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1.
An. pediatr. (2003. Ed. impr.) ; 92(3): 173.e1-173.e8, mar. 2020. tab, graf
Artigo em Espanhol | IBECS-Express | IBECS | ID: ibc-FGT-4083

RESUMO

La actividad física (AF) y el ejercicio físico (EF) mejoran la calidad de vida global, previenen la aparición de enfermedades en niños y adolescentes sanos, y sirve para el tratamiento de enfermedades crónicas prevalentes en la infancia. Si la AF y el EF son medicina, el sedentarismo y la inactividad provocan enfermedad. Se revisa en este artículo la evidencia científica existente al respecto y se ponen al día las recomendaciones para los profesionales involucrados en la salud del niño, ya que es necesario un buen conocimiento de cómo prescribir EF y AF en pediatría en diferentes enfermedades. Las intervenciones para evitar la inactividad del niño y del adolescente deben estar sustentadas en el apropiado aumento del nivel de AF, mediante programas de integración y capacitación, que consigan una mejora conjunta de la condición física neuromuscular y del rendimiento físico, cognitivo y psicosocial. La Asociación Española de Pediatría, a través del Comité de Promoción de la Salud, propone estrategias que faciliten este objetivo para mejorar la salud de nuestros pacientes a través de la práctica de EF y el aumento de la AF


Physical activity (PA) and exercise improve the overall quality of life, as well as prevent the onset of diseases in healthy children and adolescents, and as an aid to treat prevalent chronic diseases in childhood. PA and exercise are like medicine, but sedentary lifestyle and inactivity cause disease. In this article, the existing scientific evidence in this field is reviewed and recommendations for professionals involved in child health are updated. A good knowledge of how to prescribe exercise and PA in paediatrics in different diseases is necessary. Interventions to avoid inactivity of children and adolescents must be supported by the appropriate increase in the level of PA, through integration and training programs, which achieve both an overall improvement of the neuromuscular physical condition and also physical, cognitive, and psychosocial performance. The Health Promotion Committee of Spanish Paediatric Association proposes strategies that help to obtain this objective, aiming to improve the health of our patients through the practice of exercise and the increase in PA

2.
An Pediatr (Barc) ; 92(3): 173.e1-173.e8, 2020 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-32061527

RESUMO

Physical activity (PA) and exercise improve the overall quality of life, as well as prevent the onset of diseases in healthy children and adolescents, and as an aid to treat prevalent chronic diseases in childhood. PA and exercise are like medicine, but sedentary lifestyle and inactivity cause disease. In this article, the existing scientific evidence in this field is reviewed and recommendations for professionals involved in child health are updated. A good knowledge of how to prescribe exercise and PA in paediatrics in different diseases is necessary. Interventions to avoid inactivity of children and adolescents must be supported by the appropriate increase in the level of PA, through integration and training programs, which achieve both an overall improvement of the neuromuscular physical condition and also physical, cognitive, and psychosocial performance. The Health Promotion Committee of Spanish Paediatric Association proposes strategies that help to obtain this objective, aiming to improve the health of our patients through the practice of exercise and the increase in PA.

3.
Blood Press ; 29(1): 13-20, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31829032

RESUMO

Background: Childhood obesity, including overweight, continues increasing worldwide affecting health expectancy, quality of life and healthcare expenditure. These subjects have higher probability of suffering or developing cardio metabolic risk factors. Recent studies have revealed cardiorespiratory fitness (CRF) as a valuable clinical parameter to identify these subjects and have even suggested cut-off values. However, evaluating CRF in overweight and obese youth can be difficult to implement, unfriendly and expensive.Objective: Develop a screening tool to identify high-risk subjects in a representative population of those attending overweight/obesity assessment programmes without prior intervention. It will be based on heart rate variability parameters, which has strong association with CRF and cardio metabolic risk factors.Methods: Sixty-three subjects, overweight and obese, between 9 and 17 years of age, and of both sexes were enrolled. None of them had secondary obesity syndromes and/or suffered from acute or chronic disease. Anthropometric parameters, electrocardiogram signal recording under resting conditions and cardiorespiratory fitness - evaluated by oxygen consumption and time elapsed of cardiopulmonary exercise test - were measured.Results: Significant differences in the sympathetic nervous system activity - assessed by heart rate variability analysis - are observed when grouping by overweight and obesity degree as well as by CRF (poor/normal). Body mass index, puberty and sympathetic nervous system activity are the significant variables of a logistic regression model develop to identify poor CRF individuals. Its accuracy reaches 92%.Conclusions: A screening tool based on heart rate variability and anthropometric parameters was developed to identify subjects with higher probability of suffering or developing cardio metabolic risk factors.

