Effect of combined training on body composition and metabolic variables in people living with HIV: A randomized clinical trial.

PURPOSE: The aim of this study was to conduct a randomized clinical trial to assess the effects of 16 weeks of combined training on body composition, lipid profile, adiponectin, C-reactive protein (CRP), and leptin levels in people living with HIV/AIDS (PLWHA). METHODS: Fifty-eight HIV-infected individuals were randomized into a training group (T) or a control group (C). Combined training consisted of aerobic and resistance exercises performed at the same training session, applied at a frequency of three times a week for a total of 16 weeks. Waist circumference, body mass, body fat percentage (%fat), fat mass, lipid profile, adiponectin, CRP, and leptin levels were measured pre- and post-training in both groups. RESULTS: Sixteen weeks of combined training decreased (P < 0.05) body fat in different body segments in PLWHA. Lipodystrophic PLWHA experienced greater reduction in body fat in the android region than non-lipodystrophic PLWHA after combined training. Lipid profile and circulating levels of adiponectin, leptin, and CRP remained unchanged. CONCLUSIONS: Sixteen weeks of combined training was effective to reduce body fat in different body segments, without altering plasma lipid and cytokine levels.

Oxidative stress and inflammation in obesity after taurine supplementation: a double-blind, placebo-controlled study.

PURPOSE: Some researchers found decreased levels of plasma taurine in obese subjects and animals, and reduced expression of an important enzyme of taurine synthesis. These evidences, coupled with the metabolic imbalance of obesity and the possible anti-inflammatory and antioxidant effects of taurine, highlighted the use of taurine as a supplement in obesity treatment. The aim of the present study was to investigate whether taurine supplementation, associated with nutritional counseling, modulates oxidative stress, inflammatory response, and glucose homeostasis in obese women. METHODS: A randomized double-blind placebo-controlled study was conducted with 16 women with obesity diagnosis and 8 women in the normal weight range. The obese volunteers were matched by age and body mass index and randomly assigned to either the placebo (3 g/day starch flour) or taurine (3 g/day taurine) group. The study lasted 8 weeks, and the experimental protocol included nutritional assessment and determination of plasma sulfur amino acids, insulin, and adiponectin, serum glycemia, and markers of inflammatory response and oxidative stress. RESULTS: Plasma taurine levels were significantly decreased (41%) in the obese volunteers. Both the placebo and taurine groups showed significant reduction in weight (3%), with no differences between groups. Different from placebo, taurine-supplemented group showed significant increase in plasma taurine (97%) and adiponectin (12%) and significant reduction in the inflammatory marker hs-C-reactive protein (29%) and in the lipid peroxidation marker thiobarbituric acid reactive substances (TBARS) (20%). CONCLUSIONS: Eight weeks of taurine supplementation associated with nutritional counseling is able to increase adiponectin levels and to decrease markers of inflammation (high-sensitivity C-reactive protein) and lipid peroxidation (TBARS) in obese women.

Short-term creatine supplementation does not reduce increased homocysteine concentration induced by acute exercise in humans.

PURPOSE: The purpose of the study is to evaluate the effects of creatine supplementation on homocysteine (Hcy) plasma levels after acute exercise in humans. METHODS: Twenty-three young (under-20) soccer players were divided into 2 groups: creatine (Cr)- and placebo (Pla)-supplemented groups. The supplementation was performed in double-blind controlled manner using creatine or placebo tablets with 0.3 g/kg during 7 days. Before and after 7 days of supplementation, the athletes performed an acute high-intensity sprint exercise (two consecutive running-based anaerobic sprint test protocol consisted in 6 × 35 m sprint with 10 s between them). Blood samples were collected before and after 7 days of supplementation as well as 0 and 1 h after exercise protocol. RESULTS: Homocysteine concentration significant increased (P < 0.05) 1 h after acute exercise (18%). Acute exercise also decreased red blood cell S-adenosylmethionine (SAM) 30% with no changes in SAM/SAH ratio. Seven days of creatine supplementation were able to increase (P < 0.05) plasma creatine concentration (Pla 130.1 ± 21.7 vs Cr 1,557.2 ± 220.3 µmol/L) as well as decrease (P < 0.05) plasma guanidinoacetic acid (33%). Controversially, creatine supplementation did not change Hcy plasma level after 7-day supplementation (Pla 6.9 ± 0.2 vs Cr 7.2 ± 0.2 µmol/L) or after acute exercise (Pla 8.2 ± 0.3 vs Cr 8.4 ± 0.3 µmol/L). No changes in plasma vitamin B12 and folate as well as cysteine and methionine were found. CONCLUSIONS: Seven days of creatine supplementation does not avoid increased plasma Hcy induced by acute sprint exercise in humans.

