Influence of Mediterranean diet adherence, physical activity patterns, and weight status on cardiovascular response to cardiorespiratory fitness test in Chilean school children

A Comprehensive Review of Phytonutrients as a Dietary Therapy for Obesity

Obesity is a complex medical condition mainly caused by eating habits, genetics, lifestyle, and medicine. The present study deals with traditional diets like the Mediterranean diet, Nordic diet, African Heritage diet, Asian diet, and DASH, as these are considered to be sustainable diets for curing obesity. However, the bioavailability of phytonutrients consumed in the diet may vary, depending on several factors such as digestion and absorption of phytonutrients, interaction with other substances, cooking processes, and individual differences. Hence, several phytochemicals, like polyphenols, alkaloids, saponins, terpenoids, etc., have been investigated to assess their efficiencies and safety in the prevention and treatment of obesity. These phytochemicals have anti-obesity effects, mediated via modulation of many pathways, such as decreased lipogenesis, lipid absorption, accelerated lipolysis, energy intake, expenditure, and preadipocyte differentiation and proliferation. Owing to these anti-obesity effects, new food formulations incorporating these phytonutrients were introduced that can be beneficial in reducing the prevalence of obesity and promoting public health.

Associations between Dietary Patterns and Physical Activity with Physical Fitness among Adolescents in Shandong Province, China: A Cross-Sectional Study

Background: The trend of physical fitness (PF) and physical activity (PA) among Chinese adolescents is not optimistic, and unhealthy dietary behaviors are common. PA and dietary patterns (DPs) have been linked to PF in adolescents, but the associations between DPs and PF with PF in Chinese adolescents are rarely discussed. Methods: A total of 8796 adolescents aged 11–18 were enrolled from Shandong Province, China. The CNSPFS battery was applied to assess PF. PA levels and diet quality were determined using the Physical Activity Questionnaire for Adolescents and the modified Chinese Diet Quality Questionnaire, respectively. This study used factor analysis to identify DPs and linear regression models to investigate the association between PF and related factors. Results: The average PF score of the participants was 75.67. Adolescents who were girls, lived in rural areas and were active in PA performed better on the PF test (p < 0.05). Boys whose fathers were university educated or above had a higher probability of achieving higher PF scores (OR 4.36, 95% CI 1.32–14.36); however, if their mothers were university educated or above, they had a lower probability of achieving higher PF scores (OR 0.22, 95% CI 0.063–0.76). Unhealthy dietary pattern was negatively correlated with cardiorespiratory fitness in boys (OR 0.56, 95% CI 0.31–0.98). The association between unhealthy dietary pattern and girls’ BMI became significant after adjustment for PA (p < 0.05). Conclusions: Girls performed better in PF than boys. Highly educated fathers could contribute to improve the PF performance in boys. There were four DPs among adolescents in Shandong Province, and different DPs may have different effects on PF in boys and girls.

Negative Physical Self-Concept Is Associated to Low Cardiorespiratory Fitness, Negative Lifestyle and Poor Mental Health in Chilean Schoolchildren

Background: Evidence suggests that physical self-concept (PSC) is linked to well-being in children and adolescents. Objective: The objective was to investigate the association of PSC with mental health (i.e., depression and body image), physical status (i.e., fitness and weight status) and lifestyle (physical activity (PA) patterns and nutritional level) in Chilean schoolchildren. Methods: A total of 617 schoolchildren (n = 271 girls and n = 346 boys) aged 10−14 years participated in this study. Self-concept, depression and body image dissatisfaction were determined by questionnaires. Physical fitness, PA, screen time (ST), Mediterranean diet (MD) adherence and anthropometric parameters were also included. Results: Poor PSC was linked to bad cardiorespiratory fitness (CRF) (<42 VO2max) (OR 1.64; 95%CI 1.12−2.34; p = 0.01), severe body image dissatisfaction (OR 2.51, 95%CI 0.99−6.35; p = 0.05), ST of more than two hours a day (OR 2.1; 95%CI 1.41−3.12; p < 0.001), PA after school of no more than two hours per week (OR 1.52; 95%CI 1.08−2.13; p = 0.015) and depression (OR 1.80; 95%CI 1.1−2.92; p = 0.017). High nutritional level showed an association with general PSC and general self-concept (p < 0.05). Absence of body image dissatisfaction was related to general self-concept (p < 0.01) and physical condition dimensions (p < 0.05). Conclusions: PSC is associated with CRF, PA after school, ST and nutritional level. According to mental health variables, poor PSC is related to depression in Chilean schoolchildren. Therefore, promoting a healthy lifestyle among children should be a target of community- and school-based interventions to promote PSC.

