[Pharmacological treatment of obesity. Current situation and new treatments]. / Tratamiento farmacológico de la obesidad. Situación actual y nuevos tratamientos.

The high incidence of obesity in our environment, the progressive and recurrent nature of this disease makes it necessary to know and use all the possibilities of prevention and treatment. When a person suffers from obesity we must offer a treatment plan with specific objectives that will include healthy eating, physical activity and, if necessary, treatment with medication or even surgery. At present in Spain, there are 3 medications available: New molecules will soon be marketed that will expand the treatment possibilities, which will also be reviewed in this article.

Anthropometric assessment of schoolchildren from the La Mancha-Centro health area. Comparison with the Spanish Cross-Sectional Growth Study 2010.

OBJECTIVES: To determine weight, height and body mass index (BMI) of schoolchildren from the La Mancha-Centro health area and compare them with those determined by the Spanish Cross-sectional Growth Study 2010 (SCGS-2010). METHODS: Cross-sectional study of 954 schoolchildren aged 6-12 years. Mean, standard deviation, and percentile distributions of weight, height, and BMI by gender and age were obtained. Differences in each 6-month age group were analyzed. RESULTS: There was a progressive increase in BMI with age, which was significant in girls from nine years of age on and in boys from 8.5 years on. From age 10, average BMI was 2.3 kg/m2 higher than at younger ages (p < 0.001). The biggest difference between genders occurred at age 12: 2 ± 0.98 kg/m2 higher in boys (p = 0.042). Overall, no significant differences were found in weight, height and BMI vs. SCGS-2010, although mean weight of male children from La Mancha-Centro aged between 8.5 and 11.5 years was 3.9 kg higher than that of the rest of Spanish male children. CONCLUSIONS: Anthropometric parameters of schoolchildren from La Mancha-Centro do not significantly differ from national standards; however, preadolescent males from La Mancha-Centro weigh almost 4 kg more.

OBJETIVOS: Determinar peso, talla e índice de masa corporal (IMC) de escolares del área de salud La Mancha-Centro y compararlos con los definidos en el Estudio Transversal Español de Crecimiento 2010 (ETEC-2010). MÉTODOS: Estudio transversal de 954 escolares entre 6 y 12 años. Se obtuvieron media, desviación estándar y distribuciones percentilares de peso, talla e IMC por sexo y edad. Se analizaron las diferencias en cada grupo semestral de edad. RESULTADOS: Existió incremento progresivo del IMC con la edad, significativo en las niñas a partir de los nueve años y en los niños desde los 8.5 años. Desde los 10 años, el IMC promedio resultó 2.3 kg/m2 superior al de edades menores (p < 0.001); la mayor diferencia entre los sexos ocurrió a los 12 años: 2 ± 0.98 kg/m2 más en los varones (p = 0.042). Globalmente no se hallaron diferencias significativas de peso, talla e IMC con el ETEC-2010, aunque el peso medio de los niños manchegos de 8.5 a 11.5 años fue 3.9 kg mayor que el del resto de los niños españoles. CONCLUSIONES: Los parámetros antropométricos de los escolares manchegos no difieren de los estándares nacionales; sin embargo, los varones preadolescentes manchegos pesan casi 4 kg más.

HIV status, breastfeeding modality at 5 months and postpartum maternal weight changes over 24 months in rural South Africa.

OBJECTIVE: To determine the effect of infant feeding practices on postpartum weight change among HIV-infected and -uninfected women in South Africa. METHODS: In a non-randomised intervention cohort study of antiretroviral therapy-naïve women in South Africa, infants were classified as exclusive (EBF), mixed (MF) or non-breastfed (NBF) at each visit. We analysed infant feeding cumulatively from birth to 5 months using 24-hour feeding history (collected weekly for each of the preceding 7 days). Using generalised estimating equation mixed models, allowing for repeated measures, we compared postpartum weight change (kg) from the first maternal postpartum weight within the first 6 weeks (baseline weight) to each subsequent visit through 24 months among 2340 HIV-infected and -uninfected women with live births and at least two postpartum weight measurements. RESULTS: HIV-infected (-0.2 kg CI: -1.7 to 1.3 kg; P = 0.81) and -uninfected women (-0.5 kg; 95% CI: -2.1 to 1.2 kg; P = 0.58) had marginal non-significant weight loss from baseline to 24 months postpartum. Adjusting for HIV status, socio-demographic, pregnancy-related and infant factors, 5-month feeding modality was not significantly associated with postpartum weight change: weight change by 24 months postpartum, compared to the change in the reference EBF group, was 0.03 kg in NBF (95% CI: -2.5 to +2.5 kg; P = 0.90) and 0.1 kg in MF (95% CI: -3.0 to +3.2 kg; P = 0.78). CONCLUSION: HIV-infected and -uninfected women experienced similar weight loss over 24 months. Weight change postpartum was not associated with 5-month breastfeeding modality among HIV-infected and -uninfected women.

Intermittent hypoxia in sport nutrition, performance, health status and body composition.

Introduction: Intermittent hypoxia refers to the discontinuous use of low oxygen levels in normobaric environment. These conditions can be reproduced in hypoxic tents or chambers while the individual is training in different physical activity protocols. Intermittent hypoxia can affect several body systems, impacting nutrition, physical performance, health status and body composition. Therefore, it is necessary to assess protocols, regarding time and frequency of exposure, passive exposure or training in hypoxia, and the simulated altitude. At the molecular level, the hypoxia-inducible factor-1α is the primary factor mediating induction of target genes, including vascular endothelial growth factor and erythropoietin. The goal of these molecular changes is to preserve oxygen supply for cardiac and neuronal function. In addition, hypoxia produces a sympathetic adrenal activation that can increase the resting metabolic rate. Altogether, these changes are instrumental in protocols designed to improve physical performance as well as functional parameters for certain pathological disorders. In addition, nutrition must adapt to the increased energy expenditure. In this last context, performing physical activity in intermittent hypoxia improves insulin sensitivity by increasing the presence of the glucose transporter GLUT-4 in muscle membranes. These changes could also be relevant for obesity and type 2 diabetes treatment. Also, the anorectic effect of intermittent hypoxia modulates serotonin and circulating leptin levels, which may contribute to regulate food intake and favor body weight adaptation for optimal sport performance and health. All these actions suggest that intermittent hypoxia can be a very effective tool in sports training as well as in certain clinical protocols.

