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Abstract

Exercise may be described as a polypill to prevent and/or treat almost every chronic disease, with obvious benefits such as its low cost and practical lack of adverse effects. Implementing physical activity interventions in public health is therefore a goal at the medical, social, and economic levels. This chapter describes the importance of health promotion through physical activity and discusses the impacts of exercise on the most prevalent chronic diseases, namely metabolic syndrome-related disorders, cardiovascular diseases, cancer, and Alzheimer's disease. For each of these chronic conditions, we discuss the epidemiological evidence supporting a beneficial role of exercise, provide guidelines for exercise prescription, and describe the biological mechanisms whereby exercise exerts its modulatory effects.

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... The combination of AI, blockchain, sensors, and wearable devices for monitoring body activity, various environments, and location data will improve the efficiency of implementing chronic disease prevention; this technology has shown great commercial and medical prospects [19,20,26,29,35,42,47,51,57,58] . However, making full use of such scattered real-time multidimensional data requires the establishment of structured and intelligent multidisciplinary integration as well as the iteration and innovation of machine learning and AI for the high-performance calculation of data [54] . ...
... A digital chronic disease management platform based on AI, blockchain, and wearable devices can effectively utilize the advantages of these emerging technologies, regularly send drug intake reminders to patients, process the collected monitoring data in real-time, and issue abnormal data warnings to patients and doctors, thus realizing remote monitoring of the treatment process [38] . For elderly patients in remote areas, when they are far away from relevant hospitals or when it is inconvenient to use medical facilities, such as during a pandemic, remote telemedicine has shown great value in the control of chronic diseases [18,19,25,58] . With the development of wireless communication networks, blockchain, wearable sensors, and AI technology, the diversity and accuracy of the medical internet of things are expected to be greatly improved [20,31,32,37,39,43,50,59] . ...
... Although the application of these technologies in the medical field has improved people's well-being, they are also prone to causing ethical risks [32,33,39,58,59] . First of all, the AI algorithm used for disease diagnosis may have problems of security and accuracy, which may cause harm to a patient's health. ...
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Chronic diseases are a growing concern worldwide, with nearly 25% of adults suffering from one or more chronic health conditions, thus placing a heavy burden on individuals, families, and healthcare systems. With the advent of the “Smart Healthcare” era, a series of cutting-edge technologies has brought new experiences to the management of chronic diseases. Among them, smart wearable technology not only helps people pursue a healthier lifestyle but also provides a continuous flow of healthcare data for disease diagnosis and treatment by actively recording physiological parameters and tracking the metabolic state. However, how to organize and analyze the data to achieve the ultimate goal of improving chronic disease management, in terms of quality of life, patient outcomes, and privacy protection, is an urgent issue that needs to be addressed. Artificial intelligence (AI) can provide intelligent suggestions by analyzing a patient’s physiological data from wearable devices for the diagnosis and treatment of diseases. In addition, blockchain can improve healthcare services by authorizing decentralized data sharing, protecting the privacy of users, providing data empowerment, and ensuring the reliability of data management. Integrating AI, blockchain, and wearable technology could optimize the existing chronic disease management models, with a shift from a hospital-centered model to a patient-centered one. In this paper, we conceptually demonstrate a patient-centric technical framework based on AI, blockchain, and wearable technology and further explore the application of these integrated technologies in chronic disease management. Finally, the shortcomings of this new paradigm and future research directions are also discussed.
... Physical activity is another key factor in promoting health and preventing the onset of non-communicable diseases [14,15]. Indeed, consistent moderate physical exercise has been associated with multifaceted interventions yielding substantial benefits for health, with a number of investigations supporting a therapeutic potential for a range of chronic conditions, including both the primary and secondary prevention of CVD, obesity, type 2 diabetes, among others [16][17][18][19][20]. On the other hand, prolonged sedentary behavior has been shown to increase the risk of various chronic diseases associated with fat accumulation [21]. ...
... Nutrients 2024,16, 1777 ...
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Translational research has documented the conjoint beneficial relationships between dietary and physical activity habits concerning weight maintenance. However, the precise interplay between diet and exercise impacting body composition remains unclear, challenging personalized interventions. This study aimed to explore potential interactions and effect modifications of these factors affecting the body mass index (BMI) within an online adult cohort. Data from 11,883 NUTRiMDEA cohort participants were analyzed in this cross-sectional study, categorizing individuals by age, sex, and BMI using linear regression models to assess the interactions between lifestyle factors and adiposity. Significant differences emerged in anthropometry, lifestyle, and health-related quality of life (HRQoL) across categories. The combined effect of diet and physical activity had a greater impact on BMI than physical activity or Mediterranean diet adherence alone, with lower BMI as physical activity levels increased (β: −0.5) and adherence to the Mediterranean diet decreased, where a modification effect between them was identified (β: −0.28). Participants with lower Mediterranean diet adherence displayed superior BMI when physical activity was low, but when activity levels were higher, their BMI aligned with those with healthier dietary habits. An interaction link between lifestyle factors and BMI was found, showing the differential effects of the Mediterranean diet and physical activity combination concerning adiposity.
... La letteratura scientifica internazionale riconosce il ruolo cruciale dell'attività fisica (AF) come "strumento terapeutico", per prevenire e gestire malattie croniche non trasmissibili come le malattie cardio-cerebrovascolari, oncologiche, respiratorie, psichiatriche e metaboliche, che determina anche il miglioramento della qualità della vita nella popolazione (1) . Proprio per tali motivazioni, l'Organizzazione Mondiale della Sanità (OMS) ha pubblicato nel 2020 le "Linee guida in materia di attività fisica e comportamento sedentario" (2) ed il tavolo di lavoro per la promozione dell'AF e la tutela della salute nelle attività sportive, istituito con Decreto del Ministro della Salute, ha promosso la "Linee guida sull'attività fisica. ...
... ESERCIZIO FISICO, L'INTERESSE DEI DIABETOLOGI → P. MAZZUCA Tabella 1 | Le domande nel sondaggio sulla conoscenza e sull'interesse dei diabetologi verso la prescrizione di EF nella pratica clinica.1 Ritieni che l'EF nelle sue diverse modalità esecutive (tipo, intensità, durata, frequenza, progressione) possa essere uno strumento preventivo e terapeutico per il diabete, ed in particolare per il DMT2? sì □ no □2 Ritieni di avere sufficienti informazioni e formazione su l'EF? ...
Article
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INTRODUZIONE L’evidenza scientifica e clinica pone l’accento sull’importanza della pratica dell’esercizio fisico (EF) nella prevenzione e nel trattamento delle più comuni patologie croniche non trasmissibili, incluso il diabete mellito di tipo 2. Le stesse evidenze pongono l’accento sull’importanza di individuare e di facilitare il superamento delle barriere al cambiamento comportamentale dei pazienti e la diffusione della cultura della prescrizione dell’EF da parte dell’equipe multidisciplinare che segue il paziente diabetico. Pertanto, ci siamo posti l’obiettivo di indagare sulla presenza di eventuali barriere legate alla conoscenza dell’importanza dell’EF e della sua prescrizione, oltre che alla conoscenza dell’area delle Scienze Motorie, da parte dei medici diabetologici. MATERIALI E METODI Tra giugno e luglio 2023, il gruppo di studio interassociativo AMD-SID “Diabete ed attività fisica” ha promosso una survey, in modalità web-based, inviata, tramite le newsletter istituzionali, ai soci AMD e SID. RISULTATI I 415 medici rispondenti, la maggior parte dei quali (i.e. 66%) operanti in un servizio di diabetologia, hanno delineato un quadro ottimistico, ovvero: il 76.4% di loro è fisicamente attivo, il 99.5% ritiene importante l’EF nel percorso terapeutico del paziente diabetico ed il 96.9% dei rispondenti ritiene che nella fase di educazione terapeutica possa essere inserito anche il supporto tecnico all’autogestione dell’EF. Tuttavia, il 59.8% dei rispondenti ha dichiarato di non avere sufficienti informazioni in tema di EF, il 94.9% parteciperebbe a seminari di implementazione formativa per la prescrizione di EF ed il 78.3% ha dichiarato di non conoscere l’identità ed il ruolo del chinesiologo specialista. CONCLUSIONI I risultati sottolineano l’importanza di favorire la formazione e l’integrazione delle professionalità nell’ambito dell’EF e la promozione della collaborazione interprofessionale con gli specialisti del movimento. PAROLE CHIAVE esercizio fisico; diabete mellito; prescrizione.
... Most research has been focused on improving physical fitness to CVD risk, due to its association with early mortality in childhood cancer survivors. 71 However, because childhood cancer survivors are also at increased risk for early onset endocrine, 72,73 musculoskeletal, 74 and severe neurological disorders, 75,76 and because PA and associated gains in physical fitness mitigates risk for these diseases in other populations, [77][78][79] observational and interventional work is needed to determine if increasing PA and improving physical fitness decreases the risk of future chronic disease in childhood cancer survivors. The robust literature describing biological mechanisms responsible for associations between PA, physical fitness, and CVD in noncancer populations provides some insight into why PA and/or better physical fitness may reduce, but not completely eliminate CVD risk among childhood cancer survivors. ...
... 95 The relationship between PA, physical fitness, and health is interdependent. 79,104,105 As the heart and the rest of the body adapt, physical fitness increases, enabling increased frequency, duration, and intensity of PA. However, childhood cancer survivors do not appear to reap the same rewards from PA as their peers, 30 and have lower physiological reserve than the cancer-free population. ...
Article
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Background Estimates indicate that nearly 8% of the over 500,000 survivors of childhood cancer living in the United States are frail in their fourth and fifth decades of life, a phenotype typically seen in geriatric populations. Participation in regular physical activity to improve physical fitness in healthy and diseased populations reduces risk for frail health by increasing physiologic reserve. However, physical activity may not have the same effects on fitness in childhood cancer survivors as it does among their peers with no cancer history. Aims This scoping review seeks to describe associations between physical activity, physical fitness, chronic disease, and mortality in childhood cancer survivors. Methods Relevant literature was identified through a comprehensive search in the PubMed, Web of Science, CINAHL, and Cochrane databases. A narrative synthesis was performed on observational studies that had physical activity or physical fitness clearly defined and compared with chronic disease outcomes. Results A total of 595 studies were screened, and results from 11 studies are presented. Childhood cancer survivors who participate in regular physical activity have improved markers of cardiovascular health, decreased risk of overt cardiovascular disease, and decreased risk of all-cause mortality compared to survivors who are not physically active. Childhood cancer survivors who are physically fit have increased neurocognition, and decreased risk of all-cause mortality compared to survivor's who are not fit. The differential effects of physical activity on fitness and health among childhood cancer survivors when compared to peers is potentially related to treatment exposures that damage cardiovascular tissue and impact regenerative potential. Conclusion Research is needed to determine the optimal timing, frequency, intensity, and duration of physical activity necessary to optimize fitness in childhood cancer survivors.
... As well, we found the greater all-cause mortality risk among persons with underweight (BMI < 18.5 kg/m 2 ) in this study, which agreed with previous studies [21,39,40]. In addition, this study suggests that physical activity is associated with a lower mortality risk, and the underlying mechanism behind this finding may be that physical activity delays disease progression by preventing many chronic diseases, including diabetes, cardiovascular and respiratory diseases, and some types of cancer [41]. Therefore, once any of these chronic conditions is diagnosed, physical activity is often incorporated into treatment plans to improve quality of life and survival [30,41,42]. ...
... In addition, this study suggests that physical activity is associated with a lower mortality risk, and the underlying mechanism behind this finding may be that physical activity delays disease progression by preventing many chronic diseases, including diabetes, cardiovascular and respiratory diseases, and some types of cancer [41]. Therefore, once any of these chronic conditions is diagnosed, physical activity is often incorporated into treatment plans to improve quality of life and survival [30,41,42]. ...
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Background Previous studies have evaluated the association of multimorbidity with higher mortality, but epidemiologic data on the association between the disease clusters and all-cause mortality risk are rare. We aimed to examine the relationship between multimorbidity (number/ cluster) and all-cause mortality in Chinese older adults. Methods We conducted a population-based study of 50,100 Chinese participants. Multiple logistic regression analysis was used to estimate the impact of long-term conditions (LTCs) on all-cause mortality. Results The prevalence of multimorbidity was 31.35% and all-cause mortality was 8.01% (50,100 participants). In adjusted models, the odds ratios (ORs) and 95% confidence intervals (CIs) of all-cause mortality risk for those with 1, 2, and ≥ 3 LTCs compared with those with no LTCs was 1.45 (1.32–1.59), 1.72 (1.55–1.90), and 2.15 (1.85–2.50), respectively ( P trend < 0.001). In the LTCs ≥2 category, the cluster of chronic diseases that included hypertension, diabetes, CHD, COPD, and stroke had the greatest impact on mortality. In the stratified model by age and sex, absolute all-cause mortality was higher among the ≥75 age group with an increasing number of LTCs. However, the relative effect size of the increasing number of LTCs on higher mortality risk was larger among those < 75 years. Conclusions The risk of all-cause mortality is increased with the number of multimorbidity among Chinese older adults, particularly disease clusters.
... 15, 16 Thus, it is necessary to identify effective and sustainable initiatives, which can attenuate the accelerated brain health deterioration in the CAD patient population. [5][6][7][8][9][10][11][12][13][14] Mounting evidence supports that exercise training has important systemic and multi-organ health benefits in patients with CAD 15, [17][18][19][20][21][22][23] and is recommended in clinical guidelines of the American Heart Association 24 and the European Society of Cardiology. 25 Importantly, literature showed that exercise might also mitigate cognitive and mental health impairments observed in this population. However, the effect of different types and settings of exercise on distinct domains of brain health remains unclear. ...
