Gait speed as a mediator of the effect of sarcopenia on dependency in activities of daily living.

BACKGROUND: Sarcopenia in older adults is strongly associated with an increase in dependency in activities of daily living (ADL) and with a decline in gait speed. Interestingly, gait speed has been shown to independently predict mortality. In this context, our study aimed to explore the mediator role of gait speed on the relationship between sarcopenia and dependency in ADL. METHODS: A cross-sectional study was conducted in Colombia, 19 705 older adults with a mean age of 70 years, 55.6% women, 16.1% with sarcopenia, and 14.7% mild, moderate, or severe dependency in ADL, according to 'SABE Survey 2015'. Sarcopenia was assessed by calf circumference and ADL dependence through the Barthel Index. Gait speed was measured over a distance of 3 m. The association between sarcopenia condition and gait speed and dependency level was analysed by linear regression adjusted by covariates. To examine whether gait speed mediated the association between sarcopenia and dependence components of physical function, simple mediation models were generated using ordinary least squares with the macro PROCESS version 3.2, adjusted for age, sex, and body mass index (BMI). RESULTS: Significant differences (P < 0.05) were found in gait speed and dependency in ADL between the sarcopenia and non-sarcopenia groups after adjusting for age, sex, and BMI. BMI was significantly higher in the non-sarcopenia group whereas dependency was significantly higher in the sarcopenia group (19.6% vs. 13.8%). Results from mediation model regression analysis indicated a significant and direct detrimental effect of sarcopenia on dependency in ADL (ß = -0.05; P < 0.001), and a significant indirect effect of gait speed on the direct effect (-0.009 to -0.004). CONCLUSIONS: The negative effect of sarcopenia on functional dependence was mediated by the gait speed. Therefore, gait speed may positively influence the detrimental effect of sarcopenia for dependency, after adjusting for age, gender, and BMI. Consequently, physical exercise should be promoted and focused to circumvent the gait speed decline associated with age in older people with sarcopenia.

Reference values for handgrip strength and their association with intrinsic capacity domains among older adults.

OBJECTIVE: The purposes of this study were three-fold: (i) to describe handgrip strength in older individuals aged ≥60 years in Colombia; (ii) to identify sex-specific and age-specific muscle weakness cut-off points in older adults; and (iii) to determine the odds of adverse events for each of the intrinsic capacity domains for individuals with handgrip strength greater than the muscle weakness cut-off points, as compared with their weaker counterparts. METHODS: A cross-sectional study was conducted in Colombia, among 5237 older adults aged ≥60 years old (58.5% women, 70.5 ± 7.8 years), according to 'SABE Survey 2015'. Handgrip strength data were obtained with a Takei dynamometer. Sociodemographic variables, five domains of intrinsic capacity (i.e. locomotion, vitality, cognition, psychological, and sensory), and medical conditions were assessed and analyzed. Adjustments variables were age, ethnicity, socio-economic status, urbanicity, body mass index, smoking status, alcohol intake, drug use, physical activity, and co-morbid chronic diseases. Sex-stratified analyses were conducted with logistic regression models. RESULTS: Handgrip strength was greater among men than among women (26.7 ± 8.5 vs. 16.7 ± 5.7 kg, respectively, P < 0.001) at all ages. Weak handgrip strength cut-off points ranged from 17.4 to 8.6 and from 10.1 to 4.9 in men and women, respectively. Overall, participants with optimal handgrip strength had better intrinsic capacity [in men, odds ratio (OR) = 0.62, 95% confidence interval (CI) 0.53 to 0.71; P < 0.001; and in women, OR = 0.79, 95% CI 0.68 to 0.92; P = 0.002] than their weaker counterparts. Also, men with optimal handgrip strength had a lower risk of hospitalization (OR = 0.47, 95% CI 0.29 to 0.78; P = 0.004) than their weaker counterparts. CONCLUSIONS: This study is the first to describe handgrip strength values and cut-off points for muscle weakness among a nationally representative sample of Colombian older adults by age and sex. After categorizing older adults as weak or not weak based on the handgrip cut-off points, non-weakness was associated with a decreased odds of intrinsic capacity impairments. These cut-off points may be good candidates for clinical assessment of risks to physical and mental health in older Colombian adults.

Etapas de cambio comportamental frente al consumo de sustancias psicoactivas en escolares de 9 a 17 años de Bogotá D.C., Colombia / Stages of behavior change and their correlation with alcohol, tobacco and drug use in schoolchildren aged 9 to 17 in Bogotá D.C., Colombia

Resumen Introducción. El consumo de sustancias psicoactivas (SPA) es una problemática que afecta a estudiantes desde edades tempranas. Objetivo. Describir las etapas de cambio de comportamiento frente al consumo de SPA en escolares de Bogotá D.C., Colombia. Materiales y métodos. Estudio transversal en 6 965 escolares de Bogotá D.C. El cambio de comportamiento se evaluó por autoreporte a través de un cuestionario estructurado a partir del Modelo Transteórico en las etapas de precontemplación, contemplación, preparación y acción/mantenimiento. Resultados. 58.4% fueron mujeres con edad promedio de 12.7±2.3 años. Frente al consumo de drogas alucinógenas, 6% de los escolares se ubicaron en la categoría de precontemplación, 44% en contemplación, 30% en preparación y 20% en acción/mantenimiento. Respecto al consumo de alcohol, 5% se encontraban en precontemplación, 36% en contemplación, 12% en preparación y 46% en acción/mantenimiento. El tabaquismo mostró prevalencias de 4% para precontemplación, 33% para contemplación, 12% para preparación y 51% para acción/mantenimiento. Conclusiones. El consumo de SPA es una problemática que se presenta cada vez con mayor frecuencia en población escolar. La mayoría de entrevistados se ubican en etapa de mantenimiento en el consumo de tabaco y alcohol y en la etapa de contemplación de consumo de drogas alucinógenas. Se requieren esfuerzos gubernamentales que fomenten programas preventivos de consumo de SPA en el ámbito escolar.

