Impact of Chemotherapy Regimens on Body Composition of Breast Cancer Women: A Multicenter Study across Four Brazilian Regions.

This study aimed to investigate the effect of chemotherapy (CT) and its different types of regimens on the anthropometry and body composition of women with breast cancer. Three-hundred-and-four women with breast cancer were enrolled in this multicenter study. The participants were evaluated before the infusion of the first cycle of CT (pre-CT), and until two weeks after CT completion (post-CT), regarding body weight, body mass index (BMI); waist circumference (WC); waist-to-height ratio (WHtR); conicity index (C-index); fat mass index (FMI); and fat-free mass index (FFMI). CT regimens were classified as anthracycline-based (AC-doxorubicin or epirubicin); anthracyclines and taxane (ACT); cyclophosphamide, methotrexate, and 5-fluorouracil (CMF); or isolated taxanes (paclitaxel or docetaxel). Women significantly increased BMI and FMI post-CT (p < 0.001 and p = 0.007, respectively). The ACT regimen increased FMI (p < 0.001), while FFMI increased after AC (p = 0.007). It is concluded that the CT negatively impacted body composition and the type of regime had a strong influence. The ACT regimen promoted an increase in FMI compared to other regimens, and the AC increased FFMI. These findings reinforce the importance of nutritional monitoring of breast cancer patients throughout the entire CT treatment.

Low hand grip strength is associated with worse functional capacity and higher inflammation in people receiving maintenance hemodialysis.

OBJECTIVES: To evaluate the associations of hand grip strength (HGS) with body composition, functional capacity, muscle quality, and inflammatory markers in people receiving maintenance hemodialysis. METHODS: This is a cross-sectional study in people receiving maintenance hemodialysis. HGS was measured by hydraulic dynamometer on the upper limb without fistula. Participants were stratified into low or adequate HGS, based on population-specific cutoff points. Body composition was assessed by dual-energy X-ray absorptiometry, and functional capacity by the Short Physical Performance Battery and timed up-and-go tests. In addition, serum creatinine, interleukin-6 (IL-6), IL-10, tumor necrosis factor-α, and ultra-sensitive C-reactive protein (us-CRP) were measured before the dialysis session. RESULTS: A total of 67 participants (41.8% women, 58.2% male; ages 54.1 ± 11.7 y) were included. Those with low HGS had worse functional capacity than those with adequate HGS (timed up-and-go test, 10.7 ± 1.0 versus 8.5 ± 0.8 sec, respectively; P < 0.001). IL-6 and us-CRP were higher in those with low HGS than their counterparts (IL-6: 2.7 ± 0.3 versus 1.9 pg/mL, P = 0.03; us-CRP: 14.8 ± 3.0 versus 4.7 ± 1.9 mg/L, P = 0.03). Multiple linear regression analysis showed that appendicular lean mass, us-CRP, age, sex, and seven-point subjective global assessment score were associated with HGS. CONCLUSIONS: Participants with low HGS showed higher inflammation and lower functional capacity. In addition to muscle mass, inflammation and nutritional status also affect HGS..

The Effect of Baru (Dypterix alata Vog.) Almond Oil on Markers of Bowel Habits in Hemodialysis Patients.

Gastrointestinal symptoms are common in patients in hemodialysis treatment and were frequently associated with low intake of dietary fibers and liquids, oral iron supplementation, phosphate binders, and low level of physical activity. Thus, the aim of this study was to evaluate the effect of baru almond oil in comparison with mineral oil supplementation on bowel habits of hemodialysis patients. Thirty-five patients on hemodialysis (57% men, 49.9 ± 12.4 years) were enrolled in a 12-week single-blind clinical trial. Patients were allocated (1 : 2) by sex and age into (1) the mineral group: 10 capsules per day of mineral oil (500 mg each) or (2) the baru almond oil group: 10 capsules per day of baru almond oil (500 mg each). Bowel habits were assessed by the Rome IV criteria, Bristol scale, and self-perception of constipation. Food consumption, physical activity level, and time spent sitting were also evaluated at the baseline and at the end of the study. After 12 weeks of supplementation, the baru almond oil group showed reduced Rome IV score (6.1 ± 5.5 vs 2.8 ± 4.3, p=0.04) and the straining on the evacuation score (1.2 ± 1.4 vs 0.4 ± 0.7; p=0.04), while the mineral group did not show any change in the parameters. The frequency of self-perception of constipation was lower in the baru almond oil group after intervention (45.0% vs 15.0%, p=0.04). Baru almond oil improved bowel habit and the straining on evacuation in hemodialysis patients.

