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To compare the serum levels of renin-angiotensin system (RAS) components between patients with migraine and healthy controls, and to evaluate whether these levels are associated with migraine severity. We hypothesized that migraine would be associated with the activation of the inflammatory arm of the RAS, possibly leading to increased levels of angiotensin (Ang) II.Recent studies have proposed the use of drugs that interfere with RAS, a hormonal system primarily implicated in blood pressure regulation, as a prophylactic strategy for migraine. However, no previous studies have directly assessed RAS components in migraine.This was a cross-sectional study involving 30 patients with episodic migraine who were in the interictal period and 20 healthy controls. This study was conducted at Hospital das Clínicas (Universidade Federal de Minas Gerais, Belo Horizonte, Brazil) outpatient clinic. Headache severity was evaluated using the Headache Impact Test, version 6 (HIT-6) and the Migraine Disability Test (MIDAS) questionnaires. Given that migraine is comorbid with mood disorders, depressive and anxious symptoms were evaluated using the Beck Anxiety and Depression Inventories (BDI and BAI), respectively. Clinical and demographic data were also collected. Serum levels of angiotensin-converting enzyme (ACE), ACE2, Ang II, and Ang (1-7) were measured by enzyme-linked immunosorbent assay.Patients with migraine and controls were comparable in age, body mass index, blood pressure, and depressive and anxious symptoms. Patients with migraine showed lower levels of ACE [85.2 (66.8, 101.2) vs 65.5 (54.2, 77.5); P = .005] and lower ACE/ACE2 ratio [4.3 (3.4, 5.2) vs 3.5 (2.9, 4.1); P = .032] than controls. Conversely, patients with migraine had higher levels of Ang II [309.7 ± 147.4 vs 605.4 ± 200.4; difference: -287.1 (95% CI: -391.4--182.8), P .001] and Ang (1-7) [214.4 ± 155.8 vs 397.9 ± 217.9; difference: -184.6 (95% CI: -296.7--72.6), P = .001] than controls. There were no correlations between RAS serum markers and migraine severity scores (HIT and MIDAS) or depressive and anxious symptoms (BDI and BAI) (P .05).Altogether, our results suggest the participation of RAS in migraine pathophysiology, but not in its severity.

Food components with thermogenic properties are promising antiobesity agents. Ginger (Zingiber officinale Rosc.) bioactive compounds have a capsaicin-like vanillyl portion, which has been attributed to thermogenic effect in previous experimental studies. However, studies conducted in humans have evaluated only the acute thermogenic effect of ginger, and demonstrated contradictory results. We evaluated the effect of long-term consumption of dry ginger extract on the resting energy expenditure (REE) of female adults with high body adiposity.This is a secondary analysis of a randomized, double-blind, placebo-controlled clinical trial (NCT02570633). Participants age 18 to 60 y were randomly assigned into two groups: Intervention (600 mg of ginger extract daily) and placebo (cellulose). The intervention lasted 3 mo. Anthropometric measurements, blood pressure, and REE were assessed at each visit.A total of 66 female participants with high body adiposity were included in the analysis (mean age: 29 y [range, 20-55 y]; body mass index: 23.3 ± 2.7), with 30 participants in the ginger group and 36 in the placebo group. There were no significant differences in baseline characteristics between the groups. No differences were observed for group × time interaction on REE. Body composition and blood pressure followed the same pattern (all Pgt; 0.05).Ginger extract consumption for 3 mo did not change the REE, anthropometric, and clinical data of female adults with excess adiposity.

BackgroundPrevious studies have shown an analgesic effect of ginger in the acute treatment of migraine, and there is anecdotal evidence of its efficacy in migraine prophylaxis.ObjectiveThis study aimed to evaluate the potential of ginger to prevent migraine attacks.MethodsThis double-blind, placebo-controlled randomized clinical trial took place at the Headache Clinic, Universidade Federal de Minas Gerais (Belo Horizonte, Minas Gerais, Brazil), involving 107 patients. Only subjects diagnosed with episodic migraine, aged between 18 and 60 years old, and who were not taking any prophylactic medication, were enrolled in the study. After one month of observation, subjects selected for the study were randomized 1:1 into placebo and treatment groups. Patients received capsules three times per day of 200 mg of dry extract of ginger (5% active ingredient) or placebo (cellulose) for three months. Visits were performed monthly and the patients were asked to fill in a migraine diary. The adherence to treatment was evaluated by counting capsules.ResultsThe percentage of patients who responded to treatment (i.e. a reduction of 50% in the number of migraine attacks at the end of treatment) did not differ between the groups. There was a decrease in the number of days with severe pain, analgesic use for acute migraine and duration of migraine attacks in both groups, without significant difference between ginger and placebo groups.ConclusionsGinger provides no greater benefit in the prophylactic treatment of migraine when compared to placebo. This trial is registered at ClinicalTrials.gov (NCT02570633).

