Acute Consumption of Cooked Green Banana Pulp Beverage (Musa cavendishii) Decreases Plasma Glucose in Healthy Women: A Cross-Sectional Controlled Study.

This study aimed at comparing the carbohydrate composition of three banana varieties (cv. Nanica, Nanicão, and Prata) and investigating the effect of a single dose of cooked green banana pulp beverage (GBPd) on plasma glycemic homeostasis indexes (glucose, PYY, GIP, insulin) and hunger and satiety sensation (visual analog scale-VAS). The bananas were classified according to the color scale. The fiber, total carbohydrate, and resistant starch (RS) were determined using validated methods. Glucose homeostasis indexes and hunger/satiety sensation were determined in ten healthy women in two stages before and after intake: (1) glucose solution (250 g/L); (2) one week later, consumption of the glucose solution plus 75 g/L of GBPd. Blood samples were collected twice in stage-1 and every 15 min for 2 h in stage-2. Cv. Nanicão was selected, because it presented a higher content in RS and dietary fiber on dry base than the other cultivars. Thus, it was used to test glycemic response. After 2 h of GBPd intake, no difference was observed in hunger/satiety sensation and plasma glycemic homeostasis indexes, except for a decrease in plasma glucose concentration (-15%, p = 0.0232) compared to stage-1. These results suggest that cv. Nanicão has a higher potential as a functional ingredient and can influence the reduction in the glycemic index of a meal compared to other cultivars. However, it had not a short-term effect on hormones GIP and PYY in healthy women. Further research is needed to understand the long-term effects and mechanisms of green banana on glycemic control and satiety.

Fat-free mass predictive equation using multifrequency bioelectrical impedance data in adolescent soccer athletes: development and cross-validation.

OBJECTIVES: This study aimed to develop and cross-validate a fat-free mass (FFM) predictive equation using multifrequency bioelectrical impedance analysis (BIA) data in adolescent soccer athletes. METHODS: Male adolescent soccer athletes (n = 149; 13-19 y old) were randomly sorted using Excel and independently selected for development group (n = 100) or cross-validation group (n = 49). The FFM reference values were determined using dual-energy X-ray absorptiometry. Single-frequency BIA was used to plot tolerance ellipses. Multifrequency-BIA raw data were used as independent variables in regression models. Student's independent t-test was used to compare development and cross-validation groups. Stepwise multiple regression was used to develop the FFM predictive equation. Bland-Altman plots, Lin's concordance correlation coefficient, according to McBride criteria, precision, accuracy, and standard error of estimate (SEE) were calculated to evaluate the concordance and reliability of estimates. Bioelectrical impedance vector analysis was plotted to assess hydration status. RESULTS: No differences (P > 0.05) were observed between development and validation groups in chronological age, anthropometric data, bioelectrical impedance data, and FFM values obtained using dual-energy X-ray absorptiometry. Bioelectrical impedance vector analysis tolerance showed that all participants presented adequate hydration status compared to the reference population. The new FFM predictive equation developed and validated: FFM (kg) = -7.064 + 0.592 × chronological age (y) + 0.554 × weight (kg) + 0.365 × height²/resistance (cm²/Ω), presented R² = 0.95; SEE = 1.76 kg; concordance correlation coefficient = 0.95, accuracy = 0.98, and strength of concordance = 0.99. CONCLUSIONS: The present study developed and cross-validated an FFM predictive equation based on multifrequency bioelectrical data providing substantial FFM accuracy for male adolescent soccer athletes.

Fat-free mass predictive equation using bioelectrical impedance and maturity offset in adolescent athletes: Development and cross-validation.

OBJECTIVES: This is a cross-sectional study, aimed to develop and cross-validate a fat-free mass (FFM) predictive equation using single-frequency bioelectrical impedance (BIA), considering the predicted age at peak height velocity (PHV) as a variable. Additionally, the study aims to test the FFM-BIA obtained using a previous predictive equation that used skeletal maturity as a variable. METHOD: The participants (n = 169 male adolescent athletes) were randomly divided into two groups: development of a new predictive equation (n = 113), and cross-validation (n = 56). The concordance test between the FFM values obtained by Koury et al. predictive equation and DXA data was determined (n = 169). Bioelectrical data was obtained using a single-frequency analyzer. RESULTS: Among the models tested, the new predictive equation has resistance index (height2/resistance) and predictive age at PHV as variables and presented R2 = 0.918. The frequency of maturity status using skeletal maturity and PHV diagnosis was inadequate (Kappa = 0.4257; 95%CI = 0.298-0.553). Bland-Altman plots and concordance correlation coefficient showed substantial concordance between the FFM-DXA values (48.8 ± 11.2 kg) and the new predictive equation (CCC = 0.960). The results showed that the new equation performed better than the equation developed by Koury et al. (CCC = 0.901). CONCLUSIONS: Our results show that it is feasible to predict FFM in male adolescent athletes using predictive age at PHV, with moderate concordance. The calculation of FFM using more economical and less complex variables is viable and should be further explored.