Chemotherapy negatively impacts body composition, physical function and metabolic profile in patients with breast cancer.

BACKGROUND: Evidence suggests that chemotherapy (CT) leads to unfavorable outcomes on nutritional and metabolic profile; however, this is poorly understood. OBJECTIVE: To evaluate the impact of CT on body composition, bone mineral density (BMD), insulin resistance, lipid markers related to atherosclerotic cardiovascular diseases in women recently diagnosed with breast cancer according to menopausal status. METHODS: This is a prospective study that enrolled women newly diagnosed with stage II-III breast cancer (2014-18). Body composition were measured by dual-energy x-ray absorptiometry. Blood samples were collected to assess lipid profile, insulin resistance and sensitivity, visceral adiposity index and lipid accumulation product were calculated. Dietary intake, physical activity and function were also evaluated at the time of breast cancer diagnosis and after CT completion. RESULTS: Ninety-nine women (40.4% in the premenopausal stage) aged 51 ± 1 years took part in this study. CT duration was 197 ± 27 days and main regimen was anthracyclines with taxanes (88.9%). CT was associated with an increase in total and central adiposity, insulin resistance, and all lipid-related markers, and a decrease in appendicular lean mass index, BMD and HDL-c concentration. Premenopausal women experienced greater unfavorable outcomes on adiposity markers and BMD compared to postmenopausal women (p < 0.01). No changes were observed in dietary intake and physical activity after CT. CONCLUSIONS: Breast cancer CT negatively impacted body composition and metabolic profile. Premenopausal women experienced greater unfavorable impact on adiposity markers and BMD.

Once a Week Resistance Training Improves Muscular Strength in Breast Cancer Survivors: A Randomized Controlled Trial.

Background: Exercise has been shown to reduce adverse outcomes related to breast cancer. However, the rate of adherence to physical exercise is very low among breast cancer survivors (BCS). This study investigated the effects of high supervision ratio resistance training (RT), once a week for 8 weeks, on changes in body composition and muscular strength in BCS. Methods: Twenty-five female BCS undergoing hormone therapy were randomized into resistance training group (TG, n = 12) or control (CG, n = 13) group. The TG performed 8 weeks of supervised RT, with 1 trainer per volunteer, once a week. Body composition was evaluated by dual-energy X-ray absorptiometry, and muscle strength was evaluated by 10 repetition maximum (10 RM) for leg press (45°) and bench press exercises. A 1-way analysis of variance was used to compare within-group effects at pre- and post-intervention. An analysis of covariance test was used to compare post-intervention values, using pre-intervention measures as covariates. The effect size (ES) was calculated by Cohen's d. Results: The TG improved muscle strength in 10 RM leg press (45°; Δ 33.75 ± 11.51 kg, P = .02; ES = 0.96) and bench press (Δ 4.08 ± 1.83 kg, P = .01; ES = 1.15). Adherence to training was more than 99%. Changes in body composition were not detected. There were no changes in the CG for any assessment. Conclusion: Once-weekly supervised RT could be an alternative to increase the adherence to exercise and improve muscular strength in BCS.

Sedentary Behavior and Alcohol Consumption Increase Breast Cancer Risk Regardless of Menopausal Status: A Case-Control Study.

