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

Redução na força muscular e capacidade funcional em pacientes fisicamente inativos com lúpus eritematoso sistêmico de início juvenil, apesar de doença muito leve

ResumoObjetivoComparar a força muscular (ou seja, a força muscular dos membros superiores e inferiores) e a capacidade funcional de pacientes fisicamente inativos com lúpus eritematoso sistêmico de início juvenil (LESJ) com controles saudáveis (CTRL).MétodosEstudo transversal cuja amostra foi composta por 19 pacientes com LESJ (entre 9 e 18 anos) e 15 CTRL pareados por idade, sexo, índice de massa corporal (IMC) e nível de atividade física (avaliada através do uso de acelerômetros). A força dos membros superiores e inferiores foi avaliada pelo teste de uma repetição máxima (1‐RM). A força isométrica foi avaliada através do uso de um dinamômetro. A capacidade funcional foi avaliada pelo Timed‐stands test (TST) e Timed‐up‐and‐go test (TUG).ResultadosQuando comparados com os CTRL, os pacientes com LESJ apresentaram menor força em 1‐RM no Leg press e supino (p=0,026 e p=0,008, respectivamente) e uma tendência a menor força de preensão manual (p=0,052). Os pacientes com LESJ apresentaram menores escores no TST (p=0,036) e uma tendência a maior pontuação no TUG (p=0,070), quando comparados com o grupo CTRL.ConclusãoPacientes com LESJ, fisicamente inativos, com doença muito leve mostraram redução na força muscular e capacidade funcional quando comparados com controles saudáveis pareados por níveis de atividade física. Esses achados sugerem que pacientes com LESJ podem apresentar mais efeitos deletérios por manter um estilo de vida fisicamente inativo do que controles saudáveis. Além disso, alguns efeitos “residuais” subclínicos da doença ou do tratamento farmacológico parecem afetar pacientes com LESJ, mesmo com uma doença bem controlada.AbstractObjectiveTo compare muscle strength (i.e. lower‐ and upper‐body strength) and function between physically inactive childhood‐onset systemic lupus erythematosus patients (C‐SLE) and healthy controls (CTRL).MethodsThis was a cross‐sectional study and the sample consisted of 19 C‐SLE (age between 9 to 18 years) and 15 CTRL matched by age, sex, body mass index (BMI), and physical activity levels (assessed by accelerometry). Lower‐ and upper‐body strength was assess by the one‐repetition‐maximum (1‐RM) test. Isometric strength was assessed through a handgrip dynamometer. Muscle function was evaluated by the timed‐stands test (TST) and the timed‐up‐and‐go test (TUG).ResultsWhen compared with CTRL, C‐SLE showed lower leg‐press and bench‐press 1‐RM (p=0.026 and p=0.008, respectively), and a tendency towards lower handgrip strength (p=0.052). C‐SLE showed lower TST scores (p=0.036) and a tendency towards higher TUG scores (p=0.070) when compared with CTRL.ConclusionPhysically inactive C‐SLE patients with very mild disease showed reduced muscle strength and functionality when compared with healthy controls matched by physical activity levels. These findings suggest C‐SLE patients may greatly suffer from a physically inactive lifestyle than healthy controls do. Moreover, some sub‐clinical “residual” effect of the disease or its pharmacological treatment seems to affect C‐SLE patients even with a well‐controlled disease

Cross-cultural adaptation of the State and Trait Food Cravings Questionnaires ( FCQ-S and FCQ-T) into Portuguese

This study aimed to present the cross-cultural adaptation of the State and Trait Food Cravings Questionnaires (FCQ-S and FCQ-T) into Portuguese. Tools were translated and back-translated, field experts evaluated the conceptual, operational and item-based equivalence and a sample of students assessed tools, evaluating the level of understanding and analyzing internal consistency through Cronbach's coefficient. In addition, the semantic equivalence was assessed though the intraclass correlation coefficient between the bilingual scores in each question of both versions (English and Portuguese). Tools were considered easy to understand (experts scored 95.4% and 97% for the FCQ-T and FCQ-S, respectively, and 81.8% of students considered them easy to understand), and showed satisfactory internal consistency values (FCQ-T ranged from 0.6 to 0.8 and FCQ-S ranged from 0.5 to 0.8). From the cross-cultural adaptation process, the satisfactory results enable the recommendation of the Brazilian version of FCQs.Univ Sao Paulo, Dept Nutr, Fac Saude Publ, Av Dr Arnaldo 715, BR-01246904 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Inst Saude & Soc, Sao Paulo, SP, BrazilUniv Sao Paulo, Escola Educ Fis & Esporte, Sao Paulo, SP, BrazilUniv Estadual Campinas, UNICAMP, Fac Ciencias Aplicadas, Limeira, SP, BrazilUniv Estadual Campinas, Fac Educ Fis, Campinas, SP, BrazilUniv Fed Sao Paulo, Inst Saude & Soc, Sao Paulo, SP, BrazilWeb of Scienc

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

Does creatine supplementation improve the plasma lipid profile in healthy male subjects undergoing aerobic training?

