BRUNO GUALANO
Projetos de Pesquisa
Unidades Organizacionais
Departamento de Clínica Médica, Faculdade de Medicina - Docente
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder
LIM/17 - Laboratório de Investigação em Reumatologia, Hospital das Clínicas, Faculdade de Medicina - Líder
73 resultados
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- It is over there, next to that fat lady: a qualitative study of fat women's own body perceptions and weight-related discriminations(2020) ULIAN, Mariana Dimitrov; SATO, Priscila de Morals; PINTO, Ana Jessica; BENATTI, Fabiana B.; CAMPOS-FERRAZ, Patricia Lopes de; COELHO, Desire; ROBLE, Odilon J.; SABATINI, Fernanda; PEREZ, Isabel; ABURAD, Luiz; VESSONI, Andre; UNSAIN, Ramiro Fernandez; GUALANO, Bruno; SCAGLIUSI, Fernanda B.We investigated fat women's perceptions of their own bodies and their experiences with weight-related discriminations, and how these situations affected their well-being. Thirty-nine obese women were interviewed, and three axes of analysis were identified: (1) repercussions of being fat, (2) living with a fat body, and (3) am I a person or just a fat body? These axes were composed of eight themes which had similar meaning or complemented each other. The results showed our participants had mechanisms to diminish the magnitude of their stigmatized bodies (e.g., attempting to lose weight and changing their current food choices). Participants also reported being fat had physical and psychological consequences for them. Most notably, their larger bodies influenced their self-evaluation, making them feel devalued, unlovable, incapable, and incomplete. They reported stigmatizing experiences in familiar situations, at the workplace and in public spaces, and reported being stigmatized by both close and unknown individuals, including healthcare professionals. These professionals were reported to treat patients disrespectfully, which urges attention to health care inequalities for obese people. Our results stress stigmatizing attitudes towards fat people and their own considerations about themselves have negative consequences in their physical and mental well-being.
- Safety and possible effects of low-intensity resistance training associated with partial blood flow restriction in polymyositis and dermatomyositis(2014) MATTAR, Melina Andrade; GUALANO, Bruno; PERANDINI, Luiz Augusto; SHINJO, Samuel Katsuyuki; LIMA, Fernanda Rodrigues; SA-PINTO, Ana Lucia; ROSCHEL, HamiltonIntroduction: Our aim was to evaluate the safety and efficacy of a low-intensity resistance training program combined with partial blow flow restriction (BFR training) in a cohort of patients with polymyositis (PM) and dermatomyositis (DM). Methods: In total, 13 patients with PM and DM completed a 12-week twice a week low-intensity (that is, 30% one-repetition-maximum (1RM)) resistance exercise training program combined with partial blood flow restriction (BFR). Assessments of muscle strength, physical function, quadriceps cross sectional (CSA) area, health-related quality of life, and clinical and laboratory parameters were assessed at baseline and after the intervention. Results: The BFR training program was effective in increasing the maximal dynamic strength in both the leg-press (19.6%, P < 0.001) and knee-extension exercises (25.2% P < 0.001), as well as in the timed-stands (15.1%, P < 0.001) and timed-up-and-go test (-4.5%, P = 0.002). Quadriceps CSA was also significantly increased after the intervention (4.57%, P = 0.01). Similarly, all of the components of the Short Form-36 Health Survey, the Health Assessment Questionnaire scores, and the patient-and physician reported Visual Analogue Scale were significantly improved after training (P < 0.05). Importantly, no clinical evidence or any other self-reported adverse event were found. Laboratory parameters (creatine kinase and aldolase) were also unchanged (P > 0.05) after the intervention. Conclusions: We demonstrated that a 12-week supervised low-intensity resistance training program associated with partial blood flow restriction may be safe and effective in improving muscle strength and function as well as muscle mass and health-related quality of life in patients with PM and DM.
