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Aim: This study examined the association of low handgrip strength (HGS) for falls in middle-aged adults and older adults every half-decade of life., Methods: This cross-sectional study was conducted using the public data from the first wave of the Brazilian Longitudinal Study of Aging (ELSI-Brazil). The participants were allocated into seven age groups 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, and ≥ 80 years. Binary logistic regression analysis was performed to identify the odds ratio (OR) of low HGS to the falls regardless of confounding variables such as sex, balance, gait speed, and total number of health conditions., Results: A total of 8,112 participants aged 50-105 years (median = 62.0 years): 3,490 males (median = 60.0 years) and 4,622 females (median = 63.0 years) attended the study. Altogether, 21.5% of participants experienced at least one fall. HGS gradually decreases over each half-decade of life. In addition, low HGS presented a significative OR (p < 0.05) for falls for age groups, until 80 s, even when considering confounding variables., Conclusions: Low HGS is associated with falls in middle-aged adults over their 50 s and remained a strong measure of falls across each subsequent half-decade of life, until 80 s., (© 2024. The Author(s).)

Objective: To verify the association between low self-reported sleep quality (LSQ) and fall in middle-aged and older adults every half-decade of life., Method: A cross-sectional study was conducted using data from the first wave (2015-2016) of the Brazilian Longitudinal Study of Aging (ELSI-Brazil), which is nationally representative. The sample consisted of 8,950 participants who were allocated into eight age groups: 50-54, 55-59, 60-64, 65-69, 70-74, 75-79, 80-84, and ≥ 85 years. The questionnaires used included self-reported sleep quality and the International Physical Activity Questionnaire short version. Fisher's exact test followed by binary logistic regression analysis was performed to identify the odds ratio of sleep quality for fall occurrence, controlled for confounding variables., Results: Individuals aged 50-105 years (63.6 ± 10.2 years), 57.0% females and 43.0% males, participated in this study. Overall, 21.5% of participants experienced at least one fall. The relative frequency of participants classified as having high or LSQ remained constant across each half-decade of life. The LSQ exhibited a statistically significant OR (p < 0.05) for falls across age groups up to 84, even after accounting for confounding variables., Conclusion: LSQ is significantly associated with an increased occurrence of fall in adults aged >50 years, but not for ≥ 85 years regardless of sex and physical activity level.

Background: There is a limited research on predictive models of fat mass ratio (FMR) in people living with human immunodeficiency virus (HIV) (PWH). This study aimed to develop models considering anthropometric and health-related factors to predict and validate FMR in PWH regardless of sex., Methods: One hundred and six Brazilian PWH (46.4±9.8 years) were evaluated for body composition using dual-energy X-ray absorptiometry (DXA), body circumference (BC), and skinfold thicknesses (SKs). FMR predictive models were developed using stepwise linear regression, and their agreement with DXA was assessed using Bland-Altman plots. Cross-validation was performed using the predicted residual error sum of squares (PRESS) method., Results: Six FMR estimation models were developed for PWH, with adjusted R 2 ranging from 0.43 to 0.72, standard error of the estimate (SEE) from 0.16% to 0.22%, and 95% confidence interval (CI) from 1.03 to 1.15. Model 6, including thigh SK, waist BC, therapy duration, subscapular SK, education years, and abdominal SK, exhibited the highest determination power (R 2 adjusted 0.72, SEE 0.16%, and 95% CI: 1.06-1.15). The agreement between DXA-based FMR and predictive models showed minimal bias (-0.03 to +0.04) and narrower limits of agreement, particularly for the top-performing model (-0.33 to +0.30). Model 6 exhibited a high adjusted Q 2 PRESS (0.70) and low SPRESS (0.17)., Conclusions: Our predictive models advance the study of body composition in PWH by consolidating the use of anthropometry for diagnosing and monitoring lipodystrophy regardless of sex., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://atm.amegroups.com/article/view/10.21037/atm-23-1946/coif). A.P.d.S. received a scholarship from the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) - (Finance Code 001, grant No. 88882.317622/2019-01), and from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) (grant No. 201126/2022-2). Additionally, the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (CAPES) will pay the article processing charges for this manuscript. The other authors have no conflicts of interest to declare., (2024 Annals of Translational Medicine. All rights reserved.)

This study investigated the associations of sarcopenic obesity (SO) with muscle strength and physical performance in sufficiently active older adults. Data from 72 older sarcopenic obese adults classified as sufficiently active were analyzed. Participants were categorized into four groups based on sex and SO status. Muscle strength/physical performance tests were compared using independent sample t-tests. Multiple linear regression and binary logistic regression were performed to examine the associations between SO and muscle strength and physical performance, adjusting for confounding variables. Only handgrip strength showed differences between SO groups, regardless of sex (p < 0.05). SO negatively explained the variability of handgrip strength (p < 0.05). An increase in handgrip strength values was associated with a decrease in the chances of older adults being classified as SO (p < 0.05). The findings suggest that even with SO, sufficiently active older adults did not present a significant reduction in muscle strength in the lower limbs and physical performance., (© 2024. The Author(s).)

Background: Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium., Methods: The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants., Conclusion: The BIA International Database represents a key resource for research on body composition., (© 2023. The Author(s), under exclusive licence to Springer Nature Limited.)

