NEUROCANTRIAL: study protocol for a randomised controlled trial of a pain neuroscience education programme in adults with cancer pain.

INTRODUCTION: Pain is the second most frequent symptom reported in patients with cancer among the main reasons for consultation. The incorporation of educational modalities in pain intervention processes has been suggested. This study aims to examine the efficacy of neuroscience pain education (PNE) in relation to pain, biopsychosocial variables and functional capacity in comparison with conventional treatment. It is hypothesised that an intervention based on PNE achieves better outcomes than conventional management, in terms of pain, biopsychosocial variables and functional capacity in adults with oncological pain. METHODS AND ANALYSIS: This will be a single-blind, controlled clinical trial in which two groups will be compared using changes in pain as the primary measure. The first group will receive conventional treatment in addition to PNE, and participants will undergo an intervention of nine sessions (one session per week, for a total of 9 weeks), each lasting 30-40 min. Specifically, these sessions will teach biophysiological elements using metaphors that allow the adoption of these concepts related to pain. The second group will receive conventional treatment (pharmacological treatment). For this study, a sample size calculation was made based on the background, where 80 adults with oncological pain were required. An initial evaluation will be made to establish the baseline characteristics, and then, according to the randomisation, the assignment to the PNE group or the control group will be made and the two groups will be summoned again. Ten weeks later, for the intervention evaluation, the statistical analysis plan will be established by protocol and by intention-to-treat. ETHICS AND DISSEMINATION: This protocol complies with all ethical considerations. The authors commit to presenting the study's results. This study was approved by the ethics committees of the Universidad Santiago de Cali, Clínica de Occidente/Angiografía de Occidente. The authors commit to presenting the study's results. TRIAL REGISTRATION NUMBER: NCT05581784.

Estimation of Pubertal Growth-Spurt Parameters in Children and Adolescents in Colombia: Comparison between Low and Moderate Altitudes.

Context-specific information, including differences in geographical areas, such as distinct altitudes, can be important to explain variations in physical growth. We aimed to compare the estimation of maximum growth velocity and pubertal growth-spurt parameters of children and adolescents living at low and moderate altitudes in Colombia. A cross-sectional study, including a representative cohort of 30.305 (51% boys) children and adolescents aged 1−18 years from Colombia, was performed. The heights were measured with standardized techniques. The Preece−Baines growth model was used to estimate the mathematical and biological parameters of the height-growth velocities and growth spurts for both sexes. The altitudes were categorized as low (18 to 564 m above sea level) or moderate (2420 to 2640 m above sea level). There were no differences in final height (h1), peak height velocity size (hθ), age at peak height velocity (APHV), or peak height velocity PHV (cm/y) between the subjects living in both altitudes (p > 0.05). The APHV was estimated at 12.75 ± 0.75 years in the boys and at 10.05 ± 0.65 years in the girls. The girls reached the APVH 2.70 years earlier than the boys. Regarding the PHV, the boys reached higher growth velocity, which was 6.85 ± 0.55 cm/y. In conclusion, there were no significant differences in final height, peak height, APHV, or PHV between the children and adolescents living at distinct altitudes in Colombia. The PHV occurred approximately 3 years earlier in the girls than in the boys. Furthermore, the girls' estimated PHV, APHV, and final height were lower than those of the boys. This study allows additional insight into pubertal growth-spurt parameters and also provides a valuable reference database for the assessment of Colombian children and adolescents.

Effects of Different Doses of Exercise on Inflammation Markers Among Adolescents With Overweight/Obesity: HEPAFIT Study.

