Publications by authors named "Ignacio Ara"

111 Publications

Changes in Health Behaviors, Mental and Physical Health among Older Adults under Severe Lockdown Restrictions during the COVID-19 Pandemic in Spain.

Int J Environ Res Public Health 2021 07 1;18(13). Epub 2021 Jul 1.

Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28029 Madrid, Spain.

We used data from 3041 participants in four cohorts of community-dwelling individuals aged ≥65 years in Spain collected through a pre-pandemic face-to-face interview and a telephone interview conducted between weeks 7 to 15 after the beginning of the COVID-19 lockdown. On average, the confinement was not associated with a deterioration in lifestyle risk factors (smoking, alcohol intake, diet, or weight), except for a decreased physical activity and increased sedentary time, which reversed with the end of confinement. However, chronic pain worsened, and moderate declines in mental health, that did not seem to reverse after restrictions were lifted, were observed. Males, older adults with greater social isolation or greater feelings of loneliness, those with poorer housing conditions, as well as those with a higher prevalence of chronic morbidities were at increased risk of developing unhealthier lifestyles or mental health declines with confinement. On the other hand, previously having a greater adherence to the Mediterranean diet and doing more physical activity protected older adults from developing unhealthier lifestyles with confinement. If another lockdown were imposed during this or future pandemics, public health programs should specially address the needs of older individuals with male sex, greater social isolation, sub-optimal housing conditions, and chronic morbidities because of their greater vulnerability to the enacted movement restrictions.
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http://dx.doi.org/10.3390/ijerph18137067DOI Listing
July 2021

Relative sit-to-stand power: aging trajectories, functionally relevant cut-off points, and normative data in a large European cohort.

J Cachexia Sarcopenia Muscle 2021 Jul 3. Epub 2021 Jul 3.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.

Background: A validated, standardized, and feasible test to assess muscle power in older adults has recently been reported: the sit-to-stand (STS) muscle power test. This investigation aimed to assess the relationship between relative STS power and age and to provide normative data, cut-off points, and minimal clinically important differences (MCID) for STS power measures in older women and men.

Methods: A total of 9320 older adults (6161 women and 3159 men) aged 60-103 years and 586 young and middle-aged adults (318 women and 268 men) aged 20-60 years were included in this cross-sectional study. Relative (normalized to body mass), allometric (normalized to height squared), and specific (normalized to legs muscle mass) muscle power values were assessed by the 30 s STS power test. Body composition was evaluated by dual energy X-ray absorptiometry and bioelectrical impedance analysis, and legs skeletal muscle index (SMI; normalized to height squared) was calculated. Habitual and maximal gait speed, timed up-and-go test, and 6 min walking distance were collected as physical performance measures, and participants were classified into two groups: well-functioning and mobility-limited older adults.

Results: Relative STS power was found to decrease between 30-50 years (-0.05 W·kg ·year ; P > 0.05), 50-80 years (-0.10 to -0.13 W·kg ·year ; P < 0.001), and above 80 years (-0.07 to -0.08 W·kg ·year ; P < 0.001). A total of 1129 older women (18%) and 510 older men (16%) presented mobility limitations. Mobility-limited older adults were older and exhibited lower relative, allometric, and specific power; higher body mass index (BMI) and legs SMI (both only in women); and lower legs SMI (only in men) than their well-functioning counterparts (all P < 0.05). Normative data and cut-off points for relative, allometric, and specific STS power and for BMI and legs SMI were reported. Low relative STS power occurred below 2.1 W·kg in women (area under the curve, AUC, [95% confidence interval, CI] = 0.85 [0.84-0.87]) and below 2.6 W·kg in men (AUC [95% CI] = 0.89 [0.87-0.91]). The age-adjusted odds ratios [95% CI] for mobility limitations in older women and men with low relative STS power were 10.6 [9.0-12.6] and 14.1 [10.9-18.2], respectively. MCID values for relative STS power were 0.33 W·kg in women and 0.42 W·kg in men.

Conclusions: Relative STS power decreased significantly after the age of 50 years and was negatively and strongly associated with mobility limitations. Our study provides normative data, functionally relevant cut-off points, and MCID values for STS power for their use in daily clinical practice.
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http://dx.doi.org/10.1002/jcsm.12737DOI Listing
July 2021

Impact of the Home Confinement Related to COVID-19 on the Device-Assessed Physical Activity and Sedentary Patterns of Spanish Older Adults.

Biomed Res Int 2021 31;2021:5528866. Epub 2021 May 31.

GENUD (Growth, Exercise, Nutrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.

The main objective of this study was to device-assess the levels of physical activity and sedentary behaviour patterns of older adults during the situation prior to the COVID-19 pandemic, home confinement, and phase-0 of the deescalation. We also aimed to analyse the effectiveness of an unsupervised home-based exercise routine to counteract the potential increase in sedentary behaviour during the periods within the pandemic. A total of 18 noninstitutionalized older adults(78.4 ± 6.0 y.), members of the Spanish cohort of the EXERNET-Elder 3.0 project, participated in the study. They were recommended to perform an exercise prescription based on resistance, balance, and aerobic exercises during the pandemic. Wrist triaxial accelerometers (ActiGraph GT9X) were used to assess the percentage of sedentary time, physical activity, sedentary bouts and breaks of sedentary time. An ANOVA for repeated measures was performed to analyse the differences between the three different periods. During home quarantine, older adults spent more time in sedentary behaviours (71.6 ± 5.3%) in comparison with either the situation prior to the pandemic (65.5 ± 6.7%) or the ending of isolation (67.7 ± 7.1%) (all < 0.05). Moreover, participants performed less bouts of physical activity and with a shorter duration during home quarantine (both < 0.05). Additionally, no differences in the physical activity behaviours were found between the situation prior to the pandemic and the phase-0 of deescalation. According to our results, the home confinement could negatively affect health due to increased sedentary lifestyle and the reduction of physical activity. Therefore, our unsupervised exercise program does not seem to be a completely effective strategy at least in this period.
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http://dx.doi.org/10.1155/2021/5528866DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8195650PMC
July 2021

Fitness vs. fatness as determinants of survival in non-institutionalized older adults: The EXERNET multi-center study.

J Gerontol A Biol Sci Med Sci 2021 Jun 21. Epub 2021 Jun 21.

GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, Zaragoza, Spain.

Background: Physical fitness and body composition are important health indicators, nevertheless their combined pattern inter-relationships and their association with mortality are poorly investigated.

Methods: This longitudinal study is part of the Spanish EXERNET-Elder project. Person-months follow-up were calculated from the interview date, performed between June 2008 and November 2009, until date of death or censoring on March 2018 (whichever came first). In order to be included, participants had to fulfill the following criteria: 1) be over 65 years old, 2) live independently at home, 3) not suffer dementia and/or cancer and 4) have a BMI above 18.5. Body fat and weight were assessed by a bioelectrical impedance analyzer. Fitness was measured with the Senior Fitness and the one leg static balance tests. The Spanish Death Index was consulted for the death's identification. Cluster analysis was performed to identify Fat-Fit patterns and traditional cut points and percentiles to create the Fat-Fit groups. Cox proportional hazards regression models were used to calculate the hazard ratios of death in clustered Fat-Fit patterns and in traditional Fat-Fit groups.

