Ricardo Luís Fernandes Guerra

Equações de referência para os testes de caminhada de campo em adultos saudáveis

OBJECTIVE: To develop regression equations for predicting six-minute and incremental shuttle walk distances (6MWD and ISWD, respectively), based on demographic characteristics, anthropometric variables, and grip strength. METHODS: We evaluated 6MWD and ISWD in 98 healthy adults. Height, weight, and grip strength were also assessed. Using data from 90 of the participants (40 males; 60 ± 9 years of age), we devised linear equations adjusted for age, gender, height, and weight, and we developed alternate models that included grip strength. We prospectively applied the equations in the 8 remaining participants (4 males; 59 ± 10 years), who had been randomly separated from the initial sample. RESULTS: Age, gender, height, and weight collectively explained 54.5% and 64.9% of the variance in 6MWD and ISWD, respectively, whereas age, height, weight, and grip strength collectively explained 54.4% and 69.0% of the respective variances. There was no significant difference between the measured and predicted 6MWD using equations with and without grip strength (14 ± 57 vs. 13 ± 67 m). Similar results were observed for ISWD (25 ± 104 vs. 25 ± 93 m). CONCLUSIONS: Grip strength is a determinant of ISWD and 6MWD; however, it could not improve the power of equations adjusted by demographic and anthropometric variables. The validity of our models including grip strength should be further evaluated in patients with skeletal muscle dysfunction.

Valores de referência para o teste de caminhada com carga progressiva em indivíduos saudáveis: da distância percorrida às respostas fisiológicas

OBJECTIVE: To determine reference values for incremental shuttle walk distance (ISWD) and peak physiological responses during the incremental shuttle walk test (ISWT), as well as to develop a series of predictive equations for those variables in healthy adults. METHODS: We evaluated 103 healthy participants > 40 years of age (54 women and 49 men). We fitted each participant with a gas analysis system for use during the ISWT. Oxygen consumption (VO2), carbon dioxide production, minute ventilation, heart rate (HR), ISWD, and maximal walking velocity (MWV) were obtained as primary outcomes. We also assessed hand grip strength (HGS) and lean body mass (LBM). RESULTS: The regression analysis models, including physiological variables, ISWD, and MWV (adjusted for age, body mass, height, and sex), produced R2 values ranging from 0.40 to 0.65 (for HR and peak VO2, respectively). Using the models including LBM or HGS, we obtained no significant increase in the R2 values for predicting peak VO2, although the use of those models did result in slight increases in the R2 values for ISWD and MWV (of 8% and 12%, respectively). The variables ISWD, MWV, and ISWD × body mass, respectively, explained 76.7%, 73.3%, and 81.2% of peak VO2 variability. CONCLUSIONS: Our results provide reference values for ISWD and physiological responses to the ISWT, which can be properly estimated by determining simple demographic and anthropometric characteristics in healthy adults > 40 years of age. The ISWT could be used in assessing physical fitness in the general adult population and in designing individualized walking programs.OBJECTIVE: To determine reference values for incremental shuttle walk distance (ISWD) and peak physiological responses during the incremental shuttle walk test (ISWT), as well as to develop a series of predictive equations for those variables in healthy adults. METHODS: We evaluated 103 healthy participants ≥ 40 years of age (54 women and 49 men). We fitted each participant with a gas analysis system for use during the ISWT. Oxygen consumption (VO2), carbon dioxide production, minute ventilation, heart rate (HR), ISWD, and maximal walking velocity (MWV) were obtained as primary outcomes. We also assessed hand grip strength (HGS) and lean body mass (LBM). RESULTS: The regression analysis models, including physiological variables, ISWD, and MWV (adjusted for age, body mass, height, and sex), produced R2 values ranging from 0.40 to 0.65 (for HR and peak VO2, respectively). Using the models including LBM or HGS, we obtained no significant increase in the R2 values for predicting peak VO2, although the use of those models did result in slight increases in the R2 values for ISWD and MWV (of 8% and 12%, respectively). The variables ISWD, MWV, and ISWD × body mass, respectively, explained 76.7%, 73.3%, and 81.2% of peak VO2 variability. CONCLUSIONS: Our results provide reference values for ISWD and physiological responses to the ISWT, which can be properly estimated by determining simple demographic and anthropometric characteristics in healthy adults ≥ 40 years of age. The ISWT could be used in assessing physical fitness in the general adult population and in designing individualized walking programs.

