Análisis de la carga interna durante una temporada de balonmano femenino adolescente

Este estudio examina la carga interna basada en la frecuencia cardiaca (FC) durante una liga regional en jugadoras adolescentes de balonmano, comparando estos parámetros entre la primera y la segunda parte del partido. Un total de 10 jugadoras adolescentes de balonmano participaron en este estudio (edad 14,70 ± 0,67 años (rango, 14-15), masa corporal 55,78 ± 6,80 kg (rango, 46,70-68,90), talla 160,44 ± 8,53 cm (rango, 150,00-177,00), IMC 21,60 ± 1,10 kg/m2 (rango, 19,90-23,10), masa grasa 30,89 ± 3,70 % Masa Grasa (rango, 24,40-35,60) y VO2max 35,00 ± 1,00 ml·min·kg-1 (rango, 33,76-36,00)). El análisis de la frecuencia cardíaca (n=120) fue registrado durante 12 partidos oficiales usando monitores de frecuencia cardiaca. Las demandas individuales fueron categorizada en 6 zonas de intensidad basándose en el % Frecuencia Cardíaca Máxima (FCmáx): zona I: 0-50%; zona II: 51-60%; zona III: 61-70%; zona IV: 71-80%, zona V: 81-90 y zona VI: 91-100% de la FCmáx. La FCmáx Efectiva y Media durante el partido fueron 204,14±6,12 y 185,71±8,33 ppm, respectivamente. Durante la segunda parte, la frecuencia cardiaca máxima efectiva (201.71±5.23 vs 204.15±6.57 ppm; p=0.001) y media efectiva (183.51±8.61 vs 189.67±7.47 ppm; p=0.000) decrecieron en comparación con las primeras partes. Las jugadoras de balonmano adolescente desarrollaron una alta intensidad durante partidos oficiales, siendo más alta en la primera parte comparada con la segunda.This study examined the internal load based on heart rate (HR) in a teenage female handball team, which is playing in a regional league, comparing these parameters between the first and second half of the matches. A total of 10 adolescent female handball players participated in the study (age 14.70 ± 0.67 years (range, 14-15), weight 55.78 ± 6.80 kg (range, 46.70-68.90), height 160.44 ± 8.53 cm (range, 150.00-177.00), BMI 21.60 ± 1.10 kg/m2 (range, 19.90-23.10), fat mass 30.89 ± 3.70 % Fat Mass (range, 24.40-35.60) and VO2max 35.00 ± 1.00 ml·min·kg-1 (range, 33.76-36.00). Heart Rate (n=120) analyses were registered throughout 12 official matches using Heart Rate monitors. Individual demands were categorized into six intensity zones based on % Maximum Heart Rate (HRmax): zone I: 0-50%; zone II: 51-60%; zone III: 61-70%; zone IV: 71-80%, zone V: 81-90 and zone VI: 91-100% of HRmax. Effective maximum and mean Heart Rate in the total match were 204.14±6.12 and 185.71±8.33 b·min-1, respectively. During the second half, effective maximum (201.71±5.23 vs 204.15±6.57 b·min-1; p=0.001) and effective mean (183.51±8.61 vs 189.67±7.47 b·min-1; p=0.000). Heart Rate decreased comparing to the first half. Female adolescent team handball players develop a high intensity during official matches. This intensity is higher in first half compared to the second half.peerReviewe

Efeitos de intervenções multicomponentes em marcadores bioquímicos em jovens obesos: um protocolo de revisão sistemática