The association between diet and migraine has been reported in the literature, but only a few studies have evaluated whether the diet consumed by patients with migraine differs from individuals without migraine.Herein, we aimed to investigate whether the quality and the Dietary Inflammatory Index (DII) of diet consumed by migraine patients differ from that consumed by healthy controls. We also evaluated whether the severity of migraine and headache frequency were associated with these parameters.Patients of both sexes, aged between 18 and 65, with episodic migraine and healthy controls were enrolled in this cross-sectional study. Disability and impact caused by migraine and depressive symptoms were evaluated. Dietary intake was assessed using a 24-hour dietary recall and a three-day non-consecutive food record. The quality of the diet was calculated using the Healthy Eating Index (HEI)-2015 adapted to the Brazilian population, and DII was calculated based on the method developed by Shivappa et al. (2014).Ninety patients with migraine and 62 individuals without migraine were included in this study. The groups did not differ regarding age, sex, marital status, years of schooling, anthropometric characteristics, and depressive symptoms. Patients with migraine had lower HEI total score than controls, indicating that these patients have a lower quality of the diet. Patients with migraine also had higher DII than controls. Nevertheless, HEI and DII scores did not correlate with migraine frequency and severity.This study corroborates the view that the characteristics of the diet might be involved in migraine pathophysiology.

Summary Background & aims The thermic effect of food (TEF) is one of the components of total energy expenditure (TEE). Some bioactive compounds present in food could be useful to increase TEE. In this context, ginger has been extensively used as a thermogenic food despite no clear effect has been demonstrated yet. Herein, we evaluated the acute thermogenic effect of gingerol, a bioactive compound present in ginger, in healthy women. Methods We carried out a randomized double-masked, cross-over and placebo-controlled clinical trial with 20 healthy eutrophic women. Anthropometric, body composition, indirect calorimetry and clinical variables were collected at baseline and throughout the intervention phase. A standardized breakfast was offered together with two dry extract of ginger capsules (5% gingerol) or a placebo (cellulose). Indirect calorimetry, blood pressure, heart rate, axillary temperature and blood collection were assessed at baseline and thereafter, at 30, 60, 120, 180 and 240 min postprandial. The analyses were repeated with a minimum of seven days' washout period. Results Ginger intake did not increase the TEF of a standardized breakfast compared to the placebo. Oxygen consumption, respiratory quotient, blood pressure, heart rate, axillary temperature and metabolic profile were not different as well. Conclusions Our data show that gingerol did not modify the acute TEF in healthy women. More studies in human subjects, using different concentrations of gingerol, administration methods and intervention type (chronic effect) are necessary to clarify the putative thermogenic effect of ginger. Registered at ClinicalTrials.gov (Thermogenic Effect of Ginger - NCT03089593).

Background Previous studies have demonstrated the analgesic effects of ginger in different conditions, but evidence about its efficacy in migraine treatment is scarce. Objective This study aimed to evaluate the potential of ginger to improve acute migraine as an add-on strategy to standard treatment. Methods A double-blind placebo-controlled randomized clinical trial in the emergency room of a general hospital was conducted. Patients who sought medical care at the time of migraine attack were enrolled in this study. Only adults with episodic migraine (one to six migraine attacks per month) with or without aura were included. Sixty participants were randomized into two groups in which they received 400 mg of ginger extract (5% active ingredient) or placebo (cellulose), in addition to an intravenous drug (100 mg of ketoprofen) to treat the migraine attack. Patients filled a headache diary before, 0.5 h, 1 h, 1.5 h and 2 h after the medication. Pain severity, functional status, migraine symptoms and treatment satisfaction were also recorded. Results Patients treated with ginger showed significantly better clinical response after 1 h ( p = 0.04), 1.5 h ( p = 0.01) and 2 h ( p = 0.04). Furthermore, ginger treatment promoted reduction in pain and improvement on functional status at all times assessed. Conclusions The addition of ginger to non-steroidal anti-inflammatory drugs may contribute to the treatment of migraine attack. This trial is registered at ClinicalTrials.gov (NCT02568644)

