Anabolic-Androgenic Steroids and Exercise Training: Breaking the Myths and Dealing With Better Outcome in Sarcopenia.

Sarcopenia is an emerging clinical condition determined by the reduction in physical function and muscle mass, being a health concern since it impairs quality of life and survival. Exercise training is a well-known approach to improve physical capacities and body composition, hence managing sarcopenia progression and worsening. However, it may be an ineffective treatment for many elderly with exercise-intolerant conditions. Thus, the use of anabolic-androgenic steroids (AAS) may be a plausible strategy, since these drugs can increase physical function and muscle mass. The decision to initiate AAS treatment should be guided by an evidence-based patient-centric perspective, once the balance between risks and benefits may change depending on the clinical condition coexisting with sarcopenia. This mini-review points out a critical appraisal of evidence and limitation of exercise training and AAS to treat sarcopenia.

Correlation between strength and skin temperature asymmetries in the lower limbs of Brazilian elite soccer players before and after a competitive season.

This study aimed to investigate the correlation between strength and skin temperature (Tsk) asymmetries in the lower limbs of elite soccer players before and after a competitive season. The sample (n = 20) was composed of elite male soccer players. Strength asymmetry and Tsk asymmetry was measured through the countermovement jump (CMJ) test and infrared thermography, respectively. Asymmetries were quantified using the symmetry angle (SA) equation. A strong correlation was found between the SA of rate of force development (RFD) and the SA of Tsk before (baseline) (r = 0.7; r2 = 0.43; p = 0.03) and after (r = 0.6; r2 = 0.42; p = 0.04) the competitive season. Moreover, after the competitive season there were significant decreases in Peak force (p < 0.018), Impulse (p < 0.04), RFD (p = 0.0001) and CMJ height (p = 0.05), and significant increases in Tsk (p < 0.03), C-reactive protein (p = 0.03), Creatine kinase (p = 0.0001) and Cortisol (p = 0.04), even after a 3-day rest interval (no training). These results suggest that the CMJ test can be combined with infrared thermography for monitoring strength asymmetry and contribute to the prevention of muscle injuries.

Can conditions of skeletal muscle loss be improved by combining exercise with anabolic-androgenic steroids? A systematic review and meta-analysis of testosterone-based interventions.

Sarcopenia, cachexia, and atrophy due to inactivity and disease states are characterized by a loss of skeletal muscle mass, often accompanied by reduced levels of anabolic hormones (e.g. testosterone). These conditions are associated with an increase in mortality, hospitalization and worsening in quality of life. Both physical exercise (EX) and anabolic-androgenic steroid (AAS) administration can improve the prognosis of patients as they increase physical functionality. However, there is a gap in the literature as to the impact of these therapies on the gains in strength and muscle mass and their implications for patient safety. Accordingly, we performed a random-effects meta-analysis to elucidate the effects of AAS and/or EX interventions on lean body mass (LBM) and muscle strength in conditions involving muscle loss. A systematic search for relevant clinical trials was conducted in MEDLINE, EMBASE, SCOPUS, Web of Science, and SPORTDiscus. Comparisons included AAS vs. Control, EX vs. Control, AAS vs. EX, AAS + EX vs. AAS and AAS + EX vs. EX. A total of 1114 individuals were analyzed. AAS increased LBM (effect size [ES]: 0.46; 95% CI: 0.25, 0.68, P = 0.00) and muscle strength (ES: 0.31; 95% CI: 0.08, 0.53, P = 0.01) when compared to a control group. EX promoted an increase in muscular strength (ES: 0.89; 95% CI: 0.53, 1.25, P = 0.00), with no effect on LBM when compared to the control group (ES: 0.15; 95% CI: -0.07, 0.38, P = 0.17). AAS did not demonstrate statistically significant differences when compared to EX for LBM and muscle strength. The combination of EX + AAS promoted a greater increase in LBM and muscular strength when compared to AAS or EX in isolation. Qualitatively, AAS administration had relatively few side effects. Significant heterogeneity was found in some analyses, which may be explained by the use of different AAS types and EX protocols. Our findings suggest that AAS administration in cachectic and sarcopenic conditions may be a viable interventional strategy to enhance muscle function when exercise is not a possible approach. Moreover, combining AAS with exercise may enhance positive outcomes in this population.

