Supervised Exercise Immediately After Bariatric Surgery: the Study Protocol of the EFIBAR Randomized Controlled Trial.

BACKGROUND: Previous studies have investigated weight loss caused by exercise following bariatric surgery. However, in most cases, the training program is poorly reported; the exercise type, volume, and intensity are briefly mentioned; and the sample size, selection criteria, and follow-up time vary greatly across studies. PURPOSE: The EFIBAR study aims to investigate over 1 year the effects of a 16-week supervised exercise program, initiated immediately after bariatric surgery, on weight loss (primary outcome), body composition, cardiometabolic risk, physical fitness, and quality of life in patients with severe/extreme obesity. MATERIAL AND METHODS: The EFIBAR study is a parallel-group, superiority, randomized controlled trial (RCT), comprising 80 surgery patients. Half of the participants, randomly selected, perform a 16-week supervised exercise program, including both strength and aerobic training, starting immediately after the surgery (7-14 days). For each participant, all primary and secondary outcomes are measured at three different time points: (i) before the surgery, (ii) after the intervention (≈4 months), and (iii) 1 year after the surgery. CONCLUSION: The EFIBAR study will provide new insights into the multidimensional benefits of exercise in adults with severe/extreme obesity following bariatric surgery. TRIAL REGISTRATION: EFIBAR randomized controlled trial was prospectively registered at Clinicaltrials.gov (NCT03497546) on April 13, 2018.

Effects of Tele-Rehabilitation Compared with Home-Based in-Person Rehabilitation for Older Adult's Function after Hip Fracture.

This study aimed to examine the effect of a multidisciplinary tele-rehabilitation program on functional recovery of older adults with hip fracture compared with home-based in-person rehabilitation. In this single-blinded, non-randomized clinical trial, we included older with hip fracture. The tele-rehabilitation group received a 12-week tele-rehabilitation program (supervised by their family caregivers). The control group received the usual postoperative rehabilitation provided by the Andalusian health system (Spain). The primary outcome was the patient-reported functional status assessed with the Functional Independence Measure. We also measured performance-based functional recovery using the Timed Up and Go Test and Short Physical Performance Battery. We performed both a per-protocol (62 participants; 28 tele-rehabilitation and 34 control groups) and an intention-to-treat analysis (71 participants; 35 tele-rehabilitation and 36 control groups). Participants who used the tele-rehabilitation program had higher Functional Independence Measure scores (high effect size: 0.98 Cohen's d; p < 0.001) and better performance in the Timed Up and Go Test (medium effect size: 0.63 Cohen's d; p = 0.025) compared with the control group. Differences between groups post-intervention were not statistically significant in the Short Physical Performance Battery. The tele-rehabilitation intervention proposed in this study is a valuable treatment option in the recovery process for older adults with hip fracture. ClinicalTrials.gov Identifier: NCT02968589.

Low cardiorespiratory fitness and obesity for ADHD in childhood and adolescence: A 6-year cohort study.

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent disorder in childhood and identifying risk factors associated with developing ADHD during childhood and adolescence is relevant from a clinical and epidemiological point of view. This work examines (a) whether overweight/obesity and low cardiorespiratory fitness (CRF) are associated with increased ADHD symptoms in childhood (cross-sectional analysis), and (b) whether overweight/obesity and low CRF levels during childhood predict increased ADHD symptoms in adolescence (longitudinal analysis). Data were examined from a longitudinal study of Estonian inhabitants who took part in the European Youth Heart Study (EYHS) in 1998 and 1999 (baseline age 9 years), who were re-evaluated 6 years later as part of the longitudinal Estonian Children Personality Behaviour and Health Study (ECPBHS). CRF was determined via an incremental maximal cycle-ergometer test, overweight/obesity was based on body mass index (BMI), and the 7-point af Klinteberg Hyperactivity Scale was used to assess ADHD symptoms at both time points. In the cross-sectional analysis, children with overweight/obesity were at greater risk of ADHD symptoms compared to underweight/normal weight children, as were those unfit compared to fit children (OR = 1.92 and 95%CI = 1.02-3.55, and OR = 1.84 and 95%CI = 1.13-2.98, respectively). The cross-sectional association between BMI and ADHD symptoms was mediated by CRF (z = 2.116, 42.9%; P = .034). The longitudinal analysis showed being unfit in childhood was associated with a greater risk of increased ADHD symptoms 6 years later in adolescence (OR = 2.26 and 95%CI = 1.14-4.47), even after adjusting for baseline ADHD symptoms and BMI. Our result suggests that being unfit is an additional risk factor for increased ADHD symptoms during childhood and adolescence. The association between BMI and ADHD symptoms was mediated by CRF in the cross-sectional analysis, and no association was seen between overweight/obesity and increased ADHD symptoms.

