preschoolers. Ninety-nine children enrolled in two philanthropic preschools participated of the study. Children of one of the preschools were offered UR® mixed with polished rice, as part of school meals (test group) and the children of another preschool were offered pure polished rice (control group). Biochemical evaluations were performed before and after 4 months of intervention. Dietary assessment and sensory evaluation of UR® mixed with polished rice were performed during the study. The fortified rice improved the concentrations of zinc (p < 0.001), thiamine (p < 0.001), folic acid (p = 0.003), mean corpuscular hemoglobin (p < 0.001) and mean corpuscular hemoglobin concentration (p < 0.001). The fortified rice showed good acceptability among preschoolers. This study demonstrated the effectiveness of using rice fortified with iron, zinc, thiamine and folic acid on the nutritional status of children.

Aims: the present study aims to evaluate the prevalence of cardiometabolic changes according to the hypertriglyceridemic waist (HW) phenotype in Brazilian adults. Methods: it is a population based transversal study with 976 adults (n = 533 women) 20-59 years old. Phenotype was defined by triglycerides concentration (TGL) ≥150 mg/dl and waist circumference (WC) ≥80 cm in females and ≥90 cm in males. All the analyses were adjusted according to the study design and pondered by gender, age and schooling. A descriptive analysis was performed through averages and ratios; their respective confidence intervals were herein presented (CI 95%). The prevalence of cardiometabolic changes due to the presence of HW and to gender was calculated and compared by means of Pearson�fs chi-square test. Statistic significance level was 0.05. The probability of coronary event risk was estimated in 10 years and calculated from Framinghan score, using Kernel density graph. Results: no difference in phenotype prevalence between genders was observed. Higher averages in all the cardiometabolic risk factors analyzed and higher probability of evolving to a cardiovascular event in 10 years were observed in individuals with the HW phenotype. Lower HDL values were only verified in this group. Conclusion: the HW phenotype is an important cardiovascular risk sign and allows the premature identification of individuals with higher risk, so that its use in clinical practice must be encouraged, mainly because it is a simple low cost asset.

Objetivos: evaluar la prevalencia de alteraciones cardiometabólicas según el fenotipo cintura hipertrigliceridémica (CH) en adultos brasileños. Métodos: estudio transversal, de base poblacional, con 976 (n = 533 mujeres) individuos de 20 a 59 años. El CH fue definido por un aumento en las concentraciones de triglicéridos y en la circunferencia de la cintura (CC). Todos los análisis fueron ajustados por el efecto del diseño del estudio y ponderados por género, edad y escolaridad. Fue realizado un anaìlisis descriptivo de promedio y presentados sus respectivos intervalos de confianza (IC 95%). La prevalencia de las alteraciones cardiometabólicas según la presencia o no del fenotipo CH y según el sexo fue calculada y comparada a través del test chi-cuadrado de Pearson. El nivel de significancia estadística adoptado fue de 0,05. Se estimó la probabilidad de riesgo de evento coronario en 10 años, a partir del score de Framinghan a través del gráfico de densidad de Kernel. Resultados: la prevalencia del fenotipo CH en la muestra fue de 17,32% (IC 95% 13,54-21,89), no se observó diferencia entre sexos. Se observaron mayores promedios para todos los factores de riesgo cardiometabólico analizados en aquellos con CH. Sólo Se verificaron menores valores medianos para el HDL en este grupo. Los individuos con CH presentaban mayor probabilidad de evolucionar hacia un evento cardiovascular en 10 años que aquellos sin el fenotipo. Conclusión: el fenotipo CH constituye un importante marcador precoz del riesgo cardiovascular. Su utilización en la práctica clínica debe ser incentivada, ya que se trata de una herramienta sencilla y de bajo coste.

Introduction: there is a lack of consensus on the benefits of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) supplementations on cognition in dementia and/or Alzheimer's disease (AD) elderly. Objective: this study presents a systematic review of the results of randomized clinical trials about this topic. The adopted search criteria were randomized clinical trials involving elderly over 65 years of age with no limit to the year of publication of the study. Results: we identified 139 articles, and from the eligible ones a reverse search was conducted. The quality of the trials was assessed using the Jadad scale. Of the four selected studies, three were related to mild to moderate AD elderly, of both genders. Mini Mental State Examination, Alzheimer's Disease Assessment Scale Cognitive, and Clinical Dementia Rate were the main tests used to assess cognitive performance. Conclusion: EPA and/or DHA supplementations did not affect scores obtained on the cognitive tests. However, supplementation with EPA and/or DHA improved verbal fluency and attention in patients who had only very mild dementia or AD or presented APOEε4 negative genotype. In case of advanced AD elderly patients, EPA and/or DHA supplementations did not reduce cognitive decline rates.

