Effect of Menstrual Cycle Phase on Perceived Exertion During Aerobic Exercise in Eumenorrheic Women: A Systematic Review and Meta-analysis

Background

The rating of perceived exertion (RPE) is a readily available and practical tool widely used in exercise science to monitor exercise load, but a rigorous review of the effect of menstrual cycle (MC) phases on RPE within continuous aerobic exercise has not yet been completed.

Objective

This study investigated the effects of the MC phase on RPE during aerobic exercise.

Study Design

This was a systematic review and meta-analysis.

Methods

The search strategy was carried out using the 5 most common scientific databases. While qualitative analyses were performed in all included studies, random effects to standard mean difference were calculated and meta-analysis was performed where possible. This study addresses comparison for RPE at the beginning, middle, and end of the exercise adopting 2 mains analysis. The first adopted early cycle (first session of the cycle) as control compared with the subsequent phases, and the second adopted days 1 to 5 (early follicular) as control compared with the subsequent phases.

Results

A total of 17 studies (n = 160) were included in the qualitative synthesis. The meta-analysis showed that MC phases did not impact RPE (P > .05).

Conclusions

The current meta-analysis showed that MC does not impact RPE. Although acute RPE is not impacted by MC phases, future studies and practitioners should pay attention to the impact of RPE session by session throughout the MC.

Cadet and Junior Performance Is Associated With Senior's World Championship and Olympics Achievement in Judo

Purpose: We determined whether cadet and junior Judo World Championship participation and medal achievement would predict senior performance at World Championship (WC) and Olympic Games (OG). Methods: We analyzed retrospectively a total of 7780 athletes who competed at the OG and WC in the cadet, junior, and senior between 2009 and 2021. Results: There was an increase in the probability of winning a medal in the senior category (WC and OG, and only WC) ranged from 4.3 to 4.5 for medal-winning cadets compared to non-medalists and this probability remained around 3.3-3.8 for medalists in the male and 5.3-5.4 for the female medalists in cadet WC. Moreover, the chance of winning a medal in the senior category (WC and OG) was 8.1-8.5 times greater for medalists when compared to non-medalists in the junior WC. In turn, the probability of winning a medal in the senior (WC) was 1.5-1.7 times greater for athletes who did not compete in the junior WC. In the OG, the probability of winning a medal was 3.5 greater times for medalists when compared to non-medalists at cadet and junior WC. Conclusion: Thus, being a cadet or junior WC medalist increases the probability of winning a senior WC or an Olympic medal.

The knowledge, attitudes, and behaviours of pregnant women regarding seafood consumption during the antenatal period: a qualitative study

BACKGROUND

Maternal nutrition impacts fetal growth and development. The Food Standards Australia New Zealand (FSANZ) guidelines recommend pregnant women consume 2-3 servings (224-336 g) of fish/seafood per week to support intake of long chain omega 3 fatty acids, given adequate consumption supports numerous health benefits including reduced risk of preterm and early preterm birth. Evidence indicates that pregnant women purposely lower their fish/seafood intake, largely due to fears of methylmercury exposure. The aim of this study was to explore pregnant women's knowledge, attitudes, and behaviours regarding their fish/seafood consumption during the antenatal period.

METHODS

Semi-structured interviews were conducted between October 2018 and December 2020 among a purposive sample of 12 pregnant women from the Australian Capital Territory (ACT). The interviews were recorded, transcribed verbatim, and analysed using an interpretative phenomenological approach. Themes were developed on the women's lived experience related to fish/seafood knowledge, attitudes, and consumption behaviour.

RESULTS

The most prominent finding was widespread non-adherence to fish/seafood consumption guidelines. This was largely owing to a lack of proactive health promotion related to the health benefits of fish/seafood throughout pregnancy, including the health promoting roles of long chain omega 3 fatty acids for fetal growth and development. Three themes were identified: nutrition knowledge; sources of health promotion; and barriers and enablers to fish/seafood consumption.

CONCLUSIONS

To support adequate maternal consumption of fish/seafood throughout pregnancy, emphasis should be placed on the benefits of consuming this food group regularly. Additionally, pregnant women should receive education about the health promoting role of long chain omega 3 fatty acids. Dietitians are well placed to provide this information.

Different experiences of weight management and physical activity during pregnancy - a qualitative study of women and healthcare professionals in Australia

OBJECTIVE

Pregnancy is often described as a pivotal life stage for women, where regular contact with health professionals may play an important role in lifestyle awareness. This study explored the knowledge, practices, and beliefs of health professionals and pregnant women regarding physical activity and weight management during the antenatal period.

METHODS

A qualitative study was undertaken in southeastern Australia using individual interviews. Recruitment sought women of gestation >12 weeks, experiencing an uncomplicated pregnancy (n = 6), and antenatal health professionals including midwives (n = 4) and an obstetrician (n = 1). Data were analysed using Interpretive Phenomenological Analysis.

RESULTS

Three major themes emerged: (1) women rely on multiple sources of pregnancy-related healthy lifestyle information; (2) discussions around healthy lifestyle behaviours are low priority and often inconsistent; and (3) lifestyle-related topics perceived as sensitive make some conversations and actions difficult.

CONCLUSIONS

Pregnant women expressed gaps in lifestyle-related knowledge and education being provided by health professionals. In turn, health professionals expressed difficulty discussing sensitive topics such as weight with pregnant women and had limited knowledge of pregnancy-specific physical activity guidelines. The themes generated by this study may form the foundation for further research to inform clinical policy and practice regarding advice in antenatal care.

