[glucosa] y

RELACIONES METABÓLICAS ENTRE
TEJIDOS EN VARIOS ESTADOS
NUTRICIONALES Y HORMONALES
INTEGRACIÓN DE METABOLISMO
(ATANDO CABOS)
Qué tienen en común los
siguientes procesos?
• 
• 
• 
• 
• 
• 
• 
• 
Mantenimiento de presión arterial
Hambre
Nivel de glucosa en la sangre
Diferenciación sexual
Desarrollo
Embriogénesis
Regulación
Reproducción
Hormonal
Digestión
Mecanismos de Acción Hormonal
Distintas Clases de Hormonas
Sildenafil
Viagra
Insulina
Glándulas Endocrinas
Sistema Neuroendocrino
Metabolismo Tejido-Específico
División de Tareas en el Cuerpo Humano
Each tissue of the human body has a specialized function:
- Skeletal muscle allows directed motion.
- Adipose tissue stores and releases energy in the form of
fats, which serve as fuel throughout the body.
- The brain pumps ions across plasma membranes to
produce electrical signals.
- The liver plays a central processing and distributing role in
metabolism and furnishes all other organs and tissues with an
appropriate mix of nutrients via the bloodstream.
Metabolismo Tejido-Específico
Hígado
Rutas Metabólicas para Glucosa 6-P en el
Hígado
Rutas Metabólicas para Amino Ácidos en el
Hígado
Rutas Metabólicas para Amino Ácidos en el
Hígado
Rutas Metabólicas para Grasas en el Hígado
Rutas Metabólicas para Grasas en el Hígado
Tejido Adiposo - Reserva de Ácidos Grasos
También, es όrgano endocrino que produce y libera hormonas que indican status
de reservas energéticas y coordinan metabolismo de grasas y CHO.
Tejido Adiposo – “White vs. Brown”
Thermogenin – uncoupling
protein expressed in brown
adipocytes. Thermogenin
provides an alternative route
for protons to reenter the
matrix that bypasses ATP
synthase. The energy of the
proton gradient is dissipated
as heat to maintain the body
at optimal temperature. In
particular, the nervous
system, head, pancreas,
adrenal glands, kidneys, etc.
Prominent in newborns but
recently shown to be present
in adults.
Músculo – ATP necesario para realizar trabajo
Low pH
Phosphorolysis of glycogen produces glucose 6-P, thus each glucose degraded
from glycogen produces 3ATP! (No ATP is used in hexokinase reaction).
Creatine and Creatine Kinase
Mitochondrial creatine kinase
(mCK) transfers a phosphoryl group
from ATP to creatine (Cr) to form
creatine phosphate (PCr), which
difusses to sites of ATP use, where
cytosolic creatine kinase (cCK)
then passes the phosphoryl group
back to ATP. cCK can also use ATP
produced from glycolysis to
synthesize PCr.
During periods of little ATP demand,
the pools of ATP and PCr are
replenished in preparation for the
next period of intense demand for
ATP.
Spontaneous Formation of Creatinine from
Creatine and Creatine Phosphate
To maintain adequate levels,
creatine must be obtained from
the diet (meat & dairy products)
or by synthesis (Gly, Arg, Met).
In vegans?? Synthesis only.
In athletes taking supplements,
efficient uptake by muscle from
the blood (processed and
exported by liver and kidney)
requires continuous exercise.
Combination of exercise and
creatine!!!! (next slide!)
Heart attack – the heart muscle contains a unique enzyme of creatine
kinase (the MB isozyme), which is not normally found in blood but appears
after heart attack. Measurement of MB isozyme is used for diagnosis of
heart attack!
In the healthy kidney, creatinine from creatine breakdown is cleared from
the blood into the urine. When creatinine levels rise above the normal
range (0.8 – 1,4 mg/dL)!!!!
Red flag - RENAL FAILURE (due to diabetes or other serious conditions).
Músculo – ATP necesario para realizar trabajo
Músculo – ATP necesario para realizar trabajo
Cerebro – Utiliza ATP para Transmitir Impulso
Eléctrico
Cerebro – Utiliza ATP para Transmitir Impulso
Eléctrico
Gamma-hydroxybutyrate (Date Rape Drug) – naturally occurring
substance found in the CNS, beef, wine, beer. Structurally related to betahydroxybutyrate, naturally-produced in human cells, used to treat
insomnia, alcoholism and narcolepsy.
