Practical but Inaccurate? A-Mode Ultrasound and Bioelectrical Impedance Underestimate Body Fat Percentage Compared to Dual-Energy X-ray Absorptiometry in Male College Students.

Bioelectrical impedance (BIA) and ultrasound (US) have become popular for estimating body fat percentage (BF%) due to their low cost and clinical convenience. However, the agreement of these devices with the gold-standard method still requires investigation. The aim was to analyze the agreement between a gold-standard %BF assessment method with BIA and US devices. Twenty-three men (aged 30.1 ± 7.7 years, weighing 82.5 ± 14.9 kg, 1.77 ± 0.05 m tall) underwent dual-energy X-ray absorptiometry (DXA), BIA (tetrapolar) and US (three-site method) %BF assessments. Pearson and concordance correlations were analyzed. A T-test was used to compare the means of the methods, and Bland-Altman plots analyzed agreement and proportional bias. Alpha was set at <0.05. The Pearson coefficients of BIA and US with DXA were high (BIA = 0.94; US = 0.89; both p < 0.001). The concordance coefficient was high for BIA (0.80) and moderate for US (0.49). The BF% measured by BIA (24.5 ± 7.5) and US (19.4 ± 7.0) was on average 4.4% and 9.6% lower than DXA (29.0 + 8.5%), respectively (p < 0.001). Lower and upper agreement limits between DXA and BIA were -1.45 and 10.31, while between DXA and US, they were 2.01 and 17.14, respectively. There was a tendency of both BIA (p = 0.09) and US (p = 0.057) to present proportional bias and underestimate BF%. Despite the correlation, the mean differences between the methods were significant, and the agreement limits were very wide. This indicates that BIA and US, as measured in this study, have limited potential to accurately measure %BF compared to DXA, especially in individuals with higher body fat.

Predictive Models of Muscle Strength in Older People with Type 2 Diabetes Mellitus.

Purpose: To propose predictive models for absolute muscle strength (AMS) of elderly people with type 2 Diabetes Mellitus (DM2) in primary health care. Patients and Methods: The cross-sectional study was conducted with 138 elderly diabetics. The AMS was measured by a JAMAR® hydraulic handgrip dynamometer, determined by the sum of both hands. The following indices were evaluated: waist-to-height ratio (WHtR), body mass index (BMI), Lipid Accumulation Product (LAP), Triglyceride/High Density Lipoprotein (TG/HDL) ratio and platelet/lymphocyte ratio (PLR). Multiple linear regression was used in the statistical analysis. Results: The final regression model indicated 66.4% (R²=0.66) of the variation in AMS. WHtR decreased AMS by 41.1% (ß = -0.19; t = -3.70; p < 0.001), while PLR by 11.3% (ß = -0.12; t = -2.36; p = 0.020). Male sex increased AMS by 10.6% (ß = 0.32; t = 4.16; p < 0.001), and lean mass (LM) by 0.89% (ß = 0.46; t = 6.03; p < 0.001). Conclusion: WHtR and PLR predicted a decrease, while male sex and LM predicted an increase in AMS. It is suggested that these markers be used as screening measures for variation in AMS in older adults with DM2. These results have relevant practical application in primary health care since the markers are easy to use.

Could sarcopenia-related mortality in end-stage renal disease be underpinned by the number of hospitalizations and cardiovascular diseases?

PURPOSE: To investigate the association between sarcopenia with the number of all-cause mortality, hospitalizations, and cardiovascular diseases in patients with end-stage renal disease (ESRD). METHODS: 247 patients with ESRD (women, n = 97) (66.6 ± 3.53 years) participated in this study. At baseline, all participants were measured with dual-energy X-ray absorptiometry and handgrip dynamometer and were prospectively followed up for 5 years. The European Working Group on Sarcopenia in Older People guidelines were utilized for Sarcopenia determination. Cox proportional hazard analysis adjusted for established risk factors was used to quantify the risk between Sarcopenia and all-cause mortality. RESULTS: Sixty-five participants (26%) were determined to have Sarcopenia at baseline and 38 (15%) have died during the follow-up. At baseline, Participants with Sarcopenia had lower body mass index and fat-free mass index. Moreover, through the 5-year follow-up, sarcopenic patients had higher number of cardiovascular disease (56.9% vs. 12.6%) and hospitalizations (93.8% vs. 49.5%) (all P < 0.0001). Sarcopenia was associated with significantly higher risk of mortality, [Hazard ratio = 3.3, (95% CI: 1.6-6.9), P = 0.001]. CONCLUSION: Sarcopenia may be a risk factor for hospitalizations, cardiovascular diseases, and all-cause mortality in patients with ESRD. These results provide support of the relevance in assessing sarcopenia in the clinical practice of chronic kidney disease and how muscle mass and strength may negatively impact the daily life of ESRD patients undergoing hemodialysis. Greater efforts at preventing muscle wasting and malfunctioning are needed through the worldwide healthcare system.

