1,720,994 research outputs found

    Type 1 diabetes and body composition in youth: A systematic review

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    An increasing prevalence of overweight and obesity was reported in youth with type 1 diabetes, likely due to the intensive insulin treatment and/or an unhealthy lifestyle. Analyses of body composition may help describe the real increase in fat mass, which contributes to the diabetes-related cardio-metabolic risk. This systematic review evaluated the current literature on body composition assessments in youth with type 1 diabetes and the potential association with cardio-metabolic, functional, or behavioural risk factors. A systematic search of literature studies reporting assessments of body composition in youth with type 1 diabetes published until April 2018 was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Twenty-three articles with different study designs reported assessments of body composition. The following methods were used to assess body composition: computerized dual energy X-ray absorptiometry (n = 10), bioelectrical impedance analysis (n = 8), skinfold thickness measurement (n = 4), and air displacement plethysmography (n = 1). Higher fat mass values were found in youth with type 1 diabetes in seven of the 13 studies that included a healthy control group. Most studies investigating the association between body composition and cardio-metabolic risk factors showed that youth with higher fat mass levels had poor glycaemic control, dyslipidaemia, or higher blood pressure. Assessments of body composition may represent a useful clinical procedure to support decision-making in type 1 diabetes management. Further research is needed to standardize the assessment of body composition and develop a consensus guideline

    Very low-protein diet to postpone renal failure: Pathophysiology and clinical applications in chronic kidney disease

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    : The uremic syndrome is a metabolic disorder characterized by the impairment of renal handling of several solutes, the resulting accumulation of toxic products and the activation of some adaptive but detrimental mechanisms which all together contribute to the progression of renal damage. In moderate to advanced renal failure, the dietary manipulation of nutrients improves metabolic abnormalities and may contribute to delay the time of dialysis initiation. This commentary focuses on the physiopathological rationale and the clinical application of the very low-protein diet supplemented with ketoanalogs for the management of chronic kidney disease

    Physical activity and renal transplantation.

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    Renal transplantation is burdened by high cardiovascular risk because of increased prevalence of traditional and disease-specific cardiovascular risk factors and, consequently, patients are affected by greater morbidity and mortality. In renal transplanted patients, healthy lifestyle and physical activity are recommended to improve overall morbidity and cardiovascular outcomes. According to METs (Metabolic Equivalent Task; i.e. the amount of energy consumed while sitting at rest), physical activities are classified as sedentary (= 6.0 METs). Guidelines suggest for patients with chronic kidney disease an amount of physical activity of at least 30 minutes of moderate-intensity activity five times per week (min 450 MET-minutes/week). Data on physical activity in renal transplanted patients, however, are limited and have been mainly obtained by mean of non-objective methods. Available data suggest that physical activity is low either at the start or during renal transplantation and this may be associated with poor patient and graft outcomes. Therefore, in renal transplanted patients more data on physical activity obtained with objective, accelerometer-based methods are needed. In the meanwhile, physical activity have to be considered as an essential part of the medical care for renal transplanted recipient

    Physical activity and renal transplantation

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    Renal transplantation is burdened by high cardiovascular risk because of increased prevalence of traditional and disease-specific cardiovascular risk factors and, consequently, patients are affected by greater morbidity and mortality. In renal transplanted patients, healthy lifestyle and physical activity are recommended to improve overall morbidity and cardiovascular outcomes. According to METs (Metabolic Equivalent Task; i.e. the amount of energy consumed while sitting at rest), physical activities are classified as sedentary (< 3.0 METs), of moderate( 3.0 to 5.9 METs) or vigorous-intensity (>= 6.0 METs). Guidelines suggest for patients with chronic kidney disease an amount of physical activity of at least 30 minutes of moderate-intensity activity five times per week (min 450 MET-minutes/week). Data on physical activity in renal transplanted patients, however, are limited and have been mainly obtained by mean of non-objective methods. Available data suggest that physical activity is low either at the start or during renal transplantation and this may be associated with poor patient and graft outcomes. Therefore, in renal transplanted patients more data on physical activity obtained with objective, accelerometer-based methods are needed. In the meanwhile, physical activity have to be considered as an essential part of the medical care for renal transplanted recipients. Copyright (C) 2014 S. Karger AG, Base

