Sojourns at high altitude are often accompanied by weight loss and changes in body composition. The aim was to study body composition before and after 40 days high-altitude exposure. The subjects were four women and six men, non-smoking, healthy and active students and a scientist from Mid Sweden University in Östersund with a mean (SD) age of 26 (10) years. All subjects volunteered for a six-week trek to the Mount Everest Base Camp via Rolwaling in Nepal. Before the sojourn subject’s height was 177 (10) cm and weight was 71.9 (10) kg. Body composition was measured with Lunar iDXA at the Swedish Winter Sports Research Centre in Östersund before and after the trek. Total body mass (SD) decreased from 71.8 (10.0) kg before to 69.7 (9.4) kg after the trek (P=0.00). Total fat mass decreased from 14.7 (5.9) kg to 13.8 (4.6) kg (P=0.01). Fat percent decreased from 21.6 (7.9) % to 21.0 (7.2) % (P=0.03). Total lean mass decreased from 54.0 (10.0) kg to 52.9 (9.7) kg (P=0.01). Bone mineral content was unchanged, 3.04 (0.5) kg before and 3.03 (0.5) after (P=0.13). Thus both total body mass and total lean mass had decreased after a six week trekking in Nepal.

The increased participation in elite wheelchair sport has provided the need to investigate the physiological requirements of wheelchair sporting competition and daily wheelchair propulsion. However, from a nutritional perspective, guidelines that have been established from the able-bodied population tend to be used by the practitioners working in disability sport and it is not known whether this information is directly transferable to the wheelchair athlete. Wheelchair sport is complex and athletes differ with respect to their sports classification based on factors relating to disability and functional capacity. Therefore, if nutritional guidance is required to optimise performance then information regarding energy expenditure (EE) in the wheelchair sports population becomes important for specific feedback. The aim of this thesis was to investigate EE in wheelchair athletes. The results from Chapter 3 found resting energy expenditure (REE) in tetraplegic athletes to be lower than that calculated using predictive equations derived from an ablebodied cohort. However, paraplegic athletes showed comparable values to those which were predicted, suggesting these equations may be of use in paraplegic athletes. Chapter 4 extended this work and found similarities in the REE of the two aforementioned cohorts. This could have been due to the similarities that were found in their total-body fat free mass (FFM). The results from Chapter 5 showed EE reduced after both a short 36 minute exposure of wheelchair propulsion and after 3 weeks of wheelchair propulsion practice in novice wheelchair users. Temporal parameters improved after the practice period, suggesting there is an association between EE and propulsion technique. Chapter 6 extended these findings with results confirming that experienced wheelchair users expended significantly less energy during wheelchair propulsion than novice individuals who had up to 3 weeks practice. It is clear that EE of daily wheelchair ambulation should not be a generic value and different levels of experience must be considered so that the nutritional needs can be tailored accordingly. Chapters 7 and 8 examined the physiological demands of elite competitive wheelchair basketball players in relation to the International Wheelchair Basketball Federation (IWBF) classification categories and identified differences in the physiological demands and physiological fitness of wheelchair basketball and tennis players. These results found that IWBF Class 3 - 4.5 (high point) players expended more energy per hour during competition than those with a lower classification (IWBF Class 1 - 2.5). However, when actual playing time was considered the low classification group showed a similar EE to the higher classification group. Furthermore, wheelchair basketball players had a higher EE per hour than wheelchair tennis players during elite competition. However, the wheelchair tennis players spent a significantly longer duration on court resulting in similar EE during a typical competition within each sport. This suggests nutritional advice should be tailored both to the duration of competitive play (where EE may be similar between sports (basketball vs. tennis)); and to training (where athletes with a higher functional capacity may have higher EE). This thesis revealed several important physiological considerations to appreciate when investigating the EE of wheelchair sportsmen and women. Findings would suggest that type of disability, wheelchair propulsion experience and sport classification are all important considerations for the accurate assessment of EE in this cohort of athletes.