Bioactive compounds with effects on inflammation markers in humans.

Obesity and other chronic diseases are accompanied by adipose tissue, liver, pancreas, muscle and brain low-grade chronic inflammation. Indeed, the obese condition and metabolic syndrome are characterized by an increased expression of inflammatory cytokines and infiltration of immune cells in adipocytes. The inflammatory response promotes the activation of transcriptional factors and pro-inflammatory cytokines, which can lead to an unresolved inflammatory response associated with an inhibition of insulin signalling and high risk for cardiovascular events. Epidemiological and intervention studies have been carried out to find out dietary patterns, foods and bioactive compounds with protective anti-inflammatory actions. The most studied compounds are polyphenols, especially isoflavone and anthocyanin, but quercertin, catechin and resveratrol have also been investigated. Furthermore, some studies have reported the effects of milk peptides, plant sterol and stanol, l-carnitine and α-lipoic acid on inflammatory processes. This review aimed to collect and discuss those relevant studies reported in the scientific literature following a systematic scientific search about the effect of such bioactive compounds on inflammation in humans.

Combining Machine Learning and Metabolomics to Identify Weight Gain Biomarkers.

Weight gain is a metabolic disorder that often culminates in the development of obesity and other comorbidities such as diabetes. Obesity is characterized by the development of a chronic, subclinical systemic inflammation, and is regarded as a remarkably important factor that contributes to the development of such comorbidities. Therefore, laboratory methods that allow the identification of subjects at higher risk for severe weight-associated morbidity are of utter importance, considering the health, and safety of populations. This contribution analyzed the plasma of 180 Brazilian individuals, equally divided into a eutrophic control group and case group, to assess the presence of biomarkers related to weight gain, aiming at characterizing the phenotype of this population. Samples were analyzed by mass spectrometry and most discriminant features were determined by a machine learning approach using Random Forest algorithm. Five biomarkers related to the pathogenesis and chronicity of inflammation in weight gain were identified. Two metabolites of arachidonic acid were upregulated in the case group, indicating the presence of inflammation, as well as two other molecules related to dysfunctions in the cycle of nitric oxide (NO) and increase in superoxide production. Finally, a fifth case group marker observed in this study may indicate the trigger for diabetes in overweight and obesity individuals. The use of mass spectrometry combined with machine learning analyses to prospect and characterize biomarkers associated with weight gain will pave the way for elucidating potential therapeutic and prognostic targets.

Antioxidant vitamin supplementation prevents oxidative stress but does not enhance performance in young football athletes.

OBJECTIVES: The aim of this study was to verify the effects of supplementation with antioxidants (vitamins C and E) on oxidative stress, delayed-onset muscle soreness (DOMS), and performance in football players during a recovery period after an exercise-induced oxidative stress protocol. METHODS: Twenty-one football athletes were randomly assigned to two groups: placebo and antioxidant-supplemented. Supplementation was performed in a double-blind, controlled manner using vitamin C (500 mg/d) and E (400 UI/d) for 15 d. After 7 d of supplementation, athletes were submitted to an exercise-induced oxidative stress protocol consisting of plyometric jumping and strength resistance sets to exhaustion. Blood samples, performance tests, and DOMS were determined before and 24, 48, and 72 h after exercise. RESULTS: Antioxidant supplementation was continued during the recuperation week and for a total of 15 d. Antioxidant supplementation caused a significant increase in plasma vitamins C and E. The antioxidant supplementation could inhibit oxidative stress characterized by elevated lipid peroxidation markers malondialdehyde and total lipid peroxidation as well as reduced ratio of glutathione to oxidized glutathione promoted by exercise. Antioxidant supplementation, however, did not significantly reduce the plasma creatine kinesis concentration or DOMS during the recovery days. Likewise, supplementation with vitamin C and E did not improve lower body power, agility, or anaerobic power, nor did it provide any indication of faster muscle recovery. CONCLUSION: Antioxidant supplementation does not attenuate elevated markers of muscle damage or muscle soreness promoted by acute exercise and do not exert any ergogenic effect on football performance of young athletes, although it reduced oxidative stress.

