Background:Hypoxia and high altitudes affect various organs, which impairs important physiological functions, such as a disruption of the intestinal barrier mediated by increased translocation of bacteria and increased circulating endotoxin levels. Physical exercise can alter endotoxin concentration in normoxia. The aim of this study is to evaluate the effects of moderate exercise on endotoxin concentration in normobaric hypoxia.Methods:Nine healthy male volunteers exercised on a treadmill for 60 minutes at an intensity of 50% VO2peak in normoxic or hypoxic conditions (4200 m). Blood was collected at rest, immediately after exercise and 1 hour after exercise to evaluate serum endotoxin levels.Results:Under hypoxic exercise conditions, SaO2% saturation was lower after exercise compared with resting levels (P < 0.05) and returned to the resting level during recovery in normoxia (P < 0.05). Endotoxin concentration increased after exercise in hypoxia (P < 0.05); it remained high 1 hour after exercise in hypoxia compared with normoxia (P < 0.05) and was higher after exercise and recovery compared with resting levels (P < 0.05). HR was higher during exercise in relation basal in both conditions (P < 0.05) and RPR increase after 60 minutes in comparison to 20 minutes in hypoxia (P < 0.05).Conclusion:Moderate exercise performed in hypoxia equivalent to 4200 m increased endotoxin plasma concentration after exercise. One hour of rest in normoxic conditions was insufficient for the recovery of circulating endotoxins.

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Objective: To investigate the effects of an interdisciplinary intervention on biomarkers of inflammation and their relationship with fibroblast growth factor 21 (FGF21) concentrations in women with overweight and obesity. Subjects and methods: Thirty-one women were enrolled in a 12-week interdisciplinary weight loss program delivered by a team comprising an endocrinologist, nutritionist and exercise physiologist. Body composition; anthropometric measures; metabolic and inflammatory markers including adiponectin, leptin, and atrial natriuretic peptide (ANP) were assessed at baseline and post-therapy. The homeostasis model assessment of insulin resistance (HOMA-IR) and the homeostasis model assessment of adiponectin (HOMA-AD) were calculated. The participants were divided into two groups: those with increased FGF21, and those with decreased FGF21. Results: The sample comprised women aged 32 ± 5 years with a body mass index of 33.64 ± 3.49 kg/m². Body weight, waist circumference and leptin concentration were decreased in the whole sample after therapy. However, only the group with an increase in FGF21 concentration presented significant improvements in adiponectin concentration and adiponectin/leptin ratio. Moreover, although there was a reduction of leptin in both groups, it was greater in the increased FGF21 groups. There was a reduction in ANP in the decreased FGF21 group. Conclusions: Changes in FGF21 concentrations were different among the women participating in the weight loss program, with some having increased levels and some reduced levels. Furthermore, improvements in adiponectin and the adiponectin/ leptin ratio were found only in the group with increased FGF21 concentration.

Objetivo: el objetivo de este estudio fue evaluar la prevalencia de hipovitaminosis D en los candidatos a cirugía bariátrica (CB) y su relación con factores de riesgo y los componentes del síndrome metabólico. Material y métodos: los parámetros clínicos, antropométricos y bioquímicos se midieron en 56 pacientes caucásicos incluidos en un protocolo de cirugía bariátrica entre enero y junio de 2014. Los pacientes fueron estratificados en tres grupos de acuerdo al status de vitamina D: suficiencia (≥ 40 ng/ml), insuficiencia (40-20 ng/ml) y deficiencia (< 20 ng/ml). Resultados: se observó deficiencia de vitamina D en el 75% de los pacientes. Estos pacientes tenían mayor índice de masa corporal (p = 0,006) y concentraciones plasmáticas mas bajas de PTH (p = 0,045). Además, hubo más pacientes con diabetes mellitus tipo 2 (DM2) y dislipemia (DLPM) en el grupo con niveles de 25 (OH) D < 20 ng/ml. Asimismo la 25 (OH) D se correlacionó negativamente con la masa grasa (r =-0,504; p = 0,009), el IMC (r =-0,394; p = 0,046) y la hipertensión arterial (r =-0,637; p = 0,001). Conclusión: De nuestros hallazgos concluimos que la deficiencia de vitamina D es muy común entre los candidatos a CB y que la misma está asociada con DM2 y DLPM. Aunque hay pocos datos sobre el mejor tratamiento para el bajo nivel de vitamina D en los pacientes candidatos CB, la detección de la deficiencia de vitamina D debe realizarse de forma rutinaria en estos casos. 25-hydroxy vitamin D and syndrome metabolic components in candidates to bariatric surgery Vitamina D y componentes del síndrome metabólico en candidatos a cirugía bariátrica

