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BACKGROUND: Deregulation of orexigenic and anorexigenic pathways occurs among adolescents with obesity. Alpha-melanocyte-stimulating hormone (α-MSH) is a key catabolic mediator of energy homeostasis and an important anorexigenic neuropeptide in the control of energy balance and thermogenesis. However, it was not well explored if α-MSH can modulate long-term weight loss therapy responses in a dependent manner according to its concentration. Our hypothesis is that a high α-MSH concentration at baseline promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents. METHODS: One hundred ten post-pubertal obese adolescents (body mass index >95th percentile) were submitted to 1 year of interdisciplinary therapy (clinical, nutritional, psychological, physical exercise, and physiotherapy support). Body composition and plasma levels of α-MSH, neuropeptide Y (NPY), melanin-concentrating hormone, and agouti-related peptide (AgRP) were measured before and after therapy. The volunteers were grouped on the basis of Tertiles of α-MSH concentration: Low (<0.75 ng/mL), Medium (≤0.76 to ≥1.57 ng/mL), and High (>1.57 ng/mL). Significance was set as p < 0.05. RESULTS: The treatment promoted a significant improvement in body adiposity and fat free mass for all groups. It is important to note that only in the high α-MSH group, a significant increase of the α-MSH/NPY ratio and decrease NPY/AgRP ratio post treatment were observed. CONCLUSION: The high α-MSH concentration promotes better modulation of anorexigenic/orexigenic pathways in obese adolescents following long-term weight loss therapy and this is important in clinical practice.
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Metabolismo Energético , Obesidad Infantil/sangre , Obesidad Infantil/terapia , Pérdida de Peso , alfa-MSH/sangre , Adolescente , Ejercicio Físico , Terapia por Ejercicio , Femenino , Humanos , Hormonas Hipotalámicas/sangre , Masculino , Melaninas/sangre , Neuropéptido Y/sangre , Hormonas Hipofisarias/sangreRESUMEN
Investigations suggest the benefits of low-level laser therapy (LLLT) to improve noninvasive body contouring treatments, inflammation, insulin resistance and to reduce body fat. However, the mechanism for such potential effects in association with exercise training (ET) and possible implications in browning adiposity processes remains unclear. Forty-nine obese women were involved, aged between 20 and 40 years with a body mass index (BMI) of 30-40 kg/m2. The volunteers were divided into Phototherapy (808 nm) and SHAM groups. Interventions consisted of exercise training and phototherapy applications post exercise for 4 months, with three sessions/week. Body composition, lipid profile, insulin resistance, atrial natriuretic peptide (ANP), WNT5 signaling, interleukin-6 (IL-6), and fibroblast growth factor-21 (FGF-21) were measured. Improvements in body mass, BMI, body fat mass, lean mass, visceral fat, waist circumference, insulin, HOMA-IR, total cholesterol, LDL-cholesterol, triglycerides, and ANP in both groups were demonstrated. Only the Phototherapy group showed a reduction in interleukin-6 and an increase in WNT5 signaling. In addition, it was possible to observe a higher magnitude change for the fat mass, insulin, HOMA-IR, and FGF-21 variables in the Phototherapy group. In the present investigation, it was demonstrated that exercise training associated with LLLT promotes an improvement in body composition and inflammatory processes as previously demonstrated. The Phototherapy group especially presented positive modifications of WNT5 signaling, FGF-21, and ANP, possible biomarkers associated with browning adiposity processes. This suggests that this kind of intervention promotes results applicable in clinical practice to control obesity and related comorbidities.
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Tejido Adiposo/patología , Biomarcadores/metabolismo , Transdiferenciación Celular/efectos de la radiación , Ejercicio Físico/fisiología , Terapia por Luz de Baja Intensidad , Obesidad/fisiopatología , Obesidad/radioterapia , Adulto , Índice de Masa Corporal , Femenino , Humanos , Inflamación , Insulina/metabolismo , Resistencia a la Insulina , Grasa Intraabdominal , Fototerapia , Transducción de Señal , Proteína Wnt-5a/metabolismo , Adulto JovenRESUMEN
Introduction: Cashew nut contains bioactive compounds that modulate satiety and food intake, but its effects on body fat during energy restriction remains unknown. This study aimed to assess the effects of cashew nut and cashew nut oil on body fat (primary outcome) as well as adiposity, cardiometabolic and liver function markers (secondary outcomes). Materials and methods: An eight-week (8-wk) randomized controlled-feeding study involved 68 adults with overweight/obesity (40 women, BMI: 33 ± 4 kg/m2). Participants were randomly assigned to one of the energy-restricted (-500 kcal/d) groups: control (CT, free-nuts), cashew nut (CN, 30 g/d), or cashew nut oil (OL, 30 mL/d). Body weight, body composition, and blood collection were assessed at the baseline and endpoint of the study. Results: After 8-wk, all groups reduced significantly body fat (CT: -3.1 ± 2.8 kg; CN: -3.3 ± 2.7 kg; OL: -1.8 ± 2.6 kg), body weight (CT: -4.2 ± 3.8 kg; CN: -3.9 ± 3.1 kg; OL: -3.4 ± 2.4 kg), waist (CT: -5.1 ± 4.6 cm; CN: -3.9 ± 3.9 cm; OL: -3.7 ± 5.3 cm) and hip circumferences (CT: -2.9 ± 3.0 cm; CN: -2.7 ± 3.1 cm; OL: -2.9 ± 2.3 cm). CN-group reduced liver enzymes (AST: -3.1 ± 5.3 U/L; ALT: -6.0 ± 9.9 U/L), while the OL-group reduced LDL-c (-11.5 ± 21.8 mg/dL) and atherogenic index (-0.2 ± 0.5). Both intervention groups decreased neck circumference (CN: -1.0 ± 1.2 cm; OL: -0.5 ± 1.2 cm) and apo B (CN: -6.6 ± 10.7 mg/dL; OL: -7.0 ± 15.3 mg/dL). Conclusion: After an 8-wk energy-restricted intervention, all groups reduced body fat (kg), weight, and some others adiposity indicators, with no different effect of cashew nut or cashew nut oil. However, participants in the intervention groups experienced additional reductions in atherogenic marker, liver function biomarkers, and cardiovascular risk factors (neck circumference and apo B levels), with these effects observed across the OL group, CN group, and both intervention groups, respectively.Clinical trial registration:https://ensaiosclinicos.gov.br/rg/RBR-8xzkyp2, identifier 8xzkyp2.
