SUPLEMENTAÇÃO E ALIMENTAÇÃO ADEQUADA NO CONTEXTO ATUAL DA PANDEMIA CAUSADA PELA COVID-19

O surto do coronavírus foi classificado pela Organização Mundial da Saúde, como pandemia. Desde então, o assunto vem sendo abordado de forma exaustiva nas redes sociais e veículos de comunicação em massa. A importância de uma alimentação balanceada e rica em nutrientes, além de enfatizar que não existem superalimentos, fórmulas, “shots”, sucos ou soroterapias por infusão endovenosa de nutrientes, que sejam indicados para prevenir ou até mesmo tratar pessoas contaminadas pelo coronavírus, precisa ser reforçada. Esse artigo tem como objetivo informar os profissionais da saúde e população em geral, a cerca do papel da alimentação e da real necessidade do uso de suplementos alimentares nesse contexto. As informações utilizadas basearam-se nos conhecimentos já consolidados na literatura sobre nutrição, e em documentos científicos e oficiais até então divulgados.  Alguns nutrientes como Vitamina A, D, C, Complexo B, Ferro, Zinco e Selênio podem atuar de maneira positiva no sistema imunológico, no entanto, uma alimentação balanceada é capaz de fornecer esses nutrientes. Já o uso de suplementação para melhora da imunidade  na prevenção e tratamento da COVID-19 não tem respaldo cientifico até o momento. Palavras-chave: COVID-19, Alimentação saudável, Imunidade.&nbsp

A influência da gordura visceral e subcutânea na densidade mineral óssea de adolescentes obesos

OBJECTIVE: To verify the influence of visceral and subcutaneous fat, as well adipokines in bone mineral density (BMD) in obese adolescents. SUBJECTS AND METHODS: The study involved 125 postpubertal obese adolescents (45 boys and 80 girls). Anthropometric measurements, body composition, visceral and subcutaneous fat, and BMD were determined. Leptin, adiponectin, and insulin levels also analyzed. RESULTS: Data demonstrated a negative relationship between BMD with insulin resistance, visceral fat and leptin concentration; and bone mineral content with visceral/subcutaneous ratio. Positive association between BMD and subcutaneous fat was observed. CONCLUSIONS: Visceral fat and insulin resistance, as well as visceral/subcutaneous ratio and leptin concentration, were negative predictors of BMD in boys and girls, respectively. However, subcutaneous fat had a protective influence in BMD only in boys.OBJETIVO: Verificar a influência da gordura visceral e subcutânea, assim como das adipocinas na densidade mineral óssea (DMO) em adolescentes obesos. SUJEITOS E MÉTODOS: O estudo envolveu 125 adolescentes obesos pós-púberes. Medidas antropométricas, composição corporal, gordura visceral e subcutânea e DMO foram determinadas. Níveis de leptina, adiponectina e insulina foram analisados. RESULTADOS:Os dados demonstraram associação negativa entre DMO com resistência insulínica, gordura visceral e concentração de leptina; e conteúdo mineral ósseo com a razão visceral/subcutânea. Associação positiva entre DMO e gordura subcutânea foi observada. CONCLUSÕES: Gordura visceral, resistência insulínica, razão visceral/subcutânea e concentração de leptina foram preditores negativos da DMO em meninos e meninas, respectivamente. Entretanto, a gordura subcutânea demonstrou exercer influência positivamente na DMO somente nos meninos.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Universidade Federal de São Paulo (UNIFESP) Graduate Studies Program in NutritionUNIFESP Endocrinology DepartmentUNIFESP Psychobiology DepartmentUNIFESP Graduate Studies Program in Interdisciplinary Health SciencesUNIFESP Biosciences DepartmentUNIFESP, Graduate Studies Program in NutritionUNIFESP, Endocrinology DepartmentUNIFESP, Psychobiology DepartmentUNIFESP, Graduate Studies Program in Interdisciplinary Health SciencesUNIFESP, Biosciences DepartmentSciEL

Higher increase degree of FGF21 post long-term interdisciplinary weight loss therapy preserves the free fat mass and rest metabolic rate in adolescents with obesity