Sangre – Transportador de Oxígeno,
Metabolitos y Hormonas
Different Nutritional States
A Big Picture View on Metabolism
Well-Fed State – Dieta suple energía necesaria
GLUCOSA
 Llega al hígado es convertida a glucógeno; o
piruvato o lactato por glucólisis.
 Piruvato convertido a Acetil CoA y de ahí a CO2
por el Ciclo de Krebs o a grasas.
 Mayoría pasa por el hígado y de ahí llega a otros
tejidos:
 Cerebro – utiliza para producción ATP
 Eritrocitos- lactato y piruvato
 Tejido Adiposo- convierte en grasas
 Músculo – convierte en glucógeno o utiliza en
glucólisis y TCA.
Well-Fed State – Metabolismo de Glucosa
 Muchos tejidos producen lactato y piruvato
del consumo de glucosa.
 El hígado utiliza éstos y los convierte en
grasas.
 Importante en este estado:
 Gluconeogénesis en el hígado está
inactivada.
Menos de 4 horas entre comidas
Well-Fed State – Metabolismo de Proteínas
Proteínas
 Son hidrolizadas en el intestino. Los amino
ácidos son transportados en la sangre.
 El hígado no remueve éstos de la sangre a
menos que estén en [ ] altas.
 Los tejidos los utilizan para síntesis de
proteínas.
Menos de 4 horas entre comidas
Well-Fed State – Metabolismo de Grasas
Grasas
 Glucosa, lactato, piruvato y amino ácidos son
utilizados por el hígado para sintetizar grasas.
 Éstas son transportadas y almacenadas en
tejido adiposo.
 Grasas de la dieta – son también almacenadas
en adipocitos.
Menos de 4 horas entre comidas
Well-Fed State
Pancreas
 Células β del pancreas son muy sensitivas a
las [glucosa] y [amino ácidos].
 Éstas secretan insulina durante y después
que ingerimos alimentos.
 Paso esencial para el metabolismo de
nutrientes por el hígado, músculo y tejido
adiposo.
Menos de 4 horas entre comidas
Early Fasting State – Glucogenólisis hepática
Importante para mantener
[glucosa] durante este
período. Síntesis de grasas
se detiene y piruvato,
lactato y a.a. son utilizados
para formación de glucosa.
Ciclo de alanina y Ciclo
Cori – muy importantes
Catabolismo de amino
ácidos – no ocurre
4 -16 horas entre comidas
Fasting State – Activa Gluconeogenesis
No hay glucógeno en el
hígado, tejidos que necesitan
glucosa dependen de
gluconeogénesis (a partir de
lactato, piruvato o alanina).
Glucosa formada de alanina y
lactato por el hígado sólo
reemplaza aquella que fue
convertida a lactato y alanina
por los tejidos extrahepáticos.
Cerebro –continúa
convirtiendo glucosa en CO2 y
agua
>16 horas entre comidas
Fasting State – Fuente Neta de Carbono
Ácidos Grasos?para Gluconeogénesis
Proteínas del músculo- fuente
de carbono
Ciclo de Urea – Imp.
Tejido adiposo – los bajos
niveles de insulina activan
degradación de grasas como
fuente de energía.
Músculo y corazón – se inhibe
glucólisis y oxidación de
piruvato. Se utilizan grasas.
Hígado – β-oxidación suple
energía (ATP) para
gluconeogénesis.
Fasting State – Producción Cuerpos Cetónicos
Acetil CoA NO se oxida
en TCA en el hígado, se
utiliza en formación de
cuerpos cetónicos.
Cuerpos cetónicos se
transportan a otros tejidos
y se utilizan como fuente
de energía.
Cuerpos cetónicos entran
al cerebro y se oxidan (no
reemplazan glucosa pero
se utilizan como último
recurso).
Fasting State – Producción Cuerpos Cetónicos
Producción alta de cuerpos cetónicos en el hígado
mantiene gluconeogénesis en el hígado y
degradación de amino ácidos en el músculo baja.
