Influence of regular aerobic exercise on endothelium-dependent vasodilation and cardiorespiratory fitness in pregnant women.

AIM: To evaluate the effect of regular aerobic exercise on the endothelial function and cardiorespiratory fitness in pregnant women. METHOD: This was a randomized, double-blinded, controlled clinical trial of 64 healthy primigravid women between 16 and 20 weeks' gestation. The experimental group took part in aerobic exercise at an intensity of 50-65% of their maximum heart rate for 60 min, three times a week for 16 weeks. The control group undertook their usual physical activity. The outcomes were the endothelial function evaluated by flow-mediated dilatation and cardiorespiratory fitness evaluated by the maximum indirect oxygen consumption (VO2max) in a 6-min walk test. RESULTS: Initially, no differences were found between the groups in any of the variables. At the end of the intervention, the participants that performed exercise showed a higher cardiorespiratory fitness, measured by the walked distance in the 6-min walk test (P = 0.014) and by the VO2max (P = 0.014). Also, the exercise group showed a lower heart rate at rest and a higher flow-mediated dilatation than the control group (P = 0.02). CONCLUSIONS: Regular aerobic exercise improves endothelium-dependent vasodilation in pregnancy. This intervention may be an early and effective alternative to strengthen the prevention of disorders associated to endothelial dysfunction.

[Association between adiposity and cardiovascular risk factors in prepubertal children]. / Asociación entre adiposidad y factores de riesgo cardiovascular en infantes pre-púberes.

INTRODUCTION AND OBJECTIVES: To examine the relationships between of four measures of adiposity, namely waist circumference (WC), body mass index (BMI), and subscapular and abdominal skinfolds, with different cardiovascular risk factors in prepubertal children. METHODS: Four hundred and ninety-four prepubertal children aged 6-10 years participated in this cross-sectional study. The subscapular and abdominal skinfolds, WC, and BMI were measured to assess adiposity, and cardiovascular risk factors (CVRFs) were assessed by measuring systolic (SBP) and diastolic blood pressures (DBP), glucose, triglycerides (TG), and high density (HDL-C) and low density lipoprotein cholesterol (LDL-C). Dichotomous variables were created based on whether or not the subjects were in the upper quartile (Q4) for the WC, BMI, and skinfold variables. RESULTS: No CVRF was found in 52.8% of children, 33.4% had one factor, and 10.9% and 2.8% had 2 and 3 factors respectively. An adjusted logistic regression analysis showed that being in Q4 of anthropometric variables and CVRFs was associated to TG levels ≥ 100 mg/dL. Glucose levels ≥ 96 mg/dL were associated to Q4 and abdominal fold. Presence of 2 or more CVRFs was significantly associated to Q4 in all anthropometric variables despite adjustment for age, gender, and calorie intake. The subscapular skinfold was the adiposity marker associated to the highest risk. CONCLUSIONS: Children with a more unfavorable adiposity profile tend to have a greater cardiovascular risk in the prepubertal stage.

Centile values for anthropometric variables in Colombian adolescents.

BACKGROUND AND OBJECTIVE: Reference data for anthropometric parameters are not available for adolescents in Cali (Colombia). This study aimed to develop representative age- and sex-specific percentiles for anthropometric indicators [fat percentage, body mass index (BMI), and waist circumference] in urban adolescents aged 10-16 years in Cali. METHODS: The sample (n=1,773) consisted of 865 boys and 908 girls from the descriptive, cross-sectional population-based IFRECNTEC study (Identification of Risk Factors for Non-communicable Chronic Diseases in Adulthood in a Population aged 6 to 18 years old attending School in the Municipality of Cali, Colombia). Data on anthropometric variables were recorded. Smoothed age- and sex- specific 5(th), 25(th), 50(th), 75(th), 90(th) and 95(th) centiles were derived using the least mean squares (LMS) regression method. RESULTS: In most ages, anthropometric indicators were higher for girls than for boys. The BMI p50 ranged from 16.8 to 19.9kg/m² in boys and from 16.7 to 21.1kg/m² in girls. Fat percentage in boys in the p50 varied from ≈12% at the ages of 10 and 11 years to ≈13% at the age of 16 years; for girls, these percentages varied from ≈13% in the earliest ages to ≈16% in older ages. Waist circumference was lower in girls than in boys in most ages. CONCLUSION: The results of this study could be used to identify adolescents with an elevated risk of developing obesity, dyslipidemia, hypertension and cardiovascular disorders in adulthood, to plan and implement preventive policies, and to study temporal trends. The introduction of centile values will help to classify adolescents from Cali and compare their anthropometric indicators with those of a reference population.

