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Objective: bring up the profile of patients diagnosed with obesity, in first care in the Ambulatory of Nutrology of Municipal Board of Ribeirão Preto (RP), from October 2008 to December of 2013. Method: this is a cross-sectional, retrospective and descriptive study based on survey data from medical records of patients diagnosed with obesity. Results: this study was conducted with 1386 patients data, 71,7% female and 28,3% male; 8% being children, 19.8% adolescents, 63.7% adults and 8.5% elderly and respectively have Systemic Arterial Hypertension, 0.9%, 3.6%, 49.9% and 83.9%; type 2 Diabetes Mellitus, 0%, 0%, 19.3% and 47.5%; Dyslipidemia, 83.8%, 81.1%, 33.3% and 39.8%; do not use any medicines, 83.3%, 69.8%, 21.4% and 5.1% and use 5 or more medicines, 0%, 0%, 17.5% and 51.7%; do not consume soft drinks, 4.5%, 6.5%, 13.6% and 16.1% and consume soft drinks on a daily basis, 41.4%, 40.7%, 33.7% and 19.5%; do not practice physical activity, 41.4%, 41.4%, 78% and 78% and practice 5-7 times a week, 1.8%, 10.2%, 8.1% and 4.2%; consume alcoholic drinks, 0%, 5.5%, 38.8% and 23.7%; are smokers, 0%, 1.1%, 11.9% and 0.8% and quit smoking, 0%, 0%, 16.9% and 30.5%. In the adult group, 12.5% are class I obese and in the elderly group, 15.3% and respectively class II, 21.3% and 20.3% and class III, 66.2% and 64.4%. Conclusion: there was a prevalence of females in demand for the medical care service, the increase of comorbidities is significant and potentially modifiable habits may be relevant both for the prevention and the treatment of Obesity.

Objetivo: Avaliar o grau de conhecimento dos utentes da Unidade de Saúde Familiar Camélias face ao rastreio do cancro da próstata. Tipo de estudo: Estudo observacional transversal. Local: USF Camélias. População: Utentes da USF Camélias, do sexo masculino, entre os 40 e os 74 anos. Métodos: Da população de 3.067 utentes foi selecionada uma amostra aleatória e estratificada de 500 indivíduos. O conhecimento dos utentes sobre o rastreio do cancro da próstata foi avaliado através de um questionário, aplicado mediante entrevista telefónica. Resultados: Dos 308 utentes que aceitaram participar no estudo, 77,9% já tinham ouvido falar do teste prostate specific antigen (PSA) (47,7% pelo seu médico de família). A maioria afirmou que os homens deveriam realizar o teste PSA pelo menos a cada dois anos a partir dos 40-50 anos; contudo, relativamente ao exame do toque retal, uma percentagem de 43,8% não respondeu ou afirmou não conhecer as recomendações. Conclusão: Os utentes desta USF do Grande Porto estão moderadamente informados sobre os métodos de rastreio do cancro da próstata. São necessários mais estudos nesta área, preferencialmente multicêntricos, de forma a poder extrapolar os resultados para a população portuguesa. Objective: To assess patients’ knowledge of prostate cancer screening in a Family Health Unit in the North of Portugal (USF Camélias). Study Design: Cross sectional. Setting: USF Camélias. Population: Male patients between 40 and 75 years old in USF Camélias. Methods: From a population of 3067 males, a stratified random sample of 500 individuals was selected. We assessed patients’ knowledge of prostate cancer screening in a telephone survey. Results: Of the 308 men who completed the survey, 77.9% had heard about prostate specific antigen (PSA) (47.7% from their family doctor). Most stated that men should have a PSA test performed at least every two years starting at 40-50 years of age. Regarding digital rectal examination (DRE), 43.8% did not respond or claimed they did not know the recommendation for the examination. Conclusion: The patients surveyed had a moderate knowledge about prostate cancer screening. In order to better understand knowledge of prostate cancer screening in Portugal, more studies in a wider setting are required.

