Sarcopenic obesity does not impair lower limb strength and physical performance in sufficiently active older adults: a cross-sectional study.

This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance.

Non-rigorous versus rigorous home confinement differently impacts mental health, quality of life and behaviors. Which one was better? A cross-sectional study with older Brazilian adults during covid-19 first wave.

BACKGROUND: The implementation of social distancing measures during covid-19 influenced health outcomes and population´s behaviors, and its rigidity was very different across countries. We aimed to verify the association between the rigidity of social distancing measures of covid-19 first wave with depression symptoms, quality of life and sleep quality in older adults. METHODS: This is a cross-sectional study including 1023 older adults (90% women; 67.68 ± 5.92 years old) of a community-based program in Fortaleza (Brazil). Dependent variables (depression symptoms, sleep quality, and quality of life) were measured through phone calls along June 2020, during the first covid-19 wave. Confinement rigidity (non-rigorous and rigorous) was considered as independent variable. Sociodemographic characteristics (sex, marital status, scholarity, and ethnicity), number of health conditions, nutritional status, movement behavior (physical activity and sitting time), technological skills, and pet ownership were considered as confounding variables. A binomial logistic regression (odds ratio [OR]) was performed to verify the association of confinement rigidity and depression symptoms, sleep quality, and quality of life, adjusted by confounding variables. RESULTS: Older adults who adopted a less rigid lockdown had a higher frequency of depression symptoms, worse perception of quality of life, and bad sleep quality (p < 0.001). Confinement rigidity was able to explain the probability of depression symptoms occurrence (OR: 2.067 [95% CI: 1.531-2.791]; p < 0.001), worse quality of life (OR: 1.488 [95% CI: 1.139-1.944]; p < 0.05), and bad sleep quality (OR: 1.839 [95% CI: 1.412-2.395]; p < 0.001). Even adjusted by confounding variables, confinement rigidity was able to explain the poor outcomes analyzed in older adults. CONCLUSION: Our findings showed that less rigid lockdown was associated with a superior frequency of depression symptoms, worse sleep quality, and lower perception of quality of life in older adults. Therefore, our study could improve comprehension regarding the impact of social distancing measures rigidity in health-related conditions and in the context of covid-19 and other similar pandemic situations.

Characteristics of resistance training-based protocols in older adults with sarcopenic obesity: a scoping review of training procedure recommendations.

Background: Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO. Methods: This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency. Results: A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions. Not all studies reported how the exercise selection, repetition cadence, and rest interval were made. Conclusion: The characteristics of RT protocols and their variables prescribed in the literature for older adults with SO were mapped. The lack of detail on some training variables (i.e., exercise selection, repetition cadence, and rest interval) was identified. RT protocols are heterogeneous and described only partially among studies. The recommendations for RT prescription details in older adults with SO are provided for future studies. Systematic review registration: https://osf.io/wzk3d/.

Handgrip strength conditional tolerance regions suggest the need for personalized sarcopenia definition: an analysis of the American NHANES database.

BACKGROUND: Handgrip strength (HGS) is a well-established clinical biomarker that assesses functional capacity in older populations. In addition, HGS is a diagnostic tool that forecasts aging health conditions, such as sarcopenia. AIMS: This paper provides HGS statistical tolerance regions and presents the need to establish HGS reference values according to patients' characteristics. METHODS: For this purpose, we used a conditional tolerance algorithm for HGS, and we observed the tolerances regions in different age strata and sex of non-sarcopenic individuals from the National Health and Nutrition Examination Survey (NHANES, wave 2011-2012). RESULTS AND DISCUSSION: Our results have critical implications for sarcopenia, since conventional and available HGS cut-offs do not consider age range. CONCLUSIONS: This paper offers new perspectives on the evolution of traditional definitions of sarcopenia according to the principles of precision medicine.

Moderate Physical Activity Reduces the Odds of Sarcopenia in Community- dwelling Older Women: A Cross-sectional Study.