Regular physical activity is vital for the health and disease prevention of older adults. Outdoor fitness equipment has gained popularity for natural exercise spaces among middle-aged and older individuals. This narrative review demonstrates that these programs have the potential to improve cardiovascular health, muscle strength, flexibility, balance, and reduce falls, while also enhancing quality of life, alleviating depression and anxiety, and boosting self-esteem. However, our understanding is hindered by limited rigorous experimental studies. Future directions include implementing standardized measurements, conducting long-term studies, and addressing equipment limitations to enable better adjustment of training intensity and promote correct postures on machines. New, more rigorous research is needed to comprehensively understand the psychophysiological and social effects on health. Additionally, suggested modifications could render the machines more effective and safer. The primary objective is to enhance this type of machinery to encourage its use in outdoor spaces, thus aiding adults and older individuals in achieving overall health and enjoying a healthy aging process., Competing Interests: Declaration of competing interest The authors declare that they have no competing interests. The funders had no role in the design of the study; in the analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: Introduction: food type represents higher odds of having obesity (OB), especially in overweight (OW) subjects. Minimally and ultra-processed foods can be associated with the odds of having OB in OW subjects. Objective: to investigate the association of minimally and ultra-processed food consumption with OB in OW adults. Methods: we included 15,024 participants (9,618 OW [25.0-29.9 kg/m2], 5,406 OB [≥ 30 kg/m2]) with ages ranging from 18 to 59 years from the 2019 baseline survey of the Surveillance of Risk Factors and Protection for Chronic Diseases by Telephone Survey (VIGITEL, Brazil). Minimally and ultra-processed food daily consumption scores and confounding variables (age, sex, scholarly, physical activity, hypertension, and diabetes) were measured. Binary logistic regression analyzes the association of minimally and ultra-processed food consumption scores with OB (odds ratio [OR]). Results: minimally processed food consumption score quartiles (1st = 1[food-score/day]; 2nd = 6[food-score/day]; 3rd = 7[food-score/day]; 4th = 8[food-score/day]) presented higher values compared to ultra-processed food (1st = 1[food-score/day]; 2nd = 1[food-score/day]; 3rd = 2[food-score/day]; 4th = 4[food-score/day]). For each score of minimally processed food consumed, there was a -5.9 % odds of OB. Thus, the higher quartile (4th) of minimally processed food consumption score represents less odds of OB (OR: -47.2 %; p < 0.001). Each ultra-processed food score consumed presented odds of 3.7 % of OB. Therefore, higher consumption of ultra-processed food (4th quartile) shows higher odds of OB (OR: +14.8 %; p < 0.001). All associations remained significatively even after being adjusted by the confounders. Conclusion: the consumption scores of minimally processed and ultra-processed foods presented a magnitude capable of impacting OW adults' odds of OB, even when controlled by sociodemographic factors, physical activity, hypertension, and diabetes.

Background: Handgrip strength (HGS) is a well-established clinical biomarker that assesses functional capacity in older populations. In addition, HGS is a diagnostic tool that forecasts aging health conditions, such as sarcopenia., Aims: This paper provides HGS statistical tolerance regions and presents the need to establish HGS reference values according to patients' characteristics., Methods: For this purpose, we used a conditional tolerance algorithm for HGS, and we observed the tolerances regions in different age strata and sex of non-sarcopenic individuals from the National Health and Nutrition Examination Survey (NHANES, wave 2011-2012)., Results and Discussion: Our results have critical implications for sarcopenia, since conventional and available HGS cut-offs do not consider age range., Conclusions: This paper offers new perspectives on the evolution of traditional definitions of sarcopenia according to the principles of precision medicine., (© 2023. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Sarcopenic obesity (SO) is a clinical and functional disease characterized by the coexistence of obesity and sarcopenia. Resistance training (RT) characteristics for older adults with sarcopenia or obesity are already well established in the scientific literature. Nonetheless, we still do not know how detailed the RT protocols are described for older adults with SO. Therefore, we aimed to analyze the characteristics of RT programs, including each of their variables, recommended for older adults with SO., Methods: This is a scoping review study that was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews. The search was carried out until November 2022 in PubMed/MEDLINE, EMBASE, Cochrane Library, Web of Science, Scopus, LILACS, Google Scholar, and medRxiv databases. The studies included SO diagnosis and RT as an intervention strategy. The RT variables analyzed were as follows: exercise selection, the volume of sets, the intensity of load, repetition cadence, rest interval between sets, and weekly frequency., Results: A total of 1,693 studies were identified. After applying the exclusion criteria, 15 studies were included in the final analysis. The duration of the RT intervention ranged from 8 to 24 weeks. All studies included full-body routines, with single/multi-joint exercises. Regarding the volume of sets, some studies fixed it in three sets, whereas others varied between one and three sets. The load was reported by repetition range and the weight lifted, elastic-band color/resistance, percentage of one repetition maximum, or perceived exertion scale. Repetition cadence was fixed in some studies, while it was self-selected between concentric and eccentric phases in others. The interval between sets of rest varied from 30 to 180 s. All studies reported progression overload during the interventions. Not all studies reported how the exercise selection, repetition cadence, and rest interval were made., Conclusion: The characteristics of RT protocols and their variables prescribed in the literature for older adults with SO were mapped. The lack of detail on some training variables (i.e., exercise selection, repetition cadence, and rest interval) was identified. RT protocols are heterogeneous and described only partially among studies. The recommendations for RT prescription details in older adults with SO are provided for future studies., Systematic Review Registration: https://osf.io/wzk3d/., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Silva, Gonçalves, Abdalla, Benjamim, Tasinafo, Venturini, Bohn, Mota, Marcos-Pardo, Kemmler, dos Santos and Machado.)

Abstract: People living with HIV (PWH) experience an accelerated aging process. There is no anthropometric predictive model for appendicular skeletal muscle mass (ASM) in PWH. This study develops anthropometric models to predict and validate ASM measured by dual energy x-ray absorptiometry (DXA) in PWH; DXA scans were obtained for 125 PWH (male = 74; age >18 years) on antiretroviral therapy. Fat mass ratio was used for lipodystrophy diagnosis. A multiple stepwise linear regression considered ASM DXA as the dependent variable and validated by PRESS method. A high power of determination and low standard estimate error were found for ASM DXA -predicted (adjusted r2 = 0.84 to 0.87, standard estimate error = 1.7-1.6 kg) and high PRESS validation coefficients (Q 2PRESS = 0.84-0.86, S PRESS = 1.7-1.6 kg). The variables included were lipodystrophy diagnosis, medial calf circumference, sex, and total body weight. We present novel, reliable, and validated anthropometric models to predict ASM DXA in PWH., (Copyright © 2023 Association of Nurses in AIDS Care.)

