Publications by authors named "Julio Sergio Marchini"

102 Publications

Taurine supplementation associated with exercise increases mitochondrial activity and fatty acid oxidation gene expression in the subcutaneous white adipose tissue of obese women.

Clin Nutr 2021 Apr 5;40(4):2180-2187. Epub 2020 Oct 5.

School of Physical Education and Sport of Ribeirao Preto, University of Sao Paulo -EEFERP USP, Ribeirao Preto, Sao Paulo, Brazil; Department of Food and Nutrition, School of Pharmaceutical Sciences of Araraquara, State University of Sao Paulo - FCF UNESP, Araraquara, Sao Paulo, Brazil. Electronic address:

Purpose: To evaluate the effects of taurine supplementation associated or not with chronic exercise on body composition, mitochondrial function, and expression of genes related to mitochondrial activity and lipid oxidation in the subcutaneous white adipose tissue (scWAT) of obese women.

Methods: A randomized and double-blind trial was developed with 24 obese women (BMI 33.1 ± 2.9 kg/m, 32.9 ± 6.3 y) randomized into three groups: Taurine supplementation group (Tau, n = 8); Exercise group (Ex, n = 8); Taurine supplementation + exercise group (TauEx, n = 8). The intervention was composed of 3 g of taurine or placebo supplementation and exercise training for eight weeks. Anthropometry, body fat composition, indirect calorimetry, scWAT biopsy for mitochondrial respiration, and gene expression related to mitochondrial activity and lipid oxidation were assessed before and after the intervention.

Results: No changes were observed for the anthropometric characteristics. The Ex group presented an increased resting energy expenditure rate, and the TauEx and Ex groups presented increased lipid oxidation and a decreased respiratory quotient. Both trained groups (TauEx and Ex) demonstrated improved scWAT mitochondrial respiratory capacity. Regarding mitochondrial markers, no changes were observed for the Tau group. The TauEx group had higher expression of CIDEA, PGC1a, PRDM16, UCP1, and UCP2. The genes related to fat oxidation (ACO2 and ACOX1) were increased in the Tau and Ex groups, while only the TauEx group presented increased expression of CPT1, PPARa, PPARγ, LPL, ACO1, ACO2, HSL, ACOX1, and CD36 genes.

Conclusion: Taurine supplementation associated with exercise improved lipid metabolism through the modulation of genes related to mitochondrial activity and fatty acid oxidation, suggesting a browning effect in the scWAT of obese women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnu.2020.09.044DOI Listing
April 2021

Should we use ferritin in the diagnostic criteria of iron deficiency in heart failure patients?

Clin Nutr ESPEN 2020 10 5;39:119-123. Epub 2020 Aug 5.

Department of Internal Medicine, Medical School of Ribeirao Preto - University of Sao Paulo, Av. Bandeirantes n. 3900, CEP 14048-900, Ribeirão Preto, São Paulo, Brazil. Electronic address:

Background And Aims: Iron deficiency (ID) is a common comorbidity in patients with chronic heart failure (HF) and is associated with worse prognosis. We aimed at comparing the currently European Society of Cardiology (ESC) criterion for diagnosis of ID (ferritin < 100 μg/L or ferritin 100-299 μg/L with transferrin saturation [TSAT] < 20%) with either isolated low TSAT or isolated low ferritin on survival, in a cohort of HF patients.

Methods: This was an observational prospective study, investigating ambulatory patients with HF and reduced ejection fraction (n = 108). All patients were assessed for clinical aspects and iron indexes. The primary endpoint was all-cause death.

Results: Abnormal iron status was observed in 50 (46%) of patients. During the median follow-up time of 857.5 [647-899] days, 31 patients died (29%). In univariate analyses ESC-criterion (p = 0.022) and isolated TSAT <20% (p = 0.002), but not isolated ferritin <100 μg/L (p = 0.439), were significantly related to an increased risk of all-cause death. However, in multivariate analyses only TSAT <20% (HR = 2.3; [95% CI: 1.11-4.85]; p = 0.026) was independently related to all-cause mortality.

Conclusions: Our results indicated that diagnosis of ID based on isolated TSAT <20% identifies HF patients with worse prognosis, while ferritin was not associated with mortality risk, suggesting that ferritin should not be taken into account for evaluation of clinical impact of ID in HF patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnesp.2020.07.008DOI Listing
October 2020

Regional cerebral blood flow at rest in obesity.

Nutrition 2020 Nov - Dec;79-80:110888. Epub 2020 Jun 2.

Section of Nuclear Medicine, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; Division of Medical Nutrition, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; The Center for Interdisciplinary Research on Applied Neurosciences, University of São Paulo, São Paulo, Brazil.

Objectives: Imaging studies have shown brain abnormalities associated with eating behavior (taste perception, food intake, and food reward), neural connectivity, and cognition related to obesity. The aim of this study was to investigate whether obese individuals have changes in regional cerebral blood flow (rCBF) during fasting and rest using single-photon emission computed tomography (SPECT), and whether these differences are associated with body fat and serum levels of leptin, insulin, and glucose.

Methods: For this purpose, rCBF assessed by ([99]Tc)-ECD-SPECT was compared between 10 obese women (30 ± 5 y of age, body fat: 38 ± 3 kg) and 10 lean women (30 ± 6 y of age, body fat: 17 ± 5 kg) using statistical parametric mapping. Pearson's coefficient and linear regression were used to search for associations among variables.

Results: The obese women showed antagonic rCBF in the left frontoparietal region and greater rCBF in areas related to the default mode network and the salience network (P = 0.0001). Positive linear correlations of rCBF, body fat, and the serum levels of glucose and insulin were found, but no associations were detected using linear regression.

Conclusion: Obese women showed rCBF differences in areas related to the frontoparietal neural circuit, the default mode network, and the salience network, suggesting loss of cognitive control and a higher perception of physiologic processes, such as hunger. Hyperactivation in these areas might jeopardize the recognition of changes in energy homeostasis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2020.110888DOI Listing
June 2020

Taurine Supplementation Increases Post-Exercise Lipid Oxidation at Moderate Intensity in Fasted Healthy Males.

Nutrients 2020 May 25;12(5). Epub 2020 May 25.

Department of Food and Nutrition. School of Pharmaceutical Sciences of Araraquara. State University of São Paulo, Araraquara 14801-902, Brazil.

