Publications by authors named "Luis Paulo Gomes Mascarenhas"

12 Publications

  • Page 1 of 1

Influence of Insulin Application Time and High-Intensity Intermittent Exercise on Hypoglycemic Risk in Adolescents With Type 1 Diabetes.

Pediatr Exerc Sci 2021 Jul 26:1-7. Epub 2021 Jul 26.

Federal University of Paraná.

Purpose: The study analyzed the influence of exercise on hypoglycemia episodes postexercise and in the subsequent 24 hours in children and adolescents with type 1 diabetes.

Methods: Thirty young people performed the same protocol of physical exercises for 1 hour (Ex1h) and 2 hours (Ex2h) after the administration of insulin. They performed 30 minutes of exercise on a cycle ergometer with a load of 60% of maximal oxygen uptake, interspersed with maximum intensity sprints lasting 10 seconds every 5 minutes.

Results: Regarding the occurrence of hypoglycemia, in the 8 hours following the exercises, there was no occurrence in Ex1h (χ2 = 0.001; P = .0001) and a greater proportion for Ex2h (n = 71 episodes, 53.8%), while Ex1h had a higher number of nocturnal hypoglycemic episodes (n = 60, 71.4%) compared with Ex2h (n = 31, 23.1%, χ2 = 49.521, P = .0001), Ex1h triggered a lower number of hypoglycemia (n = 84) than Ex2h (n = 134, χ2 = 11.504, P = .001). There was a greater reduction in the average amount of fast-acting insulin administered the day after Ex1h compared with Ex2h (P = .031).

Conclusions: Intermittent exercise performed 1 hour after insulin administration shows a lower risk of hypoglycemia within 8 hours after exercise, as well as a reduction in insulin the following day.
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July 2021

Different amounts of moderate to vigorous physical activity and change in glycemic variability in adolescents with type 1 diabetes: is there dose-response relationship?

Arch Endocrinol Metab 2020 May-Jun;64(3):312-318

Programa de Pós-Graduação Interdisciplinar em Desenvolvimento Comunitário. Departamento de Educação Física, Universidade Estadual do Centro-Oeste (Unicentro), Irati, PR, Brasil.

Objective: To identify the level of physical activity and glycemic variability of adolescents with type 1 diabetes mellitus and to compare glycemic variability on days with different amounts of moderate to vigorous physical activity (MVPA).

Subjects And Methods: A sample of 34 subjects aged 10 to 15 years, 18 (52.94%) female; age: 13.04 ± 1.94; HbA1c: 9.76 ± 1.51. Physical activity was measured by wGT3X accelerometer. The glucose data were obtained using continuous glucose monitoring, and the following glycemic variability measures were calculated: standard deviation (SD), low blood glucose index (LBGI), high blood glucose index (HBGI), mean amplitude of glycemic excursions (MAGE), glycemic risk assessment in diabetes equation (GRADE) and coefficient of variation (CV). The most and least active days (the days with greater and lesser time dedicated to physical activities of moderate to vigorous intensity, respectively) were identified. In addition, based on the whole period of accelerometer use, daily means of time spent in MVPA were identified among participants, who were then divided into three groups: up to 100 minutes; from 101 to 200 minutes and above 201 minutes. Then, the measures of glycemic variability were compared among the most and least active days and among the groups too.

Results: The amount of MVPA was significantly different between the days evaluated (237.49 ± 93.29 vs. 125.21 ± 58.10 minutes), but glycemic variability measures did not present a significant difference.

Conclusion: Despite the significant differences in the amount of MVPA between the two days evaluated, the glycemic variability did not change significantly. Arch Endocrinol Metab. 2020;64(3):312-8.
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June 2020

Bone mass and dietary intake in children and adolescents with type 1 diabetes mellitus.

J Diabetes Complications 2020 06 27;34(6):107573. Epub 2020 Feb 27.

Department of Pediatrics, Federal University of Paraná, Curitiba, Paraná, Brazil.