Background: Handgrip strength (HGS) asymmetry is associated with slow gait speed. Both mark muscle dysfunction, potential risk of falls, and adverse health outcomes. This association was found in older adults from high-income countries, but not yet studied in low- and middle-income countries. Moreover, there is no HGS asymmetry referential to identify the disabling process. Thus, our study aims to verify the association of HGS asymmetry with slowness in older adults from six low- and middle-income countries and to propose cut points to slowness., Methods: A cross-sectional study with data from 12,669 older adults (≥60 years) of the Study on Global Aging and Adult Health (SAGE) conducted in six low- and middle-income countries were analyzed. Based in the difference between upper body sides HGS (asymmetry), participants were categorized in groups as 0.0-10.0% (reference group), 10.1-20.1%, 20.1-30.0% or >30.0%. Slow gait speed was established as <0.59 (men) and <0.51 (women) m/s. Associations of HGS asymmetry with gait speed were ascertained with logistic regression. HGS asymmetry index "[(HGS asymmetry*HGS)/(BMI*Age)]*100" cut points to identify slowness were generated with the ROC curve and Youden index (α = 5%)., Results: Compared to HGS reference group, those with HGS asymmetry of 10.1-20%, 20.1-30.0% and >30.0% had a superior odds for slowness [1.18(CI:1.02,1.42); 1.17(CI: 0.97; 1.44); and 1.21(CI:1.03;1.43), respectively]. HGS asymmetry index cut points to identify slowness were ≤1.14 (women) and ≤1.77 (men)., Conclusions: HGS asymmetry association with slowness is present in economically disadvantaged countries. We proposed a new index for impaired muscle function with acceptable sensibility and specificity., Competing Interests: Declaration of Competing Interest None. All authors declare that they have no conflict of interest., (Copyright © 2022. Published by Elsevier B.V.)

Background: During aging, changes occur in the proportions of muscle, fat, and bone. Body composition (BC) alterations have a great impact on health, quality of life, and functional capacity. Several equations to predict BC using anthropometric measurements have been developed from a bi-compartmental (2-C) approach that determines only fat mass (FM) and fat-free mass (FFM). However, these models have several limitations, when considering constant density, progressive bone demineralization, and changes in the hydration of the FFM, as typical changes during senescence. Thus, the main purpose of this study was to propose and validate a new multi-compartmental anthropometric model to predict fat, bone, and musculature components in older adults of both sexes., Methods: This cross-sectional study included 100 older adults of both sexes. To determine the dependent variables (fat mass [FM], bone mineral content [BMC], and appendicular lean soft tissue [ALST]) whole total and regional dual-energy X-ray absorptiometry (DXA) body scans were performed. Twenty-nine anthropometric measures and sex were appointed as independent variables. Models were developed through multivariate linear regression. Finally, the predicted residual error sum of squares (PRESS) statistic was used to measure the effectiveness of the predicted value for each dependent variable., Results: An equation was developed to simultaneously predict FM, BMC, and ALST from only four variables: weight, half-arm span (HAS), triceps skinfold (TriSK), and sex. This model showed high coefficients of determination and low estimation errors (FM: R 2 adj : 0.83 and SEE: 3.16; BMC: R 2 adj : 0.61 and SEE: 0.30; ALST: R 2 adj : 0.85 and SEE: 1.65)., Conclusion: The equations provide a reliable, practical, and low-cost instrument to monitor changes in body components during the aging process. The internal cross-validation method PRESS presented sufficient reliability in the model as an inexpensive alternative for clinical field use., (© 2023. The Author(s).)

Introduction: The time spent in different physical activity (PA) intensities is associated with sarcopenia risk for community-dwelling older women., Aim: To evaluate the role of sitting time and physical activity (PA) level as predictors of sarcopenia odds., Methods: In a cross-sectional study, physically independent older women (n = 67) performed the six-minute walk test to identify functional limitation (≤ 400 m). Sedentary time (as sitting time) and PA (light, moderate and vigorous) were obtained with the International Physical Activity Questionnaire (IPAQ). Sarcopenia was diagnosed as recommended by the Society of Sarcopenia, Cachexia and Wasting Disorders (SCWD). Sarcopenia odds (low muscle mass and functional limitation) was predicted by binary logistic regression, considering the weekly sitting time and PA as independent variables., Results: Sarcopenia prevalence was 7.5% (n = 5), with functional limitation present in 38.8% (n = 26), and low muscle mass in 22.4% (n = 15). The predictive model (p = 0.014) involved moderate PA as the only significant predictor (OR = 0.999; p = 0.005; 95% CI: 0.998-1.000) of functional limitation. Moderate PA prevents sarcopenia odds. Each weekly hour of moderate PA decreased sarcopenia odds by 6%., Conclusion: Time spent in moderate PA can prevent sarcopenia., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: The risk of falling increases with neuromusculoskeletal and cognitive changes resulting from aging. Physical exercise shows beneficial effects on the risk of falling, but the results are unknown when associated with cognitive activity dual-task (DT)., Objective: The objective of the study was to evaluate the impacts of the Otago Exercise Program (OEP) plus DT cognitive activity on the risk of falling in older adults., Methods: 36 older adults (83.5 ± 5.7 years) participated in a quasi-experimental study, distributed in two experimental groups and a control group: 1) OEP (OEPG; n=12), 2) OEP plus DT (OEPDTG; n = 12), and a control group (CG; n=12). Older adults were evaluated at pre- and post- 12 weeks of intervention. The thresholds for the risk of falling were considered as multiparameter scores of the 10 Meter Walking Test (10MWT), evocative 10MWT, Timed Up and Go (TUG), Sit to Stand Test (STS), and The Four-Stage Balance Test (Four-Stage), and the Montreal Cognitive Assessment (MoCA), to test the cognitive impairment., Results: At baseline, all groups were homogeneous. Post-intervention, the experimental groups presented significant functional differences, in comparison to the CG, for 10MWT (OEPDTG: p= 0.002; OEPG: p= 0.002); evocative 10MWT (OEPDTG: p=0.001; OEPG: p=0.001); TUG (OEPDTG: p=0.034); STS (OEPDTG: p<0.001; OEPG: p<0.001) and cognitive for MoCA (OEPDTG: p<0.019). Significant intra-group differences (pre-post) were observed in all intervention groups, but none in CG. The risk of falling (Four-Stage) in experimental groups (OEPDTG: 33.3%; OEPG: 41.7%) was considerably lower than CG (83.3%)., Conclusion: Otago Exercise Program alone can reduce the risk of falling due to improved functionality, but adding the dual task also improves cognitive capacity in older adults. The clinical significance of these interventions goes beyond statistics., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

The regular practice of physical activity helps in the prevention and control of several non-communicable diseases. However, evidence on the role of physical activity in mitigating worsening clinical outcomes in people with COVID-19 is still unclear. The aim of this study was to verify whether different levels of physical activity provide protection for clinical outcomes caused by SARS-CoV-2 infection. A cross-sectional study was conducted with 509 adults (43.8 ± 15.71 years; 61.1% female) with a positive diagnosis of COVID-19 residing in Ribeirão Preto, São Paulo, Brazil. Participants were interviewed by telephone to determine the severity of the infection and the physical activity performed. Binary logistic regression was used to indicate the odds ratio (OR) of active people reporting less harmful clinical outcomes from COVID-19. Active people had a lower chance of hospitalization, fewer hospitalization days, less respiratory difficulty and needed less oxygen support. The results suggest that active people, compared to sedentary people, have a lower frequency of hospitalization, length of stay, breathing difficulty and need for oxygen support. These results corroborate the importance of public policies to promote the practice of physical activity, in order to mitigate the severity of the clinical outcomes of COVID-19.