Based on the fact that taurine can increase lipid metabolism, the objective of the present study was to evaluate the effects of different doses of acute taurine supplementation on lipid oxidation levels in healthy young men after a single bout of fasting aerobic exercise. A double-blind, acute, and crossover study design was conducted. Seventeen men (age 24.8 ± 4.07y; BMI: 23.9 ± 2.57 kg/m²) participated in the present study. Different doses of taurine (TAU) (3 g or 6 g) or placebo were supplemented 90 minutes before a single bout of fasting aerobic exercise (on a treadmill at 60% of VO2 max). The subjects performed three trials, and each one was separated by seven days. Blood samples were collected at baseline and after the exercise protocol of each test to analyze plasma levels of glycerol and taurine. Lipid and carbohydrate oxidation were determined immediately after exercise for 15 minutes by indirect calorimetry. We observed that TAU supplementation (6 g) increased lipid oxidation (38%) and reduced the respiratory coefficient (4%) when compared to the placebo ( < 0.05). However, no differences in lipid oxidation were observed between the different doses of taurine (3 g and 6 g). For glycerol concentrations, there were no differences between trials. Six grams of TAU supplementation 90 minutes before a single bout of aerobic exercise in a fasted state was sufficient to increase the lipid oxidation post-exercise in healthy young men.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.3390/nu12051540DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285212PMC
May 2020

Noninvasive neuromodulation of the prefrontal cortex in young women with obesity: a randomized clinical trial.

Int J Obes (Lond) 2020 06 19;44(6):1279-1290. Epub 2020 Feb 19.

Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA.

Background/objectives: Obesity is associated with reduced neurocognitive performance. Individuals with obesity show decreased activation in the left dorsolateral prefrontal cortex (DLPFC), a key brain region relevant to the regulation of eating behavior. Transcranial direct current stimulation (tDCS) has emerged as a potential technique to correct these abnormalities. However, there is limited information to date, particularly in clinical settings and regarding long-term effects of tDCS. This study aimed to investigate the effects of DLPFC-targeted tDCS in young women with obesity.

Subject/methods: Randomized, double-blind, sham-controlled parallel-design clinical trial conducted in 38 women, aged 20-40 years, with BMI 30-35 kg/m.

Study Design: Phase I: target engagement (immediate effects of tDCS on working memory performance), Phase II: tDCS only (ten sessions, 2 weeks), Phase III: tDCS + hypocaloric diet (six sessions, 30% energy intake reduction, 2 weeks, inpatient), Phase IV: follow-up at 1, 3, and 6 months.

Primary Outcome: change in body weight.

Secondary Outcomes: change in eating behavior and appetite. Additional analyses: effect of Catechol-O-methyl transferase (COMT) gene variability. Data were analyzed as linear mixed models.

Results: There was no group difference in change in body weight during the tDCS intervention. At follow-up, the active group lost less weight than the sham group. In addition, the active group regained weight at 6-month follow-up, compared with sham. Genetic analysis indicated that COMT Met noncarriers were the subgroup that accounted for this paradoxical response in the active group.

Conclusion: Our results suggest that in young women with class I obesity, tDCS targeted to the DLPFC does not facilitate weight loss. Indeed, we found indications that tDCS could have a paradoxical effect in this population, possibly connected with individual differences in dopamine availability. Future studies are needed to confirm these findings.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1038/s41366-020-0545-3DOI Listing
June 2020

The effects of short-term combined exercise training on telomere length in obese women: a prospective, interventional study.

Sports Med Open 2020 Jan 16;6(1). Epub 2020 Jan 16.

Internal Medicine Department, Ribeirao Preto Medical School, University of Sao Paulo, Av. Bandeirantes 3900, Ribeirão Preto, 14049-900, Brazil.

Background: Telomere length is inversely associated with the senescence and aging process. Parallelly, obesity can promote telomere shortening. Evidence suggests that physical activity may promote telomere elongation.

Objective: This study's objective is to evaluate the effects of combined exercise training on telomere length in obese women.

Design And Methods: Twenty pre-menopausal women (BMI 30-40 kg/m, 20-40 years) submitted to combined training (strength and aerobic exercises), but only 13 finished the protocol. Each exercise session lasted 55 min/day, three times a week, throughout 8 weeks. Anthropometric data, body composition, physical performance (Vo), and 8-h fasting blood samples were taken before and after 8 weeks of training. Leukocyte DNA was extracted for telomere length by RT-qPCR reaction, using the 2 methodology.

Results: After the training intervention, significant differences (p < 0.05) were observed in telomere length (respectively before and after, 1.03 ± 0.04 to 1.07 ± 0.04 T/S ratio), fat-free mass (46 ± 7 to 48 ± 5 kg), Vo (35 ± 3 to 38 ± 3 ml/kg/min), and waist circumference (96 ± 8 to 90 ± 6 cm). In addition, an inverse correlation between waist circumference and telomere length was found, before (r = - 0.536, p = 0.017) and after (r = - 0.655, p = 0.015) exercise training.

Conclusion: Combined exercise promoted leukocyte telomere elongation in obese women. Besides, the data suggested that greater waist circumference may predict shorter telomere length.

Clinical Trial Registration: ClinicalTrails.gov, NCT03119350. Retrospectively registered on 18 April 2017.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s40798-020-0235-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6965549PMC
January 2020

IS THERE ANY CHANGE IN PHENOTYPIC CHARACTERISTICS COMPARING 5 TO 10 YEARS OF FOLLOW-UP IN OBESE PATIENTS UNDERGOING ROUX-EN-Y GASTRIC BYPASS?

Arq Bras Cir Dig 2019 21;32(3):e1453. Epub 2019 Oct 21.

Internal Medicine Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil.

Background: : Bariatric surgery promotes significant weight loss and improvement of associated comorbidities; however, nutrients deficiencies and weight regain may occur in the middle-late postoperative period.

Aim: To investigate nutritional status in 10 years follow-up.

Methods: : Longitudinal retrospective study in which anthropometric, biochemical indicators and nutritional intake were assessed before and after one, two, three, four, five and ten years of Roux-en Y gastric bypass through analysis of medical records.

Results: : After ten years there was a reduction of 29.2% of initial weight; however, 87.1% of patients had significant weight regain. Moreover, there was an increase of incidence of iron (9.2% to 18.5%), vitamin B12 (4.2% to 11.1%) and magnesium deficiency (14.1% to 14.8%). Folic acid concentrations increased and the percentage of individuals with glucose (40.4% to 3.7%), triglycerides (38% to 7.4%), HDL cholesterol (31 % to 7.4%) and uric acid (70.5% to 11.1%) abnormalities reduced. Also, there is a reduction of food intake at first year postoperative. After 10 years, there was an increase in energy, protein and lipid intake, also a reduction in folid acid intake.

Conclusions: : Roux-en Y gastric bypass is an effective procedure to promote weight loss and improve comorbidities associated with obesity. However, comparison between postoperative period of five and 10 years showed a high prevalence of minerals deficiency and a significant weight regain, evidencing the need for nutritional follow-up in the postoperative period.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/0102-672020190001e1453DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6812142PMC
October 2019

Severe malnutrition after bariatric surgery and clinic manifestations of infection.

