Risk of low energy availability among female and male elite runners competing at the 26th European cross-country championships

Low energy availability (LEA) causes impaired physiological functioning. Cross-country running is a weight-sensitive sport, making athletes more prone to LEA. We aimed to estimate the prevalence of elite European cross-country athletes at risk of LEA using the LEA in Females Questionnaire (LEAF-Q) and to analyze demographic and physical characteristics that are associated with LEA. Athletes ≥ 18 years competing at the 26th European Cross-Country Championships (n = 602) were invited to complete a questionnaire (sociodemographic, training, anthropometric characteristics, and LEAF-Q). A total of 207 valid surveys were collected (83 females, 22.1 (4.0) years, and 124 males, 22.3 (4.1) years), and 16 surveys were excluded. A high prevalence of athletes at risk of LEA (64.3%) was observed, being higher in females than in males (79.5 and 54.0% respectively, p < 0.001). More than half of athletes (54.1%, n = 112) reported bowel movements once a week or more rarely, while 33 female athletes (41.3%) did not report normal menstruation. Overall, cross-country athletes are at high risk of LEA. Moreover, a high prevalence of gastrointestinal and menstrual impairments was reported. Hence, athletes should be followed by multidisciplinary teams to inform, prevent, and treat LEA and its effects.publishersversionpublishe

the WLM3P study

Funding Information: This work was sponsored by Farmodietica S.A. The study was also promoted by the CINTESIS@RISE, NOVA Medical School, NOVA University of Lisbon and financed by national funds through FCT Fundacao para a Ciencia e a Technologia, I.P., within the scope of the project \u201CRISE \u2013 LA/P/0053/2020\u201D. The sponsor and funder had no role in the study design and had no role during its execution, analysis, interpretation of the data, or decision to submit the results. Publisher Copyright: © The Author(s), under exclusive licence to Springer Nature Limited 2024.Background/Objectives: The escalating obesity epidemic necessitates effective, sustainable weight loss (WL) and maintenance strategies. This study aimed to evaluate the effectiveness of the Weight Loss Maintenance 3 Phases Program (WLM3P) in achieving a clinically significant long-term weight loss (WL) (≥5% initial WL at 18 months) in adults with obesity compared to a standard low-carbohydrate diet (LCD). Subjects/Methods: In this two-phase trial, 112 participants targeting initial WL (0–6 months) and subsequent maintenance (7–18 months) were randomly assigned to either WLM3P or LCD groups. Outcomes assessed included change in body weight (kg, %), improvements in body composition, and metabolic profile. Results: Of 112 randomized participants, 69% (n = 77) completed the study. At 18 months, WL in the WLM3P group (n = 40) was 15.5 ± 8.3% compared to 9.6 ± 8.5% in the LCD group (n = 37) (p < 0.001). The odds ratio of achieving WL ≥ 10% and ≥15% were significantly higher in the WLM3P group. Complete-case analysis revealed significantly greater improvements in BMI, body fat mass, visceral fat area, waist circumference, waist-to-hip ratio, HDL, and triglyceride/HDL ratio in WLM3P than in LCD. No serious adverse events were reported. Conclusion: Both programs effectively promoted clinically relevant WL and its maintenance. However, the WLM3P program was more successful in helping participants achieve greater WL targets of ≥10% and ≥15%, along with other clinical benefits, after an 18-month intervention. Trial registration number: NCT04192357.publishersversioninpres

Nutrition education in portuguese medical students: impact on the attitudes and knowledge

Nutrition has been underrepresented in the curriculum of many medical schools and therefore physicians do not feel adequately prepared to provide dietary counselling. The aim of the present study is to determine the impact of a Nutrition and Metabolism curricular unit on nutrition attitudes, knowledge and confidence on future clinical practice of medical students.info:eu-repo/semantics/publishedVersio

