Structural Equation Modelling for Predicting the Relative Contribution of Each Component in the Metabolic Syndrome Status Change

Associations of Estimated Pulse Wave Velocity with Body Mass Index and Waist Circumference among General Korean Adults

The correlation between body fat parameters and arterial stiffness is still under debate. This study aimed to examine the associations of body mass index (BMI) and waist circumference (WC) with estimated pulse wave velocity (ePWV). We utilized data from 14,228 subjects (mean age 53.4 ± 16.8 years; 56.9% were female) from the Korean National Health and Nutrition Examination Survey. The ePWV was calculated using a formula based on age and blood pressure. Simple linear correlation analyses revealed significant associations between both BMI and ePWV (r = 0.098; p < 0.001) and WC and ePWV (r = 0.291; p < 0.001), with a stronger correlation observed between WC and ePWV. Multiple linear regression analysis demonstrated that WC remained significantly associated with ePWV after adjusting for potential confounders (β = 0.020; p = 0.001). However, a statistically significant association was not found between BMI and ePWV (β = 0.011; p = 0.076). Multiple binary logistic regression analysis further indicated that both higher BMI and WC were independently associated with higher ePWV, but the association was more pronounced between WC and ePWV than between BMI and ePWV. These findings underscore a stronger correlation between visceral obesity (as indicated by WC) and arterial stiffness (as indicated by ePWV) compared to overall obesity (as indicated by BMI). This highlights the potential significance of abdominal obesity in assessing cardiovascular risk.

A Deep Learning Neural Network to Classify Obesity Risk in Portuguese Adolescents Based on Physical Fitness Levels and Body Mass Index Percentiles: Insights for National Health Policies

The increasing prevalence of overweight and obesity among adults is a risk factor for many chronic diseases and death. In addition, obesity among children and adolescents has reached unprecedented levels and studies show that obese children and adolescents are more likely to become obese adults. Therefore, both the prevention and treatment of obesity in adolescents are critical. This study aimed to develop an artificial intelligence (AI) neural network (NNET) model that identifies the risk of obesity in Portuguese adolescents based on their body mass index (BMI) percentiles and levels of physical fitness. Using datasets from the FITescola^® project, 654 adolescents aged between 10-19 years old, male: 334 (51%), female: n = 320 (49%), age 13.8 ± 2 years old, were selected to participate in a cross-sectional observational study. Physical fitness variables, age, and sex were used to identify the risk of obesity. The NNET had good accuracy (75%) and performance validation through the Receiver Operating Characteristic using the Area Under the Curve (ROC AUC = 64%) in identifying the risk of obesity in Portuguese adolescents based on the BMI percentiles. Correlations of moderate effect size were perceived for aerobic fitness (AF), upper limbs strength (ULS), and sprint time (ST), showing that some physical fitness variables contributed to the obesity risk of the adolescents. Our NNET presented a good accuracy (75%) and was validated with the K-Folds Cross-Validation (K-Folds CV) with good accuracy (71%) and ROC AUC (66%). According to the NNET, there was an increased risk of obesity linked to low physical fitness in Portuguese teenagers.

Prevalence of Type 2 Diabetes, Impaired Fasting Glucose, and Diabetes Risk in an Adult and Older North-Eastern Portuguese Population

The aims of this study were (1) to evaluate the prevalence of type 2 diabetes (T2D) in a middle-aged north-eastern Portuguese population, (2) to analyze the prevalence of impaired fasting glucose (IFG), and (3) to assess the risk of T2D in this community-based sample. An exploratory, retrospective, and cross-sectional study was conducted from a total of 6570 individuals aged 18-102 years, among which 3865 were women (57.4 ± 18.1 years) and 2705 were men (60.0 ± 16.8 years). T2D diagnosis, IFG, and the diabetes risk score (low to very high risk) were assessed. The prevalence of T2D in this adult and an older north-eastern Portuguese population was 17.4%. A higher prevalence of T2D was reported in men (22.2%) than in women (14.0%); however, this was without significant differences (p = 0.086). Otherwise, the prevalence of T2D was significantly different among the age groups and increased with age (p < 0.001). Regarding IFG, a higher percentage of cases was observed in men (14.1%) than in women (8.4%) (p < 0.001). The risk of developing T2D in the next 10 years showed an association with sex and age group (p < 0.001) with a small-to-moderate effect (V = 0.1-0.3). Men and the elderly had the highest percentage of cases in the moderate-to-very high-risk bands. The current research confirmed a higher prevalence of T2D, IFG, and diabetes risk than previous Portuguese epidemiological reports. The results also suggest potential prediabetes cases, which should be carefully monitored. The current research adds evidence to the worldwide trend of the increasing prevalence of T2D and intermediate hyperglycemia (i.e., prediabetes).