Objectives: To evaluate the bone mineral density (BMD) in children/adolescents with type 1 diabetes mellitus (T1DM) and its association with the nutritional intake, metabolic control, and physical activity level of this population.

Methods: Study including 34 patients with T1DM and 17 controls. Assessments included the participants disease history, intake of macronutrient, calcium, phosphorus and magnesium, physical activity level, total body and lumbar spine BMD and serum levels of glycated hemoglobin, vitamin D, calcium, phosphorus, magnesium, osteocalcin and C-terminal telopeptide.

Results: Total body and lumbar spine BMD z-scores were normal in all but two participants in the T1DM group. The T1DM group had significantly lower total body BMD z-score values (p < 0.001) and levels of osteocalcin, C-terminal telopeptide, calcium, phosphorus, and magnesium. Intake of macronutrients and calcium was inadequate in both groups. Participants in the T1DM group were more sedentary (88%) and had inadequate metabolic control (91%) and low vitamin D levels (82%). Bone mass in the T1DM group was influenced by body mass index (BMI), pubertal stage, disease duration, calcium intake, and physical activity level.

Conclusions: Bone mass in patients with T1DM was adequate but lower than controls and was influenced by BMI, pubertal stage, disease duration, calcium consumption, and physical activity level.
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June 2020

[Association between physical activity levels and adolescents' self-perception of self-esteem].

Cien Saude Colet 2019 Feb;24(2):455-464

Departamento de Educação Física, Setor Ciências da Saúde, Universidade Estadual do Centro-Oeste. PR 153 Km 07, Riozinho. 84500-000 Irati PR Brasil.

Physical activity levels and the self-perception of self-esteem are kindred factors of the health status of the population. Therefore, the scope of this research was to analyze the association between physical activity levels and adolescents' self-perception of self-esteem. The sample consisted of 98 individuals with an average age of 16.7 ± 1.2. Two tools were used: The International Physical Activity Questionnaire - short version, and the Rosenberg Self-Esteem Scale. Binary logistic regression (Odds Ratio) with α of 5% was then applied. The theoretical evidence revolved around the contemporary approach to the definition of health; and the results were discussed in the light of the behavioral theory of the adolescent. There was a predominance of active adolescents (41.8%), as well as a smaller proportion of sedentary adolescents (4.1%). A total of 55.1% had high self-esteem, while 44.9% were found to have low self-esteem. The conclusion drawn is that there was no association (Wald F = 2.756; p = 0.600) between the level of physical activity and the self-perception of self-esteem. Lastly, the behavioral aspects of the adolescent that point to future potential areas of investigation related to the theme of this group were discussed.
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February 2019


Rev Paul Pediatr 2019 Jan-Mar;37(1):73-81. Epub 2019 Jan 7.

Universidade Estadual do Centro-Oeste, Irati, PR, Brazil.

Objective: To associate the Maximal Oxygen Uptake (VO2max) with body fat percentage (%BF), and to establish the best VO2max cutoff point for predicting risk %BF in teenagers.

Methods: This study was carried out with 979 subjects aged 10 to 18.8 years, 556 (56.8%) girls. The 20 m shuttle run protocol determined the VO2max, which was analyzed in quintiles and in a numeric scale. Cutaneous fold equations determined the %BF, later classified as risk to health/obesity when >25 in girls and >20 in boys. Regression method was used - Odds Ratio (OR) and Receiver Operating Characteristics Curve (ROC curve) with α <5%.

Results: From the total number of valid cases, 341 (65.6%) girls and 202 (53.2%) boys presented %BF of risk, and a larger proportion of %BF of risk was observed in the 1st quintile of the VO2max for both genders. There was inverse association between VO2max and %BF of risk from the 4th quintile (OR 1.84, 95%CI 1.05-3.24) until the 1st quintile (OR 4.74, 95%CI 2.44-9.19) for girls, and from the 2nd quintile (OR 2.99, 95%CI 1.48-6.00) until the 1st quintile (OR 5.60, 95%CI 2.64-11.87) for boys. As analytic highlights, VO2max Cutoff points for prediction of %BF of risk were ≤40.9 mL/kg-1/min-1 (AUC: 0.65; p<0.001) for girls and ≤44.8 mL/kg-1/min-1 (AUC: 0.66; p<0.001)for boys.

