Mediterranean Diet and Cardiometabolic Biomarkers in Children and Adolescents: A Systematic Review and Meta-Analysis.

Importance: No prior systematic review and meta-analysis has specifically verified the association of Mediterranean diet (MedDiet)-based interventions with biomarkers of cardiometabolic health in children and adolescents. Objective: To review and analyze the randomized clinical trials (RCTs) that assessed the effects of MedDiet-based interventions on biomarkers of cardiometabolic health among children and adolescents. Data Sources: Four electronic databases were searched (PubMed, Cochrane Library, Web of Science, and Scopus) from database inception to April 25, 2024. Study Selection: Only RCTs investigating the effect of interventions promoting the MedDiet on cardiometabolic biomarkers (ie, systolic blood pressure [SBP], diastolic blood pressure [DBP], triglycerides [TGs], total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], low-density lipoprotein cholesterol [LDL-C], glucose, insulin, and homeostatic model assessment for insulin resistance [HOMA-IR]) among children and adolescents (aged ≤18 years) were included. Data Extraction and Synthesis: A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Data were extracted from the studies by 2 independent reviewers. Results across studies were summarized using random-effects meta-analysis. Main Outcome and Measures: The effect size of each trial was computed by unstandardized mean differences (MDs) of changes in biomarker levels (ie, SBP, DBP, TGs, TC, HDL-C, LDL-C, glucose, insulin, HOMA-IR) between the intervention and the control groups. The quality of the evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations approach. Results: Nine RCTs were included (mean study duration, 17 weeks; range, 8-40 weeks). These studies involved 577 participants (mean age, 11 years [range, 3-18 years]; 344 girls [59.6%]). Compared with the control group, the MedDiet-based interventions showed a significant association with reductions in SBP (mean difference, -4.75 mm Hg; 95% CI, -8.97 to -0.52 mm Hg), TGs (mean difference, -16.42 mg/dL; 95% CI, -27.57 to -5.27 mg/dL), TC (mean difference, -9.06 mg/dL; 95% CI, -15.65 to -2.48 mg/dL), and LDL-C (mean difference, -10.48 mg/dL; 95% CI, -17.77 to -3.19 mg/dL) and increases in HDL-C (mean difference, 2.24 mg/dL; 95% CI, 0.34-4.14 mg/dL). No significant associations were observed with the other biomarkers studied (ie, DBP, glucose, insulin, and HOMA-IR). Conclusions and Relevance: These findings suggest that MedDiet-based interventions may be useful tools to optimize cardiometabolic health among children and adolescents.

Is meeting with the 24-h movement recommendations linked with suicidality? Results from a nationwide sample of 44,734 U.S. adolescents.

BACKGROUND: To our knowledge, only few studies have analyzed the relationship between meeting the 24-h movement guidelines and suicidality in adolescents. The aim of this study was twofold: first, to examine the association between meeting the 24-h movement recommendations and suicidal ideation, suicide planning, and attempted suicide in a representative sample of adolescents from the U.S.; and second, to test whether age group, sex, or race moderate these associations. METHOD: This is a cross-sectional study including pooled data from the 2011, 2013, 2015, 2017, 2019, and 2021 high school Youth Risk Behavior Surveys (YRBS). A total sample of 44,734 participants (48.5 % females) was included. The recommendations of the 24-h movement guidelines included physical activity, screen time, and sleep duration. Suicidality was examined considering three suicide-related behaviors: suicidal ideation (yes/no), suicide planning (yes/no), and attempted suicide (at least one time or more during the past 12 months). RESULTS: Adolescents who met all three recommendations showed a lower likelihood of suicidal ideation (odds ratio [OR] = 0.49, 95 % confidence interval [CI] 0.37 to 0.64, p < 0.001), suicide planning (OR = 0.51, 95 % CI 0.37 to 0.68, p < 0.001), and attempted suicide (OR = 0.66, 95 % CI 0.44 to 0.96, p = 0.038) than those who did not meet all the recommendations. Overall, when younger adolescents, female adolescents, and adolescents of minority races met the 24-h movement recommendations, they had lower odds of suicide-related outcomes than when they did not. LIMITATIONS: This is a cross-sectional study using self-reported data. It is not possible to establish cause-and-effect relationships, and the results could be influenced by some biases. CONCLUSION: This study suggests that meeting the 24-h movement recommendations could play a relevant role in the prevention of suicidal ideation, planning suicide, and attempted suicide in a nationwide sample from the U.S. adolescents.

Physical Activity and Sitting Time Patterns and Sociodemographic Correlates Among 155,790 South American Adults.

