Physiological and metabolic characterization of older adults. Especial focus on cardiorespiratory fitness and its role on cognitive function

Advances in modern medicine from developing countries have caused an increase in overall life expectancy and consequently among the older adults population. Ageing is a multifactorial and multi-organic process characterized by decreases in physiological functions, among others, causing deterioration of the physical integrity, and increases in the incidence of health-related problems and non-communicable diseases. Dementia is one of the most common and relevant non-communicable diseases, and in fact, it is one of the main causes of dependency and disability in older adults. Scientific evidence supports that regular exercise has positive effects on ageing process and promotes brain health in older adults. There is a special interest on the relationship between physical fitness and brain health, particularly, the role of cardiorespiratory fitness (CRF) as a powerful health marker in different population groups. Scientific literature has clearly shown an inverse association of CRF with the incidence of many chronic diseases and all-cause mortality. Therefore, to better know the factors that determine and predict CRF level is essential to develop interventions for enhancing both determinants and CRF. Since these factors have been identified in young and middle-aged adults but not clearly in older adults, additional investigation on this topic is needed. Therefore, the main aim of this International Doctoral Thesis was to analyse the physiological, metabolic and cardiovascular determinants of CRF and to develop new and specific equations to predict CRF in older adults. Additionally, the current thesis aimed to study the associations of CRF, both objectively-measured and estimated using new equations, with cognitive function in this population. The sample comprised of 92 people (41 females) between 65 and 75 years from the EFFICOM project (NCT03923712), recruited through the Public Health Care Centers of the province of Cadiz. Participants completed 4 measurements sessions including: i) laboratory measurements of body composition, resting cardiovascular, metabolic and spirometry parameters, and CRF by the modified Bruce incremental test; ii) field assessments of Senior Fitness Test Battery and handgrip test; iii) self-reported questionnaires and interviews on sociodemographic characteristics, activities of daily living and physical activity; and iv) a complete battery of neuropsychological tests to evaluate cognitive function. The main findings of this thesis indicate that: i) The physiological, metabolic and cardiovascular characteristics of older adults were different between males and females, ii) body composition, resting cardiovascular and metabolic parameters, spirometry values and physical fitness performance were identified as relevant and independent determinants of CRF, iii) fifteen equations have been developed with the high prediction values for CRF of older adults. Three different complexity levels were considered; Level 1) basic variables such as body composition parameters, meeting physical activity recommendations, field tests and basal metabolic and cardiovascular parameters; Level 2) basic variables plus spirometry parameters; and Level 3) basic variables, spirometry parameters and simple cardiopulmonary exercise test (CPET) information. The best equation models proposed, from levels 1 and 2, explain 80% of the variability of CRF and, when using maximum HR and time to exhaustion from the CPET (level 3), the best model proposed reach to explain 87% of the variability of CRF, and iv) CRF, both objectively-measured and estimated, were associated with better performance on language, fluency and cognitive flexibility independently of sex, age and education level. The findings of the present International Doctoral Thesis identify key determinants and predictors of CRF, and suggest CRF may be a protective factor against the deterioration of cognitive function associated with ageing in older adults, providing different predictive equations for CRF with low cost and high feasibility

Rol del tiempo de recuperación ventilatoria post-ejercicio sobre los cambios de presión arterial y frecuencia cardiaca como factores de riesgo cardiovasculares

La recuperación de la tensión arterial (TA) y de la frecuencia cardíaca (FC) post-ejercicio es indicativo del nivel de salud cardiovascular. Existen varios factores conocidos que influyen en esa respuesta como es la edad, el sexo, el IMC, la FC en reposo y la capacidad aeróbica. Sin embargo, se desconoce si la recuperación ventilatoria post-ejercicio está relacionada con los cambios en la TA y FC. Objetivos: (i) Analizar la relación entre el tiempo de recuperación del RER, y los cambios de la PA y FC post-ejercicio; (ii) determinar las diferencias entre hombres y mujeres, y (iii) determinar la influencia de la edad, IMC, VO2max y FC de reposo sobre el tiempo de recuperación del RER y los cambios en TA después del ejercicio. Metodología: Se realizó una prueba de esfuerzo máximo a 37 estudiantes universitarios, para determinar su VO2max. Además se midió la composición corporal de los individuos, la PA pre y post-ejercicio, la FC en reposo, durante y post-ejercicio y el RER durante la prueba y hasta que los participantes alcanzaban el RER=1 durante la recuperación. Resultados: Tras analizar la muestra, no hubo diferencias significativas en las medidas de PA y FC post-ejercicio entre los sujetos que necesitaban más y menos tiempo para alcanzar el RER=1. No hubo diferencias entre hombres y mujeres cuando se analizaron los deltas de la PA y FC con respecto al pre. La edad, el sexo, el IMC, la FC en reposo y la capacidad aeróbica tampoco tuvo efectos en la recuperación de la TA post-ejercicio. Conclusiones: No encontramos influencias de ninguna variable en la recuperación post-ejercicio de la TA. Esto sugiere que una vez recuperado el coeficiente respiratorio del proceso de anaerobiosis (RER=1), también lo ha hecho el sistema cardiovascular en la muestra analizada. Futuras investigaciones son necesarias para confirmar estos hallazgos