The aim of this study was to gather information on the use of stable isotopes to measure total body water and body composition scan in children. We selected studies in the last 13 years, in addition to classical studies on the subject, indexed in the database PubMed, LILACS, BVS and SciELO. The body composition was characterized by the amount of bone tissue, muscle and adipose tissue, also including the organs as well as levels of body water. Your knowledge becomes increasingly important in light of the changes that occur in the nutritional status of various types of diseases in frameworks, such as diabetes mellitus, protein energy malnutrition, in cases of obesity and metabolic syndrome. The ability to accurately assess body fat mass especially in children is associated with the importance of effective strategies for prevention and treatment of childhood obesity. Historically, in addition to clinical applications, measurements of total body water were used to determine body composition in nutritional studies. To the knowledge of the body composition, the body water can be measured and used by the ingestion of a dose of labeled water. The measured isotope enrichment is a function of the amount of body water. The method of deuterium is particularly interesting for the assessment of body composition in children, due to its characteristics of collection and analysis.

This article presents data on the fortification of foods, necessary as an important public health approach for the success in reducing anemia. The use of food vehicles, iron salts and their costs, as well as recent work on iron fortification of foods in Brazil are reviewed. Recent research serves as a cornerstone for countries that attempt to implement permanent, long-lasting iron fortification programs aimed at the prevention of anemia considering cultural habits, type of iron salts and at-risk groups.

Because short bowel syndrome is associated with iron deficiency, the objective of the present study was to monitor ferremia after the ingestion of different iron compounds and doses in enterectomized patients.This was a randomized, double-blind, cross-over study conducted in 13 patients of both sexes in the metabolic unit of Hospital das Clínicas de Faculdade de Medicina de Ribeirão Preto-Universídade de São Paulo and was divided into two stages. Three different iron compounds, ferrous sulfate (FS), sodium iron ethylenediaminetetra-acetic acid (EDTA), and dehydrated cell fraction (DCF), were studied. The patients were randomly assigned to one of four groups receiving high-dose DCF (120mg) and low-dose DCF (5mg) and the two iron compounds. The subjects (n=7) receiving high-dose DCF participated in 2 test days. All patients receiving the physiologic dose (low-dose DCF, n=6) participated in 3 test days with a 1-mo interval between compounds. After an 8-h fast, blood samples were collected at 0.25, 0.5, 1, and 2h. Serum iron curve and the sum of the area under the curve were calculated and adjusted according to a mixed-effect linear model (P0.05).Serum FS levels were higher in the 120-mg group compared with the others (P0.005). The mean areas under the curve for FS and EDTA at the doses of 120 and 5mg of elemental iron were 238, 224, 177, and 153 microg/dL, respectively. The mean area under the curve for DCF was 165 microg/dL, with no significant difference between groups.Regardless of dose, FS was the compound that resulted in higher ferremia compared with the other doses and compounds.

It has been demonstrated that glutamine, a conditionally essential amino acid, improves nitrogen balance, acts as a stimulant of protein synthesis, and decreases proteolysis in myopathic children. In contrast, other studies have shown no beneficial effect of glutamine supplementation on burn victims or critically ill patients. Nonetheless, we hypothesized that glutamine supplementation would increase the fractional protein synthesis rate (FSR) in the jejunal mucosa of malnourished male Wistar rats. Thus, the objective of the present study was to test the effect of daily oral glutamine supplementation (0.42 g kg(-1) d(-1) for 14 days) on the FSR of the jejunal mucosa of healthy and malnourished rats. A 4-hour kinetic study with l-[1-(13)C]leucine was subsequently performed, and jejunal biopsies were obtained 1.5 cm from the Treitz angle and analyzed. Malnourished rats showed a 25% weight loss and increased urinary nitrogen excretion. Plasma amino acid concentration did not differ between groups. (13)C enrichment in plasma and jejunal cells was higher in the malnourished groups than in the healthy group. The FSR (percent per hour) was similar for the control and experimental groups (P > .05), with a mean range of 22%/h to 27%/h. Oral glutamine supplementation alone did not induce higher protein incorporation by the jejunal mucosa in malnourished rats, regardless of total food intake or the presence or absence of glutamine supplementation.

