Influence of Physical Activity Levels and Functional Capacity on Brain ß-Amyloid Deposition in Older Women.

Physical activity (PA) and Alzheimer's disease are associated. However, how PA influences the cerebral ß-amyloid (Aß) burden remains unclear. The aim of this study was to determine if PA levels and/or functional capacity (FC) are associated with Aß plaque deposition, and whether these associations differed according to APOE-ε4 genotype. A total of 117 women (69.7 ± 2.6 years; 33.3% APOE-ε4-carriers) from the Women's Healthy Ageing Project cohort (WHAP) were analyzed. PA was measured using the International Physical Activity Questionnaire and, FC was evaluated using the Timed Up and Go test (TUGt). Positron emission tomography with F-18 Florbetaben was carried out to assess cerebral Aß burden, and quantified using standardized uptake value rations. The sample was split into PA and TUGt tertiles (T1, T2 and T3), and compared according to APOE-ε4 genotype (positive/negative). There were no significant differences in Aß accumulation according to PA tertiles and APOE-ε4 genotype. Regarding FC, APOE-ε4+ participants in the first TUGt tertile (high performance) obtained significant lower Aß accumulations compared with the other two tertiles (p < 0.05). Comparing between genotypes, greater Aß depositions were found between T2 and T3 in APOE-ε4+ compared with those who were APOE-ε4- (p < 0.05). Values of TUGt ≥ 6.5 s (APOE-ε4+) and 8.5 s (APOE-ε4-) were associated with an increased risk of having higher Aß retention. In conclusion, low performance in TUGt is associated with a negative effect on brain pathology with increasing cerebral Aß depositions in older women who are APOE-ε4+. In physically active older women (> 600 METs·min/week), higher PA levels are not associated with reduction in Aß depositions.

How important is current physical fitness for future quality of life? Results from an 8-year longitudinal study on older adults.

INTRODUCTION: A vast amount of research has focused on the effects of physical fitness (PF) on mortality, with little research evaluating the effects of PF on future expected health related quality of life (HRQoL). AIM: To evaluate how current PF influences future HRQoL measured in a prospective 8-year study in older adults. METHODS: A total of 617 (157 males) older adults (>65y) participated in the study. PF was assessed with the EXERNET battery in 2008-2009 (baseline) and 2016-2017 (follow-up). HRQoL was assessed using the EQ-5D-3L questionnaire in both evaluations. PF tertiles were developed from baseline PF variables: FIT (highest PF values), REGULAR and UNFIT (lowest PF values) taking into account age and sex. Follow-up HRQoL values were compared to sex and age-specific expected values. Logistic regressions were performed to test differences between PF tertiles regarding future expected quality of life. Linear regressions were developed to test whether baseline PF could predict future HRQoL scores. RESULTS: The FIT group showed higher probabilities of an improved HRQoL when compared to the UNFIT group. All PF variables seemed to be important at some point of the study except upper extremities flexibility. Aerobic endurance was the variable that showed to be significant for most of the HRQoL predictions. CONCLUSION: PF influences future HRQoL in older adults who accordingly should try to remain fit to maintain an increased age-adjusted HRQoL.

'Fat but powerful' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study.

OBJECTIVES: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults. METHODS: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated. RESULTS: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively). CONCLUSION: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.

Health Risk, Functional Markers and Cognitive Status in Institutionalized Older Adults: A Longitudinal Study.

A Follow-up of vitamin B12 and lipids status is essential in older people, being closely related to non-communicable diseases. Their relationships with cognitive and physical status are not clear. The aim was to analyze the evolution of vitamin B12 and related parameters, lipid and hematological profiles, and their relationships with cognitive and physical status among institutionalized elderly. Sixty residents, ranged from 62 to 99, were evaluated. Biomarkers (vitamin B12 and related parameters, lipid and hematological profiles), functional capacity (handgrip, arm and leg strength), and cognitive status (Mini-Mental State Examination) were evaluated four times at 4-month intervals. At the beginning of the study, 63% and 70% of the sample showed abnormal homocysteine and folate values, respectively. At the end of the year, abnormal homocysteine increased to 68%, abnormal folate values decreased to 50%. Throughout the year, serum folate showed a significant increase (14.9 vs. 16.3 nmol/L), (p < 0.05). Serum cobalamin (299 vs. 273 pmol/L). HDL-cholesterol (49.9 vs. 47.0 mg/dL) and triglyceride levels (102.4 vs. 123.2 mg/dL) showed a significant decrease and increase respectively in mean values (all p < 0.05). Serum cobalamin and HDL-cholesterol were the most important biomarkers associated with cognitive function (both p < 0.05). The most relevant biomarkers associated with poor physical strength depending on the body part analyzed were low concentrations of HDL-cholesterol, LDL-cholesterol, apolipoprotein A1, and albumin (all p < 0.05). The evolution of lipid biomarkers, their significance with cognitive values, and association with handgrip, point to the importance of the handgrip measurement, a very simple test, as an important health marker. Both serum albumin and physical strength are important health markers in older people.

