Caloric Deficit Research Articles

МАКРО- И МИКРОНУТРИЕНТНЫЙ СОСТАВ СУТОЧНОГО РАЦИОНА ПИТАНИЯ СТУДЕНТОВ ХМАО-ЮГРЫ С РАЗНЫМ УРОВНЕМ ФИЗИЧЕСКОЙ АКТИВНОСТИ

The article analyzes the macro- and micronutrient composition of the daily diet of students of KhMAO Yugra with different levels of physical activity. Athletes were found to have a slight caloric deficit against the background of optimal protein intake, excess fat and insufficient carbohydrates, reduced consumption of bioelements and vitamins, with the exception of Fe and vitamin A. In young men who do not engage in sports, a decrease in the energy value of the diet and a deficiency of macro- and micronutrients, expressed to a greater extent, were revealed.

INTERMITTENT KETOGENIC DIETS EXTEND LIFESPAN AND ATTENUATE INFLAMMAGING IN MALE MICE

Abstract A ketogenic diet (KD) has been shown to increase functional lifespan in male mice when fed isocalorically to a control diet (CD). However, it is not clear if intermittent ketogenic diets (IKD) that induce brief and recurring periods of ketosis would be as effective at prolonging lifespan. In the present study, 12-month-old C57BL/6JN male mice were fed an intermittent single day KD (KD fed on Mon, Wed and Fri each week, IK1) or 2-day KD (KD fed on 2 consecutive days each week, IK2). These two IKD regimes were selected to mimic the widely used alternate-day or 5:2 intermittent fasting approaches, without the caloric deficit. Our results showed that lifespan was significantly increased in both IK1 and IK2 groups, with IK1 showing a 13.6% and IK2 showing a 7.9% increase in median lifespan compared to the CD (p < 0.01). At 27 months of age, levels of circulating proinflammatory cytokines were significantly decreased in IK1 and IK2 mice compared to control mice. Also, levels of proinflammatory cytokines were significantly elevated in 27-month-old control mice compared to 12-month-old mice, while levels in IK1 and IK2 mice were not significantly altered with aging, and these effects were still persistent during days the animals were fed the CD. Unlike the continuous KD, health span measures were not altered in IK1 or IK2 mice at 26 months of age. In summary, IKDs that produce shorts episodes of ketosis can be effective at extending longevity in mice, possibly by attenuating systemic inflammation with aging.

Effect of multiday endurance exercise on total body water and calculated body composition in racing sled dogs

Prolonged multiday exercise in dogs is often associated with a caloric deficit that can lead to changes in body composition but may also result in an increase in lean body mass due to a conditioning effect. To test the hypothesis that multiday exercise decreases fat mass but increases lean body mass, body composition was measured using deuterium oxide dilution in a team of racing Alaskan sled dogs competing in a multiday race. Twelve dogs completed 961 km in 6 days, resulting in a 3% decrease in body mass (P=0.003) and 16% decrease in body fat (P=0.005), and an increase in total body water as a fraction of body mass (P=0.01). Within the study population, there was considerable dog-to-dog variation, with 2 dogs gaining fat mass and 2 dogs losing over 40% of their pre-race fat mass during the measurement period. These results confirm that dogs participating in multiday exercise events are at risk for loss of body fat reserve, likely due to a net calorie deficit. However, individual dog responses to an exercise challenge can be highly variable, emphasizing the need for careful assessment of individual dogs.

The greater calorie deficit applied to the bodybuilding athlete, the greater their loss of fat-free mass on the stage presentation?

The greater calorie deficit applied to the bodybuilding athlete, the greater their loss of fat-free mass on the stage presentation?

Вплив gamecrize-засобів на втрату ваги у жінок-вітуберок на прикладі Ring Fit Adventure

