A low fermentable oligo-di-mono saccharides and polyols (FODMAP) diet reduced pain and improved daily life in fibromyalgia patients

Fibromyalgia (FM) is a chronic, rheumatic disease characterized by widespread myofascial pain, of unknown aetiology, having a major impact on quality of life (QOL). Available pharmacotherapy for FM is marginally effective. FM is associated with co-morbidities of gastrointestinal (GI) disorders and Irritable Bowel Syndrome (IBS). There is growing evidence that diets low in FODMAPs, “fermentable oligo-, di- or mono-saccharides and polyols” [Low FODMAP Diet (LFD)], are effective in treating IBS. The aim of this pilot study was to examine the effects of LFDs on symptoms of FM, especially with regard to pain, QOL and GI disorders. Methods A longitudinal study using LFD intervention was performed on 38, 51 ± 10 year-old, female patients diagnosed with FM for an average of 10 years, based on ACR (American College of Rheumatology) 2010 criteria. The study was conducted from January through May, 2015, using a four-week, repeated-assessment model, as follows: Moment 0 – introduction of the protocol to participants; Moment 1 – first assessment and delivery of individual LFD dietary plans; Moment 2 – second assessment and reintroduction of FODMAPs; Moment 3 – last assessment and final nutritional counselling. Assessment tools used were the following: RFIQ (Revised Fibromyalgia Impact Questionnaire), FSQ (Fibromyalgia Survey Questionnaire), IBS-SSS (Severity Score System), EQ-5D (Euro-QOL quality of life instrument), and VAS (Visual Analogue Scale). Daily consumption of FODMAPs was quantified based on published food content analyses. Statistical analyses included ANOVA, non-parametric Friedman, t-student and Chi-square tests, using SPSS 22 software. Results The mean scores of the 38 participants at the beginning of the study were: FSQ (severity of FM, 0–31) – 22 ± 4.4; RFIQ (0–100) – 65 ± 17; IBS-SSS (0–500) – 275 ± 101; and EQ-5D (0–100) – 48 ± 19. Mean adherence to dietary regimens was 86%, confirmed by significant difference in FODMAP intakes (25 g/day vs. 2.5 g/day; p < 0.01). Comparisons between the three moments of assessment showed significant (p < 0.01) declines in scores in VAS, FSQ, and RFIQ scores, in all domains measured. An important improvement was observed with a reduction in the severity of GI symptoms, with 50% reduction in IBS scores to 138 ± 117, following LFD therapy. A significant correlation (r = 0.36; p < 0.05) was found between improvements in FM impact (declined scores) and gastrointestinal scores. There was also a significant correlation (r = 0.65; p < 0.01) between “satisfaction with improvement” after introduction of LFDs and “diet adherence”, with satisfaction of the diet achieving 77% among participants. A significant difference was observed between patients who improved as compared to those that did not improve (Chi-square χ2 = 6.16; p < .05), showing that the probability of improvement, depends on the severity of the RFIQ score. Conclusions Implementation of diet therapy involving FODMAP restrictions, in this cohort of FM patients, resulted in a significant reduction in GI disorders and FM symptoms, including pain scores. These results need to be extended in future larger studies on dietary therapy for treatment of FM. Implications According to current scientific knowledge, these are the first relevant results found in an intervention with LFD therapy in FM and must be reproduced looking for a future dietetic approach in FM.

Identification with the neighborhood: Discrimination and neighborhood size

This paper analyzes the impact of a geographical social grouping (neighborhood) and its relative perceived size in the spontaneous group’s identiication level and place satisfaction, as well as the intensity of and motives for discrimination against inhabitants of other places. Two studies are presented: an experimental one using the minimal group categorization paradigm and an onsite investigation of a city neighborhood. Consistent with the predictions, the results showed that smaller neighborhoods reported higher identiication and satisfaction with the place of residence, as well as higher discrimination of other neighborhoods. In line with the optimal distinctiveness theory (ODT), the indings showed that the motivation for discrimination varies as a function of the in-group size. Thus, the members of larger groups discriminate by increasing the diferentiation between the in-group and the out-group, whereas the members of smaller groups increased the value of the in-group. Furthermore, the results were consistent with a social identity theory and ODT explanation of diverse research that shows the non-trivial nature of geographical bounded social grouping and its importance in a diverse set of contexts and its impact in inter-neighborhood relationships.

Efeitos da dança criativa em mulheres idosas

Objectivo: Verificar os efeitos da prática da Dança Criativa (DC) em mulheres idosas, no peso (P), altura (A), índice de massa corporal (IMC), perímetro abdominal (PA), força, resistência e flexibilidade dos membros superiores e inferiores (F, R, FL-MS/MI), mobilidade física (MF) [agilidade (AG), velocidade (V), equilíbrio dinâmico (ED)], resistência aeróbia (RA) e satisfação com a vida (SV). Método: A amostra foi de 57 mulheres, entre os 65 e os 80 anos, tendo sido distribuídas aleatoriamente pelo grupo de controlo (GC) (n=25) e pelo grupo experimental (GE) (n=32). Este último frequentou aulas de DC durante 6 meses, 3 vezes por semana, com a duração de 50'. A análise estatística foi efectuada através do SPSS 17, b:mdo sido utilizadas técnicas não paramétricas. As variáveis funcionais foram avaliadas através da bateria funcional Fitness Test (Rikli & Jones, 1999) - Idosos e a SV através da Satisfaction with Live Scale (SWLS), (Diener, Larsen and Gri1fin, 1985). Resultados: Os resultados demonstraram diferenças significativas, para melhor, em todas as variáveis, excepto no P, no PA e na FLMS, entre o início e os 3 meses e entre o início E os 6 meses. No P e no PA foram observadas diferenças entre os 3 e os 15 meses. Na FRMS ambos os grupos apresentaram diferenças significativas, para melhor, e na FLMS só o GC apresentou diferenças significativas para pior. Não havia diferenças significativas entre o GE e o GC no início do estudo, excepto na RA. Conclusões: A DC promove melhorias no P; A; IMC; PA; F, R, FL-MI; MF; RA e SV em mulheres idosas. ABSTRACT: Objective: To test and verify the effects of the practice of Creative Dance in the weight, height, body mass, abdominal perimeter, strength, resistance and flexibility of the lower and upper limbs, as well as physical mobility (agility, velocity, dynamic balance), aerobic resistance and life satisfaction in elderly women. Method: 57 females constituted the sample analyzed within the ages of 65 and 80 years old randomly divided between the control group (25) and the experimental group (32). The experimental group attended 50 minutes’ classes prepared and orientated to the target core of this study during six months. The statistical analysis was processed with SPSS 17 software under non-parametric techniques. The functional battery Fitness Test (Rikli & Jones, 1999) was used to evaluate the functional variables and life satisfaction was accessed trough the Satisfaction with Live Scale (SWLS), (Diener, Larsen and Griffin, 1985). Results: The results defined positive significant differences in all variables evaluated, except weigh, abdominal perimeter and flexibility of the upper limbs between the beginning and the 3-month and the beginning and the 6- month. Differences were observed in weight and abdominal perimeter between the 3 and 6 months. 8oth groups showed considerable positive differences in the strength and resistance of the upper limbs and only the control group showed negative differences in flexibility of the upper limbs. At the beginning of the study there were no significant differences between the two groups, except in the aerobic resistance. Conclusions: Creative Dance promotes the improvement of weight, height, body mass index, abdominal perimeter, strength, resistance, flexibility of both upper and lower limbs in elderly women.