Effects of functional training and 2 interdisciplinary interventions on maximal oxygen uptake and weight loss of women with obesity: a randomized clinical trial.

Our aim was to analyze and compare functional training, interdisciplinary therapy, and interdisciplinary education on cardiorespiratory fitness (CF) and anthropometric characteristics of women with obesity. Forty-four women (age = 39.7 ± 5.9 years, body mass index (BMI) = 35.5 ± 2.8 kg/m2) completed 30 weeks of intervention randomly assigned to 3 groups: functional training (FT) (n = 14), interdisciplinary therapy (IT) (n = 19), and interdisciplinary education (IE) (n = 11). The FT group participated in the training program (3/week), the IT group received the same training intervention plus nutrition (1/week) and psychology advice (1/week) and physical therapy (1/week). The IE group participated in interdisciplinary lectures on topics related to health promotion (1/month). CF (ergospirometry), anthropometry, and body composition (electrical bioimpedance) were measured pre-intervention (Pre) and post-intervention (Post). CF increased (p ≤ 0.05) significantly (Pre vs. Post) in the FT (7.5%) and IT (10.8%) groups, but not in the IE group (1.8%). Body mass (BM), BMI, relative fat mass, and waist circumference significantly (p ≤ 0.05) decreased (Pre vs. Post) in IT (-4.4%, -4.4%, -2.3%, and -5.1%, respectively). The IE group showed a significant decrease in BM (-3.7%), BMI (-3.7%), and waist circumference (-3.5%), whereas the FT group promoted significant decrease in waist circumference (-3.4%). In conclusion, functional training increased CF but only interdisciplinary interventions improved the anthropometric profile of women with obesity. Novelty Interdisciplinary therapy provided more comprehensive adaptations in women with obesity, including morphological variables and CF. Functional training increased CF but reduced only abdominal obesity. Interdisciplinary education provided benefits on morphological variables, but it does not increase CF.

Does the level of leisure-time physical activity after bariatric surgery affect bone parameters? / Nível de atividade física no lazer após a cirurgia bariátrica afeta parâmetros ósseos?

Abstract Bariatric surgery (BS) causes an exacerbated loss of body weight and fat, and can promote changes in other body tissues such as bone tissue. The aim of this study was to compare the profile of serum and urinary bone markers and bone mineral density (BMD) of active and sedentary patients after BS. The sample consisted of 89 patients, of both sexes, who underwent BS through the gastric bypass in Roux-Y, between years 2003 and 2013. Anthropometry, body composition, spine and femur BMD was evaluated by dual energy x-ray absormetry (DEXA), as well as biochemical variables through serum collected for the dosage of calcium, osteocalcin and PTH levels,and also 24-hours urine for deoxypyridinoline and calcium. The level of leisure-time physical activity was assessed by questionnaire. Statistical significance was set at 5%. The average age of active and sedentary groups was [51.76 (9.66)] and [47.06 (12.16)] and body mass index [34.98 (6.90)] and [29,26 (5.92)], respectively. There are statistically significant differences in osteocalcin levels between groups (p = 0.021), as well as small effect size observed in the following variables: BMD of the total femur, osteocalcin, deoxypyridinoline and serum calcium (respectively d = 0:36; d = 0:39; d = 00:41 d = 0.3).The incorporation of an active lifestyle demonstrated a positive impact on circulating levels of osteocalcin and other boneparameters, thereby indicating a possible preservation of BMD during the aging process.

Resumo A cirurgia bariátrica (CB) ocasiona uma perda acentuada de massa corporal e gordura, com reflexos em outros tecidos corporais como o ósseo. Objetivou-se comparar o perfil de marcadores ósseos séricos e urinários e a densidade mineral óssea (DMO) de pessoas submetidas a CB classificadas como ativas ou sedentárias. A amostra foi composta por 89 pacientes submetidos a CB por bypass em Y de Roux, entre os anos de 2003 a 2013, de ambos os sexos. Foram realizadas avaliações antropométricas, composição corporal, DMO de coluna e fêmur por Absormetria por dupla emissão de raio-x (DXA) e variáveis bioquímicas, por meio de coletas séricas para a dosagem de cálcio, osteocalcina, PTH e coletas urinárias (urina-24 horas) para dosagem de deoxipiridinolina e cálcio. O nível de atividade física no lazer foi avaliado por questionário. A significância estatística foi estabelecida em 5%. A idade média dos grupos classificados como ativo e sedentário foi de [51,76(9,66)] e [47,06(12,16)] e o índice de massa corporal de [34,98(6,90)] e [29,26(5,92)], respectivamente. Houve diferenças nos níveis de osteocalcina (P=0,021), bem como tamanho de efeito pequeno observados nas variáveis: DMO do Fêmur total, osteocalcina, deoxipiridinolina e cálcio sérico (respectivamente d= 0.36; d=0.39; d=0.41; d=0.3). A adoção de um nível de atividade física considerada "alta" no lazer apresentou impacto positivo sobre os níveis circulantes de osteocalcina, além de outros parâmetros ósseos, indicando uma possível preservação da DMO no decorrer do processo de envelhecimento.

