INTRODUÇÃO: A obesidade é uma doença crônica e de etiologia multifatorial, relacionada a fatores genéticos, ambientais e comportamentais. Apresenta associação com diversas alterações metabólicas já na infância, levando ao aumento do risco de doenças cardiovasculares na vida adulta. O tratamento envolve mudança de estilo de vida, com orientação de dieta balanceada e estímulo à atividade física. O tratamento nesta faixa etária tem apresentado dados limitados, além de altas taxas de abandono. Um tipo original de orientação alimentar é através da contagem de equivalentes calóricos, onde as calorias são convertidas em pontos. O objetivo deste estudo foi avaliar a variação do escore Z do índice de massa corpórea (ZIMC) de adolescentes obesos submetidos à orientação de dois grupos de dieta hipocalórica: tradicional e baseada no sistema de pontos, assim como avaliar variáveis antropométricas, composição corporal, alterações metabólicas, ingestão alimentar e o automonitoramento. MÉTODOS: Estudo clínico randomizado com duração de 24 semanas, com 66 adolescentes com idade média de 13,7 ± 0,7 anos de ambos os gêneros, com escore do IMC >= 2 a <= 4 da curva ajustada para gênero e idade da Organização Mundial da Saúde. Foram verificados peso, estatura, pressão arterial e circunferência abdominal, intensidade de atividade física e automonitoramento, assim como efetuada a orientação nutricional a cada visita. Parâmetros laboratoriais, aplicação da escala de compulsão alimentar periódica, composição corporal e estadiamento puberal, foram avaliados no início e final do seguimento. Os pacientes foram divididos em dois grupos: um que recebeu orientação de dieta hipocalórica tradicional e preenchia o registro de consumo alimentar (RCA) de três dias (Grupo A) e outro que recebeu orientação de dieta hipocalórica baseada no sistema dos pontos e preenchia o RCA diário (Grupo B). RESULTADOS: Quarenta e quatro pacientes concluíram o tratamento. Houve redução do ZIMC nos dois grupos (p < 0,0001), porém a redução observada no Grupo A não foi diferente da observada no Grupo B (p=0,87). Ocorreu aumento da massa livre de gordura (%), redução da circunferência abdominal, pressão arterial sistólica e diastólica, além da massa gorda (%). Houve diferença no escore de compulsão alimentar entre as visitas 1 e 8, o qual se manteve durante o estudo. Verificamos melhora de todos os parâmetros laboratoriais, com diminuição significativa de insulina, HOMA-IR, gama-GT e ALT, não havendo diferença entre os dois grupos. Houve redução do valor energético total nos dois grupos, acompanhada do aumento percentual de proteínas, redução de carboidratos e manutenção dos lipídios. O automonitoramento médio não foi relacionado à variação do ZIMC. CONCLUSÃO: Dieta hipocalórica com orientação tradicional ou baseada no sistema de pontos levou a redução do ZIMC, de marcadores metabólicos e do valor energético total em adolescentes obesos de forma semelhante nesta coorte de pacientes / INTRODUCTION: Obesity is a chronic illness and multifactorial etiology, related to genetic factors, environmental and behavioral. Features association with several metabolic abnormalities in childhood, leading to increased risk of cardiovascular disease in adult life. The treatment involves lifestyle change, with balanced diet guidance and encouraging physical activity. The treatment in this age group have brought limited data, in addition to high drop-out rates. A unique type of food guidance is the equivalent calorie count, where calories are converted into points. The objective of this study was to evaluate the variance of Z score of body mass index (ZIMC) of obese adolescents undergoing orientation of two groups of low-calorie diet: traditional and based on the points system, as well as evaluate anthropometric variables, body composition, food intake, metabolic changes and self-monitoring. METHODS: randomized clinical study with duration of 24 weeks, with 66 adolescents with an average age of 13.7 ± 0.7 years of both genders, with scores of BMI >= 2 to <= 4 curve adjusted for gender and age of the World Health Organization. Were verified weight, height, blood pressure and waist