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Ramos TDA, Medeiros CCM, Figueiroa JN, de Carvalho DF, Gusmão TME, Alves JGB. Effects of exergaming on the microcirculation of adolescents with overweight or obesity-a clinical trial efficacy. Appl Physiol Nutr Metab 2023; 48:379-385. [PMID: 36919852 DOI: 10.1139/apnm-2022-0335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
To assess the effect of exergaming on the microcirculation function of adolescents with overweight or obesity, this non-randomized clinical trial efficacy was conducted with 61 adolescents aged between 10 and 16 years. The intervention group (n = 31) performed exergaming three times per week for 8 weeks. Both groups received guidelines for a healthy diet and staying physically active. Microcirculation was assessed using a laser Doppler flowmetry (LDF) at baseline and after intervention. Primary outcomes derived from LDF assessment included resting flow, maximum flow, maximum/resting flow ratio, area under hyperemia, and post-occlusive reactive hyperemia (PORH). Secondary outcomes were body mass index and systemic blood pressure. Unpaired Student's t test compared intergroup analyses, and paired Student's t test compared intragroup analyses. The significance was set at 5%. Statistical analysis intergroup and intragroup was done by fitting a two-way mixed effects model. Microcirculation was similar between groups. Maximum flow (109.0 ± 38.3 versus 124.6 ± 43.0, P = 0.022), area under hyperemia (1614 ± 472 versus. 1755 ± 461, P = 0.023), and PORH (2.18 ± 0.49 versus 2.01 ± 0.52, P = 0.031) were statistically different after intervention. Body mass index decreased in intervention (24.5 ± 3.8-24.1 ± 4.0 kg/m2, P = 0.002) and control (25.2 ± 3.2-25.1 ± 3.3 kg/m2, P = 0.031) groups. Systolic blood pressure decreased significantly in the intervention group (110 ± 10-106 ± 9 mm Hg; P = 0.041) but not diastolic blood pressure (66.0 ± 7-68.8 ± 8 mm Hg; P = 0.089). Exergaming for 8 weeks led to improvements in the microcirculation function in adolescents with overweighed or obesity. Clinical trials: NTC03532659.
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Affiliation(s)
- Thacira Dantas Almeida Ramos
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil.,UniFacisa, Departament of Medicine, Campina Grande, PB, Brazil
| | | | - José Natal Figueiroa
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil
| | | | - Tatianne Moura Estrela Gusmão
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil.,UniFacisa, Departament of Medicine, Campina Grande, PB, Brazil
| | - João Guilherme Bezerra Alves
- Instituto de Medicina Integral Prof. Fernando Figueira (IMIP), Department of Integral Medicine, Postgraduate Program in Integral Medicine, Recife, PE, Brazil
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From Metabolic Syndrome to Type 2 Diabetes in Youth. CHILDREN 2023; 10:children10030516. [PMID: 36980074 PMCID: PMC10047215 DOI: 10.3390/children10030516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 01/26/2023] [Accepted: 02/13/2023] [Indexed: 03/08/2023]
Abstract
In the frame of metabolic syndrome, type 2 diabetes emerges along a continuum of the risk from the clustering of all its components, namely visceral obesity, high blood pressure and lipids, and impaired glucose homeostasis. Insulin resistance is the hallmark common to all the components and, in theory, is a reversible condition. Nevertheless, the load that this condition can exert on the β-cell function at the pubertal transition is such as to determine its rapid and irreversible deterioration leading to plain diabetes. The aim of this review is to highlight, in the context of metabolic syndrome, age-specific risk factors that lead to type 2 diabetes onset in youth; resume age specific screening and diagnostic criteria; and anticipate potential for treatment. Visceral obesity and altered lipid metabolism are robust grounds for the development of the disease. Genetic differences in susceptibility to hampered β-cell function in the setting of obesity and insulin resistance largely explain why some adolescents with obesity do develop diabetes at a young age and some others do not. Lifestyle intervention with a healthy diet and physical activity remains the pillar of the type 2 diabetes treatment in youth. As to the pharmacological management, metformin and insulin have failed to rescue β-cell function and to ensure long-lasting glycemic control in youth. A new era might start with the approval for use in pediatric age of drugs largely prescribed in adults, such as dipeptidyl peptidase-4 and sodium-dependent glucose transport inhibitors, and of new weight-lowering drugs in the pipeline such as single and multiple agonists of the glucagon-like peptide 1 receptor. The latter drugs can have tremendous impact on the natural history of the disease. By treating diabetes, they will reduce the burden of all the metabolic abnormalities belonging to the syndrome while causing a tremendous weight loss hitherto never seen before.
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Castelli F, Valero-Breton M, Hernandez M, Guarda F, Cornejo J, Cabello-Verrugio C, Cabrera D. Regulatory Mechanisms of Muscle Mass: The Critical Role of Resistance Training in Children and Adolescent. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1410:21-34. [PMID: 36280657 DOI: 10.1007/5584_2022_743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Muscle mass and strength are subjected to several regulations. We found endocrine signals such as growth hormone, insulin-like growth factor 1, testosterone, thyroid hormones, and glucocorticoids among them. Neural inputs also influence muscle development, modulating mass and strength. Among the external stimuli that modulate these muscular features is physical training such as resistance and endurance training. Specifically, resistance training can mediate an increase in muscle mass by hypertrophy in adults, but the effects in children and adolescents are full of myths for most of the population. However, the evidence shows that the impact of resistance training on children and adolescents is clear and provides a wide range of benefits. However, qualified professionals must be available since exercise prescription and subsequent supervision must follow this population's abilities, needs, and interests.
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Affiliation(s)
- F Castelli
- Experimental Hepatology Laboratory, Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - M Valero-Breton
- Laboratory of Muscle Pathology, Fragility and Aging, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Millennium Institute on Immunology and Immunotherapy, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile
| | - M Hernandez
- Experimental Hepatology Laboratory, Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - F Guarda
- Departmento de Endocrinología, Escuela de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - J Cornejo
- Experimental Hepatology Laboratory, Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - C Cabello-Verrugio
- Laboratory of Muscle Pathology, Fragility and Aging, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile.
- Millennium Institute on Immunology and Immunotherapy, Faculty of Life Sciences, Universidad Andres Bello, Santiago, Chile.
- Center for the Development of Nanoscience and Nanotechnology (CEDENNA), Universidad de Santiago de Chile, Santiago, Chile.
| | - D Cabrera
- Experimental Hepatology Laboratory, Department of Gastroenterology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
- School of Medicine, Faculty of Medical Sciences, Universidad Bernardo O Higgins, Santiago, Chile.
