Calcium, Vitamin D, and Health

Calcium is the main mineral in the body [...]

Prospective physical fitness status and development of cardiometabolic risk in children according to body fat and lifestyle behaviours: The IDEFICS study

Ministerio de Ciencia e Innovacion, Grant/Award Number: FJCI-2017-34967; Sixth Framework Programme, Grant/Award Number: 016181 FOODThis work was done as part of the IDEFICS study (www.idefics.eu). We gratefully acknowledge the financial support of the European Community within the Sixth RTD Framework Programme Contract No. 016181 (FOOD).Background Elevated cardiometabolic risk (CMR) is an important factor for cardiovascular diseases later in life while physical fitness seems to decrease CMR. Objective Thus, the aim of the present study is to assess the association between muscular fitness (MF) and cardiorespiratory fitness (CRF) on CMR in European children, both cross-sectional and longitudinally. Methods A total of 289 children (49.5% males) from eight European countries, aged 6 to 9, with longitudinal information on blood pressure, triglycerides, total cholesterol, HDL-cholesterol, homoeostasis model assessment, body mass index, data on fitness level, objectively measured physical activity (PA), diet quality, and total screen time were included. A CMR score was calculated and dichotomized. MF and CRF were also dichotomized. Cross-sectional and longitudinal multilevel logistic regressions adjusting for lifestyle behaviours were performed. Results Reaching a high level of MF during childhood as well as remaining in that level over-time were associated with an 82% and 62% lower probability of high CMR at follow-up, respectively. Also, children who became top CRF over time, showed a 77% lower probability (P < 0.05) of being in the highest CMR quartile at follow-up, independently of sociodemographic and lifestyle indicators. Conclusions A high MF at early childhood and during childhood reduces the odds of having CMR. Same occurs with the improvement of CRF during childhood. These findings highlight the importance of enhancing fitness to avoid CMR already in children.Instituto de Salud Carlos III Spanish Government European Commission FJCI-2017-34967European Commission 016181 FOO

Cardiorespiratory fitness and bone turnover markers in adults with metabolic syndrome: the mediator role of inflammation

The relationship between inflammatory markers and bone turnover in adults is well known, whilst a negative association between cardiorespiratory fitness (CRF) and inflammatory markers has also been described. Hence, we tested whether the association between CRF and bone turnover markers is mediated by inflammatory markers in adults with metabolic syndrome. A total of 81 adults (58.5±5.0 yrs, 62.7% women) were included in the analysis. CRF was measured by the six-minute walking test. Serum interleukine (IL)-1β, IL-6, IL-10, tumor necrosis factor alpha, high-sensitivity c-reactive protein (hsCRP) and vascular endothelial growth factor, collagen type I cross-linked C-telopeptide, procollagen type I N-terminal propeptide (P1NP) and total osteocalcin were assessed using a sensitive ELISA kit. Body composition was assessed by dual-energy x-ray absorptiometry. Partial correlation was used to test the relationship between CRF, inflammatory markers and bone turnover markers, controlling for sex, lean mass and fat mass. Boot-strapped mediation procedures were performed and indirect effects with confidence intervals not including zero were interpreted as statistically significant. CRF was positively correlated with P1NP levels (r=0.228, p=0.044) and osteocalcin levels (r=0.296, p=0.009). Furthermore, CRF was positively correlated with IL-1β levels (r=0.340, p=0.002) and negatively correlated with hsCRP levels (r=-0.335, p=0.003), whereas IL-1β levels were positively correlated with P1NP levels (r=0.245, p=0.030) and hsCRP levels were negatively correlated with P1NP levels (r=-0.319, p=0.004). Finally, the association between CRF and P1NP levels was totally mediated by hsCRP (PM=39.9). Therefore, CRF benefits on bone formation could be dependent on hsCRP concentrations in this population.Heart and Diseases Foundation (Fondation 234 Coeur et Artères) 59200 Loos, Franc

Effect of exercise on bone health in children and adolescents with cancer during and after oncological treatment: A systematic review and meta-analysis

