Behavioral, Sociodemographic, and Sleep Correlates of Symptoms of Depression amongst Older Brazilian Females According to Age: A Cross- Sectional Network Analysis.

BACKGROUND: Examining the interrelationships between symptoms of depression and sociodemographic and behavioral correlates is challengeful using traditional regression analysis. OBJECTIVE: to identify the sociodemographic, movement behaviors, and sleep correlates that contribute the most to symptoms of depression in Brazilian older females, using a network analysis approach. METHODS: This cross-sectional study analyzed 1019 older females from Brazil. Data (sociodemographic, height (meters), weight (kilograms), symptoms of depression, physical activity, sleep) were self-reported via phone calls. The relationships between symptoms of depression and their correlates were assessed using the Network Analysis (qgraph package of the Rstudio) for entire sample and age groups (60-69; 70-79 and 80+ years old). RESULTS: 60-69 and 70-79 groups have more weekly home exits, with aging "single, widowed or divorced" was progressively higher, and "married or stable union" and Overweight/obesity were progressively fewer (p < 0.05). 60-69 have more education years and fewest medicaments use. Sleep compliance (for the entire sample), body mass index (for the 60-69), compliance with moderate to vigorous physical activity (for the 70-79), and educational level (for 80+) were the variables with the highest expected influence values (p < 0.05) on symptoms of depression (1.370; 1.388; 1.129; and 1.354, respectively). CONCLUSION: Symptoms of depression vary throughout the aging process and thus determine that intervention strategies encompass these specific factors according to each age group. Poor sleep behavior has a strong positive association with symptoms of depression. This result highlights that health professionals must be aware of the importance of sleep to mitigate the worsening of depression among older Brazilian females.

Acute and chronic cardiometabolic responses induced by resistance training with blood flow restriction in HIV patients.

Resistance training with blood flow restriction (RTBFR) allows physically impaired people living with HIV (PWH) to exercise at lower intensities than traditional resistance training (TRT). But the acute and chronic cardiac and metabolic responses of PWH following an RTBFR protocol are unknown. The objective was to compare the safety of acute and chronic effects on hemodynamic and lipid profiles between TRT or RTBFR in PWH. In this randomized control trial, 14 PWH were allocated in RTBFR (GRTBFR; n = 7) or TRT (GTRT; n = 7). Both resistance training protocols had 36 sessions (12 weeks, three times per week). Protocol intensity was 30% (GRTBFR) and 80% (GTRT). Hemodynamic (heart rate, blood pressure) and lipid profile were acutely (rest and post exercise 7th, 22nd, and 35th sessions) and chronically (pre and post-program) recorded. General linear models were applied to determine group * time interaction. In the comparisons between groups, the resistance training program showed acute adaptations: hemodynamic responses were not different (p > 0.05), regardless of the assessment session; and chronicles: changes in lipidic profile favors GRTBFR, which significantly lower level of total cholesterol (p = 0.024), triglycerides (p = 0.002) and LDL (p = 0.030) compared to GTRT. RTBFR and TRT induced a similar hemodynamic adaptation in PWH, with no significant risks of increased cardiovascular stress. Additionally, RTBFR promoted better chronic adequacy of lipid profile than TRT. Therefore, RTBFR presents a safe resistance training alternative for PWH.Trial registration: ClinicalTrials.gov ID: NCT02783417; Date of registration: 26/05/2016.

Classification of nutritional status by fat mass index: does the measurement tool matter? / Classificação do estado nutricional pelo índice de massa gorda: o instrumento de medição importa?

Abstract Assessment of the Nutritional Status (NS) allows screening for malnutrition and obesity, conditions associated with chronic non-communicable diseases. The fat mass index (FMI) stands out concerning traditional NS indicators. However, proposals that define thresholds for FMI are not sensitive to discriminate extreme cases (degrees of obesity or thinness). Only one proposal (NHANES), determined by total body densitometry (DXA), established eight categories of NS classification (FMI). However, DXA is expensive and not always clinically available. Our study aims to test the validity of the NHANES method using electrical bioimpedance (BIA) and skinfold thickness (ST) to classify NS. The FMI of 135 (69 women) university students aged 18 to 30 years old was determined using DXA, BIA, and ST. The agreement between the instruments (Bland-Altman) and the agreement coefficient in the NS classifications (Chi-square and Kappa index) were tested. The agreement test against DXA indicated that ST underestimated the FMI (-1.9 kg/m2) for both sexes and BIA in women (-2.0 kg/m2). However, BIA overestimated FMI (1.4 kg/m2) in men, although with less bias. There was no agreement between the NS classifications (NHANES) by FMI between DXA and BIA, or DXA and ST. The exception occurred between DXA and BIA in men who showed a slightly better consensus, considered "fair" (k = 0.214; p = 0.001). In conclusion, ST and BIA did not show enough agreement to replace DXA for NS classification, within NHANES thresholds. The FMI measurement tools for the NHANES classification of the categories of NS matters.

Resumo Avaliar o Estado Nutricional (EN) permite rastrear desnutrição e obesidade, condições associadas a doenças crônicas não transmissíveis. O índice de massa gorda (IMG) destaca-se em relação aos indicadores tradicionais de EN. No entanto, propostas que definem limiares para IMG não são sensíveis para discriminar casos extremos (graus de obesidade ou magreza). Apenas uma proposta (NHANES) estabeleceu oito categorias de classificação EN (IMG), mas foi determinada por densitometria corporal total (DXA). Porém, DXA é caro e nem sempre disponível. O objetivo foi testar a validade do método NHANES usando bioimpedância elétrica (BIA) e dobras cutâneas (DOCs) para classificar o EN. O IMG de 135 (69 mulheres) universitários com idade entre 18 e 30 anos foi obtido por DXA, BIA e DOCs. A concordância foi testada entre os instrumentos (Bland-Altman) e classificações de EN (Qui quadrado e índice Kappa). O teste de concordância com a DXA indicou as DOCs subestimarem o IMG (-1,9 kg/m2) para ambos os sexos e a BIA em mulheres (-2,0 kg/m2). No entanto, as BIA superestimaram o IMG (1,4 kg/m2) nos homens, embora com menos viés. Não houve concordância entre as classificações de EN (NHANES) pelo IMG entre DXA e BIA/DOCs. A exceção ocorreu entre DXA e BIA em homens que apresentaram concordância "razoável" (k = 0,214; p = 0,001). Em conclusão, DOCs e BIA não mostraram concordância suficiente para substituir DXA pela classificação de EN, dentro dos limites NHANES. As ferramentas diferem para medir IMG e classificar categorias de EN (NHANES).