People living with HIV (PWH) experience an accelerated reduction in bone mineral content (BMC), and a high risk of osteopenia and osteoporosis. Anthropometry is an accurate and low-cost method that can be used to monitor changes in body composition in PWH. To date, no studies have used anthropometry to estimate BMC in PWH. To propose and validate sex-specific anthropometric models to predict BMC in PWH. This cross-sectional study enrolled 104 PWH (64 males) aged >18 years at a local university hospital. BMC was measured using dual energy X-ray absorptiometry (DXA). Anthropometric measures were collected. We used linear regression analysis to generate the models. Cross-validations were conducted using the "leave one out", from the predicted residual error sum of squares (PRESS) method. Bland-Altman plots were used to explore distributions of errors. We proposed models with high coefficient of determination and reduced standard error of estimate for males (r 2 = 0.70; SEE = 199.97 g; Q 2 PRESS = 0.67; SEE PRESS = 208.65 g) and females (r 2 = 0.65; SEE = 220.96 g; Q 2 PRESS = 0.62; SEE PRESS = 221.90 g). Our anthropometric predictive models for BMC are valid, practical, and a low-cost alternative to monitoring bone health in PWH.

Background: Identifying muscle weakness is challenging, because the reduction of strength with aging does not depend only on sarcopenia, but also on sensorimotor deficits. Nevertheless, this identification is improved by adjusting muscle strength allometrically, by removing the influence of body size. However, the effectiveness of foreign models to normalize these (dys)functionalities is not yet tested. This study aimed to compare and apply foreign allometric exponents for normalizing isokinetic knee extension strength in Portuguese older adults to identify muscle weakness/mobility limitation. Additionally, to attest any populational difference, data of these people and Brazilian older adults were compared METHODS: This is a cross-sectional study encompassing 226 Portuguese (n = 132) and Brazilian (n = 94) older adults. Mobility limitation (six-minute walk test, at lowest quartile), lower limb strength (knee extension isokinetic strength at 60º/s), and body dimensions measures were taken. Foreign allometric exponents ( b ) were used to normalize Portuguese strength (strength/body-size variables b ). Non-normalized and normalized strength were compared (ROC) to generate the most accurate cut-point for identifying muscle weakness/mobility limitation., Results: Older Portuguese men and women had better mobility than their Brazilian counterparts. Older Portuguese women had superior muscle strength to Brazilian women. Normalization from 11 foreign models removed the influence of body size on muscle strength, with a negligible correlation (r ≤ 0.30). In contrast to the non-normalized strength, the normalized strength cut-off points were sufficiently accurate (AUC ≥ 0.70) to avoid identifying false-negative cases of weakness/mobility limitation., Conclusions: Portuguese older women were stronger and had superior functional capacity compared to Brazilian ones. Normalized foreign models improved the accuracy in identifying muscle weakness/mobility limitation in Portuguese older adults. The isokinetic knee extension muscle strength normalized, even using foreign allometric exponents, should be better than no adjustment., (© 2022. The Author(s).)

Background: To verify (1) the association between classic and specific bioelectrical impedance vector analysis (BIVA) with body composition, hydration, and physical performance in older adults with and without sarcopenia; (2) which BIVA most accurately distinguishes sarcopenia., Methods: A sample of 94 older adults with and without sarcopenia (29 men and 65 women, 60-85 years) was evaluated. The classic and specific BIVA procedures, Dual energy X-ray absorptiometry (DXA), and deuterium dilution were performed. Sarcopenia was defined by muscle weakness and low skeletal muscle index, while severity was indicated by low physical performance., Results: The BIVA's potential to monitor hydration and muscle mass loss in older adults seems feasible. Classic and specific BIVA were able to distinguish sarcopenia in women (p < 0.001), but not in men. When the sarcopenia criteria were individually analyzed, both classic and specific BIVA were able to distinguish low skeletal muscle index in women, while only classic BIVA did for men. For the criterion of slow physical performance, only the classic BIVA showed severity differences for women. The vectors of adults without sarcopenia of both sexes tended to be positioned in the left region of the ellipses, revealing a predominance of soft tissues., Conclusions: Classic BIVA has a distinct sarcopenic association with body composition, hydration, and physical performance in older adults, while specific BIVA was similar between groups. Both BIVAs are sensible to detect female morphological changes (skeletal muscle index) but not for functional (handgrip, 6-min walk test) sarcopenia criteria. These procedures are promising tools for monitoring sarcopenia risks during aging., (© 2022. The Author(s).)

Objectives: Absolute handgrip strength and adjusted by body mass index are useful to identify age-related conditions. However, these values are not accurate for older adults with extreme body size because of the nonlinear relationship between strength, height, and body mass. The purpose of this study was to determine cut-off points for age-related conditions of older adults using allometric coefficients to normalize grip strength by body size., Design: Cross-sectional study., Setting and Participants: Data from 13,235 older adults of Study on Global Aging and Adult Health conducted in 6 low- and middle-income countries were analyzed., Methods: Country- and sex-specific allometric exponents for body-size variables (mass and height) were computed with log-linear models. Partial correlation verified whether allometric normalization removed the effect of body size on grip strength. Cut-off points were established (<20th percentile) for low allometrically adjusted grip strength., Results: Allometric exponents for normalization of grip strength were provided for body-size variables, ranging from 0.19 to 2.45. Allometric normalization removed the effect of body size on grip strength (r < 0.30). Overall, frequencies of low muscle strength were overestimated with international criteria (absolute grip strength) compared with the cut-off points proposed in this study., Conclusions and Implications: The proposed allometric exponents normalized grip strength according to body-size variables. These exponents improved the accuracy in identifying age-related conditions in older adults with extreme body size. The variability between strength reveals the need for developing specific cut-off points for low- and middle-income countries. New cut-off points of low normalized grip strength with automatized applicability were proposed for health care providers use in clinical practice., (Copyright © 2022 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.)

