Mortality trends in the general population: the importance of cardiorespiratory fitness

Cardiorespiratory fitness (CRF) is not only an objective measure of habitual physical activity, but also a useful diagnostic and prognostic health indicator for patients in clinical settings. Although compelling evidence has shown that CRF is a strong and independent predictor of all-cause and cardiovascular disease mortality, the importance of CRF is often overlooked from a clinical perspective compared with other risk factors such as hypertension, diabetes, smoking, or obesity. Several prospective studies indicate that CRF is at least as important as the traditional risk factors, and is often more strongly associated with mortality. In addition, previous studies report that CRF appears to attenuate the increased risk of death associated with obesity. Most individuals can improve their CRF through regular physical activity. Several biological mechanisms suggest that CRF improves insulin sensitivity, blood lipid profile, body composition, inflammation, and blood pressure. Based on the evidence, health professionals should encourage their patients to improve CRF through regular physical activity

Body adiposity index and incident hypertension: The Aerobics Center Longitudinal Study

Background and aim The body adiposity index (BAI) has been recently proposed as a new method to estimate the percentage of body fat. The association between BAI and hypertension risk has not been investigated yet. The aim of our study was to evaluate the ability of BAI to predict hypertension in males and females compared with traditional body adiposity measures. Methods and results The present follow-up analysis comprised 10,309 individuals (2259 females) free of hypertension from the Aerobics Center Longitudinal Study, who completed a baseline examination between 1988 and 2003. Body adiposity measures included BAI, body mass index (BMI), waist circumference, hip circumference, percentage of body fat and waist to hip ratio (WHR). Incident hypertension was ascertained from responses to mail-back surveys between 1990 and 2004. During an average of 9.1 years of follow-up, 872 subjects (107 females) became hypertensive. Hazard ratios (HRs) and 95% confidence intervals (95% CI) showed that males in the highest categories of all body adiposity measures showed a higher incident risk of hypertension (HRs ranged from 1.37 to 2.09). Females showed a higher incident risk of hypertension only in the highest categories of BAI, BMI and WHR (HRs ranged from 1.84 to 3.36). Conclusion Our results suggest that in order to predict incident hypertension BAI could be considered as an alternative to traditional body adiposity measures.The authors thank the Cooper Clinic physicians and technicians for collecting the data, and staff at the Cooper Institute for data entry and data management. This work was supported by “Conselleria de Educación de la Generalitat Valenciana” [BEST/2012/257]; Spanish Ministry of Education [EX-2010-1008]; National Institutes of Health [AG06945, HL62508, R21DK088195] and in part by an unrestricted research grant from The Coca-Cola Company. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding institutions

Características antropométricas y nivel de condición física en relación con el estado ponderal en niños chilenos de edad preescolar

The purpose of this study was to describe anthropometric and physical fitness characteristics of low-income Chilean preschool children and to examine whether weight status influences children’s performance on fitness tests. A total of 434 preschool children (246 boys; 5.48 ± 0.31 years) participated in our study. Anthropometry (weight, height, body mass index -BMI- and waist circumference) and fitness tests (handgrip strength test, standing long jump and 20 m sprint) were assessed by trained nutritionists and physical education teachers, respectively. Significant differences in anthropometry and fitness tests between boys and girls were found. The prevalence of overweight was higher in girls; in contrast to that of obesity. Compared to normal-weight children, overweight/obese boys and girls were heavier and had greater waist circumference (P < 0.001), were taller (P ≤ 0.002), and showed higher performance in handgrip strength (P ≤ 0.027) but not in standing long jump nor 20 m sprint (P ≥ 0.052). Screening physical fitness levels in overweight/obese preschool children could be an important tool in order to design an efficacy physical activity programme.El objetivo de este estudio fue describir las características antropométricas y el nivel de condición física de preescolares chilenos de bajo nivel socioeconómico y examinar si el estado ponderal influye en el rendimiento de los niños en las pruebas de condición física. Un total de 434 preescolares (246 niños; 5,48 ± 0,31 años) participaron en nuestro estudio. Antropometría (peso, talla, índice de masa corporal –IMC– y perímetro de cintura) y tests de condición física (test de fuerza de prensión manual, test de salto de longitud y 20 m sprint) fueron evaluados por nutricionistas entrenados y profesores de educación física, respectivamente. Se encontraron diferencias significativas en antropometría y tests de condición física entre niños y niñas. La prevalencia de sobrepeso fue mayor en las niñas; en contraste con la de la obesidad. En comparación con los preescolares con normopeso, los niños y niñas con sobrepeso/obesidad pesaron más y tuvieron mayor perímetro de cintura (P < 0.001), eran más altos (P ≤ 0.002) y mostraron mayor rendimiento en el test de fuerza de prensión manual (P ≤ 0.027), pero no en el test de salto de longitud ni en el test de sprint de 20 m (P ≥ 0.052). Detectar los niveles de condición física en preescolares con sobrepeso/obesidad puede ser una herramienta importante para diseñar programas eficaces de actividad física.They would like to thank the “Corporación Municipal de Educación y Salud” of Ñuñoa for funding the study. Likewise, we thank Francisco B. Ortega from the University of Granada, Spain, for his valuable comments on an earlier draft. Cristina Cadenas-Sánchez is supported by a grant from the Spanish Ministry of Economy and Competitiveness (BES-2014-068829)

