Aquatic training improves HbA1c, blood pressure and functional outcomes of patients with type 2 diabetes: A systematic review with meta-analysis.

AIM: This study aimed to summarize the effects of aquatic training on the health outcomes of type 2 diabetes (T2D) patients. METHODS: This is a systematic review with meta-analysis that followed the PRISMA recommendations. Searches were performed in four databases in April 2021. The following eligibility criteria were adopted: adults with T2D; aquatic training (AT) intervention in an upright position; pre- and post-intervention assessments of the following outcomes: HbA1c, SBP and DBP, functional capacity, VO2peak. The random-effects meta-analysis results are presented as mean differences and 95% confidence intervals. RESULTS: Of the 375 studies, 12 studies were eligible and included in the meta-analysis. Favorable effects of AT post-intervention were observed in HbA1c (-0.62 %), VO2peak (2.16 mL.Kg-1.min-1), SBP (-5.55 mmHg), DBP (-4.99 mmHg), and the 6-minute walk test (76.64 m). AT also revealed superior effects when compared to the control group (CG) and similar effects to land training (LT) in HbA1c (AT vs CG = -0.67 % and AT vs LT = -0.40 %), VO2peak (AT vs CG = 3.78 mL.Kg-1.min-1; AT vs LT = -0.12 mL/Kg-1.min-1), SBP (AT vs LT = -0.85 mmHg), and DBP (AT vs LT = 2.12 mmHg). CONCLUSION: AT improves HbA1c, VO2peak, SBP, DBP, and functional capacity in T2D patients. Beneficial effects favored AT over CG, while similar effects were verified between AT and LT on HbA1c, VO2peak, and blood pressure.

Association between simultaneity of health-risk behaviours and self-rated health in Brazilian adolescents.

INTRODUCTION: This study examined the association between simultaneity of four health-risk behaviours, namely, low levels of moderate-to-vigorous physical activity (insufficient MVPA: <420 min/week), tobacco use, alcohol consumption, and excessive television (TV)-(>2 h/d of TV viewing) and self-rated health (SRH) in Brazilian adolescents. METHODS: We used data of 100,551 adolescents from the National School Health Survey, a national cross-sectional study carried out in 2015. Association between simultaneity of health risk behaviours (i.e. the ratio between observed and expected prevalence rates) and SRH was examined using logistic regression models. RESULTS: The majority of the participants were female (51.9%) and 14 years of age (50.6%), and 26% of the participants' SRH ranged from 'average' to 'extremely poor'. Those who engaged in the following combinations of health-risk behaviours had higher odds of worse SRH than their healthier counterparts: insufficient MVPA and tobacco use (odds ratio-OR: 2.0, 95% confidence interval [CI]: 1.4 to 3.0); insufficient MVPA and alcohol consumption (OR: 1.6, 95%CI: 1.3 to 1.9); insufficient MVPA and >2 h/day of TV viewing (OR: 1.3, 95%CI: 1.1 to 1.6); insufficient MVPA, tobacco use and alcohol consumption (OR: 2.1, 95%CI: 1.7, to 2.7); and insufficient MVPA, alcohol consumption and >2 h/day of TV viewing (OR: 1.6, 95%CI: 1.4 to 2.0). CONCLUSIONS: Insufficient MVPA, alcohol consumption, and other health-risk behaviours were associated with worse SRH in Brazilian adolescents.

Effects of linear periodization of combined training on quality of life of adults with obesity: a blind randomized controlled trial.

