Effects of a supervised exercise training on body composition after bariatric surgery: a randomized controlled trial.

OBJECTIVE: This study aimed to determine the effects of a multicomponent exercise intervention during the first year post-bariatric surgery (BS) on body composition, weight loss (WL), energy expenditure, and nutrient intake. METHODS: A total of 84 patients were included in this study and were randomly assigned to either an exercise group (n = 41) or a control group (n = 20). The exercise group participated in a multicomponent exercise program that began 1-month post-BS, whereas the control group received only standard medical care post-BS. Body composition was assessed by dual-energy x-ray absorptiometry, and physical activity energy expenditure was assessed by accelerometers. Nutritional intake was assessed through a 4-day food diary. RESULTS: A total of 6-months post-BS, exercise was found to be effective in mitigating the loss of lower-limb and appendicular lean mass (LM), as well as favoring trunk fat mass (FM) loss. Moreover, it further decreased percent FM and promoted additional excess WL. After 12 months, exercise not only reduced waist circumference but also helped to lessen the loss of total, trunk, and appendicular LM. CONCLUSIONS: Exercise further induced trunk fat mass, percent FM, excess WL, and waist circumference reductions. Moreover, exercise attenuated the loss of total and regional LM.

Usual dietary intake, physical activity, weight loss, and body composition after five years of Roux-en-Y gastric bypass.

OBJECTIVE: To estimate usual dietary intake (UDI), physical activity (PA), and their association with weight loss and body composition in patients who underwent Roux-en-Y gastric bypass (RYGB) after five years in the Federal District, Brazil. METHODS: We assessed anthropometry and body composition using bioimpedance, and dietary intake and PA with three nonconsecutive 24-h recalls. PC-Side was used to estimate UDI. Dietary patterns (DPs) were identified through principal component analysis, and association between UDI and PA with percentage of total weight loss (%TWL) and fat-free mass (FFM) through multinomial logistic regression. RESULTS: Sample (n = 124) presented mean (SD) age of 48.9 (9.4) years, median (IQR) of 9 years (7-10) post RYGB, current BMI = 32.3 kg/m² (28.8-35.7), %TWL = 24.7% (10.9), and FFM = 45.1 kg (41.1-51.9). Mean usual energy intake of 1556 kcal/d, with adequate protein intake, poor fiber intake, and excessive carbohydrate, total fat, and added sugar intake, compared to dietary guidelines. Calcium, vitamins C, D, and E presented the greatest inadequacy (15%, 24%, 32%, and 49% of individuals, respectively, reported usual intake below EAR); 83 participants were considered active/very active, according PA. DP with high energy, protein, total fat, saturated fat, and sodium intake, was negatively associated with %TWL (OR = 0.545, p = 0.037). Protein intake was positively associated with FFM (OR = 1.091, p = 0.004). PA was not associated with %TWL or FFM. CONCLUSION: Participants demonstrated intake of carbohydrate, fat, fiber, added sugar not in accordance with guidelines. A DP rich in energy, protein, total fat, saturated fat, and sodium appears to decrease TWL. However, protein intake appears to increase FFM.

Frequency of Vitamin D Deficiency and Associated Factors in Long-term Bariatric Surgery Patients: a Cross-sectional Study.

BACKGROUND: Vitamin D deficiency is a common consequence of bariatric surgery (BS). However, few studies have evaluated influential factors and to date there are no studies investigating individual ultraviolet B (UVB) radiation levels in BS patients. This study aimed to evaluate vitamin D deficiency and its associated factors, including UVB radiation, in Roux-Y gastric bypass (RYGB) patients. METHODS: This study included 104 adults (90.4% female) at least 5 years after RYGB. Patients underwent surgery in private hospitals (Private; n = 47) or in two public hospitals, one with ongoing outpatient care (Active; n = 17), and the other with discontinued service for BS (Discontinued; n = 40). 25-hydroxyvitamin D (25(OH)D) concentrations were analyzed by chemiluminescence, individual UVB radiation levels by dosimeter badges. Vitamin D intake, anthropometric, skin phototype, sociodemographic and lifestyle patterns were also assessed. RESULTS: Mean age was 49.6 ± 9.1 years and post-operative period 8.7 ± 2.2 years. The prevalence of 25(OH)D deficiency and insufficiency was 25.0% and 51.9% respectively. 25(OH)D concentration differed among the hospitals (private = 26.2 ± 8.5; active = 28.7 ± 11.4; discontinued = 23.5 ± 6.5 ng/mL; p = 0.038). A total of 26.2% of the variance observed in 25(OH)D concentrations was explained by daily UVB radiation levels (ß = 0.224; p = 0.032) and vitamin D intake (ß = 0.431; p < 0.001), controlling for age and BMI. CONCLUSION: A quarter of the evaluated patients presented vitamin D deficiency, which was associated with the discontinuation of the health care, higher BMI, lower vitamin D intake, and lower individual UVB radiation levels.