circumference, intensity of physical activity and self- monitoring, as well as performed the nutritional guidance to each visit. Laboratory parameters, applying the scale of binge eating, pubertal, stage and body composition were evaluated at the beginning and end of the action. The patients were divided into two groups: one that received guidance of traditional low-calorie diet and meet the food consumption record (RCA), three days (Group A) and another that received low-calorie diet guidance based on the system of points and meet the daily RCA (Group B). RESULTS: forty-four patients have completed treatment. There was a reduction of Z BMI in both groups (p 0.0001 < ), however the reduction observed in the Group was not different from that observed in Group B (p = 0.87). There was increased fat free mass (%), abdominal circumference, systolic and diastolic blood pressure and body fat (%). There was difference in binge eating score between 1 and 8 visits, which remained during the study. We improved all laboratory parameters, with significant decrease of insulin and HOMA-IR, gamma GT and ALT, and there is no difference between the two groups. There was a reduction of the total energy in both groups, accompanied by the increasing percentage of protein, carbohydrate and maintenance reduction of lipids. The average self-monitoring was not related to the variation of Z BMI. CONCLUSION: low-calorie diet with traditional or orientation based on points system led to reduction of metabolic markers, Z BMI and total energy value in obese adolescents similarly in this cohort of patients

Polyphenols are naturally-occurring phytochemicals, which form an integral part of the human diet. Results from epidemiological studies have associated polyphenol intake with reduced risk of cardiovascular diseases. Previous human intervention studies suggested that dietary polyphenols exert their cardioprotective effects through their antioxidant and anti-inflammatory effects. While most in vitro experiments have not accounted for the bioavailability and metabolism of these polyphenols, our work has provided direct evidence, using quercetin, that metabolic transformation, together with bioavailability, exert profound effects on bioactivity. We examined the effect of quercetin and its major metabolites on the production of pro-inflammatory eicosanoids by human leukocytes. Studies comparing free radical scavenging, antioxidant activity and eicosanoid production demonstrate that there are different structural requirements for antioxidant and anti-inflammatory activity. We also investigated the effect of metabolic transformation on flavonoid bioactivity by comparing the activity of quercetin and its major metabolites to inhibit inflammatory eicosanoid production from human leukocytes. Quercetin was a potent inhibitor of leukotriene B4 formation in leukocytes (IC50 ~ 2µM), and its activity was dependent on specific structural features, particularly the 2,3 double bond of the C ring. Functionalisation of the 3'-OH group with either methyl or sulfate reduced inhibitory activity up to 50% while a glucuronide substituent at the 3-OH effectively removed the leukotriene B4 inhibitory activity. The major quercetin metabolite quercetin-3'-O-sulfate retained considerable lipoxygenase inhibitory activity (IC50 ~ 7 µM) while quercetin-3-O-glucuronide maintained antioxidant activity but had no lipoxygenase inhibitory activity at physiologically relevant concentrations. We conclude that structural modification of quercetin due to metabolic transformation had a profound effect on bioactivity, and that the structural features required for antioxidant activity of 8 quercetin and related flavonoids were unrelated to those required for inhibition of inflammatory eicosanoids.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

This thesis consists of a brief description on cancer, carcinogenesis, the changes in the type and level of dietary fat available in our diets over time and association with the development of certain diseases. The main focus of this research was on omega 6 and omega 3 essential fatty acids (EFA) and their interaction with regards to carcinogenesis.

