Ana Cecilia Aguilar de Plata

Aerobic exercise during pregnancy improves health-related quality of life: a randomised trial

QUESTION Does supervised aerobic exercise during pregnancy improve health-related quality of life in nulliparous women? DESIGN Analysis of secondary outcomes of a randomised trial with concealed allocation, blinded assessors, and intention-to-treat analysis. PARTICIPANTS 64 nulliparous, pregnant women attending for prenatal care at one of three tertiary hospitals. INTERVENTION The experimental group completed a 3-month supervised exercise program, commencing at 16 to 20 weeks of gestation. Each session included walking (10 min), aerobic exercise (30 min), stretching (10 min), and relaxation (10 min). The control group continued usual activities and performed no specific exercise. OUTCOME MEASURES The primary outcome was health-related quality of life assessed by the Colombian version of the Medical Outcome Study Short-Form Health Survey at baseline and immediately after the 3-month intervention. RESULTS Fifty women completed the study. After the 3-month intervention, the experimental group had improved their health-related quality of life more than the control group in the physical component summary of the questionnaire by 6 points (95% CI 2 to 11), the physical function domain (7 points, 95% CI 0 to 14), the bodily pain domain (7 points, 95% CI 1 to 13) and the general health domain (5 points, 95% CI 1 to 10). CONCLUSIONS A supervised 3-month program of primarily aerobic exercise during pregnancy improves health-related quality of life. TRIAL REGISTRATION NCT00741312.

Influence of regular aerobic exercise on endothelium-dependent vasodilation and cardiorespiratory fitness in pregnant women

Aim:  To evaluate the effect of regular aerobic exercise on the endothelial function and cardiorespiratory fitness in pregnant women.

Effect of Exercise Training on Enos Expression, NO Production and Oxygen Metabolism in Human Placenta

Objective To determine the effects of combined aerobic and resistance exercise training during the second half of pregnancy on endothelial NOS expression (eNOS), nitric oxide (NO) production and oxygen metabolism in human placenta. Methods The study included 20 nulliparous in gestational week 16–20, attending prenatal care at three tertiary hospitals in Colombia who were randomly assigned into one of two groups: The exercise group (n = 10) took part in an exercise session three times a week for 12 weeks which consisted of: aerobic exercise at an intensity of 55–75% of their maximum heart rate for 60 min and 25 mins. Resistance exercise included 5 exercise groups circuit training (50 repetitions of each) using barbells (1–3 kg/exercise) and low-to-medium resistance bands. The control group (n = 10) undertook their usual physical activity. Mitochondrial and cytosol fractions were isolated from human placental tissue by differential centrifugation. A spectrophotometric assay was used to measure NO production in cytosolic samples from placental tissue and Western Blot technique to determine eNOS expression. Mitochondrial superoxide levels and hydrogen peroxide were measured to determine oxygen metabolism. Results Combined aerobic and resistance exercise training during pregnancy leads to a 2-fold increase in eNOS expression and 4-fold increase in NO production in placental cytosol (p = 0.05). Mitochondrial superoxide levels and hydrogen peroxide production rate were decreased by 8% and 37% respectively in the placental mitochondria of exercising women (p = 0.05). Conclusion Regular exercise training during the second half of pregnancy increases eNOS expression and NO production and decreases reactive oxygen species generation in human placenta. Collectively, these data demonstrate that chronic exercise increases eNOS/NO production, presumably by increasing endothelial shear stress. This adaptation may contribute to the beneficial effects of exercise on the vascular and antioxidant system and in turn reduce the risk of preeclampsia, diabetes or hypertension during pregnancy.

A factorial randomized controlled trial to evaluate the effect of micronutrients supplementation and regular aerobic exercise on maternal endothelium-dependent vasodilatation and oxidative stress of the newborn