Healthy lifestyles and physical fitness are associated with abdominal obesity among Latin-American and Spanish preschool children: A cross-cultural study

BACKGROUND

Identifying environmental factors that influence health in children are necessary to develop preventive strategies.

OBJECTIVE

To determine the association between the lifestyles of children (i.e., Mediterranean diet (MD), physical activity (PA), fitness and screen time (ST) with abdominal obesity (AO) of preschoolers from three Spanish-speaking countries (Chile, Colombia and Spain) with different socioeconomic levels and Human Development Index (HDI) indicators.

MATERIAL AND METHODS

This cross-sectional study included 982 schoolchildren (aged 4-6 years; 56.8% girls) from Chile (n = 409), Colombia (n = 281), and Spain (n = 292). Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), adherence to the MD, PA, ST and physical fitness were evaluated.

RESULTS

Spanish preschoolers reported a lower WtHR (p < 0.001), greater physical fitness (Z-score) (p < 0.001) and higher adherence to the MD (p < 0.001) than their Chilean and Colombian peers. In addition, Colombian preschoolers had a better lifestyle (PA + ST) than their Chilean and Spanish peers (p < 0.001). Chilean preschoolers reported a higher prevalence of AO than the Spanish preschoolers (65% vs. 51.9%; p = 0.001).

CONCLUSION

Lifestyle had a significant association with AO among Spanish-speaking preschool children, with physical fitness especially being a relevant factor regardless of the country of origin. The findings of the current study may support the development of public guidelines focusing on healthy lifestyles in children to create effective plans that contribute to the early treatment of AO in preschool children.

The association between modifiable lifestyle behaviour in Latin-American schoolchildren with abdominal obesity and excess weight. A comparison of Chile and Colombia

OBJECTIVE

The purpose was to determine the association of lifestyle (i.e., Mediterranean diet [MD] adherence, physical activity [PA], screen time [ST]) and fitness with abdominal obesity (AO) and excess weight in the Chilean and Colombian schoolchildren.

RESEARCH METHODS & PROCEDURES

This cross-sectional study included 969 schoolchildren, girls (n=441, 5.24±0.80 years old) and boys (n=528, 5.10±0.78 years old) from Chile (n=611) and Colombia (n=358). The body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), MD adherence, PA, ST and cardiorespiratory fitness (CRF) were evaluated. The association of AO and anthropometric variables with lifestyle was estimated through multiple linear regression. To determine the association between AO and lifestyle, a logistic regression and the inclusion of odds ratios (ORs) with 95% confidence intervals (CIs) were used.

RESULTS

Worse CRF in Chilean children were positively correlated with WC. Excess weight in Chilean and Colombian children was positively associated with an unhealthy lifestyle. In Chilean children unhealthy lifestyle was also associated with AO based on WC≥85th percentile and AO based on WtHR≥85th percentile. In Chilean children, excess weight (BMI≥85th percentile) was positively associated with poor MD adherence.

CONCLUSION

AO and excess weight were associated with an unhealthy lifestyle in Latin-American schoolchildren. Interventions to reduce the prevalence of AO should include promoting healthier lifestyle choices (i.e., increasing PA after school, reducing ST and improving CRF).

