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Obesity is a global epidemic chronic condition and is progressing at a rapid rate. This review focuses on the potential prebiotic properties of nuts and edible seeds and the plausible mechanisms that their consumption may help the prevention and the management of overweight and obesity. The literature review was performed by searching papers about the topic in MEDLINE and SCOPUS databases. The healthy attributes of nuts and edible seeds, especially dietary fibers and polyphenols contents, indicate that their mechanism of weight gain prevention may occur through interaction with the gut microbiota, by means of prebiotic effects. Among the etiological factors associated with obesity, the gut microbiota seems to play a significant role. Dysbiosis causes an imbalance in energy homeostasis that contributes to obesity. Three mechanisms are proposed in this review to explain the potential role of nut and edible seed consumption on intestinal homeostasis and body weight control: maintenance of the enteric barrier integrity, improvement of anti-inflammatory status and enhancement of butyrate synthesis. Further high-quality clinical trials should explore the interaction between oilseed consumption, microbiota, and body adiposity control, particularly investigating the microbiota metabolites and their relation to the prevention and management of obesity.

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Septic shock is associated with unacceptably high mortality rates, mainly in developing countries. New adjunctive therapies have been explored to reduce global mortality related to sepsis. Considering that metabolic changes, mitochondrial dysfunction and increased oxidative stress are specific disorders within the path of septic shock, several micronutrients that could act in cellular homeostasis have been studied in recent decades. Thiamine, also known as vitamin B1, plays critical roles in several biological processes, including the metabolism of glucose, synthesis of nucleic acids and reduction of oxidative stress. Thiamine deficiency could affect up to 70% of critically ill patients, and thiamine supplementation appears to increase lactate clearance and decrease the vasopressor dose. However, there is no evident improvement in the survival of septic patients. Other micronutrients such as vitamin C and D, selenium and zinc have been tested in the same context but have not been shown to improve the outcomes of these patients. Some problems related to the neutrality of these clinical trials are the study design, doses, route, timing, length of intervention and the choice of endpoints. Recently, the concept that multi-micronutrient administration may be better than single-micronutrient administration has gained strength. In general, clinical trials consider the administration of a single micronutrient as a drug. However, the antioxidant defense is a complex system of endogenous agents in which micronutrients act as cofactors, and the physiological interactions between micronutrients are little discussed. In this context, the association of thiamine, vitamin C and corticoids was tested as an adjunctive therapy in septic shock resulting in a significant decrease in mortality. However, after these initial results, no other study conducted with this combination could reproduce those benefits. In addition, the use of low-dose corticosteroids is recommended in patients with septic shock who do not respond to vasopressors, which can affect the action of thiamine. Therefore, given the excellent safety profile, good biologic rationale and promising clinical studies, this review aims to discuss the mechanisms behind and the evidence for single or combined thiamine supplementation improving the prognosis of patients with septic shock.

Introduction: Bioelectrical impedance vector analysis (BIVA) is a non-invasive and low-cost strategy. The methods used to assess malnutrition in patients undergoing HD are still a challenge. The aim of the present study was to compare BIVA to 7-Point Subjective Global Assessment (7-point SGA) to identify malnutrition. We also investigated the sensitivity and specificity of the previously proposed cutoffs point for BIVA parameters. Methods: Patients of both sexes, over 20 years of age, on HD treatment were included. Anthropometric parameters, laboratory data, and bioelectrical impedance analysis (BIA) were evaluated. Values of resistance (R) and reactance (Xc) obtained by mono-frequency BIA were normalized to body height (H) to generate a graph of the bioimpedance vector with the BIVA software. The analysis of the area under the receiver operating curve ROC (AUC) was performed. Results: Among the included 104 patients, the mean age was 51.70 (±15.10) years, and 52% were male. The BIVA had a sensitivity of 35% for diagnosing malnutrition. The specificity of BIVA for identifying the well-nourished patients was 85.7%. The diagnostic accuracy between the BIVA and 7-point SGA was AUC=0.604; 95%CI 0.490-0.726, higher than the previously established cutoff values (AUC=0.514; 95%CI: 0.369-0.631). The 95% confidence ellipses did not overlap (p<0.05). Conclusion: Our study showed low accuracy of BIVA for diagnosing malnutrition using a 7-point SGA as a reference standard. However, it is a complementary method for assessing nutritional status as it provides data on cellularity and hydration, which are important aspects for the HD population.