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Background To study the associations of Protein Tyrosine Phosphatase-N1 (PTPN1) polymorphisms with obesity-related phenotypes in European adolescents, and the influence of physical activity on these relationships. Methods Five polymorphisms of PTPN1 were genotyped in 1,057 European adolescents (12–18 years old). We measured several phenotypes related to obesity, such as adiposity markers, and biochemical and clinical parameters. Physical activity was objectively measured by accelerometry. Results The T, A, T, T and G alleles of the rs6067472, rs10485614, rs2143511, rs6020608 and rs968701 polymorphisms, respectively, were associated with lower levels of obesity-related phenotypes (i.e., body mass index, body fat percentage, hip circumference, fat mass index, systolic blood pressure and leptin) in European adolescents. In addition, the TATTG haplotype was associated with lower body fat percentage and fat mass index compared to the AACCA haplotype. Finally, when physical activity levels were considered, alleles of the rs6067472, rs2143511, rs6020608 and rs968701 polymorphisms were only associated with lower adiposity in active adolescents. Conclusions PTPN1 polymorphisms were associated with adiposity in European adolescents. Specifically, alleles of these polymorphisms were associated with lower adiposity only in physically active adolescents. Therefore, meeting the recommendations of daily physical activity may reduce obesity risk by modulating the genetic predisposition to obesity.

Resumen Antecedentes La evaluación de la condición física en jóvenes es importante desde el punto de vista educativo, deportivo y de salud. El proyecto FitBack, financiado por la Comisión Europea, ha desarrollado una herramienta que permite interpretar los resultados de la evaluación de la condición física en niños/as y adolescentes de forma individualizada. Objetivos (1) Presentar la base científica y valores de referencia sobre la que se construye la plataforma FitBack (2) Presentar la utilidad práctica de plataforma a las educadoras y educadores físico deportivos. Método Se han recopilado datos de jóvenes europeos de 6 a 19 años para crear valores de referencia de condición física. Se ha utilizado la batería de test ALPHA que ha demostrado previamente ser fiable, válida y relacionada con la salud. Con la batería ALPHA se mide la capacidad cardiorrespiratoria, fuerza muscular y antropometría. Los percentiles se obtuvieron utilizando el método GAMLSS. Resultados Se han recopilado en torno a 8.000.000 de datos de 34 países (106 bases de datos) para desarrollar los percentiles específicos para sexo y edad. Se ha generado una plataforma multilingüe e interactiva que permite la creación automática de informes individuales sobre los niveles de condición física y propuestas de mejora. Conclusión Este estudio muestra la base científica, valores de referencia y funcionalidad de la plataforma FitBack, que se presenta como una herramienta que ofrece múltiples posibilidades a las educadoras y educadores físico deportivos para valorar los niveles de condición física de la población joven.

Objectives(1) To develop reference values for health-related fitness European children and adolescents aged 6–18 years that are the foundation for the web-based, open-access and multi-language fitness platform (FitBack); (2) To provide comparisons across European countries.MethodsThis study builds on a previous large fitness reference study in European youth by: (1) widening the age demographic, (2) identifying the most recent and representative country-level data, and (3) including national data from existing fitness surveillance and monitoring systems. We used the ALPHA test battery as it comprises tests with the highest test-retest reliability, criterion/construct validity, and health-related predictive validity: the 20-m shuttle run (cardiorespiratory fitness); handgrip strength and standing long jump (muscular strength); and body height, body mass, body mass index, and waist circumference (anthropometry). Percentile values were obtained using the GAMLSS method.ResultsA total of 7,966,693 data points from 34 countries (106 datasets) were used to develop sex- and age-specific percentile values. In addition, country-level rankings based on mean percentiles are provided for each fitness test, as well as an overall fitness ranking. Finally, an interactive fitness platform, including individual and group reporting, and European fitness maps, is provided and freely available at www.fitbackeurope.eu.ConclusionsThis study discusses the major implications of fitness assessment in youth from a health, educational and sport perspective, and how the FitBack reference values and interactive web-based platform contribute to it. Fitness testing can be conducted in school and/or sport settings, and the interpreted results be integrated in the healthcare systems across Europe.What is already known on this topic-Fitness testing in youth is important from a health, educational and sport point of view.-The EU-funded ALPHA project reviewed the existing evidence and proposed a selection of field-based fitness tests that showed the highest test-retest reliability, criterion/construct validity, and health-related predictive validity among available tests.What this study adds-The FitBack project provides the most up-to-date and geographically diverse reference fitness values for 6-to 18-year-old Europeans.-This study introduces the first web-based, open-access, and multi-lingual fitness reporting platform (FitBack) providing interactive information and visual mapping of the European fitness landscape.How this study might affect research, practice, or policy-From a health perspective, very low fitness levels are a non-invasive indicator of poor health at both the individual and group level (e.g., school, region), which have utility for health screening and may guide public health policy. There are already examples of regional and national fitness testing systems that are integrated into the healthcare systems.-From an educational perspective, fitness testing is part of the school curriculum in many countries, and the FitBack platform offers physical education teachers an easy-to-use tool for interpreting fitness test results by sex and age.-From a sport perspective, these reference values can help identify young individuals who are talented in specific fitness components.