BACKGROUND: To estimate the prevalence of different physical activity (PA) domains and sitting time (ST), and to analyze the association with sociodemographic indicators. METHODS: Data from the most recent nationally representative survey from each of the South American countries, comprising 155,790 adults (18-64 y), were used. Data on leisure-time, transport, and occupational PA (all 3 domains as nonzero), total PA (≥150 min/wk), and ST (≥8 h/d) were assessed by specific questionnaires in each survey. Gender, age group (18-34, 35-49, and 50-64 y), and education (quintiles) were used as sociodemographic factors. Random effect meta-analysis of the association between sociodemographic factors and PA and ST were conducted. RESULTS: The prevalence of PA guidelines compliance and elevated ST in South America was 70.3% and 14.1%, respectively. Women were less likely to achieve the recommended levels of total and domain-based PA. Participants in the highest quintile of education were more likely for elevated ST (2.80, 2.08-3.77), lower occupational PA (0.65, 0.44-0.95), but higher leisure-time PA (3.13, 2.31-4.27), in comparison with lowest quintile. Older adults were less likely to participate in total and leisure-time PA. CONCLUSION: Our findings highlight the urge to tackle the inequalities in PA practice in South America, especially gender and education inequalities, for leisure-time PA.

Normative Values and Psychometric Properties of EQ-5D-Y-3L in Chilean Youth Population among Different Weight Statuses.

BACKGROUND: This study aimed to provide population norms among children and adolescents in Chile using the EQ-5D-Y-3L questionnaire and to examine its feasibility and validity among body weight statuses. METHODS: This was a cross-sectional study in which 2204 children and adolescents (aged 8-18 years) from Chile completed a set of questionnaires providing sociodemographic, anthropometric and health-related quality of life (HRQoL) data using the five EQ-5D-Y-3L dimensions and its visual analogue scale (EQ-VAS). Descriptive statistics of the five dimensions and the EQ-VAS were categorized into body weight status groups for the EQ-5D-Y-3L population norms. The ceiling effect, feasibility and discriminant/convergent validity of the EQ-5D-Y-3L were tested. RESULTS: The dimensions of the EQ-5D-Y-3L questionnaire presented more ceiling effects than the EQ-VAS. The validity showed that the EQ-VAS could discriminate among body weight statuses. However, the EQ-5D-Y-3L index (EQ-Index) demonstrated a non-acceptable discriminant validity. Furthermore, both the EQ-Index and the EQ-VAS presented an acceptable concurrent validity among weight statuses. CONCLUSIONS: The normative values of the EQ-5D-Y-3L indicated its potential use as a reference for future studies. However, the validity of the EQ-5D-Y-3L for comparing the HRQoL among weight statuses could be insufficient.

Factors associated with meeting the WHO physical activity recommendations in pregnant Colombian women.

In the absence of medical contraindications, physical activity (PA) can offer health maternal and fetal health outcomes during pregnancy. However, most pregnant women may not consider PA to be feasible, suitable and safe. Hence, it is essential to determine the prevalence of pregnant women who meet the PA recommendations and the possible factors associated with that meeting, since it might be important from the perspective of pregnant women's health. The aim of the present study was to establish the prevalence of meeting the World Health Organization PA recommendations for Colombian pregnant women, as well as possible factors that may be associated with meeting that recommendations. A cross-sectional study including representative data from the National Nutritional Situation Survey (2015) in Colombia was performed. Data were collected in 2015-2016. From an initial sample of 1140 Colombian pregnant women, 702 participants with complete data were included in the final analysis. PA was assessed by self-reported information through the long version of the International Physical Activity Questionnaire. Several potential factors were analysed according to four levels of the socioecological model: the individual, interpersonal, organizational and community levels. The prevalence of Colombian pregnant women who met with the PA recommendations was 7.5%. Indigenous and Mestizo pregnant women showed lower probabilities of meeting the PA recommendations [Indigenous: OR 0.05, 95% CI (0.01-0.18); Mestizo: OR 0.12, 95% CI (0.06-0.22)] than Afro-Colombian participants. Additionally, participants who lived near green and safe spaces for PA were more likely to meet the PA recommendations [OR 2.30, 95% CI (1.06-4.79)] than those who did not live near green areas. In conclusion, a low percentage of Colombian pregnant women met the new PA recommendations. The associations found according to race/ethnicity and living near green and safe areas underline the presence of fundamental disparities associated with meeting PA recommendations.

Cross-sectional association between physical fitness and cardiometabolic risk in Chilean schoolchildren: the fat but fit paradox.