Role of Dietary Intake and Serum 25(OH)D on the Effects of a Multicomponent Exercise Program on Bone Mass and Structure of Frail and Pre-Frail Older Adults.

The multicomponent training (MCT) effect on bone health in frail and pre-frail elders, which is influenced by dietary intake, is still unknown. The objective of this non-randomized intervention trial was to assess the effects of a 6-month MCT on bone structure in frail and pre-frail elders, and to analyse the influence of dietary intake and serum vitamin D (25(OH)D) in these changes. Thirty MCT (TRAIN) and sixteen controls (CON), frail and pre-frail completed the information required for this study. Peripheral quantitative computed tomography measurements were taken at 4% and 38% of the tibia length and dietary intake was registered. The 25(OH)D values were obtained from blood samples. Analyses of covariance (ANCOVA) for repeated measures showed significant decreases for CON in total bone mineral content at 38% of tibia length. One factor ANOVAs showed smaller decreases in bone mineral density and cortical thickness percentage of change in TRAIN compared to CON. Linear regression analyses were performed to study the influence of nutrients and 25(OH)D on bone changes. Alcohol showed a negative influence on fracture index changes, while polyunsaturated fatty acid and vitamin A showed a positive association with some bone variables. The 25(OH)D only affected positively the cortical bone mineral density. In conclusion, our MCT seems to slow down some of the bone detriments associated with ageing in frail and pre-frail older adults, with alcohol showing a negative effect on the bone and apparent limited effect of nutrients and serum 25(OH)D on training related changes.

Physical performance, plasma S-klotho, and all-cause mortality in elderly dialysis patients: A prospective cohort study.

The secreted protein form of the α-klotho gene, S-klotho, is gaining popularity as a predictor of overall morbimortality, and its role in dialysis patients has been recently highlighted. However, physical performance -which can be assessed through practical field-tests- might be a more practical prognostic marker. The present study aimed to analyze the relationship between physical performance, plasma S-klotho and all-cause mortality in this population. 30 male hemodialysis patients (71 ±â€¯9 years) participated in this prospective, cohort study. Their plasma S-klotho levels and physical performance (assessed by means of the 6-minute walk test [6MWT], handgrip strength, and the sit-to-stand test [STS]) were determined at baseline, and the incidence of mortality was assessed 18-month later. Lower S-klotho levels were associated with a worse performance in all physical tests (all p < 0.05). 12 participants died during the 18 months following baseline measurements. An increased mortality risk was observed in those patients with a worse performance in the STS (RR: 3.0 [95%CI: 1.01-8.95], p < 0.05), the handgrip test (RR: 3.0 [95%CI: 1.01-8.95], p < 0.05) and the 6MWT (RR: 5.0 [95%CI: 1.31-19.07], p < 0.01), being the latter the best predictor of mortality. By contrast, this relationship was not found for plasma S-klotho (RR: 1.6 [95%CI: 0.65-1.35], p > 0.05). In summary, low plasma S-klotho levels are related to impaired physical performance in male dialysis patients. However, physical performance appears as a better and more practical predictor of mortality in this patient population.

How do energy balance-related behaviors cluster in adolescents?

OBJECTIVES: To delineate the clustering of energy balance-related behaviors in adolescents and investigate whether these behaviors are associated with the household socioeconomic status and parental education level. METHODS: Two cross-sectional studies assessed information on sedentary behavior, physical activity, sugar-sweetened beverages and fruit and vegetable consumption, and sleep duration by self-reported questionnaires in adolescents (12.5-17.5 years old) from Maringá/Brazil (BRACAH Study; n = 682) and ten European cities (HELENA Study; n = 1252) from nine different countries. Gender-specific cluster analyses were performed separately for each study, applying a combination of hierarchical and non-hierarchical methods. RESULTS: Girls showed equivalent behaviors: Sedentary; Active; Unhealthy Eating; Healthy Eating; while boys differed (Brazilian: Sedentary; Active; Healthy Eating; European: Sedentary; Healthy; Unhealthy Eating). In Brazil, we found no association between socioeconomic status and parental education. In European girls, the high socioeconomic status and both parents' university degree were associated with Healthy Eating. In European boys, the high socioeconomic status was associated with Unhealthy Eating, and the mothers' university degree was associated with the Healthy cluster. CONCLUSIONS: Adolescents show Sedentary behavior, regardless of their sex, country of origin, or socioeconomic condition.

Adherence to the Mediterranean diet in metabolically healthy and unhealthy overweight and obese European adolescents: the HELENA study.

