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Background: Sarcopenic obesity (SO) is a clinical disorder characterized by increased adiposity and decreased muscle mass and function, commonly observed in older adults. However, most of the studies that investigated SO prevalence rates were not based on current standardized diagnostic methods. Thus, this study aims to estimate the prevalence rates of SO and their level of agreement using different instruments proposed by the European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) Consensus, in a sample of hospitalized older adults with severe obesity., Methods: A cross-sectional study with 90 older adults (≥ 60 years) with severe obesity (body mass index ≥ 35 kg/m/²) seeking an in-hospital multidisciplinary body weight reduction program. Skeletal muscle function was assessed using the five-repetition Sit-Stand test (5-SSt) and Handgrip Strength (HGS). Body composition was evaluated by high percentages of fat mass (FM), low appendicular lean mass (ALM/W), and skeletal muscle mass (SMM/W), adjusted to body weight. The stage of SO was assessed on the presence of at least one comorbidity and specific cut-offs were adopted for each step. All analyses were performed according to gender and age range., Results: The prevalence rates of SO in the total sample were 23.3%, 25.5%, 31.1%, and 40.0% considering altered values of 5-SSt+FM+ALM/W, HGS+FM+ALM/W, 5-SSt+FMSSM/W, and HGS+FM+SSM/W, respectively. Higher prevalence rates were observed among female and old elderly subgroups, regardless of the diagnostic combination. There were weak agreements between the muscle function tests (5-SSt versus HGS) using both muscle mass indexes in the total sample and all subgroups. Moderate agreements were observed between muscle mass indexes (SMM/W versus ALM/W) in the total sample, male and younger older adults (using 5-SSt), and strong agreements for men and younger older adults (using HGS)., Conclusion: The discrepancies observed between the prevalence rates and their levels of agreement reinforce the need for new studies in similar populations aiming for better standardization of SO assessment., 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 © 2024 Danielewicz, Marra, Tringali, Micheli, Abbruzzese, Fanari, Codecasa, Lazzer, Mendonça, Lacerda, de Avelar and Sartorio.)

Objectives: Bilateral Deficit (BLD) occurs when the force generated by both limbs together is smaller than the sum of the forces developed separately by the two limbs. BLD may be modulated by physical training. Here, were investigated the effects of unilateral or bilateral plyometric training on BLD and neuromuscular activation during lower limb explosive extensions., Methods: Fourteen young males were randomized into the unilateral (UL_) or bilateral (BL_) training group. Plyometric training (20 sessions, 2 days/week) was performed on a sled ergometer, and consisted of UL or BL consecutive, plyometric lower limb extensions (3-to-5 sets; 8-to-10 repetitions). Before and after training, maximal explosive efforts with both lower limbs or with each limb separately were assessed. Electromyography of representative lower limb muscles was measured., Results: BL_training significantly and largely decreased BLD (p=0.003, effect size=1.63). This was accompanied by the reversion from deficit to facilitation of the electromyography amplitude of knee extensors during bilateral efforts (p=0.007). Conversely, UL_training had negligible effects on BLD (p=0.781). Also, both groups showed similar improvements in their maximal explosive power generated after training., Conclusions: Bilateral plyometric training can mitigate BLD, and should be considered for training protocols focused on improving bilateral lower limb motor performance., Competing Interests: The authors have no conflict of interest.