BACKGROUND Diabetes mellitus is a metabolic disorder that affects hundreds of millions of people worldwide and causes several million deaths every year. Such a dramatic scenario puts some pressure on administrations, care services, and the scientific community to seek novel solutions that may help control and deal effectively with this condition and its consequences. OBJECTIVE This study aims to review the literature on the use of modern mobile and wearable technology for monitoring parameters that condition the development or evolution of diabetes mellitus. METHODS A systematic review of articles published between January 2010 and July 2020 was performed according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Manuscripts were identified through searching the databases Web of Science, Scopus, and PubMed as well as through hand searching. Manuscripts were included if they involved the measurement of diabetes-related parameters such as blood glucose level, performed physical activity, or feet condition via wearable or mobile devices. The quality of the included studies was assessed using the Newcastle-Ottawa Scale. RESULTS The search yielded 1981 articles. A total of 26 publications met the eligibility criteria and were included in the review. Studies predominantly used wearable devices to monitor diabetes-related parameters. The accelerometer was by far the most used sensor, followed by the glucose monitor and heart rate monitor. Most studies applied some type of processing to the collected data, mainly consisting of statistical analysis or machine learning for activity recognition, finding associations among health outcomes, and diagnosing conditions related to diabetes. Few studies have focused on type 2 diabetes, even when this is the most prevalent type and the only preventable one. None of the studies focused on common diabetes complications. Clinical trials were fairly limited or nonexistent in most of the studies, with a common lack of detail about cohorts and case selection, comparability, and outcomes. Explicit endorsement by ethics committees or review boards was missing in most studies. Privacy or security issues were seldom addressed, and even if they were addressed, they were addressed at a rather insufficient level. CONCLUSIONS The use of mobile and wearable devices for the monitoring of diabetes-related parameters shows early promise. Its development can benefit patients with diabetes, health care professionals, and researchers. However, this field is still in its early stages. Future work must pay special attention to privacy and security issues, the use of new emerging sensor technologies, the combination of mobile and clinical data, and the development of validated clinical trials.

Additional file 3. Predicted time spent per day in total physical activity, moderate to vigorous PA and sedentary by country and stratified by children and adolescents.

Additional file 4. Physical activity outputs (CPM and MVPA) by “ActiGraph model”.

Additional file 1. Descriptive characteristics (mean, SD) of study participants by country. This table describes proportion of boys and girls, age and weight status within each country

Additional file 2. Accelelloremeter-assessed physical activity and sedentary time by region for the total sample and based on ages

Additional file 5. Odds ratio (95% CI) for being categorized as physically active by European region excluding participants

Table S1. Search equations for both databases. (DOCX 14 kb)

Supplementary Material

El objetivo de la presente revision sistematica fue realizar una busqueda acerca de la validez del perimetro de cuello como marcador de adiposidad en ninos y adolescentes asi como en poblacion adulta. Se realizo una busqueda sistematica de articulos publicados antes del 30 de junio de 2017, utilizando las bases de datos PubMed y Web of Science. Se buscaron estudios originales, en idioma espanol o ingles, que analizaran la asociacion entre el perimetro del cuello y al menos un marcador de adiposidad. En PubMed se usaron las categorias MeSH (medical subject heading).El criterio de busqueda utilizado fue: ((“neck circumference” or “neck diameter”) AND (“Body Composition”[Mesh] OR “Anthropometry”[Mesh])). Se repitio la busqueda en Web of Science. Se identifico un total de 494 estudios, de los cuales 47 fueron finalmente seleccionados para esta revision. El 66% de los estudios (16 en ninos y adolescentes y 15 en adultos) solo especifican que existe relacion entre perimetro del cuello e indicadores doblemente-indirectos tales como el indice de masa corporal, la circunferencia de cintura o ratio circunferencia cintura/cadera en ninos y adultos. Ademas, se observo que el perimetro del cuello se asocia de forma directa con marcadores de adiposidad indirectos, medidos mediante metodos de referencia tales como la tomografia axial computarizada (TAC) o la absorciometria dual de rayos X (DXA) en adultos, mientras que no se encontraron estudios en ninos. En conclusion, el perimetro del cuello se asocia a marcadores indirectos de masa grasa total y central en ninos y adolescentes, mientras que en adultos el perimetro del cuello se asocia a parametros de adiposidad medidos tanto con metodos indirectos como doblemente-indirectos. Se requieren nuevos estudios con metodos que analicen la asociacion entre el perimetro del cuello y la composicion corporal analizada mediante metodos de referencia, principalmente en ninos y adolescentes.

Additional file 1: Table S1. TaqMan™ OpenArray™ custom assay designs of candidate gene SNPs included in the present study. Table S2. Rationale for the inclusion of the 64 single nucleotide polymorphisms (SNPs) in the present study. Table S3. Thermal cycling conditions. Table S4. Further details of the single nucleotide polymorphisms (SNP) included in the present study. Table S5. Socio-demographic and clinical characteristics of the study samples. Table S6. Genotype frequencies of single nucleotide polymorphisms (SNP) in fibromyalgia (FM) and non-fibromyalgia (controls, HC) women.