PROPOSE: Obesity-related metabolic risk factors in adolescents who are overweight/obese may be associated with systemic low-grade inflammation; therefore, we investigated whether 6 months of exercise training altered markers of inflammation. METHODS: Secondary analyses of a randomized controlled exercise-based intervention trial (September 2017-December 2018). Adolescents aged 11 to 17 years (Tanner stage II-V), 70% girls, with a body mass index z-score at or above the 85th percentile, and/or with excess of adiposity (body fat ≥ 30%). The participants were randomly assigned to the following 4 groups for 6 months: (1) standard physical education lessons, as a control (CTRL); (2) high-intensity physical education class (HIPE); (3) low-to-moderate intensity physical education class (LIPE); (4) a combined group (PLUS). Inflammatory markers and immune molecules including chemokines, cytokines, and growth factors (n = 65 biomarkers) were determined by cytokine antibody array. RESULTS: Of the 120 randomly assigned participants, 95 were included in the analysis. Considering these 22 proteins, the LIPE group shows statistical significance in 9 proteins with log-fold change (logFC) and P < 0.05 (in BLC, eotaxin, fibroblast growth factor-6 [FGF-6], GCP-2, I-309, IGFBP-4, MCP-4, NAP-2, and PARC), followed by the PLUS group in 9 proteins (BLC, pro-epidermal growth factor, eotaxin, FGF-6, MCP-4, NAP-2, osteopontin, PARC, and RANTES), the HIPE group in 7 proteins (FGF-4, FGF-7, GCP-2, IGF-1, IGFBP-1, IGFBP-4, and MIP-1 delta), and the CTRL group in 6 proteins (FGF-4, IP-10, Leptin, MCP-1, MIG, and MIP-1 delta). However, subanalysis performed to detect differentially expressed proteins at baseline and after intervention, with significance at an adjusted P value ≤ 0.05 and absolute log fold-change (logFC) ≥ 1.0, showed 3 downregulated proteins in the LIPE group (BLC(logFC) = 1.27, eotaxin(logFC) = 1.18, and MCP-4(logFC) = 1.14), and 4 proteins in the HIPE group (BLC(logFC) = 1.45, FGF-6(logFC) = 1.20, MCP-4(logFC) = 1.50, and PARC(logFC) = 1.33), supporting that the changes we observed in the exercise groups were not time-related changes but occurred in response to exercise. CONCLUSIONS: Implementing a 6-month physical exercise program in overweight/obese adolescents, based on LIPE and PLUS groups, significantly change several circulating inflammatory levels. Interventions involving supervised physical exercise may reduce the associated effects of systemic low-grade inflammation, thus preventing the development of obesity-related metabolic diseases in adolescents with overweight/obesity.

Exercise dose on hepatic fat and cardiovascular health in adolescents with excess of adiposity.

OBJECTIVE: The HEPAFIT study was aimed at examining the impact of a 6-month physical education intervention, considering various levels of exercise intensity, on hepatic fat and cardiometabolic health outcomes in adolescents with excess adiposity. METHODS: Adolescents (n = 120), 11-17 years with excess adiposity by body fat >30%, were randomly assigned to one of the following 4 groups for 6 months: (1) standard physical education lessons, control (CTRL); (2) high-intensity physical education (HIPE); (3) low-to-moderate intensity physical education (LIPE) and (4) combined HIPE and LIPE (PLUS). The primary outcome was hepatic fat content measured by vibration-controlled transient elastography (controlled attenuation parameter [CAP]). Secondary outcomes were traditional cardiovascular health markers (body composition, serum lipids, aminotransferases and health-related physical fitness components). RESULTS: Adjusted mixed effects linear models revealed a significant decrease in CAP levels in HIPE (-20.02 dB/m, p < 0.0001) (p = 0.001 vs. CTRL group) and PLUS (-16.25 dB/m, p = 0.005) groups. Body fat decreased in the HIPE (-2.88%, p < 0.001) (p = 0.001 vs. CTRL group) and LIPE (-1.26%, p = 0.022) groups. The physical fitness components were increased in the HIPE and PLUS group relative to the baseline (p < 0.05), and the HIPE group showed a reduction in the total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels (p < 0.05). CONCLUSIONS: Implementation of a 6-month physical education exercise program, particularly high-intensity or combined high and low-intensity, improves hepatic fat storage and significantly reduces cardiometabolic markers in adolescents with excess of adiposity. Interventions involving supervised physical exercise may help to improve metabolism and fat deposition at the hepatic level, thus preventing the development of non-alcoholic fatty liver disease in adolescents.

Serum leptin as a mediator of the influence of insulin resistance on hepatic steatosis in youths with excess adiposity.