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Obesity, a complex disease that involves energy imbalance and chronic low-grade inflammation, is implicated in the pathogenesis of several chronic non-communicable diseases. As dietary components modulate the human body's inflammatory status, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed in 2009 to characterize the inflammatory potential of a habitual diet. Abundant research has been conducted to investigate the associations between DII and obesity. In this narrative review, we examined the current state of the science regarding the relationships between DII and the inflammatory pathophysiological aspects related to obesity. DII is associated with inflammation in obesity. The most pro-inflammatory diet was directly related to higher levels of pro-inflammatory markers, which included C-reactive protein (CRP), interleukin-6 (IL-6), IL-1ß, and tumor necrosis factor-α (TNF-α). Therefore, evidence suggests that the use of the DII may be useful for understanding the relationship between diet and the inflammatory process related to obesity.
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Dieta , Obesidad , Humanos , Biomarcadores , Obesidad/complicaciones , Inflamación , Proteína C-Reactiva/análisisRESUMEN
BACKGROUND: The action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations. OBJECTIVE: To evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity. METHODS: 73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels. RESULTS: Both groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only. CONCLUSION: This study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.
FUNDAMENTO: A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. OBJETIVO: Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. MÉTODOS: 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). RESULTADOS: Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. CONCLUSÃO: Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.
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Enfermedades Cardiovasculares , Síndrome Metabólico , Obesidad Infantil , Adolescente , Factor Natriurético Atrial/metabolismo , Composición Corporal , Índice de Masa Corporal , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Niño , Humanos , Síndrome Metabólico/epidemiología , Obesidad Infantil/terapia , Pérdida de Peso/fisiologíaRESUMEN
STUDY OBJECTIVES: Patients with congestive heart failure (CHF) frequently exhibit an elevated ratio of minute ventilation over CO2 output (VE/VCO2 slope) while undergoing exercise tests. One of the factors contributing to this elevated slope is an increased chemosensitivity to CO2 in that this slope significantly correlates with the slope of the ventilatory response to CO2 rebreathing at rest. A previous study in patients with CHF and central sleep apnea showed that the highest VE/VCO2 slope during exercise was associated with the most severe central sleep apnea. In the current study, we tested the hypothesis that in patients with CHF and obstructive sleep apnea (OSA), the highest VE/VCO2 slope is also associated with the most severe OSA. If the hypothesis is correct, then it implies that in CHF, augmented instability in the negative feedback system controlling breathing predisposes to both OSA and central sleep apnea. METHODS: This preliminary study involved 70 patients with stable CHF and a spectrum of OSA severity who underwent full-night polysomnography, echocardiography, and cardiopulmonary exercise testing. Peak oxygen consumption and the VE/VCO2 slope were calculated. RESULTS: There was significant positive correlation between the apnea-hypopnea index and the VE/VCO2 slope (r = .359; P = .002). In the regression model, involving the relevant variables of age, body mass index, sex, VE/VCO2 slope, peak oxygen consumption, and left ventricular ejection fraction, the apnea-hypopnea index retained significance with VE/VCO2. CONCLUSIONS: In patients with CHF, the VE/VCO2 slope obtained during exercise correlates significantly to the severity of OSA, suggesting that an elevated CO2 response should increase suspicion for the presence of severe OSA, a treatable disorder that is potentially associated with excess mortality. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Comparison Between Exercise Training and CPAP Treatment for Patients With Heart Failure and Sleep Apnea; URL: https://clinicaltrials.gov/ct2/show/record/NCT01538069; Identifier: NCT01538069. CITATION: Bittencourt L, Javaheri S, Servantes DM, Pelissari Kravchychyn AC, Almeida DR, Tufik S. In patients with heart failure, enhanced ventilatory response to exercise is associated with severe obstructive sleep apnea. J Clin Sleep Med. 2021;17(X):1875-1880.