Effects of blood flow restriction in large and small muscle groups / Efeitos da restrição do fluxo sanguíneo em grupamentos musculares grandes e pequenos / Efectos de la restricción del flujo sanguíneo en grupos musculares grandes y pequeños

ABSTRACT Introduction It is known that strength training brings improvements in health and sports performance by causing muscle hypertrophy and increased strength, as well as modifying some hemodynamic and physiological factors. Several strength training methodologies have been developed, one of which is vascular occlusion. There are few studies with large muscle groups due to poor adherence to the training style and the fact that vascular occlusion of large muscle groups is more difficult. Objective To verify and compare the hemodynamic effects of exercise with and without vascular occlusion in different muscle groups. Methods Quantitative crossover study, with cross-sectional and field procedures. The sample consisted of 10 physically active healthy male and female subjects between 18 and 30 years of age. With the cross-over design, all the volunteers participated in 3 groups: intervention with vascular occlusion, intervention without vascular occlusion and the control group. Results Overall, lactate and cholesterol remained elevated after 15 minutes of recovery and blood glucose and blood pressure did not vary among the groups. Conclusion Vascular occlusion training is an effective method for manipulating hemodynamic variables. Evidence level II; Clinical study.

RESUMO Introdução Sabe-se que o treino de força traz melhorias para a saúde e o desempenho esportivo, por ocasionar hipertrofia muscular e aumento de força, além de modificar alguns fatores hemodinâmicos e fisiológicos. Foram desenvolvidos vários métodos de treinamento de força, entre eles, a oclusão vascular. Porém, existem poucos estudos com grandes grupamentos musculares, devido à pouca adesão ao estilo de treino e ao fato de a oclusão vascular de grandes grupos musculares ser mais difícil. Objetivo Verificar e comparar os efeitos hemodinâmicos do exercício com e sem oclusão vascular em diferentes grupamentos musculares. Métodos Estudo quantitativo, cruzado, com procedimentos transversais e de campo. A amostra foi composta por 10 indivíduos saudáveis e fisicamente ativos do sexo masculino e feminino, na faixa etária de 18 a 30 anos. Com o desenho cruzado, todos os voluntários participaram de 3 grupos: intervenção com oclusão vascular, intervenção sem oclusão vascular e grupo controle. Resultados De forma geral, entre grupos, o lactato e o colesterol se mantiveram elevados depois de 15 minutos de recuperação, a glicemia e as pressões arteriais não variaram. Conclusão O treinamento com oclusão vascular é um método eficaz para manipular as variáveis hemodinâmicas. Nível de evidência II; Estudo clínico.

RESUMEN Introducción Se sabe que el entrenamiento de fuerza trae mejoras para la salud y el desempeño deportivo, por causar hipertrofia muscular y aumento de fuerza, además de modificar algunos factores hemodinámicos y fisiológicos. Fueron desarrollados varios métodos de entrenamiento de fuerza, entre ellos, la oclusión vascular. Sin embargo, existen pocos estudios con grandes grupos musculares, debido a la poca adhesión al estilo de entrenamiento y al hecho de que la oclusión vascular de grandes grupos musculares grandes es más difícil. Objetivo Verificar y comparar los efectos hemodinámicos del ejercicio con y sin oclusión vascular en diferentes grupos musculares. Métodos Estudio cuantitativo, cruzado, con procedimientos transversales y de campo. La muestra fue compuesta por 10 individuos saludables y físicamente activos del sexo masculino y femenino, en el grupo de edad de 18 a 30 años. Con el diseño cruzado, todos los voluntarios participaron en 3 grupos: intervención con oclusión vascular, intervención sin oclusión vascular y grupo control. Resultados De forma general, entre los grupos, el lactato y el colesterol se mantuvieron elevados después de 15 minutos de recuperación, la glucemia y las presiones arteriales no variaron. Conclusión El entrenamiento de oclusión vascular es un método eficaz para manipular las variables hemodinámicas. Nivel de evidencia II; Estudio clínico.

The Effects of Strength Training Combined with Vitamin C and E Supplementation on Skeletal Muscle Mass and Strength: A Systematic Review and Meta-Analysis.

