No description available.

Introdução - O peso mais baixo ao nascimento (PN<3 kg) pode estar relacionado a modificações na composição corporal na infância e vida adulta, pois a desnutrição intra-utero pode se associar a diminuição de massa magra e muitas vezes ao aumento de massa gorda. O peso mais alto ao nascimento (PN3 kg) e/ou ganho ponderal acima de 2DP em relação ao peso de nascimento nos primeiros dois anos de vida (catch-up growth) também podem se associar ao aumento de massa gorda, IMC, circunferência abdominal e circunferência do pescoço. Objetivos - Verificar a associação entre peso ao nascimento, ganho de peso nos primeiros dois anos de vida e alteração na composição corporal na idade escolar. Materiais e métodos - Estudo transversal avaliando-se 124 crianças escolares com cinco anos de idade, matriculadas no primeiro ano de quatro escolas municipais e uma particular de Capão Bonito, SP. Foram investigados fatores socioeconômicos e demográficos através de questionários e realizadas medidas antropométricas (peso, estatura, circunferências abdominal e do pescoço). A bioimpedanciometria foi utilizada para avaliação da composição corporal. O peso ao nascimento (PN) foi transcrito das fichas hospitalares dos recém-nascidos e o ganho de peso nos primeiros dois anos de vida, das carteiras de vacina ou prontuários médicos dos postos de saúde de Capão Bonito. Análise estatística - Para armazenamento e análise dos dados foi utilizado o software Stata versão 10. Foi estabelecido um nível de significância de 5 por cento . Para investigação das relações entre peso ao nascimento, ganho ponderal nos primeiros dois anos de vida e composição corporal aos 5 anos de idade, foi utilizada análise de regressão linear múltipla. Resultados O PN 3,0 kg, o catch-up growth (>2DP) e a obesidade materna se associaram a aumentos de média de massa gorda (p=0,036; p=0,007; p= 0,018, respectivamente); IMC (p=0,011; p=0,004; p=0,002, respectivamente) e circunferência abdominal (p= 0,002; p=0,001; p= 0,002, respectivamente). O PN 3 kg e catch-up growth se associaram (p=0,003 nos dois casos) ao aumento da média da circunferência do pescoço. Quando avaliados separadamente por sexo tanto o catch-up growth como a obesidade materna apresentaram associação com aumentos na média de massa gorda (p= 0,033 e p=0,014, respectivamente) e circunferência abdominal (0,048; 0,003, respectivamente) em meninos. A obesidade materna teve associação com maior media de IMC (p=0,001) no sexo masculino. O PN 3 kg esteve associado a aumentos de média de IMC (p=0,008), circunferência abdominal (p=0,001) e circunferência do pescoço em meninas (p=0,002). Conclusões Nesta pesquisa as maiores médias de massa gorda, IMC, circunferência abdominal estiveram associadas ao PN 3kg, catch-up growth e à obesidade materna. Maiores médias de circunferência de pescoço estiveram associadas ao PN 3kg e à ocorrência de catch-up. No sexo masculino as maiores médias de massa gorda e circunferência abdominal apresentaram associação positiva com a ocorrência de catch-up growth e obesidade materna. A maior média de IMC esteve associada à obesidade materna. Não houve associação entre a circunferência do pescoço e as variáveis independentes estudadas. No sexo feminino não foi observada associação de massa gorda com estas variáveis, contudo houve associação de maiores médias de IMC, circunferência abdominal e circunferência do pescoço com PN 3kg. Visando a prevenção e controle de sobrepeso e obesidade em crianças e adultos, é importante considerar PN, catch-up growth, historia de obesidade materna e o sexo do individuo / Introduction: Sub nutrition during intra-uterine life may be related to a decrease in lean mass and, quite often, to an increase in fat mass. Therefore, lower birth weight (BW<3kg) may bear a relationship with changes in body composition during childhood and adult life. Heavier birth weight (BW3kg) and/or weight gain during the first two years above 2 DP in relation to birth weight (catch-up growth) may also be associated to increased fat mass, BMI, abdominal and neck circumferences. Objectives: To determine the relationship between birth weight, weight gain during the first two years of life and changes in body composition at school age. Materials and methods: One hundred twenty four children aged five years were included in a cross-sectional study carried out in Capão Bonito, SP, Brazil. A survey was carried out by means of structured questionnaires in order to establish socioeconomic and demographic parameters. In addition, anthropometric data (weight, height, abdominal and neck circumferences) were recorded for each student. Body composition was determined by bioimpedance measurements. Birth weight (BW) was obtained from medical records on file