Assessment of autonomous nerve system through non-linear heart rate variability outcomes in sedentary healthy adults.

BACKGROUND: Heart rate variability (HRV) is a psycho-physiological phenomenon with broad health implications. Different data analysis methods have been used to assess the autonomic nervous system activity, but the validation of new indexes that accurately describe its balance through non-invasive methods (i.e., HRV analysis) is of clinical interest. This study aimed: (i) to evaluate the association of the Stress Score (SS) and the Sympathetic/Parasympathetic Ratio (S/PS) with time domain and frequency domain analysis of HRV, and (ii) to set reference values of SS and S/PS in sedentary healthy adults. METHODS: A total of 156 sedentary healthy adults (38.4 ± 15.57 years old, 81 women), aged were involved in this study. HRV was measured for 15 min in a supine position at rest. SS and S/PS were calculated from the non-linear HRV analyses based on Poincare Plot. RESULTS: Stress Score showed a non-linear negative power-law relationship with SDNN (ß = -0.969; R 2 = 0.963; P < 0.001), RMSSD (ß = -0.867; R 2 = 0.722; P < 0.001), high frequency (ß = -0.834; R 2 = 0.752; P =< 0.001), low frequency (ß = -0.627; R 2 = 0.330; P < 0.001), SD1 (ß = -0.867; R 2 = 0.722; P < 0.001) and SD2 (ß = -1.000; R 2 > 0.999; P < 0.001). There was observed a negative cubic relationship between SS with PNN50 (ß = -1.972; R 2 = 0.644; P < 0.001). A linear regression model was conducted between SS with Ratio Low/High Frequency (ß = 0.026; R 2 < 0.001; P = 0.750). Non-linear power-law regression models were built between S/PS and SDNN (ß = -0.990; R 2 = 0.981; P < 0.001), RMSSD (ß = -0.973; R 2 = 0.939; P < 0.001), high frequency (ß = -0.928; R 2 = 0.970; P < 0.001), low frequency (ß = -2.344; R 2 = 0.557; P < 0.001), SD1 (ß = -0.973; R 2 = 0.939; P < 0.001) and SD2 (ß = -0.611; R 2 = 0.908; P < 0.001). A non-linear negative regression model was built between S/PS and PNN50 (ß = -3.412; R 2 = 0.868; P < 0.001). A linear regression model was conducted between S/PS and SD2/SD1 (ß = 0.075; R 2 = 0.006; P < 0.001). CONCLUSION: Our results support the use of SS as a sympathetic activity marker, and S/PS as an indicator of the sympathetic and parasympathetic activity of the autonomic nervous system in sedentary healthy adults.

Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project.

