Moderate-Intensity Combined Training Induces Lipidomic Changes in Individuals with Obesity and Type 2 Diabetes.

CONTEXT: Alterations in the lipid metabolism are linked to metabolic disorders such as insulin resistance (IR), obesity and type 2 diabetes (T2D). Regular exercise, particularly combined training (CT), is a well-known non-pharmacological treatment that combines aerobic (AT) and resistance (RT) training benefits. However, it is unclear whether moderate-intensity exercise without dietary intervention induces changes in lipid metabolism to promote a 'healthy lipidome'. OBJECTIVE: The study aimed to investigate the effect of 16 weeks of CT on plasma and white adipose tissue in both sexes, middle-aged subjects with normal weight, obesity and T2D using an ultra-high performance liquid chromatography-mass spectrometry (UHPLC-MS) untargeted lipidomics approach. METHODS: Body composition, maximum oxygen consumption (VO2 max), strength, and biochemical markers were evaluated before and after the control/training period and correlated with lipid changes. CT consisted of 8 to 10 RT exercises, followed by 35 min of AT (45 -70% VO2 max), 3 times a week for 16 weeks. RESULTS: The CT significantly reduced the levels of saturated and monounsaturated fatty acid side-chains (SFA/MUFA) in sphingolipids, glycerolipids (GL) and glycerophospholipids (GP) as well as reducing fat mass, circumferences and IR. Increased levels of polyunsaturated fatty acids in GPs, and GLs were also observed, along with increased fat-free mass, VO2 max, and strength (all p < 0.05) after training. CONCLUSION: Our study stated that 16 weeks of moderate-intensity CT remodelled the lipid metabolism in OB, and T2D individuals, even without dietary intervention, establishing a link between exercise-modulated lipid markers and mechanisms that reduce IR and obesity-related comorbidities.

Rho-Kinase Is Differentially Expressed in the Adipose Tissue of Rodent and Human in Response to Aging, Sex, and Acute Exercise.

White adipose tissue (WAT) controls energy storage, expenditure, and endocrine function. Rho-kinase (ROCK) is related to impaired thermogenesis, downregulation of preadipocyte differentiation, and adipokine production. Furthermore, WAT ROCK responds to metabolic stress from high-fat diets or diabetes. However, ROCK distribution in adipose depots and its response to aging and sex remain unclear. Thus, we aim to investigate ROCK function in adipose tissue of rodent and human in response to aging and sex. We observed specific differences in the ROCK1/2 distribution in inguinal WAT (ingWAT), perigonadal WAT (pgWAT), and brown adipose tissue of male and female rodents. However, ROCK2 expression was lower in female ingWAT compared with males, a fact that was not observed in the other depots. In the pgWAT and ingWAT of male and female rodents, ROCK activity increased during development. Moreover, middle-aged female rodents and humans showed downregulation in ROCK activity after acute physical exercise. Interestingly, ROCK levels were associated with several inflammatory markers both in rats and humans WAT (Nfkb1, Tnf, Il1b, Il6, and Mcp1). Induction of cell senescence by etoposide elevates ROCK activity in human preadipocytes; however, silencing ROCK1/2 demonstrates improvement in the inflammatory and cell senescence state. Using public databases, several pathways were strongly associated with ROCK modulation in WAT. In summary, WAT ROCK increases with development in association with inflammatory markers. Further, ROCK activity was attenuated by acute physical exercise, implicating it as a possible therapeutic target for metabolism improvement mediated by adipose tissue inflammatory state changes.

Effects of Different Exercise Types on Chrna7 and Chrfam7a Expression in Healthy Normal Weight and Overweight Type 2 Diabetic Adults.

Purpose: Considering that the CHRNA7 and CHRFAM7A genes can be modulated by acute or chronic inflammation, and exercise modulates inflammatory responses, the question that arises is whether physical exercise could exert any effect on the expression of these genes. Thus, the aim of this work is to identify the effects of different types of exercises on the expression of the CHRNA7, CHRFAM7A and tumor necrosis factor-α (TNF-α) in leukocytes of healthy normal weight (HNW), and overweight with type 2 diabetes (OT2D) individuals. Methods: 15 OT2D and 13 HNW participants (men and women, from 40 to 60 years old) performed in a randomized crossover design three exercise sessions: aerobic exercise (AE), resistance exercise (RE) and combined exercise (CE). Blood samples were collected at rest and post-60-min of the exercise sessions. The leukocytes were the analysis of the CHRNA7, CHRFAM7A and (TNF-α) gene expression. Results: At baseline, OT2D had higher CHRFAM7A and TNF-α expression compared to HNW. No statistical differences were observed between groups for CHRNA7; however, the HNW group presented almost twice as many subjects with the expression of this gene (24% vs. 49%). Post exercise, the CHRFAM7A increased in AE, RE and CE for HNW, and in AE and CE for OT2D. There was no significant difference for TNF-α and CHRNA7 expression between any type of exercise and group. Conclusions: Our study shows that OT2D individuals presented higher baseline expression of TNF-α and CHRFAM7A, besides evidence of decreased CHRNA7A expression in leukocytes when compared with HNW. On the other hand, acutely physical exercise induces increased CHRFAM7A expression, especially when the aerobic component is present.

