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Biomedical subjects

C L Lafortuna

Publications and source records attributed to C L Lafortuna.

At least 19 recordsLinked to original sources
PubMed2006

Age- and gender-related variations of leg power output and body composition in severely obese children and adolescents.

A low level of physical activity is considered to be both a determinant factor and a negative effect of childhood obesity, notably contributing to its development and maintenance, but the motor capabilities of obese children of different ages have scarcely been evaluated. The purpose of the study is to depict the general trends of muscle anaerobic performance in a cohort of obese Italian children. Three-hundred-six obese children (141 males, 165 females), aged 10-17 yr with body mass index (BMI) range 28.9-62.0 kg/m2 (mean BMI z-score: 2.71 +/- 0.56 SD; range: 1.6-4.5), were cross-sectionally studied. Lower limb maximal anaerobic power output (W) was assessed with the Margaria stair climbing test, and a consistent subgroup of 77 subjects (37 males, 40 females) was also selected for accessory study of body composition with bioimpedance analysis (BIA), in order to evaluate the relationships between fat-free mass (FFM) and W. In both genders, W increased significantly for effect of age and degree of obesity [three-factor multivariate analysis of variance (MANOVA), p < 0.001], but, while no difference was found between boys and girls in the age groups of 10-11 and 12-13 yr (post-hoc Tukey test, p > 0.05), boys in the age groups 14-15 and 16-17 yr were more powerful than girls of the same age (p < 0.001), wherease the relative W per unit body mass W BM) was higher (two-factor MANOVA) in boys (p < 0.01) of all age groups (p > 0.05). In the subgroup tested with BIA, the amount of FFM increased significantly [two-factor analysis of variance (ANOVA), p < 0.001] according to age, being similar in males and females in lower age groups (post-hoc Tukey test, p > 0.05), but higher in boys of older groups (post-hoc Tukey test, p < or = 0.001), so that all differences between age groups and genders disappeared (two-factor MANOVA) when W was expressed per unit FFM (p > 0.05). A significant linear correlation was found between FFM and W, (R2 = 0.66, p < 0.001). In conclusion, no difference in absolute W can be detected between obese boys and girls up to the age of 13, but W differences observed in older age groups appear to be consistent with a concomitant gender-related variation in body composition. The capability of performing external work in short bursts (as represented by trends in WBM) is lower in girls of all ages, and merits consideration on the clinical ground.

Adolescent↗
PubMed2006

The combined effect of adiposity, fat distribution and age on cardiovascular risk factors and motor disability in a cohort of obese women (aged 18-83).

Obesity is associated with a number of serious diseases and with a degree of motor disability, but the extent of the risk and functional derangement within the obese population is not yet completely defined. The study aims to evaluate the combined effect of degree of adiposity, body fat distribution and age on selected cardiovascular risk factors and functional motor disability in a cohort of obese women. A multivariate analysis of variance (MANOVA) is employed to show the combined impact of body mass index (BMI), waist-to-hip ratio (WHR) and age on systolic and diastolic blood pressure (SBP and DBP), total and HDL cholesterol (T-CH and HDL-CH), coronary heart disease (CHD) risk, leg power output (W, assessed with a Margaria test for stair climbing) and subjective general fatigue in a cohort of 463 obese women (BMI range 30.2-66.7 kg/m2; age range 18-83 yr). High WHR and older age, but not BMI, are to a variable degree related to unfavorable values of parameters which contribute to the cardiovascular risk. WHR in the high range is associated with significantly higher values of SBP (p<0.001), CHD risk scores (p<0.001) as well as lower levels of HDL-CH (p=0.01), while older age is significantly associated with higher SBP (p<0.001), T-CH (p<0.001) and CHD risk scores (p<0.001). A significant interaction between age and WHR was detected in the effect on DBP (p=0.01), the negative role of high WHR values being apparent in older women (age > or = 51 yr) but not in younger ones (age < 51 yr). Although not significantly related to CHD risk scores, BMI interacted significantly with WHR in determining high risk score values (p=0.01), the negative effect of a high WHR being apparent in women with a high degree of obesity (BMI > or = 40 kg/m2) but not in those with a low one (BMI < 40 kg/m2). In contrast, WHR did not significantly affect W, which appeared to be mainly dependent on age (p<0.001) and BMI (p<0.001), when considered in terms of unit body mass (BM). Subjective global fatigue, however, was unaffected by any of the factors considered. In the present cohort of obese women, older age and excessive abdominal fat distribution (as assessed by WHR) appear to be significant factors in relation to increased cardiovascular disease risk, irrespective of BMI, while older age and higher levels of overall adiposity are associated with functional motor derangement irrespective of body fat distribution. This suggests that obesity increases metabolic risk and induces motor dysfunction by means of different biological mechanisms and with a different impact within the obese female population.

