Thesis (MNutr (Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Background and objectives: An understanding of the effect of HAART on different aspects of health, including nutritional status, of HIV-infected individuals in South Africa is needed to ensure that appropriate population-specific guidelines and policies can be developed. This study aimed to investigate the impact of HAART on nutritional status, focusing on changes in anthropometric measures, and to explore the relationship between these measures and immunological and virological response to HAART. Methods: A prospective study of 30 adult females was carried out at a clinic in Cato Manor, KwaZulu-Natal. Anthropometric measurements, including weight, mid-upper arm circumference (MUAC), waist circumference, hip circumference, body mass index (BMI) and waist-to-hip ratio (WHR), were performed at baseline and 12 and 24 weeks after commencing HAART. Laboratory values, including CD4 lymphocyte count, viral load, albumin and haemoglobin as well as bioelectrical impedance analysis data, including lean body mass (LBM), fat mass (FM) and body fat percentage (BF%), were collected at baseline and after 24 weeks on HAART. Results: Overall, there was a statistically significant increase in all anthropometric measures, except WHR and LBM. The mean weight change was 3.4±5.8kg (p=0.006). Fifty percent of the subjects had a BMI above normal at baseline and mean BMI increased from 25.6±5.7kg/m2 to 27.3±5.6kg/m2 (p=0.007). Seventy percent of subjects gained weight, 18.5% had a stable weight and 11.1% lost weight. The weight gain in most subjects was attributable to a gain in FM while in subjects who lost weight, the loss consisted mainly of LBM. Some patients with stable body weight experienced changes in the relative proportions of fat and lean mass. Six patients showed evidence of disproportionate gains and losses in body circumference measurements which may be indicative of fat redistribution. Subjects with lower CD4 lymphocyte counts experienced greater increases in weight, BMI, FM and BF%. The strongest correlation was observed with FM (rs=-0.53; p=0.00). Greater increases in weight, BMI, MUAC, waist circumference, hip circumference, FM and BF% were seen in those with lower baseline haemoglobin. Baseline viral load and albumin did not correlate significantly with changes in any anthropometric variables. Change in CD4 count was only significantly associated with baseline MUAC (rs=0.40; p=0.04). Change in viral load was significantly correlated with baseline weight, LBM, FM, BF% and MUAC with the strongest correlation being with weight (rs=0.44; p=0.01). No significant association was found between anthropometric changes and changes in CD4 count and viral load between baseline and the 24-week visit. Conclusion: Overall, subjects experienced a significant increase in most anthropometric measures. There appears to be a relationship between some anthropometric and laboratory measures but this needs clarification. The findings of this study demonstrate the value of including circumference measurements and body composition techniques as part of nutritional status assessment and demonstrate the need for studies to determine the prevalence and significance of overweight and obesity in the HIV-infected population. Research is needed to determine the best methods of bringing about the most favourable anthropometric changes to enhance the health of patients on HAART.