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Insuficiencia Cardíaca , Apnea Obstructiva del Sueño , Ejercicio Físico , Prueba de Esfuerzo , Tolerancia al Ejercicio , Insuficiencia Cardíaca/complicaciones , Humanos , Consumo de Oxígeno , Apnea Obstructiva del Sueño/complicaciones , Volumen Sistólico , Función Ventricular IzquierdaRESUMEN
BACKGROUND: The purpose of the present study was to compare the impact of semi-intensive and intensive interdisciplinary weight-loss therapies on the treatment of metabolic syndrome (MS) and selected inflammatory markers in adolescents with obesity. METHODS: The study included 166 adolescents enrolled in two groups for 22 weeks: the intensive group (in-person aerobic and resistance exercise three times a week, and psychological and nutritional counselling once a week), or the semi-intensive group (six in-person exercise orientation meetings and six in-person psychological support sessions with an online nutritional and exercise program). Anthropometric parameters, blood pressure, fasting glucose, insulin, lipid profile, triglycerides (TG), leptin and adiponectin were assessed before and after the interventions. RESULTS: Body weight and waist circumference decreased in both groups (P<0.001) and large effect sizes (η2= 0.586 and η2=0.465, respectively) were noted. Significant time and group interactions were found (P=0.001) with medium effect sizes (η2=0.095 and η2=0.105, respectively). The prevalence of MS decreased from 27.9% to 13.1% (P=0.012) and 29.4% to 5.9% (P=0.004) in the semi-intensive and intensive groups, respectively. All MS risk factors decreased significantly over time (P<0.001) and a significant time*group interaction was observed (P<0.05), except for fasting TG (P=0.832) and glucose (P=0.128, η2=0.021). CONCLUSION: The results suggested that both approaches promoted significant clinical improvement in the condition of adolescents with MS and reduced associated risk factors. Studies that consider the cost effectiveness of both treatments are still needed to determine whether semi-intensive care, with its lower financial costs, may be a suitable option to treat obesity and MS in adolescents with obesity.
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OBJECTIVE: The aim of this study was to investigate the association between the magnitude of weight loss (WL) and serum concentrations of the main adipocytokines and appetite-regulating hormones in adolescents with obesity. METHODS: After completion of informed consent,108 adolescents with obesity (14-19 y of age; postpubertal) were submitted to clinical, nutritional, psychological, physical exercise, and physiotherapy support for 1 y. Body composition (BC) and plasma levels of neuropeptides (neuropeptide Y [NPY], agouti-related peptide [AgRP], and α-melanocyte-stimulating hormone [α-MSH]) and leptin were measured at baseline and post-intervention. RESULTS: After therapy, adolescents who lost <10% body weight and <10% body weight (were compared. Both groups presented improvements in BC and reduced leptin. The Δα-MSH, Δα-MSH/AgRP ratio, and Δα-MSH/NPY ratio were lower and AgRP and NPY variations were higher in the low weight loss group. The leptin concentration was close to normal in the high weight loss only. The ΔWeight, Δα-MSH and Δleptin were associated with body fat loss by multiple linear regressions for all samples. CONCLUSION: Weight loss >10% seems to reverse obesity-induced hyperleptinemia while stabilizing the neuropeptides that control appetite in adolescents with obesity. We were able to produce a prognostic mathematical model to predict body fat loss using weight, leptin, and α-MSH variations.
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Ghrelina , Pérdida de Peso , Adipoquinas , Adolescente , Apetito , Humanos , Leptina , Obesidad/terapia , alfa-MSHRESUMEN
Objective Fibroblast growth factor 21 (FGF21) is among the activators that can stimulate thermogenesis in the white adipose tissue and brown adipose tissue. People with obesity have elevated blood levels of FGF21, but also develop resistance to its action, impairing its beneficial role. Inversely, clinical treatments to weight loss has been pointed out as an important therapy for increasing and recovering sensitivity to FGF21. The aim was to analyse the effect of long-term weight loss interdisciplinary intervention on FGF21 and body composition. Subjects and methods Eighty-six post-pubertal obese adolescents (14-19 years-old), were submitted to 20 weeks of weight loss therapy (clinical, nutritional, psychological and physical exercise support). Anthropometric measures, body composition and rest metabolic rate (RMR) by bioelectrical impedance, and serum FGF21 sample by ELISA were evaluated. The adolescents were grouped according to FGF21 individual delta variations after therapy: Higher Increase (HI); lower increase (LI); lower decrease (LD); higher decrease (HD). Results All groups present weight loss. Only in FGF21 ≥ 76,5 pg/mL variation the free-fat-mass and rest metabolic rate were preserved and to others group these variables were significantly reduced. Conclusion High increase in FGF21 can contribute to preservation of FFM and RMR after weight loss therapy, could have important implications for energy balance regulation. Future studies are necessary to continue determining the role of magnitude effects of FGF21 levels in obesity to improve clinical practice, especially in paediatrics population.