The combination of high volume of moderate-intensity continuous training with a low volume of high-intensity interval training improved body composition and physical capacities in individuals with obesity. However, polarized training (POL) has never been used in adult men with obesity. Thus, the purpose of this study was to investigate changes in body composition and physical capacities induced by a 24-week POL or threshold (THR) program in obese male adults. Twenty male patients (mean age 39.8±6.3 yrs; mean body mass index [BMI] 31.6±2.7 kg∙m -2 ) participated in this study (n: 10 POL, n: 10 THR). After 24-week, body mass (BM) and fat mass (FM) decreased by -3.20±3.10 kg (P<0.05) and -3.80±2.80 kg (P<0.05), respectively, similarly in both groups. Maximal oxygen uptake (  ̇VO 2 max) and   ̇VO 2 at respiratory compensation point (RCP) increased in the POL group (+8.5±12.2 and+9.0±17.0%, P<0.05) and in the THR group (+4.24±8.64 and+4.0±6.70%, P<0.05), as well   ̇VO 2 at gas exchange threshold (GET) increased similarly in both groups (+12.8±12.0%, P<0.05). POL and THR were equally effective in improving body composition and physical capacities in obese subjects. Future studies are needed to determine whether adherence to the training program can be improved by adding a running competition compared with a group without competition at the end of the training program., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose: In sky- and trail-running competitions, many athletes use poles. The aims of this study were to investigate whether the use of poles affects the force exerted on the ground at the feet (Ffoot), cardiorespiratory variables and maximal performance during uphill walking., Methods: Fifteen male trail runners completed four testing sessions on different days. On the first two days, they performed two incremental uphill treadmill walking tests to exhaustion with (PW incr ) and without poles (W incr ). On the following days, they performed submaximal and maximal tests with (PW 80 and PW max ) and without (W 80 and W max ) poles on an outdoor trail course. We measured cardiorespiratory parameters, the rating of perceived exertion, the axial poling force and Ffoot., Results: When walking on the treadmill, we found that poles reduced maximum Ffoot (- 2.8 ± 6.4%, p = 0.03) and average Ffoot (- 2.4 ± 3.3%, p = 0.0089) . However, when outdoors, we found pole effect only for average Ffoot (p = 0.0051), which was lower when walking with poles (- 2.6 ± 3.9%, p = 0.0306 during submaximal trial and - 5.21 ± 5.51%, p = 0.0096 during maximal trial). We found no effects of poles on cardiorespiratory parameters across all tested conditions. Performance was faster in PW max than in W max (+ 2.5 ± 3.4%, p = 0.025)., Conclusion: The use of poles reduces the foot force both on the treadmill and outdoors at submaximal and maximal intensities. It is, therefore, reasonable to conclude that the use of poles "saves the legs" during uphill without affecting the metabolic cost., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: In the last decade a large number of studies proposed and/or validated equations to estimate the Resting Energy Expenditure (REE) in adults and/or older adults, however, no equation currently available showed good accuracy for older adults with severe obesity. Thus, this study aimed to develop and validate new predictive equations for REE, based on data from the indirect calorimetry, in Italian older adults with severe obesity., Methods: A retrospective study was as conducted with 764 Caucasian older adults with severe obesity (age range: 60-74 years and BMI ≥ 35 kg/m/²). Four models were used to test the accuracy of anthropometry and body composition variables in multivariable prediction of REE. All models were derived by stepwise multiple regression analysis using a calibration group of 382 subjects [295 females and 87 males] and the equations were cross-validated in the remaining 382 subjects [295 females and 87 males] as validation group. The new prediction equations and the other published equations were tested using the Bland-Altman method. Prediction accuracy was defined as the percentage of subjects whose REE was predicted within ± 10% of measured REE., Results: All the equations analyzed predicted higher energy requirements for males than females, and most of them underestimated the energy requirement values of our sample. The highest accuracy values were observed in the new equations, with 62% in the anthropometric model and 63% in the body composition model., Conclusion: Although the accuracy of our equations was slightly higher in comparison with the other taken into consideration, they cannot be considered completely satisfactory for predicting REE in Italians older adults with severe obesity. When predicting equations cannot guarantee precise or acceptable values of REE, the use of indirect calorimetry (if available) should be always recommended, especially in clinical practice., 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 Danielewicz, Lazzer, Marra, Abbruzzese, D’Alleva, Martino, Isola, Avelar, Mendonça, Lacerda and Sartorio.)

Purpose: Exercise prescription based on fixed heart rate (HR) values is not associated with a specific work rate (WR) during prolonged exercise. This phenomenon has never been evaluated in cardiac patients and might be associated with a slow component of HR kinetics and β-adrenergic activity. The aims were to quantify, in cardiac patients, the WR decrease at a fixed HR and to test if it would be attenuated by β-blockers., Methods: Seventeen patients with coronary artery disease in stable conditions (69 ± 9 yr) were divided into two groups according to the presence (BB) or absence (no-BB) of a therapy with β-blockers, and performed on a cycle ergometer: an incremental exercise (INCR) and a 15-min "HR CLAMPED " exercise, in which WR was continuously adjusted to maintain a constant HR, corresponding to the gas exchange threshold +15%. HR was determined by the ECG signal, and pulmonary gas exchange was assessed breath-by-breath., Results: During INCR, HR peak was lower in BB versus no-BB ( P < 0.05), whereas no differences were observed for other variables. During HR CLAMPED , the decrease in WR needed to maintain HR constant was less pronounced in BB versus no-BB (-16% ± 10% vs -27 ± 10, P = 0.04) and was accompanied by a decreased V̇O 2 only in no-BB (-13% ± 6%, P < 0.001)., Conclusions: The decrease in WR during a 15-min exercise at a fixed HR (slightly higher than that at gas exchange threshold) was attenuated in BB, suggesting a potential role by β-adrenergic stimulation. The phenomenon may represent, also in this population, a sign of impaired exercise tolerance and interferes with aerobic exercise prescription., (Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American College of Sports Medicine.)

This study aimed to investigate the effects of combined training (COMB, a combination of moderate-intensity continuous training-MICT and high-intensity interval training-HIIT) vs. continuous MICT administered during a 3-week in-hospital body weight reduction program (BWRP) on body composition, physical capacities, and substrate oxidation in adolescents with obesity. The 3-week in-hospital BWRP entailed moderate energy restriction, nutritional education, psychological counseling, and two different protocols of physical exercise. Twenty-one male adolescents with obesity (mean age: 16.1 ± 1.5 years; mean body mass index [BMI] 37.8 ± 4.5 kg m -2 ) participated in this randomized control trial study (n:10 for COMB, n:11 MICT), attending ~ 30 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V'O 2 peak) (e.g., HIIT ≤ 20%), followed by 30 min at 60% of V'O 2 peak (e.g., MICT ≥ 80%). Body composition, V'O 2 peak, basal metabolic rate (BMR), energy expenditure, and substrate oxidation rate were measured during the first week (W0) and at the end of three weeks of training (W3). The two training programs were equivalent in caloric expenditure. At W3, body mass (BM) and fat mass (FM) decreased significantly in both groups, although the decrease in BM was significantly greater in the MICT group than in the COMB group (BM: - 5.0 ± 1.2 vs. - 8.4 ± 1.5, P < 0.05; FM: - 4.3 ± 3.0 vs. - 4.2 ± 1.9 kg, P < 0.05). V'O 2 peak increased only in the COMB by a mean of 0.28 ± 0.22 L min -1 (P < 0.05). The maximal fat oxidation rate (MFO) increased only in the COMB group by 0.04 ± 0.03 g min -1 (P < 0.05). COMB training represents a viable alternative to MICT for improving anthropometric characteristics, physical capacities, and MFO in adolescents with obesity during a 3-week in-hospital BWRP., (© 2023. Springer Nature Limited.)

