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1.
Rev Mal Respir ; 37(9): 699-709, 2020 Nov.
Artigo em Francês | MEDLINE | ID: mdl-33071062

RESUMO

BACKGROUND: There is no validated Arabic version of the French questionnaire of quality of life, the VQ11. This study aimed to test the applicability of the Arabic version of the VQ11 in Tunisian patients with chronic obstructive pulmonary disease (COPD). METHODS: It was a prospective and cross-sectional study, spread over seven months, that included 40 stable COPD male patients. The Arabic version of VQ11, translated by a bilingual expert, was used. The functional, psychological, relational and total scores were calculated. Patients were divided into two groups according to the GOLD classification: "A-B" (n=25) and "C-D" (n=15). A significant correlation-coefficient (r) of≥0.51, between the VQ11 total score and the ADO index (age, dyspnoea, obstruction), and higher quality of life scores in GOLD "C-D" when compared to GOLD "A-B" would be in favour of application of the Arabic version of the VQ11. RESULTS: The mean±standard deviation of age, post-bronchodilator FEV1/FVC, ADO index and VQ11 total score were 64±8 years, 0.55±0.08, 4.8±1.7 and 2±10, respectively. A significant "r" (0.56) was identified between the ADO index and the total score. Psychological, relational and total scores of GOLD "A-B" patients were significantly lower than those in GOLD "C-D" patients: 10±4 vs. 12±3, 11±4 vs. 13±3 and 30±11 vs. 36±7, respectively. CONCLUSION: The Arabic version of VQ11 is applicable in Tunisian COPD patients with reliable results.


Assuntos
Comparação Transcultural , Idioma , Doença Pulmonar Obstrutiva Crônica , Qualidade de Vida , Inquéritos e Questionários , Idoso , Árabes/estatística & dados numéricos , Comorbidade , Jejum/fisiologia , Feminino , França/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/psicologia , Religião e Medicina , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Fumar/epidemiologia , Fumar/psicologia , Inquéritos e Questionários/normas , Tradução , Tunísia/epidemiologia
2.
PLoS One ; 15(10): e0239720, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33017436

RESUMO

BACKGROUND: Women with hyperglycaemia first detected in pregnancy (HFDP), including those with gestational diabetes mellitus (GDM), should undergo a glucose evaluation 4-12 weeks after delivery. Globally, suboptimal postpartum return rates limit the opportunity to intervene in women with sustained hyperglycaemia and pragmatic solutions should be sought to bridge this gap. OBJECTIVE: To assess the utility of postpartum in-hospital glucose evaluation to predict the outcome of the oral glucose tolerance test (OGTT) performed 4-12 weeks after delivery. METHODS: The study was performed prospectively at Tygerberg Hospital, Cape Town, South Africa. Women with HFDP, classified as GDM based on the modified National Institute for Health and Care Excellence criteria, who delivered between November 2018 and June 2019 were included in the study. Fasting plasma glucose (FPG) was performed 24-72 hours after delivery (t1) in the postnatal ward, provided glucose lowering medication was discontinued at delivery. An OGTT 4-12 weeks postpartum (t2) was scheduled for the total cohort. We compared glucose values and glucose categories at t1 and t2 and evaluated antenatal characteristics of women who returned, compared to the group that was lost to follow-up. RESULTS: In-hospital post-delivery glucose assessment (t1) was performed in 115 women. Glucose levels were significantly lower at t1 compared to antenatal diagnostic values (t0) and assessment at t2. Of the fourteen women with hyperglycaemia at t2, none had abnormal fasting glucose concentrations at t1. Women with HFDP who fulfilled criteria for overt diabetes at t0, all (24/115) had normal fasting glucose levels at t1 except for IFG in one (1/24). The antenatal characteristics of women with HFDP who returned at t2, were similar to the women who did not return. CONCLUSION: Based on this study, in-hospital fasting glucose 24-72 hours postpartum cannot replace the OGTT 4-12 weeks postpartum. Pragmatic solutions for low postpartum return rates in women with HFDP should be pursued.


