Empowering frail older adults: multicomponent elastic-band exercises and BCAA supplementation unleash physical health and preserve haematological biomarkers.

The effectiveness of Branched Chain Amino Acids (BCAAs) supplementation on enhancing exercise performance in both young and older adults remains a topic of debate. Recent research suggests that BCAAs combined with regular exercise might have an impact on human erythropoiesis, blood dynamics, and iron homeostasis. Given the increasing longevity of the global population, it is crucial to investigate the potential benefits of BCAA supplementation and regular exercise as non-pharmacological interventions for improving the overall health of frail older adults. To assess the influence of a 40-week multicomponent exercise intervention (MEP) combined BCCA supplementation on the haematological indicators of frail older adults (83-93 years old) residing in nursing homes. A prospective, naturalistic, controlled clinical trial employing an intervention-washout-intervention was conducted for this purpose. The study included four experimental groups: MEP plus BCAA supplementation (MEP + BCAA, n = 8), MEP only (n = 7), BCAA supplementation only (n = 7), and control group non exercising (CG, n = 13). Fried's physical frailty (PF) protocol was employed to stratify the participants. Additionally, the assessment included the evaluation of nutritional status, comorbidities, and anthropometric measurements. Among the several haematological markers examined, only mean cellular Haemoglobin Concentration (MCH) [F = 4.09; p < 0.03] and Mean Cell haemoglobin Concentration (MCHC) [F = 10, 323; p < 0,0001] showed significant effects of time group. Our findings demonstrate that a long-term intervention with BCAA plus MEP did not lead to significant alterations in the haematological profile. An 8-week withdrawal from interventions did not affect the frailty status in the MEP and MEP + BCAA groups, whereas the control group exhibited an increase in PF status. The findings, demonstrating the potential pro-immune effect and maintenance of MCH and MCHC levels, highlight the relevance of incorporating exercise and nutritional strategies to promote healthy aging. This study contributes to the achievement of the United Nations Sustainable Development Goals 3 (good health and well-being) and 10 (reduced Inequalities) for all.

Effect of a 40-weeks multicomponent exercise program and branched chain amino acids supplementation on functional fitness and mental health in frail older persons.

BACKGROUND: The ageing process implies several physiological and psychological changes that hence affect the general health, mood states, and quality of life of older persons. Exercise and adequate nutrition are renowned non-pharmacological strategies that significantly delay and alleviate the adverse consequences of the ageing process. This study aimed to evaluate the effects of branched-chain amino acid (BCAA) supplementation and a multicomponent exercise program (ME) on the physical frailty and mood states of older persons. METHODS: 35 participants (women and men; 83 ± 3 years old) from residential care homes were submitted to a 40-week exercise-washout-retraining intervention (16 weeks of the elastic band based exercise and/or supplementation, 8 weeks of washout, and 16 weeks of multicomponent exercise and/or resupplementing), with or without BCAA supplementation. The experimental groups were: (i) ME plus BCAA supplementation (ME+BCAA); (ii) ME; (iii) BCAA supplementation (BCAA), and (iv) control group (CG). Fried's phenotype was used to assess frailty prevalence. Geriatric Depression Scale (GDS), Profile of Mood State (POMS), Mini-Mental State Examination (MMSE), were used to access mental health and cognition. The Short Physical Performance Battery (SPPB) was used to access functional capacity. Salivary testosterone levels (ST) were also determined to access the anabolic effects of the intervention. RESULTS: Exercise was effective in improving functional capacity and prevented the increase in frailty that occurred in the non-exercising CG, where the frailty scores increased over time (p < 0.01). BCAAs supplement alone had no impact on functional fitness, but in a short time (16 weeks) contributed to diminishing frailty and combined with exercise may have the potential to reduce the effect of a detraining period on functional capacity. Salivary testosterone levels correlated with handgrip strength and could be a useful indicator of susceptibility to frailty. No effects were found for mood states, cognition, and depression. CONCLUSION: This study showed that a long-term exercise program, independent of being multicomponent or strength elastic band-based, was effective in improving functional capacity and prevented an increase in frailty in frail and pre-frail older persons living in residential care homes.

Physical Exercise: A Versatile Anti-Inflammatory Tool Involved in the Control of Hypothalamic Satiety Signaling.

