Publications by authors named "Roberto Carlos Burini"

33 Publications

Effect of whey protein supplementation combined with resistance training on body composition, muscular strength, functional capacity, and plasma-metabolism biomarkers in older women with sarcopenic obesity: A randomized, double-blind, placebo-controlled trial.

Clin Nutr ESPEN 2019 08 13;32:88-95. Epub 2019 May 13.

Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Highway Celso Garcia Cid, Londrina, Paraná 86057-970, Brazil. Electronic address:

Backgrounds & Aims: Obesity and sarcopenia are independent illnesses associated with contemporary dietary and physical activity behaviors, aggravated by aging. Their coexistence is termed sarcopenic obesity (SO). Hence, increasing protein intake and resistance training (RT) are interventions that could counteract these illnesses. The objective of this investigation was to analyze the effects of whey protein (WP) supplementation associated with RT on body composition, muscular strength, functional capacity, and plasma-metabolism biomarkers in older women with SO.

Methods: Twenty six sarcopenic (appendicular lean soft tissue ALST < 15.02 kg) obese (body fat mass ≥ 35%) older women were randomly assigned to receive daily, either 35 g of WP (WP group) or placebo (PLA group), combined with supervised RT (8 exercises, 3 × 8-12 rep, 3 times a week), during a 12-week protocol. Blood samples, blood pressure, dietary intake, functional capacity tests, the one repetition maximum (1RM) test, and body composition were assessed before and after the intervention period. Two-way analysis of variance for repeated measures was applied for comparisons.

Results: The WP group presented greater (P < 0.05) increases in ALST (WP = 6.0% vs. PLA = 2.5%) and decreases in (P < 0.05) total (-3.3% vs. -0.3%) and trunk fat mass (WP = -5.1% vs. PLA = -1.1) and IL-6 (WP = -34.6% vs. PLA = 9.3%) compared with the PLA group. Both groups demonstrated improved (P < 0.05) scores for muscular strength, waist-hip ratio, functional capacity, and other plasma-metabolism biomarkers without significant differences between conditions.

Conclusion: Whey protein combined with RT increased ALST, and decreased total and trunk fat mass, improving sarcopenia and decreasing SO in older women, with a limited impact on inflammation. Registered under ClinicalTrials.gov Identifier n° NCT03752359.
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http://dx.doi.org/10.1016/j.clnesp.2019.04.007DOI Listing
August 2019

Comparative effects of acute-methionine loading on the plasma sulfur-amino acids in NAC-supplemented HIV+ patients and healthy controls.

Amino Acids 2018 May 1;50(5):569-576. Epub 2018 Feb 1.

Department of Surgery, Harvard Medical School, Massachusetts General Hospital, Shriners Burns Hospital, Boston, MA, USA.

In this study, an acute overloading of methionine (MetLo) was used to investigate the trassulfuration pathway response comparing healthy controls and HIV+ patients under their usual diet and dietary N-acetyl-L-cysteine (NAC) supplementation. MetLo (0.1 g Met/kg mass weight) was given after overnight fasting to 20 non-HIV+ control subjects (Co) and 12 HIV+ HAART-treated patients. Blood samples were taken before and after the MetLo in two different 7-day dietary situations, with NAC (1 g/day) or with their usual diet (UD). The amino acids (Met, Hcy, Cys, Tau, Ser, Glu and Gln) and GSH were determined by HPLC and their inflow rate into circulation (plasma) was estimated by the area under the curve (AUC). Under UD, the HIV+ had lower plasma GSH and amino acids (excepting Hcy) and higher oxidative stress (GSSG/GSH ratio), similar remethylation (RM: Me/Hcy + Ser ratio), transmethylation (TM; Hcy/Met ratio) and glutaminogenesis (Glu/Gln ratio), lower transsulfuration (TS: Cys/Hcy + Ser ratio) and Cys/Met ratio and, higher synthetic rates of glutathione (GG: GSH/Cys ratio) and Tau (TG: Tau/Cys ratio). NAC supplementation changed the HIV pattern by increasing RM above control, normalizing plasma Met and TS and, increasing plasma GSH and GG above controls. However, plasma Cys was kept always below controls probably, associatively to its higher consumption in GG (more GSSG than GSH) and TG. The failure of restoring normal Cys by MetLo, in addition to NAC, in HIV+ patients seems to be related to increased flux of Cys into GSH and Tau pathways, probably strengthening the cell-antioxidant capacity against the HIV progression (registered at http://www.clinicaltrials.gov , NCT00910442).
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http://dx.doi.org/10.1007/s00726-018-2538-2DOI Listing
May 2018

Lower protein and higher carbohydrate intake are related with altering metabolic syndrome components in elderly women: A cross-sectional study.

Exp Gerontol 2018 03 11;103:132-137. Epub 2018 Jan 11.

Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, Paraná, Brazil.

Background: Metabolic Syndrome (MetS) is an energy-disturbance disease associated with insulin resistance. Hence, the intake of energy-rich macronutrients might affect some MetS components. The aim of this study was to explore the association of ingested macronutrients with MetS components in older women.

Methods: A cross sectional study was conducted in 245 older women (≥60 years). Whole-body dual-energy X-ray absorptiometry was used to assess total body fat, percentage body fat (absolute and relative), and skeletal muscle mass. Venous blood samples were collected after a 12 h fasting to determine glucose, high-density lipoprotein (HDL-c), and triglycerides. Anthropometric measurements and resting blood pressure were also evaluated. Food consumption was assessed through the 24-hour dietary recall method, and the macronutrients were distributed by tertiles of consumption. The Student t-test, Mann-Whitney U test, and logistic regression analysis were used for statistical analysis.

Results: The MetS and non-MetS groups demonstrated similar food-energy intake and fat consumption. The MetS group presented lower protein and higher carbohydrate intake than the non-MetS group. Individuals in the lowest protein intake (<0.72 g/kg/d) had greater odds of presenting abdominal obesity and impaired glucose levels. Higher consumption of carbohydrates was associated with lower HDL levels and higher hypertriglyceridemia. The chances of having MetS were increased by three times when ingesting either a low protein or high carbohydrate diet.

Conclusion: Either high carbohydrate or low protein intake would be risk factors for altering MetS components and the presence of MetS in elderly women.
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http://dx.doi.org/10.1016/j.exger.2018.01.013DOI Listing
March 2018

Dietary factors associated with metabolic syndrome and its components in overweight and obese Brazilian schoolchildren: a cross-sectional study.

Diabetol Metab Syndr 2016 24;8(1):58. Epub 2016 Aug 24.

