Enhancing the Bioavailability and Bioactivity of Curcumin for Disease Prevention and Treatment.

Curcumin, a natural polyphenolic component from Curcuma longa roots, is the main bioactive component of turmeric spice and has gained increasing interest due to its proposed anti-cancer, anti-obesity, anti-inflammatory, antioxidant, and lipid-lowering effects, in addition to its thermogenic capacity. While intake from dietary sources such as curry may be sufficient to affect the intestinal microbiome and thus may act indirectly, intact curcumin in the body may be too low (<1 microM) and not sufficient to affect signaling and gene expression, as observed in vitro with cultured cells (10-20 microM). Several strategies can be envisioned to increase curcumin levels in the body, such as decreasing its metabolism or increasing absorption through the formation of nanoparticles. However, since high curcumin levels could also lead to undesired regulatory effects on cellular signaling and gene expression, such studies may need to be carefully monitored. Here, we review the bioavailability of curcumin and to what extent increasing curcumin levels using nanoformulations may increase the bioavailability and bioactivity of curcumin and its metabolites. This enhancement could potentially amplify the disease-preventing effects of curcumin, often by leveraging its robust antioxidant properties.

Agreement and diagnostic differences among three definitions of sarcopenia in patients with chronic hepatitis C.

BACKGROUND: There is neither a gold standard definition nor a universal consensus to diagnose sarcopenia in patients with chronic hepatitis C. Thus, we aimed to compare the prevalence of sarcopenia and the agreement and discrepancies between European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, and Foundation for the National Institutes of Health Biomarkers Consortium Sarcopenia Project (FNIH) definitions in chronic hepatitis C. METHODS: Dual-energy x-ray absorptiometry was used to assess muscle mass by quantifying appendicular lean mass (ALM) adjusted for squared height (ALM/ht2 ) or for body mass index (ALMBMI ). Muscle function was evaluated by handgrip strength. Subjective Global Assessment was used to assess the nutrition status. RESULTS: This cross-sectional study included 103 outpatients (mean age, 50.6 ± 11.3 years; 33.0% with compensated cirrhosis). Sarcopenia prevalence was 8.7%, 9.7%, and 9.7%, according to EWGSOP1, EWGSOP2, and FNIH definitions, respectively. There was neither a sex- nor a liver disease severity-specific difference in the prevalence of sarcopenia between the criteria applied. Sixteen (15.5%) patients fulfilled at least one of these criteria, and 3 out of 16 (18.8%) simultaneously had sarcopenia by consensus of the three criteria. Sarcopenic obesity was identified in 9 out of 16 (56.3%) patients, and 6 out of 9 (66.7%) of these only met FNIH consensus. CONCLUSIONS: In patients without cirrhosis or with compensated cirrhosis, and with chronic hepatitis C, the agreement between EWGSOP1 and EWGSOP2 classifications was substantial for sarcopenia diagnosis. Concerning EWGSOP and FNIH criteria, a fair agreement and limited overlap were found in these patients.

The Dose-Dependent Effect of Curcumin Supplementation on Inflammatory Response and Gut Microbiota Profile in High-Fat Fed C57BL/6 Mice.

SCOPE: The prevalence of obesity has increased, with excessive consumption of high-fat foods being one of the primary causes. Curcumin, a polyphenol extracted from Curcuma longa L., exhibits anti-inflammatory activity.  The study aims to investigate the effects of curcumin supplementation in different doses on the biochemical profile, inflammatory response, and gut microbiota profile in mice that are fed with high-fat diet (HFD). METHODS AND RESULTS: C57BL/6 male mice are fed a standard diet, or a HFD with or without different doses of curcumin (50, 250, and 500 mg kg-1 of body weight). Throughout the experimental period, food intake and body weight are assessed weekly. At euthanasia, blood, stool, and tissue samples are collected for biochemical, histological, and molecular analyses. Curcumin increases the IL-10 protein expression in the white adipose tissue. In the liver, there is a reduction in tumor necrosis factor alpha (TNF-α) and an increase in IL-10 gene expression. Also, curcumin promotes the growth of butyrogenic bacteria, such as Clostridium clusters IV and XIVa. CONCLUSIONS: The findings suggest that curcumin has the potential to improve the inflammatory response and modulate healthy gut microbiota. Further studies are needed to clarify the role of curcumin as a preventive and effective strategy for obesity.

Bioactive dietary components-Anti-obesity effects related to energy metabolism and inflammation.