PURPOSE: To examine the adherence to the Mediterranean dietary pattern (MDP) in metabolically healthy overweight or obese (MHO) and metabolically unhealthy obese (MUO) European adolescents. METHODS: In this cross-sectional study, 137 overweight/obese adolescents aged 12-17 years old from the HELENA study were included. Height, weight, waist circumference and skinfold thickness were measured and body mass index and body fat percent were calculated. Systolic and diastolic blood pressure, glucose, HDL cholesterol, triglycerides and cardiorespiratory fitness (20 m shuttle run test) were measured. MHO and MUO phenotypes were categorized following the Jolliffe and Janssen criteria. Two non-consecutive 24 h recalls were used for dietary intake assessment and the adherence to the MDP was calculated using the Mediterranean dietary pattern score (MDP score) (range 0-9). RESULTS: A total of 45 (22 girls) adolescents (32.8%) were categorized as MHO. The adherence to the MDP was significantly higher in MHO than in MUO adolescents regardless of age, sex, body fat percentage, energy intake and center (MDP score: 4.6 ± 1.6 vs. 3.9 ± 1.5, p = 0.036), but this difference became non-significant after further adjustment for cardiorespiratory fitness. Participants who had a low adherence to the MDP (MDP score ≤ 4) had a higher likelihood of having MUO phenotype regardless of sex, age, energy intake, center and body fat percentage (OR 2.2; 95% CI 1.01-4.81, p = 0.048). CONCLUSIONS: Adherence to the MDP might be beneficial to maintain metabolic health in overweight/obese adolescents, yet cardiorespiratory fitness seems to play a key role on the metabolic phenotype.

Association between Physical Condition and Body Composition, Nutrient Intake, Sociodemographic Characteristics, and Lifestyle Habits in Older Spanish Adults.

In this study, we assessed physical condition and its association with body composition, nutrient intake, sociodemographic characteristics, and lifestyle habits in older Spanish adults. In this cross-sectional study, we investigated 380 individuals (54% women; men aged 55⁻80 years and women aged 60⁻80 years) with no previously documented cardiovascular disease. A general questionnaire was used, and body weight, height, fat, appendicular skeletal muscle mass, and waist circumference were assessed. Physical condition measurements included handgrip strength (HGS) and agility/dynamic balance by eight-foot time up-and-go (8-f TUG) test. The lowest maximum HGS score (kg) was found in older participants, inactive men, and men with abdominal obesity. The highest maximum 8-f TUG score (s) was found in older and inactive, low education, low income, and abdominal obesity and overfat participants; 24.5% of participants had low maximum HGS and 36.8% had a high 8-f TUG score. Sex- and/or age-adjusted odds ratio (OR) for low maximum HGS in women, older participants, overweight and overfat participants were 4.6, 2.9, 0.6 and 0.6 respectively. Sex and/or age adjusted OR for high maximum 8-f TUG in women, overweight, overfat, and abdominally obese participants were 2.4, 1.6, 1.7, and 3.4, respectively; in participants with higher education, those who earned €900 or more per month, and slightly active and active participants had OR values of 0.4, 0.4, and 0.3, respectively. Sarcopenia incidence was 0.3%; however, 4.5% of men and 19.1% of women registered low physical condition (high and low scores in 8-f TUG and HGS tests, respectively). Overall, 36.8%, 24.5%, and 0.3% of participants had high maximum 8-f TUG score, low maximum HGS, and sarcopenia, respectively. Prevalence of these low values varies according to sociodemographic and body composition variables.

Intradialytic Exercise: One Size Doesn't Fit All.

Purpose: Hemodialysis patients commonly have impaired physical performance and mental health. We studied the effects of an intradialytic exercise program on these variables. Methods: 27 patients (33% women; 68 ± 13 years) were enrolled in a 14-week intradialytic endurance-resistance training program ('exercise' group, 40 programmed sessions per patient); 40 hemodialysis patients (28% women; 68 ± 11 years) performing no exercise during the same time length were used as controls. Endpoints included physical performance (6-min walk test [6MWT], 10-repetition sit to stand [STS-10] and handgrip strength), emotional status (Beck's depression inventory and State-Trait Anxiety Inventory), and mental and physical component scores of the short-from (SF)-12 Health Survey. Results: There were no differences (p> 0.05) between groups at baseline for sex distribution, or mean age, body mass index and time spent on dialysis. Exercise benefits were observed for 6MWT (11 and -3% for the exercise and control groups, respectively; p < 0.001), STS-10 performance time (-22 and 6%; p < 0.001) and handgrip strength (4 and -4%; p < 0.02). No significant benefits (p> 0.05) were observed for emotional status endpoints or SF-12 component scores. Despite significant benefits on physical performance, the proportion of clinically meaningful responders was low (<50%). Responsiveness was dependent on baseline physical performance (p < 0.05) but not on age or sex (p > 0.05). Conclusion: A 14-week intradialytic training program induced significant improvements on physical performance. However, the rate of clinically meaningful responders observed in the present study was low, being the level of responsiveness dependent on baseline physical status. Efforts to individualize exercise prescription are needed in clinical practice.