Assuntos
Glicemia/análise , Glucose/metabolismo , Hiperglicemia/fisiopatologia , Adulto , Estudos de Coortes , Diabetes Mellitus Tipo 2/sangue , Diabetes Gestacional/sangue , Jejum/sangue , Jejum/fisiologia , Feminino , Intolerância à Glucose/sangue , Teste de Tolerância a Glucose , Humanos , Período Pós-Parto/sangue , Gravidez , Prognóstico , Estudos Prospectivos , Fatores de Risco , África do Sul
3.
PLoS One ; 15(8): e0237065, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785233

RESUMO

BACKGROUND: Vegetarian diets adapted for various reasons that may include religious, ethical, and health considerations have reasonable health benefits including weight loss, and favorable metabolic changes. However, studies that assessed health benefits associated with vegan diet practices during the Ethiopian Orthodox Christian (EOC) Lenten fasting remains limited. This study has, therefore, assessed how short-term vegan diet associated with metabolic traits, including weight, body mass index (BMI), circumference, blood pressure, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C), through longitudinal cross-sectional study design. METHODS: Seventy-five subjects (34 females and 41 males) with a mean age of [+SD] 27.3 + 5.8 years (range, 18 and 35) took part in the study. The study followed three assessment sessions: at baseline, during the Lenten (week 7), and 7 weeks after the end of the Lenten (week 14). An automatic chemistry analyzer (Mindray, BE-2000, China) used for lipid profile analysis. We used paired sample t-test in pre and post-performance and repeated measures ANOVA with Bonferroni post hoc adjustment between time points. The statistical significance was set at p < 0.05. RESULTS: The EOC fasting with vegan diet induced significantly lower blood pressure, weight, BMI, TC, HDL-C, LDL-C, and TC: HDL-C ratios, during Lenten (that is vegan diet consumption), but a regain noted in these parameters 7-weeks after Lenten (that is omnivore diet). On gender differences, vegan diet associated with significantly lower blood pressure, TC, and LDL-C in females compared with age-matched male counterparts. Some methodological limitations of this study are discussed with particular reference to lack of a randomized control group and self-reported data that limit this study in establishing a causal relationship through observed associations. CONCLUSIONS: Vegan diet consumption even for short period corroborate ideal metabolic traits, with more favorable changes noted in women than age-matched men counterparts. These findings might help to define vegetarian diets as part of religious fasting (beyond its spiritual goals) as a non-pharmacological prescription in different populations, and our findings add to growing evidence in these subjects.


Assuntos
Peso Corporal/fisiologia , Dieta Vegana/métodos , Perda de Peso/fisiologia , Adolescente , Adulto , Pressão Sanguínea , Índice de Massa Corporal , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Estudos Transversais , Dieta/métodos , Dieta Vegetariana , Etiópia , Jejum/fisiologia , Feminino , Humanos , Lipídeos/sangue , Masculino , Fatores de Risco , Fatores Sexuais , Fatores de Tempo , Triglicerídeos/sangue , Adulto Jovem
4.
Metabolism ; 111: 154336, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32777443

RESUMO

BACKGROUND & AIMS: Alternate-day fasting (ADF) is related to weight reduction, lowered risks of weight regain, and relative lean body mass preservation compared to continuous energy restriction. This meta-analysis aimed to assess the effects of ADF on obesity-related factors and cardiometabolic risk factors in adults. METHODS: Using PubMed, EMBASE, and Cochrane online databases, an electronic search was performed. Randomized controlled trials were investigated to evaluate ADF effects on body mass index (BMI), body weight (BW), waist circumference, body fat mass (FM), lean body mass, and cardiometabolic risk factors in adults aged ≥18 years. By utilizing a random-effects model, meta-analyses to assess weighted mean difference (WMD) with 95% confidence intervals (CIs) were performed for eight randomized controlled trials (total participants = 728). RESULTS: We observed significant effects of ADF for BMI (WMD -0.73 kg/m2, 95% CI -1.13 to -0.34), FM (WMD -1.27 kg, 95% CI -2.09 to -0.46), and total cholesterol (WMD -8.14 mg/dL, 95% CI -14.59 to -1.69). Subgroup analyses indicated that significant intervention effects were observed for BMI, BW, FM, and total cholesterol when compared to the control, the participants were overweight, and the study duration was <6 months. ADF is effective in reducing waist circumference in adults aged ≥40 years with obesity. However, there was no difference between ADF and continuous energy restriction, time-restricted feeding, or control with regard to lean body mass. CONCLUSIONS: Current evidence suggests that ADF effectively lowers BMI, BW, FM, and total cholesterol in adults with overweight within 6 months compared to the control.