INTRODUCTION: The time spent in different physical activity (PA) intensities is associated with sarcopenia risk for community-dwelling older women. AIM: To evaluate the role of sitting time and physical activity (PA) level as predictors of sarcopenia odds. METHODS: In a cross-sectional study, physically independent older women (n = 67) performed the six-minute walk test to identify functional limitation (≤ 400 m). Sedentary time (as sitting time) and PA (light, moderate and vigorous) were obtained with the International Physical Activity Questionnaire (IPAQ). Sarcopenia was diagnosed as recommended by the Society of Sarcopenia, Cachexia and Wasting Disorders (SCWD). Sarcopenia odds (low muscle mass and functional limitation) was predicted by binary logistic regression, considering the weekly sitting time and PA as independent variables. RESULTS: Sarcopenia prevalence was 7.5% (n = 5), with functional limitation present in 38.8% (n = 26), and low muscle mass in 22.4% (n = 15). The predictive model (p = 0.014) involved moderate PA as the only significant predictor (OR = 0.999; p = 0.005; 95% CI: 0.998-1.000) of functional limitation. Moderate PA prevents sarcopenia odds. Each weekly hour of moderate PA decreased sarcopenia odds by 6%. CONCLUSION: Time spent in moderate PA can prevent sarcopenia.

Appendicular Skeletal Muscle Mass Prediction in People Living With HIV: A Cross-sectional Study.

ABSTRACT: People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASM DXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASM DXA -predicted (adjusted r2 = 0.84 to 0.87, standard estimate error = 1.7-1.6 kg) and high PRESS validation coefficients (Q 2PRESS = 0.84-0.86, S PRESS = 1.7-1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASM DXA in PWH.

Anthropometric equations to estimate appendicular muscle mass from dual-energy X-ray absorptiometry (DXA): A scoping review.

BACKGROUND: Appendicular skeletal muscle mass (ASM) obtained from dual-energy x-ray absorptiometry (DXA) is recommended to quantify sarcopenia, but has limited availability in disadvantaged-income countries, moreover in an epidemiological context. Predictive equations are easier and less costly to apply, but a review of all available models is still lacking in the scientific literature. The objective of this work is to map, with a scoping review, the different proposed anthropometric equations to predict ASM measured by DXA. METHODS: Six databases were searched without restriction on publication date, idiom, and study type. A total of 2,958 studies were found, of which 39 were included. Eligibility criteria involved ASM measured by DXA, and equations proposed to predict ASM. RESULTS: predictive equations (n = 122) were gathered for 18 countries. The development phase involves sample size, coefficient of determination (r2), and a standard error of estimative (SEE) varying between 15 and 15,239 persons, 0.39 and 0.98, 0.07 and 3.38 kg, respectively. The validation phase involves a sample size, accuracy, and a SEE between 15 and 3,003 persons, 0.61 and 0.98, 0.09 and 3.65 kg, respectively. CONCLUSIONS: The different proposed predictive anthropometric equations of ASM DXA were mapped, including validated pre-existing equations, offering an easy-to-use referential article for clinical and research applications. It is necessary to propose more equations for other continents (Africa and Antarctica) and specific health-related conditions (e.g., diseases), once the equations can only have sufficient validity and accuracy to predict ASM generally when applied to the same population.

Multicompartment body composition analysis in older adults: a cross-sectional study.

BACKGROUND: During aging, changes occur in the proportions of muscle, fat, and bone. Body composition (BC) alterations have a great impact on health, quality of life, and functional capacity. Several equations to predict BC using anthropometric measurements have been developed from a bi-compartmental (2-C) approach that determines only fat mass (FM) and fat-free mass (FFM). However, these models have several limitations, when considering constant density, progressive bone demineralization, and changes in the hydration of the FFM, as typical changes during senescence. Thus, the main purpose of this study was to propose and validate a new multi-compartmental anthropometric model to predict fat, bone, and musculature components in older adults of both sexes. METHODS: This cross-sectional study included 100 older adults of both sexes. To determine the dependent variables (fat mass [FM], bone mineral content [BMC], and appendicular lean soft tissue [ALST]) whole total and regional dual-energy X-ray absorptiometry (DXA) body scans were performed. Twenty-nine anthropometric measures and sex were appointed as independent variables. Models were developed through multivariate linear regression. Finally, the predicted residual error sum of squares (PRESS) statistic was used to measure the effectiveness of the predicted value for each dependent variable. RESULTS: An equation was developed to simultaneously predict FM, BMC, and ALST from only four variables: weight, half-arm span (HAS), triceps skinfold (TriSK), and sex. This model showed high coefficients of determination and low estimation errors (FM: R2adj: 0.83 and SEE: 3.16; BMC: R2adj: 0.61 and SEE: 0.30; ALST: R2adj: 0.85 and SEE: 1.65). CONCLUSION: The equations provide a reliable, practical, and low-cost instrument to monitor changes in body components during the aging process. The internal cross-validation method PRESS presented sufficient reliability in the model as an inexpensive alternative for clinical field use.

