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.

Effects of Oral Nutritional Supplementation on Patients with Venous Ulcers: A Clinical Trial.

Background: The dosage and safety of nutritional supplements for patients with venous ulcers are still not well established. Aim: To evaluate the effects of a high calorie, high protein, arginine-, zinc-, and vitamins A, C, and E-enriched nutritional supplement on the biochemical profile, dietary intake, anthropometry, muscle strength, and characteristics of lesions of patients with venous ulcers. Methods: A controlled before−after clinical trial with a four-week follow-up involved 27 patients with venous ulcers under outpatient treatment in Brazil. It was administered in two to three doses per day (200 mL each) of a high-calorie and high-protein supplement enriched with arginine, zinc, and vitamins A, C, and E. Patients were assessed for anthropometric parameters, dietary intake, biochemical tests, and healing conditions according to the Pressure Ulcer Scale for Healing (PUSH). Results: It was observed that an increase in energy and protein supply led to an adequate intake of immunonutrients (zinc and vitamins A, C, and E), increased body weight, increased body mass index, and stronger handgrip strength. The injury area and the score on the PUSH notably decreased after the intervention (p < 0.001). Conclusions: The administered supplement, at the tested dosage, improved the nutritional status and characteristics of lesions in patients with venous ulcers.

Factors that Moderate the Effect of Nitrate Ingestion on Exercise Performance in Adults: A Systematic Review with Meta-Analyses and Meta-Regressions.

To identify how variables such as exercise condition, supplementation strategy, participant characteristics and demographics, and practices that control oral microbiota diversity could modify the effect of inorganic nitrate ingestion (as nitrate salt supplements, beetroot juice, and nitrate-rich vegetables) on exercise performance, we conducted a systematic review with meta-analysis. Studies were identified in PubMed, Embase, and Cochrane databases. Eligibility criteria included randomized controlled trials assessing the effect of inorganic nitrate on exercise performance in healthy adults. To assess the variation in effect size, we used meta-regression models for continuous variables and subgroup analysis for categorical variables. A total of 123 studies were included in this meta-analysis, comprising 1705 participants. Nitrate was effective for improving exercise performance (standardized mean difference [SMD]: 0.101; 95% CI: 0.051, 0.151, P <0.001, I2 = 0%), although nitrate salts supplementation was not as effective (P = 0.629) as ingestion via beetroot juice (P <0.001) or a high-nitrate diet (P = 0.005). Practices that control oral microbiota diversity influenced the nitrate effect, with practices harmful to oral bacteria decreasing the ergogenic effect of nitrate. The ingestion of nitrate was most effective for exercise lasting between 2 and 10 min (P <0.001). An inverse dose-response relation between the fraction of inspired oxygen and the effect size (coefficient: -0.045, 95% CI: -0.085, -0.005, P = 0.028) suggests that nitrate was more effective in increasingly hypoxic conditions. There was a dose-response relation for acute administration (P = 0.049). The most effective acute dose was between 5 and 14.9 mmol provided ≥150 min prior to exercise (P <0.001). An inverse dose-response for protocols ≥2 d was observed (P = 0.025), with the optimal dose between 5 and 9.9 mmol·d-1 (P <0.001). Nitrate, via beetroot juice or a high-nitrate diet, improved exercise performance, in particular, in sessions lasting between 2 and 10 min. Ingestion of 5-14.9 mmol⋅d-1 taken ≥150 min prior to exercise appears optimal for performance gains and athletes should be aware that practices controlling oral microbiota diversity may decrease the effect of nitrate.

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.

Dietary recommendations during the COVID-19 pandemic.

Optimal nutrition can improve well-being and might mitigate the risk and morbidity associated with coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This review summarizes nutritional guidelines to support dietary counseling provided by dietitians and health-related professionals. The majority of documents encouraged the consumption of fruits, vegetables, and whole grain foods. Thirty-one percent of the guidelines highlighted the importance of minerals and vitamins such as zinc and vitamins C, A, and D to maintain a well-functioning immune system. Dietary supplementation has not been linked to COVID-19 prevention. However, supplementation with vitamins C and D, as well as with zinc and selenium, was highlighted as potentially beneficial for individuals with, or at risk of, respiratory viral infections or for those in whom nutrient deficiency is detected. There was no convincing evidence that food or food packaging is associated with the transmission of COVID-19, but good hygiene practices for handling and preparing foods were recommended. No changes to breastfeeding recommendations have been made, even in women diagnosed with COVID-19.

Creatine supplementation does not promote additional effects on inflammation and insulin resistance in older adults: A pilot randomized, double-blind, placebo-controlled trial.

