Changes in bone mass and body composition after bariatric surgery.

Aim: To analyze the effects of body weight loss on bone mineral density (BMD) on hip (Hip BMD) and lumbar spine (Lumbar BMD) after six months of bariatric surgery. Bariatric surgery is an effective treatment for morbid obesity. Nonetheless, there are scant data on the effect of weight bearing on bone structure.Material and methods: Seventeen obese women aged 41.2 ± 11.3 yrs. who underwent Roux-en-Y gastric bypass (RYGB) were included. Body composition assessments were performed through dual-energy X-ray absorptiometry immediately before and after 6-months RYGB. Data collected pre- and post-RYGB included total body weight, body mass index (BMI), lean body mass (LM), fat mass (FM) and bone mineral content. The pre- (PRE) and post-operative (POST) results were compared.Results: Lumbar BMD POST presented a non-significant loss of 1.8% whereas Hip BMD POST showed a significant loss of 17.8%. The analysis demonstrated that BMI and LM PRE explained 26% and 49%, respectively, of Hip BMD PRE variability. In addition, LM POST explained 30% of hip BMD POST variability and was not significant for Lumbar BMD POST.Conclusions: Obesity and rapid weight loss showed direct influence in Hip BMD after six months of bariatric surgery. However, its effect on the lumbar spine area was smaller due to the higher capacity of the spine to dissipate loads through its curvature.

Just noticeable difference in perception of physical exertion during cycle exercise in young adult men and women.

The purpose of this investigation was to describe the just noticeable difference (JND) in perceived exertion during cycle exercise. Males (n = 20) and females (n = 26) (21.4 ± 3.1 year) performed load-incremented cycle exercise to peak intensity. At the end of each minute, subjects rated their overall-body perceived exertion using the OMNI (0-10) rating of perceived exertion (RPE) scale. Individual regression derived the power output (PO) corresponding to RPE 5. This PO served as the standard stimulus (SS). On a separate occasion, four 5-min cycling bouts were performed with 5 min rest between bouts. During bouts 1 and 3 subjects cycled at the SS. During bouts 2 and 4 subjects adjusted the resistance to achieve a level of exertion just noticeably above/below the SS. The difference in final 30-s oxygen consumption (VO2) and PO between each JND bout and the previous SS were the above (JND-A) and below (JND-B) perceived exertion JNDs. JND-A and JND-B were compared between genders and between subjects exhibiting lower versus higher ventilatory threshold (VT) and VO(2PEAK) within genders for VO2 (l · min(-1), %VO(2PEAK)) and PO (W, %SS). JND-B was significantly (P < 0.05) greater than JND-A for VO2 and PO, when expressed in absolute (l · min(-1), W) and relative units (%VO(2PEAK), %SS). Males exhibited greater JND values than females in absolute, but not relative, units. Subjects with lower and higher VT and VO(2)PEAK exhibited similar JND values. The JND can serve as an effective tool to measure perceptual acuity and to determine individual ability to self-regulate prescribed exercise intensities.

Is the self-selected resistance exercise intensity by older women consistent with the American College of Sports Medicine guidelines to improve muscular fitness?

The purpose of this study was to verify the self-selected intensity during resistance training (RT) in older women. Twenty healthy women (mean age, 65.6 years) underwent a 2-week familiarization period followed by 3 experimental sessions. During the first session, anthropometric measurements were taken. The second session involved completion of a 1 repetition maximum (1RM) test for the following exercises: chest press, leg press, lat pull-down, leg extension, lateral shoulder raise, leg curl, biceps curl, and triceps pushdown. Last, a single RT session was performed at a self-selected intensity. During the RT session, participants were instructed to self-select a load for performing 3 sets of 10-15 repetitions. Data were analyzed by mean (SD) and analysis of variance with repeated measures (p < 0.05). Global mean of the 3 sets was bench press 41.0% 1RM (11.9), leg press 43.0% 1RM (17.2), lat pull-down 47.2% 1RM (11.1), leg extension 33.0% 1RM (8.1), lateral shoulder raise 51.1% 1RM (12.1), leg curl 43.5% 1RM (8.8), biceps curl 48.0% 1RM (15.5), and triceps pushdown 51.7% 1RM (13.3); there were no significant differences between the sets (p > 0.05). These results indicate that inactive older women self-selected an intensity exercise during RT below the recommendation for improvements on muscle fitness in apparently healthy older adults. However, this intensity is recommended for very deconditioned individuals. Nevertheless, the use of self-selection strategy during an exercise program can have greater advantages because of its easy applicability, its positive relation with exercise adherence, and for promoting initial muscle conditioning in older adults. Furthermore, it is crucial to gradually increase the RT load to guarantee better and sustainable effects on muscle fitness. Finally, future studies are needed to establish the chronic effects of RT at self-selected intensity on muscle fitness and the functional health of older adults.

