COVID-19 pandemic and explicit processes towards physical activity in Brazilian older adults with hypertension.

This study investigated the initial three-month impact of the COVID-19 pandemic on the explicit processes towards physical activity (PA). In addition, we explored whether potential changes in explicit processes are associated with changes in PA and sedentary behavior (SB). Seventeen older adults (aged 65.7 ± 3.8 years; 76.5% women) with hypertension were included in this longitudinal study performed in Natal, Brazil. Explicit processes (explicit attitude [perceived benefits and cons perceived], social norms, social modeling, self-efficacy, intention and motivation) were evaluated through self-reported questionnaire before (January to March 2020) and during (June 2020) the COVID-19 pandemic. In addition, PA and SB were measured by accelerometry during seven days. Generalized linear and mixed models were used for data analysis. There was a decrease in the explicit attitudes (ß = - 4.8, p = 0.001) and moderate-vigorous PA (ß = - 4.8, p = 0.035) during the COVID-19. Changes in the explicit attitudes were associated with the changes in the moderate-vigorous PA (ß = - 1.6, 95% CI - 2.9, - 0.3, p = 0.034). No significant changes were found in the additional explicit process measures, time spent doing light PA and SB, and step count. Our findings may suggest that the COVID-19 pandemic has negatively impacted the explicit attitudes related to PA and contributed to decrease the time spent in the moderate-vigorous PA in older adults with hypertension.

Associations of objectively measured movement behavior and cardiorespiratory fitness with mental health and quality of life in older adults with hypertension: an exploratory analysis during the COVID-19 pandemic.

Objectives: Herein, we explored the associations of pre-pandemic COVID-19 physical activity (PA), sedentary behavior (SB) and cardiorespiratory fitness (CRF) with mental health and quality of life in older adults with hypertension.Method: Objectively measured PA and SB, perceived stress, depression symptoms, and quality of life were assessed before and during the pandemic in seventeen older adults with hypertension. CRF was assessed before the pandemic by cardiopulmonary exercise testing. Longitudinal and cross-sectional associations were analyzed using the mixed linear model.Results: Pre-pandemic light PA (positive association) and SB (negative association) were associated with quality of life during the pandemic. Higher pre-pandemic CRF was associated with less negative changes in perceived stress, depression symptoms, and quality of life during the pandemic.Conclusion: Our preliminary findings suggest that a healthier pre-pandemic movement behavior (more PA, less SB) and better CRF can mitigate the negative impact of the COVID-19 pandemic on mental health and quality of life in older adults with hypertension.

Catheter-related bloodstream infection due to Acinetobacter ursingii in a hemodialysis patient: case report and literature review.

Acinetobacter ursingii is an anaerobic gram negative opportunistic coccobacillus, rarely isolated in bacteremic patients. It is mainly found in immunocompromised and severely ill patients with no identifiable source of infection. When isolated into the bloodstream, it usually displays resistance to at least two antimicrobial agents. To date only seven cases of bacteremia due to this microorganism have been reported in adults, of which, this accounts for the second one associated to renal replacement therapy and the first case of a documented catheter-related bloodstream infection (CRBSI) in a patient with a hemodialysis catheter. A 78-year-old male presented into the emergency department with acute kidney injury requiring hemodialysis, later developing bacteremia due to Acinetobacter ursingii.

Housing type is associated with objectively measured changes in movement behavior during the COVID-19 pandemic in older adults with hypertension: An exploratory study.

PURPOSE: To investigate the association between housing characteristics with objectively measured changes in physical activity (PA) and sedentary behavior (SB) during the COVID-19 pandemic in older adults with hypertension. METHODS: Thirty-five older adults with hypertension were included in this exploratory study. Accelerometer-based PA and SB measures were assessed before and during a period of social distancing policy imposed due to the COVID-19 pandemic. Housing type, housing surface area and household size were tested as predictors of changes in PA and SB. A generalized linear mixed model was used for the analysis. RESULTS: Housing type was associated with changes in PA and SB. Individuals residing in an apartment showed a greater decrease in light PA on weekdays (ß= -65 min/day, p=0.035) and a trend for an increase in SB (ß= 55 min/day, p=0.056) compared to those residing in a detached house. Individuals residing in a row house showed a greater decrease in moderate-vigorous PA (ß= -10 min/day, p=0.037) and steps/day (ß= -2064, p=0.010) compared to those residing in a detached house. Individuals residing in an apartment showed a greater decrease in light PA on the weekends (ß= -83 min/day, p=0.015) and an increase in SB (ß= 72 min/day, p=0.036) compared to those residing in a detached house. No association was found for housing surface area and household size. CONCLUSIONS: Older adults with hypertension residing in an apartment or row house have greater unhealthy changes in movement behavior during the COVID-19 pandemic. Further studies are needed to confirm our preliminary findings.