BACKGROUND: A chronic, low-grade inflammation is commonly present in older adults and has been associated with the onset of age-related chronic diseases. Resistance training (RT) and creatine (CR) supplementation emerged as promising strategies to reduce circulating pro-inflammatory cytokines. This study aimed to investigate the effects of CR supplementation combined with RT on markers of inflammation and insulin resistance in community-dwelling older adults. METHODS: In a pilot randomized, double-blind, placebo-controlled trial, participants were allocated to one of the following groups: 1) Creatine supplementation and resistance training (CR + RT, n = 13); 2) Placebo and resistance training (PL + RT, n = 14). While engaged in a 12-week RT program, participants from CR + RT group received 5 g/day of CR monohydrate and participants from PL + RT group received the same dose of maltodextrin. At baseline and at week 12, blood samples were collected for glucose, insulin, adiponectin, leptin, interleukin 6, interleukin 10, monocyte chemo-attractant protein-1 and C-reactive protein analysis. RESULTS: After 12 weeks of intervention, there were no differences between groups in any of the variables analyzed. Monocyte chemoattractant protein-1 was reduced in both groups (CR + RT: -55.66 ± 48.93 pg/mL, p < 0.01, dz = 1.13; PL + RT: -46.52 ± 55.21 pg/mL, p < 0.01, dz = 0.84). CONCLUSION: Resistance training, regardless of CR supplementation, decreased MCP-1 concentration in older adults.

Bioanalytical method by HPLC-FLD for curcumin analysis in supplemented athletes.

In sports, curcumin, a substance derived from the rhizome of Curcuma longa (turmeric) plant with antioxidant effect 8 times greater than vitamin E, has attracted the attention of scientists because of its potent antioxidant action, since in athletes subjected to intense exercise the-endogenous mechanisms of neutralization of reactive species are saturated. However, the pharmacokinetic characteristics of curcumin do not favor its medicinal use due to its low absorption, accelerated metabolism and rapid systemic elimination. Thus, the determination of plasma levels in supplemented patients is a crucial step in their pharmacodynamic evaluation. Therefore, the objective of this work was to develop and validate an analytical method by HPLC-FLD for curcumin evaluation in plasma of supplemented athletes. Luna column (C18; 150 × 4 mm; 3 µm), acetonitrile: acetic acid pH 3.2 (45:55 to 60:40) as mobile phase, flow rate of 1 mL min-1, excitation at 429/285 nm and emission at 529 nm and injection of 10 µL were the chromatographic conditions used. Plasma samples were extracted using ethylacetate and methanol (95: 5, 500 µL) and estradiol (30 µg mL-1) as internal standard, with subsequent stirring (3 min) and centrifugation (8 min) (triple extraction). The organic fraction was evaporated under N2 (20 min) and the dried residue reconstituted in acetonitrile. The method was linear between 44 and 261 ng mL-1, showing intra-day (2.05.6%) and inter-day (4.0-5.1%) precision with accuracy and selectiveness (curcumin tR = 8.7 min and internal standard tR = 13.9 min with relative recovery of 83.2%). So, it can be successfully used for curcumin evaluation in plasma samples from supplemented athletes, as well as being an alternative and advantageous method to UV-Vis and MS/MS in bioavailability studies.

Effects of turmeric extract supplementation on inflammation and muscle damage after a half-marathon race: a randomized, double-blind, placebo-controlled trial.

PURPOSE: Strenuous exercise induces inflammation and muscle damage. Turmeric (Curcuma longa L.) is a widely used spice that exhibits potent anti-inflammatory response and appears to decrease indirect markers of muscle damage. A randomized, double-blind, placebo-controlled trial was conducted to evaluate the effects of Curcuma longa L. extract (CLE) on inflammation and muscle damage after a half-marathon race. METHODS: Twenty-eight healthy, normal-weight men were randomly assigned to one of two groups: (1) CLE (3 capsules per day, 500 mg each); or (2) placebo (PLA, 3 capsules per day, 500 mg of microcrystalline cellulose). Participants received the intervention for 4 weeks and immediately before and after the half-marathon race. Creatine kinase, lactate dehydrogenase, alanine aminotransferase, aspartate aminotransferase, myoglobin, interleukins 6 and 10 were assessed at baseline, immediately before, after, and at 2, 24, and 48 h after the half-marathon race. RESULTS: The half-marathon race increased markers of inflammation and muscle damage. A greater increase in interleukin-10 was observed in the CLE group immediately after the competition compared to the PLA group (7.54 ± 1.45 vs 5.25 ± 0.59 pg/mL; p < 0.05; d = 0.55). Myoglobin concentration was lower 2 h after the race in participants from the CLE group compared to the PLA group (62.10 ± 8.26 vs 107.85 ± 18.45 ng/mL; p = 0.01; d = 0.86). CONCLUSION: Curcuma longa L. extract supplementation leads to an increase in IL-10 and decreased myoglobin in recreational male runners after a half-marathon race. TRIAL REGISTRATION NUMBER: U1111-1179-6335, February 13, 2016.

