The Impact of Undernutrition Risk on Rehabilitation Outcomes in Ischemic Stroke Survivors: A Hospital-Based Study.

Patients experiencing a cerebrovascular event are vulnerable to declining nutritional status, hindering rehabilitation. This study aims to analyze the association between malnutrition risk and hospital rehabilitation indicators in ischemic stroke survivors (ISS). This analytical study examined medical records of 160 adult patients (69.3 ± 13 years). Undernutrition risk (UR; independent variable) and rehabilitation indicators (dependent variables) like hospital stay, clinical outcome, functionality, stroke severity, food intake, mobility (bedridden), mechanical ventilation, and enteral nutrition were assessed. Data were dichotomized, and the chi-square test identified associations (p ≤ 0.05), followed by Poisson regression for prevalence ratios. Patients at UR had 2-fold higher risk of death (95% confidence interval [CI], 0.99-4.79), 1.8-fold higher risk of high stroke severity (95% CI, 1.06-3.11), 76% higher chance of being bedridden (95% CI, 1.28-2.44), and 3-fold higher risk of mechanical ventilation (95% CI, 1.20-9.52). UR in hospitalized ISS is associated with deteriorating rehabilitation indicators, including mobility, decreased food intake, mechanical ventilation use, and neurological deficit, indicating an increased mortality risk post-stroke.

Systematic review and meta-analysis of randomized controlled trials on the effects of exercise interventions on amyloid beta levels in humans.

Alzheimer's disease (AD) represents the most common type of dementia. A crucial mechanism attributed to its development is amyloid beta (Aß) dynamics dysregulation. The extent to which exercise can modulate this phenomenon is uncertain. The aim of this study was to summarize the existing literature evaluating this issue. A comprehensive systematic search was performed in Pubmed, Scopus, Embase, Web of Science, and SciELO databases and completed in August 2023, aiming to identify randomized controlled trials investigating the effect of exercise upon Aß-related pathology. The keywords "exercise" and "amyloid beta", as well as all their equivalents and similar terms, were used. For the analysis, the negative or positive dementia status of the subjects was initially considered and then the soluble amyloid precursor protein (sAPP) components and Aß fragments separately. A meta-analysis was performed and involved eight studies (moderate-to-high quality) and 644 assessments, which were 297 for control and 347 for exercise. No overall effect favoring exercise interventions was observed for both negative (SMD95%=0,286 [-0,131; 0,704]; p = 0,179) or positive AD dementia status (SMD95%=0,110 [-0,155; 0,375]; p = 0,416). The absence of an overall effect favoring exercise interventions was also found for Aß peptides (SMD95%=0,226 [-0,028; 0,480]; p = 0,081) and for sAPP components (SMD95%=-0,038 50 [-0,472; 0,396]; p = 0,863) levels. Our findings suggest that exercise interventions do not improve Aß-related pathology in both healthy individuals and individuals with dementia (SMD95%=0,157 [-0,059; 0,373]; p = 0,155), indicating that the beneficial effects of exercise for AD reported in previous studies are related to other mechanistic effects rather than direct amyloid effects (PROSPERO registration number: CRD42023426912).

Overweight and Blood Pressure in Pre-Pubertal Children: A Longitudinal Study.

OBJECTIVE: To analyze the longitudinal relationship between overweight and hypertension in school children. METHODS: This cohort study enrolled children 6-8 years of age who were then prospectively followed up over a 24 months period with repeat assessments performed at an interval of 11-13 months. Information on participation in physical education classes in school, sports practice outside of school, and economic status were obtained through questionnaires answered by parents/guardians. The measurement of blood pressure, weight, height, and waist circumference was performed during the serial follow-up visits in school. RESULTS: The proportion of hypertension did not change significantly over the 24 months (7.1% to 8.2%; P = 0.690). However, children with overweight and obesity throughout the period, had a 198% [HR (95% CI) 2.98 (1.40, 6.35)] higher risk of having hypertension diagnosed during follow-up when compared to eutrophic children in the same period. CONCLUSION: The development trajectory of overweight and obesity in children aged 6-8 years was associated with hypertension.

Parent-child associations of sleep quality: is physical activity a confounder? The EPI-FAMILY health study.

INTRODUCTION: The incidence of sleep deprivation has increased in pediatric populations, however, the relationship with physical activity (PA) remains uncertain and lacks evidence. Although some studies have shown that parents' lifestyle habits can influence this process, one point that requires further clarification in the literature is whether parents' sleep quality is linked to that of their children and whether parents' physical activity could play an important role in these possible relationships. OBJECTIVES: To investigate the relationship of sleep quality between parents and children and verify the role of physical activity in this association. METHODS: This is a cross-sectional study. Sleep quality was assessed using the Mini Sleep Questionnaire. The amount of sleep was estimated by the number of hours slept. PA domains (occupational activities, leisure, and active commuting) were assessed using the Baecke questionnaire, while moderate to vigorous PA (MVPA) was assessed with an accelerometer. Socioeconomic status was obtained through a questionnaire. The relationship of sleep quality between parents and children was carried out using hierarchical models with Binary Logistic Regression, where the factors were inserted one by one (1. unadjusted model; 2. sociodemographic variables; 3. children's PA; 4. parents' PA). RESULTS: The study sample consisted of 102 children and adolescents (6-17 years), 92 mothers, and 69 fathers. Poor sleep quality of mothers was associated with their children's sleep quality (OR = 3.95; 95%CI = 1.33-11.38; P = 0.013). After inserting mothers' PA intensity into the final model, the associations remained significant (OR = 8.05; 1.33-48.59; P = 0.023). No relationship was observed between poor sleep quality of fathers and their children's sleep quality. CONCLUSION: The relationship between poor sleep quality of mothers and that of their children remained significant, regardless of confounding variables.