Backgroud: Sarcopenia is a common skeletal muscle syndrome that is common in older adults but can be mitigated by adequate and regular physical activity. The development and severity of sarcopenia is favored by several factors, the most influential of which are a sedentary lifestyle and physical inactivity. The aim of this observational longitudinal cohort study was to evaluate changes in sarcopenia parameters, based on the EWGSOP2 definition in a population of active older adults after eight years. It was hypothesized that selected active older adults would perform better on sarcopenia tests than the average population., Methods: The 52 active older adults (22 men and 30 women, mean age: 68.4 ± 5.6 years at the time of their first evaluation) participated in the study at two time points eight-years apart. Three sarcopenia parameters were assessed at both time points: Muscle strength (handgrip test), skeletal muscle mass index, and physical performance (gait speed), these parameters were used to diagnose sarcop0enia according to the EWGSOP2 definition. Additional motor tests were also performed at follow-up measurements to assess participants' overall fitness. Participants self-reported physical activity and sedentary behavior using General Physical Activity Questionnaire at baseline and at follow-up measurements., Results: In the first measurements we did not detect signs of sarcopenia in any individual, but after 8 years, we detected signs of sarcopenia in 7 participants. After eight years, we detected decline in ; muscle strength (-10.2%; p < .001), muscle mass index (-5.4%; p < .001), and physical performance measured with gait speed (-28.6%; p < .001). Similarly, self-reported physical activity and sedentary behavior declined, too (-25.0%; p = .030 and - 48.5%; p < .001, respectively)., Conclusions: Despite expected lower scores on tests of sarcopenia parameters due to age-related decline, participants performed better on motor tests than reported in similar studies. Nevertheless, the prevalence of sarcopenia was consistent with most of the published literature., Trial Registration: The clinical trial protocol was registered on ClinicalTrials.gov, identifier: NCT04899531., (© 2023. The Author(s).)

Obesity and related metabolic diseases represent a worldwide health problem. The main factor predisposing to obesity is an unhealthy lifestyle including the lack of physical activity. A pivotal role in the etio-pathogenesis of obesity is carried out by adipose tissue, an endocrine organ secreting several adipokines involved in numerous metabolic and inflammatory processes. Among these, of particular importance is adiponectin, an adipokine involved in the regulation of insulin sensibility and in anti-inflammatory processes. The aim of the study was to determine the effects of 24 weeks of two different training programs polarized (POL) and threshold training (THR) on body composition, physical capacities and adiponectin expression. Thirteen male obese subjects (BMI: 32.0 ± 3.0 kg m-2) followed 24 weeks of two different training programs, POL and THR, consisting of walking or running (or a combination of the two methods) in their normal living conditions. Before (T0) and after the end of the program (T1), the assessment of body composition was assessed by bioelectrical impedance and the concentration of salivary and serum adiponectin was analyzed by enzyme-linked immunosorbent assay and western blotting. Although the results obtained did not show significant differences between the two training programs, body mass and body mass index decreased by a mean of -4.46 ± 2.90 kg and 1.43 ± 0.92 kg m -2  (P < 0.05). Fat mass decreased by -4.47 ± 2.78 kg (P < 0.05). V'O 2 max increased by a mean of 0.20 ± 0.26 L min -1 (P < 0.05) Also, we observed an increase in saliva and in serum of adiponectin concentrations at T1 compared to T0 by 4.72 ± 3.52 μg mL -1 and 5.22 ± 4.74 ng mL -1  (P < 0.05) respectively. Finally, we found significant correlations between Δ serum adiponectin and Δ Hip (R = -0.686, P = 0.001) and between Δ salivary adiponectin and ΔWaist (R = -0.678, P = 0.011). Our results suggest that a 24 weeks training program, independently from intensity and volume, induces an amelioration of body composition and fitness performance. These improvements are associated with an increase in total and HMW adiponectin expression in both saliva and in serum., Competing Interests: The authors declare no conflicts of interest with respect to the research, authorship, and/or publication of this article.The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

Recent evidence shows that simple and inexpensive anthropometric measurements can be used to identify, at an early stage, women with obesity at increased risk of developing metabolic syndrome (MetS). Thus, the aim of this study was to compare the accuracy of five different indexes of adiposity and/or body composition in identifying MetS in a group of 876 women (mean age ± SD: 52.1 ± 13.8 years; body mass index (BMI): 43.6 ± 6.1 kg m -2 ). The following indexes were determined for each subject: waist-to-hip ratio (WHR), waist-to-height ratio (WtHR), body mass fat index (BMFI), visceral adiposity index (VAI), and cardiometabolic index (CMI). Overall, the presence of MetS was detected in 544 patients (62%). Pearson correlation coefficients were calculated to evaluate the relationships between body composition indexes and metabolic characteristics of the women. Receiver operating characteristic (ROC) analysis was used to determine the best predictor for each adiposity index among metabolic risk factors. The ROC analysis showed VAI (AUC = 0.84) and CMI (AUC = 0.86) showed the best performance in predicting MetS. Differences were found between the ROC area of CMI and VAI with all other indexes ( p < 0.05). The optimal cutoff point for early diagnosis of MetS was >0.92 for WHR, >0.76 for WtHR, >30.1 kg m -1 for BMFI, >1.94 for VAI, and >0.84 for CMI. In addition, VAI and CMI were the most sensitive and specific indexes compared with other indexes. In conclusion, VAI and CMI represent the most useful and reliable indexes to be used for detecting MetS in women suffering from obesity in clinical practice.

