Effect of physical activity on the relationship between adiposity and cardiac autonomic modulation in female breast cancer survivors: a longitudinal study.

This longitudinal study aimed to analyze the influence of physical activity (PA) on the relationship between body adiposity and cardiac autonomic modulation (CAM) in women survivors of breast cancer. We collected body adiposity through electrical bioimpedance considering body fat percentage (BFP), CAM through heart rate variability (considering RMSSD, SDNN, PNN50, LF (m2), HF (m2), SD1 indexes and SD1/SD2 ratio) and PA through a questionnaire in 64 participants (58.0 ± 9.6 years), recruited through the local association of support for breast cancer and by direct indications from city mastologists. After insertion of PA into the multivariate statistical model, significant attenuation was observed in the relationship between body adiposity and CAM for the indices: SDNN (ß = -0.94; 95 percent CI: -1.93; 0.04; p = .060) and SD1/SD2 (ß = -0.01;95 percent CI = -0.02; 0.001; p = .065). In conclusion, it was observed that PA was able to mitigate the relationships between BFP and CAM (considering SDNN index and SD1/SD2 ratio) in breast cancer survivors.

Association Between Physical Activity Levels in Different Domains and Cardiac Autonomic Modulation in Breast Cancer Survivors: A Cross-sectional Study.

BACKGROUND: Breast cancer survivors frequently present cardiac autonomic dysfunction. Physical activity (PA) has been associated with better cardiac autonomic modulation (CAM) in breast cancer survivors. OBJECTIVE: This study aimed to analyze the association between CAM and PA levels performed in different domains (work and occupation, sport and exercise, and leisure time and commuting) in breast cancer survivors. METHODS: This is a cross-sectional study with 99 breast cancer survivors (age, 55.3 ± 10.4 years). Cardiac autonomic modulation was assessed by heart rate variability, and PA levels at work and occupation, sport and exercise, and leisure time and commuting were assessed using the Baecke PA questionnaire. The sum of these 3 domains provided the total PA. The Mann-Whitney test was used to compare CAM between active and inactive women in different domains of PA. RESULTS: Cardiac autonomic modulation was similar between active and inactive women in the different domains ( P > .05). However, when considering the total PA, active breast cancer survivors presented higher SDNN (average standard deviation of all normal RR intervals) (20.0 ± 13.4 vs 28.8 ± 14.0; P = .008) and SD2 (standard deviation of the long-term intervals between consecutive heartbeats) indices (29.2 ± 17.3 vs 38.7 ± 19.9; P = .005) compared with their inactive counterparts. CONCLUSION: Breast cancer survivors with higher total PA presented better CAM compared with their less active peers. IMPLICATIONS FOR PRACTICE: The results of this study are promising and show the importance of increasing PA levels in different domains for the maintenance of cardiovascular health among breast cancer survivors.

Do Sociodemographic, Behavioral, Clinical, and Anthropometric Factors Influence the Association Between Sex and Functional Capacity in Patients with Peripheral Arterial Disease?

BACKGROUND: To explore the influence of sociodemographic, behavioral, clinical, and anthropometric factors on the association between sex and functional capacity in patients with peripheral arterial disease. METHODS: A cross-sectional study was conducted with patients aged more than 45 years, diagnosed with peripheral artery disease (PAD), from 2 Brazilian hospitals. Data on sociodemographic characteristics, behavioral risk factors, clinical profile, and anthropometric measurements were collected. Functional capacity was assessed using the 6-min walk test and the Walking Impairment Questionnaire. Statistical analyses, including t-tests, chi-square tests, and logistic regression, were performed to assess the relationships between sex, functional capacity, and potential influencing factors. RESULTS: Among the 262 patients with PAD, 67 were women and 113 were men. Women exhibited lower absolute functional capacity and lower Walking Impairment Questionnaire scores compared to men, even after adjusting for potential confounders. However, relative functional capacity did not significantly differ between sexes after adjusting for variables. Pain-free walking distance was also lower in women compared to that in men, but this association lost significance after adjusting for sociodemographic factors. CONCLUSIONS: Women with PAD had lower absolute functional capacity compared to men, influenced by various factors such as sociodemographic, behavioral, clinical, and anthropometric factors. However, the relative functional capacity was similar between genders, being influenced only by behavioral factors, while for the distance walked until pain, the association was lost after adjustments for sociodemographic factors.

