Resistance Exercise Sessions Comprising Multijoint vs. Single-Joint Exercises Result in Similar Metabolic and Hormonal Responses, But Distinct Levels of Muscle Damage in Trained Men.

ABSTRACT: Barbosa, PH, Bueno de Camargo, JB, Jonas de Oliveira, J, Reis Barbosa, CG, Santos da Silva, A, Dos-Santos, JW, Verlengia, R, Barreira, J, Braz, TV, and Lopes, CR. Resistance exercise sessions comprising multijoint vs. single-joint exercises result in similar metabolic and hormonal responses, but distinct levels of muscle damage in trained men. J Strength Cond Res 38(5): 842-847, 2024-Resistance-type exercise (RE) elicits distinct acute metabolic and hormonal responses, which can be modulated by the manipulation of training variables. The purpose of this study was to compare the metabolic (blood lactate and estimated lactic anaerobic system energy expenditure) and hormonal (growth hormone [GH]) responses to RE sessions composed exclusively of multijoint (MULTI) or single-joint (SINGLE) exercises. Assessments of creatine kinase (CK) levels were also performed. In a crossover design, 10 recreationally resistance-trained men (age: 26.9 ± 3.0 years, total body mass: 83.2 ± 13.8 kg; height: 176 ± 7.0 cm; training experience: 5.5 ± 2.4 years) were randomly submitted to both protocols. Blood collections were made pre, 3 minutes after, and 36 hours after each experimental session. No significant difference between MULTI vs. SINGLE was observed for the rises in blood lactate (p = 0.057) and GH (p = 0.285) levels. For CK, a significant difference between the protocols was noted, in which MULTI resulted in significant rises after 3 minutes (p = 0.017) and 36 hours (p = 0.043) compared with SINGLE. In conclusion, the findings of this study suggest that resistance-trained individuals display similar metabolic and hormonal responses when performing MULTI and SINGLE exercise protocols. Also, RE sessions comprising MULTI exercises induce a higher magnitude of muscle damage, which may require a longer recovery period compared with SINGLE.

Association between physical activity measured by accelerometry and cognitive function in older adults: a systematic review.

OBJECTIVE: To analyze studies that investigated the association between physical activity assessed by accelerometry and cognitive function in older people. METHODS: A systematic review was carried out in four electronic databases (PubMed, Web of Science, Scopus, and SportsDiscus). RESULTS: In total, 195 records were identified. Fifty-two studies were selected for a full evaluation; 23 were selected according to the inclusion criteria adopted and divided into four chapters (characteristics of the studies, the association between physical activity level and cognitive function decline, effects of physical activity in reducing the chances of cognitive function decline and effects of physical activity on brain plasticity. The cross-sectional studies had an average score of 7 points, and the cohort studies obtained 10 points, indicating the high quality of the selected studies. Seven studies indicated an association between Moderate to vigorous physical activities (MVPA) and cognitive function, two specifically indicated a reduction in the chances of cognitive function decline according to the interquartile of MVPA, and three studies indicated improvements in MVPA in brain plasticity. CONCLUSION: Measured by accelerometry, seems to be favorably associated with important outcomes in cognitive function assessed through questionnaires, imaging analyses, and biochemical markers with older adults.

Lack of association between 11 gene polymorphisms on weight loss 1 year after Roux-en-y gastric bypass surgery in woman.

BACKGROUND: Although effective, the impact of bariatric surgery on weight loss is variable, and little is known about the influence of single-nucleotide polymorphisms (SNPs). The present study investigated the association of eleven SNPs related to obesity with weight loss 1 year after Roux-Y gastric bypass (RYGB) surgery in female patients. METHODS: This prospective study included 351 women with obesity. The genotypes for eleven SNPs (GHRL-rs26802; GHSR-rs572169; LEP-rs7799039; LEPR-rs1137101; 5HT2C-rs3813929; UCP2-rs659366; UCP3-rs1800849; SH2B1-rs7498665; TAS1R2-rs35874116; TAS1R2-rs9701796; FTO-rs9939609) were determined using a real-time polymerase chain reaction and TaqMan assays. Anthropometric measurements were performed before and 1 year after RYGB surgery. To evaluate the factors that influenced the proportion of weight loss 1 year after surgery, beta regression analysis was used. The models were estimated using the GLIMMIX procedure in SAS statistical software. p < 0.05 was considered statistically significant. RESULTS: The mean ± SD percentage of total body weight loss in 1 year was 64.4 ± 5.8% and the median was 65.0%. When assessing the proportion of weight loss in 1 year after surgery, using univariate analysis (beta regression), no SNPs influenced weight loss. Furthermore, in the multiple analysis, with stepwise process of variable selection, no variable was significant to compose the multiple model. CONCLUSIONS: The 11 SNPs investigated did not influence weight loss 1 year after RYGB surgery in female patients. This result indicates that individual behaviours and other factors might better contribute to the magnitude of loss weight loss in a short period after bariatric surgery.

