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Paoli A, Campa F. Problems and Opportunities in the use of Bioelectrical Impedance Analysis for Assessing Body Composition During Ketogenic Diets: A Scoping Review. Curr Obes Rep 2024:10.1007/s13679-024-00573-0. [PMID: 38802722 DOI: 10.1007/s13679-024-00573-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE OF THE REVIEW The use of bioelectrical impedance analysis (BIA) for monitoring body composition during the ketogenic diet has experienced a rapid surge. This scoping review aimed to assess the validity of procedures applying BIA in the ketogenic diet and to suggest best practices for optimizing its utilization. RECENT FINDINGS We conducted a systematic scoping review of peer-reviewed literature involving BIA for assessing body composition in individuals adhering to a ketogenic diet. Searches of international databases yielded 1609 unique records, 72 of which met the inclusion criteria and were reviewed. Thirty-five studies used foot-to-hand technology, 34 used standing position technology, while 3 did not declare the technology used. Raw bioelectrical parameters were reported in 21 studies. A total of 196 body mass components were estimated, but predictive equations were reported in only four cases. Most research on BIA during ketogenic diets did not report the equations used for predicting body composition, making it impossible to assess the validity of BIA outputs. Furthermore, the exceedingly low percentage of studies reporting and analyzing raw data makes it challenging to replicate methodologies in future studies, highlighting that BIA is not being utilized to its full potential. There is a need for more precise technology and device characteristics descriptions, full report of raw bioelectrical data, and predictive equations utilized. Moreover, evaluating raw data through vectorial analysis is strongly recommended. Eventually, we suggest best practices to enhance BIA outcomes during ketogenic diets.
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Affiliation(s)
- Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy.
| | - Francesco Campa
- Department of Biomedical Sciences, University of Padua, Padua, Italy
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Liu S, Zhang S, Cheng X, Wu D, Chen J, Liang W, Qian S, Zhang J, Jiang F. A meta-analysis on the impact of resistance training on phase angle in middle-aged and older individuals. Arch Gerontol Geriatr 2024; 119:105318. [PMID: 38194828 DOI: 10.1016/j.archger.2023.105318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE To determine the impact of resistance training (RT) on phase angle (PhA) in middle-aged and older individuals via meta-analysis, explore effects in subgroups, and identify optimal RT protocol. MATERIALS AND METHODS We searched five databases using predefined criteria, assessed literature quality per Cochrane 5.1 Handbook, and used Revman 5.3 for effect size aggregation, bias assessment, sensitivity analysis, and subgroup analysis. RESULTS RT improved PhA in middle-aged and older individuals (d = 0.34, 95 % CI: 0.27-0.40, P < 0.05). Effective subgroups included Suspension (d = 0.62, 95 % CI: 0.33-0.90, P < 0.05), free-weights and machine (d = 0.36, 95 % CI: 0.28-0.45, P < 0.05), equipment training (d = 0.24, 95 % CI: 0.13-0.36, P < 0.05), and moderate-intensity RT (d = 0.34, 95 % CI: 0.27-0.42, P < 0.05). RT was conducted 2-3 times/week (d = 0.20, 95 % CI: 0.01-0.38, P < 0.05) or (d = 0.38, 95 % CI: 0.30-0.47, P < 0.05). PhA improved after 8 weeks (d = 0.37, 95 % CI: 0.23-0.51, P < 0.05), 12 weeks (d = 0.35, 95 % CI: 0.26-0.44, P < 0.05), and ≥ 24 weeks (d = 0.26, 95 % CI: 0.11-0.41, P < 0.05) of RT in aged and older individuals. Low- and high-intensity RT, elastic band training, and weekly exercises did not significantly improve PhA. CONCLUSIONS RT enhances PhA in middle-aged and older adults. For optimal results, we recommend 2-3 weekly sessions of free weights and machine training lasting at least 8 weeks.
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Affiliation(s)
- Siqi Liu
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Siqing Zhang
- School of Physical Education, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Xuejing Cheng
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Danting Wu
- Department of Physical Education, Tongji University, Shanghai, 200092, China
| | - Jiongxun Chen
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Wenqi Liang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, 510006, China
| | - Siyu Qian
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Jisheng Zhang
- School of Physical Education, Hunan Normal University, Changsha, 410012, China.
| | - Fanglin Jiang
- School of Physical Education, Hunan Normal University, Changsha, 410012, China.
