Fátima Palha de Oliveira

Technical error of measurement in anthropometry

Las medidas antropometricas estan siendo ampliamente utilizadas para el acompanamiento y el desenvolvimiento de ninos, en la verificacion de las adaptaciones en respuesta a entrenamiento, en la selecion de atletas y en estudios de caracterizacion etnica, entre varias otras areas. El control da la calidad de esas medidas va a resultar en datos mas confiables y medidas antropometricas mas precisas. El proposito del presente estudio es el de difundir la estrategia para la obtencion del error tecnico de medicion (ETM), siguiendo la metodologia de Kevin Norton y Tim Olds (2000) y evaluar el desempeno de empleados de laboratorio. Tres antropometristas del Laboratorio de Fisiologia del Ejercicio (Labofise) de la Universidad del Brasil fueron evaluados. Ellos realizaron las medidas de pliegues cutaneos (Cescorf, 0.1mm) en nueve diferentes puntos antropometricos de 35 voluntarios (25,45 ± 9,96 anos). Para las medidas, fue adoptada la padronizacion de la International Society for Advancement in Kinanthropometry (ISAK). Para la verificacion del ETM intra-evaluador, las medidas fueron realizadas en los mismos voluntarios en dos dias diferentes; y, para la obtencion del ETM inter-avaliador, las medidas fueron hechas en un mismo grupo de voluntarios, en el mesmo dia, por los tres antropometristas. Los resultados apuntaron ETMs no aceptables apenas para dos evaluadores en el analisis intra-evaluador. Los demas ETMs alcanzaron resultados aceptables. Los ETMs no aceptables demostraron la necesidad de entrenamiento tecnico de los antropometristas, de modo de minimizar la variabilidad constatada.

Comportamento alimentar e imagem corporal em atletas

The sports environment can enhance social and cultural pressure towards a lean body. The close relationship between corporal image and performance makes the female athletes a group particularly vulnerable to eating disorders and weight-control practices. The aim of the present work is to evaluate the presence of behaviors suggestive of eating disorders, shifts in body perception, and menstrual dysfunctions in female athletes of the Federal University of Rio de Janeiro School of Physical Education (EEFD-UFRJ). Twelve female athletes (20 ± 2 years), who had been training for 4.6 ± 2.3 years, a total of 13.8 ± 2.9 hours per week, were examined. The results of the athletes and of 32 young non-athletes (15 ± 1.4 years) were compared. The Eating Attitudes Test (EAT-26) was used to evaluate weight-control and eating attitudes and behaviors. The Bulimic Investigatory Test Edimburgh (BITE) was used to identify suggestive behaviors of bulimia nervosa, and also to obtain data about cognitive and behavioral aspects of this disorder. The Body Shape Questionnaire (BSQ) was used to verify dissatisfaction with body image. The three self-applied questionnaires were used in their Portuguese versions. The athletes presented body mass of 59 ± 7.3 kg, height of 1.65 ± 0.03 m, percentage of body fat (%F) of 23.1 ± 4.1% and body mass index (BMI) of 21.6 ± 2.3 kg/m2. The entire sample had a %F compatible for age and sex, although 33% of the athletes presented some body image dissatisfaction. The BITE evidenced that 16.6% of the athletes presented a non-usual dietary pattern according to symptoms, but with no significance in terms of severity. These athletes are included among those who are not happy with their body. No athlete had a positive EAT-26 results. The findings of this study suggest the presence of symptoms that do not actually characterize bulimia or anorexia nervosa, but they point to the need of a careful surveillance and assessment of eating disorders and their precursors among athletes, as a way of prevention.

