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Central accumulation and distribution of body fat (BF) is an important cardiometabolic risk factor. Waist-to-hip ratio (WHR), commonly elevated in nonalcoholic fatty liver disease (NAFLD) patients, has been endorsed as a risk related marker of central BF content and distribution, but no standardized waist circumference measurement protocol (WCmp) has been proposed. We aimed to investigate whether using different WCmp affects the strength of association between WHR and BF content and distribution in NAFLD patients. BF was assessed with dual energy X-ray absorptiometry (DXA) in 28 NAFLD patients (19 males, 51 ± 13 years, and 9 females, 47 ±13 years). Waist circumference (WC) was measured using four different WCmp (WC1: minimal waist; WC2: iliac crest; WC3: mid-distance between iliac crest and lowest rib; WC4: at the umbilicus) and WHR was calculated accordingly (WHR1, WHR2, WHR3 and WHR4, respectively). High WHR was found in up to 84.6% of subjects, depending on the WHR considered. With the exception of WHR1, all WHR correlated well with abdominal BF (r = .47 for WHR1; r = .59 for WHR2 and WHR3; r = .58 for WHR4) and BF distribution (r = .45 for WHR1; r = .56 for WHR2 and WHR3; r = .51 for WHR4), controlling for age, sex and body mass index (BMI). WHR2 and WHR3 diagnosed exactly the same prevalence of high WHR (76.9%). The present study confirms the strong relation between WHR and central BF, regardless of WCmp used, in NAFLD patients. WHR2 and WHR3 seemed preferable for use in clinical practice, interchangeably, for the diagnosis of high WHR in NAFLD patients. [ABSTRACT FROM AUTHOR]

Evaluate the student’s satisfaction in Physical Education (PE) classes can contribute to help teachers in developing strategies to better planning and get students more motivated. The aim of this study is to describe what students’ value most and why in a PE class. It was used a qualitative and descriptive approach of the critical incidents in a PE classroom interviewing 278 Portuguese students. The results reveal in the satisfaction striking moments, playing and compete, getting individually and collective success in a satisfactory class climate. The less welcome striking moments were a mixture of playing, compete and failure. The warmup and negative class climate also were reported as not very gratifying. The fun moments reported were personal realization, pleasure and sharing. The teacher appreciation reveals pedagogical interactions, specific knowledge and personal conduct. The students like PE classes. Planning by the PE teacher should maximize opportunities of enjoyable situations by the students, in order to improve their motivation. [ABSTRACT FROM AUTHOR]

The beneficial effects of short-term exercise programs (4-16 weeks) in the glycemic control of patients with type 2 diabetes mellitus (DM2) are well documented in the literature. Less consensus exists on the long-term effects. This study aims to evaluate the effects of a longterm exercise program on glycemic control and insulin resistance in patients with DM2. The sample consisted of a reference group (GR) (n=102) and an intervention group (IG) (n=23), all with DM2. The GR subjects did not participate in any program, having been assessed 1 time. Subjects of the GI participated on a long-term exercise program (32 months), with assessments every 4 months in a total of 9 assessments. Between each evaluation, there was a significant effect in reducing the mean values of fasting glucose [-0.119 mmol·L-1 (95% CI: - 0.193 - -0.046)], insulin resistance (HOMA IR) [-0.080 units (95% CI: -0.142 - -0.019)] and chronic levels of blood glucose (HbA1c) [-0.073% (95% CI: -0.130 - -0.016)]. The long-term exercise program consisted a safe and effective auxiliary treatment in improving glycemic control. [ABSTRACT FROM AUTHOR]

The growing competitiveness of modern sport means that children, from very early ages, are increasingly submitted to intensive training programmes. These programmes are problematic for young athletes not only because their developing bodies are particularly susceptible to different kinds of injuries, but because athletes are also particularly vulnerable to experiences of different kinds of abuses. Using data collected through semi-structured interviews this study examines the various kinds of abuse that former Portuguese female gymnasts underwent during their sporting careers. Interviewees were asked to reflect on their past experiences and discuss aspects of the gymnastics subculture. Weight control, training/competing with injuries and corporal punishment emerged as key themes. The study therefore shows that the physical and psychological abuse of young athletes occurs even beyond the confines of elite professional sport, and thus that a broader spectrum of athletes learn to consider these forms of exploitation and abuse as normal. [ABSTRACT FROM PUBLISHER]

