Open Access
High intensity interval- vs resistance or combined-training for improving cardiometabolic health in overweight adults (cardiometabolic HIIT-RT study): study protocol for a randomised controlled trial
(BioMed Central, 2016) Ramírez Vélez, Robinson; Hernández, Alejandra; Castro, Karem; Tordecilla Sanders, Alejandra; González Ruiz, Katherine; Correa Bautista, Jorge Enrique; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Although evidence shows the positive health effects of physical activity, most of the adult population in Colombia are sedentary. It is, therefore, important to implement strategies that generate changes in lifestyle behaviours. This protocol describes a study in which we will compare the effects of 12 weeks of high-intensity interval training (HIIT), resistance training (RT) or combined training (HIIT + RT) on the improvement of body composition, endothelial function, blood pressure, blood lipids, and cardiorespiratory fitness in a cohort of sedentary, overweight adults (aged 30–50 years). Methods/design: Sixty sedentary, overweight adults attending primary care in Bogotá, Colombia will be included in a factorial randomised controlled trial. Participants will be randomly assigned to the following intervention groups: (1) non-exercise group: usual care with dietary support, (2) HIIT group: 4 × 4-min intervals at 85–95 % maximum heart rate (HRmax) (with the target zone maintained for at least 2 minutes), interspersed with a 4-min recovery period, at 65 % HRmax, (3) RT group: completing a resistance circuit (including upper and lower muscle groups) as many times as needed according to subject’s weight until an expenditure of 500 kcal at 40–80 % of one-rep max (1RM) has been achieved, and (4) combined group: HIIT + RT. The primary end point for effectiveness is vascular function as measured by flow-mediated vasodilatation 1 week after the end of exercise training. Discussion: The results of this study will provide new information about the possible effect of the programme in improving the cardiometabolic health of overweight adults, making a more efficient use of an adult’s resources over time.
Open Access
Effects of exercise training on glycaemic control in youths with type 1 diabetes: a systematic review and meta-analysis of randomised controlled trials
(Taylor & Francis, 2022) García Hermoso, Antonio; Ezzatvar, Yasmin; Huerta Uribe, Nidia; Alonso Martínez, Alicia; Chueca-Guindulain, María J.; Berrade-Zubiri, Sara; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
The aim of the study is to evaluate whether exercise interventions are associated with improved glycaemic control in children and adolescents with type 1 diabetes mellitus (T1DM), and to examine its relationship with the characteristics of the intervention (i.e. type, intensity, length, and duration of the sessions). Eligible criteria were randomised controlled trials of youth aged 6– 18 years with T1DM, participating in an exercise-based intervention where glycaemic control is measured (i.e. glycated haemoglobin [HbA1c]). Pooled effect sizes (Hedges’g) were calculated using random-effects inverse-variance analyses. Fourteen studies enrolling 509 patients were analysed. Effect size was expressed as Hedges’ g to correct for possible small sample bias. Overall, HbA1c levels in the exercise group (g = –0.38 95% confidence interval [CI], –0.66 to –0.11; mean difference [MD] = –0.62%) were reduced compared with the control group. Concurrent training (g = –0.63 95%CI, –1.05 to –0.21), high-intensity exercise (g = –0.43 95%CI, –0.83 to –0.03), interventions ≥24 weeks (g = –0.92 95%CI, –1.44 to –0.40), and sessions ≥60 minutes (g = –0.71 95%CI, –1.05 to –0.08) showed larger changes (MD = –0.66% to 1.30%). In conclusion, our study suggests that programmes longer than 24 weeks with at least 60 min/session of high-intensity concurrent exercise may serve as a supportive therapy to metabolic control in youth with T1DM.
Open Access
International exercise recommendations in older adults (ICFSR): expert consensus guidelines
(Springer, 2021) Izquierdo Redín, Mikel; Merchant, R.A.; Morley, John E.; Anker, S.D.; Aprahamian, I.; Arai, H.; Aubertin-Leheudre, M.; Bernabei, R.; Lusa Cadore, Eduardo; Cesari, Matteo; Chen, L.-K.; Souto Barreto, Philipe de; Duque, Gustavo; Ferrucci, L.; Fielding, R.A.; García Hermoso, Antonio; Gutiérrez Robledo, L.M.; Harridge, S.D.R.; Kirk, B.; Kritchevsky, S.; Landi, F.; Lazarus, N.; Martin, F.C.; Marzetti, E.; Pahor, M.; Ramírez Vélez, Robinson; Rodríguez Mañas, Leocadio; Rolland, Y.; Ruiz, J.G.; Theou, O.; Villareal, D.T.; Waters, D.L.; Won Won, C.; Woo, J.; Vellas, Bruno; Fiatarone Singh, Maria; Ciencias de la Salud; Osasun Zientziak
The human ageing process is universal, ubiquitous and inevitable. Every physiological function is being continuously diminished. There is a range between two distinct phenotypes of ageing, shaped by patterns of living-experiences and behaviours, and in particular by the presence or absence of physical activity (PA) and structured exercise (i.e., a sedentary lifestyle). Ageing and a sedentary lifestyle are associated with declines in muscle function and cardiorespiratory fitness, resulting in an impaired capacity to perform daily activities and maintain independent functioning. However, in the presence of adequate exercise/PA these changes in muscular and aerobic capacity with age are substantially attenuated. Additionally, both structured exercise and overall PA play important roles as preventive strategies for many chronic diseases, including cardiovascular disease, stroke, diabetes, osteoporosis, and obesity; improvement of mobility, mental health, and quality of life; and reduction in mortality, among other benefits. Notably, exercise intervention programmes improve the hallmarks of frailty (low body mass, strength, mobility, PA level, energy) and cognition, thus optimising functional capacity during ageing. In these pathological conditions exercise is used as a therapeutic agent and follows the precepts of identifying the cause of a disease and then using an agent in an evidence-based dose to eliminate or moderate the disease. Prescription of PA/structured exercise should therefore be based on the intended outcome (e.g., primary prevention, improvement in fitness or functional status or disease treatment), and individualised, adjusted and controlled like any other medical treatment. In addition, in line with other therapeutic agents, exercise shows a dose-response effect and can be individualised using different modalities, volumes and/or intensities as appropriate to the health state or medical condition. Importantly, exercise therapy is often directed at several physiological systems simultaneously, rather than targeted to a single outcome as is generally the case with pharmacological approaches to disease management. There are diseases for which exercise is an alternative to pharmacological treatment (such as depression), thus contributing to the goal of deprescribing of potentially inappropriate medications (PIMS). There are other conditions where no effective drug therapy is currently available (such as sarcopenia or dementia), where it may serve a primary role in prevention and treatment. Therefore, this consensus statement provides an evidence-based rationale for using exercise and PA for health promotion and disease prevention and treatment in older adults. Exercise prescription is discussed in terms of the specific modalities and doses that have been studied in randomised controlled trials for their effectiveness in attenuating physiological changes of ageing, disease prevention, and/or improvement of older adults with chronic disease and disability. Recommendations are proposed to bridge gaps in the current literature and to optimise the use of exercise/PA both as a preventative medicine and as a therapeutic agent.
