Energy balance and macronutrient intake during season trainings: influence on anthropometric and lipid profiles in professional athletes

This study evaluated energetic balance and macronutrient intake at competitive training and transition training and their impact on anthropometric and lipid profiles in sixteen professional male athletes. Dietary data, body composition measurements and lipid profile were obtained at the end of both season trainings. Despite increased carbohydrate supplementation during exercise and higher caloric intake at competitive training (+10%, P =0.01), total daily energy expenditure was higher than caloric intake (79%, P<0.001). These results show negative energy balance at competitive training. However, total daily energy expenditure and caloric intake were similar at transition training (P =0.35). Higher intake of carbohydrate, fat, and protein were observed at competitive training (+13%, P =0.001 for all), although caloric intake was below the requirements during this period. Body mass (+2%, P =0.05), body fat percentage (+56%, P =0.01), fat mass (+57%, P =0.01), and waist and hip circumferences (+10%, P =0.004) were higher at transition training, as well as total and LDL-cholesterols (+14%, P =0.001). Endurance athletes showed negative energy balance at competitive training and maintained similar caloric intake at transition training despite decreased total daily energy expenditure, which might have contributed to changes in anthropometric and lipid profiles. These findings emphasize the importance of nutritional counseling for professional athletes during different season trainings. RESUMO Balanço energético e ingestão de macronutrientes  durante periodos de treinamento: influência nos perfis antropométrico e lipídico em atletas profissionaisEste estudo avaliou o balanço energético e a ingestão de macronutrientes nos treinamentos competitivo e de transição do treinamento e o seu impacto nos perfis antropométrico e lipídico de dezesseis atletas profissionais. Dados da dieta, medidas da composição corporal e perfil lipídico foram obtidos no final de ambos os treinamentos físico. Apesar do aumento da suplementação de carboidrato durante exercício e maior ingestão calórica no treinamento competitivo (+10%, P =0,01), o gasto energético diário total foi maior do que a ingestão calórica (79%, P<0,001), mostrando balanço energético negativo no treinamento competitivo. Entretanto, o gasto energético diário total e ingestão colórica foram similares no treinamento de transição (P =0,35). Maior ingestão de carboidrato, lipídio e proteína foram observados no treinamento competitivo (+13%, P =0,001), embora a ingestão calórica tenha sido abaixo da recomendada. Massa corporal (+2%, P =0,05), percentual de gordura corporal (+56%, P =0,01), massa de gordura (+57%, P =0,01), e circunferências de cintura e quadril (+10%, P =0,004) foram maiores no treinamento de transição, assim como o cholesterol total e LDL-c (+14%, P =0,001). Atletas de resistência apresentaram balanço energético negativo no treinamento competitivo e mantiveram ingestão calórica similar no treinamento de transição, apesar da diminuição do gasto energético, o que provavelmente contribuiu para as mudanças nos perfis antropométrico e lipídico. Esses achados ressaltam a importância do aconselhamento nutricional para atletas nos diferentes períodos do treinamento.Â

The Effects of Resistance Exercise With Blood Flow Restriction on Flow-Mediated Dilation and Arterial Stiffness in Elderly People With Low Gait Speed: Protocol for a Randomized Controlled Trial

Background: During aging, a significant loss of muscle mass, strength, and power is associated with a decline in daily functional capacities. Traditionally, resistance training is prescribed to prevent or reverse the skeletal muscle weakness, but the required training intensity may be too demanding for older people with poor physical performance. Resistance exercise with blood flow moderation (KAATSU training), originally developed in Japan, combines resistance exercise with blood flow restriction. It has been reported that KAATSU training enhances muscle hypertrophy in many populations. However, few studies have evaluated the effects of resistance exercises with blood flow restriction in elderly people and how this affects vascular structure and function. Objective: The aim of this study was to evaluate (1) the acute and chronic effects of resistance exercise with blood flow restriction on vascular health in elderly people with low gait speed and (2) whether low-load resistance training with blood flow restriction elicits similar strength and gait speed gains to those elicited by conventional resistance training without blood flow restriction. Methods: This is an ongoing randomized controlled trial in elderly people with low gait speed. Overall, two study arms of 13 participants each perform resistance exercise with and without blood flow restriction. The 2 groups are as follows: the control group will perform conventional resistance exercise (60% of 1 repetition maximum) and the KAATSU group will perform the low-load resistance exercise with blood flow restriction (20% of 1 repetition maximum) for 12 weeks. Pulse wave velocity, venous occlusion plethysmography, and flow-mediated dilation are used to assess arterial stiffness, muscle blood flow, and endothelial function, respectively. The secondary outcomes are gait speed, strength, and quality of life. All measures will be performed before and after the training program. Results: This research study is in progress. Recruitment has started, and data collection is expected to finish in August 2020. Conclusions: The findings of this study will have important implications for the rehabilitation of elderly people