Lack of validity of free-living physical activity energy expenditure estimated from ActiGraph equations in severely obese women: A doubly labelled water study.

The current study aimed to investigate the validity of three ActiGraph predictive equations that are available to estimate free-living physical activity energy expenditure (PAEE) in women with severe obesity. The study included 20 women with class III obesity (age: 22-38 years). During 14 days of free-living conditions, total energy expenditure was measured using the doubly labelled water method; in addition, participants wore a triaxial accelerometer (model GT3X+) on the hip. The resting metabolic rate was measured by indirect calorimetry. At group level, the Freedson VM3 Combination was found to be more precise (bias = -61 kcal/day) than the Williams Work-Energy (bias = -283 kcal/day) and the Freedson Combination equations (bias = -186 kcal/day) for estimating PAEE. However, the three predictive equations had a wider limit of agreement (Williams Work-Energy [258, -824 kcal/day], Freedson Combination equations [324, -697 kcal/day] and Freedson VM3 Combination [424, -546 kcal/day]), indicating great uncertainty of the estimate. In conclusion, a wide variation was observed in the performance of different ActiGraph equations in estimating free-living PAEE among women with class III obesity. Therefore, our data do not support the use of these equations, and more studies are needed to improve predictive performance in free-living conditions.

Effect of Different Recoveries During HIIT Sessions on Metabolic and Cardiorespiratory Responses and Sprint Performance in Healthy Men.

ABSTRACT: Germano, MD, Sindorf, MAG, Crisp, AH, Braz, TV, Brigatto, FA, Nunes, AG, Verlengia, R, Moreno, MA, Aoki, MS, and Lopes, CR. Effect of different recoveries during HIIT sessions on metabolic and cardiorespiratory responses and sprint performance in healthy men. J Strength Cond Res 36(1): 121-129, 2022-The purpose of this study was to investigate how the type (passive and active) and duration (short and long) recovery between maximum sprints affect blood lactate concentration, O2 consumed, the time spent at high percentages of V̇o2max, and performance. Subjects were randomly assigned to 4 experimental sessions of high-intensity interval training exercise. Each session was performed with a type and duration of the recovery (short passive recovery-2 minutes, long passive recovery [LPR-8 minutes], short active recovery-2 minutes, and long active recovery [LAR-8 minutes]). There were no significant differences in blood lactate concentration between any of the recoveries during the exercise period (p > 0.05). The LAR presented a significantly lower blood lactate value during the postexercise period compared with LPR (p < 0.01). The LPR showed a higher O2 volume consumed in detriment to the active protocols (p < 0.001). There were no significant differences in time spent at all percentages of V̇o2max between any of the recovery protocols (p > 0.05). The passive recoveries showed a significantly higher effort time compared with the active recoveries (p < 0.001). Different recovery does not affect blood lactate concentration during exercise. All the recoveries permitted reaching and time spent at high percentages of V̇o2max. Therefore, all the recoveries may be efficient to generate disturbances in the cardiorespiratory system.

Compliance of the Physical Activity Guidelines Accumulated in Bouts ≥10 Min and Nonbouts and Its Association With Body Composition and Physical Function: A Cross-Sectional Study in Brazilian Older Adults.

This study aimed to investigate the association between compliance with the guidelines of moderate to vigorous physical activity (MVPA) accumulated in bouts of ≥10 min or nonbouts with body composition and physical function in older adults. The authors evaluated 230 noninstitutionalized older adults. Body composition was estimated using bioimpedance, and physical function was assessed using four physical tests. Physical activities were monitored for 7 days using an accelerometer. Older adults who were physically active according to MVPA in bouts of ≥10 min were less likely to have low appendicular skeletal muscle mass (odds ratio [OR] = 0.12), excess body fat (OR = 0.30), and abdominal obesity (OR = 0.34) and more likely to have a higher physical function (OR = 5.78). No significant association was observed with MVPA nonbout. Our findings indicate that older adults who accumulate MVPA in bouts of  ≥10 min have better parameters for body composition and physical function.

