Artigos para publicação

A seguir encontram-se três artigos em análise para publicação e os jornais para os quais foram enviados. Cada artigo esta editado de acordo com as normas de publicação do respectivo jornal. Aqui a fim de padronização dos nossos apêndices, eles são apresentados em espacejamento simples, mas foram encaminhados para as revistas em espaço duplo.

Artigo 1

To: Birgitte Kjaer

Editorial Office Scandinavian Journal of Medicine & Science in Sports

Sports Medicine Research Unit

Department of Rheumatology H, Building 8, 1st floor Bispebjerg Hospital,

Bispebjerg Bakke, 23, DK-2400 Copenhagen NV Denmark

Tel: + 45 35 31 60 89 Fax: + 45 35 31 27 33 Ribeirão Preto: 02/12/2004.

Referent to manuscript:

“Obese women’s fitness before and after 8 weeks of circuit or jogging training and a low- calorie diet”

Cover Letter

This manuscript was edited in accordance with the author guidelines and references Hulens et al. (2001, 2003), Wedderkopp (2004), and represents results of original work that have not been published (except as an abstract in conference proceedings). This manuscript has not and will not be submitted for publication elsewhere until a decision is made regarding its acceptability for publication in Scandinavian

Journal of Medicine & Science in Sports. If accept for publication, it will not be published elsewhere.

Furthermore, there are not any perceived financial conflicts of interest related to the research reported in the manuscript. This research is not a part of a larger study. We (the authors), assume public responsibility by the manuscript information.

Best regards.

*Carlos Alexandre Fett – cafett@hotmail.com

*Waléria Christiane Rezende Fett – wcrfett@hotmail.com

*Sandra Regina Oyama - sroyama@hotmail.com

*Vivian Marques Miguel Suen – viviansuen@terra.com.br

*Júlio Sérgio Marchini - jsmarchini@fmrp.usp.br

*Working Address of all authors:

Laboratory of Mass Spectrometry, Division of Nutrology, Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, 14049-900, Ribeirão Preto, SP, Brazil. (55) (0xx16) 6023375.

Obese women’s fitness before and after 8 weeks of circuit weight training or jogging and a low- calorie diet

Fitness of obese women

C. A. Fett2,W. C. R. Fett1, S. R. Oyama1, V. M. M. Suen1, J. S. Marchini1

1

Laboratory of Mass Spectrometry, Division of Nutrology, Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Av. Bandeirantes, 3900, 14049-900 Ribeirão Preto, SP, Brazil, 2Faculty of Physical Education, Federal University of Mato Grosso, Av. Fernando Correa da Costa, University Campus, Sport Gymnasium, 78068-900 Cuiabá, MT, Brazil.

Corresponding author: Carlos Alexandre Fett, Faculdade de Educação Física, Universidade Federal de Mato Grosso, Av. Fernando Correa da Costa, Cidade Universitária, Ginásio de Esportes, Cuiabá, MT, Brazil; Zip code: 78.068-900. Tel: 55 65 615 8830/ 55 16 602 3187

cafett@hotmail.com or fett@e-mailanywhere.com

ABSTRACT

Objective: The aim of this study was to observe the effect of eight weeks of circuit weight training (CWT)

or jogging (JOG) on obese women. Materials and methods: Groups: CWT: n=14, body mass index (BMI, kg/m2) = 33±8 (mean±SD); age=33±10 (years), and JOG: n=12, BMI=29±3; age = 39±11. Training volume was 1 hour x 3 days/week in the first month and 1 hour x 4 days/week in the second adjusted by heart rate and Borg scale, plus a low-calorie diet. Results: Comparison between the beginning and the end of the study showed a significant reduction in weight, body fat percent and an increase in lean body mass in both groups. Arm muscle circumference increased only in CWT. CWT improved in six physical tests and JOG in three. Resting energy expenditure (REE) did not differ in either group and the nitrogen balance continued to be positive in both. Conclusion: Body composition and REE were similar for both groups but CWT showed a better physical performance. We suggest that the two types of exercise should be combined for the treatment of obesity and comorbid conditions.

Key words: Body composition, resting energy expenditure, 1-RM, physical activity, nitrogen balance.

Obesity can be defined as the accumulation of excess energy in the form of fat resulting from a disequilibrium between energy ingestion and expenditure (Nobre & Monteiro, 2003), influenced by a complex of genetic, environmental and behavioral factors (Aronne, 2002), and is considered to be one of the most serious problems of the 21st century (Chopra & Galbraith, 2002).

Several studies have shown that a sedentary life style predominates among obese people and may be the main cause of obesity (Vincent,

Pangrazi, Raustorp, Tomson, Cuddihy, 2003; Wickelgren, 1998), even more than overnutrition (Pescatello & VanHeest, 2000). Several studies have shown that a sedentary life style is increasing in different regions of the planet and among different ethnic groups (Vincent et al., 2003; Sichieri, 2000; Wedderkopp, Froberg, Hansen, Andersen, 2000; Chopra & Galbraith, 2002). In addition, there is evidence that weight reduction is qualitatively more effective when obtained by physical activity than by diet only. Thus, a diet without exercise reduces lean body mass (LBM)

and basal energy expenditure (BEE) (Molé, Stern, Schultz, Bernauer, Holcomb, 1989). Exercises alone without calorie reduction diminish intra- abdominal fat (Ross, Dagnone, Jones, Smith, Paddags, Hudson, Janssen, 2000). A diet and exercise combination produces a greater body weight loss and helps maintain LBM (Molé et al., 1989). Therefore, circuit weight training (CWT) and aerobic exercise of low intensity such as jogging (JOG) are two types of training that can be used as co-adjuvants in the treatment of obesity.

