Open Access
Effect of high-intensity interval training on body composition, cardiorespiratory fitness, blood pressure, and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity
(Frontiers Media, 2020) Delgado Floody, Pedro; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Caamaño Navarrete, Felipe; Moris, Roberto; Jerez Mayorga, Daniel; Andrade, David C.; Álvarez, Cristian; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Regular exercise training is a recognized lifestyle strategy to lower resting blood pressure (BP), but little is known about substrate metabolism in population with high BP. Thus, the purpose of this study was to investigate the effects of 16-weeks of HIIT on body composition, BP, cardiorespiratory fitness by (Formula presented.) O2max, and substrate utilization during exercise among prehypertensive and hypertensive patients with excessive adiposity. We also aimed to test the potential association between changes in cardiorespiratory fitness, substrate utilization during exercise and BP. Forty-two physically inactive overweight/obese participants participated in 16-weeks of HIIT intervention. The HIIT frequency was three times a week (work ratio 1:2:10, for interval cycling: rest period: repeated times; 80–100% of the maximum heart rate). Groups were distributed based on their baseline BP: HIIT-hypertensive (H-HTN: age 47.7 ± 12.0 years; body mass index [BMI] 30.3 ± 5.5 kg/m2; systolic [SBP]/diastolic BP [DBP] 151.6 ± 10/81.9 ± 4.2 mmHg), HIIT-pre-hypertensive (H-PreHTN: age 37.6 ± 12.0 years; BMI 31.9 ± 5.3 kg/m2; SBP/DBP 134.4 ± 3.2/74.9 ± 7.0 mmHg), and a normotensive control group (H-CG: age 40.7 ± 11.0 years; BMI 29.5 ± 4.2 kg/m2; SBP/DBP 117.0 ± 6.2/72.4 ± 4.1 mmHg). Anthropometry/body composition, BP, and metabolic substrate utilization during exercise (fat [FATox], carbohydrate [CHOox] oxidation, respiratory exchange ratio [RER], and (Formula presented.) O2max), were measured before and after the 16-week HIIT intervention. Adjusted mixed linear models revealed a significant improved in (Formula presented.) O2max were + 3.34 in the H-CG, + 3.63 in the H-PreHTN, and + 5.92 mL⋅kg–1⋅min–1, in the H-HTN group, however, the Time × Group interaction were not significant (p = 0.083). All the exercise types induced similar decreases on SBP (−8.70) in the H-HTN, (−7.14) in the H-CG, and (−5.11) mmHg in the H-PreHTN, as well as DBP levels (−5.43) mmHg in H-CG group (p = 0.032 vs. H-HTN group). At 16-week, no significant correlations were noted for the changes of blood pressure, cardiorespiratory fitness or exercise metabolism substrates outcomes. In conclusion, our results suggest that a 16-week HIIT-intervention improved (Formula presented.) O2max and blood pressure BP, but these changes are independent of substrate utilization during exercise in normotensive and hypertensive participants with excessive adiposity.
Open Access
Relative handgrip strength diminishes the negative effects of excess adiposity on dependence in older adults: a moderation analysis
(MDPI, 2020) Ramírez Vélez, Robinson; Pérez Sousa, Miguel A.; García Hermoso, Antonio; Zambom Ferraresi, Fabrício; Martínez Velilla, Nicolás; López Sáez de Asteasu, Mikel; Cano Gutiérrez, Carlos Alberto; Rincón Pabón, David; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The adverse effects of fat mass on functional dependence might be attenuated or worsened, depending on the level of muscular strength. The aim of this study was to determine (i) the detrimental effect of excess adiposity on dependence in activities of daily living (ADL), and (ii) whether relative handgrip strength (HGS) moderates the adverse effect of excess adiposity on dependence, and to provide the threshold of relative HGS from which the adverse effect could be improved or worsened. A total of 4169 participants (69.3 +/- 7.0 years old) from 244 municipalities were selected following a multistage area probability sampling design. Measurements included anthropometric/adiposity markers (weight, height, body mass index, waist circumference, and waist-to-height ratio (WHtR)), HGS, sarcopenia 'proxy' (calf circumference), and ADL (Barthel Index scale). Moderation analyses were performed to identify associations between the independent variable (WHtR) and outcomes (dependence), as well as to determine whether relative HGS moderates the relationship between excess adiposity and dependence. The present study demonstrated that (i) the adverse effect of having a higher WHtR level on dependence in ADL was moderated by relative HGS, and (ii) two moderation thresholds of relative HGS were estimated: 0.35, below which the adverse effect of WHtR levels on dependency is aggravated, and 0.62, above which the adverse effect of fat on dependency could be improved. Because muscular strength represents a critically important and modifiable predictor of ADL, and the increase in adiposity is inherent in aging, our results underscore the importance of an optimal level of relative HGS in the older adult population.
