Obesity and diabetes: the link between adipose tissue dysfunction and glucose homeostasis.

Obesity and type 2 diabetes mellitus (T2DM) epidemics, which have already spread, imply the possibility of both conditions being closely related. Thus, the goal of the present review was to draw a parallel between obesity, adipose tissue (AT) changes, and T2DM development. To this end, a search was conducted in PubMed, MEDLINE and SciELO databases, using the following key words and their combinations: obesity; diabetes; insulin resistance; diet; weight loss; adipocin; inflammation markers; and interleukins. Based on a literature review, AT dysfunction observed in obesity is characterised by adipocyte hypertrophy, macrophage infiltration, impaired insulin signalling and insulin resistance. In addition, there is release of inflammatory adipokines and an excessive amount of NEFA promoting ectopic fat deposition and lipotoxicity in muscle, liver and pancreas. Recent evidence supports the hypothesis that the conception of AT as a passive energy storage organ should be replaced by a dynamic endocrine organ, which regulates metabolism through a complex adipocyte communication with the surrounding microenvironment. The present review demonstrates how glucose homeostasis is changed by AT dysfunction. A better understanding of this relationship enables performing nutritional intervention strategies with the goal of preventing T2DM.

Eating carbohydrate mostly at lunch and protein mostly at dinner within a covert hypocaloric diet influences morning glucose homeostasis in overweight/obese men.

PURPOSE: To evaluate the effects of two dietary patterns in which carbohydrates and proteins were eaten mostly at lunch or dinner on body weight and composition, energy metabolism, and biochemical markers in overweight/obese men. METHODS: Fifty-eight men (30.0 ± 7.4 years; 30.8 ± 2.4 kg/m(2)) followed a covert hypocaloric balanced diet (-10 % of daily energy requirements) during 8 weeks. Subjects were randomly assigned to three groups: control diet (CT); diurnal carbohydrate/nocturnal protein (DCNP); and nocturnal carbohydrate/diurnal protein (NCDP). Main analyzed outcomes were weight loss, body composition, diet-induced thermogenesis (DIT), and glucose/lipid profile. RESULTS: In all groups, a significant decrease in body weight, BMI, and fat mass (kg and %) was verified, without differences between groups. Interestingly, within group analyses showed that the fat-free mass (kg) significantly decreased in NCDP and in CT after 8-week intervention, but not in DCNP. A detrimental increase in fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMAIR) was verified only in DCNP, while NCDP and CT groups presented a non-significant reduction. Moreover, significant differences between DCNP and the other groups were detected for fasting insulin and HOMAIR. After the adjustments, NCDP presented a significantly higher DIT and energy expenditure after lunch, compared with DCNP, but after dinner, there were no differences among groups. CONCLUSION: Eating carbohydrates mostly at dinner and protein mostly at lunch within a hypocaloric balanced diet had similar effect on body composition and biochemical markers, but higher effect on DIT compared with control diet. Moreover, eating carbohydrates mostly at lunch and protein mostly at dinner had a deleterious impact on glucose homeostasis.

Relative age effect in elite Brazilian athletes in different combat sports: an observational study.

Background: The relative age effect (RAE) suggests that, due to maturity, young athletes born in the first quartiles of the year may have advantages over those born in the last quartiles of the year. Thus, it is important to evaluate the RAE in different sports and to consider the particularities of the subdivisions of the sports categories. Objective: To analyze the RAE in the top 20 of the Brazilian rankings in different combat sports. Methods: Observational study that analyzed the national databases for the year 2019 (from categories U-11 to U-18) made publicly available by the Brazilian confederations of karate, taekwondo and fencing. We obtained data on date of birth, age category and body weight of all modalities, type of fencing competition weapon (Epee, Foie and Saber) and type of karate modality (kumite and kata) from the top 20 places in each ranking. The final sample consisted of 1,486 athletes (Age: 14.2 ± 2.3. Male-53.2%. Female-46.8%). To identify the RAE, we performed a contingency analysis and compared the results between the sexes within the same sport. Results: There was RAE in the U-11, U-12, U-15 and U-17 fencing categories (p < 0.05), being higher in the female categories (p < 0.05). The RAE was higher for males in the Epee test, and similar between the sexes for the Saber and Foie tests. In karate, RAE occurred in categories U-14 and U-16 (p < 0.05), being higher in males (p < 0.05). The RAE was similar between the sexes in the kumite modality (p < 0.05). There was no RAE for the kata modality in karate (p > 0.05) and for the Taekwondo categories (p > 0.05). Conclusion: The results showed the existence of a relative age effect in elite athletes ranked (top 20 places in each ranking) only for the sport of fencing and karate kumite.