The aim of this review was to determine what type of physical activity programmes have been developed in patients with fibromyalgia and what are its effects and benefits on the degree of pain and quality of life. The search was performed in MEDLINE, Web of Science and SPORTDiscus databases. The word "fibromyalgia" was always used as a criterion for combined search (using "AND" connector) with physical activity, exercise, physical therapy and training (MeSH terms). Of the 2,531 initial results, 33 papers were selected for review. The studies reviewed focus primarily on dance activities, water activities, multidisciplinary, mind-body work, fitness and stretching. After applying the intervention program, the pain level was reduced between 10 and 44.2%, and the impact of the disease between 5.3 and 17.9%, improving the symptoms of these patients. In conclusion, a multidisciplinary programme (in which physical activity is included) may have positive effects on the quality of life of people with fibromyalgia.

© 2014 American Society for Nutrition. Adolescence is a critical period, because major physical and psychologic changes occur during a very short period of time. Changes in dietary habits may induce different types of nutritional disorders and are likely to track into adulthood. The aim of this review is to describe the key findings related to nutritional status in European adolescents participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study. We performed a cross-sectional study in 3528 (1845 females) adolescents aged 12.5-17.5 y. Birth weight was negatively associated with abdominal fat mass in adolescents and serum leptin concentrations (in female adolescents), providing additional evidence for a programming effect of birth weight on energy homeostasis control. Breakfast consumption was associated with lower body fat content and healthier cardiovascular profile. Adolescents eat half of the recommended amount of fruit and vegetables and less than two-thirds of the recommended amount of milk and milk products but consume more meat and meat products, fats, and sweets than recommended. For beverage consumption, sugar-sweetened beverages, sweetened milk, low-fat milk, and fruit juice provided the highest amount of energy. Although the intakes of saturated fatty acids (FAs) and salt were high, the intake of polyunsaturated FAs was low. Adolescents spent, on average, 9 h/d of their waking time (66-71% and 70-73% of the registered time in boys and girls, respectively) in sedentary activities. Factors associated with adolescents' sedentary behavior included the following: 1) age; 2) media availability in the bedroom; 3) sleeping time; 4) breakfast consumption; and 5) season. Sedentary time was also associated with cardiovascular risk factors and bone mineral content. In European adolescents, deficient concentrations were identified for plasma folate (15%), vitamin D (15%), pyridoxal 59-phosphate (5%), β-carotene (25%), and vitamin E (5%). Scientists and public health authorities should raise awareness of the importance of a healthy and sustainable lifestyle as a foundation of the health of the European population, now and in the future.

Recommendations for Interventional Trials (SPIRIT) Checklist. (DOC 122 kb)

Summary Objective This study aimed to examine the association of television (TV) time, the frequency of meals while watching TV and the presence of TV set in the bedroom with total and abdominal obesity and to assess whether physical activity (PA) attenuates the obesity risk of TV viewing. Methods Cross-sectional data were obtained from 2200 adolescents (46% boys) from 10 European cities, The Healthy Lifestyle in Europe by Nutrition in Adolescence study, between 2006 and 2007. TV viewing, PA (by accelerometry) and body composition were measured. Binary logistic regression analyses were performed. Results Even adjusting by vigorous PA, TV in the bedroom (odds ratio [OR]: 1.33, 95% confidence interval [CI], 1.01–1.74) and >4 h d−1TV during week days (OR: 1.30, 95% CI, 1.02–1.67) (in boys) and eating every day with TV (OR: 1.18, 95% CI, 1.07–1.30) and >2 h d−1TV during weekend days (OR: 1.68, 95% CI, 1.25–2.26) (in girls) were significantly associated with total obesity. Likewise, in both sexes, having a TV set at bedroom was significantly associated with abdominal obesity. Conclusions Adolescents spending excessive TV time are prone to obesity independently of their PA levels. Families should put TV sets out of adolescents’ bedroom and keep TV sets off during meal times.

There is compelling evidence that genetic factors influence several phenotype traits related to physical performance and training response as well as to elite athletic status. Previous case-control studies showed that ∼20 genetic variants seem to be associated with elite endurance athletic status. The present review aims to introduce novel methodological approaches in the field of sports genetics research, which can be applied in the near future to analyse the genotype profile associated with elite athletic status. These include genotype–phenotype association studies using gene expression analysis, analysis of post-transcriptional factors, particularly microRNAs, genome-wide scan linkage or genome-wide association studies, and novel algorithm approaches, such as ‘genotype scores’. Several gaps in the current body of knowledge have been indentified including, among others: small sample size of most athletic cohorts, lack of corroboration with replication cohorts of different ethnic backgrounds (particularly, made up of non-Caucasian athletes), the need of research accounting for the potential role of epigenetics in elite athletic performance, and also the need for future models that take into account the association between athletic status and complex gene–gene and gene–environment interactions. Some recommendations are provided to minimize research limitations in the field of sport genetics.