Thesis (MNutr(Interdisciplinary Health Sciences. Human Nutrition))--Stellenbosch University, 2008. / Objective: The aim of this study was to determine the body composition, dietary intake and supplement use among training olympic and ironman distance triathletes residing in the Western Cape region. Design: Descriptive, analytical, cross-sectional study design Setting: Western Cape Province (South Africa) Subjects: Triathletes residing in the Western Cape region registered with Triathlon South Africa (N = 26) Outcome measures: Percentage body fat, total energy intake, macro– and micronutrient intake, use and reasons for use of nutritional supplements or nutritional ergogenic aids. Results: The mean age of the men and women was 37.9 [Standard Deviation (SD) 6.82] and 37.5 (9.6) years respectively. The corresponding mean amount of training per week for men and women respectively were 15.1 (4.1) and 15.3 (4.7) hours. The percentage body fat as determined by multi-frequency bio-electrical impedance analysis of the men and women were 12.97% (4.3) and 21.4% (6.3) respectively. The mean dietary macronutrient intake as determined by a three day food record for men was for total energy intake 14 534.7kJ (4509.8), carbohydrate intake 5.3g/kg body weight (BW) (1.9), protein intake 2.0g/kg BW (0.5) and fat intake 34.6% (10.31) of total energy requirements. Dietary micronutrients not reaching 67% of dietary reference intakes (DRI) from food alone included iodine (44%) and fluoride (49%). Vitamin C (154%). Micronutrient intake above upper limit (UL) was sodium (213%), manganese (162%) and niacin (228%). The dietary macronutrient intake for women was for total energy intake 9004.1kJ (2368.8), carbohydrate intake 3.5g/kg BW (1.0), protein intake 1.2g/kg BW (0.2) and fat intake 29.8% of total energy intake (6.0). Micronutrients not reaching 67% of the DRI were chloride (61%), iodine (31%) and fluoride (52%). Micronutrient intake above the UL was vitamin C (218%) and manganese (174%). The dietary intake of the men was inadequate in carbohydrate, provided sufficient energy and protein and excessive fat. The dietary intake of the women was inadequate in total energy and carbohydrate, with an adequate protein intake and excessive fat intake. Although the sample size was very small, some associations were found between dietary intake and clinical health status. Seventy three percent of the triathletes use over the counter dietary supplements. The supplements used most often included carbohydrate supplements (81%), multivitamin and mineral supplements (81%) single vitamins (65%), protein supplements (100%), single minerals (58%), antioxidants (54%) and herbal supplements (42%). Most popular reasons for consuming supplements included recovery (62%), increasing energy supply (61%), enhancing immune function (50%), exercise performance enhancement (46%), increasing muscle mass (54%) and to make up for an inadequate diet or nutrient replacement (31%). Conclusion: Percentage body fat of the men and women were at the upper end of the range associated with elite athletes. The athletes have a fairly good intake of macro– and micro-nutrients. Inadequate habitual carbohydrate intake can be attenuated by the vast majority of the triathletes taking additional carbohydrate supplementation. Supplements were used widely among the athletes, whether it is scientifically proven to be beneficial or not.

Orientador: Ismael Forte Freitas Júnior / Banca: Paulo Roberto Pereira Santiago / Banca: Ellen Cristini Freitas Araújo / Resumo: Objetivo: Analisar o gasto energético (GE) e a composição corporal de adolescentes obesos sedentários pré e pós teste de esforço máximo e analisar os resultados de adolescentes obesos submetidos a treinamento concorrente. Metodologia: A amostra foi composta por dois grupos: 1) grupo sedentário (GS), composto por 70 adolescentes (31 meninos e 39 meninas; idade 13,7±1,4 anos); 2) grupo treinado (GT), composto por 16 adolescentes (10 meninos e 6 meninas; idade 14,7±1,0 anos), participantes de um programa para redução de gordura corporal. O Índice de Massa Corporal (IMC) foi usado para classificação da obesidade, segundo Cole et al. (2000). A composição corporal foi analisada pela Absortiometria de Raios- X de Dupla Energia (Dual-energy x-ray absorptiometry - DEXA) para estimativa da massa livre de gordura (MLG) e da massa de gordura (MG). O GE foi calculado a partir da equação de Weir (1949) [(3.941xVO2)+(1.106xVCO2)*1440], utilizando os valores de volume de oxigênio consumido (VO2) e gás carbônico produzido (VCO2), mensurados a cada 20 segundos por Calorimetria Indireta (CI) durante 20 minutos, antes (repouso - REP), durante e após (recuperação - REC) esforço máximo realizado em esteira ergométrica, com o sistema MedGraphics VO2000 no GS e no momento pré intervenção