Association of minimally processed and ultra-processed food daily consumption with obesity in overweight adults: a cross-sectional study.

Introduction: Introduction: food type represents higher odds of having obesity (OB), especially in overweight (OW) subjects. Minimally and ultra-processed foods can be associated with the odds of having OB in OW subjects. Objective: to investigate the association of minimally and ultra-processed food consumption with OB in OW adults. Methods: we included 15,024 participants (9,618 OW [25.0-29.9 kg/m2], 5,406 OB [≥ 30 kg/m2]) with ages ranging from 18 to 59 years from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL, Brazil). Minimally and ultra-processed food daily consumption scores and confounding variables (age, sex, scholarly, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the association of minimally and ultra-processed food consumption scores with OB (odds ratio [OR]). Results: minimally processed food consumption score quartiles (1st = 1[food-score/day]; 2nd = 6[food-score/day]; 3rd = 7[food-score/day]; 4th = 8[food-score/day]) presented higher values compared to ultra-processed food (1st = 1[food-score/day]; 2nd = 1[food-score/day]; 3rd = 2[food-score/day]; 4th = 4[food-score/day]). For each score of minimally processed food consumed, there was a -5.9 % odds of OB. Thus, the higher quartile (4th) of minimally processed food consumption score represents less odds of OB (OR: -47.2 %; p < 0.001). Each ultra-processed food score consumed presented odds of 3.7 % of OB. Therefore, higher consumption of ultra-processed food (4th quartile) shows higher odds of OB (OR: +14.8 %; p < 0.001). All associations remained significatively even after being adjusted by the confounders. Conclusion: the consumption scores of minimally processed and ultra-processed foods presented a magnitude capable of impacting OW adults' odds of OB, even when controlled by sociodemographic factors, physical activity, hypertension, and diabetes.

Introducción: Introducción: el tipo de alimentación representa una mayor probabilidad de tener obesidad (OB), especialmente en sujetos con sobrepeso (SO). Los alimentos mínimamente procesados y ultraprocesados se pueden asociar con las probabilidades de tener OB en sujetos con SO. Objetivo: investigar la asociación del consumo de alimentos mínimamente procesados y ultraprocesados con la OB en adultos con SO. Métodos: se incluyeron 15.024 participantes (9.618 SO [25,0-29,9 kg/m2], 5.406 OB [≥ 30 kg/m2]) con edades entre 18 y 59 años de la encuesta basal 2019 de la Vigilancia de Factores de Riesgo y Protección para Enfermedades Crónicas mediante una Encuesta Telefónica (VIGITEL, Brasil). Se midió el puntaje de consumo diario de alimentos mínimamente procesados y ultraprocesados y variables de confusión (edad, sexo, escolaridad, actividad física, hipertensión y diabetes). Mediante una regresión logística binaria se analizóla asociación de las puntuaciones de consumo de alimentos mínimamente procesados y ultraprocesados con la OB (odds ratio [OR]). Resultados: los cuartiles de puntuación de consumo de alimentos mínimamente procesados (1.º = 1[alimento-puntuación/día]; 2.º = 6[alimento-puntuación/día]; 3.º = 7[alimento-puntuación/día]; 4.º = 8[alimento-puntuación/día]) presentaron valores superiores en comparación con los alimentos ultraprocesados (1.º = 1[alimento-puntuación/día]; 2.º = 1[alimento-puntuación/día]; 3.º = 2[alimento-puntuación/día]; 4.º = 4[alimento-puntuación/día]). Por cada punto de alimentos mínimamente procesados consumidos, hubo una probabilidad de OB del -5,9 %. Por lo tanto, el cuartil más alto (4.º) de puntuación de consumo de alimentos mínimamente procesados representa menos probabilidades de OB (OR: -47,2 %; p < 0,001). Cada puntaje de alimentos ultraprocesados consumidos presentó probabilidades de 3.7 % de OB. Por lo tanto, un mayor consumo de alimentos ultraprocesados (cuartil 4.º) muestra mayores probabilidades de OB (OR: +14,8 %; p < 0,001). Todas las asociaciones se mantuvieron significativamente incluso después de ajustarlas por los factores de confusión. Conclusión:las puntuaciones de consumo de alimentos mínimamente procesados y ultraprocesados impactaron en la probabilidad de desarrollar OB en adultos con SB, incluso cuando se controló por factores sociodemográficos, actividad física, hipertensión y diabetes.