Diet quality is influenced by socio-economic and geographical factors. The present study sought to assess whether adolescents' diet quality is affected by their parents' socio-economic status and whether the relationship between these factors is similar in northern and southern Europe. Data collected in the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study in eight European countries were analysed. Dietary intake data were recorded via repeated 24 h recalls (using specifically developed HELENA Dietary Intake Assessment Tool software) and converted into an adolescent-specific Diet Quality Index (DQI-AM). Socio-economic status was estimated through parental educational level (Par-Educ-Lev) and parental occupation level (Par-Occ-Lev) as reported by the adolescents in a specific questionnaire. The DQI-AM data were then analysed as a function of Par-Educ-Lev and Par-Occ-Lev in northern European countries (Austria, Belgium, France, Germany and Sweden) and southern European countries (Greece, Italy and Spain). We studied a total of 1768 adolescents (age 14·7 (sd 1·3) years; percentage of girls: 52·8 %; 1135 and 633 subjects from northern and southern Europe, respectively). On average, the DQI-AM score was higher in southern Europe than in northern Europe (69·1 (sd 0·1) v. 60·4 (sd 2·8), respectively; PP interaction = 0·004 for the mother and 0·06 for the father). The DQI was also positively correlated with Par-Occ-Lev (all P trends P interaction = 0·51 for the mother and 0·50 for the father). In conclusion, Par-Educ-Lev and Par-Occ-Lev are associated with diet quality in adolescents in Europe. However, this association differs between northern Europe and southern Europe.

Aim: To describe the effects of chronological age and biological age (pubertal development) on serum lipid and lipoprotein levels, body mass index (BMI) and waist circumference in Spanish adolescents. Methods: A representative Spanish sample of 526 adolescents (254 males and 272 females), were studied. Total cholesterol (TC), high density lipoprotein cholesterol (HDLc), triglycerides, apolipoprotein A1 and B, and lipoprotein(a) were measured, and low density lipoprotein cholesterol (LDLc) was calculated. Additional measurements included BMI and waist circumference. Adolescents were classified according to chronological age, and pubertal development (also age of menarche in females). Results: In males, serum TC levels were lower at late puberty in comparison with early puberty, and serum LDLc levels were lower at late puberty in comparison with mid and early puberty. Serum HDLc levels were lower at mid puberty in comparison with early and late puberty. Serum TC and LDLc levels were not different when analyzed according to chronological age. In females, HDLc levels were lower at late puberty in comparison with early and mid puberty, but no differences were found when HDLc and the other studied lipid and lipoprotein variables were analyzed according to chronological age, or age of menarche. All the observed differences persisted after adjusting for BMI and waist circumference. In female adolescents, both BMI and waist circumference were higher at late puberty in comparison with early and mid puberty, while in males, BMI and waist circumference were different when analyzed according to chronological age. Conclusion: The results suggest that the assessment of pubertal development may provide additional valuable information when interpreting lipid profile and body fat in adolescents. © Georg Thieme Verlag KG Stuttgart.

Ruiz, J.R;Ortega, F. B.;Moreno, L. A.;Wärnberg, Julia; González-Gross, M.;Marcos, Ascensión; et al., Objectives: To provide current reference values for serum lipid and lipoprotein levels in Spanish adolescents according to age and sex. Methods: A cross sectional study conducted in five representative Spanish cities (Granada, Madrid, Murcia, Santander and Zaragoza) including a representative sample of 581 adolescents (299 male and 282 female), aged 13 to 18.5 years. Age- and sex-specific means, standard deviations and percentiles were determined for: Total (TC), high density lipoprotein (HDLc) and low density lipoprotein (LDLc) cholesterol, triglycerides, apolipoprotein A-1 and B-100, and lipoprotein(a). Results: The 90th percentile for TC was 4.95 mmol/L for males and 5.19 mmol/L for females. HDLc levels were significantly higher in females of all age groups. LDLc levels ranged from 2.32 to 2.54 mmol/ L in males and from 2.38 to 2.62 mmol/L in females, peaking at 13 years of age in both sexes. Triglyceride levels tended to increase gradually and to peak at 17 years of age for both sexes. Apolipoprotein A-1 and B-100 levels paralleled those of HDLc and LDLc values, respectively. The geometric mean for lipoprotein(a) levels ranged from 0.44 to 0.57 μmol/L in males and from 0.50 to 0.67 μmol/L in females. Conclusions: The present study provides reference data on the distribution of lipid and lipoprotein levels of Spanish adolescents. © Birkhäuser Verlag, Basel 2006.

Introduccion y objetivos En diversos estudios se ha mostrado la relacion entre el nivel de forma fisica durante la infancia-adolescencia y el riesgo cardiovascular en la edad adulta. Dado que no se dispone de datos relativos al nivel de condicion fisica de los adolescentes espanoles, los objetivos de este estudio son: a) determinar el nivel de condicion fisica de los adolescentes espanoles y establecer valores de referencia que puedan ser utilizados en el medio sanitario y educativo como indicadores de salud cardiovascular, y b) conocer la proporcion de adolescentes espanoles que no alcanza valores de capacidad aerobica indicativos de salud cardiovascular futura. Sujetos y metodo Se ha utilizado la bateria EUROFIT modificada para evaluar la condicion fisica de una muestra representativa de adolescentes espanoles (n = 2.859; 1.357 varones y 1.502 mujeres) procedente del estudio AVENA (Alimentacion y Valoracion del Estado Nutricional de los Adolescentes). Resultados Se han obtenido los valores normativos de condicion fisica de la poblacion adolescente espanola. El rango del percentil 5 respecto a la capacidad aerobica maxima (test de Course Navette) es de 2,0-3,3 y 1,4-1,9 paliers para varones y mujeres, respectivamente. Casi 1 de cada 5 adolescentes presenta riesgo cardiovascular futuro sobre la base de su capacidad aerobica. Este subgrupo de adoles- centes mostro tambien una peor forma fisica que el resto de adolescentes en todas las pruebas fisicas realizadas. Conclusiones Los resultados obtenidos en el presente estudio permiten evaluar e interpretar correctamente el nivel de forma fisica de cualquier adolescente. Los resultados obtenidos indican la necesidad de mejorar el nivel de condicion fisica de los adolescentes espanoles.

