Gerusa Eisfeld Milano

Effects of physical exercise and nutritional guidance on metabolic syndrome in obese adolescents

OBJETIVOS: Analisar os efeitos de exercicios fisicos (EF) e orientacao nutricional (ON) sobre a composicao corporal, aptidao fisica, perfil lipidico e resistencia insulinica em adolescentes obesos com e sem sindrome metabolica (SM). METODOS: 64 obesos (26 meninos), com idade entre 10 a 16 anos, divididos em dois grupos: com SM (n=29) e sem SM (n=35). Utilizou-se como criterio de classificacao de SM a presenca de tres ou mais criterios para idade e sexo de acordo com Adult Treatment Panel III (ATP III). Mensuraram-se antes e apos 12 semanas de intervencao: pressao arterial, circunferencia abdominal, consumo maximo de oxigenio (VO2pico), glicemia, insulinemia, Homeostatic Metabolic Assessments (HOMA-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) e perfil lipidico. Os dois grupos participaram de 12 semanas de EF e duas sessoes de ON. Cada sessao de EF consistiu em 50 minutos de ciclismo indoor, 50 minutos de caminhada e 20 minutos de alongamento, tres vezes por semana. RESULTADOS: 55 sujeitos (com SM=25; sem SM=30) completaram o tratamento. Apos 12 semanas, houve diminuicao na massa corporal, IMC escore-z, circunferencia abdominal, massa gorda, TG e aumento na estatura, HDL-C e VO2pico, em ambos os grupos. Alem disso, houve uma reducao na pressao arterial sistolica, aumento na sensibilidade a insulina (p<0,05) no grupo com SM. Os fatores de risco para SM diminuiram em 72%. CONCLUSAO: Apos a intervencao multidisciplinar, houve uma reducao nos fatores de risco, melhorando a aptidao fisica e perfil metabolico. A intervencao multidisciplinar foi efetiva para reducao da SM.

Gender-dependent association of HSD11B1 single nucleotide polymorphisms with glucose and HDL-C levels

In this study, we investigated the influence of two SNPs (rs846910 and rs12086634) of the HSD11B1 gene that encodes 11β-hydroxysteroid dehydrogenase type 1(11β-HSD1), the enzyme that catalyzes the conversion of cortisol to cortisone, on variables associated with obesity and metabolic syndrome in 215 individuals of both sexes from southern Brazil. The HSD11B1 gene variants were genotyped using the TaqMan SNP genotyping assay. Glucose, triglycerides, total cholesterol, HDL-cholesterol and LDL-cholesterol were measured by standard automated methods. Significant results were found in women, with carriers of the G allele of SNP rs12086634 having higher glucose levels than non-carriers. Carriers of the A allele of SNP rs846910 had higher levels of HDL-cholesterol. The involvement of both polymorphisms as independent factors in determining the levels of glucose and HDL-cholesterol was confirmed by multiple regression analysis (β = 0.19 ±0.09, p = 0.03 and β= 0.22 ± 0.10, p = 0.03, respectively). Our findings suggest that the HSD11B1SNPs studied may indirectly influence glucose and HDL-cholesterol metabolism in women, possibly through down-regulation of the HSD11B1 gene by estrogen.

116A and K BCHE gene variants associated with obesity and hypertriglyceridemia in adolescents from Southern Brazil.

Butyrylcholinesterase (BChE) has been associated to body mass index (BMI), weight, cholesterol and triglyceride levels. -116A (rs1126680) and K (A539T, 1615A, rs1803274) BCHE gene variants had previously been associated to BChE activity, weight and BMI variance in adults. The present study examined -116A and K variants, BChE activity, anthropometric and biochemical variables associated with obesity in adolescents (120 obese and 150 non-obese from Curitiba, Brazil). Both -116A and K variants were found with significantly lower frequencies (p<0.05) in obese adolescents when compared with non-obese adolescents and with the general population. Mean BChE activity (KU/L) was significantly higher in obese adolescents when compared with non-obese adolescents and with the general population. Analyzing only the obese adolescents, it was found that carriers of the -116A variant showed lower BChE activity and higher triglyceride levels than homozygotes for the usual allele. Indeed, obese carriers of the -116A variant had triglyceride levels considered high according to reference values for serum triglycerides in Brazilian adolescents. These results show: (1) a protective effect of -116A and K variants on juvenile obesity risk, suggesting a role for the BCHE gene on juvenile onset obesity different from that observed on adult onset obesity and (2) an association of the -116A variant with hypertriglyceridemia in obese adolescents probably because of its effect on lowering BChE activity and consequently diminishing the enzyme capability of maintaining homeostasis on lipid metabolism during the metabolic stress caused by obesity.

