Effects of type of physical exercise and leisure activities on the depression scores of obese Brazilian adolescent girls

Several studies have indicated that depressive states may lead to hypokinesia with diminished metabolic rate and energy use. Hypokinesia associated with certain eating behaviors may lead to an unfavorable energy balance that can contribute to the emergence and prevalence of obesity among children and adults. The purpose of the present study was to examine the possibility of reducing depression inventory scores in female adolescents with third-degree obesity while testing the effectiveness of different exercise programs in reducing anxiety and depression scores. The sample consisted of 40 female subjects (mean age 16 ± 1.56 years) divided into 4 groups (aerobic training, anaerobic training, leisure activities, and control). Subjects had a body mass index of 95% or more in relation to the 50th percentile. The aerobic program consisted of three ergometric bicycle sessions per week over a 3-month period (12 weeks) and the activities were prescribed after determining the anaerobic ventilatory threshold (VO2 threshold). Anaerobic training was based on the Wingate anaerobic power test. The leisure program consisted of a varied range of activities (games, exercises, etc.). A nutritionist interviewed the members of these two groups and the control group every week in order to adapt them to the nutritional guidelines proposed for the study. The study showed that all three programs (aerobic exercise, anaerobic exercise and leisure activities) were effective in reducing body mass. However, we found a significant reduction when analyzing the depression scores only for aerobic exercise (18.9 ± 9.33 to 10.6 ± 9.56 or 43.9%) but no significant alterations for anaerobic exercise (11.36 ± 5.23 to 9.63 ± 4.78 or 15.22%) and leisure (17.28 ± 7.55 to 15.07 ± 7.54 or 12.78%), thus indicating that in principle this type of activity could be included to improve emotional well-being of obese adolescent girls.Universidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Programa de Pós-Graduação em NutriçãoUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PsicobiologiaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PediatriaFaculdades Integradas Faculdade de Educação Física de Santo AndréInstituto do Sono Associação Fundo de Incentivo à PsicofarmacologiaUNIFESP, EPM, Programa de Pós-Graduação em NutriçãoUNIFESP, EPM, Depto. de PsicobiologiaUNIFESP, EPM, Depto. de PediatriaSciEL

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

A História da Alimentação: balizas historiográficas

Os M. pretenderam traçar um quadro da História da Alimentação, não como um novo ramo epistemológico da disciplina, mas como um campo em desenvolvimento de práticas e atividades especializadas, incluindo pesquisa, formação, publicações, associações, encontros acadêmicos, etc. Um breve relato das condições em que tal campo se assentou faz-se preceder de um panorama dos estudos de alimentação e temas correia tos, em geral, segundo cinco abardagens Ia biológica, a econômica, a social, a cultural e a filosófica!, assim como da identificação das contribuições mais relevantes da Antropologia, Arqueologia, Sociologia e Geografia. A fim de comentar a multiforme e volumosa bibliografia histórica, foi ela organizada segundo critérios morfológicos. A seguir, alguns tópicos importantes mereceram tratamento à parte: a fome, o alimento e o domínio religioso, as descobertas européias e a difusão mundial de alimentos, gosto e gastronomia. O artigo se encerra com um rápido balanço crítico da historiografia brasileira sobre o tema

Effect of strength exercise in periferic and visceral adiposity, lipidic, glicidic and hormonal profile in obese adolescents