Radiotherapy for Brain Metastases Near the End of Life: Characterizing Patients and Tumor Features.

PURPOSE: Patients with brain metastases are often referred for brain radiotherapy (BrRT) when exclusive palliative management would be more appropriate. To assess the indication of BrRT during end-of-life (EOL) care and evaluate the characteristics of the patients who underwent the treatment. METHODS: This retrospective study comprised patients from four independent oncology centers who had undergone BrRT for metastases. The variables included were Karnofsky performance status (KPS), primary tumor site, metastatic status, neurologic symptomatic status, the number and size of metastases, posterior fossa or meningeal involvement, type of BrRT, having undergone brain metastasectomy, and the availability of systemic therapies after BrRT. Patients were allocated into three subgroups with ≤30, 31-60, and 61-90 days of survival, and a control group of patients who survived >90 days. RESULTS: A total of 546 patients were included in the study. A KPS of <70 (P = .021), the number of brain metastases (P = .001), the lack of brain metastasectomy (P = .006), and the lack of systemic therapies after BrRT (P = .047) were significantly associated with the EOL subgroups. Multivariate analysis showed that a KPS of <70 (P < .001), the lack of brain metastasectomy (P = .015), and the lack of systemic therapies after BrRT (P = .027) were significantly associated with worse survival. In all, 241 (44.1%) patients died within 90 days-120 (22.0%) within 30 days, 75 (13.7%) within 31-60 days, and 46 (8.4%) within 61-90 days of BrRT. Patients with colorectal cancer were significantly more likely to die within 90 days of BrRT than >90 days. CONCLUSION: Considering patients' performance status and whether they are candidates for brain metastasectomy or systemic therapies after BrRT is critical to improving BrRT benefits in scenarios of EOL.

Whole-Genome Sequences of Mycobacterium abscessus subsp. massiliense Isolates from Brazil.

The Mycobacterium abscessus complex comprises multidrug-resistant, opportunistic, and rapidly growing pathogens responsible for severe infections. Here, we report the genome composition of four Mycobacterium abscessus subsp. massiliense isolates from three sources: two from the lung of a cystic fibrosis patient, one from a mammary cyst, and one from a gutter system.

Physicochemical and sensorial characteristics of beef burgers with added tannin and tannin-free whole sorghum flours as isolated soy protein replacer.

The physicochemical and sensorial characterization of beef burgers with added sorghum flours as replacer for the isolated soy protein (ISP) usually used in the conventional formulations was performed. Three formulations were prepared: one conventional (CN) with 3% ISP and two with 3% tannin (BRS 305) and tannin-free (BR 501) whole sorghum flour (WSF) of BRS 305 and BR 501 genotypes. There was no difference among the formulations for most of the physicochemical characteristics. The moisture retention was higher in BRS 305 (P < .05). The added WSF influenced the color of the raw beef burger; and the proximate composition and the antioxidant characteristics of the raw and cooked formulations (P < .05). The purchase intention and flavor, texture and overall acceptability scores were higher for the sorghum products than CN (P < .05). Therefore, the replacing of ISP by WSF in beef burger, especially by the BRS 305 genotype, might be a technologically, nutritionally and sensorially viable option.

Greek yogurt with added sorghum flours: antioxidant potential and sensory acceptance / Yogurt griego adicionado de harinas integrales de sorgo: potencial antioxidante y evaluación sensorial

ABSTRACT The aim of this study was to develop and evaluate the antioxidant characteristics and sensory acceptance of Greek yogurt with added whole sorghum flours (WSF) from genotypes BRS305 (tannin) and BR501 (tannin-free). Five formulations were elaborated: 1) Control (without WSF); 2) 2% BR501; 3) 4% BR501; 4) 2% BRS305 and 5) 4% BRS305 and evaluated for antioxidant capacity, total anthocyanins, total phenols, condensed tannins, sensory acceptance and purchase intention. The 4% BRS305 formulation presented higher antioxidant properties, but lower sensory acceptance. No significant difference was observed for: color, flavor and overall acceptability between the control and 2% BR501; nor for texture and overall acceptability between the control and 4% BR501. Principal component analysis explained that all variables associated with antioxidant properties were positively correlated with the first major component (PC1: 82.7%). The 2% and 4% BR501 formulations were more highly correlated with PC1 (92.7%), as well as the control in relation to sensorial characteristics. The addition of WSF BRS305 improved the antioxidant properties of yogurts and the addition of WSF BR501 did not interfere with the sensory acceptance of the formulations. The similarity of the sensory acceptance of the yogurt containing WSF from the BR 501 genotype to the control, opens perspectives for the insertion of sorghum in human food, using dairy products as suitable matrices, adding potential functionality to this type of product.

