Endurance training associated with a hypocaloric diet in obese university students / Treino aeróbico associado a dieta hipocalórica em universitários obesos / Entrenamiento aeróbico asociado a dieta hipocalórica en universitarios obesos

ABSTRACT Introduction: The long-term energy imbalance between intake and consumption is the main reason for obesity in college students. Therefore, weight loss should also combine an inversely proportional intervention. Based on this premise, a growing number of studies combine physical training and diet to restore physical health in this population group. Objective: Study the impacts of endurance training associated with a low-calorie diet on the constitution and metabolism of obese college students. Methods: Through a questionnaire survey and a 4-week experimental endurance training program and hypocaloric diet, 20 obese college students volunteered for the intervention project. The exercise protocol for the training composition and the diet menu followed the updated recommendations in the scientific literature. At the end of the experiment, the relevant data collected were statistically analyzed and discussed. Results: After the diet intervention associated with endurance training, the BMI index of college students reduced from 28,075 to 26,378; the basal metabolic rate increased from 1581,046 kcal to 1681,317 kcal. Conclusion: Endurance training associated with a hypocaloric diet significantly reduced fat in obese college students. The efficacy of this association promoted a better joint effect on the outcome, compared to individual weight loss plans. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: O desequilíbrio energético entre ingestão e consumo a longo prazo é o principal motivo da obesidade nos universitários, portanto, a perda de peso também deve combinar uma intervenção inversamente proporcional. Valendo-se dessa premissa, são crescentes os estudos que combinam treinos físicos e dietas com o propósito de restaurar a saúde física nessa parcela da população. Objetivo: Estudar os impactos do treino aeróbico associado a dieta hipocalórica sobre a constituição e o metabolismo de estudantes universitários obesos. Métodos: Através de uma pesquisa por questionário e um programa experimental com duração total de 4 semanas de treino aeróbico e dieta hipocalórica, 20 universitários obesos voluntariaram-se para o projeto de intervenção. O protocolo de exercícios para a composição do treino e o cardápio da dieta seguiram as recomendações atualizadas da literatura científica. Ao final do experimento, os dados relevantes coletados foram analisados estatisticamente e discutidos. Resultados: Após a intervenção da dieta associada ao treino aeróbico, o índice IMC de estudantes universitários reduziu de 28.075 para 26.378; o índice metabólico basal aumentou de 1581.046 kcal para 1681.317 kcal. Conclusão: O treino aeróbico associado à dieta hipocalórica demonstrou um efeito significativo na diminuição da gordura dos universitários obesos. A eficácia dessa associação promoveu um melhor efeito conjunto no resultado, em comparação a planos individuais de emagrecimento. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

Resumen Introducción: El desequilibrio energético entre la ingesta y el consumo a largo plazo es la razón principal de la obesidad en los estudiantes universitarios, por lo tanto, la pérdida de peso también debe combinar una intervención inversamente proporcional. Aprovechando esta premisa, cada vez son más los estudios que combinan entrenamiento físico y dietas con el fin de restablecer la salud física en esta parte de la población. Objetivo: Estudiar los impactos del entrenamiento aeróbico asociado a dieta hipocalórica sobre la constitución y el metabolismo de estudiantes universitarios obesos. Métodos: Mediante una encuesta con cuestionario y un programa experimental con una duración total de 4 semanas de entrenamiento aeróbico y dieta hipocalórica, 20 estudiantes universitarios obesos se presentaron como voluntarios para el proyecto de intervención. El protocolo de ejercicios para la composición del entrenamiento y el menú dietético siguieron las recomendaciones actualizadas de la literatura científica. Al final del experimento, se analizaron y discutieron estadísticamente los datos pertinentes recogidos. Resultados: Tras la intervención dietética asociada al entrenamiento aeróbico, el índice de IMC de los estudiantes universitarios se redujo de 28,075 a 26,378; el índice metabólico basal aumentó de 1581,046 kcal a 1681,317 kcal. Conclusión: El entrenamiento aeróbico asociado a una dieta hipocalórica mostró un efecto significativo en la reducción de grasa en estudiantes universitarios obesos. La eficacia de esta asociación promovió un mejor efecto conjunto sobre el resultado en comparación con los planes individuales de pérdida de peso. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Restrictive diet or excessive exercise: ¿What are the adolescents choose to reduce the size? / Dieta restringida o ejercicio excesivo: ¿Qué eligen las adolescentes para reducir la talla?

