Open Access
Muscle strength cut-offs for the detection of metabolic syndrome in a nonrepresentative sample of collegiate students from Colombia
(Elsevier, 2018) García Hermoso, Antonio; Tordecilla Sanders, Alejandra; Correa Bautista, Jorge Enrique; Peterson, Mark Dean; Izquierdo Redín, Mikel; Quino Ávila, Aura Cristina; Sandoval Cuellar, Carolina; González Ruiz, Katherine; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background: Evidence shows an association between grip strength and health; however, grip strength cut-offs for the detection of metabolic syndrome (MetS) in Latin American populations are scarce. The purpose of this study was to determine cut-offs of normalized grip strength (NGS) for the detection of MetS in a large nonrepresentative sample of a collegiate student population from Colombia. Methods: A total of 1795 volunteers (61.4% female, age = 20.68 ± 3.10 years, mean ± SD), ranging between 18 and 30 years of age participated in the study. Strength was estimated using a handheld dynamometer and normalized to body mass (handgrip strength (kg)/body mass (kg)). Anthropometrics, serum lipids indices, blood pressure, and fasting plasma glucose were measured. Body composition was measured by bioelectrical impedance analysis. MetS was defined as including ≥3 of the 5 metabolic abnormalities according to the International Diabetes Federation definition. A metabolic risk score was computed from the following components: waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and systolic and diastolic blood pressure. Results: Receiver operating curve analysis showed significant discriminatory accuracy of NGS in identifying the thresholds and risk categories. Lower strength was associated with increased prevalence of MetS. In males, weak, intermediate, and strong NGS values at these points were <0.466, 0.466–0.615, >0.615, respectively. In females, these cut-off points were <0.332, 0.332–0.437, >0.437, respectively. Conclusion: Our sex-specific cut-offs of NGS could be incorporated into a clinical setting for identifying college students at cardiometabolic disease risk.
Open Access
Handgrip strength attenuates the adverse effects of overweight on cardiometabolic risk factors among collegiate students but not in individuals with higher fat levels
(Nature Research, 2019) García Hermoso, Antonio; Tordecilla Sanders, Alejandra; Correa Bautista, Jorge Enrique; Peterson, Mark Dean; Izquierdo Redín, Mikel; Prieto Benavides, Daniel Humberto; Sandoval Cuellar, Carolina; González Ruiz, Katherine; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
The aims of this study are to (i) examine a clustered metabolic syndrome composite score (MetScore) and fatness among college students across body mass index (BMI) categories, and (ii) determine whether fit individuals have lower MetScores, fewer individual metabolic syndrome components, and lower fatness than unfit individuals across BMI categories. A total of 1,795 participants aged >18 years who participated in The FUPRECOL Study were selected for the present analyses. Handgrip strength was tested by a grip dynamometer and used to classify adults as fit or unfit. Among all participants, MetScore, percentage of body fat, and visceral adiposity increased linearly across the BMI categories among college students (all P < 0.001). Individuals who were overweight and fit had a lower MetScore (-0.6 SD; P =0.02), body fat percentage (-2.6%; P < 0.001) and visceral adiposity (-0.2; P = 0.01) than unfit peers. Moderately fit obese individuals had significantly lower visceral fat levels than unfit obese peers (-3.0; P = 0.03). These results suggest that having adequate handgrip strength-a proxy of overall strength capacity-may attenuate obesity-related cardiometabolic risk. Moreover, weight loss should be recommended to all individuals with obesity, even among those who are currently considered fit.