Conclusions: VO2max was inversely associated to the %BF, and VO2max cutoff points for prediction of %BF of risk are important results to generate action to fight early obesity.
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August 2019

Health-related quality of life in a cohort of youths with type 1 diabetes.

Rev Assoc Med Bras (1992) 2018 Nov;64(11):1038-1044

Universidade Federal do Paraná, Pediatric Endocrinology Unit, Department of Pediatrics, Hospital de Clínicas, Curitiba, PR, Brasil.

Objective: Health-related quality of life (HRQOL) in type 1 diabetes mellitus (T1DM) has been widely studied. The objectives of this study were to evaluate and identify the factors influencing the HRQOL of children and adolescents with T1DM.

Material And Methods: In total, 59 patients (9-16 years, T1DM for ≥1 year) responded to a version of the Diabetes Quality of Life Instrument for Youth (DQOLY) adapted to adapted to Brazilian patients, the Instrumento de Qualidade de Vida para Jovens com Diabetes (IQVJD). This instrument comprises 50 items (domains satisfaction, impact, and concerns, with the lowest scores corresponding to better HRQOL) and a questionnaire gathering social, demographic, and clinical parameters.

Results: The mean age of the patients was 13.6 years, and 57.6% were girls. The median age at diagnosis was 7.16 years, 63% presented diabetic ketoacidosis (DKA) at diagnosis and 29% during follow-up. Mean glycated hemoglobin (HbA1c) in the previous year was 10%. All patients administered multiple insulin doses (mean 4.2 applications/day), 74.5% used rapid-acting and intermediate-acting insulin analogs, and 67.8% used pens for insulin application. The results of the DQOLY were within the cutoff limit for better HRQOL. An isolated analysis of each domain and the questionnaire results showed that the following factors were associated with better HRQOL: height Z-score, lower HbA1c, practice of physical activity, use of pen, fewer hospitalizations, and residence in a rural area. There was a high DKA rate at diagnosis, and the metabolic control was inappropriate in most patients. Despite coming from low-income households, most patients had access to the recommended treatment.

Conclusion: Among T1DM patients, 71% had IQVJD scores compatible with better HRQOL.
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November 2018

Physical Activity Levels of Adolescents with Type 1 Diabetes Physical Activity in T1D.

Pediatr Exerc Sci 2017 05 4;29(2):213-219. Epub 2017 Jan 4.

1 Federal University of Paraná.

The aim of this study was to evaluate the level of physical activity and cardiorespiratory fitness in teenagers with type 1 diabetes mellitus (T1D) in comparison with healthy scholar participants. Total of 154 teenagers (T1D = 45 and CON = 109). Height, weight, cardiorespiratory fitness (VO), and the level of physical activity by the Bouchard's Physical Activity Record were measured, and glycated hemoglobin (HbA1c) in T1D. The VO was lower in the T1D (38.38 ± 7.54) in comparison with the CON (42.44 ± 4.65; p < .05). The VO had correlation with the amount of time of moderate-to-vigorous physical activity (r = .63; p = .0001) and an inverse correlation with sedentary activities (r= -0.46; p = .006). In the T1D the levels of HbA1c had an inverse correlation with the amount of time of moderate-to-vigorous physical activity (r= -0.34; p = .041) and correlation with the BMI z-score (r = .43; p = .017). Only 37,8% of the participants in the T1D reached the adequate amount of daily moderate-to-vigorous intensity physical activity, in the CON 81,7% reached the WHO's recommendation.