Introducción: La hipoxia intermitente se refiere al uso discontinuo de bajas concentraciones de oxígeno en un entorno normobárico. Estas condiciones pueden ser reproducidas en tiendas de hipoxia o en cámaras mientras el sujeto está entrenando diferentes protocolos de actividad física. La hipoxia intermitente puede afectar a varios sistemas corporales, impactando sobre la nutrición, el estado de salud y la composición corporal. Por lo tanto, es necesario establecer protocolos que consideren el tiempo y la frecuencia de exposición, exposición pasiva o entrenamiento en hipoxia, así como la altitud simulada. A nivel molecular, el factor inducible por hypoxia-1α es el primer factor que media la activación de genes diana, incluidos el factor de crecimiento del endotelio vascular y la eritropoyetina. La finalidad de estos cambios es preservar el aporte de oxígeno para la función cardiaca y neuronal. Además, la hipoxia produce activación simpático-adrenal, que puede incrementar el metabolismo basal. Todos estos cambios son necesarios en protocolos diseñados para mejorar el rendimiento físico al igual que parámetros funcionales para el tratamiento de ciertas patologías. Además, la nutrición debe adaptarse al gasto energético incrementado. En este contexto, la ejecución de actividad física en hipoxia intermitente mejora la sensibilidad a la insulina incrementando la presencia del transportador de glucosa GLUT-4 en las membranas musculares. Estos cambios podrían ser también relevantes para el tratamiento de la obesidad y la diabetes tipo 2. Además, el efecto anoréxico de la hipoxia intermitente modula los niveles de serotonina y leptina, contribuyendo a regular la ingesta de comida y favoreciendo una adaptación óptima del peso corporal para el desempeño deportivo y la salud. Todas estas acciones sugieren que la hipoxia intermitente puede ser una herramienta muy efectiva en entrenamiento deportivo, al igual que en ciertos protocolos clínicos.

Interevaluator reliability of a tool for measuring body height in adult intensive care patients.

BACKGROUND: The calculation of body height in the intensive care unit is essential for obtaining the ideal body weight, which is used to program the tidal volume and establish objective and effective pulmonary ventilation. The objective of the study was to determine the interrater reliability of a tool for measuring body height in adult patients in an intensive care unit (ICU) in southwestern Colombia. METHODS: This cross-sectional observational study was conducted between January and May 2021, following the recommendations of the COSMIN protocol. Two physiotherapists in the roles of observer/evaluator measured the heights of 106 patients upon admission to the ICU with a previously designed. The sample size was calculated based on Pearson's correlation coefficient. For interrater reliability, the intraclass correlation coefficient (ICC) was used, and Bland-Altman analysis was used to assess concordance. The 95% confidence interval was established, and a P value <0.05 indicated statistical significance. RESULTS: A total of 106 individuals with a mean age of 59.3 years were included; the mean body height was 158.5 cm for women. The interrater reliability of the measurement of height was excellent (global ICC of 0.99, P = 0.000), and an almost perfect positive correlation was obtained between the raters for both women and men (R = 0.99). CONCLUSIONS: Excellent interrater/interobserver reliability was obtained for the measurement of body height in the ICU. This research highlights the importance of protocolizing the measurement of height in critical patients with valid and reliable instruments.

Gender network analysis of the Eating Disorder Examination-Questionnaire (EDE-Q7) in Peruvian adults.

Introduction: Background: network assessment of eating disorder (ED)-related symptomatology from a gender perspective is an important topic of study; however, there is limited research in the Latin American context. Objective: this study aimed to explore the patterns of association of the components of the Eating Disorder Examination-Questionnaire (EDE-Q7) according to gender, using two simultaneous network models in 890 Peruvian adults (63.51 % were women; mean age: 26.40). Methods: two graphs considering the gender factor were made using the R package qgrap and the merged LASSO graph. Results: higher network centrality measures were obtained for items related to body image dissatisfaction and overvaluation in women; while in the men's network, the items of food restriction and overestimation of weight were the most central symptoms. Conclusion: both network models were invariant and showed no significant differences in both structure and connections.

Introducción: Introducción: la evaluación de redes de la sintomatología relacionada con los trastornos alimentarios (TA) desde el punto de vista del género es un tema importante de estudio; sin embargo, existen pocas investigaciones en el contexto latinoamericano. Objetivo: el objetivo de este estudio fue explorar los patrones de asociación de los componentes del Eating Disorder Examination-Questionnaire (EDE-Q7) según el sexo mediante dos modelos de red simultánea en 890 adultos peruanos (63,51 % de mujeres; edad promedio: 26,40 años). Métodos: se realizaron dos gráficos considerando el factor género utilizando el paquete R qgrap y el gráfico LASSO fusionado. Resultados: se obtuvieron medidas de centralidad de red más altas para los ítems relacionados con la insatisfacción y la sobrevaloración de la imagen corporal en las mujeres; mientras que, en la red de los hombres, los ítems de restricción alimentaria y sobrevaloración del peso eran los síntomas más centrales. Conclusión: ambos modelos de red resultaron invariables y no mostraron diferencias significativas a nivel de estructura y conexiones.

Association between adherence to the Mediterranean diet with anthropometric measurements and nutritional status in adolescents.