Initial impact of the COVID-19 pandemic on physical activity and sedentary behavior in hypertensive older adults: An accelerometer-based analysis.

BACKGROUND: This study reports the accelerometer-based physical activity (PA) and sedentary behavior (SB) before and during the COVID-19 pandemic in hypertensive older adults. METHODS: Thirty-five hypertensive older adults were included in this observational study. Accelerometer-based PA and SB measures were assessed before (January to March 2020) and during (June 2020) the COVID-19 pandemic. Linear mixed models were used to assess within-group changes in PA and SB measures, adjusted by accelerometer wear time. RESULTS: Before COVID-19 pandemic participants presented: 5809 steps/day (SE = 366), 303.1 min/day (SE = 11.9) of light PA, 15.5 min/day (SE = 2.2) of moderate-vigorous PA, and 653.0 min/day (SE = 12.6) of SB. During COVID-19 pandemic there was a decrease in steps/day (ß = -886 steps/day, SE = 361, p = 0.018), in moderate-vigorous PA (ß = -2.8 min/day, SE = 2.4, p = 0.018), and a trend in light PA (ß = -26.6 min/day, SE = 13.4, p = 0.053). In addition, SB increased during the COVID-19 pandemic (ß = 29.6 min/day, SE = 13.4, p = 0.032). The magnitude of changes was greater on the weekend, mainly for steps/day (ß = -1739 steps/day, SE = 424, p < 0.001) and the SB pattern (more time spent in bouts of ≥10 and 30 min, less breaks/day and breaks/h). CONCLUSIONS: The COVID-19 pandemic may elicit unhealthy changes in movement behavior in hypertensive older adults. Lower PA, higher and more prolonged SB on the weekend are the main features of the behavioral changes.

Comparison of Three Adiposity Indexes and Cutoff Values to Predict Metabolic Syndrome Among University Students.

PURPOSE: Obesity and high body fat are related to diabetes and metabolic syndrome (MetS) in all ethnic groups. Based on the International Diabetes Federation (IDF) definition of MetS, the aim of the present study was to compare body adiposity indexes (BAIs) and to assess their various cutoff values for the prediction of MetS in university students from Colombia. METHODS: A cross-sectional study was conducted on 886 volunteers (51.9% woman; age mean 21.4 years). Anthropometric characteristics (height, weight, waist circumference [WC], and hip circumference [HC]) were measured, and body composition was assessed by bioelectrical impedance analysis. MetS was defined as including ≥3 of the metabolic abnormalities (WC, high-density lipoprotein cholesterol [HDL-C], triglycerides, fasting glucose, and systolic and diastolic blood pressure [BP]) in the definition provided by the IDF. The BAIs (i.e., BAI-HC [BAI], BAI-WC [BAI-w], and [BAI-p]) were calculated from formulas taking into account, height, weight, and WC, and for the visceral adiposity indexes, a formula, including WC, HDL-C, and triglycerides, was used. RESULTS: The overall prevalence of MetS was 5.9%, higher in men than in women. The most prevalent components were low HDL-C, high triglyceride levels, WC, and BP levels. The receiver operating characteristic curves analysis showed that BAI, BAI-w, and BAI-p could be useful tools to predict MetS in this population. CONCLUSION: For women, the optimal MetS threshold was found to be 30.34 (area under curve [AUC] = 0.720-0.863), 19.10 (AUC = 0.799-0.925), and 29.68 (AUC = 0.779-0.901), for BAI, BAI-w, and BAI-p, respectively. For men, the optimal MetS threshold was found to be 27.83 (AUC = 0.726-0.873), 21.48 (AUC = 0.755-0.906), and 26.18 (AUC = 0.766-0.894), for BAI, BAI-w, and BAI-p, respectively. The three indexes can be useful tools to predict MetS according to the IDF criteria in university students from Colombia. Data on larger samples are needed.

A Cross-Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study.

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.

Fatness mediates the influence of muscular fitness on metabolic syndrome in Colombian collegiate students.

The purpose of this study was two-fold: to analyze the association between muscular fitness (MF) and clustering of metabolic syndrome (MetS) components, and to determine if fatness parameters mediate the association between MF and MetS clustering in Colombian collegiate students. This cross-sectional study included a total of 886 (51.9% women) healthy collegiate students (21.4 ± 3.3 years old). Standing broad jump and isometric handgrip dynamometry were used as indicators of lower and upper body MF, respectively. Also, a MF score was computed by summing the standardized values of both tests, and used to classify adults as fit or unfit. We also assessed fat mass, body mass index, waist-to-height ratio, and abdominal visceral fat, and categorized individuals as low and high fat using international cut-offs. A MetS cluster score was derived by calculating the sum of the sample-specific z-scores from the triglycerides, HDL cholesterol, fasting glucose, waist circumference, and arterial blood pressure. Linear regression models were used to examine whether the association between MF and MetS cluster was mediated by the fatness parameters. Data were collected from 2013 to 2016 and the analysis was done in 2016. Findings revealed that the best profiles (fit + low fat) were associated with lower levels of the MetS clustering (p <0.001 in the four fatness parameters), compared with unfit and fat (unfit + high fat) counterparts. Linear regression models indicated a partial mediating effect for fatness parameters in the association of MF with MetS clustering. Our findings indicate that efforts to improve MF in young adults may decrease MetS risk partially through an indirect effect on improvements to adiposity levels. Thus, weight reduction should be taken into account as a complementary goal to improvements in MF within exercise programs.