Associations between objectively measured and self‐reported sleep with academic and cognitive performance in adolescents: DADOS study

Adequate sleep has been positively related with health and school achievement out-comes during adolescence. The aim of this study was to investigate the associations ofobjectively measured and self‐reported sleep duration and quality with academic andcognitive performance in adolescents. This study was conducted with 257 adolescents(13.9 ± 0.3 years) from the DADOS study (Deporte, ADOlescencia y Salud). Objec-tively measured and self‐reported sleep duration and quality were obtained by a wrist‐worn GENEActiv accelerometer and the Spanish version of Pittsburgh Sleep QualityIndex questionnaire, respectively. Academic performance was analysed through schoolrecords using four indicators: math, language, science and grade point average score.Cognitive performance was measured using the Spanish version of the“SRA Test ofEducational Ability”. After Benjamini–Hochberg correction for the false discovery rate,objectively measured sleep duration was negatively associated with verbal ability (β=−0.179,p= .004), whilst self‐reported sleep quality was positively associated withacademic performance (βranging from 0.209 to 0.273; allp<.001). These associationsremained significant after further controlling for physical fitness and physical activity.Conversely, there were no associations between self‐reported sleep duration andobjective sleep quality with academic and cognitive performance. Our findings fit inline with previous research showing that sleep quality may play an important role onadolescents’academic performance. Further interventional research is needed to clar-ify the mechanisms by which sleep is related to academic performance in youth

Supervised Exercise Immediately After Bariatric Surgery: the Study Protocol of the EFIBAR Randomized Controlled Trial

This work was supported by the Spanish Ministry of Economy and Competitiveness (MINECO), Plan Nacional de I+D+i calls RETOS 2016 (reference DEP2016-74926-R) and RETOS 2018 (reference RTI2018-093302-A-I00). EM-R and MAI were funded by the Spanish Ministry of Science, Innovation and Universities (FPU18/01107 and FPU17/01158, respectively). AH-M and LL-S were funded by the predoctoral fellowship program of the University of Almeria. The funding sources approved this study although they had no role in the design and will not have any role during its execution, analyses and interpretation of the data, writing manuscripts, or decision to submit for publication.Background Previous studies have investigated weight loss caused by exercise following bariatric surgery. However, in most cases, the training programis poorly reported; the exercise type, volume, and intensity are briefly mentioned; and the sample size, selection criteria, and follow-up time vary greatly across studies. Purpose The EFIBAR study aims to investigate over 1 year the effects of a 16-week supervised exercise program, initiated immediately after bariatric surgery, on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, and quality of life in patients with severe/extreme obesity. Material and Methods The EFIBAR study is a parallel-group, superiority, randomized controlled trial (RCT), comprising 80 surgery patients. Half of the participants, randomly selected, perform a 16-week supervised exercise program, including both strength and aerobic training, starting immediately after the surgery (7–14 days). For each participant, all primary and secondary outcomes are measured at three different time points: (i) before the surgery, (ii) after the intervention (≈4 months), and (iii) 1 year after the surgery.Spanish Ministry of Economy and Competitiveness (MINECO), Plan Nacional de I+D+i calls RETOS DEP2016-74926-R RTI2018-093302-A-I00Spanish Ministry of Science, Innovation and Universities FPU18/01107 FPU17/01158predoctoral fellowship program of the University of Almeri