Dietary lipids are pivotal in modulating metabolic inflammation. Among the inflammatory mediators characterizing metabolic inflammation, interleukin 18 (IL-18) has been consistently associated with obesity and insulin resistance. This study aims to evaluate whether the quality of lipid intake impacts upon IL-18 plasma levels and the implications on insulin resistance computed by the homeostatic model assessment for insulin resistance (HOMA-IR). Using a cross-sectional design, this study confirmed that IL-18 correlated positively with insulin resistance and individuals with a HOMA-IR ≥ 2.5 displayed higher circulating IL-18 levels compared with their insulin-sensitive counterparts. In terms of the effect of the quality of dietary lipids on IL-18 circulating levels, the ratio between monounsaturated, omega-3, polyunsaturated and saturated fatty acids as well as the intake of eicosapentaenoic and docosahexaenoic acids correlated negatively with IL-18. Despite this, IL-18 circulating levels, but not dietary fatty acid quality, predicted insulin resistance. Nevertheless, the ratio between omega 3 and saturated fatty acids was a predictor of IL-18 plasma levels. Thus, the downregulation of IL-18 may underpin, at least partially, the beneficial metabolic effects of substituting omega 3 for saturated fatty acids with this cytokine potentially representing a biomarker linking dietary lipids and metabolic outcomes.

Background: /Objectives : A weekly combination of a high volume of moderate-intensity continuous training (MICT) with a low volume of high-intensity interval training (HIIT) provides important improvements in body composition and physical capacities in individuals with obesity. However, previous studies did not determine the weekly proportions of HIIT and MICT a priori. This study aimed to investigate changes in body composition, physical capacities and the fat oxidation rate in obese male adults by comparing a combination of MICT and HIIT, called combined training (COMB), with HIIT for a 12-week period., Methods: Thirty-four obese male adults (mean age: 39.4 ± 7.0 y; mean body mass index [BMI] 34.0 ± 4.2 kg m -2 ) participated in this study (n = 18 for COMB, n = 16 HIIT), attending ∼ 36 training sessions. The COMB group performed 3 repetitions of 2 min at 95% of peak oxygen uptake (V'O 2 peak) (e.g., HIIT ≤20%), followed by 30 min at 60% of VO 2 peak (e.g., MICT ≥80%). The HIIT group performed 5-7 repetitions of 2 min at 95% of VO 2 peak. At baseline (PRE) and at the end of the training period (POST), body composition, VO 2 peak, and the fat oxidation rate were measured. The two training programs were equivalent in caloric expenditure., Results: At POST, body mass (BM) and fat mass (FM) decreased by a mean of 3.09 ± 3.21 kg and 3.90 ± 2.40 kg, respectively (P < 0.05), in both groups and V'O 2 peak increased in both groups by a mean of 0.47 ± 0.34 L min -1 (P < 0.05). The maximal fat oxidation rate increased similarly in both groups from 0.32 ± 0.05 to 0.36 ± 0.06 g min -1 (P < 0.05)., Conclusion: COMB training represents a viable alternative to HIIT to improve anthropometric characteristics, physical capacities and fat oxidation in obese male adults., Competing Interests: There are no real or potential conflicts of financial or personal interest with the financial sponsors of the scientific project., (© 2023 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.)

Purpose: Accumulating the time near maximum aerobic power [Formula: see text] is considered to be the most effective way to improve aerobic capacity. The aims of this study were: (1) to verify whether postponing the first recovery interval improves time to exhaustion during a high-intensity interval training (HIIT) test, and (2) to verify whether a HIIT protocol with decreasing interval duration (HIDIT) is more effective in accumulating time near [Formula: see text] compared with two classical protocols with short intervals (SI HIIT ) and long intervals (LI HIIT )., Methods: Nine active males (35 ± 11 years, [Formula: see text] 52 ± 5 mL·min -1 ·kg -1 ) performed a graded exercise test on an athletic track. Critical velocity and D' were estimated from three to five high-intensity trials to exhaustion. Then, the subjects performed three trials with a single recovery interval after 30 s (Rec 30s ), after 3 min (Rec 3min ) and after exhaustion (Rec Tlim ) to verify whether postponing the first recovery interval enhances the time to exhaustion. Finally, the subjects performed the three HIIT protocols mentioned above., Results: The time to exhaustion was significantly greater in Rec Tlim (464 ± 67 s) than in Rec 3min (388 ± 48 s) (p < 0.0078) and Rec 30s (308 ± 44 s) (p > 0.0001). Additionally, it was significantly greater in Rec 3min than in Rec 30s (p = 0.0247). Furthermore, the time accumulated near [Formula: see text] was significantly longer in HIDIT (998 ± 129 s) than in SI HIIT (678 ± 116 s) (p = 0.003) and LI HIIT (673 ± 115 s) (p < 0.031)., Conclusions: During the trials, postponing the first recovery interval was effective in improving the time to exhaustion. Moreover, HIDIT was effective in prolonging the time near [Formula: see text]., (© 2022. The Author(s).)