This study aimed to compare the effect of 16-weeks of combining aerobic and strength training with a linear increase or fixed intensity on the health-related quality of life (HRQoL) of obese adults. This single-blinded clinical trial involved adults with obesity (BMI ≥ 30 kg/m2), randomized into control (CG), fixed intensity (FG), or linear increase (LG) groups. The FG and LG performed 16 weeks of combined (aerobic + strength) training for 60 min, three times a week. The FG performed aerobic exercises between 50 and 59% of the heart rate reserve (HRres) and strength at 10-12 maximum repetitions (RM). The LG started with 40-49% of HRres and 12-14 RM and progressively increased the intensity (50-59% and 10-12 RM; 60-69% and 8-10 RM). The HRQoL was assessed using the SF-36 questionnaire. Generalized estimation equations and mean differences (∆) were used. Of the 69 participants (23 per group), 36 completed the intervention (CG = 13, FG = 9, and LG = 14). A significant difference was observed in the time of the physical function, with superiority in the training groups (CG: ∆ = 1.2 vs. FG and LG, respectively: ∆ = 10.0). The mental health component and mental health domain showed significant differences for the FG (∆ = 30.2 and ∆ = 23.1, respectively). In conclusion, the combined training improved physical functioning. Specifically, fixed-intensity training effectively enhanced mental health indicators.Trial Registration: This study is registered at www.ensaiosclinicos.gov.br/ (No. RBR-3c7rt3), Date of registration: 07/02/2018.

Effects of Combined Training With Linear Periodization and Non-Periodization on Sleep Quality of Adults With Obesity.

Background: Combined exercise training has proven effective in preventing and treating sleep disorders among obese adults. However, structured progression of intensity in sleep parameters remains poorly investigated within this population. Purpose: To verify the effects of non-periodized and linear periodization combined training on the sleep quality of obese adults. Methods: This was a randomized controlled trial involving adults with body mass index ≥ 30 kg/m2, allocated to 3 groups: control (CG; n = 13), non-periodized training (NG; n = 9), and with linear periodization (PG; n = 13). Groups PG and NG trained for 16 weeks in 3 weekly sessions lasting of 60 minutes. The NG trained in 50-59% heart rate reserve (HRR) e 2 × 10-12 repetition maximum (RM) and the PG with progression in 3 mesocycles: 40-49%;50-59%; 60-69% HRR e 2x12-14; 2x10-12; 2 × 8-10 RM, with the total volume equated. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index. For statistics, we used Generalized Estimation Equations considering p ≤ 0.05. Results: Sleep latency was reduced in both training groups after intervention (NG-Δ = -25.56 minutes p = .028; PG-Δ = -22.23 minutes p = .035), while significant improvements in sleep efficiency were found only in the NG (Δ = 20.67%; p = .042). Conclusion: Despite the NG's apparent superiority, which model has the best sleep effects on obese adults cannot be stated. Hence, caution is needed while extrapolating the results.

Effects of Nonperiodized and Linear Periodized Combined Training on Health-Related Physical Fitness in Adults With Obesity: A Randomized Controlled Trial.

ABSTRACT: Streb, AR, Passos da Silva, R, Leonel, LdS, Possamai, LT, Gerage, AM, Turnes, T, and Del Duca, GF. Effects of nonperiodized and linear periodized combined training on health-related physical fitness in adults with obesity: a randomized controlled trial. J Strength Cond Res 36(9): 2628-2634, 2022-The aim of this randomized controlled trial study was to compare the effects of 16 weeks of linear periodized and nonperiodized combined training (CT) in cardiorespiratory fitness, muscle strength, and body composition indicators of adults with obesity. Thirty-four obese adults of both sexes (36.6 ± 4.4 years; body mass index, 32.9 ± 2.7 kg·m -2 ) were divided into nonperiodized (NG; n = 8), linear periodized (PG; n = 11), and control (CG; n = 15) groups. The NG and PG groups performed 3 weekly sessions of CT over 16 weeks in different ways. Anthropometric measures, maximal strength for leg press and barbell bench press, maximal oxygen uptake (V̇ o2 max), and ventilatory thresholds were determined before and after intervention. The generalized estimation equation was used, with the applied level of significance for the interaction of 0.10 and the isolated effect of time or group or both of 0.05. Significant and similar increases were observed in the 1-repetition maximum test for bench press (NG: 48.8 ± 5.7 to 55.0 ± 6.1 kg; PG: 48.7 ± 5.7 to 53.8 ± 5.9 kg; p = 0.001) and leg press (NG: 235.2 ± 18.7 to 268.3 ± 19.7 kg; PG: 223.1 ± 25.3 to 253.3 ± 23.1 kg; p = 0.05) in trained groups. Relative V̇ o2 max improved only in PG (27.8 ± 1.3 to 32.0 ± 1.4 mL·kg·min -1 ; p = 0.05), while ventilatory thresholds improved in NG and CG ( p = 0.004 and p = 0.06). There was an increase in body mass in CG (97.6 ± 3.4 to 99.1 ± 2.9 kg) and NG (92.5 ± 5.4 to 93.5 ± 5.4 kg; p = 0.05). Combined training improved maximal upper-body and lower-body strength, regardless of periodization. However, for improvement in V̇ o2 max, linear periodization may be superior to nonperiodization in obese adults.

