title: Sarcopenic obesity and physical performance in middle aged women: a cross-sectional study in Northeast Brazil.
abstract: BACKGROUND
  Sarcopenia and obesity have been independently associated with physical function decline, however little information is currently available on the relationship between sarcopenic obesity and physical performance, mainly in middle aged women. The present study aims to estimate the prevalence of sarcopenic obesity and to explore the relationship between sarcopenic obesity and physical performance in middle-aged women from Northeast Brazil.
  
  
  METHODS
  A cross-sectional study of women (40-65 years) living in Parnamirim, a city in Northeast Brazil (n = 491). Physical performance was assessed by grip strength, knee extensor and flexor strength (isometric dynamometry), gait speed, and chair stands. Using bioelectrical impedance analysis (BIA), appendicular skeletal muscle mass divided by height squared (kg / m(2)) was used to define sarcopenia. Waist circumference ≥ 88 cm was defined as abdominal obesity. Sarcopenic obesity was defined as the coexistence of obesity and sarcopenia. The physical performance outcomes were regressed in four groups defined by combinations of sarcopenia and obesity, adjusting for potential confounders (age, education and menopausal status).
  
  
  RESULTS
  Prevalence rates of the four obesity-sarcopenia groups were: Sarcopenic obesity (7.1 %), obesity (67.4 %), sarcopenia (12.4 %) and normal (13 %). Women with sarcopenic obesity had significantly lower grip strength, weaker knee extension and flexion and longer time to raise from a chair compared with non-obese and non-sarcopenic women (p.values < 0.001). Except for the chair stands, these statistically significant differences were also found between sarcopenic obese and obese women. There was no significant difference for gait speed across the four groups (p = 0.50).
  
  
  CONCLUSIONS
  Sarcopenic obesity was present in 7 % of this population of middle-aged women from Northeast Brazil and it was associated with poor physical performance. Sarcopenic obesity may occur in middle-aged women with performance limitations beyond pure sarcopenia-related muscle mass or obesity alone.
authors.affiliation: Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil. maylinhaandrade@hotmail.com.
authors.forename: Mayle A
authors.initials: MA
authors.lastname: Moreira
authors.affiliation: Institut de Recherché en Santé Publique, School of Public Health, Université de Montréal, Québec, Canada. maria.victoria.zunzunegui@umontreal.ca.
authors.forename: Maria Victoria
authors.initials: MV
authors.lastname: Zunzunegui
authors.affiliation: Department of Public Health Sciences, Carruthers Hall, Queen's University, Kingston, Canada. 5av14@queensu.ca.
authors.forename: Afshin
authors.initials: A
authors.lastname: Vafaei
authors.affiliation: Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil. saionaraaires@gmail.com.
authors.forename: Saionara M A
authors.initials: SM
authors.lastname: da Câmara
authors.affiliation: Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil. tamy.sanoliveira@hotmail.com.
authors.forename: Tamyres S
authors.initials: TS
authors.lastname: Oliveira
authors.affiliation: Department of Physiotherapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado Filho, S/N Caixa Postal 1524-Campus Universitário-Lagoa Nova CEP, Natal, RN, 59072-970, Brazil. alvarohuab@hotmail.com.
authors.forename: Álvaro C C
authors.initials: ÁC
authors.lastname: Maciel
mesh_terms: D000328:Adult; D000368:Aged; D001938:Brazil / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005684:Gait; D018737:Hand Strength; D006304:Health Status; D006801:Humans; D007717:Knee; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology*; D015995:Prevalence; D016059:Range of Motion, Articular; D055948:Sarcopenia / Q000453:epidemiology*; D055105:Waist Circumference