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Abstract Background Morbid obesity is a complex chronic condition characterized by a body mass index of 40 kg/m2 or higher. The incidence of the condition is on the rise in developed countries, and bariatric surgery has been proposed as a potential solution to address this trend. Nonetheless, bariatric surgery may also result in adverse effects, including a reduction in bone mineral density (BMD) and muscle mass, as well as an increased risk of fractures. The present study aims to elucidate the effects of bariatric surgery and whole-body vibration (WBV) training on body composition, microbiota, physical fitness, quality of life, and cardiometabolic markers. Methods Twenty-eight participants (14 females), aged 18 to 50 years, will undergo sleeve gastrectomy surgery. They will be randomly allocated into a control group or a WBV training group. The WBV group will train three times per week with increasing intensities and duration ranging from 30 to 45 min over the 4-month training period. Measurements of body composition (dual-energy X-ray absorptiometry and peripheral quantitative computed tomography), physical fitness (muscular strength, agility, cardiorespiratory fitness, and balance), gait biomechanics, cardiometabolic markers, gut microbiota, quality of life, and physical activity levels will be collected at four different time points: (1) prior to the surgery, (2) 45 days post-surgery, (3) 6 months post-surgery, and (4) 18 months post-surgery. Discussion Both groups are expected to experience improvements in most of the aforementioned variables. Nonetheless, we expect the WBV group to show larger improvements proving that the training is effective and safe. Trial registration Clinicaltrials.gov NCT05695599. Registered on January 25, 2023.

Objective: There is evidence that indicates that the Walked Distance (WD) in the 6-Minute Walk Test (6MWT) would be sensitive to the type of track and encouragement. The aim of study was compared the impact of track type and verbal encouragement provided in the 6MWT on WD, physiological cost, perceived exertion, and gait efficiency in healthy young adults unfamiliar with the test.Method: WD, heart rate, subjective sensation of dyspnea (SSD), and fatigue (SSF) were measured in four 6MWT protocols: i) 30 m linear track and protocolized encouragement (LT + PE), ii) 30 m linear track and constant encouragement (LT + CE), iii) 81 m elliptical track and protocolized encouragement (ET + PE), and iv) 81 m elliptical track and constant encouragement (ET + CE). In addition, the Gait Efficiency Index (GIE) associated with physiological cost, dyspnea and fatigue was calculated and compared between the different protocols.Results: The WD was significantly higher in the ET + CE protocol. The percentage of the heart rate reserve used (%HRRu) at minute 6 was higher in the ET + CE protocol. The SSD and SSD had difference in startup time between the protocols. The GEI was higher in %HRRu, SSD, and SSF for the ET + CE protocol.Conclusion: The ET + CE protocol showed a significant increase in WD during the 6MWT in healthy young adults. Although it obtained the highest physiological cost, it did not present perceptual differences when entering cardiopulmonary assessment windows relevant to a more efficient test for the participant. It is advisable to discuss, based on the findings, the fundamental objective of the 6MWT and national and international recommendations to achieve a result as close as possible to the real maximal effort.

Early life is critical for the programming of body composition. The literature links perinatal factors with fat mass development and its future effects (e.g., obesity); however, little evidence exists between early life factors and lean body mass (LBM). This study follows up on a cohort of 416 Spanish children at ages six to eight, previously evaluated at birth in the CALINA study. Here, we studied the association between early life factors, LBM, and limb strength. Parental origin/nutritional status, maternal smoking during pregnancy, gestational diabetes/weight gain/age, birth weight (BW), early feeding, and rapid weight gain (RWG) were collected from primary care records. Bioimpedance analysis, dual-energy X-ray absorptiometry, peripheral quantitative computed tomography, and a handgrip/standing long jump test were used to assess fat-free mass index (FFMI), total lean soft tissue mass index (TLSTMI), muscle cross-sectional area index (MCSAI), and limb strength, respectively. In girls, maternal smoking, gestational age, and BW were positively associated with FFM/LSTM. In boys, the parents’ BMI, BW, and RWG were positively associated with FFM/LSTM. BW was associated with handgrip strength in both. Maternal BMI in girls and RWG in boys were negatively associated with the standing long jump. Early life programming plays a key role in determining LBM in children.

