Open Access
Effects of a multicomponent exercise program in older adults with non-small-cell lung cancer during adjuvant/palliative treatment: an intervention study
(MDPI, 2020) Rosero Rosero, Ilem Dayana; Ramírez Vélez, Robinson; Martínez Velilla, Nicolás; Cedeño Veloz, Bernardo Abel; Morilla Ruiz, Idoia; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Clinical intervention studies support the efficacy and safety of exercise programs as a treatment modality for non-small-cell lung cancer (NSCLC) during adjuvant/palliative treatment, but the effectiveness of real-world oncogeriatric services is yet to be established. We aimed to examine the effects of a 10-week structured and individualized multicomponent exercise program on physical/cognitive functioning and mental wellness in elderly patients with NSCLC under adjuvant therapy or palliative treatment. A non-randomized, opportunistic control, longitudinal-design trial was conducted on 26 patients with NSCLC stage I-IV. Of 34 eligible participants, 21 were allocated into two groups: (i) control group (n = 7) received usual medical care; and (ii) intervention group (n =19) received multicomponent program sessions, including endurance, strength, balance, coordination and stretching exercises. Tests included the Short Physical Performance Battery (SPPB), 5-m habitual Gait Velocity Test (GVT), Timed Up & Go Test (TUG), 6-Min Walk Test (6MWT), independence of activities in daily living (IADL), muscular performance, cognitive function, and quality of life, which were measured at baseline and after 10weeks of the program. Results revealed a significant groupxtime interaction for SPPB (p = 0.004), 5-m GVT (p = 0.036), TUG (p = 0.007), and muscular performance (chest and leg power; p < 0.001). Similarly, significant changes were observed between groups for cognitive functioning (p = 0.021) and quality of life for EUROQoL 5D (p = 0.006). Our findings confirm that a multicomponent exercise program improves measures of physical/cognitive functioning and quality of life in the elderly with NSCLC under adjuvant therapy or palliative treatment. This is an interesting and important study that adds to our current body of knowledge on the safety of exercise interventions, especially in the elderly with solid tumors.
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
Lipidomic signatures from physically frail and robust older adults at hospital admission
(Springer, 2022) Ramírez Vélez, Robinson; Martínez Velilla, Nicolás; Correa Rodríguez, María; López Sáez de Asteasu, Mikel; Zambom Ferraresi, Fabrício; Palomino Echeverría, Sara; García Hermoso, Antonio; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua, 2186/2014; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, 420/2019
Identifying serum biomarkers that can predict physical frailty in older adults would have tremendous clinical value for primary care, as this condition is inherently related to poor quality of life and premature mortality. We compared the serum lipid profile of physically frail and robust older adults to identify specific lipid biomarkers that could be used to assess physical frailty in older patients at hospital admission. Forty-three older adults (58.1% male), mean (range) age 86.4 (78–100 years) years, were classified as physically frail (n = 18) or robust (n = 25) based on scores from the Short Physical Performance Battery (≤ 6 points). Non-targeted metabolomic study by ultra-high performance liquid chromatography coupled to mass spectrometry (UHPLC-MS) analysis with later bioinformatics data analysis. Once the significantly different metabolites were identified, the KEGG database was used on them to establish which were the metabolic pathways mainly involved. Area under receiver-operating curve (AUROC) analysis was used to test the discriminatory ability of lipid biomarkers for frailty based on the Short Physical Performance Battery. We identified a panel of five metabolites including ceramides Cer (40:2), Cer (d18:1/20:0), Cer (d18:1/23:0), cholesterol, and hosphatidylcholine (PC) (14:0/20:4) that were significantly increased in physically frail older adults compared with robust older adults at hospital admission. The most interesting in the physically frail metabolome study found with the KEGG database were the metabolic pathways, vitamin digestion and absorption, AGE-RAGE signaling pathway in diabetic complications, and insulin resistance. In addition, Cer (40:2) (AUROC 0.747), Cer (d18:1/23:0) (AUROC 0.720), and cholesterol (AUROC 0.784) were identified as higher values of physically frail at hospital admission. The non-targeted metabolomic study can open a wide view of the physically frail features changes at the plasma level, which would be linked to the physical frailty phenotype at hospital admission. Also, we propose that metabolome analysis will have a suitable niche in personalized medicine for physically frail older adults.
Open Access
Maximal oxidative capacity during exercise is associated with muscle power output in patients with long coronavirus disease 2019 (COVID-19) syndrome. A moderation analysis.
