Reference Values in the 6-Minute Walk Test in Chilean Children Aged 3-10 Years and Relationship With Cardiometabolic Risk.

PURPOSE: The aim of this study was to evaluate the performance of healthy Chilean children aged 3-10 years in the 6-minute walking test (6MWT) and cardiometabolic risk variables and to determine sex- and age-specific reference values. METHODS: This study involved 1165 healthy children (age = 6.36 [1.70] y old). The 6MWT was used to evaluate exercise performance. Furthermore, anthropometric measures were collected, like weight, height, body mass index, waist circumference, and skin folds. Resting heart rate and blood pressure (BP) were also evaluated. RESULTS: The prevalence of overweight and obesity was 35.0% and 25.4% in preschoolers and 29.0% and 36.2% in school-age children, respectively, showing significant differences (P < .05) between age groups. The distance walked (6-min walk distance) increased significantly year on year at ages from 3 to 10 years. According to the regression analysis, 6MWT performance was positively related to age, systolic BP, and height, whereas it was negatively related to ∑4 skinfold fat, resting heart rate, diastolic BP, and waist circumference. CONCLUSIONS: This study provides a reference equation and an age- and sex-adjusted percentile curve to assess the predicted 6MWT performance in a cohort of prepubertal Chilean children. The 6-minute walk distance depends mainly on age; however, other variables, such as resting heart rate, BP, skinfold fat, and waist circumference, add significant information and should be taken into account.

Moderate hypofractionated radiotherapy to the prostate bed with or without pelvic lymph nodes: a prospective trial.

Background: Hypofractionated radiotherapy in the treatment of prostate cancer has been widely studied. However, in the postoperative setting it has been less explored. The objective of this prospective study is to evaluate the safety and efficacy of hypofractionated radiotherapy in postoperative prostate cancer. Materials and methods: A prospective study was designed to include patients with prostate cancer with an indication of postoperative radiotherapy as adjuvant or salvage. A hypofractionated radiotherapy scheme of 51 Gy in 17 fractions was performed with the possibility of treating the pelvis at a dose of 36 Gy in 12 fractions sequentially. Safety was evaluated based on acute and late toxicity [according to the Radiation Therapy Oncology Group (RTOG) scale and Common Terminology Criteria Adverse Events (CTCAE) v4.03], International Prognostic Scoring System (IPSS) over time, and quality of life. Results: From August 2020 to June 2022, 31 patients completed treatment and were included in this report. 35.5% of patients received elective treatment of the pelvic nodal areas. Most patients reported minimal or low acute toxicity, with an acute gastrointestinal (GI) and genitourinary (GU) grade 3 or greater toxicity of 3.2% and 0%, respectively. The evolution in time of the IPSS remained without significant differences (p = 0.42). With the exception of a significant improvement in the domains of hormonal and sexual symptoms of the Expanded Prostate Cancer Index Composite (EPIC) questionnaire, the rest of the domains [EPIC, European Organization for Research and Treatment of Cancer (EORTC) Core quality of life questionnaire (C-30) and Prostate Cancer module (PR-25)] were maintained without significant differences over time. With a follow-up of 15.4 months, late GI and GU grade 2 toxicity was reported greater than 0% and 9.6%, respectively. Conclusions: Hypofractionated radiotherapy in postoperative prostate cancer appears to be safe with low reports of relevant acute or late toxicity. Further follow-up is required to confirm these results. Trial registration: The protocol was approved by the accredited Medical Ethical Committee of Pontificia Universidad Católica de Chile. All participants accepted and wrote informed consent.

Gender differences in blood pressure and body composition in schoolchildren ascendants from Amerindian and European.

