Ioná Zalcman Zimberg

Hormonal appetite control is altered by shift work: a preliminary study

Shift work has been associated with a higher propensity for developing nutritional problems and obesity. However, the possible changes in leptin and ghrelin (2 hormones that contribute importantly to the central regulation of food intake) concentrations in this population are poorly described. The objective of the study was to evaluate the daily concentrations of leptin, nonacylated ghrelin, and acylated ghrelin and the appetite ratings in men working different shift schedules. Daily concentrations of nonacylated ghrelin, acylated ghrelin, and leptin and appetite were measured in 3 groups of subjects: workers on fixed night shifts (n = 9), fixed early morning shifts (n = 6), and fixed day shifts (n = 7). Appetite was evaluated by a validated questionnaire. Blood samples were collected every 4 hours over the course of 24 hours for a total of 6 samples. When comparing the 3 groups, leptin concentrations at 8:00 am and 4:00 pm for those workers on the day shift were significantly lower than for those on the early morning shift; and concentrations at noon for those workers on the day shift were significantly lower than for those on the night shift. Nonacylated and acylated ghrelin concentrations were significantly lower for those workers on the early morning shift than for those on the day shift. In general, appetite was the lowest in those working the early morning shift. Shift workers on the early morning shift have lower appetites and concentrations of leptin and nonacylated and acylated ghrelin than the workers on other shifts. Further studies are required to better understand the detailed needs of these individuals.

Short sleep duration and obesity: mechanisms and future perspectives

A reduction of sleep time has become common over the last century, and growing evidence from both epidemiological and laboratory‐based studies suggests sleep curtailment is a new risk factor for the development of obesity. On this basis, the present review examines the role of sleep curtailment in the metabolic and endocrine alterations, including decreased glucose tolerance and insulin sensitivity, increased evening concentrations of cortisol, increased levels of ghrelin, decreased levels of leptin and increased hunger and appetite. It will be discussed how sleep restriction may lead to increase in food intake and result in greater fatigue, which may favour decreased energy expenditure. Altogether, evidences point to a possible role of decreased sleep duration in the current epidemic of obesity and therefore present literature highlights the importance of getting enough good sleep for metabolic health. Many aspects still need to be clarified and intervention studies also need to be conducted. Copyright

Relationship between Food Intake and Sleep Pattern in Healthy Individuals

STUDY OBJECTIVES The purpose of this study was to analyze the relationship between food intake and sleep patterns in healthy individuals. METHODS Fifty-two healthy volunteers (27 women and 25 men) were recruited to participate in the study. Volunteers underwent sleep evaluation through nocturnal polysomnography and completed a 3-day food diary to evaluate food intake. RESULTS No differences in sleep patterns were observed in either gender, except in the percentage of stage 1 sleep, which was greater in men. Different correlations were observed between sleep and dietary variables according to gender. The correlation between dietary and sleep variables in men indicated a negative relationship between nocturnal fat intake and the sleep latency, including REM sleep. The percentage of nocturnal fat intake correlated with sleep efficiency, sleep latency, REM latency, stage 2 sleep, REM sleep, and wake after sleep onset (WASO) in women. The percentage of nocturnal caloric intake correlated with sleep latency and efficiency in women. CONCLUSIONS We conclude that food intake during the nocturnal period is correlated with negative effects on the sleep quality of healthy individuals. Indeed, food intake near the sleeping period (dinner and late night snack) was negatively associated with sleep quality variables. More studies are necessary to elucidate the real effect of food intake on sleep.

