Aline Silva de Aguiar

Influence of the leptin and cortisol levels on craving and smoking cessation

Leptin inhibits cortisol release and may increase the craving for cigarettes, hindering the process of smoking cessation. We evaluate the influence of the initial concentration of cortisol and serum leptin on craving and smoking status in individuals after one month of treatment for smoking cessation. The leptin concentration was adjusted by the Initial Body Mass Index (BMI) (leptin/BMI) and the initial percentage of body fat (%BF) (leptin/%BF). The craving was assessed using the Questionnaire of Smoking Urges-Brief (QSU-Brief). The QSU-Brief was assessed about a score of factor 1 (positive reinforcement by tobacco), and factor 2 (negative reinforcement by tobacco). Correlation was found between QSU-Brief (Factor 1 and 2) with the initial concentration of leptin/BF% among those who continued to smoke. There was a negative correlation between cortisol levels and leptin/%BF in individuals who remained smokers after 1 month. There was a positive correlation between leptin/BMI and leptin/%BF with the QSU-Brief (Factor 2) of 1 month in women who remained smokers (r=0.565; p=0.023) and the QSU-Brief (Factor 2) initial among the abstinent women (r=0.551; p=0.033). The highest concentrations of leptin were associated with greater craving and difficulty in achieve abstinence.

Por que a ingestão de carambola é proibida para pacientes com doença renal crônica

New studies have shown the mechanism by which the star fruit (Averrhoa carambola) becomes toxic to individuals with chronic kidney disease (CKD). The aim of this study was to review the current literature on the topic. This is a review article, with publications from 2000 to 2014 available in scientific database. There are reports that neurotoxicity is due to the presence of oxalate in star fruit, but recent findings show that the neurotoxic effect of the toxin is by caramboxin, which appears to inhibit the GABAergic system which is the major inhibitory system in the central nervous system (CNS), involving changes as sobs and confusion, to more serious conditions such as seizures and death. It is important to multidisciplinary action to alert patients with CKD as the prohibition of the star fruit consumption.New studies have shown the mechanism by which the star fruit (Averrhoa carambola) becomes toxic to individuals with chronic kidney disease (CKD). The aim of this study was to review the current literature on the topic. This is a review article, with publications from 2000 to 2014 available in scientific database. There are reports that neurotoxicity is due to the presence of oxalate in star fruit, but recent findings show that the neurotoxic effect of the toxin is by caramboxin, which appears to inhibit the GABAergic system which is the major inhibitory system in the central nervous system (CNS), involving changes as sobs and confusion, to more serious conditions such as seizures and death. It is important to multidisciplinary action to alert patients with CKD as the prohibition of the star fruit consumption.

SERUM CONCENTRATION OF NITRIC OXIDE IN WOMEN SMOKERS AND NONSMOKERS WITH OVERWEIGHT.

AIM to evaluate the serum concentration of NO in overweight women, smokers (SG) and nonsmokers (NSG). METHODS blood samples from smokers (n = 20) and nonsmokers (n = 18) were collected to obtain serum, and stored at -80 °C until analysis. NO was assessed by measuring total nitrite, determined by Greiss method. It was adopted as reference 24.4 μmol/L, mean value found in a study with healthy subjects without excess weight. We used the Student t test to compare the means of age and waist circumference, and the Mann-Whitney U test to compare the median of concentrations of nitrite, number of cigarettes/day and Body Mass Index. We adopted a significance level of p < 0.05. RESULTS the median nitrite in SG was 16.53 (2.79 - 69.72) μmol/L, whereas in NSG was 10.85 (1.44 - 43.25) μmol/L (p = 0.028). BMI median value to SG and NSG, was respectively 29.50 (25.00 - 38.14) kg/m2 and 30.68 (25.10 - 36.98) kg/m2 (p = 0.530), being classified as overweight. The data showing that the average nitrite was below the estimated value for healthy individuals. CONCLUSION the results indicate a decrease of NO metabolites in women with excess weight, independently of being smoker. Despite the significant difference found between groups, these women had values well below the reference value of NO for healthy women. Therefore, it seems that smoking does not interfere in nitrite levels in patients already compromised by obesity.