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.

Otago Exercise Program Plus Cognitive Dual-task can Reduce Fall Risk, Improve Cognition and Functioning in Older Adults.

BACKGROUND: The risk of falling increases with neuromusculoskeletal and cognitive changes resulting from aging. Physical exercise shows beneficial effects on the risk of falling, but the results are unknown when associated with cognitive activity dual-task (DT). OBJECTIVE: The objective of the study was to evaluate the impacts of the Otago Exercise Program (OEP) plus DT cognitive activity on the risk of falling in older adults. METHODS: 36 older adults (83.5 ± 5.7 years) participated in a quasi-experimental study, distributed in two experimental groups and a control group: 1) OEP (OEPG; n=12), 2) OEP plus DT (OEPDTG; n = 12), and a control group (CG; n=12). Older adults were evaluated at pre- and post- 12 weeks of intervention. The thresholds for the risk of falling were considered as multiparameter scores of the 10 Meter Walking Test (10MWT), evocative 10MWT, Timed Up and Go (TUG), Sit to Stand Test (STS), and The Four-Stage Balance Test (Four-Stage), and the Montreal Cognitive Assessment (MoCA), to test the cognitive impairment. RESULTS: At baseline, all groups were homogeneous. Post-intervention, the experimental groups presented significant functional differences, in comparison to the CG, for 10MWT (OEPDTG: p= 0.002; OEPG: p= 0.002); evocative 10MWT (OEPDTG: p=0.001; OEPG: p=0.001); TUG (OEPDTG: p=0.034); STS (OEPDTG: p<0.001; OEPG: p<0.001) and cognitive for MoCA (OEPDTG: p<0.019). Significant intra-group differences (pre-post) were observed in all intervention groups, but none in CG. The risk of falling (Four-Stage) in experimental groups (OEPDTG: 33.3%; OEPG: 41.7%) was considerably lower than CG (83.3%). CONCLUSION: Otago Exercise Program alone can reduce the risk of falling due to improved functionality, but adding the dual task also improves cognitive capacity in older adults. The clinical significance of these interventions goes beyond statistics.

Handgrip strength asymmetry cut points to identify slow gait speed in six low- and middle-income countries: A cross-sectional analysis with 12,669 older adults.

BACKGROUND: Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness. METHODS: A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%). RESULTS: Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men). CONCLUSIONS: HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity.

Nutritional status, health risk behaviors, and eating habits are correlated with physical activity and exercise of brazilian older hypertensive adults: a cross-sectional study.