Objectives: Electrically-induced or voluntary conditioning-contractions (CC) can be used to affect contractile properties of a subsequent explosive contraction (EC). Here, we aimed at comparing the effect of neuromuscular-electrical-stimulation (NMES) vs voluntary CC performed prior to explosive contractions of the knee extensors., Methods: A 10 sec NMES CC (100Hz, 1000μs, 10% MVC), or a voluntary contraction (VOL CC) mimicking the NMES CC, preceded an isometric EC of the knee extensors. Explosive contraction was performed with the goal to reach the target (70% MVC) as quickly as possible., Results: All the parameters related with the explosive contractions' muscle-output were similar between protocols (difference ranging from 0.23%, Mean Torque; to 5.8%, Time to Target), except for the Time to Peak Torque, which was lower when preceded by NMES (11.1%, p=0.019). Interestingly, the RTD 0-50 ms&#95;EC was 37.3% higher after the NMES compared with the VOL CC protocol., Conclusion: Explosive contraction was potentiated by an NMES CC as compared with a voluntary CC. This may be due to a reduction in descending drive following VOL CC, which has been shown to occur even with low-level voluntary efforts. These findings could be used to improve rehabilitation or training protocols that include conditioning contractions., Competing Interests: The authors have no conflict of interest.

Background/objectives: Body composition and protein-energy partitioning changes are important factors of body weight regulation, but have not been studied in the context of clinical obesity treatment setting. Thus, the aim of the present study was to investigate the pattern of body weight loss, body composition, and energy partitioning changes during a 9-month multidisciplinary weight loss program and 4-month follow up and to test the associations among these changes in adolescents with severe obesity., Subjects/methods: Twenty-five adolescents (14.1 ± 1.5 years old; 13 girls) with severe obesity joined a pediatric obesity center for a 9-month inpatient multidisciplinary weight loss program. All participants performed body composition assessment (i.e. fat mass-FM, and fat-free mass-FFM) and completed a 36-h session in indirect calorimetric chamber before the start (T0), at the end of the intervention (T1) and 4 months follow-up to the intervention (T2). The protein-energy partitioning (P ratio) was calculated as urinary nitrogen loss/total energy expenditure over 24 hours., Interventions: 9-month individualized multidisciplinary weight loss program consisting of lifestyle education, psychological support, physical activity, and dietary intervention., Results: Initial P ratio was positively associated with changes in body weight from T0 to T1 (p = 0.038). The changes in FFM/FM were negatively associated with body weight changes in boys (p = 0.006) from T0 to T1 and in girls (p < 0.001) from T1 to T2. Urinary nitrogen excretion (p < 0.001) and total energy expenditure (p < 0.001) significantly decreased during the weight loss program while the P ratio did not significantly change., Conclusion: The present results suggest that baseline and changes in energy partitioning may be associated with changes in body weight in adolescents with severe obesity. In addition, sexual dimorphism in these patterns of change suggest the need for specific dietary and physical activity strategies in boys and girls to optimize body weight loss and to prevent or slow weight regain., (© 2022. The Author(s), under exclusive licence to Springer Nature Limited.)

In recent years, different companies have developed devices that estimate "running power". The main objective of this paper is to evaluate the effect of running speed on aerobic and running powers measured using force plates and by different devices. The second objective is to evaluate the relationship between aerobic power and running powers measured using force plates and by different devices. We enrolled 11 subjects in the study, they performed 5-min running trials at 2.22, 2.78, 3.33, 3.89 and 4.44 m/s respectively on a force-measuring treadmill while we collected metabolic data. We calculated running power as the dot product of ground reaction force and velocity of the centre of mass and compared it to the running power estimates of three devices: Skillrun (Technogym), Stryd Summit Powermeter (Stryd) and Garmin HRM-Run (Garmin). We found statistically significant linear correlations with running powers measured by all devices and running speed. Although absolute running power measurements were different among devices, an increase of 1 m/s in running speed translated to an increase of 0.944 W/kg in running power ( p  < 0.001). We found statistically significant linear correlations with running powers measured by all devices and aerobic power, in particular: as aerobic power increases by 1 W/kg, running power increases by 0.218 W/kg for all devices ( p  < 0.001). For level treadmill running, across speeds, running power measured by commercially available devices reflects force-based measurements and it can be a valuable metric, providing quasi real-time feedback during training sessions and competitions. Highlights We evaluated the effect of running speed on aerobic and running powers measured using force plates and by different devices.We also compared the relationship between aerobic power and running powers measured using force plates and by different devices.We found statistically significant linear correlations with running powers measured by all devices and aerobic power, in particular: as aerobic power increases by 1 W/kg, running power increases by 0.218 W/kg for all devices.For level treadmill running, across speeds, running power measured by commercially available devices reflects force-based measurements and it can be a valuable metric, providing quasi real-time feedback during training sessions and competitions.

Obesity is a complex condition characterized by abnormal and excessive fat accumulation, resulting in an increased risk for severe health problems. Skeletal muscles play a major role in movement and fat catabolism, but the insulin resistance that comes with obesity makes it difficult to fulfill these tasks. In this study, we analyse two types of training protocols, moderate intensity continuous training (MICT) versus high intensity interval training (HIIT), in a cohort of obese subjects to establish which muscle adaptations favour fat consumption in response to exercise. Mitochondria play a role in fat oxidation. We found protein upregulation of mitochondrial biomarkers, TOMM20 and Cox-4, in HIIT but not in MICT, without detecting any shifts in fibre composition phenotype of the vastus lateralis in both training groups. Interestingly, both MICT and HIIT protocols showed increased protein levels of perilipin PLIN2, which is involved in the delivery and consumption of fats. HIIT also augmented perilipin PLIN5. Perilipins are involved in fat storage in skeletal muscles and their upregulation, along with the analysis of circulatory lipid profiles reported in the present study, suggest important adaptations induced by the two types of training protocols that favour fat consumption and weight loss in obese subjects.