Obesity is the result of the long-term energy imbalance between the excess calories consumed and the few calories expended. Reducing the intake of energy dense foods (fats, sugars), and strategies such as fasting and caloric restriction can promote body weight loss. Not only energy in terms of calories, but also the specific composition of the diet can affect the way the food is absorbed and how its energy is stored, used or dissipated. Recent research has shown that bioactive components of food, such as polyphenols and vitamins, can influence obesity and its pathologic complications such as insulin resistance, inflammation and metabolic syndrome. Individual micronutrients can influence lipid turnover but for long-term effects on weight stability, dietary patterns containing several micronutrients may be required. At the molecular level, these molecules modulate signaling and the expression of genes that are involved in the regulation of energy intake, lipid metabolism, adipogenesis into white, beige and brown adipose tissue, thermogenesis, lipotoxicity, adipo/cytokine synthesis, and inflammation. Higher concentrations of these molecules can be reached in the intestine, where they can modulate the composition and action of the microbiome. In this review, the molecular mechanisms by which bioactive compounds and vitamins modulate energy metabolism, inflammation and obesity are discussed.

Comparison of ultrasound with computed tomography to measure skeletal muscle mass in critically ill patients: A prospective study protocol.

INTRODUCTION: Therapy and nutritional status directly interfere in the clinical evolution of critically ill patients, in reducing morbidity and mortality, by maintaining the functional integrity of the gastrointestinal tract, decreasing the catabolic response, besides contributing to the reduction of hospitalization time resulting in less treatment cost. Critical patients and trauma victims suffer early changes in the quantity and quality of muscle mass. Tools to identify the groups most susceptible to these complications are necessary so that interventions can minimize the deleterious effects of malnutrition in critically ill patients. METHODS AND ANALYSIS: The aim of the present study is to measure muscle mass loss by measuring the thickness of the rectus femoris muscle by bedside ultrasound in critically ill patients admitted to the Intensive Care Unit (ICU) of a university hospital. Information will be collected regarding the length of hospital and ICU stay, the reason for admission, anthropometric data at admission and during hospitalization, energy needs, nutritional therapy used, and fasting time. This is a prospective, observational study that will be carried out in a single center in an ICU of a tertiary university hospital. The study population will undergo 3 tomographic images and 3 ultrasounds of the rectus femoris of each patient at different times. We propose, unprecedentedly, performing a validation study of ultrasound with the gold standard Computed tomography to evaluate the musculature of critically ill patients victims of traumatic brain injury. The results got will texto be fundamental for the development of new fields of investigation and certainly contribute to the discovery of a new approach to treat sarcopenia in critically ill patients. The Research Ethics Committee approved the study and all patients included will sign an informed consent form. (Clinical Record: RBR-2bzspnz).

Dietary Protein Restriction Improves Metabolic Dysfunction in Patients with Metabolic Syndrome in a Randomized, Controlled Trial.

Dietary restriction (DR) reduces adiposity and improves metabolism in patients with one or more symptoms of metabolic syndrome. Nonetheless, it remains elusive whether the benefits of DR in humans are mediated by calorie or nutrient restriction. This study was conducted to determine whether isocaloric dietary protein restriction is sufficient to confer the beneficial effects of dietary restriction in patients with metabolic syndrome. We performed a prospective, randomized controlled dietary intervention under constant nutritional and medical supervision. Twenty-one individuals diagnosed with metabolic syndrome were randomly assigned for caloric restriction (CR; n = 11, diet of 5941 ± 686 KJ per day) or isocaloric dietary protein restriction (PR; n = 10, diet of 8409 ± 2360 KJ per day) and followed for 27 days. Like CR, PR promoted weight loss due to a reduction in adiposity, which was associated with reductions in blood glucose, lipid levels, and blood pressure. More strikingly, both CR and PR improved insulin sensitivity by 62.3% and 93.2%, respectively, after treatment. Fecal microbiome diversity was not affected by the interventions. Adipose tissue bulk RNA-Seq data revealed minor changes elicited by the interventions. After PR, terms related to leukocyte proliferation were enriched among the upregulated genes. Protein restriction is sufficient to confer almost the same clinical outcomes as calorie restriction without the need for a reduction in calorie intake. The isocaloric characteristic of the PR intervention makes this approach a more attractive and less drastic dietary strategy in clinical settings and has more significant potential to be used as adjuvant therapy for people with metabolic syndrome.

Beneficial effects of eugenol supplementation on gut microbiota and hepatic steatosis in high-fat-fed mice.

