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1.
Zhonghua Liu Xing Bing Xue Za Zhi ; 41(8): 1352-1358, 2020 Aug 10.
Artigo em Chinês | MEDLINE | ID: mdl-32867449

RESUMO

Objective: To explore the effects of dietary glycemic load (GL) during first trimester on the risk of gestational diabetes mellitus (GDM). Methods: A prospective study was conducted among healthy women with singleton pregnancy at 8-14 weeks of gestation in a maternity out-patient clinic of maternal-and-child health care institution in Chengdu, Sichuan province. Information on dietary intake during the first trimester was collected through a 3-day 24-hour dietary recall. Glycemic index (GI) values were obtained from China Food Composition Tables (Standard Edition) and International Tables of Glycemic Index and Glycemic Load Values (2008). Dietary GL and GLs of staple foods were calculated based on GI values and the amount of carbohydrate consumed per day. Diagnostic criteria of GDM was followed the Guidelines for Diagnosis and Treatment of Pregnancy Diabetes in China (2014), and used on participants who underwent an oral glucose tolerant test during 24-28 weeks of gestation. Log-binomial regression models were used to explore the associations between both quartiles of dietary GL, GLs of staple foods and the risks of GDM,respectively. Results: The medians of dietary GL and GL of staple foods were 145.70 (113.23-180.85) and 121.05 (89.08-155.70), respectively. The median GL of both rice and tubers were 73.14 (43.89-107.50) and 3.43 (0.00-9.84), respectively. After adjusting for the age at pregnancy, pre-pregnancy body mass index and other confounding factors, results of log-binomial regressions analysis showed that when compared with the lowest quartile of dietary GL group, the third and highest quartiles of dietary GL groups increased the risk of GDM (RR=1.47, 95%CI: 1.20-1.80; RR=1.31, 95%CI: 1.04-1.64), respectively. Compared with the lowest quartile of GL of staple foods, the third and highest quartiles of GL of staple foods groups also increased the risk of GDM (RR=1.28, 95%CI: 1.04-1.58; RR=1.27, 95%CI: 1.02-1.60), respectively. The third and highest quartiles of GL of rice groups increased the risk of GDM (RR=1.30, 95%CI: 1.06-1.59; RR=1.28, 95%CI: 1.03-1.59), respectively, than the lowest quartile of GL of rice group. When compared with the lowest quartile of GL of tubers group, the highest quartile of GL of tubers group increased the risk of GDM (RR=1.30, 95%CI: 1.09-1.54). However, we did not notice the effects of wheat GL and coarse grain GL on the risk of GDM. Conclusions: A positive association was found between dietary glycemic load and the risk of GDM. Higher dietary glycemic load, especially in rice and tubers during first trimester, seemed to have increased the risk of GDM.


Assuntos
Diabetes Gestacional/epidemiologia , Carboidratos da Dieta/efeitos adversos , Carga Glicêmica , Fenômenos Fisiológicos da Nutrição Materna , Primeiro Trimestre da Gravidez , China/epidemiologia , Feminino , Humanos , Gravidez , Estudos Prospectivos , Medição de Risco
2.
Toxicol Lett ; 332: 42-55, 2020 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-32629074

RESUMO

Obesity is associated with several female reproductive complications, such as polycystic ovary syndrome (PCOS). The exact mechanism of this relationship remains unclear. Few previous studies using diet containing refined carbohydrate (HCD) leading to obesity have been performed and it is unclear if HCD is linked with reproductive dysfunctions. In this investigation, we assessed whether subchronic HCD exposure results in reproductive and other irregularities. Female rats were fed with HCD for 15 days and metabolic outcomes and reproductive tract morphophysiology were assessed. We further assessed reproductive tract inflammation, oxidative stress (OS) and fibrosis. HCD rats displayed metabolic impairments, such as an increase in body weight/adiposity, adipocyte hypertrophic, abnormal lipid profile, glucose tolerance and insulin resistance (IR) and hyperleptinemia. Improper functioning of the HCD reproductive tract was observed. Specifically, irregular estrous cyclicity, high LH levels and abnormal ovarian morphology coupled with reduction in primordial and primary follicle numbers was observed, suggesting ovarian reserve depletion. Improper follicular development and a reduction in antral follicles, corpora lutea and granulosa layer area together with an increase in cystic follicles were apparent. Uterine atrophy and reduction in endometrial gland (GE) number was observed in HCD rats. Reproductive tract inflammation, OS and fibrosis were seen in HCD rats. Further, strong positive correlations were observed between body weight/adiposity and IR with estrous cycle length, cystic follicles, ovarian reserve, GE and other abnormalities. Thus, these data suggest that the subchronic HCD exposure led to PCOS-like features, impaired ovarian reserve, GE number, and other reproductive abnormalities in female rats.


Assuntos
Carboidratos da Dieta/toxicidade , Reserva Ovariana/efeitos dos fármacos , Ovário/metabolismo , Síndrome do Ovário Policístico/induzido quimicamente , Adiposidade/efeitos dos fármacos , Animais , Peso Corporal , Dieta , Ciclo Estral/efeitos dos fármacos , Feminino , Fibrose , Intolerância à Glucose/sangue , Intolerância à Glucose/induzido quimicamente , Resistência à Insulina , Leptina/sangue , Metabolismo dos Lipídeos , Folículo Ovariano/efeitos dos fármacos , Ovário/patologia , Estresse Oxidativo , Síndrome do Ovário Policístico/metabolismo , Síndrome do Ovário Policístico/patologia , Ratos , Ratos Wistar
3.
PLoS One ; 15(6): e0234344, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32502191

