This document discusses various dietary recommendations and myths in nutrition. It presents different food pyramids from places like the US, Portugal, Harvard School of Public Health, and various vegetarian, Mediterranean and Latin American pyramids. It also discusses various diets and legends in nutrition. Additionally, it covers controversies around recommendations to limit dietary cholesterol to less than 300 mg/day and the effects of eggs on cholesterol levels and cardiovascular disease risk. It notes that small, dense LDL particles are a significant risk factor for cardiovascular disease.
This document discusses various nutrition guidelines and pyramids over time including the USDA pyramid from 1992, the new Portuguese wheel from 2003, and the Harvard School of Public Health pyramid from 2005. It also discusses various diets such as vegetarian, Mediterranean, and Latin American pyramids. The document notes controversies around nutrition recommendations that are based on legends and epidemiology rather than rigorous clinical trials. It questions recommendations for limiting dietary cholesterol to below 300 mg/day given studies showing minimal effects of cholesterol intake on LDL levels.
Suplementos: Desperdício ou Necessidade?nutriscience
This document discusses the potential benefits and necessity of supplements. It presents data showing that many Americans and Europeans do not meet recommended daily intakes of certain micronutrients from diet alone. Studies suggest magnesium intake may help reduce risk of metabolic syndrome, diabetes, and heart disease by improving insulin sensitivity and metabolic markers. A randomized controlled trial found that oral magnesium supplementation improved insulin sensitivity in non-diabetic adults with insulin resistance. Overall the document argues that supplements may help fill nutritional gaps and support health, though over-reliance on supplements rather than whole foods is not ideal.
This document summarizes research on the effects of beta-hydroxy-beta-methylbutyrate (HMB). HMB is a metabolite of the essential amino acid leucine that is found in small amounts naturally. Studies have found that HMB supplementation can increase muscle strength, lean body mass, and aerobic/anaerobic capacity. The mechanisms of these effects include increasing protein synthesis and decreasing protein breakdown through inhibition of the ubiquitin-proteasome system. HMB may also act on the mTOR pathway to increase protein synthesis and provide substrates to support cell membrane integrity. However, the effects of HMB appear to be greater in untrained individuals compared to highly trained athletes.
<마더리스크라운드> Pharmacokinetics in pregnancymothersafe
This document discusses pharmacokinetics in pregnancy. It begins with an overview of absorption, distribution, metabolism, and excretion (ADME) processes and how they are altered in pregnancy. It then examines specific changes to absorption, plasma volume expansion, protein binding, enzyme activity, renal clearance, and placental transport during pregnancy and postpartum. Key points include increased volume of distribution, decreased protein binding, induction of some enzyme systems, and increased renal clearance and placental transport of drugs. The implications of these changes for dosing of individual drugs like nelfinavir, caffeine, lamotrigine, and theophylline are reviewed based on pharmacokinetic studies. Placental transporters like P-
Mary Rodavich - WVU Master's Defense PresentationMary Rodavich
The study examined the effects of non-marine sources of EPA or DHA (algae oil and yeast oil) versus fish oil on body weight and serum lipids in mice. Mice fed fish oil had significantly lower serum total cholesterol, non-HDL cholesterol, and triglycerides compared to other diet groups. Fish oil also increased EPA and DHA levels in the liver to a greater extent than algae oil or yeast oil. The results suggest that fish oil may be more effective than some non-marine sources at reducing cardiovascular disease risk factors.
This document does not contain enough information to summarize. It appears to be an email address followed by random characters and does not convey any clear ideas, topics, or essential information that could be summarized in 3 sentences or less.
1) Teenagers in Indonesia don't care about local brands and see international brands as "cool" and their "god".
2) The author proposes a program where local brands donate 1% of profits to build facilities teenagers are passionate about, like music studios.
3) Teenagers receive vouchers for local brand purchases and can vote online for which facilities to build. This gives local products added value for teenagers and makes them proud to support their country.
This document discusses various nutrition guidelines and pyramids over time including the USDA pyramid from 1992, the new Portuguese wheel from 2003, and the Harvard School of Public Health pyramid from 2005. It also discusses various diets such as vegetarian, Mediterranean, and Latin American pyramids. The document notes controversies around nutrition recommendations that are based on legends and epidemiology rather than rigorous clinical trials. It questions recommendations for limiting dietary cholesterol to below 300 mg/day given studies showing minimal effects of cholesterol intake on LDL levels.
Suplementos: Desperdício ou Necessidade?nutriscience
This document discusses the potential benefits and necessity of supplements. It presents data showing that many Americans and Europeans do not meet recommended daily intakes of certain micronutrients from diet alone. Studies suggest magnesium intake may help reduce risk of metabolic syndrome, diabetes, and heart disease by improving insulin sensitivity and metabolic markers. A randomized controlled trial found that oral magnesium supplementation improved insulin sensitivity in non-diabetic adults with insulin resistance. Overall the document argues that supplements may help fill nutritional gaps and support health, though over-reliance on supplements rather than whole foods is not ideal.
This document summarizes research on the effects of beta-hydroxy-beta-methylbutyrate (HMB). HMB is a metabolite of the essential amino acid leucine that is found in small amounts naturally. Studies have found that HMB supplementation can increase muscle strength, lean body mass, and aerobic/anaerobic capacity. The mechanisms of these effects include increasing protein synthesis and decreasing protein breakdown through inhibition of the ubiquitin-proteasome system. HMB may also act on the mTOR pathway to increase protein synthesis and provide substrates to support cell membrane integrity. However, the effects of HMB appear to be greater in untrained individuals compared to highly trained athletes.
<마더리스크라운드> Pharmacokinetics in pregnancymothersafe
This document discusses pharmacokinetics in pregnancy. It begins with an overview of absorption, distribution, metabolism, and excretion (ADME) processes and how they are altered in pregnancy. It then examines specific changes to absorption, plasma volume expansion, protein binding, enzyme activity, renal clearance, and placental transport during pregnancy and postpartum. Key points include increased volume of distribution, decreased protein binding, induction of some enzyme systems, and increased renal clearance and placental transport of drugs. The implications of these changes for dosing of individual drugs like nelfinavir, caffeine, lamotrigine, and theophylline are reviewed based on pharmacokinetic studies. Placental transporters like P-
Mary Rodavich - WVU Master's Defense PresentationMary Rodavich
The study examined the effects of non-marine sources of EPA or DHA (algae oil and yeast oil) versus fish oil on body weight and serum lipids in mice. Mice fed fish oil had significantly lower serum total cholesterol, non-HDL cholesterol, and triglycerides compared to other diet groups. Fish oil also increased EPA and DHA levels in the liver to a greater extent than algae oil or yeast oil. The results suggest that fish oil may be more effective than some non-marine sources at reducing cardiovascular disease risk factors.
This document does not contain enough information to summarize. It appears to be an email address followed by random characters and does not convey any clear ideas, topics, or essential information that could be summarized in 3 sentences or less.
1) Teenagers in Indonesia don't care about local brands and see international brands as "cool" and their "god".
2) The author proposes a program where local brands donate 1% of profits to build facilities teenagers are passionate about, like music studios.
3) Teenagers receive vouchers for local brand purchases and can vote online for which facilities to build. This gives local products added value for teenagers and makes them proud to support their country.
This 3-sentence document lists 3 topics: Wordle, TooDoo.com, and Windows Live. Wordle and TooDoo.com appear to be website names while Windows Live is a product from Microsoft. The document provides a brief listing of 3 unconnected topics in only 3 words.
The document contains 12 passages from "The Prophet" by Kahlil Gibran on the topic of giving. Some key points:
1. True giving comes from giving of yourself, not just your possessions.
2. Those who have little but give all believe in the bounty of life and their resources are never depleted.
3. It is better to give without being asked by understanding others' needs.
4. One should strive to deserve being a giver and instrument of giving, as life ultimately gives to life through all people.
The document summarizes key aspects of the United Kingdom government, including:
The Crown where inheritance determines succession to the throne under the Act of Settlement of 1700.
The Cabinet which is made up of senior government ministers chosen by the Prime Minister and meets weekly to discuss issues.
The Prime Minister who oversees the government as the head, appoints Cabinet members, and presides over Cabinet meetings while informing the Queen of business.
The Parliament consisting of the House of Commons with 659 elected members and House of Lords with around 733 members including bishops, where their main functions are to pass laws, finance government, and scrutinize policy.
