Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMEDPlus study

Background: This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Methods: This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. Results: Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). Conclusions: Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health

Valoración de la fragilidad en la persona con Diabetes Mellitus Tipo 2: análisis de expertos.

Introducción: Las personas con diabetes mellitus tipo 2 (DM2) tienen una prevalencia de fragilidad que se estima entre 3 y 5 veces mayor que aquellos que no la padecen, sin embargo, no existe un consenso claro sobre el diagnóstico y manejo clínico durante el itinerario de la persona frágil con DM2. Objetivos: El objetivo principal de este estudio es identificar las limitaciones y necesidades actuales en el uso del concepto de fragilidad en personas con DM2 (PCDM2), así como definir y evaluar, según su importancia y novedad, las dimensiones que podrían incluirse en su valoración clínica de rutina. Métodos: Se llevó a cabo un proceso basado en la técnica de grupo nominal con la participación de un equipo multidisciplinario de 8 profesionales de la salud que trabajan en diferentes hospitales de Espana. Resultados: Se identificaron y clasificaron según su importancia un total de 8 limitaciones en la evaluación de la fragilidad en PCDM2, así como 10 necesidades no satisfechas relacionadas con el diagnóstico y seguimiento de la enfermedad. Además, se identificaron 7 dimensiones que consideramos que deben incluirse en la definición de la persona frágil con DM2, ordenadas por importancia y novedad