Raul A. Martins

Effects of aerobic and strength-based training on metabolic health indicators in older adults

BackgroundThe weakening of the cardiovascular system associated with aging could be countered by increasing levels of physical activity and functional fitness. However, inconsistent findings have been found, and the variety of characteristics of exercise used in previous studies may partly explain that inconsistent results.ObjectiveTo investigate the training effect of sixteen weeks of moderate intensity, progressive aerobic and strength-based training on metabolic health of older women and men.MethodsSixty three sedentary individuals (mean (SD) age 76 (8) years) were randomly assigned to control (n = 31) or exercising (n = 32) groups. The training group was separated to aerobic (n = 18) or strength-based (n = 14). Training took place three times a week. Subjects agreed not to change their diet or lifestyle over the experimental period.ResultsExercising group attained after treatment significant differences on body weight, waist circumference, body mass index, diastolic blood pressure, triglycerides, total cholesterol, HDL-cholesterol, LDL-cholesterol, total cholesterol/HDL-cholesterol relationship, high sensitivity C-reactive protein, and 6-minute walk distance. The control group only had significant differences on waist circumference.ConclusionThe training programs produced significant benefits on metabolic health indicators of sedentary older women and men.

Nutritional status, biological maturation and cardiorespiratory fitness in Azorean youth aged 11–15 years

BackgroundSex and individual differences in biological maturity status can influence height, weight, and body fat. Thus, the rigorous control of these variables seems necessary for estimating overweight and obesity in adolescents. The aims of this study were to estimate the prevalence of overweight and obesity and over-fatness in Azorean adolescents and to examine the contributions of chronological age, sex, estimated maturity status, and cardiorespiratory fitness (CRF) to the risk of overweight and obesity and over-fatness.MethodsThe sample comprised 1,206 youth aged 11–15 years (626 boys and 580 girls) from the Azores Islands, Portugal. Body mass, stature, and skinfolds (triceps and subscapular) were measured. Body mass index (BMI) was calculated and percent fat was predicted from skinfolds. Age- and sex-specific IOTF cut-off values of the BMI defined nutritional status. Biological maturation was estimated as present height expressed as a percentage of predicted adult (mature) stature. The CRF was analyzed from the 20-m shuttle run test.ResultsThe total prevalence rates of overweight/obesity and over-fatness were of 31% and 27%, respectively. Low CRF (unfit) and being average and advanced in maturity status were positively and significantly associated with overweight/obesity and with risk of being over-fatness in both sexes.ConclusionsHigh prevalence rates of overweight/obesity and over-fatness were identified in Azorean youth, and low CRF and advanced biological maturation were positively associated with overweight/obesity and over-fatness in our sample of adolescents.

Effects of Aerobic Conditioning on Salivary IgA and Plasma IgA, IgG and IgM in Older Men and Women

As people age, they experience a decline in immune responses. Unusually heavy acute or chronic exercise could increase the risk of upper respiratory tract infection (URTI) whereas regular moderate physical activity may reduce URTI symptomatology. The purpose of the present study was to determine whether an aerobic exercise program would promote chronic adaptations in plasma IgA, IgG and IgM, and salivary IgA (Sal-IgA) in both elderly women and men. Forty-three independently living men and women, aged between 65 and 96 years, were randomly assigned to an aerobic exercising or a control group. Each participant underwent three evaluations (pre, post at 16 weeks and follow-up at 32 weeks). The aerobic exercise group increased resting plasma IgA concentration from 1.08 g. L (-1)+/-0.50 g. L (-1) to 2.29 g. L (-1)+/-0.93 g. L (-1), whereas salivary IgA concentration was unchanged. The control group maintained the plasma IgA values but experienced a decrease in Sal-IgA. The IgG and IgM plasma concentrations increased in both groups, however, only the exercise group maintained higher values in the final follow-up evaluation. Regular aerobic exercise may be effective in promoting IgA immunity and protecting against the deterioration in Sal-IgA values observed in the control group. No gender differences in the immunoglobulin responses to aerobic training were observed.

Urban - rural contrasts in fitness, physical activity, and sedentary behaviour in adolescents

Research considering physical activity (PA), physical inactivity and health outcomes among urban and rural youth has produced equivocal findings. This study examined PA, physical inactivity, sedentary behaviours and cardiorespiratory fitness (CRF) in adolescents from urban and rural communities in the Portuguese Midlands. The sample included 362 adolescents (165 males, 197 females) of 13-16 years of age. CRF was assessed by the PACER test. A GT1M accelerometer was used to record 5 consecutive days of PA and time spent sedentary. Analyses of covariance (chronological age as co-variate) were performed to test the effect of the area of residence on sedentary behaviour, PA and CRF. Urban youth of both sexes spent less time in sedentary activities than rural youth. Urban males were more active than rural peers at the weekend, whereas urban females were significantly less active than rural females on week days and across all days assessed. Rural youth of both sexes had higher levels of CRF than urban youth. Area of residence was related to aerobic fitness, PA and time spent in sedentary behaviours among Portuguese youth. Interventions seeking to enhance health and active lifestyles in Portuguese youth should consider the potential impact of socio-geographic factors.

