Open Access
Construct validity and test-retest reliability of the International Fitness Scale (IFIS) in Colombian children and adolescents aged 9-17.9 years: the FUPRECOL study
(PeerJ, 2017) Ramírez Vélez, Robinson; Cruz Salazar, Sandra Milena; Martínez, Myriam; Lusa Cadore, Eduardo; Alonso Martínez, Alicia; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; Ortega, Francisco B.; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: there is a lack of instruments and studies written in Spanish evaluating physical fitness, impeding the determination of the current status of this important health indicator in the Latin population, especially in Colombia. The aim of the study was two-fold: to examine the validity of the International Fitness Scale (IFIS) with a population-based sample of schoolchildren from Bogota, Colombia and to examine the reliability of the IFIS with children and adolescents from Engativa, Colombia. Methods: the sample comprised 1,873 Colombian youths (54.5% girls) aged 9–17.9 years. We measured their adiposity markers (waist-to-height ratio, skinfold thickness, percentage of body fat and body mass index), blood pressure, lipids profile, fasting glucose, and physical fitness level (self-reported and measured). A validated cardiometabolic risk index score was also used. An age- and sex-matched subsample of 229 schoolchildren who were not originally included in the sample completed the IFIS twice for reliability purposes. Results: our data suggest that both measured and self-reported overall physical fitness levels were inversely associated with percentage of body fat indicators and the cardiometabolic risk index score. Overall, schoolchildren who self-reported “good” or “very good” fitness had better measured fitness levels than those who reported “very poor/poor” fitness (all p < 0.001). The test-retest reliability of the IFIS items was also good, with an average weighted kappa of 0.811. Discussion: our findings suggest that self-reported fitness, as assessed by the IFIS, is a valid, reliable, and health-related measure. Furthermore, it can be a good alternative for future use in large studies with Latin schoolchildren from Colombia.
Open Access
Can physical activity attenuate the negative association between sitting time and cognitive function among older adults? A mediation analysis
(Elsevier, 2018) García Hermoso, Antonio; Ramírez Vélez, Robinson; Celis Morales, Carlos; Olloquequi, Jordi; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
The purpose of this study was to examine the combined association of sitting time and physical activity with cognitive function and to determine whether moderate-to-vigorous physical activity (MVPA) is a mediator of the association between sitting time and cognitive function in a nationally representative sample of older adults from Chile. Data from 989 older adults (≥65 years old, 61.3% female) from the 2009–2010 Chilean Health Survey were analyzed. Physical activity and sitting time were measured using the Global Physical Activity questionnaire. Cognitive function was assessed using the modified Mini-Mental State levels Examination. Physical activity levels were categorized as 'inactive' (<600 metabolic equivalent value minutes per week) or 'active' (≥600 metabolic equivalent value minutes per week). Sitting time was categorized as 'sedentary', defined as ≥4 h of reported sitting time per day, or 'non-sedentary', defined as <4 h. We created the following groups (i) non-sedentary/active; (ii) non-sedentary/inactive; (iii) sedentary/active; and (iv) sedentary/inactive. Hayes's PROCESS macro was used for the simple mediation analysis. Compared with the reference group (individuals classified as non-sedentary/active), older adults who were classified as sedentary/active had elevated odds of cognitive impairment (OR = 1.90, [95% CI, 1.84 to 3.85]). However, the odds ratio for cognitive impairment was substantially increased in those classified as sedentary/inactive (OR = 4.85 [95% CI, 2.54 to 6.24]) compared with the reference group. MVPA was found to mediate the relationship between sitting time and cognitive function (Indirect Effect = −0.070 [95% CI, −0.012 to −0.004]). Conclusion: The present findings suggest that, whether overall physical activity is high or low, spending large amounts of time sitting is associated with elevated odds of cognitive impairment and that MVPA slightly weakens the relationship between sitting time and cognitive function.
