O objetivo do presente trabalho foi desenvolver diferentes formulações de doces cremosos com baixo teor de sólidos solúveis, buscando novos produtos que atendam às necessidades das pessoas em dietas de restrição de açúcares, com as mesmas características sensoriais dos doces cremosos com teor elevado de sólidos solúveis. Analisou-se a vida útil destes produtos por monitoramento de componentes físicos, químicos e microbiológicos. As etapas consideradas durante a fase de desenvolvimento do produto foram: formulação; medição e ajuste do pH; medição do teor de sólidos solúveis; concentração; envasamento; resfriamento e armazenamento. Na fase de desenvolvimento de produto foram testados blends dos seguintes edulcorantes: aspartame e acesulfame-K; sacarina, ciclamato e acesulfame-K; sacarina, ciclamato e aspartame; sacarina, ciclamato e esteviosídeo e para as análises sensoriais e testes de vida útil foram utilizados aspartame, acesulfame-K blend de aspartame e acesulfame-K e blend de sacarina e ciclamato. Foram testadas pectinas de baixo teor de metoxilas (BTM) com baixa, média e alta reatividade ao cálcio, utilizando-se dosagem específica de cálcio para cada tipo de pectina. As características sensoriais, analisadas na fase de desenvolvimento de produto foram: doçura, aroma, cor, consistência e impressão global. Foram testadas formulações de doces cremosos diet, de goiaba, laranja, figo, banana, abóbora, mamão, coco e batata-doce. Foram aprovadas formulações de goiaba, laranja e figo para a análise sensorial e testes de vida útil. Nesta etapa, as análises físicas e químicas seguiram a mesma metodologia realizada na fase de desenvolvimento de produto, sendo analisado além de pH e sólidos solúveis; acidez titulável, ratio, viscosidade e coloração. Após a determinação da melhor combinação de edulcorantes e sua dosagem para cada tipo de fruta, através de análise sensorial, foi analisada a vida útil em 5 períodos de armazenamento (1, 7, 14, 21 e 28 dias) a 40ºC, sendo realizadas analises microbiológicas para bolores e leveduras, de acordo com a legislação brasileira RDC 12 da ANVISA e contagem de bactérias láticas. Como resultado para a implantação do processamento de doces diet, a melhor formulação foi a seguinte: 75 % de polpa de fruta; a combinação de sacarina e ciclamato, com poder edulcorante equivalente a 200; 15 % de agentes de corpo sorbitol e maltodextrina (1:2); 0,5 % de pectina de baixa reatividade com 198 mg de cálcio livre / grama de pectina para doce de laranja e 0,5 % de pectina de média reatividade com 106 mg de cálcio livre / grama de pectina para os doces de figo; 0,5 % de pectina de alta reatividade com 40 mg de cálcio livre / grama de pectina para os doces de goiaba; 0,1 % de sorbato de potássio para todos os doces, de acordo com a legislação vigente. Os resultados das análises de vida útil demonstram que os produtos desenvolvidos suportam condições extremas de armazenamento por pelo menos 28 dias. / The work aims to evaluate the physical, chemical and sensory characteristics of different formulations of jellies with low soluble solids, looking for developing new products that assists the needs of people in non-sugar diet, trying to maintain the sensory characteristics of the jellies with high soluble solids. The product shelf-life was analyzed by monitoring physical, chemical and microbiological parameters. The stages considered during the product development stage were: formulation; measurement and adjustment of pH; measurement of soluble solids; concentration; filling; cooling and storage. In the first stage blends of the following high intensity sweeteners were used: aspartame and acesulfame-K; saccharin, cyclamate and acesulfame-K; saccharin cyclamate and aspartame; saccharin, cyclamate and esteviosídeo. The low methoxyl (LM) pectin types with low, medium and high reactivity were tested using a specific dosage of calcium for each LM pectin. The sensory characteristics, analyzed in the product development stage were: sweetness, fragrance, color, consistence and global impression. Guava, orange, fig, banana, pumpkin, papaya, coconut, and sweet potato were tested to produce non-sugar jellies formulations. For the shelf-life stage, analysis were made with guava, orange and fig, in formulations containing blends of high intensity sweeteners (aspartame; acesulfame-K; aspartame and acesulfame-K; saccharin and cyclamate) with sorbitol and maltodextrin (1:2). For this stage, the physical and chemical analyses followed the same procedures of the product development stage, being analyzed besides pH and soluble solids; titratable acidity, ratio, viscosity and coloration. After the determination of the best blend of sweeteners (saccharin and cyclamate) and its dosage