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
Physical fitness and anthropometric normative values among Colombian-Indian schoolchildren
(BioMed Central, 2016) Ramos Sepúlveda, Jeison Alexander; Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Substantial evidence indicates that children’s physical fitness levels are markers of their lifestyles and their cardio-metabolic health profile and are predictors of the future risk of chronic diseases such as obesity, cardiometabolic disease, skeletal health and mental health. However, fitness reference values for ethnic children and adolescents have not been published in a Latin-American population. Therefore, the aim of the study was to provide sex- and age-specific physical fitness and anthropometric reference standards among Colombian-Indian schoolchildren. Methods: A sample of 576 participants (319 boys and 257 girls) aged 10 to 17 years old was assessed using the FUPRECOL test battery. Four components of physical fitness were measured: 1) morphological component: height, weight, body mass index (BMI), waist circumference (WC), triceps skinfold, subscapular skinfold, and body fat (%); 2) musculoskeletal component: handgrip and standing long jump test; 3) motor component: speed/agility test (4 × 10 m shuttle run); and 4) cardiorespiratory component: course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption by VO2max indirect. Centile smoothed curves for the 3rd, 10th, 25th, 50th, 75th, 90th and 97th percentiles were calculated using Cole’s LMSmethod. Results: Our results show that weight, height and BMI in each age group were higher in boys than in girls. In each groups, age showed a significant effect for BMI and WC. Boys showed better than girls in cardiorespiratory fitness, lowerand upper-limb strength and speed/agility and girls performed better in low back flexibility. Conclusion: Our results provide for the first time sex- and age-specific physical fitness and anthropometric reference values for Colombian Nasa Indian children and adolescents aged 10–17.9 years.
Open Access
Predictive validity of the body adiposity index in overweight and obese adults using dual-energy X-ray absorptiometry
(MDPI, 2016) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; González-Ruíz, Katherine; Vivas, Andrés; García Hermoso, Antonio; Triana Reina, Héctor Reynaldo; Ciencias de la Salud; Osasun Zientziak
The body adiposity index (BAI) is a recent anthropometric measure proven to be valid in predicting body fat percentage (BF%) in some populations. However, the results have been inconsistent across populations. This study was designed to verify the validity of BAI in predicting BF% in a sample of overweight/obese adults, using dual-energy X-ray absorptiometry (DEXA) as the reference method. A cross-sectional study was conducted in 48 participants (54% women, mean age 41.0 ± 7.3 years old). DEXA was used as the "gold standard" to determine BF%. Pearson¿s correlation coefficient was used to evaluate the association between BAI and BF%, as assessed by DEXA. A paired sample t-test was used to test differences in mean BF% obtained with BAI and DEXA methods. To evaluate the concordance between BF% as measured by DEXA and as estimated by BAI, we used Lin¿s concordance correlation coefficient and Bland-Altman agreement analysis. The correlation between BF% obtained by DEXA and that estimated by BAI was r = 0.844, p < 0.001. Paired t-test showed a significant mean difference in BF% between methods (BAI = 33.3 ± 6.2 vs. DEXA 39.0 ± 6.1; p < 0.001). The bias of the BAI was -6.0 ± 3.0 BF% (95% CI = -12.0 to 1.0), indicating that the BAI method significantly underestimated the BF% compared to the reference method. Lin¿s concordance correlation coefficient was considered stronger (rc = 0.923, 95% CI = 0.862 to 0.957). In obese adults, BAI presented low agreement with BF% measured by DEXA; therefore, BAI is not recommended for BF% prediction in this overweight/obese sample studied.