Comparison between frail and non-frail older adults' gut microbiota: A systematic review and meta-analysis.

BACKGROUND: Emerging evidence suggests that the intestinal microbiota (IM) undergoes remodelling as we age, and this impacts the ageing trajectory and mortality in older adults. The aim was to investigate IM diversity differences between frail and non-frail older adults by meta-analysing previous studies. METHODS: The protocol of this systematic review with meta-analysis was registered on PROSPERO (CRD42021276733). We searched for studies comparing IM diversity of frail and non-frail older adults indexed on PubMed, Embase, Cochrane, and Web of Science in November 2021. RESULTS: We included 11 studies with 1239 participants, of which 340 were meta-analysed. Frailty was defined by a variety of criteria (i.e. Fried Scale, European Consensus on Sarcopenia). There were no differences in the meta-analyses between the frail and non-frail groups for species richness index (SMD = -0.147; 95% CI = -0.394, 0.100; p = 0.243) and species diversity index (SMD = -0.033; 95% CI = -0.315, 0.250; p = 0.820). However, we identified almost 50 differences between frail and non-frail within the relative abundance of bacteria phyla, families, genera, and species in the primary studies. CONCLUSIONS: The evidence to prove that there are differences between frail and non-frail IM diversity by meta-analysis is still lacking. The present results suggest that further investigation into the role of specific bacteria, their function, and their influence on the physiopathology of frailty is needed.

The effects of ageing, BMI and physical activity on blood IL-15 levels: A systematic review and meta-analyses.

AIM: The purpose of the study was to test the effect of ageing, BMI, physical activity and chronic exercise on IL-15 blood concentration by meta-analyses of the literature. METHODS: The search was performed on PubMed/MEDLINE, Web of Science, ProQuest, Embase and Cochrane databases. First meta-analysis compared blood IL-15 of healthy adults across three age groups (<35 years, 35-65 years, and >65 years), considering BMI as confounding factor; the second compared IL-15 levels between physically active and non-physically active individuals (cross-sectional studies); and the third tested the effect of chronic exercise interventions on blood IL-15 levels on participants of any age, sex, and health condition. RESULTS: From 2582 studies retrieved, 67 were selected for the three meta-analyses (age effect: 59; physical activity cross-sectional effect: 5; chronic exercise effect: 14). Older adults had lower blood IL-15 than young and middle-aged adults (5.30 pg/ml [4.76; 5.83]; 7.11 pg/ml [6.33; 7.88]; 7.10 pg/ml [5.55; 8.65], respectively). However, the subgroup of overweight older adults had higher IL-15 than young and middle aged overweight adults; Habitual physical activity did not affect blood IL-15 (standardized mean difference [SMD] 0.61 [-0.65; 1.88], p = 0.34); Chronic exercise reduced blood IL-15 in short-term interventions (<16 weeks) (SMD -0.14 [-0.27; -0.01], p = 0.04), but not studies of >16 weeks of intervention (SMD 0.44 [-0.26; 1.15], p = 0.22). CONCLUSION: The present meta-analyses highlight the complex interaction of age, BMI and physical activity on blood IL-15 and emphasize the need to take these factors into account when considering the role of this myokine in health throughout life.

Renal protection induced by physical exercise may be mediated by the irisin/AMPK axis in diabetic nephropathy.

