Open Access
The challenge of promoting physical activity in low-income and middle-income countries
(Elsevier, 2023) Ramírez Vélez, Robinson; Silva, Danilo R.; Ciencias de la Salud; Osasun Zientziak
Physical inactivity is one of the main public health problems worldwide. Public awareness of the benefits of physical activity has increased, and advances have been made in the field of physical activity epidemiology. Findings also show that the prevalence of physical activity at the WHO-recommended level (≥150 min of moderate-intensity or 75 min of vigorous-intensity physical activity per week, or equivalent combinations1) has been stable in recent decades.2 Nevertheless, promoting physical activity in the least active groups remains a considerable challenge. Latin America is a good example of the size of this challenge, as it is the region with the highest prevalence of physical inactivity in the world.1 The region is composed mainly of low-income and middle-income countries (LMICs), characterised by recent urbanisation, large cultural differences within populations, and social inequalities.
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Exercise training in long COVID: the EXER-COVID trial
(Oxford University Press, 2024-11-22) Ramírez Vélez, Robinson; Oteiza Olaso, Julio; Legarra Gorgoñón, Gaizka; Oscoz Ochandorena, Sergio; García Alonso, Nora; García Alonso, Yesenia; Correa Rodríguez, María; Soto-Mota, Adrian; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Ciencias humanas y de la educación; Giza eta Hezkuntza Zientziak
Background: the post-COVID-19 condition is a novel condition for which guidelines recommend supervised exercise, but evidence guiding safe and effective interventions is limited. The aim of this study was to investigate the effects of a tailored exercise program (EXER-COVID 5 trial) on cardiorespiratory fitness, muscle strength, long COVID symptoms, cognitive performance, quality of life, depression, and psychological distress. Methods: this crossover study included 100 participants with post-COVID-19 conditions (mean 8 age 48 years; 68% women) at a single center in Spain from March 1, 2021, to September 30, 2022. Participants were randomized 1:1 to 6 weeks of muscle power resistance training (PRT) followed by 6 weeks of usual care (Group 1 [AB], n=50) or 6 weeks of usual care followed by 6 weeks of muscle power RT (Group 2 [BA], n=50). Results: the intervention significantly improved the peak VO2 by 2.10 mL/kg/min [95% CI 1.25 to 2.94], P<0.001. Per-protocol analyses revealed similar results (2.40 mL/kg/min [95% CI 1.56 to 3.25]), P<0.001. No carry-over or period effects were detected. After power PRT, strength (1RM) was improved for pectoral press, bilateral leg-press, knee extension, and back press (P<0.001). Significant decreases were found in psychological distress scores (P<0.001). The intervention also improved quality of life (P=0.041), cognitive capabilities (P=0.014) and cognitive performance (P=0.036). Furthermore, the exercise program reduced seven of the 22 long-COVID symptoms, including weakness (RR= 0.75) dyspnea (RR= 0.56), hearing loss/tinnitus (RR= 0.86), change in appetite (RR= 0.84), memory loss (RR= 0.84), stress (RR= 0.80) and apathy/depression (RR= 0.80), (all Ps<0.05). Conclusions: a supervised 6-week PRT intervention program safely improved cardiorespiratory fitness, strength, and mental health in participants with post-COVID-19 conditions. These findings provide clinicians with evidence to support exercise as standard co-therapy and warrant further study.
Open Access
Mode of commuting to school and its association with physical activity and sedentary habits in young ecuadorian students
(MDPI, 2018) Barranco Ruiz, Yaira; Guevara-Paz, Alfredo Xavier; Ramírez Vélez, Robinson; Chillón, Palma; Villa González, Emilio; Ciencias de la Salud; Osasun Zientziak
Active commuting to and from school (ACS) could help to increase daily physical activity levels in youth; however, this association remains unknown in Ecuadorian youth. Thus, the aims of this study were (1) to determine the patterns of commuting to and from school and (2) to analyze the associations between ACS, physical activity (PA), and sedentary habits in Ecuadorian youth. A total of 732 students (65.3% males), aged 10–18 years (children = 246, young adolescents = 310, older adolescents = 162) from the central region of Ecuador participated in this study. A self-report questionnaire, including the usual mode and frequency of commuting, distance from home to school (PACO-Questionnaire), and PA and sedentary habits (YAP-Questionnaire), was used. Most of the sample lived ≤2 km from school; however, they were mainly passive commuters (96%). The most common mode of commuting was by car (to school = 43.4%, from school = 31.6%; p < 0.001). Children presented significantly higher scores (0–4) in PA outside school and total PA compared with older adolescents (2.20 ± 0.97 vs. 1.97 ± 0.96; p = 0.013 and 2.30 ± 0.76 vs. 2.09 ± 0.74, p = 0.019, respectively), as well as the lowest scores in sedentary habits (1.51 ± 0.65, p < 0.001). PA at school and total PA were positively associated with ACS (OR 3.137; 95% CI, 1.918 to 5.131; p < 0.001, and OR 2.543; 95% CI, 1.428 to 4.527; p = 0.002, respectively). In conclusion, passive modes of transportation were the most frequently used to commute to and from school in young Ecuadorians. PA at school and total PA were positively associated with ACS. Thus, interventions at school setting could be an opportunity to improve PA levels and additionally ACS in youth from the central region of Ecuador.