Adiposity↗
PubMed2005

Postural instability of extremely obese individuals improves after a body weight reduction program entailing specific balance training.

The purposes of this study were to compare postural stability between obese and lean subjects and to investigate the effect of a 3-week body weight reduction (BWR) program entailing specific balance training on postural stability of extremely obese patients. Time of balance maintenance and mean error on the medial-lateral direction at the trunk and lower limb level were assessed during a single limb stance on a movable platform in 19 non-obese and in 20 extremely obese individuals (age range: 20-40 yr). Time of balance maintenance was shorter (obese: 21.1+/-7.7 vs lean: 27.3+/-3.1 sec) and medial-lateral sway of the trunk was larger in obese (5.4+/-3.2 degrees) than in lean (3.2+/-1.1 degrees) subjects (p<0.05). Two subgroups of obese subjects were also tested after a BWR program (energy-restricted diet, moderate physical exercise, nutritional education and psychological counselling) combined with or without 6 sessions of specific balance training on a movable platform. BWR plus specific balance training enhanced time of balance maintenance (pre: 23.8+/-7.2 vs post: 30.0+/-0.0 sec) and reduced the trunk sway (5.2+/-2.8 degrees vs 2.6+/-0.9 degrees ) more than BWR alone (p<0.05). The present findings indicate that extremely obese individuals have inadequate postural stability (compared to their lean counterparts) that could however be improved by few sessions of specific balance training incorporated into a multidisciplinary BWR program. It was concluded that balance improvement is an important goal of rehabilitation, that would probably reduce the propensity of overweight individuals to fall while performing everyday activities.

Adult↗
PubMed2005

Growth hormone responses to repeated bouts of aerobic exercise with different recovery intervals in cyclists.

To characterise the specific GH responses to repeated bouts of standardised aerobic exercise in amateur competitive cyclists, 6 volunteers (mean age +/- SE: 28.7 +/- 2.3 yr, range: 18-35 yr) performed two consecutive 30-min cycling sessions at 80% of individual maximal oxygen uptake on three occasions with different time interval between bouts: 2 h (EXP A), 4 h (EXP B) and 6 h (EXP C). Serum GH concentration was determined in blood samples collected at 15-min intervals during exercise and following 1 h of recovery. In EXP A and EXP B, peak GH concentration in response to the second bout was significantly lower (p < 0.01) than that of the first bout, but in EXP C no difference was detected between bouts. Similarly, the average integrated GH concentration (AUC), determined during the exercise period and in the following 1 h of recovery in the course of the second bout, was significantly lower than that observed during the first bout only in EXP A (p < 0.05) and EXP B (p < 0.01) and not in EXP C, so that the second bout AUC of EXP C was significantly higher than that of EXP A (p < 0.01) and EXP B (p < 0.01). It was concluded that GH responses to subsequent bouts of aerobic exercise are dependent on the time interval between the exercise sessions.