at the local hospital, while weight gain during the first two years was transcribed from the childs vaccination card or from medical files available at public health stations in Capão Bonito. Statistical Analysis: Data storage and analysis was carried out using the Stata statistical package, Version 1.0, using 5 per cent as the significance level. A multiple regression analysis was used to determine the relationship between birth weight, weight gain during the first two years of life and changes in body composition at school age. Results: BW3.0 kg, catch-up growth (>2DP) and maternal obesity were related to increased fat mass (p=0,036; p=0,007; p= 0,018, respectively), BMI (p=0,011; p=0,004; p=0,002, respectively) and abdominal circumference (p=0,002; p=0,001; p=0,002, respectively). BW 3.0 kg, catch-up growth (>2DP) were associated (p=0,003 in both cases) with increased neck circumference. When the results were considered separately for boys and girls, for boys there was a relationship between the two variables: catch-up growth and maternal obesity with fat mass (p=0,033 and p=0,014, respectively) and abdominal circumference (p=0,048 and p=0,003, respectively). BW 3.0 kg was associated with increases in BMI (p=0,008), abdominal circumference (p=0,001) and neck circumference (p=0,002) in girls. Conclusions This research shows that high averages of fat mass, BMI and abdominal circumference were associated to three main factors: i) BW 3 kg; ii) catch-up growth and, iii) maternal obesity. It also shows that high averages of neck circumference were associated to BW 3 kg and to the occurrence of catch-up growth. For males, high averages of fat mass and high averages of abdominal circumference were positively associated to the occurrence of catch-up growth and maternal obesity; the highest average of BMI was associated to maternal obesity. There was no association between neck circumference and the independent variables studied. In contrast, for females this research did not show associations between fat mass and BW 3kg, catch-up growth or maternal obesity. However, there was a positive association between high averages of BMI, abdominal circumference and neck circumference with BW 3kg.These findings indicate that, in order to prevent and control overweight and obesity in children and adults, it is important to consider BW, catch-up growth, maternal obesity and gender

Cardiovascular disease (CVD) is one of the major health issues of our time. The prevalence of CVD is increasing, both in industrialized and in developing countries, and causes suffering and a decreased quality of life for millions of people worldwide. CVD can have multiple etiologies, but the main underlying cause is atherosclerosis, which causes blood clot formation and obstructs vital arteries. Multiple risk factors of atherosclerosis have been identified, and body fatness is one of the most important ones.  The main aims of this thesis were to investigate the relation between body fatness and: CVD risk factors (paper I), incident stroke (paper II), and overall mortality (paper III). The results showed that abdominal obesity is strongly associated with both CVD risk factors and stroke incidence (papers I-II). The results also suggested that a substantial part of the association between increased body fat and stroke can be explained by an increase in traditional stroke risk factors associated with increased body fat (paper II). A gynoid fat distribution, with a high share of fat located around the hip, is, on the other hand, associated with lower risk factor levels in both men and women, and with a decreased risk of stroke in women (papers I-II). This illustrates the importance of assessing the overall distribution of body fat rather, than solely focusing on total body fatness. In elderly women, total body fat was found to be associated with increased survival, while abdominal fat moderately increased mortality risk (paper III). Lean mass (fat-free mass) was strongly associated with increased survival among elderly men and women (paper III). Erythrocyte sedimentation rate (ESR) is an indicator of inflammation and, possibly, an indicator of atherosclerotic disease. In paper IV, the relationship between ESR in young adulthood and the later risk of myocardial infarction (MI) was studied. Results showed that higher levels of ESR were associated with a higher MI risk, in a dose-responsive manner, and was independent of other well-established risk factors. In summary, both total and regional fat distribution are associated with CVD risk factors and stroke, but do not seem to correspond to an increase in mortality risk among the elderly. Also, inflammation, detected as an increase in ESR, is associated with long term MI risk in young men.