One-Year Changes in Bioelectrical Impedance Data in Adolescent Athletes.

Raw bioelectrical impedance (BI) data and vector analysis (BIVA) have been used to evaluate fat-free mass (FFM) cross-sectionally in adolescent athletes; however, there have been no longitudinal studies about it. This study aimed to assess the magnitude of changes in raw BI data (resistance [R], reactance [Xc], and phase angle [PhA]), BIVA, and FFM in adolescent athletes (n = 137, 40% female). BI data were collected using a single-frequency device at baseline and after one year of sports practice. Baseline chronological age categorized the participants (11, 12, or 13 years [y]). In females, Xc/H increased (13 to 14 y, p = 0.04) while R/H decreased in all age groups (p = 0.001). PhA (11 to 12 y, p = 0.048) and FFM (11 to 12 y and 12 to 13 y groups p = 0.001) increased and showed the lowest magnitude of changes in the 13 to 14 y group (p = 0.05). In males, Xc/H decreased (11 to 12 and 12 to 13 y groups, p = 0.001) with a higher magnitude of changes in the 13 to 14 y group (p = 0.004); R/H decreased (p = 0.001); FFM increased in all groups (p = 0.001); however, no magnitude of changes was observed. PhA increased in the 13 to 14 y group (p = 0.004). BIVA showed no differences among ellipse distances in females. In males, a high distance was observed in the 11 to 12 y group. "Time interval" influenced PhA and Xc/H in the female group and R/H and Xc/H in the male group. "Initial age" and "time interval" influenced the increase in PhA in the male group. Raw BI data and BIVA patterns can detect the magnitude of the changes in a sex-dependent manner.

Birth weight, skeletal maturity and dietary patterns are associated with body composition compartments differently in male and female physically active adolescents.

Background: Adequate body composition is important for health and performance of physically active adolescents; however, some factors can influence body composition. Aim: The purpose of this study was to evaluate the association between body composition and birth weight, skeletal maturity and dietary patterns, in male (n = 124) and female (n = 107) physically active adolescents. Methods: Birth weight was obtained from health booklets. Dual-energy X-ray absorptiometry (DXA) was used to estimate fat mass (FM), fat-free mass (FFM), visceral adipose tissue (VAT) and abdominal adipose tissue (ASAT). Skeletal maturity was assessed by a hand and fist scanner using DXA. Food intake was assessed using a food frequency questionnaire and dietary patterns by factorial analysis. Results: Seventy one percent (male = 16%, female = 55%) of the participants were mature. Two dietary patterns (in natura/minimally processed and processed/ultra-processed) were identified. In males, FM (>15%, P = 0.043) and ASAT (>30%, P = 0.042) were higher in those with low-median compared to high-median birth weight. FFM (>24%) was higher in skeletally mature compared to those immatures (P = 0.001), and VAT (>28%) was higher in processed/ultra-processed compared to in natura/minimally processed dietary patterns (P = 0.015). In females, FFM (>9%) was higher in those with low-median compared to high-median birth weight (P = 0.019); and FFM (>16%), FM (>28%) and ASAT (>45%) were higher in skeletally mature compared to those immatures (P = 0.001). Conclusion: Our results may contribute to a better understanding of the complex association among body composition, birth weight, skeletal maturity and dietary patterns and in physically active adolescents, differently according to sex.

