Publications by authors named "Luis B Sardinha"

263 Publications

Validity of water compartments estimated using bioimpedance spectroscopy in athletes differing in hydration status.

Scand J Med Sci Sports 2021 Apr 4. Epub 2021 Apr 4.

Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal.

We aimed to validate bioelectrical impedance spectroscopy (BIS), compared to tracer dilution measurements, for assessing total body water (TBW), intracellular water (ICW), and extracellular water (ECW) in athletes differing in hydration status. A total of 201 athletes participated. Reference TBW and ECW were determined by deuterium and bromide dilution methods, respectively; ICW was calculated as TBW-ECW. Water compartments were estimated by BIS. Urine specific gravity (USG) classified athletes into well-hydrated (WH) (USG<1.023), euhydrated (EH) (USG:1.024-1.026), and dehydrated (DH) (USG>1.027). No significant differences were found between BIS and the reference methods for WH, EH, and DH athletes for TBW, ICW nor ECW (p>0.05). Concordance of TBW and its compartments by method was significant (p<0.001) with coefficients of determination ranging by hydration classification [EH:52-96%;DH:56-98%;WH:71-96%]. Bland-Altman analyses showed no trend for TBW and its compartments with the exception of ICW in the WH athletes. The 95% confidence BIS intervals for the WH group ranged from -3.08 to 2.68kg for TBW, -4.28 to 4.14kg for ICW and -3.29 to 3.02kg for ECW. For the EH athletes, the 95% confidence intervals ranged from -2.78 to 2.24kg for TBW, -4.10 to 3.94kg for ICW and -3.44 to 3.06kg for ECW. In DH group, TBW ranged between -1.99 to 2.01kg, ICW between -3.78 to 6.34kg and ECW between -6.22 to 3.74kg. These findings show that BIS is useful at a group level in assessing water compartments in athletes differing in hydration status. However, the usefulness of BIS is limited at an individual level, especially in dehydrated athletes.
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http://dx.doi.org/10.1111/sms.13966DOI Listing
April 2021

Criterion validity of a single-item question for assessment of daily breaks in sedentary time in adults.

Eur J Public Health 2021 Apr 1. Epub 2021 Apr 1.

Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.

Background: As the implementation of sensor-based assessment for sedentary time (ST) and physical activity (PA) has practical limitations when applied on a large-scale, most studies rely on subjective data. We aimed to examine the criterion validity of a single-item question to assess daily breaks in ST and other PA-related outcomes for the first time using sensor-based data as the criterion.

Methods: In a sample of 858 adults, breaks in ST and other PA-related parameters were assessed through sensor-based accelerometry and subjective data, which included a comprehensive questionnaire with a specific question ('During the day, do you usually sit for a long time in a row or interrupt frequently?') with a three-level closed answer. The Spearman's rank correlation coefficient was used to determine the agreement between the single-item question and sensor-based data.

Results: Positive correlations were found for self-reported breaks in ST with sensor-based breaks in ST in both women (ρ=0.37; 95% CI=0.29-0.44) and men (ρ=0.15; 95% CI=0.04-0.26). Self-reported breaks in ST were inversely correlated with ST in women (ρ =-0.33; 95% CI=-0.40 to 0.25). For both sexes, self-reported breaks in ST showed a positive correlation with light-intensity PA (ρ=0.39; 95% CI=0.31-0.46 women; ρ=0.13; 95% CI=0.02-0.24 men), however, positive correlations between self-reported breaks in ST and moderate-to-vigorous PA (ρ=0.13; 95% CI=0.02-0.24) were found only in men.

Conclusions: Our single-item question can be used as an indication for ranking people's breaks in ST during the waking day, although acknowledging that some misclassification will occur, especially in men. There must be an effort to include this question in future national and international surveys to replicate these findings.
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http://dx.doi.org/10.1093/eurpub/ckab030DOI Listing
April 2021

Physical activity moderates the effect of sedentary time on an older adult's physical independence.

J Am Geriatr Soc 2021 Mar 29. Epub 2021 Mar 29.

Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.

Background/objectives: Moderate-to-vigorous physical activity (MVPA) and breaks in sedentary time (BST) have been proposed as viable solutions to improve an older adult's physical independence, whereas sedentary time (ST) has been associated with detrimental effects. We sought to assess the joint effects of ST, BST, and MVPA on the physical independence of older adults and determine whether and to what extent the ST relationship with physical independence is moderated by MVPA and/or BST.

Design: Cross-sectional.

Setting: Laboratory of Exercise and Health, Faculty of Human Kinetics.

Participants: Older adults (≥65 years old) from the national surveillance system in Portugal (n = 821).

Measurements: Physical activity and ST were assessed by accelerometry. Physical independence was assessed using a 12-item composite physical function (CPF) questionnaire. Multiple linear regression was used to model the outcomes.

Results: Higher ST was related to lower CPF score (β = -0.01, p < 0.0001), whereas higher MVPA was related to better CPF score (β = 0.02, p < 0.0001). BST was not related to physical independence after accounting for MVPA and ST (β = 0.03, p = 0.074). MVPA had a moderating effect on the relationship of ST with CPF score (p < 0.0001), where MVPA ≥36.30 min/day ameliorated the significant inverse relationship between ST and CPF. Engaging in ≥107.78 of MVPA resulted in ST having a significant positive relationship with CPF score. No moderation effect was found for BST (p > 0.05).

Conclusion: Regardless of the time spent in MVPA and BST, ST was inversely related to CPF. However, MVPA was found to be a moderator of the relationship between ST and physical independence, such that engaging in at least 36 min/day of MVPA may blunt the negative effects of ST. At high levels of MVPA (≥108 min/day), having some ST may actually provide some benefit to an older adult's ability to maintain physical independence.
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http://dx.doi.org/10.1111/jgs.17141DOI Listing
March 2021

Does Adaptive Thermogenesis occur after weight loss in adults? A systematic review.

Br J Nutr 2021 Mar 25:1-43. Epub 2021 Mar 25.

Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-688Cruz-Quebrada, Portugal.