Background: In spite of there are a wide knowledge of the prevalence of hypertension in adult, there is poor information on schoolchildren of different ethnicity and gender.Aim: To compare the levels of blood pressure and other cardiometabolic risk factors for hypertension between schoolchildren of different gender and ethnicity.Material and methods: In a cross-sectional study, 540 schoolchildren (6-13 years) ascendants from a Chilean public school population were analysed by ethnicity and gender in four groups (Mapuches N = 55; European boys N = 199, and Mapuches N = 64, and European girls N = 222). The study included the measurement of cardiovascular (systolic and diastolic blood pressure) as main outcomes, as well as other cardiovascular (resting heart rate), body composition (body mass, BMI, waist circumference, fat mass, muscle mass), muscle strength (handgrip strength of dominant, non-dominant, and mean handgrip strength) as additional cardiometabolic outcomes.Results: The systolic blood pressure was significantly higher in Mapuches girls 126 ± 4 vs. their European counterparts 119 ± 3 mmHg, P < .002, as well as diastolic blood pressure, was higher in Mapuches girls 82 ± 5 vs. European girls 74 ± 3 mmHg, P < .0001. There were more 'prehypertensive' Mapuches girls 10 (15.6%) vs. European peers 22 (9.9%) at P < .0001, and the 'hypertension' was significantly more prevalent in Mapuches boys 19 (34.5%) vs. European peers 39 (19.4%) at P < .0001, as well as in Mapuches girls 16 (25%) vs. European peers 33 (14.9%) at P < .0001. The 'obesity' was less prevalent in Mapuches 10 (18.2%) vs. European boys 55 (27.4%) at P < .0001. The waist circumference was high in European 74 ± 4 vs. Mapuches 67 ± 6 cm, P < .012 in boys, although, waist circumference was high in Mapuches girls 75 ± 5 vs. European peers 71 ± 3 cm, P < .021. There were higher levels of muscle mass in Mapuches boys 19.5 ± 12 vs. European peers 17.1 ± 4 kg, P < .0001.Conclusion: Mapuches girls show higher levels of systolic and diastolic BP than European girls, Mapuches boys and girls are more hypertensive than European peers, but are less obese than European schoolchildren peers. These cardiometabolic differences that are more detrimental for endemic ethnic Latinoamerican groups are in need to be explored further.

The influence of cardiometabolic risk factors on cardiorespiratory fitness in volunteer Chilean firefighters.

OBJECTIVES: Maximum oxygen consumption (VO2max ) plays a fundamental role in firefighters' occupational activities due to the high intensity tasks they perform in their professional duties. In Chile, firefighters are volunteers (non-salary) and their lack of continuous and programmed physical activity may affect their physical fitness and health. The goal of this study was to determine the influence of anthropometric parameters and cardiometabolic risk (CMR) factors on the cardiorespiratory fitness (CRF) of volunteer Chilean firefighters. METHODS: Seventy-six volunteer male firefighters (median [5-95 percentiles]) aged 27.5 years [26-56], body mass index (BMI) 27.7 kg m-2 [19.9-35], and VO2max 44 mL kg-1 min-1 [36-56]) participated in the study. The following variables were assessed: BMI, fat mass%, body density, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure, blood glucose, and VO2max . RESULTS: In total, 68% of the samples were overweight or obese. A total of 36% presented abdominal obesity (WC ≥102 cm). High blood pressure (HBP) was observed in 25% of firefighters and high blood glucose was found in about 20%. The presence of abdominal obesity was the strongest predictor of VO2max (OR = 12.35, 95% CI = 3.56-42.82, P < .001), followed by the WHR (OR = 11.5, 95% CI = 3.1-42.7, P < .001) and high blood glucose (OR = 2.87, 95% CI = 1.7-7.3, P = 0.019). CONCLUSION: This study showed that abdominal obesity in firefighters was the strongest predictor of low CRF. In addition, CRF was associated with CMR factors, except for HBP.

Association of physical inactivity with blood pressure and cardiovascular risk factors in Amerindian schoolchildren.