Effect of High Intensity Interval and Continuous Swimming Training on Body Mass Adiposity Level and Serum Parameters in High-Fat Diet Fed Rats.

This study aimed to investigate the effects of interval and continuous training on the body mass gain and adiposity levels of rats fed a high-fat diet. Forty-eight male Sprague-Dawley rats were randomly divided into two groups, standard diet and high-fat diet, and received their respective diets for a period of four weeks without exercise stimuli. After this period, the animals were randomly divided into six groups (n = 8): control standard diet (CS), control high-fat diet (CH), continuous training standard diet (CTS), continuous training high-fat diet (CTH), interval training standard diet (ITS), and interval training high-fat diet (ITH). The interval and continuous training consisted of a swimming exercise performed over eight weeks. CH rats had greater body mass gain, sum of adipose tissues mass, and lower serum high density lipoprotein values than CS. The trained groups showed lower values of feed intake, caloric intake, body mass gain, and adiposity levels compared with the CH group. No significant differences were observed between the trained groups (CTS versus ITS and CTH versus ITH) on body mass gains and adiposity levels. In conclusion, both training methodologies were shown to be effective in controlling body mass gain and adiposity levels in high-fat diet fed rats.

Muscle damage of resistance-trained men after two bouts of eccentric bench press exercise.

The present study tested the hypothesis that resistance-trained individuals would also show less muscle damage in the second than in the first eccentric exercise bout (i.e., repeated bout effect) as shown in untrained individuals. This study investigated changes in indirect markers of muscle damage after 2 bouts of free weight eccentric exercise performed by 8 resistance-trained men. The participants (24.4 ± 1.2 years) performed 4 sets of 8 eccentric actions (3 seconds for each repetition) at 70% of eccentric 1 repetition maximum (1RM) load in a bench press exercise with 2 minutes of rest between sets, and repeated the same exercise 2 weeks later. Bench press 1RM, delayed onset muscle soreness (DOMS) assessed by a 6-point Likert scale, serum creatine kinase (CK) activity, and plasma prostaglandin E2 concentration (PGE2) were measured before and 24, 48, 72, and 96 hours after the exercise, and the changes were compared between bouts. The changes in the variables were smaller (p ≤ 0.05) after the second than the first bout indicated by a smaller decline in 1RM strength (first bout: -10.2 ± 1.0% vs. second bout: -5.7 ± 1.5%), peak DOMS (3.8 ± 0.4 vs. 1.7 ± 0.5), peak CK (637.3 ± 133.3 vs. 305.4 ± 63.6 IU·L), and peak PGE2 (761.2 ± 171.0 vs. 307.2 ± 48.3 pg·mL). These results show a typical repeated bout effect. Thus, it is concluded that the repeated bout effect occurs in resistance-trained individuals.

Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study.

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.

Mechanotransduction pathways in skeletal muscle hypertrophy.

In the last decade, molecular biology has contributed to define some of the cellular events that trigger skeletal muscle hypertrophy. Recent evidence shows that insulin like growth factor 1/phosphatidyl inositol 3-kinase/protein kinase B (IGF-1/PI3K/Akt) signaling is not the main pathway towards load-induced skeletal muscle hypertrophy. During load-induced skeletal muscle hypertrophy process, activation of mTORC1 does not require classical growth factor signaling. One potential mechanism that would activate mTORC1 is increased synthesis of phosphatidic acid (PA). Despite the huge progress in this field, it is still early to affirm which molecular event induces hypertrophy in response to mechanical overload. Until now, it seems that mTORC1 is the key regulator of load-induced skeletal muscle hypertrophy. On the other hand, how mTORC1 is activated by PA is unclear, and therefore these mechanisms have to be determined in the following years. The understanding of these molecular events may result in promising therapies for the treatment of muscle-wasting diseases. For now, the best approach is a good regime of resistance exercise training. The objective of this point-of-view paper is to highlight mechanotransduction events, with focus on the mechanisms of mTORC1 and PA activation, and the role of IGF-1 on hypertrophy process.