HortEnsiA: adaptação transcultural do Garden Resource, Education, and Environment Nexus e estudo fatorial de validação / HortEnsiA: cross-cultural adaptation of the Garden Resource, Education, and Environment Nexus and factorial validation study

Resumo Introdução As hortas escolares como ambiente educador, reconhecidamente, têm desempenhado importantes mudanças nas atitudes dos estudantes. Porém, apesar dos aspectos positivos já descritos, não há no Brasil um instrumento que avalie a adesão da escola às propostas da horta escolar. Objetivo O presente estudo objetivou traduzir, adaptar transculturalmente e validar o instrumento Garden Resource, Education, and Environment Nexus (GREEN), após autorização da autora Kate Gardner Burt. Método O processo de operacionalização da adaptação transcultural baseou-se nos procedimentos sugeridos pela Organização Mundial da Saúde. O estudo psicométrico foi realizado por Análise Fatorial Exploratória. Resultados O instrumento traduzido e adaptado transculturalmente foi respondido por 123 servidores de 93 escolas do município do Rio de Janeiro. Ao longo do processo da adaptação transcultural do instrumento original em inglês "GREEN", foi criado o constructo "HortEnsiA" (Horta, Ensino e Ambiente). Conclusão A avaliação psicométrica aponta a necessidade de uma melhor organização da gestão e das atividades sociais ligadas à horta na escola. A partir da participação de técnicos agrícolas na construção e aplicação do instrumento "HortEnsiA", observou-se que a presença desses profissionais pode contribuir para a otimização da implementação e uso da horta como ambiente educador.

Abstract Background School gardens as an educational environment, admittedly, have played important changes in the attitudes of students. However, despite the positive aspects of the implementation of school gardens are recognized, there is no instrument in Brazil to assess school adherence to the proposal. Objective This study aimed to carry out the cross-cultural adaptation of the Garden Resource, Education, and Environment Nexus ("GREEN") tool, and to validating it for the Brazilian reality. Method The process of operationalizing of cross-cultural adaptation was based on the procedures suggested by the WHO. The psychometric study was carried out by exploratory factor analysis. Results The translated and cross-culturally adapted tool was applied to 125 civil servant respondents from 93 schools in the city of Rio de Janeiro. Throughout the process of transcultural adaptation of the original English "GREEN" tool, the "HortEnsiA" construct was created and properly adapted to Brazilian Portuguese. Conclusion The psychometric assessment points to a better organization of management and social activities related to the school garden at school. It was observed that the participation of agricultural technicians in the construction and application of the "HortEnsiA" tool can contribute to optimize the use of the school garden as an educational environment in the Brazilian reality.

Bioelectrical impedance vector analysis and body composition in cervical spinal cord injury: A pilot study.

Introduction: Body composition assessment in cervical spinal cord injury (c-SCI) individuals is important to monitor the fat free-mass (FFM) loss, due to immobilization, or gain, due to exercise practice. Single frequency bioelectrical impedance analysis (SF-BIA) is low in cost, simple and easy. Objectives: The aims of this study are: to evaluate the concordance between the FFM values obtained using dual X-ray absorptiometry (DXA) and the three SF-BIA previous predictive equations; and to test the applicability of the bioelectrical impedance vector analysis (BIVA). Methods: Twenty-three c-SCI males were divided into two groups: Physically active (PA; n = 13; at least 150 min/week) and non-active individuals (NPA) and were assessed by DXA and SF-BIA simultaneously. Results: FFM values were similar between groups PA and NPA. Considering all participants, FFM values obtained by Kocina and Heyward (>11%) and Sun (<15.4%) predictive equations were different when compared to DXA (p < 0.01). However, Buchholz's et al. predictive equation showed FFM values similar to DXA, but presented poor concordance (<7%, p = 0.99; concordance coefficient = 0.85). BIVA showed consistency in ellipse distribution using FFM obtained using Buchholz et al. predictive equation. Conclusions: The use of non-specific BIA equations can lead to misinterpretation in FFM values in male c-SCI individuals. Predictive equations for this group need to be developed.

Fat-Free Mass Using Bioelectrical Impedance Analysis as an Alternative to Dual-Energy X-Ray Absorptiometry in Calculating Energy Availability in Female Adolescent Athletes.

Energy availability (EA) is calculated by subtracting exercise energy expenditure from energy intake, adjusted for fat-free mass (FFM) obtained using accurate methods, such as dual-energy X-ray absorptiometry (DXA). Unlike DXA, the bioelectrical impedance analysis (BIA) is low in cost, simple and easy to carry out. This study aimed to test the concordance between the calculation of EA using FFM values from four BIA predictive equations and FFM obtained using DXA in female adolescent athletes (n = 94), recruited via social media. Paired Student's t test, Wilcoxon test, Lin's concordance correlation coefficient, root mean square error, limits of agreement, and mean absolute percentage error were used to evaluate agreement between the FFM values obtained by the four SF-BIA predictive equations and DXA. Regression linear analysis was used to determine the relation between FFM values obtained using DXA and the BIA predictive equations. Standardized residuals of the FFM and EA were calculated considering DXA values as reference. The most appropriate model for the FFM (limits of agreement = 4.0/-2.6 kg, root mean square error = 1.9 kg, mean absolute percentage error = 4.34%, Lin's concordance correlation coefficient = .926) and EA (limits of agreement = 2.51/4.4 kcal·kg FFM-1·day-1, root mean square error = 1.8 kcal·kg FFM-1·day-1, mean absolute percentage error 4.24%, Lin's concordance correlation coefficient = .992) was the equation with sexual maturity as a variable, while the equation with the greatest age variability was the one with the lowest agreement. FFM-BIA predictive equations can be used to calculate EA of female adolescent athletes. However, the equation should be chosen considering sex, age, and maturation status. In the case of athletes, researchers should use equations developed for this group.

