Epidemiological and experimental studies have and continue to offer valuable insight into the Developmental Origins of Health and Disease (DOHaD) hypothesis, which emphasizes the importance of early-life nutritional and environmental changes on the increased risk of metabolic diseases in later life. It is now known that non-communicable chronic diseases that were previously associated with lifestyle and genetics have their origins early in life. It is well established that early life environmental signals, including nutrition, set the stage for long-term health and disease risk—effects that span multiple generations. This relationship began still in the intrauterine period and extends throughout the critical period of development. Many types of nutritional challenges including caloric restriction, macronutrient excess, and micronutrient insufficiencies have been shown to induce early life adaptations that produce long-term dysfunction. Several pathways have been suggested to underpin these associations, including epigenetic reprogramming of germ cells. While the mechanisms still remain to be fully investigated, the relationship of nutrition factors in early life and metabolic diseases are clear. This chapter focuses on the role that the nutrition presents during critical periods of development and its repercussions into adulthood.

To clarify the effects of kefir in critical periods of development in adult diseases, we study the effects of kefir intake during early life on gut microbiota and prevention of colorectal carcinogenesis in adulthood. Lactating Wistar rats were divided into three groups: control (C), kefir lactation (KL), and kefir puberty (KP) groups. The C and KP groups received 1 mL of water/day; KL dams received kefir milk daily (10⁸ CFU/mL) during lactation. After weaning (postnatal day 21), KP pups received kefir treatment until 60 days. At 67 days old, colorectal carcinogenesis was induced through intraperitoneal injection of 1, 2-dimethylhydrazine. The gut microbiota composition were analyzed by 16S rRNA gene sequencing and DESeq2 (differential abundance method), revealing significant differences in bacterial abundances between the kefir consumption periods. Maternal kefir intake strong anticancer power, suppressed tumors in adult offspring and reduced the relative risk of offspring tumor development. The gut microbiota in cecal samples of the KL group was enriched with Lactobacillus, Romboutsia, and Blautia. In contrast, control animals were enriched with Acinetobacter. The administration of kefir during critical periods of development, with emphasis on lactation, affected the gut microbial community structure to promote host benefits. Pearson analysis indicated positive correlation between tumor number with IL-1 levels. Therefore, the probiotic fermented food intake in early life may be effective as chemopreventive potential against colon tumor development, especially in lactation period.

Objective: Analyze craving in smokers with cardiovascular comorbidities submitted to a nutritional approach. Methods: Two groups were randomized and submitted to clinical intervention (n = 32): Group 1 (G1, n = 15): ingested 40 g of chocolate containing 70% cocoa/day and behavioral intervention for smoking cessation for one month; Group 2 (G2, n = 17): control group, only behavioral intervention. Questionnaire of Smoking Urges-Brief (QSU-Brief) - Brazil version measured total craving and its factors. Anthropometric measurements verified the nutritional interference of the procedure and the serum assessment verified the interference of inflammatory processes related to smoking. The study was registered on the Brazilian Registry of Clinical Trials (ReBEC): RBR-83jr3. Results: After one month, compared to the initial evaluation, the G1 reduced the craving evaluated by the QSU-Brief and its Factors 1 and 2. Total QSU-Brief: 44.27 ± 15.82 x 27.00 ± 18.03 (p = 0.008); Factor 1: 21.90 ± 7.70 x 12.90 ± 8.87 (p = 0.006); Factor 2: 11.90 ± 6.30 x 7.00 ± 6.63 (0.007). G2 showed a reduction in total QSU-Brief and Factor 1, but not in Factor 2. QSU-Brief total 28.17 ± 17.24 x 19.52 ± 9.50 (p = 0.049); Factor 1: 14.47 ± 8.74 x 9.23 ± 6.11 (p = 0.046). Serum levels of cortisol, leptin, serotonin, C-Reactive Protein (CRP) and insulin did not show differences (p > 0.05). No anthropometric differences were found. Conclusion: The results demonstrate that daily consumption of chocolate for one month (70%) reduced craving in smokers at the beginning of treatment. Chocolate potentiated the well-known effect of behavioral counseling on Factor 1 (pleasurable drug effects) and also interfered with factor 2 (unpleasant withdrawal effects).