Undernutrition risk is independently associated with worsened indicators of hospital rehabilitation in COVID-19 patients.

OBJECTIVE: This study was designed to analyze the association between the risk of undernutrition and indicators of hospital rehabilitation in patients with COVID-19 while controlling for confounding variables. METHODS: This was an analytical study conducted by analyzing the medical records of patients with COVID-19. A total of 562 adult patients were eligible for the study. In addition to the risk of undernutrition (independent variable), indicators of hospital rehabilitation (dependent variables) were evaluated. These indicators included the length of hospital stay, clinical outcome (discharge or death), food intake, mobility (bedridden status), the use of mechanical ventilation, and the need for enteral nutrition. Pre-existing comorbidities (confounding/control variables) were grouped into cardiovascular, metabolic/endocrine, neurological, chronic obstructive pulmonary disease, and other categories (neoplasms, multiple sclerosis, and kidney disease). A dichotomization model was applied for data analysis. The Chi-Square test was used to verify the association between the risk of undernutrition and the dependent variables. Associations with a significance level of P < 0.05 were subjected to Poisson regression to identify the prevalence ratio. RESULTS: Patients at risk of undernutrition had a 90% higher chance of being bedridden and were 35 times more likely to experience a decrease in food intake. They also had an 89% higher chance of using invasive mechanical ventilation and a 91% higher chance of requiring enteral nutrition. Additionally, individuals at risk of undernutrition had a 73% higher chance of death. Adjustment for comorbidities did not alter these associations, demonstrating that the risk of undernutrition is independently associated with indicators of hospital rehabilitation. CONCLUSION: The risk of undernutrition is independently associated with worsened indicators of hospital rehabilitation in patients with COVID-19, including higher prevalence of mortality.

A Single Dosage of l-Arginine Oral Supplementation Induced Post-Aerobic Exercise Hypotension in Hypertensive Patients.

Lowering of peripheral vascular resistance is one of the primary processes involved in blood pressure decrease. Nitric oxide plays a significant role in this process and the availability of l-arginine is a crucial element in nitric oxide biosynthesis. Oral l-arginine supplementation may therefore be a potentiating element in post-exercise hypotension, mediated by its vasodilator action. Thus, the purpose of this study was to investigate if a single dose of l-arginine oral supplementation might impact the post-aerobic exercise blood pressure responses in treated hypertensive individuals. A double-blind, randomized, placebo-controlled crossover trial was conducted. The sample included male (4) and female (6) subjects [62 ± 10 years]. The participants were randomized to ingest one sachet containing 8 grams of l-arginine or placebo (corn starch) dissolved in water (100 ml). The substances were self-administered 120 min before the experimental or control session. The exercise was conducted on a treadmill and consisted of: a 5 min warm-up (50-65% HRreserve); 40 min of running/walking at 60-70% HRreserve; and a 5 min progressive cooldown. After the exercise sessions, blood pressure was measured every 10 min for 60 min. The l-arginine supplementation arm led to significant post-exercise systolic hypotension (mean post-exercise) in relation to rest period (117 ± 12 vs 125 ± 15 mmHg - p = 0.004 [l-arginine] and 121 ± 11 vs 125 ± 15 - p = 0.341 [placebo]). In addition, a systolic net effect of -6.9 ± 3.6 mmHg [p = 0.046] was identified for the mean post-exercise values. Therefore, this study showed that a single dosage of l-arginine oral supplementation induced post-aerobic exercise hypotension in hypertensive patients.

Effects of Aquatic Exercise in Post-exercise Hypotension: A Systematic Review and Meta-Analysis.

BACKGROUND: Post-exercise hypotension (PEH) can be an important non-pharmacological strategy in the treatment of arterial hypertension. Both aerobic and resistance exercises produce PEH, but it is not clear if the exercise environment can lead to a higher PEH. OBJECTIVE: This meta-analysis investigated whether a session of aquatic exercise (AE) induces PEH in comparison with control conditions such as land exercise (LE) or rest in hypertensive subjects. METHODS: The present systematic review and meta-analysis was conducted using the following electronic databases: PubMed, Google Scholar, and EMBASE. Ambulatory blood pressure measurements made in randomized clinical trials were pooled to compare PEH induced by AE with LE and rest conditions in hypertensive subjects. RESULTS: Data from four trials were included, which comprised 127 participants (94 women and 33 men). A 24-h analysis did not detect significant differences between AE and LE or rest for either systolic blood pressure (SBP) or diastolic blood pressure (DBP). Monitoring during the night showed that AE induced significant PEH in comparison with LE for SBP [-8.6 (-15.0 to -1.5) mmHg (p = 0.01)]. For DBP, the AE had pronounced PEH during the night in comparison with LE [-3.7 (-4.7 to -2.8) mmHg, p = 0.000] and rest [-1.7 (-1.9 to -0.8) mmHg, p = 0.000]. There were no differences in daytime values. CONCLUSION: AE showed a higher PEH effect than LE sessions and rest conditions. PEH was observed in both SBP and DBP during the night. The number of studies was low, but all studies included in this meta-analysis used 24-h monitoring. The understanding of clinical relevance of AE, inducing a higher PEH, depends on a standardization of exercise protocols plus a rigorous monitoring of blood pressure. SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration: CRD42021271928.

