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Impact of a Web-Based Exercise and Nutritional Education Intervention in Patients Who Are Obese With Hypertension: Randomized Wait-List Controlled Trial.
Lisón, JF, Palomar, G, Mensorio, MS, Baños, RM, Cebolla-Martí, A, Botella, C, Benavent-Caballer, V, Rodilla, E
Journal of medical Internet research. 2020;22(4):e14196
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Cardiovascular disease is the leading cause of morbidity and mortality in developed countries. Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviours. The aim of this study was to investigate the short- and long-term efficacy of a self-administered internet-based intervention aimed at promoting lifestyle changes in patients who are obese with hypertension. The study is a randomized wait-list controlled trial which recruited 105 adults with hypertension who were overweight or obese and randomly assigned to either a 3-month internet-based intervention group (n=55) or the wait-list control group (n=50). Results showed a significant decrease in the body mass index, body fat mass and blood glucose (blood sugar) levels at 3 months in the internet-based intervention group. In addition, there was a favourable trend towards a relation to blood pressure, which reached statistical significance at the 12-month follow-up. Authors conclude that simple strategies that can easily be incorporated into daily living in a scalable and cost-effective way can empower patients by educating them about health, thus, increasing their confidence and promoting self-management.
Abstract
BACKGROUND Internet-based interventions are a promising strategy for promoting healthy lifestyle behaviors. These have a tremendous potential for delivering electronic health interventions in scalable and cost-effective ways. There is strong evidence that the use of these programs can lead to weight loss and can lower patients' average blood pressure (BP) levels. So far, few studies have investigated the effects of internet-based programs on patients who are obese with hypertension (HTN). OBJECTIVE The aim of this study is to investigate the short- and long-term efficacy, in terms of body composition and BP parameters, of a self-administered internet-based intervention involving different modules and learning techniques aimed at promoting lifestyle changes (both physical activity and healthy eating) in patients who are obese with HTN. METHODS A randomized wait-list controlled trial design was used. We recruited 105 adults with HTN who were overweight or obese and randomly assigned them to either a 3-month internet-based intervention group (n=55) or the wait-list control group (n=50). We assessed BMI (primary outcome), body fat mass (BFM), systolic (S)BP and diastolic (D)BP, blood glucose and insulin levels, physical activity levels, and functional capacity for aerobic exercise at Time 0 (preintervention) and Time 1 (postintervention). All the patients in the wait-list control group subsequently received the intervention, and a secondary within-group analysis, which also included these participants, was conducted at Time 2 (12-month follow-up). RESULTS A 2-way mixed analysis of covariance showed a significant decrease in BMI, BFM, and blood glucose at 3 months in the internet-based intervention group; the effect size for the BMI and BFM parameters was moderate to large, and there was also a borderline significant trend for DBP and insulin. These results were either maintained or improved upon at Time 2 and showed significant changes for BMI (mean difference -0.4, 95% CI -0.1 to -0.6; P=.005), BFM (mean difference -2.4, 95% CI -1.1 to -3.6; P<.001), DBP (mean difference -1.8, 95% CI -0.2 to -3.3; P=.03), and blood glucose (mean difference -2, 95% CI 0 to -4; P=.04). CONCLUSIONS Implementation of our self-administered internet-based intervention, which involved different learning techniques aimed to promote lifestyle changes, resulted in positive short- and long-term health benefits in patients who are obese with HTN. TRIAL REGISTRATION ClinicalTrials.gov NCT03396302; https://clinicaltrials.gov/ct2/show/NCT03396302.
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Impact of changes in physical activity or BMI on risk of heart failure in women - the prospective population study of women in Gothenburg.
Halldin, AK, Lissner, L, Lernfelt, B, Björkelund, C
Scandinavian journal of primary health care. 2020;38(1):56-65
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Heart failure (HF) is a severe and progressive condition with poor prognosis. Obesity is a risk factor for HF. The aim of this study was to investigate the impact of change in physical activity or change in body mass index on the risk of later developing HF in women without a previous diagnosis of HF. This study is prospective longitudinal study which includes 1749 healthy women from the Prospective Population Study of Women in Gothenburg. Results indicate that gaining weight in early middle age is more harmful than gaining weight later in life, with regard to the risk of developing HF later in life. Furthermore, reduced risk of future HF in healthy women may be achieved by remaining physically active from young middle age and throughout life or by increasing the level of physical activity. Authors conclude that the role of physical activity in preventing the development of obesity must be taken into account.