Os efeitos benéficos da prática regular de exercício físico na melhoria do controlo glicémico em doentes com diabetes mellitus do tipo 2 (DM2) estão relativamente bem documentados na literatura, nomeadamente em programas de curta duração (4 a 16 semanas). Menor consenso existe sobre a influência dos efeitos no longo prazo. No presente estudo, procurou-se avaliar os efeitos de um programa de exercício físico regular de longa duração no controlo glicémico e na resistência à insulina, em doentes com DM2 do Centro de Saúde de Bragança. A amostra foi constituída por um grupo de referência (GR) (n=102, 53 mulheres e 49 homens, idade média de 65,1±8,7 anos) e um grupo de intervenção (GI) (n=23, 15 mulheres e 8 homens, idade média de 63,7±6,9 anos), todos com DM2 diagnosticada. Os indivíduos do GI foram sujeitos a um programa de exercícios de longa duração (32 meses), predominantemente aeróbio (caminhada a ±6 km·h-1 e exercícios de hidroginástica), 5 vezes por semana (4 sessões em meio terrestre e 1 em meio aquático por semana), com uma duração de 55 minutos por sessão. Foram realizadas avaliações de 4 em 4 meses, num total de 9. Os elementos do GR não participaram em nenhum programa de exercícios, tendo sido avaliados apenas 1 vez. Entre cada momento de avaliação, foi observado um efeito significativo do programa na redução dos valores médios da glicemia de jejum [-0,119 mmol·L-1 (IC 95%: -0,193 -- -0,046)], da resistência à insulina (homeostasis assessment model insulin resistance -- HOMA-IR) [-0,080 unidades (IC 95%: -0,142 -- -0,019)] e da glicemia crónica (hemoglobina glicada A1c -- HbA1c) [-0,073% (IC 95%: -0,130 -- -0,016)]. Foi também identificada uma associação direta e significativa da assiduidade ao programa nas reduções da glicemia de jejum, da insulina de jejum, do HOMA-IR e da HbA1c. O programa de exercício, mantido no longo prazo, consistiu numa forma auxiliar de tratamento segura e eficaz na melhoria do controlo glicémico. [ABSTRACT FROM AUTHOR]

Cognition includes all processes through which a person becomes aware of their situation, needs, goals, and necessary actions. Regular specialized cognitive and neuromotor simulation exercises have improved various cognitive processes, including memory, speed of reasoning, and problem-solving skills. This review focuses on understanding the efficacy of long-term multicomponent exercise interventions to mitigate and delay the effects on cognitive abilities in older adults with neurodegenerative disorders. The main criteria for final studies were randomised controlled trials with a minimum of a 24-week intervention. The Cochrane Central Register of Controlled Trials, Web of Science, SCOPUS, B-On, Sport Discus, Scielo, APA PsycINFO, Psychology and Behavioural Sciences, Academic Search Complete, Medline (PubMed), ERIC, and Google Scholar databases were checked. The search occurred between April 2022 and July 2022. A total of 19 studies were used in this review. The initial search identified 6.835 studies. In the first screening, a total of 6474 studies were excluded. After this, 361 studies were analysed by co-authors and did not meet the specific final criteria and were excluded. In total, 19 studies were included in the final analysis, and 14 papers met all requirements previously defined. [ABSTRACT FROM AUTHOR]

Rationale: Cancer is associated with muscle wasting. However, optimal protein intake has not been determined, limiting the efficacy of nutritional interventions. This systematic review aims to assess the effect of protein intake on muscle mass of patients with cancer types with high prevalence of sarcopenia during treatment, in longitudinal studies. Methods: MEDLINE, CINAHL, and Scopus databases were searched following PRISMA guidelines. Longitudinal studies written in English, including adults with high sarcopenia prevalence cancer diagnosis, submitted to (chemo)radiotherapy, with assessment of protein intake and muscle changes during treatment, published until 4 October 2020 were included. Studies including supplementation with substances, such as n-3 fatty acids, specific amino acids, or proteins, were excluded. Study appraisal was independently conducted by two reviewers, and a qualitative research synthesis was performed. Results: Overall, 575 records were identified, of which, eight studies were included (one randomized clinical trial and seven uncontrolled before and after studies). Patients with head and neck (n = 5), lung (n = 2), and esophageal cancer (n = 1) were included, comprising a total of 554 participants. The studies presented heterogeneous methodologies, objectives, and methods to assess body composition. Overall, participant groups with a mean protein intake below 1.2 g/kg presented muscle wasting, with one exception, while those reporting a mean intake above 1.4 g/kg, maintained muscle during treatment. Conclusions: Our findings show that protein intakes below 1.2 g/kg, even when within the recommendations, have been associated with muscle wasting during treatment. Only intakes above 1.4 g/kg have been associated with muscle maintenance. High-quality research is needed to establish an optimal dose response. [ABSTRACT FROM AUTHOR]