Identification of modifiable risk factors for breast cancer is critical for primary prevention of the disease. The aim of this study was to evaluate how certain lifestyle variables modify the chances of developing breast cancer based on menopausal status. A case-control study was performed in a group of 542 women, 197 who were diagnosed with breast cancer and 344 control individuals. The groups were matched by age, body mass index, and menopausal status. Participants were evaluated for level of physical activity, alcohol consumption, smoking habit, weight, height, and waist circumference (WC). A multivariate logistic regression model was used to estimate odds ratios and 95% confidence intervals (95% CI). Regular consumption of alcoholic beverages (2.91, 95% CI 1.58-5.38 and 1.86, 95% CI 1.15-3.03) and sedentary behavior (2.08; 95% CI 1.12-3.85 and 1.81; 95% CI 1.12-2.94) were associated with breast cancer risk in pre- and postmenopausal women, respectively. High WC (3.31, 95% CI 1.45-7.55) was associated with an increased risk of developing breast cancer in premenopausal women. While in postmenopausal women, current smoking (2.43, 95% CI 1.01-5.83) or previous history of smoking (1.90; 95% CI 1.14-3.14) increased the chances of developing breast cancer. Sedentary behavior and current consumption of alcoholic beverages were more likely to increase the risk of developing breast cancer regardless of menopausal status.

Baru Almonds Increase the Activity of Glutathione Peroxidase in Overweight and Obese Women: A Randomized, Placebo-Controlled Trial.

BACKGROUND: Obesity-induced inflammation is frequently associated with higher oxidative stress. In vitro and experimental studies have considered baru almonds (Dipteryx alata Vog) as a legume seed with high antioxidant capacity. The aim of this study was to evaluate whether baru almonds are capable of improving the inflammatory and antioxidant status in overweight and obese women. METHODS: In a parallel-arm, randomized placebo-controlled trial, 46 overweight and obese women (age: 40 ± 11 years; body mass index: 33.3 ± 4.3) were randomly assigned to receive advice to follow a normocaloric and isoenergetic diet with placebo (PLA, n = 22) or similar advice plus 20 g baru almonds (BARU, n = 24) for 8 wk. Malondialdehyde (MDA), adiponectin, tumor necrosis factor-α, interleukin-6, interleukin-10, antioxidant enzymes activities (catalase-CAT; glutathione peroxidase-GPx; superoxide dismutase-SOD), and minerals were analyzed in plasma samples. RESULTS: At baseline, groups were similar regarding the body composition, oxidative, and inflammatory parameters. The BARU group increased the activity of GPx (+0.08 U/mg, 95%CI + 0.05 to +0.12 vs. -0.07, 95%CI -0.12 to -0.03, p < 0.01) and plasma copper concentration (p = 0.037) when compared to the PLA group. No differences were observed between groups in CAT and SOD activity or MDA and cytokines concentrations. CONCLUSIONS: Baru almond supplementation increased the GPx activity in overweight and obese women.

Organic beet leaves and stalk juice attenuates HDL-C reduction induced by high-fat meal in dyslipidemic patients: A pilot randomized controlled trial.

OBJECTIVES: Beet leaves and stalks are rich in polyphenols; however, their effect on risk factors for cardiovascular disease in humans, to our knowledge, has not yet been investigated. The aim of this study was to analyze the acute effect of beet leaves and stalk juice, containing different concentrations of polyphenols, on lipemia, glycemic control, nitric oxide concentration, and blood pressure in patients with dyslipidemia after a high-fat meal. METHODS: In a randomized double-blind, placebo-controlled, crossover pilot study, patients 20 to 59 y of age with dyslipidemia were fed a single high-fat meal supplemented with either a placebo or one of two organic beet leaves and stalk juices rich in polyphenols (32 or 77.5 mg EAG/100 mL) with a 1-wk washout. Thus, each group was composed of 13 patients. Blood samples were obtained at fasting and 30, 60, 120, and 180 min after intervention. Total cholesterol, high-density lipoprotein, triacylglycerols, glucose, insulin, nitrite and nitrate, and blood pressure were assessed at each time period. The high-fat meal increased triacylglycerol levels after 120 (P < 0.001) and 180 min (P < 0.001) and reduced high-density lipoprotein cholesterol after 60 min (P < 0.05). This reduction was attenuated in both groups that received BLS juices after 120 min (P = 0.005). A reduction in diastolic blood pressure within groups that received BLS juice was also observed. RESULTS: There was no significant difference between groups for other biomarkers. CONCLUSION: The beet leaves and stalk juice attenuated the reduction of high-density lipoprotein cholesterol induced by a high-fat meal.