(Elsevier, 2023) Ramírez Vélez, Robinson; Oscoz Ochandorena, Sergio; García Alonso, Yesenia; García Alonso, Nora; Legarra Gorgoñón, Gaizka; Oteiza Olaso, Julio; Ernaga Lorea, Ander; Izquierdo Redín, Mikel; Correa Rodríguez, María; Ciencias de la Salud; Osasun Zientziak
Background & aims: Long COVID syndrome (LCS) involves persistent symptoms experienced by many patients after recovering from coronavirus disease 2019 (COVID-19). We aimed to assess skeletal muscle energy metabolism, which is closely related to substrate oxidation rates during exercise, in patients with LCS compared with healthy controls. We also examined whether muscle power output mediates the relationship between COVID-19 and skeletal muscle energy metabolism. Methods: In this cross-sectional study, we enrolled 71 patients with LCS and 63 healthy controls. We assessed clinical characteristics such as body composition, physical activity, and muscle strength. We used cardiopulmonary exercise testing to evaluate substrate oxidation rates during graded exercise. We performed statistical analyses to compare group characteristics and peak fat oxidation differences based on power output. Results: The two-way analysis of covariance (ANCOVA) results, adjusted for covariates, showed that the patients with LCS had lower absolute maximal fatty acid oxidation (MFO), relative MFO/fat free mass (FFM), absolute carbohydrates oxidation (CHox), relative CHox/FFM, and oxygen uptake (V__O2) at maximum fat oxidation (g min1 ) than the healthy controls (P < 0.05). Moderation analysis indicated that muscle power output significantly influenced the relationship between LCS and reduced peak fat oxidation (interaction b ¼ 0.105 [95% confidence interval 0.174; 0.036]; P ¼ 0.026). Therefore, when muscle power output was below 388 W, the effect of the LCS on MFO was significant (62% in our study sample P ¼ 0.010). These findings suggest compromised mitochondrial bioenergetics and muscle function, represented by lower peak fat oxidation rates, in the patients with LCS compared with the healthy controls. Conclusion: The patients with LCS had lower peak fat oxidation during exercise compared with the healthy controls, potentially indicating impairment in skeletal muscle function. The relationship between peak fat oxidation and LCS appears to be mediated predominantly by muscle power output. Additional research should continue investigating LCS pathogenesis and the functional role of mitochondria.
Open Access
Autoreporte de la calidad de vida en niños y adolescentes colombianos: estudio FUPRECOL
(Universidad del Valle, 2017) Gaitán-López, Darío Fernando; Correa Bautista, Jorge Enrique; Vinaccia, Stefano; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Objetivo: Describir por autoreporte la calidad de vida relacionada con la salud (CVRS) en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio descriptivo y transversal, en 3,245 niños y 3,354 adolescentes, entre 9 y 17.9 años de edad, de 24 instituciones educativas oficiales de Bogotá, Colombia. Se aplicó de manera auto-administrada del instrumento de CVRS infantil EQ-5D-Y proxy, versión validada al castellano. Se analizaron los datos por medidas de tendencia central y se realizó una comparación de los observados en Colombia con estudios internacionales. Resultados: De la población evaluada, el 58.3% (n= 3,848), fueron mujeres. En general, se observaron puntuaciones elevadas en la CVRS en niños y adolescentes de ambos sexos. Al comparar por género, las dimensiones del EQ-5D-Y proxy “sentirse triste/preocupado o infeliz” y “tener dolor/malestar”, presentaron la mayor frecuencia de respuesta en el grupo de las mujeres. Al comparar los resultados de este estudio, por grupos de edad, con trabajos internacionales de niños y adolescentes, se observó que las puntuaciones del EQ-5D-Y proxy fueron superiores a los reportados en Suráfrica, Alemania e Italia. Conclusión: Los niños acusan menor porcentaje de problemas en todas las dimensiones que los adolescentes. Las dimensiones relativas a “dolor/malestar” y “sentirse triste/preocupado o infeliz”, fueron en las que se indicaron más problemas. Se presentan valores de la CVRS según edad y sexo que podrán ser usados en la evaluación de la salud percibida en el ámbito escolar en Bogotá, Colombia.
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.
