Testing the Mystic School Mobile Application to Promote Active Commuting to School in Spanish Adolescents: The PACO Study.

Active commuting to and/or from school (ACS) is an opportunity to increase daily physical activity (PA) levels in young people. Mobile-device interventions focused on promoting the practice of health-related PA can be more cost-effective than traditional interventions in this population. OBJECTIVE: To analyze the adolescents' opinion of the mobile application (app) Mystic School, which was designed to promote ACS in Spanish adolescents. METHODS: A total of 44 students (14-15 years old) from Granada and Jaén participated in the test of the Mystic School app during two phases: phase 1 (n = 10) for 2 weeks and phase 2 (n = 34) for 1 month. Each phase included an app presentation, a follow-up, and focus group sessions. The qualitative analysis was carried out through NVivo software. RESULTS: In phase 1, adolescents reported improvements in the design and functioning, such as the avatar movement, virtual steps utilities, and multiplayer function. These suggestions were included in phase 2. After phase 2, adolescents reported that it is important to add the possibility of playing without an Internet connection to the game, to include more competitive options, prizes, and to increase the difficulty of the levels. In both phases, problems with the step number counting remained. CONCLUSION: The Mystic School app can be a useful tool for the physical education teacher to integrate the content from this curriculum related to the promotion of PA, such as ACS.

[Physical exercise and sports in eating disorders]. / Actividad física y deporte en los trastornos de la conducta alimentaria.

Introduction: Physical activity (PA) is recognized as a key aspect in the prevention and treatment of psychological problems. PA recommendations to maintain and improve mental health were recently updated. Despite the fact that PA can be pivotal in interventions to prevent and treat eating disorders (ED), the role and dose of PA for this purpose are unknown. The papers analyzed in this review highlight the importance of PA in intervention programs to prevent and treat ED. Emerging evidence suggests that the PA we enjoy practicing, considered important and chosen, is associated with a positive effect on mental health, while the PA performed out of a feeling of guilt, pressure or a feeling of being forced to do it is associated with a negative effect. This review highlights that the evidence available is limited to suggest a harmful impact of PA in primary prevention interventions for eating disorders and suggests practical recommendations for future interventions as well as recommendations for future research.

Introducción: La actividad física (AF) está reconocida como un aspecto clave en la prevención y tratamiento de problemas psicológicos. Recientemente se han actualizado las recomendaciones de su práctica con el fin de mantener y mejorar la salud mental. La AF puede resultar de gran importancia en las intervenciones para prevenir y tratar los trastornos de la conducta alimentaria (TCA). Sin embargo, se desconocen el rol y la dosis para este fin. Los trabajos presentados en la revisión destacan la importancia de la AF en los programas de intervención para prevenir y tratar los TCA. La evidencia emergente sugiere que la AF que disfrutamos, considerada importante y elegida, se asocia con un efecto positivo para la salud mental, mientras que la AF realizada por un sentimiento de culpa, presión o sentimiento de estar forzado a realizarla se asocia a un efecto negativo. La revisión realizada destaca que no hay suficiente evidencia para sugerir que hay un impacto nocivo de la AF en las intervenciones de prevención primaria de los TCA. Se proponen recomendaciones prácticas dentro de futuras intervenciones, así como, recomendaciones para futuras investigaciones.

Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines. / Comentario del CEIPV a la actualización de las Guías Europeas de Prevención Vascular en la Práctica Clínica.

We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.

[Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines]. / Comentario del CEIPV a la actualización de las Guías Europeas de Prevención Vascular en la Práctica Clínica.

We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.

[Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines.] / Comentario del CEIPV a la actualización de las Guías Europeas de Prevención Vascular en la Práctica Clínica.

We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.

Presentamos la adaptación para España de la actualización de las Guías Europeas de Prevención Vascular. En esta actualización se hace mayor énfasis en el abordaje poblacional, especialmente en la promoción de la actividad física y de una dieta saludable mediante políticas alimentarias y de ocio y transporte activo en España. Para estimar el riesgo vascular, se destaca la importancia de recalibrar las tablas que se utilicen, adaptándolas a los cambios poblaciones en la prevalencia de los factores de riesgo y en la incidencia de enfermedades vasculares, con particular atención al papel de la enfermedad renal crónica. A nivel individual resulta clave el apoyo personalizado para el cambio de conducta, la adherencia a la medicación en los individuos de alto riesgo y pacientes con enfermedad vascular, la promoción de la actividad física y el abandono del hábito tabáquico. Además, se revisan los ensayos clínicos recientes con inhibidores de PCKS9, la necesidad de simplificar el tratamiento farmacológico de la hipertensión arterial para mejorar su control y la adherencia al tratamiento. En los pacientes con diabetes mellitus 2 y enfermedad vascular o riesgo vascular alto, cuando los cambios de estilo de vida y la metformina resultan insuficientes, deben priorizarse los fármacos con demostrado beneficio vascular. Por último, se incluyen pautas sobre enfermedad arterial periférica y otras enfermedades específicas, y se recomienda no prescribir antiagregantes en prevención primaria.

