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1.
Effect of Creatine Supplementation on Functional Capacity and Muscle Oxygen Saturation in Patients with Symptomatic Peripheral Arterial Disease: A Pilot Study of a Randomized, Double-Blind Placebo-Controlled Clinical Trial.
Domingues, WJR, Ritti-Dias, RM, Cucato, GG, Wolosker, N, Zerati, AE, Puech-Leão, P, Coelho, DB, Nunhes, PM, Moliterno, AA, Avelar, A
Nutrients. 2021;(1)
Abstract
The aim of the study was to verify the effects of creatine (Cr) supplementation on functional capacity (walking capacity; primary outcome) and calf muscle oxygen saturation (StO2) (secondary outcome) in symptomatic peripheral arterial disease (PAD) patients. Twenty-nine patients, of both sexes, were randomized (1:1) in a double-blind manner for administration of placebo (PLA, n = 15) or creatine monohydrate (Cr, n = 14). The supplementation protocol consisted of 20 g/day for 1 week divided into four equal doses (loading phase), followed by single daily doses of 5 g in the subsequent 7 weeks (maintenance phase). Functional capacity (total walking distance) was assessed by the 6 min walk test, and calf muscle StO2 was assessed through near infrared spectroscopy. The measurements were collected before and after loading and after the maintenance phase. The level of significance was p < 0.05. No significant differences were found for function capacity (total walking distance (PLA: pre 389 ± 123 m vs. post loading 413 ± 131 m vs. post maintenance 382 ± 99 m; Cr: pre 373 ± 149 m vs. post loading 390 ± 115 m vs. post maintenance 369 ± 115 m, p = 0.170) and the calf muscle StO2 parameters (p > 0.05). Short- and long-term Cr supplementation does not influence functional capacity and calf muscle StO2 parameters in patients with symptomatic PAD.
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2.
Efficacy of a behavior change program on cardiovascular parameters in patients with hypertension: a randomized controlled trial.
Gerage, AM, Benedetti, TRB, Cavalcante, BR, Farah, BQ, Ritti-Dias, RM
Einstein (Sao Paulo, Brazil). 2020;:eAO5227
Abstract
OBJECTIVE To investigate the efficacy of a behavior change program named Vida Ativa Melhorando a Saúde on cardiovascular parameters in hypertensive patients. METHODS Ninety hypertensive patients aged over 40 years were randomly allocated to one of two groups: Vida Ativa Melhorando a Saúde or Control (n=45 respectively). Patients in the Vida Ativa Melhorando a Saúde group took part in a behavior change program aimed to encourage changes in physical activity levels and eating habits, according to the Social Cognitive Theory. The program consisted of 90-minute weekly group meetings conducted by a physical therapist and a dietitian. One chapter of the educational material (workbook) provided was discussed per meeting. Participants in the Control Group attended a single educative lecture on lifestyle changes. Brachial and central blood pressure, arterial stiffness and endothelial function parameters were measured pre- and post-intervention. RESULTS Vida Ativa Melhorando a Saúde led to reduction of brachial (131.3±15.8mmHg to 125.1±17.3mmHg; p<0.01) and central (123.6±16.3mmHg to 119.0±20.6mmHg; p=0.02) systolic and brachial diastolic (123.6±16.3mmHg to 119.0±20.6mmHg; p<0.01) blood pressure values, and improvement of post-occlusive reactive hyperemia (from 5.7±2.5mL·100mL-1 to 6.5±2.1mL·100mL-1 tissue·min-1; p=0.04). No changes in body composition, heart rate and arterial stiffness parameters were detected in both groups (p>0.05). CONCLUSION Vida Ativa Melhorando a Saúde program improved blood pressure and microvascular reactivity in hypertensive patients. Trial registration: ClinicalTrials.gov: NCT02257268.
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3.
Does Creatine Supplementation Affect Renal Function in Patients with Peripheral Artery Disease? A Randomized, Double Blind, Placebo-controlled, Clinical Trial.
