Prediction of Percentage Body Fat in Rural Thai Population Using Simple Anthropometric Measurements

Prediction of body fat percentage: Development and validation of new anthropometric equations

INTRODUCTION

The aim of this study was to test the validity of existing equations, retrieved from the literature, in the Algerian adult population. To develop, and validate, new predictive equations for body fat percentage (%BF) using simple and easy-to-measure anthropometric parameters.

METHODS

This is a cross-sectional study including 877 Algerian adults who underwent a body composition assessment by the direct segmental multi-frequency bioelectrical impedance technique (Inbody-770). Participants were randomly divided into two groups: the development group (n = 577) and the validation group (n = 300). To develop the equations, multiple linear regression models were analyzed. The predictive performance of the developed equations was compared with the direct technique. The following validation tests were used: Student's t-test for paired samples, correlation, and Bland-Altman diagram. Diagnostic accuracy has also been assessed.

RESULTS

Four existing equations were tested, and all showed statically significant bias. Four new equations were developed; all had satisfactory predictive performance, with a correlation coefficient ranging from 0.72 to 0.94 in men and 0.87 to 0.93 in women. The best-fitting equation was based on body mass index, waist-to-hip ratio, and chest circumference. The diagnostic accuracy of this equation was 96.7% in men and 95.3% in women.

CONCLUSION

The newly developed equations based on anthropometric parameters can serve as a simple tool for the accurate prediction of BF% in adult subjects, at both individual and epidemiological levels.

Criterion-Related Validity of Field-Based Methods and Equations for Body Composition Estimation in Adults: A Systematic Review

PURPOSE OF REVIEW

Overweight and obesity are associated to health prognosis. Therefore, body composition assessment is an important health outcome, especially in adult population. We analyzed the criterion-related validity of existing field-based methods and equations for body composition estimation in adults aged 19-64 years.

RECENT FINDINGS

One hundred studies met inclusion criteria. The field-based methods, waist circumference (WC), body adiposity index (BAI), and body mass index (BMI) are valid to indicate body adiposity. Likewise, several equations, including the classical Durnin/Womersley equation, Jackson/Pollock equation (males), and Jackson, Pollock, and Ward equation (females), are valid to estimate total body fat mass or body fat percentage. Anthropometric field methods can provide a simple, quick, and easy informative indicators of adiposity in adults. Classical equations, such as Durnin/Womersley equation, Jackson/Pollock equation, and Jackson, Pollock, and Ward equation, are still valid to estimate total body fat mass or body fat percentage in adult population. When choosing estimation equations, specific population characteristics, such as age, weight status, or race ethnicity, should be taken into account. (Trial Registration: Registered on PROSPERO (CRD42020194272)).

Anthropometric Prediction of DXA-Measured Percentage of Fat Mass in Athletes With Unilateral Lower Limb Amputation

To date there is no anthropometric equation specific to athletes with unilateral lower limb amputation to estimate the percentage of fat mass (%FM). This study investigated the accuracy of a set of anthropometric equations validated on able-bodied populations to predict the %FM assessed by-means of dual-energy x-ray absorptiometry (DXA) in athletes with unilateral lower limb amputation. Furthermore, a predictive anthropometric equation specific to athletes with unilateral lower limb amputation was developed from skinfold thickness measurements using DXA as the reference method for the estimation of the %FM. Twenty-nine white male athletes with unilateral lower limb amputation underwent a DXA scan and an anthropometric assessment on the same day. The %FM, calculated through several existing anthropometric equations validated upon able-bodied populations, was compared with the DXA-measured %FM (%FM_DXA). Accuracy and agreement between the two methods was computed with two-tailed paired-sample t-test, concordance correlation coefficient, reduced major axis regression and Bland-Altman analysis. A stepwise multiple regression analysis with the %FM_DXA as the dependent variable and age and nine skinfold thicknesses as potential predictors was carried out and validated using a repeated 10-fold cross-validation. A linear regression analysis with the sum of nine skinfolds as the independent variable was also carried out and validated using a repeated 10-fold cross-validation. The results showed that the anthropometric equations validated on able-bodied populations are inaccurate in the estimation of %FM_DXA with an average bias ranging from 0.51 to -13.70%. Proportional bias was also found revealing that most of the anthropometric equations considered, tended to underestimate/overestimate the %FM_DXA as body fat increased. Regression analysis produced two statistically significant models (P < 0.001 for both) which were able to predict more than 93% of total variance of %FM_DXA from the values of four skinfold measurements (i.e., thigh, abdominal, subscapular and axillary skinfold measurements) or from the sum of 9 skinfolds. Repeated cross-validation analysis highlighted a good predictive performance of the proposed equations. The predictive equations proposed in this study represent a useful tool for clinicians, nutritionists, and physical conditioners to evaluate the physical and nutritional status of athletes with unilateral lower limb amputation directly in the field.