Comparison of Electrocardiographic Criteria for Identifying Left Ventricular Hypertrophy in Athletes from Different Sports Modalities

OBJECTIVES: In athletes, isolated electrocardiogram high voltage criteria are widely used to evaluate left ventricular hypertrophy, but positive findings are thought to represent normal electrocardiogram alterations. However, which electrocardiogram criterion can best detect left ventricular hypertrophy in athletes of various sport modalities remains unknown. METHODS: Five electrocardiogram criteria used to detect left ventricular hypertrophy were tested in 180 male athletes grouped according to their sport modality: 67% low-static and high-dynamic components and 33% high-static and high-dynamic components of exercise. The following echocardiogram parameters are the gold standard for diagnosing left ventricular hypertrophy: left ventricular mass index ≥134 g.m-2, relative wall thickness ≥0.42 mm, left ventricular diastolic diameter index ≥32 mm.m-2, septum wall thickness ≥13 mm, and posterior wall thickness ≥13 mm. Results for the various criteria were compared using the kappa coefficient. Significance was established at

Health-related quality of life in Brazilian community-dwelling and institutionalized elderly: Comparison between genders

Objective: To compare the health-related quality of life (HRQL) indicators between institutionalized and community-dwelling elderly men and women. Method: This was a cross-sectional study with a sample of 496 elderly men and women, surveyed by researchers at a private hospital that attends institutionalized and community-dwelling elderly. HRQL (World Health Organization Quality of Life), daily living activities (Katz questionnaire), and instrumental daily living activities (Lawton questionnaire), mini-mental state examination, handgrip strength test, and function capacity (timed up and go test) were obtained. Results: Institutionalized men presented higher scores in physical and psychological domains of HRQL compared to elderly men living alone (p<0.05). Among women, the scores in all domains (physical, psychological, relationship, and environment) were similar between institutionalized and community-dwelling individuals. Conclusion: Institutionalized elderly men reported better scores in physical and psychological domains of HRQL compared to their community-dwelling pairs, while both institutionalized and community-dwelling elderly women presented similar HRQL

Association between respiratory capacity, quality of life and cognitive function in elderly individuals

OBJECTIVE: To investigate associations between respiratory capacity, quality of life and cognitive function in elderly individuals. METHODS: The sample included 386 elderly individuals (232 women). Respiratory capacity assessment was based on maximal expiratory pressure measured at peak expiratory flow. Subjects were classified according to peak expiratory flow values adjusted for sex, age and height of individuals with normal (peak expiratory flow curve 60%) or reduced (peak expiratory flow curve < 60%) respiratory capacity. The World Health Organization Quality of Life Questionnaire and the Mini-Mental State Examination were used to assess quality of life and cognitive function, respectively. RESULTS: Elderly women with reduced respiratory capacity scored lower on the Mini-Mental State Examination (p=0.048) and quality of life questionnaire (p=0.040) compared to those with normal respiratory capacity. These differences were not observed in men (p>0.05). CONCLUSION: Reduced respiratory capacity was associated with poorer quality of life and cognitive function in elderly women. These associations were not observed in elderly men

Peak expiratory flow mediates the relationship between handgrip strength and timed up and go performance in elderly women, but not men

OBJECTIVE: The aim of the present study was to verify if there is sex difference in the associations among handgrip strength, peak expiratory flow (PEF) and timed up and go (TUG) test results. METHODS: The sample included 288 consecutive elderly men (n=93) and women (n=195). Functional capacity was measured using the TUG test, and muscle strength was measured based on handgrip. Moreover, as a measure of current health status, PEF was evaluated. Linear regression procedures were performed to analyze the relationships between handgrip and both PEF and TUG test results, with adjustment for confounders, and to identify the possible mediating role of PEF in the association between handgrip strength and TUG test results. RESULTS: In men, handgrip strength was associated with both PEF and TUG performance (

The Effect of a Single Bout of Resistance Exercise with Blood Flow Restriction on Arterial Stiffness in Older People with Slow Gait Speed: A Pilot Randomized Study.

Purpose: Low-intensity resistance exercise with moderate blood-flow restriction (LIRE-BFR) is a new trending form of exercises worldwide. The purpose of this study was to compare the acute effect of a single bout of traditional resistance exercise (TRE) and LIRE-BFR on arterial stiffness in older people with slow gait speeds. Methods: This was a randomized, controlled clinical study. Seventeen older adults (3 men; 14 women; 82 ± 5 years old) completed a session of TRE (n = 7) or LIRE-BFR (n = 10). At baseline and after 60 min post-exercise, participants were subject to blood pressure measurement, heart rate measurements and a determination of arterial stiffness parameters. Results: There was no significant difference between the TRE and LIRE-BFR group at baseline. Pulse-wave velocity increased in both groups (p 0.05) were similar after both TRE and LIRE-BFR. Conclusion: TRE and LIRE-BFR had similar responses regarding hemodynamic parameters and pulse-wave velocity in older people with slow gait speed. Long-term studies should assess the cardiovascular risk and safety of LIRE-BFR training in this population