Body Adiposity Index Performance in Estimating Body Fat Percentage in Colombian College Students: Findings from the FUPRECOL-Adults Study.

Recently, a body adiposity index (BAI = (hip circumference)/((height)(1.5))-18) was developed and validated in adult populations. The aim of this study was to evaluate the performance of BAI in estimating percentage body fat (BF%) in a sample of Colombian collegiate young adults. The participants were comprised of 903 volunteers (52% females, mean age = 21.4 years ± 3.3). We used the Lin's concordance correlation coefficient, linear regression, Bland-Altman's agreement analysis, concordance correlation coefficient (ρc) and the coefficient of determination (R²) between BAI, and BF%; by bioelectrical impedance analysis (BIA)). The correlation between the two methods of estimating BF% was R² = 0.384, p < 0.001. A paired-sample t-test showed a difference between the methods (BIA BF% = 16.2 ± 3.1, BAI BF% = 30.0 ± 5.4%; p < 0.001). For BIA, bias value was 6.0 ± 6.2 BF% (95% confidence interval (CI) = -6.0 to 18.2), indicating that the BAI method overestimated BF% relative to the reference method. Lin's concordance correlation coefficient was poor (ρc = 0.014, 95% CI = -0.124 to 0.135; p = 0.414). In Colombian college students, there was poor agreement between BAI- and BIA-based estimates of BF%, and so BAI is not accurate in people with low or high body fat percentage levels.

Normative Reference Values for Handgrip Strength in Colombian Schoolchildren: The FUPRECOL Study.

Ramírez-Vélez, R, Morales, O, Peña-Ibagon, JC, Palacios-López, A, Prieto-Benavides, DH, Vivas, A, Correa-Bautista, JE, Lobelo, F, Alonso-Martínez, AM, and Izquierdo, M. Normative reference values for handgrip strength in Colombian schoolchildren: the FUPRECOL study. J Strength Cond Res 31(1): 217-226, 2017-The primary aim of this study was to generate normative handgrip (HG) strength data for 10 to 17.9 year olds. The secondary aim was to determine the relative proportion of Colombian children and adolescents that fall into established Health Benefit Zones (HBZ). This cross-sectional study enrolled 7,268 schoolchildren (boys n = 3,129 and girls n = 4,139, age 12.7 [2.4] years). Handgrip was measured using a hand dynamometer with an adjustable grip. Five HBZs (Needs Improvement, Fair, Good, Very Good, and Excellent) have been established that correspond to combined HG. Centile smoothed curves, percentile, and tables for the third, 10th, 25th, 50th, 75th, 90th, and 97th percentile were calculated using Cole's LMS method. Handgrip peaked in the sample at 22.2 (8.9) kg in boys and 18.5 (5.5) kg in girls. The increase in HG was greater for boys than for girls, but the peak HG was lower in girls than in boys. The HBZ data indicated that a higher overall percentage of boys than girls at each age group fell into the "Needs Improvement" zone, with differences particularly pronounced during adolescence. Our results provide, for the first time, sex- and age-specific HG reference standards for Colombian schoolchildren aged 9-17.9 years.

Predictive Validity of the Body Adiposity Index in Overweight and Obese Adults Using Dual-Energy X-ray Absorptiometry.

The body adiposity index (BAI) is a recent anthropometric measure proven to be valid in predicting body fat percentage (BF%) in some populations. However, the results have been inconsistent across populations. This study was designed to verify the validity of BAI in predicting BF% in a sample of overweight/obese adults, using dual-energy X-ray absorptiometry (DEXA) as the reference method. A cross-sectional study was conducted in 48 participants (54% women, mean age 41.0 ± 7.3 years old). DEXA was used as the "gold standard" to determine BF%. Pearson's correlation coefficient was used to evaluate the association between BAI and BF%, as assessed by DEXA. A paired sample t-test was used to test differences in mean BF% obtained with BAI and DEXA methods. To evaluate the concordance between BF% as measured by DEXA and as estimated by BAI, we used Lin's concordance correlation coefficient and Bland-Altman agreement analysis. The correlation between BF% obtained by DEXA and that estimated by BAI was r = 0.844, p < 0.001. Paired t-test showed a significant mean difference in BF% between methods (BAI = 33.3 ± 6.2 vs. DEXA 39.0 ± 6.1; p < 0.001). The bias of the BAI was -6.0 ± 3.0 BF% (95% CI = -12.0 to 1.0), indicating that the BAI method significantly underestimated the BF% compared to the reference method. Lin's concordance correlation coefficient was considered stronger (ρc = 0.923, 95% CI = 0.862 to 0.957). In obese adults, BAI presented low agreement with BF% measured by DEXA; therefore, BAI is not recommended for BF% prediction in this overweight/obese sample studied.