Homocysteine-lowering exercise effect is greater in hyperhomocysteinemic people living with HIV: a randomized clinical trial.

Elevated concentration of homocysteine has been identified as an independent risk factor for the development of cardiovascular disease and is frequently associated with oxidative stress. Moreover, studies have shown that people living with human immunodeficiency virus (PLHIV) present elevated concentration of homocysteine and oxidative stress compared with people without HIV. Our purpose was to describe blood homocysteine and oxidative stress markers in PLHIV and those without HIV infection, and to examine the effects of a 16-week combined training exercise program (CTE) on oxidative stress and homocysteine concentrations of PLHIV. We included 49 PLHIV (21 men, 28 women) and 33 people without HIV infection (13 men, 20 women). After baseline evaluations, 30 PLHIV were randomized to either CTE (trained group, n = 18) or the control group (n = 12); CTE consisted of aerobic and strength exercise sessions during 16 weeks, 3 times a week. Plasma homocysteine, oxidative damage markers, folate, and vitamin B12 were assessed pre- and post-training and by hyperhomocysteinemia (homocysteine ≥ 15 µmol/L) status. At baseline, PLHIV had higher levels of homocysteine and malondialdehyde, as well as reduced circulating folate when compared with people without HIV infection. CTE resulted in a 32% reduction (p < 0.05) in homocysteine concentration and a reduction in lipid hydroperoxide in PLHIV with hyperhomocysteinemia, which was not observed in those without hyperhomocysteinemia. Hyperhomocysteinemic participants experienced a 5.6 ± 3.2 µmol/L reduction in homocysteine after CTE. In summary, 16 weeks of CTE was able to decrease elevated homocysteine concentration and enhance redox balance of PLHIV with hyperhomocysteinemia, which could improve their cardiovascular risk.

Adipokines in rheumatoid arthritis.

Rheumatoid arthritis affects millions of people worldwide and is considered a chronic multisystem disease whose causes are unknown. In general, the main objective of rheumatoid arthritis treatment is to improve the quality of life of patients by relieving pain, maintaining or improving functional capacity, preventing thus, disability. In recent years the role of adipokines in the pathogenesis of rheumatoid arthritis has been discussed but results are still conflicting. Although results from some studies have shown the implications of adipokines in the pathophysiology of autoimmune diseases, including rheumatoid arthritis, their role in the pathogenesis of disease progression is not clear. Thus, this review aimed to describe the association of key adipokines (leptin, resistin, visfatin and adiponectin) and rheumatoid arthritis, given the high prevalence of this disease and the important social impact caused by this chronic disabling disease.

Resistance exercise prevents impaired homocysteine metabolism and hepatic redox capacity in Walker-256 tumor-bearing male Wistar rats.

OBJECTIVE: The aim of this study was to investigate changes in homocysteine (Hcy) metabolism and redox balance in response to exercise treatment in a tumor-bearing rat model. METHODS: Male Wistar rats were exposed, or not, to a resistance exercise program 6 wk before inoculation with Walker-256 tumor cells or vehicle. After application, rats maintained their routine for 12 d and were then sacrificed for plasma and liver analyses. RESULTS: Impaired Hcy metabolism was evident after 12 d of tumor cell inoculation as demonstrated by significantly increased (P < 0.05) plasma total homocysteine (tHcy) concentration (53%) and decreased plasma cysteine, methionine, and vitamin B12 concentrations. Decreased hepatic cystathionine ß-synthase (CBS) and betaine-homocysteine S-methyltransferase mRNA levels were found in tumor-bearing rats but not in controls. Tumor inoculation also decreased levels of liver reduced glutathione (GSH) and increased hepatic oxidative stress compared with non-tumor controls. However, resistance exercise prevented the tumor-impaired transsulfuration pathway as demonstrated by the decreased plasma tHcy, hepatic CBS expression, and increased GSH in tumor-exercised versus tumor-sedentary rats. Remarkably, all measures of liver oxidative stress were suppressed by exercise training. Tumor weight was unchanged between groups. CONCLUSION: Resistance exercise prevented tHcy accumulation and liver oxidative damage caused by Walker-256 tumor cell inoculation; the modulatory effects of resistance exercise on Hcy metabolism appear to be at the level of transsulfuration pathway.

