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Thesis (MScAgric) -- University of Stellenbosch, 2000. / ENGLISH ABSTRACT: Lipids remain one of the most important nutrients required by broilers. The growing awareness that some Western societies have too high a dietary ratio of n-6/n-3 polyunsaturated fatty acids is of direct relevance to broiler nutrition and lipid metabolism. Meaningful quantities of n-3 polyunsaturates have been incorporated into major poultry tissues, so that the production of broiler meat with high n-3 polyunsaturates becomes advantageous for the broiler industry as they are perceived as having a 'healthier' lipid profile. Unfortunately, such broiler meat is rather susceptible to oxidative deterioration, and oxidation often determines shelf life of poultry meat products. The addition of a-tocopherol (vitamin E) to broiler diets is an effective means of improving the oxidative stability of broiler meat. Elevated a-tocopherol levels in broiler feeds increase tissue concentrations thereof resulting in improved stability of membranal structures which may be expected to increase the oxidative stability of broiler meat and meat products. Three investigations were done at Mariendahl Poultry Research Station in Stellenbosch. The broilers were kept in 1 x 0.4 x 0.5 m cages in a broiler rearing house. All the trials started with day-old chicks, except experiment 1 where 3-week old broilers were used. At the end of trials 2 and 3 the 6-week old broilers were slaughtered and the carcasses prepared for chemical analysis. Experiment 1: Metabolisabie energy of Canola acid oil and Famarol acid oil for broiler chickens. In trials with 21-day-old male broilers the true metabolisabie energy value, corrected for nitrogen retention (TMEn) was determined by the balance method for Canala acid oil (CAO) and Famarol acid oil (FAO). The trials were duplicated, each time using different samples of the two oils from the same source (experiment 1 and 2). Each of the two oils were blended in two ratios with a basal diet to form the test diets, viz. 100% Basal; 96% Basal: 4% Oil; 92% Basal: 8% Oil. In experiment 3, 50 % bran was added to the maize to form the basal diet. The balance trials lasted for 3 days after an adaptation period of 4 days. The TMEn values determined by regression for the broilers of CAO did not differ significantly (P>0.05) between experiments 1 and 2. However, the value for experiment 3 was significantly (P<0.05) higher than those for experiments 1 and 2. The TMEn values of FAO also did not differ significantly (P>0.05) between experiments 1 and 2, although the value for experiment 3 was significantly higher than that of experiment 1. The addition of 50 % bran to the basal diet in experiment 3 could have stimulated the digestive breakdown process and hence increase the secretion of digestive enzymes. This could lead to an increase in the utilisation of the test lipid and therefore an increase in the TMEn value. The TMEn values of CAO differed significantly (P<0.05) from those of FAO for all three the experiments (exp. 1:30.6 ± 0.399 MJ/kg for CAO vs. 25.9 ± 0.441 MJ/kg for FAO; expo 2: 31.0 ± 0.633 MJ/kg for CAO vs. 26.1 ± 0.668 MJ/kg for FAO: expo 3: 32.1 ± 0.867 MJ/kg for CAO vs. 27.1 MJ/kg for FAO).Experiment 2: of broilers. The dietary effects of various combinations of Canala acid oil (CAO, a high level of C18:3n-3 and MUFA) and Famarol Effects of various dietary n-6/n-3 fatty acid ratios on the perfonnance and body composition acid oil (FAO, a high level of 18:2n-6 and SFA) on tissue fatty acid composition were studied in broiler carcasses and abdominal fat pads. From day-old to six weeks, chicks were fed one of six diets containing 100% FAO, 80% FAO-20% CAO, 60% FAO-40% CAO, 40% FAO-60% CAO, 20% FAO-80% CAO, 100% CAO. There were no statistical differences (P>0.05) in average daily gain (1.71 ± 0.059 g) or feed conversion ratios (1.97 ± 0.051) among dietary groups. No statistical differences (P>0.05) were found in the chemical proximate composition of the carcasses for the moisture (66.20 ± 0.112 %), protein (17.63 ± 0.484 %), lipid (15.92 ± 1.507 %) and ash (0.95 ± 0.115 %) content among dietary groups. No statistical differences (P>0.05) were found in the chemical proximate composition of the abdominal fat pads for the moisture (28.77 ± 0.112 %), protein (3.03 ± 0.484 %), lipid (63.32 ± 9.789 %) and ash (0.45 ± 0.135 %) content among dietary groups. With the increase in dietary CAO levels, the percentages of C18:2n-6 and C20:4n-6 in the carcasses decreased respectively with 1.78 % from 20.88 % and 0.35 % from 1.05 %, whilst C18:3n-3 and longer chain n-3 fatty acids such as C20:5n-3 and C22:6n-3 increased respectively with 2.25 % from 1 %, 0.1 % from 0.1 % and 0.67 % from 0.2 %. The same tendency was seen in the abdominal fat pads where C18:2n-6 and C20:4n-6 decreased respectively with 1.55 % from 20.75 % and 0.98 % from 1.2 % with an increase in dietary CAO, whilst C18:3n-3, C20:5n-3 and C22:6n-3 increased respectively