Being able to effectively match energy intake to energy expenditure (EE) is an important aspect in preventing weight re-gain in the post-obese. Although it is generally agreed upon that resting EE decreases concomitantly with weight loss, there is no set standard comparing the deviations with differing weight loss protocols and additionally, controversy remains as to whether this decrease is greater than can predicted. In order to address these issues 2977 subjects were analyzed using a systematic review and the differences of both the protocol and length of various interventions in addition to sex were compared. Next, data was selected from this systematic review and 815 subjects were analyzed for weight loss-induced changes in resting EE, FM and FFM. Another subgroup of studies (n = 1450) was analyzed and compared against the Harris-Benedict prediction equation to determine whether the changes in resting EE were greater than what was expected. Finally, in order to determine which factors may be involved in regulating changes in resting EE during weight loss, a secondary analysis was performed on 28 post-menopausal women (age= 50.4 ± 2.0 yrs; BMI= 32.4 ± 5.2 kg/m²) who were submitted to a 6-month caloric restriction. Body composition (DXA), resting EE (indirect calorimetry), physical activity EE (PAEE) and total EE (TEE) (doubly-labelled water) were measured before and after the 6 month weight loss. Blood samples were collected before and after to measure leptin and peptide YY. The results indicate that there was indeed a depression in resting EE during weight loss regardless of the type of intervention utilized. Furthermore, these findings suggest that the changes could not fully be explained by changes of FM and FFM alone and that leptin may be an important contributor to the changes of resting EE during weight loss.

Being able to effectively match energy intake to energy expenditure (EE) is an important aspect in preventing weight re-gain in the post-obese. Although it is generally agreed upon that resting EE decreases concomitantly with weight loss, there is no set standard comparing the deviations with differing weight loss protocols and additionally, controversy remains as to whether this decrease is greater than can predicted. In order to address these issues 2977 subjects were analyzed using a systematic review and the differences of both the protocol and length of various interventions in addition to sex were compared. Next, data was selected from this systematic review and 815 subjects were analyzed for weight loss-induced changes in resting EE, FM and FFM. Another subgroup of studies (n = 1450) was analyzed and compared against the Harris-Benedict prediction equation to determine whether the changes in resting EE were greater than what was expected. Finally, in order to determine which factors may be involved in regulating changes in resting EE during weight loss, a secondary analysis was performed on 28 post-menopausal women (age= 50.4 ± 2.0 yrs; BMI= 32.4 ± 5.2 kg/m²) who were submitted to a 6-month caloric restriction. Body composition (DXA), resting EE (indirect calorimetry), physical activity EE (PAEE) and total EE (TEE) (doubly-labelled water) were measured before and after the 6 month weight loss. Blood samples were collected before and after to measure leptin and peptide YY. The results indicate that there was indeed a depression in resting EE during weight loss regardless of the type of intervention utilized. Furthermore, these findings suggest that the changes could not fully be explained by changes of FM and FFM alone and that leptin may be an important contributor to the changes of resting EE during weight loss.

Being able to effectively match energy intake to energy expenditure (EE) is an important aspect in preventing weight re-gain in the post-obese. Although it is generally agreed upon that resting EE decreases concomitantly with weight loss, there is no set standard comparing the deviations with differing weight loss protocols and additionally, controversy remains as to whether this decrease is greater than can predicted. In order to address these issues 2977 subjects were analyzed using a systematic review and the differences of both the protocol and length of various interventions in addition to sex were compared. Next, data was selected from this systematic review and 815 subjects were analyzed for weight loss-induced changes in resting EE, FM and FFM. Another subgroup of studies (n = 1450) was analyzed and compared against the Harris-Benedict prediction equation to determine whether the changes in resting EE were greater than what was expected. Finally, in order to determine which factors may be involved in regulating changes in resting EE during weight loss, a secondary analysis was performed on 28 post-menopausal women (age= 50.4 ± 2.0 yrs; BMI= 32.4 ± 5.2 kg/m²) who were submitted to a 6-month caloric restriction. Body composition (DXA), resting EE (indirect calorimetry), physical activity EE (PAEE) and total EE (TEE) (doubly-labelled water) were measured before and after the 6 month weight loss. Blood samples were collected before and after to measure leptin and peptide YY. The results indicate that there was indeed a depression in resting EE during weight loss regardless of the type of intervention utilized. Furthermore, these findings suggest that the changes could not fully be explained by changes of FM and FFM alone and that leptin may be an important contributor to the changes of resting EE during weight loss.

