The dietary energy intake of a healthy, well-nourished population must allow the maintenance of an adequate BMI at the usual level of energy expenditure of the population. At the individual level, a normal range of 18.5 to 24.9 kg / m2 of BMI is usually accepted. To maintain this BMI range, the recommended energy intake for women at this age is approximately 1900 kcal / day (British Nutrition Foundation, 2018). This amount of energy would ensure the normal functioning of the body and a varied diet, including whole grains and dairy products, fruits and vegetables, nuts, would supply the body with the necessary vitamins and minerals. The energy intake of the subjects is above this minimum. This shows that the subjects eat adequately, being able to provide with food the energy needed for their daily needs and to be physically active from an energy point of view, the diet of the subjects is balanced, which shows their commitment to maintain a healthy weight and gain weight. the body needs energy.
Table 1
Basic nutrients and energy intake in the usual diet of the subjects from the first group.
ID | BMR, kcal | Energy intake, kcal | Proteins, g | Carbohydrates, g | Fat, g |
P1 | 1278 | 2087 | 120 | 242 | 71 |
P2 | 1336 | 1630 | 150 | 109 | 66 |
P3 | 1233 | 1991 | 149 | 270 | 35 |
P4 | 1272 | 1992 | 97 | 284 | 52 |
P5 | 1332 | 1801 | 108 | 205 | 61 |
P6 | 1267 | 1849 | 110 | 197 | 69 |
P7 | 1219 | 2046 | 130 | 251 | 58 |
P9 | 1278 | 1921 | 123 | 220 | 61 |
P10 | 1283 | 1951 | 99 | 265 | 55 |
Mean | 1277.6 | 1919 | 121 | 227 | 59 |
±SD | 38.7 | 141 | 20 | 53 | 11 |
Table 2
Basic nutrients and energy intake in the usual diet of the subjects from the second group.
ID | BMR, kcal | Energy intake, kcal | Proteins, g | Carbohydrates, g | Fat, g |
M1 | 1255 | 1808 | 103 | 205 | 64 |
M2 | 1319 | 1955 | 88 | 250 | 67 |
M3 | 1220 | 1944 | 105 | 237 | 64 |
M4 | 1387 | 1972 | 108 | 268 | 52 |
M5 | 1320 | 1897 | 72 | 238 | 73 |
M6 | 1334 | 1897 | 77 | 242 | 69 |
M7 | 1335 | 1843 | 83 | 281 | 43 |
M8 | 1372 | 2045 | 105 | 278 | 57 |
M9 | 1316 | 2089 | 96 | 253 | 77 |
Mean | 1318 | 1939 | 93 | 250 | 63 |
±SD | 52 | 90 | 13 | 24 | 11 |
. |
Table 3
Anthropometric indicators and body composition of the group of women practicing Pilates.
ID | Age, years | Height, cm | Weight, kg | BMI, kg/m2 | % BF | BF, kg | BFI, kg/m2 | % MM | MM, kg | FFM, kg | FFMI, kg/m2 | BMR, kcal | VF |
P1 | 36 | 160 | 58,0 | 22,9 | 30,8 | 17,9 | 7,0 | 29,7 | 17,2 | 40,1 | 15,7 | 1278 | 5 |
P2 | 35 | 172 | 58,4 | 19,7 | 26,7 | 15,6 | 5,3 | 30,0 | 17,5 | 42,8 | 14,5 | 1336 | 3 |
P3 | 22 | 163 | 52,6 | 19,8 | 28,8 | 15,1 | 5,7 | 27,8 | 14,6 | 37,5 | 14,1 | 1233 | 3 |
P4 | 22 | 161 | 57,7 | 22,3 | 35,9 | 20,7 | 8,0 | 24,9 | 14,4 | 37,0 | 14,3 | 1272 | 4 |
P5 | 22 | 172 | 58,5 | 19,8 | 27,7 | 16,2 | 5,5 | 29,5 | 17,3 | 42,3 | 14,3 | 1332 | 3 |
P6 | 31 | 165 | 55,2 | 20,3 | 29,2 | 16,1 | 5,9 | 28,4 | 15,7 | 39,1 | 14,4 | 1267 | 3 |
P7 | 40 | 158 | 53,7 | 21,5 | 28,5 | 15,3 | 6,1 | 30,0 | 16,1 | 38,4 | 15,4 | 1219 | 4 |
P8 | 29 | 170 | 53,3 | 18,5 | 23,3 | 12,4 | 4,3 | 30,9 | 16,5 | 40,9 | 14,1 | 1278 | 2 |
P9 | 30 | 170 | 53,9 | 18,7 | 21,3 | 11,5 | 4,0 | 32,7 | 17,6 | 42,4 | 14,7 | 1283 | 2 |
Mean | 29,7 | 165,7 | 55,7 | 20,4 | 28,0 | 15,6 | 5,7 | 29,3 | 16,3 | 40,1 | 14,6 | 1278 | 3 |
±SD | 6,7 | 5,5 | 2,4 | 1,5 | 4,2 | 2,7 | 1,2 | 2,2 | 1,2 | 2,2 | 0,6 | 39 | 1 |
BMI - body mass index; BF - body fat, body fat; BFI - body fat index; MM - muscle mass; FFM - fat-free mass; FFMI - fat-free mass index, fat-free body mass index; BMR - basal metabolic rate, basic metabolism; VF - visceral fat. |
Table 4
Anthropometric indicators and body composition of the group of women applying massage procedures.
