IJSM/5330/4.3.

2016/MPS Training & Testing

Hypertrophy-type Resistance Training Improves Phase

Angle in Young Adult Men and Women

Authors A. S. Ribeiro1, A. Avelar2, L. dos Santos1, A. M. Silva3, L. A. Gobbo4, B. J. Schoenfeld5, L. B. Sardinha3,

E. S. Cyrino1

Affiliations Affiliation addresses are listed at the end of the article

Key words Abstract water compartments) were assessed by bioim-

●
▶ strength training
▼ pedance spectroscopy (Xitron 4200 Bioimped-
●
▶ phase angle skeletal muscle
The main purpose of the present study was to ance Spectrum Analyzer). Total body water,
●
▶ cellular hydration
investigate the effect of a hypertrophy-type intracellular water and phase angle increased
●
▶ spectral bioimpedance
resistance training protocol on phase angle, an significantly (P < 0.05) in men (7.8, 8.3, and 4.3 %,

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indicator of cellular integrity, in young adult men respectively) and women (7.6, 11.7, and 5.8 %
and women. 28 men (22.2 ± 4.3 years, 67.8 ± 9.0 kg respectively), with no significant difference
and 174.2 ± 6.8 cm) and 31 women (23.2 ± 4.1 between sexes (P > 0.05). Bioimpedance resist-
years, 58.7 ± 12.1 kg and 162.7 ± 6.4 cm) under- ance decreased (P < 0.05) similarly in both sex
went a progressive RT for 16 weeks (2 phases, 8 (men =  − 4.8 %, women =  − 3.8 %). The results sug-
weeks each), 3 times per week, consisting of 10 to gest that regardless of sex, progressive RT induces
12 whole body exercises with 3 sets of 8–12 rep- an increase in phase angle and a rise in cellular
etitions maximum. Phase angle, resistance, reac- hydration.
tance and total body water (intra and extracellular

Introduction adaptations induced by RT on PhA. Thus, it is

▼ important to determine whether an RT program
Phase angle (PhA) is an angular derived bioelec- designed to promote hypertrophy results in long-
trical impedance (BIA) parameter from resistance term changes in PhA.
(R) and reactance (Xc) that has been widely used Factors such as age, body mass index and sex are
in different populations as an objective indicator primary determinants of the PhA [3, 6]. Men gen-
accepted after revision
of cellular health with higher values reflecting erally present higher PhA values than women,
January 26, 2016
better cellularity, cell membrane integrity and which may be related to their higher amount of
Bibliography cell function [9, 23]. PhA is considered a valuable skeletal muscle mass (SMM) [6] and because the
DOI  http://dx.doi.org/ alternative for predicting functionality [5, 23], R and Xc – the electrical properties that deter-
10.1055/s-0042-102788 nutritional status [38], disease prognosis [35] mine PhA – differ between sexes [6].
Published online: 2016 and mortality risk [24, 37]. Considering the abovementioned information,
Int J Sports Med Values of PhA have been proposed as a muscle fit- we cannot rule out the possibility that men and
© Georg Thieme
ness index expressing both the amount and qual- women may present different chronic adapta-
Verlag KG Stuttgart · New York
ity of soft tissue [23]. Given this information, tions in PhA pursuant to resistance exercise.
ISSN 0172-4622
resistance training (RT) can conceivably play an Therefore, the purpose of the present study was
Correspondence important role on PhA improvements, since RT is to investigate the effect of a hypertrophy-type RT
Prof. Alex Silva Ribeiro, MSc a well-recognized method of exercise for eliciting on PhA in young adult men and women.
Londrina State University increases in muscle growth and remodeling [1]. A
Physical Education and Sport cross-sectional study comparing the PhA of
Center healthy young adult males and bodybuilders Methods
Rua Carmela Dutra
86210000 Jataizinho
showed higher PhA scores for those who engaged ▼
Brazil
in regular RT [26]. Due to the premise of reverse Experimental design
Tel.:  + 55/433/2593 860 causality, however, cross-sectional studies pro- The study was carried out over a period of 22
Fax:  + 55/433/3714 772 vide limited utility for drawing robust conclu- weeks, with 16 weeks dedicated to the RT pro-
[email protected] sions about the influence of the chronic gram and 6 weeks to measurements and evalua-