Quality of Life Is Influenced by Body Weight, Education, and Family Income in Adolescents with Chronic Diseases.

OBJECTIVE: To evaluate the health-related quality of life (HRQoL) of adolescents diagnosed with different chronic conditions and to identify demographic, socioeconomic, and health-status outcomes associated with the impairment in HRQoL. STUDY DESIGN: Cross-sectional study. METHODS: We evaluated 276 adolescents (50.7% male) aged 14 ± 2 years that were assisted by healthcare public service and diagnosed with cancer (CA), type 1 diabetes mellitus (DM1), overweight (OW), asthma (AS), and no chronic health condition-control group (CG). Adolescents and parent-proxy completed age-appropriate self-report and/or parent-proxy report on generic HRQoL measures using PedsQL™. RESULTS: Adolescents with CA had lower overall HRQoL as well as poorer scores in all dimensions than either healthy participants or other chronic disease sufferers. HRQoL scores reported by parent-proxy were similar to those reported by adolescents across all chronic diseases. CG members reported better scores in all dimensions. Maternal education, family income, and marital status of parents were correlated with HRQoL scores in all dimensions. The risk of having an affected HRQoL score was higher in adolescents with CA than in adolescents with other chronic diseases. CONCLUSIONS: The likelihood of cancer affecting HRQoL was higher when compared to other chronic diseases, and the OW group had a worse overall score compared to CG. Adolescents with CA, AS, and OW reported worse school dimensions when compared to healthy adolescents. The education of adolescents and their parent-proxy, body weight, and family income influence the dimensions of HRQoL in adolescents with chronic diseases.

Visceral adiposity increases the risk of breast cancer: a case-control study.

INTRODUCTION: in recent decades, lifestyle changes in women involving physical inactivity, insulin resistance and body fat distribution have been associated with an increase in breast cancer. OBJECTIVE: to assess whether insulin resistance, lipid profile, and visceral adiposity are associated with increased risk of breast cancer. METHODS: a hospital-based case control study was conducted with 116 women newly diagnosed with breast cancer and 226 controls. Body mass index, waist circumference, total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), very-low-density lipoproteins (VLDL), triglycerides, glycated hemoglobin, HOMA-IR, HOMA-ß, lipid accumulation product (LAP), and visceral adiposity index (VAI) were assessed. Logistic regression was adjusted for body mass index and age to quantify the association between breast cancer risk and insulinresistance, dyslipidemias, and visceral adiposity. RESULTS: the case group had higher insulin resistance (p < 0.001), LAP (p = 0.012), and VAI (p = 0.004), and lower concentrations of HDL (p = 0.024) and HOMA-ß(p = 0.010) compared to the control. Insulin resistance (OR = 3.00, 95% CI: 1.75-5.17, p < 0.001) and higher VAI (OR = 1.91, 95% CI: 1.17-3.13, p = 0.01) were associated with breast cancer, whereas the highest concentration of HDL reduces the chances of cancer by 53% (95% CI: 0.32-0.86, p = 0.026). In the multivariate analysis, only LAP and VAI were associated to breast cancer. CONCLUSIONS: visceral fat accumulation increases the risk of breast cancer.

Nuts and Human Health Outcomes: A Systematic Review.

There has been increasing interest in nuts and their outcome regarding human health. The consumption of nuts is frequently associated with reduction in risk factors for chronic diseases. Although nuts are high calorie foods, several studies have reported beneficial effects after nut consumption, due to fatty acid profiles, vegetable proteins, fibers, vitamins, minerals, carotenoids, and phytosterols with potential antioxidant action. However, the current findings about the benefits of nut consumption on human health have not yet been clearly discussed. This review highlights the effects of nut consumption on the context of human health.

The additional effects of a probiotic mix on abdominal adiposity and antioxidant Status: A double-blind, randomized trial.

