Prehabilitation programs for individuals with cancer: a systematic review of randomized-controlled trials.

BACKGROUND: Prehabilitation programs focusing on exercise training as the main component are known as a promising alternative for improving patients' outcomes before cancer surgery. This systematic review determined the benefits and harms of prehabilitation programs compared with usual care for individuals with cancer. METHODS: We searched CENTRAL, MEDLINE, and EMBASE from inception to June 2022, and hand searched clinical trial registries. We included randomized-controlled trials (RCTs) in adults, survivors of any type of cancer, that compared prehabilitation programs that had exercise training as the major component with usual care or other active interventions. Outcome measures were health-related quality of life (HRQL), muscular strength, postoperative complications, average length of stay (ALOS), handgrip strength, and physical activity levels. Two reviewers independently screened the studies, extracted data, and assessed the risk of bias and the certainty of the evidence. RESULTS: Twenty-five RCTs (2682 participants) published between 2010 and 2022 met our inclusion criteria. Colorectal and lung cancers were the most common diagnoses. The studies had methodological concerns regarding outcome measurement, selective reporting, and attrition. Five prehabilitation programs were compared to usual care (rehabilitation): combined training, aerobic training, respiratory muscle training plus aerobic training, respiratory muscle training plus resistance training, and pelvic floor training. The studies provided no clear evidence of an effect between groups. We assessed the overall certainty of the evidence as very low, downgraded due to serious study limitations and imprecision. CONCLUSION: Prehabilitation programs focusing on exercise training may have an effect on adults with cancer, but the evidence is very uncertain. We have very little confidence in the results and the true effect is likely to be substantially different from these. Further research is needed before we can draw a more certain conclusion. SYSTEMATIC REVIEW REGISTRATION: CRD42019125658.

Menores valores de fuerza de prensión manual se asocian a incremento de los niveles de adiposidad y exceso de peso: un estudio transversal / Lower grip strength values are associated with increased levels of adiposity and excess weight: a cross-sectional study

Objetivo: la condición física especialmente la fuerza muscular— es uno de los predictores más relevantes del estado de salud de un individuo. No obstante, son poco los estudios que han descrito la relación del fenotipo de exceso de adiposidad con el componente muscular en escolares latinos. El objetivo del presente estudio fue determinar la asociación entre los niveles de fuerza de prensión (FP) manual con diferentes marcadores de adiposidad. Nuestra hipótesis de trabajo fue demostrar si los menores valores de FP se asocian con un fenotipo de exceso de adiposidad en una muestra de niños y adolescentes escolarizados.Métodos y procedimientos de investigación:estudio transversal realizado en 430 escolares (55,8 % mujeres) entre los 9 y 17,9 años, pertenecientes a 6 instituciones educativas oficiales de Bogotá, Colombia. Se midió la FP por dinamometría manual como indicador de fuerza muscular y se categorizó en tertiles (T) de fuerza, siendo el tertil (T3) la posición con mejor desempeño muscular. La relación cintura/estatura, el índice de masa corporal y los pliegues cutáneos se midieron como parámetros de adiposidad.Resultados:la edad media de los evaluados fue 13,2 ± 1,4 años. Se observaron correlaciones inversas y estadísticamente significativas entre la FP ajustada al peso y los parámetros antropométricos incluidos en este estudio (rango: r = -0,40 a -0,61; p < 0,001). Esta misma relación se observó tras ajustar la edad como covariable en los escolares con mejor desempeño muscular (T3), independientemente del sexo.Conclusión:basados en los resultados obtenidos en el presente trabajo, los escolares con altos niveles de FP (T3) presentaron menores niveles de adiposidad. Esto permite que los escolares con mejores valores de FP puedan contrarrestar los efectos negativos del exceso de adiposidad. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico en el futuro. (AU)

Objective: physical fitness (particularly the muscular strength component) is one of the most powerful markers of health. However, few studies have described the relationship of the higher adiposity phenotype with muscular strength in Latino schoolchildren. The aim of the present study was to determine the association between levels of handgrip strength (HGS) with different anthropometric markers. The central hypothesis of this study was that lower HGS values are associated with a higher adiposity phenotype in a sample of schoolchildren and adolescents.Research methods and procedures:a cross-sectional study was carried out in 6 public schools in Bogotá, Colombia, with a final sample of 430 participants (55.8 % women) between 9 and 17.9 years of age. HGS was assessed with a grip dynamometer, and normalized as HGS per body mass (i.e., [grip strength in kg)/(body mass in kg]). Tertiles of normalized HGS were obtained separately for both sexes and high HGS was defined as higher tertile (T3). Waist-to-height ratio, body mass index, and skinfold thickness were measured as adiposity parameters.Results:the mean (SD) age of participants was 13.2 (1.4) years. A significant inverse correlation were found between normalized HGS, waist-to-height ratio, body mass index, and skinfold thickness (range, r = -0.40 to -0.61; p < 0.001). Regardless of sex, participants with low HGS (below first tertile) had highest values of waist-to-height ratio, body mass index, and skinfold thickness after adjusting for age.Conclusion:muscular strength was inversely associated with a higher adiposity phenotype. HGS could have protective potential for increased levels of adiposity excess. The evaluation of muscular fitness at an early age will allow the implementation of future cardiovascular and metabolic risk prevention programs. (AU)

[Lower grip strength values are associated with increased levels of adiposity and excess weight: a cross-sectional study]. / Menores valores de fuerza de prensión manual se asocian a incremento de los niveles de adiposidad y exceso de peso: un estudio transversal.