Article
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Background and Aims Individuals with coronary artery disease have poorer mental health, health-related quality of life (HR-QoL), and cognition compared with (age-matched) controls. Exercise training may attenuate these effects. The aim is to systematically review and meta-analyse the effects of different exercise types and settings on brain structure/function, cognition, HR-QoL, mental health (e.g. depression, anxiety), and sleep in patients with coronary artery disease. Methods A systematic search was conducted and a network meta-analysis compared (i) exercise types, high-intensity interval training (HIIT), HIIT + resistance (HIIT + R), moderate-intensity training (MIT), MIT + R and stretching-toning-balance training, and (ii) exercise settings, in-person and home-based. Results A total of 42 randomized controlled trials with a parallel group design were identified, of which 36 were included in the meta-analysis. Few studies included cognition (n = 2), sleep (n = 2), and none brain structure/function (n = 0). Most studies examined HR-QoL (n = 30), depression (n = 15), and anxiety (n = 9), in which outcomes were meta-analysed. HIIT + R, HIIT, and MIT were associated with improved HR-QoL vs. no exercise (i.e. usual care) [standardized mean difference, SMD: 1.53 (95% confidence interval 0.83; 2.24), 0.44 (0.15; 0.73), and 0.44 (0.20; 0.67), respectively]. In-person exercise was associated with larger and significant improvements [HR-QoL SMD: 0.51 (0.28; 0.74), depressive SMD: −0.55 (−1.03; −0.07), and anxiety symptoms SMD: −1.16 (−2.05; −0.26)] compared with no exercise, whereas home-based programmes were not significantly associated with improvements in these outcomes. Findings were robust in secondary (i.e. intervention duration and volume) and sensitivity analyses excluding high risk of bias studies. Conclusions Exercise training, especially in-person sessions, was associated with improved HR-QoL, depression and anxiety, independently of exercise type. However, this study raises concern about the effectiveness of home-based programmes in improving these outcomes. Study protocol was registered in PROSPERO (ID: CRD42023402569).
... Regular physical exercise (PE) plays a crucial role not only in the prevention of several diseases but also in their management and progression [2,3]. In BC, as in other chronic 2 of 7 diseases, PE has demonstrated positive effects on recovery following treatments, including improvements in self-reported quality of life [4], physical fitness [5], and maximal oxygen consumption [6]. ...
Article
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Breast cancer (BC) is the most common cancer among women, with an incidence of 85–94 per 100,000 people annually in Europe. Despite the increasing incidence of BC, advancements in early detection and novel therapeutic approaches have improved survival rates. However, adjuvant treatments are associated with side effects, including a reduction in the left ventricular ejection fraction (LVEF), which can result in severe cardiac damage and progress to heart failure. Methods: Thirty-eight women undergoing BC treatment were included in the study. Eighteen women (47.2 ± 5.4 years old) participated in a supervised physical exercise (PE) program for 60 min/day, twice weekly, at moderate to high intensity (5 min joint mobilization, 20 min predominantly aerobic training, 30 min of strength training, and 5 min cooldown). The remaining 20 women (51.5 ± 9.5 years) were advised to remain active during treatments, but without specific supervision. In the PE group, a slight reduction in the LVEF was observed after chemotherapy (63.73 ± 3.34% vs. 61.00 ± 6.54%, p = 0.131). In contrast, the control group showed a statistically significant reduction in the LVEF (64.93 ± 4.00% vs. 60.57 ± 4.86%, p = 0.008). Although the results suggest a potential protective effect of regular physical exercise during BC treatment, the study was inconclusive regarding its role in preventing cardiac dysfunction. Further research with a larger sample size and longer follow-up is warranted.
... Regular physical activity has been recognized as a valuable strategy to promote health and to prevent or treat chronic disease (Pareja-Galeano, Garatachea & Lucia, 2015;Pedersen & Saltin, 2015;Ruegsegger & Booth, 2018). The World Health Organization recommended that individuals aged between 18 and 64 years should undertake moderate-intensity aerobic activity for a minimum of 150 min per week for substantial health benefits (e.g., reduced all-cause mortality, symptoms of anxiety and depression, as well as incident of hypertension and type 2 diabetes mellitus) (Bull et al., 2020). ...
Article
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Background Hypoxia and hyperoxia can affect the acute psycho-physiological response to exercise. Recording various perceptual responses to exercise is of particular importance for investigating behavioral changes to physical activity, given that the perception of exercise-induced pain, discomfort or unpleasure, and a low level of exercise enjoyment are commonly associated with a low adherence to physical activity. Therefore, this study aimed to compare the acute perceptual and physiological responses to aerobic exercise under intermittent hypoxia-hyperoxia (IHHT), hypoxia-normoxia (IHT), and sustained normoxia (NOR) in young, recreational active, healthy males. Methods Using a randomized, single-blinded, crossover design, 15 males (age: 24.5 ± 4.2 yrs) performed 40 min of submaximal constant-load cycling (at 60% peak oxygen uptake, 80 rpm) under IHHT (5 × 4 min hypoxia and hyperoxia), IHT (5 × 4 min hypoxia and normoxia), and NOR. Inspiratory fraction of oxygen during hypoxia and hyperoxia was set to 14% and 30%, respectively. Heart rate (HR), total hemoglobin (tHb) and muscle oxygen saturation (S m O 2 ) of the right vastus lateralis muscle were continuously recorded during cycling. Participants’ peripheral oxygen saturation (S p O 2 ) and perceptual responses ( i.e ., perceived motor fatigue, effort perception, perceived physical strain, affective valence, arousal, motivation to exercise, and conflict to continue exercise) were surveyed prior, during (every 4 min), and after cycling. Prior to and after exercise, peripheral blood lactate concentration (BLC) was determined. Exercise enjoyment was ascertained after cycling. For statistical analysis, repeated measures analyses of variance were conducted. Results No differences in the acute perceptual responses were found between conditions ( p ≥ 0.059, η p ² ≤ 0.18), while the physiological responses differed. Accordingly, S p O 2 was higher during the hyperoxic periods during the IHHT compared to the normoxic periods during the IHT ( p < 0.001, η p ² = 0.91). Moreover, HR ( p = 0.005, η p ² = 0.33) and BLC ( p = 0.033, η p ² = 0.28) were higher during IHT compared to NOR. No differences between conditions were found for changes in tHb ( p = 0.684, η p ² = 0.03) and S m O 2 ( p = 0.093, η p ² = 0.16). Conclusion IHT was associated with a higher physiological response and metabolic stress, while IHHT did not lead to an increase in HR and BLC compared to NOR. In addition, compared to IHT, IHHT seems to improve reoxygenation indicated by a higher S p O 2 during the hyperoxic periods. However, there were no differences in perceptual responses and ratings of exercise enjoyment between conditions. These results suggest that replacing normoxic by hyperoxic reoxygenation-periods during submaximal constant-load cycling under intermittent hypoxia reduced the exercise-related physiological stress but had no effect on perceptual responses and perceived exercise enjoyment in young recreational active healthy males.
... 15, 16 Thus, it is necessary to identify effective and sustainable initiatives, which can attenuate the accelerated brain health deterioration in the CAD patient population. [5][6][7][8][9][10][11][12][13][14] Mounting evidence supports that exercise training has important systemic and multi-organ health benefits in patients with CAD 15, [17][18][19][20][21][22][23] and is recommended in clinical guidelines of the American Heart Association 24 and the European Society of Cardiology. 25 Importantly, literature showed that exercise might also mitigate cognitive and mental health impairments observed in this population. However, the effect of different types and settings of exercise on distinct domains of brain health remains unclear. ...
... Growing evidence supports the benefits of exercise on the cardiovascular health of individuals with CAD (Goldhammer et al., 2005;Niessner et al., 2006;Lavie and Milani, 2011;Pareja-Galeano et al., 2015;Anderson et al., 2016;Muscella et al., 2020). Yet, the mechanisms by which different types of exercise might improve brain health or attenuate the cognitive and mental health declines observed in patients with CAD remain to be elucidated. ...
Article
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Introduction Patients with coronary artery disease (CAD) have a higher risk of developing cognitive impairment and mental health disorders compared to the general population. Physical exercise might improve their brain health. The overall goal of the HEART-BRAIN randomized controlled trial (RCT) is to investigate the effects of different types of exercise on brain health outcomes in patients with CAD, and the underlying mechanisms. Methods This three-arm, single-blinded RCT will include 90 patients with CAD (50–75 years). Participants will be randomized into: (1) control group—usual care (n = 30), (2) aerobic high-intensity interval training (HIIT) (n = 30), or (3) HIIT combined with resistance exercise training (n = 30). The 12-week intervention includes 3 supervised sessions (45-min each) per week for the exercise groups. Outcomes will be assessed at baseline and post-intervention. The primary outcome is to determine changes in cerebral blood flow assessed by magnetic resonance imaging. Secondary outcomes include changes in brain vascularization, cognitive measures (i.e., general cognition, executive function and episodic memory), and cardiorespiratory fitness. Additional health-related outcomes, and several potential mediators and moderators will be investigated (i.e., brain structure and function, cardiovascular and brain-based biomarkers, hemodynamics, physical function, body composition, mental health, and lifestyle behavior). Conclusion The HEART-BRAIN RCT will provide novel insights on how exercise can impact brain health in patients with CAD and the potential mechanisms explaining the heart-brain connection, such as changes in cerebral blood flow. The results may have important clinical implications by increasing the evidence on the effectiveness of exercise-based strategies to delay cognitive decline in this high-risk population. Clinical trial registration ClinicalTrials.gov, identifier [NCT06214624].
... 4,5 In addition, exercise has been considered an adequate intervention for several diseases. 6,7 Yet, as men generally report higher levels of PA, women are considered vulnerable. 8 In some societies, women's PA has been limited to domestic chores or their possibilities to enjoy and improve their quality of life due to planned PA has been restricted by dress and religious codes. ...
Article
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Background Scarce evidence exists on barriers to physical activity in Mexican women. Despite evidence from other countries, no research has investigated the influence of the breast on PA in this population. Objective To determine the association between the breast and physical activity in Mexican women. Design Cross-sectional observational study. Methods Volunteers were 279 Mexican women from Veracruz, Durango, and Baja California states, who completed a paper survey of their demographics, brassiere characteristics, breast pain, and frequency and amounts of weekly physical activity. Results The first barrier to physical activity was time constraints, followed by breast-related issues. Breast pain was reported by 47.1% of women, and the breast as a barrier to physical activity participation was reported by 30.6%. Responses, such as “I am embarrassed by excessive breast movement” and “My breasts are too big” were the most frequently reported breast-related barriers to physical activity. Breast pain was associated with the menstrual cycle and exercise. Breast health knowledge and pain intensity were unrelated to moderate- and vigorous-intensity physical activity. The 36.4% and 6.7% of women did not meet weekly moderate- and vigorous-intensity physical activity guidelines, respectively. Weekly moderate- and vigorous-intensity physical activity was similar between women reporting breast pain and those who did not. Conclusions Because the breast was the second most significant barrier to physical activity, it is imperative to increase breast health knowledge in Mexican women to reduce impediments to physical activity.
... As an example, we have previously observed a link between device-assessed sleep outcomes [10] and SDB [11] with brain health (i.e., gray matter volume and academic performance) in children with overweight/obesity. Given the well-contrasted multiorgan benefits of physical exercise [12], it is of interest to investigate whether physical exercise improves sleep in children with overweight/obesity. ...
Article
Objective The objective of this study was to examine the chronic effects of a 20‐week exercise training program on device‐assessed sleep and sleep‐disordered breathing; and to determine whether participating in a session of the exercise program had effects on device‐assessed sleep the subsequent night in children with overweight/obesity. Methods A randomized clinical trial was conducted from November 2014 to June 2016. A total of 109 children (age 8–11 years) with overweight/obesity were randomized into an exercise training or control group. The exercise program included aerobic and resistance training 3 to 5 days/week. The control group participants continued their usual lifestyle. Device‐assessed sleep outcomes were measured using wrist‐worn actigraphy at baseline, in the middle of the exercise program (10th week), and at postintervention for seven consecutive days (24 h/day), and sleep‐disordered breathing was measured via the Pediatric Sleep Questionnaire. Results The exercise training program had a statistically significant effect on wake after sleep onset time (−10.8 min/day, −0.5 SDs, p = 0.040). No other chronic or acute effects (i.e., the subsequent night of attending a session of the exercise training program) were observed on the remaining sleep outcomes. Conclusions A 20‐week exercise training program reduced wake after sleep onset time in children with overweight/obesity. Future randomized trials that include a sample of children with poor sleep health at baseline are needed to better appreciate the role of exercise in sleep health.
... Meanwhile, the impact of physical activity (PA) on HTN as a modifiable behavior is still questioned. Some studies attribute 5-13% of HTN to inadequate PA 12 and suggest adequate daily PA as an effective "polypill" for hypertension control 13 . However, in some other studies, no significant relationship between PA and blood pressure (BP) has been reported, and even its negative effects on BP status have been emphasized [14][15][16][17] . ...
Article
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The effectiveness of long-term leisure time physical activity (LTPA) on blood pressure (BP) changes is still under debate. Since adolescence lifestyle behaviors shape the adulthood health profile, this study aimed to investigate the sex-specific impact of LTPA on BP changes from adolescence to young adulthood. This longitudinal study uses the data of 1412 adolescents (52% females) aged 12–18 years through a median follow-up of 12.2 years in the Tehran Lipid and Glucose Study (TLGS) framework. LTPA was calculated using the reliable and valid Iranian version of the modified activity scale (MAQ), and BP was measured at least twice by trained physicians. The linear mixed model was used to examine the study variables, considering individual and intrapersonal differences during the study. The majority of participants consistently demonstrated insufficient LTPA throughout the follow-up assessments, ranging from 54.7 to 67.1% for males and 77.7–83.4% for females. Despite a declining trend in LTPA (β = − 2.77 for males and β = − 1.43 for females), an increasing trend was noticeable in SBP, DBP, and BMI (β = 1.38, β = 1.81, β = 0.97 for males, and β = 0.10, β = 0.20, β = 0.97 for females, respectively). The unadjusted model revealed a significant trend in all variables for both sexes, except for female BP (P = 0.45 for SBP and P = 0.83 for DBP). Using the adjusted model, no significant association was observed between LTPA and changes in BP over time in both sexes. Our study indicates no association between LTPA and BP changes from adolescence to young adulthood. Insufficient LTPA levels, particularly among Iranian females, are likely the primary factor. Further research is crucial to identify appropriate LTPA levels to promote cardiovascular health and implement targeted interventions to achieve optimal LTPA levels in the Iranian population.
... 15, 16 Thus, it is necessary to identify effective and sustainable initiatives, which can attenuate the accelerated brain health deterioration in the CAD patient population. [5][6][7][8][9][10][11][12][13][14] Mounting evidence supports that exercise training has important systemic and multi-organ health benefits in patients with CAD 15, [17][18][19][20][21][22][23] and is recommended in clinical guidelines of the American Heart Association 24 and the European Society of Cardiology. 25 Importantly, literature showed that exercise might also mitigate cognitive and mental health impairments observed in this population. However, the effect of different types and settings of exercise on distinct domains of brain health remains unclear. ...