Abstract
Objective: To longitudinally evaluate the impact of change in physical activity or change in body mass index (BMI) over time on the risk of developing heart failure (HF) in women without a previous diagnosis of HF.Design and setting: Longitudinal, observational, prospective study of women in Gothenburg, Sweden. Data on BMI and level of physical activity were collected from examinations 1968-1992 and hospital diagnoses and mortality data were ascertained from 1980 to 2012.Subjects: Data were obtained from 1749 women included in the Prospective Population Study of Women in Gothenburg.Main outcome measures: Hazard ratio (HR) for HF was calculated, using a Cox regression model.Results: Women with stable high physical activity during 1968-1980 and 1980-1992 reduced their risk of subsequent HF compared to the non-active women (for 1968-1980 HR 0.66, 95% Confidence Interval (CI) 0.44-0.99 and for 1980-1992 HR 0.47, 95% CI 0.29-0.74). Women with increasing levels of physical activity during 1980-1992 reduced their risk of HF compared to the non-active women (HR 0.40, 95% CI 0.22-0.72). Increase in BMI from overweight to obesity during 1968-1980 predicted increased risk of developing HF (HR 1.93, 95% CI 1.18-3.14).Conclusions: Reduced risk of future HF in healthy women may be achieved by remaining physically active from young middle age and throughout life or by increasing the level of physical activity. This is particularly important for sedentary women in middle age. The role of physical activity in preventing the development of obesity must be taken into account.Key pointsA sedentary lifestyle and obesity are risk factors for developing heart failure (HF) in women.The risk of developing HF may be reduced by increasing the level of activity in sedentary middle-aged women.For younger women, avoiding obesity is most important to reduce the risk of later HF.Primary care has a key role in guiding women towards the most effective lifestyle changes to prevent development of HF.
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The Kids Obesity Prevention Program: Cluster Randomized Controlled Trial to Evaluate a Serious Game for the Prevention and Treatment of Childhood Obesity.
Mack, I, Reiband, N, Etges, C, Eichhorn, S, Schaeffeler, N, Zurstiege, G, Gawrilow, C, Weimer, K, Peeraully, R, Teufel, M, et al
Journal of medical Internet research. 2020;22(4):e15725
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Authors developed a motion-controlled serious game for children, the Kids Obesity Prevention (KOP) program, addressing the areas of nutrition, physical activity, and stress coping. The aim of the KOP study was to evaluate the game in a cluster randomized controlled trial with two parallel groups in a primary school setting in children aged 9 to 12 years. The main aim of this study was to gain knowledge about important lifestyle factors with the focus on nutrition, especially the dietary energy density (DED) principle. Five fourth grade classes in a single school were randomly allocated to an intervention group or a control group. Results showed that: - children gained sustainable knowledge about the food pyramid concept, the DED concept (including the topic of liquids), and about stress and stress-coping strategies after game play. In fact, 4 weeks after the intervention, the knowledge level was similar to the level directly after intervention. - the children were able to apply their DED knowledge by transferring it to unknown foods. - physical activity decreased in roughly 30-40% of children, whereas it increased in 10% of the cohort. Authors conclude that the game was highly accepted by children, sustainably increased their knowledge of the topics addressed, and could be a useful tool for further studies and education.
