Maurílio Tiradentes Dutra

Acute and chronic effects of resistance exercise on blood pressure in elderly women and the possible influence of ACE I/D polymorphism.

This study investigated the chronic effect of blood pressure (BP) and post-exercise hypotension (PEH) during resistance training (RT) and its relation with the angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism in hypertensive elderly women. Participants were divided into two groups: an experimental group (EG) with exercise and a control group (CG) without exercise. The EG performed one adaptation month and one repetition maximum load (1RM) test at the end of this period. After the first month, the EG conducted a three-month program of RT at 60%, 70%, and 80% of 1RM, respectively, for each month. The CG was evaluated at the end of each month. Systolic (SBP) and diastolic (DBP) blood pressure (Microlife BP 3AC1-1) were measured, with the subject in a seated position, during an acute session for both GE and CG as follows: every 5 minutes for 20 minutes at pre-exercise rest, immediately after the resistance exercise and control, and every 15 minutes during 1 hour of recovery after exercise and CG. Analysis of covariance showed reduction in SBP and DBP (P ≤ 0.05) rest values after the RT program. PEH was observed only for the EG in acute sessions, for SBP after the second and third months (P ≤ 0.05), and for DBP after the second and fourth months (P ≤ 0.05). No significant differences in main effects and interaction effects between blood pressure and ACE I/D were observed. The occurrence of chronic reduction of blood pressure and PEH through EG may have a protective effect on the cardiovascular system with no ACE I/D polymorphism influence for this population.

Comparison of adiposity indices and cut-off values in the prediction of metabolic syndrome in postmenopausal women.

AIMS To compare adiposity indices and to assess their various cut-off values for the prediction of metabolic syndrome (MetS) in postmenopausal women. METHODS One hundred forty nine volunteers (67.17±6.12 years) underwent body composition assessment using DXA and had 5 anthropometric indices measured (Waist Circumference, WC; Waist-to-Height Ratio, WHtR; Body Mass Index, BMI; Body Adiposity Index, BAI; and Conicity Index). Blood pressure was assessed using an oscillometric device and fasting blood samples were collected. MetS was classified according NCEP-ATP III. Cut-off values to predict MetS were obtained using Receiver Operating Characteristic (ROC) curve analyses and odds ratios were also calculated. RESULTS MetS prevalence was 29.5% and subjects who were classified with MetS showed worse cardiometabolic outcomes and higher anthropometric indices values (p<0.05). With the exception of total- and LDL-cholesterol, all remaining variables were significantly correlated with at least one of the adiposity indices, with the strongest relationships observed for the indices reflecting central body fat. The cut-off values were 88cm, 0.57cm/cm, 26.85kg/m(2), 43.7%, 36.34%, and 1.24 units for WC, WHtR, BMI, DXA-derived body fat percentage, BAI, and conicity index, respectively. Significant greater risks for MetS were found for volunteers who had WHtR (odds=9.08; CI: 1.81-45.47) or WC (odds=5.20; CI: 1.30-20.73) measurements above cut-off values. CONCLUSION Adiposity indices are associated with MetS in postmenopausal women in different degrees. Indices which consider central adiposity such as WC and WHtR have a stronger relationship with MetS compared to DXA-derived body fat percentage, which is considered a gold standard.

Relationship between sarcopenic obesity‐related phenotypes and inflammatory markers in postmenopausal women