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Machado E, Jannuzzi F, Telles S, Oliveira C, Madeira I, Sicuro F, Souza MDG, Monteiro A, Bouskela E, Collett-Solberg P, Farinatti P. A Recreational Swimming Intervention during the Whole School Year Improves Fitness and Cardiometabolic Risk in Children and Adolescents with Overweight and Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:17093. [PMID: 36554976 PMCID: PMC9778733 DOI: 10.3390/ijerph192417093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/14/2022] [Accepted: 12/16/2022] [Indexed: 06/17/2023]
Abstract
The benefits of swimming as a treatment for overweight children are undefined. We investigated the effects of recreational swimming on cardiometabolic risk in children/adolescents with normal and excess weight. Participants (n = 49, 26 girls, 10.3 ± 1.8 y) were grouped as 'eutrophic swimming' (EU-Swim, n = 14); 'excess weight swimming' (EW-Swim, n = 20) with an 'obese swimming' subgroup (OB-Swim, n = 10); and 'excess weight sedentary' (EW-Sed, n = 15) with an 'obese sedentary' subgroup (OB-Sed, n = 11). Swimming (50 min, twice/week, moderate-vigorous intensity) was an extra activity during the school year (6 + 3 months with a 3-month school break). Nutritional status, blood pressure (BP), physical activity, cardiorespiratory fitness, biochemical variables, autonomic modulation, endothelial function, abdominal fat, and carotid thickness were assessed at baseline, 6, and 12 months. Greater improvements (p < 0.05) occurred in EW-Swim vs. EW-Sed in body mass index (z-BMI, -16%, d+ 0.52), waist-to-height ratio (W/H, -8%, d+ 0.59-0.79), physical activity (37-53%, d+ 1.8-2.2), cardiorespiratory fitness (30-40%, d+ 0.94-1.41), systolic BP (SBP, -6-8%, d+ 0.88-1.17), diastolic BP (DBP, -9-10%, d+ 0.70-0.85), leptin (-14-18%, d+ 0.29-0.41), forearm blood flow (FBF, 26-41%, d+ 0.53-0.64), subcutaneous fat (SAT, -6%, d+ 0.18), and intra-abdominal fat (VAT, -16%, d+ 0.63). OB-Swim showed improvements vs. OB-Sed in TNFα (-17%, d+ 1.15) and adiponectin (22%, d+ 0.40). Swimming improved fitness and cardiometabolic risk in children/adolescents with overweight/obesity. (TCTR20220216001).
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Affiliation(s)
- Elisabeth Machado
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Fernanda Jannuzzi
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Silvio Telles
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Cecilia Oliveira
- Institute of Nutrition, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Isabel Madeira
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Fernando Sicuro
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
- Centre for Environment and Marine Studies, Department of Biology, University of Aveiro, 3810-193 Aveiro, Portugal
| | - Maria das Graças Souza
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Alexandra Monteiro
- Department of Radiology, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Eliete Bouskela
- Clinical and Experimental Research Laboratory on Vascular Biology, Biomedical Center, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Paulo Collett-Solberg
- Department of Pediatrics, Faculty of Medical Sciences, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro 20550-900, Brazil
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Shi J, Gao M, Xu X, Zhang X, Yan J. Associations of muscle-strengthening exercise with overweight, obesity, and depressive symptoms in adolescents: Findings from 2019 Youth Risk Behavior Surveillance system. Front Psychol 2022; 13:980076. [PMID: 36160591 PMCID: PMC9495934 DOI: 10.3389/fpsyg.2022.980076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 08/18/2022] [Indexed: 11/29/2022] Open
Abstract
Background Previous studies have focused on the opposite relation between muscle strength, obesity, and depression in adults. Moreover, the evidence has indicated that obesity and depression in adults might be significantly decreased with Muscle Strength Exercise (MSE) albeit it might be insufficient. Therefore, the current study aimed to investigate the association between MSE, adiposity, and depression among United States adolescents. Materials and methods This cross-sectional study used the Youth Risk Behavioral Survey (YRBS) data. In YRBS, a cluster sample was used, and the investigation was divided into three stages. The study surveyed 13,677 high school students and conducted self-reported questionnaires on sex, grade, race/ethnicity, MSE days, overweight, obesity, and depressive symptoms. The study got the nationally representative population of American students in Grade 9 to 12 (around 12–18 years). Results A total of 13,677 participants (female = 6,885, male = 6641) were included in the final analysis. The participants meeting the guidelines’ requirements seemed more likely to be obese than those not meeting (OR = 1.28, 95% CI = 1.06–1.55). There was no statistical significance in the relations between the MSE guidelines and overweight and depression (OR = 0.86, 95% CI = 0.73–1.01: OR = 0.94, 95% CI = 0.83–1.06). For all the participants, the prevalence of those conforming to MSE was 30.1%. One-fifth of the participants reported no MSE per week, 7.8% reported 3 days of MSE per week, and 7.7% reported 7 days. Conclusion The main finding of this study indicated a positive relationship between the normative MSE required in guidelines and low-level obesity. Beyond that, the evidence was insufficient to confirm the positive links between MSE and depression among American adolescents. Our study could offer evidence for future MSE interventions in adolescents.
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Affiliation(s)
- Jizu Shi
- Key Laboratory of Endurance Sport, Jilin Sport University, Changchun, China
| | - Mingjun Gao
- Foundation Department of Education, Shandong Communication and Media College, Jinan, China
| | - Xiao Xu
- China Basketball College, Beijing Sport University, Beijing, China
| | - Xuyang Zhang
- China Basketball College, Beijing Sport University, Beijing, China
- *Correspondence: Xuyang Zhang,
| | - Jin Yan
- Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia
- College of Human and Social Futures, University of Newcastle, Callaghan, NSW, Australia
- Jin Yan,
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Ribeiro B, Forte P, Vinhas R, Marinho DA, Faíl LB, Pereira A, Vieira F, Neiva HP. The Benefits of Resistance Training in Obese Adolescents: A Systematic Review and Meta-analysis. SPORTS MEDICINE - OPEN 2022; 8:109. [PMID: 36057914 PMCID: PMC9441407 DOI: 10.1186/s40798-022-00501-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/06/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Physical activity is essential in acquiring healthy lifestyle behaviors in the early years of maturational development and preventing various diseases. Resistance training (RT) is fundamental for improving body composition and is increasingly recommended for obese adolescents. A systematic review and meta-analysis were performed to synthesize and analyze data on the effects of RT programs in this population, seeking to develop useful recommendations for health and sports professionals. METHODS A search was performed using four databases (Web of Science, Scopus, PubMed, and ScienceDirect). According to specific inclusion criteria, twenty-one studies were selected to evaluate the impact of RT on body mass index (BMI), body fat, waist circumference, muscle strength, insulin sensitivity, lean mass and cardiorespiratory fitness. RESULTS After the RT programs, the adolescents improved their muscle strength (SMD, 1.44; 95% CI: 0.76-2.12), cardiorespiratory fitness (SMD, 1.09; 95% CI: 0.15-2.04), BMI (SMD, 0.21; 95% CI: 0.07-0.35), waist circumference (SMD, 0.27; 95% CI: 0.06-0.47) and body fat (SMD, 0.20; 95% CI: 0.05-0.34). However, insulin sensitivity (SMD, 0.32; 95% CI: - 0.47 to 1.10) and lean mass (SMD, 0.12; 95% CI: - 0.06 to 0.31) did not reveal any changes. Different RT programs were used but it seems that 2-3 times/week ∼60 min/session of RT for 12 weeks should be recommended for positive changes. CONCLUSIONS RT seems to be effective when the objective is to improve muscle strength, cardiorespiratory fitness and can be an efficient strategy to reduce obesity in adolescents by reducing body fat, waist circumference and body mass index. PROSPERO Registration number: CRD42022333411.
