Open Access
Body composition, nutritional profile and muscular fitness affect bone health in a sample of schoolchildren from Colombia: the FUPRECOL study
(MDPI, 2017) Forero Bogotá, Mónica Adriana; Ojeda Pardo, Mónica Liliana; García Hermoso, Antonio; Correa Bautista, Jorge Enrique; González Jiménez, Emilio; Schmidt Río-Valle, Jacqueline; Navarro Pérez, Carmen Flores; Gracia-Marco, Luis; Vlachopoulos, Dimitris; Martínez Torres, Javier; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
The objective of the present study is to investigate the relationships between body composition, nutritional profile, muscular fitness (MF) and bone health in a sample of children and adolescents from Colombia. Participants included 1118 children and adolescents (54.6% girls). Calcaneal broadband ultrasound attenuation (c-BUA) was obtained as a marker of bone health. Body composition (fat mass and lean mass) was assessed using bioelectrical impedance analysis. Furthermore height, weight, waist circumference and Tanner stage were measured and body mass index (BMI) was calculated. Standing long-jump (SLJ) and isometric handgrip dynamometry were used respectively as indicators of lower and upper body muscular fitness. A muscular index score was also computed by summing up the standardised values of both SLJ and handgrip strength. Dietary intake and degree of adherence to the Mediterranean diet were assessed by a 7-day recall questionnaire for food frequency and the Kidmed questionnaire. Poor bone health was considered using a z-score cut off of ≤1.5 standard deviation. Once the results were adjusted for age and Tanner stage, the predisposing factors of having a c-BUA z-score ≤1.5 standard deviation included being underweight or obese, having an unhealthy lean mass, having an unhealthy fat mass, SLJ performance, handgrip performance, and unhealthy muscular index score. In conclusion, body composition (fat mass and lean body mass) and MF both influenced bone health in a sample of children and adolescents from Colombia. Thus promoting strength adaptation and preservation in Colombian youth will help to improve bone health, an important protective factor against osteoporosis in later life.
Open Access
Effects of exercise training on fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: a systematic review and meta-analysis
(BioMed Central, 2019) Ramírez Vélez, Robinson; García Hermoso, Antonio; Hackney, Anthony C.; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: elevated levels of fetuin-A are associated with increased risks of metabolic syndrome, type 2 diabetes and nonalcoholic fatty liver disease. This meta-analysis investigated whether exercise interventions can reduce fetuin-A in adults. Methods: we searched clinical trials that objectively assessed fetuin-A and included study arms with exercise intervention. The pre-intervention and post-intervention data were used for meta-analysis. The effect sizes were calculated as standardized mean differences or changes in fetuin-A and expressed as Hedges' g using random-effects models. Results: the overall Hedges' g for fetuin-A in all included interventions was - 0.640 (95%CI - 1.129 to - 0.151; n = 9), but this effect was not observed in obese (g = - 0.096; 95%CI, - 0.328 to 0.135) and type 2 diabetes/dysglycemia (g = - 0.56; 95%CI, - 1.348 to 0.236) individuals. Additionally, the random-effects meta-regression analysis showed that there was not a greater decrease in fetuin-A in individuals who achieved greater body mass index reductions (regression coefficient = 0.065; 95%CI, - 0.185 to 0.315). Conclusion: supervised exercise is associated with reductions in fetuin-A levels in adults and elderly. However, the results of the present meta-analysis should be interpreted with caution because of the variety of type of exercises and individual obesity related-disorders involve. Therefore, additional high-quality randomized controlled trials describing the effect of supervised exercise interventions on fetuin-A in adults are still needed.
Open Access
Reference values for handgrip strength and their association with intrinsic capacity domains among older adults
(Wiley, 2019) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; García Hermoso, Antonio; Cano Gutiérrez, Carlos Alberto; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Objective The purposes of this study were three-fold: (i) to describe handgrip strength in older individuals aged >= 60 years in Colombia; (ii) to identify sex-specific and age-specific muscle weakness cut-off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts. Methods A cross-sectional study was conducted in Colombia, among 5237 older adults aged >= 60 years old (58.5% women, 70.5 +/- 7.8 years), according to 'SABE Survey 2015'. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio-economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co-morbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models. Results Handgrip strength was greater among men than among women (26.7 +/- 8.5 vs. 16.7 +/- 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts. Conclusions This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.
