Determinant factors of bone health after long-term of Roux-en-Y gastric bypass surgery: A cross-sectional study.

OBJECTIVES: The aim of this study was to evaluate bone health and the potential influencing factors of bone metabolism disorders in adults ≥5 y after Roux-en-Y gastric bypass (RYGB) surgery. METHODS: In this cross-sectional study, patients who were ≥5 y post-RYGB were invited. Bone health considered as bone mineral content (BMC) and bone mineral density (BMD) in this study was assessed by dual x-ray absorptiometry. We also assessed 25-hydroxy-vitamin D concentrations, individual ultraviolet B radiation levels, serum ionized calcium, alkaline phosphatase, parathyroid, anthropometric, and body composition. RESULTS: The study evaluated 104 adults (90% women; 49.6 ± 9.1 y old; postoperative period 8.7 ± 2.2 y). Lumbar and femoral BMC and BMD were positively correlated to body mass index (BMI), appendicular lean mass (ALM), and negatively to %excess of weight loss (EWL). Femoral BMD was negatively correlated to age, and both femoral BMD and BMC were positively correlated to weekly exposed body part score. Sex, age, BMI, ALM, and weekly exposed body part score explained 35% and 54% of the total variance of femoral BMD and BMC, respectively. CONCLUSIONS: The present findings suggested that older age, lower BMI, higher %EWL, lower ALM, and lower weekly body part exposure score are important determinants in lowering BMD and BMC parameters in long-term post-bariatric surgery individuals, rather than serum 25-hydroxy-vitamin D and parathyroid.

Association between isokinetic strength measures and functional performance in community-dwelling older adults / Asociación entre las medidas de fuerza isocinética y el rendimiento funcional en personas mayores en la comunidad / Associação entre medidas de força isocinética e desempenho funcional em pessoas idosas da comunidade

ABSTRACT Previous studies have shown an association between lower limb muscle strength and functional performance, but a dose-response relationship between the strength of each lower limb muscle group and performance in daily life activities in older adults has not been well established. Thus, this study aimed to investigate the association between isokinetic muscle strength of all eight major lower limb muscle groups and functional performance in community-dwelling older adults. The muscle strength of the plantar flexors and dorsiflexors of the ankle, flexors and extensors of the knee, and flexors, extensors, adductors, and abductors of the hip were evaluated using a Biodex System 4 Pro® isokinetic dynamometer. Functional performance was evaluated in 109 participants using the five-times sit-to-stand test (STS) and 4-meter usual walking speed (UWS). The multiple linear regression analyses showed that the hip abductors strength predicted 31.3% of the variability for UWS (p=0.011), and the knee extensors strength (p=0.015) predicted 31.6% of the variability for the STS. We conclude that hip abductors and knee extensors could be the key muscle groups involved in sit to stand and walking speed performance in older adults.

RESUMEN Estudios previos ya demostraron la asociación entre la fuerza muscular de los miembros inferiores y el rendimiento funcional, sin embargo, no está bien establecida la contribución de los principales músculos de los miembros inferiores sobre el rendimiento de las personas mayores en las actividades diarias. El objetivo de este estudio fue evaluar la asociación entre la fuerza muscular isocinética de los ocho principales grupos musculares de los miembros inferiores y el rendimiento funcional en personas mayores que viven en la comunidad. La fuerza muscular de los plantiflexores y dorsiflexores del tobillo, los flexores y extensores de la rodilla y los flexores, extensores, aductores y abductores de la cadera se evaluaron por medio del dinamómetro isocinético Biodex System 4 Pro®. El rendimiento funcional de 109 participantes se evaluó mediante el test de sentarse y pararse cinco veces (STS) y la velocidad de marcha habitual de 4 metros. Los análisis de regresión lineal múltiple mostraron que la fuerza de los abductores de la cadera predijo el 31,3% de la variabilidad para la velocidad de marcha habitual (p=0,011); y la fuerza de los extensores de la rodilla (p=0,015), el 31,6% de variabilidad para STS. Se concluyó que los abductores de la cadera y los extensores de la rodilla pueden ser los principales grupos musculares involucrados en el rendimiento de los adultos mayores para sentarse, pararse y caminar.