Being able to effectively match energy intake to energy expenditure (EE) is an important aspect in preventing weight re-gain in the post-obese. Although it is generally agreed upon that resting EE decreases concomitantly with weight loss, there is no set standard comparing the deviations with differing weight loss protocols and additionally, controversy remains as to whether this decrease is greater than can predicted. In order to address these issues 2977 subjects were analyzed using a systematic review and the differences of both the protocol and length of various interventions in addition to sex were compared. Next, data was selected from this systematic review and 815 subjects were analyzed for weight loss-induced changes in resting EE, FM and FFM. Another subgroup of studies (n = 1450) was analyzed and compared against the Harris-Benedict prediction equation to determine whether the changes in resting EE were greater than what was expected. Finally, in order to determine which factors may be involved in regulating changes in resting EE during weight loss, a secondary analysis was performed on 28 post-menopausal women (age= 50.4 ± 2.0 yrs; BMI= 32.4 ± 5.2 kg/m²) who were submitted to a 6-month caloric restriction. Body composition (DXA), resting EE (indirect calorimetry), physical activity EE (PAEE) and total EE (TEE) (doubly-labelled water) were measured before and after the 6 month weight loss. Blood samples were collected before and after to measure leptin and peptide YY. The results indicate that there was indeed a depression in resting EE during weight loss regardless of the type of intervention utilized. Furthermore, these findings suggest that the changes could not fully be explained by changes of FM and FFM alone and that leptin may be an important contributor to the changes of resting EE during weight loss.

OBJECTIVE: The main objective of the present study was to assess the association between varying amounts of strength training and insulin resistance. Another goal was to assess the influence of several potential confounding variables on the strength training and insulin resistance relationship. Lastly, the role of waist circumference, fat free mass, and body fat percentage on the association between strength training and insulin resistance was assessed. METHODS: This cross-sectional study included 6561 randomly selected men and women in the US. Data were collected using the precise protocol established by NHANES. HOMA-IR was used as the outcome variable. Both time spent strength training and frequency of strength training bouts were used as exposure variables. RESULTS: There was not a statistically significant relationship between strength training and insulin resistance in women. However, after controlling for 10 potential confounding variables, men who reported no strength training had significantly higher levels of HOMA-IR compared to men who reported moderate or high levels of strength training (F = 9.87, P < 0.0001). Odds ratios were also assessed, and 10 potential confounding variables were controlled. Men reporting no strength training had 2.42 times the odds of having insulin resistance compared to men reporting moderate levels of strength training (95% CI: 1.19 to 4.93). Similarly, men reporting no strength training had 2.50 times the odds of having insulin resistance compared to men reporting high levels of strength training (95% CI: 1.25 to 5.00). CONCLUSION: There was a strong relationship between strength training and insulin resistance in US men, but not in US women. Differences in waist circumference, fat free mass, and body fat percentage, as well as demographic and lifestyle measures, do not appear to mediate the relationship.