... Diabetes mellitus (DM) is one of the world's most common chronic diseases, affecting approximately 422 million people and resulting in 1.6 million deaths each year [1]. Impaired glucose metabolism and chronic hyperglycemia resulted into damage of vital organs [2][3][4]. Type 2 diabetes is the most common hyperglycemic condition characterised by resistant behaviour of body towards insulin. α-Amylase is a key carbohydrate-hydrolysing enzyme located in the epithelium of small intestine and have a significant role in carbohydrate digestion. ...
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The present manuscript describes the synthesis, spectral characterisation, DFT studies and biological activity of a series of 3d transition metal complexes of (E)-2-((2-(benzo[d]thiazole-2-yl)hydrazono)methyl)-5-(diethylamino)phenol (L1) in (1:1) and (1:2) ratio. Various spectral analysis revealed the presence of ONN binding domain in L1. The elemental composition was confirmed using mass spectrometry technique. The stability of the geometry was also confirmed with DFT based method using B3LYP/LanL2Dz level of theory. Absence of any imaginary frequency revealed the presence of geometry on global minima of potential energy surface. Job’s plot confirm the stoichiometric ratio of metal complexes. Electrochemical behaviour (cyclic voltammetry), magnetic moment and Conductance measurements were also investigated for the metal-complexes. Kinetic parameters for different stages of thermal decomposition of metal complexes were calculated by using Coats–Redfern and Broido method. Positive free-energy of decomposition describes the non-spontaneous nature of thermal decomposition. The negative ΔS value observed for metal complexes under consideration reveals the ordered arrangement of metal complexes than their reactants. The octahedral environment of Co²⁺, Ni²⁺, Cu²⁺ and Cd²⁺ complexes was elucidated with the help of spectroscopic data. The ligand (L1) and its metal complexes (M1–M8) exhibited excellent α-amylase and moderate anti-oxidant activities. Maximum α-amylase inhibition was exhibited by M7 with a percentage inhibition of 96.65% (IC50 = 0.070 µM) and the lowest by M1 (87.00%, IC50 = 0.086 µM).
... This geriatric syndrome is described as the state of progressive physiological vulnerability to a stressor (e.g., acute illness, injury, surgery, disease, changes in medication) as a consequence of the accumulated deterioration in the various physiological systems over time, such that frail patients have an increasingly reduced capacity to recover their previous state of health once they have been exposed to physiological stress. Regular physical activity is considered a protective factor for the prevention and management of many pathologies, such as cardiovascular disease, obesity, type 2 diabetes, colon and breast cancer [12][13][14], as well as for preventing premature mortality [15,16]. Physical activity also grants mental health benefits [17,18], delaying the onset of dementia and cognitive impairment [19,20] and helping to maintain overall wellbeing [21]. ...
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Physical exercise has demonstrated its effectiveness in the management of the deleterious process of aging. However, it is less studied in institutionalized elderly people. This investigation aims to clarify the benefits of a multicomponent training program in institutionalized older adults. A randomized controlled trial was conducted with institutionalized older adults (≥ 70 years old). Intervention group (IG; N = 18) were submitted to a multicomponent training program based on muscle power training and interval endurance exercise, 2 times/week for 12 weeks. Control group (CG; N = 16) continued their usual mobility exercises. Independence was estimated with the Barthel index, and physical fitness and functional mobility were evaluated by the Short Physical Performance Battery (SPPB), the Timed Up and Go (TUG) test, the 6-min Walking Test (6’WT), the 10-Meter Walking Test (10MWT), hand grip strength dynamometry, and lower limb muscle strength and power. The IG improved, compared with the CG, in TUG scores in -7.43 s (95% IC: 3.28, 11.59; p < 0.001); in 10MWT scores in -5.19 s (95% IC: 1.41, 8.97; p = 0.004) and -4.43 s (95% IC: 1.14, 7.73; p = 0.002), 6’WT scores in + 54.54 m (95% IC: 30.24, 78.84; p < 0.001); and SPPB in + 2.74 points (95% IC: 2.10, 3.37; p < 0.001). Maximum muscle power and maximum strength did not show statistically significant differences. The multicomponent training program based on muscle power and interval endurance exercise was shown to be safe, well tolerated and effective for the improvement of functional mobility and physical fitness, but not for independence in institutionalized older adults.
... It is also characterized by 1) an ability to perform daily activities with vigor, and 2) a demonstration of traits and capacities that are associated with a low risk of premature development of hypokinetic diseases (e.g., those associated with physical inactivity)" (Wilder et al., 2006). Indeed, maintaining good levels of PF during adulthood and later life, i.e., active aging, helps preserve autonomy and functional abilities and decelerate aging trajectories (Pareja-Galeano et al., 2015;Fiuza-Luces et al., 2018). Adequate PF is considered an established protective factor against chronic diseases and age-related disabilities (Sanchez-Sanchez et al., 2020). ...
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Introduction: Recent research highlights the need for a correct instrument for monitoring the individual health status, especially in the elderly. Different definitions of biological aging have been proposed, with a consistent positive association of physical activity and physical fitness with decelerated aging trajectories. The six-minute walking test is considered the current gold standard for estimating the individual fitness status in the elderly. Methods: In this study, we investigated the possibility of overcoming the main limitations of assessing fitness status based on a single measure. As a result, we developed a novel measure of fitness status based on multiple fitness tests. In 176 Sardinian individuals aged 51–80 years we collected the results of eight fitness tests to measure participants’ functional mobility, gait, aerobic condition, endurance, upper and lower limb strength, and static and dynamic balance. In addition, the participants’ state of health was estimated through validated risk scores for cardiovascular diseases, diabetes, mortality, and a comorbidity index. Results: Six measures contributing to fitness age were extracted, with TUG showing the largest contribution (beta = 2.23 SDs), followed by handgrip strength (beta = −1.98 SDs) and 6MWT distance (beta = −1.11 SDs). Based on fitness age estimates, we developed a biological aging measure using an elastic net model regression as a linear combination of the results of the fitness tests described above. Our newly developed biomarker was significantly associated with risk scores for cardiovascular events (ACC-AHA: r = 0.61; p = 0.0006; MESA: r = 0.21; p = 0.002) and mortality (Levine mortality score: r = 0.90; p = 0.0002) and outperformed the previous definition of fitness status based on the six-minute walking test in predicting an individual health status. Discussion: Our results indicate that a composite measure of biological age based on multiple fitness tests may be helpful for screening and monitoring strategies in clinical practice. However, additional studies are needed to test standardisation and to calibrate and validate the present results.
... 15, 16 Thus, it is necessary to identify effective and sustainable initiatives, which can attenuate the accelerated brain health deterioration in the CAD patient population. [5][6][7][8][9][10][11][12][13][14] Mounting evidence supports that exercise training has important systemic and multi-organ health benefits in patients with CAD 15, [17][18][19][20][21][22][23] and is recommended in clinical guidelines of the American Heart Association 24 and the European Society of Cardiology. 25 Importantly, literature showed that exercise might also mitigate cognitive and mental health impairments observed in this population. However, the effect of different types and settings of exercise on distinct domains of brain health remains unclear. ...
Article
Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): - HEARTY-BRAIN - Effects of Exercise on Brain in Patients with Coronary Heart Disease: The Heart-Brain Connection. Andalusian Plan for Research Development and Innovation (PAIDI). University of Granada. Funding: 116.000 €. PI: F. Ortega. 2021-2021. - VASCULACTIVE. Effects of exercise on brain vascularization in coronary heart disease patients. Spanish Ministry of Economy and Competitiveness (I+D+I RETOS). University of Granada. Funding: 121.000 €. PI: F. Ortega. 2021-2023. Background Coronary heart disease (CHD) is the most prevalent type of cardiovascular disease in the world, and a leading cause of mortality and morbidity. Previous research showed that patients with CHD have a decrease in health-related quality of life (HRQoL) during the course of the disease. Physical exercise may attenuate the decline in HRQoL observed in CHD patients. Purpose To determine the effect of exercise training interventions on HRQoL in CHD patients. Methods A systematic search of controlled trials (CTs) assessing the effects of exercise training on HRQoL in CHD patients was performed in Web of Science, PubMed, Scopus, EMBASE, Cochrane Register, SportDiscus, PsycINFO and Google Scholar from inception to 30 June 2022. A meta-analysis with fixed and random effects was performed on controlled trials (comparing at least one exercise group with one non-exercise group and including a global score of HRQoL assessments before and after the interventions. All statistical analyses were performed using R-Studio. Results A total of 26 CTs met all the eligibility criteria and were included in the review (25 randomized CTs and 1 non-randomized CTs). HRQoL was mostly assessed by the SF-36 instrument (11/26) and the MacNew Heart Disease Health-Related Quality of Life questionnaire (8/26). Six out of the 26 studies reported the total score of quality of life and were included in the meta-analysis, which resulted in 8 exercise interventions and 591 participants with a mean age of 61 years, and 33% was women. There was a small (effect size 0.20) borderline overall effect of exercise on HRQoL in CHD patients (95% confidence interval: fixed effect, 0.05–0.36; random effect, -0.06-0.46. The percentage of total variability attributed to between-study heterogeneity [I2] = 44%, P=0.09 (Figure 1). Conclusions Findings from this meta-analysis suggest that supervised exercise training may cause a modest improvement in HRQoL in CHD patients. Future studies should explore which type and loads of exercise lead to larger improvements.
... Notably, exercise interventions have become a potentially effective tool for preventing and treating metabolic diseases. [18][19][20][21] For instance, there is evidence that physical exercise is at least as effective as some pharmacological treatments to improve glucose tolerance in individuals at risk of developing T2DM, 22,23 an effect linked to an anti-inflammatory effect. 24 Although the relevance of physical exercise for preventing and treating metabolic diseases has been reported in the literature, the evidence of its impact on individuals with overweight or obesity provided by previous systematic reviews 25-28 is inconclusive. ...
Article
The present study aimed to investigate the evidence on the effects of different long-term training interventions (aerobic [AeT], resistance [RT], and combined [COMB]) and spontaneous physical activity (PA) in modifying cytokines and adipokines in individuals with overweight or obesity with or without cardiometabolic diseases while considering potential confounders. Although exercise interventions have become a potentially effective tool for preventing and treating metabolic diseases, the evidence provided by previous systematic reviews is inconclusive since several potential confounders have yet to be addressed. Therefore, we conducted a systematic literature search in Medline, Cochrane, and Embase databases from January 2000 to July 2022 and performed a meta-analysis. Inclusion criteria retrieved 106 full texts comprising 8,642 individuals with a range BMI of 25.1–43.8 kg m−2. We found that independently of the training mode, exercise had a beneficial effect on diminishing Adiponectin, C-reactive protein (CRP), IL-6, IL-18, IL-20, Leptin, sICAM, and TNF-α levels circulating levels. Furthermore, by subsequent analysis, we detected differential effects of AeT, RT, and COMB, with sex, age, body composition, and trial length acting as moderators. The comparison of training modes revealed a difference favoring COMB over AeT for regulating the increase in CRP with no differences in the remaining biomarkers. Meta-regression analysis revealed an effect of change in maximal oxygen uptake (VO2max) on CRP, IL-6, and TNF-α, while IL-10 was influenced by the change in body fat. The results suggest that all interventions, except PA, are effective in lessening this population's inflammatory status, provided that exercise results in an increase of VO2max.
... 55 Mushrooms and several herbac-eous remedies are systematically progressing towards nutraceuticals, cosmeceuticals, and food supplements due to their reported health benifits and safety. 56,57 Currently, G. lucidum is adopted in modern medicine, cosmeceuticals, and traditional medicine owing to its diverse biological activities and merits in treating varied human diseases. 3,58 ...
Article
With a long history in traditional Asian medicine, Ganoderma lucidum (G. lucidum) is a mushroom species suggested to improve health and extend life. Its medicinal reputation has merited it with numerous attributes and titles, and it is evidenced to be effective in the prevention and treatment of various metabolic disorders owing to its unique source of bioactive metabolites, primarily polysaccharides, triterpenoids, and polyphenols, attributed with antioxidant, anti-inflammatory, anticancer, hepatoprotective, antidiabetic activities, etc. These unique potential pharmaceutical properties have led to its demand as an important resource of nutrient supplements in the food industry. It is reported that the variety of therapeutic/pharmacological properties was mainly due to its extensive prebiotic and immunomodulatory functions. All literature summarized in this study was collated based on a systematic review of electronic libraries (PubMed, Scopus databases, Web of Science Core Collection, and Google Scholar) from 2010-2022. This review presents an updated and comprehensive summary of the studies on the immunomodulatory therapies and nutritional significance of G. lucidum, with the focus on recent advances in defining its immunobiological mechanisms and the possible applications in the food and pharmaceutical industries for the prevention and management of chronic diseases. In addition, toxicological evidence and the adoption of standard pharmaceutical methods for the safety assessment, quality assurance, and efficacy testing of G. lucidum-derived compounds will be the gateway to bringing them into health establishments.
... The beneficial effects of this dietary pattern have been mainly attributed to the anti-inflammatory and antioxidant properties provided by the foods consumed [10,25,26]. Physical activity is another factor promoting health and preventing the onset of NCDs [27,28], as well as a therapeutically agent [29][30][31]. ...
Article
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Obesity, diabetes and cardiovascular events are non-communicable diseases (NCDs) directly related to lifestyle and life quality. Rises on NCDs rates are leading to increases in early deaths concerning metabolic morbidities. Health-related quality of life (HRQoL) has been described as a subjective perception about the influence of health and personal features on human well-being. This study aimed to characterize phenotypic and lifestyle roles on the occurrence of metabolic diseases and determine the potential mutual interactions and with HRQoL. Data from an online adult population (NUTRiMDEA study, n = 17,332) were used to estimate an adapted Obesogenic Score (ObS), while logistic regression analyses were fitted in order to examine relevant factors related to the prevalence of different metabolic diseases including HRQoL. Sex and age showed significant differences depending on lifestyle and metabolic health (p < 0.05). Adherence to the Mediterranean diet and physical activity showed a mutual interaction concerning ObS (p < 0.001), as well with metabolic health (p = 0.044). Furthermore, metabolic diseases showed own features related to sociodemographic and lifestyle characteristics in this population. Metabolic syndrome components may be differently influenced by diverse lifestyle or socioeconomic factors which in turn affect the perceived HRQoL. These outcomes should be taken into account individually for a precision medicine and public health purposes.
