Relationship of sarcopenia with bone geometry and mass among postmenopausal women.

OBJECTIVE: The aim of this study was to verify whether sarcopenia and its components are associated with hip areal bone mineral density (aBMD) and geometry in postmenopausal women (PW). METHODS: In this cross-sectional study, appendicular bone-free lean mass (aLM) and hip bone mass and geometry were measured using dual-energy x-ray emission absorptiometry (DXA). Muscle power and strength were measured by five times Sit-to-Stand Test (5-STS) and dynamometry, respectively, in 175 PW. Sarcopenia was identified as low aLM plus low muscle strength or low muscle power. Multiple linear regression (covaried by age, smoking, hormonal therapy, and diseases) was used to determine the relationship between sarcopenia and bone geometry and mass. The results are presented as mean differences between groups. RESULTS: Dynamometry, five times Sit-to-Stand Test, and aLM indicated positive associations (P < 0.05) with most indicators of bone mass and geometry. Sarcopenia, applying low muscle strength or low muscle power, was negatively associated with femoral neck width (-0.2 mm, P = 0.001), cortical thickness of femoral calcar (-0.6 mm, P = 0.043), subtrochanteric cortical thickness (-1.2 mm, P = 0.002), femoral neck cross-sectional area (-19.5 mm2, P < 0.001), cross-section moment of inertia (-2,244 mm4, P < 0.001), section modulus (-115 mm3, P < 0.001), femoral neck aBMD (-0.1 g/cm2, P = 0.002), upper femoral neck aBMD (-0.1 g/cm2, P = 0.003), lower femoral neck aBMD (-0.1 g/cm2, P = 0.016), and trochanteric aBMD (-0.1 g/cm2, P = 0.035). CONCLUSIONS: Thus, muscle mass, strength and power, alone or in combination (ie, sarcopenia), are associated with low aBMD, impaired bone geometry, and, therefore, bone strength in PW. These measures may help identify PW at risk of hip fractures.

Functional high-intensity interval training is not equivalent when compared to combined training for blood pressure improvements in postmenopausal women: a randomized controlled trial.

INTRODUCTION: Low-volume functional high-intensity interval training (F-HIIT) improves cardiorespiratory fitness, body composition, and physical function similarly to combined training (CT, gold standard protocol), however no previous studies have compared the F-HIIT equivalence with CT in reducing blood pressure in older people, particularly in postmenopausal women (PW). Therefore, the aim of this study (trial registration: NCT03200639) was designed to test whether F-HIIT of low volume is an equivalent strategy to CT for improving blood pressure (BP) in PW. MATERIAL AND METHOD: Forty-nine PW were divided into two groups: F-HIIT and CT. The F-HIIT protocol was composed of 10 sets of 60 seconds of high-intensity exercises interspersed with 60 seconds of low-intensity exercises for recovery. The CT protocol was composed of 30 minutes of moderate-intensity walking, followed by five total body resistance exercises. Both protocols were performed 3-times-a-week for 12 weeks. The BP from rest condition (before exercise) was measured before and after 12 weeks of intervention in both groups, using an automatic blood pressure monitor. The boundaries values for equivalence for systolic and diastolic BP was set at 5.14 and 2.92 mmHg, respectively. RESULTS: There was only a significant reduction (P < .05) in systolic BP in CT group from baseline (-3.2 (95% CI, -6.2 to -0.2) mmHg). The difference of systolic BP between F-HIIT and CT was 5.8 (95% CI, 1.3-10.4) mmHg, showing non-equivalence (inferiority) for F-HIIT. CONCLUSION: Thus, these results suggest that low-volume F-HIIT protocol is not an equivalent strategy when compared to CT for BP improvements in PW.

Body Mass Index, waist circumference or sagittal abdominal diameter: Which parameter is better correlated with body fat changes in postmenopausal women after combined training protocol?

OBJECTIVE: We aimed to verify whether exercise-induced changes in body mass index (BMI), waist circumference (WC) and sagittal abdominal diameter (SAD) are correlated with changes in body fat (BF) in postmenopausal women. METHODS: Seventeen postmenopausal women performed combined training three times a week, for 12 weeks. Correlations of delta (Δ) BMI, Δ WC, and Δ SAD with Δ total BF, Δ android and Δ gynoid fats were performed. RESULTS: Weight, BMI and android fat decreased over time. A tendency of reductions in gynoid fat was found (p = 0.070). Delta BMI was positively correlated with Δ total BF (r = 0.56; p < 0.05), Δ android fat (r = 0.64; p < 0.05), and Δ gynoid fat (r = 0.72; p < 0.05). The Δ WC was only correlated with Δ gynoid fat (r = 0.55; p < 0.05). The Δ SAD was not correlated with all the Δ body fat parameters evaluated. CONCLUSION: We conclude that changes in BMI were better associated with body fat changes induced by combined training when compared to WC and SAD in postmenopausal women. The patients were part of a 12-week training study (ClinicalTrials.gov Identifier: NCT03200639).

