José Pedro Ferreira

Prevalence of the Portuguese Population Attaining Sufficient Physical Activity

PURPOSE Physical activity has many health benefits, and to implement strategies, mainly in those groups with insufficient levels of practice, it is important to evaluate physical activity. The main purpose of this study was to describe the prevalence of physical activity in the Portuguese population aged 10 yr and older using accelerometry. METHODS The accelerometers were worn for four consecutive days, and a valid record was defined as at least 3 d with 10 h of wear time, including one weekend day. Considering these conditions, 4696 participants were included. RESULTS According to the recommendations of 60 min·d(-1) of physical activity, 36% of participants age 10-11 yr (boys = 51.6%, girls = 22.5%) and 4% age 16-17 yr (boys = 7.9%, girls = 1.2%) were considered sufficiently active. In adulthood, ∼70% of participants age 18-64 yr (men = 76.6%, women = 65.2%) and 35% age older than 64 yr (men = 46%, women = 29%) reached the recommendation of 30 min·d(-1) of physical activity, when counting every minute of moderate or greater intensity. Considering bouts of 10 min or more of moderate or greater intensity in participants older than 17 yr, the prevalence was 4%-6% at 18-39 yr, 7%-9% at 40-64 yr, and ∼3% in persons age 65 yr or older. CONCLUSIONS The design and implementation of strategies to promote physical activity for health among children and adolescents and older adults, particularly girls/women, should be encouraged.

Prevalence of overweight and obesity among Portuguese youth: A study in a representative sample of 10–18-year-old children and adolescents

PURPOSE The aim of this research was to report the prevalence of overweight and obesity in a representative sample of Portuguese youth. METHODS This was a school-based study performed in Portugal. A total of 22 048 children and adolescents aged 10-18 years were included in the study. The World Health Organization (WHO) and the International Obesity Task Force (IOTF) cut-offs were used to categorise overweight and obese participants. RESULTS Using IOTF cut-offs the prevalence of overweight and obesity was 17.0 and 4.6% in girls, and 17.7 and 5.8% in boys, respectively (p < 0.001 for overweight and p > 0.05 for obesity), whereas WHO cut-offs resulted in overweight and obesity prevalence scores of 23.1 and 9.6% in girls, and 20.4 and 10.3% in boys, respectively (p < 0.001 for overweight and p >0.05 for obesity). With IOTF cut-offs, a lower prevalence of obesity and overweight was observed at higher ages, in both genders. With the WHO cut-offs, a lower prevalence of obesity and overweight was observed at higher ages, in boys. In girls, the prevalence of overweight and obesity increases from 10 to 12 years of age and decreases from the age of 13 to 18 years. CONCLUSION The prevalence for overweight/obesity among Portuguese children and adolescents vary according to the cut-off points used and are also of concern requiring strategies to promote healthy weight gain among children and adolescents.

Diurnal patterns of salivary alpha-amylase and cortisol secretion in female adolescent tennis players after 16 weeks of training

We examined the effects of 16 weeks of training on diurnal pattern of salivary alpha-amylase (sAA), cortisol, and the ratio of sAA over cortisol (AOC) in 12 national adolescent female tennis players. Stress and recovery were also evaluated using the Recovery-Stress-Questionnaire for Athletes-RESTQ-Sport. Data were collected after a 2-week rest (January, W0), and 4 months after W0 (W16). Subjects collected five saliva samples throughout a day. While all participants displayed the previously shown decrease after awakening in adolescents at W0, they showed a rise in the alpha-amylase awakening response and a higher alpha-amylase activity output (p<0.01) at W16 compared to W0. For the daily rhythm of cortisol we found subjects having a low overall output of salivary cortisol (p<0.01) and a blunted response to awakening at W16. Furthermore, an increase in the ratio AOC at W16, and a negative correlation between this ratio and Sport-specific recovery score. Our findings offer support for the hypothesis that increase of training load during the study period induced asymmetry activation between the two stress systems, in relation to psychological alterations and performance decrease. These results provide encouragement to continue exploring the impact of training program using a psychobiological approach among young athletes in order to prevent fatigue and preserve the health of these athletes.