RESUMO

Nitrogen (N) isotopic discrimination (i.e. the difference in natural 15N abundance between the animal proteins and the diet; Δ15N) is known to correlate with N use efficiency (NUE) and feed conversion efficiency (FCE) in ruminants. However, results from the literature are not always consistent across studies, likely due to isotopic discrimination pathways that may differ with the nature of diets. The objective of the present study was to assess at which level, from rumen to tissues, Δ15N originates and becomes related to NUE and FCE in fattening yearling bulls when they are fed two contrasted diets. Twenty-four Charolais yearling bulls were randomly divided into two groups and fed during 8 months, from weaning to slaughter, either 1) a high starch diet based on corn silage supplying a balanced N to energy ratio at the rumen level (starch) or 2) a high fiber diet based on grass silage supplying an excess of rumen degradable N (fiber). All animals were slaughtered and samples of different digestive pools (ruminal, duodenal, ileal and fecal contents), animal tissues (duodenum, liver and muscle), blood and urine were collected for each animal. Ruminal content was further used to isolate liquid-associated bacteria (LAB), protozoa and free ammonia, while plasma proteins were obtained from blood. All samples along with feed were analyzed for their N isotopic composition. For both diets, the digestive contribution (i.e. the N isotopic discrimination occurring before absorption) to the Δ15N observed in animal tissues accounted for 65 ± 11%, leaving only one third to the contribution of post-absorptive metabolism. Concerning the Δ15N in digestive pools, the majority of these changes occurred in the rumen (av. Δ15N = 2.12 ± 0.66‰), with only minor 15N enrichments thereafter (av. Δ15N = 2.24 ± 0.41‰), highlighting the key role of the rumen on N isotopic discrimination. A strong, significant overall relationship (n = 24) between Δ15N and FCE or NUE was found when using any post-absorptive metabolic pool (duodenum, liver, or muscle tissues, or plasma proteins; 0.52 < r < 0.73; P ≤ 0.01), probably as these pools reflect both digestive and post-absorptive metabolic phenomena. Fiber diet compared to starch diet had a lower feed efficiency and promoted higher (P ≤ 0.05) Δ15N values across all post-absorptive metabolic pools and some digestive pools (ruminal, duodenal, and ileal contents). The within-diet relationship (n = 12) between Δ15N and feed efficiency was not as strong and consistent as the overall relationship, with contrasted responses between the two diets for specific pools (diet x pool interaction; P ≤ 0.01). Our results highlight the contrasted use of N at the rumen level between the two experimental diets and suggests the need for different equations to predict FCE or NUE from Δ15N according to the type of diet. In conclusion, rumen digestion and associated microbial activity can play an important role on N isotopic discrimination so rumen effect related to diet may interfere with the relationship between Δ15N and feed efficiency in fattening yearling bulls.


Assuntos
Ração Animal/análise , Dieta/métodos , Nitrogênio/metabolismo , Fenômenos Fisiológicos da Nutrição Animal/fisiologia , Animais , Bovinos , Carboidratos da Dieta/metabolismo , Fibras na Dieta/metabolismo , Digestão/fisiologia , Fezes/química , Masculino , Rúmen/microbiologia , Ruminantes/metabolismo , Amido/metabolismo
4.
Cochrane Database Syst Rev ; 6: CD001903, 2020 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-32588435

RESUMO

BACKGROUND: Ketogenic diets (KDs) are high in fat and low in carbohydrates and have been suggested to reduce seizure frequency in people with epilepsy. Such diets may be beneficial for children with drug-resistant epilepsy. This is an update of a review first published in 2003, and last updated in 2018. OBJECTIVES: To assess the effects of ketogenic diets for people with drug-resistant epilepsy. SEARCH METHODS: For this update, we searched the Cochrane Register of Studies (CRS Web) and MEDLINE (Ovid, 1946 to 26 April 2019) on 29 April 2019. The Cochrane Register of Studies includes the Cochrane Epilepsy Group Specialized Register, the Cochrane Central Register of Controlled Trials (CENTRAL), and randomised controlled trials (RCTs) from Embase, ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We imposed no language restrictions. We checked the reference lists of retrieved studies for additional relevant studies. SELECTION CRITERIA: RCTs or quasi-RCTs of KDs for people of any age with drug-resistant epilepsy. DATA COLLECTION AND ANALYSIS: Two review authors independently applied predefined criteria to extract data and evaluated study quality. We assessed the outcomes: seizure freedom, seizure reduction (50% or greater reduction in seizure frequency), adverse effects, cognition and behaviour, quality of life, and attrition rate. We incorporated a meta-analysis. We utilised an intention-to-treat (ITT) population for all primary analyses. We presented the results as risk ratios (RRs) with 95% confidence intervals (CIs). MAIN RESULTS: We identified 13 studies with 932 participants; 711 children (4 months to 18 years) and 221 adults (16 years and over). We assessed all 13 studies to be at high risk of performance and detection bias, due to lack of blinding. Assessments varied from low to high risk of bias for all other domains. We rated the evidence for all outcomes as low to very low certainty. Ketogenic diets versus usual care for children Seizure freedom (RR 3.16, 95% CI 1.20 to 8.35; P = 0.02; 4 studies, 385 participants; very low-certainty evidence) and seizure reduction (RR 5.80, 95% CI 3.48 to 9.65; P < 0.001; 4 studies, 385 participants; low-certainty evidence) favoured KDs (including: classic KD, medium-chain triglyceride (MCT) KD combined, MCT KD only, simplified modified Atkins diet (MAD) compared to usual care for children. We are not confident that these estimated effects are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea for both the intervention and usual care group, but the true effect could be substantially different (low-certainty evidence). Ketogenic diet versus usual care for adults In adults, no participants experienced seizure freedom. Seizure reduction favoured KDs (MAD only) over usual care but, again, we are not confident that the effect estimated is accurate (RR 5.03, 95% CI 0.26 to 97.68; P = 0.29; 2 studies, 141 participants; very low-certainty evidence). Adults receiving MAD most commonly reported vomiting, constipation and diarrhoea (very low-certainty evidence). One study reported a reduction in body mass index (BMI) plus increased cholesterol in the MAD group. The other reported weight loss. The true effect could be substantially different to that reported. Ketogenic diet versus ketogenic diet for children Up to 55% of children achieved seizure freedom with a classical 4:1 KD after three months whilst up to 85% of children achieved seizure reduction (very low-certainty evidence). One trial reported a greater incidence of seizure reduction with gradual-onset KD, as opposed to fasting-onset KD. Up to 25% of children were seizure free with MAD and up to 60% achieved seizure reduction. Up to 25% of children became seizure free with MAD and up to 60% experienced seizure reduction. One study used a simplified MAD (sMAD) and reported that 15% of children gained seizure freedom rates and 56% achieved seizure reduction. We judged all the evidence described as very low certainty, thus we are very unsure whether the results are accurate. The most commonly reported adverse effects were vomiting, constipation and diarrhoea (5 studies, very low-certainty evidence). Two studies reported weight loss. One stated that weight loss and gastrointestinal disturbances were more frequent, with 4:1 versus 3:1 KD, whilst one reported no difference in weight loss with 20 mg/d versus 10 mg/d carbohydrates. In one study, there was a higher incidence of hypercalcuria amongst children receiving classic KD compared to MAD. All effects described are unlikely to be accurate. Ketogenic diet versus ketogenic diet for adults One study randomised 80 adults (aged 18 years and over) to either MAD plus KetoCal during the first month with MAD alone for the second month, or MAD alone for the first month followed by MAD plus KetoCal for the second month. No adults achieved seizure freedom. More adults achieved seizure reduction at one month with MAD alone (42.5%) compared to MAD plus KetoCal (32.5%), however, by three months only 10% of adults in both groups maintained seizure reduction. The evidence for both outcomes was of very low certainty; we are very uncertain whether the effects are accurate. Constipation was more frequently reported in the MAD plus KetoCal group (17.5%) compared to the MAD only group (5%) (1 study, very low-certainty evidence). Diarrhoea and increase/change in seizure pattern/semiology were also commonly reported (17.5% to 20% of participants). The true effects of the diets could be substantially different to that reported. AUTHORS' CONCLUSIONS: The evidence suggests that KDs could demonstrate effectiveness in children with drug-resistant epilepsy, however, the evidence for the use of KDs in adults remains uncertain. We identified a limited number of studies which all had small sample sizes. Due to the associated risk of bias and imprecision caused by small study populations, the evidence for the use of KDs was of low to very low certainty. More palatable but related diets, such as the MAD, may have a similar effect on seizure control as the classical KD, but could be associated with fewer adverse effects. This assumption requires more investigation. For people who have drug-resistant epilepsy or who are unsuitable for surgical intervention, KDs remain a valid option. Further research is required, particularly for adults with drug-resistant epilepsy.