The school has enough reasons to support School Sports, since the sport is a perfect mediator for education and is the source of great excitement and pleasure (Valdano, 2002). The objective of this study aims to perceive problems that School Sports live now according to PE teachers. In this context, we interviewed six teachers who teach school sports for more than nine years, about its development and operation. The interviews were transcribed and coded verbatim with the help of software QRS - NVivo 10, in order to group and categorize the opinions and experiences of the respondents. The results show that it is necessary for the school to become more active and capable of producing new ideas, because the better the activity plan, more students will be captivated. It is also noteworthy that the increase we are experiencing in our country with regard to physical inactivity and obesity should be tackled in the School through physical activity: it is essential that the current model offers a number of competitive moments that are desirable and do not spend too much time in commuting and in the intervals between games. [ABSTRACT FROM AUTHOR]

Early detection of impairment in vascular structure is an important clinical pursuit. However, it is unknown which measure of body composition best predicts vascular wall changes. We assess the differences in body composition among intima-media thickness (IMT) tertiles and determined which measures of body composition are associated with IMT in 385 children aged 11-13 years (196 girls). In this cross-sectional study, body mass index (BMI), waist circumference (WC), body fat mass (BFM), and trunk fat mass (TFM) from dual-energy radiographic absorptiometry and IMT through high-resolution ultrasonography were collected. Differences in body composition measures among IMT tertiles [low IMT (LIMT), ≤0.46 mm; middle IMT, 0.46-0.53 mm; higher IMT (HIMT), ≥0.53 mm] were assessed with ANOVA/ANCOVA after categorization. Regression analysis was used to assess the relationships between body composition and IMT. The groups were similar for sex, age, and maturity ( p > 0.05). As compared with LIMT group, subjects with HIMT had higher mean values of BMI, BFM, TFM, and WC ( p < 0.05). Significant differences were found for WC even when controlling for BMI ( p < 0.05). Combining all subjects, IMT was significantly correlated to BMI, BFM, TFM, and WC ( p < 0.05). In multiple regression, WC was the only predictor of IMT (β = 0.22, p < 0.001). Conclusion: Differences exist in body composition variables among IMT tertiles. In the overall model, WC was the only obesity-related predictor of increased IMT in 11-13-year-old children. [ABSTRACT FROM AUTHOR]

This study compared the effects of a bout of maximal running exercise on arterial stiffness in children and adults. Right carotid blood pressure and artery stiffness indices measured by pulse wave velocity (PWV), compliance and distensibility coefficients, stiffness index α and β (echo-tracking), contralateral carotid blood pressure, and upper and lower limb and central/aortic PWV (applanation tonometry) were taken at rest and 10 min after a bout of maximal treadmill running in 34 children (7.38 ± 0.38 years) and 45 young adults (25.22 ± 0.91 years) having similar aerobic potential. Two-by-two repeated measures analysis of variance and analysis of covariance were used to detect differences with exercise between groups. Carotid pulse pressure (PP; η2 = 0.394) increased more in adults after exercise ( p < 0.05). Compliance (η2 = 0.385) decreased in particular in adults and in those with high changes in distending pressure, similarly to stiffness index α and β. Carotid PWV increased more in adults and was related to local changes in PP but not mean arterial pressure (MAP). Stiffness in the lower limbs decreased (η2 = 0.115) but apparently only in those with small MAP changes (η2 = 0.111). No significant exercise or group interaction effects were found when variables were adjusted to height. An acute bout of maximal exercise can alter arterial stiffness and hemodynamics in the carotid artery and within the active muscle beds. Arterial stiffness and hemodynamic response to metabolic demands during exercise in children simply reflect their smaller body size and may not indicate a particular physiological difference compared with adults. [ABSTRACT FROM AUTHOR]

