Banca de DEFESA: MARIANA DANTAS DE CARVALHO VILAR

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : MARIANA DANTAS DE CARVALHO VILAR
DATE: 28/06/2024
TIME: 14:00
LOCAL: https://meet.google.com/fwf-hcxd-wde
TITLE:

NUTRITION AND AMYOTROPHIC LATERAL SCLEROSIS: SUMMARY OF EVIDENCE AND RECOMMENDATIONS

KEY WORDS:

Motor neuron disease, nutritional therapy, practice guideline, Clinical protocols.

PAGES: 92
BIG AREA: Ciências da Saúde
AREA: Nutrição
SUMMARY:

Amyotrophic Lateral Sclerosis (ALS) is a multisystem neurological disease characterized by the degeneration of motor neurons. Malnutrition is common in ALS and evidence-based nutritional interventions promote the optimization of nutritional status, contributing to improved quality of life and survival of patients with ALS. The general objective of this dissertation was to identify and synthesize scientific evidence and recommendations aimed at nutritional interventions in ALS. Thus, three products were developed: 1) a narrative review (article 1); a protocol of systematic review (article 2); and a systematic review (article 3). Each article was developed according to the required methodological specificity. The narrative review (article 1) synthesized relevant information, extracted from several relevant studies published in PubMed/MEDLINE, on intestinal microbiota and neurodegenerative diseases, with an emphasis on ALS. According to the characteristics of this type of review, there was no systematization in the selection or inclusion of studies, but rather a subjective flexibility on the part of the authors in choosing the information shared. The data extracted in this narrative review were arranged in topics covering “intestinal microbiota and human microbiome”, “intestinal microbiota and neuro-immuno-endocrine system”, “intestinal microbiota and ALS” and “modulation of intestinal microbiota in ALS”. The systematic review protocol (article 2) was registered in the PROSPERO database on April 12, 2021 (CRD42021233088) and was developed according to the Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P). It encompassed the planning of more than one systematic review to answer three research questions: RQ1- “What are the evidence-based nutritional recommendations to maintain or restore the nutritional status of patients with ALS?”; RQ2 - “What is the effect of a diet rich in energy and protein in people with ALS?”; and RQ3 - “What are the effects of supplementation of isolated micronutrients or bioactive compounds in people with ALS?”. The answer to RQ1 gave rise to the systematic review produced in this dissertation (article 3). This systematic review (article 3) followed the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) and used the following electronic libraries and databases: PubMed/MEDLINE, EMBASE, Scopus, SciELO, Web of Science, LILACS, CENTRAL, ScienceDirect, ProQuest, and Google Scholar. Of a total of 462 records identified, 11 were included, 7 of which were guidelines and 4 were systematic reviews. The quality of the evidence was assessed using the Appraisal of Guidelines for Research and Evaluation II (AGREE II). Due to the heterogeneity of the studies, it was not possible to perform a meta-analysis. The summary of nutritional recommendations was organized into five topics: “dysphagia”, “energy”, “protein”, “supplementation”, and “percutaneous endoscopic gastrostomy”. According to the products developed, it was concluded that the intestinal microbiota can modulate several physiological and behavioral activities based on the microbiota-intestine-brain axis. The study of the intestinal microbiota in ALS is an important field of research and its modulation is considered an important therapeutic target for affected patients, since intestinal dysbiosis is related to complications and worse prognoses. The developed protocol demonstrated the importance of adequate planning to prepare the systematic review and highlighted the relevance of using evidence-based nutrition in decision-making related to nutritional therapy in ALS. The evidence and recommendations summarized in the systematic review covered various aspects of the nutritional management of patients with ALS, including energy-protein needs, changes in diet consistency, and use of alternative feeding route. There were also gaps in the literature regarding specific micronutrient needs and recommendations for nutritional supplements in ALS. Finally, the scientific information gathered in this dissertation is relevant for directing safe and effective nutritional interventions in ALS, optimizing the nutritional status and prognosis of affected patients.

COMMITTEE MEMBERS:
Presidente - 2495705 - GRASIELA PIUVEZAM
Interno - ***.582.811-** - JOSE BRANDAO NETO - UFRN
Externo à Instituição - KLEYTON SANTOS DE MEDEIROS - LNRCC
Interna - 6349432 - LUCIA DE FATIMA CAMPOS PEDROSA
Externa ao Programa - 2549958 - LUCIA LEITE LAIS - UFRN