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Factores de Crecimiento de Fibroblastos/sangre , Obesidad , Pérdida de Peso , Tejido Adiposo Blanco , Adolescente , Metabolismo Energético , HumanosRESUMEN
Background and Aims: The prevalence of overweight and obesity consitutes a global epidemic and it is growing around the world. Food and nutrition are essential requirements for promoting health and protecting against non-communicable chronic diseases, such as obesity and cardiovascular disease. Specific dietary components may modulate inflammation and oxidative stress in obese individuals. The Dietary Inflammatory Index (DII®) was developed to characterize the anti- and pro-inflammatory effects of individuals' diet. Few studies have investigated the role of diet-associated inflammation in adolescents with obesity. The present study aims to investigate the effects of an interdisciplinary weight loss therapy on DII scores and cardiometabolic risk in obese adolescents and possibles correlations. Methods: A total of 45 volunteers (14-19 years old) were recruited and enrolled for long-term interdisciplinary therapy including clinical, nutritional, psychological counseling, and exercise training. Adolescents had access to videos about health education weekly. Body composition and inflammatory and serum profiles were evaluated at baseline and after intervention. The food intake was obtained by 24-h food recall. Data was used to calculate energy-adjusted DII (E-DII) scores. Negative scores indicate an anti-inflammatory diet and positive scores indicates a pro-inflammatory diet. The sample was divided according to whether individuals increased or decreased E-DII scores after therapy. Results: After therapy the body mass index (BMI), body weight, body fat, abdominal, waist, neck, and hip circumferences decreased significantly. The mean of high-density lipoprotein cholesterol (HDL-c) increased after the therapy. There was found an improvement of inflammatory and cardiometabolic parameters. In exploratory analyses, this occurred mainly when the EDII improved. Conclusion: Long-term interdisciplinary therapy combined with a health education website improved inflammatory serum markers in obese adolescents. Reduction in DII scores was associated with reduction of cardiometabolic parameters, suggesting that an anti-inflammatory diet may be an effective strategy to prevent and treat obesity and related comorbidities. Trial: http://www.ensaiosclinicos.gov.br/rg/RBR-6txv3v/, Register Number: RBR-6txv3v.
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BACKGROUND: Exercise and CPAP improve OSA. This study examined the effects of exercise in patients with heart failure (HF) and OSA. METHODS: Patients with HF and OSA were randomized to the following study groups: control, exercise, CPAP, and exercise + CPAP. RESULTS: Sixty-five participants completed the protocol. Comparing baseline vs 3 months, the mean apnea-hypopnea index (AHI) did not change significantly (in events per hour) in the control group, decreased moderately in the exercise group (28 ± 17 to 18 ± 12; P < .03), and decreased significantly more in the CPAP group (32 ± 25 to 8 ± 11; P < .007) and in the exercise + CPAP group (25 ± 15 to 10 ± 16; P < .007). Peak oxygen consumption, muscle strength, and endurance improved only with exercise. Both exercise and CPAP improved subjective excessive daytime sleepiness, quality of life, and the New York Heart Association functional class. However, compared with the control group, changes in scores on the 36-item Medical Outcomes Study Short Form Survey and Minnesota Living with Heart Failure Questionnaire were only significant in the exercise groups. CONCLUSIONS: In patients with HF and OSA, our preliminary results showed that exercise alone attenuated OSA and improved quality of life more than CPAP. In the landscape treatment of OSA in patients with HF, this analysis is the only randomized trial showing any treatment (in this case, exercise) that improved all the studied parameters. The results highlight the important therapeutic benefits of exercise, particularly because adherence to CPAP is low.
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Presión de las Vías Aéreas Positiva Contínua , Terapia por Ejercicio/métodos , Insuficiencia Cardíaca/terapia , Apnea Obstructiva del Sueño/terapia , Adulto , Anciano , Ejercicio Físico/fisiología , Femenino , Insuficiencia Cardíaca/complicaciones , Insuficiencia Cardíaca/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Fuerza Muscular/fisiología , Consumo de Oxígeno/fisiología , Polisomnografía , Calidad de Vida , Conducta Sexual/fisiología , Apnea Obstructiva del Sueño/complicaciones , Apnea Obstructiva del Sueño/fisiopatología , Volumen Sistólico , Encuestas y Cuestionarios , Resultado del Tratamiento , Disfunción Ventricular Izquierda/complicaciones , Disfunción Ventricular Izquierda/fisiopatología , Disfunción Ventricular Izquierda/terapiaRESUMEN
ABSTRACT Obesity, a complex disease that involves energy imbalance and chronic low-grade inflammation, is implicated in the pathogenesis of several chronic non-communicable diseases. As dietary components modulate the human body's inflammatory status, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed in 2009 to characterize the inflammatory potential of a habitual diet. Abundant research has been conducted to investigate the associations between DII and obesity. In this narrative review, we examined the current state of the science regarding the relationships between DII and the inflammatory pathophysiological aspects related to obesity. DII is associated with inflammation in obesity. The most pro-inflammatory diet was directly related to higher levels of pro-inflammatory markers, which included C-reactive protein (CRP), interleukin-6 (IL-6), IL-1β, and tumor necrosis factor-α (TNF-α). Therefore, evidence suggests that the use of the DII may be useful for understanding the relationship between diet and the inflammatory process related to obesity.