Comparative effects of high-intensity interval training with combined training on physical function markers in obese postmenopausal women: a randomized controlled trial.

OBJECTIVES: This study compared the effects of high-intensity interval training (HIIT) with effects of combined training (CT) on physical function, body composition, and muscle strength in obese postmenopausal women (PW) (trial registration: NCT03200639). METHODS: PW were randomized to CT (n = 12) and HIIT (n = 12). The CT group performed 30 minutes of moderate walking at 70% of maximum heart rate (MHR) and five resistance exercises at 70% of one repetition maximum (1RM) for 12 weeks. The HIIT group performed 10 sets of vigorous exercises (30 seconds (s) of stair climbing and 30 s of body weight squats) at >80% MHR interspersed by a light walk (recovery period at 60% MHR). RESULTS: Both groups reduced body fat percentage (0.5%), chair stand (3 s) and increased leg lean mass (0.3 kg). Only the CT, however, increased muscle strength (29%) and fast walking speed (5%) compared with HIIT. The fast walking speed changes were partially explained by the muscle strength changes (36%, r = 0.60, P = 0.027) in the CT group. CONCLUSIONS: These results suggest that HIIT is an alternative time-efficient protocol for improving chair stand and body composition when compared with CT, whereas only CT is an efficient protocol for improving muscular strength and fast walking speed in obese PW. Thus, CT must be prioritized when the increase of muscular strength and fast walking speed are the goals of training. : Video Summary: Supplemental Digital Content 1, http://links.lww.com/MENO/A443.

Moderate Increase in Protein Intake Promotes a Small Additional Improvement in Functional Capacity, But Not in Muscle Strength and Lean Mass Quality, in Postmenopausal Women Following Resistance Exercise: A Randomized Clinical Trial.

The aim of this study was to evaluate the effect of a moderate increase in protein intake on muscle strength, functional capacity and lean mass quality improvements in postmenopausal women following resistance exercise. Forty-seven postmenopausal women were randomized in two groups: Normal protein (NP, n = 25), who received a dietary plan containing ~0.8 g protein·kg-1·d-1 (recommended dietary allowance-RDA recommendations); and higher protein (HP, n = 22), which a moderate increase in protein intake was recommended (~1.2 g protein·kg-1·d-1). Resistance training was performed for 10 weeks, three times/week. Muscle strength (handgrip strength and one repetition maximum test-1-RM), functional capacity and lean mass (LM) quality (muscle strength to lean mass ratio) were evaluated. Dietary intake was assessed by nine 24 h food recalls. After intervention, both groups increased similarly the leg extension 1-RM and handgrip strength. Regarding functional capacity tests, both groups increased the balance test score (SPPB) and 10 m walk test speed, with no differences between the groups. In addition, an increase in speed to perform the 6 min and 400 m walk tests was observed over the time, with an additional improvement in the HP group (time × group interaction; p = 0.007 and p = 0.004, respectively). About LM quality, leg extension 1-RM/leg LM improved over the time in both groups (p = 0.050), with no time × group interaction. All these significant changes had a low effect size. In conclusion, a moderate increase in protein intake promoted a small additional improvement in functional capacity, but it did not induce a greater increase in strength and LM quality after 10 weeks of resistance exercise in postmenopausal women. This trial was registered at ClinicalTrials.gov as NCT03024125.

Muscular Strength Adaptations and Hormonal Responses After Two Different Multiple-Set Protocols of Resistance Training in Postmenopausal Women.

