RESUMO
OBJECTIVE: The aim of the study was to use linear programming (LP) analyses to adapt New Complementary Feeding Guidelines (NCFg) designed for infants aged 6 to 12 months living in poor socioeconomic circumstances in Bogota to ensure dietary adequacy for young children aged 12 to 23 months. DESIGN: A secondary data analysis was performed using dietary and anthropometric data collected from 12-month-old infants (nâ=â72) participating in a randomized controlled trial. LP analyses were performed to identify nutrients whose requirements were difficult to achieve using local foods as consumed; and to test and compare the NCFg and alternative food-based recommendations (FBRs) on the basis of dietary adequacy, for 11 micronutrients, at the population level. RESULTS: Thiamine recommended nutrient intakes for these young children could not be achieved given local foods as consumed. NCFg focusing only on meat, fruits, vegetables, and breast milk ensured dietary adequacy at the population level for only 4 micronutrients, increasing to 8 of 11 modelled micronutrients when the FBRs promoted legumes, dairy, vitamin A-rich vegetables, and chicken giblets. None of the FBRs tested ensured population-level dietary adequacy for thiamine, niacin, and iron unless a fortified infant food was recommended. CONCLUSIONS: The present study demonstrated the value of using LP to adapt NCFg for a different age group than the one for which they were designed. Our analyses suggest that to ensure dietary adequacy for 12- to 23-month olds these adaptations should include legumes, dairy products, vitamin A-rich vegetables, organ meat, and a fortified food.
Assuntos
Alimentos Fortificados/estatística & dados numéricos , Fenômenos Fisiológicos da Nutrição do Lactente , Micronutrientes/deficiência , Recomendações Nutricionais , Fatores Etários , Estudos de Casos e Controles , Colômbia , Feminino , Alimentos Fortificados/análise , Humanos , Lactente , Fórmulas Infantis/análise , Transtornos da Nutrição do Lactente/prevenção & controle , Ferro da Dieta , Modelos Lineares , Masculino , Micronutrientes/administração & dosagem , Leite Humano , Niacina/deficiência , Pobreza , Tiamina/administração & dosagem , Deficiência de Tiamina/prevenção & controleRESUMO
BACKGROUND/OBJECTIVES: The World Health Organization (WHO) recommends nutritionally adequate complementary feeding (CF) through the introduction of indigenous foodstuffs and local foods while breastfeeding for at least 2 years. To determine the adequacy of the contribution of CF to the diets of Guatemalan infants at the 7th-12th month of life receiving high-intensity continued breastfeeding. SUBJECTS/METHODS: Critical nutrient densities for CF were modelled using age- and sex-specific energy and protein requirements assuming children to be at the 50th weight percentile of local peers and 15th weight percentiles of the 2006 WHO standards. Nutrient requirements for the total diet were determined using the recommended nutrient intakes. Breast milk was assumed to provide 75% of total energy at the 7th-9th month and 50% at the 10th-12th month. Gaps between computed critical nutrient densities and the CF consumption of 128 Guatemalan infants based on data collected by means of three nonconsecutive 24-h quantitative intake recalls were examined. Locally consumed foods with nutrient densities above the modelled critical densities were identified. RESULTS: Observed non-breast milk complementation would result in total diets providing inadequate nutrient density for vitamin A, niacin and vitamin C in some age groups. Major gaps for calcium, iron and zinc were ubiquitous across all groups. Few foods commonly consumed among Guatemalan infants had adequate densities of 'problem nutrients'. CONCLUSIONS: The critical nutrient density concept is useful to evaluate the nutrient adequacy of the infant's diet. Fortified foods are essential sources of the main 'problem nutrients', namely calcium, iron and zinc, given that natural sources are scarce.