do GT, e com o sistema Parvo Medics TrueOne® 2400 no momento pós intervenção do GT. O GT participou de uma intervenção de 40 semanas de treinamento concorrente (TC), com frequência semanal de três vezes e duração de 60 minutos por sessão (aproximadamente 50% do tempo de treino aeróbio e 50% de treino resistido (musculação)). A análise estatística foi realizada no software SPSS versão 17.0 e a significância estatística foi fixada em 5%... (Resumo completo, clicar acesso eletrônico baixo) / Abstract: Objective: To analyze the energy expenditure (EE) and body composition of obese sedentary before and after maximal exercise test and analyze the results of obese adolescents undergoing concurrent training. Methods: The sample comprised two groups: 1) sedentary group (SG), composed of 70 adolescents (31 boys and 39 girls, age 13.7 ± 1.4 years), 2) the trained group (TG), composed of 16 adolescents (10 boys and 6 girls, age 14.7 ± 1.0 years) participating in a program to reduce body fat. The Body Mass Index (BMI) was used for classification of obesity according to Cole et al. (2000). Body composition was analyzed by X-ray Absorptiometry Dual Energy (DEXA) to estimate fat-free mass (FFM) and fat mass (FM). EE was calculated from the Weir (1949) equation [(3.941xVO2) + (1.106xVCO2)*1440], using the values of volume of oxygen consumed (VO2) and volume of carbon dioxide produced (VCO2), measured every 20 seconds Indirect Calorimetry (IC) for 20 minutes before (rest - RES), during and after (recovery - REC) performed maximal treadmill, with the system MedGraphics VO2000 in SG and in the pre intervention TG, and the system Parvo Medics TrueOne ® 2400 after intervention in TG. The TG participated in an intervention of 40 weeks of concurrent training (CT) with three times weekly frequency and duration of 60 minutes per session (approximately 50% of the time of aerobic training and 50% of resistance training (weight training)). Statistical analysis was performed with SPSS version 17.0 and statistical significance was set at 5%... (Complete abstract click electronic access below) / Mestre

Orientador: Paula Schmidt Azevedo Gaiolla / Resumo: Introdução: O acidente vascular cerebral (AVC) é a principal causa de incapacidade na vida adulta e cerca de dois terços dos pacientes permanecem em estado de recuperação incompleta após o evento. O estado nutricional desses pacientes é de grande importância, pois nesta fase tornam-se mais susceptíveis às perdas de peso involuntárias, ocorrendo com frequência redução do apetite, disfagia, depressão e alterações da mobilidade, com consequente dependência funcional sendo comum observar inatividade física, alterações bioquímicas e carência nutricional de macro e micronutrientes. Entretanto, pouco se sabe sobre os desfechos nutricionais e a associação destes com incapacidade funcional após o evento. Metodologia: Foram realizadas avaliações clínica, nutricional, bioquímica e de composição corporal nas primeiras 72 horas de internação e repetidas 30 dias após alta hospitalar. Foi avaliada a capacidade funcional pela escala de Rankin modificada (eRm) 90 dias após o AVC. Para determinar as associações foram realizadas análises de regressão múltipla linear e logística, considerando nível de significância de 5%. Resultados: Foram incluídos 84 pacientes, a maioria idosos do sexo masculino, com AVC de baixa gravidade (NIHSS 5), 18,1% trombolisados. Apresentaram valores aumentados de IL-6, sobrepeso e obesidade, além de baixos valores de força de preensão manual na internação. Tiveram manutenção do peso, índice de massa corporal e área muscular do braço corrigida; redução das medidas de e... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Introduction: Stroke is the leading cause of disability in adult life and two-thirds of patients remain in an incomplete recovery condition after the event. These patients nutritional status is of great importance, as they become more susceptible to involuntary weight loss, with decreased appetite, dysphagia, depression, and changes in mobility, with consequent functional dependence, biochemical changes and nutritional deficiencies of macro and micronutrients. However, little is known about the nutritional outcomes and their association with functional disability after the stroke. Methodology: Clinical, nutritional, biochemical and body composition evaluations were performed in the first 72 hours of hospitalization and repeated 30 days after hospital discharge. Functional capacity was assessed by modified Rankin scale (mRs) 90 days after stroke. To determine the associations, linear and logistic multiple regressions were performed, considering a significance level 5%. Result s: A total of 84 patients were included, mostly elderly men, with low severity stroke (NIHSS 5) and 18.1% were thrombolysed. We found increased values of IL-6, overweight and obesity, as well as low values of handgrip strength at hospitalization. After 30 days of discharge, patients showed maintenance of weight, body mass index and arm muscle area; reduction of adductor pollicis muscle thickness, arm circumference and triceps skinfold; and increase of handgrip strength. They presented increase in %body fa... (Complete abstract click electronic access below) / Mestre

