Navegando por Palavras-chave "Nutritional recovery"
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- ItemSomente MetadadadosAlbuminuria, renal function and blood pressure in undernourished children and recovered from undernutrition(Springer, 2017) Martins, Vinicius J. B.; Sesso, Ricardo [UNIFESP]; Clemente, Ana P. G.; Fernandes, Mariana B. F. [UNIFESP]; Sawaya, Ana L. [UNIFESP]Background The objective of this study was to investigate some biomarkers of renal function and blood pressure in children who had recovered from undernutrition. Methods This was cross-sectional, comparative study in which a convenience sample of children of both genders (n = 126
- ItemSomente MetadadadosChildren recovered from malnutrition exhibit normal insulin production and sensitivity(Cambridge Univ Press, 2008-02-01) Martins, Vinícius José Baccin [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Neves, Janaina das [UNIFESP]; Sawaya, Ana Lydia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Protein-energy malnutrition promotes adaptive hormonal changes that result in stunting. A previous study showed that stunted children had increased insulin sensitivity and diminished pancreatic P-cell function. the objectives of the present study were to analyse the glucose, insulin, homeostasis model assessment of insulin sensitivity (HOMA-S) and homeostasis model assessment of pancreatic P-cell function (HOMA-B) levels after nutritional recovery. the recovered group (n 62) consisted of malnourished children after treatment at a nutrition rehabilitation centre. At the beginning of treatment their age was 2.41 (SD 1.28) and 2.31 (SD 1.08) years, weight-for-age Z score -2.09 (SD 0.94) and -2.05 (SD 0.55) and height-for-age Z score - 1.85 (SD 1.11) and - 1.56 (SD 0.90), for boys and girls respectively. the control group consisted of well-nourished children without treatment (n 26). After treatment, boys of the recovered group gained 1.29 (SD 1.06) Z scores of height-for-age and 1.14 (SD 0-99) Z scores of weight-for-age, and girls, 1.12 (SD 0.91) and 1.21 (SD 0-74) Z scores respectively. No differences were found between control and recovered groups in insulin levels for boys (P=0.704) and girls (P=0.408), HOMA-B for boys (P=0.451) and girls (P=0.330), and HOMA-S (P=0.765) for boys and girls (P=0-456) respectively. the present study shows that the changes observed previously in glucose metabolism and insulin were reverted in children who received adequate treatment at nutritional rehabilitation centres and showed linear catch-up.
- ItemAcesso aberto (Open Access)Desnutrição: conseqüências em longo prazo e efeitos da recuperação nutricional(Instituto de Estudos Avançados da Universidade de São Paulo, 2006-12-01) Sawaya, Ana Lydia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Centro de Recuperação e Educação Nutricional; Universidade de São Paulo (USP); International Union of Nutritional Sciences Nutrition and Long Term HealthPOVERTY and malnutrition are still very high in slums. This condition is associated with poor sanitation and stunting. Studies in adolescents with stunting showed, high susceptibility to gain central fat, lower fat oxidation, lower energy expenditure, higher blood pressure and impaired insulin production, all factors linked with cronic diseases later in life. Adequate nutritional recovery in nutritional rehabilitation centres can revert the alterations in body composition.
- ItemAcesso aberto (Open Access)Evolution of the biochemical profile of children treated or undergoing treatment for moderate or severe stunting: consequences of metabolic programming?(Sociedade Brasileira de Pediatria, 2014-07-01) Alves, Jullyana Flávia da Rocha; Britto, Revilane Parente de Alencar; Ferreira, Haroldo da Silva; Sawaya, Ana Lydia [UNIFESP]; Florêncio, Telma Maria de Menezes Toledo [UNIFESP]; Universidade Federal de Alagoas School of Nutrition; Universidade Federal de São Paulo (UNIFESP)OBJECTIVE:to evaluate changes in the biochemical profile of children treated or being treated for moderate or severe stunting in a nutrition recovery and education center.METHODS:this was a retrospective longitudinal study of 263 children treated at this center between August of 2008 to August of 2011, aged 1 to 6 years, diagnosed with moderate (z-score of height-for-age [HAZ] < -2) or severe stunting (HAZ < -3). Data were collected on socioeconomic conditions, dietary habits, and biochemical changes, as well as height according to age.RESULTS:the nutritional intervention showed an increase in HAZ of children with moderate (0.51 ± 0.4, p = 0.001) and severe (0.91 ± 0.7, p = 0.001) stunting during the monitoring. Increased levels of insulin-like growth factor 1 (IGF-1) (initial: 71.7 ng/dL; final: 90.4 ng/dL; p = 0.01) were also observed, as well as a reduction in triglycerides (TG) in both severely (initial: 91.8 mg/dL; final: 79.1 mg/dL; p = 0.01) and in moderately malnourished children (initial: 109.2 mg/dL; final 88.7 mg/dL; p = 0.01), and a significant increase in high-density lipoprotein cholesterol HDL-C only in the third year of intervention (initial: 31.4 mg/dL; final: 42.2 mg/dL). The values of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) levels remained high throughout the treatment (initial: 165.1 mg/dL; final: 163.5 mg/dL and initial: 109.0 mg/dL; final: 107.3 mg/dL, respectively).CONCLUSION:the nutritional treatment for children with short stature was effective in reducing stunting and improving TG and HDL-C after three years of intervention. However, the levels of LDL-C and TC remained high even in treated children. It is therefore speculated that these changes may result from metabolic programming due to malnutrition.
