Open Access
Twenty-four-hour movement guidelines during middle adolescence and their association with glucose outcomes and type 2 diabetes mellitus in adulthood
(Elsevier, 2022) García Hermoso, Antonio; López Gil, José Francisco; Ezzatvar, Yasmin; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: The aim of the present study was to determine the association between adherence to the 24-h movement guidelines during middle adolescence and glucose outcomes (glycated hemoglobin and fasting glucose) and type 2 diabetes mellitus (T2DM) in adulthood, 14 and 22 years later. Methods: We analyzed data from apparently healthy adolescents aged 12-18 years who participated in Waves I and II (1994-1996, n = 14,738), Wave IV (2008-2009, n = 8913), and Wave V (2016-2018, n = 3457) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) in the United States. Physical activity, screen time, and sleep duration were measured using questionnaires, and the 24-h guidelines were defined as: 5 or more times moderate-to-vigorous physical activity per week, ≤2 h per day of screen time, and sleeping 8-10 h per day and or night. Capillary and venous whole blood was collected and analyzed to determine glycated hemoglobin and fasting glucose for Waves IV and V, respectively. Results: Only 2.1% of the adolescents met all the 3 guidelines, and 37.8% met none of them. In both waves IV and V, adolescents who met physical activity and screen time guidelines had lower odds of T2DM in adulthood than those who did not meet any of these guidelines (Wave IV; prevalence ratio (PR) = 0.57, 95%CI: 0.21-0.89; Wave V: PR = 0.43, 95%CI: 0.32-0.74). Only for Wave V did adolescents who met all three guidelines have lower odds of T2DM at follow-up compared with those who did not meet any of these guidelines (PR = 0.47, 95%CI: 0.24-0.91). Also, for each increase in meeting one of the 24-h recommendations, the odds of T2DM decreased by 18% (PR = 0.82, 95%CI: 0.61-0.99) and 15% (PR = 0.85, 95%CI: 0.65-0.98) in adulthood for Waves IV and V, respectively. Conclusion: Promoting all 24-h movement guidelines in adolescence, especially physical activity and screen time, is important for lowering the potential risk of T2DM in adulthood.
Open Access
Effects of exercise interventions on inflammatory parameters in acutely hospitalized older patients: a systematic review and meta-analysis of randomized controlled trials
(MDPI, 2021) Ramírez Vélez, Robinson; García Hermoso, Antonio; Martínez Velilla, Nicolás; Zambom Ferraresi, Fabrício; López Sáez de Asteasu, Mikel; Recarey Rodríguez, Anel Eduardo; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa; Gobierno de Navarra / Nafarroako Gobernua
The purpose of this systematic review and meta-analysis was to appraise the acute effects of exercise training on inflammatory parameters in hospitalized older adults. We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Web of Science, Medline and PubMed were searched for studies published until August 2020. The review included all randomized controlled trials (RCTs) that evaluated and compared the effect of exercise versus usual care on inflammatory parameters in acutely hospitalized older adults. Two reviewers independently assessed the studies. The quality of all the included studies was assessed using the DerSimonian–Laird random-effects inverse-variance model. Five studies (275 participants) met the inclusion criteria. The exercise interventions included resistance or multicomponent intervention programs. The results indicate that, compared with usual care, exercise interventions have a positive impact on overall inflammatory parameters, including C-reactive protein (CRP) and insulin-like growth factor-I (IGF-1) (Hedge's g = −0.19, 95% confidence interval [CI] −0.33 to −0.04, p = 0.011, I2 = 0%). However, analyses of individual inflammatory parameters revealed a non-significant trend for reductions in CRP (Hedge's g = −0.20, 95% CI −0.47 to 0.07, p = 0.151, I2 = 31.2%) and IGF-I (Hedge's g = −0.34, 95% CI −0.79 to 0.11, p = 0.138, I2 = 0%). On the basis of this review, we conclude that exercise during acute hospitalization offers a mild improvement in the inflammatory profile over usual care in older patients. Nevertheless, due to limited number of RCTs, our findings must be interpreted with caution and confirmed in future studies.
