Short-term effects of Roux-en-Y gastric bypass or gastric sleeve on bone mineral density and calciotropic hormones: a systematic review and meta-analysis.

Roux-en-Y gastric bypass (RYGB) and gastric sleeve (GS) have been associated with significant reductions in bone mineral density (BMD) and fluctuations in serum levels of calciotropic hormones. These changes pose a risk to bone health. The study assessed the short-term (12 and 24 months) effects of RYGB and GS on BMD and calciotropic hormones. PubMed, Embase, and Cochrane Library databases were searched. Analyses considered follow-up (12 and 24 months) with BMD as main outcome at three sites (femoral neck, total hip, and lumbar spine) and one for each calciotropic hormone (25 OH vitamin D and parathyroid hormone [PTH]). Estimated effect sizes were calculated as standardized mean differences (SMD), confidence interval of 95%, and P value. Nine studies totaling 473 participants (RYGB = 261 and GS = 212) were included. RYGB resulted in lower BMD than GS at 12 months for femoral neck (SMD = -0.485, 95% CI [-0.768, -0.202], P = .001), lumbar spine (SMD = -0.471, 95% CI [-0.851, -0.092], P = .015), and total hip (SMD = -0.616, 95% CI [-0.972, -0.259], P = .001), and at 24 months for total hip (SMD = -0.572, 95% CI [-0.907, -0.238], P = .001). At 24 months, 25 OH vitamin D was lower in RYGB than GS (SMD = -0.958 [-1.670, -0.245], P = .008) and PTH levels were higher in RYGB than in GS (SMD = 0.968 [0.132, 1.804, P = .023]). RYGB demonstrated significant reduction in regional BMD. It also induces lower serum 25 OH vitamin D and higher PTH levels than GS. The results support the need for preventive bone health measures in the short-term postoperative period, especially in the case of RYGB.

High-fat diet and fructose drink introduced after weaning rats, induces a better human obesity model than very high-fat diet.

In the present study, we associated a high-fat diet (HF group: 45% kcal from lipids) or very high-fat (VHF group: 60% kcal from lipids) diet with a fructose drink (10% fructose) for hydration. Normal rat chow that received the control diet (content 16.3% kcal from lipid-AIN93G) and water. The treatments were introduced soon after weaning and were administered for 70 days. We aimed to compare HF and VHF groups and find which acts as a better model mimicking human obesity. Body mass gain, final body weight, adipocyte area in inguinal depots, visceral and subcutaneous adipose depots, serum triacylglycerol, and VLDL-c were all higher in the HF group, followed by the VHF group, compared to the C group. Only the HF group showed hyperinsulinemia and hyperleptinemia and higher total caloric intake, Lee index, HOMA2-IR, and total cholesterol. Serum TNF-α and IL-6 levels were lower in the HF and VHF groups than in the C group at the end for 70 days. In Summary, the HF (45%) diet administered with fructose induced a higher similarity of metabolic and hormonal alterations associated with human obesity. PRACTICAL APPLICATIONS: High intake of lipids with sugary drinks has been associated with obesity and its comorbidities. Although a diet with 45% or 60% of lipids is considered hyperlipidic, they are different in their effects on eating behavior and also probably from a metabolic point of view. Common sense is that the reduction in intake of lipids is favorable to health. Our study shows that this is not wholly true, and this information contributes to the guidelines for the treatment of obesity. In addition, the scientific literature on the subject has shown the most diverse results and also the use of experimental models with few similarities with human obesity. Our findings can contribute as a good model of obesity initiated during childhood to investigate possible using nutritional strategies, or the adoption of ergogenic nutritional resources in future studies, for example.

Intermittent fasting compromises the performance of eutrophic rats submitted to resistance training.

OBJECTIVES: The aim of this study was to analyze the effects of intermittent fasting (IF) on the performance of rats subjected to resistance training ladder climbs (RTLCs). METHODS: Thirty-two Wistar rats (80-d-old) were placed into one of the following four groups (n = 8/group): control (C), which were fed a standard diet with no exercise; intermittent fasting (IF) rats underwent IF for 16 h/d, fed a standard diet for a period of 8 h/d with no exercise; trained control (TC) were fed a standard diet and submitted to RTLC; and trained intermittent fasting (TIF) underwent IF for 16 h/d, fed a standard diet for a period of 8 h/d, and submitted to RTLC. Training groups completed 6-wk of RTLC (3 × /wk). The maximal load test (MLT) was applied on two occasions: before the first RTLC session and at the end of week 6 of physical training. Its purpose was to compare changes in performance over time. Both blood collection and total extraction of the organs were performed at the end of the experimental period. RESULTS: Food intake was higher in the TC group than in either the IF or TIF groups. TC supported a higher load (g) during the final MLT compared with the C, IF, and TIF groups, respectively. TC (initial MLT: 371.4 ± 31.1; final MLT: 593.9 ± 33.5) and TIF (initial MLT: 402.3 ± 31.8; final MLT: 495.4 ± 83.3) presented higher values when the pre- and post-RTLC moments were compared. The relative weight of the stomach was higher in TIF than in C and TC rats. There was no difference in aspartate transaminase and alanine transaminase enzyme activities or in creatinine and total cholesterol levels. CONCLUSIONS: IF negatively affected RTLC performance. IF plus RTLC increased the relative weight of the stomach as well as reduced food intake, without an increase in body weight, suggesting this combination may have promoted dilation of this organ, due, hypothetically, to the scarcity of food for several hours and the energy expenditure generated by physical training.