[Organized physical activity in the elderly, a tool to improve physical fitness during ageing]. / La actividad física organizada en las personas mayores, una herramienta para mejorar la condición física en la senectud.

OBJECTIVE: An adequate level of fitness is critical to achieving healthy ageing. The aim of this study was to evaluate the impact of organized physical activity (PA) and the number of hours of practice on the fitness levels of the elderly. METHODS: A total of 3104 people over 65 years old from Spain, belonging to the EXERNET Multicenter Project (722 men and 2382 women, mean age: 72.1 ± 5.3 years) participated in the study. Fitness was evaluated by 8 specific tests for this population. Participation in organized PA was recorded through a questionnaire. Differences in fitness values depending on the participation in PA and the number of hours were measured with ANCOVA adjusting for age, hours of walking and sitting time. RESULTS: Those who did not participate in this type of activity increased their risk of having a low level of fitness in most variables evaluated, with some differences between sexes (OR: from 1.6 to 2.6 in men and from 1.4 to 2.2 in women). In men, no significant differences were observed between practicing less than 2, 2-4 or more than 4 hours (P grater than 0,05), with an exception in the strength of the left arm. However, women who performed more than 2 hours a week in organized PA had better balance, strength of lower and upper extremities, flexibility of lower extremities, walking speed and aerobic capacity than those who performed less than 2 hours of PA a week (P less than 0,05). CONCLUSIONS: The practice of organized PA produces a beneficial effect on the fitness of the elderly regardless of age, hours of walking and time sitting per day.

OBJETIVO: Un nivel adecuado de condición física (CF) es fundamental para el logro de un envejecimiento saludable. El objetivo de este estudio consistió en evaluar el impacto de la actividad física (AF) organizada y el número de horas de práctica sobre el nivel de CF de las personas mayores. METODOS: En el estudio participaron 3104 personas mayores de 65 años de España, pertenecientes al Proyecto Multicéntrico EXERNET (722 hombres y 2382 mujeres; edad media: 72,1±5,3 años). La CF se evaluó mediante 8 test específicos para esta población. La participación en AF organizada se registró mediante un cuestionario. Las diferencias en la CF en función de la práctica y número de horas de AF se midieron con ANCOVA ajustando por edad, horas de caminar y de estar sentado. RESULTADOS: Aquellos que no participaban en este tipo de actividad incrementaban su riesgo de tener un nivel bajo de CF en la mayoría de las variables evaluadas, observándose algunas diferencias entre sexos (OR: desde 1,6 hasta 2,6 en hombres y desde 1,4 hasta 2,2 en mujeres). En los hombres no se observó ninguna diferencia significativa entre practicar menos de 2, 2-4 o más de 4 horas (todos P mayor de 0,05), a excepción de la fuerza del brazo izquierdo; sin embargo, las mujeres que realizaban más de 2 horas de AF organizada a la semana tenían mayor equilibrio, fuerza de piernas y de brazos, flexibilidad de piernas, velocidad al caminar y resistencia aeróbica que aquellas que asistían a este tipo de sesiones menos de 2 horas a la semana (P menor de 0,05). CONCLUSIONES: La práctica de AF organizada produce un efecto beneficioso sobre la CF de las personas mayores independientemente de la edad, las horas que estén sentados o el tiempo que dediquen a caminar.

La actividad física organizada en las personas mayores, una herramienta para mejorar la condición física en la senectud / Organized physical activity in the elderly, a tool to improve physical fitness during ageing

Fundamentos. Un nivel adecuado de condición física (CF) es fundamental para el logro de un envejecimiento saludable. El objetivo de este estudio consistió en evaluar el impacto de la actividad física (AF) organizada y el número de horas de práctica sobre el nivel de CF de las personas mayores. Método. En el estudio participaron 3104 personas mayores de 65 años de España, pertenecientes al Proyecto Multicéntrico EXERNET (722 hombres y 2382 mujeres; edad media: 72,1±5,3 años). La CF se evaluó mediante 8 test específicos para esta población. La participación en AF organizada se registró mediante un cuestionario. Las diferencias en la CF en función de la práctica y número de horas de AF se midieron con ANCOVA ajustando por edad, horas de caminar y de estar sentado. Resultados. Aquellos que no participaban en este tipo de actividad incrementaban su riesgo de tener un nivel bajo de CF en la mayoría de las variables evaluadas, observándose algunas diferencias entre sexos (OR: desde 1,6 hasta 2,6 en hombres y desde 1,4 hasta 2,2 en mujeres). En los hombres no se observó ninguna diferencia significativa entre practicar menos de 2, 2-4 o más de 4 horas (todos P>0,05), a excepción de la fuerza del brazo izquierdo; sin embargo, las mujeres que realizaban más de 2 horas de AF organizada a la semana tenían mayor equilibrio, fuerza de piernas y de brazos, flexibilidad de piernas, velocidad al caminar y resistencia aeróbica que aquellas que asistían a este tipo de sesiones menos de 2 horas a la semana (P<0,05). Conclusiones. La práctica de AF organizada produce un efecto beneficioso sobre la CF de las personas mayores independientemente de la edad, las horas que estén sentados o el tiempo que dediquen a caminar. (AU)