Abstract Introduction: Psychoactive substance use is a problem that affects schoolchildren from an early age. Objective: To describe the stages of behavior change and their correlation with alcohol, tobacco and drug use in schoolchildren of Bogotá D.C., Colombia. Materials and methods: Cross-sectional study in 6 965 schoolchildren from Bogotá D.C. Behavior change was evaluated by self-report using a structured questionnaire based on the precontemplation, contemplation, preparation and action/maintenance stages of the Transtheoretical Model. Results: 58.4% of the participants were women with a mean age of 12.7±2.3 years. Regarding illicit drug use, 6% of schoolchildren were in the precontemplation stage, 44% in contemplation, 30% in preparation and 20% in action/maintenance. With respect to alcohol consumption, 5% were in precontemplation stage, 36% in contemplation, 12% in preparation and 46% in action/maintenance. Smoking showed prevalence of 4% for precontemplation, 33% for contemplation, 12% for preparation and 51% for action/maintenance. Conclusions: The use of psychoactive substances is an increasing issue among schoolchildren. Most interviewees were in the maintenance stage of tobacco and alcohol use, and in the contemplation stage of drug use. Government efforts are required to promote preventive programs in schools.

Effectiveness of HIIT compared to moderate continuous training in improving vascular parameters in inactive adults.

BACKGROUND: Strong evidence shows that physical inactivity increases the risk of many adverse health conditions, including major non-communicable diseases, such as cardiovascular disease (CVD), metabolic syndrome, and breast and colon cancers, and shortens life expectancy. We aimed to determine the effects of moderate (MCT)- versus high-intensity interval training (HIT) on vascular function parameters in physically inactive adults. We hypothesized that individualized HIT prescription would improve the vascular function parameters more than the MCT in a greater proportion of individuals. METHODS: Twenty-one inactive adults were randomly allocated to receive either MCT group (60-75% of their heart rate reserve, [HRR] or HIT group (4 min at 85-95% of peak HRR), 3 days a week for 12 weeks. Vascular function (brachial artery flow-mediated dilation, FMD [%], normalized brachial artery flow-mediated dilation, FMDn [%], aortic pulse wave velocity, PWV [m·s- 1], AIx, augmentation index: aortic and brachial [%]), were measured at baseline and over 12 weeks of training. In order for a participant to be considered a responder to improvements in vascular function parameters (FMDn and PWV), the typical error was calculated in a favorable direction. RESULTS: FMD changed by - 1.0% (SE 2.1, d = 0.388) in the MCT group, and + 1.8% (SE 1.8, d = 0.699) in the HIT group (no significant difference between groups: 2.9% [95% CI, - 3.0 to 8.8]. PWV changed by + 0.1 m·s- 1 (SE 0.2, d = 0.087) in the MCT group but decreased by - 0.4 m·s- 1 in the HIT group (SE 0.2, d = 0.497), with significant difference between groups: - 0.4 [95% CI, - 0.2 to - 0.7]. There was not a significant difference in the prevalence of no-responder for FMD (%) between the MCT and HIT groups (66% versus 36%, P = 0.157). Regarding PWV (m·s- 1), an analysis showed that the prevalence of no-responder was 77% (7 cases) in the MCT group and 45% (5 cases) in the HIT group (P = 0.114). CONCLUSIONS: Under the conditions of the present study, both groups experienced changed in vascular function parameters. Compared to MCT group, HIT is more efficacious for improving FMD and decreasing PWV, in physically inactive adults. TRIAL REGISTRATION: ClinicalTrials.gov NCT02738385 registered on 23 March 2016.

Ideal Cardiovascular Health, Handgrip Strength, and Muscle Mass Among College Students: The FUPRECOL Adults Study.

Garcia-Hermoso, A, Correa-Bautista, JE, Izquierdo, M, Tordecilla-Sanders, A, Prieto-Benavides, D, Sandoval-Cuellar, C, González-Ruíz, K, and Ramírez-Vélez, R. Ideal cardiovascular health, handgrip strength, and muscle mass among college students: the FUPRECOL Adults study. J Strength Cond Res 33(3): 747-754, 2019-The American Heart Association established the 2020 Strategic Impact Goals to define the concept of ideal cardiovascular health (CVH) and the metrics needed to monitor it across populations. The purpose of this study was to investigate the relationship between handgrip strength, muscle mass, and ideal CVH among Colombian college students. Data from 1,835 college students were analyzed (1,128 female). Muscular strength was estimated using a hand-held dynamometer and normalized to body mass (normalized grip strength [NGS]). The percentage of body fat was determined for bioelectrical impedance analysis using tetrapolar whole-body impedance. Ideal CVH was defined as meeting the ideal levels of 4 behaviors (smoking, body mass index, physical activity, and diet adherence) and 3 factors (total cholesterol, fasting glucose, and blood pressure). Higher levels of NGS and muscle mass (relative to body mass) were associated with a higher number of ideal CVH metrics in both sexes (p for trend <0.001). For the total ideal CVH metrics scored on a continuous scale from 0 (all 7 poor) to 7 (all 7 ideal), a 1-metric increase was associated with reduced odds of weak NGS (33 and 36%) and low-medium muscle mass (28 and 34%) mass in men and women, respectively (all p < 0.001). This study indicates that in Colombian college students, both handgrip strength and muscle mass are positively associated with the ideal CVH metrics. To reduce the possible future public health burden of muscular weakness, health professionals need to encourage the public to optimize lifestyle-related risk factors during the young adult stage.

Conocimiento pedagógico de contenido en docentes de fisiología / Pedagogical content knowledge (PCK) in physiology professors

Resumen Introducción. El conocimiento pedagógico de contenido (CPC) es un saber especializado resultado de la práctica y la experiencia del docente en el aula. Se requiere avanzar en la comprensión del conocimiento pedagógico del docente universitario que enseña fisiología humana. Objetivo. Explorar los tipos de contenidos, el conocimiento de los estudiantes, las estrategias y representaciones didácticas, la evaluación y las orientaciones pedagógicas utilizadas por docentes universitarios que enseñan contenidos sobre la fisiología del sistema respiratorio. Materiales y métodos. Estudio múltiple de caso realizado en cuatro docentes de fisiología pertenecientes a un programa de medicina. Se aplicó el cuestionario de representaciones de contenido de manera autodiligenciada, se realizaron videograbaciones de las clases de fisiología del sistema respiratorio y se empleó el protocolo de registro de evidencia del CPC. Resultados. La población estuvo conformada por cuatro sujetos, dos docentes expertos y dos novatos. Se caracterizó la forma en que entienden los procesos de aprendizaje de los estudiantes, el conocimiento que tienen sobre las estrategias y representaciones que utilizan y el conocimiento sobre los distintos enfoques de evaluación del aprendizaje. Cada docente evidenció visión y propósitos de enseñanza diferentes. Conclusiones. El estudio de los componentes del CPC es necesario para visibilizar la pedagogía y la didáctica del docente que enseña fisiología humana.