Orientador: Aulus Cavalieri Carciofi / Resumo: O gasto energético diário (GED) de gatos tem sido estudado há algum tempo em gatos de laboratório, com ambiente, alimentação e massa corporal controlados. O metabolismo energético destes animais pode ser dividido em quatro compartimentos: taxa metabólica basal que soma o maior GED destes animais em torno de 60%, a atividade muscular voluntária contribuindo em torno de 30%, seguido do incremento calórico e termogênese adaptativa (10%). Nota-se que a atividade muscular voluntária contribui com porção considerável do GED destes animais, não devendo ser limitada, pois interfere diretamente no gasto energético. Estudos com animais em domicílio, com número representativo de grandes populações, que apresentam rotina de vida normal com protocolo prático e eficaz, de fácil aceitação pelos proprietários para mensurar GE, composição corporal (CC) e fluxo de água (FA) no estilo de vida habitual de gatos é importante para estudos nutricionais mais precisos. Método prático e eficaz para mensuração destes parâmetros, de fácil aplicação em domicílio e que não interfira no estilo de vida e atividade física dos animais é o método da água duplamente marcada que os mensura por meio do enriquecimento e decaimento de deutério (2H) e oxigênio 18 (18O) na água corporal. O objetivo do presente trabalho foi avaliar protocolo prático de tempos de coleta de enriquecimento (2, 4, 6, 7 e 8 horas) e decaimento (2, 4, 6, 8, 10, 12, 14, 16, 18 e 20 dias), bem como os fluidos corporais alternativos saliva e u... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: The energy expenditure (EE) of cats has been studied for some time in laboratory cats, with controlled environment, feeding and body mass. The energy metabolism of these animals can be divided into four compartments: basal metabolic rate that sums the highest EE of these animals around 60%, voluntary muscle activity contributing around 30%, followed by caloric increment and adaptive thermogenesis (10%). It is noted that voluntary muscle activity contributes a considerable portion of the EE of these animals, and should not be limited, as it directly interferes with energy expenditure. Studies with animals at home, with a representative number of large populations, that present normal life routine with a practical and efficient protocol, easily accepted by the owners to measure EE, body composition (BC) and water turnover (WT) in lifestyle of cats is important for more accurate nutritional studies. A practical and effective method for measuring these parameters, which is easy to apply at home and does not interfere with the animals' lifestyle and physical activity, is the double labeled water method that measures them through the enrichment and decay of deuterium (2H) and oxygen 18 ( 18O) in body water. The aim of the present study was to evaluate the practical protocol of enrichment collection times (2, 4, 6, 7 and 8 hours) and decay (2, 4, 6, 8, 10, 12, 14, 16, 18 and 20 days ) as well as alternative body fluids saliva and urine compared to blood for assessing the concentrati... (Complete abstract click electronic access below) / Mestre

BACKGROUND: Over recent decades, the nationwide prevalence of chronic disease among children and adolescents has been on the rise. Conditions such as obesity pose a significant risk to the physical and mental health of individuals in youth as well as in adulthood, as these health risks track into later years and increase in severity. Low-income and racial/ethnic minorities are disproportionately affected by chronic conditions. In particular, African American (AA) youth are reported to have a higher prevalence of fair/poor health than their Caucasian peers. Compounding the effects of this racial disparity in health is the disparity AA youth face in SES, as many live in poverty. The individual and environmental influences associated with factors of race and SES contribute to negative health behaviors leading to poor health status among AA youth living in disadvantaged communities. Health disparities have been shown to manifest in the earliest years of life, therefore the monitoring of at-risk populations of children and adolescents is essential to identifying, addressing, and reducing poor health outcomes throughout the course of life. OBJECTIVE: To determine the health status of AA children and adolescents