The hypothalamus plays a critical role in the control of food consumption and energy expenditure. Fatty diets can elicit an inflammatory response in specific hypothalamic cells, including astrocytes, tanycytes, and microglia, disrupting anorexigenic signals in region-specific hypothalamic neurons, contributing to overeating and body weight gain. In this study, we present an update regarding the knowledge of the effects of physical exercise on inflammatory signaling and circuits to control hunger in the hypothalamus in obesity conditions. To try to understand changes in the hypothalamus, we review the use of magnetic resonance/anorexigenic hormone analysis in humans, as well as in animal models to explore the physiological and molecular mechanism by which exercise modulates satiety signals, such as the central anti-inflammatory response, myokine delivery from skeletal muscle, and others. The accumulation of scientific evidence in recent years allows us to understand that exercise contributes to weight control, and it is managed by mechanisms that go far beyond "burning calories."

Effect of Training-Detraining Phases of Multicomponent Exercises and BCAA Supplementation on Inflammatory Markers and Albumin Levels in Frail Older Persons.

Nowadays, it is accepted that the regular practice of exercise and branched-chain amino acids supplementation (BCAAs) can benefit the immune responses in older persons, prevent the occurrence of physical frailty (PF), cognitive decline, and aging-related comorbidities. However, the impact of their combination (as non-pharmacological interventions) in albumin and the inflammatory markers is not fully understood. Therefore, we investigated the effect of a 40-week multifactorial intervention [MIP, multicomponent exercise (ME) associated or not with BCAAs] on plasma levels of inflammatory markers and albumin in frail older persons (≥75 years old) living at residential care homes (RCH). This study consisted of a prospective, naturalistic, controlled clinical trial with four arms of multifactorial and experimental (interventions-wahshout-interventions) design. The intervention groups were ME + BCAAs (n = 8), ME (n = 7), BCAAs (n = 7), and control group (n = 13). Lower limb muscle-strength, cognitive profile, and PF tests were concomitantly evaluated with plasma levels of albumin, anti- and pro-inflammatory cytokines [Interleukin-10 (IL-10) and Tumor Necrosis Factor-alpha (TNF-α) respectively], TNF-α/IL-10 ratio, and myeloperoxidase (MPO) activity at four different time-points: Baseline (T1), after 16 weeks of multifactorial intervention (T2), then after a subsequent 8 weeks washout period (T3) and finally, after an additional 16 weeks of multifactorial intervention (T4). Improvement of cognitive profile and muscle strength-related albumin levels, as well as reduction in the TNF-α levels were found particularly in ME plus BCAAs group. No significant variations were observed over time for TNF-α/IL-10 ratio or MPO activity. Overall, the study showed that MIP triggered slight alterations in the inflammatory and physical function of the frail older participants, which could provide independence and higher quality of life for this population.

Taurine supplementation reduces myeloperoxidase and matrix-metalloproteinase-9 levels and improves the effects of exercise in cognition and physical fitness in older women.

Immunosenescence contributes to cognitive impairment and neurodegeneration, and those conditions could be attenuated by non-pharmacological anti-inflammatory strategies, such as exercise and supplementation with the amino acid taurine. Since taurine body content decreases with aging, we investigated the effects of supplementation (alone and combined with exercise) on oxidative stress, extracellular matrix degradation, white blood cells, neurotrophins, cognition and physical fitness of elderly women. Forty-eight women (83.58 ± 6.98 years) were enrolled into exercise training only (EO: n = 13), taurine supplementation (TS: n = 12), exercise training + taurine supplementation (ETTS: n = 11), and control group (CG: n = 12). All interventions lasted 14 weeks. Exercise was applied twice a week, and taurine was given once a day (1.5 g). Data collection occurred before and after interventions with the determination of myeloperoxidase (MPO), matrix metalloproteinase-9 (MMP-9), brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) levels, and white blood cell counts (WBC). Montreal cognitive assessment (MoCA) and physical fitness tests were also evaluated. Concentration of MPO and MMP-9 decreased after intervention in TS (p < 0.05). No effect of time or time × group was observed for WBC parameters; however, univariate analysis showed a significant decrease in lymphocytes for TS, while an increase in monocytes occurred in the CG (p < 0.05). MoCA scores decreased over time in the CG (p < 0.05). Improvements in physical fitness occurred in ETTS (better agility and aerobic capacity), mostly likely due to exercise and boosted by taurine supplementation. No changes in BDNF levels were observed (p > 0.05), while NGF concentration were undetectable in almost subjects. Exercise together with taurine supplementation appears to be a valuable strategy to enhance health-related outcomes in older persons.

