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Zinc plays a crucial role in cell structure and functionality. Neurodegenerative Duchenne muscular dystrophy (DMD) alters muscle membrane structure, leading to a loss of muscle mass and strength. The objective of this study was to evaluate the changes in phase angle (PA) and bioelectrical impedance vector analysis (BIVA) results in patients with DMD after oral zinc supplementation. This clinical trial included 33 boys aged 5.6 to 24.5 years diagnosed with DMD. They were divided into three groups according to age (G1, G2, and G3) and supplemented with oral zinc. The mean serum zinc concentration was 74 μg/dL, and 29% of patients had concentrations below the reference value. The baseline values (mean (standard deviation)) of the bioelectrical impedance parameters PA, resistance (R), and reactance (Xc) were 2.59° (0.84°), 924.36 (212.31) Ω, and 39.64 (8.41) Ω, respectively. An increase in R and a decrease in PA and lean mass proportional to age were observed, along with a negative correlation (r = -0.614; p < 0.001) between age and PA. The average cell mass in G1 was greater than that in G3 ( p = 0.012). There were no significant differences in serum zinc levels or bioelectrical impedance parameters before and after zinc supplementation. We conclude that this population is at risk of zinc deficiency and the proposed dosage of zinc supplementation was not sufficient to alter serum zinc levels, PA and BIVA results.

Background: The study hypothesized that zinc supplementation would increase or preserve lean body mass in Duchenne muscular dystrophy (DMD) patients. Therefore, we aimed to evaluate the body composition of DMD patients before and after zinc supplementation., Materials and Methods: The study is a clinical trial comprising 21 boys diagnosed with DMD. Dietary intake parameters were evaluated before zinc supplementation. Serum zinc levels, anthropometry, and body composition were measured in three moments, four months apart. The patients received 5, 10, or 15 mg of zinc bis-glycine supplementation according to age as an oral solution daily for four months. The sample was distributed into two groups according to serum zinc status: zinc deficiency (G1) or adequate zinc (G2)., Results: There was a significant difference in lean body mass between the groups: zinc deficiency (G1) or adequate zinc (G2), at three times ( p =0.041, 0.016, and 0.009, respectively). After oral zinc supplementation, serum zinc levels were not different between groups. We did not observe differences when associating the parameters between times and groups., Conclusion: Zinc supplementation was able to maintain lean body mass and fat mass in patients with DMD with previous deficiencies. Therefore, it is necessary to have a prior screening of serum zinc levels to observe changes after supplementation., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2024 Thais A. Cunha et al.)

Neurodegenerative diseases significantly impact individuals' nutritional status. Therefore, nutritional education plays a crucial role in enhancing the understanding of food and nutrition, preventing or minimizing malnutrition, promoting well-being, and empowering patients and caregivers. Educommunication is a methodology that utilizes communication as a pedagogical tool, with the potential to positively enhance the teaching-learning process. This study aims to identify and map educommunication strategies designed to educate caregivers and patients with neurodegenerative diseases about food and nutrition., Methods: This scoping review followed the JBI Institute Reviewer's Manual. The search was conducted between June 2022 and March 2023 in databases including PubMed/MEDLINE, Embase, Scopus, and Web of Science., Results: Out of 189 studies identified, 29 met the eligibility criteria, and only 3 were suitable for inclusion in this review., Conclusion: Studies using educommunication for food and nutrition education are scarce. Despite the limited number of studies included in this review, various educommunication strategies utilizing communication and information technologies were used. Educommunication strategies can facilitate knowledge acquisition in food and nutrition and change behaviors, resulting in health benefits for the participants. More studies on this subject are needed.

