Antonio Herbert Lancha Junior

Obesidade: atualização sobre sua etiologia, morbidade e tratamento

The trend in nutritional transition in this century leads to an occidentalized diet, which, allied to a decrease in physical activity, results in increasing of obesity all over the world. It raises the risk of morbidity and mortality, since obesity is the first step to several diseases such as Diabetes type II, hypertension, cardiovascular and gallbladder diseases. Obesity is not only a scientific and public health problem, but also an industry of pharmacos, special foods and governmental strategies to encourage people to be more active and to provide more food information in order to promote better habits. Several studies all around the world discuss the causes and treatments for obesity. In this way, this paper summarizes these researches, approaching the elements associated with higher obesity incidence and prevalence, the diseases related to overweight and the treatments for reducing body fat.

Exploring the therapeutic role of creatine supplementation

Creatine (Cr) plays a central role in energy provision through a reaction catalyzed by phosphorylcreatine kinase. Furthermore, this amine enhances both gene expression and satellite cell activation involved in hypertrophic response. Recent findings have indicated that Cr supplementation has a therapeutic role in several diseases characterized by atrophic conditions, weakness, and metabolic disturbances (i.e., in the muscle, bone, lung, and brain). Accordingly, there has been an evidence indicating that Cr supplementation is capable of attenuating the degenerative state in some muscle disorders (i.e., Duchenne and inflammatory myopathies), central nervous diseases (i.e., Parkinson’s, Huntington’s, and Alzheimer’s), and bone and metabolic disturbances (i.e., osteoporosis and type II diabetes). In light of this, Cr supplementation could be used as a therapeutic tool for the elderly. The aim of this review is to summarize the main studies conducted in this field and to highlight the scientific and clinical perspectives of this promising therapeutic supplement.

Rapid weight loss followed by recovery time does not affect judo-related performance

Abstract In this study, we investigated the effects of rapid weight loss followed by a 4-h recovery on judo-related performance. Seven weight-cycler athletes were assigned to a weight loss group (5% body weight reduction by self-selected regime) and seven non-weight-cyclers to a control group (no weight reduction). Body composition, performance, glucose, and lactate were assessed before and after weight reduction (5–7 days apart; control group kept weight stable). The weight loss group had 4 h to re-feed and rehydrate after the weigh-in. Food intake was recorded during the weight loss period and recovery after the weigh-in. Performance was evaluated through a specific judo exercise, followed by a 5-min judo combat and by three bouts of the Wingate test. Both groups significantly improved performance after the weight loss period. No interaction effects were observed. The energy and macronutrient intake of the weight loss group were significantly lower than for the control group. The weight loss group consumed large amounts of food and carbohydrate during the 4-h recovery period. No changes were observed in lactate concentration, but a significant decrease in glucose during rest was observed in the weight loss group. In conclusion, rapid weight loss did not affect judo-related performance in experienced weight-cyclers when the athletes had 4 h to recover. These results should not be extrapolated to inexperienced weight-cyclers.

Subnotificação da ingestão energética na avaliação do consumo alimentar

Valid data on energy and nutrient consumption are necessary in human nutrition research, mainly in epidemiologic studies concerning diet and health. Until the advent of doubly labeled water, it was not possible to validate dietary assessment methods using an independent procedure and this marker showed an important underreporting of energy intake. This paper aims to discuss the major aspects related to this phenomenon: prevalence, determinants, nutrient specificity and attenuation. Underreporting seems to be associated with obesity and with psychological and social factors, such as dietary restraint and social desirability. Error in the dietary assessments may lead to under- or over-estimation (less common). Underreporting seems to be specific to lipid- and carbohydrate-rich foods, introducing then a serious bias on conclusions based on food surveys. This paper also discusses how to deal with this error and recommends that energy intake estimates be validated against energy expenditure values, in order to detect underreporting.

The possible role of physical exercise on the treatment of idiopathic inflammatory myopathies.

Idiopathic inflammatory myopathies (IIM) are a heterogeneous group of diseases that share some symptoms such as muscular weakness and inflammation of skeletal muscle. Complete recovery of muscle function with pharmacological treatment does not always occur, suggesting that physical inability is a great concern for these patients. In this context, it has been speculated that physical exercise could result in functional benefits to patients with IIM, leading to an improvement in quality of life. In fact, recent studies of polymyositis (PM) and dermatomyositis (DM) support the notion that exercise training improves or at least stabilizes muscle strength and functional ability without inducing disease flares. Importantly, these benefits were observed not only during the chronic phase, but also in the course of active disease. This positive effect was found to be long term, as demonstrated by a six-month significant improvement in exercise capacity and strength. Together, these findings indicate that a well controlled exercise program can be recommended for patients with DM and PM. The optimal exercise modality training and the underlying mechanism for this encouraging response remain to be determined in future studies.