Concurrent validity of an OMNI rating of perceived exertion scale for bench stepping exercise.

To develop and validate a modified OMNI rating of perceived exertion (RPE) scale for use during bench stepping exercise (OMNI-BS). Thirty women (age: 19.8 ± 1.8 years) undertook 2 experimental trials, separated by 7 days. Concurrent validity was established by examining the relation between physiological criterion variables, oxygen consumption (VO2), and heart rate (HR), with the concurrent variable, RPE from OMNI-BS, during 2 trials in which the intensity increased linearly (test 1) and intermittently (test 2). The first test consisted of 3-minute stages. Subjects stepped up and down on the bench at 120 b·min(-1). The test was terminated owing to subject fatigue. Exercise intensity increased as bench height increased every 3 minutes. The second test consisted of three 3-minute exercise bouts that reproduced exercise stage 1 (low intensity), stage 3 (moderate intensity), and stage 5 (high intensity) performed in the first test. The order of these 3 exercise bouts was counterbalanced. Intraclass correlation analysis from experimental trials indicated a strong positive association between RPE and VO2 (r = 0.96 and r = 0.95) and HR (r = 0.95 and r = 0.95). Concurrent validity for the OMNI-BS RPE scale was established for women performing bench stepping exercise.

Effect of body mass index on affect at intensities spanning the ventilatory threshold.

The aim of this study was to compare acute affective responses at exercise intensities based on the ventilatory threshold between normal weight, overweight, and obese women. 66 sedentary women (22 in each Body Mass Index group) performed a maximal graded treadmill test to measure their maximal oxygen uptake and ventilatory thresholds. Affective valence was compared at intensities spanning the ventilatory threshold (below, at, and above threshold). Affective valence below ventilatory threshold did not differ among the Body Mass Index groups. The obese group had a lower affective response at ventilatory threshold and above ventilatory threshold than the normal weight and overweight groups; the latter two groups did not differ. The obese group had a lower affective response than the normal and overweight groups, which corresponds to a less pleasant experience. Exercise prescriptions for obese subjects targeting intensities below ventilatory threshold can provide a more pleasant experience and may facilitate exercise adherence.

Urinary incontinence and waist circumference in older women.

OBJECTIVE: the study aims to determine the association between adiposity and fitness with urinary incontinence (UI) in older women. METHODS: a cross-sectional study was conducted in southern Brazil. A sample of 1,069 urban women, age 60+, was assessed for UI (in-person interview), adiposity (body mass index [BMI] and waist circumference [WC]) and fitness. Logistic regression models were developed to assess the association between UI and the independent variables-adiposity (BMI and WC) and fitness indicators. All models were adjusted for age, socioecomomic level, diabetes and hypertension. RESULTS: BMI and functional tests were not significantly associated with UI. WC was an independent and significant predictor. Relative to women in the lowest quartile of WC, odds ratios for UI were 1.98 for WC of 79-86 cm, 2.07 for WC of 86-94 cm and 2.24 for WC >94 cm (P = 0.03). CONCLUSION: central adiposity, as indicated by large WC, increases the risk of UI. Intra-abdominal pressure and its effect on urethral structures may be responsible for this increased risk. Older women should be counselled on the risk of central obesity for UI.

The effects of 12 weeks of step aerobics training on functional fitness of elderly women.

The purpose of this study was to determine the effects of 12 weeks of step aerobics (SA) training on the functional fitness of apparently healthy older women. Thirteen previously sedentary elderly women (mean age 63.14 years) participated in this study. Subjects performed 3 training sessions per week for 30-60 minutes per session. All measurements were assessed at baseline, after 12 weeks of training (posttest), and after 1 month of detraining. Assessments included the evaluation of body mass index (BMI), waist circumference (WC), strength of the upper (arm-curl [AC] test) and lower body (30-second chair-stand test [CS]), dynamic balance and agility (8 foot up and go [8 ft]), flexibility (chair sit-and-reach [CSR]), and cardiorespiratory fitness (6-minute walk test [6MW]). Step aerobics significantly improved all functional fitness components except for BMI. The 12 weeks of SA promoted a large effect size in the following measurements: WC (d = 1.6); CSR (d = 1.51); CS (d = 1.49); AC (d = 1.41); 8 ft (d = 1.32); and 6MW (d = 1.06) (p < 0.05). These results indicate that 12 weeks of SA had a positive effect on the functional fitness components of these older women. Furthermore, these findings were confirmed by the reverse effect observed after 1 month of detraining, except for upper body strength (AC test). In conclusion, 12 weeks of SA training can promote improvements in the functional fitness of apparently healthy older women. Therefore, SA can be considered an effective exercise modality to prevent the loss of functional fitness and its associated consequences.