Abstract Introduction: Pedagogical content knowledge (PCK) refers to specialized knowledge resulting from the practice and experience of the teacher in the classroom. It is necessary to make progress in the understanding of the pedagogical knowledge of the university professor who teaches human physiology. Objective: To explore the types of contents, knowledge of the students, teaching strategies and representations, assessment and pedagogical guidelines used by university professors who teach physiology of the respiratory system. Materials and methods: Multiple case study conducted in four physiology professors of a medical program. A self-directed content representation questionnaire was applied, physiology classes related to the respiratory system were videotaped, and a record of evidence protocol for PCK was used. Results: The population consisted of four subjects: two expert and two novice professors. The way in which they understood the learning processes of the students, the knowledge they have about the strategies and representations they use and about the different approaches to evaluate learning were characterized. Each professor showed a different vision and teaching purpose. Conclusions: Studying PCK components is necessary to make visible the pedagogy and didactics used by professors who teach human physiology.

Función endotelial y lipemia postprandial en adultos con presencia de criterios asociados a síndrome metabólico: efecto del estado nutricional / Endothelial function and postprandial lipemia in adults presenting criteria associated to metabolic syndrome: effect of nutritional state

Resumen Introducción : La lipemia postprandial se caracteriza por un aumento de las lipoproteínas ricas en triglicéridos y varios trabajos lo describen como un factor que determina la salud metabólica de un individuo. El objetivo del estudio fue cuantificar la contribución del sobrepeso en la magnitud de la lipemia postprandial en 33 sujetos con criterios asociados al síndrome metabólico (n = 20, sobrepeso y n = 13 eutróficos, 66% hombres, edad media 31,2 ± 7,6 años). Métodos: Estudio descriptivo y transversal. Se midió la vasodilatación mediada por el flujo, la velocidad de onda del pulso, el perfil lipídico, el cociente Log triglicéridos/lipoproteínas de alta densidad, la glucosa y la presión arterial tras una ingesta estándar alta en lípidos (79% Kcal/grasa). Se calculó el Z-score de riesgo cardiovascular a partir de la suma de los residuos tipificados (Z) de las variables bioquímicas. El estado de lipemia se midió en ayuno (0 min.) y a los (60, 120, 180, y 240 minutos) postprandiales. Resultados: El valor basal de la vasodilatación mediada por el flujo y la velocidad de onda del pulso fue de 6,9 ± 5,9% y 7,0 ± 0,8 m/s, respectivamente. Se identificó que la lipemia postprandial reducía la vasodilatación mediada por el flujo en 19,2% a los 60 minutos (5,9 ± 1,5%) y a los 240 minutos (3,7 ± 1,2%) (p = 0,04), respectivamente. Este hallazgo se acompañó con un aumento en la velocidad de onda del pulso (p < 0,05). Al dividir los sujetos en dos grupos según el índice de masa corporal, los participantes en sobrepeso muestran cifras más elevadas en el Zscore de riesgo cardiovascular, la velocidad de onda del pulso, el Log triglicéridos/lipoproteínas de alta densidad y el Δ-velocidad de onda del pulso, (p < 0,001). Conclusión: Este estudio demuestra que los sujetos clasificados en sobrepeso y que presentan criterios asociados al síndrome metabólico, muestran un perfil cardiometabólico asociado con un mayor riesgo cardiovascular, tras una ingesta alta en grasas.

Abstract Introduction: Postprandial lipemia is characterised by an increase in triglyceride-rich lipoproteins and several studies describe it as a factor that determines metabolic health of an individual. The motivation of the study was to quantify the contribution to overweight in the magnitude of the postprandial lipemia in 33 persons with criteria associated to metabolic syndrome (n = 20 being overweight and n = 13 eutrophic, 66% male, average age 31.2 ± 7.6 years). Methods: Cross-sectional descriptive study. Flow-mediated vasodilation, pulse wave velocity, lipid profile, log of the triglyceride/protein ratio, glucose and blood pressure were measured after high standard intake of lipids (79% Kcal/fat). Z-score for cardiovascular risk was calculated using the sum of typified residues (Z) of biochemical variables. Lipemia state was measured at fasting (0 min) and after 60, 120, 180 and 240 postprandial minutes. Results: Baseline flow-mediated vasodilation and pulse wave velocity values were 6.9 ± 5.9% and 7.0 ± 0.8 m/s, respectively. It was identified that postprandial lipemia reduced flowmediated vasodilation by 19.2% after 60 minutes (5.9 ± 1.5%) and after 240 minutes (3.7 ± 1.2%) (p = 0.04), respectively. This finding was paired with an increase in pulse wave velocity (p < 0.05). When dividing subjects into two groups according to their body mass index, overweight participants show higher Z-score cardiovascular risk values, pulse wave velocity, log of the triglyceride/protein ratio and the Δ pulse wave velocity (p > 0.001). Conclusion: This study reveals that overweight individuals showing criteria associated to metabolic syndrome have a cardiometabolic profile linked to a higher cardiovascular risk, after high intake of lipids.

Relationship between Handgrip Strength and Muscle Mass in Female Survivors of Breast Cancer: A Mediation Analysis.