Open Access
Healthy lifestyle behaviors and their association with self-regulation in Chilean children
(MDPI, 2020) López Gil, José Francisco; Oriol Granado, Xavier; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Fernández Vergara, Omar; Ciencias de la Salud; Osasun Zientziak
Background: Self-regulation comprises a series of important competencies, such as the ability to control inner states or responses toward thoughts, attention, emotions, or even performance. The relationship between self-regulation and different healthy lifestyle behaviors among children has not been examined in depth to date. The aim of this study was to explore the association between physical activity, screen time levels, and/or Mediterranean Diet adherence and self-regulation in Chilean children. Methods: A total of 1561 children aged 8–12 years from eight public schools with low socioeconomic status were included. Physical activity, screen time, Mediterranean Diet, and self-regulation were assessed with validated questionnaires. Results: Children who were classified as active or those who reported less than 2 h per day of screen time had higher self-regulation than those who were classified as inactive or counterparts with 2 h per day or more of screen time, respectively. Using joint categories, active children both with low and high screen time showed higher self-regulation compared to inactive/high screen time peers. Additionally, active groups with adherence or non-adherence to the Mediterranean Diet had higher self-regulation compared to inactive and non-adherence peers. Conclusion: Having a greater number of healthy habits, mainly regular physical activity, was associated with higher self-regulation, which might be one potential strategy to promote child social-emotional development.
Open Access
Factors associated with meeting the WHO physical activity recommendations in pregnant colombian women
(Springer Nature, 2022) López Gil, José Francisco; Izquierdo Redín, Mikel; García Hermoso, Antonio; Alonso Martínez, Alicia; Rincón Pabón, David; Morales Osorio, Marco Antonio; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015–2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01–0.18); Mestizo: OR 0.12, 95% CI (0.06–0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06–4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.
Open Access
Exercise during pregnancy on maternal lipids: a secondary analysis of randomized controlled trial
(BioMed Central, 2017) Ramírez Vélez, Robinson; Lobelo, Felipe; Aguilar de Plata, Ana C.; Izquierdo Redín, Mikel; García Hermoso, Antonio; Ciencias de la Salud; Osasun Zientziak
Background: Today, scientific evidence has supported the popular belief that physical activity is associated with biological health in pregnant women. A randomized controlled trial was used to assess the benefits of physical exercise during pregnancy on maternal lipids in low-income Latina women. Methods: The study included 67 nulliparous low-income Latina women in gestational weeks 16–20, randomly assigned into one of two groups: 1) The exercise group, which took part in aerobic and resistance exercise for 60min, three times a week for 12 weeks, 2) The control group, which undertook their usual physical activity and prenatal care. The primary outcomes were changes in maternal blood lipids after intervention. Obstetrical and neonatal outcomes measured were type of delivery, postpartum hemorrhage, newborn and/or maternal complications’, gestational age, weight gain, birth weight, foetal growth, and Apgar score. Results: Fifty women completed the study. At the end of the intervention, there were differences between groups in low-density lipoprotein levels (mean change: −8 mg/dL, 95%CI -3 to −29; P < 0.001) and triglycerides (mean change: −6 mg/dL, 95%CI -1 to −11; P = 0.03). Also, compared with women who remained in the control group, active women showed lower complications during delivery (moderate postpartum haemorrhage) (58% compared with 75%; P < 0.05) and lower complications in newborns (e.g. cyanosis or respiratory distress) (21% compared with 46%; P < 0.001). Conclusions: An exercise programme during the second and third trimester favours less gain in low-density lipoprotein cholesterol and triglycerides fewer delivery and neonatal complications.
Open Access
Comparison of hospitalisation settings and exercise interventions in acute care: a systematic review and meta-analysis
(Oxford University Press, 2025-02-21) Etayo Urtasun, Paula; López Sáez de Asteasu, Mikel; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak
Background: Inpatient hospitalisation is associated with adverse outcomes in older adults, including hospital-associated deconditioning. The hospital-at-home (HaH) model may promote physical activity. This systematic review and meta-analysis compares functional outcomes between inpatient and HaH settings and evaluates the efficacy of exercise interventions in both settings. Methods: Systematic searches of PubMed, Scopus, Web of Science and ScienceDirect were conducted on 27 April 2024. T hreedistinct searches were performed: (i) studies comparing HaHandinpatienthospitalisation, (ii) trials evaluating inpatient exercise interventions and (iii) research on HaH exercise interventions. Two reviewers independently selected studies published from 2014 onwards using the PICOS framework and they assessed quality using PEDro scale. A meta-analysis was performed using a random effects model to analyse exercise interventions. This systematic review with meta-analysis was conducted according to PRISMA 2020 guidelines and was registered on PROSPERO (CRD42024598286). Results: Among the 9470 studies identified, nine studies comparing acute-care settings and 21 studies on exercise interventions (one in HaH) were included. Findings suggest that HaH may positively affect functional and cognitive outcomes. Inpatient exercise interventions significantly improved physical performance [standardised mean difference (SMD)=0.42, 95%confidence interval (CI)=0.12–0.72] and functional independence (SMD=0.45, 95% CI=0.14–0.77) at discharge. Conclusion: HaH may contribute to preserving physical and cognitive status. Supervised exercise interventions during inpatient hospitalisation are safe and effective for improving older adults’ functional status, although further research in the HaH model is needed.