International audienceObjective Fibroblast growth factor 21 (FGF21) is among the activators that can stimulate thermogenesis in the white adipose tissue and brown adipose tissue. People with obesity have elevated blood levels of FGF21, but also develop resistance to its action, impairing its beneficial role. Inversely, clinical treatments to weight loss has been pointed out as an important therapy for increasing and recovering sensitivity to FGF21. The aim was to analyse the effect of long-term weight loss interdisciplinary intervention on FGF21 and body composition. Subjects and methods Eighty-six post-pubertal obese adolescents (14-19 years-old), were submitted to 20 weeks of weight loss therapy (clinical, nutritional, psychological and physical exercise support). Anthropometric measures, body composition and rest metabolic rate (RMR) by bioelectrical impedance, and serum FGF21 sample by ELISA were evaluated. The adolescents were grouped according to FGF21 individual delta variations after therapy: Higher Increase (HI); lower increase (LI); lower decrease (LD); higher decrease (HD). Results All groups present weight loss. Only in FGF21 ≥ 76,5 pg/mL variation the free-fat-mass and rest metabolic rate were preserved and to others group these variables were significantly reduced. Conclusion High increase in FGF21 can contribute to preservation of FFM and RMR after weight loss therapy, could have important implications for energy balance regulation. Future studies are necessary to continue determining the role of magnitude effects of FGF21 levels in obesity to improve clinical practice, especially in paediatrics population

Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy

ABSTRACT Objectives: Obesity is a multifactorial disease characterized by the presence of the pro-inflammatory state associated with the development of many comorbidities, including bone turnover marker alterations. This study aimed to investigate the role of the inflammatory state on bone turnover markers in obese adolescents undergoing interdisciplinary weight loss treatment for one year. Subjects and methods: Thirty four post-pubescent obese adolescents with primary obesity, a body mass index (BMI) greater than > 95th percentile of the CDC reference growth charts, participated in the present investigation. Measurements of body composition, bone turnover markers, inflammatory biomarkers and visceral and subcutaneous fat were taken. Adolescents were submitted to one year of interdisciplinary treatment (clinical approach, physical exercise, physiotherapy intervention, nutritional and psychological counseling). Results: Reduction in body mass, body fat mass, visceral and subcutaneous fat, as well as, an increase in the body lean mass and bone mineral content was observed. An improvement in inflammatory markers was seen with an increase in adiponectin, adiponectin/leptin ratio and inteleukin-15. Moreover, a positive correlation between the adiponectin/leptin ratio and osteocalcin was demonstrated. Further, both lean and body fat mass were predictors of osteocalcin. Negative associations between leptin with osteocalcin, adiponectin with Beta CTX-collagen, and visceral fat with adiponectin were observed. Conclusions: It is possible to conclude that the inflammatory state can negatively influence the bone turnover markers in obese adolescents. In addition, the interdisciplinary weight loss treatment improved the inflammatory state and body composition in obese adolescents. Therefore, the present findings should be considered in clinical practice

Hyperleptinemia in obese adolescents deregulates neuropeptides during weight loss

Leptin has emerged over the past decade as a key hormone not only in energy balance regulation but also in neuroendocrine and inflammatory processes. the aim of the present study was to evaluate whether hyperleptinemia deregulates neuropeptides during weight loss. A total of 86 post-pubertal obese adolescents (with or without hyperleptinemia) participated in one year of interdisciplinary weight loss therapy (clinical, nutritional, psychological and exercise-related). Adipokine and neuropeptide concentrations were measured by ELISA, visceral fat was measured by ultrasound and body composition was measured by pletismography. the hyperleptinemic patients presented a lower alpha-MSH concentration and higher NPY/AgRP ratio while the adiponectin/leptin (A/L) ratio was lower compared with the non-hyperleptinemic group. After therapy, significant improvements in BM, BMI, body fat mass, visceral and subcutaneous fat, HOMA-IR, QUICKI, total cholesterol and triglycerides were observed in both groups. Indeed, we observed significant increases in adiponectin and A/L as well as reductions in leptin and NPY/AgRP ratio in the hyperleptinemic group. in the stepwise multiple linear regression analysis with leptin concentration as the dependent variable, alpha-MSH and body fat mass (%) were the independent predictors to explain leptin concentration. for the entire group, we found positive correlations between leptinemia and BMI and body fat mass (%) as well as a negative correlation with free fat mass (%) and alpha-MSH. Finally, we verified negative correlations between adiponectin/leptin ratio with total cholesterol and LDL-c, only in hyperleptinemic patients. in conclusion, the hyperleptinemia in obese adolescents deregulates neuropeptides during weight loss. (C) 2011 Elsevier Inc. All rights reserved.AFIPFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)CENESPFADAUNIFESP-EPMUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Biosci, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Post Grad Program Interdisiciplinary Hlth Sci, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Post Grad Program Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Endocrinol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Psychobiol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Biosci, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Post Grad Program Interdisiciplinary Hlth Sci, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Post Grad Program Nutr, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Physiol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Endocrinol, São Paulo, BrazilUniversidade Federal de São Paulo, Paulista Med Sch, UNIFESP EPM, Dept Psychobiol, São Paulo, BrazilFAPESP: 2008/53069-0FAPESP: 2006/00684-3FAPESP: 9814303-3Web of Scienc