4.
J Transl Med ; 17(1): 145, 2019 05 07.
Artigo em Inglês | MEDLINE | ID: mdl-31064394

RESUMO

BACKGROUND: Nutrition of the newborn during the early postnatal period seems to be of capital importance and there is clinical evidence showing the protective effect of breastfeeding compared with formula feeding on childhood obesity and its comorbidities. Infants born small for gestation age may be more sensitive to the type of feeding during lactation. Here, we aimed to analyze the impact of birth weight and the type of infant feeding on the expression levels in peripheral blood cells of selected candidate genes involved in energy homeostasis in 5-year-old children, to find out potential early biomarkers of metabolic programming effects during this period of metabolic plasticity. METHODS: Forty subjects were recruited at birth and divided in four groups according to birth weight (adequate or small for gestational age) and type of infant feeding (breastfeeding or formula feeding). They were followed from birth to the age of 5 years. RESULTS: At 5 years, no significant differences regarding anthropometric parameters were found between groups, and all children had normal biochemical values. Expression levels of UCP2 and MC4R in peripheral blood cells were lower and higher, respectively, in formula feeding children compared with breastfeeding ones (P = 0.002 and P = 0.064, two-way ANOVA). Differences were more marked and significant by Student's t test in small for gestation age children (P < 0.001 and P = 0.017, respectively). Transcript levels of FASN and FTO in peripheral blood cells were also different according to the type of infant feeding, but only in small for gestation age children. CONCLUSIONS: Altogether, these results suggest that small for gestation age infants are more sensitive to the type of feeding during lactation, and transcript levels of particular genes in peripheral blood cells, especially the MC4R/UCP2 mRNA ratio, may precisely reflect these effects in the absence of clear differences in phenotypic traits.


Assuntos
Biomarcadores/sangue , Células Sanguíneas/metabolismo , Aleitamento Materno , Recém-Nascido Pequeno para a Idade Gestacional/sangue , Peso ao Nascer , Pressão Sanguínea/genética , Pré-Escolar , Feminino , Regulação da Expressão Gênica , Humanos , Recém-Nascido , Masculino , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Sístole/genética
5.
J Transl Med ; 17(1): 15, 2019 01 09.
Artigo em Inglês | MEDLINE | ID: mdl-30626398

RESUMO

BACKGROUND: Early life is a period of drastic epigenetic remodeling in which the epigenome is especially sensitive to extrinsic and intrinsic influence. However, the epigenome-wide dynamics of the DNA methylation changes that occur during this period have not been sufficiently characterized in longitudinal studies. METHODS: To this end, we studied the DNA methylation status of more than 750,000 CpG sites using Illumina MethylationEPIC arrays on 33 paired blood samples from 11 subjects at birth and at 5 and 10 years of age, then characterized the chromatin context associated with these loci by integrating our data with histone, chromatin-state and enhancer-element external datasets, and, finally, validated our results through bisulfite pyrosequencing in two independent longitudinal cohorts of 18 additional subjects. RESULTS: We found abundant DNA methylation changes (110,726 CpG sites) during the first lustrum of life, while far fewer alterations were observed in the subsequent 5 years (460 CpG sites). However, our analysis revealed persistent DNA methylation changes at 240 CpG sites, indicating that there are genomic locations of considerable epigenetic change beyond immediate birth. The chromatin context of hypermethylation changes was associated with repressive genomic locations and genes with developmental and cell signaling functions, while hypomethylation changes were linked to enhancer regions and genes with immunological and mRNA and protein metabolism functions. Significantly, our results show that genes that suffer simultaneous hyper- and hypomethylation are functionally distinct from exclusively hyper- or hypomethylated genes, and that enhancer-associated methylation is different in hyper- and hypomethylation scenarios, with hypomethylation being more associated to epigenetic changes at blood tissue-specific enhancer elements. CONCLUSIONS: These data show that epigenetic remodeling is dramatically reduced after the first 5 years of life. However, there are certain loci which continue to manifest DNA methylation changes, pointing towards a possible functionality beyond early development. Furthermore, our results deepen the understanding of the genomic context associated to hyper- or hypomethylation alterations during time, suggesting that hypomethylation of blood tissue-specific enhancer elements could be of importance in the establishment of functional states in blood tissue during early-life.


Assuntos
Metilação de DNA/genética , Genoma Humano , Criança , Pré-Escolar , Cromatina/metabolismo , Ilhas de CpG/genética , Feminino , Humanos , Recém-Nascido , Estudos Longitudinais , Masculino , Reprodutibilidade dos Testes
6.
J Hypertens ; 36(9): 1840-1846, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29916994

