Sarcobesity: new paradigms for healthy aging related to taurine supplementation, gut microbiota and exercise.

Enigmatic sarcopenic obesity is still a challenge for science and adds to the global public health burden. The progressive accumulation of body fat combined with a dysfunctional skeletal muscle structure and composition, oxidative stress, mitochondrial dysfunction, and anabolic resistance, among other aggravating factors, together represent the seriousness and complexity of treating the metabolic disorder of sarcobesity in aging. For this reason, further studies are needed that encourage the support of therapeutic management. It is along these lines that we direct the reader to therapeutic approaches that demonstrate important, but still obscure, outcomes in the physiological conditions of sarcobesity, such as the role of taurine in modulating inflammatory and antioxidant mechanisms in muscle and adipose tissue, as well as the management of gut microbiota, able to systemically re-establish the structure and function of the gut-muscle axis, in addition to the merits of physical exercise as an instrument to improve muscular health and lifestyle quality.

Forecasting and validating fat mass ratio models through anthropometric measurements and health-related factors among people with HIV: a cross-sectional investigation.

Background: There is a limited research on predictive models of fat mass ratio (FMR) in people living with human immunodeficiency virus (HIV) (PWH). This study aimed to develop models considering anthropometric and health-related factors to predict and validate FMR in PWH regardless of sex. Methods: One hundred and six Brazilian PWH (46.4±9.8 years) were evaluated for body composition using dual-energy X-ray absorptiometry (DXA), body circumference (BC), and skinfold thicknesses (SKs). FMR predictive models were developed using stepwise linear regression, and their agreement with DXA was assessed using Bland-Altman plots. Cross-validation was performed using the predicted residual error sum of squares (PRESS) method. Results: Six FMR estimation models were developed for PWH, with adjusted R2 ranging from 0.43 to 0.72, standard error of the estimate (SEE) from 0.16% to 0.22%, and 95% confidence interval (CI) from 1.03 to 1.15. Model 6, including thigh SK, waist BC, therapy duration, subscapular SK, education years, and abdominal SK, exhibited the highest determination power (R2 adjusted 0.72, SEE 0.16%, and 95% CI: 1.06-1.15). The agreement between DXA-based FMR and predictive models showed minimal bias (-0.03 to +0.04) and narrower limits of agreement, particularly for the top-performing model (-0.33 to +0.30). Model 6 exhibited a high adjusted Q2PRESS (0.70) and low SPRESS (0.17). Conclusions: Our predictive models advance the study of body composition in PWH by consolidating the use of anthropometry for diagnosing and monitoring lipodystrophy regardless of sex.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study.

OBJECTIVE: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. METHOD: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. RESULTS: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. CONCLUSION: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

Sleep quality and falls in middle-aged and older adults: ELSI-Brazil study / Qualidade do sono e quedas em adultos de meia-idade e idosos: Estudo ELSI-Brasil / Calidad del sueño y caídas en adultos de mediana edad y mayores: Estudio ELSI-Brasil

ABSTRACT Objective: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life. Method: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables. Results: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables. Conclusion: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

RESUMO Objetivo: Verificar a associação entre baixa qualidade do sono autorrelatada (BQS) e quedas em adultos de meia-idade e idosos a cada meia década de vida. Método: Um estudo transversal foi conduzido utilizando dados da primeira onda (2015-2016) do Estudo Longitudinal Brasileiro do Envelhecimento (ELSI-Brasil), que é nacionalmente representativo. A população consistiu em 8.950 participantes que foram alocados em oito grupos etários: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 e ≥ 85 anos. Os questionários utilizados incluíram qualidade do sono autorrelatada e o Questionário Internacional de Atividade Física versão curta. O teste exato de Fisher seguido pela análise de regressão logística binária foi conduzida para identificar a razão de chances da BQS para ocorrência de queda, controlando por variáveis de confusão. Resultados: Pessoas com idades entre 50 e 105 anos (63,6 ± 10,2 anos), sendo 57,0% do sexo feminino e 43,0% do sexo masculino, participaram deste estudo. No geral, 21,5% dos participantes experimentaram pelo menos uma queda. A frequência relativa de participantes classificados como tendo BQS ou alta permaneceu constante em cada meia década de vida. A BQS exibiu uma OR (p < 0,05) notável para quedas em grupos etários até 84 anos, mesmo após o ajuste para variáveis de confusão. Conclusão: A BQS está significativamente associada a uma maior ocorrência de queda em adultos com mais de 50 anos, mas não para ≥ 85 anos, independentemente do sexo e do nível de atividade física.