Introduccion: no existe consenso sobre los beneficios de la suplementacion con acido eicosapentaenoico (EPA) y acido docosahexaenoico (DHA) sobre la cognicion de las personas mayores con demencia y/o Alzheimer. Objetivo: esta revision sistematica muestra los resultados de ensayos clinicos randomizados al respecto. Metodos: se realizo una busqueda de ensayos clinicos randomizados llevados a cabo en personas mayores de 65 anos, sin estabelecer limites en cuanto al ano de publicacion. Resultados: se identificaron 139 articulos y a partir de los articulos candidatos se llevo a cabo una busqueda inversa. La calidad de los ensayos clinicos aleatorios se evaluo mediante la escala de Jadad. De los cuatro estudios seleccionados, tres valoraban ancianos, con diagnostico de enfermedad de Alzheimer de leve a moderada, en ambos sexos. Mini Examen del Estado Mental, Enfermedad de Alzheimer, Escala de Evaluacion Cognitiva y Tasa Clinica de Demencia fueron los principales test utilizados para estudiar el rendimiento cognitivo. Conclusion: la suplementacion de EPA y/o DHA no afecto las puntuaciones en las pruebas cognitivas. Sin embargo, la suplementacion con EPA y/o DHA mejoro la cognicion en los dominios de fluidez y de atencion verbales en pacientes que unicamente presentaban demencia leve o enfermedad de Alzheimer o el genotipo APOEε4 negativo. En los pacientes ancianos con enfermedad de Alzheimer avanzada, la suplementacion con EPA y/o DHA no redujo las tasas de deterioro cognitivo.

Objective Evaluate the effect of glycemic index (GI) on biochemical parameters, food intake, energy metabolism, anthropometric measures and body composition in overweight subjects.Materials and methods Simple blind study, in which nineteen subjects were randomly assigned to consume in the laboratory two daily low GI (n = 10) or high GI (n = 9) meals, for forty-five consecutive days. Habitual food intake was assessed at baseline. Food intake, anthropometric measures and body composition were assessed at each 15 days. Energy metabolism and biochemical parameters were evaluated at baseline and the end of the study.Results Low GI meals increased fat oxidation, and reduced waist circumference and HOMA-IR, while high GI meals increased daily dietary fiber and energy intake compared to baseline. There was a higher reduction on waist circumference and body fat, and a higher increase on postprandial fat oxidation in response to the LGI meals than after high GI meals. High GI meals increased fasting respiratory coefficient compared to baseline and low GI meals.Conclusion The results of the present study showed that the consumption of two daily low GI meals for forty-five consecutive days has a positive effect on obesity control, whereas, the consumption of high GI meals result has the opposite effect. Arch Endocrinol Metab. 2015;59(3):245-51

Introduction: Obesity and Type 2 diabetes may be controlled by foods capable of modulating food intake and blood glucose. Objectives: We investigated whether the addition of food sources of fiber or phaseolamin to shakes can control food intake and reduce postprandial glycemia. Methods: This was a randomized, single blind, crossover design study (food intake: n=22; glycemia: n=10). Five liquid meals presenting similar amounts of macronutrients (C - control shake, OB - oat bran shake, F - flaxseed shake, WB - white bean extract shake, and UB - unripe banana flour shake) were consumed in five non-consecutive days. Participants kept dietary records during the subsequent 24 hours. Blood glucose was measured at 0 (immediately before), 15, 30, 45, 60, 90 and 120 minutes after the ingestion of each shake and the incremental areas under the curves (iAUC) were calculated. Results: Compared to C, there was a significant increase in fiber intake after the consumption of OB (+17.9g), F (+19.1g), and UB (+12.6g), and in fat after the consumption of OB (+25,4g). There was a non-significant reduction of daily energy intake in F compared to C (1524kJ; P=0.10). There was a 43% reduction in the iAUC (P=0.03) in response to UB consumption. Conclusions: Unripe banana flour reduced postprandial glycemic response of shakes almost by half. The effect of oat bran and flaxseed on food intake needs further investigation in long-term studie.