BACKGROUND AND AIMS: The relationship between insulin resistance (IR) and hepatic steatosis (fatty liver) is well known; however, the extent to which the satiety hormone leptin acts as a confounder or mediator in this relationship is uncertain. We examined whether the association between IR and hepatic steatosis is mediated by leptin in Colombian adolescents with excess adiposity. METHODS AND RESULTS: A total of 122 adolescents (mean age: 13.4 years; 68% girls) participated in the study. We assessed body composition, hepatic steatosis (as defined by the controlled attenuation parameter [CAP]), cardiometabolic risk factors (body mass index, waist circumference, body composition), biochemical variables (leptin, insulin, glucose, lipid profile, cardiometabolic Z-score, transaminases, etc.), and physical fitness (cardiorespiratory fitness and grip strength). Partial correlation, regression, and mediation analyses were conducted using the Barron and Kenny framework. RESULTS: Ninety-two youths (75.4%) had IR. Mediation analysis revealed a positive relationship between Homeostasis Model Assessment-IR (HOMA-IR) and CAP (ßdir = 3.414, 95% confidence interval [CI]: 1.012 to 5.816, p < 0.001), which was attenuated when leptin was included in the model, thus indicating that leptin mediates this relationship (ßind = 1.074, 95% CI: 0.349 to 2.686, p < 0.001). The percentage of the total effect mediated by leptin was 21%. Regarding sex, the mediation effect of leptin remains significant among boys (ßind = 0.962, 95% CI: 0.009 to 2.615, p < 0.001), but not in girls (ßind = 0.991, 95% CI: 1.263 to 5.483, p = 0.477). CONCLUSIONS: The findings are clinically relevant to consider leptin levels as a surrogate marker of insulin sensitivity when assessing youths with excess adiposity and/or suspected Nonalcoholic hepatic steatosis or nonalcoholic fatty liver disease (NAFLD).

Abdominal aortic calcification is associated with decline in handgrip strength in the U.S. adult population ≥40 years of age.

BACKGROUND AND AIMS: The present study investigated the association between abdominal aortic calcification (AAC) and handgrip strength (HGS) and the ability of HGS to predict an increased AAC phenotype in adults. METHODS AND RESULTS: The analysis consisted of data for 3140 men and women aged ≥40 years (51.7% women) from the 2013-2014 NHANES. Lateral scans of the thoraco-lumbar spine (L1-L4) were scored for AAC using a validated 8-point scale (AAC-8); subjects with a score of ≥3 were considered at increased risk for cardiovascular disease due to a high AAC phenotype. HGS was assessed using a grip dynamometer. The prevalence of severe AAC in the population was 9.0%. Decline in HGS was associated with higher AAC-8 scores in men and women (p < 0.001). General linear model analysis showed that HGS levels were negatively associated with high AAC (p < 0.001) and AAC-8 status for both sexes. Likewise, for each 5-kg higher HGS, there lower odds of a high AAC phenotype (in men OR = 0.73, CI95%, 0.64-0.84) and (women OR = 0.58, CI95%, 0.47-0.70). Receiver operating characteristic curve analysis showed that the HGS threshold value to detect high risk of AAC in adults was ≥37.3 kg (AUC = 0.692) in men and 25.1 kg (AUC = 0.705) in women. CONCLUSION: Lower muscular strength, as measured by HGS, is associated with higher AAC scores in the U.S. population ≥40 years of age. Accordingly, maintenance of muscular strength during aging may protect adults against vascular calcification, an independent predictor of cardiovascular events. HGS measurement seems to be a valid screening tool for detecting a high ACC phenotype in adults.

Metabolic Syndrome and Its Associated Factors in Older Adults: A Secondary Analysis of SABE Colombia in 2015.