This study examined the potential impact of BMI on physical function and lower-extremity muscle strength (leg extension and flexion peak torque) performance in active/trained older individuals. Sixty-four active/trained older individuals were enrolled, and later allocated to groups according to BMI categories (normal [≤ 24.9 kg/m 2 ], overweight [25 to 29.9 kg/m 2 ] and obese [≥ 30 kg/m 2 ]). Sixty-four active/trained older individuals were enrolled, and later allocated to groups according to BMI categories (normal [≤ 24.9 kg/m 2 ], overweight [25 to 29.9 kg/m 2 ] and obese [≥ 30 kg/m 2 ]). Assessments were conducted in two separate visits to the laboratory. In the first visit, participants underwent measures of height, body mass, and peak torque leg extension and flexion using an isokinetic dynamometer. On visit two, participants performed the 30-second Sit and Stand test (30SST), Timed Up and Go (TUG), and 6-minute Walk (6MW) tests. ANOVA one-way was used to analyze the data and significance was set at P < .05. One-way ANOVAs did not reveal significance differences among BMI categories for leg extension peak torque ( F (2,61) = 1.11; P = 0.336), leg flexion peak torque ( F (2,61) = 1.22; P = 0.303), 30SST ( F (2,61) =1.28; P = 0.285), TUG ( F (2,61) = 0.238; P = 0.789), and 6MW ( F (2,61) = 2.52; P = 0.089)]. Our findings indicated that for older individuals who exercise regularly, physical function tests which mimic ordinary activities of daily living, are not impacted by BMI status. Thus, being physically active may counteract some of the negative effects of high BMI observed in the older adult population.

Background: Although home confinement reduces the number of SARS-CoV-2 infections, it may negatively impact the psychological and physical health of older adults., Objective: The present study attempted to describe the quality of life (QoL) of older adults before and during the COVID-19 outbreak, focusing on evaluating QoL, physical activity, sitting time, and sleep quality during home confinement., Methods: The present study was conducted in 1,063 older adults (91 % females) enrolled in a Brazilian social program. They were interviewed for QoL (EQ-5D), physical activity (international physical activity questionnaire-short), and sleep quality [Pittsburgh sleep quality index (PSQI)] after 11.6 ± 2.4 weeks of confinement. Logistic regression confirmed changes in QoL., Results: The QoL (86.5 ± 14.7) decreased significantly during confinement (66.0 ± 21.0; P < 0.001), whereas the PSQI global score was 6.8 ± 3.9 points. Older adults spent 18.7 ± 29.8 min/day in moderate to vigorous physical activity, whereas they spent 325.5 ± 144.4 min/day sitting. The PSQI global score [odds ratio (OR): 1.10], sitting time (OR: 1.001), and diseases (OR: 1.23) were significantly associated with low QoL (P < 0.05)., Conclusion: Confinement has a deleterious effect on QoL, which is influenced by quality of sleep, sitting time, and disease. Awareness regarding the significance of sleep and physical exercise in older adults can mitigate the damage to their health during confinement., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: To propose cut-off points for older adults' weakness for upper and lower limbs muscle strength normalized by body size with the ratio standard/muscle quality and allometric scaling., Methods: Ninety-four community-dwelling older adults (69.1% women) were assessed for 49 body-size variables (anthropometry, body composition and body indexes), handgrip strength (HGS), one maximum repetition measurement for knee extensors (1RM), isokinetic knee extension peak torque at 60°/s (PT), and six-minute walk test (6MWT). Ratio standard or muscle quality (muscle strength/body size) and allometric scaling (muscle strength/body size b ; when b is the allometric exponent) were applied for body-size variables significantly correlated with HGS, 1RM and PT. Cut-off points were computed according to sex based on mobility limitation (6MWT < 400 m) with ROC curve and Youden index., Results: Absolute HGS, 1RM and PT cut-off points were not adequate because they were associated with body size (r > 0.30). But it was corrected with muscle strength normalization according to body size-variables: HGS (n = 1); 1RM (n = 24) and PT (n = 24). The best cut-off points, with the highest area under the curve (AUC), were found after normalization for men: HGS/forearm circumference (1.33 kg/cm, AUC = 0.74), 1RM/triceps skinfold (4.22 kg/mm, AUC = 0.81), and PT/body mass*height 0.43 (13.0 Nm/kg*m 0.43 , AUC = 0.94); and for women: HGS/forearm circumference (1.04 kg/cm, AUC = 0.70), 1RM/body mass (0.54 kg/kg, AUC = 0.76); and PT/body mass 0.72 (3.14 Nm/kg 0.72 ; AUC = 0.82)., Conclusions: Upper and lower limbs muscle weakness cut-off points standardized according to body size were proposed for older adults of both sexes. Normalization removes the effect of extreme body size on muscle strength (both sexes) and improves the accuracy to identify weakness at population level (for women, but not in men), reducing the risk of false-negative/positive cases., (© 2021. The Author(s).)

Reduced levels of children's physical activity (PA) and fundamental motor skills (FMS) along with increased sedentary behaviors have been observed in recent years. Yet, associations between these variables are not yet well established. This study aimed to observe the associations between FMS, PA and sedentary time in elementary school children. We evaluated 148 children (70 boys; M age  = 8.7, SD  = 1.4 years old) from a private school using the Test of Gross Motor Development - Second Edition (TGMD-2) to measure FMS and examine locomotor, object control, and gross motor skills. We used accelerometry to measure PA performed on weekdays, weekends and total PA. We used descriptive statistics, partial correlations controlling for sex and age, and linear regression adjusted for sex and equivalent motor age to explain the relationships. Total moderate to vigorous PA (MVPA) (β: 0.153; p  = .009) and weekend MVPA (β: 0.171; p  = .003) were significantly associated with FMS, regardless of gender and equivalent motor age. Sedentary time was not significantly associated with FMS ( p  = .065). Girls and boys who met PA recommendations (≥60 minutes/day of moderate to vigorous PA) had higher frequencies of high ratings on the TGMD-2 ( p  < .001 e p  = .001, respectively). MVPA was associated with children's FMS development, possibly affecting the quality of movement performed in children's daily lives.

