Changes in physical activity and sedentary patterns on cardiometabolic outcomes in the transition to adolescence: International Children's Accelerometry Database 2.0

This is an accepted manuscript version of an article published by Elsevier in Journal of Pediatrics on 14 June 2020, available from https://doi.org/10.1016/j.jpeds.2020.06.018Objective To examine the associations of changes in physical activity and sedentary patterns with changes in cardiometabolic outcomes from childhood to adolescence. Study design Youth from the International Children's Accelerometry Database (n = 1088; 55% girls), aged 8-13 years and followed for ∼4 years, were used in this analysis. Hip-mounted accelerometers were used and all physical activity intensities were expressed as the % of total wear-time. Sedentary time was separated into time spent in bouts <10 minutes and ≥10 minutes. A composite z score for cardiometabolic risk (CMR score) was computed by summing the standardized values for systolic and diastolic blood pressure, triglycerides (TG), low-density lipoprotein cholesterol (LDL-c), and the inverse high-density lipoprotein cholesterol. Multivariate analyses were performed using adjusted linear regression models. Results Increase in sedentary time was unfavorably associated with changes in CMR score (β = 0.021; CI 0.004-0.037), TG (β = 0.003; CI 0.001-0.005), and diastolic blood pressure (β = 0.068; CI 0.009-0.128). Decrease in moderate-to-vigorous physical activity was unfavorably associated with changes in LDL-c (β = −0.009; CI −0.017 to −0.001) and TG (β = −0.007; CI −0.013 to −0.001). Increase in ≥10 minutes sedentary time was unfavorably associated with changes in CMR score (β = 0.017; CI 0.004-0.030), LDL-c (β = 0.003; CI 0.000-0.005), and TG (β = 0.003; CI 0.000-0.004). Decrease in light-intensity physical activity was unfavorably associated with changes in CMR score (β = −0.020; CI = −0.040 to 0.000). Conclusions More physical activity and less prolonged sedentary time are beneficial for cardiometabolic health in youth transitioning to adolescence.acceptedVersio

Impact of combined training with different exercise intensities on inflammatory and lipid markers in type 2 diabetes : a secondary analysis from a 1-year randomized controlled trial

© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creat ivecommons .org/licen ses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creat iveco mmons .org/publi cdoma in/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Background: Exercise is a well-accepted strategy to improve lipid and infammatory profle in individuals with type 2 diabetes (T2DM). However, the exercise intensity having the most benefts on lipids and infammatory markers in patients with T2DM remains unclear. We aimed to analyse the impact of a 1-year combined high-intensity interval training (HIIT) with resistance training (RT), and a moderate continuous training (MCT) with RT on infammatory and lipid profle in individuals with T2DM. Methods: Individuals with T2DM (n=80, aged 59 years) performed a 1-year randomized controlled trial and were randomized into three groups (control, n=27; HIIT with RT, n=25; MCT with RT, n=28). Exercise sessions were super‑ vised with a frequency of 3 days per week. Infammatory and lipid profles were measured at baseline and at 1-year follow-up. Changes in infammatory and lipid markers were assessed using generalized estimating equations. Results: After adjusting for sex, age and baseline moderate-to-vigorous physical activity (MVPA), we observed a time-by-group interaction for Interleukin-6 (IL-6) in both the MCT with RT (β=−0.70, p=0.034) and HIIT with RT (β=−0.62, p=0.049) groups, whereas, only the HIIT with RT group improved total cholesterol (β=−0.03, p=0.045) and LDL-C (β=−0.03, p=0.034), when compared to control. No efect was observed for C-reactive protein (CRP), cortisol, tumour necrosis factor-α (TNF-α), soluble form of the haptoglobin-hemoglobin receptor CD163 (sCD163), triglycerides and HDL-C in both groups (p>0.05). Conclusions: Favorable adaptations on IL-6 were observed in both the HIIT and MCT combined with RT groups fol‑ lowing a long-term 1-year exercise intervention in individuals with T2DM. However, only the HIIT with RT prevented further derangement of total cholesterol and LDL-C, when compared to the control group. Therefore, in order to encourage exercise participation and improve infammatory profle, either exercise protocols may be prescribed, however, HIIT with RT may have further benefts on the lipid profle.This work was supported by fellowships from the Portuguese Foundation for Science and Technology (JM grant: SFRH/BD/85742/2012; IRC grant: IRC: SFRH/BD/149394/2019). This work is also fnanced by a national grant through the FCT–Fundação para a Ciência e Tecnologia within the unit I&D 447 (UIDB/00447/2020).info:eu-repo/semantics/publishedVersio