Objective: Verify the possible changes promote by strength exercise to visceral and periferic adipose tissue, lipidic profile, glucose and hormonal aswers, after twelvy weeks of intervention, in obese adolescents Methods: was select 126 adolescents, both genders, aged between 14and 19 years, and body mass index (BMI) 95 th, distributed in four groups: control (no exercise), leasure activity, aerobic exercise and strength exercise. They performed physical exercise for 12 weeks, 3 sessions each week, with 1hour of duration. Training intensity was not controlled in the leasure activity group, aerobic group training was at intensity corresponding to ventilatory threeshold – I, strength exercise was performed at 70% of 1 Maximun Repetition. Total body fat, subcutaneous fat and lean body mass was assessed by whole-body dual-energy X-ray absormetry scan (DEXA), visceral adipose tissue assessed by ultrassonography. Lipidic profile was measured by calorimetry and hormonals assays by radioimmunoassay. Results: Relation to body composition, after treatment, strength training promoted significant decreased in the BMI, body mass, visceral and subcutaneous fat in boys. Aerobic training promoted same changes in boys and girls. There was lean body mass preservation in both genders in all groups. Aerobic training decreased total cholesterol and LDL – c in both genders. The leasure physical activity reduced the blood levels of glucose and insulin, ass well in HOMA, only in girls. Conclusions: Strength training was the more effective to promote changes in body composition in boys. However to total cholesterol and LDL – c aerobic training is better in both genders.Objetivo: Verificar as possíveis alterações provocadas pelos exercícios de força sobre a adiposidade periférica e visceral, perfil lipídico, glicídico e respostas hormonais, após doze semanas de intervenção, em adolescentes obesos. Métodos: Foram selecionados 126 adolescentes, de ambos os gêneros, com idade entre 14 e 19 anos, sedentários, e índice de massa corporal (IMC)95th; distribuídas em quatro grupos: controle (sem exercício físico), recreação, exercícios aeróbios e exercícios de força. Realizaram exercícios físicos durante 12 semanas, três sessões semanais com duração de uma hora. O grupo recreação não controlou a intensidade do treinamento, aeróbio treinou na intensidade do Limiar Ventilatório-I, o grupo força treinou a 70% de uma repetição máxima (1RM). A gordura corporal total, subcutânea e massa livre de gordura foram avaliadas por absorciometria de feixe duplo de raios-X (DEXA), a gordura visceral por ultrassonografia. O perfil lipídico pelo método de comparativo calorimétrico e o perfil hormonal por radioimunoinsaio. Resultados: Em relação à composição corporal, após doze semanas de tratamento, o treinamento de força promoveu uma redução significativa no IMC, massa corporal, gordura visceral e subcutânea nos meninos. No grupo aeróbio também observamos uma redução significativa na massa corporal, gordura corporal e subcutânea de meninos e somente gordura corporal em meninas. Houve preservação de massa magra em todos os grupos e gêneros. Quanto ao perfil lipídico, o treinamento aeróbio diminuiu o colesterol total e LDL-c em ambos os gêneros. A atividade de recreação reduziu os níveis plasmáticos de glicose e insulina, bem como o HOMA, somente nas meninas. Conclusões: Após 12 semanas de treinamento os exercícios de força foram mais eficientes em meninos, sobre a composição corporal, enquanto que para colesterou total e LDL-c o exercício aeróbio foi mais eficiente em ambos os gêneros.TEDEBV UNIFESP: Teses e dissertaçõe

The purpose of this study was to present a psssible option non pharmacological in the obese adolescents treatment that shown indicative scores of anxiety and depression

A adolescência é uma etapa do desenvolvimento humano caracterizada por transformações físicas, emocionais e cognitivas. Dentre as inúmeras transformações, parece que a obesidade é uma patologia que também afeta esta população, podendo levar a possíveis alterações de humor e o aparecimento de distúrbios psicológicos como a ansiedade e a depressão. O propósito deste trabalho foi apresentar uma possível alternativa não medicamentosa no tratamento de adolescentes obesos que apresentam escores indicativos de ansiedade e depressão. Para a detecção destes escores na população de adolescentes obesos, os questionários não devem ser utilizados isoladamente, necessitando de uma avaliação clínica associada. O exercício físico aeróbio realizado na intensidade do limiar anaeróbio, pode ser utilizado como uma forma alternativa de tratamento dos distúrbios psicológicos, ansiedade e depressão, em adolescentes obesos, embora os motivos que o levam a esta diminuição não sejam bem descritos na literatura.BV UNIFESP: Teses e dissertaçõe

Indexes of power and aerobic capacity obtained in cycle ergometry and treadmill running: comparisons between sedentary, runners, cyclists and triathletes