Background: Previous studies have examined the "fat but fit" paradox, revealing that greater levels of physical fitness may diminish the harmful consequences of excess weight on cardiometabolic risk. Despite the above, specific information about the "fat but fit" paradox in prepuberal population is scarce. The aim of this study was to determine the relationship between cardiometabolic risk across (individual and combined) physical fitness and excess weight status and whether the "fat but fit" paradox is met in the sample of schoolchildren analyzed. Methods: A cross-sectional study was conducted including 452 children (59.1% girls), aged 7-9 years from Santiago (Chile). Physical fitness was assessed as cardiorespiratory fitness and muscular fitness. Cardiorespiratory fitness was determined by the 6-minute-walk-test and muscle strength was assessed by the handgrip and standing long jump tests. Excess weight (overweight and obesity) was computed through body mass index (z-score). Cardiometabolic risk was established by summing the z-score of the serum glucose, triglycerides, high-density lipoprotein, insulin and waist-to-height ratio. Results: Schoolchildren with high physical fitness (individual or combined) showed the lowest cardiometabolic risk mean scores (P for trend <0.001 for all physical fitness groups). Conversely, schoolchildren with low physical fitness (individual or combined) showed the highest cardiometabolic risk mean scores (P for trend <0.001 for all categories). Additionally, schoolchildren without excess weight and with high individual or combined physical fitness status exhibits lower cardiometabolic risk mean scores compared to schoolchildren with excess weight and low physical fitness status (individual or combined) (P for trend <0.001 for all physical fitness groups). A lower odd of having high cardiometabolic risk was found in schoolchildren without excess weight and with both high physical fitness (both cardiorespiratory fitness and muscular fitness) [odds ratio (OR) =0.08; 95% confidence interval (CI): 0.04 to 0.16] in comparison to those with excess weight and low physical fitness. Conclusions: Our results suggest that improvements in both fatness and aerobic fitness could be associated with lower cardiometabolic risk.

Sit to stand muscle power reference values and their association with adverse events in Colombian older adults.

Recently, a valid method to assess lower-body muscle power based on a sit-to-stand field test (STS) has been published. Our study aimed to describe lower-body muscle power in older individuals aged ≥ 60 years and examine the relationship of muscle weakness with adverse events according to gender- and age-specific muscle weakness cut-off points. A total of 3689 Colombian older adults (57.6% women, age 69.1 ± 6.9 years) from the 2015 Survey on Health, Well-Being, and Aging in Latin America and the Caribbean (SABE) participated in this study. Lower-body muscle power normalized to body mass was estimated by the five-repetitions STS test. Anthropometric, physical performance and clinical characteristics were collected. Age-specific percentiles using the LMS method, cut-off points and association with adverse events were calculated. Lower-body muscle power was greater in men than among women (2.2 ± 0.7 vs. 1.6 ± 0.5 W·kg-1, respectively; p < 0.001) at all ages. Muscle power ranked in the 50th percentile between 2.38 and 1.30 W·kg-1 in men, whereas women ranked between 1.79 and 1.21 W·kg-1. According to the cut-off points, lower-limb muscle power < 1 standard deviation  in men was associated with having dynapenia, poor gait speed, cognitive impairment and mental, visual, hearing and memory problems. While, women were associated with having sarcopenia, dynapenia, poor gait speed, cognitive impairment, mental, hearing and memory problems, dementia and hospitalizations of > 24 h in the last year. Overall, participants with poor lower-limb muscle power had a significantly higher risk of adverse events [in men: odds ratio (OR) = 1.51, 95% confidence interval (CI) = 1.19-1.91, p < 0.001; in women: OR = 1.52, 95% CI = 1.27-1.87, p = 0.001] than their stronger counterparts. This study is the first to describe lower-limb muscle power values and cut-off points among a nationally representative sample of Colombian older adults. In men, 7 of the 14 adverse events studied were associated with lower muscle strength, whereas in women, it was 9 of the 14 adverse events.

Time trends and inequalities of physical activity domains and sitting time in South America.

Background: We aimed to investigate time trends and inequalities of different physical activity (PA) domains and sitting time (ST) in adults from South American countries. Methods: We included cross-sectional data of nationally representative surveys on adults (n = 597 843) from nine South American countries (Argentina, Bolivia, Brazil, Chile, Colombia, Ecuador, Peru, Uruguay, and Venezuela), with data collection time frames ranging from 2005 to 2020. Data on different PA domains (leisure-time, transport, and occupational) and ST were assessed through questionnaires. Trends according to education level (quintiles), gender (m/w), and age group (18-34 years, 35-49 years, 50-64 years) were estimated for the harmonized indicators of nonzero PA in the different domains, ≥150 min/week of total PA and ≥8 hours/d of ST. Results: Chile (2009/2010 = 78.9% vs 2016/2017 = 70.5%), and Peru (2009/2010 = 78.6% vs 2011 = 69.6%) reduced total PA, while Brazil (2013 = 57.3% vs 2019 = 67.0%) and Uruguay (2006 = 69.4% vs 2013 = 79.4%) increased, and Argentina and Venezuela maintained. There was an increasing trend for ST in Argentina, Peru, and Uruguay. Leisure-time PA increased in most countries (6/8 countries). Transport PA was relatively stable, while occupational PA presented mixed findings. Education inequalities increased over time for total and leisure-time PA, while age and gender inequalities were relatively constant. Conclusions: Future South American countries' efforts may be warranted to promote PA and reduce ST in adults, while addressing inequalities when implementing actions.

Measurement of physical activity and sedentary behavior in national health surveys, South America.