deficiency alters metabolism, neurotransmission, glial integrity and the cortical myelin layer, besides increasing myelinization time. Environmental stimulation (handling) improves morphological, biochemical, electrophysiological and behavioral aspects of both well-nourished and malnourished animals. The objective of the present study was to determine the effects of an iron- deficient diet and of handling on the brainstem auditory evoked potential (BAEP) of rats during development. Ninety-six male rats were divided since birth into Well-nourished (W, 35 mg iron/kg) and Anemic (A, 4 mg iron/kg) groups, and subdivided into Handling (H) and No Handling (NH). Body weight, hemoglobin (Hb), hematocrit (Ht), latencies of waves I, II, III IV, I-IV interpeak interval, and response threshold to auditory stimuli were evaluated at 18, 22, and 32 days. W animals presented higher Hb and Ht levels than A animals at 18, 22 and 32 days. The animals presented longer latencies of waves I, II, III and IV and I-IV interpeak interval of BAEP at 18 than at 22 and 32 days, and AH18 rats presented longer latencies of waves I and II than AH22 and AH32 rats, and longer wave I latency than WH18 animals. Iron deficiency increased the latencies of BAEP waves, suggesting damage to the myelin layer, especially during the early development, and the effects of handling were more evident along time in anemic animals. Keywords: iron deficiency, brainstem auditory evoked potential, handling, wave latency.

OBJETIVO: Avaliar fatores determinantes de anemia e deficiência de ferro em crianças de duas creches da cidade de Pontal, sudeste do Brasil. MÉTODOS: Estudo transversal foi realizado avaliando-se 192 crianças com idades entre 12 e 72 meses. Dados pessoais (idade, sexo, uso de ferro medicamentoso, duração do aleitamento materno, tipo de parto, cuidados pré-natais, peso e estatura) e dados socioeconômicos (número de co-habitantes, escolaridade dos pais e renda per capita familiar) foram obtidos e correlacionados com hemoglobina, receptores de transferrina, ferritina e anemia ferropriva. RESULTADOS: A idade foi a variável mais afetada pelo estado nutricional de ferro, correlacionando-se com maiores valores de hemoglobina e ferritina e menores valores de receptor de transferrina, sendo que menos anemia ferropriva foi detectada quanto maior a idade. As outras variáveis estudadas não apresentaram correlação com o estado nutricional de ferro. CONCLUSÃO: Os dados sugerem que as estratégias de controle para essa população de crianças pré-escolares devem ser direcionadas especialmente para aquelas de menor idade. OBJECTIVE: To examine the determining factors of anemia and iron deficiency in children attending two day care centers in the town of Pontal, southeast of Brazil. METHODS: Cross-sectional study was conducted in 192 children aged 12 to 72 months. Personal data (age, sex, use of medicinal iron supplements, duration of breast-feeding, type of delivery, prenatal care, weight, and height), and socioeconomic data (number of co-inhabitants, parental schooling, and per capita family income) were obtained and evaluated together with hemoglobin, serum transferrin receptor, ferritin, and iron deficiency anemia. RESULTS: Age was the variable that most affected iron nutritional status, with higher hemoglobin values, lower transferrin receptor concentrations, higher ferritin values and lower iron deficiency anemia being detected with increasing age. The other studied variables did not show any correlation with iron nutritional status. CONCLUSION: The obtained data suggest that control strategies for this preschool population should be especially directed at younger children.

Iron deficiency anemia represents a serious nutritional problem worldwide, and it especially affects children and pregnant women in developing countries, like Brazil. According to World Health Organization, anemia can be considered a major public health problem in Brazil, which requires effective public policies [1] regarding the short- and long-term effects anemia can have on growth in at-risk groups [2].