OBJECTIVES: There is a wealth of published data on blood pressure (BP) and physical activity in adults of European descent, but less information is available for Amerindian schoolchildren. The aim of this study was to investigate whether BP and other cardiometabolic risk factors differ by physical activity levels in schoolchildren from different ethnic backgrounds. METHODS: This was a cross-sectional study of 540 schoolchildren (6-13 years) from two ethnic backgrounds (n = 119 Mapuche Amerindians and n = 421 of European descent). Physical activity was measured using international physical activity recommendations and a standard questionnaire, and ethnicity was classified according to previous methods using surnames. The population was divided into the following four groups: (a) physically active Mapuches (n = 45) and of European descent (n = 101); and (b) physically inactive Mapuches (n = 74) and of European descent (n = 320). RESULTS: In physically inactive schoolchildren, significant differences were found between schoolchildren of Mapuche and European descent in systolic (134 ± 3 mmHg vs 130 ± 5 mmHg, respectively, P = .034) and diastolic BP (85 ± 13 mmHg vs 81 ± 3 mmHg, P = .029). For other cardiometabolic risk factors, schoolchildren with Mapuche surnames were significantly less likely to be classified with normal weight (5 [6.8%] vs 85 [26.6%]), and more likely to be obese (30 [40.5%] vs 76 [26.6%]) at P < .0001 than European peers. Additionally, significant differences were found between Mapuche schoolchildren vs European peers in the outcomes body mass (51.2 ± 18 kg vs 47.0 ± 15), z score of body mass index (2.16 vs 1.70), fat-to-muscle mass ratio (1.68 vs 0.96), resting heart rate (81.7 ± 10 vs 86.8 ± 16), waist circumference (89.3 ± 5 cm vs 76.3 ± 2 cm), muscle mass (18.2 ± 3 kg vs 16.2 ± 2 kg), and handgrip strength normalized by body mass (0.68 vs 0.57 kg). CONCLUSION: Under conditions of similar physical inactivity, Mapuche schoolchildren have a more adverse cardiovascular and adiposity profile than their counterparts of European descent.

Low sleep time is associated with higher levels of blood pressure and fat mass in Amerindian schoolchildren.

OBJECTIVES: While altered sleep patterns (ie, low sleep time) have been studied and reported in adults as a new cardiometabolic risk factor, less information is available on how sleep patterns impact children of different ethnicities. The aim of this study was to compare the levels of blood pressure and other cardiometabolic risk factors in relation to different levels of sleep time in schoolchildren of Amerindian Mapuche or European-ancestry of Southern Chile. METHODS: In a cross-sectional study, 540 Chilean schoolchildren (6-13 years) were divided into two ethnic groups (n = 119 Mapuche Amerindians and n = 421 European-ancestry). Groups were analyzed according to sleep time per day as registered by parents' report and distributed into quartile categories of sleep time: Mapuche (quartile 1 [Q1] ≥10.0 h, n = 34; Q2 9.5-10.0 h, n = 29; Q3 8.5-9.0 h, n = 31; and Q4 ≤ 8.5 h, n = 25), and European (Q1, n = 99; Q2, n = 77; Q3, n = 144; Q4, n = 101). The main cardiovascular parameters (systolic [SBP] and diastolic blood pressure) were complemented with anthropometric/body composition (body mass, body mass index [BMI], waist circumference, fat mass, muscle mass, lean mass), cardiorespiratory (heart rate rest, oxygen saturation), and muscle strength (handgrip of dominant and non-dominant arm) outcomes. RESULTS: From Q1 and across Q2, Q3, and Q4, there was an increase in delta mean SBP in both Mapuche (Δ +17.6 mm Hg) and European (Δ +7.3 mm Hg) schoolchildren with 30-90 min of decreased sleep time (using ≥10 h as reference in Q1). The tendency for worsening of other cardiometabolic risk factors was maintained for delta mean BMI (Δ +2.6 kg/m2 ), waist circumference (Δ +12 cm), and fat mass (Δ +8.3%) in Mapuches, whereas European peers showed only worsened waist circumference (Δ +6 cm) across Q2, Q3, and Q4 in comparison with reference Q1. There was also a higher prevalence of hypertension in Mapuche (31.1%) compared to in European schoolchildren (17.6%). CONCLUSIONS: Mapuche and European schoolchildren show higher levels of SBP with a decrease in sleep time of 30 min; however, there is a higher prevalence of hypertension and obesity in ethnic Mapuches than in European schoolchildren. These findings indicate that more studies should be applied at early school ages for preventing low sleep time and their related cardiometabolic risk factors for hypertension development in different ethnic groups.