Ribeiro AS et al. Phase Angle and Resistance Training …  Int J Sports Med
 Training & Testing IJSM/5330/4.3.2016/MPS

tions. Anthropometric and body compositions measurements Before BIS measurement participants were instructed to remove
were performed at weeks 1–2, 11–12 and 21–22. The first meas- all objects containing metal. Measurements were performed on
urement took place one week before the intervention (Monday a table that was isolated from electrical conductors, with sub-
and Tuesday). The second and third evaluations were performed jects lying supine along the table’s longitudinal centerline axis,
on the following Monday and Tuesday after the end of each legs abducted at an angle of 45°, and hands pronated. After
training phase (Friday). With this procedure, there was a 48–72 h cleaning the skin with alcohol, 2 electrodes were placed on the
period between the last training session and the bioimpedance surface of the right hand and 2 on the right foot in accordance
analysis. The supervised progressive RT was performed between with procedures described by Sardinha et al. [31]. Participants
weeks 3–10, 13–20. Subjects were instructed to maintain their were instructed to urinate about 30 min before the measures,
normal level of physical activity and were specifically asked not refrain from ingesting food or drink in the last 4 h, avoid strenu-
to start a new exercise regimen during study period. ous physical exercise for at least 24 h, refrain consumption of
alcoholic and caffeinated beverages for at least 48 h, and avoid
Participants the use of diuretics during 7 days prior each assessment. Before
Participants were recruited from a university population and each measurement day, the BIS equipment was calibrated as per
though a local advertisement. All volunteers (47 women and 42 the manufacturer’s recommendations. Based on the test-retest
men) completed a detailed health history questionnaire. Inclusion procedure measured 24 h apart, it was found SEM of 0.32 L and
criteria were the following: no signs or symptoms of any disease ICC = 0.98 for ECW, SEM of 0.19 L and ICC = 0.99 for ICW, and SEM
and orthopedic injuries, insufficiently inactive (defined as perform- of 0.38 L and ICC = 0.98 for TBW, SEM of 15.6 ohms and ICC = 0.95
ing physical activity less than twice a week), and no participation for R, SEM of 3.5 ohms and ICC = 0.96 for Xc, SEM of 0.21 degrees
on any RT for at least 6 months before the beginning of the study. 28 and ICC = 0.96 for PhA, SEM of 0.40 kg and ICC = 0.99 for SMM.
men and 31 women finished the study and therefore were included
in the final analysis. The reasons for the dropouts included insuffi- Dietary intake
cient attendance to training sessions (< 85 % of the total sessions) Participants were instructed by a nutritionist to complete a food
and voluntary abandonment for different reasons. record on 3 nonconsecutive days (2 week days and one weekend