BACKGROUND: Nutritional status, health risk behaviors, eating habits, and other comorbidities (such as diabetes) may be associated with recommended amounts of physical activity (PA) and exercise (EX) in healthy older adults. However, these associations are still unclear for older hypertensive adults, who require greater care from health professionals. The purpose of this study was to associate the nutritional status, health risk behaviors, eating habits, and the presence of diabetes with recommended amounts of physical activity and exercise practice of older hypertensive adults. METHODS: Ten thousand seven hundred eighty-nine older hypertensive adults (70.9 ± 7.4 years) from the VIGITEL telephone survey were classified according to PA levels (insufficiently active/sufficiently active) and EX practice (non-practitioners/practitioners). Binary logistic regression was used to observe the odds ratio (OR) between independent variables (nutritional status [body mass index], sociodemographic characteristics [age/sex/years of study], risk behaviors [screen time/alcohol/tobacco consumption], eating habits [minimally/ultra-processed foods consumption score], and the presence of diabetes) with recommended amounts of PA/EX (dependent variable). RESULTS: Highest nutritional status (ORPA = 0.975 [95%-CI: 0.965 - 0.985]; OREX = 0.981[95%-CI: 0.972 - 0.991]), age (ORPA = 0.955 [95%-CI: 0.949 - 0.961]; OREX = 0.980[95%-CI: 0.975 - 0.986]), screen time (ORPA = 0.909[95%-CI: 0.835 - 0.990]), alcohol consumption (ORPA = 0.683[95%-CI: 0.621 - 0.758]; OREX = 0.702[95%-CI: 0.637 - 0.779]), tobacco (ORPA = 0.601 [95%-CI: 0.492 - 0.736]; OREX = 0.464[95%-CI: 0.384 - 0.562]) ultra-processed foods consumption score (ORPA = 0.896[95%-CI: 0.871 - 0.921]; OREX = 0.886[95%-CI: 0.863 - 0.909]) and having diabetes (ORPA = 0.780[95%-CI: 0.708 - 0.859]; OREX = 0.831[95%-CI: 0.759 - 0.909]) reduced the odds of being sufficiently active/practicing exercise (p < 0.05). Male sex (ORPA = 1.633[95%-CI: 1.491 - 1.789]; OREX = 1.247[95%-CI: 1.140 - 1.363]), years of study (ORPA = 1.026[95%-CI: 1.018 - 1.035]; OREX = 1.050[95%-CI: 1.041 - 1.058]), and minimally processed foods consumption score increased the odds of being sufficiently active/practicing exercise (ORPA = 1.132[95%-CI: 1.109 - 1.155]; OREX = 1.167[95%-CI: 1.145 - 1.191], respectively; p < 0.05). CONCLUSION: Nutritional status, health risk behaviors, eating habits, and the presence of diabetes were associated with the odds of older hypertensive adults complying with PA and EX recommendations. The results may help health professionals understand how these factors are associated with the changes of older hypertensive adults participating in physical activity and exercise.

The role of physical activity in the clinical outcomes of people diagnosed with Covid-19: A systematic review.

Objective: This review aimed to compile the evidence on PA and clinical outcomes of people receiving a positive diagnosis of covid-19. Design: Systematic review. Methods: The search was performed in five databases: EMBASE, MEDLINE via PubMed portal, Scopus, SPORTDiscus via EBSCO platform, and Web of Science. In addition, the "gray" literature was searched through Google Scholar and medRxiv published between January 2020 and July 2022. Studies were assessed for risk of bias, with the extraction of relevant data. Our search revealed a total of 10,028 studies. Results: After applying the eligibility criteria 32 studies were included. Thirty-one studies were at low to moderate risk of bias. Physically active individuals, who were diagnosed with covid-19, presented attenuation of clinical outcomes, such as decreased risk of hospitalization, recovery time, number of symptoms, severity, and ICU and death when compared to individuals with low levels of PA or classified as sedentary. Conclusions: Physically active individuals when diagnosed with covid-19 may have decreased risk of several clinical outcomes related to covid-19, including but not limited to hospitalization and number of symptoms. Public health authorities should develop strategies and initiatives that promote safe PA environments to improve the clinical prognosis of people diagnosed with covid-19. Study registration: Open Science Framework (OSF), DOI registry 10.17605/OSF.IO/PV6NF. It can be consulted through the access link: https://doi.org/10.17605/OSF.IO/PV6NF, October 07, 2021.

Being Physically Active Leads to Better Recovery Prognosis for People Diagnosed with COVID-19: A Cross-Sectional Study.

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.

