An ethical review on the search for performance: evidence-based nutrology and the use without indication of anabolic steroids

This study aimed to evaluate what is new in the controversial use of testosterone, as an indication in pathologies such as hypogonadism or its use by athletes and bodybuilders in search of performance. Much is said about the subject and many myths were created without any scientific foundation, one of the objectives of the monograph is to show that when there is a precise clinical indication, testosterone is necessary and extremely beneficial to the patient. It was evaluated in current literature through books and articles, advances in physiology, regulation, treatment of late adult hypogonadism, incidence of use and the most common analogues used by athletes, the harms and benefits expected from the use of the hormone and especially what we have again on cardiovascular safety in testosterone use. After an extensive review, it is still not possible to affirm all the benefits and harms of using the hormone, many old studies are disputed in new studies and even presented results opposite to what was previously believed.

Gut microbiota related to nutrition and physical activity: an integrative review

Introduction: The gut microbiota (GM) is formed by millions of microorganisms present in the gastrointestinal tract, especially in the colon. This intestinal homeostasis can be triggered by the union of a good diet, and even recent studies have suggested that aerobic physical training can modify its composition. Objective: To analyze the influence of healthy eating added to the practice of physical exercise in changing the composition of the GM. Methods: The research was carried out with an exploratory, qualitative and bibliographic approach. A literature review that brings together important studies on the influence of physical exercise on GM. Results: Data collection for this literature review was carried out from March to September, using articles, in addition to trustworthy websites, with the following descriptors: gut microbiota, microbiota, intestinal flora, food, probiotics, and physical exercise. Conclusion: The training was efficient to change the GM composition in sedentary men, thus being able to minimize possible negative interferences of the sedentary pattern. Bacteria that reside in our body work with a commensalism strategy, where there are two different structures, the microorganism, and the individual's body, but both live together normally and thus work together to maintain the GM balance.

Programming of obesity and pediatric metabolic syndromes: a review in light of epigenetic modulation

Obesity is a multifactorial health problem characterized by the excessive accumulation of fat in the body and affects approximately 338 million children and adolescents worldwide. For this reason, this study consisted of a literature review to investigate how the causes and treatments of pediatric obesity are being addressed in light of epigenetic modulation as a factor in metabolic programming. For this, preferentially original articles published in English between the years 2017 to 2021 in the PubMed and Scholar Google databases were searched using the epigenetics descriptors; epigenetic modulation; child obesity; metabolic syndrome, combined with each other. A total of 54,000 articles were returned to searches in PubMed and 16,107,000 in Scholar Google. Fewer than 500 studies jointly addressed epigenetics and aspects of obesity or metabolic syndromes in childhood. Only 14 works matched the search criteria. The most discussed epigenetic mechanism in the literature is DNA methylation, whose rates observed mainly in CpG islands of promoter regions in several genes contribute to the prevention and early diagnosis of obesity and other pediatric comorbidities even before birth, based on the correlation between the epigenetic marks, maternal and paternal health and anthropometric indices. Although experimental studies on infant metabolic programming are scarce, existing knowledge suggests that environmental, nutritional, and energy expenditure changes are capable of modulating the epigenome and reversing marks that induce susceptibility to metabolic comorbidities.

Bio-electric impedance as a tool to assess hydration in critically ill patients: an integrative review

Introduction: Assessing the hydration status of critically ill patients has been a difficult task over the decades. Determining how much fluid overload a patient has often helped in choosing a therapy. Methods such as bioelectrical impedance have been approached as a useful tool for this purpose. Objective: This study proposes to verify, through research in the literature, what is the real importance of the clinical use of bioelectrical impedance in the diagnosis of fluid overload in critically ill patients hospitalized in intensive care units. Methods: bibliographic search in the main scientific information databases: Scielo, PubMed, Cochrane, and Lilacs from January 2000 to July 2018. The selected languages were Spanish, Portuguese, and English. The keywords used were bioelectrical impedance, hydration, Intensive Care Unit, Intensive Care, bioelectrical impedance analysis, fluid balance, hydration overload. Results and Conclusion: The analysis of fluid overload in critically ill patients can be performed using multifrequency bioelectrical impedance. It is a useful tool in the diagnosis as well as in the quantification of water overload and, therefore, a corroborative method for clinical decision-making.

Nutritional Risk Screening (NRS 2002) as a tool to predict clinical outcomes in hospitalized patients: a literature review

The presence of malnutrition in hospitalized patients is prevalent and studies show its association with a higher incidence of complications, mortality, length of stay, costs, and increased frequency of hospital readmission. Routine use of simple tracking procedures is recommended. Nutritional screening detects individuals who are malnourished or at risk of developing malnutrition, and who can receive specific nutritional support. Nutritional Risk Screening (NRS 2002) is a nutritional screening method recommended by the European Society for Clinical and Metabolism (ESPEN) and identifies the risk of developing malnutrition in hospitalized patients. The aim of this paper is to review the literature on the NRS screening method (2002) and its relationship with clinical outcomes in hospitalized patients.