Glycated hemoglobin and associated risk factors in older adults

BackgroundThe aim of this study is to investigate the relationships between HbA1c and other risk factors like obesity, functional fitness, lipid profile, and inflammatory status in older adults. Epidemiological evidence suggests that HbA1c is associated with cardiovascular and ischemic heart disease risk. Excess of body weight and obesity are considered to play a central role in the development of these conditions. Age is associated with several risk factors as increased body fat and abdominal fat, deterioration of the lipid profile, diabetes, raising in inflammatory activity, or decreased functional fitness.MethodsData were available from 118 participants aged 65-95 years, including 72 women and 46 men. Anthropometric variables were taken, as was functional fitness, blood pressure and heart rate. Blood samples were collected after 12 h fasting, and HbA1c, hs-CRP, TG, TC, HDL-C, LDL-C, and glycaemia were calculated. Bivariate and partial correlations were performed to explore associations amongst the variables of interest. Differences between groups were explored by performing factorial analysis of variance.ResultsHbA1c levels ranged from 4.6%-9.4% with 93% of the cases below 6.5%. Women had higher HbA1c, glycaemia, TC, BMI, and lower and upper flexibility than men. Men had higher BW, WC, 6-min walking distance, and VO2peak than women. Age, SBP, DBP, HRrest, HRpeak, HDL-C, LDL-C, TG, TG/HDL-C ratio, Log10 hs-CRP, upper and lower strength, and agility and dynamic balance were similar in men and women. HbA1c had positive associations with glycaemia, HDL-C, TG/HDL-C, BW, WC, BMI, but not with functional fitness, TC, LDL-C, Log10 hs-CRP, PAD, or PAS. Obese participants had higher HbA1c than non-obese only when IDF and not USDHHS criteria were applied.ConclusionsOlder women had higher HbA1c than men, even after controlling for BMI. HbA1c associates equally with BW, BMI or WC. Population-based criteria are recommended to classify obesity and to identify higher levels of HbA1c in obese older adults. HbA1c associates with atherogenic dyslipidemia particularly with TG and TG/HDL-C ratio, but not with TC, HDL-C, or LDL-C. HbA1c is not associated with hs-CRP, and with functional fitness and aerobic endurance.

Independent association of clustered metabolic risk factors with cardiorespiratory fitness in youth aged 11-17 years.

Abstract Background: Although the prevalence of metabolic syndrome (MetS) has increased in youth, the potential independent contribution of cardiorespiratory fitness (CRF) to the clustering of metabolic risk factors has received relatively little attention. Aim: This study evaluated associations between the clustering of metabolic risk factors and CRF in a sample of youth. Subjects and methods: Height, weight, BMI, fasting glucose, insulin, HDL-cholesterol, triglycerides and blood pressures were measured in a cross-sectional sample of 924 youth (402 males, 522 females) of 11–17 years. CRF was assessed using the 20-metre shuttle run test. Physical activity (PA) was measured with a 3-day diary. Outcome variables were statistically normalized and expressed as Z-scores. A MetS risk score was computed as the mean of the Z-scores. Multiple linear regression was used to test associations between CRF and metabolic risk, adjusted for age, sex, BMI, PA and parental education. Results: CRF was inversely associated with MetS after adjustment for potential confounders. After adjusting for BMI, the relationship between CRF and metabolic risk has substantially improved. Conclusion: CRF was independently associated with the clustering of metabolic risk factors in youth of 11–17 years of age.

Quality of life, school backpack weight, and nonspecific low back pain in children and adolescents

