Lean body mass changes within 12 months of bariatric surgery

OBJETIVO: O objetivo da pesquisa foi determinar a perda de massa corporal magra em pacientes após cirurgia bariátrica. MÉTODOS: O estudo retrospectivo foi conduzido com 17 prontuários de mulheres obesas submetidas à Derivação Gástrica em Y de Roux com anel de contenção gástrica, incluindo dados obtidos no período pré-operatório imediato e no 1º, 3º, 6º e 12º meses após a cirurgia. Os dados obtidos no prontuário incluíram a idade, medidas de peso, de altura e massa corporal magra e gorda, calculados pela impedância bioelétrica. RESULTADOS: A média de idade das pacientes foi de 43,1, DP=7,7 anos e durante o seguimento houve diminuição significativa do índice de massa corporal [51,2 (40,2-74,1) para 33,7 (24,8-53,4)kg/m²] e da massa corporal gorda [67,5 (51,2-67,4) para 32,1 (16,4-61,9)kg] em 12 meses de seguimento. No primeiro mês após a cirurgia, houve diminuição da massa corporal magra (M=65,3, DP=7,6 para M=59,7, DP=8,1kg), que representou 8,5% em relação aos valores iniciais, sendo que a partir daí, os dados mantiveram-se constantes. CONCLUSÃO: A perda de massa corporal magra pode refletir uma alteração no metabolismo proteico durante o pós-operatório imediato da cirurgia bariátrica, que pode implicar em evolução clínica e nutricional desfavoráveis.OBJECTIVE: The aim of this study was to determine changes in lean body mass after bariatric surgery. METHODS: This retrospective study reviewed 17 medical records of obese women who underwent banded Roux-en-Y gastric bypass. The medical records contained data collected immediately before and 1, 3, 6 and 12 months after surgery. The data included age, weight, height and lean and fat body mass determined by bioelectrical impedance analysis. RESULTS: The mean age of the patients was 43.1 years (SD=7.7). Body mass index decreased significantly within 12 months of the surgery, going from 51.2 (40.2-74.1) to 33.7 (24.8-53.4)kg/m², as did fat body mass, going from 67.5 (51.2-67.4) to 32.1 (16.4-61.9)kg. In the first month after surgery, lean body mass decreased from M=65.3 (SD=7.6) to M=59.7 (SD=8.1kg), representing a decrease of 8.5%. Lean body mass remained constant after this period. CONCLUSION: Loss of lean body mass may indicate a change in protein metabolism immediately after bariatric surgery, which may result in an unfavorable clinical and nutritional course

Optimising blood glucose control with portioned meal box in type 2 diabetes mellitus patients: a randomised control trial

BackgroundThe impact of dietary factors on glycaemic control in type 2 diabetes mellitus (T2DM) is well established. However, the effectiveness of transforming portion control into a practical innovation for glycaemic control in T2DM has not yet been established for counselling in nutrition. The aim of this study was to compare the effect of general counselling in nutrition (GCN) and a portioned meal box (PMB) on fasting blood glucose, glycated haemoglobin (HbA1c) and body composition.MethodsA randomised, parallel intervention trial was conducted over 12 weeks, with GCN: carbohydrate portion control concept by using food exchange lists (n = 25) and PMB: portioned meal box was set by energy requirements (n = 25).ResultsBoth GCN and PMB demonstrated reductions in HbA1c levels at the 6th and 12th weeks compared to baseline. However, no significant difference in HbA1c was observed between GCN and PMB at either the 6th or 12th week. Using PMB at least four times a week significantly decreased HbA1c during the intervention period (p = 0.021 and p < 0.001 for weeks 6 and 12 when compared with baseline, respectively). Changes in body composition were observed: body weight decrease in PMB only, body fat decrease and constant muscle mass in both groups. Both methods tended to relieve hunger and increased satiety in both groups. The satisfaction evaluation showed that participants preferred to use PMB over GCN (p = 0.001). Additionally, participants consumed less energy, carbohydrate and fat in PMB (p = 0.001, p = 0.019, and p = 0.001, respectively) and less energy and fat in GCN (p = 0.006 and p = 0.001, respectively).ConclusionA better diet, either through GCN or PMB, can play an important role in improving dietary intake compliance and controlling blood glucose

Climaterium, food intake and medicines

Background: Polytherapy treatment is a common practice observed among menopausal patients. This study aimed to quantify food intake and medications in climacteric patients living in community. Methods: Eligible patients from Climacteric Outpatient Clinic (HCFMRP/USP) were recruited. The collected data were: food intake records, age, body weight, height, levels of physical activity and medications in use. Results: Eighty women were studied. Their age was 548 years and body mass index 307kg/m2. They had inadequate dietary Fe, K, Mg, Ca, thiamin, pyridoxine, vitamin E, folate and fiber consumption; 62% used 3 or more medications/day among hypotensive, micronutrients and anti-depressants. Conclusion: Climacteric women need special attention regarding nutrient intake and medication prescription