Introducción: Obesidad y diabetes de tipo 2 pueden ser controlados por alimentos capaces de modular la ingesta de alimentos y la glucemia. Objetivos: Se investigó si la adición de alimentos fuentes de fibra o fasolamina a batidos puede controlar la ingesta de alimentos y reducir la glucemia posprandial. Métodos: Estudio aleatorizado, simple ciego, de diseño cruzado (ingesta de alimentos:n=22; glucemia:n=10). Cinco batidos con cantidades similares de macronutrientes (C - control batido, SA - salvado de avena batido, L - linaza batido, FB - extracto de frijol blanco batido y PI - harina de plátano no maduro batido) fueron consumidos en cinco días no consecutivos. Las participantes registraron la ingesta de alimentos en las 24 horas subsiguientes. La glucosa en sangre se midió a 0 (inmediatamente antes), 15, 30, 45, 60, 90 y 120 minutos después de la ingestión de cada batido y se calcularon las áreas incrementales bajo las curvas (AIBC). Resultados: En comparación a C, hubo un aumento significativo en la ingesta de fibra después de que el consumo de SA(+17,9g), SL(+19,1g), y PI(+12,6g), y en la grasa después del consumo de SA(+25,4g). Se encontró una reducción no significativa de la ingesta diaria de energía en L (1524kJ, P=0,10) en comparación con C. Hubo una reducción del 43% en el AIBC (P=0,03) en respuesta al consumo PI. Conclusiones: Harina de plátano no maduro reduce la respuesta glucémica posprandial de batidos casi a la mitad. El efecto de salvado de avena y linaza en la ingesta de alimentos requiere mayor investigación en estudios a largo plazo.

OBJETIVO: Realizar uma análise crítica da literatura para avaliar a influência da amamentação no risco de desenvolvimento de diabetes mellitus. FONTE DOS DADOS: Revisão não sistemática nas bases de dados SciELO, LILACS, MEDLINE, Scopuse BVS, selecionando-se 52 referências mais relevantes. Especificamente sobre o tema, foram analisadas 21 (sendo 9 para diabetes tipo 1 e 12 para diabetes tipo 2). SÍNTESE DOS DADOS: A duração, a exclusividade do aleitamento materno e uso precoce do leite de vaca têm sido apresentados como fatores de risco para o desenvolvimento de diabetes. Acredita-se que o leite humano contenha substâncias que promovem a maturação do sistema imunológico protegendo contra o diabetes tipo 1. Além disso, ele possui substâncias bioativas, que promovem o equilíbrio energético e a saciedade, prevenindo o ganho de peso excessivo da criança e protegendo, consequentemente, contra o aparecimento do diabetes tipo 2. Apesar dos benefícios anteriormente citados não terem sido constatados por alguns pesquisadores, a imprecisão no relato dos hábitos dietéticos da infância e a presença de fatores interferentes têm sido responsabilizadas pela falta de identificação dos efeitos benéficos. CONCLUSÃO: Diante das evidências científicas pautadas em grande parte dos estudos, acredita-se que a ausência da amamentação seja um possível fator de risco modificável para diabetes tipo 1 e tipo 2. Estratégias que visem à promoção e ao suporte ao aleitamento materno devem ser adotadas por profissionais de saúde devidamente treinados como forma de prevenir a manifestação da doença.

OBJECTIVE: The aim of this study was to perform a review to investigate the influence of breastfeeding as a protective agent against the onset of diabetes in children. SOURCES: Non-systematic review of SciELO, LILACS, MEDLINE, Scopus, and VHL databases, and selection of the 52 most relevant studies. A total of 21 articles, specifically on the topic, were analyzed (nine related to type 1 diabetes and 12 to type 2 diabetes). DATA SYNTHESIS: The duration and exclusivity of breastfeeding, as well as the early use of cow's milk, have been shown to be important risk factors for developing diabetes. It is believed that human milk contains substances that promote the maturation of the immune system, which protect against the onset of type 1 diabetes. Moreover, human milk has bioactive substances that promote satiety and energy balance, preventing excess weight gain during childhood, thus protecting against the development of type 2 diabetes. Although the above mentioned benefits have not been observed by some researchers, inaccuracies on dietary habit reports during childhood and the presence of interfering factors have been considered responsible for the lack of identification of beneficial effects. CONCLUSION: Given the scientific evidence indicated in most published studies, it is believed that the lack of breastfeeding can be a modifiable risk factor for both type 1 and type 2 diabetes. Strategies aiming at the promotion and support of breastfeeding should be used by trained healthcare professionals in order to prevent the onset of diabetes.