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Affiliation(s)
- Bruno Ribeiro
- Department of Sport Sciences, University of Beira Interior, Convento de Santo António, 6201-001, Covilhã, Portugal
| | - Pedro Forte
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 6200-151, Covilhã, Portugal
- Instituto Politécnico de Bragança, Bragança, Portugal
- Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal
| | - Raquel Vinhas
- NOVA School of Science and Technology, Universidade NOVA de Lisbon, Lisbon, Portugal
| | - Daniel A Marinho
- Department of Sport Sciences, University of Beira Interior, Convento de Santo António, 6201-001, Covilhã, Portugal
- Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal
| | - Luís B Faíl
- Department of Sport Sciences, University of Beira Interior, Convento de Santo António, 6201-001, Covilhã, Portugal
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 6200-151, Covilhã, Portugal
| | - Ana Pereira
- Department of Science and Technology, Polytechnic Institute of Setubal, 2910-761, Setúbal, Portugal
| | - Fernando Vieira
- KinesioLab - Research Unit in Human Movement, Piaget Institute, Lisbon, Portugal
- RECI - Research Unit in Education and Community Intervention, Piaget Institute, Lisbon, Portugal
- ISEIT de Almada, Piaget Instituto, Lisbon, Portugal
| | - Henrique P Neiva
- Department of Sport Sciences, University of Beira Interior, Convento de Santo António, 6201-001, Covilhã, Portugal.
- Higher Institute of Educational Sciences of the Douro, Penafiel, Portugal.
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7
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Lopes KG, das Graças Coelho de Souza M, da Costa Tavares Bezerra M, Bessa LM, Farinatti P, Bouskela E, Madeira M, Kraemer-Aguiar LG. Effects of physical training on physical and functional fitness, physical activity level, endothelial function, hemodynamic variables, bone metabolism, and quality of life of post-bariatric patients: study protocol for a randomized controlled trial. Trials 2022; 23:733. [PMID: 36056396 PMCID: PMC9438121 DOI: 10.1186/s13063-022-06677-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 08/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evidence of the benefits induced from resistance exercise on health markers of post-bariatric patients is limited. The study will investigate the effects of a resistance training (RT) program on muscle mass and strength, bone metabolism biomarkers, bone mineral density (BMD), bone microarchitecture, and endothelial function of patients subjected to Roux-en-Y gastric bypass. METHODS/DESIGN This randomized controlled trial will include 60 post-bariatric patients, physically inactive, aging 18 to 50 years, with a post-surgery period ≥ 12 months. They will be randomly assigned into two groups: (i) the non-exercised control group, which will receive the standard clinical follow-up, or (ii) the intervention group which will consist of RT (60 min/session; 3 times/week, for 6 months). The primary outcomes will include muscle mass and strength, bone metabolism biomarkers, BMD, and bone microarchitecture. The secondary outcomes will be anthropometry, hemodynamic measurements, cardiovascular risk factors, health-related quality of life (QoL), and endothelial function. Outcomes will be assessed by blood biomarkers of bone formation and reabsorption, dual X-ray absorptiometry, repetition maximum and handgrip strength tests, high-resolution peripheral quantitative computed tomography, 36-Item Short-Form Health Survey, venous occlusion plethysmography, and nailfold videocapillaroscopy. DISCUSSION It is expected that there are greater benefits from the RT program, possibly improving muscle mass and strength, bone metabolism, density and microarchitecture, QoL, and cardiovascular risk. TRIAL REGISTRATION ClinicalTrials.gov NCT04193397. Registered on 7 December 2019.
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Affiliation(s)
- Karynne Grutter Lopes
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. .,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. .,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Maria das Graças Coelho de Souza
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Michelle da Costa Tavares Bezerra
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Lucas Miranda Bessa
- Federal University of Rio de Janeiro - Endocrinology Division, Rio de Janeiro, RJ, Brazil
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Institute of Physical Education and Sports, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil.,Postgraduate Program in Exercise and Sports Sciences, University of Rio de Janeiro State, Rio de Janeiro, RJ, Brazil
| | - Eliete Bouskela
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Miguel Madeira
- Federal University of Rio de Janeiro - Endocrinology Division, Rio de Janeiro, RJ, Brazil
| | - Luiz Guilherme Kraemer-Aguiar
- Postgraduate Program in Clinical and Experimental Physiopathology, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Obesity Unit, Centro de Pesquisa Clínica Multiusuário (CePeM), Hospital Universitário Pedro Ernesto (HUPE), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Laboratory of Clinical and Experimental Research in Vascular Biology (BIOVASC), State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.,Endocrinology, Department of Internal Medicine, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Estébanez B, Huang CJ, Rivera-Viloria M, González-Gallego J, Cuevas MJ. Exercise Outcomes in Childhood Obesity-Related Inflammation and Oxidative Status. Front Nutr 2022; 9:886291. [PMID: 35859754 PMCID: PMC9289530 DOI: 10.3389/fnut.2022.886291] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 06/08/2022] [Indexed: 12/14/2022] Open
Abstract
Childhood obesity is identified as one of the major public health issues to increase the risk for cardiometabolic diseases and related complications in adulthood. The literature has supported inflammation and oxidative stress as the primary underlying mechanisms involved in the pathogenesis of obesity-related diseases. Epidemiological evidence consistently shows the benefits of physical activity in the improvement of obesity-mediated inflammation and oxidative stress status. In this narrative mini-review, the available scientific evidence on the potential effects of exercise in alleviating these susceptibilities in childhood obesity will be assessed.
