Physical activity levels and energy intake according to the presence of metabolic syndrome among single-household elderly in Korea: Korean National Health and Nutrition Examination Survey 2016-2018.

Background: Exercise and dietary and nutritional intake affect the risk and prevalence of metabolic syndrome (MetS) in elderly people, effects that may differ according to sex in elderly single households (ESH). This study aimed to analyze the differences in physical activity (PA) levels and energy intake according to sex and prevalence of MetS among elderly people in Korea to investigate the relationships between these factors. Methods: Data from 893 elderly individuals (aged >65 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016-2018). We analyzed PA levels (occupational and recreational PA and place movement) and energy intake (EI; total, carbohydrate, protein, and fat), and found that there were sex differences in both according to the presence or absence of MetS in ESH. Results: Among both males and females, the MetS group had a significantly lower recreational moderate PA than the non-MetS group. However, total PA in males was significantly higher in the non-MetS than in the MetS group, but there was no significant difference in females. Furthermore, the EI of females did not differ in the presence or absence of MetS, except for fat intake, and in the nutritional intake of ESH in males, no difference was found in the presence or absence of MetS. We also found that in Odd ratio, "active" was associated with lowering high waist circumference (OR = 0.40, 95%CI = 0.21-0.76), and "very active" was associated with lower MetS occurrence (OR = 0.51, 95%CI = 0.33-0.81) and low high-density lipoprotein cholesterol (HDL-C) (OR = 0.55, 95%CI = 0.37-0.83). Conclusions: Therefore, in the MetS group of ESH, there was a significant correlation of the MetS component in PA rather than EI. Male ESH require interventions that increase PA, while female ESH require nutrition interventions that increase and balance PA. Therefore, a new program is needed that promotes continuous interest and healthy lifestyles in consideration of the characteristics of ESH.

Analysis of energy intakes, physical activities and metabolic syndrome according to the income level in Korean elderly people: Korean National Health and Nutrition Examination Survey 2016‒2018.

PURPOSE: To determine the correlations of differences in the income level with the presence of metabolic syndrome (MetS), energy intake, and physical activity across Korean elderly populations. METHODS: We obtained data from 2,139 elderly individuals (aged >65 years) based on the Korea National Health and Nutrition Examination Survey (KNHANES) (2016‒2018). We analyzed the levels of physical activity (PA) and energy intake using the survey data. Moreover, we analyzed the differences in energy intake and PA levels according to the income level and MetS. RESULTS: Compared with the non-MetS group, the MetS group displayed significantly higher levels of waist circumference (p=0.000), triglycerides (p=0.000), systolic blood pressure (p=0.000), diastolic blood pressure (p=0.016), and fasting blood glucose (p=0.000) for both high and low income levels. However, the level of high-density lipoprotein cholesterol was significantly lower in the MetS group than that in the non-MetS group (p=0.000). The level of smoking in non-MetS men was significantly higher than that in MetS men across all participants (p=0.047). Except carbohydrate intake, the total energy intake (p=0.022), fat intake (p=0.009), and protein intake (p=0.005) were significantly lower in the MetS group than those in the non-MetS group for high income levels. We obtained similar results for low income levels. The two-way analysis of variance (ANOVA) did not identify an interaction between the income level and the presence of MetS; however, the total energy, i.e., the level of total energy intake, was significantly lower in participants with low income levels than in those with high income levels. For high income levels, transport PA (p=0.002), vigorous recreational PA (p=0.001), moderate recreational PA (p=0.001), and total PA (p=0.000) were significantly lower in the MetS group than those in the non-MetS group. For low income levels, moderate occupational PA (p=0.012), transport PA (p=0.018), and total PA ((p=0.000) were significantly lower in the MetS group than those in the non-MetS group. The total PA, i.e., the level of energy consumption, was significantly lower in the elderly with low income levels than in those with high income levels. CONCLUSION: Regardless of the income level, the elderly with MetS exhibited low levels of energy intake and PA, compared with those without MetS. In addition, regardless of the presence of MetS, the elderly with low income levels exhibited lesser energy intake and PA. These findings implied the need for balanced nutrient intake and increased participation in PA as well as education and program development to prevent MetS in the elderly.

Impact of Body Mass Index on Muscle Strength, Thicknesses, and Fiber Composition in Young Women.

