Impact of Routine and Long-Term Follow-Up on Weight Loss after Bariatric Surgery.

BACKGROUND: Weight loss after bariatric surgery varies among patients. Patients who do not complete long-term follow-up are considered to loose less weight than those with regular follow-up visits. OBJECTIVE: To evaluate the influence of patients' follow-up compliance on long-term excess weight loss (%EWL) and total weight loss (%TWL) after bariatric surgery, comparing results between gastric bypass (GB) and sleeve gastrectomy (SG). METHODS: Patients with up to 5 years of follow-up data after bariatric surgery were included in this retrospective analysis. Patients were divided in 2 groups: those in group 1 who had attended every scheduled postoperative appointment and those in group 2 who had been lost to follow-up before 1 year and were later contacted by telephone. %EWL and %TWL were compared to determine the possible relationship between type of surgery and regularity of the follow-up. RESULTS: A total of 385 patients were included. A significant difference in EWL was observed at 5 years in the SG group (78% for group 1 versus 39% for group 2; p = 0.02) and GB group (75% for group 1 versus 62% for group 2; p = 0.01). No significant differences between surgeries were found when comparing long-term EWL in group 1 patients 77% for SG versus 75% for GB. For group 2 patients, GB achieved greater EWL than SG; p = 0.005. %TWL patients in group 2 showed significant differences in all periods of study (p < 0.05). CONCLUSION: Bariatric surgery patients who attended all scheduled follow-up appointments experienced significantly greater long-term EWL and TWL than those who did not. GB has apparent increased benefits for weight loss in long-term follow-up when compared with SG for patients who did not attend long-term follow-up. Therefore, continued long-term follow-up of bariatric patients should be encouraged to increase postoperative weight loss results.

Role of ghrelin isoforms in the mitigation of hepatic inflammation, mitochondrial dysfunction, and endoplasmic reticulum stress after bariatric surgery in rats.

BACKGROUND/OBJECTIVES: Bariatric surgery improves nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), but the underlying mechanisms remain elusive. We evaluated the potential role of ghrelin isoforms in the amelioration of hepatic inflammation after sleeve gastrectomy and Roux-en-Y gastric bypass (RYGB). SUBJECTS/METHODS: Plasma ghrelin isoforms were measured in male Wistar rats (n = 129) subjected to surgical (sham operation, sleeve gastrectomy, or RYGB) or dietary interventions [fed ad libitum a normal (ND) or a high-fat diet (HFD) or pair-fed diet]. The effect of acylated and desacyl ghrelin on markers of inflammation, mitochondrial dysfunction, and endoplasmic reticulum (ER) stress in primary rat hepatocytes under palmitate-induced lipotoxic conditions was assessed. RESULTS: Plasma desacyl ghrelin was decreased after sleeve gastrectomy and RYGB, whereas the acylated/desacyl ghrelin ratio was augmented. Both surgeries diminished obesity-associated hepatic steatosis, CD68+- and apoptotic cells, proinflammatory JNK activation, and Crp, Tnf, and Il6 transcripts. Moreover, a postsurgical amelioration in the mitochondrial DNA content, oxidative phosphorylation (OXPHOS) complexes I and II, and ER stress markers was observed. Specifically, following bariatric surgery GRP78, spliced XBP-1, ATF4, and CHOP levels were reduced, as were phosphorylated eIF2α. Interestingly, acylated and desacyl ghrelin inhibited steatosis and inflammation of palmitate-treated hepatocytes in parallel to an upregulation of OXPHOS complexes II, III, and V, and a downregulation of ER stress transducers IRE1α, PERK, ATF6, their downstream effectors, ATF4 and CHOP, as well as chaperone GRP78. CONCLUSIONS: Our data suggest that the increased relative acylated ghrelin levels after bariatric surgery might contribute to mitigate obesity-associated hepatic inflammation, mitochondrial dysfunction, and ER stress.

Monitoring the effects of training load changes on stress and recovery in swimmers.

This study was designed to investigate if monitoring of stress and recovery may be useful to detect overreaching in its early stages and may be used to evaluate effects of changes in training load. Nine swimmers were applied the Recovery-Stress Questionnaire for Athletes (RESTQ-Sport) in four different occasions (M1, M2, M3, M4) along a 6-week training period prior to a competition. During the basal training period (M1), recovery scales scored higher than stress scales, being the scales General well-being, Social recovery and Being in shape those reaching higher scores. Following the measure corresponding to the second training period (M2), in which training volume reached a maximum, there were significant increases in two stress scales (Injury and Emotional exhaustion), and decreases in three recovery scales (Success, Physical recovery, and Self-efficacy). Values increased again and did not significantly differ from those corresponding to the first measure during measures M3 and M4, in which there was a decrease in training volume and training time. Only a recovery scale score (Success) increased significantly from period M2 to period M4. When the recovery-stress (total recovery - total stress) state was calculated, it was found that there was a significant decreases in M2, and values progressively increased in measures M3 and M4, with no significant difference from M1. Results obtained indicate that the RESTQ-Sport is able to show significant changes concurrently with training loads. Regular monitoring of stress and recovery by these measures may help to detect overreaching in its early stages.

