Variaciones en el consumo de medicamentos para la salud mental en una unidad de atención primaria brasileña: ¿hay influencia de la pandemia? / Variations in the consumption of mental health medications in a brazilian primary care unit: is there influence of the pandemic?

Introducción: La pandemia de COVID-19 ha generado la necesidad de ajustes y adaptaciones en diversas áreas, desde el comportamiento hasta la normativa, con grandes repercusiones en términos de salud pública. Objetivo: Comparar los consumos promedio mensuales (CPM) de medicamentos de control especial utilizados para la salud mental antes y durante la pandemia en una Unidad Básica de Salud (UBS) en el Distrito Federal, Brasil. Métodos: Los consumos se obtuvieron a través del sistema de gestión de inventarios local y el CPM (±desviación estándar) se calculó sin tener en cuenta los meses de desabastecimiento, considerando el período de 2020 a 2022. Como parámetro comparativo, se utilizó el CPM±DE de 2019. Resultados: Se analizaron los consumos de 32 medicamentos, siendo la mayoría antiepilépticos (N=10; 31,2 %), antidepresivos (N=10; 31,2 %) y antipsicóticos (N=8; 25,0 %). Se observó que más de la mitad de los medicamentos analizados (n=18; 56,3 %) mantuvieron un aumento en el consumo a lo largo de los años de la pandemia. Conclusión: Hubo una variación significativa en el consumo de medicamentos sujetos a control especial en la UBS durante la pandemia. Estos resultados pueden estar asociados a diversos factores, como el aumento de los cuadros clínicos que justifican su prescripción, en línea con la literatura actual sobre el impacto potencial del aislamiento social y las medidas tomadas por las autoridades competentes para contener la propagación del virus SARS-COV-2. (AU)

Introduction: The COVID-19 pandemic has generated the need for adjustments and adaptations in various areas, from behaviour to regulations, with significant repercussions in terms of public health. Objective: To compare the monthly average consumption (MAC) of special control medications used for mental health before and during the pandemic in a Basic Health Unit (UBS) in the Federal District, Brazil. Methods: Consumption data were obtained through the local inventory management system, and the MAC (±stan-dard deviation) was calculated excluding months of stockouts, considering the period from 2020 to 2022. The MAC±SD of 2019 was used as a comparative parameter. Results: Consumption of 32 medications was analyzed, with the majority being antiepileptics (N=10; 31.2 %), anti-depressants (N=10; 31.2 %), and antipsychotics (N=8; 25.0 %). It was observed that more than half of the analyzed medications (n=18; 56.3 %) maintained an increase in consumption throughout the pandemic years. Conclusion: There was a significant variation in the consumption of special control medications at the UBS during the pandemic. These results may be associated with various factors, such as the increase in clinical conditions justi-fying their prescription, in line with current literature on the potential impact of social isolation and measures taken by competent authorities to contain the spread of the SARS-CoV-2 virus. (AU)

Association between physical activity measured by accelerometry and cognitive function in older adults: a systematic review.

OBJECTIVE: To analyze studies that investigated the association between physical activity assessed by accelerometry and cognitive function in older people. METHODS: A systematic review was carried out in four electronic databases (PubMed, Web of Science, Scopus, and SportsDiscus). RESULTS: In total, 195 records were identified. Fifty-two studies were selected for a full evaluation; 23 were selected according to the inclusion criteria adopted and divided into four chapters (characteristics of the studies, the association between physical activity level and cognitive function decline, effects of physical activity in reducing the chances of cognitive function decline and effects of physical activity on brain plasticity. The cross-sectional studies had an average score of 7 points, and the cohort studies obtained 10 points, indicating the high quality of the selected studies. Seven studies indicated an association between Moderate to vigorous physical activities (MVPA) and cognitive function, two specifically indicated a reduction in the chances of cognitive function decline according to the interquartile of MVPA, and three studies indicated improvements in MVPA in brain plasticity. CONCLUSION: Measured by accelerometry, seems to be favorably associated with important outcomes in cognitive function assessed through questionnaires, imaging analyses, and biochemical markers with older adults.

