Effect of proteins, amino acids, and other nitrogenated supplements on the skeletal muscle mass in people living with HIV (PLWH): A systematic review.

BACKGROUND & AIMS: Skeletal muscle losses (both quantitative and qualitative) and the consequent risk of sarcopenia are important issues in people living with HIV (PLWH), even when treated with antiretroviral therapies (ART). We aimed to conduct a systematic review (SR) investigating the effects of dietary interventions with proteins, amino acids, and other nitrogenated compounds on the skeletal muscle of PLWH. METHODS: We searched the published literature until August 24th, 2020, including clinical trials predominantly with AIDS-free PLWH treated with ART. RESULTS: From the 82 studies initially selected, 75 were excluded for the following reasons: nutritional interventions different from nitrogenated compounds; non-nutritional interventions; lack of information on body composition; and studies with most participants with AIDS. From the publications included (n = 7), the majority were performed with small and heterogeneous samples. None of the studies included any new-generation ART or pre- or post-exposition drugs. Two studies found benefits of supplementation on muscle mass; one was performed in a very unfavorable socioeconomic setting, and the supplementation was based on food-derived substances. The other study supplemented creatine, and its benefits were found only when combined with physical exercise training and only by one of the methods of body composition analysis (DXA). CONCLUSIONS: Our results showed that nutritional interventions with proteins, amino acids, or other nitrogenated compounds could not improve the skeletal muscle mass in PLWH. Further studies are needed, with bigger sample sizes and more precise control of ART schemes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration number CRD42019139981.

Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) emerged and rapidly spread worldwide. Several countries have imposed lockdown and isolation in attempt to mitigate viral spread. However, social isolation has a negative effect on psychological aspects, increasing stress, fear, anxiety, anger and emotional disturbance, as well as affecting sleep pattern and the practice of physical activity. Negative emotions and lifestyle changes trigger overeating, consequently affecting dietary practices. The aim of this study was to verify the prevalence of lifestyle factors (i.e., sleep time/quality and practice of physical exercise), eating behavior dimensions, chronotype, and association with dietary practices (planning, domestic organization, food choice, ways of eating) in home confinement during the COVID-19 pandemic in São Paulo, Brazil. METHODS: This cross-sectional study was conducted between April 27 and May 25, 2020. An anonymous online questionnaire (Microsoft Forms) was used for data collection by the snowball method. We verified dietary practices (outcome), eating behavior, physical exercise practice, sleep quality and duration, and chronotype (exposure variables). Sex, age, educational and social status were assessed as covariates and confounders. We evaluated 724 adults (585 women and 139 men). Mean age was 32.6 y (±11.3) for women and 33.5 y (±10.5) for men. RESULTS: Emotional eating (EE) and binge eating (BE) were positively correlated (r = 0.66; P <0.001). Dietary practices were negatively correlated with BE (r = -0.41; P <0.001), EE (r = -0.33; P <0.001) and body mass index (r = -0.24; P <0.001). Linear regression demonstrated that EE (ß = -0.1351; t = -2.841; P = 0.005; ηp2 = 0.013), BE (ß = -0.2580; t = -5.612; P < 0.001; ηp2 = 0.050), no practice of physical exercise at home (ß = -0.4271; t = -5.933; P < 0.001; ηp2 = 0.055), being vespertine (ß = -0.3435; t = 2.076; P = 0.038; ηp2 = 0.019), and age (ß = -0.082; t = -2.210; P = 0.027; ηp2 = 0.008) are negative predictors of dietary practices. Finally, cognitive restraint (ß = 0.1407; t = 3.858; P < 0.001; ηp2 = 0.024), better sleep quality (ß = 0.1768; t = 2.506; P = 0.012; ηp2 = 0.010), receiving 4-10 wages per month (according to a minimum wage in Brazil that corresponds to US $ 183.01) (ß = 0.2568; t = 2.573; P = 0.10; ηp2 = 0.027) and 10 - 20 wages per month (ß = 0.4490; t = 3.726; P < 0.001; ηp2 = 0.027) are positive predictors of dietary practices. CONCLUSION: Eating behavior, physical exercise, sleep, and social factors can be important predictors for dietary practices during COVID-19 social confinement. Longitudinal studies in Brazil are needed to confirm these findings.

Night shift work and immune response to the meningococcal conjugate vaccine in healthy workers: a proof of concept study.

BACKGROUND: It is well-established that sleep regulates immune functions. Immunological functions are dependent on circadian rhythms and regular sleep as both have an impact on the magnitude of immune responses following antigenic challenge (eg, in vaccination). Here we investigated whether nocturnal shift work can influence post-vaccination response. METHODS: Thirty-four healthy workers (23 females) working either nocturnal or diurnal shifts (17 in each group) received the meningococcal C meningitis vaccine. Sleep was recorded polysomnographically (PSG) and with actigraphy. Humoral and cellular responses were assessed after vaccination. RESULTS: Night workers showed decreased N3 stage and REM sleep duration, increased inflammatory mediators (TNF-α and IL-6 levels), and a weak specific humoral response to vaccination associated with reduced CD4 T lymphocytes, reduced plasmacytoid dendritic cells, reduced prolactin levels, increased TReg and increased IL-10 levels. In addition, the decrease in total sleep time and circadian rhythm alterations were associated with a reduced humoral response post-vaccination. CONCLUSIONS: Our findings provide novel evidence concerning immune alterations of shift work on workers' health based on real-life circumstances. In association with circadian components, sufficient sleep time and rhythm synchronization were important for the development of the Ag-specific immune response, suggesting that the humoral response to vaccination may be impaired in individuals with chronic sleep restriction and circadian misalignment.