living in a low-income community using multiple health measures, examine the relationships between these health measures in AA youth, as well as to identify barriers to participation in a family-oriented health promotion program. METHODS: A total of 111 AA boys and girls attending a community fine arts program located in a low-income suburb of Chicago participated in the study. Data from anthropometric measurements, the 20-m Shuttle Run Test, and curl-ups were collected and analyzed to assess the health measures of Body Mass Index (BMI) and BMI Percentile, Cardiorespiratory Fitness (CRF), and Muscular Fitness (MF), respectively. Data pertaining to barriers encountered in attending a health promotion program were collected from 13 families who were active members of the community fine arts program and had participated in health promotion program. The cross-sectional survey consisted of questions pertaining to the different components of the intervention program as well as to family demographic information. RESULTS: The prevalence of overweight and obesity in the entire study population was 34.2%, with 31.6% of boys and 34.8% of girls being classified as overweight/obese. 16.2% of youth categorized specifically as obese, with 26.3% of boys and 15.2% of girls being obese. 43.9% of study participants aged 10-18 years needed improvement in CRF, all of whom were girls. All but one boy reached the healthy fitness zone for curl-ups. Significant positive correlations were found between BMI and age as well as curl-ups and age, and significant negative correlation was found between CRF and age as well as BMI and CRF for AA youth. Of reported barriers, scheduling conflicts and time constraints were consistently most listed by survey respondents. CONCLUSION: Within the at-risk population of AA youth studied, despite high levels of MF, a large proportion presented with problematic health as indicated by the high levels of poor CRF and weight status observed, suggesting a need for intervention in order to address these health issues. An intervention program targeting youth within this and similar communities should take into consideration attenuating excessive program-associated expenses as well as offering more scheduling options and information on efficient food preparation and exercise.

Resumo: O objetivo deste estudo foi determinar pelo método de abate comparativo as exigências líquidas em proteína e energia para crescimento de cabritas Saanen com peso corporal variando dos 30 aos 45 kg. Para tal, foram utilizados 30 animais, dos quais seis animais foram abatidos no início do experimento para a estimativa da composição corporal inicial, outros seis animais foram abatidos quando atingiram peso médio de 38 kg e, foram utilizados para a estimativa da composição corporal intermediária. Os demais animais foram distribuídos aleatoriamente em seis grupos de três animais, sendo um animal por nível de restrição alimentar (0% de restrição ou alimentação à vontade, 30 e 60% de restrição). Cada grupo foi considerado como bloco e, os animais de cada grupo foram abatidos quando o animal do nível de 0% de restrição atingiu 45 kg de PC. Os animais alimentados à vontade (abate inicial, intermediário e 0% de restrição) foram utilizados para a estimativa da composição corporal e da composição do ganho. Para a estimativa das exigências de mantença foram utilizados os animais submetidos aos tratamentos 0, 30 e 60% restrição. A exigência líquida em proteína e energia para mantença foi estimada em 2,12 g PLm/kg0,75 PC/dia e 88,74 kcal/kg0,75PC/dia, respectivamente. A exigência líquida em proteína e energia para ganho em peso variou entre 11,47 e 10,81 g/ 100 g de ganho de peso corporal e entre 357 e 485 kcal/ 100 g de ganho de peso corporal. A exigência líquida em proteína e energia total para crescimento de cabritas Saanen pode ser estimada pelos respectivos modelos, PLt= (2,5 * PCV0,75) + (197,01 * PCV-0,12 * GP) variando 40,52 a 52,41 g/100 g de ganho/dia e, ELt= (104,71 * PCV0,75) + (639,99 * PCV0,59 * GP) variando de 1577,36 a 2229,29 kcal/100 g de ganho/dia à medida que o peso corporal dos animais aumentou de 30 para 45 kg / Abstract: The objective of this study was to determine by the comparative slaughter the protein and energy requirements for growth of female Saanen goat kids. A total of 30 female goats with initial body weight of 30 kg were used, in which six animals were slaughtered at beginning of the experiment (baseline animals), another six animals were slaughtered when they reached 38 kg of body weight (intermediate slaughter). The remainder was randomly allocated randomly in six groups of three animals (0% of feed restriction or ad libitum and restricted to 30 or 60% of thread libitum intake) and each group was considered a block. .The animals of each group