Cardiac Autonomic Modulation in Response to Muscle Fatigue and Sex Differences During Consecutive Competition Periods in Young Swimmers: A Longitudinal Study

Objective: To study the differences in cardiac autonomic modulation in response to muscle fatigue caused by high-intensity exercise during two consecutive competition periods in young swimmers. Methods: Twenty-six competitive swimmers, selected by their training volume, were separated in two groups, females (n = 12 [46%], age: 13.5 ± 1.4 years) and males (n = 14 [54%], age: 13.9 ± 1.7 years), aged between 10 and 16 years, were evaluated five times as follow: (i) 21 days before the first competition (t-0); (ii) two days before (t-1; t-3); and (iii) two days after (t-2; t-4) of the first and second competitions. Morphological measurements (body mass, percentage of total body fat and height), blood pressure, power, and resting heart rate variability (RR with Polar band) were recorded before and after Wingate test at each time. Results: Body fat was higher in females compared to males. However, no differences were found in other morphological parameters. An intra-subject analysis grouped by sex in cardiovascular parameters shows longitudinal variations in systolic pressure and mean pressure among females. Additionally, females depicted higher, very low frequency (VLF, which is intrinsically generated by the heart and strongly associated with emotional stress) after physical fatigue compared to males at t-1. Further, before the competition, the high frequency (HF) component of HRV (parasympathetic drive) was higher in males than females at t-0 and t-4. Conclusion: Our data revealed that males displayed greater parasympathetic reactivity after an anaerobic muscle fatigue test during their competition periods. Contrarily, females had a less cardiac autonomic modulation when comparing the pre-post Wingate test after two consecutive competition periods.

Association between the Sociodemographic Characteristics of Parents with Health-Related and Lifestyle Markers of Children in Three Different Spanish-Speaking Countries: An Inter-Continental Study at OECD Country Level

The purpose of this cross-cultural study was to determine the association between the sociodemographic background of a child’s parents (i.e., their socioeconomic level, marital status, and educational level) with the child’s lifestyle (i.e., Mediterranean diet (MD), physical activity (PA) and screen time (ST)), and health markers. Material: This cross-sectional study included 1273 children, from Chile (n = 496), Colombia (n = 340), and Spain (n = 437). The sociodemographic information together with the lifestyle and health markers of the children were measured. There was an inverse association between a low or medium-low socioeconomic level for the parents of Chilean children and handgrip strength (β −0.61, p < 0.001); meanwhile, for Spanish children, an inverse association between a low or medium-low socioeconomic level and PA after school (β −0.58, p = 0.016), lifestyle (β −0.74, p = 0.015), and with MD adherence (β −0.86, p = 0.004) was found. The risk (i.e., by odd ratios (OR)) of being divorced/separated parents marital status showed an inverse association with abdominal obesity (OR 0.21, p = 0.045) in Spanish children; however, the parent’s marital status and a low educational level were risk factors for the suffering of a low nutritional level in Colombian children (OR 2.02, p = 0.048; OR 2.49, p < 0.001, respectively). On the other hand, a low educational level for parents reported for Chilean children had a positive association with ST of ≥4 h per day (OR 1.82, p = 0.020). In conclusion, in Spanish-speaking children, the lifestyle and health markers of the children are affected by the sociodemographic background of their parents; however, these effects could be moderated by the socio-cultural and economic status of their countries as members of the OCDE; therefore, it is essential to develop policies that decrease these gaps, so that children who are under-resourced can reach their full potential.

The social and psychological health of children is associated with Mediterranean diet adherence items, cardiorespiratory fitness, and lifestyle

BACKGROUND

Mediterranean diet (MD) adherence, physical activity (PA) patterns, and physical fitness are associated with physical, social, and psychological health in children.

OBJECTIVE

the purpose of this study was to determine the association of items of MD adherence, fitness components, and lifestyle with psychological and social health in Chilean schoolchildren.

MATERIAL AND METHODS

this cross-sectional study included 615 schoolchildren, both girls (n = 271, 11.7 ± 1.00 years old) and boys (n = 344, 11.8 ± 1.1 years old). Anthropometric parameters, fitness components, lifestyle, health-related quality of life (HRQoL), and self-esteem were measured.

