Dualidade metabólica no exercício físico condicionada a massa muscular: adaptações metabólicas ao estresse oxidativo e inflamatório
Arquivos
Data
2017-08-28
Autores
Manda, Rodrigo Minoru [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O tecido muscular esquelético está relacionado com o gasto energético total, homeostase protéica bem como capacidades antioxidantes e de equilíbrio ácido-básico do organismo. Redução significativa da massa muscular, sarcopenia, é considerada como síndrome contemporânea relacionada ao estilo de vida moderno, com hábitos sedentários e inadequação alimentar OBJETIVO: Avaliar o efeito de programa para mudança do estilo de vida sobre a massa muscular e os determinantes de sua responsividade em adultos. METODOLOGIA: 539 indivíduos (82,2% mulheres, 52,9 + 11,8 anos) clinicamente selecionados para participação no Programa Mexa-se Pró Saúde, foram submetidos a 10 semanas de protocolo de intervenção com exercícios físicos supervisionados (aeróbio e força) e aconselhamento nutricional. Inicialmente foram submetidos a avaliação clínica/médica (da pressão arterial e aptidão cardiorrespiratória), antropométricas, de composição corporal, dietéticas, de aptidão física (flexibilidade e força de preensão manual) e análises bioquímicas, incluindo resistência insulínica (HOMA-IR), estresse oxidativo (Malondialdeido) e estresse inflamatório (Proteína C- reativa). As análises estatísticas foram realizadas pelo software SAS 9.2, adotando p<0,05. RESULTADOS: Ao ingressarem no programa (M0) os indivíduos foram divididos em quartis de IMM, de acordo com gênero. Os indivíduos sarcopênicos (Índice de Massa Muscular - IMM<p25) apresentaram menores indicadores de adiposidade (Índice de Massa Corporal, Circunferência Abdominal, Diâmetro Abdominal Sagital), menor ingestão de macronutrientes, (onde somente as mulheres apresentaram menor consumo de proteína e os homens menor ingestão energética total), menores concentrações de ácido úrico e menores valores de %Gordura Corporal e Força de Preensão Manual, apenas nas mulheres. A circunferência abdominal elevada foi determinante para os valores de IMM no momento basal. Após 10 semanas de intervenção, 64,3% dos indivíduos deixaram de ser sarcopênicos, apresentando melhoras significativas na aptidão física (tempo de esteira, VO2max, Flexibilidade e Força de Preensão Manual), adiposidade (Circunferência Abdominal), e redução de Proteína C-Reativa, triglicerídios, gama GT, pressão arterial, resistência insulínica (limitado ao ganho de 2% de massa muscular) e aumento de HDL. Análise de regressão logística indica que o %GC apresenta fator de risco para o ganho de massa muscular, porém seu efeito é neutralizado com o ajuste para IMC. CONCLUSÃO: o programa Mexa-se Pró Saúde representa estratégia eficaz na melhoria de parâmetros metabólicos relacionandos aos agravos crônicos não transmissíveis, com indicativos positivos de que seus efeitos estejam atrelados a melhor aptidão muscular obtida com a intervenção.