In patients with diabetes, it has been suggested that physical exercise may reduce albuminuria and the progression of renal disease. However, the molecular mechanism by which physical exercise protects the kidney in diabetes remains poorly understood. The aim of the present study was to determine the contribution of muscle irisin secretion induced by aerobic physical exercise with the subsequent activation of AMPK for kidney protection under diabetic conditions. Aerobic physical exercise in rats protected the kidney in streptozotocin-induced diabetes. It reduced albuminuria, glomerular hypertrophy, and glomerular expression of collagen IV and fibronectin, as well as markers of kidney inflammation, when compared to sedentary diabetic rats. These effects were associated with elevation in muscle FNDC5/irisin and activity of AMPK in the diabetic kidney. However, the beneficial effects of exercise were lost when the diabetic rats were treated with CycloRGDyK, that in the bone it has been described as an irisin receptor blocker. In cultured human tubular (HK-2) cells, treatment with recombinant irisin counteracted the effect of high glucose in a dose-dependent manner. Irisin, per se, also activated AMPK in HK-2 cells. It is concluded that in diabetes, the renal protective effect of exercise may be mediated by the irisin/AMPK pathway.

Combined training increases thermogenic fat activity in patients with overweight and type 2 diabetes.

BACKGROUND: Exercise is an important strategy in the management of diabetes. Experimental studies have shown that exercise acts, at least in part, by inducing the production of myokines that improve metabolic control and activate brown/beige adipose tissue depots. Combined training (CT) is recommended by the major diabetes guidelines due to its metabolic and cardiovascular benefits, however, its impact on brown/beige adipose tissue activities has never been tested in humans with overweight and type 2 diabetes (T2D). Here, we evaluated the effects of 16-week combined training (CT) program on brown adipose tissue activity; browning and autophagy markers, and serum pro-thermogenic/inflammatory inducers in patients with overweight and T2D. METHODS: Thirty-four patients with overweight and T2D were assigned to either a control group (CG) or a combined training group (CTG) in a randomized and controlled study. Functional/fitness parameters, anthropometry/body composition parameters, blood hormone/biochemical parameters, thermogenic/autophagic gene expression in subcutaneous adipose tissue were evaluated before and at the end of the intervention. In addition, cold-induced 18-Fluoroxyglucose Positron Emission Computed Tomography (18F-FDG PET/CT) was performed in the training group before and after the end of the intervention. RESULTS: CT increased cervical/supraclavicular brown adipose tissue (BAT) thermogenic activity (p = 0.03) as well as in perirenal adipose tissue (p = 0.02). In addition, CT increased the expression of genes related to thermogenic profile (TMEM26: + 95%, p = 0.04; and EPSTI1: + 26%, p = 0.03) and decreased autophagic genes (ULK1: -15%, p = 0.04; LC3: -5%, p = 0.02; and ATG4: -22%, p < 0.001) in subcutaneous adipose tissue. There were positive correlations between Δ% BAT activity with Δ% of post training energy expenditure cold exposure, HDL-c, IL4, adiponectin, irisin, meteorin-like, and TMEM26 and ZIC1 genes, besides negative correlations with LDL-c, total cholesterol and C-reactive protein. CONCLUSION: This is the first evidence of the beneficial actions of CT on adipose tissue thermogenic activity in humans, and it adds important support for the recommendation of CT as a strategy in the management of diabetes.

Inhibitory control after aerobic exercise with and without blood flow restriction in older adults / Controle inibitório após exercícios aeróbicos com e sem restrição do fluxo sanguíneo em idosos / Control inhibitorio después del ejercicio aeróbico con y sin restricción del flujo sanguíneo en adultos mayores

Introduction: Regular aerobic exercise (AE) can reduce the cognitive losses typically experienced with aging can be blunted by regular aerobic exercise (AE). AE also induces acute improvement of cognitive function among older adults; and AE practice with blood flow restriction (BFR) addss other benefits to elderly health, such as improvements in aerobic fitness, and increase in muscle mass and strength, however, it is not clear which EA protocol is more efficient to cognitive function. Objectives: Thus, the aimof this study was to compare AE protocols with and without BFR on the inhibitory control of the elderly. Methodology: Twenty-one elderly performed the Stroop test before and after three AE sessions in a repeated measure, cross-over design: AE with high load (70% VO2max), AE with low load (40% VO2max), and AE with blood flow restriction (AE-BFR) BFR (40% VO2max and 50% of BFR). Results and discussion: There was no significant effect from experimental sessions on cognitive function, assessed by inhibitory control in Stroop test. Perhaps, the load applied was not proper to stimulate cognitive function improvements, as seen the moderate loads have been more efficient to increase cerebral blood flow, among other physiological mechanisms encompassed. Final Considerations: Moreover, we observed very heterogeneous responses among individuals and sessions, suggesting that future research also considers biological individuality.