Rev Assoc Med Bras (1992) 2019 10;65(9):1151-1155. Epub 2019 Oct 10.

. Divisão de Nutrologia do Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brasil.

This report describes the post-bariatric-surgery evolution of an obese patient who had low adherence to the diet and micronutrient supplementation. Four years after two bariatric surgeries, the patient was admitted due to transient loss of consciousness, slow thinking, anasarca, severe hypoalbuminemia, in addition to vitamin and mineral deficiencies. She had subcutaneous foot abscess but did not present fever. Received antibiotics, vitamins A, D, B12, thiamine, calcium, and parenteral nutrition. After hospitalization (twenty-eight days), there was a significant body weight reduction probably due to the disappearance of clinical anasarca. Parenteral nutrition was suspended after twenty-five days, and the oral diet was kept fractional. After hospitalization (weekly outpatient care), there was a gradual laboratory data improvement, which was now close to the reference values. Such outcome shows the need for specialized care in preventing and treating nutritional complications after bariatric surgeries as well as clinical manifestations of infection in previously undernourished patients.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1590/1806-9282.65.9.1151DOI Listing
October 2019

Physical training, UCP1 expression, mitochondrial density, and coupling in adipose tissue from women with obesity.

Scand J Med Sci Sports 2019 Nov 22;29(11):1699-1706. Epub 2019 Jul 22.

Nutrology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Background: Exercise training may improve energy expenditure, thermogenesis, and oxidative capacities. Therefore, we hypothesized that physical training enhances white adipose tissue mitochondrial oxidative capacity from obese women.

Objective: To evaluate mitochondrial respiratory capacity, mitochondrial content, and UCP1 gene expression in white adipose tissue from women with obesity before and after the physical training program.

Methods: Women (n = 14, BMI 33 ± 3 kg/m , 35 ± 6 years, mean ± SD) were submitted to strength and aerobic exercises (75%-90% maximum heart rate and multiple repetitions), 3 times/week during 8 weeks. All evaluated subjects were paired, before and after training for resting metabolic rate (RMR), substrate oxidation (lipid and carbohydrate) by indirect calorimeter, deuterium oxide body composition, and aerobic maximum velocity (V ) test. At the beginning and at the ending of the protocol, abdominal subcutaneous adipose tissue was collected to measure the mitochondrial respiration by high-resolution respirometry, mitochondrial content by citrate synthase (CS) activity, and UCP1 gene expression by RT-qPCR.

Results: Combined physical training increased RMR, lipid oxidation, and V but did not change body weight/composition. In WAT, exercise increased CS activity, decreased mitochondrial uncoupled respiration and mRNA of UCP1. RMR was positively correlated with fat-free mass.

Conclusion: Physical training promotes an increase in mitochondrial content without changing tissue respiratory capacity, a reduction in mitochondrial uncoupling degree and UCP1 mRNA expression in WAT. Finally, it improved the resting metabolic rate, lipid oxidation and physical performance, independent of the body changing free, or fat mass in obese women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/sms.13514DOI Listing
November 2019

Taurine supplementation increases irisin levels after high intensity physical training in obese women.

Cytokine 2019 11 18;123:154741. Epub 2019 Jun 18.

Department of Food and Nutrition, School of Pharmaceutical Sciences of Araraquara, State University of São Paulo, Rod. Araraquara - Jau Km 1, Araraquara, SP, Brazil; School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Av. Bandeirantes 3900, Ribeirão Preto, SP, Brazil. Electronic address:

Background: Irisin is a myokine/adipokine that under stimulus of physical exercise is able to improve thermogenic capacity in adipose tissue. Likewise, taurine supplementation has demonstrated similar effects on energy metabolism. Therefore, we hypothesized that taurine supplementation combined with physical training may induce an increase in irisin concentrations, optimizing energy metabolism in obese individuals.

Objective: To evaluate if taurine supplementation associated with a high intensity physical training program increases irisin levels in obese women.

Methods: double-blind study with 22 obese women (BMI 32.4 ± 2.0 kg/m, 36.6 ± 6.4 years and sedentary) who were randomly divided into two groups, control group (GC, n = 14), exercised and supplemented with placebo (3 g of starch), and taurine group (GTAU, n = 8), exercised and supplemented with taurine (3 g). The subjects performed high intensity physical training, Deep Water Running (DWR), for 8 weeks, 3 times/week, for 50 min per training session, at 70-85% maximum heart rate. Resting metabolic rate (RMR) was evaluated by indirect calorimetry, body composition by deuterium oxide, plasma taurine by HPLC, plasma irisin by Multiplex Kit, and food consumption by food records. The results were analyzed by an ANOVA two way repeated measures mixed model, with the Sidak post hoc (p < 0.05).

Results: No changes were observed in body composition. DWR increased RMR independent of supplementation (p < 0.001) and irisin levels (pg/mL) showed a significant difference only in the GTAU in 1 h after exercise (p < 0.001).

Conclusion: DWR associated with taurine supplementation resulted in increased plasma irisin concentrations after physical training in obese adult women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cyto.2019.154741DOI Listing
November 2019

Green tea supplementation improves oxidative stress biomarkers and modulates IL-6 circulating levels in obese women.

Nutr Hosp 2019 Jul;36(3):583-588

Ribeirão Preto Medical School. University of São Paulo.

Introduction: Introduction: obesity is associated with high levels of oxidative stress (OS) and inflammation. There is a lot of evidence that some polyphenols, such as green tea, have a positive impact on the OS state and consecutively, on inflammation. Objectives: the purposes of this study were: a) evaluate OS biomarkers in both obese and normal weight women; and b) evaluate if green tea supplementation has an impact on OS and inflammatory cytokine biomarkers of obese women. Methods: we evaluated obese (body mass index [BMI] ≥ 40 kg/m²) and normal weight (BMI between 18.5 and 24.9 kg/m²) women. Blood samples were used to access malondialdehyde (MDA), trolox equivalent antioxidant capacity (TEAC) and inflammatory cytokines. We randomly chose obese patients (18 individuals) and then gave them green tea supplementation for eight weeks. Statistical analysis included the Shapiro-Wilk, Wilcoxon, independent and paired t tests; p < 0.05 were considered as significant. Results: we enrolled 42 obese (BMI: 48.2 ± 9.3kg/m2) and 21 normal weight (BMI: 22.5 ± 2 kg/m2) women with an average age of 36.2 ± 9.1 years old. The serum levels of MDA were higher in obese (2.52 ± 0.31 µmol/l) than in eutrophic women (2.13 ± 0.26 µmol/l; p = 0.000). On the other hand, lower TEAC values were observed in the obese (0.75 ± 0.06 mM/l) than in the eutrophic group (0.78 ± 0.04 mM/l; p = 0.009). After the green tea intervention, MDA decreased 4.7% and TEAC increased 10%. Interleukin-6 (IL-6) serum levels decreased 12.7% after treatment (p = 0.03). Conclusions: a) the obese group had lower antioxidant capacity than eutrophic; and b) green tea supplementation ameliorated TEAC and MDA and reduced serum levels of IL-6 in obese women.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.20960/nh.2159DOI Listing
July 2019

Appetite effects of prefrontal stimulation depend on COMT Val158Met polymorphism: A randomized clinical trial.