Lack of association of estrogen receptor alpha gene polymorphisms with cardiorespiratory and metabolic variables in young women.

This study examined the association of estrogen receptor alpha gene (ESR1) polymorphisms with cardiorespiratory and metabolic parameters in young women. In total, 354 healthy women were selected for cardiopulmonary exercise testing and short-term heart rate (HR) variability (HRV) evaluation. The HRV analysis was determined by the temporal indices rMSSD (square root of the mean squared differences of successive R-R intervals (RRi) divided by the number of RRi minus one), SDNN (root mean square of differences from mean RRi, divided by the number of RRi) and power spectrum components by low frequency (LF), high frequency (HF) and LF/HF ratio. Blood samples were obtained for serum lipids, estradiol and DNA extraction. ESR1 rs2234693 and rs9340799 polymorphisms were analyzed by PCR and fragment restriction analysis. HR and oxygen uptake (VO(2)) values did not differ between the ESR1 polymorphisms with respect to autonomic modulation. We not find a relationship between ESR1 T-A, T-G, C-A and C-G haplotypes and cardiorespiratory and metabolic variables. Multiple linear regression analysis demonstrated that VO(2), total cholesterol and triglycerides influence HRV (p < 0.05). The results suggest that ESR1 variants have no effect on cardiorespiratory and metabolic variables, while HRV indices are influenced by aerobic capacity and lipids in healthy women.

A Bibliographic Analysis of Primary Studies on Physical Activity and COVID-19 during 2020-2021.

Physical distancing and restrictions have been implemented to reduce the transmission rate of the novel coronavirus (COVID-19). In contrast, the impact of the pandemic on levels of physical activity has been the subject of studies worldwide. Since the first reported case in December 2019, the number of scientific studies on COVID-19 has grown in a way that has never been seen before. The current study aimed to perform a bibliometric analysis of primary studies on physical activity and COVID-19 during the first two years of the pandemic. The search was carried out using the SCOPUS and Web of Science databases. Our analysis identified a total of 2023 published documents from 10,199 authors, with an annual growth rate of 330% between 2020 and 2021. Open-access scientific journals were the main sources of publication, and the level of collaboration among the most influential researchers contributed to productivity. A co-occurrence analysis of the authors' keywords indicated a high prevalence of themes related to mental health, depression, anxiety, stress, sleep, and quality of life. In conclusion, the bibliometric analysis revealed a high volume of primary studies on physical activity and COVID-19 during the first two years of the pandemic, and mental health was a much discussed topic.

Yoga and mental health among Brazilian practitioners during COVID-19: An internet-based cross-sectional survey.

This study aimed to describe yoga practice and verify its association with depression, anxiety, and stress during the COVID-19 pandemic among Brazilian practitioners. A cross-sectional anonymous online survey was conducted in all regions of Brazil using a snowball sampling strategy among yoga practitioners. A total of 860 participants (87% female, aged: 19-82 years) completed the survey. Sociodemographic data, lifestyle factors, yoga practice during the pandemic, and the Depression Anxiety and Stress Scale (DASS-21) scores were collected between July 9 and July 15, 2021. Overall, 9.5%, 9.3%, and 5.6% of participants exhibited some traits (mild to severe) of depression, anxiety, and stress, respectively. Hatha yoga (48%) was the most commonly practiced yoga style. In the adjusted analysis, a higher yoga experience (> 5 years) was associated with better anxiety (odds ratio; bootstrap 95% confidence interval: 2.42; 1.32, 4.49) and stress status (1.80; 1.06, 3.00) than beginners (< 1 year). Practitioners who reported higher time and days of yoga practice during the study period were more likely to show normal levels of depression (odds ratio: 2.56-6.49; p â€‹< â€‹0.05), anxiety (odds ratio: 3.68-8.84; p â€‹< â€‹0.05), and stress (odds ratio: 2.15-5.21; p â€‹< â€‹0.05). Moreover, the maintenance of practice frequency during the pandemic was associated with higher odds of normal levels of depression (2.27; 1.39-3.79), anxiety (1.97; 1.25-3.10), and stress (1.97; 1.32-2.96). In conclusion, our findings indicated that a higher level of yoga practice was associated with better mental health levels during the COVID-19 pandemic.

