Élvio R. Gouveia

Tracking of fatness during childhood, adolescence and young adulthood: a 7-year follow-up study in Madeira Island, Portugal

Aims: Investigating tracking of fatness from childhood to adolescence, early adolescence to young adulthood and late adolescence to young adulthood. Subjects and methods: Participants from the Madeira Growth Study were followed during an average period of 7.2 years. Height, body mass, skin-folds and circumferences were measured, nine health- and performance-related tests were administered and the Baecke questionnaire was used to assess physical activity. Skeletal maturity was estimated using the TW3 method. Results: The prevalence of overweight plus obesity ranged from 8.2–20.0% at baseline and from 20.4–40.0% at follow-up, in boys. Corresponding percentages for girls were 10.6–12.0% and 13.2–18.0%. Inter-age correlations for fatness indicators ranged from 0.43–0.77. BMI, waist circumference and sum of skin-folds at 8, 12 and 16-years old were the main predictors of these variables at 15, 19 and 23-years old, respectively. Strength, muscular endurance and aerobic fitness were negatively related to body fatness. Physical activity and maturation were independently associated with adolescent (15 years) and young adult (19 years) fatness. Conclusions: Over 7.2 years, tracking was moderate-to-high for fatness. Variance was explained by fatness indicators and to a small extent by physical fitness, physical activity and maturation.

Skeletal maturation, fundamental motor skills and motor coordination in children 7–10 years

Abstract Relationships between skeletal maturation and fundamental motor skills and gross motor coordination were evaluated in 429 children (213 boys and 216 girls) 7–10 years. Skeletal age was assessed (Tanner-Whitehouse 2 method), and stature, body mass, motor coordination (Körperkoordinations Test für Kinder, KTK) and fundamental motor skills (Test of Gross Motor Development, TGMD-2) were measured. Relationships among chronological age, skeletal age (expressed as the standardised residual of skeletal age on chronological age) and body size and fundamental motor skills and motor coordination were analysed with hierarchical multiple regression. Standardised residual of skeletal age on chronological age interacting with stature and body mass explained a maximum of 7.0% of the variance in fundamental motor skills and motor coordination over that attributed to body size per se. Standardised residual of skeletal age on chronological age alone accounted for a maximum of 9.0% of variance in fundamental motor skills, and motor coordination over that attributed to body size per se and interactions between standardised residual of skeletal age on chronological age and body size. In conclusion, skeletal age alone or interacting with body size has a negligible influence on fundamental motor skills and motor coordination in children 7–10 years.

Gross motor coordination and weight status of Portuguese children aged 6-14 years.

To construct age‐ and gender‐specific percentiles for gross motor coordination (MC) tests and to explore differences in gross MC in normal‐weight, overweight and obese children.

Short-term secular change in height, body mass and Tanner-Whitehouse 3 skeletal maturity of Madeira youth, Portugal.

Background: Secular trends in height and weight are reasonably well documented in Europe. Corresponding observations for skeletal maturation are lacking. Aim: To assess secular trends in height, body mass and skeletal maturity of Portuguese children and adolescents and to provide updated reference values for skeletal maturity scores (SMSs). Subjects and methods: Data for 2856 children and adolescents of 4–17 years, 1412 boys and 1444 girls, from The ‘Madeira Growth Study’ (MGS; 1996–1998) and from the‘Healthy Growth of Madeira Children Study’ (CRES; 2006) were used. Height and body mass were measured. Skeletal maturity was assessed with the Tanner-Whitehouse 2 and 3 methods. Results: Children from CRES were taller and heavier than peers from MGS. Differences in height reached 5.8 cm in boys and 5.5 cm in girls. RUS SMSs did not differ consistently between surveys boys, while higher RUS scores were observed in CRES girls. Adult RUS SMSs for MGS and CRES combined were attained at 15.8 years in boys and 14.8 years in girls. Corresponding ages for adult Carpal SMSs were 14.4 and 14.0, respectively. Conclusion: The short-term trends for height and mass were not entirely consistent with the trends in RUS and Carpal SMSs and SAs.