RESUMO

OBJECTIVE: Observational studies have indicated that high levels of serum uric acid are associated with the risk of cardiovascular disease. The aim of the present study is to investigate the association of uric acid with individual cardiometabolic risk factors, as well as their degree of clustering, in overweight and moderate obese youth. METHODS: Three hundred and thirty-three Caucasians of both sexes (149 women), from 5-18 years of age from those who underwent an assessment of overweight/obesity. Anthropometric parameters, office and 24-h blood pressure measurements and metabolic profile, including HDL-cholesterol, triglycerides, insulin, HOMA index and uric acid were assessed. RESULTS: Uric acid was significantly higher in boys than in girls. A positive significant association between uric acid, and office, daytime and night-time SBP, insulin and triglycerides was observed. When boys and girls were grouped by sex-specific uric acid tertiles, a progressive increment was observed in BMI, BMI z-score and waist circumference as well as fasting insulin and HOMA index. In boys, this was also present in office and ambulatory SBP. Likewise, the number of abnormal metabolic risk factors also increases with the uric acid values and the higher the number of metabolic components the higher the uric acid values. Moreover, in a multiple regression analysis, uric acid was significantly related with male sex, waist circumference, both office and night-time SBP and birth weight. CONCLUSION: The present study found a positive association between uric acid and blood pressure, insulin and triglycerides. As uric acid levels increase there is a relevant clustering of metabolic risk factors, whereas elevated blood pressure is the risk factor less frequently present. Further studies need to assess the mechanistic link between uric acid and the cardiometabolic risk factors.


Assuntos
Doenças Cardiovasculares/sangue , Obesidade/sangue , Ácido Úrico/sangue , Adolescente , Antropometria , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Criança , Pré-Escolar , HDL-Colesterol/sangue , Feminino , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Obesidade/fisiopatologia , Sobrepeso/complicações , Fatores de Risco , Triglicerídeos/sangue , Circunferência da Cintura
7.
J Pediatr Nurs ; 42: e79-e84, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29747957

RESUMO

PURPOSE: To compare the impact of adhering to a Mediterranean diet plus mixed physical exercise program (Move-It) implemented by means of printed instructions or via a web-platform (with or without e-mail support) on body composition, physical fitness, and blood pressure. DESIGN AND METHODS: Randomized clinical trial. Fifty-two overweight or obese Spanish children and adolescents were randomly assigned to the print-based (n = 18), Move-It (n = 18), or Move-It plus support (n = 16) intervention groups. Two-way mixed ANOVA tests were used to compare any changes between the groups in terms of percentage body fat, physical fitness (VO2peak), handgrip strength, and systolic and diastolic blood pressure. The measurements were taken before and after a three-month mixed-exercise (aerobic and resistance) and Mediterranean-diet program which was either implemented by means of printed instructions or via a web-platform (with or without e-mail support). RESULTS: No statistical differences were found between groups. However, the results highlighted significant improvements in body fat percentage metrics over time for all three groups (print-based: -1.8%, 95%CI -3.3% to -0.3%; Move-It: -1.8%, 95%CI -3.3% to -0.3%; Move-It plus support: -2.0%, 95%CI -3.7% to -0.4%, P < 0.05). We also observed a tendency towards improvement in the VO2peak, handgrip strength, and blood pressure variable values 10 min after the exercise-stress test in these three groups. CONCLUSIONS: The program improved the body composition, regardless of the way it is implemented. PRACTICE IMPLICATIONS: A mixed physical exercise program lasting for three months, combined with a Mediterranean diet, improves the body composition of children and adolescents with overweight/obesity.


Assuntos
Terapia por Exercício/métodos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Obesidade Pediátrica/terapia , Perda de Peso , Adolescente , Análise de Variância , Criança , Feminino , Humanos , Masculino , Treinamento de Resistência/métodos , Espanha , Resultado do Tratamento , Programas de Redução de Peso/métodos
8.
Clin Biomech (Bristol, Avon) ; 52: 1-6, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-29291461

RESUMO

BACKGROUND: Excess body weight during childhood causes reduced motor functionality and problems in postural control, a negative influence which has been reported in the literature. Nevertheless, no information regarding the effect of body composition on the postural control of overweight and obese children is available. The objective of this study was therefore to establish these relationships. METHODS: A cross-sectional design was used to establish relationships between body composition and postural control variables obtained in bipedal eyes-open and eyes-closed conditions in twenty-two children. Centre of pressure signals were analysed in the temporal and frequency domains. Pearson correlations were applied to establish relationships between variables. Principal component analysis was applied to the body composition variables to avoid potential multicollinearity in the regression models. These principal components were used to perform a multiple linear regression analysis, from which regression models were obtained to predict postural control. FINDINGS: Height and leg mass were the body composition variables that showed the highest correlation with postural control. Multiple regression models were also obtained and several of these models showed a higher correlation coefficient in predicting postural control than simple correlations. These models revealed that leg and trunk mass were good predictors of postural control. More equations were found in the eyes-open than eyes-closed condition. INTERPRETATION: Body weight and height are negatively correlated with postural control. However, leg and trunk mass are better postural control predictors than arm or body mass. Finally, body composition variables are more useful in predicting postural control when the eyes are open.


