Sedentary Time Accumulated in Bouts is Positively Associated with Disease Severity in Fibromyalgia: The Al-andalus Project

To examine the associations of prolonged sedentary time (ST) with disease severity in women with fibromyalgia, and to analyse the combined association of total ST and prolonged ST with the disease severity in this population. Women (n = 451; 51.3 +/- 7.6 years old) with fibromyalgia participated. Sedentary time and moderate-to-vigorous physical activity (MVPA) were measured using triaxial accelerometry and ST was processed into 30- and 60-min bouts. Dimensions of fibromyalgia (function, overall, symptoms) and the overall disease impact were assessed with the Revised Fibromyalgia Impact Questionnaire (FIQR). Body fat percentage was assessed using a bio-impedance analyser, and physical fitness was assessed with the Senior Fitness Tests Battery. Greater percentage of ST in 30-min bouts and 60-min bouts were associated with worse function, overall, symptoms and the overall impact of the disease (all, P 60-min bouts) presented lower overall impact compared to participants with high levels of total ST and prolonged ST (mean difference = 6.56; 95% confidence interval (CI) = 1.83 to 11.29, P = 0.002). Greater percentage of ST accumulated in 30- and 60-min bouts and a combination of high levels of total and prolonged ST are related to worse disease severity. Although unable to conclude on causality, results suggest it might be advisable to motivate women with fibromyalgia to break prolonged ST and reduce their total daily ST

Patterns of Sedentary Time and Quality of Life in Women With Fibromyalgia: Cross-Sectional Study From the al-Ándalus Project

Background: Sedentary time (ST) has been associated with detrimental health outcomes in fibromyalgia. Previous evidence in the general population has shown that not only is the total amount of ST harmful but the pattern of accumulation of sedentary behaviors is also relevant to health, with prolonged unbroken periods (ie, bouts) being particularly harmful. Objective: To examine the association of the patterns of ST with health-related quality of life (HRQoL) in women with fibromyalgia and to test whether these associations are independent of moderate-to-vigorous physical activity (MVPA). Methods: A total of 407 women (mean 51.4 years of age [SD 7.6]) with fibromyalgia participated. ST and MVPA were measured with triaxial accelerometry. The percentage of ST accumulated in bouts and the frequency of sedentary bouts of different lengths (>= 10 min, >= 20 min, >= 30 min, and >= 60 min) were obtained. Four groups combining total ST and sedentary bout duration (>= 30 min) were created. We assessed HRQoL using the 36-item Short-Form Health Survey (SF-36). Results: A greater percentage of ST spent in all bout lengths was associated with worsened physical function, bodily pain, vitality, social function, and physical component summary (PCS) (all P= 30 min and >= 60 min), physical role (>= 60 min), bodily pain (>= 60 min), and vitality (>= 20 min, >= 30 min, and >= 60 min) (all P<.05). Overall, for different domains of HRQoL, these associations were independent of MVPA for higher bout lengths. Patients with high total ST and high sedentary bout duration had significantly worsened physical function (mean difference 8.73 units, 95% CI 2.31-15.15; independent of MVPA), social function (mean difference 10.51 units, 95% CI 2.59-18.44; not independent of MVPA), and PCS (mean difference 2.71 units, 95% CI 0.36-5.06; not independent of MVPA) than those with low ST and low sedentary bout duration. Conclusions: Greater ST in prolonged periods of any length and a higher frequency of ST bouts, especially in longer bout durations, are associated with worsened HRQoL in women with fibromyalgia. These associations were generally independent of MVPA

Physiological responses to acute cold exposure in young lean men

The aim of this study was to comprehensively describe the physiological responses to an acute bout of mild cold in young lean men (n = 11, age: 23 ± 2 years, body mass index: 23.1 ± 1.2 kg/m2) to better understand the underlying mechanisms of non-shivering thermogenesis and how it is regulated. Resting energy expenditure, substrate metabolism, skin temperature, thermal comfort perception, superficial muscle activity, hemodynamics of the forearm and abdominal regions, and heart rate variability were measured under warm conditions (22.7 ± 0.2ÊC) and during an individualized cooling protocol (air-conditioning and water cooling vest) in a cold room (19.4 ± 0.1ÊC). The temperature of the cooling vest started at 16.6ÊC and decreased ~ 1.4ÊC every 10 minutes until participants shivered (93.5 ± 26.3 min). All measurements were analysed across 4 periods: warm period, at 31% and at 64% of individualÂs cold exposure time until shivering occurred, and at the shivering threshold. Energy expenditure increased from warm period to 31% of cold exposure by 16.7% (P = 0.078) and to the shivering threshold by 31.7% (P = 0.023). Fat oxidation increased by 72.6% from warm period to 31% of cold exposure (P = 0.004), whereas no changes occurred in carbohydrates oxidation. As shivering came closer, the skin temperature and thermal comfort perception decreased (all P<0.05), except in the supraclavicular skin temperature, which did not change (P>0.05). Furthermore, the superficial muscle activation increased at the shivering threshold. It is noteworthy that the largest physiological changes occurred during the first 30 minutes of cold exposure, when the participants felt less discomfort.The study was supported by the Spanish Ministry of Economy and Competitiveness (PTA 12264-I), Fondo de InvestigacioÂn Sanitaria del Instituto de Salud Carlos III (PI13/01393), and Retos de la Sociedad (DEP2016-79512-R), Fondos Estructurales de la UnioÂn Europea (FEDER), by the Spanish Ministry of Education (FPU 13/04365 and 15/04059), by the FundacioÂn Iberoamericana de NutricioÂn (FINUT), by the Redes temaÂticas de investigacioÂn cooperativa RETIC (Red SAMI