OBJECTIVES: To analyze the association of sedentary time and physical activity (PA) intensity levels with immunometabolic markers during early pregnancy; and to examine if meeting the PA recommendations is associated with the immunometabolic profile of pregnant women. METHODS: Fifty Caucasian pregnant women (age: 32.8 ± 4.7 years old, body mass index: 24.2 ± 4.1kg/m2 , gestational age: 17 ± 1.5weeks) participated in this cross-sectional study (from September 2015 through May 2016). Sedentary time and PA intensity levels were objectively measured with triaxial accelerometer (seven consecutive valid days). Fasting serum glucose, total cholesterol, phospholipids, and triglycerides were assessed with standard methods. Serum pro-inflammatory and anti-inflammatory cytokines (fractalkine, interleukin-1ß, interleukin-6, interleukin-8, interleukin-10, interferon-γ, and tumor necrosis factor-α) were measured using Luminex xMAP technology. RESULTS: Sedentary time and PA were not correlated with any glycemic or lipid marker (P > .05). After adjusting for the potential confounders, vigorous PA showed a positive non-significant association with interleukin-6 (P = .06), and bouts of moderate-vigorous PA was inversely associated with interleukin-1ß and interferon-γ (P = .02 and P = .04, respectively). Meeting the PA guidelines was inversely associated with interleukin-1ß and positively associated with interleukin-8 (P = .01 and P = .04, respectively). These associations disappeared after controlling for multiplicity. CONCLUSIONS: Increasing the time spent in moderate-vigorous PA, or meeting the PA recommendations, is associated with the cytokine profile of women without metabolic disruptions in early pregnancy. However, sedentary time and PA do not seem to be associated with glucose or lipid levels. These results should be interpreted cautiously in view of the discrepancies after adjusting for multiple comparisons. Future studies in this novel field of research are warranted before reaching any conclusion.

Influence of a Concurrent Exercise Training Intervention during Pregnancy on Maternal and Arterial and Venous Cord Serum Cytokines: The GESTAFIT Project.

The aim of the present study was to analyze the influence of a supervised concurrent exercise-training program, from the 17th gestational week until delivery, on cytokines in maternal (at 17th and 35th gestational week, and at delivery) and arterial and venous cord serum. Fifty-eight Caucasian pregnant women (age: 33.5 ± 4.7 years old, body mass index: 23.6 ± 4.1kg/m2) from the GESTAFIT Project (exercise (n = 37) and control (n = 21) groups) participated in this quasi-experimental study (per-protocol basis). The exercise group followed a 60-min 3 days/week concurrent (aerobic-resistance) exercise-training from the 17th gestational week to delivery. Maternal and arterial and venous cord serum cytokines (fractalkine, interleukin (IL)-1ß, IL-6, IL-8, IL-10, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α) were assessed using Luminex xMAP technology. In maternal serum (after adjusting for the baseline values of cytokines), the exercise group decreased TNF-α (from baseline to 35th week, p = 0.02), and increased less IL-1ß (from baseline to delivery, p = 0.03) concentrations than controls. When adjusting for other potential confounders, these differences became non-significant. In cord blood, the exercise group showed reduced arterial IL-6 and venous TNF-α (p = 0.03 and p = 0.001, respectively) and higher concentrations of arterial IL-1ß (p = 0.03) compared to controls. The application of concurrent exercise-training programs could be a strategy to modulate immune responses in pregnant women and their fetuses. However, future research is needed to better understand the origin and clearance of these cytokines, their role in the maternal-placental-fetus crosstalk, and the influence of exercise interventions on them.

Exercise training as S-Klotho protein stimulator in sedentary healthy adults: Rationale, design, and methodology.

AIMS: The secreted form of the α-Klotho gene (S-Klotho), which is considered a powerful biomarker of longevity, makes it an attractive target as an anti-ageing therapy against functional decline, sarcopenic obesity, metabolic and cardiovascular diseases, osteoporosis, and neurodegenerative disorders. The S-Klotho plasma levels could be related to physical exercise inasmuch physical exercise is involved in physiological pathways that regulate the S-Klotho plasma levels. FIT-AGEING will determine the effect of different training modalities on the S-Klotho plasma levels (primary outcome) in sedentary healthy adults. FIT-AGEING will also investigate the physiological consequences of activating the klotho gene (secondary outcomes). METHODS: FIT-AGEING will recruit 80 sedentary, healthy adults (50% women) aged 45-65 years old. Eligible participants will be randomly assigned to a non-exercise group, i.e. the control group, (n = 20), a physical activity recommendation from World Health Organization group (n = 20), a high intensity interval training group (n = 20), and a whole-body electromyostimulation group (n = 20). The laboratory measurements will be taken at the baseline and 12 weeks later including the S-Klotho plasma levels, physical fitness (cardiorespiratory fitness, muscular strength), body composition, basal metabolic rate, heart rate variability, maximal fat oxidation, health blood biomarkers, free-living physical activity, sleep habits, reaction time, cognitive variables, and health-related questionnaires. We will also obtain dietary habits data and cardiovascular disease risk factors.