with 2.13 % from 1.15 %, 0.45 % from 0.03 % and 0.95 % from 0.05 %. The n-3/n-6 ratio in the carcasses and abdominal fat pads increased respectively with 0.16 % from 0.06 % and 0.19 % from 0.06 % with an increase in dietary CAO. These results clearly indicate that dietary CAO enriched with a-linolenic acid lower saturated fatty acids respectively in broiler carcasses and abdominal fat pads with 4.88 % from 31.6 % and 10.63% from 31.1 %, whilst increasing monounsaturated fatty acids with 3.87 % from 44.95 % and 7.25 % from 46.7 % respectively and polyunsaturated fatty acids with 1.02 % from 23.45 % and 2.38 % from 23.2 % respectively. Experiment 3: Effect of dietary vitamin E on the performance of broilers and oxidative stability, colour, microbiological stability, fatty acid composition and pH of broiler meat during refrigerated and frozen storage. Experiment 1 was carried out with 220 one-day-old broiler chicks to evaluate the effect of eleven concentrations of vitamin E (0, 20, 40, 60, 80, 100, 120, 140, 160, 180 and 200 mg a-tocopheryl acetate 1 kg diet) on their production performance and the oxidative stability of their frozen broiler carcasses. The diets with vitamin E levels 0 to 100 mg were fed from day-old to 42 days of age while the diets with vitamin E levels 120 to 200 mg were fed from 21 to 42 days of age. The oxidative stability, evaluated by thiobarbituric acid reactive substances (TBARS) values, was determined after 30, 90, 120 and 150 days of storage at -20°C. There were no statistical differences (P>0.05) in average daily gain (1.85 ± 0.111 g) or feed conversion ratios (2.29 ± 0.397) among dietary groups. TBARS values increased significantly (P<0.05) with increasing time of storage (basal diet: day 30 = 1.71 ± 0.51; day 150 = 4.89 ± 0.51), but decreased significantly (P<0.05) with increasing vitamin E levels (day 150: basal = 4.89 ± 0.51; 100 mg / kg = 1.09 ± 0.27). Experiment 2 was carried out with day-old broiler chicks to evaluate the effect of five concentrations of vitamin E (0, 40, 80, 120 and 160 mg atocopheryl acetate / diet) on their performance and the oxidative stability of their refrigerated carcasses. The experimental diets were fed from day-old to 42 days of age. The oxidative stability, evaluated by TBARS values, colour deterioration and microbiological stability were determined after 0, 4, 8, 10 and 12 days of storage at 4°C. Fatty acid analysis was done on the samples of days 0 and 12. There were no statistical differences (P>0.05) in average daily gain (1.88 ± 0.117 g) or feed conversion ratios (2.37 ± 0.467) among dietary groups. TBARS values increased significantly (P<0.05) with increasing time of storage, but decreased significantly (P<0.05) with increasing vitamin E levels. There were no statistical differences (P>0.05) in colour measurements for L* (44.97 ± 0.662), a* (5.23 ± 0.315) or b* (12.76 ± 0.321) values between treatments. Microbiological counts increased significantly (P<0.05) over time with vitamin E concentration showing no effect. There were no statistical differences (P>0.05) for any of the fatty acid groups measured (SFA: Day 0 = 26.1 ± 1.13%, Day 12 = 26.1 ± 1.17%; MUFA: Day 0 = 41.4 ± 1.46%, Day 12 = 40.2 ± 2.28%; PUFA: Day 0 = 32.4 ± 1.95%, Day 12 = 33.8 ± 2.52%) among dietary groups. Similarly, none of the fatty acids showed statistical significant (P>0.05) concentration changes over time. There were no statistical differences (P>0.05) in pH (6.01 ± 0.206) among dietary groups. / AFRIKAANSE OPSOMMING: Lipiede is steeds een van die mees belangrike voedingstowwe wat deur braakuikens benodig word. Die groeiende bewuswording dat sekere Westerse gemeenskappe 'n te hoë verhouding van n-6/n-3 poli-onversadigde vetsure in hul dieet het, is direk relevant vir braaikuikenvoeding en lipiedmetabolisme. Betekenisvolle hoeveelhede n-3 polionversadigde vetsure is geïnkorporeer in die belangrikste hoendersnitte, met die gevolg dat die produksie van braaikuikenvleis met hoë n-3 poli-onversadigde vetsure voordelig is vir die braaikuikenindustrie en geag word 'n meer "gesonde" beeld te hê. Ongelukkig is sodanige braaikuikenvleis redelik vatbaar vir oksidatiewe bederf, en oksidasie bepaal dikwels die rakleeftyd van hoendervleisprodukte. Die byvoeging van a-tokoferol (vitamine E) by braaikuikendiëte is 'n effektiewe manier om die oksidatiewe stabiliteit van braaikuikenvleis te verbeter. Verhoogde a-tokoferol vlakke in braakuikenvoere verhoog die weefselkonsentrasie wat verhoogde stabiliteit van die membraanstrukture en derhalwe moontlike verhoogde oksidatiewe stabiliteit van braakuikenvleis en -produkte tot gevolg het. Drie ondersoeke is onderneem by Mariendahl Pluimvee Navorsingstasie te Stellenbosch. Die braakuikens is aangehou in 1 x 0.4 x 0.5m hokke in braaikuikenhuise. In al die proewe is dagoud kuikens gebruik, behalwe eksperiment 1 waar drieweek oue kuikens gebruik is. Aan die einde van proewe 2 en 3 is die ses-week oue braaikuikens geslag en die karkasse voorberei vir analise. Eksperiment 1: