Efeito do tratamento multidisciplinar em adolescentes obesos: um estudo de follow up / Effect of a multidisciplinary treatment in obese adolescents: a follow up study

Introdução: O tratamento multidisciplinar é um método de controle da obesidade, porém, poucos estudos relatam os efeitos após cessar este tipo de intervenção. Objetivo: Acompanhar adolescentes um e dois anos após a cessação do tratamento multidisciplinar por meio de reavaliações física, metabólica e antropométrica, aplicação de questionários e entrevista semiestruturada para diagnosticar as causas da evasão e alteração do estilo de vida. Resultados: As variáveis físicas, e antropométricas dos adolescentes que concluíram o tratamento se mantiveram por dois anos após a cessação do tratamento. As principais causas de evasão foram necessidade de inserção no mercado de trabalho e ingresso no ensino técnico ou superior. Conclusão: O tratamento multidisciplinar provavelmente causou prevenção de ganho de massa corporal e aumento do IMC e os indivíduos que completaram o tratamento tiveram maiores chances de alterar o estilo de vida.

Introduction: The multidisciplinary treatment is an obesity control method, however, few studies have reported the effects after ceasing this intervention type. Objective: To monitor teenagers one and two years after multidisciplinary treatment through physical, metabolic and anthropometric revaluations, questionnaires and semi-structured interviews to diagnose the causes of evasion and change of lifestyle. Results: The physical and anthropometric variables of adolescents who completed treatment were maintained for two years after cessation of treatment. The main evasion causes were necessity of a employment and technical education and university admission. Conclusion: The multidisciplinary treatment probably caused body weight and BMI gain prevention and individuals who completed treatment had higher chances to change the lifestyle.

Interdisciplinary therapy changes superoxide dismutase activity and adiponectin in obese adolescents: a randomised controlled trial.

The objective of this study is to evaluate the effect of interdisciplinary therapy in the parameters of the oxidative stress and the anti-inflammatory responses of obese adolescents. We selected 57 participants, who were randomly divided into 2 groups: interdisciplinary therapy group and a control group. After 6 months of intervention, 17 participants of the interdisciplinary therapy group and 8 of the control group returned for re-evaluation. The interdisciplinary therapy group participated in a treatment with 4 weekly sessions of exercise, a weekly group therapy session and a weekly nutritional education session. Blood parameters of oxidative stress and anti-inflammatory response were evaluated. The results demonstrated that there were significant increases in the interdisciplinary therapy group for superoxide dismutase activity (6.56 ± 3.22 to 11.40 ± 7.49) and ferric-reducing antioxidant potential concentration (532.91 ± 106.48 to 573.25 ± 112.57), although adiponectin levels did not reduce (40.9 ± 29.34 to 49.05 ± 41.22). A significant decrease in nitrite levels was also found (14.23 ± 8.48 to 11.45 ± 6.05). In the control group, significant reduction was found in adiponectin (31.56 ± 18.88 to 18.01 ± 11.66). This study suggests that interdisciplinary therapy for 6 months was effective in improving the anti-inflammatory responses and the antioxidant defences in obese adolescents.

Associação da ingestão de macronutrientes com o padrão de sono de adolescentes obesos / Associations of macronutrients intake with sleep pattern among obese adolescents

Introdução: A obesidade tornou-se uma preocupação mundial. Estudos mostraram relação negativa entre a duração do sono e o Índice de Massa Corporal (IMC), adicionalmente, pesquisas revelam que a privação do sono está relacionada com a inadequação alimentar. Objetivos: Avaliar e relacionar a qualidade do sono, ingestão alimentar e percentual de gordura de adolescentes obesos. Métodos: A amostra foi composta por 41 adolescentes obesos. Foi realizada avaliação da composição corporal, ingestão alimentar por recordatório e análise do sono por questionários. Resultados: Foi observada alta prevalência de dietas hiperlipídicas (60,98%), além de má qualidade do sono (82,93%) e sonolência (56,10%). Além disso,a sonolência apresentou correlação positiva com massa corporal (r=0,327), com IMC (r=0,363) e ingestão hiperproteíca (r=0,343). A má qualidade do sono apresentou correlação com a massa corporal (r=0,336). Conclusão: Os sujeitos apresentaram importantes alterações no padrão de sono, possivelmente associada à ingestão exacerbada de nutrientes e a adiposidade.