Introdução: As perdas cognitivas tipicamente experimentadas com o envelhecimento podem ser atenuadas por exercícios aeróbicos (EA) regulares. EA também induz melhora aguda da função cognitiva em idosos; e a prática de EA com restrição de fluxo sanguíneo (RFS) agrega outros benefícios à saúde do idoso, como melhorias na aptidão aeróbia e aumento da massa e força muscular. No entanto, não está claro qual protocolo de EA é mais eficaz para a funcao cognitiva. Objetivos: Assim, o objetivo deste estudo foi comparar diferentes protocolos de EA com e sem RFS no controle inibitório de idosos. Metodologia: Vinte e um idosos realizaram o teste de Stroop antes e após três sessões de EA em medida repetida, desenho cruzado: EA com alta carga (70% VO2máx), EA com baixa carga (40% VO2máx) e EA com RFS (40% VO2máx e 50% do RFS). Resultados e discussão: Não houve efeito significativo das sessões experimentais na função cognitiva avaliada pelo controle inibitório no Stroop Test. Talvez, as cargas aplicadas não tenham sido adequadas para estimular melhorias no controle inibitório, visto que as cargas moderadas têm sido mais eficientes para aumentar o fluxo sanguíneo cerebral, entre outros mecanismos fisiológicos Considerações Finais: Além disso, observamos respostas bastante heterogêneas entre indivíduos e sessões, sugerindo que pesquisas futuras considere também a individualidade biológica.

Introducción: El ejercicio aeróbico regular (EA) puede reducir la perdida cognitiva tipicamente experimentada durante el envejecimiento. EA puede tambien inducir mejora en la funcion cognitiva entre adultos mayores, ademas, la practica de resticcion de flujo sanguíneo (RFS) agrega otros beneficios para la salud en los ancianos, así como mejoras en la aptitud aeróbica, aumento de la masa muscular y la fuerza, sin embargo, no está claro qué protocolo de EA es más eficiente para la función cognitiva. Objetivos: El objetivo de este estudio fue comparar los protocolos de EA con y sin RFS en el control inhibitorio de los ancianos. Metodología: Veintiún ancianos realizaron la prueba de Stroop antes y después de tres sesiones de EA en medida repetida, diseño cruzado: EA con carga alta (70% VO2max), EA con carga baja (40% VO2max) y EA con restricción del flujo sanguíneo (EA-RFS) RFS (40% VO2max y 50% de RFS). Resultados y discusión: No hubo efecto significativo de las sesiones experimentales sobre la función cognitiva, evaluada por el control inhibitorio en la prueba de Stroop. Quizás, la carga aplicada no fue la adecuada para estimular mejoras en la función cognitiva, ya que las cargas moderadas han sido más eficientes para aumentar el flujo sanguíneo cerebral, entre otros mecanismos fisiológicos englobados. Consideraciones finales: Además, nosotros observamos respuestas muy heterogéneas entre individuos y sesiones, lo que sugiere que para futuras investigaciones también se debe considerar la variabilidad biológica.

HIIT vs. SIT: What Is the Better to Improve V˙O2max? A Systematic Review and Meta-Analysis.

Lack of time is seen as a barrier to maintaining a physically active lifestyle. In this sense, interval training has been suggested as a time-efficient strategy for improving health, mainly due to its potential to increase cardiorespiratory fitness. Currently, the most discussed interval training protocols in the literature are the high-intensity interval training (HIIT) and the sprint interval training (SIT). Objective: We investigated, through a systematic review and meta-analysis, which interval training protocol, HIIT or SIT, promotes greater gain in cardiorespiratory fitness (V˙O2max/peak). The studies were selected from the PubMed (MEDLINE), Scopus and Web of Science databases. From these searches, a screening was carried out, selecting studies that compared the effects of HIIT and SIT protocols on V˙O2max/peak. A total of 19 studies were included in the final analysis. Due to the homogeneity between studies (I2 = 0%), fixed-effects analyses were performed. There was no significant difference in the V˙O2max/peak gains between HIIT and SIT for the standardized mean difference (SMD = 0.150; 95% CI = -0.038 to 0.338; p = 0.119), including studies that presented both measurements in mL·kg-1·min-1 and l·min-1; and raw mean differences (RMD = 0.921 mL·kg-1·min-1; 95% CI = -0.185 to 2.028; p = 0.103) were calculated only with data presented in mL·kg-1·min-1. We conclude that the literature generates very consistent data to confirm that HIIT and SIT protocols promote similar gains in cardiorespiratory fitness. Thus, for this purpose, the choice of the protocol can be made for convenience.

Combined Physical Training Increases Plasma Brain-Derived Neurotropic Factor Levels, But Not Irisin in People Living with HIV/AIDS.