Efectos del entrenamiento de fuerza isométrica sobre la presión arterial

La hipertensión arterial es un problema de salud pública, que afecta a un número muy elevado de personas en todo el mundo. Por ello creo de interés social investigaciones en esta enfermedad para mejorar el control, conocimiento y tratamiento de la misma. En esta revisión se han analizado numerosas publicaciones con el objetivo de estudiar los efectos del entrenamiento de fuerza isométrica (FI) sobre la presión arterial (PA) y para comprobar si es seguro trabajar este tipo de ejercicio físico en personas hipertensas y normotensas, adultas y mayores. Se han analizado 16 investigaciones, 10 llevadas a cabo con personas normotensas y 6 con personas hipertensas. En personas normotensas, para obtener beneficios en las cifras de PA a través del entrenamiento de FI, es necesario trabajar al menos 4 semanas, mientras que en personas hipertensas se recomienda 8 semanas. En ambas poblaciones es necesario trabajar 3 días en semana. En personas hipertensas, el entrenamiento de FI, mediante HG al 30% de la máxima contracción voluntaria (MVC), es efectivo para reducir la PA, tanto en personas medicadas como no medicadas, con valores normales-altos de PA. El entrenamiento de FI es seguro en ambas poblaciones

Effect of a 12-Week Concurrent Training Intervention on Cardiometabolic Health in Obese Men: A Pilot Study

The present study aimed to investigate the effects of a 12-week concurrent training intervention on cardiometabolic health in obese men. Twelve obese men (42.5 +/- 5.3 years old) participated in the current 12-week randomized controlled trial with a parallel group design. The participants were randomly assigned to a concurrent training group or to a no-exercise control group. Anthropometry and body composition assessment were determined by electrical bio-impedance. Blood samples were obtained and a cardiometabolic risk Z-Score was calculated. Energy metabolism-related parameters [i.e., resting metabolic rate (RMR), respiratory quotient (RQ), and substrate oxidation in both resting conditions and during exercise] were determined by indirect calorimetry. Echocardiographic studies were performed using an ultrasound system equipped with a transducer to measure cardiac function. A significant decrease of weight (Delta = -4.21 kg; i.e., primary outcome), body mass index (Delta = -1.32 kg/m(2)), fat mass (FM; Delta = -3.27 kg), blood pressure (BP; Delta = -10.81 mmHg), and cardiometabolic risk Z-Score (Delta = -0.39) was observed in the exercise group compared with the control group (all P 0.1). Moreover, a significant increment of left ventricular (LV) end diastolic diameter (Delta = -4.35 mm) was observed in the exercise group compared with the control group (P = 0.02). A 12-week concurrent training intervention is an effective strategy to induce weight and fat loss with simultaneous reductions of BP and cardiometabolic risk, and improving cardiac function in obese men.LCurrent research activities of DJ-P are supported by a grant from the Spanish Ministry of Science and Innovation-MINECO (RYC-2014-16938) and the Spanish Ministry of Economy and Competitiveness-MINECO/FEDER (DEP2016-76123R), the Government of Andalusian, Integrated Territorial Initiative 2014-2020 for the province of Cadiz (PI-00022017); the European Union's ERASMUS C SPORT program (Grant Agreement: 603121-EPP-1-2018-1-ES-SPO-SCP), and the EXERNET Research Network on Exercise and Health in Special Populations (DEP2005-00046/ACTI). Technology Fund-FEDER funds (R&D&I Operating Program) by and for the benefit of companies (Technology Fund) INNTERCONECTA (BRISA Contract-University of Cadiz). The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation

Mejora de una asignatura para la formación del profesorado en programación basada en bloques