A systematic review and meta-analysis of randomized controlled trials

Funding Information: This work was conducted at the Interdisciplinary Center for the Study of Human Performance (CIPER), unit I&D 447 (UIDB/00447/2020), Faculty of Human Kinetics of the University of Lisbon, and supported by the Portuguese Foundation for Science and Technology , the Portuguese Ministry of Science. IRC and GBR are supported by the Portuguese Foundation for Science and Technology ( IRC: SFRH/BD/149394/2019 ; GBR: 2020.07856.BD ). Publisher Copyright: © 2023 The AuthorsObjectives: This systematic review and meta-analysis aimed to investigate the effects of home-based exercise on physical fitness (cardiorespiratory fitness, muscle strength, and body composition) in cancer patients undergoing active treatment. Design: Systematic review with meta-analysis and Grading Recommendations Assessment, Development, and Evaluation of the evidence. Methods: A comprehensive search of existing literature was carried out in four electronic databases: PubMed, Web of Science, Scopus, and PEDro. All databases were searched for randomized controlled trials assessing the effects of home-based exercise on physical fitness outcomes in cancer patients during active treatment. Multicomponent interventions (i.e., exercise plus diet/behavioral therapy) were excluded. The methodological quality of each study was assessed using the Revised Cochrane risk-of-bias tool for randomized trials. Meta-analytical procedures were performed when appropriate and standardized mean differences (SMD) were calculated. Results: Twenty-eight randomized controlled trials (n = 2424 cancer patients) were included. Most of the interventions were conducted in breast cancer patients (n = 13) during the adjuvant treatment period (n = 17); 18 studies included a walking component in their home-based protocol. Home-based exercise was effective at improving the distance of the 6-minute walk test (k = 6; SMD = 0.321, p = 0.010). However, the results were no longer significant when performing sensitivity analysis based on exclusively walking (k = 1) and non-exclusively walking interventions (k = 5; SMD = 0.258; p = 0.072). No effects were found for muscle strength and body composition outcomes (p > 0.05). Conclusions: Regular home-based exercise programs are an effective strategy to improve 6-minutes walk test in cancer patients undergoing active treatment. Conversely, no alterations were found in muscle strength and body composition.proofepub_ahead_of_prin

Physical activity moderates the effect of sedentary time on an older adult's physical independence

Background/objectives: Moderate-to-vigorous physical activity (MVPA) and breaks in sedentary time (BST) have been proposed as viable solutions to improve an older adult's physical independence, whereas sedentary time (ST) has been associated with detrimental effects. We sought to assess the joint effects of ST, BST, and MVPA on the physical independence of older adults and determine whether and to what extent the ST relationship with physical independence is moderated by MVPA and/or BST. Design: Cross-sectional. Setting: Laboratory of Exercise and Health, Faculty of Human Kinetics. Participants: Older adults (≥65 years old) from the national surveillance sys tem in Portugal (n = 821). Measurements: Physical activity and ST were assessed by accelerometry. Physi cal independence was assessed using a 12-item composite physical function (CPF) questionnaire. Multiple linear regression was used to model the outcomes. Results: Higher ST was related to lower CPF score (β = −0.01, p < 0.0001), whereas higher MVPA was related to better CPF score (β = 0.02, p < 0.0001). BST was not related to physical independence after accounting for MVPA and ST (β = 0.03, p = 0.074). MVPA had a moderating effect on the relationship of ST with CPF score (p < 0.0001), where MVPA ≥36.30 min/day ameliorated the significant inverse relationship between ST and CPF. Engaging in ≥107.78 of MVPA resulted in ST having a significant positive relationship with CPF score. No moderation effect was found for BST (p > 0.05). Conclusion: Regardless of the time spent in MVPA and BST, ST was inversely related to CPF. However, MVPA was found to be a moderator of the relationship between ST and physical independence, such that engaging in at least 36 min/day of MVPA may blunt the negative effects of ST. At high levels of MVPA (≥108 min/day), having some ST may actually provide some benefit to an older adult's ability to maintain physical independence

