Recomendaciones médicas para mujeres que van a altitud. Documento de consenso de la comisión médica de la UIAA

A menudo, los médicos de cabecera deben atender la demanda de mujeres, embarazadas o no, que quieren ir a altitud para hacer alpinismo u otras actividades. Este documento de consenso pretende establecer guías claras, basadas en la evidencia científica disponible, para responder a estas cuestiones. Se espera que esta información sea útil a médicos, sanitarios y en general a las mujeres que planeen ir a altitud durante períodos breves (de días a semanas)

Physical activity intensity and surrogate markers for cardiovascular health in adolescents

We examined the impact of physical activity (PA) on surrogate markers of cardiovascular health in adolescents. 52 healthy students (28 females, mean age 14.5±0.7years) were investigated. Microvascular endothelial function was assessed by peripheral arterial tonometry to determine reactive hyperemic index (RHI). Vagal activity was measured using 24h analysis of heart rate variability [root mean square of successive normal-to-normal intervals (rMSSD)]. Exercise testing was performed to determine peak oxygen uptake ( $$\dot{V}{\text{O}}_{{2{\text{ peak}}}}$$ ) and maximum power output. PA was assessed by accelerometry. Linear regression models were performed and adjusted for age, sex, skinfolds, and pubertal status. The cohort was dichotomized into two equally sized activity groups (low vs. high) based on the daily time spent in moderate-to-vigorous PA (MVPA, 3,000-5,200 counts.min−1, model 1) and vigorous PA (VPA, >5,200 counts.min−1, model 2). MVPA was an independent predictor for rMSSD (β=0.448, P=0.010), and VPA was associated with maximum power output (β=0.248, P=0.016). In model 1, the high MVPA group exhibited a higher vagal tone (rMSSD 49.2±13.6 vs. 38.1±11.7ms, P=0.006) and a lower systolic blood pressure (107.3±9.9 vs. 112.9±8.1mmHg, P=0.046). In model 2, the high VPA group had higher maximum power output values (3.9±0.5 vs. 3.4±0.5 Wkg−1, P=0.012). In both models, no significant differences were observed for RHI and $$\dot{V}{\text{O}}_{{ 2 {\text{ peak}}}}$$ . In conclusion, in healthy adolescents, PA was associated with beneficial intensity-dependent effects on vagal tone, systolic blood pressure, and exercise capacity, but not on microvascular endothelial functio

Recomanacions mèdiques per a dones que van a altitud. Document de consens de la comissió mèdica de la UIAA

Sovint els metges de capçalera atenen la demanda de dones, embarassades o no, que volen anar a altitud per fer-hi alpinisme o altres activitats. Aquest document de consens pretén establir guies clares, basades en l'evidència científica disponible, per respondre a aquestes qüestions. S'espera que aquesta informació sigui útil a metges, sanitaris i, en general, a les dones que tinguin planejat d'anar a altitud durant períodes breus (de dies a setmanes)

Health-related quality of life in migrant preschool children

BACKGROUND: Minority groups have a lower health-related quality of life (HRQOL), but there is little information if this finding also applies to children. In this study, we compared HRQOL between young children with and without migrant parents. METHODS: Two cross-sectional studies of culturally diverse preschool populations in Switzerland: Ballabeina (40 preschools, 258 girls and 232 boys aged 4 to 6 years) and Youp'la Bouge (58 child care centers, 453 girls and 522 boys aged 2 to 4 years). Most children were born in Switzerland (Ballabeina: 92.3%; Youp'la Bouge: 93.7%). Number of migrant parents was considered as the main exposure. HRQOL was measured using the 23-item Pediatric Quality of Life Inventory. RESULTS: Children of migrant parents had a significantly lower HRQOL total score (mean +/- SD, Ballabeina: 84.2 +/- 9.1; 82.7 +/- 9.6 and 81.7 +/- 11.7 for children with none, one or two migrant parents, respectively; Youp'la Bouge: 83.8 +/- 8.6; 82.9 +/- 9.5; 80.7 +/- 11.7, all p > 0.05). Similar results were found in Ballabeina and Youp'la Bouge for social, school and physical functioning (all p > 0.05), but not for emotional functioning. The differences in HRQOL measures were partly mediated by children's place of birth, parental education, paternal occupational level, children's BMI, screen time and physical activity in one study (Ballabeina), but not in the other (Youp'la Bouge). CONCLUSION: In preschoolers, children of migrant parents have lower HRQOL than children of non-migrant parents. These differences are only partly mediated by other sociocultural characteristics or lifestyle behavior. These families may need assistance to prevent further inequalities

