The availability of wearable devices (WDs) to collect biometric information and their use during activities of daily living is significantly increasing in the general population. These small electronic devices, which record fitness and health-related outcomes, have been broadly utilized in industries such as medicine, healthcare, and fitness. Since they are simple to use and progressively cheaper, they have also been used for numerous research purposes. However, despite their increasing popularity, most of these WDs do not accurately measure the proclaimed outcomes. In fact, research is equivocal about whether they are valid and reliable methods to specifically evaluate physical activity and health-related outcomes in older adults, since they are mostly designed and produced considering younger subjects’ physical and mental characteristics. Additionally, their constant evolution through continuous upgrades and redesigned versions, suggests the need for constant up-to-date reviews and research. Accordingly, this article aims to scrutinize the state-of-the-art scientific evidence about the usefulness of WDs, specifically on older adults, to monitor physical activity and health-related outcomes. This critical review not only aims to inform older consumers but also aid researchers in study design when selecting physical activity and healthcare monitoring devices for elderly people.

Exercise has been suggested as a therapeutic approach to attenuate bone loss induced by bariatric surgery (BS), but its effectiveness remains unclear. Our aim was to determine if an exercise‐training program could induce benefits on bone mass after BS. Eighty‐four patients, submitted to gastric bypass or sleeve gastrectomy, were randomized to either exercise (EG) or control group (CG). One month post‐BS, EG underwent a 11‐month supervised multicomponent exercise program, while CG received only standard medical care. Patients were assessed before BS and at 1, 6, and 12 months post‐BS for body composition, areal bone mineral density (BMD), bone turnover markers, calciotropic hormones, sclerostin, bone material strength index, muscle strength, and daily physical activity. A primary analysis was conducted according to intention‐to‐treat principles and the primary outcome was the between‐group difference on lumbar spine BMD at 12 months post‐BS. A secondary analysis was also performed to analyze if the exercise effect depended on training attendance. Twelve months post‐BS, primary analysis results revealed that EG had a higher BMD at lumbar spine (+0.024 g∙cm⁻² [95% confidence interval (CI) 0.004, 0.044]; p = .015) compared with CG. Among total hip, femoral neck, and 1/3 radius secondary outcomes, only 1/3 radius BMD improved in EG compared with CG (+0.013 g∙cm⁻² [95% CI 0.003, 0.023]; p = .020). No significant exercise effects were observed on bone biochemical markers or bone material strength index. EG also had a higher lean mass (+1.5 kg [95% CI 0.1, 2.9]; p = .037) and higher number of high impacts (+51.4 [95% CI 6.6, 96.1]; p = .026) compared with CG. In addition, secondary analysis results suggest that exercise‐induced benefits may be obtained on femoral neck BMD but only on those participants with ≥50% exercise attendance compared with CG (+5.3% [95% CI 2.0, 8.6]; p = .006). Our findings suggest that an exercise program is an effective strategy to ameliorate bone health in post‐BS patients. © 2020 American Society for Bone and Mineral Research (ASBMR).

Background: Bariatric surgery is the most effective treatment for patients with severe obesity, but success rates vary substantially. Exercise is recommended after bariatric surgery to reduce weight regain but the effectiveness remains undetermined on weight loss due to conflicting results. It is also unclear what should be the optimal exercise prescription for these patients. A systematic review and meta‐analysis of randomized controlled trials on the effects of exercise on body weight (BW), anthropometric measures, and body composition after bariatric surgery was performed.Methods: PubMed/MEDLINE^®, EBSCO^®, Web of Science^® and Scopus^® databases were searched to identify studies evaluating exercise effectiveness.Results: The analysis comprised 10 studies (n = 487 participants). Exercise favored BW (−2.51kg; p = 0.02), waist circumference (−4.14cm; p = 0.04) and body mass index (−0.84kg·m⁻²; p = 0.02) reduction but no improvements in body composition. Combined exercise interventions were the most effective in reducing BW (−5.50kg; p < 0.01) and body mass index (−1.86kg·m⁻²; p < 0.01). Interventions starting >6‐months after bariatric surgery were more successful in reducing BW (−5.02kg; p < 0.01) and body mass index (−1.62kg·m⁻²; p < 0.01).Conclusion: Exercise, combined exercise regimens and interventions starting >6‐months after bariatric surgery were effective in promoting BW, waist circumference and body mass index reduction. Exercise following bariatric surgery does not seem to favor body composition improvements.