Background: Understanding the metabolic syndrome (MetS) prevalence at the national level is important to develop effective programs and strategies to prevent and control MetS. This study aimed to analyze the prevalence of MetS according to gender and aging stage, and its association with potential factors in older individuals ≥60 years of age in Colombia. Methods: The data for this study came from a secondary cross-sectional, nationally representative SABE study Survey on Health, Well-Being, and Aging in Colombia, 2015. A total of 1637 participants (60.7% women, 70.5 ± 7.9 years) from 86 Colombian municipalities participated. A structured questionnaire was used to collect data on socio-demography, lifestyle, and self-report medical conditions. Measurements included anthropometric (weight, waist circumference, body mass index), sarcopenia "proxy" status (calf circumference) handgrip strength levels, high-density lipoprotein cholesterol, triglycerides, fasting glucose, and blood pressure. Univariate and multiple regression models were established as part of the main analysis. Results: Using the harmonized Joint Scientific Statement criteria, MetS was present in 54.9% of the study population, with a higher prevalence among females than males (59.8% vs. 47.3%). Individuals who were cigarette smokers (odds ratio [OR] = 1.5; 95% confidence interval [CI] = 1.0-2.4; P = 0.034), female gender (OR = 1.3; 95% CI = 1.0-1.8; P = 0.020), and sarcopenia "proxy" (OR = 1.6; 95% CI = 1.0-2.5; P = 0.026) were more likely to have a higher prevalence estimate of MetS, after controlling for relevant covariates. Conclusions: Overall prevalence of MetS among older adults in Colombia is high. Smoking, female gender, and sarcopenia "proxy" status are associated with MetS. These results suggested that MetS is still a serious public burden in Colombia, and screening for promotion of healthy lifestyle and nutrition counseling should be offered routinely in old age.

Higher Cardiorespiratory Fitness Levels May Attenuate the Detrimental Association between Weight Status, Metabolic Phenotype and C-Reactive Protein in Adolescents-A Multi-Cohort Study.

Results from several studies show that only obese, unfit subjects, but not obese, fit subjects, are at higher mortality risk than are normal-weight fit subjects. The aim of the study was two-fold: (1) to examine the differences in C-reactive protein levels across different metabolic phenotypes (healthy and unhealthy) of weight status and (2) ascertain whether high levels of cardiorespiratory fitness (CRF) attenuate the association of C-reactive protein and metabolic phenotypes of weight status. This was a pooled study, which included data from three cross-sectional projects (1706 youth (921 girls) aged 12-18 years). We used a Shuttle run test to assess CRF. Adolescents were classified into six metabolic phenotypes (healthy and unhealthy) of weight status (non-overweight, overweight and obese), based on age- and sex-specific cutoff points for triglycerides, systolic blood pressure, HDL-cholesterol, glucose and body mass index. High-sensitivity assays were used to obtain the C-reactive protein as inflammatory biomarker. After adjustment for potential confounders (age, sex, pubertal stage and country), the analysis of covariance (ANCOVA) shows that C-reactive protein is directly associated with metabolic phenotypes of weight status. Subjects with obesity, regardless of their metabolic profile, had higher levels of C-reactive protein Z-score. In addition, (after adjustments for potential confounders) a two-way ANCOVA showed that high levels of CRF attenuated the associations of C-reactive protein levels in metabolic healthy non-overweight and in adolescents with obesity. In conclusion, higher CRF levels may attenuate the detrimental association between obesity and C-reactive protein independently of metabolic phenotype. Findings from this study are important for prevention, clinical practice on issues associated with adiposity and metabolic disorders.

Muscle strength cut-offs for the detection of metabolic syndrome in a nonrepresentative sample of collegiate students from Colombia.

BACKGROUND: Evidence shows an association between grip strength and health; however, grip strength cut-offs for the detection of metabolic syndrome (MetS) in Latin American populations are scarce. The purpose of this study was to determine cut-offs of normalized grip strength (NGS) for the detection of MetS in a large nonrepresentative sample of a collegiate student population from Colombia. METHODS: A total of 1795 volunteers (61.4% female; age = 20.68 ± 3.10 years, mean ± SD), ranging between 18 and 30 years of age participated in the study. Strength was estimated using a handheld dynamometer and normalized to body mass (handgrip strength (kg)/body mass (kg)). Anthropometrics, serum lipids indices, blood pressure, and fasting plasma glucose were measured. Body composition was measured by bioelectrical impedance analysis. MetS was defined as including ≥3 of the 5 metabolic abnormalities according to the International Diabetes Federation definition. A metabolic risk score was computed from the following components: waist circumference, triglycerides, high-density lipoprotein cholesterol, glucose, and systolic and diastolic blood pressure. RESULTS: Receiver operating curve analysis showed significant discriminatory accuracy of NGS in identifying the thresholds and risk categories. Lower strength was associated with increased prevalence of MetS. In males, weak, intermediate, and strong NGS values at these points were <0.466, 0.466-0.615, >0.615, respectively. In females, these cut-off points were <0.332, 0.332-0.437, >0.437, respectively. CONCLUSION: Our sex-specific cut-offs of NGS could be incorporated into a clinical setting for identifying college students at cardiometabolic disease risk.