ID | Age, years | Height, cm | Weight, kg | BMI, kg/m2 | % BF | BF, kg | BFI, kg/m2 | % MM | MM, kg | FFM, kg | FFMI, kg/m2 | BMR, kcal | VF |
M1 | 36 | 165 | 53,7 | 19,7 | 27,4 | 14,7 | 5,4 | 28,9 | 15,5 | 39,0 | 14,3 | 1255 | 3 |
M2 | 43 | 165 | 58,7 | 21,6 | 25,0 | 14,7 | 5,4 | 32,6 | 19,1 | 44,0 | 16,2 | 1319 | 4 |
M3 | 44 | 162 | 51,5 | 19,6 | 25,2 | 13,0 | 4,9 | 30,4 | 15,7 | 38,5 | 14,7 | 1220 | 4 |
M4 | 42 | 169 | 65,1 | 22,8 | 32,4 | 21,1 | 7,4 | 28,4 | 18,5 | 44,0 | 15,4 | 1387 | 5 |
M5 | 43 | 166 | 59,0 | 21,4 | 26,8 | 15,8 | 5,7 | 31,0 | 18,3 | 43,2 | 15,7 | 1320 | 4 |
M6 | 40 | 160 | 62,9 | 24,6 | 31,0 | 19,5 | 7,6 | 30,5 | 19,2 | 43,4 | 17,0 | 1334 | 6 |
M7 | 37 | 170 | 58,8 | 20,3 | 25,2 | 14,8 | 5,1 | 31,7 | 18,6 | 44,0 | 15,2 | 1335 | 3 |
M8 | 45 | 175 | 60,2 | 19,7 | 26,9 | 16,2 | 5,3 | 29,8 | 17,9 | 44,0 | 14,4 | 1372 | 3 |
M9 | 33 | 163 | 61,7 | 23,2 | 34,5 | 21,3 | 8,0 | 27,4 | 16,9 | 40,4 | 15,2 | 1316 | 5 |
Mean | 40,3 | 166,1 | 59,1 | 21,4 | 28,3 | 16,8 | 6,1 | 30,1 | 17,8 | 42,3 | 15,3 | 1318 | 4 |
±SD | 4,1 | 4,6 | 4,3 | 1,8 | 3,5 | 3,1 | 1,2 | 1,6 | 1,4 | 2,3 | 0,9 | 52 | 1 |
BMI - body mass index; BF - body fat, body fat; BFI - body fat index; MM - muscle mass; FFM - fat-free mass; FFMI - fat-free mass index, fat-free body mass index; BMR - basal metabolic rate, basic metabolism; VF - visceral fat |
Dietary recommendations differ, but there are some general rules for the ratio of essential nutrients (Food and Agriculture Organisation & World Health Organisation, Carbohydrates in Human Nutrition, 1998; Food and Agriculture Organisation, World Health Organisation, & United Nations, Energy and Protein Requirements. Technical Report Series No. 724, 1985; Food and Agriculture Organization & World Health Organisation, 1994). Fat consumption should provide 30–35% of daily energy needs, with an emphasis on poly- and monounsaturated fatty acids. Carbohydrate intake should provide about 55–60% of daily calories, and they should be taken in the form of complex carbohydrates in combination with a lot of fiber.
From these recommendations we can conclude that in a properly structured diet the share of energy from carbohydrates should be about 55–60%, from fat − 30–35% and respectively from protein − 15–20%.
As can be seen from the diagrams (Fig. 1) in both groups there are significant deviations from the correct ratio of essential nutrients. Reducing carbohydrate intake is a characteristic trend in people who strive to maintain weight with the thought that they gain weight. On the other hand, reduced carbohydrate intake is also associated with lower intake of vitamins and minerals, which are mainly contained in carbohydrate sources. This trend in the long run would lead to health problems. Therefore, after the analysis, we talked to the participants in the study and recommended that they increase their intake of carbohydrates in the form of whole grains, fruits and vegetables, which would improve their diet.
With regard to proteins in both groups, their intake is increased, probably due to the fashion in the diet of people engaged in exercise, that they are extremely necessary to support muscle growth and maintenance. Studies have shown (Burke & Deakin, 2015) that the intake of 0.8-1 g protein / kg body weight per day is completely satisfactory, even in persons engaged in heavy physical activity, where muscle strength is of particular importance. Large amounts of protein in the diet would increase the acidity of the body, lead to liver and kidney problems, as well as reduce calcium in the bones.