Abstract
BACKGROUND Health games provide opportunities for the treatment and prevention of childhood obesity. We developed a motion-controlled serious game for children that addresses 3 core topics of nutrition, physical activity, and stress coping. It is the first serious game that extensively targets the dietary energy density principle (DED-P) in relation to nutrition. The game is intended to provide an additional educational component for the prevention and treatment of obesity in children. OBJECTIVE The Kids Obesity Prevention study aimed to evaluate the newly developed game and to evaluate how well children are able to understand and apply the DED-P. METHODS This cluster randomized controlled trial collected data from 82 primary school children aged 9 to 12 years and their parents at baseline (T0), at 2 weeks after study commencement (T1), and at the 4-week follow-up (T2). The dropout rate was 3.6%. The intervention group (IG) played the game within 2 weeks (2 sessions with different game modules). One part of the game involves selection of food with the lower energy density when presented with a pair of foods. This allows assessment of whether the children have understood the DED-P and whether they can apply it to unknown foods under time pressure. The control group (CG) received a brochure about the food pyramid concept and physical activity. The primary outcome was the gain in knowledge (nutrition and stress coping) and measured with a pretested questionnaire. The secondary outcomes were the maintenance of knowledge, application of the DED-P, feelings during game play, game acceptance, and behavioral measures (physical activity, media consumption, and dietary intake). RESULTS The knowledge score ranging from 0 to 100 increased from T0 (IG: 53 [SD 10], CG: 50 [SD 11]) to T1 (IG: 69 [SD 11], CG: 52 [SD 12]) in IG versus CG (P<.001). At T2, the knowledge score of IG remained at the same level as that of T1. Game data showed that after DED-P education, the classification under time pressure of unknown versus known food pairs according to their DED category was similar (hit rate around 70%). Overall, 95% of the children liked the game very much or much. No group changes were observed at the behavioral level. CONCLUSIONS The Kids Obesity Prevention program sustainably increased knowledge in the areas of nutrition and stress coping, and children were able to apply the DED-P. TRIAL REGISTRATION ClinicalTrials.gov NCT02551978; https://clinicaltrials.gov/ct2/show/NCT02551978.
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Referral to Slimming World in UK Stop Smoking Services (SWISSS) versus stop smoking support alone on body weight in quitters: results of a randomised controlled trial.
Lycett, D, Aveyard, P, Farmer, A, Lewis, A, Munafò, M
BMJ open. 2020;10(1):e032271
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Weight gain is a well-known consequence of smoking cessation. The aim of this study was to compare standard stop smoking behavioural support with an intervention that, in addition to providing standard stop smoking support, included personalised weight management support, provided by Slimming World. This study is a parallel group, individually randomised controlled trial. Participants were randomised (1:1) to usual care or Slimming World with usual care. Stop smoking advisors were unaware of the randomisation sequence. Results showed that referral to the Slimming World programme plus usual stop smoking support achieved significantly less weight gain than usual stop smoking support alone. Furthermore, percentage quit was no worse in the treatment than the control group. Authors conclude that referral to a behavioural weight loss programme may be a pragmatic option within stop smoking clinics.
Abstract
INTRODUCTION Most people who stop smoking gain weight. Dietary modification may seem an obvious solution, but food restriction may increase cigarette craving and smoking relapse. TRIAL DESIGN An unblinded parallel randomised controlled trial. METHODS Participants were adult smokers with a body mass index greater or equal to 23 kg/m2. Setting was National Health Service commissioned Stop Smoking Services, interventions were referral to a commercial weight management programme, plus stop smoking support (treatment group), compared with stop smoking support alone (control group). Objective was to compare weight change between interventions in smoking abstainers and not abstinent rates in all. Primary outcome was change in weight (kg) at 12 weeks. Randomisation sequence was computer generated and concealed until allocation. RESULTS Seventy-six participants were recruited, 37 were randomised to the treatment group and 39 to the control group. Change in weight was analysed in long-term abstainers (13 treatment, 14 control) only because the aim was to prevent weight gain associated with smoking cessation. Abstinence was analysed on an intention-to-treat basis (37 treatment, 39 control). At 12 weeks weight gain was less in the treatment than the control group with an adjusted mean difference of -2.3 kg 95% CI (-4.4 to -0.1). Craving scores were lower (Mood and Physical Symptoms Scale craving domain -1.6 (-2.7 to -0.5)) and quit rates were higher in the treatment than the control group (32% vs 21%), although the trial was not powered to superiority in cravings and quit rates. No adverse events or side effects were reported. CONCLUSION In people who are obese and want to quit smoking, these data provide modest encouragement that providing weight management at the time of quitting may be helpful. Those who are not obese, but who are informed about potential weight gain during their quit attempt, were uninterested in a weight management programme. TRIAL REGISTRATION NUMBER ISRCTN65705512.
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Effects of COVID-19 Lockdown on Lifestyle Behaviors in Children with Obesity Living in Verona, Italy: A Longitudinal Study.