Made available in DSpace on 2015-07-22T20:49:28Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-06-24 / Introdução: O aumento da expectativa de vida em nossa população traz preocupações relacionadas a morbi-mortalidade decorrente das fraturas osteoporóticas. É consensual que a prática de atividade física orientada traz benefícios, aumentando as chances de um envelhecimento saudável. A cidade de São Caetano do Sul (SCS) possui o primeiro Índice de desenvolvimento humano (IDH) e possui a 2ª maior renda per capta de nosso país. Tivemos a possibilidade de utilizar os dados do Projeto Longitudinal de Envelhecimento e Aptidão Física de SCS, que consiste em avaliar e acompanhar munícipes de São Caetano do Sul com idade acima de 50 anos, quanto as variáveis de aptidão física, capacidade funcional, aspectos sociais, nutricionais e psicológicos, envolvidos estes na prática de atividades físicas, no mesmo local. Objetivos: verificar a associação entre a composição corporal, das variáveis de aptidão física e da capacidade funcional sobre a densidade mineral óssea em mulheres pós-menopausadas praticantes de atividade física. Desenho do Estudo: Corte transversal da coorte do Projeto Longitudinal de Envelhecimento e Aptidão Física de São Caetano do Sul. Local de realização: Centro Social e Recreacional da Terceira Idade “Dr. Moacyr Rodrigues”, localizado no município de São Caetano do Sul, São Paulo - SP, Brasil. Participantes: 117 mulheres com idade acima de 50 anos e média de 67,8 ± 7,0 anos. Participantes de um programa regular de atividades físicas com sessões de duas vezes semanais e duração de 50 minutos, por em média pelo menos 8,0 ± 6,8 anos. Métodos: Todas as mulheres da amostra responderam a uma anamnese em forma de entrevista e passaram por uma avaliação física e por exames clínicos. Avaliamos a composição corporal (a massa corporal, a estatura corporal total, calculamos o IMC, as circunferências corporais de braço contraído, de perna (panturrilha), de cintura e de quadril, calculamos a RCQ, a massa magra, a massa gorda e a densidade mineral óssea em diversos sítios). Verificamos as variáveis de aptidão física (a força de preensão manual, a força de membros superiores e a força de membros inferiores mediante dois diferentes testes) e na capacidade funcional(equilíbrio estático com controle visual), além de submetermos a amostra a testes bioquímicos (creatinina, cálcio total, paratormônio, TSH). Resultados: Encontramos uma prevalência de osteoporose bastante similar a encontrada em populações de outros países semelhantes quanto à etnia. A força de preensão manual foi a variável de melhor associação com a densidade mineral óssea de todos os sítios ósseos analisados. Quando propusemos o modelo de regressão linear múltipla, a massa magra juntamente com a força de preensão manual explicaram em 28% a DMO de colo de fêmur e 24% DMO de corpo total; enquanto que 21% da DMO de coluna lombar foi explicada pela força de preensão manual, a massa corporal e o equilíbrio estático com controle visual, sempre levando em consideração a correção pela idade cronológica e a idade de menopausa. Conclusões: A variável de melhor associação com os sítios da densidade mineral óssea foi a força de preensão manual e nos modelos múltiplos a massa magra e a força de preensão manual apresentaram melhor relação com a DMO de colo de fêmur e corpo total. Na DMO de coluna lombar (L1- L4) obtivemos associação das variáveis de força de preensão manual, a massa corporal e o equilíbrio estático com controle visual. Isto reforça a importância da melhoria e/ou da manutenção da força de muscular e da massa magra ao longo da vida, com o objetivo de contribuir para a autonomia e independência do indivíduo diante do processo de envelhecimento. / Introduction: The increase of life expectation in our population results in concerns related to the morbi-mortality due to the osteoporotic fractures. It is consensual that the practice of guided physical activity leads to benefits, increasing the chances of a healthy aging. The city of São Caetano do Sul (SCS), the first one in the Index of human development (IDH) in Brazil, presents the second larger income per capture of our country. We had the possibility to use the data of the Longitudinal Project of Aging and Physical fitness of SCS, that consists of evaluating and following citizens from São Caetano do Sul aged 50 an over, concerning functional capacity, as well as social, nutritional and psychological aspects related to the physical activity practice in the same. Objectives: to verify the association of body composition, physical fitness variables and functional capacity on bone mineral density in physically active postmenopausal women. Design: this study is a part of Longitudinal Project of Aging and Physical Fitness of São Caetano do Sul. Setting: the Social Center and Recreacional of the Third Age "Dr. Moacyr Rodrigues", located in the district of São Caetano do Sul, São Paulo - SP, Brazil. Participants: 117 women aging 50 years or more (average of 67,8 ± 7,0 years), participants of a regular physical activity program, in a 50-minute-session twice a week, with a mean of 8,0 ± 6,8 years of practice. Measurements: all the women of the sample were interviewed for an anamnesis and were submitted to a physical evaluation and clinical exams. We evaluated the body composition (body weight, total body stature, BMI, body circumferences of contracted arm, leg (calf), waist and hip, RCQ, lean mass, fat mass and bone mineral density in several sites). We verified the physical fitness variables (handgrip, strength of upper and lower limbs using two different tests) and a functional capacity (static balance with visual control). Besides we submitted the XXIII sample to biochemical analysis (creatinine, total calcium, PTH, TSH). Results: we found a prevalence of osteoporosis that was quite similar to the one seen in populations of other