Adaptive thermogenesis (AT) has been proposed to be a compensatory response that may resist weight loss(WL) and promote weight regain. This systematic review examined the existence of AT in adults after a period of negative energy balance with or without a weight stabilization phase. Studies published until May 15th, 2020 were identified from PubMed, Cochrane Library, EMBASE, MEDLINE, SCOPUS and Web of Science. Inclusion criteria included: statistically significant WL; observational with follow-up or experimental studies; age>18years; sample size≥10 participants; intervention period ≥1week; published in English; objective measures of total daily energy expenditure(TDEE), resting energy expenditure(REE) and sleeping energy expenditure(SEE). The systematic review was registered at PROSPERO(2020 CRD42020165348). A total of 33 studies comprising 2528 participants, were included. AT was observed in 27 out of 33 studies. Twenty-three studies showed significant values for AT for REE(82.8%), 4 studies for TDEE(80.0%) and 2 studies for SEE(100%). A large heterogeneity in the methods used to quantify AT and between subjects and among studies regarding the magnitude of WL and/or of AT was reported. Well-designed studies reported lower or non-significant values for AT. Overall, these findings suggest that although WL may lead to AT in some of the EE components, these values may be small or non-statistically significant when higher-quality methodological designs are used. Furthermore, AT seems to be attenuated, or non-existent, after periods of weight stabilization/neutral energy balance. Therefore, more high-quality studies are warranted not only to disclose the existence of AT, but to understand its clinical implications on weight management outcomes.
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http://dx.doi.org/10.1017/S0007114521001094DOI Listing
March 2021

Children's moderate-to-vigorous physical activity on weekdays versus weekend days: a multi-country analysis.

Int J Behav Nutr Phys Act 2021 02 10;18(1):28. Epub 2021 Feb 10.

MRC Epidemiology Unit & Centre for Diet and Activity Research, University of Cambridge, Cambridge, UK.

Purpose: The Structured Days Hypothesis (SDH) posits that children's behaviors associated with obesity - such as physical activity - are more favorable on days that contain more 'structure' (i.e., a pre-planned, segmented, and adult-supervised environment) such as school weekdays, compared to days with less structure, such as weekend days. The purpose of this study was to compare children's moderate-to-vigorous physical activity (MVPA) levels on weekdays versus weekend days using a large, multi-country, accelerometer-measured physical activity dataset.

Methods: Data were received from the International Children's Accelerometer Database (ICAD) July 2019. The ICAD inclusion criteria for a valid day of wear, only non-intervention data (e.g., baseline intervention data), children with at least 1 weekday and 1 weekend day, and ICAD studies with data collected exclusively during school months, were included for analyses. Mixed effects models accounting for the nested nature of the data (i.e., days within children) assessed MVPA minutes per day (min/day MVPA) differences between weekdays and weekend days by region/country, adjusted for age, sex, and total wear time. Separate meta-analytical models explored differences by age and country/region for sex and child weight-status.

Results/findings: Valid data from 15 studies representing 5794 children (61% female, 10.7 ± 2.1 yrs., 24% with overweight/obesity) and 35,263 days of valid accelerometer data from 5 distinct countries/regions were used. Boys and girls accumulated 12.6 min/day (95% CI: 9.0, 16.2) and 9.4 min/day (95% CI: 7.2, 11.6) more MVPA on weekdays versus weekend days, respectively. Children from mainland Europe had the largest differences (17.1 min/day more MVPA on weekdays versus weekend days, 95% CI: 15.3, 19.0) compared to the other countries/regions. Children who were classified as overweight/obese or normal weight/underweight accumulated 9.5 min/day (95% CI: 6.9, 12.2) and 10.9 min/day (95% CI: 8.3, 13.5) of additional MVPA on weekdays versus weekend days, respectively.

Conclusions: Children from multiple countries/regions accumulated significantly more MVPA on weekdays versus weekend days during school months. This finding aligns with the SDH and warrants future intervention studies to prioritize less-structured days, such as weekend days, and to consider providing opportunities for all children to access additional opportunities to be active.
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http://dx.doi.org/10.1186/s12966-021-01095-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877033PMC
February 2021

Sedentary behaviours and their relationship with body composition of athletes.

Eur J Sport Sci 2021 Feb 2:1-7. Epub 2021 Feb 2.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal.

During the recovery period, athletes present high sedentary behaviour (SB). In non-athletes, there is a direct relationship between SB and obesity. However, little is known about this relationship in athletes. We hypothesized that different types of SB entail different associations with body composition outcomes. We examined the associations between different types of SB and body composition outcomes in 135 athletes (70 males) aged 21.3 ± 3.9 years old. Dual-energy X-ray absorptiometry was performed to assess fat mass (FM), fat-free mass (FFM) and trunk fat mass (TFM). A validated SB questionnaire (PACE) was used to estimate total SB and specific sedentary pursuits on an average day. Multiple linear regression analyses were performed, adjusting for age, sex, weekly training time, years of sport practice, and sport type. A positive association was found for total SB and total screen time with %TFM ( = 0.220, = 0.038 and = 0.319, = 0.040, respectively), while an inverse association was found for %FFM ( = -0.214, = 0.042 and = -0.310, = 0.026). A higher total screen time was related with a higher %FM ( = 0.283, = 0.035). With a much stronger effect size, cell phone screen time was positively related with %FM ( = 1.447, = 0.001). There is still debate whether high levels of physical activity can fully counteract the harms of SB. These findings suggest that SB, particularly cell phone screen time, can compromise athletes' body composition, regardless of weekly training time. Sport federations and coaches may improve athletes' body composition by targeting specific sedentary pursuits, i.e. total screen time and cell phone screen time, during athletes' recovery time. Even in athletes, SB can compromise total and regional body composition regardless of high training time. Screen time, specifically cell phone screen time seems to be the sedentary pursuit to target in athletes. Sport federations and coaches must control SB during athletes' recovery time.
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http://dx.doi.org/10.1080/17461391.2021.1874060DOI Listing
February 2021

Recommendations for determining the validity of consumer wearable heart rate devices: expert statement and checklist of the INTERLIVE Network.

Br J Sports Med 2021 Jan 4. Epub 2021 Jan 4.

Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University Cologne, Cologne, Germany

Assessing vital signs such as heart rate (HR) by wearable devices in a lifestyle-related environment provides widespread opportunities for public health related research and applications. Commonly, consumer wearable devices assessing HR are based on photoplethysmography (PPG), where HR is determined by absorption and reflection of emitted light by the blood. However, methodological differences and shortcomings in the validation process hamper the comparability of the validity of various wearable devices assessing HR. Towards Intelligent Health and Well-Being: Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives towards developing best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice validation protocol for consumer wearables assessing HR by PPG. The recommendations were developed through the following multi-stage process: (1) a systematic literature review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, (2) an unstructured review of the wider literature pertaining to factors that may introduce bias during the validation of these devices and (3) evidence-informed expert opinions of the INTERLIVE Network. A total of 44 articles were deemed eligible and retrieved through our systematic literature review. Based on these studies, a wider literature review and our evidence-informed expert opinions, we propose a validation framework with standardised recommendations using six domains: considerations for the target population, criterion measure, index measure, testing conditions, data processing and the statistical analysis. As such, this paper presents recommendations to standardise the validity testing and reporting of PPG-based HR wearables used by consumers. Moreover, checklists are provided to guide the validation protocol development and reporting. This will ensure that manufacturers, consumers, healthcare providers and researchers use wearables safely and to its full potential.
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http://dx.doi.org/10.1136/bjsports-2020-103148DOI Listing
January 2021

Sedentary patterns are associated with BDNF in patients with type 2 diabetes mellitus.

