Omega-3 mechanism of action in inflammation and endoplasmic reticulum stress in mononuclear cells from overweight non-alcoholic fatty liver disease participants: study protocol for the "Brazilian Omega Study" (BROS)-a randomized controlled trial.

The low-grade inflammation is pivotal in obesity and its comorbidities; however, the inflammatory proteins are out of target for traditional drug therapy. Omega-3 (ω3) fatty acids can modulate the downstream signaling of Toll-like receptor (TLR) and tumor necrosis factor-α receptor (TNFα) through GPR120, a G-protein-coupled receptor, a mechanism not yet elucidated in humans. This work aims to investigate if the ω3 supplementation, at a feasible level below the previously recommended level in the literature, is enough to disrupt the inflammation and endoplasmic reticulum stress (ER-stress), and also if in acute treatment (3 h) ω3 can activate the GPR120 in peripheral blood mononuclear cells (PBMC) and leukocytes from overweight non-alcoholic fatty liver disease (NAFLD) participants. The R270H variant of the Ffar4 (GPR120 gene) will also be explored about molecular responses and blood lipid profiles. A triple-blind, prospective clinical trial will be conducted in overweight men and women, aged 19-75 years, randomized into placebo or supplemented (2.2 g of ω3 [EPA+DHA]) groups for 28 days. For sample calculation, it was considered the variation of TNFα protein and a 40% dropout rate, obtaining 22 individuals in each group. Volunteers will be recruited among patients with NAFLD diagnosis. Anthropometric parameters, food intake, physical activity, total serum lipids, complete fatty acid blood profile, and glycemia will be evaluated pre- and post-supplementation. In the PBMC and neutrophils, the protein content and gene expression of markers related to inflammation (TNFα, MCP1, IL1ß, IL6, IL10, JNK, and TAK1), ER-stress (ATF1, ATF6, IRE1, XBP1, CHOP, eIF2α, eIF4, HSP), and ω3 pathway (GPR120, ß-arrestin2, Tab1/2, and TAK1) will be evaluated using Western blot and RT-qPCR. Participants will be genotyped for the R270H (rs116454156) variant using the TaqMan assay. It is hypothesized that attenuation of inflammation and ER-stress signaling pathways in overweight and NAFLD participants will be achieved through ω3 supplementation through binding to the GPR120 receptor. TRIAL REGISTRATION: ClinicalTrials.gov #RBR-7x8tbx. Registered on May 10, 2018, with the Brazilian Registry of Clinical Trials.

Risco cardiovascular, indicadores antropométricos e mini avaliação nutricional reduzida: associação com índice de massa corporal na avaliação nutricional de idosos / Cardiovascular risk, anthropometric indicators and reduced mini nutritional assessment: association with body mass index in the nutritional evaluation of the elderly

Introdução: O envelhecimento é caracterizado por adaptações fisiológicas que impactam no estado nutricional dos idosos. A avaliação nutricional é um processo complexo e sistemático composto por indicadores antropométricos de massa magra e gorda, responsáveis por descrever a composição corporal e estado nutricional dos idosos. Ademais, o diagnóstico nutricional pode ser obtido por instrumentos e indicadores nutricionais, como a miniavaliação nutricional versão curta e o índice de massa corporal. Objetivos: Analisar o risco cardiovascular, indicadores antropométricos e a miniavaliação nutricional versão curta na fase idosa e comparar os resultados com o índice de massa corporal. Metodologia: Trata-se de um estudo descritivo, transversal, realizado entre agosto e novembro de 2017, baseado na aplicação de um questionário sociodemográfico, avaliação antropométrica, índice de massa corporal e miniavaliação nutricional versão curta. Os resultados foram avaliados quanto a normalidade da amostra e as associações foram realizados os testes de Kolmogorov-Smirnov, T de student e Qui-quadrado, considerando margem de erro 5,0% (p<0,05). Resultados: Foram avaliados 65 idosos com média e desvio padrão de idade de 67 ± 5,79 anos, sendo maioria do sexo feminino (73,8%). Foi observado associação positiva entre os indicadores antropométricos e miniavaliação nutricional versão curta com o índice de massa corporal. Verificou-se a prevalência de excesso de peso, segundo Índice de Massa Corporal, de 53,1%, e risco aumentado para doenças cardiovascular, de acordo com a Circunferência da Cintura, de 87,6%. A partir do percentual de adequação da Circunferência do Braço, Dobra Cutânea Tricipital e escore da miniavaliação nutricional versão curta; foi verificado considerável prevalência de desnutrição, sendo 24,6%, 38,4% e 41,3%, respectivamente. Conclusão: Os resultados demonstram a prevalência do excesso de peso com a simultânea presença da desnutrição e risco cardiovascular aumentado, além de associações entre os indicadores antropométricos

Introduction: Aging is a process characterized by physiological changes that affect the nutritional status of the elderly. Nutritional assessment is a complex and systematic process composed of anthropometric indicators of lean and fat mass, responsible for describing the body composition and nutritional status of the elderly. In addition, the nutritional diagnosis can be obtained by screening instruments and nutritional indicators, such as mini nutritional assessment short form and body mass index. Objectives: Analyze the cardiovascular risk, anthropometric indicators and the mini nutritional assessment short form in the elderly phase and compare the results with the body mass index. Methods: Its a descriptive, cross-sectional study carried out from August to November 2017, based on the application of a sociodemographic questionnaire, anthropometric evaluation, body mass index and mini nutritional assessment short form. Kolmogorov-Smirnov, Student's T and Chi-square tests were used to evaluate the normality of the sample and the associations, considering a margin of error of 5.0% (p <0.05). Results: Sixty-five elderly individuals with mean and standard deviation of 67 ± 5.79 years were evaluated, with a majority of females (73.8%). It was observed a positive association between the anthropometric indicators and mini nutritional assessment short form with the body mass index. In addition, the prevalence of excess weight, according to Body Mass Index, was 53.1%, and the risk of cardiovascular diseases increased according to the Waist Circumference of 87.6%. Based on the adequacy percentage of Arm Circumference, Tricipital Cut Fold, and mini nutritional assessment short form score; there was a considerable prevalence of malnutrition, being 24.6%, 38.4% and 41.3%, respectively. Conclusion: The results demonstrate the prevalence of overweight with the simultaneous presence of malnutrition and increased cardiovascular risk, as well as associations between the anthropometric indicators

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