Hélio José Coelho-Júnior

Acute effects of power and resistance exercises on hemodynamic measurements of older women

Purpose The purpose of this study was to compare the acute effects of resistance training (RT) and power training (PT) on the hemodynamic parameters and nitric oxide (NO) bioavailability of older women. Materials and methods A randomized experimental design was used in this study. Twenty-one older women (age: 67.1±4.6 years; body mass index: 28.03±4.9 kg/m2; systolic blood pressure: 135.1±21.1 mmHg) were recruited to participate in this study. Volunteers were randomly allocated into PT, RT, and control session (CS) groups. The PT and RT groups underwent a single session of physical exercise equalized by training volume, characterized by 3 sets of 8–10 repetitions in 8 different exercises. However, RT group performed exercise at a higher intensity (difficult) than PT (moderate) group. On the other hand, concentric contractions were faster in PT group than in RT group. Hemodynamic parameters and saliva samples (for NO quantification) were collected before and during an hour after exercise completion. Results Results demonstrated post-exercise hypotension during 35 minutes in the PT when compared to rest period (P=0.001). In turn, RT showed decreased heart rate and double product (P<0.001) during the whole evaluation period after exercise completion compared with the rest period. NO levels increased in the PT and RT during the whole evaluation period in relation to rest period. However, there were no differences between PT, RT, and CS regarding hemodynamic and NO evaluations. Conclusion Data indicate that an acute session of power and resistance exercise can be effective to cause beneficial changes on hemodynamic parameters and NO levels in older women.

Effects of inspiratory muscle exercise in the pulmonary function, autonomic modulation, and hemodynamic variables in older women with metabolic syndrome

The aim of the present study was to investigate the effects of inspiratory muscle exercise (IME) on metabolic and hemodynamic parameters, cardiac autonomic modulation and respiratory function of older women with metabolic syndrome (MS). For this, sixteen older women with MS and 12 aged-matched controls participated of the present study. Two days before and 2 days after the main experiment, fasting blood samples (i.e., total cholesterol, triglycerides and blood glucose), cardiac autonomic modulation (i.e., heart rate variability), and respiratory muscle function were obtained and evaluated. The sessions of physical exercise was based on a IME, which was performed during 7 days. Each session of IME was performed during 20 min, at 30% of maximal static inspiratory pressure. In the results, MS group presented higher levels of triglycerides, blood glucose, and systolic blood pressure when compared to control group. IME was not able to change these variables. However, although MS group showed impaired respiratory muscle strength and function, as well as cardiac autonomic modulation, IME was able to improve these parameters. Thus, the data showed that seven days of IME are capable to improve respiratory function and cardiac autonomic modulation of older women with MS. These results indicate that IME can be a profitable therapy to counteracting the clinical markers of MS, once repeated sessions of acute IME can cause chronical alterations on respiratory function and cardiac autonomic modulation.

Relative Protein Intake and Physical Function in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

(1) Background: The present work aims to conduct a systematic review and meta-analysis of observational studies, in order to investigate the association of relative protein intake and physical function in older adults; (2) Methods: Observational studies, that investigated the association between protein intake and physical function in older adults, were retrieved from MEDLINE, SCOPUS, CINAHL, AgeLine, EMBASE, and Cochrane-CENTRAL. Two independent researchers conducted study selection and data extraction; (3) Results: Very high protein intake (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) groups showed better lower limb physical functioning and walking speed (WS) performance, respectively, in comparison to individuals who present relative low protein (<0.80 g/kg/day) intake. On the other hand, relative high protein intake does not seem to propitiate a better performance on isometric handgrip (IHG) and chair rise in comparison to relative low protein intake. In addition, there were no significant differences in the physical functioning of high and middle protein intake groups; (4) Conclusions: In conclusion, findings of the present study indicate that a very high (≥1.2 g/kg/day) and high protein intake (≥1.0 g/kg/day) are associated with better lower-limb physical performance, when compared to low protein (<0.80 g/kg/day) intake, in community-dwelling older adults. These findings act as additional evidence regarding the potential need to increase protein guidelines to above the current recommendations. However, large randomized clinical trials are needed to confirm the addictive effects of high-protein diets (≥1.0 g/kg/day) in comparison to the current recommendations on physical functioning. All data are available in the Open ScienceFramework.