Cross-validation of the Beunen–Malina method to predict adult height

Abstract The purpose of this study was to cross-validate the Beunen–Malina method for non-invasive prediction of adult height. Three hundred and eight boys aged 13, 14, 15 and 16 years from the Madeira Growth Study were observed at annual intervals in 1996, 1997 and 1998 and re-measured 7–8 years later. Height, sitting height and the triceps and subscapular skinfolds were measured; skeletal age was assessed using the Tanner–Whitehouse 2 method. Adult height was measured and predicted using the Beunen–Malina method. Maturity groups were classified using relative skeletal age (skeletal age minus chronological age). Pearson correlations, mean differences and standard errors of estimate (SEE) were calculated. Age-specific correlations between predicted and measured adult height vary between 0.70 and 0.85, while age-specific SEE varies between 3.3 and 4.7 cm. The correlations and SEE are similar to those obtained in the development of the original Beunen–Malina method. The Beunen–Malina method is a valid method to predict adult height in adolescent boys and can be used in European populations or populations from European ancestry. Percentage of predicted adult height is a non-invasive valid method to assess biological maturity.

Skeletal Maturation, Body Size, and Motor Coordination in Youth 11-14 Years.

PURPOSE The objective of this study is to estimate the relative contribution of biological maturation to variance in the motor coordination (MC) among youth and to explore gender differences in the associations. METHODS Skeletal maturation (Tanner-Whitehouse 3), stature, body mass, and MC (Körperkoordinationstest für Kinder) were assessed in 613 youths, 284 boys and 329 girls 11-14 yr of age. Standardized residuals of skeletal age on chronological age were used as the estimate of skeletal maturity status independent of chronological age. Hierarchical multiple regression analyses were used to analyse associations between skeletal maturity status and MC. RESULTS Skeletal maturity status by itself, i.e., standardized residuals of skeletal age on chronological age (step 3) explained a maximum of 8.1% of the variance in MC in boys (ΔR3 in the range of 0.0%-8.1%) and 2.8% of the variance in girls (ΔR3 in the range of 0.0%-2.8%), after controlling for stature, body mass and interactions of the standardized residuals of skeletal age on chronological age with stature and body mass. Corresponding percentages for the interactions of the standardized residuals of skeletal age and stature and body mass, after adjusting for stature and body mass (step 2) were 8.7% in boys (ΔR2 in the range of 0.3%-8.7%) and 7.1% in girls (ΔR2 in the range of 0.1%-7.1%). Chow tests suggested structural changes in β-coefficients in the four MC tests among boys and girls, 12-13 yr. CONCLUSION The percentage of variance in the four MC tests explained by skeletal maturation was relatively small, but the relationships differed between boys and girls. By inference, other factors, e.g., neuromuscular maturation, specific instruction and practice, sport participation, and others may influence MC at these ages.

An evaluation of a nurse-led rehabilitation programme (the ProBalance Programme) to improve balance and reduce fall risk of community-dwelling older people: a randomised controlled trial

OBJECTIVE This study aims to assess the effect of a nurse-led rehabilitation programme (the ProBalance Programme) on balance and fall risk of community-dwelling older people from Madeira Island, Portugal. DESIGN Single-blind, randomised controlled trial. SETTING University laboratory. PARTICIPANTS Community-dwelling older people, aged 65-85, with balance impairments. Participants were randomly allocated to an intervention group (IG; n=27) or a wait-list control group (CG; n=25). INTERVENTION A rehabilitation nursing programme included gait, balance, functional training, strengthening, flexibility, and 3D training. One trained rehabilitation nurse administered the group-based intervention over a period of 12 weeks (90min sessions, 2 days per week). A wait-list control group was instructed to maintain their usual activities during the same time period. OUTCOME Balance was assessed using the Fullerton Advanced Balance (FAB) scale. The time points for assessment were at zero (pre-test), 12 (post-test), and 24 weeks (follow up). RESULTS Changes in the mean (SD) FAB scale scores immediately following the 12-week intervention were 5.15 (2.81) for the IG and -1.45 (2.80) for the CG. At follow-up, the mean (SD) change scores were -1.88 (1.84) and 0.75 (2.99) for the IG and CG, respectively. The results of a mixed between-within subjects analysis of variance, controlling for physical activity levels at baseline, revealed a significant interaction between group and time (F (2, 42)=27.89, p<0.001, Partial Eta Squared=0.57) and a main effect for time (F (2, 43)=3.76, p=0.03, Partial Eta Squared=0.15), with both groups showing changes in the mean FAB scale scores across the three time periods. A significant main effect comparing the two groups (F (1, 43)=21.90, p<0.001, Partial Eta Squared=0.34) confirmed a clear positive effect of the intervention when compared to the control. CONCLUSION This study demonstrated that the rehabilitation nursing programme was effective in improving balance and reducing fall risk in a group of older people with balance impairment, immediately after the intervention. A decline in balance was observed for the IG after a period of no intervention. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12612000301864.