Physical activity and maximal oxygen uptake in adults with Prader-Willi syndrome

BACKGROUND

Prader-Willi Syndrome (PWS) is the most common genetic syndrome causing life-threatening obesity. Strict adherence to a low-calorie diet and regular physical activity are needed to prevent weight gain. Direct measurement of maximal oxygen uptake (VO₂ max), the "gold standard" for assessing aerobic exercise capacity, has not been previously described in PWS.

OBJECTIVES

Assess aerobic capacity by direct measurement of VO₂ max in adults with PWS, and in age and BMI-matched controls (OC), and compare the results with values obtained by indirect prediction methods.

METHODS AND PATIENTS

Seventeen individuals (12 males) age: 19-35 (28.6 ± 4.9) years, BMI: 19.4-38.1 (27.8 ± 5) kg/m² with genetically confirmed PWS who exercise daily, and 32 matched OC (22 males) age: 19-36 (29.3 ± 5.2) years, BMI: 21.1-48.1 (26.3 ± 4.9) kg/m². All completed a medical questionnaire and performed strength and flexibility tests. VO₂ max was determined by measuring oxygen consumption during a graded exercise test on a treadmill.

RESULTS

VO₂ max (24.6 ± 3.4 vs 46.5 ± 12.2 ml/kg/min, p < 0.001) and ventilatory threshold (20 ± 2 and 36.2 ± 10.5 ml/kg/min, p < 0.001), maximal strength of both hands (36 ± 4 vs 91.4 ± 21.2 kg, p < 0.001), and flexibility (15.2 ± 9.5 vs 26 ± 11.1 cm, p = 0.001) were all significantly lower for PWS compared to OC. Predicted estimates and direct measurements of VO₂ max were almost identical for the OC group (p = 0.995), for the PWS group, both methods for estimating VO₂ max gave values which were significantly greater (p < 0.001) than results obtained by direct measurements.

CONCLUSIONS

Aerobic capacity, assessed by direct measurement of VO₂ max, is significantly lower in PWS adults, even in those who exercise daily, compared to OCs. Indirect estimates of VO₂ max are accurate for OC, but unreliable in PWS. Direct measurement of VO₂ should be used for designing personal training programs and in clinical studies of exercise in PWS.

Dual-Energy X-Ray Absorptiometry, Skinfold Thickness, and Waist Circumference for Assessing Body Composition in Ambulant and Non-Ambulant Wheelchair Games Players

Field-based assessments provide a cost-effective and accessible alternative to dual-energy X-ray absorptiometry (DXA) for practitioners determining body composition in athletic populations. It remains unclear how the range of physical impairments classifiable in wheelchair sports may affect the utility of field-based body composition techniques. The present study assessed body composition using DXA in 14 wheelchair games players who were either wheelchair dependent (non-walkers; n = 7) or relied on a wheelchair for sports participation only (walkers; n = 7). Anthropometric measurements were used to predict body fat percentage with existing regression equations established for able-bodied persons by Sloan and Weir, Durnin and Womersley, Lean et al, Gallagher et al, and Pongchaiyakul et al. In addition, linear regression analysis was performed to calculate the association between body fat percentage and BMI, waist circumference, sum of 6 skinfold thickness and sum of 8 skinfold thickness. Results showed that non-walkers had significantly lower total lean tissue mass (46.2 ± 6.6 kg vs. 59.4 ± 8.2 kg, P = 0.006) and total body mass (65.8 ± 4.2 kg vs. 79.4 ± 14.9 kg; P = 0.05) than walkers. Body fat percentage calculated from most existing regression equations was significantly lower than that from DXA, by 2 to 9% in walkers and 8 to 14% in non-walkers. Of the anthropometric measurements, the sum of 8 skinfold thickness had the lowest standard error of estimation in predicting body fat content. In conclusion, existing anthropometric equations developed in able-bodied populations substantially underestimated body fat content in wheelchair athletes, particularly non-walkers. Impairment specific equations may be needed in wheelchair athletes.