countries with similar ethnic characteristics. The handgrip strength was the variable that better associated with the bone mineral density of all analyzed bone sites. When the model of multiple lineal regression was proposed, it revealed that the lean mass together with the handgrip strength explained by 28% the BMD of femoral neck and 24% the BMD of total body; while the BMD of lumbar spine (L1-L4) was explained by 21% by the variables handgrip, body weigh and static balance all together, always taking into account the adjustment for chronologic and menopause age. Conclusion: the variable that best associated with the bone mineral density was the handgrip strength, and in the multiple regression models the lean mass and the handgrip strength presented a better association with BMD of femoral neck and total body. About the BMD of lumbar spine (L1 - L4) we found association of the variables handgrip, body weight and static balance, always taking into account the chronological and the menopause age. These data demonstrate, importance of improving and/or maintaining the muscle strength and the lean mass along life aiming to contribute for the individual's autonomy throughout the aging progress. / TEDE / BV UNIFESP: Teses e dissertações

Os pacientes idosos em hemodiálise (HD) são altamente suscetíveis ao desenvolvimento de sarcopenia, devido ao processo natural de envelhecimento e ao catabolismo induzido pelo procedimento de HD. O objetivo deste estudo foi primeiro, avaliar a prevalência de sarcopenia, dinapenia e atrofia muscular em um grupo de pacientes idosos em HD; o segundo, avaliar se os critérios aplicados para o diagnóstico de sarcopenia, propostos por sociedades internacionais, são capazes de distinguir os pacientes com pior condição clínica, estado nutricional e qualidade de vida. Este estudo multicêntrico e transversal incluiu 94 pacientes idosos em HD (> 60 anos) de cinco centros de diálise. Todos os participantes foram submetidos à avaliação antropométrica, de composição corporal, força de preensão manual (FPM), laboratorial e avaliação da condição nutricional através da avaliação subjetiva global de 7 pontos (AGS-7p). Adicionalmente, os participantes responderam um questionário de qualidade de vida. Para o diagnóstico de sarcopenia, foram adotados os critérios propostos por sociedades internacionais, que englobam os parâmetros indicativos de baixa massa muscular e baixa função muscular. Para a massa muscular adotou-se o índice de massa magra (IMM) < percentil 20 para o gênero e faixa etária de uma população de referência, avaliado a partir da massa magra obtida pelo somatório de dobras cutâneas. Para o critério de baixa função muscular, adotou-se a FPM < percentil 10 para o gênero, faixa etária e o braço utilizado de uma população de referência. Os pacientes foram classificados como Sarcopênicos (baixo IMM associado à baixa FPM); Dinapênicos (baixa FPM) e Atrofia muscular (baixo IMM). A sarcopenia estava presente em 13.8% dos pacientes, enquanto a dinapenia foi observada em 37.2% e a atrofia muscular em 35.1%. A sarcopenia foi capaz de distinguir os pacientes que possuíam maior comprometimento do estado nutricional e da composição corporal. O critério de função muscular (isoladamente ou em combinação com a massa muscular) também identificou os pacientes com pior qualidade de vida. Em conclusão, a prevalência de sarcopenia foi observada em 13,8% do grupo. Entretanto, ao usar apenas critérios que indicam redução da força ou massa muscular, esta prevalência aumentou para 30%. A condição de sarcopenia distinguiu pacientes com pior estado nutricional e qualidade de vida. / Elderly patients undergoing maintenance hemodialysis (MHD) are highly susceptible to develop sarcopenia, due to the natural process of ageing and to the catabolism induced by the hemodialysis procedure. The aim of this study was first, to evaluate the prevalence of sarcopenia, dynapenia and muscle atrophy in a group of elderly patients on MHD; second, to evaluate whether the criteria applied for diagnosis of sarcopenia proposed by international societies are able to distinguish patients with worse clinical condition, nutritional status and quality of life. This multicenter, cross-sectional study included 94 elderly MHD patients (>60 years) from five dialysis centers. All participants underwent anthropometric measurements, body composition, handgrip strength (HGS) and laboratory measurements, and the assessment of nutritional status by 7 point subjective global (7p-SGA) assessment. In addition, the participants answered a health related quality of life (HRQoL) questionnaire. For the diagnosis of sarcopenia, the criteria proposed by international societies were adopted, which included parameters indicative of low muscle mass and low muscle function. For muscle mass, we adopted the criterion of lean body mass index (LBMI) < 20 percentile for gender and age of a reference population, assessed by lean body mass from skinfold thicknesses. For the criterion of low muscle function, we adopted the HGS < 10 percentile for gender, age and arm specific side from a reference population. Patients were classified as Sarcopenic (low LBMI associated with low HGS); Dynapenic (low HGS) and with Muscular atrophy (low LBMI). Sarcopenia was present in 13.8% of the patients, while dynapenia was observed in 37.2% and muscle atrophy in 35.1%. Sarcopenia was able to distinguish patients who had greater impairment of nutritional status and body composition. The criteria of muscle function (alone or combined with muscle mass) also identified patients with worse quality of life. In conclusion, we report that the prevalence of sarcopenia was observed in 13.8% of the group. However, when using only criteria indicating reduction of strength or muscle mass, this prevalence increased to 30%. The condition of sarcopenia distinguished patients with poor nutritional status and quality of life.