This study explored the mediating factors of sarcopenia in a group of women survivors of breast cancer in Bogotá, Colombia. This was a descriptive cross-sectional study with 98 women survivors of breast cancer, who were registered with the SIMMON (Integrated Synergies to Improve Oncological Management in Colombia) Foundation. Body weight, height, and waist circumference (WC) were measured, and body mass index (BMI) was calculated. Body composition (percentage of fat and muscle mass) was evaluated via four-pole bioelectrical impedance analysis. Sarcopenia was defined as low muscle mass plus low grip strength or low gait speed (European Working Group on Sarcopenia in Older People (EWGSOP) criteria). A "causal" mediation analysis with the Baron & Kenny procedure (PROCESS® macro, Columbus, OH, USA) was used to explore variables related to sarcopenia. Analyses were performed with the IBM SPSS 21 statistical package (SPSS Inc., Chicago, IL, USA). The significance level of the results obtained in the hypothesis contrast was p < 0.05. The mean age of the sample was 65.5 ± 5.9 years, with a BMI of 27.8 ± 4.7 kg/m². The prevalence of sarcopenia was 22.4%. Linear regression models suggest a partial mediation of anthropometric parameters (body mass, body mass index and waist circumference) in the association between handgrip strength and muscle mass. In conclusion, one in every five women survivors of breast cancer had sarcopenia. The findings seem to emphasize the importance of obesity prevention in women survivors of breast cancer, suggesting that high handgrip strength may not relate closely to greater muscle mass and therefore would not exclude the risk of sarcopenia.

Internal consistency and content validity of a questionnaire aimed to assess the stages of behavioral lifestyle changes in Colombian schoolchildren: The Fuprecol study / Confiabilidade e validade do conteúdo de um questionário para avaliar os estágios de mudança de comportamento no estilo de vida escolar, em crianças colombianas: estudo Fuprecol

ABSTRACT Objective To assess internal consistency and content validity of a questionnaire aimed to assess the stages of Behavioural Lifestyle Changes in a sample of school-aged children and adolescents aged 9 to 17 years-old. Methods This validation study involved 675 schoolchildren from three official school in the city of Bogota, Colombia. A self-administered questionnaire called Behavioural Lifestyle Changes has been designed to explore stages of change regarding to physical activity/exercise, fruit and vegetable consumption, alcohol abuse, tobacco use, and drug abuse. Cronbach-α, Kappa index and exploratory factor analysis were used for evaluating the internal consistency and validity of content, respectively. Results The study population consisted of 51.1% males and the participants' average age was 12.7±2.4 years-old. Behavioural Lifestyle Changes scored 0.720 (range 0.691 to 0.730) on the Cronbach α and intra-observer reproducibility was good (Kappa=0.71). Exploratory factor analysis determined two factors (factor 1: physical activity/exercise, fruit and vegetable consumption, and factor 2: alcohol abuse tobacco use and drug abuse), explaining 67.78% of variance by the items and six interactions χ2/gL=11649.833; p<0.001. Conclusion Behavioural Lifestyle Changes Questionnaire was seen to have suitable internal consistency and validity. This instrument can be recommended, mainly within the context of primary attention for studying the stages involved in the lifestyle behavioural changes model on a school-based population.

RESUMO Objetivo Estimar a confiabilidade e validade do conteúdo do Questionário de Mudança Comportamental nos Estilos de Vida em uma amostra de crianças e adolescentes escolares e adolescentes de 9 a 17 anos. Métodos Estudo de validação em 675 alunos pertencentes a 3 instituições oficiais de ensino da cidade de Bogotá, Colômbia. Elaborou-se e aplicou-se o Questionário de Mudança Comportamental nos Estilos de Vida, perguntando sobre as etapas de mudanças na atividade física/exercício, no consumo de frutas, legumes, drogas, tabaco e bebidas alcoólicas por esforço próprio, através de formulário estruturado. A α-cronbach, Kappa e a análise fatorial exploratória foram utilizadas para avaliar a confiabilidade e a validade do conteúdo, respectivamente. Resultados Da população avaliada, 51,1% eram homens e a idade média dos participantes foi de 12,7±2,4 anos. O Questionário de Mudança Comportamental nos Estilos de Vida mostrou um α-cronbach global de 0,720 (intervalo 0,691 a 0,730) e bom acordo de peritos (Kappa=0,71). A análise fatorial exploratória determinou dois fatores (fator 1: atividade física/exercício, consumo de frutas e verduras e fator 2: consumo de drogas, tabaco e álcool), que representaram 67,78% da variante, com seis interações χ2/gL=11649,833; p<0,001. Conclusão O Questionário de Mudança Comportamental nos Estilos de Vida apresentou consistência interna e validade adequadas. Este instrumento é recomendado principalmente no contexto de atendimento primário, para o estudo das etapas do modelo comportamental de estilos de vida na população escolar.

Self-report health-related quality of life among children and adolescents from Bogotá, Colombia. The FUPRECOL study / Autoreporte de la calidad de vida en niños y adolescentes colombianos: Estudio FUPRECOL

Abstract Objective: To describe by self-report the HRQoL among schoolchildren from Bogotá, Colombia belonging to the FUPRECOL study. Methods: A cross-sectional study in 3,245 children and 3,354 adolescents, between 9 and 17.9 years old, participated in the study. Spanish version of the EQ-5D-Y was self-assessment. Percentages of missing values and reported problems were calculated. The data was analyzed by measurement of central tendency stratified by age group, and to compare them to international references. Results: A total of 58.3%, (n= 3,848) were women. In all ages, the HRQoL was higher in boys than in girls. To compare by sex, the dimensions of the EQ-5D-Y "feeling worried, sad or unhappy" and "having pain or discomfort", showed the highest frequency among women. Overall, our HRQoL were higher than South Africa, Germany and Italy references. Conclusion: The HRQoL was higher in boys than in girls The HRQoL. The dimensions of the EQ-5D-Y "feeling worried, sad or unhappy" and "having pain or discomfort", showed the highest frequency. The HRQoL by age and sex may be used in the evaluation of the health perceived among schoolchildren from Bogotá.