Pietrobelli, A, Pecoraro, L, Ferruzzi, A, Heo, M, Faith, M, Zoller, T, Antoniazzi, F, Piacentini, G, Fearnbach, SN, Heymsfield, SB
Obesity (Silver Spring, Md.). 2020;28(8):1382-1385
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The coronavirus disease 2019 (COVID-19) pandemic has had far reaching health, social, and economic implications. Among them is the abrupt cessation of school programs for children and adolescents in Italy. The aim of this study was to test the hypothesis that factors contributing to weight gain among children and adolescents with overweight and obesity are exacerbated during a pandemic-associated lockdown. This study is a longitudinal clinical trial which enrolled non-adult participants (n=41) with obesity as controls in the ongoing longitudinal observational OBELIX Study in Verona, Italy. Results indicate that eating, activity, and sleeping behaviours changed in an unfavourable direction just after three weeks into their confinement during the national lockdown. Thus, findings support the hypothesis that lockdown appears to create an unfavourable environment for maintaining healthy lifestyle behaviours Authors conclude that recognition of the lockdown phenomenon is the first step in taking preventive measures.
Abstract
OBJECTIVE The aim of this study was to test the hypothesis that youths with obesity, when removed from structured school activities and confined to their homes during the coronavirus disease 2019 pandemic, will display unfavorable trends in lifestyle behaviors. METHODS The sample included 41 children and adolescents with obesity participating in a longitudinal observational study located in Verona, Italy. Lifestyle information including diet, activity, and sleep behaviors was collected at baseline and 3 weeks into the national lockdown during which home confinement was mandatory. Changes in outcomes over the two study time points were evaluated for significance using paired t tests. RESULTS There were no changes in reported vegetable intake; fruit intake increased (P = 0.055) during the lockdown. By contrast, potato chip, red meat, and sugary drink intakes increased significantly during the lockdown (P value range, 0.005 to < 0.001). Time spent in sports activities decreased by 2.30 (SD 4.60) h/wk (P = 0.003), and sleep time increased by 0.65 (SD 1.29) h/d (P = 0.003). Screen time increased by 4.85 (SD 2.40) h/d (P < 0.001). CONCLUSIONS Recognizing these adverse collateral effects of the coronavirus disease 2019 pandemic lockdown is critical in avoiding depreciation of weight control efforts among youths afflicted with excess adiposity. Depending on duration, these untoward lockdown effects may have a lasting impact on a child's or adolescent's adult adiposity level.
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Nutritional Intervention for a Patient with Laparoscopic Sleeve Gastrectomy for Morbid Obesity: a Case Report.
Lee, HO, Choi, SI, Jeong, IK
Clinical nutrition research. 2020;9(2):157-162
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Bariatric surgery improves obesity-related complications by reducing body weight and recovering body functions. In order to recover quickly after surgery, continuous nutrition management is required. The aim of the medical institution was to examine the contents of nutritional arbitration conducted on patients who underwent gastric surgery, examine the results, identify the nutritional problems that can be seen through the course of the patient's meal process, and share the clinical experience. This study is a case report of a 46-year-old female patient who was diagnosed with morbid obesity, impaired fasting glucose (blood sugar) and hypertension. Results show that: - the patient did not lose weight preoperatively because she thought she would be unable to eat postoperatively and did not change her eating habits. - Blood sugar and blood lipid levels improved after weight loss. - The patient’s biochemical data showed no nutritional deficiency. Author concludes that for stomach surgery patients, a multidisciplinary approach and continuous nutritional management, motivation for weight loss, postoperative dietary adaptation, and individual access to patients are most important.
Abstract
Nutritional intervention for individual patients has a wide range of postoperative food adaptability, so an individual evaluation is required. The medical institution intends to examine the contents of nutritional arbitration conducted on patients who underwent gastric surgery, examine the results, identify the nutritional problems that can be seen through the course of the patient's meal process, and share the clinical experience. In this case study, a 46-year-old female patient was diagnosed with morbid obesity, impaired fasting glucose and hypertension. She was 153 cm tall and weighed 88 kg, with a body mass index 37.6 kg/m2 at initial evaluation. The patient maintained normal biochemical data before and after surgery and shows postoperative weight loss, body fat reduction, and abdominal fat reduction. In this case, blood sugar and blood lipid levels improved after weight loss. The repeated nutritional intervention for a sleeve gastrectomy patient, which is performed by clinical dietitians, is as follows. A balanced diet, supplemented with vitamins and minerals, is very important for preventing nutritional complications after obesity surgery. In conclusion, for stomach surgery patients, a multidisciplinary approach and continuous nutritional management, motivation for weight loss, postoperative dietary adaptation, and individual access to patients are most important.