Assuntos
Doenças Cardiovasculares/metabolismo , Doenças Cardiovasculares/fisiopatologia , Jejum/metabolismo , Jejum/fisiologia , Coração/fisiopatologia , Obesidade/metabolismo , Obesidade/fisiopatologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
5.
Am J Clin Nutr ; 112(4): 1015-1028, 2020 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-32729615

RESUMO

BACKGROUND: Altering the temporal distribution of energy intake (EI) and introducing periods of intermittent fasting (IF) exert important metabolic effects. Restricting EI to earlier in the day [early time-restricted feeding (eTRF)] is a novel type of IF. OBJECTIVES: We assessed the chronic effects of eTRF compared with an energy-matched control on whole-body and skeletal muscle insulin and anabolic sensitivity. METHODS: Sixteen healthy males (aged 23 ± 1 y; BMI 24.0 ± 0.6 kg·m-2) were assigned to 2 groups that underwent either 2 wk of eTRF (n = 8) or control/caloric restriction (CON:CR; n = 8) diet. The eTRF diet was consumed ad libitum and the intervention was conducted before the CON:CR, in which the diet was provided to match the reduction in EI and body weight observed in eTRF. During eTRF, daily EI was restricted to between 08:00 and 16:00, which prolonged the overnight fast by ∼5 h. The metabolic responses to a carbohydrate/protein drink were assessed pre- and post-interventions following a 12-h overnight fast. RESULTS: When compared with CON:CR, eTRF improved whole-body insulin sensitivity [between-group difference (95% CI): 1.89 (0.18, 3.60); P = 0.03; η2p = 0.29] and skeletal muscle uptake of glucose [between-group difference (95% CI): 4266 (261, 8270) µmol·min-1·kg-1·180 min; P = 0.04; η2p = 0.31] and branched-chain amino acids (BCAAs) [between-group difference (95% CI): 266 (77, 455) nmol·min-1·kg-1·180 min; P = 0.01; η2p = 0.44]. eTRF caused a reduction in EI (∼400 kcal·d-1) and weight loss (-1.04 ± 0.25 kg; P = 0.01) that was matched in CON:CR (-1.24 ± 0.35 kg; P = 0.01). CONCLUSIONS: Under free-living conditions, eTRF improves whole-body insulin sensitivity and increases skeletal muscle glucose and BCAA uptake. The metabolic benefits of eTRF are independent of its effects on weight loss and represent chronic adaptations rather than the effect of the last bout of overnight fast. This trial was registered at clinicaltrials.gov as NCT03969745.


Assuntos
Jejum/fisiologia , Resistência à Insulina , Adulto , Aminoácidos de Cadeia Ramificada/metabolismo , Composição Corporal , Ingestão de Energia , Metabolismo Energético , Glucose/metabolismo , Humanos , Masculino , Músculo Esquelético/metabolismo
8.
Nature ; 583(7817): 620-624, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32669709

RESUMO

Approximately 75% of all breast cancers express the oestrogen and/or progesterone receptors. Endocrine therapy is usually effective in these hormone-receptor-positive tumours, but primary and acquired resistance limits its long-term benefit1,2. Here we show that in mouse models of hormone-receptor-positive breast cancer, periodic fasting or a fasting-mimicking diet3-5 enhances the activity of the endocrine therapeutics tamoxifen and fulvestrant by lowering circulating IGF1, insulin and leptin and by inhibiting AKT-mTOR signalling via upregulation of EGR1 and PTEN. When fulvestrant is combined with palbociclib (a cyclin-dependent kinase 4/6 inhibitor), adding periodic cycles of a fasting-mimicking diet promotes long-lasting tumour regression and reverts acquired resistance to drug treatment. Moreover, both fasting and a fasting-mimicking diet prevent tamoxifen-induced endometrial hyperplasia. In patients with hormone-receptor-positive breast cancer receiving oestrogen therapy, cycles of a fasting-mimicking diet cause metabolic changes analogous to those observed in mice, including reduced levels of insulin, leptin and IGF1, with the last two remaining low for extended periods. In mice, these long-lasting effects are associated with long-term anti-cancer activity. These results support further clinical studies of a fasting-mimicking diet as an adjuvant to oestrogen therapy in hormone-receptor-positive breast cancer.