Efectos de un programa escolar orientado a la mejora de la condición física sobre el perfil lipídico de adolescentes: estudio EDUFIT

Observational studies have reported an association among physical activity, fitness and lipid profile in youth. The purpose of this study was to analyse the effect of a school-based intervention focused on increasing the number and intensity of Physical Education (PE) sessions a week, on adolescents' lipid profile. METHODS: A 4-month group-randomized controlled trial was conducted in 67 adolescents (12-14 years-old) from South-East Spain, 2007. Three school classes were randomly allocated into control group (CG), experimental group-1 (EG1) and experimental group-2 (EG2). The CG received the usual PE in Spain (2 sessions/week), the EG1 received 4 PE sessions/week, and the EG2 received 4 PE sessions/week of high intensity. The main study outcomes were fasting levels of total cholesterol, high-density lipoprotein cholesterol (HDLc), low-density lipoprotein cholesterol (LDLc) and triglycerides. All the analyses were adjusted for sex, sexual maturation, attendance and baseline value of the outcome studied. RESULTS: The intervention did not positively affect cardio-metabolic parameters except for LDLc, that was marginally yet significantly reduced in EG2 (-10.4 mg/dl), compared with the CG (+4.1 mg/dl) (p = 0.04); no differences were observed however for the LDLc/HDLc ratio. No significant effects were observed in EG1. DISCUSSION: Overall, a 4-month school-based physical activity intervention did not substantially influence lipid profile in adolescents. However, the results suggest that increasing both frequency and intensity of PE sessions had a modest effect on LDLc in youth. Future studies involving larger sample sizes and longer interventions should focus on the separate effects of volume and intensity of PE.Objetivos: Los estudios observacionales han notificado una asociación entre la actividad física, la forma física y el perfil lipídico en la juventud. El propósito de este estudio fue analizar el efecto de una intervención basada en la escuela centrada en aumentar el número y la intensidad de las sesiones de educación física (EF) a lo largo de la semana, en el perfil lipídico de los adolescentes. Métodos: Se realizó un estudio controlado de distribución aleatoria en 67 adolescentes (12-14 2013s) del sudeste de España, en 2007. Tres clases fueron distribuidas al azar a un grupo control (GC), un grupo experimental-1 (GE1) y un grupo experimental-2 (GE2). El GC recibió las sesiones habituales de EF en España (2 sesiones semanales), el GE1 recibió 4 sesiones de EF /semana y el GE2 recibió 4 sesiones de EF /semana de alta intensidad. Los criterios de valoración principales del estudio fueron las concentraciones en ayunas de colesterol toral, lipoproteínas de densidad elevada-colesterol (HDLc), lipoproteínas de densidad baja-colesterol (LDLc) y de triglicéridos. Se ajustaron todos los análisis para el sexo, maduración sexual, asistencia y valor basal de la variable estudiada. Resultados: La intervención no afectó de forma positiva a los parámetros cardiovasculares a excepción de las LDLc que disminuyeron marginal aunque significativamente en el GE2 (-10,4 mg/dl), en comparación del GC (+4,1 mg/dl) (p = 0,04); sin embargo, no se observaron diferencias para el cociente LDLc/HDLc ratio. No se observaron efectos significativos en el GE1. Discusión: De forma global, una intervención de actividad física basada en la escuela durante 4 meses no influyó de forma sustancial en el perfil lipídico de los adolescentes. Sin embargo, los resultados sugieren que el aumentar tanto la frecuencia como la intensidad de las sesiones de EF tiene un efecto modesto sobre las LDLc en los jóvenes. Los estudios futuros que impliquen una muestra mayor e intervenciones más duraderas deberían centrarse en los efectos separados del volumen e intensidad de la EF

Longitudinal algorithms to estimate cardiorespiratory fitness: associations with nonfatal cardiovascular disease and disease-specific mortality