The effect of physical activity on total homocysteine concentrations and cardiovascular risk in older Brazilian adults with type 2 diabetes.

A low level of physical activity has a potential association with high levels of homocysteine, which implies an increased chance of older adults with type 2 diabetes mellitus developing cardiovascular disease (CVD). However, the effects of physical activity on homocysteine levels have been poorly explored in the literature. Therefore, this study compared homocysteine levels and cardiovascular risk among physically active and inactive older women with type 2 diabetes mellitus. Fifty-nine women with type 2 diabetes mellitus, between 60 and 91 years old, were evaluated. The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) long version to identify active and inactive older women. Blood samples were collected and anthropometric, body composition, and blood pressure measurements were performed to determine homocysteine levels and cardiovascular risk. The results demonstrated that active older women with type 2 diabetes mellitus have lower homocysteine values (F = 17.79, p < 0.001, ηp2 = 0.238), cardiovascular risk scores (F = 15.84, p = p < 0.001, ηp2 = 0.217), and waist circumferences (F = 2.95, p = 0.013, ηp2 = 0.049) when compared with inactive older women. It was concluded that there was a difference in the levels of homocysteine, cardiovascular risk, and waist circumference between active and inactive older women with type 2 diabetes. Active older women are less likely to have cardiovascular risk than inactive older women.

Açaí (Euterpe oleracea Mart) seed extract protects against maternal vascular dysfunction, hypertension, and fetal growth restriction in experimental preeclampsia.

Objective: To investigate whether Euterpe oleracea Mart. (açaí) seed extract (ASE) prevents maternal cardiovascular changes and intrauterine growth restriction (IUGR) in experimental preeclampsia (PE).Methods: ASE administration (200 mg/kg/day) during mid to late pregnancy in a rat model of L-NAME-induced PE.Results: ASE impaired the maternal hypertension and microalbuminuria as well as the lower fetal and placental weight in experimental PE. ASE also prevented the maternal vascular dysfunction and lipoperoxidation in this model.Conclusion: ASE protected against maternal cardiovascular changes and IUGR in the L-NAME-induced PE. The protective effect of ASE may be partly explained by its antioxidant property.

The effect of aerobic vs. resistance training on plasma homocysteine in individuals with type 2 diabetes.

Elevated plasma homocysteine concentration is a risk factor for cardiovascular disease, which seems to be the main cause of increased mortality in patients with type 2 diabetes. Previous studies have demonstrated the effect of exercise on homocysteine levels and the magnitude of these benefits seems to depend on the type, mode and frequency of training. The present study aimed to compare the effects of aerobic and resistance training on plasma homocysteine in individuals with type 2 diabetes. The study included 15 individuals undergoing aerobic training, 14 subjects undergoing resistance training, and 18 individuals in the control group. Homocysteine, total cholesterol and fractions, glucose, and anthropometric measurements were conducted. The training program lasted 16 weeks. Aerobic training was performed twice a week and lasted 75 min, and resistance training was performed twice a week and lasted 75 min. Homocysteine levels were not significantly different between before and after training. High-density lipoprotein levels increased in both training groups and decreased in the control group. Glucose levels decreased after aerobic and resistance training. Body fat mass (percentage and total) decreased in both training group, but with more expression in the aerobic group. We conclude that 16-week aerobic and resistance training programs did not significantly affect plasma homocysteine levels in patients with type 2 diabetes. Nevertheless, these training programs yielded positive results in HDL control, plasma glucose, and body composition.

Effect of Strength Training on Plasma Levels of Homocysteine in Patients with Type 2 Diabetes.

