Metabolic responses to high glycemic index and low glycemic index meals: a controlled crossover clinical trial

BACKGROUND: The consumption of low glycemic index (LGI) foods before exercise results in slower and more stable glycemic increases. Besides maintaining an adequate supply of energy during exercise, this response may favor an increase in fat oxidation in the postprandial period before the exercise compared to high glycemic index (HGI) foods. The majority of the studies that evaluated the effect of foods differing in glycemic index on substrate oxidation during the postprandial period before the exercise are acute studies in which a single meal is consumed right before the exercise. The purpose of this study was to investigate the effect of consuming two daily HGI or LGI meals for five consecutive days on substrate oxidation before the exercise and in the concentrations of glucose, insulin and free fatty acids before and during a high intensity exercise. METHODS: Fifteen male cyclists, aged 24.4 ± 3.8 years, with body mass index of 21.9 ± 1.4 kg.m(-2 )and a V(O2 max )of 70.0 ± 5.3 mL.kg(-1).min(-1), participated in this crossover study. All test meals were consumed in the laboratory. On days 1 and 5, substrate oxidation (30 minutes before and 90 minutes after breakfast (HGI or LGI)) and diet-induced thermogenesis (90 minutes postprandial) were assessed before the exercise. The levels of glucose, insulin, and free fatty acids were determined during 2 h after breakfast on these same days. Ninety minutes after breakfast, subjects completed a 30 min cycloergometric exercise at 85 to 95% of their maximum heart rate, during which lactate concentrations were assessed. RESULTS: The consumption of HGI meals resulted in higher areas under the glycemic and insulinemic curves in the postprandial period. However, glycemia did not differ by study treatment during exercise. There were no differences in free fatty acids in the postprandial period or in lactate levels during exercise. LGI meals resulted in lower fat oxidation and higher carbohydrate oxidation than the HGI meal in the postprandial period. CONCLUSIONS: The results do not support a differential glycemia according to glycemic index during exercise. The ingestion of LGI foods did not lead to higher fat oxidation relative to the ingestion of HGI foods. TRIAL REGISTRATION: ACTRN: ACTRN1260900052221

Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial

Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aims of this study are to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy and also to describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study. Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2 × 2 factorial feasibility clinical trial were used. Eighteen women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions, and the data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies. Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (> 20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, patients being unresponsive to phone calls and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthful and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation costs) could hinder participation in the study. Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related sociodemographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings. Trial registration: ClinicalTrials.gov, NCT03148483. Registered on 11 May 2017

Jejum intermitente e exercício físico: Efeitos crônicos em parâmetros de composição corporal e de desempenho físico: Intermittent fasting and physical exercise: Chronic effects on parameters of body composition and physical performance

O jejum intermitente é uma estratégia dietética, caracterizada por modificações alimentares que envolvem períodos regulares de ingesta calórica intercaladas com abstenção dietética com duração superior a um jejum típico durante o sono noturno. A literatura mostra que a combinação do jejum com a realização de exercícios físicos é capaz conferir alterações metabólicas e redução da adiposidade corporal, contudo, pode causar efeitos negativos no desempenho físico. O objetivo do presente trabalho é apresentar resultados de pesquisas atuais que avaliaram o impacto das referidas intervenções sobre parâmetros antropométricos e de desempenho físico. Para tal, foi realizado um levantamento bibliográfico na base de dados Pubmed. Após análise dos 4 artigos selecionados, constatou-se que a combinação crônica do jejum intermitente com exercícios físicos promove melhorias na composição corporal e não compromete o ganho ou a manutenção do desempenho físico. Entretanto, intervenções mais curtas, com modelos de jejum que promovam déficit calórico sem uma adequada ingestão de proteína parece afetar negativamente o desempenho físico e mitigar o ganho de massa magra

Exploratory Efficacy of Calcium-Vitamin D Milk Fortification and Periodontal Therapy on Maternal Oral Health and Metabolic and Inflammatory Profile