- Daily Leucine Intake Is Positively Associated with Lower Limb Skeletal Muscle Mass and Strength in the Elderly(2021) LIXANDRAO, Manoel E.; LONGOBARDI, Igor; LEITAO, Alice E.; MORAIS, Joao V. M.; SWINTON, Paul A.; AIHARA, Andre Y.; GOES, Paola C. K.; UGRINOWITSCH, Carlos; CANDOW, Darren G.; GUALANO, Bruno; ROSCHEL, HamiltonHigher daily protein intake, with an emphasis on leucine content, is thought to mitigate age-related anabolic resistance, potentially counteracting age-related morphological and functional declines. The present study investigated potential associations between total daily leucine intake and dependent variables, including quadriceps muscle cross-sectional area (CSA) and maximum dynamic muscle strength (1-RM) in a cohort of healthy free-living older individuals of both sexes (n = 67; 34/33 men/women). Participants performed three 24 h dietary recalls and underwent a magnetic resonance imaging exam followed by 1-RM tests. Our results demonstrate moderate associations between total daily leucine and both quadriceps CSA (r = 0.42; p = 0.004) and 1-RM (r = 0.45; p = 0.001). Furthermore, our exploratory biphasic linear regression analyses, adjusted for sex, age, and protein intake relative to body weight, revealed a plateau for daily leucine intake and muscle mass and muscle strength (~7.6-8.0 g & BULL;day(-1)) in older adults. In conclusion, we demonstrated that total daily leucine intake is associated with muscle mass and strength in healthy older individuals and this association remains after controlling for multiple factors, including overall protein intake. Furthermore, our breakpoint analysis revealed non-linearities and a potential threshold for habitual leucine intake, which may help guide future research on the effects of chronic leucine intake in age-related muscle loss.
- Omega-3 Fatty Acid Supplementation Improves Endothelial Function in Primary Antiphospholipid Syndrome: A Small-Scale Randomized Double-Blind Placebo-Controlled Trial(2018) FELAU, Sheylla M.; SALES, Lucas P.; SOLIS, Marina Y.; HAYASHI, Ana Paula; ROSCHEL, Hamilton; SA-PINTO, Ana Lucia; ANDRADE, Danieli Castro Oliveira de; KATAYAMA, Keyla Y.; IRIGOYEN, Maria Claudia; CONSOLIM-COLOMBO, Fernanda; BONFA, Eloisa; GUALANO, Bruno; BENATTI, Fabiana B.Endothelial cells are thought to play a central role in the pathogenesis of antiphospholipid syndrome (APS). Omega-3 polyunsaturated fatty acid (n-3 PUFA) supplementation has been shown to improve endothelial function in a number of diseases; thus, it could be of high clinical relevance in APS. The aim of this study was to evaluate the efficacy of n-3 PUFA supplementation on endothelial function (primary outcome) of patients with primary APS (PAPS). A 16-week randomized clinical trial was conducted with 22 adult women with PAPS. Patients were randomly assigned (1:1) to receive placebo (PL, n = 11) or n-3 PUFA (omega-3, n = 11) supplementation. Before (pre) and after (post) 16 weeks of the intervention, patients were assessed for endothelial function (peripheral artery tonometry) (primary outcome). Patients were also assessed for systemic markers of endothelial cell activation, inflammatory markers, dietary intake, international normalized ratio (INR), and adverse effects. At post, omega-3 group presented significant increases in endothelial function estimates reactive hyperemia index (RHI) and logarithmic transformation of RHI (LnRHI) when compared with PL (+13 vs. -12%, rho = 0.06, ES = 0.9; and +23 vs. -22%, rho = 0.02, ES = 1.0). No changes were observed for e-selectin, vascular adhesion molecule-1, and fibrinogen levels (rho > 0.05). In addition, omega-3 group showed decreased circulating levels of interleukin-10 (-4 vs. +45%, rho = 0.04, ES = -0.9) and tumor necrosis factor (-13 vs. +0.3%, rho = 0.04, ES = -0.95) and a tendency toward a lower intercellular adhesion molecule-1 response (+3 vs. +48%, rho = 0.1, ES = -0.7) at post when compared with PL. No changes in dietary intake, INR, or self-reported adverse effects were observed. In conclusion, 16 weeks of n-3 PUFA supplementation improved endothelial function in patients with well-controlled PAPS. These results support a role of n-3 PUFA supplementation as an adjuvant therapy in APS. Registered at http://ClinicalTrials.gov as NCT01956188.