The socio-cultural or peer pressure on pre-adolescents and adolescents who desire a perfect body figure can lead to the practice of excessive exercise and/or restrictive diet in order to achieve thinness. So the purpose of this study is to evaluate both factors in a group of Mexican women who practice organized and disciplined physical activity in an institutional framework and Mexican female who don't practice it. The sample consisted on N= 774 women: n=387 practice physical activity and n=387 do not exercise in a disciplined manner. The average age was M=11.8, SD=2.2 with a range between 9 and 16 years old. It was used a scale that measure dietary risk factors and one that measure excessive exercise. Results. An ANOVA generated a model that suggests that women who don't practice organized and disciplined exercise and are more exercise dependence, incur in more restrictive diet. It follows that among the girls who don't practice organized physical activity (exercise) dependence could be reduced to an attitude towards physical exercise combined with restricted diet, for weight control and reducing size. This suggests that physical activity, sports and recreational organized activities organized within an institutional framework promotes eating health.

La presión cultural sobre púberes y adolescentes que desean una figura ideal puede orillarlas a la práctica de ejercicio excesivo y/o dieta restringida con el fin de alcanzar la delgadez. Por ello el propósito del presente trabajo es evaluar ambos factores en un grupo de mujeres mexicanas que practican actividad física organizada y otro que no la practica. La muestra quedó formada por N=774 mujeres: n=387 practican ejercicio y n=387 no lo practican de forma disciplinada. La edad promedio fue M=11.8, DE= 2.2 con un rango de entre 9 y 16 años. Se utilizó una escala que mide factores alimentarios de riesgo y una que mide factores deportivos. Resultados. Un ANOVA generó un modelo que sugiere que las mujeres que no practican actividad física organizada y que son más dependientes al ejercicio incurren más en la dieta restringida. De ello se deduce que entre las chicas que no practican actividad física organizada la dependencia al ejercicio podría reducirse a una actitud hacia el ejercicio físico que además combinan con dieta restringida para controlar el peso y reducir la talla. Esto sugiere que la actividad físico-deportiva-recreativa-organizada dentro de un marco institucional promueve la salud alimentaria.

Comparing Body Image and Risky Eating Behavior between Mexican and German Women / Comparando Imagen Corporal y Conducta Alimentaria de Riesgo entre Mujeres Mexicanas y Alemanas

Background. Body dissatisfaction is regarded as a powerful risk factor for dietary restraint and bulimic behavior among women. Objective. To compare Mexican and German women's body image and eating risk factors by developing structural models to find similarities or differences between the two samples. Participants. The non-random sample of N = 404 (Mexican: 175; German: 229) medical and nursing students (total Mage = 20.6, SD = 0.86) answered standardized scales (EAT and EDI) and a culture-free 10-silhouette scale on body dissatisfaction. Hypothesis. The main hypothesis proposed that Mexican women will show a stronger relationship between body dissatisfaction and restrained diet than the German women will. Results.The findings confirmed this hypothesis by showing that in the relationship dissatisfaction-dieting, the Mexican group obtained the highest values of the correlation and determination coefficients, compared to the German group. Discussion.Mexican women underestimated their body size, and it could be that body size underestimation lessens social pressure. It is concluded that whether this may be seen as a contradictory result or as a cognitive-defensive strategy in order to minimize the pressure experienced must be decided with further investigation.

