Exercise for peri- and postmenopausal women: Recommendations from synergistic alliances of women's medicine and health psychology for the promotion of an active lifestyle.

Adopting healthy behaviors is a multifaceted and complex process that poses significant challenges for individuals. Despite awareness of the detrimental effects of certain behaviors on health, many individuals continue to engage in risky practices. Traditional medical advice and prescriptions, while well intentioned, often fall short in fostering lasting lifestyle changes. Although individuals may also have good intentions, solely relying on doctor's counsel does not ensure successful lifestyle adjustments. One primary reason for this limitation is the lack of specialized expertise in behavioral modification among gynecologists and healthcare providers. Health psychologists are specialized professionals capable of effectively guiding and assisting individuals in modifying health-related behaviors. Their expertise in behavior change strategies and psychological interventions proves invaluable in empowering individuals to embrace healthier lifestyles and contributes to people's well-being. This paper emphasizes the importance of collaborative efforts between medical professionals, such as gynecologists, and health psychologists to promote healthy behaviors among peri- and postmenopausal women and enhance women's health. By forging integrative alliances, they can develop comprehensive and tailored interventions. By bridging the gap between medical advice and behavior modification, this collaborative effort has the potential to ensure a more effective intervention process. This holistic approach not only addresses women's specific health needs but also fosters sustainable behavior change when promoting healthy behaviors among middle-aged women. The ultimate goal of such a synergy is to improve women's health outcomes and contribute to a healthier society overall.

The AHAWOMEN project: study protocol of a multi-design research for exploring HAPA predictors of exercise in postmenopausal women.

BACKGROUND: The postmenopausal period can represent an opportunity for women to improve their health and well-being. The Active and Healthy Ageing in Women during early postmenopause (AHAWOMEN) study aims to identify the key determinants of an active lifestyle among middle-aged women, with a focus on the stages and the social-cognitive variables outlined in the Health Action Process Approach (HAPA) model, a theoretical framework for understanding health behaviour change. We expected that HAPA factors and processes of intention creation (motivational phase) and action adoption (volitional phase) will be significant predictors of exercise initiation and maintenance, supporting both the HAPA tenets and the efficacy of HAPA-based interventions. METHODS/DESIGN: This study was approved by the authors' Institutional Review Committee. Postmenopausal women aged between 45 and 65 years will voluntarily participate. The participants will be allocated to one of three groups: Intervention-Initiators (n = 100, random allocation), Control-Sedentary (n = 100, random allocation) or Control-Active (n = 100, non-random allocation). The intervention group will engage in a supervised exercise programme lasting at least 3 months, supplemented with a HAPA-based intervention for behaviour change. The sedentary control group will not receive any intervention to change their physical activity, while the active control group will consist of women who are already regularly adhering to an active lifestyle. Study variables will be measured at baseline and postintervention phases, as well as at 1, 3, 6 and 12-month follow-ups. The predictors of exercise behaviour in the different phases of the behavioural change process will be explored and compared within and between groups throughout the study. These analyses will help identify the factors that determine the adoption of a healthy active behaviour. Additionally, the effectiveness of the model and the intervention for changing active behaviour will be evaluated. DISCUSSION: This paper describes the rationale, development and methods used in the AHAWOMEN project. Supporting women who intend to become active can help them to translate their goals into sustainable action. Verifying that the HAPA predictions are applicable to postmenopausal women's adoption of exercise would provide the basis for designing effective interventions for promoting healthy and active ageing that are also tailored to the experiences of middle-aged women. TRIAL REGISTRATION: ISRCTN16251361. Registration date: 01/06/2023 (retrospectively registered).

Active Gains in brain Using Exercise During Aging (AGUEDA): protocol for a randomized controlled trial.

