Maria Fernandez-del-Valle

Resistance training enhances muscular performance in patients with anorexia nervosa: A randomized controlled trial

OBJECTIVE Low-intensity exercise applied in anorexia nervosa patients has been shown to have a harmless effect on body composition and to effect short-term improvements in muscular strength and agility. The aim of this study was to determine the effects of a high-intensity resistance training program designed for adolescents to improve strength and agility in anorexia nervosa restricting-type patients (AN-R). METHODS From a total of 36 female patients with AN-R, one group (intervention, n = 18) underwent a supervised high-intensity resistance training program lasting 8 weeks, and the other group with no exercise (control, n = 18). Body weight, body mass index, whole-body muscular strength, and agility were assessed before, after, and 4 weeks after training (detraining). RESULTS Leg-press, bench-press, and lateral row tests improved significantly (p < 0.001) after 8 weeks of training compared with controls. Improvements were maintained after the detraining period. The training program also showed beneficial effects on agility. DISCUSSION A high-intensity resistance training program adapted to the recommendations for adolescents in AN-R patients was effective and safe, improving muscular strength in the whole body and the ability to perform daily tasks. However, long-term maintenance of gains seems to be linked to the continuance of training or the use of a maintenance program.

Muscle function and body composition profile in adolescents with restrictive anorexia nervosa: does resistance training help?

Abstract Purpose: The aim of this study was to analyze the effects of short-term resistance training on the body composition profile and muscle function in a group of Anorexia Nervosa restricting type (AN-R) patients. Methods: The sample consisted of AN-R female adolescents (12.8 ± 0.6 years) allocated into the control and intervention groups (n = 18 each). Body composition and relative strength were assessed at baseline, after 8 weeks and 4 weeks following the intervention. Results: Body mass index (BMI) increased throughout the study (p = 0.011). Significant skeletal muscle mass (SMM) gains were found in the intervention group (p = 0.045, d = 0.6) that correlated to the change in BMI (r = 0.51, p < 0.031). Meanwhile, fat mass (FM) gains were significant in the control group (p = 0.047, d = 0.6) and correlated (r > 0.60) with change in BMI in both the groups. Significant relative strength increases (p < 0.001) were found in the intervention group and were sustained over time. Conclusions: SMM gain is linked to an increased relative strength when resistance training is prescribed. Although FM, relative body fat (%BF), BMI and body weight (BW) are used to monitor nutritional progress. Based on our results, we suggest to monitor SMM and relative strength ratios for a better estimation of body composition profile and muscle function recovery. Implications for Rehabilitation Anorexia Nervosa Restricting Type (AN-R) AN-R is a psychiatric disorder that has a major impact on muscle mass content and function. However, little or no attention has been paid to muscle recovery. High intensity resistance training is safe for AN-R after hospitalization and enhances the force generating capacity as well as muscle mass gains. Skeletal muscle mass content and muscular function improvements are partially maintained for a short period of time when the exercise program ceases.

INFLUENCE OF FAT PERCENTAGE, FRONT THIGH SKINFOLD AND GIRTH ON THE MAXIMUM RADIAL DISPLACEMENT OF THE DOMINANT RECTUS FEMORIS

Background Tensiomyography (TMG) is an innovative tool to control athletic training, and prevent and follow up muscular injuries. The reliability and validity for different population (sport modality, physical activity level, medical history, body composition, etc.) have been reported (Rodriguez-Matoso et al., 2012; Tous-Fajardo et al., 2010). Body composition of individuals may determine the mechanical response of muscular contraction produced by electrical stimulation. The aim of this study was to analyze the correlation of the values of fat percentage (%F), front thigh skinfold (FTS) and thigh girth (TG) to the maximal radial deformation (Dm) of the Rectus Femoris (RF) obtained using TMG. Methods A total of 193 participants were assessed: 132 high performance volleyball players (79 male, and 53 female), and 61 Sport Sciences college students (40 male, and 21 female). Anthropometric variables (%F, FTS, and TG) where assessed following the ISAK guidelines (Marfell-Jones, 2001) by a certified instructor (level 3). Faulkners equation was used to calculate %F, and the TMG was used following Rodriguez-Matoso et al (2012) guidelines. Pearson correlation was assessed for statistical analysis using the SPSS v.19.0 with a level of signification p≤0.05. Results Results did not show differences between total sample and gender-related samples (FTS vs Dm: r 2=0.0096; p=0.19, y %G vs Dm: r 2<0.001; p=0.98), neither when TG is used as a control variable (FTS vs Dm: r 2=0.01; p=0.18, and %G vs Dm: r 2<0.001; p=0.82). Conclusions In conclusion, the results point that Dm in this population is not affected by body composition variables such %F, FTS, or TG.