Open Access
Incidence of type 1 diabetes mellitus in children and adolescents under 20 years of age across 55 countries from 2000 to 2022: a systematic review with meta-analysis
(Wiley, 2023) Hormazábal Aguayo, Ignacio; Ezzatvar, Yasmin; Huerta Uribe, Nidia; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Aims: the aim of this study was to determine the global incidence of type 1 diabetes mellitus (T1DM) in children and adolescents under 20 years of age from 2000 to 2022. Materials and methods: two reviewers searched three electronic databases (PubMed, Web of Science, and CINAHL) for studies published between January 2000 and November 2022. Pooled estimates of T1DM incidence with a 95% confidence interval (CI) per 100,000 person-years were calculated by country/region, sex, age, and COVID-19 pandemic period (pre-COVID-19 and pandemic). Results: the study included 126 studies from 55 countries and 18 regions. The incidence rate (IR) of T1DM from 2000 to 2022 was 14.07 (95%CI, 12.15-16.29) per 100,000 person-years. Finland and high-income North America had the highest IR, with 56.81 (95%CI, 55.91-57.73) and 28.77 (95%CI, 26.59-31.13) per 100,000 person-years, respectively. The IR was 13.37 (95%CI, 10.60-16.88) per 100,000 person-years in boys and 13.87 (95%CI, 11.51-16.70) per 100,000 person-years in girls. There were statistically significant differences among different age ranges: 0-4 versus 5-9 and 10-14 years old (p < 0.001); 5-9 versus 15-19 (p < 0.001) and 10- 14 versus 15-19 years old (p = 0.003). Finally, during the pandemic period (2020-2022), the IR was 24.84 (95%CI, 17.16-35.96) per 100,000 person-years, which was higher but not significant compared with the prepandemic period (2017-2019) of 13.56 (95%CI, 7.49-24.56) per 100,000 person-years (p = 0.090). Conclusions: the IR of T1DM in children and adolescents under 20 years of age is substantial, especially during the pandemic period, although it varies across regions. More reliable data from additional countries are needed to determine the worldwide incidence of T1DM.
Open Access
Prevalence of non-responders for glucose control markers after 10 weeks of high-intensity interval training in adult women with higher and lower insulin resistance
(Frontiers Media, 2017) Álvarez, Cristian; Ramírez Campillo, Rodrigo; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: Exercise training improves performance and biochemical parameters on average, but wide interindividual variability exists, with individuals classified as responders (R) or non-responders (NRs), especially between populations with higher or lower levels of insulin resistance. This study assessed the effects of high-intensity interval training (HIIT) and the prevalence of NRs in adult women with higher and lower levels of insulin resistance. Methods: Forty adult women were assigned to a HIIT program, and after training were analyzed in two groups; a group with higher insulin resistance (H-IR, 40 ± 6 years; BMI: 29.5 ± 3.7 kg/m2; n = 20) and a group with lower insulin resistance (L-IR, 35 ± 9 years; 27.8 ± 2.8 kg/m2; n = 20). Anthropometric, cardiovascular, metabolic, and performance variables were measured at baseline and after 10 weeks of training. Results: There were significant training-induced changes [delta percent (Δ%)] in fasting glucose, fasting insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) scores in the H-IR group (−8.8, −26.5, −32.1%, p < 0.0001), whereas no significant changes were observed in the L-IR. Both groups showed significant pre-post changes in other anthropometric variables [waist circumference (−5.2, p < 0.010, and −3.8%, p = 0.046) and tricipital (−13.3, p < 0.010, and −13.6%, p < 0.0001), supra-iliac (−19.4, p < 0.0001, and −13.6%, p < 0.0001), and abdominal (−18.2, p < 0.0001, and −15.6%, p < 0.010) skinfold measurements]. Systolic blood pressure decreased significantly only in the L-IR group (−3.2%, p < 0.010). Both groups showed significant increases in 1RMLE (+12.9, p < 0.010, and +14.7%, p = 0.045). There were significant differences in the prevalence of NRs between the H-IR and L-IR groups for fasting glucose (25 vs. 95%, p < 0.0001) and fasting insulin (p = 0.025) but not for HOMA-IR (25 vs. 45%, p = 0.185). Conclusion: Independent of the “magnitude” of the cardiometabolic disease (i.e., higher vs. lower insulin resistance), no differences were observed in the NRs prevalence with regard to improved HOMA-IR or to anthropometric, cardiovascular, and muscle performance co-variables after 10 weeks of HIIT in sedentary adult women. This research demonstrates the protective effect of HIIT against cardiometabolic disease progression in a sedentary population.