OBJECTIVE: To investigate whether a probiotic mix has additional effects when compared with an isolated dietary intervention on the body composition, lipid profile, endotoxemia, inflammation, and antioxidant profile. METHODS: Women who had excess weight or obesity were recruited to a randomized, double-blind trial and received a probiotic mix (Lactobacillus acidophilus and casei; Lactococcus lactis; Bifidobacterium bifidum and lactis; 2 × 1010 colony-forming units/day) (n = 21) or placebo (n = 22) for 8 weeks. Both groups received a dietary prescription. Body composition was assessed by anthropometry and dual-energy X-ray absorptiometry. The lipid profile, lipid accumulation product, plasma fatty acids, lipopolysaccharide, interleukin-6, interleukin-10, tumor necrosis factor-α, adiponectin, and the antioxidant enzymes activities were analyzed. RESULTS: In comparison with the dietary intervention group, the dietary intervention + probiotic mix group showed a greater reduction in the waist circumference (-3.40% vs. -5.48%, P = 0.03), waist-height ratio (-3.27% vs. -5.00%, P = 0.02), conicity index (-2.43% vs. -4.09% P = 0.03), and plasma polyunsaturated fatty acids (5.65% vs. -18.63%, P = 0.04) and an increase in the activity of glutathione peroxidase (-16.67% vs. 15.62%, P < 0.01). CONCLUSIONS: Supplementation of a probiotic mix reduced abdominal adiposity and increased antioxidant enzyme activity in a more effective way than an isolated dietary intervention.

Excesso de peso e de gordura androide em mulheres goianas recém-diagnosticadas com câncer de mama / Overweight and android fat depot in women from Goiás newly diagnosed with breast cancer

Objetivo: Descrever a prevalência de excesso de peso e de gordura localizada na região androide avaliadas pelo método absortometria radiológica de feixe duplo (DXA) em mulheres goianas recém-diagnosticadas com câncer de mama. Métodos: Estudo transversal com 48 mulheres com câncer de mama atendidas no Programa de Mastologia do Hospital das Clínicas da Universidade Federal de Goiás. Foram coletadas características sociodemográficas, medidas antropométricas e avaliada a composição corporal por meio do DXA. Resultados: A média de idade das participantes foi de 53±11 anos, 78,00% apresentavam renda de até um salário mínimo e 69,00% referiram residir com o companheiro. Com relação à medida da circunferência da cintura, 69,00% apresentaram valores acima da recomendação máxima para esse parâmetro. Apenas 14,58% apresentaram valores de índice de massa corporal (IMC) na faixa de normalidade. Ao considerar o percentual de gordura corporal total obtido pelo DXA, nenhuma mulher foi classificada com percentual de gordura normal, além de apresentarem um elevado percentual de gordura na região androide (52,34%). Conclusão: Mulheres recém-diagnosticadas com câncer de mama apresentaram alta prevalência de excesso de peso e risco aumentado para complicações metabólicas e cardiovasculares considerando a elevada prevalência de hiperadiposidade abdominal avaliada pelas medidas de circunferência da cintura e de gordura androide.

Objective: To describe the prevalence of overweight and fat located in the android region assessed by dual x-ray absorptiometry (DXA) in women from Goiás, Brazil, newly diagnosed with breast cancer. Methods: Cross-sectional study of 48 women with breast cancer assisted in the Mastologia Program in the Clinical Hospital of the Federal University of Goiás. Socio-demographic characteristics and anthropometric measurements were collected, and body composition was evaluated by DXA. Results: The mean age of participants was 53±11 years, 78.00% had incomes up to one minimum wage and 69.00% reported living with a partner. According to waist circumference, 69.00% had values above the maximum recommendation for this parameter. Only 14.58% had body mass index (BMI) in the normal range. When the percentage of total body fat was analyzed by DXA, no woman was classified as regular body fat; in addition, they showed high percentage of the localized android fat (52.34%). Conclusion: Women newly diagnosed with breast cancer showed high prevalence of overweight and increased risk for metabolic and cardiovascular complications considering the high prevalence of abdominal adiposity assessed by waist circumference and android fat.