Tradução e adaptação cultural do questionário sobre motivo das escolhas alimentares (Food Choice Questionnaire – FCQ) para a língua portuguesa

The Food Choice Questionnaire (FCQ) assesses the importance that subjects attribute to nine factors related to food choices: health, mood, convenience, sensory appeal, natural content, price, weight control, familiarity and ethical concern. This study sought to assess the applicability of the FCQ in Brazil; it describes the translation and cultural adaptation from English into Portuguese of the FCQ via the following steps: independent translations, consensus, back-translation, evaluation by a committee of experts, semantic validation and pre-test. The pre-test was run with a randomly sampled group of 86 male and female college students from different courses with a median age of 19. Slight differences between the versions were observed and adjustments were made. After minor changes in the translation process, the committee of experts considered that the Brazilian Portuguese version was semantically and conceptually equivalent to the English original. Semantic validation showed that the questionnaire is easily understood. The instrument presented a high degree of internal consistency. The study is the first stage in the process of validating an instrument, which consists of face and content validity. Further stages, already underway, are needed before other researchers can use it.

Serum levels of nitric oxide and cytokines in smokers at the beginning and after 4 months of treatment for smoking cessation

INTRODUCTION Nitric oxide (NO) modulates inflammatory reactions, having beneficial or toxic effects depending on the concentration. Its elevation can cause proinflammatory effects amplifying the inflammatory process with the participation of cytokines. Smoking has a negative impact on health and is considered one of the risk factors that influence disease development facilitating inflammatory processes. AIM To compare the serum concentration of NO and cytokines in smokers at baseline and after 4months of abstinence treatment. METHODS Blood samples which were collected to obtain the serum, at baseline and after 4months, were stored at -80°C until analysis. NO was measured by the total dose of nitrite determined by the Greiss method. CBA was the used technique to determine the concentration of cytokines in supernatants serum. The initial and final results of NO, TNF-α, IL-1, IL-6, IL-8, IL-10 and IL-12 that remained after 4months treatment were compared. Wilcoxon test was used to compare the data and Spearman test for correlations between NO and other variables. A significance level of p<0.05 was adopted. RESULTS The analysis of NO observed a significant reduction (p=0.001) of the initial median value of 18.80 (3.55-80.01) μmol/L to 8.10 (2.85-14.97) μmol/L after 4months of treatment. There were no significant differences in cytokines from baseline to the end of treatment. CONCLUSION The results may not mean harm to the body, but an adaptive process, decreasing the metabolism of abstinents due to the reduction of the use of nicotine.

Estágios motivacionais para mudança de comportamento em indivíduos que iniciam tratamento para perda de peso

Objective Although there are effective programs for treating obesity, are large dropout rates. The aim of this study was to investigate the motivational stage in patients who were overweight or obesity I and II, in an outpatient clinic nutrition, and its associated factors. Methods It is a cross-sectional study with convenience sampling, in which information from the clinical history, anthropometry, binge eating (BES – Binge Eating Scale) and motivation for treatment (URICA – University of Rhode Island Change Assessment Scale) were collected. Results Of the 48 evaluated, 29.2% were in precontemplation stage, 41.7% were in contemplation stage and 29.2% were in action stage. Who sought treatment for comorbidity control besides the weight loss had greater readiness score (p = 0.024). Motivation was not related to nutritional status, nor the previous attempt at weight loss, but was related to the previous professional guidance (p = 0.005). Among 26.8% had moderate or severe symptoms for binge eating, 90.9% were in contemplation, with a significant difference in pre-contemplation (p = 0.001) and action (p = 0.02). Conclusion These results suggest that individuals who seek treatment for weight loss do not make it with the necessary motivation, and that if professional advice on the weight loss importance occurred before the associated with obesity pathologies were installed, more motivated individuals could seek treating and preventing these complications.

