Body mass index and physical fitness in Brazilian adolescents / Índice de massa corporal e aptidão física em adolescentes brasileiros

Abstract Objective: Evaluate the relationship between body mass index and physical fitness in a cross-sectional sample of Brazilian youth. Methods: Participants were 3849 adolescents (2027 girls) aged 10 -17 years. Weight and height were measured; body mass index was calculated. Physical fitness was evaluated with a multistage 20 m shuttle run (cardiovascular endurance), standing long jump (power), and push-ups (upper body strength). Participants were grouped by sex into four age groups: 10 -11, 12 -13, 14 -15, and 16 -17 years. Sex-specific ANOVA was used to evaluate differences in each physical fitness item among weight status categories by age group. Relationships between body mass index and each physical fitness item were evaluated with quadratic regression models by age group within each sex. Results: The physical fitness of thin and normal youth was, with few exceptions, significantly better than the physical fitness of overweight and obese youth in each age group by sex. On the other hand, physical fitness performances did not consistently differ, on average, between thin and normal weight and between overweight and obese youths. Results of the quadratic regressions indicated a curvilinear (parabolic) relationship between body mass index and each physical fitness item in most age groups. Better performances were attained by adolescents in the mid-range of the body mass index distribution, while performances of youth at the low and high ends of the body mass index distribution were lower. Conclusion: Relationships between the body mass index and physical fitness were generally nonlinear (parabolic) in youth 10 -17 years.

Resumo Objetivo: Avaliar a relação entre o índice de massa corporal e a aptidão física em uma amostra transversal de jovens brasileiros. Métodos: Os participantes foram 3.849 adolescentes (2.027 meninas) entre 10-17 anos. Foram medidos o peso e a estatura e foi calculado o índice de massa corporal. A aptidão física foi avaliada com: a corrida vaivém de 20 metros de vários estágios (resistência cardiovascular), impulsão horizontal (energia) e flexões (força superior do corpo). Os participantes foram agrupados por sexo em quatro faixas etárias: 10-11, 12-13, 14-15 e 16-17 anos. A Anova específica para sexo foi usada para avaliar as diferenças em cada item de aptidão física entre as categorias de status do peso por faixa etária. As relações entre o índice de massa corporal e cada item de aptidão física foram avaliadas com os modelos de regressão quadrática por faixa etária com relação ao sexo. Resultados: A aptidão física de jovens magros e normais foi, com poucas exceções, significativamente melhor do que a aptidão física de jovens com sobrepeso e obesos em cada faixa etária por sexo. Por outro lado, os desempenhos na aptidão física não diferiram de forma consistente, em média, entre jovens magros e com peso normal e entre jovens com sobrepeso e obesos. Os resultados das regressões quadráticas indicaram uma relação curvilínea (parabólica) entre o índice de massa corporal e cada item de aptidão física na maior parte das faixas etárias. Os melhores desempenhos foram obtidos pelos adolescentes na faixa intermediária da distribuição do índice de massa corporal, ao passo que os desempenhos dos jovens nas extremidades inferiores e superiores da distribuição do índice de massa corporal foram menores. Conclusão: As relações entre o índice de massa corporal e a aptidão física foram, em geral, não lineares (parabólica) nos jovens entre 10-17 anos.

Sleep quality is inversely related to body mass index among university students

SUMMARY OBJECTIVE: The purpose of this study was to investigate the prevalence of overweight and obesity and its association with sleep quality in university students from the Anhui province in China. METHODS: A cross-sectional study was conducted in China with 1328 participants. The prevalence of underweight and obesity in university students was estimated according to the reference working group on obesity in China. The sleep quality was evaluated using the standard PSQI (Pittsburgh Sleep Quality Index). RESULTS: This study included 470 male and 858 female students from a university in Anhui; 4.4% of the females and 17.7% of the males were overweight or obese. The prevalence of obesity in males was significantly higher than in females, and the prevalence of obesity in higher years was greater than in other years (p<0.05). In general, the mean score for sleep quality was 4.91±2.67; 36.5% of male and 39.1% of female students had poor sleep quality (PSQI score >5). Among the seven components of sleep quality, sleep duration and the use of sleep medication showed significant differences between male and female students and different years (p<0.05). An obvious correlation was found between sleep quality and body mass index (BMI)(p<0.000) in females who took hypnotic drugs. CONCLUSION: This study suggests that the sleep quality of females is probably associated with their BMI. College students are a special group of young adults whose cause of poor sleeping quality and BMI may be significant to study, so the health status of university students can be improved.