Comportamento alimentar e imagem corporal entre estudantes de educação física

OBJECTIVE: To characterize eating practices and possible risk factors associated with eating disorders among physical education students in a public university of the Municipality of Rio de Janeiro, Brazil. METHODS: Sectional study, electing as target population a risk group for the emergence of eating disorders. The questionnaires Bulimic Investigatory Test Edinburgh (BITE), Eating Attitudes Test (EAT-26), Body Shape Questionnaire (BSQ) and a variety that considers related issues were applied. RESULTS: A positive result was detected in 6.9% of cases (IC95%: 3.6-11.7%) on EAT-26. On BITE, for elevated symptoms and severe cases, a prevalence of 5% was found (IC95%: 2.4-9.5%) and 2.5% (IC95%: 0.7-6.3%), respectively. It was evidenced that 26.29% of students presented abnormal eating behavior. CONCLUSION: The results of this study demonstrate the need to pay attention to risk eating behaviors in this group, being justified to take special care with these future health care educators.

Cálculo do erro técnico de medição em antropometria

Las medidas antropometricas estan siendo ampliamente utilizadas para el acompanamiento y el desenvolvimiento de ninos, en la verificacion de las adaptaciones en respuesta a entrenamiento, en la selecion de atletas y en estudios de caracterizacion etnica, entre varias otras areas. El control da la calidad de esas medidas va a resultar en datos mas confiables y medidas antropometricas mas precisas. El proposito del presente estudio es el de difundir la estrategia para la obtencion del error tecnico de medicion (ETM), siguiendo la metodologia de Kevin Norton y Tim Olds (2000) y evaluar el desempeno de empleados de laboratorio. Tres antropometristas del Laboratorio de Fisiologia del Ejercicio (Labofise) de la Universidad del Brasil fueron evaluados. Ellos realizaron las medidas de pliegues cutaneos (Cescorf, 0.1mm) en nueve diferentes puntos antropometricos de 35 voluntarios (25,45 ± 9,96 anos). Para las medidas, fue adoptada la padronizacion de la International Society for Advancement in Kinanthropometry (ISAK). Para la verificacion del ETM intra-evaluador, las medidas fueron realizadas en los mismos voluntarios en dos dias diferentes; y, para la obtencion del ETM inter-avaliador, las medidas fueron hechas en un mismo grupo de voluntarios, en el mesmo dia, por los tres antropometristas. Los resultados apuntaron ETMs no aceptables apenas para dos evaluadores en el analisis intra-evaluador. Los demas ETMs alcanzaron resultados aceptables. Los ETMs no aceptables demostraron la necesidad de entrenamiento tecnico de los antropometristas, de modo de minimizar la variabilidad constatada.

Effect of levothyroxine replacement on exercise performance in subclinical hypothyroidism

Although muscle metabolism and exercise capacity seem to be affected in patients with subclinical hypothyroidism, there is little evidence indicating improvement of the exercise tolerance due to levothyroxine (L-T4) replacement. The aim of the present study was to verify possible cardiopulmonary changes during exercise in patients with subclinical hypothyroidism on L-T4 replacement with a normal serum TSH for six months. Twenty-three patients with subclinical hypothyroidism were randomized into treated (no.=11) and untreated (no.=12) patients. A cardiopulmonary test was performed with a treadmill, using the modified Balke protocol. Heart rate, oxygen uptake, minute ventilation and other cardiopulmonary parameters were assessed at the 5th minute of exercise. FT4 levels increased while TSH normalized after hormone replacement. Oxygen uptake decreased significantly after hormone replacement (24.1 ±6.3 vs 17.1 ±4.2 ml.kg.min−1; p=0.03). Minute ventilation also showed an enhanced performance in treated patients (28.0±8.1 vs 23.5±5.6 l.min−1; p=0.03), as did the heart rate (128±17 vs 121±17 bpm; p=0.03). There were no changes in the untreated group. The results demonstrate that submaximal cardiopulmonary exercise performance improved after six months of TSH normalization and this improvement can help enhance the ability to carry out daily life activities in patients with subclinical hypothyroidism.