Introduction: Objective: physical fitness (particularly the muscular strength component) is one of the most powerful markers of health. However, few studies have described the relationship of the higher adiposity phenotype with muscular strength in Latino schoolchildren. The aim of the present study was to determine the association between levels of handgrip strength (HGS) with different anthropometric markers. The central hypothesis of this study was that lower HGS values are associated with a higher adiposity phenotype in a sample of schoolchildren and adolescents. Research methods and procedures: a descriptive cross-sectional study was carried out in 6 public schools in Bogotá, Colombia, with a final sample of 430 participants (55.8 % women) between 9 and 17.9 years of age. Handgrip strength (HGS) was assessed with a handheld dynamometer, and normalized as HGS per body mass (i.e., [grip strength in kg)/(body mass in kg]). Tertiles of normalized HGS were obtained separately for both sexes and high HGS was defined as higher tertile (T3). Waist-to-height ratio, body mass index, and skinfold thickness were measured as adiposity parameters. Results: the mean (SD) age of participants was 13.2 (1.4) years. Significant inverse correlations were found between normalized HGS, waist-to-height ratio, body mass index, and skinfold thickness (range, r = -0.40 to -0.61; p < 0.001). Regardless of sex, participants with low HGS (below the first tertile) had the highest values of waist-to-height ratio, body mass index, and skinfold thickness after adjusting for age. Conclusion: muscular strength was inversely associated with a higher adiposity phenotype. HGS could have protective potential for increased levels of adiposity excess. The evaluation of muscular fitness at an early age will allow the implementation of future cardiovascular and metabolic risk prevention programs.

Introducción: Objetivo: la condición física ­especialmente la fuerza muscular­ es uno de los predictores más relevantes del estado de salud de un individuo. No obstante, son poco los estudios que han descrito la relación del fenotipo de exceso de adiposidad con el componente muscular en escolares latinos. El objetivo del presente estudio fue determinar la asociación entre los niveles de fuerza de prensión (FP) manual con diferentes marcadores de adiposidad. Nuestra hipótesis de trabajo fue demostrar si los menores valores de FP se asocian con un fenotipo de exceso de adiposidad en una muestra de niños y adolescentes escolarizados. Métodos y procedimientos de investigación: estudio transversal realizado en 430 escolares (55,8 % mujeres) entre los 9 y 17,9 años, pertenecientes a 6 instituciones educativas oficiales de Bogotá, Colombia. Se midió la FP por dinamometría manual como indicador de fuerza muscular y se categorizó en tertiles (T) de fuerza, siendo el tertil (T3) la posición con mejor desempeño muscular. La relación cintura/estatura, el índice de masa corporal y los pliegues cutáneos se midieron como parámetros de adiposidad. Resultados: la edad media de los evaluados fue 13,2 ± 1,4 años. Se observaron correlaciones inversas y estadísticamente significativas entre la FP ajustada al peso y los parámetros antropométricos incluidos en este estudio (rango: r = -0,40 a -0,61; p < 0,001). Esta misma relación se observó tras ajustar la edad como covariable en los escolares con mejor desempeño muscular (T3), independientemente del sexo. Conclusión: basados en los resultados obtenidos en el presente trabajo, los escolares con altos niveles de FP (T3) presentaron menores niveles de adiposidad. Esto permite que los escolares con mejores valores de FP puedan contrarrestar los efectos negativos del exceso de adiposidad. La evaluación de la fuerza muscular en edades tempranas permitirá implementar programas de prevención de riesgo cardiovascular y metabólico en el futuro.

Relación de la composición corporal y la velocidad de procesamiento cognitivo en estudiantes universitarios. Un estudio transversal / Relationship of body composition and speed of cognitive processing in college students. A cross-sectional study

Resumen Introducción. Existe una amplia discusión acerca del papel de la composición corporal en el desarrollo de funciones cognitivas como la velocidad de procesamiento (VPC), especialmente sobre la masa grasa. Además, pocos estudios -especialmente en Colombia- han explorado dicha relación en universitarios de diferentes áreas de conocimiento. Objetivo. Determinar la relación existente entre la velocidad de procesamiento cognitivo y la composición corporal, en estudiantes universitarios de Bogotá D.C., Colombia. Materiales y métodos. Estudio transversal de tipo descriptivo y correlacional en una muestra total de 122 estudiantes hombres aparentemente sanos (17 a 31 años) de diferentes áreas de conocimiento (72,1% de Cultura física y 27,9% de otras carreras), pertenecientes a universidades privadas del Distrito Capital. Se midieron parámetros antropométricos (talla, peso, circunferencia de cintura (CC)), variables de composición corporal (báscula de bioimpedancia); la VPC se evaluó mediante la Prueba de Adición en Serie Audible Estimulada (PASAT (60)-3"). El análisis estadístico se realizó empleando el software IBM SPSS V. 25 para el cálculo de los resultados. Resultados. Con una media de 20,9 (3,4) años, se identificó un Índice de Masa Corporal (IMC) de 40,5% en sobrepeso y 4,1% en obesidad. El PASAT (60)-3") se relacionó de manera positiva con el IMC, porcentaje de grasa (%GC) y CC, negativamente con el porcentaje de masa muscular (%MM) en el grupo de otras carreras. Sin embargo, la VPC disminuida tenían mayor %GC, CC y %MM menor, en comparación con quienes tenían una VPC dentro de lo esperado (p= < 0,05). Conclusión. La masa grasa parece tener influencia sobre la velocidad de procesamiento cognitivo, no obstante, dicha relación no sigue un patrón claramente definido, parece comportarse de manera curva en donde valores extremos podrían afectar negativamente dicha función cognitiva. Aparentemente una composición corporal más saludable puede ser beneficiosa para la velocidad de procesamiento en universitarios.

