Management of Patients With Chronic Coronary Disease.

This JAMA Clinical Guidelines Synopsis summarizes the 2023 American Heart Association (AHA)/American College of Cardiology (ACC) guideline on management of patients with chronic coronary disease.

Effect of sit-to-stand-based training on muscle quality in sedentary adults: a randomized controlled trial.

The aim of this study was to compare the effects of sit-to-stand (STS) training programs with 5 vs. 10 repetitions on muscle architecture and muscle function in sedentary adults. Sixty participants were randomly assigned into three groups: five-repetition STS (5STS), 10-repetition STS (10STS), or a control group (CG). Participants performed three sets of five or 10 repetitions of the STS exercise three times per week for 8 weeks. Before and after 8 weeks, all groups performed ultrasound measures to evaluate muscle thickness (MT), pennation angle (PA), and fascicle length (FL), and the five-repetition STS test to estimate the relative STS power and muscle quality index (MQI). After 8 weeks, both experimental groups improved MQI (40-45%), relative STS power (29-38%), and MT (8-9%) (all p < 0.001; no differences between the 5STS vs. 10STS groups). These improvements in both groups resulted in differences regarding the CG, which did not present any change. In addition, only the 5STS group improved PA (15%; p = 0.008) without differences to the 10STS and CG.This suggests that STS training is time-effective and low-cost for improving muscle function and generating adaptations in muscle architecture.

Exercise/Physical Activity in Individuals with Type 2 Diabetes: A Consensus Statement from the American College of Sports Medicine.

ABSTRACT: This consensus statement is an update of the 2010 American College of Sports Medicine position stand on exercise and type 2 diabetes. Since then, a substantial amount of research on select topics in exercise in individuals of various ages with type 2 diabetes has been published while diabetes prevalence has continued to expand worldwide. This consensus statement provides a brief summary of the current evidence and extends and updates the prior recommendations. The document has been expanded to include physical activity, a broader, more comprehensive definition of human movement than planned exercise, and reducing sedentary time. Various types of physical activity enhance health and glycemic management in people with type 2 diabetes, including flexibility and balance exercise, and the importance of each recommended type or mode are discussed. In general, the 2018 Physical Activity Guidelines for Americans apply to all individuals with type 2 diabetes, with a few exceptions and modifications. People with type 2 diabetes should engage in physical activity regularly and be encouraged to reduce sedentary time and break up sitting time with frequent activity breaks. Any activities undertaken with acute and chronic health complications related to diabetes may require accommodations to ensure safe and effective participation. Other topics addressed are exercise timing to maximize its glucose-lowering effects and barriers to and inequities in physical activity adoption and maintenance.

Attention to principles of exercise training: an updated systematic review of randomized controlled trials in cancers other than breast and prostate.

BACKGROUND: The primary objective of this systematic review was to update our previous review on randomized controlled trials (RCTs) of exercise in cancers other than breast or prostate, evaluating: 1) the application of principles of exercise training within the exercise prescription; 2) reporting of the exercise prescription components (i.e., frequency, intensity, time, and type (FITT)); and 3) reporting of participant adherence to FITT. A secondary objective was to examine whether reporting of these interventions had improved over time. METHODS: MEDLINE, EMBASE, CINAHL and SPORTDiscus databases were searched from 2012 to 2020. Eligible studies were RCTs of at least 4 weeks of aerobic and/or resistance exercise that reported on physiological outcomes relating to exercise (e.g., aerobic capacity, muscular strength) in people with cancer other than breast or prostate. RESULTS: Eighty-six new studies were identified in the updated search, for a total of 107 studies included in this review. The principle of specificity was applied by 91%, progression by 32%, overload by 46%, initial values by 72%, reversibility by 7% and diminishing returns by 5%. A significant increase in the percentage of studies that appropriately reported initial values (46 to 80%, p < 0.001) and progression (15 to 37%, p = 0.039) was found for studies published after 2011 compared to older studies. All four FITT prescription components were fully reported in the methods in 58% of all studies, which was higher than the proportion that fully reported adherence to the FITT prescription components in the results (7% of studies). Reporting of the FITT exercise prescription components and FITT adherence did not improve in studies published after 2011 compared to older studies. CONCLUSION: Full reporting of exercise prescription and adherence still needs improvement within exercise oncology RCTs. Some aspects of exercise intervention reporting have improved since 2011, including the reporting of the principles of progression and initial values. Enhancing the reporting of exercise prescriptions, particularly FITT adherence, may provide better context for interpreting study results and improve research to practice translation.

[Level of physical activity, sedentary behavior, and sleep in the early childhood population]. / Nivel de actividad física, comportamiento sedentario y sueño en la población de la primera infancia.