Effects of 2 or 5 consecutive exercise days on adipocyte area and lipid parameters in Wistar rats

BackgroundExercise has been prescribed in the treatment and control of dyslipidemias and cholesterolemia, however, lipid responses to different training frequencies in hypercholesterolemic men have been inconsistent. We sought to verify if different frequencies of continuous moderate exercise (2 or 5 days/week, swimming) can, after 8 weeks, promote adaptations in adipocyte area and lipid parameters, as well as body weight and relative weight of tissues in normo and hypercholesterolemic adult male rats.MethodsNormal cholesterol chow diet or cholesterol-rich diet (1% cholesterol plus 0.25% cholic acid) were freely given during 8 weeks to the rats divided in 6 experimentals groups: sedentary normal cholesterol chow diet (C); sedentary cholesterol-rich diet (H); 5× per week continuous training normal cholesterol chow diet (TC5) and cholesterol-rich diet (TH5); 2× per week continuos traning normal cholesterol chow diet (TC2) and cholesterol-rich diet (TH2).ResultsNo changes were observed in lipid profile in normal cholesterol chow diet, but both 2 a 5 days/week exercise improved this profile in cholesterol-rich diet. Body weight gain was lower in exercised rats. Decrease in retroperitoneal and epididymal relative weights as well as reductions in adipocyte areas under all diets types were observed only in 5 days/week, while 2 days/week showed improvements mainly in cholesterol-rich diet rats.ConclusionOur results confirm the importance of exercise protocols to control dyslipidemias and obesity in rats. The effects of 5 days/week exercise were more pronounced compared with those of 2 consecutive days/week training.

Perfil antropométrico e ingestão de macronutrientes em atletas profissionais brasileiros de futebol, de acordo com suas posições

The aim of this study was to evaluate the anthropometric profile, total energy value of the diet and macronutrient intake of professional soccer players, as well as verifying the differences among tactical positions: goalkeepers (n = 12), center backs (n = 20), median fields (n = 41), running backs (n = 21) and strikers (n = 24) in the studied variables. The sample was composed by 118 professional players (23 years ± 5 years) of the elite of the Sao Paulo state. All the evaluations were accomplished during the competitive period. Body composition was determined through skin folds measurement and the dietary data obtained through usual food intake. The goalkeepers and center backs were shown taller, heavier and with larger amount of lean mass than the other athletes, even so without significant differences among body fat percentage. The dietary habits of these athletes indicate a lower carbohydrate ingestion, hyperprotein and tendency to hyperlipidic diet. Thus, we can conclude that there are nutritional inadequacies and anthropometric differences among the players and their tactical positions. The results of the present study suggest that nutritional interventions are accomplished in the soccer elite, seeking to maximize the athletic performance.

Does aerobic exercise intensity affect health-related parameters in overweight women?

The aim of this study was to compare the effect of a cycling training programme performed at intensity corresponding to the lowest value of the respiratory quotient (RQ) versus at intensity corresponding to the ventilatory threshold (VT), on body composition and health‐related parameters in overweight women. Thirty‐two sedentary obese women (27–42 years old) were studied in a randomized trial of either RQ (n = 17) or VT (n = 15). RQ and VT training sessions were equalized by time (60 min) and performed in a cycloergometer. Anthropometry, body composition, lipid profile, glucose, basal metabolic rate (BMR) and fitness (maximal oxygen uptake) were evaluated before and after 12 weeks of intervention. Body weight, body mass index, fatness and fitness were improved in both groups (P<0·001). Triglycerides (TG) levels decreased only in response to RQ (P<0·001) and fat‐free mass (FFM) to VT (P = 0·002). No differences were observed between groups. Both exercise intensities seem to be effective for improving health in overweight women. However, low‐intensity compared with the high‐intensity exercise training appears to have additional benefits on TG levels and to maintenance of FFM.