Fabíola Rainato Gabriel, Vivian MM Suen, Julio Sergio Marchini, José Eduardo Dutra de OliveiraDivision of Clinical Nutrition, Department of Internal Medicine, Ribeirão Preto School of Medicine, São Paulo University, São Paulo, BrazilObjective: The present study aimed to determine the influence of vitamin A on iron absorption when vitamin A and iron are administered together orally compared with the administration of iron alone.Methods: This was a randomized double-blind clinical trial conducted on healthy men with normal red blood cell indices. Five experiments were performed, with iron (10 mg); iron (10 mg) plus vitamin A (450, 900 and 1800 µg), and placebo. After an 8-hour fast, basal (T0) blood samples were collected: basal (T0), 2 hours (T1), and 4 hours (T2) after the ingestion of the compounds to be studied. Iron was determined by inductively coupled plasma mass spectrometry. Serum ferritin was determined by an immunometric method, ie, by chemoluminescent enzyme immunoassay. Plasma retinol was measured by high-pressure liquid chromatography. Serum curves and the sum of the area under the curve adjusted to the mixed effects linear model were determined (P < 0.05).Results: Vitamin A at the doses of 450 and 900 µg had a stimulating effect, which, however, did not differ significantly from that of experiment 1 in which iron was used alone. At the dose of 1800 µg, vitamin A had a negative effect on iron absorption.Conclusion: High doses of vitamin A may cause lower serum iron levels, whereas a low dose favors iron absorption.Keywords: iron absorption, serum iron, vitamin A, oral iron, oral supplement

Hospitalized patients often have to stay in bed for long periods. This is particularly true in the most debilitated patients, when it is impossible to obtain their height and weight. the present study was conducted to assess the use of an alternative anthropometric guideline to evaluate the nutritional status of hospitalized patients. A proposed index, referred to as arm fat index (AFI), is the quotient of triceps skinfold thickness (in mm) and the olecranon-acromial distance (in dm) squared. the AFI was evaluated on 256 adults and afier clinical examination 104 adults were classified as normal, 61 as obese and 18 as having protein-calorie malnutrition. AFI values (mean±SD) for adult women and men were obtained. 1.49±0.39 mm dm−2 for 38 normal healthy women, 2.98±0–67 mm dm−2 for 38 obese women, and 0.53±0.27 mm dm−2 for 10 female patients with protein-calorie malnutrition; 0.78±0.28 mm dm−2 for 66 normal healthy men; 1.93±0.75 mm dm−2 for 23 obese men, and 0.37±0.22 mm dm−2 for 8 male patients with prote...

Objective: To determine iron bioavailability in obese subjects after the ingestion of a nutritional supplement containing multiple nutrients. Methods: Fourteen persons were studied before and after bariatric surgery after the ingestion of a nutritional formulation containing 25 mg iron, 25 g fiber and 800 mg calcium. Serum iron levels were measured basally and every hour after the ingestion of 200 mL of the formulation, and serum ferritin, unsaturated iron binding capacity (UIBC), hemoglobin, albumin, total proteins, total triglycerides, total cholesterol and fractions (LDL-cholesterol and HDL-cholesterol) sere determined at the same time points. Results: The following ferremia values (median/minimum - maximum) were obtained before and after bariatric surgery, respectively: Fasting, 105 (70 - 364) &x00B5;g/dL and 198 (38 - 617) &x00B5;g/dL; 1 hour, 103 (63 - 305) &x00B5;g/dL and 160 (11 - 207) &x00B5;g/dL; 2 hours, 103 (62 - 150) &x00B5;g/dL and 141 (10 - 412) &x00B5;g/dL; 3 hours. 97 (63 - 190) &x00B5;g/dL and 153 (6 - 270) &x00B5;g/dL; 4 hours, 91 (58 - 163) &x00B5;g/dL and 156 (40 - 251) &x00B5;g/dL (p>0.05), with no association of serum iron levels with time. There was a difference in total triglycerides (95 &177; 29 mg/dL and 60 &177; 10 mg/dL) which were correlated with a decrease in serum ferritin levels (r = 0,926, p = 0.008), UIBC (r = 0.910, p = 0.01), total cholesterol (r = 0,918, p = 0.01) and LDL-c fraction (r = 0.830, p = 0.04), with an increase in HDL-c fraction (r = 0,807, p = 0.05). Conclusion: Iron bioavailability in obese subjects was affected by the ingestion of the nutritional formulation containing calcium and fiber and the serum ferritin and UIBC values involved in the body metabolism of iron were reduced by the surgery, a fact that may cause these patients to develop iron deficiency.