Appetite 2019 09 13;140:142-150. Epub 2019 May 13.

Laboratory of Bariatric and Nutritional Neuroscience, Center for the Study of Nutrition Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA 02215, United States. Electronic address:

The regulation of appetite is supported by dopamine-modulated brain circuits. Recent studies have shown that transcranial direct current stimulation (tDCS) aimed at increasing the excitability of the dorsolateral prefrontal cortex can reduce appetite, but the underlying mechanisms remain unknown, and response variability is large. The aim of this study was to determine whether individual differences in Catechol-O-methyl transferase (COMT) Val158Met polymorphism can influence tDCS effects on appetite. Thirty-eight adult women with obesity, classified as carriers or non-carriers of the Met allele, underwent a randomized, double-blind, sham-controlled tDCS intervention involving three phases: Phase I, target engagement (immediate effects of tDCS on working memory performance), Phase II, tDCS only (10 sessions, two weeks), and Phase III, tDCS + hypocaloric diet: (6 sessions, two weeks, 30% energy intake reduction, inpatient). Data were analyzed using linear mixed-effects models and mixed ANCOVA. Appetite was evaluated using visual analogue scales. We found that Met-carriers receiving active tDCS were the only participants who experienced a significant reduction of appetite over time. Conversely, Met non-carriers maintained high levels of appetite during the intervention; this effect was driven by a delayed paradoxical rise in appetite after stimulation. Working memory task performance at phase I correlated with subsequent appetite change in a COMT-dependent manner: speed improvements during the task predicted appetite increase in Met carriers and appetite reduction in Met non-carriers. Our findings suggest that genotype differences impacting dopamine levels influence prefrontal tDCS effects on appetite. This source of variability should be considered in the design of future studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.appet.2019.05.015DOI Listing
September 2019

Impact of green tea epigallocatechin-3-gallate on HIF1-α and mTORC2 expression in obese women: anti-cancer and anti-obesity effects?

Nutr Hosp 2019 Apr;36(2):315-320

Department of Internal Medicine. University of São Paulo.

Introduction: Introduction: epigallocatechin-3-gallate (EGCG) is the most abundant catechin contained in green tea (Camellia sinensis) and has been associated with anti-obesity and anti-cancer effects, but the exact molecular mechanisms remain elusive. In this context, this study was designed to improve the understanding of the EGCG anti-obesity and anti-cancer action. Objectives: this study was designed to examine the effects of EGCG on the expression of genes involved in obesity and cancer pathways in the peripheral blood mononuclear cells of obese women. Material and methods: this longitudinal interventional study enrolled eleven women with severe obesity that were submitted to eight weeks of green tea (decaffeinated green tea capsules with 450.7 mg of EGCG, two capsules/day) supplementation (intervention group) and ten eutrophic women as a control group. Weight (kg), body mass index (BMI, kg/m2), fat mass (kg) and gene expression (qPCR method) were assessed before and after supplementation. HIF1-alpha (HIF1-α), phosphoinositide-3-kinase regulatory subunit 1 (PIK3R1) and rapamycin-insensitive companion of mTOR (RICTOR) were selected as potential targets. Results: after supplementation, body weight (114.9 ± 14.3 versus 115 ± 13.8 kg), body mass index (44.1 ± 3.7 versus 44.1 ± 3.9 kg/m2) and fat mass (47.6 ± 3.3 versus 47.3 ± 3.4 kg) did not change. EGCG upregulated the RICTOR and HIF1-α expression, however, did not modify PI3K expression. Conclusion: this study demonstrated that EGCG has a potential role to obesity and cancer related to obesity control and can be used not only for the purpose of weight loss, but also for the improvement of obesity-related comorbidities.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.20960/nh.2216DOI Listing
April 2019

Iron absorption from beans with different contents of iron, evaluated by stable isotopes.

Clin Nutr ESPEN 2018 06 13;25:121-125. Epub 2018 Apr 13.

Internal Medicine Department (Nutrology Division), Medical School of Ribeirao Preto, University of São Paulo, Brazil.

Background: The introduction of biofortified foods such as beans with higher iron content may be a useful tool in preventing iron deficiency. The biofortification aims to reach the root of the problem of malnutrition, targets the neediest population, uses embedded distribution mechanisms, is scientifically feasible and effective in terms of cost, and complements other ongoing interventions to control micronutrient deficiency. However, to ensure effectiveness, measurement of the absorption of minerals is essential.

Objective: The objective of this study was to evaluate the iron bioavailability of common bean BRS Pontal (PO), targeted for biofortification, compared with common bean BRS Estilo in man through reliable techniques that have not been previously used in Brazil.

Methods: The study included 29 young adult volunteers divided into 2 groups: Group CB (13 subjects) received 100 g of common beans (BRS-Estilo) cooked labeled with iron-58 (Fe) and Group TBB (16 patients) received 100 g common bean target for iron biofortification (BRS-Pontal), cooked and labeled with iron58 (Fe). The next day they received the reference dose of ferrous sulfate enriched iron-57 (Fe). Isotopic evaluation of iron for measurement of iron incorporation into erythrocytes was performed 14 days after consumption. The beans used, were produced, through conventional breeding program, by EMBRAPA/Rice and Beans.

Results: The iron absorption was evaluated by assessing the isotopic enrichment of the stable isotope. Mean iron absorption from the meal with common beans was 0.409% (±0.040%) and mean iron incorporation from the meal with target beans for biofortification 0.407% (±0.038%) and did not differ between the groups.

Conclusions: This study tested the iron absorption from a single bean meal in healthy volunteers or non anemics, In the present study the iron absorption ratio from common bean Pontal (PO), targeted for biofortification and compared with common bean BRS Estilo was not significantly different. The iron concentration of the TBB, probably was not sufficient to improve higher bioavailability. It is recommended to evaluate the not only the absorption of iron in cultivars that present a higher difference in iron concentration but also in association with other components of the Brazilian diet, such as rice and beans.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnesp.2018.03.120DOI Listing
June 2018

Mammalian target of rapamycin complex 2 signaling in obese women changes after bariatric surgery.