Os pacientes idosos em hemodiálise (HD) são altamente suscetíveis ao desenvolvimento de sarcopenia, devido ao processo natural de envelhecimento e ao catabolismo induzido pelo procedimento de HD. O objetivo deste estudo foi primeiro, avaliar a prevalência de sarcopenia, dinapenia e atrofia muscular em um grupo de pacientes idosos em HD; o segundo, avaliar se os critérios aplicados para o diagnóstico de sarcopenia, propostos por sociedades internacionais, são capazes de distinguir os pacientes com pior condição clínica, estado nutricional e qualidade de vida. Este estudo multicêntrico e transversal incluiu 94 pacientes idosos em HD (> 60 anos) de cinco centros de diálise. Todos os participantes foram submetidos à avaliação antropométrica, de composição corporal, força de preensão manual (FPM), laboratorial e avaliação da condição nutricional através da avaliação subjetiva global de 7 pontos (AGS-7p). Adicionalmente, os participantes responderam um questionário de qualidade de vida. Para o diagnóstico de sarcopenia, foram adotados os critérios propostos por sociedades internacionais, que englobam os parâmetros indicativos de baixa massa muscular e baixa função muscular. Para a massa muscular adotou-se o índice de massa magra (IMM) < percentil 20 para o gênero e faixa etária de uma população de referência, avaliado a partir da massa magra obtida pelo somatório de dobras cutâneas. Para o critério de baixa função muscular, adotou-se a FPM < percentil 10 para o gênero, faixa etária e o braço utilizado de uma população de referência. Os pacientes foram classificados como Sarcopênicos (baixo IMM associado à baixa FPM); Dinapênicos (baixa FPM) e Atrofia muscular (baixo IMM). A sarcopenia estava presente em 13.8% dos pacientes, enquanto a dinapenia foi observada em 37.2% e a atrofia muscular em 35.1%. A sarcopenia foi capaz de distinguir os pacientes que possuíam maior comprometimento do estado nutricional e da composição corporal. O critério de função muscular (isoladamente ou em combinação com a massa muscular) também identificou os pacientes com pior qualidade de vida. Em conclusão, a prevalência de sarcopenia foi observada em 13,8% do grupo. Entretanto, ao usar apenas critérios que indicam redução da força ou massa muscular, esta prevalência aumentou para 30%. A condição de sarcopenia distinguiu pacientes com pior estado nutricional e qualidade de vida. / Elderly patients undergoing maintenance hemodialysis (MHD) are highly susceptible to develop sarcopenia, due to the natural process of ageing and to the catabolism induced by the hemodialysis procedure. The aim of this study was first, to evaluate the prevalence of sarcopenia, dynapenia and muscle atrophy in a group of elderly patients on MHD; second, to evaluate whether the criteria applied for diagnosis of sarcopenia proposed by international societies are able to distinguish patients with worse clinical condition, nutritional status and quality of life. This multicenter, cross-sectional study included 94 elderly MHD patients (>60 years) from five dialysis centers. All participants underwent anthropometric measurements, body composition, handgrip strength (HGS) and laboratory measurements, and the assessment of nutritional status by 7 point subjective global (7p-SGA) assessment. In addition, the participants answered a health related quality of life (HRQoL) questionnaire. For the diagnosis of sarcopenia, the criteria proposed by international societies were adopted, which included parameters indicative of low muscle mass and low muscle function. For muscle mass, we adopted the criterion of lean body mass index (LBMI) < 20 percentile for gender and age of a reference population, assessed by lean body mass from skinfold thicknesses. For the criterion of low muscle function, we adopted the HGS < 10 percentile for gender, age and arm specific side from a reference population. Patients were classified as Sarcopenic (low LBMI associated with low HGS); Dynapenic (low HGS) and with Muscular atrophy (low LBMI). Sarcopenia was present in 13.8% of the patients, while dynapenia was observed in 37.2% and muscle atrophy in 35.1%. Sarcopenia was able to distinguish patients who had greater impairment of nutritional status and body composition. The criteria of muscle function (alone or combined with muscle mass) also identified patients with worse quality of life. In conclusion, we report that the prevalence of sarcopenia was observed in 13.8% of the group. However, when using only criteria indicating reduction of strength or muscle mass, this prevalence increased to 30%. The condition of sarcopenia distinguished patients with poor nutritional status and quality of life.