Physically inactive adults are the main users of sports dietary supplements in the capital of Brazil.

PURPOSE: This cross-sectional study aimed to provide estimates of dietary supplements (DS) use and to examine the relationship between sports dietary supplements (SDS) use and sociodemographic and lifestyle characteristic, body mass index and total daily physical activity (PA) in the adult population of Brasília, Brazil. METHODS: DS use was collected from 506 adults via a Food Frequency Questionnaire. DS were divided into multivitamin-minerals, electrolyte drinks, energy, protein, partial meal replacements, creatine, caffeine, and others. Electrolyte drinks, energy, and protein supplements were considered as SDS. PA was estimated from a 24-h PA recall, and total MET (metabolic equivalents)/day and MET-h/day were calculated. Participants were categorized as physically inactive or active according to MET-h/day. RESULTS: DS were used by 68% of adults; multivitamin-minerals (38%) and protein supplements (29%) were the most commonly used products. SDS use was associated with the highest socioeconomic level, younger age, and male gender, but not with PA. Also, most SDS users were physically inactive. CONCLUSION: These findings indicate that SDS may be used unnecessarily by adults in Brasília. Specific recommendations and control procedures for the use of SDS are warranted.

Comparison and calibration of 24-hour physical activity recall in adult population.

AbstractThis study compared and calibrated metabolic equivalents (METs) per day from 24-hour physical activity recall (24hPAR) with accelerometry. A sub-sample of 74 adults of both sexes, residents of Brasília, Brazil, from a larger study had same day measurements of accelerometry and 24hPAR data. METs values were assessed by accelerometry (7 consecutive days of use) and by 24hPAR (minimum of one and maximum of 2 per person). A script was written in the R statistical software to analyse the recall and accelerometer data. The script ran a simple linear regression to visualize the relationship between total METs/day for the two methods and to execute the recall measurement error correction. Most of participants were female (54.1%), with at least university graduate (94.6%) and mean age of 34.8 years (±11.83). The correlation coefficient obtained between 24hPAR and accelerometer was r = 0.55, considered moderate and significant (p < 0.001). A majority of the participants (77%) underestimated METs values compared to accelerometry when answering the questionnaire. Calibration of 24hPAR allowed us to approximate MET values to the accelerometer. The calibration equation to correct total METs/day for measurement error is (total 24hPAR METs/day - 10.6)/0.619. The 24hPAR is a decent tool to assess PA level in large adults' samples. However, compared with accelerometer, it underestimates METs values, which can be corrected with the use of the calibration equation provided in this study.

The effect of coffee consumption on glucose homeostasis and redox-inflammatory responses in high-fat diet-induced obese rats.