Chair-based exercise programs in institutionalized older women: Salivary steroid hormones, disabilities and frailty changes.

PURPOSE: Many people experience aging-related losses in different physical domains, which leads to a condition often called physical frailty (PF). The aim of this study was to analyse the effects of two different, 28-weeks, class chair-exercise protocols on salivary steroid hormones (SH), PF, and functional disabilities (FD) in frail older women. METHODS: A sample of older frail individuals (n = 60, 817.84 years) participated in the study and were divided into three groups: chair elastic-band muscle strength exercises (CSE), n = 20), chair-multimodal exercise (CME, n = 21) and a control non-exercise group (CGne, n = 19). Both exercise programs consisted of 45 min of supervised chair-based exercise group classes, carried out 3 times/week. CME participants performed a progressive training using walking, mobility and body weight resistance exercises. The CSE participants exercised using an elastic-band system of progressive exercises. Both CSE and CME followed a circuit training protocol. The controls did not change their usual lifestyle. The indicators of PF, FD and SH concentrations were analyzed before and after the intervention. RESULTS: Both exercise programs diminished the PF status showing significant time and time versus treatment interactions (p < .01). An increase in the CME group, between baseline and 14-weeks, and in the CSE group, after 28 weeks, for Testosterone concentrations was observed (p < .01). Dehydroepiandrosterone (DHEA) increased after 28-weeks in the CME group and decreased in the CGne after the same period (p < .05). Both exercise programs decreased the negative scores of several FD domains, specially fear of falling that showed significant effects with time (p < .01), and time vs intervention (p < .05). CONCLUSION: Both chair-exercise based programs were effective in stimulating positive changes in physical health and in steroid hormone responses, especially in DHEA. The control group did show a negative trend towards an increased PF status and decreased levels of SH. It is crucial for public health to identify the main factors associated with Functional Disability and Physical Frailty that underlie the development of new methods for complementary therapies, such as the use of low doses of hormonal supplementation combined with long-term exercise interventions.

Exercise and taurine in inflammation, cognition, and peripheral markers of blood-brain barrier integrity in older women.

Immunosenescence contribute to increase the blood-brain barrier (BBB) permeability, leading cognitive impairment and neurodegeneration. Thus, we investigated the anti-inflammatory effect of exercise and taurine supplementation on peripheral markers of BBB, inflammation, and cognition of elderly women. Forty-eight elderly women (age, 83.58 ± 6.9 years) participated in the study, and were allocated into combined exercise training (CET: n = 13), taurine supplementation (TAU: n = 12), exercise training associated with taurine (CET+TAU: n = 11), or control (CG: n = 12) groups. Exercise was applied twice a week (multi-modal exercise). Taurine ingestion was 1.5 g., once a day. Participants were evaluated before and after 14-weeks of intervention. Plasma levels of interleukin (IL)-1ß, IL-1ra, IL-6, IL-10, IL-17, tumor necrosis factor alpha (TNF-α), and serum concentration of S100ß and neuron specific enolase (NSE) were determined. The mini mental state examination (MMSE) was also applied. Concentrations of S100ß were maintained in all intervention groups, while a subtle increase in the CG was found. NSE levels increased only in TAU group (p < 0.05). CET reduced TNF-α, IL-6, and IL-1ß/IL-1ra, IL-6/IL10, and TNF-α/IL-10 ratios (p < 0.05). TAU decreased the IL-1ß/IL-1ra ratio (p < 0.05). MMSE score increased only in the CET+TAU group (p < 0.05). Multiple regression analysis showed that there was a trend for changes in IL-1ß and the Charlson Comorbidity Index to be independently associated with changes in S100ß. Exercise and taurine decreased inflammation, and maintained the BBB integrity in elderly women. Exercise emerged as an important tool to improve brain health even when started at advanced ages.