Assuntos
Aleitamento Materno , Desenvolvimento Infantil , Qualidade dos Alimentos , Fenômenos Fisiológicos da Nutrição do Lactente , Micronutrientes/administração & dosagem , Modelos Biológicos , Anemia Ferropriva/etnologia , Anemia Ferropriva/etiologia , Anemia Ferropriva/prevenção & controle , Deficiência de Ácido Ascórbico/etnologia , Deficiência de Ácido Ascórbico/etiologia , Deficiência de Ácido Ascórbico/prevenção & controle , Aleitamento Materno/etnologia , Cálcio/deficiência , Feminino , Guatemala , Guias como Assunto , Humanos , Lactente , Fenômenos Fisiológicos da Nutrição do Lactente/etnologia , Masculino , Micronutrientes/análise , Micronutrientes/deficiência , Leite Humano/química , Niacina/administração & dosagem , Niacina/análise , Niacina/deficiência , Necessidades Nutricionais , Valor Nutritivo , Deficiência de Vitamina A/etnologia , Deficiência de Vitamina A/etiologia , Deficiência de Vitamina A/prevenção & controle , Organização Mundial da Saúde , Zinco/administração & dosagem , Zinco/análise , Zinco/deficiênciaRESUMO
OBJECTIVE: HIV infection induces a state of pellagra in cell culture models. This study compared the nutritional status and the 24-hour urine excretion of N-methylnicotinamide between HIV-positive children and HIV-negative children who were or were not born of mothers with HIV-1 infection. PATIENTS AND METHODS: Forty patients were included in the study: HIV-positive children (group 1; n = 20), HIV-negative children born to infected mothers (group 2; n = 10), and HIV-negative control children (group 3; n = 10). Usual dietary intake was assessed by a semiquantitative food-frequency questionnaire. Weight and height were assessed and compared with the reference data of the U.S. National Center for Health Statistics/Centers for Disease Control and Prevention. For the estimation of fat-free mass and total body water, bioelectrical impedance technique was used. N-methylnicotinamide was measured by a modified method of high-performance liquid chromatography. RESULTS: Groups were matched in relation to age, sex, percentage of malnutrition, anthropometric measures, and body composition. Daily niacin intake did not differ statistically across groups (group 1 = 18.0 +/- 11.4 mg/day; group 2 = 18.9 +/- 8.0 mg/day; group 3 = 14.2 +/- 5.2 mg/day), nor did intake of tryptophan, vitamin B6, and zinc. The values of urinary niacin per gram of creatinine were similar and adequate across the groups (group 1 = 4.68 [0.75-14.9]; group 2 = 3.74 [1.13-5.69]; group 3 = 3.85 [1.80-8.19]). CONCLUSIONS: HIV-positive children excreted the same amount of N-methylnicotinamide in urine as did the control children. These findings may be attributed to similarities in nutritional status, adequate intestinal absorption (no children experienced diarrhea) and stable clinical condition.
Assuntos
Infecções por HIV/complicações , Niacina/deficiência , Estado Nutricional , Pelagra/diagnóstico , Estudos Transversais , HIV-1 , Humanos , Transmissão Vertical de Doenças Infecciosas , Niacinamida/análogos & derivados , Niacinamida/urina , Pelagra/etiologiaRESUMO
BACKGROUND & AIMS: Increased intestinal permeability is one of the grastointestinal changes observed in alcoholic patients. However, there are no objective definitions as yet of how alcohol induces pathological changes in the various organs. The action of oxygen-free radicals during ethanol metabolism has been considered a determinant factor of these alterations. The present study was undertaken to determine the effect of niacin supplementation on intestinal permeability and oxidative stress in patients with alcoholic pellagra. METHODS: The study was divided into two phases: in Phase 1 we studied ten patients with pellagra before treatment with niacin, and in Phase 2 we studied the same patients after 27 days of treatment with niacin. Intestinal permeability was assessed by the (51)CrEDTA test and the antioxidant action of niacin supplementation was assessed by the determination of lipid peroxidation (plasma malondialdehyde, MDA), protein oxidation (plasma carbonyl group) and of the antioxidants plasma vitamin E and erythrocyte glutathione peroxidase. RESULTS: Comparison of intestinal permeability by the (51)CrEDTA test before and after niacin treatment showed a significant decrease in permeability from 4.29+/-1.92% to 1.90+/-1.19% (P<0.05). Assessment of oxidative stress showed a significant decrease (P<0.05) in lipid and protein peroxidation (MDA: 1.19+/-0.40-0.89+/-0.27 micromol/l; carbonyl groups: 2.22+/-0.36-1.84+/-0.40 nmol/mg protein). CONCLUSIONS: The results suggest that niacin and vitamin E deficiency in patients with pellagra could be important factors in increased intestinal permeability and decreased antioxidant conditions, recovering to normal values after treatment with niacin, associated to alcohol abstinence and a balanced diet.