braaikuikens. Die ware metaboliseerbare energie waarde van Canola voergraadolie (CAO) en Famarol voergraadolie (FAO), Metaboliseerbare energie van Canola voergraadolie en Famarol voergraadolie vir gekorregeer vir stikstof retensie (WMEn), is by wyse van proewe op 21 dae oue braaikuikenhaantjies bepaal deur van die balansrnetode gebruik te maak. Die proewe is tweemaal herhaal vir verhoogde akkuraatheid, met die gebruik van verskillende monsters van die twee olies vanaf dieselfde bron. Die olies is in twee verhoudings met 'n basale diëet gemeng om die proef dieet te vorm, nl. 100% Basaal; 96% Basaal: 4% Olie en 92% Basaal: 8% Olie. Die balans proewe het 3 dae geduur na afloop van 'n aanpassingsperiode van 4 dae. Die WMEn waardes van CAO, bepaal deur middel van regressie analise, het nie betekenisvol verskil (P>0.05) tussen eksperimente 1 en 2 nie. Die waarde van eksperiment 3 was betekenisvol hoër (P<0.05) as die van die eerste twee eksperimente. Die WMEn waardes van FAO het ook nie betekenisvol verskil (P>0.05) tussen eksperimente 1 en 2 nie, maar die waarde vir eksperiment 3 was betekenisvol hoër as dié van eksperiment 1. Die WMEn waardes van COA het betekenisvol verskil (P< 0.05) van dié van FAO vir al die eksperimente (exp. 1: 30.6 ± 0.399 MJ/kg vir CAO vs. 25.9 ± 0.441 MJ/kg vir FAO; expo 2: 31.0 ± 0.633 MJ/kg vir CAO vs. 26.1 ± 0.668 MJ/kg vir FAO: expo 3: 32.1 ± 0.867 MJ/kg vir CAO vs. 27.1 MJ/kg vir FAO). Eksperiment 2: Die invloed van verskeie rantsoen n-6/n3 vetsuurverhoudings op die produksie en liggaamsamestelling van braaikuikens. Die rantsoeneffek van verskeie kombinasies Canola voergraadolie (CAO, 'n hoë vlak van C18:3n-3 en monoonversadigde vetsure) en Famarol voergraadolie (FAO, 'n hoë vlak van 18:2n-6 en versadigde vetsure) op die weefselvetsuursamestelling is bestudeer in braaikuikenkarkasse en abdominale vetneerlegging. Die kuikens is van dagoud to op ses-weke ouderdom een van ses diëte gevoer met die volgende samestellings: 100% FAO, 80% FAO-20% CAO, 60% FAO - 40%CAO, 40% FAO - 60% CAO, 20% FAO - 80% CAO, 100% CAO. Daar was geen statistiese verskil tussen die rantsoengroepe (P>0.05) in die gemiddelde daaglikse toename (1.71 ± 0.059 g) of die voeromsetverhoudings (1.97 ± 0.051) nie. Geen statistiese verskil (P>0.05) is gevind in die chemiese samestelling van die karkasse vir vog (66.20 ± 0.112 %), proteïn (17.63 ± 0.484 %), lipied (15.92 ± 1.507 %) en as (0.95 ± 0.115 %) inhoud tussen die rantsoen groepe nie. Geen statistiese verskille (P>0.05) is gevind in die chemiese samestelling van die abdominale vetneerlegging vir vog (28.77 ± 0.112 %), proteien (3.03 ± 0.484 %), lipied (63.32 ± 9.789 %) en as (0.45 ± 0.135 %) inhoud onder die rantsoengroepe nie. Met die verhoging in die rantsoen CAO vlakke het die persentasie van C18:2n-6 en C20:4n-6 in die karkasse verminder met 1.78 % en 0.35 % respektiewelik, terwyl C18:3n-3 en langer ketting n-3 vetsure soos C20:5n-3 en C22:6n-3 respektiewelik met 2.25 %, 0.1 % en 0.67 % verhoog het. Dieselfde tendens is opgemerk in die abdominale vetneerlegging waar C18:2n-6 en C20:4n-6 afgeneem het met 1.55 % en 0.98 % respektiewelik met die verhoging van rantsoen CAO, terwyl C18:3n-3, C20:5n-3 en C22:6n-3 verhoog het met 2.13 %, 0.45 % en 0.95 % respektiewelik. Die n- 3/n-6 verhouding in die karkasse en abdominale vetneerlegging het verhoog met 0.16 % en 0.19 % respektiewelik met die verhoging van die rantsoen CAO. Die resultate toon onomwonde aan dat rantsoen CAO verryk met c-Iinoletensuur, verlaag versadigde vetsure in braaikuikenkarkasse en -adbdominale vetneerleggings met 4.88 % en 10.63% respektiewelik, terwyl die mono-onversadigde vetsure met 3.87 % en 7.25 % respektiewelik verhoog word en polionversadigde vetsure met 1.02 % en 2.38 % respektiewelik verhoog word. Eksperiment 3: Die invloed van vitamine E op die produksie van braaikuikens en die oksidatiewe stabiliteit, kleur, mikrobiologiese stabilitiet, vetsuursamestelling en pH van braaikuikenvleis gedurende verkoelde en bevrore berging. Eksperiment 1 is uitgevoer met 220 dagoud braaikuikens ten einde die effek van elf konsentrasies van vitamine E (0, 20, 40, 60, 80, 100, 120, 140, 160, 180 en 200 mg a-tokoferyl acetaat / kg voer) op hul produksieprestasie en die oksidatiewe stabiliteit van hul gevriesde braakuikenkarkasse te evalueer. Die diëte met vitamine E vlakke 0 tot 100 mg is vanaf dagoud tot 42-dae-ouderdom gevoer, terwyl die diëte met vitamine E vlakke van 120 tot 200mg gevoer is vanaf 21 tot 42- dae-ouderdom. Die oksidatiewe stabiliteit, soos geëvalueer deur tiobarbituriese suur reaktiewe stowwe (TBARS) waardes, is bepaal na 30, 90, 120 en 150 dae van berging teen -20°C. Daar was geen statistiese verskille (P>0.05) in die gemiddelde daaglikse toename (1.85 ± 0.111 g) of voeromsetverhoudings (2.29 ± 0.397) tussen die rantsoengroepe nie. TBARS waardes het betekenisvol toegeneem (P<0.05) met die verhoging in bergingsperiode, maar het betekenisvol afgeneem (P<0.05) met verhoogde vitamine E vlakke. Eksperiment 2 is uitgevoer met dagoud