Assuntos
Dieta Cetogênica/métodos , Carboidratos da Dieta/administração & dosagem , Gorduras na Dieta/administração & dosagem , Epilepsia Resistente a Medicamentos/dietoterapia , Adolescente , Adulto , Fatores Etários , Idoso , Criança , Pré-Escolar , Dieta com Restrição de Carboidratos/métodos , Dieta Rica em Proteínas e Pobre em Carboidratos/métodos , Dieta Cetogênica/efeitos adversos , Humanos , Lactente , Análise de Intenção de Tratamento , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Retrospectivos , Tamanho da Amostra , Adulto Jovem
5.
PLoS One ; 15(6): e0233364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530969

RESUMO

Type 2 diabetes mellitus (T2DM) is among the most prevalent diseases in the world, affecting over 420 million people. The disease is marked by a poor metabolic effect of insulin leading to chronic hyperglycaemia, which can result in microvascular complications. It is widely known that postprandial glycaemia is reliant on the total carbohydrate content of a meal. However, the importance of the amount and the source of these carbohydrates remains controversial due to mechanisms other than insulin secretion. Oxidative stress, inflammation, pyruvate production and the quality of the intestinal microbiota, resulting in plasma lipopolysaccharides and short-chain fatty acids production, play an important role in blood sugar control and consequently in type 2 diabetes. Thus, we systematically reviewed the preclinical evidences on the impact of the amount and type of carbohydrate found in different diets and its influence on blood glucose levels in diabetic animals. We used a comprehensive and structured search in biomedical databases Medline (PubMed), Scopus and Web of Science, recovering and analyzing 27 original studies. Results showed that sucrose-rich diets deteriorated diabetic condition in animal models regardless of the total dietary carbohydrate content. On the other hand, fiber, particularly resistant starch, improved blood glucose parameters through direct and indirect mechanisms, such as delayed gastric emptying and improved gut microbiota. All studies used rodents as animal models and male animals were preferred over females. Improvements in T2DM parameters in animal models were more closely related to the type of dietary carbohydrate than to its content on a diet, i. e., resistant starch seems to be the most beneficial source for maintaining normoglycemia. Results show that current literature is at high risk of bias due to neglecting experimental methods.


Assuntos
Diabetes Mellitus Tipo 2/dietoterapia , Carboidratos da Dieta/análise , Animais , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/metabolismo , Dieta/métodos , Carboidratos da Dieta/metabolismo , Fibras na Dieta/metabolismo , Sacarose na Dieta/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Insulina/metabolismo , Secreção de Insulina/efeitos dos fármacos , Masculino , Período Pós-Prandial/fisiologia , Triglicerídeos/sangue
6.
Curr Diabetes Rev ; 16(6): 619-627, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32552634