Physical exercise is effective in modulating circulating inflammatory markers of obesity. However, little is known about the effects of interventions with physical exercise programs accompanied by nutritional and/or psychological guidance, configuring themselves as multicomponent programs. Thus, the aim of this review is to systematically evaluate the evidence related to the effects of multicomponent weight-loss interventions in modulating circulating inflammatory markers in children and adolescents. Therefore, the following databases will be searched to identify all relevant articles: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Randomized controlled trials and quasi-experimental studies of children and adolescents (6 to 18 years old) will be included. Eligible interventions will target weight-related behaviors (including diet, physical activity, behavior modification and/or combinations thereof ). Two independent reviewers will select studies using Rayyan QCRI software and extract the data to a standard form. The main outcomes of the review will be the circulating values of leptin, interleukin 6 (IL-6) and tumor necrosis factor-alpha (TNF- α) in a quantitative way. To assess the methodological quality (or risk of bias) of individual studies, Effective Public Health Practice Project assessment tool will be used. The meta-analysis will be performed using the Review Manager software.O exercício físico é eficaz na modulação dos marcadores inflamatórios circulantes da obesidade. Porém, pouco se sabe sobre os efeitos de intervenções com programas de exercícios físicos acompanhados de orientações nutricionais e/ou psicológicas, configurando-se como programas multicomponentes. Assim, o objetivo deste protocolo é propor uma revisão sistematicamente das evidências relacionadas aos efeitos de intervenções multicomponentes para perda de peso na modulação de marcadores inflamatórios circulantes em crianças e adolescentes. Para tanto, as seguintes bases de dados serão pesquisadas para identificar todos os artigos relevantes: PubMed, SciELO, Lilacs, Web of Science, EMBASE, Scopus, SPORT Discus. Serão incluídos ensaios clínicos randomizados e estudos quase experimentais com crianças e adolescentes (6 a 18 anos). As intervenções elegíveis terão como foco a melhora dos comportamentos relacionados ao peso (incluindo dieta, atividade física, modificação de comportamento e/ou combinações dos mesmos). Dois revisores independentes selecionarão estudos usando o software Rayyan QCRI e extrairão os dados em um formulário padrão. O principal resultado da revisão serão os valores circulantes de leptina, interleucina 6 (IL-6) e fator de necrose tumoral alfa (TNF-α) de forma quantitativa. Para avaliar a qualidade metodológica (ou risco de viés) de estudos individuais será utilizada a ferramenta de avaliação Effective Public Health Practice Project. A meta-análise será realizada no software Review Manager

High-intensity interval training in normobaric hypoxia leads to greater body fat loss in overweight/obese women than high-intensity interval training in normoxia