Background. An adequate level of fitness is critical to achieving healthy ageing. The aim of this study was to evaluate the impact of organized physical activity (PA) and the number of hours of practice on the fitness levels of the elderly. Method. A total of 3104 people over 65 years old from Spain, belonging to the EXERNET Multicenter Project (722 men and 2382 women, mean age: 72.1 ± 5.3 years) participated in the study. Fitness was evaluated by 8 specific tests for this population. Participation in organized PA was recorded through a questionnaire. Differences in fitness values depending on the participation in PA and the number of hours were measured with ANCOVA adjusting for age, hours of walking and sitting time.Results. Those who did not participate in this type of activity increased their risk of having a low level of fitness in most variables evaluated, with some differences between sexes (OR: from 1.6 to 2.6 in men and from 1.4 to 2.2 in women). In men, no significant differences were observed between practicing less than 2, 2-4 or more than 4 hours (P>0,05), with an exception in the strength of the left arm. However, women who performed more than 2 hours a week in organized PA had better balance, strength of lower and upper extremities, flexibility of lower extremities, walking speed and aerobic capacity than those who performed less than 2 hours of PA a week (P<0,05). Conclusions. The practice of organized PA produces a beneficial effect on the fitness of the elderly regardless of age, hours of walking and time sitting per day (AU)

A Novel Physical Activity and Sedentary Behavior Classification and Its Relationship With Physical Fitness in Spanish Older Adults: The PHYSMED Study.

BACKGROUND: As there is no gold-standard methodology to classify older people in relation to physical activity (PA) and sedentary behavior (SB), this paper aimed to propose a classification combining PA and SB. METHODS: Within a broader study, 433 subjects, aged 55 years and older (57% females) from Madrid and Majorca, were evaluated for PA and SB by means of validated questionnaires. Physical fitness was analyzed objectively using the EXERNET test battery. Cluster analyses were used to establish behavioral patterns, combining PA and SB. RESULTS: Males spent more time doing regular PA but less time walking and working at home than females (P < .001). Comparing the groups (inactive and high sedentary, inactive and low sedentary, active and high sedentary, and active and low sedentary), the worst aerobic endurance (P < .001) and lower body strength (P < .05) were obtained in males from both inactive groups. Agility was highest in the active and low sedentary group (P < .05). No significant differences were observed in females. CONCLUSIONS: The proposed classification is valid, as it classifies subjects according to their PA and SB, and outcomes are related to objectively measured fitness. It could facilitate the work of public health authorities, researchers, and physicians.

Amino acids intake and physical fitness among adolescents.

The aim was to investigate whether there was an association between amino acid (AA) intake and physical fitness and if so, to assess whether this association was independent of carbohydrates intake. European adolescents (n = 1481, 12.5-17.5 years) were measured. Intake was assessed via two non-consecutive 24-h dietary recalls. Lower and upper limbs muscular fitness was assessed by standing long jump and handgrip strength tests, respectively. Cardiorespiratory fitness was assessed by the 20-m shuttle run test. Physical activity was objectively measured. Socioeconomic status was obtained via questionnaires. Lower limbs muscular fitness seems to be positively associated with tryptophan, histidine and methionine intake in boys, regardless of centre, age, socioeconomic status, physical activity and total energy intake (model 1). However, these associations disappeared once carbohydrates intake was controlled for (model 2). In girls, only proline intake seems to be positively associated with lower limbs muscular fitness (model 2) while cardiorespiratory fitness seems to be positively associated with leucine (model 1) and proline intake (models 1 and 2). None of the observed significant associations remained significant once multiple testing was controlled for. In conclusion, we failed to detect any associations between any of the evaluated AAs and physical fitness after taking into account the effect of multiple testing.

Effects of clustering of multiple lifestyle-related behaviors on blood pressure in adolescents from two observational studies.