Association between classic and specific bioimpedance vector analysis and sarcopenia in older adults: a cross-sectional study.

BACKGROUND: To verify (1) the association between classic and specific bioelectrical impedance vector analysis (BIVA) with body composition, hydration, and physical performance in older adults with and without sarcopenia; (2) which BIVA most accurately distinguishes sarcopenia. METHODS: A sample of 94 older adults with and without sarcopenia (29 men and 65 women, 60-85 years) was evaluated. The classic and specific BIVA procedures, Dual energy X-ray absorptiometry (DXA), and deuterium dilution were performed. Sarcopenia was defined by muscle weakness and low skeletal muscle index, while severity was indicated by low physical performance. RESULTS: The BIVA's potential to monitor hydration and muscle mass loss in older adults seems feasible. Classic and specific BIVA were able to distinguish sarcopenia in women (p < 0.001), but not in men. When the sarcopenia criteria were individually analyzed, both classic and specific BIVA were able to distinguish low skeletal muscle index in women, while only classic BIVA did for men. For the criterion of slow physical performance, only the classic BIVA showed severity differences for women. The vectors of adults without sarcopenia of both sexes tended to be positioned in the left region of the ellipses, revealing a predominance of soft tissues. CONCLUSIONS: Classic BIVA has a distinct sarcopenic association with body composition, hydration, and physical performance in older adults, while specific BIVA was similar between groups. Both BIVAs are sensible to detect female morphological changes (skeletal muscle index) but not for functional (handgrip, 6-min walk test) sarcopenia criteria. These procedures are promising tools for monitoring sarcopenia risks during aging.

Foreign allometric exponents adequately normalize isokinetic knee extension strength to identify muscle weakness and mobility limitation in Portuguese older adults: a cross-sectional study.

BACKGROUND: Identifying muscle weakness is challenging, because the reduction of strength with aging does not depend only on sarcopenia, but also on sensorimotor deficits. Nevertheless, this identification is improved by adjusting muscle strength allometrically, by removing the influence of body size. However, the effectiveness of foreign models to normalize these (dys)functionalities is not yet tested. This study aimed to compare and apply foreign allometric exponents for normalizing isokinetic knee extension strength in Portuguese older adults to identify muscle weakness/mobility limitation. Additionally, to attest any populational difference, data of these people and Brazilian older adults were compared METHODS: This is a cross-sectional study encompassing 226 Portuguese (n = 132) and Brazilian (n = 94) older adults. Mobility limitation (six-minute walk test, at lowest quartile), lower limb strength (knee extension isokinetic strength at 60º/s), and body dimensions measures were taken. Foreign allometric exponents (b) were used to normalize Portuguese strength (strength/body-size variablesb). Non-normalized and normalized strength were compared (ROC) to generate the most accurate cut-point for identifying muscle weakness/mobility limitation. RESULTS: Older Portuguese men and women had better mobility than their Brazilian counterparts. Older Portuguese women had superior muscle strength to Brazilian women. Normalization from 11 foreign models removed the influence of body size on muscle strength, with a negligible correlation (r ≤ 0.30). In contrast to the non-normalized strength, the normalized strength cut-off points were sufficiently accurate (AUC ≥ 0.70) to avoid identifying false-negative cases of weakness/mobility limitation. CONCLUSIONS: Portuguese older women were stronger and had superior functional capacity compared to Brazilian ones. Normalized foreign models improved the accuracy in identifying muscle weakness/mobility limitation in Portuguese older adults. The isokinetic knee extension muscle strength normalized, even using foreign allometric exponents, should be better than no adjustment.

Sleep Quality and Quality of Life Among Older Adults During COVID-19 Pandemic: A Cross-Sectional Study.