This study evaluated plasma levels of brain-derived neurotropic factor (BDNF), irisin, and lactate in people living with HIV/AIDS who completed a combined physical training program. Nineteen HIV+ participants (age: 39.60 ± 10.96 years; carrier time: 7.75 ± 7.88 years; time of ART: 6.41 ± 5.93 years) performed strength/aerobic training (combined physical training) in the same session for 8 weeks and levels of BDNF, irisin, and lactate were assessed. BDNF (pg/mL) was higher post-CPT (Pre: 1258.73 ± 372.30; Post: 1504.17 ± 322.30; p < 0.001). Irisin (ng/mL) showed no change (Pre: 115.61 ± 72.41; Post: 125.87 ± 81.14; p = 0.973). There was positive correlation between irisin and lactate (mmol/L) pre (r = 0.55, p = 0.04), and lactate values were higher in the group with the highest value of irisin (3.65 ± 0.69 × 2.82 ± 0.59, p = 0.02). Combined physical training results in increased basal BDNF in people living with HIV/AIDS, this finding suggests that increased concentration of BDNF may be associated with decreased chances of developing cognitive disorders or HIV-associated dementia. Further studies involving molecular mechanisms on this subject are necessary.

Effects of Non-periodized and Linear Periodized Combined Exercise Training on Insulin Resistance Indicators in Adults with Obesity: A Randomized Controlled Trial.

BACKGROUND: The aim was to verify the effect of non-periodized and linear periodized combined (aerobic plus resistance) exercise training on insulin resistance markers in adults with obesity. METHODS: A blinded randomized control trial was conducted with three groups of individuals with obesity (BMI, 30-39.9 kg/m2): control group (CG, n = 23), non-periodized group (NG, n = 23), and linear periodized group (PG, n = 23). The NG and PG performed aerobic and resistance exercises in the same session in aerobic-resistance order for 16 weeks. Both intervention groups trained three sessions weekly, with a total duration of 60 min each. The aerobic training of the NG had a duration of 30 min always between 50% and 59% of the reserve heart rate (HRres), while resistance exercise was comprised of 6 exercises, performed always in 2 × 10-12 maximum repetitions (MRs). The PG progressed the aerobic and resistance training from 40%-49% to 60%-69% (HRres) and from 2 × 12-14 to 2 × 8-10 RM, respectively, along the intervention period. The evaluated indicators of insulin resistance included fasting glucose, fasting insulin, and homeostasis model assessment-estimated insulin resistance (HOMA-IR) collected pre- and post-intervention. The analyses to verify the exercise training effect were performed using generalized estimating equations. RESULTS: After 16 weeks of training, per protocol analysis (n = 39) showed significant reductions in HOMA-IR only in the training groups (NG: Δ = - 1.6, PG: Δ = - 0.6; p = 0.094). Intention-to-treat analysis demonstrated significant reductions in fasting insulin levels (NG: Δ = - 1.4, PG: Δ = - 1.0; p = 0.004) and HOMA-IR (NG: Δ = - 5.5, PG: Δ = - 3.8; p = 0.002). CONCLUSION: Periodized and non-periodized combined exercise training similarly reduces insulin resistance markers in adults with obesity. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials, RBR-3c7rt3. Registered 07 February 2019- https://ensaiosclinicos.gov.br/trial/5970/1 .

Fatores sociodemográficos e de saúde intervenientes na funcionalidade e atividade física de idosos / Sociodemographic and health factors interfering with functionality and physical activity of the elderly

O presente estudo transversal teve como objetivo identificar os fatores sociodemográficos e de saúde intervenientes na funcionalidade e atividade física de 654 idosos usuários das Unidades Básicas de Saúde (UBSs) de Maringá, Paraná, Brasil. Utilizou-se questionário de perfil sociodemográfico e de saúde, o International Physical Activity Questionnaire, e o WHODAS 2.0. A análise dos dados foi feita por meio do teste Kolmogorov-Smirnov, Kruskal-Wallis e "U" de Mann-Whitney (p<0,05). As mulheres realizam mais atividades moderadas por dia (p=0,039) e por semana (p=0,048). Os homens possuem menos dificuldades de compreensão e comunicação (p=0,011), mobilidade (p=0,001), atividades da vida diária (p=0,004), participação social (p=0,023) e melhor funcionalidade total (p= 0,001). Idosos de 70 a 79 anos apresentam melhor funcionalidade do que os mais jovens e os com 80 anos ou mais (p=0,032). Sexo, faixa etária e histórico de quedas são intervenientes na duração e frequência da prática de atividade física dos idosos e em sua funcionalidade.