Eur J Appl Physiol 2021 Mar 2;121(3):871-879. Epub 2021 Jan 2.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.

Purpose: Exercise is beneficial to type-2 diabetes-mellitus (T2DM), and there is evidence showing that one of those benefits include a higher expression of brain-derived neurotrophic factor (BDNF), which has been implicated in improving fat oxidation and cognitive development. The deleterious effect of prolonged sedentary time (ST) on BDNF levels has never been examined in patients with T2DM. Our goal was to analyse the associations for sedentary patterns [i.e. breaks in ST per sedentary hour (BST-ST) and bouts of sedentary time (BSB) of different length] with BDNF in patients with T2DM, independent of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF).

Methods: Sample included 80 patients (38 women) with T2DM (58.3 ± 7.8 years). ST and MVPA were assessed by accelerometry (ActiGraph, GT3X + model), BDNF by blood collection and plasma quantification using commercial enzyme-linked immunosorbent assay kits, and CRF was determined using a Bruce protocol to exhaustion, on a motorized treadmill.

Results: Positive associations for BST-ST (β = 0.155; p = 0.007) with BDNF, and negative associations for BSB longer than 15 min with BDNF were found (β = - 0.118; p = 0.049). Neither MVPA nor cardiorespiratory fitness eliminated the associations for BST-ST with BDNF, but MVPA eradicated the associations between BSB > 15 min and BDNF.

Conclusions: Our findings suggest that interrupting ST and especially avoiding longer sedentary periods (> 15 min) may be beneficial for BDNF plasma abundance that may influence metabolic and cognitive functioning of patients with T2DM, especially for the ones presenting lower MVPA levels.

Trial Registration: May 5, 2017, ClinicalTrials.govID:NCT03144505.
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http://dx.doi.org/10.1007/s00421-020-04568-2DOI Listing
March 2021

Recommendations for determining the validity of consumer wearable and smartphone step count: expert statement and checklist of the INTERLIVE network.

Br J Sports Med 2020 Dec 24. Epub 2020 Dec 24.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal

Consumer wearable and smartphone devices provide an accessible means to objectively measure physical activity (PA) through step counts. With the increasing proliferation of this technology, consumers, practitioners and researchers are interested in leveraging these devices as a means to track and facilitate PA behavioural change. However, while the acceptance of these devices is increasing, the validity of many consumer devices have not been rigorously and transparently evaluated. The Towards Intelligent Health and Well-Being Network of Physical Activity Assessment (INTERLIVE) is a joint European initiative of six universities and one industrial partner. The consortium was founded in 2019 and strives to develop best-practice recommendations for evaluating the validity of consumer wearables and smartphones. This expert statement presents a best-practice consumer wearable and smartphone step counter validation protocol. A two-step process was used to aggregate data and form a scientific foundation for the development of an optimal and feasible validation protocol: (1) a systematic literature review and (2) additional searches of the wider literature pertaining to factors that may introduce bias during the validation of these devices. The systematic literature review process identified 2897 potential articles, with 85 articles deemed eligible for the final dataset. From the synthesised data, we identified a set of six key domains to be considered during design and reporting of validation studies: target population, criterion measure, index measure, validation conditions, data processing and statistical analysis. Based on these six domains, a set of key variables of interest were identified and a 'basic' and 'advanced' multistage protocol for the validation of consumer wearable and smartphone step counters was developed. The INTERLIVE consortium recommends that the proposed protocol is used when considering the validation of any consumer wearable or smartphone step counter. Checklists have been provided to guide validation protocol development and reporting. The network also provide guidance for future research activities, highlighting the imminent need for the development of feasible alternative 'gold-standard' criterion measures for free-living validation. Adherence to these validation and reporting standards will help ensure methodological and reporting consistency, facilitating comparison between consumer devices. Ultimately, this will ensure that as these devices are integrated into standard medical care, consumers, practitioners, industry and researchers can use this technology safely and to its full potential.
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http://dx.doi.org/10.1136/bjsports-2020-103147DOI Listing
December 2020

Whole body and regional phase angle as indicators of muscular performance in athletes.

Eur J Sport Sci 2021 Jan 18:1-9. Epub 2021 Jan 18.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal.

Bioelectrical impedance analysis (BIA)-derived phase angle (PhA) has been used to assess cellular health in various populations, but its usefulness as a tool for measuring muscular performance in adult athletes has not been extensively investigated. Our investigation examined the association of whole-body (WB) PhA with muscular performance in 117 adult athletes from different sports and additionally assessed whether regional PhA was a better indicator of muscular performance compared to WB, while accounting for lean soft tissue (LST). Muscular performance was assessed with handgrip strength and countermovement jump power. WB and regional PhA and LST were obtained by BIA and dual-energy x-ray absorptiometry, respectively. Multiple linear regression was used to model outcomes, while adjusting for LST. WB PhA was positively associated with relative power and relative and absolute strength ( < 0.05), irrespective of LST. Regional PhA measures explained similar amounts of variance in absolute and relative power and strength as that of WB PhA after accounting for age, sex, height, and sport type (lower limb adj  = 0.42, 0.60 for power; upper limb adj  = 0.38, 0.74 for strength; WB adj  = 0.44, 0.63 and 0.38, 0.75 for power and strength, respectively). Only upper limb PhA was related with strength ( < 0.05) after accounting for upper limb LST. PhA may have the potential to be used as a marker of functional muscle mass, which is important when it comes to assessing muscular performance of athletes. Regional measures of PhA do not provide a better indicator of regional strength or power when compared to WB PhA.
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http://dx.doi.org/10.1080/17461391.2020.1858971DOI Listing
January 2021

The impact of 2 weeks of detraining on phase angle, BIVA patterns, and muscle strength in trained older adults.

Exp Gerontol 2021 Feb 3;144:111175. Epub 2020 Dec 3.

Exercise and Health Laboratory, Interdisciplinary Center for the Study of Human Performance, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal. Electronic address:

Background: An intermission in the training routine, in which older adults refrain from regular structured exercise, may have deleterious effects on muscle performance and bioelectric phase angle (PhA), which is a predictive marker for cellular integrity.

Purpose: To determine the effects of a 2-week detraining period on PhA and muscular strength (MS) in trained older adults.