BACKGROUND: The objective of this study was to analyze the effects of strength training on plasma homocysteine levels and cardiovascular risk factors in patients with type 2 diabetes. METHODS: The sample consisted of 14 diabetic women with a mean age of 68 ± 6 years. Biochemical evaluations and anthropometric measurements were taken before and after training. Training sessions lasted 50 min and comprised three sets of 8-12 repetitions each. The established load was 60% of 1 repetition maximum. RESULTS: After the training program, it was observed that the levels of homocysteine (average before 13.4 ± 2.9 and after 12.8 ± 3.3, P = 0.40), very low-density lipoprotein (LDL) (average before 41.9 ± 17.0 and after 36.2 ± 11.8, P = 0.47), total cholesterol (average before 214.4 ± 60.6 and after 190.2 ± 62.3, P = 0.09), triglycerides (average before 209.3 ± 85.4 and after 181.5 ± 59.2, P = 0.47), and blood glucose (average before 123.5 ± 30.4 and after 110.1 ± 24.7, P = 0.26) showed no significant changes, but the LDL (average before 129.1 ± 63.4 and after 95.7 ± 53.3, P = 0.04), high-density lipoprotein (average before 43.2 ± 12.0 and after 58.2 ± 15.6, P = 0.01), lean mass (average before 41.1 ± 5.7 and after 42.8 ± 5.4, P = 0.008), fat mass (average before 31.4 ± 8.8 and after 29.7 ± 8.5, P = 0.001), and percentage fat (average before 42.6 ± 4.0 and after 40.3 ± 4.6, P = 0.000) showed significant changes. CONCLUSIONS: This study concluded that strength training does not improve homocysteine levels, but help to improve the lipoprotein profile in type 2 diabetic patients.

Níveis plasmáticos de homocisteína em mulheres idosas com úlceras nos pés / Plasma levels of homocystein in women elderly with ulcers in the foot

Introdução: A homocisteína é um amino ácido produzido no fígado e seus níveis elevados apresentam relação com aterosclerose e úlceras. Objetivo: Avaliar os níveis plasmáticos de homocisteína de mulheres idosas com úlceras nos membros inferiores. Métodos: Participaram 40 mulheres idosas, idade média 67,4±6,49 anos, divididas em grupo com úlcera (GU) e controle (GC). A avaliação da presença de úlcera foi realizada por observação, a avaliação da concentração de homocisteína (µmol/L) foi realizada por high performance liquid chromatography (HPLC) e a aferição da pressão arterial foi realizada pelo uso de um esfigmomanômetro aneroide ­ HICO HM 1001. Resultados: Níveis de homocisteína mais elevados para o grupo úlcera 17,69 ± 6,82 versus controle 11,70 ± 1,51. As pressões arteriais sistólica e diastólica não apresentaram diferenças entre os grupos ulcera 134,16±19,28/74,16±11,64 e controle 136,15±16,09/77,69 ± 5,99 respectivamente. Conclusão: Conclui-se que os níveis plasmáticos de homocisteína em mulheres idosas com úlcera estão aumentados.

Introduction: Homocysteine is an amino acid produced in the liver and its elevated levels are related to atherosclerosis and ulcer. Objective: To evaluate the plasma levels of homocysteine of elderly women with ulcers in the lower limbs. Methods: Participated 40 elderly women, mean age 67.4 ± 6.49 years, separated into ulcer (GU) and control (CG) groups. The evaluation of the presence of ulcer was performed by observation, the homocysteine concentration (µmol/L) was evaluated by high performance liquid chromatography (HPLC) and blood pressure was measured using an aneroid sphygmomanometer HICO HM 1001. Results: Higher homocysteine levels for the ulcer group 17.69 ± 6.82 vs control 11.70 ± 1.51. The systolic and diastolic blood pressures did not differences between the ulcer group 134,16±19,28/74,16±11,64 and control group 136,15±16,09/77,69±5,99, respectively. Conclusion: It is concluded that plasma levels of homocysteine in elderly women with ulcer are increased.

