"Fat but powerful'' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study

Objectives: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the fat but powerful'' (F+P) (or fat but fit'') paradox in older adults. Methods: A total of 2563 older adults (65 €''91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. Results: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). Conclusion: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful

How to Improve the Functional Capacity of Frail and Pre-Frail Elderly People? Health, Nutritional Status and Exercise Intervention. The EXERNET-Elder 3.0 Project

Aging is associated with the impairment of health and functional capacity, and physical exercise seems to be an effective tool in frailty prevention and treatment. The purpose of this study was to present the methodology used in the EXERNET-Elder 3.0 project that aims to evaluate the immediate and residual effects and of a multicomponent exercise training program called Elder-fit on frailty, fitness, body composition and quality of life, and also to analyse a possible dietary intake interaction according to health and metabolic status. A total of 110 frail and pre-frail elders participated in this study and were divided into a control group (CG = 52) and an intervention group (IG = 58). The IG performed a supervised multicomponent exercise training program of 6 months and 3 days per week, which included strength, endurance, balance, coordination and flexibility exercises, while the CG continued with their usual daily activities. Both groups received four speeches about healthy habits along the project. Four evaluations were performed: at baseline, after 3 months of training, at the end of the training program (6 months) and 4 months after the program had ended to examine the effects of detraining. Evaluating the efficacy, safety and feasibility of this program will help to develop efficacious physical interventions against frailty. Further, protocols should be described accurately to allow exercise programs to be successfully replicated

La actividad física organizada en las personas mayores, una herramienta para mejorar la condición física en la senectud

Fundamentos. Un nivel adecuado de condición física (CF) es fundamental para el logro de un envejecimiento saludable. El objetivo de este estudio consistió en evaluar el impacto de la actividad física (AF) organizada y el número de horas de práctica sobre el nivel de CF de las personas mayores. Método. En el estudio participaron 3104 personas mayores de 65 años de España, pertenecientes al Proyecto Multicéntrico EXERNET (722 hombres y 2382 mujeres; edad media: 72, 1±5, 3 años). La CF se evaluó mediante 8 test específicos para esta población. La participación en AF organizada se registró mediante un cuestionario. Las diferencias en la CF en función de la práctica y número de horas de AF se midieron con ANCOVA ajustando por edad, horas de caminar y de estar sentado. Resultados. Aquellos que no participaban en este tipo de actividad incrementaban su riesgo de tener un nivel bajo de CF en la mayoría de las variables evaluadas, observándose algunas diferencias entre sexos (OR: desde 1, 6 hasta 2, 6 en hombres y desde 1, 4 hasta 2, 2 en mujeres). En los hombres no se observó ninguna diferencia significativa entre practicar menos de 2, 2-4 o más de 4 horas (todos P>0, 05), a excepción de la fuerza del brazo izquierdo; sin embargo, las mujeres que realizaban más de 2 horas de AF organizada a la semana tenían mayor equilibrio, fuerza de piernas y de brazos, flexibilidad de piernas, velocidad al caminar y resistencia aeróbica que aquellas que asistían a este tipo de sesiones menos de 2 horas a la semana (P<0, 05). Conclusiones. La práctica de AF organizada produce un efecto beneficioso sobre la CF de las personas mayores independientemente de la edad, las horas que estén sentados o el tiempo que dediquen a caminar. Background. An adequate level of fitness is critical to achieving healthy ageing. The aim of this study was to evaluate the impact of organized physical activity (PA) and the number of hours of practice on the fitness levels of the elderly. Method. A total of 3104 people over 65 years old from Spain, belonging to the EXERNET Multicenter Project (722 men and 2382 women, mean age: 72.1 +/- 5.3 years) participated in the study. Fitness was evaluated by 8 specific tests for this population. Participation in organized PA was recorded through a questionnaire. Differences in fitness values depending on the participation in PA and the number of hours were measured with ANCOVA adjusting for age, hours of walking and sitting time. Results. Those who did not participate in this type of activity increased their risk of having a low level of fitness in most variables evaluated, with some differences between sexes (OR: from 1.6 to 2.6 in men and from 1.4 to 2.2 in women). In men, no significant differences were observed between practicing less than 2, 2-4 or more than 4 hours (P>0, 05), with an exception in the strength of the left arm. However, women who performed more than 2 hours a week in organized PA had better balance, strength of lower and upper extremities, flexibility of lower extremities, walking speed and aerobic capacity than those who performed less than 2 hours of PA a week (P<0, 05). Conclusions. The practice of organized PA produces a beneficial effect on the fitness of the elderly regardless of age, hours of walking and time sitting per day