Estimation of percentage body fat in 6- to 13-year-old children by skinfold thickness, body mass index and waist circumference

We evaluated the accuracy of skinfold thicknesses, BMI and waist circumference for the prediction of percentage body fat (PBF) in a representative sample of 372 Swiss children aged 6-13 years. PBF was measured using dual-energy X-ray absorptiometry. On the basis of a preliminary bootstrap selection of predictors, seven regression models were evaluated. All models included sex, age and pubertal stage plus one of the following predictors: (1) log-transformed triceps skinfold (logTSF); (2) logTSF and waist circumference; (3) log-transformed sum of triceps and subscapular skinfolds (logSF2); (4) log-transformed sum of triceps, biceps, subscapular and supra-iliac skinfolds (logSF4); (5) BMI; (6) waist circumference; (7) BMI and waist circumference. The adjusted determination coefficient (R _{adj}^{2} ) and the root mean squared error (RMSE; kg) were calculated for each model. LogSF4 (R _{adj}^{2} 0·85; RMSE 2·35) and logSF2 (R _{adj}^{2} 0·82; RMSE 2·54) were similarly accurate at predicting PBF and superior to logTSF (R _{adj}^{2} 0·75; RMSE 3·02), logTSF combined with waist circumference (R _{adj}^{2} 0·78; RMSE 2·85), BMI (R _{adj}^{2} 0·62; RMSE 3·73), waist circumference (R _{adj}^{2} 0·58; RMSE 3·89), and BMI combined with waist circumference (R _{adj}^{2} 0·63; RMSE 3·66) (P<0·001 for all values of R _{adj}^{2} ). The finding that logSF4 was only modestly superior to logSF2 and that logTSF was better than BMI and waist circumference at predicting PBF has important implications for paediatric epidemiological studies aimed at disentangling the effect of body fat on health outcome

Correlates of children’s physical activity during physical education classes

Aim: The aim of this study was to investigate the influence of correlates on physical activity (PA) during physical education (PE). Method: One hundred and ninety children (11.2 ± 0.8 y, 1.5 ± 0.1 m, 37.7 ± 8.3 kg) of 12 classes participated. Children were asked to wear an accelerometer for seven days. Teachers filled in a questionnaire to collect data about correlates of PA during PE (i.e. sex, weight, age of children, daily PA of the children, class size, PA behavior and formation of the teacher and size of gym). Correlates for moderate-to-vigorous PA (MVPA) during PE were determined using multifactor linear regression analysis. Results Fifty-three percent of the variability of MVPA during PE was explained by the investigated correlates. Apart from individual correlates (sex, weight, age), PE taught in small classes and large gyms by a PE specialist and a high overall PA of the child had independent positive effects on MVPA during PE. Conclusion: The results underline the importance of small PE classes taught by specialized PE teachers in large gyms and the increase of overall PA of children for effective future intervention studies and for political discussion focusing on increasing PA during PE

Associations between measures of physical fitness and cognitive performance in preschool children

BACKGROUND Given that recent studies report negative secular declines in physical fitness, associations between fitness and cognition in childhood are strongly discussed. The preschool age is characterized by high neuroplasticity which effects motor skill learning, physical fitness, and cognitive development. The aim of this study was to assess the relation of physical fitness and attention (including its individual dimensions (quantitative, qualitative)) as one domain of cognitive performance in preschool children. We hypothesized that fitness components which need precise coordination compared to simple fitness components are stronger related to attention. METHODS Physical fitness components like static balance (i.e., single-leg stance), muscle strength (i.e., handgrip strength), muscle power (i.e., standing long jump), and coordination (i.e., hopping on one leg) were assessed in 61 healthy children (mean age 4.5 ± 0.6 years; girls n = 30). Attention was measured with the "Konzentrations-Handlungsverfahren für Vorschulkinder" [concentration-action procedure for preschoolers]). Analyses were adjusted for age, body height, and body mass. RESULTS Results from single linear regression analysis revealed a significant (p < 0.05) association between physical fitness (composite score) and attention (composite score) (standardized ß = 0.40), showing a small to medium effect (F$^{2}$ = 0.14). Further, coordination had a significant relation with the composite score and the quantitative dimension of attention (standardized ß = 0.35; p < 0.01; standardized ß =  - 0.33; p < 0.05). Coordination explained about 11% (composite score) and 9% (quantitative dimension) of the variance in the stepwise multiple regression model. CONCLUSION The results indicate that performance in physical fitness, particularly coordination, is related to attention in preschool children. Thus, high performance in complex fitness components (i.e., hopping on one leg) tends to predict attention in preschool children. Further longitudinal studies should focus on the effectiveness of physical activity programs implementing coordination and complex exercises at preschool age to examine cause-effect relationships between physical fitness and attention precisely