Variações agudas na contagem leucocitária após aula de ciclismo indoor / Acute changes in white blood cell count after indoor cycling class

Introdução: Tem sido sugerido que a prática do exercício físico pode modular o sistema imunológico. Objetivo: Avaliar a influência de uma aula de ciclismo indoor sobre a contagem leucocitária. Métodos: Participaram do estudo 12 voluntários, idade média de 23±4 anos, aptos à prática de exercício físico. Os voluntários realizaram uma aula de ciclismo indoor em bicicleta estacionária, volume de 60 minutos, e intensidade média de 71% da frequência cardíaca máxima. Resultados: Após a aula de ciclismo indoor, durante a recuperação (24 e 48 horas), foi observado redução na contagem de leucócitos em 4% e 8,9%, linfócitos 5% e 1,3%; neutrófilos 19,8% e 11,3% e monócitos 20,17% e 18,25% respectivamente. Conclusão: Conclui-se que uma aula de ciclismo indoor com volume de 60 minutos e intensidade média de 71% da frequência cardíaca máxima, tem um potencial efeito munomodulador. (AU)

Introduction: It has been suggested that the practice of physical exercise can modulate the immune system. Objective: The aim of this study was to evaluate the influence of an indoor cycling class of white blood cell counts. The study included 12 volunteers, mean age 23 ± 4 years, able to physical exercise. Methods: Volunteers performed an indoor cycling class on stationary bike, volume 60 minutes and mean intensity of 71% of maximum heart rate. Results: After the indoor cycling class, during the recovery period (24 and 48 hours), was observed reduction in leukocyte count in 4% and 8.9%, lymphocyte 5% and 1.3%, neutrophils 19.8% and 11.3% and monocytes 18.25% and 20.17%, respectively. Conclusion: In conclusion the indoor cycling class with a volume of 60 minutes and mean intensity of 71% maximum heart rate, have a potential immune modulator effect. (AU)

EFEITOS DO TREINAMENTO EM JOGOS REDUZIDOS COM INFERIORIDADE NUMÉRICA NO FUTEBOL / EFFECTS OF TRAINING IN REDUCED MATCHES WITH NUMERICAL INFERIORITY IN FOOTBALL / EFECTOS DEL ENTRENAMIENTO EN PARTIDOS REDUCIDOS CON INFERIORIDAD NUMÉRICA EN EL FÚTBOL

RESUMO Introdução: Os jogos reduzidos são altamente eficientes, pois permitem a simulação de movimentos que ocorrem durante uma partida e geram melhor resposta fisiológica, perceptiva e técnico-tática. Objetivo: Comparar os efeitos do treinamento de jogos reduzidos com inferioridade numérica 3 vs. 4 e 4 vs. 5 sobre a variação da frequência cardíaca, percepção subjetiva de esforço e teste de atenção concentrada em atletas de futebol. Métodos: A amostra foi composta por 10 indivíduos do sexo masculino, com idade entre 17 e 24 anos. Para análise da frequência cardíaca média e máxima durante os jogos com campo reduzido e o coletivo foram utilizados monitores de frequência cardíaca e, para determinar a percepção subjetiva de esforço, utilizou-se de uma adaptação da escala de Borg. Também foi usado o teste de atenção concentrada. Resultados: Os resultados demonstram que os métodos de treino apresentam diferenças no teste de atenção concentrada (p < 0,004). A frequência cardíaca média (p < 0,121), máxima (p < 0,404) e a percepção de esforço (p < 0,639) não apresentam diferenças entre os métodos de treinamento. Conclusão: Concluímos que os jogos reduzidos com inferioridade numérica melhoram os resultados do teste de atenção concentrada.

