N-acetylcysteine (NAC) is a medicine widely used to treat paracetamol overdose and as a mucolytic compound. It has a well-established safety profile, and its toxicity is uncommon and dependent on the route of administration and high dosages. Its remarkable antioxidant and anti-inflammatory capacity is the biochemical basis used to treat several diseases related to oxidative stress and inflammation. The primary role of NAC as an antioxidant stems from its ability to increase the intracellular concentration of glutathione (GSH), which is the most crucial biothiol responsible for cellular redox imbalance. As an anti-inflammatory compound, NAC can reduce levels of tumor necrosis factor-alpha (TNF-α) and interleukins (IL-6 and IL-1β) by suppressing the activity of nuclear factor kappa B (NF-κB). Despite NAC’s relevant therapeutic potential, in several experimental studies, its effectiveness in clinical trials, addressing different pathological conditions, is still limited. Thus, the purpose of this chapter is to provide an overview of the medicinal effects and applications of NAC to human health based on current therapeutic evidence.

Este trabalho analisou a contribuição dos alimentos ultraprocessados (AUP) no perfil alimentar e nutricional da dieta de gestantes. Trata-se de um estudo transversal conduzido com uma amostra representativa de gestantes usuárias de unidades básicas de saúde de Maceió, Alagoas, Brasil. O consumo alimentar foi avaliado pela aplicação de dois recordatórios de 24 horas em dias não consecutivos e os itens de consumo agrupados segundo a classificação NOVA. As estimativas gerais foram expressas no consumo alimentar absoluto (média de ingestão calórica) e relativo (percentual da ingestão energética total segundo grupos de alimentos e itens de consumo). Análises de variâncias foram utilizadas para comparar as médias do consumo energético e de nutrientes, segundo grupos alimentares. A associação entre os quintis de contribuição energética dos AUP (variável de exposição) e (1) itens de consumo e grupos alimentares, (2) contribuição percentual para o total de energia de macronutrientes e (3) densidade de micronutrientes foi analisada por meio de modelos ajustados de regressão linear. O consumo médio de energia das gestantes foi de 1.966,9Kcal/dia, sendo 22% proveniente dos AUP. Observou-se relação direta entre a contribuição energética dos AUP na dieta e o consumo energético total (β = 228,78Kcal; EP = 21,26). Ainda, o aumento da participação de AUP implicou a redução estatisticamente significativa da ingestão de proteínas, fibras, magnésio, ferro, pótassio, zinco, selênio, folato e vitaminas D e E, assim como o consumo de alimentos tradicionais, como arroz, feijão, raízes e tubérculos. Portanto, nossos dados apontam que o consumo de AUP reduz a qualidade global (nutricional e alimentar) da dieta de gestantes.

COVID-19, caused by SARS-CoV-2, has become a global public health threat. Although no replication-competent virus has been found in breast milk samples, breastfeeding practices during the pandemic were impacted. It is well known that breast milk is adapted to meet the needs of infants, providing the appropriate amounts of nutrients and various bioactive compounds that contribute to the maturation of the immune system and antioxidant protection, safeguarding infants against diseases. While its composition is variable, breast milk contains immune cells, antibodies, and cytokines, which have anti-inflammatory, pro-inflammatory, antiviral, and antibacterial properties that strengthen infant immunity. Since COVID-19 vaccines have not yet been approved for infants under six months of age, newborns rely on the passive transfer of antibodies via the placenta and breast milk to protect them against severe SARS-CoV-2 infection. Several studies that analyzed breast milk samples in the context of COVID-19 have demonstrated that a strong antibody response is induced following maternal infection with SARS-CoV-2. Therefore, this review aims to provide a comprehensive overview of the impact of maternal exposure to SARS-CoV-2 through natural infection and/or vaccination on the immunological composition of breast milk based on the studies conducted on this topic.

Evidence suggests that the intake of ultra-processed foods (UPF) influences gut microbiota. The present study evaluated the impact of energy restriction of dietary UPF compared to a general energy restriction on the gut microbiota of individuals with obesity. This was a parallel, randomized clinical trial. Individuals with obesity were randomly allocated into two groups: control, with general energy restriction (ER-G), and intervention, with energy restriction associated with UPF restriction (ER-UPF), limited to 5% of total intake. Individuals were followed-up monthly for 6 months. Stool samples were collected at baseline and after 6 months for DNA extraction and sequencing of the 16S rRNA gene (V3–V4 region). Socioeconomic, clinical, anthropometric, and dietary intake data were also collected. Abundance of microbiota data was analyzed using the Linear Models for Microarray Data (limma-voom) and the Microbiome Multivariable Associations with Linear Models (MaAsLin2) packages, with the Benjamini–Hochberg correction method. Alpha-diversity was analyzed using the Shannon, Simpson and Simpson-inverse index, whereas beta-diversity was analyzed using the Bray–Curtis index with the PERMANOVA test. Other variables were analyzed using mixed ANOVA with an alpha level of 5%. A total of 43 individuals were included, and at the end of the study, 34 individuals (18 intervention and 16 control) had complete data and were analyzed. %UPF consumption significantly decreased in the group that restricted UPF (p-interaction = 0.01), whereas waist circumference and body fat decreased in both groups (p-moment < 0.01). It was observed an increase in phylum and family microbial alpha-diversity in both groups with a slight decrease at the genus level. The Ruminococcaceae family showed a significantly greater increase in the ER-UPF group compared to the control group (p-interaction = 0.03), as did the Faecalibacterium genus (p = 0.02). These findings highlight the complexity of interactions between diet, body composition, and gut microbiota, suggesting that UPF restriction may have positive but limited effects on microbiota modulation in the short to medium term. Registration number of Clinical Trial: RBR – 3q9vgk9.