Conclusion: T1D had less cardiorespiratory capacity then healthy controls, the teenagers of T1D with lower BMI z-score and that dedicated a greater time in moderate-to-vigorous intensity physical activity demonstrated a better glycemic control.
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May 2017

The effects of strength training on cognitive performance in elderly women.

Clin Interv Aging 2016 1;11:749-54. Epub 2016 Jun 1.

Research Group on Metabolism, Nutrition and Strength Training, Department of Physical Education, Federal University of Parana, Curitiba, Brazil; Department of Health and Exercise Science, Appalachian State University, Boone, NC, USA.

Aging is a degenerative process marked by recognized functional, physiological, and metabolic impairments, such as dynapenia and diminished cognitive capacity. Therefore, the search for innovative strategies to prevent/delay these physiological and cognitive disorders is essential to guarantee the independence and life quality of an elderly population. The aim of this work is to verify the effect of a 12-week resistance exercise program on the general physical aptitude and cognitive capacities of elderly and sedentary women. Twenty-nine women (65.87±5.69 years) were divided into two groups. The control group was composed of eight elderly women who met the same inclusion criteria of the study and the strength training group was composed of 29 elderly women who were subjected to a resistance exercise program defined by 12 upper and lower limb exercises combined in 3×10 repetitions with 1-minute interval between repetitions and two resting minutes between exercises (three times/week). Weight loads were fixed between 60% and 75% of the apparent 1 repetition maximum, which was estimated by the test of 10 maximum repetitions. The direct curl was performed for upper body strength evaluation with 2.3 kg dumbbells for 30 seconds, whereas the chair test was used for lower body evaluation (total sit-stand movements in 30 seconds). The cognitive capacities of subjects were evaluated by "The Montreal Cognitive Assessment" questionnaire. After 12 weeks, the elderly group showed significant increases in the average upper body strength (58%), lower body strength (68%), and cognitive capacity (19%). The present study demonstrated that regular resistance exercises could provide significant gains on the upper and lower body strength concomitant to positive improvements on cognitive capacities of elderly women, bringing enhanced life quality.
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February 2017

Variability of lipid and lipoprotein concentrations during puberty in Brazilian boys.

J Pediatr Endocrinol Metab 2015 Jan;28(1-2):125-31

Background: Evaluation of lipid profile in children and adolescents is important for early diagnosis of dyslipidemias. Physiological changes might be observed in the concentration of the lipid profile components, according to the stage of sexual maturation.

Objective: To evaluate the variation in lipid and lipoprotein concentrations in boys during puberty.

Methods: The sample consisted of 570 male adolescents with ages between 10 and 17 years. Weight, height, and body mass index (BMI) were assessed. Total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) were determined by the enzymatic method, and low-density lipoprotein cholesterol (LDL-C) was calculated. Puberty was classified according to Tanner references. The percentile criterion was adopted for the distribution and identification of lipoprotein levels. The analysis of variance and description tests with p<0.05 was applied.

Results: Participants had similar BMI z-score and physical activity habits in all groups. A significant reduction in TC and HDL-C concentrations between the start and end of puberty was observed. LDL-C levels rose during stage 3 of development, decreasing at the end of the pubertal process. TG levels did not change significantly with pubertal status.

Conclusion: Lipid and lipoprotein concentrations tend to undergo changes during puberty in boys. The use of percentile values can be very useful to track variations in lipid and lipoprotein levels during the maturation process.
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January 2015

[Metabolic syndrome in adolescents of different nutritional status].

Arq Bras Endocrinol Metabol 2012 Mar;56(2):104-9

Centro de Ciências da Saúde, Universidade Estadual do Norte do Paraná, Jacarezinho, PR, Brasil.

Objective: To investigate the prevalence of metabolic syndrome (MetS) in adolescents of different nutritional status.

Subjects And Methods: The sample consisted of 582 adolescents aged 12 to 18 years. Body mass index (BMI) classification of nutritional status was performed using the NCHS growth charts. MetS diagnosis was determined by the presence of three or more risk factors.