Comparação das variáveis cardiorrespiratórias de adolescentes obesos e não obesos em esteira e bicicleta ergométrica

O objetivo deste estudo foi investigar o consumo maximo de oxigenio (VO2max) em adolescentes obesos e nao obesos em esteira e bicicleta ergometrica. O estudo foi transversal e descritivo com a amostra de 54 individuos obesos (23 meninos e 31 meninas) e 33 nao obesos (16 meninos e 17 meninas) com idade entre 10 e 16 anos. Utilizou-se o criterio dos Centers for Disease Control and Prevention (CDC, 2000) para a classificacao do indice de massa corporal (IMC). Foram avaliados o peso, estatura, indice de massa corporal (IMC) e IMC-escore Z. Para avaliacao cardiorrespiratoria foi realizado teste maximo em esteira e bicicleta ergometrica. Foram avaliados a frequencia cardiaca maxima (FCmax), coeficiente respiratorio (RER), consumo maximo de oxigenio (VO2max), tempo total de teste (TT) e carga final (w) na bicicleta ergometrica. Utilizou-se o teste de t de Student para a comparacao dos ergometros. Nas analises dos grupos, utilizou-se a ANOVA fatorial. Considerou-se significante p < 0,05. Os resultados revelaram que o peso, IMC e IMC-escore Z foram maiores nos obesos. Os valores de VO2max absoluto (l.min-1) foram mais altos nos obesos, em ambos os generos, na esteira, sem diferencas entre os grupos na bicicleta. Entretanto, o VO2max relativo ao peso corporal (ml.kg-1.min-1) foi menor no grupo obeso e nas meninas, em ambos os ergometros. A carga de trabalho na bicicleta foi similar entre os obesos e nao obesos. Concluiu-se que os obesos apresentaram valores de VO2max mais baixos que os nao obesos em ambos os ergometros. Entretanto, o fato de o individuo obeso na bicicleta suportar a mesma carga final que o nao obeso sugere-se que a bicicleta pode ser indicado como o melhor ergometro para obesos.

Efeitos de Exercícios Aquáticos e Orientação Nutricional na Composição Corporal de Crianças e Adolescentes Obesos

The objective of this study was to analyze the effects of aquatic exercise and nutritional guidance on the body composition of obese children and adolescents. Thirty obese children aged 10 to 16 years, with a body mass index (BMI) above the 95th percentile according to the classification proposed by the Centers for Disease Control and Prevention (CDC, 2000), were divided into two groups: the first group started learning to swim (GSwim, n = 10) and the second group underwent a deep water running program (GDeep, n = 20). Weight, height, BMI, BMI Z-scores, relative and absolute fat, and relative and absolute lean body mass were evaluated at baseline and after 12 weeks. The program consisted of 12 meetings for nutritional guidance (once a week) and 36 sessions of exercise (three times per week). MANOVA and Fisher’s exact test were used for statistical analysis, with the level of significance set at p < 0.05. After 12 weeks,GDeep showed a significant reduction in BMI, BMI Z-scores and relative and absolute fat, and an increase in relative and absolute lean body mass. Significant differences were observed between GDeep and GSwim in terms of the reduction in body fat (p = 0.014) and the increase in lean mass (p = 0.006). A program of deep water running together with nutritional guidance may promote significant changes in the body composition of obese children and adolescents due to the cyclic characteristic of this physical activity.