Changes in the nutritional profile of medicine students during the COVID-19 pandemic period and its correlation with anxiety: a prospective cross-sectional observational study

Introduction: Pandemics cause strong social, economic, and political impacts. Social isolation to reduce the virus’ impact and to retard the health system breakdown caused by SARS-Cov-2 have affected the population’s lifestyle, including medical students. Objective: Identity which impacts the daily meal plan has the COVID-19’s Pandemic caused in medical students; Correlate data obtained in different grades of the medical course and present the nutritional profile of the students, who attended the study. Methods: Survey realized in students of a private medical course in the São Paulo northwestern region, with a questionary containing open questions and tests, sent online in conjunction with the Term of Consent. This study was analyzed and approved by the Research Ethics Committee according to a substantiated opinion number 4.373.785, and obtaining the patient's consent through the Informed Consent Form. Results: 117 students, between the 1st and 4th grade of the course, have attended the following study, 75 female, 42 male, allocated in similar proportions in the 4 initial grades of the course, ages between 17 and 31 years old; Most of the students feel more anxiety (78,6%), associated with changes in the nutritional profile, with the increase of high-energy food, highlighted by the bigger propension of this group to the consumption of sweets and white-wheat pasta in the daily meal plan. It is important to notice that many other food groups have suffered an enhancement in consumption as well, such as legumes, dried meat, vegetal oil, olive oil, and greenery. Conclusion: The COVID-19 Pandemic brought impacts to the daily meal plan of the medical students, especially in the ones who feel more anxious. The enhancement of the daily consumption of food by the medical students is notable, in the most diverse food classifications. However, it is concluded in this study that it cannot be said that anxiety and/or self-declared stress is a risk factor for the increase in food consumption observed, as well as a pattern of its impacts on the students' food, cannot be defined.

Major metabolic and metabolomic approaches of dietary therapy in the control of inflammatory obesity processes in COVID-19: a concise systematic review

Introduction: Obesity stands out as a multifactorial disease that can cause several public health problems. Currently, more than 30% of the world's population is overweight or obese. By 2020, it is estimated that over 60% of the world population will be overweight or obese. It has been postulated that a healthy nutritional status promotes immune function and can prevent the onset of a severe inflammatory process and severe infections, especially in times of pandemics such as COVID-19. The optimal immune response depends on proper diet and nutrition to keep the infection under control. Objective: This study analyzed the main interactions of dietary therapy in the control of obesity and its comorbidities, especially meta-inflammation. Methods: This study followed a systematic review model. The search strategy was performed in the PubMed, Cochrane Library, Web of Science and Scopus, and Google Scholar databases, using scientific articles from 2009 to 2021. The low quality of evidence was attributed to case reports, editorials, and brief communications, according to the GRADE instrument. The risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: 105 studies were analyzed and submitted to eligibility analysis, and then 42 high to medium quality studies were selected. Biases did not compromise the scientific basis of the studies. Research has shown that unbalanced dietary patterns, such as the Western diet, rich in simple sugars, refined carbohydrates, saturated and trans-fatty acids, lead to chronic inflammatory responses, increased fat deposition, and future comorbidities associated with overweight and obesity. In addition, some nutrients have important effects in decreasing the inflammatory response and in metabolic restoration, reducing oxidative stress. Therefore, adequate dietary interventions for the management of overweight and obesity are needed, especially starting early in children and adolescents for healthy growth, preventing comorbidities in adulthood.

Use of growth hormone in region 19p13.3 microduplication syndrome in girl with central early puberty: a clinical case report

Chromosomal mutations involving 19p13.3 have been described as pathogenic. clinical and phenotypic features can include, in most cases, psychomotor development delay, microcephaly, typical facial appearance, hand and foot anomalies, umbilical hernia, hypotonia, and low percentage of lean mass. The main types of mutation found on this chromosome are deletion or duplication. Short stature is often the cause of medical demand and the use of exogenous GH for patients with this syndrome is not beneficial. This article reports the case of a 5-year-old girl who sought medical help due to short stature and was diagnosed with this syndrome. Furthermore, this case study may contribute to the dissemination in the medical community about the association of this genetic mutation with the child's clinical condition, warning about this syndrome, and the possibility of the occurrence of early puberty. This study was analyzed and approved by the Research Ethics Committee (CEP) according to a substantiated opinion number 4.765.113.

Medical nutrition therapeutic approach of non-alcoholic fatty liver: diet, nutraceuticals, phytotherapy and probiotics

Although the genetic and pharmacological research of the non-alcoholic fatty liver disease (NAFLD), the commonest liver disease in the world, affecting more than a quarter of the population, shows a promising future, the non-pharmacological therapy continues to be an important approach of this concerning public health issue. The present study focused on the therapeutical potential of the diet and mainly the phytotherapy, nutraceuticals, and probiotics use, employing the literature review methodology by a selection of recent (last 5-10 years) national and international articles from the PubMed and Google Scholar databases. The conclusion was that the non-pharmacological medical nutrition approach could be considered as a first-line therapeutical option for NAFLD due to its low cost, few adverse effects, and a mainly positive impact on an individual's health and life quality.

The benefits of glutamine in the treatment of patients with cancer

The subject of this study is the benefits of immunonutrition or immunomodulation, based on the concept that malnutrition impairs immune function. It is a therapeutic approach in an artificial form of food with the function of rebuilding cells for the immune response, which involves specific amino acids such as arginine, glutamine, and fiber. In this sense, it is intended to deal specifically with glutamine, which is a “conditionally essential” amino acid, as its concentration in plasma can decrease by up to 50% during stress, causing a deficiency condition. In the treatment of cancer patients, glutamine constitutes an immunomodulatory nutrient, being a fundamental substrate for the cells of the immune system, stimulating the multiplication of lymphocytes, the differentiation of B cells, the production of interleukin 1, and the phagocytosis of macrophages. The high use of glutamine by lymphocytes and macrophages suggests that the provision of this amino acid is of paramount importance for the functioning of these cells and also for the proper functioning of the immune response. Important in viral infections and in combating tumor cells, Natural Killer (NK) cells are dependent on adequate glutamine stores for their proliferation. It also exerts a local immunostimulating effect, increasing intestinal T cells, and is a precursor of an important intracellular antioxidant, glutathione. This is bibliographical research, of a qualitative nature, carried out through specialized scientific articles on the chosen topic.