Monitoring the effects of training load changes on stress and recovery in swimmers

This study was designed to investigate if monitoring of stress and recovery maybe useful to detect overreaching in its early stages and may be used to evaluate effectsof changes in training load. Nine swimmers were applied the Recovery-Stress Questionnairefor Athletes (RESTQ-Sport) in four different occasions (M1, M2, M3, M4)along a 6-week training period prior to a competition. During the basal training period(M1), recovery scales scored higher than stress scales, being the scales Generalwell-being, Social recovery and Being in shape those reaching higher scores. Followingthe measure corresponding to the second training period (M2), in which trainingvolume reached a maximum, there were significant increases in two stress scales(Injury and Emotional exhaustion), and decreases in three recovery scales (Success,Physical recovery, and Self-efficacy). Values increased again and did not significantlydiffer from those corresponding to the first measure during measures M3 and M4, inwhich there was a decrease in training volume and training time. Only a recoveryscale score (Success) increased significantly from period M2 to period M4. When therecovery-stress (total recovery – total stress) state was calculated, it was found thatthere was a significant decreases in M2, and values progressively increased in measuresM3 and M4, with no significant difference from M1. Results obtained indicatethat the RESTQ-Sport is able to show significant changes concurrently with trainingloads. Regular monitoring of stress and recovery by these measures may help todetect overreaching in its early stages (AU)

No disponible

The relationship between sources of motivation and level of practice in young Portuguese swimmers.

AIM: The aim of this study was to examine the relationship between participation motives and level of practice in young Portuguese swimmers and to investigate whether swimmers with a different expertise differ in their reasons for participation involvement. METHODS: A total of 155 subjects (68 male and 87 female), aged 7 to 18 years, responded to the Portuguese versions of the Participation Motivation Inventory. The subjects were divided into those participating in learn-to swim programs (n=40), advanced programs (n=49) or competition (n=56). RESULTS: A significant multivariate effect was obtained for level of practice, with children involved in learn-to swim programs rating fitness, competition, general affiliation, technical skills and fun significantly lower in importance than the other two groups. A 2 (subject gender) x3 (practice level) MANCOVA, with age at dropout, revealed that the effect of the covariate itself was not significant, but a main effect was found for gender, differing boys and girls only in the emotion factor. A significant interaction was also detected between gender and participation level, with a higher importance given to general affiliation by girls in comparison to boys in the advanced programs and competition categories. CONCLUSION: Our results in a sample of Portuguese swimmers indicate the existence of multiple motives for participation and significant differences in motivational factors in relation to the practice level.

Relationship between perceived physical ability and sport participation motives in young competitive swimmers.

AIM: The purpose of this study was to examine the relationship between participation motives and perceived physical ability in young Spanish swimmers and to investigate whether swimmers with high or low perceived physical competence differ in their intrinsic and/or extrinsic reasons for participation involvement. METHODS: Four hundred and twenty-eight swimmers (204 boys and 224 girls), aged 8-22 years, responded to the Spanish versions of the Participation Motivation Inventory (PMI) and the Perceived Physical Ability Scale (PPA). Swimmers were divided into low (below the 33%), medium (between the 33-66%) and high (above the 66%) perceived ability groups. RESULTS: Multivariate analysis indicated the existence of differences in motives for participation between swimmers with different levels of perceived physical ability. Follow-up univariate analyses yielded significant (p<0.05) effects for 5 motivational factors: health/fitness, fun/friendship, competition/skills, affiliation and status. In all cases swimmers high in perceived physical ability rated significantly higher than those in the other categories. The PPA by gender, age or level of expertise interaction was not significant. CONCLUSIONS: Practitioners must consider the perceived ability of the competitors to better structure the social environment within which their swimmers operate.

Identification of dropout reasons in young competitive swimmers.

AIM: The purpose of this study was to examine reasons for discontinuing sport participation in Spanish competitive swimmers. METHODS: Sixty-two swimming dropouts (40 males and 22 females, ranging in age from 14 to 30 years) were administered the Questionnaire of Reasons for Attrition of Gould et al. RESULTS: The results of the survey indicated that having other things to do was the most important reason for attrition. Other items rated important were related to lack of fun, perception of failure or low skill, while low ratings were given to items related to achievement/status or affiliation. A significant multivariate effect was obtained for gender and for experience at dropout. Analysis of individual items by "t"-test demonstrated that females placed greater emphasis than males on excessive pressure, hard training, dislike of competition, not winning enough and not feeling important enough. Former swimmers with less experience at dropout rated interest in another sport as more important and being too old as less important than swimmers with more experience. CONCLUSION: The results of this study support the importance of negative factors related with aspects of the athletic environment that lead to discontinuing in competitive swimming.

Relationship of measures of leisure time physical activity to physical fitness indicators in Spanish adults.

BACKGROUND: The purpose of our study was to examine the association between estimates of energy expenditure obtained by the Minnesota Leisure Time Physical Activity questionnarie (LTPA) and physical fitness indicators. METHODS. PARTICIPANTS: An adaptation of the LTPA was assessed in a sample of Spanish population: male (n = 44) and female (n = 38). INTERVENTIONS: the LTPA 1 year recall questionnaire was administered twice with a 12-month interval and participants also responded monthly the Four Week Physical Activity History (FWH) questionnaire. MEASURES: test-retest reliability of the LTPA and the relationships between changes in V.O2max, percent body fat and leisure time physical activity were examined. RESULTS: Corresponding components of the LTPA and the FHW were highly correlated and scores in heavy leisure time activities and household chores showed a relatively low variance ratio, indicating an acceptable reliability of the questionnaire. Heavy intensity physical activity and household chores were highly related to V.O2max and there was a weaker association to moderate or light activity. CONCLUSIONS: Our results suggest that the Spanish version of the LTPA is a relatively valid and reliable measure of regular physical activity and a valid estimator of cardiorespiratory fitness in adults.