Assuntos
Neoplasias da Mama/dietoterapia , Neoplasias da Mama/tratamento farmacológico , Dietoterapia/métodos , Jejum/fisiologia , Fulvestranto/uso terapêutico , Animais , Fatores Biológicos/sangue , Neoplasias da Mama/patologia , Dieta Saudável/métodos , Modelos Animais de Doenças , Progressão da Doença , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Proteína 1 de Resposta de Crescimento Precoce/metabolismo , Feminino , Fulvestranto/administração & dosagem , Humanos , Insulina/sangue , Fator de Crescimento Insulin-Like I/metabolismo , Leptina/sangue , Células MCF-7 , Camundongos Endogâmicos NOD , Camundongos SCID , PTEN Fosfo-Hidrolase/metabolismo , Piperazinas/administração & dosagem , Piperazinas/uso terapêutico , Piridinas/administração & dosagem , Piridinas/uso terapêutico , Receptores Estrogênicos , Receptores de Progesterona , Tamoxifeno/efeitos adversos , Tamoxifeno/uso terapêutico , Ensaios Antitumorais Modelo de Xenoenxerto
9.
BMC Surg ; 20(1): 168, 2020 Jul 25.
Artigo em Inglês | MEDLINE | ID: mdl-32711489

RESUMO

BACKGROUND: Adhesive small bowel obstruction (ASBO) is one of the most common causes of postoperative morbidity. According to Boyle's law, decreased barometric pressure expands the volume of intestinal gas. We aimed to elucidate the relationship between barometric pressure and ASBO. METHODS: We divided 215 admissions of 120 patients with ASBO into three groups: the fasting group, which responded to fasting (n = 51); the decompression group, which was successfully treated with gastrointestinal decompression (n = 104); and the surgery group which required emergency or elective surgery to treat ASBO (n = 60). We compared and examined clinical backgrounds, findings on admission, and barometric pressure during the peri-onset period (29 days: from 14 days before to 14 days after the onset of ASBO). RESULTS: There were significant differences among the three groups regarding gender, history of ASBO, hospital length of stay, and barometric pressure on the onset day of ASBO. Barometric pressure on the onset day was significantly higher in the fasting group than in the decompression group (p = 0.005). During pre-onset day 5 to post-onset day 2, fluctuations in the barometric pressure in the fasting and decompression groups showed reciprocal changes with a symmetrical axis overlapping the median barometric pressure in Matsumoto City; the fluctuations tapered over time after onset. In the fasting group, the barometric pressure on the onset day was significantly higher than that on pre-onset days 14, 11, 7, 4, 3, and 2; post-onset days 3 and 10; and the median pressure in Matsumoto City. Conversely, in the decompression group, the barometric pressure on the onset day was lower than that on pre-onset days 14, 5-2; post-onset days 1, 2, 7, 8, 11, 13, and 14; and the median pressure in Matsumoto City. In the surgery group, the barometric pressure on the onset day was equivalent to those on the other days. CONCLUSIONS: ASBO with response to conservative treatment is vulnerable to barometric pressure. Additionally, ASBO that is successfully treated with fasting and decompression is associated with a different barometric pressure on the onset day and reciprocal fluctuations in the barometric pressure during the peri-onset period.