Tradução, adaptação e avaliação psicométrica da Escala de Conhecimento Nutricional do National Health Interview Survey Cancer Epidemiology

OBJECTIVE: The study aimed to translate and adapt into Portuguese the nutrition knowledge scale applied in the National Health Interview Survey Cancer Epidemiology and to evaluate its validity and precision. METHODS: The scale was translated, back-translated, and then adapted. Typical foods from the American diet were replaced by other foods that are typical of the Brazilian diet. The questionnaire was administered to 39 women with eating disorders and 57 Dietetics students. The students were expected to have higher scores, which would attest the discriminating validity of the scale. The students were tested twice and a correlation coefficient between test and retest was obtained. RESULTS: The students scored 10.5 points with a standard deviation of 1.7 points while the patients scored 7.4 points with a standard deviation of 2.6 points (p=0.0000001). Only 1.75% of the students presented low knowledge versus 34.21% of the patients (p<0.005). High knowledge was found among 57.90% of the students and among 13.16% of the patients (p<0.005). Spearmans correlation coefficient was 0.52 (p=0.00009). CONCLUSION: The test fulfilled all the psychometric criteria for validation but its precision needs to be reassessed. The time interval between the first and second test should be smaller. Since the students are still learning, it would be interesting to apply the scale to dietitians given that their knowledge is more stable.

Development, validity and reliability of a questionnaire designed to evaluate rapid weight loss patterns in judo players

The aim of this study was to develop a questionnaire to evaluate rapid weight loss patterns of competitive judo players and to assess its validity and reliability. We evaluated the reliability (n=94), content validity (evaluation by 10 experts), discriminant validity (differences in scores between athletes with body weight below and above their weight class; n=100) and convergent validity (correlation with Restraint Scale; n=60). No item was considered unclear or ambiguous by more than 20% of the experts. The intraclass Coefficient Correlation was above 0.90 for all questions whose answers were parametric (P<0.001; n=94) and no significant differences were found between test and retest scores (n=94 – Wilcoxons signed rank test). Cronbachs α was 0.98 for scores obtained between test and retest. Non‐numerical questions showed proportions of agreement >80%; Spearmans Correlation between the Restraint Scale and the Rapid Weight Loss Questionnaire was 0.62 (P<0.001; n=60). Athletes below their weight class (n=50) had a significantly lower score compared with athletes above the weight class (n=50; P<0.001 – Mann–Whitney U test). In conclusion, the questionnaire showed good validity and reliability and could be used accurately to assess weight loss patterns of judo players.

Magnitude e métodos de perda rápida de peso em judocas de elite

Fizeram parte do estudo 28 judocas de elite do sexo masculino, da cidade de Sao Paulo. Os atletas tiveramaferido o seu peso corporal, e relataram em que categorias de peso competiam. Desses, 19 foram entrevistadospor nutricionista, para a investigacao de questoes relativas ao historico de peso e de dietas. O estudo foiconduzido entre agosto de 2002 e junho de 2004.

Dietas hiperglicídicas: efeitos da substituição isoenergética de gordura por carboidratos sobre o metabolismo de lipídios, adiposidade corporal e sua associação com atividade física e com o risco de doença cardiovascular

For many years the reduction in the dietary fat has been recommended to the population, in order to prevent cardiovascular diseases, obesity, type 2 diabetes mellitus, among other chronic diseases. The consequence has been the replacement of carbohydrates by fat, resulting in the adoption of high carbohydrate diets. However, it has been still discussed if very rich carbohydrate diets should be recommended to the general population. Researches point out controversies about the association between these dietary habits and harmful effects on health and metabolic aspects, such as raise in de novo lipogenesis and triglyceride concentration, reduction in HDL concentration and effects on adiposity. This review evaluates the effects of diet modification, particularly the high-carbohydrate diet, in cardiovascular risk factors such as dyslipidemia and obesity. It also reviews its interaction with physical activity since it is still unknown with which extension it can minimize possible harmful effects of high carbohydrate diets in the long term.

Does long-term creatine supplementation impair kidney function in resistance-trained individuals consuming a high-protein diet?

BackgroundThe aim of this study was to determine the effects of creatine supplementation on kidney function in resistance-trained individuals ingesting a high-protein diet.MethodsA randomized, double-blind, placebo-controlled trial was performed. The participants were randomly allocated to receive either creatine (20 g/d for 5 d followed by 5 g/d throughout the trial) or placebo for 12 weeks. All of the participants were engaged in resistance training and consumed a high-protein diet (i.e., ≥ 1.2 g/Kg/d). Subjects were assessed at baseline (Pre) and after 12 weeks (Post). Glomerular filtration rate was measured by 51Cr-EDTA clearance. Additionally, blood samples and a 24-h urine collection were obtained for other kidney function assessments.ResultsNo significant differences were observed for 51Cr-EDTA clearance throughout the trial (Creatine: Pre 101.42 ± 13.11, Post 108.78 ± 14.41 mL/min/1.73m2; Placebo: Pre 103.29 ± 17.64, Post 106.68 ± 16.05 mL/min/1.73m2; group x time interaction: F = 0.21, p = 0.64). Creatinine clearance, serum and urinary urea, electrolytes, proteinuria, and albuminuria remained virtually unchanged.ConclusionsA 12-week creatine supplementation protocol did not affect kidney function in resistance-trained healthy individuals consuming a high-protein diet; thus reinforcing the safety of this dietary supplement.Trial registrationClinicalTrials.gov NCT01817673