Abstract Introduction. There is a wide discussion about the role of body composition in the development of cognitive functions such as processing speed, especially on fat mass. Furthermore, few studies that are being developed in Colombia, South America, have explored this relationship in college students from different areas of knowledge. Objective. To determine the relationship between cognitive processing speed (CPS) and body composition in college students from Bogotá D.C., Colombia. Material and methods. Cross-sectional descriptive and correlational study in a total sample of 122 apparently healthy male students (17 to 31 years old) from different areas of knowledge (72.1% from Physical Culture and 27.9% from other careers), belonging to private universities of the Capital District. Anthropometric parameters (height, weight, waist circumference (WC)), body composition variables (bioimpedance scale) were measured; CPS was assessed using the Paced Auditory Serial Addition Test (PASAT (60) -3"). Statistical analysis was performed using the IBM SPSS V. 25 software to calculate the results. Results. With a mean of 20.9 (3.4) years, a Body Mass Index (BMI) of 40.5% was identified in overweight and 4.1% in obesity. PASAT (60) -3") was positively related to BMI, body fat percentage (% BF) and WC, negatively to muscle mass percentage (% MM) in the group of other races. However, the decreased CPS had a higher% CG, CC and% MM lower, compared to those who had a CPS within the expected (p = <0.05). Conclusion. Fat mass seems to influence the cognitive processing speed; however, this relationship does not follow a clearly defined pattern, it seems to behave in a curved way where extreme values could negatively affect said cognitive function. Apparently, healthier body composition can be beneficial for processing speed in college students.

Validation of two field tests to determine maximum oxygen consumption in university students at high altitude / Validación de dos test de campo para determinar el consumo máximo de oxígeno en estudiantes universitarios en una altura elevada

Abstract Introduction: Various research has used field tests to establish cardiorespiratory fitness from VO.max obtained; however, under high altitude conditions there may be variations that influence the behavior of this variable untrained and untrained healthy subjects. Objective: The objective of this study was to compare the VO.max obtained by means of two field tests: Cooper Run Test and Shuttle Run Test 20 meters (CRT and SRT-20m) and the values obtained by ergospirometry in trained university students above 2600 masl. Method: Descriptive cross-sectional study;30 trained subjects (8 women 22 men) participated, with ± an average age of 19.0 to 2.2 years for women and 20.1 ± to 2.1 years for men. A one-way variance analysis was applied; a post hoc analysis was subsequently performed with the Games-Howell procedure which is most powerful in small samples (p<0.01). Results: No significant differences were founding the VO.max mean for SRT-20m and the direct method, however, with respect to the CRT, differences were presented (p <0.01), reflecting the higher accuracy of the SRT-20m test to estimate the VO.max in the sample evaluated. Conclusions: Our results suggested that SRT-20m predicted VO.max closely to data reported in ergospirometry in both men and women living at high altitude. Additional research with larger sample sizes is warranted. MÉD.UIS.2021;34(1): 19-26.

Resumen Introducción: Diversas investigaciones han empleado las pruebas de campo con la finalidad de establecer el fitness cardiorrespiratorio a partir del VO.máx obtenido; no obstante, en condiciones de gran altitud pueden existir variaciones que influencien el comportamiento de esta variable en sujetos sanos entrenados y no entrenados. Objetivo: El objetivo de este estudio fue comparar el VO.max obtenido mediante dos pruebas de campo: Cooper Run Test y Shuttle Run Test 20 metros (CRT y SRT-20m) y los valores obtenidos mediante ergoespirometría. Método: Estudio descriptivo de corte transversal; participaron 30 sujetos entrenados (8 mujeres 22 hombres), con una edad promedio de 19,0 ± 2,2 años para las mujeres y 20,1 ± 2,1 años para los hombres. Se aplicó un análisis de varianza de una vía; posteriormente se realizó un análisis post hoc con el procedimiento de Games-Howell, que es más poderoso en muestras pequeñas (p<0.01). Resultados: No se encontraron diferencias significativas en la media del VO.max para SRT-20m y el método directo, sin embargo, con respecto al CRT, se presentaron diferencias (p <0.01), reflejando la mayor precisión de la prueba SRT-20m para estimar el VO.max. en la muestra evaluada. Conclusiones: Nuestros resultados sugirieron que SRT-20m predijo los valores de VO.máx de manera cercana a los datos reportados en ergoespirometría tanto en hombres como en mujeres que habitan a gran altitud. Se justifica la investigación adicional con tamaños de muestra más grandes. MÉD.UIS.2021;34(1): 19-26

Weight Loss after 12 Weeks of Exercise and/or Nutritional Guidance Is Not Obligatory for Induced Changes in Local Fat/Lean Mass Indexes in Adults with Excess of Adiposity.