This document discusses various medical career paths such as administrative medical assistant, dental assisting, medical assisting, pharmacy technician, EKG/phlebotomy, and clinical days. It emphasizes that success is defined not by what we do but who we are, and expresses gratitude to Deanna Head and Mr. and Mrs. Head for their vision and support of the medical career training program.
El documento describe tres tipos de bullying: ciberbullying, bullying escolar y bullying familiar. El ciberbullying involucra insultar y burlarse de las víctimas a través de redes sociales. El bullying escolar es el más común alrededor del mundo. El bullying familiar es considerado el peor tipo porque el hogar deja de ser un lugar de protección para las víctimas.
This document discusses key questions to consider when developing questionnaires or surveys. It covers the functional needs of questionnaires, including the target audience and complexity. It also addresses modalities for data collection, including methods of administration and the necessary infrastructure. Finally, it examines issues related to the availability and use of collected data, as well as characteristics of the software used to create and manage questionnaires and surveys.
El área de Personal Social promueve el desarrollo personal y la ciudadanía activa a través de cinco competencias: construye su identidad, convive democráticamente, construye interpretaciones históricas, gestiona responsablemente el espacio y el ambiente, y gestiona responsablemente los recursos económicos. Se basa en los enfoques de desarrollo personal y ciudadanía activa, enfocándose en el autoconocimiento, las relaciones interpersonales, la participación social, y el desarrollo de una perspectiva crítica y ética. Tamb
The document provides an overview of the United Kingdom and its constituent nations. It describes the UK as a constitutional monarchy located in Western Europe with London as its capital city. Key details are given about England, Wales, Scotland, and Northern Ireland, including their capital cities, flags, famous landmarks, and symbols.
The document discusses the field of instructional design and technology. It provides the history and evolution of naming the field, from instructional media to instructional design and technology. The author then provides definitions of the field from organizations like AECT and their own definition, emphasizing a systematic process of designing instruction to meet learner needs using appropriate technologies.
Fundamental Rights and Values of the European Union (in Albanian Language) by...Lorenc Gordani
Lecture on the Fundamental Rights and Values of the European Union (in Albanian Language) by Dr Lorenc Gordani, 05-01-2015, Tirana, Albania
Dr. Lorenc Gordani - Leksion mbi Vlerat dhe Liritë Themelore te Bashkimit Evropiane
Bashkimi Evropiane si çdo forme organizimi ngjizet nga një projekt i përbashkët qe ka ne baze disa vlera te themelore. Te kuptuarit dhe përvetësuarit e te cilit gjate trajtimi te kuadrit kushtetuese behet thelbësore për te zotëruar kuptimi e rendit ligjore dhe vete strukturën e Unionit.
Për sa me sipër me specifikisht ne këtë kuadër do referojnë nder te tjera mbi te drejtat themelore ne traktatet e BE-se dhe respektimin e tyre me ane te procedures se sanksionit. Duke u ndaluar ne mënyre specifike: tek projeksionin e Bashkimit si promotorë i paqes, vlera e përhershme e unitetit dhe barazisë, garantimi i lirive themelore te lëvizjes, parimi i solidaritetit e drejtësisë sociale, pluralizmi kulturorë e identitetet kombëtare, dhe politikat e sigurisë dhe mirëqenies shoqërore (welfare).
Sugar and body weight control is a complex issue with multiple factors involved. While sugar consumption has increased alongside rising obesity rates, the evidence that sugar directly causes weight gain is limited. Appetite regulation is complex and involves many biological and behavioral mechanisms. Further research is still needed to fully understand the relationship between sugar intake and body weight.
1. Complications are 2-20 times greater in malnourished patients compared to well-nourished patients. Nutritional status can range from normal to borderline to malnourished.
2. Guidelines for initiating specialized nutrition support involve assessing nutritional status and determining if the gastrointestinal tract is functional. Enteral nutrition is preferred if the GI tract is intact. Parenteral nutrition is used if the GI tract is compromised.
3. Total parenteral nutrition involves supplying glucose, lipids, electrolytes, vitamins, minerals, and amino acids intravenously. The amounts supplied depend on factors like a patient's weight, medical condition, and nutritional requirements. Maintaining appropriate fluid and nutrient levels is important for recovery.
This 3-sentence document lists 3 topics: Wordle, TooDoo.com, and Windows Live. Wordle and TooDoo.com appear to be website names while Windows Live is a product from Microsoft. The document provides a brief listing of 3 unconnected topics in only 3 words.
The document contains 12 passages from "The Prophet" by Kahlil Gibran on the topic of giving. Some key points:
1. True giving comes from giving of yourself, not just your possessions.
2. Those who have little but give all believe in the bounty of life and their resources are never depleted.
3. It is better to give without being asked by understanding others' needs.
4. One should strive to deserve being a giver and instrument of giving, as life ultimately gives to life through all people.
The document summarizes key aspects of the United Kingdom government, including:
The Crown where inheritance determines succession to the throne under the Act of Settlement of 1700.
The Cabinet which is made up of senior government ministers chosen by the Prime Minister and meets weekly to discuss issues.
The Prime Minister who oversees the government as the head, appoints Cabinet members, and presides over Cabinet meetings while informing the Queen of business.
The Parliament consisting of the House of Commons with 659 elected members and House of Lords with around 733 members including bishops, where their main functions are to pass laws, finance government, and scrutinize policy.
This document discusses various medical career paths such as administrative medical assistant, dental assisting, medical assisting, pharmacy technician, EKG/phlebotomy, and clinical days. It emphasizes that success is defined not by what we do but who we are, and expresses gratitude to Deanna Head and Mr. and Mrs. Head for their vision and support of the medical career training program.
El documento describe tres tipos de bullying: ciberbullying, bullying escolar y bullying familiar. El ciberbullying involucra insultar y burlarse de las víctimas a través de redes sociales. El bullying escolar es el más común alrededor del mundo. El bullying familiar es considerado el peor tipo porque el hogar deja de ser un lugar de protección para las víctimas.
This document discusses key questions to consider when developing questionnaires or surveys. It covers the functional needs of questionnaires, including the target audience and complexity. It also addresses modalities for data collection, including methods of administration and the necessary infrastructure. Finally, it examines issues related to the availability and use of collected data, as well as characteristics of the software used to create and manage questionnaires and surveys.
El área de Personal Social promueve el desarrollo personal y la ciudadanía activa a través de cinco competencias: construye su identidad, convive democráticamente, construye interpretaciones históricas, gestiona responsablemente el espacio y el ambiente, y gestiona responsablemente los recursos económicos. Se basa en los enfoques de desarrollo personal y ciudadanía activa, enfocándose en el autoconocimiento, las relaciones interpersonales, la participación social, y el desarrollo de una perspectiva crítica y ética. Tamb
The document provides an overview of the United Kingdom and its constituent nations. It describes the UK as a constitutional monarchy located in Western Europe with London as its capital city. Key details are given about England, Wales, Scotland, and Northern Ireland, including their capital cities, flags, famous landmarks, and symbols.
The document discusses the field of instructional design and technology. It provides the history and evolution of naming the field, from instructional media to instructional design and technology. The author then provides definitions of the field from organizations like AECT and their own definition, emphasizing a systematic process of designing instruction to meet learner needs using appropriate technologies.
Fundamental Rights and Values of the European Union (in Albanian Language) by...Lorenc Gordani
Lecture on the Fundamental Rights and Values of the European Union (in Albanian Language) by Dr Lorenc Gordani, 05-01-2015, Tirana, Albania
Dr. Lorenc Gordani - Leksion mbi Vlerat dhe Liritë Themelore te Bashkimit Evropiane
Bashkimi Evropiane si çdo forme organizimi ngjizet nga një projekt i përbashkët qe ka ne baze disa vlera te themelore. Te kuptuarit dhe përvetësuarit e te cilit gjate trajtimi te kuadrit kushtetuese behet thelbësore për te zotëruar kuptimi e rendit ligjore dhe vete strukturën e Unionit.
Për sa me sipër me specifikisht ne këtë kuadër do referojnë nder te tjera mbi te drejtat themelore ne traktatet e BE-se dhe respektimin e tyre me ane te procedures se sanksionit. Duke u ndaluar ne mënyre specifike: tek projeksionin e Bashkimit si promotorë i paqes, vlera e përhershme e unitetit dhe barazisë, garantimi i lirive themelore te lëvizjes, parimi i solidaritetit e drejtësisë sociale, pluralizmi kulturorë e identitetet kombëtare, dhe politikat e sigurisë dhe mirëqenies shoqërore (welfare).