BACKGROUD: Several lifestyle-related behaviors are associated with cardiovascular health outcomes in adolescents. To examine the associations between clustered lifestyle-related behaviors and blood pressure (BP) levels in adolescents. METHODS: Participants were recruited by multistage random cluster in two cross-sectional studies; one conducted in 2006 and 2007 in ten cities from nine European countries: Athens and Heraklion in Greece, Dortmund in Germany, Ghent in Belgium, Lille in France, Pécs in Hungary, Rome in Italy, Stockholm in Sweden, Vienna in Austria, and Zaragoza in Spain; and another conducted in 2007 one city in Brazil (Maringá/PR). Systolic BP (SBP) and diastolic BP (DBP) (outcomes) and clustered behaviors (weekly consumption of fruits and vegetables, weekly consumption of sugar-sweetened beverages, sleep duration, screen time and physical activity) were analyzed. RESULTS: The Healthy Eating cluster was negatively associated with DBP in European girls, ß=-2.46 (-4.62; -0.30), and with SBP in Brazilian boys, ß=-2.79 (-3.10; -0.15). Furthermore, the Unhealthy Eating cluster was associated with increased SBP in European girls, ß=4.54 (1.29; 7.79), and in Brazilian boys, ß=4.10 (0.80; 7.40). CONCLUSION: The Healthy Eating cluster was associated with lower blood pressure, whereas the Unhealthy Eating cluster was associated with increased SBP in adolescents.

Associations between obesity, physical fitness, and urinary incontinence in non-institutionalized postmenopausal women: The elderly EXERNET multi-center study.

OBJECTIVES: To investigate the associations between body composition, fitness level, and urinary incontinence (UI) in 471 non-institutionalized women ≥ 65 years of age. STUDY DESIGN: Cross-sectional study. METHOD: UI was assessed using the International Consultation on Incontinence Questionnaire Short-Form and a specific severity UI item. Anthropometric measurements were obtained using standardized techniques and equipment. Body fat percentage (BF%) was measured by bioelectrical impedance. Physical fitness (PF) was evaluated by a set of 8 tests and a fitness index (FI) was calculated. Active and sedentary behaviors were recorded by standardized questionnaires. RESULTS: UI was reported in 28.5% of the participants. Women with UI showed higher values of body mass index (BMI), BF% and waist circumference (WC) (all p<0.05) compared to urinary continent women, whereas there was a lower fitness index (FI) level in women with UI (p=0.08). Among all fitness capacities, upper body flexibility showed the closest relationship with UI. UI risk increased by 87.0% [95% confidence intervals (1.01-3.17)] in obese women compared to the normal group, according to the BF% while no significant results were found when PF, WC and BMI were included in the model. Mean sitting and walking time per day were 4.3±1.4 and 1.8±0.9 h/d, respectively. CONCLUSION: UI was associated with an excess of fat mass and poor PF, especially upper-body flexibility.

Physical activity assessment in the general population; instrumental methods and new technologies

The objective measurement of human movement and the quantification of energy expenditure due to physical activity is an identified need in both research and the clinical setting. Validated and well-defined reference methods (double labelled water, direct calorimetry, indirect calorimetry) are expensive and mostly limited to the laboratory setting. Therefore, in the last years, several objective measurement devices have been developed which are appropriate for field studies and clinical settings. There is no gold standard among them, as all have limitations. Pedometers are small, non-expensive, count the steps taken and give information on total physical activity, but not about physical activity patterns and behaviour. Accelerometers are expensive, save information about frequency and intensity of physical activity, but not about type of physical activity. Both pedometers and accelerometers only save information about lower body movement, but reliability about the estimation of energy expenditure is limited. Heart rate monitoring relates intensity to energy expenditure, but gives no information about physical activity. GPS watches are portable, relatively inexpensive, non-invasive and provide distance, speed, and elevation with exact time and location, but are maybe limited for the assessment of brief higher speed movement and energy expenditure. Combined motion sensors combine accelerometry with the measurement of physiological variables and share advantages of single devices and are more precise. Manufacturer software which applies activity-specific algorithms for the calculation of energy expenditure can affect energy expenditure results. Most of the devices estimate energy expenditure more accurately at light to moderate intensities; underestimation increases at very light and higher intensity activities (AU)

La medición objetiva del movimiento humano y la cuantificación del gasto energético debido a la actividad física es una necesidad identificada tanto en investigación como en clínica. Los métodos de referencia validados y bien definidos (el agua doblemente marcada, la calorimetría directa, la calorimetría indirecta) son caros y prácticamente se limitan a la investigación en el laboratorio. Por lo tanto, en los últimos años, se han desarrollado diferentes dispositivos de medición objetiva que son apropiados para los estudios de campo y clínicos. No hay ningún estándar de oro entre ellos, ya que todos tienen limitaciones. Los podómetros son ligeros, poco costosos, cuentan los pasos y aportan información sobre la actividad física total, pero no sobre el comportamiento y los patrones de actividad física. Los acelerómetros son caros, aportan información sobre patrón, frecuencia e intensidad de la actividad física, pero no sobre el tipo de actividad física. Los podómetros y acelerómetros únicamente recogen información sobre el movimiento del movimiento corporal, pero la validez en la estimación del gasto energético es limitada. La monitorización de la frecuencia cardíaca relaciona intensidad del ejercicio con gasto de energía, pero no aporta información sobre la actividad física. Los dispositivos GPS son portátiles, relativamente asequibles, no invasivos y recogen distancia, velocidad y elevación con hora y lugar exactos, pero quizás estén limitados para la evaluación de movimientos cortos de alta intensidad y elevado gasto energético. Los dispositivos de última generación combinan acelerometría con la medición de variables fisiológicas, comparten las ventajas de los dispositivos individuales y son más precisos. Para el cálculo del gasto energético se aplican algoritmos específicos de la actividad incluidos en el software del fabricante que pueden afectar a los resultados. La mayoría de los dispositivos estiman con mayor precisión el gasto energético a intensidades ligeras y moderadas, pero subestiman el gasto a intensidades muy ligeras y de mayor intensidad (AU)

