André Bonadias Gadelha

Sarcopenia and sarcopenic obesity classifications and cardiometabolic risks in older women

The purpose of this study was to examine the association between sarcopenia and sarcopenic obesity (SO) with cardiometabolic risk factors in postmenopausal women. 149 volunteers (67.17±6.12 years) underwent body composition assessment using dual energy X-ray absorptiometry (DXA) and had analyzed blood samples collected for lipid profile, glucose metabolism and C-reactive protein (CRP). Sarcopenia was defined as an appendicular fat-free mass (AFFM) divided by height squared ≤5.45 kg/m(2) while SO was classified based on the residuals of a regression. Waist circumference (WC) and arterial blood pressure were also measured. Students t-tests and correlations were used for analyses. Prevalence of sarcopenia and SO were respectively 16.8 and 21.5%. WC was significantly correlated with all the examined risk factors. AFFM relative to height squared was positively correlated with systolic blood pressure (SBP) and diastolic blood pressure (DBP), CRP, insulinaemia, HOMA score, and those classified as sarcopenic presented lower HOMA score when compared to nonsarcopenic. Regarding SO, although volunteers classified presented significantly higher fat mass (FM) and lower AFFM, it was not observed association with the examined risk factors. These findings support the association between WC and cardiometabolic risk factors in older women. In contrast, the approaches used to define sarcopenia and SO are not associated with cardiometabolic impairments.

Session rating of perceived exertion following resistance exercise with blood flow restriction.

Session ratings of perceived exertion (SRPE) provide a valid and reliable indicator of resistance exercise session intensity. However, there is a lack of studies on the effects of resistance exercise with blood flow restriction (BFR) on SRPE. Thus, the aim of this study is to compare the effects of resistance exercise at high intensity versus low intensity with BFR on internal training load measured by SRPE. Thirteen young (22·2 ± 3·8 years) resistance‐trained men (training experience 3·2 ± 2·4 years) participated in the study protocol. After determining one maximum repetition (1‐RM), the subjects were assigned to two groups in a counterbalanced design (i) high‐intensity exercise (HIE, performed one training session at 80% of 1‐RM) and (ii) low intensity with BFR (BFR, performed an exercise session at 50% of 1‐RM with BFR). During each session, subjects performed three sets of unilateral elbow flexion leading to concentric failure with a 1‐min rest interval between sets. A cuff around the arm, inflated at 110 mmHg, was used continuously for BFR. The SRPE was reported 30 min after the end of the session. The low intensity with BFR showed lower total work (197·13 ± 63·49 versus 300·92 ± 71·81 kg; P = 0·002) and higher SRPE (9 versus 6; P = 0·007) than high‐intensity resistance exercise. The present results indicate that BFR is an important factor to increase internal training load. Future studies should investigate the physiological stress imposed by different training methods rather than just quantify the external training load such as intensity or volume.

resistance training improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women

Purpose To examine the effects of resistance training (RT) on metabolic syndrome-related phenotypes in postmenopausal women. Patients and methods Twenty-two postmenopausal women (65.0±4.2 years) underwent 12 weeks of whole body progressive training with intensity prescribed based on rating of perceived exertion. Dominant knee extension strength was assessed using an isokinetic dynamometer before and after the intervention. Moreover, all volunteers had blood samples collected for lipid profile, glycemic control, and C-reactive protein analyses. Waist circumference and arterial blood pressure were also measured at baseline and after the training period. Student’s t-tests for paired samples and repeated measures ANOVA were used to compare dependent variables, and statistical significance was set at P<0.05. Results Isokinetic muscle strength significantly increased (P<0.01) with training. It was observed that waist circumference as well as total and low-density lipoprotein cholesterol levels significantly decreased with training (P<0.01). Total cholesterol/high-density lipoprotein cholesterol ratio, an important marker of cardiovascular disease incidence, was also significantly reduced (from 3.91±0.91 to 3.60±0.74; P<0.01) after the program. Blood glucose, basal insulin, and homeostatic model assessment of insulin resistance were also significantly reduced (P<0.01). No significant alterations were observed for resting blood pressure, triglycerides, or C-reactive protein. Conclusion Based on the observed results, it can be concluded that a 12-week progressive RT program, besides increasing isokinetic muscle strength, induces beneficial alterations on metabolic syndrome-related phenotypes in postmenopausal women. These findings highlight this mode of exercise as an important component of public health promotion programs for aged women. RT improves isokinetic strength and metabolic syndrome-related phenotypes in postmenopausal women.