Introduction: Background: adolescence is a critical period for developing healthy eating habits. It is crucial to evaluate and encourage adherence to the Mediterranean diet, a sustainable and healthy diet model in this age group. Objective: this study aimed to evaluate the relationship between adherence to the Mediterranean diet and anthropometric measurements and nutritional status in Turkish adolescents. Material and methods: the demographic characteristics, health information, nutritional habits, physical activity status, and 24-hour dietary recall of the adolescents were obtained with a questionnaire. Adherence to Mediterranean diet was evaluated with the Mediterranean-Style Dietary Pattern Score (MSDPS). Results: a total of 1,137 adolescents (mean age 14.0 ± 1.37 years) were included; 30.2 % of the boys and 39.5 % of the girls were overweight/obese. The median (interquartile range) value of the MSDPS was 10.7 (7.7), and this value was 11.0 (7.6) for the boys and 10.6 (7.4) for the girls (p > 0.05). The levels of protein, fiber, vitamin A, vitamin C, folate, vitamin B12, iron, magnesium, zinc, and potassium intake increased with adherence to Mediterranean diet (p < 0.001). Age, parental education level, body mass index (BMI), waist circumference, and skipping meals affected MSDPS. Conclusion: adolescents' adherence to the Mediterranean diet was low and correlated with some anthropometric measures. Increasing adherence to the Mediterranean diet may contribute to preventing obesity and adequate and balanced nutrition in adolescents.

Introducción: Introducción: la adolescencia es un periodo crítico para el desarrollo de hábitos alimentarios saludables. Es fundamental evaluar y fomentar la adherencia a la dieta mediterránea, un modelo de alimentación sostenible y saludable en este grupo de edad. Objetivo: este estudio tuvo como objetivo evaluar la relación entre la adherencia a la dieta mediterránea y las medidas antropométricas y el estado nutricional en adolescentes turcos. Material y métodos: las características demográficas, la información de salud, los hábitos nutricionales, el estado de actividad física y el recuerdo dietético de 24 horas de los adolescentes se obtuvieron mediante un cuestionario. La adherencia a la dieta mediterránea se evaluó con el Mediterranean-Style Dietary Pattern Score (MSDPS). Resultados: se incluyó un total de 1.137 adolescentes (edad media 14,0 ± 1,37 años). El 30,2 % de los niños y el 39,5 % de las niñas tenían sobrepeso/obesidad. El valor de la mediana (rango intercuartílico) del MSDPS fue de 10,7 (7,7), siendo este valor de 11,0 (7,6) para los niños y de 10,6 (7,4) para las niñas (p > 0,05). Los niveles de ingesta de proteína, fibra, vitamina A, vitamina C, folato, vitamina B12, hierro, magnesio, zinc y potasio aumentaron con la adherencia a la dieta mediterránea (p < 0,001). La edad, el nivel de educación de los padres, el índice de masa corporal (IMC), la circunferencia de la cintura y la omisión de comidas afectaron al MSDPS. Conclusión: la adherencia a la dieta mediterránea de los adolescentes fue baja y se correlacionó con algunas medidas antropométricas. El aumento de la adherencia a la dieta mediterránea puede contribuir a la prevención de la obesidad y a una nutrición adecuada y equilibrada en los adolescentes.

[Obesity, weight-related stigma and its association with the perception of quality of life in Chilean university students]. / Obesidad, estigma relacionado con el peso y su asociación con la percepción de la calidad de vida en estudiantes universitarios chilenos.

Introduction: Introduction: little attention has been paid to the effect of exposure to weight-related stigma on the quality of life of young Chileans with obesity. Objective: to identify the prevalence of weight-related stigma and to analyze its association with obesity and the perception of quality of life in university students from Valparaíso, Chile. Methods: correlational type study and cross-sectional design. Two hundred and sixty-two university students participated, from 18 to 29 years old, matriculated in the Faculty of Health Sciences of a public university in Valparaíso, Chile. Quality of life was assessed with the WHOQOL-BREF scale, weight-related stigma with the Brief Stigmatizing Situations Inventory (SSI), and nutritional status with body mass index (BMI) classification. The application of the questionnaires was on-line and the answers were anonymous. Multiple logistic regression models were used to evaluate the association between the variables, adjusted for gender and age. Results: the prevalence of stigma related to weight was 13,2 % in eutrophic, 24,4 % in overweight and 68,0 % in obese. Weight-related stigma, rather than obesity itself, is associated with poorer perceived physical health (OR: 4.30; 95 % CI: 2.10-8.80), psychological health (OR: 4.51; 95 % CI: 2.20-9.26), social relationships (OR: 3.21; 95 % CI: 1.56-6.60) and environment (OR: 2.86; 95 % CI: 1.33-6.14). Conclusion: students exposed to stigmatizing situations related to weight had a worse perception of their quality of life compared to those not stigmatized.

Introducción: Introducción: el efecto de la exposición al estigma relacionado en la calidad de vida de los jóvenes con obesidad ha recibido poca atención. Objetivo: identificar la prevalencia de estigma relacionado con el peso y analizar su asociación con la obesidad y la percepción de la calidad de vida en estudiantes universitarios de Valparaíso, Chile. Metodología: estudio de tipo correlacional y diseño transversal. Participaron 262 estudiantes universitarios, de 18 a 29 años de edad, matriculados en la Facultad de Ciencias de la Salud de una universidad pública de Valparaíso, Chile. La calidad de vida se evaluó con la escala WHOQOL-BREF; el estigma relacionado con el peso, con el Inventario breve de Situaciones Estigmatizantes (SSI); y el estado nutricional, con la clasificación del índice de masa corporal (IMC). La aplicación de los cuestionarios fue en línea y las respuestas fueron anónimas. Se realizaron modelos de regresión logística múltiple para evaluar la asociación entre las variables, ajustados por sexo y edad. Resultados: la prevalencia de estigma relacionado con el peso fue del 13,2 % en eutróficos, 24,4 % en sobrepesos y 68,0 % en obesos. El estigma relacionado con el peso, más que la obesidad en sí misma, se asoció con una peor salud física percibida (OR: 4,30; 95 % IC: 2,10-8,80), salud psicológica (OR: 4,51; 95 % IC: 2,20-9,26), relaciones sociales (OR: 3,21; 95 % IC: 1,56-6,60) y ambiente (OR: 2,86; 95 % IC: 1,33-6,14). Conclusiones: los estudiantes expuestos a situaciones estigmatizantes relacionadas con el peso tuvieron una peor percepción de su calidad de vida en comparación con aquellos no estigmatizados.