We investigated the phenomenon of second wind in four patients with McArdle's disease: a brother and sister (aged 4 and 12 years respectively) and two unrelated patients, a boy of 14 and a 17-year-old girl. We also studied the siblings' healthy 6-year-old sister. Each patient performed a 15-min exercise test at a constant workload and a subsequent graded exercise test until exhaustion. Overall the healthy girl and the youngest McArdle's patient, the 4-year-old boy, did not show a second wind phenomenon. Further, the peak cardio-respiratory capacity of the young McArdle's boy was normal for his age (32.3 mL 02/kg/min) and he did not report any function limitations during physical education classes. 2.977 JCR (2009) Q2, 49/167 Clinical neurology, 105/231 Neurosciences UEM

Nueve triatletas hombres (68,0 ± 2,0 mL·kg-1·min-1, 25 ± 1,9 años, 68,3 ± 2,2 kg y 1,77 ± 0,22 m), realizaron un test incremental en cicloergómetro en tres ocasiones correspondientes con el inicio de la temporada, periodo precompetitivo y periodo competitivo. El consumo de oxígeno máximo y los umbrales ventilatorios (aeróbico y anaeróbico respectivamente) fueron medidos en cada visita. A pesar de los cambios en la distribución del entrenamiento entre disciplinas, tiempo total de entrenamiento, tiempo de entrenamiento por semana, e intensidad del entrenamiento, potencia máxima, consumo de oxígeno máximo, frecuencia cardiaca submáxima, y concentración de lactato permanecieron estables a lo largo de la temporada. Dada la estabilidad mostrada con la relación entre la frecuencia cardiaca y los umbrales ventilatorios en nuestra muestra, concluimos que un único test de laboratorio al comienzo de la temporada podría ser suficiente para prescribir intensidades de entrenamiento (al menos en ciclismo) basándose en zonas de frecuencia cardiaca en triatletas altamente entrenados. Estos resultados deberán ser comprobados además con muestras mayores para poder ser generalizados., Nine male triathletes (68.0 ± 2.0 mL·kg-1·min-1, 25 ± 1.9 years, 68.3 ± 2.2 kg, 177.4 ± 2.2 cm), performed an incremental maximal cycle exercise test on three separate occasions corresponding to the start of the season, pre-competitive period, and competitive period. Maximal oxygen uptake and ventilatory thresholds (aerobic and anaerobic respectively) were assessed in each visit. Despite changes in the distribution of training among disciplines, total training time, training time per week, and intensity of the training, maximal power output, maximal oxygen uptake, submaximal heart rate, and lactate concentration remained stable throughout the season. Due to the stability displayed by the heart rate ventilatory thresholds relationship in our sample, we conclude that a single laboratory testing at the start of the season could be enough to prescribe training intensities (at least for cycling) based on heart rate zones in highly trained triathletes. These results should be compared in future studies with longer samples in order to be generalised., Este estudio ha sido parcialmente financiado por la Universidad Politécnica de Madrid mediante una beca de doctorado a Zapico, AG. Así como el Programa Marier Curie – COFUND (contract UNITE 246565) a becado a Díaz, V., y el Ministerio de Ciencia e Innovación a Ruiz, J. (RYC-2010-05957) .

For centuries, the general consensus has been that vigorous, competitive exercise was harmful and shortened life expectancy. Recent data from prospective cohort studies conducted on marathon runners, professional cyclists, and Olympic athletes indicate, however, that regular intense endurance-exercise training has protective benefits against cardiovascular disease and premature death. There are still important questions to be answered, such as what is the optimal dose, in terms of both duration and intensity of training or competition, beyond which the health benefits of regular exercise stabilize or might even potentially disappear. 2.662 JCR (2014) Q1, 13/81 Sport sciences; Q2, 34/83 Physiology UEM

The aim of this review was to determine what type of physical activity programmes have been developed in patients with fibromyalgia and what are its effects and benefits on the degree of pain and quality of life. The search was performed in MEDLINE, Web of Science and SPORTDiscus databases. The word "fibromyalgia" was always used as a criterion for combined search (using "AND" connector) with physical activity, exercise, physical therapy and training (MeSH terms). Of the 2,531 initial results, 33 papers were selected for review. The studies reviewed focus primarily on dance activities, water activities, multidisciplinary, mind-body work, fitness and stretching. After applying the intervention program, the pain level was reduced between 10 and 44.2%, and the impact of the disease between 5.3 and 17.9%, improving the symptoms of these patients. In conclusion, a multidisciplinary programme (in which physical activity is included) may have positive effects on the quality of life of people with fibromyalgia.

