192 research outputs found
Body composition symmetry in long-term active middle-aged and older individuals
This study aimed to analyze body composition and strength symmetry in a sample of 165 middle-aged and elderly Italian volunteers, which included 97 active (67 men and 30 women; 61.17 ± 7.56 years) individuals regularly engaged in Tai Chi Chuan, tennis, or running, and a control group of 59 age-matched sedentary (27 men and 32 women) individuals. Anthropometric and bioelectrical measurements and hand grip strength of both sides were collected. Segmental body composition was analyzed through specific bioelectrical impedance vector analysis. The body composition of the right and left limbs was similar among active individuals (arms: T2 = 6.3, n.s.; legs: T2 = 5.0, n.s.), with a similar pattern in the three different disciplines. By contrast, the control group showed bilateral asymmetry (arms: T2 = 6.8, p < 0.001; legs: T2 = 8.8, p < 0.001), mainly because of the higher values of specific reactance (t = 2.4; p = 0.018) and phase angle (t = 2.0; p = 0.054) in the dominant arm, and the higher specific vector length (t = −3.0; p = 0.027) in the left leg. All of the groups showed a higher hand grip strength in the dominant arm (active: t = 7.0, p < 0.001; control: t = 2.9; p < 0.01). In conclusion, the active individuals showed stronger body composition symmetry than the controls, thus indicating a previously undetected positive effect of sport in middle-aged and older adults
Effects of a 12-week suspension versus traditional resistance training program on body composition, bioimpedance vector patterns, and handgrip strength in older men: A randomized controlled trial
This investigation aimed to compare the effects of suspension training versus traditional resistance exercise using a combination of bands and bodyweight on body composition, bioimpedance vector patterns, and handgrip strength in older men. Thirty-six older men (age 67.4 ± 5.1 years, BMI 27.1 ± 3.3 kg/m2) were randomly allocated into suspension training (n = 12), traditional training (n = 13), or non-exercise (n = 11) groups over a 12-week study period. Body composition was assessed using conventional bioelectrical impedance analysis and classic and specific bioelectric impedance vector analysis, and handgrip strength was measured with a dynamometer. Results showed a significant (p < 0.05) group by time interaction for fat mass, fat-free mass, total body water, skeletal muscle index, classic and specific bioelectrical resistance, classic bioelectrical reactance, phase angle, and dominant handgrip strength. Classic and specific vector displacements from baseline to post 12 weeks for the three groups were observed. Handgrip strength increased in the suspension training group (p < 0.01, ES: 1.50), remained stable in the traditional training group, and decreased in the control group (p < 0.01, ES: −0.86). Although bodyweight and elastic band training helps to prevent a decline in muscle mass and handgrip strength, suspension training proved more effective in counteracting the effects of aging in older men under the specific conditions studied
Determinants of vitamin D levels in children and adolescents with Down syndrome.
Background. Poor studies have evaluated 25-hydroxycholecalciferol (25(OH)D) levels in Down syndrome (DS). Objective. To assess in DS subjects serum 25(OH)D value, to identify risk factors for vitamin D deficiency, and to evaluate whether a normal 25(OH)D value can be restored with a 400 I.U. daily supplement of cholecalciferol in respect to controls. Methods. We have longitudinally evaluated 31 DS patients (aged 4.5–18.9 years old) and 99 age- and sex-matched healthy controls. In these subjects, we analysed calcium, phosphate, parathyroid hormone (PTH), 25(OH)D concentrations, and calcium and 25(OH)D dietary intakes, and we quantified outdoor exposure. After 12.3 months (range 8.1–14.7 months) of 25(OH)D supplementation, we reevaluated these subjects. Results. DS subjects showed reduced 25(OH)D levels compared to controls (P<0.0001), in particular DS subjects with obesity (P<0.05) and autoimmune diseases history (P<0.005). PTH levels were significantly higher in DS subjects than controls (P<0.0001). After cholecalciferol supplementation, 25(OH)D levels were significantly ameliorated (P<0.05), even if reduced compared to controls (P<0.0001), in particular in DS subjects with obesity (P<0.05) and autoimmune diseases (P<0.001). Conclusions. Hypovitaminosis D is very frequent in DS subjects, in particular in presence of obesity and autoimmune diseases. In these subjects, there could be a need for higher cholecalciferol supplementation