Are C-reactive protein concentrations affected by smoking status and physical activity levels? A longitudinal study.

BACKGROUND AND OBJECTIVE: To compare high-sensitivity C-reactive protein (hsCRP) levels according to smoking status and physical activity (PA) changes in adults. METHODS: The sample consisted of 6028 participants (4833 men) who underwent a voluntary routine health evaluation at the Preventive Medicine Center at the Hospital Israelita Albert Einstein, Sao Paulo, Brazil, from January 2007 to December 2013. Data were collected at baseline and follow-up (2.7±1.6 years). Plasma hsCRP (in mg/L) was analyzed in both moments. Smoking status was obtained through a self-reported questionnaire, being participants classified as non-smokers, once smokers (report smoking at baseline or follow-up), and persistently smokers (reported smoking at both baseline and follow-up). PA was assessed by questionnaire in both moments, being participants classified as persistently inactive, became inactive, became active, and persistently active. The Rank Analysis of Covariance was used to compare hsCRP follow-up values according to smoking and physical activity status. RESULTS: Persistently smokers showed significantly higher median values of hsCRP at follow-up (1.3 mg/L, IQR:0.6-2.8) than once smokers (1.1 mg/L, IQR: 0.6-2.4) and non-smokers (1.0 mg/L, IQR: 0.5-2.2), even considering covariates (p<0.001). Persistently actives had lower levels of hsCRP at follow-up when compared to persistently inactive in the three smoking status groups (non-smokers p<0.001, once smokers p = 0.001, and persistently smokers p = 0.037). CONCLUSION: Persistently active participants had lower hsCRP values at follow-up than those persistently inactive in all the smoking status groups. Regular practice of PA is an important strategy for facing low-grade inflammation, even among smokers.

Prospective associations between multiple lifestyle behaviors and depressive symptoms.

BACKGROUND: Our aim was to analyze the associations between multiple lifestyle behaviors and depressive symptoms. METHODS: We included 4,725 adults (18-59y), that provided data in routine health evaluations of a hospital in Brazil, followed for a mean period of 3.1 ± 1.6 years. Physical activity, alcohol consumption (measured using Alcohol Use Disorders Identification Test) and tobacco smoking were categorized as: (1) absence of the behavior (inactivity i.e. not complying with 150 min of moderate-to-vigorous PA/week, not smoking, no risky drinking, i.e. AUDIT<5) during baseline and follow-up; (2) Absence during baseline and presence during follow-up; (3) Presence during baseline and absence during follow-up; (4) Presence during both time points. Depressive symptoms were measured with the Beck Inventory was adopted to analyze patterns of depressive symptoms over time (as exposure). C-reactive protein [HS-CRP]) was assessed and its role in the association was tested. Incidence indicators of behaviors and depressive symptoms were created and used as outcomes. We used crude and adjusted Poisson regression analysis. RESULTS: Fully adjusted models revealed that persistently physical inactive participants (RR:1.71;95%CI:1.33-2.21), those who became physically inactive (1.68;1.19-2.26), with consistently risky drinking (1.62;1.15-2.30), and who became risky drinkers (1.62;1.15-2.30) had higher risk for incidence of elevated depressive symptoms. Vice versa participants with incidence of depressive symptoms over time presented higher risk for physical inactivity (1.44;1.11-1.87) and risky drinking (1.65;1.16-2.34) incidence. HS-CRP did not influence the associations. LIMITATIONS: Self-reported physical activity, binary tobacco smoking, and non-probabilistic sampling. CONCLUSIONS: There is a prospective relationship between elevated depressive symptoms and adverse lifestyle behaviors.

Association between cardiac autonomic modulation and sedentary behavior in breast cancer survivors: a 12-month cohort study.