Introduction: Neurodegenerative diseases affect the nervous system and are characterised by the deterioration and/or death of neurons. Nutrition care is essential for maintaining an adequate nutritional status, which influences the prognosis and survival of patients with neurological diseases. Caregivers participate assiduously in the care of these patients and must be integrated into the multidisciplinary team. They often need specific training or knowledge regarding food and nutrition to perform their roles with patients. Health educommunication is a learning tool that can positively influence the appropriation of the theme and the construction of care autonomy. This scoping review (ScR) will map educommunication actions/strategies in nutrition and neurodegenerative diseases., Methods and Analysis: This ScR will be designed based on the methodology of Arksey and O'Malley and will follow the methodological guidance for conducting a Joanna Briggs Institute ScR. The research question addressed by the scoping review will be: what actions/strategies for educommunication in nutrition and neurodegenerative diseases have been developed for patients or caregivers? Many search sites it will be used in this review, such as electronic databases (Embase, PubMed/MEDLINE, Scopus, Web of Science), Google Scholar and grey literature sources. No restrictions of date or language will be applied to the search strategy. Two reviewers will independently screen all abstracts and full-text studies for inclusion. Data, including the study design, objective, study population, neurodegenerative diseases, nutrition topics and educommunication strategies will be logically organised and tabulated in Microsoft Excel., Ethics and Dissemination: The data used for this review are from secondary sources and available to the public; thus, no ethical approval and human consent will be required for this study. Dissemination of the results will be published in a peer-reviewed journal and presented at conferences., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Objective: amyotrophic lateral sclerosis (ALS) is a rare and fatal neurodegenerative disorder with variable incidence and prevalence worldwide. However, clinical-epidemiological studies on ALS are scarce in Brazil. Thus, this study investigated whether ALS incidence had uniform spatial distribution in population-based cluster analysis in Rio Grande do Norte state (Brazil), from 2005 to 2018., Methods: new cases of ALS were identified in a database of the ALS multidisciplinary care center of the Onofre Lopes University Hospital in Natal (Rio Grande do Norte, Brazil). Approaches were based on incidence (empirical Bayes estimator and Moran's I analysis) and cluster analyses (Moran scatter plot and spatial correlogram)., Results: a total of 177 patients (59% males) participated in the study; the mean age of ALS onset was 57 years. Mean annual incidence of ALS was 0.3769 per 100,000 inhabitants (95% confidence interval of 0.0889), higher in males than in females (0.4516 per 100,000 vs. 0.3044 per 100,000). According to spatial statistics, patients were homogeneously distributed throughout the studied area., Conclusion: a low estimate was observed compared with other populations. Results did not indicate areas of increased risk or significant spatial geographic dependence, suggesting a random ALS incidence in Rio Grande do Norte.

Introduction: Amyotrophic lateral sclerosis (ALS) is a complex neurodegenerative disease characterised by the degeneration of motor neurons. Nutritional interventions in ALS are essential and must be based on scientific evidence to provide quality of healthcare, improve the quality of life and increase survival time. Therefore, this protocol of systematic reviews and meta-analyses aims to present a synthesis of evidence-based recommendations to support adequate nutrition therapy for patients with ALS., Methods and Analysis: The search will be performed using the following databases: PubMed, Excerpta Medica Database (Embase), Scopus, SciELO, Web of Science, LILACS, Cochrane Central Register of Controlled Trials (CENTRAL), ScienceDirect, ProQuest and Google Scholar. We will include clinical practice guidelines, treatment protocols, systematic reviews and clinical trials according to the three research questions to be answered related to nutrition therapy and interventions in patients with ALS. This protocol will be developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols. To evaluate the methodological quality of the studies, Appraisal of Guidelines, Research and Evaluation II, Cochrane Risk of Bias 2.0 and Risk of Bias In Non-randomized Studies of Interventions (ROBINS-I) tools will be used. In addition, the Grading of Recommendations Assessment, Development and Evaluation will be used to assess the quality of evidence and the strength of the recommendations. The findings will be summarised and presented descriptively according to the Cochrane Collaboration Handbook and the standard statistical meta-analysis techniques., Ethics and Dissemination: Ethical approval and human consent are not required because this is a protocol for systematic review and only secondary data will be used. Findings will be published in a peer-reviewed journal and presented at conferences. In case of any changes in this protocol, amendments will be updated in International Prospective Register of Systematic Reviews (PROSPERO) and the modifications will be explained in the final report of this review., Prospero Registration Number: CRD42021233088., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Sickle cell disease (SCD) is an inherited disease caused by hemoglobin S mutated hemoglobin S. It is characterized by chronic hemolysis, intermittent vaso-occlusive crises followed by ischemia-reperfusion, and organ damage. These patients have an increased risk of multiple micronutrient deficiencies, such as zinc. The reduced zinc bioavailability in sickle cell patients may lead to several complications such as growth retardation, delayed wound healing, increased vaso-occlusive crises, and infections. This narrative review aims to analyze the literature concerning the zinc status in SCD and their possible consequences on the patients' clinical evolution. We found in children and adolescents a direct association between zinc insufficiencies/deficiencies with increased disease severity in SCD. Monitoring zinc status in children and adolescent SCD appears essential for reducing disease-associated morbidity and infections. Zinc supplementation is a safe therapeutic modality for treating SCD patients. New research must be carried out, especially for adults, to ensure more remarkable survival for this population., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