RESUMO Estudos anteriores já demonstraram a associação entre força muscular de membros inferiores e desempenho funcional, mas a contribuição dos principais músculos dos membros inferiores para o desempenho de pessoas idosas nas atividades cotidianas não foi bem estabelecida. O objetivo deste estudo foi investigar a associação entre a força muscular isocinética dos oito principais grupos musculares dos membros inferiores e o desempenho funcional em pessoas idosas da comunidade. A força muscular dos plantiflexores e dorsiflexores do tornozelo, flexores e extensores do joelho e flexores, extensores, adutores e abdutores do quadril foi avaliada utilizando um dinamômetro isocinético Biodex System 4 Pro®. O desempenho funcional de 109 participantes foi avaliado usando o teste de sentar e levantar cinco vezes (TSL) e de velocidade de marcha habitual de 4 metros (VMH). As análises de regressão linear múltipla mostraram que a força dos abdutores do quadril previu 31,3% da variabilidade para a VMH (p=0,011), e a força dos extensores do joelho (p=0,015) 31,6% da variabilidade para o TSL. Concluímos que os abdutores do quadril e os extensores do joelho podem ser os principais grupos musculares envolvidos no desempenho de pessoas idosas para sentar-levantar e caminhar.

Sarcopenic obesity diagnosis by different criteria mid-to long-term post-bariatric surgery.

BACKGROUND/AIMS: The aim of this study was to apply the European Society for Clinical Nutrition and Metabolism/European Association for the Study of Obesity (ESPEN/EASO) consensus to identify sarcopenic obesity (SO) in adults mid to long-term post-Roux-en-Y gastric bypass (RYGB) using both dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA). Further, this approach was compared to accepted sarcopenia diagnostic criteria (Revised European Working Group on Sarcopenia in Older People [EWGSOP2] and Sarcopenia Definition and Outcomes Consortium [SDOC]). METHODS: This cross-sectional study included adults ≥2 years post-RYGB surgery. Obesity was diagnosed by excess fat mass (FM) for all diagnostic criteria. Agreement was evaluated using Cohen's Kappa. RESULTS: We evaluated 186 participants (90.9% female, median age 43.9 years, 6.8 years post-surgery), of which 60.2% (BIA), and 83.3% (DXA) had excess FM. Low muscle strength was not identified using absolute handgrip strength. The prevalence of SO by BIA or DXA, respectively, was 7.9% (95%CI 3.9-12.5), and 23.0% (95%CI 17.1-30.3) [ESPEN/EASO SO consensus]; 0.7% (95%CI 0-2.0), and 3.3% (95%CI 0.7-5.9) [EWGSOP2]; and 27.0% (95%CI 19.7-34.2), and 30.3% (95%CI 23.0-37.5) [SDOC]. Agreement between the ESPEN/EASO SO consensus and other diagnostic criteria was none to slight using DXA: EWGSOP2 k = 0.19; 95% CI 0.04-0.34, or SDOC k = 0.16; 95% CI -0.01-0.32. Moderate agreement was observed within the ESPEN/EASO SO consensus for BIA and DXA (k = 0.43; 95% CI 0.26-0.60). CONCLUSIONS: This is the first study to explore the prevalence of SO using the ESPEN/EASO criteria. We identified a high but variable prevalence of SO in post-bariatric surgery patients (7.9-23.0%), depending on the body composition technique used; prevalence was higher using DXA. Little agreement was observed for the diagnosis of SO using the three diagnostic criteria. Future studies are needed to explore the relationship between SO identified by the ESPEN/EASO consensus and health status/outcomes.

Effects of Resistance Training With or Without Protein Supplementation on Body Composition and Resting Energy Expenditure in Patients 2-7 Years PostRoux-en-Y Gastric Bypass: a Controlled Clinical Trial.

BACKGROUND: Resistance training (RT) and adequate protein intake are recommended as strategies to preserve fat-free mass (FFM) and resting metabolic demand after bariatric surgery. However, the effect of both interventions combined in the late postoperative period is unclear. This study investigated the effects of RT, isolated and combined with protein supplementation, on body composition and resting energy expenditure (REE) in the late postoperative period of Roux-en-Y gastric bypass (RYGB). METHODS: This controlled trial involved patients who were 2-7 years postRYGB. Participants were partially matched on body mass index (BMI), age, sex, and years after surgery, and divided into four groups, placebo maltodextrin (control [CON]; n = 17), whey protein supplementation (PRO; n = 18), RT combined with placebo (RTP; n = 13), and RT combined with whey protein supplementation (RTP + PRO; n = 15)-considering the participants who completed the protocol. REE was measured by indirect calorimetry and body composition by multifrequency electrical bioimpedance. RESULTS: Participant characteristics (40.3 ± 8.3 years old; average BMI 29.7 ± 5.3 kg/m2; 88.9% females) were similar among groups. The RTP+PRO group showed an increase of 1.46 ± 1.02 kg in FFM and 0.91 ± 0.64 kg in skeletal muscle mass (SMM), which was greater than the equivalent values in the CON group (- 0.24 ± 1.64 kg, p = 0.006 and - 0.08 ± 0.96 kg, p = 0.008, respectively). There was no significant time-by-group interaction for absolute or relative REE. CONCLUSION: Combined RT and adequate protein intake via supplementation can increase FFM and SMM in the late postoperative period without changing REE. These associated strategies were effective in improving muscle-related parameters and potentially in improving the patients' physical function.