High-Protein Diet Associated with Resistance Training Improves Performance and Decreases Adipose Index in Rats.

The study tested the hypothesis that a high protein diet based on isolated whey protein (IWP) associated with strength training improves performance and reduces body fat without promoting health damage. Male Wistar rats, 45 days old, were divided into four groups (n = 8/group): normoprotein sedentary (IWP 14%; NS); hyperprotein sedentary (IWP 35%; HS); normoprotein trained (IWP 14%; NT) and hyperprotein trained (IWP 35%; HT). All groups performed the maximum load test at the beginning and after the vertical ladder training protocol for 6 weeks (3x/week). The performance improved in HT when compared to other groups. There was no difference in the plasma levels of testosterone, IGF-1 and the hematological parameters remained normal. The relative weights of the kidneys were higher in the groups fed with high protein; the liver was higher in HT compared to NS and NT, and the heart was higher in HS compared to NS and NT. Concerning relative muscle weight, quadriceps, and gastrocnemius, HT showed higher value compared to NT. Diet containing 35% isolate whey protein associated with resistance training improved performance as well as increased muscles and organs weight of the animals, without damaging the tissues related to protein metabolism (confirmed by unchanged hematological parameters), which may minimize the risk of developing cardiometabolic disorders.

Effects of high-protein diet containing isolated whey protein in rats submitted to resistance training of aquatic jumps.

OBJECTIVES: Isolated whey protein (IWP) can decrease body fat compared with other protein sources. The present study verified the effects of high protein diet (HD) containing IWP on several parameters of rats subjected to resistance training (RT). METHODS: Thirty-two male Wistar rats (60 days of age) were separated into four groups (n = 8/group): sedentary normoproteic (IWP 14%; SN); sedentary hyperproteic (IWP 35%; SH); trained normoproteic (IWP 14%; TN), and trained hyperproteic (WPI 35%; TH). RESULTS: Relative tissue/organ weight (g): perirenal and retroperitoneal adipose tissues were lower in SH and TH compared with SN (no difference to TN); omental and subcutaneous adipose tissues were higher in SN compared with SH. Epididymal adipose tissue was higher in SN compared with other groups. Heart weight was higher in TH compared with TN and SN, but not SH; kidney and liver higher in TH and SH compared with SN and TN; gastrocnemius lower in SN compared with other groups; soleus higher in SH in relation to other groups. The triglycerides levels (mg/dL) was reduced in the TH groups compared with SH, TN, and SN. There were no changes both in the concentrations of adiponectin and leptin and in the protein expression of GLUT-4 and p70s6k. CONCLUSION: HD containing WPI improved body composition, increased the weight of the heart, kidneys, liver and gastrocnemius and soleus muscles; however, this diet maintained the normal histomorphology of muscle and liver and, when associated with RT, reduced the serum levels of triglycerides.

Effect of administration of high-protein diet in rats submitted to resistance training.

PURPOSE: Although there is limited evidence regarding the pathophysiological effects of a high-protein diet (HD), it is believed that this type of diet could overload the body and cause damage to the organs directly involved with protein metabolism and excretion. The aim of this study was to verify the effects of HD on biochemical and morphological parameters of rats that completed a resistance training protocol (RT; aquatic jump) for 8 weeks. METHODS: Thirty-two adult male Wistar rats were divided into four groups (n = 8 for each group): sedentary normal protein diet (SN-14%), sedentary high-protein diet (SH-35%), trained normal protein diet (TN-14%), and trained high-protein diet (TH-35%). Biochemical, tissue, and morphological measurements were made. RESULTS: Kidney (1.91 ± 0.34) and liver weights (12.88 ± 1.42) were higher in the SH. Soleus muscle weight was higher in the SH (0.22 ± 0.03) when compared to all groups. Blood glucose (123.2 ± 1.8), triglycerides (128.5 ± 44.0), and HDL cholesterol levels (65.7 ± 20.9) were also higher in the SH compared with the other experimental groups. Exercise reduced urea levels in the trained groups TN and TH (31.0 ± 4.1 and 36.8 ± 6.6), respectively. Creatinine levels were lower in TH and SH groups (0.68 ± 0.12; 0.54 ± 0.19), respectively. HD negatively altered renal morphology in SH, but when associated with RT, the apparent damage was partially reversed. In addition, the aquatic jump protocol reversed the damage to the gastrocnemius muscle caused by the HD. CONCLUSIONS: A high-protein diet promoted negative metabolic and morphological changes, while RT was effective in reversing these deleterious effects.