High-Intensity Interval Training as a Tool for Counteracting Dyslipidemia in Women.

Sedentary overweight or obese adult (age<60 years) women, allocated in type 2 diabetes mellitus (T2DM, n=13), dyslipidemia alone (DYS, n=12), dyslipidemia associated with hyperglycaemia (DYSHG, N=12), or healthy control (CON, n=10) groups, had their lipid, glucose, blood pressure, endurance performance, and anthropometry variables assessed before and after 16 weeks of a thrice-weekly high-intensity interval training (HIIT) program. Triglycerides reduced significantly (P<0.05) in all groups, and high-density lipoprotein increased (P<0.01) in T2DM, DYS and DYSHG; however, low-density lipoprotein reduced (P<0.05) only in DYSHG, and total cholesterol reduced (P<0.01) only in DYS and DYSHG. Fasting glucose reduced (P<0.05) significantly in T2DM, DYS and DYSHG, but with higher decreases in T2DM and DYSHG. Blood pressure, endurance performance and body composition improved (P<0.05) in all groups. The HIIT program was effective for restoring lipid profile of DYS and DYSHG, and fasting glucose of DYSHG to levels similar to those of CON, with a weekly time commitment 25% to 56% lower than the minimum recommended in current exercise guidelines. These findings suggest that HIIT may be a time-efficient intervention for counteracting dyslipidemia.

Heart Rate, Technical Performance, and Session-RPE in Elite Youth Soccer Small-Sided Games Played With Wildcard Players.

The aim of this study was to compare heart rate (HR), rating of perceived exertion (RPE), and technical-tactical actions during small-sided games (SSGs) played without (CTR), with internal (IW), and with IW and external (IEW) wildcard players. A total of 22 young male soccer players (age 17.2 ± 0.9 years) randomly completed six 4vs4 SSG situations. The control conditions occurred with goals scored without goalkeeper (4vs4-NO) and with goalkeeper (4vs4-GK). During the experimental conditions, the situations incorporated 2 IW (4vs4+2IW-NO, 4vs4+2IW-GK) and 2 IEW (4vs4+2IW+2IEW-NO, 4vs4+2IW+2IEW-GK). Processed results did not include data from goalkeepers, IW, and IEW players. The HR was divided in intensity-zones (Z1, Z2, and Z3, for <80%, 80-90%, and >90% of maximal HR, respectively) and the analyzed technical-tactical actions were the pass, dribbling, collective success, and pause. The effects of IW and IEW were analyzed through repeated measures analysis of variance. During 4vs4+2IW+2IEW-NO, greater time was recorded in Z1 (p ≤ 0.05) compared with 4vs4-NO and 4s4+2IW-NO. During 4vs4+2IW+2IEW-GK, greater time was recorded in Z1 and less in Z3 (p ≤ 0.05) compared with 4vs4-GK. Greater RPE was reported in 4vs4-NO (p < 0.01) and 4vs4+2IW-NO (p < 0.01) compared with 4vs4+2IW+2IEW-NO, and during 4vs4-GK (p < 0.01) than 4vs4+2IW+2IEW-GK. Greater number of dribbling situations were recorded during 4vs4-NO (p ≤ 0.05) compared with 4vs4+2IW+2IEW-NO. In conclusion, compared with the control condition of 4vs4, the incorporation of IEW reduced HR, RPE, and dribbling actions.

Adaptaciones al ejercicio físico en el perfil lipídico y la salud cardiovascular de obesos mórbidos.