for each fruit, the shelf-life period was evaluated in 5 storage periods (1, 7, 14, 21 and 28 days) at 40°C, being accomplished microbiological analyses for counting of molds and yeasts, according to the Brazilian legislation RDC 12 of ANVISA and count of lactic acid bacteria. As result for diet jellies production, the best formulation is: 75% of fruit pulp; a blend of saccharin and cyclamate, in a proportion according to the amount to be produced; 10% of maltodextrin; 5% of sorbitol; 0,5% of low reactivity pectin with 198 mg of calcium / gram of pectin for orange jelly, 0,5% of medium reactivity pectin with 106 mg of calcium / gram of pectin for fig jellies and 0,5% of medium reactivity pectin with 40 mg of calcium / gram of pectin for guava jellies; and 0,1% of preservative in the form of potassium sorbato for all jellies, according to Brazilian legislation. The shelf-life analysis shows that the products support extreme condition of storage for at least 28 days.

Investigou-se a validade do método recordatório de 24 horas, comparando-o com o método de pesagem dos alimentos. A comparação levou em conta alguns atributos do entrevistado (idade, sexo, nível de instrução e ocupação) e do entrevistador (técnico e não técnico) considerando, ainda, o tempo de duração das entrevistas do método recordatório de 24 horas. Verificou-se, além disso, a capacidade desse método na identificação de fatores de risco. Para isso, pesquisou-se o consumo de alimentos, obtendo-se energia e macronutrientes e alguns micronutrientes de 100 indivíduos de 19 anos e mais, de ambos os sexos, residentes no Distrito de Caucaia do Alto, Municipio de Cotia, Estado de São Paulo. Foi elaborado, especificamente para este trabalho, material de apoio, que constituiu de álbum de fotografias de alimentos (com porções diversificadas em vários tamanhos) preparados de acordo com os hábitos alimentares levantados na mesma comunidade, em estudo piloto, acompanhado de lista de equivalência de medidas caseiras e pesos. Considerando energia e nutrientes, os resultados no método recordatório subestimaram a energia, glicídios, ferro e proteínas, para o sexo masculino em alguns grupos etários. Considerando a diferença entre os dois sexos, estas foram significantes para proteínas e glicídios no sexo masculino do grupo etário de 41 a 60 anos. Verificou-se na comparação dos dois métodos, quanto às características do entrevistado, que seu desempenho no recordatório está mais relacionado à idade e sexo do que ao grau de instrução e ocupação. Quanto aos entrevistadores, os não técnicos apresentaram maior percentual de discordâncias no almoço e no jantar. Entrevistas realizadas em tempo inferior a 15 minutos propiciaram mais erros, tanto por omissão como por adição de alimentos. Na identificação de fatores de risco dietético, o método recordatório de 24 horas não conseguiu identificar todos os individuos com alto grau de sensibilidade, como o método de pesagem. / The validity of the 24-hours recall method was investigated compared with the method of the direct weighing of the foodstuffs consumed. The comparison took into consideration some of the data regarding the person interviewed (age, sex, schooling and occupation) and of the interviewer (technician or non-technician) and also considered the duration of the interviews of the 24-hours recall method. Further, the ability of this method to detect risk factors was also taken into consideration. For this purpose, the actual consumption of foodstuffs was researched, thus identifying energy, macro-nutrients and some micro-nutrients, of 100 individuals of 19 years or more of age, of both sexes, resident in the Caucaia do Alto district, Cotia county, São Paulo State. Was prepared especially for this research, pictures of food portions and the list of domestic measures and weight correspondent got from the same community by a previous study. With regard to energy and nutrients, the results of the recall method, underestimated energy, carbohydrates, iron and proteins for the male sex for some age groups. As for the difference between the sexes, there were significant differences for proteins and carbohydrates for the male sex age group of 40 to 60 years. It was discovered that the person interviewed performance in the 24-hours recall method, in terms of age and sex, was better than terms of schooling and occupation. Among the interviewers, the non-technicians showed more errors in lunch and dinner data. The interviews carried out in under 15 minutes contained more errors, whether by omission or by additioin of foodstuffs. In the identification of dietetic risk factors, the 24 hours - recall method didn\'t show a high degree of sensibility as the method of the direct weighing of food.