As can be seen from the table, the two groups differ significantly in their age. The group dealing with Pilates is on average 10 years younger than the group involved in massage procedures (Mann Whitney test, P value = 0.001). There is a statistically significant difference in weight (Mann Whitney test, P value = 0.02). In healthy women, the difference in weight is most significant between these studied groups (Gaba & Pridalova, 2014), as the difference reported in the literature is a difference = 5.5 kg, p = 0.05. Our study included women who are physically active, taking care of their appearance and body weight and it increases with age, with a difference of 3.4 kg on average, p = 0.02. The study included women with normal weight, which can be seen from the BMI, which averages 20.4 and 21.4 kg / m2 in both groups. The normal body mass index is in the range of 18.5–25 kg / m2 (Roberts & Dallal, 2001)
Studies show (Bazzocchi, и др., 2013) that significant changes in women's body composition occur at the age of about 40 years. These changes are the result of an increase in fat mass. The study group of 40-year-old women proved that targeted actions in terms of weight maintenance, including physical activity and anti-cellulite massage can reduce the process of fat accumulation in the body, both subcutaneous and visceral. No statistically significant difference (Mann Whitney test, ns) was found in the two study groups with respect to adipose tissue percentage, adipose tissue mass, fat mass index, and visceral fat level. In both groups the average percentage of fat is normal (21.0-32.9% for the first group and 23.0-33.9% for the second group), but in both groups there is one person with a high percentage of body fat − 35.9 in the first and 34.5 in the second, respectively (Gallagher, et al., 2000). However, this higher percentage of body fat does not lead to a change in BMI and fat mass index. BMI does not give an idea of the distribution of FFM and BF. As studies show that body composition is a major determinant of health (Segal, et al., 1987), FFM and BF should be identified as part of the health assessment. However, they change in height, weight and age. Therefore, it is difficult to determine whether individual subjects have low or high FFM or BF. FFMI and BFMI eliminate differences in FFM and BF due to height and allow the creation of recommended ranges, regardless of age and height. FFMI and BFMI have been reported in studies in a small number of healthy individuals (Van Itallie, et al., 1990; Westerterp, et al., 1992) and patients (Mostert, et al., 2000; Engelen, et al., 1999; Engelen, et al., 1999a). According to a study conducted by Schutz et al. (2002), the normal fat mass index for women aged 35–54 years is 6.2 ± 2.1 kg / m2. The fat mass indices in the two study groups were 5.7 ± 1.2 kg / m2 in the first and 6.1 ± 1.2 kg / m2 in the second, respectively, which shows that it deviates slightly in the direction lower than the normal values.
Visceral fats in the two groups are respectively: first group - third level and second group − 4 level, which falls within the norm, which is from 1st to 9th level (OMRON Healthcare, 2021). An increased amount of visceral fat is thought to be directly linked to an increased risk of disease. Even people with normal weight may have elevated levels of visceral fat, which is associated with metabolic disorders.
If women maintain physical activity, according to (Bazzocchi, et al., 2013), their lean body tissue will be preserved in the period from 20 to 70 years. Our study shows that physical activity in both groups leads to the maintenance of normal muscle mass levels (24.3–30.3% for the first group and 24.1–30.1% for the second group). There is no statistically significant difference in the percentage of muscle mass, but the muscle mass of the second group is higher (Mann Whitney test, P value = 0.04) than the muscle mass of the first, and the same dependence is observed in lean body mass ( Mann Whitney test, P value = 0.03). Higher weight and BMI lead to higher fat and muscle mass indices. This is because a mathematical BMI is the sum of both indices and as one or both of them increase, so does it.
Normal muscle mass indices range from 14.6 to 16.8 kg / m2 in women with normal BMI (Kyle, et al., 2003; Schutz, et al, 2002). In the studied groups this index was 14.6 ± 0.6 in the first and 15.2 ± 0.9 in the second, respectively, which shows that both studied groups are within the normal muscle mass. Higher muscle mass and lean body mass in the second group are clear evidence that continuous physical activity leads to its increase. On the other hand, lean body mass includes not only muscle mass, but the mass of bones and body fluids. It is known (Burke & Deakin, 2015) that maximum bone density with proper nutrition and physical activity can be reached around the 35th anniversary of a person. The second group of women are over 35 years old, while the first are with an average age of 29. 7 years. Since all of them are physically active and from the previous analysis of nutrition they eat well, probably the higher lean body mass is due to the higher bone density in the second group.
Somatotyping is another suitable method for comparing different groups of people. In our case, it was used in order to find the differences in the two studied groups. As we have seen from the anthropometric data, there are no statistically significant differences in most of the data.
Both groups are quite heterogeneous in terms of somatotype and it cannot be used to compare them. Although the subjects have a low percentage of fat mass, it is clear that in the first group there are two women with a predominant endomorphic component, one of them has a higher percentage of fat mass than the others, while in the other the percentage of fat mass is normal. In the second group, there is only one person with a predominant endomorphic component, but this is not the person with a higher percentage of fat mass. Somatotyping in this case shows the distribution of subcutaneous fat in the body and can be used to correct exercise and massage in the second group.
Both methods for determining body composition and somatotyping allow for individual analysis and follow-up. This can help to create an appropriate set of exercises to help "clear the fat" of specific areas of the body. During the massage you can also pay more attention to certain areas in order to help regenerate the skin and reduce subcutaneous fat.