Effect of strength training and antioxidant supplementation on perceived and performance fatigability in breast cancer survivors: a randomized, double-blinded, placebo-controlled study.

This randomized, double-blinded, placebo-controlled study aimed to investigate the effect of strength training (ST) combined with vitamin C and E supplementation on perceived and performance fatigability in breast cancer survivors (BCS). Twenty-five BCS were randomly assigned to 1 of 2 groups: vitamins (VIT; n = 12; 51.0 ± 9.0 years) or placebo (PLA; n = 13; 48.2 ± 8.3 years). Both groups performed a 10-week ST protocol, twice a week. The VIT group was supplemented with vitamins C (500 mg/day) and E (180 mg/day) and the PLA group with polydextrose (1 g/day), once a day after breakfast. At the beginning and at the end of the training period, perceived fatigability was assessed using Multidimensional Fatigue Inventory (MFI)-20 (general fatigue and physical fatigue). Performance fatigability was assessed during 30 maximal isokinetic knee extensions at 120°/s. General fatigue decreased similarly in the VIT (p = 0.004) and PLA (p = 0.011) groups. Physical fatigue decreased similarly in the VIT (p = 0.011) and PLA (p = 0.001) groups. Performance fatigability also decreased similarly in the VIT (p = 0.026) and PLA (p < 0.001) groups. There was no difference between groups at any moment (p > 0.05). In summary, antioxidant supplementation does not add any positive synergistic effect to ST in terms of improving perceived or performance fatigability in BCS. This clinical trial is registered in the Brazilian Clinical Trials Registry, number RBR-843pth (UTN no.: U1111-1222-6511). Novelty ST with maximal repetitions reduces perceived and performance fatigability of BCS. Vitamins C and E supplementation does not add any positive synergistic effect to ST in terms of reducing fatigability in BCS.

Resistance Training Modulates the Humoral Inflammatory (but Not the DNA Methylation) Profile of Diabetic Older Adults Using Metformin.

BACKGROUND AND AIM: Inflammatory and methylation imbalances occur in patients with type 2 diabetes mellitus (T2DM). The aim of the present study was to analyze the effect of acute resistance exercise on the inflammatory profile and on DNA methylation of elderly patients with T2DM using metformin. METHODS: For this purpose, we enrolled 22 male and female older adults (68.2 ± 5.3 years), of whom 13 had controlled T2DM (D) under metformin use and 9 were nondiabetics (ND). All subjects underwent a neuromuscular circuit (8 exercises in 40 min, with each exercise performed in 3 sets of 40 s each and a 20-s interval between repetitions). RESULTS: The main results indicated a significant difference between groups for baseline interleukin (IL)-10, with a higher concentration in the D group compared to the ND group (p = 0.019). An increase in IL-6 concentration after intervention was observed in group D (p = 0.035). No effect was observed in total DNA methylation within or between groups. CONCLUSIONS: The resistance training protocol applied in this study modulates the IL-10 and IL-6 concentrations in elderly people with T2DM and under metformin use, possibly as a result of physiological adaptations, with no effect on nondiabetic elderly. No effects on absolute levels of DNA methylation were observed.

Body fat, but not muscle quality, is related to perceived fatigue in young-adult active and inactive women / Gordura corporal, mas não a qualidade muscular, é relacionada a fadiga percebida em mulheres adultas jovens ativas e inativas

Abstract The purpose of this study was to investigate the association of perceived fatigue with body composition and muscle quality (strength, thickness and specific torque) in young adult women. Fifty-one healthy women (31.98 ± 6.88 years) were assessed regarding perceived fatigue, body composition, knee extensors muscle strength, muscle thickness, and muscle quality. The short version of International Physical Activity Questionnaire was applied to classify subjects as active or inactive. To examine the relationship between perceived fatigue and dependent variables, the Pearson's correlation was performed. Perceived fatigue was significantly correlated (p < 0.05) with body weight (r = 0.469), body mass index (r = 0.369), fat mass (r = 0.469), percent body fat (r = 0.396), and relative peak torque (r = -0.378). Additionally, inactive women had significantly greater (p < 0.05) body weight, body mass index, fat mass, percent body fat, and perceived fatigue than active women. Perceived fatigue is related to body weight and fat mass, but not to muscle strength or muscle quality. Moreover, physically active women showed lower perceived fatigue, body weight, and body fat compared to physically inactive women. These results suggest that body fat may play a role in perceived fatigue and physical activity could attenuate such symptom.

