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Association between maximal oxygen consumption and physical activity and sedentary lifestyle in metabolic syndrome. Usefulness of questionnaires.
Tojal, L, Alonso-Gómez, A, Alberich, S, Wärnberg, J, Sorto, C, Portillo, MP, Schröder, H, Salas-Salvadó, J, Arós, F
Revista espanola de cardiologia (English ed.). 2020;(2):145-152
Abstract
INTRODUCTION AND OBJECTIVES To analyze whether variations in physical activity (PA) and sedentary behaviors are accompanied by differences in maximal oxygen consumption (VO2max). METHODS We conducted a prospective cross-sectional study of 243 participants (82 women), aged 65.0±4.9 years old, with metabolic syndrome and overweight/obesity who performed a maximal exercise test with expired gas analysis. PA was evaluated using subjective methods, the REGICOR and RAPA 1 self-reported questionnaires, and objective methods, the chair test and accelerometry. Sedentariness was analyzed with the Nurses' Health Study questionnaire and accelerometry. RESULTS VO2max was higher in participants who reported they adhered to the recommendations of the PA guidelines in the REGICOR questionnaire (21.3±4.6 vs 18.0±4.4 mL/kg/min; P <.001) and was 18% higher in those who reported more PA in the RAPA 1 questionnaire than the less active group (P <.001). The chair test (> 15 vs ≤ 15 repetitions) also showed significant differences in VO2max (21.2±4.8 vs 18.7±4.5 ml/kg/min; P <.001). Correlations between PA variables and VO2max were significant but low (r: 0.2 to 0.4). Sedentary activities showed less relationship with VO2max. CONCLUSIONS Participants with metabolic syndrome and overweight/obesity who reported adhering to PA recommendations achieved higher VO2max. The self-reported questionnaires and the chair test identified significant variations in VO2max. Sedentary activities do not appear to modify VO2max.
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Adherence to Mediterranean Diet or Physical Activity After Bariatric Surgery and Its Effects on Weight Loss, Quality of Life, and Food Tolerance.
Gils Contreras, A, Bonada Sanjaume, A, Becerra-Tomás, N, Salas-Salvadó, J
Obesity surgery. 2020;(2):687-696
Abstract
OBJECTIVE To assess whether a healthy dietary pattern or physical activity after bariatric surgery mediates the effects of surgery on weight loss, the quality of life, or food tolerance. METHODS A prospective observational study conducted in the context of a randomized controlled trial. We assessed the extent to which increasing or decreasing adherence to the Mediterranean diet (MedDiet)-assessed by MEDAS (Mediterranean Diet Adherence Screener)-and of increasing or decreasing physical activity (PA)-assessed with the Short Questionnaire of International PA (IPAQ-Short Q)-after bariatric surgery affected changes in weight, body mass index (BMI), quality of life (Moorehead-Arlet Questionnaire), and food tolerance (Suter test). Assessments were recorded at baseline and quarterly up to 12 months of surgery. RESULTS Seventy-eight morbidly obese participants undergoing bariatric surgery were assessed up to 1 year after surgery. Those individuals who increased adherence to MedDiet showed a significantly higher mean of total weight loss percentage than those who decreased or maintained their adherence during follow-up: 37.6% (35.5-39.8) versus 34.1% (31.8-36.5) (p = 0.036). No significant differences were observed in changes in weight or BMI comparing individuals who increased their PA versus those who maintained or decreased PA, nor in quality of life or food tolerance between those individuals who increased versus those who decreased adherence to MedDiet or PA during the follow-up. CONCLUSIONS After bariatric surgery, morbidly obese subjects present greater weight loss if they adhere to the MedDiet. PA after surgery is not associated with the magnitude of weight loss nor the quality of life and tolerance to diet.
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Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial.
Salas-Salvadó, J, Díaz-López, A, Ruiz-Canela, M, Basora, J, Fitó, M, Corella, D, Serra-Majem, L, Wärnberg, J, Romaguera, D, Estruch, R, et al
Diabetes care. 2019;(5):777-788
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Abstract
OBJECTIVE The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention. RESEARCH DESIGN AND METHODS Overweight/obese adults with metabolic syndrome aged 55-75 years (n = 626) were randomized to an intensive weight loss lifestyle intervention based on an energy-restricted Mediterranean diet, physical activity promotion, and behavioral support (IG) or a control group (CG). The primary and secondary outcomes were changes in weight and cardiovascular risk markers, respectively. RESULTS Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P < 0.002). Reductions in insulin resistance, HbA1c, and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts. CONCLUSIONS PREDIMED-Plus intensive lifestyle intervention for 12 months was effective in decreasing adiposity and improving cardiovascular risk factors in overweight/obese older adults with metabolic syndrome, as well as in individuals with or at risk for diabetes.
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Isotemporal substitution of inactive time with physical activity and time in bed: cross-sectional associations with cardiometabolic health in the PREDIMED-Plus study.