Abstract\ud \ud \ud \ud \ud \ud We aimed to investigate the effects of creatine (Cr) supplementation on the plasma lipid profile in sedentary male subjects undergoing aerobic training.\ud \ud \ud \ud Methods\ud \ud Subjects (n = 22) were randomly divided into two groups and were allocated to receive treatment with either creatine monohydrate (CR) (~20 g·day-1 for one week followed by ~10 g·day-1 for a further eleven weeks) or placebo (PL) (dextrose) in a double blind fashion. All subjects undertook moderate intensity aerobic training during three 40-minute sessions per week, over 3 months. High-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), very low-density lipoprotein cholesterol (VLDL), total cholesterol (TC), triglyceride (TAG), fasting insulin and fasting glycemia were analyzed in plasma. Thereafter, the homeostasis model assessment (HOMA) was calculated. Tests were performed at baseline (Pre) and after four (Post 4), eight (Post 8) and twelve (Post 12) weeks.\ud \ud \ud \ud Results\ud \ud We observed main time effects in both groups for HDL (Post 4 versus Post 8; P = 0.01), TAG and VLDL (Pre versus Post 4 and Post 8; P = 0.02 and P = 0.01, respectively). However, no between group differences were noted in HDL, LDL, CT, VLDL and TAG. Additionally, fasting insulin, fasting glycemia and HOMA did not change significantly.\ud \ud \ud \ud Conclusion\ud \ud These findings suggest that Cr supplementation does not exert any additional effect on the improvement in the plasma lipid profile than aerobic training alone.We are grateful to Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, 2003/140885) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for financial support.We are grateful to Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, 2003/14088-5) and Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) for financial support

Efeito da suplementação de creatina, associada ou não ao treinamento de força, sobre a peroxidação lipídica em mulheres idosas

The aim of this study was to evaluate the effects of creatine supplementation associated or not with strength training upon lipid peroxidation in older women. This was a clinical, randomized, double-blind, placebo-controlled trial. Older women were randomly allocated into four groups: 1) placebo supplementation (PL, n = 10), 2) creatine supplementation (CR; n = 10), 3) placebo supplementation associated with strength training (PL + RT, n = 6) and 4) creatine supplementation associated with strength training (CR + RT, n = 8). Before (PRE) and after 24 weeks (POST), blood samples were collected to measure lipid hydroperoxides concentration by spectrophotometry. No statistical difference was observed on the lipid hydroperoxides concentration between groups (PL: PRE = 48.7 ± 36.9; POST = 29.3 ± 18.8; Δ = -13.0 ± 26.8; CR : PRE = 51.0 ± 46.0; POST = 54.2 ± 51.6; Δ = -8.6 ± 30.2; + PL TR: PRE = 33.0 ± 11.2; POST = 47.3 ± 31.6, Δ = 14.3 ± 39.2; CR + TR: PRE = 18.5 ± 10.1; POST = 28.1 ± 17.9, Δ = 9.7 ± 16.4 pmol.mg-1 of total protein, p = 0.17). Creatine supplementation associated or not with strength training did not affect the lipid peroxidation, an important plasmatic marker of oxidative stress, in elderly women.O objetivo desse trabalho foi avaliar o efeito da suplementação de creatina associada ou não ao treinamento de força sobre a peroxidação lipídica em mulheres idosas. Foi conduzido um estudo clínico, randomizado, duplo-cego e controlado por placebo, no qual mulheres idosas foram randomizadas para compor quatro grupos: 1) suplementação com placebo (PL; n = 10); 2) suplementação com creatina (CR; n = 10); 3) suplementação com placebo associado ao treinamento de força (PL+TR; n = 6); e 4) suplementação com creatina associado ao treinamento de força (CR+TR; n = 8). Antes (PRE) e após 24 semanas (POS) de intervenção, foram coletadas amostras de sangue para posterior análise das concentrações plasmáticas de hidroperóxidos lipídicos por espectrofotometria. Nenhuma diferença estatística foi observada na concentração de hidroperóxidos lipídicos entre os grupos (PL: PRE = 48,7 ± 36,9; POS = 29,3 ± 18,8; delta = -13,0 ± 26,8; CR: PRE = 51,0 ± 46,0; POS = 54,2 ± 51,6; delta = -8,6 ± 30,2; PL+TR: PRE = 33,0 ± 11,2; POS = 47,3 ± 31,6; Δ = 14,3 ± 39,2; CR+TR: PRE = 18,5 ± 10,1; POS = 28,1 ± 17,9; delta = 9,7 ± 16,4 pmol.mg-1 de proteína total; p = 0,17). A suplementação de creatina associada ou não ao treinamento de força não afetou a peroxidação lipídica, um importante marcador de estresse oxidativo no plasma, em mulheres idosas