Antecedentes. La insatisfacción corporal es un poderoso factor de riesgo para dieta restringida y conducta bulímica en mujeres. Objetivo. Comparar imagen corporal y conducta alimentaria de riesgo en mujeres mexicanas y alemanas mediante el desarrollo de modelos estructurales detectando al mismo tiempo similitudes y diferencias. Participantes. La muestra no aleatoria de N = 404 estudiantes de medicina y enfermería (175 mexicanas y 229 alemanas) con una Media total = 20.6 años (DE = 0.86) respondió a escalas estandarizadas (EAT y EDI) y a una escala de insatisfacción corporal de 10- siluetas libre de influencia cultural. Hipótesis. Las mexicanas mostrarán una relación más fuerte entre insatisfacción corporal y dieta restringida que las alemanas. Resultados. Los hallazgos confirman la hipótesis, mostrando que el grupo mexicano obtuvo los coeficientes (de correlación y de determinación) más altos en la relación insatisfacción-dieta. Discusión. Las mexicanas subestiman el tamaño de su cuerpo y se asume que dicha subestimación podría tener como propósito disminuir la presión social. Se concluye que si esto puede interpretarse como un resultado contradictorio o como una estrategia cognitivo defensiva para minimizar la presión experimentada debe decidirse con nuevas investigaciones.

Conductas alimentarias de riesgo y habilidades sociales en una muestra de adolescentes mexicanas / Risk eating behaviors and social skills in a sample of Mexican adolescents

Research about ED (eating disorder) has shown important advances in the last decades. We have distinguished two main ways of aproaching this topic. On the one hand there are several works in the clinical field, focused in studying the symptomatology, psychiatric taxonomy and treatment of those disorders. On the other hand, there is significant research on the epidemiological field, which is more focused towards the understanding of the phenomenon. In fact, this second approach led to the development of the preventive approach in the late 90s. This approach focuses in the population at risk and this work is framed in the preventive approach. The difference between a TCA and a risk factor is that the first one forms a syndrome, a set of symptoms (quantitatively and qualitatively) grouped as diagnostic criteria identified in the DSM-IV-TR. On the other hand, risk factors are those isolated manifestations or symptoms that appear with a lesser magnitude and frequency. For example, abnormal eating behavior like following a diet to control weight or excessive concern about personal body weight. One of the most important factors that occurs before the development of an ED is following a restricted diet. Hence, the risk for people on a diet of turning into clinical cases increases eight times. Moreover, such behavior has become a normative practice, specifically in Western societies. Thus, several authors have pointed out that patients show autonomy problems previous to the disorder. Examples include interpersonal problems such as introversion, insecurity, dependency, social anxiety, lack of assertiveness, difficulty to establish relationships with the opposite gender, inefficiency feelings, failure and lack of control in the academic, working and social fields. All these are indicators of a latent discrepancy of social skills. Considering that restricted dieting represents a fundamental risk factor on the development of an ED, and under the assumption that the deficit in social skills is a predisposing factor in such disorders, the aim of this work was to determine if there is a relation between various social skills and abnormal eating behaviors (following a restricted diet or concern about weight and food) in Mexican adolescent women. We worked with a sample of N = 700 women, coming from five different public middle schools mixed with or = 12.81 years old and SD = 0.73. The data was collected through two instruments: Health and Nourishing Questionnaire, and Pluridimensional Assertive Behavior Scale, adapted to the Mexican population. Among the more relevant results we found a significant correlation between the following two variables: social skills and eating behaviors (dieting r = 0.148, p<0.01 and concern about weight and food r = 0.081, p< 0.05). Although the correlation was low, it can be interpreted as a tendency in the following way: <>. In a second analysis, in which extreme groups (high and low social skills) were compared, our results confirmed the theory about relating these two variables. The mean values indicate that in the first group (low social skills) restricted dieting was a greater problem [t (306) = -1.329, p= .002] than in the second group (high social skills). Other results showed that more than half of the participants (56%) have followed a restricted dieting in the past and 65% of them are concerned about their body weight. Additionally, a significant correlation between these two variables was found (r = 0.677, p<0.01), confirming that these behaviors have become normative among women at this age and these constitute a latent risk to the development of ED. Furthermore, it is a cause of concern that the findings of this study show that girls are involved in restricted dieting even at an early age (seven years old) and that at six years old they begin to be concerned about their body weight. These results are similar to other studies that show women starting practices that might produce eating disorders at very early stages nowadays, due to being more exposed and more vulnerable to social pressure that promotes the thinness culture. One of the most interesting contributions was the fact that among Mexican adolescent women, similarly to women in the western world (USA, France or Spain), we have found a relation between low levels in social skills and restricted dieting. This phenomenon increases the risk of suffering from an ED, and shows the effects of social pressure referring to the thinness culture in countries such as Mexico, with its still developing society. It is important to point out that, in order to make the relation clear, it is necessary to accomplish more research towards determining a causal relationship between the two variables. In this way, data can be obtained in order to build up prevention strategies in the following way: training in Social Skills (TSS) could act as a protection factor against the development of these disorders. If a deficit in social skills can predict weight control dieting, the TSS might decrease or eliminate the risk in adolescents frequently subdued to dieting and/or show risky eating behavior as a consequence of social pressure towards thinness. Among the limitations of this study we can mention that the results cannot be generalized from the particular study sample. For this purpose we propose working with probabilistic samples and with different features, as well as implementing a new analysis that could show the specific social skills in which the problem is accentuated. This would contribute to search the possible causal link between the variables <> and <>.