Nutrition 2018 10 21;54:94-99. Epub 2018 Mar 21.

Department of Internal Medicine, Ribeirao Preto Medical School of University of Sao Paulo, Sao Paulo, Brazil. Electronic address:

Objectives: After bariatric surgery, modifications to signaling pathway networks including those of the metabolic regulator called mammalian or mechanistic target of rapamycin (mTOR) may lead to molecular alterations related to energy source availability, systemic nutrients, and catabolic and anabolic cellular processes. This study aimed to identify gene expression changes with regard to the mTOR complex 2 subunit signaling pathway in obese patients before and after bariatric surgery.

Methods: The experimental group included 13 obese women who were examined before (preoperative) and 6 mo after (postoperative) Roux-en-Y gastric bypass (RYGB) surgery. The control group included nine apparently eutrophic women matched by age and without any other metabolic diseases (i.e., no diabetes and no liver or kidney diseases). Peripheral blood mononuclear cell samples were collected for RNA extraction and subsequent microarray analysis.

Results: After this methodological procedure, we identified 47 000 differentially expressed genes. A subsequent bioinformatic analysis showed that three diferentially expressed genes (rapamycin-insensitive companion of mTOR [RICTOR], phosphoinositide-3-kinase regulatory subunit 1 [PIK3 R1], and hypoxia inducible factor 1 alpha subunit 1A [HIF1 A]) participated in the mTOR signaling pathway. Real-time quantitative polymerase chain reaction revealed that RICTOR, PIK3 R1, and HIF1 A were upregulated 6 mo after RYGB surgery (P <0.05). In addition, patients in the experimental group lost weight significantly and presented significant improvement in biochemical/metabolic variables.

Conclusions: The weight loss that was induced by RYGB surgery alters the mTOR signaling pathway and specifically the mTOR complex 2 subunit. The increased expression of genes that act in this pathway such as RICTOR, PIK3 R1, and HIF1 A reflects the induced weight loss and improved metabolic indicators (e.g., insulin resistance and lipolysis) that are evidenced in this study.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2018.02.016DOI Listing
October 2018

A new resting metabolic rate equation for women with class III obesity.

Nutrition 2018 05 11;49:1-6. Epub 2017 Dec 11.

Department of Internal Medicine, University of Sao Paulo School of Medicine, Ribeirao Preto Campus, Ribeirao Preto, SP, Brazil. Electronic address:

Objective: Resting metabolic rate (RMR) is an important parameter to guide the nutritional therapy of class III obese patients. The aims of the present study were to develop a predictive equation for RMR estimation in class III obese women using anthropometric indicators and to compare indirect calorimetry with other predictive equations.

Methods: This was a cross-sectional study on women with class III obesity (body mass index >40 kg/m). Weight, height, fat-free mass, fat mass, and RMR of all individuals were measured. Multiple linear regression was used to determine the new RMR equation and the Bland-Altman plot was used to analyze the agreement between indirect calorimetry and the results of predictive equations.

Results: We evaluated 101 women with obesity class III and a mean age of 36.3 ± 10 y. The anthropometric and body composition variables used in the new equation had a coefficient of determination of 0.80, and a significant influence on RMR (P = 0.01). Harris-Benedict and World Health Organization equations showed similar bias and limits (181.6, +2 SD = 765.5, -2 SD = -402.2; 156.4, +2 SD = 799.4, -2 SD = -486.6, respectively). The Mifflin-St Jeor and Owen equations showed large clinical bias (mean, 239.2 and 463.9, respectively), and a tendency to overestimate RMR.

Conclusion: The prediction equations tested in the study had low accuracy in estimating RMR of women with class III obesity. However, our equation was developed specifically for this population, using variables known to influence their energy expenditure.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nut.2017.11.024DOI Listing
May 2018

Green tea supplementation upregulates uncoupling protein 3 expression in severe obese women adipose tissue but does not promote weight loss.

Int J Food Sci Nutr 2018 Dec 26;69(8):995-1002. Epub 2018 Feb 26.

a Department of Internal Medicine , Ribeirao Preto Medical School, University of São Paulo , Ribeirão Preto , Brazil.

This study aims (i) to verify expression of the UCPs, PLIN1, PPARG2, and ADRB3 genes in the abdominal subcutaneous adipose tissue of obese women at baseline and after 8 weeks of supplementation with decaffeinated green tea extract, and (ii) to associate findings with clinical parameters. This is a longitudinal study during which 11 women with obesity grade III were submitted to supplementation with 450 mg of (-)-epigallocatechin gallate (EGCG) (intervention group); the control group consisted of 10 eutrophic women. Anthropometric parameters [weight, height, and body mass index (BMI)], resting metabolic rate (RMR, measured by indirect calorimetry), and gene expression (measured by real-time PCR, RT-qPCR) were determined before and after supplementation. After 8 weeks, clinical parameters and UCP1, PLIN1, PPARG2, and ADRB3 expression remained unaltered in the intervention group (p > .05). Genetic analysis also showed that the UCP3 gene was upregulated (p = .026), but its upregulation did not promote weight loss.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/09637486.2018.1442819DOI Listing
December 2018

Energy intake in short bowel syndrome: assessment by 24-h dietary recalls compared with the doubly labelled water method.

Br J Nutr 2018 01 22;119(2):196-201. Epub 2017 Dec 22.

1Department of Internal Medicine,Ribeirão Preto Medical School,University of São Paulo,Ribeirão Preto,SP,Brazil.

Short bowel syndrome (SBS) represents a serious intestinal absorption disorder, and patients may be prone to severe malnutrition. Dietetic therapy is critically important both for immediate prognosis and successful long-term rehabilitation. To maintain energy balance, an accurate assessment of energy intake is required. Our objective was to compare energy intake (EI) assessed by 24-h dietary recalls (EIrecall), a standard clinical assessment, with the total energy expenditure measured by the doubly labelled water (TEEdlw) method in SBS patients and matched controls. A total of twenty-two participants (eleven each in the SBS and control groups (CG), six female and five male) were evaluated; CG were matched to SBS patients on the basis of age, BMI and sex. TEE was measured by DLW and compared with EI determined by four 24-h dietary recalls using the USDA Automated Multiple-Pass Method. Bland-Altman plots and paired Student's t test were used to compare EIrecall with TEEdlw (P<0·05). Participants' mean age was 53 (sd 8) years. TEEdlw (7·85 (SD 1·16) MJ/d, 0·14 (SD 0·02) MJ/kg per d) was significantly lower (P=0·014) compared with EIrecall (11·07 (SD 3·45) MJ/d, 0·21 (SD 0·08) MJ/kg per d) in the SBS group. On the other hand, in the CG group TEEdlw (10·02 (SD 1·86) MJ/d, 0·18 (SD 0·03) MJ/kg per d) was significantly higher (P=0·001) compared with EIrecall (7·19 (SD 1·68) MJ/d, 0·13 (SD 0·03) MJ/kg per d). In SBS patients, reported EI is higher than DLW-measured EI. Therefore, providing or prescribing energetic intake based on EIrecall without accounting for potential malabsorption-related losses can compromise the energy needs in SBS patients and affect nutritional status in the long term.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1017/S0007114517003373DOI Listing
January 2018

Changes in Global Transcriptional Profiling of Women Following Obesity Surgery Bypass.