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Resumo Fundamento A ação do peptídeo natriurético atrial (ANP) na natriurese, diurese e vasodilatação, resistência à insulina, fígado, rim e tecido adiposo pode contribuir para o desenvolvimento metabólico e cardiovascular saudável. Embora o nível circulante de ANP seja reduzido em pacientes com obesidade, sua resposta à perda de peso ainda é pouco explorada em populações pediátricas. Objetivo Avaliar os efeitos das variações do ANP em resposta à intervenção interdisciplinar para perda de peso na Síndrome Metabólica (SMet) e nos riscos cardiometabólicos em adolescentes com obesidade. Métodos 73 adolescentes com obesidade participaram de uma terapia interdisciplinar para perda de peso de 20 semanas, incluindo uma abordagem clínica, nutricional, psicológica e de exercícios físicos. A composição corporal, análises bioquímicas e pressão sanguínea foram avaliadas. A SMet foi classificada de acordo com a Federação Internacional de Diabetes (IDF) (2007). Após o tratamento, os voluntários foram divididos de acordo com os níveis de plasma do ANP aumento (n=31) ou ANP redução (n=19). Resultados Ambos os grupos apresentaram redução significativa de peso corporal, índice de massa corporal (IMC) e circunferências de cintura, pescoço e quadril (CC, CP e CQ, respectivamente), e aumento da massa livre de gordura (MLG). É interessante observar que houve uma redução significativa na gordura corporal, na razão de TG/HDL-c e na prevalência de SMet (de 23% para 6%) somente no grupo com ANP aumento. Conclusão Este estudo sugere que o aumento nos níveis séricos de ANP após a terapia para perda de peso pode estar associado a melhorias nos riscos cardiometabólicos e na prevalência reduzida de SMet em adolescentes com obesidade.
Abstract Background The action of atrial natriuretic peptide (ANP) on natriuresis, diuresis and vasodilatation, insulin resistance, liver, kidney, and adipose tissue may contribute to the healthy metabolic and cardiovascular development. Even though the circulating level of ANP is reduced in patients with obesity, its response to weight loss remains poorly explored in pediatric populations. Objective To evaluate the effects of ANP variations in response to interdisciplinary weight loss intervention on metabolic syndrome (MetS) and cardiometabolic risks in adolescents with obesity. Methods 73 adolescents with obesity attended a 20-week clinical interdisciplinary weight loss therapy including clinical, nutritional, psychological and exercise training approach. Body composition, biochemical analyses and blood pressure were evaluated. MetS was classified according to the International Diabetes Federation (IDF) (2007). After the treatment, volunteers were divided according to Increasing (n=31) or Decreasing (n=19) ANP plasma levels. Results Both groups present significant reduction of body weight, Body Mass Index (BMI), waist, neck and hip circumferences (WC, NC and HC, respectively) and increasing fat-free mass (FFM). Interestingly, a significant reduction in body fat, TG/HDL-c ratio and MetS prevalence (from 23% to 6%) was observed in the Increased ANP group only. Conclusion This study suggests that an increase in ANP serum levels after weight loss therapy could be associated with improvements in cardiometabolic risks and the reduced prevalence of MetS in adolescents with obesity.
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Humanos , Niño , Adolescente , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/prevención & control , Síndrome Metabólico/epidemiología , Obesidad Infantil/terapia , Composición Corporal , Pérdida de Peso/fisiología , Índice de Masa Corporal , Factor Natriurético Atrial/metabolismoRESUMEN
ABSTRACT Objective Fibroblast growth factor 21 (FGF21) is among the activators that can stimulate thermogenesis in the white adipose tissue and brown adipose tissue. People with obesity have elevated blood levels of FGF21, but also develop resistance to its action, impairing its beneficial role. Inversely, clinical treatments to weight loss has been pointed out as an important therapy for increasing and recovering sensitivity to FGF21. The aim was to analyse the effect of long-term weight loss interdisciplinary intervention on FGF21 and body composition. Subjects and methods Eighty-six post-pubertal obese adolescents (14-19 years-old), were submitted to 20 weeks of weight loss therapy (clinical, nutritional, psychological and physical exercise support). Anthropometric measures, body composition and rest metabolic rate (RMR) by bioelectrical impedance, and serum FGF21 sample by ELISA were evaluated. The adolescents were grouped according to FGF21 individual delta variations after therapy: Higher Increase (HI); lower increase (LI); lower decrease (LD); higher decrease (HD). Results All groups present weight loss. Only in FGF21 ≥ 76,5 pg/mL variation the free-fat-mass and rest metabolic rate were preserved and to others group these variables were significantly reduced. Conclusion High increase in FGF21 can contribute to preservation of FFM and RMR after weight loss therapy, could have important implications for energy balance regulation. Future studies are necessary to continue determining the role of magnitude effects of FGF21 levels in obesity to improve clinical practice, especially in paediatrics population.
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Humanos , Adolescente , Pérdida de Peso , Factores de Crecimiento de Fibroblastos/sangre , Obesidad , Metabolismo Energético , Tejido Adiposo BlancoRESUMEN
Abstract This study aimed to generate an age-based maximum heart rate (HRmax) equation for endurance-trained runners. Thirty-four male runners performed three tests on a motorized treadmill, starting at 8 km h-1 with increments of 1 km h-1 every 1, 2 or, 3 min. HRmax was defined as the highest heart rate value recorded during each test. Post hoc analyses indicated that the HRmax derived from each test was significantly lower than the highest HRmax value, for each participant. HRmax predicted by "206 - 0.7 × age" underestimated the highest HRmax by 8.6 beats min-1. Thus, the generated age-based "218 - 0.8 × age" equation should be used to predict HRmax in endurance-trained runners.