[Weight loss and body composition changes through ketogenic diet and physical activity: a methodological and systematic review]. / Cambios en la pérdida de peso y la composición corporal con dieta cetogénica y práctica de actividad física: revisión narrativa, metodológica y sistemática.

INTRODUCTION: Introduction: practice of physical activity and the ketogenic diet monitoring can have a double effect in helping in processes of weight loss and improvement of body composition and lipid profile. Objective: the objective of this review was to investigate the work done with obese patients who undertook a ketogenic diet and a physical exercise program, as well as to calculate the overall effect size in terms of improvements in fat mass, through a meta-analysis. Methods: the selection of studies was based on the following criteria: experimental studies; a) experimental studies (randomized controlled designs) and quasi-experimental (e.g. pre-test/post-test); b) studies with low-carbohydrate diet (< 30%) or very low in carbohydrates (5-10%) (< 50 g Ch) and/or high in fats (> 35%); c) studies were admitted exclusively with subjects that facility overweight or obesity (BMI > 25; and d) with measurements of body composition and/or Lipid profile at the beginning and end of the intervention. Results: for the methodological review, 7 articles and 3 reviews were analyzed. All studies, whether by establishing aerobic or strength training and show significant weight loss in all outcomes. Conclusions: comparing different types of exercise, we could say that interventions based on endurance exercise reported a decrease in muscle mass, however there was a maintenance, and even an increase, in studies with resistance exercises. Meta-analysis showed significant results at the global level with a medium heterogeneity, therefore, there will be greater reduction of fat mass in groups that realize diets with low carbohydrates and exercise that in those who do not undertake this type of diet, and those only perform exercise.

INTRODUCCIÓN: Introducción: la práctica de actividad física y el seguimiento de una dieta cetogénica pueden suponer un doble efecto con mejores resultados en los procesos de pérdida de peso y mejora de la composición corporal y perfil lipídico. Objetivo: el objetivo de esta revisión fue investigar los trabajos realizados con pacientes obesos que siguen una dieta cetogénica y un programa de ejercicio físico, así como calcular el tamaño del efecto en cuanto a las mejoras en la masa grasa, a través de un metaaanálisis. Métodos: la selección de estudios se basó en los siguientes criterios: estudios experimentales; a) estudios experimentales (diseños controlados aleatorizados) y cuasi-experimentales (por ejemplo: pre-test/post-test); b) estudios con dieta baja en carbohidratos (< 30%) o muy baja en carbohidratos (5-10%) (< 50 g Ch) y/o alta en grasas (> 35%); c) se admitieron estudios exclusivamente con sujetos que padecieran sobrepeso u obesidad (IMC > 25 y/o enfermedad metabólica relacionada; y d) con mediciones de composición corporal y/o perfil lipídico al principio y al final de la intervención. Resultados: se analizaron 7 artículos y 3 revisiones. Comparando los diferentes tipos de ejercicio se podría afirmar que destaca la disminución de masa muscular en aquellos en los que las intervenciones son con ejercicio aeróbico, manteniéndose e incluso aumentando, en los estudios donde se realizó un ejercicio de fuerza. El metaanálisis nos muestra una reducción significativa de la masa grasa con una heterogeneidad media, por lo tanto, habrá mayor reducción de masa grasa en grupos que realizan dieta baja en carbohidratos y ejercicio que en los que no realizan dieta o tan solo realizan ejercicio. Conclusiones: la combinación de dieta cetogénica y ejercicio físico puede reducir la masa grasa en comparación con realizar solo dieta o solo ejercicio físico.

Effect of Experience and Psychophysiological Modification by Combat Stress in Soldier's Memory.