RESUMEN El trabajo tuvo como propósito desarrollar y evaluar las características antioxidantes y la aceptación sensorial de yogurt griego con adición de harinas integrales de sorgo (HIS) de los genotipos BRS305 (con taninos) y BR501 (sin taninos). Cinco formulaciones fueron elaboradas: 1) Control (sin HIS); 2) 2% BR501; 3) 4% BR501; 4) 2% BRS305 y 5) 4% BRS305. Las formulaciones fueron evaluadas en función de su actividad antioxidante, antocianinas totales, fenólicos totales, taninos condensados, aceptación sensorial e intención de compra. La formulación 4% BRS305 presentó más propiedades antioxidantes, pero menor aceptación sensorial que las otras formulaciones. No se observó diferencia significativa entre el control y el 2% BR501 para el color, sabor e impresión global, ni tampoco para textura e impresión global en relación al 4% BR501. El análisis de componente principal ha explicado que todas las variables asociadas a las propiedades antioxidantes han sido positivamente correlacionadas con el primer componente principal (PC1: 82,7%). Las formulaciones 2% y 4% BR501 se han correlacionado más con el PC1 (92,7%), así como el control con las características sensoriales. La adición de HIS BRS305 ha mejorado las propiedades antioxidantes de los yogurts y la adición de HIS BR501 no ha interferido en la aceptación sensorial de las formulaciones. La similitud de la aceptación sensorial del yogurt que contiene el HIS del genotipo BR501 con el control, abre perspectivas para la inserción del sorgo en la alimentación humana, utilizando productos lácteos como matrices adecuadas, agregando funcionalidad potencial a este tipo de producto.

Soil organic matter and production of ears of green corn after four years under tillage systems and previous crops in costal tablelands / Matéria orgânica do solo e a produção espigas de milho-verde após quatro anos sob sistemas de cultivo e culturas antecedentes nos tabuleiros costeiros

The current study aimed to evaluate the effects of different tillage systems on soil organic matter (SOM) contents and green corn yield (total ear weight) of an Argissolo Vermelho-Amarelo(Ultissol) in Coastal tablelands of northeast Brazil. The experiment was arranged as a strip plot design with three replications. Three tillage practices [conventional tillage (CT), minimum tillage (MT) and no-tillage (NT)] were laid out as a whole plot each (830 m²). Then, each plot was equally split into 12 experimental units (60 m²), distant 1 x 10 m from each other, where in four cover crops [pigeon pea (Cajanus cajan (L.) Millsp.), sunn hemp (Crotalaria juncea L.), beans (Phaseolus vulgaris) and peanut (Arachis hypogeae) were seedling previous to corn cultivation. Neither cover crops, nor tillage practices affected SOM contents at 0.20 m depth. An exception was observed on beans plots in which CT resulted on the lowest SOM content (8.5 dag kg-1) at 0-10 cm soil layer. Regarding green corn ears yield, CT adoption also resulted in lower weight (4.11 t ha-1) than those on NT (7.65 t ha-1), regardless of cover crop. On the other hand, the influence of cover crops on green corn yield relied upon tillage practices. Peanuts and sunn hemp performed best to improve corn yield in CT; peanuts and beans increased by 14 % the green corn ears yield in MT, while sunn hemp resulted in the highest total ear weight (9.42 t ha-1). Linear correlation of Pearson was significant for SOM and productivity green maize ears in minimum tillage beans (p <0.001; r = 0.996). After four years of absence or reduced soildisturbance, there was no increase in SOM levels. The plowing appears to be important for increasing the entry of C soil and chemical protection SOM of Argissols mainly in the surface layer of Coastal tablelands in brazilian northeast. Although the NT did not provide higher levels of SOM, the yield of green maize incommercial was significantly higher when adopting conservation systems.