Adolescent↗
PubMed2005

Gender-related changes in body composition, muscle strength and power output after a short-term multidisciplinary weight loss intervention in morbid obesity.

Obese men and women have notably different body composition, which contributes to a different functional motor impairment, but it is unknown whether they respond differently to the same intervention for body weight (BW) reduction and motor capability improvement. The aim of this investigation was to compare changes in body composition, strength production and power output observed in severely obese men and women after a BW reduction intervention, and to test the hypothesis that changes in body composition may be related to changes in motor functionality. Ninety-five obese men and women of the same age (29.3 +/- 7.0 SD yr) and body mass index (41.2 +/- 4.4 kg/m2) participated in a short-term (3 week) mass reduction program (5 days/week) entailing exercise (aerobic and strength training) and energy-restricted diet. BW and body composition, maximum voluntary total isotonic strength (ST), and maximum leg power output (W) were evaluated before and after the program. After the intervention, BW decreased significantly in both men and women, but males lost a significantly higher amount of their initial BW than females (5.12 +/- 0.91 vs 4.27 +/- 1.42%, p<0.01). In men the BW loss was composed by a similar amount of fat mass (FM) and fat-free mass (FFM), whereas women lost FM almost entirely. Both men and women significantly improved ST after the intervention, but no difference in improvement was detected between genders, while W increased significantly in females (p<0.001), and no change was detected in males, although W per unit BW and FFM increased significantly in both genders (p<0.05-0.001). In spite of the positive correlation of ST and W with FFM (p<0.001), there was no detectable relation between the changes in body composition and those in motor performance, the improvement in ST and W being better attributable to factors other than muscle mass change. The present diet/exercise intervention induced significant effects on BW changes and composition as well as on ST and W, with a different impact in males and females.

Adult↗
PubMed2005

Changes in body composition, physical performance and cardiovascular risk factors after a 3-week integrated body weight reduction program and after 1-y follow-up in severely obese men and women.

OBJECTIVE: To investigate the short- and medium-term (ie, at 1-y follow-up) effects of a hospital-based body weight reduction (BWR) program lasting 3 weeks in severely obese individuals. DESIGN: Longitudinal, clinical intervention study entailing energy-restricted diet, tailored aerobic-strength exercise, psychological counselling and nutritional education during a 3-week period followed by 49 weeks of indirect supervision at home. SUBJECTS: In all, 45 women and 19 men aged 30.2 +/- 7.2 y (mean +/- s.d.) with severe obesity (BMI: 41.3 +/- 4.3 kg/m(2)), classified as weight losers (final < initial weight) and regainers (final> or =initial weight). INTERVENTIONS: Body composition, physical performance and cardiovascular risk factors before and after the BWR program and at follow-up. RESULTS: The large majority of the experimental subjects obtained a clinical success after the 1-y period, and the rate was higher in females (n = 37/45, ie, 82.2%) than in males (n = 11/19, ie, 57.9%). At follow-up, weight losers had higher percent fat-free mass, muscle strength, HDL-cholesterol and self-reported physical activity level and lower total cholesterol and glucose levels than weight regainers (P < 0.05-0.01). Males displayed significantly larger fat-free mass losses than females at post-BWR and at follow-up. CONCLUSIONS A 3-week hospital-based integrated BWR program resulted in a high rate of clinical success in severely obese individuals at 1-y follow-up (particularly in females), that was associated with increased levels of self-reported physical activity and improved muscle strength and lipid profile. Further research is needed to establish the long-term effects (ie, at 2-5 y) associated to this treatment.

Adult↗
PubMed2005

Gender variations of body composition, muscle strength and power output in morbid obesity.