- Potential of Creatine in Glucose Management and Diabetes(2021) SOLIS, Marina Yazigi; ARTIOLI, Guilherme Giannini; GUALANO, BrunoCreatine is one of the most popular supplements worldwide, and it is frequently used by both athletic and non-athletic populations to improve power, strength, muscle mass and performance. A growing body of evidence has been identified potential therapeutic effects of creatine in a wide variety of clinical conditions, such as cancer, muscle dystrophy and neurodegenerative disorders. Evidence has suggested that creatine supplementation alone, and mainly in combination with exercise training, may improve glucose metabolism in health individuals and insulin-resistant individuals, such as in those with type 2 diabetes mellitus. Creatine itself may stimulate insulin secretion in vitro, improve muscle glycogen stores and ameliorate hyperglycemia in animals. In addition, exercise induces numerous metabolic benefits, including increases in insulin-independent muscle glucose uptake and insulin sensitivity. It has been speculated that creatine supplementation combined with exercise training could result in additional improvements in glucose metabolism when compared with each intervention separately. The possible mechanism underlying the effects of combined exercise and creatine supplementation is an enhanced glucose transport into muscle cell by type 4 glucose transporter (GLUT-4) translocation to sarcolemma. Although preliminary findings from small-scale trials involving patients with type 2 diabetes mellitus are promising, the efficacy of creatine for improving glycemic control is yet to be confirmed. In this review, we aim to explore the possible therapeutic role of creatine supplementation on glucose management and as a potential anti-diabetic intervention, summarizing the current knowledge and highlighting the research gaps.
- Serum cytokines in childhood-Takayasu arteritis: Are they biomarkers for indolent disease activity?(2023) CLEMENTE, Gleice; TERRERI, Maria Teresa; PEREIRA, Rosa M. R.; GUALANO, Bruno; SILVA, Clovis Artur; SOUZA, Alexandre Wagner de
- Disordered Eating Attitudes and Food Choice Motives Among Individuals Who Follow a Vegan Diet in Brazil(2023) MAZZOLANI, Bruna Caruso; SMAIRA, Fabiana Infante; ESTEVES, Gabriel P.; SANTINI, Martin Hindermann; LEITAO, Alice Erwig; ANDRE, Heloisa C. Santo; GUALANO, Bruno; ROSCHEL, HamiltonIMPORTANCE It remains controversial whether adhering to a vegan diet may be associated with a higher prevalence of disordered eating. Also, main food choice motives and their association with disordered eating in this population are still unknown. OBJECTIVE To determine the association between disordered eating attitudes and food choice motives of individuals who follow a vegan diet. DESIGN, SETTING, AND PARTICIPANTS This is a cross-sectional online survey conducted between September 2021 and January 2023. Individuals of both sexes, aged 18 years or older, following a vegan diet for at least 6 months, currently living in Brazil were recruited through advertisements on social media. EXPOSURE Adherence to a vegan diet and food choice motives. MAIN OUTCOMES AND MEASURES Disordered eating attitudes and food choice motives. RESULTS Nine hundred seventy-one participants completed the online survey. Median (IQR) age and BMI of participants was 29 (24-36) years and 22.6 (20.3-24.9), respectively, and 800 participants (82.4%) were female. Most participants (908 respondents [94%]) were categorized with the lowest level of disturbed eating attitudes. ""Need and hunger,"" ""liking,"" ""health,"" ""habits,"" and ""natural concerns"" were the most important food choice motives in this population, while ""affect regulation,"" ""social norms,"" and ""social image"" were the less important ones. Adjusted models showed that ""liking,"" ""need and hunger,"" and ""health"" were associated with lower levels of disordered eating attitudes, while ""price,"" ""pleasure,"" ""sociability,"" ""traditional eating,"" ""visual appeal,"" ""social norms,"" ""social image,"" ""weight control,"" and ""affect regulation"" were associated with higher levels of disordered eating attitudes. CONCLUSIONS AND RELEVANCE In this cross-sectional study, as opposed to previous suggestions, levels of disordered eating were very low among vegans, although certain food choice motives were associated with disordered eating attitudes. Understanding the motivations of adhering to diets that may impose restrictions, which include vegan diets, may help tailor interventions focused on promoting healthy eating and preventing or treating disordered eating.