Intense muscle contractile activity can result in reactive oxygen species production in humans. Thus, supplementation of antioxidant vitamins has been used to prevent oxidative stress, enhance performance, and improve muscle mass. In this sense, randomized controlled studies on the effect of vitamin C and E supplementation combined with strength training (ST) on skeletal muscle mass and strength have been conducted. As these studies have come to ambiguous findings, a better understanding of this topic has yet to emerge. The purpose of the present review is to discuss the current knowledge about the effect of vitamin C and E supplementation on muscle mass and strength gains induced by ST. Search for articles was conducted in the following databases: PubMed/Medline, Web of Science, Scopus, Cochrane Central Register of Controlled Trials, and Google Scholar. This work is in line with the recommendations of the PRISMA statement. Eligible studies were placebo-controlled trials with a minimum of four weeks of ST combined with vitamin C and E supplementation. The quality of each included study was evaluated using the Physiotherapy Evidence Database Scale (PEDro). 134 studies were found to be potentially eligible, but only seven were selected to be included in the qualitative synthesis. A meta-analysis of muscle strength was conducted with 3 studies. Findings from these studies indicate that vitamins C and E has no effect on muscle force production after chronic ST. Most of the evidence suggests that this kind of supplementation does not potentiate muscle growth and could possibly attenuate hypertrophy over time.

Antioxidant Supplementation Impairs Changes in Body Composition Induced by Strength Training in Young Women.

Strength training (ST) is known to promote muscle hypertrophy and body composition adaptations. However, only a few studies investigated the effects of ST combined with antioxidant supplementation (AS) on these adaptations. The aim of this study was to investigate chronic effects of ST combined with AS on fat mass (FM) and fat-free mass (FFM) of young women. In a double-blinded design, thirty-three subjects (22.9 ± 2.5 years, 57.7 ± 8.4 kg, 1.6 ± 0.6 m) were allocated into three groups: 1) vitamins (n=12), 2) placebo (n=11) and 3) control (n=10). Vitamins and placebo underwent a ST program for 10 weeks. Vitamins supplemented with vitamin C (1g/day) and E (400IU/day) during the training period. FM and FFM were assessed by DEXA. Multiple 3 x 2 (group x time) mixed-factor ANOVA with Tukey adjustment was performed to examine differences in the dependent variables. The significance level was set at P ≤ .05. Only placebo increased total FFM (34.9 ± 4.9 vs 36.3 ± 4.8 kg, P<0.05) and decreased total FM (21.8 ± 7.8 vs 21.0 ± 8.3 kg, P<0.05) after training for 10 weeks. Moreover, only placebo presented a significantly greater FFM percent change from pre to post-intervention compared to control (4.0 ± 3.4 vs -0.7 ± 3.1%, respectively, P < 0.05). These results suggest that chronic AS can mitigate ST related improvements of body composition in young women.

Association Between Adiposity Indices and Blood Pressure is Stronger in Sarcopenic Obese Women.

BACKGROUND: Anthropometric indices are useful to identify excess weight and poor health outcomes. Previous research showed that some indices are correlated to blood pressure (BP) among adults. Yet, these associations are poorly characterized in women with sarcopenic obesity (SO). SO is characterized as the combination of sarcopenia and obesity and has been examined as an emerging cause of disorders and frailty. OBJECTIVE: The study aims to examine the association between anthropometric indices and BP in community-dwelling women with and without SO. METHOD: 118 women (46.3 ± 15.6 years; 1.56 ± .07m; 66.9 ± 12.5kg) underwent BP and anthropometric assessments. Body weight, height, as well as waist (WC) and hip circumference were measured. Body mass index (BMI), body adiposity index (BAI), waist-to-hip (WHR) and waist-toheight (WHtR) ratio were calculated. SO was identified based on median values of percent body fat and muscle mass. Partial correlation was used to assess the association between adiposity indices and BP adopting age, presence of hypertension and use of antihypertensive medication as controlling variables. The significance level was set at P ≤ .05. RESULTS: systolic BP was significantly higher in subjects with SO (126.4 ± 14.1 vs 121.0 ± 11.6mmHg, P = .01). Correlations between anthropometric indices and systolic BP were generally higher in women with SO, reaching statistical significance for WC (r = .39, P < .05) and WHtR (r = .30, P < .05) when age was the controlling variable. CONCLUSION: The association of adiposity indices and BP is stronger in subjects with SO when compared to those without SO.

Comparative Evaluation of Adiposity Indices as Predictors of Hypertension among Brazilian Adults.