braaikuikens ten einde die effek van vyf konsentrasies van vitamine E (0, 40, 80, 120 and 160 mg a-tokoferyl acetaat / kg voer) op hul prestasie en die oksidatiewe stabiliteit van hul verkoelde karkasse te evalueer. Die eksperimentele diëte is gevoer vanaf dagoud tot 42- dae-ouderdom. Die oksidatiewe stabiliteit, geëvalueer deur middel van TBARS waardes, kleur afname en mikrobiologiese stabiliteit is bepaal na 0, 4, 8, 10 en 12 dae van berging teen 4°C. Vetsuuranalises is gedoen op die monsters van dae 0 en 12. Daar was geen statistiese verskille (P>0.05) in die gemiddelde daaglikse toename (1.88 ± 0.117 g) of voeromsetverhoudings (2.37 ± 0.467) tussen die rantsoengroepe nie. TBARS waardes het betekenisvol verhoog (P<0.05) met die verlengde bergingsperiode, maar het betekenisvol afgeneem (P<0.05) met verhoogde viatmine E vlakke. Daar was geen statistiese verskille (P>0.05) in kleur metings vir L* (44.97 ± 0.662), a* (5.23 ± 0.315) of b* (12.76 ± 0.321) waardes tussen behandelings nie. Mikrobiologiese tellings het betekenisvol verhoog (P<0.05) oor tyd met die vitamine E konsentrasie wat geen effek getoon het nie. Daar was geen statisties betekenisvolle verskille (P>0.05) vir enige van die vetsuurgroepe tussen die behandelings nie. Soortgelyks het geen van die vetsure statisties betekenisvolle (P>0.05) konsentrasieveranderings oor tyd aangetoon nie. Daar was geen statistiese verskil (P>0.05) in die pH (6.01 ± 0.206) tussen die rantsoengroepe nie.

Thesis (PhD (Food Science))--University of Stellenbosch, 2006. / Long-chain polyunsaturated fatty acids (LCPUFA), especially the n-3 LCPUFA metabolic products eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) play an important role as regulators in many biological processes. To date hake (Merluccius capensis) heads, a rich source of EPA and DHA, have been discarded at sea. The South African Fisheries Policy Development Committee concerned with the environmental impact of this practice has rendered it undesirable. The high prevalence of under-nutrition amongst children in South Africa can be addressed by the supplementation of their diet with this unexploited fish source. The aim of the current study was to develop a microbiologically safe and sensory acceptable sandwich spread using fish flour prepared from fish heads, as a prime ingredient. The intervention trial aimed to compare the effects of an increased dietary intake of n-3 LCPUFA, specifically DHA, on the blood fatty acid levels and absenteeism (as indicator of immune function), as well as the cognitive status, of the subjects. The microbiological content of the sandwich spread was determined after storage for 20 d at 5°C and 15 d at 25°C. Sensory evaluation was performed by consumers (n = 95; M:F = 44:51; 6 – 9 yr) to determine acceptance of the five different flavours individually incorporated into the sandwich spread to mask the fishy note and to provide different flavour options. For the intervention trial subjects (n = 351) were stratified within class group (A - E) and gender and randomly assigned to two treatment categories, an experimental group (EG; n = 174) receiving 25 g sandwich spread.d-1 (191.66 mg DHA. d-1) and a control group (CG; n = 177) receiving an analogous placebo. On school days (104 d), each subject received two sandwiches consisting of two slices of bread (ca. 60 g), spread with 25 g of either the placebo or the experimental spread. Blood samples were drawn at baseline and post intervention. Plasma fatty acid and red blood cell (RBC) membrane status, C-reactive protein levels, as well as vitamin and micronutrient status, were determined. Trained test administrators conducted a battery of cognitive tests. According to South African Government health standards, the sandwich spread remained microbiologically safe after storage. Male and female consumer respondents revealed a significant difference between gender preferences of the five different spread flavours (p <0.05). Significant treatment effects (p <0.05) were observed in n-3 LCPUFA status of the EG, as well as for their absenteeism from school. The two subtests of the Hopkins Verbal Learning test, Recognition and Discrimination Index, showed significant differences between the EG and CG (p <0.05) post intervention in the Grade 2 subjects. The Spelling tests also showed a significant difference between the two groups (p <0.05). In the current study a microbiologically safe and sensory acceptable sandwich spread was developed and tested during an intervention trial, and could possibly in future, provide a healthier option in the School Nutritional Programme. This study proved that supplementation of children (6 - 9 yr) with n-3 LCPUFA, with specific reference to EPA and DHA from a marine source, could have a beneficial effect on their fatty acid status and absenteeism from school. Based on the outcomes of the Hopkins Verbal Learning test and Spelling test, the current study proved that an n-3 fatty acid-rich spread improved the learning ability and memory of children.

