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
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.
Open Access
Fatness mediates the influence of muscular fitness on metabolic syndrome in Colombian collegiate students
(Public Library of Science, 2017) García Hermoso, Antonio; Carrillo Arango, Hugo Alejandro; González Ruiz, Katherine; Vivas, Andrés; Triana Reina, Héctor Reynaldo; Martínez Torres, Javier; Prieto Benavides, Daniel Humberto; Correa Bautista, Jorge Enrique; Ramos Sepúlveda, Jeison Alexander; Villa González, Emilio; Peterson, Mark Dean; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
The purpose of this study was two-fold: to analyze the association between muscular fitness (MF) and clustering of metabolic syndrome (MetS) components, and to determine if fatness parameters mediate the association between MF and MetS clustering in Colombian collegiate students. This cross-sectional study included a total of 886 (51.9% women) healthy collegiate students (21.4 ± 3.3 years old). Standing broad jump and isometric handgrip dynamometry were used as indicators of lower and upper body MF, respectively. Also, a MF score was computed by summing the standardized values of both tests, and used to classify adults as fit or unfit. We also assessed fat mass, body mass index, waist-to-height ratio, and abdominal visceral fat, and categorized individuals as low and high fat using international cut-offs. A MetS cluster score was derived by calculating the sum of the sample-specific zscores from the triglycerides, HDL cholesterol, fasting glucose, waist circumference, and arterial blood pressure. Linear regression models were used to examine whether the association between MF and MetS cluster was mediated by the fatness parameters. Data were collected from 2013 to 2016 and the analysis was done in 2016. Findings revealed that the best profiles (fit + low fat) were associated with lower levels of the MetS clustering (p 0.001 in the four fatness parameters), compared with unfit and fat (unfit + high fat) counterparts. Linear regression models indicated a partial mediating effect for fatness parameters in the association of MF with MetS clustering. Our findings indicate that efforts to improve MF in young adults may decrease MetS risk partially through an indirect effect on improvements to adiposity levels. Thus, weight reduction should be taken into account as a complementary goal to improvements in MF within exercise programs.
Open Access
Optimal adherence to a mediterranean diet and high muscular fitness are associated with a healthier cardiometabolic profile in collegiate students
(MDPI, 2018) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Ojeda Pardo, Mónica Liliana; Sandoval Cuellar, Carolina; García Hermoso, Antonio; Carrillo Arango, Hugo Alejandro; González Ruiz, Katherine; Prieto Benavides, Daniel Humberto; Tordecilla Sanders, Alejandra; Martinkenas, Arvydas; Agostinis-Sobrinho, César; Ciencias de la Salud; Osasun Zientziak
The aim of the study was to investigate the combined association of adherence to a Mediterranean diet (MedDiet) and muscular fitness (MF) with cardiometabolic health in collegiate students. The present cross-sectional analysis consisted of 1248 (714 females) healthy collegiate students (20.1 ± 2.7 years old). Adherence to a MedDiet was assessed by a KIDMED (Mediterranean Diet Quality Index) questionnaire. Standing broad jump, standing vertical jump, and isometric handgrip dynamometry were used as indicators of MF. The cardiometabolic profile was assessed using the following components: triglycerides, blood pressure, triglycerides, high-density lipoprotein (HDL)-cholesterol, glucose, and waist circumference. Analysis of covariance shows a significant difference in the cardiometabolic profile of both genders between the high MF/low MedDiet and high MF/optimal MedDiet groups, and the low MF/low MedDiet and low MF/optimal MedDiet groups (p < 0.001). No difference was found on cardiometabolic profile between high MF/optimal MedDiet and high MF/low MedDiet, both in males and females. Additionally, logistic regression shows that both female (odds ratio (OR) = 2.01; 95% confidence interval (CI): (1.8¿3.7); p = 0.02) and male (OR = 3.38; 95% CI: (1.9-5.8); p < 0.001) participants in the optimal MedDiet/high MF group had the highest odds of expressing a healthier cardiometabolic profile as compared to those in the low MF/low MedDiet group. In conclusion, a combination of high MF levels and optimal adherence to a MedDiet is associated with a healthier cardiometabolic profile; however, high MF levels seem to circumvent the deleterious effects of having a low adherence to a MedDiet.
Open Access
Tri-ponderal mass index vs. fat mass/height3 as a screening tool for metabolic syndrome prediction in Colombian children and young people
(MDPI, 2018) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Carrillo Arango, Hugo Alejandro; González Jiménez, Emilio; Schmidt Río-Valle, Jacqueline; Correa Rodríguez, María; García Hermoso, Antonio; González Ruiz, Katherine; Ciencias de la Salud; Osasun Zientziak
Tri-ponderal mass index (TMI) and fat mass index (FMI) have been proposed as alternative approaches for assessing body fat since BMI does not ensure an accurate screening for obesity and overweight status in children and adolescents. This study proposes thresholds of the TMI and FMI for the prediction of metabolic syndrome (MetS) in children and young people. For this purpose, a cross-sectional study was conducted on 4673 participants (57.1% females), who were 9-25 years of age. As part of the study, measurements of the subjects¿ weight, waist circumference, serum lipid indices, blood pressure and fasting plasma glucose were taken. Body composition was measured by bioelectrical impedance analysis (BIA). The TMI and FMI were calculated as weight (kg)/height (m3) and fat mass (kg)/height (m3), respectively. Following the International Diabetes Federation (IDF) definition, MetS is defined as including three or more metabolic abnormalities. Cohort-specific thresholds were established to identify Colombian children and young people at high risk of MetS. The thresholds were applied to the following groups: (i) a cohort of children where the girls' TMI 12.13 kg/m3 and the boys' TMI 12.10 kg/m3; (ii) a cohort of adolescents where the girls' TMI 12.48 kg/m3 and the boys' TMI 11.19 kg/m3; (iii) a cohort of young adults where the women's TMI 13.21 kg/m3 and the men's TMI 12.19 kg/m3. The FMI reference cut-off values used for the different groups were as follows: (i) a cohort of children where the girls¿ FMI 2.59 fat mass/m3 and the boys' FMI 1.98 fat mass/m3; (ii) a cohort of adolescents where the girls' FMI 3.12 fat mass/m3 and the boys' FMI 1.46 fat mass/m3; (iii) a cohort of adults where the women's FMI 3.27 kg/m3 and the men's FMI 1.65 kg/m3. Our results showed that the FMI and TMI had a moderate discriminatory power to detect MetS in Colombian children, adolescents, and young adults.