Taurine supplementation does not decrease homocysteine levels and liver injury induced by a choline-deficient diet.

AIMS: The aim of this study is to examine the effects of taurine supplementation on homocysteine (Hcy) metabolism and liver injury in rats fed a choline-deficient diet. MAIN METHODS: Thirty rats were divided into three groups (n=10), to receive one of the following diets for 4 weeks: control diet (C), choline-deficient diet (CDD), or choline-deficient diet supplemented with taurine (CDDT). The CDD and the CDDT consisted of AIN-93 without the recommended choline content of 2.5%, and the CDDT was supplemented by the addition of 2.5% taurine. KEY FINDINGS: Four weeks of ingesting a CDD resulted in a significant increase in plasma Hcy (50%) as well as a decrease in liver S-adenosylmethionine (SAM) concentration and S-adenosylmethionine/S-adenosylhomocysteine ratio. No changes were found in plasma methionine and cysteine plasma levels compared to control group. Four weeks of ingesting a CDD also caused a significant (P<0.05) increase in hepatic total fat, hepatic malondialdehyde (MDA), and plasma alanine aminotransferase (ALT) levels. In addition, reduced hepatic glutathione (GSH) levels and reduced/oxidized glutathione ratios (GSH/GSSG) were found in rats fed a CDD compared to controls. Taurine supplementation of the CDD normalized genes involved in the remethylation pathway, BHMT and CHDH, which were impaired by CDD alone. However, taurine supplementation failed to prevent CDD-induced Hcy metabolism disturbances and hepatic injury. Also, taurine added to CDD caused decreased expression of PEMT, CHKa, and CHKb, key genes involved in phosphatidylcholine (PC) synthesis and liver fat accumulation. SIGNIFICANCE: Taurine supplementation failed to ameliorate impaired Hcy metabolism and liver injury caused by CDD intake.

Effects of creatine supplementation on oxidative stress and inflammatory markers after repeated-sprint exercise in humans.

OBJECTIVE: The goal of this study was to evaluate the effects of creatine (Cr) supplementation on oxidative stress and inflammation markers after acute repeated-sprint exercise in humans. METHODS: Twenty-five players under age 20 y were randomly assigned to two groups: Cr supplemented and placebo. Double-blind controlled supplementation was performed using Cr (0.3 g/kg) or placebo tablets for 7 d. Before and after 7 d of supplementation, the athletes performed two consecutive Running-based Anaerobic Sprint Tests (RAST). RAST consisted of six 35-m sprint runs at maximum speed with 10 sec rest between them. Blood samples were collected just prior to start of test (pre), just after the completion (0 h), and 1 h after completion. RESULTS: Average, maximum, and minimum power values were greater in the Cr-supplemented group compared with placebo (P < 0.05). There were significant increases (P < 0.05) in plasma tumor necrosis factor alpha (TNF-α) and C-reactive protein (CRP) up to 1 h after acute sprint exercise in the placebo-supplemented group. Malondialdehyde, lactate dehydrogenase (LDH), catalase, and superoxide dismutase enzymes also were increased after exercise in both groups. Red blood cell glutathione was lower after exercise in both groups. Cr supplementation reversed the increase in TNF-α and CRP as well as LDH induced by acute exercise. Controversially, Cr supplementation did not inhibit the rise in oxidative stress markers. Also, antioxidant enzyme activity was not different between placebo and Cr-supplemented groups. CONCLUSION: Cr supplementation inhibited the increase of inflammation markers TNF-α and CRP, but not oxidative stress markers, due to acute exercise.

Calibration of the food list and portion sizes of a food frequency questionnaire applied to free-living elderly people.