Strength Training Decreases Inflammation and Increases Cognition and Physical Fitness in Older Women with Cognitive Impairment

Introduction: Cognitive impairment that affects older adults is commonly associated with an inflammatory imbalance, resulting in decreased physical fitness. Exercise has been pointed to mitigate immunosenescence and cognitive impairment associated with aging, while increase in physical fitness. However, few studies explored the relationship between changes in cytokine concentration and improvement on cognition due to elastic band strength training. The aim of this study was to investigate the effects of strength training on pro-and anti-inflammatory cytokines, hematological markers and physical fitness of older women with cognitive impairment. Methods: Thirty-three women (82.7 ± 5.7 years old) participated in the study and were divided in two groups: strength exercise training group (ST; n = 16) and Control Group (CG; n = 17) and were evaluated before and after 28 weeks of the exercise program. The CG did not undergo any type of exercise programs. Data for IL-10, TNF-α, IFN-γ, C-Reactive Protein (CRP), white blood counts (WBC), red blood counts (RBC), Mini Mental State Examination (MMSE) and physical fitness tests were analyzed in both moments. Results: IL-10 increased in the ST group without changes in CG. TNF-α and CRP increased in the control group while no changes were observed for IFN-γ in both groups. Strength training decreased leukocyte and lymphocyte counts and increase hemoglobin, mean cell volume and mean cell hemoglobin concentration. The MMSE score increased in strength training group but remained unchanged in the control group. A correlation between the variation of granulocyte counts and the MMSE scores was also observed within the total sample. An improvement in physical fitness was observed with strength training. Conclusion: Resistance exercise promoted better anti-inflammatory balance and physical performance simultaneously with an increase in cognitive profile in older women with cognitive impairment.

Study Protocol on Hormonal Mediation of Exercise on Cognition, Stress and Immunity (PRO-HMECSI): Effects of Different Exercise Programmes in Institutionalized Elders

Physical activity (PA) in elders has been shown to have positive effects on a plethora of chronic diseases and to improve immunity, mental health, and cognition. Chronic stress has also been shown to have immuno-suppressive effects and to accelerate immunosenescence. Exercise could be a significant factor in ameliorating the deleterious effects of chronic stress, but variables such as the type, intensity, and frequency of exercise that should be performed in order to effectively reduce the stress burden need to be defined clearly. PRO-HMECSI will allow us to investigate which hormonal and immunological parameters are able to mediate the effects of exercise on mucosal immunity, psychological/biological stress, and cognitive functioning in older people. Phase I consists of an observational cross-sectional study that compares elders groups (n = 223, >65 years) by functional fitness levels aiming to identify biomarkers involved in maintaining immune and mental health. Neuroendocrine and immune biomarkers of stress, psychological well-being related to mental health, neurocognitive function, functional fitness, and daily PA will be evaluated. Phase II consists of a 28-week intervention in elders with mild cognitive impairment (MCI) profile (n = 149, >65 years, divided in three groups of exercise and one control group), aiming to investigate whether the positive effect of three different types of chair-based exercise programs on physical and psychological health is mediated by an optimal endocrine environment. Primary outcomes are measures of cognitive function and global health. Secondary outcomes include the evaluation the other dimensions such as immune function, psychological health, and depression. Few studies addressed the effects of different types of exercise interventions in older population samples with MCI. We will also be able to determine which type of exercise is more effective in the immune and hormonal function of this population.

Perception of Creativity and Game Intelligence in Soccer

A questionnaire was used to investigate the perception of creativity and game intelligence of coaches (n = 34, mean age 28.6 with an average of 14.3 years of experience) and players (n = 118, belonging to the ranks U-15 and U-19). Analyses indicated that there were statistically significant differences in most creative concepts inherent in the perception of creativity on the part of coaches. The results for the perception of the players showed that there were statistically significant differences in the importance attached to creativity and game intelligence. Apparently coaches mostly associate the creativity in soccer to a kind of magical thinking, adding also the game intelligence to the ability of rationality, problem solving, and decision. There was a strong correlation between creativity and game intelligence for the players.