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A Comparison of the Weight Loss Effect between a Low-carbohydrate Diet and a Calorie-restricted Diet in Combination with Intragastric Balloon Therapy.
Maekawa, S, Niizawa, M, Harada, M
Internal medicine (Tokyo, Japan). 2020;59(9):1133-1139
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Obesity is one of the most important public health issues, and its incidence is increasing worldwide. Conventional treatments, such as diet therapy, regular physical activity and behavioural modification, are important and essential for managing obesity. However, bariatric surgery is the most effective weight loss intervention. The aim of this study was to compare the effectiveness of a low-carbohydrate diet with that of a calorie-restricted diet when used in combination with intragastric balloon (IGB) therapy. This study is a randomised single-centred study which was conducted on 51 patients who had undergone IGB therapy. Participants were randomly assigned to either a low-carbohydrate diet or a conventional calorie-restricted diet in combination with IGB therapy. Results show that at 12 months after IGB placement, the body weight and body mass index were significantly lower than those observed at baseline in both groups. In fact, there were no significant differences in the body weight or body mass index outcomes between the two groups. Authors conclude that both a low-carbohydrate diet and a calorie-restricted diet are effective interventions for weight management in combination with IGB therapy.
Abstract
Objective Intragastric balloon (IGB) therapy is a low-invasion treatment for obesity. Recently, a low-carbohydrate diet has shown effectiveness for encouraging weight loss, but whether or not a low-carbohydrate diet improves the efficacy of IGB therapy remains unclear. Therefore, we examined the effectiveness of a low-carbohydrate diet compared with a calorie-restricted diet in combination with IGB therapy. Methods A prospective study was conducted on 51 patients who had undergone IGB therapy from October 2012 to December 2017. Overall, 31 of the 51 patients were included in this study (12-month assessment after IGB placement). These 31 cases consisted of 18 IGB plus low-carbohydrate diet and 13 IGB plus calorie-restricted diet. We compared the two groups with respect to body weight loss as outcomes. Results At 12 months after IGB placement, the body weight was significantly lower than that observed at baseline in both the IGB plus low-carbohydrate diet group (baseline 101.9±25.8 kg, 12 months 88.2±21.9 kg) (p<0.0001) and the IGB plus calorie-restricted diet group (baseline 103.5±17.0 kg, 12 months 89.1±6.2 kg) (p<0.005). The percentage of excess weight loss in the IGB plus low-carbohydrate diet group was slightly higher than that in the IGB plus calorie-restricted diet group, but there was no significant difference between the 2 groups at 12 months after IGB placement (IGB plus low-carbohydrate 49.9±60.0%, IGB plus calorie-restricted diet 33.1±27.0%). Conclusion Our study demonstrated that both a low-carbohydrate diet and a calorie-restricted diet were effective interventions for weight reduction in combination with IGB therapy.
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Food processing and cardiometabolic risk factors: a systematic review.
Santos, FSD, Dias, MDS, Mintem, GC, Oliveira, IO, Gigante, DP
Revista de saude publica. 2020;54:70
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Cardiovascular diseases (CVD) comprise the main cause of mortality in the world and approximately three quarters of deaths occur in low- and middle-income countries. The aim of this study was to assess the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. This study is a systematic review of eleven studies. Five studies (46%) had a sample size greater than 10,000 participants and the smallest sample identified evaluated 302 individuals. Results indicate that the consumption of UPF can have an unfavourable impact on the health of individuals, especially contributing to increase the body mass index. The cardiometabolic risk factors identified were overweight or obesity, arterial hypertension and metabolic syndrome. Authors conclude that their findings may contribute to strengthening scientific evidence that underlies public policies related to the area of food and nutrition and the coping with cardiovascular diseases.
