Rita de Cássia Gonçalves Alfenas

Influence of a high-fat diet on gut microbiota, intestinal permeability and metabolic endotoxaemia

Lipopolysaccharide (LPS) may play an important role in chronic diseases through the activation of inflammatory responses. The type of diet consumed is of major concern for the prevention and treatment of these diseases. Evidence from animal and human studies has shown that LPS can diffuse from the gut to the circulatory system in response to the intake of high amounts of fat. The method by which LPS move into the circulatory system is either through direct diffusion due to intestinal paracellular permeability or through absorption by enterocytes during chylomicron secretion. Considering the impact of metabolic diseases on public health and the association between these diseases and the levels of LPS in the circulatory system, this review will mainly discuss the current knowledge about high-fat diets and subclinical inflammation. It will also describe the new evidence that correlates gut microbiota, intestinal permeability and alkaline phosphatase activity with increased blood LPS levels and the biological effects of this increase, such as insulin resistance. Although the majority of the studies published so far have assessed the effects of dietary fat, additional studies are necessary to deepen the understanding of how the amount, the quality and the structure of the fat may affect endotoxaemia. The potential of food combinations to reduce the negative effects of fat intake should also be considered in future studies. In these studies, the effects of flavonoids, prebiotics and probiotics on endotoxaemia should be investigated. Thus, it is essential to identify dietetic strategies capable of minimising endotoxaemia and its postprandial inflammatory effects.

Estresse oxidativo: conceito, implicações e fatores modulatórios

There is evidence that oxidative stress, defined as a persistent imbalance between the production of highly oxidative compounds and antioxidant defenses, leads to tissue damage. Oxygen metabolism generates free radicals and/or non-radical reactive oxygen species. The mitochondria, through the electron transport chain, are the main generator of these species. The antioxidant defense system has the function of inhibiting and/or reducing the damage caused by the deleterious free radicals and/or non-radical reactive oxygen species. This system is divided into enzymatic (superoxide dismutase, catalase and glutathione peroxidase), and nonenzymatic. The nonenzymatic system consists of a variety of antioxidant substances, which may be endogenous or dietary. This study proposed to review the main mechanisms of reactive oxygen species generation and the role of the most relevant agents of the antioxidant defense system on the biomarkers of oxidative stress. The main exogenous factors that modulate oxidative stress will also be discussed.O estresse oxidativo decorre de um desequilibrio entre a geracao de compostos oxidantes e a atuacao dos sistemas de defesa antioxidante. A geracao de radicais livres e/ou especies reativas nao radicais e resultante do metabolismo de oxigenio. A mitocondria, por meio da cadeia transportadora de eletrons, e a principal fonte geradora. O sistema de defesa antioxidante tem a funcao de inibir e/ou reduzir os danos causados pela acao deleteria dos radicais livres e/ou especies reativas nao radicais. Esse sistema, usualmente, e dividido em enzimatico (superoxido dismutase, catalase e glutationa peroxidase) e nao-enzimatico. No ultimo caso, e constituido por grande variedade de substâncias antioxidantes, que podem ter origem endogena ou dietetica. Objetivou-se revisar os principais mecanismos de geracao de radicais livres, bem como a acao dos agentes mais relevantes do sistema de defesa antioxidante, ressaltando suas implicacoes sobre os marcadores do estresse oxidativo. Tambem serao abordados os principais fatores exogenos moduladores do estresse oxidativo.

Role of bariatric-metabolic surgery in the treatment of obese type 2 diabetes with body mass index <35 kg/m2: a literature review.

Bariatric surgery has been used to treat type 2 diabetes mellitus (T2DM); however, its efficacy is still debatable. This literature review analyzed articles that evaluated the effects of bariatric surgery in treatment of T2DM in obese patients with a body mass index (BMI) of <35 kg/m(2). A paired t test was applied for the analysis of pre- and postintervention mean BMI, fasting plasma glucose (FPG), and glycosylated hemoglobin (A1c) values. A significant (P<0.001) reduction in BMI (from 29.95±0.51 kg/m(2) to 24.83±0.44 kg/m(2)), FPG (from 207.86±8.51 mg/dL to 113.54±4.93 mg/dL), and A1c (from 8.89±0.15% to 6.35±0.18%) was observed in 29 articles (n=675). T2DM resolution (A1c <7% without antidiabetes medication) was achieved in 84.0% (n=567) of the subjects. T2DM remission, control, and improvement were observed in 55.41%, 28.59%, and 14.37%, respectively. Only 1.63% (n=11) of the subjects presented similar or worse glycemic control after the surgery. T2DM remission (A1c <6% without antidiabetes medication) was higher after mini-gastric bypass (72.22%) and laparoscopic/Roux-en-Y gastric bypass (70.43%). According to the Foregut and Hindgut Hypotheses, T2DM results from the imbalance between the incretins and diabetogenic signals. The procedures that remove the proximal intestine and do ileal transposition contribute to the increase of glucagon-like peptide-1 levels and improvement of insulin sensitivity. These findings provide preliminary evidence of the benefits of bariatric-metabolic surgery on glycemic control of T2DM obese subjects with a BMI of <35 kg/m(2). However, more clinical trials are needed to investigate the metabolic effects of bariatric surgery in T2DM remission on pre-obese and obese class I patients.

