Research Outputs
Dumping Syndrome After Bariatric Surgery: Advanced Nutritional Perspectives and Integrated Pharmacological Management
Dumping Syndrome (DS) is a significant complication following bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB). This condition is characterised by gastrointestinal and vasomotor symptoms resulting from altered anatomy and hormonal dysregulation, notably accelerated gastric emptying and an exaggerated release of gut peptides. Based on the timing of symptom onset after food ingestion, DS is classified as early (EDS) or late (LDS). The critical roles of peptides such as GLP-1, GIP, insulin, and YY peptide are highlighted, along with the involvement of neuroendocrine pathways in symptom manifestation. Diagnosis relies on a combination of clinical evaluation and dynamic testing, with the oral glucose tolerance test (OGTT) often considered a key reference standard for diagnosis. Initial management involves dietary modifications, emphasising the glycaemic index of foods and meal distribution. In cases where nutritional interventions are insufficient, pharmacotherapy with agents such as acarbose, somatostatin analogues (octreotide and pasireotide), GLP-1 receptor agonists (liraglutide), calcium channel blockers (verapamil), and emerging therapies, including herbal medicine, may be considered. For refractory cases, surgical options like bypass reversal or partial pancreatectomy are reserved, although their efficacy can be variable. Despite advancements in understanding and treating DS, further large-scale, randomised controlled trials are essential to validate novel strategies and optimise long-term management. This review provides an updated and comprehensive overview of the aetiology, pathophysiological mechanisms, diagnostic approaches, and current management strategies for DS.
Relationship between anthropometric nutritional status and functional capacity in older adults living in the community
Background: The functional fitness of older people may be associated with their nutritional status. Aim: To assess the association between of anthropometric measures with functional fitness in older people. Material and Methods: Cross-sectional study conducted in 75 participants aged 65 to 89 years. Body mass index (BMI), waist-to-height ratio (WHtR), fat mass (FM) and skeletal muscle mass index (SMI) were calculated from anthropometric measures. The functional fitness was determined using the Senior Fitness Test battery. Results: BMI and FM indicated obesity, and WHtR indicated cardiometabolic risk in 49%, 55% and 83% of participants, respectively. SMI indicated a low muscle mass in 91% of females. Performance standards of chair stand, arm curl, 2-min step test and 8-foot up-and-go tests were met in 1%, 8%, 1% and 89% of participants, respectively. Significant negative correlations were found between 2-min step test and BMI, WHtR and FM (r = −0.26, −0.31 and −0.48 respectively). Back scratch had a negative correlation with BMI (r = −0.23) and SMI (rho = −0.28). Significant positive correlations were found between 8-foot up-and-go, WHtR (rho = 0.28) and FM (rho = 0.23), and between 2-min step test and SMI (rho = 0.28). The coefficient of determination (R2) between 2-min step test with BMI, WHtR and FM were 0.05, 0.08 and 0.22, respectively, while the R2 between back scratch and BMI was 0.04. Multiple regression models indicated that FM affected the 2-min step test independently of BMI and WHtR (adjusted R2 = 0.22), however age and sex negatively influenced these associations. Conclusions: Functional fitness of older adults is influenced by nutritional anthropometric measures, particularly BMI, WHtR and FM for aerobic capacity, and BMI for upper limb flexibility.
Características antropométricas y condición física funcional de adultos mayores chilenos insertos en la comunidad
Introducción: la antropometría y condición física funcional (CFF) son aspectos fundamentales para la conservación de la independencia funcional del adulto mayor (AM). Sin embargo, poco se ha investigado en AM chilenos. Objetivo: analizar características antropométricas y CFF de AM autovalentes. Métodos: participaron 116 sujetos del estudio. Se determinó la prevalencia de categorías de peso (índice de masa corporal [IMC]) y riesgo cardiometabólico (RCM) (perímetro de la cintura [PCIN], índice cintura-cadera [ICC] e índice cintura-talla [ICT]). Además, rendimiento físico "bajo la norma" y estándares de rendimiento (Batería Senior Fitness Test [SFT]). Se analizaron las diferencias antropométricas y de CFF en función del sexo y categorías etarias. Resultados: un 63,8% y 73,5% de hombres y mujeres respectivamente presentó exceso de peso. La mayor prevalencia de RCM se obtuvo mediante ICT y las pruebas con mayor prevalencia de bajo rendimiento fueron "Paso 2 minutos" (P2M) y "Juntar las manos detrás de la espalda" (JME). El estándar de rendimiento se alcanzó en un 29,7% y 17,3%, en hombres y mujeres respectivamente. Hombres presentaron mayor talla, ICC, fuerza y capacidad aeróbica. Mujeres presentaron mayor perímetro de cadera, IMC, ICT y flexibilidad. Estos resultados tienden a conservarse en los análisis de acuerdo a categorías etarias. Conclusiones: la muestra presentó una alta prevalencia de exceso de peso, RCM y bajo rendimiento físico, especialmente en mujeres. Debido a su bajo costo y complejidad, se plantea que la evaluación integral de parámetros antropométricos y de CFF debiese implementarse en programas de atención primaria orientados a la conservación de la funcionalidad del AM.