Efeito da dieta cetogênica clássica no tratamento de crises epilépticas refratárias

Objective The ketogenic diet is used as a therapeutic alternative for the treatment of epilepsy in patients with refractory epilepsy. It simulates biochemical changes typical of fasting. The present study verified the nutritional impact of the ketogenic diet on children with refractory epilepsy. Methods Nutritional status data (dietary, biochemical and anthropometric measurements), seizure frequency, and adverse events were collected from the medical records and during outpatient clinic visits of children over a period of 36 months. Results Of the 29 children who initiated the ketogenic diet, 75.8% presented fewer seizures after one month of treatment. After six months, 48.3% of the patients had at least a 90.0% decrease in seizure frequency, and 50.0% of these patients presented total seizure remission. At 12 months, eight patients continued to show positive results, and seven of these children remained on the ketogenic diet for 24 months. There was an improvement of the nutritional status at 24 months, especially in terms of weight, which culminated with the recovery of proper weight-for-height. There were no significant changes in biochemical indices (total cholesterol and components, triglycerides, albumin, total protein, creatinine, glycemia, serum aspartate transaminase and serum alanine transaminase). Serum cholesterol levels increased significantly in the first month, fell in the following six months, and remained within the normal limits thereafter. Conclusion In conclusion, patients on the classic ketogenic diet for at least 24 months gained weight. Moreover, approximately one third of the patients achieved significant reduction in seizure frequency, and some patients achieved total remission.OBJETIVO: A dieta cetogênica é empregada como uma terapia alternativa para o tratamento da epilepsia em pacientes com epilepsia refratária e simula as alterações bioquímicas de jejum. Neste trabalho, verificouse o impacto nutricional da dieta cetogênica em crianças com epilepsia refratária.\ud MÉTODOS: Os dados sobre o estado nutricional (bioquímica, alimentar e medidas antropométricas), a frequência de crises e os eventos adversos de crianças acompanhadas durante 36 meses foram coletados de prontuários médicos e visitas ambulatoriais.\ud \ud RESULTADOS: Vinte e nove crianças iniciaram o tratamento; após um mês, 75,8% apresentaram redução das crises. Em seis meses, 48,3% dos pacientes tiveram pelo menos 90,0% de redução na frequência de crises, e, desses, 50,0% obtiveram o controle completo das crises. Aos doze meses, oito pacientes continuaram a apresentar Resultados positivos, e, desses, sete permaneceram em dieta cetogênica durante 24 meses. Observouse melhora do estado nutricional aos 24 meses de tratamento, especialmente em termos de peso, o que indica a recuperação da condição peso para altura. Não houve mudanças significativas nos índices bioquímicos analisados (colesterol total e de componentes, triglicerídeos, albumina, proteína total, creatinina, glicemia, transaminase glutâmico oxalacética sérica e transaminase glutâmico pirúvico sérica). Os níveis de colesterol aumentaram significativamente no primeiro mês, mas diminuíram nos seis meses seguintes e, posteriormente, se mantiveram dentro dos valores de referência.\ud \ud CONCLUSÃO: Os pacientes em uso da dieta cetogênica clássica por pelo menos 24 meses apresentaram melhora de peso e cerca de um terço dos pacientes conseguiu uma redução significativa da frequência de crises, com alguns pacientes completamente livres delas

Novel Zinc-Related Differentially Methylated Regions in Leukocytes of Women With and Without Obesity

INTRODUCTION: Nutriepigenetic markers are predictive responses associated with changes in “surrounding” environmental conditions of humans, which may influence metabolic diseases. Although rich in calories, Western diets could be linked with the deficiency of micronutrients, resulting in the downstream of epigenetic and metabolic effects and consequently in obesity. Zinc (Zn) is an essential nutrient associated with distinct biological roles in human health. Despite the importance of Zn in metabolic processes, little is known about the relationship between Zn and epigenetic. Thus, the present study aimed to identify the epigenetic variables associated with Zn daily ingestion (ZnDI) and serum Zinc (ZnS) levels in women with and without obesity. MATERIALS AND METHODS: This is a case-control, non-randomized, single-center study conducted with 21 women allocated into two groups: control group (CG), composed of 11 women without obesity, and study group (SG), composed of 10 women with obesity. Anthropometric measurements, ZnDI, and ZnS levels were evaluated. Also, leukocyte DNA was extracted for DNA methylation analysis using 450 k Illumina BeadChips. The epigenetic clock was calculated by Horvath method. The chip analysis methylation pipeline (ChAMP) package selected the differentially methylated regions (DMRs). RESULTS: The SG had lower ZnS levels than the CG. Moreover, in SG, the ZnS levels were negatively associated with the epigenetic age acceleration. The DMR analysis revealed 37 DMRs associated with ZnDI and ZnS levels. The DMR of PM20D1 gene was commonly associated with ZnDI and ZnS levels and was hypomethylated in the SG. CONCLUSION: Our findings provide new information on Zn's modulation of DNA methylation patterns and bring new perspectives for understanding the nutriepigenetic mechanisms in obesity

