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Association between adipose tissue characteristics and metabolic flexibility in humans: A systematic review
(Frontiers Media S.A., 2021-12-03) Glaves, Alice; Díaz-Castro, Francisco; Farías, Javiera; Ramírez-Romero, Rodrigo; Galgan, Jose E.; Fernández-Verdejo, Rodrigo
Adipose tissue total amount, distribution, and phenotype influence metabolic health. This may be partially mediated by the metabolic effects that these adipose tissue characteristics exert on the nearby and distant tissues. Thus, adipose tissue may influence the capacity of cells, tissues, and the organism to adapt fuel oxidation to fuel availability, i.e., their metabolic flexibility (MetF). Our aim was to systematically review the evidence for an association between adipose tissue characteristics and MetF in response to metabolic challenges in human adults. We searched in PubMed (last search on September 4, 2021) for reports that measured adipose tissue characteristics (total amount, distribution, and phenotype) and MetF in response to metabolic challenges (as a change in respiratory quotient) in humans aged 18 to <65 years. Any study design was considered, and the risk of bias was assessed with a checklist for randomized and non-randomized studies. From 880 records identified, 22 remained for the analysis, 10 of them measured MetF in response to glucose plus insulin stimulation, nine in response to dietary challenges, and four in response to other challenges. Our main findings were that: (a) MetF to glucose plus insulin stimulation seems inversely associated with adipose tissue total amount, waist circumference, and visceral adipose tissue; and (b) MetF to dietary challenges does not seem associated with adipose tissue total amount or distribution. In conclusion, evidence suggests that adipose tissue may directly or indirectly influence MetF to glucose plus insulin stimulation, an effect probably explained by skeletal muscle insulin sensitivity
Effect of supervised resistance training on arm volume, quality of life and physical perfomance among women at high risk for breast cancer-related Lymphedema: A study protocol for a randomized controlled Trial (STRONG-B)
(Frontiers Media S.A., 2022-03) Ramírez-Parada, Karol; Lopez-Garzon, Maria; Sanchez-Rojel, Cesar; Petric-Guajardo, Militza; Alfaro-Barra, Margarita; Fernández-Verdejo, Rodrigo; Reyes-Ponce, Alvaro; Merino-Pereira, Gina; Cantarero-Villanueva, Irene
Objectives: To determine the preventive effects of supervised resistance training on arms volume, quality of life, physical performance, and handgrip strength in Chilean women at high risk for breast cancer-related lymphedema (BCRL) undergoing chemotherapy. Design: Randomized control trial. Participants: One hundred and six women at high risk for breast cancer-related lymphedema aged 18 to 70 years. Interventions: Participants will be randomized into two groups: [a] intervention, who will receive 12 weeks of supervised resistance training (STRONG-B) during adjuvant chemotherapy; and [b] control, who will receive education to promote lymphatic and venous return, maintain range of motion, and promote physical activity. Main Outcome Measures: The primary outcome will be arms volume measured with an optoelectric device (perometer NT1000). Secondary outcomes will be quality of life, handgrip strength, and physical performance. Primary and secondary outcomes will be measured at baseline, just after the intervention, and 3 and 6 months after. Statistical analysis will be performed following intention-to-treat and per-protocol approaches. The treatment effect will be calculated using linear mixed models. Discussion: The STRONG-B will be a tailored supervised resistance training that attempts to prevent or mitigate BCRL in a population that, due to both intrinsic and extrinsic factors, will commonly suffer from BCRL.