[Centile values for serum lipids in Colombian adolescents]. / Centiles de lípidos séricos en adolescentes de Colombia.

OBJECTIVE: To assess age- and sex-specific percentile baseline data for total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) in Colombian children and adolescents aged 10 to 17 years. PATIENTS AND METHODS: A cross-sectional, descriptive study was conducted on 1,773 children and adolescents. Each participant underwent a fasting measurement to quantify TC, HDL-C, and TG levels using enzymatic-colorimetric methods. Smoothed age- and sex-specific 5(th), 25(th), 50(th), 75(th), 90(th) and 95(th) percentile values where derived using LMS regression (Least Mean Square) using the statistical package Growth Analyzer. RESULTS: Overall, males had lower serum TC and TG levels as compared to females. P95 of TG and TC was higher in males aged 10 to 14 years as compared to females, while HDL-C levels were similar in both sexes. CONCLUSIONS: Percentile values will help classify children and adolescents as compared to other populations based on this health indicator.

A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn.

BACKGROUND: Many studies have suggested a relationship between metabolic abnormalities and impaired fetal growth with the development of non-transmissible chronic diseases in the adulthood. Moreover, it has been proposed that maternal factors such as endothelial function and oxidative stress are key mechanisms of both fetal metabolic alterations and subsequent development of non-transmissible chronic diseases. The objective of this project is to evaluate the effect of micronutrient supplementation and regular aerobic exercise on endothelium-dependent vasodilation maternal and stress oxidative of the newborn. METHODS AND DESIGN: 320 pregnant women attending to usual prenatal care in Cali, Colombia will be included in a factorial randomized controlled trial. Women will be assigned to the following intervention groups: 1. CONTROL GROUP: usual prenatal care (PC) and placebo (maltodextrine). 2. Exercise group: PC, placebo and aerobic physical exercise. 3. Micronutrients group: PC and a micronutrients capsule consisting of zinc (30 mg), selenium (70 µg), vitamin A (400 µg), alphatocopherol (30 mg), vitamin C (200 mg), and niacin (100 mg). 4. Combined interventions Group: PC, supplementation of micronutrients, and aerobic physical exercise. Anthropometric measures will be taken at the start and at the end of the interventions. DISCUSSION: Since in previous studies has been showed that the maternal endothelial function and oxidative stress are related to oxidative stress of the newborn, this study proposes that complementation with micronutrients during pregnancy and/or regular physical exercise can be an early and innovative alternative to strengthen the prevention of chronic diseases in the population. TRIAL REGISTRATION: NCT00872365.

Aerobic exercise during pregnancy improves health-related quality of life: a randomised trial.

QUESTION: Does supervised aerobic exercise during pregnancy improve health-related quality of life in nulliparous women? DESIGN: Analysis of secondary outcomes of a randomised trial with concealed allocation, blinded assessors, and intention-to-treat analysis. PARTICIPANTS: 64 nulliparous, pregnant women attending for prenatal care at one of three tertiary hospitals. INTERVENTION: The experimental group completed a 3-month supervised exercise program, commencing at 16 to 20 weeks of gestation. Each session included walking (10 min), aerobic exercise (30 min), stretching (10 min), and relaxation (10 min). The control group continued usual activities and performed no specific exercise. OUTCOME MEASURES: The primary outcome was health-related quality of life assessed by the Colombian version of the Medical Outcome Study Short-Form Health Survey at baseline and immediately after the 3-month intervention. RESULTS: Fifty women completed the study. After the 3-month intervention, the experimental group had improved their health-related quality of life more than the control group in the physical component summary of the questionnaire by 6 points (95% CI 2 to 11), the physical function domain (7 points, 95% CI 0 to 14), the bodily pain domain (7 points, 95% CI 1 to 13) and the general health domain (5 points, 95% CI 1 to 10). CONCLUSIONS: A supervised 3-month program of primarily aerobic exercise during pregnancy improves health-related quality of life. TRIAL REGISTRATION: NCT00741312.