Introduction: Introduction: functional limitation is a result of sarcopenia and is associated with loss of skeletal muscle mass (SMM). Cost-effective methods are important for the identification of sarcopenia. Objective: to propose cutoff points for normalized calf circumference (CC) in order to identify low SMM in older women based on their functional limitation. Methods: in this descriptive, cross-sectional study the CC values of a young female sample (n = 78) were used to establish cutoff points (-2 SD) for low SMM in older women (n = 67). Functional limitation was identified by the six-minute walk test (≤ 400 m). CC was normalized by body mass, height, and BMI. The diagnostic accuracy of CC was calculated with a ROC curve, using functional limitation as standard. Results: cutoff points and area under the curve (AUC) were: CC (≤ 28.5; 0.62); CC·body mass-1 (≤ 0.40; 0.63); CC·height-2 (≤ 8.52; 0.55) and CC·BMI-1 (≤ 1.10; 0.73). Only CC·BMI-1 achieved a desirable accuracy (AUC > 0.7) to distinguish functional limitation. Conclusion: the accuracy attained supports the use of CC·BMI-1 to identify low SMM in older women. In the clinical context it is possible to predict the risk of sarcopenia when sophisticated methods for determining SMM are not available.

Objective: To qualify a 3C approach model of dual-energy X-ray absorptiometry (DXA) to estimate multicomponent resting energy expenditure (REE) referenced by indirect calorimetry (IC)., Methods: A sample of 155 college students, of both sexes (18-30 years old) was evaluated. Anthropometric measures, REE by IC, and whole-body DXA-scans were performed. The REE for each body component was determined after transforming the components from the molecular (DXA) to the organ tissue level. Bland-Altman and proportional bias analyses were used to verify agreement between REE measured (REE IC ) and estimated (REE DXA )., Results: Statistically significant differences were found for all sex comparisons (P < .001), except for age (P = .950). Differences from the final sex-specific models' were not found between REE IC and REE DXA (P > .05). Men also presented greater expenditure (P < .001) in each component, except for adipose tissue. The plots confirmed the validity of the model for both sexes, with low difference values between the measured and estimated REE. The mean of the differences of REE IC and REE DXA showed heteroscedasticity of the data for men (P = .004). The same error tendency was not evident for women (P = .333)., Conclusions: This 3C model, estimating REE from a multicomponent approach, allows a new application of DXA as tool for understanding intraindividual differences in terms of the mass of metabolically active tissue. Sex and populational differences should be taken in account. Consequently, we present qualified sex-specific DXA models that can be applied in different contexts such as health and sports, besides considering interpersonal differences in terms of energy expenditure., (© 2020 Wiley Periodicals LLC.)

The aim of the study was to compare the impact of 12-week resistance training with blood flow restriction (G RTBFR ) versus, traditional resistance training (G TRT ) and non-training on the muscle strength and body composition HIV/AIDS participants. Muscle strength was tested at baseline, and on the 6th, 21st and 36th training sessions, using maximal repetition test. Pre- and post-intervention body composition changes were measured by dual-energy X-ray absorptiometry. Resistance training was undertaken three times a week comprising bilateral elbow extension and flexion exercises, unilateral flexion and bilateral knee extension. Changes in strength and body composition (pre- and post-intervention) between groups were evaluated by mixed models of repeated measures, and by paired and unpaired comparisons, considering the Effect Size. All groups were similar at baseline for muscle strength and body composition. Post-intervention, the training groups showed similar, statistically significant increases in muscle strength (G RTBFR =25.7-57.4%; G TRT= 24.5-52.3%) and skeletal muscle tissue (G RTBFR =8.4%; G TRT =8.3%). There was also a significant change in body fat ( p =0.023-0.043), with significant effect sizes for strength and skeletal muscle tissue (0.41-2.27), respectively. These results suggest that both resistance training interventions promoted muscle hypertrophy, body fat reduction and positive impact on muscle strength in people living with HIV/AIDS. Resistance training with blood flow restriction proved to be an effective alternative to include patients with marked physical weakness, unable to engage in regular strength training programme.ClinicalTrials.gov identifier: NCT02783417.

Objective: To evaluate the influence of strength exercises on remote pain sensitivity in women with endometriosis-related symptoms., Design: A quasi-experimental study., Setting: University Hospital, a tertiary health unit., Subjects: Twenty-one women with endometriosis-related symptoms and 21 healthy women provided written informed consent., Methods: The participants performed weekly exercise sessions on an extensor chair for four consecutive weeks. An electronic algometer was used to measure the pressure pain thresholds on the nondominant forearm. Heart rate and blood pressure were measured using a digital device. All measurements were taken before, immediately after, and 10 and 20 minutes after the exercise series., Results: Women with endometriosis-related symptoms had lower pain thresholds. Pressure pain thresholds increased immediately after exercise in healthy women, returning to baseline level 20 minutes after exercise. Women with endometriosis-related symptoms did not present significant pressure pain threshold alterations after exercise. However, they had a higher heart rate and systolic, diastolic, and average blood pressure than healthy women at all the timepoints. There were no consistent correlations between pressure pain thresholds and heart rate or blood pressure., Conclusions: The strength exercise regimen used in this study increased pain thresholds in healthy women but not in women with endometriosis-related painful symptoms. The maintenance or even worsening of pain perception after exercise in women with persistent pain, such as those with endometriosis, may limit their adherence to a physical training program, which in turn could prevent them from experiencing the long-term beneficial effects of exercise., (© The Author(s) 2020. Published by Oxford University Press on behalf of the American Academy of Pain Medicine.All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Introduction: Introduction: the estimation of appendicular lean soft tissue by DXA (ALSTDXA) is one of the criteria for the diagnosis of sarcopenia. However, this method is expensive and not readily avaiable in clinical practice. Anthropometric equations are low-cost and able to accurate predict ALST, but such equations have not been validated for male Brazilian older adults between the ages of 60 to 79 years. To this end, this study sought to validate the existing predictive anthropometric equations for ALST, and to verify its accuracy for the diagnosis of sarcopenia in male Brazilian older adults. Methods: this cross-sectional study recruited and enrolled 25 male older adults (69.3 ± 5.60 years). ALSTDXA and anthropometric measures were determined. ALST estimations with 13 equations were compared to ALSTDXA. The validity of the equations was established when: p > 0.05 (paired t-test); standard error of the estimate (SEE) < 3.5 kg; and coefficient of determination r² > 0.70. Results: two Indian equations met the criteria (Kulkarini 1: 22.19 ± 3.41 kg; p = 0.134; r² = 0.78; EPE = 1.3 kg. Kulkarini 3: 22.14 ± 3.52 kg; p = 0.135; r² = 0.82; SEE = 1.2 kg). However, these equations presented an average bias (Bland-Altman: 0.54 and 0.48 kg) and 'false negative' classification for the ALST index. Thus, three explanatory equations were developed. The most accurate equation demonstrated a high level of agreement (r2adj = 0.87) and validity (r²PRESS = 0.83), a low predictive error (SEEPRESS = 1.53 kg), and an adequate ALST classification. Conclusion: anthropometric models for predicting ALST are valid alternatives for the diagnosis and monitoring of sarcopenia in older adults; however, population specificity affects predictive validity, with risks of false positive/negative misclassification.