PURPOSE: To compare several anthropometric indices in the prediction of hypertension among adults. METHODS: This is a cross-sectional study. Five hundred and eighteen adult men and women (40.9 ± 10.5 years; 1.62 ± .09 m; 72.3 ± 15.6 kg) volunteered to participate and underwent blood pressure and anthropometric measures. Anthropometric assessments were used to calculate body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-stature ratio (WSR), body adiposity index (BAI), and conicity index (C). Comparisons between men and women were carried out by independent t-test and chi-square test. Cut-off points for each adiposity index to predict hypertension were obtained using Receiver Operating Characteristic (ROC) curve analyses. The significance level was set at P ≤ .05. RESULTS: All adiposity indices regarding both genders showed significant odds ratios, except BAI (odds ratio: 1.534; CI: 0.916-2.571) for women. In men, WHR and WSR were considered as more balanced indices regarding their sensitivity (AUC: 73.8 and 71.4, respectively) and specificity (AUC: 77.6 and 73.1, respectively). In women, WHR and WSR presented areas under the ROC curves higher than C index (P = .007) and BAI (P = .03), respectively. CONCLUSION: Indices that consider abdominal adiposity such as WC, WHR, and WSR have a stronger relationship with hypertension compared to others.

Effect of strength training combined with antioxidant supplementation on muscular performance.

This was a placebo-controlled randomized study that aimed to investigate the effects of strength training (ST) combined with antioxidant supplementation on muscle performance and thickness. Forty-two women (age, 23.8 ± 2.7 years; body mass, 58.7 ± 11.0 kg; height, 1.63 ± 0.1 m) were allocated into 3 groups: vitamins (n = 15), placebo (n = 12), or control (n = 15). The vitamins and placebo groups underwent an ST program, twice a week, for 10 weeks. The vitamins group was supplemented with vitamins C (1 g/day) and E (400 IU/day) during the ST period. Before and after training, peak torque (PT) and total work (TW) were measured on an isokinetic dynamometer, and quadriceps muscle thickness (MT) was assessed by ultrasound. Mixed-factor ANOVA was used to analyze data and showed a significant group × time interaction for PT and TW. Both the vitamins (37.2 ± 5.4 to 40.3 ± 5.6 mm) and placebo (39.7 ± 5.2 to 42.5 ± 5.6 mm) groups increased MT after the intervention (P < 0.05) with no difference between them. The vitamins (146.0 ± 29.1 to 170.1 ± 30.3 N·m) and placebo (158.9 ± 22.4 to 182.7 ± 23.2 N·m) groups increased PT after training (P < 0.05) and PT was higher in the placebo compared with the control group (P = 0.01). The vitamins (2068.3 ± 401.2 to 2295.5 ± 426.8 J) and placebo (2165.1 ± 369.5 to 2480.8 ± 241.3 J) groups increased TW after training (P < 0.05) and TW was higher in the placebo compared with the control group (P = 0.01). Thus, chronic antioxidant supplementation may attenuate peak torque and total work improvement in young women after 10 weeks of ST.

Resistance training-induced gains in muscle strength, body composition, and functional capacity are attenuated in elderly women with sarcopenic obesity.

OBJECTIVES: The purpose of this study was to compare the effects of resistance training (RT) on body composition, muscle strength, and functional capacity in elderly women with and without sarcopenic obesity (SO). METHODS: A total of 49 women (aged ≥60 years) were divided in two groups: without SO (non-SO, n=41) and with SO (n=8). Both groups performed a periodized RT program consisting of two weekly sessions for 16 weeks. All measures were assessed at baseline and postintervention, including anthropometry and body composition (dual-energy X-ray absorptiometry), muscle strength (one repetition maximum) for chest press and 45° leg press, and functional capacity (stand up, elbow flexion, timed "up and go"). RESULTS: After the intervention, only the non-SO group presented significant reductions in percentage body fat (-2.2%; P=0.006), waist circumference (-2.7%; P=0.01), waist-to-hip ratio (-2.3; P=0.02), and neck circumference (-1.8%; P=0.03) as compared with baseline. Muscle strength in the chest press and biceps curl increased in non-SO only (12.9% and 11.3%, respectively), while 45° leg press strength increased in non-SO (50.3%) and SO (40.5%) as compared with baseline. Performance in the chair stand up and timed "up and go" improved in non-SO only (21.4% and -8.4%, respectively), whereas elbow flexion performance increased in non-SO (23.8%) and SO (21.4%). Effect sizes for motor tests were of higher magnitude in the non-SO group, and in general, considered "moderate" compared to "trivial" in the SO group. CONCLUSION: Results suggest that adaptations induced by 16 weeks of RT are attenuated in elderly woman with SO, compromising improvements in adiposity indices and gains in muscle strength and functional capacity.