The purpose of the study was to determine the effectiveness of exergaming with the use of gamecrize tools using the example of Ring Fit Adventure for weight loss in female vitubers aged 18-25 years in conditions of self-isolation. Materials and methods. A statistical analysis of the tables of the results of the first streams of vitubers by Ring Fit Adventure for 25 vloggers with a total gameplay time of 1 hour, 12 minutes, 38 seconds was carried out. Statistics were created on the number of repetitions and holding time for 7 exercises performed by streamers during the game. The overall effectiveness of using Ring Fit Adventure for weight loss was calculated based on calories burned per hour of exercise. A comparison was made with the results of a previous study on exterior mobile exergames and the results of similar studies by other scientists. Results and discussion. The average rate of burning calories per minute of training for streamers was determined at the level of 4.5 kcal, or 269.87 kcal/h. Considering the calorie content of subcutaneous fat, which is 7,716 kcal/kg, it takes 28 hours 35 minutes and 4 seconds to lose 1 kg of weight. Given that Ring Fit Adventure exercises are the equivalent of moderate-intensity exercise, no more than 250 minutes of exercise per week is recommended, which means the possibility of losing a kilogram of subcutaneous fat in 7 weeks. Of course, at the same time, the real mass loss in the intermediate stages, due to water loss, will be higher, but we are talking about the burning of adipose tissue. At the same time, a one-hour training session provides only slightly more than half of the maximum calorie deficit recommended by the World Health Organization (500 kcal/day), and it is better to train no more than 4 times a week for 1 hour 32 minutes, so that the muscles have time to rest. A study of the effectiveness of burning calories with the use of gamecrize tools was conducted using the example of Ring Fit Adventure and the result was 269.87 kcal/h, or 4.5 kcal/h per 1 kg of body weight for an average woman according to the World Health Organization standards (65 kg). Conclusion. The average rate of energy loss from outdoor mobile games, determined by a previous study, is 5.65 kcal per 1 kg of body weight, or 367.25 kcal/day (5 km). This means that walking 5 km per day using outdoor mobile games like PokemonGo is more effective than an hour's training in Ring Fit Adventure. At the same time, repetition of training with the gamecrize ring should take into account the need for breaks, because daily training of this nature will not allow the muscles to recover. However, the positive effect on joints and ligaments, as well as the burning of calories by muscles in a passive mode, make such training a fairly effective substitute for walking in conditions of self-isolation

Adequacy of protein and calorie delivery according to the expected calculated targets: a day-by-day assessment in critically ill patients undergoing enteral feeding.

In critically ill patients requiring mechanical ventilation for longer than 48-72 h enteral nutrition (EN) should be started early. Because EN alone may be unable to reach the target nutritional requirement, supplemental parenteral nutrition (PN) should be administered. This study aimed at describing the daily rate of administered calories and proteins according to the expected calculated targets. The impact of calorie adequacy, deficit or excess on relevant clinical outcomes was explored. A retrospective cohort study was conducted in 217 patients undergoing cardiac surgery, admitted postoperatively in intensive care unit and undergoing EN. The effective intake provided via EN, PN, oral nutritional supplements (ONS) and nonnutritional calories (NNC) was documented for a maximum of 20 days. The administered/required calorie and protein ratios (KcalA/R , ProtA/R ) were calculated daily. Patients receiving 80%-100%, <80% or >100% of KcalA/R and ProtA/R were identified. The association between mean KcalA/R between days 4-7 and 30 days' mortality was explored. A mean KcalA/R ratio of 92.0 ± 40.6% was ensured between days 4 and 20. During days 4-7 the 80%-100% calorie target was achieved in 26.9% of patients, whereas 44.9% were below and 28.2% over this range. EN contributed 47.1% and PN 41.2% to the total energy intake. An increase in 30-day mortality risk was documented for patients exceeding 100% of KcalA/R ratio (adjusted-hazard ratio [HR] 5.2; 95% confidence interval [CI] 1.1 -23.9; p = 0.035). Despite a preliminary estimate of nutritional requirement, a steady daily optimal 80%-100% KcalA/R was not ensured for all patients. EN contributed only partially to both energy and protein intakes so that PN was largely used to achieve the desired nutritional targets.

Appetitive and Metabolic Responses to an Exercise versus Dietary Intervention in Adults with Obesity.

