Efeitos combinados do treinamento contrarresistência e dietas restritivas em carboidrato ou convencional na perda de peso, variáveis sanguíneas e função endotelial
Palavras-chave:
Carboidratos, Dieta, Endotélio, Estado nutricional, ObesidadeResumo
Objetivo
Comparar os efeitos entre a dieta com restrição de carboidratos e a dieta hipoenergética convencional combinadas com treinamento contrarresistência. Trabalhou-se com a hipótese de que as dietas com restrição em carboidratos poderiam acarretar maior perda de peso, mas que, no entanto, ambas causariam efeitos similares nos biomarcadores de saúde.
Métodos
Vinte e um adultos com sobrepeso ou obesos participaram de um programa de 8 semanas de treinamento contrarresistência progressive combinado com dieta com restrição de carboidratos (inicialmente com <30 g de carboidrato; n=12) ou com dieta hipoenergética convencional (30% de restrição energética; carboidrato/proteína/lipídeos: 51/18/31% do valor energético total; n=9). Massa e composição corporais, variáveis sanguíneas (glicose, ureia, creatinina, ácido úrico, lipemia sanguínea, proteína c-reativa de alta sensibilidade) e dilatação fluxo-mediada da artéria braquial (por ultrassom) foram acompanhadas para observar os efeitos das intervenções.
Resultados
Foram identificadas reduções significativas na massa corporal (-5,4±3,5%; p=0,001 versus -3,7±3,0%; p=0,015) e na gordura corporal (-10,2±7,0%; p=0,005 versus -9,6±8,8%; p=0,017) de indivíduos em dieta com restrição de carboidratos e dieta hipoenergética convencional, respectivamente, sem diferenças significativas entre os grupos. Massa livre de gordura, variáveis sanguíneas e dilatação fluxo-mediada da artéria braquial não sofreram modificações significativas, exceto a razão colesterol total/lipoproteína de alta densidade, que reduziu 10,4±16,9% em dietas com restrição de carboidratos (p=0,037) e 0,5±11,3% em dieta hipoenergética
convencional (p=0,398).
Conclusão
A dieta com restrição de carboidratos associada ao treinamento contrarresistência foi tão efetiva quanto a dieta convencional em reduzir a massa e a gordura corporais, assim como em manter os valores da massa livre de gordura, das variáveis sanguíneas e da dilatação fluxo-mediada da artéria braquial. No entanto, foi mais efetiva na redução da razão colesterol total/lipoproteína de baixa densidade.
Referências
American Dietetic Association. Position stand on weight management. J Am Diet Assoc. 2009; 109(2):330-6. http://dx.doi.org/10.1016/j.jada. 2008.11.041
Westman EC, Feinman RD, Mavropoulos JC, Vernon MC, Volek JS, Wortman JA, et al. Low-carbohydrate nutrition and metabolism. Am J Clin Nutr. 2007; 86(2):276-84.
Hession M, Rolland C, Kulkarni U, Wise A, Broom J. Systematic review of randomized controlled trials of low-carbohydrate vs low-fat/low-calorie diets in the management of obesity and its comorbidities. Obes Rev. 2009; 10(1):36-50. http://dx.doi.org/ 10.1111/j.1467-789X.2008.00518.x
Patel AR, Kuvin JT, Sliney KA, Rand WM, Chiang JC, Udelson JE, et al. Gender-based differences in brachial artery flow-mediated vasodilation as an indicator of significant coronary artery disease. Am J Cardiol. 2005; 96(9):1223-6. http://dx.doi.org/ 10.1016/j.amjcard.2005.06.060
Phillips SA, Jurva JW, Syed AQ, Syed AQ, Kulinski JP, Pleuss J, et al. Benefit of low-fat over low- -carbohydrate diet on endothelial health in obesity. Hypertension. 2008; 51(2):376-82. http://dx.doi. org/10.1161/HYPERTENSIONAHA.107.101824
Buscemi S, Verga S, Tranchina MR, Cottone S, Cerasola G. Effects of hypocaloric very-low-carbohydrate diet vs Mediterranean diet on endothelial function in obese women. Eur J Clin Invest. 2009; 39(5):339-47. http://dx.doi.org/10.1111/j.1365-23 62.2009.02091.x
Keogh JB, Brinkworth GD, Clifton PM. Effects of weight loss on a low-carbohydrate diet on flow- -mediated dilatation, adhesion molecules and adiponectin. Br J Nutr. 2007; 98(4):852-9. http:// dx.doi.org/10.1017/S0007114507747815
Keogh JB, Brinkworth GD, Noakes M, Belobrajdic DP, Buckley JD, Clifton PM. Effects of weight lossfrom a very-low-carbohydrate diet on endothelial function and markers of cardiovascular disease risk in subjects with abdominal obesity. Am J Clin Nutr. 2008; 87(3):567-76.
Ridker PM, Stampfer MJ, Rifai N. Novel risk factors for systemic atherosclerosis a comparison of c-reactive protein, fibrinogen, homocysteine, lipoprotein(a), and standard cholesterol screening as predictors of peripheral arterial disease. Jama. 2001; 285(19):2481-5. http://dx.doi.org/10.1001/jama. 285.19.2481
Seshadri P, Iqbal N, Stern L, Williams M, Chicano KL, Daily DA. A randomized study comparing the effects of a low-carbohydrate diet and a conventional diet on lipoprotein subfractions and C-reactive protein levels in patients with severe obesity. Am J Med. 2004; 117(6):398-405. http:// dx.doi.org/10.1016/j.amjmed.2004.04.009
American College of Sports Medicine. Position stand: Appropriate intervention strategies for weight loss and prevention of weight regain for adults. Med Sci Sports Exerc. 2009; 41(2):459-71. http://dx.doi.org/10.1249/MSS.0b013e3181 949333
World Health Organization. Human energy requirements. Report of a Joint FAO/WHO/UNU Expert consultation. Rome: WHO; 2004.
Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes: Macronutrients. Washington (DC); 2005. [cited 2010 July 24]. Available from: http://www.nap.edu
Jackson AS, Pollock ML. Generalized equations for predicting body density of men. Br J Nutr. 1978; 40(3):497-504. http://dx.doi.org/10.1079/BJN197 80152
Jackson AS, Pollock ML, Ward A. Generalized equations for predicting body density of women. Med Sci Sports Exerc. 1980; 12(3):175-81. http:// dx.doi.org/10.1249/00005768-198023000-00009
Siri WE. Body composition from fluid spaces and density. In Brozek J, Henschel A, editors. Technics for measuring body composition. Washington (DC): National Academy of Sciences; 1961. p.223-4.
Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem. 1972; 18(6):499-502.
Meirelles CM, Leite SP, Montenegro CAB, Gomes PSC. Reliability of brachial artery flow-mediated dilatation measurement using ultrasound. Arq Bras Cardiol. 2007; 89(3):160-7. http://dx.doi.org/ 10.1590/S0066-782X2007001500006
Paddon-Jones D, Sheffield-Moore M, Zhang X, Volpi E, Wolf SE, Aarsland A, et al. Amino acid ingestion improves muscle protein synthesis in the young and elderly. Am J Physiol Endocrinol Metab. 2004; 286(3):E321-8. http://dx.doi.org/10.1152/ ajpendo.00368.2003
Ludwig DS. Dietary glycemic index and obesity. J Nutr. 2000; 130(2S Suppl):280S-3S. 21. Sharman MJ, Gómez AL, Kraemer WJ, Volek JS. Very low-carbohydrate and low-fat diets affect fasting lipids and postprandial lipemia differently in overweight men. J Nutr. 2004; 134(4):880-5.
Noakes M, Foster PR, Keogh JB, James AP, Mamo JC, Clifton PM. Comparison of isocaloric very carbohydrate restrictive/high saturated fat and high carbohydrate/low saturated fat diets on body composition and cardiovascular risk. Nutr Metab. 2006: 3:7. http://dx.doi.org/10.1186/1743-707 5-3-7
Johnstone AM, Horgan GW, Murison SD, Bremner DM, Lobley GE. Effects of a high-protein ketogenic diet on hunger, appetite, and weight loss in obese men feeding ad libitum. Am J Clin Nutr. 2008; 87(1):44-55.
Volek JS, Sharman MJ, Gómez AL, Judelson DA, Rubin MR, Watson G, et al. Comparison of energy restricted very low-carbohydrate and low-fat diets on weight loss and body composition in overweight men and women. Nutr Metab. 2004; 1:13. http:// dx.doi.org/10.1186/1743-7075-1-13
Bazzano LA, Hu T, Reynolds K, Yao L, Bunol C, Liu Y, et al. Effects of low-carbohydrate and low-fat diets: A randomized trial. Ann Intern Med. 2014; 161(5):309-18. http://dx.doi.org/10.7326/M14-0 180
Pesta D, Samuel V. A high-protein diet for reducing body fat: Mechanisms and possible caveats. Nutr Metab. 2014; 11:53. http://dx.doi.org/10.1186/17 43-7075-11-53
Wood RJ, Gregory SM, Sawyer J, Milch CM, Matthews TD, Headley SAE. Preservation of fat-free mass after two distinct weight loss diets with and without progressive resistance exercise. Metab Syndr Relat Disord. 2012; 10(3):167-74. http://dx. doi.org/10.1089/met.2011.0104
Volek JS, Ballard KD, Silvestre R, Judelson DA, Quann EE, Forsythe CE, et al. Effects of dietary carbohydrate restriction vs low-fat diet on flow- -mediated dilation. Metab Clin Exp. 2009; 58(12):1769-77. doi: 10.1016/j.metabol.2009.06. 005
Mohler ER 3rd, Sibley AA, Stein R, Davila-Roman V, Wyatt H, Badellino K, et al. Endothelial functionand weight loss: Comparison of low carbohydrate and low-fat diets. Obesity. 2013; 21(3):504-9. http:// dx.doi.org/10.1002/oby.20055
Beck DT, Martin JS, Casey DP, Braith RW. Exercise training improves endothelial function in resistance arteries of young prehypertensives. J Hum Hypertens. 2014; 28(5):303-9. http://dx.doi.org/ 10.1038/jhh.2013.109
Cuenca-Sánchez M, Naves-Carrillo D, Orenes Piñero E. Controversies surrounding high-protein diet intake: Satiating effect and kidney and bone health. Adv Nutr. 2015; 15(6):260-6. http://dx.doi. org/10.3945/an.114.007716
Tirosh A, Golan R, Harman-Boehm I, Henkin Y, Schwarzfuchs D, Rudich A, et al. Renal function following three distinct weight loss dietary strategies during 2 years of a randomized controlled trial. Diabetes Care. 2013; 36(8):2225-32. http:// dx.doi.org/10.2337/dc12-1846
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Claudia Mello MEIRELLES, Paulo Sergio Chagas GOMES
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.