This cross-sectional study aimed to identify the sociodemographic and health factors involved in functionality and physical activity of 654 elderly users of Basic Health Units in Maringá, state of Paraná, Brazil. The sociodemographic and health profile questionnaire, the International Physical Activity Questionnaire, and the WHODAS 2.0 were used. Data were analyzed using the Kolmogorov-Smirnov, Kruskal-Wallis and Mann-Whitney U-tests (p<0.05). Women perform more moderate activities per day (p=0.039) and per week (p= 0.048). Men have less understanding and communication difficulties (p=0.011), mobility (p=0.001), activities of daily living (p=0.004), social participation (p=0.023) and better overall functionality (p=0.001). Elderly from 70 to 79 years old have better functionality than younger and those aged 80 or over (p=0.032). Gender, age group and history of falls are interfering with the duration and frequency of physical activity, as well as their functionality.

Effects and Responsiveness of a Multicomponent Intervention on Body Composition, Physical Fitness, and Leptin in Overweight/Obese Adolescents.

Physical exercise reduces the biochemical markers of obesity, but the effects of multicomponent interventions on these markers should be explored. The present study aimed to elucidate how overweight/obese adolescents respond to a multicomponent program approach on body composition, physical fitness, and inflammatory markers, using a quasi-experimental study with 33 overweight/obesity adolescents (control group (CG) = 16; intervention group (IG) = 17). The intervention consisted of 24 weeks with physical exercises and nutritional and psychological guidance. Both groups were evaluated at the pre/post-intervention moments on body mass index (BMI); body fat (%Fat); waist circumference (WC); waist/hip ratio (WHR); waist-to-height ratio (WHtR), cardiorespiratory fitness (CRF); abdominal strength, flexibility; leptin; interleukin 6; interleukin 10; and tumor necrosis factor-alpha. Mixed-analysis of variance and generalized estimation equations were used for statistical analysis. There was an interaction effect between groups and time on %Fat (p = 0.002), WC (p = 0.023), WHR (p < 0.001), WHtR (p = 0.035), CRF (p = 0.050), and leptin (p = 0.026). Adolescents were classified as 82.4% responders for %Fat, 70.6% for WC, 88.2% for WHR, and 70.6% for CRF. Further, there was an association between changes in %Fat (p = 0.033), WC (p = 0.032), and WHR (p = 0.033) between responders and non-responders with CRF in the IG. There was a positive effect on body composition, physical fitness, and leptin. In addition, reductions in body composition parameters were explained by CRF improvements.

Combined Chair-Based Exercises Improve Functional Fitness, Mental Well-Being, Salivary Steroid Balance, and Anti-microbial Activity in Pre-frail Older Women.

INTRODUCTION: Regular exercise has long been shown to positively impact the immune system responsiveness and improve mental well-being (MWB). However, the putative links between biomarkers of mental health and immune efficiency in exercising subjects have been scarcely investigated. The aim of this study was to verify the effect of a 14-week combined chair-based exercise program (CEP) on salivary steroid hormones and anti-microbial proteins, functional fitness, and MWB indexes in pre-frail older women. METHODS: The participant women (82.8 4.6 years old; n = 32) were randomly divided into the exercising group (CEP, n = 17) and the non-exercising control group (CG, n = 15). The pre/post assessment included: (1) salivary anti-microbial proteins lysozyme; (Lys) and immunoglobulin-A (IgA); (2) salivary steroid hormones of testosterone (TT) and cortisol (COR); (3) functional fitness (gait speed, hand grip strength, and static balance); (4) MWB questionnaires (happiness, depression state, satisfaction with life, and stress). RESULTS: Significant differences with large Cohen's (d) effect sizes were found on increased salivary TT (p < 0.05; d = 0.60) after exercise intervention. The results revealed a decrease in IgA levels after CEP (p < 0.01, d = 0.30). The increase in subjective happiness levels (p < 0.05, d = 0.30) and decrease of stress perception (p < 0.01, d = 2.60) and depressive state (p < 0.05, d = 0.30) were found after intervention in the CEP group. Robust statistical differences in gait speed (p < 0.05; d = 0.60) and balance tests (p < 0.05; d = 0.80) were also found in the CEP group. In control, COR increased moderately (p < 0.05; d = 0.65) while no changes were found for the other indicators. Correlation analyses showed inter-dependence between pre-post variations of MWB, biochemical indexes, and fitness function (e.g., COR inverse correlation with hand grip strength and balance tests). CONCLUSION: The CEP program was able to improve functional-fitness performance, decrease feelings of stress, and increase happiness. The CEP also induced clinically relevant hormonal and immune responses, which suggests that chair exercises that combine muscular strength, balance, and gait speed training are promising interventions to improve physical and mental health of older pre-frail adults.