Low Protein Intake Is Associated with Frailty in Older Adults: A Systematic Review and Meta-Analysis of Observational Studies

(1) Background: Several factors have been suggested to be associated with the physiopathology of frailty in older adults, and nutrition (especially protein intake) has been attributed fundamental importance in this context. The objective of this study was to conduct a systematic review and meta-analysis to investigate the relationship between protein intake and frailty status in older adults. (2) Methods: A search of scientific studies was conducted in the main databases (Medline, Scopus, Cochrane library), and in the reference lists of selected articles. The search terms included synonyms and Medical Subject Headings and involved the use of Boolean operators which allowed the combination of words and search terms. Observational studies—cross-sectional and longitudinal—that met the eligibility criteria were included in the review. Article selection and data extraction were performed by two independent reviewers. Meta-analyses with random effects were performed. Publication bias was measured using the Strengthening the Reporting of Observational Studies in Epidemiology instrument. (3) Results: In the final sample, 10 articles, seven cross-sectional and three longitudinal, were included in the present study. Overall, studies investigated a total of 50,284 older adults from three different continents between 2006 and 2018. Four cross-sectional studies were included in the meta-analyses. The results demonstrated that a high protein intake was negatively associated with frailty status in older adults (odds ratio: 0.67, confidence interval = 0.56 to 0.82, p = 0.0001). (4) Conclusions: Our findings suggest that a high consumption of dietary protein is inversely associated with frailty in older adults.

A Distinct Pattern of Circulating Amino Acids Characterizes Older Persons with Physical Frailty and Sarcopenia: Preliminary Results from the BIOSPHERE Study

Physical frailty and sarcopenia (PF&S) are hallmarks of aging that share a common pathogenic background. Perturbations in protein/amino acid metabolism may play a role in the development of PF&S. In this preliminary study, 68 community-dwellers aged 70 years and older, 38 with PF&S and 30 non-sarcopenic, non-frail controls (nonPF&S), were enrolled. A panel of 37 serum amino acids and derivatives was assayed by UPLC-MS. Partial Least Squares Discriminant Analysis (PLS-DA) was used to characterize the amino acid profile of PF&S. The optimal complexity of the PLS-DA model was found to be three latent variables. The proportion of correct classification was 76.6 ± 3.9% (75.1 ± 4.6% for enrollees with PF&S; 78.5 ± 6.0% for controls). Older adults with PF&S were characterized by higher levels of asparagine, aspartic acid, citrulline, ethanolamine, glutamic acid, sarcosine, and taurine. The profile of nonPF&S individuals was defined by higher levels of α-aminobutyric acid and methionine. Distinct profiles of circulating amino acids and derivatives characterize older individuals with PF&S. The dissection of these patterns may provide novel insights into the role played by protein/amino acid perturbations in the disabling cascade and possible new targets for interventions.

Hypertension, Sarcopenia, and Global Cognitive Function in Community-Dwelling Older Women: A Preliminary Study

The present study aimed to investigate whether sarcopenia interferes in the association between HTN and cognitive function in community-dwelling older women. One hundred and eleven older women were recruited and dichotomized in hypertensive (n=63) and normotensive groups (n=48). Volunteers underwent evaluations of the sarcopenic state (i.e., skeletal muscle mass, short physical performance battery (SPPB), balance), hemodynamic parameters, and global cognitive status (i.e., Mini-Mental State Examination (MMSE)). Data demonstrated that hypertensive patients had lower global cognitive status than normotensive subjects. When volunteers were divided according to sarcopenic status, data demonstrated that hypertensive patients with low performance on SPPB (0.006), low values of sarcopenic index (0.03), and low performance on sit-to-stand (0.09) demonstrated poor cognitive status compared with hypertensive patients with normal values of these variables. In conclusion, data of the current study indicate that the sarcopenic state might interfere in the association among hypertension and poor cognitive status, once a higher frequency of hypertensive patients with low lower limb muscle function (i.e., SPPB and sit-to-stand) and muscle mass index (i.e., Janssen index) was observed in the <24 MMSE segment, in comparison with hypertensive patients with normal results in these parameters.

Protective Effects of Accumulated Aerobic Exercise in Infarcted Old Rats

Mailing Address: Daniele Jardim Feriani Avenida Érico Veríssimo, 701. Postal Code: 13083-851, Barão Geraldo, Campinas, SP Brazil. E-mail: dani_feriani@hotmail.com Protective Effects of Accumulated Aerobic Exercise in Infarcted Old Rats Daniele Jardim Feriani,1,2 Hélio José Coelho-Júnior,2 Maria Cláudia Irigoyen,3 Bruno Rodrigues2 Universidade São Judas Tadeu;1 Mooca, SP Brazil Universidade Estadual de Campinas (UNICAMP),2 Campinas, SP Brazil Instituto do Coração (InCor) Faculdade de Medicina da Universidade de São Paulo,3 São Paulo, SP Brazil

Pyridostigmine Improves the Effects of Resistance Exercise Training after Myocardial Infarction in Rats

