Associations between energy and fat intakes with adiposity in schoolchildren – the Cuenca Study

Introduction: the relationship between changes in energy intake (EI) over the last few decades and the trends towards of excess weight in children is still debated. Objective: to examine the relationship between energy and macronutrient intakes with adipostity in children, controlling for cardiorespiratory fitness (CRF) as a surrogate measure of physical activity. Method: we conducted a cross-sectional study of 320 schoolchildren aged 9-11 years (54.5% girls). We collected data on socio-demographic variables, and measured weight, height, waist circumference (WC), and fat mass percentage by bioimpedance analysis. Fat mass index (FMI) was calculated as fat mass (kg) divided by height (m) squared, to adjust for body size. Energy (kcal) and macronutrient intake (percentages) were measured by two non-consecutive 24-h recalls (weekday and weekend day), using the Young Adolescents’ Nutrition Assessment on Computer (YANA-C) software program; CRF was measured by the 20-m shuttle run test. Results: boys in the 4th quartile of the WC distribution had lower fat intake (34.9%) than boys in the 1st (42.4%; p = 0.019) and 2nd quartiles (41.6%; p = 0.022). Children in the 1st quartile of the FMI distribution had higher daily EIs than children in the 4th quartile (1762.3 kcal vs. 1496.8 kcal; p = 0.023). All macronutrient intakes relative to weight were lower in children in the more adipose categories for weight status, WC and FMI (p < 0.001). Conclusion: adiposity was inversely related to energy and fat intakes. Excessive EI and high EI from fats not appears to be directly associated with the current obesity epidemic among schoolchildren living in Cuenca (Spain).Introducción: la relación entre los cambios en la ingesta energética en las últimas décadas y el incremento en las cifras de obesidad en niños está aún en debate. Objetivo: examinar la asociación entre la ingesta energética y de macronutrientes con diferentes medidas de adiposidad en niños, controlando por resistencia cardiorrespiratoria como una medida sustituta de la actividad física. Método: se realizó un estudio observacional sobre 320 escolares de entre 9 y 11 años (54,5% niñas). Se tomó información sobre variables sociodemográficas y se midió peso, altura, perímetro de cintura y porcentaje de masa grasa a través de bioimpedancia. El índice de masa grasa fue calculado dividiendo la masa grasa (en kg) entre la altura al cuadrado (en m), para ajustar por el tamaño corporal. La ingesta energética y el porcentaje de macronutrientes fueron medidos con dos recordatorios de 24-h en días no consecutivos (entre semana y fin de semana), empleando el software Young Adolescents’ Nutrition Assessment on Computer (YANA-C); el fitness cardiorrespiratorio fue medido a través del test de 20 metros de ida y vuelta. Resultados: los niños en el cuarto cuartil de perímetro de cintura tienen una ingesta de grasas menor (34,9%) que los chicos en el primer (42,4%; p = 0,019) y segundo cuartil (41,6%; p = 0,022). Los escolares en el primer cuartil de índice de masa grasa tienen mayor ingesta energética total que los escolares del cuarto cuartil (1762,3 kcal vs. 1496,8 kcal; p = 0,023). Las ingestas de macronutrientes relativas al peso son menores en los sujetos de las categorías más altas de estatus ponderal, perímetro de cintura e índice de masa corporal (p < 0,001). Conclusión: la adiposidad está inversamente asociada con las ingestas energética y de grasas. Una excesiva ingesta energética y de grasas no parece estar directamente asociada con la actual epidemia de obesidad de los escolares de Cuenca (España)