Relative Age Effect in Judo Competitions: Influence of Age, Weight Category, Sex, and Time Frames

This study was conducted to determine whether the relative age effect (RAE) is present in different age groups, weight categories, sexes, and across different time frames in international-level judo competition. A total of 9451 judo athletes competing at the Olympic Games and/or World Championships in the Cadet, Junior and/or Senior age groups between 1993 and 2020 were considered. Athletes' birthdate distributions were grouped in four quartiles (Q1: January-March; Q2: April-June; Q3: July-September; Q4: October-December) and compared to a day-corrected theoretical distribution using Chi-squared analysis. Poisson regression was also used to evaluate the ability to explain weekly birth count. RAE was more prevalent in males than females (p < .05), and for Cadets and Juniors compared to Seniors (p < .05). Heavyweight and middleweight categories presented RAEs in Senior and Junior males, while for females it was present in Cadet heavyweights (p < .05). RAE was more prevalent in recent years (2009-2021) for Senior male judo athletes (p < .05). Poisson analysis illustrated some nuanced information, including RAE detection during an earlier time frame, not readily apparent with the traditional analysis.

Post-exercise energy intake: do the intensity and mode of exercise matter? A systematic review and meta-analysis comparing high-intensity interval with moderate-intensity continuous protocols

The present systematic review and meta-analysis aimed to compare the impact of exercise intensity and mode (high-intensity interval exercise-HIIE or sprint interval exercise-SIE versus moderate-intensity continuous exercise-MICE) on post-exercise ad libitum energy intake. The studies were required to have at least two exercise conditions (HIIE or SIE vs MICE). Overall, 642 manuscripts were initially identified and 17 met the eligibility criteria. The random effect meta-analysis did not reveal differences for absolute energy intake (28 pairwise comparisons) between HIIE (p = 0.54; 95% Confidence Interval - CI: -0.14 to 0.26; 22 pairwise comparisons) or SIE (p = 0.08; 95% CI -0.65 to 0.03; 6 pairwise comparisons) versus MICE, neither for relative energy intake (p = 0.97; 95% CI: -0.35 to 0.10 for HIIE; p = 0.28; 95% CI: -1.03 to 0.06 for SIE) with five and one pairwise comparisons, respectively. Subgroup analyses for methods to evaluate ad libitum energy intake, body mass, sex, volume, and timing of exercise were non-significant. Inspecting each study, two pairwise comparisons reported lower post-exercise absolute energy intake in HIIE compared to control (CRTL), and three pairwise comparisons reported lower absolute energy intake after SIE compared to MICE. None pairwise comparison reported differences between protocols (HIIE or SIE versus MICE) for relative energy intake. In conclusion, the meta-analysis did not show differences between protocols for absolute and relative energy intake; five pairwise comparisons from 28 demonstrated lower absolute energy intake in HIIE or SIE compared to CRTL or MICE. Further studies are needed to address the key relevant variables in which exercise intensity and mode may impact energy intake.

Maternal body mass index and country of birth in relation to the adverse outcomes of large for gestational age and gestational diabetes mellitus in a retrospective cohort of Australian pregnant women

BACKGROUND

The prevalence of gestational diabetes mellitus in Australia has been rising in line with the increased incidence of maternal overweight and obesity. Women with gestational diabetes mellitus, high body mass index or both are at an elevated risk of birthing a large for gestational age infant. The aim was to explore the relationship between country of birth, maternal body mass index with large for gestational age, and gestational diabetes mellitus. In addition to provide additional information for clinicians when making a risk assessment for large for gestational age babies.

METHOD

A retrospective cohort study of 27,814 women residing in Australia but born in other countries, who gave birth to a singleton infant between 2008 and 2017 was undertaken. Logistic regression analysis was used to examine the association between the aforementioned variables.

RESULTS

A significantly higher proportion of large for gestational age infants was born to overweight and obese women compared to those who were classified as underweight and healthy weight. Asian-born women residing in Australia, with a body mass index of ≥40 kg/m2, had an adjusted odds ratio of 9.926 (3.859-25.535) for birthing a large for gestational age infant. Conversely, Australian-born women with a body mass index of ≥40 kg/m2 had an adjusted odds ratio of 2.661 (2.256-3.139) for the same outcome. Women born in Australia were at high risk of birthing a large for gestational age infant in the presence of insulin-requiring gestational diabetes mellitus, but this risk was not significant for those with the diet-controlled type. Asian-born women did not present an elevated risk of birthing a large for gestational age infant, in either the diet controlled, or insulin requiring gestational diabetes mellitus groups.

CONCLUSIONS

Women who are overweight or obese, and considering a pregnancy, are encouraged to seek culturally appropriate nutrition and weight management advice during the periconception period to reduce their risk of adverse outcomes.