RESUMO

BACKGROUND: There is no data available on the best insulin treatment to counteract the effects of glucose excursions due to a moderate alcohol intake associated with portions of slight fat and protein-containing food, as often the case during social happenings or "happy hours". INTRODUCTION: This study analyzes the glycemic control and quality of life in 8 adult type 1 diabetic (T1D) patients on insulin-pump therapy which were invited to consume a traditional Italian aperitif ("Spritz" and chips). METHODS: Patients consumed Spritz aperitif twice: using their habitual bolus, based on carbohydrates (CHO) counting (V1), or with a personalized, advanced bolus (V2) calculated from insulin/Kcal derived from Fats and Proteins (FPU). Post-prandial glucose was continuously monitored; glucose incremental areas (iAUC), glucose peak and time to peak, and estimated change from V1 to V2 from repeated- measures models were computed. Each patient fulfilled validated questionnaires on quality of life, knowledge about diabetes and CHO counting. RESULTS: After the educational program, a reduced iAUC (0-80 min: -306, p=ns; 40-80 min: -400, p=0.07) due to greater (p=0.03) and prolonged double-wave insulin boluses was observed. Blood glucose peak and time to peak were also reduced. Moreover, improvements in the psycho-affective dimension, as well as in the alimentary knowledge were detected. CONCLUSION: Therefore, a personalized educational program on CHO + FPU counting together with insulin bolus management can improve glycemic control during social consumption of alcohol, with positive reflections on the psycho-affective dimension. Further studies are mandatory to confirm such preliminary results.


Assuntos
Consumo de Bebidas Alcoólicas/metabolismo , Diabetes Mellitus Tipo 1/tratamento farmacológico , Hipoglicemiantes/administração & dosagem , Insulina/administração & dosagem , Educação de Pacientes como Assunto , Adulto , Consumo de Bebidas Alcoólicas/efeitos adversos , Consumo de Bebidas Alcoólicas/psicologia , Glicemia/análise , Estudos Cross-Over , Diabetes Mellitus Tipo 1/metabolismo , Diabetes Mellitus Tipo 1/psicologia , Carboidratos da Dieta/análise , Gorduras na Dieta/análise , Proteínas na Dieta/análise , Feminino , Humanos , Sistemas de Infusão de Insulina , Masculino , Pessoa de Meia-Idade , Período Pós-Prandial , Qualidade de Vida , Adulto Jovem
7.
Sports Health ; 12(4): 382-389, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32520660

RESUMO

BACKGROUND: Sport concussion (SC) causes an energy crisis in the brain by increasing energy demand, decreasing energy supply, and altering metabolic resources. Whole-body resting metabolic rate (RMR) is elevated after more severe brain injuries, but RMR changes are unknown after SC. The purpose of this study was to longitudinally examine energy-related changes in collegiate athletes after SC. HYPOTHESIS: RMR and energy consumption will increase acutely after SC and will return to control levels with recovery. STUDY DESIGN: Case-control study. LEVEL OF EVIDENCE: Level 4. METHODS: A total of 20 collegiate athletes with SC (mean age, 19.3 ± 1.08 years; mean height, 1.77 ± 0.11 m; mean weight, 79.6 ± 23.37 kg; 55% female) were compared with 20 matched controls (mean age, 20.8 ± 2.17 years; mean height, 1.77 ± 0.10 m; mean weight, 81.9 ± 23.45 kg; 55% female). RMR, percentage carbohydrate use (%CHO), and energy balance (EBal; ratio between caloric consumption and expenditure) were assessed 3 times: T1, ≤72 hours after SC; T2, 7 days after T1; and TF, after symptom resolution. A 2 × 2 × 3 (group × sex × time) multivariate analysis of variance assessed RMR, %CHO, and EBal. Changes in RMR, %CHO, and EBal (T1 to TF) were correlated with days to symptom-free and days to return to play in the concussed group. RESULTS: Women reported being symptom-free (median, 6 days; range, 3-10 days) sooner than men (median, 11 days; range, 7-16 days). RMR and %CHO did not differ across time between groups or for group × sex interaction. SC participants had higher EBal than controls at T1 (P = 0.016) and T2 (P = 0.010). In men with SC, increasing %CHO over time correlated with days to symptom-free (r = 0.735 and P = 0.038, respectively) and days to return to play (r = 0.829 and P = 0.021, respectively). CONCLUSION: Participants with SC were in energy surplus acutely after injury. Although women recovered more quickly than men, men had carbohydrate metabolism changes that correlated with recovery time. CLINICAL RELEVANCE: This pilot study shows that male and female student-athletes may have differing physiologic responses to SC and that there may be a role for dietary intervention to improve clinical outcomes after SC.


Assuntos
Traumatismos em Atletas/metabolismo , Metabolismo Basal , Concussão Encefálica/metabolismo , Carboidratos da Dieta/metabolismo , Ingestão de Energia , Metabolismo Energético , Feminino , Humanos , Masculino , Projetos Piloto , Fatores Sexuais , Adulto Jovem
8.
Nat Med ; 26(6): 964-973, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32528151

RESUMO

Metabolic responses to food influence risk of cardiometabolic disease, but large-scale high-resolution studies are lacking. We recruited n = 1,002 twins and unrelated healthy adults in the United Kingdom to the PREDICT 1 study and assessed postprandial metabolic responses in a clinical setting and at home. We observed large inter-individual variability (as measured by the population coefficient of variation (s.d./mean, %)) in postprandial responses of blood triglyceride (103%), glucose (68%) and insulin (59%) following identical meals. Person-specific factors, such as gut microbiome, had a greater influence (7.1% of variance) than did meal macronutrients (3.6%) for postprandial lipemia, but not for postprandial glycemia (6.0% and 15.4%, respectively); genetic variants had a modest impact on predictions (9.5% for glucose, 0.8% for triglyceride, 0.2% for C-peptide). Findings were independently validated in a US cohort (n = 100 people). We developed a machine-learning model that predicted both triglyceride (r = 0.47) and glycemic (r = 0.77) responses to food intake. These findings may be informative for developing personalized diet strategies. The ClinicalTrials.gov registration identifier is NCT03479866.