No description available.

The nutritional care and management of patients includes provision of adequate nutrition support to ensure that they attain and maintain a desirable body weight, improve nutritional status and avoid negative outcomes associated with over- or underfeeding. The success of nutrition support relies on accurately estimating energy requirements so that adequate energy and nutrients can be provided to the patient. Energy requirements are most accurately determined by measurement of energy expenditure. Most methods for doing so however are expensive, time-consuming, require trained technicians to perform them and are therefore impractical in the clinical setting. As such, prediction equations, which are easy to use, inexpensive and universally available, are commonly used to estimate the energy requirements of hospitalised patients. The accuracy of these equations however is questionable. Recently, a new portable hand-held indirect calorimeter (MedGem(tm), HealtheTech, USA), which has been promoted for its ease of use and relatively short measurement time, has been validated in healthy subjects but is yet to be validated in patients with illnesses. Weight loss and malnutrition occur commonly in patients with cancer and are often thought to be associated with disturbances in energy metabolism caused by the tumour. Minimising weight loss is an important goal for the nutritional care of patients with cancer. The ability to accurately determine the energy requirements of these patients is therefore essential for the provision of optimal nutrition support. This research project proceeded in two phases. Phase 1 aimed to determine current methods used by dietitians for estimating adult patients' energy requirements using a descriptive study. Results of this study informed phase 2, which aimed to investigate differences in energy expenditure of cancer patients compared to healthy control subjects and to compare different methods for determining energy requirements of people with cancer in the clinical setting. To address phase 1 a national cross-sectional survey of dietitians working in acute care adult hospitals was undertaken to determine their usual dietetic practice with respect to estimating patients' energy requirements. Responses to the survey (n=307, 66.2%) indicated a large variation in dietitians' practice for estimating energy requirements particularly with respect to the application of methods involving injury factors. When applied to a case study, these inconsistencies resulted in an extremely wide range for the calculated energy requirement, suggesting that there is error inherent in the use of prediction methods, which may be associated with negative consequences associated with under- or overfeeding. The types of patients for whom dietitians estimate energy requirements appears to be heavily influenced by feeding method. Initial dietetic education was identified as the main influencing factor in the choice of method for estimation of energy requirements. Phase 2 was addressed using four studies based on the same study population - a case-control study, two clinical validation studies and a measurement methods study. Patients had histologically proven solid tumours, excluding tumours of the breast, prostate and brain, and were undergoing anti-cancer therapy (n=18). Healthy control subjects were group matched to cancer patients by gender, age, height and weight from a purposive sample (n=17). Resting energy expenditure (REE) was measured by respiratory gas exchange using a traditional indirect calorimeter (VMax 229) and the MedGem indirect calorimeter. A measurement methods side-study established that steady state defined as a three-minute period compared to a five-minute period measured REE within clinically acceptable limits. REE was also predicted from a range of prediction equations. Analyses of available data found that REE in cancer patients was not significantly different from healthy subjects, with only a 10% higher REE observed in this sample of cancer patients when adjusted for fat free mass. For both cancer patients and healthy subjects the portable MedGem indirect calorimeter and all prediction equations did not measure or estimate individual REE within clinically acceptable limits compared to the VMax 229 (limits of agreement of approximately -40% to 30% for both the MedGem and prediction equations). Collectively, the results of this research project have indicated that current practical methods for determining patients' energy requirements in a clinical setting do not accurately predict the resting energy expenditure of individual subjects, healthy or with cancer. Greater emphasis should therefore be placed on ensuring intake meets requirements. For this to occur, dietetic practice should be focused on directly monitoring both patients' actual energy intake and patient outcomes, such as weight, body composition and nutritional status, to determine whether energy requirements are being met. This research has led to multiple recommendations for dietetic practice, focusing on the standardisation of education practices. Recommendations for future research address methodological improvements.