RESUMEN Objetivo: Verificar la asociación entre la baja calidad del sueño autorreportada (BCS) y las caídas en adultos de mediana edad y mayores cada media década de vida. Método: Se realizó un estudio transversal utilizando datos de la primera oleada (2015-2016) del Estudio Longitudinal Brasileño sobre el Envejecimiento (ELSI-Brasil), que es representativo a nivel nacional. La muestra consistió en 8,950 participantes que fueron asignados a ocho grupos de edad: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84 y ≥ 85 años. Los cuestionarios utilizados incluyeron calidad del sueño autorreportada y el Cuestionario Internacional de Actividad Física versión corta. Se realizó una prueba exacta de Fisher seguida por un análisis de regresión logística binaria para identificar la razón de probabilidades de la calidad del sueño para la ocurrencia de caídas, controlando las variables de confusión. Resultados: Participaron en este estudio individuos con edades entre 50 y 105 años (63,6 ± 10,2 años), siendo el 57,0% mujeres y el 43,0% hombres. En general, el 21,5% de los participantes experimentaron al menos una caída. La frecuencia relativa de participantes clasificados como con alta calidad de sueño o baja calidad de sueño (BCS) se mantuvo constante a lo largo de cada media década de vida. La BCS mostró un OR (p < 0,05) notable para las caídas en grupos de edad hasta los 84 años, incluso después de ajustar por variables de confusión. Conclusión: La BCS está significativamente asociada con una mayor ocurrencia de caídas en adultos mayores de 50 años, pero no para ≥ 85 años, independientemente del sexo y del nivel de actividad física.

Classification of nutritional status by fat mass index: does the measurement tool matter? / Classificação do estado nutricional pelo índice de massa gorda: o instrumento de medição importa?

Abstract Assessment of the Nutritional Status (NS) allows screening for malnutrition and obesity, conditions associated with chronic non-communicable diseases. The fat mass index (FMI) stands out concerning traditional NS indicators. However, proposals that define thresholds for FMI are not sensitive to discriminate extreme cases (degrees of obesity or thinness). Only one proposal (NHANES), determined by total body densitometry (DXA), established eight categories of NS classification (FMI). However, DXA is expensive and not always clinically available. Our study aims to test the validity of the NHANES method using electrical bioimpedance (BIA) and skinfold thickness (ST) to classify NS. The FMI of 135 (69 women) university students aged 18 to 30 years old was determined using DXA, BIA, and ST. The agreement between the instruments (Bland-Altman) and the agreement coefficient in the NS classifications (Chi-square and Kappa index) were tested. The agreement test against DXA indicated that ST underestimated the FMI (-1.9 kg/m2) for both sexes and BIA in women (-2.0 kg/m2). However, BIA overestimated FMI (1.4 kg/m2) in men, although with less bias. There was no agreement between the NS classifications (NHANES) by FMI between DXA and BIA, or DXA and ST. The exception occurred between DXA and BIA in men who showed a slightly better consensus, considered "fair" (k = 0.214; p = 0.001). In conclusion, ST and BIA did not show enough agreement to replace DXA for NS classification, within NHANES thresholds. The FMI measurement tools for the NHANES classification of the categories of NS matters.

Resumo Avaliar o Estado Nutricional (EN) permite rastrear desnutrição e obesidade, condições associadas a doenças crônicas não transmissíveis. O índice de massa gorda (IMG) destaca-se em relação aos indicadores tradicionais de EN. No entanto, propostas que definem limiares para IMG não são sensíveis para discriminar casos extremos (graus de obesidade ou magreza). Apenas uma proposta (NHANES) estabeleceu oito categorias de classificação EN (IMG), mas foi determinada por densitometria corporal total (DXA). Porém, DXA é caro e nem sempre disponível. O objetivo foi testar a validade do método NHANES usando bioimpedância elétrica (BIA) e dobras cutâneas (DOCs) para classificar o EN. O IMG de 135 (69 mulheres) universitários com idade entre 18 e 30 anos foi obtido por DXA, BIA e DOCs. A concordância foi testada entre os instrumentos (Bland-Altman) e classificações de EN (Qui quadrado e índice Kappa). O teste de concordância com a DXA indicou as DOCs subestimarem o IMG (-1,9 kg/m2) para ambos os sexos e a BIA em mulheres (-2,0 kg/m2). No entanto, as BIA superestimaram o IMG (1,4 kg/m2) nos homens, embora com menos viés. Não houve concordância entre as classificações de EN (NHANES) pelo IMG entre DXA e BIA/DOCs. A exceção ocorreu entre DXA e BIA em homens que apresentaram concordância "razoável" (k = 0,214; p = 0,001). Em conclusão, DOCs e BIA não mostraram concordância suficiente para substituir DXA pela classificação de EN, dentro dos limites NHANES. As ferramentas diferem para medir IMG e classificar categorias de EN (NHANES).

