Open Access
Resistance training and clinical status in patients with postdischarge symptoms after COVID-19: protocol for a randomized controlled crossover trial 'The EXER-COVID Crossover Study'.
(BMC, 2022) Ramírez Vélez, Robinson; Oteiza Olaso, Julio; Casas Fernández de Tejerina, Juan Manuel; García Alonso, Nora; Legarra Gorgoñón, Gaizka; Oscoz Ochandorena, Sergio; Arasanz Esteban, Hugo; García Alonso, Yesenia; Correa Rodríguez, María; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: physical exercise induces a coordinated response of multiple organ systems, including the immune system. In fact, it has been proposed that physical exercise may modulate the immune system. However, the potential effect of an exercise program on COVID-19 survivors has not been investigated. Thus, the aim of this study is to evaluate the modifications in immunological parameters, physical condition, inflammatory profile, and perceived persistent symptoms after 6 weeks of supervised resistance training (RT), in addition to the standard care on the clinical status of patients with persistent COVID-19 symptoms. The objective of this protocol is to describe the scientific rationale in detail and to provide information about the study procedures. Methods/design: a total of 100 patients with postdischarge symptoms after COVID-19 will be randomly allocated into either a group receiving standard care (control group) or a group performing a multicomponent exercise program two times a week over a period of 6 weeks. The main hypothesis is that a 6-week multicomponent exercise program (EXER-COVID Crossover Study) will improve the immunological and inflammatory profile, physical condition, and persistent perceived symptoms (fatigue/tiredness, musculoskeletal pain, and shortness of breath) in patients with postdischarge symptoms after COVID-19. Discussion: our results will provide insights into the effects of a multicomponent exercise program on immunological parameters, physical condition, inflammatory profile, and persistent perceived symptoms in patients with postdischarge symptoms after COVID-19. Information obtained by this study will inform future guidelines on the exercise training rehabilitation of patients with postdischarge symptoms after COVID-19.
Open Access
The dietary inflammatory index and hepatic health in the US adult population
(The British Dietetic Association Ltd, 2021) Ramírez Vélez, Robinson; García Hermoso, Antonio; Izquierdo Redín, Mikel; Correa Rodríguez, María; Ciencias de la Salud; Osasun Zientziak
Background: There is limited evidence on the role of an anti‐/pro‐inflammatory diet in the prevention of non‐alcoholic fatty liver disease (NAFLD). We aimed (i) to assess the anti‐inflammatory diet profile and its association with transient elastography parameters, including liver stiffness measurement (LSM) and controlled attenuation parameter (CAP), and (ii) to analyse the relationship between the anti‐inflammatory diet and surrogate markers of liver disease in a multiethnic US population. Methods: A cross‐sectional study was conducted on a nationally representative population of 4189 US adults aged 20–80 years. A FibroScan® 502 V2 device (Echosens) was used to estimate the CAP and LSM. Liver markers, including the aspartate transaminase (AST) to alanine transaminase (ALT) ratio, fatty liver index (FLI) and fibrosis‐4 score, were also calculated. The Dietary Inflammatory Index (DII) was calculated using a 24‐h diet recall. Results: Lower DII scores (anti‐inflammatory diet) were associated with a lower AST:ALT ratio (p < 0.001) and FLI (p < 0.036) after adjusting for covariates. Linear regression analysis revealed that gamma‐glutamyl transferase levels (β = 1.702, 95% confidence interval [CI] = 0.325–3.080, p = 0.015), ALT levels (β = −0.616, 95% CI = −1.097 to −0.135, p = 0.012), AST:ALT ratio (β = 0.025, 95% CI = 0.014–0.036, p < 0.001) and FLI (β = 1.168, 95% CI = 0.224–2.112, p = 0.015) were significantly associated with the DII in the multivariable‐adjusted model. Participants in the highest anti‐inflammatory tertile had the lowest odds ratio (OR) for NAFLD assessed by FLI in both unadjusted (OR = 0.652, 95% CI = 0.539–0.788, p ≤ 0.001) and adjusted models (OR = 0.722, 95% CI = 0.537–0.972, p = 0.032). For the transient elastography parameters (LSM and CAP), no significant associations were identified. Conclusions: There was no relationship between the transient elastography parameters and the anti‐inflammatory diet profile, although our study showed an association between higher pro‐inflammatory properties of diet and poorer hepatic health assessed by surrogate markers of liver disease. Therefore, strategies to promote an anti‐inflammatory diet should be considered to prevent NAFLD in adults.

Ramírez Vélez, Robinson

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