Dietary restriction (DIET) and aerobic exercise (AEX) interventions may impact energy balance differently. Our aim was to describe the effects of weight loss interventions via DIET or AEX on measures of energy balance. Adults with overweight or obesity were randomized to 12 weeks of DIET or AEX with similar calorie deficit goals. A study day was conducted before and after the intervention to assess subjective and hormonal (ghrelin, peptide-YY, glucagon-like peptide-1) appetite responses to a control meal, ad libitum energy intake (EI) at a single meal, and over three days of free-living conditions and eating behavior traits. Resting metabolic rate (RMR) was measured with indirect calorimetry and adjusted for body composition measured by dual X-ray absorptiometry. Non-exercise activity was measured using accelerometers. Forty-four individuals were included (age: 37 ± 9 years, body mass index: 30.6 ± 3.1 kg/m2). Both interventions resulted in weight and fat mass loss. The DIET group lost fat-free mass, although differences between groups were not significant (DIET: -1.2 ± 1.7 kg, p<0.001; AEX: 0.4 ± 1.5 kg, p=0.186; p=0.095 interaction). There were no differences in RMR after body composition adjustment. Both interventions were associated with an increase in dietary restraint (DIET: 4.9 ± 1.2, AEX: 2.8 ± 0.7; p<0.001 in both groups). Hunger decreased with DIET (-1.4 ± 0.5, p=0.003), and disinhibition decreased with AEX (-1.5 ± 0.5, p<0.001), although these changes were not different between groups (i.e., no group × time interaction). No other differences in appetite, EI, or non-exercise physical activity were observed within or between groups. AEX did not result in compensatory alterations in appetite, ad libitum EI, or physical activity, despite assumed increased energy expenditure. Modest evidence also suggested that disinhibition and hunger may be differentially impacted by weight loss modality.

How will an increase in organic agricultural area affect land use in Germany?

Organic agriculture is an attractive land use alternative to conventional farming in terms of environmental and biodiversity protection. The official German target is a 30% share of organic agricultural area by 2030, while German stakeholders consider 24% realistic and 44% desirable. It is unclear how such a shift may affect the food and land use system. We use data from a crop/pest model to estimate yield differences between conventional and organic systems, and the FABLE accounting tool to assess changes in indicators like calories available per person and day, and the extent of cropland, pasture and area where natural processes predominate. We investigate how an increase in organic agricultural area may affect these indicators up to 2050, and if adaptation measures may become necessary to ameliorate the potential pressure to expand cropland or raise import rates. The results show that if organic agricultural area is increased, there will be a calorie deficit of 7–80 kcal per person and day, corresponding to 1000–5000 km2 of missing cropland. The deficit will disappear without any changes to the system by 2045 at the latest due to demographic and technological development. No additional cropland at all would be required if crop productivity increased at a higher rate than observed today, and an additional 600,000 ha could be freed even with a 30% share of organic agriculture. A higher share of organic agriculture is thus a realistic target for Germany, but technological advancements should accompany the transformation to minimize cropland demand.

Role of Intermittent Fasting in the Management of Prediabetes and Type 2 Diabetes Mellitus.

Diabetes mellitus (DM) is a highly prevalent disease in the modern society. It can be defined as a group of metabolic diseases marked by chronic hyperglycemia arising from defects in insulin secretion or resistance to insulin action, or both. Its predecessor, prediabetes, is also an important entity, and its management is essential to prevent its progression to DM. Together, these entities burden global health and the world economy, and therefore, prevention and management are key to improving global health and reducing the financial burden on the world economy. Comprehensive lifestyle modification has been proven to be a safe and effective method for preventing the progression of prediabetes and treatment of type 2 diabetes mellitus. Lifestyle modifications such as weight loss, exercise, and diets such as low-carbohydrate one, Mediterranean, and very low calorie diets are traditionally recommended. These particular diets aim to attain calorie deficits and thus induce weight loss. Intermittent fasting (IF) is one such diet that focuses more on the timing of calorie consumption. However, there are several methods of achieving this, which are highlighted in this review. IF has been shown to promote weight loss, reduce insulin resistance, improve glycemic control and lower the risk of cardiometabolic diseases. However, little literature is available regarding the use of IF in managing DM. This review intends to elucidate the role of intermittent fasting in preventing and treating DM, including its benefits and limitations. From the various studies reviewed in this article, it can be deduced that intermittent fasting can achieve suitable glycemic targets and weight control.

Remission in Type 2 DM with Personalized Medical Interventions Including Life Style Modification and Appropriate Pharmacotherapy - A Case Report