Furthermore, it was demonstrated that physical fitness, of which habitual physical exercise is a major determinant, improves health and body composition status and reduces all cause mortality in obese people (Pescatello & VanHeest, 2000). Obese women have low physical fitness and effort tolerance, more susceptibility to pain and greater difficulty to sustain intense physical activity (Hulens, Vansant, Lysens, Claessens, Muls, 2001). However, it was demonstrated that obese women receiving a very low calorie diet and weight lift training could improve strength and physical fitness, without increasing lean body mass (Pronk, Donnelly, Pronk, 1992), suggesting this kind of training could be appropriate to improve the physical fitness of obese people. Additionally, strength has an influence on effort perception and is an important factor for personal independence. High BMI and body fat were inversely correlated with muscle strength in elderly women (Zoico, Di Francesco, Guralnik, Mazzali, Bortolani, Guariento, et al., 2004).

On the other hand, some authors have shown that the highest thermic effect of food (TEF) comes from protein sources (Jéquier, 2001), and high levels of fat intake are associated with the development of obesity (Bray & Popkin, 1998). However, there are controversies about the effect of macronutrients on the metabolic changes occurring in obese subjects submitted to exercise and/or a diet. No relation between TEF and diet composition (Suen, Silva, Tannus, Unamuno, Marchini, 2003), or between metabolism and a low-calorie diet (1099 kcal/day) with low protein ingestion (0.6 g/kg/d) has been observed in obese women (Marchini, Lambertini, Ferriolli, Dutra de Oliveira, 2001). Also, no relation has been reported between a higher prevalence of obesity and a greater fat consumption (Sichieri, 2000).

The first aim of this study was to assess the influence of two months of intervention with a moderate low-calorie diet containing slightly more protein and less fat, plus CWT or JOG on performance of physical tests by obese women that could reflect physical fitness. Secondly, to observe the effect of interventions on body composition. The third aim was to investigate alterations in metabolic indicators. And fourth, to compare the effect of two kinds of exercises on these variables.

Materials and methods

The study was conducted on sedentary women aged 18 to 60 years with a body mass index (BMI, kg/m2) of 28 to 40. The subjects were submitted to physical examination performed by a physician of the Nutrology team of the Department of Internal Medicine, Faculty of Medicine of Ribeirão Preto, University of São Paulo (FMRP-USP). Women with a history of metabolic diseases in addition to obesity such as diabetes, smokers and alcoholics (> 15 g ethanol equivalents/day), taking medications such as beta blockers (e.g., Propranolol) and/or sympathomimetic drugs (e.g., Anfepramone), who had been performing physical activities over the last 6 months (two or more weekly sessions of formal or informal physical activity), and with orthopedic limitations were excluded from the study. After an initial interview, the subjects were divided at random into two groups: CWT, submitted to circuit weight training (n = 14, BMI = 33 ± 8 (mean ± SD), age = 33 ± 10 years) and JOG, submitted to jogging training (n = 12, BMI = 29 ± 3, age = 39 ± 11 years). The groups trained for 60 minutes x 3 days/week during the first month and 60 minutes x 4 days/week in during the second. The intensity was adjusted to both groups by heart rate palpated at the wrist and by a modified Borg scale between 3-5 (moderate to hard) (Pollock, Wilmore, Fox III, 1986). CWT consisted of 15 stations of resisted exercise of 30 s each intercalated with 30 s of walking/jogging until completing a period of 40-45 minutes. JOG walked continuously for 45 minutes and the remaining 15 minutes were used for warm-up and for the cool down in both groups. The calorie supply for the two groups was similar to the respective resting energy expenditure (REE) and had the following composition: 20% protein, 20% fat and 60% carbohydrates. The Research Ethics Committee of the Faculty of Medicine of Ribeirão

Preto approved the study and issued a free consent form, which was signed by all participants.

Measurements and date collections

Anthropometry

Body weight (kg) and height (cm) were measured with a Filizola® electronic scale ID1500 (São Paulo, SP, Brazil) with 0.1 kg and 0.5 cm precision (Vannucchi, Marchini, Santos, Dutra de Oliveira, 1984). Skinfolds were measured using a Lange® adipometer (Beta Technology INC, Santa Cruz, CA, USA) with a constant pressure of 10 g/mm2 on the contact surface and 0.1 mm precision, with a 0-65 mm scale, for the measurement of the thickness of subcutaneous adipose tissue. The value considered was the mean of 3 consecutive measurements. Body density was calculated on the basis of the equation for three skinfolds for women corrected for age (Jackson, Pollock, Ward, 1980):

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0

(

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0000023

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0

(

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0009929

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0

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0994921

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1

Y

X

X

BD

−

+

−

=

Where: BD = body density (g/ml); X = sum o the triceps, suprailiac and thigh skinfolds in mm; Y = age in years.

Percent fat was obtained from the calculation of BD (Siri, 1961):

100

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5

.

4

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/

95

.

4

[(

%F

=

BD

−

×

Where: %F = fat percent calculated from the anthropometrics variables; BD = body density.

Once total weight and fat percent were obtained, fat body mass (FM) was calculated from the following data:

100

/

)

%

(P

F

FM

=

×

Where: FM = fat body mass (kg) calculated from the anthropometrics variables; %F = fat percent.

Lean body mass (LBM, kg) was obtained by subtracting FM from total weight.

The abdominal circumference (AbC, cm) was assessed in the standing position in parallel to the ground above the umbilical scar using a

flexible non-extensible metal tape with 0.1 cm precision.

Arm muscle circumference (AMC) was calculated by the formula:

)

(

×π

−

=

AC

TF

AMC

Where: AC = circumference at the midpoint of the arm in cm; TF = triceps fold in cm.

Physical tests

Six physical tests were carried out with the purpose of investigating general physical performance.