... Generally described as polypill (Pareja-Galeano et al., 2015), physical training (e.g., aerobic training) has been recognized as a valuable intervention strategy for health promotion and disease prevention and/or treatment in older adults. Particularly for aerobic training, these recommendations proposed a duration of 20-60 min per session, a frequency of 3-7 days per week, and an intensity corresponding to 40-70% of the individual's heart rate reserve (Izquierdo et al., 2021). ...
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Background: Intermittent hypoxic-hyperoxic exposure (IHHE) and aerobic training have been proposed as non-pharmacological interventions to reduce age-related risk factors. However, no study has yet examined the effects of IHHE before aerobic exercise on cardiovascular risk factors in the elderly. Therefore, the aim of this study was to investigate the acute and chronic effects of IHHE prior to aerobic cycling exercise on blood lipid and lipoprotein concentrations as well as blood pressure in geriatric patients. Methods: In a randomized, controlled, and single-blinded trial, thirty geriatric patients (72–94 years) were assigned to two groups: intervention (IG; n = 16) and sham control group (CG; n = 14). Both groups completed 6 weeks of aerobic cycling training, 3 times a week for 20 min per day. The IG and CG were additionally exposed to IHHE or sham IHHE (i.e., normoxia) for 30 min prior to aerobic cycling. Blood samples were taken on three occasions: immediately before the first, ∼10 min after the first, and immediately before the last session. Blood samples were analyzed for total (tCh), high-density (HDL-C), and low-density lipoprotein cholesterol (LDL-C), and triglyceride (Tgl) serum concentration. Resting systolic (SBP) and diastolic blood pressure (DBP) was assessed within 1 week before, during (i.e., at week two and four), and after the interventions. Results: The baseline-adjusted ANCOVA revealed a higher LDL-C concentration in the IG compared to the CG after the first intervention session (ηp ² = 0.12). For tCh, HDL-C, Tgl, and tCh/HDL-C ratio there were no differences in acute changes between the IG and the CG (ηp ² ≤ 0.01). With regard to the chronic effects on lipids and lipoproteins, data analysis indicated no differences between groups (ηp ² ≤ 0.03). The repeated measures ANOVA revealed an interaction effect for SBP (ηp ² = 0.06) but not for DBP (ηp ² ≤ 0.01). Within-group post-hoc analysis for the IG indicated a reduction in SBP at post-test (d = 0.05). Conclusion: Applying IHHE prior to aerobic cycling seems to be effective to reduce SBP in geriatric patients after 6 weeks of training. The present study suggests that IHHE prior to aerobic cycling can influence the acute exercise-related responses in LDL-C concentration but did not induce chronic changes in basal lipid or lipoprotein concentrations.
... Aware of the role that PA plays in individuals' health, functioning as a polypill with broad benefits in the case of chronic diseases [46], it is also important to highlight the importance of PA to the cancer population. While no differences in body composition or psychological state were found in our sample, possibly due to this group's poor parameters to begin with, there was a decline in strength and fitness level as well as less time of PA levels during this period. ...
Article
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Backgrounds Due to the COVID-19 pandemic that we are currently facing, many governments across the world have declared a state of emergency and even confinements. This stressful situation, in addition to prolonged stays at home, may imply a radical change in lifestyle behavior and physical activity (PA). The aim of this study is to evaluate the physiological and psychological effects in cancer patients who changed their PA habits during the COVID-19 state of emergency in Spain. Methods Thirty-three participants were evaluated pre- and post-state of emergency. A series of questionnaires was used to assess cancer-specific quality of life. Results The most relevant results revealed significantly lower walking time ( p < 0.001) and sitting time ( p = 0.014). Upper and lower body strength also decreased significantly ( p = 0.009 and 0.012, respectively) and oxygen consumption (VO2 peak) ( p = 0.023). None of the parameters analysed showed significant differences for psychological aspects (QLQ-C-30 and SF-36) and body composition. Conclusion Lower physical activity leads to negative physiological adaptation, particularly affecting cardiovascular and strength levels. While it is important to maintain the general population’s amount and intensity of exercise, this particularly vulnerable group’s physical capacity is vital to their health and well-being.
... [7][8][9] As an example, we have previously observed a link between device-assessed sleep outcomes 10 and SDB 11 with brain health (i.e., gray matter volume and academic performance) in children with overweight/obesity. Given the wellcontrasted multi-organ benefits of physical exercise, 12 it is of interest to investigate whether physical exercise improves sleep in children with overweight/obesity. A large number of studies have supported the positive chronic and acute effects of physical exercise on device-assessed sleep in adults. ...
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Objectives To examine 1) the chronic effects of a 20-week physical exercise program on device-assessed sleep and on sleep-disordered breathing (SDB); and 2) whether attending to a session of the exercise program had effects on device-assessed sleep the subsequent night in children with overweight/obesity. Methods A total of 99 children with overweight/obesity (n=47 in the exercise group) participated in this secondary analysis of the ActiveBrains randomized clinical trial. The exercise program included a combination of aerobic and resistance exercise training, 3-5 days/week (90 min/session). The control group was asked to maintain usual lifestyle. Sleep outcomes were measured using wrist actigraphy and included: total sleep time, total time in bed, sleep efficiency, and wake after sleep onset (WASO) time. SDB was assessed via the Paediatric Sleep Questionnaire. Results The ActiveBrains exercise program had a statistically significant effect on WASO time (−10.8 min/day, -0.5 standard deviations (SD), P =0.040). Furthermore, we observed a small non-statistically significant effect on sleep efficiency (+2%, 0.4 SD, P =0.1). No other chronic effects were observed on the other sleep outcomes. The nights (at maximum of 4) after attending the ActiveBrains exercise sessions, children showed higher total sleep time (+8 min, P =0.17), sleep efficiency (+1%, P =0.15), and lower WASO time (−6 min, P =0.18) although did not reach statistical significance. Conclusion A 20-week physical exercise program reduced WASO time in children with overweight/obesity in comparison with control group peers, yet we did not observe effects on SDB. Future randomized trials that include a clinical sample of children with poor sleep health at baseline are needed to better appreciate the role of exercise in sleep health. Clinal Trial Registration The ActiveBrains project is registered at ClinicalTrials.gov , no. NCT02295072 . Data Sharing Statement: We did not obtain children’s parents consent to widely share the data nor was it included in the IRB protocol. What’s known on this subject Sleep is an essential component in children’s health. Previous researchers have found positive effects of exercise on sleep in adolescents with obesity, but the literature in childhood obesity is lacking. What this study adds A physical exercise program showed positive effects on device-assessed sleep habits in children with overweight/obesity, yet not on sleep-disordered breathing. Exercise programs should be promoted in children to improve their sleep health, especially in those with overweight/obesity.
... It has been well established that regular physical activity has considerable health benefits [5,8]. However, repeated skeletal muscle contractions generate RONS and, if intense and prolonged, exercise can cause oxidative damage to cells, both in untrained and trained individuals [6,9]. ...
Article
Objetives : This double-blind randomized controlled trial examines whether antioxidant vitamin supplementation with vitamin C (VitC) and vitamin E (VitE) affects the hypertrophic and functional adaptations to resistance training in trained men. Methods : Participants were daily supplemented with VitC and VitE (VIT; N=12) or placebo (PLA; N=11) while completing a 10-week resistance training programme accompanied by a dietary intervention (300 kcal surplus and adequate protein intake) designed to optimize hypertrophy. Body composition (dual-energy X-ray absorptiometry), handgrip strength, and one-repetition maximum (1-RM), maximal force (F0), velocity (V0) and power (Pmax) were measured in bench press (BP) and squat (SQ) tests conducted before and after the intervention. To detect between-group differences, multiple-mixed ANOVA, standardized differences and qualitative differences were estimated. Relative changes within each group were assessed using a paired Student's t test. Results : In both groups, similar improvements were produced in 1-RM (BP), 1-RM (SQ) and F0 (BP) (p<0.05) after resistance training program. A small effect size was observed for 1-RM (BP) (d=0.53), F0 (BP) (d=0.48) and 1-RM (SQ) (d=-0.39), but not for F0 (SQ) (d=0.03). Dominant hand grip strength was significantly increased only in the PLA group (p<0.05). According to body composition data, a significant increase was produced in upper body fat-free mass soft tissue (FFMST; p<0.05) in PLA, while neither total nor segmental FFMST was increased in the VIT group. Small intervention effect sizes were observed for upper body FFSMT (d=0.32), non-dominant and dominant leg FFMST (d=-0.39; d=-0.42). While a significant increase in total body fat was observed in both groups (p<0.05) only the PLA group showed an increase in visceral adipose tissue (VAT; p<0.05), showing a substantial intervention effect (d=0.85). Conclusions : Our data indicate that, while VitC/VitE supplementation seems to blunt the upper body strength and hypertrophy adaptations to resistance training, it could also mitigate VAT gains elicited by an energy surplus.
... It has been well established that regular physical activity has considerable health benefits [5,8]. However, repeated skeletal muscle contractions generate RONS and, if intense and prolonged, exercise can cause oxidative damage to cells, both in untrained and trained individuals [6,9]. ...
Article
Objetives : This double-blind randomized controlled trial examines whether antioxidant vitamin supplementation with vitamin C (VitC) and vitamin E (VitE) affects the hypertrophic and functional adaptations to resistance training in trained men. Methods : Participants were daily supplemented with VitC and VitE (VIT; N=12) or placebo (PLA; N=11) while completing a 10-week resistance training programme accompanied by a dietary intervention (300 kcal surplus and adequate protein intake) designed to optimize hypertrophy. Body composition (dual-energy X-ray absorptiometry), handgrip strength, and one-repetition maximum (1-RM), maximal force (F0), velocity (V0) and power (Pmax) were measured in bench press (BP) and squat (SQ) tests conducted before and after the intervention. To detect between-group differences, multiple-mixed ANOVA, standardized differences and qualitative differences were estimated. Relative changes within each group were assessed using a paired Student's t test. Results : In both groups, similar improvements were produced in 1-RM (BP), 1-RM (SQ) and F0 (BP) (p<0.05) after resistance training program. A small effect size was observed for 1-RM (BP) (d=0.53), F0 (BP) (d=0.48) and 1-RM (SQ) (d=-0.39), but not for F0 (SQ) (d=0.03). Dominant hand grip strength was significantly increased only in the PLA group (p<0.05). According to body composition data, a significant increase was produced in upper body fat-free mass soft tissue (FFMST; p<0.05) in PLA, while neither total nor segmental FFMST was increased in the VIT group. Small intervention effect sizes were observed for upper body FFSMT (d=0.32), non-dominant and dominant leg FFMST (d=-0.39; d=-0.42). While a significant increase in total body fat was observed in both groups (p<0.05) only the PLA group showed an increase in visceral adipose tissue (VAT; p<0.05), showing a substantial intervention effect (d=0.85). Conclusions : Our data indicate that, while VitC/VitE supplementation seems to blunt the upper body strength and hypertrophy adaptations to resistance training, it could also mitigate VAT gains elicited by an energy surplus.
... It is therefore necessary to identify effective strategies to attenuate these adverse consequences. In this context, physical exercise is a candidate to produce such positive stimuli, as it exerts multisystemic benefits on human organs, including the brain 5,6 . Existing exercise-based interventions have mostly targeted executive functions and other dimensions of cognition (e.g., processing speed, language, etc.) [7][8][9] , yet evidence on the effect of exercise on intelligence and its components, i.e., crystallized and fluid, 10 is lacking. ...
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Objectives To investigate the effects of exercise on intelligence, executive functions, academic performance and brain outcomes in children with overweight/obesity. In secondary analyses, we explored potential mediators and moderators of the exercise effects. Methods A total of 109 children (8-11.9y) with overweight/obesity were randomized (intention-to-treat) and 90 (82.6%) completed the post-exercise evaluation and attended ≥70% of the exercise sessions (per-protocol). Participants in the control group continued with their usual routines and received lifestyle recommendations, whereas the exercise group attended 3 sessions/week of aerobic plus resistance training during 20 weeks. Intelligence, executive functions (cognitive flexibility, inhibition, working memory) and academic performance were assessed with standardized tests; and hippocampal volume with magnetic resonance imaging (MRI). Results In per-protocol analyses, the exercise intervention improved intelligence and cognitive flexibility (medium-large effect sizes observed, 0.4-0.7 SDs). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. Moreover, we found a positive, small-magnitude (i.e., 0.2-0.3 SDs) effect of exercise on academic performance (total, mathematics and problem solving), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain MRI outcomes studied were not affected by our exercise program. Our intervention increased cardiorespiratory fitness performance (0.4 SDs) and these changes in fitness mediated some of the effects. Effects were mostly consistent across the studied moderators, except for larger improvements for intelligence in boys compared to girls. Conclusion Exercise positively impacts intelligence and cognitive flexibility during development in children with overweight/obesity, without changes in the structural and functional brain outcomes studied. Trial Registration ClinicalTrials.gov Identifier: NCT02295072 SUMMARY BOX What is already known on this topic - Pediatric obesity is associated not only with poorer physical health but also with poorer cognitive and brain development. - Previous exercise interventions have mostly focused on executive functions and other dimensions of cognition, yet is largely unknown the extent to which exercise can improve intelligence during childhood, and actually, at any period of life. - Studies integrating effects of exercise on behavioral and brain magnetic resonance outcomes in a single article are scarce. - A in-depth study of the exercise characteristics (mode) and intensity, potential compensatory/contamination effects and role of potential mediators and moderators of the exercise effects is warranted. What this study adds - A 20-week randomized controlled trial of exercise improved intelligence and cognitive flexibility in preadolescent children with overweight/obesity. - Moreover, we found a positive, small-magnitude effect of exercise on academic performance, which was partially mediated by cognitive flexibility. - Cardiorespiratory peak performance mediated some yet not all the exercise effects observed. - The structural and functional brain outcomes studied were not affected by participation in the exercise program. How this study might affect research, practice or policy Our investigation suggests that exercise can positively impact intelligence and cognitive flexibility during a sensitive period of brain development in childhood. This stimulus can positively affect academic performance, as shown in our study, indicating that an active lifestyle during preadolescent development may lead to more successful life trajectories. This is particularly important in children with overweight/obesity who are known to be at higher risk of poorer physical and brain health.