INTRODUÇÃO: As doenças cardiovasculares (DCV) aparecem em primeiro lugar entre as principais causas de mortalidade no mundo, representando 46,2% do total de mortes, número muito próximo aos encontrados no Brasil, impactando os gastos com saúde. A prevenção baseia-se em estilo de vida saudável, contudo, uma vez instaladas, é consenso o tratamento medicamentoso com estatinas. Alguns tratamentos alternativos vêm sendo estudados como o ômega-3 (w-3) na prevenção das DCV. Apesar das evidências clínicas favoráveis, não existem muitos estudos acerca da viabilidade econômica de tais tratamentos. OBJETIVO: Avaliar o custo-efetividade das intervenções com w-3 isolado ou associado às estatinas na redução dos fatores de risco cardiovascular sob a perspectiva do Sistema Único de Saúde (SUS). MATERIAL E MÉTODOS: Para avaliar a efetividade do w-3 isolado e combinado com estatina foram utilizados os dados secundários do ensaio clínico CARDIONUTRI no momento basal e após 8 semanas. A amostra foi composta por 186 indivíduos com idade entre 30 e 74 anos divididos entre aqueles que não tomavam medicação e os que tomavam estatinas. Aleatoriamente, uma parcela deles recebeu cápsulas de 1 g de w-3 (37% de ácido eicosapentaenoico e 23% de docosaexaenoico) ou cápsulas de placebo. A recomendação era de que todos deveriam tomar 3 cápsulas ao dia, totalizando 3g/dia (de w-3 ou placebo) durante 8 semanas. Ao final, obteve-se quatro grupos: a) w-3; b) placebo; c) w-3 + estatina; e d) estatina. Para a avaliação do impacto foi usado o método Diferenças em Diferenças com a adição de variáveis de controle: densidade calórica do consumo alimentar, Índice de Massa Corporal (IMC), prática de atividade física, idade, sexo, raça, hábito tabagista, escolaridade e grau de adesão. Os custos dos tratamentos foram estimados com base no custo médio ponderado pelas probabilidades das eventuais intercorrências relacionadas a efeitos adversos e de sucesso e fracasso por meio do método da árvore de decisão. Foi considerado para fins do cômputo dos custos o período de 2 meses de tratamento. RESULTADOS: Nos quatro grupos, a maioria eram mulheres, obesas e com escore de risco muito alto para DCV. Os grupos w-3 e placebo possuíam maior escolaridade e renda comparadas a aqueles que tomavam estatinas. Todas as variáveis de controle foram estatisticamente significantes em pelo menos um dos modelos, exceto raça. A suplementação com w-3 associada às estatinas mostrou efetividade sobre HDLPEQUENA, com diminuição de 2,211 mg/dL e custo-efetividade de R$ 109,31 por redução em mg/dl da lipoproteína em 2 meses de tratamento. CONCLUSÃO: O tratamento com 1,8g de óleo de peixe isolado ou associado às estatinas em intervenção primária não evidenciou efeitos significativos nas mudanças dos parâmetros lipídicos, exceto no caso da HDLPEQUENA com o tratamento associado, mostrando não ser custo-efetivo na redução dos fatores de risco cardiovascular em geral. Em virtude da existência de controvérsias acerca de seus potenciais efeitos, sugere-se que os ensaios clínicos utilizem métodos estatísticos mais robustos para avaliar o impacto líquido da suplementação. / INTRODUCTION: Cardiovascular diseases (CVD) are among the leading causes of death worldwide, accounting for 46.2% of all cases, very close to those found in Brazil, impacting health expenses. Current prevention is based on a healthy lifestyle, and once a CVD diagnosis is made, the current consensus is drug treatments with statins. Some alternative treatments such as omega-3 (w-3) have been studied in the prevention of these diseases. However, despite favorable clinical evidence, there are not many studies of economic viability of this treatment. OBJECTIVE: To evaluate the cost-effectiveness of interventions with w-3 alone or associated with statins in reducing cardiovascular risk factors from the perspective of the Unified Health System (SUS). METHODS: To assess the effectiveness of w-3 alone and its combination with statin, the secondary data of the classic lipid profile and lipoprotein size of the CARDIONUTRI clinical trial were used at baseline and after 8 weeks. The sample consisted of 186 subjects aged 30 to 74 years randomly received capsules containing 3g of w-3 per day (37% of eicosapentaenoic acid and 23% of docosahexaenoic acid) or 3g of mineral oil (placebo). Capsules were randomly assigned to individuals who were not taking medication or were already taking statins, separated into four groups: a) w-3; b) placebo; c) w-3 associated with statins; d) statins. Data analysis was conducted using the Difference in Differences statistical method with the addition of control variables: caloric density of food consumption, Body Mass Index (BMI), physical activity practice, age, sex, race, smoking, educational level and adherence to the treatment. The treatment costs were estimated based on the weighted average cost by the probabilities of the eventual intercurrences related to adverse effects and of success and failure by means of the decision tree method elapsed in 2 months of treatment. RESULTS: In all four groups, the majority were women, obese and with a very high-risk score for CVD. W-3 and placebo groups had higher educational level and income compared to those who were already taking statins. All control variables were statistically significant in at least one of the models except race. W-3 supplementation showed efficacy on HDLSMALL among those who consumed w-3 + statins with a reduction of 2,211 mg /dL and cost-effectiveness R$ 109.31 per mg/dL for 2 months of treatment. CONCLUSION: The treatment with 1.8g of fish oil isolated or associated with statins in primary intervention did not show significant effects on changes in lipid parameters except HDLSMALL of interventions associated with statins. Therefore it was not cost-effective in reducing cardiovascular risk factors. Due to the existence of controversies about its potential effects, it is suggested that clinical trials use more robust statistical methods to assess the net impact of supplementation.

No description available.