Alzheimer's disease is currently the leading cause of dementia and one of the most expensive, lethal and severe diseases worldwide. Age-related decline in executive function is widespread and plays a key role in subsequent dementia risk. Physical exercise has been proposed as one of the leading non-pharmaceutical approaches to improve executive function and ameliorate cognitive decline. This single-site, two-arm, single-blinded, randomized controlled trial (RCT) will include 90 cognitively normal older adults, aged 65-80 years old. Participants will be randomized to a 24-week resistance exercise program (3 sessions/week, 60 min/session, n = 45), or a wait-list control group (n = 45) which will be asked to maintain their usual lifestyle. All study outcomes will be assessed at baseline and at 24-weeks after the exercise program, with a subset of selected outcomes assessed at 12-weeks. The primary outcome will be indicated by the change in an executive function composite score assessed with a comprehensive neuropsychological battery and the National Institutes of Health Toolbox Cognition Battery. Secondary outcomes will include changes in brain structure and function and amyloid deposition, other cognitive outcomes, and changes in molecular biomarkers assessed in blood, saliva, and fecal samples, physical function, muscular strength, body composition, mental health, and psychosocial parameters. We expect that the resistance exercise program will have positive effects on executive function and related brain structure and function, and will help to understand the molecular, structural, functional, and psychosocial mechanisms involved.

Influence of Mediterranean Diet Adherence and Physical Activity on Bone Health in Celiac Children on a Gluten-Free Diet.

We aimed to assess the influence of the Mediterranean Diet adherence and physical activity (PA) on body composition, with a particular focus on bone health, in young patients with celiac disease (CD). The CD group (n = 59) included children with CD with a long (>18 months, n = 41) or recent (<18 months, n = 18) adherence to a gluten-free diet (GFD). The non-celiac group (n = 40) included non-celiac children. After adjusting for potential confounders, the CD group showed lower body weight (p = 0.034), lean mass (p = 0.003), bone mineral content (p = 0.006), and bone Z-score (p = 0.036) than non-celiac children, even when the model was further adjusted for adherence to a GFD for at least 18 months. Among CD children, spending greater time in vigorous physical activity was associated with higher lean mass (p = 0.020) and bone mineral density with evidence of statistical significance (p = 0.078) regardless of the time they followed a GFD. In addition, a greater Mediterranean Diet adherence was associated with a higher bone Z-score (p = 0.020). Moreover, lean mass was strongly associated with bone mineral density and independently explained 12% of its variability (p < 0.001). These findings suggest the importance of correctly monitoring lifestyle in children with CD regarding dietary habits and PA levels to improve lean mass and, consequently, bone quality in this population.

Evaluation of the Analgesic Efficacy of a Bioelectronic Device in Non-Specific Chronic Low Back Pain with Neuropathic Component. A Randomized Trial.

Low energy pulsed electromagnetic signals (PEMS) therapy, in the field of bioelectronics, has been suggested as a promising analgesic therapy with special interest in treating conditions with poor response to pharmacotherapy. This study evaluated the effectiveness of PEMS therapy on the treatment of chronic low back pain patients with a neuropathic component. A group of 64 individuals with such condition was allocated to a 2-week treatment period (10 twenty-minute sessions on consecutive days) with an active PEMS therapy device or an inactive device in random order. The pain was assessed on a visual analog scale, and the functional status was assessed using the SF-12 questionnaire. The visual analog scale scores were lower after treatment than at baseline but only in the group treated with the active device. According to the DN4 score, neuropathic pain decreased in both experimental groups with respect to baseline, but this was only significant for the group treated with the active device. Similarly, an improvement in the SF-12 and Medical Outcomes Study (MOS) sleep scale components was reported. The study demonstrated that low-energy PEMS therapy was efficient in reducing pain and improving function in chronic low back pain patients with a neuropathic component.

Better brain connectivity is associated with higher total fat mass and lower visceral adipose tissue in military pilots.

A lack of exercise leads to being overweight or obese affecting regional brain structure and functional connectivity associated with impaired cognitive function and dementia. In recent decades, several studies of healthy individuals suggest that adiposity may also produce negative independent effects on the brain. We aimed to investigate the relationship between body composition - total fat mass (TFM) and visceral adipose tissue (VAT) - with white matter (WM) integrity using a whole-brain approach in military pilots. Twenty-three military helicopter pilots (Mage = 36.79; SD = 8.00; MBMI = 25.48; SD = 2.49) took part in the study. Brain volumes were studied using diffusion tensor imaging technique by means of a 3T Magnetom Tim Trio. Measurements of body mass index (BMI), TFM and VAT were obtained using Dual-energy X-ray Absorptiometry (DXA). The results showed that, on one hand, higher TFM was associated with higher white matter fractional anisotropy (FA) and, on the other hand, higher VAT was associated with lower FA. Data showed that TFM and VAT are the critical factors underlying WM integrity in combat helicopter pilots. The authors suggest that fat presence enhance brain connectivity while there is no excess, specifically in VAT.