The impact of obesity towards prostate diseases

Evidence has supported obesity as a risk factor for both benign prostate hyperplasia (BPH) and prostate cancer (PCa). Obesity causes several mechanisms including increased intra-abdominal pressure, altered endocrine status, increased sympathetic nervous activity, increased inflammation process, and oxidative stress, all of which are favorable in the development of BPH. In PCa, there are several different mechanisms, such as decreased serum testosterone, peripheral aromatization of androgens, insulin resistance, and altered adipokine secretion caused by inflammation, which may precipitate the development of and even cause high-grade PCa. The role of obesity in prostatitis still remains unclear. A greater understanding of the pathogenesis of prostate disease and adiposity could allow the development of new therapeutic markers, prognostic indicators, and drug targets. This review was made to help better understanding of the association between central obesity and prostate diseases, such as prostatitis, BPH, and PCa.

Anthropometric predictive equations for estimating body composition

Background:

Precise and accurate measurements of body composition are useful in achieving a greater understanding of human energy metabolism in physiology and in different clinical conditions, such as, cardiovascular disease and overall mortality. Dual-energy x-ray absorptiometry (DXA) can be used to measure body composition, but the easiest method to assess body composition is the use of anthropometric indices. This study has been designed to evaluate the accuracy and precision of body composition prediction equations by various anthropometric measures instead of a whole body DXA scan.

Materials and Methods:

We identified 143 adult patients underwent DXA evaluation of the whole body. The anthropometric indices were also measured. Datasets were split randomly into two parts. Multiple regression analysis with a backward stepwise elimination procedure was used as the derivation set and then the estimates were compared with the actual measurements from the whole-body scans for a validation set. The SPSS version 20 for Windows software was used in multiple regression and data analysis.

Results:

Using multiple linear regression analyses, the best equation for predicting the whole-body fat mass (R² = 0.808) included the body mass index (BMI) and gender; the best equation for predicting whole-body lean mass (R² = 0.780) included BMI, WC, gender, and age; and the best equation for predicting trunk fat mass (R² = 0.759) included BMI, WC, and gender.

Conclusions:

Combinations of anthropometric measurements predict whole-body lean mass and trunk fat mass better than any of these single anthropometric indices. Therefore, the findings of the present study may be used to verify the results in patients with various diseases or diets.

Brief communication: Body mass index, body adiposity index, and percent body fat in Asians

Human obesity is a growing epidemic throughout the world. Body mass index (BMI) is commonly used as a good indicator of obesity. Body adiposity index (BAI = hip circumference (cm)/stature (m)(1.5) - 18), as a new surrogate measure, has been proposed recently as an alternative to BMI. This study, for the first time, compares BMI and BAI for predicting percent body fat (PBF; estimated from skinfolds) in a sample of 302 Buryat adults (148 men and 154 women) living in China. The BMI and BAI were strongly correlated with PBF in both men and women. The correlation coefficient between BMI and PBF was higher than that between BAI and PBF for both sexes. For the linear regression analysis, BMI better predicted PBF in both men and women; the variation around the regression lines for each sex was greater for BAI comparisons. For the receiver operating characteristic (ROC) analysis, the area under the ROC curve for BMI was higher than that for BAI for each sex, which suggests that the discriminatory capacity of the BMI is higher than the one of BAI. Taken together, we conclude that BMI is a more reliable indicator of PBF derived from skinfold thickness in adult Buryats.

Population differences in the relationship between height, weight, and adiposity: an application of Burton's model

The study of human variation in adiposity and lean mass is important for understanding core processes in human evolution, and is increasingly a public health concern as the "obesity epidemic" expands globally. The dominant measure of population differences in adiposity is Body Mass Index (BMI), which suffers from systematic biases across populations due to variation in the relationship between true body fat, height and weight. Here we develop simplified corrections for such anthropometric-based measures of adiposity that can take into account this population variation. These corrections derive from a recent model proposed by Burton that assumes humans accrue mass in two ways-growth in height that adds bone and muscle, and growth in body fat and the ancillary fat-free mass (FFM) needed to support this additional body fat. We analyze two ethnically diverse datasets with dual X-ray absorptiometry-measured (DXA) fat mass, assessing the fit of Burton's model and deriving novel corrections based on estimated musculoskeletal slenderness. The resulting model provides excellent fit to fat mass within populations (average R2 = 0.92 for women and R2 = 0.83 for men). World populations differ dramatically in musculoskeletal slenderness (up to a difference of 4.4 kg/m2), as do men and women (differences of 3.3-4.5 kg/m2), leading to clear population corrections. These findings point to a conceptually straightforward tool for estimating true differences in adiposity across populations, and suggest an alternative to BMI that provides a more accurate and theoretically based estimate of body fat than that traditionally derived from height and weight measures.