Acute cardiovascular response to pre-prandial and postprandial exercise in active men / Resposta cardiovascular aguda ao exercício pré e pós-prandial em homens ativos / Respuesta cardiovascular aguda al ejercicio preprandial y postprandial en hombres activos

ABSTRACT Introduction: Pre-prandial exercise promotes greater mobilization of fat metabolism due to the increased release of catecholamines, cortisol, and glucagon. However, this response affects how the cardiovascular system responds to exercise. Objective: To evaluate the response of systolic, diastolic, and mean blood pressure, heart rate (HR) and rate-pressure product (RPP) to pre- and postprandial exercise. Methods: Ten physically active male subjects (25.50 ± 2.22 years) underwent two treadmill protocols (pre- and postprandial) performed for 36 minutes at 65% of VO2max on different days. On both days, subjects attended the laboratory on a 10-hour fasting state. For the postprandial session, volunteers ingested a pre-exercise meal of 349.17 kcal containing 59.3 g of carbohydrates (76.73%), 9.97 g of protein (12.90%), and 8.01 g of lipids (10.37%). Blood pressure, HR and RPP were measured before and after exercise. The 2x2 factorial Anova with the multiple comparisons test of Bonferroni was applied to analyze cardiovascular variables in both moments (pre- vs. postprandial). The significance level was set at p<0.05. Results: Systolic (121.70 ± 7.80 vs. 139.78 ± 12.91 mmHg) and diastolic blood pressure (66.40 ± 9.81 vs. 80.22 ± 8.68 mmHg) increased significantly after exercise only in the postprandial session (p<0.05). HR increased significantly (p<0.05) after both protocols (64.20 ± 15.87 vs. 141.20 ± 10.33 bpm pre-prandial and 63.60 ± 8.82 vs. 139.20 ± 10.82 bpm postprandial). RPP had a similar result (8052.10 ± 1790.68 vs. 18382.60 ± 2341.66 mmHg.bpm in the pre-prandial session and 7772.60 ± 1413.76 vs. 19564.60 ± 3128.99 mmHg.bpm in the postprandial session). Conclusion: These data suggest that fasted exercise does not significantly alter the blood pressure. Furthermore, the meal provided before the postprandial exercise may promote a greater blood pressure responsiveness during exercise.

RESUMO Introdução: O exercício pré-prandial promove maior mobilização do metabolismo de gordura devido ao aumento da liberação de catecolaminas, cortisol e glucagon. Contudo, tal resposta afeta a forma como o sistema cardiovascular responde ao exercício. Objetivo: Avaliar a resposta da pressão sistólica, diastólica e média, a frequência cardíaca (FC) e o duplo produto (DP) ao exercício pré e pós-prandial. Métodos: Dez indivíduos ativos (25,50 ± 2,22 anos) foram submetidos a dois protocolos de exercício em esteira (pré e pós-prandial) realizados durante 36 minutos a 65% do VO2máx em dias diferentes. Em ambos os dias, os indivíduos compareceram ao laboratório em jejum de 10 horas. Para a sessão pós-prandial, os voluntários ingeriram uma refeição pré-exercício de 349,17 kcal, contendo 59,3 g de carboidratos (76,73%), 9,97 g de proteína (12,90%) e 8,01 g de lipídeos (10,37%). A pressão sanguínea, a FC e o DP foram medidos antes e depois do exercício. A Anova fatorial (2 X 2) com as comparações múltiplas de Bonferroni foi aplicada para análise das variáveis nos dois momentos (pré e pós-prandial). O nível de significância foi fixado em p < 0,05. Resultados: A pressão sanguínea sistólica (121,70 ± 7,80 vs. 139,78 ± 12,91 mmHg) e a diastólica (66,40 ± 9,81 vs. 80,22 ± 8,68 mmHg) aumentaram significantemente após o exercício somente na sessão pós-prandial (p < 0,05). A FC aumentou significantemente (p < 0,05) após ambos os protocolos (64,20 ± 15,87 vs. 141,20 ± 10,33 bpm pré-prandial e 63,60 ± 8,82 vs. 139,20 ± 10,82 bpm pós-prandial). O DP teve resultado semelhante (8.052,10 ± 1.790,68 vs. 18.382,60 ± 2.341,66 mmHg.bpm na sessão pré-prandial e 7.772,60 ± 1.413,76 vs. 19.564,60 ± 3.128,99 mmHg.bpm na sessão pós-prandial). Conclusão: Esses dados sugerem que o exercício em jejum não altera significantemente a pressão sanguínea. Além disso, a refeição fornecida antes do exercício pós-prandial pode promover maior responsividade da pressão sanguínea durante o exercício.