Association of Body Mass Index and Serum Markers of Tissue Damage with Postoperative Pain. The Role of Lactate Dehydrogenase for Postoperative Pain Prediction.

OBJECTIVES: i) To analyze the association of body mass index (BMI) and some serum tissue damage markers with postoperative pain. ii) To establish a biochemical marker cutoff point able to predict moderate to severe postoperative pain. DESIGN: Cross-sectional study. SUBJECTS: Ninety-six adult male patients from Southern Spain (55 ± 13 years old) who underwent an inguinal hernioplasty. METHODS: Postoperative pain (eight hours after surgery) was assessed through a visual analog scale (VAS). Moderate to severe pain was defined as a VAS > 50 mm. BMI was calculated and medication, alcohol consumption, and smoking habit registered. Eight hours after surgery, some serum markers such as fibrinogen, lactate dehydrogenase (LDH), C-reactive protein, cortisol, creatine kinase, glutamic-pyruvic, glutamic oxaloacetic, and gamma-glutamyltransferase transaminases were determined by standard procedures. RESULTS: After adjusting for potential confounders, BMI was not associated with postoperative pain (P > 0.05). Serum fibrinogen was associated with greater postoperative pain (ß = 0.333, P < 0.05). Serum LDH concentration was strongly associated with greater postoperative pain (ß = 0.606, P < 0.001). Alcohol consumption was associated with higher postoperative pain (ß = 0.212, P < 0.05). No associations were observed regarding age, tobacco consumption, and the rest of serum markers studied. Serum LDH concentration was able to discriminate between presence/absence of moderate to severe postoperative pain (receiver operating characteristic area under the curve = 0.655, P ≤ 0.01). An LDH concentration >204 IU/L was associated with a three-times increased odds ratio of moderate to severe postoperative pain. CONCLUSIONS: Contrary to expectations, greater BMI was not associated with higher postoperative pain. Notwithstanding, the assessment of serum LDH might provide useful information to predict moderate to severe postoperative pain.

Heart Rate Is a Better Predictor of Cardiorespiratory Fitness Than Heart Rate Variability in Overweight/Obese Children: The ActiveBrains Project.

Cardiac autonomic function can be quantified through mean heart rate (HR) or heart rate variability (HRV). Numerous studies have supported the utility of different HRV parameters as indicators of cardiorespiratory fitness (CRF). However, HR has recently shown to be a stronger predictor of CRF than HRV in healthy young adults, yet these findings need to be replicated, in other age groups such as children. Therefore, this study aimed: (1) to study the associations between indicators of cardiac autonomic function (HR, standard and corrected HRV parameters) and CRF in overweight/obese children; and (2) to test which of the two indicators (i.e., HR or HRV) is a stronger predictor of CRF. This study used cross-sectional baseline data of 107 overweight/obese children (10.03 ± 1.13 years, 58% boys) from the ActiveBrains project. Cardiac autonomic indicators were measured with Polar RS800CX®. CRF was assessed using a gas analyzer while performing a maximal incremental treadmill test. Correlations and stepwise linear regressions were performed. Mean HR and standard HRV parameters (i.e., pNN50, RMSSD, and SDNN) were associated with CRF (r coefficients ranging from -0.333 to 0.268; all p ≤ 0.05). The association of HR with CRF persisted after adjusting for sex, peak height velocity (PHV), adiposity moderate-to-vigorous physical activity, energy intake and circadian-related variable intradaily variability of activity patterns whilst for HRV parameters (i.e., pNN50, RMSSD, and SDNN) disappeared. Stepwise linear regression models entering HR and all HRV parameters showed that mean HR was the strongest predictor of CRF (ß = -0.333, R 2 = 0.111, p < 0.001). Standard and corrected HRV parameters did not provide additional value to the coefficient of determination (all p > 0.05). Our findings suggest that HR is the strongest indicator of CRF. It seems that quantification of HRV parameters in time and frequency domain do not add relevant clinical information about the cardiovascular health status (as measured by CRF) in overweight/obese children beyond the information already provided by the simple measure of HR.