Results: A total of 2299 older adults (76.8% of women) were included with a baseline mean age of 71.9 ± 5.2 years. A total of 196 deaths (8.7% of the sample) were identified during the 8 years of follow up. Four clustered Fat-Fit patterns (Low fat-Fit, Medium fat-Fit, High fat-Unfit and Low fat-Unfit) and nine traditional Fat-Fit groups emerged. Using the Low fat-Fit pattern as the reference, significantly increased mortality was noted in High fat-Unfit (HR: 1.68, CI: 1.06 - 2.66) and Low fat-Unfit (HR: 2.01, CI: 1.28 - 3.16) groups. All the traditional Fit groups showed lower mortality risk when compared to the reference group (obese-unfit group).

Conclusions: Physical fitness is a determinant factor in terms of survival in community-dwelling older adults, independently of adiposity levels.
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http://dx.doi.org/10.1093/gerona/glab179DOI Listing
June 2021

Assessment of functional sit-to-stand muscle power: Cross-sectional trajectories across the lifespan.

Exp Gerontol 2021 Sep 9;152:111448. Epub 2021 Jun 9.

Geriatric Research Unit, Geriatric Department, Bispebjerg University Hospital, Copenhagen, Denmark; Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet-Glostrup University Hospital, Copenhagen, Denmark; Geriatric Research Unit, Department of Internal Medicine, Herlev-Gentofte University Hospital, Copenhagen, Denmark. Electronic address:

Background: The 30-s sit-to-stand (STS) muscle power test is a valid test to assess muscle power in older people; however, whether it may be used to assess trajectories of lower-limb muscle power through the adult lifespan is not known. This study evaluated the pattern and time course of variations in relative, allometric and specific STS muscle power throughout the lifespan.

Methods: Subjects participating in the Copenhagen Sarcopenia Study (729 women and 576 men; aged 20 to 93 years) were included. Lower-limb muscle power was assessed with the 30-s version of the STS muscle power test. Allometric, relative and specific STS power were calculated as absolute STS power normalized to height squared, body mass and leg lean mass as assessed by DXA, respectively.

Results: Relative STS muscle power tended to increase in women (0.08 ± 0.05 W·kg·yr; p = 0.082) and increased in men (0.14 ± 0.07 W·kg·yr; p = 0.046) between 20 and 30 years, followed by a slow decline (-0.05 ± 0.05 W·kg·yr and -0.06 ± 0.08 W·kg·yr, respectively; both p > 0.05) between 30 and 50 years. Then, relative STS power declined at an accelerated rate up to oldest age in men (-0.09 ± 0.02 W·kg·yr) and in women until the age of 75 (-0.09 ± 0.01 W·kg·yr) (both p < 0.001). A lower rate of decline was observed in women aged 75 and older (-0.04 ± 0.02 W·kg·yr; p = 0.039). Similar age-related patterns were noted for allometric and specific STS power.

Conclusions: The STS muscle power test appears to provide a feasible and inexpensive tool to monitor cross-sectional trajectories of muscle power throughout the lifespan.
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http://dx.doi.org/10.1016/j.exger.2021.111448DOI Listing
September 2021

Threshold of Relative Muscle Power Required to Rise from a Chair and Mobility Limitations and Disability in Older Adults.

Med Sci Sports Exerc 2021 Jun 7. Epub 2021 Jun 7.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha. Toledo, Spain CIBER of Frailty and Healthy Aging (CIBERFES). Madrid, Spain Geriatric Research Unit, Department for Geriatric and Palliative Medicine, Bispebjerg and Frederiksberg University Hospital. Copenhagen, Denmark Geriatric Research Unit, Department of Internal Medicine, Herlev and Gentofte University Hospital, Denmark CopenAge - Copenhagen Center for Clinical Age Research, University of Copenhagen. Denmark Exercise and Health Laboratory, CIPER, Faculty of Human Motricity, University of Lisbon. Lisbon, Portugal. CIDEFES, Research Center in Sports, Physical Education and Exercise and Health, Lusofona University. Lisbon, Portugal Physical Activity, Sports and Health Research Group, Department of Movement Sciences, KU Leuven. Leuven, Belgium ImFine Research Group, Department of Health and Human Performance, Faculty of Science and Physical Activity and Sports Sciences, Polytechnic University of Madrid. Madrid, Spain CIBER of Pathophysiology of Obesity and Nutrition (CIBEROBN). Madrid, Spain Geriatric Department, Hospital Universitario de Getafe, Getafe, Spain Growth, Exercise, Nutrition, and Development Research Group, University of Zaragoza. Zaragoza, Spain Department of Internal Medicine, Geriatric Division, Amager and Hvidovre Hospital, Glostrup. Copenhagen, Denmark Geriatric Research Unit, Hospital Virgen del Valle, Complejo Hospitalario de Toledo. Toledo, Spain.

Purpose: Being able to rise from a chair is paramount for independent living and is strongly influenced by the ability of the lower limbs to exert mechanical power. This study assessed minimal thresholds of lower-limb relative muscle power required to perform the sit-to-stand (STS) task in older adults and its association with mobility limitations and disability.

Methods: A total of 11,583 older adults (age: 60-103 years old) participated in this investigation. The 5-rep and 30-s versions of the STS test were used to assess chair rising ability. Relative power was calculated by the STS muscle power test. The minimum thresholds of power required to perform the STS tests were derived from the minimum values (i.e. 'floor' effect) reported in the power tests through regression analyses. Mobility limitations and disability in activities of daily living (ADL) were recorded.

Results: For the average older man and woman, the thresholds to complete five STS repetitions were 1.1 and 1.0 W·kg-1, respectively, while the thresholds to complete one STS repetition were 0.3 W·kg-1 in both sexes. These thresholds increased linearly with height (5- and 1-rep, respectively: +0.13 and + 0.03 W·kg-1 per 10-cm increase; both p < 0.001), and did not differ by sex or testing condition (both p ≥ 0.259). All participants with relative power below the 5-rep threshold presented mobility limitations and 51 - 56% of women and 36 - 49% of men also showed disability in ADL (all χ2 ≥ 290.4; p < 0.001).

Conclusion: A minimum level of relative muscle power is required to rise from a chair independently, which depends on the individual height and is associated with increased mobility limitations and disability. This information will help interpret data yielded by the STS muscle power test and may contribute to the prevention and treatment of mobility limitations in older people.
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http://dx.doi.org/10.1249/MSS.0000000000002717DOI Listing
June 2021

Calibration and Cross-Validation of Accelerometer Cut-Points to Classify Sedentary Time and Physical Activity from Hip and Non-Dominant and Dominant Wrists in Older Adults.

Sensors (Basel) 2021 May 11;21(10). Epub 2021 May 11.

Laboratory of Epidemiology and Population Science, Intramural Research Program of the National Institutes of Health, National Institute on Aging, Baltimore, MD 20892, USA.