BackgroundMany studies have suggested a relationship between metabolic abnormalities and impaired fetal growth with the development of non-transmissible chronic diseases in the adulthood. Moreover, it has been proposed that maternal factors such as endothelial function and oxidative stress are key mechanisms of both fetal metabolic alterations and subsequent development of non-transmissible chronic diseases. The objective of this project is to evaluate the effect of micronutrient supplementation and regular aerobic exercise on endothelium-dependent vasodilation maternal and stress oxidative of the newborn.Methods and design320 pregnant women attending to usual prenatal care in Cali, Colombia will be included in a factorial randomized controlled trial. Women will be assigned to the following intervention groups: 1. Control group: usual prenatal care (PC) and placebo (maltodextrine). 2. Exercise group: PC, placebo and aerobic physical exercise. 3. Micronutrients group: PC and a micronutrients capsule consisting of zinc (30 mg), selenium (70 μg), vitamin A (400 μg), alphatocopherol (30 mg), vitamin C (200 mg), and niacin (100 mg). 4. Combined interventions Group: PC, supplementation of micronutrients, and aerobic physical exercise. Anthropometric measures will be taken at the start and at the end of the interventions.DiscussionSince in previous studies has been showed that the maternal endothelial function and oxidative stress are related to oxidative stress of the newborn, this study proposes that complementation with micronutrients during pregnancy and/or regular physical exercise can be an early and innovative alternative to strengthen the prevention of chronic diseases in the population.Trial registrationNCT00872365.

Asociación entre adiposidad y factores de riesgo cardiovascular en infantes pre-púberes

INTRODUCTION AND OBJECTIVES To examine the relationships between of four measures of adiposity, namely waist circumference (WC), body mass index (BMI), and subscapular and abdominal skinfolds, with different cardiovascular risk factors in prepubertal children. METHODS Four hundred and ninety-four prepubertal children aged 6-10 years participated in this cross-sectional study. The subscapular and abdominal skinfolds, WC, and BMI were measured to assess adiposity, and cardiovascular risk factors (CVRFs) were assessed by measuring systolic (SBP) and diastolic blood pressures (DBP), glucose, triglycerides (TG), and high density (HDL-C) and low density lipoprotein cholesterol (LDL-C). Dichotomous variables were created based on whether or not the subjects were in the upper quartile (Q4) for the WC, BMI, and skinfold variables. RESULTS No CVRF was found in 52.8% of children, 33.4% had one factor, and 10.9% and 2.8% had 2 and 3 factors respectively. An adjusted logistic regression analysis showed that being in Q4 of anthropometric variables and CVRFs was associated to TG levels ≥ 100 mg/dL. Glucose levels ≥ 96 mg/dL were associated to Q4 and abdominal fold. Presence of 2 or more CVRFs was significantly associated to Q4 in all anthropometric variables despite adjustment for age, gender, and calorie intake. The subscapular skinfold was the adiposity marker associated to the highest risk. CONCLUSIONS Children with a more unfavorable adiposity profile tend to have a greater cardiovascular risk in the prepubertal stage.

Centiles de lípidos séricos en adolescentes de Colombia

OBJECTIVE To assess age- and sex-specific percentile baseline data for total cholesterol (TC), triglycerides (TG), and high-density lipoprotein cholesterol (HDL-C) in Colombian children and adolescents aged 10 to 17 years. PATIENTS AND METHODS A cross-sectional, descriptive study was conducted on 1,773 children and adolescents. Each participant underwent a fasting measurement to quantify TC, HDL-C, and TG levels using enzymatic-colorimetric methods. Smoothed age- and sex-specific 5(th), 25(th), 50(th), 75(th), 90(th) and 95(th) percentile values where derived using LMS regression (Least Mean Square) using the statistical package Growth Analyzer. RESULTS Overall, males had lower serum TC and TG levels as compared to females. P95 of TG and TC was higher in males aged 10 to 14 years as compared to females, while HDL-C levels were similar in both sexes. CONCLUSIONS Percentile values will help classify children and adolescents as compared to other populations based on this health indicator.