No description available.

p. 1-112 / Submitted by Santiago Fabio (fabio.ssantiago@hotmail.com) on 2013-04-10T18:15:14Z No. of bitstreams: 1 Tese _ Maria Efigenia.pdf: 1177812 bytes, checksum: e7ab5f7bbee1bf8001e5519270ae0b07 (MD5) / Approved for entry into archive by Rodrigo Meirelles(rodrigomei@ufba.br) on 2013-04-13T20:13:39Z (GMT) No. of bitstreams: 1 Tese _ Maria Efigenia.pdf: 1177812 bytes, checksum: e7ab5f7bbee1bf8001e5519270ae0b07 (MD5) / Made available in DSpace on 2013-04-13T20:13:39Z (GMT). No. of bitstreams: 1 Tese _ Maria Efigenia.pdf: 1177812 bytes, checksum: e7ab5f7bbee1bf8001e5519270ae0b07 (MD5) Previous issue date: 2009 / Objetivo: avaliar o efeito da suplementação dietética com o antioxidante N-acetilcisteína (NAC), oferecido a crianças com diarréia persistente. Método: trata-se de um ensaio clínico, duplo-cego, randomizado, controlado com placebo no qual foram estudadas 55 crianças, de ambos os sexos, com idades entre 02 e 36 meses, atendidas em um hospital pediátrico com diagnóstico de diarréia persistente ( 14 dias de duração). Os pacientes foram distribuídos, randomicamente, em dois grupos que receberam como dieta padrão o iogurte natural integral e a suplementação dietética com 3g de N-ACC(28 crianças) ou placebo(27 crianças) duas vezes ao dia. Estas crianças foram mantidas em uma unidade metabólica, onde o peso, a ingestão dietética de soro de reidratação oral e água, assim como as perdas fecais, urinárias e por vômitos, foram mensuradas durante todo o estudo e analisadas a cada 24 horas. Foram realizadas avaliações antropométricas e bioquímicas no momento do internamento e da alta do estudo. Resultados: Ao final do período de observação, os dados mostraram que a mediana de duração da diarréia (h) e de perda fecal (ml/kg/dia) foram menores em favor do grupo teste, embora sem significância estatística. Conclusão: Este estudo demonstra que a utilização de NAC como suplemento na dieta de crianças com diarréia persistente pode proporcionar vantagem terapêutica em comparação com a alimentação convencional. / Salvador

Doctor of Philosophy / Department of Food, Nutrition, Dietetics, and Health / Tandalayo Kidd / HIV and nutrition status are interrelated. Nutrition problems associated with HIV or its treatment occur in nearly all people living with HIV (PLHIV) and can be indicative of the stage and progression of infection. On the other hand, adequate nutrition ensures good nutrition status, immune function, improved treatment outcome, and quality of life. The growing problems of HIV and AIDS in Indonesia require health professionals, including dietitians, to mobilize for HIV care and control. However, studies have demonstrated health care workers to have prejudicial attitudes towards PLHIV, which may further jeopardize the quality of care. The objective of this study was to implement the attribution theory to improve HIV-related knowledge and attitudes among dietetics students. It is hypothesized that given the opportunity to revisit the antecedent of their stigma, dietetic students might be able to improve their attitudes and emotional reactions to HIV. Results from the cross-sectional study confirmed the attribution theory, showing that the stigmatizing attitudes were influenced by both personal values and environmental factors. The study also found that greater knowledge about HIV was associated with a better attitude toward PLHIV. This and the fact that universities differed in how they educated dietetic students about HIV, raise questions on the current dietetic curriculum in Indonesia and the teaching conduct in each dietetic school. These notions were studied in the second study, using a qualitative approach to inquire lecturers and school administrators. Four major themes emerged from the analysis confirming that HIV discourse in dietetic schools in Indonesia is very limited since it is not mandatory in the