Effect of hormone replacement on exercise cardiopulmonary reserve and recovery performance in subclinical hypothyroidism

Subclinical hypothyroidism (SH) patients present cardiopulmonary, vascular and muscle dysfunction, but there is no consensus about the benefits of levothyroxine (L-T₄) intervention on cardiopulmonary performance during exercise. The aim of the present study was to investigate the effects of L-T₄ on cardiopulmonary exercise reserve and recovery in SH patients. Twenty-three SH women, 44 (40-50) years old, were submitted to two ergospirometry tests, with an interval of 6 months of normalization of thyroid-stimulating hormone (TSH) levels (L-T₄ replacement group) or simple observation (TSH = 6.90 μIU/mL; L-T₄ = 1.02 ng/dL). Patients with TSH >10 μIU/mL were excluded from the study to assure that they would receive treatment in this later stage of SH. Twenty 30- to 57-year-old women with no thyroid dysfunction (TSH = 1.38 μIU/mL; L-T₄ = 1.18 ng/dL) were also evaluated. At baseline, lower values of gas exchange ratio reserve (0.24 vs 0.30; P < 0.05) were found for SH patients. The treated group presented greater variation than the untreated group for pulmonary ventilation reserve (20.45 to 21.60 L/min; median variation = 5.2 vs 25.09 to 22.45 L/min; median variation = -4.75, respectively) and for gas exchange ratio reserve (0.19 to 0.27; median variation = 0.06 vs 0.28 to 0.18; median variation = -0.08, respectively). There were no relevant differences in cardiopulmonary recovery for either group at baseline or after follow-up. In the sample studied, L-T₄ replacement improved exercise cardiopulmonary reserve, but no modification was found in recovery performance after exercise during this period of analysis.

Comportamentos bulímicos em atletas adolescentes corredoras de fundo

OBJETIVO: Avaliar a presenca de comportamentos bulimicos e sua intensidade entre atletas adolescentes do sexo feminino corredoras de fundo. METODO: De um total de 40 atletas adolescentes (16±1,8 ano), registradas na Federacao de Atletismo do Rio de Janeiro, foram estudadas 17 meninas corredoras de fundo. O instrumento utilizado para investigar comportamentos bulimicos e sua gravidade foi o BITE (Bulimic Investigatory of Edinburg), um questionario auto-aplicavel, em sua versao em portugues. RESULTADOS: Os resultados apontaram que 35,6% das atletas (N=6) apresentavam escores acima do limite de normalidade (=10) e 29,4% (N=5) padrao nao usual (entre 10 e 19). Foi detectado um caso com escore superior a 20, indicando presenca do problema. No que se refere a gravidade, valores acima de 5 na escala de gravidade do BITE foram considerados significativos, totalizando na amostra apenas um caso. CONCLUSAO: Tendo em vista a deteccao de padroes nao usuais e mesmo um caso de maior gravidade indicado pelo alto escore encontrado, tornam-se necessarios estudos mais abrangentes junto ao segmento focalizado, de modo a subsidiar medidas preventivas. Os resultados indicam, ainda, a necessidade de alertar e informar familiares e profissionais envolvidos no trabalho junto a essas adolescentes sobre o perigo potencial dos comportamentos identificados.

Effects of physical activity on body composition and fatigue perception in patients on thyrotropin-suppressive therapy for differentiated thyroid carcinoma.