Knowledge and Health Care resource allocation: CME/CPD course guidelines-based efficacy
Background: Most Health Care Systems consider Continuing Medical Education a potential tool to improve quality of care and reduce disease management costs. Its efficacy in general practitioners needs to be further explored. Objective: This study assesses the effectiveness of a one-year continuing medical education/continuing professional development course for general practitioners, regarding the improvement in knowledge of ARIA and GINA guidelines and compliance with them in asthma management. Methods: Sixty general practitioners, covering 68,146 inhabitants, were randomly allocated to continuing medical education/continuing professional development (five residential events + four short distance-learning refresher courses over one year) or no training. Participants completed a questionnaire after each continuing medical education event; key questions were repeated at least twice. The Local Health Unit prescription database was used to verify prescription habits (diagnostic investigations and pharmacological therapy) and hospitalizations over one year before and after training. Results: Fourteen general practitioners (46.7%) reached the cut-off of 50% attendance of the training courses. Knowledge improved significantly after training (p<0.001, correct answers to key questions +13%). Training resulted in pharmaceutical cost containment (trained general practitioners +0.5% vs controls +18.8%) and greater attention to diagnosis and monitoring (increase in spirometry +63.4%, p<0.01). Conclusion: This study revealed an encouraging impact of educational events on improvement in general practitioner knowledge of guidelines and daily practice behavioral changes. Long-term studies of large populations are required to assess the effectiveness of education on the behavior of physicians in asthma management, and to establish the best format for educational events
Policaptil Gel Retard significantly reduces body mass index and hyperinsulinism and may decrease the risk of type 2 diabetes mellitus (T2DM) in obese children and adolescents with family history of obesity and T2DM.
BACKGROUND: Treatments for childhood obesity are critically needed because of the risk of developing co-morbidities, although the interventions are frequently time-consuming, frustrating, difficult, and expensive. PATIENTS AND METHODS: We conducted a longitudinal, randomised, clinical study, based on a per protocol analysis, on 133 obese children and adolescents (n = 69 males and 64 females; median age, 11.3 years) with family history of obesity and type 2 diabetes mellitus (T2DM). The patients were divided into three arms: Arm A (n = 53 patients), Arm B (n = 45 patients), and Arm C (n = 35 patients) patients were treated with a low-glycaemic-index (LGI) diet and Policaptil Gel Retard®, only a LGI diet, or only an energy-restricted diet (ERD), respectively. The homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda, insulinogenic and disposition indexes were calculated at T(0) and after 1 year (T(1)). RESULTS: At T(1), the BMI-SD scores were significantly reduced from 2.32 to 1.80 (p < 0.0001) in Arm A and from 2.23 to 1.99 (p < 0.05) in Arm B. Acanthosis nigricans was significantly reduced in Arm A (13.2% to 5.6%; p < 0.05), and glycosylated-haemoglobin levels were significantly reduced in Arms A (p < 0.005). The percentage of glucose-metabolism abnormalities was reduced, although not significantly. However, the HOMA-IR index was significantly reduced in Arms A (p < 0.0001) and B (p < 0.05), with Arm A showing a significant reduction in the insulinogenic index (p < 0.05). Finally, the disposition index was significantly improved in Arms A (p < 0.0001) and B (p < 0.05). CONCLUSIONS: A LGI diet, particularly associated with the use of Policaptil Gel Retard®, may reduce weight gain and ameliorate the metabolic syndrome and insulin-resistance parameters in obese children and adolescents with family history of obesity and T2DM
Bone mineral status and metabolism in patients with Williams-Beuren syndrome.
OBJECTIVE: To evaluate bone mineral status and metabolism in a cohort of patients with Williams-Beuren syndrome (WBS).