INTRODUCTION: Introduction: the daily general activity pattern of preschool aged children is composed of sleep time, sedentary time, and physical activity of mild, moderate, or vigorous intensity. Objective: to determine the compliance with the recommendations for physical activity, sedentary behavior, and sleep according to the days of the week, sex, and age in children aged from 2 to 5 years. Methods: a cross-sectional study in 361 preschool aged boys and girls. The Questionnaire for the Measurement of Physical Activity and Sedentary Behavior in Children from Preschool to 4th grade (C-MAFYCS) was used, which inquires about three behaviors (physical activity, sedentary behavior, and sleep). The statistical analysis was carried out using the SPSS, version 24 program (Simón Bolívar University license). Results: on average, children perform 132.4  95.2 minutes of physical activity and spend 70.4  63.4 minutes per day in sedentary behaviors. The time dedicated to active play and organized sport is greater on Saturdays and Sundays (175.1  140 minutes) (p = 0.0001). The time spent watching television was greater during the weekend (70.7  69.4 minutes). On average, preschoolers sleep 10.2  0.9 hours per day, less during the week (9.3  0.7 minutes). Conclusions: balance between these behaviors is essential for the health of children in this first stage of life. It is essential that parents, caregivers, and the community in general attend to the healthy lifestyles of this population since these are patterns that are learned and acquired to remain in the following stages of the life cycle.

INTRODUCCIÓN: Introducción: el patrón de actividad general diario en la edad preescolar se compone de tiempo de sueño, tiempo sedentario y actividad física de intensidad ligera, moderada o vigorosa. Objetivo: determinar el cumplimiento de las recomendaciones de actividad física, comportamiento sedentario y sueño según los días de la semana, el sexo y la edad de los niños (as) entre 2 a 5 años. Métodos: estudio de corte transversal y analítico en 361 niños y niñas en edad preescolar. Se usó el Cuestionario para la Medición de Actividad Física y Comportamiento Sedentario en niños de Preescolar a Cuarto Grado (C-MAFYCS), que indaga sobre tres comportamientos (actividad física, comportamiento sedentario y sueño). El análisis estadístico se realizó en el programa SPSS, versión 24 (licencia de la Universidad Simón Bolívar). Resultados: en promedio, los niños realizan 132,4  95,2 minutos de actividad física y gastan 70,4  63,4 minutos por día en comportamientos sedentarios. Es mayor el tiempo dedicado al juego activo y al deporte organizado durante los sábados y domingos (175,1  140 minutos) (p = 0,0001). El tiempo dedicado a ver televisión fue mayor durante el fin de semana (70,7  69,4 minutos). En promedio, los prescolares duermen 10,2  0,9 horas por día, siendo menor el tiempo de sueño entre semana (9,3  0,7 minutos). Conclusiones: el equilibrio entre estos comportamientos es fundamental para la salud del niño en esta primera etapa de la vida. Es fundamental que los padres, los cuidadores y la comunidad en general atiendan los estilos de vida saludables de esta población dado que son patrones que se aprenden y adquieren para permanecer en los siguientes momentos del ciclo vital.

Effect of Gamification With and Without Financial Incentives to Increase Physical Activity Among Veterans Classified as Having Obesity or Overweight: A Randomized Clinical Trial.

Importance: Gamification is increasingly being used for health promotion but has not been well tested with financial incentives or among veterans. Objective: To test the effectiveness of gamification with social support, with and without a loss-framed financial incentive, to increase physical activity among veterans classified as having overweight and obesity. Design, Setting, and Participants: This 3-group randomized clinical trial had a 12-week intervention period and an 8-week follow-up period. Participants included veterans with a body mass index greater than or equal to 25 who were receiving care from a single site in Philadelphia, Pennsylvania. Participants underwent a remotely monitored intervention from March 19, 2019, to August 9, 2020. Data analyses were conducted between October 1, 2020, and November 14, 2020. Interventions: All participants received a wearable device to track step counts and selected a step goal. The control group received feedback from their devices only. Participants in the 2 gamification groups were entered into a 12-week game with points and levels designed using behavioral economic principles and selected a support partner to receive weekly updates. Participants in the loss-framed financial incentive group had $120 allocated to a virtual account and lost $10 if weekly goals were not achieved. Main Outcomes and Measures: The primary outcome was the change in mean daily steps from baseline during the intervention. Secondary outcomes include proportion of days goals were achieved and changes during follow-up. Results: A total of 180 participants were randomized, 60 to the gamification with social support group, 60 to the gamification with social support and loss-framed financial incentives group, and 60 to the control group. The participants had a mean (SD) age of 56.5 (12.9) years and a mean (SD) body mass index of 33.0 (5.6); 71 participants (39.4%) were women, 90 (50.0%) were White, and 67 (37.2%) were Black. During the intervention period, compared with control group participants, participants in the gamification with financial incentives group had a significant increase in mean daily steps from baseline (adjusted difference, 1224 steps; 95% CI, 451 to 1996 steps; P = .005), but participants in the gamification without financial incentives group did not (adjusted difference, 433 steps; 95% CI, -337 to 1203 steps; P = .81). The increase for the gamification with financial incentives group was not sustained during the follow-up period, and the step count was not significantly different than that of the control group (adjusted difference, 564 steps; 95% CI, -261 to 1389 steps; P = .37). Compared with the control group, participants in the intervention groups had a significantly higher adjusted proportion of days meeting their step goal during the main intervention and follow-up period (gamification with social support group, adjusted difference from control, 0.21 participant-day; 95% CI, 0.18-0.24 participant-day; P < .001; gamification with social support and loss-framed financial incentive group, adjusted difference from control, 0.34 participant-day; 95% CI, 0.31-0.37 participant-day; P < .001). Conclusions and Relevance: Among veterans classified as having overweight and obesity, gamification with social support combined with loss-framed financial incentives was associated with a modest increase in physical activity during the intervention period, but the increase was not sustained during follow-up. Gamification without incentives did not significantly change physical activity. Trial Registration: ClinicalTrials.gov Identifier: NCT03563027.