Identification of a rating of perceived exertion-based warning zone to anticipate graded treadmill test termination.

The purpose of this investigation was to identify a perceptually based warning zone to anticipate termination of Bruce treadmill tests. Apparently healthy adult women (n = 116) and men (n = 55) participated. The time to test termination was measured from the point during the treadmill test at which participants estimated a rating of perceived exertion of 12, 13, 14, 15, 16, and 17 using the Borg 6-20 scale to specify the rating of perceived exertion which was less than or equal to one exercise test stage. Women exercised for 141.9 +/- 99.2 sec. after reporting a rating of perceived exertion of 14. Men terminated the treadmill test 120.1 +/- 80.0 sec. after estimating their rating of perceived exertion to be 15, indicating volitional test termination will occur before the next exercise stage is completed. Accurate and timely prediction of test termination using ratings of perceived exertion may enhance the safety of exercise tests administered to apparently healthy adults and facilitate obtaining endpoint measures upon which to prescribe exercise intensity.

Association of adiposity, cardiorespiratory fitness and exercise practice with the prevalence of type 2 diabetes in Brazilian elderly women.

BACKGROUND: Diabetes incidence in people with advanced age is increasing at an alarming rate, and for this reason the screening of high-risk individuals such as elderly women is critically important. OBJECTIVE: To analyze the association of adiposity, cardiorespiratory fitness and exercise practice with type 2 diabetes (T2D) in elderly Brazilian women. METHODS: Participated of this cross sectional study 1,059 elderly women (mean 69.5 yr; SD 6.1), who self-reported family history of cardiovascular disease, smoking status, hypertension, and T2D diagnosed previously by a physician. The following independent variables were assessed: exercise practice, body mass index, waist circumference, and cardiorespiratory fitness. Logistic regression analysis was used to investigate the association between each independent variable with T2D using adjusted-models. RESULTS: T2D prevalence was 16%. General and central adiposity were directly associated with T2D, whereas cardiorespiratory fitness was inversely related with T2D. The joint effect of exercise practice and central adiposity showed that inactive women had higher odds ratio for T2D when compared with active ones, within the same WC group. Inactive women with WC > or = 94.0 cm had an odds ratio of 5.8 (95%IC 1.3-25.3). CONCLUSIONS: A direct positive association was found between general and central adiposity, as well as an inverse relation between CRF and exercise practice with T2D. Elderly women who practice exercise regularly had lower odds for T2D. Health professionals should encourage individuals of all ages to engage on regular exercise practice, which could reduce body fatness and may be beneficial in reducing the prevalence of T2D in older ages.

A comparison of functional fitness of older Brazilian and American women.

The purpose of this cross-sectional study was to generate a functional-fitness profile for older women from the south of Brazil and to compare their functional profile with an age-matched cohort of American women. The Fullerton Functional Fitness Test (body-mass index, 6-min-walk test, chair sit-and-reach, chair stand, arm curl, and 8-ft up-and-go) was administered to 1,033 participants. Z scores indicate that older American women performed better in all functional tests than age-matched Brazilians. This fact could be explained by the delayed establishment of specific health policies for older adults in Brazil. In conclusion, the findings provide guidelines about the normal variation of functional fitness in older women from the southern region of Brazil. In addition, these data can be used to help identify older women with functional losses, thereby assisting in the diagnosis of early disability.

Analysis of the lipid profile of elderly women in Curitiba - Parana.