Due to the increase in the prevalence of obesity, new therapies have emerged and eugenol has been shown to be beneficial in metabolic changes and gut microbiota. This study aimed to investigate the effects of eugenol on gut microbiota, hepatic lipid accumulation, body weight, adipose tissue weight, lipid and glycemic profile in mice fed a high-fat diet. Forty C57BL/6 male mice were divided into standard diet (SD), high-fat diet (HFD), standard diet with eugenol (SDE) and high-fat diet with eugenol (HFDE). The dose used of eugenol was 500 mg kg-1 for 8 weeks. Eugenol did not prevent weight gain, but it was effective in preventing hepatic lipid accumulation evidenced by the presence of fat droplets in the HFD group and absence in the HFDE group. An improvement in the gut microbiota profile was observed, proved by an increase in the Actinobacteria phylum in the treated groups and a reduction of Proteobacteria phylum in the HFDE group. Despite not preventing weight gain, eugenol appeared to have a protective effect on hepatic lipid accumulation and beneficially modulate the gut microbiota in mice fed with HFD.

Effect of immunonutrition on serum levels of C-reactive protein and lymphocytes in patients with COVID-19: a randomized, controlled, double-blind clinical trial.

INTRODUCTION: Introduction: patients with COVID-19 undergo changes in leukocyte count, respiratory disorders, and an increase in inflammatory substances. To improve the inflammatory condition, some nutrients can be used, including arginine, omega-3 fatty acids and nucleotides. This study aims to evaluate how oral immunonutrient supplements affects serum C-reactive protein (CRP) levels and lymphocyte count in patients with COVID-19. Methods: in this double-blind clinical trial, we randomized 43 adult patients with COVID-19 to receive a standard high-protein normocaloric supplement (control) or an immunonutrient-enriched supplement (experiment) for 7 days. The primary outcome was to evaluate changes in total lymphocyte count and serum level of CRP. The assessment of risk and nutritional status of these patients was also performed. Results: forty-three patients with mean age of 41.5 (± 1.8) years were followed up, 39.5 % of them women. The mean body mass index was 27.6 (± 0.8) kg/m² and 58.1 % had low nutritional risk. In the experiment group, there was a CRP reduction of 23.6 (± 7.5) mg/L, while in the control branch the decrease was 14.8 (± 12.1) mg/L (p = 0.002). There was an increase in lymphocytes in the experiment group (+367.5 ± 401.8 cells/mm³) and a reduction in the control group (-282.8 ± 327.8 cells/mm³), although there was no statistical significance (p = 0.369). Relative risk (RR) of treatment in reducing CRP by 30 % or more was 4.45 (p < 0.001; 95 % CI, 1.79-11.07). RR in increasing lymphocyte count by 30 % or more was 1.28 (p = 0.327; 95 % CI, 0.67-2.45). Conclusion: we conclude that immunonutrient supplements seem to reduce CRP levels more than standard high-protein normocaloric supplements.

INTRODUCCIÓN: Introducción: los pacientes con COVID-19 sufren cambios en el recuento de leucocitos, trastornos respiratorios y aumento de sustancias inflamatorias. Para mejorar la condición inflamatoria se pueden usar algunos nutrientes, como la arginina, los ácidos grasos omega-3 y los nucleótidos. Este estudio tiene como objetivo evaluar cómo los suplementos de inmunonutrientes orales afectan a los niveles séricos de proteína C-reactiva (PCR) y al recuento de linfocitos en pacientes con COVID-19. Métodos: en este ensayo clínico doble ciego, aleatorizamos a 43 pacientes adultos con COVID-19 para recibir un suplemento normocalórico estándar alto en proteínas (control) o un suplemento enriquecido con inmunonutrientes (experimento) durante 7 días. El resultado primario fue evaluar los cambios en el recuento total de linfocitos y el nivel sérico de PCR. También se realizó la evaluación del riesgo y el estado nutricional de estos pacientes. Resultados: cuarenta y tres pacientes con edad media de 41,5 (± 1,8) años fueron seguidos, el 39,5 % de ellos mujeres. El índice de masa corporal medio fue de 27,6 (± 0,8) kg/m² y el 58,1 % tenían bajo riesgo nutricional. En el grupo experimental hubo una reducción de la PCR de 23,6 (± 7,5) mg/L, mientras que en la rama de control la disminución fue de 14,8 (± 12,1) mg/L (p = 0,002). Hubo un aumento de linfocitos en el grupo experimental (+367,5 ± 401,8 células/mm³) y una reducción en el grupo de control (-282,8 ± 327,8 células/mm³), aunque no hubo significación estadística (p = 0,369). El riesgo relativo (RR) del tratamiento para reducir la PCR en un 30 % o más fue de 4,45 (p < 0,001; IC 95 %: 1,79-11,07). El RR en el aumento del recuento de linfocitos en un 30 % o más fue de 1,28 (p = 0,327; IC 95 %: 0,67-2,45). Conclusión: se concluye que los suplementos de inmunonutrientes parecen reducir los niveles de PCR más que los suplementos normocalóricos estándar altos en proteína.

