Eating Disorders: The Systemic Effects of Platelet-Rich Plasma Injection.
The Systemic Effects of Platelet-Rich Plasma Injection.
Filed under: Eating Disorders
Am J Sports Med. 2012 Dec 4;
Wasterlain AS, Braun HJ, Harris AH, Kim HJ, Dragoo JL
BACKGROUND:Platelet-rich plasma (PRP) is an autologous blood product used to treat acute and chronic tendon, ligament, and muscle injuries in over 86,000 athletes in the United States annually. The World Anti-Doping Agency (WADA) banned intramuscular PRP injections in competitive athletes in 2010 because of concerns that it may increase performance-enhancing growth factors. The ban on PRP was removed in 2011 because of limited evidence for a systemic ergogenic effect of PRP, but the growth factors within PRP remain prohibited. PURPOSE:To quantify the effect of PRP injection on systemic growth factors with performance-enhancing effects and to identify molecular markers to detect treated athletes. STUDY DESIGN:Descriptive laboratory study. METHODS:Six ergogenic growth factors monitored by WADA-human growth hormone (hGH), insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), basic fibroblast growth factor (bFGF or FGF-2), vascular endothelial growth factor (VEGF), and platelet-derived growth factor-BB (PDGF-BB)-were measured in 25 patients before (baseline) and at 0.25, 3, 24, 48, 72, and 96 hours after intratendinous leukocyte-rich PRP injection. Eating and exercise were prohibited for 3 hours before testing. Growth factors were quantified by enzyme-linked immunosorbent assay, and the change relative to each patient’s baseline was calculated. RESULTS:Relative to serum, PRP contained significantly more bFGF (226 vs 5 pg/mL), VEGF (1426 vs 236 pg/mL), and PDGF-BB (26,285 vs 392 pg/mL), but IGF-1 and hGH were not elevated. Serum levels increased significantly for IGF-1 at 24 and 48 hours, for bFGF at 72 and 96 hours, and for VEGF at 3, 24, 48, 72, and 96 hours after PRP injection. Additionally, VEGF was increased in all 25 patients after PRP treatment. CONCLUSION:Serum IGF-1, VEGF, and bFGF levels are significantly elevated after PRP injection, supporting a possible ergogenic effect of PRP. An indirect marker for hGH doping, the product of IGFBP-3 × IGF-1, also significantly increased after PRP. Platelet-rich plasma appears to trigger an increase in circulating growth factors through activating biological pathways rather than by serving as a vehicle for the direct delivery of presynthesized growth factors. Elevated VEGF was observed in all patients after PRP, and ?88% of patients had elevated VEGF at each time point from 3 to 96 hours after PRP, suggesting that VEGF may be a sensitive molecular marker to detect athletes recently treated with PRP. CLINICAL RELEVANCE:This is the first and only adequately powered study of the systemic effects of PRP. We present evidence that PRP contains and may trigger systemic increases in substances currently banned in competitive athletes. Finally, we provide evidence that VEGF could serve as a useful molecular marker to detect athletes treated with PRP.
HubMed – eating
Preventing excessive gestational weight gain-a secondary analysis of a cluster-randomised controlled trial.
Filed under: Eating Disorders
Eur J Clin Nutr. 2012 Dec; 66(12): 1344-50
Kinnunen TI, Raitanen J, Aittasalo M, Luoto R
Background:Healthy diet, physical activity and modest weight gain during pregnancy may prevent developing gestational diabetes mellitus (GDM). We examined whether a lifestyle intervention designed to prevent GDM was effective in reducing excessive gestational weight gain (GWG).Methods:A cluster-randomised controlled trial (n=399) was conducted in maternity clinics in 14 municipalities in Southern Finland. Pregnant women with at least one risk factor for GDM (for example, overweight) but no pre-existing diabetes were recruited at 8-12 weeks’ gestation. The intervention included counselling on GWG, physical activity and healthy eating at five routine visits. Usual counselling practices were continued in the usual care municipalities. Statistical analyses were performed using multilevel linear and logistic regression models adjusted for weeks’ gestation at last weight measurement, pre-pregnancy body mass index and smoking status.Results:The intervention group had a lower mean GWG by weeks’ gestation than the usual care group (adjusted coefficient for the between-group difference -0.016?kg per day, P=0.041). There was no difference in mean (±s.d.) GWG between the intervention and the usual care groups (13.7±5.8 vs 14.3±5.0?kg, P=0.64). In total, 46.8% of the intervention group and 54.4% of the usual care group exceeded the GWG recommendations. The adjusted odds ratio for excessive GWG was 0.82 (95% CI 0.53-1.26, P=0.36) in the intervention group as compared with the usual care group.Conclusions:The intervention had minor effects on GWG among women who were at increased risk for GDM. In order to prevent excessive GWG, additional focus on restriction of energy intake may be needed.
HubMed – eating
Preschool children with lower executive function may be more vulnerable to emotional-based eating in the absence of hunger.
Filed under: Eating Disorders
Appetite. 2012 Dec 1;
Pieper JR, Laugero K
Decreased executive function (EF) has been linked to unhealthy eating behaviors and obesity in older children and adults, however little is known about this relationship in young children. One possible reason for this association is that individuals with degraded EF are more vulnerable to emotional-based overeating. Emotional eating may thus be more likely to occur in persons with lower self-control or ability to regulate emotions. A pilot project in a research-based preschool was conducted to examine the relationships between executive function, emotional arousal and eating in the absence of hunger (EAH) in three to six year-old children. Executive function was measured through child-completed tasks, parent questionnaires, and standardized teacher reports. Emotional arousal was measured via skin conductance. Children who had lower cognitive development scores as indicated by teacher reports had higher EAH. Increased emotional arousal was associated with increased EAH, but only in a subgroup of children who had a lower capacity for emotional regulation as suggested by lower delay of gratification scores, lower effortful control (parent questionnaire), and overall lower teacher-reported cognitive development. Further studies are necessary to determine whether interventions to improve executive function and emotional regulation in young children may also have the benefit of improving eating behaviors and decreasing risk of obesity in the long run.
HubMed – eating
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