Effects of Citrulline Malate Supplementation on Muscle Strength in Resistance-Trained Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Although the ergogenic mechanisms of supplementation with citrulline malate are well known, unclear findings regarding variables of muscle strength have been recorded. Such misleading findings in the literature illustrate the need for well-conducted meta-analysis research to elucidate the possible ergogenic impact, which could have major practical consequences for athletes and recreational practitioners seeking to optimize gains in muscle strength. The objective of this systematic review was to summarize the existing literature that evaluated the effects of citrulline malate supplementation on muscle strength outcomes from resistance exercise in resistance-trained individuals. A systematic electronic search in Medline and Scientific Electronic Library Online (SciELO) was completed in August 2020 identifying randomized controlled trials investigating the effect of citrulline malate supplementation on muscle strength in resistance-trained adults. A subsequent meta-analysis was performed. The meta-analysis involved four studies and 138 assessments (69 in citrulline-malate and 69 in placebo groups). We did not observe an overall effect favoring citrulline-malate supplementation (SMD95% = 0.13 [-0.21; 0.46]). Considering the lower (SMD95% = 0.06 [-0.47; 0.60]) and upper (SMD95% = 0.17 [-0.26; 0.60]) limbs, a non-significant overall effect was identified. The mean effects were similar for "limbs" (upper vs lower) [p = 0.763]. Accordingly, our findings suggest that citrulline malate supplementation does not improve muscle strength in healthy and resistance-trained individuals (PROSPERO registration number: CRD42020159338).

Effect of Different Sports Practice on Sleep Quality and Quality of Life in Children and Adolescents: Randomized Clinical Trial.

BACKGROUND: Sports practice can promote several health benefits in pediatric populations; nonetheless, most of the studies that investigated these benefits are of cross-sectional design. Thus, our objective was to verify the effectiveness of two types of physical activities through sports, judo and ball games (soccer, volleyball, handball, and basketball) on the quality of sleep and life of Brazilian children and adolescents. METHODS: The study is a randomized clinical trial, conducted with 65 participants of both sexes (6-15 years old) in a philanthropic institution in Brazil. The variables investigated were the quality of sleep and life, using the mini-sleep questionnaire and KidsCreen-52 questionnaires (this instrument has a scale ranging from 0 to 100, where 100 is the best value for each domain), respectively. The interventions carried out during 12 weeks (twice a week) were judo and ball games. In the statistical analysis, analysis of variance (ANOVA) for repeated measures was used and the level of statistical significance used was 5%. RESULTS: Judo (P = 0.032) and ball games (P = 0.005) contributed to improving the quality of sleep in the participants. Considering the score of the domains of quality of life, judo and ball games significantly increased the perception of health and physical activity [mean = 6.9 (8.3%) and 8.91 (12.2%) points, respectively], autonomy [mean = 5.81 (7.3%) and 5.00 (6.9%) points], friends and social support (mean = 2.83 (3.8%) and 12.00 (15.9%) points), provocation and bullying [mean = 10.21 (18.1%) and 2.14 (4.1%) points]. CONCLUSION: It is concluded that both judo and ball games brought benefits to the quality of sleep and life of children and adolescents. Health promotion actions should encourage the increase in sports practice in children and adolescents to improve sleep and quality of life.

Post-exercise Hypotension Following a Single Bout of High Intensity Interval Exercise vs. a Single Bout of Moderate Intensity Continuous Exercise in Adults With or Without Hypertension: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.

Background: Post-exercise hypotension (PEH) is an important tool in the daily management of patients with hypertension. Varying the exercise parameters is likely to change the blood pressure (BP) response following a bout of exercise. In recent years, high-intensity interval exercise (HIIE) has gained significant popularity in exercise-based prevention and rehabilitation of clinical populations. Yet, to date, it is not known whether a single session of HIIE maximizes PEH more than a bout of moderate-intensity continuous exercise (MICE). Objective: To compare the effect of HIIE vs. MICE on PEH by means of a systematic review and meta-analysis. Methods: A systematic search in the electronic databases MEDLINE, Embase, and SPORTDiscus was conducted from the earliest date available until February 24, 2020. Randomized clinical trials comparing the transient effect of a single bout of HIIE to MICE on office and/or ambulatory BP in humans (≥18 years) were included. Data were pooled using random effects models with summary data reported as weighted means and 95% confidence interval (CIs). Results: Data from 14 trials were included, involving 18 comparisons between HIIE and MICE and 276 (193 males) participants. The immediate effects, measured as office BP at 30- and 60-min post-exercise, was similar for a bout of HIIE and MICE (p > 0.05 for systolic and diastolic BP). However, HIIE elicited a more pronounced BP reduction than MICE [(-5.3 mmHg (-7.3 to -3.3)/ -1.63 mmHg (-3.00 to -0.26)] during the subsequent hours of ambulatory daytime monitoring. No differences were observed for ambulatory nighttime BP (p > 0.05). Conclusion: HIIE promoted a larger PEH than MICE on ambulatory daytime BP. However, the number of studies was low, patients were mostly young to middle-aged individuals, and only a few studies included patients with hypertension. Therefore, there is a need for studies that involve older individuals with hypertension and use ambulatory BP monitoring to confirm HIIE's superiority as a safe BP lowering intervention in today's clinical practice. Systematic Review Registration: PROSPERO (registration number: CRD42020171640).

