Danilo Fernandes da Silva

Multidisciplinary therapy reduces risk factors for metabolic syndrome in obese adolescents

This study aims to assess the effects of a 16-week multidisciplinary program of obesity treatment on the control of metabolic syndrome (MS) and dyslipidemia in obese adolescents. Eighty-six adolescents aged 10–18xa0years were allocated in either the intervention group (IG; nu2009=u200944) or control group (CG; nu2009=u200942). IG was submitted to a multidisciplinary intervention based on cognitive behavioral therapy that aimed to modify eating habits and exercise behavior. We analyzed, before and after the intervention period, anthropometric parameters, body composition, bone mineral density, cardiorespiratory fitness, blood pressure, glucose, insulin, and lipid profile of the subjects. MS was classified according to International Diabetes Federation (2007) and the presence of dyslipidemia according to Back et al. (Arq Bras Cardiol 85:4–36, 2005). In the beginning of the intervention, the median number (range) of risk factors for MS present was 2.0 (0.0–5.0) in the IG and 2.0 (0.0–4.0) in the CG. After the intervention, this parameter reduced significantly in the IG (1.0 (0.0–5.0); pu2009=u20090.004) while no change was observed in the CG (2.0 (0.0–4.0); pu2009=u20090.349). In addition, we observed improvements in body mass index, waist circumference, hip circumference, maximal oxygen uptake, absolute and relative body fat, systolic blood pressure, diastolic blood pressure, and total cholesterol in the IG which was not identified in the CG. Conclusion: We suggest that a 16-week multidisciplinary intervention based on cognitive behavioral therapy was adequate to reduce risk factors for MS in obese adolescents.

Incremental test design, peak ‘aerobic’ running speed and endurance performance in runners

OBJECTIVESnPeak running speed obtained during an incremental treadmill test (Vpeak) is a good predictor of endurance run performance. However, the best-designed protocol for Vpeak determination and the best Vpeak definition remain unknown. Therefore, this study examined the influence of stage duration and Vpeak definition on the relationship between Vpeak and endurance run performance.nnnDESIGNnRelationship.nnnMETHODSnTwenty-seven male, recreational, endurance-trained runners (10-km running pace: 10-17 k mh(-1)) performed, in counterbalanced order, three continuous incremental treadmill tests of different stage durations (1-, 2-, or 3-min) to determine Vpeak, and two 5-km and two 10-km time trials on a 400-m track to obtain their 5-km and 10-km run performances. Vpeak was defined as either (a) the highest speed that could be maintained for a complete minute (Vpeak-60 s), (b) the speed of the last complete stage (Vpeak-C), or (c) the speed of the last complete stage added to the multiplication of the speed increment by the completed fraction of the incomplete stage (Vpeak-P).nnnRESULTSnThe Vpeak determined during the 3-min stage duration protocol was the most highly correlated with both the 5-km (r=0.95) and 10-km (r=0.92) running performances and these relationships were minimally influenced by the Vpeak definition. However, independent of the stage duration, the Vpeak-P provided the highest correlation with both running performances.nnnCONCLUSIONSnIncremental treadmill tests comprising 3-min stage duration is preferred to 1-min and 2-min stage duration protocols in order to determine Vpeak to accurately predict 5-km and 10-km running performances. Further, Vpeak-P should be used as standard for the determination of Vpeak.

Longitudinal changes in cardiac autonomic function and aerobic fitness indices in endurance runners: A case study with a high-level team