Open Access
Effectiveness of HIIT compared to moderate continuous training in improving vascular parameters in inactive adults
(BMC, 2019) Ramírez Vélez, Robinson; Hernández Quiñonez, Paula Andrea; Tordecilla Sanders, Alejandra; Álvarez, Cristian; Ramírez Campillo, Rodrigo; Izquierdo Redín, Mikel; Correa Bautista, Jorge Enrique; García Hermoso, Antonio; García, Ronald G.; Ciencias de la Salud; Osasun Zientziak
Background: Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases, such as cardiovascular disease (CVD), metabolic syndrome, and breast and colon cancers, and shortens life expectancy. We aimed to determine the effects of moderate (MCT)- versus high-intensity interval training (HIT) on vascular function parameters in physically inactive adults. We hypothesized that individualized HIT prescription would improve the vascular function parameters more than the MCT in a greater proportion of individuals. Methods; Twenty-one inactive adults were randomly allocated to receive either MCT group (60-75% of their heart rate reserve, [HRR] or HIT group (4min at 85-95% of peak HRR), 3 days a week for 12weeks. Vascular function (brachial artery flow-mediated dilation, FMD [%], normalized brachial artery flow-mediated dilation, FMDn [%], aortic pulse wave velocity, PWV [ms(-1)], AIx, augmentation index: aortic and brachial [%]), were measured at baseline and over 12weeks of training. In order for a participant to be considered a responder to improvements in vascular function parameters (FMDn and PWV), the typical error was calculated in a favorable direction. Results: FMD changed by -1.0% (SE 2.1, d=0.388) in the MCT group, and+1.8% (SE 1.8, d=0.699) in the HIT group (no significant difference between groups: 2.9% [95% CI, -3.0 to 8.8]. PWV changed by +0.1ms(-1) (SE 0.2, d=0.087) in the MCT group but decreased by -0.4ms(-1) in the HIT group (SE 0.2, d=0.497), with significant difference between groups: -0.4 [95% CI, -0.2 to -0.7]. There was not a significant difference in the prevalence of no-responder for FMD (%) between the MCT and HIT groups (66% versus 36%, P=0.157). Regarding PWV (ms(-1)), an analysis showed that the prevalence of no-responder was 77% (7 cases) in the MCT group and 45% (5 cases) in the HIT group (P=0.114). Conclusions: Under the conditions of the present study, both groups experienced changed in vascularfunction parameters. Compared to MCT group, HIT is more efficacious for improving FMD and decreasing PWV, in physically inactive adults.
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
Aerobic capacity and future cardiovascular risk in Indian community from a low-income area in Cauca, Colombia
(BioMed Central, 2017) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Ramos Sepúlveda, Jeison Alexander; Piñeros Álvarez, Carlos Andrés; Giraldo, Lorena Isabel; Izquierdo Redín, Mikel; García Hermoso, Antonio; Rodríguez Rodríguez, Fernando; Cristi Montero, Carlos; Ciencias de la Salud; Osasun Zientziak
Background: Several studies indicates that children’s aerobic capacity levels are predictors of the future risk of non-communicable diseases. Therefore, the aim of this study was to establish the proportion of subjects whose aerobic capacity is indicative of future cardiovascular risk in Indian-Nasa community from a low-income area in Cauca, Colombia. Methods: We performed a cross-sectional analysis of morphological component (height, weight, body mass index (BMI), waist circumference, triceps skinfold, subscapular skinfold, and body fat percent [BF%]), and the cardiorespiratory component (course-navette 20 m, shuttle run test and estimation of maximal oxygen consumption by indirect VO2max) from 576 participants (319 boys and 257 girls) aged 10 to 17.9 years, using the standardized FUPRECOL test battery. Results: We showed that the boys performed better than the girls in cardiorespiratory fitness. The proportion of subjects with an aerobic capacity indicative of future cardiovascular risk was 7.3%. By sex, 3.8% of boys and 11.7% of girls (X2 p = 0.001) displayed an unhealthy aerobic capacity in this study. Conclusion: The findings of this study that provide the first data on aerobic capacity health for Colombian Nasa Indian children and adolescents aged 10–17.9 years. Although the known loss of aerobic capacity is a serious consequence of the future risk of non-communicable diseases, the deterioration of physical fitness deserves increased attention among indigenous population.
Open Access
Cardiorespiratory fitness normative values in Latin-american adolescents: role of fatness parameters
(MDPI, 2019) Ramírez Vélez, Robinson; García Hermoso, Antonio; Alonso Martínez, Alicia; Agostinis-Sobrinho, César; Correa Bautista, Jorge Enrique; Triana Reina, Héctor Reynaldo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
The aim of this study was to provide percentile values for a cardiorespiratory fitness (CRF) field test for Latin-American adolescents (34,461 girls and 38,044 boys) aged 13 to 15 years. The role of fatness parameters on the CRF level across age groups was also examined, with a focus on non-obese (healthy) and obese groups. CRF was assessed using the 20-meter shuttle run test protocol. Anthropometric parameters were measured using body mass index z-score (body mass index (BMI) z-score), BMI, waist circumference (WC), and waist-to-height ratio (WHtR). Participants were categorized according to the BMI z-score, WC, and WHtR international cut-off points as healthy and obese. Age-and sex-specific reference tables for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centile scores were calculated using Cole’s lambda, mu, and sigma method. The prevalence of obesity according to the BMI z-score, WC, and WHtR was 9.6%, 11.2%, and 15.0%, respectively. Across all age and sex groups, a negative association was found between relative peak oxygen uptake (VO2 peak) and BMI, WC, and WHtR. In boys and girls there were higher levels of performance across all age groups, with most apparent gains between the ages of 13 and 14 years old. Overall, participants categorized in the healthy group had shown to have significantly higher VO2 peak than their obese counterparts (p < 0.001; Cohen’s d> 1.0). In conclusion, our study provides age-and sex-specific reference values for CRF (VO2 peak, mL·kg−1·min−1 ). The anthropometric parameters were inversely associated with CRF in all ages in both sexes. The obese group had worse CRF than their healthy counterparts independent of anthropometric parameters used to determine obesity.