Un estímulo hipóxico moderado se considera una modalidad terapéutica prometedora para varios estados patológicos, incluida la obesidad. Hay pruebas científicas que sugieren que cuando se combinan la hipoxia y la actividad física, podrían aportar beneficios a la población obesa. El objetivo del presente estudio fue investigar si la exposición a la hipoxia combinada con dos protocolos diferentes de ejercicio de intervalo de alta intensidad en mujeres con sobrepeso/obesas era más eficaz en comparación con el ejercicio en la normoxia. Los participantes en el estudio incluyeron 82 mujeres con sobrepeso/obesas, que iniciaron un programa de 12 semanas de 36 sesiones, y fueron divididas al azar en cuatro grupos: (1) entrenamiento de intervalo aeróbico en hipoxia (AitH; FiO2 = 17,2%; n = 13), (2) entrenamiento de intervalo aeróbico en normoxia (AitN; n = 15), (3) entrenamiento de intervalo de sprint en hipoxia (SitH; n = 15), y (4) entrenamiento de intervalo de sprint en normoxia (SitN; n = 18). Se evaluaron la masa corporal, el índice de masa corporal, el porcentaje de masa grasa total, la masa muscular, el índice metabólico basal, la oxidación de grasas y carbohidratos y la energía de las grasas y los carbohidratos. Los resultados se midieron en la línea de base (T1), después de 18 sesiones de entrenamiento (T2), 7 días después de la última sesión (T3) y 4 semanas después de la última sesión (T4). La masa grasa en el grupo SitH se redujo significativamente en comparación con el grupo SitN de T1 a T3 (p < 0,05) y de T1 a T4 (p < 0,05) y la masa muscular aumentó significativamente de T1 a T4 (p < 0,05). La masa grasa en el grupo AitH disminuyó significativamente (p < 0,01) y la masa muscular aumentó (p = 0,022) en comparación con el grupo AitN de T1 a T4. Todos los grupos de entrenamiento mostraron una reducción del porcentaje de masa grasa, con una reducción estadísticamente significativa en los grupos de hipoxia (p < 0,05). La masa muscular aumentó significativamente en los grupos de hipoxia (p < 0,05), especialmente en T4. Mientras que la oxidación de las grasas tendió a aumentar y la oxidación de los hidratos de carbono tendió a disminuir en ambos grupos de hipoxia, la tendencia se invirtió en los grupos de normoxia. Así pues, el entrenamiento con intervalos de alta intensidad bajo hipoxia intermitente normobárica durante 12 semanas en mujeres con sobrepeso/obesas parece ser prometedor para reducir el contenido de grasa corporal con un aumento concomitante de la masa muscular.A moderate hypoxic stimulus is considered a promising therapeutic modality for several pathological states including obesity. There is scientific evidence suggesting that when hypoxia and physical activity are combined, they could provide benefits for the obese population. The aim of the present study was to investigate if exposure to hypoxia combined with two different protocols of high-intensity interval exercise in overweight/obese women was more effective compared with exercise in normoxia. Study participants included 82 overweight/obese women, who started a 12 week program of 36 sessions, and were randomly divided into four groups: (1) aerobic interval training in hypoxia (AitH; FiO2 = 17.2%; n = 13), (2) aerobic interval training in normoxia (AitN; n = 15), (3) sprint interval training in hypoxia (SitH; n = 15), and (4) sprint interval training in normoxia (SitN; n = 18). Body mass, body mass index, percentage of total fat mass, muscle mass, basal metabolic rate, fat, and carbohydrate oxidation, and fat and carbohydrate energy were assessed. Outcomes were measured at baseline (T1), after 18 training sessions (T2), 7 days after the last session (T3), and 4 weeks after the last session (T4). The fat mass in the SitH group was significantly reduced compared with the SitN group from T1 to T3 (p < 0.05) and from T1 to T4 (p < 0.05) and muscle mass increased significantly from T1 to T4 (p < 0.05). Fat mass in the AitH group decreased significantly (p < 0.01) and muscle mass increased (p = 0.022) compared with the AitN group from T1 to T4. All training groups showed a reduction in the percentage of fat mass, with a statistically significant reduction in the hypoxia groups (p < 0.05). Muscle mass increased significantly in the hypoxia groups (p < 0.05), especially at T4. While fat oxidation tended to increase and oxidation of carbohydrates tended to decrease in both hypoxia groups, the tendency was reversed in the normoxia groups. Thus, high-intensity interval training under normobaric intermittent hypoxia for 12 weeks in overweight/obese women seems to be promising for reducing body fat content with a concomitant increase in muscle mass.• Junta de Extremadura. Ayuda GR15020, para el Grupo de investigación GAEDAF • Ministerio de Educación, Cultura y Deporte. Beca FPU15/00450peerReviewe

Acute effects of block jumps in female volleyball players: the role of performance level