O presente estudo teve como objetivo avaliar o efeito de diferentes sistemas de cultivo nos teores de matéria orgânica do solo (MOS) e na produtividade do milho verde (peso total das espigas) emArgissolo Vermelho-Amarelo (Ultissol) nos Tabuleiros costeiros da região nordeste do Brasil.. O experimento foi disposto em faixas experimentais com três repetições.Três práticas de cultivo [cultivo convencional (CC), cultivo mínimo (CM) e plantio direto (PD)] foram arranjadas em faixas (830 m²). Então, cada faixa foi dividida igualmente em doze unidades experimentais (60 m²), distante entre si a cada 1 x 10 m, onde quatro culturas antecessoras [guandu (Cajanus cajan (L.) Millsp.) crotalária (Crotalaria juncea), feijão (Phaseolus vulgaris) e amendoim (Arachis hypogeae)] foram semeadas previamente ao cultivo do milho. As culturas antecessoras e as práticas de cultivo não afetaram os teores de MOS da profundidade de 0.20 m. Uma exceção foi observada nas parcelas com feijão no qual o CC resultou no menor teor de MOS (8.5 dag kg-1) na camada 0-10 cm. Em relação a produtividade das espigas de milho verde, a adoção do CC também resultou em menor peso (4,11 t ha-1) que no PD (7,65 t ha-1), independente da cultura antecessora. Por outro lado, a influência da cultura de cobertura sob a produtividade do milho verde foi dependente da prática de cultivo. Amendoim e crotalária saíram-se melhor para aumentar a produtividade do milho no CC; amendoim e feijão aumentaram em 14 % a produtividade das espigas de milho verde no CM, enquanto crotalária resultou no mais alto peso total das espigas (9,42 t ha-1). A correlação linear de Pearson foi significativo para a MOS e produtividade de espigas de milho verde com crotalária sob o cultivo mínimo (p <0,001; r = 0,996). Após quatro anos da ausência ouredução do revolvimento do solo, não houve aumento nos níveis de MOS. A aração parece ser importante para aumentar a entrada de C no solo e a proteção química da MOS em Argissolos, principalmente na camada superficial. Embora o PD não tenha fornecido níveis mais elevados de MOS, o rendimento de espigas comerciais de milho verde foi significativamente maior ao se adotar sistemas conservacionistas.

Agreement between different methods and predictive equations for resting energy expenditure in overweight and obese Brazilian men.

Predictive equations and methods tend to overestimate or underestimate resting energy expenditure (REE) compared with indirect calorimetry (IC). This cross-sectional study aimed to evaluate the agreement between methods and equations for REE estimation of overweight and obese Brazilian men. Data from 48 healthy volunteers, ages 20 to 43 years and with body mass index ranging from 26.4 to 35.2, were collected between October 2008 and October 2009. REE was measured by IC, using Deltatrac (IC1) and KORR-MetaCheck (IC2) devices. It was estimated by bioelectrical impedance analysis (BIA) using tetrapolar (BIA1) and bipolar (BIA2) devices, and by the equations of Mifflin, World Health Organization/Food and Agriculture Organization/United Nations University, Fleisch, Horie-Waitzberg and Gonzalez, and Ireton-Jones. The association and agreement among the methods and equations were assessed by the interclass correlation coefficient, Bland-Altman analysis, and by the percentage of the difference between values obtained from the standard method and alternative methods and equations. Most methods showed high agreement with IC1. The highest agreements were found for Mifflin (-2.14%), Fleisch (-3.05%), Horie-Waitzberg and Gonzalez (4.41%), and BIA2 (5.25%). Similar results were shown by the Bland-Altman analyses. BIA2, followed by BIA1, Ireton-Jones, Mifflin, and Fleisch, showed the highest association with IC1. Thus, the Mifflin, Fleisch, Horie-Waitzberg and Gonzalez equations, and BIA2, were the most accurate methods for REE estimation in this study. However, because those equations have shown considerable variability, they should be used cautiously. In addition, the IC2 was not found to be an accurate method for REE estimation in overweight and obese men included in this study.

Alterações nutricionais e metabólicas em diabéticos: desafios ao hiperdia de uma estratégia de saúde da família / Nutritional and metabolic changes in people with diabetes: challenges for the HiperDia Program of a Family Health Strategy / Alteraciones nutricionales y metabólicas de diabéticos: desafios para el HiperDia de una estrategia de salud de la família