Assuntos
Composição Corporal , Sobrepeso/fisiopatologia , Obesidade Pediátrica/fisiopatologia , Equilíbrio Postural , Adolescente , Índice de Massa Corporal , Peso Corporal , Criança , Estudos Transversais , Feminino , Humanos , Modelos Lineares , Masculino , Postura , Análise de Componente Principal
9.
J Child Health Care ; 21(2): 153-161, 2017 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29119810

RESUMO

Few studies have evaluated the changes in physical fitness (PF) of obese children and adolescents of a physical activity program for the treatment of obesity, and even fewer have explored the modality of home-based physical exercise. The objective of this study is to evaluate the changes in PF and body composition (BC) of a home-based physical exercise for treating childhood obesity. Thirty-three overweight/obese children and adolescents participated for six months in a home-based intervention that combined aerobics and muscular strength exercises. The results were compared, before and after the intervention, for the different PF components (VO2max, abdominal muscle resistance strength, and lower body explosive strength) and BC (body mass index Z-score (BMI-Z), percentage of body fat, and fat-free mass) variables. A significant reduction was observed in the percentage of body fat (4.7%) and the BMI- Z score (.23), and there was an increase in the fat-free mass of 2.9 kg ( p < .001). In addition, the VO2max showed a significant increase ( p < .05). The results of the different strength tests also showed significant improvements ( p < .05). Our findings support the effectiveness of this program improving not only BC but also PF. However, our results should be interpreted with caution due to lack of control group.


Assuntos
Índice de Massa Corporal , Serviços de Assistência Domiciliar , Obesidade Pediátrica/prevenção & controle , Aptidão Física/fisiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Força Muscular , Estudos Prospectivos
10.
J Hypertens ; 35(3): 571-577, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27930438

RESUMO

OBJECTIVE: The main objective of this cross-sectional study is to assess the cardiac autonomic neural activity in the presence of abnormally increased body weight in youths and its relationship to metabolic risk factors and cardiorespiratory fitness (CRF). METHODS: Sixty-four overweight and obese patients, aged 9-17 years, of both sexes, stratified according to the international BMI cut-off, were enrolled. Continuous ECG was recorded during 15 min in resting conditions, and the heart rate variability (HRV) was measured in the time domain, frequency domain and for nonlinear dynamics. In addition, cardiometabolic risk factors and CRF in effort conditions were assessed. RESULTS: Among the overweight and obese youths, no significant differences were observed regarding metabolic parameters and heart rate, although CRF was the lowest in the severely obese youths. Likewise, no significant differences were observed in HRV, independent of how it was assessed. A positive and significant relationship, independent of the degree of obesity, pubertal stage and breathing rate under resting conditions, has been observed among sympathovagal balance, insulin and the homeostatic model assessment index. Furthermore, CRF assessed by volume oxygen peak was associated with insulin levels (r = -0.273; P < 0.05), the SD of the NN interval series (r = 0.268, P < 0.05) and the long-term variation using the Poincaré plot (PS1: r = 0.275, P < 0.05; PS2: r = 0.273, P < 0.05). CONCLUSION: The key findings of the present study were the presence of a link among fasting insulin, HRV and CRF independent of the degree of obesity, indicating the heterogeneity of obese children and adolescents.


Assuntos
Aptidão Cardiorrespiratória , Frequência Cardíaca , Obesidade/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Adolescente , Vias Autônomas/fisiopatologia , Criança , Estudos Transversais , Eletrocardiografia , Feminino , Coração/inervação , Humanos , Insulina/sangue , Resistência à Insulina , Masculino , Sobrepeso/fisiopatologia , Consumo de Oxigênio , Fatores de Risco
11.
J Transl Med ; 14(1): 160, 2016 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-27259700

RESUMO

BACKGROUND: Early life epigenetic programming influences adult health outcomes. Moreover, DNA methylation levels have been found to change more rapidly during the first years of life. Our aim was the identification and characterization of the CpG sites that are modified with time during the first years of life. We hypothesize that these DNA methylation changes would lead to the detection of genes that might be epigenetically modulated by environmental factors during early childhood and which, if disturbed, might contribute to susceptibility to diseases later in life. METHODS: The study of the DNA methylation pattern of 485577 CpG sites was performed on 30 blood samples from 15 subjects, collected both at birth and at 5 years old, using Illumina(®) Infinium 450 k array. To identify differentially methylated CpG (dmCpG) sites, the methylation status of each probe was examined using linear models and the Empirical Bayes Moderated t test implemented in the limma package of R/Bioconductor. Surogate variable analysis was used to account for batch effects. RESULTS: DNA methylation levels significantly changed from birth to 5 years of age in 6641 CpG sites. Of these, 36.79 % were hypermethylated and were associated with genes related mainly to developmental ontology terms, while 63.21 % were hypomethylated probes and associated with genes related to immune function. CONCLUSIONS: Our results suggest that DNA methylation alterations with age during the first years of life might play a significant role in development and the regulation of leukocyte-specific functions. This supports the idea that blood leukocytes experience genome remodeling related to their interaction with environmental factors, underlining the importance of environmental exposures during the first years of life and suggesting that new strategies should be take into consideration for disease prevention.