Evolución de los niveles de condición física en población octogenaria y su relación con un estilo de vida sedentario

Objetivos: Determinar los cambios que se producen enla condición física a lo largo de dos años de seguimiento enoctogenarios y comprobar si un estilo de vida sedentariomodifica estas variaciones. Metodología: La condición física de 182 sujetos (48hombres, 134 mujeres) con una media de edad de 82,3 ±2,3 años se evaluó mediante 8 test (adaptados de las bate-rías “Senior Fitness Test” y “Eurofit”). Se realizó un aná-lisis de medidas repetidas entre los dos periodos de eva-luación y para ver las diferencias de condición física entrelos sujetos considerados sedentarios (permanecían senta-dos = 4 horas/día) y no sedentarios (permanecían senta-dos < 4 horas/día) Resultados: Entre las dos evaluaciones encontramos undescenso significativo en los test de agilidad (p 4 horas/día sufrieron un descen-so de la agilidad (p < 0,05). Se produjo una pérdida de ve-locidad y resistencia tanto en sedentarios como en no se-dentarios (p < 0,05). Conclusión: En dos años de seguimiento, se producencambios negativos en el nivel de condición física en perso-nas octogenarias. Periodos prolongados de sedestación setraducen en una pérdida de agilidad. La velocidad de lamarcha y resistencia parecen ser los componentes de lacondición física más afectados por el proceso de envejeci-miento en este grupo poblacional y su pérdida no vienedeterminada por las horas diarias de sedestación. Objective: The aim of this study was to determine the changes in physical fitness over two years of following up in octogenarian people and to check whether a sedentary lifestyle modify these variations. Methods: Physical fitness of 182 subject (48 men, 134 women)with a mean age of 82,3 ± 2,3 years were evaluated using 8 different tests. A repeated measures analysis was carried out to see the differences between the two evaluation periods and to see the physical fitness differences between sedentary people (sit = 4 hours/day)and non sedentary people (sit 4 hours/day there was a decrease in the walking speed test between the two evaluations (p < 0.05). Moreover, there was a decrease of walking speed and endurance between the two evaluation periods in both sedentary and nonsedentary people (p < 0.05). Conclusion: In two years of following up, there are adverse changes in the level of physical fitness in octogenarians. Long periods of sitting time may translate into a loss of agility. Walking speed and endurance seem to be the components of physical fitness more affected by the ageing process in this population; and this loss is not determined by the hours of sitting per day

Ideal cardiovascular health and inflammation in European adolescents: The HELENA study

Background and aims Inflammation plays a key role in atherosclerosis and this process seems to appear in childhood. The ideal cardiovascular health index (ICHI) has been inversely related to atherosclerotic plaque in adults. However, evidence regarding inflammation and ICHI in adolescents is scarce. The aim is to assess the association between ICHI and inflammation in European adolescents. Methods and results As many as 543 adolescents (251 boys and 292 girls) from the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study, a cross-sectional multi-center study including 9 European countries, were measured. C-reactive protein (CRP), complement factors C3 and C4, leptin and white blood cell counts were used to compute an inflammatory score. Multilevel linear models and multilevel logistic regression were used to assess the association between ICHI and inflammation controlling by covariates. Higher ICHI was associated with a lower inflammatory score, as well as with several individual components, both in boys and girls (p < 0.01). In addition, adolescents with at least 4 ideal components of the ICHI had significantly lower inflammatory score and lower levels of the study biomarkers, except CRP. Finally, the multilevel logistic regression showed that for every unit increase in the ICHI, the probability of having an inflammatory profile decreased by 28.1% in girls. Conclusion Results from this study suggest that a better ICHI is associated with a lower inflammatory profile already in adolescence. Improving these health behaviors, and health factors included in the ICHI, could play an important role in CVD prevention