Beta 2-adrenergic receptor gene association with overweight and asthma in children and adolescents and its relationship with physical fitness

Objective: To investigate the association of Arg16Gly and Gln27Glu polymorphisms of β2-adrenergic receptor gene (ADRB2) with the occurrence of asthma and overweight and the genes influence on anthropometric, clinic, biochemical and physical fitness variables in children and adolescents. Methods: Subjects were evaluated for allelic frequencies of the β2-adrenergic receptor gene, height, weight, body mass index (BMI), BMI Z-score, waist circumference (WC), pubertal stage, resting heart rate (HRres), blood pressure (BP), total cholesterol (TC), glucose, insulin, high density lipoprotein (HDL-C), low density lipoprotein (LDL-C), triglyceride (TG), Homeostasis Metabolic Assessment (HOMA2-IR), Quantitative Insulin Sensitivity Check Index (QUICKI) and maximal oxygen uptake (VO2max). The participants were divided in four groups: overweight asthmatic (n=39), overweight non-asthmatic (n=115), normal weight asthmatic (n=12), and normal weight non-asthmatic (n=40). Results: Regarding the Gln27Glu polymorphism, higher total cholesterol was observed in usual genotype individuals than in genetic variant carriers (p=0.04). No evidence was found that the evaluated polymorphisms are influencing the physical fitness. The Arg16 allele was found more frequently among the normal weight asthmatic group when compared to the normal weight non-asthmatic group (p=0.02), and the Glu27 allele was more frequently found in the overweight asthmatics group when compared to the normal weight non-asthmatic group (p=0.03). Conclusions: The association of Arg16 allele with the occurrence of asthma and of the Glu27 allele with overweight asthmatic adolescents evidenced the contribution of the β2-adrenergic receptor gene to the development of obesity and asthma.

Peak Oxygen Uptake Responses to Training in Obese Adolescents: A Multilevel Allometric Framework to Partition the Influence of Body Size and Maturity Status

The influence of body size and maturation on the responses in peak oxygen uptake (VO2) to a 12-week aerobic training and nutritional intervention in obese boys (n = 30; 10–16 years) was examined using multilevel allometric regressions. Anthropometry, sexual maturity status, peak VO2, and body composition were measured pre- and postintervention. Significant decrements for body mass, body mass index z-score, and waist circumference and increments for stature, fat-free mass, and peak oxygen uptake were observed after intervention. Partitioning body size on peak VO2, the responses of the individuals to training were positive (11.8% to 12.7% for body mass; 7.6% to 8.1% for fat-free mass). Body mass and fat-free mass were found as significant explanatory variables, with an additional positive effect for chronological. The allometric coefficients (k′) in the initial models were k′ = 0.883 and k′ = 1.058 for body mass and fat-free mass, respectively. The coefficients decreased when age was considered (k′ = 0.530 for body mass; k′ = 0.860 for fat-free mass). Including maturity indicator in the models was not significant, thus the influence of variability in sexual maturity status in responses to exercise-based intervention in peak VO2 may be mediated by the changes in body dimensions.