Regional sociocultural differences as important correlate of physical activity and sedentary behaviour in Swiss preschool children

Regional differences in physical activity in school-aged children and adults even within one country with the same political and health care system have been observed and could not be explained by sociodemographic or individual variables. We analysed whether such differences were already present in preschool children.; Swiss children from 84 childcare centres in five cantons (Aargau, Bern, Fribourg, Vaud, Zurich) comprising about 50% of the population of the country participated. Physical activity was quantified with accelerometers (ActiGraph, wGT3X-BT) and potential correlates were assessed with measurements at the childcare centre or questionnaires. Mixed regression models were used to test associations between potential correlates of total physical activity (TPA), moderate-to-vigorous physical activity (MVPA), light physical activity (LPA) or sedentary behaviour with a special focus on regional differences.; 394 of 476 children (83%) provided valid physical activity data (at least 2 weekdays and 1 weekend day with 10 h recording; mean age 3.9 ± 0.7 years, 54% boys) with 26% and 74% living in the French- and German-speaking parts of Switzerland, respectively. Days consisted of (mean ± standard deviation) 1.5 ± 0.5 h MVPA, 5.0 ± 0.6 h LPA, and 6.3 ± 0.8 h sedentary behaviour with an average of 624 ± 150 counts/min TPA. TPA and MVPA (but not sedentary behaviour or LPA) increased with age, were higher in boys and children with better motor skills. Despite controlling for individual characteristics, familial factors and childcare exposure, children from the French-speaking part of Switzerland showed 13% less TPA, 14% less MVPA, 6% less LPA and 8% more sedentary behaviour than German-speaking children.; Beside motor skills and non-modifiable individual factors, the regional sociocultural difference was the most important correlate of phyical activity and sedentary behaviour. Therefore, regionally adapted public health strategies may be needed

General and abdominal adiposity and hypertension in eight world regions: a pooled analysis of 837 population-based studies with 7·5 million participants

BACKGROUND Adiposity can be measured using BMI (which is based on weight and height) as well as indices of abdominal adiposity. We examined the association between BMI and waist-to-height ratio (WHtR) within and across populations of different world regions and quantified how well these two metrics discriminate between people with and without hypertension. METHODS We used data from studies carried out from 1990 to 2023 on BMI, WHtR and hypertension in people aged 20-64 years in representative samples of the general population in eight world regions. We graphically compared the regional distributions of BMI and WHtR, and calculated Pearson's correlation coefficients between BMI and WHtR within each region. We used mixed-effects linear regression to estimate the extent to which WHtR varies across regions at the same BMI. We graphically examined the prevalence of hypertension and the distribution of people who have hypertension both in relation to BMI and WHtR, and we assessed how closely BMI and WHtR discriminate between participants with and without hypertension using C-statistic and net reclassification improvement (NRI). FINDINGS The correlation between BMI and WHtR ranged from 0·76 to 0·89 within different regions. After adjusting for age and BMI, mean WHtR was highest in south Asia for both sexes, followed by Latin America and the Caribbean and the region of central Asia, Middle East and north Africa. Mean WHtR was lowest in central and eastern Europe for both sexes, in the high-income western region for women, and in Oceania for men. Conversely, to achieve an equivalent WHtR, the BMI of the population of south Asia would need to be, on average, 2·79 kg/m$^{2}$ (95% CI 2·31-3·28) lower for women and 1·28 kg/m$^{2}$ (1·02-1·54) lower for men than in the high-income western region. In every region, hypertension prevalence increased with both BMI and WHtR. Models with either of these two adiposity metrics had virtually identical C-statistics and NRIs for every region and sex, with C-statistics ranging from 0·72 to 0·81 and NRIs ranging from 0·34 to 0·57 in different region and sex combinations. When both BMI and WHtR were used, performance improved only slightly compared with using either adiposity measure alone. INTERPRETATION BMI can distinguish young and middle-aged adults with higher versus lower amounts of abdominal adiposity with moderate-to-high accuracy, and both BMI and WHtR distinguish people with or without hypertension. However, at the same BMI level, people in south Asia, Latin America and the Caribbean, and the region of central Asia, Middle East and north Africa, have higher WHtR than in the other regions. FUNDING UK Medical Research Council and UK Research and Innovation (Innovate UK)