Assuntos
Metilação de DNA/genética , Centrômero/metabolismo , Pré-Escolar , Análise por Conglomerados , Ilhas de CpG/genética , Ontologia Genética , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Telômero/metabolismo
12.
J Hypertens ; 34(7): 1389-95, 2016 07.
Artigo em Inglês | MEDLINE | ID: mdl-27088634

RESUMO

OBJECTIVE: To identify vascular phenotypes across blood pressure (BP) conditions in overweight and obese youths, by assessing office BP (oBP), and central BP (cBP), and pulse pressure (PP) amplification. Whether or not 24-h ambulatory BP monitoring (ABPM) and pulse wave velocity (PWV) add insight to the issue has also been examined. METHODS: White youths of both sexes with overweight or obesity and of European origin, ranging from 8 to 18 years of age, were included. oBP, cBP, PWV, and 24-h ABPM were measured. oBP conditions and 'white-coat' hypertension were defined as recommend by European Society Hypertension Guidelines in Children and Adolescents. Patients were divided into subgroups of 'normal' or 'high' according to cBP and PP ratio. RESULTS: A total of 593 patients (mean age, 12.2 ±â€Š2.3 years; 275 women) were included in the study. The largest differences between office SBP and central SBP correspond to the isolated systolic hypertension (ISH) group, in which only 25% of patients have high cBP, in contrast to 50% of the systo-diastolic hypertension (SDH) group. Two patterns emerged based on cBP and PP ratio - while the highest cBP was among the SDH, the highest PP amplitude was in the ISH group. Ninety percent of the SDH were confirmed with 24-h ABPM, in contrast to 75% of the ISH, who were white-coat hypertensive. PWV showed a progressive increment across the groups from normotension to SDH. Significant differences were observed only when compared with the normotensive, but not among all other groups. CONCLUSION: In overweight and obese hypertensive patients, ISH is prevalent, posing a challenge for the clinician of whether these may therefore be diagnosed and managed as hypertensive patients. Until prospective studies can give more knowledge, 24-h ABPM can offer information for making clinical decisions.


Assuntos
Determinação da Pressão Arterial/métodos , Pressão Sanguínea , Hipertensão/fisiopatologia , Obesidade/fisiopatologia , Adolescente , Monitorização Ambulatorial da Pressão Arterial , Criança , Diástole , Grupo com Ancestrais do Continente Europeu , Feminino , Humanos , Hipertensão/complicações , Masculino , Obesidade/complicações , Sobrepeso/complicações , Sobrepeso/fisiopatologia , Fenótipo , Análise de Onda de Pulso , Sístole , Hipertensão do Jaleco Branco/diagnóstico , Hipertensão do Jaleco Branco/fisiopatologia
13.
Cyberpsychol Behav Soc Netw ; 19(2): 115-9, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26882326

RESUMO

This study analyzes the potential of virtual reality (VR) to enhance attentional distraction in overweight children as they experience bodily sensations during exercise. It has been suggested that one reason why obese children stop exercising is the perception of bodily sensations. In a counterbalanced design, a total of 109 children (33 overweight, 10-15 years old) were asked to walk twice for 6 minutes on a treadmill under one of two conditions: (a) traditional condition (TC)-focusing their attention on their physical feelings and sensations or (b) distraction condition (DC)-focusing their attention on a virtual environment. Attentional focus during exercise, bad-good feeling states (pre- and postexperimental), perceived exertion (3 minutes and post), heart rate, and enjoyment were assessed. Results indicated that overweight children focused on internal information under the TC, but they significantly shifted their attention to regard the external environment in the DC. This attentional distraction effect of VR was more intense in overweight than in normal-weight children. No differences between groups were found when examining changes in feeling states and perceived exertion. VR increased enjoyment during exercise, and children preferred exercise using virtual environments. VR is useful to promote distraction and may help overweight and obese children to enjoy exercise.


Assuntos
Atenção , Exercício Físico/psicologia , Sobrepeso/psicologia , Sensação , Terapia de Exposição à Realidade Virtual/métodos , Adolescente , Criança , Simulação por Computador , Emoções , Exercício Físico/fisiologia , Feminino , Felicidade , Frequência Cardíaca , Humanos , Masculino , Sobrepeso/terapia , Prazer , Caminhada/fisiologia , Caminhada/psicologia
14.
Paediatr Child Health ; 20(7): 373-6, 2015 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-26526217

RESUMO

BACKGROUND: Recent strategies to reduce sedentary behaviour in children include replacing sedentary screen time for active video games. Active video game studies have focused principally on the metabolic consumption of a single player, with physiological and psychological responses of opponent-based multiplayer games to be further evaluated. OBJECTIVE: To determine whether adding a competitive component to playing active video games impacts physiological and psychological responses in players. METHODS: Sixty-two healthy Caucasian children and adolescents, nine to 14 years years of age, completed three conditions (8 min each) in random order: treadmill walking, and single and opponent-based Kinect active video games. Affect, arousal, rate of perceived exertion, heart rate and percentage of heart rate reserve were measured for each participant and condition. RESULTS: Kinect conditions revealed significantly higher heart rate, percentage of heart rate reserve, rate of perceived exertion and arousal when compared with treadmill walking (P<0.001). Opponent-based condition revealed lower values for the rate of perceived exertion (P=0.02) and higher affect (P=0.022) when compared with single play. CONCLUSION: Competitive active video games improved children's psychological responses (affect and rate of perceived exertion) compared with single play, providing a solution that may contribute toward improved adherence to physical activity.