Thesis (MVoeding)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Objectives and scope of investigation Following the 1996 recommendations of a FAO/WHO expert panel for the development of food-based dietary guidelines (FBDGs) unique and specific to the needs of the populations of different countries, a South African FBDG Working Group was formed and ultimately also a Paediatric FBDG (PFBDG) Working Group with the task of the latter being the development of FBDGs for children younger than 7 years. A set of preliminary PFBDGs, chosen to address the most pressing paediatric public health issues, namely protein-energy malnutrition, micronutrient deficiencies and infectious diseases, were formulated for each age group sub-category (0-6 months, 6-12 months and 1-7 years). The following set of preliminary PFBDGs for the age group 6-12 months were approved by the Working Group to be subjected to consumer testing: • Enjoy time with your baby • From six months start giving your baby small amounts of solid foods • Gradually increase your baby’s meals to five times a day • Keep breast feeding your baby • Offer your baby clean, safe water regularly • Teach your baby to drink from a cup • Take your baby to the clinic every month Assessment of the consumer’s comprehension, interpretation of the proposed guidelines, and ability to apply them, was considered essential before the PFBDGs could be finalised, disseminated to the consumer, and implemented as an educational tool for health professionals and community workers. This study was also the first in which PFBDGs were tested, and was intended to be a pilot study for further testing of PFBDGs for this age category in other parts of the country, adapted for different circumstances. The investigation was conducted among women who were mothers or caregivers to infants 6-12 months of age in the Afrikaans-, English- and Xhosa-speaking communities of the greater Oudtshoorn area, including Bongulethu, Bridgeton and Toekomsrus and its adjacent rural areas of Dysselsdorp, Calitzdorp, Uniondale, Ladismith and Zoar. Methodology The study was designed to be an observational, descriptive and cross-sectional study. Qualitative data was collected from a sample of 64 volunteers who took part in ten focus group discussions each attended by between 3 and 11 participants. Group discussions were recorded on videotape and quantitative and qualitative questionnaires measured pre-discussion knowledge and comprehension of guidelines, perceived hindrances to compliance with guidelines and perceived importance of guidelines as well as socio-demographic data. Results and conclusions With this study, useful and enlightening information was obtained which met the research objectives. Participants discussed the guidelines in depth and information obtained from the questionnaires were found to support what was said during the discussions. Body language or non-verbal communication as observed, and recorded on videotape, also complemented the information gained from the discussions. Summarily it can be said that the guidelines were well-received and perceived as important by the majority of respondents, although some of the guidelines were initially not well-understood without explanation. Furthermore, the fact that the applicability of the guideline on prolonged breast feeding seems to be the most problematic, is a cause for concern. In view of the results obtained in this study, it can be concluded that PFBDGs will have to be supported by extensive and appropriate educational material to be effective when introduced to the public. The findings of this study will be submitted to the PFBDG Working group for consideration before finalisation of the guidelines for the age group 6-12 months. / AFRIKAANSE OPSOMMING: Doelwitte en omvang van die studie Na aanleiding van die 1996 aanbevelings van ‘n VLO/WGO paneel van kenners vir die ontwikkeling van voedselgebaseerde dieetriglyne (VGDR) wat uniek en spesifiek gerig is tot die behoeftes van die bevolkings van verskillende lande, is ‘n Suid-Afrikaanse VGDR Werkgroep gevorm en uiteindelik ook ‘n Pediatriese VGDR (PVGDR) Werkgroep met die opdrag van laasgenoemde om VGDRe te ontwikkel vir