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All women included in the analysis were in the same phase of day) at weeks 1–2, and 21–22. Participants were given specific
their menstrual cycle at the 3 time-points designated for evalu- instructions regarding the recording of portion sizes and quanti-
ation. 19 women were at the follicular phase, and 12 women ties to identify all food and fluid intake. Total dietary energy,
were at the luteal phase when body water was assessed. The fol- protein, carbohydrate and fat content were calculated using
licular phase was assumed as the first day of menstruation until nutrition analysis software (Avanutri Processor Nutrition Soft-
the fourteenth day, and the luteal phase was considered as half ware, Rio de Janeiro, Brazil; Version 3.1.4). All participants were
of the cycle (fifteenth day) until the day that precedes menstrua- asked to maintain their normal diet throughout the study period.
tion. In addition, all women were not assessed in the last week of
the luteal phase or during the days they were menstruating. Resistance training program
Written informed consent was obtained from the participants A supervised progressive RT program designed to induce muscu-
after a detailed description of all procedures was provided. The lar hypertrophy [1] was performed in two 8-week phases with
study was conducted in accordance with accepted ethical stand- training performed 3 times per week on Monday, Wednesday and
ards [12] and was approved by the Research Ethics Committee of Friday. Exercise physiologists supervised all training sessions dur-
the local University. ing which the designed exercise protocol and related safety were
assured. The progressive RT program in the first 8-week phase
Anthropometry consisted of 9 exercises selected to stress the major muscle groups
Body mass was measured to the nearest 0.1 kg using a calibrated in the following order: bench press, 45 °-angle leg press, wide-
electronic scale (Balmak, Laboratory Equipment Labstore, grip behind-the-neck pull-down, leg extension, side lateral raise,
Curitiba, PR, Brazil), with the participants wearing light workout lying leg curl, triceps pushdown, calf raise and arm curl.
clothing and no shoes. Height was measured with a stadiometer In the second 8-week training phase, the RT program was rede-
attached on the scale to the nearest 0.1 cm with participants signed, and 11 exercises were performed in the following order:
standing without shoes. Body mass index was calculated as body bench press, incline dumbbell fly, wide-grip behind-the-neck
mass in kilograms divided by the square of height in meters. pull-down, seated cable rows, military press, triceps press, arm
curl, leg extension, 45 °-angle leg press, lying leg curl and seated
Body composition calf raise. At the end of all training sessions, 3 sets of the abdom-
Bioimpedance spetroscopy (BIS) (Xitron Hydra, model 4200, inal crunch exercise were performed lying on the floor. In both
Xitron Technologies, San Diego, CA, USA) was used to determine training phases, participants were encouraged to total between
the total body water (TBW), intracellular water (ICW) and extra- 50–100 repetitions in the 3 sets of crunches.
cellular water (ECW) content, resistance (R), and reactance (Xc), For both training phases, all participants performed 3 sets of
and subsequently PhA was calculated by arc-tangent (Xc/R) x 8–12 maximum repetitions for all the exercises except calf exer-
180 °/π. SMM was estimated by the predictive equation devel- cises (3 sets of 15–20 maximum repetitions) and were instructed
oped by Janssen et al. [15]: to perform each repetition with a concentric-to-eccentric phase
ratio of 1:2. The rest period between sets was 60–90 s with a
SMM (kg) = [(Ht2/R × 0.401) + (sex × 3.825) + (age × –0.071)] + 5.102 2–3 min interval between each exercise. The training load was
consistent with the prescribed number of repetitions for the 3
where Ht is height in cm; R is BIA resistance in ohms; for sex, sets of each exercise. The load was adjusted weekly using the
men = 1 and women = 0; age is in years. A frequency of 50 kHz weight test for repetition maximums [27], which consisted of
was used to calculate SMM. executing the first and second sets at the lower end of the repeti-

Ribeiro AS et al. Phase Angle and Resistance Training …  Int J Sports Med
IJSM/5330/4.3.2016/MPS Training & Testing

tion zone (8 repetitions), and as many repetitions as possible Upper limb exercises: FW = WT + RE/2
until voluntary exhaustion in the third set. The same load was
used to perform all 3 sets of an exercise. Adjustments in the Lower limb exercises: FW = WT + RE
resistance load were made on a weekly basis using the following
equations: where FW = final weight (kg) used in training; WT = weight used
in the test (kg); RE = maximum number of repetitions performed
that exceeded the lower limit (8 repetitions) in the third set.
Table 1  General characteristics of the sample at baseline. Data are pre- To determine the load used in the first week of training a repeti-
sented as mean and standard deviation. tion maximum test was performed in the first training session of
the first week of training. The load used for this test for repeti-
Men (n = 28) Women (n = 31) P
tion maximums was set according to the perception and experi-
Age (years) 22.2 ± 4.3 23.2 ± 4.1 0.47
ence of the researchers. In the last session of the first week of
Height (cm) 174.2 ± 6.8 162.7 ± 6.4  < 0.001
training a second repetition maximum test was performed to
Body mass index (kg/m2) 22.4 ± 2.4 22.0 ± 3.5 0.66
determine the load used in the second week of training. The load