The objectives of this secondary analysis are (1) to investigate the differential effects of exercise training modalities-high-intensity interval training (HIIT), resistance training (RT), combined training (CT = HIIT + RT), and/or nutritional guidance (NG) alone-on local fat/lean mass indexes in adults with excess of adiposity; (2) to identify the individual patterns of response based on either a clinical criterion of weight loss (≥5%) and/or technical error (TE) of measurement of local fat/lean mass indexes; and (3) to assess the individual change for body composition parameters assigned either to HIIT, RT, CT, and/or NG groups utilizing a TE. A 12-week trial was conducted in 55 participants randomized to one of the four interventions. The primary outcome was clinical change in body weight (i.e., weight loss of ≥5%). Secondary outcomes included change in ratio of android and gynoid fat mass, as well as local fat and lean mass indexes (arms, trunk, and legs), before and after intervention. The main findings from the current analysis revealed that (i) after 12 weeks of follow-up, significant decreases in several body composition indexes were found including body weight, arm, trunk, and legs fat mass, and android and gynecoid fat mass were observed in HIIT, RT, and CT groups (p < 0.05); (ii) a significant proportion of individuals showed a positive response following 12 weeks of training, led by the HIIT group with 44% and followed by RT with 39% in 9 indexes; (iii) the HIIT group showed lowest rates of adverse responders with (6%); and (iv) the individual patterns of response utilizing clinically meaningful weight loss were not necessarily associated with the corresponding individual training-induced changes in body composition indexes in adults with excess of adiposity. Overall, the study suggests that HIIT has an important ability to reduce the prevalence of non-response to improve body composition indexes.

Obesity- and Lipid-Related Parameters in the Identification of Older Adults with a High Risk of Prediabetes According to the American Diabetes Association: An Analysis of the 2015 Health, Well-Being, and Aging Study.

This study evaluated the predictive ability of 11 obesity- and lipid-related parameters, including body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body roundness index (BRI), "A" body-shape index (ABSI), conicity index (CI), visceral adiposity index (VAI), triglyceride-to-glucose fasting index (TyG), triglyceride-to-glucose fasting related to BMI (TyG-BMI), triglyceride-to-glucose fasting related to WC (TyG-WC), and triglyceride-to-glucose fasting related to WtHR (TyG-WtHR), to identify patients from an elderly Colombian population with a high risk of prediabetes according to the 2016 American Diabetes Association criteria. The data were obtained from the 2015 Colombian Health and Wellbeing and Aging Survey. A total of 3307 elderly Colombian individuals (aged over 60 years) were included. Anthropometric data, fasting plasma glucose, blood lipid profiles, family history, and health-related behaviors were assessed, and prediabetes was defined as a fasting plasma glucose of 100 to 125 mg/dL. The areas under the receiver operating characteristic (ROC) curves (AUCs) were calculated for each anthropometric indicator, using the prediabetes classification to identify their sensitivity and specificity, and these indicated that the prevalence of prediabetes was 25.3% in this population. After adjusting for potential confounding factors, the TyG index was strongly associated with the odds of having prediabetes in both sexes, and multivariate logistic regression analysis showed that the ORs for prediabetes increased across quartiles (p < 0.001). The TyG index was best able to identify prediabetes in either sex (AUC and optimal cut-off = 0.700 and 8.72, and 0.695 and 8.92 for men and women, respectively), suggesting that compared to the other parameters, the TyG index has the best discriminative power to predict prediabetes in the whole population. Thus, we propose the TyG index be used as a complementary marker for assessing prediabetes in older adults.

Cardiorespiratory Fitness Normative Values in Latin-American Adolescents: Role of Fatness Parameters.

The aim of this study was to provide percentile values for a cardiorespiratory fitness (CRF) field test for Latin-American adolescents (34,461 girls and 38,044 boys) aged 13 to 15 years. The role of fatness parameters on the CRF level across age groups was also examined, with a focus on non-obese (healthy) and obese groups. CRF was assessed using the 20-meter shuttle run test protocol. Anthropometric parameters were measured using body mass index z-score (body mass index (BMI) z-score), BMI, waist circumference (WC), and waist-to-height ratio (WHtR). Participants were categorized according to the BMI z-score, WC, and WHtR international cut-off points as healthy and obese. Age- and sex-specific reference tables for the 3rd, 10th, 25th, 50th, 75th, 90th, and 97th centile scores were calculated using Cole's lambda, mu, and sigma method. The prevalence of obesity according to the BMI z-score, WC, and WHtR was 9.6%, 11.2%, and 15.0%, respectively. Across all age and sex groups, a negative association was found between relative peak oxygen uptake ( V ˙ O2peak) and BMI, WC, and WHtR. In boys and girls there were higher levels of performance across all age groups, with most apparent gains between the ages of 13 and 14 years old. Overall, participants categorized in the healthy group had shown to have significantly higher V ˙ O2peak than their obese counterparts (p < 0.001; Cohen's d > 1.0). In conclusion, our study provides age- and sex-specific reference values for CRF ( V ˙ O2peak, mL·kg-1·min-1). The anthropometric parameters were inversely associated with CRF in all ages in both sexes. The obese group had worse CRF than their healthy counterparts independent of anthropometric parameters used to determine obesity.