Coffee effects on glucose homeostasis in obesity remain controversial. We investigated whether coffee mitigates the negative effects on glucose metabolism induced by a high-fat diet and the interrelationships with redox-inflammatory responses. Rats were treated with: control (CT-); coffee (CT+) 3.9 g of freeze-dried coffee/kg of diet; high-fat (HF-); or high-fat + coffee 3.9 g of freeze-dried coffee/kg of diet (HF+) diet. The high-fat diet increased weight gain, feed efficiency, HOMA ß, muscle and hepatic glycogen, intestinal CAT and SOD activity, hepatic protein (CARB) and lipid oxidation (MDA), muscle Prkaa1 mRNA and IL6 levels, and decreased food intake, hepatic GR, GPX and SOD activities, intestinal CARB, intestinal Slc2a2 and Slc5a1 and hepatic Prkaa1 and Prkaa2 mRNA levels, hepatic glucose-6-phosphatase and muscle hexokinase (HK) activities, compared to the control diet. The high-fat diet with coffee increased hepatic GST activity and TNF and decreased IL6 and intestinal glucosidase activity compared with the high-fat diet. The coffee diet increased muscle glycogen, hepatic CARB and PEPCK activity, and decreased hepatic GR and SOD activities and intestinal CARB, compared with the control diet. Coffee increased insulin levels, HOMA IR/ß, FRAP, muscle Prkaa1 mRNA levels and hepatic and muscle phosphofructokinase-1, and it decreased intestinal CAT, hepatic Slc2a2 mRNA levels and muscle HK activity, regardless of the diet type. In conclusion, chronic coffee consumption improves antioxidant and anti-inflammatory responses, but does not ameliorate glucose homeostasis in a high-fat diet-induced obesity model. In addition, coffee consumption increases insulin secretion and promotes muscle glycogen synthesis in rats maintained on a control diet.

Coffee Increases Post-Exercise Muscle Glycogen Recovery in Endurance Athletes: A Randomized Clinical Trial.

Coffee is one of the most widely consumed beverages worldwide and caffeine is known to improve performance in physical exercise. Some substances in coffee have a positive effect on glucose metabolism and are promising for post-exercise muscle glycogen recovery. We investigated the effect of a coffee beverage after exhaustive exercise on muscle glycogen resynthesis, glycogen synthase activity and glycemic and insulinemic response in a double-blind, crossover, randomized clinical trial. Fourteen endurance-trained men performed an exhaustive cycle ergometer exercise to deplete muscle glycogen. The following morning, participants completed a second cycling protocol followed by a 4-h recovery, during which they received either test beverage (coffee + milk) or control (milk) and a breakfast meal, with a simple randomization. Blood samples and muscle biopsies were collected at the beginning and by the end of recovery. Eleven participants were included in data analysis (age: 39.0 ± 6.0 years; BMI: 24.0 ± 2.3 kg/m2; VO2max: 59.9 ± 8.3 mL·kg-1·min-1; PPO: 346 ± 39 W). The consumption of coffee + milk resulted in greater muscle glycogen recovery (102.56 ± 18.75 vs. 40.54 ± 18.74 mmol·kg dw-1; p = 0.01; d = 0.94) and greater glucose (p = 0.02; d = 0.83) and insulin (p = 0.03; d = 0.76) total area under the curve compared with control. The addition of coffee to a beverage with adequate amounts of carbohydrates increased muscle glycogen resynthesis and the glycemic and insulinemic response during the 4-h recovery after exhaustive cycling exercise.

Effects of Resistance Training With or Without Protein Supplementation on Body Composition and Resting Energy Expenditure in Patients 2-7 Years PostRoux-en-Y Gastric Bypass: a Controlled Clinical Trial.

BACKGROUND: Resistance training (RT) and adequate protein intake are recommended as strategies to preserve fat-free mass (FFM) and resting metabolic demand after bariatric surgery. However, the effect of both interventions combined in the late postoperative period is unclear. This study investigated the effects of RT, isolated and combined with protein supplementation, on body composition and resting energy expenditure (REE) in the late postoperative period of Roux-en-Y gastric bypass (RYGB). METHODS: This controlled trial involved patients who were 2-7 years postRYGB. Participants were partially matched on body mass index (BMI), age, sex, and years after surgery, and divided into four groups, placebo maltodextrin (control [CON]; n = 17), whey protein supplementation (PRO; n = 18), RT combined with placebo (RTP; n = 13), and RT combined with whey protein supplementation (RTP + PRO; n = 15)-considering the participants who completed the protocol. REE was measured by indirect calorimetry and body composition by multifrequency electrical bioimpedance. RESULTS: Participant characteristics (40.3 ± 8.3 years old; average BMI 29.7 ± 5.3 kg/m2; 88.9% females) were similar among groups. The RTP+PRO group showed an increase of 1.46 ± 1.02 kg in FFM and 0.91 ± 0.64 kg in skeletal muscle mass (SMM), which was greater than the equivalent values in the CON group (- 0.24 ± 1.64 kg, p = 0.006 and - 0.08 ± 0.96 kg, p = 0.008, respectively). There was no significant time-by-group interaction for absolute or relative REE. CONCLUSION: Combined RT and adequate protein intake via supplementation can increase FFM and SMM in the late postoperative period without changing REE. These associated strategies were effective in improving muscle-related parameters and potentially in improving the patients' physical function.