Introduction: Increase in prevalence of type-2 diabetes in background of increased prevalence of obesity has increased overall health risk and complicates its management. Health benefits of weight loss and strategies for the same have been found to be effective. Caring for people living with diabetes and obesity requires a person-centred approach using the most appropriate evidence based individualized care. This case study discusses diabetes and weight management in a patient with sub-optimally controlled diabetes and a high BMI with potential for reversal of Diabetes. Clinical Problem: Extremely obese (BMI-43.23kg/m2) middle-aged person with hypertension and diabetes as comorbidity with sedentary lifestyle having sub-optimal glycaemic control (HbA1c 11.2%) with fatty liver disease presented for management of his sub-optimal glycaemic control. Management plan and its rationales with outcomes: Proper education about self-management of diabetes and counselling for importance of weight management and its long-term benefits were explained to patient. Low calorie diet with a calorie deficit of 600 calories per day, one-hour moderate intensity exercise day, SGLT-2i (dapagliflozin 10mg daily), Metformin 2000mg daily, GLP1RA (Liraglutide in incremental dose followed by switch over to oral similitude), Saroglitazar (dual PPAR agonist) along with antihypertensive medication and statin was started in this patient.At 4 months of intervention patient has tolerated the treatment very well and lost 26kg of body weight. His glycated HbA1c came down to 4.2% from 11.2%. Reversal of urine albumin to creatinine ratio to normal range was another significant change. Conclusion: Personalized medical interventions including lifestyle changes and appropriate antidiabetic medication was associated with&gt;25% weight loss, which can potentially induce complete remission of type-2 diabetes.

Assessment of gastrointestinal function and its’ effect on bone mineral density and body composition in hypermobility spectrum disorder and hypermobile Ehlers-Danlos syndrome

BackgroundHypermobile Ehlers-Danlos Syndrome (hEDS) and Hypermobility Spectrum Disorders (HSD) are associated with hypermobility, musculoskeletal pain, a decreased bone mineral density (BMD) and gastrointestinal (GI) complications. The role of GI symptoms and diet in BMD has not been established in this population. The GI complications can lead to an energy deficit due to lack of essential macronutrients. The primary objective of this study was to determine the severity of GI symptoms compared to body composition and BMD in individuals with hEDS/HSD. The secondary objective is to examine GI symptoms on energy balance, body composition and strength. MethodologyThis study was IRB approved. Eighteen female participants (aged 28.2 ± 4.9; BMI 22.5 ± 4.9) with a diagnosis of hEDS or HSD and 18 female healthy control participants (aged 28.1 ± 3.8; BMI 22.8 ±3.9) signed consent to participate. Participants were matched by sex, age, and BMI. The Gastrointestinal Symptom Rating Scale (GSRS) was used to investigate severity of GI symptoms. Dual X-ray absorptiometry was used to determine body composition (body fat%, lean body mass (LBM). BMD was measured by Z- scores of both femurs and lumbar spine. Resting metabolic rate (RMR) was measured using indirect calorimetry and strength was determined using a hand grip dynamometer. ResultsAll hEDS/HSD participants reported GI symptoms. There was no difference in body composition between hEDS/HSD and controls. Participants with hEDS/HSD had lower BMD both femoral z scores (p=0.02,0.004) and spine z scores (p= 0.04). There was no difference in caloric intake between groups; yet both groups demonstrated caloric deficits. Additionally, hEDS/HSD consumed less protein and more carbohydrates (p=0.03, p=0.03). There were no differences in grip strength. ConclusionsThis study identified that pre-menopausal women with hEDS/HSD presented with significant GI complications and lower BMD than age matched controls. The GI complications and the reduced protein intake long-term may have a lasting impact on bone health. This study found that the GSRS identified and quantified GI symptoms in persons with hEDS/HSD. Future studies are needed for the longitudinal effects of a caloric/protein deficit in this population and to help guide future preventive and nutritional treatment approaches in individuals with hEDS/HSD.

Pre-hospital caloric deficits in surgical patients.

The timing, route, and amount of nutrition for surgical patients with substantial caloric deficits remain active areas of study. Current guidelines are based on in-hospital days NPO after admission to the hospital. This historic process neglects the multiple days of caloric deficit patients experience prior to hospital admission. To determine the impact of pre-hospital caloric deficit (PHCD) for surgical patients on their outcomes. 313 patients admitted with a diagnosis of small bowel obstruction, pancreatitis, or diverticulitis were analyzed for their PHCD's. PHCD's were estimated using patient-reported days with significant emesis, and absent oral intake. Patients with PHCD's were compared to patients with no PHCD for length of stay, status on discharge, disposition, and 30-day readmission rate. There were 313 patients and 42% of the patients were male. The median age was 65 years. Median number of days sick prior to hospital admission was 1 (IQR: 1 to 2). Median PHCD was 1882 kcal (IQR: 1355 to 3650). Median number of days NPO while in-hospital was 3 (IQR: 2 to 5). Median in-hospital caloric deficit was 4268 kcal (IQR: 2825 to 6610). No significant association was observed between discharge disposition, complication rate, ambulatory status, 30-day readmission rate and PHCD. In-hospital caloric deficit was associated with complications after surgery (p < 0.0001). Small PHCD's in patients with SBO's, pancreatitis, or diverticulitis do not negatively affect their outcomes. Further research of patients with large PHCD's is needed to best treat surgical patients at risk for malnutrition.