Leucine Supplementation Does Not Improve Muscle Recovery from Resistance Exercise in Young Adults: A Randomized, Double-Blinded, Crossover Study.

This study aimed to investigate the effects of free leucine supplementation on muscle recovery from resistance exercise (RE) in young adults. Fourteen untrained subjects (23.9 ± 3.6 years old) underwent RE sessions (leg press and hack squat: three sets of 8-12 reps at 70% 1RM) supplemented with leucine (LEU: two daily doses of 3g) or a placebo (PLA), separated by a seven-day washout period. Following each occasion, participants were evaluated in three subsequent days (24h, 48h, and 72h) for muscle recovery via a repetition-to-failure test. The following markers were assessed: repetition performance, perceived exertion, lactate, creatine kinase, muscle soreness (DOMS), testosterone, and cortisol. No significant difference was observed between LEU and PLA conditions (p > 0.05). Number of repetitions performed in the repetition-to-failure tests, perceived exertion, cortisol, and testosterone:cortisol ratio did not change over time (p > 0.05). Creatine kinase increased immediately after exercise, at 24h, and 48h, and was attenuated at 72h post-exercise, while testosterone, lactate, and DOMS increased at 24h post-exercise (p < 0.05) and remained elevated up to 72h. All outcomes were similar between LEU and PLA. Results indicate that a 6g daily dose of free leucine supplementation does not improve muscle recovery following lower-limb RE in untrained young adults.

Effects of Citrulline Malate Supplementation on Aerobic and Muscular Endurance in Young Adults Men / Efeitos da Suplementação de Citrulina Malato sobre a Resistência Aeróbica e Muscular em Homens Adultos Jovens

The aim of this study was to evaluate the effects of citrulline malate (CIT) supplementation on aerobic and muscular endurance in young adult males. Eighteen young adult men (age: 21.5 ± 2.7 years) were randomized into two groups (Citrulline malate - CIT and Placebo - PLA; N = 9/ group ) and received the respective supplements for 7 days. The CIT group was supplemented with 6 g CIT + 6 g dextrose (total: 12 g), while the PLA group received the same amount (12 g) of dextrose. At the pre- and post-supplementation, the following variables were analyzed: aerobic (maximal treadmill test, Tmax) and muscle (repetitions maximum test, Rmax) endurance tests, as well as mean and maximum heart rate (HR) in Tmax and ratings of perceived exertion (PSE) in Rmax. No significant (P > 0.05) differences were found between CIT and PLA groups in time until exhaustion in Tmax, total repetitions in Rmax, maximal HR and PSE from pre- to post-supplementation. The mean HR was statistically lower (P < 0.05) in the CIT group compared to the PLA in the Tmax. In conclusion, supplementation of CIT (6 g / day) does not improve aerobic and muscular endurance, as well as maximal HR or PSE in healthy young adults, despite reducing the mean HR during the maximal incremental test. (AU)

O objetivo deste estudo foi avaliar os efeitos da suplementação de citrulina malato (CIT) sobre a resistência aeróbica e muscular em homens adultos jovens. Em um desenho experimental randomizado, duplo-cego e controlado com placebo, dezoito homens adultos jovens (idade: 21,5 ± 2,7 anos) foram randomizados em dois grupos (Citrulina malato ­ CIT e Placebo ­ PLA; N = 9/grupo) e receberam os respectivos suplementos por um período de 7 dias. O grupo CIT foi suplementado com 6 g de CIT + 6 g de dextrose (total: 12 g), enquanto o grupo PLA recebeu a mesma quantidade (12 g) de dextrose. Nos momentos pré e pós suplementação as seguintes variáveis foram analisadas: resistência aeróbia (teste incremental máximo em esteira rolante, Tmáx) e muscular (teste de repetições máximas, Rmáx), bem como a frequência cardíaca (FC) média e máxima no Tmáx e a análise da percepção subjetiva de esforço (PSE) no Rmáx. Nenhuma diferença significante (P > 0,05) foi encontrada entre os grupos CIT e PLA no tempo até a exaustão no Tmáx, total de repetições no Rmáx, FC máxima e PSE do momento pré para o pós suplementação. A FC média foi estatisticamente (P < 0,05) menor no grupo CIT comparado ao PLA no Tmáx. Em conclusão, a suplementação de CIT (6 g/dia) não melhora a resistência aeróbica e muscular, bem como a FC máxima ou PSE em adultos jovens saudáveis, apesar de reduzir a FC média durante o teste incremental máximo. (AU)

Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders / A atividade física está associada à frequência cardíaca de repouso em meninos e meninas? Estudo representativo controlado para fatores de confusão

Abstract Objective: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. Method: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. Results: Total physical activity was associated with low RHR in boys (β = −0.52; 95% CI: −0.92, −0.12) and girls (β = −0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (β = −0.58; 95% CI: −1.05, −0.11) and girls (β = −0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (β = −1.56; 95% CI: −2.99, −0.14). Conclusion: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.

