Effect of branched-chain amino acid nutritional supplementation in adult strength and endurance athletes: A literature review

Introducción: En la actualidad, un gran número de deportistas consideran que llegan a tener dificultades a la hora de alcanzar sus requerimientos de proteína a partir de los alimentos. Es por esta razón que optan por ingerir suplementos nutricionales, los cuales en lo últimos años han incrementado sus ventas y los deportistas los consumen para cubrir sus requerimientos nutricionales. Los aminoácidos de cadena ramificada hacen parte del grupo de suplementos nutricionales, los cuales se considera que tienen posibles efectos sobre el tejido muscular que son causados por el ejercicio físico. Por ello, el objetivo de la presente revisión de literatura es describir la causa y efecto de la suplementación con aminoácidos de cadena ramificada sobre el daño muscular, la recuperación muscular, ganancia de la masa muscular y fuerza, composición corporal y fatiga en atletas de resistencia y fuerza de edad adulta en rendimiento deportivo y recreativo. Materiales y Métodos: Estudio descriptivo de revisión de literatura. Se realizó una búsqueda de palabras claves en bases de datos EbscoHost, Scopus, PubMed y Embase. Resultados: Se estudian los efectos de los aminoácidos de cadena ramificada (AACR) en variables como daño muscular, recuperación muscular, masa muscular, fuerza, composición corporal y fatiga. La suplementación con AACR puede ser eficaz en los resultados de daño muscular inducido por el ejercicio. Sin embargo, se encontró una alta heterogeneidad con respecto a los resultados de los diferentes estudios y la pequeña cantidad de estudios no permite evaluar con mayor precisión las demás variables mencionadas. Conclusiones: El suplemento con aminoácidos de cadena ramificada podrían tener un efecto positivo en la disminución del daño muscular posterior al ejercicio y recuperación muscular. Sin embargo, hacen falta más estudios para esclarecer los beneficios que los diferentes autores mencionan tener sobre la composición corporal, la fatiga, incremento de la masa muscular y la fuerza.Introduction: Currently, a large number of athletes considering that they have difficulties in meeting their protein requirements from food. It is for this reason that they choose to take nutritional supplements, which in recent years have increased their sales and athletes consume them to cover their nutritional requirements. Branched-chain amino acids are part of the group of nutritional supplements, which are considered to have possible effects on muscle tissue that are caused by physical exercise. Therefore, the objective of this literature review is to describe the cause and effect of branched-chain amino acid supplementation on muscle damage, muscle recovery, gains in muscle mass and strength, body composition, and fatigue in endurance athletes. and adulthood strength in athletic and recreational performance. Materials and Methods: Descriptive literature review study. A keyword search was performed in EbscoHost, Scopus, PubMed and Embase databases. Results: The effects of branched chain amino acids (BCAA) on variables such as muscle damage, muscle recovery, muscle mass, strength, body composition and fatigue are studied. BCAA supplementation may be effective in results of exercise-induced muscle damage. However, a high heterogeneity was found regarding the results of the different studies and the small number of studies does not allow a more precise evaluation of the other variables mentioned. Conclusions: The supplement with branched chain amino acids could have a positive effect on the reduction of muscle damage after exercise and muscle recovery. However, more studies are needed to clarify the benefits that different authors mention having on body composition, fatigue, increased muscle mass and strength.Nutricionista DietistaPregrad

The use of multicriteria decision analysis to support decision making in healthcare: an updated systematic literature review

Objectives Multicriteria decision analysis (MCDA) is increasingly used for decision making in healthcare. However, its application in different decision-making contexts is still unclear. This study aimed to provide a comprehensive review of MCDA studies performed to inform decisions in healthcare and to summarize its application in different decision contexts. Methods We updated a systematic review conducted in 2013 by searching Embase, MEDLINE, and Google Scholar for MCDA studies in healthcare, published in English between August 2013 and November 2020. We also expanded the search by reviewing grey literature found via Trip Medical Database and Google, published between January 1990 and November 2020. A comprehensive template was developed to extract information about the decision context, criteria, methods, stakeholders involved, and sensitivity analyses conducted. Results From the 4295 identified studies, 473 studies were eligible for full-text review after assessing titles and abstracts. Of those, 228 studies met the inclusion criteria and underwent data extraction. The use of MCDA continues to grow in healthcare literature, with most of the studies (49%) informing priority-setting decisions. Safety, cost, and quality of care delivery are the most frequently used criteria, although there are considerable differences across decision contexts. Almost half of the MCDA studies used the linear additive model whereas scales and the analytical hierarchy process were the most used techniques for scoring and weighting, respectively. Not all studies report on each one of the MCDA steps, consider axiomatic properties, or justify the methods used. Conclusions A guide on how to conduct and report MCDA that acknowledges the particularities of the different decision contexts and methods needs to be developed