P-576 Spontaneous pregnancy rates after the weight loss program in infertile PCOS women with obesity

Abstract Study question What is the spontaneous pregnancy rate in infertile polycystic ovary syndrome (PCOS) women with obesity after the weight loss program in womoen who achieve ≥ 5% BMI reduction? Summary answer Spontaneous pregnancy rate in infertile PCOS women is 29.4 % after the end of the weight loss program and reduction of BMI for ≥ 5%. What is known already PCOS affects 6 to 15% of reproductive age women and is the most common cause of anovulatory infertility. Twenty-five to 75 % of women with PCOS are overweight (BMI &amp;gt;25 kg/m2) or obese (BMI &amp;gt;30 kg/m2). Obesity aggravates symptoms of PCOS. Women with obesity and women with PCOS have lower spontaneous and IVF pregnancy rates. Pregnant women with PCOS and obesity have higher incidence of pregnancy-associated complications. Weight reduction of even 5% improves metabolic and hormonal profile as well as reproductive functions and weight reduction through lifestyle modification is the treatment of choice for overweight and obese women with PCOS. Study design, size, duration Twenty-seven infertile PCOS women with BMI &amp;gt;30 kg/m2 were prospectively included to the study. They attended a weight loss program prior to inclusion to IVF procedures. The program lasted for 8-12 consecutive weeks. Participants/materials, setting, methods Twenty-seven infertile women, aged less than 38 years, with PCOS and obesity were prospectively included to the weight loss program. The program consisted of lifestyle modifications (diet with daily caloric deficit) and physical exercise. Group trainings were held twice a week and were designed as circuit interval trainings. Individual aerobic activity (walking, brisk walking, cycling, walking up the hill) were also performed twice a week. Main results and the role of chance All women completed the prescribed weight loss program. Mean body weight before the program (106.43 kg ± 15.09 kg) was significantly (p &amp;lt; 0.001) higher than after the program (100.63 kg ± 14.67 kg). Mean BMI prior to the start was 37.65 ± 5.1 kg/m2 and after the end of the program 35.68 ± 4.9 kg/m2. The difference was statistically significant (p &amp;lt; 0.001). Of 27 included women, 17 (62.9 %) achieved the desirable BMI reduction of ≥ 5%. Of women who reduced their BMI by ≥ 5%, 5 (29.4 %) conceived spontaneously in three months after the end of the weight loss program. All other were included to IVF procedures. Besides weight loss, significantly more women reported on having healthier eating habits, started to exercise regularly, and improved their sleep after the end of the weight loss program. Limitations, reasons for caution The limitation of the present study is a relatively small sample size. Wider implications of the findings Weight loss represents an important approach towards treatment of obese infertile PCOS women prior to inclusion to IVF procedures. Almost 30 % of women who achieved the desirable BMI reduction conceived spontaneously. They were therefore spared of IVF procedures which has a beneficial health, psychological as well as financial impact. Trial registration number NCT04989244

Local Drd1-neurons input to subgroups of arcuate AgRP/NPY-neurons

SummaryObesity is a pandemic afflicting more than 300 million people worldwide, driven by consumption of calorically dense and highly rewarding foods. Dopamine (DA) signaling has been implicated in neural responses to highly palatable nutrients, but the exact mechanisms through which DA modulates homeostatic feeding circuits remains unknown. A subpopulation of arcuate (ARC) agouti-related peptide (AgRP)/neuropeptide Y (NPY) (ARCAgRP/NPY+) neurons express the D(1A) dopamine receptor (Drd1) and are stimulated by DA, suggesting one potential avenue for dopaminergic regulation of food intake. Using patch clamp electrophysiology, we evaluated the responses of ARC Drd1-expressing (ARCDrd1+) neurons to overnight fasting and leptin. Collectively, ARCDrd1+ neurons were less responsive to caloric deficit than ARCAgRP/NPY+ neurons; however, ARCDrd1+ neurons were inhibited by the satiety hormone leptin. Using Channelrhodopsin-2-Assisted Circuit Mapping, we identified novel subgroups of ARCDrd1+ neurons that inhibit or excite ARCAgRP/NPY+ neurons. These findings suggest dopamine receptive neurons have multimodal actions in food intake circuits.

