Open Access
Relative handgrip strength diminishes the negative effects of excess adiposity on dependence in older adults: a moderation analysis
(MDPI, 2020) Ramírez Vélez, Robinson; Pérez Sousa, Miguel A.; García Hermoso, Antonio; Zambom Ferraresi, Fabrício; Martínez Velilla, Nicolás; López Sáez de Asteasu, Mikel; Cano Gutiérrez, Carlos Alberto; Rincón Pabón, David; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
The adverse effects of fat mass on functional dependence might be attenuated or worsened, depending on the level of muscular strength. The aim of this study was to determine (i) the detrimental effect of excess adiposity on dependence in activities of daily living (ADL), and (ii) whether relative handgrip strength (HGS) moderates the adverse effect of excess adiposity on dependence, and to provide the threshold of relative HGS from which the adverse effect could be improved or worsened. A total of 4169 participants (69.3 +/- 7.0 years old) from 244 municipalities were selected following a multistage area probability sampling design. Measurements included anthropometric/adiposity markers (weight, height, body mass index, waist circumference, and waist-to-height ratio (WHtR)), HGS, sarcopenia 'proxy' (calf circumference), and ADL (Barthel Index scale). Moderation analyses were performed to identify associations between the independent variable (WHtR) and outcomes (dependence), as well as to determine whether relative HGS moderates the relationship between excess adiposity and dependence. The present study demonstrated that (i) the adverse effect of having a higher WHtR level on dependence in ADL was moderated by relative HGS, and (ii) two moderation thresholds of relative HGS were estimated: 0.35, below which the adverse effect of WHtR levels on dependency is aggravated, and 0.62, above which the adverse effect of fat on dependency could be improved. Because muscular strength represents a critically important and modifiable predictor of ADL, and the increase in adiposity is inherent in aging, our results underscore the importance of an optimal level of relative HGS in the older adult population.
Open Access
Predictive validity of the body adiposity index in overweight and obese adults using dual-energy X-ray absorptiometry
(MDPI, 2016) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; González-Ruíz, Katherine; Vivas, Andrés; García Hermoso, Antonio; Triana Reina, Héctor Reynaldo; Ciencias de la Salud; Osasun Zientziak
The body adiposity index (BAI) is a recent anthropometric measure proven to be valid in predicting body fat percentage (BF%) in some populations. However, the results have been inconsistent across populations. This study was designed to verify the validity of BAI in predicting BF% in a sample of overweight/obese adults, using dual-energy X-ray absorptiometry (DEXA) as the reference method. A cross-sectional study was conducted in 48 participants (54% women, mean age 41.0 ± 7.3 years old). DEXA was used as the "gold standard" to determine BF%. Pearson¿s correlation coefficient was used to evaluate the association between BAI and BF%, as assessed by DEXA. A paired sample t-test was used to test differences in mean BF% obtained with BAI and DEXA methods. To evaluate the concordance between BF% as measured by DEXA and as estimated by BAI, we used Lin¿s concordance correlation coefficient and Bland-Altman agreement analysis. The correlation between BF% obtained by DEXA and that estimated by BAI was r = 0.844, p < 0.001. Paired t-test showed a significant mean difference in BF% between methods (BAI = 33.3 ± 6.2 vs. DEXA 39.0 ± 6.1; p < 0.001). The bias of the BAI was -6.0 ± 3.0 BF% (95% CI = -12.0 to 1.0), indicating that the BAI method significantly underestimated the BF% compared to the reference method. Lin¿s concordance correlation coefficient was considered stronger (rc = 0.923, 95% CI = 0.862 to 0.957). In obese adults, BAI presented low agreement with BF% measured by DEXA; therefore, BAI is not recommended for BF% prediction in this overweight/obese sample studied.
Open Access
Pubertal stage, body mass index, and cardiometabolic risk in children and adolescents in Bogotá, Colombia: the cross-sectional FUPRECOL study
(MDPI, 2017) Ramírez Vélez, Robinson; García Hermoso, Antonio; Agostinis-Sobrinho, César; Mota, Jorge; Santos, Rute; Correa Bautista, Jorge Enrique; Peña-Guzmán, Carlos Andrés; Domínguez Sánchez, María Andrea; Schmidt Río-Valle, Jacqueline; González Jiménez, Emilio; Ciencias de la Salud; Osasun Zientziak
This study explored the association between pubertal stage and anthropometric and cardiometabolic risk factors in youth. A cross-sectional study was conducted in 2877 Colombian children and adolescents (9¿17.9 years of age). Weight, height, and waist circumference were measured and body mass index (BMI) was calculated. A biochemical study was performed to determine the cardiometabolic risk index (CMRI). Blood pressure was evaluated and pubertal stage was assessed with the Tanner criteria. Hierarchical multiple regression analyses were performed. The most significant variable (p < 0.05) in the prognosis of cardiometabolic risk was found to be the BMI in both boys and girls. In the case of girls, the pubertal stage was also a CMRI predictive factor. In conclusion, BMI was an important indicator of cardiovascular risk in both sexes. Pubertal stage was associated with cardiovascular risk only in the girls.