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.

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.

The effect of artichoke on lipid profile: A review of possible mechanisms of action.

Cardiovascular disease is a highly prevalent issue worldwide, and one of its main manifestations, dyslipidaemia, needs more attention. Cooked artichoke (Cynara scolymus) hearts or artichoke leaf extract (ALE) are believed to be helpful in the treatment of dyslipidaemia. In this narrative review, we provide a brief overview of the potential impact of artichoke consumption on lipid profile. We appraised the Cochrane, MEDLINE and Web of Science databases, and included articles published between 2000 and June 2018 on intervention in humans only. The main potential of ALE administration observed on lipid profile relates to decreased serum LDL, total cholesterol and triglyceride concentrations, although no strong evidence for increasing HDL appears to exist. Evidence suggests that decreases of 8-49 mg/dL for LDL concentration, 12-55 mg/dL for total cholesterol, and 11-51 mg/dL for triglycerides, can be attributed to 2 to 3 g/d of ALE, in which its components luteolin and chlorogenic acid may play a key role. On the other hand, the effects of cooked artichoke hearts can be attributed mainly to its soluble fibres, particularly inulin. Despite the convincing evidence on its health benefits, additional long-term clinical trials are pivotal to fully elucidate the potential effects of ALE administration on positive cardiovascular outcomes.

Green tea extract outperforms metformin in lipid profile and glycaemic control in overweight women: A double-blind, placebo-controlled, randomized trial.

BACKGROUND & AIMS: Both green tea and metformin are used as adjuvants to treat and prevent complications associated with obesity; however, studies comparing their action and interaction in non-diabetic overweight women have not been reported. Thus, the current study evaluated the effects of green tea extract and metformin, both individually and in combination, on type 2 diabetes risk factors in non-diabetic overweight women. METHODS: A total of 120 overweight women were randomly assigned in a double-blind manner to 1 of 4 groups, as follows: control (n = 29; 1 g of cellulose), green tea (n = 32; 1 g of dry green tea extract), metformin (n = 28; 1 g of metformin), and green tea + metformin (n = 31; 1 g of dry green tea extract + 1 g of metformin). Each group took the indicated capsules daily for 12 weeks. Anthropometric measurements, body composition, and fasting blood samples were evaluated. RESULTS: Although no significant interactions were observed in glycaemic control (p = 0.07), green tea in the absence of metformin reduced fasting glucose (-4.428 ± 2.00; p = 0.031), but when combined the lowering effect was nullified. In contrast, metformin increased HbA1c concentration (0.048 ± 0.189%; p = 0.017) and also reduced body weight (-1.318 ± 0.366 kg; p = 0.034) and LM (lean mass) (-1.249 ± 0.310; p = 0.009). Regarding lipid parameters, green tea significantly reduced total cholesterol and LDL-c. CONCLUSIONS: Green tea was superior to metformin in improving glycaemic control and lipid profile in non-diabetic overweight women and, therefore, green tea extract is a promising alternative for reducing type 2 diabetes risk in overweight women.

Creatine supplementation and glycemic control: a systematic review.

The focus of this review is the effects of creatine supplementation with or without exercise on glucose metabolism. A comprehensive examination of the past 16 years of study within the field provided a distillation of key data. Both in animal and human studies, creatine supplementation together with exercise training demonstrated greater beneficial effects on glucose metabolism; creatine supplementation itself demonstrated positive results in only a few of the studies. In the animal studies, the effects of creatine supplementation on glucose metabolism were even more distinct, and caution is needed in extrapolating these data to different species, especially to humans. Regarding human studies, considering the samples characteristics, the findings cannot be extrapolated to patients who have poorer glycemic control, are older, are on a different pharmacological treatment (e.g., exogenous insulin therapy) or are physically inactive. Thus, creatine supplementation is a possible nutritional therapy adjuvant with hypoglycemic effects, particularly when used in conjunction with exercise.

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.

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.

[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]. / A suplementação de L-carnitina não promove alterações na taxa metabólica de repouso e na utilização dos substratos energéticos em indivíduos ativos.

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, VO(2max), 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/m(2)), 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 VO(2max) (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.

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.