Acute/Chronic Responses of Combined Training on Serum Pro-thermogenic/Anti-inflammatory Inducers and Its Relation With Fed and Fasting State in Overweight Type 2 Diabetic Individuals.

Concentrations of pro-thermogenic/anti-inflammatory inductors are influenced by fed/fasting, sedentary/trained states, and metabolic pattern. However, there is a lack of information on the interactions of these conditions, especially in humans. Thus, the present study aimed to evaluate the chronic and acute training responses as well as the fed/fasted states of serum pro-thermogenic/anti-inflammatory inducers in overweight type 2 diabetics individuals. Fifteen individuals with type 2 diabetes [body mass index (BMI): 29.61 ± 3.60 kg/m2; age: 50.67 ± 3.97 years] participated in the study. In the pre- and post-experimental periods, baseline clinical parameters analyses were performed. Pro-thermogenic/anti-inflammatory inductors were evaluated pre/post-baseline and before, shortly after, and after 30' and 60' in the first and last sessions of a 16-week combined training (CT) period. These inducers were also compared for fasting and feeding before and after the training period. CT has improved baseline physical fitness, metabolic pattern, and it has also increased interleukin (IL)33 and FNDC5/irisin. In the first training session, there was a decrease in IL4, IL13, and IL33, besides an increase in FNDC5/irisin, and natriuretic peptides. In the last training session, there was an increase in natriuretic peptides and bone morphogenic protein 4 (BMP4). Differences in responses between the first and last training sessions were observed at certain post-session times for IL4, IL33, and natriuretic peptides, always with higher concentrations occurring in the last session. In evaluating the area under the curve (AUC) of the first and last training session, FNDC5/irisin, natriuretics peptides, and meteorin-like showed increased areas in the last training session. The pre-training fed state showed an increase in IL4 and IL33, while in fasting there was an increase in meteorin-like, natriuretic peptides, and FNDC5/irisin. In the post-training, IL4, IL13, and IL33 were increased in the fed state, while meteorin-like, natriuretic peptides, and FNDC5/irisin remained increased in the fast. Adaptation to physical training and a better metabolic pattern favor an improvement in the acute secretory pattern in part of pro-thermogenic and anti-inflammatory substances analyzed. The fed and fasting states also interfere differently in these substances, where fasting interferes with the increase of myokines, while the fed state induces an increase in interleukins. Clinical Trial Registration: [http://www.ensaiosclinicos.gov.br/rg/RBR-62n5qn/], identifier [U1111-1202-1476].

Factors influencing depression markers in elderly primary healthcare center patients in Maringá, Paraná, Brazil, 2017. / Fatores intervenientes nos indicativos de depressão em idosos usuários das unidades básicas de saúde de Maringá, Paraná, 2017.

OBJECTIVE: to analyze factors influencing depression markers in elderly patients at primary healthcare centers (PHC) in the city of Maringá, Paraná, Brazil, in 2017. METHODS: this was a cross-sectional study carried out with elderly individuals at PHCs in Maringá city; we used a questionnaire comprising sociodemographic questions, the Geriatric Depression Scale (GDS) and the International Physical Activity Questionnaire (IPAQ); we analyzed associations and compared depression markers with sociodemographic variables and health conditions. RESULTS: 645 elderly people took part in the study; those with the highest depression markers had lower income, poor health perception, a history of falls and three or more comorbidities; the physically active elderly had lower depression markers. CONCLUSION: monthly income and health conditions are factors that influence depression markers; doing light physical activities is associated with lower tendency of depression in the elderly.

O nível de atividade física como um fator interveniente no estado cognitivo de idosos da atenção básica à saúde / The level of physical activity as an intervening factor in the cognitive state of primary care older adults