Risk factors related with lifestyle in patients with musculoskeletal disorders / Factores de riesgo relacionados con los hábitos de vida en pacientes con patología osteomuscular

Background: Musculoskeletal disorders (MSDs) encompass a series of debilitating diseases with high incidence and prevalence, representing a high economic and social cost. Prevention is crucial, so is of great interest to determine modifiable risk factors, such as those related to lifestyle. Methods: A descriptive cross-sectional study was performed in 91 patients selected by systematic random sampling and were divided into three experimental groups according to the cause and evolution of its MSD (neck pain, knee pain and back pain). A biometric measurement, nutritional assessment, physical and occupational activity, muscle balance and oxidative status was performed. Results: The female is the most affected gender by the presence of musculoskeletal injuries such as neck pain and back pain. Overall, most patients (67.4%) had normal weight, overweight 24.41% and only 8.1% were obese type I. Patients with neck pain are the group doing less physical activity and worse muscular balance present. Oxidative stress was higher in patients with knee pain than in the other groups. Regarding the consumed diet, differences between experimental groups on the mineral content (Zn, Mn, Se and I) and vitamins (folate and ascorbic acid) are observed. Conclusions: Cholecalciferol intake and vitamins A and D is less than those recommended in all subjects, which promotes muscle disease. Folate intake was below recommendations, increasing susceptibility to oxidative stress. Obesity and oxidative stress related to the prevalence of the different types of MSDs studied.

Introducción: las enfermedades osteomusculares (EOM) engloban una serie de patologías discapacitantes con alta incidencia y prevalencia, representando un alto costo económico y social. Es fundamental su prevención, por lo que es de gran interés determinar factores de riesgo modificables, como son los relacionados con los hábitos de vida. Métodos: se realizó un estudio descriptivo y trasversal en 91 pacientes seleccionados mediante muestreo aleatorio sistemático y que fueron distribuidos en tres grupos experimentales según la causa y evolución de su EOM (cervicalgia, gonalgia y lumbalgia). Se realizó una medición biométrica, evaluación nutricional, de la actividad física y laboral, del balance muscular y del estado oxidativo. Resultados: el sexo femenino es el más afectado por la presencia de lesiones osteomusculares como cervicalgia y lumbalgia. En conjunto, la mayor parte de los pacientes (67,4%) tiene normopeso, el 24,41% sobrepeso y tan solo un 8,1% obesidad tipo I. Los pacientes con cervicalgia son el grupo que realiza menos actividad física y peor balance muscular presentan. El estrés oxidativo fue superior en pacientes con gonalgia que en los otros grupos. Con respecto a la dieta consumida, se observan diferencias entre grupos experimentales en el contenido mineral (Zn, Mn, Se y I) y vitamínico (folato y ácido ascórbico). Conclusiones: la ingesta de colecalciferol y vitaminas A y D es inferior a las recomendadas en todos los sujetos, lo que favorece la dolencia muscular. La ingesta de folato está por debajo de las recomendaciones, incidiendo en la mayor susceptibilidad al estrés oxidativo. La obesidad y estrés oxidativo se relacionan con la prevalencia de los diferentes tipos de EOM estudiados.

Benefits of physical exercise in postmenopausal women.

Physical inactivity not only places women's health at risk during menopause, but also increases menopausal problems. Abundant evidence links habitual physical exercise (PE) to a better status on numerous health indicators and better quality of life and to the prevention and treatment of the ailments that typically occur from mid-life onwards. We can infer that PE is something more than a lifestyle: it constitutes a form of therapy in itself. A panel of experts from various Spanish scientific societies related to PE and menopause (Spanish Menopause Society, Spanish Cardiology Society, Spanish Federation of Sports Medicine) met to reach a consensus on these issues and to decide the optimal timing of and methods of exercise, based on the best evidence available.

An exercise-based randomized controlled trial on brain, cognition, physical health and mental health in overweight/obese children (ActiveBrains project): Rationale, design and methods.