Cirurgia e terapia nutricional oral: [revisão] / Surgery and oral nutritional therapy: [review] / La cirugía y la terapia nutricional oral: [revisión]

O trauma cirúrgico está associado ao hipermetabolismo e influencia o estado nutricional dos pacientes, constituindo-se em fator de risco e de complicações pós-cirúrgicas. Um dos principais fatores relacionados ao alto índice de mortalidade pós-operatória é a desnutrição protéico-calórica, frequentemente observada entre os pacientes hospitalizados no momento da admissão hospitalar, e agravada durante a hospitalização. O aumento das necessidades protéico-energéticas do paciente cirúrgico decorre da ativação de mecanismos fisiológicos de adptação metabólica. Dentre as alterações metabólicas, ocorrem simultaneamente as alterações hormonais e de citocinas propícias para o desenvolvimento da resposta inflamatória sistêmica. Desse modo, há a necessidade de avaliação nutricional para suprir o gasto protéico-energético adicional. Diversos estudos têm mostrado que o jejum pré e pós-cirurgia não é uma regra geral. Além disso, a terapia nutricional com o uso de suplementos nutricionais orais, bem como a teraa imunomoduladora, aparecem como aliadas em reduzir o impacto dos processos hipercatabólicos e a incidência de complicações pós-cirúrgicas. Por isso, o objetivo do presente trabalho foi mostrar a importância da avaliação do estado nutricional na prática hospitalar e descrever os benefícios do uso da terapia nutricional oral.

Surgical trauma is associated with hypermetabolism and influence the nutritional status of patients, constituting a risk factor and post-surgical complications. One of the main factors behind the high rate of postoperative mortality is the protein-calorie malnutrition often observed among patients hospitalized at the time of hospital admission, and worsened during hospitalization. The increase in protein-energy needs of the surgical patient follows the activation of physiological mechanisms of metabolic adptação. Among the metabolic changes, hormonal changes occur simultaneously and cytokines conducive to the development of systemic inflammatory response. Thus, there is a need for nutritional assessment to meet the additional protein-energy spending. Several studies have shown that fasting and post-surgery is not a general rule. In addition, nutritional therapy with the use of oral nutritional supplements, as well as therapeutic immunomodulation, as allies appear to reduce the impact of processes hypercatabolic and the incidence of postoperative complications. Therefore, the objective of this study was to show the importance of assessing nutritional status in hospital practice and describe the benefits of the use of oral nutritional therapy.

Trauma quirúrgico se asocia con hipermetabolismo e influir en el estado nutricional de los pacientes, lo que constituye un factor de riesgo y las complicaciones post-quirúrgicas. Uno de los principales factores que explican la alta tasa de mortalidad postoperatoria es la desnutrición proteico-calórica observa con frecuencia entre los pacientes hospitalizados en el momento de ingreso en el hospital, y se agravó durante la hospitalización. El aumento de las necesidades energéticas de la proteína del paciente quirúrgico sigue a la activación de los mecanismos fisiológicos del metabolismo adptação. Entre los cambios metabólicos, los cambios hormonales ocurren simultáneamente y citoquinas propicio para el desarrollo de la respuesta inflamatoria sistémica. Por lo tanto, hay una necesidad de una evaluación nutricional adicional para cumplir con las proteínas-el gasto de energía. Varios estudios han demostrado que el ayuno y post-cirugía no es una regla general. Además, la terapia nutricional con el uso de suplementos nutricionales orales, así como la inmunomodulación terapéutica, como aliados parecen reducir el impacto de los procesos de hipercatabolismo y la incidencia de complicaciones postoperatorias. Por lo tanto, el objetivo de este estudio fue demostrar la importancia de evaluar el estado nutricional en la práctica hospitalaria y describir los beneficios de la utilización de la terapia nutricional oral.

Aplicações clínicas da suplementação de L-carnitina / Clinical uses of L-carnitine supplementation

A carnitina, uma amina quaternária (3-hidroxi-4-N-trimetilamino-butirato), é sintetizada no organismo (fígado, rins e cérebro) a partir de dois aminoácidos essenciais: lisina e metionina, exigindo para sua síntese a presença de ferro, ácido ascórbico, niacina e vitamina B6. Tem função fundamental na geração de energia pela célula, pois age nas reações transferidoras de ácidos graxos livres do citosol para mitocôndrias, facilitando sua oxidação e geração de adenosina Trifosfato. A concentração orgânica de carnitina é resultado de processos metabólicos - como ingestão, biossíntese, transporte dentro e fora dos tecidos e excreção - que, quando alterados em função de diversas doenças, levam a um estado carencial de carnitina com prejuízos relacionados ao metabolismo de lipídeos. A suplementação de L-carnitina pode aumentar o fluxo sangüíneo aos músculos devido também ao seu efeito vasodilatador e antioxidante, reduzindo algumas complicações de doenças isquêmicas, como a doença arterial coronariana, e as conseqüências da neuropatia diabética. Por esse motivo, o objetivo do presente trabalho foi descrever possíveis benefícios da suplementação de carnitina nos indivíduos com necessidades especiais e susceptíveis a carências de carnitina, como os portadores de doenças renais, neuropatia diabética, síndrome da imunodefeciência adquirida e doenças cardiovasculares.