Normal-Weight Obesity Is Associated with Increased Cardiometabolic Risk in Young Adults.

Normal-weight obesity (NWO) has been shown to be associated with cardiometabolic dysfunction. However, little is known regarding this potential relationship in early adulthood. The aim of this study was to investigate the associations between NWO and cardiometabolic risk factors in a large population of Colombian young adults. A cross-sectional study was conducted on 1354 subjects (61% women), aged from 18 to 30. Anthropometric data, including body mass index (BMI) and waist circumference (WC), were estimated, and the percentage of fat mass was measured through bioelectrical impedance analysis (BIA). Muscular fitness was determined by using a handgrip strength test and normalized grip strength (NGS = handgrip (kg)/body mass (kg)). A cardiometabolic risk Z-score was derived by assessing WC, triglycerides, high-density lipoprotein cholesterol (HDL-C) cholesterol, fasting glucose, and systolic blood pressure. NWO was defined by the combination of excess %BF (over 25.5% for men and 38.9% for women) and a BMI < 25 kg/m2. The overall prevalence of NWO was 29.1%. Subjects with NWO have an increased risk of cardiometabolic risk compared to the normal-weight lean group (OR = 3.10). Moreover, NWO was associated with an increased risk of presenting low HDL-C (OR = 2.34), high abdominal obesity (OR = 7.27), and low NGS (OR = 3.30), p < 0.001. There is a high prevalence of NWO in American Latin young adults and this condition is associated with an increased cardiovascular risk, high blood pressure, low HDL-C, high abdominal obesity, and low muscular strength early in life. Screening for adiposity in subjects with a normal BMI could help to identify young adults at a high risk of cardiometabolic abnormalities.

The Effect of 12 Weeks of Different Exercise Training Modalities or Nutritional Guidance on Cardiometabolic Risk Factors, Vascular Parameters, and Physical Fitness in Overweight Adults: Cardiometabolic High-Intensity Interval Training-Resistance Training Randomized Controlled Study.

Ramírez-Vélez, R, Castro-Astudillo, K, Correa-Bautista, JE, González-Ruíz, K, Izquierdo, M, García-Hermoso, A, Álvarez, C, Ramírez-Campillo, R, and Correa-Rodríguez, M. The effect of 12 weeks of different exercise training modalities or nutritional guidance on cardiometabolic risk factors, vascular parameters and physical fitness in overweight adults: cardiometabolic high-intensity interval training-resistance training randomized controlled study. J Strength Cond Res 34(8): 2178-2188, 2020-Evidence suggests that exercise training improves cardiometabolic risk factors. The aim of this study was to investigate whether 12 weeks of high-intensity interval training (HIIT), resistance training (RT), concurrent training (CT = HIIT + RT), or nutritional guidance (NG) induced improvements in cardiometabolic risk factors, vascular parameters, and physical fitness in overweight adults, and to compare the responses between the 4 intervention groups. This is a twelve-weeks factorial randomized design examining the effects of different exercise regimes and/or NG on anthropometric and body composition (fat and lean mass at whole body, trunk fat, fat mass index, appendicular muscle mass, and waist circumference); cardiometabolic risk factors and vascular parameters (blood lipids, fasting glucose, blood pressure, flow-mediated dilation [FMD%], aortic pulse wave velocity (PWV), and augmentation index); and physical fitness (cardiorespiratory fitness and handgrip strength). Adjusted mixed linear models revealed a significant improvement in cardiorespiratory fitness (mL·kg·min): HIIT +8.3, RT +4.1, and CT +6.3 (all p < 0.001). The improvement difference between the groups was statistically significant between the HIIT and NG group (p = 0.014), (time × group interaction F(23.564); p < 0.001; η partial = 0.365). In addition, the RT and CT groups have a significant positive impact on PWV (m·s) (d = 0.391 and 0.229 respectively; p < 0.001, (time × group interaction F(5.457); p = 0.003; η partial = 0.280). Hereafter, the RT group has a significant positive impact on the FMD (%) in comparison to HIIT, CT, or NG group (time × group interaction F(2.942); p = 0.044; η partial = 0.174). The main findings of this study are that 12 weeks of HIIT leads to significant improvements in cardiorespiratory fitness, whereas RT resulted in improvements in the vascular profile, supporting the positive effect of both training programs for cardiometabolic risk factors in sedentary and overweight adults.