Accelerometers' accuracy for sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) classification depends on accelerometer placement, data processing, activities, and sample characteristics. As intensities differ by age, this study sought to determine intensity cut-points at various wear locations people more than 70 years old. Data from 59 older adults were used for calibration and from 21 independent participants for cross-validation purposes. Participants wore accelerometers on their hip and wrists while performing activities and having their energy expenditure measured with portable calorimetry. ST and MVPA were defined as ≤1.5 metabolic equivalents (METs) and ≥3 METs (1 MET = 2.8 mL/kg/min), respectively. Receiver operator characteristic (ROC) analyses showed fair-to-good accuracy (area under the curve [AUC] = 0.62-0.89). ST cut-points were 7 m (cross-validation: sensitivity = 0.88, specificity = 0.80) and 1 count/5 s (cross-validation: sensitivity = 0.91, specificity = 0.96) for the hip; 18 m (cross-validation: sensitivity = 0.86, specificity = 0.86) and 102 counts/5 s (cross-validation: sensitivity = 0.91, specificity = 0.92) for the non-dominant wrist; and 22 m and 175 counts/5 s (not cross-validated) for the dominant wrist. MVPA cut-points were 14 m (cross-validation: sensitivity = 0.70, specificity = 0.99) and 54 count/5 s (cross-validation: sensitivity = 1.00, specificity = 0.96) for the hip; 60 m (cross-validation: sensitivity = 0.83, specificity = 0.99) and 182 counts/5 s (cross-validation: sensitivity = 1.00, specificity = 0.89) for the non-dominant wrist; and 64 m and 268 counts/5 s (not cross-validated) for the dominant wrist. These cut-points can classify ST and MVPA in older adults from hip- and wrist-worn accelerometers.
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http://dx.doi.org/10.3390/s21103326DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8150960PMC
May 2021

Association of accelerometer-derived step volume and intensity with hospitalizations and mortality in older adults: A prospective cohort study.

J Sport Health Sci 2021 May 23. Epub 2021 May 23.

GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo 45071, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid 28029, Spain.

Purpose: To examine the associations of accelerometer-derived steps volume and intensity with hospitalizations and all-cause mortality in older adults.

Methods: This prospective cohort study involved 768 community-dwelling Spanish older adults (78.8 ± 4.9 years, mean ± SD; 53.9% females) from the Toledo Study for Healthy Aging (2012-2017). The number of steps per day and step cadence (steps/min) were derived from a hip-mounted accelerometer worn for at least 4 days at baseline. Participants were followed-up over a mean period of 3.1 years for hospitalization and 5.7 years for all-cause mortality. Cox proportional hazards regression models were used to estimate the individual and joint associations between daily steps and stepping intensity with hospitalizations and all-cause mortality.

Results: Included participants walked 5835 ± 3445 steps/day (mean ± SD) with an intensity of 7.3 ± 4.1 steps/min. After adjusting for age, sex, body mass index (BMI), education, income, marital status and comorbidities, higher step count (hazard ratio (HR) = 0.95, 95% confidence intervals (95%CI: 0.90-1.00, and HR = 0.87, 95%CI: 0.81-0.95 per additional 1000 steps) and higher step intensity (HR = 0.95, 95%CI: 0.91-0.99, and HR = 0.89, 95%CI: 0.84-0.95 per each additional step/min) were associated with fewer hospitalizations and all-cause mortality risk, respectively. Compared to the group having low step volume and intensity, individuals in the group having high step volume and intensity had a lower risk of hospitalization (HR = 0.72, 95%CI: 0.52-0.98) and all-cause mortality (HR = 0.60, 95%CI: 0.37-0.98).

Conclusion: Among older adults, both high step volume and step intensity were significantly associated with lower hospitalization and all-cause mortality risk. Increasing step volume and intensity may benefit older people.
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http://dx.doi.org/10.1016/j.jshs.2021.05.004DOI Listing
May 2021

Unsupervised home-based resistance training for community-dwelling older adults: A systematic review and meta-analysis of randomized controlled trials.

Ageing Res Rev 2021 08 19;69:101368. Epub 2021 May 19.

GENUD Toledo Research Group, University of Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.

Background: We aimed to summarize evidence on the safety, adherence and effectiveness of home-based resistance training (UHBRT) for improving health-related endpoints in community-dwelling older adults.

Methods: Randomized controlled trials of UHBRT in older adults (≥60yrs) were included after a systematic search (PubMed, CINAHL, PsycInfo, SPORTDiscus, Web of Science, MEDLINE, Cochrane Central Register of Controlled Trials) until 02/19/2021. Adverse events and adherence rates were assessed as indicators of feasibility. Other endpoints included physical (muscle strength, muscle power, balance, physical performance) and mental-related measures (cognition, quality of life [QoL]) as well as other health-related variables (body composition, physical activity levels, falls).

Results: 21 studies (N = 4,053) were included. No major adverse events were reported, with adherence averaging 67 % (range 47-97 %). UHBRT significantly improved lower-limb muscle strength (Hedges' g = 0.33; 95 % confidence interval [CI] = 0.11-0.57), muscle power measured through the sit-to-stand test (g = 0.44; 95 %CI = 0.06-0.84), and balance (assessed with the postural sway, g = 0.32; 95 %CI = 0.16-0.49). No benefits were found for other strength indices (handgrip strength), balance (single leg stance and functional reach test), physical performance (walking speed, TUG and SPPB), QoL, nor for the risk or rate of falls (all p > 0.05, g<0.61). No meta-analysis could be performed for the remaining endpoints.

Conclusions: Although efforts are needed to increase adherence, preliminary evidence suggests that UHBRT can be safe and modestly effective for improving some measures of lower-limb muscle strength, balance, and muscle power in community-dwelling older adults. However, no benefits were found for other physical fitness measures, QoL or falls. More evidence is therefore needed to draw definite conclusions.
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http://dx.doi.org/10.1016/j.arr.2021.101368DOI Listing
August 2021

Functional Frailty, Dietary Intake, and Risk of Malnutrition. Are Nutrients Involved in Muscle Synthesis the Key for Frailty Prevention?

Nutrients 2021 Apr 8;13(4). Epub 2021 Apr 8.

GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.

Frailty is a reversible condition, which is strongly related to physical function and nutritional status. Different scales are used to screened older adults and their risk of being frail, however, Short Physical Performance Battery (SPPB) may be more adequate than others to measure physical function in exercise interventions and has been less studied. Thus, the main aims of our study were: (1) to describe differences in nutritional intakes by SPPB groups (robust, pre-frail and frail); (2) to study the relationship between being at risk of malnourishment and frailty; and (3) to describe differences in nutrient intake between those at risk of malnourishment and those without risk in the no-frail individuals. One hundred one participants (80.4 ± 6.0 year old) were included in this cross-sectional study. A validated semi-quantitative food frequency questionnaire was used to determine food intake and Mini Nutritional Assessment to determine malnutrition. Results revealed differences for the intake of carbohydrates, -3 fatty acids (n3), and saturated fatty acids for frail, pre-frail, and robust individuals and differences in vitamin D intake between frail and robust (all < 0.05). Those at risk of malnutrition were approximately 8 times more likely to be frail than those with no risk. Significant differences in nutrient intake were found between those at risk of malnourishment and those without risk, specifically in: protein, PUFA -3, retinol, ascorbic acid, niacin equivalents, folic acid, magnesium, and potassium, respectively. Moreover, differences in alcohol were also observed showing higher intake for those at risk of malnourishment (all < 0.05). In conclusion, nutrients related to muscle metabolism showed to have different intakes across SPPB physical function groups. The intake of these specific nutrients related with risk of malnourishment need to be promoted in order to prevent frailty.
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http://dx.doi.org/10.3390/nu13041231DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8068284PMC
April 2021

Associations between Daily Movement Distribution, Bone Structure, Falls, and Fractures in Older Adults: A Compositional Data Analysis Study.