Impact of creatine supplementation in combination with resistance training on lean mass in the elderly.

BACKGROUND: Human ageing is a process characterized by loss of muscle mass, strength, and bone mass. We aimed to examine the efficacy of low-dose creatine supplementation associated with resistance training on lean mass, strength, and bone mass in the elderly. METHODS: This was a 12-week, parallel-group, double-blind, randomized, placebo-controlled trial. The individuals were randomly allocated into one of the following groups: placebo plus resistance training (PL + RT) and creatine supplementation plus resistance training (CR + RT) . The participants were assessed at baseline and after 12 weeks. The primary outcomes were lean mass and strength, assessed by dual energy X-ray absorptiometry (DXA) and ten-repetition maximal tests (10 RM), respectively. Secondary outcomes included the lumbar spine, right and left femoral neck, both femur and whole body bone mineral density (BMD), and whole body bone mineral content (BMC), assessed by DXA. RESULTS: The CR + RT group had superior gains in lean mass when compared with the PL + RT group (P = 0.02). Changes in the 10 RM tests in bench press and leg press exercises, body composition, BMD, and BMC of all assessed sites did not significantly differ between the groups (P > 0.05). CONCLUSIONS: Twelve weeks of low-dose creatine supplementation associated with resistance training resulted in increases in lean mass in the elderly.

Métodos de análise da composição corporal em adultos obesos / Methods for body composition analysis in obese adults

Os métodos de avaliação da composição corporal em obesos têm sido amplamente discutidos, uma vez que nesses indivíduos a avaliação é dificultada devido às limitações dos equipamentos e características dos métodos utilizados. Esta sessão temática tem o objetivo de esclarecer as características, vantagens e limitações dos métodos de avaliação da composição corporal em adultos obesos. A quantificação de gordura corporal e mas-sa livre de gordura, assim como a avaliação da perda de massa muscular e de massa óssea em obesos são temas de grande interesse científico, uma vez que são utilizados para diagnosticar a obesidade osteosarcopênica. A avaliação da composição corporal de obesos pelo modelo de múltiplos compartimentos é padrão-ouro na prática científica. Por outro lado, o método de absorciometria radiológica de feixe duplo é considerado o padrão de referência em pesquisas e na prática clínica. Estudos indicam que a ressonância magnética e a tomografia computadorizada, em alguns casos, são fortemente correlacionadas com a absorciometria radiológica de feixe duplo. Os demais métodos apresentam limitações em avaliar a composição corporal, bem como suas modificações durante a redução ponderal em indivíduos obesos.

The analysis of body composition in obese individuals has been intensively discussed due to the methodological limitations of most measurement methods. The aim of this thematic section was to clarify the characteristics, advantages, and limitations of methods of body composition evaluation in obese adults. In addition to the measurement of body fat and fat-free mass, evaluation of specific patterns of body composition change, such as loss of both muscle and bone mass in obese individuals, is also of special scientific interest because they are used for the diagnosis and prognosis of osteosarcopenic obesity. Although the use of multi-compartment models are gold-standard for the assessment of body composition, dual-energy X-ray absorptiometry may be used as a method of reference in scientific research and clinical practice. Studies indicate that magnetic resonance and computed tomography are, in some instances, strongly correlated with dual-energy X-ray absorptiometry. Other techniques present with limitations in assessing the body composition of obese individuals, especially when evaluating weight loss changes.

Nutritional and hormonal modulation of adiponectin and its receptors adipoR1 and adipoR2.

Adiponectin is the most abundant plasma protein synthesized mostly by adipose tissue and is an insulin-sensitive hormone, playing a central role in glucose and lipid metabolism. Adiponectin effects are mediated via two receptors, adipoR1 and adipoR2. Several hormones and diet components that are involved in insulin resistance may impair insulin sensitivity at least in part by decreasing adiponectin and adiponectin receptors. Adiponectin expression and serum levels are associated with the amount and type of fatty acids and carbohydrate consumed. Other food items, such as vitamins, alcohol, sodium, green tea, and coffee, have been reported to modify adiponectin levels. Several hormones, including testosterone, estrogen, prolactin, glucocorticoids, catecholamines, and growth hormone, have been shown to inhibit adiponectin production, but the studies are still controversial. Even so, adiponectin is a potential therapeutic target in the treatment of diabetes mellitus and other diseases associated with hypoadiponectinemia.