were slaughtered when the animal in the 0% feed restriction reached 45 kg of body weight. Animals fed ad libitum (initial, intermediate and final slaughter, 0% of feed restriction) were used to estimate body composition and net requirements for gain. To estimate maintenance requirements were used the animals fed 0, 30 and 60% of feed restriction. Net protein and energy requirements for maintenance were 2,12 g of net protein/kg0,75 BW/day e 88,74 kcal/kg0,75BW/day, respectively. Net protein and energy requirements for gain ranged from 11,47 to 10,81 g/ 100 g of body weight gain and 357 to 485 kcal/100 g of body weight gain, respectively. The total net protein and energy requirement were estimated by the followed models, Total net protein = (2,5 * PCV0 75) + (197,01 * EBW-0,12 * BWG), which ranged from 40,52 to 52,41 g/100 g of body weight gain/day, and Total net energy = (104,71 * PCV0 75) + (639,99 * EBW0,59 * BWG), which ranged from 1577,36 to 2229,20 kcal/100 g of body weight gain/day, as the animals' body weight increased from 30 to 45 kg / Orientador: Izabelle Auxiliadora Molina Almeida Teixeira / Coorientador: Telma Teresinha Berchielli / Banca: Kleber Tomas de Resende / Banca: Mario Luiz Chizzoti / Mestre

Traditional three-dimensional (3D) photonic scanning (3DPS) can be used to obtain body volume data and to enable visualization of 3D body shape in one rapid scan, which is helpful for determining people’s obesity level, health risk and sport performance as well as motivating individuals to reduce weight efficiently. Nevertheless, traditional 3DPS is restricted to expensive and fixed hardware and specific software that requires specialist interpretation in laboratory settings, which reduces possible applications. Therefore, the purpose of this research was to develop a fast, inexpensive, portable and automatic 3DPS system to measure body volume data and to display body shape in 3D. To ensure that the system could be used for monitoring changes over time, the accuracy and reliability of the estimated body volumes were also established. Four studies and one technical description were conducted to achieve the purpose of this research. In the first three studies, a new technique, DScan, was developed that could generate individual 3D human models and calculate body volume. In Study 1, the reliability of the body dimension features obtained by four extraction methods was compared to find an appropriate method to improve the quality of extracted body dimension features. In Study 2, two different parameter groups were compared to enable subsequent selection of appropriate parameters to generate realistic 3D human models. A procedure and a program were presented which can set the parameters to match the extracted features and generate individual 3D human models effectively. In Study 3, Blender scripts and shell scripts were used to develop a customized program which can obtain body volume data from generated 3D human models. In Study 4, the accuracy and the reliability of the body volume data acquired from DScan were examined by comparing with the traditional 3DPS and the geometric modelling technique, elliptical zone (E-Zone). In the technical description, a Body Shape Monitoring System (BSMS) which can help non-expert users complete the DScan procedure and visualize body shape changes was introduced. The processing speed, cost and portability of the introduced BSMS were also shown in the technical description. The accuracy of the BSMS for whole-body volume indicated by an inter-method relative technical error of measurement was within 5% of that obtained from the traditional 3DPS. The repeated reliability expressed as an intra-method relative technical error of measurement was under 3% for whole-body volume. The accuracy and the reliability of the BSMS for segmental volumes (upper torso, lower torso, upper arm, lower arm, thigh and shank) indicated by inter-method and intra-method relative technical error of measurements were less than 10% and 5% respectively. These were similar to those obtained by the E-Zone. The BSMS reduces the requirement of hardware, software and expert knowledge as well as the processing time compared to other techniques of quantifying whole-body volume and segmental volumes. The GUI of the BSMS enables it to be used without specific training in computer programing or machine operation. The system is highly portable, and its components are inexpensive (under £700). Each analysis can be completed in three minutes without requiring subjective interpretations. The results showed that the system has the potential to be applied in the domains of health and medicine, the fashion industry, ergonomics, and sports science. Further studies should be conducted to develop a complete system which is consequently suitable for home use.