In this 2 × 2 factorial, outcome-assessor blinded, feasibility randomised trial we explored the effect of a non-pharmaceutical multi-component intervention on periodontal health and metabolic and inflammatory profiles among pregnant women with periodontitis receiving prenatal care in a Brazilian public health centre. 69 pregnant women (gestational age ≤20 weeks, T0) were randomly allocated into four groups: (1) fortified sachet (vitamin D and calcium) and powdered milk plus periodontal therapy during pregnancy (early PT) (n = 17); (2) placebo sachet and powdered milk plus early PT (n = 15); (3) fortified sachet and powdered milk plus late PT (after delivery) (n = 19); (4) placebo sachet and powdered milk plus late PT (n = 18). Third trimester (T1) and 6–8 weeks postpartum (T2) exploratory outcomes included periodontal health (% sites with bleeding on probing (BOP)), glucose, insulin, C-Reactive Protein, serum calcium and vitamin D. The mean BOP was significantly reduced in the early PT groups, while BOP worsened in the late PT groups. No significant effect of fortification on BOP was observed. Changes in glucose levels and variation on birthweight did not differ among groups This feasibility trial provides preliminary evidence for estimating the minimum clinically important differences for selected maternal outcomes. A large-scale trial to evaluate the interventions’ clinical benefits and cost-effectiveness is warranted

Association between Pre-Pregnancy BMI and Inflammatory Profile Trajectories during Pregnancy and Postpartum in Brazilian Women with Periodontitis:The IMPROVE Trial

This study aimed to explore the association between pre-pregnancy BMI and longitudinal changes in inflammatory markers from the second trimester of pregnancy to 6–8 weeks postpartum in women with periodontitis. This is a secondary exploratory analysis of 68 women who took part in a feasibility clinical trial in Rio de Janeiro, Brazil. Inflammatory markers included C-reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), and matrix metalloproteinase-9 (MMP-9) blood concentrations at 11–22 (T0) and 30–36 gestational weeks (T1), and 6–8 weeks postpartum (T3). Longitudinal generalised linear mixed-effects models were used to identify possible associations between pre-pregnancy BMI and changes in concentrations of inflammatory markers. Pre-pregnancy excess weight (β = 4.39; 95% CI, 2.12–6.65) was significantly associated with increased CRP levels from pregnancy to postpartum. There were no significant associations between pre-pregnancy BMI and longitudinal changes in IL-6, IL-10 and MMP-9. Our findings provide evidence that a higher pre-pregnancy BMI may lead to increases in CRP levels during pregnancy in women with periodontitis, irrespective of the severity of clinical periodontal parameters. Further studies need to investigate if predictors of changes in inflammatory markers can be used as prognostic factors for gestational outcomes

Relação entre atividade física e estresse percebido em professores universitários: uma revisão sistemática

Este estudo buscou, por meio de uma revisão sistemática de literatura, investigar artigos que abordassem sobre a relação da atividade física com sintomas de estresse em professores universitários. A busca bibliográfica foi realizada nas bases de dados MEDLINE (Medical Literature Analysis and Retrieval System Online/PubMed), EMBASE (Elsevier), LILACS (Literatura científica e técnica da América Latina e Caribe/BVS – Biblioteca Virtual em Saúde) e no Google Acadêmico, com período limite de seis anos. Os artigos incluídos foram aqueles que relacionavam atividade física e os sintomas de estresse (SE) em professores universitários. Inicialmente, obteve-se total de 893 registros para análise do resumo, desse montante, 22 artigos foram selecionados para leitura na íntegra e após análise de texto completo, apenas 5 manuscritos foram considerados elegíveis. Dos 5 estudos selecionados, 60% obtiveram relação inversa entre atividade física e estresse percebido, enquanto os demais artigos não verificaram relação significativa entre as variáveis descritas. De acordo com a presente revisão e considerando a maioria dos estudos investigados, conclui-se que há uma relação inversa da prática de atividade física e SE percebido em professores universitários, o que indica que um estilo de vida fisicamente ativo possa auxiliar no controle desses SE, que frequentemente acomete o público docente

Dietary patterns and their association with adiponectin and leptin concentrations throughout pregnancy:a prospective cohort