Can weight-related health risk be more accurately assessed by BMI, or by gender specific calculations of Percentage Body Fatness?

The problem of obesity over the last 10 years has consistently been referred to as a 'global epidemic'. The Body Mass Index (BMI) is the currently accepted measure for classifying weight-related risk, but is a crude measure that has not changed in 150 years. It is recognised as having significant limitations, largely due to its lack of distinction between fat and muscle tissue. As the health risks of obesity are linked to the fat content of the body, a more accurate method of classifying would be Percentage Body Fatness (PBF). Although skinfold thickness analysis is recognised as a valid and accurate estimate of PBF in field studies, this method is not routinely used in clinical practice. Using data collected from young adults in the United Kingdom, we compared classifications (underweight, normal weight, overweight and obese) using BMI, with classifications using estimated PBF (from skinfold thickness analysis). We identified disparity between these two methods in approximately 1/3 of participants. BMI correctly classified 66.5% of females and 62.7% of males, with different gender profiles of incorrect classification. Regression analysis was conducted using estimated PBF (by skinfold thickness analysis) as the dependent variable, with explanatory variables of age, height, weight, systolic blood pressure, frequency of vigorous exercise and grip strength. The resulting gender-specific formulae derived from this regression analysis provides a regression R(2) of around 65%, and improved correct classifications to 74% for females and 76% for males. This represents an average improvement of roughly ten percentage points over BMI (male: 7.2% points; female: 13.4% points). We hypothesise that the presented formulae provide gender-specific calculations of PBF, which result in a more accurate indicator of weight-related health risk, compared with BMI in this population. This provides a new approach to an increasingly important clinical issue. These formulae use data that can be easily, quickly and cost-effectively measured in a practice setting. If shown to be repeatable with larger and more diverse populations, the PBF formulae could provide an alternative to the BMI as the major indicator of body-composition related health risk. This would ensure resources are targeted more appropriately and efficiently.

The variations of body mass index and body fat in adult Thai people across the age spectrum measured by bioelectrical impedance analysis

Background

The measurements of body mass index (BMI) and percentage of body fat are used in many clinical situations. However, special tools are required to measure body fat. Many formulas are proposed for estimation but these use constant coefficients of age. Age spectrum might affect the predicted value of the body composition due to body component alterations, and the coefficient of age for body fat prediction might produce inconsistent results. The objective of this study was to identify variations of BMI and body fat across the age spectrum as well as compare results between BMI predicted body fat and bioelectrical impedance results on age.

Methods

Healthy volunteers were recruited for this study. Body fat was measured by bioelectrical impedance. The age spectrum was divided into three groups (younger: 18–39.9; middle: 40–59.9; and older: ≥60 years). Comparison of body composition covariates including fat mass (FM), fat free mass (FFM), percentage FM (PFM), percentage FFM (PFFM), FM index (FMI) and FFM index (FFMI) in each weight status and age spectrum were analyzed. Multivariable linear regression coefficients were calculated. Coefficient alterations among age groups were tested to confirm the effect of the age spectrum on body composition covariates. Measured PFM and calculated PFM from previous formulas were compared in each quarter of the age spectrum.

Results

A total of 2324 volunteers were included in this study. The overall body composition and weight status, average body weight, height, BMI, FM, FFM, and its derivatives were significantly different among age groups. The coefficient of age altered the PFM differently between younger, middle, and older groups (0.07; P = 0.02 vs 0.13; P < 0.01 vs 0.26; P < 0.01; respectively). All coefficients of age alterations in all FM- and FFM-derived variables between each age spectrum were tested, demonstrating a significant difference between the younger (<60 years) and older (≥60 years) age groups, except the PFFM to BMI ratio (difference of PFM and FMI [95% confidence interval]: 17.8 [12.8–22.8], P < 0.01; and 4.58 [3.4–5.8], P < 0.01; respectively). The comparison between measured PFM and calculated PFM demonstrated a significant difference with increments of age.