Made available in DSpace on 2014-06-11T19:23:32Z (GMT). No. of bitstreams: 0 Previous issue date: 2007-03-22Bitstream added on 2014-06-13T18:50:44Z : No. of bitstreams: 1 sanchez_ff_dr_botfm.pdf: 1771868 bytes, checksum: 429488c50f3fd192853726c00c1fd7c1 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A doença pulmonar obstrutiva crônica (DPOC) apresenta manifestações sistêmicas e, dentre entre elas, as alterações nutricionais são bastante evidentes. A perda de peso e o índice de massa do corpo (IMC) foram os primeiros indicadores do estado nutricional relacionados ao prognóstico em pacientes com DPOC. Entretanto, estudos recentes ressaltam a maior prevalência da depleção da massa magra do corpo (MMC) nestes pacientes. Embora algumas repercussões da depleção da MMC em pacientes com DPOC sejam conhecidas, as informações sobre a distribuição, mecanismos e características das alterações parecem contraditórios. Alguns estudos sustentam a idéia de que a fraqueza muscular é proporcional à perda de massa muscular. Por outro lado, os resultados de estudos recentes sugerem que as alterações qualitativas ou funcionais são mecanismos, adicionais à atrofia, envolvidos na disfunção muscular de pacientes com DPOC. Outro aspecto contraditório é o envolvimento de diferentes grupos musculares; alguns estudos mostram que a função dos músculos dos membros superiores (MMSS) encontra-se relativamente preservada enquanto outros sugerem a existência de fraqueza muscular generalizada. O impacto da disfunção muscular na endurance e na tolerância ao exercício também é controverso. Os objetivos deste estudo foram avaliar a prevalência e as repercussões da depleção da massa muscular sistêmica e localizada em pacientes com DPOC. Foram avaliados sessenta e dois pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu – UNESP; vinte e seis pacientes (VEF1: 49,0±18,0%) com depleção de MMC e trinta e seis pacientes... / Chronic obstructive pulmonary disease (COPD) presents significant systemic manifestations and, among them, the nutritional alterations are very important. Loss of body weight and the body mass index (BMI) were the first indicators of the nutritional status related to the prognosis in patients with COPD. However, recent studies have shown the predominance of the fat-free mass (FFM) depletion in these patients. Although some consequences of FFM depletion are well known, information regarding the distribution, mechanism and characteristics of the modification remains unclear. Some researches support the idea that the muscular weakness is proportional to the loss of FFM. On the other hand, results of recent investigations suggest that either the qualitative or functional alterations are mechanisms, additional to the atrophy, involved in the muscular dysfunction in patients with COPD. Another controversial aspect is related to the involvement of different muscular groups; some findings show that the function of the upper-limb muscles are relatively preserved while others suggest the existence of generalized muscular weakness. The impact of the muscular dysfunction in the endurance function and in exercise tolerance is also controversial. The goals of this research were to evaluate the prevalence and the consequences of the systemic and peripheral FFM depletion in patients with COPD. Sixty-two patients with COPD attending to the respiratory outpatient clinic (Botucatu School of Medicine UNESP) were included in the study; twenty-six (FEV1: 49.0l18.0%) with FFM depletion and thirty-six (FEV1: 59.8l24.4%) without FFM depletion. The depletion was characterized by the presence of FFM index <15 kg/m2, for women, and <16 kg/m2, for men. Patients were, in average, 64.0l9.3 years old and 68% were male... (Complete abstract, access undermentioned eletronic address)