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Increasing Muscle Mass in Elders through Diet and Exercise: A Literature Review of Recent RCTs. Foods 2023; 12:foods12061218. [PMID: 36981144 PMCID: PMC10048759 DOI: 10.3390/foods12061218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/23/2023] [Accepted: 03/09/2023] [Indexed: 03/14/2023] Open
Abstract
This study aimed to review the current evidence on the independent and combined effects of diet and exercise and their impact on skeletal muscle mass in the elderly population. Skeletal muscle makes up approximately 40% of total body weight and is essential for performing daily activities. The combination of exercise and diet is known to be a potent anabolic stimulus through stimulation of muscle protein synthesis from amino acids. Aging is strongly associated with a generalized deterioration of physiological function, including a progressive reduction in skeletal muscle mass and strength, which in turn leads to a gradual functional impairment and an increased rate of disability resulting in falls, frailty, or even death. The term sarcopenia, which is an age-related syndrome, is primarily used to describe the gradual and generalized loss of skeletal muscle mass (mainly in type II muscle fibers) and function. Multimodal training is emerging as a popular training method that combines a wide range of physical dimensions. On the other hand, nutrition and especially protein intake provide amino acids, which are essential for muscle protein synthesis. According to ESPEN, protein intake in older people should be at least 1 g/kgbw/day. Essential amino acids, such as leucine, arginine, cysteine, and glutamine, are of particular importance for the regulation of muscle protein synthesis. For instance, a leucine intake of 3 g administered alongside each main meal has been suggested to prevent muscle loss in the elderly. In addition, studies have shown that vitamin D and other micronutrients can have a protective role and may modulate muscle growth; nevertheless, further research is needed to validate these claims. Resistance-based exercise combined with a higher intake of dietary protein, amino acids, and/or vitamin D are currently recognized as the most effective interventions to promote skeletal muscle growth. However, the results are quite controversial and contradictory, which could be explained by the high heterogeneity among studies. It is therefore necessary to further assess the impact of each individual exercise and nutritional approach, particularly protein and amino acids, on human muscle turnover so that more efficient strategies can be implemented for the augmentation of muscle mass in the elderly.
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Abstract
The biophysical response of the human body to electric current is widely appreciated as a barometer of fluid distribution and cell function. From distinct raw bioelectrical impedance (BIA) variables assessed in the field of body composition, phase angle (PhA) has been repeatedly indicated as a functional marker of the cell's health and mass. Although resistance training (RT) programs have demonstrated to be effective to improve PhA, with varying degrees of change depending on other raw BIA variables, there is still limited research explaining the biological mechanisms behind these changes. Here, we aim to provide the rationale for the responsiveness of PhA determinants to RT, as well as to summarize all available evidence addressing the effect of varied RT programs on PhA of different age groups. Available data led us to conclude that RT modulates the cell volume by increasing the levels of intracellular glycogen and water, thus triggering structural and functional changes in different cell organelles. These alterations lead, respectively, to shifts in the resistive path of the electric current (resistance, R) and capacitive properties of the human body (reactance, Xc), which ultimately impact PhA, considering that it is the angular transformation of the ratio between Xc and R. Evidence drawn from experimental research suggests that RT is highly effective for enhancing PhA, especially when adopting high-intensity, volume, and duration RT programs combining other types of exercise. Still, additional research exploring the effects of RT on whole-body and regional BIA variables of alternative population groups is recommended for further knowledge development.
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Affiliation(s)
- Luís B Sardinha
- Exercise and Health Laboratory, Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, , Cruz Quebrada, Portugal.
| | - Gil B Rosa
- Exercise and Health Laboratory, Faculdade de Motricidade Humana, CIPER, Universidade de Lisboa, , Cruz Quebrada, Portugal
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Martins AD, Fernandes O, Oliveira R, Bilro V, Lopes G, Rego AM, Parraça JA, Raimundo AMM, Brito JP. Effects of exercise programs on phase angle in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2022; 103:104787. [PMID: 35961106 DOI: 10.1016/j.archger.2022.104787] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
The purpose of this study was to calculate the effects of exercise programs on phase angle (PhA) in older people. A systematic review was undertaken in multiple electronic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines for the purposes of selecting randomized controlled trials that measured the effects of the exercise programs on PhA in older adults on 31 March 2022. We carried out a random-effect meta-analysis for the effects of exercise programs on PhA. Additionally, we analysed the differences between subgroups in terms of weekly frequency, number of sets and repetitions, and duration of interventions. Studies were methodological assessed through the PEDro scale where one had excellent, ten had good, and three had poor methodological quality. For the purposes of the study, fourteen studies met the criteria for inclusion. However, four studies did not have enough information to be included in the quantitative analysis. The remaining ten articles revealed moderate effects on PhA in favour of intervention groups (p=0.009, SMD=0.72 [0.46-0.99], I2=54%). The meta-analysis also showed that interventions lasting twelve weeks are more successful in generating positive effects on PhA as opposed to eight weeks (SMD's=0.79 vs. 0.64, respectively). These results indicate that resistance training (RT) is an effective and safe to improve PhA in the older people, especially through RT programs lasting from eight to twelve weeks. A novel finding of this study was that RT is the most used type of exercise by authors when assessing the PhA in older adults.
