Open Access
Exercise during pregnancy on maternal lipids: a secondary analysis of randomized controlled trial
(BioMed Central, 2017) Ramírez Vélez, Robinson; Lobelo, Felipe; Aguilar de Plata, Ana C.; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Today, scientific evidence has supported the popular belief that physical activity is associated with biological health in pregnant women. A randomized controlled trial was used to assess the benefits of physical exercise during pregnancy on maternal lipids in low-income Latina women. Methods: The study included 67 nulliparous low-income Latina women in gestational weeks 16–20, randomly assigned into one of two groups: 1) The exercise group, which took part in aerobic and resistance exercise for 60min, three times a week for 12 weeks, 2) The control group, which undertook their usual physical activity and prenatal care. The primary outcomes were changes in maternal blood lipids after intervention. Obstetrical and neonatal outcomes measured were type of delivery, postpartum hemorrhage, newborn and/or maternal complications’, gestational age, weight gain, birth weight, foetal growth, and Apgar score. Results: Fifty women completed the study. At the end of the intervention, there were differences between groups in low-density lipoprotein levels (mean change: −8 mg/dL, 95%CI -3 to −29; P < 0.001) and triglycerides (mean change: −6 mg/dL, 95%CI -1 to −11; P = 0.03). Also, compared with women who remained in the control group, active women showed lower complications during delivery (moderate postpartum haemorrhage) (58% compared with 75%; P < 0.05) and lower complications in newborns (e.g. cyanosis or respiratory distress) (21% compared with 46%; P < 0.001). Conclusions: An exercise programme during the second and third trimester favours less gain in low-density lipoprotein cholesterol and triglycerides fewer delivery and neonatal complications.
Open Access
Handgrip strength cutoff for cardiometabolic risk index among colombian children and adolescents: the FUPRECOL study
(Springer Nature, 2017) Peña Ibagon, Jhonatan Camilo; Martínez Torres, Javier; Tordecilla Sanders, Alejandra; Correa Bautista, Jorge Enrique; Lobelo, Felipe; García Hermoso, Antonio; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Evidence shows an association between muscular strength (MS) and health among young people, however low muscular strength cut points for the detection of high metabolic risk in Latin-American populations are scarce. The aim of this study was twofold: to explore potential age- and sex-specific thresholds of MS, for optimal cardiometabolic risk categorization among Colombian children and adolescents; and to investigate whether cardiometabolic risk differed by MS group by applying the receiver operating characteristic curve (ROC) cut point. MS was estimated by using a handle dynamometer on 1,950 children and adolescents from Colombia, using MS relative to weight (handgrip strength/body mass). A metabolic risk score was computed from the following components: waist circumference, triglycerides, HDL-c, glucose, and systolic and diastolic blood pressure. ROC analysis showed a significant discriminatory accuracy of MS in identifying the low/high metabolic risk in children and adolescents and in both genders. In children, the handgrip strength/body mass levels for a low metabolic risk were 0.359 and 0.376 in girls and boys, respectively. In adolescents, these points were 0.440 and 0.447 in girls and boys, respectively. In conclusion, the results suggest an MS level relative to weight for having a low metabolic risk, which could be used to identify youths at risk.
Open Access
Ideal cardiovascular health and incident cardiovascular disease among adults: a systematic review and meta-analysis
(Mayo Foundation, 2018) Ramírez Vélez, Robinson; Saavedra, José M.; Lobelo, Felipe; Celis Morales, Carlos; Pozo Cruz, Borja del; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Objective: To investigate the association between ideal cardiovascular health (CVH) metrics and incident cardiovascular disease (CVD) by conducting a systematic review and meta-analysis of prospective cohort studies. Methods: The MEDLINE, EMBASE, and CINAHL databases were searched from January 1, 2010, through July 31, 2017, for studies that met the following criteria: (1) prospective studies conducted in adults, (2) with outcome data on CVD incidence and (3) a measure of ideal CVH metrics. Results: Twelve studies (210,443 adults) were included in this analysis. Compared with adults who met 0 to 2 of the ideal CVH metrics (high-risk individuals), a significantly lower hazard for CVD incidence was observed in those who had 3 to 4 points for the ideal CVH metrics (hazard ratio [HR]=0.53; 95% CI, 0.47-0.59) and 5 to 7 points (HR=0.28; 95% CI, 0.23-0.33). Weaker associations were observed in studies with older individuals, suggesting that there is a positive relationship between age and HR. Conclusion: Although meeting 5 to 7 metrics is associated with the lowest hazard for CVD incidence, meeting 3 to 4 metrics still offers an important protective effect for CVD. Therefore, a realistic goal in the general population in the short term could be to promote at least an intermediate ideal CVH profile (3 to 4 metrics).
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
Using LMS tables to determine waist circumference and waist-to-height ratios in colombian children and adolescents: the FUPRECOL study
(BioMed Central, 2017) Ramírez Vélez, Robinson; Moreno-Jiménez, Javier; Correa Bautista, Jorge Enrique; Martínez Torres, Javier; González-Ruíz, Katherine; González-Jiménez, Emilio; Schmidt Río-Valle, Jacqueline; Lobelo, Felipe; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Waist circumference (WC) and waist-to-height ratio (WHtR) are often used as indices predictive of central obesity. The aims of this study were: 1) to obtain smoothed centile charts and LMS tables for WC and WHtR among Colombian children and adolescents; 2) to evaluate the utility of these parameters as predictors of overweight and obesity. Method: A cross-sectional study was conducted of a sample population of 7954 healthy Colombian schoolchildren [3460 boys and 4494 girls, mean age 12.8 (±2.3) years]. Weight, height, body mass index (BMI), WC and WHtR were measured, and percentiles were calculated using the LMS method (Box-Cox, median and coefficient of variation). Appropriate cut-off points of WC and WHtR for overweight and obesity, according to International Obesity Task Force definitions, were selected using receiver operating characteristic (ROC) analysis. The discriminating power of WC and WHtR is expressed as area under the curve (AUC). Results: Reference values for WC and WHtR are presented. Mean WC increased and WHtR decreased with age for both genders. A moderate positive correlation was observed between WC and BMI (r = 0.756, P < 0.01) and between WHtR and BMI (r = 0.604, P < 0.01). ROC analysis revealed strong discrimination power in the identification of overweight and obesity for both measures in our sample population. Overall, WHtR was a slightly better predictor of overweight/obesity (AUC 95% CI 0.868-0.916) than WC (AUC 95% CI 0.862-0.904). Conclusion: This paper presents the first sex and age-specific WC and WHtR percentiles for Colombian children and adolescents aged 9.0-17.9 years. The LMS tables obtained, based on Colombian reference data, can be used as quantitative tools for the study of obesity and its comorbidities.
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.