... Therefore, reducing SB is useful for improving longevity, long-term health and well-being. It is even better to replace SB with PA, which is highly effective in preventing and treating diseases [9,10]. According to the latest guidelines, 150-300 min of moderate to vigorous intensity or 75-150 min of vigorous intensity PA per week is considered sufficient to maintain health and well-being [11]. ...
Article
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Patients after joint arthroplasty tend to be less physically active; however, studies measuring objective physical activity (PA) and sedentary behavior (SB) in these patients provide conflicting results. The aim of this meta-analysis was to assess objectively measured PA, SB and performance at periods up to and greater than 12 months after lower limb arthroplasty. Two electronic databases (PubMed and Medline) were searched to identify prospective and cross-sectional studies from 1 January 2000 to 31 December 2020. Studies including objectively measured SB, PA or specific performance tests in patients with knee or hip arthroplasty, were included in the analyses both pre- and post-operatively. The risk of bias was assessed using the Scottish Intercollegiate Guidelines Network (SIGN). After identification and exclusion, 35 studies were included. The data were analyzed using the inverse variance method with the random effects model and expressed as standardized mean difference and corresponding 95% confidence intervals. In total, we assessed 1943 subjects with a mean age of 64.9 (±5.85). Less than 3 months post-operative, studies showed no differences in PA, SB and performance. At 3 months post-operation, there was a significant increase in the 6 min walk test (6MWT) (SMD 0.65; CI: 0.48, 0.82). After 6 months, changes in moderate to vigorous physical activity (MVPA) (SMD 0.33; CI: 0.20, 0.46) and the number of steps (SMD 0.45; CI: 0.34, 0.54) with a large decrease in the timed-up-and-go test (SMD −0.61; CI: −0.94, −0.28) and increase in the 6MWT (SMD 0.62; CI: 0.26–0.98) were observed. Finally, a large increase in MVPA (SMD 0.70; CI: 0.53–0.87) and a moderate increase in step count (SMD 0.52; CI: 0.36, 0.69) were observed after 12 months. The comparison between patients and healthy individuals pre-operatively showed a very large difference in the number of steps (SMD −1.02; CI: −1.42, −0.62), but not at 12 months (SMD −0.75; −1.89, 0.38). Three to six months after knee or hip arthroplasty, functional performance already exceeded pre-operative levels, yet PA levels from this time period remained the same. Although PA and functional performance seemed to fully restore and exceed the pre-operation levels at six to nine months, SB did not. Moreover, PA remained lower compared to healthy individuals even longer than twelve months post-operation. Novel rehabilitation protocols and studies should focus on the effects of long-term behavioral changes (increasing PA and reducing SB) as soon as functional performance is restored.
... This applies not only to the general population but also to older adults and chronically ill populations, particularly those at high risk of death from Covid-19 (23). Our bodies require a relatively long period of time to take advantage of the healthy adaptations produced by physical activity (24)(25)(26). However, it takes only a few days to reverse these positive adaptations and the body returns to a physiological state similar to the initial condition or worse (27). ...
Article
This study aims to evaluate relationship between physical activity level, smartphone usage, back and neck health during Covid-19 pandemic. Participants between ages of 18-65 were included in study. Smartphone usage was evaluated with Smartphone Addiction Scale-Short Version, physical activity levels with short form of International Physical Activity Questionnaire. Oswestry Disability Index and Neck Bournemouth Questionnaire was used to evaluate back and neck problems. A total of 251 people (179 women, 72 men, age: 28.11±9.49 years, min-max: 18-62 years) participated in study. 134 participants (53.38%) had low physical activity levels; 35 individuals (13.94%) had sufficient physical activity levels while 82 participants (32.66%) were not physically active. A weak positive correlation was found between neck pain and total score of smartphone addiction scale, daily smartphone usage time, daily smartphone check frequency, and first check time after waking up (r=0.199, r=0.149, r=0.132, respectively). A weak negative correlation was found between neck pain and first check time after waking up (r=-0.145). As a result of study, it was observed that physical activity levels were insufficient in majority of individuals who participated in survey. The relationships we expected between physical activity level, smartphone usage characteristics, low back and neck health could not be demonstrated, only weak relationships were found between some features of smartphone use and neck health. We believe that finding solutions to increase physical activity levels of individuals during pandemic period will have both protective effects on health and will prevent problems by affecting musculoskeletal system positively.
... Cada vía de señalización de estrés oxidativo, sistemas de proteólisis, factores de crecimiento y diferenciación celular en el diafragma que concluyan en autofagia y apoptosis genera un círculo vicioso de débito energético y disminución de número de células musculares [36] (ver Figura 1). Es así que el reto de la fisioterapia respiratoria es generar un estímulo que pro-mueva la supervivencia celular y la diferenciación de células satélites para mejorar trofismo y un metabolismo oxidativo sostenible, por lo que la mejor estrategia para lograr cambios celulares y morfológicos en base a la ecografía por medio del entrenamiento funcional de los músculos respiratorios, es decir aplicar el concepto de ejercicio físico como estrategia terapéutica [37,38] en la rehabilitación de pacientes COVID-19 Figura1. ...
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Resumen La infección por COVID-19 ha afectado a la población mundial y a los sistemas de salud que le han hecho frente. No obstante, los efectos respiratorios aborda-dos desde fisioterapia aún son inciertos. Por lo tanto, esta revisión de literatura tiene como objetivo establecer las perspectivas de las intervenciones desde la fisioterapia respiratoria en los sujetos infectados con COVID-19 donde se seleccionaron las bases de datos Pubmed, Medline, PEDro y Scielo en la búsqueda de artículos científicos y guías de manejo en idioma de inglés, portugués y español acerca de las bases moleculares y los efectos funcionales del COVID-19 sobre el sistema respiratorio. Se pudo concluir que la fisioterapia respiratoria implica un razonamiento clínico terapéutico acerca de los cambios celulares y morfológicos de los músculos respiratorios que se suscitan desde la patokinesis, intervenciones neumáticas, posicionamiento ventilatorio los cuales determinan efectos positivos Archivos de Medicina (Manizales) Volumen 21 N° 2, Julio-Diciembre 2021, ISSN versión impresa 1657-320X, ISSN versión en línea 2339-3874, Moreno-Collazos JE, Torres JI, Reyes MM, Pinzón ID, Rodríguez LC.
... These lockdown measures have influenced people's work, education, travel, and recreation, and subsequently, their levels of physical activity (PA) and sedentary behaviors (SB) all over the world, as two recent reviews show [7,8]. Research shows that physical activity has many positive effects on physical and mental health and can lead to higher social contentedness [9][10][11]. Additionally, it can help to overcome stress, anxiety, and depressive symptoms, all symptoms that were reported by many persons due to the pandemic [12][13][14]. ...
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The new coronavirus (COVID-19) pandemic and the resulting response measures have led to severe limitations of people’s exercise possibilities with diminished physical activity (PA) and increased sedentary behavior (SB). Since for migrant groups in Germany, no data is available, this study aimed to investigate factors associated with changes in PA and SB in a sample of Turkish descent. Participants of a prospective cohort study (adults of Turkish descent, living in Berlin, Germany) completed a questionnaire regarding COVID-19 related topics including PA and SB since February 2020. Changes in PA and SB were described, and sociodemographic, migrant-related, and health-related predictors of PA decrease and SB increase were determined using multivariable regression analyses. Of 106 participants, 69% reported a decline of PA, 36% reported an increase in SB. PA decrease and SB increase seemed to be associated with inactivity before the pandemic as well as with the female sex. SB increase appeared to be additionally associated with educational level and BMI. The COVID-19 pandemic and the response measures had persistent detrimental effects on this migrant population. Since sufficient PA before the pandemic had the strongest association with maintaining PA and SB during the crisis, the German government and public health professionals should prioritize PA promotion in this vulnerable group.
... for example. The current discussion rather takes place against a backdrop of assertions highlighting exercise as a poly-pill (e.g., Fiuza-Luces,Garatachea, Berger, & Lucia, 2013;Li et al., 2019;Loellgen & Bachl, 2016;Pareja-Galeano, Garatachea, & Lucia, 2015). In accordance with the comprehensive Handbuch Gesundheitssport ...
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In Germany, even though the health aspect was still been doubted as an integral element of sport science until the early 1990s (see, for example, the instrumentalization debate), questions related to health have gained increasing importance and popularity in recent decades. On a global level, health-related physical activity promotion can be divided into individual approaches, on the one hand, and environmental-structural approaches, on the other. The physical activity-related health competence (PAHCO) model, which is identifiable as an individual approach, assumes that people require three central sub-competences to lead a healthy, physically active lifestyle: movement competence, control competence, and self-regulation competence. These sub-competences are, in turn, the result of the coupling of basic elements. Manuscript A, which constitutes the first conceptual study of its kind on the international level, focused on elaborating the theoretical link between the sub-competence level and the level of basic elements by describing how the integration of skills, knowledge, and attitudes may vary across situations and individuals. In this context, a theoretical article from the educational-vocational sciences served as a blueprint to introduce the ideas of low-road, high-road, and transformative integration (Baartman & DeBruijn, 2011). The integrative ideas were also used to highlight the interlocking of exercise, learning, and experiencing necessary for interventions. We further located PAHCO at the interface between health literacy (Sørensen et al., 2012) and physical literacy (Edwards et al., 2017) research and integrated it into the more comprehensive capability approach (Ruger, 2010; Sen, 2005). Subsequently, theory of science considerations stressed that the PAHCO model contains important interdisciplinary ideas and, thus, merits the status of a “middle-range theory” (Merton, 1968; Willimczik, 2001) of comparably broad application scope. This characteristic, in turn, allows researchers to set up a research program across different populations. According to Herrmann (1976, 1994), such a research program can be classified as quasi-paradigmatic. Owing to beneficial conditions at the chair Physical Activity and Health of the Friedrich-Alexander University Erlangen-Nürnberg, this doctoral dissertation was able to realize such a research program through (a) the development of a multidimensional assessment instrument for PAHCO and (b) the accumulation of population-specific model results. Building on a published three-factor measurement model for PAHCO (Sudeck & Pfeifer, 2016), the author of this doctoral thesis performed a stepwise extension of measurement models in four different populations. Manuscript B reports the findings of a five-factor measurement model applied to a sample of 341 rehabilitants with chronic obstructive pulmonary disease (COPD) and of an eight-factor measurement model applied to a sample of 745 apprentices in nursing care and automotive mechatronics. More specifically, this study presents results regarding reliability, factorial validity, discriminant validity, and criterion validity. Using data from 475 individuals with multiple sclerosis and 502 teaching students in a program for a basic qualification certificate in physical education, Manuscript C cross-validates and extends these model variants to a ten-factor measurement solution. Second-order analysis and multidimensional scaling techniques demonstrated that the ten specified factors can be statistically bundled into three theory-conform second-order factors (movement competence, control competence, and self-regulation competence). Although the analyses comprised a total of 2,063 participants, cross-validations and more representative samples are required to put the assessment instrument on a stronger empirical footing. Nevertheless, the validations justify the use of the instrument with the included samples. Manuscript D examines the relevance of the three PAHCO sub-competences in 475 persons with multiple sclerosis. The path analyses in the multivariate case indicated that only self-regulation competence was significantly associated with the self-reported amount of physical activity, whereas movement competence (which was closely linked to disease severity) and control competence were not. However, control competence has shown an independent, theory-confirm relationship with individuals’ subjective health, going beyond the mere volume of physical activity. Manuscript E explores the usual physical activity behavior of apprentices in automotive mechatronics and nursing care as a first step. The accelerometer study with 55 apprentices from both sectors recorded considerable values, suggesting that mere volume is not an issue in this target group. In line with this result, an analysis of the 745 apprentices demonstrated in the second step that the physical activity volume was not correlated with an individual’s work ability and health. However, the PAHCO indicators as person-related resources in dealing with physical activities were consistently related to the two outcomes. Finally, Manuscript F investigates the predictive quality of the five PAHCO indicators (measured at the end of an inpatient rehabilitation stay) for the physical activity behavior and quality of life of rehabilitants with COPD six weeks and six months after pulmonary rehabilitation. The longitudinal accelerometer study with 327 participants underlined the considerable diagnostic power of a six-minutes walking test, which is often used as a standard measure in pulmonary rehabilitation. Furthermore, the five PAHCO indicators only provided inconsistent evidence with respect to the additional explanatory power of the two outcome variables beyond the six-minutes walking test. In summary, the three analyses yielded important findings for the specific populations of persons with multiple sclerosis, apprentices in nursing care and automotive mechatronics as well as individuals with COPD. Future studies could apply different analytical approaches to gain further insights. For instance, it could be worth dissolving the multivariate strategy, in which PAHCO indicators are simultaneously regressed on important outcome variables by applying moderating or mediating effects instead. Furthermore, analyses between populations could be performed through secondary data use and data-set merging. The dissertation concludes with general perspectives and challenges related to PAHCO. For instance, it would be worth promoting discussions on potential PAHCO applications for the physical education context. It is argued that sport-pedagogical arguments could complement the health science perspective to underpin schools as relevant settings of application. Furthermore, the theoretical and empirical results accumulated so far should be increasingly transferred into interventional endeavors, including the development of intervention components, their implementation into practice, and their subsequent evaluation. It would also be essential from a theoretical perspective to map out the relevance of the environment and structure within the PAHCO model as its role has not yet been sufficiently elaborated. Therefore, the final section of this doctoral dissertation suggests six different positions regarding how researchers dealing with competences for physically active lifestyles could design the competence-environment relationship within their models. In any case, tackling any of these challenges would further nourish the quasi-paradigmatic research program on PAHCO initiated by this cumulative doctoral thesis.
... Exercise is one of the most powerful pleiotropic interventions available to reduce the risk of developing many chronic conditions [1][2][3]. Redox signaling is one of several critical mechanisms involved in adaptations to exercise [4][5][6]. These adaptations may also improve redox homeostasis and redox stress resilience to non-exercise stressors. ...