The present research aimed to analyze the effect of experience and psychophysiological modification by combat stress in soldier's memory in a simulated combat situation. Variables of rate of perceived exertion, blood glucose, blood lactate, lower body muscular strength manifestation, cortical arousal, specific fine motor skills, autonomic modulation, state anxiety, and memory and attention through a postmission questionnaire were analyzed before and after a combat simulation in 15 experienced soldiers of a special operation unit and 20 non-experienced soldiers of light infantry unit from the Spanish Army. The stress of combat simulation produces a significant increase (p < 0.05) in rated perceived exertion, blood glucose, blood lactate, somatic anxiety and a low frequency domain of the heart rate, and a significant decrease of rifle magazine reload time, high frequency domain of the heart rate and somatic anxiety in both groups. The variables of RPE, glucose, CFFT, RMRT, RMSSD, LF/HF, CA, SA and STAI were significantly different in experienced soldiers shown the activation of fight-flight system. The anticipatory anxiety in experienced soldiers shows a cognitive behavioral association by past experiences. The analysis of correct response in the postmission questionnaire show elements more related with the sight and that endanger the physical integrity of soldiers are more remembered, and some significant differences (p < 0.05) in the memory performance of experienced soldiers and non experienced soldiers where experienced soldiers shown a better performance. As conclusion, combat stress produce an increase in the psichophysiological response of soldiers independently of experience, but experienced ones presented a lower negative effect on memory than non experienced.

Higher use of techniques studied and performance in melee combat produce a higher psychophysiological stress response.

We aimed to analyse the effectiveness of an operative training in soldiers' psychophysiological and melee combat performance. Nineteen soldiers performed a 50-hr training for 10 weeks. After training, they were divided into two groups: higher performance group (HPG) and lower performance group (LPG), then they conducted a realistic melee simulation where psychophysiological response, task performance, and the utilization of techniques learned were measured. HPG presented a significantly (p < 0.05) higher heart rate, blood lactate, and jump height; a lower blood oxygen saturation, task performance mark, use of studied techniques than LPG after the simulation; and a higher low frequency/high frequency ratio of heart rate variability previous the simulation than LPG. Independent of performance and the use of studied techniques by the participants, the melee simulation produced an increase in fight or flight response, increasing rated of stress and perceived exertion, sympathetic modulation, and physiological response. A specific melee combat training program induced different modifications in psychophysiological and task performance depending on the level of studied technique used. HPG presented a significantly higher cardiovascular response than LPG and time perception, and memory presented no differences between groups; also HPG presented a significantly higher use of studied techniques.

Effectiveness of Psycho-Physiological Portable Devices to Analyse Effect of Ergogenic Aids in Military Population.

Caffeine is one of the ergogenic substances most used by warfighters in current operation areas, but the effect on the organic response and operational performed is already poor knowledge. This research aimed to study the acute effect of 400 mg of caffeine monohydrate on the psycho-physiological response and rifle marksmanship of warfighters during a close quarter combat simulation. We analysed parameter of heart rate, blood lactate, cortical arousal, state anxiety and marksmanship of 20 Spanish Army veteran warfighters before and after a close quarter combat simulation in a double-blind procedure, also a correlation analysis was conducted between all the study variables. Marksmanship of warfighters did not improve with the caffeine ingestion, but it produced an increase in blood lactate concentration (caffeine: 1.9 ± 0.5 vs. 9.2 ± 1.1 mmol.l-1; placebo: 1.8 ± 0.7 vs. 6.9 ± 2.2 mmol.l-1), cortical arousal (% of change: caffeine: 2.51; placebo: -1.96) and heart rate (caffeine: 80.0 ± 7.2 vs. 172.9 ± 28.2 bpm; placebo: 79.3 ± 6.4 vs. 154.0 ± 26.8 bpm). In addition, higher heart rate values correlated negatively with marksmanship in close quarter combat. We concluded that caffeine intake did not improve the warfighters rifle marksmanship in close quarter combat possibly due to the increase in the physiological response.

[Sarcopenic obesity in elderly women: influence of I/D polymorphism of the angiotension converter enzyme]. / Obesidad sarcopénica en mujeres mayores: influencia del polimorfismo I/D de la enzima convertidora de angiotensina.

INTRODUCTION: Sarcopenic obesity (SO) is a term that refers to an increase of fat mass together with a decrease of muscle mass, which is suffered by a high percentage of elderly population. Physical activity seems to be a good strategy to prevent it getting worse. However, genetic factors related to the aging process and to elderly's physical fitness could have an influence on it. AIM: To determine if elderly women > 60 who practice physical activity regularly had differences in sarcopenic obesity according to the I/D polymorphism from the ACE (angiotensin converter enzyme) gen. METHODS: Cross-sectional study of 300 elderly women who have practiced physical exercise at least twice a week for the past two years. Anthropometric data, physical activity and sedentary behaviour questionnaire, sarcopenic obesity (determining the percentage of fat mass and total muscle mass by electrical impedance and grouping the quintiles of these values into four groups) and physical fitness assessment, as well as ACE gen genotype measured by oral mucosa sample, were evaluated. RESULTS: There were significant differences (p < 0.05) in sarcopenic obesity according to ACE I/D genotype (SO values: 2.18 ACE DD vs 2.48 ACE II + ACE ID). CONCLUSIONS: Women who were ACE DD presented lower risk of sarcopenic obesity than those in the ACE II and ACE ID groups.