Open Access
Factors associated with active commuting to school by bicycle from Bogotá, Colombia: the FUPRECOL study
(BMC, 2016) Ramírez Vélez, Robinson; Beltrán, Cesar Augusto; Correa Bautista, Jorge Enrique; Vivas, Andrés; Prieto Benavides, Daniel Humberto; Martínez Torres, Javier; Triana Reina, Héctor Reynaldo; Villa González, Emilio; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Active commuting to school (ACS) can contribute to daily physical activity (PA) levels in children and adolescents. The aim of the study was to analyze the characteristics of active commuting to and from school by bicycle and to identify the factors associated with the use of bicycles for active commuting to school based in a sample of schoolchildren in Bogotá, Colombia. Methods: A cross-sectional study was conducted in 8,057 children and adolescents. A self-reported questionnaire was used to measure frequency and mode of commuting to school and the time it took them to get there. Weight, height, and waist circumference measurements were obtained using standardized methods, and mothers and fathers self-reported their highest level of educational attainment and household level. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis. Results: 21.9 % of the sample reported commuting by bicycle and 7.9 % reported commuting for more than 120 min. The multivariate logistic regression showed that boys, aged 9-12 years, and those whose parents had achieved higher levels of education (university/postgraduate) were the factors most strongly associated with a use bicycles as a means of active commuting to and from school. Conclusion: The findings of this study suggest that it's necessary to promote ACS from childhood and to emphasize its use during the transition to adolescence and during adolescence itself in order to increase its continued use by students.
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
Prevalence and sociodemographic correlates of physical activity and sitting time among south american adolescents: a harmonized analysis of nationally representative cross-sectional surveys
(BMC Public Health, 2022) Araujo, Raphael H. O.; Werneck, André de Oliveira; Barboza, Luciana L.; Ramírez Vélez, Robinson; Martins, Clarice M. L.; Tassitano, Rafael M.; Silva, Ellen C. M.; Jesus, Gilmar M. de; Matias, Thiago S.; Lima, Luiz R. A. de; Brazo-Sayavera, Javier; Silva, Danilo R.; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Background: to identify the prevalence and sociodemographic correlates of diferent domains of physical activity (PA) and higher sitting time among South American adolescents. Methods: data from national surveys of 11 South American countries were analyzed, and comprised information on 166,901 adolescents. PA (≥60 min/day of moderate-vigorous PA), physical education classes (PEC) (≥3 classes/wk), active commuting to school (≥1 d/wk), and higher sitting time (≥3 h/d) were self-reported. Sociodemographic correlates, such as gender, age, and food security status were explored using a random efect meta-analysis for logistic parameters. Results: recommended PA ranged between 7.5% (Brazil) and 19.0% (Suriname). Peru (2.2%) and Guyana (43.1%) presented the lowest prevalence of PEC and active commuting to school, respectively. Higher sitting time was less prevalent in Bolivia (24.6%) and more prevalent in Argentina (55.6%). Compared to girls, boys were more prone to reach recommendations for PA [OR=1.94(1.65;2.28)]; to reach≥3 PEC [OR=1.17(1.04;1.33)] and to be active in commuting to school [(OR=1.14(1.06;1.23)], but less prone to higher sitting time [(OR=0.89(0.82;0.96)]. Older adolescents had less odds of reach PA guidelines [OR=0.86(0.77; 0.97)] and accumulated higher sitting time [OR=1.27(1.14;1.41)]. Adolescents with food insecurity reported more PEC [OR=1.12(1.04;1.21)] and active commuting to school [OR=1.12(1.02;1.22)] but had less higher sitting time than their food security pairs [OR=0.89(0.81;0.98)]. Conclusions: few adolescents reach the PA recommendation. Actions aiming the promotion of PA and the reduction of sitting time must consider girls and older adolescents as target groups, as well as the specifcs of each country.
Open Access
Factors associated with meeting the WHO physical activity recommendations in pregnant colombian women
(Springer Nature, 2022) López Gil, José Francisco; Izquierdo Redín, Mikel; García Hermoso, Antonio; Alonso Martínez, Alicia; Rincón Pabón, David; Morales Osorio, Marco Antonio; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015–2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01–0.18); Mestizo: OR 0.12, 95% CI (0.06–0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06–4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.