- INFLUENCE OF PHYSICAL EXERCISE ON COGNITION: AN UPDATE ON PHYSIOLOGICAL MECHANISMS(2014) MEREGE FILHO, Carlos Alberto Abujabra; ALVES, Christiano Robles Rodrigues; SEPULVEDA, Carlos Andres; COSTA, Andre dos Santos; LANCHA JUNIOR, Antonio Herbert; GUALANO, BrunoAlthough a growing body of literature has supported the beneficial role of exercise on cognition, there is no consensus on the mechanisms underlying acute and chronic cerebral adaptations to exercise. The present review aims to present and discuss the mechanisms by which exercise affects cognitive performance. It has been speculated that the acute effects of exercise on cognitive response may be mediated by increases in cerebral blood flow and, hence, in nutrient availability, or by increases in neurotransmitter activity. It has been also postulated that chronic exercise may induce adaptations in brain structures and the synaptic plasticity, which would result in cognitive improvements. These hypotheses are discussed in light of available scientific evidence in animal models and humans
- Creatine Supplementation and Brain Health(2021) ROSCHEL, Hamilton; GUALANO, Bruno; OSTOJIC, Sergej M.; RAWSON, Eric S.There is a robust and compelling body of evidence supporting the ergogenic and therapeutic role of creatine supplementation in muscle. Beyond these well-described effects and mechanisms, there is literature to suggest that creatine may also be beneficial to brain health (e.g., cognitive processing, brain function, and recovery from trauma). This is a growing field of research, and the purpose of this short review is to provide an update on the effects of creatine supplementation on brain health in humans. There is a potential for creatine supplementation to improve cognitive processing, especially in conditions characterized by brain creatine deficits, which could be induced by acute stressors (e.g., exercise, sleep deprivation) or chronic, pathologic conditions (e.g., creatine synthesis enzyme deficiencies, mild traumatic brain injury, aging, Alzheimer's disease, depression). Despite this, the optimal creatine protocol able to increase brain creatine levels is still to be determined. Similarly, supplementation studies concomitantly assessing brain creatine and cognitive function are needed. Collectively, data available are promising and future research in the area is warranted.
- Histidine dipeptides are key regulators of excitation-contraction coupling in cardiac muscle: Evidence from a novel CARNS1 knockout rat model(2021) GONCALVES, Livia de Souza; SALES, Lucas Peixoto; SAITO, Tiemi Raquel; CAMPOS, Juliane Cruz; FERNANDES, Alan Lins; NATALI, Jose; JENSEN, Leonardo; ARNOLD, Alexandre; RAMALHO, Lisley; BECHARA, Luiz Roberto Grassmann; ESTECA, Marcos Vinicius; CORREA, Isis; SANT'ANNA, Diogo; CERONI, Alexandre; MICHELINI, Lisete Compagno; GUALANO, Bruno; TEODORO, Walcy; CARVALHO, Victor Henrique; VARGAS, Bianca Scigliano; MEDEIROS, Marisa Helena Gennari; BAPTISTA, Igor Luchini; IRIGOYEN, Maria Claudia; SALE, Craig; FERREIRA, Julio Cesar Batista; ARTIOLI, Guilherme GianniniHistidine-containing dipeptides (HCDs) are abundantly expressed in striated muscles. Although important properties have been ascribed to HCDs, including H+ buffering, regulation of Ca2+ transients and protection against oxidative stress, it remains unknown whether they play relevant functions in vivo. To investigate the in vivo roles of HCDs, we developed the first carnosine synthase knockout (CARNS1-/-) rat strain to investigate the impact of an absence of HCDs on skeletal and cardiac muscle function. Male wild-type (WT) and knockout rats (4 months-old) were used. Skeletal muscle function was assessed by an exercise tolerance test, contractile function in situ and muscle buffering capacity in vitro. Cardiac function was assessed in vivo by echocardiography and cardiac electrical activity by electrocardiography. Cardiomyocyte contractile function was assessed in isolated cardiomyocytes by measuring sarcomere contractility, along with the determination of Ca2+ transient. Markers of oxidative stress, mitochondrial function and expression of proteins were also evaluated in cardiac muscle. Animals were supplemented with carnosine (1.8% in drinking water for 12 weeks) in an attempt to rescue tissue HCDs levels and function. CARNS1-/- resulted in the complete absence of carnosine and anserine, but it did not affect exercise capacity, skeletal muscle force production, fatigability or buffering capacity in vitro, indicating that these are not essential for pH regulation and function in skeletal muscle. In cardiac muscle, however, CARNS1-/- resulted in a significant impairment of contractile function, which was confirmed both in vivo and ex vivo in isolated sarcomeres. Impaired systolic and diastolic dysfunction were accompanied by reduced intracellular Ca2+ peaks and slowed Ca2+ removal, but not by increased markers of oxidative stress or impaired mitochondrial respiration. No relevant increases in muscle carnosine content were observed after carnosine supplementation. Results show that a primary function of HCDs in cardiac muscle is the regulation of Ca2+ handling and excitation-contraction coupling.