Relación Importante entre hígado, músculo y
tejido adiposo en la síntesis de glucosa por
gluconeogénesis necesaria para el cerebro:
Hígado sintetiza la glucosa.
Músculo suple sustrato (alanina).
Tejido adiposo suple ATP (via β-oxidación en el
hígado) necesaria para gluconeogénesis.
Fasting State
Esta cooperación entre tejidos depende de los
niveles de hormonas:
Niveles de glucosa bajos, reducen secreción de
insulina, favorecen secreción de glucagón por el
pancreas y epinefrina por la corteza adrenal.
Early Re-Fed State
Grasas se metabolizan normal, glucosa no se
absorbe muy bien en el hígado por las primeras
horas. Hígado se mantiene gluconeogénico por
algún tiempo. Gluconeogénesis produce Gluc-6P
que se utiliza para sintetizar glucógeno y
almacenarlo nuevamente.
Requisitos energéticos y reservas
Personal normal (155 lbs) – necesita 200-300 g de CHO,
70-100 g de proteína y 60-90 g de grasas.
Reservas son utilizadas entre comidas y durante la noche
para mantener niveles constantes de glucosa.
Reservas de glucógeno – no muy impresionantes
Reservas de grasas – utilizadas en ayuno
Proteínas – sólo utilizadas en casos extremos
(pérdida de musculo)
Homeostasis Calórica
Disponibilidad constante de “fuels” en la sangre sin
importar estado nutricional para mantener niveles de
glucosa y requisitos de ATP.
Nivel de glucosa (ATP) – no puede salirse de ciertos
límites. Muy controlado ya que el cerebro los requiere
(no menos de 2 mM) Coma, Muerte.
Tampoco puede subir mucho (hiperglicemia),
glucosa se pierde en la orina, deshidratación y coma.
Muy distinto a ácidos grasos y cuerpos cetónicos que
varían mucho.
Homeostasis Calórica
Cambios en insulina/glucagón son muy importantes para
mantener homeostasis calórica.
Well-Fed – insulina/glucagón ratio ALTO (favorece
almacenamiento de glucógeno y grasas).
Starved – insulina/glucagón ratio BAJO (favorece
degradación de grasas y proteínas, gluconeogénesis)
Las Cinco Fases de Homeostasis de Glucosa
I
II
III
IV
V
Dieta
Glucógeno
Gluconeogénesis
Fase I – Well-Fed state; glucosa proviene de la dieta
Las Cinco Fases de Homeostasis de Glucosa
I
II
III
IV
V
Dieta
Glucógeno
Gluconeogénesis
Fase II – Termina glucosa de la dieta, comienza
glucogenólisis (duración aprox. 20 hrs)
Las Cinco Fases de Homeostasis de Glucosa
I
II
III
IV
V
Dieta
Glucógeno
Gluconeogénesis
Fase II – Glucogenólisis disminuyendo y comienza
gluconeogénesis hepática
Las Cinco Fases de Homeostasis de Glucosa
I
II
III
IV
V
Dieta
Glucógeno
Gluconeogénesis
Fase III – Gluconeogénesis hepática – fuente
principal, glucógeno un poco
Las Cinco Fases de Homeostasis de Glucosa
I
II
III
IV
V
Dieta
Glucógeno Gluconeogénesis
Fase IV – después de varios días de ayuno gluconeogénesis
hepática y renal – fuentes principales, al final comienzan
a subir niveles de cuerpos cetónicos en el hígado. Son
transportados y utilizados por tejidos extrahepáticos
incluyendo el cerebro y comienza a disminuir dependencia
en gluconeogénesis.
Las Cinco Fases de Homeostasis de Glucosa
I
II
III
IV
V
Dieta
Glucógeno
Gluconeogénesis
Fase V – (Prolonged Starvation) oxidación de grasas y
producción de cuerpos cetónicos; evita degradación de
proteínas del músculo; cuando se terminan las grasas,
comienza degradación de proteínas del músculo y Muerte.
Hígado de una persona bien nutrida está envuelto en:
 
Síntesis de glucógeno y grasas
 
Glucogénico, lipogénico y glucolítico
Hígado de una persona en ayuno es:
 
Glucogenolítico, gluconeogénico,
cetogénico y proteolítico.