Resumo O objetivo deste estudo foi investigar a associação da fadiga percebida com a composição corporal e a qualidade muscular (força, espessura e torque específico) em mulheres adultas jovens. Cinquenta e uma mulheres foram avaliadas quanto a fadiga percebida, a composição corporal, a força muscular de extensão de joelho, a espessura muscular e a qualidade muscular. A versão curta do Questionário Internacional de Atividade Física foi aplicada para classificar as voluntárias como ativas ou inativas.Para examinar a relação entre a fadiga percebida e as variáveis dependentes, a correlação de Pearson foi executada. A fadiga percebida apresentou relação significativa (p < 0,05) com o peso corporal (r = 0,469), IMC (r = 0,369), massa gorda (r = 0,469), percentual de gordura (r = 0,396) e pico de torque relativo (r = -0,378). Adicionalmente, mulheres inativas apresentaram maior (p < 0,05) peso corporal, índice de massa corporal, massa gorda, percentual de gordura e fadiga percebida, comparadas com mulheres ativas. A fadiga percebida se relaciona com o peso corporal e com a gordura corporal, mas não com a força muscular ou com a qualidade muscular. Além disso, mulheres fisicamente ativas tem uma menor fadiga percebida, peso corporal e gordura corporal do que mulheres fisicamente inativas. Esses resultados sugerem que a gordura corporal exerce um papel importante na fadiga percebida e que a atividade física pode atenuar esse sintoma.

Effects of a 12-Week Exercise Training Program on Physical Function in Institutionalized Frail Elderly.

With the increase in life expectancy, the Brazilian elderly population has risen considerably. However, longevity is usually accompanied by problems such as the loss of functional capacity, cognitive decline, frailty syndrome, and deterioration in anthropometric parameters, particularly among those living in long-term care facilities. This randomized controlled trial aimed to verify the effects of exercise training on biochemical, inflammatory, and anthropometric indices and functional performance in institutionalized frail elderly. The sample consisted of 37 elderly people of both genders, aged 76.1 ± 7.7 years, who were randomly allocated into 2 groups: 13 individuals in the exercise group (EG) and 24 in the control group (CG). Anthropometrics, clinical history, functional tests, and biochemical evaluation were measured before and after the completion of a physical exercise program, which lasted for 12 weeks. The 12-week exercise program for frail elderly residents in a long-term care facility was efficient in improving muscle strength, speed, agility, and biochemical variables, with reversal of the frailty condition in a considerable number. However, no effects in anthropometric and inflammatory parameters were noted.

Greater volumes are required to reduce muscle performance in well-trained individuals / Grandes volumes são necessários para reduzir o desempenho muscular em indivíduos bem treinados

Abstract A specific drop jumps (DJs) protocol (using 100 jumps) has been largely used to induce muscle damage. However, it failed to show relevant drop in performance in well-trained individuals. Trained subjects may require a protocol with greater volume to induce decrease of muscle performance. The aim of this study was to assess muscle performance after two DJs damaging protocols with different volumes in well-trained individuals. Eighteen strength and/or power-trained males (4.92 ± 2.78 years of training experience) were randomly assigned into one of two groups: DJ100 (five sets of 20 DJs) or DJ140 (seven sets of 20 DJs), with 2-min of rest interval. DJs were performed from a 60-cm box. After landing, the volunteers performed a maximal vertical rebound jump. Muscle swelling increased significantly on both DJ100 and DJ140 (p < 0.001). Maximal isometric torque (MIT) decreased significantly on both DJ100 (p = 0.005) and DJ140 (p < 0.001). MIT showed no between-group difference on pre-assessment (p = 0.815). However, on post-assessment, MIT was significantly lower on DJ140 than DJ100 (p = 0.043). Countermovement jump (CMJ) decreased significantly on DJ140 (p = 0.001), but not on DJ100 (p = 0.802). There was no between-group difference on pre-assessment (p = 0.978). However, on post-assessment, CMJ was significantly lower on DJ140 than DJ100 (p = 0.038). DJ140 induced greater drop in isometric strength than DJ100 and only DJ140 significantly reduced jump performance. These results demonstrated that well-trained individuals require a great volume of DJs to reduce substantially muscle performance.