RESUMEN Introducción: El ejercicio preprandial promueve una mayor movilización de metabolismo de la grasa debido al aumento de la liberación de catecolaminas, cortisol y glucagón. Sin embargo, tal respuesta afecta la forma en que el sistema cardiovascular responde al ejercicio. Objetivo: Evaluar la respuesta de la presión sistólica, diastólica y media, la frecuencia cardíaca (FC) y el doble-producto (DP) al ejercicio pre y postprandial. Métodos: Diez hombres activos (25,50 ± 2,22 años), fueron sometidos a dos protocolos de ejercicio en cinta rodante (pre y postprandial) realizados durante 36 minutos a 65% del VO2máx en días diferentes. En ambos días, los individuos asistieron al laboratorio después de un ayuno de 10 horas. Para la sesión postprandial, los voluntarios ingirieron una comida pre-ejercicio de 349,17 kcal, que contenía 59,3 g de hidratos de carbono (76,73%), 9,97 g de proteínas (12,90%) y 8,01 g de lípidos (10,37%). La presión sanguínea, la FC y el DP se midieron antes y después del ejercicio. Se aplicó el ANOVA factorial (2 x 2) con las comparaciones múltiples de Bonferroni para analizar las variables en los dos momentos (pre y postprandial). El nivel de significación se ha fijado en p < 0,05. Resultados: La presión sanguínea sistólica (121,70 ± 7,80 vs. 139,78 ± 12,91 mmHg) y la diastólica (66,40 ± 9,81 vs. 80,22 ± 8,68 mmHg) aumentaron significativamente después del ejercicio sólo en la sesión postprandial (p < 0,05). La FC aumentó significativamente (p < 0,05) después de ambos protocolos (64,20 ± 15,87 vs. 141,20 ± 10,33 lpm preprandial y 63,60 ± 8,82 vs. 139,20 ± 10,82 lpm postprandial). El DP tuvo un resultado similar (8.052,10 ± 1.790,68 vs. 18.382,60 ± 2.341,66 mmHg.lpm preprandial y 7.772,60 ± 1.413,76 vs. 19.564,60 ± 3.128.99 mmHg.lpm postprandial). Conclusión: Estos datos sugieren que el ejercicio en ayunas no altera significativamente la presión sanguínea. Además, la comida suministrada antes del ejercicio postprandial puede promover una mayor capacidad de respuesta de la presión sanguínea durante el ejercicio.

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.

Relationship between sarcopenic obesity-related phenotypes and inflammatory markers in postmenopausal women.

Ageing is associated with changes in body composition that may result in sarcopenic obesity (SO). Interleukin-6 (IL-6) and C-reactive protein (CRP) are important inflammatory markers related to ageing. SO has been examined as an important public health problem, but its association with inflammatory markers has yet to be investigated. The aim of this study was to investigate the association between SO-related phenotypes and inflammatory markers in postmenopausal women. A total of 130 women (66·7 ± 5·2 years) underwent body composition evaluation using dual-energy X-ray absorptiometry. Volunteers were classified according to a SO definition previously described in the literature. Waist circumference (WC) and handgrip strength (HG) were also measured. Blood samples were collected for CRP, tumour necrosis factor and IL-6 measurements. All the inflammatory markers were higher in SO individuals when compared to non-SO; however, only IL-6 reached statistical significance (median 3·34 versus 1·37 pg ml-1 ; P<0·05). Also, CRP was significantly correlated (P<0·01) with body mass index (rs  = 0·34), fat mass (FM; rs  = 0·25) and WC (rs  = 0·33). Similarly, IL-6 levels were significantly correlated (P<0·05) to age (rs  = 0·19), FM (rs  = 0·19) and WC (rs  = 0·17). HG was found to be significantly reduced among subjects with higher IL-6 levels (P = 0·02). In summary, the combination of reduced muscle mass and excess body fat (i.e. SO) is associated with elevated inflammatory markers in postmenopausal women. Moreover, CRP and IL-6 are associated with SO-related phenotypes in this population.

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.

Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrome in postmenopausal women.