OBJECTIVE: To calibrate the food list and relative portion sizes of a food frequency questionnaire (FFQ) for application to a free-living, healthy, elderly population. METHODS: Cross-sectional study. One hundred free-living, healthy participants, aged from 60 to 75 y, randomly selected from among individuals in the area served by the Family Health Program, School of Medicine of Ribeirao Preto, University of São Paulo. A Food Frequency Questionnaire (FFQ) and a Diet History Questionnaire (DH) were applied by trained dietitians. Each food item of the FFQ had its portion size recalculated according to the percentiles referenced by the volunteers in the DH (25th = small, 50th = medium, and 75th = large). The list of foods and portion sizes of the original FFQ and those obtained by the application of the DH were compared. The percent contribution of energy, protein, fat, carbohydrate, folic acid, vitamin C, calcium, and fiber of each food item mentioned in the FFQ was determined from the data obtained by the application of the DH. RESULTS: FFQ, as compared with the DH, provided good estimation of the intake of protein, calcium, folic acid, and fiber (paired t test P < 0.05). Portion sizes of the FFQ differed from those obtained by the application of the DH (-23% to 300%). CONCLUSIONS: Adjustments to the FFQ in particular, new portion sizes and a reduction of the food list were found to be appropriate for application to healthy, urban, free-living elderly people in Ribeirao Preto, Brazil.

Evidence of zinc deficiency in competitive swimmers.

OBJECTIVE: The aim of this study was to assess the nutritional zinc (Zn) status of elite swimmers during different training periods. METHODS: A longitudinal paired study was performed at the University of Sao Paulo in eight male swimmers 18 to 25 y old who had been swimming competitively at the state and national levels for at least 5 y. The swimmers were evaluated over a total period of 14 wk: before the basic and specific preparatory period (BSPP-baseline), at the end of the basic and specific preparatory period (post-BSPP), and at the end of the polishing period (PP). Levels of Zn were determined in the plasma, erythrocyte, urine, and saliva by atomic absorption spectrophotometry. Anthropometric measurements and a 3-d food record were also evaluated. RESULTS: The median plasma Zn concentration was below the reference value in all training periods (BSPP-baseline 59 µg/dL, post-BSPP 55.9 µg/dL, after PP 58.8 µg/dL, P > 0.05), as were threshold values for erythrocytes (BSPP-baseline 36.5 µg of Zn/g of hemoglobin, post-BSPP 42 µg of Zn/g of hemoglobin, after PP 40.7 µg of Zn/g of hemoglobin, P > 0.05), urinary Zn (BSPP-baseline 280 µg/24 h, post-BSPP 337 µg/24 h, after PP 284 µg/24 h, P > 0.05), and salivary Zn (BSPP-baseline 66.1 µg/L, post-BSPP 54.1 µg/L, after PP 79.7 µg/L, P > 0.05). Salivary Zn did not correlate with plasma and erythrocyte Zn levels. CONCLUSION: The results suggest that the elite swimmers studied presented a possible Zn deficiency and that salivary Zn was not adequate to evaluate the Zn nutritional status.

Altered plasma response to zinc and iron tolerance test after Roux-en-Y gastric bypass.

BACKGROUND: The duodenum and proximal jejunum are excluded after Roux-en-Y gastric bypass but these intestinal sites are where iron and zinc are most absorbed. Therefore, they are among the nutrients whose digestive and absorptive process can be impaired after surgery. The aim of the present study was to investigate the iron and zinc plasma response to a tolerance test before and after bariatric surgery. The study was performed at São Paulo University School of Medicine of Ribeirão Preto, Brazil. METHODS: In a longitudinal paired study, 9 morbidly obese women (body mass index ≥40 kg/m(2)) underwent an iron and zinc tolerance test before and 3 months after surgery. The iron and zinc levels were determined at 0, 1, 2, 3, and 4 hours after a physiologic unique oral dose. The mineral concentrations in the plasma and 24-hour urine sample were assayed using an atomic absorption spectrophotometer. The anthropometric measurements and 3-day food record were also evaluated. A linear mixed model was used to compare the plasma concentration versus interval after the oral dose, before and after surgery. RESULTS: The pre- and postoperative test results revealed a significantly lower plasma zinc response (P <.01) and a delayed response to iron intake after surgery. The total plasma iron concentration area, during the 4 hours, was not different after surgery (P >.05). The 24-hour urinary iron and zinc excretion did not differ between the pre- and postoperative phases. CONCLUSION: The present data showed a compromised response to the zinc tolerance test after gastric bypass surgery, suggesting an impaired absorption of zinc. More attention must be devoted to zinc nutritional status after surgery.