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Affiliation(s)
- Alexandre Duarte Martins
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal; Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal.
| | - Orlando Fernandes
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal; Research Centre in Sport Sciences, Health Sciences and Human Development, Vila Real 5001-801, Portugal
| | - Vitor Bilro
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Gabriel Lopes
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - António Maia Rego
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - José A Parraça
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Armando Manuel Mendonça Raimundo
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal; Research Centre in Sport Sciences, Health Sciences and Human Development, Vila Real 5001-801, Portugal
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Campa F, Colognesi LA, Moro T, Paoli A, Casolo A, Santos L, Correia RR, Lemes ÍR, Milanez VF, Christofaro DD, Cyrino ES, Gobbo LA. Effect of resistance training on bioelectrical phase angle in older adults: a systematic review with Meta-analysis of randomized controlled trials. Rev Endocr Metab Disord 2022; 24:439-449. [PMID: 35918569 PMCID: PMC10140106 DOI: 10.1007/s11154-022-09747-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/13/2022] [Indexed: 10/16/2022]
Abstract
Resistance training has been proposed as a valid practice to counteract the aging effect on body mass and its components, which can be easily evaluated though the bioelectrical impedance analysis. This study aimed to achieve a systematic review with meta-analysis on the impact of resistance training on bioelectrical proprieties in older adults.A literature review was done in four electronic databases up to 1 January 2022. The inclusion criteria were: (i) participants aged ≥ 60 years; (ii) resistance training lasted ≥ 8 weeks; (iii) measurement of raw bioelectrical parameters in randomized controlled study designs.The outcomes of the trial had to be bioelectrical phase angle (PhA), resistance (R), and reactance (Xc). The methodological quality was assessed using the Rosendal scale.Overall, seven studies with a total of 344 participants were eligible for the analysis. The quality assessment yielded a score of 71.3%. Bioelectrical PhA (0.52 degree [95%CI 0.32, 0.71], p < 0.001) and Xc (3.58 ohms [95%CI 1.97, 5.19], p < 0.001) increased, whereas R decreased (-28.50 ohms [95%CI -41.39, -15.60], p < 0.001) after the resistance training programs.In this meta-analysis, resistance training promoted increases of PhA, which result from an increase in Xc concomitant with a reduction in R. According to the bioimpedance vector analysis, resistance-trained people experienced a beneficial leftward vector displacement, whilst inactivity induced a rightward vector displacement within the R-Xc graph. In future, more sophisticated and rigorous studies that address specific criteria, methods and targeted designs are required to identify which equipment and protocols allow for an optimization of the resistance training effects.Registration code in PROSPERO: CRD42020168057.
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Affiliation(s)
- Francesco Campa
- Department of Biomedical Sciences, University of Padua, 35131, Padova, Italy.