Effect of bariatric surgery on neurocognitive function after 6 months of follow-up: a pilot study.

Introduction: Background: reduced cognitive performance has been observed in patients with severe obesity. Bariatric surgery and subsequent adipose tissue loss seem to affect cognitive functioning positively; however, improvement predictors are not well established. Aim: to evaluate the cognitive performance and the nutritional status of patients with severe obesity 6-month after bariatric surgery. Methods: we assessed the neuropsychological performance of 22 patients with obesity (body mass index: ~ 42.9 kg/m²). The nutritional evaluation consisted of the routine tests performed in the baseline and postoperative periods. Lastly, we calculated the correlation between neuropsychological assessment results and blood biomarkers. Results: the patients did not present cognitive impairment in the preoperative assessment, but performed below the standard range. The patients underwent significant weight loss after 6 months from surgery (~ 22 kg), with a change in obesity class III to I. Also, the patients presented a significant improvement in attention, mental flexibility, inhibitory control, and processing speed. Additionally, we observed a significant improvement in serum folic acid (108 %), gamma-glutamyl transferase (-41 %), uric acid (-32 %), ferritin (-28 %), triglycerides (-19 %), and high-density lipoprotein (9 %). Lastly, we found a moderate positive correlation between processing speed and body weight (r = 0.46), gamma-glutamyl transferase (r = 0.54), and total protein and mental flexibility (r = 0.75). Conclusion: bariatric surgery promoted significant weight loss and improved attention, mental flexibility, processing speed, and several nutritional biomarkers. Nevertheless, the surgery had limited effects on other cognitive functions such as short- and long-term memory and language.

Introducción: Introducción: se ha observado una disminución del rendimiento cognitivo en los pacientes con obesidad grave. La cirugía bariátrica y la pérdida de tejido adiposo parecen mejorar el funcionamiento cognitivo; sin embargo, los predictores de mejora no están bien establecidos. Objetivos: evaluar el rendimiento cognitivo y el estado nutricional de pacientes con obesidad severa después de 6 meses de una cirugía bariátrica. Métodos: evaluamos el desempeño neuropsicológico de 22 pacientes con un índice de masa corporal ~ 42,9 kg/m². Se analizaron las pruebas de rutina realizadas al inicio y después de la cirugía. Calculamos la correlación con la evaluación neuropsicológica y los biomarcadores sanguíneos. Resultados: los pacientes no mostraron deterioro cognitivo en la evaluación preoperatoria, pero sí un rendimiento por debajo del estándar. Los pacientes mostraron una pérdida de peso significativa 6 meses después de la cirugía (~ 22 kg), con un cambio de la clasificación de obesidad de III a I. Además, los pacientes mostraron una mejora significativa de la atención, la flexibilidad mental, el control inhibitorio y la velocidad de procesamiento. Además, observamos una mejora significativa del ácido fólico sérico (108 %), la gamma-glutamil-transferasa (-41 %), el ácido úrico (-32 %), la ferritina (-28 %), los triglicéridos (-19 %) y las lipoproteínas de alta densidad (9 %). Finalmente, encontramos una correlación positiva moderada entre la velocidad de procesamiento y el peso corporal (r = 0,46) y la gamma-glutamil-transferasa (r = 0,54), y entre la proteína total y la flexibilidad mental (r = 0,75). Conclusiones: la cirugía bariátrica promovió una pérdida de peso significativa y mejoró la atención, la flexibilidad mental, la velocidad de procesamiento y varios biomarcadores nutricionales. Sin embargo, tuvo efectos limitados sobre otras funciones cognitivas, como la memoria y el lenguaje a corto y largo plazo.

Relationship between the COVID-19 pandemic, binge eating, and mental suffering in health professionals in Brazil: a cross-sectional study.

Introduction: The high levels of anxiety, stress, and depression produced by the global Coronavirus disease 2019 pandemic could trigger eating disorders. Health professionals are more exposed to these changes due to their work environment. Objectives: To evaluate the relationship between the COVID-19 pandemic and the onset of binge eating disorder and psychiatric disorders in Brazilian health professionals. Methods: This descriptive, prospective, cross-sectional study interviewed 219 Brazilian health professionals between June and October 2020 using an online questionnaire. The 7-Item Binge Eating Disorder Screener was used to diagnose binge eating disorder. The Self-Reporting Questionnaire was used to assess psychiatric disorders. The statistical analysis included calculation of absolute frequency, relative frequency, mean and standard deviation. Contingency coefficient C was used to determine the association between the variables. Results: A total of 35 (16%) participants reported symptoms related to binge eating disorder, while 131 (59.8%) reported psychiatric symptoms. There was an association between binge eating disorder, psychiatric disorders, and body mass index. Conclusions: Our findings suggest the onset of psychiatric disorders and binge eating disorders in these professionals and that elevated body mass index is directly associated with these disorders.