Assuntos
Pressão Atmosférica , Obstrução Intestinal , Intestino Delgado/fisiopatologia , Aderências Teciduais/complicações , Idoso , Idoso de 80 Anos ou mais , Jejum/fisiologia , Feminino , Humanos , Obstrução Intestinal/etiologia , Obstrução Intestinal/fisiopatologia , Obstrução Intestinal/cirurgia , Obstrução Intestinal/terapia , Intestino Delgado/patologia , Intestino Delgado/cirurgia , Intubação Gastrointestinal , Japão , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Aderências Teciduais/cirurgia , Resultado do Tratamento
10.
PLoS One ; 15(6): e0234443, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32598395

RESUMO

Ramadan fasting is associated with changes in eating, physical activity, sleeping patterns, and medication. Unfortunately, only limited studies examine glucose variability in subjects with type 2 diabetes who fast in Ramadan. Our study aims to evaluate glucose variability in subjects with type 2 diabetes on oral antidiabetic agents using continuous glucose monitoring system (CGMS) during and after Ramadan fasting. This observational study was done in The Indonesian Medical Education and Research Institute, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia, which recruited 10 subjects with type 2 diabetes who underwent Ramadan fasting in 2019. These subjects were free from cardiovascular disease, kidney disease, severe liver disease, chronic gastrointestinal disease and autoimmune disease. Insertion of CGMS for measuring interstitial glucose was performed after at least 2 weeks of Ramadan fasting and 4 weeks after the end of the Ramadan fasting, with a minimum of 3 days observation. The mean amplitude of glycemic excursion (MAGE) during and after Ramadan were similar (p = 0.94). In line with this, the average interstitial glucose (p = 0.48), the maximum interstitial glucose (p = 0.35), the minimum interstitial glucose (p = 0.24), and the duration of hypoglycemia (p = 0.25) were also similar in both periods. Overall, nutritional intake and energy expenditure during both periods were comparable. Ramadan fasting is not associated with increased glucose variability in subjects with type 2 diabetes. Thus, Ramadan fasting is safe in subjects with type 2 diabetes with no complications.


Assuntos
Glicemia/fisiologia , Diabetes Mellitus Tipo 2/sangue , Jejum/fisiologia , Hipoglicemiantes/administração & dosagem , Islamismo , Administração Oral , Glicemia/análise , Glicemia/efeitos dos fármacos , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/fisiopatologia , Metabolismo Energético/fisiologia , Feminino , Humanos , Indonésia , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Monitorização Ambulatorial , Estudos Prospectivos
11.
PLoS One ; 15(6): e0234439, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32530967

RESUMO

Disturbance of circadian rhythms underlies various metabolic diseases. Constant light exposure (LL) is known to disrupt both central and peripheral circadian rhythms. Here, we attempted to determine whether the effects of LL are different between various peripheral tissues and whether time-restricted feeding restores the circadian rhythms especially in white adipose tissue (WAT). Six-week-old mice were subjected to three feeding regimes: ad libitum feeding under light/dark phase (LD), ad libitum feeding under LL cycle, and restricted feeding at night-time under LL cycle with a normal chow. After 3 weeks, we compared body weight, food intake, plasma levels of lipids and glucose, and the expression patterns of the clock genes and the genes involved in lipid metabolism in the liver and WAT. The mice kept under LL with or without time-restricted feeding were 5.2% heavier (p<0.001, n = 16) than the mice kept under LD even though the food intakes of the two groups were the same. Food intake occurred mostly in the dark phase. LL disrupted this pattern, causing disruptions in circadian rhythms of plasma levels of triglycerides (TG) and glucose. Time-restricted feeding partially restored the rhythms. LL eliminated the circadian rhythms of the expression of the clock genes as well as most of the genes involved in lipid metabolism in both liver and WAT. More notably, LL markedly decreased not only the amplitude but also the average levels of the expression of the genes in the liver, but not in the WAT, suggesting that transcription in the liver is sensitive to constant light exposure. Time-restricted feeding restored the circadian rhythms of most of the genes to various degrees in both liver and WAT. In conclusion, LL disrupted the peripheral circadian rhythms more severely in liver than in WAT. Time-restricted feeding restored the circadian rhythms in both tissues.