Peanut digestion and energy balance

Objective:To explore the effects of peanut consumption on fecal energy excretion with a balanced, non-vegetarian diet.Design:Four arm parallel group design (that is, whole peanut (P), peanut butter (PB), peanut oil (PO) or peanut flour (PF) consumption) with one crossover (control and intervention).Subjects:In total 63 healthy men and women from Ghana, Brazil and USA (N=15–16 per group) with an average body mass index of 21.8 kg m−2.Measurements:Percent fat of fecal wet weight daily energy excretion during the control and the treatment periods.Results:Compared to control, the percentage of fat in the feces increased significantly for the P group (5.22±0.29%) relative to the other three groups ((PO=3.07±0.36%, PB=3.11±0.31% (P=0.001), and PF=3.75±0.40% (P=0.019)). The same findings held for kJ g−1 of feces excreted. During the P supplementation period, the energy excretion was 21.4±1.0 kJ g−1 versus 18.7±1.0 kJ g−1 for PO (P=0.034), 18.8±0.7 kJ g−1 for PB (P=0.042) and 18.5±0.8 kJ g−1 for PF (P=0.028).Conclusion:Fecal fat and energy loss is greater with consumption of whole peanuts compared to peanut butter, oil or flour. This may contribute to the less than predicted change of body weight observed with peanut consumption. There were no cultural differences.

Effects of protein quality on appetite and energy metabolism in normal weight subjects.

OBJECTIVE The purpose of this study was to compare the effects of consumption of different protein sources on food intake and energy expenditure in normal weight subjects. SUBJECTS AND METHODS Breakfast preparations (casein, soy protein, whey protein or control) were ingested during seven consecutive days. Appetite, food intake, and energy expenditure were assessed. RESULTS Casein consumption led to a lower energy intake than whey protein. There was lower energy intake on day 7 than on day 1 of the casein session. Soy protein preparations resulted in higher diet induced thermogenesis (DIT) than in control preparations. The respiratory quotient (RQ) obtained in the whey protein session was lower than the control and soy protein sessions. CONCLUSION These results suggest that the consumption of different protein types leads to distinct effects on satiety (casein), DIT (soy protein), and/or RQ (whey protein).

Perfil sociossanitário e estilo de vida de hipertensos e/ou diabéticos, usuários do Programa de Saúde da Família no município de Teixeiras, MG

O objetivo deste estudo foi tracar o perfil sociossanitario e estilo de vida da populacao hipertensa e/ou diabetica do municipio de Teixeiras (MG). Foram realizadas entrevistas semi-estruturadas nos domicilios de hipertensos e/ou diabeticos cadastrados no Programa de Saude da Familia de Teixeiras (MG), selecionados aleatoriamente. Foram entrevistados 150 hipertensos (10,33% da populacao hipertensa) e 30 diabeticos (15% da populacao diabetica), havendo uma predominância de individuos idosos (idade media=63,59 + 13,12 anos), do sexo feminino (74,4%), de baixa escolaridade (40,9% de analfabetismo) e de baixa renda (mediana de 0,5 salario minimo). O tratamento destas morbidades foi basicamente medicamentoso (96,6%); houve uma elevada prevalencia do sedentarismo (67,4%). Alem disso, houve um grande consumo per capita diario de acucar (153g + 110,66g), sal (18g + 21,26g) e oleo (60g + 43,23g). Os resultados obtidos apontam para a importância de intervencoes multiprofissionais, por meio do Programa de Saude da Familia, com o objetivo de promover a adocao de habitos e estilos de vida saudaveis, prevenir complicacoes dessas doencas e proporcionar melhoria da qualidade de vida.

Red but not white meat consumption is associated with metabolic syndrome, insulin resistance and lipid peroxidation in Brazilian middle-aged men