15.
Rev. chil. pediatr ; 85(3): 344-350, jun. 2014. ilus, tab
Artigo em Espanhol | LILACS | ID: lil-719142

RESUMO

Introducción: El situs inversus totalis es un hallazgo poco común. Sólo un pequeño porcentaje presentará cardiopatías asociadas, por lo que el diagnóstico suele realizarse de forma casual. Objetivo: Destacar las claves diagnósticas del situs inversus totalis y la importancia de un diagnóstico temprano. Caso clínico: Presentamos dos pacientes pediátricos de 9 y 14 años que fueron diagnosticados de forma incidental. El primer caso fue estudiado por dolor precordial, en la auscultación cardíaca se escuchaba aumento de ruidos cardíacos en precordio derecho y atenuados en el izquierdo. El electrocardiograma (ECG) mostró eje QRS y onda P de +150°, QRS estrecho de voltaje atenuado en precordiales V3-V6 y ondas T negativas en V1-V4 y aVL. La radiografía de tórax confirmó dextrocardia, además se apreció burbuja gástrica a la derecha y sombra hepática a la izquierda. La ecocardiografía evidenció dextrocardia especular clásica sin malformaciones asociadas. En el segundo caso se encontró incidentalmente dextrocardia en radiografía solicitada para evaluación de escoliosis. El ECG objetivó eje QRS +120°, eje onda P +150°, QRS estrecho de voltaje atenuado en precordiales izquierdas. La ecocardiografía doppler confirmó dextrocardia especular sin anomalías asociadas. En ecografía abdominal el hígado se encontró en hipocondrio izquierdo y el bazo en hipocondrio derecho. Conclusión: El diagnóstico temprano del situs inversus totalis es importante, dado que el abordaje quirúrgico torácico y abdominal es diferente y determinadas patologías pueden presentarse con clínica inusual. Además, tras el diagnóstico de situs inversus se puede estudiar la presencia de patologías asociadas como discinesia ciliar primaria (Síndrome de Kartagener).


Introduction: Situs inversus totalis is a rare find and only a small percentage are associated with heart disease; its diagnosis is usually made incidentally. Objective: To discuss the diagnostic features of situs inversus totalis and the importance of early diagnosis. Case reports: Two pediatric patients aged 9 and 14 years who were incidentally diagnosed are reported. The first case presented chest pain and during cardiac auscultation, increased heart sounds were heard on the right precordium and attenuated on the left. An electrocardiogram (ECG) showed P wave and QRS axis equal to +150°, narrow QRS voltage attenuated in V3-V6 precordial leads, and negative T waves in leads V1-V4 and aVL. Chest radiography confirmed dextrocardia, and gastric bubble was on the right and hepatic shadow on the left. Echocardiography showed classic mirror dextrocardia without associated malformations. In the second case, dextrocardia was found incidentally after radiography was requested for the evaluation of scoliosis. ECG showed QRS of +120°, P wave axis of +150° and narrow QRS voltage axis attenuated on left precordial leads. Doppler echocardiography confirmed dextrocardia without associated anomalies. Abdominal ultrasound found the liver in left upper quadrant and the spleen in right upper quadrant. Conclusions: Early diagnosis of situs inversus totalis is important because the thoracic and abdominal surgical approach is different and certain diseases could be presented with unusual characteristics. Also, after the diagnosis of situs inversus, the presence of associated pathologies such as primary ciliary dyskinesia can be studied (Kartagener syndrome).


Assuntos
Humanos , Masculino , Adolescente , Criança , Síndrome de Kartagener/diagnóstico , Situs Inversus/diagnóstico , Dextrocardia/diagnóstico , Ecocardiografia , Eletrocardiografia , Achados Incidentais , Radiografia Torácica
16.
Rev Chil Pediatr ; 85(3): 344-50, 2014 Jun.
Artigo em Espanhol | MEDLINE | ID: mdl-25697252

RESUMO

INTRODUCTION: Situs inversus totalis is a rare find and only a small percentage are associated with heart disease; its diagnosis is usually made incidentally. OBJECTIVE: To discuss the diagnostic features of situs inversus totalis and the importance of early diagnosis. CASE REPORTS: Two pediatric patients aged 9 and 14 years who were incidentally diagnosed are reported. The first case presented chest pain and during cardiac auscultation, increased heart sounds were heard on the right precordium and attenuated on the left. An electrocardiogram (ECG) showed P wave and QRS axis equal to +150°, narrow QRS voltage attenuated in V3-V6 precordial leads, and negative T waves in leads V1-V4 and aVL. Chest radiography confirmed dextrocardia, and gastric bubble was on the right and hepatic shadow on the left. Echocardiography showed classic mirror dextrocardia without associated malformations. In the second case, dextrocardia was found incidentally after radiography was requested for the evaluation of scoliosis. ECG showed QRS of +120°, P wave axis of +150° and narrow QRS voltage axis attenuated on left precordial leads. Doppler echocardiography confirmed dextrocardia without associated anomalies. Abdominal ultrasound found the liver in left upper quadrant and the spleen in right upper quadrant. CONCLUSIONS: Early diagnosis of situs inversus totalis is important because the thoracic and abdominal surgical approach is different and certain diseases could be presented with unusual characteristics. Also, after the diagnosis of situs inversus, the presence of associated pathologies such as primary ciliary dyskinesia can be studied (Kartagener syndrome).