Resumo Esse estudo objetivou gerar uma equação de frequência cardíaca máxima (FCmax) baseada na idade para corredores aerobiamente treinados. Trinta e quatro corredores homens realizaram três testes incrementais em esteira motorizada, com início a 8 km·h-1 e incrementos de 1 km·h-1 a cada um, dois ou, três minutos. A FCmax foi definida como o valor mais alto de frequência cardíaca registrado em cada teste. As análises de post hoc indicaram que a FCmax de cada teste foi significativamente menor que o valor mais elevado de FCmax para cada participante. A FCmax predita pela equação "206 - 0,7 x idade" subestimou a mais alta FCmax em 8,6 batimentos·min-1. Logo, a equação gerada baseada em idade "218 - 0,8 x idade" deveria ser usada para predizer a FCmax em corredores aerobiamente treinados.
Resumen El objetivo de este estudio fue generar una ecuación de la frecuencia cardíaca máxima (FCmáx) basada en la edad en corredores entrenados en resistencia. Treinta y cuatro corredores de sexo masculino realizaron 3 pruebas en una cinta ergométrica motorizada, comenzando con la velocidad de 8 km/h-1 con incrementos de 1 km/h-1 cada uno, 2 o 3 min. La FCmáx fue definida como el valor de la frecuencia cardíaca más elevada registrada durante cada prueba. Los análisis posteriores indicaron que la FCmáx derivada de las pruebas fue considerablemente más baja que el valor más alto de la FCmáx de cada participante. La FCmáx pronosticada por la ecuación «206-0,7 × edad¼, subestimada la más alta FCmás por 8,6 lat/min-1. Así, la ecuación generada basada en la edad «218-0,8 × edad¼ debería utilizarse para pronosticar la FCmáx en corredores entrenados en resistencia.
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ResumoO objetivo do estudo foi verificar a influência do nível de performance na estratégia de ritmo de corrida de corredores recreacionais. Adicionalmente, objetivou-se descrever o comportamento da frequência cardíaca (FC) obtida em prova de 10 km em pista de atletismo. Participaram 39 corredores recreacionais (31,5 ± 6,7 anos), experientes em provas de 10 km que realizaram uma performance nesta distância em pista de atletismo (400 m). A FC foi constantemente monitorada (Polar RS800) e o tempo a cada 400 m foi registrado para determinação da velocidade média (VM), posteriormente analisada a cada 2 km. Os participantes foram divididos em dois grupos de acordo com a VM alcançada nos testes: G1 = VM 10 km ≤ 11,81 (n = 20) e G2 = VM 10 km > 11,81 (n = 19). A comparação entre os valores de VM e FC obtidos nos diferentes momentos da performance para os dois grupos foi realizada pela Anova mista, adotando-se nível de significância de p < 0,05. Os valores de VM foram diferentes entre os grupos em todos os momentos analisados, com aumento significante da VM do momento 6-8 km para 8-10 km para o mesmo grupo. Os valores de FC foram diferentes apenas intra-grupos. No G1, houve aumento significante da FC a cada 2 km de prova. Para o G2, a FC aumentou do 2º ao 4º km e permaneceu estável até o 8º km, aumentando novamente nos últimos 2 km da performance. Concluímos que o nível de performance não influencia a estratégia de corrida de corredores recreacionais.
AbstractThe aim of the present study was to verify the influence of the performance level in the strategy of running pacing from recreational runners. Additionally, it was aimed to describe the heart rate (HR) responses measured in a 10-km running performance in a track. Thirty-nine recreational runners took part (31.5 ± 6.7 years), who had experience in 10-km races and realized a 10-km running performance in a track (400 m). HR was constantly monitored (Polar RS800) and the time each 400 m was registered to determine MS, and then analyzed each 2 km. Participants were divided into two groups according to their MS attained in the tests: G1 - MS 10 km ≤ 11.81 (n = 20) and G2 - MS 10 km > 11.81 (n = 19). The comparison between MS and GR obtained in different moments of the performance for both groups was made by mixed Anova for repeated measures, adopting a significance level of p < 0.05. MS values were different between the groups in all moments analyzed with a significant increase in MS from moment 6-8 km to 8-10 km for the same group. HR values were different only within-groups. In G1, there was a significant increase in HR each 2 km. For G2, HR increased from the second to the forth km and remained stable up to the eighth km, increasing again in the last 2 km of the performance. We concluded that the performance level does not influence in the running strategy of recreational runners.