kinders jonger as 7 jaar. ‘n Stel voorlopige Pediatriese VGDRe, gekies om die mees dringende pediatriese publieke gesondheidsvraagstukke, naamlik proteïn-energie wanvoeding, mikronutriënttekorte en infektiewe siektetoestande aan te spreek, is geformuleer vir elke ouderdomsgroep subkategorie (0-6 maande, 6-12 maande en 1-7 jaar). Die volgende stel voorlopige PVGDRe vir die ouderdomsgroep 6-12 maande is deur die Werkgroep goedgekeur om aan verbruikerstoetsing te onderwerp: • Geniet tyd saam met jou baba • Begin vanaf ses maande om jou baba klein hoeveelhede vaste kos te gee • Vermeerder jou baba se maaltye geleidelik na vyf keer per dag • Hou aan om jou baba te borsvoed • Bied gereeld vir jou baba skoon, veilige drinkwater aan • Leer jou baba om uit ‘n koppie te drink • Neem jou baba elke maand kliniek toe Evaluering van die verbruiker se begrip, interpretasie van die riglyne en die vermoë om die riglyne te implementeer, is as noodsaaklik beskou voordat die PVGDRe gefinaliseer kon word, vrygestel kon word aan die publiek, en aan professionele- en gemeenskapsgesondheidswerkers beskikbaar gestel kon word as ‘n onderrighulpmiddel. Hierdie studie was die eerste waarin PVGDRe getoets is en dit is bedoel as ‘n voorloperstudie vir verdere toetsing van PVGDRe vir hierdie ouderdomskategorie in ander dele van die land en aangepas vir ander omstandighede. Die ondersoek is gedoen onder vroue wat moeders of versorgers van babas van 6-12 maande was in die Afrikaans- Engels- en Xhosasprekende gemeenskappe van die groter Oudtshoorn area wat Bongulethu, Bridgton en Toekomsrus insluit asook die nabygeleë plattelandse gemeenskappe van Dysselsdorp, Calitzdorp, Uniondale, Ladismith en Zoar. Metodiek Die studie is ontwerp om ‘n waarnemende en beskrywende analise van ‘n deursnee van die studiepopulasie moontlik te maak. Kwalitatiewe data is verkry van ‘n proefmonster van 64 vrywilligers wat deelgeneem het aan tien fokusgroep besprekings wat elk deur 3 tot 11 persone bygewoon is. Groepbesprekings is op videoband opgeneem en kwantitatiewe en kwalitatiewe vraelyste het voorbesprekings kennis en begrip van die voorgestelde riglyne, vermeende verhindering tot uitvoering van die riglyne en vermeende belangrikheid van riglyne sowel as sosio-demografiese inligting gemeet. Resultate en gevolgtrekkings Met hierdie studie is bruikbare en verhelderende inligting verkry wat beantwoord het aan die doelwitte van die studie. Deelnemers het die riglyne in diepte bespreek en dit is bevind dat inligting wat van die vraelyste verkry is, ook dit bevestig het wat gedurende die sessies bespreek is. Lyftaal en nie-verbale kommunikasie soos waargeneem en soos op videoband vasgelê, het ook die inligting ondersteun wat van die besprekingsessies verkry is. Opsommend kan gesê word dat die riglyne goed ontvang is en as belangrik beskou is deur die meerderheid van respondente. Sommige van die riglyne was nie vir deelnemers goed verstaanbaar sonder meegaande verduideliking nie. Verder is die feit dat die toepasbaarheid van die riglyn met betrekking tot ‘n verlengde tydperk van borsvoeding voorgekom het as die mees problematiese, ‘n rede tot kommer In die lig van die resultate van hierdie studie, kan daar tot die slotsom gekom word dat PVGDRE ondersteun sal moet word deur omvattende en gepaste onderrigmateriaal om effektief te kan wees wanneer dit aan die publiek bekend bekend gestel word. Die bevindings van hierdie studie sal aan die Pediatriese VGDR Werkgroep voorgelê word vir oorweging voordat riglyne vir die ouderdomsgroep 6-12 maande gefinaliseer word.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / Background Critical illness is associated with increased production of reactive oxygen species and oxidative stress, and low levels of most micronutrients with resultant diminished endogenous antioxidant defences. Micronutrient supplementation is thought to be beneficial to the critically ill patient by ameliorating oxidative stress and by improving clinical outcome. Objectives This systematic review assessed the effects of micronutrient supplementation on adults recovering from critical illness. Primary outcomes included clinical endpoints [mortality, infectious complications, length of