Assuntos
Mucosa Intestinal/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Niacina/uso terapêutico , Estresse Oxidativo , Pelagra/fisiopatologia , Complexo Vitamínico B/uso terapêutico , Alcoolismo/complicações , Glutationa Peroxidase/metabolismo , Humanos , Absorção Intestinal , Intestinos/efeitos dos fármacos , Masculino , Malondialdeído/metabolismo , Niacina/deficiência , Estresse Oxidativo/efeitos dos fármacos , Pelagra/tratamento farmacológico , Pelagra/etiologia , Permeabilidade , Proteínas/metabolismo , Deficiência de Vitaminas do Complexo B/complicações , Deficiência de Vitaminas do Complexo B/tratamento farmacológico , Deficiência de Vitamina E/complicações , Deficiência de Vitamina E/tratamento farmacológicoRESUMO
OBJECTIVE: Malnourished patients with the acquired immunodeficiency syndrome (AIDS) can develop pellagra-like manifestations such as dermatitis, diarrhea, and dementia; therefore, we tested the hypothesis that patients with AIDS and diarrhea would have niacin depletion. This study compared 24-h urine excretion of N1-methyl-nicotinamide (N1MN) among patients with pellagra and patients with AIDS who did and did not have diarrhea. METHODS: Three groups were studied: G1 (patients with AIDS and diarrhea, n = 5); G2 (patients with AIDS and no diarrhea, n = 7), and G3 (patients with alcoholic pellagra and without the human immunodeficiency virus, n = 8). Diarrhea was defined as the production of at least three liquid stools per day over 3 to 5 d. Studies included mucosal intestinal biopsy, malabsorption tests, detection of parasites in stool, and serum albumin measurements. Semiquantitative food-frequency questionnaire, anthropometry, and daily urinary N1MN excretion were also determined. Groups were matched in relation to age, sex, presence of parasites in stool, and intestinal absorption results. RESULTS: G1 had normal intestinal examination by light microscopy and no parasites in stools. G2 group showed lower levels of serum albumin (2.6 +/- 0.3 g/dL) when compared with G1 (3.4 +/- 0.3 g/dL) and G3 (3.1 +/- 0.7 g/dL). Except for patients with pellagra, groups met their energy requirements. Patients in G3 (0.013, 0.01-0.081 mg/dL) and G1 (0.062, 0.001-0.33 mg/dL) excreted smaller amounts of N1MN in urine than did those in G2 (0.63, 0.02-2.9 mg/dL). CONCLUSIONS: Patients with AIDS and diarrhea excreted less N1MN in urine than did those without diarrhea. These patients may have an impaired niacin nutritional status, possibly associated with increased metabolic needs.
Assuntos
Síndrome da Imunodeficiência Adquirida/urina , Alcoolismo/urina , Diarreia/urina , Niacina/metabolismo , Niacinamida/análogos & derivados , Niacinamida/urina , Pelagra/urina , Síndrome da Imunodeficiência Adquirida/complicações , Adulto , Albuminas/metabolismo , Alcoolismo/complicações , Índice de Massa Corporal , Creatinina/urina , Diarreia/etiologia , Registros de Dieta , Feminino , Humanos , Absorção Intestinal/fisiologia , Masculino , Niacina/deficiência , Avaliação Nutricional , Pelagra/etiologiaRESUMO
We carried out a review of the studies related to vitamin deficiencies in the Mexican population published since 1950. Forty four studies were published from which we can conclude that: a) dietary intake data suggest that ascorbic acid, riboflavin and retinol intake are deficient: reported intakes were 40-70%, 35-64% and 20-72% of the recommended daily amounts respectively; niacin intake was also deficient in some studies; b) about 10% of Mexican children in rural areas had deficient values of plasma retinol (< 100 ng/ml) and about 25 to 30% had low values (100-200 ng/ml); this prevalence is reduced in children with a higher socioeconomic level; c) some studies were found that show the existence of marginal deficiencies of vitamin E, riboflavin and vitamin B12 in apparently healthy populations. Further studies are required to identify the magnitude of these and perhaps other vitamin deficiencies and their potential effects on the health and function of the Mexican population.