AIMS: To compare adiposity indices and to assess their various cut-off values for the prediction of metabolic syndrome (MetS) in postmenopausal women. METHODS: One hundred forty nine volunteers (67.17±6.12 years) underwent body composition assessment using DXA and had 5 anthropometric indices measured (Waist Circumference, WC; Waist-to-Height Ratio, WHtR; Body Mass Index, BMI; Body Adiposity Index, BAI; and Conicity Index). Blood pressure was assessed using an oscillometric device and fasting blood samples were collected. MetS was classified according NCEP-ATP III. Cut-off values to predict MetS were obtained using Receiver Operating Characteristic (ROC) curve analyses and odds ratios were also calculated. RESULTS: MetS prevalence was 29.5% and subjects who were classified with MetS showed worse cardiometabolic outcomes and higher anthropometric indices values (p<0.05). With the exception of total- and LDL-cholesterol, all remaining variables were significantly correlated with at least one of the adiposity indices, with the strongest relationships observed for the indices reflecting central body fat. The cut-off values were 88cm, 0.57cm/cm, 26.85kg/m(2), 43.7%, 36.34%, and 1.24 units for WC, WHtR, BMI, DXA-derived body fat percentage, BAI, and conicity index, respectively. Significant greater risks for MetS were found for volunteers who had WHtR (odds=9.08; CI: 1.81-45.47) or WC (odds=5.20; CI: 1.30-20.73) measurements above cut-off values. CONCLUSION: Adiposity indices are associated with MetS in postmenopausal women in different degrees. Indices which consider central adiposity such as WC and WHtR have a stronger relationship with MetS compared to DXA-derived body fat percentage, which is considered a gold standard.

Comparison of percentage body fat and body mass index for the prediction of inflammatory and atherogenic lipid risk profiles in elderly women.

OBJECTIVE: To compare the clinical classification of the body mass index (BMI) and percentage body fat (PBF) for the prediction of inflammatory and atherogenic lipid profile risk in older women. METHOD: Cross-sectional analytical study with 277 elderly women from a local community in the Federal District, Brazil. PBF and fat-free mass (FFM) were determined by dual energy X-ray absorptiometry. The investigated inflammatory parameters were interleukin 6 and C-reactive protein. RESULTS: Twenty-five percent of the elderly women were classified as normal weight, 50% overweight, and 25% obese by the BMI. The obese group had higher levels of triglycerides and very low-density lipoproteins than did the normal weight group (P≤0.05) and lower levels of high-density lipoproteins (HDL) than did the overweight group (P≤0.05). According to the PBF, 49% of the elderly women were classified as eutrophic, 28% overweight, and 23% obese. In the binomial logistic regression analyses including age, FFM, and lipid profile, only FFM (odds ratio [OR]=0.809, 95% confidence interval [CI]: 0.739-0.886; P<0.0005) proved to be a predictor of reaching the eutrophic state by the BMI. When the cutoff points of PBF were used for the classification, FFM (OR=0.903, CI=0.884-0.965; P=0.003) and the total cholesterol/HDL ratio (OR=0.113, CI=0.023-0.546; P=0.007) proved to be predictors of reaching the eutrophic state. CONCLUSION: Accurate identification of obesity, systemic inflammation, and atherogenic lipid profile is key to assessing the risk of cardiometabolic diseases. Classification based on dual energy X-ray absorptiometry measures, along with biochemical and inflammatory parameters, seems to have a great clinical importance, since it allows the lipid profile eutrophic distinction in elderly overweight women.

Acute and chronic effects of resistive exercise on blood pressure in hypertensive elderly women.

The purpose of this study was to investigate postexercise hypotension (PEH) during a 4-month period of resistance training in hypertensive elderly women. Sixty-four women were divided into 2 groups: an experimental group (EG), which performed resistance training, and a control group (CG) that did not practice any exercise. The EG carried out the following steps: (a) 3 weeks of exercise adaptation and 1 repetition maximum (1RM) test (month 1); (b) resistance exercise at 60% 1RM (month 2); (c) resistance exercise at 70% 1RM (month 3); (d) resistance exercise at 80% 1RM (month 4); and (e) PEH analyses at the end of each month. Measurements of systolic (SBP) and diastolic blood pressure (DBP) were calculated each 5 minutes during a 20-minute resting period before the sessions and each 15 minutes during 1 hour of post-session recovery. Analysis of covariance for repeated measures showed a reduction in SBP of about 14 mm Hg (p ≤ 0.05) and in DBP of 3.6 mm Hg (p ≤ 0.05) between resting values after the training period. In the EG group, SBP showed acute PEH during months 2 and 3, whereas DBP showed acute PEH during months 2 and 4. The CG did not show acute PEH or variations during the 4-month period. Postexercise hypotension occurrence and chronic reduction of resting blood pressure observed in the EG may have a protective effect on the cardiovascular system of the study participants.