Use of dietary supplements by pregnant women in Colombia.

BACKGROUND: During pregnancy, the need for certain nutrients increases. This study assessed the prevalence and socio-demographic factors associated with dietary supplement use in a representative sample of pregnant women in Colombia. METHOD: Data for this study were obtained from a cross-sectional, nationally representative survey (ENSIN, 2010). A total of 1856 pregnant women, 13-49 years of age, were recruited. The use of prenatal dietary supplements (Vitamins A, C or E) was treated as a binary outcome (used at some time or never sued during pregnancy when prescribed by a doctor) in multinomial analyses. Sociodemographic data and associated factors were assessed by computer-assisted personal interview technology. RESULTS: Of the sample, 1123 women (68.6%) reported taking prenatal dietary supplements at some stage during their pregnancy. Most users had a high socioeconomic level (79.5%), were in their third trimester of pregnancy (79.5%), were 30-49 years of age (74.0%), and lived in the central region of Colombia (73.8%). The multivariate logistic regression showed that third trimester of pregnancy (OR 6.2;95% CI 4.0 to 9.3), high educational level (OR 2.3; 95% CI 1.5 to 3.4), high socioeconomic level -SISBEN IV or more- (OR 2.0; 95% CI 1.4 to 2.8), residence in the Atlantic region (north) (OR 2.6; 95% CI 1.7 to 3.6), Eastern region (OR 2.0; 95% CI 1.3 to 3.1), central region (OR 2.6; 95% CI 1.7 to 3.9), Pacific region (west) (OR 1.5; 95% CI 1.0 to 2.3), and belonging to the mestizo (others) ethnic group (OR 1.2; 95% CI 1.0 to 2.6), were all associated with a higher probability of dietary supplement intake. CONCLUSION: The prevalence of prenatal dietary supplements in pregnant women in Colombia was found to be substantial. The variables significantly associated with their use were educational level, socioeconomic level, trimester of pregnancy, geographic level and ethnic group. These results indicate the necessity of implementing new health policies that guarantee uniform access to nutritional supplements for all population sectors, especially in countries, such as Colombia, who are currently undergoing a process of nutritional transition.

Validation of multi-frequency bioelectrical impedance analysis versus dual-energy X-ray absorptiometry to measure body fat percentage in overweight/obese Colombian adults.

OBJECTIVES: To verify the validity of multi-frequency bioelectrical impedance analysis (mBCA) for predicting body fat percentage (BF%) in overweight/obese adults using dual-energy X-ray absorptiometry (DXA) as the reference method. METHODS: Forty-eight adults participated (54% women, mean age = 41.0 ± 7.3 years old). The Pearson's correlation coefficient was used to evaluate the correlation between BIA and BF% assessed by DXA. The concordance between BF% measured by both methods was obtained with Lin's concordance correlation coefficient and Bland-Altman difference plots. RESULTS: Measures of BF% were estimated as 39.0 (SD = 6.1) and 38.3 (SD = 6.5) using DXA and mBCA, respectively. The Pearson's correlation coefficient reflected a strong correlation (r =.921, P = .001). The paired t-test showed a significant mean difference between these methods for obese men BF% of -0.6 [(SD 1.95; 95% CI = -4.0 to 3.0), P =.037]. Overall, the bias of the mBCA was -0.6 [(SD 2.2; 95% CI = -5.0 to 3.7), P =.041], which indicated that the mBCA method significantly underestimated BF% in comparison to the reference method. Finally, in both genders, Lin's concordance correlation coefficient showed a strong agreement. More specifically the DXA value was ρc = 0.943 (95% CI = 0.775 to 0.950) and the mBCA value was ρc = 0.948 (95% CI = 0.778 to 0.978). CONCLUSIONS: Our analysis showed a strong agreement between the two methods as reflected in the range of BF%. These results show that mBCA and DXA are comparable methods for measuring body composition with higher body fat percentages. However, due to broad limits of agreement, we can only recommend mBCA for groups of populations.

Comparison of Three Adiposity Indexes and Cutoff Values to Predict Metabolic Syndrome Among University Students.

PURPOSE: Obesity and high body fat are related to diabetes and metabolic syndrome (MetS) in all ethnic groups. Based on the International Diabetes Federation (IDF) definition of MetS, the aim of the present study was to compare body adiposity indexes (BAIs) and to assess their various cutoff values for the prediction of MetS in university students from Colombia. METHODS: A cross-sectional study was conducted on 886 volunteers (51.9% woman; age mean 21.4 years). Anthropometric characteristics (height, weight, waist circumference [WC], and hip circumference [HC]) were measured, and body composition was assessed by bioelectrical impedance analysis. MetS was defined as including ≥3 of the metabolic abnormalities (WC, high-density lipoprotein cholesterol [HDL-C], triglycerides, fasting glucose, and systolic and diastolic blood pressure [BP]) in the definition provided by the IDF. The BAIs (i.e., BAI-HC [BAI], BAI-WC [BAI-w], and [BAI-p]) were calculated from formulas taking into account, height, weight, and WC, and for the visceral adiposity indexes, a formula, including WC, HDL-C, and triglycerides, was used. RESULTS: The overall prevalence of MetS was 5.9%, higher in men than in women. The most prevalent components were low HDL-C, high triglyceride levels, WC, and BP levels. The receiver operating characteristic curves analysis showed that BAI, BAI-w, and BAI-p could be useful tools to predict MetS in this population. CONCLUSION: For women, the optimal MetS threshold was found to be 30.34 (area under curve [AUC] = 0.720-0.863), 19.10 (AUC = 0.799-0.925), and 29.68 (AUC = 0.779-0.901), for BAI, BAI-w, and BAI-p, respectively. For men, the optimal MetS threshold was found to be 27.83 (AUC = 0.726-0.873), 21.48 (AUC = 0.755-0.906), and 26.18 (AUC = 0.766-0.894), for BAI, BAI-w, and BAI-p, respectively. The three indexes can be useful tools to predict MetS according to the IDF criteria in university students from Colombia. Data on larger samples are needed.