Open Access
Macroeconomic, demographic and human developmental correlates of physical activity and sitting time among South American adults
(BMC, 2020) Werneck, André de Oliveira; Sadarangani, Kabir P.; Ramírez Vélez, Robinson; Baldew, Se-Sergio; Gomes, Thayse N.; Ferrari, Gerson; Szwarcwald, Célia L.; Miranda, Jaime; Silva, Danilo R.; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, ID 420/2019
Background: Our aim was to investigate the association of macroeconomic, human development, and demographic factors with different domains of physical activity and sitting time among South American adults. Methods: We used data from nationally representative samples in Argentina (n = 26,932), Brazil (n = 52,490), Chile (n = 3866), Colombia (n = 14,208), Ecuador (n = 19,883), Peru (n = 8820), and Uruguay (n = 2403). Our outcomes included leisure time (≥150 min/week), transport (≥10 min/week), occupational (≥10 min/week), and total (≥150 min/week) physical activity, as well as sitting time (≥4 h/day), which were collected through self-reported questionnaires. As exposures, gross domestic product, total population, population density, and human development index indicators from the most updated national census of each country were used. Age and education were used as covariates. Multilevel logistic regressions with harmonized random effect meta-analyses were conducted, comparing highest vs. lowest (reference) tertiles. Results: Higher odds for transport physical activity were observed among the highest tertiles of total population (ORmen: 1.41; 95% CI: 1.23–1.62), ORwomen: 1.51; 95% CI:1.32–1.73), population density (ORmen: 1.36; 95% CI: 1.18–1.57, ORwomen: 1.49; 95% CI: 1.30–1.70), and gross domestic product (ORmen: 1.16; 95% CI: 1.00–1.35, ORwomen: 1.39; 95% CI: 1.20–1.61). For leisure physical activity, women living in departments with higher human development index presented 18% higher odds for being active, and for total physical activity a similar estimate in both sexes was observed among those who live in more populated areas. No consistent associations were found for occupational physical activity and sitting time. Conclusion: Macroeconomic, demographic and human development indicators are associated with different domains of physical activity in the South American context, which can in turn guide policies to promote physical activity in the region.
Open Access
Concurrent aerobic plus resistance exercise versus aerobic exercise alone to improve health outcomes in paediatric obesity: a systematic review and meta-analysis
(BMJ, 2018) García Hermoso, Antonio; Ramírez Vélez, Robinson; Ramírez Campillo, Rodrigo; Peterson, Mark Dean; Martínez Vizcaíno, Vicente; Ciencias de la Salud; Osasun Zientziak
Objective To determine if the combination of aerobic and resistance exercise is superior to aerobic exercise alone for the health of obese children and adolescents. Design Systematic review with meta-analysis. Data sources Computerised search of 3 databases (MEDLINE, EMBASE, and Cochrane Controlled Trials Registry). Eligibility criteria for selecting studies Studies that compared the effect of supervised concurrent exercise versus aerobic exercise interventions, with anthropometric and metabolic outcomes in paediatric obesity (6–18 years old). The mean differences (MD) of the parameters from preintervention to postintervention between groups were pooled using a random-effects model. Results 12 trials with 555 youths were included in the meta-analysis. Compared with aerobic exercise alone, concurrent exercise resulted in greater reductions in body mass (MD=−2.28 kg), fat mass (MD=−3.49%; and MD=−4.34 kg) and low-density lipoprotein cholesterol (MD=−10.20 mg/dL); as well as greater increases in lean body mass (MD=2.20 kg) and adiponectin level (MD=2.59 μg/mL). Differences were larger for longer term programmes (>24 weeks). Summary Concurrent aerobic plus resistance exercise improves body composition, metabolic profiles, and inflammatory state in the obese paediatric population. Trial registration number CRD42016039807.
Open Access
Intensity training and cardiovascular health in Colombian adults: results from HIIT-Heart Study and Cardiometabolic HIIT-RT Study
(2018) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Correa Bautista, Jorge Enrique; Ciencias de la Salud; Osasun Zientziak
The current Ph.D. dissertation revolves around the relationship between exercise intensity and improvement cardiometabolic health. It has been suggested that high intensity interval training and also moderate or resistance training generate positive effects on metabolic risk factors. For these reasons, it is necessary to clarify which type of training, is more effective to improve cardiometabolic health in Latin American population. This doctoral thesis is based on 6 scientific studies that have been published or submitted for publication in scientific international journals. The first study (Chapter 2), we aimed to determine the effects of moderate- versus high-intensity interval exercise training on vascular function parameters in physically inactive adults. The second study (Chapter 3) to compare the effects of high-intensity interval training and steady-state moderate-intensity training on clinical components of metabolic syndrome (MetS) in healthy physically inactive adults. The third study (Chapter 4), we investigated the effect of moderate versus high-intensity interval exercise training on the HRV indices in physically inactive adults. Study five (Chapter 6) are Lab-based studies to evaluate the chronic impact of MCT or HIT on biomarkers of endothelial function, arterial stiffness and heart rate variability parameters postprandially after a high-fat meal. The last study of the current Ph.D. dissertation we aimed to investigate whether 12 weeks of high-intensity interval training (HIIT), resistance training (RT), concurrent training (CT=HIII+RT) or nutritional guidance (NG) induced improvements in metabolic syndrome (MetS) risk factors, vascular function parameters and ideal cardiovascular health (CVH) in sedentary and overweight adults, and to compare the training adaptations between intervention groups. ClinicalTrials.gov NCT02738385 registered on March 23, 2016 and ClinicalTrials.gov identifier (NCT number): NCT02715063 First registered on March 22, 2016.