The hyperleptinemia state can downregulate cardiorespiratory fitness and energy expenditure in obese women.

INTRODUCTION: In general, in obese people a state of hyperleptinemia may impair both energy balance and the inflammatory process. However, it has not been fully investigated whether there is a relationship between hyperleptinemia and cardiorespiratory fitness (CRF) and resting energy expenditure (REE), in obese women. METHODS: 83 obese women were enrolled in this cross-sectional study. Anthropometric measures, body composition, REE, CRF and serum concentration of leptin were measured. Pearson's correlation coefficient was performed to examine the relationship between circulating leptin level and other clinical variables. Multiple regression analysis was applied to determine predictors of REE and CRF. Effects were considered significant at p≤0.05. RESULTS: The most important finding in the present study is that the hyperleptinemia state was inversely correlated with CRF (r=-0.382, p=0.001) and REE (r=-0.447, p<0.001). Moreover, a positive correlation with fat mass was confirmed (r=0.419, p<0.001). In addition, hyperleptinemia was an independent negative predictor of REE (r2=-2.649, p=0.010) and CRF (r2=-2.335, p=0.023). CONCLUSION: Together our results may suggest a vicious cycle between the state of hyperleptinemia and a decrease in energy expenditure and cardiorespiratory fitness in obese women, which can impair whole body energy homeostasis. This information is important to contribute to clinical practices.

Effects of concurrent training on morphological and functional parameters and blood pressure in hypertensive women / Efeitos do treinamento concorrente sobre parâmetros morfofuncionais e pressão arterial de mulheres hipertensas

Aerobic and resistance exercise have been prescript to prevention and non pharmacological treatment of hypertension. However, there is a lack of studies investigating the effects of concurrent training in hypertensive women. Thus, the aim of this study was to investigate the effects of concurrent training program on rest blood pressure, biochemical variables (blood glucose and total cholesterol), anthropometric (body mass index and waist circumference) and functional fitness in hypertensive women. Eighteen hypertensive postmenopausal and untrained women (59±12 years old) started in the intervention, but only ten subjects finished. The voluntaries were enrolled in concurrent training, 60 min/day, 3 times a week, during 6 months. Systolic and diastolic blood pressure, blood glucose, total cholesterol, body mass index, waist circumference and functional fitness (AAPHERD) were measured pre and post experimental period. Data were analyzed using the Student's t test with significance level set at 5% (P≤0.05) and Cohen's Effect Size (ES). The results showed significant improvement in systolic and diastolic blood pressure at rest. The other variables did not show significantly changes, but the ES was medium and large for several variables (body mass index, blood glucose, total cholesterol, agility, coordination, aerobic fitness, strength endurance and general functional fitness index). In conclusion, this study confirms that 6 month of concurrent training program improved systolic and diastolic blood pressure in hypertensive women. In addition, the protocol suggests an improvement in anthropometric, biochemical and functional variables related to health...(AU)

O treinamento aeróbio e resistido têm sido prescritos para prevenção e tratamento não farmacológico da hipertensão arterial. No entanto, há escassez de trabalhos investigando os efeitos do treinamento concorrente em mulheres hipertensas. Assim, o objetivo desse trabalho foi investigar os efeitos de um programa de treinamento concorrente sobre pressão arterial de repouso, variáveis bioquímicas (glicose sanguínea e colesterol total), antropométricas (índice de massa corporal e perímetro de cintura) e aptidão funcional em mulheres hipertensas. Dezoito mulheres menopausadas, hipertensas e destreinadas iniciaram o programa, mas somente 10 terminaram. As voluntárias foram submetidas a programa de treinamento concorrente, com frequência de 3 vezes por semana (60 minutos/sessão) e duração de 6 meses. Pressão arterial sistólica e diastólica de repouso, glicemia de jejum, colesterol total, índice de massa corporal, perímetro de cintura e aptidão funcional (AAPHERD) foram mensurados nos períodos pré e pós intervenção. Após confirmação da normalidade, os dados foram analisados usando o test t para amostras em pares, adotando nível de significância de 5% (P≤0,05), além do cálculo do tamanho do efeito de Cohen (ES). Os resultados permitiram observar melhora significativa na pressão sistólica e diastólica de repouso. As outras variáveis não se alteraram significativamente, mas o ES foi médio a grande em diversas variáveis analisadas (índice de massa corporal, glicemia, colesterol total, agilidade, coordenação, aptidão aeróbia, resistência de força e índice geral de aptidão funcional). Em conclusão, esse estudo confirma que um programa de treinamento concorrente de 6 meses diminui os níveis de pressão arterial sistólica e diastólica de repouso em mulheres hipertensas. Além disso, o protocolo sugere melhora em variáveis antropométricas, bioquímicas e funcionais relacionadas à saúde...(AU)