Introduction: Obesity has become a global concern. Studies show negative relationship between sleep duration and body mass index (BMI), additionally, research shows that sleep deprivation is related to inadequate diet. Objectives: To analyze the quality of sleep, food intake and body fat percentage of obese adolescents. Methods: The sample consisted of 41 obese adolescents. The assessment of body composition has been carried out by food intake recall, sleep analysis questionnaires. Results: We found a high prevalence of high fat diet (60.98%), and poor sleep quality (82.93%) and somnolence (56.10%). In addition, sleepiness was positively correlated with body weight (r = 0.327), BMI (r = 0.363) and the high protein intake (r = 0.343). The poor sleep quality correlated with body mass (r = 0.336). Conclusion: The subjects showed significant changes in sleep patterns, possibly associated with exacerbated nutrient intake and adiposity.

Efeito da leucina na hipertrofia cardíaca e na concentração sérica de creatina quinase em ratos Wistar em hipertireoidismo experimental / Effect of leucine in cardiac hypertrophy and serum creatine kinase in rats in experimental hyperthyroidism

A leucina é um regulador do metabolismo proteico in vivo, e existem poucas informações referentes à sua ação na hipertrofia cardíaca induzida pelo hipertireoidismo experimental e sua relação com a creatina quinase sérica. O estudo teve por objetivo verificar a ação da leucina na hipertrofia cardíaca e na concentração sérica de creatina quinase em ratos Wistar em hipertireoidismo. Foram utilizados 20 animais, divididos em quatro grupos sendo estes o controle, hormônio, leucina e hormônio + leucina. O hipertireoidismo foi induzido administrando-se, diariamente, 20µg/100 gramas de levotiroxina sódica em suspensão aquosa, por gavagem. A leucina foi suplementada adicionando-se 5% do aminoácido à ração convencional. O sangue foi coletado por punção cardíaca e as análises feitas em kits para CK-NAC, CK-MB e TSH. Ao final do período experimental de sete dias o coração foi removido e pesado. Posteriormente, foi separado o ventrículo esquerdo juntamente com o septo interventricular e pesado. Na comparação estatística foi utilizada a análise de variância (ANOVA) de duas vias e pós-teste de Tukey, considerando-se significativos valores de p<0,05. As concentrações séricas de CK-MB sérica foram menores no grupo leucina (p<0,05) e hormônio + leucina (p<0,05) em comparação a controle. O grupo hormônio, apresentou peso relativo do coração maior que o grupo controle (p<0,05) e peso absoluto do coração maior que hormônio + leucina (p<0,05). Em conclusão, a leucina parece reduzir a hipertrofia cardíaca e a concentração sérica da creatina quinase por mecanismos ainda desconhecidos.

Leucine is a regulator of protein metabolism in vivo, and there is little information regarding its action on cardiac hypertrophy induced by experimental hyperthyroidism and its relationship to serum creatine kinase. The study aimed to verify the effect of leucine in cardiac hypertrophy and serum creatine kinase in rats with hyperthyroidism. We used 20 animals were divided into four groups and these control, hormone, hormone + leucine and leucine. Hyperthyroidism was induced by administration of daily 20µg/100 grams of levothyroxine sodium in aqueous suspension by gavage. Leucine was supplemented by adding 5% of the amino conventional diet. Blood was collected by cardiac puncture and analyzes made in kit CK-NAC, CK-MB and TSH. At the end of the trial period of seven days the hearts were removed and weighed. Subsequently, the left ventricle was separated together with the interventricular septum and weighed. In statistical comparison was used analysis of variance (ANOVA) and two-way post-Tukey test, considering p values <0.05. Serum concentrations of serum CK-MB were lower in leucine (p <0.05) and hormone + leucine (p <0.05) compared to control. The hormone group, showed greater relative heart weight than the control group (p <0.05) and absolute heart weight greater than hormone + leucine (p <0.05). In conclusion, leucine appears to reduce cardiac hypertrophy and serum concentration of creatine kinase by unknown mechanisms.