Factors associated with active commuting to school by bicycle from Bogotá, Colombia: The FUPRECOL study.

BACKGROUND: Active commuting to school (ACS) can contribute to daily physical activity (PA) levels in children and adolescents. The aim of the study was to analyze the characteristics of active commuting to and from school by bicycle and to identify the factors associated with the use of bicycles for active commuting to school based in a sample of schoolchildren in Bogotá, Colombia. METHODS: A cross-sectional study was conducted in 8,057 children and adolescents. A self-reported questionnaire was used to measure frequency and mode of commuting to school and the time it took them to get there. Weight, height, and waist circumference measurements were obtained using standardized methods, and mothers and fathers self-reported their highest level of educational attainment and household level. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis. RESULTS: 21.9 % of the sample reported commuting by bicycle and 7.9 % reported commuting for more than 120 min. The multivariate logistic regression showed that boys, aged 9-12 years, and those whose parents had achieved higher levels of education (university/postgraduate) were the factors most strongly associated with a use bicycles as a means of active commuting to and from school. CONCLUSION: The findings of this study suggest that it's necessary to promote ACS from childhood and to emphasize its use during the transition to adolescence and during adolescence itself in order to increase its continued use by students.

Triceps and Subscapular Skinfold Thickness Percentiles and Cut-Offs for Overweight and Obesity in a Population-Based Sample of Schoolchildren and Adolescents in Bogota, Colombia.

The assessment of skinfold thickness is an objective measure of adiposity. The aims of this study were to establish Colombian smoothed centile charts and LMS L (Box-Cox transformation), M (median), and S (coefficient of variation) tables for triceps, subscapular, and triceps + subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic (ROC) analysis based on a population-based sample of children and adolescents in Bogotá, Colombia. A cross-sectional study was conducted in 9618 children and adolescents (55.7% girls; age range of 9-17.9 years). Triceps and subscapular skinfold measurements were obtained using standardized methods. We calculated the triceps + subscapular skinfold (T + SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived using the LMS method. ROC curve analyses were used to evaluate the optimal cut-off point of skinfold thickness for overweight and obesity, based on the International Obesity Task Force definitions. Subscapular and triceps skinfolds and T + SS were significantly higher in girls than in boys (p < 0.001). The ROC analysis showed that subscapular and triceps skinfolds and T + SS have a high discriminatory power in the identification of overweight and obesity in the sample population in this study. Our results provide sex- and age-specific normative reference standards for skinfold thickness values from a population from Bogotá, Colombia.

Metabolic Syndrome and Associated Factors in a Population-Based Sample of Schoolchildren in Colombia: The FUPRECOL Study.

BACKGROUND: In contrast to the definition of metabolic syndrome (MetS) in adults, there is no standard definition of MetS in pediatric populations. We aimed at assessing the differences in the prevalence of MetS in children and adolescents aged 9-17 years using four different operational definitions for these age groups and at examining the associated variables. METHODS: A total of 675 children and 1247 adolescents attending public schools in Bogota (54.4% girls; age range 9-17.9 years) were included. The prevalence of MetS was determined by the definitions provided by the International Diabetes Federation (IDF) and three published studies by Cook et al., de Ferranti et al., and Ford et al. In addition, we further examined the associations between each definition of MetS in the total sample and individual risk factors using binary logistic regression models adjusted for gender, age, pubertal stage, weight status, and inflammation in all participants. RESULTS: The prevalence of MetS was 0.3%, 6.3%, 7.8%, and 11.0% according to the definitions by IDF, Cook et al., Ford et al., and de Ferranti et al., respectively. The most prevalent components were low high-density lipoprotein cholesterol and high triglyceride levels, whereas the least prevalent components were higher waist circumference and hyperglycemia. Overall, the prevalence of MetS was higher in obese than in non-obese schoolchildren. CONCLUSIONS: MetS diagnoses in schoolchildren strongly depend on the definition chosen. These findings may be relevant to health promotion efforts for Colombian youth to develop prospective studies and to define which cut-offs are the best indicators of future morbidity.