Abstract To determine the effects of preparatory phase training on aerobic parameters, resting heart rate variability (HRV) and 5-km performance of high-level endurance runners and the relationship between the percentage change (% change) of resting HRV with the % change of aerobic parameters and 5-km performance. Six runners were assessed before and after seven weeks of training. The aerobic parameters were determined in an incremental test. The HRV was assessed by a heart rate monitor. Athletes performed a 5-km running test in a track. The analysis revealed ‘likely’ and ‘very likely’ improvements for velocity associated with maximal oxygen uptake ( O2max) (20.0±1.0 km·h−1 to 21.2±0.6 km·h−1) and 5-km performance (18.0±0.4 km·h−1 to 18.9±0.7 km·h−1), respectively, as well as ‘likely’ decrease in high frequency (41.4±18.5 nu to 30.4±14.3 nu), and increase in low frequency (58.5±18.5 nu to 69.6±14.3 nu) band densities. The variation in the velocity associated with O2max showed the highest correlation with 5-km performance (r=0.95). The % change in the square root of the mean sum of the squared differences between R–R intervals and standard deviation 1 were highly correlated with variation in 5-km performance (r=0.69 and 0.66). Changes in the velocity associated with O2max and vagally mediated HRV were highly associated with 5-km running performance within the investigated team. These results have important implications because these parameters can be assessed longitudinally to monitor adaptation to training.

Parasympathetic Cardiac Activity is Associated with Cardiorespiratory Fitness in Overweight and Obese Adolescents

The aim of this study was to investigate the association between cardiac parasympathetic activity and cardiorespiratory fitness, insulin, and hemodynamic profile in overweight and obese adolescent girls and boys (aged 12–16xa0years). Data were taken from the Multidisciplinary Obesity Treatment Program. Only post-intervention measurements are presented herein. Body composition, cardiorespiratory fitness, blood pressure, and metabolic profile (insulin and glucose profile) of adolescents were assessed. Cardiac parasympathetic activity was determined by resting heart rate variability, which was analyzed using a heart rate monitor. Greater parasympathetic cardiac activity was associated with higher levels of cardiorespiratory fitness in both girls and boys (0.375xa0≤xa0rxa0≤xa00.900), while the sympathetic-vagal balance was negatively related to maximal oxygen uptake (VO2max) in girls (rxa0=xa00.478). An association between lower parasympathetic activity and insulin resistance was noted in girls (mean of R–R intervals [RRmean] and homeostasis model assessment insulin-resistance index [HOMA-IR]: rxa0=xa0−0.678), while greater systolic blood pressure (SBP) and lower parasympathetic activity were associated in both sexes (RRmean and SBP: rxa0=xa0−0.526; high frequency [HF (nu)] and SBP: rxa0=xa0−0.754). In conclusion, autonomic nervous system activity was associated with cardiorespiratory fitness, insulin resistance, and SBP in overweight and obese adolescents. The identification of these potential relationships assists with the establishment of future long-term exercise interventions that evaluate the improvements in parasympathetic nervous system activity, in addition to metabolic profile and cardiorespiratory fitness in overweight and obese adolescents.

Parent-proxy perception of overweight adolescents' health-related quality of life is different according to adolescent gender and age and parent gender

This study assessed health-related quality of life (HRQoL) reported by overweight adolescents and compared to their parent-proxy perception of HRQoL, according to adolescent gender, adolescent age, and parent gender. Patients and a total of 179 adolescents aged 10 to 18xa0years with excess weight were evaluated for perceived HRQoL prior to beginning a weight-loss intervention, using the Pediatric Quality of Life Inventory (PedsQL 4.0) questionnaire, estimating quality of life in the physical, emotional, social, and school domains, as well as index measures of psychosocial and overall quality of life. Parents completed the same questionnaire estimating his or her childs HRQoL. Compared to their childs self-report, parents underestimated all the domains of HRQoL except the school domain. Parents underestimated all the domains of HRQoL among boys; however, they only underestimated the physical domain among girls. Comparisons between parent-proxy perception and self-report of the adolescent according to adolescents age revealed that parents underestimated their childrens HRQoL in the younger adolescents (10 to 13xa0years) for all except for the school domain and underestimated only the physical domain in older adolescents (14 to 18xa0years). The same comparison between parent-proxy perception and their childs self-report of HRQoL according to parent gender showed that mothers underestimated HRQoL in all domains except for the school domain, while fathers only underestimated the school domain. Conclusion: The differences between self-report of overweight adolescent and perceptions of their parents about the HRQoL of their children are influenced by adolescent gender and age and parent gender.