Resumo Objetivo Investigar a relação entre diferentes domínios de atividade física e frequência cardíaca de repouso (FCRep) em meninos e meninas. Método A amostra incluiu 1.011 adolescentes, entre 10 e 17 anos. A FCRep foi medida por um monitor de frequência cardíaca e a atividade física foi avaliada no total e em três diferentes domínios (escolar, ocupacional e prática esportiva) através de um questionário. A antropometria foi obtida diretamente para o índice de massa corporal e gordura central. Etnia, comportamento sedentário e tabagismo foram autorrelatados e usados para ajustar a análise, através da regressão linear hierárquica. Resultados A atividade física total foi associada à baixa FCRep nos meninos (β = −0,52; IC95% −0,92; −0,12) e meninas (β = −0,67; IC95% −1,07; −0,28). Embora as atividades físicas esportivas estivessem associadas à baixa FCRep em ambos, meninos (β = −0,58; IC95% −1,05, −0,11) e meninas (β = −0,87; IC95% −1,34, −0,39), a atividade física ocupacional estava relacionada à baixa FCRep apenas em meninos (β = −1,56; IC95% −2,99; −0,14). Conclusão A prática de atividade física no domínio da prática esportiva e a atividade física total foram relacionadas à baixa FCRep em ambos os sexos, enquanto as atividades físicas ocupacionais foram associadas à FCRep apenas em meninos.

Pilates exercise and postural balance in older adults: A systematic review and meta-analysis of randomized controlled trials.

INTRODUCTION: The effects of exercising with the Pilates method on aspects such as balance for the general population have been reported by recent systematic reviews. However, whereas the effects of the Pilates method on improving general balance have been well studied, less is known about postural balance and the respective determinants of Pilates effects. OBJECTIVES: (1) provide more up-to-date evidence to determine the effects of Pilates on postural balance and (2) examine the effects of length of intervention, Pilates amount per week (times per week X session duration), and study quality (risk of bias) on postural balance in older adults. METHODS: A systematic electronic search in Medline and Scientific Electronic Library Online (SciELO) was completed in December 2018 identifying randomized controlled trials investigating the effect of a Pilates method on postural balance in healthy older adults. A subsequent meta-analysis was performed. RESULTS: The meta-analysis involved 6 studies and 261 individuals (128 Pilates and 133 control groups). We observed an overall effect favoring the Pilates group SMD95% = 0.89 [0.29-1.49]. The subgroup mean effects were similar for "length of intervention" (low vs high) [P = 0.557], "Pilates amount per week" (low vs high) [P = 0.565], and "study quality" (low vs high) [P = 0.869]. CONCLUSION: Accordingly, our findings suggest that a Pilates training program can be considered as an effective form of exercise to improve balance in older adults. Additionally, length of intervention, Pilates amount per week, and study quality were not related to the magnitude of effect on postural balance.

Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders.

OBJECTIVE: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. METHOD: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. RESULTS: Total physical activity was associated with low RHR in boys (ß=-0.52; 95% CI: -0.92, -0.12) and girls (ß=-0.67; 95% CI: -1.07, -0.28). Although sporting physical activities were associated with low RHR in both boys (ß=-0.58; 95% CI: -1.05, -0.11) and girls (ß=-0.87; 95% CI: -1.34, -0.39), occupational physical activity was related to low RHR only in boys (ß=-1.56; 95% CI: -2.99, -0.14). CONCLUSION: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.

L-arginine supplementation improves post-exercise hypotension in elderly women / Suplementação de l-arginina potencializa a hipotensão pós-exercício em mulheres idosas / La suplementación de l-arginina potencializa la hipotensión post ejercicio en mujeres de la tercera edad

ABSTRACT Introduction: L-Arginine supplementation increases plasma levels of nitric oxide (NO) metabolites, an important mediator of peripheral dilatation. Therefore, L-Arginine supplementation can improve the duration and magnitude of post-exercise hypotension. Objectives: This study investigated the effects of L-Arginine supplementation on post-exercise hypotension, femoral artery area and heart rate variability in elderly women. Methods: Twenty prehypertensive and hypertensive adult female participants were divided (in a random and balanced manner) into two groups (placebo and L-arginine). The participants ingested eight grams of inert substance (placebo group) or eight grams of L-Arginine (L-arginine group), dissolved in water, 90 min prior to the experimental session. The experimental session consisted of an isokinetic maximal strength test. Blood pressure was measured using an oscillometric device (Omron MX3 Plus, Bannockburn, US) every 10 minutes for 60 minutes after the experimental session. Femoral artery area (ultrasound) and heart rate variability were also analyzed. Data underwent repeated measures (ANOVA) analysis and respective assumptions. Results: L-Arginine supplementation associated with exercise produced a significant decrease in systolic blood pressure [placebo vs L-Arginine] (p <0.05) at the "half-life" time point (90 minutes after supplementation) (141±12 vs 130±11 mmHg) and 40 min. (146±13 vs 127±13 mmHg), 50 min. (145±20 vs 127±15 mmHg) and 60 min. (147±19 vs 129±14mmHg) post-exercise. No significant differences were identified in femoral artery area and heart rate variability. Conclusion: Acute L-Arginine supplementation can increase post-exercise hypotension effects in elderly women. Additionally, acute L-Arginine supplementation is not related to either femoral artery area or heart rate variability responses. Level of evidence I; Randomized clinical trial.