No additional effects of ursolic acid supplementation associated with combined exercise program on metabolic syndrome of postmenopausal women: A double-blind, randomized, placebo-controlled trial.

BACKGROUND & AIMS: Ursolic acid (UA) supplementation may have therapeutic effects on metabolic syndrome (MetS). Therefore, this study aimed to investigate the effects of UA supplementation associated with a combined exercise program on MetS components in postmenopausal women. METHODS: Twenty-six women (61 ± 7 years) were randomized into two groups: UA (n = 13) and placebo (PLA, n = 13). Both groups followed a combined exercise program for 8 weeks (twice a week; ~60 min at moderate intensity) associated with either UA (450 mg/day) or placebo supplementation. Before and post-intervention, waist circumference (primary outcome), resting blood pressure, fasting blood analyses, body composition and physical function (secondary outcomes) were evaluated. RESULTS: Greater changes in the absolute (mean difference: 1.8 kgf, 95% CI 0.3, 3.2) and relative (0.03 kgf/kg, 95% CI 0.01, 0.05) handgrip strength was observed for the UA group compared with PLA. However, no significant effects between groups were observed for waist circumference and other secondary outcomes. Furthermore, remission of MetS (according to the NCEP ATP III criteria) occurred in 38.5% of the participants in both groups. CONCLUSIONS: The UA supplementation did not promote additional MetS profile improvement after 8 weeks of free-living intervention. However, our data indicated that UA resulted in a higher response on handgrip strength than did placebo in postmenopausal women, but further long-term studies are needed. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ensaiosclinicos.gov.br): number RBR-276rrt.

Associations between sociodemographic factors and physical activity and sedentary behaviors in adults with chronic diseases during COVID-19 pandemic.

The pandemic of the new coronavirus (COVID-19) may be affecting the physical activity (PA) level in much of the population. This study aimed to investigate the prevalence of physical inactivity and sedentary behavior (SB) among adults with chronic diseases and their associations with sociodemographic factors during the COVID-19 pandemic. This cross-sectional study included 249 participants (age: 18-91 years; 61.4% female) with chronic conditions and attended the Family Health Strategy program in a small town in Brazil. Data were collected between 2020-07-13 and 2020-07-24 by face-to-face interviews. Self-reported PA, sitting time, chronic diseases, medication use, sociodemographic data, and self-isolation adherence were obtained by questionnaire. During this specific time point of the COVID-19 pandemic, 71.5% of participants did not meet the PA recommendations (≥500 METs-min/week), and the prevalence of SB risk (≥4 h sitting) was 62.7%. Adjusted logistic regression indicated that male participants (odds ratio [OR]: 1.89 [95% CI 1.02-3.53]), living alone (OR: 2.92 [95% CI 1.03-8.30]) or in a two-person household (OR: 2.32 [95% CI 1.16-4.63]), and those who reported sometimes performing self-isolation (OR: 3.07 [95% CI 1.47-6.40]) were more likely to meet the minimum PA recommendations. Current smokers had a lower odds (OR: 0.36 [95% CI 0.14-0.95]) of meeting the PA recommendations. Older participants (OR: 2.18 [95% CI 1.06-4.50]) and those who had multimorbidity (OR: 1.92 [95% CI 1.07-3.44]) were more likely to have a higher degree of SB. There is an urgent need to mitigate physical inactivity and SB, and public health interventions must take into account sociodemographic status.

Análise bibliométrica: profissionais da frente de linha da saúde e COVID-19 - Estudos do período 2020-2021 / Bibliometric analysis: frontline health professionals and COVID-19 - Studies for 2020-2021 / Análisis bibliométrico: profesionales de primera línea de salud y COVID-19 - Estudios del período 2020-2021

Objetivo: Realizar uma análise bibliométrica da literatura revisada por pares para identificar tendências das publicações sobre os profissionais da saúde da linha de frente da COVID-19. Métodos: O presente estudo é uma revisão bibliométrica. Para tanto, realizou-se busca na base de dados Web of Science de documentos publicados entre 2020 e 2021. Resultados: Foram encontrados 281 documentos, com uma taxa de aumento anual de 57,8%. Os tipos mais comuns de documentos foram artigos originais (n= 226) seguidos por documentos de revisão (n =37). As análises de rede das palavras-chave revelaram alta predominância de temáticas como ansiedade, depressão, estresse, equipamento de proteção individual, excesso de trabalho (burnout), insônia e estresse pós-traumático. Conclusão: Os achados revelam que a saúde mental dos profissionais da saúde na linha de frente da COVID-19 foi um tópico importante nos primeiros anos de pandemia e indicam uma necessidade de suporte psicológico a esses profissionais (AU).

