Relação entre a suplementação de proteína do soro do leite e hipertrofia muscular: uma revisão

A utilização de proteínas e aminoácidos comerciais tem aumentado entre os atletas e praticantes de atividade física. Entretanto, estudos demonstram que esta população não tem o conhecimento adequado sobre quais os reais efeitos da suplementação de proteína do soro do leite no metabolismo muscular. Sendo assim, o objetivo desta revisão é discorrer acerca da utilização de proteína do soro do leite e o ganho de massa muscular. Para tanto, buscou-se informações mediante revisão de artigos apresentados nos sites Science Direct, Bireme, Lilacs e Pubmed. Os termos utilizados em português e inglês foram: proteína do soro do leite, hipertrofria, composição corporal, massa muscular e síntese miofibrilar. Para os critérios de inclusão dos estudos considerou-se: a utilização da suplementação de proteína do soro do leite por indivíduos que realizassem atividade física com o objetivo de hipertrofia muscular. A suplementação em atletas não foi considerada. Todos as pesquisas priorizaram também a adequação da alimentação quanto aos macronutrientes antes da administração do suplemento. A combinação de evidências encontradas sugere que a suplementação de proteína do soro do leite associada a exercícios de resistência ou força é eficiente na síntese de proteína miofibrilar, portanto, hipertrofia muscular. Entretanto, é preciso cautela na inclusão de suplementação proteica, uma vez que a proteína proveniente da dieta também é eficiente em promover reparo e síntese muscular. Ao optar pela proteína do soro do leite é necessário considerar as demais proteínas da alimentação, assim como os outros nutrientes a fim de manter o suporte necessário para o desempenho físico eficiente. ABSTRACTRelationship between whey protein supplementation and muscle hypertrophy: A reviewThe use of proteins and amino acids has increased among athletes. However, studies have shown this population still does not have the proper knowledge about what the actual effects of supplementation of whey protein in muscle metabolism. Thus, the aim of this review is to discuss about the use of whey protein and muscle mass gain. To this end, we sought information upon review of submitted articles in Science Direct, Bireme, Lilacs and Pub Med. Terms used in portuguese and english were: whey protein, hypertrophy, body composition, lean mass and myofibrillar protein synthesis. The criteria for inclusion of studies considered: the use of protein supplementation of whey by individuals who performed physical activity with the goal of muscle hypertrophy. The supplementation in athletes was not considered. All research also prioritized feeding adequacy regarding macronutrients before administration of the supplement. The combination of evidence found suggests that supplementation of whey protein associated with resistance exercise or strength is effective in myofibrillar protein synthesis, therefore muscle hypertrophy. However, caution is required in the inclusion of protein supplementation, since the protein from diet is also effective in promoting muscle synthesis and repair. By choosing whey proteins, is necessary to consider the feed, as well as other nutrients in order to maintain the necessary support for efficient physical performance

METODOLOGIA PARA TESTES DE ACEITABILIDADE DE PRODUTOS EM PASTA

Testes de aceitabilidade de produtos pastosos como queijos creme, patês, doces em pasta, etc, exigem a complementação por elemento suporte. Para a realização do teste, o produto deve ser aplicado socre o elemento suporte, e baseado nisso determinou-se a sistemática do procedimento. A análise dos resultados dos testes, permite identificar as características de consumo, quantificado numericamente. Exemplo teórico ilustra a metodologia

Relação entre a suplementação de proteína do soro do leite e hipertrofia muscular: uma revisão

Relationship between whey protein supplementation and muscle hypertrophy: A reviewThe use of proteins and amino acids has increased among athletes. However, studies have shown this population still does not have the proper knowledge about what the actual effects of supplementation of whey protein in muscle metabolism. Thus, the aim of this review is to discuss about the use of whey protein and muscle mass gain. To this end, we sought information upon review of submitted articles in Science Direct, Bireme, Lilacs and Pub Med. Terms used in portuguese and english were: whey protein, hypertrophy, body composition, lean mass and myofibrillar protein synthesis. The criteria for inclusion of studies considered: the use of protein supplementation of whey by individuals who performed physical activity with the goal of muscle hypertrophy. The supplementation in athletes was not considered. All research also prioritized feeding adequacy regarding macronutrients before administration of the supplement. The combination of evidence found suggests that supplementation of whey protein associated with resistance exercise or strength is effective in myofibrillar protein synthesis, therefore muscle hypertrophy. However, caution is required in the inclusion of protein supplementation, since the protein from diet is also effective in promoting muscle synthesis and repair. By choosing whey proteins, is necessary to consider the feed, as well as other nutrients in order to maintain the necessary support for efficient physical performance.A utilização de proteínas e aminoácidos comerciais tem aumentado entre os atletas e praticantes de atividade física. Entretanto, estudos demonstram que esta população não tem o conhecimento adequado sobre quais os reais efeitos da suplementação de proteína do soro do leite no metabolismo muscular. Sendo assim, o objetivo desta revisão é discorrer acerca da utilização de proteína do soro do leite e o ganho de massa muscular. Para tanto, buscou-se informações mediante revisão de artigos apresentados nos sites Science Direct, Bireme, Lilacs e Pubmed. Os termos utilizados em português e inglês foram: proteína do soro do leite, hipertrofria, composição corporal, massa muscular e síntese miofibrilar. Para os critérios de inclusão dos estudos considerou-se: a utilização da suplementação de proteína do soro do leite por indivíduos que realizassem atividade física com o objetivo de hipertrofia muscular. A suplementação em atletas não foi considerada. Todos as pesquisas priorizaram também a adequação da alimentação quanto aos macronutrientes antes da administração do suplemento. A combinação de evidências encontradas sugere que a suplementação de proteína do soro do leite associada a exercícios de resistência ou força é eficiente na síntese de proteína miofibrilar, portanto, hipertrofia muscular. Entretanto, é preciso cautela na inclusão de suplementação proteica, uma vez que a proteína proveniente da dieta também é eficiente em promover reparo e síntese muscular. Ao optar pela proteína do soro do leite é necessário considerar as demais proteínas da alimentação, assim como os outros nutrientes a fim de manter o suporte necessário para o desempenho físico eficiente.

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society