Maternal anxiety symptoms in the perinatal period might have long-term health effects on both the mother and the developing child. Valerian is a phytotherapeutic agent that is widely used for the treatment of anxiety. This study investigated the effects of valerian treatment in postpartum rats on maternal care, toxicity, and milk composition. Postnatal development, memory, and anxiety behavior in the offspring were also assessed. Postpartum Wistar rats received the valerian (500, 1000, or 2000 mg·kg-1·day-1) by oral gavage. Clinical and biochemical toxicity was evaluated with commercial kits. Maternal behavior was observed daily. Milk composition was analyzed by colorimetric methods. Physical and neuromotor tests were used to analyze postnatal development. Anxiolytic activity was assessed by the elevated plus maze, and memory was evaluated by the step-down inhibitory avoidance task. Maternal toxicity and care behavior were not altered by the treatment, while only the highest dose promoted a significant increase of lactose, and the doses 1000 and 2000 mg·kg-1·day-1 promoted a reduction of protein contents in milk. Postnatal development was similar in all offspring. Adult offspring did not display altered anxiety behavior, while long-term memory was impaired in the female adult offspring by maternal treatment with 1000 mg·kg-1·day-1. These results suggested that high doses of valerian had significant effects on important maternal milk components and can cause long-term alterations of offspring memory; thus, treatment with high doses of valerian is not safe for breastfeeding Wistar rat mothers.

Introduction: Cystic fibrosis (CF) is an autosomal recessive genetic disorder caused by different mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, responsible for chloride ion transport across apical membranes of epithelial cells in tissues and bicarbonate secretion. Objective: To investigate the correlation of anthropometric parameters of nutritional status, lung function, peripheral strength, and functional capacity in children and adolescents diagnosed with CF. Methods: A cross-sectional study was carried out with 18 children, adolescents with CF aged between 6 and 15 years old. Anthropometric, body composition, bioimpedance, lung function, and peripheral muscle strength and functional capacity data were collected. Results: The pulmonary function assessment indexes FEV1 and FVC presented a statistically significant correlation with the nutritional status parameters - corrected lean mass (CLM), mid-upper arm circumference (MUAC), mid-arm muscle circumference (MAMC), with manual dynamometry. Concerning the parameters of the peripheral muscle strength and functional capacity, both the six-minute walk test and manual dynamometry showed a positive correlation with the height/age, CLM, MUAC, and MAMC index. Conclusion: Given the correlation between nutritional parameters that reflect muscle mass with lung function, peripheral muscle strength, and functional capacity, the incorporation of these anthropometric measures in the clinical routine could allow a better assessment of the muscular component and the health status of these patients.

Introduction: Critically ill patients present clinical and metabolic changes, and enteral nutrition therapy is an integral part of treatment, with formulations of diverse compositions available on the market. Objective: To analyze the nutritional composition of closed-system enteral nutrition formulations available for use in Brazilian Intensive Care Units. Methods: This is a cross-sectional, observational, and descriptive study. We performed a composition analysis of labels/portfolios of enteral nutrition in a closed system from the three main brands supplying to Brazil, to obtain data such as the quantity and source of macronutrients, and compliance to international and national recommendations about the quantity of micronutrients. Pearson correlation, ANOVA and Kruskal-Wallis were conducted with SPSS software version 23.0. Results: Forty-two enteral nutrition formulations were analyzed. All samples provided micronutrient levels recommended by Brazilian legislation, except for vitamin D. Maltodextrin was the main carbohydrate source, and glucose syrup was present in five samples. Fiber was present in 57%, with a predominance of soluble fibers. Calcium caseinate was the main protein source, and only 21.4% of the samples had a blend of animal and plant-based proteins. Sunflower and canola oils were the main lipid sources, and 61.9% of the formulations contained fish oil. Conclusion: Enteral nutrition composition can influence gastrointestinal tolerance, immune and inflammatory response, the prevention of malnutrition and ICU-acquired weakness.