Avaliação comparativa do teor de cloro ativo e oxigênio dos irrigantes utilizados na terapia endodôntica / Comparative evaluation of chlorine tenor and liberation by irrigants used in endodontic therapy

O presente estudo objetivou determinar os teores de cloro e oxigênio em ppm, quando empregado hipoclorito de sódio (NaOCl) nas concentrações de 0,5%; 1,0% e 5,0% associado com peróxido de hidrogênio (H2O2) 3%, ácido cítrico 10% e EDTA 17%. Avaliaram-se, também, as reações do creme Endo PTC com NaOCl 0,5% e 5%. A determinação do teor de cloro (Cl2) foi realizada no espectrofotômetro ultravioleta visível analógico pelo método alaranjado de metila. O teor de oxigênio (O2) foi analisado volumetricamente pelo método de Winkler. O tempo reacional para produzir cloro e oxigênio foi 3 minutos. Padronizou-se o volume em 10 ml para as soluções testadas. Para realizar a reação do creme Endo PTC, utilizou-se 0,2 g com 2 ml das soluções de NaOCl 0,5% e 5,0%, no mesmo período de tempo. Os resultados demonstraram que a produção de CL2 foi encontrada nas reações entre NaOCl com ácido cítrico (0,07; 0,11 e 0,15 ppm) e com EDTA (0,01; 0,05 e 0,08 ppm). A produção de O2 foi encontrada nas reações do NaOCl com H2O2 (0,03; 0,18 e 0,49 ppm). Na reação com Endo PTC e NaOCl a 0,5% e 5,0%, observou-se também a produção de O2 (0,08 e 0,43 ppm), porém o gás cloro Cl2 só foi constatado na reação com NaOCl 5,0% (0,06 ppm). Concluiu-se que formação de Cl2 foi maior quando NaOCl 5% reagiu com ácido cítrico. A maior formação de O2 foi encontrada na reação de NaOCl 5% com H2O2, assim como na reação do NaOCl 5% com Endo PTC.

Efeito quelante do ácido cítrico a 10 por cento e EDTA a 17 por cento sobre Ca++ da dentina radicular / Effect of chelating by 10 per cent citric acid and 17 per cent EDTA on Ca++ from root canal dentin

Baseou-se verificar in vitro a capacidade de quelaçäo de íons de cálcio (Ca++) da dentina dos canais radiculares, quando do emprego de EDTA a 17 por cento e ácido cítrico a 10 por cento. A determinaçäo do teor de cálcio nas amostras foi feita pela espectrofotometria de absorçäo atômica. Os valores das leituras foram analisados estatisticamente tendo como nível crítico de significância 5 por cento. Considerando os intervalos de tempo de 3, 10 e 15 minutos versus substâncias, näo existiu diferença significativa entre o ácido cítrico a 10 por cento e EDTA a 17 por cento (p>0,05)

Prescriçäo de chás para crianças menores de seis meses: a opiniäo dos médicos de uma cidade de porte médio no sul do Brasil / Prescription of herbal teas for children under six months of age: the opinion of physicians from a middle size city in Southern Brazil

Através de listagem dos médicos que atendiam crianças no final de 1993 em Pelotas, RS, acadêmicos de Medicina da Universidade Federal de Pelotas aplicaram questionário padronizado sobre recomendaçäo de chás para crianças menores de seis meses, fatores de risco associados ao seu uso e noçöes básicas de aleitamento materno. Cerca de metade dos entrevistados recomendava o uso de chás. Os principais motivos foram para o tratamento de cólicas intestinais(35 por cento), suplementaçäo à dieta(21 por cento)e reidrataçäo oral(18 por cento).A associaçäo entre o uso de chás e a ocorrência de diarréia foi mencionada por apenas 19 por cento dos entrevistados, enquanto que com desnutriçäo e desmame precoce foram, respectivamente,47 por cento e 83 por cento. Estas associaçöes mostraram-se significativas(P<0,05)mesmo após ajuste por tempo de formado e realizaçäo de residência ou especializaçäo em Pediatria. Os resultados revelam que boa parte dos médicos entrevistados näo vem manejando de forma adequada aspectos comuns relacionados à dieta infantil, o que é preocupante em virtude da sua repercussäo negativa sobre a saúde dessas crianças.