Percentiles de presión arterial de niños y adolescentes de Santiago de Cali-Colombia / Blood pressure centiles for Santiago de Cali-Colombian children and adolescents

Objetivo: Determinar los valores percentiles de presión arterial de niños y adolescentes de 10 a 16 años de Santiago de Cali-Colombia. Materiales y Métodos: Estudio descriptivo de corte transversal en 1773 niños y adolescentes de ambos géneros (n=865 hombres y n=908 mujeres) pertenecientes al estudio IFRECNTEC (Identificación de Factores de Riesgo de Enfermedades Crónicas No Transmisibles del Adulto en la Población Escolarizada de 6 a 18 años en el Municipio de Cali, Colombia). Se calcularon los valores percentiles a partir de la regresión de los mínimos cuadrados (Least Mean Squares) según edad y sexo p5, p25, p50, p75, p90 y p95 de la presión arterial. Resultados: La presión arterial por sexo fue similar en la infancia, aumentando progresivamente con la edad y con mayor rapidez durante la pubertad. La presión sistólica y diastólica fue mayor en los adolescentes hombres que en las mujeres. Discusión y Conclusiones: La presentación de valores percentiles permite clasificar la presión arterial de niños y adolescentes de Cali-Colombia y comparar con sus contemporáneos. La presión arterial alta para la edad debería definirse en percentiles por encima del p95 y la presión arterial alta y normal podría definirse entre el p90 y p95...

Aim. To determine age- and sex- specific centile values of Blood pressure for urban Santiago de Cali-Colombia children and adolescents aged 10–16 years. Material and Methods. The sample (n=1773) consisted of 865 boys and 908 girls from the crosssectional population survey, IFRECNTEC Study (Identificación de Factores de Riesgo de Enfermedades Crónicas No Transmisibles del Adulto en la Población Escolarizada de 6 a 18 años en el Municipio de Cali, Colombia) for whom the data for Blood pressure was recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th Centile values where derived using Least Mean Squares regression. Results. Blood pressure in both sexes was similar in childhood, rising progressively with age and more rapidly during puberty. Systolic and Diastolic pressure rose faster and was appreciably higher in men than in adolescents women. Discussion and Conclusion. These centiles increase our knowledge of blood pressure data in contemporary Colombian children and young people. High blood pressure for age should be defi ned as blood pressure above the 95th centile, and high-normal blood pressure for age as blood pressure between the 90th and 95th centiles...

Efecto potencial del ejercicio físico y del consumo de micronutrientes durante la gestación en factores maternos y placentarios asociados con enfermedades crónicas no transmisibles (ECNT) del adulto / Potential effect of physical exercise and consumption of micronutrients during pregnancy on the placental and maternal factors associated with chronic non-communicable diseases in adult

Introducción: En la actualidad casi todos los esfuerzos para prevenir las enfermedades crónicas no transmisibles (ECNT) a nivel poblacional, se han centrado en promover comportamientos saludables como el ejercicio, la actividad física, el consumo de frutas y verduras, y el desestimular el consumo de tabaco y alcohol en la población adulta, pero los resultados han sido poco alentadores. En los últimos años, múltiples estudios han señalado la relación entre alteraciones del crecimiento fetal y el desarrollo de ECNT en la edad adulta. Más recientemente, se ha propuesto que factores maternos (función endotelial, estrés oxidativo y alteraciones en adipoquinas) y placentarios (disfunción mitocondrial) pueden ser mecanismos precursores de alteraciones metabólicas fetales y del desarrollo posterior de ECNT y que intervenciones como el ejercicio físico y la complementación con micronutrientes durante la gestación podrían regular dichos factores maternos y placentarios. Objetivo: Realizar una revisión de la literatura para verificar el papel del ejercicio físico y los micronutrientes durante la gestación sobre factores maternos y placentarios relacionados con ECNT del adulto. Metododología: Se utilizaron las siguientes bases de datos: Medline, Scielo, EMBASE, Science Direct, Cochrane Central Register of Controlled Trials y The Cochrane Libraryp Pregnancy, fetal development, oxidative stress, vascular endothelium, mitochondrial, adipokines, micronutrients, exercise. Resultados: El estrés oxidativo, como mecanismo central de otros eventos fisiopatológicos (alteración en los niveles de adipoquinas, disfunción endotelial y mitocondrial), tiene un papel importante en la programación fetal de ECNT, factores como la complementación con micronutrientes y el ejercicio físico, durante la gestación, podrían modular este estado y contribuir posiblemente a la prevención temprana de ECNT.