Hipotensão pós-exercício resistido: uma revisão da literatura / Hypotension after resistance exercise: a literature review

A hipotensão pós-exercício tem sido alvo de diversas investigações. Todavia, não é consenso que exercícios resistidos induzam este fenômeno. O propósito deste trabalho foi, através de revisão da literatura, apresentar os principais achados no que tange à Hipotensão Pós-Exercício Resistido (HPER) e seus possíveis mecanismos. Os resultados dos estudos analisados apresentam controvérsias, possivelmente pelos diferentes delineamentos metodológicos e protocolos de exercício adotados para análise da HPER. Controvérsias na literatura podem também estar relacionadas ao nível da PA em repouso, uma vez que pessoas com valores basais mais elevados apresentam reduções mais importantes após o exercício. Futuras pesquisas são necessárias para melhor elucidar os mecanismos responsáveis pela HPER. Contudo, a HPER parece factível, especialmente em hipertensos, pelo menos nos primeiros 60 a 90 min de recuperação pós-sessão. Essas informações são importantes para a prescrição do exercício.

Post-exercise hypotension (PEH) has been the subject of several investigations. However, there is no consensus that resistance exercise promotes this phenomenon. The purpose of this work was to present, through a literature review, the main findings regarding post-resistance exercise hypotension and its possible mechanisms. The results of the studies are conflicting, which may be due to different methodological designs and exercise protocols adopted. Controversies may also be related to the level of blood pressure (BP) at rest, since people with higher baseline levels usually have more important reductions after exercise. Future researches are important to elucidate the physiological mechanisms that induce PEH. Although some studies have failed to report it, this phenomenon seems feasible, especially in hypertensive patients, at least in the first 60 to 90 minutes after a resistance exercise session. This information is important for exercise prescription.

O efeito da natação e da hidroginástica sobre a pressão arterial pós-exercício de mulheres normotensas / The effect of swimming and water aerobics on post exxercise blood pressure of normotensive women

O decréscimo da pressão arterial (PA) para valores inferiores aos de repouso pré-exercício após uma sessão de exercício dinâmico foi denominado hipotensão pós-exercício. A prática de exercícios que induzam este fenômeno tem sido sugerida para prevenção e tratamento não medicamentoso da hipertensão arterial. O objetivo deste estudo foi analisar respostas da PA de jovens normotensas após uma sessão de natação, estilo crawl, bem como após uma sessão de hidroginástica. Participaram do estudo 10 mulheres fisicamente ativas e sem complicações cardiovasculares (26,6 +-2,91 anos; 21,95 +- 5,07% gordura), que realizaram 3 sessões experimentais em ordem aleatória 1) sessão de natação com duração de 20 minutos a 70% da FCres 2) sessão de hidroginástica com duração de 20 minutos a 70% da FCres 3) sessão controle. PA e freqüência cardíaca foram mensuradas durante 20 minutos pré-sessão e a cada 15 minutos durante 1 hora após as sessões. Foi empregada ANOVA para medidas repetidas para análise dos dados. Houve redução da pressão arterial sistólica (PAS) de 4,7mmHg após a natação e de 5,6mmHg após a hidroginástica aos 45 minutos de recuperação (p<0,05), mas não houve queda da pressão arterial diastólica (PAD). Ocorreu aumento da PAS e PAD no 15º minuto após a sessão de natação (p<0,05). Ambas modalidades induziram queda de PAS, entretanto, a natação gerou maior sobrecarga cardiovascular. Desta forma, caso o objetivo seja proteção cardiovascular, a hidroginástica pode ser preferível para a população estudada.

The decrease in blood pressure (BP) to below pre-exercise resting values after a session of dynamic exercise was named post-exercise hypotension, and the practice of exercises that evoke this phenomena has been suggested for prevention and treatment of hypertension. This study analyzed the responses of normotensive women blood pressure after a session of swimming, crawl style, and after a session of water aerobics. 10 physically active women with no cardiovascular complications participated in the study (26.6 +-2.91 years, 21.95 +-5.07% body fat), who underwent 3 experimental sessions in randomized order 1) 20 minutes of swimming session at 70% of HRres 2) 20 minutes of water aerobics session at 70% of HRres 3) control session. BP and heart rate were measured during 20 minutes pre-session, and each 15 minutes during 1 hour after the sessions. Repeated measures ANOVA was adopted for data analysis. Reduction of 4,7mmHg and 5,6mmHg on systolic blood pressure (SBP) was observed after swimming and water aerobics respectively (p<0,05) at 45 minutes of recovery, but no decrease in diastolic blood pressure (DBP) was found. There was an increase in SBP and DBP at 15 minutes after the swimming session (p<0.05). Conclusion: Both methods produced post exercise hypotension of SBP, however, the swimming session evoked a greater cardiovascular overload. Thus, if the aim is cardiovascular protection, the water aerobics may be preferable for the population studied.