Open Access
Liver fat content and body fat distribution in youths with excess adiposity
(MDPI, 2018) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Correa Bautista, Jorge Enrique; Correa Rodríguez, María; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; González Ruiz, Katherine; Ciencias de la Salud; Osasun Zientziak
This study had two main objectives: To examine the association between body fat distribution and non-alcoholic fatty liver disease (NAFLD) and liver fat content, and to determine whether the relationship between NAFLD and regional body fat distribution, with respect to liver fat content in youths with excess adiposity, is independent of cardiorespiratory fitness (CRF) and a healthy diet. Liver fat content (controlled attenuation parameter (CAP)), body fat distribution (body mass index (BMI) z-score, waist circumference, waist-to-height ratio, fat mass/height, body fat percentage, total fat mass, android-to-gynoid fat mass ratio, visceral adipose tissue (VAT), and lean mass index, determined by dual-energy X-ray absorptiometry (DXA)), CRF (20-m shuttle-run test), and healthy diet (adherence to the Mediterranean diet by KIDMED questionnaire) were measured in 126 adolescents (66% girls) aged between 11 and 17 years. Participants were assigned to two groups according to the presence or absence of hepatic steatosis (CAP values >225 dB/m or <225 dB/m of liver fat, respectively). Considering the similar total fat values for the two groups (>30% by DXA), youths with NAFLD had higher fat distribution parameters than those without NAFLD, regardless of sex, age, puberty stage, lean mass index, CRF, and healthy diet (p < 0.01). In the non-NAFLD group, the association between hepatic fat and fat distribution parameters presented a similar pattern, although the association was statistically insignificant after adjusting for a potential confounding variable (ps > 0.05), except for the case of VAT. Body fat distribution parameters were higher in youths with NAFLD compared to those without NAFLD. Additionally, body fat distribution showed a significant association with liver fat content as assessed by CAP in youths with NAFLD independent of CRF and adherence to the Mediterranean diet, supporting the notion that upper body fat distribution might play a pivotal role in the development of NAFLD in adolescents. These results may have implications for the clinical management of youths with excess adiposity given the high prevalence of NAFLD in children and young adults.
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
Similar cardiometabolic effects of high- and moderate-intensity training among apparently healthy inactive adults: a randomized clinical trial
(BioMed Central, 2017) Ramírez Vélez, Robinson; Tordecilla Sanders, Alejandra; Téllez Tinjaca, Luis Andrés; Camelo Prieto, Diana; Hernández Quiñonez, Paula Andrea; Correa Bautista, Jorge Enrique; García Hermoso, Antonio; Ramírez Campillo, Rodrigo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: Metabolic syndrome (MetS) increases the risk of morbidity and mortality from cardiovascular disease, and exercise training is an important factor in the treatment and prevention of the clinical components of MetS. Objective: The aim was to compare the effects of high-intensity interval training and steady-state moderate-intensity training on clinical components of MetS in healthy physically inactive adults. Methods: Twenty adults were randomly allocated to receive either moderate-intensity continuous training [MCT group; 60–80% heart rate reserve (HRR)] or high-intensity interval training (HIT group; 4 × 4 min at 85–95% peak HRR interspersed with 4 min of active rest at 65% peak HRR). We used the revised International Diabetes Federation criteria for MetS. A MetS Z-score was calculated for each individual and each component of the MetS. Results: In intent-to-treat analyses, the changes in MetS Z-score were 1.546 (1.575) in the MCT group and −1.249 (1.629) in the HIT group (between-groups difference, P = 0.001). The average number of cardiometabolic risk factors changed in the MCT group (−0.133, P = 0.040) but not in the HIT group (0.018, P = 0.294), with no difference between groups (P = 0.277). Conclusion: Among apparently healthy physically inactive adults, HIT and MCT offer similar cardiometabolic protection against single MetS risk factors but differ in their effect on average risk factors per subject.
Open Access
Normative reference values for the 20 m shuttle-run test in a population-based sample of school-aged youth in Bogota, Colombia: the FUPRECOL study
(Wiley, 2017) Ramírez Vélez, Robinson; Palacios López, Adalberto; Prieto Benavides, Daniel Humberto; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak
Objectives: Our aim was to determine the normative reference values of cardiorespiratory fitness (CRF) and to establish the proportion of subjects with low CRF suggestive of future cardio‐metabolic risk. Methods: A total of 7244 children and adolescents attending public schools in Bogota, Colombia (55.7% girls; age range of 9–17.9 years) participated in this study. We expressed CRF performance as the nearest stage (minute) completed and the estimated peak oxygen consumption (V˙O2peak). Smoothed percentile curves were calculated. In addition, we present the prevalence of low CRF after applying a correction factor to account for the impact of Bogota's altitude (2625 m over sea level) on CRF assessment, and we calculated the number of participants who fell below health‐related FITNESSGRAM cut‐points for low CRF. Results: Shuttles and V˙O2peak were higher in boys than in girls in all age groups. In boys, there were higher levels of performance with increasing age, with most gains between the ages of 13 and 17. The proportion of subjects with a low CRF, suggestive of future cardio‐metabolic risk (health risk FITNESSGRAM category) was 31.5% (28.2% for boys and 34.1% for girls; X2 P = .001). After applying a 1.11 altitude correction factor, the overall prevalence of low CRF was 11.5% (9.6% for boys and 13.1% for girls; X2 P = .001).
