In Patients with Established RA, Positive Effects of a Randomised Three Month WBV Therapy Intervention on Functional Ability, Bone Mineral Density and Fatigue Are Sustained for up to Six Months

Functional ability is often impaired for people with rheumatoid arthritis (RA), rendering these patients highly sedentary. Additionally, patients with RA often take medication known to negatively affect bone mass. Thus improving functional ability and bone health in this group of patients is important. The aim of this study was to investigate the effects of whole body vibration (WBV) therapy in patients with stable, established RA. Thirty one females with RA were randomly assigned to a control group (CON, n = 15) who continued with their normal activities or a WBV group (n = 16) who underwent a three month WBV therapy intervention, consisting of 15 minutes of intermittent vibration, performed twice per week. Patients were assessed at baseline, three months, and three months post intervention for functional ability using the modified Health Assessment Questionnaire; for RA disease activity using the Clinical Disease Activity Index, for quality of life using self-report fatigue and pain scores; for physical activity profiles using accelerometry, and for BMD and body composition using DXA. Patients in both groups were matched for all variables at baseline. After the intervention period, functional ability was significantly improved in the WBV group (1.22(0.19) to 0.92(0.19), p = 0.02). Hip BMD was significantly reduced in the CON group (0.97(0.05) to 0.84(0.05) g.cm-2, p = 0.01), while no decreases were seen in the WBV group (1.01(0.05) to 0.94(0.05) g.cm-2, p = 0.50). Despite no change in RA disease activity in either group at either follow up, fatigue levels were improved in the WBV group (4.4(0.63) to 1.1(0.65), yet remained unchanged in the CON group at both follow ups (p = 0.01). Ten minute bouts of light to moderate physical activity were significantly reduced in the CON group after the intervention (2.8(0.61) to 1.8(0.64) bouts per day, p = 0.01), and were preserved in the WBV group (3.1(0.59) to 3.0(0.61) bouts per day, p = 0.70). Intermittent WBV shows promise for sustained improvements in functional ability, for attenuating loss of bone mass at the hip, as well as for decreasing fatigue in patients with established RA. TRIAL REGISTRATION: Pan African Clinical Trials Registry PACTR201405000823418

High plasma uric acid concentration: causes and consequences

High plasma uric acid (UA) is a precipitating factor for gout and renal calculi as well as a strong risk factor for Metabolic Syndrome and cardiovascular disease. The main causes for higher plasma UA are either lower excretion, higher synthesis or both. Higher waist circumference and the BMI are associated with higher insulin resistance and leptin production, and both reduce uric acid excretion. The synthesis of fatty acids (tryglicerides) in the liver is associated with the de novo synthesis of purine, accelerating UA production. The role played by diet on hyperuricemia has not yet been fully clarified, but high intake of fructose-rich industrialized food and high alcohol intake (particularly beer) seem to influence uricemia. It is not known whether UA would be a causal factor or an antioxidant protective response. Most authors do not consider the UA as a risk factor, but presenting antioxidant function. UA contributes to > 50% of the antioxidant capacity of the blood. There is still no consensus if UA is a protective or a risk factor, however, it seems that acute elevation is a protective factor, whereas chronic elevation a risk for disease

Efeito de um programa misto de intervenção nutricional e exercício físico sobre a composição corporal e os hábitos alimentares de mulheres obesas em climatério The effects of a mixed program of nutritional intervention and physical exercise on body composition and feeding habits of obese climacteric women

OBJETIVO: Foi avaliar o efeito de programa misto de intervenção nutricional e exercício físico sobre a composição corporal e hábitos alimentares de mulheres obesas em climatério. MÉTODOS: Trabalhou-se com 2 grupos de 15 pessoas por 40 semanas: Grupo Dieta (intervenção nutricional) e Grupo Exercício (intervenção nutricional e exercício). RESULTADO: As reduções do peso (-2,3kg para Grupo Dieta e -5,3kg para o Grupo Exercício) e da circunferência da cintura (-4,8cm para Grupo Dieta e -7,6cm para Grupo Exercício), foram maiores para o Grupo Exercício. Foi verificada evolução positiva na classificação do Índice de Massa Corporal para ambos os grupos, sendo que o Grupo Exercício respondeu melhor ao tratamento. O padrão alimentar foi considerado monótono e com baixo consumo de alimentos regionais. CONCLUSÃO: O programa foi efetivo para perda de peso, em maior intensidade na presença de exercício. A educação alimentar proposta foi capaz de acarretar mudanças nos hábitos alimentares.<br>OBJECTIVE: The effects of a mixed program of nutrition intervention and physical exercise on body composition and feeding habits were evaluated in obese climacteric women. METHODS: Thirty participants were randomly assigned in 2 groups during 40 weeks: Diet Group (nutritional intervention) and Exercise Group (nutritional intervention and exercise). RESULTS: Weight reductions (Diet Group 2,3kg/Exercise Group -5,3kg) and waist circunference (Diet Group -4,8cm/Exercise Group 7,6cm) were greater in Exercise Group. A positive evolution was noticed in the Body Mass Index in both groups, with Exercise Group having better answer to treatment. It was observed a monotonous feeding pattern and low compliance to the consumption of regional typical foods. CONCLUSION: We concluded that the program was effective for weight loss at a higher intensity in the presence of exercise and the feeding education was able to modify the feeding habits

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