Effect of eight weeks of upper-body plyometric training during the competitive season on professional female volleyball players.

BACKGROUND: The purpose of this study was to assess the effect of incorporating specific upper-body plyometric training for the spike into the competitive season of a women's professional volleyball team. METHODS: A professional team from the Spanish first division participated in the study. An A-B-A' quasi-experimental design with experimental and control groups was used. The independent variable was the upper-body plyometric training for eight weeks during the competitive season. The dependent variables were the spiked ball's speed (km/h); the player's body weight (kg), BMI (kg/m2), and muscle percentage in arms (%); 1 repetition maximum (1RM) in the bench press (kg); 1RM in the pullover (kg); and overhead medicine ball throws of 1, 2, 3, 4, and 5 kg (m). Inter-player and inter-group statistical analyses of the results were carried out (Wilcoxon test and linear regression model). RESULTS: The experimental group significantly improved their spike speed 3.8% from phase A to phase B, and they maintained this improvement after the retention phase. No improvements were found in the control group. The experimental group presented a significant improvement from phase A to phase B in dominant arm muscle area (+10.8%), 1RM for the bench press (+8.41%), 1RM for the pullover (+14.75%), and overhead medicine ball throws with 1 kg (+7.19%), 2 kg (+7.69%), and 3 kg (+5.26%). The control group did not present differences in these variables. CONCLUSIONS: Data showed the plyometric exercises that were tested could be used by performance-level volleyball teams to improve spike speed. The experimental group increased their upper-body maximal strength, their power application, and spike speed.

Evaluación de la capacidad cardiorrespiratoria en niños de edad preescolar: adaptación del test de 20m de ida y vuelta / Assessment of cardiorspiratory fitness in preschool children: adaptation of the 20 metres shuttle run test

La capacidad cardiorrespiratoria es un potente indicador de salud presente y futura en niños y adolescentes, sin embargo se desconoce si también lo es para niños de edad reescolar, de 3 a 5 años. En el presente estudio, describimos la adaptación a preescolares del test original de 20m de ida y vuelta, su viabilidad y asimilación en niños de 3 a 5 años, así como su maximalidad y fiabilidad. Un total de 130 alumnos (4,91 ± 0,89 años; 77 niños), realizaron el test dos veces, con dos semanas de separación. La adaptación del test consistió principalmente en reducir la velocidad inicial de 8,5 km/h a 6,5 km/h. El test fue viable y tuvo una buena asimilación tanto en niños como en niñas y en los tres grupos de edad, 3, 4 y 5 años. La frecuencia cardíaca máxima (FCmáx) alcanzada para la muestra completa fue de 199,4 ± 12,5 latidos/minuto, equivalente a un 97% de la FCmáx teórica estimada, y sin diferencias significativas por sexo o edad. La diferencia de medias test-retest (error sistemático) en el número de vueltas alcanzado fue de 2 vueltas, sin diferencias por sexo o edad. No hubo evidencia de heterocedasticidad. Nuestros resultados sugieren que el test es máximo y fiable en este grupo de edad. Futuros estudios de intervención o longitudinales que utilicen este test deberían tener en cuenta que cambios en el rendimiento en el test de 2 vueltas podrían deberse a la propia variabilidad de la medida, mientras que cambios de mayor magnitud podrían ser atribuibles a la intervención o cambios asociados a la edad (AU)

