Efeito da oferta dietética de proteína sobre o ganho muscular, balanço nitrogenado e cinética da 15N-glicina de atletas em treinamento de musculação Effect of the dietary protein intake on the muscular gain, nitrogen balance and 15N-glycine kinetics of athletes in resistance training

O efeito da oferta crescente de proteína sobre o ganho muscular, balanço nitrogenado e cinética da 15N-glicina de atletas de musculação foi estudado em seis jovens saudáveis, praticantes de treinamento com pesos (> 2 anos), sem uso de anabolizantes e concordes com os princípios éticos da pesquisa. Todos receberam adequações dietéticas (0,88g de proteína/kg/dia) pré-experimento de 2 semanas (D1) após o que se ofereceu, por idêntico período, dieta contendo 1,5g de proteína/kg de peso corporal/dia com 30kcal/g de proteína (dieta D2). A seguir receberam, nas próximas 2 semanas, a dieta D3, contendo 2,5g de proteína/kg de peso corporal/dia e 30 kcal/g proteína. As avaliações antropométricas, alimentares, biquímicas, balanço nitrogenado (BN) e cinética com 15N-glicina foram realizadas no início do estudo, pós D1 (M0) e no último dia das dietas D2 (M1) e D3 (M2). Ao final do estudo (4 semanas) houve aumento significativo na massa muscular (1,63±0,9kg), sem diferença entre D2 e D3. O BN acompanhou o consumo protéico/energético (M0 = -7,8g/dia; M1 = 5,6g/dia e M2 = 16,6g/dia) e a síntese protéica acompanhou o BN, com significância estatística (p<0,05) em relação ao basal (M0) mas semelhante entre D2 e D3 (M1 = 49,8±12,2g N/dia e M2 = 52,5±14,0g N/dia) e sem alteração significativa do catabolismo. Assim, os dados de BN e cinética da 15N-glicina indicam que a ingestão protéica recomendável para esses atletas é superior ao preconizado para sedentários (0,88g/kg) e inferior a 2,5g/kg de peso, sendo no caso, 1,5g de proteína/kg de peso/dia com ajuste do consumo energético para 30 kcal/g de proteína.<br>The effect of increased protein intake on the muscle mass gain, nitrogen balance and 15N-glycine kinetics was studied in six young, healthy subjects practitioners of strength training (> 2 years), without use of anabolic steroids and in agreement with the ethical principles of the research. All athletes received adequate diet (0.88g protein/kg/day) during 2 weeks prior the study (D1), and thereafter with diet providing 1.5g of protein/kg/day and 30kcal/g of protein (D2 diet) for the subsequent 2 weeks. Later on, they all received diet with 2.5g of protein/kg/day (D3 diet) and 30 kcal/g protein for the last two weeks. Body composition, food intake, blood biochemistry, nitrogen balance (NB) and 15N-glycine kinetics were determined at the beginning, after D1 (M0) and in the last days of the D2 (M1) and D3 (M2). The results showed at the end of the study (4 weeks) significant increase in muscle mass (1.63±0.9kg), without difference between D2 and D3. The NB followed the protein/energy consumption (M0 = -7.8g/day; M1 = 5.6g/day and D3 = 16.6g/day), the protein synthesis followed the NB, with M0 < (M1=M2) (M1 = 49.8±12.2g N/day and M2 = 52.5±14.0g N/day). Protein catabolism rate was similarly kept among diets. Thus, the results of the NB and 15N-glycine kinetics indicate that the recommended protein intake for these athletes is higher than the one for sedentary adults (0.88g/kg) and lower than 2.5g/kg, around 1.5g of protein/kg/day, with adjustment of the energy consumption to 30 kcal/g of protein

Health effects of protein intake in healthy adults: a systematic literature review

The purpose of this systematic review is to assess the evidence behind the dietary requirement of protein and to assess the health effects of varying protein intake in healthy adults. The literature search covered the years 2000&#x2013;2011. Prospective cohort, case-control, and intervention studies were included. Out of a total of 5,718 abstracts, 412 full papers were identified as potentially relevant, and after careful scrutiny, 64 papers were quality graded as A (highest), B, or C. The grade of evidence was classified as convincing, probable, suggestive or inconclusive. The evidence is assessed as: probable for an estimated average requirement of 0.66 g good-quality protein/kg body weight (BW)/day based on nitrogen balance studies, suggestive for a relationship between increased all-cause mortality risk and long-term low-carbohydrate&#x2013;high-protein (LCHP) diets; but inconclusive for a relationship between all-cause mortality risk and protein intake per se; suggestive for an inverse relationship between cardiovascular mortality and vegetable protein intake; inconclusive for relationships between cancer mortality and cancer diseases, respectively, and protein intake; inconclusive for a relationship between cardiovascular diseases and total protein intake; suggestive for an inverse relationship between blood pressure (BP) and vegetable protein; probable to convincing for an inverse relationship between soya protein intake and LDL cholesterol; inconclusive for a relationship between protein intake and bone health, energy intake, BW control, body composition, renal function, and risk of kidney stones, respectively; suggestive for a relationship between increased risk of type 2 diabetes (T2D) and long-term LCHP-high-fat diets; inconclusive for impact of physical training on protein requirement; and suggestive for effect of physical training on whole-body protein retention. In conclusion, the evidence is assessed as probable regarding the estimated requirement based on nitrogen balance studies, and suggestive to inconclusive for protein intake and mortality and morbidity. Vegetable protein intake was associated with decreased risk in many studies. Potentially adverse effects of a protein intake exceeding 20&#x2013;23 E% remain to be investigated

Protein turnover, amino acid requirements and recommendations for athletes and active population

info:eu-repo/semantics/publishe

Riociguat treatment in patients with chronic thromboembolic pulmonary hypertension: Final safety data from the EXPERT registry

Objective: The soluble guanylate cyclase stimulator riociguat is approved for the treatment of adult patients with pulmonary arterial hypertension (PAH) and inoperable or persistent/recurrent chronic thromboembolic pulmonary hypertension (CTEPH) following Phase 3 randomized trials. The EXPosurE Registry RiociguaT in patients with pulmonary hypertension (EXPERT) study was designed to monitor the long-term safety of riociguat in clinical practice. Methods: EXPERT was an international, multicenter, prospective, uncontrolled, non-interventional cohort study of patients treated with riociguat. Patients were followed for at least 1 year and up to 4 years from enrollment or until 30 days after stopping riociguat treatment. Primary safety outcomes were adverse events (AEs) and serious adverse events (SAEs) coded using Medical Dictionary for Regulatory Activities preferred terms and System Organ Classes version 21.0, collected during routine clinic visits and collated via case report forms. Results: In total, 956 patients with CTEPH were included in the analysis. The most common AEs in these patients were peripheral edema/edema (11.7%), dizziness (7.5%), right ventricular (RV)/cardiac failure (7.7%), and pneumonia (5.0%). The most common SAEs were RV/cardiac failure (7.4%), pneumonia (4.1%), dyspnea (3.6%), and syncope (2.5%). Exposure-adjusted rates of hemoptysis/pulmonary hemorrhage and hypotension were low and comparable to those in the long-term extension study of riociguat (Chronic Thromboembolic Pulmonary Hypertension Soluble Guanylate Cyclase–Stimulator Trial [CHEST-2]). Conclusion: Data from EXPERT show that in patients with CTEPH, the safety of riociguat in routine practice was consistent with the known safety profile of the drug, and no new safety concerns were identified