The multicomponent training (MCT) effect on bone health in frail and pre-frail elders, which is influenced by dietary intake, is still unknown. The objective of this non-randomized intervention trial was to assess the effects of a 6-month MCT on bone structure in frail and pre-frail elders, and to analyse the influence of dietary intake and serum vitamin D (25(OH)D) in these changes. Thirty MCT (TRAIN) and sixteen controls (CON), frail and pre-frail completed the information required for this study. Peripheral quantitative computed tomography measurements were taken at 4% and 38% of the tibia length and dietary intake was registered. The 25(OH)D values were obtained from blood samples. Analyses of covariance (ANCOVA) for repeated measures showed significant decreases for CON in total bone mineral content at 38% of tibia length. One factor ANOVAs showed smaller decreases in bone mineral density and cortical thickness percentage of change in TRAIN compared to CON. Linear regression analyses were performed to study the influence of nutrients and 25(OH)D on bone changes. Alcohol showed a negative influence on fracture index changes, while polyunsaturated fatty acid and vitamin A showed a positive association with some bone variables. The 25(OH)D only affected positively the cortical bone mineral density. In conclusion, our MCT seems to slow down some of the bone detriments associated with ageing in frail and pre-frail older adults, with alcohol showing a negative effect on the bone and apparent limited effect of nutrients and serum 25(OH)D on training related changes.

BACKGROUND: Swimming, a sport practiced in hypogravity, has sometimes been associated with decreased bone mass. AIM: This systematic review aims to summarize and update present knowledge about the effects of swimming on bone mass, structure and metabolism in order to ascertain the effects of this sport on bone tissue. METHODS: A literature search was conducted up to April 2013. A total of 64 studies focusing on swimmers bone mass, structure and metabolism met the inclusion criteria and were included in the review. RESULTS: It has been generally observed that swimmers present lower bone mineral density than athletes who practise high impact sports and similar values when compared to sedentary controls. However, swimmers have a higher bone turnover than controls resulting in a different structure which in turn results in higher resistance to fracture indexes. Nevertheless, swimming may become highly beneficial regarding bone mass in later stages of life. CONCLUSION: Swimming does not seem to negatively affect bone mass, although it may not be one of the best sports to be practised in order to increase this parameter, due to the hypogravity and lack of impact characteristic of this sport. Most of the studies included in this review showed similar bone mineral density values in swimmers and sedentary controls. However, swimmers present a higher bone turnover than sedentary controls that may result in a stronger structure and consequently in a stronger bone.

Abstract Background Lean / Fat Free Body Mass (LBM) is metabolically involved in active processes such as resting energy expenditure, glucose uptake, and myokine secretion. Nonetheless, its association with insulin sensitivity / resistance / glucose tolerance and metabolic syndrome remains unclear in childhood. Methods The current investigation aimed to examine the differences in fat-free mass /lean body mass according to the presence of insulin sensitivity/insulin resistance/glucose tolerance/metabolic syndrome in children. A systematic search was carried out in Medline/PubMed, Embase, Scopus, Web of Science, and SciELO, covering the period from each database’s respective start to 21 June 2021. Two researchers evaluated 7111 studies according to the inclusion criteria: original human studies, written in English or Spanish, evaluating fat-free mass/lean body mass in children and adolescents including both with and without insulin sensitivity/insulin resistance /glucose tolerance and metabolic syndrome and reported the differences between them in terms of fat free mass/lean body mass. The results of the studies were combined with insulin sensitivity, insulin, resistance, glucose tolerance and metabolic syndrome. The standardized mean difference (SMD) in each study was calculated and combined using the random-effects model. Heterogeneity between studies was tested using the index of heterogeneity (I2), leave-one-out sensitivity analyses were performed, and publication bias was assessed using the Egger and Begg tests. Results Finally, 15 studies which compared groups defined according to different glucose homeostasis criteria or metabolic syndrome out of 103 eligible studies were included in this systematic review and 12 studies in the meta-analysis. Meta-analysis showed lower fat-free mass/lean body mass percentage in participants with insulin resistance/glucose tolerance/metabolic syndrome (SMD -0.47; 95% CI, − 0.62 to − 0.32) while in mass units (kg), higher values were found in the same group (SMD, 1.01; 95% CI, 0.43 to 1.60). Conclusions Our results identified lower values of fat-free mass/lean body mass (%) in children and adolescents with insulin resistance/glucose tolerance/metabolic syndrome and higher values of fat-free mass/lean body mass when these are expressed in kg. The evidence of the impact of lean mass on children’s glucose homeostasis or metabolic syndrome is limited, so future studies research should focus on explaining the effect of fat-free mass/lean body mass on different metabolic outcomes. Moreover, it may be interesting to evaluate the quality (muscle density) or functional (muscle strength) outcomes in addition to both absolute (kg) and relative (%) values in future studies. The systematic review was prospectively registered at PROSPERO (registration number CRD42019124734; available at: http://www.crd.york.ac.uk/prospero [accessed: 05 April 2019]).