Changes in leptin levels and its association with insulin: effects of chronic endurance training in rats

Atualmente, a obesidade pode ser classificada como uma pandemia. Com a clonagem do gene ob e do seu receptor, foi descoberta a leptina. Secretada principalmente pelo tecido adiposo, está diretamente correlacionada à quantidade de gordura corporal. Entretanto, diversos fatores influenciam sua expressão e síntese, tais como jejum, atividade simpática, exercício físico e alterações no balanço energético. Os efeitos do treinamento aeróbio sobre este hormônio são ainda contraditórios. Desta forma, este estudo teve como objetivo a verificação dos efeitos do treinamento aeróbio nas concentrações plasmáticas de leptina. Ratos Wistar machos foram divididos em dois grupos: treinado (T) e controle (C). Não houve diferença na ingestão energética e no gasto energético de repouso. Ratos treinados apresentaram menor peso corporal final, conteúdo de gordura corporal, insulinemia e melhora na resposta glicêmica. Houve maior expressão do mRNA da leptina no tecido adiposo visceral do que no subcutâneo nos dois grupos. Não houve, entretanto, diferença na expressão da leptina entre os grupos em ambos os depósitos. A menor concentração de leptina plasmática nos animais treinados ocorreu, principalmente, devido ao menor conteúdo de gordura corporal deste grupo. No entanto, após a correção da concentração de xiii leptina pelo conteúdo de gordura corporal, ainda foi observada diferença significativa entre os grupos, sugerindo que exista(m) outro(s) fator(es) de modulação das concentrações de leptina após o treinamento aeróbio, sendo a principal candidata a tal regulação a insulinaObesity currently qualifies as a worldwide health epidemic. With the cloning of mouse ob gene and its receptor leptin was discovered. Leptin is expressed and secreted primarily by adipose tissue and is highly correlated to body fat mass. Nevertheless many factors can regulate leptin synthesis and expression, such as fasting, sympathetic activity, insulin, exercise and changes in energy balance. Endurance training effects on leptin are still contradictory. Therefore the aim of the present study was to verify the effects of endurance training on leptin levels. Male Wistar rats were separated in two groups: trained (T) and sedentary control (C). Energy intake and basal energy expenditure were not different between groups. Trained rats had lower final body weight, body fat mass, insulin levels and improved glycemic response. Leptin mRNA expression was higher in visceral than in subcutaneous adipose tissue in both groups. However, no difference in leptin expression between groups in either fat depot was found. Lower leptin levels in trained rats were due primarily to their lower body fat mass. Nonetheless, after correction for body fat mass leptin levels were still lower in exercised rats, suggesting that there might be other regulators of leptin levels in response to endurance training, being insulin the main candidate for such rol

The effects of liposuction and exercise training on metabolic profile and body composition in adult normal weight healthy women