Ageing is associated with changes in body composition that may result in sarcopenic obesity (SO). Interleukin‐6 (IL‐6) and C‐reactive protein (CRP) are important inflammatory markers related to ageing. SO has been examined as an important public health problem, but its association with inflammatory markers has yet to be investigated. The aim of this study was to investigate the association between SO‐related phenotypes and inflammatory markers in postmenopausal women. A total of 130 women (66·7 ± 5·2 years) underwent body composition evaluation using dual‐energy X‐ray absorptiometry. Volunteers were classified according to a SO definition previously described in the literature. Waist circumference (WC) and handgrip strength (HG) were also measured. Blood samples were collected for CRP, tumour necrosis factor and IL‐6 measurements. All the inflammatory markers were higher in SO individuals when compared to non‐SO; however, only IL‐6 reached statistical significance (median 3·34 versus 1·37 pg ml−1; P<0·05). Also, CRP was significantly correlated (P<0·01) with body mass index (rs = 0·34), fat mass (FM; rs = 0·25) and WC (rs = 0·33). Similarly, IL‐6 levels were significantly correlated (P<0·05) to age (rs = 0·19), FM (rs = 0·19) and WC (rs = 0·17). HG was found to be significantly reduced among subjects with higher IL‐6 levels (P = 0·02). In summary, the combination of reduced muscle mass and excess body fat (i.e. SO) is associated with elevated inflammatory markers in postmenopausal women. Moreover, CRP and IL‐6 are associated with SO‐related phenotypes in this population.

Body Adiposity Index, but not Visceral Adiposity Index, Correlates with Inflammatory Markers in Sarcopenic Obese Elderly Women

Background/Study Context: The association of body adiposity index (BAI) and visceral adiposity index (VAI) with inflammatory markers has yet to be understood. The aim of this work was to investigate the association of BAI and VAI with inflammatory markers in elderly women with sarcopenic obesity (SO). Methods: A total of 130 women (age: 66.7 ± 5.2 years) underwent body composition analysis by dual-energy x-ray absorptiometry (DEXA). Volunteers were classified according to SO definition. BAI, VAI, and waist-to-hip ratio (WHR) were calculated. Blood samples were collected for C-reactive protein (CRP), tumor necrosis factor, and interleukin-6 (IL-6) measurements. Results: SO prevalence was 20.8%. BAI correlated with the DEXA-derived body fat content (rS = .90), CRP (rS = .55), and IL-6 (rS = .53), whereas WHR correlated with CRP (rS = .60) only (all p < .01). VAI did not correlate with any of the inflammatory variables. Conclusion: Simple and cheap anthropometric indices such as BAI and WHR may be better predictors of low-grade inflammation than VAI in elderly women with SO.

Comparison of percentage body fat and body mass index for the prediction of inflammatory and atherogenic lipid risk profiles in elderly women.

Objective To compare the clinical classification of the body mass index (BMI) and percentage body fat (PBF) for the prediction of inflammatory and atherogenic lipid profile risk in older women. Method Cross-sectional analytical study with 277 elderly women from a local community in the Federal District, Brazil. PBF and fat-free mass (FFM) were determined by dual energy X-ray absorptiometry. The investigated inflammatory parameters were interleukin 6 and C-reactive protein. Results Twenty-five percent of the elderly women were classified as normal weight, 50% overweight, and 25% obese by the BMI. The obese group had higher levels of triglycerides and very low-density lipoproteins than did the normal weight group (P≤0.05) and lower levels of high-density lipoproteins (HDL) than did the overweight group (P≤0.05). According to the PBF, 49% of the elderly women were classified as eutrophic, 28% overweight, and 23% obese. In the binomial logistic regression analyses including age, FFM, and lipid profile, only FFM (odds ratio [OR]=0.809, 95% confidence interval [CI]: 0.739–0.886; P<0.0005) proved to be a predictor of reaching the eutrophic state by the BMI. When the cutoff points of PBF were used for the classification, FFM (OR=0.903, CI=0.884–0.965; P=0.003) and the total cholesterol/HDL ratio (OR=0.113, CI=0.023–0.546; P=0.007) proved to be predictors of reaching the eutrophic state. Conclusion Accurate identification of obesity, systemic inflammation, and atherogenic lipid profile is key to assessing the risk of cardiometabolic diseases. Classification based on dual energy X-ray absorptiometry measures, along with biochemical and inflammatory parameters, seems to have a great clinical importance, since it allows the lipid profile eutrophic distinction in elderly overweight women.

Combined Exercise in HIV Treatment: Prospects for Non Pharmacological Therapy

The physical exercise is a tool that assists the treatment of various diseases because it improves from aspects of functional capacity (mobility, balance, muscle strength) to the risk factors for several diseases (obesity, Diabetes mellitus, systemic arterial hypertension). Among the many exercise types, the combined physical training has been considered a very interesting method due to responses generated in several populations, for instance, people living with HIV/AIDS.