Disordered Eating Issues in Active Children and Adolescence

The development of a child’s body image is strongly influenced by peers, school, family, society, and the media. While it is important for children to learn healthy eating habits and attitudes toward physical activity early in life, it is also essential that children learn to value themselves and develop a strong self-esteem. Without such positive influences, children and adolescents may develop disordered eating habits, which include the use of diet pills, laxatives, and excessive exercise. These disordered eating habits may manifest themselves as clinical eating disorders, such as anorexia and bulimia. It is of great importance that children receive support and positive influences from family, peers, and school to develop a healthy self-image and prevent the formation of disordered eating habits and eating disorders.

Eating Disorders and Disordered Eating: A Global Perspective

The continuous progression of the prevalence of eating disorders (ED) is a cause of concern during the last decades, and epidemiologic research has shown different increases between countries. Food is as well a psychological need that presents interindividual differences such as preferences/rejections to foods, healthy/unhealthy dietary habits, and worries about the shape, which result in “body dissatisfaction.” Thus, dieting and compensatory behaviors to control weight are acquired as normal behaviors by the general population increasing the risk to suffer from ED. In addition, healthy people and other atypical disorders are strongly influenced by emotions in their eating behaviors, not only EDs.

Cardiovascular Exercise Guidelines for Children and Adolescent Women

Exercise participation implemented during childhood and adolescence may promote a continued active lifestyle later in life. This may then prevent the apparition of cardiovascular, metabolic, and other diseases known to be prevalent in young and older adults. Children and adolescents have unique exercise capacity characteristics. Thus, appropriate cardiovascular exercise guidelines were developed in order to receive maximum benefits from exercise training while also emphasizing safety. Furthermore, approaches to training with the youth were developed to promote exercise and sport adherence. This chapter focuses on cardiovascular exercise guidelines for children and adolescent women.

Excessive Exercise and Immunity: The J-Shaped Curve

Exercise modulates the innate and specific arms of the immune system with a marked intensity-dependent response. This response might be influenced by sex differences and other factors including age, nutrition status, and overall level of psychological stress. Exercise immunology is the field that studies this area. In the 1990s, Dr. Nieman formulated the controversial “J-shaped hypothesis” to describe the relationship between exercise intensity and the risk of acquiring upper respiratory tract infections (URTI). This hypothesis suggests that moderate exercise has the ability to improve immune function above sedentary levels while high intensity exercise depresses the immune system. However, some methodological problems exist in studies of the J-curve which makes evidence more anecdotal than evidence-based regarding the role of moderate and intense exercise in the incidence of URTI. These limitations are presented in the chapter.

Screening Tools for Excessive Exercise in the Active Female

Excessive Exercise etiology and diagnosis has been deeply studied with inconclusive results. The criteria used for diagnosis are based on the Diagnostic and Statistical Manual for Mental Disorders (DSM) to diagnose addictive behaviors or substance abuse (alcohol, drugs, etc.). Moreover, the screening tools proposed by different authors have been subjective, inaccurate and co-assess other psychological and psychiatric disorders. Subjective screening tools (questionnaires, inventories, interviews, etc.) show information related to the psychological factors contributing to this behavior, and the information related to the characteristics of the exercise performed is scarce. Further, no validated cut-points exist to assess excessive exercise in different groups (children, adolescents, adults, elders, athletes, females, males, etc.). Therefore, the objective screening tools (accelerometers, pedometers, etc.) could add meaningful knowledge about the real characteristics of the activity performed by individuals.

Resistance Training Guidelines for Active Females Throughout the Lifespan: Children, Adolescences, Adult Women, and the Aging Woman

Due to recent changes in physical activity practices, strength training, or resistance training, has become an area of focus in the research of determining the overall health of an individual. As individuals age, disorders relating to both bone and muscle begin to cause a decline in health and functional activity. Bone disorders, such as osteoporosis and osteopenia, have been linked to muscle disorders like sarcopenia (a loss of skeletal muscle mass). While these disorders do affect males, females tend to show higher incidences of these diseases. Current research suggests that resistance training can help to delay the effects of these diseases. Resistance training implemented in the early stages of life, such as childhood and adolescence, has been shown to cause increases in both bone growth, specifically bone mass and bone mineral density, and skeletal muscle mass. Resistance training can help maintain current levels of fitness in adults and improve activities of daily living in the elderly. In order to receive maximum benefits from resistance training, guidelines spanning the entire lifespan needed to be developed. The resistance training guidelines cover everything from basic supervision needs to intensity, duration, and frequency of the program. The guidelines include specific directions to increase hypertrophy, power, strength, and endurance. So, resistance training, which was once thought to cause injury in some, is now seen as a way to increase health and even reduce the chance of injury when done properly.