High body mass index (BMI) may influence muscle strength, muscle thickness (Mtk), and fiber composition. We evaluated these parameters in 31 and 27 women grouped in non-oral contraceptive (non-OC) groups and OC groups, respectively, and further divided them into groups based on BMI: BMIlow, BMInorm, and BMIhigh. Maximum isometric force (Fmax), Mtk, and the relative percentage of muscle fiber composition (%) were examined in both groups. Fmax and Mtk values were significantly greater in the BMIhigh than the BMIlow within the OC group. However, there was no significant difference in the non-OC group. BMIlow and BMInorm groups showed a difference in the distribution of muscle fiber types 1 and 2 with almost the same proportions in both non-OC and OC groups. However, the BMIhigh group showed a difference in the distribution of muscle fiber types 1 and 2, with type 1 about 18.76% higher in the non-OC group. Contrastively, type 2 was about 34.35% higher in the OC group. In this study, we found that there was a significant difference in Fmax and Mtk according to the BMI level in the OC group, but no significant difference was found in the non-OC group. Moreover, the distribution of type 2 muscle fibers tended to be higher in the OC group of BMIhigh, although the sample size was small. Therefore, although no significant difference of Fmax and Mtk was found according to BMI level in the non-OC group in this study, the increase in BMI level appeared to be more associative of muscle strength in the OC group. Based on the present results, future studies are needed that consider the BMI level as well as the presence or absence of OC in future research about women's muscle strength.

Effects of oral contraceptive use on muscle strength, muscle thickness, and fiber size and composition in young women undergoing 12 weeks of strength training: a cohort study.

BACKGROUND: It is suspected that hormonal fluctuations during menstruation may cause different responses to strength training in women who use oral contraceptives (OC) versus those who do not. However, previous studies that investigated the existence of such differences produced conflicting results. In this study, we hypothesized that OC use has no effect on muscle strength and hypertrophy among women undergoing strength training. Thus, we compared the differences in muscle strength and thickness among women who used OCs and those who did not. METHODS: We investigated the influence of OC use on muscle strength (Fmax), muscle thickness (Mtk), type 1-to-type 2 muscle fiber (NO) ratio, muscle fiber thickness (MFT), and nuclear-to-fiber (N/F) ratio. Seventy-four healthy young women (including 34 who used OCs and 40 who did not) underwent 12 weeks of submaximal strength training, after which Fmax was evaluated using a leg-press machine with a combined force and load cell, while Mtk was measured using real-time ultrasonography. Moreover, the NO ratio, MFT, and N/F ratio were evaluated using muscle needle biopsies. RESULTS: Participants in the non-OC and OC groups experienced increases in Fmax (+ 23.30 ± 10.82 kg and + 28.02 ± 11.50 kg respectively, p = 0.073), Mtk (+ 0.48 ± 0.47 cm2 and + 0.50 ± 0.44 cm2 respectively, p = 0.888), Fmax/Mtk (+ 2.78 ± 1.93 kg/cm2 and + 3.32 ± 2.37 kg/cm2 respectively, p = 0.285), NO ratio (type 2 fibers: + 1.86 ± 6.49% and - 4.17 ± 9.48% respectively, p = 0.169), MFT (type 2 fibers: + 7.15 ± 7.50 µm and + 4.07 ± 9.30 µm respectively, p = 0.435), and N/F ratio (+ 0.61 ± 1.02 and + 0.15 ± 0.97 respectively, p = 0.866) after training. There were no significant differences between the non-OC and OC groups in any of these parameters (p > 0.05). CONCLUSIONS: The effects of 12 weeks of strength training on Fmax, muscle thickness, muscle fiber size, and composition were similar in young women irrespective of their OC use.

Household-specific physical activity levels and energy intakes according to the presence of metabolic syndrome in Korean young adults: Korean National Health and nutrition examination survey 2016-2018.

BACKGROUND: Participation in exercise, and dietary and nutritional intakes have an impact on the risk and prevalence of metabolic syndrome (MetS), but these effects may differ according to whether a person lives alone or in a multi-person household. We analyzed differences in physical activity (PA) levels and energy intake according to household-type and MetS presence among young adults, to investigate the relationships among these factors. METHODS: Data of 3974 young adults (aged > 19 years and < 40 years) were obtained from the Korean National Health and Nutrition Examination Survey (2016-2018). We analyzed PA levels (occupational and recreational PA, and transport) and energy intake (total, carbohydrate, protein, and fat). RESULTS: Logistic regression data showed that low PA levels and higher energy intake were associated with MetS incidence and its components in young adults, after adjusting for body mass index, smoking, household-type, and sex. Overall, there was no significant difference in PA level between the MetS and non-MetS group. The total energy intake was higher in the MetS than in the non-MetS group (p <  0.05). These results were similar to those found in multi-person households. In single-person households, the MetS group had significantly lower PA levels (p <  0.01) and total energy intake (p <  0.05) than the non-MetS group. CONCLUSIONS: We found significant association among low PA levels, high energy intake, and MetS components in young Korean adults, but with patterns differing according to household type. Energy intake was higher in young adults with than those without MetS, who lived in multi-person households, while young adults with MetS who lived alone had lower PA levels and lower energy intake than those without MetS. These findings highlight the need for different approaches of implementing PA and nutrition strategies according to the type of household in order to prevent MetS.