| | - Lucas Antonio Colognesi
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, 19060-900, Padova, SP, Brazil
- Graduate Program in Physical Therapy, School of Technology and Science, São Paulo State University (UNESP), Brazil, UNESP, 19060-900, Presidente Prudente, SP, Brazil
| | - Tatiana Moro
- Department of Biomedical Sciences, University of Padua, 35131, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padua, 35131, Padova, Italy
| | - Andrea Casolo
- Department of Biomedical Sciences, University of Padua, 35131, Padova, Italy
| | - Leandro Santos
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, 86057-970, Londrina, PR, Brazil
| | - Rafael Ribeiro Correia
- Multicentric Program of Postgraduate in Physiological Sciences, São Paulo State University (UNESP), School of Dentistry of Araçatuba, São Paulo, Brazil., UNESP, 19060-900, Sao Paulo, SP, Brazil
| | - Ítalo Ribeiro Lemes
- Graduate Program in Physical Therapy, School of Technology and Science, São Paulo State University (UNESP), Brazil, UNESP, 19060-900, Presidente Prudente, SP, Brazil
| | - Vinícius Flávio Milanez
- Department of Physical Education, Oeste Paulista University, UNOESTE, 19067-175, Presidente Prudente, SP, Brazil
| | - Diego Destro Christofaro
- Graduate Program in Physical Therapy, School of Technology and Science, São Paulo State University (UNESP), Brazil, UNESP, 19060-900, Presidente Prudente, SP, Brazil
| | - Edilson Serpeloni Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, 86057-970, Londrina, PR, Brazil
| | - Luís Alberto Gobbo
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, 19060-900, Padova, SP, Brazil
- Graduate Program in Physical Therapy, School of Technology and Science, São Paulo State University (UNESP), Brazil, UNESP, 19060-900, Presidente Prudente, SP, Brazil
- Metabolism, Nutrition, and Exercise Laboratory, Physical Education and Sport Center, Londrina State University, 86057-970, Londrina, PR, Brazil
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de Oliveira Matos B, da Costa Rosa CS, Ribeiro HS, Marcos NM, Losilla MPR, Monteiro HL, Gimenes C. Obesity phenotypes are, in part, associated with physical activity in diabetic hemodialysis patients. Int Urol Nephrol 2021; 54:1751-1759. [PMID: 34816362 DOI: 10.1007/s11255-021-03060-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 11/11/2021] [Indexed: 01/07/2023]
Abstract
PURPOSE To investigate the prevalence of obesity phenotypes and their association with physical activity levels among diabetic hemodialysis patients. METHODS This is a cross-sectional study with 84 diabetic hemodialysis patients (63.5 ± 9.4 years, 54.8% of men). Obesity was diagnosed as high body fat (≥ 40% for male and ≥ 30% for female). Sarcopenic obesity was considered if low skeletal muscle mass (< 20.0 kg for males and < 15.0 kg for females) and obesity were combined. Dynapenic obesity was defined in the presence of low handgrip strength (< 27 kg for males and < 16 kg for females) and obesity. Muscle failure obesity was confirmed in the concomitant presence of obesity, sarcopenia, and dynapenia. Physical activity level was assessed by the Baecke questionnaire and patients were classified as low physical activity according to the first tertile for each of and total domains. RESULTS Fifty-four patients (64%) presented obesity. From these, 5 (6%), 19 (23%) and 8 (10%) were classified as sarcopenic obese, dynapenic obese, and muscle failure obese, respectively, and 22 (26%) were only obese. Patients with sarcopenic obesity and muscle failure obesity had lower leisure and locomotion physical activity scores than non-obese, whereas the total domain score did not differ across the groups. Muscle failure obesity was independently associated with low leisure physical activity (OR 10.8, 95% CI 1.3-88.1). Only sarcopenic obesity was independently associated with the locomotion and total physical activity domains (OR 15.4, 95% CI 1.4-90.2 and OR 17.0, 95% CI 1.5-95.4, respectively). CONCLUSION Our study found a lower prevalence of sarcopenic obesity compared to dynapenic obesity and muscle failure obesity among diabetic hemodialysis patients. Moreover, sarcopenic obesity and muscle failure obesity, but not dynapenic obesity, were associated with low physical activity levels.
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Affiliation(s)
- Beatriz de Oliveira Matos
- Centro Universitário do Sagrado Coração (UNISAGRADO), Pró-reitoria de Pesquisa e Pós-graduação, Bauru, SP, Brazil
| | - Clara Suemi da Costa Rosa
- Universidade Estadual Paulista (UNESP), Faculdade de Ciências, Bauru, SP, Brazil.
- UNESP-Instituto de Biociências, Campus de Rio Claro, Seção Técnica de Pós-graduação, Avenida 24-A no. 1515, Bairro Bela Vista, Rio Claro, SP, 13506-900, Brazil.
| | - Heitor Siqueira Ribeiro
- Faculty of Physical Education, University of Brasília, Brasília, Brazil
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Porto, Portugal
| | - Natasha Maggi Marcos
- Centro Universitário do Sagrado Coração (UNISAGRADO), Pró-reitoria de Pesquisa e Pós-graduação, Bauru, SP, Brazil
| | | | | | - Camila Gimenes
- Centro Universitário do Sagrado Coração (UNISAGRADO), Pró-reitoria de Pesquisa e Pós-graduação, Bauru, SP, Brazil
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