Influence of a Concurrent Exercise Training Intervention during Pregnancy on Maternal and Arterial and Venous Cord Serum Cytokines: The GESTAFIT Project

The aim of the present study was to analyze the influence of a supervised concurrent exercise-training program, from the 17th gestational week until delivery, on cytokines in maternal (at 17th and 35th gestational week, and at delivery) and arterial and venous cord serum. Fifty-eight Caucasian pregnant women (age: 33.5 +/- 4.7 years old, body mass index: 23.6 +/- 4.1kg/m(2)) from the GESTAFIT Project (exercise (n = 37) and control (n = 21) groups) participated in this quasi-experimental study (per-protocol basis). The exercise group followed a 60-min 3 days/week concurrent (aerobic-resistance) exercise-training from the 17th gestational week to delivery. Maternal and arterial and venous cord serum cytokines (fractalkine, interleukin (IL)-1 beta, IL-6, IL-8, IL-10, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha) were assessed using Luminex xMAP technology. In maternal serum (after adjusting for the baseline values of cytokines), the exercise group decreased TNF-alpha (from baseline to 35th week, p = 0.02), and increased less IL-1 beta (from baseline to delivery, p = 0.03) concentrations than controls. When adjusting for other potential confounders, these differences became non-significant. In cord blood, the exercise group showed reduced arterial IL-6 and venous TNF-alpha (p = 0.03 and p = 0.001, respectively) and higher concentrations of arterial IL-1 beta (p = 0.03) compared to controls. The application of concurrent exercise-training programs could be a strategy to modulate immune responses in pregnant women and their fetuses. However, future research is needed to better understand the origin and clearance of these cytokines, their role in the maternal-placental-fetus crosstalk, and the influence of exercise interventions on them

Effects of a concurrent exercise training program on low back and sciatic pain and pain disability in late pregnancy

Objective: The aim of the present study was to explore the influence of a concurrent exercise (aerobic + resistance) training program, from the 17th gestational week (g.w.) until birth on low back and sciatic pain, and pain disability. A total of 93 pregnant women divided into exercise (n = 49) and control (n = 44) groups followed a 60-min, 3 days/week, concurrent exercise training. Methods: Low back and sciatic pain were measured with a Visual Analogic Scale (VAS). The disability resulting from pain was assessed with the Oswestry Disability Index (ODI). Measures were performed at the 16th and 34th g.w. Results: The exercise group increased 21.9 mm less the VAS low back (between-group differences (B): 95% CI: −33.6 to −10.2; p < 0.001) and 12.9 mm less the VAS sciatica score (between-group differences: 95% CI (B): −21.8 to −4.0; p = 0.005) than the control group. Regarding the ODI questionnaire, the exercise group increased 0.7, 0.5, and 0.7 less than the control group in pain while sleeping (between-group differences (B): 95% CI: −1.4 to −0.01; p = 0.025), pain while lifting weight (between-group differences (B): 95% CI: −0.9 to −0.01; p = 0.016), and limitations of the social life due to pain (between-group differences(B): 95% CI: −1.3 to −0.06; p = 0.032). Furthermore, the exercise group suffered 6.9% less pain than the control group in the ODI total score (between-group differences (B): 95% CI: −13.9 to 0.053; p = 0.052). Conclusion: This concurrent exercise training program adapted to pregnant women improved pain compared to controls.Funding information Regional Ministry of Health of the Junta de Andalucía, Grant/Award Number: PI-0395-2016; Spanish Ministry of Education, Culture, and Sports, Grant/Award Number: FPU17/03715; University of Granada, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES), and by the Junta de Andalucía, Consejería de Conocimiento, Investigación y Universidades and European Regional Development Fund (ERDF), Grant/ Award Number: REF. SOMM17/6107/UGR10 página

Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project

Aim To analyse i) the association of physical fitness during early second trimester and late pregnancy with maternal and neonatal outcomes; and ii) to investigate whether physical fitness is associated with the type of birth (vaginal or caesarean section). Methods Pregnant women from the GESTAFIT Project (n = 159) participated in this longitudinal study. Maternal physical fitness including upper- and lower-body strength, cardiorespiratory fitness (CRF) and flexibility were measured through objective physical fitness tests at the 16th and 34th gestational weeks. Maternal and neonatal outcomes were collected from obstetric medical records. Umbilical arterial and venous blood gas pH and partial pressure of carbon dioxide (PCO2) and oxygen (PO2), were assessed. Results At the 16th week, greater upper-body muscle strength was associated with greater neonatal birth weight (r = 0.191, p<0.05). Maternal flexibility was associated with a more alkaline arterial pH (r = 0.220, p<0.05), higher arterial PO2 (r = 0.237, p<0.05) and lower arterial PCO2 (r = -0.331, p<0.01) in umbilical cord blood. Maternal CRF at the 16th gestational week was related to higher arterial umbilical cord PO2 (r = 0.267, p<0.05). The women who had caesarean sections had lower CRF (p<0.001) at the 16th gestational week and worse clustered overall physical fitness, both at the 16th (-0.227, p = 0.003, confidence interval (CI): -0.376, -0.078) and 34th gestational week (-0.223; p = 0.018; CI: -0.432, -0.015) compared with the women who had vaginal births. Conclusion Increasing physical fitness during pregnancy may promote better neonatal outcomes and is associated with a decrease in the risk of caesarean section. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.This study was part of VAA fellowship from the Andalucı´a Talent-Hub Program, launched by the Andalusian Knowledge Agency, co-funded by the European Union’s Seventh Framework Program, Marie Skłodowska-Curie actions (COFUND–Grant Agreement nº291780) and the Junta de Andalucı´a. ICR (grant number: FPU13/01993) was supported by the Spanish Ministry of Education. This study was also partially funded by the Regional Ministry of Health of the Junta de Andalucı´a (PI-0395-2016) and the University of Granada, Plan Propio de Investigacio´n 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Body Composition Changes Following a Concurrent Exercise Intervention in Perimenopausal Women: The FLAMENCO Project Randomized Controlled Trial

We assessed the efects of a 16-week primary-care-based exercise program on body composition in perimenopausal women. The women (n = 150) were randomized into control (n = 75) or exercise (n = 75) groups. Exercise was provided in a 16-week (60 min/session, 3 days/week) concurrent program. Body composition was measured using dual-energy X-ray absorptiometry. These are secondary analyses of the FLAMENCO Project (Clinical Trials Reference NCT02358109). In the intention-to-treat analyses, the control group showed no changes in body mass index (BMI) between post- and pre-test, whereas the exercise group showed a 0.75 kg/m2 decrease in BMI (95% CI: -1.29 to -0.22; p = 0.006). Gynoid and android fat mass in control group decreased by 98.3 g and 46.1 g after the 16 weeks, whereas they decreased by 213 g and 139 g in the exercise group, respectively (95% CI: -209 to -3.86; p = 0.042 and 95% CI: -164 to -26.9; p = 0.007, respectively). The control group decreased their pelvis bone mineral content by 2.85 g in the post-test compared with the pre-test, whereas the exercise group increased it by 1.13 g (95% CI: 0.93 to 7.81; p = 0.013). Per-protocol analyses showed similar results. These analyses suggest that the exercise intervention decreased fat depositions and BMI. Exercise might improve bone mineral content in specific areas such as the pelvis

Sedentary Time, Physical Activity, and Sleep Duration: Associations with Body Composition in Fibromyalgia. The Al-Andalus Project

To explore the individual-independent relationships of sedentary time (ST) and physical activity (PA) (light and moderate-to-vigorous intensity (MVPA)), with sleep duration and body composition (waist circumference, body mass index (BMI), body fat percentage, and muscle mass index) in women with fibromyalgia, and to determine whether these associations are independent of physical fitness. This cross-sectional study involved 385 women with fibromyalgia. ST and PA were assessed by triaxial accelerometry, sleep duration was self-reported. Waist circumference was measured using an anthropometric tape, and body weight, body fat percentage, and muscle mass were estimated using a bio-impedance analyzer. In individual regression models, ST and sleep were directly associated with waist circumference, BMI, and body fat percentage (beta between 0.10 and 0.25; all p < 0.05). Light PA and MVPA were inversely associated with waist circumference, BMI, and body fat percentage (beta between -0.23 and -0.12; all p < 0.05). In multiple linear regression models, ST (beta between 0.17 and 0.23), light PA (beta between -0.16 and -0.21), and sleep duration (beta between 0.11 and 0.14) were independently associated with waist circumference, BMI, and body fat percentage (all p < 0.05). MVPA was associated with waist circumference independent of light physical activity (LPA) and sleep duration (beta = -0.11; p < 0.05). Except for MVPA, these associations were independent of physical fitness. These results suggest that longer ST and sleep duration, and lower PA levels (especially light intensity PA), are independently associated with greater adiposity, but not muscle mass, in women with fibromyalgia. These associations are, overall, independent of physical fitness

