Priscila Giacomo Fassini

Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study

BackgroundFlaxseed has received attention for its anti-inflammatory and antioxidant role. The present study hypothesizes if flaxseed added to a weight loss diet could improve the lipid and metabolic profiles and decrease risk factors related to cardiovascular disease.MethodsIn a prospective, single blinded 42 days protocol, subjects were allocated into two groups with low carbohydrates intake: GriceLC (35% of carbohydrate and 60g of raw rice powder per day) and GflaxLC (32% of carbohydrate and 60g of flaxseed powder per day). Blood pressure, anthropometric measures and serum levels of isoprostane, C-reactive protein, Tumor Necrosis Factor-alpha, glucose, lipidic profile, uric acid, adiponectin, leptin and insulin were measured at baseline and at the end of interventions. Serum and urinary enterodiol and enterolactione were also measured.ResultsA total of 27 men with cardiovascular risk factors were evaluated, with mean age of 33 ± 10 years to GriceLC and 40 ± 9 years to GflaxLC. Both groups experienced weight loss and systolic blood pressure reduction. A decrease in inflammatory markers (CRP and TNF-α) was observed after flaxseed intake (mean decrease of 25% and 46% for GflaxLC respectively). All groups also showed improvement in levels of total cholesterol, LDL-c, uric acid and adiponectin. Only GflaxLC group showed a decrease in triglyceride levels.ConclusionThis study suggests that flaxseed added to a weight loss diet could be an important nutritional strategy to reduce inflammation markers such as CRP and TNF-α.Trial registrationClinicalTrials.gov NCT02132728.

Assessment of energy requirements in patients with short bowel syndrome by using the doubly labeled water method

BACKGROUND Short bowel syndrome (SBS) is a serious malabsorption disorder, and dietetic management of patients with SBS is extremely challenging. Once the degree of undernutrition has been assessed, successful dietary intervention is contingent on an accurate estimation and provision of energy needs. OBJECTIVE We quantified total energy expenditure (TEE) in patients with SBS by using the doubly labeled water (DLW) method to inform energy needs and nutritional therapy goals. DESIGN In this observational study, TEE was measured in 22 participants, 11 with SBS and 11 sex-, age-, and body mass index (BMI)-matched controls (non-SBS), for 14 d with the DLW method. Predicted energy requirements were determined by using the Escott-Stump equation and compared with TEE determined with DLW. Resting energy expenditure was measured by using indirect calorimetry, and an accelerometer was also used to determine physical activity level. RESULTS Participants were aged (mean ± SD) 53 ± 8 y. Measured TEE was significantly higher than predicted TEE for the SBS group (1875 ± 276 compared with 1517 ± 175 kcal/d, P = 0.001) and also for the non-SBS group (2393 ± 445 compared with 1532 ± 178 kcal/d, P < 0.01). Measured TEE was significantly lower in the SBS group than in the non-SBS group (P < 0.01); however, predicted TEE did not differ significantly between the groups (P = 0.84). No significant differences were seen between measured and predicted resting energy expenditure either within or between groups. CONCLUSIONS Measured TEE in patients with SBS was significantly higher than predicted by using standard equations but also lower than values for age-, BMI-, and sex-matched non-SBS controls. Currently used formulas in clinical practice appear to underestimate energy requirements of patients with SBS, and revision is needed to prevent underfeeding and improve long-term prognosis. This trial was registered at clinicaltrials.gov as NCT02113228.

Retraction Note: Impact of weight loss diet associated with flaxseed on inflammatory markers in men with cardiovascular risk factors: a clinical study.

The Editor is retracting this article [1] because of concerns raised after publication with respect to the methods and the statistical analysis [2] which the authors have not been able to adequately address [2]. We apologise to all affected parties for the inconvenience caused. All authors support this retraction.

Body surface infrared thermometry in patients with central venous cateter-related infections

Objective To evaluate if body surface temperature close to the central venous catheter insertion area is different when patients develop catheter-related bloodstream infections. Methods Observational cross-sectional study. Using a non-contact infrared thermometer, 3 consecutive measurements of body surface temperature were collected from 39 patients with central venous catheter on the following sites: nearby the catheter insertion area or totally implantable catheter reservoir, the equivalent contralateral region (without catheter), and forehead of the same subject. Results A total of 323 observations were collected. Respectively, both in male and female patients, disregarding the occurrence of infection, the mean temperature on the catheter area minus that on the contralateral region (mean ± standard deviation: -0.3±0.6°C versus -0.2±0.5ºC; p=0.36), and the mean temperature on the catheter area minus that on the forehead (mean ± standard deviation: -0.2±0.5°C versus -0.1±0.5ºC; p=0.3) resulted in negative values. Moreover, in infected patients, higher values were obtained on the catheter area (95%CI: 36.6-37.5ºC versus 36.3-36.5ºC; p<0.01) and by temperature subtractions: catheter area minus contralateral region (95%CI: -0.17 - +0.33ºC versus -0.33 - -0.20ºC; p=0.02) and catheter area minus forehead (95%CI: -0.02 - +0.55ºC versus -0.22 - -0.10ºC; p<0.01). Conclusion Using a non-contact infrared thermometer, patients with catheter-related bloodstream infections had higher temperature values both around catheter insertion area and in the subtraction of the temperatures on the contralateral and forehead regions from those on the catheter area.

Management of obesity over five year’s follow-up: the challenging of long-term weight reduction

A 30-year-old woman diagnosed with obesity was admitted at the outpatient obesity clinic from Clinical Hospital of Ribeirão Preto Medical School, University of São Paulo for a treatment of obesity. She had been treated in other health centers with no success. The medical team investigated secondary causes of weight gain and endocrine disorders were ruled out. The patient was hospitalized and submitted to an 8-week nutritional education program. Her initial weight and body mass index were respectively: 166kg and 64kg/m2. A body composition assessed by single frequency bioelectrical impedance analysis (50kHz) method using Biodynamics 450® (BiodynamicsTM Corp., Shoreline, Washington, United States), showed 75kg of lean body mass and 92kg of fat mass. The daily energy intake was reduced weekly as follows: 1800kcal/day during the first and second weeks, 1500kcal/day during the third to sixth weeks and 1200kcal/day during the seventh and eighth weeks. The percentage of macro-nutrients was 50% carbohydrate, 30% lipid and 20% protein, during the whole period. At hospital discharge the patient ́s weight was 154kg, body mass index was 60kg/m2, 71kg of lean body mass and 84kg of fat mass. After hospital discharge, the patient continued to be followed at the outpatient clinic by the same team and regained weight (Figure 1). She continued the follow-up for up to five years and then dropped out.

Indirect Calorimetry: From Expired CO2 Production, Inspired O2 Consumptionto Energy Equivalent

This paper emphasizes the methodology of data collection of indirect calorimetry, including establishment of steady state conditions and the standards in which the values are presented. It also aims to describe in details the calculations of VO2, VCO2, Resting Energy Expenditure (REE) and Respiratory Quotient (RQ). The trial is registered with ClinicalTrials.gov number NCT02072694.