Aunque el papel de la capacidad de salto en las jugadoras de voleibol es bien conocido, el efecto de la fatiga en esta habilidad no es bien conocido. El objetivo del presente estudio fue examinar el efecto de una serie de saltos en bloque (BJ) en la capacidad de salto y si varía según el nivel de rendimiento. Diez jugadores de voleibol femenino de élite (EG) y 11 aficionados (AG) realizaron una intervención de fatiga que consistió en 45 BJ, que se probaron para el salto de sentadilla (SJ), el salto de contramovimiento (CMJ) y BJ antes y después de la intervención. Índice de elasticidad (EI): (100 x (CMJ - SJ) / SJ) e índice de coordinación de las extremidades superiores (ULCI): se calcularon (100 x (BJ - CMJ) / CMJ). Después de la intervención, EG mostró una disminución de 4.40% en la altura de BJ (p = 0.04; ES = 0.40), mientras que AG presentó un aumento de 1.27%, que no fue significativo (p = 0.57; ES = 0.07). Sin embargo, EG y AG no presentaron diferencias significativas en SJ (p = 0.965 y p = 0.655) y CMJ (p = 0.742 yp = 0.211) cuando se compararon los valores iniciales con la intervención posterior. Aunque EI y ULCI no mostraron diferencias significativas después de la intervención en ningún grupo (AG: p = 0.989 y p = 0.114; EG: p = 0.242 yp = 0.205, respectivamente), AG presentó un tamaño de efecto medio (ES = 0.50) en EI y una pequeña en ULCI (ES = 0.37), también EG mostró un efecto medio-grande en ULCI (ES = 0.75). Estos hallazgos sugieren que el rendimiento de EG en BJ tiende a disminuir al final de una práctica específica de entrenamiento de salto. Por lo tanto, los entrenadores y preparadores físicos que trabajan con jugadores de voleibol de élite deben concentrarse en los ejercicios para mantener la capacidad de salto durante un partido.Although the role of jumping ability in female volleyball players is well recognised, the effect of fatigue on this ability is not well known. The aim of the present study was to examine the effect of a series of block jumps (BJ) on jumping ability and whether it varies by performance level. Ten elite (EG) and 11 amateur (AG) female volleyball players performed a fatigue intervention consisting of 45 BJ, being tested for squat jump (SJ), countermovement jump (CMJ) and BJ before and after the intervention. Elasticity index (EI): (100 x (CMJ - SJ)/SJ) and upper limbs coordination index (ULCI): (100 x (BJ - CMJ)/CMJ) were calculated. After the intervention, EG showed a decrease of 4.40% in BJ height (p = 0.04; ES = 0.40), whereas AG presented an increase of 1.27%, which was not significant (p = 0.57; ES = 0.07). However, EG and AG presented no significant differences in SJ (p = 0.965 and p = 0.655) and CMJ (p = 0.742 and p = 0.211) when comparing baseline with post-intervention. Although EI and ULCI showed no significant differences after intervention in any group (AG: p = 0.989 and p = 0.114; EG: p = 0.242 and p = 0.205, respectively), AG presented a medium effect size (ES = 0.50) in EI and a small one in ULCI (ES = 0.37), also EG showed a medium-large effect in ULCI (ES = 0.75). These findings suggest that EG performance in BJ tends to decrease at the end of a specific jump training practice. Therefore, coaches and fitness trainers working with elite volleyball players should focus on exercises to maintain jumping ability during a match.• Junta de Extremadura. Ayuda GR15020peerReviewe

Anthropometric and physical performance of youth handball players: The role of the relative age

FUNDAMENTOS: El efecto de la edad relativa es esencial a lo largo de todos los procesos de selección de talentos en el deporte, especialmente durante la adolescencia, lo que deja menos atletas dentro de cada cohorte que nacen al final del año seleccionado. El objetivo del presente estudio fue examinar el papel de la edad relativa en las características antropométricas y de rendimiento físico de los jóvenes jugadores de balonmano por sexo. MÉTODOS: La muestra que se seleccionó incluyó 47 participantes (varón n = 23, mujer n = 24). La recolección de datos incluyó parámetros antropométricos, de composición corporal y de niveles de rendimiento físico. RESULTADOS: Hubo una representación significativamente mayor de jugadores en el primer semestre en comparación con el segundo semestre, para todos los grupos de género, excepto para los jugadores masculinos seleccionados. En los varones, se encontraron diferencias estadísticamente significativas en altura, altura sentada, peso, envergadura, circunferencias de brazos y piernas, y en la velocidad de los lanzamientos (en apoyo y en suspensión) entre los jugadores que nacieron en el primer y segundo semestre. CONCLUSIÓN: Los resultados confirmaron un efecto de edad relativa en los jugadores nacidos en 2002 que fueron seleccionados para participar en el Campeonato de España, que fue diferente para hombres y mujeres. A pesar de este efecto, que sólo apareció en las hembras, aparecieron diferencias significativas en las condiciones antropométricas y físicas de los jugadores masculinos.BACKGROUND: The relative age effect is essential throughout all of the talent selection processes in sports, especially during adolescence, which leaves fewer athletes within each cohort that are born late in the selected year. The aim of the present study was to examine the role of relative age in anthropometric and physical performance characteristics of youth handball players by gender. METHODS: The sample that was selected included 47 participants (male n = 23, female n = 24). The data collection included anthropometric, body compositions parameters, and physical performance levels. RESULTS: There was a significantly higher representation of players in the first semester in comparison with the second semester, for all of the gender groups, except for the selected male players. In males, statistically significant differences were found in height, sitting height, weight, wingspan, arm and leg circumferences, and in throws speed (in support and in suspension) between those players that were born in the first and second semester. CONCLUSION: The results confirmed an effect of relative age in the players born in 2002 that were selected to participate in the Spanish Championship, which was different for males and females. In spite of this effect, which only appeared in females, significant differences in the anthropometric and physical conditions appeared in the male players.• Junta de Extremadura y Programa FEDER. bECA gr15020 • Ministerio de Educación, Cultura y Deportes. Beca FPU15/00450 y FPU15/00452peerReviewe