- ItemSomente MetadadadosHeight and weight gains in a nutrition rehabilitation day-care service(Cambridge Univ Press, 2010-10-01) Alves Vieira, Maria de Fatima; Ferraro, Alexandre Arcanjo; Nascimento Souza, Maria Helena do; Fernandes, Maria Tereza B.; Sawaya, Ana Lydia [UNIFESP]; Univ Fed Pelotas; Universidade Federal de São Paulo (UNIFESP); Universidade Federal do Rio de Janeiro (UFRJ); CRENObjective: To evaluate nutritional recovery patterns in 106 undernourished children assisted by the Center of Nutritional Recovery and Education (CREN, in Portuguese) between January 1995 and December 1999.Design: CREN assists undernourished children aged 0 to 72 months living in the southern regions of São Paulo, in an outpatient setting. Nutritional status was assessed by Z-scores of weight-for-age, height-for-age and weight-for-height. Nutritional recovery evaluation considered Z-score gains in weight-for-age and height-for-age, grouping into four categories (Z-score increment of 0.50 between groups). Children with birth weight less than 2500 g were classified as low birth weight (LBW), while those born at term and with LBW were classified as small for gestational age.Setting: CREN (Center of Nutritional Recovery and Education in Portuguese), São Paulo, Brazil.Subjects: One hundred and six children from CREN.Results: Among the 106 evaluated children, ninety-eight (92.5%)recovered their weight or height and seventy-two (67.9%) recovered both. Nearly half of studied children presented a nutritional recovery (increase in Z-score) of more than 0.50 in height-for-age (46.2%) and about 40% in weight-for-age (38.7%). Multivariate analysis showed that treatment duration and initial weight-for-age contributed to weight-for-age Z-score increment, explaining 25% of the variation; and treatment duration, initial height-for-age and weight-for-age Z-score increment contributed to height-for-age Z-score increment, explaining 62% of the variation.Conclusions: Our findings show that nutritional recovery among children who attended CREN was influenced primarily by the degree of nutritional deficit at admission. It has also been shown that biological variables are more important than socio-economic status in determining the rate of nutritional recovery.
- ItemSomente MetadadadosImpact of nutritional recovery with linear growth on the concentrations of adipokines in undernourished children living in Brazilian slums(Cambridge Univ Press, 2014-09-28) Martins, Vinicius J. B. [UNIFESP]; Neves, Andrea P. O. [UNIFESP]; Franco, Maria do C. P. [UNIFESP]; Clemente, Ana P. G.; Sawaya, Ana L. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Fed AlagoasUndernutrition in early life has been reported to be closely associated with the development of non-communicable diseases in adulthood. Adequate treatment is important for reversing these effects. in the present study, we investigated the effects of undernutrition and anthropometric recovery on the weights and heights of children in relation to the concentrations of leptin, adiponectin and plasminogen activator inhibitor-1 (PAI-1). A total of 119 children (aged 616 years) from the slums of São Paulo were selected according to their nutritional status and divided into three groups as follows: control (healthy without intervention, n 38) with a height-for-age Z score (HAZ) and a BMI-for-age Z score (BAZ) > - 1.6; undernourished (HAZ and/or BAZ < - 1.6, n 54); recovered from undernutrition (after treatment in a rehabilitation centre; HAZ and BAZ > - 1.6, n 27). Blood samples were collected to determine insulin, glucose, leptin, adiponectin and PAI-1 concentrations. Leptin concentrations in the undernourished group were lower than those in the control and recovered groups (mean 0.92 (95 % CI 0.67, 1.25), 2.03 (95 % CI 1.46, 2.82) and 1.66 (95 % CI 1.15, 2.44) ng/ml, P=0.003), which had similar leptin concentrations. There were no differences in adiponectin and PAI-1 concentrations among the groups. A positive correlation between waist circumference and leptin concentrations was observed in all the girls and boys of the control group (control: r 0.729, P<0.01; undernourished: r 0.490, P<0.05; and recovered: r 0.829, P<0.01; r 0.673, P<0.05). Stronger correlations between leptin and insulin concentrations were observed in the recovered group. the results of the present study indicate that normal leptin concentrations are found when normal height and weight are achieved.
- ItemSomente MetadadadosMalnourished children treated in day-hospital or outpatient clinics exhibit linear catch-up and normal body composition(Amer Society Nutritional Science, 2006-03-01) Neves, Janaina das [UNIFESP]; Martins, Paula Andrea [UNIFESP]; Sesso, Ricardo de Castro Cintra [UNIFESP]; Sawaya, Ana Lydia [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)The nutritional programming hypothesis proposes that early life malnutrition is related to an increase in body fat later in life. Brazilian boys and girls (n = 94; 4-14 y old) were studied. Malnourished children treated in a Nutrition Recovery Center, were followed up and divided into 2 groups: the Outpatient group (recovered after outpatient care, n = 28), and the Day-hospital group (recovered after day-hospital care, n = 38). They were compared with a Control group (healthy individuals without intervention, n = 28). Nutritional recovery was confirmed by anthropometry. Body composition was evaluated by dual-energy X-ray absorptiometry. Both recovered groups had a greater increase in height-for-age Z-scores than in weight-for-age Z-scores after treatment (P < 0.03). Body fat mass (kg) and the percentage of body fat were significantly lower in recovered groups of girls and boys compared with controls. Among boys, lean mass/height (kg/cm), fat-free mass (kg) and the fat-free mass index (kg/m(2)) were significantly lower in the Outpatient and Day-hospital groups than in Controls, but girls did not differ. Bone mineral content (BMC)/height (g/cm) did not differ between the recovered girls and the girls in the Control group (P < 0.15) or between the boys in the Day-hospital group and those in the Control group (P 0.06). The Outpatient boys group had lower BMC/height than boys in the Control group (P = 0.02). This study demonstrates that when malnourished children receive adequate treatment, linear catch-up growth occurs and is followed by appropriate gain in lean body mass and BMC.