Hígado es regulado entre estos estados metabólicos
por:
  Insulina, glucagón y epinefrina
 
[sustrato], alosterismo, modificaciones covalentes
Efectos de Hormonas
[Sustrato] controla rutas metabólicas
[Ácidos Grasos] de la sangre que entran
al hígado controlan formación de cuerpos
cetónicos.
Síntesis de Grasas no ocurre hasta que
se consumen grandes cantidades de
sustratos lipogénicos.
Síntesis de glucosa en el hígado depende
de sustratos gluconeogénicos en el hígado.
ALOSTERISMO
Well –Fed State
 Glucosa inactiva fosforilasa de glucógeno y
activa sintetasa de glucógeno
 Fructosa 2,6-Bifosfatada activa PFK1 e inhibe
fructosa 1,6 bifosfatasa
 Fructosa 1,6-Bifosfatada activa kinasa de piruvato
 Piruvato activa deshidrogenasa de piruvato
ALOSTERISMO
Fasting State
 Acetil CoA activa carboxilasa de piruvato e inhibe
Deshidrogenasa de piruvato.
 Citrato inhibe PFK1, inhibe entrada a Ciclo de Krebs.
 cAMP activa PKA, promueve regulación covalente
de múltiples enzimas.
 NADH, producto de β-oxidación, inhibe
entrada al Ciclo de Krebs.
MODIFICACIONES COVALENTES
 Fosforilación de enzimas claves.
 Defosforilación de enzimas claves.
Ejemplos: fosforilasa de glucógeno, sintetasa de
glucógeno, kinasa de piruvato, deshidrogenasa de
piruvato, etc.
ALTERACIONES EN METABOLISMO
OBESIDAD
En E.U., 30% adultos obesos y 35% sobrepeso (BMI >25).
Obesidad – aumenta riesgo de diabetes, enfermedades
cardiovasculares, derrame cerebral, cancer de colon, seno,
prostata y endometrio, entre otros. Diabetes = Fallo renal,
cicatrizacion anormal, amputaciones, neuropatia diabetica,
ceguera, etc.
Gastos Medicos, Planes de Salud, seguros de vida!!!!
Obesidad - resulta de consumir mas calorias en la dieta de
las que se requieren para llevar a cabo el metabolismo
normal del organismo.
ALTERACIONES EN METABOLISMO
OBESIDAD
Se ha comido mas de lo necesario, se acumulan grasas
en grandes cantidades.
Numero de adipocitos no incrementa, sólo su tamaño.
Tratamiento – disminuir consumo de comida y ejercicio.
Ejercicio no es tan eficiente como disminucion de lo que
Ingerimos.
Leptin (ratones) – gen de obesidad, se produce en
adipocitos, se transporta en la sangre hasta el cerebro,
actúa en el hipotálamo y reduce el apetito.
Adipose Tissue Releases Adipokines •  Adipose *ssue is also an endocrine organ •  Releases pep*de hormones called adipokines –  Carry informa*on about fuel stores to brain –  Includes lep*n, adiponec*n Lep1n is an Appe1te Suppressant •  Sent from adipose *ssue to brain  reduces appe*te •  First iden*fied in obese mice, product of OB gene –  Homozygous ob/ob mice ate con*nually, had elevated cor*sol, shivered, did not reproduce, had insulin resistance, were obese •  See Fig. 23-­‐33 •  When lep*n was injected, the mice lost weight, temperature returned to normal ALTERACIONES EN METABOLISMO
OBESIDAD
Animal con dos copias defectuosas del gen de leptin – obesos,
resistencia a insulina, defectos en crecimiento y defectos reproductivos.
Leptin – informa al hipotálamo que reservas de grasas son suficientes y
detiene consumo.