Short- and Long-Term Effects of Concurrent Strength and HIIT Training in Octogenarians with COPD.

To investigate the short- and long-term effects of concurrent strength and high-intensity interval training (HIIT) on octogenarian COPD patients, nine males (age = 84.2 ± 2.8 years, BMI = 29.3 ± 2.3) with low to severe COPD levels (2.1 ± 1.5 BODE index) underwent a supervised 9-week strength and HIIT exercise program. Training had a significant (p < .05) impact on senior fitness test scores (23-45%), 30-m walking speed (from 1.29 ± 0.29-1.62 ± 0.33 m/s), leg and chest press 1RM (38% and 45% respectively), maximal isometric strength (30-35%), and 6-min walking test (from 286.1 ± 107.2-396.2 ± 106.5 m), and tended to increase predicted forced vital capacity by 14% (p = .07). One year after the intervention all training-induced gains returned to their preintervention values except for the chest press 1RM (p <.05). Short-term concurrent strength and HIIT training increases physical fitness in the oldest-old COPD patients, and has potential long-term benefits.

[Achievement of physical activity healthy guidelines in hypertensive adults]. / Cumplimiento de las recomendaciones de actividad física para la salud en adultos hipertensos.

INTRODUCTION: It seems necessary to educate patients in the need of realize the importance of physical activity to improve their health, and specifically, about the important implications that the intensity of physical activity has for health and fitness benefits. OBJECTIVE: The aim of this was to evaluate achievement of physical activity recommendations for health in a group of hypertensive controlled patients from two primary care centers: La Estación y La Algodonera located in Talavera de la Reina (Toledo). DESIGN: Cross-sectional study. LOCATION: Primary care centers: La Estación y La Algodonera located in Talavera de la Reina. PARTICIPANTS: A total of 80 controlled hypertensive patients aged 40 to 60 years old who met the inclusion criteria were invited to the study. A sample of 52 patients obtained valid results to enter the study. MAIN MEASURES: Minutes of Moderate to vigorous physical activity (MVPA), minutes of light activity and number steps were measured. Data was displayed by gender and weekdays vs weekend days. RESULTS: Only 59.6% of patients achieved the minimum recommendation of 30 minutes of MVPA at least every day to improve health. Male achieved significantly more MVPA during the weekend than female did. Only women presented significant differences between MVPA during week days vs weekend days. CONCLUSIONS: 59.6% of hypertensive controlled patients of our sample achieve the minimal physical activity recommendations for health; the rest of the sample should increase their physical activity to achieve the recommendation and to improve their blood pressure levels.

Introducción: Parece necesario educar a los pacientes en la importancia de realizar AF para mejorar su salud, y específicamente, sobre las implicaciones que la intensidad de la AF tiene para la salud. Objetivo: El propósito de este estudio fue evaluar si se cumplían las recomendaciones de actividad física (AF) para la salud en un grupo de pacientes hipertensos controlados de dos centros de atención primaria: La Estación y La Algodonera, situados en Talavera de la Reina (Toledo). Métodos: Diseño: Estudio descriptivo transversal. Emplazamiento: Centros de atención primaria "La Estación" y "La Algodonera", situados en Talavera de la Reina. Participantes: Un total de 80 pacientes hipertensos controlados de 40 a 60 años que cumplían los criterios de inclusión, fueron invitados a formar parte en el estudio, de los cuales fueron analizados los resultados válidos de 52 pacientes. Mediciones principales: Se cuantificó la actividad física diaria con acelerometría, obteniéndose los minutos de AF a intensidad de moderada a vigorosa (AFMV) y de actividad ligera, y el número de pasos. Los datos se presentaron diferenciando los días laborables y los días festivos. Resultados: Sólo un 59,6 % de los sujetos de la muestra cumplía la recomendación de realizar un mínimo de 30 minutos de AF de intensidad de moderada a vigorosa al día para la mejora de la salud. Los hombres realizaron significativamente más minutos de AFMV en los días festivos que las mujeres, y solamente las mujeres, mostraron diferencias significativas en los minutos de AFMV entre en los días laborables respecto a los festivos. Conclusiones: El 59,6% de los pacientes hipertensos controlados de esta muestra cumplían con las recomendaciones mínimas de AF para la salud; el resto debería incrementar su AF para cumplir las recomendaciones y con ello mejorar sus niveles de tensión arterial.