La polimedicación en mayores institucionalizados: su efecto sobre los niveles de vitamina B12, folato y homocisteína Polymedication in institutionalized elderly and its effect on vitamin B12, folate, and homocysteine levels

Objetivo: Determinar qué tipo de medicamentos consume una población de ancianos institucionalizados en la Comunidad de Madrid y valorar la influencia de estos fármacos sobre las concentraciones de vitamina B12 (B12 y holotranscobalamina), folato sérico (FS) y homocisteína (Hcy). Metodología: 167 individuos (32% varones), edad media 83 ± 7 años, fueron categorizados dependiendo de si la variable bioquímica estaba dentro o fuera del intervalo de normalidad. Los medicamentos fueron agrupados según la clasificación ATC. Mediante una prueba exacta de Fisher se estudió la relación entre el consumo de un determinado grupo de fármacos y la alteración de los niveles de las variables bioquímicas. Resultados: El consumo medio diario fue de 5 fármacos diferentes. Los mas consumidos fueron psicolépticos y antiácidos (ambos 53%). Se observaron deficiencias de B12 (mediana 158,2 pg/mL; 10,7%), FS (5,3 ng/mL; 52,1%), holotranscobalamina (11,76 pmoL/L; 7,8%) y un 65,9% de hiperhomocisteinemia (19,4 &mu;moL/L). La toma de antianémicos normalizaba los valores de B12, los preparados urológicos y los corticosteroides los niveles de folato y los psicoanalépticos los de holotranscobalamina. La medicación contra obstrucciones pulmonares aumentaba los niveles de Hcy (todos p Aim: To determine drug consumption in institutionalized elderly living in the Region of Madrid (Spain) and to assess the relationship between drug intake and biochemical parameters for vitamin B12 (Cobalamin and Holotranscobalamin), serum folate (SF) and homocysteine (Hcy). Methods: 167 subjects (32% men), mean age 83±7 years, were classified according to biochemical parameter levels (in or out of reference range) and drugs were classified according to ATC system. The relationship between drug intake and biochemical levels was studied by means of the Fisher exact test. Results: The daily mean drug intake was 5. Psicoleptic and antiacid drugs were the most consumed (both 53%). Cobalamin (median 158.2 pg/mL; 10.7% of individuals), SF (5.3 ng/mL; 52.1%) and holotranscobalamin (11.76 pmoL/L; 7.8%) deficiencies were observed. Hyperhomocysteinaemia (19.4 &mu;moL/L) was present in 65% of population. Antiaenemic drug intake normalized cobalamin, urologic drug and corticosteroids SF and psicoanaleptics holotranscobalamin levels. Drugs against pulmonar obstruction increased Hcy concentration (all p < 0.05). Conclusion: There is a high prevalence of SF deficiency and hyperhomocysteinaemia in the studied population. The elevated number of drugs taken simultaneously by each subject makes it difficult to analyze which drugs are responsible for those alterations

Adolescent's physical activity levels and relatives' physical activity engagement and encouragement: The HELENA study

7 páginas.Background: The aim of this article is to examine the association between adolescents' physical activity (PA) levels and their relatives' (father, mother, brothers, sisters and best friend) PA engagement and encouragement. Methods: Adolescents (52.3 girls) aged 12.5-17.5 years were gathered from the HELENA study. Adolescents' PA levels were assessed by the International Physical Activity Questionnaire for Adolescents (valid data on 3007 participants) and accelerometry (valid data on 2200 participants). Relatives' engagement and encouragement were reported by the adolescents and encoded into three categories (low, middle and high). Results: Analysis of covariance showed that relatives' PA encouragement was more strongly associated with adolescents' PA levels than relatives' PA engagement. Pairwise comparisons indicated that the higher the encouragement level (from most relatives) the higher the adolescent's PA levels. This finding was overall consistent when using self-report or objective methods for assessing adolescents' PA levels, yet the associations were stronger when using self-report methods. Conclusions: These findings highlight the important role of social encouragement on adolescents' PA levels. Community interventions aiming to enhance PA levels in the adolescent population might be more successful when family and peers are also targeted.Peer reviewe