Nunes, PRP, Barcelos, LC, Oliveira, AA, Furlanetto, R, Martins, FM, Resende, EAMR, and Orsatti, FL. Muscular strength adaptations and hormonal responses after two different multiple-set protocols of resistance training in postmenopausal women. J Strength Cond Res 33(5): 1276-1285, 2019-We studied the effects of 2 different resistance training (RT) multiple-set protocols (3 and 6 sets) on muscle strength and basal hormones concentrations in postmenopausal women (PW). Postmenopausal women were randomly allocated into 3 groups: control (CT, n = 12), low RT volume (LV = 3 sets for each exercise, n = 10), and high RT volume (HV = 6 sets for each exercise, n = 12). The LV and HV groups performed 8 exercises of a total body RT protocol 3 times a week, at 70% of 1 repetition maximum (1RM) for 16 weeks. Muscle strength and basal hormone concentrations were measured before and after RT. Our findings show that 3 sets or 6 sets at 70% of 1RM protocol increased muscular strength similarly after 16 weeks (sum of all exercises, LV: 37.7% and HV: 34.1% vs. CT: 2.1%, p < 0.001). Moreover, the RT volume does not affect basal levels of testosterone (TT) (LV: 0.02%, HV: -0.12%, and CT: 0.006%, p = 0.233), cortisol (C) (LV: 72.4%, HV: 36.8%, and CT: 16.8%, p = 0.892), insulin-like growth factor-1 (LV: 6.7%, HV: 7.3%, and CT: 4.1%, p = 0.802), dehydroepiandrosterone sulfate (LV: 0.1%, HV: -4.5%, and CT: -6.7%, p = 0.885), and TT:C ratio (LV: -0.9%, HV: -1.6%, and CT: -0.4%, p = 0.429). Our results suggest that 3 sets and 6 sets at 70% of 1RM seem to promote similar muscle strength gain. Thus, 3-set RT is a time efficient protocol for strength gain after 16 weeks in PW.

Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial.

OBJECTIVES: This study tested whether high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women when compared with combined training. Moreover, we tested whether change in visceral adiposity tissue is associated with alterations in these inflammatory markers. METHODS: Postmenopausal women were randomized in two groups: combined training (n = 13) and high-intensity interval training (n = 13). The combined training group performed 60 minutes of walking at 70% of maximum heart rate and resistance exercises at 70% of one repetition maximum. The high-intensity interval training group performed 28 minutes of high-intensity exercises (> 80% of maximum heart rate). Both groups trained three times a week for 12 weeks. Body composition and inflammatory markers were analyzed with dual-energy x-ray absorptiometry scanning and enzyme-linked immunosorbent assay, respectively. RESULTS: All groups reduced body fat percentage (P = 0.026), visceral adiposity tissue (P = 0.027), leptin (P = 0.043), and increased interleukin (IL)-1 receptor antagonist (P < 0.01). The high-intensity interval training group reduced visceral adiposity tissue (P = 0.021) in a greater magnitude and increased interleukin-6 (P = 0.037) level when compared with the combined training group. Moreover, the visceral adiposity tissue changes explained the changes in IL-6 (56%; P = 0.002) only in the high-intensity interval training group. CONCLUSIONS: These results suggest that high-intensity interval training is a time-efficient strategy for improving visceral adiposity tissue and inflammatory markers in obese postmenopausal women. Moreover, we observed that serum cytokine changes, at least in part, depend on visceral adiposity tissue alterations.

Adding Soy Protein to Milk Enhances the Effect of Resistance Training on Muscle Strength in Postmenopausal Women.

Resistance training (RT) and high-quality protein ingestion improves muscle mass (MM) and strength (MS). However, no study has evaluated the effect of ingesting milk plus soy protein (SOY) on MM and MS in postmenopausal women (PW). Thus, the aim of this study was to evaluate the effects of adding SOY to milk on MM and MS after 16 weeks of RT. Thirty-two PW were randomized and allocated into two groups: placebo and RT (PL+RT, n = 16) and SOY and RT (SOY+RT, n = 16). The SOY+RT received 25 g of SOY while the PL+RT received 25 g of maltodextrin (placebo). All supplements were given in the form of a chocolate-flavored powder added to 200 mL of milk. The RT protocol consisted of eight total body exercises at 70% of one repetition maximum (1RM), three sets of 8-12 repetitions, 2-3 times/week. No differences were found in the baseline measures between groups (age, menopause status, anthropometric and nutrition patterns), except for protein intake, which was higher in the SOY+RT. Both groups increased the MM (bioimpedance) showing no difference between groups (PL+RT = 1.5 kg; SOY+RT = 1.1 kg). For MS, the SOY+RT showed a larger (p < .05) increase in 1RM of bench press (PL+RT = 6.7 kg; SOY+RT = 12.5 kg), knee extension (PL+RT = 3.7 kg; SOY+RT = 6.7 kg), total load (PL+RT = 15.1 kg; SOY+RT = 24.2 kg), and the total load exercises/MM (PL+RT = 0.3 kg; SOY+RT = 0.9 kg). These results suggest that adding SOY to milk combined with 16 weeks of RT resulted in more significant increases in MS in PW.