Objective: To conduct a bibliometric analysis of the peer-reviewed literature to identify publication trends about the frontline healthcare workers. Methods: Bibliometric review, the data were extracted from the Web of Science database, published between 2020 and 2021. Results: A total of 281 documents were found, with an annual increase rate of 57,8%. The most common type of document identified by the analysis were original articles (n = 226) followed by review documents (n = 37). Keywords network analysis revealed a high predominance of topics such as anxiety, depression, stress, personal protective equipment, burnout, insomnia and post-traumatic stress disorder. Conclusion: The findings reveal that the mental health of COVID-19 frontline healthcare workers was an important topic in the first years of the pandemic and indicate a need to provide psychological support of these professionals (AU).

Objetivo: realizar un análisis bibliométrico de la literatura revisada por pares para identificar las tendencias de publicación sobre los trabajadores de la salud de primera línea. Métodos: Los datos fueron extraídos de la base de datos Web of Science, publicados entre 2020 y 2021. Resultados: Se encontraron un total de 281 documentos, con una tasa de incremento anual de 57,8%. El tipo de documento más común identificado fueron los artículos originales (n = 226), seguidos de los documentos de revisión (n = 37). El análisis de redes de palabras clave reveló un alto predominio de temas como ansiedad, depresión, estrés, equipo de protección personal, agotamiento, insomnio y trastorno de estrés postraumático. Conclusión: La salud mental de los trabajadores de salud de primera línea de COVID-19 fue un tema importante en los primeros años de la pandemia e indican la necesidad de brindar apoyo psicológico a estos profesionales (AU).

Changes in Physical Activities and Body Composition after Roux-Y Gastric Bypass Surgery.

PURPOSE: Given the importance of physical activities for health outcomes, it is still unclear whether bariatric surgery per se and the standard care after surgery would result in an increase of physical activity level. This study aimed to determine physical activities preoperatively and at 6 and 12 months postoperatively among female patients who underwent bariatric surgery, and to investigate its relationship with body composition changes. MATERIAL AND METHODS: Thirty-four women who had Roux-Y gastric bypass (RYGB) surgery completed the study. Physical activity was measured objectively for 7 consecutive days by using an ActiGraph GT3X+ accelerometer. Body composition was estimated by using multifrequency bioimpedance analysis. RESULTS: The percentage of time spent in moderate-to-vigorous physical activity (MVPA) changed significantly from preoperatively to 6 months postoperatively; however, no difference was observed at 12 months. No significant changes were detected for other physical activity variables. Multivariable regression analysis suggested that the percentage of time spent in sedentary activity was associated with fat-free mass loss at 6 months (ß = - 0.323; 95% CI = - 0.649 to 0.003) and 12 months (ß = - 0.510; 95% CI = - 0.867 to - 0.154) postoperatively. CONCLUSION: The overall MVPA increased at 6 months post-RYGB surgery; however, this change was not maintained at 12 months. Despite the considerable body mass loss postoperatively, most of the subjects were classified as being physically inactive and did not change their sedentary behavior. These findings indicate that female patients undergoing bariatric surgery should be encouraged to increase their physical activity level.

Influence of polymorphisms in IRS1, IRS2, MC3R, and MC4R on metabolic and inflammatory status and food intake in Brazilian adults: An exploratory pilot study