Cross-validation of 20 anthropometric prediction equations for appendicular muscle mass in older Brazilian women: a cross-sectional study / Validação cruzada de 20 equações antropométricas de massa muscular apendicular para idosas brasileiras: um estudo transversal

Objective: To test the cross-validation of anthropometric prediction equations for appendicular muscle mass (AMM) in older Brazilian women. Methods: Sixty-seven older women (69.84 ± 5.95 years old) underwent anthropometric measurements. AMM (kg) reference values obtained by dual-energy X-ray absorptiometry (AMMDXA) were compared to 20 anthropometric equations for estimating AMM in older adults. A paired t-test (p > 0.05), standard error of estimate (SEE < 3.50 kg), and r2 > 0.70 confirmed the validity of the equations. The agreement between predictions and the reference was also verified (Bland-Altman analysis of agreement between methods). Results: Four American equations and one Mexican equation were not statistically different from AMMDXA (p > 0.05) but did not present suitable r2 values for validation. The American equation from the National Health and Nutrition Examination Survey (NHANES), AMM (kg) = (-0.04 × age [years]) + (0.46 × calf circumference [cm]) + (0.32 × arm circumference [cm]) + (0.11 × thigh circumference [cm]) ­ (0.27 × body mass index [BMI, kg/m2 ]) + (0.07 × waist circumference [cm]) ­ 13 119 showed the best performance (r2 = 0.64; SEE = 3.24 kg), with minimal mean difference (0.26 kg), no heteroscedasticity for extreme values, and with high agreement with the Brazilian sample (-3.90 to 3.40 kg). Conclusion: When specific equations for a given population are not available, the use of generic equations of greater sample representativeness with scientifically and reliably analyzed data is allowed.

Objetivo: Testar a validação cruzada das equações antropométricas preditivas da massa muscular apendicular (MMA) em idosas brasileiras. Metodologia: Sessenta e sete idosas (69,84 ± 5,95 anos) foram submetidas a medidas antropométricas. Os valores de referência da MMA (kg) fornecida pela absorciometria de raios X de dupla energia (MMADXA) foi comparada com 20 equações antropométricas preditivas para estimar a MMA para idosos. Teste t pareado (p > 0,05), erro padrão de estimativa (EPE) < 3,50 kg e r2 > 0,70 confirmaram a validade das equações. A concordância entre as previsões e a referência também foi verificada (análise de concordância entre métodos de Bland-Altman). Resultados: Quatro equações americanas e uma equação mexicana não foram estatisticamente diferentes da MMADXA (p > 0,05), mas nenhuma delas apresentou r2 adequado para validação. A equação americana dos dados do National Health and Nutrition Examination Survey (NHANES), MMA (kg) = (-0,04 × idade [anos]) + (0,46 × circunferência da panturrilha [cm]) + (0,32 × circunferência do braço [cm]) + (0,11 × circunferência da coxa [cm]) ­ (0,27 × índice de massa corporal-IMC [kg/m2 ]) + (0,07 × circunferência da cintura [cm]) ­ 13,12 apresentou o melhor desempenho (r2 = 0,64; EPE = 3,24 kg): com diferença média mínima (0,26 kg), sem heterocedasticidade para valores extremos e alta concordância com a amostra brasileira (-3,90 a 3,40 kg). Conclusão: Quando não existem equações específicas para uma determinada população, é permitida a utilização de equações genéricas de maior representatividade amostral, cujos dados tenham sido analisados de forma científica e confiável

Estimate of Resting Energy Expenditure by DXA in Boys of Different Nutritional Statuses