Botucatu School of Medicine, Public Health Department and Exercise Metabolism and Nutrition Center, São Paulo State University, Distrito de Rubião Júnior, s/n, Botucatu, SP 18618-970 Brazil.

Background: The metabolic syndrome (MS) has been assessed since childhood mainly because of the nutritional and epidemiological transition that has occurred worldwide. Our objectives were to explore the MS and its components according to anthropometric and demographic factors and to assess the relationship among MS components and dietary characteristics in overweight and obese schoolchildren.

Methods: This was a cross-sectional study which included 147 schoolchildren (aged 6-10 years) from three elementary schools, with body mass index (BMI) higher than the 85th percentile. Sexual maturation stages, anthropometric measures (weight, height, skinfold thickness and waist circumference), biochemical data (glucose, HDL-C and triacylglycerol), blood pressure and dietary intake were assessed. The metabolic syndrome was diagnosed if three or more of the following components were presented: waist circumference ≥90th age and sex-specific cut-off, blood pressure ≥90th age, sex and height-specific cut-off, glucose ≥100 mg/dL, HDL-C ≥ 40 mg/dL and triacylglycerols ≥ 110 mg/dL. The dietary intake was assessed by three non-consecutive 24-h recalls. The T test, Kruskal-Wallis and multiple linear regression analysis were applied to assess MS components and dietary intake.

Results: The MS percentage was 10.2 % and it was higher in obese children and ones with high body fat percentage. The waist circumference was the main altered component of MS and 62 % of overweight schoolchildren showed at least one altered component of MS. The components of metabolic syndrome associated with dietary intake were triacylglycerol (positive association with saturated and monounsaturated fat, whole-milk products and processed foods and negative associated with legumes and polyunsaturated fat), glycemia (positive association with processed foods and negative with cereals), HDL-C (positive association with vegetables and greens) and waist circumference was negative associated with protein.

Conclusions: The frequency of MS was higher in obese than overweight schoolchildren and the frequency of at least one MS component was high in more than half of our subjects. The waist circumference was the most frequent among all other components. The triacylglycerol and glycemia were the most frequent MS components associated with dietary intake. Unprocessed food was considered a protective dietary factor for MS metabolic components and processed food with high percentage of sugar and saturated fat was a risk factor for MS metabolic components.
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http://dx.doi.org/10.1186/s13098-016-0178-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4995765PMC
August 2016

WITHDRAWN: The increase of dairy intake is the main dietary factor associated with reduction of body weight in overweight adults after lifestyle change program.

Diabetes Metab Syndr 2015 Aug 21. Epub 2015 Aug 21.

Center for exercise metabolism and nutrition (CeMENutri) - Department of Public Health -School of Medicine - São Paulo State University (UNESP), Brazil.

This article has been withdrawn at the request of the author(s) and editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at http://www.elsevier.com/locate/withdrawalpolicy.
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http://dx.doi.org/10.1016/j.dsx.2015.08.005DOI Listing
August 2015

THE INCREASE OF DAIRY INTAKE IS THE MAIN DIETARY FACTOR ASSOCIATED WITH REDUCTION OF BODY WEIGHT IN OVERWEIGHT ADULTS AFTER LIFESTYLE CHANGE PROGRAM.

Nutr Hosp 2015 Sep 1;32(3):1042-9. Epub 2015 Sep 1.

Center for exercise metabolism and nutrition (CeMENutri). Department of Public Health. School of Medicine. São Paulo State University (UNESP)..

This study evaluated which was the main nutritional change associated with weight reduction of overweight adult participants of a lifestyle change program. It was hypothesized that increases in dairy intake could be an important nutrition intervention in a lifestyle change program. 117 individuals, male (19.5%) and female (80.5%), with a minimum age of 36 years (54.2 ± 10.4). All study participants were enrolled in a lifestyle change program consisting of nutritional counseling and physical activity during 20 weeks. All participants were grouped in three groups according to Body Mass Index (BMI) delta median (-0.87 kg/m2) of individuals that showed weight loss: G1 - lost more than 0.87 kg/m2 of BMI (n = 38); G2 - lost 0 to 0.87 kg/m2 of BMI (n = 36); and G3 - increased BMI (n = 43). G1 increased dairy, fruit and vegetables intake and after forward stepwise multiple regression analysis, it was noted that an increase in dairy product intake of 0.40 servings per day had an impact of 9.6% on the loss of one kg/m2 of BMI. In conclusion, an increase in dairy product intake was the main dietary factor associated with reductions in body weight in overweight adults after 20 weeks of lifestyle change program.
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http://dx.doi.org/10.3305/nh.2015.32.3.9345DOI Listing
September 2015

Gastrointestinal complaints during exercise: prevalence, etiology, and nutritional recommendations.

Sports Med 2014 May;44 Suppl 1:S79-85

School of Medicine, Federal University of Uberlândia, Av. Pará, no 1720 Bloco 2U, Campus Umuarama, Uberlândia, Minas Gerais, 38400-902, Brazil,

Gastrointestinal problems are common, especially in endurance athletes, and often impair performance or subsequent recovery. Generally, studies suggest that 30-50% of athletes experience such complaints. Most gastrointestinal symptoms during exercise are mild and of no risk to health, but hemorrhagic gastritis, hematochezia, and ischemic bowel can present serious medical challenges. Three main causes of gastrointestinal symptoms have been identified, and these are either physiological, mechanical, or nutritional in nature. During intense exercise, and especially when hypohydrated, mesenteric blood flow is reduced; this is believed to be one of the main contributors to the development of gastrointestinal symptoms. Reduced splanchnic perfusion could result in compromised gut permeability in athletes. However, although evidence exists that this might occur, this has not yet been definitively linked to the prevalence of gastrointestinal symptoms. Nutritional training and appropriate nutrition choices can reduce the risk of gastrointestinal discomfort during exercise by ensuring rapid gastric emptying and the absorption of water and nutrients, and by maintaining adequate perfusion of the splanchnic vasculature. A number of nutritional manipulations have been proposed to minimize gastrointestinal symptoms, including the use of multiple transportable carbohydrates, and potentially the use of nutrients that stimulate the production of nitric oxide in the intestine and thereby improve splanchnic perfusion. However, at this stage, evidence for beneficial effects of such interventions is lacking, and more research needs to be conducted to obtain a better understanding of the etiology of the problems and to improve the recommendations to athletes.
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http://dx.doi.org/10.1007/s40279-014-0153-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4008808PMC
May 2014

[Consumption of fruit and vegetables associated with the metabolic syndrome and its components in an adult population sample].