Sugar and body weight control is a complex issue with multiple factors involved. While sugar consumption has increased alongside rising obesity rates, the evidence that sugar directly causes weight gain is limited. Appetite regulation is complex and involves many biological and behavioral mechanisms. Further research is still needed to fully understand the relationship between sugar intake and body weight.
1. Complications are 2-20 times greater in malnourished patients compared to well-nourished patients. Nutritional status can range from normal to borderline to malnourished.
2. Guidelines for initiating specialized nutrition support involve assessing nutritional status and determining if the gastrointestinal tract is functional. Enteral nutrition is preferred if the GI tract is intact. Parenteral nutrition is used if the GI tract is compromised.
3. Total parenteral nutrition involves supplying glucose, lipids, electrolytes, vitamins, minerals, and amino acids intravenously. The amounts supplied depend on factors like a patient's weight, medical condition, and nutritional requirements. Maintaining appropriate fluid and nutrient levels is important for recovery.
Asrt malaysia itm rice bran projects presentationAmr Helal
Rice bran , instead of using as animal feed, was stablized , studied from the phytochemical , pharmacological, toxicological and formulation points of view. It is developed to be used in bakery, nutraceutical, cosmoceutical preparations with soild scientific proof of evidence.
Nutrition metabolism and inflammation an essential but dangerous crosstalkNorwich Research Park
Nutrition, metabolism and inflammation are closely intertwined processes. Excessive or prolonged metabolic and inflammatory stress from modern diets can lead to non-resolving organ inflammation over time. Research is exploring the early events and biomarkers that indicate transition to a pathological "two hit state", as well as understanding individual responses to diet. Modulating inflammation through nutrition interventions may help prevent or treat obesity-related diseases.
Costa rica Lecture 3. on 4 Oct 2012 Nutrigenomics: We are what we eat - why?Norwich Research Park
Nutrigenomics is the study of how nutrients and foods impact gene expression and phenotype. A high protein diet was shown to prevent non-alcoholic fatty liver disease in mice by enhancing lipid secretion and reducing energy utilization from food. High protein diets modulate lipid handling in the small intestine and alter the gut microbiota. Deeper genomic profiling and systems biology approaches are needed to better understand metabolic flexibility and personalize nutrition recommendations.
Suplementos: Desperdício ou NecessidadePedro Bastos
This document discusses the potential benefits and necessity of supplements. It presents data showing that many Americans and Europeans do not meet recommended daily intakes of certain micronutrients from diet alone. Studies suggest magnesium intake may help reduce risk of metabolic syndrome, diabetes, and heart disease by improving insulin sensitivity and metabolic markers. A randomized controlled trial found that oral magnesium supplementation improved insulin sensitivity in non-diabetic adults with insulin resistance. Overall the document argues that supplements may help fill nutritional gaps and support health, though over-reliance on supplements rather than whole foods is not ideal.
feeding pigs trans fat vahmani meadus 2016 cjas-2015-0080Adam Sebzda
1) Sixteen pigs were randomly assigned to diets containing either 5% biohydrogenation product (BHP)-enriched beef fat or control beef fat for 7 weeks.
2) Feeding the enriched fat led to deposition of various BHPs, including trans fatty acids and conjugated linoleic acids, in the pigs' subcutaneous fat tissues.
3) While growth performance and body composition were unaffected, total and HDL cholesterol decreased in pigs fed the enriched fat diet, though LDL cholesterol and triglycerides did not change.
1. Optimal broiler diets were explored to maximize carcass yield and quality by manipulating dietary energy and protein densities throughout growth phases.
2. Results showed that a high protein prestarter diet improved body weight and breast yield at 42 days, and that lowering energy:protein ratios in grower and finisher diets optimized profitability.
3. Early nutrition strongly impacts economics, and formulating diets with the end product in mind can improve lean meat yield and profitability.
Dr. John Patience - A Critical Look at the Science Underlying Feed EfficiencyJohn Blue
A Critical Look at the Science Underlying Feed Efficiency - Dr. John Patience, Iowa State University, from the 2012 Allen D. Leman Swine Conference, September 15-18, St. Paul, Minnesota, USA.
In this slide deck I show on the basis of meta-analyses how red and processed meat is linked to diabetes, strokes, heart disease and cancer whereas dairy is not.
Compare Effect of Fatty Acid Composition (Olive, Coconut Oil and Butter) on A...IOSR Journals
This document compares the effects of olive oil, coconut oil, and butter on adipose tissue, liver tissue, and serum lipid profiles in albino rats. It finds that coconut oil has the highest saturated fat content. Females were more affected than males in their lipid profiles and relative liver and heart weights. Microscopic examination found histopathological changes in livers of rats fed different fats. The conclusion is that saturated fatty acids generally raise cholesterol levels, while monounsaturated fatty acids are neutral or mildly lowering and polyunsaturated fatty acids are cholesterol-lowering.
1. Friday Monogastric Sessions dr dean boyd hanor group usa - recently adopte...2damcreative
This document provides an overview of recently adopted nutrition concepts in North America presented by R. Dean Boyd. Key points include:
1) Feeding essential fatty acids like linoleic acid and alpha-linolenic acid to lactating sows to improve reproductive efficiency under heat stress.
2) The increased adoption of net energy systems over metabolizable energy in North America to improve diet formulation accuracy.
3) Strategies to improve pig viability like feeding xylanase and controlling lipid peroxidation in diets, which can impact health and performance.
4) Expanded use of synthetic amino acids in swine diets including newer additions like L-histidine and L-arginine.
This document summarizes a study that examined the histological effects of Peganum harmala seed extract on the spleen, liver enzymes, and blood parameters of albino rats. Rats were administered normal saline or 1%, 2%, or 3% doses of P. harmala extract daily for one month. Higher doses caused more severe structural changes in the spleen, including hemorrhaging, degeneration, and necrosis. The extract also significantly affected body and liver weight. Blood glucose and cholesterol decreased significantly with treatment. While some liver enzymes were affected, white and red blood cell counts remained unchanged. Histological examination showed dose-dependent damage to spleen tissue.
Dr. John Patience - Dietary Fat: It Is Much More Than An Energy Source To The...John Blue
Dietary Fat: It Is Much More Than An Energy Source To The Pig - Dr. John Patience, from the 2015 Allen D. Leman Swine Conference, September 19-22, 2015, St. Paul, Minnesota, USA.
More presentations at http://www.swinecast.com/2015-leman-swine-conference-material
Evaluation of anti atherosclerotic activity of virgin coconut oilRam Sahu
1. The study evaluated the anti-atherosclerotic effects of virgin coconut oil (VCO) in male Wistar rats fed high lipid and high carbohydrate diets to induce atherosclerosis.
2. Rats fed VCO along with normal, high carbohydrate, and high lipid diets had significantly lower body weight, total cholesterol, triglycerides, LDL, and VLDL, but higher HDL compared to control diet groups after 8 weeks.
3. VCO treatment also significantly reduced the atherogenic index and increased percentage of protection against atherosclerosis in all diet groups compared to controls. This suggests VCO has anti-atherosclerotic properties.
This document summarizes a research study on the effects of the pesticides malathion and cypermethrin on biochemical constituents in the freshwater fish Lepidocephalichthys guntea. The study found that exposing the fish to sub-lethal concentrations of both pesticides for 96 hours resulted in significant decreases in glycogen, protein, and lipid levels compared to the control group. The decreases indicated that the pesticides affected the fish's metabolism and energy utilization. Both malathion and cypermethrin were shown to be highly toxic to L. guntea and cause harmful biochemical changes.
The document discusses the history of milk and dairy consumption by humans. It notes that dairy culture began around 10,000 years ago with the domestication of animals like cattle, goats, and sheep in the Middle East. While lactase production normally declines after weaning for most humans, some populations developed the ability to digest milk as adults, known as lactase persistence. The document discusses evidence that two major lactase persistence alleles - one found in Europeans (T-13910) and another compound allele found in Middle Eastern populations - arose independently in response to different histories of animal domestication and milk consumption. It provides support for the convergent evolution of lactase persistence in diverse populations.