Uno de los principales retos para la introducción de una materia obligatoria de informática en niveles educativos preuniversitarios es la falta de profesorado formado en informática. En nuestra universidad ofrecemos un máster para formar profesores en competencia digital y programación. La asignatura “Programación y Pensamiento Computacional I” presenta una introducción a la programación basada en bloques. En el curso académico 2021/22 se realizó un diseño de la asignatura basada en cuatro lenguajes de bloques en orden creciente de complejidad. Aunque los alumnos valoraron muy positivamente la asignatura, se identificaron varias cuestiones mejorables. En la comunicación se presentan los cambios introducidos durante el curso 2022/23, que consisten en la eliminación del lenguaje Code.org, una revisión de los apuntes de Scratch, el desarrollo de nuevos ejercicios de autoestudio para ScratchJr y Scratch, y la transición de Scratch a App Inventor. Se presentan los resultados obtenidos de rendimiento de los alumnos y de aceptación de la asignatura. La asignatura ha consolidado su aceptación por los alumnos, pero los cambios introducidos no han redundado en una mejora apreciable y aún persiste como reto el aprendizaje de los elementos más complejos, principalmente App Inventor.One of the main challenges to introduce informatics as a mandatory subject matter in pre-college education is the lack of teachers adequately trained on informatics. Our university offers master’s studies aimed at teachers’ development in digital competence and computer programming. The course “Programming and computational thinking I” introduces block-based programming. In the academic year 2021/22, the course was designed as a sequence of four languages, in increasing order of complexity. The students rated the course very high, but a few issues were amenable to improvement. In this paper, we present the changes introduced for the academic year 2022/23, comprising the removal of Code.org, re-elaboration of Scratch lecture notes, development of additional self-study exercises for ScratchJr and Scratch, and transition between Scratch and App Inventor. The paper also presents the out-comes obtained on students’ performance and course acceptance. The course is consolidated according to students’ high acceptance. However, the changes introduced did not produce a significant enhancement of acceptance, and learning the most complex elements remains an open challenge, especially App Inventor.Este trabajo se ha financiado con el proyecto de investigación e-Madrid-CM (S2018/TCS-4307) de la Comunidad Autónoma de Madrid y los proyectos-puente PROGRAMA de la Universidad Juan Carlos (M2614 y M3035). El proyecto e-Madrid-CM también está financiado con los fondos estructurales FSE y FEDER

Conductas Alimentarias de Riesgo y su asociación con el exceso de peso en adolescentes del Istmo de Tehuantepec, Oaxaca: un estudio transversal

Introduction: Risky Eating Behaviors (REB) are manifestations similar to eating disorders, however, they occur with less frequency and intensity and generally develop during adolescence. The objective of this study was to evaluate the prevalence of REB and its relationship with excess weight in high school students from the Isthmus of Tehuantepec region of the state of Oaxaca, Mexico.Material and methods: Analytical cross-sectional observational design. A total of 268 adolescents between 12 and 15 years old were included. The Brief Questionnaire of Risky Eating Behaviors (CBCAR) was used to determine the prevalence of CAR. Excess weight was identified considering the references established by the WHO of the z-scores of the body mass index for age (BMI / E) by sex. The qualitative variables were analyzed using Chi-square. The association analysis was performed using Poisson regression with robust variance in the statistical package STATA v. 14.Results: 8,6% of the adolescents presented a high risk of CAR, being more prevalent in women without showing statistically significant differences. Concern about gaining weight was higher in women (p <0,001) compared to men.Overweight and obesity were significantly associated with the presence of CAR; (PR = 1,55; 95% CI 1,03-2,32) and (PR = 2,79; 95% CI 1,75-4,44) respectively.Conclusions: The prevalence of high risk of CAR in the study population was higher than previously reported, being more prevalent in women. In addition, high BMI was significantly associated with the presence of CAR, therefore, it is important to generate interventions for weight control that include biopsychosocial aspects to prevent risk behaviors among adolescents.Introducción: Las Conductas Alimentarias de Riesgo (CAR) son manifestaciones similares a los trastornos de la conducta alimentaria, sin embargo,se presentan con menor frecuencia e intensidad y generalmente se desarrollan durante la adolescencia. El objetivo de este estudio fue evaluar la prevalencia de CARpor sexo y su asociación con el exceso de pesoen estudiantes de secundaria de la región del Istmo de Tehuantepec del Estado de Oaxaca, México.Material y métodos: Diseño observacional de tipo transversal analítico. Un total de 268 adolescentes entre 12 y 15 años fueron incluidos. Se utilizó el Cuestionario Breve de Conductas Alimentarias de Riesgo (CBCAR) para determinar la prevalencia de CAR. Se identificó el exceso de peso considerando las referencias establecidas por la OMS de los puntajes z del índice de masa corporal para la edad (IMC/E) por sexo. Las variables cualitativas se analizaron mediante χ2. El análisis de asociación se realizó mediante regresión de Poisson con varianza robusta obteniendo razones de prevalencia en el paquete estadístico STATA v. 14.Resultados: El 8,6 % de los adolescentes presentó un alto riesgo de CAR, siendo más prevalente en mujeres sin mostrar diferencias estadísticamente significativas. La preocupación por engordar fue mayor en mujeres (p<0,001) en comparación con los hombres. El sobrepeso y la obesidad se asociaron significativamente con la presencia de CAR; (RP= 1,55; IC 95% 1,03-2,32) y (RP= 2,79; IC 95% 1,75-4,44) respectivamente.Conclusiones: La prevalencia de alto riesgo de CAR en la población de estudio fue mayor a lo reportado con anterioridad, siendo más prevalente en mujeres. Además, el IMC elevado se asoció significativamente con la presencia de CAR, por lo tanto, es importante generar intervenciones para el control de peso que incluyan aspectos biopsicosociales para prevenir conductas de riesgo entre los adolescentes