Interplay between genetics and lifestyle on pain susceptibility in women with fibromyalgia: the al-Ándalus project

This work was supported by the Spanish Ministry of Economy and Competitiveness (I + D+i DEP2010-15639, I + D+i DEP2013-40908-R to M.D.-F.; BES-2014-067612 to F.E.-L.), the Spanish Ministry of Education (FPU13/03410 to D.S.-T.; FPU15/0002 to B.G.-C.), the Consejeria de Turismo, Comercio y Deporte, Junta de Andalucia (CTCD-201000019242-TRA to M.D.-F.), the Consejeria de Salud, Junta de Andalucia (PI-0520-2016 to M.D.-F.) and the University of Granada, Plan Propio de Investigacion 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). The funders of the present study did not have any role in the study design, data collection and analyses, decision to publish or preparation of the manuscript.Objectives. It is widely acknowledged that the experience of pain is promoted by both genetic susceptibility and environmental factors such as engaging in physical activity (PA), and that pain-related cognitions are also important. Thus, the purpose of the present study was to test the association of 64 polymorphisms (34 candidate genes) and the gene–gene, gene–PA and gene–sedentary behaviour interactions with pain and pain-related cognitions in women with FM. Methods. Saliva samples from 274 women with FM [mean (S.D.) age 51.7 (7.7) years] were collected for extracting DNA. We measured PA and sedentary behaviour by accelerometers for a week, pain with algometry and questionnaires, and pain-related cognitions with questionnaires. To assess the robustness of the results, a meta-analysis was also performed. Results. The rs6311 and rs6313 polymorphisms (5-hydroxytryptamine receptor 2A, HTR2A) were individually related to algometer scores. The interaction of rs4818 (catechol-O-methyltransferase, COMT) and rs1799971 (opioid receptor l gene, OPRM1) was related to pain catastrophizing. Five gene–behaviour interactions were significant: the interactions of sedentary behaviour with rs1383914 (adrenoceptor alpha 1A, ADRA1A), rs6860 (charged multivesicular body protein 1A, CHMP1A), rs4680 (COMT), rs165599 (COMT) and rs12994338 (SCN9A) on bodily pain subscale of the Short Form 36. Furthermore, the meta-analysis showed an association between rs4680 (COMT) and severity of FM symptoms (codominant model, P-value 0.032). Conclusion. The HTR2A gene (individually), COMT and OPRM1 gene–gene interaction, and the interactions of sedentary behaviour with ADRA1A, CHMP1A, COMT and SCN9A genes were associated with pain-related outcomes. Collectively, findings from the present study indicate a modest contribution of genetics and gene– sedentary behaviour interaction to pain and pain catastrophizing in women with FM. Future research should examine whether reducing sedentary behaviour is particularly beneficial for reducing pain in women with genetic susceptibility to pain.Spanish Government I + D+i DEP2010-15639 I + D+i DEP2013-40908-R BES-2014-067612 FPU13/03410 FPU15/0002Junta de Andalucia CTCD-201000019242-TRA PI-0520-2016University of Granada, Plan Propio de InvestigacionUnit of Excellence on Exercise and Health (UCEES

Influence of an exercise intervention plus an optimal Mediterranean diet adherence during pregnancy on the telomere length of the placenta. The GESTAFIT project

We aimed to investigate whether the effects of exercise on placental relative telomere length (RTL) after delivery are modulated by the Mediterranean diet [MD] adherence in 65 pregnant women (control n = 34, exercise n = 31). No differences were found in placental RTL between the exercise and the control groups (p = 0.557). The interaction-term between exercise and MD adherence with placental RTL was significant (p = 0.001). Specifically, women in the exercise group showed longer placental RTL after birth compared to controls (referent group), only for those women with a high MD adherence (mean difference = 0.467, p=0.010). A concurrentexercise training plus an optimal MD adherence during pregnancy might prevent the placental RTL shorteningRegional Ministry of Health of the Junta de Andalucia PI -0395-2016Research and Knowledge Transfer Fund (PPIT) 2016Excellence Actions Programme: Scientific Units of Excellence (UCEES)European Commission 2021 - 00036Swedish Research Council for Health Working Life & Welfare (Forte) 101027215European Commission FPU17/03715Regional Ministry of Economy, Knowledge, Enterprises and Universit