Background: Although regular physical activity and exercise programs might improve bone health caused by oncological treatment and the disease itself, it remains unknown the pooled effect of exercise interventions following frequency, intensity, time and type prescriptions. Objective: This systematic review and meta-analysis aimed to synthesise evidence regarding the effectiveness of exercise interventions on bone health in children and adolescents with cancer during and after oncological treatment. Methods: A systematic search was conducted in the MEDLINE (via PubMed), Web of Science and Scopus databases from November 2021 to January 2022. Randomised controlled trials (RCTs) and non-RCTs reporting pre-post changes of the effectiveness of exercise interventions on DXA-measured bone parameters in young population (1–19 years) during or after oncological treatment were included. Pooled (ESs) and 95% confidence intervals (95%CIs) were calculated. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed. Results: A total of eight trials with 341 participants were included. The metaanalyses did not reveal a statistically significant increase in whole body areal bone mineral density (ES = 0.10; 95%CI: −0.14, 0.34), lumbar spine (ES = 0.03; 95%CI: −0.21, 0.26) or femoral neck (ES = 0.10; 95%CI: −0.37, 0.56). Similarly, during the oncological treatment phase the ES was 0.04 (95%CI: −0.17, 0.25) and after the ES was 0.07 (95%CI: −0.20, 0.33). Conclusion: To date, exercise interventions have been inappropriate and therefore, ineffective to illustrate any beneficial effect on bone health in children and adolescents with cancer during and after oncological treatment.Spanish Ministry of Science and Innovation (ref: PID2020-117302RA-I00La Caixa Foundation (ref: LCF/BQ/PR19/11700007)the University of Granada Plan Propio de Investigación 2021-Excellence actions: Unit of Excellence on Exercise, Nutrition and Health (UCEENS)CIBEROBN, Centro de Investigación Biomédica en Red (CB22/03/ 00058Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea – European Regional Development Fund. AM-P is recipient of a predoctoral fellowship (FPU20/05530) by the Spanish Ministry of Education, Culture and Sport. EU-G is supported by the Maria Zambrano fellowship by the Ministerio de Universidades y la Unión Europea—NextGenerationEU

Relationship between 1,25-Dihydroxyvitamin D and Body Composition in Middle-Aged Sedentary Adults: The FIT-AGEING Study

Vitamin D deficiency is a worldwide health problem that, in addition to its well-known negative effects on musculoskeletal health, has been related to a wide range of acute and chronic age-related diseases. However, little is known about the association of body composition with the active, hormonal form of vitamin D, 1,25-dihydroxyvitamin D plasma levels (1,25(OH)2D). Therefore, the aim of this study was to investigate the association of 1,25(OH)2Dwith body composition including lean and fat body mass as well as bone mineral density (BMD) in middle-aged sedentary adults. Atotal of 73 (39 women) middle-aged sedentary adults (53.7 5.1 years old) participated in the current study. We measured weight and height, and we used dual energy X-ray absorptiometry to measure lean body mass, fat body mass and BMD. Body mass index (BMI), lean mass index (LMI), and fat mass index (FMI) were calculated. 1,25(OH)2D was measured using a DiaSorin Liaison®immunochemiluminometric analyzer. The results showed a negative association of 1,25(OH)2D with BMI, LMI and BMD ( = -0.274, R2 = 0.075, p = 0.019; = -0.268, R2 = 0.072, p = 0.022; and = -0.325, R2 = 0.105, p = 0.005, respectively), which persisted after controlling for age and sex. No significant differences in 1,25(OH)2D across body weight status were observed after controlling for the same covariates. In summary, our results suggest that 1,25(OH)2D could be negatively associated with BMI, LMI and BMD whereas no association was found with FMI in middle-aged sedentary adultsA.D.-l.-O. is funded by the Spanish Ministry of Education (FPU15/03960). L.G.-M. is supported by a fellowship from “la Caixa” Foundation (ID 100010434) and the fellowship code is LCF/BQ/PR19/11700007. F.J.A.-G. is funded by the Spanish Ministry of Education (FPU14/04172), the University of Granada Plan Propio de Investigación 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES)-and Plan Propio de Investigación 2018-Programa Contratos-Puente

Comparative effects of different types of exercise on health-related quality of life during and after active cancer treatment: A systematic review and network meta-analysis

