Does creatine supplementation harm renal function?

Enquanto o consumo de creatina por atletas e praticantes de atividade física tem crescido vertiginosamente, os efeitos adversos desse suplemento continuam sendo alvos de calorosos debates científicos, sobretudo no que se refere à função renal. O objetivo dessa revisão é descrever as falhas metodológicas e lacunas na literatura, que contribuem para a divergência do tema. Relatos de caso sugerem que a creatina é um potencial agente nefrotóxico. Em contrapartida, estudos longitudinais, embora possuam diversas limitações, indicam o oposto. Pesquisas com humanos não demonstram efeitos deletérios da suplementação de creatina à função renal, porém a falta de controle experimental e o caráter retrospectivo da maioria delas comprometem as conclusões dos autores. Já os estudos experimentais com ratos empregam bons marcadores de função renal e possuem controle de variáveis satisfatório. Contudo, os resultados destes são contraditórios. Estudos futuros devem investigar os efeitos da suplementação de creatina em diversas patologias renais, assim como em idosos, diabéticos do tipo 2 e hipertensos, cuja propensão a nefropatia é bem descrita. Não há evidências de que a suplementação de creatina prejudique a função renal em sujeitos saudáveis, quando consumida na dosagem preconizada. Diante disso, questiona-se a legitimidade científica da proibição do comércio de creatina no Brasil.While creatine consumption has been greatly increasing among athletes and physical activity practitioners, the adverse effects of this supplement remain scientifically controversial, especially concerning renal function. The aim of this review is to describe the methodological limitations and gaps in the literature which contribute to the topic’s divergence. Case reports suggest that creatine is a nephrotoxic agent. On the other hand, despite having several limitations, longitudinal studies have indicated the opposite. Research with humans does not demonstrate any deleterious effects as a consequence of creatine supplementation; however, the absence of experimental control as well as their retrospective characteristics compromise the authors’ conclusion. Experimental studies with animal models though, use both gold standard for renal function and have satisfactory variable control. However, the results remain controversial. Future studies should investigate the effects of creatine supplementation in several kidneys diseases as well as in the elderly, type 2 diabetis and hypertensive individuals, whose tendency to renal dysfunction is well-described. There is not evidence that creatine supplementation causes renal deterioration in healthy subjects when it is ingested in the recommended dosage. Thus, we have some concerns about the sale prohibition of creatine supplementation in Brazil

Estratégias de reposição hídrica: revisão e recomendações aplicadas

Grande atenção tem-se dado às estratégias de reidratação durante e após a atividade física, como forma de manter os líquidos corporais. Quando discutimos a necessidade de repor as perdas hídricas associadas à atividade física, buscamos, em última análise, formas de prolongar ou manter pelo maior tempo possível o rendimento do indivíduo. Alterações das funções fisiológicas conseqüentes das perdas hídricas comprometem o desempenho, tomando-se assim fatores determinantes de fadiga. Este artigo de revisão discute a necessidade de repor as perdas hídricas associadas à atividade física, apresentando algumas * estratégias presentes na literatura. Alguns artigos consideram a reposição hídrica, em conjunto com a oferta de nutrientes e eletrólitos, como um importante recurso ergogênico, já que a depleção de substratos energéticos (glicogênio muscular e hepático), o acúmulo de metabólitos (lactato e ions H4) e o prejuízo dos processos de termorregulação estão intimamente ligados à diminuição do desempenho. Assim, além da oferta de água, as estratégias discutidas nesta revisão procuram também avaliar a disponibilidade de carboidratos e eletrólitos, quer como agentes facilitadores da própria reposição hídrica ou como fonte exógena de substratosThe fluid replacement strategies are very important before, during and after physical activity to maintain body fluids. When we discuss about the need for fluid replacement as a consequence of physical activity, the main focus is to enhance endurance to prolonged exercise. The physiological modifications due to body water loss can decrease the performance and also be responsible to the fatigue. This review paper will emphasize the importance of body water replacement due to physical activity, and present different ways to manage it. Some papers regard the water consumption, associated to different nutrients and electrolytes and an important ergogenic aid, as a mean of trying to keep carbohydrate concentration in the body (liver and muscle glycogen), as well as to prevent the accumulation of metabolites (lactate and H+ ions) and also to keep the efficiency of thermoregulatory process. Moreover, this paper will argue that the availability of carbohydrates and electrolytes will facilitate water replacement as well as being an exogen source of substrate

Possible effect of the supplementation of branched chain aminoacids, aspartate and asparagine on anaerobic threshold