Introdução - O peso mais baixo ao nascimento (PN<3 kg) pode estar relacionado a modificações na composição corporal na infância e vida adulta, pois a desnutrição intra-utero pode se associar a diminuição de massa magra e muitas vezes ao aumento de massa gorda. O peso mais alto ao nascimento (PN3 kg) e/ou ganho ponderal acima de 2DP em relação ao peso de nascimento nos primeiros dois anos de vida (catch-up growth) também podem se associar ao aumento de massa gorda, IMC, circunferência abdominal e circunferência do pescoço. Objetivos - Verificar a associação entre peso ao nascimento, ganho de peso nos primeiros dois anos de vida e alteração na composição corporal na idade escolar. Materiais e métodos - Estudo transversal avaliando-se 124 crianças escolares com cinco anos de idade, matriculadas no primeiro ano de quatro escolas municipais e uma particular de Capão Bonito, SP. Foram investigados fatores socioeconômicos e demográficos através de questionários e realizadas medidas antropométricas (peso, estatura, circunferências abdominal e do pescoço). A bioimpedanciometria foi utilizada para avaliação da composição corporal. O peso ao nascimento (PN) foi transcrito das fichas hospitalares dos recém-nascidos e o ganho de peso nos primeiros dois anos de vida, das carteiras de vacina ou prontuários médicos dos postos de saúde de Capão Bonito. Análise estatística - Para armazenamento e análise dos dados foi utilizado o software Stata versão 10. Foi estabelecido um nível de significância de 5 por cento . Para investigação das relações entre peso ao nascimento, ganho ponderal nos primeiros dois anos de vida e composição corporal aos 5 anos de idade, foi utilizada análise de regressão linear múltipla. Resultados O PN 3,0 kg, o catch-up growth (>2DP) e a obesidade materna se associaram a aumentos de média de massa gorda (p=0,036; p=0,007; p= 0,018, respectivamente); IMC (p=0,011; p=0,004; p=0,002, respectivamente) e circunferência abdominal (p= 0,002; p=0,001; p= 0,002, respectivamente). O PN 3 kg e catch-up growth se associaram (p=0,003 nos dois casos) ao aumento da média da circunferência do pescoço. Quando avaliados separadamente por sexo tanto o catch-up growth como a obesidade materna apresentaram associação com aumentos na média de massa gorda (p= 0,033 e p=0,014, respectivamente) e circunferência abdominal (0,048; 0,003, respectivamente) em meninos. A obesidade materna teve associação com maior media de IMC (p=0,001) no sexo masculino. O PN 3 kg esteve associado a aumentos de média de IMC (p=0,008), circunferência abdominal (p=0,001) e circunferência do pescoço em meninas (p=0,002). Conclusões Nesta pesquisa as maiores médias de massa gorda, IMC, circunferência abdominal estiveram associadas ao PN 3kg, catch-up growth e à obesidade materna. Maiores médias de circunferência de pescoço estiveram associadas ao PN 3kg e à ocorrência de catch-up. No sexo masculino as maiores médias de massa gorda e circunferência abdominal apresentaram associação positiva com a ocorrência de catch-up growth e obesidade materna. A maior média de IMC esteve associada à obesidade materna. Não houve associação entre a circunferência do pescoço e as variáveis independentes estudadas. No sexo feminino não foi observada associação de massa gorda com estas variáveis, contudo houve associação de maiores médias de IMC, circunferência abdominal e circunferência do pescoço com PN 3kg. Visando a prevenção e controle de sobrepeso e obesidade em crianças e adultos, é importante considerar PN, catch-up growth, historia de obesidade materna e o sexo do individuo / Introduction: Sub nutrition during intra-uterine life may be related to a decrease in lean mass and, quite often, to an increase in fat mass. Therefore, lower birth weight (BW<3kg) may bear a relationship with changes in body composition during childhood and adult life. Heavier birth weight (BW3kg) and/or weight gain during the first two years above 2 DP in relation to birth weight (catch-up growth) may also be associated to increased fat mass, BMI, abdominal and neck circumferences. Objectives: To determine the relationship between birth weight, weight gain during the first two years of life and changes in body composition at school age. Materials and methods: One hundred twenty four children aged five years were included in a cross-sectional study carried out in Capão Bonito, SP, Brazil. A survey was carried out by means of structured questionnaires in order to establish socioeconomic and demographic parameters. In addition, anthropometric data (weight, height, abdominal and neck circumferences) were recorded for each student. Body composition was determined by bioimpedance measurements. Birth weight (BW) was obtained from medical records on file at the local hospital, while weight gain during the first two years was transcribed from the childs vaccination card or from medical files available at public health stations in Capão Bonito. Statistical Analysis: Data storage and analysis was carried out using the Stata statistical package, Version 1.0, using 5 per cent as the