Purpose: Handgrip strength used to identify sarcopenia is not representative of overall strength, especially as greater muscle volume and consequent autonomy-mobility are concentrated in the lower limbs. While absolute strength or relative to body mass is used to define sarcopenia, this relationship is not always linear. The aim of this study was to establish allometrically adjusted cut-off points of lower limb (quadriceps) muscle strength to identify sarcopenia risk in older adults., Methods: ninety-four physically independent individuals over the age of 60 were measured by DXA and sarcopenia was identified. The one-repetition maximum (1RM) test of knee extension strength was estimated using the extensor chair by the submaximal repetition protocol. The six-minute walk test performance was recorded. 1RM values were scaled by body mass (1RM/body mass) and allometrically adjusted (1RM/body mass b ). Cut-off points for sarcopenia from 1RM were defined with ROC curve and Youden index with functional limitation (walking distance<400 m). Analyzes considered sex (α = 5%)., Results: Sarcopenia was present in 10.6 % of participants. The exponents b obtained were 0.70 for women and 0.96 for men. Except for absolute 1RM in women, all areas under the curve were acceptable (>0.70). The cut-off points for women and men were respectively, 38.1 and 56.1 kg for 1RM, 0.53 and 0.85 for 1RM/body mass, 1.48 and 1.00 for 1RM/body mass b ., Conclusions: 1RM of knee extension scaled by body mass or allometrically adjusted is an effective parameter to identify sarcopenia in older adults. The proposed cut-off points could be used to monitor sarcopenia risk in geriatrics., Competing Interests: Declaration of Competing Interest None. All authors declare that they have no conflict of interest., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Background: Dynamic knee extensor muscle strength is a valid measure among healthy older adults but has not been tested in the sarcopenia condition. This study's objective was to test the validity of a one-repetition submaximal strength protocol to measure dynamic knee extension strength in older adults with and without sarcopenia., Methods: Ninety-four physically independent older adults (female: n  = 64, 60 to 85 years; male: n  = 29, 60 to 85 years) participated in this study in Brazil during 2016-2017. Sarcopenia was classified and isokinetic unilateral knee extension strength was measured at 60°/s. Bilateral dynamic knee extension strength was estimated with an extensor chair using one-repetition submaximal protocol. Validity was determined using Spearman's correlation with isokinetic muscle strength., Results: The frequency of sarcopenia was 11.7%. Sarcopenic individuals presented lower body mass, body mass index and skeletal muscle index. Only chronological age was higher among the sarcopenic individuals. A high correlation was found between isokinetic unilateral knee extension strength and bilateral estimated one-repetition with submaximal protocol (r = 0.74; p  <  0.001), when the presence (r = 0.71; p  = 0.014) and absence of sarcopenia (r = 0.74; p <  0.001) were considered. The validity of the one-repetition submaximal protocol for bilateral knee extension was confirmed., Conclusions: The estimated measure of bilateral knee extension muscle strength can be used to monitor adaptations promoted by physical exercise for older adults with and without sarcopenia. The validation enable studies that will propose cutoff points to identify sarcopenia with this submaximal protocol. This will enable early diagnosis and better management of sarcopenia, a disease with adverse impacts for older adults., Competing Interests: Competing interestsThe authors declare that they have no competing interests., (© The Author(s) 2020.)

Introduction: Introduction: appropriate appendicular lean soft tissue (ALST) parameters to identify sarcopenia in Brazil are scarce. The use of international references may lead to a false positive diagnosis. The objective was to propose cut-off points to identify sarcopenia in older men and women using DXA-derived ALST values from a young adult population. Methods: this was an observational study with a cross-sectional analysis. University students of both sexes (n = 125), aged 20 to 30 years, underwent anthropometric measurements and DXA scanning to obtain their ALST (kg). Cut-off points for sarcopenia were set at -2 standard deviations (-2SDs) away from the mean ALST of a young sample. Absolute values and indices (ALST/height2, ALST/weight, and ALST/body mass index [BMI]) were considered as recommended by international consensus. Results: compared to women, men presented higher values of weight, height, BMI, bone mineral content, lean soft tissue, ALST, and ALST index (kg/m²). Only fat mass was higher in women, and age was not different between genders. The -2SD ALST indices obtained were ≤ 6.56 kg/m² for men and ≤ 4.67 kg/m² for women. They were below international and national values, which tended to classify false positives. Conclusions: the -2SD ALST values proposed here are validated cut-offs for identifying low muscle in older adults and to prevent misdiagnosis with sarcopenia. In addition, they contribute to efficient monitoring and control of this disease in geriatric populations.

Background: The aim of the study was to examine the contribution of chronological age (CA), skeletal maturation, training experience and concurrent body size descriptors, to inter-individual variance in left ventricular mass (LVM) among female adolescent soccer players., Methods: The sample included 228 female soccer players 11.8-17.1 years. Training experience defined as years of participation in competitive soccer (range 2-9 years), was obtained by interview. Stature, body mass and skinfolds (triceps, medial calf) were measured. Fat mass was estimated; Fat-free mass was derived. LVM was assessed by echocardiography. Skeletal maturity status was as the difference of skeletal age (SA, Fels method) minus CA., Results: Fat-free mass was the most prominent single predictor of LVM (R 2  = 36.6%). It was associated with an allometric coefficient close to linearity (k = 0.924, 95%CI: 0.737 to 1.112). A significant multiplicative allometric model including body mass, fat-free mass, CA, training experience and skeletal maturity status was also obtained (R = 0.684; R 2  = 46.2%)., Conclusion: Stature has limitations as a valid size descriptor of LVM. Body mass, fat-free mass, training experience, CA, body mass and skeletal maturity status were relevant factors contributing to inter-individual variability in LVM.

