Effect of resistance training volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females:Systematic review and meta-analysis of randomized controlled trials

Purpose:This meta-analytical study aimed to explore the effects of resistance training(RT) volume on body adiposity,metabolic risk,and inflammation in postmenopausal and older females.Methods:A systematic search was performed for randomized controlled trials in PubMed,Scopus,Web of Science,and SciELO.Randomized controlled trials with postmenopausal and older females that compared RT effects on body adiposity,metabolic risk,and inflammation with a control group(CG) were included.Independent reviewers selected the studies,extracted the data,and performed the risk of bias and certainty of the evidence(Grading of Recommendations,Assessment,Development,and Evaluation(GRADE)) evaluations.Total body and abdominal adiposity,blood lipids,glucose,and C-reactive protein were included for meta-analysis.A random-effects model,standardized mean difference(Hedges’ g),and 95% confidence interval(95%CI) were used for meta-analysis.Results:Twenty randomized controlled trials(overall risk of bias:some concerns;GRADE:low to very low) with overweight/obese postmenopausal and older females were included.RT groups were divided into low-volume RT(LVRT,~44 sets/week) and high-volume RT(HVRT,~77 sets/week).Both RT groups presented improved body adiposity,metabolic risk,and inflammation when compared to CG.However,HVRT demonstrated higher effect sizes than LVRT for glucose(HVRT=-1.19;95%CI:-1.63 to-0.74;LVRT=-0.78;95%CI:-1.15 to-0.41) and C-reactive protein(HVRT=-1.00;95%CI:-1.32 to-0.67;LVRT=-0.34;95%CI,-0.63 to-0.04)) when compared to CG.Conclusion:Compared to CG,HVRT protocols elicit greater improvements in metabolic risk and inflammation outcomes than LVRT in overweight/obese postmenopausal and older females.

Reciprocal interactions between gut microbiota and autophagy

A symbiotic relationship has set up between the gut microbiota and its host in the course of evolution,forming an interkingdom consortium.The gut offers a favorable ecological niche for microbial communities,with the whole body and external factors(e.g.,diet or medications)contributing to modulating this microenvironment.Reciprocally,the gut microbiota is important for maintaining health by acting not only on the gut mucosa but also on other organs.However,failure in one or another of these two partners can lead to the breakdown in their symbiotic equilibrium and contribute to disease onset and/or progression.Several microbial and host processes are devoted to facing up the stress that could alter the symbiosis,ensuring the resilience of the ecosystem.Among these processes,autophagy is a host catabolic process integrating a wide range of stress in order to maintain cell survival and homeostasis.This cytoprotective mechanism,which is ubiquitous and operates at basal level in all tissues,can be rapidly down-or upregulated at the transcriptional,post-transcriptional,or post-translational levels,to respond to various stress conditions.Because of its sensitivity to all,metabolic-,immune-,and microbial-derived stimuli,autophagy is at the crossroad of the dialogue between changes occurring in the gut microbiota and the host responses.In this review,we first delineate the modulation of host autophagy by the gut microbiota locally in the gut and in peripheral organs.Then,we describe the autophagy-related mechanisms affecting the gut microbiota.We conclude this review with the current challenges and an outlook toward the future interventions aiming at modulating host autophagy by targeting the gut microbiota.

No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19

Background:Regular physical activity(PA)has been postulated to improve,or at least maintain,immunity across the life span.However,the link between physical(in)activity and coronavirus disease 2019(COVID-19)remains to be established.This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19.Methods:Hospitalized patients with COVID-19(mean age:54.9 years)were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo(a quaternary referral teaching hospital)and from Ibirapuera Field Hospital,both located in Sao Paulo,Brazil.PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity.The primary outcome was hospital length of stay.The secondary outcomes were mortality,admission to the intensive care unit(ICU),and mechanical ventilation requirement.Results:The median hospital length of stay was 7.0§4.0 days,median§IQR;3.3%of patients died,13.8%were admitted to the ICU,and 8.6%required mechanical ventilation.Adjusted linear regression models showed that PA indices were not associated with hospital length of stay(work index:b=-0.57(95%confidence interval(95%CI):-1.80 to 0.65),p=0.355;sport index:b=0.43(95%CI:-0.94 to 1.80),p=0.536;leisure-time index:b=1.18(95%CI:-0.22 to 2.59),p=0.099;and total activity index:b=0.20(95%CI:-0.48 to 0.87),p=0.563).None of the PA indices were associated with mortality,admission to the ICU,or mechanical ventilation requirement(all p>0.050).Conclusion:Among hospitalized patients with COVID-19,PA did not independently associate with hospital length of stay or any other clinically relevant outcomes.These findings should be interpreted as meaning that,among already hospitalized patients with more severe forms of COVID-19,being active is a potential protective factor likely outweighed by a cluster of comorbidities(e.g.,type 2 diabetes,hypertension,weight excess)and older age,suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.

Effects of Intake of Milk Enriched with <i>Aloe vera</i>on Patients with Gastrointestinal Reflux Disease

Background: Aloe vera has been used by many civilizations throughout history due to the numerous properties attributed. Gastro oesophageal reflux disease is a common disorder with consequences for the patient’s health related quality of life. Aims: The purpose of this study was to assess the benefits of the Aloe vera in 80 patients with gastro oesophageal reflux. Methods: This is probably the first randomised and double-blind trail ever performed on this subject. The study included eight weeks of treatment with milk enriched with Aloe vera or placebo. Data of diet (frequency questionnaire), symptoms (gastrointestinal symptom rating scale) and quality of life (quality of life in reflux and disease) were obtained. Results: So far, there has been hardly any proof that Aloe vera decreases symptoms of reflux disease;on the contrary, a lower percentage of remission of pain is observed among the Aloe vera group. As long as its effectiveness has not been proven properly, the use of Aloe vera in reflux disease cannot be recommend. Conclusion: Aloe vera does not have a beneficial effect on reflux disease under the study conditions.