Conclusion

The relationship between body FM and BMI varies on the age spectrum. A calculated formula in older people might be distorted with the utilization of constant coefficients.

Accuracy of Siri and Brozek equations in the percent body fat estimation in older adults

OBJECTIVE

To identify which equation, Siri or Brozek, based on the two compartment model, provides a more accurate conversion of body density (BD) in percent body fat (%BF) in a group of older adults.

STUDY DESIGN

Cross-sectional study.

SETTING

Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto.

PARTICIPANTS

60 older adults, aged 60-92 years.

MEASUREMENTS

Skinfold thickness was used to estimate BD through Visser et al. prediction equation. The conversion of BD to %BF was done with Siri (%BF-Siri) and Brozek (%BF-Brozek) formulas and these determined values were both compared to Dual-Energy X-ray Absorptiometry (%BF-DXA) evaluations.

RESULTS

A strong correlation between the %BF-DXA value and %BF-Siri (r=0.91, p < 0.001) and %BF-Brozek (r=0.91, p < 0.001) was found, although %BF-Siri and %BF-Brozek overestimated %BF-DXA (p < 0.001). The comparison of the %BF-Siri and %BF-Brozek mean values also revealed significant differences (p < 0.001). The %BF-Brozek reflects a better agreement than the %BF-Siri with %BF-DXA with respectively a mean difference of -4.0 %BF (limits of agreement = -10.9 to 2.9%) and -5.7 %BF (-12.6 to 1.2). The Bland and Altman plots confirmed that %BF-Brozek reflects a better agreement with %BF-DXA.

CONCLUSION

The results of the present study show that the use of Brozek equation may correspond to a more accurate alternative than Siri equation for the conversion of BD in %BF in older adults.

[Reliability of the classification of nutritional status obtained through the BMI and three different methods of body fat percentage in patients with type 1 diabetes mellitus]

OBJECTIVE

To assess the reliability of classification of nutritional status (NS) obtained through the body mass index (BMI) and three different methods of body composition (BC) in individuals type 1 diabetics (T1D) and non-diabetic subjects.

METHODS

84 patients with T1D and 37 controls were evaluated. Anthropometric data was collected to calculate BMI and assessment of BC was performed through the methods of skinfold thickness (SF), bipolar (BI) and tetrapolar (TT) bioelectrical impedance. The agreement between the scores of each method was determined by Kappa (K) coefficient.

RESULTS

Considering all the patients, only 48 (57.1%) presented classification of BMI that agreed with the SF method, 58 (69%) with the BI and 45 (53.5%) with the TT. The K results for individuals with T1D was DC = 0.261, BI = 0.320 and TT = 0.174. The controls had higher values (DC = 0.605, BI = 0.360 and TT = 0.400). However, all values were considered low.

CONCLUSIONS

The method of BMI showed little sensitivity to BC changes in patients with T1D. Appropriated methods for the assessment of BC should be used to classify the NS of this population.

Dosing regimens of cotrimoxazole (trimethoprim-sulfamethoxazole) for melioidosis

Melioidosis is an infectious disease with a propensity for relapse, despite prolonged antibiotic eradication therapy for 12 to 20 weeks. A pharmacokinetic (PK) simulation study was performed to determine the optimal dosing of cotrimoxazole (trimethoprim-sulfamethoxazole [TMP-SMX]) used in current eradication regimens in Thailand and Australia. Data for bioavailability, protein binding, and coefficients of absorption and elimination were taken from published literature. Apparent volumes of distribution were correlated with body mass and were estimated separately for Thai and Australian populations. In vitro experiments demonstrated concentration-dependent killing. In Australia, the currently used eradication regimen (320 [TMP]/1,600 [SMX] mg every 12 h [q12h]) was predicted to achieve the PK-pharmacodynamic (PD) target (an area under the concentration-time curve from 0 to 24 h/MIC ratio of >25 for both TMP and SMX) for strains with the MIC90 of Australian strains (< or = 1/19 mg/liter). In Thailand, the former regimen of 160/800 mg q12h would not be expected to attain the target for strains with an MIC of > or = 1/19 mg/liter, but the recently implemented weight-based regimen (<40 kg [body weight], 160/800 mg q12h; 40 to 60 kg, 240/1,200 mg q12h; >60 kg, 320/1,600 mg q12h) would be expected to achieve adequate concentrations for strains with an MIC of < or = 1/19 mg/liter. The results were sensitive to the variance of the PK parameters. Prospective PK-PD studies of Asian populations are needed to optimize TMP-SMX dosing in melioidosis.