Suplementação de ferro em indivíduos submetidos à derivação gástrica em Y-de-Roux / Iron supplementation in individuals undergoing Roux-en-Y gastric bypass

Objetivo - Avaliar os efeitos da suplementação de ferro glicina quelato sobre as concentrações séricas de ferro e as mudanças na composição corporal após derivação gástrica em Y-de-Roux. Métodos - Foram coletados dados de prontuários de 41 pacientes submetidos à derivação gástrica em Y-de-Roux, os quais foram avaliados quanto ao Índice de Massa Corporal (IMC), circunferência de cintura, dobra cutânea triciptal e exames bioquímicos. Estes pacientes receberam suplementação sob a forma de ferro glicina quelato, na dosagem de 30 mg/dia de ferro elementar durante doze meses. Resultados - Após três e doze meses do procedimento cirúrgico, os indivíduos apresentaram redução significativa do IMC, peso, circunferência da cintura e dobra cutânea triciptal (P<0,001). As concentrações de colesterol total, glicose, hemoglobina e hematócrito reduziram significativamente três e doze meses após a cirurgia (P<0,001), enquanto que as de triacilglicerol reduziram após três meses, se mantendo até o décimo segundo mês. As concentrações de ferro sérico não apresentaram reduções durante o período estudado. Conclusões - A cirurgia bariátrica reduziu os indicadores de adiposidade. Os dados sugerem que a suplementação com ferro glicina quelato não evitou reduções nos valores séricos de hemoglobina e hematócrito, mas pode prevenir reduções nas concentrações de ferro sérico no pós-cirúrgico.

Objective - The aim of this work was to evaluate the effects of iron supplementation and changes in the body composition in individuals submitted to Roux-en-Y gastric bypass supplemented with ferrous sulphate. Methods - Data were collected from medical records of 41 patients undergoing Roux-en-Y gastric bypass, which were evaluated for body mass index (BMI), waist circumference, triceps skinfold and biochemical tests. These patients received supplementation in the form of iron glycine chelate, in dosages of 30 mg/day of elemental iron for twelve months. Results - Three and twelve months after surgery, subjects had significantly lower BMI, weight, waist circumference and triceps skinfold (P <0.001). The concentrations of total cholesterol and glucose, hemoglobin and hematocrit decreased three and twelve months significantly after surgery (P <0.001), whereas triacylglycerol dropped after three months remained until the twelfth month. Concentrations of serum iron showed no reduction during the study period. Conclusions - Bariatric surgery reduced body fat indicators. Data suggest that supplementation with iron glycine chelate did not prevent reductions in serum hemoglobin and hematocrit, but can prevent reductions in serum iron concentrations in post-surgical.

Indicadores antropométricos como marcadores de risco para anormalidades metabólicas / Anthropometric indicators as risk markers for metabolic abnormalities

O objetivo do presente trabalho foi avaliar qual indicador antropométrico apresenta maior relação com as anormalidades metabólicas em participantes de um programa de Mudança de Estilo de Vida. Tratou-se de uma pesquisa do tipo exploratória, transversal e analítica, na qual foram avaliados 273 adultos e idosos (idade superior a 40 anos) quanto ao Índice de Massa Corporal (IMC), circunferência cintura (CC), por cento gordura corporal (GT) e por cento massa muscular ( por centoMM). Foi colhida amostra de sangue em jejum para dosagem de colesterol total e frações, triacilglicerol e glicose. Foram realizadas análises estatísticas para diferenciação entre os grupos e determinação de associações. O nível de significância adotado foi de p<0,05. Ao avaliar as anormalidades metabólicas como variável dependente e IMC, CC, GT, por centoMM como variáveis independentes, observamos que a CC foi o indicador antropométrico que mostrou melhor associação com todas as anormalidades metabólicas (p<0,0001), seguida da por centoMM. Conclui-se que as anormalidades metabólicas comumente associadas à obesidade apresentam como principal marcador de risco antropométrico a CC e não o IMC. Dado um mesmo valor de CC, sobrepesos e obesos apresentaram riscos à saúde comparáveis aos indivíduos eutróficos.