Physical fitness components in relation to attention capacity in Latin American youth with overweight and obesity.

The aim of the study was twofold: (a) to examine the association between health-related physical fitness and attention capacity in Latin American children and adolescents with overweight and obesity and (b) to test whether body composition outcomes are moderators of this association. A cross-sectional design was used to study 201 overweight/obese participants (12.1 ± 2.1 years of age; 34.3% girls) from Chile (Active-Start study) and Colombia (HEPAFIT study). Body composition, muscular fitness, speed-agility, and cardiorespiratory fitness were evaluated using two similar test batteries (ALPHA and FUPRECOL). Attention capacity was measured by the d2 Test. Linear regression and moderation analyses were conducted. Linear regression analysis revealed an association between muscular fitness (ß = 0.245, P = .015), speed-agility (ß = -0.16, P = .027), cardiorespiratory fitness (ß = 0.331, P < .001) and overall fitness score (ß = 0.210; P = .004) and attention capacity (all analyses were controlled for age, sex, peak height velocity, maternal education, and study setting). Moderation analysis using the Johnson-Neyman technique revealed that the effect of the relationship between muscular fitness score and speed-agility and attention capacity was stronger as fat mass and fat mass index increased. In conclusion, physical fitness components are associated with higher attention capacity in youth with overweight/obesity, but body composition seems to moderate these relationships. Randomized controlled trials in this population would help to better understand whether improvements in different components of physical fitness lead to better attention capacity, especially in youth with excess adiposity.

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study.

This study evaluated the predictive ability of 11 obesity- and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), "A" body-shape index (ABSI), conicity index (CI), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles (p < 0.001). The TyG index was best able to identify prediabetes in either sex (AUC and optimal cut-off = 0.700 and 8.72, and 0.695 and 8.92 for men and women, respectively), suggesting that compared to the other parameters, the TyG index has the best discriminative power to predict prediabetes in the whole population. Thus, we propose the TyG index be used as a complementary marker for assessing prediabetes in older adults.

Correction: Ramírez-Vélez, R.; et al. Validation of Surrogate Anthropometric Indices in Older Adults: What Is the Best Indicator of High Cardiometabolic Risk Factor Clustering? Nutrients 2019, 11, 1701.

The authors would like to make the following corrections to the published paper [1]: (1) In the result section replace: On page 6, in the text of the Section 3 [...].

Gait speed moderates the adverse effect of obesity on dependency in older Colombian adult.

INTRODUCTION: Gait speed worsens with the presence of obesity, and is a powerful marker of functional dependence. Accordingly, gait speed could be a factor that improves or worsens the relationship between obesity and dependence in activities of daily living (ADL). However, to date this potential role has not been examined and the minimum gait speed threshold in the relationship between obesity and ADL is not known. The aim of this study was to determine whether speed moderates the association between obesity and dependence in ADL, and also define the gait speed threshold of this relationship. METHODS: A total of 20,507 community-dwelling older adults from a cross-sectional analysis of national survey data - the Colombian Health, Well-being and Aging study (SABE, 2015) - were surveyed. The research data were collected using structured questionnaires, including basic information, ADL measured using the Barthel Index, body mass index, and gait speed (3 m). The Johnson-Neyman technique was applied to determine the gait speed threshold adjusted for age, sex and comorbidities. RESULTS: Regression analysis showed a significant detrimental effect of obesity on dependence in ADL, which was moderated by gait speed (ß = 0.081; 95%CI: 0.045 to 0.117; p < 0.001). Adjusted for major covariates, the Johnson-Neyman technique defined two gait speed thresholds: < 0.77 m/s, indicating an aggravated adverse effect; and >1.06 m/s, indicating a positive effect. CONCLUSIONS: The adverse effect of obesity on dependence in ADL is moderated by gait speed. Considering these thresholds, the distribution of older adults in each of the proposed areas of significance were: below 0.77 (m/s) = 14,324 (70.0%), above 1.06 (m/s) = 1553 older adults (7.5%) and between areas = 4630 older adults (22.5%).