Obes Surg 2018 Jan;28(1):176-186

Department of Internal Medicine, Laboratory of Nutrigenomic Studies, Ribeirao Preto Medical School, FMRP, University of Sao Paulo, USP, Av Bandeirantes, 3900, Monte Alegre, Ribeirao Preto, SP, 14049-900, Brazil.

Background: Differential gene expression in peripheral blood mononuclear cells (PBMCs) after Roux-en-Y gastric bypass (RYGB) is poorly characterized. Markers of these processes may provide a deeper understanding of the mechanisms that underlie these events. The main goal of this study was to identify changes in PBMC gene expression in women with obesity before and 6 months after RYGB-induced weight loss.

Methods: The ribonucleic acid (RNA) of PBMCs from 13 obese women was analyzed before and 6 months after RYGB; the RNA of PBMCs from nine healthy women served as control. The gene expression levels were determined by microarray analysis. Significant differences in gene expression were validated by real-time quantitative polymerase chain reaction (RT-qPCR).

Results: Microarray analysis for comparison of the pre- and postoperative periods showed that 1366 genes were differentially expressed genes (DEGs). The main pathways were related to gene transcription; lipid, energy, and glycide metabolism; inflammatory and immunological response; cell differentiation; oxidative stress regulation; response to endogenous and exogenous stimuli; substrate oxidation; mTOR signaling pathway; interferon signaling; mitogen-activated protein kinases (MAPK), cAMP response element binding protein (CREB1), heat shock factor 1 (HSF1), and sterol regulatory element binding protein 1c (SREBP-1c) gene expression; adipocyte differentiation; and methylation.

Conclusions: Six months after bariatric surgery and significant weight loss, many molecular pathways involved in obesity and metabolic diseases change. These findings are an important tool to identify potential targets for therapeutic intervention and clinical practice of nutritional genomics in obesity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11695-017-2828-xDOI Listing
January 2018

Influence of expression of UCP3, PLIN1 and PPARG2 on the oxidation of substrates after hypocaloric dietary intervention.

Clin Nutr 2018 08 15;37(4):1383-1388. Epub 2017 Jun 15.

Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil. Electronic address:

Background & Aims: In addition to environmental and psychosocial factors, it is known that genetic factors can also influence the regulation of energy metabolism, body composition and determination of excess weight. The objective of this study was to evaluate the influence of UCP3, PLIN1 and PPARG2 genes on the substrates oxidation in women with grade III obesity after hypocaloric dietary intervention.

Subjects/methods: This is a longitudinal study with 21 women, divided into two groups: Intervention Group (G1): 11 obese women (Body Mass Index (BMI) ≥40 kg/m), and Control Group (G2): 10 eutrophic women (BMI between 18.5 kg/m and 24.9 kg/m). Weight (kg), height (m), BMI (kg/m), substrate oxidation (by Indirect Calorimetry) and abdominal subcutaneous adipose tissue were collected before and after the intervention. For the dietary intervention, the patients were hospitalized for 6 weeks receiving 1200 kcal/day.

Results: There was a significant weight loss (8.4 ± 4.3 kg - 5.2 ± 1.8%) and reduction of UCP3 expression after hypocaloric dietary intervention. There was a positive correlation between carbohydrate oxidation and UCP3 (r = 0.609; p = 0.04), PLIN1 (r = 0.882; p = 0.00) and PPARG2 (r = 0.791; p = 0.00) expression before dietary intervention and with UCP3 (r = 0.682; p = 0.02) and PLIN1 (r = 0.745; p = 0.00) genes after 6 weeks of intervention. There was a negative correlation between lipid oxidation and PLIN1 (r = -0.755; p = 0.00) and PPARG2 (r = 0.664; p = 0.02) expression before dietary intervention and negative correlation with PLIN1 (r = 0.730; p = 0.02) expression after 6 weeks of hypocaloric diet.

Conclusion: Hypocaloric diet reduces UCP3 expression in individuals with obesity and the UCP3, PLIN1 and PPARG2 expression correlate positively with carbohydrate oxidation and negatively with lipid oxidation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnu.2017.06.012DOI Listing
August 2018

Comparison of gene expression profile between blood cells and white adipose tissue of patients with obesity

Nutr Hosp 2017 06 5;34(3):608-612. Epub 2017 Jun 5.

University of Sao Paulo.

Introduction: Gene expression analyses from peripheral blood mononuclear cells (PBMC) and white adipose tissue are conflicting. It seems that results from single tissue are not enough to explain how changes affect humans as a complex biological system.

Objective: The aim of this study was to compare, from obesity subjects, PBMC and white adipose tissue gene expression that regulates adipogenesis (perilipin 1 [PLIN1], adrenoreceptor beta 3 [ADRB3] and peroxisome proliferator-activated receptor [PPARG2]) and the energy metabolism (uncoupling protein UCP1, UCP2 and UCP3) process.

Methods: This study enrolled 35 obese patients, with a body mass index (BMI) > 40 kg/m2 (obesity group [OG]), and ten eutrophic health subjects, 18 > BMI > 24.9 kg/m2 (control group [CG]). Anthropometric and body composition data were assessed at recruitment using standardized protocols. Samples of peripheral blood and subcutaneous adipose tissue (biopsy) were collected to analyze gene expression by RT-qPCR technique. For statistical analysis, we used the Shapiro-Wilk test and Wilcoxon tests by the SPSS software version 20.0; a p < 0.05 significance level was adopted.

Results: There were significant differences of PLIN1, ADRB3, PPARG2 and UCP3 expression between blood against adipose tissue samples, showing that these genes are upregulated in adipose tissue. UCP2 expression was upregulated in PBMC.

Conclusion: The PLIN1, ADRB3, PPARG2 and UCP3 genes were preferentially expressed in adipose tissue. However, UCP2 was upregulated in PBMC, suggesting that this gene may be assessed in a peripheral blood cell, which is easily accessible, safe and practical.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.20960/nh.438DOI Listing
June 2017

Overweight postmenopausal women with different plasma estradiol concentrations present with a similar pattern of energy expenditure and substrate oxidation rate before and after a fatty meal challenge.