Effects of an intradialysis exercise program in patients with chronic kidney disease

The aim of this study was to check the grade of enforcement and to assess the effect of an intradialytic exercise program on fitness and health in hemodialysis patients. The design of this study consisted of 2 periods of 14 weeks, the first one without exercise and the next one with exercise. The program included both aerobic endurance and strength exercise in sessions of 60 minutes, 3 days per week. Physical condition was evaluated through handgrip strength, lower extremity strength and aerobic capacity. 62% of patients completed 75% of the exercise program. A statistically significant decrease in all fitness parameters was observed in period without exercise. This decrease stopped, due to the intervention of exercise program, without significance improvement. Intradialytic exercise program is important to reduce the loss of fitness associated to chronic kidney disease.El objetivo de este estudio fue comprobar el grado de cumplimiento y analizar el efecto de un programa intradiálisis de ejercicio físico sobre la condición física y salud del paciente con enfermedad renal crónica (ERC) que recibe hemodiálisis. Estudio de intervención con dos periodos de 14 semanas, uno sin intervención de ejercicio y otro con intervención, combinando trabajo de resistencia aeróbica y fuerza, en sesiones de 60 minutos, 3 días/semana. La condición física se evaluó a través de la capacidad de fuerza máxima de prensión manual, fuerza resistencia en extremidades inferiores y capacidad cardiorrespiratoria. El 62% de los pacientes cumplieron el 75% del programa. Durante el periodo sin ejercicio intradiálisis se observó una disminución significativa de la condición física, que se frenó durante el periodo con intervención de ejercicio. El programa de ejercicio intradiálisis es importante para frenar la pérdida de condición física ocasionada por la ERC

Effects of an intradialysis exercise program in patients with chronic kidney disease

El objetivo de este estudio fue comprobar el grado de cumplimiento y analizar el efecto de un programa intradiálisis de ejercicio físico sobre la condición física y salud del paciente con enfermedad renal crónica (ERC) que recibe hemodiálisis. Estudio de intervención con dos periodos de 14 semanas, uno sin intervención de ejercicio y otro con intervención, combinando trabajo de resistencia aeróbica y fuerza, en sesiones de 60 minutos, 3 días/semana. La condición física se evaluó a través de la capacidad de fuerza máxima de prensión manual, fuerza resistencia en extremidades inferiores y capacidad cardiorrespiratoria. El 62% de los pacientes cumplieron el 75% del programa. Durante el periodo sin ejercicio intradiálisis se observó una disminución significativa de la condición física, que se frenó durante el periodo con intervención de ejercicio. El programa de ejercicio intradiálisis es importante para frenar la pérdida de condición física ocasionada por la ERC.The aim of this study was to check the grade of enforcement and to assess the effect of an intradialytic exercise program on fitness and health in hemodi - alysis patients. The design of this study consisted of 2 periods of 14 weeks, the first one without exercise and the next one with exercise. The program included both aerobic endurance and strength exercise in sessions of 60 minutes, 3 days per week. Physical condition was evaluated through handgrip strength, lower extremity strength and aerobic capacit y . 62% of patients completed 75% of the exercise program. A statistically significant decrease in all fitness parameters was observed in period without exercise. This decrease stopped, due to the interven - tion of exercise program, without significance improvement. Intradialytic exercise program is important to reduce the loss of fitness associated to chronic kidney diseaseCátedra Real Madrid - Universidad Europea (2016RM/09)Fundación Renal Íñigo Álvarez de Toledo (FRI A T) (P14 11 15303)0.484 IDR (2019) C2, 20/43 DeporteNo data JCR 2019No data SJR 2019UE