The document discusses vitamin D and minerals. It provides the following key information:
1) The human body is composed primarily of oxygen, hydrogen, nitrogen, carbon, calcium, phosphorus, potassium, sulfur, sodium, chlorine, and magnesium. Vitamins and other micronutrients make up only 0.1% of the body.
2) Important sources of nutrients include oxygen and hydrogen from air and water, carbon as the basic structure of all foods, nitrogen from proteins, and minerals distributed across various foods.
3) Vitamins are divided into water-soluble vitamins like B vitamins and vitamin C, and fat-soluble vitamins like vitamins A, D, E, and K.
The document discusses inflammation in sports. It describes acute inflammation as characterized by heat, redness, swelling, and pain, resulting in loss of function. It occurs as the body's response to injury or infection, involving the immune system cells like monocytes, macrophages, neutrophils, basophils, eosinophils, NK lymphocytes, T lymphocytes and B lymphocytes that work to remove injurious stimuli and initiate healing.
Dieta e prevenção cvd versão slidesharenutriscience
1) Higher consumption of eggs (up to one egg per day) is not associated with an increased risk of coronary heart disease or stroke according to a meta-analysis of prospective cohort studies.
2) The meta-analysis found an increased risk of coronary heart disease among diabetic patients who consumed more eggs, warranting further study.
3) The meta-analysis also found a reduced risk of hemorrhagic stroke with higher egg consumption, again warranting further study in subgroup analyses.
This document summarizes a presentation about milk signaling and Western diseases. It discusses how milk, through its high leucine content, is an endocrine system that activates mTORC1 signaling. This leads to increased insulin secretion, insulin resistance, and may disturb beta-cell homeostasis over time. Studies are needed that directly measure tissue mTORC1 activity and insulin signaling after milk versus other protein challenges to better characterize any milk-induced insulin resistance. The document also notes that type 2 diabetes is an mTORC1-driven disease.
4. NOVA RODA
PORTUGUESA
Cereais e 4 a 11 doses
derivados,
tubérculos
Hortaliças 3 a 5 doses
Fruta 3 a 5 doses
Lácteos 2 a 3 doses
Carnes, peixe e ovos 1,5 a 4,5 doses
Leguminosas 1 a 2 doses
Gorduras e óleos 1 a 3 doses
Instituto do Consumidor, 2003
5.
6. HARVARD SCHOOL OF PUBLIC HEALTH, 2005
http://www.hsph.harvard.edu/nutritionsource/what-should-you-eat/pyramid/
19. Estudos com Humanos:
Estudos Metabólicos de curto prazo
RCTs
CAUSA/EFEITO
Estudos com Animais
Epidemiologia
Estudos In vitro
Cordain L. Dietary implications for the development of acne: a shifting paradigm. In: U.S. Dermatology Review II 2006, (Ed.,Bedlow, J).
Touch Briefings Publications, London, 2006.
24. ALIMENTO (100 G) COLESTEROL
(MG)
Queijo de Azeitão 88
Nata 33% gordura 97
Costoleta de Porco (gorda) grelhada 111
Peito de vitela estufado 121
Camarão Cozido 198
Mexilhão cozido 360
Fígado de vitela grelhado 387
Ovo cozido 408
Tabela de Composição dos Alimentos. Centro de Segurança Alimentar e Nutrição. Instituto nacional de
Saúde Dr. Ricardo Jorge, 2006
25.
26. EFEITOS NO CURTO PRAZO
INCREMENTO DE 100 MG/D DE COLESTEROL DIETÉTICO AUMENTOU:
ü CT: 2.2 mg/dl
ü C- HDL: 0.3 mg/dl
26
Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.
27. EFEITOS A LONGO PRAZO
3 grupos de Consumo de ovos por semana (Framingham Heart Study)
27
Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.
28. EFEITOS A LONGO PRAZO
Colesterol Total nos 3 grupos
28
Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.
29. of each
that th
Dietary cholesterol The
changes
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1.2 statistica
erate
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35.43
. Confined Inst meals Free : :ii- mg/dL;
Location of subjects mmol/L
0.6%
FIGURE 2. Regression WH, et al. Am J Clin Nutr. 1997 Jun;65(6):1747-64.
Howell coefficients of saturated fatty acids, poly- On
unsaturated fatty acids, and &holesterol for studies of subjects free-living
analysis
30. US NATIONAL HEALTH AND NUTRITIONAL
SURVEY (1984–1994)
30
Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.
31. CHOLESTEROL SYNTHESIS, TRANSPORT, & EXCRETION / 225
ENTEROHEPATIC CIRCULATION
HEPATIC PORTAL VEIN Diet (0.4 g/d)
C
CE
GALL
BLADDER
Synthesis
–
– Bile acids
(total pool, 3–5 g)
BILE DUCT
Unesterified
cholesterol CE
pool
C
ACAT CE Bile
C C acids
HL VLDL
C TG Chylomicron CE
TG ILEUM
,C CE
E
LDL C
(apo B-100, E) TG
LIVER receptor CE 8 –9 9
%
9
LDL C
TG
CE
LRP receptor CE
C TG
CE CE
TG C CE
TP
C Bile acids
TG TG CE AT
A-I (0.6 g/d) (0.4 g/d)
CE
LC
CE IDL
C C HDL Feces
(VLDL remnant)
Chylomicron
remnant
LPL C
LDL
(apo B-100, E)
C receptor
EXTRAHEPATIC C Synthesis
TISSUES
CE
Murray R, et al. Harper’s Illustrated Biochemistry 26th Edition.
McGraw-Hill, 2003
Figure 26–6. Transport of cholesterol between the tissues in humans. (C, unesterified cholesterol; CE, cho-
32.
33. 826 HERRON ET AL
Table 1. Distribution of Cholesterol in LDL Subclasses and LDL Peak Diameter of Hypo- and Hyper-responders
During the EGG or SUB Periods
LDL Peak
LDL-1 (mg/dL) LDL-2 (mg/dL) LDL-3 (mg/dL) Diameter (nm)
Women
Hyper-responders (n ϭ 14)
EGG 31.7 Ϯ 12.2a 22.1 Ϯ 10.7b 5.1 Ϯ 5.5a 26.90 Ϯ 0.25a
SUB 28.1 Ϯ 10.4b 16.6 Ϯ 7.8a 4.1 Ϯ 5.5a 26.99 Ϯ 0.33a
Hypo-responders (n ϭ 13)
EGG 21.8 Ϯ 7.8c 19.4 Ϯ 10.5ab 4.5 Ϯ 5.5a 26.58 Ϯ 0.57b
SUB 21.9 Ϯ 8.0c 19.1 Ϯ 11.5ab 4.6 Ϯ 6.8a 26.67 Ϯ 0.62b
Men
Hyper-responders (n ϭ 12)
EGG 23.3 Ϯ 8.4c 19.6 Ϯ 8.2ab 16.6 Ϯ 16.2c 26.24 Ϯ 0.58b
SUB 20.0 Ϯ 7.9c 25.6 Ϯ 5.6b 9.9 Ϯ 10.4bc 26.40 Ϯ 0.53b
Hypo-responders (n ϭ 13)
EGG 18.2 Ϯ 8.8d 20.5 Ϯ 5.6ab 6.8 Ϯ 6.1ab 26.75 Ϯ 0.35a
SUB 20.5 Ϯ 9.0c 20.5 Ϯ 9.0ab 7.8 Ϯ 7.5b 26.67 Ϯ 0.52b
Sex effect P Ͻ .05 NS P Ͻ .01 P Ͻ .01
Response effect P Ͻ .05 NS NS NS
Diet effect NS NS P Ͻ .05 NS
Interaction sex ϫ response NS NS NS P Ͻ .001
Interaction sex ϫ diet NS NS NS NS
Interaction response ϫ diet P Ͻ .001 P Ͻ .05 P Ͻ .001 NS
Interaction sex ϫ diet ϫ response NS P Ͻ .01 P Ͻ .05 NS
NOTE. Values are presented as mean Ϯ SD for the number of subjects indicated in parentheses. Values in the same column with different
superscripts are significantly different as determined by 3-way ANOVA and LSD as post hoc test.
Abbreviations: EGG, egg; SUB,KL, Lofgren NS,Sharman M, Volek JS, Fernandez ML. Metabolism. 2004 Jun;53(6):823-30.