Assuntos
Glicemia/metabolismo , Microbioma Gastrointestinal , Insulina/metabolismo , Nutrientes , Período Pós-Prandial , Triglicerídeos/metabolismo , Adolescente , Adulto , Idoso , Peptídeo C/metabolismo , Carboidratos da Dieta , Gorduras na Dieta , Fibras na Dieta , Proteínas na Dieta , Feminino , Variação Genética , Teste de Tolerância a Glucose , Voluntários Saudáveis , Humanos , Individualidade , Aprendizado de Máquina , Masculino , Pessoa de Meia-Idade , Polimorfismo de Nucleotídeo Único , Medicina de Precisão , Adulto Jovem
9.
J Sci Med Sport ; 23(7): 670-679, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: covidwho-306388

RESUMO

OBJECTIVES: To describe the perceptions of South African elite and semi-elite athletes on return to sport (RTS); maintenance of physical conditioning and other activities; sleep; nutrition; mental health; healthcare access; and knowledge of coronavirus disease 2019 (COVID-19). DESIGN: Cross- sectional study. METHODS: A Google Forms survey was distributed to athletes from 15 sports in the final phase (last week of April 2020) of the level 5 lockdown period. Descriptive statistics were used to describe player demographic data. Chi-squared tests investigated significance (p<0.05) between observed and expected values and explored sex differences. Post hoc tests with a Bonferroni adjustment were included where applicable. RESULTS: 67% of the 692 respondents were males. The majority (56%) expected RTS after 1-6 months. Most athletes trained alone (61%; p<0.0001), daily (61%; p<0.0001) at moderate intensity (58%; p<0.0001) and for 30-60min (72%). During leisure time athletes preferred sedentary above active behaviour (p<0.0001). Sleep patterns changed significantly (79%; p<0.0001). A significant number of athletes consumed excessive amounts of carbohydrates (76%; p<0.0001; males 73%; females 80%). Many athletes felt depressed (52%), and required motivation to keep active (55%). Most had access to healthcare during lockdown (80%) and knew proceedings when suspecting COVID-19 (92%). CONCLUSIONS: COVID-19 had physical, nutritional and psychological consequences that may impact on the safe RTS and general health of athletes. Lost opportunities and uncertain financial and sporting futures may have significant effects on athletes and the sports industry. Government and sporting federations must support athletes and develop and implement guidelines to reduce the risk in a COVID-19 environment.


Assuntos
Atletas , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Volta ao Esporte , Betacoronavirus , Estudos Transversais , Depressão , Carboidratos da Dieta , Exercício Físico , Feminino , Humanos , Masculino , Comportamento Sedentário , Sono , Inquéritos e Questionários
10.
Nihon Koshu Eisei Zasshi ; 67(4): 261-271, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32389925

RESUMO

Objective This study aimed to identify the characteristics of nutrition and food intake among people who have limited access to grocery stores (hereinafter, "people with limited access").Method Data from the 2011 National Health and Nutrition Survey and 2011 Comprehensive Survey of Living Conditions were compiled using a data-linkage method. These are the only surveys that contain data regarding people's access to grocery stores. Nutrition and food intake among people with limited access were examined using an econometric method targeting 1,051 women aged 65 years and older. The objective variables for the analysis were caloric intake (kcal) from energy-providing nutrients, namely, proteins, fats, and carbohydrates, and 17 items in different food groups (g/1,000 kcal). The analysis used the seemingly unrelated regressions model, a simultaneous equations model designed to address endogeneity through simultaneous determinations of objective variables. This model indicated, by way of coefficients, the influence of the factors (variables) that define caloric intake from each nutrient and food group. The substitution-complementary relation among the nutrients and among the food groups was expressed as a correlation matrix between error terms.Results The characteristics of people with limited access were examined targeting women aged 65 years and older with respect to their access to grocery stores and intake of energy-providing nutrients. The results indicated that their caloric intake (kcal) of carbohydrates was significantly high, whereas their caloric intake (kcal) of fats was significantly low. Their caloric intake by food group (g/1,000 kcal) also confirmed similar results: their intake of grains was high, but that of fats was low. Thus, the results indicated a strong likelihood that people with limited access, even after accounting for the substitution-complementary relation, had a diet that was too high in carbohydrates.Conclusion People with limited access tended to have a diet that was too high in carbohydrates. This tendency had a strong likelihood to be because of not simply the prices or their preferences but their food environment-that is, their limited access to grocery stores. The food environment prescribes people's diet, even when individuals' financial situations are taken into account. Therefore, the study indicated the necessity for chain store operators to cooperate with one another and with the government to create an environment that facilitates shopping-support services.


Assuntos
Ingestão de Alimentos , Indústria Alimentícia , Abastecimento de Alimentos , Alimentos , Inquéritos Nutricionais/métodos , Idoso , Dieta , Carboidratos da Dieta , Ingestão de Energia , Feminino , Humanos , Japão
11.
Cochrane Database Syst Rev ; 5: CD011737, 2020 05 19.
Artigo em Inglês | MEDLINE | ID: mdl-32428300