Eficácia e segurança de mudanças no estilo de vida na Esteatose Hepática não Alcoólica: revisão rápida de evidências / Effectiveness and safety of lifestyle modifications for Nonalcoholic Hepatic Steatosis: rapid response review of evidence

Tecnologia: Intervenção de mudança no estilo de vida (dieta, exercícios). Indicação: doença hepática gordurosa não alcoólica (DHGNA). Pergunta clínica: Intervenções de mudança no estilo de vida, comparados a nenhum tratamento ou placebo, são eficazes no tratamento de DHGNA para modificar indicadores metabólicos, reduzir mortalidade e prevenir complicações relacionadas à esteatose hepática? Métodos: Foi feito levantamento bibliográfico na base de dados PUBMED, seguindo estratégias de buscas predefinidas. As revisões sistemáticas foram avaliadas com a ferramenta "AMSTAR 2 - Assessing the Methodological Quality of Systematic Reviews version 2". Resultados: Foram selecionadas 4 revisões sistemáticas, que atendiam aos critérios de inclusão. Conclusão: As evidências disponíveis não são suficientes para confirmar ou refutar que as modificações do estilo de vida têm efeitos benéficos de longo prazo sobre a DHGNA. Protocolos com dieta mediterrânea, jejum intermitente ou exercícios aeróbicos são benéficos para reduzir parâmetros metabólicos em pessoas com DHGNA

Technology: Lifestyle change intervention (diet, exercise). Indication: Non-alcoholic fatty liver disease (NAFLD). Clinical question: Are lifestyle change interventions, compared to no treatment or placebo, effective in NAFLD treatment to modify metabolic indicators, reduce mortality and prevent complications related to hepatic steatosis? Methods: A bibliographic survey was carried out in the PUBMED database, following predefined search strategies. Systematic reviews were evaluated using the tool "AMSTAR 2 - Assessing the Methodological Quality of Systematic Reviews version 2". Results: 4 systematic reviews that met the inclusion criteria were selected. Conclusion: The available evidence is not sufficient to confirm or refute that lifestyle modifications have long-term beneficial effects on NAFLD. Protocols such as a Mediterranean diet, intermittent fasting, or aerobic exercise are beneficial in reducing metabolic parameters in people with NAFLD

Should we use ferritin in the diagnostic criteria of iron deficiency in heart failure patients?

BACKGROUND AND AIMS: Iron deficiency (ID) is a common comorbidity in patients with chronic heart failure (HF) and is associated with worse prognosis. We aimed at comparing the currently European Society of Cardiology (ESC) criterion for diagnosis of ID (ferritin < 100 µg/L or ferritin 100-299 µg/L with transferrin saturation [TSAT] < 20%) with either isolated low TSAT or isolated low ferritin on survival, in a cohort of HF patients. METHODS: This was an observational prospective study, investigating ambulatory patients with HF and reduced ejection fraction (n = 108). All patients were assessed for clinical aspects and iron indexes. The primary endpoint was all-cause death. RESULTS: Abnormal iron status was observed in 50 (46%) of patients. During the median follow-up time of 857.5 [647-899] days, 31 patients died (29%). In univariate analyses ESC-criterion (p = 0.022) and isolated TSAT <20% (p = 0.002), but not isolated ferritin <100 µg/L (p = 0.439), were significantly related to an increased risk of all-cause death. However, in multivariate analyses only TSAT <20% (HR = 2.3; [95% CI: 1.11-4.85]; p = 0.026) was independently related to all-cause mortality. CONCLUSIONS: Our results indicated that diagnosis of ID based on isolated TSAT <20% identifies HF patients with worse prognosis, while ferritin was not associated with mortality risk, suggesting that ferritin should not be taken into account for evaluation of clinical impact of ID in HF patients.

Noninvasive neuromodulation of the prefrontal cortex in young women with obesity: a randomized clinical trial.