intensive care unit and hospital stay (LICU and LOS)]. Secondary outcomes included descriptions of practice issues, micronutrient status, morbidity, course of the acute phase response and oxidative stress. Search strategy An electronic bibliographic database search was carried out, bibliographies of retrieved articles were reviewed and personal files searched to obtain additional citations. Databases were searched from inception until 29 February 2008. Selection criteria Randomized controlled trials (RCTs) of micronutrient supplementation (by any route) in adult critically ill patients, given in addition to their routine care, were included. Data collection and analysis Two authors independently extracted data and assessed trial quality. For the primary outcomes the random-effects model was used to estimate overall relative risk / mean difference and effect size due to the presence of study heterogeneity. Selected exploratory analyses were undertaken. Differences at the level of p<0.05 was considered to be statistically significant. The secondary outcomes were sparse and variably recorded such that this data was not formally aggregated. Main results Fifteen RCTs involving 1714 participants and 18 RCTs involving 1849 participants were included for the primary and secondary objectives respectively. The quality of the RCTs, as reported, was disappointing, particularly for allocation concealment. Fourteen trials (n=1468) of micronutrient supplementation showed a statistically significant reduction in overall mortality [relative risk (RR) 0.78, 95% confidence interval (CI) 0.67-0.90, I2=0%, p=0.0009]. An asymmetrical funnel plot necessitates caution when directly interpreting these results. Six RCTs (n=1194) indicated a statistically significant reduction in 28 day mortality (RR 0.75, 95% CI 0.63-0.88, I2=0%, p=0.0006) (symmetrical funnel plot). Micronutrient supplementation in this systematic review was not associated with a reduction in infectious complications, LICU or LOS. In sub-group analyses, single nutrients were associated with borderline statistical significance (RR 0.82, 95% CI 0.66-1.01, I2=0%, p=0.06) in terms of mortality, whist a sensitivity analysis of combined micronutrients indicated a significant reduction in mortality (RR 0.69, 95% CI 0.54-0.90, I2=2%, p= 0.006). This review did not find clear evidence that parenteral is superior to enteral administration in terms of clinical outcomes. The secondary outcomes confirmed that timing, duration and dosing are key factors to ensure optimal clinical benefit. Conclusion This review does suggest potential benefit of micronutrient supplementation in critically ill adults for some clinical outcomes (especially mortality), but also highlights that caution is warranted as nutrient interactions and risk of toxicity are not clearly defined in critical illness. More large multi-centre randomized trials are necessary to assess the effects of different types and doses of micronutrient supplementation in selected groups of patients with different types of critical illness.

Thesis (MNutr)--Stellenbosch University, 2012. / ENGLISH ABSTRACT: The role of fructose restriction in addition to dietary modifications for weight loss and lifestyle improvement, on fertility outcome and other markers of metabolic syndrome, in obese women with polycystic ovarian syndrome (PCOS) Introduction: At the time at which the current study was undertaken no data, as yet, existed on whether restriction of fructose, while treating obese patients with PCOS for weight loss, improves the clinical symptoms and metabolic/anthropometric profile so as to promote fertility. Objectives: To evaluate the baseline intake of fructose, as well as the effect of restricting fructose intake from fruit and soft beverages to less than 20 g daily, as well as to provide guidelines for weight loss on anthropometric measurements, for improving subjective clinical symptoms, and for promoting fertility outcome in obese patients with PCOS, who seek to become fertile. Methods: The study was conducted in the Tygerberg Hospital Infertility Clinic, as an experimental cohort. Patients with a body mass index (BMI) higher than 27, seeking fertility after