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Affiliation(s)
- Brisamar Estébanez
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
- *Correspondence: Brisamar Estébanez,
| | - Chun-Jung Huang
- Exercise Biochemistry Laboratory, Department of Exercise Science and Health Promotion, Florida Atlantic University, Boca Raton, FL, United States
| | | | - Javier González-Gallego
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - María J. Cuevas
- Institute of Biomedicine (IBIOMED), University of León, León, Spain
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Effects of Strength Training on Body Fat in Children and Adolescents with Overweight and Obesity: A Systematic Review with Meta-Analysis. CHILDREN 2022; 9:children9070995. [PMID: 35883978 PMCID: PMC9319224 DOI: 10.3390/children9070995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/20/2022] [Accepted: 06/25/2022] [Indexed: 11/27/2022]
Abstract
Childhood overweight and obesity represent a growing public health problem worldwide. Since the 1980s, the global prevalence of overweight and obesity in childhood and adolescence has increased by 47%. The promotion of exercise is an important intervention to reduce the physical damage of obesity. The meta-analysis was conducted in accordance with the general guidelines for the reporting of systematic reviews and meta-analyses (PRISMA). The PubMed, SciELO, ScienceDirect and Google Scholar databases were searched from August to December 2021. The search yielded 722 titles published between 2000 and 2021. After screening the titles and abstracts, 64 duplicate articles were detected, and 27 articles were ultimately included in the systematic review, including 26 articles published in English and one published in Spanish. There was a statistically significant effect of the strength training interventions on the percentage of body fat, Test of 0 i = (p = 0.00, z = 6.92), Test of 0 = (p = 0.00, Q (9) = 42.63). The findings reveal that strength training has a positive impact on the treatment of body fat in children and adolescents with overweight and obesity.
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10
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Vasconcellos F, Cunha FA, Gonet DT, Farinatti PTV. Does Recreational Soccer Change Metabolic Syndrome Status in Obese Adolescents? A Pilot Study. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2021; 92:91-99. [PMID: 32083979 DOI: 10.1080/02701367.2019.1711007] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Accepted: 12/24/2019] [Indexed: 06/10/2023]
Abstract
Purpose: To evaluate whether a soccer program (RSP) might lower risk factors related to metabolic syndrome (MetS) in obese adolescents. Methods: A 12-week randomized controlled trial [RSP: n = 6 (2 girls), age = 13.9 ± 1.6 yr, body mass index = 30.5 ± 2.1 kg/m2; Control: n = 7 (2 girls); age = 14.7 ± 2.3 yr, body mass index: 30.8 ± 3.1 kg/m2] was conducted. Participants underwent anthropometric, body fractioning, blood pressure, lipid profile, and glucose tolerance assessments at baseline and post-intervention. MetS status was determined based on waist circumference and at least two additional criteria: high blood pressure, hypertriglyceridemia, dyslipidemia, and hyperglycemia. RSP included eutrophic and overweight adolescents and consisted of small-sided games (85 ± 4% maximal heart rate) performed three times/week. Results: High-density lipoprotein increased [(HDL) ∆15.5 ± 5.2 mg·dL-1; p = .01] and triglycerides lowered [(TG) ∆-34.7 ± 7.1 mg·dL-1; p = .02] after RSP intervention. Between-group differences were also detected for changes in HDL (∆13.0 ± 6.1 mg·dL-1; p = .04) and TG (∆-47.1 ± 7.7 mg·dL-1; p = .05). The presence of MetS lowered in RSP (5 in 6 participants; p = .02), but not Control (1 in 7 participants; p = .32). Conclusion: A 12-week RSP was effective to reduce MetS risk factors and status in obese adolescents.
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Current Perspectives on Management of Type 2 Diabetes in Youth. CHILDREN-BASEL 2021; 8:children8010037. [PMID: 33435250 PMCID: PMC7826614 DOI: 10.3390/children8010037] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 01/01/2021] [Accepted: 01/06/2021] [Indexed: 12/16/2022]
Abstract
The prevalence of type 2 diabetes mellitus (T2DM) in children and adolescents is on the rise, and the increase in prevalence of this disorder parallels the modern epidemic of childhood obesity worldwide. T2DM affects primarily post-pubertal adolescents from ethnic/racial minorities and those from socioeconomically disadvantaged backgrounds. Youth with T2DM often have additional cardiovascular risk factors at diagnosis. T2DM in youth is more progressive in comparison to adult onset T2DM and shows lower rates of response to pharmacotherapy and more rapid development of diabetes-related complications. Lifestyle modifications and metformin are recommended as the first-line treatment for youth with T2DM in the absence of significant hyperglycemia. Assessment of pancreatic autoimmunity is recommended in all youth who appear to have T2DM. Pharmacotherapeutic options for youth with T2DM are limited at this time. Liraglutide, a GLP-1 agonist, was recently approved for T2DM in adolescents 10 years of age and older. Several clinical trials are currently underway with youth with T2DM with medications that are approved for T2DM in adults. Bariatric surgery is associated with excellent rates of remission of T2DM in adolescents with severe obesity and should be considered in selected adolescents.
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Zouhal H, Ben Abderrahman A, Khodamoradi A, Saeidi A, Jayavel A, Hackney AC, Laher I, Algotar AM, Jabbour G. Effects of physical training on anthropometrics, physical and physiological capacities in individuals with obesity: A systematic review. Obes Rev 2020; 21:e13039. [PMID: 32383553 DOI: 10.1111/obr.13039] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/07/2020] [Accepted: 04/07/2020] [Indexed: 12/11/2022]
Abstract
Increasing the amount of physical activity is an important strategy for weight loss. This systematic review summarizes recent findings on the effects of physical training on anthropometric characteristics, physical performances and physiological capacities in individuals with overweight and obesity. A systematic literature search strategy was conducted from inception until June 2019 using four electronic databases that identified 2,708 records. After screening for titles, abstracts and full texts, 116 studies were included in our final analysis. Both aerobic (e.g., endurance training) and anaerobic training (e.g., high-intensity training, resistance training) improved body composition and physical fitness indicators in adults, adolescents and children with obesity (effect size: 0.08 < d < 2.67, trivial to very large). This systematic review suggests that both low- and high-intensity training significantly reduced body weight and fat mass while increasing fat-free mass in individuals with obesity (effect size: 0.04 <d <3.2, trivial to very large). A significant increase in VO2max also occurs in individuals with obesity in response to aerobic training or high-intensity interval training (effect size: 0.13 < d < 6.24, trivial to very large). Further studies are needed to define the optimal combination of training intensity and duration needed to produce the most efficacious results in individuals with obesity.
