Open Access
Long-term impact of adherence to muscle-strengthening guidelines on inflammation markers: a 17-year follow-up study with obesity parameters as mediators
(BMJ Publishing, 2024-12-07) García Hermoso, Antonio; Ezzatvar, Yasmin; Yáñez-Sepúlveda, Rodrigo; Olivares-Arancibia, Jorge; Páez-Herrera, Jacqueline; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak
Objective: To evaluate the relationship between adherence to muscle-strengthening guidelines in young adulthood and inflammation markers over a 17-year follow-up period. Additionally, it aims to examine whether body mass index (BMI) and waist circumference (WC) act as mediators in this relationship. Methods: The study analysed data from young adults aged 18–26 years who participated in waves III (2001–2002), IV (2008–2009) and V (2016–2018) of the Add Health Study. Adherence to muscle-strengthening guidelines was self-reported, and participants were classified as adherent if they engaged in strength training ≥2 days per week across all waves. Venous blood samples were collected at participants’ homes to measure highsensitivity C reactive protein (hs-CRP) levels and various cytokine concentrations, including interleukin (IL)−6, IL1beta, IL-8, IL-10 and tumour necrosis factor-alpha (TNFα). A global inflammation score was also calculated using z-scores of these markers. Results: A total of 2320 individuals participated (60.8% females). Participants adhering to muscle-strengthening guidelines exhibited significant reductions in hs-CRP, IL-6 and the inflammation z-score, with mean difference (MD) of −1.556mg/L (95% CI BCa −2.312 to −0.799), −0.324 pg/mL (95% BCa CI −0.586 to −0.062), and −0.400 (95% BCa CI −0.785 to −0.035), respectively. Mediation analysis revealed that BMI and WC levels at wave V significantly mediated the relationship between strength training and inflammation z-score, with significant indirect effects of −0.142 (95% CI −0.231 to −0.055) for BMI and −0.210 (95% CI −0.308 to −0.124) for WC. Conclusion: Adherence to muscle-strengthening guidelines alone may not be sufficient to achieve a notable decrease in inflammation without concurrent reductions in these obesity parameters.
Open Access
Are 24-hour movement recommendations associated with obesity-related indicators in the young population? A meta-analysis
(Wiley, 2023) López Gil, José Francisco; Tapia-Serrano, Miguel Ángel; Sevil-Serrano, Javier; Sánchez-Miguel, Pedro Antonio; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Objective: This study aimed to determine the relationship between meeting all three 24-hour movement recommendations (i.e., physical activity, sleep duration, and screen time) and obesity-related indicators among young people. Methods: Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Library). Results: Meeting the 24-hour movement recommendations was cross-sectionally associated with lower overall obesity-related indicators (r = −0.09, 95% CI: −0.11 to −0.06), but no longitudinal association was found. Regarding each obesity-related indicator separately, meeting all three recommendations was related to lower odds of overweight/obesity (odds ratio = 0.65, 95% CI: 0.56 to 0.76) and obesity alone (odds ratio = 0.28, 95% CI: 0.16 to 0.50). An inverse relationship between meeting 24-hour movement recommendations and BMI, BMI z score, waist circumference, and body fat was also found. Regarding subgroup analysis, the association between 24-hour movement recommendations and overall obesity-related indicators was similar regardless of sex, comparison used (meeting all three vs. not meeting [i.e., those who met zero to two of the movement behaviors] or meeting all three vs. none), and type of measure to assess 24-hour movement recommendations (i.e., self-reported or accelerometer-based measures). Conclusions: Meeting all 24-hour movement recommendations may be a crucial factor in maintaining a healthy weight status in the young population.
Open Access
Combined aerobic and muscle-strengthening activity guidelines and their association with obesity in US adolescents
(Wiley, 2023) García Hermoso, Antonio; Izquierdo Redín, Mikel; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
Most of the evidence on physical activity for maintaining a healthy weight in adolescents is based solely on aerobic physical activity alone, with little attention given to the muscle strength component. This study aimed to investigate the associations between aerobic activities and muscle-strengthening activities (MSA) and overweight/obesity among a representative sample of adolescents. Data from the United States-based Youth Risk Behavior Surveillance System for the 2011–2019 cycle were used in this cross-sectional study. Adolescents self-reported their adherence to aerobic and MSA guidelines, as well as their height and weight. Overweight and obesity were defined using the age- and sex-specific criteria of the Centers for Disease Control and Prevention, with a body mass index (BMI) ≥85th and ≥95th percentiles, respectively. We examined the associations between adherence to physical activity guidelines (reference: not meeting either of the physical activity guidelines) and overweight/obesity or obesity using binary logistic regressions. These analyses were adjusted for race/ethnicity, sex, age, screen time, sleep duration, tobacco, alcohol, fruit, vegetables, and soda consumption. A total of 42 829 adolescents (48.98% girls) were included in the study. Of these, 22.23% met both guidelines for physical activity, 30.47% had overweight/obesity, and 14.51% had obesity. Compared with meeting neither guideline, meeting both aerobic and MSA guidelines was associated with lower odds of having overweight/obesity (odds ratio [OR] = 0.64, 95% confidence interval [CI], 0.60 to 0.68) and obesity (OR = 0.52, 95% CI 0.48 to 0.56). These results were consistent across years of assessment, sex, and race/ethnicity. In conclusion, our results highlight the importance of MSA, which is often overlooked in physical activity recommendations in many studies, in combating childhood obesity in the United States.