Previous studies have shown an analgesic effect of ginger in the acute treatment of migraine, and there is anecdotal evidence of its efficacy in migraine prophylaxis.This study aimed to evaluate the potential of ginger to prevent migraine attacks.This double-blind, placebo-controlled randomized clinical trial took place at the Headache Clinic, Universidade Federal de Minas Gerais (Belo Horizonte, Minas Gerais, Brazil), involving 107 patients. Only subjects diagnosed with episodic migraine, aged between 18 and 60 years old, and who were not taking any prophylactic medication, were enrolled in the study. After one month of observation, subjects selected for the study were randomized 1:1 into placebo and treatment groups. Patients received capsules three times per day of 200 mg of dry extract of ginger (5% active ingredient) or placebo (cellulose) for three months. Visits were performed monthly and the patients were asked to fill in a migraine diary. The adherence to treatment was evaluated by counting capsules.The percentage of patients who responded to treatment (i.e. a reduction of 50% in the number of migraine attacks at the end of treatment) did not differ between the groups. There was a decrease in the number of days with severe pain, analgesic use for acute migraine and duration of migraine attacks in both groups, without significant difference between ginger and placebo groups.Ginger provides no greater benefit in the prophylactic treatment of migraine when compared to placebo. This trial is registered at ClinicalTrials.gov (NCT02570633).

OBJECTIVES: This study aims to verify if the quality of diet and the Dietary Inflammatory Index (DII) of migraine patients differ from that consumed by healthy individuals, and whether the severity of migraine is associated with these parameters. METHODS: This cross-sectional study was conducted at the Neurology Outpatient Clinic, Hospital das Clinicas, Universidade Federal de Minas Gerais – UFMG (Belo Horizonte, MG, Brazil). Patients with episodic migraine of both sexes, aged between 18–65 years were enrolled. Healthy volunteers without a history of primary headaches were recruited through advertisements and invitation to participate. Disability and impact caused by migraine were evaluated, respectively, by the Migraine Disability Test (MIDAS) and the Headache Impact Test, version 6 (HIT-6) questionnaires. Dietary intake was assessed using a 24-hour dietary recall and/or a three-day non-consecutive dietary record. The quality of diet was calculated using the Healthy Eating Index (HEI)-2015, adapted to the Brazilian population and DII was calculated based on the method developed by Shivappa et al. (2014). RESULTS: Ninety patients with migraine and 62 individuals without migraine were included in the study. The groups did not differ regarding age, sex, marital status, years of schooling and anthropometric characteristics. Patients with migraine had lower HEI total score than controls [50.9 (23.9 – 83.2) vs. 44.6 (27.1 – 67.7); P 0.05). CONCLUSIONS: The quality and the inflammatory index of the diet may contribute to the physiopathology of migraine, but not necessarily to its severity. FUNDING SOURCES: Brazilian government funding agencies (CNPq and CAPES) and UTHealth Houston Department of Psychiatry and Behavioral Sciences.

It is a non-controlled nutritional intervention study with three months length, which aimed to evaluate the adherence of public employees to life quality program and nutritional intervention. Nutritional evaluation and individualized guidelines were made and questionnaires regarding accession to the participants who left the nutritional monitoring. Began the study 52 individuals, mostly women (76,9%), with an average of 40,8 ± 8,9 years old. Any meaningful alteration was observed after nutritional intervention. The rate of abandonment to nutritional intervention 55,8% and 78,3% of them gave up the other program activities. The main reason for abandonment were dissatisfaction with the time of activities (44,4%), lack of motivation (27,8%), and health problems (22,2%). Among employees who continued the physical activity and did not returned to nutritional consultation, 60,0% reported difficulty in leaving job to attend the evaluations and 40,0% did not feel motivated to return. The low adherence to the program and nutritional intervention may have contributed to the lack of dietary and anthropometric modification. Evaluate intervention strategies becomes important to restructure the methods and increase the participation of individuals.