Asunto(s)
Humanos , Masculino , Adulto , Carrera , Atletismo , Rendimiento AtléticoRESUMEN
INTRODUÇÃO: testes diretos são considerados "padrão ouro" para determinar variáveis fisiológicas, porém o seu custo financeiro é elevado e há a necessidade de mão de obra especializada para sua operacionalização. Sendo assim, os testes indiretos são utilizados pela maioria dos profissionais de Educação Física como uma alternativa acessível à falta da medida direta. OBJETIVO: comparar os valores de consumo máximo de oxigênio (VO2máx) determinados diretamente por um sistema de espirometria com valores determinados a partir de protocolos indiretos. MÉTODOS: participaram 15 pessoas do gênero masculino (27,4 ± 3,5 anos), fisicamente ativas, que realizaram o teste incremental em esteira rolante para determinação direta do VO2máx com analisador de gases. Os testes para predição do VO2máx foram: ErgoPC; Polar Fitness Test; testes do banco e de Cooper. Foi utilizada a estatística descritiva (média ± desvio padrão - DP); a esfericidade foi testada pelo teste de Mauchly, os métodos foram comparados por ANOVA de medidas repetidas com o ajuste de Bonferroni para comparações múltiplas. A normalidade dos dados foi aferida pelo teste de Shapiro-Wilk e também foi aplicado o teste coeficiente de correlação de Pearson, adotando-se p<0,05. RESULTADOS: o valor médio de VO2máx direto foi de 55,8 ± 6,1 ml•kg-1•min-1 e os valores para os testes indiretos, percentual de subestimação e coeficiente de correlação, foram, respectivamente: ErgoPc 33,7 ± 4,5 ml•kg-1•min-1 (39,6%; r = 0,71; p<0,001); Polar Fitness Test 53,2 ± 6,4 ml•kg-1•min-1 (4,6%; r = 0,64; p = 0,774); teste do banco 48,8 ± 6,3 ml•kg-1•min-1 (12,5%; r = 0,60; P=0,001) e de Cooper 43,9 ± 7,9 ml•kg-1•min-1 (21,4%; r = 0,65; p<0,001). CONCLUSÃO: os métodos indiretos podem sugerir sobrecarga de treino inferior ou superior para adaptações fisiológicas pretendidas por subestimarem o direto, sendo o Polar Fitness Test o mais indicado ...
INTRODUCTION: direct tests are considered "gold standard" for determining physiological variables. However, the financial cost is high and there is the need of skilled labor for its operation. Thus, the indirect tests are used by most professional of Physical Education as an affordable alternative to the lack of direct measurement. OBJECTIVE: to compare the values of maximum consumption of oxygen (VO2max), determined directly by a system with spirometry values determined from indirect protocols. METHODS: 15 male individuals participated (27.4 ± 3.5 years), physically active, who performed the incremental test on treadmill for the direct determination of VO2max with the gas analyzer. The tests for the prediction of VO2max were ErgoPC; Polar Fitness Test, test bank and Cooper. We used descriptive statistics (mean ± standard deviation - SD); the sphericity was tested by Mauchly's test, the methods were compared by ANOVA of repeated measurements, with Bonferroni adjustment for multiple comparisons. Data normality was evaluated by the Shapiro-Wilk test, and the Pearson correlation coefficient was also applied, adopting a significance level of p <0.05. RESULTS: the average VO2max was determined directly from 55.8 ± 6.1 ml • kg -1 • min-1 and the values for the indirect tests, the percentage of underestimation and correlation coefficient were, respectively: 33.7 ErgoPc ± 4.5 ml • kg -1 • min-1 (39.6%, r = 0.71, p <0.001); Polar Fitness Test 53.2 ± 6.4 ml • kg -1 • min-1 (4.6%, r = 0.64, p = 0.774); bank test 48.8 ± 6.3 ml • kg -1 • min-1 (12.5%, r = 0.60, p = 0.001 ) and Cooper 43.9 ± 7.9 ml • kg -1 • min-1 (21.4%, r = 0.65, p <0.001). CONCLUSION: the indirect methods may suggest overload in lower or higher training for required physiological adaptations and only the Polar Fitness Test showed no difference statistically significant. .
INTRODUCCIÓN: los tests directos son considerados "estándar oro" para determinar variables fisiológicas, sin embargo su costo financiero es elevado y se necesita mano de obra especializada para su operacionalización. Siendo así, los tests indirectos son usados por la mayoría de los profesionales de Educación Física como una alternativa accesible a la falta de la medida directa. OBJETIVO: comparar los valores de consumo máximo de oxígeno (VO2máx) determinados directamente por un sistema de espirometría con valores determinados a partir de protocolos indirectos. MÉTODOS: participaron 15 sujetos del género masculino (27,4 ± 3,5 años), físicamente activos que realizaron el test incremental en cinta para determinación directa del VO2máx con analizador de gases. Los tests para predicción del VO2máx fueron: ErgoPC; Polar Fitness Test; tests del banco y de Cooper. Fue utilizada la estadística descriptiva (promedio ± desvío estándar - DP); la esfericidad fue probada por el test de Mauchly, los métodos fueron comparados por ANOVA de medidas repetidas con el ajuste de Bonferroni para comparaciones múltiples. La normalidad de los datos fue probada a través del test de Shapiro-Wilk y aplicado el test coeficiente de correlación de Pearson, adoptándose p<0,05. RESULTADOS: el valor promedio de VO2máx directo fue de 55,8 ± 6,1 ml•kg-1•min-1 y los valores para los tests indirectos, porcentual de subestimación y coeficiente de correlación fueron, respectivamente: ErgoPc 33,7 ± 4,5 ml•kg-1•min-1 (39,6%; r = 0,71; p<0,001); Polar Fitness Test 53,2 ± 6,4 ml•kg-1•min-1 (4,6%; r = 0,64; p = 0,774); test del banco 48,8 ± 6,3 ml•kg-1•min-1 (12,5%; r = 0,60; P=0,001) y de Cooper 43,9 ± 7,9 ml•kg-1•min-1 (21,4%; r = 0,65; p<0,001). CONCLUSIÓN: los métodos indirectos pueden sugerir sobrecarga de entrenamiento inferior o superior para adaptaciones fisiológicas pretendidas, por subestimar el directo, ...