Commercial Bakery, Fast-Food, and Soft Drink Consumption and Quality of Life in the SUN Project

Objective: Few studies have related nutritional factors with quality of life in healthy populations. Our aim was to analyze the relationship between commercial bakery, fast food or soft drinks consumption and mental and physical quality of life. Study Design: This analysis included 8335 participants from the 'Seguimiento Universidad de Navarra' (SUN) Project (a multipurpose, dynamic cohort). Methods: The consumption of commercial bakery, fast food and soft drinks was assessed through a validated food-frequency questionnaire at baseline. Quality of life was measured after 4 years of follow-up with the Short-Form 36 (SF-36) Health Survey. Generalized Linear Models were fit to assess the regression coefficients (b) and their 95% confidence intervals (95% CI) for the association between commercial bakery, fast food and soft drinks consumption and each domain and the two standardized measures of the SF-36. Results: As compared to the participants in the lowest quintile of consumption, those participants in the highest quintile of consumption of commercial bakery, fast food and soft drinks showed a score significantly lower (>2 points) for vitality (b = -2.14, 95% CI = -3.31 to -0.96), role emotional (b = -2.23, 95% CI = -4.33 to -0.13), and role physical (b = -2.31, 95% IC = -4.26 to -0.36) domains with statistically significant dose-response relationships (p for trend < 0.05). When the food groups were analysed separately, significant inverse associations were found only for commercial bakery and fast-food consumption. Conclusions: The results suggest that high consumption of commercial bakery, fast-food and soft drinks at baseline was associated with worse scores on self-perceived quality of life. This association was stronger for the mental domains of the SF-36.

Nutritional therapy for hospitalized patients with COVID-19:A narrative and integrative review

Hospitalized patients affected by coronavirus disease 19(COVID-19)have a sustained pro-inflammatory state and recurrent gastrointestinal symptoms that correlate with a decline in the nutritional status,which is directly related to poor immune response and clinical evolution.Nutritional therapy has proven crucial in COVID-19 treatment through the provision of adequate amounts of nutrients.Since the beginning of the pandemic,medical societies have mobilized to provide practical nutritional guidelines to support decision-making;despite this,there are only a few studies dedicated to compiling the most relevant recommendations.In this narrative review,we aimed to summarize and stratify the current scientific literature on nutritional support for hospitalized COVID-19 patients.We carried out a literature review from three databases between January 2020 and July 2021,using nutrition therapy(or medical nutrition or enteral nutrition or parental nutrition or nutritional support)and COVID-19(SARS-CoV-2 infection)as the search terms.Only those studies that evaluated adult hospitalized patients with admissions to wards,specific clinics,or intensive care units were included.The nutritional intervention considered was that of specific nutritional support via oral,enteral,or parenteral modes.A total of 37 articles were included.In general,the nutritional care provided to COVID-19 patients follows the same premises as for other patients,i.e.,it opts for the most physiological route and meets nutritional demands based on the clinical condition.However,some protocols that minimize the risk of contamination exposure for the health team have to be considered.Energy requirements varied from 15 kcal/kg/day to 30 kcal/kg/day and protein goals from 1.2 g/kg/day to 2 g/kg/day.In both cases,the ramp protocol for increased supply should be considered.In cases of enteral therapy,ready-to-use diet and continuous mode are recommended.Attention to refeeding syndrome is essential when parenteral nutrition is used.

Serum levels of the novel adipokine isthmin-1 are associated with obesity in pubertal boys

Objectives To evaluate whether there is an association between the serum levels of the novel insulin-like adipokine isthmin-1(ISM1)and obesity-related phenotypes in a population of Spanish children and to investigate the plausible molecular alterations behind the alteration of the serum levels of this protein in children with obesity.Methods The study population is a sub-cohort of the PUBMEP research project,consisting of a cross-sectional population of 119 pubertal children with overweight(17 boys,19 girls),obesity(20 boys,25 girls),and normal weight(17 boys,21 girls).All subjects were classified into experimental groups according to their sex,obesity,and insulin resistance(IR)status.They were counted anthropometry,glucose and lipid metabolism,inflammation and cardiovascular biomarkers as well as isthmin-1(ISM1)serum levels.This population was intended as a discovery population to elucidate the relationship between obesity and ISM1 levels in children.Furthermore,the study population had blood whole-genome DNA methylation examined,allowing deepening into the obesity–ISM1 molecular relationship.Results Higher serum ISM1 levels were observed in boys with obesity than in normal weight(P=0.004)and overweight(P=0.007)boys.ISM1 serum levels were positively associated with body mass index(BMI)Z-score(P=0.005)and fat mass(P=0.058)and negatively associated with myeloperoxidase(MPO)(P=0.043)in boys.Although we did not find associations between ISM1 serum levels and metabolic outcomes in girls,which may indicate a putative sexual dimorphism,fat mass was positively associated in all children,including boys and girls(P=0.011).DNA methylation levels in two-enhancer-related CpG sites of ISM1(cg03304641 and cg14269097)were associated with serum levels of ISM1 in children.Conclusions ISM1 is associated with obesity in boys at the pubertal stage,elucidating how this protein might be of special relevance as a new biomarker of obesity in children.Further studies including a longitudinal design during puberty are needed.