Clin Nutr ESPEN 2016 Oct 2;15:21-27. Epub 2016 Jun 2.

Faculdade de Medicina de Ribeirão Preto, Departamento de Clínica Médica, Universidade de São Paulo (FMRP/USP), Brazil.

Menopause-related withdrawal of ovarian estrogens is associated with reduced energy metabolism and overall impairment of substrate oxidation. Estradiol's withdrawal after menopause is associated with a reduction in energy metabolism and impaired substrate oxidation, which contributes to weight gain and visceral fat accumulation. Here we aimed to investigate the association between plasma estradiol concentrations and energy expenditure (EE)/substrate oxidation in a group of overweight postmenopausal women before and after a fatty meal challenge. Women were divided into three groups according to their plasma estradiol concentrations (E2): group 1 - E ≤ 39, group 2 - 40 ≤ E ≤ 59, and group 3 - E ≥ 60 pg/mL. VO and VCO volumes were collected following indirect calorimetry 5 h following a single lipid overload meal (1100 kcal, 72% of fat). For comparisons between groups and within the same group, a linear regression model with mixed effects was applied (P < 0.05). Forty-four women aged 55 ± 0.7 years-old, 8 ± 1.1 years following menopause, with a BMI of 30.5 ± 0.5 kg/m, and 41.9 ± 0.7% of body fat were enrolled the study. Plasma E2 concentrations were: group 1 - 30.4 ± 1.9, group 2 - 46.9 ± 1.5, and group 3 - 91.3 ± 12.0 pg/mL (P < 0.0001). EE at baseline and in the resting state was 1320 ± 24.3 kcal/d, and increased to 1440 ± 27.0 kcal/d 30 min following ingestion of the fatty meal (P < 0.0001), and rose again to an average of 1475 ± 30.3 kcal/d at the completion of experiment (P < 0.0001). Carbohydrate oxidation (Chox) was 0.155 ± 0.01 g/min at resting, maintained as 0.133 ± 0.00 g/min 30 min after ingestion of the fatty meal, and was 0.123 ± 0.01 g/min at the end of the testing period. Lipid oxidation (Lipox) was 0.041 ± 0.003 g/min at resting, increasing to 0.054 ± 0.003 g/min at 30 min (P = 0.01), and reaching 0.063 ± 0.003 g/min at the end of the experiment (P < 0.0001). There was no difference between groups for EE, Chox or Lipox. Our data suggest that EE and substrate oxidation were modulated following a lipid-meal challenge equally in all groups and this did not differ with plasma E2 concentrations.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnesp.2016.05.003DOI Listing
October 2016

Pregnancy After Roux en Y Gastric Bypass: Nutritional and Biochemical Aspects.

Obes Surg 2017 07;27(7):1815-1821

Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto-FMRP, Laboratory of Nutrigenomic Studies, University of São Paulo-USP, Av Bandeirantes, 3900, Monte Alegre, Ribeirao Preto, SP, 14049-900, Brazil.

Introduction: Although pregnancy after bariatric surgery is related to risk reduction, nutritional complications may occur. This study aimed to evaluate nutritional and biochemical indicators of women who became pregnant after Roux en Y gastric bypass (RYGB).

Materials And Methods: We carried out a retrospective study with women who became pregnant after RYGB. We evaluated anthropometric, biochemical, and dietary intake indicators in the preoperative period and before, during, and after pregnancy by analysis of medical records. Shapiro-Wilk test and ANOVA for repeated measures were performed (p < 0.05).

Results: The study included 25 patients (35.7 ± 3.8 years), who became pregnant 31.3 ± 21.7 months after RYGB. Weight loss until the beginning of pregnancy was 32.4%, and the gestational weight gain was 3.8 ± 12 kg. There was a higher frequency of patients with hypertension in the preoperative time when compared to that during the pregnancy period. Total cholesterol (180.9 ± 24.8 versus 148.5 ± 30.4 mg/dL), LDL-cholesterol (103.5 ± 19.2 versus 85.8 ± 23.1 mg/dL), HDL-cholesterol (56.4 ± 8 versus 46.9 ± 8.7 mg/dL), and latent iron-binding capacity (337.6 ± 95.8 versus 277.8 ± 65 μg/dL) were higher during the pregnancy compared to that before the pregnancy, while hemoglobin values (11.2 ± 1 versus 12.3 ± 1.2 g/dL) and sodium (138.8 ± 2.9 versus 141 ± 3 mmol/L) were lower. No differences of food intake were found among times. There is no difference on gestational weight gain between women who became pregnant before or after the first year.

Conclusion: During pregnancy, there was an expected weight gain and maintenance of the lipid profile within the normal range; however, there was a reduction of hemoglobin levels. These findings show the need for individualized follow-up with adequate nutritional intervention in the event of deficiencies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s11695-017-2558-0DOI Listing
July 2017

The Genetic Predisposition Score of Seven Obesity-Related Single Nucleotide Polymorphisms Is Associated with Better Metabolic Outcomes after Roux-en-Y Gastric Bypass.

J Nutrigenet Nutrigenomics 2016 3;9(5-6):222-230. Epub 2016 Nov 3.

Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.

Background/aims: Genetic variants associated with obesity have cumulative effects on obesity risk and related phenotypes. This study aimed to estimate the contribution of a genetic predisposition score (GPS) calculated from 7 obesity-related polymorphisms to the improvement of biochemical parameters 1 year after Roux-en-Y gastric bypass (RYGB).

Methods: Obese patients (n = 150; aged 47.2 ± 10.5 years) were enrolled and weight, body mass index (BMI), and biochemical parameters (glycemia and lipid profile) were evaluated preoperatively and 1 year after RYGB. A GPS was calculated with the polymorphisms rs1801282 of PPARG2, rs4994 of ADRB3, rs1800592 of UCP1, rs659366 and rs669339 of UCP2, rs7121 of GNAS1, and rs5443 of GNB3. We observed that 66.3% of the patients has a GPS >5.

Results: During the preoperative period, the GPS showed a significant association with weight (β = -0.163; p = 0.020), BMI (β = -0.169; p = 0.038), and glucose concentrations (β = -0.177; p = 0.036). After sex and age adjustment, a higher GPS was associated with a greater reduction in glycemia (β = -0.158; p = 0.048), triglycerides (β = -0.256; p = 0.002), and total cholesterol (β = -0.172; p = 0.038) concentrations 1 year after surgery.