Reference Percentiles for Bioelectrical Phase Angle in Athletes.

The present study aimed to develop reference values for bioelectrical phase angle in male and female athletes from different sports. Overall, 2224 subjects participated in this study [1658 males (age 26.2 ± 8.9 y) and 566 females (age 26.9 ± 6.6 y)]. Participants were categorized by their sport discipline and sorted into three different sport modalities: endurance, velocity/power, and team sports. Phase angle was directly measured using a foot-to-hand bioimpedance technology at a 50 kHz frequency during the in-season period. Reference percentiles (5th, 15th, 50th, 85th, and 95th) were calculated and stratified by sex, sport discipline and modality using an empirical Bayesian analysis. This method allows for the sharing of information between different groups, creating reference percentiles, even for sports disciplines with few observations. Phase angle differed (men: p < 0.001; women: p = 0.003) among the three sport modalities, where endurance athletes showed a lower value than the other groups (men: vs. velocity/power: p = 0.010, 95% CI = -0.43 to -0.04; vs. team sports: p < 0.001, 95% CI = -0.48 to -0.02; women: vs. velocity/power: p = 0.002, 95% CI = -0.59 to -0.10; vs. team sports: p = 0.015, 95% CI = -0.52 to -0.04). Male athletes showed a higher phase angle than female athletes within each sport modality (endurance: p < 0.01, 95% CI = 0.63 to 1.14; velocity/power: p < 0.01, 95% CI = 0.68 to 1.07; team sports: p < 0.01, 95% CI = 0.98 to 1.23). We derived phase angle reference percentiles for endurance, velocity/power, and team sports athletes. Additionally, we calculated sex-specific references for a total of 22 and 19 sport disciplines for male and female athletes, respectively. This study provides sex- and sport-specific percentiles for phase angle that can track body composition and performance-related parameters in athletes.

Bioimpedance Vector Patterns according to Age and Handgrip Strength in Adolescent Male and Female Athletes.

Bioelectric Impedance Vector Analysis (BIVA) can be used to qualitatively compare individuals' hydration and cell mass independently of predictive equations. This study aimed to analyze the efficiency of BIVA considering chronological age and handgrip strength in adolescent athletes. A total of 273 adolescents (male; 59%) engaged in different sports were evaluated. Bioelectrical impedance (Z), resistance (R), reactance (Xc), and phase angle (PhA) were obtained using a single-frequency bioelectrical impedance analyzer. Fat-free mass (FFM) and total body water were estimated using bioimpedance-based equations specific for adolescents. Female showed higher values of R (5.5%, p = 0.001), R/height (3.8%, p = 0.041), Z (5.3%, p = 0.001), and fat mass (53.9%, p = 0.001) than male adolescents. Male adolescents showed higher values of FFM (5.3%, p = 0.021) and PhA (3.1%, p = 0.033) than female adolescents. In both stratifications, adolescents (older > 13 years or stronger > median value) shifted to the left on the R-Xc graph, showing patterns of higher hydration and cell mass. The discrimination of subjects older than 13 years and having higher median of handgrip strength values was possibly due to maturity differences. This study showed that BIVA identified age and strength influence in vector displacement, assessing qualitative information and offering patterns of vector distribution in adolescent athletes.

Bioelectrical impedance analysis-derived phase angle is related to risk scores of a first cardiovascular event in adults.