Men (n = 28) Women (n = 31) ANOVA Effects F P Table 2  Dietary intake of the
participants at pre- and post-
Carbohydrate (g/kg/d) Sex 0.59 0.44
training. The results are presented
Pre-training 4.1 ± 1.8 4.2 ± 1.8 Time 3.80 0.08
as mean and standard deviation.
Post-training 3.9 ± 1.3 4.0 ± 1.8 Interaction 1.06 0.30
Protein (g/kg/d) Sex 0.44 0.50
Pre-training 1.5 ± 0.6 1.3 ± 0.5 Time 3.30 0.09
Post-training 1.3 ± 0.3 1.3 ± 0.6 Interaction 0.28 0.59
Fat (g/kg/d) Sex 2.85 0.09

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Pre-training 1.1 ± 0.4 1.2 ± 0.3 Time 3.36 0.09
Post-training 1.0 ± 0.3 1.2 ± 0.6 Interaction 0.64 0.42
Energy intake (kcal/kg/d) Sex 0.75 0.38
Pre-training 31.9 ± 12.5 34.7 ± 11.8 Time 3.96 0.07
Post-training 29.7 ± 8.3 31.9 ± 14.4 Interaction 0.03 0.84

Men (n = 28) Women (n = 31) ANCOVA Effects F P Table 3  Participant’s scores

at baseline (pre-training), after
Body mass (kg)
8 weeks (mid-training), and 16
Pre-training 67.8 ± 9.0 58.7 ± 12.1 Group 0.23 0.64
weeks (post-training) of resistance
Mid-training 68.8 ± 8.4 a 60.7 ± 12.6 a Time 4.81 0.05
training. Data are expressed as
Post-training 70.0 ± 8.1 a 61.3 ± 13.0 a Interaction 0.87 0.41 mean and standard deviation.
Skeletal muscle mass (kg)
Pre-training 31.1 ± 2.7 20.7 ± 2.6 Group 0.18 0.66
Mid-training 31.9 ± 2.7 a 21.0 ± 2.8 a Time 8.49  < 0.01
Post-training 32.4 ± 2.8 ab 21.5 ± 3.0 ab Interaction 0.47 0.62
Total body water (L)
Pre-training 39.9 ± 5.5 28.9 ± 4.6 Group 0.92 0.25
Mid-training 41.6 ± 4.6 a 29.7 ± 6.0 a Time 4.11  < 0.05
Post-training 43.0 ± 4.9 ab 31.1 ± 5.6 ab Interaction 3.02 0.10
Intracellular water (L)
Pre-training 24.1 ± 2.9 16.3 ± 2.9 Group 0.04 0.83
Mid-training 24.8 ± 3.3 a 17.2 ± 3.2 a Time 5.61  < 0.05
Post-training 26.1 ± 3.3 ab 18.2 ± 3.7 ab Interaction 0.46 0.62
Extracellular water (L)
Pre-training 16.3 ± 1.8 12.5 ± 1.9 Group 0.32 0.56
Mid-training 16.7 ± 1.8 12.9 ± 2.8 Time 1.22 0.29
Post-training 16.8 ± 1.9 12.9  ± 2.1 Interaction 0.29 0.74
Resistance (ohms)
Pre-training 515.2 ± 45.6 625.5 ± 68.7 Group 1.38 0.24
Mid-training 496.9 ± 37.2 a 615.2 ± 75.9 a Time 4.99 0.05
Post-training 490.7 ± 46.7 a 601.6 ± 75.9 a Interaction 1.73 0.18
Reactance (ohms)
Pre-training 64.7 ± 5.0 69.3 ± 8.4 Group 2.42 0.12
Mid-training 64.6 ± 5.6 70.4 ± 10.2 Time 1.96 0.14
Post-training 64.3 ± 5.3 70.4 ± 9.3 Interaction 1.44 0.24
Phase angle (degrees)
Pre-training 7.19 ± 0.63 6.34 ± 0.63 Group 1.21 0.27
Mid-training 7.42 ± 0.59 a 6.54 ± 0.70 a Time 4.94  < 0.01
Post-training 7.50 ± 0.60 ab 6.71 ± 0.69 ab Interaction 0.60 0.54
a
P < 0.05 vs. pre-training and bP < 0.05 vs. mid-training