A Cross-Sectional Study of the Prevalence of Metabolic Syndrome and Associated Factors in Colombian Collegiate Students: The FUPRECOL-Adults Study.

Metabolic syndrome (MetS) is one of the major public health problems worldwide. The objective of the present study is to investigate the prevalence and the associated variables of MetS in Colombian collegiate students. This cross-sectional study included a total of 890 (52% women) healthy collegiate students (21.3 ± 3.2 years old). The prevalence of MetS was determined by the definition provided by the International Diabetes Federation (IDF). We further examined associations between the prevalence of MetS and related factors, such as age, gender, anthropometric and body composition, weight status, and nutrition profile. The overall prevalence of MetS was 6.0% (95% CI = 4.5% to 7.6%), and it was higher in men than women. The most prevalent components were low high-density lipoprotein cholesterol, high triglyceride levels, waist circumference, and blood pressure levels. The predisposing factors for having a MetS included: being male, over 23 years old, overweight or obese, and having an unhealthy waist-to-height ratio. In conclusion, the occurrence of MetS in young adults is substantial. These findings may be relevant to health promotion efforts for collegiate students in order to develop prospective studies and screening for young adults, which will aid in targeted intervention development to decrease cardiometabolic risk factors.

Fatness mediates the influence of muscular fitness on metabolic syndrome in Colombian collegiate students.

The purpose of this study was two-fold: to analyze the association between muscular fitness (MF) and clustering of metabolic syndrome (MetS) components, and to determine if fatness parameters mediate the association between MF and MetS clustering in Colombian collegiate students. This cross-sectional study included a total of 886 (51.9% women) healthy collegiate students (21.4 ± 3.3 years old). Standing broad jump and isometric handgrip dynamometry were used as indicators of lower and upper body MF, respectively. Also, a MF score was computed by summing the standardized values of both tests, and used to classify adults as fit or unfit. We also assessed fat mass, body mass index, waist-to-height ratio, and abdominal visceral fat, and categorized individuals as low and high fat using international cut-offs. A MetS cluster score was derived by calculating the sum of the sample-specific z-scores from the triglycerides, HDL cholesterol, fasting glucose, waist circumference, and arterial blood pressure. Linear regression models were used to examine whether the association between MF and MetS cluster was mediated by the fatness parameters. Data were collected from 2013 to 2016 and the analysis was done in 2016. Findings revealed that the best profiles (fit + low fat) were associated with lower levels of the MetS clustering (p <0.001 in the four fatness parameters), compared with unfit and fat (unfit + high fat) counterparts. Linear regression models indicated a partial mediating effect for fatness parameters in the association of MF with MetS clustering. Our findings indicate that efforts to improve MF in young adults may decrease MetS risk partially through an indirect effect on improvements to adiposity levels. Thus, weight reduction should be taken into account as a complementary goal to improvements in MF within exercise programs.

Body Adiposity Index Performance in Estimating Body Fat Percentage in Colombian College Students: Findings from the FUPRECOL-Adults Study.

Recently, a body adiposity index (BAI = (hip circumference)/((height)(1.5))-18) was developed and validated in adult populations. The aim of this study was to evaluate the performance of BAI in estimating percentage body fat (BF%) in a sample of Colombian collegiate young adults. The participants were comprised of 903 volunteers (52% females, mean age = 21.4 years ± 3.3). We used the Lin's concordance correlation coefficient, linear regression, Bland-Altman's agreement analysis, concordance correlation coefficient (ρc) and the coefficient of determination (R²) between BAI, and BF%; by bioelectrical impedance analysis (BIA)). The correlation between the two methods of estimating BF% was R² = 0.384, p < 0.001. A paired-sample t-test showed a difference between the methods (BIA BF% = 16.2 ± 3.1, BAI BF% = 30.0 ± 5.4%; p < 0.001). For BIA, bias value was 6.0 ± 6.2 BF% (95% confidence interval (CI) = -6.0 to 18.2), indicating that the BAI method overestimated BF% relative to the reference method. Lin's concordance correlation coefficient was poor (ρc = 0.014, 95% CI = -0.124 to 0.135; p = 0.414). In Colombian college students, there was poor agreement between BAI- and BIA-based estimates of BF%, and so BAI is not accurate in people with low or high body fat percentage levels.

Effects of Exercise on Carotid Arterial Wall Thickness in Obese Pediatric Populations: A Meta-Analysis of Randomized Controlled Trials.