BACKGROUND: Dyslipidemia is considered one of the main risk factors for cardiovascular disease (CVD), which is more frequent in older individuals. However, evidence suggests that a large number of elderly individuals is not aware of their lipid profile status; additionally, many of them do not have access to adequate treatment. OBJECTIVE: To analyze the lipid profile and the frequency of lipid-lowering therapy use in elderly women from the city of Curitiba, state of Parana, Brazil. METHODS: The sample consisted of 312 women (mean age = 68.8; SD = 6.0 years). The lipid profile was determined by plasma levels of total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C) and triglycerides (TG). The number of subjects that reported being on lipid-lowering therapy was self-reported; therefore, the groups were divided into two subgroups, satisfactory and unsatisfactory. RESULTS: A high prevalence of individuals with unsatisfactory levels of lipid profile components was observed in the group that self-reported not being on lipid-lowering therapy; of these, 74.2% of women with CVD presented levels above the LDL-C goal. On the other hand, 45.8 to 49.3% of the individuals from the group that self-reported being on lipid-lowering therapy had unsatisfactory values of TC, TG and LDL-C, and 25.4% had HDL-C levels lower than 40.0 mg/dl. CONCLUSION: The results of this investigation indicate a high prevalence of elderly women, regardless of self-reports of being on lipid-lowering therapy, with an unsatisfactory lipid profile, mainly related to LDL-C goal for those individuals with CVD.

Análise do perfil lipídico de mulheres idosas em Curitiba - Paraná / Analysis of the lipid profile of elderly woman in Curitiba - Parana

FUNDAMENTO: A dislipidemia é considerada um dos principais fatores de risco para a doença cardiovascular, que, por sua vez, é mais freqüente em indivíduos de idade avançada. Contudo, evidências sugerem que uma parcela da população idosa desconhece a característica de seu perfil lipídico, assim como muitos não possuem acesso a um tratamento adequado. OBJETIVO: Analisar o perfil lipídico e a freqüência da utilização da terapia hipolipemiante de mulheres idosas em Curitiba - Paraná. MÉTODOS: A amostra foi composta por 312 mulheres (idade média 68,8; desvio padrão 6,0 anos). O perfil lipídico foi determinado por meio das dosagens de colesterol total (CT), colesterol de lipoproteína de alta densidade (HDL-C), colesterol de lipoproteína de baixa densidade (LDL-C) e triglicerídeos (TG). A utilização da terapia hipolipemiante foi verificada por meio de auto-relato, em seguida os grupos foram divididos em dois subgrupos, satisfatório e insatisfatório. RESULTADOS: Foi encontrada uma grande prevalência de indivíduos com valores insatisfatórios nos componentes do perfil lipídico, no grupo que relatou não estar sob terapia hipolipemiante: 74,2 por cento das mulheres portadoras de doenças cardiovasculares (DCV) apresentaram valores superiores à meta lipêmica para o LDL-C (<100,0 mg/dl). Por sua vez, 45,8 por cento a 49,3 por cento dos indivíduos do grupo que relatou utilizar medicamento hipolipemiante apresentaram valores insatisfatórios para CT, TG e LDL-C, e 25,4 por cento obtiveram valores de HDL-C inferiores a 40,0 mg/dl. CONCLUSÃO: Os resultados desta investigação indicam uma alta prevalência de mulheres idosas, independentemente do auto-relato de utilizar terapia hipolipemiante, com o perfil lipídico desfavorável, principalmente em relação à meta lipêmica para o LDL-C nas mulheres idosas portadoras de DCV.

BACKGROUND: Dyslipidemia is considered one of the main risk factors for cardiovascular disease (CVD), which is more frequent in older individuals. However, evidence suggests that a large number of elderly individuals is not aware of their lipid profile status; additionally, many of them do not have access to adequate treatment. OBJECTIVE: To analyze the lipid profile and the frequency of lipid-lowering therapy use in elderly women from the city of Curitiba, state of Parana, Brazil. METHODS: The sample consisted of 312 women (mean age = 68.8; SD = 6.0 years). The lipid profile was determined by plasma levels of total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C) and triglycerides (TG). The number of subjects that reported being on lipid-lowering therapy was self-reported; therefore, the groups were divided into two subgroups, satisfactory and unsatisfactory. RESULTS: A high prevalence of individuals with unsatisfactory levels of lipid profile components was observed in the group that self-reported not being on lipid-lowering therapy; of these, 74.2 percent of women with CVD presented levels above the LDL-C goal. On the other hand, 45.8 to 49.3 percent of the individuals from the group that self-reported being on lipid-lowering therapy had unsatisfactory values of TC, TG and LDL-C, and 25.4 percent had HDL-C levels lower than 40.0 mg/dl. CONCLUSION: The results of this investigation indicate a high prevalence of elderly women, regardless of self-reports of being on lipid-lowering therapy, with an unsatisfactory lipid profile, mainly related to LDL-C goal for those individuals with CVD.