Quality of life and its relationship with different anthropometric indicators in adults with obesity / Qualidade de vida e sua relação com diferentes indicadores antropométricos em adultos com obesidade

Abtract Introduction: Obesity compromises the quality of life. However, few studies have investigated the influence of different anthropometric indicators on the quality of life of this population. Objective: We aimed to correlate the physical and mental components of quality of life and verify its association with different anthropometric indicators in adults with obesity. Methods: A cross-sectional study was conducted in adults with obesity [body mass index (BMI) ≥ 30 kg/m²]. The quality of life was investigated using the SF-36 questionnaire, with scores ranging from 0 (worst-case scenario) to 100 (best scenario for the outcome). The anthropometric indicators used were BMI, waist circumference, waist/height ratio (WHR), and lean and fat body mass. For analysis, Spearman's correlation and crude and adjusted linear regression for sociodemographic variables were used. Results: A total of 75 subjects (nfemales = 47; µage= 34.8 ± 7.1 years) were included, and their means of the physical and mental components were 64.5 ± 15.9 and 50.8 ± 21.3 points, respectively. The social functioning domain presented a strong positive correlation (r = 0.760) with the mental health domain, and eight moderate correlations (0.400 ≤ r ≥ 0.699) were found between the different domains of the questionnaire. The functional capacity domain and the physical component presented a moderate negative correlation with the WHR (r = -0.402 and r = -0.407, respectively). After adjustment, the WHR was inversely associated with the physical component (β = -1.197; p = 0.002). Conclusion: In adults with obesity, important correlations were observed between the physical and mental components of quality of life, and the waist/height ratio was the only anthropometric indicator correlated and associated with the physical component of the outcome.

Resumo Introdução: A obesidade compromete a qualidade de vida física e mental em função do excesso de peso corporal. Entretanto poucos estudos se propuseram a compreender a influência dos diferentes indicadores antropométricos na qualidade de vida dessa população. Objetivo: Correlacionar os componentes físico e mental da qualidade de vida e verificar a sua associação com diferentes indicadores antropométricos em adultos com obesidade. Métodos: Realizou-se um estudo transversal com adultos com obesidade (índice de massa corporal [IMC] ≥ 30kg/m²). A qualidade de vida foi investigada pelo questionário SF-36, com amplitude de escores de zero (pior cenário) a 100 (melhor cenário para o desfecho). Os indicadores antropométricos foram: IMC, perímetro de cintura, razão cintura/estatura (RCE), massa corporal magra e gorda. Na estatística, empregou-se correlação de Spearman e regressão linear bruta e ajustada para variáveis sociodemográficas. Resultados: Nos 75 sujeitos (nmulheres = 47; µidade = 34,8 ± 7,1 anos), o componente físico apresentou média de 64,5 ± 15,9 pontos e mental de 50,8 ± 21,3 pontos. O domínio de aspecto social apresentou forte correlação positiva (r = 0,760) com o domínio da saúde mental e foram encontradas oito correlações moderadas (0,400 ≤ r ≥ 0,699) entre os distintos domínios do questionário. O domínio capacidade funcional e o componente físico apresentaram moderada correlação negativa com a RCE (r = -0,402 e r = -0,407, respectivamente). Na análise ajustada, a RCE apresentou uma associação inversa com o componente físico (β = -1,197; p = 0,002). Conclusão: Em adultos com obesidade, observou-se importantes correlações entre os componentes físico e mental da qualidade de vida e a razão cintura/estatura foi o único indicador antropométrico correlacionado e associado ao componente físico do desfecho.