BACKGROUND/OBJECTIVES: Obesity is associated with reduced neurocognitive performance. Individuals with obesity show decreased activation in the left dorsolateral prefrontal cortex (DLPFC), a key brain region relevant to the regulation of eating behavior. Transcranial direct current stimulation (tDCS) has emerged as a potential technique to correct these abnormalities. However, there is limited information to date, particularly in clinical settings and regarding long-term effects of tDCS. This study aimed to investigate the effects of DLPFC-targeted tDCS in young women with obesity. SUBJECT/METHODS: Randomized, double-blind, sham-controlled parallel-design clinical trial conducted in 38 women, aged 20-40 years, with BMI 30-35 kg/m2. STUDY DESIGN: Phase I: target engagement (immediate effects of tDCS on working memory performance), Phase II: tDCS only (ten sessions, 2 weeks), Phase III: tDCS + hypocaloric diet (six sessions, 30% energy intake reduction, 2 weeks, inpatient), Phase IV: follow-up at 1, 3, and 6 months. PRIMARY OUTCOME: change in body weight. SECONDARY OUTCOMES: change in eating behavior and appetite. Additional analyses: effect of Catechol-O-methyl transferase (COMT) gene variability. Data were analyzed as linear mixed models. RESULTS: There was no group difference in change in body weight during the tDCS intervention. At follow-up, the active group lost less weight than the sham group. In addition, the active group regained weight at 6-month follow-up, compared with sham. Genetic analysis indicated that COMT Met noncarriers were the subgroup that accounted for this paradoxical response in the active group. CONCLUSION: Our results suggest that in young women with class I obesity, tDCS targeted to the DLPFC does not facilitate weight loss. Indeed, we found indications that tDCS could have a paradoxical effect in this population, possibly connected with individual differences in dopamine availability. Future studies are needed to confirm these findings.

Curcuma supplementation in high-fat-fed C57BL/6 mice: no beneficial effect on lipid and glucose profile or prevention of weight gain.

PURPOSE: This experimental study investigated the effects of curcuma supplementation on weight gain, Body Adiposity Index, glucose and lipid profile, and liver and pancreas histology in C57BL/6 mice fed with a high-fat diet. METHODS: 40 animals were separated into four groups: standard diet (SD), standard diet plus curcuma (SD + C), high-fat diet (HFD), and high-fat diet plus curcuma (HFD + C). Curcuma dose was 8 mg/animal/day. Histological and biochemical analyses were performed at the end of the experimental period. RESULTS: Curcuma prevented weight gain, despite a higher food intake, and increased brown adipose tissue weight only in mice receiving standard diet. However, these changes were not observed in HFD + C group. The groups that received curcuma (SD + C and HFD + C) showed a pancreas with diffuse macro- and microgoticular steatosis. CONCLUSIONS: Curcuma supplementation did not prevent weight gain or improved glucose and lipid profile in mice receiving high-fat diet. Furthermore, there was evidence of possible curcuma toxicity in the pancreas of C57BL/6 mice. The implications of these findings on humans still need to be investigated.

Appetite effects of prefrontal stimulation depend on COMT Val158Met polymorphism: A randomized clinical trial.

The regulation of appetite is supported by dopamine-modulated brain circuits. Recent studies have shown that transcranial direct current stimulation (tDCS) aimed at increasing the excitability of the dorsolateral prefrontal cortex can reduce appetite, but the underlying mechanisms remain unknown, and response variability is large. The aim of this study was to determine whether individual differences in Catechol-O-methyl transferase (COMT) Val158Met polymorphism can influence tDCS effects on appetite. Thirty-eight adult women with obesity, classified as carriers or non-carriers of the Met allele, underwent a randomized, double-blind, sham-controlled tDCS intervention involving three phases: Phase I, target engagement (immediate effects of tDCS on working memory performance), Phase II, tDCS only (10 sessions, two weeks), and Phase III, tDCS + hypocaloric diet: (6 sessions, two weeks, 30% energy intake reduction, inpatient). Data were analyzed using linear mixed-effects models and mixed ANCOVA. Appetite was evaluated using visual analogue scales. We found that Met-carriers receiving active tDCS were the only participants who experienced a significant reduction of appetite over time. Conversely, Met non-carriers maintained high levels of appetite during the intervention; this effect was driven by a delayed paradoxical rise in appetite after stimulation. Working memory task performance at phase I correlated with subsequent appetite change in a COMT-dependent manner: speed improvements during the task predicted appetite increase in Met carriers and appetite reduction in Met non-carriers. Our findings suggest that genotype differences impacting dopamine levels influence prefrontal tDCS effects on appetite. This source of variability should be considered in the design of future studies.

Measured energy content of frequently purchased restaurant meals: multi-country cross sectional study.