Objectives: To characterize how physical activity and sedentary behavior have been measured in national health surveys in South American countries. Methods: An extensive search was made for national health surveys from all 12 South American countries through health websites, national statistical offices, and contact with researchers and policy-makers. The following eligibility criteria were used to select surveys: conducted in a South American country; used a nationally representative sample ≥ 18 years; coordinated by the public, private or mixed private-public sector; and assessed physical activity and/or sedentary behavior. Data were extracted on general information about the surveys, specific details about the physical activity and sedentary behavior assessment, and additional questions related to activity behavior. Results: In total, 36 surveys were included, two of which were multicountry surveys; all surveys assessed physical activity and 27 assessed sedentary behavior. Most surveys (23/36; 64%) were based on previously validated international questionnaires, but 13 (57%) of these deviated from the reference tools, introducing changes and adaptations. Sedentary behavior was assessed mostly through questions on screen time and/or daily sitting time in the same physical activity questionnaires. No survey used device-based measures to generate data on these behaviors. Conclusions: Differences between instruments used and modifications limit the comparability of data across countries. This highlights the importance of standardizing assessment within South America for physical activity and sedentary behavior sections in national surveys, with the broader aim of contributing to establishing a standardized strategy for the surveillance of physical activity and sedentary behavior in South America.

Body composition adaptations to lower-body plyometric training: a systematic review and meta-analysis.

The aim of this meta-analysis was to explore the effects of plyometric jump training (PJT) on body composition parameters among males. Relevant articles were searched in the electronic databases PubMed, MEDLINE, WOS, and SCOPUS, using the key words "ballistic", "complex", "explosive", "force-velocity", "plyometric", "stretch-shortening cycle", "jump", "training", and "body composition". We included randomized controlled trials (RCTs) that investigating the effects of PJT in healthy male's body composition (e.g., muscle mass; body fat), irrespective of age. From database searching 21 RCTs were included (separate experimental groups = 28; pooled number of participants = 594). Compared to control, PJT produced significant increases in total leg muscle volume (small ES = 0.55, p = 0.009), thigh muscle volume (small ES = 0.38, p = 0.043), thigh girth (large ES = 1.78, p = 0.011), calf girth (large ES = 1.89, p = 0.022), and muscle pennation angle (small ES = 0.53, p = 0.040). However, we did not find significant difference between PJT and control for muscle cross-sectional area, body fat, and skinfold thickness. Heterogeneity remained low-to-moderate for most analyses, and using the Egger's test publication bias was not found in any of the analyses (p = 0.300-0.900). No injuries were reported among the included studies. PJT seems to be an effective and safe mode of exercise for increasing leg muscle volume, thigh muscle volume, thigh and calf girth, and muscle pennation angle. Therefore, PJT may be effective to improve muscle size and architecture, with potential implications in several clinical and sport-related contexts.

Adherence to the Mediterranean diet and subjective well-being among Chilean children.

Scientific literature has demonstrated positive associations between psychological health (e.g., self-esteem, self-concept) and quality of diet in young population. However, the relationship between subjective well-being (SWB) (referred to the way in which individuals experience and evaluate their lives in positive versus negative ways) and adherence to the Mediterranean diet (MD), as well as the specific eating MD patterns in this population is unexplored. The aim of this study was two-fold: first, to explore the association between subjective well-being (SWB) and adherence to the MD, and second, to determine the possible MD specific eating patterns that could be associated with SWB among schoolchildren. This cross-sectional study includes a sample of 1490 Chilean children aged 8-12 (33.6% girls). SWB was evaluated according to Diener's tripartite model, evaluating the life satisfaction (CUBE questionnaire), positive affect and negative affect (PANAS-C questionnaire). Adherence to the MD was assessed by the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) questionnaire. Both life satisfaction (p = 0.009) and positive affect (p = 0.041) are significant higher in children with high adherence to the MD in comparison to non-adherence peers. Similarly, daily intake of fruit or fruit juice was associated with life satisfaction (ß = 0.117, p = 0.008) and positive affect (ß = 0.087, p = 0.050). This association was also found for the intake of a dairy product for breakfast (life satisfaction: ß = 0.117, p = 0.005; positive affect: ß = 0.104, p = 0.013). Our study demonstrated that higher life satisfaction and SWB are related with higher adherence to the MD, as well as, with the intake of fruit/fruit juice and dairy intake (for breakfast); not being so for negative affect.