RESUMO Introdução: A suplementação de L-arginina aumenta os níveis plasmáticos dos metabólitos de óxido nítrico, um importante mediador da dilatação periférica. Dessa forma, é possível que a suplementação de L-arginina maximize a duração e a magnitude dos efeitos hipotensores pós-exercício. Objetivos: O presente estudo investigou os efeitos da suplementação de L-arginina na hipotensão pós-exercício, área da artéria femoral e variabilidade da frequência cardíaca em mulheres idosas. Métodos: Vinte participantes, adultas, pré-hipertensas e hipertensas foram divididas (de modo aleatório e equilibrado)em dois grupos (placebo e L-arginina). As participantes ingeriram oito gramas de substância inerte (grupo placebo) ou oito gramas de L-arginina (grupo L-arginina), dissolvido em água, 90 min antes da realização da sessão experimental. A sessão experimental consistia em um teste de força isocinética máxima. A pressão arterial foi aferida utilizando um dispositivo oscilométrico (Omron MX3 Plus, Bannockburn, EUA) a cada 10 minutos, durante 60 minutos, após o término da sessão experimental. Foram analisadas ainda a variabilidade da frequência cardíaca e a área da artéria femoral (ultrassom). Os dados foram submetidos à análise de variância para medidas repetidas (ANOVA) e seus respectivos pressupostos. Resultados: A suplementação de L-arginina associada ao exercício promoveu redução significativa da pressão arterial sistólica [placebo vs. L-arginina] (p<0,05) no intervalo de "meia-vida" (90 minutos após a suplementação) (141±12 vs. 130±11 mmHg) e aos 40 min. (146±13 vs. 127±13 mmHg), 50 min. (145±20 vs. 127±15 mmHg) e 60 min. (147±19 vs. 129±14 mmHg) pós-exercício. Não foram identificadas diferenças significativas na área da artéria femoral e na variabilidade da frequência cardíaca. Conclusão: A suplementação aguda de L-arginina pode potencializar os efeitos hipotensores pós-exercício em mulheres idosas. Além disso, a suplementação de L-arginina aguda não está associada às respostas de variabilidade da frequência cardíaca ou da área da artéria femoral. Nível de evidência I; Ensaio clínico randomizado.

RESUMEN Introducción: La suplementación de L-arginina aumenta los niveles plasmáticos de los metabolitos de óxido nítrico, un importante mediador de la dilatación periférica. De esa forma, es posible que la suplementación de L-arginina maximice la duración y la magnitud de los efectos hipotensores post ejercicio. Objetivos: El presente estudio investigó los efectos de la suplementación de L-arginina en la hipotensión post ejercicio, área de la arteria femoral y variabilidad de la frecuencia cardíaca en mujeres de la tercera edad. Métodos: Veinte participantes, adultas, pre hipertensas e hipertensas fueron divididas (de modo aleatorio y equilibrado) en dos grupos (placebo y L-arginina). Las participantes ingirieron ocho gramos de sustancia inerte (grupo placebo) u ocho gramos de L-arginina (grupo L-arginina), disuelta en agua, 90 minutos antes de la realización de la sesión experimental. La sesión experimental consistía en un test de fuerza isocinética máxima. La presión arterial fue medida utilizando un dispositivo oscilométrico (Omron MX3 Plus, Bannockburn, EE.UU.) a cada 10 minutos, durante 60 minutos, después del término de la sesión experimental. Fueron analizadas además la variabilidad de la frecuencia cardíaca y el área de la arteria femoral (ultrasonido). Los datos fueron sometidos a análisis de variancia para medidas repetidas (ANOVA) y sus respectivas premisas. Resultados: La suplementación de L-arginina asociada al ejercicio promovió reducción significativa de la presión arterial sistólica [placebo vs. L-arginina] (p<0,05) en el intervalo de "media vida" (90 minutos después de la suplementación) (141±12 vs. 130±11 mmHg) y a los 40 min. (146±13 vs. 127±13 mmHg), 50 min. (145±20 vs. 127±15 mmHg) y 60 min. (147±19 vs. 129±14 mmHg) post ejercicio. No fueron identificadas diferencias significativas en el área de la arteria femoral ni en la variabilidad de la frecuencia cardíaca. Conclusión: La suplementación aguda de L-arginina puede potencializar los efectos hipotensores post ejercicio en mujeres de la tercera edad. Además, la suplementación de L-arginina aguda no está asociada a las respuestas de variabilidad de la frecuencia cardíaca o del área de la arteria femoral. Nivel de evidencia I; Ensayo clínico aleatorizado.