Body composition changes following total thyroidectomy: A one-year follow-up study.

INTRODUCTION: Thyroid hormones play an important role in body weight regulation. In this study, we investigated which body composition parameters cause a change in body weight after total thyroidectomy. MATERIALS AND METHOD: We performed a retrospective cohort study of a prospectively maintained database of patients who underwent total thyroidectomy. Demographics, thyroid function tests, indications for surgery, final pathology, and postoperative thyroid status were collected. Body composition analyses measured by the bioelectrical impedance analysis method were recorded at two-time points, 12 months apart. RESULTS: Forty-four patients were included in the study with a mean age of 51.6 years. There were statistically significant increases in weight (p=0.049), body mass index (p=0.021), and fat mass (p=0.001) over time. While 12 patients (27.3%) lost or maintained weight, 32 patients (72.7%) gained weight. There was no significant difference in age, sex, preoperative thyroid function tests, postoperative thyroid status, or pathology between those who gained weight and those who did not. Although changes in all body composition parameters were higher in males than in females, these differences were not significant overall. Multivariable regression analysis revealed a significant positive relationship between increase in fat mass and baseline free-T3 (p=0.041) and found that lower baseline percent body fat was a significant factor for greater fat mass gain (p=0.016). However, no predictors of change in weight were identified. CONCLUSION: We conclude that total thyroidectomy results in a significant change in body weight and fat mass. Higher free-T3 and lower percent body fat at baseline were significant factors of fat mass gain.

[Changes in the eating behavior of highly educated adults during the different stages of home confinement by COVID-19 in Iberoamerica]. / Cambios en el comportamiento alimentario de personas adultas con elevado nivel académico durante las diferentes etapas del confinamiento domiciliario por COVID-19 en Iberoamérica.

Introduction: Introduction: the COVID-19 pandemic has forced governments of affected countries to implement preventive measures including quarantine or house confinement. This situation has generally been seen to have affected the dietary patterns of the population. Objective: to evaluate changes in dietary habits and food acquisition during the different stages of home confinement caused by COVID-19 in the highly educated adult population in different Latin American countries. Methods: an observational and cross-sectional study was carried out in which 9,572 people from 58 different countries and with university studies participated. The instrument used for data collection was a survey designed by the International Ibero-American University of Mexico (UNINI-México) to study food habits during home confinement due to COVID-19 as part of the HALCON-COVID-19 study. Results: most of the respondents indicated having maintained their weight during quarantine (57.3 %), although they reported having reduced their physical activity (23.9 %) and eliminated the consumption of ultra-processed foods (53.4 %), alcoholic beverages (43.3 %), chocolates and sweets (41.1 %), while including vegetables (37.7 %), fruits (37 %) and eggs (30.6 %) in their diet. Conclusions: people who usually do not eat healthily have been even more affected in the way they eat during confinement, reducing their physical activity and increasing their body weight, while those with healthier lifestyles have not changed their habits or even maintained their healthy lifestyles during the pandemic.

Introducción: Introducción: la pandemia por COVID-19 ha obligado a los gobiernos de los países afectados a aplicar medidas preventivas que incluyen la cuarentena o el confinamiento domiciliario. Se ha visto que, en general, esta situación ha afectado los patrones alimentarios de la población. Objetivo: evaluar los cambios en los hábitos alimentarios y en la adquisición de los alimentos durante las diferentes etapas del confinamiento domiciliario ocasionado por COVID-19 en la población adulta de alto nivel educativo en diferentes países de Iberoamérica. Métodos: se realizó un estudio observacional y transversal en el que participaron 9.572 personas de 58 países diferentes con estudios universitarios. El instrumento utilizado para la recolección de datos fue una encuesta diseñada por la Universidad Internacional Iberoamericana de México (UNINI-México) para estudiar los hábitos alimentarios durante el confinamiento domiciliario por COVID-19 como parte del estudio HALCON-COVID-19. Resultados: la mayoría de los encuestados indicaron haber mantenido su peso durante la cuarentena (57,3 %), aunque reportaron haber reducido su actividad física (23,9 %)y repecto al consumo de alimentos, reportaron haber disminuido el consumo de alimentos ultraprocesados (53,4 %), de bebidas alcohólicas (43,3 %) y de chocolates y golosinas (41,1 %), mientras que aumentaron en su dieta el consumo de vegetales (37,7 %), frutas (37 %) y huevos (30,6 %). Conclusiones: las personas que no comían de forma saludable previamente, han empeorado la calidad de su dieta durante el periodo de confinamiento además de haber reducido su actividad física, sin embargo, aquellos que tenían un estilo de vida más sano lo han mantenido durante este el periodo.

[Physical exercise and loss of weight and body mass index in bariatric surgery: a systematic review]. / Ejercicio físico y disminución del peso y el índice de masa corporal en la cirugía bariátrica: una revisión sistemática.

INTRODUCTION: Introduction: bariatric surgery is considered successful when the percentage of weight loss is equal to or higher than 25 %, or when the percentage loss of body mass index occurs above 50 % long-term. Objective: to analyze the effect of physical exercise on body weight and body mass index before and/or after bariatric surgery. Methodology: articles registered in the PudMed, Scopus and Web of Science databases were searched for original papers with open access in English and Spanish that compared one or more physical exercise programs as treatment before and/or after bariatric surgery, with results on initial and final weight and body mass index, muscle mass, and fat mass from January to April 2021. Results: a total of 730 articles were obtained in the different databases and only 7 were selected for the analysis. Aerobic exercise combined with resistance training showed a greater decrease in the percentage of weight loss (% PP) and the percentage of loss of body mass index (% PBMI). Conclusions: aerobic physical exercise in combination with endurance training is the most applied program in subjects with bariatric surgery, and the most important effects are an increase in percentage of weight loss and a decrease in body mass index.