BACKGROUND: Motor capabilities are reduced in obese (OB) individuals, and this impairment may result also from quantitative variation of muscle mass due to alterations in body composition. OBJECTIVE: This study aims to evaluate the differences in body mass (BM) and composition, as well as in muscle strength (ST) and power output W(.) between OB and NW males and females, and to test the hypothesis that variations in body composition affect muscle performance in OB subjects. DESIGN AND METHODS: Body composition (determined by BIA with a two-compartment model), upper and lower limb maximum ST (evaluated with isotonic machines) and lower limb maximum anaerobic W(.) (measured with a jumping test) were studied in a group of 95 extremely OB subjects (OB: 28 males, 67 females; mean age+/-s.d.: 29.3+/-7.0 y; BMI: 41.2+/-4.4 kg/m(2)) and in a control group of 18 NW voluntary subjects (NW: eight males, 10 females; age: 30.3+/-5.3 y; BMI: 22.6+/-2.1 kg/m(2)). RESULTS: OB male and female subjects differed significantly with increases in BM being attained by a similar contribution of fat mass (FM) and fat-free mass (FFM) in male subjects, but mainly contributed by FM in female subjects. Compared with NW, both OB men and women had a greater amount of FFM (P<0.001) and, since a general linear correlation was found between ST and FFM (ST (N)=64.4 FFM (kg)-190.0, R(2)=0.612, P<0.001), they developed higher values of ST (P<0.05) than their respective NW counterparts. For the same reason, both OB and NW male subjects had higher ST (P<0.001) than their female counterparts. Correction for FFM eliminated all gender- and obesity-related ST differences. On the contrary, in spite of their higher absolute muscle strength, both OB men and women could develop absolute W(.) similar to that of NW subjects, and were notably less powerful per unit BM than NW subjects (P<0.001), women being most affected among the OB. CONCLUSIONS: Obesity-related variation in body composition differs considerably by gender, and is responsible for differences in muscle performance: the higher muscle strength observed in OB subjects (both men and women) and in male subjects (both OB and NW) is accounted for by a greater amount of FFM. Nonetheless, biomechanical limitations appear to impair muscle power development during jumping in OB individuals.

Adult↗
PubMed2004

Effect of a 3-week body mass reduction program on body composition, muscle function and motor performance in pubertal obese boys and girls.

The aim of this study was to investigate the effects of a multidisciplinary body mass reduction (BMR) program on body composition, muscle function and motor performance in 50 obese [mean body mass index (BMI): 35.9+/-5.8 kg/m2] boys and girls aged 12-17 yr (Tanner stage III, IV and V). The hospital-based BMR program combined an energy-restricted diet (1400-1600 kcal), nutritional education, psychological counselling and moderate physical activity (45-60 min/ session; 5 sessions/week; 60-80% of the maximal heart rate) during a 3-week period. Fat mass, fat-free mass, maximal power during jumping and stair climbing as well as maximal strength of the upper and lower limb muscles were quantified before and after the treatment. Body mass and fat mass significantly decreased following the BMR program, respectively -5.1 and -7.8% (p<0.001), while percent fat-free mass increased 2.3% (p<0.001). The treatment significantly increased both stair climbing and jumping power, respectively 8.2 and 8.9% (p<0.05), and the same was true for maximal strength of the upper and lower limb muscles (p<0.001). For the first time, it was demonstrated that a BMR program entailing diet and physical exercise significantly improved body composition, muscle function and motor performance in obese boys and girls aged 12-17 yr, while gender and pubertal stages had no influence on BMR program-induced changes.

Adolescent↗
PubMed2004

The relationship between body composition and muscle power output in men and women with obesity.