PURPOSE: This study aimed to analyze the longitudinal influence of sitting time (ST) on cardiac autonomic modulation (CAM) and resting heart rate (RHR) in a 12-month cohort of 67 breast cancer survivors. METHODS: CAM was assessed by heart rate variability with heart monitor which also assessed RHR, and ST was self-reported. The relationship between the variables was analyzed by the Pearson correlation and its magnitude by linear regression. RESULTS: At baseline, no associations were found between ST and CAM or RHR. In the delta analyses, a decrease in RMSSD, SD1, and HF(ms2) was associated with sitting time. At 12-month follow-up, there was an increase in the ST and a decrease in RHR. ST was negatively related with CAM (RMSSD, PNN50, and SD1), but no association was observed between ST and RHR. CONCLUSION: The increase in ST was associated with worsening of CAM after 12-month follow-up. Promoting reduction in ST will be an important strategy against cardiovascular impairment in breast cancer survivors.

Physical Activity Is Associated With Improved Eating Habits During the COVID-19 Pandemic.

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of minutes/hours engaging in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity (0-30; 31-90; 91-150; 151-300; and >300 min/week) and into active (≥150 min) or inactive (<150 min). Increased sweets consumption was the most commonly reported change to eating habits (42.5%), followed by an increase in the consumption of vegetables (26.6%), fruits (25.9%), and fried foods (17.9%). Physical activity practice was related to lower consumption of fried foods (OR = 0.60; p < 0.001) and sweets (OR = 0.53; p < 0.001). A cluster analysis revealed subjects with higher the level of physical activity was more likely to follow a healthy diet (p < 0.001). Thus, physical activity was positively associated with healthier eating habits. Health authorities must recommend regular physical as a strategy to improve overall health during the COVID-19 pandemic. Future studies should address the physical activity interventions to improve health status during a pandemic.

Functional and Cardiovascular Parameters in Peripheral Artery Disease Patients with Interarm Blood Pressure Difference.

BACKGROUND: To analyze the impact of interarm blood pressure difference (IAD) on functional and cardiovascular parameters in patients with peripheral artery disease (PAD). METHODS: Ninety-eight patients with PAD were recruited in this cross-sectional study. Patients with differences between the right and left arms of systolic and/or diastolic blood pressure ≥10 mm Hg were classified as IAD, whereas the remaining patients were classified as PAD control subjects. Functional parameters included were the 6-min walk test, short physical performance battery, walking impairment questionnaire (WIQ), and the walking estimated-limitation calculated by history. Systemic cardiovascular parameters included were arterial stiffness and heart rate variability. Local cardiovascular parameters assessed in both arms were brachial blood pressure and flow-mediated dilation. RESULTS: Patients with IAD presented higher systolic blood pressure and pulse pressure compared with control patients (P < 0.01). The carotid femoral pulse wave velocity tended to be higher and flow-mediated dilation tended to be lower in PAD patients with IAD compared with control subjects (P < 0.09). Patients with IAD presented lower scores in short physical performance battery (P = 0.012), WIQ distance (P = 0.003), WIQ speed (P = 0.008), WIQ stair climbing (P = 0.034), and walking estimated-limitation calculated by history (P = 0.026) when compared with PAD control patients. CONCLUSIONS: In patients with PAD, IAD is associated with lower physical function and impairments in cardiovascular parameters compared with PAD patients without IAD.

Symptoms of anxiety and depression and their relationship with barriers to physical activity in patients with intermittent claudication

OBJECTIVES: Although the practice of physical exercise in patients with intermittent claudication (IC) is often encouraged, adherence is low. The difficulty in performing physical training may be related to the psychological characteristics of patients with claudication. To verify the association between anxiety and depression symptoms and barriers to physical exercise and walking capacity in patients with IC. METHODS: One-hundred and thirteen patients with a clinical diagnosis of IC were included in the study. Patients underwent clinical evaluation by a vascular surgeon, answered the Beck Depression Inventory, and Beck Anxiety Inventory tests were applied by the psychologist. The patients performed the 6-minute test and reported their barriers to physical activity practice in a questionnaire. RESULTS: Patients with signs of depression had a shorter pain-free walking distance (p=0.015) and total walking distance (p=0.035) compared to patients with no signs of depression. Pain-free walking distance (p=0.29) and total walking distance (p=0.07) were similar between patients with and without signs of anxiety. Patients with symptoms of moderate to severe depression reported more barriers to physical activity practice compared to patients without signs of depression. CONCLUSION: Symptoms of anxiety and depression are prevalent among patients with peripheral arterial occlusive disease (PAD). Depression symptoms are associated with personal barriers to exercise, while anxiety symptoms are not. The main barriers to physical activity among patients with IC are exercise-induced pain and the presence of other diseases.