Effect of stage duration on maximal heart rate and post-exercise blood lactate concentration during incremental treadmill tests.

OBJECTIVESnThis study compared the responses during maximal incremental treadmill tests of 1-min, 2-min, and 3-min stage durations mainly in terms of maximal heart rate (HRmax) and peak blood lactate concentration (LApeak).nnnDESIGNnRepeated-measures.nnnMETHODSnThirty-four male, recreational, endurance-trained runners (40±13 years) performed three tests on a motorized treadmill. The tests started at 8kmh(-1) with increments of 1kmh(-1) every 1min for the short-stage protocol, every 2min for the intermediate-stage protocol, and every 3min for the long-stage protocol. LApeak was defined for each subject as the highest value among the lactate concentrations determined at the end of each test and at the third, fifth and seventh minutes after test, during passive recovery.nnnRESULTSnAnalysis of variance revealed a significant effect of the stage duration on the HRmax (p=0.003) and LApeak (p=0.001). The HRmax was higher in the intermediate-stage compared to the short-stage protocol (184.8±12.7 vs. 181.8±12.1beatsmin(-1), p<0.001), but no significant differences were found between the long-stage (183.1±12.1beatsmin(-1)) and the intermediate-stage or short-stage protocols (p>0.05). The LApeak was lower in the long-stage compared to the short-stage and intermediate-stage protocols (7.9±2.2 vs. 9.4±2.2 and 9.2±1.9mmolL(-1), respectively, p<0.05). Further, blood lactate reached peak concentration at the fifth minute after test for all the protocols.nnnCONCLUSIONSnThus, HRmax and LApeak depend on the stage duration of the incremental test, but the moment at which blood lactate reaches peak concentration is independent of the duration. Further, we suggest 2-min stage duration protocols to determine HRmax.

Physical, clinical, and psychosocial parameters of adolescents with different degrees of excess weight

OBJECTIVE: To compare body composition, hemodynamic parameters, health-related physical fitness, and health-related quality of life of adolescents with anthropometric diagnosis of overweight, obesity, and severe obesity. METHODS: 220 adolescents with excess body weight were enrolled. They were beginners in a intervention program that included patients based on age, availability, presence of excess body weight, place of residence, and agreement to participate in the study . This study collected anthropometric and hemodynamic variables, health-related physical fitness, and health-related quality of life of the adolescents. To compare the three groups according to nutritional status, parametric and non-parametric tests were applied. Significance level was set at p<0.05. RESULTS: There was no significant difference in resting heart rate, health-related physical fitness, relative body fat, absolute and relative lean mass, and health-related quality of life between overweight, obese, and severely obese adolescents (p>0.05). Body weight, body mass index, waist and hip circumference, and systolic blood pressure increased as degree of excess weightincreased (p<0.05). Dyastolic blood pressure of the severe obesity group was higher than the other groups (p<0.05). There was an association between the degree of excess weight and the prevalence of altered blood pressure (overweight: 12.1%; obesity: 28.1%; severe obesity: 45.5%; p<0.001). The results were similar when genders were analyzed separately. CONCLUSION: Results suggest that overweight adolescents presented similar results compared to obese and severely obese adolescents in most of the parameters analyzed.

Relação entre estado nutricional, adiposidade corporal, percepção de autoimagem corporal e risco para transtornos alimentares em atletas de modalidades coletivas do gênero feminino

The objective of the present study was to analyze wheter there is association between body self-image, risk for eating disorders, body fat, and BMI classification in collective sports female athletes. Forty-five basketball, volleyball, handball and futsal athletes participated in the research. We measured weight, height and skinfolds were measures for determining the Body Mass Index (BMI) and Body Fat Percentage (%fat). It was used the questionnaires Body Shape Questionnaire (BSQ) and Eating Attitudes Test (EAT-26). The association analysis was done by Chi-square 2x2 and Fishers Exact Test (p < 0.05). The mean BMI and %fat were 22.82 ± 2.73 kg•m-2 and 23.42 ± 5.10%, respectively. The BSQ was associated with BMI (p = 0.001) and %fat (p = 0.008) and EAT-26 was not associated with any anthropometric variables. It was concluded that overweight and obese athletes had a greater tendency to body self-image distortion, but these athletes did not have the propensity to develop eating disorders.