Comparative analysis of energy intake and physical activity according to household type and presence of metabolic syndrome in middle-aged men based on data from the 7th Korea national health and nutrition examination survey (KNHANES) (2016-2018).

PURPOSE: This study analyzed data from the 7th Korean National Health and Nutrition Examination Survey (2016‒2018) to compare the differences in energy intake and physical activity (PA) levels in middle-aged Korean men aged 40-59 years according to household type and the presence of metabolic syndrome (MetS). METHODS: Data from 2,266 young adults (aged >39 years and <60 years) were obtained from the KNHANES. We analyzed the differences in energy intake and PA levels according to household type and MetS. The presence or absence of MetS was determined by measuring waist circumference, blood pressure, fasting blood glucose, triglyceride, and HDL-C levels. RESULTS: Regarding total nutritional intake, no relationship with MetS was observed regardless of household type (interaction between MetS and household type: p = 0.875). No differences in total PA were observed between multiple- and single-person households (interaction between MetS and household type: p = 0.122). The relationship between MetS and MetS components according to nutritional intake showed that participants with a higher energy intake had a 27% lower prevalence of low high-density lipoprotein cholesterol (HDL-C) (p < 0.05) and a 36% higher prevalence of high blood pressure (p < 0.01). The relationship between MetS and MetS components according to the PA level showed significantly reduced prevalence of MetS by approximately 39%, 35%, and 43% (p < 0.01, 0.01, and 0.001) in subjects who were somewhat active, active, and very active, respectively, compared to inactivity. CONCLUSION: Middle-aged men showed no difference in nutritional intake and PA between multiple- and single-person households. However, the risk of MetS was significantly higher in participants with approximately 1.5 times the energy intake compared to the group with the lowest energy intake. Moreover, higher levels of PA had a marked positive effect on the risk factors and prevalence of MetS. Therefore, we suggest that reducing the total energy intake and increasing total PA are important for preventing MetS in middle-aged men regardless of household type.

The effect of oral glucose tolerance testing on changes in arterial stiffness and blood pressure in elderly women with hypertension and relationships between the stage of diabetes and physical fitness levels.

PURPOSE: The purpose of this study was to assess changes in blood glucose level, blood pressure, and arterial stiffness after a 75 g oral glucose tolerance test (OGTT) in elderly women aged over 65 years with hypertension and either normal glycemic control, impaired fasting glucose tolerance, or diabetes mellitus. We also wished to investigate the relationship between stages of diabetes and physical fitness. METHODS: A total of 24 elderly women with hypertension were assigned to a control group (CON; n=7), impaired fasting glucose group (IFG; n=9), and diabetes mellitus group (DM; n=8). In each group, blood glucose level, brachial ankle pulse wave velocity (PWV), and blood pressure were measured at baseline as well as 60 and 120 minutes after a 75 g OGTT. Physical fitness factors such as hand grip strength, balance test, 4 m gait speed test, chair stand test, short physical performance battery, and 6-minute walking test were subsequently assessed. RESULTS: In all three groups, blood glucose levels were significantly increased at 60 and 120 minutes after a 75 g OGTT. In the DM group, blood glucose levels were significantly higher before and after a 75 g OGTT than in the CON group. In the CON group, PWV was significantly increased at 60 minutes after a 75 g OGTT; however, there were no changes in other groups after glucose ingestion. In the CON group, systolic and diastolic blood pressures were significantly decreased at 60 and 120 minutes after a 75 g OGTT compared to baseline. However, there was no change in blood pressure after ingestion in the DM group. The IFG group had greater grip strength than the CON group; however, there were no differences in other variables between the groups. CONCLUSION: After a 75 g OGTT, elderly women with hypertension and diabetes maintain higher blood glucose levels compared to those with hypertension alone. Unlike elderly women with hypertension alone, those with hypertension and diabetes did not show changes in arterial stiffness and blood pressure after a 75 g OGTT. Therefore, elderly women with hypertension and diabetes may not be able to control their blood vessels following a 75 g OGTT due to impaired vascular endothelial function. Moreover, there was no association between diabetes stage and physical fitness in elderly women with hypertension.