Early consumption of ultra-processed foods among children under 2 years old in Brazil.

OBJECTIVE: To evaluate the complementary food consumption according to the extent and purpose of food processing based on NOVA classification among children aged 6-24 months of Federal District, Brazil. DESIGN: We performed a cross-sectional study using a 24-h recall to estimate the daily energy intake and nutrients according to NOVA classification. We conducted a linear regression to assess the association between the processed and ultra-processed foods (UPF) energy intake and the daily energy intake from saturated fat, daily energy intake from total sugars and daily intake of sodium. SETTING: Federal District, Brazil. PARTICIPANTS: Five hundred and thirty-eight children aged between 6 and 24 months attended at Primary Health Care Units from March 2017 to March 2018. RESULTS: On average, children aged from 6 to 12 and from 12 to 24 months consumed 2393 and 4054 kJ/d, respectively, and processed and UPF represented one-third of dietary energy intake. Group 2 (processed and UPF) was higher carbohydrate contributors, and lower protein, fibre and most micronutrient contributors, when compared with Group 1 (unprocessed, minimally processed foods and processed culinary ingredients). In addition, the higher the energy intake from processed and UPF, the higher was the daily energy intake from saturated fat, daily energy intake from total sugar and daily intake of sodium. CONCLUSION: Children are being exposed early to processed and UPF and their share affect the diet's nutritional quality.

Adherence to National Food Guide Recommendations: Can It Slow the Obesity Epidemic? A Systematic Review.

PURPOSE OF REVIEW: Dietary guidelines (DG) have the objective to promote healthy diet and prevent chronic diseases. In order to evaluate if this purpose is being achieved, we systematically reviewed studies that associated adherence to DG with obesity. RECENT FINDINGS: We identified 2012 articles published in the last 5 years, and 38 remained in the final sample. The majority of studies demonstrated a negative association between adherence to DG and obesity. Studies with positive or no association presented mutual characteristics, such as populations composed only by children or adolescents, and dietary intake or dietary adherence assessed through non-validated or weak methods. Adherence to DG seems to be a protective factor for obesity in adults, but this relationship is not so clear for children and adolescents. To improve the quality of dietary intake results, studies must utilize appropriate methods to answer their questions with less biased estimate of dietary intake.

Translation and Validation of the Caffeine Expectancy Questionnaire in Brazil (CaffEQ-BR).

Caffeine is the world's most commonly used stimulant of the central nervous system. Caffeine is present in coffee and other beverages such as tea, soft drinks, and cocoa-based foods. The caffeine expectancy questionnaire was developed to investigate the effects of caffeine expectations and thus contribute to knowledge about its usage and subjective effects (response expectancies). This study aimed to evaluate caffeine expectation psychometrically in a sample of the Brazilian population. The original version of the "Caffeine Expectancy Questionnaire (CaffEQ)" was translated and validated into Brazilian-Portuguese and adapted to Brazilian culture to be used in the Brazilian adult (19-59 y) population. After the translation and back-translation processes of the original CaffEQ questionnaire, the content and semantic validation were performed by a group of experts. The Brazilian-Portuguese version of the questionnaire consists of 47 items, in seven factors, which assess subjective perceptions about the effects of caffeine. Interobserver reproducibility and internal consistency of the questionnaire were tested with a convenience sample (n = 50) of Brazilian adult consumers of caffeine sources, who completed the Brazilian CaffEQ (CaffEQ-BR) on two occasions separated by 24 h. All of the 47 questions were adequate regarding reliability, clarity, and comprehension. Psychometric properties could be replicated consistently. Appropriate internal consistency and validation were confirmed by Cronbach's alpha (α) 0.948, and an intraclass correlation coefficient of 0.976 was observed. The CaffEQ-BR was applied using a web-based platform to a convenience sample of Brazilian adults from all 27 Brazilian states (n = 4202 participants), along with measures of sociodemographic and caffeine consumption data. Factor validity was verified by confirmatory factor analysis. The seven factors presented a good fit for Root Mean Square Error of Approximation-RMSEA = 0.0332 (95% CI: 0.0290-0.0375). By confirming the validity and reliability of CaffEQ-BR, a useful tool is now available to assess caffeine expectations in the Brazilian adult population.