Multidisciplinary intervention in obese adolescents: predictors of dropout

Objective To identify biological and psychosocial factors associated with dropout in a multidisciplinary behavioral intervention in obese adolescents. Methods A total of 183 adolescents (15.4±1.6 years), pubertal (Tanner stage 3 or 4) and obese (34.7±4.0kg/m2), were enrolled in a 12-week behavioral intervention, which included clinical consultations (monthly), nutritional and psychological counseling (once a week), and supervised aerobic training (three times/week). The studied variables were weight, height, body mass index, body composition (skinfold), cardiorespiratory fitness (direct gas analysis), blood lipids and self-reported symptoms of eating disorders (bulimia, anorexia and binge eating), anxiety, depression, body image dissatisfaction and quality of life. Statistical analysis included binary logistic regression and independent t-tests. Results Of the adolescents, 73.7% adhered to the program. The greatest chance for dropout was observed among adolescents older than 15 years (odds ratio of 0.40; 95%CI: 0.15-0.98), with more anorexia symptoms (odds ratio of 0.35; 95%CI: 0.14-0.86) and hypercholesterolemia (odds ratio of 0.40; 95%CI: 0.16-0.91) at baseline. Conclusion Older adolescents, with more symptoms of eating disorders and total cholesterol have less chance to adhere to multidisciplinary treatments.

Efeitos de um programa de jogos pré-desportivos nos aspectos psicobiológicos de idosas

OBJECTIVE: To investigate the effects of a program of teaching games (TG) in psychobiological aspects of elderly women. METHODS: 53 female elderly volunteers were distributed in two groups: Active group (n=27) participating of a TG program composed by adapted sporting activities for six months, three times a week, for one hour; Control group (n=26) was told not to change their routine and not to start any physical exercise regular program. The mean (±standard-deviation) of height, weight, BMI were: 67.91±6.11years; 1.55±0.06cm; 80.68±8.45kg; and 33.41±2.62kg/m2, respectively. Before and after of program proposed, the volunteers answered a psychobiology battery composed by: mini-mental state examination; Epworth sleepiness scale; Pittsburgh sleep quality index; SF-36; geriatric depression scale; STAI-trait/state; Brunel mood scale; habitual physical activity; and body shape questionnaire. RESULTS: After the intervention period, the Active group showed better human psychobiological answers, represented by lower scores of anxiety and depression, better quality of life with increased functional capacity and vitality, and improved body image, when compared to the Control group. CONCLUSION: These results suggest that a 6-month TG program improves psychobiological aspects of elderly women.

Program of combined physical exercise reduces the perception of pain in a patient with sickle cell anemia. Case report

BACKGROUND AND OBJECTIVES: Sickle cell anemia is one of the most common hereditary hematological disease in the world. Among many clinical manifestations, the main characteristic of this disease is the painful crises. Considering the increasing number of individuals with sickle cell anemia in Brazil, the increase in life expectancy of these individuals, who are advised to restrict physical activity, it is important to investigate this subject since exercises have been listed as relevant in health promotion. The objective of this study was to analyze the perception of pain, some physiological responses and the quality of life of a patient with sickle cell anemia undergoing a program of physical exercises (aerobic and resistance). CASE REPORT: Female patient, 56 years old, diagnosed with sickle cell anemia as a child, and in the course of this research did not make routine use of drugs in the control of the disease. On physical and ergo-spirometric examination, and during fourmonth of combined exercise, she did not present critic clinical condition, only some characteristic difficulties such as musculoskeletal pain, low cardiorespiratory resistance, and early fatigue. CONCLUSION: The results suggested that a program of combined and regular exercises produced important changes in the patient, in several aspects related to her health, including the reduction of musculoskeletal pain and increased general physical fitness, contributing to the improvement of the perception of quality of life.

Experimental Diet Models in the Investigation of Obesity

Several experimental models of dietary manipulation have been created for the purpose of investigating chronic-degenerative diseases. In general, such models allow for the assessment of the qualitative and quantitative alterations of nutrients and substances contained in a food regimen. Recent studies have made use of alternative forms of dietary manipulation that have resulted in the experimental development of diseases such as diabetes, dyslipidemia, and obesity (Duarte et al. 2003; Estadella et al. 2004; Manzoni et al. 2005; Cheik 2005; Guerra 2005).