Domingues, WJR, Ritti-Dias, RM, Cucato, GG, Wolosker, N, Zerati, AE, Puech-Leão, P, Nunhes, PM, Moliterno, AA, Avelar, A
Annals of vascular surgery. 2020;:45-52
Abstract
BACKGROUND Case studies and reviews have shown that creatine supplementation can affect kidney function. The objective of this study is to verify the effects of 8 weeks of creatine supplementation on renal function (creatinine clearance: primary outcome) in patients with symptomatic peripheral arterial disease. METHODS Twenty-nine patients, of both genders, were randomized (1:1) in a double-blind manner for administration of Placebo (PLA; n = 15) or creatine monohydrate (Cr; n = 14). The supplementation protocol consisted of 20 g/day for 1 week divided into 4 equal doses (loading phase), followed by single daily doses of 5 g in the subsequent 7 weeks (maintenance phase). Before and after the supplementation period, markers of renal function, serum creatinine, creatinine excretion rate, and creatinine clearance were evaluated. The Generalized Estimation Equation Model was used for comparison between groups. The level of significance was P < 0.05. RESULTS No significant differences were found between groups before and after the intervention for serum creatinine (Cr: pre 1.00 ± 0.15 mL/dL vs. post 1.07 ± 0.16 mL/dL; PLA: pre 1.30 ± 0.53 mL/dL vs. post 1.36 ± 0.47 mL/dL, P = 0.590), creatinine excretion rate (Cr: pre 81.73 ± 43.80 mg/dL vs. post 102.92 ± 59.57 mg/dL; PLA: pre 74.37 ± 38.90 mg/dL vs. post 86.22 ± 39.94 mg/dL, P = 0.560), or creatinine clearance (Cr; pre 108 ± 59 mL/min/1.73 m2 vs. post 117 ± 52 mL/min/1.73 m2; PLA: pre 88 ± 49 mL/min/1.73 m2 vs. post 82 ± 47 mL/min/1.73 m2, P = 0.366). CONCLUSIONS Eight weeks of creatine supplementation is safe and does not compromise the renal function of patients with peripheral arterial disease.
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4.
Effect of Low- Versus High-Intensity Exercise Training on Biomarkers of Inflammation and Endothelial Dysfunction in Adolescents With Obesity: A 6-Month Randomized Exercise Intervention Study.
Tenório, TRS, Balagopal, PB, Andersen, LB, Ritti-Dias, RM, Hill, JO, Lofrano-Prado, MC, Prado, WL
Pediatric exercise science. 2018;(1):96-105
Abstract
PURPOSE To investigate the effects of a low- versus high-intensity aerobic training on biomarkers of inflammation and endothelial dysfunction in adolescents with obesity. METHODS Sixty-two adolescents with obesity [age = 15 (14) y, body mass index = 34.87 (4.22) kg·m-2] were randomized to receive either a high-intensity training (HIT, n = 31) or a low-intensity training (LIT, n = 31) for 24 weeks. All participants also received nutritional, psychological, and clinical counseling. Leptin, total and subtype leukocyte counts, tumor necrosis factor-alpha, interleukin-6, myeloperoxidase, soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule-1 were obtained at baseline and after 24 weeks. RESULTS HIT reduced neutrophils [from 4.4 (1.9) to 3.6 (1.3) µL-1 × 103; P = .01] and monocytes [from 7.2 (2.5) to 5.2 (1.8) µL-1 × 102; P < .01], but LIT increased neutrophils [from 4.5 (1.7) to 5.2 (3.3) µL-1 × 103; P = .01]. Although tumor necrosis factor-alpha increased in LIT [from 13.3 (7.5) to 17.7 (10.8) pg·mL-1; P = .01], it decreased in HIT [from 12.4 (7.5) to 11.3 (6.2) pg·mL-1; P = .01]. No changes in leukocyte counts, soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, and homeostasis assessment model for insulin resistance were observed. CONCLUSIONS Both HIT and LIT improved the inflammatory profile. The study, however, indicated that the number of biomarkers and the magnitude of changes were higher in the HIT compared with LIT.