RESUMO OBJETIVO: O objetivo do estudo era investigar a prevalência de sobrepeso e obesidade e sua relação com a qualidade do sono em estudantes universitários da província de Anhui, China. METODOLOGIA: Um estudo transversal foi realizado na China com 1328 participantes. A prevalência de baixo peso e obesidade em estudantes universitários foi estimada com base nas referências do Grupo de Trabalho sobre Obesidade da China. A qualidade do sono foi avaliada utilizando o padrão PSQI (Pittsburgh Sleep Quality Index). RESULTADOS: O estudo incluiu 470 homens e 858 mulheres, todos estudantes universitários de Anhui; 4,4% das mulheres e 17,7% dos homens foram classificados com sobrepeso ou obesidade. A prevalência da obesidade em homens foi significativamente maior do que em mulheres, e a prevalência da obesidade nos últimos anos foi maior do que em outras categorias (P < 0, 05). Em geral, a pontuação média de qualidade do sono foi 4,91 ± 2,67; 36,5% dos homens e 39, 1% das mulheres tiveram uma qualidade de sono ruim (PSQI > 5). Considerando os sete componentes da qualidade do sono, a duração do sono e o uso de medicação para dormir apresentaram diferenças significativas entre estudantes homens e mulheres de anos diferentes (P < 0,05). Uma clara correlação foi encontrada entre a qualidade do sono e o Índice de Massa corporal (IMC) (P < 0.0000) em mulheres que usavam drogas hipnóticas. CONCLUSÃO: Este estudo sugere que a qualidade do sono das mulheres está provavelmente associada com o IMC. Os universitários são um grupo especial de jovens adultos, por isso é importante para estudar a causa da sua má qualidade do sono e sua relação com o IMC, para que seja possível melhorar a saúde dos estudantes universitários.

Lean mass as a determinant of bone mineral density of proximal femur in postmenopausal women

ABSTRACT Objective: To verify which component of body composition (BC) has greater influence on postmenopausal women bone mineral density (BMD). Subjects and methods: Four hundred and thirty women undergoing treatment for osteoporosis and 513 untreated women, except for calcium and vitamin D. Multiple linear regression analysis was performed in order to correlated BMD at lumbar spine (LS), total femur (FT), femoral neck (FN) with body mass (BM), total lean mass (LM) and total fat mass (FM), all determined by DXA. Results: BM significantly correlated with all bone sites in untreated and treated women (r = 0.420 vs 0.277 at LS; r = 0.490 vs 0.418 at FN, r = 0.496 vs 0.414 at FT, respectively). In untreated women, the LM correlated better than FM with all sites, explaining 179% of LS; 32.3% of FN and 30.2% of FT; whereas FM explained 13.2% of LS; 277% of FN, 23.4% of FT In treated women, correlations with BC were less relevant, with the LM explaining 6.7% of BMD at LS; 15.2% of FN, 16% of FT, whereas the FM explained 8.1% of LS; 179% of FN and 176% of FT. Conclusion: LM in untreated women was better predictor of BMD than FM, especialy for distal femur, where it explained more than 30% of the BMD, suggesting that maintaining a healthy muscle mass may contribute to decrease osteoporosis risk. Treatment with anti-osteoporotic drugs seems to mask these relationships. Arch Endocrinol Metab. 2018;62(4):431-7

Baixo peso e dependência funcional em idosos institucionalizados de Uberlândia (MG), Brasil / Low weight and functional disability in institutionalized elderly interns in Uberlândia in the State of Minas Gerais, Brazil