a randomized comparative effectiveness trial

Funding Information: The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was sponsored by CUF and Pingo Doce, as part of the Menos Sal Portugal project, and with support from the Centro de Medicina Laboratorial Germano de Sousa. The sponsors did not play a role in the study design or the interpretation of the results. The study was also promoted by the CINTESIS@RISE (UIDB/4255/2020 and UIDP/4255/2020), NOVA Medical School of Universidade NOVA de Lisboa and supported by national funds through FCT Fundação para a Ciência e a Tecnologia, I.P., within the scope of the project “RISE-LA/P/0053/2020”. Publisher Copyright: Copyright © 2023 Moreira-Rosário, Ismael, Barreiros-Mota, Morais, Rodrigues, Castela, Mendes, Soares, da Costa, Oliveira, Henriques, Pinto, Pita, de Oliveira, Maciel, Serafim, Araújo, Rocha, Pestana, Silvestre, Marques, Faria, Polonia and Calhau.Introduction: Empowerment lifestyle programs are needed to reduce the risk of hypertension. Our study compared the effectiveness of two empowerment-based approaches toward blood pressure (BP) reduction: salt reduction-specific program vs. healthy lifestyle general program. Methods: Three hundred and eleven adults (median age of 44 years, IQR 34–54 years) were randomly assigned to a salt reduction (n = 147) or a healthy lifestyle program (n = 164). The outcome measures were urinary sodium (Na+) and potassium (K+) excretion, systolic (SBP) and diastolic (DBP) blood pressure, weight, and waist circumference. Results: There were no significant differences in primary and secondary outcomes between the two program groups. When comparing each program to baseline, the program focused on salt reduction was effective in lowering BP following a 12-week intervention with a mean change of −2.5 mm Hg in SBP (95% CI, −4.1 to −0.8) and − 2.7 mm Hg in DBP (95% CI, −3.8 to −1.5) in the intention-to-treat (ITT) analysis. In the complete-case (CC) analysis, the mean change was −2.1 mm Hg in SBP (95% CI, −3.7 to −0.5) and − 2.3 mm Hg in DBP (95% CI, −3.4 to −1.1). This effect increases in subjects with high-normal BP or hypertension [SBP − 7.9 mm Hg (95% CI, −12.5 to −3.3); DBP − 7.3 mm Hg (95% CI, −10.2 to −4.4)]. The healthy lifestyle group also exhibited BP improvements after 12 weeks; however, the changes were less pronounced compared to the salt reduction group and were observed only for DBP [mean change of −1.5 mm Hg (95% CI, −2.6 to −0.4) in ITT analysis and − 1.4 mm Hg (95% CI, −2.4 to −0.3) in CC analysis, relative to baseline]. Overall, improvements in Na+/K+ ratio, weight, and Mediterranean diet adherence resulted in clinically significant SBP decreases. Importantly, BP reduction is attributed to improved dietary quality, rather than being solely linked to changes in the Na+/K+ ratio. Conclusion: Salt-focused programs are effective public health tools mainly in managing individuals at high risk of hypertension. Nevertheless, in general, empowerment-based approaches are important strategies for lowering BP, by promoting health literacy that culminates in adherence to the Mediterranean diet and weight reduction.publishersversionpublishe

Empowerment-based nutrition interventions on blood pressure: a randomized comparative effectiveness trial

IntroductionEmpowerment lifestyle programs are needed to reduce the risk of hypertension. Our study compared the effectiveness of two empowerment-based approaches toward blood pressure (BP) reduction: salt reduction-specific program vs. healthy lifestyle general program.MethodsThree hundred and eleven adults (median age of 44 years, IQR 34–54 years) were randomly assigned to a salt reduction (n = 147) or a healthy lifestyle program (n = 164). The outcome measures were urinary sodium (Na+) and potassium (K+) excretion, systolic (SBP) and diastolic (DBP) blood pressure, weight, and waist circumference.ResultsThere were no significant differences in primary and secondary outcomes between the two program groups. When comparing each program to baseline, the program focused on salt reduction was effective in lowering BP following a 12-week intervention with a mean change of −2.5 mm Hg in SBP (95% CI, −4.1 to −0.8) and − 2.7 mm Hg in DBP (95% CI, −3.8 to −1.5) in the intention-to-treat (ITT) analysis. In the complete-case (CC) analysis, the mean change was −2.1 mm Hg in SBP (95% CI, −3.7 to −0.5) and − 2.3 mm Hg in DBP (95% CI, −3.4 to −1.1). This effect increases in subjects with high-normal BP or hypertension [SBP − 7.9 mm Hg (95% CI, −12.5 to −3.3); DBP − 7.3 mm Hg (95% CI, −10.2 to −4.4)]. The healthy lifestyle group also exhibited BP improvements after 12 weeks; however, the changes were less pronounced compared to the salt reduction group and were observed only for DBP [mean change of −1.5 mm Hg (95% CI, −2.6 to −0.4) in ITT analysis and − 1.4 mm Hg (95% CI, −2.4 to −0.3) in CC analysis, relative to baseline]. Overall, improvements in Na+/K+ ratio, weight, and Mediterranean diet adherence resulted in clinically significant SBP decreases. Importantly, BP reduction is attributed to improved dietary quality, rather than being solely linked to changes in the Na+/K+ ratio.ConclusionSalt-focused programs are effective public health tools mainly in managing individuals at high risk of hypertension. Nevertheless, in general, empowerment-based approaches are important strategies for lowering BP, by promoting health literacy that culminates in adherence to the Mediterranean diet and weight reduction