Int J Environ Res Public Health 2021 04 3;18(7). Epub 2021 Apr 3.

GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.

With aging, bone density is reduced, increasing the risk of suffering osteoporosis and fractures. Increasing physical activity (PA) may have preventive effects. However, until now, no studies have considered movement behaviors with compositional data or its association to bone mass and structure measured by peripheral computed tomography (pQCT). Thus, the aim of our study was to investigate these associations and to describe movement behavior distribution in older adults with previous falls and fractures and other related risk parameters, taking into account many nutritional and metabolic confounders. In the current study, 70 participants above 65 years old (51 females) from the city of Zaragoza were evaluated for the EXERNET-Elder 3.0 project. Bone mass and structure were assessed with pQCT, and PA patterns were objectively measured by accelerometry. Prevalence of fear of falling, risk of falling, and history of falls and fractures were asked through the questionnaire. Analyses were performed using a compositional data approach. Whole-movement distribution patterns were associated with cortical thickness. In regard to other movement behaviors, moderate-to-vigorous PA (MVPA) showed positive association with cortical thickness and total true bone mineral density (BMD) at 38% (all < 0.05). In addition, less light PA (LPA) and MVPA were observed in those participants with previous fractures and fear of falling, whereas those at risk of falling and those with previous falls showed higher levels of PA. Our results showed positive associations between higher levels of MVPA and volumetric bone. The different movement patterns observed in the groups with a history of having suffered falls or fractures and other risk outcomes suggest that different exercise interventions should be designed in these populations in order to improve bone and prevent the risk of osteoporosis and subsequent fractures.
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http://dx.doi.org/10.3390/ijerph18073757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8038494PMC
April 2021

Acute Physiological Response to Light- and Heavy-load Power-oriented Exercise in Older Adults.

Int J Sports Med 2021 Apr 26. Epub 2021 Apr 26.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.

This study investigated the acute responses to volume-load-matched heavy-load (80% 1RM) versus light-load (40% 1RM) power-oriented resistance training sessions in well-functioning older adults. Using a randomized cross-over design, 15 volunteers completed each condition on a leg press. Neuromuscular (maximal isometric force and rate of force development) and functional performance (power during sit-to-stand test), lactate, and muscle damage biochemistry (creatine kinase, lactate dehydrogenase and C-reactive protein serum concentration) were assessed pre- and post-exercise. Performance declines were found after heavy-load (Cohen's d effect size (d); maximal isometric force=0.95 d; rate of force development=1.17 d; sit-to-stand power =0.38 d, all p<0.05) and light-load (maximal isometric force=0.45 d; rate of force development=0.9 d; sit-to-stand power=1.17 d, all p<0.05), while lactate concentration increased only after light-load (1.7 d, p=0.001). However, no differences were found between conditions (all p>0.05). Both conditions increased creatine kinase the day after exercise (marginal effect=0.75 d, p<0.001), but no other blood markers increased (all, p>0.05). Irrespective of the load used, power training induced non-clinically significant decreases in sit-to-stand performance, moderate declines in maximal isometric force, but pronounced decreases in the rate of force development. Furthermore, the metabolic stress and muscle damage were minor; both sessions were generally well tolerated by well-functioning older adults without previous experience in resistance training.
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http://dx.doi.org/10.1055/a-1408-4793DOI Listing
April 2021

Benefits of Regular Table Tennis Practice in Body Composition and Physical Fitness Compared to Physically Active Children Aged 10-11 Years.

Int J Environ Res Public Health 2021 03 11;18(6). Epub 2021 Mar 11.

Department of Physical Activity and Sport, Faculty of Sport Sciences, University of Murcia, 30720 Murcia, Spain.

The aim of this study was to identify the differences in body composition and physical fitness between children who played table tennis regularly during a two-year period compared to physically active children who were not engaged in a regular activity. Three hundred seventy-four children aged 10 to 11 years were divided into two groups: table tennis players ( = 109 boys and 73 girls) and physically active group ( = 88 boys and 104 girls). Anthropometric analysis included body mass index, skinfolds, perimeters and bone diameters. Somatotype and body composition were determined according to age-specific equations. Physical fitness assessment included hand grip dynamometry (strength), sit-and-reach test (range of movement) and maximal multistage 20 m shuttle run test (cardiovascular fitness). The result show that children who regularly played table tennis had greater bone development and superior physical fitness compared to those who were physically active but not engaged in a regular physical activity. This is the largest study to date presenting data about the potential of table tennis to benefit health in children. These results constitute an important first step in clarifying the effectiveness of table tennis as a health-promotion strategy to encourage children to undertake regular physical activity and limit sedentary behavior.
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http://dx.doi.org/10.3390/ijerph18062854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8000723PMC
March 2021

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

J Am Geriatr Soc 2021 Jul 29;69(7):1964-1970. Epub 2021 Mar 29.

Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal.

Background/objectives: Moderate-to-vigorous physical activity (MVPA) and breaks in sedentary time (BST) have been proposed as viable solutions to improve an older adult's physical independence, whereas sedentary time (ST) has been associated with detrimental effects. We sought to assess the joint effects of ST, BST, and MVPA on the physical independence of older adults and determine whether and to what extent the ST relationship with physical independence is moderated by MVPA and/or BST.

Design: Cross-sectional.

Setting: Laboratory of Exercise and Health, Faculty of Human Kinetics.

Participants: Older adults (≥65 years old) from the national surveillance system in Portugal (n = 821).

Measurements: Physical activity and ST were assessed by accelerometry. Physical independence was assessed using a 12-item composite physical function (CPF) questionnaire. Multiple linear regression was used to model the outcomes.

Results: Higher ST was related to lower CPF score (β = -0.01, p < 0.0001), whereas higher MVPA was related to better CPF score (β = 0.02, p < 0.0001). BST was not related to physical independence after accounting for MVPA and ST (β = 0.03, p = 0.074). MVPA had a moderating effect on the relationship of ST with CPF score (p < 0.0001), where MVPA ≥36.30 min/day ameliorated the significant inverse relationship between ST and CPF. Engaging in ≥107.78 of MVPA resulted in ST having a significant positive relationship with CPF score. No moderation effect was found for BST (p > 0.05).

Conclusion: Regardless of the time spent in MVPA and BST, ST was inversely related to CPF. However, MVPA was found to be a moderator of the relationship between ST and physical independence, such that engaging in at least 36 min/day of MVPA may blunt the negative effects of ST. At high levels of MVPA (≥108 min/day), having some ST may actually provide some benefit to an older adult's ability to maintain physical independence.
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http://dx.doi.org/10.1111/jgs.17141DOI Listing
July 2021

'Fat but powerful' paradox: association of muscle power and adiposity markers with all-cause mortality in older adults from the EXERNET multicentre study.