Introduction: The effects of dietary glycemic load (GL) on cardiometabolic risk factors in physically active subjects are not completely known. Objective: This cross-sectional study assessed the association of habitual dietary GL with cardiometabolic risk factors in physically active Brazilian middle-aged men. Methods: One-hundred seventy-six subjects (Age: 50.6 ± 5.0 years, BMI: 25.5 ± 3.6 kg/m²) were evaluated. Anthropometry, lifestyle features, insulin resistance, oxidative stress biomarkers (8-iso-prostaglandin F2α; 8-iso-PGF2α and 8-hydroxydeoxyguanosine; 8-OHdG) and lipid profile were assessed. Dietary intake was estimated through a quantitative food frequency questionnaire. Results: The dietary GL was positively associated with free fatty acid concentrations (β = 0.311, r² = 0.13, P-value = 0.034) and triglycerides/HDL cholesterol ratio (β = 0.598, r² = 0.19, P-value = 0.028) regardless of confounding factors (central obesity, red meat consumption, age and energy intake). The oxidative stress biomarker, 8-OHdG, was associated with habitual dietary GL (β = 0.432, r² = 0.11, P-value = 0.004), regardless of previous confounding factors plus excessive alcohol consumption, iron intake and current smoking status. Conclusions: The dietary GL was positively associated with lipid profile (free fatty acid concentrations and triglycerides/HDL cholesterol ratio) and oxidative stress biomarker (8-OHdG). These results indicate potential harmfulness of diet with higher GL to cardiometabolic risk factors in middle-aged men, even in physically active individuals.

Introducción: Los efectos de la carga glucémica (CG) de la dieta sobre los factores de riesgo cardiometabólico en sujetos físicamente activos no están establecidos por completo. Objetivo: Este estudio transversal evaluó la asociación entre la CG de la dieta habitual y los factores de riesgo cardiometabólico en hombres brasileños de mediana edad físicamente activos. Métodos: Ciento setenta y seis sujetos (índice de masa corporal: 25,5 ± 3,6 kg/m²; edad: 50,6 ± 5,0 años) fueron evaluados. Antropometría, características del estilo de vida, la resistencia a la insulina, biomarcadores del estrés oxidativo (8-iso-prostaglandina F2α, 8-iso-PGF2α y 8 hidroxideoxiguanosina, 8-OHdG) y el perfil lipídico fueron evaluados. La ingesta dietética se estimó por medio de un cuestionario cuantitativo de frecuencia de consumo. Resultados: La CG de la dieta se asoció positivamente con las concentraciones de ácidos grasos libres (β = 0,311, r² = 0,13, P = 0,034) y la razón triglicéridos/colesterol HDL (β = 0,598, r² = 0,19, P = 0,028), independientemente de los factores de confusión (obesidad central, consumo de carne roja, edad e ingesta calórica). El biomarcador del estrés oxidativo, 8-OHdG, también se asoció con CG de la dieta habitual (β = 0,432, r² = 0,11, P = 0,004), independientemente de los factores de confusión anteriores más el consumo excesivo de alcohol, la ingesta de hierro y tabaquismo actual. Conclusiones: La CG de la dieta se asoció positivamente con el perfil lipídico (concentraciones de ácidos grasos libres y razón triglicéridos/HDL colesterol) y el biomarcador de estrés oxidativo 8-OHdG. Estos resultados indican el potencial de nocividad de una dieta con mayor CG respecto a los factores de riesgo cardiometabólico en hombres de mediana edad, incluso en aquellos físicamente activos.

O objetivo deste estudo foi verificar o efeito da ingestão de uma bebida esportiva cafeinada (CAFD) em comparação a uma bebida carboidratada comercial (CHOD) sobre parâmetros bioquímicos e a taxa de percepção de esforço em jogadores de futebol categoria juvenil. O desenho experimental foi duplo-cego cruzado, onde os atletas consumiram 5mL.Kg-1 de peso corporal (PC) antes do jogo e 3mL.Kg-1 PC a cada 15 minutos durante o jogo. A ingestão de CAFD resultou no aumento da glicemia (GS) e do lactato sanguíneo (LS) e do valor médio da frequência cardíaca máxima em relação ao consumo do CHOD (p = 0,01). Nenhuma diferença foi observada nas outras variáveis. CAFD promoveu maior concentração plasmática de GS e LS em comparação com o CHOD. A CAFD não aumentou a mobilização dos ácidos graxos livres, não alterou a concentração de potássio plasmático e não foi capaz de reduzir a percepção subjetiva do esforço.