Resumen Objetivo: Describir por autoreporte la calidad de vida relacionada con la salud (CVRS) en una población escolar de Bogotá, Colombia, pertenecientes al estudio FUPRECOL. Métodos: Estudio descriptivo y transversal, en 3,245 niños y 3,354 adolescentes, entre 9 y 17.9 años de edad, de 24 instituciones educativas oficiales de Bogotá, Colombia. Se aplicó de manera auto-administrada del instrumento de CVRS infantil EQ-5D-Y proxy, versión validada al castellano. Se analizaron los datos por medidas de tendencia central y se realizó una comparación de los observados en Colombia con estudios internacionales. Resultados: De la población evaluada, el 58.3% (n= 3,848), fueron mujeres. En general, se observaron puntuaciones elevadas en la CVRS en niños y adolescentes de ambos sexos. Al comparar por género, las dimensiones del EQ-5D-Y proxy "sentirse triste/preocupado o infeliz" y "tener dolor/malestar", presentaron la mayor frecuencia de respuesta en el grupo de las mujeres. Al comparar los resultados de este estudio, por grupos de edad, con trabajos internacionales de niños y adolescentes, se observó que las puntuaciones del EQ-5D-Y proxy fueron superiores a los reportados en Suráfrica, Alemania e Italia. Conclusión: Los niños acusan menor porcentaje de problemas en todas las dimensiones que los adolescentes. Las dimensiones relativas a "dolor/malestar" y "sentirse triste/preocupado o infeliz", fueron en las que se indicaron más problemas. Se presentan valores de la CVRS según edad y sexo que podrán ser usados en la evaluación de la salud percibida en el ámbito escolar en Bogotá, Colombia.

Etapas de cambio conductual y estado nutricional relacionado al consumo de frutas y verduras en escolares de Bogotá, Colombia: Estudio fuprecol / Stages of behaviour change and nutritional status regarding fruit and vegetable consumption among schoolchildren from Colombia: The fuprecol study

RESUMEN Este trabajo se ha centrado en describir la relación de las etapas de cambio conductual frente al consumo de frutas y verduras con el estado nutricional en 1.922 escolares (54.3% mujeres) de Bogotá, Colombia. Se aplicó de manera autodiligenciada un cuestionario de cambio de comportamiento (CCC-FUPRECOL), y se calculó el IMC como marcador del estado nutricional. Nuestros resultados muestran que el 46,6% de las mujeres, y el 45,4% de los varones acusaron tener un cumplimiento diario de la recomendación de frutas, mientras que el 39,0% de las mujeres, y el 40,4% de los varones, alcanzaron el cumplimiento de la recomendación diaria de verduras (p< 0,05). En la población total, los escolares con sobrepeso/obesidad acusaron mayor frecuencia de no cumplimiento con la recomendación mínima de frutas-verduras/día, que los agrupados con peso saludable. Se observó que ser mujer, se asociaba como variable para el cumplimiento de la recomendación mínima de frutas y verduras con valores de OR 1,54 (IC95% 1,22-1,93) y OR 1,48 (IC95% 1,19-1,84), respectivamente. En conclusión, aproximadamente, 2/3 de los participantes tienen la intención o cumplen con la recomendación diaria de consumo de frutas y verduras.

ABSTRACT This article describes the relationship between stages of behavioural change regarding fruit and vegetable consumption with nutritional status among 1,922 schoolchildren (54.3% girls) from Bogotá, Colombia. A self-administered questionnaire called Behavioural Lifestyle Changes (FUPRECOL) was applied. BMI was used to categorize nutritional status. We found that 46.6% of girls and 45.4% of boys reported compliance with the daily recommendation for fruits, while 39.0% of girls and 40.4% of boys reported compliance with the daily recommendation for vegetables (p< 0.05). Overall, overweight/obese schoolchildren showed higher frequency of not meeting the minimum recommended number of daily fruits/vegetables (precontemplation + contemplation stage) than normal weight children. Binary logistic regression showed that being a girl was associated with compliance with the minimum recommendation for fruit and vegetables (OR 1.54: 1.22-1.93, 95%CI; and OR 1.48; 1.19-1.84, 95%CI), respectively. In conclusion, around 2/3 of the participants intend or comply to consume the recommended quantities of fruit and vegetables.

Estado nutricional y etapas de cambio comportamental frente a la actividad física en niños y adolescentes de Bogotá, Colombia: estudio FUPRECOL.

Objetivo: el propósito del estudio fue relacionar la etapa en el cambio en el comportamiento frente a la actividad física y el estado nutricional en escolares de Bogotá, Colombia, pertenecientes al estudio FUPRECOL.Método: se trata de un estudio transversal, realizado en 8.000 niños y adolescentes de entre 9 y 17 años, pertenecientes a 24 instituciones educativas. Se aplicó de manera autodiligenciada el cuestionario de cambio de comportamiento en función de la intención de realizar actividad física (CCC-FUPRECOL) y se midió el peso y la estatura para determinar el estado nutricional con el índice de masa corporal (IMC).Resultados: el porcentaje de respuesta fue del 82,5% y se consideraron válidos 6.606 registros, siendo el 58,3% (n = 3.850) niñas, con un promedio de edad de 12,7 ± 2,3 años. En la población general, el 5,3% de los escolares se encontraba en etapa de precontemplación, el 31,8% en contemplación, el 26,7% en acción y el 36,2% en etapa de mantenimiento. Al comparar la etapa de cambio con el estado nutricional por IMC, los escolares clasificados como obesos mostraron mayor frecuencia de respuesta en la etapa de precontemplación, mientras que los escolares con peso saludable acusaron mayores porcentajes en la etapa de mantenimiento.Conclusión: en escolares de Bogotá, Colombia, se encontró una relación estadísticamente significativa entre la intención de realizar actividad con el estado nutricional medido con el IMC. Fomentar la promoción de la actividad física y monitorizar el estado nutricional deberá ser una prioridad en las agendas y políticas públicas dentro del ámbito escolar.

Handgrip Strength and Ideal Cardiovascular Health among Colombian Children and Adolescents.