curriculum, lecturers are reluctant to talk about HIV, and there is apparent restriction to work with the key population. The way the lecturers attribute HIV with blames of personal responsibility and fear of contagion, heavily influence their teaching conduct. The intervention model with transformative learning supported the hypothesis that given the opportunity to reflect and re-question their judgment, students were able to improve their knowledge and reduce their stigmatizing attitudes. Overall, these studies give a warning to policy makers in health and education sectors as well as the school administrators that dietetics students have negative attitudes towards PLHIV and this stigma is associated with lack of knowledge about HIV, hence the need to improve response from both sectors. This study also serves as a strong call to provide more opportunities to students to learn about HIV and to reach out to the patients and key population to instill better understanding and acceptance to HIV.

O objetivo do presente trabalho foi desenvolver diferentes formulações de doces cremosos com baixo teor de sólidos solúveis, buscando novos produtos que atendam às necessidades das pessoas em dietas de restrição de açúcares, com as mesmas características sensoriais dos doces cremosos com teor elevado de sólidos solúveis. Analisou-se a vida útil destes produtos por monitoramento de componentes físicos, químicos e microbiológicos. As etapas consideradas durante a fase de desenvolvimento do produto foram: formulação; medição e ajuste do pH; medição do teor de sólidos solúveis; concentração; envasamento; resfriamento e armazenamento. Na fase de desenvolvimento de produto foram testados blends dos seguintes edulcorantes: aspartame e acesulfame-K; sacarina, ciclamato e acesulfame-K; sacarina, ciclamato e aspartame; sacarina, ciclamato e esteviosídeo e para as análises sensoriais e testes de vida útil foram utilizados aspartame, acesulfame-K blend de aspartame e acesulfame-K e blend de sacarina e ciclamato. Foram testadas pectinas de baixo teor de metoxilas (BTM) com baixa, média e alta reatividade ao cálcio, utilizando-se dosagem específica de cálcio para cada tipo de pectina. As características sensoriais, analisadas na fase de desenvolvimento de produto foram: doçura, aroma, cor, consistência e impressão global. Foram testadas formulações de doces cremosos diet, de goiaba, laranja, figo, banana, abóbora, mamão, coco e batata-doce. Foram aprovadas formulações de goiaba, laranja e figo para a análise sensorial e testes de vida útil. Nesta etapa, as análises físicas e químicas seguiram a mesma metodologia realizada na fase de desenvolvimento de produto, sendo analisado além de pH e sólidos solúveis; acidez titulável, ratio, viscosidade e coloração. Após a determinação da melhor combinação de edulcorantes e sua dosagem para cada tipo de fruta, através de análise sensorial, foi analisada a vida útil em 5 períodos de armazenamento (1, 7, 14, 21 e 28 dias) a 40ºC, sendo realizadas analises microbiológicas para bolores e leveduras, de acordo com a legislação brasileira RDC 12 da ANVISA e contagem de bactérias láticas. Como resultado para a implantação do processamento de doces diet, a melhor formulação foi a seguinte: 75 % de polpa de fruta; a combinação de sacarina e ciclamato, com poder edulcorante equivalente a 200; 15 % de agentes de corpo sorbitol e maltodextrina (1:2); 0,5 % de pectina de baixa reatividade com 198 mg de cálcio livre / grama de pectina para doce de laranja e 0,5 % de pectina de média reatividade com 106 mg de cálcio livre / grama de pectina para os doces de figo; 0,5 % de pectina de alta reatividade com 40 mg de cálcio livre / grama de pectina para os doces de goiaba; 0,1 % de sorbato de potássio para todos os doces, de acordo com a legislação vigente. Os resultados das análises de vida útil demonstram que os produtos desenvolvidos