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5.
Acute effects of walking and combined exercise on oxidative stress and vascular function in peripheral artery disease.
Lima, AHRA, Correia, MA, Soares, AHG, Farah, BQ, Forjaz, CLM, Silva, AS, Brasileiro-Santos, MS, Santos, AC, Ritti-Dias, RM
Clinical physiology and functional imaging. 2018;(1):69-75
Abstract
The aim of this study was to compare the effects of a single session of walking and combined exercise on oxidative stress and vascular function in peripheral arterial disease patients. Thirteen patients with peripheral arterial disease underwent two experimental sessions in random order: walking (ten sets of 2-min walking at the speed corresponding to the onset of claudication pain with 2-min interval between sets) and combined exercise (1 × 10 reps in eight resistance exercises plus five-two-minute sets of walking). Before and after the exercise, vascular function (blood flow, leg vascular resistance and blood-flow postreactive hyperaemia) and oxidative stress (malondialdehyde and plasma nitrite levels) were obtained. Blood flow increased similarly after both sessions, whilst leg vascular resistance decreased similarly after both sessions. Plasma nitrite increased only after the combined exercise. Malondialdehyde decreased after both sessions, and the decrease was greater after combined exercise. As a conclusion, a single session of combined exercise improves blood flow and leg vascular resistance similarly to walking session; however, combined exercise promoted better effects on oxidative stress.
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6.
Effectiveness of a Behavior Change Program on Physical Activity and Eating Habits in Patients With Hypertension: A Randomized Controlled Trial.
Gerage, AM, Benedetti, TRB, Ritti-Dias, RM, Dos Santos, ACO, de Souza, BCC, Almeida, FA
Journal of physical activity & health. 2017;(12):943-952
Abstract
BACKGROUND This study aimed to analyze the effect of a behavior change program, called Vida Ativa Melhorando a Saúde (VAMOS), on physical activity, eating habits, and quality of life in patients with hypertension. METHODS A randomized controlled trial was carried out in 90 patients with hypertension (57.8 ± 9.9 y). They were randomly assigned to 2 groups: VAMOS group (n = 45) and control group (n = 45). The VAMOS group participated in a behavioral change program aimed at motivating changes in physical activity and nutrition behavior for 12 weeks. Physical activity, eating habits, quality of life, self-efficacy, and social support were evaluated at preintervention and postintervention. RESULTS The control group increased sedentary time (407 ± 87 vs 303 ± 100 min/d; P < .05) and sedentary bouts (434 ± 86 vs 336 ± 98 min/d; P < .05) and reduced total physical activity (553 ± 87 vs 526 ± 86 min/d; P < .05). The VAMOS group improved the general healthy eating habits score (36.9 ± 6.6 vs 43.4 ± 5.8; P < .05) and quality of life (44% vs 92%; P < .05). CONCLUSION The VAMOS program was effective in improving eating habits and quality of life in patients with hypertension.
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7.
Acute Effects of T'ai Chi Chuan Exercise on Blood Pressure and Heart Rate in Peripheral Artery Disease Patients.
Dantas, FF, da Silva Santana, F, da Silva, TS, Cucato, GG, Farah, BQ, Ritti-Dias, RM
Journal of alternative and complementary medicine (New York, N.Y.). 2016;(5):375-9
Abstract
OBJECTIVE To investigate the acute effect of a t'ai chi chuan session on blood pressure and heart rate in patients with peripheral artery disease (PAD). DESIGN Randomized crossover intervention study. SETTING Outpatient therapy center. PARTICIPANTS Seven patients with PAD, aged 50-79 years, not using β-blockers, calcium-channel blockers, or nondihidropiridinic vasodilators. INTERVENTION T'ai chi chuan and control session (both sessions lasted 40 minutes). OUTCOME MEASURES Systolic and diastolic blood pressure and heart rate, which were evaluated before and after the intervention (10, 30, and 50 minutes). RESULTS T'ai chi chuan exercise acutely decreased systolic blood pressure at 30 minutes after exercise (p = 0.042) and increased diastolic blood pressure at 50 minutes after exercise (p = 0.041). Heart rate did not change after t'ai chi chuan exercise. CONCLUSION T'ai chi chuan acutely decreases systolic blood pressure in patients with PAD.