Resumo Um protocolo específico de Drop Jumps (DJs), com 100 saltos, tem sido amplamente utilizado para induzir o dano muscular. Entretanto, este protocolo tem falhado em mostrar uma queda relevante em indivíduos treinados. Objetivou-se avaliar o desempenho muscular após dois protocolos de DJs com diferentes volumes em indivíduos treinados. Dezoito homens treinados em força e/ou potência (4,92 ± 2,78 anos de treinamento) foram aleatoriamente designados em um dos dois grupos: DJ100 (cinco séries de 20 DJs) ou DJ140 (sete séries de 20 DJs), com 2 minutos entre as séries. Os DJs foram executados de uma caixa de 60 cm de altura. Após a aterrisagem, os voluntários executaram um salto vertical máximo. O inchaço muscular aumentou significativamente em ambos os grupos (p < 0,001). O torque isométrico máximo (TIM) reduziu significativamente tanto no DJ100 (p = 0,005) quanto no DJ140 (p < 0,001). O TIM não apresentou diferenças entre grupos no momento pré (p = 0,815). Entretanto, no momento pós, o TIM foi significativamente inferior no DJ140 em relação ao DJ100 (p = 0,043). O salto com contra movimento (SCM) reduziu significativamente no DJ140 (p = 0,001), mas não no DJ100 (p = 0,802). No momento pós, o SCM foi significativamente inferior no DJ140 em relação ao DJ100. O DJ140 induziu uma queda maior na força isométrica em relação do DJ100, e somente o DJ140 reduziu significativamente o desempenho no salto. Esses resultados demonstraram que indivíduos bem treinados requerem um grande volume DJs para reduzir substancialmente o desempenho muscular.

Pre-exercise ß-hydroxy-ß-methylbutyrate free-acid supplementation improves work capacity recovery: a randomized, double-blinded, placebo-controlled study.

The purpose of this study was to investigate the effects of a single-dose of ß-hydroxy-ß-methylbutyrate free acid (HMB-FA) supplementation on muscle recovery after a high-intensity exercise bout. Twenty-three trained young males were randomly assigned to receive either a single-dose supplementation of 3 g of HMB-FA (n = 12; age, 22.8 ± 3.0 years) or placebo (PLA; n = 11; age, 22.9 ± 3.1 years). A muscle damage protocol was applied 60 min after supplementation, and consisted of 7 sets of 20 drop jumps from a 60-cm box with 2-min rest intervals between sets. Muscle swelling, countermovement jump (CMJ), maximal voluntary isometric torque (MVIT), and work capacity (WC) were measured before, immediately after, and 24, 48, and 72 h after the exercise protocol. Muscle swelling, CMJ, and MVIT changed similarly in both groups after the exercise protocol (p < 0.001), but returned to pre-exercise levels after 24 h in both groups. WC decreased similarly in both groups after the exercise protocol (p < 0.01). For HMB-FA, WC returned to pre-exercise level 24 h after exercise protocol. However, for PLA, WC did not return to pre-exercise level even 72 h after the exercise protocol. In summary, a single-dose of HMB-FA supplementation improved WC recovery after a high-intensity exercise bout. However, HMB-FA did not affect the time-course of muscle swelling, MVIT, and CMJ recovery.

Association between obesity, risk of falls and fear of falling in older women / Associação entre obesidade, risco de quedas e medo de cair em mulheres idosas

Abstract The aim of this cross-sectional study was to investigate the association between obesity, risk of falls and fear of falling in older women. Two hundred and twenty-six volunteers (68.05 ± 6.22 years, 68.06 ± 11.79 kg, 1.56 ± 0.06 m) were classified as normal weight, overweight or obese, according to the body mass index. Risk of falls and fear of falling were evaluated using QuickScreen Clinical Falls Risk Assessment and Falls Efficiency Scale - International (FES-I), respectively. Comparisons between groups were conducted using Chi-square and ANOVA One-way tests. The significance level was set at p< 0.05. Obesity was associated with greater probability of falls (p< 0.001), which may be partly explained by decreased muscle strength (p< 0.001) and reaction time (p< 0.001). In addition, significant differences between groups was observed in FES-I score (p< 0.01), with obese women showing more pronounced fear of falling (30.10 ± 8.4) than normal weigh (25. 33 ± 7.11, p< 0.01) and overweight subjects (26.97 ± 7.05, p< 0.05). These findings corroborate previous evidence pointing obesity as a major risk factor for falls. Therefore, health professionals dealing with fall prevention should consider the effects of overweight.