O objetivo deste artigo é identificar a associação entre estado nutricional e dependência funcional dos idosos institucionalizados de Uberlândia (MG). Estudo transversal, com 233 idosos. Foram avaliadas variáveis sociodemográficas, estado nutricional e o grau de dependência dos idosos. Realizou-se análise multivariada pela Regressão de Poisson com variância robusta, para verificar a associação entre o estado nutricional e dependência funcional. O baixo peso pelo Índice de Massa Corporal se associou à dependência funcional após controle para variáveis socioeconômicas e demográficas, os idosos com baixo peso tinham uma razão de prevalência de dependência de 1,20 vezes àquela dos eutróficos. Como bem reportado pela literatura, a idade também se associou à dependência, com razão de prevalência de 1,19, para os longevos. O baixo peso constituiu importante fator associado à incapacidade funcional. Dessa forma, ressalta-se a necessidade de avaliação, monitoramento e recuperação do estado nutricional de idosos institucionalizados, que além de reduzir morbimortalidade por diversas doenças e melhorar a qualidade de vida, ainda pode prevenir e retardar a dependência funcional.

This article seeks to identify the association between nutritional status and functional dependence in institutionalized elderly interns in Uberlândia, Minas Gerais. It involved a cross-sectional study with 233 elderly interns in which sociodemographic variables, nutritional status and degree of dependency were assessed. Multivariate analysis was performed using Poisson regression with robust variance to assess the association between nutritional status and functional dependence of these senior citizens. Low weight by the Body Mass Index was associated with functional dependence after controlling for socioeconomic and demographic variables. The elderly with low weight had a prevalence ratio of dependence of 1.2 times the prevalence rate of dependence of well nourished elderly interns. As reported in the literature, age was also associated with dependence with a prevalence ratio of 1.19 for the longest living. Low weight is an important factor associated with functional disability. Thus, the need for evaluation, monitoring and recovery of nutritional status in the institutionalized elderly is stressed, as in addition to reducing morbidity and mortality from several diseases and improve quality of life, it can also prevent and delay functional dependency.

Nutritional status is related to fat-free mass, exercise capacity and inspiratory strength in severe chronic obstructive pulmonary disease patients

INTRODUCTION: Being overweight or obese is associated with a higher rate of survival in patients with advanced chronic obstructive pulmonary disease (COPD). This paradoxical relationship indicates that the influence of nutritional status on functional parameters should be further investigated. OBJECTIVE: To investigate the impact of nutritional status on body composition, exercise capacity and respiratory muscle strength in severe chronic obstructive pulmonary disease patients. METHODS: Thirty-two patients (nine women) were divided into three groups according to their body mass indices (BMI): overweight/obese (25 < BMI < 34.9 kg/m², n=8), normal weight (18.5 < BMI < 24.9 kg/m², n=17) and underweight (BMI <18.5 kg/m², n=7). Spirometry, bioelectrical impedance, a six-minute walking distance test and maximal inspiratory and expiratory pressures were assessed. RESULTS: Airway obstruction was similar among the groups (p=0.30); however, overweight/obese patients had a higher fat-free mass (FFM) index [FFMI=FFM/body weight² (mean±SEM: 17±0.3 vs. 15±0.3 vs. 14±0.5 m/kg², p<0.01)], exercise capacity (90±8 vs. 79±6 vs. 57±8 m, p=0.02) and maximal inspiratory pressure (63±7 vs. 57±5 vs. 35±8 percent predicted, p=0.03) in comparison to normal weight and underweight patients, respectively. In addition, on backward multiple regression analysis, FFMI was the unique independent predictor of exercise capacity (partial r=0.52, p<0.01). CONCLUSIONS: Severe chronic obstructive pulmonary disease (COPD) patients who were overweight or obese had a greater FFM, exercise capacity and inspiratory muscle strength than patients with the same degree of airflow obstruction who were of normal weight or underweight, and higher FFM was independently associated with higher exercise capacity. These characteristics of overweight or obese patients might counteract the drawbacks of excess weight and lead to an improved prognosis in COPD.