Biomarkers of physical activity and exercise

Traditionally, biomarkers have been of interest in sports in order to measure performance, progress in training and for identifying overtraining. During the last years, growing interest is set on biomarkers aiming at evaluating health-related aspects which can be modulated by regular physical activity and sport. The value or concentration of a biomarker depends on many factors, as the training status of the subject, the degree of fatigue and the type, intensity and duration of exercise, apart from age and sex. Most of the biomarkers are measured in blood, urine and saliva. One of the main limitations for biochemical biomarkers is that reference values for blood concentration of biomarkers specifically adapted to physically active people and athletes are lacking. Concentrations can differ widely from normal reference ranges. Therefore, it is important to adapt reference values as much as possible and to control each subject regularly, in order to establish his/her own reference scale. Other useful biomarkers are body composition (specifically muscle mass, fat mass, weight), physical fitness (cardiovascular capacity, strength, agility, flexibility), heart rate and blood pressure. Depending on the aim, one or several biomarkers should be measured. It may differ if it is for research purpose, for the follow up of training or to prevent risks. For this review, we will get deeper into the biomarkers used to identify the degree of physical fitness, chronic stress, overtraining, cardiovascular risk, oxidative stress and inflammation (AU)

Tradicionalmente, los biomarcadores han sido de interés en las ciencias del deporte para medir el rendimiento, el progreso en el entrenamiento y para identificar el sobreentrenamiento. Durante los últimos años, cada vez hay mayor interés en evaluar los efectos relacionados con la salud que se producen en el organismo debidos a una actividad física regular y al deporte. El valor o la concentración de un biomarcador depende de muchos factores, como el grado de entrenamiento, el grado de fatiga y del tipo, la intensidad y la duración del ejercicio, aparte de la edad y del sexo. La mayor parte de los biomarcadores se miden en sangre, orina y saliva. Una de las principales limitaciones que presentan los biomarcadores bioquímicos es la falta de valores de referencia adaptados específicamente para deportistas y personas físicamente activas. Las concentraciones pueden variar considerablemente de los valores de referencia normales. Por lo tanto, es importante adaptar los valores de referencia siempre y cuando sea posible y controlar a cada sujeto regularmente, con el fin de establecer su propia escala de referencia. Otros biomarcadores útiles son la composición corporal (específicamente masa muscular, masa grasa, peso), la condición física (capacidad cardiorrespiratoria, fuerza, agilidad, flexibilidad), frecuencia cardíaca y presión arterial. Dependiendo de la finalidad, será conveniente analizar uno o varios biomarcadores. Para esta revisión, profundizaremos en los biomarcadores que se emplean para evaluar condición física, fatiga crónica, sobreentrenamiento, riesgo cardiovascular, estrés oxidativo e inflamación (AU)

Physical activity assessment in the general population; instrumental methods and new technologies.

The objective measurement of human movement and the quantification of energy expenditure due to physical activity is an identified need in both research and the clinical setting. Validated and well-defined reference methods (double labelled water, direct calorimetry, indirect calorimetry) are expensive and mostly limited to the laboratory setting. Therefore, in the last years, several objective measurement devices have been developed which are appropriate for field studies and clinical settings. There is no gold standard among them, as all have limitations. Pedometers are small, non-expensive, count the steps taken and give information on total physical activity, but not about physical activity patterns and behaviour. Accelerometers are expensive, save information about frequency and intensity of physical activity, but not about type of physical activity. Both pedometers and accelerometers only save information about lower body movement, but reliability about the estimation of energy expenditure is limited. Heart rate monitoring relates intensity to energy expenditure, but gives no information about physical activity. GPS watches are portable, relatively inexpensive, non-invasive and provide distance, speed, and elevation with exact time and location, but are maybe limited for the assessment of brief higher speed movement and energy expenditure. Combined motion sensors combine accelerometry with the measurement of physiological variables and share advantages of single devices and are more precise. Manufacturer software which applies activity-specific algorithms for the calculation of energy expenditure can affect energy expenditure results. Most of the devices estimate energy expenditure more accurately at light to moderate intensities; underestimation increases at very light and higher intensity activities.