Background: We investigated the effects of single (SL-ET) and double leg (DL-ET) high-intensity interval training on O2 deficit (O2Def) and mean response time (MRT) during square-wave moderate-intensity exercise (DL-MOD), and on the amplitude of V˙O2p slow component (SCamp), during heavy intensity exercise (DL-HVY), on 33 patients (heart transplant = 13, kidney transplanted = 11 and liver transplanted = 9). Methods: Patients performed DL incremental step exercise to exhaustion, two DL-MOD tests, and a DL-HVY trial before and after 24 sessions of SL-ET (n = 17) or DL-ET (n = 16). Results: After SL-ET, O2Def, MRT and SCamp decreased by 16.4% ± 13.7 (p = 0.008), by 15.6% ± 13.7 (p = 0.004) and by 35% ± 31 (p = 0.002), respectively. After DL-ET, they dropped by 24.9% ± 16.2 (p < 0.0001), by 25.9% ± 13.6 (p < 0.0001) and by 38% ± 52 (p = 0.0003), respectively. The magnitude of improvement of O2Def, MRT, and SCamp was not significantly different between SL-ET and DL-ET after training. Conclusions: We conclude that SL-ET is as effective as DL-ET if we aim to improve V˙O2p kinetics in transplanted patients and suggest that the slower, V˙O2p kinetics is mainly caused by the impairment of peripherals exchanges likely due to the immunosuppressive medications and disuse.

Background: The purpose was to compare the effects of 8-week resistance training programs (flywheel iso-inertial [FW] versus traditional gravity-dependent resistance training [GD]) performed twice a week at the same rate of perceived exertion (RPE), on muscle force and power capacities and physical performance in healthy older participants., Methods: Twenty-four participants were randomly assigned to either FW (male/female ratio: 7/5, age: 67.1±3.8 years) or GD (male/female ratio: 6/6, age 68.3±3.0 years) group. Knee extension maximal isometric voluntary contractions (MVC), lower limb maximal explosive power (MEP), Six-Minute Walking Test (6MWT), Timed Up-and-Go Test (TUG), metabolic cost of walking (CW) and agonist-antagonist co-contraction time (CCT) during walking were evaluated before and after training., Results: absolute MEP and MEP normalized for body mass increased only in FW than GD group (+10.8% vs. +0.31%, P=0.056, respectively; +14.8% vs. +13.9%, P<0.001, respectively). Both training modalities improved MVC to a similar extent (+11.1% in FW vs. +13.4% in GD, P<0.001). Analogously, 6MWT distance increased in FW and GD (+5.2 and +5.5%, P<0.041, respectively). No effects of time and training modality were observed on the other parameters., Conclusions: The results of this study suggest that when FW and GD are administered at the same RPE with FW performed at higher movement speed in the concentric phase, both the trainings generate similar improvements in muscle strength but only the former can promote greater muscle power enhancements than GD in healthy older adults.

The detrimental effect of physical inactivity on muscle characteristics are well known. Irisin, an exercise-induced myokine cleaved from membrane protein fibronectin type III domain-containing protein-5 (FNDC5), mediates at least partially the metabolic benefits of exercise. This study aimed to assess the interplay between prolonged inactivity, circulating irisin, muscle performance, muscle fibers characteristics, as well as the FNDC5 gene expression (FNDC5ge) in muscle and adipose tissue among healthy subjects. Twenty-three healthy volunteers were tested before and after 14 days of Bed Rest, (BR). Post-BR circulating levels of irisin significantly increased, whereas body composition, muscle performance, and muscle fiber characteristics deteriorated. Among the subjects achieving the highest post-BR increase of irisin, the lowest reduction in maximal voluntary contraction and specific force of Fiber Slow/1, the highest increase of FNDC5ge in adipose tissue, and no variation of FNDC5ge in skeletal muscle were recorded. Subjects who had the highest FNDC5ge in adipose tissue but not in muscle tissue showed the highest circulating irisin levels and could better withstand the harmful effect of BR.

Diet plays a pivotal role in shaping the trajectory of chronic diseases. In this regard, the Mediterranean diet has been widely shown to exert beneficial effects on cardiometabolic health. On the contrary, the Western diet, which has also been reported to be an acidogenic dietary pattern, elicits detrimental effects on both metabolic and cardiovascular (CV) health. However, the role of dietary acid load (DAL) as a predictor of cardiometabolic prognosis remains to be elucidated. Thus, this study aims to compare Mediterranean diet adherence (MDA) and DAL focusing on their relationship with metabolic and CV prognosis. A total of 448 individuals aged 55-80 years were grouped depending on their MDA, assessed using food frequency questionnaires, or DAL, evaluated using potential renal load acid (PRAL) and net-endogenous acid production (NEAP). Study participants underwent anthropometric and biochemical measurements. The metabolic syndrome (MetS) prevalence was evaluated according to the National Cholesterol Education Program-Adult Treatment Panel III. Finally, the CV risk was evaluated using three independent algorithms: atherosclerotic cardiovascular disease (ASCVD), European Systematic COronary Risk Evaluation (SCORE), and Cuore risk scores. Mediterranean diet adherence was negatively associated with PRAL and NEAP. Individuals in the higher MDA tertile group had higher HDL cholesterol as well as lower homeostasis model assessment index (HOMA-IR) and fat mass relative to the lowest MDA tertile. However, in the high-MDA tertile group, there was neither a significantly lower MetS prevalence nor CV risk. Instead, both the MetS prevalence and CV risk were higher in individuals in the higher acid PRAL quartile relative to the lower alkaline PRAL quartile. Dietary acid load, especially assessed using PRAL but not MDA, was associated with indices of metabolic and CV prognosis. Thus, DAL assessed by 24-h dietary recalls may represent a better predictor of cardiometabolic health if compared to MDA evaluated using food frequency questionnaires., 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 © 2022 Sanz, Sergi, Colombari, Capatti, Situlin, Biolo, Di Girolamo, Lazzer, Šimunič, Pišot and Passaro.)