Polymorphisms in genes of leptin-melanocortin and insulin pathways have been associated with obesity and type 2 diabetes. We hypothesized that polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory markers and food intake composition in Brazilian subjects. This exploratory pilot study included 358 adult subjects. Clinical, anthropometric, and laboratory data were obtained through interview and access to medical records. The variants IRS1 rs2943634 A˃C, IRS2 rs1865434 C>T, MC3R rs3746619 C>A, and MC4R rs17782313 T>C were analyzed by real-time polymerase chain reaction. Food intake composition was assessed in a group of subjects with obesity (n = 84) before and after a short-term nutritional counseling program (9 weeks). MC4R rs17782313 was associated with increased risk of obesity (P = .034). Multivariate linear regression analysis adjusted by covariates indicated associations of IRS2 rs1865434 with reduced low-density lipoprotein cholesterol and resistin, MC3R rs3746619 with high glycated hemoglobin, and IRS1 rs2943634 and MC4R rs17782313 with increased high-sensitivity C-reactive protein (P < .05). Energy intake and carbohydrate and total fat intakes were reduced after the diet-oriented program (P < .05). Multivariate linear regression analysis showed associations of IRS2 rs1865434 with high basal fiber intake, IRS1 rs2943634 with low postprogram carbohydrate intake, and MC4R rs17782313 with low postprogram total fat and saturated fatty acid intakes (P < .05). Although significant associations did not survive correction for multiple comparisons using the Benjamini-Hochberg method in this exploratory study, polymorphisms in IRS1, IRS2, MC3R, and MC4R influence metabolic and inflammatory status in Brazilian adults. IRS1 and MC4R variants may influence carbohydrate, total fat, and saturated fatty acid intakes in response to a diet-oriented program in subjects with obesity.

Association of 5-HT2C (rs3813929) and UCP3 (rs1800849) gene polymorphisms with type 2 diabetes in obese women candidates for bariatric surgery.

OBJECTIVE: Obesity can cause systemic arterial hypertension (SAH) and type 2 diabetes mellitus (DM2) factor that is also influenced by genetic variability. The present study aims to investigate the association between gene polymorphisms related with obesity on the prevalence of SAH and DM2 in the preoperative period and 1 year after Roux-en-Y gastric bypass surgery. SUBJECTS AND METHODS: In total, 351 obese women in a Brazilian cohort completed the study. The clinical diagnosis of SAH and DM2 was monitored from medical records. Twelve gene polymorphisms (rs26802; rs572169; rs7799039; rs1137101; rs3813929; rs659366; rs660339; rs1800849; rs7498665; rs35874116; rs9701796; and rs9939609) were determined using real-time polymerase chain reaction and TaqMan assay. RESULTS: In the preoperative period, prevalence of SAH and DM2 was 57% and 22%, respectively. One year postoperatively, 86.8% subjects had remission of DM2 and 99.5% had control of SAH. Subjects with T allele from the serotonin receptor gene (5-HT2C, rs3813929) had five times greater chance of DM2, and the CC genotype from uncoupling protein 3 gene (UCP3, rs1800849) had three times greater chance in the preoperative period. CONCLUSION: These findings indicate that polymorphisms rs3813929 and rs1800849 from 5-HT2C and UCP3 genes were related to DM2 prevalence among the Brazilian obese women candidates for bariatric surgery.

Micronutrient supplementation in gastric bypass surgery: prospective study on inflammation and iron metabolism in premenopausal women.

BACKGROUND: Low-grade chronic inflammation in morbid obesity is associated with impaired iron metabolism. Bariatric surgery is effective in weight loss; however, it can induce specific nutritional deficiencies, such as iron, especially in premenopausal women. Alternatively, after surgery, there is an improvement in systemic inflammation, raising questions concerning the dosages of micronutrient supplementation. OBJECTIVES: This study aimed to assess the effect of two micronutrient supplementation schemes before and 6 months after a Roux-en-Y gastric bypass (RYGB) surgery on inflammation and iron metabolism in premenopausal women. METHODS: This prospective study included 45 premenopausal women (aged 20-45 years; body mass index [BMI] ≥ 35 kg/m2) divided into two supplementation schemes: group 1 (n = 34): daily supplemental dose of 1 RDA 30 days before surgery and 2 RDAs during the six months following surgery; and group 2 (n = 11): daily supplementation of 1 RDA during the 6 months postsurgery. Anthropometry, dietary intake, inflammation, and iron metabolism were monitored. RESULTS: Evident reductions in BMI, high-sensitivity C-reactive protein, and ferritin levels for both groups occurred 6 months after surgery. Additionally, anemia was 9% in both groups after surgery. However, group 1 exhibited an increased transferrin saturation index and reduced transferrin levels. Multivariate regression analysis suggested serum iron, hepcidin, and iron intake determined ferritin values before and after RYGB surgery. CONCLUSION: Six months after RYGB, systemic inflammation was reduced in both supplementation schemes. However, supplementation of 1 RDA before and 2 RDAs after surgery resulted in better improvements on iron metabolism.