Cardiorespiratory fitness is a strong indicator of present and future health in children and adolescents, however it is unknown whether it is for pre-schoolers, from 3 to 5 years. In the present study, we described the adaptation of the original 20m shuttle run test, it feasibility and acceptance in children from 3 to 5 years and its maximality and reliability. A total of 130 students (4.91 ± 0.89 years; 77 boys) performed the test twice, two weeks apart. The test adaptation consisted mainly in reducing the initial speed of 8.5 km/h to 6.5 km/h. The test was feasible and was well accepted in both boys and girls and the three age groups, 3, 4 and 5 years. The maximum heart rate (MHR) achieved for the entire sample was 199.4 ± 12.5 beats/min, equivalent to 97% of the estimated theoretical MHR, and no significant differences by gender or age. Mean test-retest difference (systematic error) in the number of laps achieved was 2 laps, with no significant differences between sex or age. There was no evidence of heteroscedasticity. Our results suggest the test is maximum and reliable in this age group. Future longitudinal or intervention studies using this test should take into account that changes in the test performance of 2 laps may be due to the variability of the measure, while wider changes would be attributable to the intervention or changes associated with age (AU)

[Assessment of cardiorespiratory fitness in preschool children: adaptation of the 20 metres shuttle run test]. / Evaluación de la capacidad cardiorrespiratoria en niños de edad preescolar: adaptación del test de 20m de ida y vuelta.

Cardiorespiratory fitness is a strong indicator of present and future health in children and adolescents, however it is unknown whether it is for pre-schoolers, from 3 to 5 years. In the present study, we described the adaptation of the original 20m shuttle run test, it feasibility and acceptance in children from 3 to 5 years and its maximality and reliability. A total of 130 students (4.91 ± 0.89 years; 77 boys) performed the test twice, two weeks apart. The test adaptation consisted mainly in reducing the initial speed of 8.5 km/h to 6.5 km/h. The test was feasible and was well accepted in both boys and girls and the three age groups, 3, 4 and 5 years. The maximum heart rate (MHR) achieved for the entire sample was 199.4 ± 12.5 beats/min, equivalent to 97% of the estimated theoretical MHR, and no significant differences by gender or age. Mean test-retest difference (systematic error) in the number of laps achieved was 2 laps, with no significant differences between sex or age. There was no evidence of heteroscedasticity. Our results suggest the test is maximum and reliable in this age group. Future longitudinal or intervention studies using this test should take into account that changes in the test performance of 2 laps may be due to the variability of the measure, while wider changes would be attributable to the intervention or changes associated with age.

La capacidad cardiorrespiratoria es un potente indicador de salud presente y futura en niños y adolescentes, sin embargo se desconoce si también lo es para niños de edad preescolar, de 3 a 5 años. En el presente estudio, describimos la adaptación a preescolares del test original de 20m de ida y vuelta, su viabilidad y asimilación en niños de 3 a 5 años, así como su maximalidad y fiabilidad. Un total de 130 alumnos (4,91 ± 0,89 años; 77 niños), realizaron el test dos veces, con dos semanas de separación. La adaptación del test consistió principalmente en reducir la velocidad inicial de 8,5 km/h a 6,5 km/h. El test fue viable y tuvo una buena asimilación tanto en niños como en niñas y en los tres grupos de edad, 3, 4 y 5 años. La frecuencia cardíaca máxima (FCmáx) alcanzada para la muestra completa fue de 199,4 ± 12,5 latidos/minuto, equivalente a un 97% de la FCmáx teórica estimada, y sin diferencias significativas por sexo o edad. La diferencia de medias test-retest (error sistemático) en el número de vueltas alcanzado fue de 2 vueltas, sin diferencias por sexo o edad. No hubo evidencia de heterocedasticidad. Nuestros resultados sugieren que el test es máximo y fiable en este grupo de edad. Futuros estudios de intervención o longitudinales que utilicen este test deberían tener en cuenta que cambios en el rendimiento en el test de 2 vueltas podrían deberse a la propia variabilidad de la medida, mientras que cambios de mayor magnitud podrían ser atribuibles a la intervención o cambios asociados a la edad.

Effects of the amount and source of dietary protein on bone status in rats.