Déficit bilateral em exercício multiarticular para membros superiores / Bilateral deficit in multiarticular exercise for upper extremities

A força muscular é um componente importante para a atividade física e para o desempenho das tarefas da vida diária. Um fenômeno observado geralmente é que a capacidade de geração de força máxima está comprometida quando os membros homólogos se contraem bilateralmente. Esse fenômeno é chamado de déficit bilateral. Assim, objetivou-se comparar a atividade elétrica do músculo deltoide, porção medial durante contrações unilaterais e bilaterais em um aparelho multiarticular de desenvolvimento articulado convergente, com 90% da carga voluntária máxima (CVM), em nove homens com idades entre 20 e 30 anos, estatura 174 ± 5cm e massa corporal 78 ± 15kg. Os sinais mioelétricos foram captados através da colocação de eletrodos ativos de superfície diferenciais da EMG System do Brasil, um eletrodo de referência (terra) e um módulo condicionador de sinais (eletromiógrafo), que forneceu dados numéricos em RMS (raiz quadrada da média) para análise dos resultados. Cada sinal coletado captou apenas a fase concêntrica do movimento e o mesmo teve duração de três segundos. Os resultados evidenciaram que durante exercício bilateral e unilateral com 90% da CVM, a atividade elétrica do membro não dominante predominou significativamente sobre o dominante (p = 0,018). Quando somados os valores obtidos no trabalho do membro dominante com aqueles obtidos com o membro não dominante no exercício bilateral (2.231 ± 504µv) e comparados com os valores obtidos no trabalho unilateral (2.663 ± 701µv), o déficit bilateral foi encontrado (p = 0,018). De acordo com nosso estudo, verificamos que o fenômeno do déficit bilateral se faz presente para o músculo deltoide médio no exercício multiarticular de desenvolvimento articulado convergente em indivíduos familiarizados em exercícios resistidos.

Muscular strength is an important component for physical activity and performance of activities of daily living. A phenomenon usually observed is that the capacity of generating maximum strength is compromised when the homologous extremities bilaterally contract. This phenomenon is called bilateral deficit. Thus, the aim of this work was to compare the electrical activity of the deltoid muscle, medial portion, during unilateral and bilateral contractions in a multiarticular machine of convergent articulated development, with 90% of maximum voluntary load (mvl), in nine men aged between 20 and 30 years, stature of 174 ± 5cm and body mass of 78 ± 15 kg. The myoelectrical signals were obtained through placement of differential active surface electrodes by EMG System of Brazil, a reference electrode (ground) and a signal conditioner module (electromyograph), which provided numerical data in RMS (root median square) for results analysis. Each signal collected picked only the concentric phase of the movement and it had duration of three seconds. The results evidenced that during bilateral and unilateral exercise with 90% of MVL, the electric activity of the non-dominant extremity was significantly higher than in the dominant one (p = 0.018). When the values obtained in the work of dominant extremity are summed with the work of non-dominant extremity in the bilateral exercise (2.231 ± 504µv) and compared with the values obtained in the unilateral work (2.663 ± 701µv), bilateral deficit was found (p = 0.018). According to our study, it was verified that the bilateral defict phenomenon is present in the medium deltoid muscle in the multiarticular exercise of convergent articulated development in individuals familiarized with resistance exercises.

Circuit resistance training in sedentary women: body composition and serum cytokine levels.

Exercise can generate alterations in body composition and modulate the immune system. The objective of this study was to verify whether a circuit resistance training (CRT) protocol can increase lean body mass (LM), and reduce fat body mass (FM) and the percent of FM (%FM) of sedentary women, without inducing inflammatory responses, indicated by serum cytokine levels. The initial hypothesis was that CRT would improve body composition, without changing serum cytokine levels. The study consisted of 14 healthy, sedentary women, aged 33-45 years (mean +/- SD, 40.23 +/- 3.98 years), with a normal body mass index. They participated in 3 sessions per week of CRT, which included 2 rounds in 9 stations with 1 set of 8-12 repetition maximum at each station, for 10 weeks. During the 10-week CRT period, participants maintained their pretraining nutritional standard. Body composition was analysed with dual-energy X-ray absorptiometry both pre- and post-training. Blood samples were collected after 96 h of rest pre- and post-training, and 5 min, 24 h, and 48 h after the second and last training sessions to measure serum cytokine levels by flow cytometry. The nutritional standard was accompanied throughout the study period with 24-h dietary recall. Increases in LM (35.937 +/- 4.926 to 39.130 +/- 4.950 kg) and decreases in FM (21.911 +/- 8.150 to 17.824 +/- 4.235 kg) and %FM (37.10 +/- 10.84 to 31.19 +/- 6.06), without concurrent changes in serum cytokine levels, and in the nutritional standard (alpha = 0.05). The proposed CRT improved body composition and did not induce any changes in serum cytokine levels characteristic of the inflammatory response in women.