Improving nutrition practices for postoperative high-risk heart transplant and ventricular assist device implant patients in circulatory compromise: A quality improvement pre- and post-protocol intervention outcome study.

Patients undergoing heart transplant (HT) and ventricular assist device (VAD) implant may experience intra- and postoperative complications requiring high-dose vasopressor agents and/or mechanical circulatory support. These complications increase the risk of nonocclusive bowel ischemia (NOBI) and inadequate enteral nutrition (EN) delivery, and guidance for this high-risk patient population is limited. To optimize nutrition support practices in this patient population at our institution, we created the High-Risk Nutrition Support Protocol (HRNSP) to improve nutrient delivery and promote safer EN practices in the setting of NOBI risk factors after HT and VAD implant. We developed and implemented a nutrition support protocol as a quality improvement (QI) initiative. Data were obtained before (n = 62) and after (n = 52) protocol initiation. We compared nutrition and clinical outcomes between the pre- and post-intervention groups. Fewer calorie deficits (P < 0.001), fewer protein deficits (P < 0.001), a greater proportion of calorie/protein needs met (P < 0.001), zero NOBI cases (0%), and decreased intensive care unit (ICU) length of stay (LOS) (P = 0.005) were observed with 100% (n = 52 of 54) HRNSP implementation success. Increased use of parenteral nutrition did not increase central line-associated bloodstream infections (P = 0.46). There was no difference in hospital LOS (P = 0.44) or 90-day and 1-year mortality (P = 0.56, P = 0.35). This single-center, QI pre- and post-protocol intervention outcome study suggests that implementing and adhering to a nutrition support protocol for VAD implant/HT patients with hemodynamic complications increases nutrient delivery and is associated with reduced ICU LOS and NOBI.

Effects of Nigella sativa supplementation on blood concentration and mRNA expression of TNF-α, PPAR-γ and adiponectin, as major adipogenesis-related markers, in obese and overweight women: a crossover, randomised-controlled trial.

Adipocyte expansion through adipogenesis can offset the adverse metabolic effects of obesity. Nigella sativa (NS) (black seed) oil is shown to have therapeutic features in the management of obesity. NS oil might have beneficial changes in obese populations through mediating serum levels of adipogenesis-related parameters and relative transcriptional gene-diet interactions (nutrigenomics), though no previous studies assessed this mechanism in overweight/obese participants. This study assessed the effects of NS oil supplements on blood concentration and mRNA expression levels of TNF-α, PPAR-γ and serum adiponectin and expression of AdipoR1, as major adipogenesis and obesity-related parameters, in overweight/obese women using a cross-over design. Eligible women were randomised to receive either NS oil supplements (2000 mg/d) or placebo. Two periods of interventions (8 weeks in each) were cross-changed by a 4-week washout period. An individualised diet plan without calorie deficits was given to participants to match their energy/macronutrient intakes. The Pkcross procedure and intention-to-treat analysis were performed using Stata. Cohen's d(d) was estimated to measure the magnitude of the effects. Forty-six participants were included. NS oil capsules reduced transcription levels ((d = -2·31), P < 0·001) and blood concentrations of TNF-α ((d = -0·29), P < 0·001). AdipoR1 expression (d = 2·24, P < 0·001) and serum adiponectin (d = 0·88, P < 0·001) showed a significant augmentation with a medium-high effect size, as did gene expression (d = 0·69, P < 0·001) and serum levels of PPAR-γ (d = 0·97, P < 0·001). There was a moderate but significant decrease in body weight (d = 0·6, P < 0·001). The present beneficial findings would provide strong information for future nutrigenomics/clinical trial studies assessing the role of NS in the management of obesity and other comorbidities.