Objective There is a substantial interest in the potential role of chocolate in the prevention of cardiovascular diseases. It has been recently reported that a higher frequency of chocolate intake is linked to lower body mass index (BMI) in adults. The aim of the present study was to determine if higher chocolate consumption also is associated with lower BMI, as well as other markers of total and central body fat, in adolescents. Methods This study comprised 1458 adolescents (ages 12.5–17.5 y) participating in HELENA-CSS (Healthy Lifestyle in Europe by Nutrition in Adolescence Cross-Sectional Study). Dietary intake was self-registered using a computer-based tool for 24-h dietary recall on 2 non-consecutive days. Weight and height were measured, and BMI was calculated. Adiposity was estimated using skinfolds (Slaughter's equation) and bioelectrical impedance analysis (BIA). Waist circumference was measured. Sexual maturation also was recorded. Physical activity was measured by accelerometry. Results Higher chocolate consumption was associated with lower levels of total and central fatness, as estimated by BMI, body fat estimated from skinfolds and BIA, and waist circumference, regardless of potential confounders ( P ≤ 0.01). Conclusion Our results demonstrate that a higher chocolate consumption was associated with lower total and central fatness in European adolescents.

We examined the association of cardiorespiratory fitness and fatness with health complaints and health risk behaviors in 691 (323 girls) Spanish children aged 6 to 17.9. Methods: Health complaints and health risk behaviors were self-reported using items of the Health Behavior in School-aged Children questionnaire. Weight and height were measured and body mass index was computed. Cardiorespiratory fitness was measured by the 20-m shuttle-run test, and youth categorized as fit/unfit. Results: Unfit youth were more likely to report health complaints sometime (OR: 2.556, 95% CI: 1.299–5.031; and OR: 1.997, 95% CI: 1.162–3.433, respectively) and health risk behaviors such as drinking alcohol sometime (OR: 5.142, 95% CI: 1.214–21.783; and OR: 2.413, 95% CI: 1.484–3.923) than their fit counterparts. Overweight-obese youth were more likely to report health complaints (OR: 1.732, 95% CI: 1.019–2.945; and OR: 1.983, 95% CI: 1.083–3.629, respectively). The analysis of the combined influence of fitness and fatness revealed that fit youth had lower health complaints index than the fat-unfit and unfat-unfit groups (all P < .05). Conclusions: Low fitness and overweight-obesity increased the risk of having health complaints in youth, yet high levels of cardiorespiratory fitness might overcome deleterious effects of overweight-obesity on health complaints.

OBJECTIVE:To examine the associations between active commuting to school and cognitive performance in adolescents. DESIGN:Cross-sectional study. SETTING Five cities (Granada, Madrid, Murcia, Santander, and Zaragoza) in Spain. PARTICIPANTS: A total of 1700 adolescents (892 girls) aged 13 to 18.5 years. Main Exposures Mode and duration of transportation to school and participation in extracurricular physical activity were self-reported. MAIN OUTCOME MEASURES: Cognitive performance (verbal, numeric, and reasoning abilities and an overall score) was measured by the Spanish version of the SRA Test of Educational Ability. RESULTS: Active commuting to school was associated with better cognitive performance (all P < .05) in girls but not in boys, independent of potential confounders including participation in extracurricular physical activity. In addition, adolescent girls who spent more than 15 minutes actively commuting to school had better scores in 3 of the 4 cognitive performance variables (all P < .05) than those who spent less time actively commuting to school (¿15 minutes) as well as better scores in all of the cognitive performance variables (all P < .001) than girls inactively commuting. CONCLUSION: Active commuting to school and its duration may positively influence cognitive performance in adolescent girls.

We studied the A55T, E164K, I225T, K153R and P198A variants in the myostatin (GDF8) gene, muscle strength and mass, and physical function during daily living in 41 nonagenarians [33 women, age range, 90, 97]. No participant carried a mutant allele of the aforementioned variants, except three participants (all women), who carried the R allele of the K153R polymorphism, with one of them (woman aged 96 years) being homozygous. Overall, in KR women muscle phenotype values (1RM leg press and estimated muscle mass) were low-to-normal compared to the whole group (approximately 25th-50th percentile), and their functional capacity (Barthel and Tinetti tests) was normal. In the woman bearing the RR genotype, values of muscle mass and functional capacity were below the 25th percentile. She is the first RR Caucasian whose phenotype has been characterised specifically. In summary, heterozygosity for the GDF8 K153R polymorphism does not seem to exert a negative influence on the muscle phenotypes of women who are at the end of the human lifespan, yet homozygosity might do so. More research on larger cohorts of nonagenarians is needed to corroborate the present findings. 6.280 JCR (2010) Q1, 4/45 Geriatrics & gerontology UEM