Introdução: O Método Pilates apesar de prática difundida, apresenta escassez de evidências que demosntrem sua eficácia. Objetivos: Verificar a adaptação cardiorrespiratória, antropométrica e parâmetros da aptidão física ao treinamento proporcionado pela prática do Método Pilates Clássico. Métodos: Participaram deste estudo quinze mulheres saudáveis (GP) as quais realizaram o treinamento no Método Pilates Clássico, durante 12 semanas, 3 vezes por semana e 13 controles saudáveis (GC) que mantiveram sua rotina de atividades. Foi avaliado consumo máximo de oxigênio, pressão arterial, peso, percentual de gordura, massa gorda, massa corporal magra, amplitude de movimento articular, flexibilidade, resistência muscular localizada (abdominais, membros superiores e membros inferiores) e equilíbrio dinâmico antes e após o treinamento para o GP e antes e após 12 semanas para GC. Ocorreu monitoramento da frequência cardíaca em cada sessão do treinamento para o GP. Resultados: O presente estudo demonstrou que houve redução no percentual de gordura (p < 0,001) e aumento da massa corporal magra (p < 0,001). A amplitude de movimento articular e a flexibilidade, avaliadas em todas as articulações, tiveram melhora (p < 0,001), assim como a ressitência msucular localizada (p < 0,001) e o equilíbrio dinâmico ( p = 0,001). Além disso, este é o primeiro ensaio clínico que demonstra melhora da capacidade funcional, avaliada pela medida do VO2 pico (p < 0,001). Conclusão: Os resultados apresentados sugerem que mulheres, previamente sedentárias, se beneficiaram com a melhora significativa da aptidão física, tanto parâmetros motores, quanto físicos, apresentando alterações significativas na composição corporal, na amplitude de movimento articular, na flexibilidade, na resistência muscular localizada e no equilíbrio dinâmico. Além disso, o incremento da capacidade funcional atavés do VO2 pico. / Introduction: Despite it widespread practice, the Pilates Method presents scarcity of relevant scientific evidence of justify its efficacy. Objectives: To present a comprehensive evaluation of the adaptations to cardiorespiratory parameters, anthropometric and physical fitness provided by the practice of the Pilates Method. Methods: Fifteen healthy participants (PG) who underwent training in the Classical Pilates Method for 12 weeks, 3 times a week were evaluated against 13 healthy controls (CG) who maintained their routine activities. Measurements of VO2 peak, blood pressure, weight, fat percentage, fat mass, lean body mass, range of movement, flexibility, muscular endurance (abdominal, upper and lower limbs) and dynamic balance before and after training for the PG, and before and after 12 weeks for CG were taken. Heart rate was monitoring at each training session for the PG. Results: The study showed that the exercises practiced resulted in a reduction in body fat percentage (p <0.001) and increased lean body mass (p <0.001). The range of motion and flexibility in all joints evaluated, reported improvement (p <0.001), as well muscle endurance (p <0.001) and dynamic balance (p = 0.001). Moreover, this is the first clinical trial that demonstrates improved functional capacity, assessed by measurement of VO2 peak (p <0.001). Conclusion: The results suggest that sedentary women obtain significant changes in body composition, joint range of movement, flexibility, muscular endurance and dynamic balance from practicing Classical Pilates Method 3 times a week. Furthermore, they increased the functional capacity through the VO2 peak.