The purpose of this study was to verify the effect of the intake of a caffeinated sport drink (CAFD) compared to a commercial carbohydrate drink (CHOD) on biochemical parameters and rate of perception exertion in youth soccer players. The experiment was setup in a double-blind crossover design where athletes consumed 5mL.Kg-1 body weight (BW) before the game and 3mL.Kg-1 BW every 15 minutes during the game. Intake of the CAFD resulted in increased blood glucose (BG) and blood lactate (BL) levels and average of maximum heart rate compared to consumption of the CHOD (p = 0.01). No difference was observed in the other variables. CAFD promoted greater plasmatic concentration of BG and BL compared with the CHOD. The CAFD did not increase the mobilization of free fatty acids, did not alter the plasma potassium concentration and was not able to reduce subjective perceived exertion.

El objetivo fue verificar el efecto del consumo de una bebida deportiva con cafeína (CAFD) frente a una bebida carbohidratada comercial (CHOD) sobre parámetros bioquímicos y el índice de percepción de esfuerzo percibido en jugadores de fútbol de la categoría juvenil. El diseño experimental utilizado fue de tipo doble-ciego cruzado, donde los deportistas ingieren 5mL.Kg-1 del peso corporal (PC) antes del partido y 3mL.Kg-1 PC a cada 15 minutos durante el partido. El consumo de CAFD produjo un aumento en la glucemia (GS) y del lactato sanguíneo (LS) y del valor medio de frecuencia cardiaca máxima frente al consumo de CHOD (p = 0,01). No hubo diferencias en las demás variables. CAFD produjo mayor concentración plasmática de GS y LS en comparación con la CHOD. La CAFD no aumento la movilización de ácidos grasos libres, no hubo alteración en la concentración de potasio plasmático y no fue capaz de reducir el índice de percepción de esfuerzo.

Recentemente, a falta de artigos que visam fornecer orientação quanto ao uso do índice glicêmico foi apontada como causa de sua baixa utilização na educação nutricional. O objetivo do presente trabalho é oferecer suporte para o uso do índice glicêmico como ferramenta a ser adotada na educação nutricional, para estimular o consumo preferencial de alimentos que apresentem menores valores nesse indicador. Foram selecionados estudos publicados nos últimos doze anos, além de estudos clássicos referentes ao tema, indexados nos bancos de dados MedLine, ScienceDirect, SciELO e Lilacs, que exploraram a importância do índice glicêmico e os fatores que interferem em seu valor. A elaboração de listas agrupando os alimentos segundo o índice glicêmico deve ser feita com base nas informações encontradas em tabelas e sites específicos. Essa é uma estratégia interessante que deve ser conduzida de maneira criteriosa, considerando-se os hábitos alimentares do público assistido. Para resultar em resposta glicêmica pós-prandial mais baixa, os produtos de alto índice glicêmico devem ser ingeridos em associação com alimentos ricos em proteína e pobres em gordura, com óleos de boa qualidade, com alimentos menos processados por ricos em fibras, evitando-se os com alto teor em cafeína. O índice glicêmico deve ser considerado uma ferramenta adicional para a escolha de alimentos fonte de carboidratos, os quais devem ser incluídos em uma dieta nutricionalmente equilibrada, capaz de promover e/ou manter tanto o peso corporal adequado quanto a saúde.

Recently, the lack of studies providing practical guidance for the use of the glycemic index has been indicated as the cause of its little use in nutrition education. The aim of this study is to give instructions on the use of the glycemic index as a tool to be used in nutrition education to estimulate the consumption of low glycemic index foods. Studies published over the past 12 years, in addition to classic studies on this topic, found in the databases MedLine, ScienceDirect, SciELO and Lilacs exploring the importance of the glycemic index and the factors that affect the glycemic index were selected for this article. The preparation of lists grouping foods according to their glycemic index should be based on information found in tables and specific web sites. This is an interesting strategy that must be very carefully conducted, considering the eating habits of the assisted people. To reduce the postprandial blood glucose response, high glycemic index foods should be consumed in association with the following foods: high protein and low fat foods, good quality oils and unprocessed foods with high fiber content. Caffeine should also be avoided. The glycemic index should be considered as an additional carbohydrate-selection tool, which should be part of a nutritionally balanced diet capable of promoting and/or maintaining body weight and health.