Muscle mass is related to whole-body energy and protein homeostasis as well as its acid-basic and antioxidant capacity. Lower muscle mass (sarcopenia) is a contemporary syndrome related to sedentary and inadequacy diet lifestyles. AIM: To define the major determinants of low muscle mass in a community-based cohort and the effective response to a Lifestyle Modification Program. METHODS: 539 subjects (82.2% female, 52.9 + 11.8 years old) ethical and clinically selected to our ongoing epidemiological study (Move for Health - from 2005 to 2016), met the inclusion criteria. They were assessed for medical anamneses, blood pressure, anthropometry, food intake, plasma biochemistry profile (insulin resistance, inflammatory and pro/antioxidant states) and physical fitness. Muscle-Mass Index (MMI) was taken as primary variable analyzed against and demographic, anthropometric (body and abdominal fatness), dietary intake, fitness (aerobic, flexibility and handgrip strength) and plasma-biochemical data, as co-variables. Muscle mass variables were distributed into gender-quartiles for categorized comparisons with co-variables. Baseline (M0) was followed up by 10-wk (M1) measurements in a longitudinal study under Lifestyle Modification Program (LiSM) composed by weekly dietary counseling and daily supervised physical exercises. Statistical analysis used SAS version 9.2 (p<0.05). RESULTS: The subjects at lower quartile of MMI were predominantly older (55.9 + 11,3 years old), presented lower body fatness, and were consuming lower macronutrients (but only females showed lower protein intake whereas only males presented lower total energy intake), presented lower uric acid and higher colesterol (total and HDL) levels (only females). Only higher WC was defined as independent protective risk factor against lower muscle mass. The intervention with 10-wk LiSM protocol was efficient to promote a reclassification of 64.3% of sarcopenic subjects at M0, with improve on fitness (aerobic capacity, flexibility and handgrip strength), abdominal fatness, blood pressure, pró inflammatory state and insulin sensitivity improvements (but only a limited gain (2%) in MM. After logistc regression, muscle mass gain was associated with % body fat, but this effect was neutralized after BMI adjustments. CONCLUSION: The Move for Health Program was effective to improve metabolic parameters associated with non-communicable chronic diseases, with purpose that the effects are related to muscle mass gain after intervention.
Muscle mass is related to whole-body energy and protein homeostasis as well as its acid-basic and antioxidant capacity. Lower muscle mass (sarcopenia) is a contemporary syndrome related to sedentary and inadequacy diet lifestyles. AIM: To define the major determinants of low muscle mass in a community-based cohort and the effective response to a Lifestyle Modification Program. METHODS: 539 subjects (82.2% female, 52.9 + 11.8 years old) ethical and clinically selected to our ongoing epidemiological study (Move for Health - from 2005 to 2016), met the inclusion criteria. They were assessed for medical anamneses, blood pressure, anthropometry, food intake, plasma biochemistry profile (insulin resistance, inflammatory and pro/antioxidant states) and physical fitness. Muscle-Mass Index (MMI) was taken as primary variable analyzed against and demographic, anthropometric (body and abdominal fatness), dietary intake, fitness (aerobic, flexibility and handgrip strength) and plasma-biochemical data, as co-variables. Muscle mass variables were distributed into gender-quartiles for categorized comparisons with co-variables. Baseline (M0) was followed up by 10-wk (M1) measurements in a longitudinal study under Lifestyle Modification Program (LiSM) composed by weekly dietary counseling and daily supervised physical exercises. Statistical analysis used SAS version 9.2 (p<0.05). RESULTS: The subjects at lower quartile of MMI were predominantly older (55.9 + 11,3 years old), presented lower body fatness, and were consuming lower macronutrients (but only females showed lower protein intake whereas only males presented lower total energy intake), presented lower uric acid and higher colesterol (total and HDL) levels (only females). Only higher WC was defined as independent protective risk factor against lower muscle mass. The intervention with 10-wk LiSM protocol was efficient to promote a reclassification of 64.3% of sarcopenic subjects at M0, with improve on fitness (aerobic capacity, flexibility and handgrip strength), abdominal fatness, blood pressure, pró inflammatory state and insulin sensitivity improvements (but only a limited gain (2%) in MM. After logistc regression, muscle mass gain was associated with % body fat, but this effect was neutralized after BMI adjustments. CONCLUSION: The Move for Health Program was effective to improve metabolic parameters associated with non-communicable chronic diseases, with purpose that the effects are related to muscle mass gain after intervention.
Descrição
Palavras-chave
Massa Muscular, Sarcopenia, Mudança do Estilo de Vida, Bioquímica, Exercícios Físicos, Ingestão Alimentar, Gordura Corporal