Purpose: To compare energetics and spatiotemporal parameters of steep uphill pole walking on a treadmill and overground., Methods: First, the authors evaluated 6 male trail runners during an incremental graded test on a treadmill. Then, they performed a maximal overground test with poles and an overground test at 80% (OG80) of vertical velocity of maximal overground test with poles on an uphill mountain path (length = 1.3 km, elevation gain = 433 m). Finally, they covered the same elevation gain using poles on a customized treadmill at the average vertical velocity of the OG80. During all the tests, the authors measured oxygen uptake, carbon dioxide production, heart rate, blood lactate concentration, and rate of perceived exertion., Results: Treadmills required lower metabolic power (15.3 [1.9] vs 16.6 [2.0] W/kg, P = .002) and vertical cost of transport (49.6 [2.7] vs 53.7 [2.1] J/kg·m, P < .001) compared with OG80. Also, oxygen uptake was lower on a treadmill (41.7 [5.0] vs 46.2 [5.0] mL/kg·min, P = .001). Conversely, respiratory quotient was higher on TR80 compared with OG80 (0.98 [0.02] vs 0.89 [0.04], P = .032). In addition, rate of perceived exertion was higher on a treadmill and increased with elevation (P < .001). The authors did not detect any differences in other physiological measurements or in spatiotemporal parameters., Conclusions: Researchers, coaches, and athletes should be aware that steep treadmill pole walking requires lower energy consumption but same heart rate and rate of perceived exertion than overground pole walking at the same average intensity.

Background: The aim of the present study was to examine the short-term changes in body composition and physical capabilities in subjects with obesity during a multidisciplinary inpatient body weight reduction program (BWRP)., Methods: One hundred thirty-nine adolescents (56 boys and 83 girls; BMI: 37.1 ± 6.5 kg/m 2 ; Fat Mass, FM: 45.3 ± 7.2%) and 71 adults (27 males and 44 females; BMI: 44 ± 4.7 kg/m 2 ; FM: 51.4 ± 4.7%) followed a 3-week inpatient BWRP consisting of regular physical activity, moderate energy restriction, nutritional education and psychological counseling. Before (T0) and after the end of the BWRP (T21), body composition was assessed with an impedancemeter, lower limb muscle power with Margaria Stair Climbing Test (SCT), lower limb functionality with Short Physical Performance Battery (SPPB), and the capacity of performing activity of daily living (ADL) with Physical Performance Test (PPT)., Results: At T21, obese adolescents showed a 4% reduction in body mass (BM) ( p < 0.001), associated with a FM reduction in boys (-10%) and girls (-6%) ( p < 0.001) and with a 3% reduction in fat-free mass (FFM) recorded only in boys ( p = 0.013). Obese adults showed a 5% BM reduction ( p < 0.001), associated with a 2% FFM and 9% FM reduction ( p < 0.001) in males, and 7% FM reduction in females ( p < 0.001). Regarding physical capabilities, at T21 in obese adolescents, PPT score increased by 4% ( p < 0.001), SCT decreased by -5% (boys) and -7% (girls) ( p < 0.001), while SPPB score did not change significantly. In obese adults at T21, PPT score increased by 9% ( p < 0.001), SCT decreased by -16% ( p < 0.001) only in females, and SPPB score increased by 7% (males) and 10% (females) ( p < 0.01)., Conclusion: In conclusion, moderate energy restriction and regular physical activity determine a 4-5% BM reduction during a 3-week inpatient BWRP, improve physical capabilities and induce beneficial changes in body composition in adolescents and adults with obesity., Trial Registration: This study was approved by the Ethical Committee of the Istituto Auxologico Italiano (Milan, Italy; research code: 01C124; acronym: PRORIPONATFIS). Registered 11 November 2020 - Retrospectively registered., 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 © 2022 Lazzer, D’Alleva, Vaccari, Tringali, De Micheli and Sartorio.)