A new reliable device to assess trunk extensors strength
Purpose: This study aimed to examine the reliability of trunk extensor strength assessment with a functional electromechanical dynamometer (FEMD). Methods: Thirty-one men performed strength assessment at different velocities (V) (V1 = 0.15 m·s−1, V2 = 0.30 m·s−1, V3 = 0.45 m·s−1) and range of movement (R) (R1 = 25% cm; R2 = 50% cm), and isometric contraction at 90º. Reliability was obtained through the intraclass correlation coefficient (ICC), typical error (TE), and coefficient of variation (CV). Results: The absolute reliability provided stable repeatability of the average eccentric strength in the V1R1 condition (CV = 9.52%) and the maximum eccentric strength in V1R1 (CV = 9.63%) and V2R2 (CV = 9.66%). The relative reliability of the trunk extensor’s average strength was good (ICC = 0.77–0.83) for concentric and good (ICC = 0.78–0.85) and moderate (ICC = 0.67–0.74) for eccentric contraction. Also, good (ICC = 0.77–0.81) and moderate (ICC = 0.55–0.74) reliability of the maximum strength were obtained for concentric and eccentric contraction. The most reliable manifestation to evaluate the concentric (CV = 11.33%) and eccentric (CV = 9.52%) strength was the average strength in the V1R1 condition and the maximum strength (CV = 10.29%) to isometric assessment. The average concentric strength in the V2R2 condition (r = 0.69) and the maximum eccentric strength in the V1R1 condition (r = 0.65) were the best related to the maximum isometric strength. Conclusions: FEMD is a highly reliable device to evaluate trunk extensors strength.
Assessment of the load-velocity profile in the free-weight prone bench pull exercise through different velocity variables and regression models
This aims of this study were (I) to determine the velocity variable and regression model which best fit the load-velocity relationship during the free-weight prone bench pull exercise, (II) to compare the reliability of the velocity attained at each percentage of the one-repetition maximum (1RM) between different velocity variables and regression models, and (III) to compare the within- and between-subject variability of the velocity attained at each %1RM. Eighteen men (14 rowers and four weightlifters) performed an incremental test during the free-weight prone bench pull exercise in two different sessions. General and individual load-velocity relationships were modelled through three velocity variables (mean velocity [MV], mean propulsive velocity [MPV] and peak velocity [PV]) and two regression models (linear and second-order polynomial). The main findings revealed that (I) the general (Pearson’s correlation coefficient [r] range = 0.964–0.973) and individual (median r = 0.986 for MV, 0.989 for MPV, and 0.984 for PV) load-velocity relationships were highly linear, (II) the reliability of the velocity attained at each %1RM did not meaningfully differ between the velocity variables (coefficient of variation [CV] range = 2.55–7.61% for MV, 2.84–7.72% for MPV and 3.50–6.03% for PV) neither between the regression models (CV range = 2.55–7.72% and 2.73–5.25% for the linear and polynomial regressions, respectively), and (III) the within-subject variability of the velocity attained at each %1RM was lower than the between-subject variability for the light-moderate loads. No meaningful differences between the within- and between-subject CVs were observed for the MV of the 1RM trial (6.02% vs. 6.60%; CV ratio = 1.10), while the within-subject CV was lower for PV (6.36% vs. 7.56%; CV ratio = 1.19). These results suggest that the individual load-MV relationship should be determined with a linear regression model to obtain the most accurate prescription of the relative load during the free-weight prone bench pull exercise.
Effect of muscle strength at different intensities on resting energy expenditure
Introduction: the regular practice of physical exercise is an important modulator of resting energy expenditure (REE), which depending on the intensity, duration, and type of exercise can increase the REE in an acute manner as well as long term. The effects of dynamic muscular strength exercises on the REE have been treated very little in literature. Objective: compare the effect of muscle strength exercise (MSE) at different intensities on the REE in young males. Methods: Intra-group design. Fourteen subjects aged 22,5±1,5 0,05) after the exercise at 40%RM. The REEpost 24h was maintained according to the REEpre when the intensity was 80%RM. Conclusion: The REEpost exercise is independent of the intensity of the exercise and only is maintained after 24 hours when the MSE is at a high intensity
Reliability of a standing isokinetic shoulder rotators strength test using a functional electromechanical dynamometer: effects of velocity
Background. The evaluation of the force in internal rotation (IR) and external rotation (ER) of the shoulder is commonly used to diagnose possible pathologies or disorders in the glenohumeral joint and to assess patient’s status and progression over time. Currently, there is new technology of multiple joint isokinetic dynamometry that allows to evaluate the strength in the human being. The main purpose of this study was to determine the absolute and relative reliability of concentric and eccentric internal and external shoulder rotators with a functional electromechanical dynamometer (FEMD). Methods. Thirty-two male individuals (21.46 ± 2.1 years) were examined of concentric and eccentric strength of shoulder internal and external rotation with a FEMD at velocities of 0.3 m s−1 and 0.6 m s−1 . Relative reliability was determined by intraclass correlation coefficients (ICC). Absolute reliability was quantified by standard error of measurement (SEM) and coefficient of variation (CV). Systematic differences across velocities testing circumstances, were analyzed with dependent t tests or repeated measures analysis of variance in case of two or more than two conditions, respectively. Results. Reliability was high to excellent for IR and ER on concentric and eccentric strength measurements, regardless of velocity used (ICC: 0.81–0.98, CV: 5.12–8.27% SEM: 4.06–15.04N). Concentric outcomes were more reliable than eccentric due to the possible familiarization of the population with the different stimuli. Conclusion. All procedures examined showed high to excellent reliability for clinical use. However, a velocity of 0.60 m s−1 should be recommended for asymptomatic male patients because it demands less time for evaluation and patients find it more comfortable.