Resumo O objetivo deste estudo transversal foi verificar a associação entre obesidade, risco de quedas e medo de cair em mulheres idosas. Duzentas e vinte e seis voluntárias (68,05 ± 6,22 anos; 68,06 ± 11,79 kg; 1,56 ± 0,06 m) foram classificadas em eutróficas, sobrepesadas ou obesas, de acordo com o índice de massa corporal. O risco de quedas e o medo de cair foram mensurados por meio do QuickScreen Clinical Falls Risk Assessment e da Escala de Eficácia de Quedas - Internacional (FES-I), respectivamente. Para comparação entre grupos, empregaram-se os testes Qui-quadrado e ANOVA One-way. O nível de significância adotado foi de p< 0,05. A obesidade foi associada a uma probabilidade de quedas aumentada (p< 0,001), o que pode ser parcialmente explicado pela diminuição da força muscular (p< 0,001) e do tempo de reação (p< 0,001). Adicionalmente, observou-se diferença significativa entre os grupos no escore da FES-I (p< 0,01), sendo que as idosas obesas exibiram um medo de cair mais acentuado (30,10 ± 8,4) que as eutróficas (25,33 ± 7,11; p< 0,01) e as sobrepesadas (26,97 ± 7,05; p< 0,05). Esses achados se agregam a evidências prévias que apontam a obesidade como um importante fator de risco para quedas em idosos. Portanto, profissionais da saúde devem considerar os efeitos do excesso de peso ao lidar com prevenção de quedas.

Body Adiposity Index, but not Visceral Adiposity Index, Correlates with Inflammatory Markers in Sarcopenic Obese Elderly Women.

Background/Study Context: The association of body adiposity index (BAI) and visceral adiposity index (VAI) with inflammatory markers has yet to be understood. The aim of this work was to investigate the association of BAI and VAI with inflammatory markers in elderly women with sarcopenic obesity (SO). METHODS: A total of 130 women (age: 66.7 ± 5.2 years) underwent body composition analysis by dual-energy x-ray absorptiometry (DEXA). Volunteers were classified according to SO definition. BAI, VAI, and waist-to-hip ratio (WHR) were calculated. Blood samples were collected for C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6) measurements. RESULTS: SO prevalence was 20.8%. BAI correlated with the DEXA-derived body fat content (rS = .90), CRP (rS = .55), and IL-6 (rS = .53), whereas WHR correlated with CRP (rS = .60) only (all p < .01). VAI did not correlate with any of the inflammatory variables. CONCLUSION: Simple and cheap anthropometric indices such as BAI and WHR may be better predictors of low-grade inflammation than VAI in elderly women with SO.

Comparisons between body adiposity indexes and cutoff values in the prediction of functional disability in older women / Comparações entre índices de adiposidade corporal e pontos de corte na predição de incapacidade funcional em mulheres idosas

Abstract The aim of this study was to compare body adiposity indexes and to identify cutoff values in the prediction of disability in older women. Eighty-seven volunteers (67.27±6.45 years) underwent body composition assessment using dual-energy X-ray absorptiometry (DXA) and had five anthropometric indexes measured (Waist Circumference, WC; Waist-to-Height Ratio, WHtR; Body Mass Index, BMI; Body Adiposity Index, BAI; and conicity index). Functionality was assessed from three Senior Fitness Test Battery protocols: 30-second chair stand, 8-foot up-and-go, and 6-minute walk. Pearson’s correlation was conducted to identify the relationship between body adiposity indexes and functionality results. Cutoff values to predict disability were obtained from ROC curves and odds ratio were calculated for the same outcome. Disability prevalence was 36.8%. Scores in the 30-second chair stand, 8-foot up-and-go, and 6-minute walk tests showed stronger associations with WC (r=-0.345; p<0.01), WHtR (r=-0.417; p<0.01) and BAI (r=0.296; p<0.01), respectively. The cutoff values identified were 89.5cm, 39.2%, 26.93kg/m2, 34.6%, 0.51cm and 1.23 for WC, DXA-derived body fat percentage, BMI, BAI, WHtR and conicity index, respectively. WC showed greater odds ratio for disability outcome (odds ratio: 3.16; CI: 1.3–7.8). WC showed strong relationship with functional tests and its cutoff values exhibited predicting skill for disability in older women.