INTRODUCCIÓN: Introducción: la cirugía bariátrica se considera exitosa cuando el porcentaje de pérdida de peso es igual o superior al 25 % o bien cuando el porcentaje de pérdida de índice de masa corporal ocurre por encima del 50 % a largo plazo. Objetivo: analizar el efecto del ejercicio físico en el peso corporal y el índice de masa corporal antes y después de la cirugía bariátrica. Metodología: se buscaron artículos registrados en las bases de datos de PudMed, Scopus y Web of Science, de artículos originales con acceso abierto en inglés y español que compararan uno o varios programas de ejercicio físico como tratamiento antes y/o después de la cirugía bariátrica, con resultados de peso e índice de masa corporal inicial y final, masa muscular y masa grasa, de enero a abril de 2021. Resultados: se obtuvieron en total 730 artículos de las diferentes bases de datos y solo 7 se seleccionaron para el análisis. El ejercicio aerobio combinado con el entrenamiento de resistencia mostró una mayor disminución del porcentaje de peso perdido (% PP) y del porcentaje perdido de índice de masa corporal (% PIMC). Conclusiones: el ejercicio físico aerobio, en combinación con el entrenamiento de resistencia, es el programa más aplicado a los sujetos con cirugia bariátrica y los efectos más importantes son el aumento del porcentaje de pérdida de peso y la disminución del índice de masa corporal.

Rescuers' characteristics associated with the correct chest compression during cardiopulmonary resuscitation.

AIM: To analyse the caregivers' physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR). METHODS: An observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models. RESULTS: Two hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR = 3.03; 95% CI 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI .87-.99) and grip strength (OR: .94; 95% CI .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil. CONCLUSIONS: The caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.

[Body composition, mineral metabolism, and endocrine function of adipose tissue: influence of a nutritional supplement of propolis]. / Composición corporal, metabolismo mineral y función endocrina del tejido adiposo: influencia de un suplemento nutricional de propóleo.

INTRODUCTION: Introduction: propolis and its components influence lipid metabolism; however, its effect on body composition and mineral metabolism remains unknown. Objectives: to determine the effect of natural propolis supplementation on body composition, mineral metabolism, and the endocrine function of adipose tissue. Material and methods: twenty albino male Wistar rats (8 weeks old) were divided into two groups of 10 animals each. The rats were fed two different types of diet for 90 days: a standard diet for the control group (group C) and the same standard diet + 2 % propolis (group P). Thyroid hormones, ghrelin, leptin, adiponectin and insulin, non-esterified fatty acids (NEFA) in plasma, body composition (lean mass, fat mass and body water), and mineral deposition in target organs (spleen, brain, heart, lungs, testicles, kidneys and femur) were assessed. Results: thyroid stimulating hormone (TSH), triiodothyronine (T3) and thyroxine (T4) did not show any differences after supplementation with propolis, while ghrelin and adiponectin decreased (p < 0.01 and p < 0.05, respectively) and insulin (p < 0.01), leptin (p < 0.05) and NEFA (p < 0.05) increased when 2 % propolis was supplied, while weight and body fat were reduced (p < 0.05) and lean mass increased. Lastly, the propolis supplement improves calcium deposition in the spleen, lungs, testes, and femur (p < 0.05). Conclusion: propolis supplementation of the diet (2 %) causes a decrease in the secretion of ghrelin and adiponectin, increasing the release of non-esterified fatty acids and the rate of insulin secretion. In addition, propolis supplementation induces an improvement in calcium deposition in target organs without affecting the rest of minerals, which improves body composition by inducing a reduction in weight and visceral adipose tissue, and improvement in lean mass.

INTRODUCCIÓN: Introducción: el propóleo y sus componentes influyen en el metabolismo lipídico; sin embargo, se desconoce su efecto sobre la composición corporal y el metabolismo mineral. Objetivos: determinar el efecto de la suplementación de la dieta con propóleo natural sobre la composición corporal, el metabolismo basal y mineral, y la función endocrina del tejido adiposo. Material y métodos: veinte ratas albinas Wistar macho (8 semanas) se dividieron en dos grupos de 10 animales cada uno. Las ratas fueron alimentadas con dos tipos diferentes de dietas durante 90 días: una dieta estándar para el grupo de control (grupo C) y la misma dieta estándar + un 2 % de propóleo (grupo P). Se determinaron las hormonas tiroideas, la grelina, la leptina, la adiponectina y la insulina, los ácidos grasos no esterificados (AGNE) en el plasma, la composición corporal (masa magra, masa grasa y agua corporal) y el depósito de minerales en órganos diana (bazo, cerebro, corazón, pulmones, testículos, riñones y fémur). Resultados: los niveles plasmáticos de hormona estimulante del tiroides (TSH), triyodotironina (T3) y tiroxina (T4) no mostraron diferencias tras la ingesta del suplemento de propóleo, mientras que los de grelina y adiponectina disminuyeron (p < 0,01 y p < 0,05, respectivamente) y los de insulina (p < 0,01), leptina (p < 0,05) y AGNE (p < 0,05) aumentaron cuando la dieta se suplementó con propóleo al 2 %. Se redujeron el peso y la grasa corporal (p < 0,05), incrementándose la masa magra. Por último, el suplemento de propóleo mejoró el depósito de calcio en el bazo, los pulmones, los testículos y el fémur (p < 0,05). Conclusión: el suplemento de propóleo al 2 % de la dieta produjo una disminución de la secreción de grelina y adiponectina, incrementando la concentración de AGNE y aumentando la tasa de secreción de insulina. Además, el suplemento de propóleo indujo una mejora del depósito de calcio en los órganos diana sin afectar al resto de minerales, lo que en conjunto mejora la composición corporal al inducir una reducción del peso y del tejido adiposo visceral, mejorando la masa magra.

Light-dark cycle inversion effect on food intake and body weight in rats.