Open Access
Measurement of physical activity and sedentary behavior in national health surveys, South America
(PAHO, 2022) Silva, Danilo R.; Leite Silva, Luciana; Baldew, Se-Sergio; Anza-Ramirez, Cecilia; Ramírez Vélez, Robinson; Gomes, Thayse N.; Sadarangani, Kabir P.; García Hermoso, Antonio; Nieto-Martinez, Ramfis; Ferrari, Gerson; Miranda, Jaime; Werneck, André de Oliveira; Ciencias de la Salud; Osasun Zientziak
Objetivos. Describir cómo se han medido la actividad física y el sedentarismo en las encuestas nacionales de salud en los países de América del Sur. Métodos. Se llevó a cabo una extensa búsqueda de encuestas nacionales de salud de los doce países sudamericanos en sitios web de salud, oficinas nacionales de estadística y mediante el contacto con investigadores y responsables de formular políticas. Para escoger las encuestas se emplearon los siguientes criterios de selección: realizada en un país sudamericano; muestra representativa a nivel nacional de ≥ 18 años; coordinada por el sector público, el sector privado o mixto público-privado; y evaluación de la actividad física o el sedentarismo. Se extrajeron datos como información general de las encuestas, detalles específicos de la evaluación de la actividad física y el sedentarismo, y otras preguntas relacionadas con la actividad física. Resultados. En total, se incluyeron 36 encuestas, dos de las cuales se realizaron en varios países. Todas las encuestas evaluaron la actividad física; 27, el sedentarismo. La mayoría de las encuestas (23/36; 64%) tividad física mediante preguntas sobre el tiempo invertido delante de pantallas o el tiempo diario sentado. Ninguna encuesta aplicó medidas basadas en dispositivos para obtener datos sobre estos comportamientos. Conclusiones. Las diferencias entre los instrumentos empleados y las modificaciones limitan la comparabilidad de los datos en todos los países. Esto pone de relieve la importancia de estandarizar la evaluación en América del Sur de las secciones dedicadas a la actividad física y al sedentarismo en las encuestas nacionales, con el objetivo general de contribuir a la creación de una estrategia estandarizada para la vigilancia de la actividad física y el sedentarismo en América del Sur.
Open Access
A before-school physical activity intervention to improve cognitive parameters in children: The Active-Start study
(Wiley, 2019-08-19) García Hermoso, Antonio; Hormazábal Aguayo, Ignacio; Fernández Vergara, Omar; González-Calderón, Nicole; Russell-Guzmán, Javier; Vicencio-Rojas, Francisca; Chacana-Canas, Cesar; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
The aim of the study was threefold: (a) to test a before-school physical activity intervention (Active-Start) on academic performance, selective attention, and concentration capacity; (b) to test the effect of the Active-Start intervention on anthropometry, body composition, and physical fitness parameters; and (c) whether the physical fitness components are moderators of the effect of the Active-Start program on academic performance, selective attention, and concentration capacity in Chilean children. The Active-Start intervention was a RCT which comprised 170 children (8-10 years old) from three public schools with low socioeconomic status from the city of Santiago (Chile). The exercise intervention was delivered daily, before starting the first school-class (8:00-8:30 am) for 8 weeks. Changes in academic performance, selective attention and concentration capacity, anthropometric, body composition, and physical fitness parameters were measured. The analyses used were mixed regression models for repeated measures over time. No statistically significant changes in attention and concentration capacity were found. However, significant changes were seen in language (0.63; 95% CI 0.49-0.77) and mathematics (0.49; 95% CI 0.32-0.66) performance (P < .001). Also, improvements were seen in fat mass, fat-free mass, muscular, and cardiorespiratory fitness (all P < .05). The Johnson-Neyman technique revealed a significant relationship between the effect of intervention and attention and concentration when change in cardiorespiratory fitness was above, but not below, 3.05 and 0.70 mL/kg/min, respectively. Implementing before-school physical activity programs such as the Active-Start to enhance the cardiorespiratory fitness may benefit attention capacity and academic success among schoolchildren.