Br J Sports Med 2021 Mar 16. Epub 2021 Mar 16.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain

Objectives: To assess the influence of muscle power and adiposity on all-cause mortality risk and to evaluate the 'fat but powerful' (F+P) (or 'fat but fit') paradox in older adults.

Methods: A total of 2563 older adults (65‒91 years old) from the EXERNET multicentre study were included. Adiposity (body mass index (BMI), waist circumference, body fat percentage (BF%) and fat index), allometric and relative power (sit-to-stand muscle power test) and various covariates (age, sex, hypertension, smoking status and walking and sitting times per day) were registered at baseline. All-cause mortality was recorded during a median follow-up of 8.9 years. Participants were classified into four groups: lean and powerful (L+P), F+P, lean but weak and fat and weak (F+W). Cox proportional hazard regression models and adjusted HRs were calculated.

Results: According to BMI and waist circumference, all-cause mortality risk was reduced in the F+P (HR=0.55 and 0.63, p=0.044 and 0.049, respectively) and L+P (HR=0.57 and 0.58, p=0.043 and 0.025, respectively) groups. According to BF%, all-cause mortality decreased in the L+P group (HR=0.53; p=0.021), and a trend for a reduction was reported in the F+P group (HR=0.57; p=0.060). According to fat index, a survival benefit was only noted in the L+P group (HR=0.50; p=0.049). Higher levels of relative power reduced all-cause mortality risk among older people (HR=0.63 and 0.53, p=0.006 and 0.011, respectively).

Conclusion: Powerful older people exhibited a reduced 9-year all-cause mortality regardless of BMI, waist circumference and BF%. Obesity according to fat index blunted the survival benefits of being powerful.
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http://dx.doi.org/10.1136/bjsports-2020-103720DOI Listing
March 2021

Effects of Power-Oriented Resistance Training With Heavy vs. Light Loads on Muscle-Tendon Function in Older Adults: A Study Protocol for a Randomized Controlled Trial.

Front Physiol 2021 18;12:635094. Epub 2021 Feb 18.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.

Background: Power-oriented resistance training (PRT) is one of the most effective exercise programs to counteract neuromuscular and physical function age-related declines. However, the optimal load that maximizes these outcomes or the load-specific adaptations induced on muscle power determinants remain to be better understood. Furthermore, to investigate whether these adaptations are potentially transferred to an untrained limb (i.e., cross-education phenomenon) could be especially relevant during limb-immobilization frequently observed in older people (e.g., after hip fracture).

Methods: At least 30 well-functioning older participants (>65 years) will participate in a within-person randomized controlled trial. After an 8-week control period, the effects of two 12-week PRT programs using light vs. heavy loads will be compared using an unilateral exercise model through three study arms (light-load PRT vs. non-exercise; heavy-load PRT vs. non-exercise; and light- vs. heavy- load PRT). Muscle-tendon function, muscle excitation and morphology and physical function will be evaluated to analyze the load-specific effects of PRT in older people. Additionally, the effects of PRT will be examined on a non-exercised contralateral limb.

Discussion: Tailored exercise programs are largely demanded given their potentially greater efficiency preventing age-related negative consequences, especially during limb-immobilization. This trial will provide evidence supporting the use of light- or heavy-load PRT on older adults depending on individual needs, improving decision making and exercise program efficacy.

Clinical Trial Registration: NCT03724461 registration data: October 30, 2018.
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http://dx.doi.org/10.3389/fphys.2021.635094DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7935559PMC
February 2021

Effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression: systematic review and meta-analysis of randomised controlled trials.

Br J Psychiatry 2021 Feb 3:1-10. Epub 2021 Feb 3.

Prevention and Health Promotion Research Network (redIAPP), Institute of Health Carlos III (ISCIII); and Biomedical Research Institute of Malaga (IBIMA), Spain.

Background: In most trials and systematic reviews that evaluate exercise-based interventions in reducing depressive symptoms, it is difficult to separate treatment from prevention.

Aims: To evaluate the effectiveness of exercise-based interventions in reducing depressive symptoms in people without clinical depression.

Method: We searched PubMed, PsycINFO, Embase, WOS, SPORTDiscus, CENTRAL, OpenGrey and other sources up to 25 May 2020. We selected randomised controlled trials (RCTs) that compared exclusively exercise-based interventions with control groups, enrolling participants without clinical depression, as measured using validated instruments, and whose outcome was reduction of depressive symptoms and/or incidence of new cases of people with depression. Pooled standardised mean differences (SMDs) were calculated using random-effect models (registration at PROSPERO: CRD42017055726).

Results: A total of 14 RCTs (18 comparisons) evaluated 1737 adults without clinical depression from eight countries and four continents. The pooled SMD was -0.34 (95% CI -0.51 to -0.17; P < 0.001) and sensitivity analyses confirmed the robustness of this result. We found no statistical evidence of publication bias and heterogeneity was moderate (I2 = 54%; 95% CI 22-73%). Only two RCTs had an overall low risk of bias and three had long-term follow-up. Multivariate meta-regression found that a larger sample size, country (Asia) and selective prevention (i.e. people exposed to risk factors for depression) were associated with lower effectiveness, although only sample size remained significant when adjustment for multiple tests was considered. According to the Grading of Recommendations Assessment, Development and Evaluation tool, the quality of evidence was low.

Conclusions: Exercise-based interventions have a small effect on the reduction of depressive symptoms in people without clinical depression. It could be an alternative to or complement psychological programmes, although further higher-quality trials with larger samples and long-term follow-up are needed.
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http://dx.doi.org/10.1192/bjp.2021.5DOI Listing
February 2021

Impact of COVID-19 Confinement on Physical Activity and Sedentary Behaviour in Spanish University Students: Role of Gender.

Int J Environ Res Public Health 2021 01 6;18(2). Epub 2021 Jan 6.

AgeingOn Research Group, Department of Physiology, University of the Basque Country (UPV/EHU), 48940 Leioa, Spain.

During the COVID-19 pandemic, entire populations were instructed to live in home-confinement to prevent the expansion of the disease. Spain was one of the countries with the strictest conditions, as outdoor physical activity was banned for nearly two months. This study aimed to analyse the changes in physical activity and sedentary behaviours in Spanish university students before and during the confinement by COVID-19 with special focus on gender. We also analysed enjoyment, the tools used and motivation and impediments for doing physical activity. An online questionnaire, which included the International Physical Activity Questionnaire Short Form and certain "ad hoc" questions, was designed. Students were recruited by distributing an invitation through the administrative channels of 16 universities and a total of 13,754 valid surveys were collected. Overall, university students reduced moderate (-29.5%) and vigorous (-18.3%) physical activity during the confinement and increased sedentary time (+52.7%). However, they spent more time on high intensity interval training (HIIT) (+18.2%) and mind-body activities (e.g., yoga) (+80.0%). Adaptation to the confinement, in terms of physical activity, was handled better by women than by men. These results will help design strategies for each gender to promote physical activity and reduce sedentary behaviour during confinement periods.
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http://dx.doi.org/10.3390/ijerph18020369DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7825050PMC
January 2021

Relationship between Physical Performance and Frailty Syndrome in Older Adults: The Mediating Role of Physical Activity, Sedentary Time and Body Composition.