INTRODUCTION: Background: most organisms inhabiting this planet have rhythmic functions in cycles that approximate 24 hours as a result of evolutionary adaptation. Disruption of these rhythms causes disruption in many bodily functions, including energy expenditure and consumption, and lipid and glucose metabolism, in addition to altering several biochemical parameters. Objective: the aim of this study was to determine the effect of altering the light-dark cycle on diurnal and nocturnal food consumption and body weight in rats. Material and methods: three experiments were carried out with an experimental group and a control group in each one. The groups included six males with an age of four months at the beginning of the experiment. Each experiment was 30 days long, starting with a baseline of 10 days and then inverting the light-dark cycle for another 20 days. In the first experiment the inversion took place at the end of the baseline period; in the second, the inversion was performed on days 10 and 20; in the third experiment inversions occurred every five days following the initial 10 days of baseline. Results: our results show a lower body weight gain in the experimental groups when compared to the control groups. Conclusions: significant differences in total consumption of food were not found, but were seen in the patterns of day and night consumption, along with a tendency to develop alterations characteristic of metabolic syndrome, which increased with the frequency of light-dark cycle inversion.

INTRODUCCIÓN: Introducción: la mayoría de los organismos que habitan este planeta tienen funciones rítmicas que siguen ciclos cercanos a las 24 horas, resultado de la adaptación evolutiva. La alteración de estos ritmos provoca disrupción en funciones como el gasto y el consumo de energía, y el metabolismo de los lípidos y la glucosa, además de alterar varios parámetros bioquímicos. Objetivo: el objetivo de este trabajo fue determinar el efecto de la alteración del ciclo luz-oscuridad sobre el consumo diurno y nocturno de alimento y el peso corporal en ratas. Material y métodos: se llevaron a cabo tres experimentos con un grupo experimental y uno de control en cada uno de ellos. Los grupos estuvieron compuestos de seis machos de cuatro meses de edad cada uno. Cada experimento tuvo una duración de 30 días, comenzando con una línea base de 10 días y realizando inversiones del ciclo luz-oscuridad durante los otros 20 días. En el primer experimento se realizó una inversión al término de la línea base; en el experimento dos se realizó en los días 10 y 20; en el tercero, las inversiones se realizaron cada cinco días, tras los 10 días de la línea base. Resultados: los resultados muestran una ganancia de peso corporal menor en los grupos experimentales en relación con los grupos de control. Conclusión: no se encontró ninguna diferencia significativa en el consumo de alimento total pero sí en los patrones de consumo diurno y nocturno, que se intensificaron con el aumento de la frecuencia de la inversión del ciclo luz-oscuridad.

Development and validation of a weight estimation tool for paediatric emergency care. / Desarrollo y validación de una fórmula de estimación del peso para emergencias pediátricas.

OBJECTIVE: To develop and validate a weight estimation tool applicable in paediatric emergency care. METHODS: Using anthropometric data from a computerized database of the primary health care paediatric services, Bilbao (Basque Country, Spain), linear regression models were developed with the objective of estimating weight from height. Subsequently, these models were prospectively validated using a consecutive sample of children attended in the emergency department of two tertiary hospitals. Estimated weights were compared with actual weights, calculating the intraclass correlation coefficient (ICC), mean difference and percentages of estimations falling within 10% and 20% of the actual weight. RESULTS: Using anthropometric data from 15522 children two weight predictive formulas were developed (Bilbao Formulas). The formulas were validated on a sample of 780 children and estimated weight values with a high degree of intraclass correlation with the real weight (ICC=.93, P<.001) and a mean difference of .63 (SD: 4.3). The percentages of estimations falling within 10% and 20% of the actual weight of the child was 62.2% (95% CI: 58.7-65.6) and 93.1% (95% CI: 91.1-94.8), respectively. Weight estimations were more accurate using Bilbao Formulas than other classical formulas. CONCLUSIONS: Bilbao Formulas would be a valid tool for estimating weight in children in the emergency department and predict weight more accurately than other more commonly used age-based formulas.

Rescuers' characteristics associated with the correct chest compression during cardiopulmonary resuscitation. / Características de los reanimadores asociadas a la correcta compresión torácica durante la reanimación cardiopulmonar.

AIM: To analyse the caregivers' physical, anthropometrical and educational characteristics associated with adequate chest compression and full chest recoil during cardiopulmonary resuscitation (CPR). METHODS: An observational prospective research study was conducted. Emergency and critical care health professionals and students performed two minutes of chest compressions on a dummy. Depth and residual leaning after the compressions were assessed and their association with several variables (physical, anthropometrical, and educational) was analysed using logistic regression models. RESULTS: Two hundred thirty-eight volunteers participated. Previous experience of the rescuer in less than six CPRs (OR: 3.03; CI 95%: 1.2-7.63) was related to a higher probability of not achieving an adequate depth of compressions. Greater height (OR: .93; 95% CI: .87-.99) and grip strength (OR: .94; 95% CI: .89-.99) were associated with correct performance of chest compression. We did not find any characteristic related to chest recoil. CONCLUSIONS: The caregiver's previous experience with CPR was the strongest factor associated with adequate performance of chest compressions. To a lesser extent, the professional's height and upper body muscle strength also have an influence. No factors associated with the adequacy of full chest recoil were identified.

Comparison of weight estimation methods in hospitalized Brazilian children and adolescents.

INTRODUCTION: Introduction: in emergencies or in situations involving critically ill patients, an accurate calculation of body weight is essential to ensure adequate medical care. Generally, simple techniques are used to determine weight. Aim: to evaluate the weight estimation methods Advanced Paediatric Life Support (APLS) Update, Luscombe and Owens, Best Guess, and the Broselow tape, comparing measured weight with the weight estimated by each method in hospitalized Brazilian children and adolescents. Methods: an observational study in which anthropometric data were collected from patients of 0-14 years of age between August 2016 and January 2017. The paired t-test was used to compare the patients' measured weight with their estimated weight. The accuracy of each method was analyzed using Bland-Altman plots and Lin's concordance correlation coefficient. Results: the sample consisted of 446 patients. Most of the patients were male (58.1%), of 1-5 years of age (43%) and well nourished (85%). For those under 12 months of age, the APLS Update and Best Guess methods performed best, with the difference in means of measured weight and estimated weight being 0.4 kg (p = 0.183) and -0.2 kg (p = 0.140), respectively. In the 1-5 years of age group only the APLS Update yielded satisfactory results (0.2 kg; p = 0.200). The best agreement with measured weight, according to the Bland-Altman plots and Lin's coefficient, was found for the Broselow tape (CC = 0.96). Conclusion: of the estimation methods evaluated the Broselow tape was the most accurate one. Further studies are required to adapt this method for use in the Brazilian population, thus ensuring its appropriate application in this country.