ABSTRACT Introduction: Reduced games are highly efficient because they allow the simulation of movements that occur during a match and generate better physiological, perceptual and technical-tactical response. Objective: To compare the effects of reduced training games with numerical inferiority 3 vs. 4 and 4 vs. 5 on heart rate variation, subjective perception of exertion and focused attention test in soccer players. Methods: The sample consisted of 10 males, aged between 17 and 24 years. For the analysis of the mean and maximum heart rate during the games with reduced field and players, heart rate monitors were used, and to determine the subjective perception of effort, an adaptation of the Borg scale was used. The concentrated attention test was also used. Results: The results show that the training methods differ in the concentrated attention test (p<0.004). Mean heart rate (p<0.121), maximal (p<0.404), and perceived exertion (p<0.639) did not show differences between training methods. Conclusion: We conclude that the reduced games with numerical inferiority improve the results of the concentrated attention test.

RESUMEN Introducción: Los juegos reducidos son altamente eficientes porque permiten la simulación de movimientos que ocurren durante un partido y generan una mejor respuesta fisiológica, perceptual y técnico-táctica. Objetivo: Comparar los efectos de la reducción de los juegos de entrenamiento con inferioridad numérica 3 vs. 4 y 4 vs. 5 en la variación de la frecuencia cardiaca, la percepción subjetiva del esfuerzo y la atención enfocada en los jugadores de fútbol. Métodos: La muestra consistió en 10 varones, con edades comprendidas entre 17 y 24 años. Para analizar la frecuencia cardiaca media y máxima durante los juegos con campo reducido y menos jugadores se utilizaron monitores de frecuencia cardiaca y para determinar la percepción subjetiva del esfuerzo se utilizó una adaptación de la escala de Borg. También se utilizó la prueba de la atención concentrada. Resultados: Los resultados muestran que los métodos de entrenamiento difieren en la prueba de atención concentrada (p < 0,004). La frecuencia cardiaca media (p<0,121), máxima (p < 0,404) y el esfuerzo percibido (p < 0,639) no mostraron diferencias entre los métodos de entrenamient. Conclusión: Se concluye que los juegos reducidos con inferioridad numérica mejoran los resultados de la prueba de atención concentrada.

Efeito do treinamento aeróbio nos níveis de homocisteína em indivíduos diabéticos do tipo 2 / Effect of aerobic training on plasma levels of homocysteine in patients with type 2 diabetes / Efecto del entrenamiento aeróbico en los niveles de homocisteína en individuos diabéticos del tipo 2

INTRODUÇÃO: Os programas de treinamento aeróbio têm demonstrado bons resultados no controle das variáveis de risco cardiovascular em indivíduos diabéticos; no entanto, os efeitos nos níveis de homocisteína não estão claros. Objetivo: Analisar os efeitos do treinamento aeróbio nos níveis plasmáticos de homocisteína e fatores de risco cardiovascular em indivíduos diabéticos do tipo 2.MÉTODOS: Participaram do estudo 15 mulheres com diabetes do tipo 2 e média de idade 68,86 ± 11,2 anos. Todos os indivíduos da amostra foram submetidos a um teste de avaliação do consumo máximo de oxigénio (VO2máx) seguindo o protocolo de Bruce, avaliação da pressão arterial e avaliação antropométrica. Foi também efetuada uma coleta de 10 ml de sangue (veia antecubital) em jejum de no mínimo 12 horas. O plasma foi separado e processado para posterior análise da concentração de homocisteína (mmol/l), colesterol total (mg/dl), lipoproteína de muito baixa densidade (VLDL) (mg/dl), lipoproteína de baixa densidade (LDL) (mg/dl), lipoproteína de alta densidade (HDL) (mg/dl), triglicérides (mg/dl) e glicemia (mg/dl). Os testes foram feitos antes e após 16 semanas de treinamento aeróbio. O programa foi realizado com 2 sessões de treinamento não consecutivas por semana, com intensidade compreendida entre 60% e 70% da frequência cardíaca máxima e duração de 75 minutos por sessão.RESULTADOS: Os resultados observados revelam que o programa de exercício físico induziu uma diminuição não significativa da concentração plasmática de homocisteína. Foram ainda identificadas melhorias do perfil lipídico e do Consumo Máximo de Oxigênio (VO2máx), diminuição da glicemia, da pressão arterial diastólica, do percentual de gordura e massa gorda.CONCLUSÃO: Conclui-se que o programa de treinamento aeróbio reduziu o risco cardiovascular em indivíduos diabéticos do tipo 2, embora a alteração da homocisteína não tenha sido significativa.