Cien Saude Colet 2013 Feb;18(2):385-92

Centro de Metabolismo em Exercício e Nutrição, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista Júlio de Mesquita Filho, SP, Brazil.

Metabolic Syndrome (MS) increases the risk of cardiovascular events and the recommended intake of fruits and vegetables (FV) is related to its prevention. The scope of this study is to associate the intake of FV and its relation to MS and its components in an adult population sample. A prospective cross-sectional study was conducted with 636 adults in the period between 2004 and 2008. Anthropometric, clinical, dietary and biochemical profiles were recorded for all participants. MS was classified by the NCEP ATP-III, modified for glucose >100 mg/dl. Logistic regression was used to determine the odds ratio (OR) between the consumption of FV with MS and its components, and the level of significance adopted was 5%. The intake of fruit had protective effects against obesity (OR: 0.77, CI: 0.38-0.93), hypertriglyceridemia (OR: 0.76, CI: 0.35-0.96) and presence of MS (OR: 0.78, CI: 0.39-0.96), and proper intake of FV showed a protective effect for the presence of MS (OR: 0.79, CI: 0.41-0.95). Vegetable intake did not show protective effects / risk for the presence of MS and its components. The conclusion drawn is that the recommended intake of FV revealed a protective effect against MS and recommended intake of fruit had a protective effect not only for MS but also for its components.
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http://dx.doi.org/10.1590/s1413-81232013000200010DOI Listing
February 2013

Dietary, anthropometric, and biochemical determinants of uric acid in free-living adults.

Nutr J 2013 Jan 12;12:11. Epub 2013 Jan 12.

Center for exercise metabolism and nutrition (CeMENutri) Department of Public Health Botucatu School of Medicine (UNESP), Botucatu, Brazil.

Background: High plasma uric acid (UA) is a prerequisite for gout and is also associated with the metabolic syndrome and its components and consequently risk factors for cardiovascular diseases. Hence, the management of UA serum concentrations would be essential for the treatment and/or prevention of human diseases and, to that end, it is necessary to know what the main factors that control the uricemia increase. The aim of this study was to evaluate the main factors associated with higher uricemia values analyzing diet, body composition and biochemical markers.

Methods: 415 both gender individuals aged 21 to 82 years who participated in a lifestyle modification project were studied. Anthropometric evaluation consisted of weight and height measurements with later BMI estimation. Waist circumference was also measured. The muscle mass (Muscle Mass Index - MMI) and fat percentage were measured by bioimpedance. Dietary intake was estimated by 24-hour recalls with later quantification of the servings on the Brazilian food pyramid and the Healthy Eating Index. Uric acid, glucose, triglycerides (TG), total cholesterol, urea, creatinine, gamma-GT, albumin and calcium and HDL-c were quantified in serum by the dry-chemistry method. LDL-c was estimated by the Friedewald equation and ultrasensitive C-reactive protein (CRP) by the immunochemiluminiscence method. Statistical analysis was performed by the SAS software package, version 9.1. Linear regression (odds ratio) was performed with a 95% confidence interval (CI) in order to observe the odds ratio for presenting UA above the last quartile (♂UA > 6.5 mg/dL and ♀ UA > 5 mg/dL). The level of significance adopted was lower than 5%.

Results: Individuals with BMI ≥ 25 kg/m2 OR = 2.28(1.13-4.6) and lower MMI OR = 13.4 (5.21-34.56) showed greater chances of high UA levels even after all adjustments (gender, age, CRP, gamma-gt, LDL, creatinine, urea, albumin, HDL-c, TG, arterial hypertension and glucose). As regards biochemical markers, higher triglycerides OR = 2.76 (1.55-4.90), US-CRP OR = 2.77 (1.07-7.21) and urea OR = 2.53 (1.19-5.41) were associated with greater chances of high UA (adjusted for gender, age, BMI, waist circumference, MMI, glomerular filtration rate, and MS). No association was found between diet and UA.

Conclusions: The main factors associated with UA increase were altered BMI (overweight and obesity), muscle hypotrophy (MMI), higher levels of urea, triglycerides, and CRP. No dietary components were found among uricemia predictors.
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http://dx.doi.org/10.1186/1475-2891-12-11DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573899PMC
January 2013

Dietary intake and blood lipid profile in overweight and obese schoolchildren.

BMC Res Notes 2012 Oct 30;5:598. Epub 2012 Oct 30.

CeMENutri - Centre for Physical and Nutritional Metabolism, Sao Paulo State University/UNESP, Department Of Public Health, Botucatu City, Sao Paulo State, Brazil.

Background: The high blood lipid levels and obesity are one of the main risk factors for cardiovascular diseases, and the atherosclerotic process begins in childhood. Some environmental factors are supposed to be involved in this relationship, such as dietary factors. This study aimed to investigate the relationship between dietary intake and blood lipids levels in overweight and obese schoolchildren.

Methods: This is a cross-sectional study with 147 overweight and obese schoolchildren in Botucatu city, Brazil. The anthropometric measurements (body weight, height, body mass index, waist circumference and skinfolds), pubertal staging evaluation and biochemical tests were taken in all children. Three 24h-recall were applied in order to estimate the dietary intake and its relationship with blood lipid levels. The Student t test and multiple linear regression analysis were used for statistical analysis. Statistical significance was assessed at the level of 0.05. The data were processed in SAS software (version 9.1.3; SAS Institute).

Results: At this study, 63% of children were obese (body mass index higher than 95th percentile) and 80% showed high body fat percentage. The percentage of children with abnormal total cholesterol and triglycerides was 12% and 10%, respectively, and 28% presented at least one abnormal lipid levels. The average values of anthropometric measurements were higher in children with elevated lipid levels. Total cholesterol levels were positively related to full-fat dairy products and triglycerides levels to saturated fat percentage.

Conclusions: Saturated fat was positively associated with elevated lipid levels in overweight and obese schoolchildren. These results reinforce the importance of healthy dietary habits since childhood in order to reduce the risks of cardiovascular diseases in adulthood.
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http://dx.doi.org/10.1186/1756-0500-5-598DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3532384PMC
October 2012

Pathological and behavioral risk factors for higher serum C-reactive protein concentrations in free-living adults--a Brazilian community-based study.

Inflammation 2013 Feb;36(1):15-25

Department of Pathology, Botucatu School of Medicine, UNESP-Univ Estadual Paulista, Botucatu, SP, Brazil.