In order to investigate the effect of gender, age and level of obesity on body composition and anaerobic power output, and to test the hypothesis that variation in body composition affects muscle power output in obesity, a cohort of 377 subjects (112 males and 265 females, aged 18-75 yr) with different levels of obesity [class IIII, body mass index (BMI) range: 30.6-60.3 kg m(-2)] was cross-sectionally investigated. Body composition was assessed with bioelectric impedance analysis (BIA), in standardized conditions and using obesity-specific prediction formulas. Lower limb anaerobic power output (W) was measured with a modification of the Margaria stair climbing test. In males, a similar increase in fat-free mass (FFM) and fat mass (FM) was observed as a function of BMI, while in females, FM increased more than FFM. In both genders, FFM significantly decreased as a function of age (p<0.001), but was higher in men of all ages. Similar patterns of variation were observed in W. A differently significant correlation between BMI and W was observed between men and women, and it was found by multivariate analysis of variance (MANOVA) that W was affected negatively by age (p<0.001) and positively by BMI (p<0.001) in males, while in females only age had a significant effect (p<0.001) but not BMI. A positive correlation (p<0.001) was detected between FFM and W, in both genders. W per unit body mass, the actual muscle power for rapid external work, was higher in men than in women of all groups, and decreased with age in both genders, but only in older women decreased significantly (p<0.01) depending on BMI. It is concluded that the gender-dependent pattern of variation in body composition may be an important determinant of the different motor limitations observed in men and women. Older women (> or =50 yr) with extreme obesity (class III) suffered from the most serious motor dysfunction within this obese cohort. This result may have important clinical relevance in the care of obesity.

Adult↗
PubMed2004

Influence of gender, age and BMI on lower limb muscular power output in a large population of obese men and women.

OBJECTIVE: To depict the general trends of muscle anaerobic performance in obese subjects within a wide range of age and body weight. DESIGN: Cross-sectional study for the measurement of lower limb maximal anaerobic power output with a modification of the Margaria stair climbing test in a large population of obese subjects of both genders within a wide span of age (18-80 y) and body mass index (BMI, 30-68 kg m(-2)). Furthermore, body composition was also determined by bioimpedance analysis in a representative subgroup, in order to evaluate the relationships between fat-free mass (FFM) and power output. SUBJECTS: A total of 1298 obese subjects (486 males, 812 females) from an Italian population seeking medical support for body weight reduction. Within this sample, a consistent subgroup of 193 subjects (59 males, 134 females) was also selected for accessory study of body composition. RESULTS: In general, male subjects developed significantly higher lower limb power output (W) than female subjects (P<0.001-0.01), both in absolute terms and per unit body mass. In both genders, W was influenced negatively by age (P<0.001) and positively by BMI (P<0.001). While the effect of age was similar in both genders, BMI had a different positive effect in male and in female subjects, being more definite in male subjects. In the subgroup, FFM was found to depend both on age and BMI, in a fashion comparable with that displayed by W. The gender-related differences in W disappeared when expressed per unit FFM and a significant linear correlation was found between FFM and W, both in male and female subjects (R2=0.32-0.51, P<0.001). CONCLUSIONS: The lower limb maximal power output is significantly higher in obese male subjects than in female subjects, being negatively influenced by age but positively related to BMI. Female subjects appear to be at a greater disadvantage for effect of obesity, the major motor limitations being suffered by older women with higher BMI. These gender differences in age- and BMI-dependent W changes seem to be related to changes in FFM in the subgroup in whom body composition was studied.

Adolescent↗
PubMed2004

Elderly obese women display the greatest improvement in stair climbing performance after a 3-week body mass reduction program.