Effects of ketone bodies on energy expenditure, substrate utilization, and energy intake in humans
(American Society for Biochemistry and Molecular Biology, 2023-09-11) Fernández-Verdejo, Rodrigo; Mey, Jacob T.; Ravussin, Eric
Recientemente se ha prestado atención al potencial de los enfoques cetogénicos para regular el equilibrio energético, ya que las cetonas pueden influir tanto en el gasto como en la ingesta de energía. En esta revisión narrativa, resumimos la evidencia más relevante sobre el papel de la cetosis en el gasto de energía, la utilización de sustratos y la ingesta de energía en humanos. Consideramos diferentes estrategias para inducir la cetosis, como el ayuno, la manipulación dietética y las fuentes exógenas de cetonas. En general, la cetosis no tiene una influencia importante en el gasto energético, pero promueve un cambio en la utilización del sustrato hacia la oxidación de los cuerpos cetónicos. Las estrategias para inducir la cetosis mediante la reducción de la disponibilidad de carbohidratos en la dieta (p. ej., dietas cetogénicas) no influyen de forma independiente en la ingesta de energía, por lo que son igualmente efectivas para perder peso que las dietas con mayor contenido de carbohidratos. Por el contrario, la ingesta de triglicéridos de cadena media y ésteres de cetonas induce cetosis y parece aumentar el gasto energético y reducir la ingesta energética en el contexto de una alta disponibilidad de carbohidratos. Estas últimas estrategias conducen a una pérdida de peso ligeramente mayor. Desafortunadamente, distinguir los efectos de las diversas estrategias cetogénicasper se de los efectos de otras respuestas fisiológicas no es posible con los datos humanos disponibles. Se necesitan estudios hospitalarios altamente controlados que utilicen estrategias específicas para aislar los efectos independientes de las cetonas para abordar adecuadamente esta brecha de conocimiento.
Effects of school closure on lifestyle behaviours and health outcomes in children during the COVID-19 pandemic in Chile: A time-matched analysis
(Wiley; World Obesity Federation, 2024-10-08) Suárez-Reyes, Mónica; Fernández-Verdejo, Rodrigo; Quintiliano, Daiana; Pinheiro, Anna Cristina; Pizarro, Tito
Background The COVID-19 pandemic led to school closures, potentially impairing children's behaviours and health. We aimed to explore the effects of school closure on lifestyle behaviours (dietary habits, physical activity) and health outcomes (adiposity, fitness, self-esteem, self-concept) in children. Methods We measured 247 children before school closure (October–November 2019) and after school reopening (October–November 2021) (COVID-19 group). To distinguish the changes due to school closure from changes due to growth, we included 655 age-matched children with cross-sectional measurements in October–November 2019 (control group). The response of this group (i.e., differences between children with 2 years of difference) was considered the expected response to growth. Two-way ANOVA was used to test age-by-group interactions, indicating an effect of school closure. Results In 7-to-9-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.4 points), resulting in higher physical inactivity prevalence (by 19 percent points) at 9 years. This was accompanied by larger-than-expected increases in fat percentage (by 6.1 percent point). In 8-to-10-year-old children, the COVID-19 group had higher physical inactivity prevalence at 10 years (by 20 percent points). This was accompanied by larger-than-expected increases in fat percentage (by 8.3 percent points), z-score BMI (by 0.90 units), and waist circumference (by 6.1 cm). In 9-to-11-year-old children, the COVID-19 group had larger-than-expected decreases in physical activity (by 0.3 points) and increases in self-concept (by 0.2 points). The response in dietary habits, fitness, or self-esteem was not different between groups. Conclusion Overall, school closure negatively impacted physical activity and adiposity, particularly in the youngest children.
Elevated Risk of Overweight/Obesity-Related Markers and Low Muscular Fitness in Children Attending Public Schools in Chile
(MDPI, 2022) Suárez-Reyes, Mónica; Fernández-Verdejo, Rodrigo
In Chile, children of low socioeconomic status usually attend public schools and have few opportunities to engage in healthy behaviors. This may increase their risk of overweight/obesity and low muscular fitness. Therefore, we aimed to determine the association between the school type attended with overweight/obesity-related markers and the muscular fitness of children in Chile. We included 1410 children (6–13 years old) attending public, subsidized, or private schools. Overweight/obesity-related markers included BMI Z-scores, waist circumference, and body fat percentage. Muscular fitness assessment included handgrip strength and standing long jump. The odds ratios [95% CI] of overweight/obesity, elevated waist circumference, elevated body fat, low handgrip strength, and low standing long jump were compared between school types. Compared with boys attending public schools, those attending subsidized or private schools had lower odds ratios of low handgrip strength (0.63 [0.42–0.94] and 0.44 [0.25–0.78], respectively). Girls attending subsidized schools, compared with those in public schools, had lower odds of overweight/obesity (0.63 [0.44–0.90]) and of having low handgrip strength (0.51 [0.34–0.78]). Compared with girls in public schools, those attending private schools had lower odds (vs. public schools) of overweight/obesity (0.45 [0.28–0.74]), of having elevated body fat (0.53 [0.29–0.96]), and of having low standing long jump (0.41 [0.21–0.77]). The elevated risk of overweight/obesity-related markers and lower muscular fitness in children, particularly girls, attending public schools increase their current and future disease risk. This suggests that childhood socioeconomic status plays a central role in determining disease risk. Health-promoting interventions specifically focused on children from disadvantaged contexts are required.