Low-grade chronic systemic inflammation is often associated with chronic non-communicable diseases, and its most frequently used marker, the C-reactive protein (CRP), has become an identifier of such diseases as well as an independent predictor for cardiovascular disorders and mortality. CRP is produced in response to pro-inflammatory signaling and to individual and behavioral factors, leading to pathological states. The aim of this study was to rank the predicting factors of high CRP concentrations in free-living adults from a community-based sample. We evaluated 522 adults (40-84 years old; 381 women) for anthropometric characteristics, dietary intake, clinical and physical tests, and blood analysis. Subjects were assigned to groups, according to CRP concentrations, as normal CRP (G1; <3.0 mg/L; n = 269), high CRP (G2; 3.0-6.0 mg/L; n = 139), and very high CRP (G3; >6.0 mg/dL; n = 116). Statistical comparison between groups used one-way ANOVA or Kruskal-Wallis tests, and prediction of altered values in increasing CRP was evaluated by proportional hazard models (odds ratio). CRP distribution was influenced by gender, body mass index, body and abdominal fatness, blood leukocytes, and neutrophil counts. The higher CRP group was discriminated by the above variables in addition to lower VO(2max), serum metabolic syndrome components (triglycerides, glucose, and HDL cholesterol), higher insulin, homeostasis assessment of insulin resistance, uric acid, gamma-GT, and homocysteine. After adjustments, only fatness, blood leukocytes, and hyperglycemia remained as independent predictors for increased serum CRP concentrations. Intervention procedures to treat low-grade chronic inflammation in overweight women would mainly focus on restoring muscle mass and functions in addition to an antioxidant-rich diet.
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http://dx.doi.org/10.1007/s10753-012-9515-9DOI Listing
February 2013

[Relationship of pattern hyperlipidic intake with quality of diet, insulin resistance and homocysteinemia in adults].

Acta Med Port 2011 Sep-Oct;24(5):719-26. Epub 2011 Dec 29.

Curso de especialização lato sensu em Cuidados Nutricionais do Doente e do Desportista, Centro de Metabolismo em Exercício e Nutrição, Faculdade de Medicina de Botucatu, São Paulo, Brasil.

Objectives: To evaluate the association between the consumption of different dietary fats with the quality of the diet, insulin resistance, and hyperhomocysteinemia in adults.

Methods: Cross-sectional study conducted with 624 overweight subjects (73.7% females). Assessments of food intake (24h food recall and health eating index-HEI), anthropometry, and biochemical assays of fasting glucose, insulin (HOMA-IR and ß calculus) and homocysteinemia were performed.

Results: The low quality of diet was associated with the vegetable oil at 3rd quintile (≥1.5-2.0 servings) showed risk 2.9 times and cholesterol at quintiles 2nd, 3rd, and 4th was 2.0 times. HOMA-IR was higher at 5th quintile of saturated fat (≥10,7% - total caloric value) with risk of 60% and hyperhomocysteinemia the vegetable oil at 3rd quintile (>1.5-2.0 servings) with risk of 12.0 times and 5th (≥3.5 servings) 7.1 times. However, significance disappeared when adjusted for anthropometric variables.

Conclusion: Dietary fats were associated with the harm diet quality, insulin resistance, andhyperhomocysteinemia. However, associations are dependant of demographic variables, dietetic, and nutritional state.
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August 2012

High plasma uric acid concentration: causes and consequences.

Diabetol Metab Syndr 2012 Apr 4;4:12. Epub 2012 Apr 4.

Center for exercise metabolism and nutrition (CeMENutri), Department of Public Health, Botucatu School of Medicine (UNESP), Botucatu, Brazil.

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.
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http://dx.doi.org/10.1186/1758-5996-4-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3359272PMC
April 2012

Dietary variety is a protective factor for elevated systolic blood pressure.

Arq Bras Cardiol 2012 Apr 15;98(4):338-43. Epub 2012 Mar 15.

Centro de Metabolismo em Exercício e Nutrição (CeMENutri) - Departamento de Saúde Pública - Faculdade de Medicina de Botucatu (UNESP), Botucatu, SP, Brazil.

Background: Diet directly influences systemic arterial hypertension (SAH), which is one of the main risk factors for cardiovascular disease.

Objective: To associate hypertension with dietary factors in adults clinically selected for a change-of-lifestyle program.

Methods: Cross-sectional study comprising 335 individuals, aged between 44 and 65 years, clinically selected for a change-of-lifestyle program. We evaluated anthropometric data (BMI, %body fat and waist circumference), biochemical components (plasma glucose, triglycerides, total cholesterol, HDL-C and LDL-c) and diet, through the 24-hour recall method. The quality of the diet was assessed by the Healthy Eating Index. Blood pressure was measured according to the V Brazilian Guidelines on Hypertension and classified according to NCEP-ATPIII. Logistic regression was performed to determine the likelihood of changes in SBP and DBP according to dietary intake. The level of significance was set at p <0.05.

Results: There was a positive correlation between diastolic blood pressure and sugar and cholesterol intake, and a negative one with intake of fiber, portions of oil and fats and diet quality. Dietary variety with ≥ 8 food items showed a protective effect for alterations in systolic blood pressure, OR = 0.361 (0.148 to 0.878).

Conclusion: A greater dietary variety had a protective effect on the systolic blood pressure.
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http://dx.doi.org/10.1590/s0066-782x2012005000024DOI Listing
April 2012

Dietary factors associated with metabolic syndrome in Brazilian adults.

Nutr J 2012 Mar 14;11:13. Epub 2012 Mar 14.

Center for exercise metabolism and nutrition (CeMENutri), Department of Public Health, Botucatu School of Medicine (UNESP), Botucatu, Brazil.

Background: Metabolic Syndrome (MS) is defined as the association of numerous factors that increase cardiovascular risk and diet is one of the main factors related to increase the MS in the population. This study aimed to evaluate the association of diet on the presence of MS in an adult population sample.

Methodology: 305 adults were clinically screened to participate in a lifestyle modification program. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m2) and muscle-mass index (MMI kg/m2). Dietary intake was estimated by 24 h dietary recall. Fasting blood was used for biochemical analysis. MS was diagnosed using NCEP-ATPIII (2001) criteria with adaptation for glucose (≥100 mg/dL). Logistic regression (Odds ratio) was performed in order to determine the odds ratio for developing MS according to dietary intake.

Results: An adequate intake of fruits, OR=0.52 (CI:0.28-0.98), and an intake of more than 8 different items in the diet (variety), OR=0.31 (CI:0.12-0.79) showed to be a protective factor against a diagnosis of MS. Saturated fat intake greater than 10% of total caloric value represented a risk for MS diagnosis, OR=2.0 (1.04-3.84).