OBJECTIVE: To investigate whether stair climbing performance and body composition are similarly affected by a body mass reduction (BMR) program in obese individuals of different gender, age and body mass index (BMI) level. DESIGN: Longitudinal, clinical intervention study entailing energy-restricted diet (5023-7535 kJ/day), nutritional education, psychological counselling and moderate physical activity (indoor cycling, outdoor walking, gymnastics routines, five sessions/week) during a 3-week period. SUBJECTS: A total of 466 male and 807 female subjects categorized as a function of gender, age (< vs >/=50 y) and BMI (< vs >/=40 kg/m(2)). MEASUREMENTS: Body mass, stair climbing time and power before and after the BMR program. Fat-free mass and fat mass were also evaluated by bioimpedance analysis, in a representative subgroup of 160 patients, to evaluate the relation between fat-free mass and power output. RESULTS: Body mass, fat-free mass and fat mass significantly decreased following the BMR program (P<0.001), with male subjects reducing body mass and fat-free mass more than and fat mass less than the female subjects. Stair climbing time decreased (P<0.001) and therefore anaerobic power significantly increased 9.7% after the treatment. The greatest improvement in stair climbing performance was observed in obese women aged >/=50 y. Significant inverse correlations were found between initial power or fat-free mass level and respective percent increases (R=-0.35/-0.37, P<0.001) and between BMR-induced percent changes in body mass and power (R=-0.13, P<0.001). CONCLUSION: Subjects with the lowest baseline level in stair climbing performance (and probably with the lowest amount of fat-free mass), that is, obese women aged more than 50 y, obtained the largest enhancement after the 3-week BMR program, likely improving overall functional capacities and resulting in greater independence during daily-living activities in such a population.

Activities of Daily Living↗
PubMed2003

Effects of different training protocols on exercise performance during a short-term body weight reduction programme in severely obese patients.

The effects on aerobic, anaerobic and strength performance of aerobic (A) or A and strength (AS) training, integrated with a 3-week body weight reduction programme involving an energy-restricted diet, nutritional education and psychological counselling, were evaluated in 52 grade II or III obese individuals (A: n = 26; AS: n = 26). After 3 weeks, both training programmes led to a similar and significant reduction (p < 0.001) in body mass (A: 4.8%; AS: 4.4%) and an increase (p < 0.05 - p < 0.01) in maximal oxygen consumption (A: 16.8%; AS: 10.9%). A significant (p < 0.05 - p < 0.001) increase was found in absolute lower limb anaerobic power output evaluated by means of a jumping test (A: 13.7%; AS: 18.1%) and stair climbing test (A: 9.7%; AS: 4.3%), without any significant difference between A and AS. A comparable and significant (p < 0.01) increase was also found in average horizontal velocity during a short sprint running test (A: 8.1%; AS: 7.1%), with a shorter time of foot-ground contact (A: 4.9%; AS: 6.6.%) and a higher step frequency (A: 4.0%; AS: 10.4%). The maximum strength increase after the body weight reduction programme determined by one maximal repetition test of lower and upper limb muscle groups was significantly greater (p < 0.05 - p < 0.001) in the AS group, ranging from 11.4% to 25.4% (A) and from 26.7% to 41.8% (AS). These results indicate that integrating a body weight reduction programme involving diet nutritional education and psychological counselling with A or AS exercise has similar positive effects in lowering body mass and improving A and anaerobic performance. However, the addition of strength training to A conditioning increases maximum strength.

Combined Modality Therapy↗
PubMed2003

Three-week integrated body weight reduction programme markedly improves performance and work capacity in severely obese patients.

The aim of this study was to assess the effects on performance and work capacity of a short-term (3-week) integrated body weight reduction programme consisting of an energy-restricted diet, nutritional education, psychological counselling and aerobic exercise training at a constant metabolic load (5 days/week) in 71 severely obese patients (18 males and 53 females aged 29.3 +/- 0.8 years, with a mean weight of 113.8 +/- 2.2 kg and a mean BMI of 41.3 +/- 0.5 kg/m(-2)). Body mass and composition, and maximum oxygen consumption (VO2max) were determined before and after the programme. The caloric equivalent of work output and a performance index (PI) during 10 min of bicycle ergometer pedalling (50-60 rpm) and 20 min of treadmill walking (incline 0-3%) at a constant metabolic load (50% of individual VO2max during the preliminary conditioning period--1st week--and 60% during the exercise conditioning period--2nd and 3rd week) were evaluated daily throughout the study. After the programme, body mass reduced significantly (-4.5%, p<0.001), the weight loss being sustained entirely by a significant reduction in fat mass (-7.6%, p<0.001) without any significant changes in fat-free mass. Absolute and body mass-related VO2max significantly increased by respectively 14.5% and 20.2% (p<0.001). Both daily work output during constant metabolic load (ANOVA, p<0.05-0.001) and PI (ANOVA, p<0.05-0.001) increased significantly during each week of the programme, leading to a total increase in work output in response to exercise conditioning of 44.6 +/- 5.8 kcal. It is concluded that the changes in exercise capacity induced by the present programme offer significant advantages for obese patients that can be quantified in terms of an improvement in their ability to perform everyday activities, thus contributing towards improving their quality of life.