Ob/ob Mice: Untreated vs. Treated with Lep1n Defects in the lep1n receptor also produced obese mice •  Db/db mice were obese and diabe*c •  DB gene encodes lep*n receptor in brain –  Expressed mostly in hypothalmus •  Almond-­‐sized region of brain, just above brain stem, links endocrine system to neurons •  Associated with ea*ng behavior •  See Fig. 23-­‐34a Hypothalmic Regula1on of Food Intake and Energy Expenditure Hormones that Control Ea1ng Lep1n is a fuel-­‐burning, appe1te-­‐
suppressing hormone •  S*mulates produc*on of anorexigenic (appe*te-­‐suppressing) hormones •  S*mulates sympathe*c nervous system •  Triggers cascade that regulates gene expression •  May be involved in hard-­‐wiring of neuronal circuits during development Lep1n resistance occurs in obese individuals •  Restoring lep*n to ob/ob mice results in restora*on to normal body mass •  BUT, lep*n administra*on to most obese people does NOT restore normal body mass –  This was a great disappointment to the pharmaceu*cal industry –  Lep*n is in fact elevated in many cases of obesity •  Something downstream in lep2n response must be defec2ve (“lep2n resistance”) The Type 2 Diabetes Epidemic •  90% of diabetes cases are type 2 •  300 million diagnosed cases world-­‐wide and growing •  Hallmark is resistance to insulin •  Ini*ally, the body responds by making more insulin •  Over *me, some individuals have to supplement with insulin Type 2 Diabetes and Metabolic Syndrome •  Believed to affect 27% of adult U.S. popula*on •  Cluster of symptoms along with insulin resistance: – 
– 
– 
– 
– 
Abdominal obesity High triglycerides (TAGs) Low HDL High blood pressure Elevated blood glucose (but may not be full-­‐blown diabe*c) –  O`en includes other signs of inflamma*on Link with Obesity and Gene1cs •  80% of individuals with type 2 diabetes are obese •  But most obese people don’t develop type 2 diabetes •  Gene*c variants may predispose people The “Lipid Burden” Hypothesis to Explain the Path to Type 2 Diabetes •  Adipocytes become packed and unable to accommodate more TAG •  Inability to deposit TAG leads to ↑ FA in blood •  Excess FA enter muscle and liver, create TAG lipid droplets, cause these organs to lose sensi*vity to insulin Ul*mately, blood glucose levels rise ALTERACIONES EN METABOLISMO
Diabetes Mellitus (Noninsulin-dependent, Type II)
Diabetes de personas en mediana edad (maturity-onset)
Presencia de insulina pero resistencia a la acción de
insulina (problemas en los receptores).
Obesidad - factor contribuyente en este tipo de Diabetes.
Debido a la resistencia, la cantidad de insulina producida
no es suficiente.
Dieta muchas veces es suficiente para controlar Diabetes
Tipo II.
ALTERACIONES EN METABOLISMO
Diabetes Mellitus (Insulin-dependent, Type I)
Diabetes en niños (juvenile-onset).
Ausencia de insulina. Hígado permanece gluconeogénico y
cetogénico aún en presencia de altos niveles
de glucosa. No es posible hacer el cambio a: glucólisis,
glucogenólisis y síntesis de grasas.
Paciente padece de hiperglicemia.
Degradación de grasas sin control en tejido adiposo,
incrementa niveles de ácidos grasos en la sangre y
formación de cuerpos cetónicos en el hígado.
Tratamiento – inyección de insulina.
ALTERACIONES EN METABOLISMO
Hígado Graso
Acumulación de ácidos grasos y triglicéridos en los hepatocitos.
Un tipo de esta enfermedad es asociado a consumo excesivo de alcohol.
Inflamación hepática, fibrosis y cirrosis.
Otro tipo no es asociado al consumo de alcohol (resistencia a insulina,
obesidad, diabetes, stress oxidativo, liberación de citoquinas, niveles de
colesterol y triglicéridos altos).
No existen drogas para tratar la enfermedad al momento. Se recomienda
cambiar la dieta y mayor actividad física.
Algunas drogas utilizadas en tratamiento de cáncer y enfermedades
cardiovasculares pueden causar el hígado graso.
DIETAS
Glycemic Index (GI)
Measurement of the effects of carbohydrates (CHO) on blood sugar
levels.
CHO that break down QUICKLY during digestion and release glucose
rapidly into the bloodstream have a HIGH GI.
CHO that break down SLOWLY during digestion and release glucose
slowly into the bloodstream have a LOW GI.
Lower glycemic index equates lower insulin demand (but not always).
It is better to measure Insulin Index vs. Glycemic Index – a direct
measure of insulin response to food.