Energy balance and macronutrient intake during season trainings: influence on anthropometric and lipid profiles in professional athletes

This study evaluated energetic balance and macronutrient intake at competitive training and transition training and their impact on anthropometric and lipid profiles in sixteen professional male athletes. Dietary data, body composition measurements and lipid profile were obtained at the end of both season trainings. Despite increased carbohydrate supplementation during exercise and higher caloric intake at competitive training (+10%, P =0.01), total daily energy expenditure was higher than caloric intake (79%, P<0.001). These results show negative energy balance at competitive training. However, total daily energy expenditure and caloric intake were similar at transition training (P =0.35). Higher intake of carbohydrate, fat, and protein were observed at competitive training (+13%, P =0.001 for all), although caloric intake was below the requirements during this period. Body mass (+2%, P =0.05), body fat percentage (+56%, P =0.01), fat mass (+57%, P =0.01), and waist and hip circumferences (+10%, P =0.004) were higher at transition training, as well as total and LDL-cholesterols (+14%, P =0.001). Endurance athletes showed negative energy balance at competitive training and maintained similar caloric intake at transition training despite decreased total daily energy expenditure, which might have contributed to changes in anthropometric and lipid profiles. These findings emphasize the importance of nutritional counseling for professional athletes during different season trainings. RESUMO Balanço energético e ingestão de macronutrientes  durante periodos de treinamento: influência nos perfis antropométrico e lipídico em atletas profissionaisEste estudo avaliou o balanço energético e a ingestão de macronutrientes nos treinamentos competitivo e de transição do treinamento e o seu impacto nos perfis antropométrico e lipídico de dezesseis atletas profissionais. Dados da dieta, medidas da composição corporal e perfil lipídico foram obtidos no final de ambos os treinamentos físico. Apesar do aumento da suplementação de carboidrato durante exercício e maior ingestão calórica no treinamento competitivo (+10%, P =0,01), o gasto energético diário total foi maior do que a ingestão calórica (79%, P<0,001), mostrando balanço energético negativo no treinamento competitivo. Entretanto, o gasto energético diário total e ingestão colórica foram similares no treinamento de transição (P =0,35). Maior ingestão de carboidrato, lipídio e proteína foram observados no treinamento competitivo (+13%, P =0,001), embora a ingestão calórica tenha sido abaixo da recomendada. Massa corporal (+2%, P =0,05), percentual de gordura corporal (+56%, P =0,01), massa de gordura (+57%, P =0,01), e circunferências de cintura e quadril (+10%, P =0,004) foram maiores no treinamento de transição, assim como o cholesterol total e LDL-c (+14%, P =0,001). Atletas de resistência apresentaram balanço energético negativo no treinamento competitivo e mantiveram ingestão calórica similar no treinamento de transição, apesar da diminuição do gasto energético, o que provavelmente contribuiu para as mudanças nos perfis antropométrico e lipídico. Esses achados ressaltam a importância do aconselhamento nutricional para atletas nos diferentes períodos do treinamento.

Barriers to enrollment in pulmonary rehabilitation in a private hospital in Brazil: a physician survey study

Introduction: Pulmonary rehabilitation (PR) plays a key role in the management of chronic lung diseases, but it remains largely underused worldwide. The aim of this study was to assess clinicians’ knowledge about PR and to identify the barriers they encounter when referring patients with medical insurance to PR in a private hospital in Brazil. Methodology: This was a survey-based cross-sectional study conducted in 2019 at a reference hospital in São Paulo, Brazil. Eligible participants were physicians registered with the following specialties: Internal Medicine, Geriatrics, Cardiology, Pulmonology or Thoracic Surgery. Results: We collected 72 responses. While 99% of participants recognized COPD as a potential indication for PR, interstitial lung disease, bronchiectasis and pulmonary hypertension were less often recognized (75%). Most participants (67%) incorrectly associated PR with lung function improvement, while 28% of cardiologists and 35% of internists/geriatricians failed to recognize benefits on mood disorders. Notably, 18% of participants recommended PR only to patients on supplemental oxygen and 14% prescribed only home physiotherapy, patterns more commonly seen among non-respiratory physicians. The 3 most perceived barriers to referral and adherence were health insurance coverage (79%), transportation to the PR center (63%) and lack of social support (29%). Conclusions: Financial, logistic and social constraints pose challenges to PR enrollment even for patients with premium healthcare insurance plans. Moreover, physician knowledge gaps may be an additional barrier to PR referral and uptake. Providing continued medical education, incorporating automatic reminders in electronic medical records and using telerehabilitation tools may improve PR referral, adherence and ultimately patient care