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
Creencias y conocimientos relacionados a la práctica del autoexamen de mama en mujeres universitarias de Colombia: un estudio descriptivo
(Sociedad Chilena de Obstetricia y Ginecologia, 2018) Meneses Echávez, José Francisco; Martínez Torres, Javier; Chavarriaga-Ríos, Marcia Cristina; González-Ruíz, Katherine; Vinaccia, Stefano; Rincón-Castro, Andrés David; Rincón-Castro, German Guillermo; Muñoz-Rozo, Bryan Orlando; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Objetivo: Estudios epidemiológicos han identificado el autoexamen de mama (AEM) y el conocimiento de los factores de riesgo como estrategias para la detección precoz del cáncer de mama. El objetivo de este estudio es determinar la prevalencia de la práctica del AEM e identificar los conocimientos de autocuidado y creencias relacionados al AEM en mujeres de Bogotá, Colombia. Métodos: Estudio descriptivo y transversal, en 628 mujeres universitarias entre 18 y 30 años de edad, de Bogotá, Colombia. La práctica del AEM, el autocuidado y las creencias se recogieron por medio de una encuesta estructurada. Se calcularon prevalencias y se establecieron asociaciones mediante la construcción de modelos de regresión logística binaria. Resultados: De la población evaluada, el 11,3% de las mujeres acusaron practicarse el AEM mensualmente en los últimos 12 meses. Tras ajustar por edad y estrato socioeconómico se observó que las participantes que recibieron información previa acerca de la detección temprana del cáncer de seno OR 2,76 (IC95% 1,29-5,91), que tenían conocimientos de la enfermedad OR 3,24 (IC95% 1,76-5,97) y que reportaron conocer el examen de mamografía OR 2,04 (IC95% 1,13-3,68); se asociaron como variables con la realización del AEM. Conclusión: La práctica del AEM en la población estudiada fue baja y el conocimiento sobre los factores de riesgo del cáncer se asociaron positivamente con la práctica del AEM. Estos datos podrían utilizarse para ofrecer programas de intervención educativa entre las mujeres universitarias de Colombia.
Open Access
Association of muscular fitness and body fatness with cardiometabolic risk factors: the FUPRECOL study
(MDPI, 2018) Correa Rodríguez, María; Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Castellanos-Vega, Rocío del Pilar; Arias-Coronel, Florencio; González Ruiz, Katherine; Carrillo Arango, Hugo Alejandro; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; Ciencias de la Salud; Osasun Zientziak
This study investigated the associations of muscular fitness and various indicators of body fatness with cardio-metabolic risk factors and determined the muscular strength and body fatness thresholds for detecting a high risk of cardio-metabolic dysfunction in young adults. A cross-sectional study was conducted on 1798 collegiate students (61.5% females, mean age 20.5 years). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). Body mass index (BMI), waist circumference (WC), percentage of fat mass (BF%), fat-mass index (FMI), and waist-to-height ratio (WHR) were also included as body fatness measurements. A high cardio-metabolic risk cluster was derived by assessing triglycerides, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, fasting glucose, and blood pressure. Logistic regression models showed that men and women with lower NGS had an increased cardio-metabolic risk odds ratio (OR) = 1.8, 95% confidence interval (CI) 1.1 to 2.9, p = 0.006, and OR = 1.6, 95% CI 1.0 to 2.5, p = 0.036, respectively). In both sexes, higher levels of all fatness parameters were also associated with increased cardio-metabolic risk (p < 0.001). In both men and women, high FMI had the highest OR for clustered risk (OR = 4.7, 95% CI 2.6 to 8.4, and OR = 7.3, 95% CI 3.4 to 9.7, p < 0.001, respectively). Combined analysis showed that unfitness (lower NGS) and high fat had the highest OR for WC and FMI in men and women, respectively (OR = 5.5, 95% CI 2.6 to 11.4, OR = 7.7, 95% CI 2.3 to 15.8, p < 0.01). Muscular strength and body fatness are independently and jointly associated with increased cardiometabolic risk in young adults, which suggests that both are predictor variables for this.