OBJECTIVE: To assess the effects of a physical exercise program on the lipid profile, weight status and the cardiovascular health of obese candidates for bariatric surgery. METHOD: 22 morbidly obese patients participated in a 6-month physical exercise program. 16 formed the adherent group (attendance ≥ 80%; age: 37.81 ± 11.90 years) and six the non-adherent group (attendance < 80%; age: 45.83 ± 14.23 years). Before and 72 h after the last session were evaluated: weight, body mass index (BMI), contour waist, blood pressure, fasting, cardio respiratory fitness, cholesterol and triglycerides. RESULTS: Weight, BMI and WC showed significant changes (p < 0.05) in both groups, with the results of the adherent group being better. In the adherent group, cardiorespiratory capacity (p = 0.001) was also increased, while diastolic pressure (p = 0.011), basal glycemia (p = 0.021) and triglycerides decreased significantly (p < 0.001). The non-adherent group did not present significant changes in these variables (p ≥ 0.05). CONCLUSIONS: The intervention was feasible to perform without negative effects for the participants, and it is possible to recommend improving the cardiovascular health of these of patients.

Effects of plyometric training on maximal-intensity exercise and endurance in male and female soccer players.

In a randomised controlled trial design, effects of 6 weeks of plyometric training on maximal-intensity exercise and endurance performance were compared in male and female soccer players. Young (age 21.1 ± 2.7 years) players with similar training load and competitive background were assigned to training (women, n = 19; men, n = 21) and control (women, n = 19; men, n = 21) groups. Players were evaluated for lower- and upper-body maximal-intensity exercise, 30 m sprint, change of direction speed and endurance performance before and after 6 weeks of training. After intervention, the control groups did not change, whereas both training groups improved jumps (effect size (ES) = 0.35-1.76), throwing (ES = 0.62-0.78), sprint (ES = 0.86-1.44), change of direction speed (ES = 0.46-0.85) and endurance performance (ES = 0.42-0.62). There were no differences in performance improvements between the plyometric training groups. Both plyometric groups improved more in all performance tests than the controls. The results suggest that adaptations to plyometric training do not differ between men and women.

Men and Women Exhibit Similar Acute Hypotensive Responses After Low, Moderate, or High-Intensity Plyometric Training.

The aim of this study was to compare the acute effects of low-, moderate-, high-, and combined-intensity plyometric training on heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rate-pressure product (RPP) cardiovascular responses in male and female normotensive subjects. Fifteen (8 women) physically active normotensive subjects participated in this study (age 23.5 ± 2.6 years, body mass index 23.8 ± 2.3 kg · m(-2)). Using a randomized crossover design, trials were conducted with rest intervals of at least 48 hours. Each trial comprised 120 jumps, using boxes of 20, 30, and 40 cm for low, moderate, and high intensity, respectively. For combined intensity, the 3 height boxes were combined. Measurements were taken before and after (i.e., every 10 minutes for a period of 90 minutes) each trial. When data responses of men and women were combined, a mean reduction in SBP, DBP, and RPP was observed after all plyometric intensities. No significant differences were observed pre- or postexercise (at any time point) for HR, SBP, DBP, or RPP when low-, moderate-, high-, or combined-intensity trials were compared. No significant differences were observed between male and female subjects, except for a higher SBP reduction in women (-12%) compared with men (-7%) after high-intensity trial. Although there were minor differences across postexercise time points, collectively, the data demonstrated that all plyometric training intensities can induce an acute postexercise hypotensive effect in young normotensive male and female subjects.

Changes in Body Composition and Physical Performance after a Six-Week International Tour in Young Chilean Female Tennis Players.

Junior tennis players travel a lot to play tennis tournaments; this causes them to spend a lot of time away from their homes and disrupts their training, which could reduce their performance and increase the risk of injury. The purpose of this study was to analyze the changes in physical performance and body composition after a six-week international tour in young Chilean female tennis players. Thirty young female tennis players (15.4 ± 0.6) participated in this study. Body weight, skinfolds, and perimeters were measured. Body fat percentage (BFP) and skeletal muscle mass (SMM) were calculated. For physical performance, 5 m sprint, the 505 with stationary start test (505 test), the pro-agility test, countermovement jump (CMJ), and medicine ball throw (MBT) were evaluated. The results show a significant increase in BFP and decrease in SMM (p < 0.01; d = -0.18 and 0.19, respectively). In terms of physical performance, 5 m sprint, the 505 test (p < 0.01; d = -0.95 and -0.95, respectively), CMJ, MBT, and HJ significantly decreased post-tour (p < 0.05; d = 0.96, 0.89 and 0.47, respectively). We conclude that, after a six-week international tour, there were changes in body composition and a significant decrease in 5 m sprint, the 505 test, CMJ, and MBT.