Results: Overall MetS prevalence was 6.7% (CI: 4.9%-9%); in boys, prevalence was 9.4%; and in girls, 4.1%. MetS prevalence was 17.2% (CI: 10%-28.2%) and 37.1% (CI: 23.2%-53.7%) in overweight and obese adolescents, respectively. All obese adolescents had at least one risk factor present, and demonstrated high MetS prevalence ratio compared with adolescents of normal weight (PR: 11.1; CI: 5.75-21.47).

Conclusion: High prevalence of MetS was observed in obese adolescents. Prevention strategies should focus on body weight control since the beginning of adolescence.
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March 2012

[Physical activity, lipid consumption and risk factors for atherosclerosis in adolescents].

Arq Bras Cardiol 2010 May 16;94(5):601-7. Epub 2010 Apr 16.

Universidade Federal do Paraná, Curitiba, PR.

Background: Atherosclerosis is the coronary disease that most often affects the adult Brazilian population. Although it is a predominantly adult disease, the risk factors can appear in young individuals.

Objective: To verify the association between the physical activity level (PAL) and the consumption of lipids with the risk factors for atherosclerosis in adolescents.

Methods: A total of 260 boys and 237 girls aged 10-18 years were assessed. The PAL was estimated based on the activity record proposed by Bouchard et al. The consumption of lipids was assessed through the food frequency questionnaire developed by Sichieri and Everhart. Blood pressure was measured using a mercury-column sphygmomanometer. Total cholesterol (TC), HDL-c and triglycerides (TG) were measured by the enzymatic-colorimetric method. LDL-c was calculated by Friedewald's formula. The statistical analysis was carried out through logistic regression, with a level of significance set at p < 0.05.

Results: Regarding the PAL, 17.3% of the boys and 22.6% of the girls were classified as sedentary. As for the diet, 54% and 48.6% of the boys and girls, respectively, presented a consumption of lipids above the recommended level. Boys with high TC and LDL-c levels had a higher OR to be sedentary than their more active peers. High levels of LDL-c were associated with the excessive consumption of saturated fats in both sexes.

Conclusion: The results reinforce the previous evidence that young people must be encouraged since an early age to adopt a more physically active lifestyle, associated to more adequate dietary habits.
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May 2010

Cardiovascular risk factors in adolescents with different levels of energy expenditure.

Arq Bras Cardiol 2008 Oct;91(4):207-12, 227-33

Universidade Federal do Paraná, Curitiba, PR, Brasil.

Background: Physical inactivity in adolescence is related to body fat accumulation, which apparently can increase the probability of onset and development of metabolic changes.

Objective: To verify the predisposition to cardiovascular risk factors in adolescents with different levels of energy expenditure.

Methods: A total of 108 young men and 132 young women aged between 12 and 16 years were selected. Daily energy expenditure was obtained using the questionnaire proposed by Bouchard et al. The sample was previously divided according to the quartiles of energy expenditure (Kcal/kg/day) into three groups: sedentary (SG), moderately active (MG), and active (AG). The enzyme-colorimetric method was used to determine the total cholesterol (TC), HDL-C, and triglycerides (TG) levels. LDL-C was calculated using the Friedewald et al's formula. The one-factor analysis of variance was used for statistical analysis, considering p<0.05.

Results: For the male gender, significant differences were found between the groups for the TC variable (mg/dl); AG (121.56+/-19.15) was different from MG (142.70+/-27.65) and from SG (145.63+/-36.54). Likewise, MG was different from SG (F=3.70 and p=0.03). For the TG variable (mg/dl), AG (65.69+/-18.95) was different from MG (82.25+/-33.73) and from SG (97.44+/-45.95). Also, MG was different from SG (F=3.40 and p=0.04). For the female gender, no significant differences were found in relation to daily energy expenditure.

Conclusion: More active young men show lower TC and TG levels in comparison with their moderately active and sedentary peers.
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October 2008