[Association between the practice of physical activity of different types and the use of insulin in adult and elderly diabetics in Brazil]. / Associação entre a prática de atividade física em diferentes domínios e o uso de insulina em adultos e idosos com diabetes no Brasil.

The scope of this paper was to verify the association between the practice of physical activity of different types and the use of insulin in adults and the elderly. This is a cross-sectional population-based study with data from the survey entitled Surveillance of risk factors and protection for chronic diseases by telephone (VIGITEL 2013). The sample consisted of individuals aged ≥18 years, living in the 27 Brazilian capitals and diagnosed with diabetes. The practice of physical activity in commuting, the home, leisure, work and the use of insulin were self-reported. Binary logistic regression was used in crude and adjusted analyses for sociodemographic factors. Of the 4,593 subjects with diabetes, insulin use was reported by 16.2% and 25.5% of adults and the elderly, respectively. The practice of physical activity in the home (OR: 0.61, 95%CI: 0.40; 0.94) and at work (OR: 0.38, 95%CI: 0.18; 0.78) were associated with the lowest use of insulin among the elderly. There was a tendency to reduce insulin use as the number of physically active domains increased among the elderly (p = 0.003). The conclusion drawn was that physical activity practiced alone or in a cumulative way in different domains was associated with lower insulin use among the elderly.

Objetivou-se verificar a associação entre a prática de atividade física em diferentes domínios e o uso de insulina em adultos e idosos. Trata-se de um estudo transversal de base populacional com dados do inquérito Vigilância de fatores de risco e proteção para doenças crônicas por Inquérito Telefônico (VIGITEL 2013). A amostra foi composta por indivíduos com idade ≥18 anos, residentes nas 27 capitais do Brasil e com diagnóstico de diabetes. A prática de atividade física no deslocamento, domicílio, lazer e trabalho, e o uso de insulina foram por autorrelato. Empregou-se regressão logística binária em análises bruta e ajustada para fatores sociodemográficos. Dos 4.593 indivíduos com diabetes, uso de insulina foi relatado por 16,2% e 25,5% dos adultos e idosos, respectivamente. A prática de atividade física no domicílio (RO: 0,61; IC95%: 0,40; 0,94) no trabalho (RO: 0,38; IC95%: 0,18; 0,78) estiveram associadas ao menor uso de insulina em idosos. Houve tendência de redução do uso de insulina à medida que se aumentou a quantidade de domínios fisicamente ativos em idosos (p = 0,003). Conclui-se que, em idosos, a atividade física praticada de forma isolada ou de forma acumulada em diferentes domínios teve associação com o menor uso de insulina.

Associação entre a prática de atividade física em diferentes domínios e o uso de insulina em adultos e idosos com diabetes no Brasil / Association between the practice of physical activity of different types and the use of insulin in adult and elderly diabetics in Brazil