Does physical activity influence the association between depressive symptoms and low-grade inflammation in adults? A study of 8,048 adults.

This study investigated whether physical activity (PA) influences the association between depression risk and low-grade inflammation. This was a cross-sectional study including 8,048 adults (18-59y). Depression symptoms were evaluated with the Beck depression inventory (BDI) and physical activity through the international physical activity questionnaire. Adults with infectious and inflammatory diseases were excluded. Blood samples were collected, including high sensitivity C-reactive protein (CRP), a marker of low-grade inflammation when ≥3mg/L. Additional measures of LDL-C, HDL-C, triglycerides and fasting glucose were also determined. Sex, chronological age, tobacco smoking, alcohol drinking, body mass index, dyslipidemia, high blood pressure and fasting glucose were used as covariates. Mediation models were conducted using the procedures of Karlson Holm Breen. Adults with elevated CRP (≥3mg/L) compared to those with low CRP (<3mg/L) presented with higher BDI scores [8.5%(95%CI:7.2%-10.1%) vs. 5.8%(95%CI:5.2-6.4)] as well as higher prevalence of physical inactivity 67.4% (95%CI:64.9-69.9) vs. 59.7% (95%CI:58.4-60.9). The prevalence of elevated CRP was highest in physically inactive adults with greater depression risk. Models revealed that physical activity risk explained 13% of the association between depression risk and elevated CRP (p=0.035), independently of potential confounders. Physical activity may reduce the association between depression symptoms and elevated CRP. Future longitudinal research is required to determine the directionality of the relationships observed.

Self-initiated changes in physical activity and incidence of Metabolic Syndrome: A longitudinal follow-up study.

AIM: The aim of this study was to analyze the association between longitudinal physical activity patterns (persistently inactive, became active, became inactive, and persistently active) and the incidence of Metabolic Syndrome (MS) among adults. METHODS: Our cohort included 5766 adults (18-59y) undergoing repeated routine health screening examinations, with a mean follow-up period of three years. Only subjects without MS at baseline were included in the study. MS was defined according to the ATP III definition, including assessments of fasting blood samples for the collection of HDL-C, triglycerides and glucose, blood pressure, and waist circumference. Physical activity was estimated using the international physical activity questionnaire and four patterns were created (persistently active, became active, became inactive, and persistently inactive). Information on tobacco smoking and alcohol consumption (through structured validated questionnaires), age, interval between baseline and follow-up, anti-hypertensive drugs, statin, anti-diabetic drugs were used as covariates. Logistic regression was conducted. RESULTS: The mean age of participants at baseline was 41.6 ± 7.9 years. We identified 1701 subjects who were active at both moments, 1246 who became active, 709 who became inactive, and 2210 who were inactive at both moments. Persistently inactive subjects presented a higher incidence of MS [10.4% (95%CI = 9.2-11.8%)]. In the adjusted logistic regression analyses, subjects that became active [OR = 0.55(95%CI = 0.40-0.74)] and persistently active [OR = 0.35(95%CI = 0.26-0.46)] were less likely to develop MS when compared with persistently inactive subjects. CONCLUSION: Persistently active subjects demonstrated the lowest likelihood of developing MS, while subjects who became active presented an attenuated risk.

Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders / A atividade física está associada à frequência cardíaca de repouso em meninos e meninas? Estudo representativo controlado para fatores de confusão

Abstract Objective: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. Method: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. Results: Total physical activity was associated with low RHR in boys (β = −0.52; 95% CI: −0.92, −0.12) and girls (β = −0.67; 95% CI: −1.07, −0.28). Although sporting physical activities were associated with low RHR in both boys (β = −0.58; 95% CI: −1.05, −0.11) and girls (β = −0.87; 95% CI: −1.34, −0.39), occupational physical activity was related to low RHR only in boys (β = −1.56; 95% CI: −2.99, −0.14). Conclusion: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.