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Affiliation(s)
- Hassane Zouhal
- Department of Sport Sciences, University of Rennes, M2S (Laboratoire Mouvement, Sport, Santé), Rennes, France
| | | | - Arash Khodamoradi
- Young Researchers and Elite Club, Karaj Branch, Islamic Azad University, Karaj, Iran
| | - Ayoub Saeidi
- Department of Physical Education, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Ayyappan Jayavel
- SRM College of Physiotherapy, SRM Institute of Science and Technology, Kattankulathur Chengalpattu (DT), India
| | - Anthony C Hackney
- Department of Exercise & Sport Science; Department of Nutrition, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology& Therapeutics, University of British Columbia, Vancouver, Canada
| | - Amit M Algotar
- Department of Family and Community Medicine, University of Arizona Tucson, Arizona, USA
| | - Georges Jabbour
- Department of Sport Sciences, College of Arts and Sciences, Qatar University, Doha, Qatar
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13
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Brasil I, Monteiro W, Lima T, Seabra A, Farinatti P. Effects of judo training upon body composition, autonomic function, and cardiorespiratory fitness in overweight or obese children aged 8- to 13 years. J Sports Sci 2020; 38:2508-2516. [PMID: 32646282 DOI: 10.1080/02640414.2020.1792189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Physical training is recommended for obese paediatric populations. We investigated the effects of recreational judo training (JT) upon body composition and distribution, cardiorespiratory fitness, and heart rate variability (HRV) in overweight or obese children. A controlled trial (RBR-9d94td) was conducted with 35 children (8-13 years) assigned into groups according to their body mass index (BMI): eutrophic (EU; n = 15; z-BMI ≤ +l and ≥ -2) and overweight or obese (OB; n = 20; z-BMI > +1 and ≤ +3). The 12-week JT included 60-min sessions performed 2 times/week at 65-75% maximal heart rate (HR). BMI, waist circumference, blood pressure, HRV, peak oxygen uptake (VO2peak), gas exchange threshold (GET), and body fractioning were assessed. Significant reductions in OB (P < 0.05) occurred for whole body and trunk fat (~3%), trunk/limb fat-ratio (~4%), resting HR (~3%), and sympathovagal balance (log LF:HF, ~85%). Increases (P < 0.05) occurred in lean mass (~8%), parasympathetic modulation (log HF, ~4%), VO2peak (~5-10%), and VO2 (~15%), speed (~10%) and slope (~13%) at GET. Markers of cardiorespiratory fitness (relative VO2, slope and speed at GET) in OB approached EU after JT. In conclusion, a relatively short JT intervention to improved body composition, autonomic modulation, and physical fitness in obese children.
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Affiliation(s)
- Iedda Brasil
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil
| | - Walace Monteiro
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University , Niterói, Brazil
| | - Tainah Lima
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil
| | - André Seabra
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto , Porto, Portugal
| | - Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Exercise Science and Sports, University of Rio de Janeiro State , Rio de Janeiro, Brazil.,Graduate Program in Physical Activity Sciences, Salgado de Oliveira University , Niterói, Brazil
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14
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Exploring the feasibility of an exercise programme including aerobic and resistance training in people with limited cutaneous systemic sclerosis. Clin Rheumatol 2020; 39:1889-1898. [PMID: 31933034 PMCID: PMC7237402 DOI: 10.1007/s10067-019-04921-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Revised: 12/23/2019] [Accepted: 12/27/2019] [Indexed: 01/05/2023]
Abstract
Objectives It is suggested that exercise can improve the vascular function and quality of life (QoL) in people with systemic sclerosis (SSc), potentially offering clinical benefits to this population. Yet the feasibility of such an intervention remains untested. Therefore, the purpose of this study is to examine the feasibility of a combined exercise protocol (aerobic and resistance training) in people with limited cutaneous SSc (lcSSc). Methods Thirty-two lcSSc patients (66.5 ± 12 years old) were randomly allocated in two groups (exercise and control group). The exercise group underwent a 12-week exercise programme, twice per week. All patients performed the baseline, three- and six-month follow-up measurements where functional ability, body composition and QoL were assessed. Participants’ experiences were explored through interviews. Results Compliance was 92.6% with no dropouts. The individuals’ confidence to participate in the study’s exercise protocol for twice per week was 95%. The average value for the physical activity enjoyment scale was 103 ± 10 out of 119 (highest score). The mean values for the intention to engage in exercise twice per week were 6.4 ± 1 (likely) out of 7 (very likely). QoL for the exercise group showed to have a better life satisfaction, less anxiety and Raynaud’s phenomenon-accompanied pain. Conclusions Our results suggest that a combined exercise protocol was feasible for people with lcSSc, with no adverse events, resulting in high adherence and low attrition rates, high enjoyment levels and intentions for future engagement to this exercise. Thus, the specific protocol is a safe adjunct therapy for people with lcSSc. Trial registration:ClinicalTrials.gov (NCT number): NCT03058887, February 23, 2017, https://clinicaltrials.gov/ct2/show/NCT03058887?term=NCT03058887&rank=1Key Points • High-intensity interval training in combination with resistance training constitutes a feasible exercise protocol for people with lcSSc. • Overall, the exercise programme demonstrated high adherence and enjoyment levels and low attrition rates. • The exercise protocol was proved to be safe with no adverse events for people with lcSSc. |
Electronic supplementary material The online version of this article (10.1007/s10067-019-04921-7) contains supplementary material, which is available to authorized users.
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Oliveira CQ, Oliveira RB, Brasil IA, Junior LL, Mendes E, Monteiro WD, Farinatti P. Four-second dynamic exercise testing (T4S) for the assessment of cardiac vagal modulation in obese adolescents. Physiol Meas 2019; 40:115003. [PMID: 31627205 DOI: 10.1088/1361-6579/ab4f1d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Reduced vagal activity is often present in obese adolescents. Simple and practical strategies for the assessment of isolate parasympathetic outflow in this population are therefore useful. OBJECTIVES To compare the methods derived from heart rate variability (HRV) analysis at rest and 4 s exercise testing (T4S) for the assessment of cardiac parasympathetic modulation in adolescents classified as obese (OB) or with normal weight (NW). Additionally, associations between total and trunk fat versus autonomic modulation determined by the two methods were calculated. APPROACH A cross-sectional study was conducted with 50 adolescents (26 OB and 24 NW, 14.7 ± 1.5 years), comparing autonomic indices provided by HRV and T4S. Body fractioning was determined employing dual-energy x-ray absorptiometry (DXA). MAIN RESULTS The cardiac vagal index (CVI) obtained from T4S and standard time- and frequency-domain HRV measures were lower in OB versus NW (P ⩽ 0.05). Correlations between CVI and HRV indices of cardiac vagal modulation were as follows: CVI versus RMSSD (r = 0.44; P = 0.003); CVI versus pNN50 (r = 0.32; P = 0.04); CVI versus HF (r = 0.35; P = 0.02). Associations between body fat, android/gynoid ratio, and percent trunk fat versus CVI were of similar magnitude and direction than versus HRV indices. SIGNIFICANCE The T4S proved to be adequate to detect cardiac parasympathetic impairment in obese adolescents. Moreover, vagal modulation assessed by HRV and T4S inversely correlated with visceral adipose tissue. These findings along with the simplicity and safety of the T4S should encourage its use in the assessment of cardiac parasympathetic modulation in obese pediatric populations.