Resumo Este estudo propôs a avaliar o nível de atividade física e o estado cognitivo de idosos usuários das Unidades Básicas de saúde (UBS) do Município de Maringá, Paraná. Trata-se de um estudo epidemiológico descritivo, de corte observacional e transversal, realizado com 654 idosos, de ambos os sexos, usuários das UBS. Foi utilizado um questionário sociodemográfico, o Mini exame do estado mental e o International Activity Questionnaire (IPAQ), versão curta. A análise dos dados foi realizada mediante o teste Kolmogorov-Smirnov, Qui quadrado, Kruskal-Wallis e "U" de Mann-Whitney, adotando significância quando p < 0,05. Os idosos não realizam atividades físicas vigorosas e poucas atividades moderadas durante a semana. Porém, apresentaram alto escore na orientação temporal (Md = 5,0), Orientação espacial (Md = 5,0), memória imediata (Md = 3,0), evocação (Md = 3,0) e linguagem (Md = 8,0). Ao comparar o estado mental em função do nível de atividade física dos idosos verificou-se que os Muito ativo/ativo possuem melhor atenção e cálculo (p = 0,036), evocação (p = 0,001) e estado cognitivo geral (p = 0,002), se comparado aos irregularmente ativos e sedentários. Níveis adequados de atividade física podem estar relacionados a melhores escores de funções cognitivas de sujeitos idosos.

Abstract This study proposed to evaluate the level of physical activity and the cognitive state of elderly users of Primary Care Facilities (UBS) of the Municipality of Maringá, State of Paraná, Brazil. This is a descriptive, cross-sectional, epidemiological study with 654 elderly men and women UBS users. A sociodemographic questionnaire, the Mini Mental State Examination (MMSE) and the short version of the International Physical Activity Questionnaire (IPAQ) were employed. Data was analyzed using the Kolmogorov-Smirnov, Chi-square, Kruskal-Wallis and Mann-Whitney "U" tests, with a significance level of p<0.05. However, they evidenced a high score in temporal orientation (Md = 5.0), spatial orientation (Md = 5.0), immediate memory (Md = 3.0), recall (Md = 3.0) and language (Md = 8.0). When comparing the mental state according to the level of physical activity of the elderly, we observed that very active/active individuals had better attention and calculation (p = 0.036), recall (p = 0.001) and general cognitive status (p = 0.002) against irregularly active and sedentary elderly. Adequate levels of physical activity may be related to better scores of cognitive functions of elderly subjects.

The level of physical activity as an intervening factor in the cognitive state of primary care older adults. / O nível de atividade física como um fator interveniente no estado cognitivo de idosos da atenção básica à saúde.

This study proposed to evaluate the level of physical activity and the cognitive state of elderly users of Primary Care Facilities (UBS) of the Municipality of Maringá, State of Paraná, Brazil. This is a descriptive, cross-sectional, epidemiological study with 654 elderly men and women UBS users. A sociodemographic questionnaire, the Mini Mental State Examination (MMSE) and the short version of the International Physical Activity Questionnaire (IPAQ) were employed. Data was analyzed using the Kolmogorov-Smirnov, Chi-square, Kruskal-Wallis and Mann-Whitney "U" tests, with a significance level of p<0.05. However, they evidenced a high score in temporal orientation (Md = 5.0), spatial orientation (Md = 5.0), immediate memory (Md = 3.0), recall (Md = 3.0) and language (Md = 8.0). When comparing the mental state according to the level of physical activity of the elderly, we observed that very active/active individuals had better attention and calculation (p = 0.036), recall (p = 0.001) and general cognitive status (p = 0.002) against irregularly active and sedentary elderly. Adequate levels of physical activity may be related to better scores of cognitive functions of elderly subjects.

Este estudo propôs a avaliar o nível de atividade física e o estado cognitivo de idosos usuários das Unidades Básicas de saúde (UBS) do Município de Maringá, Paraná. Trata-se de um estudo epidemiológico descritivo, de corte observacional e transversal, realizado com 654 idosos, de ambos os sexos, usuários das UBS. Foi utilizado um questionário sociodemográfico, o Mini exame do estado mental e o International Activity Questionnaire (IPAQ), versão curta. A análise dos dados foi realizada mediante o teste Kolmogorov-Smirnov, Qui quadrado, Kruskal-Wallis e "U" de Mann-Whitney, adotando significância quando p < 0,05. Os idosos não realizam atividades físicas vigorosas e poucas atividades moderadas durante a semana. Porém, apresentaram alto escore na orientação temporal (Md = 5,0), Orientação espacial (Md = 5,0), memória imediata (Md = 3,0), evocação (Md = 3,0) e linguagem (Md = 8,0). Ao comparar o estado mental em função do nível de atividade física dos idosos verificou-se que os Muito ativo/ativo possuem melhor atenção e cálculo (p = 0,036), evocação (p = 0,001) e estado cognitivo geral (p = 0,002), se comparado aos irregularmente ativos e sedentários. Níveis adequados de atividade física podem estar relacionados a melhores escores de funções cognitivas de sujeitos idosos.