Inter-Individual Responses to Citrulline Malate Oral Supplementation on Post-Exercise Hypotension in Hypertensives: A 24-Hour Analysis / Respostas Interindividuais à Suplementação Oral de Citrulina Malato na Hipotensão Pós-Exercício em Hipertensos: Uma Análise de 24 Horas

Abstract Background: Studies have persuasively demonstrated that citrulline has a key role in the arginine-nitric oxide system, increasing nitric oxide bioavailability, an important mediator of peripheral vasodilation. Objective: To analyze the inter-individual post-exercise hypotension responsiveness following acute citrulline supplementation in hypertensives. Methods: Forty hypertensives were randomly assigned to one of the four experimental groups (control-placebo, control-citrulline, exercise-placebo, and exercise-citrulline). They ingested placebo or citrulline malate [CM] (6 grams). During the exercise session, individuals performed 40 minutes of walking/running on a treadmill at 60-70% of HR reserve. For the control session, the individuals remained seated at rest for 40 minutes. Office blood pressure (BP) was taken every 10 minutes until completing 60 minutes after the experimental session. The ambulatory BP device was programmed to take the readings every 20 minutes (awake time) and every 30 minutes (sleep time) over the course of 24 hours of monitoring. Statistical significance was defined as p < 0.05. Results: Unlike the other experimental groups, there were no "non-responders" in the exercise/citrulline (EC) for "awake" (systolic and diastolic BP) and "24 hours" (diastolic BP). The effect sizes were more consistent in the EC for systolic and diastolic ambulatorial BP response. The effects were "large" (> 0.8) for "awake", "asleep", and "24 hours" only in the EC for diastolic BP. Conclusion: CM supplementation can increase the post-exercise hypotensive effects in hypertensives. In addition, the prevalence of non-responders is lower when associated with aerobic exercise and CM supplementation.

Resumo Fundamento: Estudos demonstraram de maneira persuasiva que a citrulina tem um papel fundamental no sistema arginina-óxido nítrico, aumentando a biodisponibilidade do óxido nítrico, um importante mediador da vasodilatação periférica. Objetivo: Analisar a responsividade interindividual da hipotensão pós-exercício após suplementação aguda com citrulina em hipertensos. Métodos: Quarenta hipertensos foram aleatoriamente designados para um dos quatro grupos experimentais (controle-placebo, controle-citrulina, exercício-placebo e exercício-citrulina). Eles ingeriram placebo ou citrulina malato [CM] (6 gramas). Durante a sessão de exercício, os indivíduos realizaram 40 minutos de caminhada/corrida em esteira a 60-70% da FC de reserva. Para a sessão de controle, os indivíduos permaneceram sentados em repouso por 40 minutos. A medida da pressão arterial (PA) no consultório foi realizada a cada 10 minutos até completar 60 minutos após a sessão experimental. O dispositivo ambulatorial de PA foi programado para fazer as leituras a cada 20 minutos (tempo de vigília) e a cada 30 minutos (tempo de sono) ao longo de 24 horas de monitoramento. A significância estatística foi definida como p < 0,05. Resultados: Diferentemente de outros grupos experimentais, não houve "não respondedores" no exercício/citrulina (EC) para "acordado" (PA sistólica e diastólica) e "24 horas" (PA diastólica). Os tamanhos de efeito foram mais consistentes no EC para a resposta sistólica e diastólica da PA ambulatorial. Os efeitos foram "grandes" (> 0,8) para "acordado", "dormindo", e para "24 horas" apenas no EC para a PA diastólica. Conclusão: A suplementação com CM pode aumentar os efeitos hipotensivos pós-exercício em hipertensos. Além disso, a prevalência de "não respondedores" é menor quando associada ao exercício aeróbico e à suplementação com CM.

Inter-Individual Responses to Citrulline Malate Oral Supplementation on Post-Exercise Hypotension in Hypertensives: A 24-Hour Analysis.

BACKGROUND: Studies have persuasively demonstrated that citrulline has a key role in the arginine-nitric oxide system, increasing nitric oxide bioavailability, an important mediator of peripheral vasodilation. OBJECTIVE: To analyze the inter-individual post-exercise hypotension responsiveness following acute citrulline supplementation in hypertensives. METHODS: Forty hypertensives were randomly assigned to one of the four experimental groups (control-placebo, control-citrulline, exercise-placebo, and exercise-citrulline). They ingested placebo or citrulline malate [CM] (6 grams). During the exercise session, individuals performed 40 minutes of walking/running on a treadmill at 60-70% of HR reserve. For the control session, the individuals remained seated at rest for 40 minutes. Office blood pressure (BP) was taken every 10 minutes until completing 60 minutes after the experimental session. The ambulatory BP device was programmed to take the readings every 20 minutes (awake time) and every 30 minutes (sleep time) over the course of 24 hours of monitoring. Statistical significance was defined as p < 0.05. RESULTS: Unlike the other experimental groups, there were no "non-responders" in the exercise/citrulline (EC) for "awake" (systolic and diastolic BP) and "24 hours" (diastolic BP). The effect sizes were more consistent in the EC for systolic and diastolic ambulatorial BP response. The effects were "large" (> 0.8) for "awake", "asleep", and "24 hours" only in the EC for diastolic BP. CONCLUSION: CM supplementation can increase the post-exercise hypotensive effects in hypertensives. In addition, the prevalence of non-responders is lower when associated with aerobic exercise and CM supplementation.