Falta de relación entre el nivel de actividad física con marcadores de riesgo cardiovascular y síndrome metabólico en hombres aparentemente sanos

BACKGROUND The World Health Report 2002 estimated that sedentary is one of the main 10 causes of morbidity and mortality and the proportion of people whose health is at risk due to sedentary life is approximately 60%. OBJECTIVE To assess the relationship of the physical activity level with cardiovascular risk factors and metabolic syndrome in 61 healthy men. METHODS The short version of the International Physical Activity Questionnaire (IPAQ) recommended by the World Health Organization was used as a valid measure to estimate two categories of physical activity, such as: low level (insufficient and sedentary) and vigorous level (moderate and very active). Cardiovascular risk factors and metabolic syndrome were defined according to criteria of the National Cholesterol Education Program of the United States and International Diabetes Federation respectively. Serum levels of C-reactive protein and ferritin were also measured, and insulin sensitivity was estimated by the Homeostatic Model Assessment-Insulin Resistance (HOMA-IR). RESULTS Mean age of study population was 47.1 ± 6.9 years. 17 participants (28%) had metabolic syndrome. There were no differences between the categories of low and vigorous level physical activity, or relationship with total physical activity (MET × week). No association was seen between low levels of physical activity and metabolic syndrome criteria. CONCLUSIONS The high prevalence of physical inactivity found in study participants using the IPAQ questionnaire was not associated to cardiovascular risk factors and metabolic syndrome.

Los niveles de ferritina y los marcadores de riesgo cardiovascular se correlacionan con mayor tiempo sedentario auto-reportado en hombres aparentemente sanos

Objective: to evaluate the correlation between serum ferritin and cardiovascular risk markers with the time of self-reported physical activity and sedentary life style in apparently healthy men. Methods: we included 69 men from three private and public companies in the metropolitan area of Cali, Colombia, aged between 25 and 64. The short version of the International Physical Activity Questionnaire (IPAQ) was applied, and were grouped in four categories of physical activity: 1. Minutes of intense physical activity (IFA)/week. 2. Minutes of moderate physical activity (MFA)/week. 3. Minutes of walk/week. 4. Minutes of sitting/day. Cardiovascular risk markers were defined based on the criteria of the ATP-III and the International Diabetes Federation. Results: positive correlations were found in subjects who self-reported more time in sedentary activities according to the IPAQ category (average minutes sitting/day) in anthropometric indicators: percentage of body fat (rho = 0.249, p <0.05), mass index (rho = 0.268, p <0.05) and waist circumference (rho = 0.266, p <0.05). This same behavior was observed in biochemical variables: ferritin (rho = 0.247, p <0.05), triglycerides (rho = 0.258, p <0.05), insulin (rho = 0.284, p <0.05) and HOMA index (rho = 0.261). Also, lower levels of HDL-C were evidenced with lower levels of physical activity (rho =- 0.279, P <0.05). Conclusions: sedentary time (minutes sitting/week) reported by the subjects correlated positively with ferritin levels as well as with insulin resistance and cardiovascular risk markers. The body iron deposits estimated as serum ferritin, when related to sedentary lifestyle parameters, behave as a potential marker of cardiovascular risk.

El ejercicio físico aeróbico incrementa la vasodilatación dependiente del endotelio y el consumo de oxígeno de mujeres primigestantes saludables. Ensayo clínico controlado, aleatorizado. NCT00741312

Objetivo Evaluar el efecto del ejercicio aerobico en la funcion dependiente del endotelio (VDE) y en el consumo de oxigeno en mujeres primigestantes. Metodos Ensayo clinico controlado, enmascarado y aleatorizado, llevado a cabo en 67 mujeres saludables, primigestantes, entre 16 a 20 semanas de gestacion. Grupo de intervencion: ejercicio aerobico entre 50% y 65% de la frecuencia cardiaca maxima, durante 45 minutos, tres veces por semana, durante dieciseis semanas. Grupo control: actividad fisica habitual. Mediciones: VDE: vasodilatacion mediada por flujo (VMF), consumo de oxigeno VO2max: prueba de caminata de seis minutos; antropometria: peso y talla. Resultados En las mediciones iniciales no se encontraron diferencias entre grupos en ninguna de las variables. Al finalizar la intervencion, las participantes que realizaron ejercicio tenian mayor capacidad fisica, medida por la distancia recorrida en el test de caminata (p=0,043) y por el VO2max (p=0,023). Ademas, el grupo de ejercicio tuvo menor frecuencia cardiaca en reposo y mayor VMF que el grupo control (p Conclusion La practica regular de ejercicio aerobico y controlado, mejora la funcion endotelial y la capacidad fisica en mujeres gestantes. Por esta razon, intervenciones como esta podrian ser una alternativa temprana y efectiva para fortalecer la prevencion de patologias durante el embarazo asociadas con disfuncion endotelial.