Influência da massa magra corporal nas repercussões cardiopulmonares durante o teste de caminhada de seis minutos em pacientes com DPOC / Influence of lean body mass on cardiopulmonary repercussions during the six-minute walk test in patients with COPD

OBJETIVO: A massa magra corporal (MMC) tem sido associada à mortalidade em pacientes com DPOC, mas seu impacto na limitação funcional é pouco conhecido. O objetivo deste trabalho foi analisar as variáveis cardiopulmonares em pacientes com DPOC, com ou sem depleção da MMC, antes e após a realização do teste de caminhada de seis minutos (TC6). MÉTODOS: Foram avaliados pacientes com DPOC, 36 sem depleção de MMC e 32 com depleção de MMC. Todos os pacientes foram submetidos à avaliação clínica, espirometria, avaliação da composição da massa corpórea e TC6 e responderam a questionários de qualidade de vida e de percepção de dispnéia. RESULTADOS: Não foram observadas diferenças significativas na gravidade de obstrução das vias aéreas, na percepção da dispnéia e na qualidade de vida entre os grupos. A distância percorrida no TC6 foi similar nos pacientes com DPOC com e sem depleção de MMC (470,3 ± 68,5 m vs. 448,2 ± 89,2 m). Entretanto, durante a realização do teste, os pacientes com depleção de MMC apresentaram aumento significativamente maior na diferença entre os valores final e basal da frequência cardíaca e do índice da escala de Borg para cansaço dos membros inferiores. A distância percorrida no TC6 apresentou correlação significativa positiva com o VEF1 (r = 0,381; p = 0,01). CONCLUSÕES: Não houve influência da depleção da MMC na capacidade funcional de exercício e na qualidade de vida dos pacientes estudados. Entretanto, os pacientes com depleção de MMC apresentam sintomas de fadiga dos membros inferiores mais acentuados durante o TC6, o que reforça a importância da avaliação e tratamento das manifestações sistêmicas da DPOC.

OBJECTIVE: Although lean body mass (LBM) has been associated with mortality in patients with COPD, its influence on functional limitation is not clear. The objective of this study was to analyze the cardiopulmonary variables in COPD patients with or without LBM depletion, prior to and after the six-minute walk test (6MWT). METHODS: We evaluated COPD patients, 32 with LBM depletion and 36 without. All patients underwent clinical evaluation, spirometry, evaluation of body mass composition and 6MWT, as well as completing questionnaires related to quality of life and perception of dyspnea. RESULTS: No significant differences in the severity of airway obstruction, perception of dyspnea and quality of life scores were found between the groups. The distance covered on the 6MWT was similar in COPD patients with and without LBM depletion (470.3 ± 68.5 m vs. 448.2 ± 89.2 m). However, patients with LBM depletion presented significantly greater differences between baseline and final values in terms of heart rate and Borg scale index for lower limb fatigue. There was a significant positive correlation between distance covered on the 6MWT and FEV1 (r = 0.381, p = 0.01). CONCLUSIONS: In the patients studied, functional exercise tolerance and quality of life were unaffected by LBM depletion. However, the patients with LBM depletion presented more pronounced lower limb fatigue during the 6MWT, which underscores the importance of the evaluation and treatment of systemic manifestations in COPD patients.

Lean (underweight) NIDDM - peculiarities and differences in metabolic and hormonal status - a pilot study.

In the present series of 204 patients with NIDDM, 37 were lean and 35 obese. Mean FBG and HbA1C were significantly higher (P<0.02 and <0.01) in the former. Serum lipids such as total cholesterol (Tc) and triglycerides (Tg) were lower (P<0.05) in the lean while HDLc values were similar. Eight lean patients and 6 obese (Mean BMI : 15.7 vs.27.4) having similar age (48.0 vs 47.7 years) and mean duration of diabetes (4.6 vs 4.2 years) were subjected to the study of insulin and C-peptide status as well as beta cell reserve. The mean basal serum insulin (IRI) level was lower in the lean (15.3 vs. 28.9 mu u/ml ; P<0.05) while there was no statistical difference in the basal C-peptide values. Serum samples analysed 2 hours after 75 G of oral glucose and 1 mg I.V. glucagon (Novo) on two consecutive occasions for IRI and C-peptide responses revealed remarkable differences. The rise in IRI was significantly lower (p<0.01) in the lean after oral glucose and glucagon as compared to the obese. But the C-peptide values did not reveal significant difference suggesting similar reserve in beta cell function in both these groups of patients with NIDDM. The disparity between IRI and C-peptide levels observed was most likely due to excess extraction of insulin by the liver in lean-NIDDM, leading to lower peripheral levels. This phenomenon accounts for the occurrence of severe hyperglycemia inspite of good beta cell function in lean NIDDM.