Physical Exercise and Executive Function in the Pediatric Overweight and Obesity Population: A Systematic Review Protocol.

BACKGROUND: Executive function is often altered in overweight/obese children and adolescents, which has a negative impact on their learning and daily life. Furthermore, research has shown the benefits of physical exercise in improving cognitive performance. This protocol aims to define in a detailed and structured manner the procedures that will be conducted for the development of a systematic review of the literature aimed at evaluating the effects of physical exercise on the executive functions of children and adolescents (≤18 years) with overweight/obesity in comparison with peers in control groups. METHODS: The Web of Science, PubMed, Scopus, and EBSCO databases will be searched for longitudinal studies that have at least one experimental and one control group using pre- and post-intervention measures of executive function, including working memory, inhibition, and cognitive flexibility in the pediatric population who are overweight or obese. The risk of bias and certainty of evidence will be assessed using Cochrane RoB2 and GRADE, respectively. Furthermore, Der Simonian-Laird's random effects model will be employed for meta-analyses. The effect sizes will be calculated with 95% confidence intervals, and p values < 0.05 indicate statistical significance for each dimension of executive function in the different groups before and after the intervention. DISCUSSION: The results of this review may be useful for education and health professionals to design treatment plans for overweight/obese children and adolescents, offering potential benefits related to the learning and cognitive abilities of this population. PROSPERO registration number: CRD42023391420.

Effects of physical exercise on executive functions of individuals with schizophrenia spectrum disorders: Protocol for a systematic review and meta-analysis.

INTRODUCTION: Executive functions are commonly impaired in individuals with schizophrenia spectrum disorders. Physical exercise has the potential for improving executive functions and can be easily implemented as a therapeutic method. However, there are only few systematic reviews of exercise effects in schizophrenia including cognitive outcomes, and no meta-analytical syntheses of effects on "cool" and "hot" executive functions. The purpose of this systematic review and meta-analysis will be to determine the effects of physical exercise on "cool" and "hot" executive functions of adults with schizophrenia spectrum disorders. METHODS AND ANALYSIS: This protocol was guided by PRISMA-P guidelines. Studies will be searched using combinations of keywords and medical terms in the Web of Science, PubMed, Scopus, and EBSCO databases. Inclusion criteria will be determined as per PICOS approach. The risk of bias will be assessed using the Cochrane RoB2 tool. The certainty of evidence (per outcome) will be assessed using the GRADE method. The meta-analyses will be performed using the DerSimonian and Laird random effects model. Effect sizes (Hedges' g) with 95% confidence intervals will be calculated for each main outcome. CONCLUSIONS: The results of this review may be useful for mental health professionals to design treatment plans for adults with schizophrenia spectrum disorders, offering potential benefits related to the quality of life and cognitive abilities of this population. PROSPERO REGISTRATION NUMBER: CRD42023392295.

Effects of a High Intensity Interval Training (HIIT) Program on Anthropomorphic and Cardiometabolic Variables in School Children with Overweight and Obesity.

The aim of this study was to assess the effects of a high intensity interval training (HIIT) program on anthropomorphic and cardiometabolic variables in schoolchildren with overweight and obesity. A total of 443 schoolchildren (age: 6.37 ± 0.65 years) took part in this study. The experimental group (EG; n = 295; age = 6.40 ± 0.64 years) was compound with children with overweight and obesity, whereas children with normoweight were included in the control group (CG; n = 148; 6.31 ± 0.67 years). The EG performed a training program based on HIIT two times per week for 28 weeks (56 sessions), whilst the CG performed their habitual physical education classes based on the national curriculum. Body mass index (BMI), waist circumference, body fat, ∑ 4 skinfold fat, waist to height ratio, waist circumference, and cardiometabolic risk were measured. The dependent variables were analysed by two-way analysis of covariance (ANCOVA 2 × 2). To analyse the percentage differences between groups, the chi-square test was used. P-value was set at p < 0.05. Significant differences were found in the EG in BMI, waist circumference, body fat, ∑ 4 skinfold fat, and waist to height ratio. In conclusion, an HIIT training program can be an effective tool for improving anthropomorphic variables and reducing cardiometabolic risk in schoolchildren with overweight and obesity.