Breastfeeding reduces ultra-processed foods and sweetened beverages consumption among children under two years old.

BACKGROUND: Breastfeeding and adequate complementary feeding are associated with healthy eating habits, prevention of nutritional deficiencies, obesity and non-communicable diseases. Our aim was to identify feeding practices and to evaluate the association between breastmilk intake and complementary feeding, focusing on ultra-processed foods (UPF) and sweetened beverages, among children under 2 years old. METHODS: We conducted a cross-sectional study including 847 children from 20 Primary Health Units. We evaluated children's food consumption using a food intake markers questionnaire. We conducted a logistic regression to evaluate the effect of breastmilk intake on feeding practices. RESULTS: The breastmilk intake was associated with lower odds of consuming non-recommended foods, such as cookies or crackers (OR: 0.29; IC 95%: 0.20-0.41) for children under 6 months, yogurt (OR: 0.33; CI 95%: 0.12-0.88) for children between 6 and 12 months and soft drinks (OR: 0.36; CI 95%: 0.17-0.75) for children between 12 and 24 months. Moreover, the breastmilk intake was associated with lower odds of consuming UPF (OR: 0.26; CI 95%: 0.09-0.74) and sweetened beverages (OR: 0.13; CI 95%: 0.05-0.33) for children under 6 months. For children between 12 and 24 months, breastmilk intake was associated with lower odds of consuming sweetened beverages (OR: 0.40; CI 95%: 0.24-0.65). CONCLUSION: Breastmilk intake was associated with a reduced consumption of UPF and sweetened beverages. Investment in actions to scale up breastfeeding can generate benefits, besides those of breastmilk itself, translating into better feeding habits and preventing health problems in childhood.

Intakes of energy, macronutrients and micronutrients of a population in severe food insecurity risk in Brazil.

OBJECTIVE: To analyse usual intakes of energy, macronutrients and micronutrients, and their percentage of inadequacy, in a Brazilian population at severe food insecurity (SFI) risk, determined from a predictive model using two national databases. DESIGN: Cross-sectional study. Our study used a statistical model to predict SFI using the 2009 National Sample Household Survey, where the Brazilian Food Insecurity Scale measured SFI. SETTING: Brazil. PARTICIPANTS: The model was applied in a probabilistic sample of 34 003 Brazilians aged 10 years or older that participated in a national dietary survey during 2008-2009. The application of the model generated the probability of each individual being in SFI. The probability of SFI was grouped into quartiles (first quartile with the lowest SFI risk, fourth quartile with highest probability of SFI risk). RESULTS: The intakes of macro- and micronutrients were associated with SFI. The amount of energy and nutrients in the diet tended to be lower among individuals in the fourth quartile, with highest probability of SFI. The average intake of all studied minerals (Ca, Fe, Na, Mg) was less in individuals in the fourth quartile. Only Na presented a higher percentage of inadequacy in the first quartile, the one with a lower chance of SFI. CONCLUSIONS: The food intake of the Brazilian population at higher SFI risk is characterized by energy reduction, reduced consumption of macronutrients and high prevalence of inadequate micronutrient intakes, as well as a lower mean intakes, when compared with the first quartile with the lowest SFI risk.

Perception of Hunger/Satiety and Nutrient Intake in Women Who Regain Weight in the Postoperative Period After Bariatric Surgery.