Background: In the pubertal period, each part of the body grows at different rates. This makes the relationship between the parts nonlinear. Particularly, the fat mass (FM) of boys tends to decrease, further exacerbating the issue of linearity in growth. Aim: To propose predictive models of FM from skinfolds (SF) adjusted allometrically. Subjects and methods: 75 pubertal boys (14.4 ± 0.9 years) composed the sample by self-selected pubic hair. FM was determined by DXA (FM DXA ) (kg), stature (cm), body mass (kg) and nine SF (mm) by anthropometric measurements. The SF were individually adjusted allometrically. FM DXA ( Y ) values and each anthropometric independent variable-IV ( X ) underwent logarithmic transformation. Linear regressions were used. The significance of the prediction of the FM DXA of each model (ANOVA) and the concordance analysis (Bland-Altman) were performed. Results: Predictive allometric models of FM DXA showed high determination coefficients ( r 2 ) and reduced standard errors of estimation (SEE). The adjusted model involved reduced agreement limits, demonstrating its accuracy. Conclusions: It was possible to propose models with allometric adjustments to estimate FM of pubertal boys. Allometry may aid in the development of predictive linear models of body composition, since it has an indicative capacity of the variables for estimation.

Introduction: Introduction: currently, there is no consensus regarding accurate and low-cost methods for diagnosing lipodystrophy in people living with HIV/AIDS (PLWHA). The aim of this study was to propose anthropometric cutoff points for the diagnosis of lipodystrophy among PLWHA. Methods: we included 106 PLWHA (men = 65, women = 41) who are under antiretroviral therapy and have been clinically classified into either a "lipodystrophy" or "non-lipodystrophy" group. Anthropometric measurements included 19 regions of body perimeters and 6 skinfold thickness measures. The Youden index was used to establish anthropometric cutoff points for the diagnosis of lipodystrophy, using the mean values of the anthropometric data (referred to as "original") along with the "Z index" (ZI) values, which were adjusted by the "Phantom Strategy." The cutoff points were proposed when "original" anthropometric measurements and ZI values had a statistical significance of p < 0.01 and an area under the curve (AUC) higher than 70%. The size effect was assessed to verify the influence of lipodystrophy on each anthropometric measure. Results: our data analysis proposes sex-specific cutoff points for the diagnosis of lipodystrophy in PLWHA - 17 points using the "original" anthropometric measurements, and 20 using the ZI values (average effect size between 1.0 and 1.1, and AUC = 76.7% and 78%). Conclusions: our study proposes accurate cutoff points for the diagnosis of lipodystrophy using "original" anthropometric measurements and ZI values adjusted by the "Phantom Strategy." Our findings support the use of anthropometric measurements as a simplified method for diagnosing lipodystrophy and monitoring body composition alterations in people living with HIV/AIDS.

Background: Body composition alterations, or lipodystrophy, can lead to serious health problems in people living with HIV/AIDS (PLWHA). The objectives of this study are to predict and validate sex-specific anthropometric predictive models for the diagnosis of lipodystrophy in PLWHA., Methods: A cross-sectional design was employed to recruit 106 PLWHA (men = 65 and women = 41) in Brazil during 2013-2014. They were evaluated using dual-energy X-ray absorptiometry, and 19 regions of body perimeters and 6 skinfold thicknesses were taken. Sex-specific predictive models for lipodystrophy diagnosis were developed through stepwise linear regression analysis. Cross-validations using predicted residual error sum of squares was performed to validate each predictive model., Results: Results support the use of anthropometry for the diagnosis of lipodystrophy in men and women living with HIV/AIDS. A high power of determination with a small degree of error was observed for lipodystrophy diagnosis for men in model six (r 2  = 0.77, SEE = 0.14, r 2 PRESS  = 0.73, SEE PRESS  = 0.15), that included ratio of skinfold thickness of subscapular to medial calf, skinfold thickness of thigh, body circumference of waist, formal education years , time of diagnosis to HIV months , and type of combined antiretroviral therapy (cART) (with protease inhibitor "WI/PI = 1" or without protease inhibitor "WO/PI = 0"); and model five for women (r 2  = 0.78, SEE = 0.11, r 2 PRESS  = 0.71, SEE PRESS  = 0.12), that included skinfold thickness of thigh, skinfold thickness of subscapular, time of exposure to cART months , body circumference of chest, and race (Asian) ("Yes" for Asian race = 1; "No" = 0)., Conclusions: The proposed anthropometric models advance the field of public health by facilitating early diagnosis and better management of lipodystrophy, a serious adverse health effect experienced by PLWHA.

Introduction: The HIV lipodystrophy syndrome is characterized by changes in metabolism, and body composition that increase cardiovascular risk of people living with HIV/AIDS (PLWHA) using highly active antiretroviral therapy (HAART)., Objective: To assess the prevalence of lipodystrophy and changes in lipid and glucose metabolism in PLWHA in use of HAART., Methods: For the anthropometric evaluation we measured weight, height and abdominal circumference (AC). For the lipodystrophy evaluation we conducted physical examination (subjective) and the (objective) examination of absorptiometry with X-ray dual energy (DEXA) by fat mass ratio (FMR). We also conducted lipid profile tests and fasting glucose and used the criteria suggested by The National Cholesterol Education Program III for metabolic disorders classification., Results: The final sample consisted of 262 patients with a mean age of 44.3 ± 10.2 years. Lipodystrophy, according to the physical examination, was present in 47.7% (95%CI 41.7 - 53.8) of patients, while the prevalence using FMR (DEXA) was 40.8% (95%CI 33.1 - 48.5). Most (53.0%; 95%CI 47.0 - 59.1) of the patients showed increased abdominal adiposity according to AC. The most prevalent metabolic alterations were reduced HDL (67.6%; 95%CI 61.9 - 73.2) and hypertriglyceridemia (55.7%; 95%CI 49.7 - 61.7)., Conclusion: The high prevalence of lipodystrophy and changes in lipid and glucose metabolism show the importance of early intervention in this group of patients to prevent cardiovascular complications.