RESUMO
BACKGROUND: Asthma and obesity are public health problems with increasing prevalence worldwide. Clinical and epidemiologic studies have demonstrated that obese asthmatics have worse clinical control and health related quality of life (HRQL) despite an optimized medical treatment. Bariatric surgery is successful to weight-loss and improves asthma control; however, the benefits of nonsurgical interventions remain unknown. METHODS/DESIGN: This is a randomized controlled trial with 2-arms parallel. Fifty-five moderate or severe asthmatics with grade II obesity (BMI ≥ 35 kg/m(2)) under optimized medication will be randomly assigned into either weight-loss program + sham (WL + S group) or weight-loss program + exercise (WL + E group). The weight loss program will be the same for both groups including nutrition and psychological therapies (every 15 days, total of 6 sessions, 60 min each). Exercise program will include aerobic and resistance muscle training while sham treatment will include a breathing and stretching program (both programs twice a week, 3 months, 60 min each session). The primary outcome variable will be asthma clinical control. Secondary outcomes include HRQL, levels of depression and anxiety, lung function, daily life physical activity, body composition, maximal aerobic capacity, strength muscle and sleep disorders. Potential mechanism (changes in lung mechanical and airway/systemic inflammation) will also be examined to explain the benefits in both groups. DISCUSSION: This study will bring a significant contribution to the literature evaluating the effects of exercise conditioning in a weight loss intervention in obese asthmatics as well as will evaluate possible involved mechanisms. TRIAL REGISTRATION: NCT02188940.
Assuntos
Asma/fisiopatologia , Terapia por Exercício/métodos , Obesidade/terapia , Qualidade de Vida , Programas de Redução de Peso/métodos , Acelerometria , Ansiedade/psicologia , Asma/complicações , Asma/psicologia , Terapia Comportamental , Composição Corporal , Testes Respiratórios , Depressão/psicologia , Teste de Esforço , Tolerância ao Exercício , Humanos , Atividade Motora , Força Muscular , Óxido Nítrico/análise , Obesidade/complicações , Obesidade/psicologia , Qualidade de Vida/psicologia , Treinamento Resistido/métodos , Índice de Gravidade de Doença , Transtornos do Sono-Vigília , Espirometria , Resultado do TratamentoRESUMO
Utilizando análise nutricional minuciosa, avaliamos a ingestlo calórica, a proporçäo de nutrientes e o consumo de calorias, colesterol e fibras em 282 pacientes obesos do Ambulatório de Obesidade do Hospital das Clínicas da Faculdade Medicina da Universidade de Säo Paulo. Foi observado um elevado consumo de lípides e proteínas e uma proporçäo baixa no consumo de hidratos de carbono nesta populaçäo, de acordo com os critérios RDA. Observamos também baixo consumo de cálcio e fibras e alta ingestäo de colesterol.(au)