BACKGROUND Subclinical thyrotoxicosis (scTox) may be associated with alterations in body composition and fatigue that can be possibly reversed with physical activity. The aim of the present study was to evaluate whether the systematic practice of physical activity improves lower extremity muscle mass and fatigue perception in patients with scTox. MATERIALS AND METHODS We studied 36 patients (2 men) with median age of 48.0 (43.0-51.0) years, body mass index of 27.4 (22.1-30.2) kg/m(2), thyrotropin <0.4 mU/L, and free thyroxine between 0.8 and 1.9 ng/dL and 48 control subjects (C group; 7 men). Patients were randomly divided in two groups according to the adherence to the exercise training: scTox-Tr (n = 19)-patients who adhered to the exercise intervention and scTox-Sed (n = 17)--patients who did not adhere to it. The C group did not participate in the randomization. The exercise training was supervised by a physical education instructor, and it was composed of 60 minutes of aerobic activity and stretching exercises, twice a week, during 12 weeks. In both groups, body composition was assessed (anthropometric method), and the Chalder Fatigue Scale was determined at baseline and after 3 months of intervention (scTox-Tr group) or observation (scTox-Sed group). RESULTS At baseline, patients with scTox had lower muscle mass and mid-thigh girth and more fatigue on the Chalder Fatigue Scale than euthyroid control subjects. The scTox-Tr group had an increase in muscle mass, reduction in the variables reflecting whole body fat, and lesser perception of fatigue during the exercise training period (p ≤ 0.05 for these parameters at the start and end of the exercise training period). CONCLUSIONS scTox is associated with lower muscle mass and mid-thigh girth and more fatigue. Physical activity training can partially ameliorate these characteristics. More studies are needed to determine what training program would be optimum, both in terms of beneficial effects and for avoiding potential adverse responses.

Impacto do hipotireoidismo subclínico na resposta cárdio-pulmonar em esforço e na recuperação

In order to identify the characteristics of subclinical hypothyroidism (SH) during physical stress and its recovery, 15 SH patients and 16 healthy women were compared by a treadmill cardiopulmonary test. Means of variables were analyzed by the Mann-Whitney U test. Patients obtained lower values for peak expired fraction of O2 (14.90+/-1.05 x 16+/-1.14%; p = 0.014); systolic blood pressure variation (34.33+/-17.92 x 52.50+/-17.22; p = 0.009); exercise duration (8.83+/-2.91 x 14.5+/-5.63 min; p = 0.0005), maximal test load (11.6+/-4.22 x 18.94+/-5.45%; p = 0.0004), as well as tendencies in gas exchange ratio and peak heart rate. Between the first and the third recovery minutes, there was a reduction of only 0.71 mmHg in the diastolic blood pressure, whereas there was a 5.33-mmHg reduction to control group (p = 0.0009) (slower recovery of patients). It is presumable that SH may cause cardiopulmonary dysfunctions, with higher sensibility to the parameters previously cited.

Eating behavior and body image in athletes

The sports environment can enhance social and cultural pressure towards a lean body. The close relationship between corporal image and performance makes the female athletes a group particularly vulnerable to eating disorders and weight-control practices. The aim of the present work is to evaluate the presence of behaviors suggestive of eating disorders, shifts in body perception, and menstrual dysfunctions in female athletes of the Federal University of Rio de Janeiro School of Physical Education (EEFD-UFRJ). Twelve female athletes (20 ± 2 years), who had been training for 4.6 ± 2.3 years, a total of 13.8 ± 2.9 hours per week, were examined. The results of the athletes and of 32 young non-athletes (15 ± 1.4 years) were compared. The Eating Attitudes Test (EAT-26) was used to evaluate weight-control and eating attitudes and behaviors. The Bulimic Investigatory Test Edimburgh (BITE) was used to identify suggestive behaviors of bulimia nervosa, and also to obtain data about cognitive and behavioral aspects of this disorder. The Body Shape Questionnaire (BSQ) was used to verify dissatisfaction with body image. The three self-applied questionnaires were used in their Portuguese versions. The athletes presented body mass of 59 ± 7.3 kg, height of 1.65 ± 0.03 m, percentage of body fat (%F) of 23.1 ± 4.1% and body mass index (BMI) of 21.6 ± 2.3 kg/m2. The entire sample had a %F compatible for age and sex, although 33% of the athletes presented some body image dissatisfaction. The BITE evidenced that 16.6% of the athletes presented a non-usual dietary pattern according to symptoms, but with no significance in terms of severity. These athletes are included among those who are not happy with their body. No athlete had a positive EAT-26 results. The findings of this study suggest the presence of symptoms that do not actually characterize bulimia or anorexia nervosa, but they point to the need of a careful surveillance and assessment of eating disorders and their precursors among athletes, as a way of prevention.