The objectives of this study were: a) to determine, in a cross-sectional manner, the effect of aerobic training on the peak oxygen uptake (<img border=0 id="_x0000_i1026" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak), the intensity at <img border=0 id="_x0000_i1027" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak (I<img border=0 id="_x0000_i1028" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak) and the anaerobic threshold (AnT) during running and cycling; and b) to verify if the transference of the training effects are dependent on the analized type of exercise or physiological index. Eleven untrained males (UN), nine endurance cyclists (EC), seven endurance runners (ER), and nine triathletes (TR) were submitted, on separate days, to incremental tests until voluntary exhaustion on a mechanical braked cycle ergometer and on a treadmill. The values of <img border=0 id="_x0000_i1029" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak (ml.kg-1.min-1) obtained in running and cycle ergometer (ER = 68.8 ± 6.3 and 62.0 ± 5.0; EC = 60.5 ± 8.0 and 67.6 ± 7.6; TR = 64.5 ± 4.8 and 61.0 ± 4.1; UN = 43.5 ± 7.0 and 36.7 ± 5.6; respectively) were higher in the group that presented specific training in the modality. The UN group presented the lower values of <img border=0 id="_x0000_i1030" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak, regardless of the type of exercise. This same behavior was observed for the AnT (ml.kg-1.min-1) determined in running and cycle ergometer (ER = 56.8 ± 6.9 and 44.8 ± 5.7; EC = 51.2 ± 5.2 and 57.6 ± 7.1; TR = 56.5 ± 5.1 and 49.0 ± 4.8; UN = 33.2 ± 4.2 and 22.6 ± 3.7; respectively). It can be concluded that the transference of the training effects seems to be only partial, independently of the index (<img border=0 id="_x0000_i1031" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak, I<img border=0 id="_x0000_i1032" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak or AnT) or exercise type (running or cycling). In relation to the indices, the specificity of training seems to be less present in the <img border=0 id="_x0000_i1033" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak than in the I<img border=0 id="_x0000_i1034" src="../../img/revistas/rbme/v9n4/a04img01.gif" align=absmiddle>O2peak and the AnT

Estudo comparativo entre dois diferentes protocolos de avaliação para ciclistas

Este estudo tem como objetivo relacionar diferentes respostas fisiológicas conseqüentes de dois diferentes protocolos, um validado (cicloergômetro) e outro não validado (rolo estacionário). Objetiva verificar a confiabilidade de aplicação de novos equipamentos/protocolos para o controle do processo de treinamento de desportistas de alto nível, tendo como princípio básico a maior aproximação possível das características materiais, fisiológicas, biomecânicas e ergonômicas do ciclismo de competição. Foram avaliados 7 atletas treinados, do sexo masculino com idade de 24,29 ± 2,05 anos e, tempo de competição médio de 4,42 ± 3,21 anos. Após análise dos dados, não foram encontradas diferenças estatisticamente significativas entre as variáveis mensuradas (freqüência cardíaca máxima, ventilação máxima por minuto, limiar de Conconi, limiar ventilatório, freqüência cardíaca no limiar ventilatório, percepção subjetiva de esforço (PSE) no limiar ventilatório e PSE no limiar de Conconi), obtidas através dos dois protocolos. Pela semelhança das respostas fisiológicas, similaridade da geometria do equipamento, pegada do guidom, conforto do selim, postura mais confortável, plena fixação dos pés nos pedais, cadência próxima à de competição, conclui-se que o teste de rolo estacionário pode ser indicado para avaliação ciclistas de alto nível

Depression, anxiety and quality of life scores in seniors after an endurance exercise program

OBJECTIVE: Mood disorders are a frequent problem in old age, and their symptoms constitute an important public health issue. These alterations affect the quality of life mainly by restricting social life. The participation in a regular exercise program is an effective way of reducing or preventing the functional decline associated with aging. The aim of the present study was to examine the effects of fitness-endurance activity (at the intensity of Ventilatory Threshold 1 (VT-1)) in depression, anxiety and quality of life scores in seniors. METHODS: The study involved 46 sedentary seniors aged 60-75 (66.97 ± 4.80) who were randomly allocated to two groups: 1) Control group, which was neither asked to vary their everyday activities nor to join a regular physical fitness program; and 2) Experimental group, whose members took part in an aerobic fitness program consisting of ergometer cycle sessions 3 times a week on alternate days for six months working at a heart rate corresponding to ventilatory threshold (VT-1) intensity. Subjects were submitted to a basal evaluation using the geriatric depression screening scale - GDS, STAI trait/state (anxiety scale) and SF-36 (quality of life scale). RESULTS: Comparing the groups after the study period, we found a significant decrease in depressive and anxiety scores and an improvement in the quality of life in the experimental group, but no significant changes in the control group. CONCLUSION: The data suggest that an aerobic exercise program at VT-1 intensity suffices to promote favorable modifications in depressive and anxiety scores to improve the quality of life in seniors