Relationship between health-related fitness and quality of life in elderly with type 2 diabetes: an exploratory study in the province of Seville

Under a Creative Commons license.[Objetivos]: Caracterizar a la población adulta-mayor afectada por diabetes mellitus tipo 2 (DM2) tratada en las consultas de atención primaria en cuanto al nivel de condición física relacionada con la salud (CFRS) y calidad de vida relacionada con la salud (CVRS), y por otro lado, corroborar si existe relación entre los diferentes test de CFRS y la CVRS. [Método]: Se utilizó un diseño transversal observacional de casos y controles para comparar la CFRS y la CVRS (evaluada mediante el cuestionario EQ-5D-3L) entre 42 pacientes con DM2 y 54 pacientes sin DM2, y se estableció la relación existente entre la CFRS y la CVRS en los pacientes con DM2. [Resultados]: En cuanto a la CFRS, los pacientes con DM2 obtuvieron mayores resultados en el test de dinamometría manual que sus pares sin dicha afección (p < 0,025). Los valores alcanzados en el test sit and reach fueron mayores en el grupo control que en el grupo DM2 (p < 0,001). No se detectaron diferencias estadísticamente significativas en cuanto a la CVRS entre ambos grupos. El coeficiente de correlación de Pearson desveló un nivel de correlación de moderado a alto entre los componentes de la CVRS y los test de fuerza, movilidad y equilibrio que componen la CFRS (p < 0,05). [Conclusiones]: Este estudio muestra la asociación existente entre la CVRS evaluada con el EQ-5D-3L y los test de fuerza, movilidad y equilibrio dinámico en pacientes con DM2 tratados en atención primaria, cualidades vitales para el desarrollo de las actividades de la vida diaria de estos pacientes.[Objectives]: To characterize the type 2 diabetic (DM2) population treated in primary care consultations in regard of Health-Related Fitness (HRF) and Health-Related Quality of Life (HRQoL), and, on the other hand, to confirm if there is a relationship between HRF and HRQoL in DM2 patients. [Methods]: A cross-sectional, observational, case-control study was performed to compare the HRF and HRQoL between 42 DM2 patients and 54 patients without DM2 and the relationship between these two concepts was revealed. [Results]: In regard of HRF, statistically significant differences were found in the hand dynamometer test in favor of DM2 patients group (p = , 025) and statistically significant differences were achieved in favor of the reference group in sit and reach test (p = , 001). Pearson's correlation coefficient revealed a moderate to high level of correlation between the different dimensions and index of EQ-5D-3L and strength, mobility and balance tests (p < ,05). [Conclusions]: This study showsthe relationship between EQ-5D-3L componentsand strength, mobility and balance tests in DM2 patients treated in primary care, key functional capacities to a correct development of daily activities in these patients.A los autores del presente trabajo les gustaría agradecer la colaboración prestada por el Centro de Salud Los Bermejales por financiar parcialmente este proyecto.Open Access funded by Consejería de Educación, Cultura y Deporte de la Junta de Andalucía.Peer Reviewe

Evolution of occupational asthma: Does cessation of exposure really improve prognosis?

SummaryAimTo assess the evolution of occupational asthma (OA) depending on whether the patient avoids or continues with exposure to the offending agent.MethodsStudy in patients diagnosed with OA using a specific inhalation challenge. Patients underwent the following examinations on the same day: clinical interview, physical examination, forced spirometry, methacholine test and determination of total IgE. Clinical improvement, deterioration or no change were defined according to the changes seen on the GINA severity scale at the time of diagnosis.ResultsOf the 73 patients finally included, 55 had totally ended exposure and 18 continued to be exposed at work. Clinical improvement was observed in 47% of those who had terminated exposure and in 22% of those who remained exposed; clinical deterioration was observed in 14% and 17% respectively (p = 0.805). Logistical regression analysis, including the type of agent and the persistence or avoidance of exposure among the variables, did not show any predictive factors of clinical evolution. Similarly, the changes in FEV1 and in bronchial hyperresponsiveness were not associated with the avoidance or continuation of exposure to the causative agent.ConclusionsAvoiding exposure to the causative agent in patients with OA does not seem to improve prognosis in this disease. Despite these findings, there is insufficient evidence to recommend a change in current management guidelines

Light-Intensity Physical Activity and Life Expectancy: National Health and Nutrition Survey