Assuntos
Peptídeos e Proteínas de Sinalização do Ritmo Circadiano/genética , Ritmo Circadiano/fisiologia , Jejum/fisiologia , Luz/efeitos adversos , Metabolismo dos Lipídeos/fisiologia , Tecido Adiposo Branco/metabolismo , Animais , Ritmo Circadiano/efeitos da radiação , Regulação da Expressão Gênica/efeitos da radiação , Metabolismo dos Lipídeos/efeitos da radiação , Fígado/metabolismo , Masculino , Camundongos , Modelos Animais , Fotoperíodo
12.
Obesity (Silver Spring) ; 28(6): 1110-1116, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32369268

RESUMO

OBJECTIVE: This study aimed to determine the relationship between metabolic flexibility (MetFlex) measured during a euglycemic-hyperinsulinemic clamp and a prolonged fast. This study also analyzed the association between MetFlex and metabolic health. METHODS: Eighteen healthy men (mean [SD]: 22 [2] years old; BMI: 22 [1] kg/m2 ) performed two sessions: (1) euglycemic-hyperinsulinemic clamp (2 mIU/kg of insulin per minute) and (2) ~20-hour fast. Clamp MetFlex corresponded to the change in (Δ) respiratory quotient (RQ) (ΔRQ = postchallenge RQ - prechallenge RQ) adjusted for M value and prechallenge RQ. Prolonged fast MetFlex corresponded to the ΔRQ adjusted for the Δß-hydroxybutyrate and prechallenge RQ. RESULTS: MetFlex during the clamp related directly with MetFlex during prolonged fast (r = 0.59, P = 0.014). Using the median of MetFlex for each challenge, this study split participants into high or low MetFlex. Participants with high or low MetFlex to both challenges were identified. Participants with high MetFlex had 3% lower serum low-density lipoprotein cholesterol than participants with low MetFlex (P = 0.021). CONCLUSIONS: Measuring MetFlex during a clamp or a prolonged fast produces similar results, despite challenging the oxidation of different substrates. An impaired MetFlex in response to these challenges may be an early event in the development of abnormal lipid metabolism.


Assuntos
Jejum/fisiologia , Técnica Clamp de Glucose/métodos , Resistência à Insulina/fisiologia , Insulina/sangue , Adulto , Humanos , Masculino , Adulto Jovem
13.
J Biomed Sci ; 27(1): 58, 2020 May 05.
Artigo em Inglês | MEDLINE | ID: mdl-32370764

RESUMO

Short-term fasting (STF) is a technique to reduce nutrient intake for a specific period. Since metabolism plays a pivotal role in tumor progression, it can be hypothesized that STF can improve the efficacy of chemotherapy. Recent studies have demonstrated the efficacy of STF in cell and animal tumor models. However, large-scale clinical trials must be conducted to verify the safety and effectiveness of these diets. In this review, we re-examine the concept of how metabolism affects pathophysiological pathways. Next, we provided a comprehensive discussion of the specific mechanisms of STF on tumor progression, derived through studies carried out with tumor models. There are currently at least four active clinical trials on fasting and cancer treatment. Based on these studies, we highlight the potential caveats of fasting in clinical applications, including the onset of metabolic syndrome and other metabolic complications during chemotherapy, with a particular focus on the regulation of the epithelial to mesenchymal pathway and cancer heterogeneity. We further discuss the advantages and disadvantages of the current state-of-art tumor models for assessing the impact of STF on cancer treatment. Finally, we explored upcoming fasting strategies that could complement existing chemotherapy and immunotherapy strategies to enable personalized medicine. Overall, these studies have the potential for breakthroughs in cancer management.


Assuntos
Tratamento Farmacológico , Jejum/fisiologia , Imunoterapia , Neoplasias/prevenção & controle , Animais , Humanos
14.
Diabetes Res Clin Pract ; 166: 108189, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32360709