Open Access
Association between bullying victimization and physical fitness among children and adolescents
(Asociación Española de Psicología Conductual (AEPC), 2019) García Hermoso, Antonio; Oriol Granado, Xavier; Correa Bautista, Jorge Enrique; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Antecedentes/Objetivo: el objetivo del estudio fue analizar la relación entre el bullying y la condición física, y determinar si un nivel físico saludable está relacionado con menor nivel de victimización en niños y adolescentes con sobrepeso y obesidad en comparación con suscompañeros con sobrepeso u obesidad no aptos. Método: se incluyó un total de 7.714 niños y adolescentes (9-17 años), categorizados en peso normal o sobrepeso/obeso y aptos o no aptos a través de puntos de corte específicos para la capacidad aeróbica y fuerza manual en esta población. El bullying (físico, verbal, exclusión social, acoso sexual y cyberbullying) se evaluó a través de autoinforme. Resultados: los jóvenes categorizados como aptos (capacidad cardio-respiratoria) padecen menos bullying en comparación con sus homólogos no aptos. Además, un nivel saludable de capacidad cardiorrespiratoria se relacionó con menor bullying tradicional entre los jóvenes con sobrepeso/obesidad en comparación con sus homólogos no aptos. Conclusiones: la capacidad cardiorrespiratoria se relaciona con un menor riesgo de sufrir acoso escolar tradicional en los jóvenes latinos con y sin obesidad, lo que enfatiza el papel del buen estado físico incluso entre los jóvenes con exceso de adiposidad.
Open Access
Effectiveness of HIIT compared to moderate continuous training in improving vascular parameters in inactive adults
(BMC, 2019) Ramírez Vélez, Robinson; Hernández Quiñonez, Paula Andrea; Tordecilla Sanders, Alejandra; Álvarez, Cristian; Ramírez Campillo, Rodrigo; Izquierdo Redín, Mikel; Correa Bautista, Jorge Enrique; García Hermoso, Antonio; García, Ronald G.; Ciencias de la Salud; Osasun Zientziak
Background: Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases, such as cardiovascular disease (CVD), metabolic syndrome, and breast and colon cancers, and shortens life expectancy. We aimed to determine the effects of moderate (MCT)- versus high-intensity interval training (HIT) on vascular function parameters in physically inactive adults. We hypothesized that individualized HIT prescription would improve the vascular function parameters more than the MCT in a greater proportion of individuals. Methods; Twenty-one inactive adults were randomly allocated to receive either MCT group (60-75% of their heart rate reserve, [HRR] or HIT group (4min at 85-95% of peak HRR), 3 days a week for 12weeks. Vascular function (brachial artery flow-mediated dilation, FMD [%], normalized brachial artery flow-mediated dilation, FMDn [%], aortic pulse wave velocity, PWV [ms(-1)], AIx, augmentation index: aortic and brachial [%]), were measured at baseline and over 12weeks of training. In order for a participant to be considered a responder to improvements in vascular function parameters (FMDn and PWV), the typical error was calculated in a favorable direction. Results: FMD changed by -1.0% (SE 2.1, d=0.388) in the MCT group, and+1.8% (SE 1.8, d=0.699) in the HIT group (no significant difference between groups: 2.9% [95% CI, -3.0 to 8.8]. PWV changed by +0.1ms(-1) (SE 0.2, d=0.087) in the MCT group but decreased by -0.4ms(-1) in the HIT group (SE 0.2, d=0.497), with significant difference between groups: -0.4 [95% CI, -0.2 to -0.7]. There was not a significant difference in the prevalence of no-responder for FMD (%) between the MCT and HIT groups (66% versus 36%, P=0.157). Regarding PWV (ms(-1)), an analysis showed that the prevalence of no-responder was 77% (7 cases) in the MCT group and 45% (5 cases) in the HIT group (P=0.114). Conclusions: Under the conditions of the present study, both groups experienced changed in vascularfunction parameters. Compared to MCT group, HIT is more efficacious for improving FMD and decreasing PWV, in physically inactive adults.