Herron substitute; IE, not significant.
consumption, while hyporesponders experienced no change for contrast, plasma LCAT and CETP activities were significantly
34. 24, 25]. Other cholesterol-containing foods, such as dairy fed for 4 weeks with a 1-month washout period in between.
products, also contain high concentrations of saturated fat, The participants were classified as insulin sensitive (n=65),
Curr Atheroscler Rep (2010) 12:377–383
which is a confounder for dietary cholesterol effects. This
DOI 10.1007/s11883-010-0130-7
insulin resistant (n=75), and obese insulin resistant (OIR,
might be the reason why controversial results exist n=58). Insulin-resistant and insulin-sensitive individuals had
regarding the effects of dairy products on CHD risk [26]. significant increases in LDL-C of 7.8% and 3.3%, respec-
Clinical trials conducted in children [27], younger adults tively, after consuming 4 eggs per day, whereas OIR
Revisiting Dietary Cholesterol Recommendations: LDL-C at any intake level.
[24, 25], and the elderly [28, 29] have clearly demonstrated individuals had no changes in
that although dietary cholesterol provided by eggs signifi-
Does the Evidence Support a LimitHDL-C was significantly increased for all groups
In contrast,
of 300 mg/d?
cantly increases LDL-C in one third of the population, those even after the consumption of only 2 eggs per day. These
individuals considered hyper-responders to & a cholesterol
Maria Luz Fernandez Mariana Calle studies suggest that dietary management of OIR individuals
challenge exhibit increases in both LDL-C and HDL-C, with need not include restrictions on eggs.
Table 2 Changes in LDL-C, HDL-C, LDL size, and HDL size as a response to dietary cholesterol provided by eggs in various populations
Published online: 4 August 2010
# Springer Science+Business Media, LLC 2010
Population Duration Additional dietary cholesterol LDL-C HDL-C LDL-C/HDL-C ratio LDL size HDL size
Children (n=54) [27] 4 Abstract The mg/d
wk 518 perceived association between Increase Introduction No change
dietary cho- Increase Increase ND
lesterol (DC) and risk for coronary heart disease (CHD) has
Women (n=51) [25] 4 resulted in recommendations of no more than 300 mg/d for Increase
wk 640 mg/d Increase The AmericanNo change
Heart Association (AHA)Increase
recommends ND
no
Men (n=28) [32••] 12 healthy 640 mg/d the United States. These change Increase 300 Decrease
wk persons in No dietary more than mg/d of dietary cholesterolIncrease healthy
(DC) for Increase
recommendations proposed in the 1960s had little scientific
Men/women (n=42) [34] 12 wk 215 mg/d No change Increaseto prevent change risk for coronary heart disease
persons
No increased Increase Increase
evidence other than the known association between (CHD) [1]. These recommendations are mostly based on
Men/women (n=34) [28] 4 saturated640 and cholesterol and animal studies where Increase
wk fat mg/d Increase No change Increase Increase
the presence of both saturated fat and cholesterol in many
Men/women (n=56) [35•] 12 wk 250 mg/d No normal foods and onDecrease
cholesterol was fed in amounts far exceeding change Increase data derived from animal studies where
ND ND
intakes. In contrast, European countries, Asian countries, supraphysiologic doses of cholesterol, ranging from the
Men/women (n=45) [33•] 12 and Canada do not have an upper limit for DC. change No changeof 1,000 mg to 20,000 mg/d for humans, were
wk 400 mg/d No Further, equivalent No change ND ND
current epidemiologic data have clearly demonstrated that fed in order to produce atherosclerosis [2].
HDL-C high-density lipoprotein increasing concentrations of DC arelipoprotein cholesterol; ND not determined. that many other countries do not
cholesterol; LDL-C low-density not correlated with It is important to note
increased risk for CHD. Clinical studies have shown that have the same guidelines for DC. Canada [3••], Korea [4•],
even if DC may increase plasma low-density lipoprotein New Zealand [5], and India [6], for example, do not set an
(LDL) cholesterol in certain individuals (hyper-responders), upper limit for DC, focusing instead on controlling the
this is always accompanied by increases in high-density intake of saturated fat and trans fat, which are the major
lipoprotein (HDL) cholesterol, so the LDL/HDL cholesterol determinants of blood cholesterol concentrations. Similarly,
ratio is maintained. More importantly, DC reduces circu- the European guidelines on cardiovascular disease preven-
lating levels of small, dense LDL particles, a well-defined tion have the following recommendations regarding healthy
risk factor for CHD. This article presents recent evidence food choices: “consume a wide variety of foods, adjust
from human studies documenting the lack of effect of DC energy intake to maintain a healthy weight, encourage
on CHD risk, suggesting that guidelines for DC should be consumption of fruits and vegetables, replace saturated fat
revisited. with mono or polyunsaturated fatty acids and reduce salt
intake” [7]. In contrast to US policies, Europeans have no
Keywords Dietary cholesterol . LDL cholesterol . dietary guidelines for DC [7]. A summary of the dietary
35. LDL PEQUENAS E DENSAS
ü sdLDL:
ü Tamanho da partícula <
25.5nm
ü Densidade > 1.04g/ml
ü Aumenta
significativamente o
risco de DCV
ü TG elevados e HDL-C
baixo é um bom preditor
de sdLDL
Griffin BA. Proc Nutr Soc 1999;58:163-69
36.
37. Cordain, 2009
FLUXO DE LDL PARA A INTIMA É > PARA LDL PEQUENAS E DENSAS
UMA VEZ NA INTIMA, LDL PEQUENAS E DENSAS SÃO SUSCEPTÍVEIS DE SOFRER
OXIDAÇÃO
37
40. 214 Esrey et al.
TABLE 3. Cox regression estimates of the effect of dietary intake measured at baseline on coronary heart disease death among
3925 men and women 30 to 59 years of age after 12.4 years foIIow-up in the North American Lipid Research Clinics Prevalence
FoIIow-Up Study
Model 3
Model 1 Modei 2 (adjusted for age, sex,
(adjusted for age, sex, (adjusted for age, sex, energy intake, serum lipids,
energy intake) energy intake, serum lipids”) and other risk factorsb)
Variable Estimate RR (95% CI) Estimate RR (95% CI) Estimate RR (95% CI)
% Fat
Total 0.044" 1.04 (1.01-1.08) 0.043" 1.04 (1.01-1.08) 0.043' 1.04 (l.Ol-1.08)
Saturated 0.104” 1.11 (1.04-1.18) 0.095" 1.10 (1.03-1.17) 0.103" 1.11 (1.04-1.18)
Monounsaturated 0.095" 1.10 (1.03-1.17) 0.094' l 1.10 (1.03-1.18) 0.080' 1.08 (1.01-1.16)
Polyunsaturated -0.040 0.96 (0.88-1.05) -0.027 0.97 (0.89-1.07) -0.014 0.99 (0.90-1.08)
% Carbohydrate -0.034" 0.97 (0.94-0.99) -0.040" 0.96 (0.93-0.99) -0.036' 0.96 (0.94-0.99)
% Protein 0.020 1.02 (0.97-1.08) 0.013 1.01 (0.96-1.07) 0.011 1.01 (0.95-1.07)
% Alcohol + alcohol’ -0.019 0.98 (0.92-1.05) 0.001 1.00 (0.94-1.06) 0.0001 1.00 (0.95-1.07)
Cholesterol (10 mg) per 5000 kJ 0.004 1.00 (0.99-1.02) 0.006 1.01 (0.99-1.02) 0.004 1.00 (0.99-1.02)
?Serum lipids (mmoliliter) included total serum cholesterol and high-density lipoproteins.
bOther risk factors were systolic blood pressure (mmHg), cigarette smoking status (current smoker/nonsmoker), body mass index (kg/m*), and glucose
intolerance (present/absent).
‘p < 0.05.
41. ?Serum lipids (mmoliliter) included total serum cholesterol and high-density lipoproteins.
bOther risk factors were systolic blood pressure (mmHg), cigarette smoking status (current smoker/nonsmoker), body mass index (kg/m*), and glucose
intolerance (present/absent).
‘p < 0.05.
“p < 0.01.
RR = Relative risk for coronary heart disease mortality, defined as exp(@, associated with a I+unit increase in the dietary variable; 95% CI = 95% confidence
interval, defined as exp@ 2 1.96 SE)(z, - q), where SE is the standard error of /3, and 7, and Q represent the two levels of the dietary variable being
compared; % =percentage of total energy provided by the dietary variable.