Assuntos
Deficiência de Vitaminas/epidemiologia , Adulto , Fatores Etários , Deficiência de Ácido Ascórbico/epidemiologia , Criança , Pré-Escolar , Feminino , Deficiência de Ácido Fólico/epidemiologia , Humanos , Lactente , Recém-Nascido , Masculino , México/epidemiologia , Niacina/deficiência , Gravidez , Deficiência de Riboflavina/epidemiologia , População Rural , Deficiência de Tiamina/epidemiologia , Oligoelementos/deficiência , População Urbana , Deficiência de Vitamina A/epidemiologia , Deficiência de Vitamina B 12/epidemiologia , Deficiência de Vitamina B 6/epidemiologia , Deficiência de Vitamina E/epidemiologiaRESUMO
A absorçäo jejunal eletrogênica ativa da glicose foi estudada pelo método da perfusäo intestinal "in vivo", infundido-se soluçöes de glicose com concentraçäo crescente (2,5;5,0; 10,0; 20,0; 50,0 e 100,0 mM/L) em 15 cm de jejuno isolado de 12 ratos com deficiência de niacina. Os resultados dos animais carentes foram comparados com os de 12 animais que ingeriram dieta controle na mesma quantidade ingerida pelo seu par carente. A diferença de potencial transmural média em cada concentraçäo infundida de glicose foi estatisticamente menor nos animais carentes, em relaçäo aos controles. Além disso, nos ratos carentes, o Km foi maior (16,1 x 12,7), enquanto que Pdmax foi menor que o dos controles (12,5 x 19,4), respectivamente, demonstrando a ocorrência da depleçäo do transporte ativo eletrogênico da glicose, na carência de niacina. Uma possível explicaçäo para este achado seria a depleçäo das fontes de energia intra-enterocitária
Assuntos
Animais , Masculino , Ratos , Glucose/farmacocinética , Jejuno/metabolismo , Niacina/deficiência , Transporte Biológico Ativo , Estudos de Casos e Controles , Absorção Intestinal , Niacinamida/análogos & derivados , Niacinamida/urina , Perfusão , Ratos WistarRESUMO
The active electrogenic absorption of glucose was studied in 12 niacin deficient rats using a method for measuring changes in transmural potential difference across jejunal mucosa. The glucose was infused in 6 different concentrations (2.5; 5.0; 10.0; 20.0; 50.0 and 100.0 mM/L) at a constant rate of 1.7 ml per minute. The apparent kinetic parameters (Km and Pdmax) of active electrogenic transport were obtained graphically from curves of glucose transfer potentials. The results were compared with that obtained in a control group. The curve of glucose transfer potential in niacin deficient group was significantly lower than that of the control group. The apparent Km of niacin deficient group was greater than in the control group (16.1 x 12.7 mM/L). Furthermore, the Pdmax of the deficient group was lower than that of the control group (12.5 x 19.4 mV). The results showed that in niacin deficiency occurs a decreasing of the active electrogenic glucose absorption. One of the possible interpretation of the differences in the kinetic characteristics of electrogenic glucose transport would be a depleted energy supplement for the active transport in the enterocyte of the niacin deficient rats.
Assuntos
Glucose/farmacocinética , Jejuno/metabolismo , Niacina/deficiência , Animais , Transporte Biológico Ativo , Absorção Intestinal , Masculino , Niacinamida/análogos & derivados , Niacinamida/urina , Ratos , Ratos WistarRESUMO
Trinta e quatro casos de pelegra foram observados no Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro no período de 1978 a 1991: 22 pacientes do sexo masculino e 12 do sexo feminino, todos acima de 30 anos de idade e alcoólatras crônicos, apresentaram principalmente no seu quadro, a dermnatite de áreas expostas. É discutida a freqüência desta condiçäo em nosso meio
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Niacina/deficiência , Pelagra/complicações , Deficiência de Vitaminas do Complexo B/complicações , Isoniazida , Pelagra/epidemiologia , Manifestações Cutâneas , Triptofano/fisiologiaRESUMO
El especialista en patología oral debe estar conciente de la existencia de lesiones carenciales con asiento en cavidad bucal, así como también de la correlación de estas lesiones con las existentes en la piel, ya que el tratamiento es sencillo y curativo, aunque en el paciente alcohólico cabe esperar que ocurran recaídas por la tendencia natural de este tipo de pacientes a persistir en su adicción al alcohol. Se presenta un caso clínico con manifestaciones en cavidad bucal, piel y sistema nervioso central. Asimismo lecturas de complemento