RESUMO

BACKGROUND: Reducing saturated fat reduces serum cholesterol, but effects on other intermediate outcomes may be less clear. Additionally, it is unclear whether the energy from saturated fats eliminated from the diet are more helpfully replaced by polyunsaturated fats, monounsaturated fats, carbohydrate or protein. OBJECTIVES: To assess the effect of reducing saturated fat intake and replacing it with carbohydrate (CHO), polyunsaturated (PUFA), monounsaturated fat (MUFA) and/or protein on mortality and cardiovascular morbidity, using all available randomised clinical trials. SEARCH METHODS: We updated our searches of the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid) and Embase (Ovid) on 15 October 2019, and searched Clinicaltrials.gov and WHO International Clinical Trials Registry Platform (ICTRP) on 17 October 2019. SELECTION CRITERIA: Included trials fulfilled the following criteria: 1) randomised; 2) intention to reduce saturated fat intake OR intention to alter dietary fats and achieving a reduction in saturated fat; 3) compared with higher saturated fat intake or usual diet; 4) not multifactorial; 5) in adult humans with or without cardiovascular disease (but not acutely ill, pregnant or breastfeeding); 6) intervention duration at least 24 months; 7) mortality or cardiovascular morbidity data available. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed inclusion, extracted study data and assessed risk of bias. We performed random-effects meta-analyses, meta-regression, subgrouping, sensitivity analyses, funnel plots and GRADE assessment. MAIN RESULTS: We included 15 randomised controlled trials (RCTs) (16 comparisons, ~59,000 participants), that used a variety of interventions from providing all food to advice on reducing saturated fat. The included long-term trials suggested that reducing dietary saturated fat reduced the risk of combined cardiovascular events by 21% (risk ratio (RR) 0.79; 95% confidence interval (CI) 0.66 to 0.93, 11 trials, 53,300 participants of whom 8% had a cardiovascular event, I² = 65%, GRADE moderate-quality evidence). Meta-regression suggested that greater reductions in saturated fat (reflected in greater reductions in serum cholesterol) resulted in greater reductions in risk of CVD events, explaining most heterogeneity between trials. The number needed to treat for an additional beneficial outcome (NNTB) was 56 in primary prevention trials, so 56 people need to reduce their saturated fat intake for ~four years for one person to avoid experiencing a CVD event. In secondary prevention trials, the NNTB was 32. Subgrouping did not suggest significant differences between replacement of saturated fat calories with polyunsaturated fat or carbohydrate, and data on replacement with monounsaturated fat and protein was very limited. We found little or no effect of reducing saturated fat on all-cause mortality (RR 0.96; 95% CI 0.90 to 1.03; 11 trials, 55,858 participants) or cardiovascular mortality (RR 0.95; 95% CI 0.80 to 1.12, 10 trials, 53,421 participants), both with GRADE moderate-quality evidence. There was little or no effect of reducing saturated fats on non-fatal myocardial infarction (RR 0.97, 95% CI 0.87 to 1.07) or CHD mortality (RR 0.97, 95% CI 0.82 to 1.16, both low-quality evidence), but effects on total (fatal or non-fatal) myocardial infarction, stroke and CHD events (fatal or non-fatal) were all unclear as the evidence was of very low quality. There was little or no effect on cancer mortality, cancer diagnoses, diabetes diagnosis, HDL cholesterol, serum triglycerides or blood pressure, and small reductions in weight, serum total cholesterol, LDL cholesterol and BMI. There was no evidence of harmful effects of reducing saturated fat intakes. AUTHORS' CONCLUSIONS: The findings of this updated review suggest that reducing saturated fat intake for at least two years causes a potentially important reduction in combined cardiovascular events. Replacing the energy from saturated fat with polyunsaturated fat or carbohydrate appear to be useful strategies, while effects of replacement with monounsaturated fat are unclear. The reduction in combined cardiovascular events resulting from reducing saturated fat did not alter by study duration, sex or baseline level of cardiovascular risk, but greater reduction in saturated fat caused greater reductions in cardiovascular events.


Assuntos
Doenças Cardiovasculares/prevenção & controle , Gorduras na Dieta/administração & dosagem , Ácidos Graxos/administração & dosagem , Adulto , Doenças Cardiovasculares/mortalidade , Causas de Morte , Colesterol/sangue , Carboidratos da Dieta/administração & dosagem , Gorduras Insaturadas na Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Ingestão de Energia , Feminino , Humanos , Masculino , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Acidente Vascular Cerebral/prevenção & controle
12.
PLoS One ; 15(5): e0232689, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32384105

RESUMO

Bacteria residing in the gastrointestinal tract of mammals are crucial for the digestion of dietary nutrients. Bacterial community composition is modified by age and diet in other species. Although horses are adapted to consuming fibre-based diets, high-energy, often high-starch containing feeds are increasingly used. The current study assessed the impact of age on the faecal bacteriome of ponies transitioning from a hay-based diet to a high-starch diet. Over two years, 23 Welsh Section A pony mares were evaluated (Controls, 5-15 years, n = 6/year, 12 in total; Aged, ≥19 years, n = 6 Year 1; n = 5 Year 2, 11 in total). Across the same 30-week (May to November) period in each year, animals were randomly assigned to a 5-week period of study and were individually fed the same hay to maintenance (2% body mass as daily dry matter intake) for 4-weeks. During the final week, 2g starch per kg body mass (micronized steam-flaked barley) was incorporated into the diet (3-day transition and 5 days at maximum). Faecal samples were collected for 11 days (final 3 days hay and 8 days hay + barley feeding). Bacterial communities were determined using Ion Torrent Sequencing of amplified V1-V2 hypervariable regions of 16S rRNA. Age had a minimal effect on the bacteriome response to diet. The dietary transition increased Candidatus Saccharibacteria and Firmicutes phyla abundance and reduced Fibrobactres abundance. At the genera level, Streptococcus abundance was increased but not consistently across individual animals. Bacterial diversity was reduced during dietary transition in Streptococcus 'responders'. Faecal pH and VFA concentrations were modified by diet but considerable inter-individual variation was present. The current study describes compositional changes in the faecal bacteriome associated with the transition from a fibre-based to a high-starch diet in ponies and emphasises the individual nature of dietary responses, which may reflect functional differences in the bacterial populations present in the hindgut.