INTRODUCTION: Aerobic training programs have shown good control of cardiovascular risk variables in diabetic subjects, but the effects on homocysteine levels remains unclear. Objective: To analyze the effects of aerobic training on plasma homocysteine levels and cardiovascular risk factors in patients with type 2 diabetes.METHODS: The study included 15 women with type 2 diabetes, mean age 68.86 ± 11.2 years. All individuals in the sample underwent an evaluation test of maximal oxygen uptake (VO2max) according to Bruce protocol, evaluation of blood pressure and anthropometric measurements. Additionally, a sample of venous blood (10ml from cubital vein) was drawn from subjects fasted for at least 12 hours. The plasma was separated and processed for further analysis of homocysteine concentration (mmol/l), total cholesterol (mg/dl), very low density lipoprotein (VLDL) (mg/dl), low density lipoprotein (LDL) (mg/dl), high density lipoprotein (HDL) (mg/dl), triglycerides (mg/dl) and blood glucose (mg/dl). The tests were done before the aerobic training and repeated 16 weeks later. The program consisted of 2 non-consecutive training sessions of 75 minutes a week, between 60% and 70% of maximum heart rate.RESULTS: The observed results show that physical exercise program induced a non-significant decrease in plasma concentration of homocysteine. Were also identified improvements in lipid profile and maximal oxygen uptake (VO2max), decreased blood glucose, diastolic blood pressure, body fat percentage and body fat.CONCLUSION: The aerobic training program reduced cardiovascular risk factor in individuals with type 2 diabetes, although homocysteine decline was not significant.

INTRODUCCIÓN: Los programas de entrenamiento aeróbico han demostrado buenos resultados en el control de las variables de riesgo cardiovascular en individuos diabéticos, sin embargo, los efectos en los niveles de homocisteína no están claros. Objetivo: Analizar los efectos del entrenamiento aeróbico en los niveles plasmáticos de homocisteína y factores de riesgo cardiovascular en individuos diabéticos del tipo 2.MÉTODOS: Participaron en el estudio 15 mujeres con diabetes del tipo 2 y promedio de edad de 68,86 ± 11,2 años. Todos los individuos de la muestra fueron sometidos a un test de evaluación del consumo máximo de oxígeno (VO2máx) siguiendo el protocolo de Bruce, evaluación de la presión arterial y evaluación antropométrica. Fue también efectuada una colecta de 10 ml de sangre (vena antecubital) en ayunas de como mínimo 12 horas. El plasma fue separado y procesado para posterior análisis de la concentración de homocisteína (mmol/l), colesterol total (mg/dl), Lipoproteína de Muy Baja Densidad (VLDL) (mg/dl), Lipoproteína de Baja Densidad (LDL) (mg/dl), Lipoproteína de Alta Densidad (HDL) (mg/dl), triglicéridos (mg/dl) y glucemia (mg/dl). Los tests fueron realizados antes y después de 16 semanas de entrenamiento aeróbico. El programa fue realizado con 2 sesiones de entrenamiento no consecutivas por semana, con una intensidad comprendida entre 60-70% de la frecuencia cardíaca máxima y una duración de 75 minutos por sesión.RESULTADOS: Los resultados observados revelan que el programa de ejercicio físico indujo a una disminución no significativa de la concentración plasmática de homocisteína. Fueron además identificadas mejoras del perfil lipídico y del Consumo Máximo de Oxígeno (VO2máx), disminución de la glucemia, de la presión arterial diastólica, del porcentual de grasa y masa gorda.CONCLUSIÓN: Se concluye que el programa de entrenamiento aeróbico redujo el riesgo cardiovascular en individuos diabéticos del tipo 2, aunque la alteración de la homocisteína no haya sido significativa.