Int J Environ Res Public Health 2020 12 29;18(1). Epub 2020 Dec 29.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.

The objectives were to clarify whether the relationship between physical performance and frailty was independently and jointly mediated by movement behaviors and body composition. We analyzed 871 older adults (476 women) from The Toledo Study for Healthy Aging. Skeletal muscle index (SMI) and fat index (FI) were determined using bone densitometry. Sedentary time (ST) and moderate-to-vigorous physical activity (MVPA) were assessed using accelerometry. The Frailty Trait Scale and The Short Physical Performance Battery (SPPB) were used to evaluate frailty and physical performance, respectively. Simple and multiple mediation analyses were carried out to determine the role of movement behaviors and body composition, adjusted for potential confounders. ST and MVPA acted independently as mediators in the relationship between SPPB and frailty (0.06% for ST and 16.89% for MVPA). FI also acted as an independent mediator in the same relationship (36.47%), while the mediation role of SMI was not significant. MVPA and FI both acted jointly as mediators in this previous relationship explaining 58.15% of the model. Our data support the fact that interventions should simultaneously encourage the promotion of MVPA and strategies to decrease the FI in order to prevent or treat frailty through physical performance improvement.
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http://dx.doi.org/10.3390/ijerph18010203DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7794741PMC
December 2020

Long-Term Benefits of Tailored Exercise in Severe Sarcoidosis: A Case Report.

Int J Environ Res Public Health 2020 12 18;17(24). Epub 2020 Dec 18.

Instituto de Investigación Hospital 12 de Octubre (imas12), 28041 Madrid, Spain.

Background: We studied the effects of a supervised, structured exercise program in a severe sarcoidosis patient.

Methods: After being clinically stable for two years, a 52-year-old woman (stage IV, American Thoracic Society) who originally had irreversible lung fibrosis, pulmonary arterial hypertension (PAH), mild mitral insufficiency, and atrial dilatation, and was candidate for lung transplant, performed a combined high-intensity interval, high load resistance, and inspiratory muscle training for 4.5 years, and was tested (cardiopulmonary exercise testing and dual X-ray absorptiometry) every six months.

Results: Cardiorespiratory fitness (CRF) and maximal pulmonary ventilation increased by 44% and 60%, respectively. Ventilatory efficiency also improved (decrease in the ventilatory equivalent for oxygen by 32% and 14% at the ventilatory threshold and respiratory compensation point, respectively). She improved New York Heart Association (NYHA) class (from III to II), and cardiac alterations as well as PAH reversed so that she was not in need of lung transplantation anymore. Likewise, she suffered no more episodes of hemoptysis. Bone health was overall maintained despite the post-menopausal status and the corticoid treatment.

Conclusions: A long-term combined exercise intervention safely contributed-at least partly-to improve CRF and NYHA class in a patient with severe sarcoidosis, suggesting a potential coadjuvant effect to attenuate clinical manifestations.
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http://dx.doi.org/10.3390/ijerph17249512DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7766182PMC
December 2020

Sit-to-stand muscle power test: Comparison between estimated and force plate-derived mechanical power and their association with physical function in older adults.

Exp Gerontol 2021 03 21;145:111213. Epub 2020 Dec 21.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain. Electronic address:

Objectives: This study aimed i) to assess the assumptions made in the sit-to-stand (STS) muscle power test [body mass accelerated during the ascending phase (90% of total body mass), leg length (50% of total body height) and concentric phase (50% of total STS time)], ii) to compare force plate-derived (FPD) STS power values with those derived from the STS muscle power test; and iii) to analyze the relationships of both measurements with physical function.

Material And Methods: Fifty community-dwelling older adults (71.3 ± 4.4 years) participated in the present investigation. FPD STS power was calculated as the product of measured force (force platform) and velocity [difference between leg length (DXA scan) and chair height, divided by time (obtained from FPD data and video analysis)], and compared to estimated STS power using the STS muscle power test. Physical function was assessed by the timed-up-and-go (TUG) velocity, habitual gait speed (HGS) and maximal gait speed (MGS). Paired t-tests, Bland-Altman plots and regressions analyses were conducted.

Results: Body mass accelerated during the STS phase was 85.1 ± 3.8% (p < 0.05; compared to assumed 90%), leg length was 50.7 ± 1.3% of body height (p < 0.05; compared to 50%), and measured concentric time was 50.3 ± 4.6% of one STS repetition (p > 0.05; compared to assumed 50%). There were no significant differences between FPD and estimated STS power values (mean difference [95% CI] = 6.4 W [-68.5 to 81.6 W]; p = 0.251). Both FPD and estimated relative (i.e. normalized to body mass) STS power were significantly related to each other (r = 0.95 and ICC = 0.95; p < 0.05) and to MGS and TUG velocity after adjusting for age and sex (p < 0.05).

Conclusions: Estimated STS power was not different from FPD STS power and both measures were strongly related to each other and to maximal physical performance.
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http://dx.doi.org/10.1016/j.exger.2020.111213DOI Listing
March 2021

Low relative mechanical power in older adults: An operational definition and algorithm for its application in the clinical setting.

Exp Gerontol 2020 12 27;142:111141. Epub 2020 Oct 27.

Department of Geriatrics, Hospital Virgen del Valle, Complejo Hospitalario de Toledo, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain. Electronic address:

Introduction: The assessment and treatment of low relative muscle power in older people has received little attention in the clinical setting when compared to sarcopenia. Our main goal was to assess the associations of low relative power and sarcopenia with other negative outcomes in older people.

Methods: The participants were 1189 subjects (54% women; 65-101 years old) from the Toledo Study for Healthy Aging. Probable sarcopenia was defined as having low handgrip strength, while confirmed sarcopenia also included low appendicular skeletal muscle index (assessed by dual energy X-ray absorptiometry) (EWGSOP2's definition). Low relative (i.e. normalized to body mass) muscle power was assessed with the 5-repetition sit-to-stand power test (which uses an equation that converts sit-to-stand performance into mechanical power) and diagnosed in those subjects in the lowest sex-specific tertile. Low usual gait speed (UGS), frailty (according to Fried's criteria and the Frailty Trait Scale), limitations in basic (BADL) and instrumental activities of daily living (IADL) and poor quality of life were also recorded.

Results: Age-adjusted logistic regression analyses demonstrated that low relative muscle power was associated with low UGS (odds ratio (OR) = 1.9 and 2.5), frailty (OR = 3.9 and 4.7) and poor quality of life (OR = 1.8 and 1.9) in older men and women, respectively, and with limitations in BADL (OR = 1.6) and IADL (OR = 3.8) in older women (all p < 0.05). Confirmed sarcopenia was only associated with low UGS (OR = 2.5) and frailty (OR = 5.0) in older men, and with limitations in IADL in older women (OR = 4.3) (all p < 0.05).