PATIENTS: Thirty-one children (15 females, 16 males; mean age 9.6±2.74 years) and 10 young adults (6 females, 4 males; mean age 21.4±5.11 years) with WBS were cross-sectionally evaluated and compared with two age-, sex-, and body-size-matched paediatric (155 subjects, 75 females and 80 males; mean age 9.7±2.93 years) and adult (50 subjects, 30 females and 20 males; mean age 22.3±5.42 years) healthy controls.
MEASUREMENTS: We evaluated ionised and total calcium, phosphate, parathyroid hormone (PTH), 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D, osteocalcin, bone alkaline phosphatase levels, and urinary deoxypyridinoline concentrations. We also calculated the phalangeal amplitude-dependent speed of sound (AD-SoS) and the bone transmission time (BTT) z-scores.
RESULTS: WBS patients showed a significantly reduced AD-SoS z-score (p <0.001) and BTT z-score (p <0.001) compared with the controls. This finding persisted when we divided the sample into paediatric and adult patients. WBS patients also had significantly higher ionised (p <0.001) and total calcium (p <0.001) levels as well as higher PTH levels (p <0.001) compared with the controls. Furthermore, WBS children and adolescents had significantly lower serum osteocalcin levels (p <0.001) and urinary deoxypyridinoline concentrations (p <0.001) than controls.
CONCLUSIONS: WBS subjects exhibit a significant reduction in bone mineral status and impaired bone metabolism. These findings point to the need for close monitoring of WBS patients
New bioelectrical impedance vector references and phase angle centile curves in 4,367 adults: The need for an urgent update after 30 years
Background & aims: the bioelectrical impedance vector analysis (BIVA) represents a qualitative analysis of body composition. The vector, defined by resistance (R) and reactance (Xc) standardized by stature, can be evaluated compared to the 50%,75%, and 95% tolerance ellipses representative of the reference populations. The tolerance ellipses for healthy adults have been provided in 1995 and were developed by mixing underage, adult, and elderly subjects, possibly misrepresenting the actual adult population. The current multicentric, cross-sectional study aimed to provide new tolerance ellipses specific for the general adult population and as a secondary aim to present centile curves for the bioelectrical phase angle.Methods: R, Xc, and phase angle were measured in 2137 and 2230 males and females using phase-sensitive foot-to-hand analyzers at 50 kHz. A minimum of 35 subjects were included for each sex and age category from 18 to 65 years.Results: the new mean vectors showed a leftward shift on the R-Xc graph with respect to the former reference values (males: F = 75.3; p < 0.001; females: F = 36.6, p < 0.001). The results provided new 3rd, 5th, 10th, 25th, 50th, 75th, 90th, 95th, and 97th percentile curves for phase angle, identifying time point phases of decrement (males:-0.03 degrees per year at 33.0-51.0 years and-0.05 degrees per year after 51 years; females:-0.03 degrees per year from 37.2 to 57.9 years).Conclusions: compared to the original references, the new data are characterized by a different distribution within the R-Xc graph with a higher phase angle. Thirty years after the BIVA invention, the current study presents new tolerance ellipses and phase angle reference values for the adult population. (c) 2023 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Skeptical Look at the Clinical Implication of Metabolic Syndrome in Childhood Obesity
Metabolic syndrome (MetS) is defined by a cluster of several cardio-metabolic risk factors, specifically visceral obesity, hypertension, dyslipidemia, and impaired glucose metabolism, which together increase risks of developing future cardiovascular disease (CVD) and type 2 diabetes mellitus (T2D). This article is a narrative review of the literature and a summary of the main observations, conclusions, and perspectives raised in the literature and the study projects of the Working Group of Childhood Obesity (WGChO) of the Italian Society of Paediatric Endocrinology and Diabetology (ISPED) on MetS in childhood obesity. Although there is an agreement on the distinctive features of MetS, no international diagnostic criteria in a pediatric population exist. Moreover, to date, the prevalence of MetS in childhood is not certain and thus the true value of diagnosis of MetS in youth as well as its clinical implications, is unclear. The aim of this narrative review is to summarize the pathogenesis and current role of MetS in children and adolescents with particular reference to applicability in clinical practice in childhood obesity
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