Contagens leucocitárias e sintomas de infecções respiratórias após curto período de treinamento concorrente / Leukocyte counts and symptoms of upper respiratory tract infections after a short period of concurrent training

Introdução: Pessoas comumente iniciam a prática de exercícios por períodos não compatíveis com o nível de treinabilidade, podendo induzir diminuição da competência imunológica. Objetivos: Analisar as possíveis modulações nas contagens dos leucócitos circulantes e incidência de sintomas de infecções do trato respiratório superior, ao final de uma semana de treinamento concorrente. Métodos: Participaram dez voluntários do gênero masculino e sedentários, submetidos a uma semana de treino concorrente com cinco sessões em dias sequenciais, apresentando intensidades moderadas e duração de cem minutos. Resultados: Não foram observadas alterações nas contagens dos leucócitos. Quanto aos sintomas de infecções do trato respiratório superior, 10% dos voluntários apresentaram coriza, 20% congestão nasal e 40% dor de cabeça ao final da intervenção. Conclusões: A referida intervenção não apresenta potencial para modular negativamente as contagens dos leucócitos. Contudo, a incidência de sintomas de infecções do trato respiratório superior pode estar associada à diminuição da funcionalidade celular, possivelmente decorrente do volume delineado nas sessões.

Introduction: People often begin to practice exercises for periods not compatible with their level of trainability, and this could to induce a decrease in immune competence. Objective: To analyze the possible modulations in counts of circulating leukocytes and incidence of infections of the upper respiratory tract symptoms at the end of a week of concurrent training. Methods: A total of ten volunteers and sedentary male gender underwent a week of concurrent training sessions with five sequential days, with moderate intensity and duration of hundred minutes. Results: No changes were observed in leukocyte counts. As symptoms of upper respiratory tract infections, 10% of the volunteers had coryza, 20% nasal congestion, and 40% headache at the end of intervention. Conclusions: Such intervention has no potential to negatively modulate leukocyte counts. However, the incidence of symptoms of upper respiratory tract infections may be associated with decreased cellular functionality, possibly due to the volume outlined in the sessions.

Effects of physical activity and training programs on plasma homocysteine levels: a systematic review.

Homocysteine is an amino acid produced in the liver that, when present in high concentrations, is thought to contribute to plaque formation and, consequently, increased risk of cardiovascular disease. However, daily physical activity and training programs may contribute to controlling atherosclerosis. Given that physical exercise induces changes in protein and amino acid metabolism, it is important to understand whether homocysteine levels are also affected by exercise and to determine possible underlying mechanisms. Moreover, regarding the possible characteristics of different training programs (intensity, duration, repetition, volume), it becomes prudent to determine which types of exercise reduce homocysteine levels. To these ends, a systematic review was conducted to examine the effects of daily physical activity and different training programs on homocysteine levels. EndNote(®) was used to locate articles on the PubMed database from 2002 to 2013 with the keyword combinations "physical activity and homocysteine", "training and homocysteine", and/or "exercise and homocysteine". After 34 studies were identified, correlative and comparative studies of homocysteine levels revealed lower levels in patients engaged in greater quantities of daily physical activity. Regarding the acute effects of exercise, all studies reported increased homocysteine levels. Concerning intervention studies with training programs, aerobic training programs used different methods and analyses that complicate making any conclusion, though resistance training programs induced decreased homocysteine levels. In conclusion, this review suggests that greater daily physical activity is associated with lower homocysteine levels and that exercise programs could positively affect homocysteine control.