The new and recent advances in neuroelectric and neuroimaging technologies provide a new era for further exploring and understanding how brain and cognition function can be stimulated by environmental factors, such as exercise, and particularly to study whether physical exercise influences brain development in early ages. The present study, namely the ActiveBrains project, aims to examine the effects of a physical exercise programme on brain and cognition, as well as on selected physical and mental health outcomes in overweight/obese children. A total of 100 participants aged 8 to 11 years are randomized into an exercise group (N=50) or a control group (N=50). The intervention lasts 20-weeks, with 3-5 sessions per week of 90 min each, and is mainly focused on high-intensity aerobic exercise yet also includes muscle-strengthening exercises. The extent to what the intervention effect remains 8-months after the exercise programme finishes is also studied in a subsample. Brain structure and function and cognitive performance are assessed using structural and functional magnetic resonance imaging and electroencephalographic recordings. Secondary outcomes include physical health outcomes (e.g. physical fitness, body fatness, bone mass and lipid-metabolic factors) and mental health outcomes (e.g. chronic stress indicators and overall behavioural and personality measurements such as anxiety or depression). This project will substantially contribute to the existing knowledge and will have an impact on societies, since early stimulation of brain development might have long lasting consequences on cognitive performance, academic achievement and in the prevention of behavioural problems and the promotion of psychological adjustment and mental health. Clinical trials. Gov identifier: NCT02295072.

Activating brown adipose tissue through exercise (ACTIBATE) in young adults: Rationale, design and methodology.

AIMS: The energy expenditure capacity of brown adipose tissue (BAT) makes it an attractive target as a therapy against obesity and type 2 diabetes. BAT activators namely catecholamines, natriuretic peptides and certain myokines, are secreted in response to exercise. ACTIBATE will determine the effect of exercise on BAT activity and mass measured by positron emission tomography/computed tomography (PET/CT, primary outcome) in young adults. ACTIBATE will also investigate the physiological consequences of activating BAT (secondary outcomes). METHODS: ACTIBATE will recruit 150 sedentary, healthy, young adults (50% women) aged 18-25 years. Eligible participants will be randomly assigned to a non-exercise group (n ≈ 50) or one of two exercise groups (n=50 each). Participants in the exercise groups will perform aerobic and strength training 3-4 days/week at a heart rate equivalent to 60% of heart rate reserve (HRres), and at 50% of 1 repetition maximum (RM) for the moderate-intensity group, and at 80% of HRres and 70% RM for the vigorous-intensity group. Laboratory measures completed at baseline and 6 months include BAT activity and mass, resting energy expenditure, meal and cold-induced thermogenesis, body temperature regulation and shivering threshold, body composition and cardiovascular disease risk factors. We will also obtain biopsies from abdominal subcutaneous white adipose tissue and skeletal muscle to analyse the expression of genes encoding proteins involved in the thermogenic machinery. DISCUSSION: Findings from ACTIBATE will have significant implications for our understanding of exercise and its protective effects against the development of type 2 diabetes, obesity and related metabolic diseases. ClinicalTrials.gov ID: NCT02365129.

eVITAL: a preliminary taxonomy and electronic toolkit of health-related habits and lifestyle.

OBJECTIVES: To create a preliminary taxonomy and related toolkit of health-related habits (HrH) following a person-centered approach with a focus on primary care. METHODS: From 2003-2009, a working group (n = 6 physicians) defined the knowledge base, created a framing document, and selected evaluation tools using an iterative process. Multidisciplinary focus groups (n = 29 health professionals) revised the document and evaluation protocol and participated in a feasibility study and review of the model based on a demonstration study with 11 adult volunteers in Antequera, Spain. RESULTS: The preliminary taxonomy contains 6 domains of HrH and 1 domain of additional health descriptors, 3 subdomains, 43 dimensions, and 141 subdimensions. The evaluation tool was completed by the 11 volunteers. The eVITAL toolkit contains history and examination items for 4 levels of engagement: self-assessment, basic primary care, extended primary care, and specialty care. There was positive feedback from the volunteers and experts, but concern about the length of the evaluation. CONCLUSIONS: We present the first taxonomy of HrH, which may aid the development of the new models of care such as the personal contextual factors of the International Classification of Functioning (ICF) and the positive and negative components of the multilevel person-centered integrative diagnosis model.