Open Access
Evaluación de los dominios de la actividad física y los componentes de la condición física en niños de 4-5 años en un centro de salud
(Lúa Ediciones 3.0, 2023) Legarra Gorgoñón, Gaizka; García Alonso, Yesenia; Ramírez Vélez, Robinson; Erice Echegaray, Blanca; Moreno González, Paula; Izquierdo Redín, Mikel; Alonso Martínez, Alicia; Ciencias de la Salud; Osasun Zientziak
Introducción: la falta de actividad física y el sedentarismo en niños se asocia con una mayor adiposidad, bajo nivel de aptitud cardiovascular y riesgo de enfermedades cardiovasculares. Sin embargo, cumplir con las recomendaciones de actividad física se relaciona con mejoras en la salud mental, disminución de la ansiedad y depresión, así como adopción de hábitos saludables. Objetivos: evaluar la relación entre los diferentes dominios de la actividad física y del sedentarismo, medidos de forma objetiva, y los componentes de la condición física en niños españoles de 4 y 5 años. Población y métodos: estudio transversal dentro del proyecto 'Observatorio y programa de intervención de ejercicio físico y estilos de vida en familia para niños y niñas de 4 a 5 años en Atención Primaria' (https://observatorioactividadfisica.es). La condición física se evaluó con la batería PREFIT y la cantidad e intensidad de actividad física mediante un acelerómetro tri-axial GENEActiv durante 7 días consecutivos las 24 horas del día. Resultados: la muestra evaluada fue de 70 niños (38 niños y 32 niñas) con una media (intervalo de confianza [IC] del 95%) de 4,83 años. No se observaron diferencias significativas en la condición física entre niños y niñas. Los niños realizaron una actividad física de mayor intensidad y tiempo que las niñas. Además, se encontró una fuerte relación significativa entre los componentes de la condición física y los dominios de la actividad física. Conclusiones: estos hallazgos resaltan la importancia de promover estilos de vida activos desde temprana edad y la necesidad de programas de entrenamiento estructurado para reducir el sedentarismo y mejorar la condición física en esta población.
Open Access
Active commuting to and from university, obesity and metabolic syndrome among Colombian university students
(BioMed Central, 2018) García Hermoso, Antonio; Quintero, Andrea P.; Hernández, Enrique; Izquierdo Redín, Mikel; Ramírez Vélez, Robinson; Ciencias de la Salud; Osasun Zientziak
Background: There is limited evidence concerning how active commuting (AC) is associated with health benefits in young. The aim of the study was to analyze the relationship between AC to and from campus (walking) and obesity and metabolic syndrome (MetS) in a sample of Colombian university students. Methods: A total of 784 university students (78.6% women, mean age = 20.1 ± 2.6 years old) participated in the study. The exposure variable was categorized into AC (active walker to campus) and non-AC (non/infrequent active walker to campus: car, motorcycle, or bus) to and from the university on a typical day. MetS was defined in accordance with the updated harmonized criteria of the International Diabetes Federation criteria. Results: The overall prevalence of MetS was 8.7%, and it was higher in non-AC than AC to campus. The percentage of AC was 65.3%. The commuting distances in this AC from/to university were 83.1%, 13.4% and 3.5% for < 2 km, 2-5 km and > 5 km, respectively. Multiple logistic regressions for predicting unhealthy profile showed that male walking commuters had a lower probability of having obesity [OR = 0.45 (CI 95% 0.25–0.93)], high blood pressure [OR = 0.26 (CI 95% 0.13–0.55)] and low HDL cholesterol [OR = 0.29 (CI 95% 0.14–0.59)] than did passive commuters. Conclusions: Our results suggest that in young adulthood, a key life-stage for the development of obesity and MetS, AC could be associated with and increasing of daily physical activity levels, thereby promoting better cardiometabolic health.