Introdução: A Síndrome dos Ovários Policísticos (SOP) é uma endocrinopatia que afeta de 6% a 10% das mulheres em idade reprodutiva. Cerca de 38 a 88% das pacientes apresentam obesidade, particularmente a visceral, que pode agravar o grau de resistência insulínica (RI) e interferir nas alterações metabólicas intrínsecas à síndrome. A redução de 5 a 10% do peso inicial pode melhorar as funções reprodutivas e metabólicas, denotando a importância de modificações nos modos de vida. Adicionalmente, o uso da metformina para a melhora da RI na síndrome com efeito sobre o peso tem sido investigado, porém os dados são inconclusivos. Objetivo: Avaliar a efetividade da intervenção nutricional em curto e longo prazo sobre o estado nutricional e consumo alimentar de portadoras de SOP em uso ou não de metformina. Métodos: Estudo de intervenção nutricional não controlado, com duração de seis meses, realizado com mulheres portadoras de SOP. As pacientes receberam plano alimentar hipocalórico (déficit 500 a 700 kcal/dia) e orientações nutricionais individualizadas. Coletaram-se dados antropométricos, alimentares - ingestão de energia, nutrientes e índice de qualidade da dieta revisado (IQD-R), informações referentes à realização de atividade física e utilização da metformina. Resultados: Iniciaram o estudo 70 mulheres, com média de idade de 30,8 ± 5,6 anos, sendo 42,9% portadoras de alguma doença ou agravo não transmissível. Destas, 95,5% apresentavam excesso de peso, 91,3% e 89,9% risco de complicações metabólicas e de doença cardiovascular avaliados por meio da circunferência da cintura (CC) e relação cintura/ quadril (RCE), respectivamente. O consumo excessivo de calorias foi observado em 35,3% da amostra. Quinze mulheres finalizaram a intervenção nutricional (180 dias), sendo essas significantes mais velhas do que as que abandonaram o estudo (33,9 ± 5,40 vs. 30,0 ± 5,45 anos; p=0,017). As demais características foram similares (p>0,05). O uso de metformina na dose de 1500mg/dia foi relatado por 40% da amostra. Houve redução dos parâmetros antropométricos em curto (30 dias) e longo prazo (180 dias) após a intervenção nutricional, sendo observadas diminuição de 6,44 ± 4,59% do peso, 4,09 ± 4,15% da CC e 3,57 ± 4,34% da RCE ao término do estudo. Quanto ao consumo alimentar, verificou-se melhora do escore total do IQD-R com a intervenção (71,82 ± 9,61 vs. 55,15 ± 8,88) em longo prazo. Não houve alteração do nível de atividade física (NAF). A redução do peso foi significativamente maior no grupo em tratamento com metformina (-10,25 ± 2,39% vs. -3,90 ± 3,89% no grupo tratado sem o fármaco; p=0,004), apesar da similaridade no consumo alimentar, tanto por meio da ingestão de energia e nutrientes quanto pelo IQD-R, e atividade física entre os grupos. Não foram identificadas diferenças nos demais parâmetros antropométricos avaliados. Conclusão: A intervenção nutricional, pautada em restrição calórica e orientações nutricionais individualizadas, foi efetiva em promover incremento da qualidade da dieta e melhoria dos parâmetros antropométricos, em curto e longo prazo, sendo a redução do peso potencializada com o uso de metformina. Introduction: The Polycystic Ovary Syndrome (PCOS) is an endocrinopathy that affects 6% to 10% of all childbearing aged women. Approximately 38% to 88% of the patients are obesity, especially visceral, which can increase the degree of insulin resistance (IR) and interfere with the metabolic alterations that are intrinsic to the syndrome. The reduction of 5% to 10% in the initial body weight can improve the reproductive and metabolic functions. Previous studies have been shown that the use of metformin could improve the IR with subsequent impact on body weight; however, some studies have shown inconclusive results. Aim: To evaluate the effectiveness of short and long-term of nutritional intervention in patient with POCS regarding the nutritional state and food intake considering the use or not of metformin. Methods: six-month of uncontrolled nutritional intervention were carried out on PCOS women patients who received a hypocaloric diet plan (deficit of 500 to 700 kcal/day) and individual nutritional advice. This study evaluated anthropometric and food intake data - intake of energy, nutrients and diet quality index revised, information related to the physical activity, and the use of metformin. Results: 70 women, at an average age of 30.8 ± 5.6 years, were included in the study. 42.9% of the patients presented noncommunicable diseases and injuries other than PCOS. Of all women evaluated 95.5% presented excess of body weight, while 91.3% and 89.9% presented risks of metabolic complications and cardiovascular disease, evaluated by means of waist measurement (WM) and waist/hip relation (WHR), respectively. The excessive consumption of calories could be observed in 35.3% of the sample. Fifteen women completed the nutritional intervention period (180 days). The women who finished the study presented more advanced age than those who abandoned the study (33.9 ± 5.40 vs. 30.0 ± 5.45 years; p=0.017). Other characteristics proved to be similar (p>0.05). The use of metformin, at doses of 1500mg/day, was reported by 40% of the sample. Reduction in the anthropometric parameters during the short (30 days) and long (180 days) periods, after nutritional intervention, could be observed, with a reduction of 6.44 ± 4.59% in body weight, 4.09 ± 4.15% of WM, and 3.57 ± 4.34% of WHR, at the end of the study. Concerning the food intake, an improvement in the total score quality of the diet could be observed (71.82 ± 9.61 vs. 55.15 ± 8.88) after the nutritional intervention period. No change in the level of physical activity was identified. The reduction in body weight was significantly higher in the group treated with metformin (-10.25 ± 2.39% vs. -3.90 ± 3.89%; p=0.004), despite similarities in food intake and physical activity. No differences in other anthropometric parameters were identified. Conclusion: The nutritional intervention at short and long term, based on caloric restriction and individual nutritional advice, proved to be effective in promoting the improvement of anthropometric and food intake parameters. The use of metformin seems to have an additional effect since it improves weight loss without change the food consumption or the level of physical activity.