Validation of Surrogate Anthropometric Indices in Older Adults: What Is the Best Indicator of High Cardiometabolic Risk Factor Clustering?

The present study evaluated the ability of five obesity-related parameters, including a body shape index (ABSI), conicity index (CI), body roundness index (BRI), body mass index (BMI), and waist-to-height ratio (WtHR) for predicting increased cardiometabolic risk in a population of elderly Colombians. A cross-sectional study was conducted on 1502 participants (60.3% women, mean age 70 ± 7.6 years) and subjects' weight, height, waist circumference, serum lipid indices, blood pressure, and fasting plasma glucose were measured. A cardiometabolic risk index (CMRI) was calculated using the participants' systolic and diastolic blood pressure, triglycerides, high-density lipoprotein and fasting glucose levels, and waist circumference. Following the International Diabetes Federation definition, metabolic syndrome was defined as having three or more metabolic abnormalities. All surrogate anthropometric indices correlated significantly with CMRI (p < 0.01). Receiver operating characteristic curve analysis of how well the anthropometric indices identified high cardiometabolic risk showed that WtHR and BRI were the most accurate indices. The best WtHR and BRI cut-off points in men were 0.56 (area under curve, AUC 0.77) and 4.71 (AUC 0.77), respectively. For women, the WtHR and BRI cut-off points were 0.63 (AUC 0.77) and 6.20 (AUC 0.77), respectively. In conclusion, BRI and WtHR have a moderate discriminating power for detecting high cardiometabolic risk in older Colombian adults, supporting the idea that both anthropometric indices are useful screening tools for use in the elderly.

Handgrip strength attenuates the adverse effects of overweight on cardiometabolic risk factors among collegiate students but not in individuals with higher fat levels.

The aims of this study are to (i) examine a clustered metabolic syndrome composite score (MetScore) and fatness among college students across body mass index (BMI) categories, and (ii) determine whether fit individuals have lower MetScores, fewer individual metabolic syndrome components, and lower fatness than unfit individuals across BMI categories. A total of 1,795 participants aged  >18 years who participated in The FUPRECOL Study were selected for the present analyses. Handgrip strength was tested by a grip dynamometer and used to classify adults as fit or unfit. Among all participants, MetScore, percentage of body fat, and visceral adiposity increased linearly across the BMI categories among college students (all P < 0.001). Individuals who were overweight and fit had a lower MetScore (-0.6 SD; P = 0.02), body fat percentage (-2.6%; P < 0.001) and visceral adiposity (-0.2; P = 0.01) than unfit peers. Moderately fit obese individuals had significantly lower visceral fat levels than unfit obese peers (-3.0; P = 0.03). These results suggest that having adequate handgrip strength-a proxy of overall strength capacity-may attenuate obesity-related cardiometabolic risk. Moreover, weight loss should be recommended to all individuals with obesity, even among those who are currently considered fit.

Effects of kinesio taping alone versus sham taping in individuals with musculoskeletal conditions after intervention for at least one week: a systematic review and meta-analysis.

BACKGROUND: Kinesiotaping (KT), has emerged as an interesting and relatively novel method for treating musculoskeletal conditions. To date, none of the systematic reviews with meta-analysis have addressed the efficacy of KT alone (without any other intervention) over sham taping (ST). OBJECTIVE: The present meta-analysis aimed to investigate the effectiveness of KT versus ST in patients with musculoskeletal conditions in interventions lasting at least 1 week on musculoskeletal conditions and functional performance outcomes. DATA SOURCE: Manual and electronic searches (CENTRAL, EMBASE, MEDLINE and PEDro) were conducted using kinesiotaping, strapping, musculoskeletal pain and musculoskeletal conditions. STUDY SELECTION CRITERIA: Randomised controlled trials on adults with a diagnosis of musculoskeletal conditions. DATA EXTRACTION AND DATA SYNTHESIS: Two researchers independently carried out the search and the third author was referred to for arbitration. The methodological quality of the studies using the PEDro scale and GRADE approach. RESULTS: Six RCTs were identified and included in the meta-analysis. When compared with ST in adults with chronic non-specific low-back pain (LBP), KT resulted in superior effects on pain at follow-up, but the pooled pain in the immediate post-treatment period and disability scores (in the immediate post-treatment period and at follow-up) were not significantly different. Generally, all results were supported by low quality evidence according to GRADE criteria. CONCLUSION: Our findings indicate inconclusive and low-quality evidence of a beneficial effect of KT alone over ST in LBP and knee osteoarthritis. Systematic review registration number: PROSPERO CRD42018084151.