OBJECTIVE: The aim of this study was to investigate the association between phase angle (PhA) and first cardiovascular (CV) event risk. METHODS: This was a cross-sectional study. PhA was determined using a single-frequency bioelectrical impedance analyzer. Scores from the American College of Cardiology/American Heart Association (ACC/AHA; N = 455; 49% men) and the Framingham General Cardiovascular (FRS-CVD; N = 489; 49% men) were used to estimate the risk for a first CV event in adults. Logistic and multinomial regressions were used to evaluate the relationship between ACC/AHA and FRS-CVD risk scores (outcomes) and PhA. Additionally, the consumption of in natura or minimally processed foods was included in the models as an adjustment variable. RESULTS: Men and women, classified according to ACC/AHA (P < 0.001; P = 0.035) and FRS-CVD scores (P = 0.002; P = 0.012) as low risk for first event CV, presented higher PhA values than participants with elevated risk. However, only in men categorized as CV high risk, the third PhA tertile (>7.3°) was associated with a CV lower risk (ACC/AHA, odds ratio, 0.28; 95% confidence interval [CI], 0.14-0.56; FRS-CVD, relative risk ratio, 0.11; 95% CI, 0.03-0.37). The adjustment of all models for consumption of in natura or minimally processed foods did not change the results. CONCLUSION: Higher PhA values were associated with lower risk for a first CV event in men classified in higher-risk categories. In natura or minimally processed food consumption did not influence the relationship between PhA and CV risk. These results may encourage future research about possible applications of PhA as an additional index in primary prevention of CV events.

Healthy eating promoting in a Brazilian sports-oriented school: a pilot study.

BACKGROUND: Adolescents, particularly athletes, have high exposure to ultra-processed foods, which could be harmful to their health and physical performance. School environments are capable of improving eating patterns. Our study is aimed at capturing changes in students' food consumption three years after they enrolled at an experimental school, considered a model of health promotion in Rio de Janeiro city. We also aimed to depict the promising nature of the healthy eating promotion program implemented in the school and share the learnings from its implementation. METHODS: Our pilot study was a follow-up on the implementation of a school garden, experimental kitchen activities, and health promotion classes. We evaluated 83 adolescent athletes' food consumption twice during the study: at its beginning (2013) and end (2016), by administering a food frequency questionnaire (FFQ) that inquired about the frequency of foods consumed in the past week. To evaluate how effectively the activities were established, integrated, and sustained in schools, the Garden Resources, Education, and Environment Nexus (GREEN) tool was used, and the school's adherence to the school garden program was classified as high (scored 47 points out of 57). RESULTS: In 2013, 89 adolescents (mean ± SD 11.9 ± 0.4 years, 54% male) participated in the study, of which 83 continued until 2016 (14.8 ± 0.5 years, 55% male). In 2013, the mean frequency of raw salad and fruits consumption was 1.4 (CI [1.0-1.9]) and 4.3 (CI [3.8-4.9]) days per week, respectively. Three years later, the frequency of raw salad and fruits consumption was 2.2 (CI [1.6-2.7]) and 5.0 (4.5-5.5), respectively. Considering that five meals were offered at school (five days/week), it may be possible to assume that the program raised awareness on the importance of healthy eating. CONCLUSION: Our results suggest that such integrated healthy eating promotion programs may improve adolescent athletes' eating habits, by increasing the frequency of their consumption of unprocessed foods. This pilot study's results inspired us to implement an expanded project at the municipal level. Since 2018, teachers who participated in this program are working with Rio de Janeiro's Municipal Secretary of Education for Coordination of Curricular Projects. Some learnings from this pilot study on implementing the garden/experimental kitchen project in this school are being applied in 65 schools of the municipal network: joint activities must be fostered among students, teachers, and parents; healthy eating needs to be a respected value among adolescent athletes and become an example for parents and teachers.

Smoking status affects bioimpedance-derived phase angle in men but not in women: The Pró-Saúde Study, Brazil.

OBJECTIVE: Phase angle (PhA) is determined by bioelectrical impedance (BIA) and it is interpreted as an index of cell membrane integrity. Smokers are susceptible to systemic oxidative stress and often adopt unhealthy habits, which may contribute to cellular damage. This unfavorable conjuncture may result in lower PhA in smokers. The aim of this study was to investigate the association between PhA and smoking status. METHODS: This cross-sectional study included 247 (48%) adult men. Body composition and PhA were determined using dual-energy x-ray absorptiometry and BIA, respectively. Blood sampling, food habits, and smoking status information were collected. Statistical analyses were performed for each sex separately. Analysis of covariance controlling for body mass index and age compared PhA values across smoking categories. Multiple linear regression determined whether smoking status was a PhA predictor. RESULTS: PhA was lower in male current smokers (6.6 ± 0.13°) compared with never-smokers (7 ± 0.06°; P = 0.038). The ratio of extracellular to intracellular water was higher in current (P = 0.003) and former male smokers (P = 0.006) compared with never-smokers. Body composition did not differ in male and female smoking categories. Male current smokers ingested more calories, protein, carbohydrates, and alcohol than never and former smokers (P < 0.05). Current female smokers had higher alcohol consumption compared with never smokers (P = 0.019). Male current smokers presented lower than never-smokers (unstandardized ß coefficient = -0.202; 95% confidence interval, -0.359 to -0.046). Smoking status was associated with PhA decrease only in men. CONCLUSION: The results from the present study suggest that being a current smoker results in lower PhA in men, even when controlling for other variables.