Foro Internacional : Hacia la eliminación del contrabando de cigarrillos

Este foro reúne a expertos nacionales e internacionales con experiencia en la medición de contrabando de cigarrillos y en el impacto sobre la salud de los impuestos a los productos de tabaco. Se presentarán los resultados del más reciente estudio sobre la penetración de comercio ilícito en 2017 y se discutirán los efectos de la reforma tributaria sobre el mercado de cigarrillos en Colombia. Las discusiones permitirán identificar los pasos a seguir para continuar en la tarea de eliminación del comercio ilícito de cigarrillos, fundamentados en la implementación de las medidas del Convenio Marco para el Control de Tabaco

Does coronary plaque morphology matter beyond plaque burden?

Purpose of review: Imaging of adverse coronary plaque features by coronary computed tomography angiography (CCTA) has advanced greatly and at a fast pace. We aim to describe the evolution, present and future in plaque analysis, and its value in comparison to plaque burden.Recent findings: Recently, it has been demonstrated that in addition to plaque burden, quantitative and qualitative assessment of coronary plaque by CCTA can improve the prediction of future major adverse cardiovascular events in diverse coronary artery disease scenarios. The detection of high-risk non-obstructive coronary plaque can lead to higher use of preventive medical therapies such as statins and aspirin, help identify culprit plaque, and differentiate between myocardial infarction types. Even more, over traditional plaque burden, plaque analysis including pericoronary inflammation can potentially be useful tools for tracking disease progression and response to medical therapy. The identification of the higher risk phenotypes with plaque burden, plaque characteristics, or ideally both can allow the allocation of targeted therapies and potentially monitor response. Further observational data are now required to investigate these key issues in diverse populations, followed by rigorou

Imaging subclinical coronary atherosclerosis to guide lipid management, are we there yet?

Atherosclerotic cardiovascular disease risk (ASCVD) is an ongoing epidemic, and lipid abnormalities are its primordial cause. Most individuals suffering a first ASCVD event are previously asymptomatic and often do not receive preventative therapies. The cornerstone of primary prevention has been the identification of individuals at risk through risk calculators based on clinical and laboratory traditional risk factors plus risk enhancers. However, it is well accepted that a clinical risk calculator misclassifies a significant proportion of individuals leading to the prescription of a lipid-lowering medication with very little yield or a missed opportunity for lipid-lowering agents with a potentially preventable event. The development of coronary artery calcium scoring (CAC) and CT coronary angiography (CCTA) provide complementary tools to directly visualize coronary plaque and other risk-modifying imaging components that can potentially provide individualized lipid management. Understanding patient selection for CAC or potentially CCTA and the risk implications of the different parameters provided, such as CAC score, coronary stenosis, plaque characteristics and burden, epicardial adipose tissue, and pericoronary adipose tissue, have grown more complex as technologies evolve. These parameters directly affect the shared decision with patients to start or withhold lipid-lowering therapies, to adjust statin intensity or LDL cholesterol goals. Emerging lipid lowering studies with non-invasive imaging as a guide to patient selection and treatment efficacy, plus the evolution of lipid lowering therapies from statins to a diverse armament of newer high-cost agents have pushed these two fields forward with a complex interaction. This review will discuss existing risk estimators, and non-invasive imaging techniques for subclinical coronary atherosclerosis, traditionally studied using CAC and more recently CCTA with qualitative and quantitative measurements. We will also explore the current data, gaps of knowledge and future directions on the use of these techniques in the risk-stratification and guidance of lipid management

Does Coronary Plaque Morphology Matter Beyond Plaque Burden?

Purpose of review: Imaging of adverse coronary plaque features by coronary computed tomography angiography (CCTA) has advanced greatly and at a fast pace. We aim to describe the evolution, present and future in plaque analysis, and its value in comparison to plaque burden.Recent findings: Recently, it has been demonstrated that in addition to plaque burden, quantitative and qualitative assessment of coronary plaque by CCTA can improve the prediction of future major adverse cardiovascular events in diverse coronary artery disease scenarios. The detection of high-risk non-obstructive coronary plaque can lead to higher use of preventive medical therapies such as statins and aspirin, help identify culprit plaque, and differentiate between myocardial infarction types. Even more, over traditional plaque burden, plaque analysis including pericoronary inflammation can potentially be useful tools for tracking disease progression and response to medical therapy. The identification of the higher risk phenotypes with plaque burden, plaque characteristics, or ideally both can allow the allocation of targeted therapies and potentially monitor response. Further observational data are now required to investigate these key issues in diverse populations, followed by rigorou