Associação entre IMC e teste de coordenação corporal para crianças (KTK). Uma meta-análise

The Body Coordination Test for Children (Korperkoordinationstest fur Kinder, KTK) has been used in the evaluation of motor coordination in young people. The objective of this systematic review and meta-analysis study was to analyze the relationship between body mass index (BMI) and the motor performance by the KTK test in healthy children. The study was based on research indexed in the electronic databases PubMed and SciELO. The descriptors were “Korperkoordinationstest fur Kinder” and “KTK”. Studies published in English and Portuguese until October 2014 were considered. The quality of the studies was determined by PEDro and STROBE scales. Meta-analysis was performed using the Comprehensive MetaAnalysis V2 software. A total of 10 studies were included. The overall result based on the fixed effects model showed that higher values of the BMI are directly associated with low performance in the KTK. Despite the small difference between genders, the magnitude of the association effect was classified as small, but significant for males (r = 0.29; 95% CI 0.27 to 0.32; Z = 22.47; p = 0.000) and moderate for females (r = 0.32; 95% CI 0.30 to 0.34; Z = 24.76, p = 0.000). Studies have shown different characteristics as the sample size and the age of the subjects, and none of them have analyzed the maturational status of the participants. Based on these results, there is a trend of a positive relationship between high values of BMI and low performance in the KTK.

Physical Fitness and Frailty Syndrome in Institutionalized Older Women

Associations between frailty and physical-functional fitness (PFF) indicators in frail women over 65 years of age remain largely unexplored. This study analyzed the relationship between frailty syndrome (FS) and PFF indicators and assessed how the latter might predict the former. Participants were 119 elderly women (81.96 ± 7.89 years) recruited from four social and healthcare centers. PFF was assessed through muscle strength tests of upper and lower limbs, endurance, agility-dynamic balance, flexibility, and body composition. The following FS indicators were assessed: weight loss, exhaustion, weakness, slowness, and low physical activity level. Significant correlations were found between FS and endurance, agility-dynamic balance, upper and lower limbs muscle strength tests. Comparitive analyses also revealed that, among FS groups, the frail subgroup performed significantly poorer on all PFF measures except body composition. Additionally, a receiving operating characteristics curve analysis revealed good diagnostic accuracy for predicting FS using the agility-dynamic balance test (Area Under Curve [AUC] = .82, 95% CI [0.74, 0.90]; sensitivity and specificity were 70.4% and 84.8% for the cutoff = 16.22 seconds). Accurately, the risk of frail condition (not pre-frail) increases about 2.12% per second spent in this test. Thus, the agility-dynamic balance test is a promising tool for screening institutionalized older people for risk of FS.

Exercise Effects for Children With Autism Spectrum Disorder: Metabolic Health, Autistic Traits, and Quality of Life:

This study examined the effects of a 48-week exercise-based intervention on the metabolic profile, autism traits, and perceived quality of life in children with autism spectrum disorder (ASD). We randomly allocated 64 children with ASD (aged 6–12 years) to experimental (n = 46) and control groups (n = 18) and used multilevel regression modeling to examine responses to receiving or not receiving the intervention. The experimental group showed beneficial effects on metabolic indicators (high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and total cholesterol), autism traits, and parent-perceived quality of life. Our results provide support for exercise and physical activity, including basic coordination and strength exercises, as important therapeutic interventions for children with ASD.

Effects of a Physical Exercise Program (PEP-Aut) on Autistic Children’s Stereotyped Behavior, Metabolic and Physical Activity Profiles, Physical Fitness, and Health-Related Quality of Life: A Study Protocol

Physical exercise has shown positive effects on symptomatology and on the reduction of comorbidities in population with autism spectrum disorder (ASD). However, there is still no consensus about the most appropriate exercise intervention model for children with ASD. The physical exercise program for children with autism (PEP-Aut) protocol designed allow us to (i) examine the multivariate associations between ASD symptoms, metabolic profile, physical activity level, physical fitness, and health-related quality of life of children with ASD; (ii) assess the effects of a 40-week exercise program on all these aspects of children with ASD. The impact of the exercise program will be assessed based on the sequence of the two phases. Phase 1 is a 12-week cross-sectional study assessing the symptomatology, metabolic profile, physical fitness and physical activity levels, socioeconomic status profile, and health-related quality of life of participants. This phase is the baseline of the following phase. Phase 2 is a 48-week intervention study with a 40-week intervention with exercise that will take place in a specialized center for children with ASD in the city of Maceió-Alagoas, Brazil. The primary outcomes will be change in the symptomatic profile and the level of physical activity of children. Secondary outcomes will be anthropometric and metabolic profiles, aerobic function, grip strength, socioeconomic status, and health-related quality of life. The study will provide critical information on the efficacy of exercise for children with ASD and help guide design and delivery of future programs.