Conclusion: Our data elucidated that a higher GPS provides a greater metabolic benefit of RYGB.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1159/000452129DOI Listing
November 2017

A new family home approach to controlling iron deficiency anemia in all ages in less-developed and developing countries using iron-fortified water.

Arch Latinoam Nutr 2016 Sep;66(3):159-164

Nutritional iron deficiency anemia is considered the main public health problem of poor less-developed and developing countries. The World Health Organization has estimated that 1.5-2.0 billion persons are anemic. It has been said that close to 1 million deaths are linked to iron deficiency anemia. The groups most vulnerable to this form of anemia are said to be small children and women of reproductive age. Our goal is to show that iron fortification in the water, will control anemia. The method used was a literature review. Methods have been identified to control anemia, but the fortification of water is a more efficient, low cost, reaches the entire population, prevents and treats deficiency anemia. We concluded that the iron fortification of drinking water at home is a simple, effective, and low-priced approach for the prevention of iron deficiency anemia prevalent in poor and developing countries.
View Article and Find Full Text PDF

Download full-text PDF

Source
September 2016

Bioelectrical impedance vector analysis as a useful predictor of nutritional status in patients with short bowel syndrome.

Clin Nutr 2017 08 27;36(4):1117-1121. Epub 2016 Jul 27.

Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900, Bairro Monte Alegre, Brazil.

Background & Aims: Short bowel syndrome (SBS) represents a serious intestinal absorption disorder. Therefore, patients with SBS may have severe malnutrition and excessive mineral and fluid losses. Once the assessment of nutritional status is important in their follow-up, body composition measurements and especially total body water (TBW) must be repeatedly evaluated for the assessment of changes in hydration and nutritional care. The aim of this study was to investigate if bioelectrical impedance vector analysis (BIVA) is a useful predictor of nutritional and hydration status in SBS patients.

Methods: In this observational study, 22 participants (12 women), 11 with SBS and 11 gender, age and BMI-matched controls, were evaluated using the bioelectrical impedance measurements (BIA) and BIVA to assess nutritional and hydration status.

Results: Participants age was 53 ± 8 y (mean ± SD). Body water, fat mass and lean mass as assessed by BIA did not differ between the two groups. However, BIVA showed important differences between the groups regarding hydration and amount of soft tissue (p < 0.0001 for women and p = 0.0015 for men). The results also evidenced that women's vectors were related to cachexia, while men's vectors were divided into lean and cachexia quadrants. The use of BIVA analysis also evidenced hydration disturbance and losses of soft tissue.

Conclusions: BIVA may represent a better predictor of nutritional status for analysis and interpretation of body composition in patients with short bowel syndrome. This trial was registered at ClinicalTrials.gov as NCT02113228.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.clnu.2016.07.011DOI Listing
August 2017

The impact of intestinal resection on the immune function of short bowel syndrome patients.

Hum Immunol 2016 Dec 30;77(12):1202-1208. Epub 2016 Jul 30.

Departamento de Análises Clínicas, Toxicológicas e Bromatológicas - Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil. Electronic address:

Short bowel syndrome (SBS) is characterized by a massive intestinal loss after surgery resection. Likewise, disturbances involving the intestine, which represents a complex immune environment, may result in breakdown of homeostasis and altered responses, thus leading to unpredictable clinical outcomes. However, the consequences of bowel resection were poorly investigated until now. Therefore, this study aimed to evaluate the immunological status of SBS-patients. For this purpose, ten subjects and nine healthy controls were evaluated. Along with some metabolic disturbances, the main results showed higher levels of the inflammatory cytokine IL-6 in plasma among SBS-patients. However, there were no differences in the frequency of CD3, CD3CD4 or CD3CD8 T lymphocytes. An augmented frequency in CD4 and CD8 cells producing IFN-γ was also observed in peripheral blood mononuclear cells (PBMC), together with elevated percentage of CD4 cells producing IL-10. No differences were observed in the frequency of total CD4CD25, CD4CD25 lymphocytes nor in the expression of FoxP3 or GITR. Nevertheless, SBS-patients showed higher frequency of the regulatory T cell population CD4CD25CD39 cells in PBMC. In conclusion, these data pointed to SBS as an important disturbance that compromises not only the intestinal environment but also negatively influences systemic immune components.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.humimm.2016.07.237DOI Listing
December 2016

Retraction Note: Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study.

Nutr J 2016 06 7;15(1):59. Epub 2016 Jun 7.

Department of Medicine, Division of Medical Nutrition, Ribeirão Preto Medical School, University of São Paulo, Avenida Bandeirantes, 3900 Bairro Monte Alegre, Ribeirão Preto, São Paulo, CEP: 14049-900, Brazil.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1186/s12937-016-0165-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4895999PMC
June 2016

Parenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines.

Nutr Res 2016 07 3;36(7):751-5. Epub 2016 Feb 3.

Department of Internal Medicine, Ribeirao Preto Medical School/University of Sao Paulo (USP), Sao Paulo, Brazil. Electronic address:

Short bowel syndrome is a severe malabsorption disorder, and prolonged parenteral nutrition is essential for survival in some cases. Among the undesirable effects of long-term parenteral nutrition is an increase in proinflammatory cytokines. The aim of the present study was to measure the serum levels of interleukin-6, interleukin-10, tumor necrosis factor alpha, and transforming growth factor beta, in patients with short bowel syndrome on cyclic parenteral nutrition and patients who had previously received but no longer require parenteral nutrition. The study was cross-sectional and observational. Three groups were studied as follows: Parenteral nutrition group, 9 patients with short bowel syndrome that receive cyclic parenteral nutrition; Oral nutrition group, 10 patients with the same syndrome who had been weaned off parenteral nutrition for at least 1 year prior to the study; Control group, 13 healthy adults, matched for age and sex to parenteral and oral groups. The following data were collected: age, tobacco use, drug therapies, dietary intake, body weight, height, blood collection. All interleukins were significantly higher in the parenteral group compared with the control group as follows: interleukin-6: 22 ± 19 vs 1.5 ± 1.4 pg/mL, P= .0002; transforming growth factor β: 854 ± 204 vs 607 ± 280 pg/mL, P= .04; interleukin-10: 8 ± 37 vs 0.6 ± 4, P= .03; tumor necrosis factor α: 20 ± 8 vs 8 ± 4 pg/mL, P< .0001. We concluded that parenteral nutrition in short bowel syndrome patients, regardless of its duration, increases serum proinflammatory cytokines.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.nutres.2016.01.012DOI Listing
July 2016

Effect of Strontium Ranelate on Bone Metabolism of Elderly Men.

J Am Geriatr Soc 2015 Dec;63(12):2634-2635

Discipline of Medical Nutrition, Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1111/jgs.13861DOI Listing
December 2015