Recently, the concept of "Anaerobic Threshold” has been widely criticized. The most important critiques are about the mccanisms involved in the concentration of blood lactate increment, mainly muscular hipoxia, and about the supposed aclion-and-reaction relation between the metabolic and ventilatory threshold. In spite of the criticisms the Anaerobic Threshold has been found to have wide aplicabilities, thus, many researches had been done in order to facilitate its measurement, not in a invasive way, but with ventilator)' parameters and using the heart rate deflection curve. Recently, the amount of people who practices motor activities using aminoacids has been widely spread, and this fact became an issue of discussion to many researches. It was proposed that suplemcntation with branched chain aminoacids, aspartate and asparagine results in increased resistance to prolonged exercise, due to an increase of the muscle glycogen content and oxaloacetatc synthesis to sustain the Krebs cycle activity and oxidative metabolism. Thus, glucose transport to inner muscle cell decreases, delaying the depletion of muscle glycogen content and metabolic acidosis, the evident causes of fatigue. In consequence, the oxidation of fatty acids during continuous and moderate exercise increases, delaying the lactate accumulation in muscles and blood. This would delay the metabolic stimulus for the H C 03‘ buffering process and consequent C 02 ventilator)' compensation, and may dissociate the metabolic threshold from ventilator)' threshold. This dissociation of thresholds would reinforce critiques about the concept of Anaerobic Threshold and it would, other, also, make difficult its identification through methods such as the heart rale deflection curveRecentemente o conceito “Limiar Anacróbio” tem sido muito criticado. As principais críticas repousam sobre os mecanismos considerados para o aumento da concentração de laclato sangüíneo, hipóxia muscular principalmente, c sobre a suposta relação de causa-c-cfeito entre os limiares mctabólico e ventilatório. Apesar de criticado, o conceito Limiar Anacróbio encontrou muitas aplicações, c por esta razão, vários estudos foram realizados para facilitar a sua determinação não invasivamente, a partir de parâmetros ventilatórios c da dcílexão da curva de freqüência cardíaca. Recentemente o uso de aminoácidos tem se difundido largamente entre os praticantes de atividades motoras, tornando-se objeto de estudo para vários pesquisadores. Foi proposto que a suplementação de aminoácidos de cadeia ramificada, aspartalo c asparagina promove aumento da resistência ao esforço físico prolongado, em decorrência do aumento do conteúdo de glicogênio muscular c síntese de oxaloacetato para manutenção da atividade do ciclo de Krebs c do própio metabolismo oxidativo. Com isto o transporte de glicose para o interior da célula muscular diminui, retardando a dcplcção de glicogênio muscular e a acidose metabólica, causas evidentes de fadiga. Em conseqüência, a oxidação de AGLs durante o exercício contínuo moderado aumenta, retardando o acúmulo de lactato sangüíneo c muscular. Isto retardaria o estímulo mctabólico para o processo de tamponamento pelo H C 03' c a conseqüente compensação venlilalória para C 0 2, podendo dissociar os limiares mctabólico c ventilatório. A dissociação dos limiares reforçaria as críticas sobre o conceito Limiar Anacróbio c poderia, inclusive, prejudicar a sua identificação através de outros métodos, como por exemplo, a dcílexão da curva de freqüência cardíac

Técnicas de coaching de bemestar na mudança do estilo de vida no sistema público de saúde

According to the latest Vigitel 2017 report, non-communicable chronic diseases accounted for 68% of a total of 38 million deaths worldwide in 2012. In Brazil, the scenario is no different; in 2011 the non-communicable diseases were responsible for 68.3% of all deaths. Thousands of dollars are spent today on policies that encourage healthier living habits, but this strategy, by itself, has continually failed to produce consistent and long-lasting results. A new approach is needed that promotes lifestyle changes, making it possible to improve people’s health parameters. The process of coaching supports the development of a help-oriented relationship, encouraging patients to identify their vision, needs and goals. In addition, coaching aims to assist in the organization of routines and priorities, while putting patients in control of their health end-goal.De acordo com o último relatório da Vigitel 2017 as Doenças Crônicas Não Transmissíveis (DCNT) são responsáveis por 68% de um total de 38 milhões de mortes ocorridas no mundo em 2012. No Brasil, esse cenário não é diferente: em 2011 as DCNT foram responsáveis por 68,3% do total de mortes. Milhares de dólares são gastos hoje com políticas que estimulam hábitos de vida mais saudável, mas essa estratégia, por si só, tem continuamente falhado em produzir resultados consistentes e duradouros. É necessário uma nova abordagem, que promova mudanças no estilo de vida, possibilitando a melhora dos parâmetros de saúde das pessoas. O processo de coaching apoia o desenvolvimento de um relacionamento de ajuda, incentivando o paciente a identificar sua visão, necessidades e objetivos. Além disso, o coaching visa ajudar na organização de rotinas e prioridades, enquanto coloca o paciente no controle de seu destino de saúde