La medición objetiva del movimiento humano y la cuantificación del gasto energético debido a la actividad física es una necesidad identificada tanto en investigación como en clínica. Los métodos de referencia validados y bien definidos (el agua doblemente marcada, la calorimetría directa, la calorimetría indirecta) son caros y prácticamente se limitan a la investigación en el laboratorio. Por lo tanto, en los últimos años, se han desarrollado diferentes dispositivos de medición objetiva que son apropiados para los estudios de campo y clínicos. No hay ningún estándar de oro entre ellos, ya que todos tienen limitaciones. Los podómetros son ligeros, poco costosos, cuentan los pasos y aportan información sobre la actividad física total, pero no sobre el comportamiento y los patrones de actividad física. Los acelerómetros son caros, aportan información sobre patrón, frecuencia e intensidad de la actividad física, pero no sobre el tipo de actividad física. Los podómetros y acelerómetros únicamente recogen información sobre el movimiento del movimiento corporal, pero la validez en la estimación del gasto energético es limitada. La monitorización de la frecuencia cardíaca relaciona intensidad del ejercicio con gasto de energía, pero no aporta información sobre la actividad física. Los dispositivos GPS son portátiles, relativamente asequibles, no invasivos y recogen distancia, velocidad y elevación con hora y lugar exactos, pero quizás estén limitados para la evaluación de movimientos cortos de alta intensidad y elevado gasto energético. Los dispositivos de última generación combinan acelerometría con la medición de variables fisiológicas, comparten las ventajas de los dispositivos individuales y son más precisos. Para el cálculo del gasto energético se aplican algoritmos específicos de la actividad incluidos en el software del fabricante que pueden afectar a los resultados. La mayoría de los dispositivos estiman con mayor precisión el gasto energético a intensidades ligeras y moderadas, pero subestiman el gasto a intensidades muy ligeras y de mayor intensidad.

Biomarkers of physical activity and exercise.

Traditionally, biomarkers have been of interest in sports in order to measure performance, progress in training and for identifying overtraining. During the last years, growing interest is set on biomarkers aiming at evaluating health-related aspects which can be modulated by regular physical activity and sport. The value or concentration of a biomarker depends on many factors, as the training status of the subject, the degree of fatigue and the type, intensity and duration of exercise, apart from age and sex. Most of the biomarkers are measured in blood, urine and saliva. One of the main limitations for biochemical biomarkers is that reference values for blood concentration of biomarkers specifically adapted to physically active people and athletes are lacking. Concentrations can differ widely from normal reference ranges. Therefore, it is important to adapt reference values as much as possible and to control each subject regularly, in order to establish his/her own reference scale. Other useful biomarkers are body composition (specifically muscle mass, fat mass, weight), physical fitness (cardiovascular capacity, strength, agility, flexibility), heart rate and blood pressure. Depending on the aim, one or several biomarkers should be measured. It may differ if it is for research purpose, for the follow up of training or to prevent risks. For this review, we will get deeper into the biomarkers used to identify the degree of physical fitness, chronic stress, overtraining, cardiovascular risk, oxidative stress and inflammation.

Tradicionalmente, los biomarcadores han sido de interés en las ciencias del deporte para medir el rendimiento, el progreso en el entrenamiento y para identificar el sobreentrenamiento. Durante los últimos años, cada vez hay mayor interés en evaluar los efectos relacionados con la salud que se producen en el organismo debidos a una actividad física regular y al deporte. El valor o la concentración de un biomarcador depende de muchos factores, como el grado de entrenamiento, el grado de fatiga y del tipo, la intensidad y la duración del ejercicio, aparte de la edad y del sexo. La mayor parte de los biomarcadores se miden en sangre, orina y saliva. Una de las principales limitaciones que presentan los biomarcadores bioquímicos es la falta de valores de referencia adaptados específicamente para deportistas y personas físicamente activas. Las concentraciones pueden variar considerablemente de los valores de referencia normales. Por lo tanto, es importante adaptar los valores de referencia siempre y cuando sea posible y controlar a cada sujeto regularmente, con el fin de establecer su propia escala de referencia. Otros biomarcadores útiles son la composición corporal (específicamente masa muscular, masa grasa, peso), la condición física (capacidad cardiorrespiratoria, fuerza, agilidad, flexibilidad), frecuencia cardíaca y presión arterial. Dependiendo de la finalidad, será conveniente analizar uno o varios biomarcadores. Para esta revisión, profundizaremos en los biomarcadores que se emplean para evaluar condición física, fatiga crónica, sobreentrenamiento, riesgo cardiovascular, estrés oxidativo e inflamación.