The efficiency of nutrition support division in patient care is linked to the status of clinical nutrition in teaching hospitals. There should be opportunities for physicians interested in Clinical Nutrition to be trained and have a profile to other clinical specialists. The Clinical Nutrition Group in the Department of Internal Medicine at the teachig hospital of the Medical School of Ribeirao Preto, Brazil, is an example of a functioning clinical unit. Statistics are presented comparing patients number for the Clinical Nutrition Group at Ribeirao Preto with other clinical services (Cardiology, Nephrology and Geriatrics). Clinical Nutrition has its own clinical methodology and technology. When Clinical Nutrition will extend beyond hospital boundaries and become useful in the primary care of patients at the community level.

133 children from birth to 1 year of age and living in the squatter settlement of Paranoa 25 kilometers from Brasilia were studied to investigate the value of breast milk as a solution to the infant nutrition problem. Data were obtained on socioeconomic and sanitary conditions diet during the last 24 hours and health status. A random subsample of 95 children was used for the anthropometric study. The infants mothers were interviewed in their homes by 2 nurses previously trained to use a standardized technique. The questionnaire used included both open and closed questions and had been previously validated in a pilot study. The 95 infants of the subsample were weighed and measured between 9 am and 5 pm by the same 2 nurses at a station established in each neighborhood. 15% of the sample was being fed exclusively breast milk 44.4% breast milk plus cows milk and 40.6% only cows milk. The most common feeding practice in infants 6 months of age or less was breast milk mixed with cows milk followed by cows milk only and breast milk only. For infants of more than 6 months of age cows milk only was the most common feeding practice followed by breast milk with cows milk and breast milk alone. Some children as old as 12 months were still breastfeeding. The food eaten by the infants studied came from 5 categories: breast milk or cows milk cereals and cereal derivates; beans and bean broth; various kinds of tea; and occasionally some kind of meat fruit or vegetables. Among the 95 infants for whom anthropometric data were available 63.2% were eutrophic and 36.8% undernourished 27.4% of these suffering from 1st degree malnutrition and 9.5% from 2nd and 3rd degree malnutrition according to Gomez classification. There were similar percentages of undernourished children among breastfed infants (33.3%) and infants fed breast milk plus cows milk (30.4%). The largest percentage of undernourished infants (47.1%) was found among those fed only cows milk. More undernourished infants were boys (65.5%). The prevalence of malnutrition was greater in infants older than 6 months (24 in 47) than in younger infants (11 in 46). Artificial feeding was the commonest practice among undernourished infants of 6-12 months. There was a general decline in weight for age from the 1st to the 2nd month. Using Waterlows classifications the combined malnutrition of weight for age and height for age together was 1.0%.