Open Access
Glucose levels as a mediator of the detrimental effect of abdominal obesity on relative handgrip strength in older adults
(MDPI, 2020) Pérez Sousa, Miguel A.; Pozo Cruz, Jesús del; Cano Gutiérrez, Carlos Alberto; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak; Gobierno de Navarra / Nafarroako Gobernua
Excess central adiposity accelerates the decline of muscle strength in older people. Additionally, hyperglycemia, independent of associated comorbidities, is related to the loss of muscle mass and strength, and contributes to functional impairment in older adults. We studied the mediation effect of glucose levels, in the relationship between abdominal obesity and relative handgrip strength (HGS). A total of 1571 participants (60.0% women, mean age 69.1 +/- 7.0 years) from 86 municipalities were selected following a multistage area probability sampling design. Measurements included demographic and anthropometric/adiposity markers (weight, height, body mass index, and waist circumference). HGS was measured using a digital dynamometer for three sets and the mean value was recorded. The values were normalized to body weight (relative HGS). Fasting glucose was analyzed by enzymatic colorimetric methods. Mediation analyses were performed to identify associations between the independent variable (abdominal obesity) and outcomes (relative HGS), as well as to determine whether fasting glucose levels mediated the relationship between excess adiposity and relative HGS. A total of 1239 (78.8%) had abdominal obesity. Abdominal obesity had a negative effect on fasting glucose (beta = 9.04, 95%CI = 5.87 to 12.21); while fasting glucose to relative HGS was inversely related (beta = -0.003, 95%CI = -0.005 to -0.001),p< 0.001. The direct effect of abdominal obesity on relative HGS was statistically significant (beta = -0.069, 95%CI = -0.082 to -0.057),p< 0.001. Lastly, fasting glucose levels mediates the detrimental effect of abdominal obesity on relative HGS (indirect effect beta = -0.002, 95%CI = -0.004 to -0.001),p< 0.001. Our results suggest that the glucose level could worsen the association between abdominal obesity status and lower HGS. Thus, it is plausible to consider fasting glucose levels when assessing older adults with excess adiposity and/or suspected loss of muscle mass.
Open Access
Weight loss after 12 weeks of exercise and/or nutritional guidance is not obligatory for induced changes in local fat/lean mass indexes in adults with excess of adiposity
(MDPI, 2020) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Castro Astudillo, Karem; Medrano Mena, Carolina; Monroy Díaz, Ángela Liliana; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The objectives of this secondary analysis are (1) to investigate the differential effects of exercise training modalities–high-intensity interval training (HIIT), resistance training (RT), combined training (CT = HIIT + RT), and/or nutritional guidance (NG) alone–on local fat/lean mass indexes in adults with excess of adiposity; (2) to identify the individual patterns of response based on either a clinical criterion of weight loss (≥ 5%) and/or technical error (TE) of measurement of local fat/lean mass indexes; and (3) to assess the individual change for body composition parameters assigned either to HIIT, RT, CT, and/or NG groups utilizing a TE. A 12-week trial was conducted in 55 participants randomized to one of the four interventions. The primary outcome was clinical change in body weight (i.e., weight loss of ≥ 5%). Secondary outcomes included change in ratio of android and gynoid fat mass, as well as local fat and lean mass indexes (arms, trunk, and legs), before and after intervention. The main findings from the current analysis revealed that (i) after 12 weeks of follow-up, significant decreases in several body composition indexes were found including body weight, arm, trunk, and legs fat mass, and android and gynecoid fat mass were observed in HIIT, RT, and CT groups (p < 0.05); (ii) a significant proportion of individuals showed a positive response following 12 weeks of training, led by the HIIT group with 44% and followed by RT with 39% in 9 indexes; (iii) the HIIT group showed lowest rates of adverse responders with (6%); and (iv) the individual patterns of response utilizing clinically meaningful weight loss were not necessarily associated with the corresponding individual training-induced changes in body composition indexes in adults with excess of adiposity. Overall, the study suggests that HIIT has an important ability to reduce the prevalence of non-response to improve body composition indexes.
