Alterações da massa magra e massa óssea após cirurgia bariátrica. Efeitos de um programa de exercício físico.

Este estudo tem como objetivos, identificar o papel e valor do exercício físico regular na modulação da composição corporal de pacientes submetidos a cirurgia bariátrica. Também constatar se a assiduidade no programa de exercício físico influência em melhores resultados no que se refere a manutenção de massa magra (MMa). Para apoiar nosso objetivo compilamos dois artigos nesse documento, sendo o primeiro um artigo de revisão para fundamentar as bases teóricas necessárias para a realização do estudo experimental, que é apresentado na sequencia como segundo artigo do estudo. Na revisão de literatura foi apresentado uma introdução à obesidade, estudos relacionados ao tratamento da obesidade por procedimento cirúrgico bariátrico, bem como a técnica do bypass em Y de Roux (RGYB), as alterações na absorção dos nutrientes, a avaliação da composição corporal por densitometria radiológica de dupla energia (DXA), os efeitos da cirurgia bariátrica na massa muscular (MM), massa gorda (MG) e massa óssea (MO). O estudo experimental investigou o efeito de um programa de exercício físico na composição corporal (CC) de indivíduos obesos submetidos a cirurgia bariátrica (CB), classificou-se como um ensaio clinico aleatorizado com controlo e foi desenvolvido em paralelo a subamostra de um projeto de investigação. Foi possível concluir que a cirúrgica bariátrica resultou em diminuição significativa da massa corporal total e CC. O exercício não alterou a CC nos 6 meses após a cirurgia, independentemente da assiduidade ao programa.This study aims to identify the role and value of regular physical exercise in modulating the body composition of patients undergoing bariatric surgery. Also verify if attendance in the physical exercise program influences in better results regarding the maintenance of lean mass. To support our goal we have compiled two articles in this paper, the first being a review article to provide the theoretical basis for the experimental study, which is presented as a second article in the study. The review of the literature presented an introduction to obesity, studies related to the treatment of obesity by bariatric surgical procedure, as well as Roux-en-Y bypass technique (RGYB), changes in nutrient absorption, body composition assessment by densitometry (DXA), the effects of bariatric surgery on muscle mass (MM), fat mass (FM) and bone mass (BM). The experimental study investigated the effect of a physical exercise program on the body composition (BC) of obese subjects undergoing bariatric surgery (BS), was classified as a randomized controlled clinical trial with control and was developed in parallel the sub-sample of a research project. It was possible to conclude that bariatric surgery resulted in a significant decrease in total body mass and BC. Exercise did not change BC within 6 months after surgery, regardless of program attendance

a critical review

The availability of wearable devices (WDs) to collect biometric information and their use during activities of daily living is significantly increasing in the general population. These small electronic devices, which record fitness and health-related outcomes, have been broadly utilized in industries such as medicine, healthcare, and fitness. Since they are simple to use and progressively cheaper, they have also been used for numerous research purposes. However, despite their increasing popularity, most of these WDs do not accurately measure the proclaimed outcomes. In fact, research is equivocal about whether they are valid and reliable methods to specifically evaluate physical activity and health-related outcomes in older adults, since they are mostly designed and produced considering younger subjects? physical and mental characteristics. Additionally, their constant evolution through continuous upgrades and redesigned versions, suggests the need for constant up-to-date reviews and research. Accordingly, this article aims to scrutinize the state-of-the-art scientific evidence about the usefulness of WDs, specifically on older adults, to monitor physical activity and health-related outcomes. This critical review not only aims to inform older consumers but also aid researchers in study design when selecting physical activity and healthcare monitoring devices for elderly people.DB19-D819-F720 | Carlos Eduardo da Silva TeixeiraN/

The effect of an exercise intervention program on bone health after bariatric surgery: a randomized controlled trial

Exercise has been suggested as a therapeutic approach to attenuate bone loss induced by bariatric surgery (BS), but its effectiveness remains unclear. Our aim was to determine if an exercise-training program could induce benefits on bone mass after BS. Eighty-four patients, submitted to gastric bypass or sleeve gastrectomy, were randomized to either exercise (EG) or control group (CG). One month post-BS, EG underwent a 11-month supervised multicomponent exercise program, while CG received only standard medical care. Patients were assessed before BS and at 1, 6, and 12 months post-BS for body composition, areal bone mineral density (BMD), bone turnover markers, calciotropic hormones, sclerostin, bone material strength index, muscle strength, and daily physical activity. A primary analysis was conducted according to intention-to-treat principles and the primary outcome was the between-group difference on lumbar spine BMD at 12 months post-BS. A secondary analysis was also performed to analyze if the exercise effect depended on training attendance. Twelve months post-BS, primary analysis results revealed that EG had a higher BMD at lumbar spine (+0.024 g∙cm-2 [95% confidence interval (CI) 0.004, 0.044]; p = .015) compared with CG. Among total hip, femoral neck, and 1/3 radius secondary outcomes, only 1/3 radius BMD improved in EG compared with CG (+0.013 g∙cm-2 [95% CI 0.003, 0.023]; p = .020). No significant exercise effects were observed on bone biochemical markers or bone material strength index. EG also had a higher lean mass (+1.5 kg [95% CI 0.1, 2.9]; p = .037) and higher number of high impacts (+51.4 [95% CI 6.6, 96.1]; p = .026) compared with CG. In addition, secondary analysis results suggest that exercise-induced benefits may be obtained on femoral neck BMD but only on those participants with ≥50% exercise attendance compared with CG (+5.3% [95% CI 2.0, 8.6]; p = .006). Our findings suggest that an exercise program is an effective strategy to ameliorate bone health in post-BS patients. © 2020 American Society for Bone and Mineral Research (ASBMR).publishe