Global urban environmental change drives adaptation in white clover

Urbanization transforms environments in ways that alter biological evolution. We examined whether urban environmental change drives parallel evolution by sampling 110,019 white clover plants from 6169 populations in 160 cities globally. Plants were assayed for a Mendelian antiherbivore defense that also affects tolerance to abiotic stressors. Urban-rural gradients were associated with the evolution of clines in defense in 47% of cities throughout the world. Variation in the strength of clines was explained by environmental changes in drought stress and vegetation cover that varied among cities. Sequencing 2074 genomes from 26 cities revealed that the evolution of urban-rural clines was best explained by adaptive evolution, but the degree of parallel adaptation varied among cities. Our results demonstrate that urbanization leads to adaptation at a global scale

Soft Tissue Composition, Cardiometabolic Risk, and Bone Development in Young Girls

Obesity in childhood is a major pediatric concern as excess adiposity increases the risk for developing metabolic dysfunction, cardiovascular disease (CVD) and type 2 diabetes in adulthood. Far less attention has been focused on the effects of obesity during childhood on bone development. Obesity and skeletal fragility have been previously thought to be two distinct conditions rarely found occurring in the same individual, as excess adiposity is thought to enhance bone strength due to the increase in mechanical loading on the skeleton stimulating bone formation. In fact, overweight and obese children tend to have larger bones and greater bone mineral content and density than children with healthy weight. On the contrary, there have been recent findings of a greater fracture incidence in obese children compared to those of normal weight. Overall, the relationship between excess adiposity and bone remains controversial, with reports of both augmented and compromised bone mass accrual in overweight and obese children. There is evidence that obesity-related metabolic dysfunction may compromise gains in bone mass, despite the increased loading on bone with excess weight. Thus, the conflicting relationship reported between excess adiposity and bone in children may be explained by the presence of metabolic dysfunction in some but not all overweight and obese children. The objective of this dissertation was to use cross-sectional data from the “Soft tissue and bone development in young girls (STAR)” study to examine the relationship of soft tissue composition with measures of bone density, geometry, and strength in young girls and assess the influence of cardiometabolic risk factors, which are biomarkers of metabolic dysfunction, on these relationships. Through utilizing state-of-the-art, direct imaging techniques to measure body composition and parameters of bone density, geometry, and strength, findings from this study showed that fat mass is a positive contributor to bone independent of lean mass, however the degree to which adiposity adds to total bone mass and area may be attenuated if there is co-occurring metabolic dysfunction. These findings indicate that obesity in children is a protective factor for bone, however, the attenuation of this protective effect due to the presence of metabolic dysfunction may compromise maximum bone mineral accrual in obese children during a time when maximizing bone mineral accrual is of utmost importance for fracture and osteoporosis prevention in adulthood. Hence, obesity in children should not only be seen as a risk factor for cardiovascular disease, but should be recognized as a risk factor for compromised bone development

Intensity Matters: Impact of Physical Activity Energy Expenditure at Moderate and Vigorous Intensity on Total and Abdominal Obesity in Children

Abstract Background/Objectives: Physical activity (PA) guidelines advocate that children should accumulate at least 60 minutes of moderate-to-vigorous PA daily. Still, it is not clear how the body composition profile may differ if the same dose of PA if accumulated at different intensities. We aimed to determine the independent associations of energy expenditure (EE) at moderate (MPA) and vigorous (VPA) PA intensity on total and abdominal fat in children and if these associations were moderated by cardiorespiratory fitness (CRF). Subjects/Methods: A total of 326 children, (girls = 171, boys n = 151) aged 10–12 years had PA assessed with accelerometers. Total fat mass index (FMI) and abdominal FMI were assessed with DXA. CRF was assessed by a cycle ergometer test. Linear regression models were used to model the outcomes with the inclusion of an interaction term to test for moderation effects. Results An inverse association was found between VPA EE and FMI (β=-0.013, p &lt; 0.001) and abdominal FMI (β=-0.0014, p &lt; 0.001) independent of MPA EE. In contrast, MPA EE was not related to adiposity independent of VPA EE (p &gt; 0.05). The relationships between the PA intensities and FMI and abdominal FMI were moderated by CRF. MPA EE was positively associated with adiposity in children with high levels of CRF, whereas VPA EE remained inversely associated with adiposity regardless of CRF level, although the strength of the association was lower in those with higher CRF levels. Conclusion PA programs should provide opportunities for children to perform VPA in order to achieve healthier body composition profiles and avoid excess adiposity.</jats:p