Fat-free mass in adolescent athletes: Accuracy of bioimpedance equations and identification of new predictive equations.

OBJECTIVES: The aims of this study were to evaluate the effect of biological maturity on body composition in Brazilian adolescent athletes, to verify the accuracy of previous bioimpedance predictive equations for estimating fat-free mass (FFM), and to develop new predictive equations, considering sexual and skeletal maturity. METHODS: There were 318 Brazilian adolescent athletes (52% male) involved in this study. FFM was determined using single-frequency (50 kHz) bioelectrical impedance analysis (BIA) and dual-energy x-ray absorptiometry (DXA), which was used as the reference method. The adolescents were classified into skeletally mature using bone age (both sexes), and sexually mature using menarche occurrence (female). The effect of maturity on bioelectrical values was tested using bioelectrical impedance vector analysis. Three predictive BIA equations to estimate FFM were selected from the reviewed literature. Lin's concordance correlation coefficient and Bland-Altman test were used to test the concordance and accuracy of BIA equations. Stepwise multiple regression was used to develop new predictive equations, considering BIA vectors, age, skeletal, and sexual maturity. RESULTS: DXA and BIA results showed wide limits of disagreement for FFM for all the three equations. Two new equation models were developed, including age and skeletal maturity for both sexes and menarche status for females. Both models showed high R2 (males = 0.92 and females = 0.84). CONCLUSIONS: The assessment of body composition in adolescent athletes should consider sexual (female) or skeletal (male) maturity. The newly proposed equations showed promising results in Brazilian adolescent athletes. A test in different groups and populations is necessary to evaluate the general suitability of the equations in adolescents.

Serum Hepcidin Concentration in Individuals with Sickle Cell Anemia: Basis for the Dietary Recommendation of Iron.

Dietary iron requirements in patients with sickle cell disease (SCD) remain unclear. SCD is a neglected hemoglobinopathy characterized by intense erythropoietic activity and anemia. Hepcidin is the hormone mainly responsible for iron homeostasis and intestinal absorption. Intense erythropoietic activity and anemia may reduce hepcidin transcription. By contrast, iron overload and inflammation may induce it. Studies on SCD have not evaluated the role of hepcidin in the presence and absence of iron overload. We aimed to compare serum hepcidin concentrations among individuals with sickle cell anemia, with or without iron overload, and those without the disease. Markers of iron metabolism and erythropoietic activity such as hepcidin, ferritin, and growth differentiation factor 15 were evaluated. Three groups participated in the study: the control group, comprised of individuals without SCD (C); those with the disease but without iron overload (SCDw); and those with the disease and iron overload (SCDio). Results showed that hepcidin concentration was higher in the SCDio > C > SCDw group. These data suggest that the dietary iron intake of the SCDio group should not be reduced as higher hepcidin concentrations may reduce the intestinal absorption of iron.

Bioimpedance parameters in adolescent athletes in relation to bone maturity and biochemical zinc indices.