Open Access
Twenty-four-hour movement guidelines during adolescence and its association with obesity at adulthood: results from a nationally representative study
(Springer, 2022) García Hermoso, Antonio; Ezzatvar, Yasmin; Alonso Martínez, Alicia; Ramírez Vélez, Robinson; Izquierdo Redín, Mikel; López Gil, José Francisco; Ciencias de la Salud; Osasun Zientziak; Universidad Pública de Navarra / Nafarroako Unibertsitate Publikoa
To determine the association between adherence to the 24-h movement guidelines during adolescence with obesity at adulthood 14 years later in a nationally representative cohort. We analyzed data from 6984 individuals who participated in Waves I (1994–1995) and IV (2008–2009) of the National Longitudinal Study of Adolescent Health (Add Health) in the USA. Obesity was defined by the International Obesity Task Force cut-off points at Wave I and adult cut-points at Wave IV (body mass index [BMI]≥30 kg/m2 and waist circumference [WC]≥102 cm in male and 88 cm in female). Physical activity, screen time and sleep duration were self-reported. Adolescents who met screen time recommendation alone (β = −1.62 cm, 95%CI −2.68 cm to −0.56), jointly with physical activity (β = −2.25 cm, 95%CI −3.75 cm to −0.75 cm), and those who met all three recommendations (β = −1.92 cm, 95%CI −3.81 cm to −0.02 cm) obtained lower WC at Wave IV than those who did not meet any of these recommendations. Our results also show that meeting with screen time recommendations (IRR [incidence rate ratio] = 0.84, 95%CI 0.76 to 0.92) separately and jointly with physical activity recommendations (IRR = 0.86, 95%CI 0.67 to 0.97) during adolescence is associated with lower risk of abdominal obesity at adulthood. In addition, adolescents who met all 24-h movement recommendations had lower risk of abdominal obesity later in life (IRR = 0.76, 95%CI 0.60 to 0.97). Conclusion: Promoting the adherence to the 24-h movement guidelines from adolescence, especially physical activity and screen time, seems to be related with lower risk of abdominal obesity later in life, but not for BMI.
Embargo
Exercise training in long COVID: the EXER-COVID trial
(Oxford University Press, 2024-11-22) Ramírez Vélez, Robinson; Oteiza Olaso, Julio; Legarra Gorgoñón, Gaizka; Oscoz Ochandorena, Sergio; García Alonso, Nora; García Alonso, Yesenia; Correa Rodríguez, María; Soto-Mota, Adrian; Izquierdo Redín, Mikel; Ciencias de la Salud; Osasun Zientziak; Ciencias humanas y de la educación; Giza eta Hezkuntza Zientziak
Background: the post-COVID-19 condition is a novel condition for which guidelines recommend supervised exercise, but evidence guiding safe and effective interventions is limited. The aim of this study was to investigate the effects of a tailored exercise program (EXER-COVID 5 trial) on cardiorespiratory fitness, muscle strength, long COVID symptoms, cognitive performance, quality of life, depression, and psychological distress. Methods: this crossover study included 100 participants with post-COVID-19 conditions (mean 8 age 48 years; 68% women) at a single center in Spain from March 1, 2021, to September 30, 2022. Participants were randomized 1:1 to 6 weeks of muscle power resistance training (PRT) followed by 6 weeks of usual care (Group 1 [AB], n=50) or 6 weeks of usual care followed by 6 weeks of muscle power RT (Group 2 [BA], n=50). Results: the intervention significantly improved the peak VO2 by 2.10 mL/kg/min [95% CI 1.25 to 2.94], P<0.001. Per-protocol analyses revealed similar results (2.40 mL/kg/min [95% CI 1.56 to 3.25]), P<0.001. No carry-over or period effects were detected. After power PRT, strength (1RM) was improved for pectoral press, bilateral leg-press, knee extension, and back press (P<0.001). Significant decreases were found in psychological distress scores (P<0.001). The intervention also improved quality of life (P=0.041), cognitive capabilities (P=0.014) and cognitive performance (P=0.036). Furthermore, the exercise program reduced seven of the 22 long-COVID symptoms, including weakness (RR= 0.75) dyspnea (RR= 0.56), hearing loss/tinnitus (RR= 0.86), change in appetite (RR= 0.84), memory loss (RR= 0.84), stress (RR= 0.80) and apathy/depression (RR= 0.80), (all Ps<0.05). Conclusions: a supervised 6-week PRT intervention program safely improved cardiorespiratory fitness, strength, and mental health in participants with post-COVID-19 conditions. These findings provide clinicians with evidence to support exercise as standard co-therapy and warrant further study.