Methods: A total of 14 trained older adults (6 females) aged ≥65 years (77.2 ± 6.6) were assessed at baseline (i.e. trained condition) and after 2 weeks of detraining, where they refrained from their usual participation in structured exercise sessions. Whole-body resistance (R), reactance (Xc), and PhA were assessed using bioelectrical impedance analysis (BIA, single frequency, 50 kHz ± 1%, NutriLab, Akern). MS was assessed on both lower and upper limbs under isometric conditions. Differences between moments were examined using ANOVA for repeated measures, while adjusting for sex. Bioimpedance vector analysis (BIVA) was performed to evaluate changes in cellular function and body fluid content.

Results: Detraining resulted in declines in PhA (-4.34%) (p = 0.017). There was a significant difference in the mean impedance vectors from baseline to post-detraining (p < 0.05), which were driven by decreases in reactance (Xc) relative to height (Xc/H) with little change in resistance (R) relative to height (R/H) for both males and females. No differences were found in MS for both the leg press (p = 0.992) and bench press (p = 0.166) tests.

Conclusion: A detraining period as short as 2-weeks is enough to cause alterations in the bodies bioelectrical properties, resulting in detrimental changes in PhA, due to alterations in cellular integrity, but not in MS. These results highlight the importance of maintaining structured exercise sessions in older adults, and reinforce the potential role of PhA as a sensitive predictor to detect acute changes in muscle cell integrity following alterations in exercise training.
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http://dx.doi.org/10.1016/j.exger.2020.111175DOI Listing
February 2021

Sedentary Patterns Are Associated with Bone Mineral Density and Physical Function in Older Adults: Cross-Sectional and Prospective Data.

Int J Environ Res Public Health 2020 11 6;17(21). Epub 2020 Nov 6.

Skeletal Muscle Assessment Laboratory, Department of Physical Education, School of Technology and Sciences, São Paulo State University, São Paulo 19060-900, Brazil.

Aging causes some unfavorable morphological and functional changes, such as the decline in bone mineral density (BMD) and physical function. Moderate-to-vigorous physical activity (MVPA) and sedentary time seem to be related with these alterations, but the impact of distinct patterns remains unclear. The aim of this study was to cross-sectionally and prospectively assess the association between objectively measured MVPA and sedentary patterns (bouts and breaks) with BMD and physical function in older adults. The study considered 151 Brazilians (aged ≥ 60 years), out of which 68 participants completed 2-year follow-up measurements. MVPA and sedentary patterns were measured by means of accelerometry, BMD-(total proximal femur and lumbar spine (L1-L4)) by means of dual-energy X-ray absorptiometry (DXA), and physical function-by means of physical tests. In older women, sedentary bouts >60 min were inversely associated with handgrip strength (β = -2.03, 95% CI: from -3.43 to -0.63). The prospective analyses showed that changes in sedentary bouts (20 to 30 min and >60 min) were inversely associated with changes in the lumbar spine's BMD (β = -0.01, 95% CI: from -0.01 to -0.00 and β = -0.03, 95% CI: from -0.06 to -0.01) and the lumbar spine's T-score (β = -0.06, 95% CI: from -0.10 to -0.01 and β = -0.27, 95% CI: from -0.49 to -0.04), respectively. In older women, sedentary patterns are cross-sectionally associated with handgrip strength and prospectively associated with BMD independent of MVPA.
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http://dx.doi.org/10.3390/ijerph17218198DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7664175PMC
November 2020

Fitness, physical activity, or sedentary patterns? Integrated analysis with obesity surrogates in a large youth sample.

Am J Hum Biol 2020 Oct 20:e23522. Epub 2020 Oct 20.

CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.

Objective: Physical fitness (PF) and physical activity (PA) are inversely associated with body mass index and waist circumference (WC), whereas sedentary time (ST) seems to boost obesity in youth. The aim was to examine the associations of each selected PF test, PA-related exposures, and specific ST patterns with obesity and determine the most relevant ones, in a large sample of a school-aged adolescent.

Methods: The sample consisted of 2696 Portuguese youth aged 10 to 18 years. Height, weight, and WC were measured. PA and ST components were measured using accelerometry. PF was evaluated using a battery of tests.

Results: The Progressive Aerobic Cardiovascular Endurance Run (PACER) and push-up tests seemed to be the exposures that presented the strongest and more consistent associations with obesity, independent of PA/ST profiles (P < .05). The second exposure of relevance for adolescent obesity level was the breaks in ST with a negative relationship regardless of PA/PF profiles (P < .05). Finally, ST accumulated in periods of <30 minutes, and moderate-to-vigorous PA were favorably associated with obesity, independent of ST/PF.

Conclusions: Independent of PA and ST, cardiorespiratory fitness (CRF), measured by PACER, was associated with obesity markers. This may be in part due to the dependence of PACER performance on adiposity. Also, limiting prolonged ST and promoting interruptions in this behavior were associated with obesity. These associations suggest that future research should examine other strategies beyond PA promotion for tackling obesity that consider CRF and breaking ST.
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http://dx.doi.org/10.1002/ajhb.23522DOI Listing
October 2020

Impact of combined training with different exercise intensities on inflammatory and lipid markers in type 2 diabetes: a secondary analysis from a 1-year randomized controlled trial.

Cardiovasc Diabetol 2020 10 7;19(1):169. Epub 2020 Oct 7.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal.

Background: Exercise is a well-accepted strategy to improve lipid and inflammatory profile in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefits on lipids and inflammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on inflammatory and lipid profile in individuals with T2DM.

Methods: Individuals with T2DM (n = 80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n = 27; HIIT with RT, n = 25; MCT with RT, n = 28). Exercise sessions were supervised with a frequency of 3 days per week. Inflammatory and lipid profiles were measured at baseline and at 1-year follow-up. Changes in inflammatory and lipid markers were assessed using generalized estimating equations.

Results: After adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β = - 0.70, p = 0.034) and HIIT with RT (β = - 0.62, p = 0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β = - 0.03, p = 0.045) and LDL-C (β = - 0.03, p = 0.034), when compared to control. No effect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p > 0.05).

Conclusions: Favorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups following a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve inflammatory profile, either exercise protocols may be prescribed, however, HIIT with RT may have further benefits on the lipid profile. Trial registration Clinicaltrials.gov ID: NCT03144505.
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http://dx.doi.org/10.1186/s12933-020-01136-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7539392PMC
October 2020

The multivariate physical activity signature associated with metabolic health in children and youth: An International Children's Accelerometry Database (ICAD) analysis.

Prev Med 2020 12 3;141:106266. Epub 2020 Oct 3.