Prader-Willi syndrome (PWS), a multisystemic disorder caused by lack of expression of genes on the paternally inherited chromosome 15q11.2-q13 region, is characterized by hyperphagia and childhood-onset morbid obesity, A retrospective cohort study of 60 PWS patients, 38 females and 22 males, undergoing a 6-year rehabilitation program was analysed. Mean age at the time of first admission was 27 ± 7 years, body weight (BW) was 97 kg ± 29 kg and height was 1.53 ± 0.09 m. Twenty-four patients (40%) showed BW loss after 6 years of follow-up, seventeen (28%) remained stable and nineteen (32%) gained BW. Responsiveness in term of BW reduction was less frequent in patients with the UPD karyotype, karyotype del15 being more frequent among responsive patients. Furthermore, responsive PWS subjects had a higher BMI (47 vs. 36 kg/m 2 ), waist (123 vs. 106 cm) and hip (136 vs. 118 cm) circumferences than non-responsive at the time of first hospitalization. Baseline body composition and metabolic parameters did not differentiate between responsive and non-responsive patients. Given the rarity of PWS and relative lack of studies, these results can be considered relevant because based on a relatively large number of PWS patients followed up for a long term period., (© 2022. The Author(s).)

Purpose: The aim of this study was to compare pole walking (PW) and walking without poles (W) on a steep uphill mountain path (1.3 km, 433 m of elevation gain) at 2 different intensities: a maximal effort that would simulate a vertical kilometer intensity and a lower intensity (80% of maximal) simulating an ultratrail race., Methods: On the first day, we tested the participants in the laboratory to determine their maximal physiological parameters, respiratory compensation point, and gas exchange threshold. Then, they completed 4 uphill tests along a mountain path on 4 separate days, 2 at their maximum effort (PWmax and Wmax, randomized order) and 2 at 80% of the mean vertical velocity maintained during the first 2 trials (PW80 and W80, randomized order). We collected metabolic data, heart rate, blood lactate concentration, and rating of perceived exertion at the end of each trial. We also collected rating of perceived exertion at every 100 m of elevation gain during PW80 and W80., Results: Participants completed the maximal effort faster with poles versus without poles (18:51 [03:12] vs 19:19 [03:01] in min:s, P = .013, d = 0.08, small). Twelve of the 15 participants (80%) improved their performance when they used poles. During PW80 and W80, none of the physiological or biomechanical parameters were different., Conclusion: In the examined condition, athletes should use poles during steep uphill maximal efforts to obtain the best performance. Conversely, during submaximal effort, the use of poles does not provide advantages in uphill PW.

Background: Weight loss through physical exercise is warranted among obese individuals. Recently, a greater benefit in cardiorespiratory fitness was achievable with high-intensity interval training (HIIT) as compared with moderate intensity continuous training. The beneficial effect of training on CV health might be related to a specific modulation of circulating irisin, an adypo-myokine implicated in the regulation of energy expenditure. Methods : The present study investigates the circulating plasma levels of irisin at baseline and in response to 12-week of training program either with HIIT or moderate-intensity continuous training (MICT) among young female and male obese subjects. Clinical, anthropometric, and training characteristics for each participant were available. A sex-disaggregated data for circulating plasma levels of irisin pre- and post-training are provided as well as an adjusted multivariate linear regression model to identify the determinants of post-training irisin levels. Results: Data from a total of 32 obese healthy individuals (47% female, mean age 38.7 years, mean BMI 35.6 kg/m 2 ), randomized in a 1:1 manner to HIIT or MICT were analyzed. Circulating plasma levels of irisin similarly and significantly decreased in both MICT and HIIT interventional groups. Females had higher post-exercise irisin levels than males (6.32 [5.51-6.75] vs. 4.97 [4.57-5.72] μg/mL, p = 0.001). When stratified by an interventional group, a statistically significant difference was observed only for the MICT group (male, 4.76 [4.20-5.45] μg/mL vs. female 6.48 [4.88-6.84] μg/mL p = 0.03). The circulating post-training level of irisin was independently associated with post-training fat-free mass (β -0.34, 95% confidence interval, CI -0.062, -0.006, p = 0.019) in a model adjusted confounders. When female sex was added into the adjusted model, it was retained as the only factor independently associated with irisin levels (β 1.22, 95% CI, 0.50, 1.93, p = 0.002). Conclusions: In obese healthy subjects, circulating irisin levels were reduced in response to 12-weeks of exercise involving either HIIT or MICT. A sex-specific differences in circulating irisin levels at baseline and as biological response to chronic exercise was described. Sex-specific biological response of irisin to exercise should be further explored to tailor sex-specific training approaches for improving the cardiovascular health of obese healthy subjects.

Background: This study aimed to evaluate the relationship between physical activity habits, physical performance and cognitive capacity in older adults' population of Italy and Slovenia., Methods: Anthropometric characteristics and body composition bioelectrical impedance analysis were evaluated in 892 older adults (60-80 y). Aerobic capacity was measured using the 2-km walk test and handgrip and flexibility tests were performed. Physical activity habits and cognitive functions were evaluated by the Global-Physical-Activity-Questionnaires (GPAQ) and by Montreal-Cognitive-Assessment (MoCA) questionnaires, respectively., Results: GPAQ scores were associated with lower BMI (r=-0.096; P=0.005), lower percentage of fat-mass (r=-0.138; P=0.001), better results in the 2-km walk test (r=-0.175; P=0.001) and a higher percentage of fat-free mass (r=0.138; P=0.001). We also evaluated that a higher MoCA Score correlates with age (r=-0.208; P=0.001), 2-km walk test (r=-0.166; P=0.001), waist-hip ratio (r=-0.200; P=0.001), resting heart-rate (r=-0.087; P=0.025) and heart-rate at the end of 2-km walk test (r=0.189; P=0.001)., Conclusions: Older adults with a higher level of daily physical activity showed reduction in fat-mass and BMI, and higher aerobic fitness; these characteristics have a protection effect on cognitive function.