Resumo Objetivou-se comparar índices de adiposidade corporal e identificar pontos de corte na predição de incapacidade funcional em mulheres idosas. Oitenta e sete voluntárias (67,27±6,45 anos) foram submetidas à avaliação de composição corporal através de Dual energy x-ray absorptiometry (DXA), e tiveram cinco índices antropométricos mensurados (perímetro de cintura, PC; relação cintura estatura, RCE; índice de massa corporal, IMC; índice da adiposidade corporal, IAC; e índice de conicidade). A funcionalidade foi avaliada a partir de três protocolos da Senior Fitness Test Battery: sentar e levantar em 30 segundos; 8-foot up-and-go; e caminhada de seis minutos. A correlação de Pearson foi conduzida para identificar o relacionamento entre as medidas de adiposidade corporal e os resultados de funcionalidade. Foram obtidos pontos de corte para incapacidade funcional a partir de curvas ROC, e o odds ratio foi calculado para o mesmo desfecho. A prevalência de incapacidade funcional foi de 36,8%. Os escores dos testes sentar e levantar em 30 segundos, caminhada de seis minutos e 8-foot up-and-goapresentaram associações mais consistentes para PC (r=-0,345; p<0,01), RCE (r=-0,417; p<0,01) e IAC (r=0,296; p<0,01), respectivamente. Os pontos de corte identificados foram 89,5cm, 39,2%, 26,93kg/m2, 34,6%, 0,51cm e 1,23, para PC, percentual de gordura medido pelo DXA, IMC, IAC, RCE e índice de conicidade, respectivamente. O PC apresentou maior razão de chances para incapacidade funcional (odds ratio:3,16; IC:1,3–7,8). O PC apresentou associação mais consistente com os testes funcionais e seus valores de corte exibiram habilidade preditora para incapacidade em mulheres idosas.

Effects of resistance training on sarcopenic obesity index in older women: A randomized controlled trial.

The purpose of this study was to examine the effects of resistance training (RT) on sarcopenic obesity (SO) in older women. 243 older women underwent body composition measurement using dual-energy X-ray absorptiometry, and the SO index was calculated. This randomized controlled trial adopted from the baseline sample, 113 volunteers (67.0±5.2years) were randomly assigned to a control group (CG, n=64) or an experimental group (EG, n=69). The EG took part in a 24-week RT program, conducted three times per week. Body composition measurements were repeated at the end of the training program. RT induced a significant increase in fat-free mass (P<0.01), but not decrease in fat mass in the EG. Moreover, the SO index was also significantly improved in the EG (P<0.01), while it decreased significantly in the CG (P<0.01). It is concluded that RT is an effective approach to promote body composition alterations in older women, and it might improve SO-related phenotypes.

Balance Exercises Circuit improves muscle strength, balance, and functional performance in older women.

This study introduces the Balance Exercises Circuit (BEC) and examines its effects on muscle strength and power, balance, and functional performance in older women. Thirty-five women aged 60+ (mean age = 69.31, SD = 7.35) were assigned to either a balance exercises group (BG, n = 14) that underwent 50-min sessions twice weekly, of a 12-week BEC program, or a wait-list control group (CG, n = 21). Outcome measures were knee extensor peak torque (PT), rate of force development (RFD), balance, Timed Up & Go (TUG), 30-s chair stand, and 6-min walk tests, assessed at baseline and 12 weeks. Twenty-three participants completed follow-up assessments. Mixed analysis of variance models examined differences in outcomes. The BG displayed improvements in all measures at follow-up and significantly improved compared with CG on, isokinetic PT60, PT180 (p = 0.02), RFD (p < 0.05), balance with eyes closed (p values range .02 to <.01) and TUG (p = 0.03), all with medium effect sizes. No changes in outcome measures were observed in the CG. BEC improved strength, power, balance, and functionality in older women. The BEC warrants further investigation as a fall prevention intervention.

Resistance training improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women.