Ratos foram tratados com salina, óleos de peixe (OP) ou soja (OS) por via intragástrica durante 20 dias antes da indução do IAM. A área de infarto e atividades da creatina quinase no plasma e da caspase 3 no ventrículo esquerdo (VE) foram menores no grupo OP comparado a salina ou OS. Os conteúdos de IL-1&beta;, TNF-&alpha;, CINC 2&alpha;/&beta;, IL-6 e VEGF-&alpha; no VE e de IL-1&beta;, TNF-&alpha;, MIP-3, IL-6 e VEGF-&alpha; no fígado foram elevados pelo OS. O OP aumentou os conteúdos de ATP e lactato e diminuiu o de glicogênio no VE. A redução do fluxo coronariano no VE dos animais infartados foi abolida pelo OP. A expressão gênica de iNOS, eNOS, HIF-1&alpha;, GLUT-1, VEGF-&alpha;, p53 e Bax2 no VE aumentou pelo OP. A fração de ejeção, fração de encurtamento e velocidade de encurtamento das fibras cardíacas foram mais elevadas pelo OP. Portanto, o tratamento com OP induziu um estado de pré-condicionamento que conferiu proteção do miocárdio à injúria isquêmica. / Rats were treated with saline, fish (FO) or soybean (SO) oils by gavage for 20 days before myocardial infarction (MI). Infarct size, activities of plasma CK and caspase 3 in the left ventricle (LV) were decreased by FO as compared with saline or SO. The contents of IL-1&beta;, TNF-&alpha;, CINC 2&alpha;/&beta;, IL-6, VEGF-&alpha; in the LV and of IL-1&beta;, TNF-&alpha;, MIP-3, IL-6, VEGF-&alpha; in the liver were increased by SO. Contents of ATP and lactate in the LV were increased and of glycogen decreased by FO. FO prevented the decrease in the coronary blood flow in the LV of infarcted rats. The mRNA contents of iNOS, eNOS, HIF-1&alpha;, GLUT 1, VEGF-&alpha;, p53 and Bax2 in the VE were increased by FO. Ejection fraction, fractional shortening and velocity of circumferential fiber-shortening were also increased by FO. So, treatment with FO leads to a preconditioning state that protected the heart from MI injury.

Atherosclerosis, one major cause of morbidity and mortality worldwide, is a complex and multifactorial disease that involves three mainly conditions: chronic inflammation, dyslipidemia and oxidative stress. Although statins are the first-line therapy for LDL cholesterol (LDL-C) lowering, the efficacy of cardiovascular events prevention is limited to 30-40%. This residual risk brought attention to the need of new therapies and clinical targets beyond LDL-C, such as inflammation and oxidative stress. Importantly, suboptimal treatment and/or statin discontinuation due to adverse effects have also been a very challenging clinical problem. Complementary diet therapy can be an effective and safe approach to support pharmacological treatment, especially when drugs alone are insufficient to attenuate risk factors and/or the recommended dose is not well tolerated. The aim of this study was to evaluate the effects of three bioactive components, namely omega-3 fatty acids, plant sterols and polyphenols, on markers of dyslipidemia, inflammation and oxidative stress in patients treated with statins. A randomized, crossover clinical study was carried out, with the participation of 53 subjects. At each intervention period, study participants received a packaged for the functional or control treatment. Functional treatment consisted of fish oil (1.7 g of EPA+DHA/day), chocolate containing plant sterols (2.2 g/day) and green tea (two tea sachets/day). Control treatment consisted of soy oil softgels, regular chocolate and anise tea. After 6 weeks of intervention, functional treatment reduced plasma LDL-C (-13.7% ± 3.7, p=0.002) and C-reactive protein (-35.5% ± 5.9, p=0.027). Plasma triacylglycerol (-15.68% ± 5.94, p=0.02) and MDA (-40.98% ± 6.74, p=0.04) were reduced in subgroups of patients (n=23) with baseline values above the median (93 mg/dL and 2.23 umol/L, respectively). Analysis of lathosterol and campesterol in plasma suggested that intensity of LDL-C reduction was influenced by cholesterol absorption rate rather than its endogenous synthesis. After multivariate analysis, patients identified as \"good responders\" to supplementation (n=10) were recruited for a pilot protocol of statin dose reduction with complementary diet therapy. Responders received the functional treatment for 12 weeks: standard statin therapy was kept during the first 6 weeks and reduced by 50% from weeks 6 to 12. No difference was observed for plasma lipids and inflammation biomarkers, cholesterol efflux capacity or HDL particle number after statin dose reduction when compared to standard therapy. Although limited by the small sample size, our study demonstrates the potential for a new therapeutic approach combining lower statin dose and specific dietary compounds. This may be particularly helpful for the many patients with, and at risk for, CVD who cannot tolerate high-dose statin therapy. / A aterosclerose, uma importante causa mundial de morbidade e mortalidade, é uma doença complexa e multifatorial que envolve três principais condições: inflamação crônica, dislipidemia e estresse oxidativo. Embora as estatinas sejam fármacos de primeira linha para redução de LDL colesterol (LDL-C), sua eficácia na prevenção de eventos cardiovasculares é limitadada a 30-40%. Este risco cardiovascular residual evidencia a necessidade de novas terapias e marcadores clínicos que vão além do LDL-C, como inflamação e estresse oxidativo. Não obstante, tratamento subótimo e/ou interrupção do uso de estatinas devido à ocorrencia de efeitos adversos também é um grave obstáculo na clínica médica. Neste contexto, a terapia dietética complementar representa uma abordagem efetiva e segura para o suporte do tratamento farmacológico, especialmente quando as drogas são insuficientes para atenuar fatores de risco e/ou quando a dose recomendada não é bem tolerada. O objetivo do presente estudo foi avaliar o efeito de três compostos bioativos - ácidos graxos ômega 3, fitosteróis e polifenóis - sobre marcadores de inflamação, lipemia e estresse oxidativo em indivíduos tradados com estatinas. Foi realizado um estudo clínico randomizado, de delineamento