Abstract
OBJECTIVE To systematically review the evidence for the association between food consumption according to processing and cardiometabolic factors in adults and/or the elderly. METHOD Two independent evaluators analyzed the electronic databases PubMed, Web of Science and Lilacs until December 2018. We used the following terms: (convenience foods OR food processing OR highly-processed OR industrialized foods OR minimally-processed OR prepared foods OR processed foods OR ultra-processed OR ultraprocessed OR ultra processed OR unprocessed) AND (metabolic syndrome OR hypertension OR blood pressure OR diabetes mellitus OR glucose OR glycaemia OR insulin OR cholesterol OR triglycerides OR blood lipids OR overweight OR obesity) AND (adult OR adults OR adulthood OR aged OR elderly OR old). We assessed methodological and evidence qualities, and also extracted information for the qualitative synthesis from the selected studies. RESULTS Of the 6,423 studies identified after removing duplicates, eleven met the eligibility criteria. The main food classification we used was Nova. The consumption of ultra-processed foods was positively associated with overweight and obesity, high blood pressure and metabolic syndrome. All articles included met more than 50% of the methodological quality criteria. The quality of evidence was considered moderate for the outcome overweight and obesity and weak for hypertension and metabolic syndrome. CONCLUSIONS The Nova food classification stands out in the area of nutritional epidemiology when assessing the effects of food processing on health outcomes. Although caution is required in the interpretation, the results indicated that the consumption of ultra-processed foods can have an unfavorable impact in the health of individuals.
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From mitochondria to healthy aging: The role of branched-chain amino acids treatment: MATeR a randomized study.
Buondonno, I, Sassi, F, Carignano, G, Dutto, F, Ferreri, C, Pili, FG, Massaia, M, Nisoli, E, Ruocco, C, Porrino, P, et al
Clinical nutrition (Edinburgh, Scotland). 2020;39(7):2080-2091
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Despite the increase in life expectancy, there is no corresponding increase in healthy life expectancy. Lifestyle changes appear to be fundamental in increasing healthy life expectancy, and adequate nutrition is enormously important, given that malnutrition (i.e., undernutrition), particularly as protein-energy deficit is very common amongst the elderly population. It has been suggested that the aging process significantly affects protein metabolism and enhances the muscle wastage that accompanies undernutrition and sarcopenia. The aim of this study was to evaluate the efficacy of a specific branched-chain amino acids enriched mixtures (BCAAem) compared to diet advice to promote mitochondrial function and improve clinical outcomes, particularly muscle and cognitive performance, in malnourished elderly community-dwelling subjects. This study is a parallel, randomised, controlled, open-label trial. One hundred and fifty-five malnourished elderly patients were enrolled. The participants were randomly assigned to one of the two groups: diet advice, summarised in an easy-to-use brochure for lay persons or BCAAem supplements. Results show that amelioration of nutritional status is associated with improvement in general health status, muscle and cognitive performances in old, malnourished patients. In fact, the diagnosis of malnutrition and its treatment, albeit using different approaches, is fundamental in improving the patients’ general health and nutritional status. Authors conclude that BCAAem treatment in old, malnourished patients may be a good strategy to ameliorate the bioenergetic capacity of peripheral blood mononuclear cells.
Abstract
RATIONALE Malnutrition often affects elderly patients and significantly contributes to the reduction in healthy life expectancy, causing high morbidity and mortality. In particular, protein malnutrition is one of the determinants of frailty and sarcopenia in elderly people. METHODS To investigate the role of amino acid supplementation in senior patients we performed an open-label randomized trial and administered a particular branched-chain amino acid enriched mixture (BCAAem) or provided diet advice in 155 elderly malnourished patients. They were followed for 2 months, assessing cognitive performance by Mini Mental State Examination (MMSE), muscle mass measured by anthropometry, strength measure by hand grip and performance measured by the Timed Up and Go (TUG) test, the 30 s Chair Sit to Stand (30-s CST) test and the 4 m gait speed test. Moreover we measured oxidative stress in plasma and mitochondrial production of ATP and electron flux in peripheral blood mononuclear cells. RESULTS Both groups improved in nutritional status, general health and muscle mass, strength and performance; treatment with BCAAem supplementation was more effective than simple diet advice in increasing MMSE (1.2 increase versus 0.2, p = 0.0171), ATP production (0.43 increase versus -0.1, p = 0.0001), electron flux (0.50 increase versus 0.01, p < 0.0001) and in maintaining low oxidative stress. The amelioration of clinical parameters as MMSE, balance, four meter walking test were associated to increased mitochondrial function. CONCLUSIONS Overall, our findings show that sustaining nutritional support might be clinically relevant in increasing physical performance in elderly malnourished patients and that the use of specific BCAAem might ameliorate also cognitive performance thanks to an amelioration of mitochondria bioenergetics.