Introdução: As mudanças ocorridas no estilo de vida nas últimas décadas têm levado a um aumento na prevalência de excesso de peso. Isso afeta tanto países desenvolvidos como aqueles em desenvolvimento e também todas as faixas etárias. Diversas intervenções para reverter essa situação vêm sendo testadas, porém, em crianças e adolescentes o melhor manejo para reverter esse quadro ainda não está completamente elucidado. Objetivo: Avaliar as mudanças ocorridas no escore-z do índice de massa corporal (zIMC), circunferência do braço (CB), prega cutânea tricipital (PCT) e subescapular (PCSE), circunferência muscular do braço (CMB), percentual de gordura corporal (GC), circunferência da cintura (CC) e exames bioquímicos em crianças e adolescentes após uma intervenção exclusivamente dietoterápica ajustada pela taxa metabólica basal (TMB) obtida através do exame de calorimetria indireta (CI). Procedimentos Metodológicos: Após randomização, os participantes alocados para essa pesquisa participaram de encontros mensais individuais com a nutricionista responsável pelo projeto, pelo período de 1 ano. Os participantes tinham entre 8 e 15 anos, todos com excesso de peso (zIMC≥+1). As medidas antropométricas e de GC foram avaliadas na inclusão, no 6° e no 12° mês, após cada criança ou adolescente ser submetido ao exame de CI. A GC foi medida através do equipamento de bioimpedância elétrica. A coleta de sangue para as análises bioquímicas foi realizada após a CI. Cada participante recebeu uma dieta ajustada pelo valor do exame de CI. Usamos ANOVA para medidas repetidas, e teste de Friedman e Cochran’s Q para avaliar os resultados. Para as análises estatísticas foi utilizado o PASW 18.0 para Windows e valores-P<0,05 foram considerados estatisticamente significativos. Resultados: Completaram as três avaliações 27 participantes, com média de idade de 12±2 anos, 51,9% do sexo feminino. A TMB não apresentou mudança significativa ao final do estudo (P=0,233), enquanto o zIMC reduziu -0,19±0,04 nos primeiros 6 meses e -0,17±0,05 (P=0,014) ao final do seguimento. A CB aumentou em 12 meses e a PCSE nos últimos 6 meses, permanecendo estável ao final da pesquisa. O percentual de GC reduziu inicialmente, mas nos últimos 6 meses apresentou aumento, ainda que mais da metade dos participantes tenha reduzido a GC em 12 meses. O colesterol total (CT) e a lipoproteína de baixa densidade (LDL-c) reduziram nos primeiros 6 meses (-11,5±2,7;P=0,001/-8,1±2,5;P=0,011), mas essa redução não se manteve significativa ao final da intervenção. A maior parte das crianças e adolescentes reduziu os valores de triglicerídeos, LDL-c (88,9%) e CT (66,7%) ao final do estudo. Conclusões: O manejo dietoterápico da obesidade infanto-juvenil realizado por um nutricionista, com encontros mensais, é efetivo após 12 meses de intervenção e, especialmente em 6 meses. / Background: The changes in lifestyle over the past decades have led to an increase in the prevalence of overweight. This affects both developed countries and developing ones as well as all age groups. Several interventions to reverse this situation have been tested, however, in children and adolescents the best management to reverse this situation is not yet fully elucidated. Objective: To evaluate the changes in the z-score of body mass index (zBMI), arm circumference (AC), triceps skinfold (TSF) and subscapular (SSF), arm muscle circumference (AMC), body fat percentage (BF), waist circumference (WC) and biochemical tests in children and adolescents after an intervention only dietotherapeutic adjusted for basal metabolic rate (BMR) was obtained through examination of indirect calorimetry (IC). Methodological Procedures: After randomization, participants allocated to this research participated in monthly and individual meetings with the nutritionist responsible for the project for a period of one year. Participants aged between 8 and 15 years, all overweight (≥ zBMI+1). Anthropometric measurements and BF were evaluated at inclusion in the 6th and 12th month after each child or adolescent be submitted to the examination of IC. The BF was measured by bioelectrical impedance equipment. Blood samples for biochemical analysis was performed after IC. Each participant received a diet adjusted by the value of IC exam. We used repeated measures ANOVA and Friedman and Cochran's Q test to evaluate the results. The statistical analysis was used PASW 18.0 for Windows and P-values <0.05 were considered statistically significant. Results: Completed all three assessments 27 participants, mean age 12±2 years, 51.9% were female. The BMR showed no significant change at the end of the study (P=0.233), while the Zimc reduced -0.19 0.04 in the first 6 months and -0.17±0.05 (P=0.014) at the end of follow-up. The AC increased by 12 months and SSF in the last six months, remaining stable at the end of the study. The BF percentage was initially reduced, but in the last six months had increased, although more than half of the participants has reduced BF in 12 months. The total cholesterol (TC) and low density lipoprotein (LDL-c) reduced in the first 6 months (-11.5±2.7;P=0.001/-8.1±2.5;P=0.011), but this significant reduction was not maintained to the end of the intervention. Most children and adolescents reduced the values of triglycerides, LDL-c (88.9%) and TC (66.7%) at the end of the study. Conclusions: The dietary management of obesity in children and adolescents conducted by a nutritionist, with monthly meetings, is effective after 12 months of intervention, and especially in six months.