Effectiveness of an intervention focusing on diet and walking during pregnancy in the primary health care service

Interventions during prenatal care can mitigate negative outcomes of a sedentary lifestyle and unhealthy diet during pregnancy. We aimed to evaluate the effectiveness of an intervention that promoted healthy diet and leisure-time walking during antenatal care in a pragmatic, controlled, non-randomized intervention study. Physicians and nurses from all health care units of the Family Health Strategy model of health assistance participated in educational training to promote leisure-time walking and healthy diet during antenatal care visits. Pregnant women who received health care from these professionals constituted the intervention group (n = 181). The control group (n = 172) included pregnant women who received routine antenatal care, in health care units of the traditional model of health assistance. Data were collected in each trimester of pregnancy. Diet was investigated using a food frequency questionnaire adapted from Risk and Protective Factors Surveillance System for Chronic Non-Comunicable Diseases Through Telephone Interview (Vigitel). Leisure-time walking in a typical week was assessed using questions from the Physical Activity in Pregnancy Questionnaire. There were positive effects on leisure-time walking during the second trimester and the third trimester of pregnancy and on the women who achieved 150 minutes per week of walking during the third trimester. The intervention reduced the risk of pregnant women consuming soft drinks and/or commercially prepared cookies in the third trimester. This lifestyle intervention was partially effective, tripling the proportion of pregnant women who achieved the recommended walking time and reducing by half the proportion of women who had a high weekly consumption of soft drinks and industrially processed cookies.

Might High-Intensity Interval Exercise Be Remembered as More Pleasurable? An Attempt to Test the Peak-End Rule in the Exercise Context

Given humans' limited ability to recall past experiences for evaluation, scholars have proposed the peak-end rule stating that if perceived discomfort at the end of an aversive experience is lower than the peak discomfort experienced, the aversive experience will be remembered more positively. The purpose of this study was to evaluate the peak-end rule as applied to high-intensity interval exercise (HIIE). Participants were 30 inactive men (M age = 27.9, SD =  5.2 years). In the first session they performed a graded exercise test on cycle-ergometer to determine their maximal aerobic power (MAP) (M = 233, SD = 35W); and, in the second and third sessions, they performed two HIIE protocols in randomized order: (a) Short trial - 20-minutes of HIIE, composed of 30-second efforts at 100% of MAP interspersed by 30-seconds of passive recovery; and (b) Long trial - 20-minutes of the short trial, plus 10-minutes more of HIIE, decreasing 3% of MAP in each additional bout, resulting in 70% of MAP in the last bout. During exercise, we recorded the participants' rating of perceived exertion (RPE) and affect, using the Feeling Scale (FS). At 30-minutes post-exercise, we again recorded the participants' affect, using the Global Affect Evaluation (GAE) and their session-RPE, and we recorded their enjoyment, using the Physical Activity Enjoyment Scale (PACES). In the last session, the participants chose a favorite protocol to repeat. All sessions were interspersed by at least 72 hours. The 10-minutes extra HIIE in the Long-trial condition resulted decreased heart rate values (M = 157, SD = 13bpm to M = 144, SD = 14bpm; p < 0.001), but psychological responses during and after exercise did not differ, nor did participants' preferred HIIE protocol. As the load drop for the Long-trial was not enough to change the psychological responses during exercise, there was no difference in the retrospective evaluation as the peak-end rule would have suggested.

The Association Between Pre-Pregnancy Body Mass Index, Perinatal Depression and Maternal Vitamin D Status: Findings from an Australian Cohort Study

Purpose

This study aimed to assess the relationship between early-pregnancy Body Mass Index (BMI), perinatal depression risk and maternal vitamin D status.

Patients and Methods

A retrospective cohort study from 2013 to 2017 was undertaken involving 16,528 birth events in the Australian Capital Territory. Multivariate binary logistic regression was conducted using the forced entry method. Mediation of the association between maternal early-pregnancy BMI and perinatal depression risk by vitamin D status was also tested.

Results

Adjusted logistic regression models found that high maternal early-pregnancy BMI was associated with increased risk of developing perinatal depression (AOR 1.421; 95% CI, 1.191, 1.696) as well as increased odds of being vitamin D deficient (AOR 1.950; 95% CI; 1.735, 2.191). In comparison to women with low perinatal depression risk, women with high perinatal depression risk had increased odds of being vitamin D deficient (AOR 1.321; 95% CI, 1.105, 1.579). Maternal early-pregnancy BMI was a weak significant predictor of perinatal depression risk after including vitamin D as a mediator, consistent with partial mediation, Path C: B=0.016 (95% CI 1.003, 1.030), p= 0.02. Path C´: B=0.014 (95% CI 1.001, 1.028), p= 0.04.

Conclusion

In line with current Australian recommendations, women with high early-pregnancy BMI should be screened for both perinatal depression risk and vitamin D deficiency, with referral to relevant support services when indicated.

Effects of Different Fatigue Levels on Physiological Responses and Pacing in Judo Matches

Franchini, E, Takito, MY, Alves, ED, Shiroma, SA, Julio, UF, and Humberstone, C. Effects of different fatigue levels on physiological responses and pacing in judo matches. J Strength Cond Res 33(3): 783-792, 2019-The objective of this study was to compare athletes' pacing during judo match simulation between different fatigue states. Twelve judo athletes (30.2 ± 3.2 years old, 85.6 ± 10.8 kg, 181.0 ± 5.7 cm, 19 ± 7 years of judo experience) completed three 4-minute matches against the same opponents, at 15-minute intervals in 3 different conditions: after warm-up (Control; C); after a regular training session (totaling 90 minutes); after a high-intensity interval exercise (2 blocks of 10 sets of 20-second all-out uchi-komi, with 10-second interval between sets and 5-minute interval between blocks). All matches were mediated according to the official rules, filmed, and analyzed concerning: rating of perceived recovery (RPR), rating of perceived exertion (RPE), heart rate (before and after match), blood lactate concentrations [La] before, peak after match and delta (peak minus the prematch values), and time-motion measures (frequencies and durations of actions). Time-motion measures included athlete displacement without contact, gripping, attack, feint, groundwork combat, pauses, and high- to low-intensity effort ratio. The experimental conditions resulted in different physiological and perceived responses prematch (HR, [La], RPR) and postmatch simulations (HR and [La]peak), with no change in RPE and few changes in technical variables. There was a decrease in grip dispute time, and increase in time of displacement without contact. These technical changes were enough to preserve the pace during the matches, which seemed to be controlled by the athletes to maintain their number of attacks, feints, and RPE.