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Purpose . Perturbations in redox homeostasis can lead to physiological dysfunction and impaired stress resilience. This randomized controlled trial investigated whether aerobic exercise training could improve redox stress resilience measured by the response to a non-exercise redox stressor (forearm ischemia/reperfusion; I/R trial) in young and older men and women. We hypothesized that older adults would have impaired responses to redox perturbations, but that exercise training would reverse the dysfunction. Methods . Young (18-28yo, n=21) and older (60-77yo, n=19) men and women were randomized to 8-week exercise training (ET; 3 d/wk, 45 min/day) or a non-exercise control group (CON). Aerobic capacity was measured by VO2 peak test on a cycle ergometer. Plasma F2-isoprostane responses to the I/R trial were measured across 7 time points: pre-trial, and 15-, 30-, 60-, 120-, 180-, and 240-minutes post-trial. The I/R trial was completed before and after the 8-week exercise intervention or control arm. Results . There were no significant differences in I/R trial responses across age, sex, or groups randomized to training or control. Exercise training significantly improved I/R trial response compared to controls (p<0.01). This improvement was directly related to the degree of improvement in VO2 peak (Pearson correlation r = -0.464, p=0.003). Conclusions . These data demonstrate that the beneficial effects of moderate exercise in previously inactive adults elicit increased redox capacity that translates to an improved response to a non-exercise redox stressor regardless of age or sex. Furthermore, greater improvements in aerobic fitness resulted in greater resilience to the I/R-induced redox stress. ClinicalTrials.gov ID : NCT03419988
... Regular exercise causes a myriad of desirable effects with clear beneficial outcomes for health promotion, the treatment of diseases, and lifespan, and decreases mental health outcomes [1], such as anxiety [2] and depression [3], hence being considered as a polypill for health [4][5][6]. Physical exercise (PEx) is a type of physical activity (PA), that is planned, structured, repetitive, and favors physical fitness maintenance or development [7]; by ...
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Objective: To evaluate the impact of the COVID-19 pandemic and the following lockdown on physical exercise (PEx) practice, pain, and psychological well-being. Methods: A cross-sectional multicentric study was performed using a nonrandom convenience sampling from the general population (≥18 years-old) of 6 countries (Brazil, Italy, France, Portugal, Germany, and Spain) adopting social isolation (SI). The validated self-administered online survey (PEF-COVID19) was used. The tests T-test and Chi-square with Bonferroni correction were used for statistical analysis and a multivariate logistic regression model (p ˂ 0.05). Results: We included 3194 replies and ~80% of the respondents were in SI. Brazilian sample was highly influenced by the pandemic considering PEx practice and habits, pain, anxiety, and stress (p ˂ 0.05). Among the European countries, Italy presented the major changes. The model to predict the non-practice of PEx during SI showed that the variables countries, smoking, SI, and PEx level were significant predictors (p ˂ 0.001). Conclusion: The pandemic changed the PEx practice and habits, and the psychological well-being of populations in different manners. Countries, smoking, SI, and PEx level were predictors for the non-practice of PEx. Public health strategies are suggested to avoid sedentary lifestyles and quality of life decrease.
Chapter
The human body has approximately 2500 reported metabolites, 3500 food components, and about 1200 drugs. These molecules are produced through several bodily processes, such as metabolic activities, that are responsible for smooth functioning. Some produce immune responses that may protect the body from infectious and non-infectious diseases.
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Despite substantial evidence emphasizing the pleiotropic benefits of exercise for the prevention and treatment of various diseases, the underlying biological mechanisms have not been fully elucidated. Several exercise benefits have been attributed to signaling molecules that are released in response to exercise by different tissues such as skeletal muscle, cardiac muscle, adipose, and liver tissue. These signaling molecules, which are collectively termed exerkines, form a heterogenous group of bioactive substances, mediating inter-organ crosstalk as well as structural and functional tissue adaption. Numerous scientific endeavors have focused on identifying and characterizing new biological mediators with such properties. Additionally, some investigations have focused on the molecular targets of exerkines and the cellular signaling cascades that trigger adaption processes. A detailed understanding of the tissue-specific downstream effects of exerkines is crucial to harness the health-related benefits mediated by exercise and improve targeted exercise programs in health and disease. Herein, we review the current in vivo evidence on exerkine-induced signal transduction across multiple target tissues and highlight the preventive and therapeutic value of exerkine signaling in various diseases. By emphasizing different aspects of exerkine research, we provide a comprehensive overview of (i) the molecular underpinnings of exerkine secretion, (ii) the receptor-dependent and receptor-independent signaling cascades mediating tissue adaption, and (iii) the clinical implications of these mechanisms in disease prevention and treatment.
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Introduction Patients with coronary artery disease (CAD), also called coronary heart disease, have a higher risk of developing cognitive impairment and mental health disorders compared to the general population. There is a need to identify effective and sustainable strategies to improve brain health in individuals with CAD, in which physical exercise could play a major role. The overall goal of the HEART-BRAIN randomized controlled trial (RCT) is to investigate the effects of exercise, including different types, on brain health outcomes in patients with CAD, and the underlying mechanisms. Methods This three-arm, single-blinded RCT will include 90 adults with CAD, aged 50-75 years. The participants will be randomized into: 1) control group - usual care (n=30), including periodic medical visits and medication management, 2) aerobic high-intensity interval training (HIIT) (n=30), or 3) aerobic HIIT combined with resistance exercise training (n=30). The intervention will last 12 weeks, offering 3 sessions (45min each) per week to the exercise groups, and the study outcomes will be assessed at baseline and after the intervention. The primary outcome of the study is to determine changes in global and regional cerebral blood flow assessed by magnetic resonance imaging. Secondary outcomes include changes in brain vascularization, cognitive measures (i.e., general cognition, executive function and episodic memory), and cardiorespiratory fitness. Additional health-related outcomes will be evaluated, and several potential mediators and moderators will be investigated (i.e., brain structure and function, cardiovascular and brain-based biomarkers, hemodynamics, physical function, body composition, mental health, and lifestyle behavior). Conclusions The HEART-BRAIN RCT will provide novel insights on how exercise can impact brain health in patients with CAD and the potential mechanisms explaining the heart-brain connection, such as changes in cerebral blood flow. The results might have important clinical implications by increasing the evidence on the effectiveness of exercise-based preventive strategies that could delay cognitive decline in this high-risk CAD population. Our findings will be relevant for patients with CAD, researchers and healthcare providers involved in CAD-related clinical care.
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The use of data-driven high-throughput analytical techniques, which has given rise to computational oncology, is undisputed. The widespread use of machine learning (ML) and mathematical modeling (MM)-based techniques is widely acknowledged. These two approaches have fueled the advancement in cancer research and eventually led to the uptake of telemedicine in cancer care. For diagnostic, prognostic, and treatment purposes concerning different types of cancer research, vast databases of varied information with manifold dimensions are required, and indeed, all this information can only be managed by an automated system developed utilizing ML and MM. In addition, MM is being used to probe the relationship between the pharmacokinetics and pharmacodynamics (PK/PD interactions) of anti-cancer substances to improve cancer treatment, and also to refine the quality of existing treatment models by being incorporated at all steps of research and development related to cancer and in routine patient care. This review will serve as a consolidation of the advancement and benefits of ML and MM techniques with a special focus on the area of cancer prognosis and anticancer therapy, leading to the identification of challenges (data quantity, ethical consideration, and data privacy) which are yet to be fully addressed in current studies.
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Hypoxia and hyperoxia can affect the acute psycho-physiological response to exercise. Recording various perceptual responses to exercise is of particular importance for investigating behavioural changes to physical activity towards health, given that the perception of exercise-induced pain, discomfort or unpleasure, and a low level of exercise enjoyment are commonly associated with a low adherence to physical activity. Therefore, this study aimed to compare the acute perceptual (i.e., ratings of perceived motor fatigue, effort perception, perceived physical strain, affective valence, arousal, motivation to exercise, conflict to continue exercise, and activity enjoyment) and physiological responses (i.e., heart rate (HR), capillary blood lactate concentration (BLC), peripheral blood oxygenation (S p O 2 ), total tissue (tHb) and oxygenated haemoglobin concentration (S m O 2 ) of the vastus lateralis muscle) to 40 min constant-load cycling (60% peak oxygen uptake) under intermittent hypoxia-hyperoxia (IHHT), hypoxia-normoxia (IHT), and sustained normoxia (NOR) in young recreational active healthy males. No differences in the acute perceptual responses were found between conditions (p ≥ 0.059, η p ²≤0.18), while the physiological responses differed. Accordingly, S p O 2 was higher during hyperoxia and normoxia in IHHT compared to IHT (p < 0.001, η p ²=0.91), respectively. Moreover, HR (p = 0.005, η p ²=0.33) and BLC (p = 0.033, η p ²=0.28) were higher during IHT compared to NOR. No differences between conditions were found for percentual changes in tHb and S m O 2 of the vastus lateralis. These results suggest that replacing normoxic by hyperoxic reoxygenation-periods during submaximal constant-load cycling under intermittent hypoxia reduced the exercise-related physiological stress but had no effect on perceptual responses and perceived activity enjoyment in young recreational active healthy males.
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The aim of this paper is to provide a narrative review of the effects of physical exercise in the treatment of chronic musculoskeletal pain. Physical inactivity and sedentary behavior are associated with chronic musculoskeletal pain and can aggravate it. For the management of musculoskeletal pain, physical exercise is an effective, cheap, and safe therapeutic option, given that it does not produce the adverse effects of pharmacological treatments or invasive techniques. In addition to its analgesic capacity, physical exercise has an effect on other pain-related areas, such as sleep quality, activities of daily living, quality of life, physical function, and emotion. In general, even during periods of acute pain, maintaining a minimum level of physical activity can be beneficial. Programs that combine several of the various exercise modalities (aerobic, strengthening, flexibility, and balance), known as multicomponent exercise, can be more effective and better adapted to clinical conditions. For chronic pain, the greatest benefits typically occur with programs performed at light-to-moderate intensity and at a frequency of two to three times per week for at least 4 weeks. Exercise programs should be tailored to the specific needs of each patient based on clinical guidelines and World Health Organization recommendations. Given that adherence to physical exercise is a major problem, it is important to empower patients and facilitate lifestyle change. There is strong evidence of the analgesic effect of physical exercise in multiple pathologies, such as in osteoarthritis, chronic low back pain, rheumatoid arthritis, and fibromyalgia.
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Context: Flag football is promoted as a safer alternative to tackle football. This may be one reason why participation rates have risen by 39% over the past three years. Despite rising participation, there remains a lack of epidemiologic research on sport-specific injuries and associated relative risk. Objective: To prospectively document epidemiology of injury in youth flag football. Design: Descriptive Epidemiology Study. Setting: Regional and National youth flag football tournaments. Patients or other participants: 1939 (1744 boys; 195 girls) athletes, ages 5 to 12 years. An athletic trainer prospectively monitored athletes for sport-related injury and exposures. Main outcome measure(s): Athlete risk of injury and injury rates were calculated overall and by gender. Injury characteristics were reported for the total population and by gender. Results: 47 injuries to unique individuals were recorded in 1,939 athletes with a total of 9,228 athlete exposures (AEs). The overall risk of injury was 2.4% (95%CI 1.8, 3.2), overall injury rate 5.1 per 1000 AE (95% CI 3.7, 6.8). Of the 47 injuries, 36 occurred in males (8,365 AE) and 11 in females (863 AE). There was a statistically significant higher risk in girls as evidenced by both Injury Risk Ratio 2.73 (95% CI 1.41, 5.3) and Injury Rate Ratio 2.96 (95% CI 1.51, 5.82). The most common injury sites were Head/Face/Neck (n=15; 31.9%) followed by Ankle/Foot (n=9; 19.1%); most common types of injury were contusion (55.3%), sprain/subluxation (14.9%), and general trauma (10.6%); 74.5% of all injuries resulted from direct impact. Conclusion: While the competition injury rate for youth flag football was lower than studies reporting comparable tackle football data, frequencies by body part, type and mechanism were similar. Given that most injuries were related to some form of impact and predominantly contusions, adopting minimal protective equipment or padding may reduce the number of these reported injuries.
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The term GETomics has been recently proposed to illustrate that human health and disease are actually the final outcome of many dynamic, interacting and cumulative gene (G) - environment (E) interactions that occur through the lifetime (T) of the individual. According to this new paradigm, the final outcome of any GxE interactions depends on both the age of the individual at which such GxE interaction occurs as well as on the previous, cumulative history of previous GxE interactions through the induction of epigenetic changes and immune memory (both lasting overtime). Following this conceptual approach, our understanding of the pathogenesis of chronic obstructive pulmonary disease (COPD) has changed dramatically. Traditionally believed to be a self-inflicted disease induced by tobacco smoking occurring in older men and characterized by an accelerated decline of lung function with age, now we understand that there are many other risk factors associated with COPD, that it occurs also in females and young individuals, that there are different lung function trajectories through life, and that COPD is not always characterized by accelerated lung function decline. In this paper we discuss how a GETomics approach to COPD may open new perspectives to better understand its relationship with exercise limitation and the ageing process.