Department of Sport, Food and Natural Sciences, Faculty of Education, Arts and Sports, Western Norway University of Applied Sciences, Sogndal, Norway. Electronic address:

There is solid evidence for an association between physical activity and metabolic health outcomes in children and youth, but for methodological reasons most studies describe the intensity spectrum using only a few summary measures. We aimed to determine the multivariate physical activity intensity signature associated with metabolic health in a large and diverse sample of children and youth, by investigating the association pattern for the entire physical intensity spectrum. We used pooled data from 11 studies and 11,853 participants aged 5.8-18.4 years included in the International Children's Accelerometry Database. We derived 14 accelerometry-derived (ActiGraph) physical activity variables covering the intensity spectrum (from 0-99 to ≥8000 counts per minute). To handle the multicollinearity among these variables, we used multivariate pattern analysis to establish the associations with indices of metabolic health (abdominal fatness, insulin sensitivity, lipid metabolism, blood pressure). A composite metabolic health score was used as the main outcome variable. Associations with the composite metabolic health score were weak for sedentary time and light physical activity, but gradually strengthened with increasing time spent in moderate and vigorous intensities (up to 4000-5000 counts per minute). Association patterns were fairly consistent across sex and age groups, but varied across different metabolic health outcomes. This novel analytic approach suggests that vigorous intensity, rather than less intense activities or sedentary behavior, are related to metabolic health in children and youth.
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http://dx.doi.org/10.1016/j.ypmed.2020.106266DOI Listing
December 2020

Creatine Supplementation Does Not Influence the Ratio Between Intracellular Water and Skeletal Muscle Mass in Resistance-Trained Men.

Int J Sport Nutr Exerc Metab 2020 Sep 11:1-7. Epub 2020 Sep 11.

Londrina State University.

The authors aimed to compare the effects of creatine (Cr) supplementation combined with resistance training on skeletal muscle mass (SMM), total body water, intracellular water (ICW), and extracellular water (ECW) in resistance-trained men as well as to determine whether the SMM/ICW ratio changes in response to the use of this ergogenic aid. Twenty-seven resistance-trained men received either Cr (n = 14) or placebo (n = 13) over 8 weeks. During the same period, subjects performed two split resistance training routines four times per week. SMM was estimated from appendicular lean soft tissue assessed by dual-energy X-ray absorptiometry. Total body water, ICW, and ECW were determined by spectral bioelectrical impedance. Both groups showed improvements (p < .05) in SMM, total body water, and ICW, with greater values observed for the Cr group compared with placebo. ECW increased similarly in both groups (p < .05). The SMM/ICW ratio did not change in either group (p > .05), whereas the SMM/ECW ratio decreased only in the Cr group (p < .05). A positive correlation was observed (p < .05) between SMM and ICW changes (r = .71). The authors' results suggest that the increase in muscle mass induced by Cr combined with resistance training occurs without alteration of the ratio of ICW to SMM in resistance-trained men.
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http://dx.doi.org/10.1123/ijsnem.2020-0080DOI Listing
September 2020

Body mass index trajectories and noncommunicable diseases in women: The role of leisure time physical activity.

Am J Hum Biol 2020 Sep 4:e23492. Epub 2020 Sep 4.

Department of Physical Education, Federal University of Sergipe - UFS, São Cristóvão, Brazil.

Objective: To analyze the association between body mass index trajectories and non-communicable diseases (NCDs) in women, and the interaction effects of leisure time physical activity on this relationship.

Methods: Sample was composed by 15 628 women (≥30 years old) who performed objective measurement of body mass, height, and blood pressure in the 2013 Brazilian Health Survey (2013). Information regarding the body mass at 20 years old, current type 2 diabetes (T2DM), dyslipidemia diagnosis, and leisure time physical activity were self-reported by the participants. Socio-demographic and behavioral covariates were considered. Logistic regression models were used for the statistical analysis.

Results: Those who were obese in both moments and women who become obese showed similar high risk, however, the prevalence of NCDs among women who were no longer obese was similar to the consistently non-obese. Leisure time physical activity attenuated the general deleterious effect of obesity, especially among the consistently obese women for dyslipidemia (inactive: OR: 2.02 [95%CI: 1.69-2.43] vs active: OR: 1.05 [95%CI: 0.55-1.99]), T2DM (inactive: OR: 3.84 [95%CI: 2.72-5.43] vs active: OR: 4.38 [95%CI: 1.49-12.86]) and high blood pressure (inactive: OR: 2.00 [95%CI: 1.56-2.57] vs active: OR: 1.15 [95%CI: 0.57-2.52]).

Conclusions: Changes in body mass index appear to be sensitive to detecting the risk of NCDs over lifespan. In addition, leisure time physical activity attenuates the negative effects of obesity on NCDs, but this appears more important for the consistently non-obese women.
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http://dx.doi.org/10.1002/ajhb.23492DOI Listing
September 2020

Effects of Pyramid Resistance-Training System with Different Repetition Zones on Cardiovascular Risk Factors in Older Women: A Randomized Controlled Trial.

Int J Environ Res Public Health 2020 08 22;17(17). Epub 2020 Aug 22.

Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sports Center, Londrina State University, 86057-970 Londrina, PR, Brazil.

This study analyzed the effects of the pyramidal resistance training (RT) system with two repetition zones on cardiovascular risk factors in older women (≥60 years old). Fifty-nine older women were randomly assigned in three groups: non-exercise control (CON, = 19), narrow-pyramid system (NPR, = 20), and wide-pyramid system (WPR, = 20). Training was performed for eight weeks (eight exercises for the whole-body, 3x/week) in which NPR and WPR performed three sets of 12/10/8 and 15/10/5 repetitions, respectively. Regional body fat was estimated by dual-energy X-ray absorptiometry, and blood parameters related to glycemic, lipid, and inflammatory profiles were assessed. After the training period, although no difference was observed for the magnitude of the changes between NPR and WPR, significant group by time interactions indicated benefits with RT compared to CON for reducing body fat (mainly android body fat; -7%) and improving glucose, HDL-C, LDL-C and C-reactive protein ( < 0.05). Composite z-score of cardiovascular risk, created by the average of the intervention effects on the outcomes, indicate similar responses between NPR and WPR, differing from CON ( < 0.001). Results indicate that both the repetition zones of the pyramidal RT reduced similarly the cardiovascular risk in older women.
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http://dx.doi.org/10.3390/ijerph17176115DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7503540PMC
August 2020

Fat-free Mass Bioelectrical Impedance Analysis Predictive Equation for Athletes using a 4-Compartment Model.

Int J Sports Med 2021 Jan 7;42(1):27-32. Epub 2020 Aug 7.

Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade de Lisboa, Cruz Quebrada, Portugal.