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 Training & Testing IJSM/5330/4.3.2016/MPS

used for this test was the one used in training. In the last training for comparisons, with baseline scores used as covariate. 2-way
session of all other training weeks, a repetition maximum test analysis of variance (ANOVA) for repeated measures was used for
was performed in the last training session of the week using the nutritional comparisons. In variables where sphericity was vio-
load used in training for each exercise. The results of these tests lated as indicated by Mauchly’s test, the analyses were adjusted
were used to determine the load to be used during the following using a Greenhouse-Geisser correction. When F-ratio was sig-
week. nificant, Bonferroni’s post hoc test was employed to identify the
mean differences. For all statistical analyses, significance was
Statistical analysis accepted at P < 0.05. The data were stored and analyzed using
Normality was checked by the Shapiro-Wilk’s test. Levene’s test STATISTICA software version 10.0 (StatSoft Inc, Tulsa, OK, USA).
was used to analyze the homogeneity of variances. The inde-
pendent t-test indicated baseline differences between sexes for
all dependent variables analyzed. For this reason, the 2-way Results
analysis of covariance (ANCOVA) for repeated measures was used ▼
The anthropometric characteristics of the participants are pre-
sented in ●  ▶  Table 1. As expected, men were taller ( + 11.5 cm)
a compared to women (P < 0.001).
50
Total energy and macronutrients daily intake at pre- and post-
training are shown in ●  ▶  Table 2. There were no significant main
40
effects or interactions (P > 0.05) for daily relative energy and
macronutrients within and between groups over time.
30 Changes in body mass, SMM, TBW, ICW and ECW fractions, R,
and Xc at the different time points of the study are presented
% 20 in ●  ▶  Table 3. There was no group by time interaction (P > 0.05)
for any of the outcomes analyzed. A significant main effect of

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10 time (P < 0.05) was observed for body mass, SMM, TBW, ICW, R
and PhA. The covariate means as well as the adjusted mid- and
0 post-training scores are presented in ●  ▶  Table 4.
 ▶  Fig. 1 presents the box plot of relative changes (Panel A), as
●
well as the individual changes (Panel B) from pre- to post-train-
– 10
Men Women ing (16 weeks) in PhA according to sex.
b
50

40
Discussion
▼
30
The main and novel findings of the present study were that the
hypertrophy-oriented RT produced significant increases in PhA,
% 20 and these changes were not influenced by sex. To the best of the
authors’ knowledge, this is the first study to analyze the effects
10 of RT on PhA in young men and women, providing unique
insights into the topic. We had hypothesized that PhA would
0 increase after 16 weeks of RT, and this adaptation would be
influenced by the participants’ sex. This hypothesis was partially
– 10 confirmed since, contrary to our initial speculation, both men
Women Men and women displayed similar increases in the PhA.
PhA is calculated as the arctangent of the ratio between R and Xc
Fig. 1  Relative ( %) group changes and individual changes (Panels a and [4]. Xc describes the capacitive impedance of cell membranes
b, respectively) on phase angle after 16 weeks of resistance training in
that is based on the dielectric properties of cell membranes and
young adult men (n = 28) and women (n = 31).

Table 4  Covariate mean and the adjusted mean by ANCOVA to mid- and post-training.