Measurement of physical activity and sedentary behavior in national health surveys, South America

[ABSTRACT]. Objectives. To characterize how physical activity and sedentary behavior have been measured in national health surveys in South American countries. Methods. An extensive search was made for national health surveys from all 12 South American countries through health websites, national statistical offices, and contact with researchers and policy-makers. The following eligibility criteria were used to select surveys: conducted in a South American country; used a nationally representative sample ≥ 18 years; coordinated by the public, private or mixed private–public sector; and assessed physical activity and/or sedentary behavior. Data were extracted on general information about the surveys, specific details about the physical activity and sedentary behavior assessment, and additional questions related to activity behavior. Results. In total, 36 surveys were included, two of which were multicountry surveys; all surveys assessed physical activity and 27 assessed sedentary behavior. Most surveys (23/36; 64%) were based on previously validated international questionnaires, but 13 (57%) of these deviated from the reference tools, introducing changes and adaptations. Sedentary behavior was assessed mostly through questions on screen time and/or daily sitting time in the same physical activity questionnaires. No survey used device-based measures to generate data on these behaviors. Conclusions. Differences between instruments used and modifications limit the comparability of data across countries. This highlights the importance of standardizing assessment within South America for physical activity and sedentary behavior sections in national surveys, with the broader aim of contributing to establishing a standardized strategy for the surveillance of physical activity and sedentary behavior in South America.

[RESUMEN]. Objetivos. Describir cómo se han medido la actividad física y el sedentarismo en las encuestas nacionales de salud en los países de América del Sur. Métodos. Se llevó a cabo una extensa búsqueda de encuestas nacionales de salud de los doce países sudamericanos en sitios web de salud, oficinas nacionales de estadística y mediante el contacto con investigadores y responsables de formular políticas. Para escoger las encuestas se emplearon los siguientes criterios de selección: realizada en un país sudamericano; muestra representativa a nivel nacional de ≥ 18 años; coordinada por el sector público, el sector privado o mixto público-privado; y evaluación de la actividad física o el sedentarismo. Se extrajeron datos como información general de las encuestas, detalles específicos de la evaluación de la actividad física y el sedentarismo, y otras preguntas relacionadas con la actividad física. Resultados. En total, se incluyeron 36 encuestas, dos de las cuales se realizaron en varios países. Todas las encuestas evaluaron la actividad física; 27, el sedentarismo. La mayoría de las encuestas (23/36; 64%) se basaron en cuestionarios internacionales anteriormente validados, de los cuales 13 (57%) se desviaron de las herramientas de referencia al tener cambios y adaptaciones. El sedentarismo se evaluó principalmente en los mismos cuestionarios de actividad física mediante preguntas sobre el tiempo invertido delante de pantallas o el tiempo diario sentado. Ninguna encuesta aplicó medidas basadas en dispositivos para obtener datos sobre estos comportamientos. Conclusiones. Las diferencias entre los instrumentos empleados y las modificaciones limitan la comparabilidad de los datos en todos los países. Esto pone de relieve la importancia de estandarizar la evaluación en América del Sur de las secciones dedicadas a la actividad física y al sedentarismo en las encuestas nacionales, con el objetivo general de contribuir a la creación de una estrategia estandarizada para la vigilancia de la actividad física y el sedentarismo en América del Sur.

[RESUMO]. Objetivos. Caracterizar como a atividade física e o comportamento sedentário têm sido medidos em pesquisas nacionais de saúde em países sul-americanos. Métodos. Foi realizada uma busca extensa de pesquisas nacionais de saúde de todos os 12 países sul-americanos em sites de saúde e órgãos nacionais de estatística, e pelo contato com pesquisadores e formuladores de políticas. Foram usados os seguintes critérios de elegibilidade para selecionar as pesquisas: conduzida em um país sul-americano; que tenha usado uma amostra nacionalmente representativa ≥ 18 anos; coordenada pelo setor público, privado ou público-privado; e que tenha avaliado a atividade física e/ou o comportamento sedentário. Os dados extraídos eram sobre informações gerais das pesquisas, detalhes específicos sobre a avaliação da atividade física e do comportamento sedentário e questões adicionais relacionadas ao comportamento na atividade. Resultados. Ao todo, 36 pesquisas foram incluídas, duas das quais foram conduzidas em vários países. Todas as pesquisas avaliaram a atividade física e 27 avaliaram o comportamento sedentário. A maioria das pesquisas (23/36; 64%) baseou-se em questionários internacionais previamente validados e 13 (57%) delas se desviaram das ferramentas de referência, introduzindo mudanças e adaptações. O comportamento sedentário foi avaliado principalmente por meio de perguntas sobre tempo de tela e/ou tempo diário sentado nos mesmos questionários sobre atividade física. Nenhuma pesquisa utilizou medições realizadas por dispositivos para gerar dados sobre esses comportamentos. Conclusões. As diferenças entre os instrumentos usados e as modificações limitam a comparabilidade dos dados entre os países, o que destaca a importância de padronizar a avaliação na América do Sul para as seções de atividade física e comportamento sedentário em pesquisas nacionais, com o objetivo mais amplo de contribuir para o estabelecimento de uma estratégia padronizada para a vigilância da atividade física e do comportamento sedentário na América do Sul.

Exercise dose on hepatic fat and cardiovascular health in adolescents with excess of adiposity.