Physical Exercise Methods and Their Effects on Glycemic Control and Body Composition in Adults with Type 2 Diabetes Mellitus (T2DM): A Systematic Review.

The prevalence of T2DM represents a challenge for health agencies due to its high risk of morbidity and mortality. Physical Activity (PA) is one of the fundamental pillars for the treatment of T2DM, so Physical Exercise (PE) programs have been applied to research their effectiveness. The objective of the study was to analyze the effects of PE methods on glycemic control and body composition of adults with T2DM. A systematic review without meta-analysis was performed, using the PubMed database. Quasi-experimental and pure experimental clinical trials were included, which were available free of charge and were published during 2010-2020. In the results, 589 articles were found and 25 passed the inclusion criteria. These were classified and analyzed according to the methods identified (AE, IE, RE, COM, and others), duration and variable(s) studied. It is concluded that PE is effective for glycemic control and body composition in adults with T2DM using different methods (AE, IE, RE, COM, and others), both in the short and long term. Adequate organization of PE components such as frequency, duration, volume, and intensity, is essential.

Healthy Eating as Potential Mediator of Inverse Association between Purpose in Life and Waist Circumference: Emerging Evidence from US and Chilean Cohorts.

High sense of purpose in life, a fundamental domain of eudaimonic well-being, has been consistently associated with lower risk for various obesity-related chronic diseases. Although this psychological feature correlates with some health behaviors as potential mediators, its association with healthy eating remains less explored. In addition, studies of these psycho-behavioral and health relationships in the South American population are lacking. This research sought to assess: (1) the cross-sectional association between self-reported purpose in life and overall healthy eating patterns, and (2) healthy food intake as a potential mediator of the inverse relationship between purpose in life and waist circumference. Data collected of 2060 US adults from the MIDUS study (5 ± 12 years, 55% women, mostly white people, and 42.5% obese) and 223 Chilean adults from the CHILEMED study (46.6 ± 9 years, 58.3% women, and 71.3% obese) were used. Anthropometric and sociodemographic variables were collected. Sense of purpose was assessed using the purpose in life subscale of the Ryff's psychological well-being questionnaire. Diet quality was evaluated using healthy eating or low-fat diet indexes, according to extant food intake data in each cohort. The relationship between these variables was estimated by bivariate and multivariate linear regressions with appropriate adjustments. To establish whether a better diet quality could mediate a link of purpose in life and improved nutritional status (assessed by waist circumference), the association between these three variables was tested by bootstrapping-based mediation analysis. Our results show significant associations of sense of purpose with healthy eating and low-fat dietary patterns in both US and Chilean cohorts, respectively, even after adjusting for sociodemographic variables. According to the mediation analysis, the relationship between sense of purpose and waist circumference, as an indicator of abdominal obesity, appears to be partially mediated by healthier food intake in both samples. In conclusion, our findings suggest a plausible mechanism underlying the favorable impact of this well-being dimension on physical health. Given its protective effects, interventions aimed at increasing purpose in life may facilitate adherence to better dietary patterns, which, in turn, will reduce the risk for obesity-related chronic diseases.

Pharmacological treatment for challenging behavior in adults with intellectual disability: Systematic review and meta-analysis.

INTRODUCTION: Few evidence on the use of antipsychotics in people with intellectual disabilities and challenging behaviors, generates the need to develop studies that contribute to collect, compare and synthesize the available information. The present systematic review and meta-analysis aims to determine the clinical efficacy of antipsychotic medication in reducing critical episodes in this population. METHODS: We searched Web of Science, Scopus, EBSCO, Embase, and PubMed for randomized controlled trials of antipsychotic medication versus placebo. Preliminarily yielded 1354 abstracts and citations; six studies with 274 subjects met the inclusion criteria of studies with experimental design, longitudinal type, with pre- and post-intervention measurements. RESULTS: There is evidence for the use of psychotropic drugs in the acute management of challenging behaviors in patients with intellectual disability (SMD=-0.85; 95% CI=-1.69 to -0.01; p=0.05). CONCLUSIONS: Our results coincide with the recommendations on the efficacy of the use of antipsychotics. Although our study provides evidence, the limited number of studies included in this research does not allow us to obtain totally conclusive results, although it can be considered as a guide for future studies.