PURPOSE: To examine the effects of resistance training (RT) on metabolic syndrome-related phenotypes in postmenopausal women. PATIENTS AND METHODS: Twenty-two postmenopausal women (65.0±4.2 years) underwent 12 weeks of whole body progressive training with intensity prescribed based on rating of perceived exertion. Dominant knee extension strength was assessed using an isokinetic dynamometer before and after the intervention. Moreover, all volunteers had blood samples collected for lipid profile, glycemic control, and C-reactive protein analyses. Waist circumference and arterial blood pressure were also measured at baseline and after the training period. Student's t-tests for paired samples and repeated measures ANOVA were used to compare dependent variables, and statistical significance was set at P<0.05. RESULTS: Isokinetic muscle strength significantly increased (P<0.01) with training. It was observed that waist circumference as well as total and low-density lipoprotein cholesterol levels significantly decreased with training (P<0.01). Total cholesterol/high-density lipoprotein cholesterol ratio, an important marker of cardiovascular disease incidence, was also significantly reduced (from 3.91±0.91 to 3.60±0.74; P<0.01) after the program. Blood glucose, basal insulin, and homeostatic model assessment of insulin resistance were also significantly reduced (P<0.01). No significant alterations were observed for resting blood pressure, triglycerides, or C-reactive protein. CONCLUSION: Based on the observed results, it can be concluded that a 12-week progressive RT program, besides increasing isokinetic muscle strength, induces beneficial alterations on metabolic syndrome-related phenotypes in postmenopausal women. These findings highlight this mode of exercise as an important component of public health promotion programs for aged women. RT improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women.

Strength, muscle quality and markers of cardiometabolic risk in older women / Força, qualidade muscular e marcadores de risco cardiometabólico em mulheres idosas

Abstract The aging process is associated with a decline in physiological functions, including a reduction in muscle quality, as well as changes in cardiometabolic risk factors. Thus, the aim of this study was to verify if a correlation exists between muscle strength and quality and cardiometabolic risk markers in older women. Thirty older women (66.13±5.26 years, 67.33±12.45 kg, 1.54±0.07 m, body mass index: 28.20±4.72) were submitted to the evaluation of muscle thickness and strength and blood analysis of cardiometabolic risk markers (glucose, basal insulin, C-reactive protein, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol, triglycerides, and HOMA-IR). No significant correlations were found between muscle phenotypes and markers of cardiometabolic risk, even after adjustment for confounding factors. The present study indicates that muscle strength or quality is not correlated with markers of cardiometabolic risk.

Resumo O processo de envelhecimento está associado a um declínio nas funções fisiológicas, refletindo em reduções na qualidade muscular, bem como em alterações de marcadores de risco cardiometabólico. Nesse sentido, o objetivo do estudo foi verificar a associação entre qualidade muscular e marcadores de risco cardiometabólico em mulheres idosas. Trinta mulheres idosas (66,13±5,26 anos, 67,33±12,45 kg, 1,54±0,07 m, 28,20±4,72 IMC) foram submetidas à avaliação da espessura e força musculares do quadríceps, e à análise sanguínea de marcadores de risco cardiometabólico (glicemia, insulina basal, proteína C-reativa, colesterol total, HDL-colesterol, LDL-colesterol, VLDL-colesterol, triglicerídeos, e índice HOMA-IR). Não foram encontradas correlações significativas entre os fenótipos musculares e os marcadores de risco cardiometabólico estudados, mesmo com controle para fatores de confusão. A presente pesquisa indica não haver correlação entre força e qualidade muscular com os marcadores de risco cardiometabólico estudados.

Sarcopenia and sarcopenic obesity classifications and cardiometabolic risks in older women.

The purpose of this study was to examine the association between sarcopenia and sarcopenic obesity (SO) with cardiometabolic risk factors in postmenopausal women. 149 volunteers (67.17±6.12 years) underwent body composition assessment using dual energy X-ray absorptiometry (DXA) and had analyzed blood samples collected for lipid profile, glucose metabolism and C-reactive protein (CRP). Sarcopenia was defined as an appendicular fat-free mass (AFFM) divided by height squared ≤5.45 kg/m(2) while SO was classified based on the residuals of a regression. Waist circumference (WC) and arterial blood pressure were also measured. Student's t-tests and correlations were used for analyses. Prevalence of sarcopenia and SO were respectively 16.8 and 21.5%. WC was significantly correlated with all the examined risk factors. AFFM relative to height squared was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), CRP, insulinaemia, HOMA score, and those classified as sarcopenic presented lower HOMA score when compared to nonsarcopenic. Regarding SO, although volunteers classified presented significantly higher fat mass (FM) and lower AFFM, it was not observed association with the examined risk factors. These findings support the association between WC and cardiometabolic risk factors in older women. In contrast, the approaches used to define sarcopenia and SO are not associated with cardiometabolic impairments.