diagnosis with PCOS, were referred for dietary consultation, and followed up 3 monthly over 1 year. At each visit anthropometric measurements and a detailed dietary history were taken and a questionnaire for clinical symptoms was completed. Results: Baselinely, 86 patients were included in the study. Averages for weight and BMI were 99.8 ± 24.3 kg and 39.2 ± 8.7kg/m2, respectively. Average baseline daily fructose intake was 167 ± 116.8g. At baseline, significant relationships were shown between fructose intake and burning feet (ρ=0.02) and frequent waking (ρ=0.02), with a trend towards nightly eating (ρ=0.07). The dropout rate after visit 1 was 50%, with a further dropout of 41% after visit 2. After 3 visits (n=18), fructose intake significantly reduced (ρ=0.018), with the significant relationships with clinical symptoms having disappeared by visit 2. After 3 visits (n=18), both weight and BMI decreased significantly (ρ=0.017) and (ρ=0.019), respectively. Fructose was tested as a covariate to BMI, with high significance (ρ=0.006) in said population group. Conclusion: Dietary intervention to reduce fructose intake proved significant for weight loss and BMI after 3 visits. Reduced fructose intake was associated with reduced clinical symptoms. With fructose being a significant covariate to BMI, it can be concluded that fructose overconsumption could possibly contribute to both clinical symptoms and elevated BMI in said study population. / AFRIKAANSE OPSOMMING: Die rol wat die beperking van fruktose speel bykomend tot dieetaanpassings en lewenstylverbetering vir gewigsverlies by oorgewig vroue met polisistiese ovariële sindroom (PCOS) in die uitkoms van fertiliteit en ander merkers van metaboliese sindroom. Inleiding: Met die aanvang van hierdie studie was daar is geen data beskikbaar oor die invloed van die beperking van fruktose in die dieet van oorgewig pasiënte met PCOS wat vir gewigsverlies behandel word nie. Dit was ook nie bekend of laasgenoemde pasiënte se kliniese simptome en metaboliese/antropometriese profiel sou verbeter met die beperking van fruktose sodat fertiliteit by hierdie pasiënte terselfdertyd ook bevorder word nie. Doelwitte: Die evaluering van die aanvanklike inname van fruktose, sowel as die beperking van fruktose afkomstig van eetbare vrugte en versoete drankies en sap tot ’n inname van minder as 20 g daagliks, tesame met riglyne vir gewigsverlies. Die uitkoms hiervan is bepaal deur antropometriese metings, die verbetering in subjektiewe kliniese simptome en die fertiliteituitkoms by oorgewig pasiënte wat hulp met fertiliteit verlang. Metodes: Die studie het as ’n eksperimentele kohort by die Infertiliteitskliniek by Tygerberg Hospitaal plaasgevind. Pasiënte wat na diagnose met PCOS fertiliteitsbehandeling verlang het en ’n BMI hoër as 27 gehad het , is vir dieetbehandeling verwys en driemaandeliks oor ’n tydperk van een jaar opgevolg. Tydens elke besoek is antropometriese metings en ’n omvattende dieetgeskiedenis geneem en ’n vraelys oor kliniese simptome ingevul. Resultate: Aanvanklik is 86 pasiënte by die studie ingesluit. Gemiddeldes vir gewig en BMI was 99.8 ± 24.3 kg en 39.2 ± 8.7 kg/m2 respektiewelik. Gemiddelde aanvanklike daaglikse inname van fruktose was 167 ± 116.8 g. Oorspronklik het betekenisvolle verhoudings tussen fruktose en die volgende bestaan: brandvoete (ρ=0.02) en veelvuldige episodes van nagtelike wakkerheid (ρ=0.02), met ’n neiging na nagtelike etery (ρ=0.07). Die uitvalsyfer na een besoek was 50% met ’n verdere uitvalsyfer van 41% na die tweede besoek. Na drie besoeke (n=18) het sowel die gewig as die BMI betekenisvolle afname getoon (ρ= 0.017) en (ρ=0.019), respektiewelik. Fruktose is as ’n belangrike kovariant vir BMI (ρ= 0.006) vir hierdie populasiegroep geïdentifiseer. Gevolgtrekking: Dieetintervensie vir die vermindering van die inname van fruktose was beduidend vir gewigsverlies en afname in BMI na drie besoeke. Verminderde fruktose-inname het gelei tot die vermindering van kliniese simptome. Met fruktose as beduidende kovariant vir BMI kan die gevolgtrekking gemaak word dat die oor-inname van fruktose by hierdie studiepopulasie waarskynlik tot sowel kliniese simptome as BMI bygedra het.