Introduction: Currently, most efforts to prevent nontransmissible chronic diseases at population level have centered on promoting healthy behaviors like physical activity, consumption of fruits and vegetables, and discouraging from the consumption of tobacco and alcohol in the adult population, but the results have been less than hopeful. During recent years, a number of studies have indicated the relation between metabolic alterations and fetal growth with the development of nontransmissible chronic diseases in adult age. More recently, it has been proposed that maternal factors (endothelial function, oxidative stress, and alterations in adipokynes) and placental factors (mitochondrial dysfunction) are the precursory mechanisms of fetal metabolic alterations and of the later development of nontransmissible chronic diseases. Also, it has been suggested that possibly supplementation with micronutrients and physical exercise during gestation could regulate these maternal and placental factors. Aim: To conduct a literature review to verify the role of physical exercise and micronutrients during pregnancy on placental and maternal factors related to nontransmissible chronic diseases in adults. Methods: Medline, SciELO, Embase, Science Direct, Cochrane Central Register of Controlled Trials, and the Cochrane Library were used in the last 10 years (1998-2008). The following topics were reviewed: pregnancy, fetal development, oxidative stress, vascular endothelium, mitochondrial dysfunction, adipokines, micronutrients, and exercise. Results: Oxidative stress, as the central pathophysiological event, such as changes in levels of adipokynes, mitochondrial and endothelial dysfunction, plays an important role in fetal programming of chronic diseases and factors such as micronutrient supplementation and physical exercise during pregnancy could modulate this state in a charity institution aiding in the early prevention of chronic diseases.

Los niveles de ferritina y los marcadores de riesgo cardiovascular se correlacionan con mayor tiempo sedentario auto-reportado en hombres aparentemente sanos / Ferritin levels and cardiovascular risk markers correlate with higher self-reported sedentary time in apparently healthy men

Objetivo: evaluar la correlación entre las concentraciones séricas de ferritina y los marcadores de riesgo cardiovascular con el tiempo de actividad física y sedentarismo auto-reportados en hombres aparentemente sanos. Métodos: se incluyeron 69 hombres pertenecientes a tres empresas de servicio privado y público del área metropolitana de Cali, Colombia, con edades entre 25 y 64 años. Se aplicó la versión corta del International Physical Activity Questionnaire (IPAQ) y se agruparon cuatro categorías de actividad física: 1. Minutos actividad física intensa (AFI)/semana. 2. Minutos actividad física moderada (AFM)/semana. 3. Minutos caminata/semana. 4. Minutos sentado/día. Los marcadores de riesgo cardiovascular se definieron con base en los criterios del ATP-III y la Federación Internacional de Diabetes. Resultados: se encontraron correlaciones positivas en los sujetos que auto-reportaban mayor tiempo en actividades sedentarias según la categoría del IPAQ (minutos promedio sentado/día) en los indicadores antropométricos: porcentaje de grasa corporal (rho=0,249, p<0,05), índice de masa (rho=0,268, p<0,05) y circunferencia de cintura (rho=0,266, p<0,05). Este mismo comportamiento se observó en las variables bioquímicas: ferritina (rho=0,247, p<0,05), triglicéridos (rho=0,258, p<0,05), insulina (rho=0,284, p<0,05) e índice HOMA (rho=0,261). Asimismo, se evidenciaron menores niveles de c-HDL a menores niveles de actividad física (rho=-0,279; p<0,05). Conclusiones: el tiempo sedentario (minutos sentado/semana) reportado por los sujetos, se correlacionó de manera positiva con los niveles de ferritina así como con la resistencia a la insulina y los marcadores de riesgo cardiovascular. Los depósitos de hierro corporales estimados como ferritina sérica, al relacionarse con parámetros de sedentarismo, se comportan como un potencial marcador de riesgo cardiovascular.