Background There is increasing evidence indicating that genes involved in certain metabolic processes of cardiovascular diseases may be of particular influence in people with low body weight at birth. We examined whether the apolipoprotein (APO) E, APOC3 and the peroxisome proliferator-activated receptor-γ-2 (PPARγ2) polymorphisms influence the association between low birth weight and blood lipid levels in healthy adolescents aged 13–18.5 years. Methods A cross-sectional study of 502 Spanish adolescents born at term was conducted. Total (TC) and high density lipoprotein cholesterol (HDLc), triglycerides (TG), apolipoprotein (apo) A and B, and lipoprotein(a) [Lp(a)] were measured. Low density lipoprotein cholesterol (LDLc), TC-HDLc, TC/HDLc and apoB/apoA were calculated. Results Low birth weight was associated with higher levels of TC, LDLc, apoB, Lp(a), TC-HDLc, TC/HDLc and apoB/apoA in males with the APOE ε3ε4 genotype, whereas in females, it was associated with lower HDLc and higher TG levels. In males with the APOC3 S1/S2 genotype, low birth weight was associated with lower apoA and higher Lp(a), yet this association was not observed in females. There were no associations between low birth weight and blood lipids in any of the PPARγ2 genotypes. Conclusion The results indicate that low birth weight has a deleterious influence on lipid profile particularly in adolescents with the APOE ε3/ε4 genotype. These findings suggest that intrauterine environment interact with the genetic background affecting the lipid profile in later life., The AVENA study was supported by the Spanish Ministry of Health Instituto de Salud Carlos III (FIS PI021830), the Spanish Ministry of Health, FEDER-FSE funds FIS n° 00/0015, CSD grants 05/UPB32/0, 109/UPB31/03 and 13/UPB20/04, the Spanish Ministry of Education (AP-2004-2745; EX-2007-1124), scholarships from Panrico S.A., Madaus S.A. and Procter and Gamble S.A.

Objective: To assess the association between birth weight and body composition and fat distribution in adolescents, and to test the possible sex-specific effect in these relationships. Methods and Procedures: A total of 1,223 adolescents 13-18.5 years old (553 male adolescents and 670 female adolescents) born at >35 weeks, were selected from a cross-sectional multicenter study conducted in five Spanish cities in 2000-2002. BMI was calculated from weight and height. Triceps and subscapular skinfold thickness (ST) were measured on the left side, and fat mass (FM) and fat-free mass (FFM) were estimated according to the equations of Slaughter et al. Subscapular skinfold adjusted by tricipital (ST) and waist circumference were used as markers of central adiposity. Results: Birth weight Z-score was positively associated with FFM in female adolescents (P < 0.001), but not in male adolescents, after controlling for age, pubertal stage, gestational age, socioeconomic status, physical activity, and current height (P < 0.001 for interaction between adjusted birth weight Z-score and sex). Adjusted birth weight Z-score was inversely associated with central adiposity in male and female adolescents as measured by ST (P = 0.026). Discussion: These results provide further evidence that gender has an important influence on the programming effect of birth weight on later FFM in adolescents because the effect was only observed in female adolescents. Our results suggest that small size for gestational age at birth could program more central subcutaneous fat deposition in adolescents of both sexes, but further research is needed on this issue. © 2008 The Obesity Society.

Objetivo: El consumo de tabaco entre los adolescentes así como la disminución de los niveles de práctica de actividad física constituyen un problema de salud pública. El objetivo es conocer la relación existente entre el consumo de tabaco y la práctica de actividad física. Ámbito: Adolescentes españoles escolarizados. Sujetos: 2.859 adolescentes españoles (1.357 hombres, 1.502 mujeres; rango de edad: 13-18,5 años) Intervenciones: Se aplica un cuestionario para conocer el consumo de tabaco y otros cuatro cuestionarios para conocer la práctica de actividad física en diferentes periodos de tiempo. Resultados: Un 40,8% de los adolescentes indicaron no practicar actividad física, mostrándose los varones más activos que las mujeres (p < 0,001). Un 29,9% de los adolescentes indicaron consumir tabaco habitualmente, no existiendo diferencias en función del sexo. Tanto en varones como en mujeres, los adolescentes activos manifiestan un menor consumo de tabaco (P ≤ 0,01). A mayor edad mayor consumo de tabaco y menor práctica de actividad física, tanto en varones como en mujeres (p < 0,001). Conclusiones: Los niveles de práctica de actividad física son bajos, siendo menores aún en el caso de las chicas. El consumo de tabaco muestra relación inversa con la práctica de actividad física, resultando los sujetos más activos físicamente los menos consumidores de tabaco., Objective: Cigarette smoking among adolescents as well as the level of physical activity constitutes a public health care issue. The aim is knowing the relationship between cigarette smoking and practice of physical activity. Setting: Schooled Spanish adolescents Subjects: 2859 Spanish adolescents (1357 boys, 1502 girls; age range: 13-18.5 years). Interventions: A questionnaire is applied to know the level of cigarette smoking and four other questionnaires to know the level of physical activity during different periods. Results: 40.8% of the adolescents stated not doing any physical activity at all, boys being more active than girls (p < 0.001). 29.9% of the adolescents stated usually smoking cigarettes, without differences by gender. Both active boys and girls stated smoking less (P ≤ 0.01). The greater the age, the higher cigarette smoking and the lower the level of physical activity, both in boys and girls (p < 0.001). Conclusions: The level of physical activity is low, being even lower for girls. Cigarette smoking shows a negative relationship with the level of physical activity, the individuals more physically active being those smoking the less., El estudio AVENA ha sido financiado por el Ministerio de Sanidad, fondos FEDER-FSE (FIS nº 00/0015), CSD grants 05/UPB32/0, 109/UPB31/03 y 13/UPB20/04, Ministerio de Educación (AP2002- 2920; AP2003-2128; AP-2004-2745), y grants from Panrico S.A., Madaus S.A., y Procter y Gamble S.A.