crossover, com a participação de 53 voluntários. A cada período de intervenção, os participantes receberam um tratamento funcional ou controle. O tratamento funcional foi composto por cápsulas de óleo de peixe (1.7 g/dia de EPA+DHA), chocolate contendo fitosteróis (2.2 g/dia) e chá verde (dois sachês/dia). O tratamento controle foi composto por cápsulas de óleo de soja, chocolate sem adição de fitosteróis e chá de anis. Após 6 semanas de intervenção, o tratamento funcional reduziu a concentração plasmática de LDL-C (-13.7% ± 3.7, p=0.002) e proteína C-reativa (-35.5% ± 5.9, p=0.027). Triglicerídeos (- 15.68% ± 5.94, p=0.02) e malondialdeído (-40.98% ± 6.74, p=0.04) foram reduzidas apenas em subgrupos de indivíduos que apresentavam valores basais acima da mediana (93 mg/dL e 2.23 umol/L, respectivamente). A análise de latosterol e campesterol no plasma sugeriu que a intensidade da redução de LDL-C não foi influenciada pela síntese endógena de colesterol, mas sim pela taxa de absorção. Após análise multivariada dos resultados, pacientes identificados como \"good responders\" à suplementação (n=10) foram recrutados para um estudo piloto de redução da dosagem da estatina, aliado à terapia dietética complementar. Estes pacientes receberam o tratamento funcional por 12 semanas: durante as 6 primeiras semanas mantevese a dosagem de estatina, que em seguida foi reduzida em 50% das semanas 6 a 12. Não foram observadas diferenças para os marcadores plasmáticos de lipídeos, inflamação, capacidade de efluxo de colesterol ou número de partículas de HDL após a redução da dose de estatina, quando comparada à terapia convencional. Embora limitado pelo reduzido número de pacientes, o estudo demonstra o potencial para uma nova abordagem terapêutica, combinando reduzida dose de estatina com específicos compostos bioativos. Esta pode ser uma importante alternativa para muitos pacientes em risco cardiovascular e que são intolerantes à terapia com altas doses de estatina.

Introdução: Epilepsia é uma desordem cerebral caracterizada predominantemente pela interrupção paroxística do funcionamento normal do cérebro causada por crises epilépticas que ocorrem de maneira recorrente e imprevisível. Aproximadamente 50% dos adultos com epilepsia têm ao menos uma comorbidade médica associada, e algumas condições apresentam uma prevalência maior quando comparados à população em geral. Entre elas podemos citar as comorbidades psiquiátricas e as alterações nutricionais. Objetivos: O presente estudo avaliou o consumo alimentar de pacientes portadores de epilepsia, e de forma mais específica, o consumo dos ácidos graxos poli-insaturados (PUFAS), e a sua relação com a presença de transtornos neuropsiquiátricos. Métodos: Foi realizado um estudo transversal onde o consumo alimentar de paciente com epilepsia do lobo temporal foi avaliado por um questionário de frequência alimentar (QFA) validado para a população de Porto Alegre –RS. Também foi avaliado a presença de transtornos psiquiátricos e sintomas de ansiedade através dos questionários estruturados, SCID, BAI e Escala de Hamilton. Resultados: Pacientes com diagnóstico de transtornos psiquiátricos avaliado por SCID apresentaram menor consumo de ácidos graxos omega-3, (0,53 ± 0,34g vs 0,84 ± 0,58g; p=0,047) e (0,21g ± 0,13g/1000kcal vs 0,32±0,21g/1000kcal; p=0,049). Pacientes com maiores níveis de ansiedade avaliados pelo BAI também apresentaram menor ingestão de PUFAS n-3 (9,14 ± 3,65g vs 12,82 ± 4,84g; p=0,011 e 3,41 ± 1,21% vs 4,14 ± 1,05% do VET; p=0,04). A Escala de Hamilton apresentou correlação inversa ao consumo de PUFAS n-3 (-0,306; p=0,041). Conclusão: Foi identificada uma associação entre o consumo de PUFAS n-3 e a presença de transtornos psiquiátricos e níveis mais altos de ansiedade em pacientes com epilepsia do lobo temporal. Ainda que o nosso estudo não pode determinar uma relação de cause efeito entre alterações neuropsiquiátricas e consumo de PUFAS é possível que um consumo de alimentos ricos em Omega-3 possa ser uma estratégica terapêutica a fim de melhorar anormalidades neuropsiquiátricas nesses pacientes. Essa é uma interessante questão que necessita ser melhor avaliada no futuro. / Background: Epilepsy is a brain disorder characterized by recurrent and unpredictable interruptions of normal brain function. About 50% of the adults patients with epilepsy have one or more coexisting medical conditions. Among the comorbidities, we highlight nutritional problems as well psychiatric disorders, which have a significant impact in the life quality of this patient. Aims: The aim of this study is to evaluate the nutritional intake of lobe temporal epilepsy patients and investigate its relation with psychiatric disorders diagnosis. Patients and Methods: we performed a cross-sectional study with 45 temporal lobe epilepsy patients and applied a food frequency questionary (FFQ), comparing the results with psychiatric diagnosis assessed by SCID to any disorders and depression by BAI and Hamilton Scale for anxiety. Results: All patients had a higher consumption of calories (38,89 ± 15,44). than the preconized for people in general and a lower intake of PUFAS than the recommended for cardiovascular protection. Patients identified with any psychiatric disorder by SCID had a lower intake of PUFAS n-3 (0,53 ± 0,34g vs 0,84 ± 0,58g; p=0,047 and 0,21g ± 0,13g/1000kcal vs 0,32±0,21g/1000kcal; p=0,049 than those free of diagnosis. Patients with high levels of anxiety also had also had a lower consumption of PUFAS n-3 (9.14 ± 3.65g vs 12.82 ± 4,84g; p=0.011). The Hamilton Scale had a negative correlation with PUFAS n-3 intake (0,306; p=0,041). Conclusion: We found a negative relation between the diagnosis of psychitric disorders and anxiety as assessed by SCID and BAI respectively. It’s not possible to determine a cause and effect relationship in this association, but we can consider the omega-3 fat acid and PUFAS n-3 rich food might be potentially therapeutic in patients with temporal lobe epilepsy. This question might deserve further studies.