Sex-Specific Relationships of Physical Activity and Sedentary Behaviour with Oxidative Stress and Inflammatory Markers in Young Adults

This study aims to analyse sex-specific associations of physical activity and sedentary behaviour with oxidative stress and inflammatory markers in a young-adult population. Sixty participants (21 women, 22.63 ± 4.62 years old) wore a hip accelerometer for 7 consecutive days to estimate their physical activity and sedentarism. Oxidative stress (catalase, superoxide dismutase, glutathione peroxidase, glutathione, malondialdehyde, and advanced oxidation protein products) and inflammatory (tumour necrosis factor-alpha and interleukin-6) markers were measured. Student t-tests and single linear regressions were applied. The women presented higher catalase activity and glutathione concentrations, and lower levels of advanced protein-oxidation products, tumour necrosis factor-alpha, and interleukin-6 than the men (p < 0.05). In the men, longer sedentary time was associated with lower catalase activity (β = −0.315, p = 0.04), and longer sedentary breaks and higher physical-activity expenditures were associated with malondialdehyde (β = −0.308, p = 0.04). Vigorous physical activity was related to inflammatory markers in the women (tumour necrosis factor-alpha, β = 0.437, p = 0.02) and men (interleukin−6, β = 0.528, p < 0.01). In conclusion, the women presented a better redox and inflammatory status than the men; however, oxidative-stress markers were associated with physical activity and sedentary behaviours only in the men. In light of this, women could have better protection against the deleterious effect of sedentarism but a worse adaptation to daily physical activity.This work was partly supported by Universidad de Cádiz (grant number PR2016-051 and PR2019-054), by Instituto de Investigación e Innovación Biomédica de Cádiz (LI19/21IN-CO09), and by the Spanish Ministry of Science and Innovation (Ministerio de Ciencia e Innovación) (MCIN/AEI/ 10.13039/501100011033), grants PID2019-110063RA-I00 and PID2020-120034RA-I00. J.C.-P. is supported by a predoctoral grant from the Spanish Ministry of Education (Ministerio de Educación) (grant number FPU19/02326). D.V.-D is funded by the Margarita Salas Postdoctoral Program from European Union Next GenerationEU and University of Cádiz. Partial funding for open access charge: Universidad de Málag

BASES TEÓRICAS Y METODOLÓGICAS PARA LA CONFECCIÓN DE UNA ESTRATEGIA DE NEGOCIOS BASADA EN EL ENFOQUE DE MARKETING RELACIONAL PARA LOGRAR LA INTEGRACIÓN DEL SISTEMA DE DIRECCIÓN EN EL MUSEO DEL RON HAVANA CLUB