OBJECTIVE: The HEPAFIT study was aimed at examining the impact of a 6-month physical education intervention, considering various levels of exercise intensity, on hepatic fat and cardiometabolic health outcomes in adolescents with excess adiposity. METHODS: Adolescents (n = 120), 11-17 years with excess adiposity by body fat >30%, were randomly assigned to one of the following 4 groups for 6 months: (1) standard physical education lessons, control (CTRL); (2) high-intensity physical education (HIPE); (3) low-to-moderate intensity physical education (LIPE) and (4) combined HIPE and LIPE (PLUS). The primary outcome was hepatic fat content measured by vibration-controlled transient elastography (controlled attenuation parameter [CAP]). Secondary outcomes were traditional cardiovascular health markers (body composition, serum lipids, aminotransferases and health-related physical fitness components). RESULTS: Adjusted mixed effects linear models revealed a significant decrease in CAP levels in HIPE (-20.02 dB/m, p < 0.0001) (p = 0.001 vs. CTRL group) and PLUS (-16.25 dB/m, p = 0.005) groups. Body fat decreased in the HIPE (-2.88%, p < 0.001) (p = 0.001 vs. CTRL group) and LIPE (-1.26%, p = 0.022) groups. The physical fitness components were increased in the HIPE and PLUS group relative to the baseline (p < 0.05), and the HIPE group showed a reduction in the total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels (p < 0.05). CONCLUSIONS: Implementation of a 6-month physical education exercise program, particularly high-intensity or combined high and low-intensity, improves hepatic fat storage and significantly reduces cardiometabolic markers in adolescents with excess of adiposity. Interventions involving supervised physical exercise may help to improve metabolism and fat deposition at the hepatic level, thus preventing the development of non-alcoholic fatty liver disease in adolescents.

The genetic predisposition to obesity has no influence on waist circumference when screen time and sleep duration are adequate in children and adolescents.

The aim of the present study was to verify whether the amount of sleep duration, screen time, and physical activity moderate the relationship between FTO rs9939609 polymorphism and waist circumference (WC) in children and adolescents. This is a cross-sectional study conducted with 1338 children and adolescents, aged between 6 and 17 years. Lifestyle habits were assessed through self-reported questionnaire. WC was measured on the narrowest part of the trunk between the last rib and the iliac crest. FTO rs9939609 polymorphism was genotyped by real time polymerase chain reaction. The PROCESS macro for the SPSS was used for moderation analyses, through multiple linear regression models. Results indicated significant interactions were found between sleep duration and screen time X FTO rs9939609, showing that these lifestyle behaviours are moderators in the relationship between a genetic predisposition for obesity and higher WC. For physical activity, there was no significant interaction. Therefore, sleeping more than 564 min a day (i.e. 9.4 h) and spending no more than 233 min in front of screen may counteract the genetic predisposition to obesity in children and adolescents.Highlights A healthy lifestyle may counteract the genetic predisposition to central obesity;Children and adolescents should sleep more than approximately 9 h (564 min) per day and spend less than approximately 4 h (233 min) per day in front of screens in order to counteract the genetic predisposition to central obesity conferred by the FTO gene variant.It is fundamental to promote actions for the adoption of a healthy lifestyle, including the importance of presenting adequate sleep habits and low screen time for a better cardiometabolic health and reduction of obesity.

Exercise in school Physical Education increase bone mineral content and density: Systematic review and meta-analysis.

ABSTRACTThis systematic review and meta-analysis aimed to evaluate the effectiveness of interventions through Physical Education (PE) exercises on bone mineral content (BMC) and density (BMD) of children and adolescents. The research was conducted using the online electronic databases PubMed, Science Direct, Web of Science and Scopus (March 2021). The analysis was restricted to school-based studies that examined the effect of PE interventions on BMC and BMD in schoolchildren (<18 years old). Standardised mean differences (SMD) with 95% confidence interval (CI) and random-effects models were calculated. The heterogeneity and inconsistency of the studies were estimated using Cochran's Q-statistic and I2, respectively. Twenty-two studies with 2,556 participants were selected. PE interventions were associated with a significant increase in BMC (SMD = 1.348; 95% CI, 1.053-1.643) and BMD (SMD = 0.640; 95% CI, 0.417-0.862). Femoral neck subgroup analysis indicate an increase in BMC for boys (SMD = 1.527; 95% CI, 0.990-2.065) and girls (SMD = 1.27; 95% CI, 0.782-1.767), and in BMD for boys (SMD = 0.518; 95% CI, 0.064-0.972) and girls (SMD = 0.817; 95% CI, 0.349-1.284). Finally, increases are reported in the lumbar spine BMC for boys (SMD = 1.860; 95% CI, 1.018-2.700) and girls (SMD = 1.275; 95% CI, 0.782-1.767). This meta-analysis provides insights into the effectiveness of interventions aimed at including physical exercise in PE on bone mass, suggesting that increasing the proportion of curriculum time allocated to PE may improve students' BMD and BMC, especially in the femoral neck and lumbar spine.