The addition of very light loads into the routine testing of the bench press increases the reliability of the force–velocity relationship
Background: The aim of this study was to examine whether the addition of very light loads for modeling the force–velocity (F–V) relationship during the bench press (BP) exercise can confirm its experimental linearity as well as to increase the reliability and concurrent validity of the F–V relationship parameters (maximum force (F0), maximum velocity (V0), F–V slope, and maximum power (Pmax)). Method: The F–V relationship of 19 healthy men were determined using three different methods: (I) 6-loads free method: six loads performed during the traditional free-weight BP exercise (≈ 1–8–29–39–49–59 kg), (II) 4-loads free method: four loads performed during the traditional free-weight BP exercise (≈ 29–39–49–59 kg), and (III) 4-loads Smith method: four loads performed during the ballistic bench press throw exercise in a Smith machine (≈ 29–39–49–59 kg). Results: The linearity of the F–V relationship was very high and comparable for the three F–V methods (p = 0.204; median Pearson’s correlation coefficient (r) = 0.99). The three methods were ranked from the most to the least reliable as follows: 6-loads free (coefficient of variation (CV) range = 3.6–6.7%) > 4-loads Smith (CV range = 4.6–12.4%) > 4-loads free (CV range = 3.8–14.5%). The higher reliability of the 6-loads free method was especially pronounced for F–V slope (CVratio ≥ 1.85) and V0 (CVratio ≥ 1.49) parameters, while the lowest difference in reliability was observed for F0 (CVratio ≤ 1.27). The 6-loads free and 4-loads free methods showed a very high concurrent validity respect to the 4-loads Smith method for F0 and Pmax (r ≥ 0.89), a moderate validity for the F–V slope (r = 0.66–0.82), and a low validity for V0 (r ≤ 0.37). Discussion: The routine testing of the F–V relationship of upper-body muscles through the BP exercise should include trials with very light loading conditions to enhance the reliability of the F–V relationship.
Estudio comparado de la intensidad de entrenamiento sobre la máxima tasa de oxidación de grasas
Introducción: El ejercicio físico es un importante modulador de la máxima tasa de oxidación de grasas (MFO). Sin embargo, en la relación MFO-ejercicio, las zonas de transición metabólica en la prescripción del ejercicio no son consideradas. Objetivo: Conocer el efecto del entrenamiento en diferentes zonas de transición metabólica sobre la cinética de la MFO y su localización (Fatmax) en jóvenes varones activos. Método: 97 varones fueron distribuidos en 4 grupos homogéneos, 3 experimentales y un grupo control (GC). Cada grupo experimental participó en 8 semanas de entrenamiento administrado de forma continua a intensidad de umbral aeróbico o VT1 (CCVT1), interválica en umbral anaeróbico o VT2 (ITVT2), y en potencia aeróbica máxima o VO2max (ITVO2max). Antes y después del tratamiento los sujetos fueron testados en sendas pruebas con control de gases espirados para determinar el VO2max, VT1 y VT2, y la MFO (calorimetría indirecta) y Fatmax. Resultados: Los resultados muestran un incremento (entre 16,49 y 18,51%; p<0,01) en la MFO en los grupos experimentales. La Fatmax se redujo de media del 60,72±10,52 al 52,35±7,61 %VO2max (p<0,01) por efecto del entrenamiento. El grupo control no experimentó cambios de interés. El análisis intergrupo no presentó diferencias entre los grupos experimentales en ambas variables, sin embargo la comparación contra el GC, reflejó un mayor descenso de la Fatmax en CCVT1 (p<0,05). No se registraron cambios en el rendimiento, salvo un descenso del VO2max en el GC (p<0,05). Conclusión: 8 semanas de entrenamiento de diferente intensidad incrementan la MFO y reducen la Fatmax.