Conclusions: Low relative muscle power had a greater clinical relevance than low handgrip strength and confirmed sarcopenia among older people. An operational definition and algorithm for low relative muscle power case finding in daily clinical practice was presented.
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http://dx.doi.org/10.1016/j.exger.2020.111141DOI Listing
December 2020

Role of Dietary Intake and Serum 25(OH)D on the Effects of a Multicomponent Exercise Program on Bone Mass and Structure of Frail and Pre-Frail Older Adults.

Nutrients 2020 10 1;12(10). Epub 2020 Oct 1.

GENUD (Growth, Exercise, NUtrition and Development) Research Group, Universidad de Zaragoza, 50009 Zaragoza, Spain.

The multicomponent training (MCT) effect on bone health in frail and pre-frail elders, which is influenced by dietary intake, is still unknown. The objective of this non-randomized intervention trial was to assess the effects of a 6-month MCT on bone structure in frail and pre-frail elders, and to analyse the influence of dietary intake and serum vitamin D (25(OH)D) in these changes. Thirty MCT (TRAIN) and sixteen controls (CON), frail and pre-frail completed the information required for this study. Peripheral quantitative computed tomography measurements were taken at 4% and 38% of the tibia length and dietary intake was registered. The 25(OH)D values were obtained from blood samples. Analyses of covariance (ANCOVA) for repeated measures showed significant decreases for CON in total bone mineral content at 38% of tibia length. One factor ANOVAs showed smaller decreases in bone mineral density and cortical thickness percentage of change in TRAIN compared to CON. Linear regression analyses were performed to study the influence of nutrients and 25(OH)D on bone changes. Alcohol showed a negative influence on fracture index changes, while polyunsaturated fatty acid and vitamin A showed a positive association with some bone variables. The 25(OH)D only affected positively the cortical bone mineral density. In conclusion, our MCT seems to slow down some of the bone detriments associated with ageing in frail and pre-frail older adults, with alcohol showing a negative effect on the bone and apparent limited effect of nutrients and serum 25(OH)D on training related changes.
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http://dx.doi.org/10.3390/nu12103016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7601843PMC
October 2020

Relation between leg extension power and 30-s sit-to-stand muscle power in older adults: validation and translation to functional performance.

Sci Rep 2020 10 1;10(1):16337. Epub 2020 Oct 1.

Geriatric Research Unit, Department of Geriatric and Palliative Medicine, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark.

This study aimed to assess the validity and functional relevance of a standardized procedure to assess lower limb muscle power by means of the 30-s sit-to-stand (STS) test when compared to leg extension power (LEP), traditional STS performance and handgrip strength. A total of 628 community-dwelling older subjects (60-93 years) from the Copenhagen Sarcopenia Study were included. Physical performance was assessed by the 30-s STS and 10-m maximal gait speed tests. Handgrip strength and LEP were recorded by a hand-held dynamometer and the Nottingham power rig, respectively. STS muscle power was calculated using the subjects' body mass and height, chair height and the number of repetitions completed in the 30-s STS test. We found a small albeit significant difference between LEP and unilateral STS power in older men (245.5 ± 88.8 vs. 223.4 ± 81.4 W; ES = 0.26; p < 0.05), but not in older women (135.9 ± 51.9 vs. 138.5 ± 49.6 W; ES = 0.05; p > 0.05). Notably, a large positive correlation was observed between both measures (r = 0.75; p < 0.001). Relative STS power was more strongly related with maximal gait speed than handgrip strength, repetition-based STS performance and relative LEP after adjusting for age (r = 0.53 vs 0.35-0.45; p < 0.05). In conclusion, STS power obtained from the 30-s STS test appeared to provide a valid measure of bilateral lower limb power and was more strongly related with physical performance than maximal handgrip strength, repetition-based STS performance and LEP.
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http://dx.doi.org/10.1038/s41598-020-73395-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7529789PMC
October 2020

Mechanical Characteristics of Heavy vs. Light Load Ballistic Resistance Training in Older Adults.

J Strength Cond Res 2020 Sep 16. Epub 2020 Sep 16.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain.

Rodriguez-Lopez, C, Alcazar, J, Sánchez-Martín, C, Ara, I, Csapo, R, and Alegre, LM. Mechanical characteristics in heavy vs. light load ballistic resistance training in older adults. J Strength Cond Res XX(X): 000-000, 2020-Although power-oriented resistance training (RT) is strongly recommended to counter age-related neuromuscular function declines, there is still controversy about which intensities of load should be used to elicit optimal training adaptations. Knowledge of the mechanical characteristics of power-oriented RT performed at different intensities might help to better understand the training stimulus that triggers load-dependent adaptations in older adults. Using a cross-over design, 15 well-functioning older volunteers (9 men and 6 women; 73.6 ± 3.8 years) completed 2 volume × load-matched ballistic RT sessions with heavy (HL: 6 × 6 × 80% 1-repetition maximum [1RM]) and light-load (LL: 6 × 12 × 40% 1RM) on a horizontal leg press exercise. Electromyographic (EMG) and mechanical variables (work, force, velocity, and power) as well as intraset neuromuscular fatigue (i.e., relative losses in force, velocity, and power) were analyzed. More concentric mechanical work was performed in the LL training session, compared with HL (36.2 ± 11.2%; p < 0.001). Despite the higher mean EMG activity of the quadriceps femoris muscle (13.2 ± 21.1%; p = 0.038) and greater concentric force (35.2 ± 7.6%; p < 0.001) during HL, higher concentric velocity (41.0 ± 12.7%, p < 0.001) and a trend toward higher concentric power (7.2 ± 18.9%, p = 0.075) were found for LL. Relative velocity losses were similar in both sessions (≈10%); however, relative force losses were only found in LL (7.4 ± 6.5%, p = 0.003). Considering the greater mechanical work performed and concentric power generated, ballistic RT using LL may, therefore, represent a stronger stimulus driving training adaptations as compared with volume × load-matched heavy-load training. Relative losses in force and power should be monitored in addition to velocity losses during ballistic RT.
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http://dx.doi.org/10.1519/JSC.0000000000003826DOI Listing
September 2020

Breaking Sedentary Time Predicts Future Frailty in Inactive Older Adults: A Cross-Lagged Panel Model.

J Gerontol A Biol Sci Med Sci 2021 Apr;76(5):893-900

GENUD Toledo Research Group, University of Castilla-La Mancha, Spain.

Background: Cross-sectional evidence exists on the beneficial effects of breaks in sedentary time (BST) on frailty in older adults. Nonetheless, the longitudinal nature of these associations is unknown. This study aimed to investigate the direction and temporal order of the association between accelerometer-derived BST and frailty over time in older adults.

Methods: This longitudinal study analyzed a total of 186 older adults aged 67-90 (76.7 ± 3.9 years; 52.7% females) from the Toledo Study for Healthy Aging over a 4-year period. Number of daily BST was measured by accelerometry. Frailty was assessed with the Frailty Trait Scale. Multiple cross-lagged panel models were used to test the temporal and reciprocal relationship between BST and frailty.