suportam condições extremas de armazenamento por pelo menos 28 dias. / The work aims to evaluate the physical, chemical and sensory characteristics of different formulations of jellies with low soluble solids, looking for developing new products that assists the needs of people in non-sugar diet, trying to maintain the sensory characteristics of the jellies with high soluble solids. The product shelf-life was analyzed by monitoring physical, chemical and microbiological parameters. The stages considered during the product development stage were: formulation; measurement and adjustment of pH; measurement of soluble solids; concentration; filling; cooling and storage. In the first stage blends of the following high intensity sweeteners were used: aspartame and acesulfame-K; saccharin, cyclamate and acesulfame-K; saccharin cyclamate and aspartame; saccharin, cyclamate and esteviosídeo. The low methoxyl (LM) pectin types with low, medium and high reactivity were tested using a specific dosage of calcium for each LM pectin. The sensory characteristics, analyzed in the product development stage were: sweetness, fragrance, color, consistence and global impression. Guava, orange, fig, banana, pumpkin, papaya, coconut, and sweet potato were tested to produce non-sugar jellies formulations. For the shelf-life stage, analysis were made with guava, orange and fig, in formulations containing blends of high intensity sweeteners (aspartame; acesulfame-K; aspartame and acesulfame-K; saccharin and cyclamate) with sorbitol and maltodextrin (1:2). For this stage, the physical and chemical analyses followed the same procedures of the product development stage, being analyzed besides pH and soluble solids; titratable acidity, ratio, viscosity and coloration. After the determination of the best blend of sweeteners (saccharin and cyclamate) and its dosage for each fruit, the shelf-life period was evaluated in 5 storage periods (1, 7, 14, 21 and 28 days) at 40°C, being accomplished microbiological analyses for counting of molds and yeasts, according to the Brazilian legislation RDC 12 of ANVISA and count of lactic acid bacteria. As result for diet jellies production, the best formulation is: 75% of fruit pulp; a blend of saccharin and cyclamate, in a proportion according to the amount to be produced; 10% of maltodextrin; 5% of sorbitol; 0,5% of low reactivity pectin with 198 mg of calcium / gram of pectin for orange jelly, 0,5% of medium reactivity pectin with 106 mg of calcium / gram of pectin for fig jellies and 0,5% of medium reactivity pectin with 40 mg of calcium / gram of pectin for guava jellies; and 0,1% of preservative in the form of potassium sorbato for all jellies, according to Brazilian legislation. The shelf-life analysis shows that the products support extreme condition of storage for at least 28 days.

Nutrition education is an integral part of dental education as well as a variety of other healthcare professions1, but interprofessional education (IPE) between the fields of dietetics and dental hygiene is limited. The purpose of this pilot study was to define areas of opportunity to establish a foundation for the implementation of complimentary curriculum between the dietetics and dental hygiene programs at ETSU. A 76-question survey was developed and administered to dietetic interns (n=26), dental hygiene students (n=49), dietetic faculty (n=23), and dental hygiene faculty (n=19) at ETSU and Baylor College of Dentistry at Texas A&M Health Science Center. Data analysis reveals a knowledge proficiency deficit in dental hygiene students related to nutrition and oral health as well as significant findings in perceived roles of the ‘other’ profession. The potential for interdisciplinary education and training between dietetic and dental hygiene students at ETSU is promising, potentially leading to improved patient care.

No description available.