Resumo Objetivo Investigar a relação entre diferentes domínios de atividade física e frequência cardíaca de repouso (FCRep) em meninos e meninas. Método A amostra incluiu 1.011 adolescentes, entre 10 e 17 anos. A FCRep foi medida por um monitor de frequência cardíaca e a atividade física foi avaliada no total e em três diferentes domínios (escolar, ocupacional e prática esportiva) através de um questionário. A antropometria foi obtida diretamente para o índice de massa corporal e gordura central. Etnia, comportamento sedentário e tabagismo foram autorrelatados e usados para ajustar a análise, através da regressão linear hierárquica. Resultados A atividade física total foi associada à baixa FCRep nos meninos (β = −0,52; IC95% −0,92; −0,12) e meninas (β = −0,67; IC95% −1,07; −0,28). Embora as atividades físicas esportivas estivessem associadas à baixa FCRep em ambos, meninos (β = −0,58; IC95% −1,05, −0,11) e meninas (β = −0,87; IC95% −1,34, −0,39), a atividade física ocupacional estava relacionada à baixa FCRep apenas em meninos (β = −1,56; IC95% −2,99; −0,14). Conclusão A prática de atividade física no domínio da prática esportiva e a atividade física total foram relacionadas à baixa FCRep em ambos os sexos, enquanto as atividades físicas ocupacionais foram associadas à FCRep apenas em meninos.

Is physical activity associated with resting heart rate in boys and girls? A representative study controlled for confounders.

OBJECTIVE: Investigate the relationship between different domains of physical activity and resting heart rate (RHR) in boys and girls. METHOD: The sample included 1011 adolescents, aged between 10 and 17 years. RHR was measured by a heart rate monitor and physical activity was assessed in total and in three different domains (school, occupational, and sports practice) by a questionnaire. Anthropometry was directly obtained for body mass index and central fat. Ethnicity, sedentary behavior, and smoking habits were self-reported and used to adjust the analysis, through hierarchical linear regression. RESULTS: Total physical activity was associated with low RHR in boys (ß=-0.52; 95% CI: -0.92, -0.12) and girls (ß=-0.67; 95% CI: -1.07, -0.28). Although sporting physical activities were associated with low RHR in both boys (ß=-0.58; 95% CI: -1.05, -0.11) and girls (ß=-0.87; 95% CI: -1.34, -0.39), occupational physical activity was related to low RHR only in boys (ß=-1.56; 95% CI: -2.99, -0.14). CONCLUSION: The practice of physical activity in the sport practice domain and total physical activity were related to low RHR in both sexes, while occupational physical activities were associated with RHR only in boys.

Health self-perception and its association with physical activity and nutritional status in adolescents / Autopercepção de saúde e sua associação com atividade física e estado nutricional em adolescentes

Abstract Objective: To evaluate the association between total physical activities, physical activity in free time and nutritional status with self-perceived health in adolescents of both genders. Methods: This is a quantitative study that integrates the school-based, cross-sectional epidemiological survey with statewide coverage, whose sample consisted of 6261 adolescents (14 -19 years old) selected by random conglomerate sampling. Data were collected using the Global School-based Student Health Survey. The chi-squared test (χ 2) and the Poisson regression model with robust variance were used in the data analyses. Results: It was observed that 27.3% of the adolescents had a negative health self-perception, which was higher among girls (33.0% vs. 19.0%, p < 0.001). After adjusting for potential confounding factors, it was observed that boys who did not practice physical activity during free time (PR = 1.44, 95% CI: 1.15 -1.81) and were classified as insufficiently active (PR = 1.27, 95% CI: 1.04 -1.56), as well as girls who did not practice physical activity during free time (PR = 1.15, 95% CI: 1.02 -1.29) and were classified as overweight (PR = 1.27, 95% CI: 1.01 -1.29) had a greater chance of negative health self-perception. Conclusion: Behavioral issues may have different effects on health self-perception when comparing boys with girls. Negative health self-perception was associated with nutritional status in girls and a lower level of physical activity in boys, and the practice of physical activity in the free time was considered a protective factor against a negative health self-perception for adolescents of both genders.