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ResumoExaminou-se a reprodutibilidade do desempenho em provas de corrida de 5 e 10 km em pista de atletismo. Trinta e um corredores recreacionistas, do gênero masculino, fizeram duas provas de 5 e duas de 10 km em uma pista oficial de atletismo. Não houve diferença significativa entre os testes-retestes para ambas as provas com o uso do teste t pareado (p > 0,05). Os coeficientes de correlação intraclasse e de variação foram de 0,94/3,44% (5 km) e de 0,97/2,43% (10 km), respectivamente. A reprodutibilidade de ambas as provas em pista de atletismo foi semelhante às reprodutibilidades reportadas na literatura para testes em laboratório. Além disso, a prova de 10 km se mostrou mais reprodutível do que a prova de 5 km para a amostra estudada e necessitou de aproximadamente metade da amostra necessária para se detectarem aumentos significativos durante teste-reteste em provas de 5 km.
AbstractWe examined the reproducibility of performance in running events of 5 and 10 km in running track. Thirty-one recreational, male, runners performed two tests of 5 and two tests of 10 km in an official running track. There was no significant difference in time between the test-retest for both tests using the paired t test (P > 0.05). The intraclass coefficient of correlation and the coefficient of variation were 0.94/3.44% (5 km) and 0.97/2.43% (10 km), respectively. The reproducibility of both running events in running track was similar to that reported in the literature for laboratory tests. In addition, the 10 km test was more reproducible than the 5 km test for this studied sample, requiring approximately half the sample needed to detect significant increases during test-retest in running events of 5 km.
ResumenHemos examinado la reproducibilidad del desempeño en pruebas de carrera de 5 y 10 km en pista de atletismo. Treinta y un corredores recreativos, género masculino, realizaron dos pruebas de 5 y dos de 10 km en una pista oficial de atletismo. No hubo diferencia significativa en el tiempo test-retest entre ambas pruebas mediante la prueba de t para muestras apareadas (P > 0,05). Los coeficientes de correlación intraclase y de variación fueron de 0,94/3,44% (5 km) y 0,97/2,43% (10 km), respectivamente. Se encontró que la reproducibilidad de las dos pruebas de carrera en pista de atletismo fue similar a la descrita en la literatura para pruebas de laboratorio. Además, la prueba de 10 km fue más reproducible que la prueba de 5 km para la muestra estudiada, lo que requiere aproximadamente la mitad de la muestra necesaria para detectar un aumento significativo en test-retest en pruebas de 5 km.
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O objetivo do presente estudo foi analisar se há associação entre a autoimagem corporal, risco para transtornos alimentares, adiposidade corporal e estado nutricional em atletas de modalidades coletivas do gênero feminino. Participaram 45 atletas das modalidades de basquetebol, voleibol, handebol e futsal. Foram aferidas massa corporal, estatura e dobras cutâneas para a determinação do Índice de Massa Corporal (IMC) e percentual de gordura corporal (%G). Os questionários aplicados foram o Body Shape Questionnarie (BSQ) e o Eating Atittudes Test (EAT-26). A análise de associação foi feita pelo teste Qui-quadrado 2×2 e Exato de Fisher (p < 0,05). A média do IMC e %G foram de 22,82 ± 2,73 kgm-2 e 23,42 ± 5,10%, respectivamente. O BSQ se associou com o IMC (p = 0,001) e com o %G (p = 0,008), já EAT-26 não se associou com as variáveis antropométricas. Conclui-se que atletas em sobrepeso e obesidade possuem maior tendência a distorção da autoimagem corporal, porém não tem propensão para desenvolver transtornos alimentares...
The objective of the present study was to analyze wheter there is association between body self-image, risk for eating disorders, body fat, and BMI classification in collective sports female athletes. Forty-five basketball, volleyball, handball and futsal athletes participated in the research. We measured weight, height and skinfolds were measures for determining the Body Mass Index (BMI) and Body Fat Percentage (%fat). It was used the questionnaires Body Shape Questionnaire (BSQ) and Eating Attitudes Test (EAT-26). The association analysis was done by Chi-square 2x2 and Fisher's Exact Test (p < 0.05). The mean BMI and %fat were 22.82 ± 2.73 kgm-2 and 23.42 ± 5.10%, respectively. The BSQ was associated with BMI (p = 0.001) and %fat (p = 0.008) and EAT-26 was not associated with any anthropometric variables. It was concluded that overweight and obese athletes had a greater tendency to body self-image distortion, but these athletes did not have the propensity to develop eating disorders...