DIETAS
Glycemic Index (GI)
White Bread: GI = 100
Glucose: GI = 140
Low GI (55 or less): fruits and vegetables (no potatoes or watermelon),
whole grain breads, pasta, legumes, milk, fructose.
Medium GI (56-69): whole wheat, sweet potato, table sugar
Hi GI (70 and above): corn flakes, rice crispies, baked potatoes,
croissants, white bread.
Life is Beautiful!
Chocolate Cake or Ice Cream – Low GI
DIETAS
South Beach Diet
Bad Carbs vs. Good Carbs.
Bad Fats vs. Good Fats
South Beach Diet is based on GI
Eliminates trans-fats, low saturated fats. These are replaced by omega
3-fatty acids and unsaturated fats (contribute to HDL cholesterol).
No red meat and poultry. These are replaced with lean meats, nuts and
oily fish.
First Week – no CHO 8 to 12 lbs in 2 weeks!!!!!
DIETAS
Atkins Diet
Reduce CHO intake and you will loose weight.
No CHO, no sugar…. Lots of Proteins, fibers and fats.
First Week – CHO restricted to 20g per day!!!!!
What can you eat during the first stage of the Atkins Plan? Lots of
proteins. This means you can load up on eggs, meat, and seafood. But
there are exceptions. You can’t eat breaded meats such as veal schnitzel
or meat loaf. I don’t usually think of bacon and eggs as a diet food, but
this combination is sort of OK. You must hold the toast and jelly, the
coffee, the orange juice, and the hash browns (NO potatoes).
Some vegetables are OK. Be careful to count your vegetable
carbohydrates as most of your carbs come from the veggies. List of
permitted vegetables in approximate order of carbohydrate contents,
starting with the lowest: Bean or alfalfa sprouts, greens such as lettuce,
spinach, radicchio, and endives, herbs, celery, radishes, cabbage (or
sauerkraut), mushrooms, avocado, cucumbers, asparagus, green and
wax beans, broccoli, cauliflower, green, red, and jalapeno peppers,
summer squash (including zucchini), green onions, leeks, brussels
sprouts, snow peas, tomatoes, eggplant, artichoke hearts, onions,
spaghetti squash, carrots, turnips, water chestnuts, and pumpkins.
Sangre – Transportador de Oxígeno,
Metabolitos y Hormonas
Blood Glucose Levels in
Atkins Diet 64.5mg/100mL
DIETAS
Paleo Diet
The Paleo Diet is based upon everyday, modern foods that mimic the food
groups of our pre-agricultural, hunter-gatherer ancestors.
Higher protein intake – Protein comprises 15 % of the calories in the
average western diet, which is considerably lower than the average values of
19-35 % found in hunter-gatherer diets. Meat, seafood, and other animal
products represent the staple foods of modern day Paleo diets.
Lower carbohydrate intake and lower glycemic index – Non-starchy fresh
fruits and vegetables represent the main carbohydrate source and will
provide for 35-45 % of your daily calories. Almost all of these foods have low
glycemic indices that are slowly digested and absorbed.
Higher fiber intake – Dietary fiber is essential for good health, whole grains
aren’t the place to find it. Non-starchy vegetables contain 8X more fiber than
whole grains and 31 times more than refined grains. Even fruits contain twice
as much fiber as whole grains and seven times more than refined grains.
DIETAS
Paleo Diet
Moderate to higher fat intake dominated by monounsaturated and
polyunsaturated fats with balanced Omega-3 and Omega-6 fats –Cut the
trans fats and the Omega-6 polyunsaturated fats in your diet and increase
the healthful monounsaturated and Omega-3 fats that were the mainstays of
Stone Age diets.
Higher potassium and lower sodium intake – Unprocessed, fresh foods
naturally contain 5 to 10 times more potassium than sodium, and Stone Age
bodies were adapted to this ratio. Potassium is necessary for the heart,
kidneys, and other organs to work properly. Low potassium is associated
with high blood pressure, heart disease, and stroke – the same problems
linked to excessive dietary sodium.
Net dietary alkaline load that balances dietary acid – After digestion, all
foods present either a net acid or alkaline load to the kidneys. Acid producers
are meats, fish, grains, legumes, cheese, and salt. Alkaline-yielding foods
are fruits and veggies. Higher intake of, vitamins, minerals, antioxidants,
and plant phytochemicals.