Estágio de prontidão para mudança de comportamento de adolescentes interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade

OBJETIVO: Avaliar o estagio de prontidao para mudanca do comportamento (EPMC) alimentar e de atividade fisica de adolescentes e verificar a associacao entre as variaveis genero, faixa etaria e classificacao do indice de massa corporea (IMC) com o EPMC. METODOS: Foram avaliados 145 adolescentes entre dez e 18 anos interessados em ingressar no Programa Multiprofissional de Tratamento da Obesidade (PMTO). As avaliacoes incluiram, alem dos EPMC, parâmetros antropometricos. A analise estatistica envolveu a aplicacao do teste t de Student para amostras independentes e do teste de Mann-Whitney na comparacao entre os grupos. O teste do qui-quadrado de tendencia foi utilizado para verificar se houve ou nao associacao entre as variaveis do estudo, sendo significante p<0,05. RESULTADOS: Em relacao ao comportamento alimentar (quantidade e tamanho das porcoes), verificou-se associacao entre IMC e o EPMC. Tambem foi observado que os adolescentes mais velhos apresentaram EPMC mais avancado em relacao ao consumo de frutas e verduras. O mesmo se verificou em relacao a pratica habitual de atividade fisica. CONCLUSOES: Ha associacao entre IMC e o EPMC relacionado ao comportamento alimentar (quantidade e tamanho das porcoes), do mesmo modo que entre a idade e o EPMC relacionado ao consumo de frutas e vegetais e pratica habitual de atividade fisica. Recomenda-se a realizacao de estudos experimentais a fim de verificar se o EPMC tem poder preditivo em programas de intervencao destinados ao tratamento do excesso de peso

MORPHOLOGICAL PROFILE OF ATHLETE STARTERS AND NONSTARTERS OF FEMININE FUTSAL

O objetivo do estudo foi comparar as caracteristicas morfologicas de atletas de futsal feminino titulares e reservas de alto nivel competitivo. Participaram 115 atletas, 60 titulares e 55 reservas pertencentes a 10 equipes que disputaram da XX Taca Brasil de Clubes, divisao especial. Medidas antropometricas foram obtidas com a finalidade de caracterizar e determinar o somatotipo corporal. As analises foram realizadas com auxilio de um pacote estatistico comercial (SPSS versao 18.0) adotando como nivel de significância p<0,05. Os resultados revelaram que as atletas titulares sao mais velhas (p=0,024), possuem maior tempo de pratica (p=0,019), menor percentual de gordura (p=0,047) e diâmetro do femur (p=048) do que as reservas, porem apresentaram semelhante classificacao somatotipologica (mesomorfo-endomorfo). Considerando que a composicao corporal e a experiencia esportiva sao atributos associados ao desempenho, as diferencas observadas entre as atletas titulares e reservas podem contribuir para a tomada de decisao do treinador na formacao da equipe titular em jogos de futsal feminino.The objective of the study was to compare the morphological characteristics of female futsal athlete starters and nonstarters. The study included 115 athletes, 60 starters and 55 nonstarters, belonging to 10 teams that competed in the XX Brazilian Cup of Clubs, special division. Anthropometric measurements were obtained with the purpose of characterizing and determining body somatotype. The analyzes were performed with the aid of a commercial statistical package (SPSS version 18.0), adopting a significance level of p< 0.05. The results showed that the athlete starters were older (p=0.024), had a longer practice time (p=0.019), and lower fat percentage (p=0.047) and femur diameter (p=0.048) than the nonstarters, however, the last two variables lost significance after adjustment for practice time. Nevertheless, they presented a similar somatotypological classification (mesomorph-endomorph). Considering that body composition and sports experience are attributes associated with performance, the observed differences between the athlete starters and nonstarters could contribute to the decision making of coaches in the formation of the titular team in womens futsal matches.