AbstractThe aim of this study was to evaluate the association of dietary patterns (DP) with maternal adiposity indicators, leptin, adiponectin and insulin concentrations during pregnancy. A prospective cohort of pregnant women followed up at the 5th–13th, 20th –26th and 30th–36th gestational weeks and 30–40 d postpartum was conducted in Rio de Janeiro. A FFQ was administered in the third trimester (30th–36th gestational weeks). The reduced rank regression procedure was used to identify DP that explain response variables (dietary fibre and total fat) related to indicators of maternal adiposity (postpartum weight retention and gestational weight gain (GWG) adequacy), and plasma leptin, adiponectin and insulin concentrations. The associations between tertiles of DP and the outcomes were determined using logistic regression or longitudinal linear mixed-effect regression models. The mean daily energy intake during pregnancy was 10 104 (sd 3234) kJ (2415 (sd 773) kcal), and GWG was 11·9 (sd 4·2) kg. In all, 40 % of women presented pre-gestational overweight/obesity. Excessive GWG occurred in 34·7 % of pregnant women and 56·6 % were overweight/obese at postpartum. The ‘common-Brazilian’ DP (characterised by higher intake of beans, rice and lower intake of fast food/snacks, candies/table sugar and processed meats/bacon) was positively associated with adiponectin (β=1·07; 95 % CI 0·17, 1·98). The ‘Western’ DP (characterised by higher intake of fast food/snacks and processed meat/bacon and lower intake of noodles/pasta/roots/tubers and sodas) was negatively associated with adiponectin (β=−1·11; 95 % CI −2·00, −0·22) and positively associated with leptin concentrations (β=64·9; 95 % CI 22·8, 107·0) throughout pregnancy. It may be suggested that the ‘common-Brazilian’ is a healthy DP and beneficial for serum concentrations of adiponectin and leptin.</jats:p

Factors impacting the formation of 3-MCPD esters and glycidyl esters during deep fat frying of chicken breast meat

The effect of the frying temperature, frying duration and the addition of NaCl on the formation of 3-monochloropropane-1,2-diol (3-MCPD) esters and glycidyl esters (GE) in palm olein after deep frying was examined in this study. The eight frying systems were deep-fat frying (at 160 and 180 °C) of chicken breast meat (CBM) (with 0, 1, 3 and 5% sodium chloride, NaCl) for 100 min/day for five consecutive days. All oil samples collected after each day were analyzed for 3-MCPD ester, GE, and free fatty acid (FFA) contents, specific extinctions at 232 and 268 nm (K 232 and K 268), p-anisidine value (pA), and fatty acid composition. There was a significant (p < 0.05) decrease in the 3-MCPD esters and a significant (p < 0.05) decrease in the GE with the increasing of the frying duration. There were significant (p < 0.05) increases in the 3-MCPD esters formed when the concentration of NaCl increased from 0 to 5%. The addition of NaCl to the CBM during deep frying had no significant effect on the GE generation. The FFA contents, K 232 and K 268 and pA showed that all the frying oils were within the safety limit

Benefícios do exercício físico e da nutrição na imunidade: POSSÍVEIS ESTRATÉGIAS PARA PREVENÇÃO DO COVID-19

O momento vivenciado pela sociedade frente à pandemia causada pelo novo coronavírus (COVID-19) tem sido alvo massivo de estudos, principalmente no que tange às formas de prevenção, vacinas, medicamentos e cuidados do paciente com a COVID-19. Desse modo, a presente revisão narrativa teve como objetivo avaliar artigos que abordassem o impacto da prática de exercício físico e da nutrição no sistema imunológico e a possível associação desses comportamentos com a prevenção da COVID-19. As informações coletadas no presente estudo são fruto de uma pesquisa bibliográfica acerca das últimas publicações na literatura internacional envolvendo as temáticas de exercício físico, nutrição, sistema imunológico e suas relações com a COVID-19. Dessa forma, pôde-se perceber que incentivar a aliança entre a prática regular de exercício físico de moderada intensidade e uma alimentação saudável e rica em nutrientes como, vitaminas A, C, D, E, e o mineral zinco são estratégias que poderiam ser adotada para auxiliar na redução da necessidade de hospitalização e de complicações associadas à COVID-19.&nbsp; &nbsp; Palavras-chave: Exercício físico; nutrição; alimentação; imunidade; COVID-19