significance level. A multiple regression analysis was used to determine the relationship between birth weight, weight gain during the first two years of life and changes in body composition at school age. Results: BW3.0 kg, catch-up growth (>2DP) and maternal obesity were related to increased fat mass (p=0,036; p=0,007; p= 0,018, respectively), BMI (p=0,011; p=0,004; p=0,002, respectively) and abdominal circumference (p=0,002; p=0,001; p=0,002, respectively). BW 3.0 kg, catch-up growth (>2DP) were associated (p=0,003 in both cases) with increased neck circumference. When the results were considered separately for boys and girls, for boys there was a relationship between the two variables: catch-up growth and maternal obesity with fat mass (p=0,033 and p=0,014, respectively) and abdominal circumference (p=0,048 and p=0,003, respectively). BW 3.0 kg was associated with increases in BMI (p=0,008), abdominal circumference (p=0,001) and neck circumference (p=0,002) in girls. Conclusions This research shows that high averages of fat mass, BMI and abdominal circumference were associated to three main factors: i) BW 3 kg; ii) catch-up growth and, iii) maternal obesity. It also shows that high averages of neck circumference were associated to BW 3 kg and to the occurrence of catch-up growth. For males, high averages of fat mass and high averages of abdominal circumference were positively associated to the occurrence of catch-up growth and maternal obesity; the highest average of BMI was associated to maternal obesity. There was no association between neck circumference and the independent variables studied. In contrast, for females this research did not show associations between fat mass and BW 3kg, catch-up growth or maternal obesity. However, there was a positive association between high averages of BMI, abdominal circumference and neck circumference with BW 3kg.These findings indicate that, in order to prevent and control overweight and obesity in children and adults, it is important to consider BW, catch-up growth, maternal obesity and gender

Introduction Researchers have, for decades, contributed to an increased collective understanding of the physiological demands in cross-country skiing; however, almost all of these studies have used either non-elite subjects and/or performances that emulate cross-country skiing. To establish the physiological demands of cross-country skiing, it is important to relate the investigated physiological variables to the competitive performance of elite skiers. The overall aim of this doctoral thesis was, therefore, to investigate the external validity of physiological test variables to determine the physiological demands in competitive elite cross-country skiing. Methods The subjects in Study I – IV were elite male (I – III) and female (III – IV) cross-country skiers. In all studies, the relationship between test variables (general and ski-specific) and competitive performances (i.e. the results from competitions or the overall ski-ranking points of the International Ski Federation (FIS) for sprint (FISsprint) and distance (FISdist) races) were analysed. Test variables reflecting the subject’s general strength, upper-body and whole-body oxygen uptake, oxygen uptake and work intensity at the lactate threshold, mean upper-body power, lean mass, and maximal double-poling speed were investigated. Results The ability to maintain a high work rate without accumulating lactate is an indicator of distance performance, independent of sex (I, IV). Independent of sex, high oxygen uptake in whole-body and upper-body exercise was important for both sprint (II, IV) and distance (I, IV) performance. The maximal double-poling speed and 60-s double-poling mean power output were indicators of sprint (IV) and distance performance (I), respectively. Lean mass was correlated with distance performance for women (III), whereas correlations were found between lean mass and sprint performance among both male and female skiers (III). Moreover, no correlations between distance performance and test variables were derived from tests of knee-extension peak torque, vertical jumps, or double poling on a ski-ergometer with 20-s and 360-s durations (I), whereas gross efficiency while treadmill roller skiing showed no correlation with either distance or sprint performance in cross-country skiing (IV). Conclusion The results in this thesis show that, depending on discipline and sex, maximal and peak oxygen uptake, work intensity at the lactate threshold, lean mass, double-poling mean power output, and double-poling maximal speed are all externally valid physiological test variables for evaluation of performance capability among elite cross-country skiers; however, to optimally indicate performance capability different test-variable expressions should be used; in general, the absolute expression appears to be a better indicator of competitive sprint performance whereas the influence of body mass should be considered when evaluating competitive distance performance capability of elite cross-country skiers.