Background Skeletal muscle is one of the main components of lean soft tissue mass (LSTM). Low levels in children affect locomotion, posture, and increase the risk of metabolic syndrome. Aim (1) To evaluate the association between muscle cross-sectional area (MCSA) of the lower left leg measured by peripheral quantitative computed tomography (pQCT) and total LSTM; namely, total left leg and left lower leg LSTM assessed by dual-energy X-ray absorptiometry (DXA) in a group of children, (2) to examine if MCSA is a predictor of LSTM, (3) to determine the ability of pQCT to identify children with low LSTM. Subjects and methods Lower left leg MCSA and LSTM were measured using pQCT and DXA, respectively, in 396 children. Results Statistically significant positive correlations were found between the lower leg MCSA – total LSTM (r² = 0.789), total leg LSTM (r² = 0.79), and lower leg LSTM (r² = 0.791) (p

The aims of the present study were, firstly, to evaluate areal bone mineral density (aBMD), bone strength and structure during a swimming season and compare them to those of normo-active controls (CG), and secondly to ascertain whether practising an additional weight-bearing sport other than swimming might improve bone. Twenty-three swimmers who only swam (SWI-PURE; 14 males, 9 females), 11 swimmers who combined swimming with an additional weight-bearing sport (SWI-SPORT; 8 males, 3 females) and 28 controls (CG; 16 males, 12 females) participated in the present study. aBMD was assessed with dual energy X-ray (DXA). Bone mass, area, structure and strength of the non-dominant tibia and radius were measured with peripheral quantitative computed tomography (pQCT). Measurements were performed at the beginning of the swimming season and 8 months later. The only difference among groups for DXA and pQCT variables was found for arm aBMD, which was higher in the SWI-SPORT than in the CG group at both pre- and post-evaluation. Group by time interactions (GxT) were found for trochanter aBMD when comparing SWI-SPORT to CG and SWI-SPORT to SWI-PURE, favouring in both cases SWI-SPORT. No GxT were found for the radius. For the tibia, GxT were found between SWI-SPORT and CG and between SWI-PURE and CG, in both cases favouring the swimmers. A season of swimming does not confer any additional benefits to aBMD, but may confer minor benefits to structure and mass. Complementing swimming with a weight-bearing activity is beneficial to bone.

Introduction: Recent original research and meta-analyses suggest that acute caffeine supplementation improves exercise performance in team-sport athletes (TSA). Nonetheless, most of the studies testing the effects of caffeine on TSA included samples of male athletes, and there is no meta-analysis of the performance-enhancing effects of caffeine on female TSA. The aim of the present study was to synthesize the existing literature regarding the effect of caffeine supplementation on physical performance in adult female TSA. Methods: A search was performed in Pubmed/Medline, SPORTDiscus and Scopus. The search was performed from the inception of indexing until 1 September 2021. Crossover randomized controlled trials (RCT) assessing the effects of oral caffeine intake on several aspects of performance in female TSA were selected. The methodological quality and risk of bias were assessed for individual studies using the Physiotherapy Evidence Database scale (PEDro) and the RoB 2 tool. A random-effects meta-analysis of standardized mean differences (SMD) was performed for several performance variables. Results: The search retrieved 18 articles that fulfilled the inclusion/exclusion criteria. Overall, most of the studies were of excellent quality with a low risk of bias. The meta-analysis results showed that caffeine increased performance in specific team-sport skills (SMD: 0.384, 95% confidence interval (CI): 0.077–0.691), countermovement jump (SMD: 0.208, CI: 0.079–0.337), total body impacts (SMD: 0.488; 95% CI: 0.050, 0.927) and handgrip strength (SMD: 0.395, CI: 0.126–0.665). No effects were found on the ratings of perceived exertion, squat jumps, agility, repeated sprint ability or agility tests performed after fatigue. Conclusions: The results of the meta-analysis revealed that acute caffeine intake was effective in increasing some aspects of team-sports performance in women athletes. Hence, caffeine could be considered as a supplementation strategy for female athletes competing in team sports.