[Assessment of adherence to the Mediterranean diet in university Health Sciences students and its relationship with level of physical activity]. / Valoración de la adherencia a la dieta mediterránea en estudiantes universitarios de Ciencias de la Salud y su relación con el nivel de actividad física.

INTRODUCTION: Objective: to assess the degree of adherence to the Mediterranean diet and the practice of physical activity in university Health Sciences students in Castile-La Mancha. Methods: this was a cross-sectional, observational study by means of a dietary and physical activity survey. The sample consisted of 575 university students (77.7 % women). An initial data collection survey was developed using the Google Forms platform (https://www.google.com/forms/about/). Adherence to the Mediterranean diet was assessed with the Mediterranean Diet Adherence Screener (MEDAS) questionnaire and the modified Prevention with Mediterranean Diet (PREDIMED) questionnaire. The Rapid Assessment of Physical Activity Scale (RAPA) questionnaire was used to measure physical activity. Results: we found a 58.3 % adherence to Mediterranean diet among Health Sciences students, with 38.6 % of average adherence, and 5.0 % of poor adherence, with a low consumption of fruits with no gender differences, and a high consumption of red or processed meat and butter or cream with significant differences between women and men. There is also a high consumption of carbonated beverages (more frequent in women). Likewise, a high percentage of students (22.5 %) do practically no physical activity. As for physical exercise, it is always higher in men, with significant differences (p > 0.05). Conclusion: this study suggests that the sample of university Health Sciences students in Castile-La Mancha shows an acceptable adherence to the Mediterranean diet and insufficient levels of physical activity.

INTRODUCCIÓN: Objetivo: valorar el grado de adherencia a la dieta mediterránea y la práctica de actividad física en estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha. Método: estudio observacional transversal mediante encuesta alimentaria y de actividad física. La muestra contó con 575 estudiantes universitarios (77,7 % de mujeres). Se desarrolló una encuesta de recogida de datos inicial mediante la plataforma Google Forms (https://www.google.com/forms/about/). La adherencia a la dieta mediterránea se valoró con el cuestionario Mediterranean Diet Adherence Screener (MEDAS) y el cuestionario PREvención con DIeta MEDiterránea (PREDIMED), modificado. Para medir la actividad física se utilizó el cuestionario Rapid Assessment of Physical Activity Scale (RAPA), que valora la actividad física desempeñada. Resultados: se encontró en los estudiantes de Ciencias de la Salud una adherencia a la dieta mediterránea del 58,3 %, siendo la adherencia media del 38,6 % y la mala adherencia del 5,0 %, observándose un bajo consumo de frutas sin diferencias de sexo, un alto consumo de carne roja o procesada y de mantequillas o natas, con diferencias significativas entre mujeres y hombres. También hay un consumo alto de bebidas carbonatadas (más frecuente en mujeres). Asimismo, un porcentaje alto de estudiantes (22,5 % del total) no hace prácticamente ninguna actividad física. En cuanto al ejercicio físico, siempre es mayor entre los hombres, con diferencias significativas (p > 0,05). Conclusión: este estudio sugiere que la muestra de estudiantes universitarios de Ciencias de la Salud de Castilla-La Mancha presenta una aceptable adherencia a la dieta mediterránea y unos niveles de actividad física insuficientes.