Resumo Objetivou-se verificar a associação entre a prática de atividade física em diferentes domínios e o uso de insulina em adultos e idosos. Trata-se de um estudo transversal de base populacional com dados do inquérito Vigilância de fatores de risco e proteção para doenças crônicas por Inquérito Telefônico (VIGITEL 2013). A amostra foi composta por indivíduos com idade ≥18 anos, residentes nas 27 capitais do Brasil e com diagnóstico de diabetes. A prática de atividade física no deslocamento, domicílio, lazer e trabalho, e o uso de insulina foram por autorrelato. Empregou-se regressão logística binária em análises bruta e ajustada para fatores sociodemográficos. Dos 4.593 indivíduos com diabetes, uso de insulina foi relatado por 16,2% e 25,5% dos adultos e idosos, respectivamente. A prática de atividade física no domicílio (RO: 0,61; IC95%: 0,40; 0,94) no trabalho (RO: 0,38; IC95%: 0,18; 0,78) estiveram associadas ao menor uso de insulina em idosos. Houve tendência de redução do uso de insulina à medida que se aumentou a quantidade de domínios fisicamente ativos em idosos (p = 0,003). Conclui-se que, em idosos, a atividade física praticada de forma isolada ou de forma acumulada em diferentes domínios teve associação com o menor uso de insulina.

Abstract The scope of this paper was to verify the association between the practice of physical activity of different types and the use of insulin in adults and the elderly. This is a cross-sectional population-based study with data from the survey entitled Surveillance of risk factors and protection for chronic diseases by telephone (VIGITEL 2013). The sample consisted of individuals aged ≥18 years, living in the 27 Brazilian capitals and diagnosed with diabetes. The practice of physical activity in commuting, the home, leisure, work and the use of insulin were self-reported. Binary logistic regression was used in crude and adjusted analyses for sociodemographic factors. Of the 4,593 subjects with diabetes, insulin use was reported by 16.2% and 25.5% of adults and the elderly, respectively. The practice of physical activity in the home (OR: 0.61, 95%CI: 0.40; 0.94) and at work (OR: 0.38, 95%CI: 0.18; 0.78) were associated with the lowest use of insulin among the elderly. There was a tendency to reduce insulin use as the number of physically active domains increased among the elderly (p = 0.003). The conclusion drawn was that physical activity practiced alone or in a cumulative way in different domains was associated with lower insulin use among the elderly.

Aquatic exercise and Far Infrared (FIR) modulates pain and blood cytokines in fibromyalgia patients: A double-blind, randomized, placebo-controlled pilot study.

Fibromyalgia (FM) has an inflammatory component, as elevated serum levels of inflammatory biomarkers are associated with its diagnosis. Treatments decreased pain, body temperature, improved quality of life and reduced serum levels of IL-6 in both groups; however, these beneficial effects were more pronounced in aquatic exercise (AE) + Far-Infrared (FIR) group. The findings of the present study suggest that the association of AE to FIR increases the benefits of aquatic exercise in patients with FM.

Comparison of linear periodized and non-periodized combined training in health markers and physical fitness of adults with obesity: Clinical trial protocol.

The literature discusses that combined training, aerobic more resistance exercises in the same session, is a suitable strategy for people with obesity and that exercise periodization leads to positive health outcomes; however, the implication of different periodizations of combined training for health outcomes in obese adults requires further investigation. The aim of the study will be to describe the methodology used to compare the effect of linear periodized and non-periodized combined training on health markers and health-related physical fitness in adults with obesity. This is a blinded randomized controlled clinical trial investigating adults with obesity in the age group 20-50 years. The sample will be non-probabilistic, and participants will be allocated randomly into one of three groups: control group (CG), non-periodized group (NG), and periodized group (PG). The intervention will occur in 60-min sessions, 3 days a week for 16 weeks, with 1 week dedicated to familiarization with the training and 15 weeks of combined training (aerobic followed by resistance in the same session). The PG group will perform three mesocycles of 5 weeks each, progressing in intensity throughout the intervention [aerobic: from 40-49% to 60-69% of heart rate reserve (HRR); strength: from 12 to 14 maximum repetitions (MR) to 8 to 10MR]; the NG group will maintain the same relative intensity throughout the study (aerobic: 50-59% of HRR; strength: 2 sets of 10-12 MR). Participants in the CG group will maintain their usual activities without the proposed intervention. Pre- and post-intervention assessments will be performed for biochemical markers, body composition, cardiovascular parameters, cardiorespiratory fitness, maximum upper and lower limb strength, flexibility, and subjective health-related parameters. This project was approved by the Committee of Ethics and Research with Human Beings of the institution of origin (protocol 2,448,674) and registered in the Brazilian Registry of Clinical Trials (RBR-3c7rt3).