Resumo Objetivo: Avaliar a associação entre atividade física total, atividade física no tempo livre e estado nutricional com a autopercepção de saúde em adolescentes de ambos os sexos. Métodos: Trata-se de um estudo com abordagem quantitativa, que integra o levantamento epidemiológico transversal de base escolar e abrangência estadual, cuja amostra foi constituída por 6.261 adolescentes (14 a 19 anos) selecionados por meio de uma estratégia de amostragem aleatória de conglomerados. Os dados foram coletados a partir do questionário Global School-based Student Health Survey. O teste de qui-quadrado (χ2) e o modelo de regressão de Poisson com variância robusta foram usados nas análises dos dados. Resultados: Observou-se que 27,3% dos adolescentes tinham uma autopercepção de saúde negativa, maior entre as meninas (33,0% vs. 19,0%; p < 0,001). Após o ajuste pelos potenciais fatores de confusão, constatou-se que tinham maior chance de ter uma autopercepção de saúde negativa os meninos que não praticavam atividade física no tempo livre (RP = 1,44; IC 95%: 1,15-1,81) e que eram classificados como insuficientemente ativos (RP = 1,27; IC 95%: 1,04-1,56) e as meninas que não praticavam atividade física no tempo livre (RP = 1,15; IC 95%: 1,02-1,29) e que eram classificadas como sobrepesadas (RP = 1,27; IC 95%: 1,01-1,29). Conclusão: Questões comportamentais podem ter diferentes repercussões na autopercepção de saúde quando comparados os meninos e meninas. A autopercepção de saúde negativa esteve associada ao estado nutricional entre as meninas e a um menor nível de atividade física entre os meninos e a prática de atividade física no tempo livre foi tida como fator de proteção para uma autopercepção de saúde negativa para os adolescentes de ambos os sexos.

Depression and cancer were independently associated with quality of life in Brazilian older people.

OBJECTIVE: To analyse the factors associated with low health-related quality of life (HRQoL) in older people living in Brazil. METHODS: In this cross-sectional study of the Jewish community residing in Sao Paulo, Brazil, we extensively evaluated the characteristics - including clinical, functional and sociodemographic - of 496 older people. Quality of life was assessed using the World Health Organization Quality of Life-BREF (WHOQOL-BREF), while the Geriatric Depression Scale (GDS) was used to measure depressive symptoms. RESULTS: After adjusting for potential confounders, we found that GDS score (ß = -0.07; P = 0.04) and cancer (ß = -0.47; P = 0.05) were associated with a low WHOQOL-BREF score. CONCLUSION: Depressive symptoms and cancer were independently associated with low HRQoL among older people living in Brazil.

Health self-perception and its association with physical activity and nutritional status in adolescents.

OBJECTIVE: To evaluate the association between total physical activities, physical activity in free time and nutritional status with self-perceived health in adolescents of both genders. METHODS: This is a quantitative study that integrates the school-based, cross-sectional epidemiological survey with statewide coverage, whose sample consisted of 6261 adolescents (14-19 years old) selected by random conglomerate sampling. Data were collected using the Global School-based Student Health Survey. The chi-squared test (χ2) and the Poisson regression model with robust variance were used in the data analyses. RESULTS: It was observed that 27.3% of the adolescents had a negative health self-perception, which was higher among girls (33.0% vs. 19.0%, p<0.001). After adjusting for potential confounding factors, it was observed that boys who did not practice physical activity during free time (PR=1.44, 95% CI: 1.15-1.81) and were classified as insufficiently active (PR=1.27, 95% CI: 1.04-1.56), as well as girls who did not practice physical activity during free time (PR=1.15, 95% CI: 1.02-1.29) and were classified as overweight (PR=1.27, 95% CI: 1.01-1.29) had a greater chance of negative health self-perception. CONCLUSION: Behavioral issues may have different effects on health self-perception when comparing boys with girls. Negative health self-perception was associated with nutritional status in girls and a lower level of physical activity in boys, and the practice of physical activity in the free time was considered a protective factor against a negative health self-perception for adolescents of both genders.

Calf Muscle Oxygen Saturation during 6-Minute Walk Test and Its Relationship with Walking Impairment in Symptomatic Peripheral Artery Disease.

BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients. METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations. RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048). CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.

Association between physical activity and walking capacity with cognitive function in peripheral artery disease patients.