Resumen: Objetivo: Aportar evidencias de la eficacia de una intervención comunitaria en salud a través de un programa de estimulación cognitiva (PEC) implementada con el paso del tiempo en mayores con deterioro cognitivo leve en la comunidad. Diseño: Seguimiento de un ensayo controlado aleatorizado (normas grupo CONSORT). Emplazamiento: Centro de salud San José Norte-Centro y Fundación La Caridad (Zaragoza). Participantes: Veintinueve personas ≥ 65 años, con 24-27 puntos en el MEC-35 que completaron el ensayo a los 48 meses, 15 aleatorizados en el grupo intervención y 14 en el grupo control. Intervenciones: Se realizaron 10 sesiones, 45 min/semana, durante 10 semanas, con el cuaderno rojo de activación mental que ejercita: memoria, orientación, lenguaje, praxis, gnosis, cálculo, percepción, razonamiento lógico, atención y funciones ejecutivas. Mediciones principales: MEC-35, Set-test, Barthel, Lawton-Brody, subescala de ansiedad Goldberg y Yesavage abreviado (GDS-15). Resultados: Analizando los incrementos sobre el nivel basal para MEC-35, el grupo intervención obtiene, de media: postintervención 3,14 puntos, a los 6 meses 3,76 puntos y a los 12 meses 2,26 puntos más que el grupo control, siendo estos incrementos estadísticamente significativos. A los 48 meses el grupo intervención sigue obteniendo 2 puntos más que el control, sin ser significativos. La intervención no mejoró el desempeño en fluidez verbal, actividades de la vida diaria ni estado de ánimo. Conclusiones: Nuestro PEC podría ser eficaz en la mejora de la cognición general, medida con el MEC-35, en postintervención, a los 6, 12 y 48 meses. No se evidencian mejoras en fluidez verbal, actividades de la vida diaria ni estado de ánimo.Clinicaltrials.gov Identifier: NCT03831061. Abstract: Objective: To provide evidence about the efficacy of a community health intervention through a cognitive stimulation program at long term in older people with mild cognitive impairment. Design: Randomized controlled trial (CONSORT group norms). Location: San José Norte-Centro Primary Care Center and La Caridad Foundation (Zaragoza, Spain). Participants: Twenty-nine people over 65 years old with a 24-27 MEC score that completed 48 months follow up. They were randomized between the intervention group (15) and the control group (14). Interventions: The intervention was applied in 10 sessions of 45 min for 10 weeks using the red notebook tool for mental activation that works memory, orientation, language, praxis, gnosis, calculation, perception, logical reasoning, attention and executive functions. Main measurements: The main outcome variables were MEC-35, Set-test, Barthel index, Lawton-Brody scale, Goldberg anxiety scale and Yesavage geriatric depression scale short form. Results: Increases of the main result variable over the baseline level of MEC-35 were analyzed. On average, the intervention group obtained higher scores than control: 3.14 points post intervention, 3.76 points after 6 months and 2.26 points more than control group after 12 months. All the differences were statistically significant. After 48 months the intervention group obtained 2 points more than control group. The intervention did not improve verbal fluency, activity daily living and mood. Conclusions: Our cognitive stimulation program seems to improve cognitive performance, measured with the variable MEC-35 at post intervention, 6, 12 and 48 months. There is no evidence of improvement in verbal fluency, activity daily livings and mood.Clinicaltrials.gov Identifier: NCT03831061.