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Importance: Pediatric overweight and obesity are highly prevalent across the world, with implications for poorer cognitive and brain health. Exercise might potentially attenuate these adverse consequences. Objectives: To investigate the effects of an exercise program on brain health indicators, including intelligence, executive function, academic performance, and brain outcomes, among children with overweight or obesity and to explore potential mediators and moderators of the main effects of exercise. Design, setting, and participants: All preexercise and postexercise data for this 20-week randomized clinical trial of 109 children aged 8 to 11 years with overweight or obesity were collected from November 21, 2014, to June 30, 2016, with neuroimaging data processing and analyses conducted between June 1, 2017, and December 20, 2021. All 109 children were included in the intention-to-treat analyses; 90 children (82.6%) completed the postexercise evaluation and attended 70% or more of the recommended exercise sessions and were included in per-protocol analyses. Interventions: All participants received lifestyle recommendations. The control group continued their usual routines, whereas the exercise group attended a minimum of 3 supervised 90-minute sessions per week in an out-of-school setting. Main outcomes and measures: Intelligence, executive function (cognitive flexibility, inhibition, and working memory), and academic performance were assessed with standardized tests, and hippocampal volume was measured with magnetic resonance imaging. Results: The 109 participants included 45 girls (41.3%); participants had a mean (SD) body mass index of 26.8 (3.6) and a mean (SD) age of 10.0 (1.1) years at baseline. In per-protocol analyses, the exercise intervention improved crystallized intelligence, with the exercise group improving from before exercise to after exercise (mean z score, 0.62 [95% CI, 0.44-0.80]) compared with the control group (mean z score, -0.10 [95% CI, -0.28 to 0.09]; difference between groups, 0.72 SDs [95% CI, 0.46-0.97]; P < .001). Total intelligence also improved significantly more in the exercise group (mean z score, 0.69 [95% CI, 0.48-0.89]) than in the control group (mean z score, 0.07 [95% CI, -0.14 to 0.28]; difference between groups, 0.62 SDs [95% CI, 0.31-0.91]; P < .001). Exercise also positively affected a composite score of cognitive flexibility (mean z score: exercise group, 0.25 [95% CI, 0.05-0.44]; control group, -0.17 [95% CI, -0.39 to 0.04]; difference between groups, 0.42 SDs [95% CI, 0.13-0.71]; P = .005). These main effects were consistent in intention-to-treat analyses and after multiple-testing correction. There was a positive, small-magnitude effect of exercise on total academic performance (mean z score: exercise group, 0.31 [95% CI, 0.18-0.44]; control group, 0.10 [95% CI, -0.04 to 0.24]; difference between groups, 0.21 SDs [95% CI, 0.01-0.40]; P = .03), which was partially mediated by cognitive flexibility. Inhibition, working memory, hippocampal volume, and other brain magnetic resonance imaging outcomes studied were not affected by the exercise program. The intervention increased cardiorespiratory fitness performance as indicated by longer treadmill time to exhaustion (mean z score: exercise group, 0.54 [95% CI, 0.27-0.82]; control group, 0.13 [95% CI, -0.16 to 0.41]; difference between groups, 0.42 SDs [95% CI, 0.01-0.82]; P = .04), and these changes in fitness mediated some of the effects (small percentage of mediation [approximately 10%-20%]). The effects of exercise were overall consistent across the moderators tested, except for larger improvements in intelligence among boys compared with girls. Conclusions and relevance: In this randomized clinical trial, exercise positively affected intelligence and cognitive flexibility during development among children with overweight or obesity. However, the structural and functional brain changes responsible for these improvements were not identified. Trial registration: ClinicalTrials.gov Identifier: NCT02295072.
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Background and Aims Multimorbidity is a major public health and healthcare challenge around the world, including in Finland. As multimorbidity necessitates self‐management in everyday life, the effects of patient activation – a patient's knowledge, skills, and confidence in managing own health – on the capacity for self‐management warrant study, especially in primary healthcare settings. This study aimed to assess patient activation among multimorbid primary healthcare patients, identify factors associated with patient activation, and determine whether patients with low and high activation differ in terms of health and self‐management behavior, related perceptions, and health‐related quality of life (HRQoL). Methods A cross‐sectional survey was conducted among multimorbid patients who attended Finnish primary healthcare consultations (November 2019 to May 2020). The main outcome, patient activation, was assessed using the patient activation measure, PAM‐13®. Responses from 122 patients were analyzed using descriptive statistics, t‐tests, analysis of variance, linear modeling, the χ² test, and binary regression analysis. Results The mean score of patient activation was 56.12 (SD 12.82) on a scale 0–100 where ≤55.1 indicate low activation. The lower activation scores were significantly associated with old age, obesity, loneliness, and lower perceived health, functional ability, and vitality. Patients with low activation (47%) had significantly poorer physical activity, diets, adherence to care, and HRQoL, and significantly worse perceptions related to self‐management including motivation and energy, sense of normality, and support from physicians, nurses, and close people. Conclusion Patient activation among multimorbid outpatients was rather low. Findings indicate that patients' perceptions of their health and psychosocial factors may be important for activation and that patients with low and high activation differ with respect to several health variables. Determining patient activation in multimorbid patients may facilitate adaptation of care to better meet patient capabilities and needs in clinical settings. Knowledge of a patient's activation level may also be useful when developing interventions and care strategies for this patient group.
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For centuries, regular exercise has been acknowledged as a potent stimulus to promote, maintain, and restore healthy functioning of nearly every physiological system of the human body. With advancing understanding of the complexity of human physiology, continually evolving methodological possibilities, and an increasingly dire public health situation, the study of exercise as a preventative or therapeutic treatment has never been more interdisciplinary, or more impactful. During the early stages of the NIH Common Fund Molecular Transducers of Physical Activity Consortium (MoTrPAC) Initiative, the field is well-positioned to build substantially upon the existing understanding of the mechanisms underlying benefits associated with exercise. Thus, we present a comprehensive body of the knowledge detailing the current literature basis surrounding the molecular adaptations to exercise in humans to provide a view of the state of the field at this critical juncture, as well as a resource for scientists bringing external expertise to the field of exercise physiology. In reviewing current literature related to molecular and cellular processes underlying exercise-induced benefits and adaptations, we also draw attention to existing knowledge gaps warranting continued research effort. © 2021 American Physiological Society. Compr Physiol 12:3193-3279, 2022.
Article
Purpose Exercise is an effective way to alleviate insulin resistance (IR). However, the underlying mechanisms remain to be elucidated. Previous studies demonstrated that cardiolipin synthase 1 (CRLS1)/interferon-regulatory factor-2 binding protein 2 (IRF2bp2)-activating transcription factor 3 (ATF3)-adiponectin receptor 2 (AdipoR2)-adaptor protein containing PH domain, PTB domain and leucine zipper motif 1 (APPL1)-protein kinase B (AKT/PKB)-related signaling was closely associated with obesity-induced IR-related diseases, but the correlation between exercise training alleviating obesity-induced IR and the protein levels of hepatic CRLS1/IRF2bp2-ATF3-AdipoR2-APPL1-AKT-related signaling in rats is unknown. Therefore, We want to investigate the effect of exercise training on IR and the protein levels of hepatic CRLS1/IRF2bp2-ATF3-AdipoR2-APPL1-AKT-related signaling in rat. Methods The male healthy Sprague-Dawley rats were divided into four groups: normal control group (NCG, n=10), diet-induced obesity-sedentary group (DIO-SG, n=10), diet-induced obesity-chronic exercise group (DIO-CEG, n=10) received chronic swim exercise training and diet-induced obesity-acute exercise group (DIO-AEG, n=10) received acute swim exercise training. We measured the levels of IR-related indicators and the protein levels of hepatic CRLS1/IRF2bp2-ATF3-AdipoR2-APPL1-AKT-related signaling in NCG, DIO-SG, DIO-CEG and DIO-AEG. Results We found that high-fat diet (HFD)-induced obesity decreased insulin sensitivity in rats accompanied by decreased protein levels of hepatic CRLS1, IRF2bp2, AdipoR2, APPL1, p-AKT and increased protein level of hepatic ATF3. The acute exercise and the chronic exercise both increased insulin sensitivity in rats. The chronic exercise decreased hepatic ATF3 protein level and increased CRLS1, IRF2bp2, AdipoR2, APPL1, p-AKT protein levels in HFD-fed rats. The acute exercise decreased hepatic ATF3 protein level and increased hepatic IRF2bp2, APPL1 and p-AKT protein levels in HFD-fed rats. The acute exercise had no significant effect on hepatic CRLS1 and AdipoR2 protein levels in HFD-fed rats. Conclusion Our current findings indicated that exercise alleviated obesity-induced IR accompanied by changes in protein levels of hepatic ATF3-related signaling in rats. Our results are meaningful for exploring the molecular mechanism of exercise alleviating IR symptoms.
Article
Aim: The aim of the study was to explore the adherence to self-management of patients with multimorbidity, identify associated factors, and determine explanatory factors of their adherence to self-management in terms of the Theory of Adherence of People with Chronic Disease. Background: Adherence to self-management is essential for successful care of multimorbid patients, but multimorbidity poses challenges for both patients and practitioners due to its care complexity and broad impact on patients' lives. Design: A cross-sectional, descriptive exploratory design with the STROBE reporting checklist was applied. Methods: Adult multimorbid patients who attended primary healthcare consultations in Finland were surveyed using self-administered questionnaires with several instruments including the Adherence of People with Chronic Disease Instrument, Kasari's FIT Index, and Alcohol Use Disorders Identification test. Responses of 124 patients were analysed using descriptive statistics, Spearman correlations, binary logistic regression analysis, and Chi-squared, or corresponding, tests. Results: Most patients' responses indicated good or adequate adherence to care regimens and medications. However, adherence to self-management for a healthy lifestyle was more frequently inadequate. Adherence was significantly associated with several patient-related factors, including demographic and health-related factors, perceived adequacy of loved ones, and patient activation. Significant explanatory factors for adherence included energy and willpower, motivation, results of care, sense of normality, fear of complications and additional diseases, and support from nurses, from physicians, and from family and friends. Various factors were relevant for specific aspects of self-management. Conclusions: Multimorbid patients' adherence to self-management is not an 'all or none phenomenon, but a multifaceted process with numerous associated and explanatory factors. Relevance to clinical practice: The findings highlight needs for an individualised whole-person approach in multimorbid patients' care to provide the required support for good adherence to self-management. Healthcare professionals, especially nurses working in primary health care, are well-positioned to meet this need.
Article
In the present study, metal complexes of 1-amidino-O-alkylureas were designed, synthesized and characterized by elemental analyses, FT-IR spectra, XRD, Mass analyses and scanning electron microscopy (SEM). All synthesized complexes were screen as α-Glucosidase inhibitors. According to the in vitro results, the Cu (II) complexes showed superior potency compared to other tested metal complexes. Particularly, [Cu(L-Me)2](Cl)2 (1b) showed the strongest inhibition against α-Glucosidase with an IC50 value of 2.75 ± 0.3 µM which was comparable to that of acarbose (IC50 = 750 µM). These findings are supported by the ligands and enzyme interactions through molecular docking.
Thesis
Sickness absence is a multicausal phenomenon influenced by the working environment, job role and lifestyle. Its high cost is supported by companies and public institutions in accordance with the current legislation and represents a substantial part of the budget for many countries. Nevertheless, this is not only an economic issue but also a public health issue; longterm sickness absence has been associated to experience disability pension, as well as mortality risk. Both chronic conditions and diseases have been pointed at among its main relevant causes, occasionally, linked to specific occupational classes. Thus, back pain (i.e. low back pain and neck pain), mental disorders (i.e. anxiety and depression) and different cardiovascular diseases have been observed among the most prevalent in workers experiencing long-term sickness absence. On the other hand, moderate and high levels of physical activity, particularly when they are performed during leisure or when commuting to work, have been associated with lower sickness absence, as well as lower of the most common chronic diseases among both general and specific populations of workers. In addition, this inverse association has been observed to be more pronounced with higher leisure-time physical activity. The aim of these studies was to widen knowledge about the physical activity and sickness absence relationship, focusing on its observation among different samples of Spanish and Danish workers, specific population of workers, as well as chronic conditions and diseases associated with these situations. Observational studies examining samples of both Spanish and Danish workers were carried out. Manuscripts II and III analysed two samples of university workers (n=1025 and n=757). Manuscripts IV and VI followed up a general (n=10427) as well as a specific sample of Danish workers (n=4699). Manuscripts V, VII and VIII investigated samples of general populations of Spanish workers (n=9512 y n=9885). Tools such as International Physical Activity Questionnaire (IPAQ) were used to estimate physical activity levels, while sickness absence was assessed through either a question included in the questionnaires or the Danish Registry for Evaluation of Marginalization (DREAM). Analyses were adjusted for different control variables appointed by literature and collected in the questionnaires. Results of the present Thesis showed an inverse association between physical activity and sickness absence in Spanish workers. Such association was observed stronger with higher levels of physical activity and certain subgroups of workers. Similarly, an inverse association between physical activity and certain conditions (i.e. chronic back pain, depression, anxiety, hypertension, diabetes, work-related stress, and usual activity limitations). Moreover, leisuretime physical activity reduced the risk of long-term sickness among Danish workers. In conclusion, the results suggest that higher levels of physical activity associates with lower prevalence and risk of sickness absence. Strategies based on promoting physical activity during leisure might be beneficial for reducing sickness absence.
Article
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To determine the comparative effectiveness of exercise versus drug interventions on mortality outcomes. Metaepidemiological study. Meta-analyses of randomised controlled trials with mortality outcomes comparing the effectiveness of exercise and drug interventions with each other or with control (placebo or usual care). Medline and Cochrane Database of Systematic Reviews, May 2013. Mortality. We combined study level death outcomes from exercise and drug trials using random effects network meta-analysis. We included 16 (four exercise and 12 drug) meta-analyses. Incorporating an additional three recent exercise trials, our review collectively included 305 randomised controlled trials with 339 274 participants. Across all four conditions with evidence on the effectiveness of exercise on mortality outcomes (secondary prevention of coronary heart disease, rehabilitation of stroke, treatment of heart failure, prevention of diabetes), 14 716 participants were randomised to physical activity interventions in 57 trials. No statistically detectable differences were evident between exercise and drug interventions in the secondary prevention of coronary heart disease and prediabetes. Physical activity interventions were more effective than drug treatment among patients with stroke (odds ratios, exercise v anticoagulants 0.09, 95% credible intervals 0.01 to 0.70 and exercise v antiplatelets 0.10, 0.01 to 0.62). Diuretics were more effective than exercise in heart failure (exercise v diuretics 4.11, 1.17 to 24.76). Inconsistency between direct and indirect comparisons was not significant. Although limited in quantity, existing randomised trial evidence on exercise interventions suggests that exercise and many drug interventions are often potentially similar in terms of their mortality benefits in the secondary prevention of coronary heart disease, rehabilitation after stroke, treatment of heart failure, and prevention of diabetes.
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Purpose: Conduct a systematic review of previous meta-analyses addressing the effects of exercise in the treatment of overweight and obese children and adolescents. Methods: Previous meta-analyses of randomized controlled exercise trials that assessed adiposity in overweight and obese children and adolescents were included by searching nine electronic databases and cross-referencing from retrieved studies. Methodological quality was assessed using the Assessment of Multiple Systematic Reviews (AMSTAR) Instrument. The alpha level for statistical significance was set at P ≤ 0.05. Results: Of the 308 studies reviewed, two aggregate data meta-analyses representing 14 and 17 studies and 481 and 701 boys and girls met all eligibility criteria. Methodological quality was 64% and 73%. For both studies, statistically significant reductions in percent body fat were observed (P = 0.006 and P < 0.00001). The number-needed-to treat (NNT) was 4 and 3 with an estimated 24.5 and 31.5 million overweight and obese children in the world potentially benefitting, 2.8 and 3.6 million in the US. No other measures of adiposity (BMI-related measures, body weight, and central obesity) were statistically significant. Conclusions: Exercise is efficacious for reducing percent body fat in overweight and obese children and adolescents. Insufficient evidence exists to suggest that exercise reduces other measures of adiposity.