Phlebodium decumanum is a natural supplement that ameliorates the oxidative stress and inflammatory signalling induced by strenuous exercise in adult humans.

Strenuous exercise induces muscle damage due to a highly increased generation of free radicals and inflammatory response and therefore, in this type of exercise, it is important to reduce both oxidative stress and inflammation, at least their negative aspects. The purpose of this study was investigate, for the first time, whether a purified, standard water-soluble fraction obtained from Phlebodium decamanum could reduce the over-expression of inflammation and oxidative stress induced by strenuous exercise. The physical test consisted of a constant run that combined several degrees of high effort (mountain run and ultra-endurance), in permanent climbing. Biochemical parameters, oxidative stress and inflammatory mediators were assessed. The results showed that oral supplementation of P. decumanum during high-intensity exercise effectively reduces the degree of oxidative stress (decreased 8-hydroxy-2'-deoxyguanosine and isoprostanes generation, increased antioxidant enzyme activities in erythrocyte and total antioxidant status in plasma). The data obtained also indicate that this supplementation is efficient in reducing the inflammatory response through the decrease of TNF-α and increase of sTNF-RII, but kept the levels of IL-6 and IL-1ra. In conclusion, oral supplementation of P. decamanum extract during high-intensity exercise effectively reduces the degree of oxidative stress and has anti-inflammatory protective effects, preventing the over-expression of TNF-α but keeping the levels and effects of IL-6. These findings provide a basis for similar Phlebodium supplementation for both professional and amateur athletes performing strenuous exercise in order to reduce the undesirable effects of the oxidative stress and inflammation signalling elicited during high-intensity exercise.

Coenzyme Q(10) supplementation ameliorates inflammatory signaling and oxidative stress associated with strenuous exercise.

BACKGROUND: Exhausting exercise induces muscle damage associated with high production of free radicals and pro-inflammatory mediators. AIM: The objective of this study was to determine for the first time and simultaneously whether oral coenzyme Q(10) (CoQ(10)) supplementation can prevent over-expression of inflammatory mediators and oxidative stress associated with strenuous exercise. METHODS: The participants were classified in two groups: CoQ(10) group (CG) and placebo group (PG). The physical test consisted in a constant run (50 km) that combined several degrees of high effort (mountain run and ultra-endurance), in permanent climbing. RESULTS: Exercise was associated with an increase in TNF-α, IL-6, 8-hydroxy-2'-deoxyguanosine (8-OHdG), and isoprostane levels, revealing the degree of inflammation and oxidative stress induced. Oral supplementation of CoQ(10) during exercise was efficient reducing oxidative stress (decreased membrane hydroperoxides, 8-OHdG and isoprostanes generation, increased catalase, and total antioxidant status), which would lead to the maintenance of the cell integrity. Data obtained also indicate that CoQ(10) prevents over-expression of TNF-α after exercise, together with an increase in sTNF-RII that limits the pro-inflammatory actions of TNF. Moreover, CoQ(10) supplementation reduced creatinine production. CONCLUSIONS: CoQ(10) supplementation before strenuous exercise decreases the oxidative stress and modulates the inflammatory signaling, reducing the subsequent muscle damage.

Melatonin supplementation ameliorates oxidative stress and inflammatory signaling induced by strenuous exercise in adult human males.

Strenuous exercise induces inflammatory reactions together with high production of free radicals and subsequent muscle damage. This study was designed to investigate for the first time and simultaneously whether over-expression of inflammatory mediators, oxidative stress, and alterations in biochemical parameters induced by acute exercise could be prevented by melatonin. This indoleamine is a potent, endogenously produced free radical scavenger and a broad-spectrum antioxidant; consequently, it might have positive effects on the recovery following an exercise session. The participants were classified into two groups: melatonin-treated men (MG) and placebo-treated individuals (controls group, CG). The physical test consisted in a constant run that combined several degrees of high effort (mountain run and ultra-endurance). The total distance of the run was 50 km with almost 2800 m of ramp in permanent climbing and very changeable climatic conditions. Exercise was associated with a significant increase in TNF-α, IL-6, IL-1ra (in blood), and also an increase in 8-hydroxy-2'-deoxyguanosine (8-OHdG) and isoprostane levels (in urine), and indicated the degree of oxidative stress and inflammation induced. Oral supplementation of melatonin during high-intensity exercise proved efficient in reducing the degree of oxidative stress (lower levels of lipid peroxidation, with a significant increase in antioxidative enzyme activities); this would lead to the maintenance of the cellular integrity and reduce secondary tissue damage. Data obtained also indicate that melatonin has potent protective effects, by preventing over-expression of pro-inflammatory mediators and inhibiting the effects of several pro-inflammatory cytokines. In summary, melatonin supplementation before strenuous exercise reduced muscle damage through modulation of oxidative stress and inflammation signaling associated with this physical challenge.