Background The influence of diet on metabolic syndrome and oxidative stress are not completely known. Design This cross-sectional study assessed the association of red meat and white meat consumption with metabolic syndrome, insulin resistance and lipid peroxidation in Brazilian middle-aged men. Methods A total of 296 subjects (age: 50.5 ± 5.0 years, body mass index: 25.8 ± 3.5 kg/m2) were evaluated. Anthropometry, lifestyle features, blood biochemical parameters, diagnosis of metabolic syndrome, homeostatic model assessment for insulin resistance, a lipid peroxidation marker (oxidized low-density lipoprotein) and triglycerides:high-density lipoprotein cholesterol ratio were assessed. Dietary intake was estimated by a food frequency questionnaire. Results The subjects included in the highest tertile red meat (≥81.5 g/d) and saturated fatty acid from red meat consumption (≥4.3 g/d) had higher occurrence of central obesity (nearly 60%, p < 0.01), hypertriglyceridaemia (nearly 43%, p < 0.01) and metabolic syndrome (35%, p < 0.01). They also had higher values of homeostatic model assessment for insulin resistance, oxidized low-density lipoprotein, and triglycerides:high-density lipoprotein cholesterol ratio, regardless of interfering factors. There were no associations of highest white meat tertile (≥39.4 g/d) and saturated fatty acid from white meat (≥1.0 g/d) consumption with the assessed parameters (p > 0.05). Conclusions Red meat consumption was cross-sectionally associated with the occurrence of central obesity, hypertriglyceridaemia, and metabolic syndrome as well as with higher homeostatic model assessment for insulin resistance, oxidized low-density lipoprotein concentrations and triglycerides:high-density lipoprotein cholesterol ratio. The content of saturated fatty acid from red meat consumption may be a factor that contributed to this relationship, while white meat consumption was not associated with metabolic syndrome and the assessed biomarkers.

Promoção da saúde e diabetes: discutindo a adesão e a motivação de indivíduos diabéticos participantes de programas de saúde

The objective of the present study was to evaluate, by means of a systematic literature review, the adherence and motivation presented by diabetic patients that participate in health intervention programs, which stimulate the adoption of a healthy life style. The ingestion of an adequate diet and the increase in physical activity, focusing in the disease perception, considering the diabetic patient knowledge, making evident the recommendations that should be followed to reach a better life quality, demonstrating that it is possible to live well even if you have a chronic disease such as diabetes. A literature research in the main public health databases (Medline, Lilacs, Scielo, among others) was conducted from 1994 to 2006. A total of 37 studies focused in the interaction among the subject health and disease versus diabetes were selected. This study mentions some daily difficulties felt by the diabetic patient and his family to control the disease. These difficulties can directly affect the patient adhesion to the prescribed treatment. Therefore, the behavioral and emotional factors presented by each patient must be considered when the health activities are being planned to reach total assistance to this population.

Pre-game hydration status, sweat loss, and fluid intake in elite Brazilian young male soccer players during competition

Abstract In this study, we assessed the pre-game hydration status and fluid balance of elite young soccer players competing in a match played in the heat (temperature 31.0 ± 2.0°C, relative humidity 48.0 ± 5.0%) for an official Brazilian soccer competition. Fluid intake was measured during the match, as were urine specific gravity and body mass before and after the game to estimate hydration status. Data were obtained from 15 male players (age 17.0 ± 0.6 years, height 1.78 ± 0.06 m, mass 65.3 ± 3.8 kg); however, data are only analysed for 10 players who completed the full game. The mean (±s) sweat loss of players amounted to 2.24 ± 0.63 L, and mean fluid intake was 1.12 ± 0.39 L. Pre-game urine specific gravity was 1.021 ± 0.004, ranging from 1.010 to 1.025. There was no significant correlation between sweat loss and fluid intake (r = 0.504, P = 0.137) or between urine specific gravity and fluid intake (r = −0.276, P = 0.440). We conclude that young, native tropical soccer players started the match hypohydrated and replaced about 50% of the sweat lost. Thus, effective strategies to improve fluid replacement are needed for players competing in the heat.

Effects of peanut processing on body weight and fasting plasma lipids

Peanuts and peanut butter are commonly consumed as a snack, meal component and ingredient in various commercial products. Their consumption is associated with reduced CVD risk and they pose little threat to positive energy balance. However, questions have arisen as to whether product form (e.g. whole nut v. butter) and processing properties (e.g. roasting and adding flavours) may compromise their positive health effects. The present study investigated the effects of peanut form and processing on two CVD risk factors: fasting plasma lipids and body weight. One hundred and eighteen adults (forty-seven males and seventy-one females; age 29.2 (sd 8.4) years; BMI 30.0 (sd 4.5) kg/m2) from Brazil, Ghana and the United States were randomised to consume 56 g of raw unsalted (n 23), roasted unsalted (n 24), roasted salted (n 23) or honey roasted (n 24) peanuts, or peanut butter (n 24) daily for 4 weeks. Peanut form and processing did not differentially affect body weight or fasting plasma lipid responses in the total sample. However, HDL-cholesterol increased significantly at the group level, and total cholesterol, LDL-cholesterol and TAG concentrations decreased significantly in individuals classified as having elevated fasting plasma lipids compared with those with normal fasting plasma lipids. These observations suggest that the processing attributes assessed in this trial do not compromise the lipid-lowering effects of peanuts, and do not negatively impact body weight. Further studies are warranted to determine the effects of form and processing on other health risk factors.