Unravelling the role of adipose tissue metabolism in diet-induced weight loss : results from a randomised controlled trial

Adiposity-based chronic disease (ABCD, obesity) development and severity are directly related to changes in adipose tissue composition and function. It is acknowledged that adipose-originated metabolic inflammation and altered adipokine dynamics are strongly associated with systemic inflammation, insulin resistance, and dyslipidaemia. Although intermittent energy restriction (IER) seems to be as effective as continuous energy restriction (CER) for weight loss, its impact on metabolic-inflammatory status is often disregarded. We compared the effects of a 12-week IER versus CER on cardiometabolic and inflammatory markers in adults with obesity [mean (standard deviation) body mass index: 35.4 (3.7) kg/m2 ]. Our findings suggested that IER, in comparison to CER, could be advantageous to reduce pro-inflammatory cytokines associated with obesity, and, consequently, improve insulin resistance, regardless of the amount of weight loss. Aiming at studying the contribution of adipose tissue dysfunction in predicting peripheral insulin resistance, we demonstrated that adiponectin/leptin ratio (AdipoQ/Lep) was significantly correlated with both morphological and functional adipose tissue characteristics, reinforcing its usefulness as a biomarker for assessing adipose tissue function. More importantly, AdipoQ/Lep, triacylglycerols, and waist-to-hip ratio explained almost half of HOMA-IR (a surrogate marker of insulin resistance) variance, supporting that adipose tissue dysfunction appears to be a central feature of the pathophysiology of obesity and insulin resistance. Furthermore, adipose tissue and metabolic dysfunction may be exacerbated by exposure to mixtures of lipophilic persistent organic pollutants (POPs) that are stored in lipid droplets of adipocytes. This led us to characterize the levels of POPs in plasma and evaluate their putative effects on weight loss and cardiometabolic and inflammatory markers in adults with obesity undergoing a dietary intervention for weight loss. Twelve different POPs, mainly organochlorine pesticides, were determined by gas chromatography with electron-capture detection. Persistent organic pollutants are pervasive in this population and their concentration in plasma seems to be associated with obesity-related characteristics. Despite the pre-intervention POPs levels in plasma did not appear to have an impact on weight loss and changes in metabolic parameters, our findings revealed an association between POPs levels and inflammatory cytokines that should be further investigated. A comprehensive understanding of these results allows us to provide novel insights with public health and clinical significance relating to obesity management, adipose tissue and metabolism dysfunction, and emergent environmental risk factors for metabolic diseases. Our findings highlight the prominent role of adipose tissue function and adipose tissue-derived factors on obesity-associated metabolic complications as well as support that the focus of obesity management could be moved towards improving patient-centred metabolic-inflammatory outcomes rather than weight loss alone

Unidade Didática do gênero discursivo reportagem com uso da ferramenta digital Google Docs para desenvolver multiletramentos no ensino fundamental

The contemporaneity and the contemporaneous texts made from multiple semiosis put new challenges to literacies. To be literate, nowadays, is to be able to read and produce meanings from a variety of languages. It is the teacher´s responsibility to incorporate new and different practices of text writing in his/her classes, making the student feel stimulated to write. In this regard, the objective of this article is to present a teaching unit whose aim is to help the development of the student´s capacities as texts producer in the multiliteracies perspective. This proposal was applied to the ninth grade at the middle school, it is about writing the gender report using collaborative writing in a virtual environment through the tool Google Docs. This teaching material is part of the thesis that we are developing at the Professional Master degree program in Languages at the West State University of Parana (Universidade Estadual do Paraná - UNIOESTE), Campus of Cascavel and it´s going to be implemented at the second semester in 2018. We used as theoretical framework authors as Bakhtin (2003), Geraldi (1993), Soares (2003; 2004), Rojo (2009; 2012), Ribeiro (2012), Kleiman (1995), Bruns (2006), Lévy (1993), and others. The didactics proposal presented intend to contribute so other teachers feel themselves willing to develop and use in their classes this kind of teaching material at the same theoretical framework we used in this article.A contemporaneidade e, sobretudo, os textos contemporâneos, produzidos a partir de múltiplas semioses, colocam novos desafios aos letramentos. Ser letrado, nos dias de hoje, é ser capaz de ler e produzir significados provenientes de diversas linguagens. Cabe ao professor incorporar novas e variadas práticas de produção textual em suas aulas, fazendo com que o aluno se sinta estimulado a escrever. Neste sentido, este artigo tem por objetivo apresentar uma Unidade Didática que visa favorecer o desenvolvimento de capacidades do aluno como produtor de textos na perspectiva dos multiletramentos. A proposta aplica-se ao nono ano do ensino fundamental, trata-se da produção do gênero discursivo reportagem por meio da escrita colaborativa em ambiente virtual, utilizando a ferramenta Google Docs. Esse material pedagógico integra a dissertação, que estamos desenvolvendo no programa de Mestrado Profissional em Letras (PROFLETRAS) na Universidade Estadual do Oeste do Paraná (UNIOESTE), Campus de Cascavel e será implementado no 2º semestre de 2018. Utilizamos como embasamento teórico autores como Bakhtin (2003), Geraldi (1993), Soares (2003; 2004), Rojo (2009; 2012), Ribeiro (2012), Kleiman (1995), Bruns (2006), Lévy (1993), entre outros. A proposta didática elaborada visa contribuir para que outros docentes se sintam estimulados a desenvolverem e aplicarem, em suas aulas, esse tipo de proposta pedagógica na perspectiva teórica adotada e apresentada nesse artigo