Measurement of physical activity and sedentary behavior in national health surveys, South America / Medición de la actividad física y del sedentarismo en encuestas nacionales de salud en América del Sur / Mensuração de atividade física e comportamento sedentário em pesquisas nacionais de saúde, América do Sul

ABSTRACT Objectives. To characterize how physical activity and sedentary behavior have been measured in national health surveys in South American countries. Methods. An extensive search was made for national health surveys from all 12 South American countries through health websites, national statistical offices, and contact with researchers and policy-makers. The following eligibility criteria were used to select surveys: conducted in a South American country; used a nationally representative sample ≥ 18 years; coordinated by the public, private or mixed private-public sector; and assessed physical activity and/or sedentary behavior. Data were extracted on general information about the surveys, specific details about the physical activity and sedentary behavior assessment, and additional questions related to activity behavior. Results. In total, 36 surveys were included, two of which were multicountry surveys; all surveys assessed physical activity and 27 assessed sedentary behavior. Most surveys (23/36; 64%) were based on previously validated international questionnaires, but 13 (57%) of these deviated from the reference tools, introducing changes and adaptations. Sedentary behavior was assessed mostly through questions on screen time and/or daily sitting time in the same physical activity questionnaires. No survey used device-based measures to generate data on these behaviors. Conclusions. Differences between instruments used and modifications limit the comparability of data across countries. This highlights the importance of standardizing assessment within South America for physical activity and sedentary behavior sections in national surveys, with the broader aim of contributing to establishing a standardized strategy for the surveillance of physical activity and sedentary behavior in South America.

RESUMEN Objetivos. Describir cómo se han medido la actividad física y el sedentarismo en las encuestas nacionales de salud en los países de América del Sur. Métodos. Se llevó a cabo una extensa búsqueda de encuestas nacionales de salud de los doce países sudamericanos en sitios web de salud, oficinas nacionales de estadística y mediante el contacto con investigadores y responsables de formular políticas. Para escoger las encuestas se emplearon los siguientes criterios de selección: realizada en un país sudamericano; muestra representativa a nivel nacional de ≥ 18 años; coordinada por el sector público, el sector privado o mixto público-privado; y evaluación de la actividad física o el sedentarismo. Se extrajeron datos como información general de las encuestas, detalles específicos de la evaluación de la actividad física y el sedentarismo, y otras preguntas relacionadas con la actividad física. Resultados. En total, se incluyeron 36 encuestas, dos de las cuales se realizaron en varios países. Todas las encuestas evaluaron la actividad física; 27, el sedentarismo. La mayoría de las encuestas (23/36; 64%) se basaron en cuestionarios internacionales anteriormente validados, de los cuales 13 (57%) se desviaron de las herramientas de referencia al tener cambios y adaptaciones. El sedentarismo se evaluó principalmente en los mismos cuestionarios de actividad física mediante preguntas sobre el tiempo invertido delante de pantallas o el tiempo diario sentado. Ninguna encuesta aplicó medidas basadas en dispositivos para obtener datos sobre estos comportamientos. Conclusiones. Las diferencias entre los instrumentos empleados y las modificaciones limitan la comparabilidad de los datos en todos los países. Esto pone de relieve la importancia de estandarizar la evaluación en América del Sur de las secciones dedicadas a la actividad física y al sedentarismo en las encuestas nacionales, con el objetivo general de contribuir a la creación de una estrategia estandarizada para la vigilancia de la actividad física y el sedentarismo en América del Sur.

RESUMO Objetivos. Caracterizar como a atividade física e o comportamento sedentário têm sido medidos em pesquisas nacionais de saúde em países sul-americanos. Métodos. Foi realizada uma busca extensa de pesquisas nacionais de saúde de todos os 12 países sul-americanos em sites de saúde e órgãos nacionais de estatística, e pelo contato com pesquisadores e formuladores de políticas. Foram usados os seguintes critérios de elegibilidade para selecionar as pesquisas: conduzida em um país sul-americano; que tenha usado uma amostra nacionalmente representativa ≥ 18 anos; coordenada pelo setor público, privado ou público-privado; e que tenha avaliado a atividade física e/ou o comportamento sedentário. Os dados extraídos eram sobre informações gerais das pesquisas, detalhes específicos sobre a avaliação da atividade física e do comportamento sedentário e questões adicionais relacionadas ao comportamento na atividade. Resultados. Ao todo, 36 pesquisas foram incluídas, duas das quais foram conduzidas em vários países. Todas as pesquisas avaliaram a atividade física e 27 avaliaram o comportamento sedentário. A maioria das pesquisas (23/36; 64%) baseou-se em questionários internacionais previamente validados e 13 (57%) delas se desviaram das ferramentas de referência, introduzindo mudanças e adaptações. O comportamento sedentário foi avaliado principalmente por meio de perguntas sobre tempo de tela e/ou tempo diário sentado nos mesmos questionários sobre atividade física. Nenhuma pesquisa utilizou medições realizadas por dispositivos para gerar dados sobre esses comportamentos. Conclusões. As diferenças entre os instrumentos usados e as modificações limitam a comparabilidade dos dados entre os países, o que destaca a importância de padronizar a avaliação na América do Sul para as seções de atividade física e comportamento sedentário em pesquisas nacionais, com o objetivo mais amplo de contribuir para o estabelecimento de uma estratégia padronizada para a vigilância da atividade física e do comportamento sedentário na América do Sul.