14-weeks combined exercise epigenetically modulated 118 genes of menopausal women with prediabetes

Background: Pre-diabetes precedes Diabetes Mellitus (DM) disease and is a critical period for hyperglycemia treatment, especially for menopausal women, considering all metabolic alterations due to hormonal changes. Recently, the literature has demonstrated the role of physical exercise in epigenetic reprogramming to modulate the gene expression patterns of metabolic conditions, such as hyperglycemia, and prevent DM development. In the present study, we hypothesized that physical exercise training could modify the epigenetic patterns of women with poor glycemic control. Methods: 48 post-menopause women aged 60.3 ± 4.5 years were divided according to their fasting blood glucose levels into two groups: Prediabetes Group, PG (n=24), and Normal Glucose Group, NGG (n=24). All participants performed 14 weeks of physical exercise three times a week. The Infinium Methylation EPIC BeadChip measured the participants’ Different Methylated Regions (DMRs). Results: Before the intervention, the PG group had 12 DMRs compared to NGG. After the intervention, five DMRs remained different. Interestingly, when comparing the PG group before and after training, 118 DMRs were found. The enrichment analysis revealed that the genes were related to different biological functions such as energy metabolism, cell differentiation, and tumor suppression. Conclusion: Physical exercise is a relevant alternative in treating hyperglycemia and preventing DM in post-menopause women with poor glycemic control

Can the Brazilian caffeine expectancy questionnaires differentiate the CYP1A2 and ADORA2A gene polymorphisms? : an exploratory study with Brazilian athletes

This study investigated the ability of the Brazilian Caffeine Expectancy Questionnaire (CaffEQ-BR), full and brief versions, to differentiate genetic profiles regarding the polymorphisms of the CYP1A2 (rs 762551) and ADORA2A (rs 5751876) genes in a cohort of Brazilian athletes. Onehundred and fifty participants were genotyped for CYP1A2 and ADORA2A. After the recruitment and selection phase, 71 (90% male and 10% female, regular caffeine consumers) completed the CaffEQ-BR questionnaires and a self-report online questionnaire concerning sociodemographic data, general health status, and frequency of caffeine consumption. The order of completion of the CaffEQBR questionnaires was counterbalanced. The concordance between the full and brief versions of the CaffEQ-BR was analyzed using the intraclass correlation coefficient (ICC). To determine the discriminatory capacity of the questionnaires for genotype, the receiver operating characteristic (ROC) curve was applied for sensitivity and specificity (significance level of 5%). Mean caffeine intake was 244 161 mg day1. The frequency of AA genotypes for CYP1A2 was 47.9% (n = 34) and 52.1% (n = 37) for C-allele carriers (AC and CC). The frequencies of TT genotypes for ADORA2A were 22.7% (n = 15) and 77.3% (n = 51) for C-allele carriers (TC and CC). All CaffEQ-BR factors, for the full and brief versions, were ICCs > 0.75, except for factor 6 (anxiety/negative effects; ICC = 0.60), and presented ROC curve values from 0.464 to 0.624 and 0.443 to 0.575 for CYP1A2 and ADORA2A. Overall, the CaffEQ-BR (full and brief versions) did not show discriminatory capacity for CYP1A2 and ADORA2A gene polymorphisms. In conclusion, the CaffEQ-BR was not able to differentiate genotypes for the CYP1A2 or ADORA2A genes in this group of Brazilian athletes

Older postmenopausal women with lower lean mass have hypermethylated sites in the PI3K-Akt pathway

Introduction: The decrease in lean mass is directly related to the loss of independence, muscle strength, and worse quality of life over the years. Although the genetic determinants of muscle mass were well recognized, recent literature has been uncovering new epigenetic factors affecting the state of muscular tissue. This study aimed to verify differences in the DNA methylation profile among Brazilian postmenopausal women aged 50–70 years according to the lean mass evaluation.Methods: A cross-sectional study comprised 40 women aged 50–70 years. After K-means cluster analysis the 40 participants were divided into two groups, the Lower Lean Mass group with 20 participants (61.1 ± 4.6 years) and the Higher Lean Mass group with 20 participants (60.7 ± 3.2 years). Lean mass was measured by dual-energy X-ray emission densitometry (DEXA). The participants' DNA was extracted using the Salting Out technique and subsequently, the Illumina 850k EPIC Infinium Methylation BeadChip was performed to obtain methylation data.Results: We obtained 1,913 differentially methylated sites (p ≤ 0.005 of β > 5% and β < −5%) in a total of 979 genes between groups (p ≤ 0.005; −5% > β > 5%). In addition, the PI3K-Akt pathway had the greatest power of significance with an FDR of 4.6 × 10–3.Conclusion: Our results demonstrate a differentiation between specific sites of different genes, which have essential functions in body composition and energy metabolism, supporting future studies that aim to relate lean mass with epigenetics