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The concept of a "polypill" is receiving growing attention to prevent cardiovascular disease. Yet similar if not overall higher benefits are achievable with regular exercise, a drug-free intervention for which our genome has been haped over evolution. Compared with drugs, exercise is available at low cost and relatively free of adverse effects. We summarize epidemiological evidence on the preventive/therapeutic benefits of exercise and on the main biological mediators involved.
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Abstract Reactive oxygen species (ROS) are continuously generated during metabolism. ROS are involved in redox signalling but, in significant concentrations they can greatly elevate oxidative damage leading to neurodegeneration. Because of the enhanced sensitivity of brain to ROS, it is especially important to maintain a normal redox state in brain and spinal cord cell types. The complex effects of exercise benefit brain function, including functional enhancement as well as preventive and therapeutic roles. Exercise can induce neurogenesis via neurotrophic factors, increase capillarization, decrease oxidative damage, and enhance repair of oxidative damage. Exercise is also effective in attenuating age-associated loss in brain function, which suggests that physical activity-related complex metabolic and redox changes are important for a healthy neural system.
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Overweight and obesity affects more than 66% of the adult population and is associated with a variety of chronic diseases. Weight reduction reduces health risks associated with chronic diseases and is therefore encouraged by major health agencies. Guidelines of the National Heart, Lung, and Blood Institute (NHLBI) encourage a 10% reduction in weight, although considerable literature indicates reduction in health risk with 3% to 5% reduction in weight. Physical activity (PA) is recommended as a component of weight management for prevention of weight gain, for weight loss, and for prevention of weight regain after weight loss. In 2001, the American College of Sports Medicine (ACSM) published a Position Stand that recommended a minimum of 150 min wk(-1) of moderate-intensity PA for overweight and obese adults to improve health; however, 200-300 min wk(-1) was recommended for long-term weight loss. More recent evidence has supported this recommendation and has indicated more PA may be necessary to prevent weight regain after weight loss. To this end, we have reexamined the evidence from 1999 to determine whether there is a level at which PA is effective for prevention of weight gain, for weight loss, and prevention of weight regain. Evidence supports moderate-intensity PA between 150 and 250 min wk(-1) to be effective to prevent weight gain. Moderate-intensity PA between 150 and 250 min wk(-1) will provide only modest weight loss. Greater amounts of PA (>250 min wk(-1)) have been associated with clinically significant weight loss. Moderate-intensity PA between 150 and 250 min wk(-1) will improve weight loss in studies that use moderate diet restriction but not severe diet restriction. Cross-sectional and prospective studies indicate that after weight loss, weight maintenance is improved with PA >250 min wk(-1). However, no evidence from well-designed randomized controlled trials exists to judge the effectiveness of PA for prevention of weight regain after weight loss. Resistance training does not enhance weight loss but may increase fat-free mass and increase loss of fat mass and is associated with reductions in health risk. Existing evidence indicates that endurance PA or resistance training without weight loss improves health risk. There is inadequate evidence to determine whether PA prevents or attenuates detrimental changes in chronic disease risk during weight gain.
Article
Physical activity is inversely related to mortality from respiratory diseases including lung cancer. Physical activity improves pulmonary function but its impact on lung‐cancer risk has not been studied much. During 1972–1978, 53,242 men and 28,274 women, aged 20 to 49 years, participated in a population‐based health survey and were followed until 31 December 1991. We observed a total of 413 men and 51 women with lung cancer. Leisure activity and work activity were assessed using a questionnaire in 4 categories. In a sub‐cohort, physical activity was assessed twice at an interval of 3 to 5 years. Leisure but not work activity was inversely related to lung‐cancer risk in men after adjustment for age, smoking habits, body‐mass index and geographical residence (p for trend = 0.01). Men who exercised at least 4 hours a week had a lower risk than men who did not exercise [relative risk (RR) = 0.71; 95% confidence interval (CI) = 0.52–0.97]. Reduced risk of lung cancer was particularly marked for small‐cell carcinoma (RR = 0.59; 95% CI = 0.38–0.94) and for adenocarcinoma RR = 0.65; 95% CI = 0.41–1.05), with no association seen for squamous‐cell carcinoma. In the sub‐cohort in which physical activity was assessed twice, the risk of lung cancer was particularly reduced among men who were most active at both assessments (RR = 0.39; 95% CI = 0.18–0.85). No consistent association between physical activity and lung‐cancer risk was observed among women. Our results suggest that leisure physical activity has a protective effect on lung‐cancer risk in men. The small number of incident cases, combined with the narrow range of physical activity reported, may have limited our ability to detect an association between physical activity and lung cancer in women. © 1997 Wiley‐Liss, Inc.
Book
Introducing the Fifth Edition of the more focused version of the best-selling Exercise Physiology text. Ideal for an introductory course, this title emphasizes nutrition as the foundation of exercise and uses a new student-friendly magazine-style design, hallmark pedagogy, and an engaging, accessible writing style to make exercise physiology interesting and understandable for todays students. Featuring updates in every section that reflect the latest trends and research in the field, Essentials of Exercise Physiology helps students develop a deep understanding of the interrelationships among energy intake, energy transfer during exercise, and the related physiologic systems. As they progress through the book, students also master the how-tos of applying key concepts to enhance exercise training, athletic performance, and health. © 2016 Wolters Kluwer 2011 Lippincott Williams & Wilkins|Wolters Kluwer © 2006 and 2000 Lippincott Williams & Wilkins
Article
We reviewed the effect of resistance training on blood pressure and other cardiovascular risk factors in adults. Randomized, controlled trials lasting ≥4 weeks investigating the effects of resistance training on blood pressure in healthy adults (age ≥18 years) and published in a peer-reviewed journal up to June 2010 were included. Random- and fixed-effects models were used for analyses, with data reported as weighted means and 95% confidence limits. We included 28 randomized, controlled trials, involving 33 study groups and 1012 participants. Overall, resistance training induced a significant blood pressure reduction in 28 normotensive or prehypertensive study groups [-3.9 (-6.4; -1.2)/-3.9 (-5.6; -2.2) mm Hg], whereas the reduction [-4.1 (-0.63; +1.4)/-1.5 (-3.4; +0.40) mm Hg] was not significant for the 5 hypertensive study groups. When study groups were divided according to the mode of training, isometric handgrip training in 3 groups resulted in a larger decrease in blood pressure [-13.5 (-16.5; -10.5)/-6.1(-8.3; -3.9) mm Hg] than dynamic resistance training in 30 groups [-2.8 (-4.3; -1.3)/-2.7 (-3.8; -1.7) mm Hg]. After dynamic resistance training, Vo(2) peak increased by 10.6% (P=0.01), whereas body fat and plasma triglycerides decreased by 0.6% (P<0.01) and 0.11 mmol/L (P<0.05), respectively. No significant effect could be observed on other blood lipids and fasting blood glucose. This meta-analysis supports the blood pressure-lowering potential of dynamic resistance training and isometric handgrip training. In addition, dynamic resistance training also favorably affects some other cardiovascular risk factors. Our results further suggest that isometric handgrip training may be more effective for reducing blood pressure than dynamic resistance training. However, given the small amount of isometric studies available, additional studies are warranted to confirm this finding.
Article
The age-specific relevance of blood pressure to cause-specific mortality is best assessed by collaborative meta-analysis of individual participant data from the separate prospective studies. Methods Information was obtained on each of one million adults with no previous vascular disease recorded at baseline in 61 prospective observational studies of blood pressure and mortality. During 12.7 million person-years at risk, there were about 56 000 vascular deaths (12 000 stroke, 34000 ischaemic heart disease [IHD], 10000 other vascular) and 66 000 other deaths at ages 40-89 years. Meta-analyses, involving "time-dependent" correction for regression dilution, related mortality during each decade of age at death to the estimated usual blood pressure at the start of that decade. Findings Within each decade of age at death, the proportional difference in the risk of vascular death associated with a given absolute difference in usual blood pressure is about the same down to at least 115 mm Hg usual systolic blood pressure (SBP) and 75 mm Hg usual diastolic blood pressure (DBP), below which there is little evidence. At ages 40-69 years, each difference of 20 mm Hg usual SBP (or, approximately equivalently, 10 mm Hg usual DBP) is associated with more than a twofold difference in the stroke death rate, and with twofold differences in the death rates from IHD and from other vascular causes. All of these proportional differences in vascular mortality are about half as extreme at ages 80-89 years as at,ages 40-49 years, but the annual absolute differences in risk are greater in old age. The age-specific associations are similar for men and women, and for cerebral haemorrhage and cerebral ischaemia. For predicting vascular mortality from a single blood pressure measurement, the average of SBP and DBP is slightly more informative than either alone, and pulse pressure is much less informative. Interpretation Throughout middle and old age, usual blood pressure is strongly and directly related to vascular (and overall) mortality, without any evidence of a threshold down to at least 115/75 mm Hg.
Article
OBJECTIVE—To assess the relation between fasting plasma glucose (FPG) or 2-h plasma glucose (2hPG) and mortality from all causes, cardiovascular disease (CVD), and non-CVD and to determine whether the relationship is graded or threshold. RESEARCH DESIGN AND METHODS—Diabetes Epidemiology: Collaborative Analysis Of Diagnostic Criteria in Europe (DECODE) is a collaborative prospective study of 22 cohorts in Europe with baseline glucose measurements for 29,714 subjects aged 30–89 years who were followed-up for 11 years (329,050 person-years). Hazard ratio (HR) for death was estimated using Cox regression analysis. RESULTS—High glucose concentrations as well as very low glucose levels were associated with increased risk of death. Compared with an FPG of 4.50–6.09 mmol/l, the multivariate-adjusted HR (95% CI) for FPG <4.50 mmol/l was 1.2 (1.0–1.4) for all-cause, 1.3 (1.0–1.8) for CVD, and 1.1 (0.9–1.4) for non-CVD mortality; the corresponding HRs for diabetes (FPG ≥7.0 mmol/l) were 1.6 (1.4–1.8), 1.6 (1.3–1.9), and 1.6 (1.4–1.9), respectively. For a 2hPG of 3.01–4.50 mmol/l, as compared with a 2hPG of 4.51–5.50 mmol/l, the HRs were 1.1 (1.0–1.2), 1.1 (0.9–1.3), and 1.1 (1.0–1.3), respectively; the corresponding HRs for diabetes (2hPG ≥11.1 mmol/l) were 2.0 (1.7–2.3), 1.9 (1.5–2.4), and 2.1 (1.7–2.5), respectively. The HR for previously undetected diabetes defined by 2hPG was not significantly different from that for known diabetes, which was significantly higher than that for undetected diabetes based on FPG. Subjects with a 2hPG of 10.01–11.09 mmol/l had mortality risks similar to those diabetic subjects defined by an FPG ≥7.0 mmol/l. CONCLUSIONS—The relation between mortality and glucose was J shaped rather than showing threshold effect at high glucose levels, except for CVD mortality and 2hPG, where the relation was graded and increasing.
Article
Context Exercise is widely perceived to be beneficial for glycemic control and weight loss in patients with type 2 diabetes. However, clinical trials on the effects of exercise in patients with type 2 diabetes have had small sample sizes and conflicting results.Objective To systematically review and quantify the effect of exercise on glycosylated hemoglobin (HbA1c) and body mass in patients with type 2 diabetes.Data Sources Database searches of MEDLINE, EMBASE, Sport Discuss, Health Star, Dissertation Abstracts, and the Cochrane Controlled Trials Register for the period up to and including December 2000. Additional data sources included bibliographies of textbooks and articles identified by the database searches.Study Selection We selected studies that evaluated the effects of exercise interventions (duration ≥8 weeks) in adults with type 2 diabetes. Fourteen (11 randomized and 3 nonrandomized) controlled trials were included. Studies that included drug cointerventions were excluded.Data Extraction Two reviewers independently extracted baseline and postintervention means and SDs for the intervention and control groups. The characteristics of the exercise interventions and the methodological quality of the trials were also extracted.Data Synthesis Twelve aerobic training studies (mean [SD], 3.4 [0.9] times/week for 18 [15] weeks) and 2 resistance training studies (mean [SD], 10 [0.7] exercises, 2.5 [0.7] sets, 13 [0.7] repetitions, 2.5 [0.4] times/week for 15 [10] weeks) were included in the analyses. The weighted mean postintervention HbA1c was lower in the exercise groups compared with the control groups (7.65% vs 8.31%; weighted mean difference, −0.66%; P<.001). The difference in postintervention body mass between exercise groups and control groups was not significant (83.02 kg vs 82.48 kg; weighted mean difference, 0.54; P = .76).Conclusion Exercise training reduces HbA1c by an amount that should decrease the risk of diabetic complications, but no significantly greater change in body mass was found when exercise groups were compared with control groups.
Article
Objective. —To identify and quantify the major external (nongenetic) factors that contribute to death in the United States.Data Sources. —Articles published between 1977 and 1993 were identified through MEDLINE searches, reference citations, and expert consultation. Government reports and compilations of vital statistics and surveillance data were also obtained.Study Selection. —Sources selected were those that were often cited and those that indicated a quantitative assessment of the relative contributions of various factors to mortality and morbidity.Data Extraction. —Data used were those for which specific methodological assumptions were stated. A table quantifying the contributions of leading factors was constructed using actual counts, generally accepted estimates, and calculated estimates that were developed by summing various individual estimates and correcting to avoid double counting. For the factors of greatest complexity and uncertainty (diet and activity patterns and toxic agents), a conservative approach was taken by choosing the lower boundaries of the various estimates.Data Synthesis. —The most prominent contributors to mortality in the United States in 1990 were tobacco (an estimated 400000 deaths), diet and activity patterns (300 000), alcohol (100 000), microbial agents (90 000), toxic agents (60 000), firearms (35 000), sexual behavior (30 000), motor vehicles (25 000), and illicit use of drugs (20 000). Socioeconomic status and access to medical care are also important contributors, but difficult to quantify independent of the other factors cited. Because the studies reviewed used different approaches to derive estimates, the stated numbers should be viewed as first approximations.Conclusions. —Approximately half of all deaths that occurred in 1990 could be attributed to the factors identified. Although no attempt was made to further quantify the impact of these factors on morbidity and quality of life, the public health burden they impose is considerable and offers guidance for shaping health policy priorities.(JAMA. 1993;270:2207-2212)