Open Access
High muscular fitness has a powerful protective cardiometabolic effect in adults: influence of weight status
(BioMed Central, 2016) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Lobelo, Felipe; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Rodríguez Rodríguez, Fernando; Cristi Montero, Carlos; Ciencias de la Salud; Osasun Zientziak
Background: Low levels of muscular fitness (MF) are recognized as an important marker of nutritional status and a predictor of metabolic complications, cardiovascular disease and death, however, the relationship between MF, body mass index (BMI) and the subsequent cardiometabolic protective effects has been less studied among Latin American populations. This study identified an association between MF and the cardiometabolic risk score index (CMRSI) and the lipid-metabolic cardiovascular risk index (LMCRI) in a wide sample of university students grouped according to their BMI. Methods: Six thousand ninety five healthy males (29.6 ± 11.7 year-old) participated in the study. Absolute strength was measured using a T.K.K. analogue dynamometer (handgrip), and the participant’s strength was then calculated relative to their body mass (MF/BM). The LMCRI was derived from the levels of triglycerides, low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and glucose levels in a blood sample. The CMRSI was calculated by summing the standardized residuals (z-score) for waist circumference, total cholesterol, LDL-c, triglycerides, HDL-c, and median blood pressure. Subjects were divided into six subgroups according to BMI (normal vs. overweight/obese) and MF/BM tertiles (unfit, average, fit). Results: The group of participants with low and moderate levels of MF/BM showed higher CMRSI values independent of BMI (P < 0.001). The group with normal BMI and high MF/BM had the highest levels of cardiometabolic protection. All overweight/obese BMI groups had significantly higher LMCRI values independent of the level of MF/BM (P < 0.001). Conclusions: Participants with high MF/BM showed reduced cardiometabolic risk, which increased significantly when they were within normal parameters.
Open Access
Exercise and postprandial lipemia: effects on vascular health in inactive adults
(BioMed Central, 2018) Ramírez Vélez, Robinson; Correa Rodríguez, María; Tordecilla Sanders, Alejandra; Aya Aldana, Viviana; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: There is evidence to suggest that postprandial lipemia are is linked to the impairment of endothelial function, which is characterized by an imbalance between the actions of vasodilators and vasoconstrictors. The aim of this study was to determine the effects of a 12-week high-intensity training (HIT) and moderate continuous training (MCT) protocol on postprandial lipemia, vascular function and arterial stiffness in inactive adults after high-fat meal (HFM) ingestion. Methods: A randomized clinical trial was conducted in 20 healthy, inactive adults (31.6 ± 7.1 years). Participants followed the two exercise protocols for 12 weeks. To induce a state of postprandial lipemia (PPL), all subjects received a HFM. Endothelial function was measured using flow-mediated vasodilation (FMD), normalized brachial artery FMD (nFMD), aortic pulse wave velocity (PWV) and augmentation index (AIx). Plasma total cholesterol, high-density lipoprotein cholesterol (HDL-c), triglycerides and glucose were also measured. Results: The effects of a HFM were evaluated in a fasted state and 60, 120, 180, and 240 min postprandially. A significant decrease in serum glucose between 0 min (fasted state) and 120 min postprandially was found in the HIT group (P = 0.035). Likewise, FMD (%) was significantly different between the fasted state and 60 min after a HFM in the HIT group (P = 0.042). The total cholesterol response expressed as area under curve (AUC)(0–240) was lower following HIT than following MCT, but no significant differences were observed (8%, P > 0.05). Similarly, triglycerides AUC(0–240) was also lower after HIT compared with MCT, which trended towards significance (24%, P = 0.076). The AUC(0–240) for the glucose response was significantly lower following HIT than MCT (10%, P = 0.008). FMD and nFMD AUC(0–240) were significantly higher following HIT than following MCT (46.9%, P = 0.021 and 67.3%, P = 0.009, respectively). PWV AUC(0–240) did not differ following between the two exercise groups (2.3%, P > 0.05). Conclusions: Supervised exercise training mitigates endothelial dysfunction and glucose response induced by PPL. Exercise intensity plays an important role in these protective effects, and medium-term HIT may be more effective than MCT in reducing postprandial glucose levels and attenuating vascular impairment.