INTRODUCCIÓN: Introducción: en las emergencias o en las situaciones que involucran a pacientes críticamente enfermos, el cálculo preciso del peso corporal es esencial para garantizar una atención médica adecuada. En general se utilizan técnicas simples para determinar el peso. Objetivo: evaluar los métodos de estimación del peso Advanced Paediatric Life Support (APLS) Update, Luscombe y Owens, Best Guess y la cinta Broselow, comparando el peso medido con el peso estimado por cada método en los pacientes hospitalizados. Métodos: estudio observacional en el que se recopilaron datos antropométricos de pacientes de 0 a 14 años de edad entre agosto de 2016 y enero de 2017. Se utilizó la prueba t pareada para comparar el peso medido de los pacientes con su peso estimado. La precisión de cada método se analizó mediante gráficos de Bland-Altman y el coeficiente de correlación de concordancia de Lin. Resultados: la muestra estuvo constituida por 446 pacientes. La mayoría eran varones (58,1%) de 1 a 5 años (43%) y bien nutridos (85%). Para los menores de 12 meses de edad, los métodos APLS Update y Best Guess obtuvieron los mejores resultados, siendo la diferencia entre las medias de peso medido y peso estimado de 0,4 kg (p = 0,183) y -0,2 kg (p = 0,140), respectivamente. En el grupo de 1 a 5 años, solo el método APLS Update arrojó resultados satisfactorios (0,2 kg; p = 0,200). El mejor acuerdo con el peso medido, según las gráficas de Bland-Altman y el coeficiente de Lin, se encontró al utilizar la cinta Broselow (CC = 0,96). Conclusión: de los métodos de estimación evaluados, la cinta Broselow fue la más precisa. Se requieren estudios adicionales para adaptar este método para su uso en la población brasileña.

Effect of the COVID-19 quarantine on body mass among combat sports athletes.

INTRODUCTION: Introduction: to combat the COVID-19 pandemic governments have adopted measures such as quarantine and social distancing. Objective: the main objective of the present study was to analyze the impact of COVID-19 quarantine on body mass in combat sports athletes. Methods: we conducted a cross-sectional, prospective, multi-center study that evaluated 234 men (mean age and standard deviation, 29 ± 10 years) residing in Argentina (n = 38); Bolivia (n = 1); Brazil (n = 105); Chile (n = 30); El Salvador (n = 1); Spain (n = 22); Mexico (n = 22) and Peru (n = 15). Of these, 12 practiced Brazilian jiu-jitsu (BJJ), 54 boxing, 67 judo, 13 karate, 52 kick boxing & muay thai (KB & MT), 9 mixed martial arts (MMA), and 27 taekwondo (TKD). An online survey was created using Google Forms. It was implemented between April 4th and April 17th, 2020. Athletes were consulted about their body mass before starting the quarantine and after 20 ± 5 days of quarantine. Results: athletes in all combat sports were heavier during quarantine as compared to pre-quarantine (p < 0.001, d = 0.12). Conclusions: combat sports athletes experienced an increase in body mass during the COVID-19 quarantine.

INTRODUCCIÓN: Introducción: para combatir la pandemia de COVID-19, los gobiernos han adoptado medidas como la cuarentena y el distanciamiento social. Objetivo: el principal objetivo del presente estudio fue analizar el impacto de la cuarentena por COVID-19 sobre la masa corporal en atletas de deportes de combate. Métodos: realizamos un estudio transversal, prospectivo y multicéntrico que evaluó a 234 hombres (media de edad y desviación estándar, 29 ± 10 años) que residen en Argentina (n = 38); Bolivia (n = 1); Brasil (n = 105); Chile (n = 30); El Salvador (n = 1); España (n = 22); México (n = 22) y Perú (n = 15). De estos, 12 practicaban jiu-jitsu brasileño (BJJ), 54 boxeo, 67 judo, 13 karate, 52 kick boxing y muay thai (KB y MT), 9 artes marciales mixtas (MMA) y 27 taekwondo (TKD). Se creó una encuesta en línea usando Google Forms. Se implementó entre el 4 y el 17 de abril de 2020. Se preguntó a los deportistas sobre su masa corporal antes de comenzar la cuarentena y después de 20 ± 5 días de cuarentena. Resultados: los atletas de todos los deportes de combate resultaron más pesados durante la cuarentena que durante la precuarentena (p < 0,001, d = 0,12). Conclusiones: los atletas de deportes de combate presentaron una mayor masa corporal durante la cuarentena a causa de la COVID-19.

Rapid weight gain in wrestling athletes during the Panamerican Championship, Lima, 2018.

INTRODUCTION: Introduction: To avoid rapid bodyweight fluctuations and the associated effects on health and performance, some combat sports federations have made changes to regulations. Objective: the objective of this study was to analyze the impact of the Rapid Weight Gain on sporting success in elite Olympic Wrestling athletes under the new weighing modality. Methods: the bodyweight of 75 athletes was recorded during the Pan-American Olympic Wrestling Championship (Lima, 2018), corresponding to 29 % of the total universe of competitors (n = 255). Of these, 29 were Greco-Roman style, eight Freestyle, and 38 Women´s Wrestling. The official weighing was carried out between 8:00 and 8:30 hours. As for the second weighing, this was done with the same official weighing scale, immediately before the first match (between 10:00 and 11:00 hours). Rapid Weight Gain after weigh-in was compared between medalist and non-medalist athletes. Results: when analyzing the difference between medalists and non-medalists, no significant differences were found in Greco-Roman athletes (t = 0.114; p = 0.910; r = 0.022), in Freestyle (Mann-Whitney U = 5,500; p = 0.486; r = 0.000), in Women´s Wrestling (Mann-Whitney U = 163.0; p = 0.774; r = 0.124), and in all competitors (Mann-Whitney U = 641.5; p = 0.855; r = 0.037). Conclusions: no significant differences were found between medalist and non-medalist athletes in any of the Olympic Wrestling styles.

