Poor Agreement between Responses to the International Physical Activity Questionnaire and Objective ActiGraph® Data among Persons with Major Depressive or Bipolar Disorders

The purpose of this research was to investigate the degree of agreement between data from the International Physical Activity Questionnaire-Short Form (IPAQ) and accelerometer (ActiGraph^®) readings for physical activity (PA), classified as moderate, vigorous, and moderate-vigorous PA, and sedentary behavior (SB) in participants with major depressive or bipolar disorder. Following a cross-sectional observational design (n = 30), participants used an accelerometer for 4 to 7 days (minimum of 10 h per day) and answered the IPAQ (for the same period as accelerometer use). Our results suggest significant differences (p < 0.05) when comparing the ActiGraph^® and IPAQ data: for moderate PA, 155 min vs. 25 min per week; for moderate-vigorous PA, 157 min vs. 50 min per week; and for SB, 8 h vs. 3 h per day. Spearman's correlation coefficients (ActiGraph^® and IPAQ) were low for moderate PA, vigorous PA, and moderate-vigorous PA (rho = 0.03 to 0.13). The Bland-Altman plot showed a bias of -75 min for moderate PA, 9 min for vigorous PA, -66 min for moderate-vigorous PA, and -5 h for SB. Considering the differences observed and the objectivity of the ActiGraph^® measurements, whenever possible, we recommend ActiGraph^® measurements of PA and SB for these clinical groups.

Supplement-based nutritional strategies to tackle frailty: A multifactorial, double-blind, randomized placebo-controlled trial

BACKGROUND

Sarcopenia plays a central role in the development of frailty syndrome. Nutrition and exercise are cornerstone strategies to mitigate the transition to frailty; however, there is a paucity of evidence for which dietary and exercise strategies are effective.

OBJECTIVE

This large, multifactorial trial investigated the efficacy of different dietary strategies to enhance the adaptations to resistance training in pre-frail and frail elderly.

METHODS

This was a single-site 16-week, double-blind, randomized, placebo-controlled trial conducted at the Clinical Hospital, School of Medicine - University of São Paulo, Sao Paulo, Brazil. Four integrated, sub-investigations were conducted to compare: 1) leucine vs. placebo; 2) whey vs. soy vs. placebo; 3) creatine vs. whey vs. creatine plus whey vs. placebo; 4) women vs. men in response to whey. Sub-investigations 1 to 3 were conducted in women, only. Two-hundred participants (154 women/46 men, mean age 72 ± 6 years) underwent a twice-a-week, resistance training program. The main outcomes were muscle function (assessed by dynamic and isometric strength and functional tests) and lean mass (assessed by DXA). Muscle cross-sectional area, health-related quality of life, bone and fat mass, and biochemical markers were also assessed.

RESULTS

We observed that leucine supplementation was ineffective to improve muscle mass and function. Supplementation with whey and soy failed to enhance resistance-training effects. Similarly, supplementation with neither whey nor creatine potentiated the adaptations to resistance training. Finally, no sex-based differences were found in response to whey supplementation. Resistance exercise per se increased muscle mass and function in all sub-investigations. There were no adverse effects.

CONCLUSION

Neither protein (whey and soy), leucine, nor creatine supplementation enhanced resistance training-induced adaptations in pre-frail and frail elderly, regardless of sex. These findings do not support the notion that some widely used supplement-based interventions can add to the already potent effects of resistance exercise to counteract frailty-related muscle wasting and dynapenia.

CLINICAL TRIAL REGISTRY

NCT01890382; https://clinicaltrials.gov/ct2/show/NCT01890382.

DATA SHARING

Data described in the manuscript will be made available upon request pending application.

Different protein and derivatives supplementation strategies combined with resistance training in pre-frail and frail elderly: Rationale and protocol for the "Pro-Elderly" Study

BACKGROUND

Frailty is a multifactorial geriatric syndrome characterized by progressive decline in health and associated with decreased muscle mass, strength, and functional capacity. Resistance training (RT) combined with protein or amino acids supplementation has been shown to be promising for mitigating age-related impairments.

AIM

To investigate the chronic effects of different strategies of protein and derivatives supplementation in association with RT on selected health-related parameters in pre-frail and frail elderly.

METHODS

This is a series of double-blind, randomized, placebo-controlled, parallel-group clinical trials. Volunteers will be divided into nine groups, comprising four different sub-studies evaluating the effects of: isolated leucine supplementation (study 1); protein source (whey vs. soy - study 2); combination of whey protein and creatine (study 3); and sexual dimorphism on the response to protein intake and RT (males vs. females - study 4). Muscle cross-sectional area, fiber cross-sectional area, body composition, lower-limb maximal dynamic and isometric strength, functionality, lipid profile, biochemical parameters, renal function, quality of life, and nutritional status will be assessed before and after a 16-week intervention period. Data will be tested for normality and a mixed-model for repeated measures will be conducted to assess within- and between-group effects of the intervention on the dependent variables. Confidence intervals (95%), effect sizes, and relative changes will also be determined, with significance set at p < 0.05.