Energy expenditure in humans: principles, methods, and changes throughout the life course
(Annual Reviews Inc., 2024-05-17) Fernández-Verdejo, Rodrigo
Humans require energy to sustain their daily activities throughout their lives. This narrative review aims to (a) summarize principles and methods for studying human energy expenditure, (b) discuss the main determinants of energy expenditure, and (c) discuss the changes in energy expenditure throughout the human life course. Total daily energy expenditure is mainly composed of resting energy expenditure, physical activity energy expenditure, and the thermic effect of food. Total daily energy expenditure and its components are estimated using variations of the indirect calorimetry method. The relative contributions of organs and tissues determine the energy expenditure under different physiological conditions. Evidence shows that energy expenditure varies along the human life course, at least in part due to changes in body composition, the mass and specific metabolic rate of organs and tissues, and levels of physical activity. This information is crucial to estimate human energy requirements for maintaining health throughout the life course.
Exploring the sequential accumulation of metabolic syndrome components in adults
(Springer Nature, 2022) Fernández-Verdejo, Rodrigo; Galgani, Jose E.
The metabolic syndrome (MetS) is diagnosed upon the manifestation of ≥ 3 out of 5 specific components, regardless of their combination. The sequence through which these components accumulate may serve to identify underlying pathophysiological mechanisms and improve MetS treatment. We aimed to explore whether there is a more frequent sequence of accumulation of components in adults. The cross-sectional data of the National Health Survey of Chile 2016–2017 was analyzed. Subjects aged 18 to < 65 years, with body mass index ≥ 18.5 kg/m2, having all MetS components measured, and not under drug treatment were included (n = 1944, 60% women). MetS components were operationalized based on harmonized criteria: elevated waist circumference (≥ 91 cm for men, ≥ 83 cm for women), reduced high-density lipoprotein cholesterol (HDL-C; < 40 mg/dL for men, < 50 mg/dL for women), elevated triglycerides (≥ 150 mg/dL), elevated blood pressure (≥ 130 mmHg for systolic, or ≥ 85 mmHg for diastolic), and elevated glycemia (≥ 100 mg/dL). Subjects were grouped according to the number of components. Then, the prevalence of the observed combinations was determined. In subjects with one component, the most prevalent was waist circumference (56.7%). In subjects with two, the most prevalent combination was waist circumference and HDL-C (50.8%), while in subjects with three components was waist circumference, HDL-C, and triglycerides (54.0%). Finally, in subjects with four, the most prevalent combination was waist circumference, HDL-C, triglycerides, and blood pressure (40.8%). This pattern suggests that the most frequent accumulation sequence starts with abdominal obesity, followed by dyslipidemia, elevated blood pressure, and ultimately, dysglycemia. The factors that determine the sequence remain to be determined.