Introduction. Quantifying the number of years gained (YLG) associated with light-intensity physical activity (LPA) may be important for risk communication in public health. With no studies having examined the role of LPA in life expectancy, this study aims to quantify YLG from LPA in a population-based US sample. Methods. This study used data from 6,636 participants in the National Health and Nutrition Examination Survey (2003-2006). The analyses were conducted in 2020. LPA was categorized into low, medium, and high based on tertiles, and survival models were applied to estimate YLG from each LPA group. The analyses were repeated in participants with MVPA above or below the median. Results. During a mean follow-up of 11 years and 55,520 person-years, 994 deaths were recorded. At age 20, participants with low, medium and high LPA had a predicted life expectancy of 55.70 (48.70 – 62.70), 58.96 (52.17 – 65.75) and 60.60 (54.03 – 67.18) years, suggesting significant YLG from medium and high levels of LPA of 3.45 (0.77 – 6.12) and 5.24 (1.88 – 8.60) years. Corresponding YLG at age 45 and 65 was 2.93 (0.40 – 5.47) and 1.98 (0.03 – 3.94) years for the medium LPA group, and 4.53 (1.26 – 7.80) and 3.10 (0.42 – 5.78) years for the high LPA group. This association was significant in participants with below-median MVPA but not for those with above-median MVPA. Conclusion. LPA may extend life expectancy. Given the low prevalence of MVPA in populations, physical activity promotion efforts may capitalise on emerging evidence on LPA, particularly among the most inactive groups

Frailty is associated with objectively assessed sedentary behaviour patterns in older adults: Evidence from the Toledo Study for Healthy Aging (TSHA)

Objective: The aim of this study was to examine the association of sedentary behaviour patterns with frailty in older people. Setting: Clinical setting. Design: Cross-sectional, observational study. Participants and measurements: A triaxial accelerometer was used in a subsample from the Toledo Study for Healthy Aging (519 participants, 67–97 years) to assess several sedentary behaviour patterns including sedentary time per day, the number and duration (min) of breaks in sedentary time per day, and the proportion of the day spent in sedentary bouts of 10 minutes or more. Frailty was assessed using the Frailty Trait Scale (FTS). Regression analysis was used to ascertain the associations between sedentary behaviour patterns and frailty. Results: Sedentary time per day and the proportion of the day spent in sedentary bouts of 10 minutes or more, were positively associated with frailty in the study sample. Conversely, the time spent in breaks in sedentary time was negatively associated with frailty. Conclusion: In summary, breaking up sedentary time and time spent in sedentary behaviour are associated with frailty in older people

Glucose levels as a mediator of the detrimental effect of abdominal obesity on relative handgrip strength in older adults

Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 ± 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (β = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (β = −0.003, 95%CI = −0.005 to −0.001), p < 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (β = −0.069, 95%CI = −0.082 to −0.057), p < 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect β = −0.002, 95%CI = −0.004 to −0.001), p < 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass

Sedentary Behavior Research Network (SBRN) - Terminology Consensus Project process and outcome

Background: The prominence of sedentary behavior research in health science has grown rapidly. With this growth there is increasing urgency for clear, common and accepted terminology and definitions. Such standardization is difficult to achieve, especially across multi-disciplinary researchers, practitioners, and industries. The Sedentary Behavior Research Network (SBRN) undertook a Terminology Consensus Project to address this need. Method: First, a literature review was completed to identify key terms in sedentary behavior research. These key terms were then reviewed and modified by a Steering Committee formed by SBRN. Next, SBRN members were invited to contribute to this project and interested participants reviewed and provided feedback on the proposed list of terms and draft definitions through an online survey. Finally, a conceptual model and consensus definitions (including caveats and examples for all age groups and functional abilities) were finalized based on the feedback received from the 87 SBRN member participants who responded to the original invitation and survey. Results: Consensus definitions for the terms physical inactivity, stationary behavior, sedentary behavior, standing, screen time, non-screen-based sedentary time, sitting, reclining, lying, sedentary behavior pattern, as well as how the terms bouts, breaks, and interruptions should be used in this context are provided. Conclusion: It is hoped that the definitions resulting from this comprehensive, transparent, and broad-based participatory process will result in standardized terminology that is widely supported and adopted, thereby advancing future research, interventions, policies, and practices related to sedentary behaviors

Practical steps needed to achieve impact of the WHO 2019 movement behaviour guidelines for children under the age of 5 : the SUNRISE Study Europe Group evaluation

The World Health Organisation (WHO) guidelines for the ‘24-h movement behaviours’1 (physical activity (PA), sedentary behaviour (SB) including screen time, and sleep) in the under-5s were published in April 2019 (Supplementary Figure S1).2 The guidelines were developed as a response to the childhood obesity pandemic,2 to help ensure that under-5s have healthy levels of PA, screen time, and sleep. Evidence review and synthesis showed that these behaviours influenced a wide range of other outcomes, with substantial short-term and long-term consequences (e.g., cognitive, social and emotional development; language development; cardiometabolic health; bone and skeletal health; motor development; physical fitness; growth; and wellbeing).2 Five years later, it is now appropriate to test whether key actions in response to these guidelines were taken across Europe, and to consider ways of increasing the impact of the WHO Guidelines across Europe in the next 5 years. Therefore, the SUNRISE Study Europe Group considered three tests to examine if European public health policy and clinical practice were sufficiently responsive to the WHO Guidelines: (1) Do European nations have national guidelines for the movement behaviours in the under-5s or have they adopted/adapted the WHO Guidelines? (2) Do they have adequate surveillance of the movement behaviours in these age groups? (3) Do they have specific movement behaviour policies for children under-5