Nutrition
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Review
Non-alcoholic fatty liver disease in children now: lifestyle changes and pharmacologic treatments.
Over the past decade, non-alcoholic fatty liver disease (NAFLD) has become one of most common chronic liver diseases in children. A greater understanding about the risk factors and molecular pathogenesis of NAFLD suggests that lifestyle interventions aiming to decrease obesity/body mass index and metabolic derangement are the first line of treatments adopted in children affected by this disease. However, because these therapeutic options are often at the beginning misjudged by the patients and their parents, the use of pharmacologic agents may help to protect the liver and other organs from further irreversible tissue damage. ⋯ On this basis, insulin sensitizers, antioxidants, cytoprotective agents, and dietary supplementations have been evaluated in pediatric clinical trials. In this review, we discuss the efficacy of the dietary approaches, possibly coupled with regular exercise, on decreasing the metabolic and histologic damage in pediatric NAFLD. We also emphasize several advantages of the pharmacologic treatments adopted or adoptable in combination with lifestyle interventions in children with NAFLD.
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Randomized Controlled Trial Comparative Study Clinical Trial
Plasma glutathione of HIV⁺ patients responded positively and differently to dietary supplementation with cysteine or glutamine.
Patients with positivity for the human immunodeficiency virus (HIV⁺) present low concentrations of antioxidant nutrients, including total glutathione (GSH) and its precursors. We investigated the responses of the sulfur-containing amino acid pathway to cysteine and glutamine (Gln) dietary supplements in patients with HIV⁺ compared with healthy controls. ⋯ An increase in GSH may be attained by NAC or Gln supplementation, with NAC acting by increasing cysteine levels and Gln likely acting by replenishing the glycine pool (trial registered at http://www.clinicaltrials.gov, identifier NCT00910442).
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This study aimed to estimate the dietary glycemic index (GI) and glycemic load (GL) of Australian Aboriginal and Torres Strait Islander and non-Indigenous rural children and identify the main foods contributing to their GI and GL. ⋯ The quality of carbohydrates in the diets of the participants was low, with poorer dietary items contributing most of the GI and GL. Substituting white breads with low/lower GI alternatives may be a useful strategy.
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Multicenter Study
The BASA-ROT table: an arithmetic-hypothetical concept for easy BMI-, age-, and sex-adjusted bedside estimation of energy expenditure.
The rule of thumb (ROT) method is used to estimate energy expenditure (EE) at bedside. ROTs are fixed numbers of calories given daily per kilogram of body weight. Textbooks nevertheless indicate that age and body mass index (BMI) affect EE. This should also affect ROTs. We thus scrutinized the impact of BMI, age, and sex on ROTs, compared the results to the often used 25 kcal/kg ROT, and calculated a BMI-, age-, and sex-adjusted ROT table containing calories per kilogram in the basal state. ⋯ We found that both BMI and age significantly impacted ROT estimates. Thus, using one single fixed ROT for all patients independent of age and BMI does not seem appropriate. We consequently suggest a calculated table of BMI-, age-, and sex-adjusted ROTs where the results of resting EE were multiplied with 1.1, 1.2, and 1.3 and separately listed in the table to account for activity/stress factors.
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The purpose of this study was to examine the status of folate and vitamin B12 (B12) in relation to serum homocysteine (HCY) and oxidative stress indices in patients with type 2 diabetes (T2DM). ⋯ The low intake of folate and B12 is associated with low serum levels of these two nutrients and hyperhomocysteinemia in Omani adults with T2DM.