Pregas cutâneas vs impedância bioelétrica na avaliação da composição corporal de atletas: uma revisão crítica / Skinfold thickness versus bioelectrical impedance for the evaluation of body composition in athletes: a critical review

A composição corporal é fator determinante no desempenho esportivo emdiversas modalidades, sendo necessária a utilização de instrumentos seguros, práticos e válidos para determinar a composição corporal e identificar as modificações que ocorrem no decorrer da temporada de treinamento. Com isso, o objetivo do presente estudo foi, atravésde uma revisão crítica, comparar estudos que avaliaram as técnicas de pregas cutâneas e impedância bioelétrica para estimar a composição corporal de atletas. Foram revisados estudos publicados de 1990 a 2007, identificados "on line" através dos bancos de dados PubMed, SportDiscus e Scielo. Para qualificar os estudos, sete elementos críticos foram avaliados: número de participantes, nível dos atletas estudados, métodos estatísticos empregados, uso de diferentes equações, controle dos testes, controle da amostra e método de referência. Como ferramenta na avaliação da composição corporal de atletas, IB e PC apresentam muitas vantagens em relação a outros métodos, principalmente, quanto à facilidade de aplicação, por ser um método não invasivo de determinação e de preço razoavelmente barato. A exatidão e confiança de resultados obtidos por esses métodos são altamente dependentes das condições do teste, das equações selecionadas e das características do grupo a ser avaliado(modalidade desportiva, gênero, idade e nível competitivo dos atletas). A técnica de PC parece mais confiável quando comparada com IB para estimar a composição corporal em atletas, principalmente, por existirem equações específicas para diferentes modalidades e situações, e pela falta de sensibilidade do método de IB às pequenas mudanças na composição corporal que ocorrem durante a temporada de treinamento.

Body composition is a determinant factor for performance in different sports modalities. Safe, practical and validated instruments are necessary for the measurement of body composition and for the identification of alterations that occur during the training period. A critical review was performed comparing studies that apply skinfold thickness (SKF) and bioelectrical impedance (BIA) for the estimation of body composition in athletes. Studies published between 1990 and 2007 available online in the Pubmed, SportDiscus and Scielo databases were reviewed. Seven critical points were evaluated to rate the studies: number of subjects, performance level of the athletes studied, statistical methods applied, number of equations tested, test control, sample control, and gold standard used to compare the data. SKF and BIA present advantages for the assessment of body composition in athletes compared to other methods, such as their easy application, non-invasiveness and relatively low cost. The accuracy and reliability of the results obtained with these methods depend on test conditions, equations selected for data analysis and characteristics of the particular group (sports modality, gender, age and performance level). SKF seems to be a better method to estimate body composition in athletes because of the availability of specific equations for different sports modalities and because of the low sensitivity of BIA indetecting minimal alterations that occur during the training period.

Avaliação clínica retrospectiva de mulheres no período do climatério: a importância da prevenção / Retrospective clinical evaluation of climacteric women: the role of prevention

O aumento da expectativa de vida torna necessária a prevenção de doenças que ocorrem com o avanço da idade. A diminuição da função ovariana, que ocorre no climatério, está associada a várias alterações, tais como: osteoporose, maior risco de fraturas e de doenças cardiovasculares, entre outras. O objetivo do presente trabalho foi o de realizar uma avaliação retrospectiva clínica e nutricional nas mulheres atendidas no Ambulatório de Climatério do HCFMRP-USP para identificar quais as doenças mais prevalentes nessa fase. Dentre as pacientes atendidas no ambulatório do climatério, de janeiro a junho de 2004, foram selecionadas, por sorteio, 150 pacientes, e analisados os seus prontuários: idade, data da última menstruação e dosagens séricas de: hemoglobina, hematócrito, glicemia de jejum, lipidograma, uréia, creatinina, estrógeno, T4 livre, TSH. Foram também obtidos dados relativos à osteosonometria dessas pacientes. A porcentagem de pacientes portadoras de anemia, diabetes mellitus, triglicérides elevados, HDL reduzido, colesterol total elevado e obesidade foi, respectivamente: 10 porcento, 14 porcento, 32 porcento, 41 porcento, 58,1 porcento. Conclui-se que mulheres climatéricas atendidas no HCFMRP-USP apresentam elevada prevalência de anemia, diabetes mellitus, dislipidemia e obesidade. Estudos que avaliem a relação entre ingestão de micro-nutrientes e o Perfil Biofísico Ósseo são relevantes para a instituição das medidas preventivas da osteoporose no climatério.