Bioelectrical impedance analysis equations for fat-free mass prediction in healthy populations exist, nevertheless none accounts for the inter-athlete differences of the chemical composition of the fat-free mass. We aimed to develop a bioimpedance-based model for fat-free mass prediction based on the four-compartment model in a sample of national level athletes; and to cross-validate the new models in a separate cohort of athletes using a 4-compartment model as a criterion. There were 142 highly trained athletes (22.9±5.0 years) evaluated during their respective competitive seasons. Athletes were randomly split into development (n=95) and validation groups (n=47). The criterion method for fat-free mass was the 4-compartment model. Resistance and reactance were obtained with a phase-sensitive 50 kHz bioimpedance device. Athletic impedance-based models were developed (fat-free mass=- 2.261+0.327*Stature/Resistance+0.525*Weight+5.462*Sex, where stature is in cm, Resistance is in Ω, Weight is in kg, and sex is 0 if female or 1 if male). Cross validation revealed R of 0.94, limits of agreement around 10% variability and no trend, as well as a high concordance correlation coefficient. The new equation can be considered valid thus affording practical means to quantify fat-free mass in elite adult athletes.
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http://dx.doi.org/10.1055/a-1179-6236DOI Listing
January 2021

Mediating role of physical fitness and fat mass on the associations between physical activity and bone health in youth.

J Sports Sci 2020 Dec 5;38(24):2811-2818. Epub 2020 Aug 5.

CIPER, Faculdade De Motricidade Humana, Universidade De Lisboa , Cruz Quebrada, Portugal.

We aimed to assess if the relationship between VPA and bone health is simultaneously mediated by PF and fat mass in adolescents. Bone health was assessed by quantitative ultrasound (QUS) in 412 participants (221 girls) aged 10-18 years. VPA was assessed by accelerometry and PF was measured using specific protocols from FITescola®. Fat mass (%) was assessed using two skinfolds (triceps and calf). Parallel mediation analysis was performed by Hayes' PROCESS (V.3.3-model 4) for SPSS. We observed that in boys, handgrip mediated the associations of VPA with speed of sound on the third distal radius (R-SoS). While, speed at 20 m and handgrip mediated the relationship of VPA with speed of sound on the tibial midshaft (T-SoS). Body fat (%) only acted as a mediator when handgrip integrates the mediation model. For girls, the only mediating variable for the relationship between VPA and R-SoS or T-SoS was the PACER test. Handgrip, speed and fat mass (%) in boys, and cardiorespiratory fitness in girls mediates the relationships between VPA and bone health assessed by QUS. Promoting muscular fitness and cardiorespiratory fitness and decrease of fat mass through VPA in adolescents may be an important strategy to improve bone health.
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http://dx.doi.org/10.1080/02640414.2020.1801326DOI Listing
December 2020

Promoting health-related cardiorespiratory fitness in physical education: A systematic review.

PLoS One 2020 3;15(8):e0237019. Epub 2020 Aug 3.

CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisboa, Portugal.

Background: This article aimed to systematically review the contribution of physical education (PE) classes to improve cardiorespiratory fitness (CRF) in children and adolescents; and to define potentially relevant factors for promoting CRF in PE classes.

Methods: Studies were identified from searches in ERIC, PubMed, SPORTDiscus, and Web of Science databases. Primary source articles, relating PE classes and CRF, published up to July 2019 in peer-reviewed journals were eligible for inclusion. Specific inclusion criteria were: (a) having cross-sectional or longitudinal and observational or interventional study designs; (b) targeting school-aged children or adolescents; (c) measuring CRF, heart rate or CRF test results as an outcome; (d) having statistical analyses of the CRF, heart rate or CRF test results outcomes reported; (e) focusing on PE classes or PE interventions that did not extended time or frequency of the classes; and (f) published in English, French, Portuguese, or Spanish.

Results: A total of 24 studies met the inclusion criteria. Overall, 10 studies have found a neutral effect of PE classes in students' CRF, eight studies found that PE indeed contributed to the improvement of CRF and six studies revealed mixed findings, when PE classes where controlled for others variables (e.g. body mass index, intensity). Higher intensity PE classes consistently demonstrated contributions to improving students' CRF.

Conclusion: Review findings suggest that PE classes can contribute to the improvement of students' CRF. Intensity, age and weight status were identified as potentially relevant factors for promoting CRF in PE classes. To improve CRF, higher intensity classes should be provided.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0237019PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7398517PMC
October 2020

Effects of Three Resistance Exercise Orders on Muscular Function and Body Composition in Older Women.

Int J Sports Med 2020 Dec 20;41(14):1024-1031. Epub 2020 Jul 20.

Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil.

The purpose of the present study was to compare the effects of three resistance exercise orders on muscular strength, body composition, and functional fitness in trained older women. Forty-five women (aged ≥60 years), after performing 12 weeks of a pre-conditioning resistance-training program were randomly assigned in one of the following groups that performed the exercises in the following orders: multi-joint to single-joint order (MJ-SJ, n=15), single-joint to multi-joint order (SJ-MJ, n=15), and alternating between upper and lower body order (ALT, n=15). Specific training intervention lasted 12 weeks (3x/week) and was composed of eight exercises performed in three sets of 15/10/5 repetitions, with increasing load through the sets. Muscular strength was estimated by one-repetition maximum tests; body composition was assessed by whole-body dual-energy x-ray absorptiometry, and functional fitness was analyzed with a sequence of four motor tests. All groups improved similarly in muscular strength (Cohen's effect size: MJ-SJ=0.45; SJ-MJ=0.48; ALT=0.45), skeletal muscle mass (MJ-SJ=0.08; SJ-MJ=0.07; ALT=0.09), and functional test performance (MJ-SJ=0.38; SJ-MJ=0.20; ALT=0.31), but no change was observed for body fat (>0.05). The results suggest that 12 weeks of resistance training induce positive changes in muscle morphofunctionality, regardless of the exercise order employed in trained older women.
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http://dx.doi.org/10.1055/a-1192-5205DOI Listing
December 2020

Publisher Correction: Neck circumference is associated with adipose tissue content in thigh skeletal muscle in overweight and obese premenopausal women.

Sci Rep 2020 Jul 16;10(1):12013. Epub 2020 Jul 16.

Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1495-688, Cruz Quebrada, Portugal.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
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http://dx.doi.org/10.1038/s41598-020-69150-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7366931PMC
July 2020

Physical Fitness and Bone Health in Young Athletes and Nonathletes.

Sports Health 2020 Sep/Oct;12(5):441-448. Epub 2020 Jul 14.

CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Cruz-Quebrada, Portugal.