Open Access
Healthy lifestyle behaviors and their association with self-regulation in Chilean children
(MDPI, 2020) López Gil, José Francisco; Oriol Granado, Xabier; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Fernández Vergara, Omar; Ciencias de la Salud; Osasun Zientziak
Background: Self-regulation comprises a series of important competencies, such as the ability to control inner states or responses toward thoughts, attention, emotions, or even performance. The relationship between self-regulation and different healthy lifestyle behaviors among children has not been examined in depth to date. The aim of this study was to explore the association between physical activity, screen time levels, and/or Mediterranean Diet adherence and self-regulation in Chilean children. Methods: A total of 1561 children aged 8–12 years from eight public schools with low socioeconomic status were included. Physical activity, screen time, Mediterranean Diet, and self-regulation were assessed with validated questionnaires. Results: Children who were classified as active or those who reported less than 2 h per day of screen time had higher self-regulation than those who were classified as inactive or counterparts with 2 h per day or more of screen time, respectively. Using joint categories, active children both with low and high screen time showed higher self-regulation compared to inactive/high screen time peers. Additionally, active groups with adherence or non-adherence to the Mediterranean Diet had higher self-regulation compared to inactive and non-adherence peers. Conclusion: Having a greater number of healthy habits, mainly regular physical activity, was associated with higher self-regulation, which might be one potential strategy to promote child social-emotional development.
Open Access
Prevalence of meeting all three 24-h movement guidelines and its correlates among preschool-aged children
(Wiley, 2023) Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; López Gil, José Francisco; Rincón Pabón, David; Martínez-Jamioy, Edwar Nicolas; Rivera-Ruiz, Rosemberg; Castellanos-Montaña, Sebastián; Atencio Osorio, Miguel Alejandro; Carrillo Arango, Hugo Alejandro; Alonso Martínez, Alicia; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The aim of the present study was twofold: first, to determine the meeting all three 24-h movement guidelines in Colombian preschool-aged children, and second, to explore the associations between different socio-ecological correlates and the meeting of these guidelines. This was a cross-sectional study with data from the Encuesta Nacional de Situación Nutricional (ENSIN-2015) in Colombia, 2015–2016. The sample comprised 3002 low-income preschoolers (3–4 years old, 50.7% boys). Data on physical activity, screen time, and sleep time were collected using the Cuestionario para la Medición de Actividad Física y Comportamiento Sedentario, reported by their parents. In total, 18 potential correlates (individual, interpersonal, organizational, and community level) were analyzed. Backward binary logistic regression analysis was performed with the potential correlates as independent variables and meeting all three 24-h movement guidelines as dependent variables. The prevalence of preschoolers meeting all three 24-h movement guidelines or none was 4.8% and 16.6%, respectively. In the final model, boys (odds ratio [OR] = 1.87, 95% confidence interval [CI] 1.00–3.50) and those who do not have television in their bedroom (OR = 2.09, 95%CI 1.05–4.14) were more likely to meet all three 24-h movement guidelines compared to with girls and those who have television, respectively. In conclusion, strategies to promote adherence to all 24-h movement guidelines among low-income preschoolers are warranted, and should focus on actions considering the importance of sex and home environment changes to support these movement behaviors.
Open Access
Patterns of healthy lifestyle behaviours in older adults: findings from the Chilean National Health Survey 2009-2010
(Elsevier, 2018) Troncoso, Claudia; Petermann-Rocha, Fanny; Brown, Rosemary; Leiva, Ana María; Martínez, María Adela; Diaz-Martinez, Ximena; Garrido-Méndez, Alex; Poblete-Valderrama, Felipe; Iturra-González, José A.; Villagrán, Marcelo; Mardones, Lorena; Salas-Bravo, Carlos; Ulloa, Natalia; García Hermoso, Antonio; Ramírez Vélez, Robinson; Vásquez-Gómez, Jaime; Celis Morales, Carlos; Ciencias de la Salud; Osasun Zientziak
The purpose of this study was to investigate healthy lifestyle behaviours across age categories in the older population in Chile. Data from 1390 older adults (¿60 years), in the 2009-2010 Chilean National Health Survey were analyzed. We derived the following age categories: 60-65, 66-70, 71-75, 76-80 and >80 years. The associations between age and compliance with healthy lifestyle behaviours (smoking, sitting time, physical activity, sleep duration and intake of salt, alcohol, fruit and vegetables) were investigated using logistic regression. The probability of meeting the guidelines for alcohol intake (OR trend: 1.35 [95% CI: 1.11; 1.64], p = 0.001) and smoking (OR trend: 1.23 [95% CI: 1.13; 1.33], p < 0.0001) increased with age, whereas spending <4 h per day sitting time or engaging in at least 150 min of physical activity per week or sleep on average between 7 and 9 h per day were less likely to be met with increasing age (OR trend: 0.77 [95% CI: 0.71; 0.83], p < 0.000; OR trend: 0.73 [95% CI: 0.67; 0.79], p < 0.0001, and OR trend: 0.89 [95% CI: 0.82; 0.96], p = 0.002, respectively). No significant trend across age categories was observed for fruit and vegetables, and salt intake. The probability of meeting at least 3 out of 7 healthy lifestyle behaviours across the age categories was also lower in older age categories compared to those aged 60 to 65 years. Overall, in older adults the probability of having the healthy lifestyle behaviours of physical activity, sitting time and sleeping behaviours was low but not for smoking or alcohol consumption. With an increasingly ageing population, these findings could inform stakeholders on which lifestyle behaviours could be targeted in the older adults and therefore which interventions should take place to promote healthy ageing.