Conclusion: Regarding the dietary aspect, a risk factor for MS was higher intake of saturated fat, and protective factors were high diet variety and adequate fruit intake.
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http://dx.doi.org/10.1186/1475-2891-11-13DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337297PMC
March 2012

Plasma glutathione of HIV⁺ patients responded positively and differently to dietary supplementation with cysteine or glutamine.

Nutrition 2012 Jul 20;28(7-8):753-6. Epub 2012 Jan 20.

Department of Public Health, Botucatu Medical School, UNESP-São Paulo State University, Botucatu, São Paulo, Brazil.

Objective: Patients with positivity for the human immunodeficiency virus (HIV⁺) present low concentrations of antioxidant nutrients, including total glutathione (GSH) and its precursors. We investigated the responses of the sulfur-containing amino acid pathway to cysteine and glutamine (Gln) dietary supplements in patients with HIV⁺ compared with healthy controls.

Methods: Twelve treated patients (six men and six women, 22-45 y old) and 20 healthy controls (10 men and 10 women, 20-59 y old) were randomly assigned to 7-d dietary supplements containing N-acetylcysteine (NAC; 1 g/d) or Gln (20 g/d), with a 7-d washout period ingesting their usual diet. Blood samples were drawn after an overnight fast. High-performance liquid chromatographic plasma analysis of sulfur-containing amino acids (methionine, homocysteine, cysteine, and taurine), GSH, oxidized GSH, and serine, glycine, glutamic acid, and Gln was carried out moments before and after 7-d supplementations. Statistical comparisons were undertaken between groups and between dietary supplements (P < 0.05).

Results: Patients with HIV⁺ showed higher oxidized GSH and lower concentrations of GSH and all amino acids except homocysteine. The HIV⁺ group responded to the NAC by increased levels of sulfur-containing amino acids and GSH and equalized taurine and GSH levels in the control group. The Gln supplements also equalized the levels of GSH, Gln, and glycine in the control group.

Conclusion: An increase in GSH may be attained by NAC or Gln supplementation, with NAC acting by increasing cysteine levels and Gln likely acting by replenishing the glycine pool (trial registered at http://www.clinicaltrials.gov, identifier NCT00910442).
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http://dx.doi.org/10.1016/j.nut.2011.10.014DOI Listing
July 2012

[Anthropometric indicators as risk markers for metabolic abnormalities].

Cien Saude Colet 2011 Sep;16(9):3901-8

Centro de Metabolismo em Exercício e Nutrição, Departamento de Saúde Pública, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, 18618-970, Brazil.

The purpose of this study was to determine which anthropometric indicator has the greatest bearing on the metabolic abnormalities in participants of a Lifestyle Change Program. It consisted of an exploratory, transversal and analytical survey, which assessed the body mass index (BMI), waist circumference (WC), percentage of body fat (%BF) and of muscle mass (%MM) of 273 adults and elderly subjects (over 40 years of age). Blood samples after an 8-hour diet were obtained to assess total cholesterol, high-density cholesterol, low-density cholesterol, triacylglycerol and glucose. Statistical analyses for differentiation between the groups and determination of associations were conducted. The level of significance was set at p<0.05. When the metabolic abnormalities were assessed as a dependent variable and BMI, WC, %BF, %MM as independent variables, it was seen that WC was the anthropometric indicator that showed the closest association with all metabolic abnormalities (P<0,0001), followed by %MM. The conclusion reached was that WC rather than BMI was the main marker of anthropometric risk for metabolic abnormalities frequently related to obesity. Given the same WC value, overweight and obese individuals had comparable health risks to eutrophic individuals.
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http://dx.doi.org/10.1590/s1413-81232011001000026DOI Listing
September 2011

Food-dependent, exercise-induced gastrointestinal distress.

J Int Soc Sports Nutr 2011 Sep 28;8:12. Epub 2011 Sep 28.

Centre for Physical Exercise and Nutrition Metabolism, UNESP School of Medicine, Public Health Department, Botucatu City, São Paulo State, Brazil.

Among athletes strenuous exercise, dehydration and gastric emptying (GE) delay are the main causes of gastrointestinal (GI) complaints, whereas gut ischemia is the main cause of their nausea, vomiting, abdominal pain and (blood) diarrhea. Additionally any factor that limits sweat evaporation, such as a hot and humid environment and/or body dehydration, has profound effects on muscle glycogen depletion and risk for heat illness. A serious underperfusion of the gut often leads to mucosal damage and enhanced permeability so as to hide blood loss, microbiota invasion (or endotoxemia) and food-born allergen absorption (with anaphylaxis). The goal of exercise rehydration is to intake more fluid orally than what is being lost in sweat. Sports drinks provide the addition of sodium and carbohydrates to assist with intestinal absorption of water and muscle-glycogen replenishment, respectively. However GE is proportionally slowed by carbohydrate-rich (hyperosmolar) solutions. On the other hand, in order to prevent hyponatremia, avoiding overhydration is recommended. Caregiver's responsibility would be to inform athletes about potential dangers of drinking too much water and also advise them to refrain from using hypertonic fluid replacements.
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http://dx.doi.org/10.1186/1550-2783-8-12DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3190328PMC
September 2011

Comparison of predictive equations for resting energy expenditure in overweight and obese adults.

J Obes 2011 21;2011:534714. Epub 2011 Jul 21.

Department of Public Health, Centre for Physical and Nutritional Metabolism (CeMENutri), São Paulo State University (UNESP), District of Rubião Junior s/no, 18618-970 Botucatu, SP, Brazil.

Objective. To compare values from predictive equations of resting energy expenditure (REE) with indirect calorimetry (IC) in overweight and obese adults. Methods. Eighty-two participants aged 30 to 60 years old were retrospectively analyzed. The persons had a body mass index ≥25 kg/m(2). REE was estimated by IC and other five equations of the literature (Harris and Benedict, WHO1, WHO2, Owen, Mifflin). Results. All equations had different values when compared to those of IC. The best values were found by Harris and Benedict, WHO1, and WHO2, with high values of intraclass correlation coefficient and low values of mean difference. Furthermore, WHO1 and WHO2 showed lower systematic error and random. Conclusion. No predictive equations had the same values of REE as compared to those of indirect calorimetry, and those which least underestimated REE were the equations of WHO1, WHO2, and Harris and Benedict. The next step would be to validate the new equation proposed.
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http://dx.doi.org/10.1155/2011/534714DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3142772PMC
November 2011

Metabolic syndrome and dietary components are associated with coronary artery disease risk score in free-living adults: a cross-sectional study.

Diabetol Metab Syndr 2011 May 9;3. Epub 2011 May 9.