Background: The positive influence of most types of exercise has been reported repeatedly, but what the most effective exercise approaches are for improving health-related quality of life (HRQoL) in people with cancer remains unknown. The aim of this systematic review and network meta-analysis was to synthesize the evidence from intervention studies to assess the effects of different types of exercise on HRQoL during and after cancer treatment. Methods: MEDLINE, SPORTDiscus, the Cochrane Library, Web of Science, and Scopus were searched for randomized controlled trials aimed at testing the effects of exercise interventions meant to improve HRQoL in people with cancer. Separate analyses were conducted for HRQoL as measured by general and cancer-specific questionnaires. We also evaluated whether the effects of exercise were different during and after cancer treatment in both the physical and mental HRQoL domains. Results: In total, 93 studies involving 7435 people with cancer were included. Network effect size estimates comparing exercise intervention vs. usual care were significant for combined exercise (0.35, 95% confidence interval (95%CI): 0.14-0.56) for HRQoL as measured by general questionnaires, and for combined (0.31, 95%CI: 0.13-0.48), mind-body exercise (0.54, 95%CI: 0.18-0.89), and walking (0.39, 95%CI: 0.04-0.74) for HRQoL as measured by cancer-specific questionnaires. Conclusion: Exercise programs combining aerobic and resistance training can be recommended to improve HRQoL during and after cancer treatment. The scarcity and heterogeneity of these studies prevents us from making recommendations about other exercise modalities due to insufficient evidence.European Regional Development FundConsejería de Educación, Cultura y Deportes-JCCMFondo Europeo de Desarrollo Regional funds (grant no. SBPLY/17/180501/000533)Grant from the University of Castilla-La Mancha (2020-PREDUCLM-15596)Grant from the Universidad de Castilla-La Mancha co-financed by the European Social Fund (2020-PREDUCLM-16746

Influence of Physical Activity on Bone Mineral Content and Density in Overweight and Obese Children with Low Adherence to the Mediterranean Dietary Pattern.

The objective of the present cross-sectional study was to examine the associations of physical activity and the adherence to the Mediterranean dietary pattern (MDP) with bone mineral content (BMC) and density (BMD) in children with overweight and obesity. A total of 177 (n = 80 girls) children with overweight and obesity aged 8 to 12 years old participated in the study. Both BMC and BMD were assessed by Dual-Energy X-ray absorptiometry. Dietary patterns were assessed by the KIDMED questionnaire and two 24-hour recalls. Physical activity was assessed by accelerometers for 7 consecutive days (24 hours/day). Low adherence to the MDP was observed in 82.4% of participants. Higher physical activity levels (of at least moderate intensity) and lower sedentary time were significantly associated with BMC and BMD in children with low adherence to the MDP (all p < 0.05). No associations were observed between physical activity and BMC and BMD in children with high adherence to the MDP. In conclusion, engaging in moderate to vigorous physical activity and reducing the time spent in sedentary behavior might be particularly beneficial for improving bone health in overweight or obese children with poor adherence to the Mediterranean dietary pattern.The ActiveBrains Project was funded by the Spanish Ministry of Economy and Competitiveness (Reference DEP2013-47540 and DEP2016-79512-R). EFIGRO was supported by the Spanish Ministry of Health, “Fondo de Investigación Sanitaria del Instituto de Salud Carlos III” (PI13/01335), “Fondos Estructurales de la Unión Europea (FEDER), Una manera de hacer Europa”, by the University of the Basque Country (GIU14/21), and by the University of Granada, Plan Propio de Investigación 2016, Excellence actions: Units of Excellence; Unit of Excellence on Exercise and Health (UCEES). LGM is funded by Programa de Captación de Talento-UGR Fellows. MM is supported by grant from the Spanish Ministry of Education, Culture and Sport (FPU14/03329) and EST17/00210. LA is supported by a grant from Education, Linguistic Policy, and Culture Department of the Government of the Basque Country (PRE_2016_1_0057)

Leptin levels were negatively associated with lumbar spine bone mineral content in children with overweight or obesity

Aim: Adipokines seem to play a role in bone morphogenesis, although this also depends on the mechanical forces applied to the skeleton. The aim was to assess the relationships of resting leptin and adiponectin with bone parameters and whether high muscular fitness levels affect these relationships in children with overweight or obesity. Methods: This cross-sectional study took part from 2014 to 2016 in Granada, Spain. Participants were recruited from University Hospitals, and we also used advertisements in local media and school contacts in the city. Adipokines were analysed in plasma. Muscular fitness was assessed by one repetition maximum in bench and leg press tests. Dual-energy X-ray absorptiometry was used to measure bone parameters. Results: We included 84 children (10.0 ± 1.2y; 63% boys) in this analysis. Leptin was negatively associated with lumbar spine bone mineral content (β = −0.162, p = 0.053)

Differences in areal bone mineral density between metabolically healthy and unhealthy overweight/obese children: the role of physical activity and cardiorespiratory fitness