OBJECTIVE: To identify the association between objectively measured physical activity and walking capacity with cognitive function in patients with symptomatic peripheral artery disease. METHODS: This was an observational, cross sectional study. One hundred and thirty patients (age 67 ± 8 years) were recruited at a tertiary centre specializing in vascular disease. Cognitive function (global, memory, executive function and attention) was evaluated using the Montreal Cognitive Assessment tool. Physical activity levels (total, light, and moderate-vigorous) were obtained using an accelerometer. A 6 min and 4 m walk test were undertaken to assess walking capacity. Crude and covariate adjusted, linear regression analyses confirmed significant associations between physical activity levels and walking capacity with cognitive function. RESULTS: Positive and significant associations were observed between moderate to vigorous physical activity (p = .039) and walking capacity (p = .030) with memory after adjusting for covariates. No significant association was identified between light physical activity and usual gait speed with any cognitive function outcome. CONCLUSION: Greater memory performance was associated with greater moderate to vigorous physical activity levels and walking capacity in patients with symptomatic peripheral artery disease. Clinical interventions focused on improving moderate to vigorous physical activity levels and walking capacity may provide important therapies to potentially enhance cognitive health in patients with peripheral artery disease.

Effect of Low- Versus High-Intensity Exercise Training on Biomarkers of Inflammation and Endothelial Dysfunction in Adolescents With Obesity: A 6-Month Randomized Exercise Intervention Study.

PURPOSE: To investigate the effects of a low- versus high-intensity aerobic training on biomarkers of inflammation and endothelial dysfunction in adolescents with obesity. METHODS: Sixty-two adolescents with obesity [age = 15 (14) y, body mass index = 34.87 (4.22) kg·m-2] were randomized to receive either a high-intensity training (HIT, n = 31) or a low-intensity training (LIT, n = 31) for 24 weeks. All participants also received nutritional, psychological, and clinical counseling. Leptin, total and subtype leukocyte counts, tumor necrosis factor-alpha, interleukin-6, myeloperoxidase, soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule-1 were obtained at baseline and after 24 weeks. RESULTS: HIT reduced neutrophils [from 4.4 (1.9) to 3.6 (1.3) µL-1 × 103; P = .01] and monocytes [from 7.2 (2.5) to 5.2 (1.8) µL-1 × 102; P < .01], but LIT increased neutrophils [from 4.5 (1.7) to 5.2 (3.3) µL-1 × 103; P = .01]. Although tumor necrosis factor-alpha increased in LIT [from 13.3 (7.5) to 17.7 (10.8) pg·mL-1; P = .01], it decreased in HIT [from 12.4 (7.5) to 11.3 (6.2) pg·mL-1; P = .01]. No changes in leukocyte counts, soluble intercellular adhesion molecule-1, soluble vascular cell adhesion molecule-1, and homeostasis assessment model for insulin resistance were observed. CONCLUSIONS: Both HIT and LIT improved the inflammatory profile. The study, however, indicated that the number of biomarkers and the magnitude of changes were higher in the HIT compared with LIT.

Acute blood pressure responses after different isometric handgrip protocols in hypertensive patients

OBJECTIVE: The present study analyzed blood pressure responses after a single session of isometric handgrip exercise performed with different volumes and intensities by patients with hypertension. METHODS: This randomized crossover trial submitted 12 hypertensive patients (58±5 years old) to four isometric handgrip exercise sessions in a random order: 4 x 2 min at 30% of the maximal voluntary contraction (S30%); 4 x 2 min at 50% of the maximal voluntary contraction (S50%2min); 4 x 3 min at 30% of the maximal voluntary contraction (S30%3min); and a control session. The systolic and diastolic blood pressure, heart rate, and rate-pressure product were measured pre- and post-exercise (30th min). RESULTS: No significant changes were observed in cardiovascular variables after any session (p>0.05 for all comparisons). Similarly, individual analyses revealed heterogeneity in the responses, including increases in blood pressure observed in some sessions. Patients with reduced blood pressure after an isometric handgrip exercise session exhibited a higher body mass index, diastolic blood pressure and heart rate (p<0.05). They also tended to be younger (p=0.07). CONCLUSION: Isometric handgrip exercise performed with different intensities and volumes did not reduce the blood pressure of hypertensive patients.