Adult↗
PubMed2003

Effects of non-specific vs individualized exercise training protocols on aerobic, anaerobic and strength performance in severely obese subjects during a short-term body mass reduction program.

The purpose of the present study was to compare aerobic, anaerobic and strength performance changes induced by two short-term (3-week) body mass reduction programs based on the same low-calory diet (1200-1500 kcal/day), nutritional education and psychological counseling, but entailing different exercise training protocols. An individualized, low-volume and moderate-intensity exercise training (IET) was contrasted with a non-specific, high-volume, low-intensity exercise training (NET). Thirty obese in-patients (12 males, 18 females; mean age +/- SD: 33.9 +/- 9.4 yr, range: 19-51yr; mean BMI: 40.5 +/- 3.8 kg/m2, range: 35.3-51.4 kg/m2) were randomly divided in two gender-matched groups of 15 subjects each undergoing a different exercise training protocol. Maximum oxygen uptake (VO2max) determined with a submaximal indirect test on a bicycle ergometer, lower limb maximum power output (W(max)) determined with the jumping method, global motor capabilities determined by analysis of locomotor pattern during a short (8 m) running, maximum strength (1-RM) of upper and lower limb muscle groups determined with isotonic machines were tested before and after the program. Adherence to an individual exercise activity and maintenance of body weight (bw) loss were evaluated with a telephonic interview 6 months after the completion of the program. In both groups a significant (p < 0.001) and comparable weight loss was observed (IET: -4.27%; NET: -4.17%). In both groups VO2max and W(max) increased significantly (p < 0.05-0.001) when expressed relatively to body mass, while in absolute terms they were significantly (p < 0.001) improved only in IET group. 1-RM in all tested muscle groups was significantly increased in both IET and NET subjects (p < 0.001-0.01), but improvements were significantly greater in IET as compared with NET (p < 0.05-0.001). The analysis of locomotor pattern during the short running indicated that IET subjects significantly improved their global motor capabilities (p < 0.05-0.001), while no change was observed in NET group. After 6 months, IET subjects reported a level of spontaneously chosen physical activity significantly higher (p < 0.05) than NET subjects, displaying a trend of further decrease in bw. It was concluded that, although no difference in bw loss was appreciated between the two studied groups and significant improvements were found also in subjects performing NET protocol, the IET protocol offers better overall results in terms of muscle performance and physical fitness, with a possibly stronger motivation to subsequent exercise activity.

Adult↗
PubMed2003

Effects of a 3-week integrated body weight reduction program on leptin levels and body composition in severe obese subjects.