Maximal isometric handgrip strength: comparison between weight categories and classificatory table for adult judo athletes

The aims of this study were to compare the maximal isometric handgrip strength of judo athletes from different weight categories and to create a classificatory table for this test. A total of 406 athletes had their maximal isometric handgrip strength measured, following standardized recommendations. Absolute and relative values were calculated for each hand and for the sum of both hands. Weight categories were compared through a one-way analysis of variance, followed by Tukey test. The effect size was determined by partial eta squared, and the relationship between variables was determined using Pearson correlation coefficient. There was a large effect of weight category in absolute handgrip strength for each hand and for the sum of both hands, with lower values for the lighter categories. Conversely, when the relative strength was considered higher values were found for the lighter categories (P<0.001). Very large and significant positive correlations (P<0.001) were found between right and left for absolute (r=0.886) and relative (r=0.883) handgrip values. Overall, there was an increase in absolute and a decrease in relative handgrip strength across weight categories. These differences found in grip strength in weight categories are probably linked to differences in muscle mass between them. There was a high correlation between each hand for absolute and relative values, which suggests that assessing only one hand may be enough, and therefore a faster way of evaluation. Finally, the normative classificatory table created may serve as a reference for different purposes.

Effects of long or short duration stimulus during high-intensity interval training on physical performance, energy intake, and body composition

To compare the effects of 6 weeks of long or short high-intensity interval training (long- or short-HIIT) on body composition, hunger perception, food intake and rating of perceived exertion (RPE). Twenty previously untrained women (25±5 years) were randomly assigned to do a long-HIIT (n=10) or a short-HIIT (n=10). The long-HIIT group performed fifteen 1-min bouts at 90% of maximum heart rate (HRmax), interspersed by 30-sec active recovery (60% HRmax). The short-HIIT group performed forty-five 20-sec bouts at 90% of HRmax, interspersed by 10-sec active recovery (60% HRmax). The training for both groups was conducted 3 times a week for 6 weeks. All subjects performed the Astrand cycle ergometer test to estimate maximal oxygen consumption (VO_2max) 1 week before and after the training period, as well as body composition, which was estimated through circumferences and skinfold thicknesses. For all training sessions, the heart rate, visual scale of hunger, internal load, and RPE were recorded. In the first and last week of training, subjects were asked to record a 24-hr food diary for 3 days. Both training induced significant pre to post decreases for fat mass, fat percentage, waist circumference, sum of seven skinfolds and RPE. As expected estimated, the VO_2max increased in both groups. There were no differences for hunger perception, energy intake, and body mass. Long and short-HIIT resulted in fat loss, without altering the energy intake.

Performance and energy systems contributions during upper-body sprint interval exercise

The main purpose of this study was to investigate the performance and energy systems contribution during four upper-body Wingate tests interspersed by 3-min intervals. Fourteen well-trained male adult Judo athletes voluntarily took part in the present study. These athletes were from state to national level, were in their competitive period, but not engaged in any weight loss procedure. Energy systems contributions were estimated using oxygen uptake and blood lactate measurements. The main results indicated that there was higher glycolytic contribution compared to oxidative (P<0.001) during bout 1, but lower glycolytic contribution was observed compared to the phosphagen system (adenosine triphosphate-creatine phosphate, ATP-PCr) contribution during bout 3 (P<0.001), lower glycolytic contribution compared to oxidative and ATP-PCr (P<0.001 for both comparisons) contributions during bout 4 and lower oxidative compared to ATP-PCr during bout 4 (P=0.040). For the energy system contribution across Wingate bouts, the ATP-PCr contribution during bout 1 was lower than that observed during bout 4 (P=0.005), and the glycolytic system presented higher percentage contribution in the first bout compared to the third and fourth bouts (P<0.001 for both comparisons), and higher percentage participation in the second compared to the fourth bout (P<0.001). These results suggest that absolute oxidative and ATP-PCr participations were kept constant across Wingate tests, but there was an increase in relative participation of ATP-PCr in bout 4 compared to bout 1, probably due to the partial phosphocreatine resynthesis during intervals and to the decreased glycolytic activity.