Fibro-adipogenic progenitors in physiological adipogenesis and intermuscular adipose tissue remodeling
(Elsevier; International Union of Biochemistry and Molecular Biology, 2024-06) Flores-Opazo, Marcelo; Kopinke, Daniel; Helmbacher, Françoise; Fernández-Verdejo, Rodrigo; Tuñón-Suárez, Mauro; Lynch, Gordon S.; Contreras, Osvaldo
Excessive accumulation of intermuscular adipose tissue (IMAT) is a common pathological feature in various metabolic and health conditions and can cause muscle atrophy, reduced function, inflammation, insulin resistance, cardiovascular issues, and unhealthy aging. Although IMAT results from fat accumulation in muscle, the mechanisms underlying its onset, development, cellular components, and functions remain unclear. IMAT levels are influenced by several factors, such as changes in the tissue environment, muscle type and origin, extent and duration of trauma, and persistent activation of fibro-adipogenic progenitors (FAPs). FAPs are a diverse and transcriptionally heterogeneous population of stromal cells essential for tissue maintenance, neuromuscular stability, and tissue regeneration. However, in cases of chronic inflammation and pathological conditions, FAPs expand and differentiate into adipocytes, resulting in the development of abnormal and ectopic IMAT. This review discusses the role of FAPs in adipogenesis and how they remodel IMAT. It highlights evidence supporting FAPs and FAP-derived adipocytes as constituents of IMAT, emphasizing their significance in adipose tissue maintenance and development, as well as their involvement in metabolic disorders, chronic pathologies and diseases. We also investigated the intricate molecular pathways and cell interactions governing FAP behavior, adipogenesis, and IMAT accumulation in chronic diseases and muscle deconditioning. Finally, we hypothesize that impaired cellular metabolic flexibility in dysfunctional muscles impacts FAPs, leading to IMAT. A deeper understanding of the biology of IMAT accumulation and the mechanisms regulating FAP behavior and fate are essential for the development of new therapeutic strategies for several debilitating conditions.
Gasto energético en reposo y concentración sérica de lipoproteínas de baja densidad en adultos con hipotiroidismo subclínico leve
(Sociedad Chilena de Nutrición, Bromatología y Toxicología, 2024-04-01) Fernández-Verdejo, Rodrigo
La alta prevalencia de hipotiroidismo subclínico en Chile puede deberse a que el límite superior normal de la hormona estimulante del tiroides (TSH) sérica es bajo. Personas con TSH levemente mayor al límite superior pueden ser metabólicamente similares a personas sanas. Se compararon marcadores de acción tiroidea (gasto energético en reposo [GER] y lipoproteína de baja densidad [LDL]) en adultos con hipotiroidismo subclínico leve y con función tiroidea normal con o sin tratamiento con levotiroxina. Se midió GER, perfil lipídico y tiroideo en personas sanas con función tiroidea normal (TSH ≥0,4-<4,5 µUI/ml; n=91); con hipotiroidismo subclínico leve (TSH ≥4,5-≤6,5 µUI/ml; n=5); y con hipotiroidismo clínico tratado con levotiroxina y TSH normal (n=13). Se analizó la LDL en 838 personas sanas con función tiroidea normal y 89 con hipotiroidismo subclínico leve de la Encuesta Nacional de Salud 2016/17 (ENS). El GER, ajustado por peso, sexo y edad, fue similar entre grupos (p=0,71). La LDL fue similar entre personas con función tiroidea normal e hipotiroidismo subclínico leve (91±24 vs. 101±17 mg/dl; p=0,67), y menor en hipotiroidismo tratado (64±22 mg/dl; p<0,01). La LDL no se asoció con TSH pero si inversamente con T4L en mujeres (r=-0,33; p=0,02; n=53). En la ENS, ambos grupos tuvieron similar LDL (p=0,34), la que se asoció inversamente con T4L en mujeres (r=-0,12; p=0,01; n=569) pero no con TSH. Personas sanas con función tiroidea normal y con hipotiroidismo subclínico leve tienen similar GER y LDL. Esto apoya la idea de redefinir el límite superior normal de TSH.
