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- Changes in metabolic and inflammatory markers after a combined exercise program in workers : a randomized controlled trialPublication . Silva, Fernanda; Duarte-Mendes, Pedro; Ferreira, José P.; Carvalho, Eugénia; Monteiro, Diogo; Massart, Alain; Farinha, Carlos; Soares, Carlos M.; Teixeira, AnaPurpose: We investigated the effects of a 16-week combined exercise training on body composition, metabolic and inflammatory markers in sedentary middle-aged workers. We also assessed whether significant alterations in metabolic markers were associated with changes in health-related outcomes. Methods: This randomized controlled trial involved 46 participants randomly allocated into control and exercise groups. The exercise group performed 16-week combined aerobic and resistance training for 75 min/session, 3 times/week. Fasting blood samples were collected at baseline and after 16-week intervention to determine lipid profile, metabolic and inflammatory markers as primary outcomes. Results: A total of 36 participants completed the intervention (53.70 ± 6.92 years old) (n = 18 in each group). Waist circumference (interaction effect: F = 7.423, p = 0.002), fat mass (interaction effect: F = 5.070, p = 0.011), and muscle mass (interaction effect: F = 5.420, p = 0.007) were improved in the exercise group compared to the control group. Fasting glucose increased after the 16-week follow-up (time effect: F = 73.253, p < 0.001), without an intergroup difference. Insulin levels were greater in the control compared to exercise group (group effect: F = 6.509, p = 0.015). The control group tended to increase the HOMA-IR index (interaction effect: F = 3.493, p = 0.070) and to decrease the QUICKI index (interaction effect: F = 3.364, p = 0.075) to a greater extent compared to the exercise group. Exercise group reduced leptin (interaction effect: F = 11.175, p = 0.002) and adiponectin (interaction effect: F = 4.437, p = 0.043) concentrations in a greater magnitude than control group. IL-6 (time effect: F = 17.767, p < 0.001) and TNF-α (time effect: F = 9.781, p = 0.004) concentrations decreased after the intervention, without an intergroup difference. IL-17A levels increased in the control compared to exercise group (interaction effect: F = 5.010, p = 0.033). Effects on adiponectin, IL-6 and IL-17A levels seem to depend on baseline BMI, age, and sex. Percentage changes in leptin correlated positively with changes in HOMA-IR index in the exercise (r = 0.565, p = 0.015) and control (r = 0.670, p = 0.002) groups. Conclusions: A combined training program can be an effective strategy to improve body composition and inflammatory markers and prevent marked reductions in insulin sensitivity among middle-aged workers.
- Heart rate variability behavior in athletes after a sports concussion : a systematic reviewPublication . Flores, Gonçalo; Monteiro, Diogo; Silva, Fernanda; Duarte-Mendes, PedroObjective: This systematic review aims to investigate the adaptations of the autonomic nervous system (ANS) after a concussion by measuring HRV in athletes over the age of 16 after injury. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Web of Science, Pubmed, SCOPUS, and Sport Discus were searched using predefined search terms to identify relevant original cross-sectional, longitudinal, and cohort epidemiological studies published before December 2021. Results: After screening 1737 potential articles, four studies met the inclusion criteria. Studies included participants with concussion (n = 63) and healthy control athletes (n = 140) who practised different sports. Two studies describe a decrease in HRV following a sports concussion, and one proposed that the resolution of symptoms does not necessarily reflect ANS recovery. Lastly, one study concluded that submaximal exercise induces alteration in ANS, not seen in rest after an injury. Conclusions: In the frequency domain, a decrease in high frequency power and an increase of low frequency/high frequency ratio is expected, as the activity of the sympathetic nervous system increases, and the parasympathetic nervous system decreases after injury. In the frequency domain, heart rate variability (HRV) may help monitor the activity of ANS evaluating signals of somatic tissue distress and early identification of other types of musculoskeletal injuries. Further research should investigate the relationship between HRV and other musculoskeletal injuries.
- Objectively Measured Physical Activity and Sedentary Behaviour on Cardiovascular Risk and Health-Related Quality of Life in Adults: A Systematic ReviewPublication . Santos, Beatriz; Monteiro, Diogo; Silva, Fernanda; Flores, Gonçalo; Bento, T.; Duarte-Mendes, PedroBackground: This systematic review analysed the association between objectively measured physical activity and sedentary behaviour with cardiovascular risk and HRQoL in adults without previous CVD. Additionally, we analysed the impact of the intensity of the physical activity in this association. Methods: The search was carried out in three electronic databases with access until February 2023 to find studies with an observational design. For quality assessment, we used The National Institute of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results: We identified 5819 references, but only five studies were included. One study shows a positive association between physical activity and HRQoL, while sedentary behaviour was negatively related to HRQoL. Another study showed an association between high-intensity physical activity with a better physical component of HRQoL and low-intensity physical activity with a better mental component of HRQoL. Three studies concluded that higher levels of physical activity are associated with lower levels of cardiovascular risk and higher levels of sedentary behaviour are associated with higher levels of cardiovascular risk. Conclusion: Our findings suggested that people who spend more time being active and spend less time being sedentary appear to have lower cardiovascular risk and higher HRQoL.