RESULTS

HRQoL showed an association with cardiorespiratory fitness (β: 0.12, p < 0.001) and PA (β: 0.32, p = 0.023). Self-esteem was inversely associated with screen time (β: -1.35, p < 0.001). Moreover, social health presented a positive association with PA after school (β: 0.06, p = 0.037). In relation to MD adherence items, HRQoL was linked to the items "Takes a fruit or fruit juice every day" (β: 1.93, p = 0.004) and "Consumes fresh or cooked vegetables ˃ 1 time/day" (β: 1.12, p = 0.018). Self-esteem was associated to "Consumes a dairy product ˃ 1 time/day" (β: 3.30, p = 0.030). Social health was inversely related to "Eats at a fast food restaurant ≥ 1 time/week" (β: -0.26, p = 0.003) and positively to "Consumes pasta or rice almost every day" (β: 0.35, p = 0.049).

CONCLUSION

MD adherence items, fitness, and lifestyle were linked to psychological and social health, therefore it is necessary to develop preventive strategies for schoolchildren to change in a positive way these modifiable lifestyle behaviors.

Association between Creativity and Memory with Cardiorespiratory Fitness and Lifestyle among Chilean Schoolchildren

The objective was to investigate the association between creativity and memory with cardiorespiratory fitness (CRF; i.e., CFR classification and V˙O_2max); lifestyle parameters (i.e., physical activity (PA), sleep duration, screen time (ST), and food habits); and anthropometric measures (i.e., body mass index (BMI), waist circumference (WC)) among Chilean schoolchildren. A total of 248 schoolchildren (137 boys, 111 girls, 11.80 ± 1.17 and 11.58 ± 1.09 years, respectively) participated in the cross-sectional study. Creativity, memory, concentration, and selective attention and lifestyle (PA, ST, sleep duration, and Mediterranean diet (MD) adherence) were measured using a standard questionnaire. CRF (measured by the 20 m shuttle run test and expressed as maximum oxygen consumption (V˙O_2max) and anthropometric measures (BMI and WC) were also included. Creativity showed a positive association with V˙O_2max (mL/kg/min) (β; 0.209, 95% CI; 0.02-0.40, p = p < 0.05) and MD Adherence (score) (β; 0.206, 95% CI; 0.01; 0.74, p = p < 0.05). Long-term memory reported a positive association with CRF (β; 1.076, 95% CI; 0.02-2.13, p = p < 0.05). An increase in CRF levels, together with healthy food habits and normal nutritional status, should be a target for community- and school-based interventions to promote cognitive development in creativity and memory among schoolchildren.

The association between modifiable lifestyle behaviour in Latin-American schoolchildren with abdominal obesity and excess weight. A comparison of Chile and Colombia

OBJECTIVE

The purpose was to determine the association of lifestyle (i.e., Mediterranean diet [MD] adherence, physical activity [PA], screen time [ST]) and fitness with abdominal obesity (AO) and excess weight in the Chilean and Colombian schoolchildren.

RESEARCH METHODS & PROCEDURES

This cross-sectional study included 969 schoolchildren, girls (n=441, 5.24±0.80 years old) and boys (n=528, 5.10±0.78 years old) from Chile (n=611) and Colombia (n=358). The body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), MD adherence, PA, ST and cardiorespiratory fitness (CRF) were evaluated. The association of AO and anthropometric variables with lifestyle was estimated through multiple linear regression. To determine the association between AO and lifestyle, a logistic regression and the inclusion of odds ratios (ORs) with 95% confidence intervals (CIs) were used.

RESULTS

Worse CRF in Chilean children were positively correlated with WC. Excess weight in Chilean and Colombian children was positively associated with an unhealthy lifestyle. In Chilean children unhealthy lifestyle was also associated with AO based on WC≥85th percentile and AO based on WtHR≥85th percentile. In Chilean children, excess weight (BMI≥85th percentile) was positively associated with poor MD adherence.