Results: For those physically inactive (n = 126), our analyses revealed a reciprocal inverse relationship between BST and frailty, such as higher initial BST predicted lower levels of later frailty (standardized regression coefficient [β] = -0.150, 95% confidence interval [CI] = -0.281, -0.018; p < .05); as well as initial lower frailty levels predicted higher future BST (β = -0.161, 95% CI = -0.310, -0.011; p < .05). Conversely, no significant pathway was found in the active participants (n = 60).

Conclusions: In physically inactive older adults, the relationship between BST and frailty is bidirectional, while in active individuals no associations were found. This investigation provides preliminary longitudinal evidence that breaking-up sedentary time more often reduces frailty in those older adults who do not meet physical activity recommendations. Targeting frequent BST may bring a feasible approach to decrease the burden of frailty among more at-risk inactive older adults.
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http://dx.doi.org/10.1093/gerona/glaa159DOI Listing
April 2021

Sex Differences and the Influence of an Active Lifestyle on Adiposity in Patients with McArdle Disease.

Int J Environ Res Public Health 2020 06 17;17(12). Epub 2020 Jun 17.

GENUD Toledo Research Group, Universidad de Castilla-La Mancha, 45071 Toledo, Spain.

McArdle disease (glycogenosis-V) is associated with exercise intolerance, however, how it affects an important marker of cardiometabolic health as it is adiposity remains unknown. We evaluated the association between physical activity (PA) and adiposity in patients with McArdle disease. We assessed 199 adults of both sexes (51 McArdle patients (36 ± 11 years) and 148 healthy controls (35 ± 10 years)). Body fat (BF) was determined using dual-energy X-ray absorptiometry (DXA) method and each patient's PA was assessed with the International PA Questionnaire (IPAQ). Although body mass index values did not differ between patients and controls, McArdle patients had significantly higher values of BF in all body regions ( 0.05) and higher risk of suffering obesity (odds ratio (OR): 2.54, 95% confidence interval (95% CI): 1.32-4.88). Male patients had higher BF and obesity risk (OR: 3.69, 95% CI: 1.46-9.34) than their sex-matched controls, but no differences were found within the female sex ( 0.05). In turn, active female patients had lower trunk BF than their inactive peers ( 0.05). Males with McArdle seem to have adiposity problems and a higher risk of developing obesity than people without the condition, while female patients show similar or even better levels in the trunk region with an active lifestyle. Therefore, special attention should be given to decrease adiposity and reduce obesity risk in males with McArdle disease.
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http://dx.doi.org/10.3390/ijerph17124334DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7344565PMC
June 2020

The effects of Age, Organized Physical Activity and Sedentarism on Fitness in Older Adults: An 8-Year Longitudinal Study.

Int J Environ Res Public Health 2020 06 16;17(12). Epub 2020 Jun 16.

GENUD (Growth, Exercise, NUtrition and Development) Research Group, University of Zaragoza, 50009 Zaragoza, Spain.

The aims of the present study were (1) to describe the changes in physical fitness during an 8 year follow-up in a large sample of Spanish adults aged 65 or over that are initially engaged in organized physical activity (OPA), (2) to compare fitness changes according to different age groups (65 to 69 vs. 70 to 74 vs. ≥75 years-old), (3) to evaluate the independent and combined effects of changes in OPA engagement and sitting time (ST) on physical fitness. A total of 642 (147 males) non-institutionalized over 65 years-old participants completed the EXERNET battery fitness tests and completed a validated questionnaire from which information regarding OPA and ST were collected. All participants completed evaluations in 2008-2009 and in 2016-2017. An impairment of fitness-related variables happens after 65 years of age in both males and females, with the older participants (≥75), showing the largest decreases. Males who continued performing OPA demonstrated lower decreases in balance, leg flexibility and agility when compared to those who stopped performing OPA during the follow-up. Females who continued performing OPA demonstrated lower decreases of all variables except for balance when compared to those who stopped performing OPA during the follow-up.
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http://dx.doi.org/10.3390/ijerph17124312DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7345727PMC
June 2020

Feeding aspects of Knodus heteresthes (Eigenmann, 1908) and Moenkhausia lepidura (Kner, 1858) (Characiformes, Characidae) in the Teles Pires and Juruena Rivers, southern Amazon.

Braz J Biol 2021 Mar-May;81(2):343-350

Centro de Pesquisa de Limnologia, Biodiversidade e Etnobiologia do Pantanal, Universidade do Estado de Mato Grosso - UNEMAT, Av. Santos Dumont, s/n, Cidade Universitária, CEP 78200-000, Cáceres, MT, Brasil.

The composition of the diet of two species of characids (Knodus heteresthes and Moenkhausia lepidura) was evaluated in the Teles Pires and Juruena Rivers, sampled in September and October 2016. We analyzed 226 stomachs of K. heteresthes and 425 of M. lepidura. The analysis of the stomach contents was based on volumetric and frequency of occurrence methods, applying the food importance index. For the similarity of the diets between the species we calculated the niche overlap with Pianka's index. Both species in the Juruena River have a dietary preference for arthropods (IAi > 0.95). In the Teles Pires River the diet is concentrated in three sources for both species: arthropods (IAi > 0.52), vegetables (IAi > 0.33) and fish (IAi > 0.12). The diet was dissimilar when compared to environments (ANOSIM, R ≥ 0.57, p < 0.001) with high trophic niche overlap (α > 0.97), regardless of the sampled environment. In the Teles Pires River, both species were classified as omnivorous with an insectivorous tendency and in the Juruena River the insectivorous behaviour occurs.
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http://dx.doi.org/10.1590/1519-6984.226136DOI Listing
February 2021

Low-Grade Inflammation Is Not Present in Former Obese Males but Adipose Tissue Macrophage Infiltration Persists.

Biomedicines 2020 May 14;8(5). Epub 2020 May 14.

Xlab, Center for Healthy Aging, Department of Biomedical Sciences, University of Copenhagen, 2200N Copenhagen, Denmark.

Macrophage infiltration in two subcutaneous adipose tissue depots and systemic low-grade inflammation were studied in post-obese (PO), obese (O), and control (C) subjects. Young males were recruited into PO: ( = 10, weight-loss avg. 26%, BMI: 26.6 ± 0.7, mean ±SEM kg/m), O: ( = 10, BMI: 33.8 ± 1.0kg/m) and C: ( = 10, BMI: 26.6 ± 0.6 kg/m). PO and C were matched by BMI. Blood and abdominal and gluteal subcutaneous adipose tissue were obtained in the overnight fasted state. Plasma concentrations of IL-6 and CRP were higher ( < 0.05) in O than in PO and C, TNF-α was higher ( < 0.05) only in O compared to PO and IL-18 was similar between groups. The number of CD68 macrophages was higher ( < 0.05) in the gluteal than the abdominal depot, and higher ( < 0.05) in O and PO compared to C in both depots. The content of CD163 macrophages was similar between depots but was higher ( < 0.05) in PO compared to C and O in the gluteal depot. In post obese men with a long-term sustained weight loss, systemic low-grade inflammation was similar to non-obese controls despite a higher subcutaneous adipose tissue CD68 macrophage content. Interestingly, the anti-inflammatory CD163 macrophage adipose tissue content was consistently higher in post obese than obese and controls.
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http://dx.doi.org/10.3390/biomedicines8050123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7277299PMC
May 2020