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Theis N, Le Warne M, Morrison SC, Drechsler W, Mahaffey R. Absolute and Allometrically Scaled Lower-Limb Strength Differences Between Children With Overweight/Obesity and Typical Weight Children. J Strength Cond Res 2019; 33:3276-3283. [DOI: 10.1519/jsc.0000000000003382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Exploring the microcirculatory effects of an exercise programme including aerobic and resistance training in people with limited cutaneous systemic sclerosis. Microvasc Res 2019; 125:103887. [DOI: 10.1016/j.mvr.2019.103887] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/15/2019] [Accepted: 06/15/2019] [Indexed: 12/13/2022]
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18
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Longlalerng K, Sonsuwan N, Uthaikhup S, Kietwatanachareon S, Kamsaiyai W, Panyasak D, Pratanaphon S. High-intensity interval training combined with resistance training improved apnea-hypopnea index but did not modify oxygen desaturation index and oxygen saturation nadir in obese children with obstructive sleep apnea. Sleep Breath 2019; 24:571-580. [PMID: 31338769 DOI: 10.1007/s11325-019-01899-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 07/03/2019] [Accepted: 07/11/2019] [Indexed: 01/12/2023]
Abstract
PURPOSE To investigate the effect of high-intensity interval training (HIIT) combined with resistance training (RT) on sleep indices and vascular functions in obese children with obstructive sleep apnea (OSA). METHODS A quasi-experimental study. Forty-four obese children with OSA were allocated into either an exercise intervention (n = 22) or a usual care control group (n = 22). The exercise group received 24 min of HIIT (> 60% heart rate reserved) and 20 min of RT (50-80% one-repetition maximum), three times per week for 8 weeks. Primary outcomes included the apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and oxygen saturation (SaO2) nadir. Secondary outcomes included the Sleep-Related Breathing Disorder-Pediatric Sleep Questionnaire (SRBD-PSQ) scores, vascular functions (flow-mediated dilation and mean blood flow velocity), and anthropometric variables. Outcomes were measured at baseline, at week 8, and at week 16. RESULTS No baseline differences were observed between groups. The compliance rate of exercise training was 99.47%. The AHI significantly decreased in the exercise group compared with the control group at week 16 (median AHI 1.30 to 0.60 and 1.00 to 1.60 episode/h, p = 0.01), but not at week 8. There were no differences between the groups in regard to the ODI and SaO2 nadir and any secondary outcomes at weeks 8 and 16 (all p > 0.05). CONCLUSIONS The eight-week HIIT combined with RT decreased AHI in obese children with OSA at week 16 follow-up. No changes in the ODI, SaO2 nadir, SRBD-PSQ, vascular function, and anthropometric outcomes were revealed at any time point. Further research is warranted.
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Affiliation(s)
- Khomkrip Longlalerng
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Nuntigar Sonsuwan
- Department of Otolaryngology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sureeporn Uthaikhup
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Suchart Kietwatanachareon
- Department of Radiologic Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Warunee Kamsaiyai
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Duanpen Panyasak
- Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand
| | - Sainatee Pratanaphon
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
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Sola-Rodríguez S, Gavilán-Carrera B, Vargas-Hitos JA, Sabio JM, Morillas-de-Laguno P, Soriano-Maldonado A. Physical Fitness and Body Composition in Women with Systemic Lupus Erythematosus. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E57. [PMID: 30795629 PMCID: PMC6410128 DOI: 10.3390/medicina55020057] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 02/13/2019] [Accepted: 02/18/2019] [Indexed: 11/17/2022]
Abstract
Background and objectives: Higher physical fitness is associated with a more favorable weight and body composition in the general population, although this association has not been studied in patients with systemic lupus erythematosus (SLE). The aim of the present study was to examine the association of different components of physical fitness with body composition in women with SLE with mild disease activity. Materials and Methods: This cross-sectional study included 77 women with SLE (43.2 ± 13.8 years old) and clinical stability during the previous 6 months. Body composition (including body mass index (BMI), fat mass index (FMI), waist circumference, waist-to-height ratio and waist-to-hip ratio) was assessed using a stadiometer, an anthropometric tape, and a bioimpedance device. Physical fitness included cardiorespiratory fitness (Siconolfi step test and 6 min walk test), muscular strength (handgrip strength test as upper body measure and 30 s chair stand as lower body measure), and flexibility (back-scratch test). Participants with a fitness level equal or above the median of the study sample were categorized as "fit" and those below the median were categorized as "unfit". Linear regression assessed the association of physical fitness with body composition parameters. Results: Cardiorespiratory fitness and upper body muscular strength were negatively associated with BMI, FMI, waist circumference, and waist-to-height ratio (all, p < 0.05). Lower body muscular strength and flexibility were negatively related to FMI, waist circumference, waist-to-height ratio, and waist-to-hip ratio (all, p < 0.05). These relationships were still significant after controlling for age, disease duration, accrual damage, and SLE activity. Overall, fit patients presented significantly lower values in all body composition parameters compared to unfit patients (all, p < 0.05). Conclusions: The main findings of the present study suggest that physical fitness is inversely associated with body composition in women with SLE. Given the cross-sectional nature of this study, future clinical trials should study the causal pathways underlying these relationships.
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Affiliation(s)
- Sergio Sola-Rodríguez
- Department of Education, Faculty of Education Sciences, University of Almería, Almería 04120, Spain.
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.
| | - José Antonio Vargas-Hitos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada 18014, Spain.
| | - José Mario Sabio
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada 18014, Spain.
| | - Pablo Morillas-de-Laguno
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería 04120, Spain.
- SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, 04120, Spain.
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Whooten R, Kerem L, Stanley T. Physical activity in adolescents and children and relationship to metabolic health. Curr Opin Endocrinol Diabetes Obes 2019; 26:25-31. [PMID: 30507695 PMCID: PMC6522241 DOI: 10.1097/med.0000000000000455] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW To summarize the recent developments relating to the role of physical activity in improving insulin resistance and metabolic syndrome in children and adolescents. RECENT FINDINGS The current literature strengthens previous findings on the relationship between physical activity and metabolic health in children; suggests a protective role for physical activity in the setting of obesity; examines population-specific findings; addresses specific effects of different modalities of physical activity in improving health; reveals potential mediators in the relationship between physical activity and metabolic health; and suggests new markers of metabolic health that could potentially be used as outcomes in future physical activity studies. SUMMARY Recent research generally confirms the role of physical activity in decreasing insulin resistance and metabolic syndrome in children and adolescents. However, the current literature is limited by unstandardized research methods and definitions, and also aggregation of different age groups, genders, and weight status. Future research should address these issues to offer targeted physical activity interventions.