(total cholesterol and HDL) were added to the regression model and none approached statistical significance. The magnitude and direc-
(model 2), the estimated relative risks for the dietary variables re- tion of some estimates changed between the three models evaluated,
mained stable. The magnitudes of these relationships were also unaf- but within a small range. When a quadratic alcohol term was included
fected by the addition of other known coronary risk factors (model 3). in the Cox model, percentage of energy intake as alcohol was signifi-
cantly associated with risk of coronary disease death within this older
Among the older age group, no relationships between dietary fat or age group.
its fatty acid components, carbohydrate, or protein, and coronary heart None of the dietary components examined were significantly associ-
disease death were identified (Table 4). The estimares of the regression ated with total mortality within either the young or the older age
coefficients were al1 smaller than those among the younger age group groups.
TABLE 4. Cox regression estimates of the effect of dietary intake measured at baseline on coronary heart disease death among
621 men and women 60 to 79 years of age after 12.4 years follow-up in the North American Lipid Research Clinics Prevalence
Follow-Up Study
Model 3
Model 1 Model 2 (adjusted for age, sex,
(adjusted for age, sex, (adjusted for age, sex, energy intake, serum lipids,
energy intake) energy intake, serum lipids”) and other risk factorsb)
Variable Estimate RR (95% CI) Estimate RR (95% CI) Estimate RR (95% CI)
% Fat
Total -0.0004 1.00 (0.96-1.04) -0.002 1.00 (0.96-1.04) -0.011 0.99 (0.95-1.03)
Saturated -0.031 0.97 (0.89-1.05) -0.026 0.97 (0.90-1.06) -0.038 0.96 (0.88-1.05)
Monounsaturated 0.025 1.03 (0.95-1.11) 0.019 1.02 (0.94-l. 11) -0.005 1.00 (0.91-1.08)
Polyunsaturated 0.006 1.01 (0.91-1.11) -0.004 1.00 (0.90-l. 10) -0.004 1.00 (0.90-1.10)
% Carbohydrate 0.004 1.00 (0.97-1.04) 0.003 1.00 (0.97-1.04) 0.016 1.02 (0.98-1.05)
% Protein 0.017 1.02 (0.94-l. 10) 0.015 1.02 (0.94-1.10) 0.0002 1.00 (0.93-1.08)
% Alcohol + alcohol’ -0.114" 0.89 (0.84-0.94) -0.116** 0.89 (0.83-0.95) -0.124” 0.88 (0.83-0.95)
Cholesterol (10 mg) per 5000 kJ 0.011 1.01 (0.99-1.03) 0.011 1.01 (0.99-1.03) 0.006 1.01 (0.98-1.03)
“Serum lipids (mmoliliter) included total serum cholesterol and high-density lipoproteins.
bOther risk factors were systolic blood pressure (mmHg), cigarette smoking status (current smoker/nonsmoker), body mass index (kg/m’), and glucose
intolerance foresent/absent).
42. 37,851 H seguidos por 8 anos
80.082 M seguidas por 14 anos
Baseado em Hu Fb, et al. JAMA. 1999;281:1387-1394 e adaptado por Okuyama H, et al. World Rev Nutr Diet. 2007;96:1-17.
46. lly twelve volunteers composite samples taken from each menu once during the
s unable to complete study for both the stabilization diet and intervention diets.
en complete physical The results for the seven composite samples were averaged
within -10 to +20 per- to find the actual composition of the diets. No alcohol was in-
tropolitan Life Insur-
values from the 1983
TABLE 1
r chronic disease was Composition of HNS*27 Diets, Proximal Analysis
a
on was not an exclu- Low-fat diets High-fat diets
cruited tended to have (% of total calories)
e for men in this age Target Target
nsumption, and evi- Measured value Measured value
sionary. Macronutrient energy
eers were confined to distribution
Protein 15.9 16.0 15.7 16.0
tern Human Nutrition Fat 22.2 20.0 38.7 40.0
or the duration of the Carbohydrate 61.9 64.0 45.7 44.0
onfines of the Nutri- Cholesterol content
sed outings, they had (mean, mg/day) -- 360 -- 360
cept that provided by Fatty acid energy
distribution
rotocol was, of neces- Saturated 6.4 5 10.6 10
was monitored, por- Monounsaturated 9.2 10 15.5 20
required to consume Polyunsaturated 6.6 5 12.6 10
heir meals. (A rubber P/S ratio 1.0 1.0 1.2 1.0
ood was scraped from ap/s, polyunsaturated/saturated; HNS-2 7 diet.
Nelson GJ, Schmidt PC, Kelley DS. Lipids. 1995 Nov;30(11):969-76
47. dicated an increase in the plasma very low density lipopro- factory because the conditions of this experiment were ca
n (VLDL) level and a decrease in both the plasma HDL and fully controlled and the statistical power of the protocol w
DL levels. Thus, the total cholesterol level remained con- excellent.
nt because the increase in plasma VLDL cholesterol com- (ii) The average cholesterol level in the subjects was co
nsated for the reduction in HDL-cholesterol and LDL-cho- siderably below that in the European and American popu
terol. Because of individual variations, the standard devia- tions used to develop the Keys et aL (5) and Hegsted et al.
TABLE 6
High- and Low-Fat Diets, Blood Cholesterol, Triglycerides, and Lipoprotein Values
Total HDL- LDL-
cholesterol Triglycerides cholesterol cholesterol
Period Diet mean + SD mean _+ SD mean • SD mean • SD
Entry A d libitum 176.3 + 33.1 85.8 + 28.4 46.3 _+ 14.0 112.8 • 26.8
Stabilization High-fat 172.5 + 30.3 75.3 • 46.4 44.8 • 11.6 112.6 • 21.9
Intervention Low-fat 173.2 _+27.3 91.5 • 38.0 40.5 • 12.4 114.5 • 21.3
Intervention High-fat 176.9 _+ 32.9 66.4 • 41.7 43.2 + 13.4 119.5 _+24.3
Paired t-test, Pvalues a 0.425 0.002 0.258 0.238
~lhe t-test compares only the values at the end of the high- or low-fat diets with the values obtained at the end of the stabi-
lization period, study day 20. Groups A and B values were taken at study day 70 and day 120, depending on the leg of the
intervention diet for the each group; HDL, high density lipoprotein; LDL, low density lipoprotein.
Lipids, Vol. 30, no. 11 (19
Nelson GJ, Schmidt PC, Kelley DS. Lipids. 1995 Nov;30(11):969-76
48. ENTRE 1968-1978, NA GRONELÂNDIA
ü Nenhum caso de
morte por DAC
ü Nenhum caso de
enfarte agudo
do miocardio
(População = 2,600)
Bang HO, Dyerberg J. Adv Nutr Res 1980 3:1-22.
49. ALIMENTOS VEGETAIS / ANIMAIS EM 13 SOCIEDADES
PRIMITIVAS!
Cordain L et al. Eur J Clin Nutr 2002; 56 (suppl 1):S42-S52. !
51. n’s Health Initiative Randomized Controlled
Health Initiative Randomized Controlled
cation TrialTrial epidemiologic studies and some trials have linked diet with car-
dification Multiple
Context
diovascular disease (CVD) prevention, but long-term intervention data are needed.
Linda Objective To test the hypothesis thatsome trials have linked diet with car- diet be low in
Context Multiple epidemiologic studies andstudies and intervention, intended to with car-
Context Multiple epidemiologic a dietary some trials have linked
Hsia, MD; fat and high in vegetables, fruits, but long-term intervention data are needed.
D;
diovascular disease (CVD) prevention, and grains to long-term intervention data are CVD risk.
. diovascular disease (CVD) prevention, but reduce cancer, would reduce needed.
L.arcia L.
D; Design, Setting, To test the hypothesis that a dietary intervention, trial of 48 835low in
Objective and Participants Randomized controlled intended
Objective To test the hypothesis that a dietary intervention, intended to be low in to be post-
s; H.