BACKGROUND: In pediatric populations, the use of carotid intima-media thickness (IMT) as a marker of cardiovascular risk has increased. However, previous studies examining the effects of exercise training on arterial structure and function in obese children and adolescents have shown inconsistent findings. The primary aim of this systematic review and meta-analysis is to expand on the current body of literature by providing a quantitative estimate of the change in carotid IMT following exercise training as well as to provide an exploratory analysis of potential moderators associated with the variation in response to an exercise training intervention in overweight and obese youth. MATERIALS AND METHODS: A computerized search was made using three databases. The analysis was restricted to studies that examined the effect of exercise interventions on carotid IMT in pediatric obesity (6-18-year-olds). Hedges' g and 95% confidence intervals (CIs) were calculated. RESULTS: Six randomized controlled trials (303 youths) were included. Exercise was associated with a small-to-moderate but significant reduction in carotid IMT (g = -0.306; 95% CI -0.540 to -0.072; p = 0.011). Likewise, exercise program duration per week significantly influenced the effect of exercise on carotid IMT (ß = -0.060; p = 0.015). CONCLUSIONS: Exercise seems to reduce carotid IMT in childhood obesity. Therefore, encouraging obese pediatric individuals to become physically active can lead to favorable changes in the arterial wall.

Percepción de barreras para la práctica de la actividad física y obesidad abdominal en universitarios de Colombia.

Objetivo: evaluar la relación entre la percepción de las barreras para la práctica de la actividad física (AF) con la presencia de obesidad abdominal (OA) en universitarios de Colombia.Métodos :estudio descriptivo y transversal en 5.663 sujetos entre 18 y 30 años de edad (3.348 hombres), pertenecientes a tres ciudades de Colombia. Se midió la circunferencia de cintura (CC) como indicador de OA y el riesgo se clasificó según valores de referencia internacionales. La autopercepción de barreras se determinó con el cuestionario Barriers to Being Active Quiz (BBAQ-21) validado en Colombia. Se calcularon razones de prevalencia (RP) entre cada dominio del cuestionario y clasificación de OA.Resultados: la prevalencia de obesidad abdominal fue del 10,4% con diferencias por sexo (7,3% hombres vs.12,6% mujeres p < 0,01). La "falta de tiempo", la "influencia social" y la "falta de habilidades" fueron las barreras más prevalentes para cesar la práctica de AF en el grupo de entrevistados con OA en ambos sexos. Al comparar los estudiantes con CC saludable, la RP de presentar OA fue mayor en el grupo de mujeres que en hombres en los dominios del cuestionario BBAQ-21 "falta de tiempo" (RP = 1,33 [IC 95% 1,11-1,60]) vs.(RP = 1,14 [IC 95% 1,03-1,26]) y "falta de recursos" (RP = 1, 93 [IC 95% 11,67-2,24])vs. (RP = 1,83 [IC 95% 1,68-1,99]), respectivamente.Conclusión: una mayor autopercepción de las barreras para realizar AF se relacionó con mayor frecuencia en el grupo con OA en universitarios de Colombia.

Predictive Validity of the Body Adiposity Index in Overweight and Obese Adults Using Dual-Energy X-ray Absorptiometry.

The body adiposity index (BAI) is a recent anthropometric measure proven to be valid in predicting body fat percentage (BF%) in some populations. However, the results have been inconsistent across populations. This study was designed to verify the validity of BAI in predicting BF% in a sample of overweight/obese adults, using dual-energy X-ray absorptiometry (DEXA) as the reference method. A cross-sectional study was conducted in 48 participants (54% women, mean age 41.0 ± 7.3 years old). DEXA was used as the "gold standard" to determine BF%. Pearson's correlation coefficient was used to evaluate the association between BAI and BF%, as assessed by DEXA. A paired sample t-test was used to test differences in mean BF% obtained with BAI and DEXA methods. To evaluate the concordance between BF% as measured by DEXA and as estimated by BAI, we used Lin's concordance correlation coefficient and Bland-Altman agreement analysis. The correlation between BF% obtained by DEXA and that estimated by BAI was r = 0.844, p < 0.001. Paired t-test showed a significant mean difference in BF% between methods (BAI = 33.3 ± 6.2 vs. DEXA 39.0 ± 6.1; p < 0.001). The bias of the BAI was -6.0 ± 3.0 BF% (95% CI = -12.0 to 1.0), indicating that the BAI method significantly underestimated the BF% compared to the reference method. Lin's concordance correlation coefficient was considered stronger (ρc = 0.923, 95% CI = 0.862 to 0.957). In obese adults, BAI presented low agreement with BF% measured by DEXA; therefore, BAI is not recommended for BF% prediction in this overweight/obese sample studied.