An Experimental Model for Resistance Exercise in Rodents

This study aimed to develop an equipment and system of resistance exercise (RE), based on squat-type exercise for rodents, with control of training variables. We developed an operant conditioning system composed of sound, light and feeding devices that allowed optimized RE performance by the animal. With this system, it is not necessary to impose fasting or electric shock for the animal to perform the task proposed (muscle contraction). Furthermore, it is possible to perform muscle function tests in vivo within the context of the exercise proposed and control variables such as intensity, volume (sets and repetitions), and exercise session length, rest interval between sets and repetitions, and concentric strength. Based on the experiments conducted, we demonstrated that the model proposed is able to perform more specific control of other RE variables, especially rest interval between sets and repetitions, and encourages the animal to exercise through short-term energy restriction and “disturbing” stimulus that do not promote alterations in body weight. Therefore, despite experimental limitations, we believe that this RE apparatus is closer to the physiological context observed in humans

An Experimental Model for Resistance Exercise in Rodents

This study aimed to develop an equipment and system of resistance exercise (RE), based on squat-type exercise for rodents, with control of training variables. We developed an operant conditioning system composed of sound, light and feeding devices that allowed optimized RE performance by the animal. With this system, it is not necessary to impose fasting or electric shock for the animal to perform the task proposed (muscle contraction). Furthermore, it is possible to perform muscle function tests in vivo within the context of the exercise proposed and control variables such as intensity, volume (sets and repetitions), and exercise session length, rest interval between sets and repetitions, and concentric strength. Based on the experiments conducted, we demonstrated that the model proposed is able to perform more specific control of other RE variables, especially rest interval between sets and repetitions, and encourages the animal to exercise through short-term energy restriction and “disturbing” stimulus that do not promote alterations in body weight. Therefore, despite experimental limitations, we believe that this RE apparatus is closer to the physiological context observed in humans

Genetics and sport performance: current challenges and directions to the future

In recent years there has been a great progress in molecular biology techniques, which has facilitated the researches on influence of genetics on human performance. There are specific regions of DNA that can vary between individuals. Such variations (i.e., polymorphisms) may, in part, explain why some individuals have differentiated responses to certain stimuli, including the responses to sports training. In a particular sport, the presence of specific polymorphisms may contribute to high levels of performance. Since 1998, several polymorphisms have been associated with athletic phenotypes; however the accumulation of information generated over these 15 years shows that the influence of genetics to sport is extremely complex. In this review, we will summarise the current status of the field, discussing the implications of available knowledge for the practice of professionals involved with the sport and suggesting future directions for research. We also discuss topics related to the importance of polygenic profile characterization of athletes, methods for the identification of new polymorphisms associated with physical performance, the use of genetic testing for predicting competitive success, and how crucial is the genetic profile for the success athletes in competition.In recent years there has been a great progress in molecular biology techniques, which has facilitated the researches on influence of genetics on human performance. There are specific regions of DNA that can vary between individuals. Such variations (i.e., polymorphisms) may, in part, explain why some individuals have differentiated responses to certain stimuli, including the responses to sports training. In a particular sport, the presence of specific polymorphisms may contribute to high levels of performance. Since 1998, several polymorphisms have been associated with athletic phenotypes; however the accumulation of information generated over these 15 years shows that the influence of genetics to sport is extremely complex. In this review, we will summarise the current status of the field, discussing the implications of available knowledge for the practice of professionals involved with the sport and suggesting future directions for research. We also discuss topics related to the importance of polygenic profile characterization of athletes, methods for the identification of new polymorphisms associated with physical performance, the use of genetic testing for predicting competitive success, and how crucial is the genetic profile for the success athletes in competition

Strategies for reducing body fat mass: effects of liposuction and exercise on cardiovascular risk factors and adiposity