A lipoaspiração é a cirurgia estética mais comumente realizada pelas mulheres no mundo. Uma vez que o tecido adiposo é um órgão metabolicamente ativo, alguns autores sugeriram que a remoção cirúrgica do tecido adiposo subcutâneo (TAS) pudesse exercer efeitos importantes no perfil metabólico. Além disso, estudos experimentais observam ganho de gordura compensatório no tecido adiposo intacto em resposta à lipectomia. O exercício físico regular induz a inúmeras melhoras no perfil metabólico e na composição corporal, promovendo o aumento do gasto energético total e preservação da massa magra. Estudos sobre os efeitos integrados do exercício e da lipoaspiração em humanos são inexistentes na literatura. Desta forma, este estudo visou avaliar o efeito da lipoaspiração acompanhada de treinamento físico sobre o perfil metabólico, a adiposidade e a distribuição de gordura corporal em mulheres adultas e eutróficas (20 a 35 anos; IMC: 23,8 ± 2.2 Kg/m2). Trinta e seis mulheres foram submetidas à cirurgia de lipoaspiração abdominal. Dois meses após a cirurgia, as voluntárias foram divididas em dois grupos: treinado (LT; n=18) e sedentário (LS; n=18). O treinamento físico consistiu de treinamento aeróbio e de força, 3x/semana, por 16 semanas. A metodologia empregada incluiu avaliação do peso corporal, composição corporal (pesagem hidrostática), distribuição da gordura abdominal (tomografia computadorizada), consumo alimentar (diário alimentar), perfil lipídico, concentração de citocinas anti e proinflamatórias, de adiponectina e de leptina antes (PRE), dois meses após a cirurgia (POS-2) e seis meses após a cirurgia (POS-6). A capacidade física (determinada pelo VO2max, e por testes de repetição máxima para membros inferiores e superiores), a taxa metabólica de repouso (TMR) (calorimetria indireta), a determinação do diâmetro médio dos adipócitos e a expressão gênica dos fatores de transcrição para adipogênese, das citocinas anti e proinflamatórias, da leptina e da adiponectina no tecido adiposo subcutâneo abdominal e femoral foram avaliadas nos tempos PRE e POS-6. O consumo alimentar permeceneu inalterado ao longo do estudo. Seis meses após a cirurgia, o grupo LS apresentou tendência ao retorno do peso e da massa gorda total aos valores basais, bem como aumento do tecido adiposo visceral (TAV) e queda da TMR. O grupo LT também apresentou queda da TMR, mas manteve os valores de peso corporal e de massa gorda diminuídos em resposta à cirurgia no POS-6 e apresentou aumento da massa magra e manutenção do TAV. Ambos os grupos apresentaram queda das concentrações de adiponectina e aumento do colesterol total, da LDL-colesterol e da razão LDL/Apolipoproteína B no POS-6. Por meio dos resultados, podemos concluir que a remoção do tecido adiposo abdominal subcutâneo (TAS) em sujeitos eutróficos parece desencadear mecanismos que favorecem a reposição e o crescimento compensatório de tecido adiposo, em especial na cavidade visceral, além de acarretar na diminuição das concentrações de adiponectina, sugerindo possíveis efeitos deletérios no risco cardiovascular em longo prazo. A prática de exercício físico após a cirurgia é de extrema importância para preservar os efeitos da cirurgia na composição corporal, prevenir contra o crescimento compensatório de gordura na cavidade visceral e atenuar seus possíveis efeitos deletérios no metabolismo em longo prazoLiposuction is the most communly cosmetic surgery performed worlwide. Because adipose tissue is metabolicaly active, researchers have suggested that the surgical removal of fat through liposuction could benefically affect the metabolic profile. In addition, in many species, when body fat is removed, it is recovered rapidly due to compensatory fat growth at intact depots. Regular exercise training benefits metabolic profile and body composition by increasing energy expenditure and preserving fat free mass. Studies about the associated effects of liposuction and physical exercise lack in the literature. Thus the aim of this study was to evaluate the effects of liposuction associated with exercise training on metabolic profile, adiposity and body fat distribution in adult normal weight women (20 to 35 years old, BMI: 23,8 ± 2.2 Kg/m2). Thirty-six women underwent a small-volume abdominal liposuction (mean fat aspirate supernantant: 1240.3 ± 363.6 ml). Two months after surgery were randomly divided into two groups: trained (TR; n=18) and sedentary control (SC; n=18). The four-month exercise program consisted of aerobic plus resistance training, thrice a week. Body composition (hydrostatic weighing), body fat distribution (computer tomography), dietary intake (food records), lipid profile, plasmatic concentration of citokyne, adiponectin and leptin were assessed at baseline (PRE), two (POST-2) and six months after surgery (POST-6). Physical capacity (by VO2max, one repetition maximum (1RM) bench and leg press ), resting energy expenditure (TMR - indirect calorimetry), adipocyte size and gene expression of adipogenesis transcription factors, leptin, adiponectin and citokyne were assessed at PRE and POST-6. Dietary intake was unchanged throughout the study. Six months after surgery, LS group showed increased visceral adipose tissue (TAV), decreased TMR and a tendency to return body weight and fat to baseline values. LT group also showed decreased TMR, but sustained liposuction-induced decreased body weight and fat, increased fat free mass and preserved TAV at POST-6. Both groups showed decreased levels of adiponectin and increased levels of total cholesterol, LDL, cholesterol and LDL/ApoB ratio at POST-6. In conclusion, abdominal subcutaneous fat removal in normal weight subjects triggers a compensatory increase of fat, specially towards the visceral cavity, and lowers adiponectin levels, which could enhance long-term cardiovascular risk. Additionally, exercise training plays a very important role in preserving against the compensatory increase of visceral fat and attenuating possible long-term deleterious effect