El siguiente artículo resume los componentes teóricos y metodológicos tratados como bases para confeccionar una estrategia de Marketing Relacional en el Museo del Ron Havana Club en La Habana, Cuba. La investigación está orientada a elevar el nivel de integración del sistema de dirección del Museo para lograr el óptimo desempeño de todas las partes que integran o realizan el total de actividades y se propone que se realice bajo la concepción metodológica para la confección de una estrategia de negocio basada en el enfoque de marketing relacional.PALABRAS CLAVE: Sistema de dirección; Marketing relacional; Estrategia de negocios.THEORETICAL AND METHODOLOGICAL BASES FOR THE CREATION OF A BUSINESS STRATEGY BASED ON THE RELATIONAL MARKETING APPROACH TO ACHIEVE THE INTEGRATION OF THE MANAGEMENT SYSTEM OF THE HAVANA CLUB RUM MUSEUMABSTRACTThis article summarizes the theoretical and methodological components treated as the bases to prepare a Relational Marketing strategy at the Havana Club Rum Museum, in Havana, Cuba. The research is aimed at raising the level of integration of the Museum's management system to achieve the optimum performance of all the parties that make up or carry out the total activities and it is proposed that it be carried out under the methodological conception for the preparation of a strategy of business based on the relational marketing approach.KEYWORDS: management system; relational marketing; business strategy

Influence of ACE Gene I/D Polymorphism on Cardiometabolic Risk, Maximal Fat Oxidation, Cardiorespiratory Fitness, Diet and Physical Activity in Young Adults

There is controversy about the relationship between ACE I/D polymorphism and health. Seventy-four healthy adults (n = 28 women; 22.5 +/- 4.2 years) participated in this cross-sectional study aimed at determining the influence of ACE I/D polymorphism, ascertained by polymerase chain reaction, on cardiometabolic risk (i.e., waist circumference, body fat, blood pressure (BP), glucose, triglycerides, and inflammatory markers), maximal fat oxidation (MFO), cardiorespiratory fitness (maximal oxygen uptake), physical activity and diet. Our results showed differences by ACE I/D polymorphism in systolic BP (DD: 116.4 +/- 11.8 mmHg; ID: 116.7 +/- 6.3 mmHg; II: 109.4 +/- 12.3 mmHg, p = 0.035) and body fat (DD: 27.3 +/- 10.8%; ID: 22.6 +/- 9.7%; II: 19.3 +/- 7.1%, p = 0.030). Interestingly, a genotype*sex interaction in relativized MFO by lean mass (p = 0.048) was found. The DD polymorphism had higher MFO values than ID/II polymorphisms in men (8.4 +/- 3.0 vs. 6.5 +/- 2.9 mg/kg/min), while the ID/II polymorphisms showed higher R-MFO values than DD polymorphism in women (6.6 +/- 2.3 vs. 7.6 +/- 2.6 mg/kg/min). In conclusion, ACE I/D polymorphism is apparently associated with adiposity and BP, where a protective effect can be attributed to the II genotype, but not with cardiorespiratory fitness, diet and physical activity. Moreover, our study highlighted that there is a sexual dimorphism in the influence of ACE I/D gene polymorphism on MFO

A new set of estimated cardiorespiratory fitness equations are associated with cognitive performance in older adults

This study aimed to develop new equations to estimate cardiorespiratory fitness specifically for older adults and, secondly, to analyze the associations of cardiorespiratory fitness, both objectively measured and estimated using new equations, with cognitive performance. Ninety-two older adults (41 females, 65-75years) from baseline data of a randomized controlled trial were analyzed ("ClinicalTrials.gov" Identifier: NCT03923712). Participants completed 4 measurement sessions including (i) physiological and health indicators in a laboratory setting, (ii) field-based fitness tests, (iii) sociodemographic and physical activity questionnaires, and (iv) a battery of neuropsychological tests to evaluate cognitive performance. The main findings were as follows: (i) a set of new equations with good predictive value for estimated cardiorespiratory fitness were developed (74-87%), using different scenarios of complexity and/or equipment requirements, and (ii) higher estimated cardiorespiratory fitness, even using its simplest equation (eCRF=-1261.99+1.97*6min walking test (m)+1.12*bioimpedance basal metabolic rate (kcal/day)+5.25*basal heart rate (bpm)), was associated with better cognitive performance evaluated by several neuropsychological tests (i.e., language, cognitive flexibility, fluency, attention, and working memory), similar to using objectively measured cardiorespiratory fitness. In summary, a new set of estimated cardiorespiratory fitness equations have been developed with predictive values ranging from 74 to 87% that could be used based on necessity, availability of equipment, resources, or measurement context. Moreover, similar to objectively measured cardiorespiratory fitness, this measure of estimated cardiorespiratory fitness was positively associated with performance on language, fluency, cognitive flexibility, attention, and working memory, independently of sex, age, and education level. © 2023. The Author(s)