The resistance training effects of different weight level during menstrual cycle in female.

We examined the different effects of body mass index (BMI) level on resistance training during menstrual cycle. Thirty-six female subjects performed resistance training and subjects were divided into three groups: BMIunder, BMInorm, BMIover. Subjects completed 12 weeks of sub-maximal resistance training with 3 sets of 8-12 repetitions. Maximum isometric force test was measured before and after training in the follicular phase (FP) and the luteal phase (LP). Maximum isometric force of whole groups (BMIunder, BMInorm, BMIover) was significantly increased both FP and LP after 12-week resistance training. Maximum isometric force after training and absolute increase value in BMInorm and BMIover were no significantly different between FP and LP. However, significant different of maximum isometric force after training (FP, 79.08±11.60; LP, 84.05±12.38) and absolute increase value (FP, 9.63±5.47; LP, 15.13±6.06) were found between FP and LP just by BMIunder. We suggest that if muscle strength is measured in the FP (LP) before training and then they should be measured same phase, such as FP and LP after training and BMIunder can be influenced muscle strength in LP.

Differences in Ankle ROM Between Young Men and Women With a History of Ankle Sprain.

BACKGROUND: Ankle injuries are the most common injuries in sports. However, very little is known about sex differences in ankle range of motion (ROM) between ankle joints with an episode of ankle sprain (ASE) and those without an episode of ankle sprain (non-ASE). This study aimed to investigate the differences of ankle ROM between men and women with and without ASE. METHODS: 26 ASE had at least one episode of ankle injury in the last 6 to 12 months. 35 non-ASE served as a control group. All subjects were examined in supine position and the ankle ROM was calculated by the sum of inversion (IV), eversion (EV), plantar flexion (PF) and dorsiflexion (DF) in both ankles. RESULTS: Subjects with ASE had a significantly smaller ROM regarding EV than non-ASE subjects in both ankles. The male subjects with ASE had a significantly higher EV and IV compared with the female subjects. However, ROM in PF was significantly lower among men compared with women who had ASE. CONCLUSIONS: Our findings suggest that the ROM after ASE affects PF in male and EV in female patients. This could point to sex-based prevention and rehabilitation after ankle injury.

The influence of ovulation on postural stability (Biodex Balance System) in young female.

The purpose of this study was to examine the influence of ovulation (OV) on dynamic balance in young female. Thirty-two eumenorrheic healthy women participated in Biodex Balance System (BBS) test for postural stability and a limit of stability menstrual cycle. BBS was tested in the menses (MS), OV, and luteal phase (LP). The limits of stabilities (total, forward-left, forward-right, backward-left, and backward-right) were significantly higher in the OV (total, 61.44±14.77; forward-left, 67.50± 15.17; forward-right, 69.50±14.43; backward-left, 64.00±20.32; and back-ward-right, 69.06±13.59) than in the MS (total, 55.44±14.63; forward-left, 60.00±15.98; forward-right, 62.17±9.78; backward-left, 57.83±19.09; and backward-right, 57.28±13.73). Furthermore, the LP (65.11±13.79) was a significantly higher limit of stability than MS (57.28±13.73) during back-ward-right. The present study showed that estrogen negatively influences postural stability. The postural sway in limits of stabilities (total, forward-left, forward-right, backward-left, and backward-right) were significantly the greatest in the OV. Since there is a different postural stability between MS, OV, and LP, this should be taken into account when devising training programs to avoid risk factor of fall and joint injury.

The difference effect of estrogen on muscle tone of medial and lateral thigh muscle during ovulation.

The purpose of this study was to investigate the difference effect of estrogen on muscle tone of medial and lateral thigh muscle during ovulation (OV). Twenty-eight untrained eumenorrheic healthy women tested muscle stiffness and frequency of vastus medialis, vastus lateralis, semitendinosus, and biceps femoris during menstrual cycle (MC). MC were divided into menses (MS), OV, and luteal phase (LP). The muscle frequency of vastus medialis and semitendinosus were significant higher in OV (13.83±1.58 Hz, 15.62±2.39 Hz) than LP (13.18±0.85 Hz, 14.67± 1.62 Hz). Also the muscle stiffness of vastus medialis and semitendinosus were significant higher in OV (211.74±46.03 N/m, 241.95±48.35 N/m) than LP (184.26±26.09 N/m, 215.42±35.29 N/m). The present study showed the highest muscle stiffness and frequency at OV and this might be due to the rapid increase of sole hormone in estrogen. Especially, medial part of quadriceps and hamstrings might be influenced during the MC with high concentration of estrogen at OV.