Alteration of inflammatory adipokines after four months of smoking abstinence in multidisciplinary intervention program

BACKGROUND many endocrine-metabolic changes are involved in smoking. OBJECTIVES to evaluate serum concentrations of inflammatory adipokines in smokers at baseline and after four months of treatment for smoking cessation. METHODS the serum concentrations of inflammatory cytokines were evaluated in smokers and abstinent. Nutritional assessment was based on measurements of body weight, height, and waist circumference (WC), to calculate body mass index (BMI), body adiposity index (BAI) and waist-to-height ratio (WHtR). Biochemical parameters were analyzed: total cholesterol, LDL-c, HDL-c, triglycerides, glucose, cortisol and insulin. The serum levels of leptin, adiponectin and ghrelin were determined by enzyme-linked immunosorbent assay (ELISA). The leptin/adiponectin ratio (L/A) was calculated. RESULTS a total of 29 subjects were included in this study (22 women and seven men). The mean age of participants was 50.7 ± 10.47 years. The medium values of WHtR and BAI were above of the proposed cutoff point, indicating abdominal obesity. The biochemical parameters did not present statistically significant differences when comparing the initial and final values. At the end of treatment, the abstinent had higher levels of adiponectin when compared to those who remained smoker (p = 0.024). There was an increase in leptin levels and L/A, and a reduction in adiponectin levels after the treatment in abstinent and smokers (p < 0.05). CONCLUSION this study has demonstrated that smoking cessation improves adiponectin levels when compared with smokers. Leptin and L/A levels increased throughout the treatment in both groups. The increased values of leptin and L/A in abstinent participants may indicate risk of metabolic events associated with smoking history that should be investigated.

Caloric and protein intake in different periods of hospitalization of patients undergoing hematopoietic stem cell transplantation

Objective To evaluate the nutritional status and caloric and protein intake during the hospitalization of patients undergoing hematopoietic stem cell transplantation. Methods A retrospective study was performed based on clinical and nutritional data of patients undergoing autologous and allogeneic hematopoietic stem cell transplantation from March 2015 to March 2017. The mean caloric and protein intake were evaluated in three different intervals (P1: from admission to the day before transplantation, P2: from the transplantation day to the day before engraftment, P3: from the engraftment day to the day of hospital discharge). Body mass index, weight loss, gastrointestinal symptoms and use of nutritional therapy were also evaluated. Results Thirty-five patients were included in this study (25 autologous and ten allogeneic). The majority (62.6%) were overweight at admission. The median and percentage weight loss were 3.2 kg and 4.6%, respectively. A nutritional supplement was provided to 33 patients for a median of nine days. The most prevalent gastrointestinal symptoms were nausea (91.4%), vomiting (88.6%) and diarrhea (80%). The mean caloric and protein intake and adequacy of patients were 1569.0 ± 443.3 Kcal (73.6 ± 22.1%) and 66 ± 22.8 g (61.9 ± 20%), respectively. The allogeneic group presented lower intake and caloric and protein adequacy throughout hospitalization, in particular in P2, compared to the autologous patients. Conclusion The patients presented deterioration of nutritional status during hospitalization with the reduction in food intake being greater in patients submitted to allogeneic transplantation.

Maternal soybean diet during lactation alters breast milk composition and programs the lipid profile in adult male rat offspring

PurposeTo evaluate the effects of maternal dietary soybean during lactation on the milk composition, body composition, lipid profile and glucose homeostasis of dams and offspring at weaning (21 days) and adulthood (150 days).MethodsLactating rats were divided into: casein control (C): casein diet; soy (S): soybean diet; soy oil control (SOC): casein diet, but with fat content similar to the S group.ResultsAt 21 days, S mothers showed lower estradiol, total cholesterol (TC), low-density lipoprotein cholesterol (LDL) and triglycerides (TG) in serum; and lower TC and TG in milk. The S offspring had lower body weight, body fat mass, TC, LDL, hyperleptinemia and hypertriglyceridemia. At 150 days, S offspring presented higher total mineral content and lower TC (v. SOC) and LDL (v. C and SOC), and hyperinsulinemia with lower glycemia v. SOC group, which had lower insulinemia with higher glycemia, TC and LDL.ConclusionsMaternal intake of soybeans in lactation changes the lipid content of breast milk and programmed offspring for phenotype of the lower metabolic risk, with lower serum TC and LDL, and seems to protect the progeny of alterations in glucose metabolism despite the higher lipid content. The difference in fat content of breast milk and the higher isoflavones content of soy diet are possible imprinting factors that could program the offspring.