Physical fitness reference standards for preschool children: The PREFIT project

Objectives Reference values are necessary for classifying children, for health screening, and for early prevention as many non-communicable diseases aggravate during growth and development. While physical fitness reference standards are available in children aged 6 and older, such information is lacking in preschool children. Therefore, the purposes of this study were (1) to provide sex-and age-specific physical fitness reference standards for Spanish preschool children; and (2) to study sex differences across this age period and to characterise fitness performance throughout the preschool period. Design Cross-sectional. Methods A total of 3179 preschool children (1678 boys) aged 2.8–6.4 years old from Spain were included in the present study. Physical fitness was measured using the PREFIT battery. Results Age- and sex-specific percentiles for the physical fitness components are provided. Boys performed better than girls in the cardiorespiratory fitness, muscular strength, and speed-agility tests over the whole preschool period studied and for the different percentiles. In contrast, girls performed slightly better than boys in the balance test. Older children had better performance in all fitness tests than their younger counterparts. Conclusions Our study provides age- and sex-specific physical fitness reference standards in preschool children allowing interpretation of fitness assessment. Sexual dimorphism in fitness tests exists already at preschool age, and these differences become larger with age. These findings will help health, sport, and school professionals to identify preschool children with a high/very low fitness level, to examine changes in fitness over time, and to analyse those changes obtained due to intervention effects

Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial

Background: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. Methods/design: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. Discussion: The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources.The HEPAFIT study was carried out with the financial support of Instituto Colombiano para el Desarrollo de la Ciencia y la Tecnología “Francisco José de Caldas” COLCIENCIAS (code 59700 and no 122277757900). Katherine González-Ruíz receive a scholarship from Universidad del Rosario, Colombia, Escuela de Medicina y Ciencias de la Salud, to do a Doctorate. This article presents independent research commissioned by COLCIENCIAS under its Program Grants for Applied Research funding scheme (Convocatoria 777–2017)

Water consumption, body composition and cardiometabolic parameters in children

Introduction: Beverage consumption and its possible association with the current obesity epidemic and metabolic syndrome is under investigation in recent years, but water intake is probably the most underestimated or poorly measured of all beverages. Water is essential for life and plain water instead of other caloric beverages is one approach to decrease energy intake and therefore could play an important role to fight against obesity and cardiovascular disease. Method: A cross sectional study was conducted in 366 schoolchildren aged 9 to 11 years from Cuenca′s province in Spain. Body composition and cardiometabolic parameters were measured and averaged 24h recalls to obtain water and beverage consumption. Cardiorespiratory fitness (CRF) was assessed by the 20m shuttle run test. Results: In linear multiple regression (adjusted by sex, aged and CRF) we found an inverse association between water (ml) /Kg weight with BMI, Fat mass, Fat free mass, Waist circumference, insulin levels, MetS index, HOMA-IR (p<0.000), and with arterial pressure parameters, SBP (p<0.010), DBP (p<0.028) and Mean Arterial Pressure (p<0.012) and also, direct associations with HDL cholesterol (p<0.001). Conclusions: Higher consumption of water/kg weight was negatively associated with BMI, Fat mass, Fat free mass, Waist circumference, insulin levels, MetS index, HOMA-IR, DBP, SBP, MAP and positively with HDL cholesterol in children. Water consumption is associated with numerous health benefits and an adequate intake of water could contribute to obesity and cardiovascular disease prevention in children and consequently in adulthood

BMI as a mediator of the relationship between muscular fitness and cardiometabolic risk in children: a mediation analysis.

Muscular fitness levels have been associated with cardiometabolic risk in children, although whether body weight acts as a confounder or as an intermediate variable in this relationship remains controversial. The aim of this study was to examine whether the association between muscular fitness and cardiometabolic risk factors is mediated by body mass index (BMI).Cross-sectional study using a sample of 1158 schoolchildren aged 8-11 years from the province of Cuenca, Spain. We measured anthropometrics and biochemical variables and we calculated a muscular fitness index as the sum of z-scores of handgrip dynamometry/weight and standing long jump, and we estimated a previously validated cardiometabolic risk index (CMRI). Linear regression models were fitted for mediation analysis to assess whether the association between muscular fitness and cardiometabolic risk was mediated by BMI.Children with normal weight (NW) had a better cardiometabolic risk profile than their overweight (OW) or obese (OB) peers after controlling for muscular fitness. Marginal estimated mean ± SE values for NW, OW and OB categories of CMRI were -0.75 ± 0.06 < 0.84 ± 0.10 < 2.18 ± 0.16 in boys and -0.73 ± 0.06 < 0.96 ± 0.10 < 2.71 ± 0.17 in girls, both p < 0.001. Children with higher levels of muscular fitness had a better cardiometabolic risk profile (CMRI marginal estimated mean ± SE 1.04 ± 0.13 > 0.05 ± 0.09 >-1.16 ± 0.13 for lower, middle and upper quartiles of muscular fitness in boys and 1.01 ± 0.16 > 0.10 ± 0.09 > -1.02 ± 0.15 in girls, both p < 0.001), but differences disappeared when controlling for BMI. BMI acted as a full mediator between muscular fitness and most cardiometabolic risk factors (Sobel test z = -11.44 for boys; z = -11.83 for girls; p < 0.001 in CMRI mediation model) and as a partial mediator in the case of waist circumference (Sobel test z=-14.86 for boys; z=-14.51 for girls; p<0.001).BMI mediates the association between muscular fitness and cardiometabolic risk in schoolchildren. Overall, good muscular fitness is associated with lower cardiometabolic risk, but particularly when accompanied by normal weight