Open Access
Handgrip strength and its relationship with white blood cell count in U.S. adolescents
(MDPI, 2021) López Gil, José Francisco; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, ID 420/2019
Background: The role of muscular fitness (as a protecting factor for an optimal immune system) and WBC count remains unclear. To the best of our knowledge, this is the first study to investigate the relationship between the total count of WBC and groups based on handgrip strength and body composition. The aim of this study was to elucidate the relationship between handgrip strength and WBC count in a nationally representative sample of adolescents from the U.S. Methods: We used data from the NHANES cross-sectional study (waves 2011 to 2014). The final analysis included 917 adolescents from 12–17 years old (51.0% boys). Normalized handgrip strength (kg) (NHS) was relativized by body composition parameters (body weight [NHSw], total body fat [NHSf], and trunk fat [NHSt]) assessed with dual energy X-ray absorptiometry. Results: An inverse association was found between total WBC count and all assessments of low NHS in both sexes (p < 0.05). Both boys and girls with low NHS had higher WBC counts in all estimations of NHS than those with high NHS (p < 0.05 for all). All estimations of low NHS showed significant differences with those with intermediate NHS (only in girls) (p < 0.05 for all). Girls with intermediate NHSt exhibited higher WBC count than those with high NHSt (p = 0.004). Conclusions: Our findings suggest that greater levels of NHS are linked to lower total WBC counts. From a public health perspective, our findings are clinically significant and emphasize the relevance of improving muscular fitness during adolescence since it may contribute to boosting the immune system among adolescents.
Open Access
Factors associated with active commuting to school by bicycle from Bogotá, Colombia: the FUPRECOL study
(BMC, 2016) Ramírez Vélez, Robinson; Beltrán, Cesar Augusto; Correa Bautista, Jorge Enrique; Vivas, Andrés; Prieto Benavides, Daniel Humberto; Martínez Torres, Javier; Triana Reina, Héctor Reynaldo; Villa González, Emilio; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Active commuting to school (ACS) can contribute to daily physical activity (PA) levels in children and adolescents. The aim of the study was to analyze the characteristics of active commuting to and from school by bicycle and to identify the factors associated with the use of bicycles for active commuting to school based in a sample of schoolchildren in Bogotá, Colombia. Methods: A cross-sectional study was conducted in 8,057 children and adolescents. A self-reported questionnaire was used to measure frequency and mode of commuting to school and the time it took them to get there. Weight, height, and waist circumference measurements were obtained using standardized methods, and mothers and fathers self-reported their highest level of educational attainment and household level. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis. Results: 21.9 % of the sample reported commuting by bicycle and 7.9 % reported commuting for more than 120 min. The multivariate logistic regression showed that boys, aged 9-12 years, and those whose parents had achieved higher levels of education (university/postgraduate) were the factors most strongly associated with a use bicycles as a means of active commuting to and from school. Conclusion: The findings of this study suggest that it's necessary to promote ACS from childhood and to emphasize its use during the transition to adolescence and during adolescence itself in order to increase its continued use by students.
Open Access
Global consensus on optimal exercise recommendations for enhancing healthy longevity in older adults (ICFSR).
(Elsevier, 2025-01-01) Izquierdo Redín, Mikel; Souto Barreto, Philipe de; Arai, Hidenori; Bischoff-Ferrari, Heike A.; Lusa Cadore, Eduardo; Cesari, Matteo; Chen, L.-K.; Coen, Paul M.; Courneya, Kerry S.; Duque, Gustavo; Ferrucci, L.; Fielding, R. A.; García Hermoso, Antonio; Gutiérrez Robledo, L.M.; Harridge, S.D.R.; Kirk, B.; Kritchevsky, S.; Landi, F.; Lazarus, N.; Liu-Ambrose, T.; Marzetti, E.; Merchant, R.A.; Morley, John E.; Pitkälä, Kaisu H.; Ramírez Vélez, Robinson; Rodríguez Mañas, Leocadio; Rolland, Y.; Ruiz, J.G.; López Sáez de Asteasu, Mikel; Villareal, D.T.; Waters, D.L.; Won Won, C.; Vellas, Bruno; Fiatarone Singh, Maria; Ciencias de la Salud; Osasun Zientziak