Open Access
Similar cardiometabolic effects of high- and moderate-intensity training among apparently healthy inactive adults: a randomized clinical trial
(BioMed Central, 2017) Ramírez Vélez, Robinson; Tordecilla Sanders, Alejandra; Téllez Tinjaca, Luis Andrés; Camelo Prieto, Diana; Hernández Quiñonez, Paula Andrea; Correa Bautista, Jorge Enrique; García Hermoso, Antonio; Ramírez Campillo, Rodrigo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: Metabolic syndrome (MetS) increases the risk of morbidity and mortality from cardiovascular disease, and exercise training is an important factor in the treatment and prevention of the clinical components of MetS. Objective: The aim was to compare the effects of high-intensity interval training and steady-state moderate-intensity training on clinical components of MetS in healthy physically inactive adults. Methods: Twenty adults were randomly allocated to receive either moderate-intensity continuous training [MCT group; 60–80% heart rate reserve (HRR)] or high-intensity interval training (HIT group; 4 × 4 min at 85–95% peak HRR interspersed with 4 min of active rest at 65% peak HRR). We used the revised International Diabetes Federation criteria for MetS. A MetS Z-score was calculated for each individual and each component of the MetS. Results: In intent-to-treat analyses, the changes in MetS Z-score were 1.546 (1.575) in the MCT group and −1.249 (1.629) in the HIT group (between-groups difference, P = 0.001). The average number of cardiometabolic risk factors changed in the MCT group (−0.133, P = 0.040) but not in the HIT group (0.018, P = 0.294), with no difference between groups (P = 0.277). Conclusion: Among apparently healthy physically inactive adults, HIT and MCT offer similar cardiometabolic protection against single MetS risk factors but differ in their effect on average risk factors per subject.
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
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
Fat-to-muscle ratio: a new anthropometric indicator as a screening tool for metabolic syndrome in young Colombian people
(MDPI, 2018) Ramírez Vélez, Robinson; Carrillo Arango, Hugo Alejandro; Correa Bautista, Jorge Enrique; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; Correa Rodríguez, María; González Ruiz, Katherine; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Fat-to-muscle ratio has been proposed as an alternative approach for assessing body fat. The objective of this study was to explore fat-to-muscle ratio thresholds in metabolic syndrome (MetS) diagnosis; it was hypothesised that the fat-to-muscle ratio is a good predictive indicator of MetS in a large population of young Colombian adults. For this purpose, a cross-sectional study was conducted on 1416 subjects (66.6% female), aged from 18.1 to 25.1. As part of the study, measurements of the subjects' anthropometric indicators, serum lipid indices, blood pressure, and fasting plasma glucose were taken. Body composition was measured through bioelectrical impedance analysis (BIA). A new variable (ratio of fat mass to muscle mass, in kg) was calculated. Following the International Diabetes Federation (IDF) definition, MetS includes three or more metabolic abnormalities. Receiver operating characteristic (ROC) curves and logistic regression determined the discriminatory ability of the fat-to-muscle ratio to predict MetS. According to the IDF, the best fat-to-muscle ratio cut-off point for detecting MetS in men was 0.225 kg, with an area under the curve (AUC) of 0.83, sensitivity of 80%, and specificity of 70%. For women, the fat-to-muscle ratio cut-off point was 0.495 kg, the AUC was 0.88, and the sensitivity and specificity were 82% and 80%, respectively. In conclusion, our results showed that the fat-to-muscle ratio cut-off points from ROC analyses demonstrate good discriminatory power for detecting MetS in young Colombian adults.