Myocardial infarction (MI) remains the leading cause of morbidity and mortality worldwide. Exercise training and pharmacological treatments are important strategies to minimize the deleterious effects of MI. However, little is known about the effects of resistance training combined with pyridostigmine bromide (PYR) treatment on cardiac and autonomic function, as well as on the inflammatory profile after MI. Thus, in the present study, male Wistar rats were randomly assigned into: control (Cont); sedentary infarcted (Inf); PYR – treated sedentary infarcted rats (Inf+P); infarcted rats undergoing resistance exercise training (Inf+RT); and infarcted rats undergoing PYR treatment plus resistance training (Inf+RT+P). After 12 weeks of resistance training (15–20 climbs per session, with a 1-min rest between each climb, at a low to moderate intensity, 5 days a week) and/or PYR treatment (0.14 mg/mL of drink water), hemodynamic function, autonomic modulation, and cytokine expressions were evaluated. We observed that 3 months of PYR treatment, either alone or in combination with exercise, can improve the deleterious effects of MI on left ventricle dimensions and function, baroreflex sensitivity, and autonomic parameters, as well as systemic and tissue inflammatory profile. Furthermore, additional benefits in a maximal load test and anti-inflammatory state of skeletal muscle were found when resistance training was combined with PYR treatment. Thus, our findings suggest that the combination of resistance training and PYR may be a good therapeutic strategy since they promote additional benefits on skeletal muscle anti-inflammatory profile after MI.

The physical capabilities underlying timed “Up and Go” test are time-dependent in community-dwelling older women

Abstract Timed ‘Up and Go’ (TUG) has been widely used in research and clinical practice to evaluate physical function and mobility in older adults. However, the physical capabilities underlying TUG performance are not well elucidated. Therefore, the present study aimed at investigating a selection of physical capacities underlying TUG performance in community‐dwelling older women. Four hundred and sixty‐eight apparently healthy older women independent to perform the activities of daily living (mean age: 65.8 ± 6.0 years) were recruited from two specialized healthcare centers for older adults to participate in the study. Volunteers had their medical books reviewed and underwent evaluations of anthropometric data as well as physical and functional capacities. Pearsons correlation results indicate that TUG performance was significantly associated with upper (i.e., handgrip strength) and lower (i.e., sit‐to‐stand) limb muscle strength, balance (i.e., one‐leg stand), lower limb muscle power (i.e., countermovement jump), aerobic capacity (i.e., 6‐minute walk test), and mobility (i.e., usual and maximal walking speeds). When the analyses were performed based on TUG quartiles, a larger number of physical capabilities were associated with TUG >75% in comparison with TUG <25%. Multiple linear regression results indicate that the variability in TUG (˜20%) was explained by lower limb muscle strength (13%) and power (1%), balance (4%), mobility (2%), and aerobic capacity (<1%), even after adjusted by age and age plus body mass index (BMI). However, when TUG results were added as quartiles, a decrease in the impact of physical capacities on TUG performance was determined. As a whole, our findings indicate that the contribution of physical capabilities to TUG performance is altered according to the time taken to perform the test, so that older women in the lower quartiles — indicating a higher performance — have an important contribution of lower limb muscle strength, while volunteers in the highest quartile demonstrate a decreased dependence on lower limb muscle strength and an increased contribution of other physical capabilities, such as lower limb muscle power and balance. Abbreviations: ADLs: activities of daily living; BMI: body mass index; DP: double product; GUG: get up and go; HC: hip circumference; iTUG: instrumented TUG; MAP: mean arterial pressure; NC: neck circumference; ANOVA: one‐way analysis of variance; 6MWT: six‐minute walk test; TUG: timed ‘Up and Go’; UMC: University of Mogi das Cruzes; WC: waist circumference.

Multicomponent Exercise Improves Physical Functioning but Not Cognition and Hemodynamic Parameters in Elderly Osteoarthritis Patients Regardless of Hypertension

The present study aimed to investigate the impact of a 6-month multicomponent exercise program (MCEP) on physical function, cognition, and hemodynamic parameters of elderly normotensive (NTS) and hypertensive (HTS) osteoarthritis patients. A total of 99 elderly osteoarthritis patients (44 NTS and 55 HTS) were recruited and submitted to functional, cognitive, and hemodynamic evaluations before and after six months of a MCEP. The program of exercise was performed twice a week at moderate intensity. The physical exercises aggregated functional and walking exercises. Results indicate that 6 months of MCEP were able to improve one-leg stand and mobility (walking speeds) of osteoarthritis patients regardless of hypertension. On the other hand, cognitive and hemodynamic parameters were not altered after the MCEP. The findings of the present study demonstrate that 6 months of MCEP were able to improve the physical functioning (i.e., usual and maximal walking speed and balance) of osteoarthritis patients regardless of hypertensive condition.