Scale of VO2peak in obese and non-obese adolescents by different methods

FUNDAMENTO: El consumo pico de oxigeno (VO2pico) puede ser definido como la mayor tasa de consumo de oxigeno durante ejercicio exhaustivo o maximo. La evaluacion de aptitud aerobica puede expresarse como relativa a la masa corporal, pero ese procedimiento puede no resolver completamente las diferencias cuando se evaluan individuos pesados. Por ello, el procedimiento con escala alometrica es una estrategia atractiva para comparar individuos con grandes diferencias en la masa corporal. OBJETIVO: Investigar el VO2pico en individuos obesos y no obesos usando el metodo de correccion de masa corporal (convencional) y la escala alometrica (metodo alometrico) y como esos metodos se aplican cuando individuos de ambos sexos se ejercitan en una cinta ergometrica. METODOS: El VO2pico relativo al peso corporal y por el metodo alometrico fue comparado en 54 adolescentes obesos y 33 no obesos (10-16 anos). Para evaluar el VO2pico durante un test maximo se utilizo calorimetria indirecta. El exponente alometrico fue calculado considerando la masa corporal individual. Asi, el VO2pico fue corregido mediante el exponente alometrico. Las comparaciones se realizaron utilizando two-way ANOVA para medidas repetidas (p 0,05). Sin embargo, el VO2pico calculado por el metodo convencional fue mayor (p 0.05) entre los grupos. CONCLUSION: Los individuos obesos presentaron VO2pico mas bajo que los no obesos, al ser evaluados mediante el metodo convencional. Sin embargo, las diferencias desaparecieron cuando se aplico el metodo de la escala alometrica.BACKGROUND Peak oxygen uptake (VO(2peak)) can be defined as the highest oxygen rate consumed during exhaustive or maximal exercise. The evaluation of the aerobic fitness can be expressed as relative to body mass, but this procedure may not fully remove differences when heavy subjects are assessed. Thus, the allometric scaling procedure is an attractive strategy to compare individuals with large differences in body mass. OBJECTIVE Investigate VO(2peak) in obese and non-obese individuals using body mass correction (conventional) and allometric scaling (allometric) methods and how these methods apply when subjects of different genders exercise on a treadmill. METHODS VO(2peak) relative to body weight and measured by the allometric method were compared in 54 obese and 33 non-obese adolescents (10 a 16 years). Indirect calorimetry was used to assess VO(2peak) during a maximal test. The allometric exponent was calculated taking into account individual body mass. Then, VO(2peak) was corrected by the allometric exponent. The comparisons were performed using a repeated measures two-way ANOVA (p<0.05). RESULTS The absolute VO(2peak) was higher (p<0.05) in the obese girls (2.80+/-0.69) compared to non-obese ones (2.00+/-0.24), but this association was not observed for the male subjects (p>0.05). However, VO(2peak) calculated by the conventional method was higher (p<0.05) among non-obese individuals in both genders (girls: 41.45+/-3.85; boys: 49.81+/-7.12) in comparison to the obese subjects (girls: 32.11+/-4.48; boys: 37.54+/-6.06). The allometric VO(2peak) was similar (p>0.05) between the groups. CONCLUSION The obese showed lower VO(2peak) values than non-obese individuals when assessed by the conventional method. However, when the allometric scaling method was applied, differences disappeared.

Escala de VO2pico em adolescentes obesos e não-Obesos por diferentes métodos

FUNDAMENTO: El consumo pico de oxigeno (VO2pico) puede ser definido como la mayor tasa de consumo de oxigeno durante ejercicio exhaustivo o maximo. La evaluacion de aptitud aerobica puede expresarse como relativa a la masa corporal, pero ese procedimiento puede no resolver completamente las diferencias cuando se evaluan individuos pesados. Por ello, el procedimiento con escala alometrica es una estrategia atractiva para comparar individuos con grandes diferencias en la masa corporal. OBJETIVO: Investigar el VO2pico en individuos obesos y no obesos usando el metodo de correccion de masa corporal (convencional) y la escala alometrica (metodo alometrico) y como esos metodos se aplican cuando individuos de ambos sexos se ejercitan en una cinta ergometrica. METODOS: El VO2pico relativo al peso corporal y por el metodo alometrico fue comparado en 54 adolescentes obesos y 33 no obesos (10-16 anos). Para evaluar el VO2pico durante un test maximo se utilizo calorimetria indirecta. El exponente alometrico fue calculado considerando la masa corporal individual. Asi, el VO2pico fue corregido mediante el exponente alometrico. Las comparaciones se realizaron utilizando two-way ANOVA para medidas repetidas (p 0,05). Sin embargo, el VO2pico calculado por el metodo convencional fue mayor (p 0.05) entre los grupos. CONCLUSION: Los individuos obesos presentaron VO2pico mas bajo que los no obesos, al ser evaluados mediante el metodo convencional. Sin embargo, las diferencias desaparecieron cuando se aplico el metodo de la escala alometrica.BACKGROUND Peak oxygen uptake (VO(2peak)) can be defined as the highest oxygen rate consumed during exhaustive or maximal exercise. The evaluation of the aerobic fitness can be expressed as relative to body mass, but this procedure may not fully remove differences when heavy subjects are assessed. Thus, the allometric scaling procedure is an attractive strategy to compare individuals with large differences in body mass. OBJECTIVE Investigate VO(2peak) in obese and non-obese individuals using body mass correction (conventional) and allometric scaling (allometric) methods and how these methods apply when subjects of different genders exercise on a treadmill. METHODS VO(2peak) relative to body weight and measured by the allometric method were compared in 54 obese and 33 non-obese adolescents (10 a 16 years). Indirect calorimetry was used to assess VO(2peak) during a maximal test. The allometric exponent was calculated taking into account individual body mass. Then, VO(2peak) was corrected by the allometric exponent. The comparisons were performed using a repeated measures two-way ANOVA (p<0.05). RESULTS The absolute VO(2peak) was higher (p<0.05) in the obese girls (2.80+/-0.69) compared to non-obese ones (2.00+/-0.24), but this association was not observed for the male subjects (p>0.05). However, VO(2peak) calculated by the conventional method was higher (p<0.05) among non-obese individuals in both genders (girls: 41.45+/-3.85; boys: 49.81+/-7.12) in comparison to the obese subjects (girls: 32.11+/-4.48; boys: 37.54+/-6.06). The allometric VO(2peak) was similar (p>0.05) between the groups. CONCLUSION The obese showed lower VO(2peak) values than non-obese individuals when assessed by the conventional method. However, when the allometric scaling method was applied, differences disappeared.