Meeting physical activity and screen time among Colombian adolescents with or without sensory-related problems.

The aim of this study was to assess the extent to which adolescents with and without visual and hearing-related problems meet physical activity (PA) and recreational screen time (ST) recommendations in a representative Colombian sample. A total of 35,404 adolescents aged 13-17 years were included from the Encuesta Nacional de Salud Escolar (ENSE) (Colombia). Sociodemographic-related information, anthropometric variables, PA, ST, and both visual- and hearing-related problems were collected by self-administered questionnaires. The prevalence of adolescents meeting with PA, ST, and both recommendations was 14.8%, 53.4%, and 7.8%, respectively. Both sexes with visual- (males: OR=0.70, 95%CI 0.59-0.83; females: OR=0.73, 95%CI 0.61-0.88) and hearing-related problems (males, OR=0.75, 95%CI 0.61-0.93; females, OR=0.76, 95%CI 0.61-0.94) are less likely to meet combined recommendations. Sensory problems such as vision- and hearing-related problems could be considered key barriers to engagement in PA and facilitators of recreational ST in Colombian adolescents.

Handgrip strength: Normative reference values in males and females aged 6-64 Years old in a Colombian population.

BACKGROUND: Handgrip strength (HGS) is an indicator of overall strength; therefore, individual HGS measurements should be interpreted using geographic region and ethnic group references. AIMS: The aim of this study was to develop new normative values for absolute and relative HGS in the Colombian population after stratification by sex, age, and body mass using the large National Representative Nutrition Survey 2015. METHODS: This cross-sectional study included 3803 subjects aged 6-64 years. Absolute HGS was measured using a hand dynamometer with an adjustable grip, and normalized HGS was calculated by dividing the HGS by body mass. Smoothed centile tables for the P3, P10, P25, P50, P75, P90, and P97 centiles were calculated using Cole's lambda-mu-sigma (LMS) method. This study used a cutoff at 2 standard deviations (SDs) below the sex-specific peak mean value across the life course to define weak, absolute and relative HGS. RESULTS: In men, HGS peaked at 26-33 years of age (~43.0 kg in P50), especially in the upper centiles, and fell away quickly. The pattern was different in females, where this value peaked at ages 25-33 (~26.0 kg in P50). We found a curvilinear pattern for HGS that declined with age in both sexes. There was significant variation in the slope for HGS in men and women around the age of 25 and 35 years, respectively. CONCLUSION: The normative values presented here are a valuable source of information for the clinical assessment of HGS and for comparison with studies from other countries.

Handgrip strength cut-off points for early detection of cardiometabolic risk in Chilean children.

The aim of this study was to determine whether handgrip strength is associated with cardiometabolic risk in children. The secondary aim was to establish sex-specific handgrip strength cut-off points for early detection of cardiometabolic risk. A total sample of 452 Chilean children (267 girls and 185 boys) aged 7-9 years old was analyzed. Muscle fitness was measured by an adjustable dynamometer and normalized by body mass (i.e., handgrip strength/body mass). Sex-specific cardiometabolic risk scores were computed as the sum of the waist-to-height ratio (Equation 1) or waist circumference (Equation 2) and insulin, triglycerides, high-density lipoproteins, and glycemia levels. Receiver operating curve (ROC) analyses were performed to identify those with cardiometabolic risk scores > 1 standard deviation above the mean. ROC analyses showed a significant discriminating accuracy of normalized handgrip strength in identifying cardiometabolic risk in boys (≤ 0.33) and girls (≤ 0.40) using both equations. The highest sensitivity was offered by Equation 2 for boys [46%; 95% CI (32-59%)] and for girls [71%; 95% CI (60-80)]. The greatest specificity was also offered by Equation 2 for boys [82%; 95% CI (74-88)] and girls [63%; 95% CI (55-70)]. Since the values obtained by ROC analyses are low (especially in boys), caution is warranted regarding the strength of the existing evidence base.Conclusion: These specific cut-off points according to sex for possible cardiometabolic risk could be used by Chilean health professionals and school staff as an initial assessment in the field setting. What is known • There is strong evidence for the importance of muscular fitness during childhood and adolescence for cardiometabolic risk. • There has been no research to establish minimum handgrip strength capacity levels to predict cardiometabolic risk among Chilean children. What is new • Cut-off points for handgrip strength relative to body mass to identify cardiometabolic risk in Chilean children are 0.33 in boys and 0.40 in girls. • The early use of these cut-off points and its appropriate identification could have benefits of preventive and diagnostic therapeutic intervention and as a starting point to define adequate levels of handgrip strength.