Background: Zinc deficiency is related to lean body mass reduction, fat deposition, and obesity. Zinc acts in catalytic, structural, and regulatory functions, being an essential micronutrient to humans. It is crucial for maintaining lean body mass, synthesizing nucleic acids and proteins, and forming new tissues. Pre-existing zinc deficiency may contribute to obesity due to its relationship with fat deposition associated with short stature. This integrative review aims to analyze the association between zinc and body composition, hitherto very poorly established in previous studies., Material and Methods: The electronic databases utilized in this review were PubMed and Web of Science. We identified titles and abstracts from 1178 articles relating to zinc and body composition that were published in the last ten years. After duplicates were removed, the reference lists of relevant reviews were checked, and 47 articles were obtained by manual search., Main Findings and Conclusions: The articles were transversal or longitudinal studies, clinical trials, randomized controlled trials, reviews, systematic reviews, and meta-analysis. Although there was heterogeneity among the methodologies, the existence of an association between zinc and body composition was predominant among the studies. All articles concluded that zinc had positive effects on proteogenesis. Moreover, zinc metabolism is dysregulated in obese individuals, whose mechanisms remain controversial., (Copyright © 2022 Elsevier GmbH. All rights reserved.)

COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was recognised by the WHO as a pandemic in 2020. Host preparation to combat the virus is an important strategy to avoid COVID-19 severity. Thus, the relationship between eating habits, nutritional status and their effects on the immune response and further implications in viral respiratory infections is an important topic discussed in this review. Malnutrition causes the most diverse alterations in the immune system, suppressing of the immune response and increasing the susceptibility to infections such as SARS-CoV-2. On the other hand, obesity induces low-grade chronic inflammation caused by excess adiposity, which increases angiotensin-converting enzyme 2. It decreases the immune response favouring SARS-CoV-2 virulence and promoting respiratory distress syndrome. The present review highlights the importance of food choices considering their inflammatory effects, consequently increasing the viral susceptibility observed in malnutrition and obesity. Healthy eating habits, micronutrients, bioactive compounds and probiotics are strategies for COVID-19 prevention. Therefore, a diversified and balanced diet can contribute to the improvement of the immune response to viral infections such as COVID-19.

The evaluation of fat-free mass (FFM) in patients with Duchenne muscular dystrophy (DMD) is useful to investigate disease progression and therapeutic efficacy. This study aimed to validate the Bioelectrical impedance (BIA) method compared with the dual-energy X-ray absorptiometry (DXA) for estimating the %FFM in boys with DMD. This is a cross-sectional study performed with children and adolescents diagnosed with DMD. Resistance and reactance were measured with a BIA analyzer, from which eight predictive equations estimated the %FFM. The %FFM was also determined by DXA and its used as a reference method. Pearson correlation test, coefficient of determination, the root-mean-square error, the interclass correlation coefficient, and linear regression analysis were performed between %FFM values obtained by BIA and DXA. The agreement between these values was verified with the Bland-Altman plot analysis. Forty-six boys aged from 5 to 20 years were enrolled in the study. All the equations showed a correlation between the %FFM estimated by BIA and determined by DXA (p < 0.05). The Bland-Altman method indicated that two equations have a significant bias (p < 0.05) and six equations showed no significant bias of %FFM (p > 0.05). However, one of them has high variation and wide limits of agreement. Five of eight %FFM predictive equations tested in DMD were accurate when compared with the DXA. It can be concluded that BIA is a validity method to evaluate patients with DMD., Competing Interests: The authors have declared that no competing interests exist.