Abstract Aim: to estimate the resting energy expenditure (REE) of organ tissue components using Dual Energy x-ray Absorptiometry (DXA) in pubertal boys. The mass of components and REE were compared among groups of different nutritional statuses. Methods: a sample of 278 boys (13.7 ± 2.4 years old) was grouped according to BMI nutritional status for Brazilian children and adolescents1 such as Underweight (UW), Normal weight (NW), Overweight (OW), and Obese (OB). The REE of organ tissue components given by DXA was calculated using specific models for skeletal muscle tissue (SMT), adipose tissue (AT), bone tissue (BT) and residual tissue (RT) based on previous reports. The absolute and relative REE (REEDXA) of each component were statistically compared among groups. Results: No differences of total REEDXA were found among nutritional groups (F(3, 274)=0.071, p=0.976). When, however, specific REE was considered per component, differences were found for BT and REEBT between NW-OW (p=0.003) and NW-OB (p=0.048); in AT and REEAT for all the groups (p<0.001), except between UW-NW (p=1.000); in RT and REERT between NW-OB (p=0,022) and SMT and REESMT (p=0,039). Greater proportions of organ tissue of RT and high metabolic rates, were observed in the UW group (78.3%) in comparison to the OB group (60.7%). Conclusion: This approach provides a new opportunity to examine energy metabolism for individual differences of pediatric populations. It is an applicable strategy both to prescribe exercises and to administer diets to this population, as it reveals the magnitude of heat-producing body components.

Validation of anthropometric models in the estimation of appendicular lean soft tissue in young athletes / Validação de modelos antropométricos na estimação da massa isenta de gordura e osso apendicular em jovens atletas

Abstract Magnetic resonance imaging and Computer tomography are gold standards in the measurement of muscle tissue (MT), but are expensive. Dual Energy X-Ray Absorptiometry (DXA) is also costly but safer and allows for the measurement of Appendicular Lean Soft Tissue (ALST), a strong predictor of MT. Alternatively, there are anthropometric models that predict the ALST of Portuguese athletes with low cost/risk that have not been validated in other populations. The aim of this study was to validate anthropometric Portuguese models that predict ALST in young athletes or, if the validation fails, to propose new models. The ALSTDXA of 174 young athletes was determined by DXA. Two anthropometric models (ALSTmod1 and ALSTmod2) measuring ALST among Portuguese athletes were tested. To validate the coefficient of determination, the difference (bias) and concordance correlation coefficient between predicted and actual values were computed. Finally, association between mean and difference of methods was verified. Validation failed and, for this reason, new multiple regression models were proposed and validated using PRESS statistics. The Portuguese models explained ~96% of the ALSTDXA variability. The difference between ALST (-0.7kg) was less than that found for the ALSTmod2 and ALSTDXA limits of agreement from 3.6 to -2.1 and from 6.1 to -1.5kg, respectively. The new models included three predictive equations for ALST. Only ASLTmod1was valid; however, it was prone to bias, depending on the magnitude of ALST values. The newly proposed models present validity with greater concordance (r2PRESS=0.98), lower standard error of estimate (SEEPRESS [kg]=0.91) and more homogeneous predicted extreme values.

Resumo Ressonância magnética e tomografia computadorizada são referências para medir o tecido muscular (TM), porém apresentam custo elevado. A Absorciometria Radiológica de Dupla Energia (DXA) é segura, embora ainda dispendiosa, permite medir a Massa Isenta de Gordura e Osso apendicular (MIGOap), forte preditor do TM. Alternativamente, existem modelos antropométricos preditivos da MIGOap de atletas portugueses com baixo custo/risco, porém sem validação para outras populações. Objetivou-se validar modelos antropométricos portugueses preditivos da MIGOap em jovens atletas ou propor novos modelos, caso a validação falhe. A determinação da MIGOapDXA de 174 jovens atletas foi realizada por DXA. Dois modelos antropométricos (MIGOapmdJ1 e MIGOapmd2) de atletas portugueses foram testados para predizer MIGOap. Para validação o coeficiente de determinação, a diferença (viés) e a concordância entre valores medidos e preditos foram calculados. Finalmente, a associação entre média-e-diferença dos métodos foi calculada. A validação falhou, assim foram propostos novos modelos de regressão múltipla validados por estatística PRESS. Os modelos portugueses explicaram ~96% da variabilidade da MIGOapDJAf A diferença entre MIGOapmod1 e MIGOapDXA (-0,7kg) foi menor do que MI-GOapmod2 (-2,3kg), com limites de concordância de3,6 a -2,1 e de 6,1 a -1,5kg, respectivamente. Os novos modelos incluíram três equaçõespreditivaspara MIGOap. Somente MIGOapmd1foi válido, todavia mostrou grande tendência a vieses, conforme magnitude dos valores de MIGOap. Os novos modelos propostos mostraram validade com maior concordância (r2PRESS=0,98), menores erros de estimativa (EPEPRESS =0,91) e valores preditos mais homogêneos para casos extremos.