e12018 Background: Many studies have suggested an inverse association between allergies and cancer, while others have found no relation between them, and still others have shown an increased risk of cancer in allergy patients. The conflicting findings from prior studies are partially due to the chosen research method, such as different definitions and measures for atopy, in addition to variations in the control of confusion factors, such as smoking and obesity. Objectives: Verify if there is a relation between certain types of cancer and allergies; investigate if there is a difference between individuals with and without cancer in relation to allergies. Methods: Case-control study carried out at the Alberto Cavalcanti Hospital of the Hospital Foundation of the State of Minas Gerais (FHEMIG), Brazil, from 2009 to 2011. The study included patients over 18 years of age, from both genders, who presented a diagnosis of cancer, as compared to healthy individuals, paired by gender and age. An anamnesis was gathered considering the medical history of the allergy, as diagnosed by a doctor, as well as the patients’ habits, associated illnesses, and the use of medications. For cancer patients, data concerning the tumor were recorded. Subsequently, an allergy percutaneous test was performed in each group to detect allergic hyperreactivity toward common inhalable, bacterial, and food antigens within our everyday environment. A blood sample was collected to quantitatively evaluate the eosinophils. Results: Both groups were paired according to interest variables, and eventual deviations were adjusted by means of multivariate analysis. Reports of allergies occurred in 30% of the patients in the cancer group, as compared to 53% in the control group (p

Although some studies have investigated the role of nutritional intervention on migraine, they had focused on triggers or on weight change and, to the best of our knowledge, none studied diet quality. Objective To investigate whether nutritional intervention focused on improving diet quality and healthy weight can promote improvement in clinical parameters of women with migraine. Methods Non-controlled and non-randomized intervention study conducted for 90 days. Women received an individualized diet meal plan and nutritional orientation according to their nutritional diagnosis. Anthropometric, clinical and nutritional data were measured once a month. Diet energy content and macronutrients were evaluated using 24-hour dietary recall. Diet quality was assessed through the Brazilian Healthy Eating Index–Revised (BHEI-R). The Migraine Disability Assessment and Headache Impact Test version 6 were used to assess the severity of migraine, and the Beck Depression Inventory evaluated depressive symptoms. Results Fifty-two women aged 44.0 ± 13.0 years were enrolled. Anthropometric characteristics, energy, macronutrients and fiber intake did not change after intervention. However, the BHEI-R scores improved after 60 and 90 days of intervention. Concurrent to this, the Beck Depression Inventory scores and Headache Impact Test scores decreased after 60 and 90 days, respectively. The change in the BHEI-R score was negatively correlated with the migraine severity as assessed by the Headache Impact Test at the end of the intervention. Conclusions We concluded that the management of diet quality may be a good strategy for improving migraine severity, regardless of the nutritional status and weight change. RESUMO Estudos investigaram o papel da intervenção nutricional, focada no consumo de alimentos “gatilhos” ou na alteração de peso, na melhora da migrânea. Porém, mudanças na qualidade da dieta ainda não foram abordadas. Objetivo Investigar se intervenção nutricional focada na qualidade da dieta e peso saudável pode melhorar parâmetros clínicos em mulheres com migrânea. Métodos Estudo de intervenção, não controlado e não randomizado. As mulheres receberam plano alimentar individualizado e orientações nutricionais, conforme o diagnóstico nutricional. Dados antropométricos, clínicos e alimentares foram medidos uma vez por mês durante três meses. Recordatório alimentar de 24 horas forneceu informações sobre o consumo alimentar. Qualidade da dieta foi avaliada pelo Índice Brasileiro de Alimentação Saudável (IQD-R). Os questionários Migraine Disability Test (MIDAS) e Headache Impact Test, versão 6 (HIT-6) avaliaram a incapacidade gerada pela enxaqueca e o Inventário de Depressão de Beck (BDI) investigou sintomas depressivos. Resultados Cinquenta e duas mulheres com 44,0 ± 13,0 anos participaram da amostra. Características antropométricas e consumo de energia, macronutrientes e fibras não se alteraram depois da intervenção. No entanto, os escores do IQD-R melhoraram após 60 e 90 dias de intervenção. Os escores do BDI e do HIT-6 diminuíram após 60 e 90 dias, respectivamente. A mudança no escore do IQD-R correlacionou de maneira negativa com a gravidade da enxaqueca avaliada pelo HIT-6 ao final da intervenção. Conclusões O manejo da qualidade da dieta pode ser estratégia para melhorar a gravidade da migrânea, independente do estado nutricional e da mudança de peso dos pacientes.