Objective: to evaluate the correlation between serum ferritin and cardiovascular risk markers with the time of self-reported physical activity and sedentary life style in apparently healthy men. Methods: we included 69 men from three private and public companies in the metropolitan area of Cali, Colombia, aged between 25 and 64. The short version of the International Physical Activity Questionnaire (IPAQ) was applied, and were grouped in four categories of physical activity: 1. Minutes of intense physical activity (IFA)/week.2. Minutes of moderate physical activity (MFA)/week. 3. Minutes of walk/week. 4. Minutes of sitting/day. Cardiovascular risk markers were defined based on the criteria of the ATP-III and the International Diabetes Federation. Results: positive correlations were found in subjects who self-reported more time in sedentary activities according to the IPAQ category (average minutes sitting/day) in anthropometric indicators: percentage of body fat (rho = 0.249, p <0.05), mass index (rho = 0.268, p <0.05) and waist circumference (rho = 0.266, p <0.05). This same behavior was observed in biochemical variables: ferritin (rho = 0.247, p <0.05), triglycerides (rho = 0.258, p <0.05), insulin (rho = 0.284, p <0.05) and HOMA index (rho = 0.261). Also, lower levels of HDL-C were evidenced with lower levels of physical activity (rho =- 0.279, P <0.05). Conclusions: sedentary time (minutes sitting/week) reported by the subjects correlated positively with ferritin levels as well as with insulin resistance and cardiovascular risk markers. The body iron deposits estimated as serum ferritin, when related to sedentary lifestyle parameters, behave as a potential marker of cardiovascular risk.

Asociación entre adiposidad y factores de riesgo cardiovascularen infantes pre-púberes / Association between adiposity and cardiovascular risk factors in prepubertal children

Introducción y objetivos: Examinar las asociaciones de cuatro medidas de adiposidad como la circunferencia de cintura (CC), el índice de masa corporal (IMC), y los pliegues cutáneos subescapular y abdominal con diferentes factores de riesgo cardiovascular (FRCV) en infantespre-púberes. Métodos: Cuatrocientos noventa y cuatro pre-púberes, de 6-10 años, participaron en este estudio transversal. Se midió la adiposidad con los pliegues cutáneos subescapular y abdominal, CCe IMC y los FRCV como presión arterial sistólica (PAS) y diastólica (PAD), glucosa, triglicéridos(TG), y el colesterol de las lipoproteínas de alta (cHDL) y baja densidad (cLDL). Se crearon variables dicotómicas respecto a estar y no estar en el cuartil superior (Q4) con las variables CC, IMC, y los pliegues en todos los sujetos. Resultados: El 52,8% de los infantes no presentó ningún FRCV, el 33,4% presentó un factor, y el10,9 y 2,8% tenían 2 y 3 factores, respectivamente. El análisis de regresión logística ajustada mostró que ubicarse en el Q4 de las variables antropométricas y los FRCV, se asociaba con TG ≥100 mg/dL. Niveles de glucosa ≥ 96 mg/dL mostraron una asociación con el Q4 y con el pliegue abdominal. Presentar 2 o más FRCV se asoció significantemente con el Q4 en todas las variables antropométricas a pesar del ajuste por edad, género e ingesta calórica. El pliegue subescapular fue el indicador de adiposidad con mayor índice de riesgo. Conclusiones: Los infantes con una adiposidad más desfavorable tienden a presentar mayor riesgo cardiovascular en la etapa pre-púber (AU)

Introduction and objectives: To examine the relationships between of four measures of adiposity, namely waist circumference (WC), body mass index (BMI), and subscapular and abdominalskinfolds, with different cardiovascular risk factors in prepubertal children. Methods: Four hundred and ninety-four prepubertal children aged 6-10 years participated in this cross-sectional study. The subscapular and abdominal skinfolds, WC, and BMI were measured to assess adiposity, and cardiovascular risk factors (CVRFs) were assessed by measuring systolic(SBP) and diastolic blood pressures (DBP), glucose, triglycerides (TG), and high density (HDL-C)and low (..) (AU)