CONCLUSION

AO and excess weight were associated with an unhealthy lifestyle in Latin-American schoolchildren. Interventions to reduce the prevalence of AO should include promoting healthier lifestyle choices (i.e., increasing PA after school, reducing ST and improving CRF).

Healthy Lifestyle Intervention and Weight Loss Improve Cardiovascular Dysfunction in Children with Obesity

Background: The aim of this study was to determine the effects of a 12-month healthy lifestyle intervention based on diet plus physical activity on cardiovascular structure and function in children and adolescents with obesity; Methods: In this longitudinal study we assessed changes in anthropometric, biochemical and cardiovascular variables in 55 subjects with obesity (6–16 years) before and after a 12-month behavioral program based on Mediterranean diet plus exercise regimen. Subjects were divided in two groups based on negative change in BMI z-score ≥10% from baseline: weight losers (WL) and non-weight losers (NWL); Results: After 12 months, WL showed a significant improvement of metabolic parameters. Treatment was effective in increasing the mitral peak early diastolic velocity E and the E/A ratio. In subjects with a reduction of the number of NCEP-ATPIII metabolic syndrome criteria, lifestyle intervention reduced left ventricular area and volume. Intervention reduced carotid intima-media thickness in subjects showing a decrease of the systemic blood pressure; Conclusions: In children with obesity, cardiovascular impairment could be partially reversed by a healthy lifestyle intervention. To adopt prompt behavioral programs in childhood obesity is crucial both for prevention and treatment of precocious complications and could have an exponential impact on long-term morbidity and mortality.

Mediterranean Lifestyle to Promote Physical, Mental, and Environmental Health: The Case of Chile

Chile is currently experiencing a progressive epidemiological transition towards chronic diseases. In this country, >50% of annual deaths are attributed to cardiovascular disease and cancer. Moreover, health surveys have shown high prevalence of obesity, diabetes, hypertension, and elevated cardiovascular disease risk. In addition, mental health issues are also frequent among Chilean adults. On the other hand, the agri-food system contributes to 21-37% of greenhouse gases emissions worldwide. Overall, current health and food chain situation calls out for design and implementation of evidence-based feasible and effective nutritional interventions needed to promote physical and mental health along with addressing food sustainability in Chile. Nowadays, the Mediterranean diet is recognized as one of the healthiest dietary patterns based on observational and interventional studies linked to a wide variety of health outcomes. However, a Mediterranean lifestyle goes well beyond food intake: it includes promotion of psychosocial resources, community life as well as cultural traditions. Indeed, Mediterranean lifestyle is a true modus vivendi that integrally promotes physical, mental, and social well-being. In addition, the Mediterranean diet stands out for its environmental sustainability because it is characterized mainly as a plant-based dietary pattern with low carbon and water footprints. Remarkably, Central Chile has a Mediterranean-like setting with plant and animal food production and availability patterns comparable to those present in countries located around the Mediterranean Sea. Therefore, this article reviews how promotion of Mediterranean lifestyle adherence in Chile offers great potential for management of the ongoing epidemiological transition to chronic diseases as well to promote psychological well-being within a unique food system and dietary sustainability vision for this Latin American country.

Negative feelings and behaviour are associated with low nutritional level, unhealthy lifestyle, and cardiometabolic risk factors in Chilean schoolchildren