BACKGROUND: Although home confinement reduces the number of SARS-CoV-2 infections, it may negatively impact the psychological and physical health of older adults. OBJECTIVE: The present study attempted to describe the quality of life (QoL) of older adults before and during the COVID-19 outbreak, focusing on evaluating QoL, physical activity, sitting time, and sleep quality during home confinement. METHODS: The present study was conducted in 1,063 older adults (91 % females) enrolled in a Brazilian social program. They were interviewed for QoL (EQ-5D), physical activity (international physical activity questionnaire-short), and sleep quality [Pittsburgh sleep quality index (PSQI)] after 11.6 ± 2.4 weeks of confinement. Logistic regression confirmed changes in QoL. RESULTS: The QoL (86.5 ± 14.7) decreased significantly during confinement (66.0 ± 21.0; P < 0.001), whereas the PSQI global score was 6.8 ± 3.9 points. Older adults spent 18.7 ± 29.8 min/day in moderate to vigorous physical activity, whereas they spent 325.5 ± 144.4 min/day sitting. The PSQI global score [odds ratio (OR): 1.10], sitting time (OR: 1.001), and diseases (OR: 1.23) were significantly associated with low QoL (P < 0.05). CONCLUSION: Confinement has a deleterious effect on QoL, which is influenced by quality of sleep, sitting time, and disease. Awareness regarding the significance of sleep and physical exercise in older adults can mitigate the damage to their health during confinement.

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).

Allometrically adjusted handgrip strength and chair stand test cut points to identify sarcopenia in older Portuguese adults / Pontos de corte da força de preensão manual e teste de sentar e levantar da cadeira ajustados alometricamente para identificar sarcopenia em idosos portugueses

ABSTRACT Absolute muscle strength or adjusted by body mass index (BMI) are useful to identify sarcopenia. However, these values are not accurate for older adults with extreme body sizes because the nonlinear relationship between strength and body size. The purpose was to determine cut-off points for identify sarcopenia in older adults using allometric coefficients to normalise handgrip strength (HGS) and 30-sec chair stand test (30-s CST) by body size. Allometric exponents were proposed with log-linear models for body-size variables (body mass, height and BMI). The remotion of body-size effect on muscle strength with allometric normalisation was tested by partial correlation. Cut-off points for low muscle strength were established by ROC curve and Youden index considering functional limitation (six-minute walk test<400m). Allometric exponents provided for body-size variables range from -0.01 to 2.28 (HGS) and -0.27 to 0.21 (30-s CST). The effect of body size on muscle strength was removed with allometric normalisation (r<0.30). Cut-off points accuracy was always adequate (AUC≥0.78; p<0.001). In conclusion, cut-off points of HGS and 30-s CST allometrically normalised were proposed to identify sarcopenia in Portuguese older adults and allometry maintained adequate the accuracy (AUC>70%). Allometry removed influence of body size on the expression of HGS and 30-s CST and permits evaluate muscle strength regardless of body-size.

RESUMO A força muscular absoluta ou ajustada pelo índice de massa corporal (IMC) é útil para identificar a sarcopenia. No entanto, esses valores não são precisos para idosos com tamanhos corporais extremos devido à relação não linear entre força e tamanho corporal. O objetivo foi determinar os pontos de corte para identificar a sarcopenia em idosos usando coeficientes alométricos para normalizar a força de preensão manual (FPM) e teste de sentar e levantar da cadeira em 30 segundos (30-s CST) por tamanho corporal. Os expoentes alométricos foram propostos com modelos log-lineares para variáveis de tamanho corporal (massa corporal, estatura e IMC). A remoção do efeito do tamanho corporal na força muscular com normalização alométrica foi testada por correlação parcial. Os pontos de corte para baixa força muscular foram estabelecidos pela curva ROC e índice de Youden considerando a limitação funcional (teste de caminhada de seis minutos<400m). Os expoentes alométricos fornecidos para variáveis de tamanho corporal variam de -0,01 a 2,28 (FPM) e -0,27 a 0,21 (30-s CST). O efeito do tamanho corporal na força muscular foi removido com normalização alométrica (r<0,30). A precisão dos pontos de corte sempre foi adequada (AUC≥0,78; p<0,001). Em conclusão, foram propostos pontos de corte para FPM e 30-s CST normalizados alometricamente para identificar sarcopenia em idosos portugueses e a alometria manteve a precisão adequada (AUC>70%). A alometria removeu a influência do tamanho corporal na expressão da FPM e 30-s CST e permite avaliar a força muscular independentemente do tamanho corporal.