Centre for Nutritional and Physical Exercise Metabolism, UNESP School of Medicine, Public Health Department, Botucatu City, São Paulo State; Brazil.

Background: Coronary artery disease (CAD) is among the main causes of death in developed countries, and diet and lifestyle can influence CAD incidence.

Objective: To evaluate the association of coronary artery disease risk score with dietary, anthropometric and biochemical components in adults clinically selected for a lifestyle modification program.

Methods: 362 adults (96 men, 266 women, 53.9 ± 9.4 years) fulfilled the inclusion criteria by presenting all the required data. The Framingham score was calculated and the IV Brazilian Guideline on Dyslipidemia and Prevention of Atherosclerosis was adopted for classification of the CAD risks. Anthropometric assessments included waist circumference (WC), body fat and calculated BMI (kg/m2) and muscle-mass index (MMI kg/m2). Dietary intake was estimated through 24 h dietary recall. Fasting blood was used for biochemical analysis. Metabolic Syndrome (MS) was diagnosed using NCEP-ATPIII (2001) criteria. Logistic regression was used to determine the odds of CAD risks according to the altered components of MS, dietary, anthropometric, and biochemical components.

Results: For a sample with a BMI 28.5 ± 5.0 kg/m2 the association with lower risk (<10% CAD) were lower age (<60 years old), and plasma values of uric acid. The presence of MS within low, intermediary, and high CAD risk categories was 30.8%, 55.5%, and 69.8%, respectively. The independent risk factors associated with CAD risk score was MS and uric acid, and the protective factors were recommended intake of saturated fat and fiber and muscle mass index.

Conclusion: Recommended intake of saturated fat and dietary fiber, together with proper muscle mass, are inversely associated with CAD risk score. On the other hand, the presence of MS and high plasma uric acid are associated with CAD risk score.
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http://dx.doi.org/10.1186/1758-5996-3-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103417PMC
May 2011

Dietary, anthropometric, and biochemical determinants of plasma high-density lipoprotein-cholesterol in free-living adults.

Cholesterol 2011 15;2011:851750. Epub 2010 Dec 15.

Department of Public Health, CeMENutri-Centre for Physical and Nutritional Metabolism, Sao Paulo State University (UNESP), District of Rubião Junior s/no, 18618-970 Botucatu, SP, Brazil.

The level of high-density lipoprotein is thought to be critical in inhibiting lesion formation as well as reducing the lipid load of preexisting atherosclerotic lesions. With the aim of determining the main determinants of plasma HDL-cholesterol (HDL-c) in free-living adults, 997 individuals (52.3 ± 10 years, 67% females) were selected for a descriptive cross-sectional study. The used data corresponded to the baseline obtained from participants clinically selected for a lifestyle modification program. Covariables of clinical, anthropometry, food intake, aerobic fitness, and plasma biochemistry were analyzed against plasma HDL-c either as continuous or categorized variables. After adjustments for age, gender, and BMI the excess of abdominal fat along with high carbohydrate-energy intake and altered plasma triglycerides were the stronger predictors of reduced plasma HDL-c. In conclusion lifestyle interventions aiming to normalize abdominal fatness and plasma triglycerides are recommended to restore normal levels of HDL-c in these free-living adults.
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http://dx.doi.org/10.1155/2011/851750DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3065868PMC
July 2011

Association of dyslipidemia with intakes of fruit and vegetables and the body fat content of adults clinically selected for a lifestyle modification program.

Arch Latinoam Nutr 2010 Jun;60(2):148-54

Department of Public Health, Botucatu School of Medicine, São Paulo State University (UNESP), São Paulo, Brazil.

To investigate the relationship of dyslipidemia with demographic distribution and patterns of body fat and dietary intakes. From a universe of adults clinically selected for a lifestyle modification program 979 subjects (409 males and 570 females, 52.2 +/- 9.6 years) fulfilled the inclusion criteria. Overnight-fasting plasma was assayed (dry chemistry) for triglycerides (TG), total (TC) and HDL fraction of cholesterol given the non-HDL (n-HDL) fraction by the difference. Anthropometric assessment included body weight (kg), height (m), fat (bioelectrical impedance) and waist circumference (WC). Food intake was assessed by the 24-hour recall questionnaire and the food groups evaluated through recommendations from an adapted food pyramid. The chances of dyslipidemia from other variable changes were determined by logistic regression with p < 0.05. Normal values of BMI and WC were protective against all dyslipidemia markers whereas only hypercholesterolemia was influenced by diet (meat intake >2 servings). Dietary intakes have protective effects against hypertriglyceridemia with whole grains, odds ratio (OR) 0.342 (CI 95%, 0.154-0.760), fruits > or =3 servings (OR 0.523, 0.290-0.941) and vegetables > or =4 servings (OR 0.360, 0.176-0.735). In general total body and abdominal adiposity influenced all dyslipidemia markers while dietary intake of fruits and vegetables protected against triglyceridemia.
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June 2010

Grade of esophageal cancer and nutritional status impact on postsurgery outcomes.

Arq Gastroenterol 2010 Oct-Dec;47(4):348-53

State University of São Paulo, Botucatu, SP, Brazil.

Context: Undernutrition is a well known underlying cause in both disease onset and outcome.

Objective: To associate disease severity with pre surgical nutritional status, the main postsurgical complications, and mortality in esophagus cancer patients.

Method: Retrospective data from 100 patients (38-81 years old, 85% males) who had undergone esophagectomy (G1/n = 25) or gastro/jejunostomy (G2/n = 75) between 1995 and 2004. Data included clinical, endoscopic, histological (TNM-UICC), dietary, anthropometric, blood chemistry, and postsurgical (>30 days) complications and mortality. Surgical groups were compared by Student's test and existing associations between variables by either c² or Fisher exact tests with P = 0.05.

Results: The studied sample was predominantly male (85%), white (80%), smokers and alcoholics (95%), dysphagics (95%) mostly presenting body weight loss before cancer diagnosis (78%). TNM III and IV predominated over I and II, associated (P≤0.005) with higher body mass index and hypoalbuminemia (<3.5 mg/dL) frequency. Esophagic obstructions (n = 77) were associated (P = 0.002) with lower body mass index (kg/m²). Postsurgical complications were more common in G1 (69.2%) than G2, predominantly with infections in G2 (80%) and pleura-pulmonary in G1 (61%). Body mass index and lower lymphocyte counts were associated with early infections and postsurgical complications in G2. Plasma albumin levels were lower in this group than G1, and were associated with postsurgical complications and mortality whereas lower lymphocyte counts was associated with mortality in G1.