Acute citrulline oral supplementation induces greater post-exercise hypotension response in hypertensive than normotensive individuals / Suplementação oral aguda de citrulina induz maior resposta hipotensiva pós-exercício em indivíduos hipertensos do que normotensos

ABSTRACT Objective To investigate whether acute citrulline supplementation might influence post-exercise hypotension in normotensive and hypertensive individuals. Methods Following a randomized double-blind design, twenty normotensive (28±7 years, 74±17kg, 1.7±0.09m) and 20 hypertensive individuals (55±12 years, 76±15kg, 1.59±0.09m) were randomly assigned to one of the four experimental groups (Normotensive-Placebo; Normotensive-Citrulline; Hypertensive-Placebo; Hypertensive-Citrulline). The placebo groups ingested 6g of corn starch and the citrulline groups ingested 6g of citrulline dissolved in water. The participants performed 40 minutes of walking/running on a treadmill at 60-70% heart rate reserve. Blood pressure was measured immediately after a 60-min exercise session using an oscillometric device and 24-h ambulatory monitoring. Results The post-exercise hypotension was more pronounced in hypertensives and the Hypertensive-Citrulline group showed a consistent systolic blood pressure reduction during the laboratorial phase, which can be seen by looking at the mean of 60 minutes (-15.01mmHg vs -3.14mmHg [P=0.005]; -4.16mmHg [P=0.009]; -6.30mmHg [P=0.033] in comparison with the Normotensive-Placebo, Normotensive-Citrulline, and Hypertensive-Placebo groups, respectively). During ambulatory blood pressure monitoring, the Hypertensive-Citrulline group showed a significant reduction in systolic blood pressure (-21.05mmHg) in the awake period compared with the Normotensive-Citrulline group (-3.17mmHg [P=0.010]). Conclusion Acute citrulline oral supplementation can induce greater post-exercise hypotension response in hypertensive than normotensive individuals.

RESUMO Objetivo Investigar se a suplementação aguda de citrulina pode influenciar a hipotensão pós-exercício em indivíduos normotensos e hipertensos. Métodos Seguindo delineamento duplo-cego randomizado, vinte indivíduos normotensos (28±7 anos, 74±17kg, 1,7±0,09m) e 20 hipertensos (55±12 anos, 76±15kg, 1,59±0,09m) foram randomizados e distribuídos em um dos quatro grupos experimentais (Normotenso-Placebo; Normotenso-Citrulina; Hipertenso-Placebo; Hipertenso--Citrulina). Os grupos placebo ingeriram 6g de amido de milho e os grupos citrulina 6g de citrulina, dissolvidos em água. Os participantes realizaram 40 minutos de caminhada/corrida em esteira a uma intensidade entre 60-70% da frequência cardíaca de reserva. A pressão arterial foi aferida imediatamente após a sessão de exercício por 60 minutos usando um equipamento oscilométrico, e durante 24 horas por monitorização ambulatorial. Resultados A hipotensão pós-exercício foi mais pronunciada nos hipertensos e o grupo Hipertenso-Citrulina mostrou uma redução consistente da pressão arterial sistólica durante a fase laboratorial, o que pode ser visto pela média de 60 minutos (-5,01mmHg vs -3,14mmHg [P=0,005]; -4,16mmHg [P=0,009]; -6,30mmHg [P=0,033] em comparação com o Normotenso-Placebo, Normotenso-Citrulina e Hipertenso-Placebo, respectivamente). Durante a monitorização ambulatorial da pressão arterial, o Hipertenso-Citrulina demonstrou uma redução significativa na pressão arterial sistólica (-21,05mmHg) durante a vigília em comparação com o Normotenso-Citrulina (-3,17mmHg [P=0,010]). Conclusão A suplementação oral aguda de citrulina induz maior resposta hipotensiva pós-exercício em indivíduos hipertensos do que normotensos.

Nitric oxide synthase inhibition impairs muscle regrowth following immobilization.

Nitric oxide (NO) has been shown to increase skeletal muscle protein synthesis. However, the role of NO during skeletal muscle regrowth after immobilization remains unknown. The purpose of this study was to determine whether NO is required for muscle regrowth/recovery after a period of disuse by immobilization. Male Wistar rats were divided into 4 groups: recovered, 1-(2-trifluoromethyl-phenyl)-imidazole (TRIM; 10 mg·kg body mass-1·day-1), NG-nitro-l-arginine methyl ester (l-NAME; 90 mg·kg body mass-1·day-1), and control. The recovered, TRIM, l-NAME groups were submitted to a 7-d muscle recovery period (by remobilization), following a 10-d immobilization period (to induce plantaris [PLA] muscle atrophy). After the experimental period, the PLA muscle was collected for morphometrical (muscle fibers cross-sectional area [CSA]) and molecular (Phospho-mTORSer2448 protein expression) analysis. After 7 d of recovery, the recovered group displayed complete muscle regrowth (CSA, recovered: 2.216 ± 214 vs. CONTROL: 2.219 ± 280 cm2; P > 0.05). However, CSA of the l-NAME (1.911 ± 267 cm2) and TRIM (1.896 ± 219 cm2) groups were statistically (P < 0.05) lower than the recovered and control groups. Additionally, there was a 29% increase in Phos-mTORSer2448 protein expression levels in the recovered group compared to control group, and this increase was blocked in both TRIM and l-NAME groups. In conclusion, our results indicate that NO is crucial for skeletal muscle regrowth after an immobilization period, potentially via the mTOR signaling pathway.