Open Access
Obesity-and lipid-related parameters in the identification of older adults with a high risk of prediabetes according to the American diabetes association: an analysis of the 2015 health, well-being, and aging study
(MDPI, 2019) Ramírez Vélez, Robinson; Pérez Sousa, Miguel A.; González Ruiz, Katherine; Cano Gutiérrez, Carlos Alberto; Schmidt Río-Valle, Jacqueline; Correa Rodríguez, María; Izquierdo Redín, Mikel; Romero García, Jesús Astolfo; Campos Rodríguez, Adriana Yolanda; Triana Reina, Héctor Reynaldo; González Jiménez, Emilio; Ciencias de la Salud; Osasun Zientziak
This study evaluated the predictive ability of 11 obesity-and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), 'A' body-shape index (ABSI), conicity index (CI), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles (p < 0.001). The TyG index was best able to identify prediabetes in either sex (AUC and optimal cut-off = 0.700 and 8.72, and 0.695 and 8.92 for men and women, respectively), suggesting that compared to the other parameters, the TyG index has the best discriminative power to predict prediabetes in the whole population. Thus, we propose the TyG index be used as a complementary marker for assessing prediabetes in older adults.
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
The insulin-like growth factor system is modulated by exercise in breast cancer survivors: a systematic review and meta-analysis
(BioMed Central, 2016) Meneses Echávez, José Francisco; González Jiménez, Emilio; Schmidt Río-Valle, Jacqueline; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background: Insulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an effective intervention in improving cancerrelated outcomes and survival, although its effects on IGF´s are not well understood. This meta-analysis aimed to determine the effects of exercise in modulating IGF´s system in breast cancer survivors. Methods: Databases of PuMed, EMBASE, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials. gov, SPORTDiscus, LILACS and Scopus were systematically searched up to November 2014. Effect estimates were calculated through a random-effects model of meta-analysis according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I2 test. Risk of bias and methodological quality were evaluated using the PEDro score. Results: Five randomized controlled trials (n = 235) were included. Most women were post-menopausal. Highquality and low risk of bias were found (mean PEDro score = 6.2 ± 1). Exercise resulted in significant improvements on IGF-I, IGF-II, IGFBP-I, IGFBP-3, Insulin and Insulin resistance (P < 0.05). Non-significant differences were found for Glucose. Aerobic exercise improved IGF-I, IGFBP-3 and Insulin. No evidence of publication bias was detected by Egger´s test (p = 0.12). Conclusions: Exercise improved IGF´s in breast cancer survivors. These findings provide novel insight regarding the molecular effects of exercise on tumoral microenvironment, apoptosis and survival in breast cancer survivors.
Open Access
Confiabilidad y validez del cuestionario de trastornos de sueño BEARS en niños y adolescentes escolares de Bogotá, D.C., Colombia: Estudio FUPRECOL
(Federación Española de Docentes de Educación Física, 2018) Ramírez Vélez, Robinson; Huertas Zamora, Libardo; Correa Bautista, Jorge Enrique; Cárdenas Calderón, Edgar Giovanni; Ciencias de la Salud; Osasun Zientziak
El sueño juega un papel fundamental en muchas esferas del desarrollo de los infantes en etapa escolar. El objetivo de este estudio fue determinar la confiabilidad y validez de contenido del cuestionario BEARS en niños y adolescentes de 9 a 17 años. La muestra estuvo compuesta por 8.862 niños y adolescentes pertenecientes a 24 instituciones educativas oficiales de Bogotá, Colombia. Se aplicó el cuestionario BEARS, de manera auto-diligenciada por formulario estructurado. Una sub-muestra de 246 participantes se utilizó para los análisis de fiabilidad. La consistencia del instrumento se analizó mediante el coeficiente alfa de Cronbach, la validez de constructo a través del análisis factorial exploratorio (AFE), y la fiabilidad mediante el coeficiente Kappa ponderado. Los resultados mostraron adecuada consistencia (Cronbach global de 0,732; rango 0,706 a 0,769) y moderada fiabilidad (kappa de 0,665; rango 0,378 a 0,629). El AFE determinó un solo factor (ítem 1: problemas a la hora de dormir), explicaba el 61,4% de la varianza, agrupando dos interacciones ÷2 /gl=2690,817; p=0,001. El cuestionario BEARS mostró una adecuada consistencia interna, fiabilidad y validez. A partir de estos resultados, se recomienda este instrumento principalmente en el contexto de atención primaria, para el estudio y cribado de las alteraciones del sueño en población escolarizada de Bogotá, Colombia.