En las investigaciones relacionadas con los trastornos de la conducta alimentaria (TCA) se distinguen dos vertientes principales. Por una parte proliferan los trabajos en el ámbito clínico, éstos se enfocan en la sintomatología, en esclarecer la taxonomía psiquiátrica y en el tratamiento de dichos trastornos. Por otra parte, se constata la investigación en el ámbito epidemiológico, la cual está más enfocada en la comprensión del fenómeno. De esta segunda vertiente se deriva, a principios de la década de los noventa, el enfoque preventivo, el cual centra su interés en la población de riesgo. Es en este enfoque en el cual se enmarca el presente trabajo. La distinción entre un TCA y un factor de riesgo es que el primero conforma un síndrome, un conjunto de síntomas (cuantitativa y cualitativamente) agrupados como criterios diagnósticos señalados en el DSM-IV-TR, mientras que los factores de riesgo son aquellas manifestaciones o síntomas aislados que se presentan con menor magnitud y frecuencia. El presente trabajo tuvo como objetivo determinar si existe relación entre las variables: habilidades sociales y conductas alimentarias anómalas (seguimiento de dieta restringida y preocupación por el peso y la comida) en mujeres adolescentes mexicanas. Se trabajó con una muestra de N = 700 mujeres de cinco distintas secundarias públicas mixtas con o = 12.81 de edad y DE = 0.73. Los datos se recopilaron mediante dos instrumentos: el Cuestionario de Alimentación y Salud, y la Escala Pluridimensional de Conducta Asertiva adaptada a población mexicana. Entre los resultados de mayor relevancia se encontró una correlación significativa entre las variables: habilidades sociales y conductas alimentarias anómalas (dieta r = 0.148, p< 0.01 y preocupación por el peso y la comida r = 0.081, p< 0.05). Aunque la correlación fue baja resultó ser positiva, esto se puede interpretar como una tendencia en la siguiente dirección: <>. En un segundo análisis en el cual se compararon grupos extremos (nivel alto y nivel bajo de habilidades sociales), se encontraron resultados que confirman la relación entre estas variables. El valor de las medias indica que en el grupo con nivel bajo de habilidades sociales se reportó una mayor problemática durante el seguimiento de una dieta restringida [t (306) = -1 .329, p = .002], comparado con el grupo de nivel alto de habilidades. Una de las aportaciones más interesantes fue el hecho de que entre las adolescentes mexicanas, a semejanza de mujeres que habitan en países de primer mundo como EU, Francia y España, se encontró una relación entre niveles bajos de habilidades sociales y el seguimiento de una dieta restringida. Este fenómeno incrementa el riesgo de padecer un TCA y pone de manifiesto el efecto de la presión social con referencia a la cultura de la delgadez en países como México, que es una sociedad en vías de desarrollo.