Covariate mean Men (n = 28) Women (n = 31)

Mean (95 % CI) Mean (95 % CI)
Mid-training Post-training Mid-training Post-training
Body mass (kg) 63.3 65.1 (64.5–68.8) 65.2 (64.4–66.1) 65.0 (64.4–65.6) 65.8 (65.0–66.6)
Skeletal muscle mass (kg) 25.6 26.4 (25.7–27.2) 26.7 (26.0–27.4) 25.9 (25.3–26.6) 26.7 (26.1–27.3)
Total body water (L) 34.1 37.0 (35.2–38.7) 37.6 (36.4–38.8) 35.9 (34.2–37.5) 36.9 (35.9–38.1)
Intracellular water (L) 20.0 21.1 (20.1–22.1) 21.8 (20.9–22.7) 20.6 (20.1–21.5) 22.1 (21.2–22.9)
Extracellular water (L) 14.3 14.9 (14.1–15.7) 14.8 (14.5–15.1) 14.7 (13.8–15.3) 14.7 (14.5–15.0)
Resistance (ohms) 573.2 549.9 (536.9–562.9) 547.2 (534.4–560.0) 567.4 (555.2–579.6) 550.5 (538.5–562.5)
Reactance (ohms) 67.1 66.9 (64.9–68.9) 66.3 (64.2–68.3) 67.3 (66.4–70.2) 67.7 (66.7–70.6)
Phase angle (degrees) 6.74 7.02 (6.88–7.16) 7.14 (6.96–7.32) 6.91 (6.78–7.04) 7.05 (6.86–7.20)

Ribeiro AS et al. Phase Angle and Resistance Training …  Int J Sports Med
IJSM/5330/4.3.2016/MPS Training & Testing

tissue interfaces and is related to its structure and functionality, In conclusion, this investigation advances our understanding
while R behavior is mainly dependent on the hydration of bodily about RT adaptations related to sexual dimorphism. In young
tissues [16]. The human body R is inversely proportional to the adult men and women a 16-week progressive hypertrophy-type
intracellular fluids, which means that the higher the ICW the RT increases PhA, TBW, ICW and SMM. PhA increase was found
lower is the body’s R [4]. Therefore, we can consider that the to be dependent on the resistive component (R) of the PhA and
changes in hydration status were sufficient to affect the PhA not on the capacitive behavior of tissues associated with Xc and
changes. In the present investigation the PhA improvement was related cellularity, cell size and integrative of cell membrane.
solely due to R reduction, considering that Xc did not change These findings highlight the specific influence of hypertrophy-
during the intervention in both men and women. Given the lack type RT exercise on the resistance component of PhA and shed
of change in Xc, it seems that cellularity, cell size and integrity of light on the physiological changes that may influence this bio-
cell membrane are not influenced by resistive exercise. On the physical parameter.
other hand, PhA increases may be associated with cellular hydra-
tion influencing the resistive behavior (R) of bodily tissues. Conflict of interest: The authors declare that they have no con-
The increase in ICW content observed in the present investiga- flict of interest.
tion is in agreement with previous work from our laboratory
that used the same RT protocol in a similar cohort of healthy Affiliations
young adult men and women [28]. Consistent RT can elicit cel- 1
 Metabolism, Nutrition, and Exercise Laboratory, Physical Education and
lular hydration by an increase in glycogen storage [19], since Sport Center, Londrina State University, Londrina, Brazil
2
 Department of Physical Education, Center of Health Sciences, Maringá State
every gram of glycogen attracts 3 g of water [7]. Fast-twitch fib- University, Maringá, Brazil
ers are particularly sensitive to osmotic changes, presumably 3
 Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana,
related to a high concentration of water transport channels Universidade de Lisboa, Cruz-Quebrada, Portugal
4
 Department of Physical Education, São Paulo State University, Presidente
called aquaporin-4 [11]. Considering that the number of fast- Prudente, São Paulo, Brazil
twitch fibers seems to be proportionally higher in men than in 5
 Exercise Science Department, CUNY Lehman College, Bronx, New York, USAl
women [30, 32], and given that females have an impaired metab-

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