Galmes-Panades, AM, Varela-Mato, V, Konieczna, J, Wärnberg, J, Martínez-González, MÁ, Salas-Salvadó, J, Corella, D, Schröder, H, Vioque, J, Alonso-Gómez, ÁM, et al
The international journal of behavioral nutrition and physical activity. 2019;(1):137
Abstract
BACKGROUND This study explored the association between inactive time and measures of adiposity, clinical parameters, obesity, type 2 diabetes and metabolic syndrome components. It further examined the impact of reallocating inactive time to time in bed, light physical activity (LPA) or moderate-to-vigorous physical activity (MVPA) on cardio-metabolic risk factors, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. METHODS This is a cross-sectional analysis of baseline data from 2189 Caucasian men and women (age 55-75 years, BMI 27-40 Kg/m2) from the PREDIMED-Plus study (http://www.predimedplus.com/). All participants had ≥3 components of the metabolic syndrome. Inactive time, physical activity and time in bed were objectively determined using triaxial accelerometers GENEActiv during 7 days (ActivInsights Ltd., Kimbolton, United Kingdom). Multiple adjusted linear and logistic regression models were used. Isotemporal substitution regression modelling was performed to assess the relationship of replacing the amount of time spent in one activity for another, on each outcome, including measures of adiposity and body composition, biochemical parameters and blood pressure in older adults. RESULTS Inactive time was associated with indicators of obesity and the metabolic syndrome. Reallocating 30 min per day of inactive time to 30 min per day of time in bed was associated with lower BMI, waist circumference and glycated hemoglobin (HbA1c) (all p-values < 0.05). Reallocating 30 min per day of inactive time with 30 min per day of LPA or MVPA was associated with lower BMI, waist circumference, total fat, visceral adipose tissue, HbA1c, glucose, triglycerides, and higher body muscle mass and HDL cholesterol (all p-values < 0.05). CONCLUSIONS Inactive time was associated with a poor cardio-metabolic profile. Isotemporal substitution of inactive time with MVPA and LPA or time in bed could have beneficial impact on cardio-metabolic health. TRIAL REGISTRATION The trial was registered at the International Standard Randomized Controlled Trial (ISRCTN http://www.isrctn.com/ISRCTN89898870) with number 89898870 and registration date of 24 July 2014, retrospectively registered.
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Association of physical activity with body mass index, waist circumference and incidence of obesity in older adults.
Cárdenas Fuentes, G, Bawaked, RA, Martínez González, MÁ, Corella, D, Subirana Cachinero, I, Salas-Salvadó, J, Estruch, R, Serra-Majem, L, Ros, E, Lapetra Peralta, J, et al
European journal of public health. 2018;(5):944-950
Abstract
BACKGROUND There is limited, and inconsistent, data on the prospective association between physical activity and surrogate markers of adiposity in older adults. We aim to determine the prospective association of leisure time physical activity (LTPA) with body mass index (BMI), waist circumference (WC) and the incidence of obesity. METHODS This prospective analysis included 7144 individuals with a mean age of 67 ± 6.2 years, from the PREvención con DIeta MEDiterránea (PREDIMED) study. BMI and WC were measured and LTPA was recorded using the Minnesota Leisure Time Physical Activity Questionnaire. Exposure and outcome variables were calculated as cumulative average of repeated measurements. RESULTS Total LTPA was inversely associated (P < 0.001) with BMI and WC. The difference in BMI and WC between extreme quintiles of LTPA (Q1-Q5) was 2.1 kg/m2 (95% confidence interval (CI) 1.68; 2.49, P < 0.001) and 4.8 cm (CI 2.28; 7.25, P < 0.001), respectively. Low-intensity LTPA was inversely associated with BMI but not with WC, while moderate/vigorous LTPA showed an inverse relationship with BMI and WC. The hazard of general and abdominal obesity incidence decreased across quintiles of total and moderate/vigorous LTPA (P < 0.001 for both), whereas low-intensity LTPA was inversely associated with the incidence of general obesity (P < 0.001). CONCLUSION LTPA was inversely associated with BMI, WC and incidence of general and abdominal obesity. The finding that low-intensity LTPA was inversely related to BMI and the incidence of obesity is of particular importance because this level of physical activity could be a feasible option for many older adults.
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Physical activity, energy balance and obesity.
Luís Griera, J, María Manzanares, J, Barbany, M, Contreras, J, Amigó, P, Salas-Salvadó, J
Public health nutrition. 2007;(10A):1194-9
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Abstract
Obesity appears when energy intake exceeds energy expenditure. The most important variable compound of energy expenditure is physical activity. The global epidemics of obesity seem closely related to reduced physical activity and sedentariness widely increasing nowadays. Once obesity has developed, caloric intake becomes similar to energy expenditure. To lose weight, besides decreasing energy intake, energy expenditure must be increased. The promotion of physical activity is difficult and so the results of treatment of obesity are discouraging for doctors, other health professionals and patients. Proactive efforts from patients and health providers with an intensive feedback between them may be extremely helpful. Nevertheless, more studies are needed to provide better approaches on the role of physical activity for the prevention and treatment of obesity and for long-term weight-loss maintenance.