Is the frequency of breakfast consumption associated with life satisfaction in children and adolescents? A cross-sectional study with 154,151 participants from 42 countries

Background: The promotion of daily breakfast consumption and the importance of making appropriate breakfast choices have been underscored as significant public health messages. The aim of this study was to examine the relationship between breakfast frequency and life satisfaction in large and representative samples of school-going children and adolescents aged 10–17 years from 42 different countries. Methods: This study used information from the 2017/2018 Health Behavior in School-aged Children study, comprising nationally representative samples of children and adolescents aged 10–17 years who were attending school. The total number of participants from the 42 countries included in the study was 155,451 (51.3% girls). The evaluation of breakfast consumption in this study involved a specific question: “How often do you typically have breakfast (more than a glass of milk or fruit juice)?”. To measure life satisfaction, a subjective assessment scale was used in the form of a ladder, visually spanning from 0 to 10. On this scale, the topmost point (10) denotes the highest conceivable quality of life, whereas the bottom point (0) represents the worst imaginable quality of life. Results: After adjusting for several covariates, the lowest estimated marginal mean of life satisfaction was identified in those participants who skipped breakfast (mean [M] = 5.6, 95% confidence interval [CI] 5.5 to 5.8). Conversely, the highest estimated marginal mean of life satisfaction was observed in those who had breakfast every day (M = 6.5, 95% CI 6.3 to 6.6). Overall, a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents was identified (p-for-trend &lt; 0.001). In addition, the highest estimated marginal mean of life satisfaction score was identified in those participants from Portugal who had breakfast every day (M = 7.7; 95% CI 6.9 to 8.5 points). Conversely, the lowest estimated marginal mean of life satisfaction was observed in those participants from Romania who no breakfast (M = 3.5; 95% CI 2.6 to 4.4 points). Conclusions: There is a nearly linear relationship between higher frequency of breakfast and greater life satisfaction in children and adolescents. Considering the potential health advantages associated with breakfast during this critical age phase, these findings imply the necessity for additional global efforts to promote increased breakfast consumption among children and adolescents

Results From Spain’s 2022 Para Report Cards on Physical Activity of Children and Adolescents With Disabilities

This report aims to provide a better understanding of physical activity (PA) and related factors among Spanish children and adolescents living with disabilities. The 10 indicators used for the Global Matrix on Para Report Cards of children and adolescents living with disabilities were evaluated based on the best available data in Spain. An analysis of strengths, weaknesses, opportunities, and threats based on data provision was drafted by three experts and critically reviewed by the authorship team to provide a national perspective for each evaluated indicator. Government was the indicator with the highest grade (C+), followed by Sedentary Behaviors (C−), School (D), Overall PA (D−), and Community & Environment (F). The remaining indicators received an incomplete grade. There were low levels of PA in Spanish children and adolescents living with disabilities. Yet, opportunities to improve the current surveillance of PA among this population exist.9 página

Global matrix 4.0 physical activity report card grades for children and adolescents : results and analyses from 57 countries

Background: The Global Matrix 4.0 on physical activity (PA) for children and adolescents was developed to achieve a comprehensive understanding of the global variation in children’s and adolescents’ (5–17 y) PA, related measures, and key sources of influence. The objectives of this article were (1) to summarize the findings from the Global Matrix 4.0 Report Cards, (2) to compare indicators across countries, and (3) to explore trends related to the Human Development Index and geo-cultural regions. Methods: A total of 57 Report Card teams followed a harmonized process to grade the 10 common PA indicators. An online survey was conducted to collect Report Card Leaders’ top 3 priorities for each PA indicator and their opinions on how the COVID-19 pandemic impacted child and adolescent PA indicators in their country. Results: Overall Physical Activity was the indicator with the lowest global average grade (D), while School and Community and Environment were the indicators with the highest global average grade (C+). An overview of the global situation in terms of surveillance and prevalence is provided for all 10 common PA indicators, followed by priorities and examples to support the development of strategies and policies internationally. Conclusions: The Global Matrix 4.0 represents the largest compilation of children’s and adolescents’ PA indicators to date. While variation in data sources informing the grades across countries was observed, this initiative highlighted low PA levels in children and adolescents globally. Measures to contain the COVID-19 pandemic, local/international conflicts, climate change, and economic change threaten to worsen this situation