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
Effects of exercise training on fetuin-a in obese, type 2 diabetes and cardiovascular disease in adults and elderly: a systematic review and meta-analysis
(BioMed Central, 2019) Ramírez Vélez, Robinson; García Hermoso, Antonio; Hackney, Anthony C.; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: elevated levels of fetuin-A are associated with increased risks of metabolic syndrome, type 2 diabetes and nonalcoholic fatty liver disease. This meta-analysis investigated whether exercise interventions can reduce fetuin-A in adults. Methods: we searched clinical trials that objectively assessed fetuin-A and included study arms with exercise intervention. The pre-intervention and post-intervention data were used for meta-analysis. The effect sizes were calculated as standardized mean differences or changes in fetuin-A and expressed as Hedges' g using random-effects models. Results: the overall Hedges' g for fetuin-A in all included interventions was - 0.640 (95%CI - 1.129 to - 0.151; n = 9), but this effect was not observed in obese (g = - 0.096; 95%CI, - 0.328 to 0.135) and type 2 diabetes/dysglycemia (g = - 0.56; 95%CI, - 1.348 to 0.236) individuals. Additionally, the random-effects meta-regression analysis showed that there was not a greater decrease in fetuin-A in individuals who achieved greater body mass index reductions (regression coefficient = 0.065; 95%CI, - 0.185 to 0.315). Conclusion: supervised exercise is associated with reductions in fetuin-A levels in adults and elderly. However, the results of the present meta-analysis should be interpreted with caution because of the variety of type of exercises and individual obesity related-disorders involve. Therefore, additional high-quality randomized controlled trials describing the effect of supervised exercise interventions on fetuin-A in adults are still needed.
Open Access
Cardiorespiratory fitness cut-points are related to body adiposity parameters in Latin American adolescents
(MDPI, 2019) Prieto Benavides, Daniel Humberto; García Hermoso, Antonio; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Agostinis-Sobrinho, César; Correa Bautista, Jorge Enrique; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background and Objectives: A deficiency exists in the criterion-referenced cut-points for field-based cardiorespiratory fitness (CRF) in Latin American youths. The aims of the present study were two-fold: (1) To identify the ability of CRF estimated by the 20-m shuttle-run test (20mSRT) to differentiate between 'healthy' and 'unhealthy' phenotypes (by adiposity) in adolescents; (2) to assess the association between obesity and relative peak oxygen uptake (VO2peak) in a large and diverse sample of Latin American youths. In total, 72,505 adolescents aged between 13 and 15 years were recruited from Chile and Colombia (47.5% girls). Materials and Methods: The waist circumference (WC) and waist-to-height ratio (WHtR) were used to identify body adiposity markers. CRF was measured using the 20mSRT (VO2peak). Receiver operating characteristic curves and logistic regression were used to determine the discriminatory ability of CRF to predict body adiposity parameters. Results: For boys and girls, VO2peak showed a significant predictive capacity to detect body fat (area under the curve [AUC] > 0.62). The sensitivity of VO2peak was medium (>63%) for all age- and sex-specific cut-points, with optimal cut-points in 13- to 15-year olds for obesity identified as 43.77 mL·kg-1·min-1 and 38.53 mL·kg-1·min-1 in boys and girls, respectively. Conclusions: According to these cut-points, adolescents with low CRF were more likely to be obese either by WC or WHtR. The CRF cut-points can be used as quantitative markers for a healthier body in Latin American adolescents.
Open Access
The role of body adiposity index in determining body fat percentage in colombian adults with overweight or obesity
(MDPI, 2017) Ramírez Vélez, Robinson; Correa Bautista, Jorge Enrique; González-Ruíz, Katherine; Tordecilla Sanders, Alejandra; García Hermoso, Antonio; Schmidt Río-Valle, Jacqueline; González-Jiménez, Emilio; Ciencias de la Salud; Osasun Zientziak
The aim of this study is to investigate the accuracy of body adiposity index (BAI) as a convenient tool for assessing body fat percentage (BF%) in a sample of adults with overweight/obesity using bioelectrical impedance analysis (BIA). The study population was composed of 96 volunteers (60% female, mean age 40.6 ± 7.5 years old). Anthropometric characteristics (body mass index, height, waist-to-height ratio, hip and waist circumference), socioeconomic status, and diet were assessed, and BF% was measured by BIA-BF% and by BAI-BF%. Pearson’s correlation coefficient was used to evaluate the correlation between BAI-BF% and BF% assessed by BIA-BF%, while controlling for potential confounders. The concordance between the BF% measured by both methods was obtained with a paired sample t-test, Lin’s concordance correlation coefficient, and Bland-Altman plot analysis. Overall, the correlation between BF% obtained by BIA-BF% and estimated by BAI-BF% was r = 0.885, p < 0.001, after adjusting for potential confounders (age, socioeconomic status, and diet). Lin’s concordance correlation coefficient was moderate in both sexes. In the men, the paired t-test showed a significant mean difference in BF% between the methods (−5.6 (95% CI −6.4 to −4.8); p < 0.001). In the women, these differences were (−3.6 (95% CI −4.7 to −2.5); p < 0.001). Overall, the bias of the BAI-BF% was −4.8 ± 3.2 BF%; p < 0.001), indicating that the BAI-BF% method significantly underestimated the BF% in comparison with the reference method. In adults with overweight/obesity, the BAI presents low agreement with BF% measured by BIA-BF%; therefore, we conclude that BIA-BF% is not accurate in either sex when body fat percentage levels are low or high. Further studies are necessary to confirm our findings in different ethnic groups.
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
A cross-sectional study of the prevalence of metabolic syndrome and associated factors in Colombian collegiate students: the FUPRECOL-adults study
(MDPI, 2017) Martínez Torres, Javier; Correa Bautista, Jorge Enrique; González Ruiz, Katherine; Vivas, Andrés; Triana Reina, Héctor Reynaldo; Prieto Benavides, Daniel Humberto; Carrillo Arango, Hugo Alejandro; Ramos Sepúlveda, Jeison Alexander; Villa González, Emilio; García Hermoso, Antonio; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.
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.