Percepción de barreras para la práctica de la actividad física y obesidad abdominal en universitarios de Colombia / Perceived barriers to physical activity and abdominal obesity in university students from Colombia

Objetivo: evaluar la relación entre la percepción de las barreras para la práctica de la actividad física (AF) con la presencia de obesidad abdominal (OA) en universitarios de Colombia. Métodos: estudio descriptivo y transversal en 5.663 sujetos entre 18 y 30 años de edad (3.348 hombres), pertenecientes a tres ciudades de Colombia. Se midió la circunferencia de cintura (CC) como indicador de OA y el riesgo se clasificó según valores de referencia internacionales. La autopercepción de barreras se determinó con el cuestionario Barriers to Being Active Quiz (BBAQ-21) validado en Colombia. Se calcularon razones de prevalencia (RP) entre cada dominio del cuestionario y clasificación de OA. Resultados: la prevalencia de obesidad abdominal fue del 10,4% con diferencias por sexo (7,3% hombres vs. 12,6% mujeres p < 0,01). La «falta de tiempo», la «influencia social» y la «falta de habilidades» fueron las barreras más prevalentes para cesar la práctica de AF en el grupo de entrevistados con OA en ambos sexos. Al comparar los estudiantes con CC saludable, la RP de presentar OA fue mayor en el grupo de mujeres que en hombres en los dominios del cuestionario BBAQ-21 «falta de tiempo» (RP = 1,33 [IC 95% 1,11-1,60]) vs. (RP = 1,14 [IC 95% 1,03-1,26]) y «falta de recursos» (RP = 1, 93 [IC 95% 11,67-2,24]) vs. (RP = 1,83 [IC 95% 1,68-1,99]), respectivamente. Conclusión: una mayor autopercepción de las barreras para realizar AF se relacionó con mayor frecuencia en el grupo con OA en universitarios de Colombia (AU)

Objective: To evaluate the relationship between self-report barriers associated with the practice of the physical activity (PA) and the presence of abdominal obesity in a university students’ sample of Colombia. Methods: A cross-sectional study was carried out during 2013, involving 5,921 healthy subjects aged 18 to 30 years old (3,348 men) from three cities in Colombia. Waist circumference (WC) was measurements as obesity abdominal indicator. The reference criteria for the analysis comes from cut-off points proposed by international reference. It was applied the questionnaire "Barriers to Being Active Quiz" (BBAQ -21) which was validated in Colombia. Prevalence ratios (PR) were calculated between each domain of the questionnaire and the classification of abdominal obesity. Results: The prevalence of abdominal obesity was 10.4 % with gender differences (7.3% men vs. 12.6% women, p < 0.01). Overall, the «lack of time», the «social influence» and «lack of skills» were the most prevalent barriers to end the practice of PA in the group of respondents with abdominal obesity. When comparing healthy students with WC, the RP to present abdominal obesity was higher in the group women than men in the domains of the questionnaire BBAQ -21 «lack of time» (RP = 1.33 [95% CI 1.11 to 1.60]) vs. (OR = 1.14 [95% CI 1.03 to 1.26]) and «lack of resources» (RP = 1, 93 [95% CI 11.67 to 2.24]) vs. (OR = 1.83 [95% CI 1.68 to 1.99]), respectively. Conclusion: Participants with abdominal obesity perceived more barriers to practice physical activity in Colombia university student’s (AU)

Factors associated with active commuting to school by bicycle from Bogotá, Colombia: The FUPRECOL study.

BACKGROUND: Active commuting to school (ACS) can contribute to daily physical activity (PA) levels in children and adolescents. The aim of the study was to analyze the characteristics of active commuting to and from school by bicycle and to identify the factors associated with the use of bicycles for active commuting to school based in a sample of schoolchildren in Bogotá, Colombia. METHODS: A cross-sectional study was conducted in 8,057 children and adolescents. A self-reported questionnaire was used to measure frequency and mode of commuting to school and the time it took them to get there. Weight, height, and waist circumference measurements were obtained using standardized methods, and mothers and fathers self-reported their highest level of educational attainment and household level. Multivariate analyses using unordered multinomial logistic regression models were conducted in the main analysis. RESULTS: 21.9 % of the sample reported commuting by bicycle and 7.9 % reported commuting for more than 120 min. The multivariate logistic regression showed that boys, aged 9-12 years, and those whose parents had achieved higher levels of education (university/postgraduate) were the factors most strongly associated with a use bicycles as a means of active commuting to and from school. CONCLUSION: The findings of this study suggest that it's necessary to promote ACS from childhood and to emphasize its use during the transition to adolescence and during adolescence itself in order to increase its continued use by students.

Triceps and Subscapular Skinfold Thickness Percentiles and Cut-Offs for Overweight and Obesity in a Population-Based Sample of Schoolchildren and Adolescents in Bogota, Colombia.

The assessment of skinfold thickness is an objective measure of adiposity. The aims of this study were to establish Colombian smoothed centile charts and LMS L (Box-Cox transformation), M (median), and S (coefficient of variation) tables for triceps, subscapular, and triceps + subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic (ROC) analysis based on a population-based sample of children and adolescents in Bogotá, Colombia. A cross-sectional study was conducted in 9618 children and adolescents (55.7% girls; age range of 9-17.9 years). Triceps and subscapular skinfold measurements were obtained using standardized methods. We calculated the triceps + subscapular skinfold (T + SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived using the LMS method. ROC curve analyses were used to evaluate the optimal cut-off point of skinfold thickness for overweight and obesity, based on the International Obesity Task Force definitions. Subscapular and triceps skinfolds and T + SS were significantly higher in girls than in boys (p < 0.001). The ROC analysis showed that subscapular and triceps skinfolds and T + SS have a high discriminatory power in the identification of overweight and obesity in the sample population in this study. Our results provide sex- and age-specific normative reference standards for skinfold thickness values from a population from Bogotá, Colombia.