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Affiliation(s)
- Rachel Whooten
- Department of Pediatrics, Division of Pediatric Endocrinology, Massachusetts General Hospital for Children
- Department of Pediatrics, Division of General Academic Pediatrics, Massachusetts General Hospital for Children
- Corresponding author: ; Massachusetts General Hospital for Children, 55 Fruit Street, Boston, MA, 02114
| | - Liya Kerem
- Department of Pediatrics, Division of Pediatric Endocrinology, Massachusetts General Hospital for Children
| | - Takara Stanley
- Department of Pediatrics, Division of Pediatric Endocrinology, Massachusetts General Hospital for Children
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Mitropoulos A, Gumber A, Crank H, Akil M, Klonizakis M. Investigating the effectiveness and feasibility of exercise on microvascular reactivity and quality of life in systemic sclerosis patients: study protocol for a feasibility study. Trials 2018; 19:647. [PMID: 30463598 PMCID: PMC6249907 DOI: 10.1186/s13063-018-2980-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 10/13/2018] [Indexed: 01/19/2023] Open
Abstract
Background Raynaud’s phenomenon is one of the first clinical manifestations observed in systemic sclerosis (SSc). This microvasculature disorder affects mostly the digits in over 95% of SSc patients, significantly affecting their health-related quality of life (HRQoL) and incurring higher hospital admissions and other healthcare costs. Exercise is known to improve both micro- and macrovascular function – aerobic exercise and resistance training, separately or combined, have been demonstrated to lead to significant vasculo-physiological improvements in conditions that present vasculopathy. However, the effects of a combined exercise programme on microcirculation in SSc patients has yet to be investigated. Therefore, the purpose of this study is to assess the effects of high-intensity interval training (HIIT) combined with circuit resistance training on the microvascular function in the digital area of SSc patients. Methods This will be a randomised controlled, feasibility trial with two arms, wherein 30 patients with SSc in receipt of medical treatment will be randomly assigned to usual care (medical treatment) or to a 12-week supervised exercise programme. Patients in the exercise group will undertake two, 45-min sessions each week consisting of 30 min HIIT (30 s 100% peak power output/30 s passive recovery) on the arm crank ergometer and 15 min of upper body circuit resistance training. Patients will be assessed before as well as at 3 and 6 months following randomisation. Primary outcomes of the study will be recruitment and retention rate, intervention acceptability and adherence to the exercise programme. Secondary outcomes include the digital area cutaneous microvascular function (laser Doppler fluximetry combined with iontophoresis), physical fitness, functional ability, upper back transcutaneous oxygen tension, body composition and quality of life (EQ-5D-5L). Selected interviews with a subsample of patients will be undertaken to explore their experiences of having Raynaud’s phenomenon and the acceptability of the exercise intervention and study procedures. Discussion Data from this study will be used to identify the feasibility of a combined exercise programme to be implemented in SSc patients, the acceptability of the intervention and the study design, and to determine the effects of exercise on the microvasculature. Overall, this study will provide sufficient data to inform and support a full multicentre clinical trial. Trial registration ClinicalTrials.gov (NCT number): NCT03058887, February 23, 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-2980-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alexandros Mitropoulos
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Anil Gumber
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - Helen Crank
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, S10 2BP, UK
| | - Mohammed Akil
- Rheumatology Department, Royal Hallamshire Hospital, Sheffield, UK
| | - Markos Klonizakis
- Centre for Sport and Exercise Science, Sheffield Hallam University, Sheffield, S10 2BP, UK.
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Mitropoulos A, Gumber A, Crank H, Akil M, Klonizakis M. The effects of upper and lower limb exercise on the microvascular reactivity in limited cutaneous systemic sclerosis patients. Arthritis Res Ther 2018; 20:112. [PMID: 29871697 PMCID: PMC5989435 DOI: 10.1186/s13075-018-1605-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 04/24/2018] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Aerobic exercise in general and high-intensity interval training (HIIT) specifically is known to improve vascular function in a range of clinical conditions. HIIT in particular has demonstrated improvements in clinical outcomes, in conditions that have a strong macroangiopathic component. Nevertheless, the effect of HIIT on microcirculation in systemic sclerosis (SSc) patients is yet to be investigated. Therefore, the purpose of the study was to compare the effects of two HIIT protocols (cycle and arm cranking) on the microcirculation of the digital area in SSc patients. METHODS Thirty-four limited cutaneous SSc patients (65.3 ± 11.6 years old) were randomly allocated in three groups (cycling, arm cranking and control group). The exercise groups underwent a 12- week exercise program twice per week. All patients performed the baseline and post-exercise intervention measurements where physical fitness, functional ability, transcutaneous oxygen tension (ΔTcpO2), body composition and quality of life were assessed. Endothelial-dependent as well as -independent vasodilation were assessed in the middle and index fingers using LDF and incremental doses of acetylcholine (ACh) and sodium nitroprusside (SNP). Cutaneous flux data were expressed as cutaneous vascular conductance (CVC). RESULTS Peak oxygen uptake increased in both exercise groups (p < 0.01, d = 1.36). ΔTcpO2 demonstrated an increase in the arm-cranking group only, with a large effect, but not found statistically significant,(p = 0.59, d = 0.93). Endothelial-dependent vasodilation improvement was greater in the arm-cranking (p < 0.05, d = 1.07) in comparison to other groups. Both exercise groups improved life satisfaction (p < 0.001) as well as reduced discomfort and pain due to Raynaud's phenomenon (p < 0.05). Arm cranking seems to be the preferred mode of exercise for study participants as compared to cycling (p < 0.05). No changes were observed in the body composition or the functional ability in both exercise groups. CONCLUSIONS Our results suggest that arm cranking has the potential to improve the microvascular endothelial function in SSc patients. Also notably, our recommended training dose (e.g., a 12-week HIIT program, twice per week), appeared to be sufficient and tolerable for this population. Future research should focus on exploring the feasibility of a combined exercise such as aerobic and resistance training by assessing individual's experience and the quality of life in SSc patients. TRIAL REGISTRATION ClinicalTrials.gov (NCT number): NCT03058887 , February 23, 2017.