Background: Physical activity (PA) and physical fitness (PF) are crucial for bone health. However, children participating in competitive sports with high PA are at a greater risk of fracture from trauma or overuse. Given the importance of bone development during adolescence, associations between commonly used physical fitness tests with distal third radius (R-SoS) and midshaft tibia (T-SoS) speed of sound by quantitative ultrasound were assessed in adolescent athletes and nonathletes.

Hypothesis: The relationship between physical fitness tests and R-SoS and T-SoS will differ depending on sex and athletic status.

Study Design: Cross-sectional study.

Level Of Evidence: Level 3.

Methods: Physical fitness of 285 boys (156 athletes) and 311 girls (74 athletes) aged 10 to 18 years was assessed through strength, speed, agility, and cardiorespiratory tests. Linear regression was used to assess the associations of physical fitness tests with R-SoS and T-SoS.

Results: For boys, favorable associations were observed between physical fitness tests with R-SoS in athletes and T-SoS in both athletes and nonathletes ( < 0.05). For nonathlete girls, favorable associations were found for handgrip (R-SoS and T-SoS, both < 0.05), whereas the progressive aerobic cardiovascular endurance run, vertical jump, speed at 20 m and 40 m were only favorably associated with T-SoS. For athlete girls, the association between handgrip ( = 0.03), vertical jump, and 4 × 10 m shuttle run ( < 0.05) with T-SoS was significantly related to a bone outcome.

Conclusion: The handgrip test and vertical jump were associated with T-SoS in boys and girls independent of sport status. These results suggest that physical fitness is associated with bone health in adolescents, particularly boys, and that the relationship between physical fitness and bone may differ depending on sex and athletic status.

Clinical Relevance: Physical fitness tests are simple, easy-to-use tools for monitoring bone health and should be used by sport and health professsionals to promote healthy sport participation and prevent bone injuries.
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http://dx.doi.org/10.1177/1941738120931755DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7485020PMC
October 2020

Total and regional bone mineral density are associated with cellular health in older men and women.

Arch Gerontol Geriatr 2020 Sep - Oct;90:104156. Epub 2020 Jun 15.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Portugal. Electronic address:

Objective: This study aimed to investigate the relationship between crude bioimpedance variables with bone mineral density (BMD) in older adults.

Method: One hundred eighty-four older men and women (≥ 60 years old) composed the sample. BMD (whole-body) was measured through dual-energy X-ray absorptiometry. Bioimpedance spectroscopy was used to estimate whole-body resistance and reactance as well as to calculate the phase angle (PhA) and fat-free mass (FFM). Age, gender, body mass, FFM, height, calcium intake, vitamin D intake, number of fractures, number of diseases, and number of medications were included as covariates in the regression analyses.

Results: BMD fractions were significantly (P < 0.01) associated with PhA (femur: r = 0.524; neck: r = 0.450; and forearm: r = 0.437). Independently of age, body mass, FFM, calcium intake, vitamin D, number of diseases, fratures and medications, PhA remains a significant explanator of the variability of total (β = 0.22; P < 0.001), femur (β = 0.10; P = 0.018), and neck BMD (β = 0.07; P = 0.05) for men, and total (β = 0.08; P = 0.002), femur (β = 0.06; P = 0.005), neck (β = 0.04; P = 0.03), and forearm BMD (β = 0.05; P = 0.004) for women.

Conclusion: Our results suggest that a higher PhA is associated with BMD in older men and women fractions regardless of relevant covariates highlighting the biological meaning of this simple and crude bioimpedance-based measure in the elderly population.
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http://dx.doi.org/10.1016/j.archger.2020.104156DOI Listing
December 2020

Breaking sedentary time predicts future frailty in inactive older adults: A cross-lagged panel model.

J Gerontol A Biol Sci Med Sci 2020 Jun 27. Epub 2020 Jun 27.

GENUD Toledo Research Group, University of Castilla-La Mancha Toledo, Spain.

Background: Cross-sectional evidence exists on the beneficial effects of breaks in sedentary time (BST) on frailty in older adults. Nonetheless, the longitudinal nature of these associations is unknown. This study aimed to investigate the direction and temporal order of the association between accelerometer-derived BST and frailty over time in older adults.

Methods: This longitudinal study analyzed a total of 186 older adults aged 67 to 90 (76.7±3.9 y.; 52.7% females) from the Toledo Study for Healthy Aging over a 4-year period. Number of daily BST was measured by accelerometry. Frailty was assessed with the Frailty Trait Scale. Multiple cross-lagged panel models were used to test the temporal and reciprocal relationship between BST and frailty.

Results: For those physically inactive (n=126), our analyses revealed a reciprocal inverse relationship between BST and frailty, such as higher initial BST predicted lower levels of later frailty (std. β= -0.150, 95% CI= -0.281, -0.018; p<.05); as well as initial lower frailty levels predicted higher future BST (std. β= -0.161, 95% CI= -0.310, -0.011; p<.05). Conversely, no significant pathway was found in the active participants (n=60).

Conclusions: In physically inactive older adults, the relationship between BST and frailty is bidirectional, while in active individuals no associations were found. This investigation provides preliminary longitudinal evidence that breaking-up sedentary time more often reduce frailty in those older adults who do not meet physical activity recommendations. Targeting frequent BST may bring a feasible approach to decrease the burden of frailty among more at risk inactive older adults.
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http://dx.doi.org/10.1093/gerona/glaa159DOI Listing
June 2020

Changes in Physical Activity and Sedentary Patterns on Cardiometabolic Outcomes in the Transition to Adolescence: International Children's Accelerometry Database 2.0.

J Pediatr 2020 10 14;225:166-173.e1. Epub 2020 Jun 14.

Exercise and Health Laboratory, Interdisciplinary Center for the Study of Human Performance, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada - Portugal, Portugal.

Objective: To examine the associations of changes in physical activity and sedentary patterns with changes in cardiometabolic outcomes from childhood to adolescence.

Study Design: Youth from the International Children's Accelerometry Database (n = 1088; 55% girls), aged 8-13 years and followed for ∼4 years, were used in this analysis. Hip-mounted accelerometers were used and all physical activity intensities were expressed as the % of total wear-time. Sedentary time was separated into time spent in bouts <10 minutes and ≥10 minutes. A composite z score for cardiometabolic risk (CMR score) was computed by summing the standardized values for systolic and diastolic blood pressure, triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and the inverse high-density lipoprotein cholesterol. Multivariate analyses were performed using adjusted linear regression models.