Without refeeding days, drastically reducing calories in the pre-competition phase may does not guarantee a better reduction in bodybuilder's body fat percentage

Background & AimsThe caloric restrictions are necessary during the bodybuilder athlete preparation, especially when approaching the pre-contest phase. Although the refeed strategies for bodybuilders are current recent in the scientific literature, drastically reducing calories in the pre-competition phase linearly without periodization may does not guarantee a greater reduction in body fat and still being able harm the athlete's physical on-stage readiness.MethodsTwo cross-sectional studies (n = 42) and three case studies (n = 3) recent involved bodybuilder athletes aged between 21 and 32 years old who had 14–32 weeks, time involved the preparation phase and the pre-contest phase, to prepare himself and did not contain any refeeding strategy in their dietary protocol prescribed at work. These articles followed participants diets regarding the number of calories and macronutrients, where data collected were separated by the author himself and recorded in Excel spreadsheets for be mathematically calculated and subjectively evaluated.ResultsOf the five studies that were read and organized it's noted apparently that a greater caloric deficit does not influence a greater substantial loss of fat percentage or body weight neither looks to show any numerical visual relationship with maintenance of fat-free mass.ConclusionsObservationally, a severe caloric deficit without refeed strategies applied in pre-contest phase may not guarantee a greater the weight loss neither a greater reduction in the body fat percentage. The caloric restrictions are necessary during the bodybuilder athlete preparation, especially when approaching the pre-contest phase. Although the refeed strategies for bodybuilders are current recent in the scientific literature, drastically reducing calories in the pre-competition phase linearly without periodization may does not guarantee a greater reduction in body fat and still being able harm the athlete's physical on-stage readiness. Two cross-sectional studies (n = 42) and three case studies (n = 3) recent involved bodybuilder athletes aged between 21 and 32 years old who had 14–32 weeks, time involved the preparation phase and the pre-contest phase, to prepare himself and did not contain any refeeding strategy in their dietary protocol prescribed at work. These articles followed participants diets regarding the number of calories and macronutrients, where data collected were separated by the author himself and recorded in Excel spreadsheets for be mathematically calculated and subjectively evaluated. Of the five studies that were read and organized it's noted apparently that a greater caloric deficit does not influence a greater substantial loss of fat percentage or body weight neither looks to show any numerical visual relationship with maintenance of fat-free mass. Observationally, a severe caloric deficit without refeed strategies applied in pre-contest phase may not guarantee a greater the weight loss neither a greater reduction in the body fat percentage.

Beyond the Calorie Paradigm: Taking into Account in Practice the Balance of Fat and Carbohydrate Oxidation during Exercise?

Recent literature shows that exercise is not simply a way to generate a calorie deficit as an add-on to restrictive diets but exerts powerful additional biological effects via its impact on mitochondrial function, the release of chemical messengers induced by muscular activity, and its ability to reverse epigenetic alterations. This review aims to summarize the current literature dealing with the hypothesis that some of these effects of exercise unexplained by an energy deficit are related to the balance of substrates used as fuel by the exercising muscle. This balance of substrates can be measured with reliable techniques, which provide information about metabolic disturbances associated with sedentarity and obesity, as well as adaptations of fuel metabolism in trained individuals. The exercise intensity that elicits maximal oxidation of lipids, termed LIPOXmax, FATOXmax, or FATmax, provides a marker of the mitochondrial ability to oxidize fatty acids and predicts how much fat will be oxidized over 45–60 min of low- to moderate-intensity training performed at the corresponding intensity. LIPOXmax is a reproducible parameter that can be modified by many physiological and lifestyle influences (exercise, diet, gender, age, hormones such as catecholamines, and the growth hormone-Insulin-like growth factor I axis). Individuals told to select an exercise intensity to maintain for 45 min or more spontaneously select a level close to this intensity. There is increasing evidence that training targeted at this level is efficient for reducing fat mass, sparing muscle mass, increasing the ability to oxidize lipids during exercise, lowering blood pressure and low-grade inflammation, improving insulin secretion and insulin sensitivity, reducing blood glucose and HbA1c in type 2 diabetes, and decreasing the circulating cholesterol level. Training protocols based on this concept are easy to implement and accept in very sedentary patients and have shown an unexpected efficacy over the long term. They also represent a useful add-on to bariatric surgery in order to maintain and improve its weight-lowering effect. Additional studies are required to confirm and more precisely analyze the determinants of LIPOXmax and the long-term effects of training at this level on body composition, metabolism, and health.

