The effects of COVID-19 quarantine on eating and sleeping behaviors.

Abstract: Since the beginning of the pandemic, the population has been exposed to a substantial period of social isolation, which leads to anxiety, fear, and metabolic and immune impairments. Purpose: Considering that sleep restriction influences eating behavior, we highlight that changes in it may occur during the COVID-19 quarantine. Alterations in feeding time can uncouple the body clocks, leading to circadian misalignment and consequently to a disruption in homeostasis and disturbances in many metabolic functions. Method: Narrative review. Results: Do not apply. Conclusion: The increase of body weight is related to increased food intake in response to mental stress and more time spent at home, increased opportunity to feed, and increased visual and olfactory stimulation to eat, which represents a potential risk of overfeeding nowadays. In this article, we postulate that the unusual lifestyle imposed by the COVID-19 quarantine may induce a circadian misalignment, which is capable to induce alterations on eating and sleep behaviors.

A new clinical perspective: Treating obesity with nutritional coaching versus energy-restricted diets.

Although current guidelines for obesity treatment endorse lifestyle modifications to achieve weight loss, energy-restricted diets are still the most commonly used method for the management of overweight. Diet restriction, however, not only is ineffective in promoting long-term weight loss but also may have more costs than benefits, predisposing the individual to fat regain. Several physiological and psychological mechanisms protect the body against starvation and explain how food restriction can promote paradoxically the opposite of what it is planned to achieve, triggering changes in energy metabolism, endocrine function and, thus, body composition. New approaches that focus on behavioral treatment without diet restriction, such as nutritional coaching, are showing strong growth that arises as an innovative way to create sustainable and effective lifestyle changes.

Técnicas de coaching de bem-estar na mudança do estilo de vida no sistema público de saúde / Lifestyle change coaching techniques in the Public Health System

De acordo com o último relatório da Vigitel 2017 as Doenças Crônicas Não Transmissíveis (DCNT) são responsáveis por 68% de um total de 38 milhões de mortes ocorridas no mundo em 2012. No Brasil, esse cenário não é diferente: em 2011 as DCNT foram responsáveis por 68,3% do total de mortes. Milhares de dólares são gastos hoje com políticas que estimulam hábitos de vida mais saudável, mas essa estratégia, por si só, tem continuamente falhado em produzir resultados consistentes e duradouros. É necessário uma nova abordagem, que promova mudanças no estilo de vida, possibilitando a melhora dos parâmetros de saúde das pessoas. O processo de coaching apoia o desenvolvimento de um relacionamento de ajuda, incentivando o paciente a identificar sua visão, necessidades e objetivos. Além disso, o coaching visa ajudar na organização de rotinas e prioridades, enquanto coloca o paciente no controle de seu destino de saúde.

According to the latest Vigitel 2017 report, non-communicable chronic diseases accounted for 68% of a total of 38 million deaths worldwide in 2012. In Brazil, the scenario is no different; in 2011 the non communicable diseases were responsible for 68.3% of all deaths. Thousands of dollars are spent today on policies that encourage healthier living habits, but this strategy, by itself, has continually failed to produce consistent and long-lasting results. A new approach is needed that promotes lifestyle changes, making it possible to improve people's health parameters. The process of coaching supports the development of a helporiented relationship, encouraging patients to identify their vision, needs and goals. In addition, coaching aims to assist in the organization of routines and priorities, while putting patients in control of their health endgoal.

Improving Nutritional Habits With No Diet Prescription: Details of a Nutritional Coaching Process.

Thousands of dollars are spent today with policies encouraging physical activity and healthy eating, but nutritional consultation per se has continuously failed to yield consistent and lasting results. The aim of this case report is to detail and evaluate nutritional coaching (employing health coaching techniques) in promoting lifestyle changes, enabling improvement of nutritional and body composition associated parameters. The patient in this study had previously engaged in a series of different diet regimens, all of which failed in achieving the proposed aim. After 12 nutritional coaching sessions (one per week) with the strategy presented herein, reductions in body fat mass and in total body weight were attained. Nutritional habits also improved, as the patient showed decreased total energy intake, decreased fat intake, and increased fiber ingestion. Daily physical activity and energy expenditure were enhanced. The coaching program was able to induce immediate health benefits using a strategy with the patient at the core of promoting his own lifestyle changes. In conclusion, the nutritional coaching strategy detailed was effective at helping our patient develop new eating patterns and improve related health parameters.