INTRODUÇÃO: A obesidade é uma doença crônica e de etiologia multifatorial, relacionada a fatores genéticos, ambientais e comportamentais. Apresenta associação com diversas alterações metabólicas já na infância, levando ao aumento do risco de doenças cardiovasculares na vida adulta. O tratamento envolve mudança de estilo de vida, com orientação de dieta balanceada e estímulo à atividade física. O tratamento nesta faixa etária tem apresentado dados limitados, além de altas taxas de abandono. Um tipo original de orientação alimentar é através da contagem de equivalentes calóricos, onde as calorias são convertidas em pontos. O objetivo deste estudo foi avaliar a variação do escore Z do índice de massa corpórea (ZIMC) de adolescentes obesos submetidos à orientação de dois grupos de dieta hipocalórica: tradicional e baseada no sistema de pontos, assim como avaliar variáveis antropométricas, composição corporal, alterações metabólicas, ingestão alimentar e o automonitoramento. MÉTODOS: Estudo clínico randomizado com duração de 24 semanas, com 66 adolescentes com idade média de 13,7 ± 0,7 anos de ambos os gêneros, com escore do IMC >= 2 a <= 4 da curva ajustada para gênero e idade da Organização Mundial da Saúde. Foram verificados peso, estatura, pressão arterial e circunferência abdominal, intensidade de atividade física e automonitoramento, assim como efetuada a orientação nutricional a cada visita. Parâmetros laboratoriais, aplicação da escala de compulsão alimentar periódica, composição corporal e estadiamento puberal, foram avaliados no início e final do seguimento. Os pacientes foram divididos em dois grupos: um que recebeu orientação de dieta hipocalórica tradicional e preenchia o registro de consumo alimentar (RCA) de três dias (Grupo A) e outro que recebeu orientação de dieta hipocalórica baseada no sistema dos pontos e preenchia o RCA diário (Grupo B). RESULTADOS: Quarenta e quatro pacientes concluíram o tratamento. Houve redução do ZIMC nos dois grupos (p < 0,0001), porém a redução observada no Grupo A não foi diferente da observada no Grupo B (p=0,87). Ocorreu aumento da massa livre de gordura (%), redução da circunferência abdominal, pressão arterial sistólica e diastólica, além da massa gorda (%). Houve diferença no escore de compulsão alimentar entre as visitas 1 e 8, o qual se manteve durante o estudo. Verificamos melhora de todos os parâmetros laboratoriais, com diminuição significativa de insulina, HOMA-IR, gama-GT e ALT, não havendo diferença entre os dois grupos. Houve redução do valor energético total nos dois grupos, acompanhada do aumento percentual de proteínas, redução de carboidratos e manutenção dos lipídios. O automonitoramento médio não foi relacionado à variação do ZIMC. CONCLUSÃO: Dieta hipocalórica com orientação tradicional ou baseada no sistema de pontos levou a redução do ZIMC, de marcadores metabólicos e do valor energético total em adolescentes obesos de forma semelhante nesta coorte de pacientes / INTRODUCTION: Obesity is a chronic illness and multifactorial etiology, related to genetic factors, environmental and behavioral. Features association with several metabolic abnormalities in childhood, leading to increased risk of cardiovascular disease in adult life. The treatment involves lifestyle change, with balanced diet guidance and encouraging physical activity. The treatment in this age group have brought limited data, in addition to high drop-out rates. A unique type of food guidance is the equivalent calorie count, where calories are converted into points. The objective of this study was to evaluate the variance of Z score of body mass index (ZIMC) of obese adolescents undergoing orientation of two groups of low-calorie diet: traditional and based on the points system, as well as evaluate anthropometric variables, body composition, food intake, metabolic changes and self-monitoring. METHODS: randomized clinical study with duration of 24 weeks, with 66 adolescents with an average age of 13.7 ± 0.7 years of both genders, with scores of BMI >= 2 to <= 4 curve adjusted for gender and age of the World Health Organization. Were verified weight, height, blood pressure and waist circumference, intensity of physical activity and self- monitoring, as well as performed the nutritional guidance to each visit. Laboratory parameters, applying the scale of binge eating, pubertal, stage and body composition were evaluated at the beginning