Postprandial lipoprotein profile in two modes of high-intensity intermittent exercise

The aim of present study was to compare blood lipid postprandial profile response in two modes of high-intensity intermittent exercise. Twelve individuals (6 men and 6 women) were submitted to a maximal incremental test (to determine maximal aerobic power [MAP] and V. O_2peak [peak oxygen uptake]), high-intensity intermittent all-out exercise (60×8-sec bouts interspersed by 12-sec passive recovery) and fixed high-intensity intermittent exercise (100% maximal aerobic speed, consisted of 1-min repetitions at MAP [70 rpm] separated by 1-min of passive recovery). Blood samples were collected pre, immediately, 45 and 90-min postexercise. Serum was analyzed for total cholesterol and its ratio, high-density lipoprotein cholesterol (HDL-c), low-density lipoprotein cholesterol (LDL-c), very low-density lipoprotein (VLDL) cholesterol, and triacylglycerol (TAG). For TAG there was a main effect of moment with higher values immediately postexercise compared to 45-min postexercise. For VLDL there was a main effect to moment with higher values immediately post exercise than pre and 45-min postexercise; higher values 90-min postexercise than 45-min postexercise. There was no effect for HDL-c, LDL-c, and cholesterol. For area under the curve there was no difference for any variable. Our results indicated that both kinds of acute exercise session lead to no improvement in the acute response of serum lipid profile of healthy young.

Effect of exercise intensity and mode on acute appetite control in men and women

The aim of this study was to compare the effects of exercise intensity on appetite control: relative energy intake (energy intake minus the energy expenditure of exercise; REI), hunger scores, and appetite-regulating hormones in men and women. Eleven men and 9 women were submitted to 4 experimental sessions: high-intensity intermittent all-out exercise (HIIE-A) for 60 × 8 s interspersed by 12 s of passive recovery; high-intensity intermittent exercise (HIIE) at 100% of maximal load attained in incremental test; steady-state exercise at 60% of maximal load, matched by work done; and a control session. Exercise was performed 1.5 h after a standardized breakfast, and an ad libitum lunch was offered 4 h after breakfast. Blood concentration of insulin, cortisol, acylated ghrelin, peptideYY3-36, glucose, and hunger scores were measured when fasting, and at 1.5, 2, 3.25, and 4 h of experiment. REI was lower in all exercises than in the control, without differences between exercises and sex showing no compensation in energy intake because of any exercise; the hunger scores were lower only in the exercises performed at higher intensity (HIIE and HIIE-A) compared with the control. The area under the curve of acylated ghrelin was lower in the HIIE-A when compared with the control. PeptideYY3-36 was higher in men than women and cortisol higher in women than men independently of the condition. Although high-intensity exercises promoted a little more pronounced effects in the direction of suppressing the appetite, no differences were observed in REI, demonstrating that these modifications were not sufficient to affect energy intake.

Educational intervention regarding diet and physical activity for pregnant women: changes in knowledge and practices among health professionals

BACKGROUND

The knowledge and practices of health professionals have a recognized role in behaviors related to the health of their patients. During pregnancy, this influence can be even stronger because there is frequent contact between women and doctors/nurses at periodic antenatal visits. When trained, supported and motivated, these professionals can act as health promoters. This study aimed to evaluate the effect of a focused educational intervention on improving the knowledge and practices of health professionals concerning diet and physical activity during pregnancy.

METHODS

A controlled, non-randomized study was performed to assess the effects of an educational intervention on the knowledge and practices of nurses and doctors who provide primary care to pregnant women. The intervention group, doctors and nurses (n = 22) from the family health units in a medium-sized city of São Paulo State, Brazil, received 16 h of training comprising an introductory course and three workshops, whereas the control group, doctors and nurses (n = 20) from traditional basic health units in Botucatu, did not. The professionals' knowledge was assessed at two time points, 1 month prior to and 1 year after the beginning of the intervention, using an ad hoc self-report questionnaire. The increases in the knowledge scores for walking and healthy eating of the intervention and control groups were calculated and compared using Student's t-test. To analyze the professionals' practice, women in the second trimester of pregnancy were asked whether they received guidance on healthy eating and leisure-time walking; 140 of these women were cared for by professionals in the intervention group, and 141 were cared for by professionals in the control group. The percentage of pregnant women in each group that received guidance was compared using the chi-square test and the Prevalence Ratio (PR), and the corresponding 95 % confidence intervals (CI) were calculated.

RESULTS

The intervention improved the professionals' knowledge regarding leisure-time walking (92 % increase in the score, p < 0.001). The women who were cared for by the intervention group were more likely to receive guidance regarding leisure-time walking (PR = 2.65; 95 % CI = 1.82-3.83) and healthy eating (PR = 1.76; 95 % CI = 1.34-2.31) when compared to the control group.

CONCLUSION

It is possible to improve the knowledge and practices of health professionals through the proposed intervention aimed at primary health care teams providing antenatal care.

Weight loss practices in Taekwondo athletes of different competitive levels

This study investigated the prevalence, magnitude, and methods of rap-id weight loss among male and female Taekwondo athletes from all competitive levels. A questionnaire was administered to 72 men (regional/state level, n=31; national/international level, n=41) and 44 women (regional/state level, n=9; national/international, n=35). Among the male athletes, 77.4% of the regional/state level and 75.6% of the national/international athletes declared to have reduced weight to compete in lighter weight categories. Among women, 88.9% of regional/state level and 88.6% of national/international level reported the use of rapid weight loss strategies. Athletes reported to usually lose ~3% of their body weight, with some athletes reaching ~7% of their body weight. The methods used to achieve weight loss are potentially dangerous to health and no difference between sexes was found. Four methods were more frequently used by men athletes in higher competitive levels as compared to lower levels, as follows: skipping meals (Z=2.28, P=0.023, η²=0.21), fasting (Z=2.337, P=0.019, η²=0.22), restricting fluids (Z=2.633, P=0.009, η²=0.24) and spitting (Z=2.363, P=0.018, η²=0.22). Taekwondo athletes lost ~3% of their body mass, using methods potentially dangerous for their health. Although no difference was found between sexes, lower level athletes more frequently used methods such as skipping meals, fasting, restricting fluids and spitting. Considering that these health-threating methods are more commonly used by lower level athletes, specific education programs should be directed to them.