Ten monkeys were exposed to three levels (325, 400, 650 r) of x radiation. Anorexin, leucopenia, loss of hair, and at the high levels of irradiation, hemorrhage and diarrhea, followed. Observations on pair-fed non- irradiated controls demonstrated that the decreased urinary excretion of riboflavin, thiamine, and N/sup 1/-methylnicotinamide which followed irradiation was a result of food restriction, not a specific effect of the x-ray injury. No meaningful changes could be found in blood ascorbic acid at the levels of irradiation and intake. Diketogulonic acid excretion was increased in urine after irradiation. A temporary, moderately increased excretion of pteroylglutamic acid and of vitamin B/sub 6/ followed x-irradiation. No prolonged loss of ascorbic acid, riboflavin, thiamine, niacin (N/sup 1/- methylnicotinamide), pyridoxine, or pteroylglutamate occurs which might indicate that x radiation is a conditioning agent in producing a deficiency of these factors. (auth)

T IlE ascorbic acid content of blood serum (or plasma) reflects within limits the dietary intake of this nutrient. When, however, the concentration approaches zero the simple demonstration of an absence of vitamin C from the serum does not permit one to predict the tissue stores of the vitamin. The concentration of ascorbic acid in the plasma approaches zero some weeks prior to the appearance of clinically detectable lesions of scurvy.’ The ascorbic acid content of the white cellplatelet layer is a somewhat more sensitive index of tissue stores, but this tedious and difficult determination is not readily adapted to routine use. There is need for a simple, reliable and informative measure of ascorbic acid nutriture whenever the concentration of the vitamin in the serum has dropped to the vanishing point. Several years ago the reports of Wolfer et al.,2 Butler and Cushman3 and Kajdi4 attracted the attention of one of us toward the possibility of using a “saturation” or “tolerance” type of test to estimate tissue levels of the vitamin. Usefulness was noted of one such procedure which measures serum ascorbic acid in establishing the diagnosis of scurvy in adults’ but the evidence for this usefulness in spontaneously developing scurvy has not previously been published. The purpose of this report is to present

A study of blood levels, urinary excretion of several vitamins, and fat balance was made in apparently healthy rhesus monkeys kept on a purified diet. For the same daily intake of thiamine, riboflavin, and pyridoxine (about 1 Mg/ day) there was excreted a greater quantity of riboflavin (about 0.32 mg/day) than of pyridoxine (about 0.025 mg/day) or of talamine (about 0.17 mg/day). On an intske of 20 to 30 mg/day of niacinamide about 1 mg/day was excreted as Ni- methylnicotinamide. On a daily ascorbic acid intake of 50 mg only 2 to 3 mg/day of ascorbic acid were found in the urine. The average excretion of pteroylglutamic acid ranged from 0.003 to 0.014 mg/day on an intake of about 0.2 mg/day. Determinations on serum samples revealed average levels of about 197 I.U.% of vitamin A, 6 mu g% of carotene (carotene-free diet), and 0.77 mg% of ascorbic acid. With 5% fat in the diet only 2.8 to 8.5% of the ingested fat was lost in the feces. The fecal fat concentration ranged from 6.1 to 13.4% of the dry weight of the feces. Because of the variation in fecal fat loss in an individual monkey from one collection period tomore » another, a long balance period is a more reliable index of fat absorption than a short-time study. (auth)« less

1.1. Patients with pernicious anemia in relapse have been studied as examples of vitamin B 12 -depleted subjects. A critical study of the minimal dosage of parenterally administered vitamin B 12 required for initial response and the long-term maintenance of these patients has been made. From these data estimates of the dietary requirement of vitamin B 12 have been derived. 2.2. The data on initial response and on maintenance consistently indicate a daily utilization of vitamin B 12 ranging from 0.5 to 2.0 μg., the more usual range being 0.5 to 1.0 μg. Considering the efficiency of absorption by normal persons of quantities of this order of vitamin B 12 we estimate that the minimal daily dietary needs for this vitamin may be met by approximately 0.6 to 2.8 μg., with a narrower range of 0.6 to 1.2 μg. sufficient for most persons. 3.3. Long-term observations on patients receiving smaller than minimal dosage indicate that the demands of vitamin B 12 for hemopoiesis exceed those for other clinically recognized physiologic functions, and that macrocytosis is the most sensitive indicator of vitamin B 12 deficiency. In appraising vitamin B 12 nutriture careful estimates of erythrocyte size therefore are important.