Phase angle (PA) is derived from resistance and reactance determined by bioimpedance analysis (BIA) and it appears to relate to cellular stability and integrity. Interpretation of PA values could be complemented by bioelectrical impedance vector analysis (BIVA), which relates to body hydration and structure. Body composition, age, sex, and nutrients are known to stabilize cell membranes, such as zinc, have been related to PA although information is scarce in adolescent athletes. The aim of the present study was to assess the association of body composition, skeletal maturity and zinc biochemical indices with phase angle and bioelectrical impedance parameters, in forty male adolescent soccer athletes (13.4±0.6years). BIA was performed with a single-frequency tetrapolar analyzer. PA and BIVA were determined using resistance and reactance BIA data. Plasma and erythrocyte zinc concentrations were measured using inductively coupled plasma-optical emission spectrometry. Body composition was determined by dual-energy X-ray absorptiometry, and bone age by hand X-ray measurements. PA was higher in adolescents classified by bone age as "Early" (6.8±0.9°) compared to "Late" (5.7±0.5°) (p<0.05). PA correlated with bone age (r=0.562), BMI (r=0.382), fat-free mass (r=0.468), and erythrocyte zinc (r=0.379) (p<0.05). BIVA confidence ellipses were sensitive to skeletal maturity status. Phase angle was higher in adolescents with erythrocyte zinc concentration above the median (>0.66µmol.g hemoglobin-1) compared to those below the median. Multiple linear regression analysis showed that bone age (B=0.254, p=0.001) and erythrocyte zinc concentration (B=1.168, p=0.047) were significantly related to PA in this group, and accounted for 34% of its variability. Our results indicate that bone age and zinc erythrocyte contribute to PA values in the young male soccer athletes and that BIVA is influenced by skeletal maturity status in this group.

Biological maturation assessment methods in adolescent soccer players considering zinc status / Métodos de evaluación de la maduración biológica en jugadores adolescentes de fútbol considerando el estado de zinc

SUMMARY: The purpose of this study was to compare different methods of maturity evaluation and their relation with performance-related physical and anthropometric variables in young soccer players, with different plasma zinc status. A total of 53 healthy male young soccer players (age: 13±1 years; body mass: 48±10 kg; stature: 160±10 cm) participated in this study. Variables from physical fitness (stature, ST; fat-free mass, FFM; handgrip strength in the dominant hand, DHS), testosterone and zinc plasma concentration were measured. Biological maturity was evaluated by sexual maturity (development of: pubic hair, PH; genitals, GD; axillary hair; AH), bone maturity (TW3 method; BA), and testosterone plasma concentration methods. We observed that: (i) the frequency of hypozincemics and normozincemics children stratified by BA-CA, PH and GD were similar in each category; (ii) the BA allowed the identification of differences between the three categories, in at least two performance-related variables (FFM and DHS, p<0.0001); (iii) the AH method was able to discriminate only for DHS (p<0.0001); and (iv) the testosterone method was not able to identify differences between the four maturation categories with regard to ST, FFM, and DHS. Results suggested that Zinc deficiency did not influence the results obtained for the maturation categories defined by the different assessment methods. The assessment of biological maturation by BA seems to be the most effective for the stratification of performance-related and anthropometric variables in young soccer players. Nevertheless, the AH method should also be considered as a fair option to be used in field studies and practice.

RESUMEN: El objetivo de este estudio fue comparar diferentes métodos de evaluación de madurez y su relación con variables físicas y antropométricas relacionadas con el desempeño en jóvenes jugadores de fútbol, con diferentes niveles plasmáticos de zinc. Participaron en este estudio 53 jugadores de fútbol jóvenes sanos (edad: 13 ± 1 años, masa corporal: 48 ± 10 kg, estatura: 160 ± 10 cm). Se midieron las variables de la aptitud física (estatura, ST, masa libre de grasa, FFM, fuerza de agarre en la mano dominante, DHS), testosterona y concentración plasmática de zinc. Se evaluaron la madurez sexual (desarrollo de vello púbico, PH, genitales, DG, cabello axilar, AH), madurez ósea (método TW3, BA) y concentración plasmática de testosterona. Se observó que: (i) la frecuencia de los niños hipoxincémicos y normozincémicos estratificados por BA-CA, PH y GD fueron similares en cada categoría; (ii) el BA permitió la identificación de diferencias entre las tres categorías, en al menos dos variables relacionadas con el desempeño (FFM y DHS, p <0,0001); (iii) el método AH fue capaz de discriminar sólo para DHS (p <0,0001); y (iv) el método de testosterona no fue capaz de identificar diferencias entre las cuatro categorías de maduración con respecto a ST, FFM y DHS. Los resultados sugirieron que la deficiencia de zinc no influyó en los resultados obtenidos para las categorías de maduración definidas por los diferentes métodos de evaluación. La evaluación de la maduración biológica por BA parece ser la más efectiva para la estratificación de variables de rendimiento y antropométricas en jóvenes jugadores de fútbol. Sin embargo, el método AH también debe ser considerado como una opción justa para ser utilizado en estudios de campo y práctica.