Orientador: Irmã Godoy / Banca: Vitor Zuniga Dourado / Banca: José Alberto Neder / Banca: José Antônio Baddini Martinez / Banca: Sérgio Rupp Paiva / Resumo: A doença pulmonar obstrutiva crônica (DPOC) apresenta manifestações sistêmicas e, dentre entre elas, as alterações nutricionais são bastante evidentes. A perda de peso e o índice de massa do corpo (IMC) foram os primeiros indicadores do estado nutricional relacionados ao prognóstico em pacientes com DPOC. Entretanto, estudos recentes ressaltam a maior prevalência da depleção da massa magra do corpo (MMC) nestes pacientes. Embora algumas repercussões da depleção da MMC em pacientes com DPOC sejam conhecidas, as informações sobre a distribuição, mecanismos e características das alterações parecem contraditórios. Alguns estudos sustentam a idéia de que a fraqueza muscular é proporcional à perda de massa muscular. Por outro lado, os resultados de estudos recentes sugerem que as alterações qualitativas ou funcionais são mecanismos, adicionais à atrofia, envolvidos na disfunção muscular de pacientes com DPOC. Outro aspecto contraditório é o envolvimento de diferentes grupos musculares; alguns estudos mostram que a função dos músculos dos membros superiores (MMSS) encontra-se relativamente preservada enquanto outros sugerem a existência de fraqueza muscular generalizada. O impacto da disfunção muscular na endurance e na tolerância ao exercício também é controverso. Os objetivos deste estudo foram avaliar a prevalência e as repercussões da depleção da massa muscular sistêmica e localizada em pacientes com DPOC. Foram avaliados sessenta e dois pacientes com DPOC atendidos no Ambulatório de Pneumologia da Faculdade de Medicina de Botucatu - UNESP; vinte e seis pacientes (VEF1: 49,0±18,0%) com depleção de MMC e trinta e seis pacientes... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Chronic obstructive pulmonary disease (COPD) presents significant systemic manifestations and, among them, the nutritional alterations are very important. Loss of body weight and the body mass index (BMI) were the first indicators of the nutritional status related to the prognosis in patients with COPD. However, recent studies have shown the predominance of the fat-free mass (FFM) depletion in these patients. Although some consequences of FFM depletion are well known, information regarding the distribution, mechanism and characteristics of the modification remains unclear. Some researches support the idea that the muscular weakness is proportional to the loss of FFM. On the other hand, results of recent investigations suggest that either the qualitative or functional alterations are mechanisms, additional to the atrophy, involved in the muscular dysfunction in patients with COPD. Another controversial aspect is related to the involvement of different muscular groups; some findings show that the function of the upper-limb muscles are relatively preserved while others suggest the existence of generalized muscular weakness. The impact of the muscular dysfunction in the endurance function and in exercise tolerance is also controversial. The goals of this research were to evaluate the prevalence and the consequences of the systemic and peripheral FFM depletion in patients with COPD. Sixty-two patients with COPD attending to the respiratory outpatient clinic (Botucatu School of Medicine UNESP) were included in the study; twenty-six (FEV1: 49.0l18.0%) with FFM depletion and thirty-six (FEV1: 59.8l24.4%) without FFM depletion. The depletion was characterized by the presence of FFM index <15 kg/m2, for women, and <16 kg/m2, for men. Patients were, in average, 64.0l9.3 years old and 68% were male... (Complete abstract, access undermentioned eletronic address) / Mestre

Made available in DSpace on 2014-06-11T19:22:48Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-02-10Bitstream added on 2014-06-13T18:49:42Z : No. of bitstreams: 1 fosco_lc_me_prud.pdf: 905074 bytes, checksum: 4682160d9d51bca48d98f5cdd23c2d6d (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / A inflamação sistêmica é um fator relevante na disfunção dos músculos esqueléticos de indivíduos com doença pulmonar obstrutiva crônica (DPOC). Esta disfunção pode ser revertida parcialmente por meio de treinamento físico que, contudo, provoca respostas imunes dependentes de vários fatores, entre eles, o tipo, a intensidade e a duração do exercício. Objetivo: avaliar respostas inflamatórias, bem como níveis de força muscular e valores de massa magra em pacientes com DPOC sem tratamento prévio, comparando dois protocolos de treinamento resistido. Casuística e métodos: 24 indivíduos com diagnóstico de DPOC confirmado por espirometria foram alocados em dois grupos: 12 indivíduos realizaram um treino resistido tradicional (RT) e 12 indivíduos, treino resistido com cordas elásticas (RE). A frequencia do treinamento foi de três vezes por semana, com duração de oito semanas consecutivas. Para a quantificação dos níveis plasmáticos do Fator de Necrose Tumoral alfa (TNF-α), Interleucina 1β (IL-1β) e Interleucina 10 (IL-10)... / Systemic inflammation is an important factor in skeletal muscle dysfunction in patients with chronic obstructive pulmonary disease (COPD). This dysfunction can be reversed partially by means of physical training, however, that causes immune responses depend on various factors including the type, intensity and duration of exercise. Objective: Objective: To evaluate the inflammatory responses, as well as levels of muscle strength and fat-free mass values in COPD patients without prior treatment, comparing two protocols of resistance training. Casuistic and methods: 24 subjects with a diagnosis of COPD confirmed by spirometry were divided into two groups: 12 patients underwent conventional resistance training (RT) and 12 subjects, resistance training with elastic bands (RE); the training was executed three times a week during eight consecutive weeks. For the quantification of plasma levels of tumor necrosis factor alpha (TNF-α), interleukin 1β (IL-1β) and interleukin 10 (IL-10) ... (Complete abstract click electronic access below)