Serum sphingolipid profiling as a novel biomarker for metabolic syndrome characterization.

Background: Sphingolipids are components of cell membrane structure, but also circulate in serum and are essential mediators of many cellular functions. While ceramides have been proposed previously as a useful biomarker for cardiometabolic disease, the involvement of other sphingolipids is still controversial. The aim of this study was to investigate the cross-sectional association between blood sphingolipidomic profiles and metabolic syndrome (MetS) as well as other atherosclerotic risk factors in a large population-based study in the U.S. Methods: Clinical data and serum sphingolipidomic profiling from 2,063 subjects who participated in the biomarker project of the Midlife in the United States (MIDUS) study were used. Results: Consistent with previous reports, we found a positive association between most ceramide levels and obesity, atherogenic dyslipidemia, impaired glucose metabolism, and MetS prevalence. In contrast, most simple ß-glycosphingolipids (i.e., hexosylceramides and lactosylceramides) were inversely associated with dysmetabolic biomarkers. However, this latter sphingolipid class showed a positive link with inflammatory and vascular damage-associated biomarkers in subjects with MetS. Through metabolic network analysis, we found that the relationship between ceramides and simple ß-glycosphingolipids differed significantly not only according to MetS status, but also with respect to the participants' C-reactive protein levels. Conclusion: Our findings suggest that a comprehensive sphingolipid profile is more informative about MetS than ceramides alone, and it may reveal new insights into the pathophysiology and further diabetic vs. cardiovascular risk in patients with MetS.

Exercise Training Program Improves Subjective Sleep Quality and Physical Fitness in Severely Obese Bad Sleepers.

BACKGROUND: Sleep quality is an important modulator of neuroendocrine function, as sleep problems are related to metabolic and endocrine alterations. OBJECTIVE: The main objective was to determine the effects of an exercise training program on the sleep quality of severely obese patients with sleep problems. The secondary objective was to determine the relationship between fitness and anthropometric parameters with sleep quality scores. METHODS: Thirty severely obese patients participated in 16 weeks of PA intervention (age: 39.30 ± 11.62 y, BMI: 42.75 ± 5.27 kg/m2). Subjective sleep quality, anthropometric parameters, and fitness (i.e., handgrip strength and cardiorespiratory fitness) were measured. RESULTS: Two groups were defined as good sleepers (n = 15, 38.06 ± 12.26, men = 1) and bad sleepers (n = 15, 40.53 ± 11.23, men = 3). The good sleeper group reported improvement in cardiorespiratory fitness (61.33 ± 68.75 m vs. 635.33 ± 98.91 m, p = 0.003) and handgrip strength (29.63 ± 9.29 kg vs. 31.86 ± 7.17 kg, p = 0.049). The bad sleeper group improved their cardiorespiratory fitness (472.66 ± 99.7 m vs. 611.33 ± 148.75 m, p = 0.001). In terms of sleep quality dimensions, the bad sleeper group improved their subjective sleep quality (p < 0.001), sleep latency (p = 0.045), sleep duration (p = 0.031), and habitual sleep efficiency (p = 0.015). Comparing the changes in both groups (∆), there were differences in subjective sleep quality scores (∆ = 2.23 vs. ∆ = -3.90, p = 0.002), where 86.6% of the bad sleeper group improved sleep quality (p = 0.030). An increase in handgrip strength was correlated to improving sleep quality scores (r = -0.49, p = 0.050). CONCLUSIONS: Severely obese bad sleepers improved their subjective sleep quality, the components of sleep, and cardiorespiratory fitness through an exercise training program. Improvement in subjective sleep quality was linked to an increase in handgrip strength.