Assuntos
Dextrocardia/diagnóstico , Síndrome de Kartagener/diagnóstico , Situs Inversus/diagnóstico , Adolescente , Dor no Peito/etiologia , Criança , Diagnóstico Precoce , Eletrocardiografia , Humanos , Achados Incidentais , Masculino
17.
Nutr Hosp ; 31(2): 841-8, 2014 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-25617572

RESUMO

BACKGROUND: Physical inactivity has been identified as an important public health concern for children. An increasing sedentary way of life is directly related to obesity; hence, prevention and management of childhood obesity are commonly based on lifestyle interventions wherein increasing physical activity is one of the main targets. The use of exergames can be useful in promoting physical activity, but it is necessary more research. This study analyzes the effects of an exergaming platform that involves brisk walking, on perceived exertion, self-efficacy, positive expectations and satisfaction in a sample of clinically obese children, as compared with normal weight children. Physiological variables like heart rate, oxygen consumption and energy expenditure were also measured. METHOD: A total sample of 42 children was recruited. Children were randomized into those walking on a treadmill and those using a treadmill with the support of the exergaming platform (Wii-Fit). RESULTS: The obese children scored significantly higher in expectations and satisfaction in the exergame condition but not in self-efficacy, perceived exertion or physiological measures. CONCLUSIONS: These results suggest that this exergaming platform could be a tool to assist obese children in the practice of brisk walking as part of a programme designed to treat obesity.


Assuntos
Terapia por Exercício/métodos , Obesidade/terapia , Caminhada , Adolescente , Criança , Metabolismo Energético , Feminino , Frequência Cardíaca , Humanos , Masculino , Consumo de Oxigênio , Autoimagem
18.
Nutr. hosp ; 28(6): 1860-1866, nov.-dic. 2013. tab
Artigo em Inglês | IBECS | ID: ibc-120390

RESUMO

INTRODUCTION: Recently, the prevalence of childhood obesity is increasing significantly. Dietary and physical activity registers are frequently referred to as the "cornerstone" of behavioral weight control programs. Mobile devices such as Personal Digital Assistants (PDAs) are showing their usefulness to facilitate these self-registers. OBJECTIVE: This study is aimed to analyze and compare the efficiency and feasibility of a PDA and Paper and Pencil (P&P) registers to record dietary and physical activity in a sample of Spanish adolescents with overweight. METHODS: Sample was composed by 30 overweight participants aged 9-15 years seeking for obesity treatment. This is a counterbalance study, all participants completing both experimental conditions: PDA and P&P registers. RESULTS: For dietary records, participants filled out more records using P&P than PDA when "total" number of self-registers was considered, but when "complete" records were taken into account, these differences disappeared, and when percentages of "complete" records were analyzed, PDA produced more accurate registers than P&P. For physical activity, PDA produced more records than P&P. PDA was the preferred system. According to participants, the PDA´s strengths are the comfort, easiness to use and to transport. CONCLUSIONS: Results showed that P&P produced more incomplete dietary records than PDA. PDA is a reliable system that allows the clinician to be confident in the data recorded. Recently, several applications for mobile devices have been developed, but there are few studies supporting evidence of their efficacy and feasibility in assessment and treatment of childhood obesity. This study tries to provide some evidence in this field (AU)