METABOLIC RESPONSES ON THE EARLY SHIFT

Shiftwork has been associated with a higher propensity for the development of metabolic disorders and obesity. The aim of the study was to investigate concentrations of glucose, cortisol, and insulin among fixed night workers (n = 9), fixed early morning workers (n = 6), and day workers (n = 7). Food intake was recorded for 7 days using a diary. Blood samples were collected every 4 h over the course of 24 h, yielding six samples. Total carbohydrate intake was lowest (p < .0005), whereas fat (p = .03) and protein (p < .0005) were highest on the early morning shifts. Early morning workers also had overall elevated cortisol levels relative to the other two groups. Cortisol levels appeared to be more influenced by time since waking prior to the shift than by time-of-day. Cortisol was highest for the early morning group than the day group 12 h after waking, and both the early morning and night groups had higher levels than the day group 16 h after waking (p < .05 in all cases). In contrast, the homesostatsis model assessment of insulin resistance (HOMA-IR) appeared to be more influenced by time-of-day than by time since waking prior to the shift. The early morning group had higher levels of HOMA-IR at 08:00 h than the other groups (p < .05). In conclusion, the early morning group had the highest overall concentrations of cortisol and tended to have higher levels of HOMA-IR, indicating that more attention should be given to these workers. Moreover, all three groups showed pronounced cortisol levels on awakening, suggesting that they may have adjusted to their awaking time. (Author: heloguarita@rgnutri.com.br)

Metabolic impact of shift work.

In developing countries, shift work represents a considerable contingent workforce. Recently, studies have shown that overweight and obesity are more prevalent in shift workers than day workers. In addition, shift work has been associated with a higher propensity for the development of many metabolic disorders, such as insulin resistance, diabetes, dislipidemias and metabolic syndrome. Recent data have pointed that decrease of the sleep time, desynchronization of circadian rhythm and alteration of environmental aspects are the main factors related to such problems. Shortened or disturbed sleep is among the most common health-related effects of shift work. The plausible physiological and biological mechanisms are related to the activation of the autonomic nervous system, inflammation, changes in lipid and glucose metabolism, and related changes in the risk for atherosclerosis, metabolic syndrome, and type II diabetes. The present review will discuss the impact of shift work on obesity and metabolic disorders and how disruption of sleep and circadian misalignment may contribute to these metabolic dysfunctions.

A link between sleep loss, glucose metabolism and adipokines

The present review evaluates the role of sleep and its alteration in triggering problems of glucose metabolism and the possible involvement of adipokines in this process. A reduction in the amount of time spent sleeping has become an endemic condition in modern society, and a search of the current literature has found important associations between sleep loss and alterations of nutritional and metabolic contexts. Studies suggest that sleep loss is associated with problems in glucose metabolism and a higher risk for the development of insulin resistance and type 2 diabetes mellitus. The mechanism involved may be associated with the decreased efficacy of regulation of the hypothalamus-pituitary-adrenal axis by negative feedback mechanisms in sleep-deprivation conditions. In addition, changes in the circadian pattern of growth hormone (GH) secretion might also contribute to the alterations in glucose regulation observed during sleep loss. On the other hand, sleep deprivation stress affects adipokines - increasing tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and decreasing leptin and adiponectin -, thus establishing a possible association between sleep-debt, adipokines and glucose metabolism. Thus, a modified release of adipokines resulting from sleep deprivation could lead to a chronic sub-inflammatory state that could play a central role in the development of insulin resistance and type 2 diabetes mellitus. Further studies are necessary to investigate the role of sleep loss in adipokine release and its relationship with glucose metabolism.

Aplicação da escala de conhecimento nutricional em atletas profissionais e amadores de atletismo

An adequate nutrition is necessary to supply the energy demand required by exercise as much for active individuals and for athletes. However, much more than sports performance, the nutrition knowledge is essential for both populations for prevention of illnesses. Many interventions centered in nutritional education have been lead with the intention to increase nutrition knowledge and, consequently, improve nutritional behaviors. The aim of the present study was to evaluate the nutrition knowledge of professional and amateur track and field athletes with application of a scale previously validated in Brazil. The sample was composed by 26 professional and 41 amateur track and field athletes of several modalities in phase of continuous training. The results have shown that professional and amateur track and field athletes generally presented moderate nutritional knowledge, with the latter presenting punctuation significantly higher than the professional group, a fact associated with their higher educational background. In conclusion, professional track and field athletes present lower nutritional knowledge, which can be partly attributed to the fact that they see the nutritional science with performance as main objective. Further applications of this scale in professional and amateur athletes must be carried out in order to assess the nutritional knowledge level of this population.An adequate nutrition is necessary to supply the energy demand required by exercise as much for active individuals and for athletes. However, much more than sports performance, the nutrition knowledge is essential for both populations for prevention of illnesses. Many interventions centered in nutritional education have been lead with the intention to increase nutrition knowledge and, consequently, improve nutritional behaviors. The aim of the present study was to evaluate the nutrition knowledge of professional and amateur track and field athletes with application of a scale previously validated in Brazil. The sample was composed by 26 professional and 41 amateur track and field athletes of several modalities in phase of continuous training. The results have shown that professional and amateur track and field athletes generally presented moderate nutritional knowledge, with the latter presenting punctuation significantly higher than the professional group, a fact associated with their higher educational background. In conclusion, professional track and field athletes present lower nutritional knowledge, which can be partly attributed to the fact that they see the nutritional science with performance as main objective. Further applications of this scale in professional and amateur athletes must be carried out in order to assess the nutritional knowledge level of this population.