OBJECTIVE: To evaluate the association between handgrip strength and ideal cardiovascular health (CVH) in Colombian children and adolescents. STUDY DESIGN: During the 2014-2015 school years, we examined a cross-sectional component of the FUPRECOL (Association for Muscular Strength with Early Manifestation of Cardiovascular Disease Risk Factors among Colombian Children and Adolescents) study. Participants included 1199 (n = 627 boys) youths from Bogota (Colombia). Handgrip strength was measured with a standard adjustable hand held dynamometer and expressed relative to body mass (handgrip/body mass) and as absolute values in kilograms. Ideal CVH, as defined by the American Heart Association, was determined as meeting ideal levels of the following components: 4 behaviors (smoking status, body mass index, cardiorespiratory fitness, and diet) and 3 factors (total cholesterol, blood pressure, and glucose). RESULTS: Higher levels of handgrip strength (both absolute and relative values) were associated with a higher frequency of ideal CVH metrics in both sexes (P for trend ≤ .001). Also, higher levels of handgrip strength were associated with a greater number of ideal health behaviors (P for trend < .001 in both boys and girls), and with a higher number of ideal health factors in boys (P for trend < .001). Finally, levels of handgrip strength were similar between ideal versus nonideal glucose or total cholesterol groups in girls. CONCLUSIONS: Handgrip strength was strongly associated with ideal CVH in Colombian children and adolescents, and thus supports the relevance of early targeted interventions to promote strength adaptation and preservation as part of primordial prevention.

The insulin-like growth factor system is modulated by exercise in breast cancer survivors: a systematic review and meta-analysis.

BACKGROUND: Insulin-like growth factors (IGF´s) play a crucial role in controlling cancer cell proliferation, differentiation and apoptosis. Exercise has been postulated as an effective intervention in improving cancer-related outcomes and survival, although its effects on IGF´s are not well understood. This meta-analysis aimed to determine the effects of exercise in modulating IGF´s system in breast cancer survivors. METHODS: Databases of PuMed, EMBASE, Cochrane Central Register of Controlled Trials, EMBASE, ClinicalTrials.gov, SPORTDiscus, LILACS and Scopus were systematically searched up to November 2014. Effect estimates were calculated through a random-effects model of meta-analysis according to the DerSimonian and Laird method. Heterogeneity was evaluated with the I (2) test. Risk of bias and methodological quality were evaluated using the PEDro score. RESULTS: Five randomized controlled trials (n = 235) were included. Most women were post-menopausal. High-quality and low risk of bias were found (mean PEDro score = 6.2 ± 1). Exercise resulted in significant improvements on IGF-I, IGF-II, IGFBP-I, IGFBP-3, Insulin and Insulin resistance (P < 0.05). Non-significant differences were found for Glucose. Aerobic exercise improved IGF-I, IGFBP-3 and Insulin. No evidence of publication bias was detected by Egger´s test (p = 0.12). CONCLUSIONS: Exercise improved IGF´s in breast cancer survivors. These findings provide novel insight regarding the molecular effects of exercise on tumoral microenvironment, apoptosis and survival in breast cancer survivors.

[PHYSICAL ACTIVITY LEVELS, PHYSICAL FITNESS AND SCREE TIME AMONG CHILDREN AND ADOLESCENTS FROM BOGOTÁ, COLOMBIA]. / NIVELES DE ACTIVIDAD FÍSICA, CONDICIÓN FÍSICA Y TIEMPO EN PANTALLAS EN ESCOLARES DE BOGOTÁ, COLOMBIA: ESTUDIO FUPRECOL.

OBJECTIVE: to investigate the association between objective measures of physical activity levels, physical fitness and screen time in Colombia children and adolescents from Bogota, Colombia. METHODS: a sample of 149 healthy Colombian youth, children and adolescents (9-17.9 years old) participated in the study. Physical activity level was assessed over 7 days using an accelerometer. Weight, height, waist circumference, hip waist, subscapular/ triceps skinfold thicknesses and self-reported screen time (television/internet and videogame-viewing time) were measured. Aerobic capacity, handgrip strength, standing broad jump, vertical jump, speed/agility and flexibility were used as indicators of physical fitness. RESULTS: in girls with a high level of physical activity had favorable aerobic capacity (r = 0.366) and inverse relationship with subscapular/triceps skinfold thicknesses (r = -0.257) and (r = -0,237) p < 0.05, respectively. In boys, vigorous physical activity were associated with higher values of flexibility (r = 0.277) and aerobic capacity (r = 0.347), p < 0.05. Finally, the participants who watched 2 h or less of television per day showed 1.81 times (95%CI 1.401 to 2.672) that met physical activity guidelines. CONCLUSIONS: the healthy Colombian youth who reported moderate to vigorous objective measures of physical activity levels, presented higher levels in physical fitness especially in aerobic capacity and flexibility and lower values in subscapular/triceps skinfold thicknesses.

Objetivo: examinar la relación entre los niveles de actividad física (AF) de forma objetiva, la condición física (CF) y el tiempo de exposición a pantallas en niños y adolescentes de Bogotá, Colombia. Métodos: estudio descriptivo y transversal, realizado en 149 niños y adolescentes en edad escolar entre 9 y 17 años de Bogotá, Colombia. Los niveles de AF se valoraron con acelerómetro durante siete días. El tipo y tiempo de exposición a pantallas se registró por autorreporte. Se midió el estado de maduración, el peso, la estatura, la circunferencia de cintura/cadera y los pliegues tricipital/ subescapular. La capacidad aeróbica, la fuerza prensil, el salto de longitud y vertical, la velocidad/agilidad y la flexibilidad fueron usados como indicadores de la CF. Resultados: las mujeres clasificadas en la categoría de AF vigorosa mostraron una relación lineal con la capacidad aeróbica (r = 0,366), y una relación inversa con el pliegue tricipital (r = -0,257) y subescapular (r = -0,237), p < 0,05. En varones, los niveles de AF vigorosa se relacionaron con mayores valores de flexibilidad (r = 0,277), mientras que los niveles de AFMV se relacionaron positivamente con la capacidad aeróbica (r = 0,347), p < 0,05. Por último, los escolares que permanecieron menos de 2 h/día frente a pantallas de TV mostraron 1,819 veces de (IC 95% 1,401-2,672) oportunidad para cumplir las recomendaciones de AF. Conclusiones: los escolares que registraron valores de AF moderado y vigoroso de forma objetiva presentaron mejores niveles en la CF, especialmente en la capacidad aeróbica y la flexibilidad, y menores valores en los pliegues cutáneos.