The effects of short-term (3 weeks) integrated body weight reduction (BWR) program (including energy-restricted diet, aerobic and strength exercise (5 days/week), nutritional education and psychological counseling) on plasma leptin levels and body composition were investigated in 54 morbidly obese patients (38 females/16 males; mean BMI +/- SE: 41.8 +/- 0.1 kg/m2, range 35-58 kg/m2; mean age: 29.8 +/- 1.0 yr, age range: 18-46 yr). The BWR program induced a significant (p < 0.001) weight loss (BMI reduction: -4.8%) and a significant modification in body composition, consisting in a fat mass (FM) decrease (-7.0 +/- 0.4%, p < 0.001) with a concomitant fat-free (FFM) mass increase (1.8 +/- 0.3%, p < 0.001). On average, plasma leptin levels decreased significantly both in males (from 19.4 +/- 2.6 ng/ml to 11.6 +/- 1.3 ng/ml, p < 0.001) and in females (from 41.1 +/- 3.6 ng/ml to 29.9 +/- 3.0 ng/ml, p < 0.001). Both before and after weight loss, leptin levels were positively correlated (p < 0.001) with BMI and percent fat mass (FM) values. Weight changes after the BWR program were negatively correlated with baseline leptin concentrations both in absolute terms and expressed per unit FM. In conclusion, a short-term diet plus aerobic/strength training effectively induces body composition changes and reduces plasma leptin levels. Body FM reduction appears to be not the unique determinant of leptin levels regulation and the degree of leptin over-expression may negatively affect weight loss in morbidly obese patients.

Adipose Tissue↗
PubMed2003

GH responses to a near-maximal exercise training session on-the-field in cyclists.

Acute plasma GH response to prolonged (1 h) near-maximal exercise was studied in 7 elite cyclists (6 males, 1 female; mean age +/- SE: 24.9 +/- 1.4 yr) during a routine training session on an uphill track (length: 22.0 km, average slope: 4.39%) and during a recovery (REC) period of 60 min from the end of exercise. The training session entailed a warming-up (WARM) phase of about 20 min at 63% of individual maximal heart rate (HRmax) followed by a high intensity exercise (HIE) phase of about 60 min at 90-92% of HRmax. GH resting values averaged 0.2 +/- 0.06 ng/ml; average GH concentration attained a maximal value (21.5 +/- 3.3 ng/ml, range: 11.0-38.2 ng/ml) between 20 and 40 min of HIE and significantly decreased thereafter (p=0.01), although exercise intensity was unchanged in the following period (p=0.14). After WARM, GH concentrations were significantly lower than peak values (p=0.05). During REC, GH levels steadily decreased, attaining a value of 2.6 +/- 0.8 ng/ml 60 min after the end of exercise. It was concluded that during prolonged and sustained exercise on-the-field in cyclists, GH value determined at the end of the bout may not correspond to the maximal value, which can be observed after 20 to 40 min of near-maximal exercise.

Adult↗
PubMed2003

Short-term changes of fatigability and muscle performance in severe obese patients after an integrated body mass reduction program.

The effects of a short-term (3-week) integrated body weight reduction (BWR) program on fatigue perception and on lower limb anaerobic power output were evaluated in 200 severely obese in-patients (40 males and 160 females, age: 18-83 yr, BMI: 35.0-65.3 kg/m2). Fatigue was assessed by a 7-point Likert-type scale questionnaire (Fatigue Severity Scale, FSS), while average lower limb power output (W) during a maximal effort was determined with a modification of the Margaria test for stair climbing. In both genders, total FSS score was influenced by both age and obesity level, resulting significantly (p < 0.001) lower in younger subjects (< 45 yr) than in older (> 45 yr) and in patients with lower BMI (< 40 kg/m2) than in those with a higher one (> 40 kg/m2). An opposite trend was observed in W. The 3-week BWR integrated program with moderate aerobic exercise and free standing and ground gymnastic routines induced a significant reduction in body weight (p < 0.001), in total FSS score (p < 0.001) and a significant increase in W, both in absolute terms (p < 0.05) and relative to body mass (p < 0.001). Total FSS score and absolute or relative power output were positively correlated both before and after the BWR program (p < 0.001, Wilcoxon rank test). It is concluded that: a) subjective fatigue perception, assessed by a FSS questionnaire, can be considered an indirect indicator of effective lower limb power output in severely obese patients and, b) in spite of a relatively small, although significant, decline of BMI, the full-time participation in a hospital-based, integrated BWR program with moderate exercise activity is associated with significant short-term improvements of both fatigue sensation and power output. Dia

Adolescent↗