Open Access
Percentage of body fat and fat mass index as a screening tool for metabolic syndrome prediction in colombian university students
(MDPI, 2017) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; Sanders-Tordecilla, Alejandra; Ojeda Pardo, Mónica Liliana; Cobo-Mejía, Elisa Andrea; Castellanos-Vega, Rocío del Pilar; García Hermoso, Antonio; González-Jiménez, Emilio; Schmidt Río-Valle, Jacqueline; González Ruiz, Katherine; Ciencias de la Salud; Osasun Zientziak
High body fat is related to metabolic syndrome (MetS) in all ethnic groups. Based on the International Diabetes Federation (IDF) definition of MetS, the aim of this study was to explore thresholds of body fat percentage (BF%) and fat mass index (FMI) for the prediction of MetS among Colombian University students. A cross-sectional study was conducted on 1687 volunteers (63.4% women, mean age = 20.6 years). Weight, waist circumference, serum lipids indices, blood pressure, and fasting plasma glucose were measured. Body composition was measured by bioelectrical impedance analysis (BIA) and FMI was calculated. MetS was defined as including more than or equal to three of the metabolic abnormalities according to the IDF definition. Receiver operating curve (ROC) analysis was used to determine optimal cut-off points for BF% and FMI in relation to the area under the curve (AUC), sensitivity, and specificity in both sexes. The overall prevalence of MetS was found to be 7.7%, higher in men than women (11.1% vs. 5.3%; p < 0.001). BF% and FMI were positively correlated to MetS components (p < 0.05). ROC analysis indicated that BF% and FMI can be used with moderate accuracy to identify MetS in university-aged students. BF% and FMI thresholds of 25.55% and 6.97 kg/m2 in men, and 38.95% and 11.86 kg/m2 in women, were found to be indicative of high MetS risk. Based on the IDF criteria, both indexes¿ thresholds seem to be good tools to identify university students with unfavorable metabolic profiles.
Open Access
Effects of an exercise program on hepatic metabolism, hepatic fat, and cardiovascular health in overweight/obese adolescents from Bogotá, Colombia (the HEPAFIT study): study protocol for a randomized controlled trial
(BioMed Central, 2018) González Ruiz, Katherine; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; García Hermoso, Antonio; Domínguez Sánchez, María Andrea; Ciencias de la Salud; Osasun Zientziak
Background: A considerable proportion of contemporary youth have a high risk of obesity-related disorders such as cardiovascular disease, metabolic syndrome, or non-alcoholic fatty liver disease (NAFLD). Although there is consistent evidence for the positive effects of physical activity on several health aspects, most adolescents in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle. The HEPAFIT study aims to examine whether a 6-month exercise program has benefits for hepatic fat content and cardiovascular health outcomes among overweight/obese adolescents from Bogotá, Colombia. Methods/design: Altogether, 100 hundred overweight/obese, sedentary adolescents (aged 11–17 years) attending two public schools in Bogotá, Colombia, will be included in a parallel-group randomized controlled trial. Adolescents will be randomly assigned to an intervention group following one of four curricula: (1) the standard physical education curriculum (60 min per week of physical activity, n = 25) at low-to-moderate intensity; (2) a high-intensity physical education curriculum (HIPE, n = 25), consisting of endurance and resistance games and non-competitive activities, such as running, gymkhanas, lifting, pushing, wrestling, or hauling, for 60-min sessions, three times per week, with an energy expenditure goal of 300 to 500 kcal/session at 75–85% maximum heart rate (HRmax); (3) a low-to-moderate intensity physical education curriculum (LIPE, n = 25) consisting of endurance and resistance games and non-competitive activities (e.g., chasing, sprinting, dribbling, or hopping) for 60-min sessions, three times per week with an energy expenditure goal of 300 kcal/session at 55–75% HRmax; and (4) a combined HIPE and LIPE curriculum (n = 25). The HIPE, LIPE, and combined interventions were performed in addition to the standard physical education curriculum. The primary outcome for effectiveness is liver fat content, as measured by the controlled attenuation parameter 1 week after the end of the intervention program. Discussion: The translational focus may be suitable for collecting new information in a school setting on the possible effects of physical activity interventions to reduce liver fat content and to improve metabolic profiles and the cardiometabolic health of overweight/obese adolescents. This may lead to the more efficient use of school physical education resources.