Centiles de lípidos séricos en adolescentes de Colombia / Centile values for serum lipids in Colombian adolescents

Objetivo Determinar los valores por edad y sexo de los lípidos séricos colesterol total (CT), triglicéridos (TG), y colesterol de lipoproteínas de alta densidad (c-HDL) de niños y adolescentes de 10 a 17 años de Colombia. Material y métodos Estudio descriptivo de corte transversal en 1.773 niños y adolescentes. A cada participante se le realizó una medición en ayunas para cuantificar los niveles de CT, c-HDL y TG utilizando métodos enzimático-colorimétricos. Se calcularon centiles a partir de la regresión LMS por edad y sexo p5, p25, p50, p75, p90 y p95 con el método de los Least Mean squares (LMS, ‘mínimos cuadrados’) por curvas centiles que representan la asimetría, la mediana y la variabilidad utilizando el paquete estadístico Growth Analyzer.Resultados En general, los hombres presentan menores valores de CT y TG séricos que las mujeres. El p95 de los TG y CT en los hombres de las edades de 10 a 14 años fue mayor que en las mujeres, mientras que los niveles de c-HDL fueron similares en ambos sexos y edades. Conclusiones La obtención de valores centiles ayudará a clasificar los niños y adolescentes con respecto a otras poblaciones en función de este indicador de salud (AU)

Objective: To assess age- and sex-specific percentile baseline data for total cholesterol (TC),triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) in Colombian children and adolescents aged 10 to 17 years. Patients and Methods: A cross-sectional, descriptive study was conducted on 1,773 children and adolescents. Each participant underwent a fasting measurement to quantify TC, HDL-C, and TG levels using enzymatic-colorimetric methods. Smoothed age- and sex-specific 5th, 25th,50th, 75th, 90th and 95th percentile values where derived using LMS regression (Least MeanSquare) using the statistical package Growth Analyzer. Overall, males had lower serum TC and TG levels as compared to females. P95 of TG and TC was higher in males aged 10 to 14 years as compared to females, while HDL-C levels were similar in both sexes. Conclusions: Percentile values will help classify children and adolescents as compared to other populations based on this health indicator (AU)

Centile values for anthropometric variables in Colombian adolescents

Background and objective Reference data for anthropometric parameters are not available for adolescents in Cali (Colombia). This study aimed to develop representative age- and sex-specific percentiles for anthropometric indicators [fat percentage, body mass index (BMI), and waist circumference] in urban adolescents aged 10–16 years in Cali. Methods The sample (n=1,773) consisted of 865 boys and 908 girls from the descriptive, cross-sectional population-based IFRECNTEC study (Identification of Risk Factors for Non-communicable Chronic Diseases in Adulthood in a Population aged 6 to 18 years old attending School in the Municipality of Cali, Colombia). Data on anthropometric variables were recorded. Smoothed age- and sex- specific 5th, 25th, 50th, 75th, 90th and 95th centiles were derived using the least mean squares (LMS) regression method. Results In most ages, anthropometric indicators were higher for girls than for boys. The BMI p50 ranged from 16.8 to 19.9kg/m2 in boys and from 16.7 to 21.1kg/m2 in girls. Fat percentage in boys in the p50 varied from (..) (AU)

Antecedentes y objetivos No existen indicadores antropométricos para los adolescentes de Cali, en Colombia. Este estudio tuvo como objetivo establecer percentiles antropométricos según edad y sexo para los indicadores: porcentaje de grasa, índice de masa corporal (IMC), y perímetro de la cintura en adolescentes escolarizados y con edades comprendidas entre los 10 y los 16 años. Métodos Estudio descriptivo de corte transversal con 1.773 niños y adolescentes de ambos géneros (n=865 chicos y n=908 chicas) pertenecientes al estudio IFRECNTEC (Identificación de Factores de Riesgo de Enfermedades Crónicas No Transmisibles del Adulto en la Población Escolarizada de 6 a 18 años en el Municipio de Cali, Colombia). Se calcularon los valores percentiles p5, p25, p50, p75, p90 y p95 de los indicadores antropométricos a partir de la regresión de los mínimos cuadrados promedio (LMS) según edad y sexo. Resultados En la mayoría de las edades, los indicadores antropométricos de (..) (AU)