OBJECTIVES To describe the degree of disability, anthropometric variables, quality of life (QoL), and school backpack weight in boys and girls aged 11-17 years. The differences in QoL between those who did or did not report low back pain (LBP) were also analyzed. METHODS Eighty-six girls (13.9 ± 1.9 years of age) and 63 boys (13.7 ± 1.7 years of age) participated. LBP was assessed by questionnaire, and disability using the Roland-Morris Disability Questionnaire. QoL was assessed by the Pediatric Quality of Life Inventory (PedsQL). Multivariate analyses of variance and covariance were used to assess differences between groups. RESULTS Girls reported higher disability than boys (p = 0.01), and lower QoL in the domains of physical (p < 0.001) and emotional functioning (p < 0.01), psychosocial health (p = 0.02) and physical health summary score (p < 0.001), and on the total PedsQL score (p < 0.01). School backpack weight was similar in both genders (p = 0.61) and in participants with and without LBP (p = 0.15). After adjustments, participants with LBP reported lower physical functioning (p < 0.01), influencing lower physical health summary score (p < 0.01). CONCLUSIONS Girls had higher disability and lower QoL than boys in the domains of physical and emotional functioning, psychosocial health, and physical health summary scores, and on the total PedsQL score; however, similar school backpack weight was reported. Participants with LBP revealed lower physical functioning and physical health summary score, yet had similar school backpack weight to those without LBP.

Determination of thigh volume in youth with anthropometry and DXA: Agreement between estimates

Abstract This study examined the agreement between estimates of thigh volume (TV) with anthropometry and dual-energy x-ray absorptiometry (DXA) in healthy school children. Participants (n=168, 83 boys and 85 girls) were school children 10.0–13.9 years of age. In addition to body mass, height and sitting height, anthropometric dimensions included those needed to estimate TV using the equation of Jones & Pearson. Total TV was also estimated with DXA. Agreement between protocols was examined using linear least products regression (Deming regressions). Stepwise regression of log-transformed variables identified variables that best predicted TV estimated by DXA. The regression models were then internally validated using the predicted residual sum of squares method. Correlation between estimates of TV was 0.846 (95%CI: 0.796–0.884, Sy·x=0.152L). It was possible to obtain an anthropometry-based model to improve the prediction of TVs in youth. The total volume by DXA was best predicted by adding body mass and sum of skinfolds to volume estimated with the equation of Jones & Pearson (R=0.972; 95%CI: 0.962–0.979; R 2=0.945).

Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study

PurposeTo establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D).MethodsThis longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n = 279). Participants underwent one of two conditions: LTMEX (n = 241) trained three times per week; and unchanged lifestyle—the control group (CO; n = 38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO2 peak).ResultsLTMEX improves HRQoL, specifically physical functioning (P < 0.001), general health (P < 0.05), vitality (P < 0.001), mental health (MH; P < 0.05), physical component score (P < 0.001), mental component score (P < 0.001), and total SF-36 (P < 0.001). LTMEX group also decreased body weight (BW; P < 0.005), waist circumference (WC; P < 0.001), waist-to-hip ratio (WHR; P < 0.001), and systolic blood pressure (SBP; P < 0.001), and increased VO2 peak (P < 0.001). CO group increased WC (P = 0.012), BMI (P = 0.024), waist-to-hip ratio (WHR; P = 0.003) and SBP (P < 0.001), and decreased vitality (P < 0.001) and MH (P < 0.05).ConclusionsA LTMEX intervention improves physical and mental HRQoL in older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.

Exercise training improves functional status in hypertensive older adults under angiotensin converting enzymes inhibitors medication

Background: The study aims to analyze the effect of three types of treatment on functional status, and cardiovascular risk outcomes in hypertensive older adults with comorbidities. Methods: Participants (n = 418) underwent one of the following 3 conditions: i) multicomponent exercise training 3 times/week (MEX; n = 116); ii) angiotensin converting enzyme inhibitors used mono‐dose daily (ACEi; n = 70); iii) combined exercise and ACEi drugs (ACEiMEX; n = 232). The trial was completed by 82% of the participants (n = 342): MEX (n = 90); ACEi (n = 66); ACEiMEX (n = 186). Baseline and 2‐year follow‐up evaluations included the Senior Fitness Test battery, Short Form Health Survey 36 (SF‐36), the health history questionnaires, anthropometric and hemodynamic profile. Results: MEX and ACEiMEX groups improved all physical functional status outcomes, decreased systolic (SBP) and diastolic blood pressure (p < 0.001) and augmented the physical functioning, role physical and physical component score (PCS) (p < 0.05), but also bodily pain (p < 0.05). The ACEi group reduced the upper body strength, upper and lower body flexibility and aerobic endurance (p < 0.05); worsened the anthropometric profile, and SBP (p < 0.001); and decreased general health and PCS (p < 0.05). Conclusions: The improvement of the physical functioning and HRQoL in older hypertensive adults using ACEi medications only occur if they adopt an exercise training regimen, increasing also the management of the blood pressure and other cardiovascular risk factors. HighlightsExercise training improved functional status.ACEi jointly with exercise improved cardiovascular risk factors and HRQoL.Isolated ACEi use decreased physical functioning.Isolated ACEi use worsened anthropometric profile and physical HRQoL.