Propiedades psicométricas del test de competencias motoras Bruininks Oseretsky en versión corta para niños entre 4 y 7 años en Chía y Bogotá, D.C., Colombia / Psychometric properties of the short form of the Bruininks Oseretsky test of motor proficiency in children between 4 and 7 years in Chía and Bogotá - Colombia

Antecedentes. Existen importantes pruebas de valoración que miden habilidades o competencias motoras en el niño; a pesar de ello y teniendo presente que la intervención debe basarse en la rigurosidad que exigen los procesos de evaluación del movimiento corporal humano, Colombia carece de estudios que demuestren la validez y confiabilidad de un test de medición que permita emitir un juicio valorativo relacionado con las competencias motoras infantiles. Objetivo. El presente estudio se centró en determinar las propiedades psicométricas del test de competencias motoras Bruininks Oseretsky segunda edición (BOT 2). Materiales y métodos. Se realizó una evaluación de pruebas diagnósticas con 24 niños aparentemente sanos, de ambos géneros, entre 4 y 7 años y residentes en las ciudades de Chía y Bogotá, D.C. La evaluación fue realizada por tres evaluadores expertos: el análisis para consistencia interna se realizó utilizando el coeficiente Alfa de Cronbach; el análisis de reproducibilidad se estableció a través del coeficiente de correlación intraclase (CCI) y para el análisis de la validez concurrente se utilizó el coeficiente de correlación de Pearson, considerando α=0.05. Resultados. Para la totalidad de las pruebas se encontraron altos índices de confiabilidad y validez. Conclusiones. El BOT 2 es un instrumento válido y confiable que puede ser utilizado para la evaluación e identificación del nivel de desarrollo en que se encuentran las competencias motoras del niño.

Background. There are several important tests that measure or motor skills in children; however, and taking into account that the intervention should be based on rigorous assessment processes of body movement, in Colombia does not exist any research that shows the validity and reliability of a test that allows assessing children's motor skills. Objective. The objective of this study was to determine the psychometric properties of the short form from the Bruininks Oseretsky Test of Motor Proficiency (BOT 2) Second Edition. Materials and methods. To get the results an evaluating diagnostic test was performed in 24, apparently healthy, children, both male and female, with ages between 4 and 7 years old, living in the cities of Chia and Bogotá, D.C. The assessment was carried out by three experts, with three different methods; the internal consistency analysis was performed using the Cronbach's Alpha Coefficient; the reproducibility analysis was established by the Intraclass Correlation Coefficient; for analyzing the concurrent validity the Pearson correlation coefficient was used, considering that α = 0.05. Results. High reliability and validity ranges were obtained for all the tests. Conclusions. The BOT 2 is a valid and reliable test. It can be used in our context to assess and identify children's motor skills development levels.

[Effectiveness of physical exercise on fatigue in cancer patients during active treatment: a systematic review and meta-analysis]. / Efectividad del ejercicio físico en la fatiga de pacientes con cáncer durante el tratamiento activo: revisión sistemática y metaanálisis.

This study aimed to determine the effectiveness of physical exercise in decreasing fatigue in cancer patients during active treatment. The PubMed Central, EMBASE, and OVID databases were consulted up to April 2014 to identify randomized clinical trials that evaluated the effect of exercise on fatigue in cancer patients undergoing active treatment. Eleven studies (n = 1,407) were included. Chemotherapy was the most common form of treatment (n = 1,028). The studies showed a low risk of bias and high methodological quality. Effect estimates showed that physical exercise significantly improved fatigue (SMD = -3.0; 95%CI: -5.21; -0.80), p < 0.0001. Similar effects were found for resistance training (SMD = -4.5; 95%CI: -7.24; -1.82), p = 0.001. Significant improvements were found in breast and prostate cancer patients (p < 0.05). Exercise is a safe and effective intervention in the management fatigue in cancer patients undergoing active treatment.

Efectividad del ejercicio físico en la fatiga de pacientes con cáncer durante el tratamiento activo: revisión sistemática y metaanálisis / Effectiveness of physical exercise on fatigue in cancer patients during active treatment: a systematic review and meta-analysis / Eficácia do exercício físico na fadiga dos pacientes com câncer durante o tratamento ativo: revisão sistemática e meta-análise

El objetivo del estudio fue determinar la efectividad del ejercicio físico en la fatiga de pacientes con cáncer durante el tratamiento activo. Las bases de datos de PubMed Central, EMBASE y OVID fueron consultadas hasta abril de 2014 para identificar ensayos clínicos aleatorizados, que evaluaran el efecto del ejercicio en la fatiga de pacientes con cáncer sometidos a tratamiento activo. Once estudios (n = 1.407) fueron incluidos. La quimioterapia fue el tratamiento más común (n = 1.028). Los estudios tuvieron bajo riesgo de sesgo y alta calidad metodológica. Las estimaciones de efecto mostraron que el ejercicio físico mejoró significativamente la fatiga (SMD = -3,0; IC95%: -5,21; -0,80), p < 0,0001. Se encontraron efectos similares para el entrenamiento de resistencia (SMD = -4,5; IC95%: -7,24; -1,82), p = 0,001. Se encontraron mejoras significativas en pacientes con cáncer de mama y de próstata (p < 0,05). El ejercicio es una intervención segura y eficaz en el control de la fatiga en pacientes sometidos a tratamiento activo.

This study aimed to determine the effectiveness of physical exercise in decreasing fatigue in cancer patients during active treatment. The PubMed Central, EMBASE, and OVID databases were consulted up to April 2014 to identify randomized clinical trials that evaluated the effect of exercise on fatigue in cancer patients undergoing active treatment. Eleven studies (n = 1,407) were included. Chemotherapy was the most common form of treatment (n = 1,028). The studies showed a low risk of bias and high methodological quality. Effect estimates showed that physical exercise significantly improved fatigue (SMD = -3.0; 95%CI: -5.21; -0.80), p < 0.0001. Similar effects were found for resistance training (SMD = -4.5; 95%CI: -7.24; -1.82), p = 0.001. Significant improvements were found in breast and prostate cancer patients (p < 0.05). Exercise is a safe and effective intervention in the management fatigue in cancer patients undergoing active treatment.