Results: Increase in sedentary time was unfavorably associated with changes in CMR score (β = 0.021; CI 0.004-0.037), TG (β = 0.003; CI 0.001-0.005), and diastolic blood pressure (β = 0.068; CI 0.009-0.128). Decrease in moderate-to-vigorous physical activity was unfavorably associated with changes in LDL-c (β = -0.009; CI -0.017 to -0.001) and TG (β = -0.007; CI -0.013 to -0.001). Increase in ≥10 minutes sedentary time was unfavorably associated with changes in CMR score (β = 0.017; CI 0.004-0.030), LDL-c (β = 0.003; CI 0.000-0.005), and TG (β = 0.003; CI 0.000-0.004). Decrease in light-intensity physical activity was unfavorably associated with changes in CMR score (β = -0.020; CI = -0.040 to 0.000).

Conclusions: More physical activity and less prolonged sedentary time are beneficial for cardiometabolic health in youth transitioning to adolescence.
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http://dx.doi.org/10.1016/j.jpeds.2020.06.018DOI Listing
October 2020

Birth weight, cardiometabolic risk factors and effect modification of physical activity in children and adolescents: pooled data from 12 international studies.

Int J Obes (Lond) 2020 10 3;44(10):2052-2063. Epub 2020 Jun 3.

Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.

Objectives: Low and high birth weight is associated with higher levels of cardiometabolic risk factors and adiposity in children and adolescents, and increases the risk of cardiovascular diseases, obesity, and early mortality later in life. Moderate-to-vigorous physical activity (MVPA) is associated with lower cardiometabolic risk factors and may mitigate the detrimental consequences of high or low birth weight. Thus, we examined whether MVPA modified the associations between birth weight and cardiometabolic risk factors in children and adolescents.

Methods: We used pooled individual data from 12 cohort- or cross-sectional studies including 9,100 children and adolescents. Birth weight was measured at birth or maternally reported retrospectively. Device-measured physical activity (PA) and cardiometabolic risk factors were measured in childhood or adolescence. We tested for associations between birth weight, MVPA, and cardiometabolic risk factors using multilevel linear regression, including study as a random factor. We tested for interaction between birth weight and MVPA by introducing the interaction term in the models (birth weight x MVPA).

Results: Most of the associations between birth weight (kg) and cardiometabolic risk factors were not modified by MVPA (min/day), except between birth weight and waist circumference (cm) in children (p = 0.005) and HDL-cholesterol (mmol/l) in adolescents (p = 0.040). Sensitivity analyses suggested that some of the associations were modified by VPA, i.e., the associations between birth weight and diastolic blood pressure (mmHg) in children (p = 0.009) and LDL- cholesterol (mmol/l) (p = 0.009) and triglycerides (mmol/l) in adolescents (p = 0.028).

Conclusion: MVPA appears not to consistently modify the associations between low birth weight and cardiometabolic risk. In contrast, MVPA may mitigate the association between higher birth weight and higher waist circumference in children. MVPA is consistently associated with a lower cardiometabolic risk across the birth weight spectrum. Optimal prenatal growth and subsequent PA are both important in relation to cardiometabolic health in children and adolescents.
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http://dx.doi.org/10.1038/s41366-020-0612-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7508671PMC
October 2020

Development and validation of BIA prediction equations of upper and lower limb lean soft tissue in athletes.

Eur J Clin Nutr 2020 12 29;74(12):1646-1652. Epub 2020 May 29.

Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Cruz-Quebrada, Portugal.

Background/objective: Knowing the distribution of lean soft tissue (LST) among the body segments is of relevance for optimizing athletic performance, monitoring response to training, and for evaluating injury risk. Bioelectrical impedance (BIA) is a portable, low cost, and easy technique to assess body composition. However, most equations used by BIA to predict LST are not specific for the athlete population. The aim of this investigation was to develop and validate equations to estimate dual-energy X-ray absorptiometry (DXA) appendicular LST of the arms and legs based on whole-body BIA in athletes.

Methods: Arms and legs LST were assessed by DXA and whole-body reactance (Xc) and resistance (R) were measured by BIA in athletes from various sports. Using measures of height, the resistance index (RI) (RI = height/R) was calculated. Prediction equations were established using a cross-validation method where 177 athletes (2/3 of sample) were used for equation development and the remaining 88 athletes (1/3 of sample) were used for equation validation.

Results: The developed prediction equations were as follows: arm LST = 0.940 × sex (0 = male; 1 = female) + 0.042 × total body weight (kg) + 0.080 × RI + 0.024 × Xc - 3.927; leg LST = 1.983 × sex (0 = male; 1 = female) + 0.154 × total body weight (kg) + 0.127 × RI - 1.147. Both equations validated well for the arms (mean difference = 0.11 kg, R = 0.89, pure error (PE) = 0.61) and for the legs (mean difference = 0.05 kg, R = 0.81, PE = 1.93 kg). There were no differences (p > 0.05) in the mean observed and predicted LST for the arms and legs.

Conclusion: The developed BIA-based prediction equations provide a valid estimation of upper and lower body LST in athletes.
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http://dx.doi.org/10.1038/s41430-020-0666-8DOI Listing
December 2020

Responsiveness to muscle mass gain following 12 and 24 weeks of resistance training in older women.

Aging Clin Exp Res 2020 May 23. Epub 2020 May 23.

Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, Londrina, PR, Brazil.

Background: Many factors may influence the magnitude of individual responses to resistance training (RT). How the manipulation of training volume and frequency affects responsiveness level for muscle mass gain in older women has not been investigated.

Aims: This study had the objective of identifying responders (RP) and non-responders (N-RP) older women for skeletal muscle mass (SMM) gain from a 12-week resistance training (RT) program. Additionally, we analyzed whether the N-RP could gain SMM with an increase in weekly training volume over 12 additional weeks of training.

Methods: Thirty-nine older women (aged ≥ 60 years) completed 24 weeks of a whole-body RT intervention (eight exercises, 2-3×/week, 1-2 sets of 10-15 repetitions). SMM was estimated by DXA, and the responsive cut-off value was set at two times the standard error of measurement. Participants were considered as RP if they exceeded the cut-off value after a 12-week RT phase, while the N-RP were those who failed to reach the SMM cut-off.

Results: Of the 22 participants considered to be N-RP, only 3 accumulated SMM gains (P = 0.250) that exceeded the cut-off point for responsiveness following 12 additional weeks of training, while 19 maintained or presented negative SMM changes. Of the 17 participants considered to be RP, all continued to gain SMM after the second 12-week RT phase. No significant correlation was observed between the changes in SMM and any baseline aspect of the participants.

Conclusions: Our results suggest that some older women are RP, while others are N-RP to SMM gains resulting from RT. Furthermore, the non-responsiveness condition was not altered by an increase of training volume and intervention duration while RP participants continue to increase SMM; it appears that RP continue to be RP, and N-RP continue to be N-RP.
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http://dx.doi.org/10.1007/s40520-020-01587-zDOI Listing
May 2020