Introduction: In sports related to low body weight, such as classical ballet, the assessment of body composition is important for monitoring performance and health status. This study aimed to cross-validate anthropometry and bioelectrical impedance (BIA) predictive equations for estimating body composition of non-professional classical ballet dancers, using dual-energy-X-ray absorptiometry (DXA) as a reference method., Materials and Methods: Thirty-seven female non-professional classical dancers (median age of 19 years), at intermediate/advanced level, were evaluated in a cross-sectional study. Body composition was evaluated by DXA, anthropometry and tetrapolar BIA. Twenty different predictive equations of anthropometry (n = 8) and BIA (n = 12) were used to estimate Body Fat (BF) and Fat-Free Mass (FFM), testing their validity against DXA using the Bland-Altman statistics., Results: For BF estimated by anthropometry equations, just one equation showed agreement with DXA (r = 0.852, p < 0.0005; p = 0.600 for one sample T-test). According to the Bland-Altman analysis, this equation also showed validity, with the absence of proportional bias. Regarding the predictive BIA equations tested, none were valid for our study group., Conclusion: Only one of the anthropometric equations, the one proposed by Durnin and Womerley (1974), but none of the BIA equations analyzed, was valid for the evaluation of body composition of the studied classical dancers. Our results emphasize the importance of previous cross-validation of existing equations or the development of specific equations for body composition assessment in specific populations., Competing Interests: The authors have declared that no competing interests exist.

The parameters derived from bioelectrical impedance, phase angle (PA) and bioelectrical impedance vector analysis (BIVA) have been associated with cell membrane integrity and body cell mass. Zinc is a micronutrient that exerts important structural functions and acts in maintaining cellular functionality. To evaluate cell integrity and body cell mass, PA and BIVA were evaluated in children orally supplemented with zinc at different concentrations. Anthropometric, bioelectrical (resistance and reactance) and serum zinc variables were collected from two randomized, triple-blind, controlled clinical trials. Sampling was composed of 71 children consisting of three groups: a control group who received a placebo and two experimental groups who received oral supplementation of 5 or 10 mg-Zn/day for three months. The three groups presented increases ( p < 0.001) in the linear height and weight. In the group supplemented with 10 mg-Zn/day, there was an increase in reactance values ( p = 0.036) and PA ( p = 0.002), in addition to vector displacement ( p < 0.001) in relation to the confidence ellipses. An increase in serum zinc concentration was found ( p < 0.001) in all three groups. Whit this, the supplementation with 10 mg-Zn/day promotes changes in the integrity of the cell membrane associated with the increase in the cellular mass of healthy children., Competing Interests: The authors declare no conflict of interest.

Background: Duchenne muscular dystrophy (DMD) is a disease characterized by progressive loss of functional muscle mass followed by changes in body composition., Objective: This study aimed to describe and evaluate bioimpedance parameters in boys with DMD., Design: This cross-sectional, descriptive study investigated children and adolescents diagnosed with DMD. Age, weight, height, resistance, and reactance data were collected. Phase angle and bioelectrical impedance vector analysis were calculated based on resistance and reactance values., Results: We analyzed 43 boys aged between 2.7 and 19.8 years. Low-phase angle values were observed during the investigation of bioimpedance parameters. Bioelectrical impedance vector analysis showed that approximately 87% of the subjects presented vectors outside the tolerance ellipses, and only one patient presented vectors located within the 50% tolerance ellipse, indicating normally hydrated and a good body cell mass. Compared with the reference population, boys with DMD had lower levels of body cell mass., Conclusion: Based on the evidence, compared with the reference population, patients with DMD had lower levels of body cell mass. This evidence points to bioimpedance parameters as useful tools for the nutritional evaluation and clinical management of patients with DMD., Competing Interests: The authors have no potential conflicts of interest to disclose. This study was supported by the National Council for Scientific and Technological Development (CNPq) (grant number 422667/2016-1). Ms Karina M. Vermeulen’s work in this article was supported by a CNPq grant to Federal University of Rio Grande do Norte.