Movement behaviors and cardiometabolic risk in schoolchildren.

Growing evidence has accumulated in recent years showing that movement behaviors have important implications for health in children, especially for cardiovascular health, whose risk factors could track from childhood to adulthood. However, these findings are mixed and inconsistent in children. The aim of this study was to examine the relationship between different movement behaviors (sedentary behavior, physical activity and sleep duration) and cardiometabolic risk in schoolchildren. The study shows cross-sectional results of baseline measurement from 146 Spanish schoolchildren, aged 8-to-11 years old, participating in the MOVI-2 study. Movement behaviors were determined using accelerometry combined with self-reported sleep time. Cardiometabolic risk was assessed using a validated metabolic syndrome index. Logistic regression analysis showed that higher levels of vigorous physical activity (OR = 0.110, p = 0.004) and sleeping more than 9 hours (OR = 0.269, p = 0.015) could be protective factors against metabolic syndrome risk in children. ANCOVA analysis showed associations between vigorous physical activity and waist circumference (p < 0.001), and sleep time with insulin resistance (p = 0.017) and lipid profile (p = 0.035). No association was observed between light and moderate physical activity, sedentary behavior and metabolic syndrome (index and components). No statistically significant differences were found for blood pressure and any of the movement behaviors. Our data suggest that both the amount of vigorous physical activity accumulated and sleep duration are independently associated with higher cardiometabolic risk in children

A follow-up study to assess the determinants and consequences of physical activity in pregnant women of Cuenca, Spain

Abstract Background In recent years, the influence of physical exercise on pregnancy outcomes has been widely debated. Despite the numerous studies addressing the relationship between maternal physical activity and pregnancy outcomes, the evidence for consistent and significant impact of regular exercise during pregnancy on fetal growth remains lacking. The aims of this study were, first, to assess the level of physical activity performed throughout the pregnancy by objective (accelerometer) and self-reported (questionnaire) measurements, and, second, to ascertain pre-pregnancy physical activity levels, to estimate the relationship between levels of physical activity and some pregnancy and neonatal outcomes. Methods/design This was a prospective cohort study. Participants were pregnant women (n = 194) aged 18 to 40 years who attended for three quarterly appointments for pregnancy ultrasound scans at the Virgen de la Luz Hospital in Cuenca, Spain. All participants provided written informed consents to participate in the study. Physical activity during the pregnancy follow-up was assessed by a self-reported Pregnancy Physical Activity Questionnaire and sleep log; also objectively by a GT3X accelerometer (ActiGraph). Furthermore, pregnancy symptoms inventory, nutritional behavioural assessment, socio-demographic characteristics, and anthropometry and body composition were measured. At the end of the follow up, the following main outcomes were determined: pregnancy outcomes (incidence of gestational diabetes mellitus, pre-eclampsia, pregnancy-induced hypertension, weight gain during pregnancy, type of delivery, and neonatal outcomes (gestational age, birth weight, gender, Apgar score 1 min/5 min, type of resuscitation (I/II/III/IV), and pH of umbilical cord blood). Descriptive statistics for cross-sectional data, linear mixed regression models for absolute differences in changes baseline-final measurements were used as statistical analyses. Discussion Although the effectiveness of physical activity programmes on improving maternal and neonatal outcomes has heretofore been studied, the impact of free time physical activity during pregnancy has not been assessed using objective measures. This paper reports the design of a prospective cohort study that aims to assess the physical activity levels of pregnant women, and to estimate the relationship between those physical activity levels with maternal and neonatal outcomes. This study could contribute to providing evidence for the formulation of recommendations for physical activity for pregnant women

Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): Study protocol for a randomized controlled trial

Background: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. Methods/design: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11-17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75-85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55-75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. Discussion: The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources. © 2018 The Author(s)

Efectos de un programa de ejercicios sobre el metabolismo hepático, la grasa hepática y la salud cardiovascular en adolescentes con sobrepeso/obesidad de Bogotá, Colombia (el estudio HEPAFIT): protocolo de estudio para un ensayo controlado aleatorio

16 páginasAbstract Background A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. Methods/design Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. Discussion The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources.Abstracto Fondo Una proporción considerable de los jóvenes contemporáneos tiene un alto riesgo de sufrir trastornos relacionados con la obesidad, como enfermedades cardiovasculares, síndrome metabólico o enfermedad del hígado graso no alcohólico (NAFLD). Aunque existe evidencia consistente de los efectos positivos de la actividad física en varios aspectos de la salud, la mayoría de los adolescentes en Colombia son sedentarios. Es, por tanto, importante implementar estrategias que generen cambios en el estilo de vida. El estudio HEPAFIT tiene como objetivo examinar si un programa de ejercicio de 6 meses tiene beneficios para el contenido de grasa hepática y los resultados de salud cardiovascular entre adolescentes con sobrepeso u obesidad de Bogotá, Colombia. Métodos/diseño En total, 100 adolescentes sedentarios (de 11 a 17 años) con sobrepeso u obesidad que asisten a dos escuelas públicas en Bogotá, Colombia, se incluirán en un ensayo controlado aleatorio de grupos paralelos. Los adolescentes serán asignados aleatoriamente a un grupo de intervención siguiendo uno de cuatro planes de estudio: (1) el plan de estudios de educación física estándar (60 minutos por semana de actividad física, n = 25) de intensidad baja a moderada; (2) un plan de estudios de educación física de alta intensidad (HIPE, n = 25), que consiste en juegos de resistencia y resistencia y actividades no competitivas, como correr, yincanas, levantar objetos, empujar, luchar o arrastrar objetos, durante sesiones de 60 minutos , tres veces por semana, con un objetivo de gasto energético de 300 a 500 kcal/sesión al 75-85% de la frecuencia cardíaca máxima (FCmáx); (3) un plan de estudios de educación física de intensidad baja a moderada (LIPE, n = 25) que consiste en juegos de resistencia y resistencia y actividades no competitivas (por ejemplo, perseguir, correr, driblar o saltar) durante sesiones de 60 minutos, tres veces por semana con un objetivo de gasto energético de 300 kcal/sesión al 55-75% FCmáx; y (4) un plan de estudios combinado HIPE y LIPE (n = 25). Las intervenciones HIPE, LIPE y combinadas se realizaron además del plan de estudios estándar de educación física. El resultado principal de eficacia es el contenido de grasa del hígado, medido por el parámetro de atenuación controlada 1 semana después del final del programa de intervención. Discusión El enfoque traslacional puede ser adecuado para recopilar nueva información en un entorno escolar sobre los posibles efectos de las intervenciones de actividad física para reducir el contenido de grasa del hígado y mejorar los perfiles metabólicos y la salud cardiometabólica de los adolescentes con sobrepeso u obesidad. Esto puede conducir a un uso más eficiente de los recursos de educación física escolar

Time spent hourly in sedentary time, light activity, moderate activity, vigorous activity and MVPA and overall PA level (cpm) in Spanish university students on weekdays and weekends.

<p>Time spent hourly in sedentary time, light activity, moderate activity, vigorous activity and MVPA and overall PA level (cpm) in Spanish university students on weekdays and weekends.</p