Methodological agreement between body-composition methods in young soccer players stratified by zinc plasma levels / Acuerdo metodológico entre los métodos de composición corporal en jugadores jóvenes de fútbol estratificados por los niveles plasmáticos de zinc

It is feasible to think that the body composition assessment may be influenced by maturational and zinc status, especially in young athletes, which perform regularly high volume of physical training. In accordance, it seems important to clarify the impact of these factors in body composition assessment in athletes, since errors may lead to mistakes in training prescription and diet elaboration, and therefore affect the athletic performance. The objective was to compare (1) different methods of body composition evaluation in young soccer players stratified by zinc plasma levels; and (2) the two reference methods using skinfolds thickness in children (Slaughter's and Lohman's equations), considering the maturation level. In this cross-sectional study, fifty tree young soccer players (13.3±0.7 y) were submitted to blood collection, electric bioimpedance (BIA), dual energy X-ray absorptiometry (DXA), anthropometric measures (body mass, stature and skinfolds thickness (ST)) and hand-wrist X-ray. Body composition evaluation was performed by: DXA, ST (Lohman and Slaughter equations) and BIA (Houtkooper equation) methods. Zinc status provided two groups: Normozincemic and Hypozincemic athletes, determined by cut-off point of 11.0 µmol/L. Significant difference on descriptive data for all participants after zinc status stratification was observed only for plasma zinc concentration; (2) Significant correlations were observed between the assessment methods (fat percentage: r= 0.34 to 0.98 and p<0.001 to 0.013; fat free mass: r= 0.95 to 0.9998 and p<0.001), and lowers correlations were observed when electric impedance was involved; and (3) Bland-Altman plots across methods showed a closer agreement when DXA and ST were compared. In conclusion (1) The ST method was better than BIA to assess the body composition (in young soccer players) when DXA scans are not available; (2) The comparison of models based on ST showed that the best association with the values from DXA were obtained for the Slaughter equation, followed by the Lohman equation using bone age instead of chronological age; and (3) Plasma zinc levels seem not to influence the body composition assessment, which certainly warrants further studies.

Es factible pensar que la evaluación de la composición corporal puede estar influenciada por el estado de maduración y los niveles plasmáticos de zinc, especialmente en atletas jóvenes, que regularmente realizan un alto volumen de entrenamiento físico. Por tanto, es importante aclarar el impacto de estos factores en la evaluación de la composición corporal de los atletas, ya que errores en su análisis pueden conducir al desarrollo de una equivocada prescripción de entrenamiento, además de una dieta determinada, y por lo tanto afectar el rendimiento deportivo. El objetivo de esta investigación consistió en: (1) comparar los diferentes métodos de evaluación de la composición corporal en futbolistas jóvenes estratificados por los niveles plasmáticos de zinc; (2) comparar los dos métodos de referencia utilizando el espesor de los pliegues cutáneos en niños (ecuaciones de Slaughter y Lohman), teniendo en cuenta el nivel de maduración. En este estudio transversal, cincuenta futbolistas jóvenes (13,3±0,7 años) fueron sometidos a un perfil bioquímico de sangre, bioimpedancia eléctrica (BIA), absorciometría de rayos X de energía dual (DXA), medidas antropométricas (masa corporal, estatura y pliegues cutáneos de espesor (ST)) y radiografía de mano-muñeca. La evaluación de la composición corporal se realizó por: DXA, ST (ecuaciones Lohman y Slaughter) y BIA (ecuación Houtkooper). El nivel de zinc identificó dos grupos: deportistas normozincémicos e hipozincémicos, determinados por un punto de corte de 11,0 mmol/L. Se observó una diferencia significativa en los datos descriptivos de todos los participantes después de la estratificación del estado de zinc sólo para la concentración de zinc en plasma; se observaron correlaciones significativas entre los métodos de evaluación (porcentaje de grasa: r= 0,34 a 0,98 y p <0,001 a 0,013; masa libre de grasa: r= desde 0,95 hasta 0,9998 y p <0,001), y disminuyeron las correlaciones al estar involucrada la impedancia eléctrica. Los resultados a través de los métodos Bland y Altman mostraron un acuerdo más cercano al comparar DXA y ST. El método ST fue mejor que el BIA para evaluar la composición corporal (en los jugadores jóvenes de fútbol), cuando no estaban disponibles los escaneos DXA. La comparación de los modelos basados en ST mostró que la mejor asociación de valores DXA se obtuvieron para la ecuación Slaughter, seguidos por la ecuación Lohman utilizando la edad ósea en lugar de la edad cronológica. Los niveles de zinc en plasma parecen no influir en la evaluación de la composición corporal, lo que amerita más estudios.