Triglyceride-to-High-Density-Lipoprotein-Cholesterol Ratio as a Predictor of Metabolic Syndrome According to Stage of Life at Obesity Onset in Women with Severe Obesity—A Pilot Study

The triglyceride-to-high-density lipoprotein-cholesterol (TG/HDL-c) ratio is a simple but effective indicator of metabolic imbalance that characterizes metabolic syndrome (MetS) and can consequently indicate a higher cardiovascular risk. It may, therefore, be useful in identifying a high risk for cardiometabolic diseases according to the onset of obesity. The aim of this study was to evaluate the association between MetS and the stage of life at obesity onset and to establish the cutoff point for the TG/HDL-c ratio as a marker of MetS in women with severe obesity. Forty-seven women who were to undergo bariatric surgery were evaluated. Anthropometric and metabolic parameters were measured, and the TG/HDL-c ratio was calculated. The volunteers were grouped according to their stage of life at obesity onset. A receiver operating characteristic (ROC) curve was constructed to define cutoff points for the TG/HDL-c ratio as predictors of MetS. Women who developed obesity early (during infancy/adolescence) had higher weight (p = 0.008), body mass index (p = 0.031), and hip circumference (p = 0.036) than those who developed obesity later (in adulthood); however, no association was found between obesity onset and MetS. The cutoff points for the TG/HDL-c ratio that were established for those who developed early or late obesity were 2.30 and 2.19, respectively. Although the stage of life at the onset of obesity was not related to MetS, different cutoff points for the TG/HDL-c ratio were observed

Relationship between adiponectin and leptin on osteocalcin in obese adolescents during weight loss therapy

<div><p>ABSTRACT Objectives: Obesity is a multifactorial disease characterized by the presence of the pro-inflammatory state associated with the development of many comorbidities, including bone turnover marker alterations. This study aimed to investigate the role of the inflammatory state on bone turnover markers in obese adolescents undergoing interdisciplinary weight loss treatment for one year. Subjects and methods: Thirty four post-pubescent obese adolescents with primary obesity, a body mass index (BMI) greater than > 95th percentile of the CDC reference growth charts, participated in the present investigation. Measurements of body composition, bone turnover markers, inflammatory biomarkers and visceral and subcutaneous fat were taken. Adolescents were submitted to one year of interdisciplinary treatment (clinical approach, physical exercise, physiotherapy intervention, nutritional and psychological counseling). Results: Reduction in body mass, body fat mass, visceral and subcutaneous fat, as well as, an increase in the body lean mass and bone mineral content was observed. An improvement in inflammatory markers was seen with an increase in adiponectin, adiponectin/leptin ratio and inteleukin-15. Moreover, a positive correlation between the adiponectin/leptin ratio and osteocalcin was demonstrated. Further, both lean and body fat mass were predictors of osteocalcin. Negative associations between leptin with osteocalcin, adiponectin with Beta CTX-collagen, and visceral fat with adiponectin were observed. Conclusions: It is possible to conclude that the inflammatory state can negatively influence the bone turnover markers in obese adolescents. In addition, the interdisciplinary weight loss treatment improved the inflammatory state and body composition in obese adolescents. Therefore, the present findings should be considered in clinical practice.</p></div

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