Ideal Cardiovascular Health, Handgrip Strength, and Muscle Mass Among College Students: The FUPRECOL Adults Study.

Garcia-Hermoso, A, Correa-Bautista, JE, Izquierdo, M, Tordecilla-Sanders, A, Prieto-Benavides, D, Sandoval-Cuellar, C, González-Ruíz, K, and Ramírez-Vélez, R. Ideal cardiovascular health, handgrip strength, and muscle mass among college students: the FUPRECOL Adults study. J Strength Cond Res 33(3): 747-754, 2019-The American Heart Association established the 2020 Strategic Impact Goals to define the concept of ideal cardiovascular health (CVH) and the metrics needed to monitor it across populations. The purpose of this study was to investigate the relationship between handgrip strength, muscle mass, and ideal CVH among Colombian college students. Data from 1,835 college students were analyzed (1,128 female). Muscular strength was estimated using a hand-held dynamometer and normalized to body mass (normalized grip strength [NGS]). The percentage of body fat was determined for bioelectrical impedance analysis using tetrapolar whole-body impedance. Ideal CVH was defined as meeting the ideal levels of 4 behaviors (smoking, body mass index, physical activity, and diet adherence) and 3 factors (total cholesterol, fasting glucose, and blood pressure). Higher levels of NGS and muscle mass (relative to body mass) were associated with a higher number of ideal CVH metrics in both sexes (p for trend <0.001). For the total ideal CVH metrics scored on a continuous scale from 0 (all 7 poor) to 7 (all 7 ideal), a 1-metric increase was associated with reduced odds of weak NGS (33 and 36%) and low-medium muscle mass (28 and 34%) mass in men and women, respectively (all p < 0.001). This study indicates that in Colombian college students, both handgrip strength and muscle mass are positively associated with the ideal CVH metrics. To reduce the possible future public health burden of muscular weakness, health professionals need to encourage the public to optimize lifestyle-related risk factors during the young adult stage.

Muscle mass to visceral fat ratio is an important predictor of the metabolic syndrome in college students.

This study aimed to evaluate the associations between the muscle mass to visceral fat (MVF) ratio and cardiometabolic risk factors in a large population of college students in Colombia and to propose cut-off points of this index for the metabolic syndrome (MetS). A total of 1464 young adults recruited from the FUPRECOL (Asociación de la Fuerza Prensil con Manifestaciones Tempranas de Riesgo Cardiovascular en Jóvenes y Adultos Colombianos) study were categorised into four groups based on their MVF ratio. Muscle mass and visceral fat level of the participants were measured using a bioelectrical impedance analysis. Cardiometabolic risk factors including lifestyle characteristics, anthropometry, blood pressure and biochemical parameters were assessed. The prevalence of moderate to severe obesity, hypertension and the MetS was higher in subjects in quartile (Q)1 (lower MVF ratio) (P <0·001). ANCOVA revealed that the subjects in Q1 had higher cardiometabolic disturbances, including altered anthropometry, blood pressure, muscle strength and biochemical parameters after adjusting for age and sex compared with young adults in higher MVF ratio quartiles (P <0·001). Muscular mass and physical activity levels were significantly lower in subjects with a lower MVF ratio (P <0·001). The receiver operating characteristic curve analyses indicated that in men the best MVF ratio cut-off point for detecting the MetS was 18·0 (AUC 0·83, sensitivity 78 % and specificity 77 %) and for women, the MVF ratio cut-off point was 13·7 (AUC 0·85, sensitivity 76 % and specificity 87 %). A lower MVF ratio is associated with a higher risk cardiometabolic profile in early adulthood, supporting that the MVF ratio could be used as a complementary screening tool that may help clinicians identify young adults at high cardiometabolic risk.