The effect of a physical activity consultation in the management of adolescent excess weight: results from a non‐randomized controlled trial

© John Wiley & Sons, Inc. All rights reserved.The value of physical activity (PA) counselling and its impact on PA behaviour and weight management have been in question. The main aim of this study was to analyse 6 and 12-month effects of a PA consultation (PAC—a structured form of PA counselling) with and without the inclusion of structured exercise, on body mass index (BMI) z-score, body composition and PA levels of adolescents with excess weight (BMI ≥p85), as part of a clinical multicomponent weight management program. Participants were allocated at baseline into a control (CG—standard care, including paediatric and nutrition consultations) and two experimental groups (EGI and EGII). Both EG's were exposed to standard care plus PAC for 12 months. During the first 6 months, EGII additionally participated in two weekly exercise sessions. From 165 participants recruited, 102 completed the intervention (CG n = 28, EGI n = 36 and EGII n = 38). According to generalized estimating equations, at 6 months both EG's improved (p < 0.05) their BMI z-score, waist-height ratio (WHtR), body fat mass, skeletal muscle mass, sedentary time and moderate-vigorous PA (MVPA) compared to CG. Further improvements were observed in BMI z-score between 6 and 12 months in EG's compared to CG. At 6 months, EGII showed a higher (p < 0.05) increase in MVPA compared to EGI, and EGI a higher decrease in WHtR. No other differences were found between EG's. This study suggests that PAC is a timeeffective approach to improve BMI z-score, body composition and PA levels in adolescents with excess weight, even without the inclusion of structured exerciseAVS was supported by the Portuguese Foundation for Science and Technology (SFRH/BD/130193/2017).info:eu-repo/semantics/publishedVersio

Combined high-intensity interval training as an obesity-management strategy for adolescents

© 2021 European College of Sport Science.Effective and safe exercise protocols for obesity management in adolescents are imperative. This study aimed to analyse compliance, efficacy, and safety of combined high-intensity interval training circuit (HIIT) in the management of obesity (including overweight) in adolescents, compared to traditional training (TT). Data from 55 adolescents (47.3% girls) (TT n = 31; HIIT n = 24), aged 12-18 (mean age of 14.3 ± 1.7), with overweight and obesity (median BMI z-score of 2.95), were assessed at baseline and month 6 (Clinicaltrials.gov/NCT02941770). During the 6-month intervention, participants in both exercise groups attended two exercise sessions/week (60 min/session) along with a set of appointments with a paediatrician, nutritionist, and exercise physiologist. Forty-six participants completed the intervention (TT n = 23; HIIT n = 23). Exercise session attendance (≥80%) was significantly higher among HIIT participants (73.9 vs. 13.0%, p < .001). HIIT, but not TT, showed a significant decrease in BMI z-score (d = 0.40, p < .001), body fat mass (BFM, %) (d = 0.41, p = .001), and trunk fat mass (d = 0.56, p < .001), as well as a significant increase in muscle mass (MM, %) (d = 0.28, p = .001) between baseline and 6 months. According to generalized estimating equations, time-by-attendance interactions (instead of time-by group) were found in BMI z-score (β = 0.25, 95%CI: 0.17, 0.33), BFM (β = 2.29, 95%CI: 1.02, 3.56), trunk fat mass (β = 2.94, 95%CI: 1.70, 4.18), and MM (β = -1.16, 95%CI: -1.87, -0.45). No adverse events were reported during HIIT sessions. Although compliance may mediate the impact of an exercise protocol on health-related outcomes, HIIT showed to be safe, with higher compliance compared to TT, which may result in improved outcomes overtime.This work was supported by Fundação para a Ciência e a Tecnologia [grant number SFRH/BD/130193/2017].info:eu-repo/semantics/publishedVersio