Assuntos
Ração Animal , Carboidratos da Dieta/metabolismo , Microbioma Gastrointestinal , Cavalos/fisiologia , Amido/metabolismo , Envelhecimento , Ração Animal/análise , Animais , Carboidratos da Dieta/análise , Fibras na Dieta/análise , Fibras na Dieta/metabolismo , Fezes/microbiologia , Glucose/metabolismo , Insulina/metabolismo , Amido/análise
13.
Am J Trop Med Hyg ; 103(1): 515-519, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32431274

RESUMO

Adequate dietary intake is critically important for child growth and development. This study aimed to analyze the prevalence of undernutrition and its association with infant and child feeding index (ICFI). This cross-sectional study was conducted among children (younger than5 years) and their mothers from Lhaviyani Atoll, Maldives. The data were obtained by interviewing the children's mothers via pretested questionnaires. Infant and child feeding index scores were calculated from the dietary information. Weight-for-age z-scores (WAZ), length/height-for-age z-scores (LAZ/HAZ), and weight-for-length/height z-scores were calculated from anthropometric data taken according to the WHO criterion. Linear regression tests were used to find the association of nutritional status with ICFI scores. A total of 800 children and their mothers participated in this study. The prevalence of underweight, stunting, and wasting was 24.6%, 32.4%, and 16.3%, respectively. The mean ICFI scores (13.0) of children aged 6-8 months were better than those of children in other age-groups. In food groups, the intake of fish was higher among the respondents, whereas the consumption of vegetables and fruits was lower. Infant and child feeding index scores were significantly associated (P < 0.05) with WAZ and LAZ/HAZ after adjustment for confounders. Overall, the findings showed that Maldivian children consumed the limited number of food items that resulted in an inadequate intake of nutrients which further resulted in the high prevalence of malnutrition.


Assuntos
Dieta/estatística & dados numéricos , Transtornos do Crescimento/epidemiologia , Desnutrição/epidemiologia , Magreza/epidemiologia , Síndrome de Emaciação/epidemiologia , Alimentação Artificial/estatística & dados numéricos , Aleitamento Materno/estatística & dados numéricos , Pré-Escolar , Estudos Transversais , Laticínios , Carboidratos da Dieta , Ovos , Feminino , Frutas , Humanos , Ilhas do Oceano Índico/epidemiologia , Lactente , Modelos Lineares , Masculino , Carne , Proteínas de Vegetais Comestíveis , Alimentos Marinhos , Verduras
14.
J Sci Med Sport ; 23(7): 670-679, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32448749

RESUMO

OBJECTIVES: To describe the perceptions of South African elite and semi-elite athletes on return to sport (RTS); maintenance of physical conditioning and other activities; sleep; nutrition; mental health; healthcare access; and knowledge of coronavirus disease 2019 (COVID-19). DESIGN: Cross- sectional study. METHODS: A Google Forms survey was distributed to athletes from 15 sports in the final phase (last week of April 2020) of the level 5 lockdown period. Descriptive statistics were used to describe player demographic data. Chi-squared tests investigated significance (p<0.05) between observed and expected values and explored sex differences. Post hoc tests with a Bonferroni adjustment were included where applicable. RESULTS: 67% of the 692 respondents were males. The majority (56%) expected RTS after 1-6 months. Most athletes trained alone (61%; p<0.0001), daily (61%; p<0.0001) at moderate intensity (58%; p<0.0001) and for 30-60min (72%). During leisure time athletes preferred sedentary above active behaviour (p<0.0001). Sleep patterns changed significantly (79%; p<0.0001). A significant number of athletes consumed excessive amounts of carbohydrates (76%; p<0.0001; males 73%; females 80%). Many athletes felt depressed (52%), and required motivation to keep active (55%). Most had access to healthcare during lockdown (80%) and knew proceedings when suspecting COVID-19 (92%). CONCLUSIONS: COVID-19 had physical, nutritional and psychological consequences that may impact on the safe RTS and general health of athletes. Lost opportunities and uncertain financial and sporting futures may have significant effects on athletes and the sports industry. Government and sporting federations must support athletes and develop and implement guidelines to reduce the risk in a COVID-19 environment.


Assuntos
Atletas , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Volta ao Esporte , Betacoronavirus , Estudos Transversais , Depressão , Carboidratos da Dieta , Exercício Físico , Feminino , Humanos , Masculino , Comportamento Sedentário , Sono , Inquéritos e Questionários
15.
PLoS One ; 15(5): e0231572, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32437371

RESUMO

Healthier carbohydrate (carb)-rich foods are essential for health, but practical, validated indices for their identification are not established. We compared four pragmatic metrics, based on, per 10g of carb:(a) ≥1g fiber (10:1 carb:fiber), (b) ≥1g fiber and <1g free sugars (10:1:1 carb:fiber:free sugars), (c) ≥1g fiber and <2g free sugars (10:1:2 carb:fiber:free sugars); and (d) ≥1g fiber and, per each 1 g of fiber, <2g free sugars (10:1 carb:fiber, 1:2 fiber:free sugars; or 10:1|1:2). Using 2013-2016 National Health and Nutrition Examination Survey /Food and Nutrient Database for Dietary Studies, we assessed, overall and for 12 food categories, whether each metric discriminated carb-rich products higher or lower (per 100g) in calories, total fat, saturated fat, protein, sugar, fiber, sodium, potassium, magnesium, folate, and 8 vitamins/minerals. Among 2,208 carb-rich products, more met 10:1 (23.2%) and 10:1|1:2 (21.3%), followed by 10:1:2 (19.2%) and 10:1:1 (16.4%) ratios, with variation by product sub-categories. The 10:1 and 10:1|1:2 ratios similarly identified products with lower calories, fat, free sugars, and sodium; and higher protein, fiber, potassium, magnesium, iron, vitamin B6, vitamin E, zinc and iron. The 10:1:2 and 10:1:1 ratios identified products with even larger differences in calories and free sugars, but smaller differences in other nutrients above and lower folate, thiamine, riboflavin, and niacin; the latter findings were attenuated after excluding breakfast cereals (~9% of products). These novel findings inform dietary guidance for consumers, policy, and industry to identify and promote the development of the healthier carb-rich foods.