O objetivo deste estudo foi avaliar a influência de dietas suplementadas com semente de linhaça (ricas em ácido alfa-linolênico, LNA, ômega3) e antioxidantes naturais, provenientes do orégano e do alecrim, sobre o nível de incorporação dos ácidos graxos poliinsaturados ômega 3 (PUFA ômega3) em ovos e tecidos de aves. Para isto, 192 galinhas poedeiras da linhagem comercial Babcock de 22 semanas, foram alimentadas durante 30 dias com dietas constituídas de 0 (zero) e 5% de óleo de linhaça. Foram definidos 8 tratamentos: 4 grupos com 5% de óleo de linhaça (controle/sem antioxidante; BHA+BHT, 100+100 ppm; orégano, 200 ppm; alecrim, 200 ppm) e 4 grupos sem óleo de linhaça, mas utilizando os mesmos antioxidantes. A amostragem dos ovos foi realizada durante o experimento nos períodos 0, 10, 20 e 30 dias e dos tecidos das aves (sobrecoxa, coxa, asa, peito, coração, tecido adiposo e fígado) no tempo final do experimento. Os ácidos graxos foram determinados por cromatografia gasosa e o grau de oxidação lipídica através do teste do ácido tiobarbitúrico (TBA). De acordo aos resultados obtidos, verificou-se aumento significativo dos ácidos graxos alfa-linolênico (LNA) e docosahexaenóico (DHA) nas gemas de ovo das aves que receberam 5% de óleo de linhaça nos tratamentos controle, BHA+BHT, orégano e alecrim, nos diferentes tempos (10, 20 e 30 dias), quando comparados com a dieta 0% linhaça. Além disso, a incorporação máxima dos ácidos LNA e DHA nas gemas de ovo foi obtida aos 20 dias de alimentação das aves, com um índice de incorporação de 15 a 30 e de 2,5 a 4,5 vezes o grupo controle, respectivamente. Na avaliação do grau de oxidação lipídica nas gemas de ovo, foi verificada diferença significativa na redução dos valores de absorbância nas 2 dietas, em todos os tratamentos com antioxidantes, quando relacionados ao seu respectivo controle. Com relação aos tecidos das aves, também houve incorporação significativa dos ácidos LNA e DHA, quando comparadas as duas dietas, sendo o fígado o tecido que apresentou a maior concentração destes ácidos graxos. Também foi possível verificar a eficácia dos antioxidantes naturais na proteção contra a oxidação lipídica nos tecidos sobrecoxa, coxa, asa e peito. Portanto, os extratos das especiarias, alecrim e orégano, podem ser utilizados satisfatoriamente para se obter ovos e tecidos de aves enriquecidos com PUFA ômega-3, melhorando a estabilidade lipídica. Considerando que os PUFA ômega-3 têm um interesse considerável na saúde humana, o fornecimento de dietas ricas em ácido alfa-linolênico presente na linhaça, para galinhas poedeiras, permitiu a obtenção de ovos e tecidos enriquecidos, os quais tornam-se uma fonte alternativa de PUFA ômega-3. / The aim of this work was to evaluate the influence of diets containing flaxseed (rich in alpha-linolenic acid, LNA, omega-3) and natural antioxidants from oregano and rosemary on the level of incorporation of the polyunsaturated fatty acids omega 3 (PUFA omega-3) in eggs and tissues of poultry. For this purpose, 192 laying hens at 22 weeks of age, of commercial lineage Babcock, were fed for 30 days with diets containing 0 (zero) or 5% of flaxseed oil. The hens were divided in 8 groups: 4 groups received diets with 5% of flaxseed oil (control / no antioxidant; BHA+BHT, 100+100 ppm; oregano, 200 ppm; rosemary, 200 ppm) and 4 groups received no flaxseed oil, but the same antioxidants. The sampling of the eggs was accomplished in 4 periods (0, 10, 20 and 30 days) and of the tissues of poultry (upper thigh, thigh, wing, breast, heart, adipose tissue and liver) at the end of experiment. The fatty acids were analysed by gas chromatography and the lipid oxidation was determined by thiobarbituric acid test (TBA). The results showed that the levels of alpha-linolenic (LNA) and docosahexaenoic (DHA) acids increased in egg yolks from hens of the 4 groups fed diets with 5% flaxseed oil after 10, 20 and 30 days, when compared with diets 0% flaxseed oil. In addition, the maximum incorporation of LNA and DHA in egg yolks was obtained after 20 days, with an index of incorporation ranging from 15 to 30 and from 2.5 to 4.5, respectively. Also, a significant decrease of lipid oxidation in egg yolks for all groups receiving antioxidants was observed, when related with control. In the tissues of the hens, there was also significant incorporation of the LNA and DHA acids, when comparing the 2 diets, with the liver presenting the major concentration of these fatty acids. It was also possible to verify the effectiveness of the natural antioxidants in the protection against lipid oxidation in upper thigh, thigh, wing and breast tissues. Therefore, rosemary and oregano can be used satisfactorily to obtain eggs and tissues of poultry enriched with PUFA omega-3, improving the lipid stability. Considering that the PUFA omega-3 have considerable interest in the human health, the administration of diets rich in alpha-linolenic acid from flaxseed to laying hens allows the eggs and tissues enrichment as an alternative source of PUFA omega-3.