Association between physical inactivity in leisure, work, commuting, and household domains and nutritional status in adults in the capital cities of Brazil / Associação entre a inatividade física nos domínios do lazer, trabalho, deslocamento e domicílio e o estado nutricional em adultos das capitais do Brasil

ABSTRACT Objective To investigate the association between different domains (leisure, work, commuting, and household) of physical activity, independent and cumulative, and excess weight and obesity in Brazilian adults. Methods This is a cross-sectional survey, conducted in 2015, through telephone interviews with a representative sample of adults from the capitals of Brazil. Physical inactivity was defined as non-participation in predefined physical activities for each assessed domain. Excess weight (Body Mass Index?25kg/m2) and obesity (Body Mass Index?30kg/m2) were determined from self-reported measurements of weight and height. A binary logistic regression was conducted after adjusting for sociodemographic factors. Results Among 54,174 subjects, physical inactivity in commuting (ORexcess weight=1.27, 95%CI=1.13,1.42 and ORobesity=1.25, 95%CI=1.06,1.47) and leisure (ORexcess weight=1.12, 95%CI=1.04,1.22 and ORobesity=1.30, 95%CI=1.17,1.45) domains were associated with nutritional status. In addition, a linear trend was observed between increasing obesity and cumulative physical inactivity of all four domains (p<0.001). Conclusion Cumulative physical inactivity, especially in the commuting and leisure domains, was associated with excess weight and obesity in adults living in the capitals of Brazil. One possible explanation of these findings is that these domains involve particularly longer duration and greater intensity of physical inactivity. Public policies concerning physical activity should prioritize actions focused in promoting physical activity on commuting and leisure-time to help prevent overweight and obesity in the Brazilian adult population.

RESUMO Objetivo Investigar a associação entre a atividade física em diferentes domínios (deslocamento, domicílio, lazer e trabalho) isolados e acumulados com a ocorrência de excesso de peso e obesidade em adultos brasileiros. Métodos Trata-se de um inquérito transversal, realizado em 2015, por meio de entrevista telefônica com uma amostra representativa de adultos das capitais do Brasil. A inatividade física foi determinada como a não participação em atividades físicas específicas para cada domínio avaliado. O excesso de peso (Índice de Massa Corporal?25kg/m2) e a obesidade (Índice de Massa Corporal ?30kg/m2) foram definidos pelo autorrelato de peso e altura. Na esta-tística, empregou-se a regressão logística binária ajustada para fatores sociodemográficos. Resultados Dentre os 54.174 sujeitos, observou-se que a inatividade física no deslocamento (OR=1,27; IC95%:1,13;1,42 e OR=1,25; IC95%:1,06;1,47) e no lazer (OR=1,12; IC95%:1,04;1,22 e OR=1,30; IC95%:1,17;1,45) estiveram associadas ao excesso de peso e à obesidade, respectivamente. Observou-se ainda uma tendência linear de aumento da obesidade à medida que se acumulam domínios com inatividade física (p<0,001). Conclusão A inatividade física acumulada em diferentes domínios, particularmente no deslocamento e no lazer, apresentou associação com o excesso de peso e obesidade em adultos residentes nas capitais do Brasil. Possivelmente, importantes características da atividade física nos referidos domínios, como a maior duração e a maior intensidade, sejam potenciais justificativas para o encontro de tais achados. Portanto, recomenda-se que políticas públicas de atividade física possam priorizar ações voltadas para os domínios do deslocamento e do lazer no combate ao excesso de peso e obesidade na população adulta brasileira.