Open Access
Maintaining an active lifestyle from adolescence to adulthood might alleviate the adverse association of preterm birth with cardiometabolic health
(Elsevier, 2024) Ezzatvar, Yasmin; López Gil, José Francisco; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa.
Aims: We aimed to determine whether physical activity attenuates preterm birth's adverse effects on adult cardiometabolic health. Methods: This retrospective study utilized data from the Add Health Study, a prospective cohort conducted in the United States. During Wave V (mean age: 37 years; 60.7% women; mean body mass index: 29 kg/m2; mean waist circumference: 95 cm), we evaluated cardiometabolic risk factors and preterm birth status (i.e., born <37 weeks). Self-reported physical activity data was collected through questionnaires during Waves I (ages 12–19) and Wave V. An "active lifestyle" was defined by adherence to recommendations during both waves, spanning from adolescence to adulthood. Results: The sample, comprising 3320 individuals, with 9.5% being preterm, included 7.6% who remained physically active throughout both adolescence and adulthood. Preterm-born individuals who were inactive had higher rates of obesity (incidence rate ratio [IRR] = 1.39, 95% confidence interval (CI) 1.05–1.84), abdominal obesity (IRR = 1.46, 95% CI 1.11–1.92), hyperlipidemia (IRR 3.50, 95% CI 1.94–4.29), type 2 diabetes (IRR = 2.37, 95% CI 1.12–5.01), and metabolic syndrome (IRR = 2.61, 95% CI 1.17–5.80) compared to active term-born individuals. Maintaining an active lifestyle appeared to decrease the risk of obesity and hyperlipidemia in adults born preterm (p > 0.05). Conclusions: While preterm birth is associated with an elevated risk of adult cardiometabolic risk, maintaining an active lifestyle appeared to slightly mitigate the risk of obesity and hyperlipidemia in adults born preterm.
Open Access
Mediterranean diet-based interventions to improve anthropometric and obesity indicators in children and adolescents: a systematic review with meta-analysis of randomized controlled trials
(Elsevier, 2023) López Gil, José Francisco; García Hermoso, Antonio; Sotos-Prieto, Mercedes; Cavero-Redondo, Iván; Martínez Vizcaíno, Vicente; Kales, Stefanos N.; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa, 1225%2F2022
To our knowledge, no systematic review with meta-analysis has separately synthesized the effects of Mediterranean diet-based interventions in children and adolescents in relation to the effects on anthropometric measures. A better understanding of the effects of Mediterranean dietbased interventions on anthropometric variables could facilitate their implementation in efforts to prevent obesity in the young population. The aim of the present meta-analysis was to evaluate the effects of Mediterranean diet-based interventions on anthropometric and obesity indicators among children and adolescents. Four databases were systematically searched (PubMed, Scopus, Web of Science, and Cochrane Database of Systematic Reviews), including all studies up until 15 March, 2023. Eligible articles were randomized controlled trials measuring the effect of an intervention based on the promotion of the Mediterranean diet and obesity-associated parameters. The effect size of each study was estimated by Cohen’s d for continuous variables or risk difference for categorical variables. Compared to the control group, the Mediterranean diet-based interventions showed small and significant reductions in body mass index (d=- 0.14; 95% CI: 0.26, 0.01; I 2= 77.52%). Participants in the Mediterranean diet-based interventions had a significant reduction in the percentage of obesity (risk difference = 0.12; 95% CI: 0.01, 0.23; I 2= 84.56%) in comparison with the control group. Interventions had greater effects when aiming at participants with excess weight (that is, overweight or obesity), both for body mass index, waist circumference, waist-to-height ratio, percentage of obesity, and percentage of abdominal obesity. Mediterranean diet-based interventions have a significant effect on reducing the body mass index as well as reducing obesity in children and adolescents (aged 3–18 y). This trial was registered at PROSPERO as CRD42023386789.