Introduction

Background: feelings and behaviours are an important tool that should be considered to prevent early unhealthy lifestyles. Objective: the objective was to determine the association between feelings (i.e., sadness, loneliness, and school behaviour) with lifestyle (i.e., physical activity patterns and nutritional level), and as secondary endpoint to determine the relationship between health-related quality of life (HRQoL) and lifestyle with obesity and cardiometabolic risk (CMR) factors in Latin American schoolchildren. Methods: this cross-sectional study included a sample of 634 schoolchildren (girls, n = 282, 11.86 ± 0.82 years, and boys, n = 352, 12.02 ± 0.87 years) from publics schools in Chile. Body mass index (BMI), waist circumference (WC), waist-to-height ratio (WtHR), body fat (BF), lifestyle, nutritional level, HRQoL, and CMR (i.e., WtHR > 0.5) were evaluated. Results: schoolchildren who have felt sadness and loneliness presented an association with low nutritional level (OR: 4.26, 95 % CI: 2.0-9.0, p < 0.001, and OR: 4.47, 95 % CI: 2.5-7.9, p < 0.001, respectively), bad lifestyle (OR: 2.14, 95 % CI: 1.0-4.54, p = 0.048, and OR: 1.78, 95 % CI: 1.01-3.1, p = 0.045, respectively), and obesity (OR: 2.0, 95 % CI; 0.89-4.54, p = 0.09, and OR: 2.05, 95 % CI; 1.04-4.0, p = 0.037, respectively). Schoolchildren who have had enough time for themselves reported an association with bad lifestyle (OR: 0.69, 95 % CI: 0.47-1.02, p = 0.06), and those who have could not pay attention presented the highest association with bad lifestyle (OR: 4.64, 95 % CI: 72-12.56, p = 0.002). Conclusion: Latin American schoolchildren who have felt sadness and loneliness reported unhealthy lifestyles (i.e., lower nutritional level, increased screen time, and low physical activity), obesity, and thus a higher CMR burden.

Weight Status, Adherence to the Mediterranean Diet, and Physical Fitness in Spanish Children and Adolescents: The Active Health Study

The aim of this study was to analyze the differences in body composition and physical fitness according to the weight status (normoweight, overweight and obese) and the level of adherence to the Mediterranean diet (MD; low, medium or high), in physically active children and adolescents. Furthermore, this study also analyzed the relationship between body composition and physical fitness with Body Mass Index (BMI), fat mass and the level of adherence to the MD. In total, 1676 participants aged 6–17 from different municipal sports schools participated in this cross-sectional study. Data on adherence to the MD (a KIDMED questionnaire), anthropometric measurements, body composition and physical fitness parameters (the 20-m shuttle run test and muscular strength) were collected. A total of 43.5% of the sample were presented as overweight and obese, and only 35.7% had high or optimal adherence to the MD. The results revealed that a normoweight status was associated with greater cardiorespiratory fitness (p < 0.05; ES: 0.50 to 0.67) and lower-body muscular strength (p < 0.05; ES: 0.58 to 1.10). The overweight group showed more significant results than the other groups in handgrip strength (p < 0.01). Greater adherence to the MD in this population indicated better physical fitness, but only in boys. It is concluded that normoweight status and optimal adherence to the MD in children and adolescents are associated with health benefits, which are significant in the body composition and the effect on physical fitness.

Physical Fitness, Body Composition, and Adherence to the Mediterranean Diet in Young Football Players: Influence of the 20 mSRT Score and Maturational Stage

This study aimed to analyze the differences in physical fitness variables, body composition, and adherence to the Mediterranean diet according to the cardiorespiratory fitness and the maturational stage in young football players. A total of 194 male football players (aged 8–16) from three football sport schools participated in this study. Data on cardiorespiratory fitness (the 20-m shuttle run test), anthropometric measurements, handgrip strength, respiratory capacity (forced spirometry), and adherence to the Mediterranean diet (KIDMED questionnaire) were collected. Players were divided into two groups depending on their maturational stage (prepubertal n = 127 and pubertal n = 67). The results show a direct relationship between low levels of cardiorespiratory fitness and body mass index, as well as body fat and leg fat. Similarly, players with lower cardiorespiratory fitness presented higher values of handgrip strength in the prepubertal state. On the other hand, improvements in respiratory values were observed in the pubertal state with the rest of the parameters when the cardiorespiratory fitness was increased. Therefore, the promotion of recreational football that encourage and develop cardiorespiratory fitness is a key factor and can be used as an effective sport activity to promote physical fitness and healthy habits in children and adolescents as well as within the population that is already physically active.