IPA and its precursors differently modulate the proliferation, differentiation, and integrity of intestinal epithelial cells

Funding Information: This work was supported by ERDF through the operation POCI-01-0145-ERDF-007746 funded by the Programa Operacional Competitividade e Internacionalização – COMPETE2020 and by FCT - Fundação para a Ciência e a Tecnologia, IP national support through CINTESIS, R&D Unit (UIDB/4255/2020), CHRC (UIDP/04923/2020 and UIDB/04923/2020), through the project reference PTDC/BAA-AGR/7419/2020 and the 2020.06333.BD. Publisher Copyright: © 2023 The Korean Nutrition Society and the Korean Society of Community Nutrition This is an Open Access article distributed.BACKGROUND/OBJECTIVES: Indole-3-propionic acid (IPA) is a tryptophan-derived microbial metabolite that has been associated with protective effects against inflammatory and metabolic diseases. However, there is a lack of knowledge regarding the effects of IPA under physiological conditions and at the intestinal level. MATERIALS/METHODS: Human intestinal epithelial Caco-2 cells were treated for 2, 24, and/ or 72 h with IPA or its precursors – indole, tryptophan, and propionate – at 1, 10, 100, 250, or 500 μM to assess cell viability, integrity, differentiation, and proliferation. RESULTS: IPA induced cell proliferation and this effect was associated with a higher expression of extracellular signal-regulated kinase 2 (ERK2) and a lower expression of c-Jun. Although indole and propionate also induced cell proliferation, this involved ERK2 and c-Jun independent mechanisms. On the other hand, both tryptophan and propionate increased cell integrity and reduced the expression of claudin-1, whereas propionate decreased cell differentiation. CONCLUSIONS: In conclusion, these findings suggested that IPA and its precursors distinctly contribute to the proliferation, differentiation, and barrier function properties of human intestinal epithelial cells. Moreover, the pro-proliferative effect of IPA in intestinal epithelial cells was not explained by its precursors and is rather related to its whole chemical structure. Maintaining IPA at physiological levels, e.g., through IPA-producing commensal bacteria, may be important to preserve the integrity of the intestinal barrier and play an integral role in maintaining metabolic homeostasis.publishersversionpublishe

Trimethylamine increases intestinal fatty acid absorption: in vitro studies in a Caco-2 cell culture system

Although elevated blood levels of trimethylamine N-oxide (TMAO) have been associated with atherosclerosis development in humans, the role of its gut microbiota-derived precursor, TMA, in this process has not been yet deciphered. Taking this into account, and the fact that increased intestinal fatty acid absorption contributes to atherosclerosis onset and progression, this study aimed to evaluate the effect of TMA on fatty acid absorption in a cell line that mimics human enterocytes. Caco-2 cells were treated with TMA 250 μM for 24 h. Fatty acid absorption was assessed by measuring the apical-to-basolateral transport and the intracellular levels of BODIPY-C12, a fluorescently labelled fatty acid analogue. Gene expression of the main intestinal fatty acid transporters was evaluated by real-time quantitative reverse transcription PCR. Compared to control conditions, TMA increased, in a time-dependent manner and by 20–50 %, the apical-to-basolateral transport and intracellular levels of BODIPY-C12 fatty acid in Caco-2 cells. Fatty acid transport protein 4 (FATP4) and fatty acid translocase (FAT)/CD36 gene expression were not stimulated by TMA, suggesting that TMA-induced increase in fatty acid transport may be mediated by an increase in FAT/CD36 and/or FATP4 activity and/or fatty acid passive transport. This study demonstrated that TMA increases the intestinal absorption of fatty acids. Future studies are necessary to confirm if this may constitute a novel mechanism that partially explains the existing positive association between the consumption of a diet rich in TMA sources (e.g. red meat) and the increased risk of atherosclerotic diseases