Conclusions: Disease severity (or late diagnosis) is associated with poor nutritional status and palliative surgery which lead to more complicated postsurgery outcome and mortality. Early diagnosis and nutritional intervention are the recommended actions.
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http://dx.doi.org/10.1590/s0004-28032010000400006DOI Listing
August 2011

Physical fitness and associations with anthropometric measurements in 7 to 15-year-old school children.

J Pediatr (Rio J) 2010 Nov-Dec;86(6):497-502. Epub 2010 Nov 12.

Centro de Metabolismo em Exercício Físico e Nutrição, Departamento de Saúde Pública, Universidade Estadual Paulista, Botucatu, SP, Brazil.

Objective: To analyze associations between health-related physical fitness and the anthropometric and demographic indicators of children at three elementary schools in Botucatu, SP, Brazil.

Methods: The sample for this cross-sectional study was 988 elementary school students, recruited from the second to ninth grades (an age range of 7 to 15 years). The children underwent anthropometric assessment (weight, height, waist circumference and tricipital and subscapular skin folds) and were tested for health-related physical fitness (flexibility: sit and reach test; abdominal strength/stamina: 1-minute abdominal test; and aerobic stamina: 9-minute running/walking test). Data were analyzed using descriptive statistics plus Student's t test, the chi-square test or Fisher's exact test and logistic regression with a significance level of 5%.

Results: The physical fitness levels observed were significantly influenced by age (all levels), sex (abdominal strength/stamina), obesity (all levels), body adiposity (flexibility, abdominal strength/stamina) and abdominal adiposity (abdominal strength/stamina and aerobic stamina). Females were more prone to be unfit in abdominal strength/stamina. Both obesity and excessive abdominal adiposity predisposed children to be unfit in abdominal strength/stamina and aerobic stamina. Excess body adiposity increased the likelihood of poor trunk flexibility.

Conclusions: Unhealthy physical fitness levels were related to female sex, obesity and excessive abdominal adiposity. Implementing programs designed to effect lifestyle changes to achieve physical fitness and healthy nutrition in these schools would meet the objectives of promoting healthy body weight and increased physical fitness among these schoolchildren.
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http://dx.doi.org/10.2223/JPED.2041DOI Listing
July 2011

[Probiotics and prebiotics in primary care for colon cancer].

Arq Gastroenterol 2010 Jan-Mar;47(1):93-8

Curso de Especialização em Cuidados Nutricionais do Paciente e do Desportista, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista - UNESP, Botucatu, SP.

Context: Colon neoplasias are presently the third most common cancer type. Its treatment is still associated with high risk of complications, thus emphasizing the need to design new treatment strategies. The ingestion of probiotics and prebiotics, or the combination of both (symbiotics), represents a new therapeutic choice. In front of the importance among qualitative and quantitative balance in intestinal microbiota for human's health and with the purpose to evaluate the application of probiotics and prebiotics, this study tries to approach the importance of these in both the prevention and treatment of colon cancer.

Evidence Acquisition: A study was conducted on scientific databases (Medline, Lilacs, PubMed, Ovid, SciELO), and a review was made of recent scientific articles in the literature, from 2003 to 2008. Additional informations were taken from sites in the internet.

Results: Studies point out the inverse relation between the consumption of probiotics and prebiotics in colon cancer diagnosis through various action mechanisms, including: immune response stimulation, reduction in inflammation, for directly inhibiting the formation of tumor cells and for converting pre-carcinogenic substances into carcinogenic ones.

Conclusion: Through this literature review, it was possible to achieve positive answers as regards the use of probiotics and prebiotics in carcinogenesis, which can be adequately recommended.
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http://dx.doi.org/10.1590/s0004-28032010000100016DOI Listing
December 2010

[The supplementation of L-carnitine does not promote alterations in the resting metabolic rate and in the use of energetic substrates in physically active individuals].

Arq Bras Endocrinol Metabol 2010 Feb;54(1):37-44

Programa de Pós-graduação em Nutrição Humana Aplicada, Universidade de São Paulo, Brasil.

Purpose: To investigate the effects of L-carnitine supplementation, over thirty days, on the resting metabolic rate (RMR) and oxidation of free fatty acids (FFA) under rested or exercised conditions.

Subjects And Methods: Twenty-one overweight active volunteers (40 to 58 years old) were randomized into two groups: supplemented (GS; N = 11; 1,8 g/day of L-carnitine) or placebo (GP; N = 10; maltodextrin). Caloric intake, anthropometry, RMR, VO(2max), respiratory exchange ratio and plasma FFA were measured.

Results: No significant changes were found in the caloric intake (-244,66 vs. -126,00 kcal/day), body composition (-0.07 vs. -0.17 kg/m(2)), RMR (0.06 vs. -0.02 kcal/day), respiratory exchange ratio at rest (3.69 vs. -1.01) and exercise (0.01 vs. -0.01) or VO(2max) (0.50 vs. 1.25 mL/kg/min) between GS and GP. Plasma FFA levels were increased under resting conditions only in the GP group (0.27), but no significant changes were observed before or after physical activity in any of the groups.

Conclusion: Supplementation with L-carnitine caused no changes in the variables analyzed in this study.
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http://dx.doi.org/10.1590/s0004-27302010000100007DOI Listing
February 2010

The impact of physical exercise on the gastrointestinal tract.

Curr Opin Clin Nutr Metab Care 2009 Sep;12(5):533-8

Centre for Physical Exercise and Nutrition Metabolism, UNESP School of Medicine, Public Health Department, Botucatu City, São Paulo State, Brazil.

Purpose Of Review: Physical exercise can be both beneficial and harmful for the gastrointestinal tract in a dose-effect relationship between its intensity and health. Mild-to-moderate intensity exercises play a protective role against colon cancer, diverticular disease, cholelithiasis and constipation, whereas acute strenuous exercise may provoke heartburn, nausea, vomiting, abdominal pain, diarrhea and even gastrointestinal bleeding. This review focuses on mechanisms involved in those symptoms and their associations with type of exercises in humans.

Recent Findings: One quarter to one half of elite athletes are hampered by the gastrointestinal symptoms that may deter them from participation in training and competitive events. Vigorous exercise-induced gastrointestinal symptoms are often attributed to altered motility, mechanical factor or altered neuroimmunoendocrine secretions. Training, lifestyle modifications, meal composition, adequate hydration and avoidance of excessive use of some medications are the recommendations.