Assuntos
Carboidratos da Dieta/análise , Carboidratos da Dieta/normas , Minerais/análise , Nutrientes/análise , Valor Nutritivo , Vitaminas/análise , Humanos
16.
Nutr Metab Cardiovasc Dis ; 30(6): 984-995, 2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32402585

RESUMO

BACKGROUND & AIMS: The effect of pasta consumption within a low-energy Mediterranean diet on body weight regulation has been scarcely explored. This paper investigates the effect of two Mediterranean diets, which differed for lower or higher pasta intake, on body weight change in individuals with obesity. METHODS & RESULTS: Forty-nine volunteers finished a quasi-experimental 6-month two-parallel group dietary intervention. Participants were assigned to a low-energy high pasta (HP) or to a low-energy low Pasta (LP) group on the basis of their pasta intake (HP ≥ 5 or LP ≤ 3 times/week). Anthropometrics, blood pressure and heart rate were measured every month. Weight maintenance was checked at month 12. Body composition (bioelectrical impedance analysis, BIA), food intake (24-h recall plus a 7-day carbohydrate record) and the perceived quality of life (36-item short-form health survey, SF-36) were assessed at baseline, 3 and 6 months. Blood samples were collected at baseline and month 6 to assess glucose and lipid metabolism. After 6-month intervention, body weight reduction was -10 ± 8% and -7 ± 4% in HP and LP diet, respectively, and it remained similar at month 12. Both dietary interventions improved anthropometric parameters, body composition, glucose and lipid metabolism, but no significant differences were observed between treatment groups. No differences were observed for blood pressure and heart rate between treatments and among times. HP diet significantly improved perception of quality of life for the physical component. CONCLUSIONS: Independent of pasta consumption frequency, low-energy Mediterranean diets were successful in improving anthropometrics, physiological parameters and dietary habits after a 6-month weight-loss intervention. This trial was registered at clinicaltrials.gov as NCT03341650.


Assuntos
Dieta com Restrição de Carboidratos , Dieta Mediterrânea , Carboidratos da Dieta/administração & dosagem , Obesidade/dietoterapia , Perda de Peso , Adulto , Composição Corporal , Dieta com Restrição de Carboidratos/efeitos adversos , Carboidratos da Dieta/efeitos adversos , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Ensaios Clínicos Controlados não Aleatórios como Assunto , Obesidade/diagnóstico , Obesidade/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
18.
Nutrients ; 12(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252250

RESUMO

Consumption of low-glycemic index (GI) carbohydrates (CHO) may be superior to high-GI CHO before exercise by increasing fat oxidation and decreasing carbohydrate oxidation. We compared the effects of pre-exercise feeding of a low-GI lentil-based sports nutrition bar with a high-GI bar on metabolism and performance during a simulated soccer match. Using a randomized, double-blind, counterbalanced, crossover design, participants (n = 8) consumed 1.5 g/kg available CHO from a low-GI bar (GI = 45) or high-GI bar (GI = 101) two hours before a 90 min simulated soccer match, and 0.38 g/kg body mass during a 15 min half-time break. The test involved alternating 6 min intervals of paced jogging, running, walking, and sprinting, and 3 min intervals of soccer-specific skills (timed ball dribbling, agility running, heading, kicking accuracy). Carbohydrate oxidation rate was lower during the match after consuming the low-GI compared to high-GI bar (2.17 ± 0.6 vs. 2.72 ± 0.4 g/min; p < 0.05). Participants performed better during the low-GI versus high-GI bar condition on the agility test (5.7 ± 0.4 versus 6.1 ± 0.6 s; p < 0.01) and heading (i.e., jumping height 24.7 ± 4.3 versus 22.2 ± 4.5 cm; p < 0.01) late in the soccer match (72 min). A low-GI lentil-based sports nutrition bar provides a metabolic benefit (lower carbohydrate oxidation rate) and a modest improvement in agility running and jumping height (heading) late in the test.


Assuntos
Glicemia/metabolismo , Carboidratos da Dieta/metabolismo , Índice Glicêmico , Futebol , Fenômenos Fisiológicos da Nutrição Esportiva/fisiologia , Adulto , Desempenho Atlético , Estudos Cross-Over , Método Duplo-Cego , Humanos , Masculino , Recreação
19.
Nutrients ; 12(4)2020 Apr 02.
Artigo em Inglês | MEDLINE | ID: mdl-32252374

RESUMO

Low-carbohydrate diets (LCDs) often differ in their diet composition, which may lead to conflicting results between randomized controlled trials. Therefore, we aimed to compare the effects of different degrees of carbohydrate (CHO) restriction on cardiometabolic risk markers in humans. The experimental LCDs of 37 human trials were classified as (1) moderate-low CHO diets (<45-40 E%, n = 13), (2) low CHO diets (<40-30 E%, n = 16), and (3) very-low CHO diets (<30-3 E%; n = 8). Summary estimates of weighted mean differences (WMDs) in selected risk markers were calculated using random-effect meta-analyses. Differences between the LCD groups were assessed with univariate meta-regression analyses. Overall, the LCDs resulted in significant weight loss, reduced diastolic blood pressure BP, and increased total cholesterol and high-density lipoprotein cholesterol (HDL-C), without significant differences between the three LCD groups. Higher low-density lipoprotein cholesterol (LDL-C) concentrations were found with the very-low CHO diets compared to the moderate-low CHO diets. Decreases in triacylglycerol (TAG) concentrations were more pronounced with the low and very-low CHO diets, compared to the moderate-low CHO diets. Substitution of CHO by mainly saturated fatty acids (SFAs) increased total cholesterol, LDL-C, and HDL-C concentrations. Except for LDL-C and TAGs, effects were not related to the degree of CHO restriction. Potential effects of nutrient exchanges should be considered when following LCDs.


Assuntos
Colesterol/metabolismo , Dieta com Restrição de Carboidratos , Carboidratos da Dieta/administração & dosagem , Carboidratos da Dieta/metabolismo , Triglicerídeos/metabolismo , Doenças Cardiovasculares/sangue , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/prevenção & controle , Humanos
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