OBJECTIVE: To measure the energy content of frequently ordered meals from full service and fast food restaurants in five countries and compare values with US data. DESIGN: Cross sectional survey. SETTING: 223 meals from 111 randomly selected full service and fast food restaurants serving popular cuisines in Brazil, China, Finland, Ghana, and India were the primary sampling unit; 10 meals from five worksite canteens were also studied in Finland. The observational unit was frequently ordered meals in selected restaurants. MAIN OUTCOME MEASURE: Meal energy content, measured by bomb calorimetry. RESULTS: Compared with the US, weighted mean energy of restaurant meals was lower only in China (719 (95% confidence interval 646 to 799) kcal versus 1088 (1002 to 1181) kcal; P<0.001). In analysis of variance models, fast food contained 33% less energy than full service meals (P<0.001). In Finland, worksite canteens provided 25% less energy than full service and fast food restaurants (mean 880 (SD 156) versus 1166 (298); P=0.009). Country, restaurant type, number of meal components, and meal weight predicted meal energy in a factorial analysis of variance (R2=0.62, P<0.001). Ninety four per cent of full service meals and 72% of fast food meals contained at least 600 kcal. Modeling indicated that, except in China, consuming current servings of a full service and a fast food meal daily would supply between 70% and 120% of the daily energy requirements for a sedentary woman, without additional meals, drinks, snacks, appetizers, or desserts. CONCLUSION: Very high dietary energy content of both full service and fast food restaurant meals is a widespread phenomenon that is probably supporting global obesity and provides a valid intervention target.

Sessão de Tai Chi Chuan promove hipotensão pós-exercício e redução da sobrecarga cardiovascular em idosos hipertensos / Tai Chi Chuan session promotes post-exercise hypotension and reduces cardiac overload in elderly hypertensive patients

Modelo: Estudo intervencional, prospectivo e quantitativo. Objetivo: Analisar o comportamento da pressão arterial (PA) e duplo produto (DP) de idosos hipertensos, após uma sessão de Tai Chi Chuan (TCC). Métodos: Participaram do estudo 20 idosos hipertensos em que as variáveis hemodinâmicas foram medidas pré-sessão de TCC e sessão controle (sem exercício), e monitorada durante 60 minutos após término da sessão de TCC e controle. Foi respeitado um intervalo de 7 dias entre uma sessão e outra. Resultados: Após término da sessão de TCC, a frequência cardíaca permaneceu elevada por 30 minutos retornado aos valores pré-exercício a partir do 40° minuto. Observou-se redução significativa da pressão arterial média (PAM) a partir do 10° minuto, e redução significativa da pressão arterial sistólica (PAS) e diastólica (PAD) a partir do 20° minuto até o 60° minuto após sessão de TCC (p<0,001). Houve redução em relação aos valores pré-exercício de aproximadamente -22/-18 mmHg para PAS e PAD respectivamente (p<0,001). Observou-se redução significativa do duplo produto (DP) a partir do 30° minuto, continuando a reduzir até o 60° minuto após TCC (p<0,001). A magnitude de redução do DP comparado ao momento pré-exercício foi na ordem de 1675 (p<0,001). Conclusão: Esses achados sugerem que única sessão de TCC promove hipotensão pós-exercício (HPE) e reduz a sobrecarga cardíaca em idosos com HAS. (AU)

Design: Interventional study, prospective and quantitative study. Objective: To determine blood pressure and double product values of elderly hypertensive patients, after a single Tai Chi Chuan (TCC) session. Methods: Twenty elderly hypertensive patients participated in the study, in which the hemodynamic variables were measured pre-TCC session and control session (without exercise), and monitored for 60 minutes after the end of both sessions. Each session had an interval of 7 days. Results: The results showed that at the end of the TCC, the heart rate remained elevated for 30 minutes, returning to pre-exercise values from the 40th minute. Significant reduction in mean blood pressure (MBP) from the 10th minute, and significant reduction in systolic (SBP) and diastolic (DBP) blood pressure from the 20th minute to the 60th minute after TCC session (p<0.001) were observed. A magnitude reduction compared to pre-exercise was around -22 / -18 mmHg for SBP and DBP respectively (p<0.001). Significant reduction of the DP was observed from the 30th minute, and reduced until the 60th minute after TCC (p<0.001). The magnitude of DP reduction compared to pre-exercise was around -1675 (p<0.01). Conclusions: These findings show that single TCC session promotes post-exercise hypotension (PEH) and reduces cardiac overload in elderly hypertensive patients. (AU)

Parenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines.