It is unclear if cardiorespiratory fitness (CRF) can be used as a screening tool for premature changes in carotid intima-media thickness (cIMT) in paediatric populations. The purpose of this cross-sectional study was 3-fold: ( i) to determine if CRF can be used to screen increased cIMT; ( ii) to determine an optimal CRF cut-off to predict increased cIMT; and ( iii) to evaluate its ability to predict increased cIMT among children in comparison with existent CRF cut-offs. cIMT was assessed with high-resolution ultrasonography and CRF was determined using a maximal cycle test. Receiver operating characteristic analyses were conducted in boys ( n = 211) and girls ( n = 202) aged 11-12 years to define the optimal sex-specific CRF cut-off to classify increased cIMT (≥75th percentile). Logistic regression was used to examine the association between the CRF cut-offs with the risk of having an increased cIMT. The optimal CRF cut-offs to predict increased cIMT were 45.81 and 34.46 mL·kg−1·min−1 for boys and girls, respectively. The odds-ratios for having increased cIMT among children who were unfit was up to 2.8 times the odds among those who were fit (95% confidence interval: 1.40-5.53). Considering current CRF cut-offs, only those suggested by Adegboye et al. 2011. (Br. J. Sports Med. 45(9): 722-728) and Boddy et al. 2012 (PLoS One, 7(9): e45755) were significant in predicting increased cIMT. In conclusion, CRF cut-offs (boys: ≤ 45.8; girls: ≤ 34.5 mL·kg−1·min−1) are associated with thickening of the arterial wall in 11- to 12-year-old children. Low CRF is an important cardiovascular risk factor in children and our data highlight the importance of obtaining an adequate CRF. [ABSTRACT FROM AUTHOR]

• Phase angle cutoff value (5.6°) can be a marker of the health status and functional capacity in breast cancer survivors. • A higher PhA suggested a significantly lower ECW/TBW ratio, ECW/ICW ratio and ECW/BCM ratio in breast cancer survivors. • Intracellular water has a positive association with group a higher PhA values. • Muscle mass values has a positive association with group a higher PhA values. Accurate predictive tools are key factors for cancer care. Phase angle (PhA) has been proposed as a marker of cellular health, particularly of cell-membrane integrity. Cutoff values have been proposed, including for cancer survivors. This study aimed to assess the usefulness of the proposed PhA cutoff, as a marker of bioelectrical impedance analysis (BIA) assessed health-status, and functional capacity in breast cancer (BC) survivors. This cross-sectional study included 25 women (50.6 ± 8.6 yrs) survivors of BC, divided into two groups according to the PhA reference value of 5.6° (group 1 [G1]: PhA ≤ 5.6° [n=13]; group 2 [G2]: PhA > 5.6° [n=12]) (Gupta et al. 2008). BIA-assessed health status parameters included: extracellular water (ECW), intracellular water (ICW), total body water (TBW), PhA, body mass, fat-free mass, muscle mass, body cell mass (BCM). Four functional tests were performed: 30 s chair-stand test, timed up and go test, ball throw test and 6-minute walking test. Results showed G2 had lower ECW/ICW ratio (p=0.001; ES=1.2), ECW/BCM ratio (p=0.001; ES=3.2) and ECW/TBW ratio (p=0.001; ES=4.8). There was no difference in functional capacity between groups. The results of the present study show that patients with higher PhA values have a higher ICW values and preservation in the ECW/ICW ratio, suggesting it's a better cell membrane quality and integrity. Relation of both PhA and cell membrane integrity with functional capacity warrants further research. [ABSTRACT FROM AUTHOR]

Background Drowning is the third leading cause of death worldwide (WHO, 2010). According to Brenner et al (2009) participating in swimming lessons (SL) can reduce by 88% the risk of drowning in children 1-4 years old, despite some controversy regarding the most appropriate swimming programs (Ward, 2009). On the other hand no studies tested the skills acquired in SL in drowning prevention. So we proposed a test to evaluate the survivability of a child that accidentally falls into the water. Methods Twenty two children (4.68±0.82yrs) who practice SL (2.01±0.91yrs/practice) were subjected to two tests: aquatic readiness (AR) (Stallman et al, 2008); and survival test (ST), which consisted of an inflatable boat ride (unknown pool; presence of the usual swim teacher; wearing t-shirt) which 'accidentally' turns. Recorded images were later observed by 6 field experts whose observations obtained an overall index of concordance (IC) of 89%. Results In ST 15 children had positive responses (n=10, 100% IC; n=1, 66% IC; n=1, 83% IC; n=3, 50% IC) and 7 (n=6, 100% IC; n=1, 66% IC) would be in danger. Conclusions Through this test, we found that not all children whose result was positive in AR had a positive performance in the ST. This brings us to observe according to Langendörfer (2011) that the positive or negative response of the subject depends on the interaction of various constraints such as individual characteristics, the environment conditions, and the state in which the swimmer is. The application of ST suggests that the inclusion of safety and prevention activities in swimming lessons, aiming to develop attitudes and motor skills as a defense to drowning, must be taken into account. More studies are necessary to provide valid information to assist pediatricians in advising parents regarding what type of SL are more appropriate to reduce drowning. [ABSTRACT FROM AUTHOR]