A doença crítica desencadeia alterações que afetam tanto o metabolismo de nutrientes, quanto resposta inflamatória e da barreira intestinal culminando em prejuízo ao paciente. A Terapia Nutricional (TN) é integrante do tratamento do paciente crítico, e pode impactar positivamente nos desfechos. Entretanto, a TN não está isenta de efeitos adversos e necessita ser adequadamente implementada e monitorada. Nesse contexto, foram desenvolvidos Indicadores de Qualidade em Terapia Nutricional (IQTN’s), como ferramentas para mensurar a efetividade da TN e identificar falhas, objetivando melhorar os cuidados nutricionais. Estudos que avaliam a relação dos IQTN’s com desfechos e custos hospitalares em pacientes críticos são escassos. Este estudo teve como objetivo avaliar a adequação de dez IQTN’s propostos pelo ILSI-Brasil (2018) e a relação destes com desfechos e custos hospitalares em pacientes críticos. Trata-se de estudo coorte com coleta de dados retrospectiva, com pacientes críticos sob TN enteral (TNE) exclusiva por período ≥72h, internados em uma Unidade de Terapia Intensiva (UTI). Foram coletados dados do prontuário referentes à: características clínicas; nutricionais; TNE; e desfechos. Os custos hospitalares foram coletados dos extratos de contas de cada paciente. A partir dos dados coletados, foram calculados dez IQTN’s, os quais foram aplicados para o conjunto da amostra (avaliação geral) e individualmente para cada paciente (avaliação individual). A adequação global (% de indicadores em conformidade por paciente) foi avaliada, assim como sua relação com as características clínico-nutricionais e desfechos. Por fim, a relação entre adequação individual dos IQTN’s e custos hospitalares também foi analisada. 123 pacientes foram incluídos, sendo a maioria idosos (57,7%), do sexo masculino (61,0%) e sob ventilação mecânica (98,0%). Foram avaliados 1173 dias de TNE. À avaliação geral, quase metade dos IQTN’s apresentaram não conformidade quando comparados às metas e, maior inadequação foi evidenciada para os seguintes IQTN’s: frequência de dias com administração adequada de proteína (45,3%) e frequência de jejum >48h antes do início da TN enteral (61,8%). À avaliação individual dos IQTN’s, somente 9,8% dos pacientes apresentaram o IQTN frequência de dias com administração adequada de proteína em conformidade. Não foi encontrada associação entre baixa adequação global de IQTN’s e desfechos. Maior ocorrência de baixa adequação global esteve associada a: dose de noradrenalina nas primeiras 24h de UTI (RP: 1,082; IC95%: 1,012-1,156; p = 0,020), estase (RP: 1,082; IC95%: 1,020-1,148; p = 0,009), vômito (RP: 1.121; IC95%: 1,060-1,184; p 24h, apresentaram, respectivamente, uma redução no custo total [ꞵ: -R$850; IC95%: (-1564,6; -137,2); p=0,02] e no custo com antibióticos por dia de hospitalização [ꞵ: -R$16,2; IC95%: (-29,7; -2,7); p=0,019], comparados àqueles em não conformidade. Os achados deste estudo evidenciam baixa qualidade da TN ofertada a paciente críticos e demonstram a importância clínico-econômica do monitoramento da qualidade da TN utilizando indicadores. Palavras-chave: Terapia Nutricional; Nutrição Enteral; Indicadores de Qualidade em Assistência à Saúde; Custos Hospitalares; Cuidados Críticos; Mortalidade.