The purpose of this study was to determine which anthropometric indicator has the greatest bearing on the metabolic abnormalities in participants of a Lifestyle Change Program. It consisted of an exploratory, transversal and analytical survey, which assessed the body mass index (BMI), waist circumference (WC), percentage of body fat ( percentBF) and of muscle mass ( percentMM) of 273 adults and elderly subjects (over 40 years of age). Blood samples after an 8-hour diet were obtained to assess total cholesterol, high-density cholesterol, low-density cholesterol, triacylglycerol and glucose. Statistical analyses for differentiation between the groups and determination of associations were conducted. The level of significance was set at p<0.05. When the metabolic abnormalities were assessed as a dependent variable and BMI, WC, percentBF, percentMM as independent variables, it was seen that WC was the anthropometric indicator that showed the closest association with all metabolic abnormalities (P<0,0001), followed by percentMM. The conclusion reached was that WC rather than BMI was the main marker of anthropometric risk for metabolic abnormalities frequently related to obesity. Given the same WC value, overweight and obese individuals had comparable health risks to eutrophic individuals.

A suplementação de L-carnitina não promove alterações na taxa metabólica de repouso e na utilização dos substratos energéticos em indivíduos ativos / The supplementation of L-carnitine does not promote alterations in the resting metabolic rate and in the use of energetic substrates in physically active individuals

OBJETIVO: Avaliar o efeito da suplementação de L-carnitina, por 30 dias, sobre a taxa metabólica de repouso (TMR) e oxidação de ácidos graxos livres (AGL), em repouso e exercício. SUJEITOS E MÉTODOS: Vinte e um voluntários ativos (40 a 58 anos) com sobrepeso foram randomizados em dois grupos: suplementado (GS; N = 11; 1,8 g/dia de L-carnitina) e placebo (GP; N = 10; maltodextrina). Foi feita avaliação da ingestão calórica, antropometria, determinação da TMR, VO2máx, quociente respiratório e AGL plasmáticos. RESULTADOS: Não houve diferença significativa na ingestão (-244,66 vs. -126,00 kcal/dia), composição corporal (-0,07 vs. -0,17 kg/m²), TMR (0,06 vs. -0,02 kcal/ dia), quociente respiratório em repouso (3,69 vs. -1,01) e exercício (0,01 vs. -0,01) e VO2máx (0,50 vs. 1,25 mL/kg/min) para o grupo GS em relação ao GP. Houve aumento dos AGL em repouso no GP (0,27), porém sem diferenças no exercício para os grupos. CONCLUSÃO: Não houve efeito da L-carnitina em nenhuma das variáveis analisadas no estudo.

PURPOSE: To investigate the effects of L-carnitine supplementation, over thirty days, on the resting metabolic rate (RMR) and oxidation of free fatty acids (FFA) under rested or exercised conditions. SUBJECTS AND METHODS: Twenty-one overweight active volunteers (40 to 58 years old) were randomized into two groups: supplemented (GS; N = 11; 1,8 g/day of L-carnitine) or placebo (GP; N = 10; maltodextrin). Caloric intake, anthropometry, RMR, VO2max, respiratory exchange ratio and plasma FFA were measured. RESULTS: No significant changes were found in the caloric intake (-244,66 vs. -126,00 kcal/day), body composition (-0.07 vs. -0.17 kg/m²), RMR (0.06 vs. -0.02 kcal/day), respiratory exchange ratio at rest (3.69 vs. -1.01) and exercise (0.01 vs. -0.01) or VO2max (0.50 vs. 1.25 mL/kg/min) between GS and GP. Plasma FFA levels were increased under resting conditions only in the GP group (0.27), but no significant changes were observed before or after physical activity in any of the groups. CONCLUSION: Supplementation with L-carnitine caused no changes in the variables analyzed in this study.