Background: Polarized training intensity distribution (POL) was recently suggested to be superior to other training intensity distribution (TID) regimens for endurance performance improvement. Objective: We aimed to systematically review and meta-analyze evidence comparing POL to other TIDs on endurance performance. Methods: PRISMA guidelines were followed. The protocol was registered at PROSPERO (CRD42022365117). PubMed, Scopus, and Web of Science were searched up to 20 October 2022 for studies in adults and young adults for ≥ 4 weeks comparing POL with other TID interventions regarding VO₂peak, time-trial (TT), time to exhaustion (TTE) or speed or power at the second ventilatory or lactate threshold (V/P at VT₂/LT₂). Risk of bias was assessed with RoB-2 and ROBINS-I. Certainty of evidence was assessed with GRADE. Results were analyzed by random effects meta-analysis using standardized mean differences. Results: Seventeen studies met the inclusion criteria (n = 437 subjects). Pooled effect estimates suggest POL superiority for improving VO₂peak (SMD = 0.24 [95% CI 0.01, 0.48]; z = 2.02 (p = 0.040); 11 studies, n = 284; I² = 0%; high certainty of evidence). Superiority, however, only occurred in shorter interventions (< 12 weeks) (SMD = 0.40 [95% CI 0.08, 0.71; z = 2.49 (p = 0.01); n = 163; I² = 0%) and for highly trained athletes (SMD = 0.46 [95% CI 0.10, 0.82]; z = 2.51 (p = 0.01); n = 125; I² = 0%). The remaining endurance performance surrogates were similarly affected by POL and other TIDs: TT (SMD = – 0.01 [95% CI -0.28, 0.25]; z = − 0.10 (p = 0.92); n = 221; I² = 0%), TTE (SMD = 0.30 [95% CI – 0.20, 0.79]; z = 1.18 (p = 0.24); n = 66; I² = 0%) and V/P VT₂/LT₂ (SMD = 0.04 [95% CI -0.21, 0.29]; z = 0.32 (p = 0.75); n = 253; I² = 0%). Risk of bias for randomized controlled trials was rated as of some concern and for non-randomized controlled trials as low risk of bias (two studies) and some concerns (one study). Conclusions: POL is superior to other TIDs for improving VO₂peak, particularly in shorter duration interventions and highly trained athletes. However, the effect of POL was similar to that of other TIDs on the remaining surrogates of endurance performance. The results suggest that POL more effectively improves aerobic power but is similar to other TIDs for improving aerobic capacity.

Summary: This meta‐analysis aimed to assess the effect of Roux‐en‐Y gastric bypass (RYGB) on three‐dimensionally assessed volumetric bone mineral density (vBMD) with the effect of time on these changes, on bone quality, and the agreement of dual‐energy X‐ray absorptiometry (DXA) with quantitative computed tomography (QCT) or high‐resolution peripheral QCT (HR‐pQCT) estimates of bone loss. We searched PubMed, Web of Science, Cochrane, Scopus, and EBSCO. Longitudinal studies on adults undergoing RYGB in which vBMD was assessed by QCT or HR‐pQCT with ≥6 months follow‐up were included. Total hip (TH) changes were reported in four studies, lumbar spine (LS) in eight, radius in eight, and tibia in seven. Significant post‐RYGB vBMD reductions occurred at all skeletal sites analyzed. Meta‐regression revealed that time post‐RYGB was significantly associated with vBMD deterioration in all skeletal sites except at the TH. RYGB also led to significant deterioration on bone quality. DXA underestimated LS and overestimated TH bone losses post‐RYGB. In conclusion, RYGB was associated with significant vBMD loss, which makes screening of bone mass progression by three‐dimensional technology a crucial clinical issue to prevent fracture risk and osteoporosis.