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8.
Chronic resistance training does not affect post-exercise blood pressure in normotensive older women: a randomized controlled trial.
Gerage, AM, Ritti-Dias, RM, do Nascimento, MA, Pina, FL, Gonçalves, CG, Sardinha, LB, Cyrino, ES
Age (Dordrecht, Netherlands). 2015;(3):63
Abstract
Resistance training has been recommended for maintenance or improvement of the functional health of older adults, but its effect on acute cardiovascular responses remains unclear. Thus, the purpose of this study was to analyze the effect of 12 weeks of resistance training on post-exercise blood pressure (BP) in normotensive older women. Twenty-eight normotensive and physically inactive women (≥ 60 years) were randomly assigned to a training group (TG) or a control group (CG). The TG underwent a resistance training program (12 weeks, 8 exercises, 2 sets, 10-15 repetitions, 3 days/week), while the CG performed stretching exercises (12 weeks, 2 sets, 20 s each, 2 days/week). At baseline and after the intervention, participants were randomly submitted to two experimental sessions: a resistance exercise session (7 exercises, 2 sets, 10-15 repetitions) and a control session. BP was obtained pre- and post-sessions (90 min), through auscultation. Post-exercise hypotension was observed for systolic, diastolic, and mean BP in the TG (-6.1, -3.4, and -4.3 mmHg, respectively; P < 0.05) and in the CG (-4.1, -0.7, and -1.8 mmHg, respectively; P < 0.05). After the intervention period, the magnitude and pattern of this phenomenon for systolic, diastolic, and mean BP were similar between groups (TG -8.8, -4.1, and -5.7 mmHg, respectively; P < 0.05 vs CG -11.1, -5.8, and -7.6 mmHg, respectively; P < 0.05). These results indicate that a single session of resistance exercise promotes reduction in post-exercise BP and 12 weeks of resistance training program do not change the occurrence or magnitude of this hypotension. (ClinicalTrial.gov: NCT02346981).
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9.
Does exercise intensity affect blood pressure and heart rate in obese adolescents? A 6-month multidisciplinary randomized intervention study.
Farah, BQ, Ritti-Dias, RM, Balagopal, PB, Hill, JO, Prado, WL
Pediatric obesity. 2014;(2):111-20
Abstract
BACKGROUND Aerobic exercise improves cardiovascular health in general, but whether the impact varies with exercise intensity is not clear. OBJECTIVE The aim of the current study was to compare the effects of a high-intensity aerobic exercise training (HIT) vs. a low-intensity aerobic exercise training (LIT) on blood pressure (BP), heart rate (HR) and heart rate variability (HRV) in obese adolescents. METHODS Forty-three (13-18 years) Tanner stage (III-IV) matched obese adolescents were studied in a randomized trial of either HIT (corresponding to the ventilatory threshold I; n = 20) or LIT (corresponding to 20% below the ventilatory threshold I; n = 23) programme for a period of 6 months. All participants also received a multidisciplinary therapy that included nutritional, psychological and clinical counselling. Both HIT and LIT sessions were isocaloric, with energy expenditure set at 350 kcal. BP, HR and HRV were measured along with markers of body adiposity and insulin resistance before and after the respective interventions. RESULTS The participants in both groups had similar physical and clinical characteristics. After the 6-month intervention, systolic, diastolic and mean BP decreased (P < 0.05, for all) similarly in both groups, whereas waist circumference, HR and HRV showed beneficial changes only in the HIT group (P < 0.05). CONCLUSION Aerobic exercise training set at a high intensity compared with the low intensity appears to have additional benefits on abdominal obesity and cardiovascular health in that it enhances the parasympathetic and autonomic modulation of the heart in obese adolescents.