Several recent important studies have clearly shown that a low physical fitness represents a potent risk factor and even a predictor of both cardiovascular and all-causes morbidity and mortality. As a consequence, physical fitness assessment should be performed at the clinical level since, when properly assessed, it is a highly valuable health and life expectancy indicator. Based on the results of fitness assessment in a particular person and knowing his/her life style and daily physical activity, an individually adapted training program can be prescribed. This training program will allow that person to develop his/her maximal physical potential while improving his/her physical and mental health and attenuating the deleterious consequences of aging. In fact, physical exercise is today proposed as a highly effective means to treat and prevent major morbidity and mortality causes in industrialized countries. Most of these causes are associated with the aging process. In order to be effective, this type of intervention should be directed to improve the aerobic capacity and strength. In addition, it should be complemented with work directed to improve the general coordination and flexibility. Finally, diet optimization and use of nutritional supplements and legal ergogenic aids are key elements to improve the functional capacity and health, all of which is synonymous of anti-aging interventions.

Dehydration is one of the main problems associated to endurance sports. In order to avoid the negative effects of dehydration athletes tend to drink well above their current needs. The negative effect of drinking too much fluid is hyponatremia. Hyponatremia is defined as a plasma sodium concentration lower than 135 mmol/L. Hyponatremia is the first cause of severe illness in ultraendurance sports and has been associated with sudden death. In this article, we analyze the causes, consequences, associated factors, therapeutic treatment and prevention of ultraendurance sports-associated hyponatremia. It is concluded that an adequate fluid ingestion is the best method to avoid hyponatremia. There is not conclusive data about the amount and necessity of sodium supplementation to avoid hyponatremia. However, it might be that it is not necessary to ingest additional sodium to prevent the development of hyponatremia in athletes who only partially replace their fluid losses during prolonged exercise.

Tool replacement operations have a great influence over the cost of machined parts. At present, the common criteria used to determine the tool life do not optimize the use of tools and lead to significant economic losses. The main objective of this work is to define a new procedure to improve the decision about the time for tool replacement. The approach followed is based on digital images of the cutting edge that has already been explored in the literature. The novelty of the present work relies on the use of contour signatures of the wear region as the input to two techniques of classification, k-nearest neighbour and a neural network. The influence of the signature size vector is also analysed. A total of 1383 flank wear images were acquired and the error rate estimation was about 5%.

OBJECTIVES: The purpose of the current study was to compare physical activity (PA) levels and sedentary time between two accelerometers, the SenseWear Pro3 Armband (SWA) and the Actigraph GT1M, in Spanish female fibromyalgia patients. METHODS: Patients wore the SWA and the Actigraph for 7 consecutive days. Total minutes/day spent in sedentary, light, moderate and moderate-to-vigorous PA were analysed. The agreement between the SWA and the Actigraph were assessed by using Bland-Altman plots. RESULTS: Total PA, light, moderate, and moderate-vigorous PA levels in total-week, weekdays and weekends were higher (all, p ≤ 0.001), and sedentary time in total-week, weekdays and weekends lower (all, p

To investigate the usefulness of tenderness (tender points count (TPC) and algometer score) to characterise fibromyalgia (FM) severity and symptomatology in women.The study sample comprised 174 women aged 51±7 years. We ossesse tenderness using pressure algometry; quality of life by means of the Short-Form 36 Health Survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). We used the FM impact questionnaire (FIQ) to assess FM severity and symptomatology. Patients were categorised according to three FIQ-derived categories: FIQ70 vs. ≥70; FIQ59 vs. ≥59; and FM-type I and II.TPC was significantly higher in the group of patients with FIQ≥59 (16.9±2 vs. 15.6±4, p=0.02), whereas no differences between groups were observed according to FIQ≥70 (17.0±2 vs. 16.2±3, p=0.12) or FM type (16.8±3 for type II vs. 15.9±4 for type I, p=0.13). We observed a significant association between TPC and FIQ-job difficulty, pain, morning tiredness and stiffness dimensions (all p0.05), yet it was not correlated with total score of FIQ, FIQ-anxiety, fatigue and depression dimensions (all p0.05). Algometer score was lower in the FIQ≥70 (45.7±12 vs. 51.1±14, p=0.05) and FIQ≥59 (46.7±13 vs. 52.7±14, p=0.05) groups, and there were no difference between FM types (48.7±13 vs. 49.5±14 for type II and I respectively, p=0.81). Algometer score was not associated with total score of FIQ or FIQ dimensions (all p≥0.1).Widespread pain and pain hypersensitivity, as measured by TPC and algometer score, do not seem to be useful to characterise FM severity and symptomatology (measured by FIQ) in women.