A INFLUÊNCIA DOS PROFISSIONAIS DE SAÚDE SOBRE A PRÁTICA DE ATIVIDADE FÍSICA NO LAZER EM GESTANTES

O objetivo do presente estudo é analisar a associação entre as recomendações recebidas durante o atendimento pré-natal com a prática de atividade física na gestação. Trata-se de um estudo transversal com 290 puérperas. Apenas 9% das mulheres atingiam a recomendação (?150 minutos) de atividade física semanal para manutenção da saúde e 18% praticaram alguma atividade física no lazer (AFL)/exercício físico na gestação. A prática de atividade física anterior à gestação estava associada ao nível de AFL. Adicionalmente, a percepção da presença de recomendação do profissional para a prática de AFL no pré-natal triplicou a chance da mulher ser ativa, ainda que não suficientemente ativa. Ações junto aos profissionais de saúde podem promover modificações no nível de AFL durante a gestação.

[Physical activity in pregnant women receiving care in primary health care units]

OBJECTIVE

To describe physical-activity patterns of low-risk pregnant women and investigate associated factors.

METHODS

This is a cross-sectional study based on a sample (n = 256) of adult pregnant women in their 2nd trimester. The participants were randomly selected among those attending primary health care units in Botucatu in Sao Paulo State in 2010. Physical activities were investigated by using the pregnancy physical activity questionnaire and by analyzing the time and intensity of the following activities: occupational, commuting, household and leisure, expressed in metabolic equivalents/day. The pregnant women were classified according to their level of physical activity and to achieving 150 minutes/week of leisure physical activities, which were the dependent variables in the study. The association between such variables and socioeconomic variables, maternal characteristics, behavioral factors and the care model in the health care unit was evaluated by Poisson regression models with robust variance and by adopting the hierarchical model.

RESULTS

Most pregnant women were insufficiently active (77.7%); 12.5% were moderately active and 9.8% were vigorously active. The highest daily energy expenditure was in carrying out household activities, followed by commuting activities. Only 10.2% of them followed the recommendation, successfully achieving 150 minutes of leisure physical activities per week. Having a job outside of the home reduced the chance of achieving such recommendation (OR = 0.39, 95%CI 0.16;0.93). Having at least one previous delivery (OR = 0.87, 95%CI 0.77;0.99) and being overweight pre-pregnancy (OR = 0.85, 95%CI 0.731;0.99) reduced the chance of being insufficiently active whereas consuming healthy foods less frequently slightly increased it: OR = 1.18, 95%CI 1.02;1.36.

CONCLUSIONS

Pregnant women who were cared for in primary health care units were insufficiently active. Having at least one previous delivery and being overweight pre-pregnancy were identified as protective factors against such condition. Less frequent intake of healthy foods was found to be a risk factor, therefore suggesting a cluster of health risk factors.

Functional vs. Strength training in adults: specific needs define the best intervention

BACKGROUND/PURPOSE

Studies that have aimed to compare different strategies to improve functional capacity have produced controversial results. Furthermore, such studies have focused solely on dependent individuals. In contrast, the present study aimed to compare traditional training to functional training for independent individuals. The purpose of this study was to compare traditional training to functional training in healthy and independent middle-aged adults (40-60 years old) and elderly subjects (older than 60 years old).

METHODS

One hundred and one subjects (54.75 ± 8.84 years) were divided into two groups that each performed 24 sessions of a training protocol twice per week. The subjects were assessed using quantitative (Y-Balance Test) and qualitative methods (Functional Movement Screen™). The individuals were compared by observing changes between pretest and posttest according to their intervention group, sex and age.

RESULTS

When the entire sample was considered, the results showed that there were no differences in improvement between the training protocols. However, when specific groups were analyzed, functional training was less effective for women compared to men in the same group (Z=-2.598; p=0.009; effect size=0.43) and compared to women in the conventional group (Z=-2.704; p=0.007; effect size=0.41).

CONCLUSIONS

There were no differences between the two protocols in their ability to improve functional capacity as measured by the two chosen outcome measures. However, each subject's condition before the intervention must be considered. Some individuals may require additional basic training or specific training. In the current study, the women may have needed to improve their basic capabilities before practicing more specific training protocols.

LEVEL OF EVIDENCE

2b. This is a pre- and post-intervention analysis using within-group and between-groups comparisons.

Home advantage in judo: a study of the world ranking list

In 2009, the International Judo Federation established a ranking system (RS) to classify athletes and to distribute the competitor quotas of the Olympic Games. However, the RS does not consider the home advantage. This issue has not been studied in judo, and its implications for the RS have not been determined. The objective was to verify the home advantage in judo in terms of winning a medal or the number of matches won. Therefore, 25 competitions that computed points for the RS in 2009 were analysed. Logistic regression analysis and the Poisson generalised linear model were used for the analyses, which included the relative quality of the athletes. The sample was composed only of athletes who had competed both at home and away. The odds ratio for winning medals was higher for athletes who competed at home for both males and females. The association between the number of matches won and competing at home was significant only for the male athletes. The home advantage was observed in the competitions that used the judo RS. Thus, it is likely that athletes from countries that host competitions using the RS have an advantage in terms of obtaining their Olympic classification.