Prevalence and associated factors of overweight and obesity in a Chinese rural population

BACKGROUND

Overweight and obesity are now considered as a serious health problem, and a very important risk factor for many diseases.

OBJECTIVE

This study was designed to investigate the epidemiologic features of overweight and obesity among rural adults in China.

METHOD AND PROCEDURES

A cross-sectional survey was conducted during 2004-2005, using a multistage cluster sampling method to select a representative sample in Fuxin county, Liaoning province, China. A total of 29,970 adults, aged > or =35 years, were examined. At baseline, lifestyle and other factors were obtained. Overweight and obesity were defined according to the classification by the World Health Organization.

RESULTS

Overall, the prevalence of overweight was 18.6%; 15.1% in men and 22.1% in women. The prevalence of obesity was 1.7%; 1.2% in men and 2.2% in women. Multivariable logistic regression revealed certain risk factors of obesity that included being a women, Mongolian nationality and education status of over junior high school level. Moderate physical activity alone was shown as protective factor.

DISCUSSION

Although the prevalence of obesity was low, overweight was relatively high in the Chinese rural population, especially in adult women. Gender, diet, physical activity, education levels, and ethnicity were associated with the prevalence of these health conditions.

Evaluating the correlation and prediction of trunk fat mass with five anthropometric indices in Chinese females aged 20-40 years

BACKGROUND AND AIMS

Obesity is a worldwide problem, and excess trunk fat mass (FM(trunk)) has been associated with an increased risk of diseases. The early measurement of FM(trunk) has potential importance to evaluate trunk obesity. We sought to evaluate the correlation and predication of FM(trunk) with five anthropometric indices in Chinese females.

METHODS AND RESULTS

A sample of 850 China females aged 20-40 years were recruited and divided into four age groups with a 5-year range in each group. Five anthropometric indices were measured or calculated. FM(trunk) in kg was measured using a dual-energy X-ray absorptiometry scanner. Principal component analysis (PCA) and multiple regression analysis were performed to develop prediction equations. There was an increasing trend of FM(trunk) and five anthropometric indices in successively older age groups. Four formed principal components (PCs) interpreted over 99% of the total variation of five relative anthropometric indices in all age groups. Regression analyses showed that four PCs combined explained a greater variance (R(2)=45.2-81.6%) in FM(trunk) than did each of the five indices alone (R(2)=2.4-72.2%).

CONCLUSIONS

Our results suggested that there is an increasing trend of FM(trunk) and five anthropometric indices with aging; that age obviously influences the relationship of FM(trunk) and the anthropometric indices studied; and that the accuracy of predicting the FM(trunk) using five anthropometric indices combined is greater than using the five indices alone.

Effect of multiple oral doses of androgenic anabolic steroids on endurance performance and serum indices of physical stress in healthy male subjects

Anabolic androgenic steroids (AAS) are doping agents that are mostly used for improvement of strength and muscle hypertrophy. In some sports, athletes reported that the intake of AAS is associated with a better recovery, a higher training load capacity and therefore an increase in physical and mental performances. The purpose of this study was to evaluate, the effect of multiple doses of AAS on different physiological parameters that could indirectly relate the physical state of athletes during a hard endurance training program. In a double blind settings, three groups (n = 9, 8 and 8) were orally administered placebo, testosterone undecanoate or 19-norandrostenedione, 12 times during 1 month. Serum biomarkers (creatine kinase, ASAT and urea), serum hormone profiles (testosterone, cortisol and LH) and urinary catecholamines (noradrenalin, adrenalin and dopamine) were evaluated during the treatment. Running performance was assessed before and after the intervention phase by means of a standardized treadmill test. None of the measured biochemical variables showed significant impact of AAS on physical stress level. Data from exercise testing on submaximal and maximal level did not reveal any performance differences between the three groups or their response to the treatment. In the present study, no effect of multiple oral doses of AAS on endurance performance or bioserum recovery markers was found.