Low abundance of Mfn2 protein correlates with reduced mitochondria-SR juxtaposition and mitochondrial cristae density in human men skeletal muscle: Examining organelle measurements from TEM images
(Wiley Open Access, 2021-03-08) Castro-Sepulveda, Mauricio; Fernández-Verdejo, Rodrigo; Tuñón-Suárez, Mauro; Morales-Zúñiga, Jorge; Troncoso, Mayarling; Jannas-Vela, Sebastian; Zbinden-Foncea, Hermann
The role of mitofusin 2 (Mfn2) in the regulation of skeletal muscle (SM) mitochondria-sarcoplasmic (SR) juxtaposition, mitochondrial morphology, mitochondrial cristae density (MCD), and SM quality has not been studied in humans. In in vitro studies, whether Mfn2 increases or decreases mitochondria-SR juxtaposition remains controversial. Transmission electron microscopy (TEM) images are commonly used to measure the organelle juxtaposition, but the measurements are performed "by-hand," thus potentially leading to between-rater differences. The purposes of this study were to: (1) examine the repeatability and reproducibility of mitochondrial-SR juxtaposition measurement from TEM images of human SM between three raters with different experience and (2) compare the mitochondrial-SR juxtaposition, mitochondrial morphology, MCD (stereological-method), and SM quality (cross-sectional area [CSA] and the maximum voluntary contraction [MVC]) between subjects with high abundance (Mfn2-HA; n = 6) and low abundance (Mfn2-LA; n = 6) of Mfn2 protein. The mitochondria-SR juxtaposition had moderate repeatability and reproducibility, with the most experienced raters showing the best values. There were no differences between Mfn2-HA and Mfn2-LA groups in mitochondrial size, distance from mitochondria to SR, CSA, or MVC. Nevertheless, the Mfn2-LA group showed lower mitochondria-SR interaction, MCD, and VO2max . In conclusion, mitochondrial-SR juxtaposition measurement depends on the experience of the rater, and Mfn2 protein seems to play a role in the metabolic control of human men SM, by regulating the mitochondria-SR interaction.
Metabolic elasticity — a new trait associated with health?
(Nature Publishing Group, 2023-10-13) Fernández-Verdejo, Rodrigo; Galgani, Jose E.
A recent study by Zhou and colleagues proposed that low metabolic elasticity and gene elasticity are involved in the metabolic alterations observed in ageing and obesity. Here, we discuss some of their findings to provide a viewpoint on these potential new traits associated with metabolic health.
Predictive equations for energy expenditure in adult humans: From resting to free-living conditions
(Wiley; The Obesity Society, 2022-07-19) Fernández-Verdejo, Rodrigo; Galgani, José E.
Humans acquire energy from the environment for survival. A central question for nutritional sciences is how much energy is required to sustain cellular work while maintaining an adequate body mass. Because human energy balance is not exempt from thermodynamic principles, the energy requirement can be approached from the energy expenditure. Conceptual and technological advances have allowed understanding of the physiological determinants of energy expenditure. Body mass, sex, and age are the main factors determining energy expenditure. These factors constitute the basis for predictive equations for resting (REE) and total (TEE) energy expenditure in healthy adults. These equations yield predictions that differ up to ~400 kcal/d for REE and ~550 kcal/d for TEE. Identifying additional factors accounting for such variability and the most valid equations appears relevant. This review used novel approaches based on mathematical modeling of REE and analyses of the data from which REE predictive equations were generated. As for TEE, R2 and SE were considered because only a few predictive equations are available. From these analyses, Oxford's and Plucker's equations appear valid for predicting REE and TEE in adults, respectively.