High-Density Lipoprotein Cholesterol Level Relates to Working Memory, Immediate and Delayed Cued Recall in Brazilian Older Adults: The Role of Cognitive Reserve

Aims: The present study set out to investigate the relation of the high-density lipoprotein cholesterol (HDL-C) level to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. Methods: We assessed tests of working memory, immediate and delayed cued recall in 701 older adults from Amazonas, Brazil. The HDL-C level was derived from fasting blood samples. In addition, we interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: A critically low HDL-C level (<40 mg/dL) was significantly related to lower performance in working memory, immediate and delayed cued recall. Moderation analyses suggested that the relations of the HDL-C level to working memory and delayed cued recall were negligible in individuals with longer education, a higher cognitive level of the job, and greater engagement in cognitive leisure activity. Conclusion: Cognitive reserve accumulated during the life course may reduce the detrimental influences of a critically low HDL-C level on cognitive functioning in old age.

Change, stability and prediction of gross motor co-ordination in Portuguese children

Abstract Background: The knowledge about intra- and inter-individual variation can stimulate attempts at description, interpretation and prediction of motor co-ordination (MC). Aim: To analyse change, stability and prediction of motor co-ordination (MC) in children. Subjects and methods: A total of 158 children, 83 boys and 75 girls, aged 6, 7 and 8 years, were evaluated in 2006 and re-evaluated in 2012 at 12, 13 and 14 years of age. MC was assessed through the Kiphard-Schillings body co-ordination test and growth, skeletal maturity, physical fitness, fundamental motor skills (FMS), physical activity and socioeconomic status (SES) were measured and/or estimated. Results: Repeated-measures MANOVA indicated that there was a significant effect of group, sex and time on a linear combination of the MC tests. Univariate tests revealed that group 3 (8–14 years) scored significantly better than group 1 (6–12 years) in all MC tests and boys performed better than girls in hopping for height and moving sideways. Scores in MC were also higher at follow-up than at baseline. Inter-age correlations for MC were between 0.15–0.74. Childhood predictors of MC were growth, physical fitness, FMS, physical activity and SES. Biological maturation did not contribute to prediction of MC. Conclusion: MC seemed moderately stable from childhood through adolescence and, additionally, inter-individual predictors at adolescence were growth, FMS, physical fitness, physical activity and SES.

The Relation of Hypertension to Performance in Immediate and Delayed Cued Recall and Working Memory in Old Age: The Role of Cognitive Reserve:

Objective: We investigated the relation of hypertension to cognitive performance and its interplay with key markers of cognitive reserve in a large sample of older adults. Method: We assessed tests of immediate and delayed cued recall and working memory in 701 older adults. We measured systolic blood pressure and interviewed individuals on their education, past occupation, and cognitive leisure activity. Results: Hypertension (≥140 mmHg) was related to lower performance in all three cognitive measures. Moderation analyses suggested that these relations were reduced in individuals with greater engaging in cognitive leisure activity. Hierarchical regression analyses showed that hypertension was not related to any of the three investigated cognitive performance measures when education, cognitive level of job, and cognitive leisure activity were simultaneously taken into account. Discussion: The detrimental influences of hypertension on cognitive functioning in old age may be reduced in individuals with greater cognitive reserve accumulated during the life course.