Relationship between ankle range of motion and Biodex Balance System in females and males.

This study examined whether there are differences between range of motion (ROM) and balance in lower extremities according to gender. A total of 31 male and 28 female students measured plantar flexion (PF), dorsiflexion, inversion (IV), eversion (EV), hip flexion (HF), hip internal rotation (HIR), and hip external rotation (HER) and tested on the Biodex Balance System. ROM of PF and HF were significantly high the female group and ROMs of IV, EV, HIR, and HER were significantly higher the male group than in the female group. Low ROM of PF may be more negative related to overall balance, especially, back balance in males; therefore, it is necessary to assess and plan the training program for PF ROM in male students.

The effect of treadmill-based and track-based walking training on physical fitness in ankle-sprain experienced young people.

The purpose of this study was to evaluate the effects of 12-week treadmill-based (MT) and track-based (TT) walking program on maximal oxygen consumption (VO2max), muscular endurance, muscle strength, and ankle range of motion (ROM) in ankle sprain experienced young people. Twenty subjects (12 males, 8 females) volunteered to participate in this study and divided into two groups (MT and TT). All subjects completed MT and TT 4 times per week with each session of 60 min with 65% from maximum heart rate. Incremental test on treadmill and 20-m shuttle run test for endurance capacity (VO2max), 2-km walking test for muscular endurance, vertical jump for strength, and ankle ROM for flexibility were analyzed before and after the training intervention. We found significant increase in incremental, 2-km walking and 20-m shuttle run after both MT and TT. Just after TT were significant increased vertical jump and ankle ROM. In conclusion, TT seems to induce a more positive effect on muscle strength in lower extremity and ankle ROM than treadmill-based walking training in ankle sprain experienced young people.

The effects of aquatic walking and jogging program on physical function and fall efficacy in patients with degenerative lumbar spinal stenosis.

The purpose of this study was to evaluate the effects of 12-week aqua walking and jogging program on muscle function, ankle range of motion (ROM), balance and fell efficacy in degenerative lumbar spinal stenosis (DLSS) patients. Six patients (2 males, 4 females) with DLSS participated in aquatic exercise program 3 times per week with each session of 60 min (warming-up, aqua walking, aqua jogging and cool down) at 1 m 20 cm-1 m 30 cm deep pool. Janda's muscle function test, ankle ROM, Berg balance scale (BBS) and fall efficacy scale (FES) were analyzed before and after the training intervention. We found significant increases in balance, muscle function, ankle ROM and fall efficacy after training intervention. In conclusion, aquatic exercise seems to affect physical function and fall efficacy positively in elderly DLSS patients.

Effects of follicular versus luteal phase-based strength training in young women.

Hormonal variations during the menstrual cycle (MC) may influence trainability of strength. We investigated the effects of a follicular phase-based strength training (FT) on muscle strength, muscle volume and microscopic parameters, comparing it to a luteal phase-based training (LT). Eumenorrheic women without oral contraception (OC) (N = 20, age: 25.9 ± 4.5 yr, height: 164.2 ± 5.5 cm, weight: 60.6 ± 7.8 kg) completed strength training on a leg press for three MC, and 9 of them participated in muscle biopsies. One leg had eight training sessions in the follicular phases (FP) and only two sessions in the luteal phases (LP) for follicular phase-based training (FT), while the other leg had eight training sessions in LP and only two sessions in FP for luteal phase-based training (LT). Estradiol (E2), progesterone (P4), total testosterone (T), free testosterone (free T) and DHEA-s were analysed once during FP (around day 11) and once during LP (around day 25). Maximum isometric force (Fmax), muscle diameter (Mdm), muscle fibre composition (No), fibre diameter (Fdm) and cell nuclei-to-fibre ratio (N/F) were analysed before and after the training intervention. T and free T were higher in FP compared to LP prior to the training intervention (P < 0.05). The increase in Fmax after FT was higher compared to LT (P <0.05). FT also showed a higher increase in Mdm than LT (P < 0.05). Moreover, we found significant increases in Fdm of fibre type ΙΙ and in N/F only after FT; however, there was no significant difference from LT. With regard to change in fibre composition, no differences were observed between FT and LT. FT showed a higher gain in muscle strength and muscle diameter than LT. As a result, we recommend that eumenorrheic females without OC should base the periodization of their strength training on their individual MC.