and end of the action. The patients were divided into two groups: one that received guidance of traditional low-calorie diet and meet the food consumption record (RCA), three days (Group A) and another that received low-calorie diet guidance based on the system of points and meet the daily RCA (Group B). RESULTS: forty-four patients have completed treatment. There was a reduction of Z BMI in both groups (p 0.0001 < ), however the reduction observed in the Group was not different from that observed in Group B (p = 0.87). There was increased fat free mass (%), abdominal circumference, systolic and diastolic blood pressure and body fat (%). There was difference in binge eating score between 1 and 8 visits, which remained during the study. We improved all laboratory parameters, with significant decrease of insulin and HOMA-IR, gamma GT and ALT, and there is no difference between the two groups. There was a reduction of the total energy in both groups, accompanied by the increasing percentage of protein, carbohydrate and maintenance reduction of lipids. The average self-monitoring was not related to the variation of Z BMI. CONCLUSION: low-calorie diet with traditional or orientation based on points system led to reduction of metabolic markers, Z BMI and total energy value in obese adolescents similarly in this cohort of patients

Philosophiae Doctor - PhD / This thesis consists of a brief description on cancer, carcinogenesis, the changes in the type and level of dietary fat available in our diets over time and association with the development of certain diseases. The main focus of this research was on omega 6 and omega 3 essential fatty acids (EFA) and their interaction with regards to carcinogenesis. / South Africa

M.Tech. (Homoeopathy) / Psychological stress refers to an individual’s interaction with what he perceives as adverse or threatening phenomena of the external environment (stimulus) and the ensuing physiological response that occurs within the body. Although the stimulus itself may not be harmful, the physiological reaction of the individual to the perceived threat may lead to health consequences. University students may experience greater levels of stress than the average population. They may also experience symptoms of anxiety, irritability, sleep disturbances and impaired memory due to psychological stress. These symptoms may be exacerbated by concomitant use of alcohol and stimulants such as nicotine and caffeine, which students may use as coping mechanisms. Conventional treatment for stress might include anti-depressants and anxiolytics that often have adverse effects. TranQuin® Day Formula is a combination vitamin and herbal supplement formulated to assist the body to cope with stress. Although each individual vitamin and herbal constituent of TranQuin® Day Formula has been thoroughly researched, to date, no research has been conducted on the efficacy of TranQuin® Day Formula dietary supplement for the treatment of psychological stress in university students. The aim of this study was to determine the efficacy of TranQuin® Day Formula supplement on psychological stress in university students, with the use of the Cohen’s Perceived Stress Scale-10 (PSS-10) and Goldberg’s General Health Questionnaire-28 (GHQ-28). Thirty participants, both male and female, between the ages of 18 and 49 years, who obtained a minimum score of 10 on the Cohen’s Perceived Stress Scale-10, were selected to participate in this six week, double-blind, placebo-controlled study. Participants were also requested to complete Goldberg’s General Health Questionnaire-28. The scores obtained by the participants on both stress scales were measured at the beginning of the study (week 0) to obtain a baseline score, in the middle of the study (week 3) and at the end of the study (week 6). The participants were randomly divided into the control and experimental groups. Participants were asked to take two capsules of the supplement or placebo, preferably in the morning after breakfast, or the first meal of the day, for the duration of the study period (6 weeks). Each participant received a daily data sheet which recorded capsules taken and any symptoms experienced, as well as any other medication taken. The results of the study were statistically analysed using the Mann-Whitney-U Test, the Shapiro-Wilk Test, the Wilcoxon Signed Ranks Test, Friedman Test and descriptive statistics.