Lewis H. menopausal women aged 50 tograins to reduce cancer, would reduce would reduce CVD risk.
fat and highand high in vegetables, fruits, and grains to reduce cancer, CVD risk.
fat in vegetables, fruits, and 79 years, of diverse backgrounds and ethnicities, who
PhD; , PhDDesign,Design, Setting, and Participants Randomized controlled trial ofWomenpost-
Croix participated in the Women’s Health Initiative controlled trial of 48 835 Trial. 48 835 were
; Setting, and Participants Randomized Dietary Modification post-
menopausal women aged 50 to 79 years, of diverse541 [40%])and ethnicities, whogroup (29 294
L. menopausal to an aged 50 to 79(19 backgroundsbackgrounds
orman L. randomly assignedwomeninterventionDietary Modification Trial. Womenand ethnicities, who
years, of diverse or comparison
s, MD;
;L. [60%]) participated in the Women’s(19 541 [40%]) orDietary Modification were Women were
participated in the Women’s Health Initiative
in a free-living setting. Study enrollment occurred between Trial. and 1998 in
randomly assigned to an intervention
Health Initiative comparison group (291993 294
40 US clinical centers; mean follow-up in this 541 [40%]) or8.1 years. in group (29 294
randomly assigned to an intervention (19 analysis was comparison
Karen L. [60%]) in a free-living setting. Study enrollment occurred between 1993 and 1998
MD;
.ysiw 40 US clinical centers; mean follow-up in Study enrollment occurred between 1993 and 1998 in
[60%]) in a free-living setting.
D; , MD; Intervention Intensive behavior this analysis this in group and individual sessions de-
was 8.1 years.
modification analysis was 8.1 years.
40 US clinical centers; mean follow-up in
PhD; M. signed to reduce total fat intake to 20% of calories and increase intakes of vegetables/
inda Intervention Intensive behavior modification in group and individual sessions de-
Perri, PhD;fruits toInterventionand grains behavior modification inintakescomparison group received
signed to5 servings/d intake to 20% of calories and increase group of vegetables/ sessions de-
reduce total fat Intensive to at least 6 servings/d. The and individual
D; L.
oss fruits to 5 servings/d and grains to at intake servings/d. The comparison group received of vegetables/
signed to reduce total fat least 6 to 20% of calories and increase intakes
diet-related education materials.
bins, MD; diet-related education materials.
fruits to 5 servings/d and grains to at least 6 servings/d. The comparison group received
RISCO
0%
5%
10%
15%
20%
25%
DAC
Total
DCV
RELATIVO
E.
nda G. E. Main Outcome Measures Fatal and nonfatal coronary heart disease (CHD), fatal (CHD), fatal
GloriaG. Main Outcome Measures Fatal and nonfatal coronary heart disease
Linda diet-related education materials.
PhD;
ns, MD; ;Linda G.nonfatal stroke, andand CVD (composite of CHD and stroke). disease (CHD), fatal
z, PhD and nonfatal Outcome Measures Fatal and nonfatal coronary heart
and Main stroke, CVD (composite of CHD and stroke).
Stevens, PhD;
Resultsand nonfatal stroke, and CVD (composite of CHD and stroke). intake
Results By year 6, mean fat intakeintake decreased byenergy intake in the inter- in the inter-
By year 6, mean fat decreased by 8.2% of 8.2% of energy
DrPH;
PH;
aurizio
ouise R. ventionvs(3.3%),comparisonmean fatwith fat; increases occurred inof energy veg- in monoun-
vention the comparison group, with small decreases in saturated (2.9%), monoun-
saturated
Results By year 6, group, intake decreased by 8.2%
vs the and polyunsaturated (1.5%) small decreases in saturated (2.9%), the inter-
intakes of
intake
tolins, DrPH;
se ;R.
D saturated (3.3%),the comparison group, with small decreases in saturated (2.9%), monoun-
vention vs and polyunsaturated (1.5%) fat; increases occurred in intakes of veg-
; Annlouiseetables/fruits (1.1(3.3%), and grains grains (0.5 serving/d). Low-density lipoprotein cholesterol
etables/fruits (1.1 servings/d)
R. (0.5 serving/d). Low-density lipoprotein cholesterol
enry R. levels, diastolic blood pressure, and factor VIIc levels(1.5%) fat; increases occurred in intakes of veg-
saturated servings/d) polyunsaturated were significantly reduced by 3.55
and and
ord,; MD;
y R.
PhD mg/dL, 0.31 mm Hg, and 4.29%, respectively; levels serving/d). Low-density lipoprotein cholesterol
etables/fruits (1.1 servings/d) and grains (0.5 levels were lipoprotein cho-
levels, diastolic blood pressure, and factor VIIcof high-densitysignificantly reduced by 3.55
D; ; Henry mg/dL, triglycerides,Hg,blood 4.29%, respectively; levels of in the intervention
hD R.
lesterol, levels, mm glucose, and insulin did not significantly differ high-density lipoprotein 3.55
0.31 diastolic and pressure, and factor VIIc levels were significantly reduced by cho-
unner, PhD;vs comparison groups. mm numbers who developed CHD, stroke, of high-density lipoprotein cho-
ski, MD;
ette;
MD lesterol,mg/dL, 0.31 The Hg, and BV, et al. JAMA. 2006 Febsignificantly differ in the intervention
Howard 4.29%, respectively; levels and
triglycerides, glucose, and insulin did not 8;295(6):655-66CVD (annual-
, MD; , vs comparison groups. 1000glucose, and insulin(0.88%) 1357 (0.86%)differ in the intervention
hlebowski MD;
lesterol, triglycerides, (0.63%), 434 (0.28%), and significantly in the in-
ized incidence rates) were did not
The numbersand 2088 developed CHD, stroke,and CVD (annual-
tervention and 1549 (0.65%), 642 (0.27%), who developed the comparison group. CVD (annual-
in CHD, stroke, and
vs comparison groups. The numbers who
52. RISCO RELATIVO
25% EM MULHERES QUE
TINHAM DCV
20%
15%
RISCO
0%
5%
10%
15%
20%
25%
DAC
Total
DCV
RELATIVO
10%
5%
0%
DAC Total DCV
Howard BV, et al. JAMA. 2006 Feb 8;295(6):655-66
53. DIMINUIÇÃO DA GORDURA TOTAL
DE 35% PARA 32.3%
AUMENTO DO RÁCIO PUFA/
SAFA EM 100%
Burr ML, Fehily AM, Gilbert JF, et al. Lancet 1989; 2:757-761.
62. A meta-analysis of prospective epidemiologic
studies showed that there is no significant
evidence for concluding that dietary
saturated fat is associated with an
increased risk of CHD or CVD.
65. with omega-6 PUFAs on
follow that decreasing omega-6 levels will do the same.
re present for each trial,
Indeed, the evidence considered here suggests that it would
es and the observational
cing saturated fatty acid have the opposite AHA Science Advisory PUFA intakes
effect. Higher omega-6
ars, white bread, white can inhibit the conversion of ␣-linolenic acid to eicosa-
As reduces CHD risk. On pentaenoic Fatty 79 but and Risk for Cardiovascular Disease
Omega-6
acid, Acids such conversion is already quite
A Science Advisory From the American Heart Association Nutrition
a-6 PUFAs used in the low,80 and whether additional Nutrition, Physical would have
Subcommittee of the Council on small changes Activity, and
ies, and nonhuman pri- net effects on Council on Cardiovascular other benefits of on
Metabolism; CHD risk after the Nursing; and Council LA
Epidemiology and Prevention
eductions in CHD risk consumption are taken into account is not clear. The focus
William S. Harris, PhD, FAHA, Chair; Dariush Mozaffarian, MD, DrPH, FAHA;
PUFA intakes of 10% to on Eric Rimm, ScD, FAHA; Penny Kris-Etherton, PhD, FAHA; Lawrence L. Rudel, PhD, FAHA;
ratios, rather than on levels of intake of each type of
Lawrence J. Appel, MD, MPH, FAHA; Marguerite M. Engler, PhD, FAHA;
lower intakes, with no PUFA, has many B. Engler, PhD, FAHA; Frank Sacks, MD, FAHA
Mary conceptual and biological limitations.
81
nts.
A large body of literature suggests that higher intakes of
Conclusions
omega-6 (or n-6) polyunsaturated fatty acids (PUFAs)
reduce risk for coronary heart disease (CHD). However, for
levels,5 may have physiological sequelae.6 – 8 LA comes
primarily from vegetable oils (eg, corn, sunflower, safflower,
soy). The average US intake of LA, according to National
s of Omega-6 This advisory was undertaken to summarize the current
the reasons outlined below, some individuals and groups have
recommended substantial reductions in omega-6 PUFA in-
Health and Nutrition Examination Survey 2001 to 2002 data
for adults Ն19 years of age, is 14.8 g/d.9 On the basis of an
ds evidence on the consumption of omega-6 PUFAs, partic-
take.1– 4 The purpose of this advisory is to review evidence on
the relationship between omega-6 PUFAs and the risk of
average intake of 2000 kcal/d, LA intake is 6.7% of energy.