This study examined the effects of the dietary amount and source of protein on bone status in rats. 140 male Wistar rats aged 8 weeks were randomly allocated to 4 groups (n = 35) fed normal-protein (NP, 10% richness) or high-protein (HP, 45% richness) diets based on whey protein (WP) or soy protein (SP) sources for 12 weeks. Plasma urea was 46% higher for the HP compared to the NP diet (p < 0.001). Urinary calcium was 65% higher for the HP compared to the NP and 60% higher for the WP compared to the SP diets (all, p < 0.001). Urinary pH was 8% more acidic in the HP compared to the NP diet (p < 0.001) and 4% in the WP compared to the SP diet (p < 0.01). The plasma osteocalcin concentration was 19% higher for the NP compared to the HP (p < 0.05) and 25% for the SP compared to the WP diets (p < 0.01). Femur ash, metaphyseal and diaphyseal cross-sectional, trabecular and cortical areas were 3% higher in the HP compared to the NP diet (all, p < 0.05). Femur diaphyseal periosteal and endocortical perimeters were also 3% higher in the HP compared to the NP diet (both, p < 0.01). Groups fed the SP diet showed 2% higher femur ash percentage, 7% higher calcium content (both, p < 0.001), and 3% higher diaphyseal cortical area and thickness (both, p < 0.05) than those fed the WP diet. Some interactions were found, such as the greater effects of the SP diet on decreasing the higher plasma urea concentration promoted by the intake of the HP diet (p < 0.001). Under adequate Ca intake, HP diets could better maintain bone properties than NP diets, even with increasing some acidity markers, which could be reduced by the intake of SP sources.

ACTN3 R577X polymorphism and team-sport performance: a study involving three European cohorts.

OBJECTIVES: To determine the association between the α-actinin-3 (ACTN3) R577X polymorphism and elite team-sport athletic status in three cohorts of European team-sport athletes. DESIGN: We compared the genotype and allele frequencies of the ACTN3 R577X (rs1815739) polymorphisms between team-sport athletes (n=205), endurance athletes (n=305), sprint/power athletes (n=378), and non-athletic controls (n=568) from Poland, Russia and Spain; all participants were unrelated European men. METHODS: Genomic DNA was extracted from either buccal epithelium or peripheral blood using a standard protocol. Genotyping was performed using several methods, and the results were replicated following recent recommendations for genotype-phenotype association studies. RESULTS: Genotype distributions of all control and athletic groups met Hardy-Weinberg equilibrium (all p>0.05). Team-sport athletes were less likely to have the 577RR genotype compared to the 577XX genotype than sprint/power athletes [odds ratio: 0.58, 95% confidence interval: 0.34-0.39, p=0.045]. However, the ACTN3 R577X polymorphism was not associated with team-sports athletic status, compared to endurance athletes and non-athletic controls. Furthermore, no association was observed for any of the genotypes with respect to the level of competition (elite vs. national level). CONCLUSIONS: The ACTN3 R577X polymorphism was not associated with team-sport athletic status, compared to endurance athletes and non-athletic controls, and the observation that the 577RR genotype is overrepresented in power/sprint athletes compared with team-sport athletes needs to be confirmed in future studies.

Objectively measured sedentary time and physical activity in women with fibromyalgia: a cross-sectional study.

OBJECTIVES: To characterise levels of objectively measured sedentary time and physical activity in women with fibromyalgia. DESIGN: Cross-sectional study. SETTING: Local Association of Fibromyalgia (Granada, Spain). PARTICIPANTS: The study comprised 94 women with diagnosed fibromyalgia who did not have other severe somatic or psychiatric disorders, or other diseases that prevent physical loading, able to ambulate and to communicate and capable and willing to provide informed consent. PRIMARY OUTCOME MEASURES: Sedentary time and physical activity were measured by accelerometry and expressed as time spent in sedentary behaviours, average physical activity intensity (counts/minute) and amount of time (minutes/day) spent in moderate intensity and in moderate-to-vigorous-intensity physical activity (MVPA). RESULTS: The proportion of women meeting the physical activity recommendations of 30 min/day of MVPA on 5 or more days a week was 60.6%. Women spent, on average, 71% of their waking time (approximately 10 h/day) in sedentary behaviours. Both sedentary behaviour and physical activity levels were similar across age groups, waist circumference and percentage body fat categories, years since clinical diagnosis, marital status, educational level and occupational status, regardless of the severity of the disease (all p>0.1). Time spent on moderate-intensity physical activity and MVPA was, however, lower in those with greater body mass index (BMI) (-6.6 min and -7 min, respectively, per BMI category increase, <25, 25-30, >30 kg/m(2); p values for trend were 0.056 and 0.051, respectively). Women spent, on average, 10 min less on MVPA (p<0.001) and 22 min less on sedentary behaviours during weekends compared with weekdays (p=0.051). CONCLUSIONS: These data provide an objective measure of the amount of time spent on sedentary activities and on physical activity in women with fibromyalgia.