716 Safety and benefits of intraoperative enteral nutrition in critically ill pediatric burn patients

IntroductionBurn injuries significantly increase a patient’s metabolic demand. Adequate nutrition is essential to aid in recovery and reduce morbidity and mortality. This is important for pediatric patients, who have limited reserves and are in a period of growth, in contrast to adults. Burn patients often need multiple surgeries, with standard perioperative fasting periods leading to multiple nutritional interruptions. Continuous intraoperative feeding has been a proposed solution, but there is no current consensus on its role and safety, particularly in the pediatric population. The goal of our study was therefore to examine the safety and benefits of intraoperative nutrition in critically ill pediatric burn injury patients.MethodsA systematic review of MEDLINE, PubMed, Scopus, and Google Scholar was conducted using the following terms: Feeding or enteral or nutrition or fasting and adolescent or youth or pediatric or child or teen and burn or thermal injury or fire. The primary outcome was incidence of aspiration. Secondary outcomes included patient nutritional status (caloric deficit, weight), wound healing, days spent in the intensive care unit, ventilator days, pneumonia, number of surgeries, length of hospital stay, and mortality. Pooled analyses of binary outcomes were computed.ResultsFour studies consisting of 496 patients, met inclusion criteria. All studies were level IV evidence, but had high methodological quality. The median burn total body surface area (TBSA) was 43.8% (IQR 33.4-58.8%), with a median of one-third of patients having an inhalational injury. Patients underwent a median of 4.2 surgeries (IQR 1.8-7.4). Intraoperative feeding was conducted through nasoduodenal tubes. There were no aspiration events. Pooled analysis demonstrated that there were no differences in rates of aspiration, pneumonia, or wound infection (p >0.05) between patients who were intraoperatively fed and those who were not. Those fed intraoperatively had significantly more surgeries, ventilator days, longer hospital stays, but lower mortality (p< 0.05). There was large heterogeneity in nutritional assessment methods. Intraoperatively fed patients had an average gain of 144.4 kcal/kg and 1.7 days of exclusive enteral nutrition (vs. loss of -119.1 kcal/kg and -1.4 days) and cumulative positive caloric balance of +2673kcal ±2147 (vs. loss of -7899kcal ±3123), compared to those with interrupted feeding.ConclusionsContinuous intraoperative duodenal feeding during burn surgery appears to be safe in the Pediatric burn population, with no reported episodes of aspiration. Uninterrupted feeding was also associated with weight maintenance and reduced caloric deficit. It may also have survival benefit, as continuously fed patients needed more surgeries and intensive/hospital care, but had decreased mortality.

714 Safety and Efficacy of Enteral Nutrition During Burn Surgery: A Retrospective Chart Review

IntroductionBurn injuries are life-threatening conditions consisting of elevated oxidative stress, severe inflammation, and an increased hypermetabolic and catabolic state. It is recommended to start enteral nutrition (EN) early in the burn injured patients. These patients undergo many operations, and with stopping of EN the intermittent caloric deficit multiplies. This leads to increased risk of negative outcomes. We sought to analyze the efficacy of continuing EN feedings during burn surgeries to maximize caloric intake while also evaluating for adverse outcomes such as pneumonia.MethodsA retrospective chart review of intraoperative feeding and pneumonia rates in pediatric and adult burn patients admitted during 2011-2017 to a regional burn center was conducted. Inclusion criteria included patients with secured airway via endotracheal tube or tracheostomy, mechanical ventilation for at least four days, and those who received EN during operations. The 2017 National Burn Repository (NBR) was used as the control population with mechanical ventilation ≥4 days and a yes/no pneumonia diagnosis. Our assumption was that these patients likely did not receive intraoperative EN as this is not standard protocol at this time.Results67 patients from our center and 779 NBR patients met inclusion criterion. EN were provided in 49-79% of total operations in the study group. The study group had a longer length of stay (LOS: 62 ± 34.4 vs 41 Days ± 31.7; p< 0.0001), Ventilator days (39 ± 28.9 vs 23 ± 43.9; p< 0.0001) and total body surface area burn percentage (TBSA: 36 ± 21 vs 31 ± 23 p-0.029).The relationship between pneumonia, inhalation injury, COPD, diabetes, and current smoking status was examined in the case population. The odds of a patient with inhalation injury developing pneumonia was 2.83 times greater than a patient without an inhalation injury. There was a higher pneumonia rate in the study group compared to control population (56.7% vs 18.9%; p< 0.0001). However based on a multinomial logistics regression analysis, there was no statistically significant association between intraoperative feeding and pneumonia in the study group (p-0.597).ConclusionsWe found a significant difference in the occurrence of pneumonia in our patient group compared to the NBR population, but our patients had higher LOS, ventilator days and TBSA burns. This suggest that our study group may have had higher acuity increasing risk of pneumonia. Our pneumonia rates do correspond with the rates reported from other comparable populations of burn patients. Despite this we did not find and association suggesting intraoperative feedings as the cause.