INTRODUCCIÓN: Introducción: para evitar fluctuaciones rápidas del peso corporal y los efectos asociados sobre la salud y rendimiento, algunas federaciones de deportes de combate han realizado cambios de reglamento. Objetivo: el objetivo de este estudio fue analizar el impacto de la ganancia rápida de peso en el éxito deportivo en atletas de élite de la lucha olímpica bajo la nueva modalidad de pesaje. Métodos: se registró el peso corporal de 75 atletas durante el Campeonato Panamericano de Lucha Olímpica (Lima, 2018), correspondiente al 29 % del universo total de competidores (n = 255). De estos, 29 fueron de estilo grecorromano; 8, de estilo libre y 38, de lucha libre femenina. El pesaje oficial se realizó entre las 8:00 y las 8:30 horas. En cuanto al segundo pesaje, se hizo con la misma balanza oficial inmediatamente antes de la primera lucha (entre las 10:00 y las 11:00 horas). La ganancia de peso rápida después del pesaje se comparó entre atletas medallistas y no medallistas. Resultados: al analizar la diferencia entre medallistas y no medallistas, no se encontraron diferencias significativas en los atletas de grecorromana (t = 0,114; p = 0,910; r = 0,022), en los de estilo libre (Mann-Whitney U = 5,500; p = 0,486; r = 0,000), en los de lucha libre femenina (Mann-Whitney U = 163,0; p = 0,774; r = 0,124) ni en todos los competidores (Mann -Whitney U = 641,5; p = 0,855; r = 0,037). Conclusiones: no se encontraron diferencias significativas entre atletas medallistas y no medallistas en ninguno de los estilos de lucha olímpica.

Body mass to predict 4-6 rm of pectoral and leg muscles exercises in bodybuilders / Predicción de 4-6 rm de ejercicios de piernas y pectorales por masa corporal / Predição de 4-6 rm de exercicios de perna e peitoral pela massa corporal

ABSTRACT Introduction: Submaximal strength testing appears to be valid to prescribe the intensity for strength training protocols that reduce the risk of injuries and testing time. Objective: This study aimed to assess the predictive ability of body mass parameters to estimate 4-6 repetitions maximum (4-6 RM) of Leg press 45°, Chest press, and Pull-down exercises. Methods: Eleven male bodybuilders (age 38.27 ± 10.48 years) participated in this study. Participants completed an incremental external load up to find the load allowing them to perform 4 to 6 maximal repetitions for each exercise in random order. The starting load was 50% of body mass for chest press and pull-down exercises and 100% for leg press. The load increment after each set was 20 kg for lower limb exercises and 10 kg for upper body exercises. Results: Results revealed that body mass had good to optimal relationships with 4-6 RM for all three exercises. Results showed that body mass had a good prediction ability for all three criterion measures. Conclusion: The prediction equations suggested in this study may allow coaches to estimate the 4-6 RM of leg press 45°, chest press, and pull-down performances. Evidence Level IV; Case series.

RESUMEN Introducción: El test de fuerza submáxima parece ser válido para prescribir la intensidad en protocolos de entrenamiento de fuerza, reduciendo el riesgo de lesiones y la duración del test. Objetivo: Evaluar la capacidad predictiva de los parámetros de masa corporal para estimar 4-6 repeticiones máximas (4-6 RM) de ejercicios de Leg press 45°, Chest press y Pull-down realizados por fisicoculturistas. Métodos: Once fisicoculturistas masculinos (38,27 ± 10,48 años) participaron en el estudio. Completaron la carga externa incremental hasta encontrar la carga que les permitiera realizar de 4 a 6 repeticiones máximas para cada ejercicio, en orden aleatorio. La carga inicial se fijó en el 50% de la masa corporal para los ejercicios Chest press y Pull-down, y en el 100% para los ejercicios Leg press. El incremento de carga después de cada ronda fue de 20 kg para los miembros inferiores y 10 kg para los miembros superiores. Resultados: Los resultados revelaron que la masa corporal tiene relaciones satisfactorias con 4-6 RM para los tres ejercicios. Los resultados mostraron que la masa corporal tiene una buena capacidad predictiva en las tres medidas. Conclusión: Las ecuaciones de predicción sugeridas en este estudio pueden permitir a los entrenadores utilizar estos ejercicios para medir el rendimiento a 4-6 RM en ejercicios de Leg press 45°, Chest press y Pull-down. Nivel de Evidencia IV; serie de casos.

RESUMO Introdução: O teste de força submáxima parece ser válido para prescrever a intensidade nos protocolos de treinamento de força, reduzindo o risco de lesões e duração dos testes. Objetivo: Avaliar a capacidade preditiva dos parâmetros de massa corporal para estimar o exercício de 4-6 repetições máximas (4-6 RM) nos exercícios de Leg press 45°, Chest press e Pull-down efetuados por fisiculturistas. Métodos: Onze fisiculturistas masculinos (38,27 ± 10,48 anos) participaram do estudo. Eles completaram a carga externa incremental até encontrar a carga que lhes permitia realizar de 4 a 6 repetições máximas para cada exercício, em ordem aleatória. A carga inicial foi fixada em 50% da massa corporal para os exercícios de Chest press e Pull-down, e 100% para o de Leg press. O incremento de carga após cada rodada foi de 20 kg para o exercício de membros inferiores e 10 kg em membros superiores. Resultados: Os resultados revelaram que a massa corporal apresenta relações satisfatórias com 4-6 RM para todos os três exercícios. Os resultados mostraram que a massa corporal possui boa capacidade preditiva em todas as três medidas. Conclusão: As equações de previsão sugeridas nesse estudo podem permitir o uso desses exercícios pelos técnicos para medir a performance a 4-6 RM nos exercícios de Leg press 45°, Chest press, e Pull-down. Nível de evidência IV; série de casos.