Objetivo: Avaliar o perfil antropométrico, condições de saúde e estilo de vida de diabéticos cadastrados no HiperDia de uma Estratégia de Saúde da Família (ESF) de Sinop-MT. Métodos: Tratou-se de um estudo transversal e descritivo realizado em uma ESF, localizada no centro de Sinop-MT, de junho a outubro de 2013, com diabéticos, de ambos os sexos e idade ≥18 anos. Avaliou-se peso, altura, níveis pressóricos, percentual de gordura corporal (%GC), circunferência da cintura (CC), glicemia jejum, Índice de Massa Corporal (IMC), aferição da pressão arterial e hábitos de vida. Resultados: Os participantes (n=54) apresentaram idade média de 64,2 ± 10,2 anos e IMC de 29,0 ± 5,4 kg/m2, sendo a maioria mulheres (n=34). Alterações nutricionais e metabólicas foram encontradas entre os avaliados: excesso de peso (77,8%), %GC elevado (92,0%), CC elevada pressupondo risco para complicações associadas à obesidade (85,5%), hipertensão (87,0%) e sedentarismo (66,7%). A glicemia apresentou-se alterada em ambos os sexos (p>0,05), e 16,7% dos diabéticos desconheciam seu diagnóstico. Dos participantes, 5,6% eram tabagistas, 29,6% consumiam bebidas alcoólicas, o fracionamento das refeições foi de 4,2 ± 0,9 vezes/dia e as horas diárias de sono de 7,7 ± 1,3. Conclusão: A maioria dos diabéticos apresentou excesso de peso, %GC e CC elevados e hiperglicemia. Esses resultados, associados à hipertensão, síndrome metabólica, sedentarismo, tabagismo, consumo de bebidas alcoólicas, baixo fracionamento de refeições e desconhecimento sobre seu diagnóstico, podem contribuir para a ocorrência de complicações graves.

Objective: To assess the anthropometric profile, health conditions and lifestyle of patients with diabetes mellitus (DM) enrolled in the HiperDia program (Programa HiperDia) of the Family Health Strategy (Estratégia de Saúde da Família ­ ESF) of Sinop, Mato Grosso. Methods: This was a descriptive cross-sectional study conducted in an ESF located in the center of Sinop, Mato Grosso, from June to October 2013, with patients with diabetes of both genders and age ≥ 18 years. Weight, height, pressoric levels, body fat percentage (BF%), waist circumference (WC), fasting glucose, body mass index (BMI), blood pressure and lifestyle habits were assessed. Results: Participants (n=54) had a mean age of 64.2 ± 10.2 years and BMI of 29.0 ± 5.4 kg/m2, and were mostly women (n=34). Nutritional and metabolic changes were found among participants: excessive weight (77.8%), high BF% (92.0%), high WC suggesting risk for complications associated with obesity (85.5%), hypertension (87.0%) and sedentary lifestyle (66.7%). Glucose was altered in both genders (p>0.05) and 16.7% of the individuals with diabetes were undiagnosed. Of the participants, 5.6% were smokers, 29.6% consumed alcohol, the mean meal fractioning was 4.2 ± 0.9 times/day and the daily sleep hours were 7.7 ± 1.3. Conclusion: Most individuals with diabetes presented excessive weight, high BF% and WC and hyperglycemia. These results, associated with hypertension, metabolic syndrome, sedentary lifestyle, smoking, alcohol consumption, low meal fractioning and unawareness of the diagnosis may contribute to the occurrence of severe complications.

Objetivo: Valorar el perfil antropométrico, las condiciones de salud y el estilo de vida de diabéticos inscritos en el HiperDia de una Estrategia de Salud de la Familia (ESF) de Sinop- MT. Métodos: Se trató de un estudio transversal y descriptivo realizado en una ESF localizada en el centro de Sinop-MT entre junio y octubre de 2013 con diabéticos de ambos los sexos y edad ≥18 años. Se valoró el peso, la altura, los niveles de presión, el porcentual de grasa corporal (%GC), la circunferencia de la cintura (CC), la glucemia en ayunas, el Índice de Masa Corporal (IMC), la medición de la presión arterial y los hábitos de vida. Resultados: Los participantes (n=54) presentaron la edad media de 64,2 ± 10,2 años, el IMC de 29,0 ± 5,4 kg/m2 y la mayoría son mujeres (n=34). Las alteraciones nutricionales y metabólicas encontradas en los participantes fueron: el exceso de peso (77,8%), el %GC elevado (92,0%), la CC elevada lo que contribuye para las complicaciones asociadas con la obesidad (85,5%), la hipertensión (87,0%) y el sedentarismo (66,7%). La glucemia se presentó alterada en ambos los sexos (p>0,05) y el 16,7% de los diabéticos desconocían su diagnóstico. Entre los participantes el 5,6% era tabaquista, el 29,6% consumía bebidas alcohólicas, el fraccionamiento de las comidas fue de 4,2 ± 0,9 veces/día y las horas de sueño al día fue de 7,7 ± 1,3. Conclusión: La mayoría de los diabéticos presentó exceso de peso, el %GC y la CC elevados y hiperglucemia. Eses resultados asociados con la hipertensión, el síndrome metabólico, el sedentarismo, el tabaquismo, el consumo de bebidas alcohólicas, el bajo fraccionamiento de las comidas y el no conocimiento de su diagnostico pueden contribuir para la ocurrencia de complicaciones graves.