AIM: Obesity is recognized as an important multifactorial disease and the Cognitive-Behavioural Therapy (CBT), based on reflection on conflicts with food, has been used in a way associated with interdisciplinary clinical therapies, aiming to promote greater understanding, self-efficacy and autonomy of treated individuals. In this context, the objective of this investigation was to analyse the impact of behavioural nutritional intervention using the MTT (Transtheoretical Model); associated with non-intensive interdisciplinary clinical therapy, including digital health education. METHODS: The research was approved by the Research Ethics Committee of University Federal of São Paulo (n º 0242/2017). The 60 selected volunteers (BMI ~34.7Kg/m2) were conducted to an interdisciplinary lifestyle therapy, with duration of 12 weeks. This therapy included clinical, nutritional and exercise physiology approach associated to digital health education. At the beginning (week 0) and after the 12 weeks an anthropometric evaluation was performed and a biochemical profile analysis as well as evaluation of the stage of behavior change according to Prochaska and Diclemente. Statistical analysis was performed adopting as significant values p ≤ 5%. RESULTS: there was an increased degree of motivation and a reduction in the frequency of volunteers in the Relapse and Pre-Contemplation stages, as well as an increase in the number of women classified in the Action stage.The decision-categorized group had a statistically significant reduction on body weight (p = 0.00), BMI (p = 0.00), Neck Circumference (p = 0.00), Waist Circumference (p = 0.02), Abdominal Circumference (p = 0.03), Hip Circumference (p = 0.02) Body Fat Percentage (p = 0.00), Total Cholesterol (p = 0.02) and Non-HDL Cholesterol (p = 0.04). In the Action and Maintenance group, there was a significant reduction in body weight (p = 0.00), BMI (p = 0.01), Neck Circumference (p=0.00), Waist Circumference (p= 0.00), Abdominal Circumference (p = 0.00) and Hip Circumference (p = 0.00). CONCLUSION: the semi-presential clinical approach was effective to promote improvements in the body composition, including body fat and lipid profile, as a dependent manner considering the identification of the stage of behavior change.

Background: Obesity is a complex disease that has an epidemic character affecting more than 1 billion people worldwide. Excessive accumulation of fat is associated with increased consumption of ultra-processed foods. This type of food provides large amounts of free sugars and saturated fats, which contribute to a high energy intake. It is well established that the main cause of obesity involves regulation between calories consumed and expended, however, this concept may be incomplete. Several methods can be explored to reduce body weight, however, for a healthy weight loss process, it is important to direct the individual to a balanced diet, with control of quantity, correct proportions of macronutrients, variety and combinations of different foods and nutrients. Objective: The aim of the study was to analyse the diet quality according to the food production process considering the different obesity degree by body mass index in a women sample. Methods: 139 women with obesity aged between 20 and 45 years old were included in this observational, cross-sectional study. Body composition and the three-day food record were analyzed. Results: The consumption of carboydrates (%), lipides (%) and monounsaturated fat (%) from ultra-processed foods were higher in the group with the highest BMI. However monounsaturated fat (%) from in nature foods was higher in the group with the lowest BMI. In addition, a positive association between carbohydrates (from ultra-processed foods) and waist circumference was observed. Conclusion: This investigation can stimulate public health programs to reinforce guidelines regarding the type of food procedure, giving priority to take care of the population's health by improving nutritional quality, preventing, and treating obesity in a multidisciplinary way.

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