Bruno Affonso Parenti de Oliveira

Red meat intolerance in patients submitted to gastric bypass: a 4-year follow-up study

BACKGROUND Bariatric surgery provides significant weight reduction; however, it may result in food intolerance followed by gastrointestinal complications that may lead to nutritional deficiencies. This study evaluated the influence of red meat intolerance on the dietary pattern, biochemical indicators, and clinical symptoms after Roux-en-Y gastric bypass (RYGB). METHODS This retrospective study evaluated patients 4 years after RYGB. The patients were divided into 2 groups: patients with and without red meat intolerance, and data for the following were collected: food intake, anthropometric data, biochemical data, and presence of nausea, vomiting, weakness, weak nails, and hair loss. The difference between groups in the times postoperative was determined by ANOVA. RESULTS Of the 72 patients included in the study, 63 were evaluated during the first postoperative year, 45 during the second, 56 during the third, and 41 during the fourth. Red meat intolerance was observed in 49.2%, 42.2%, 46.4%, and 39% of the patients after 1, 2, 3, and 4 years, respectively. After 1 year, the intolerant group showed lower calorie, carbohydrate, and iron intake. After 3 years, tolerant patients showed weight regain (2.9 ± 5.3 kg), while the intolerant ones remained stable. There was no difference in the presence of clinical symptoms or biochemical indicators between groups. CONCLUSION Red meat intolerance is frequent after bariatric surgery and may alter energy, iron intake, and weight loss; however, it is not associated with the presence of clinical symptoms and biochemical profile.

UCP1 -3826 A>G polymorphism affects weight, fat mass, and risk of type 2 diabetes mellitus in grade III obese patients

OBJECTIVE We investigated whether or not the UCP1 -3826 A>G polymorphism is associated with obesity and related metabolic disorders in grade III obese patients. METHODS 150 obese patients (body mass index ≥35 kg/m(2)) who were candidates for bariatric surgery were studied. Weight (kg), body mass index (kg/m(2)); fat free mass (kg), fat mass (kg), energy intake (kcal), level of physical activity, plasma levels of glucose, total cholesterol, low-density lipoprotein, high-density lipoprotein (HDL), triacylglycerols, and the prevalence of comorbidities associated with obesity were collected from medical records. Polymorphism rs1800592 genotyping was performed through allelic discrimination method in real time polymerase chain reaction using the TaqMan predesigned SNP Genotyping Assays kits. The t test was done to determine if genotypes of each polymorphism are associated with anthropometric and body composition variables. Linear regression models were used for age, sex, height, physical activity, and energy intake in weight and body composition variations (P < 0.05). RESULTS Among these 150 individuals (47.2 ± 10.5 y, 80% women) the distribution of AA, AG, and GG was 41.3%, 45.3%, and 13.4%, respectively. Weight and body fat were lower in individuals who were carriers of a mutated allele G. It was observed that mutated homozygotes (GG) had a lower frequency of type 2 diabetes mellitus compared with those of wild allele (AA+AG). CONCLUSIONS UCP1 -3826 A>G polymorphism is associated with weight, body fat mass, and risk of type 2 diabetes mellitus in obese individuals candidates for bariatric surgery.

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

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/m2). 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.

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

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.

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

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.

Green tea supplementation promotes leukocyte telomere length elongation in obese women

INTRODUCTION inflammation and oxidative stress are factors that may play a substantial role in telomere attrition. In line of this, obesity is associated with telomere shortening. Green tea had anti-inflammatory and antioxidant effects and may alter telomere length (TL). OBJECTIVES we evaluated the effect of decaffeinated green tea supplementation in obese women on TL. METHODS we conducted a cross-sectional interventional study with ten obese (body mass index [BMI] > 40 kg/m²) and eight normal weight (BMI > 18.5 and < 24.9 kg/m²) women (age between 27 and 48 years). The supplementation was carried out with capsules (each contained 450.7 mg of epigallocatechin-3-gallate) during eight weeks. Anthropometric and dietary intake assessment, and blood collection (for biochemical and TL analysis by quantitative PCR) were performed before and after supplementation. Normal weight patients were evaluated at a single moment. RESULTS we observed a significant increase on TL after supplementation (1.57 ± 1.1 to 3.2 ± 2.1 T/Sratio; p < 0.05). Moreover, we found shorter TL in obese patients (day 0) when compared to normal weight individuals (3.2 ± 1.9 T/Sratio; p < 0.05) and an inverse association between TL and BMI, even after age adjustment (beta = -0.527; r² = 0.286; IC = -0.129, -0.009). CONCLUSION obesity is related to shorter telomeres. Green tea supplementation during eight weeks promotes telomere elongation in obese women.