Short bowel syndrome is a severe malabsorption disorder, and prolonged parenteral nutrition is essential for survival in some cases. Among the undesirable effects of long-term parenteral nutrition is an increase in proinflammatory cytokines. The aim of the present study was to measure the serum levels of interleukin-6, interleukin-10, tumor necrosis factor alpha, and transforming growth factor beta, in patients with short bowel syndrome on cyclic parenteral nutrition and patients who had previously received but no longer require parenteral nutrition. The study was cross-sectional and observational. Three groups were studied as follows: Parenteral nutrition group, 9 patients with short bowel syndrome that receive cyclic parenteral nutrition; Oral nutrition group, 10 patients with the same syndrome who had been weaned off parenteral nutrition for at least 1 year prior to the study; Control group, 13 healthy adults, matched for age and sex to parenteral and oral groups. The following data were collected: age, tobacco use, drug therapies, dietary intake, body weight, height, blood collection. All interleukins were significantly higher in the parenteral group compared with the control group as follows: interleukin-6: 22 ± 19 vs 1.5 ± 1.4 pg/mL, P= .0002; transforming growth factor ß: 854 ± 204 vs 607 ± 280 pg/mL, P= .04; interleukin-10: 8 ± 37 vs 0.6 ± 4, P= .03; tumor necrosis factor α: 20 ± 8 vs 8 ± 4 pg/mL, P< .0001. We concluded that parenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines.

Resting energy expenditure adaptation after short-term caloric restriction in morbidly obese women / Adaptação do gasto energético de repouso após restrição calórica de curto prazo em mulheres com obesidade mórbida

Objective:The objective of this study was to describe changes in the resting energy expenditure, substrate oxidation rate, and body composition in morbidly obese women subjected to short-term caloric restriction. Methods:This was a prospective study that included ten obese women with body mass index greater than 40 kg/m2 and aged between 20-50 years. The participants were hospitalized for eight days and received a controlled conventional low-calorie diet, 1200 kcal/day, for seven days. Body weight, body mass index, abdominal circumference, body composition, resting energy expenditure, and substrate oxidation rate were evaluated at the beginning and at the end of the study. Results:A significant reduction in body weight (p=0.005), body mass index (p=0.005), abdominal circumference (p=0.005), fat mass (p=0.005) and fat-free mass (p=0.008) was observed at the end of the study. There was an average reduction in resting energy expenditure of approximately 124 kcal/day (5%). Substrate oxidation rate did not show statistically significant changes. There was a positive correlation only between body weight reduction and fat-free mass reduction (r=0.753; p=0.012). Conclusion:There was an adaptive response of the resting energy expenditure with short-term energy restriction in morbidly obese women with a 5% reduction in resting energy expenditure and a positive correlation between weight loss and the fat-free mass, which indicates the influence of fat-free mass on the decrease in resting energy expenditure. Therefore, short-term caloric restriction in morbidly obese women led to a decrease in resting energy expenditure and fat-free mass, which suggests a rapid adaptation of energy expenditure.

Objetivo:Descrever as mudanças no gasto energético de repouso, na taxa de oxidação de substrato e na composição corporal em mulheres obesas mórbidas submetidas à restrição calórica de curto prazo. Métodos:Este foi um estudo prospectivo com dez mulheres obesas com índice de massa corporal maior que 40 kg/m2 e idade entre 20-50 anos. As participantes foram hospitalizadas por sete dias consecutivos e receberam uma dieta hipocalórica convencional controlada de 1200 kcal/dia. Peso corporal, índice de massa corporal, circunferência abdominal, composição corporal, gasto energético de repouso e taxa de oxidação de substratos foram avaliados no início e no final do estudo.Resultados:Reduções significativas no peso corporal (p=0,005), índice de massa corporal (p=0,005), circunferência abdominal (p=0,005), massa gorda (p=0,005) e massa livre de gordura (p=0,008) foram observadas no final do estudo. O gasto energético de repouso mostrou redução média de aproximadamente 124 kcal/dia (5%). A taxa de oxidação de substratos não apresentou mudanças estatisticamente significativas. Houve correlação importante apenas entre a redução do peso corporal e a redução da massa livre de gordura (r=0,753, p=0,012). Conclusão:Houve uma resposta adaptativa do gasto energético de repouso com restrição energética em curto prazo em mulheres obesas mórbidas, apresentando redução média de 5% do gasto energético de repouso e correlação entre a perda de peso e a massa livre de gordura, o que indica a influência da mesma na diminuição do gasto energético de repouso. Portanto, a restrição calórica de curto prazo em mulheres obesas mórbidas leva à diminuição no gasto energético de repouso e na massa livre de gordura, sugerindo uma rápida adaptação do gasto energético.