OBJECTIVE: To investigate the perception of hunger and satiety and its association with nutrient intake in women who regain weight in the postoperative period after bariatric surgery. METHODS: Cross-sectional study of adult women divided into three groups: weight regain (n = 20), stable weight (n = 20) (both at least 24 months after Roux-en-Y gastric bypass surgery), and non-operated obesity (n = 20). A visual analogue scale measured hunger/satiety perception while fasting, immediately after finishing a test meal, and 180 min after finishing the test meal. The incremental area above or under the curve was calculated. Food intake was analyzed by 3 days of food recall and adjusted for intraindividual variation. To make between-group comparisons, Mann-Whitney, ANOVA, Kruskal-Wallis, and independent-samples T tests and Pearson's correlation were used. RESULTS: There were no between-group differences in incremental areas of hunger/satiety, but protein intake was significantly lower among patients who regained weight compared with those who had stable body weight (0.99 ± 0.23 g/kg body weight vs. 1.17 ± 0.21 g/kg body weight, p = 0.047). In the group that regained weight, satiety was correlated positively with usual dietary protein density (r = 0.541; p = 0.017) and negatively with usual carbohydrate intake (r = - 0.663; p = 0.002). CONCLUSION: Women who regained weight presented similar perceptions of hunger/satiety to those of patients without weight regain and with non-operated obesity. In patients who regained weight postoperatively, satiety perception was correlated positively with usual dietary protein density and inversely with usual carbohydrate intake.

Assessment of Nutrient and Food Group Intakes across Sex, Physical Activity, and Body Mass Index in an Urban Brazilian Population.

The burden of preventable diet-related diseases is significant and becoming worse. Thus, accurately assessing food intake is crucial to guide public health policies and actions. Using food dietary recalls, we evaluated usual dietary intake according to physical activity and nutritional status in an adult urban population from Brasília, Brazil. The usual nutrient and energy intakes distributions were estimated using the Iowa State University (ISU) method. Energy and nutrient intakes were stratified by gender, age group, body mass index (BMI), and physical activity (PA). The prevalence of inadequate intake was highest for vitamins E and D. Both men and women had excessive sodium intake. The percentage of intakes below daily serving recommendations for food groups were 96% for cereals, 74% for vegetables, and 87% for dairy products, whereas percentage of intakes above daily serving recommendations were 97% for meat, 93% for pulses, and 99% for fat/oils. Energy and nutrient intakes were highest in overweight and physically active individuals within the categories of BMI and physical activity, respectively. Our study found that high-income urban Brazilians consume large quantities of meat, beans, fat/oils, and exhibit a low prevalence of nutrient inadequacies but have excessive sodium intake. Energy and nutrient intakes are highest among men, as well as overweight and physically active individuals.

Ultra-processed food consumption and adiposity trajectories in a Brazilian cohort of adolescents: ELANA study.

BACKGROUND/OBJECTIVES: In Brazil, the increase in obesity rates has been accompanied by increased consumption of ultra-processed food (UPF). The objective of this paper was to evaluate body mass index (BMI) and body fat percentage (%BF) trajectories in adolescents over a 3-year follow-up according to the frequency of UPF consumption. SUBJECTS/METHODS: Data of three consecutive years (2010, 2011, and 2012) were obtained from the Adolescent Nutritional Assessment Longitudinal Study (ELANA) that aimed to assess changes in anthropometric indicators of nutritional status, and 1035 adolescents enrolled in the 1st year of high school from six schools (four private and two public) in the metropolitan area of Rio de Janeiro, Brazil were included. At three follow-ups, they had their weights and heights measured. Body composition was measured at the first and second follow-ups. Mixed linear regression models were used to estimate BMI and %BF trajectories based on quartiles of UPF intake, adjusting for type of school, sex, physical activity, and underreporting. RESULTS: Compared to their counterparts in the 1st quartile, adolescents in the 4th quartile of UPF consumption had a lower daily intake of fruits, cooked vegetables, and raw vegetables and a higher intake of total sugar and physical activity levels (p < 0.001). There was an inverse association between UPF consumption and BMI both at baseline and at follow-up. Values for %BF followed the same trend. Adolescents in the 4th quartile had the greatest level of physical activity and lowest total energy intake. CONCLUSION: This study confirmed that greater intake of UPF is a marker of an unhealthy diet, but did not support the hypothesis of a high rate of change in BMI associated with greater UPF consumption, even after adjusting for physical activity.