Addition of Protein in Carbohydrate Supplementation Does not Improve Performance of Amateur Runners in Exercise above the Anaerobic Threshold

There is no consensus in the literature that supports the inclusion of protein in the carbohydrate supplement in endurance exercise. The purpose of this study was to compare the physical performance of amateur runners under three different supplementation protocols: placebo (PLA), carbohydrate (CHO) and carbohydrate plus protein (CHO + PTN). Twelve amateur runners performed three exercise protocols on separate occasions consisting of 60 initial minutes with intensity referring to the Anaerobic Threshold (AT) and then 10% above the AT until exhaustion. Supplements (150 mL) were ingested 15 minutes before starting the activity and every 20 minutes until the first hour of exercise. Biochemical analyzes (blood glucose and lactate) and rating of perceived exertion (RPE) were measured before, during and after exercise protocols. Total caloric intake (Kcal) and macronutrients (g) were evaluated in the 24 hours preceding each exercise protocol. The time of exhaustion was higher for the CHO group when compared to the PLA group (24.6±13.6 vs. 15.2±8.9 minutes, p = 0.001) and the CHO + PTN group (24.6±13.6 vs. 18.6±8.4 minutes, p = 0.01). In general, glycemia was higher for the CHO and CHO + PTN groups when compared to the PLA group at all times whereas lactate, RPE and dietary assement did not show great differences. Our results suggest that, unlike supplementation with CHO alone, the addition of PTN in CHO supplements does not result in improved performance for the studied population and exercise intensity.

Colorimetric Analysis of Cotton Textile Bleaching through H2O2 Activated by UV Light

The bleaching process is one of the steps of cotton fabric manufacture. Traditionally, the most common bleaching procedure is based on the use of a hydrogen peroxide (H2O2) solution in alkali pH associated with high temperature. In this study, we investigated the possibility of applying a photolysis technique, combining ultraviolet (UV) light and H2O2 in acidic pH to promote raw cotton fabric bleaching, without adding heat and stabilizers to the process. A colorimetric analysis was performed to assess the bleaching procedure in the samples. The experiment consisted in moistening cotton fabric samples with H2O2 and then illuminating them with UV light with different doses, ranging from 0.6 to 36 J cm. Our findings have shown that it is important to balance the hydrogen peroxide and the amount of delivered UV light to the cotton fabric in order to achieve a satisfactory whiteness without compromising the fabric mechanical properties.

Evaluation of cotton-fabric bleaching using hydrogen peroxide and Blue LED

The raw cotton production requires multiple steps being one of them the removal of impurities acquired during previous processes. This procedure is widely used by textile industries around the world and is called bleaching. The raw cotton is composed by cellulosic and non-cellulosic materials like waxes, pectins and oils, which are responsible for its characteristic yellowish color. The bleaching process aims to remove the non-cellulosic materials concentration in the fabric, increasing its whiteness degree. The most used bleaching method utilizes a bath in an alkali solution of hydrogen peroxide, stabilizers and buffer solutions under high temperature. In the present study we evaluated the possibility of using a blue illumination for the bleaching process. We used blue LEDs (450 nm) to illuminate an acid hydrogen peroxide solution at room temperature. The samples treated by this method were compared with the conventional bleaching process through a colorimetric analysis and by a multiple comparison visual inspection by volunteers. The samples were also studied by a tensile test in order to verify the integrity of the cloth after bleaching. The results of fabric visual inspection and colorimetric analysis showed a small advantage for the sample treated by the standard method. The tensile test showed an increasing on the yield strength of the cloth after blue light bleaching. The presented method has great applicability potential due to the similar results compared to the standard method, with relative low cost and reduced production of chemical waste.

Comparisons between predictive equations of resting metabolic rate and indirect calorimetry in obese teenagers

Objective: To measure the accuracy of predictive equations of resting metabolic rate (RMR) in obese teenagers in relation to indirect calorimetry (IC). Methods: This study was conducted with 116 obese teenagers (60 males; 13.7±1.1 years). The RMR was calculated from Harris and Benedict, Schofield, WHO, Henry and Rees equations. The RMR was measured by the QUARK-RMR system. The comparison between predictive equations and IC was by the Student’s t test. The reliability of data between predictive equations and IC was verified by the typical error of measu rement (TEM) and the coefficient of variation (CV%). Results: Henry’s equation was significantly different from IC (p<0.02). The CV% found for each equations compared to IC turned was low. However, when the TEM was measured it was considered high in absolute values which can cause errors when estimating the RMR. Therefore, it is important that specific predictive equations are developed for Brazilian obese teenagers.