Resistance training-induced gains in muscle strength, body composition, and functional capacity are attenuated in elderly women with sarcopenic obesity

Objectives The purpose of this study was to compare the effects of resistance training (RT) on body composition, muscle strength, and functional capacity in elderly women with and without sarcopenic obesity (SO). Methods A total of 49 women (aged ≥60 years) were divided in two groups: without SO (non-SO, n=41) and with SO (n=8). Both groups performed a periodized RT program consisting of two weekly sessions for 16 weeks. All measures were assessed at baseline and postintervention, including anthropometry and body composition (dual-energy X-ray absorptiometry), muscle strength (one repetition maximum) for chest press and 45° leg press, and functional capacity (stand up, elbow flexion, timed “up and go”). Results After the intervention, only the non-SO group presented significant reductions in percentage body fat (−2.2%; P=0.006), waist circumference (−2.7%; P=0.01), waist-to-hip ratio (−2.3; P=0.02), and neck circumference (−1.8%; P=0.03) as compared with baseline. Muscle strength in the chest press and biceps curl increased in non-SO only (12.9% and 11.3%, respectively), while 45° leg press strength increased in non-SO (50.3%) and SO (40.5%) as compared with baseline. Performance in the chair stand up and timed “up and go” improved in non-SO only (21.4% and −8.4%, respectively), whereas elbow flexion performance increased in non-SO (23.8%) and SO (21.4%). Effect sizes for motor tests were of higher magnitude in the non-SO group, and in general, considered “moderate” compared to “trivial” in the SO group. Conclusion Results suggest that adaptations induced by 16 weeks of RT are attenuated in elderly woman with SO, compromising improvements in adiposity indices and gains in muscle strength and functional capacity.

ACUTE CARDIOVASCULAR RESPONSE TO PRE-PRANDIAL AND POSTPRANDIAL EXERCISE IN ACTIVE MEN

Introduction: pre-prandial exercise promotes greater mobilization of fat metabolism due to the increased release of catecholamines, cortisol, and glucagon. However, this response affects how the cardiovascular system responds to exercise. Objective: to evaluate the response of systolic, diastolic, and mean blood pressure, heart rate (HR) and rate-pressure product (RPP) to pre- and postprandial exercise. Methods: ten physically active male subjects (25.50 ± 2.22 years) underwent two treadmill protocols (pre- and postprandial) performed for 36 minutes at 65% of VO2max on different days. On both days, subjects attended the laboratory on a 10-hour fasting state. For the postprandial session, volunteers ingested a pre-exercise meal of 349.17 kcal containing 59.3 g of carbohydrates (76.73%), 9.97 g of protein (12.90%), and 8.01 g of lipids (10.37%). Blood pressure, HR and RPP were measured before and after exercise. The 2x2 factorial Anova with the multiple comparisons test of Bonferroni was applied to analyze cardiovascular variables in both moments (pre- vs. postprandial). The significance level was set at p<0.05. Results: systolic (121.70 ± 7.80 vs. 139.78 ± 12.91 mmHg) and diastolic blood pressure (66.40 ± 9.81 vs. 80.22 ± 8.68 mmHg) increased significantly after exercise only in the postprandial session (p<0.05). HR increased significantly (p<0.05) after both protocols (64.20 ± 15.87 vs. 141.20 ± 10.33 bpm pre-prandial and 63.60 ± 8.82 vs. 139.20 ± 10.82 bpm postprandial). RPP had a similar result (8052.10 ± 1790.68 vs. 18382.60 ± 2341.66 mmHg.bpm in the pre-prandial session and 7772.60 ± 1413.76 vs. 19564.60 ± 3128.99 mmHg.bpm in the postprandial session). Conclusion: these data suggest that fasted exercise does not significantly alter the blood pressure. Furthermore, the meal provided before the postprandial exercise may promote a greater blood pressure responsiveness during exercise.