Comparison of the Portuguese Version of the Pregnancy Physical Activity Questionnaire (PPAQ) with Accelerometry for Classifying Physical Activity among Pregnant Women with Obesity

In recent years, the number of pregnant women with obesity has increased exponentially; thus, it is important to evaluate and characterize the physical activity levels of this specific group. The aim of this study is to evaluate the reliability and validity of the Portuguese version of the Physical Activity and Pregnancy Questionnaire and Pregnancy Questionnaire in pregnant women with obesity and to classify physical activity using the Physical Activity and Pregnancy Questionnaire and accelerometry. An analytical observational study was carried out between May and August of 2019 at the University Hospital Center of São João, with a sample of 31 pregnant women with obesity (30.9 ± 4.6 years 36.5 ± 4.6 kg/m² of BMI and 21.5 ± 9 gestational weeks). The physical activity of participants was evaluated using an accelerometer and Physical Activity and Pregnancy Questionnaire at two time points (the first visit at the moment of consultation and the second seven days after, with accelerometer retest), the interclass correlation coefficient was used to test reliability between the Physical Activity and Pregnancy Questionnaire filled out at visit1 and the Physical Activity and Pregnancy Questionnaire filled out at visit2, and Pearson's correlation was used to determine validity between the Physical Activity and Pregnancy Questionnaire and accelerometry. The interclass correlation coefficient values for total activity were 0.95, 0.97 for moderate and 0.58 for vigorous intensities. It ranged from 0.74 for sports/exercise to 0.96 for domestic activities. The Pearson's correlations showed that the Physical Activity and Pregnancy Questionnaire is moderately valid for moderate intensity (r = 0.435). A total of 67.7% of the pregnant women complied with international physical activity recommendations.

Coach leadership in a crisis context: Investigating effective coach behaviors during the COVID-19 pandemic with a process view

Introduction

Drawing from the crisis leadership conceptualization, this study aims to investigate coaches' opinion patterns on effective leadership behaviors during the COVID-19 pandemic. The study used a process view to explore how coaches as leaders act in pre, during, and post-crisis phases.

Method

Thirty-two fulltime professional coaches (28 males and 4 females) from individual and team sports who experienced the entire COVID-19 pandemic from January 2020 to July 2021 in the United Kingdom were invited to express their perceptions of effective leadership behaviors. The study used Q methodology to analyze coaches' perceptions and experiences.

Result

The study revealed that the most effective coach leadership behaviors occurred during-crisis phase, which has the most positive ratings (n = 48) compared to the pre-and post-crisis phases (n = 18). The study's main findings highlighted different phases of the COVID-19 pandemic demand various effective countermeasures from coaches. These practical and successful experiences were summarized as: division of labor, athlete-centered, team-driven, consulting, safe environment, and online coaching.

Discussion

The findings of this study further highlight (1) the importance of coach leadership in creating a safe environment as it provides a much better platform to prepare for a pre-crisis stage, (2) that coaches should employ more positive than negative behaviors while interacting with team members more frequently especially during the crisis period, reducing athletes' negative feelings such as anxiety and worry, and (3) that the online training-related activities and interactions during the crisis time can be expanded to noncrisis times, as a crisis event can have positive implications for the future if handled properly.

Association of Absolute and Relative Handgrip Strength with Prevalent Metabolic Syndrome in Adults: Korea National Health and Nutrition Examination Survey 2014-2018

Maintaining or improving muscular strength may be a key preventive strategy for metabolic syndrome (MetS). However, whether the association of handgrip strength (HGS), as a well-established marker of whole-body muscular strength, with the prevalent metabolic syndrome (MetS) varies with age stratification remains unclear. Additionally, whether absolute of relative HGS is superior to another in predicting MetS is less clear. We examined the association of both relative and absolute HGS with the prevalence of MetS in different age groups. Korean adults aged ≥19 years (n = 28,146; 55.7% female) from the Korean National Health and Nutrition Examination Survey (2014-2018) were examined. HGS was categorized using tertile split (highest, intermediate, lowest) and participants were stratified into different age groups at 10-year intervals. Multivariable logistic regression models were used to examine the association between absolute/relative HGS tertiles and MetS with adjustment for covariates. Lower odds of MetS were observed across lower absolute HGS tertiles and the associations were significant in young participants (19-29 years) in both sexes (odds ratio (OR): 0.59 (95% CI: 0.38-0.92) for intermediate and OR: 0.55 (95% CI: 0.34-0.89) for lowest in males; OR: 0.36 (95% CI: 0.20-0.65) for intermediate and OR: 0.42 (95% CI: 0.24-0.74) for lowest in females; all p < 0.05). By contrast, higher odds of MetS were observed across lower relative HGS in all age groups in both sexes (in total participants, OR: 2.32 (95% CI: 2.06-2.62) for intermediate and OR: 3.69 (95% CI: 3.27-4.16) for lowest in males and OR: 2.04 (95% CI: 1.83-2.28) for intermediate and OR: 3.28 (95% CI: 2.94-3.65) for lowest in females all p < 0.05). The associations of both absolute and relative HGS with MetS attenuated with an increase in age. Our findings suggest that poor relative HGS, as a marker of muscular strength, and not absolute HGS, may be associated with a higher risk of MetS in adults. Our findings also suggest that relative HGS may overestimate MetS in young adults.