Effect of phlebodium decumanum on the immune response induced by training in sedentary university students.

Exercise training is considered a good model to provoke different degrees of immune dysfunction affecting physical performance and some physiological responses related to oxidative stress and low grade inflammation. Phlebodium decumanum is a polypodiaceae may induce shown immunomodulating effects, specifically directed to the release of proinflammatory cytokines by macrophages in response to various stimuli, as reported different in vitro studies. The aim of this study was to evaluate the modulating effect of phlebodium decumanum, on the immune response induced by physical exercise. Thirty-one subjects (males only) were randomly divided into two groups: Group PD (n = 18); age: 22.1 ± 1.81, weight 74.21 ± 8.74 kg) that was treated with phlebodium decumanum; Group P (n = 13); age: 22.5 ± 1.63, weight 78 ± 12.5 kg) that was treated with a placebo. Before and after one month training program performed by both groups (three times a week), the following performance parameters and immune response variables were measured: Dynamic Maximum Force; Interval-Training; Tennis test; pro-inflammatory (TNF , IL6) and anti-inflammatory (TNFα-IIrs, IL1-ra) cytokines levels. Data were statistically analyzed with Mann- Whitney U test and Wilcoxon paired test (p < 0.05). Statistically significant differences were recorded within groups before and after the training program. PD group showed a significant improvement in the performance parameters (Strength Muscle Test: dorsal: p < 0.002; deltoids: p < 0.03; and pectorals: p < 0.07; Interval Training: p < 0.06; Tennis Test: p < 0.02). Cytokine levels resulted in a more positive profile in the PD group rather than in the P group, in which higher levels of IL-6 (p < 0.02) and a reduction of TNF-IIrs (p < 0.003) and IL1-ra (p < 0.03) were recorded. In this study the use of phlebodium decumanum demonstrated beneficial effects in the modulation of the immune response during physical performance. Key pointsPracticing sport or physical activity of medium-high intensity three times a week during 4 weeks induces changes in immune response indicators levels;The assumption of phlebodium decumanum induced a reduction in pro-inflammatory cytokines levels and a higher concentration of anti-inflammatory cytokines.Anti-inflammatory cytokines have a protective and modulating effect on the immune response.

Nutritional risk in institutionalized older women determined by the Mini Nutritional Assessment test: what are the main factors?

OBJECTIVES: We assessed which factors contribute to the high level of nutritional risk detected by the Mini Nutritional Assessment (MNA) test in institutionalized older women. To this end, we undertook a complete nutritional assessment. METHODS: A cross-sectional study in 89 older women (age range, 72-98 y) living in two private nursing homes in Granada (Spain) was carried out. The MNA test was used as an assessment tool to detect nutritional risk. The nutritional assessment included anthropometric measurements (body mass index, triceps and subscapular skinfold thicknesses, and mid-arm and calf circumferences), quantification of dietary intake (7-d weighed-food records), clinical and functional evaluations (number of drugs, Katz index, and Red Cross cognitive scale), and biological markers (albumin, prealbumin, transferrin, and lymphocyte counts). RESULTS: We found that 7.9% (n = 5) of the older women were malnourished (MNA score, 14.5 +/- 1.4), 61.8% (n = 56) were at risk of malnutrition (MNA score, 20.6 +/- 2.1), and 30.3% (n = 28) were well nourished (MNA score, 25.0 +/- 1.1) according to the MNA test. CONCLUSIONS: This high prevalence of risk of malnutrition detected by the MNA test in healthy institutionalized older women was due mainly to risk situations and self-perception of health and did not depend on age. Inadequate micronutrients intake may contribute to the development of malnutrition in this population.