Open Access
Active commuting to and from university, obesity and metabolic syndrome among Colombian university students
(BioMed Central, 2018) García Hermoso, Antonio; Quintero, Andrea P.; Hernández, Enrique; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background: There is limited evidence concerning how active commuting (AC) is associated with health benefits in young. The aim of the study was to analyze the relationship between AC to and from campus (walking) and obesity and metabolic syndrome (MetS) in a sample of Colombian university students. Methods: A total of 784 university students (78.6% women, mean age = 20.1 ± 2.6 years old) participated in the study. The exposure variable was categorized into AC (active walker to campus) and non-AC (non/infrequent active walker to campus: car, motorcycle, or bus) to and from the university on a typical day. MetS was defined in accordance with the updated harmonized criteria of the International Diabetes Federation criteria. Results: The overall prevalence of MetS was 8.7%, and it was higher in non-AC than AC to campus. The percentage of AC was 65.3%. The commuting distances in this AC from/to university were 83.1%, 13.4% and 3.5% for < 2 km, 2-5 km and > 5 km, respectively. Multiple logistic regressions for predicting unhealthy profile showed that male walking commuters had a lower probability of having obesity [OR = 0.45 (CI 95% 0.25–0.93)], high blood pressure [OR = 0.26 (CI 95% 0.13–0.55)] and low HDL cholesterol [OR = 0.29 (CI 95% 0.14–0.59)] than did passive commuters. Conclusions: Our results suggest that in young adulthood, a key life-stage for the development of obesity and MetS, AC could be associated with and increasing of daily physical activity levels, thereby promoting better cardiometabolic health.
Open Access
Reliability of health-related physical fitness tests among Colombian children and adolescents: the FUPRECOL study
(Public Library of Science, 2015) Ramírez Vélez, Robinson; Rodrigues Bezerra, Diogo; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; Lobelo, Felipe; Ciencias de la Salud; Osasun Zientziak
Substantial evidence indicates that youth physical fitness levels are an important marker of lifestyle and cardio-metabolic health profiles and predict future risk of chronic diseases. The reliability physical fitness tests have not been explored in Latino-American youth population. This study’s aim was to examine the reliability of health-related physical fitness tests that were used in the Colombian health promotion “Fuprecol study”. Participants were 229 Colombian youth (boys n = 124 and girls n = 105) aged 9 to 17.9 years old. Five components of health-related physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat (%) via impedance; 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4x10 m shuttle run); 4) flexibility component (hamstring and lumbar extensibility, sit-and-reach test); 5) cardiorespiratory component: 20-meter shuttle-run test (SRT) to estimate maximal oxygen consumption. The tests were performed two times, 1 week apart on the same day of the week, except for the SRT which was performed only once. Intra-observer technical errors of measurement (TEMs) and inter-rater (reliability) were assessed in the morphological component. Reliability for the Musculoskeletal, motor and cardiorespiratory fitness components was examined using Bland–Altman tests. For the morphological component, TEMs were small and reliability was greater than 95% of all cases. For the musculoskeletal, motor, flexibility and cardiorespiratory components, we found adequate reliability patterns in terms of systematic errors (bias) and random error (95% limits of agreement). When the fitness assessments were performed twice, the systematic error was nearly 0 for all tests, except for the sit and reach (mean difference: -1.03% [95% CI = -4.35% to -2.28%]. The results from this study indicate that the “Fuprecol study” health-related physical fitness battery, administered by physical education teachers, was reliable for measuring health-related components of fitness in children and adolescents aged 9–17.9 years old in a school setting in Colombia.
Open Access
Muscle strength cut-offs for the detection of metabolic syndrome in a nonrepresentative sample of collegiate students from Colombia
(Elsevier, 2018) García Hermoso, Antonio; Tordecilla Sanders, Alejandra; Correa Bautista, Jorge Enrique; Peterson, Mark Dean; Izquierdo Redín, Mikel; Quino Ávila, Aura Cristina; Sandoval Cuellar, Carolina; González Ruiz, Katherine; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background: Evidence shows an association between grip strength and health; however, grip strength cut-offs for the detection of metabolic syndrome (MetS) in Latin American populations are scarce. The purpose of this study was to determine cut-offs of normalized grip strength (NGS) for the detection of MetS in a large nonrepresentative sample of a collegiate student population from Colombia. Methods: A total of 1795 volunteers (61.4% female, age = 20.68 ± 3.10 years, mean ± SD), ranging between 18 and 30 years of age participated in the study. Strength was estimated using a handheld dynamometer and normalized to body mass (handgrip strength (kg)/body mass (kg)). Anthropometrics, serum lipids indices, blood pressure, and fasting plasma glucose were measured. Body composition was measured by bioelectrical impedance analysis. MetS was defined as including ≥3 of the 5 metabolic abnormalities according to the International Diabetes Federation definition. A metabolic risk score was computed from the following components: waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and systolic and diastolic blood pressure. Results: Receiver operating curve analysis showed significant discriminatory accuracy of NGS in identifying the thresholds and risk categories. Lower strength was associated with increased prevalence of MetS. In males, weak, intermediate, and strong NGS values at these points were <0.466, 0.466–0.615, >0.615, respectively. In females, these cut-off points were <0.332, 0.332–0.437, >0.437, respectively. Conclusion: Our sex-specific cut-offs of NGS could be incorporated into a clinical setting for identifying college students at cardiometabolic disease risk.