Adipokine levels are altered by shiftwork: a preliminary study.

Shiftwork is often associated with metabolic diseases, and in the past few years, several cytokines have been postulated to contribute to various diseases, including insulin resistance. The aim of this study was to compare the concentrations of adiponectin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in samples of young adult men exposed to a fixed (i) night shift (n = 9), working from 22:00 to 06:00 h; (ii) early morning shift (n = 6), working from 06:00 to 14:00 h; and (iii) day shift (n = 7), working from 08:00 to 17:00 h. The fixed night-shift and early-morning-shift samples were considered collectively as a shiftworker group given their work times. Blood samples were collected during the regular working day at 4-h intervals over the course of 24 h, thus totaling six samples. Morphological and physical activity parameters did not differ between the three groups. Total energy intake was lowest on the early morning shifts (p < .03). Both shiftworker groups ingested a significantly higher percentage of fat (p < .003) and a lower percentage of carbohydrate (p < .0005) than the day group. The early morning group had a lower mean 24-h level of adiponectin than the other two groups (p = .016), and both the early morning and night groups exhibited higher mean 24-h levels of TNF-α than the day group (p = .0001). The 24-h mean levels of IL-6 did not differ significantly between the groups (p = .147). None of the groups exhibited a significant circadian effect on adiponectin (p = .829), TNF-α (p = .779), or IL-6 (p = .979) levels. These results indicate that individuals who are enrolled in shiftwork are susceptible to alterations in the secretion of cytokines that are involved in insulin resistance and cardiovascular disease, both of which are known to affect this population. (Author correspondence: tmello@demello.net.br)

Meal distribution across the day and its relationship with body composition

Evidence has suggested that meal distribution across the day may influence body composition. This study aimed to evaluate the distribution of energy and macronutrient intake in healthy men and women, and to correlate it with body composition. Fifty-two healthy volunteers (24 men), aged 20–45 years old, participated in the study. Food intake was analyzed by a three-day food record and anthropometric measurements included body mass, height, body mass index, body fat percentage, and waist circumference. Positive correlations were found in men between night fat intake and body mass index, body fat percentage and waist circumference and negative correlations were seen between morning energy and macronutrient intake and the same anthropometric variables. These data suggest that fat intake at night is associated with higher values in anthropometric variables while morning food intake can be associated with lower values in anthropometric variables.

Standardization of the Food Composition Database Used in the Latin American Nutrition and Health Study (ELANS)

Between-country comparisons of estimated dietary intake are particularly prone to error when different food composition tables are used. The objective of this study was to describe our procedures and rationale for the selection and adaptation of available food composition to a single database to enable cross-country nutritional intake comparisons. Latin American Study of Nutrition and Health (ELANS) is a multicenter cross-sectional study of representative samples from eight Latin American countries. A standard study protocol was designed to investigate dietary intake of 9000 participants enrolled. Two 24-h recalls using the Multiple Pass Method were applied among the individuals of all countries. Data from 24-h dietary recalls were entered into the Nutrition Data System for Research (NDS-R) program after a harmonization process between countries to include local foods and appropriately adapt the NDS-R database. A food matching standardized procedure involving nutritional equivalency of local food reported by the study participants with foods available in the NDS-R database was strictly conducted by each country. Standardization of food and nutrient assessments has the potential to minimize systematic and random errors in nutrient intake estimations in the ELANS project. This study is expected to result in a unique dataset for Latin America, enabling cross-country comparisons of energy, macro- and micro-nutrient intake within this region.