Higher Protein Intake Does Not Improve Lean Mass Gain When Compared with RDA Recommendation in Postmenopausal Women Following Resistance Exercise Protocol: A Randomized Clinical Trial.

The aim of this study was to evaluate the effect of a higher protein intake on lean body mass (LBM) gain in postmenopausal women practicing resistance exercise and compare it to the Recommended Dietary Allowance (RDA) recommendation. Twenty-three postmenopausal women (63.2 ± 7.8 years) were randomized into two groups. The group with higher protein intake (n = 11) (HP) received a dietary plan with ~1.2 g·kg-1·day-1 of protein, while the normal protein (NP) group (n = 12) was instructed to ingest ~0.8 g·kg-1·day-1 of protein (RDA recommendation). Both groups performed the same resistance training protocol, 3 times a week, with progression of the number of sets (from 1 to 6 sets) and 8-12 repetitions. The intervention occurred over 10 weeks. Body composition evaluation was performed by dual-energy X-ray absorptiometry. The diet was evaluated by nine 24-h food recall summaries over the course of the study. During the intervention period, the HP group presented a higher protein (1.18 ± 0.3 vs. 0.87 ± 0.2 g·kg-1·day-1, p = 0.008) and leucine (6.0 ± 1.4 vs. 4.3 ± 0.9 g/day, p < 0.001) intake than the NP group, respectively. At the end of the intervention, there were increases in LBM both in HP (37.1 ± 6.2 to 38.4 ± 6.5 kg, p = 0.004) and in NP (37.6 ± 6.2 to 38.8 ± 6.4 kg, p < 0.001), with no differences between the groups (p = 0.572). In conclusion, increased protein intake did not promote higher LBM gain when compared to RDA recommendation in postmenopausal women performing resistance exercise during 10 weeks. This trial was registered at ClinicalTrials.gov as NCT03024125.

Effect of resistance training volume on walking speed performance in postmenopausal women: A randomized controlled trial.

Low muscle strength and high abdominal fatness play an important role in fast and usual walking speeds decrement in postmenopausal women (PW). Low-volume resistance training (RT) improves muscle strength. However, high-volume RT has shown to improve muscle strength and abdominal fatness in PW. Thus, high-volume RT would elicit greater improvement in fast and usual walking speeds than low-volume RT. OBJECTIVE: To confirm whether the high-volume RT is better than the low-volume RT, we performed a randomized controlled trial (clinical trial registration: RBR-8SBBVP) study to investigated the effects of two different RT volumes (three sets vs. six sets) on fast and usual walking speed performances (fast: one-mile walk test and usual: four-meter walk), muscle strength (1RM test), and abdominal fatness (WC - waist circumference; WC/W waist circumference-to-weight ratio; WHtR - waist-to-height ratio; ABSI - A body shape index; BRI - body roundness index; CI - conicity index) in PW. METHODS: Thirty-three PW were randomized (simple randomization) in three groups: control group (CT - no exercise), low-volume RT (LV) and high-volume RT (HV). The RT consisted of eight total body exercises at 70% of one repetition maximum for 16weeks performed three times a week. RESULTS: The fast walking speed (6.1% [CI 95% 2.3-9.9]), WC (-4.1% [CI 95% -6.9 to -1.4]), WHtR (-4.2% [CI 95% -7.0 to -1.4]) and BRI (-10.3% [CI 95% -17.3 to -3.4]) improved in the HV when compared to the LV and CT. The WC/W (-3.7% [CI 95% -6.5 to -0.93]), ABSI (-3.8% [CI 95% -6.5 to -1.2]) and CI (-3.9% [CI 95% -6.6 to -1.3]) improved in the HV when compared to the CT. Muscle strength improved similarly in trained groups (LV: 49.1% [CI 95% 42.5-55.6] and HV: 43.7% [CI 95% 33.0-54.5]) when compared with the CT. No differences were observed in usual walking speed. CONCLUSION: Our results suggest that high-volume RT (six sets) at 70% of 1RM is necessary to promote an improved fast walking speed performance and abdominal fatness in PW.