RESUMO

AIMS: ORION evaluated the safety and effectiveness of Gla-300 in insulin-treated people with T2DM before, during and after Ramadan, in a real-world setting. METHODS: This prospective, observational study across 11 countries included participants with T2DM treated with Gla-300 in pre-Ramadan, Ramadan and post-Ramadan periods. The primary endpoint was the percentage of participants experiencing ≥1 event of severe and/or symptomatic documented hypoglycaemia with self-monitored plasma glucose (SMPG) ≤70 mg/dL during Ramadan. Secondary endpoints included change in HbA1c and insulin dose and adverse events (AEs). RESULTS: The mean ± SD number of fasting days was 30.1 ± 3.2. The percentage of participants experiencing ≥1 event of severe and/or symptomatic documented hypoglycaemia (SMPG ≤70 [<54] mg/dL) was low in the pre-Ramadan (2.2% [0.8%]), Ramadan (2.6% [0%]) and post-Ramadan (0.2% [0%]) periods. No participants reported severe hypoglycaemia during Ramadan or post-Ramadan; one participant reported severe hypoglycaemia in pre-Ramadan. HbA1c fell pre- to post-Ramadan, and Gla-300 daily dose (mean ± SD) was reduced pre-Ramadan to Ramadan (from 25.6 ± 11.9 U/0.32 ± 0.14 U/kg to 24.4 ± 11.5 U/0.30 ± 0.13 U/kg). Incidence of AEs was 5.5%. CONCLUSIONS: In ORION, people with T2DM treated with Gla-300 who fasted during Ramadan had a low risk of severe/symptomatic hypoglycaemia and improved glycaemic control.


Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Jejum/fisiologia , Insulina Glargina/administração & dosagem , Insulina Glargina/efeitos adversos , Islamismo , Adulto , Idoso , Glicemia/efeitos dos fármacos , Glicemia/metabolismo , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/epidemiologia , Relação Dose-Resposta a Droga , Feminino , Hemoglobina A Glicada/análise , Humanos , Hipoglicemia/induzido quimicamente , Hipoglicemia/epidemiologia , Hipoglicemiantes/administração & dosagem , Hipoglicemiantes/efeitos adversos , Incidência , Masculino , Pessoa de Meia-Idade , Religião e Medicina , Resultado do Tratamento
15.
Nat Commun ; 11(1): 2332, 2020 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-32393788

RESUMO

Fasting-mimicking diets delay tumor progression and sensitize a wide range of tumors to chemotherapy, but their therapeutic potential in combination with non-cytotoxic compounds is poorly understood. Here we show that vitamin C anticancer activity is limited by the up-regulation of the stress-inducible protein heme-oxygenase-1. The fasting-mimicking diet selectivity reverses vitamin C-induced up-regulation of heme-oxygenase-1 and ferritin in KRAS-mutant cancer cells, consequently increasing reactive iron, oxygen species, and cell death; an effect further potentiated by chemotherapy. In support of a potential role of ferritin in colorectal cancer progression, an analysis of The Cancer Genome Atlas Database indicates that KRAS mutated colorectal cancer patients with low intratumor ferritin mRNA levels display longer 3- and 5-year overall survival. Collectively, our data indicate that the combination of a fasting-mimicking diet and vitamin C represents a promising low toxicity intervention to be tested in randomized clinical trials against colorectal cancer and possibly other KRAS mutated tumors.


Assuntos
Ácido Ascórbico/farmacologia , Dieta , Jejum/fisiologia , Mutação/genética , Proteínas Proto-Oncogênicas p21(ras)/genética , Animais , Morte Celular/efeitos dos fármacos , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Progressão da Doença , Heme Oxigenase-1/metabolismo , Humanos , Ferro/metabolismo , Camundongos Endogâmicos BALB C , Oxaliplatina/farmacologia , Fosforilação/efeitos dos fármacos , Espécies Reativas de Oxigênio/metabolismo , Análise de Sobrevida , Transferrina/metabolismo
16.
PLoS One ; 15(5): e0232813, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32428002