Effects of acute physical exercise on executive functions: a comparison between aerobic and strength exercise

The aim of this study was to compare the effects of acute aerobic and strength exercises on selected executive functions. A counterbalanced, crossover, randomized trial was performed. Forty-two healthy women were randomly submitted to three different conditions: (1) aerobic exercise, (2) strength exercise, and (3) control condition. Before and after each condition, executive functions were measured by the Stroop Test and the Trail Making Test. Following the aerobic and strength sessions, the time to complete the Stroop "non-color word" and "color word" condition was lower when compared with that of the control session. The performance in the Trail Making Test was unchanged. In conclusion, both acute aerobic and strength exercises improve the executive functions. Nevertheless, this positive effect seems to be task and executive function dependent.

Impacto da orientação para a prática regular de atividade física dois anos após o parto

OBJETIVOS: avaliar as modificações na prática de atividade física (AF) e as barreiras para adoção de um estilo de vida saudável em mulheres que receberam orientações nutricionais e de AF durante a gestação e no primeiro ano após o parto. MÉTODOS: estudo de coorte com 57 mulheres (Grupo Controle = 29 e Grupo Intervenção = 28), e idade média igual a 28 (±6) anos. As informações foram obtidas através de entrevistas em visita domiciliar (durante a intervenção) e inquérito telefônico (um ano após o término da intervenção), utilizou-se questionário de AF. Para análise das barreiras foi realizada uma entrevista semiestruturada com questões abertas, as quais foram codificadas e agrupadas para análise dos dados. Foram realizados testes de qui-quadrado, Mann-Whitney U e Friedman. RESULTADOS: aos seis meses, apenas 30% das mulheres do grupo Intervenção realizavam AF no lazer pelo menos 120 minutos por semana, contra 10% do grupo Controle, reduzindo para 18% e 4%, respectivamente, dois anos após o parto. As principais barreiras à prática de AF regular foram: falta de tempo (44%), cuidado com os filhos (37%), trabalho (21%), afazeres domésticos (21%) e comodismo (26%). CONCLUSÕES: futuros programas devem priorizar a aquisição de conhecimento, visando à adoção de um estilo de vida ativo no pós-parto, considerando as barreiras maternas.

Physical activity during pregnancy and fetal outcomes: a case-control study

OBJECTIVE

To investigate the relationship between physical activity during the second trimester pregnancy and low birth weight, preterm birth, and intrauterine growth restriction.

METHODS

Case-control study including 273 low birth weight newborns and 546 controls carried out in the city of São Paulo, Southeastern Brazil, in 2005. Low birth weight cases were grouped into two subsamples: preterm birth (n=117) and intrauterine growth restriction (n=134), with their related controls. Information was collected by means of interviews with mothers shortly after birth and transcription of medical records. Data were analyzed using conditional multiple and hierarchical logistic regression.

RESULTS

Light physical activity for over 7 hours per day was shown to be protective against low birth weight (adjusted OR=0.61; 95% CI 0.39-0.94) with a dose-response relationship (p-value for trend=0.026). A similar trend was found for intrauterine growth restriction (adjusted OR=0.51; 95% CI 0.26-0.97). Homemaking activities were associated as a protective factor for both low birth weight and preterm birth (p-value for trend=0.013 and 0.035, respectively). Leisure-time walking was found to be protective against preterm birth.

CONCLUSIONS

Mild physical activity during the second trimester of pregnancy such as walking has an independent protective effect on low birth weight, preterm birth, and intrauterine growth restriction.

Efeitos da suplementação prolongada de creatina mono-hidratada sobre o desempenho anaeróbio de adultos jovens treinados

O objetivo do presente estudo foi investigar o impacto de oito semanas de suplementação de creatina mono-hidratada (Crm) sobre o desempenho anaeróbio de adultos jovens treinados. Vinte e seis estudantes de educação física, do sexo masculino, saudáveis, foram divididos aleatoriamente em grupo creatina (GCr, n = 13; 22,5 ± 2,7 anos; 74,9 ± 6,8kg, 178,5 ± 4,8cm) e grupo placebo (GPl, n = 13; 22,9 ± 3,2 anos, 71,9 ± 11,3kg, 178,6 ± 4,0cm). Os indivíduos ingeriram em sistema duplo-cego doses de Crm ou placebo-maltodextrina (20 g.d-1 por 5 dias e 3 g.d-1 por 51 dias subsequentes). Ambos os grupos tiveram seus hábitos alimentares e os níveis de aptidão física controlados anteriormente. O teste anaeróbio de Wingate (TW) foi usado para avaliar o desempenho anaeróbio antes e após o período de ingestão de Crm ou placebo. Os índices de desempenho analisados foram: potência pico relativa (PPR), potência média relativa (PMR), trabalho total relativo (TTR) e índice de fadiga (IF). Para tratamento estatístico foi utilizado ANOVA, seguido pelo teste de post hoc Tukey, quando P<0,05. Não foram observadas diferenças significantes nos índices PPR, PMR, TTR e IF após o período de suplementação de Crm (P<0,05). Os resultados do presente estudo sugerem que a suplementação de Crm não parece ser um recurso ergogênico eficiente em esforços físicos de alta intensidade e curta duração que envolve uma única série.