Open Access
Asociación entre el polimorfismo rs9939609 del gen FTO y marcadores de adiposidad en población adulta chilena
(Sociedad Médica de Santiago, 2018) Petermann-Rocha, Fanny; Villagrán, Marcelo; Troncoso, Claudia; Mardones, Lorena; Leiva, Ana María; Martínez, María Adela; Garrido-Méndez, Alex; Poblete-Valderrama, Felipe; Salas-Bravo, Carlos; Ramírez Vélez, Robinson; Ulloa, Natalia; Pérez-Bravo, Francisco; Celis Morales, Carlos; Ciencias de la Salud; Osasun Zientziak
Background: Numerous studies have identified the role of Fat-mass-associated-gene (FTO) in the development of obesity. Aim: To investigate the association of FTO gene with adiposity markers in Chilean adults. Material and Methods: 409 participants were included in this cross-sectional study. The association between FTO (rs9939609) genotype and adiposity markers was determined using linear regression analyses. Adiposity markers included were: body weight, body mass index, fat mass, waist circumference, hip circumference and waist/hip ratio. Results: A fully adjusted model showed a significant association between FTO genotype and body weight (2.16 kg per each extra copy of the risk allele [95% confidence intervals (CI): 0.45 to 3.87], p = 0.014), body mass index (0.61 kg.m-2 [95% CI: 0.12 to 1.20], p = 0.050) and fat mass (1.14% [95% CI: 0.39 to 1.89], p = 0.010). The greater magnitude of association was found between the FTO gene and fat mass when the outcomes were standardized to z-score. Conclusions: This study confirms an association between the FTO gene and adiposity markers in Chilean adults, which is independent of major confounding factors.
Open Access
Cardiorespiratory fitness cut-points are related to body adiposity parameters in Latin American adolescents
(MDPI, 2019) Prieto Benavides, Daniel Humberto; García Hermoso, Antonio; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Agostinis-Sobrinho, César; Correa Bautista, Jorge Enrique; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background and Objectives: A deficiency exists in the criterion-referenced cut-points for field-based cardiorespiratory fitness (CRF) in Latin American youths. The aims of the present study were two-fold: (1) To identify the ability of CRF estimated by the 20-m shuttle-run test (20mSRT) to differentiate between 'healthy' and 'unhealthy' phenotypes (by adiposity) in adolescents; (2) to assess the association between obesity and relative peak oxygen uptake (VO2peak) in a large and diverse sample of Latin American youths. In total, 72,505 adolescents aged between 13 and 15 years were recruited from Chile and Colombia (47.5% girls). Materials and Methods: The waist circumference (WC) and waist-to-height ratio (WHtR) were used to identify body adiposity markers. CRF was measured using the 20mSRT (VO2peak). Receiver operating characteristic curves and logistic regression were used to determine the discriminatory ability of CRF to predict body adiposity parameters. Results: For boys and girls, VO2peak showed a significant predictive capacity to detect body fat (area under the curve [AUC] > 0.62). The sensitivity of VO2peak was medium (>63%) for all age- and sex-specific cut-points, with optimal cut-points in 13- to 15-year olds for obesity identified as 43.77 mL·kg-1·min-1 and 38.53 mL·kg-1·min-1 in boys and girls, respectively. Conclusions: According to these cut-points, adolescents with low CRF were more likely to be obese either by WC or WHtR. The CRF cut-points can be used as quantitative markers for a healthier body in Latin American adolescents.
Open Access
Pubertal stage, body mass index, and cardiometabolic risk in children and adolescents in Bogotá, Colombia: the cross-sectional FUPRECOL study
(MDPI, 2017) Ramírez Vélez, Robinson; García Hermoso, Antonio; Agostinis-Sobrinho, César; Mota, Jorge; Santos, Rute; Correa Bautista, Jorge Enrique; Peña-Guzmán, Carlos Andrés; Domínguez Sánchez, María Andrea; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; Ciencias de la Salud; Osasun Zientziak
This study explored the association between pubertal stage and anthropometric and cardiometabolic risk factors in youth. A cross-sectional study was conducted in 2877 Colombian children and adolescents (9¿17.9 years of age). Weight, height, and waist circumference were measured and body mass index (BMI) was calculated. A biochemical study was performed to determine the cardiometabolic risk index (CMRI). Blood pressure was evaluated and pubertal stage was assessed with the Tanner criteria. Hierarchical multiple regression analyses were performed. The most significant variable (p < 0.05) in the prognosis of cardiometabolic risk was found to be the BMI in both boys and girls. In the case of girls, the pubertal stage was also a CMRI predictive factor. In conclusion, BMI was an important indicator of cardiovascular risk in both sexes. Pubertal stage was associated with cardiovascular risk only in the girls.