Marcela Tatiana Watanabe

Scopus Publications

Dietary Intervention in Phosphatemia Control–Nutritional Traffic Light Labeling
Marcela T. Watanabe, Pasqual Barretti, and Jacqueline C.T. Caramori
Elsevier BV
THE CONTROL OF phosphatemia has been increasingly recognized as an important strategy for dialysis patients’ because hyperphosphatemia is a risk factor for cardiovascular diseases, progression of kidney disease, and mortality in chronic kidney disease (CKD) as a whole. The prevention and correction of hyperphosphatemia are important components of CKD, achieved by dietary phosphate restriction, phosphate binders administration, and adequate dialysis. In this context, we emphasize the importance of knowledge about the phosphate content in food and we developed the ‘‘phosphate traffic light’’, as a new tool for nutrition education and suggestion to improve nutrition labels. Dietary phosphate comes in an organic form (phospholipids and phosphoproteins), such as meat and dairy products, and in an inorganic form as food additives that are increasingly added to processed foods and beverages. However, estimates of dietary phosphate intake rarely considers the amount of phosphorus in mineral supplements, water, or food additives. This is extremely important because phosphate supplied in additives is more easily absorbed in the gastrointestinal tract. Protein from animal origin, such as meat, fish, and dairy products contains phosphate mainly in an organic form which is easily hydrolyzed and absorbed by the human digestive system. High-protein plant based foods, such as legumes, nuts, cereals and seeds, contain phosphate mainly in phytate, or the phytic acid form. This type is not dissolved in the human intestine due to the lack of phytase


Attention to Food Phosphate and Nutrition Labeling
Marcela T. Watanabe, Pasqual Barretti, and Jacqueline C.T. Caramori
Elsevier BV
PHOSPHATEMIAREPRESENTSA dynamic balance among dietetic absorption, urinary excretion and exchanges with bone tissue, soft tissues and intracellular stocks, and by regulatory hormonal mechanisms. The kidneys are the main organs that operate in the homeostasis of phosphatemia. In advanced stages of chronic kidney disease (CKD), when urinary phosphate excretion is severely limited, dietetic absorption plays a key role in phosphatemia, highlighting the importance of dietary control in the management of these patients. Thus, prevention and correction of hyperphosphatemia are important components of CKD, achieved by dietary phosphate restriction, phosphate binders administration, and adequate dialysis. In this context, we emphasize the importance of knowledge about the phosphate content in food and in nutrition labeling. Owing to the existence of phosphate in practically all living beings, it is found in most foods. Dietary phosphate comes in an organic form, such as meat and dairy products, and in an inorganic form as additives that are increasingly added to processed foods and drinks. Protein of animal origin, such as meat, fish, and dairy products contain phosphate mainly in the organic form as phosphoesters, which are easily hydrolyzed and absorbed by the human digestive system. High-protein plant based foods, such as legumes, nuts, cereals, and seeds, contain phosphate mainly in phytate, or the phytic acid form, which is not broken down in the human intestine because of the lack of phytase


Most consumed processed foods by patients on hemodialysis: Alert for phosphate-containing additives and the phosphate-to-protein ratio
Marcela T. Watanabe, Raphael M. Araujo, Barbara P. Vogt, Pasqual Barretti, and Jacqueline C.T. Caramori
Elsevier BV
BACKGROUND AND AIMS Hyperphosphatemia is common in patients with chronic kidney disease (CKD) stages IV and V because of decreased phosphorus excretion. Phosphatemia is closely related to dietary intake. Thus, a better understanding of sources of dietary phosphate consumption, absorption and restriction, particularly inorganic phosphate found in food additives, is key to prevent consequences of this complication. Our aims were to investigate the most commonly consumed processed foods by patients with CKD on hemodialysis, to analyze phosphate and protein content of these foods using chemical analysis and to compare these processed foods with fresh foods. METHODS We performed a cross-sectional descriptive analytical study using food frequency questionnaires to rank the most consumed industrialized foods and beverages. Total phosphate content was determined by metavanadate colorimetry, and nitrogen content was determined by the Kjeldahl method. Protein amounts were estimated from nitrogen content. The phosphate-to-protein ratio (mg/g) was then calculated. Processed meat protein and phosphate content were compared with the nutritional composition of fresh foods using the Brazilian Food Composition Table. Phosphate measurement results were compared with data from the Food Composition Table - Support for Nutritional Decisions. An α level of 5% was considered significant. RESULTS Food frequency questionnaires were performed on 100 patients (mean age, 59 ± 14 years; 57% male). Phosphate additives were mentioned on 70% of the product labels analyzed. Proteins with phosphate-containing additives provided approximately twice as much phosphate per gram of protein compared with that of fresh foods (p < 0.0001). CONCLUSIONS Protein and phosphate content of processed foods are higher than those of fresh foods, as well as phosphate-to-protein ratio. A better understanding of phosphate content in foods, particularly processed foods, may contribute to better control of phosphatemia in patients with CKD.


Detection of enterotoxin genes of Staphylococcus sp isolated from nasal cavities and hands of food handlers
V.L.M. Rall, J.M. Sforcin, V.C.M. Augustini, M.T. Watanabe, A. Fernandes Jr., R. Rall, M.G. Silva, and J.P Araújo Jr.
FapUNIFESP (SciELO)
Food handlers, an important factor in food quality, may contain bacteria that are able to cause foodborne disease. The present study aimed to research coagulase-negative (CNS) and -positive staphylococci (CPS) in 82 food handlers, analyzing nasal and hand swabs, with identification of 62 CNS (75.6%) and 20 CPS strains (24.4%). Staphylococcal enterotoxins genes were investigated by PCR. In 20 CPS strains, 19 were positive for one or more genes. The percentage of CNS presenting genes for enterotoxins was high (46.8%). Despite of the staphylococcal species, the most common gene was sea (35.4%), followed by seh and sej (29.2%). The detection of new staphylococcal enterotoxins (SEs) genes showed a higher pathogenic potential in this genus. The presence of these gene points out the importance of CNS not only as contaminant bacteria but also as a pathogen.