Physical activity by pregnant women and outcomes for newborns: a systematic review

A systematic review was carried out aiming at analyzing daily physical activity during pregnancy and the outcomes of birth weight, prematurity, and intrauterine growth restriction. Of 52 articles indexed in Medline, 22 that showed better methodological quality were included. Among the 22 articles analyzed, only two did not detect a significant association between physical activity and the outcomes studied. There was large variation between the indicators of maternal physical activity, which included occupational, household, recreational and, all or some, locomotive activities. Among ten articles that measured total daily physical activity, only one article did not find any association. The results support the hypothesis that both excessive and insufficient physical activity impact negatively on pregnancy outcomes.

Effects of recovery type after a judo match on blood lactate and performance in specific and non-specific judo tasks

The objective of the present study was to verify if active recovery (AR) applied after a judo match resulted in a better performance when compared to passive recovery (PR) in three tasks varying in specificity to the judo and in measurement of work performed: four upper-body Wingate tests (WT); special judo fitness test (SJFT); another match. For this purpose, three studies were conducted. Sixteen highly trained judo athletes took part in study 1, 9 in study 2, and 12 in study 3. During AR judokas ran (15 min) at the velocity corresponding to 70% of 4 mmol l(-1) blood lactate intensity (approximately 50% VO(2) peak), while during PR they stayed seated at the competition area. The results indicated that the minimal recovery time reported in judo competitions (15 min) is long enough for sufficient recovery of WT performance and in a specific high-intensity test (SJFT). However, the odds ratio of winning a match increased ten times when a judoka performed AR and his opponent performed PR, but the cause of this phenomenon cannot be explained by changes in number of actions performed or by changes in match's time structure.

Avaliação da reprodutibilidade e validade de questionário de atividade física para gestantes

INTRODUÇÃO: A prática de atividade física tem sido incentivada por vários organismos nacionais e internacionais visando a promoção de saúde. Entretanto não existe consenso acerca da influência e da intensidade ótima de atividade física durante a gestação, possivelmente devido a dificuldades de mensuração e classificação do nível de atividade física através de questionários. Não se identificou qualquer estudo de validação de questionário de atividade física em gestantes no Brasil. O objetivo do presente estudo é analisar a reprodutibilidade e validade concorrente de um questionário de atividades físicas para gestantes. MÉTODOS: Em amostra de 68 gestantes, no segundo trimestre de gestação foi realizada entrevista para aplicação do questionário, que foi repetida com aproximadamente uma semana de intervalo e no puerpério. No período entre as duas primeiras entrevistas, as mulheres utilizaram monitor de freqüência cardíaca (n=38). RESULTADOS: As análises de reprodutibilidade foram adequadas com coeficientes de correlação intraclasse variando de 0,54 a 0,85. A análise das variáveis categóricas, com questões subjetivas e de autopercepção da atividade física, resultou em maior intervalo de coeficiente kappa com valores entre 0,29 e 0,76 entre a aplicação do questionário com uma semana de intervalo, e 0,08 a 0,70 comparado ao puerpério. As análises de validade conduziram a resultado satisfatório quanto à média das diferenças encontrada por intermédio do gráfico de Bland e Altman (1986) entre o questionário e o freqüencímetro. Entretanto, o intervalo da dispersão não se apresentou adequado, visto que variou em mais de sete horas para atividades leves e em quase onze horas por dia para atividades moderadas. As análises do presente estudo parecem assegurar a reprodutibilidade do questionário de atividade física para gestantes. No entanto, com relação à validação, a comparação com os resultados obtidos pelo freqüêncímetro não mostrou graus de concordância adequados.

Postura materna durante a gestação e sua influência sobre o peso ao nascer

OBJETIVO: Avaliar a relação entre postura/atividade física materna e o peso inadequado ao nascer. MÉTODOS: Coorte prospectiva com 152 gestantes de serviço de assistência pré-natal de baixo risco de um hospital especializado, localizado no Município de São Paulo. Para cada gestante foram realizadas três entrevistas ao longo da gestação, quando foi avaliada a freqüência de atividades físicas diárias. O peso ao nascer (inadequado <3.000 g e adequado >3.000 g) foi a variável dependente e as variáveis de freqüência de atividades físicas foram as variáveis independentes. Foi realizada análise estatística de regressão logística univariada e múltipla, tendo como variáveis de controle a escolaridade, tabagismo, morar com o companheiro e estado nutricional inicial. RESULTADOS: Foi identificado como fator de proteção para o peso inadequado ao nascer a realização de caminhada no primeiro período da gestação por menos de 50 min (OR ajustado =0,44; IC 95%: 0,20-0,98). A permanência em pé parada por mais de 2,5 horas mostrou acentuado risco no segundo trimestre (OR ajustado =3,23; IC 95%: 1,30-7,99). Dentre as atividades que requerem a postura ereta, identificou-se relação do tipo dose-resposta para lavar roupa e cozinhar (p de tendência linear <0,01 e 0,05, respectivamente). Após ajuste pelas variáveis de controle, apenas a atividade de lavar roupa no segundo trimestre confirmou a significância estatística. CONCLUSÕES: Os resultados indicaram a importância da orientação quanto à postura e a atividade física durante o pré-natal visando à redução do peso inadequado ao nascer.