Approximately 23% of Canadians over the age of 65 are considered frail, with that number predicted to increase up to 40% for the population over the age of 85. Frailty is a geriatric syndrome defined by the natural decline in muscle mass and function caused by the natural aging process. When developing to an excessive degree, frailty may present as a disease state, which is recognized as sarcopenia. The exact definition of sarcopenia relies on the presence of low muscle mass, strength, and/or function, but quantitative cut-off values are still a topic of debate. Understanding how biomarkers measured via diagnostic imaging such as magnetic resonance imaging (MRI) and dual-energy x-ray absorptiometry (DXA) describe skeletal muscle can allow doctors to develop a profile of sarcopenia and define predictors to aide in preventative therapy. 4 male and 9 female (mean age = 78 ± 6.5 years) participants from a frailty study underwent full-body DXA and had their dominant thigh scanned using a 3.0T MRI. DXA-derived appendicular lean mass (ALM) and MRI-derived cross-sectional area (CSA), fat fraction (FF), T2 relaxation (T2), magnetization transfer ratio (MTR), fractional anisotropy (FA) and mean diffusivity (MD) from 4 muscle groups at the mid-thigh were defined as muscle biomarkers. Pearson's correlation was calculated to identify relationships between biomarkers and a Wilcoxon rank-sum test was performed to assess the agreement of low-muscle mass characterization between ALM normalized by height (ALMI), ALM normalized by BMI (ALM/BMI), and the gold standard MRI cross-sectional area. Strong positive correlations between muscle quantity biomarkers such as ALMI and CSA were recognized within the quadriceps (p=0.0095), adductors (p=0.035), and sartorius (p=0.00065) muscles while muscle quality biomarkers such as FF and T2 showed significant positive correlation within the quadriceps (p=3.58*10^-5) and the hamstring (p=0.0042) muscles. Finally, ALM/BMI displayed a much stronger agreement in muscle mass quantification with the gold-standard of MRI-CSA over the more commonly researched ALMI from DXA. The main purpose of this study was to collate a vast array of skeletal muscle biomarkers obtained using DXA and MRI on a frail population, and show that significant correlations can be recognized from a single MRI-slice located at the mid-thigh. Additionally, this study recognized the potential of ALM/BMI as the DXA-derived biomarker of choice in muscle mass assessment of frailty. / Thesis / Master of Applied Science (MASc) / A person is diagnosed with sarcopenia when they present symptoms of low muscle mass, strength, and/or function. Defining these three criteria with objective measures has been long debated by researchers and clinicians alike. By understanding how different properties, or biomarkers, of skeletal muscle relate to one another and change as a person becomes more frail, we hope to better understand sarcopenia and identify the best measures to classify someone as sarcopenic. Being able to accurately diagnose someone as sarcopenic early allows for more effective treatment of this muscle disease. In this study, non-invasive magnetic resonance imaging (MRI) and dual energy x-ray absorptiometry (DXA) were used to measure many different biomarkers of skeletal muscle at the mid-thigh. Through characterizing these measures of muscle quality and quantity between different imaging techniques this study aimed to recognize which imaging techniques, and more specifically biomarkers, can best distinguish between a person who is sarcopenic and one who is non-sarcopenic.

In this work we focused on the application of physical activity, which aimed to reduce the negative impact of physical deprivation and associated functional and structural changes in the musculoskeletal system. The principal criterion was the diagnosis of the organ systems of the locomotor system, focusing on the muscular system. The subsequent application of appropriate forms of exercise intervention was designed to mitigate the effects of the aging process and functional changes in the body of the senior individual. Finally, we wanted to assess the impact of changes in body composition in its own self- sufficiency and independence of older people and the quality of life of older people in terms of physical and psychosocial aspects. The most significant is the loss of muscle mass, sarcopenia development, increase fat mass with frequent reductions in body weight. The focus of our work and its specific purpose is to clarify the influence of the applied physical interventions. To assess changes in body composition are needed for our work used the method of multi Bioanalysis. Results in body composition in older adults have been evaluated and intra-individual measured data were compared with the general senior population. Kinesiology testing shortened muscle groups was carried out repeatedly to reduce...