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Efectos del grado de entrenamiento sobre parámetros ergoespirométricos, metabólicos y de estrés oxidativo en diferentes intensidades de esfuerzo

El ejercicio físico está reconocido por tener múltiples efectos beneficiosos para el organismo (Cooper y cols., 2002; Cornelissen y cols., 2010), especialmente en la prevención de enfermedades cardiovasculares, que conllevan la disminución del riesgo de muerte por estas causas (Erikssen y cols., 1998). La cantidad de ejercicio, así como el nivel de intensidad influyen directamente sobre los beneficios que éste puede aportar (Fentem, 1978; O'Donovan y cols., 2010). En el presente estudio, sujetos con diferentes niveles de entrenamiento han sido sometidos a un esfuerzo incremental máximo en cicloergómetro, registrándose datos ergoespirométricos, de metabolismo energético, de peroxidación lipídica y de antioxidantes no enzimáticos, para conocer el efecto del nivel de entrenamiento de los sujetos sobre estos parámetros y poder aportar conclusiones que informen del daño o beneficio que producen los diferentes niveles de actividad física en el organismo. Por ello, los objetivos de este estudio son: 1. Estudiar el efecto de una prueba incremental máxima y su recuperación a corto plazo sobre parámetros ergoespirométricos en sujetos con diferentes niveles de condición física. 2. Evaluar el metabolismo energético en sujetos con diferentes niveles de condición física durante un esfuerzo incremental máximo y una recuperación a corto plazo. 3. Determinar qué niveles de esfuerzo, en un protocolo incremental máximo, provocan menor daño celular medido a través de la respuesta antioxidante y de marcadores de estrés oxidativo en sujetos con diferentes niveles de condición física. 4. Establecer relaciones existentes entre parámetros ergoespirométricos, parámetros de metabolismo energético, marcadores de estrés oxidativo y de respuesta antioxidante. La muestra participante en el estudio estaba compuesta de un total de 60 sujetos voluntarios divididos en tres grupos en función del nivel de entrenamiento que presentaban: sedentarios (24 ± 3,02 años), moderadamente entrenados (23,53 ± 1,85 años) y entrenados (23,29 ± 2,73 años). Todos eran varones, no fumadores y no presentaban ningún problema de salud. Con el objetivo de poder comparar a los diferentes sujetos en la realización de un protocolo de esfuerzo incremental máximo, se han tomado como referencias los mismos puntos en todos los sujetos, siendo Inical para la muestra basal, Umbral Aeróbico para la muestra del primer umbral ventilatorio, Umbral Anaeróbico para la muestra del segundo umbral ventilatorio, Final para la muestra recogida en el último escalón de esfuerzo completado, Recuperación a los cinco minutos para la muestra recogida a los cinco minutos de la finalización de la prueba y Recuperación a los quince minutos para la muestra recogida a los quince minutos de la finalización de la prueba. Las principales conclusiones del presente estudio son: - Los sujetos sedentarios son los que presentan un mayor peso, un mayor porcentaje graso y un menor consumo de grasas durante la realización de un ejercicio incremental máximo. - El punto en el que la utilización de grasas es mayor (FAT máx) se encuentra por debajo del umbral aeróbico establecido. - El estrés oxidativo y la respuesta antioxidante son mayores cuanto mayor es el grado de entrenamiento. - Un mayor consumo máximo de oxígeno está altamente relacionado con un mayor consumo de grasas. - Un entrenamiento de resistencia de intensidades cercanas e inferiores al umbral anaeróbico y con una frecuencia de entre 7 y 20 horas semanales puede reportar grandes beneficios para la salud a nivel cardiorrespiratorio, metabólico y respuesta antioxidante