Effects of resistance training on sarcopenic obesity index in older women: A randomized controlled trial

The purpose of this study was to examine the effects of resistance training (RT) on sarcopenic obesity (SO) in older women. 243 older women underwent body composition measurement using dual-energy X-ray absorptiometry, and the SO index was calculated. This randomized controlled trial adopted from the baseline sample, 113 volunteers (67.0±5.2years) were randomly assigned to a control group (CG, n=64) or an experimental group (EG, n=69). The EG took part in a 24-week RT program, conducted three times per week. Body composition measurements were repeated at the end of the training program. RT induced a significant increase in fat-free mass (P<0.01), but not decrease in fat mass in the EG. Moreover, the SO index was also significantly improved in the EG (P<0.01), while it decreased significantly in the CG (P<0.01). It is concluded that RT is an effective approach to promote body composition alterations in older women, and it might improve SO-related phenotypes.

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.

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.

Muscle quality is associated with dynamic balance, fear of falling, and falls in older women

HighlightsNumerous scientists use the term “muscle quality” to refer to the relationship between muscle strength and muscle volume.The aim of the present study was to investigate the association between muscle quality and falls‐related traits in older women.Muscle quality was linked to negative outcomes in older women, in particular, falls‐related risk factors.Muscle quality may be a useful supplement to other muscular indices in the evaluation of risk of falls.

The association between body adiposity measures, postural balance, fear of falling, and fall risk in older community-dwelling women

Background and Purpose: Recent investigations demonstrate an association between obesity and the propensity of older adults to fall. The aim of this study was to investigate the association between body adiposity measures, postural balance, fear of falling, and risk of falls in older women. Methods: One hundred forty-seven volunteers took part in this cross-sectional study. Participants underwent body composition assessment using dual-energy x-ray absorptiometry and had body mass index, waist circumference (WC), and body adiposity index measured. Postural balance was assessed using a force platform, while fear of falling and risk of falls were, respectively, evaluated by the Falls Efficacy Scale—International and the QuickScreen Clinical Falls Risk Assessment. Results and Discussion: All adiposity measures were correlated to at least 1 postural stability parameter and to fear of falling (ρ= 0.163, P < .05 to r = 0.337, P < .001); however, WC was the index most strongly correlated to risk of falls (ρ= 0.325; P < .001). When obesity was classified using WC, it was observed that compared with nonobese individuals (n = 51), obese individuals (n = 96) exhibited greater center of pressure displacement in the anteroposterior and mediolateral axes, especially during conditions with feet apart (P < .05). The obese group also exhibited an increased fear of falling (28.04 vs 24.59; P = .002) and had a higher proportion of individuals with increased fall risk (72% vs 35%; P < .001). Conclusion: In summary, adiposity measures are associated with risk of falls in older women, which might be mediated by reduced postural balance and increased fear of falling. Among these indices, WC, an easy and low-cost assessment, demonstrated the strongest association with falls-related outcomes.

Obesity is associated with reduced postural control in community-dwelling older adults: a systematic review

Abstract Purpose: To summarise evidence from observational studies that examined the impact of obesity on Centre of Pressure (CoP) sway during quiet standing in community-dwelling older adults. Methods: An electronic data search (last searched April 2017) was performed on six databases (MEDLine, Web of Science, CINAHL, PsycINFO, Scopus and LILACS). Details of the study design, participants’ characteristics, obesity classification criteria, postural control conditions, CoP sway parameters and risk of bias were extracted by two independent reviewers. Results: Of 265 studies reviewed, four met the inclusion criteria and were appraised. Common to all the included studies was a negative effect of obesity on CoP sway parameters, especially at anteroposterior and mediolateral ranges. Of note, these findings were observed in a wide variety of quiet stance conditions, with significance more evident when vision was restricted. The risk of bias revealed that most studies’ samples were not representative of the entire population. Conclusions: The present systematic review suggests that obesity is associated with reduced static postural control in community-dwelling older adults. However, due to the risk of bias and the large variability of protocols used to measure CoP sway, the evidence remains inconclusive. Future longitudinal studies are needed to confirm the findings.

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.