RESUMO

Worldwide, nearly 3 million people die every year because of being overweight or obese. Although obesity is a metabolic disease, behavioral aspects are important in its etiology. Hunger changes the rewarding potential of food in normal-weight controls. In obesity, impairments related to reward processing are present, but it is not clear whether these are due to mental disorders more common among this population. Therefore, in this pilot study, we aimed at investigating whether fasting influence mood reactivity to reward in people with obesity. Women with obesity (n = 11, all mentally healthy) and normal weight controls (n = 17) were compared on a computerized monetary reward task (the wheel of fortune), using self-reports of mood and affect (e.g., PANAS and mood evaluation during the task) as dependent variables. This task was done in 2 satiety conditions, during fasting and after eating. Partially, in line with our expectation of a reduced affect and mood reactivity to monetary reward in participants with obesity accentuated by fasting, our results indicated a significant within-group difference across time (before and after the task), with monetary gains significantly improving positive affect in healthy controls (p>0.001), but not in individuals with obesity (p = 0.32). There were no significant between-group differences in positive affect before (p = 0.328) and after (p = 0.70) the task. In addition, women with obesity, compared to controls, reported more negative affect in general (p < 0.05) and less mood reactivity during the task in response to risky gains (p < 0.001) than healthy controls. The latter was independent of the level of satiety. These preliminary results suggest an impairment in mood reactivity to monetary reward in women with obesity which is not connected to the fasting state. Increasing the reinforcing potential of rewards other than food in obesity may be one target of intervention in order to verify if that could reduce overeating.


Assuntos
Afeto/fisiologia , Fome/fisiologia , Transtornos Mentais/fisiopatologia , Obesidade/psicologia , Adulto , Índice de Massa Corporal , Jejum/fisiologia , Jejum/psicologia , Feminino , Alimentos/efeitos adversos , Humanos , Masculino , Transtornos Mentais/psicologia , Pessoa de Meia-Idade , Obesidade/fisiopatologia , Sobrepeso/fisiopatologia , Sobrepeso/psicologia , Projetos Piloto , Recompensa
17.
Rev Assoc Med Bras (1992) ; 66(2): 222-226, 2020 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-32428159

RESUMO

OBJECTIVE: To verify the relationship of intermittent fasting in the bodyweight of overweight and obese individuals through a systematic literature review. METHODS: This is a systematic review based on randomized controlled trials. The articles were consulted in the databases: Science Direct, PubMed e BVS. This review was evaluated through the PRISMA recommendation. RESULTS: After the selection process, four articles were included in this review, comparing intermittent fasting (IF) with calorie restriction diet (CRD) as a control group. In 2 studies using similar protocols, there was no significant reduction in body weight of overweight or obese subjects. In the other two studies using different protocols, weight loss was significant in the IF group compared to the CRD group. CONCLUSIONS: Results did not provide evidence of the effect of intermittent fasting on weight loss in overweight or obese individuals.


Assuntos
Peso Corporal/fisiologia , Jejum/fisiologia , Obesidade/dietoterapia , Sobrepeso/dietoterapia , Perda de Peso/fisiologia , Restrição Calórica/métodos , Dieta Redutora/métodos , Humanos , Obesidade/metabolismo , Sobrepeso/metabolismo , Resultado do Tratamento
20.
Am J Med ; 133(8): 901-907, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32330491

RESUMO

Dietary patterns, such as the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean diet, have been shown to improve cardiac health. Intermittent fasting is another type of popular dietary pattern that is based on timed periods of fasting. Two different regimens are alternative day fasting and time-restricted eating. Although there are no large, randomized control trials examining the relationship between intermittent fasting and cardiovascular outcomes, current human studies that suggest this diet could reduce the risk for cardiovascular disease with improvement in weight control, hypertension, dyslipidemia, and diabetes. Intermittent fasting may exert its effects through multiple pathways, including reducing oxidative stress, optimization of circadian rhythms, and ketogenesis. This review evaluates current literature regarding the potential cardiovascular benefits of intermittent fasting and proposes directions for future research.


Assuntos
Doenças Cardiovasculares/metabolismo , Ritmo Circadiano/fisiologia , Diabetes Mellitus/metabolismo , Dislipidemias/metabolismo , Jejum/metabolismo , Hipertensão/metabolismo , Obesidade/metabolismo , Diabetes Mellitus/dietoterapia , Dieta Cetogênica , Dislipidemias/dietoterapia , Jejum/fisiologia , Humanos , Hipertensão/fisiopatologia , Corpos Cetônicos/metabolismo , Obesidade/dietoterapia , Estresse Oxidativo/fisiologia , Fatores de Risco , Comportamento de Redução do Risco
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