Prevalence of non-alcoholic fatty liver disease and its association with lifestyle habits in adults in Chile: a cross-sectional study from the National Health Survey 2016-2017
(Cambridge University Press, 2023-01) Fernández-Verdejo, Rodrigo
Non-alcoholic fatty liver disease (NAFLD) represents an excessive fat accumulation within the liver, usually associated with excess body weight. A liver biopsy is the gold standard for diagnosis, but it is inapplicable in population-based studies. In large populations, non-invasive methods could be used, which may also serve to identify potential protective factors. We aimed to: [a] estimate NAFLD prevalence in the adult population in Chile by using non-invasive methods; and [b] determine the association between the presence of NAFLD and lifestyle habits. The National Health Survey of Chile 2016-2017 was analysed. We included individuals aged 21-75 years, without infectious diseases nor risky alcohol consumption. NAFLD was detected by either Fatty Liver Index (FLI; considers circulating triglycerides, circulating gamma-glutamyl-transferase, body mass index, and waist circumference), Lipid Accumulation Product (LAP; considers sex, circulating triglycerides, and waist circumference), or their combination. Lifestyle habits were determined by questionnaires. We included 2,774 participants, representative of 10,599,094 [9,831,644-11,366,544] adults in Chile. NAFLD prevalence [95%CI] was 39.4% [36.2-42.8] by FLI, 27.2% [24.2-30.4] by LAP, and 23.5% [20.7-26.5] by their combination. The prevalence progressively increased with increasing body mass index. Less smoking, and more moderate-vigorous physical activity and whole-grain consumption were associated with lower odds of having NAFLD, independently of body mass index. At least one out of four adults in Chile is afflicted with NAFLD. Health promotion strategies focused on controlling excess body weight and promoting specific lifestyle habits are urgently required.
Resting energy metabolism and sweet taste preference during the menstrual cycle in healthy women
(Newcastle University Population Health Sciences Inst, 2023-08-29) Fernández-Verdejo, Rodrigo; Malo-Vintimilla, Lorena; Aguirre, Carolina; Vergara, Angie; Galgani, Jose E.
Differences in blood concentration of sex hormones in the follicular (FP) and luteal (LP) phases may influence energy metabolism in women. We compared fasting energy metabolism and sweet taste preference on a representative day of the FP and LP in twenty healthy women (25·3 (SD 5·1) years, BMI: 22·2 (SD 2·2) kg/m2) with regular self-reported menses and without the use of hormonal contraceptives. From the self-reported duration of the three prior menstrual cycles, the predicted FP and LP visits were scheduled for days 5–12 and 20–25 after menses, respectively. The order of the FP and LP visits was randomly assigned. On each visit, RMR and RQ by indirect calorimetry, sweet taste preference by the Monell two-series forced-choice tracking procedure, serum fibroblast growth factor 21 by a commercial ELISA (FGF21, a liver-derived protein with action in energy balance, fuel oxidation and sugar preference) and dietary food intake by a 24-h dietary recall were determined. Serum progesterone and oestradiol concentrations displayed the expected differences between phases. RMR was lower in the FP v. LP (5042 (SD 460) v.5197 (SD 490) kJ/d, respectively; P = 0·04; Cohen effect size, drm = 0·33), while RQ showed borderline significant higher values (0·84 (SD 0·05) v.0·81 (SD 0·05), respectively; P = 0·07; drm = 0·62). Also, in the FP v. LP, sweet taste preference was lower (12 (SD 8) v. 16 (SD 9) %; P = 0·04;drm = 0·47) concomitant with higher serum FGF21 concentration (294 (SD 164) v. 197 (SD 104) pg/ml; P < 0·01; drm = 0·66). The menstrual cycle is associated with changes in energy expenditure, sweet taste preference and oxidative fuel partitioning.
Severe COVID-19 correlates with lower mitochondrial cristae density in PBMCs and greater sitting time in humans
(Wiley; The Physiological Society and the American Physiological Society, 2022-05-27) Castro-Sepulveda, Mauricio; Tapia, German; Tuñón-Suárez, Mauro; Marambio, Hugo; Valero-Breton, Mayalen; Fernández-Verdejo, Rodrigo; Zbinden-Foncea, Hermann
An interaction between mitochondrial dynamics, physical activity levels, andCOVID-19 severity has been previously hypothesized. However, this has notbeen tested. We aimed to compare mitochondrial morphology and cristae den-sity of PBMCs between subjects with non- severe COVID- 19, subjects with se-vere COVID- 19, and healthy controls. Additionally, we compared the level ofmoderate-vigorous physical activity (MVPA) and sitting time between groups.Blood samples were taken to obtain PBMCs. Mitochondrial dynamics were as-sessed by electron microscopy images and western blot of protein that regulatemitochondrial dynamics. The International Physical Activity Questionnaire(IPAQ; short version) was used to estimate the level of MVPA and the sitting timeThe patients who develop severe COVID-19 (COVID-19++) not present altera-tions of mitochondrial size neither mitochondrial density in comparison to non-severe patients COVID- 19 (COVID- 19) and control subjects (CTRL). However,compared to CTRL, COVID- 19 and COVID-19++ groups have lower mitochon-drial cristae length, a higher proportion of abnormal mitochondrial cristae. TheCOVID-19++ group has lower number (trend) and length of mitochondrial cris-tae in comparison to COVID- 19 group. COVID- 19, but not COVID- 19++ grouphad lower Opa 1, Mfn 2 and SDHB (Complex II) proteins than CTRL group.Besides, COVID-19++ group has a higher time sitting. Our results show that lowmitochondrial cristae density, potentially due to physical inactivity, is associatedwith COVID-19 severity.