Introducción: En los últimos años, la prevalencia de la obesidad infantil se ha incrementado de forma significativa. Los registros de ingesta y actividad física son considerados la "piedra angular" de los programas comportamentales de control del peso. Los dispositivos móviles, como las Personal Digital Assistant (PDAs), están mostrando su utilidad en la realización de estos registros. Objetivo: El presente estudio tiene como objetivo analizar y comparar la eficiencia y viabilidad de un sistema PDA y un sistema de Lápiz y Papel (P&P) para el registro de ingesta y movimiento físico en una muestra de adolescentes españoles con sobrepeso. Método: La muestra estuvo compuesta por 30 niños de entre 9 y 15 años con sobrepeso que asisten a un tratamiento para obesidad infantil. Se trata de un estudio contrabalanceado, por lo que los participantes completaron ambas condiciones experimentales: PDA y P&P. Resultados: Considerando los registros de ingesta, cuando se consideran los registros "totales" los participantes realizaron más registros utilizando el sistema P&P que el sistema PDA, pero cuando se consideran los registros "completos", estas diferencias desaparecieron y al considerar el porcentaje de registros "completos", el sistema en PDA produjo más registros que el sistema P&P. Respecto a los registros de actividad física, el sistema PDA produjo más registros que el sistema P&P. La PDA fue considerada el sistema preferido por los participantes. De acuerdo con las opiniones de éstos, las potencialidades de la PDA es su comodidad, su facilidad de uso y de transporte. Conclusiones: Los resultados obtenidos indican que el sistema P&P produce mayor cantidad de registros de ingesta incompletos que el sistema en PDA. La PDA es un sistema fiable que permite al clínico confiar en los datos registrados por los niños respecto a la ingesta y a la actividad física. Recientemente, se han desarrollado diversas aplicaciones para llevar a cabo registros en dispositivos móviles, pero aún son escasos los estudios disponibles que avalan la eficacia y viabilidad de estos sistemas para la evaluación y el tratamiento de la obesidad infantil. Este estudio pretende proporcionar evidencia al respeto (AU)


Assuntos
Humanos , Obesidade/fisiopatologia , Atividade Motora , Ingestão de Alimentos , Aplicações da Informática Médica , Registros , Monitorização Ambulatorial/métodos
19.
Nutr Hosp ; 28(6): 1860-6, 2013 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-24506361

RESUMO

INTRODUCTION: Recently, the prevalence of childhood obesity is increasing significantly. Dietary and physical activity registers are frequently referred to as the "cornerstone" of behavioral weight control programs. Mobile devices such as Personal Digital Assistants (PDAs) are showing their usefulness to facilitate these self-registers. OBJECTIVE: This study is aimed to analyze and compare the efficiency and feasibility of a PDA and Paper and Pencil (P&P) registers to record dietary and physical activity in a sample of Spanish adolescents with overweight. METHODS: Sample was composed by 30 overweight participants aged 9-15 years seeking for obesity treatment. This is a counterbalance study, all participants completing both experimental conditions: PDA and P&P registers. RESULTS: For dietary records, participants filled out more records using P&P than PDA when "total" number of self-registers was considered, but when "complete" records were taken into account, these differences disappeared, and when percentages of "complete" records were analyzed, PDA produced more accurate registers than P&P. For physical activity, PDA produced more records than P&P. PDA was the preferred system. According to participants, the PDA´s strengths are the comfort, easiness to use and to transport. CONCLUSIONS: Results showed that P&P produced more incomplete dietary records than PDA. PDA is a reliable system that allows the clinician to be confident in the data recorded. Recently, several applications for mobile devices have been developed, but there are few studies supporting evidence of their efficacy and feasibility in assessment and treatment of childhood obesity. This study tries to provide some evidence in this field.


Assuntos
Computadores de Mão , Dieta , Atividade Motora/fisiologia , Obesidade/reabilitação , Adolescente , Criança , Registros de Dieta , Estudos de Viabilidade , Feminino , Humanos , Masculino , Obesidade/dietoterapia , Reprodutibilidade dos Testes
20.
Acad Pediatr ; 12(4): 319-25, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22634075

RESUMO

OBJECTIVE: The aim of this study was to compare the effect of a hospital clinic group- versus home-based combined exercise-diet program for the treatment of childhood obesity. METHODS: One hundred ten overweight/obese Spanish children and adolescents (6-16 years) in 2 intervention groups (hospital clinic group-based [n = 45] and home-based [n = 41]) and a sex-age-matched control group (n = 24) were randomly assigned to participate in a 6-month combined exercise (aerobic and resistance training) and Mediterranean diet program. Anthropometric values (including body weight, height, body mass index, BMI-Z score, and waist circumference) were measured pre- and postintervention for all the participants. Percentage body fat was also determined with a body fat analyzer (TANITA TBF-410 M). RESULTS: Our study showed a significant reduction in percentage body fat and body mass index Z-score among both intervention-group participants (4%, 0.16, hospital clinic group-based; 4.4%, 0.23, home-based; P < .0001). There was also a significant reduction in waist circumference in the home-based group (4.4 cm; P = .019). Attendance rates at intervention sessions were equivalent for both intervention groups (P = .805). CONCLUSIONS: The study findings indicate that a simple home-based combined exercise and Mediterranean diet program may be effective among overweight and obese children and adolescents, because it improves body composition, is feasible and can be adopted on a large scale without substantial expenses.


Assuntos
Dietoterapia/métodos , Terapia por Exercício/métodos , Serviços de Assistência Domiciliar/estatística & dados numéricos , Obesidade/terapia , Ambulatório Hospitalar/estatística & dados numéricos , Sobrepeso/terapia , Tecido Adiposo , Adolescente , Composição Corporal , Índice de Massa Corporal , Criança , Dieta Mediterrânea , Feminino , Humanos , Masculino , Treinamento de Resistência/métodos , Resultado do Tratamento , Circunferência da Cintura , Programas de Redução de Peso/métodos
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