    Going Beyond Counting First Authors in Author Co-citation Analysis

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    The present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed

    Exercise training in kidney transplant recipients: a systematic review

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    Background and aims: Evidences on the benefits of physical exercise in kidney transplant patients (KTx) are not conclusive and concerns on safety remain. We here gather and interpret current evidence on the benefits/harms of exercise training intervention in KTx. Methods: Systematic review of exercise training programs in KTx. Results: A total of 24 studies including 654 KTx patients on intervention and 536 controls were evaluated. The median age was 46 years; the transplant vintage was 2 days to 10 years. The intervention was an aerobic or resistance exercise program or a combination of both; interventions consisted of 20–60 min’ sessions, 2–3 times per week repetitions and 5.5 months’ median duration. Most studies improved cardiorespiratory fitness (expressed as VO2peak) as well as maximum heart rate, which was associated with a significant increase in muscle performances and strength. No significant changes in body weight or composition were observed, but a trend towards weight reduction in overweight or obese patients on stable KTx was noted. The arterial blood pressure reduced a little after exercise when it was high at start. Exercise intervention had no clinically relevant impact on anaemia, glycaemia or lipidaemia. In contrast, exercise training improved several aspects of quality of life. No data on long-term hard outcomes or on high-risk subpopulations such comorbid or elderly patients were available. Conclusions: In adult kidney transplant patients, a structured physical exercise program improved the aerobic capacity and ameliorated muscle performance and quality of life. No harms were observed in the short-term, but long-term RCTs are required. Overall, in mid-age kidney transplant patients without major comorbidities, an aerobic or resistance supervised exercise lasting 3–6 months could be suggested within the comprehensive treatment of kidney transplant

    Gym Members Show Lower Nutrition Knowledge than Youth Engaged in Competitive Sports

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    Objective: Adolescents may be vulnerable to misleading nutritional information and adopt unhealthy food habits. In addition, specific features related to physical training, either aimed to improve fitness or to comply with sport demands, may influence food habits of the youth. This cross-sectional study was aimed to compare nutrition knowledge, food habits and adherence to Mediterranean diet in youth engaged in fitness training, competitive sports or inactive. Methods: Three questionnaires, the General and Sport Nutrition Knowledge (GeSNK) questionnaire, a food habit questionnaire and the KIDMED were administered to gym members, athletes engaged in volleyball, long-distance swimming, and gymnastics, and inactive adolescents. Results: The total sample included 211 youth (age 16.8 ± 1.7 years). Gym members, like the inactive youth, had lower general and sport-related nutrition knowledge compared to athletes (p = 0.001). In the whole sample, general nutrition knowledge was positively associated with healthy food habits (p < 0.01) and adherence to the Mediterranean diet pattern (p < 0.02). Conclusions: Gym members had a level of nutrition knowledge lower than young athletes and similar to inactive youth. Healthy food habits were related with nutrition knowledge among adolescents. Specific nutritional education programs are needed to address food habits in fitness settings

    Adherence to Mediterranean diet in athletes: a narrative review

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    Athletes’ diet should be adequate both in quality and quantity, to avoid deficiencies and limit fatigue. In recent years, several nutritional recommendations have been published and a multitude of diets based on empirical approaches have been employed in the sport setting. In the last decades, the Mediterranean diet (MD) has been extensively studied for its beneficial effects on health but its adoption in athletes has never been critically analyzed. This review was aimed to assess the current literature about the athletes’ adherence to the MD pattern, also in comparison with the general population. The majority of the studies show that athletes reach a mean level of MD adherence, higher than that of the general population. However, the current evidence is still limited and based on studies using different methods. Further research is needed to better characterize this habit among athletes

    Variations on the Author

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    “Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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