Summary: Strenuous exercise and dehydrated states would be the causes of gastrointestinal symptoms referred by 70% of the athletes. Gut ischemia would be the main cause of nausea, vomiting, abdominal pain and (bloody) diarrhea. The frequency is almost twice as high during running than during other endurance sports as cycling or swimming and 1.5-3.0 times higher in the elite athletes than the recreational exercisers.
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http://dx.doi.org/10.1097/MCO.0b013e32832e6776DOI Listing
September 2009

[Plasma taurine levels in patients with esophagus cancer].

Arq Gastroenterol 2008 Jul-Sep;45(3):199-203

Programa de Pós-Graduação em Bases Gerais da Cirurgia, Faculdade de Medicina, Universidade Estadual Paulista, Botucatu, SP, Brazil.

Background: The esophagus cancer-host has a two way close relationship as seen in its sulphur-amino acid metabolism. Taurine one of these compounds has ubiquous role in host defense and other physiological mechanisms related to survival.

Aim: To study the plasma levels of taurine and its precursors in patients with esophagus cancer.

Methods: In a sectional design both groups, patients (n = 16, 43-73 yrs old) and healthy controls (n = 20, 27-65 yrs old) were assessed for anthropometry, body-weight lost, hematology (Hb, Ht, total leukocytes and lymphocyte counts), general biochemistry (albumin, glucose, lipids and aminotransferases) and chromatographic analysis for taurine, cysteine, and homocysteine. The survival time was registered there since from the clinical-histopathological diagnosis. All participants had a written ethical consent for the research.

Results: The cancer patients were predominantly, white males of low social economic class, with spinocellular carcinoma stage IV located at upper 3rd half of them presented hypoalbuminemia and 16% referred significant body-weight loss. The patients showed statistically lower values of Hb, Ht, total and HDL cholesterol and cysteine and significantly higher values of taurine, homocysteine and aminotransferases than healthy controls. A positive relationship was found between taurine and either TLC (r = 0.50) and survival (r = 0.81).

Conclusions: Lower plasma cysteine along with higher levels of taurine and homocysteine and the positive direct association of taurine with indications of survival suggest an effective role of this compound and therefore a prospective special nutritional care in its precursors (cysteine, methionine and B vitamins) of these patients.
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http://dx.doi.org/10.1590/s0004-28032008000300006DOI Listing
August 2009

[Sensibility of anthropometric-laboratory markers of protein-energy malnutrition in cirrhotic patients].

Arq Gastroenterol 2004 Apr-Jun;41(2):93-9. Epub 2004 Oct 27.

Centro de Metabolismo e Nutrição, Faculdade de Medicina, Universidade Estadual Paulista--UNESP, Botucatu, SP.

Aim: The prevalence and severity of protein-energy malnutrition (PEM) were investigated through the anthropometric (body mass index, triceps and subescapular skinfolds and upper arm circumferences) and blood measures in 117 cirrhotic patients. The sensitivity and specificity of single or combined PEM markers were tested among Child A (n=18), Child B (n=42) and Child C (n=57) adults (51+/-13y).

Results: Were calculated as z score and considered deficient when z< or =-1.28SD according to local standards. The most deficient markers where albumin (93%), hemoglobin (90%), upper arm circumference (61%), triceps (55%) and subescapular (53%) skinfolds. By combining upper arm circumference with triceps or subescapular skinfolds, PEM were detected in 63% of patients varying from 39-44% (Child A) to 64-68% (Child B or C).

Conclusion: Thus the pattern of PEM present in cirrhosis is predominantly in their protein compartment and worsened with the severity of hepatocellular insuficiency. Upper arm circumference can be used as sensitive markers of presence and severity of PEM in cirrhotic patients but showing low specificity for discriminate PEM among Child grades (B and C) of hepatocellular dysfunctions.
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http://dx.doi.org/10.1590/s0004-28032004000200005DOI Listing
April 2005

Decreased oxidative stress in patients with ulcerative colitis supplemented with fish oil omega-3 fatty acids.

Nutrition 2003 Oct;19(10):837-42

Laboratory of Biochemistry, Londrina State University, Londrina, Parana, Brazil.

Objective: The potential pathogenicity of free radicals may have a pivotal role in ulcerative colitis. Fish oil omega-3 fatty acids exert anti-inflammatory effects on patients with ulcerative colitis (UC), but the precise mechanism of the action of fish oil on oxidative stress is still controversial. The aim of the present work was to verify the blood oxidative stress in patients with UC and determine whether the association of sulfasalazine to fish oil omega-3 fatty acids is more effective than isolated use of sulfasalazine to reduce the oxidative stress.

Methods: Nine patients (seven female and two male; mean age = 40 +/- 11 y) with mild or moderate active UC were studied in a randomized crossover design. In addition to their usual medication (2 g/d of sulfasalazine), they received fish oil omega-3 fatty acids (4.5 g/d) or placebo for 2-mo treatment periods that were separated by 2 mo, when they only received sulfasalazine. Nine healthy individuals served as control subjects to study the oxidative stress status. Disease activity was assessed by laboratory indicators (C-reactive protein, alpha1-acid glycoprotein, alpha1-antitrypsin, erythrocyte sedimentation rate, albumin, hemoglobin, and platelet count), sigmoidoscopy, and histology scores. Analysis of oxidative stress was assessed by plasma chemiluminescence and erythrocyte lipid peroxidation, both induced by tert butyl hydroperoxide (t-BuOOH) and by plasma malondialdehyde. Antioxidant status was assayed by total plasma antioxidant capacity (TRAP) and microsomal lipid peroxidation inhibition (LPI). Superoxide dismutase (SOD) and catalase erythrocyte enzymatic activities were also determined.

Results: No significant changes were observed in any laboratory indicator or in the sigmoidoscopy or histology scores, with the exception of erythrocyte sedimentation rate, which decreased with both treatments. Oxidative stress was demonstrated by significant decreases in TRAP and LPI levels, increased chemiluminescence induced by t-BuOOH, and higher SOD activity in patients with UC. Treatment with fish oil omega-3 fatty acids reverted the chemiluminescence induced by t-BuOOH and LPI to baseline levels but that did not occur when patients received only sulfasalazine. Levels of plasma malondialdehyde, erythrocyte lipid peroxidation, and catalase were not different from those in the control group.

Conclusions: The results indicated that plasma oxidative stress occurs in patients with UC, and there was a significant decrease when the patients used sulfasalazine plus fish oil omega-3 fatty acids. However, there was no improvement in most laboratory indicators, sigmoidoscopy, and histology scores. The results suggested that omega-3 fatty acids may act as free radical scavengers protecting the patients against the overall effect of oxidative stress.
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http://dx.doi.org/10.1016/s0899-9007(03)00162-xDOI Listing
October 2003
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