O objetivo foi determinar a efetividade do exercício físico sobre a fadiga em pacientes com câncer durante o tratamento ativo. As bases de dados PubMed Central, EMBASE e OVID foram consultadas até abril de 2014 para identificar ensaios clínicos randomizados que avaliaram o efeito do exercício sobre a fadiga em pacientes com câncer em tratamento ativo. Onze estudos (n = 1.407) foram incluídos. A quimioterapia foi o tratamento mais comum (n = 1.028). Os estudos tiveram baixo risco de viés e alta qualidade metodológica. As estimativas de efeito mostraram que o exercício melhorou significativamente a fadiga (DMP = -3,0; IC95%: -5,21; -0,80), p < 0,0001. Efeitos semelhantes sobre o treinamento de resistência (DMP = -4,5; IC95%: -7,24; -1,82), p = 0,001 foram encontrados. O exercício físico é uma intervenção segura e eficaz contra a fadiga em pacientes submetidos ao tratamento ativo.

Evidence-based practice: beliefs, attitudes, knowledge, and skills among Colombian physical therapists / Práctica basada en la evidencia: creencias, actitudes, conocimientos y habilidades entre fisioterapeutas colombianos

Objective: The main purpose of this study was to describe a group of Colombian physical therapists' beliefs and attitudes towards Evidence-Based Practice (EBP), their education, knowledge and skills for implementing EBP, the use of relevant literature in clinical practice, access to and availability of scientific information and perceived barriers to including EBP in practice. Methods: This was a cross-sectional study which involved 1,064 Colombian physical therapists. The study used a 50-item screening questionnaire EBP developed to estimate attitudes, beliefs, knowledge and skills regarding. This instrument has been adapted and was validated previously in Colombia by Flórez-López et al. Results: The population mostly consisted of young females (77.2%) aged 22 to 29 years old (79.4%). Most respondents had an undergraduate degree (87.7%). The physical therapists stated that they had positive attitudes and beliefs regarding EBP, most of them answering that they agreed or strongly agreed that EBP is necessary (71.6%), the relevant literature is useful for practice (61.3%), EBP improves the quality of patient care (64.1%) and evidence helps in decision-making (44.5%). Forty-one percent of the respondents indicated that a lack of research skills was the most important barrier to the use of evidence in practice. Conclusion: The physical therapists reported that they had a positive attitude to EBP and were interested in learning about or improving the skills necessary to adopt EBP in their clinical practice.

Objetivo: Describir en un grupo colombiano de fisioterapeutas las i) creencias y actitudes hacia la practica basada en la evidencia (PBE), ii) la educación, el conocimiento y las habilidades para implementar la PBE; iii) el uso de la literatura relevante en la práctica clínica; iv) el acceso y la disponibilidad de información científica; y v) la percepción de las barreras para la inclusión de la PBE. Métodos: Se realizó un estudio transversal en 1,064 fisioterapeutas colombianos. El estudio usó el cuestionario que consta de 50-ítems para estimar las actitudes, creencias, conocimientos y habilidades hacia la PBE. Dicho instrumento fue adaptado y validado en Colombia por Flórez-López et al. Resultados: La mayoría de la población participante fueron mujeres (77.2%) en edades comprendidas entre 22 y 29 años (79.4%). El 87.7% de los encuestados eran titulados en fisioterapia. Los fisioterapeutas manifestaron tener actitudes y creencias positivas hacia la PBE. Una mayoría respondió que estaba de acuerdo o muy de acuerdo en que es necesaria la PBE (71.6%), en que la literatura es útil para la práctica clínica (61.3%), que la PBE mejora la calidad de la atención a los pacientes (64.1%), y en que la evidencia ayuda en la toma de decisiones clínicas (44.5%). El 41.0% de los encuestados indicaron que la falta de habilidades de investigación era la barrera más importante para el uso de la evidencia científica en la práctica clínica. Conclusiones: Los fisioterapeutas manifestaron una actitud positiva acerca la PBE y estaban interesados en aprender o mejorar las habilidades necesarias para adoptar la PBE en la práctica clínica.

Actividad física y función cognitiva: una comparación en dos grupos de adultos mayores, un estudio piloto / Physical activity and cognitive function: A comparison of two groups of older adults, a pilot study

Objetivo: Comparar la función cognitiva de un grupo de adultos mayores activos y otros no activos. Método: Se trata de un estudio descriptivo transversal de 62 sujetos, 32 activos y 30 sedentarios. Los adultos mayores que se consideraron activos fueron aquellos sujetos que participaron en un programa regular de actividad física por, al menos, 12 semanas. El otro grupo estuvo compuesto por sujetos que no realizaban ninguna actividad física. La función cognitiva se evaluó mediante el instrumento MiniMental State Examination (MMSE). Resultados: La edad promedio del grupo activo fue de 67,6 años con desviación estándar (DE) de 7,03, sin diferencias estadísticas con el grupo de comparación (p=0,915). Se encon-traron diferencias en las esferas de orientación (p<0,001), atención y cálculo (p<0,001), lenguaje (p<0,001) y en la puntuación total (p<0,001). Conclusión. Los adultos mayores que se consideraron activos tuvieron mejores niveles de funcionamiento cognitivo.

Objective: To compare the cognitive function of a group of active seniors and non active. Method: A cross-sectional study in active (n=32) and sedentary subjects (n=30). Active sub-jects were those older who participated in a regular program of physical activity for at least 12 weeks. The other group consisted of subjects who did not perform any physical activity. Cognitive function was assessed using the scale tool Mini-Mental State Examination (MMSE). Results: The average age of the active group was 67.6 (SD=7.03), without statistical diffe-rences with the comparison group (p=0.915). Differences were found in the areas of orien-tation (p<0.001), attention and calculation (p<0.001), language (p<0.001) and in the total score (p<0.001). Conclusion: Older adults who were considered active showed higher levels of cognitive functioning.