DIETAS
Mediterranean Diet
High consumption of fruits, vegetables, breads, cereals, potatoes,
beans and seeds.
Olive oil.
Dairy products and poultry (low to moderate amounts).
Little red meat, eggs (0 to 4 times per week), Red Wine (low to
moderate) !!!!! What is moderate????
For this diet, the calories come from fats. This diet has been associated
with a significant increase in obesity in European countries.
Mediterranean Diet
A 2011 study published in the Journal of the American College of
Cardiology covering about 535,000 people to examine the effect of a
Mediterranean diet reported that a Mediterranean diet is associated with
lower blood pressure, blood sugar, and triglycerides.
A study published in the American Journal of Clinical Nutrition in 2013
compared Mediterranean, vegan, vegetarian, low-glycemic index, lowcarbohydrate, high-fiber, and high-protein diets with control diets. The
research concluded that Mediterranean, low-carbohydrate, low-glycemic
index, and high-protein diets are effective in improving markers of risk for
cardiovascular disease and diabetes.
A recent randomized Spanish trial of diet pattern published in the
New England Journal of Medicine in 2013 followed almost 7,500 individuals
over around 5 years found that individuals on a Mediterranean diet
supplemented with mixed nuts and olive oil had a 30 percent reduction in risk
of having a major cardiovascular event and a 49 percent decrease in stroke
risk. Subjects followed one of three different diets. They included either a low
fat diet, a Mediterranean diet with 50 ml of extra virgin olive oil daily or a
Mediterranean diet with 30 grams of mixed nuts. The nuts were primarily
walnuts which have a high amount of omega-3 fatty acids.
DIETAS
Jenny Craig Diet
Expensive, personal, tailored for you, closely monitored.
1,200 calories per day.
You should loose 1-2 lbs per week.
Balanced calorie-controlled diet that improves your eating habits.
This diet plan recommends regular aerobic exercise.
The Best Overall Diets
(according to U.S. News)
The Best Overall Diets
(according to U.S. News)
The Best WeightLoss Diets
(according to U.S.
News)
Atkins - #6
Paleo – last (#29)
Alli or Orlistat Tablets
“Loosing Weight without the Pain”
Inhibits gastrointestinal lipase, an enzyme that breaks down triglycerides in the intestine.
Without this enzyme, triglycerides from the diet are prevented from being hydrolyzed into
absorbable free fatty acids and are excreted undigested. Only trace amounts of orlistat
are absorbed systemically; the primary effect is local lipase inhibition within the GI tract
after an oral dose. The primary route of elimination is through the feces. At the standard
prescription dose of 120 mg three times daily before meals, orlistat prevents
approximately 30% of dietary fat from being absorbed.
Efficacy - After orlistat was stopped, a significant number of subjects regained weight—
up to 35% of the weight they had lost.
Side effects - The primary side effects of the drug are gastrointestinal-related, and
include oily, loose stools; because orlistat blocks some of the dietary fat from being
absorbed, the fat is excreted unchanged in the feces—, fecal incontinence, frequent or
urgent bowel movements, and flatulence. To minimize these effects, foods with high fat
content should be avoided; the manufacturer advises consumers to follow a low-fat,
reduced-calorie diet.
Alli or Orlistat Tablets
Suplementos para “Pompearse”
“For Bodybuilding and Anaerobic Exercise”
Proteins (casein, whey), creatine, multivitamins, growth hormone,
amino acids, soy, etc.
Creatine – energy source for skeletal muscle. Ingesting creatine can
boost the creatine content of the muscle (gain in muscle mass).
Increases performance in high intensity anaerobic exercise by
increasing the level of phosphocreatine up to 20 %. This equals to more
ATP (energy) available to do work.
Long-term use associated with renal disease. Cramping in short-term
use associated with dehydration.
“Suplementos Naturales y Otras Vainas…”
Té Chino del Dr. Ming (“ingredientes naturales” para adelgazar)
Fataché (Atrapa Grasas)
Carbotrap (“CHO blocker”)
Fat Loss Sliming (“sibutramina” ha causado escándalo de softbolista
de PR - Aranzamendi)
Raqueteros!
MUCHO
ÉXITO!
Felices Vacaciones!!!!