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Supplement with whey protein hydrolysate in contrast to carbohydrate supports mitochondrial adaptations in trained runners.
Hansen, M, Oxfeldt, M, Larsen, AE, Thomsen, LS, Rokkedal-Lausch, T, Christensen, B, Rittig, N, De Paoli, FV, Bangsbo, J, Ørtenblad, N, et al
Journal of the International Society of Sports Nutrition. 2020;17(1):46
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Nutrition is crucial for long-term success in elite sports to support athletic performance and recovery. Furthermore, adaptations to training can be amplified or dampened by the dietary intake of food and specific supplements. The aim of this study was to investigate the effect of consuming whey protein (PRO) hydrolysate before and whey PRO hydrolysate plus carbohydrates (CHO) after each exercise session compared to intake of isocaloric CHO on mitochondrial protein content, maximal oxygen uptake and time trial performance during a controlled six-week training period in trained runners. This study is a double-blinded block-randomized controlled intervention trial. Healthy, trained runners (18–50 yrs.) were recruited for the study. Half of the participants were randomised to ingest a PRO beverage before and PRO-CHO beverage after each exercise session (PRO-CHO). The other half of the group (CHO) ingested an energy matched CHO beverage before and after each exercise session. Results show that ingestion of whey protein hydrolysate before and whey protein hydrolysate plus carbohydrate after each exercise session during a six-week endurance training period improved specific mitochondrial protein adaptations compared to isocaloric intake of CHO. Authors conclude that the significance of mitochondrial adaptations for performance remains to be elucidated since adaptations were not followed by a better performance.
Abstract
BACKGROUND Protein supplementation has been suggested to augment endurance training adaptations by increasing mixed muscle and myofibrillar protein synthesis and lean body mass. However, a potential beneficial effect on mitochondrial adaptations is yet to be clarified. The aim of the present study was to investigate the effect of consuming whey protein hydrolysate before and whey protein hydrolysate plus carbohydrate (PRO-CHO) after each exercise session during a six-week training period compared to similarly timed intake of isocaloric CHO supplements on biomarkers of mitochondrial biogenesis, VO2max and performance in trained runners. METHODS Twenty-four trained runners (VO2max 60.7 ± 3.7 ml O2 kg- 1 min1) completed a six-week block randomized controlled intervention period, consisting of progressive running training. Subjects were randomly assigned to either PRO-CHO or CHO and matched in pairs for gender, age, VO2max, training and performance status. The PRO-CHO group ingested a protein beverage (0.3 g kg- 1) before and protein-carbohydrate beverage (0.3 g protein kg- 1 and 1 g carbohydrate kg- 1) after each exercise session. The CHO group ingested an energy matched carbohydrate beverage. Resting muscle biopsies obtained pre and post intervention were analyzed for mitochondrial specific enzyme activity and mitochondrial protein content. Subjects completed a 6 K time trial (6 K TT) and a VO2max test pre, midway (only 6 K TT) and post intervention. RESULTS Following six weeks of endurance training Cytochrome C (Cyt C) protein content was significantly higher in the PRO-CHO group compared to the CHO group (p < 0.05), with several other mitochondrial proteins (Succinate dehydrogenase (SDHA), Cytochrome C oxidase (COX-IV), Voltage-dependent anion channel (VDAC), Heat shock protein 60 (HSP60), and Prohibitin (PHB1)) following a similar, but non-significant pattern (p = 0.07-0.14). β-hydroxyacyl-CoA dehydrogenase (HAD) activity was significantly lower after training in the CHO group (p < 0.01), but not in the PRO-CHO group (p = 0.24). VO2max and 6 K TT was significantly improved after training with no significant difference between groups. CONCLUSION Intake of whey PRO hydrolysate before and whey PRO hydrolysate plus CHO after each exercise session during a six-week endurance training period may augment training effects on specific mitochondrial proteins compared to intake of iso-caloric CHO but does not alter VO2max or 6 K TT performance. TRIAL REGISTRATION clinicaltrials.gov , NCT03561337 . Registered 6 June 2018 - Retrospectively registered.