Escala de VO2pico en adolescentes obesos y no obesos por diferentes métodos

FUNDAMENTO: El consumo pico de oxigeno (VO2pico) puede ser definido como la mayor tasa de consumo de oxigeno durante ejercicio exhaustivo o maximo. La evaluacion de aptitud aerobica puede expresarse como relativa a la masa corporal, pero ese procedimiento puede no resolver completamente las diferencias cuando se evaluan individuos pesados. Por ello, el procedimiento con escala alometrica es una estrategia atractiva para comparar individuos con grandes diferencias en la masa corporal. OBJETIVO: Investigar el VO2pico en individuos obesos y no obesos usando el metodo de correccion de masa corporal (convencional) y la escala alometrica (metodo alometrico) y como esos metodos se aplican cuando individuos de ambos sexos se ejercitan en una cinta ergometrica. METODOS: El VO2pico relativo al peso corporal y por el metodo alometrico fue comparado en 54 adolescentes obesos y 33 no obesos (10-16 anos). Para evaluar el VO2pico durante un test maximo se utilizo calorimetria indirecta. El exponente alometrico fue calculado considerando la masa corporal individual. Asi, el VO2pico fue corregido mediante el exponente alometrico. Las comparaciones se realizaron utilizando two-way ANOVA para medidas repetidas (p 0,05). Sin embargo, el VO2pico calculado por el metodo convencional fue mayor (p 0.05) entre los grupos. CONCLUSION: Los individuos obesos presentaron VO2pico mas bajo que los no obesos, al ser evaluados mediante el metodo convencional. Sin embargo, las diferencias desaparecieron cuando se aplico el metodo de la escala alometrica.BACKGROUND Peak oxygen uptake (VO(2peak)) can be defined as the highest oxygen rate consumed during exhaustive or maximal exercise. The evaluation of the aerobic fitness can be expressed as relative to body mass, but this procedure may not fully remove differences when heavy subjects are assessed. Thus, the allometric scaling procedure is an attractive strategy to compare individuals with large differences in body mass. OBJECTIVE Investigate VO(2peak) in obese and non-obese individuals using body mass correction (conventional) and allometric scaling (allometric) methods and how these methods apply when subjects of different genders exercise on a treadmill. METHODS VO(2peak) relative to body weight and measured by the allometric method were compared in 54 obese and 33 non-obese adolescents (10 a 16 years). Indirect calorimetry was used to assess VO(2peak) during a maximal test. The allometric exponent was calculated taking into account individual body mass. Then, VO(2peak) was corrected by the allometric exponent. The comparisons were performed using a repeated measures two-way ANOVA (p<0.05). RESULTS The absolute VO(2peak) was higher (p<0.05) in the obese girls (2.80+/-0.69) compared to non-obese ones (2.00+/-0.24), but this association was not observed for the male subjects (p>0.05). However, VO(2peak) calculated by the conventional method was higher (p<0.05) among non-obese individuals in both genders (girls: 41.45+/-3.85; boys: 49.81+/-7.12) in comparison to the obese subjects (girls: 32.11+/-4.48; boys: 37.54+/-6.06). The allometric VO(2peak) was similar (p>0.05) between the groups. CONCLUSION The obese showed lower VO(2peak) values than non-obese individuals when assessed by the conventional method. However, when the allometric scaling method was applied, differences disappeared.