Liposuction is the most popular aesthetic surgery performed in Brazil and worldwide. Evidence showing that adipose tissue is a metabolically active tissue has led to the suggestion that liposuction could be a viable method for improving metabolic profile through the immediate loss of adipose tissue. However, the immediate liposuction-induced increase in the proportion of visceral to subcutaneous adipose tissue could be detrimental to metabolism, because a high proportion of visceral to subcutaneous adipose tissue is associated with risk factors for cardiovascular disease. The results of studies investigating the effects of liposuction on the metabolic profile are inconsistent, however, with most studies reporting either no change or improvements in one or more cardiovascular risk factors. In addition, animal studies have demonstrated a compensatory growth of intact adipose tissue in response to lipectomy, although studies with humans have reported inconsistent results. Exercise training improves insulin sensitivity, inflammatory balance, lipid oxidation, and adipose tissue distribution; increases or preserves the fat-free mass; and increases total energy expenditure. Thus, liposuction and exercise appear to directly affect metabolism in similar ways, which suggests a possible interaction between these two strategies. To our knowledge, no studies have reported the associated effects of liposuction and exercise in humans. Nonetheless, one could suggest that exercise training associated with liposuction could attenuate or even block the possible compensatory fat deposition in intact depots or regrowth of the fat mass and exert an additive or even a synergistic effect to liposuction on improving insulin sensitivity and the inflammatory balance, resulting in an improvement of cardiovascular risk factors. Consequently, one could suggest that liposuction and exercise appear to be safe and effective strategies for either the treatment of metabolic disorders or aesthetic purposes

The need of a weight management control program in judo: a proposal based on the successful case of wrestling

Judo competitions are divided into weight classes. However, most athletes reduce their body weight in a few days before competition in order to obtain a competitive advantage over lighter opponents. To achieve fast weight reduction, athletes use a number of aggressive nutritional strategies so many of them place themselves at a high health-injury risk. In collegiate wrestling, a similar problem has been observed and three wrestlers died in 1997 due to rapid weight loss regimes. After these deaths, the National Collegiate Athletic Association had implemented a successful weight management program which was proven to improve weight management behavior. No similar program has ever been discussed by judo federations even though judo competitors present a comparable inappropriate pattern of weight control. In view of this, the basis for a weight control program is provided in this manuscript, as follows: competition should begin within 1 hour after weigh-in, at the latest; each athlete is allowed to be weighed-in only once; rapid weight loss as well as artificial rehydration (i.e., saline infusion) methods are prohibited during the entire competition day; athletes should pass the hydration test to get their weigh-in validated; an individual minimum competitive weight (male athletes competing at no less than 7% and females at no less than 12% of body fat) should be determined at the beginning of each season; athletes are not allowed to compete in any weight class that requires weight reductions greater than 1.5% of body weight per week. In parallel, educational programs should aim at increasing the athletes', coaches' and parents' awareness about the risks of aggressive nutritional strategies as well as healthier ways to properly manage body weight.The authors would like to thank FAPESP (#06/51293-4 and #09/02896-6) and CNPq (#1428 10/2009-6) for the financial support.The authors would like to thank FAPESP (#06/512934 and #09/028966) and CNPq (#1428 10/20096) for the financial support

The ergogenic effect of beta-alanine combined with sodium bicarbonate on high-intensity swimming performance

We investigated the effect of beta-alanine (BA) alone (study A) and in combination with sodium bicarbonate (SB) (study B) on 100- and 200-m swimming performance. In study A, 16 swimmers were assigned to receive either BA (3.2 g·day−1 for 1 week and 6.4 g·day−1 for 4 weeks) or placebo (PL; dextrose). At baseline and after 5 weeks of supplementation, 100- and 200-m races were completed. In study B, 14 were assigned to receive either BA (3.2 g·day−1 for 1 week and 6.4 g·day−1 for 3 weeks) or PL. Time trials were performed once before and twice after supplementation (with PL and SB), in a crossover fashion, providing 4 conditions: PL-PL, PL-SB, BA-PL, and BA-SB. In study A, BA supplementation improved 100- and 200-m time-trial performance by 2.1% (p = 0.029) and 2.0% (p = 0.0008), respectively. In study B, 200-m time-trial performance improved in all conditions, compared with presupplementation, except the PL-PL condition (PL-SB, +2.3%; BA-PL, +1.5%; BA-SB, +2.13% (p < 0.05)). BA-SB was not different from BA-PL (p = 0.21), but the probability of a positive effect was 78.5%. In the 100-m time-trial, only a within-group effect for SB was observed in the PL-SB (p = 0.022) and BA-SB (p = 0.051) conditions. However, 6 of 7 athletes swam faster after BA supplementation. The probability of BA having a positive effect was 65.2%; when SB was added to BA, the probability was 71.8%. BA and SB supplementation improved 100- and 200-m swimming performance. The coingestion of BA and SB induced a further nonsignificant improvement in performance