Terapia Interdisciplinar e a Diminuição da Sobrecarga Cardiovascular em Obesos / Interdisciplinary Therapy and Decrease of Cardiovascular Overload in Obese Patients

Fundamentos: Associação entre obesidade, terapia interdisciplinar e exercício físico intenso foi descrita para obesos. Contudo o estudo das atividades físicas representando as tarefas do dia a dia e o risco cardiovascular nas atividades do cotidiano torna-se necessário para verificar a ocorrência dessa associação. Objetivo: Investigar se um período de 18 semanas de terapia interdisciplinar é capaz de promover benefícios nos parâmetros cardiovasculares no repouso e durante o exercício físico em adultos obesos. Métodos: Amostra de 32 indivíduos de ambos os sexos com índice de massa corporal de 30 a 39,9 kg/m2 e idade entre 30 e 50 anos. Intervenção com terapia interdisciplinar (educação física, psicologia, nutrição e fisioterapia), duração de 18 semanas e mensuração de dados antropométricos de massa corporal, estatura, circunferências de cintura e quadril, avaliação de esforço máximo em ergômetro antes e após o período de terapia. Resultados: A terapia interdisciplinar diminuiu pressão arterial sistólica (PAS): 125,83±9,86 (basal) vs 120,28±16,82(final), frequência cardíaca (FC): 74,75 ± 11,02 (basal) vs 72,77 ± 10,72 (final), e duplo-produto (DP) em repouso. Reduziu também durante o esforço submáximo PAS estágios 1: 143,44 ± 9,28 (basal) vs 131,56 ± 15,26; estágio 2: 152,23 ± 21,91 (basal) vs 141,56 ± 17,43 (final), PAD estágio 2: 89,89 ± 9,58 (basal) vs 83,13 ± 9,65 (final), FC estágio 1: 118,40 ± 12,90 (basal) vs 110,87 ± 7,66 (final); estágio 2: 137,09 ± 16,54 (basal) vs 130,37 ± 11,51 (final) e o DP referentes aos estágios iniciais. Conclusão: A terapia interdisciplinar reduziu a sobrecarga do sistema cardiovascular em repouso e no esforço submáximo em adultos obesos otimizando o repouso e atividades do cotidiano

Background: Association between obesity, interdisciplinary therapy and intense physical exercise was described for obese patients. However, the study of physical activities representing daily tasks and cardiovascular risk in everyday activities becomes necessary to verify the occurrence of this association. Objective: To investigate whether a period of 18 weeks of interdisciplinary therapy is capable of promoting benefits in cardiovascular parameters at rest and during exercise in obese adults. Methods: Sample of 32 individuals of both sexes with body mass index of 30 to 39.9 kg/m2 and age between 30 and 50 years. Intervention with interdisciplinary therapy (physical education, psychology, nutrition and physiotherapy), duration of 18 weeks and measurement of anthropometric data of body mass, height, waist and hip circumferences, maximum exercise ergometer evaluation before and after the therapy period. Results: Interdisciplinary therapy decreased systolic blood pressure (SBP): 125.83 ± 9.86 (baseline) vs 120.28 ± 16.82 (final), heart rate (HR): 74.75 ± 11.02 (baseline) ) Vs 72.77 ± 10.72 (final), and double-product (DP) at rest. Reduced also during the submaximal PAS stress stages 1:143.44 ± 9.28 (baseline) vs 131.56 ± 15.26; Stage 2: 152.23 ± 21.91 (baseline) vs. 141.56 ± 17.43 (final), PAD stage 2: 89.89 ± 9.58 (baseline) vs 83.13 ± 9.65 (final) , FC stage 1: 118.40 ± 12.90 (baseline) vs 110.87 ± 7.66 (final); Stage 2: 137.09 ± 16.54 (baseline) vs 130.37 ± 11.51 (final) and the PD referring to the initial stages. Conclusion: Interdisciplinary therapy reduced the overload of the cardiovascular system at rest and submaximal effort in obese adults, optimizing rest and daily activities