AA (Ϸ0.15 g/d) is consumed preformed in meat, eggs, and
ega-6 PUFAs tradition- ularly LA, and CHD risk. Aggregate data from randomized
CHD and cardiovascular disease. some fish.
of essential fatty acid trials,PUFAs are characterized by the presence of at least Arguments for reduced LAandlong-term the
Omega-6
case-control and cohort studies,PUFAs intakes are based on
Omega-6 PUFAs Omega-6 and Inflammation
ngly seeking to define animal thedouble bonds, with the first bond at(LA), an assumptionthatbecause CHD has an inflammatory is the
2 carbon-carbon
carbon from
feeding experiments indicate andthat the omega-6 fatty acid, AA, com-
methyl terminus. Linoleic acid
the sixth
ponent 10 because the
consumption
k for chronic disease, of primaryleastomega-6 PUFA. LA (18:2 omega-6),energy from synthesisintakes shouldofreduce tissue AA
at dietary 5% to 10% be synthe- substrate forreducing LA of a variety PUFAs
18-carbon fatty acid with 2 double bonds
the cannot
of is molecules, the omega-6 proinflammatory
of Medicine’s Food and reduces established for healthyCHD relative content, which lower the risk the inflammatory evidence,
the risk of adults, estimates de- and therefore should reduce for The The potential
sized by humans, and although firm minimum requirements
have not been
to lower intakes. CHD. data
Reference Intake Report also suggest thathospitalized patients receiv- appear istofrom human studies, regarding this line
rived from studies in infants and
higher intakes derived primarily be safe and may
ing total parenteral nutrition suggest that an LA intake of of reasoning examined below.
67 defines an adequate be LA can be more and elongated to form(as part of a low–saturated-fat,proin-
tion,
even desaturated beneficial other eicosanoids (20-carbon AA metabolites). Some are of
Ϸ0.5% to 2% of energy is likely to suffice. After consump- AA is the substrate for the production of a wide variety
d 12 g/d for women (5% low-cholesterol the metabolically␥important flammatory, vasoconstrictive, and/or proaggregatory, such as
acids. The latter is converted to diet). In summary, the , AHA supports anHow-
omega-6 PUFAs such as ␥-linolenic and dihomo- -linolenic
prostaglandin E thromboxane A , and leukotriene B .
2 2 4
f age, approximately the omega-6 PUFA intake of at least 5% to 10% and epoxyeicosatrienoic acids.
omega-6 PUFA arachidonic acid (AA; 20:4 omega-6), the
substrate for a wide array of reactive oxygenated metabolites. prostacyclin, lipoxin A , 4
of energy in
ever, others are antiinflammatory/antiaggregatory, such as
11 12
the Dietary Reference the context focusesother on this fattylifestyle AA by a cytochrome P450recommen-
PUFA, this advisory of primarily AHA acid,
Because LA accounts for 85% to 90% of the dietary omega-6
from and dietary epoxygenase. Epoxyeicosa-
Epoxyeicosatrienoic acids are fatty acid epoxides produced
ry Guidelines for Amer- dations. To reduce omega-6 PUFA also have important vasodilatortheir via
recognizing that dietary AA, which can affect tissue AA trienoic acids
intakes from properties
acronutrient distribution current Heart Associationwouldeffort to avoid any actual or potential conflicts of interest that may arise than oftooutside
The American
levels makes every be more likely to increase as a result an
relationship or a personal, professional, or business interest of a member of the writing panel. Specifically, all members of the writing group are
particular energy source decrease risk for CHD. showing all such relationships that might be perceived as real or potential conflicts
required to complete and submit a Disclosure Questionnaire
of interest.
This statement was approved by the American Heart Association Science Advisory and Coordinating Committee on November 6, 2008. A copy of the
statement is available at http://www.americanheart.org/presenter.jhtml?identifierϭ3003999 by selecting either the “topic list” link or the “chronological
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66.
67.
68.
69. Simopoulos AP, Cleland LG (eds): Omega–6/Omega–3 Essential Fatty Acid Ratio:
The Scientific Evidence. World Rev Nutr Diet. Basel, Karger, 2003, vol 92, pp 74–80
Effects of an Indo-Mediterranean
Diet on the Omega–6/Omega–3 Ratio
in Patients at High Risk of Coronary
Artery Disease: The Indian Paradox
Daniel Pellaa, Gal Dubnovb, Ram B. Singhc, Rakesh Sharmad,
Elliot M. Berryb, Orly Manor b
a
2nd Interna Klinika,Safaric University, Kosice, Slovakia;
b
Department of Human Nutrition and Metabolism, Hebrew University, Hadassah
Medical School, Jerusalem, Israel;
c
Subharti Medical College, Medical Hospital and Research Centre, Moradabad, India;
d
Department of Medicine, Columbia University, New York, N.Y., USA
70. > PREVALÊNCIA DE DAC NOS INDIVÍDUOS DA REGIÃO
URBANA
Pella D et al. World Rev Nutr Diet. Basel, Karger, 2003, vol 92, pp 74-80.
71. Simopoulos AP, Cleland LG (eds): Omega–6/Omega–3 Essential Fatty Acid Ratio:
The Scientific Evidence. World Rev Nutr Diet. Basel, Karger, 2003, vol 92, pp 81–91
Omega–6/Omega–3 Fatty Acid Ratio:
The Israeli Paradox
Gal Dubnov, Elliot M. Berry
Department of Human Nutrition and Metabolism, Hebrew University,
Hadassah Medical School, Jerusalem, Israel
ü ÓLEO MAIS CONSUMIDO: ÓLEO DE SOJA
While the amount of fat is very important in terms of public health in
dealing with the current epidemic of obesity, an equally significant issue is the
ü R ÁCIO P/S = 0,9 – 1,2
type of fat consumed. As polyunsaturated fatty acids (PUFA) have long been
shown to possess cholesterol-lowering effects [1], increasing their consumption
has been promoted in the management of coronary artery disease (CAD) [2].
ü Á L : 10% E
CIDO INOLEICO recommendations followed bothOTAL IÁRIA
These
T
DA NERGIA experimental and population based
studies that showed decreasing rates of CAD in countries with increasing
D
polyunsaturated/saturated fat (P/S) ratios over the past years.
The dietary habits in Israel appear to be as recommended: low in total
ü % LA : 25%
NO ADIPÓCITO in total fat and in saturated fat, while high in hypolipidemic omega–6
calories,
fatty acids (6) as compared with other western countries [3, 4]. Unexpectedly, the
rates of modern-world illnesses are about the same as they are in the USA and
RÁCIO N-6/N-3 > 20/1
Europe [3, 5, 6]. The reason for this is not clear. Recent evidence suggests that
a high intake of omega–6 fatty acids may prove harmful [2, 7–9]: these fatty
acids may elevate the risk of hyperinsulinemia and its associated metabolic dis-
orders, atherogenesis, and cancer. Another group of PUFA, the omega–3 fatty
PREVALÊNCIA DE DAC É COMPARÁVEL À DE
acids (3), have demonstrated cardioprotection in observational [10–15] and
intervention studies for both secondary [16–18] and primary [18] prevention.
An example for this is shown in figure 1: an Indo-Mediterranean diet, rich in
OUTROS PAÍSES OCIDENTAIS
the plant-derived omega–3 fatty acid alpha-linolenic acid, markedly decreased
the risk for a cardiac event among both those with established coronary artery
disease, or those only with risk factors [18]. A recent meta-analysis showed that
both dietary and non-dietary sources are equally beneficial [19], and the health
benefits of plant- derived or fish- derived omega–3 fatty acids now seem to
have a sound basis [20]. As the omega–6 and omega–3 fatty acids compete for
72. non-fatal myocardial infarction (MI) + CHD death.
n-6 specific PUFA trials non significantly increased the risk of
non-fatal MI + CHD death by 13%
(risk ratio (RR) 1·13; 95% CI 0·84, 1·53; P=0·427)