Effects of time-restricted feeding in weight loss, metabolic syndrome and cardiovascular risk in obese women.

BACKGROUND: The increasing prevalence of overweight and obesity among the worldwide population has been associated with a range of adverse health consequences such as Type 2 diabetes and cardiovascular diseases. The metabolic syndrome (MetS) is a cluster of cardiometabolic abnormalities that occur more commonly in overweight individuals. Time-restricted feeding (TRF) is a dietary approach used for weight loss and overall health. TRF may be an option for those subjects who struggle with extreme restriction diets with foods that generally do not belong to an individual's habits. OBJECTIVE: The purpose of this study was to determine the effect of TRF on body composition and the association of weight loss with metabolic and cardiovascular risks in obese middle-aged women. METHODS: A non-randomized controlled clinical trial was performed over 3 months in obese women (TRF group, n = 20, BMI 32.53 ± 1.13 vs. Control n = 12, BMI 34.55 ± 1.20). The TRF protocol adopted was 16 h without any energy intake followed by 8 h of normal food intake. MAIN OUTCOMES AND MEASURES: Anthropometric measurements, body composition, blood biomarkers, cardiovascular risk in 30 years (CVDRisk30y), and quality of life were evaluated at baseline and after the 3 months. RESULTS: TRF was effective in reducing weight (~ 4 kg), BMI, % of body fat (%BF), waist circumference from baseline without changes in blood biomarkers associated with MetS. TRF promoted a reduction in CVDRisk30y (12%) wich was moderately correlated with %BF (r = 0.62, n = 64, p < 0.001) and %MM (r = - 0.74, n = 64, p < 0.001). CONCLUSIONS: TRF protocol reduces body weight without changes in biomarkers related to MetS. In addition, the anthropometric evaluation that predicts %BF and %MM could be used as an approach to follow individuals engaged in the TRF regimen since they correlate with cardiovascular risk.

Atividade física e dor lombar em brasileiros: uma revisão sistemática / Physical activity and low back pain in Brazilians: a systematic review

O objetivo deste estudo é identificar e sumarizar os estudos observacionais conduzidos em território brasileiro que avaliaram as possíveis associações entre a prática de atividade física (AF) e a dor lombar (DL), bem como analisar seus métodos. Para isto, foram realizadas buscas em cinco bases de dados eletrônicas (Lilacs, Pubmed, Scielo, Sportdiscus e Web of Science), além de buscas manuais nas listas de referências. Foram incluídos estudos observacionais desenvolvidos em território brasileiro, sem restrições quanto à idade, que apresentaram análises de associações entre AF e DL, disponíveis até 10 de outubro de 2017. Dos 153 estudos inicialmente recuperados, 11 compuseram a síntese descritiva (sete deles envolvendo adultos). Das 14 análises de associação recuperadas, apenas uma apresentou associação de risco entre a prática excessiva de AF e DL, em adolescentes. A presente síntese aponta para a necessidade de importantes avanços metodológicos nos futuros estudos, tais como: a necessi-dade da realização de estudos longitudinais; a investigação de possíveis relações entre distintos domí-nios da AF e diferentes tipos de DL; a necessidade de padronização nos pontos de corte utilizados pelos instrumentos para determinar AF suficiente e a prevalência da DL; e a utilização de medidas objetivas, em paralelo ao questionário, para avaliação da AF

The objective of this study was to identify and summarize the available studies conduced in Brazil, which evaluated possible associations between physical activity (PA) and low back pain (LBP), as well as to an-alyse their methods. Search was performed in five electronic databases (Lilacs, Pubmed, Scielo, Sportdiscus and Web of Science) and by manual searches in reference lists. Inclusion criteria were: observational studies available until October 10, 2017; which presented association analyses between PA and LBP; sample of Brazilian individuals, with no restrictions about age Of the 153 initially studies recovered, 11 were includ-ed (seven of them involving adults). Of the 14 analyses recovered, only one association was observed between excess of PA and LBP in adolescents. Most of the included articles did not show significant associations between PA and LBP. Important methodological advances are needed in future studies on this thematic, such as: longitudinal studies; the investigation of possible relationships between LBP and the distinct domains of PA; standardization in the cut-off points used to determine the prevalence of LBP and sufficient PA; the use of objective measures, in parallel to the questionnaire, for the PA assessment