Aging, a universal and inevitable process, is characterized by a progressive accumulation of physiological alterations and functional decline over time, leading to increased vulnerability to diseases and ultimately mortality as age advances. Lifestyle factors, notably physical activity (PA) and exercise, significantly modulate aging phenotypes. Physical activity and exercise can prevent or ameliorate lifestyle-related diseases, extend health span, enhance physical function, and reduce the burden of non-communicable chronic diseases including cardiometabolic disease, cancer, musculoskeletal and neurological conditions, and chronic respiratory diseases as well as premature mortality. Physical activity influences the cellular and molecular drivers of biological aging, slowing aging rates¿a foundational aspect of geroscience. Thus, PA serves both as preventive medicine and therapeutic agent in pathological states. Sub-optimal PA levels correlate with increased disease prevalence in aging populations. Structured exercise prescriptions should therefore be customized and monitored like any other medical treatment, considering the dose-response relationships and specific adaptations necessary for intended outcomes. Current guidelines recommend a multifaceted exercise regimen that includes aerobic, resistance, balance, and flexibility training through structured and incidental (integrated lifestyle) activities. Tailored exercise programs have proven effective in helping older adults maintain their functional capacities, extending their health span, and enhancing their quality of life. Particularly important are anabolic exercises, such as Progressive resistance training (PRT), which are indispensable for maintaining or improving functional capacity in older adults, particularly those with frailty, sarcopenia or osteoporosis, or those hospitalized or in residential aged care. Multicomponent exercise interventions that include cognitive tasks significantly enhance the hallmarks of frailty (low body mass, strength, mobility, PA level, and energy) and cognitive function, thus preventing falls and optimizing functional capacity during aging. Importantly, PA/exercise displays dose-response characteristics and varies between individuals, necessitating personalized modalities tailored to specific medical conditions. Precision in exercise prescriptions remains a significant area of further research, given the global impact of aging and broad effects of PA. Economic analyses underscore the cost benefits of exercise programs, justifying broader integration into health care for older adults. However, despite these benefits, exercise is far from fully integrated into medical practice for older people. Many healthcare professionals, including geriatricians, need more training to incorporate exercise directly into patient care, whether in settings including hospitals, outpatient clinics, or residential care. Education about the use of exercise as isolated or adjunctive treatment for geriatric syndromes and chronic diseases would do much to ease the problems of polypharmacy and widespread prescription of potentially inappropriate medications. This intersection of prescriptive practices and PA/exercise offers a promising approach to enhance the well-being of older adults. An integrated strategy that combines exercise prescriptions with pharmacotherapy would optimize the vitality and functional independence of older people whilst minimizing adverse drug reactions. This consensus provides the rationale for the integration of PA into health promotion, disease prevention, and management strategies for older adults. Guidelines are included for specific modalities and dosages of exercise with proven efficacy in randomized controlled trials. Descriptions of the beneficial physiological changes, attenuation of aging phenotypes, and role of exercise in chronic disease and disability management in older adults are provided. The use of exercise in cardiometabolic
Open Access
Assessing basic motor competences, physical fitness, and executive function in 4-5-year-old children: a longitudinal study in a primary care setting
(BMC, 2024) Legarra Gorgoñón, Gaizka; García Alonso, Yesenia; Ramírez Vélez, Robinson; Alonso Martínez, Loreto; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak
Background: To evaluate the progression of physical fitness (PF), basic motor competence (BMC), and executive function (EF) over one year in children aged 4-5 years at a health center. Methods: In this longitudinal analysis, children's BMC was evaluated using the MOBAK KG test for object and self-movement. The PREFIT Battery gauged PF through handgrip strength, standing long jump, and other fitness measures, while the Early Years Toolbox appraised EF. Results: Adjustments for confounding factors showed notable improvements in BMC, particularly in object movement (OM; mean difference 0.789, p=0.044) and self-movement (SM; mean difference 0.842, p=0.037), with overall MOBAK scores also increasing (mean difference 1.632, p=0.018). Enhancements in the standing long jump (mean difference 9.036 cm, p=0.014) and EF tasks "Mr. Ant" (mean difference 0.669, p<0.001) and "Go/No-Go" (mean difference 0.120, p<0.001) were evident, signifying substantial BMC gains and some progress in PF and EF. Conclusion: This research underscores the positive impact of regular training on BMC and PF in young children. Significant BMC development and associated improvements in PF and EF over the study period highlight the importance of structured activities in early childhood. These findings advocate for standardized training programs to enhance childhood health and encourage active lifestyles.