Effects of Coffee Components on Muscle Glycogen Recovery: A Systematic Review.

Coffee is one of the most consumed beverages in the world, and it can improve insulin sensitivity, stimulating glucose uptake in skeletal muscle when adequate carbohydrate intake is observed. The aim of this review is to analyze the effects of coffee and coffee components on muscle glycogen metabolism. A literature search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis, and seven studies were included, that explored the effects of coffee components on various substances and signaling proteins. In one of the studies with humans, caffeine was shown to increase glucose levels, Ca2+/calmodulin-dependent protein kinase phosphorylation, glycogen resynthesis rates, and glycogen accumulation after exercise. After intravenous injection of caffeine in rats, caffeine increased adenosine monophosphate-activated protein kinase (AMPK) and acetyl-CoA carboxylase (ACC) phosphorylation, and glucose transport. In in vitro studies, caffeine raised AMPK and ACC phosphorylation, increasing glucose transport activity and reducing energy status in rat muscle cells. Cafestol and caffeic acid increased insulin secretion in rat beta cells and glucose uptake into human muscle cells. Caffeic acid also increased AMPK and ACC phosphorylation, reducing the energy status and increasing glucose uptake in rat muscle cells. Chlorogenic acid did not show any positive or negative effect. The findings from this review must be taken with caution due to the limited number of studies on the subject. In conclusion, various coffee components had a neutral or positive role in the metabolism of glucose and muscle glycogen, whereas no detrimental effect was described. Coffee beverages should be tested as an option for athletes' glycogen recovery.

Effects of caloric restriction and low glycemic index diets associated with metformin on glucose metabolism and cortisol response in overweight/obese subjects: a case series study.

BACKGROUND: To determine whether cortisol secretion and glucocorticoid receptors in lymphocytes and monocytes are altered in patients with impaired glucose tolerance, and whether treatment with a hypocaloric diet and metformin could interfere with these aspects. METHODS: This is an analytical, interventional, case series study. Patients with impaired glucose tolerance were included. They received 500 mg of metformin twice daily and followed a low glycemic index diet for 16 weeks. Cortisol levels were assessed at 8:00 A.M. before and after use of 0.25 mg of dexamethasone at 11:00 P.M. the day before. RESULTS: Sixteen subjects (9 men) were included. Normal basal levels of cortisol and adequate responses to the low dose of dexamethasone were observed before and after treatment. There was no significant correlation between the parameters evaluated and cortisol levels. Nevertheless, there was a strong correlation between the number of glucocorticoid receptors, BMI (r = 0.88; p = 0.02), and insulin AUC (r = 0.94; p = 0.005) before treatment; after treatment, all these associations ceased to exist. CONCLUSION: The cortisol secretion remained normal in the group of patients with impaired glucose tolerance. Treatment with metformin and diet did not change this condition. However, glucocorticoid receptor number had a strong correlation with insulin, due to insulin resistance, but this characteristic was lost after treatment.

Usual coffee intake in Brazil: results from the National Dietary Survey 2008-9.

Coffee is central to the economy of many developing countries, as well as to the world economy. However, despite the widespread consumption of coffee, there are very few available data showing the usual intake of this beverage. Surveying usual coffee intake is a way of monitoring one aspect of a population's usual dietary intake. Thus, the present study aimed to characterise the usual daily coffee intake in the Brazilian population. We used data from the National Dietary Survey collected in 2008-9 from a probabilistic sample of 34,003 Brazilians aged 10 years and older. The National Cancer Institute method was applied to obtain the usual intake based on two nonconsecutive food diaries, and descriptive statistical analyses were performed by age and sex for Brazil and its regions. The estimated average usual daily coffee intake of the Brazilian population was 163 (SE 2.8) ml. The comparison by sex showed that males had a 12% greater usual coffee intake than females. In addition, the highest intake was recorded among older males. Among the five regions surveyed, the North-East had the highest usual coffee intake (175 ml). The most common method of brewing coffee was filtered/instant coffee (71%), and the main method of sweetening beverages was with sugar (87%). In Brazil, the mean usual coffee intake corresponds to 163 ml, or 1.5 cups/d. Differences in usual coffee intake according to sex and age differed among the five Brazilian regions.