The ACTN3 R577X polymorphism across three groups of elite male European athletes.

The ACTN3 R577X polymorphism (rs1815739) is a strong candidate to influence elite athletic performance. Yet, controversy exists in the literature owing to between-studies differences in the ethnic background and sample size of the cohorts, the latter being usually low, which makes comparisons difficult. In this case:control genetic study we determined the association between elite athletic status and the ACTN3 R577X polymorphism within three cohorts of European Caucasian men, i.e. Spanish, Polish and Russian [633 cases (278 elite endurance and 355 power athletes), and 808 non-athletic controls]. The odds ratio (OR) of a power athlete harbouring the XX versus the RR genotype compared with sedentary controls was 0.54 [95% confidence interval (CI): 0.34-0.48; P=0.006]. We also observed that the OR of an endurance athlete having the XX versus the RR genotype compared with power athletes was 1.88 (95%CI: 1.07-3.31; P=0.028). In endurance athletes, the OR of a "world-class" competitor having the XX genotype versus the RR+RX genotype was 3.74 (95%CI: 1.08-12.94; P=0.038) compared with those of a lower ("national") competition level. No association (P>0.1) was noted between the ACTN3 R577X polymorphism and competition level (world-class versus national-level) in power athletes. Our data provide comprehensive support for the influence of the ACTN3 R577X polymorphism on elite athletic performance.

Are there gender differences in quality of life and symptomatology between fibromyalgia patients?

The purpose of this study is to examine gender differences in quality of life (QoL) and symptomatology in fibromyalgia (FM) patients. A total of 20 men (48.0 ± 8.0 years) and 78 women (49.8 ± 7.2 years) with FM participated in the study (age range 31-63 years). Health-related QoL and FM impact were assessed by means of the Spanish versions of the Short-Form-36 Health Survey (SF36) and the Fibromyalgia Impact Questionnaire (FIQ), respectively. Comparisons in QoL were performed using one-way analysis of covariance adjusted by age and body mass index (BMI), and comparisons in FIQ dimensions were performed using Mann-Whitney test. Overall FM impact, as measured by FIQ-total score (p = .01) and FIQ-physical impairment (p = .02) was higher in men, whereas women presented higher values of FIQ-fatigue and FIQ-morning tiredness (p = .04) and less SF36-vitality (p = .02). Therefore, women appear to feel more fatigue, whereas men present higher FM overall impact. Due to the small number of men included in this study and the consequent small statistical power, these results should be taken as preliminary. Higher powered studies are warranted to further address gender differences in FM in order to design more successful treatments.

Land- and water-based exercise intervention in women with fibromyalgia: the al-Andalus physical activity randomised controlled trial.

BACKGROUND: The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. METHODS/DESIGN: One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. DISCUSSION: Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT01490281.