“This manuscript was published by SPRINGERNATURE in Pediatric Research on June 2020, available at: doi: 10.1038/s41390-019-0708-x.”OBJECTIVES: To examine whether areal bone mineral density (aBMD) differs between metabolically healthy (MHO) and unhealthy (MUO) overweight/obese children and to examine the role of moderate-to-vigorous physical activity (MVPA) and cardiorespiratory fitness (CRF) in this association. METHODS: A cross-sectional study was developed in 188 overweight/obese children (10.4 ± 1.2 years) from the ActiveBrains and EFIGRO studies. Participants were classified as MHO or MUO based on Jolliffe and Janssen’s metabolic syndrome cut-off points for triglycerides, glucose, high-density cholesterol and blood pressure. MVPA and CRF were assessed by accelerometry and the 20-m shuttle run test, respectively. Body composition was measured by dual-energy X-ray absorptiometry. RESULTS: In model 1 (adjusted for sex, years from peak high velocity, stature and lean mass), MHO children had significantly higher aBMD in total body less head (Cohen’s d effect size, ES = 0.34), trunk (ES = 0.43) and pelvis (ES = 0.33) than MUO children. These differences were attenuated once MVPA was added to model 1 (model 2), and most of them disappeared once CRF was added to the model 1 (model 3). CONCLUSIONS: This novel research shows that MHO children have greater aBMD than their MUO peers. Furthermore, both MVPA and more importantly CRF seem to partially explain these findings.The authors thank the staff and participants of the ActiveBrains and EFIGRO studies for their important contributions. This study has been partially funded by the University of Granada, UGR Research and Knowledge Transfer Fund (PPIT) 2016, Excellence Actions Programme: Units of Scientific Excellence; Scientific Unit of Excellence on Exercise and Health (UCEES), and by the Regional Government of Andalusia, Regional Ministry of Economy, Knowledge, Enterprises and University and European Regional Development Fund (ERDF), ref. SOMM17/6107/UGR. The ActiveBrains study was funded by the Spanish Ministry of Economy and Competitiveness (Reference DEP2013-47540, DEP2016-79512-R, and DEP2017-91544-EXP). The EFIGRO study was funded by the Spanish Ministry of Health, “Fondo de Investigación Sanitaria del Instituto de Salud Carlos III” (PI13/01335), “Fondos Estructurales de la Unión Europea (FEDER), Una manera de hacer Europa,” and by the University of the Basque Country (GIU14/21). L.G.-M. is supported by “La Caixa” Foundation within the Junior Leader fellowship programme (ID 100010434); M.M. is supported by the Spanish Ministry of Education, Culture and Sport (FPU14/03329) and EST17/00210; L.A. is supported by the Education Department of the Government of the Basque Country (PRE_2016_1_0057, PRE_2017_2_0224 and PRE_2018_2_0057); J.M.-G. and J.H.M. are supported by the Spanish Ministry of Education, Culture and Sport (FPU14/06837 and FPU15/02645, respectively)

The evolution of the ventilatory ratio is a prognostic factor in mechanically ventilated COVID-19 ARDS patients

Background: Mortality due to COVID-19 is high, especially in patients requiring mechanical ventilation. The purpose of the study is to investigate associations between mortality and variables measured during the first three days of mechanical ventilation in patients with COVID-19 intubated at ICU admission. Methods: Multicenter, observational, cohort study includes consecutive patients with COVID-19 admitted to 44 Spanish ICUs between February 25 and July 31, 2020, who required intubation at ICU admission and mechanical ventilation for more than three days. We collected demographic and clinical data prior to admission; information about clinical evolution at days 1 and 3 of mechanical ventilation; and outcomes. Results: Of the 2,095 patients with COVID-19 admitted to the ICU, 1,118 (53.3%) were intubated at day 1 and remained under mechanical ventilation at day three. From days 1 to 3, PaO2/FiO2 increased from 115.6 [80.0-171.2] to 180.0 [135.4-227.9] mmHg and the ventilatory ratio from 1.73 [1.33-2.25] to 1.96 [1.61-2.40]. In-hospital mortality was 38.7%. A higher increase between ICU admission and day 3 in the ventilatory ratio (OR 1.04 [CI 1.01-1.07], p = 0.030) and creatinine levels (OR 1.05 [CI 1.01-1.09], p = 0.005) and a lower increase in platelet counts (OR 0.96 [CI 0.93-1.00], p = 0.037) were independently associated with a higher risk of death. No association between mortality and the PaO2/FiO2 variation was observed (OR 0.99 [CI 0.95 to 1.02], p = 0.47). Conclusions: Higher ventilatory ratio and its increase at day 3 is associated with mortality in patients with COVID-19 receiving mechanical ventilation at ICU admission. No association was found in the PaO2/FiO2 variation