Detrimental effects for colonocytes of an increased exposure to luminal hydrogen sulfide: The adaptive response.

Protein fermentation by the gut microbiota releases in the large intestine lumen various amino-acid derived metabolites. Among them, hydrogen sulfide (H2S) in excess has been suspected to be detrimental for colonic epithelium energy metabolism and DNA integrity. The first objective of this study was to evaluate in rats the epithelial response to an increased exposure to H2S. Experiments from colonocyte incubation and intra-colonic instillation indicate that low millimolar concentrations of the sulfide donor NaHS reversibly inhibited colonocyte mitochondrial oxygen consumption and increased gene expression of hypoxia inducible factor 1α (Hif-1α) together with inflammation-related genes namely inducible nitric oxide synthase (iNos) and interleukin-6 (Il-6). Additionally, rat colonocyte H2S detoxification capacity was severely impaired in the presence of nitric oxide. Based on the γH2AX ICW technique, NaHS did not induce DNA damage in colonocytes. Since H2S is notably produced by the gut microbiota from sulfur containing amino acids, the second objective of the study was to investigate the effects of a high protein diet (HPD) on large intestine luminal sulfide content and on the expression of genes involved in H2S detoxification in colonocytes. We found that HPD markedly increased H2S content in the large intestine but the concomitant increase of the content mass maintained the luminal sulfide concentration. HPD also provoked an increase of sulfide quinone reductase (Sqr) gene expression in colonocytes, indicating an adaptive response to increased H2S bacterial production. In conclusion, low millimolar NaHS concentration severely affects colonocyte respiration in association with increased expression of genes associated with intestinal inflammation. Although HPD increases the sulfide content of the large intestine, the colonic adaptive responses to this modification limit the epithelial exposure to this deleterious bacterial metabolite.

Obesity: considerations about etiology, metabolism, and the use of experimental models.

Studies have been conducted in order to identify the main factors that contribute to the development of obesity. The role of genetics has also been extensively studied. However, the substantial augmentation of obesity prevalence in the last 20 years cannot be justified only by genetic alterations that, theoretically, would have occurred in such a short time. Thus, the difference in obesity prevalence in various population groups is also related to environmental factors, especially diet and the reduction of physical activity. These aspects, interacting or not with genetic factors, could explain the excess of body fat in large proportions worldwide. This article will focus on positive energy balance, high-fat diet, alteration in appetite control hormones, insulin resistance, amino acids metabolism, and the limitation of the experimental models to address this complex issue.

Body fat regulation: is it a result of a simple energy balance or a high fat intake?

The search for the causes of obesity has involved genetic abnormalities and endocrine and neural lesions. Although evidence suggests that genetics plays an important role in body weight regulation, rapid increases in obesity rates do not seem to be caused by significant genetic changes within populations. Total energy expenditure and total energy intake are not the only factors that regulate body fat. Nitrogen and carbohydrate balances are eased by the capacity of the organism for adjusting amino acids and glucose oxidation rates, respectively. Regarding fat, this mechanism is considerably less precise; a fat intake increase does not stimulate its oxidation on the same basis. In addition, dietary fat is stored very efficiently as body fat. Elevated carbohydrate ingestion enhances glycogen reserves, which usually are much smaller than the maximum capacity of storage and enlargement of these stores, thus stimulating this nutrient's oxidation. These data point to a very well controlled carbohydrate balance in the body. Various studies show lack of efficiency of the hyperlipidic diet in stimulating satiety. Signals arising from the gastrointestinal tract play a fundamental role in regulation of appetite and energy intake, and evidence indicates that the gastrointestinal and hormonal mechanisms involved in the suppression of appetite and in energy intake are compromised in obesity. A high-fat diet is important in its origin. Additional studies are necessary to explain the mechanisms that lead to adipose tissue retention resulting in a fat-rich diet.