Objectives This study sought to determine the capacity of cardiorespiratory fitness (CRF) algorithms without exercise testing to predict the risk for nonfatal cardiovascular disease (CVD) events and disease-specific mortality. Background Cardiorespiratory fitness (CRF) is not routinely measured, as it requires trained personnel and specialized equipment. Methods Participants were 43,356 adults (21% women) from the Aerobics Center Longitudinal Study, followed up between 1974 and 2003. Estimated CRF was determined on the basis of sex, age, body mass index, waist circumference, resting heart rate, physical activity level, and smoking status. Actual CRF was measured by a maximal treadmill test. Risk reduction per 1-metabolic equivalent increase, discriminative ability (c statistic), and net reclassification improvement were determined. Results During a median follow-up of 14.5 years, 1,934 deaths occurred, 627 due to CVD. In a subsample of 18,095 participants, 1,049 cases of nonfatal CVD events were ascertained. After adjustment for potential confounders, both measured and estimated CRF were inversely associated with risks for all-cause mortality, CVD-related mortality and nonfatal CVD events in men, and all-cause mortality and nonfatal CVD events in women. The risk reduction per 1-metabolic equivalent increase ranged from approximately 10% to 20%. Measured CRF had a slightly better discriminative ability (c statistic) than did estimated CRF, and the net reclassification improvement values in measured CRF versus estimated CRF were 12.3% in men (p < 0.05) and 19.8% in women (p < 0.001). Conclusions These CRF algorithms utilized information routinely collected to obtain an estimate of CRF, which provides a valid indication of health status. In addition to identifying people at risk, this method can provide more appropriate exercise recommendations that reflect initial CRF levels

Use of whole-body vibration as a mode of warming up before counter movement jump

This study was conducted without any conflict of interest, without financial assistance, and supported by grants from the Consejo Superior de Deportes (109/UPB31/03, 13/UPB20/04), the Spanish Ministry of Education and Science (AP2003-2128, AP-2004-2745; AP2005-3827; AP2005-4358) and the HELENA study (European Community Sixth RTD Framework Programme, FOOD-CT-005-007034)

Physiology of sport climbing

El presente trabajo revisa la literatura científica existente sobre la escalada deportiva con el objetivo de analizar en profundidad las características antropométricas y fisiológicas del escalador deportivo, así como las exigencias fisiológicas en el desarrollo de la actividad. La literatura revisada sugiere que los escaladores se caracterizan por tener un bajo peso corporal y un bajo porcentaje de masa grasa. También una alta fuerza de prensión manual y una alta fuerza resistencia. Algunos autores han considerado el consumo máximo de oxígeno como un determinante del rendimiento en escalada, sin embargo los resultados son contradictorios. Otros parámetros fisiológicos son analizados durante y después de la escalada. Se han detectado importantes diferencias metodológicas entre los estudios analizados, sugiriendo la necesidad de estandarizar los protocolos de evaluación en este deporte. La presente revisión contribuye de manera significativa a un mayor conocimiento de las características de este deporte y de quienes las practican, identificando diversas áreas de interés que requieren futuro estudio.The purpose of the present paper is to review the existing research on anthropometric and physiological characteristics of sport climbers as well as the physiological responses during the sport climbing. The literature suggests that the sport climbers are characterised by both a low percentage body fat and body mass. A high handgrip strength and high endurance strength also are specific characteristics of sport climbers. In contrast, it is not clear whether maximal oxygen consumption is a determinant of sport climbing performance. Several physiological parameters have been analysed during and after sport climbing such as heart rate, blood lactate and maximal strength. We have observed many differences in the assessment methodology between the studies, suggesting that a standardization of the evaluation protocols is needed in this sport discipline. This review provides a wide knowledge of the characteristics of this sport, as well as identifies particular areas that require further attention

The relative age effect on physical fitness in preschool children

The aim of the present study was to investigate the existence of a relative age effect (RAE) on physical fitness of preschoolers. Anthropometry and physical fitness were assessed in 3147 children (3–5 years old) using the PREFIT battery. Based on the birth year, participants were divided into 3year groups (3-, 4- and 5-years). Within each year group, 4quarter groups were created: quarter 1, preschoolers born from January to March; quarter 2, from April to June; quarter 3, from July to September; quarter 4, from October to December. The MANCOVA analysis revealed a main effect of year group (Wilks’ λ = 0.383; F10,5996 = 369.64; p < 0.001, ηp 2 = 0.381) and of quarter (Wilks’ λ = 0.874; F15,8276.6 = 27.67; p < 0.001; ηp 2 = 0.044) over the whole battery of tests. To the best of our knowledge, this is the first study to report the existence of RAE at the preschool stage. In general, performance improved as the relative age increased (i.e., those born in quarter 1 performed better than those in the other quarters). Individualization strategies should be addressed within the same academic year not only in elementary or secondary years but also in preschoolers