La actividad física en adolescentes no muestra relación con el consumo máximo de oxígeno / Physical activity is not associated with maximum consumption of oxygen in adolescents

Introducción y objetivos: La capacidad aeróbica es un potente factor de riesgo cardiovascular e indicador de salud. La actividad física es también reconocida como un importante componente del estilo de vida saludable. Sin embargo, la relación entre capacidad aeróbica y actividad física no está muy clara en adolescentes. Por ello, el objetivo del presente estudio fue examinar la asociación entre el VO2max como medida objetiva de la capacidad aeróbica y la actividad física, medida con el International Physical Activity Questionnaire (IPAQ), en adolescentes. Método: En el estudio participaron un total de 155 adolescentes (79 chicos y 76 chicas) de 15-18 años de edad. El VO2max fue medido de manera directa a través de un analizador de gases portátil (K4b2, Cosmed) durante la realización del 20 Meter Shuttle Run test. El grado de actividad física y el gasto energético se estimaron mediante el IPAQ en su versión corta autoadministrada. Resultados: Los chicos mostraron una mayor capacidad aeróbica y nivel de actividad física con respecto a las chicas (p≤0.001). No se encontraron relaciones significativas entre el gasto energético estimado (MET) y las variables de capacidad aeróbica, tanto en chicos como en chicas. Conclusiones: El nivel de actividad física medido a través del IPAQ no se relaciona consistentemente con la capacidad aeróbica (VO2max), por lo que recomendamos la utilización de otros métodos de medida más objetivos, fiables y factibles de ser utilizados en el ámbito educativo y sanitario. En base a los resultados que muestran una baja capacidad aeróbica de los adolescentes estudiados, coincidimos con la tendencia actual de demandar el desarrollo de programas específicos para mejorar la capacidad aeróbica de la población, con objeto de prevenir enfermedades cardiovasculares en la edad adulta (AU)

Introduction and objectives: Aerobic capacity is a potent factor of cardiovascular risk and health index. Physical activity is recognized also as an important component of healthy wayof life. Nevertheless, the relation between aerobic capacity and physical activity is not very clear in adolescents. The main purpose of this study was to examine the relationship between VO2max, as objective measure of the aerobic capacity, and the physical activity measured by means of the International Physical Activity Questionnaire (IPAQ), in adolescents. Method: A total of 155 adolescents of 15-18 years-old (79 boys and 76 girls) participated in the study. VO2max was objectively assessed using a portable gas analyzer (K4b2, Cosmed) during the 20 m Shuttle Run Test. Physical activity level and energy expenditure were estimated using the short IPAQ form. Results: Boys showed significantly bigger aerobic capacity and physical activity level than girls (p≤0.001). No relationships were found between energy expenditure measured by the IPAQ and variables of aerobic capacity in any gender. Conclusions: Physical activity level assessment by means of IPAQ (short auto-administered version) is not very reliable as predictive factor of aerobic capacity (VO2max) in adolescents. Therefore it is recommended to use other more objective measure methods, reliable and feasible that can be used in the educational and sanitary area. Finally, on the basis of the results that show a low aerobic capacity of the studied adolescents, we coincide with the current trend of demanding the development of specific programs to improve the aerobic capacity of the population, in order to prevent cardiovascular diseases in adult age (AU)

Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population.

Heavy metal contamination from occupational origin is a cause for concern because of its potential accumulation in the environment and in living organisms leading to long term toxic effects. This study was aimed to assess Cd, Cr, Mn, Ni and Pb levels in whole blood, urine, axillary hair and saliva from 178 individuals with occupational exposure to heavy metals. Levels of metal compounds were determined by atomic absorption spectrometry. We collected information on occupation, lifestyle habits and food intake by questionnaire. Multiple linear regression analyses for metal ion concentration in whole blood, urine, axillary hair and saliva were adjusted for age, gender, smoking and alcohol consumption, lifetime workplace exposure, residence area and food habits. Overall, blood and urine median concentrations found for the five metals analyzed do not exceed biological exposure indexes, so that they are very similar to a non-occupationally exposed population. Toxicokinetic differences may account for the lack of correlations found for metal levels in hair and saliva with those in blood or urine. For those heavy metals showing higher median levels in blood with respect to hair (Cd, Mn and Pb) indicating lesser hair incorporation from blood, the lifetime working experience was inversely correlated with their hair levels. The longer the lifetime working experience in industrial environments, the higher the Mn and Ni concentration in saliva. Axillary hair and saliva may be used as additional and/or alternative samples to blood or urine for biomonitoring hair Mn, and saliva Ni in subjects with occupational exposure.