Similar metabolic health in overweight/obese individuals with contrasting metabolic flexibility to an oral glucose tolerance test
(Frontiers Media S.A., 2021-11-16) Fernández-Verdejo, Rodrigo; Malo-Vintimilla, Lorena; Gutiérrez-Pino, Juan; López-Fuenzalida, Antonio; Olmos, Pablo; Irarrazaval, Pablo; Galgani, Jose E.
Background: Low metabolic flexibility (MetF) may be an underlying factor for metabolic health impairment. Individuals with low MetF are thus expected to have worse metabolic health than subjects with high MetF. Therefore, we aimed to compare metabolic health in individuals with contrasting MetF to an oral glucose tolerance test (OGTT). Methods: In individuals with excess body weight, we measured MetF as the change in respiratory quotient (RQ) from fasting to 1 h after ingestion of a 75-g glucose load (i.e., OGTT). Individuals were then grouped into low and high MetF (Low-MetF n = 12; HighMetF n = 13). The groups had similar body mass index, body fat, sex, age, and maximum oxygen uptake. Metabolic health markers (clinical markers, insulin sensitivity/resistance, abdominal fat, and intrahepatic fat) were compared between groups. Results: Fasting glucose, triglycerides (TG), and high-density lipoprotein (HDL) were similar between groups. So were insulin sensitivity/resistance, visceral, and intrahepatic fat. Nevertheless, High-MetF individuals had higher diastolic blood pressure, a larger drop in TG concentration during the OGTT, and a borderline significant (P = 0.05) higher Subcutaneous Adipose Tissue (SAT). Further, compared to Low-MetF, High-MetF individuals had an about 2-fold steeper slope for the relationship between SAT and fat mass index. Conclusion: Individuals with contrasting MetF to an OGTT had similar metabolic health. Yet High-MetF appears related to enhanced circulating TG clearance and enlarged subcutaneous fat.
Time reallocation of physical behaviours induced by endurance exercise in physically active individuals
(Taylor & Francis, 2023-04-16) Hayes-Ortiz, Thomas; Suárez-Reyes, Mónica; Galgani, José E.; Zbinden-Fonseca, Hermann; Fernández-Verdejo, Rodrigo
Increasing moderate-vigorous physical activity (MVPA) through exercise requires reallocating time from other physical behaviour(s). We aimed to determine the reallocations induced by endurance exercise in physically active individuals. We also searched for behavioural compensatory responses, and explored the effect of exercise on daily energy expenditure. Fourteen participants (8 women; median age 37.8 [IQR 29.9–48.5] yr) exercised on Monday, Wednesday, and Friday mornings (cycling MVPA, 65 min/session; “exercise days”), and avoided exercising on Tuesday and Thursday (“rest days”). Time spent on sleep, sedentary behaviour, light-intensity physical activity, and MVPA was determined each day by accelerometers and logs. An energy expenditure index was computed considering minutes spent on each behaviour and fixed metabolic equivalents. We found that all participants had lower sleep and higher total (including exercise) MVPA on exercise days compared to rest days. Thus, on exercise vs. rest days, sleep was lower (490 [453–553] vs. 553 [497–599] min/day, respectively, P < 0.001), and total MVPA was higher (86 [80–101] vs. 23 [15–45] min/day, respectively; P < 0.001). No differences in other physical behaviours were detected. Notably, exercise not only induced reallocations (i.e. less time in other behaviours) but also behavioural compensatory responses in some participants (e.g. increased sedentary behaviour). This rearrangement of physical behaviours manifested in exercise-induced increases in energy expenditure from 96 to 232 MET × min/day. In conclusion, active individuals reallocated time from sleep to accommodate morning exercise. Yet exercise induced variable rearrangements of behaviours, with some individuals manifesting compensatory responses. Understanding individual rearrangements may help improve exercise interventions.