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Affiliation(s)
- A. Mitropoulos
- Centre for Sport and Exercise Science, Collegiate Campus, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP UK
| | - A. Gumber
- Centre for Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - H. Crank
- Centre for Sport and Exercise Science, Collegiate Campus, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP UK
| | - M. Akil
- Rheumatology Department, Royal Hallamshire Hospital, Sheffield, UK
| | - M. Klonizakis
- Centre for Sport and Exercise Science, Collegiate Campus, Sheffield Hallam University, Collegiate Crescent, Sheffield, S10 2BP UK
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Legerlotz K. The Effects of Resistance Training on Health of Children and Adolescents With Disabilities. Am J Lifestyle Med 2018; 14:382-396. [PMID: 33281519 DOI: 10.1177/1559827618759640] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 01/16/2018] [Accepted: 01/26/2018] [Indexed: 11/15/2022] Open
Abstract
Many parents still hesitate to encourage their children to participate in resistance training programs. This is unfortunate since recent research shows that resistance training can positively affect children's health. This narrative review aims to present an overview of the health-associated effects resistance training can provide particularly in children and adolescents with disabilities by describing its effects on muscle strength, physical function, mental health, self-concept, obesity, and injury prevention. To illustrate the variety of possible fields of application, the effects of resistance training in children and adolescents suffering from Charcot-Marie-Tooth disease, cerebral palsy, Down syndrome, Ehlers-Danlos syndrome, joint hypermobility, juvenile idiopathic arthritis, obesity, and spina bifida are discussed. Although randomized controlled trials with a sufficiently large sample size are rare, the research presented in this review indicates that this mode of training might be a potent tool to improve mental and physical health by improving muscle strength, body composition, self-concept or functionality, reducing pain or injury risk, and strengthening bone or tendons even in the most vulnerable groups of children with physical or mental disability. Furthermore, it has to be emphasized that compared with other types of treatment resistance training is considered to be without adverse effects.
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Affiliation(s)
- Kirsten Legerlotz
- Department of Training and Movement Sciences, Humboldt-Universität zu Berlin, Germany
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Vargas-Ortiz K, Pérez-Vázquez V, Figueroa A, Díaz FJ, Montaño-Ascencio PG, Macías-Cervantes MH. Aerobic training but no resistance training increases SIRT3 in skeletal muscle of sedentary obese male adolescents. Eur J Sport Sci 2017; 18:226-234. [PMID: 29220206 DOI: 10.1080/17461391.2017.1406007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
In recent years, prevalence of obesity in children and adolescents has increased. A strategy for prevention and management of obesity is aerobic training (AT) due to its effectiveness to decrease fat mass. AT increases the content of SIRT3, a mitochondrial protein that increases the expression of PGC-1α and NFR1, thereby enhances mitochondrial function and metabolic health. Resistance training (RT) provides metabolic benefits but its effect on SIRT3 content is unknown. To compare the effect of AT and RT on SIRT3, PGC-1α and NRF-1 protein levels in skeletal muscle of sedentary obese adolescents. Twenty-seven sedentary obese male adolescents (age: 16.7 ± 0.9 years; BMI: 33.7 ± 4.3 kg/m2) completed a 1-month control period prior to randomization to one of two supervised exercise protocols: AT (3 days/week, 40 min/day, 70-80% peak heart rate) or RT (3 days/week, 11 exercises, 2 sets/exercise, 12 repetitions/set) for 12 weeks. Biopsies were obtained from the vastus lateralis muscle before and after 12 weeks to analyse SIRT3, PGC-1α and NRF-1 proteins content. Peak oxygen consumption (VO2peak) and anthropometric variables were evaluated before and after training. AT increased SIRT3 content, which was associated with improvements in PGC-1α content and body fat percentage. RT did not affect SIRT3 or PGC-1α. VO2peak increased only in AT. The increase in muscle mitochondrial SIRT3 was observed only following AT. In contrast, RT increased muscle mass without improving SIRT3 in obese male adolescents.
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Affiliation(s)
- Katya Vargas-Ortiz
- a Department of Medical Science , University of Guanajuato , Guanajuato , Mexico
| | | | - Arturo Figueroa
- c Department of Nutrition, Food, and Exercise Sciences , Florida State University , Tallahassee , FL , USA
| | - Francisco J Díaz
- b Division of Health Science, Department of Applied Work Science , University of Guanajuato , Guanajuato , Mexico
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Dubnov-Raz G, Berry EM. What paediatric obesity treatment programmes work, and how can we measure their success? Acta Paediatr 2017; 106:1724-1726. [PMID: 28869313 DOI: 10.1111/apa.14016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Gal Dubnov-Raz
- Exercise, Nutrition and Lifestyle Clinic; The Edmond and Lily Safra Children's Hospital; Sheba Medical Center; Tel Hashomer Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Elliot M. Berry
- Department of Human Nutrition and Metabolism; Braun School of Public Health; Hebrew University - Hadassah Medical Center; Jerusalem Israel
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Effects of resistance training on oxidative stress-related biomarkers in metabolic diseases: a review. SPORT SCIENCES FOR HEALTH 2017. [DOI: 10.1007/s11332-017-0402-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Boa BCS, Yudkin JS, van Hinsbergh VWM, Bouskela E, Eringa EC. Exercise effects on perivascular adipose tissue: endocrine and paracrine determinants of vascular function. Br J Pharmacol 2017; 174:3466-3481. [PMID: 28147449 DOI: 10.1111/bph.13732] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Revised: 01/20/2017] [Accepted: 01/23/2017] [Indexed: 12/11/2022] Open
Abstract
Obesity is a global epidemic, accompanied by increased risk of type 2 diabetes and cardiovascular disease. Adipose tissue hypertrophy is associated with adipose tissue inflammation, which alters the secretion of adipose tissue-derived bioactive products, known as adipokines. Adipokines determine vessel wall properties such as smooth muscle tone and vessel wall inflammation. Exercise is a mainstay of prevention of chronic, non-communicable diseases, type 2 diabetes and cardiovascular disease in particular. Aside from reducing adipose tissue mass, exercise has been shown to reduce inflammatory activity in this tissue. Mechanistically, contracting muscles release bioactive molecules known as myokines, which alter the metabolic phenotype of adipose tissue. In adipose tissue, myokines induce browning, enhance fatty acid oxidation and improve insulin sensitivity. In the past years, the perivascular adipose tissue (PVAT) which surrounds the vasculature, has been shown to control vascular tone and inflammation through local release of adipokines. In obesity, an increase in mass and inflammation of PVAT culminate in dysregulation of adipokine secretion, which contributes to vascular dysfunction. This review describes our current understanding of the mechanisms by which active muscles interact with adipose tissue and improve vascular function. Aside from the exercise-dependent regulation of canonical adipose tissue function, we will focus on the interactions between skeletal muscle and PVAT and the role of novel myokines, such as IL-15, FGF21 and irisin, in these interactions. LINKED ARTICLES This article is part of a themed section on Molecular Mechanisms Regulating Perivascular Adipose Tissue - Potential Pharmacological Targets? To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v174.20/issuetoc.
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Affiliation(s)
- B C S Boa
- Department of Physiology, VU University Medical Centre, Amsterdam, The Netherlands.,Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - J S Yudkin
- Department of Medicine, University College London, London, UK
| | - V W M van Hinsbergh
- Department of Physiology, VU University Medical Centre, Amsterdam, The Netherlands
| | - E Bouskela
- Laboratory for Clinical and Experimental Research on Vascular Biology (BioVasc), Biomedical Center, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - E C Eringa
- Department of Physiology, VU University Medical Centre, Amsterdam, The Netherlands
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