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.

Motivos de adesão, aderência e desistência de adultos com obesidade em um programa de exercícios físicos / Reasons for adhesion, adherence and dropout of obese adults in a exercise program

O estudo teve como objetivo determinar os motivos de adesão, aderência e desistência de adultos com obesidade em um programa de intervenção de exercícios físicos. Trata-se de uma estudo descritivo com 69 adultos com obesidade, os quais estiveram envolvidos em um ensaio clínico controlado. Nos grupos de exercícios físicos, as sessões continham treinamento aeróbio e de força, totalizando 60 minutos, durante 16 semanas. Os motivos de adesão, aderência e desistência foram determinados por questionário e uma análise descritiva (quanti-qualitativa) foi realizada, de acordo com a frequência em que os motivos foram relatados pelos participantes. Verificou-se baixa aderência ao treinamento, bem como altos índices de desistência. A saúde, a qualidade de vida e a estética foram os principais motivos de adesão. Para a aderência, os aspectos mais prevalentes foram a saúde, o comprometimento e à motivação. Contudo, para a desistência, trabalho e a desmotivação foram mais relatados. É importante a intervenção profissional no campo da atividade física e saúde considere estes diferentes motivos e as mudanças neles durante o processo e direcione ações a fim de aumentar a adesão e a aderência e reduzir as desistências

The study aimed to determine the reasons for adherence, adherence and dropout of adults with obesity in a physical exercise intervention program. This is a descriptive study with 69 adults with obesity, who were involved in a controlled clinical trial. In the physical exercise groups, the sessions contained aerobic and strength training, totaling 60 minutes, during 16 weeks. The reasons for adhesion, adherence and dropout were determined by questionnaire and a descriptive analysis (quantitative and qualitative) was carried out, according to the frequency with which the reasons were reported by the participants. There was low adher-ence to training, as well as high dropout rates. Health, quality of life and aesthetics were the main reasons for adhesion. For adherence, the most prevalent aspects were health, commitment and motivation. However, for dropout, work and lack of motivation were more reported. It is important for professional intervention in the field of physical activity and health to consider these different reasons and the changes in them during the process and direct actions in order to increase adhesion and adherence and reduce dropouts

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.

Combined relationship of physical inactivity and sedentary behaviour with the prevalence of noncommunicable chronic diseases: data from 52,675 Brazilian adults and elderly.

This paper aims to verify the association between the combined relationship of physical inactivity and sedentary behaviour (SB) at leisure-time and the prevalence of noncommunicable chronic diseases (NCDs) in Brazilian adults and elderly. This is a cross-sectional study, derived from the VIGITEL system, with individuals ≥18 years old (n = 52,675). The presence of NCDs (diabetes, hypertension, and obesity) and the independent variables were defined by self-report. Binary logistic regression was used. While adults with the presence of, at least, one risky behaviour had a higher odds to have obesity (OR active + high SB: 1.25; 95%CI: 1.01;1.54; OR inactive + low SB: 1.47; 95%CI: 1.25;1.73; OR inactive + high SB: 1.77; 95%CI: 1.47;2.12), the elderly had an increased risk for this outcome only when classified as inactive (OR inactive + low SB: 1.43; 95%CI: 1.17;1.75; OR inactive + high SB: 1.87; 95%CI: 1.47;2.38). Inactive adults with low SB were more likely to have diabetes (OR inactive + low SB: 1.31; 95%CI: 1.00;1.71) and hypertension (OR inactive + low SB: 1.26; 95%CI: 1.08;1.46), while physical inactivity was again more strongly associated with these outcomes in the elderly, for diabetes (OR inactive + low SB: 1.23; 95%CI: 1.02;1.48; OR inactive + high SB: 1.75; 95%CI: 1.39;2.19), and hypertension (OR inactive + low SB: 1.22; 95%CI: 1.05;1.41; OR inactive + high SB: 1.60; 95%CI: 1.33;1.94) Both leisure-time behaviours carry a high risk of the prevalence of different NCDs, however, physical inactivity, isolated or combined, showed a greater association with the evaluated outcomes.HighlightsThis cross-national survey included representative sample of people ≥18 years old.Adults with at least one evident risky behavior had a higher chance of obesity.Inactive adults with low sedentary behavior had higher chances for diabetes and hypertension.Physical inactivity was more strongly associated with all diseases in the elderly.

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.

Phase angle associated with different indicators of health-related physical fitness in adults with obesity.

In obese populations, the exacerbated increase in adipose tissue results in a significant reduction of health-related physical fitness and can affect the phase angle (PhA), a promising health indicator of cell health and integrity. The aim of this study was to investigate the association of PhA with health-related physical fitness indicators in obese adults. This cross-sectional study had a non-probabilistic sample and was conducted from April to June 2018. The PhA was obtained by a bioelectrical impedance analysis, and the health-related physical fitness indicators evaluated were percentage of body fat (%BF), lower- and upper-body maximal strength, cardiorespiratory fitness (relative V̇O2peak), and flexibility. Pearson and Spearman´s linear correlations, crude and adjusted linear regression analyses were performed. A total of 69 obese adults (60.8% female; BMI = 33.5 ± 2.8 kg/m2) with a mean age of 34.6 ± 7.1 years were studied. The PhA means were 5.8 (±0.6º) and had an inverse correlation with %BF (r=-0.74; p<0.001) and positive correlation with V̇O2peak (r=0.50; p<0.001), lower- and upper-body maximal strength (r=0.65; r=0.70; p<0.001, respectively). After adjustment, %BF (ß=-0.065, adjusted R2=0.53; p<0.001), lower- and upper-body maximal strength (ß=0.004; adjusted R2=0.46; p<0.001, and ß=0.024; adjusted R2=0.50; p<0.001, respectively) were predictors of PhA. Our results suggest the favorable role of PhA as a clinically viable tool to screen and identify the physical fitness variables and functional status of obese adults.

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.