Upper-Limb disability and the severity of lymphedema reduce the quality of life of patients with breast cancer-related lymphedema
(MDPI, 2023) Ramírez-Parada, Karol; Gonzalez-Santos, Angela; Riady-Aleuy, Layla; Pinto P., Mauricio; Ibáñez, Carolina; Merino, Tomas; Acevedo, Francisco; Walbaum, Benjamín; Fernández-Verdejo, Rodrigo
Breast cancer-related lymphedema (BCRL) is characterized by arm swelling, pain, and discomfort, reducing the quality of life (QoL) of affected individuals. BRCL is caused via the blockage or disruption of the lymphatic vessels following cancer treatments, leading to an accumulation of fluid in the affected arm. While current BCRL rehabilitation treatments seek to reduce arm swelling, our study aimed to examine the impact of both the magnitude of lymphedema (ΔVolume) and arm disability on three dimensions of QoL: social, physical, and psychological. Using the Disabilities of the Arm, Shoulder, and Hand questionnaire (DASH) and the Upper Limb Lymphedema 27 questionnaire (ULL) in a group of 30 patients, we found that the magnitude of lymphedema (ΔVolume) was associated with the social dimension of QoL (r = 0.37, p = 0.041), but not with other dimensions. On the other hand, arm disability was associated with all evaluated dimensions of QoL (social, physical, and psychological: p < 0.001, p = 0.019, and p = 0.050 (borderline), respectively). These findings suggest that BCRL rehabilitation strategies should not only aim to reduce the magnitude of lymphedema but should also seek to improve or preserve arm functionality to enhance the QoL of BCRL patients.
Work/household, transport, and leisure domains account for the sex gap in physical activity in Chile
(Frontiers Media S.A., 2022) Suárez-Reyes, Mónica; Fernández-Verdejo, Rodrigo
Background: Women usually have lower levels of moderate-vigorous physical activity (MVPA) than men. This sex gap can be accounted for by differences in MVPA in the work/household, transport, and/or leisure domains. Identifying where the differences lay in a context-specific manner may help close the gap. We aimed to compare MVPA by domain, and the relative contribution of each domain to total MVPA, between men and women in Chile. Methods: We analyzed the cross-sectional National Health Survey of Chile 2016–2017 (n = 5,056, 64% women, ≥18 years old). MVPA was estimated with the Global Physical Activity Questionnaire. MVPA was expressed in MET × min/week, and the relative contribution to total MVPA by each domain was expressed as percentage. Analyses were conducted including all participants, and also including participants reporting >0 MET × min/week of MVPA (relative contributions can only be computed in the latter). Results: Including all participants, women (vs. men) had lower MVPA (median [25–75th percentile]) for work/household (0 [0–960] vs. 0 [0–5,760] MET × min/week), for transport (360 [0–1,200] vs. 600 [0–1,680] MET × min/week), and for leisure domains (0 [0–0] vs. 0 [0–480] MET × min/week). Including only participants with >0 MET × min/week of MVPA, women (vs. men) had lower mean relative contributions to total MVPA from work/household (31.3 vs. 35.9%) and leisure domains (10.8 vs. 16.3%, respectively), but higher from the transport domain (57.9 vs. 47.8%). Conclusion: In Chile, differences in all physical activity domains account for the sex gap in MVPA. Strategies to break job stereotypes, increase opportunities for leisure, and ease active transport are required to encourage MVPA in women.

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