JUAN PABLO REY LOPEZ
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- Sedentary behavior and health outcomes among older adults: a systematic review(2014) REZENDE, Leandro Fornias Machado de; REY-LOPEZ, Juan Pablo; MATSUDO, Victor Keihan Rodrigues; LUIZ, Olinda do CarmoBackground: In the last decade, sedentary behavior has emerged as a new risk factor for health. The elderly spend most of their awake time in sedentary activities. Despite this high exposure, the impact of this sedentary behavior on the health of this population has not yet been reviewed. We systematically reviewed evidence for associations between sedentary behavior and multiple health outcomes in adults over 60 years of age. Methods: We searched the Medline, Embase, Web of Science, SPORTDiscus, PsycINFO, CINAHL, LILLACS, and Sedentary Research Database for observational studies published up to May 2013. Additionally, we contacted members of the Sedentary Behaviour Research Network to identify articles that were potentially eligible. After inclusion, the methodological quality of the evidence was assessed in each study. Results: We included 24 eligible articles in our systematic review, of which only 2 (8%) provided high-quality evidence. Greater sedentary time was related to an increased risk of all-cause mortality in the older adults. Some studies with a moderate quality of evidence indicated a relationship between sedentary behavior and metabolic syndrome, waist circumference, and overweightness/obesity. The findings for other outcomes such as mental health, renal cancer cells, and falls remain insufficient to draw conclusions. Conclusion: This systematic review supports the relationship between sedentary behavior and mortality in older adults. Additional studies with high methodological quality are still needed to develop informed guidelines for addressing sedentary behavior in older adults.
- The prevalence of metabolically healthy obesity: a systematic review and critical evaluation of the definitions used(2014) REY-LOPEZ, J. P.; REZENDE, L. F. de; PASTOR-VALERO, M.; TESS, B. H.We performed a systematic review of the prevalence of metabolically healthy obesity (MHO). Medline, Web of Science and EMBASE were searched for original articles from inception to November 2013. Only prospective and cross-sectional studies were included. After screening 478 titles, we selected 55 publications, of which 27 were population-based studies and were used in the narrative synthesis. From the 27 studies, we identified 30 definitions of metabolic health, mainly based on four criteria: blood pressure, high-density lipoprotein cholesterol, triglycerides and plasma glucose. Body mass index 30kgm(-2) was the main indicator used to define obesity (74% of the studies). Overall, MHO prevalence ranged between 6% and 75%. In the studies that stratified the analysis by sex, prevalence was higher in women (seven out of nine studies) and in younger ages (all four studies). One-third of the studies (n=9) reported the response rate. Of these, four reported a response rate of 70% and they showed MHO prevalence estimates between 10% and 51%. The heterogeneity of MHO prevalence estimates described in this paper strengthens calls for the urgent need for a commonly established metabolic health definition.
- Sedentary Behavior and Health Outcomes: An Overview of Systematic Reviews(2014) REZENDE, Leandro Fornias Machado de; LOPES, Mauricio Rodrigues; REY-LOPEZ, Juan Pablo; MATSUDO, Victor Keihan Rodrigues; LUIZ, Olinda do CarmoObjective: 1) To synthesize the current observational evidence for the association between sedentary behavior and health outcomes using information from systematic reviews. 2) To assess the methodological quality of the systematic reviews found. Methodology/Principal Findings: Medline; Excerpta Medica (Embase); PsycINFO; and Web of Science were searched for reviews published up to September 2013. Additional publications were provided by Sedentary Behaviour Research Network members. The methodological quality of the systematic reviews was evaluated using recommended standard criteria from AMSTAR. For each review, improper use of causal language in the description of their main results/conclusion was evaluated. Altogether, 1,044 review titles were identified, 144 were read in their entirety, and 27 were included. Based on the systematic reviews with the best methodological quality, we found in children and adolescents, strong evidence of a relationship between time spent in sedentary behavior and obesity. Moreover, moderate evidence was observed for blood pressure and total cholesterol, self-esteem, social behavior problems, physical fitness and academic achievement. In adults, we found strong evidence of a relationship between sedentary behavior and all-cause mortality, fatal and non-fatal cardiovascular disease, type 2 diabetes and metabolic syndrome. In addition, there is moderate evidence for incidence rates of ovarian, colon and endometrial cancers. Conclusions: This overview based on the best available systematics reviews, shows that sedentary behavior may be an important determinant of health, independently of physical activity. However, the relationship is complex because it depends on the type of sedentary behavior and the age group studied. The relationship between sedentary behavior and many health outcomes remains uncertain; thus, further studies are warranted.
- Obesity and sedentarism in children and adolescents: What should be bone?(2013) SANTALIESTRA-PASIAS, Alba M.; REY-LOPEZ, Juan Pablo; AZNAR, Luis A. MorenoPaediatric overweight continues to be a public health problem, and the etiology of obesity is multifactorial and complex. Dietary patterns, physical activity (PA) and sedentary behaviors are acknowledged as major behavioural determinants of obesity. New technologies and electronic based activities have produced a decrease in PA levels, and an increase in sedentary activities in children and adolescents. Potential mechanisms that explain the association between TV viewing and childhood obesity are: displacement of PA, unhealthy food preferences produced by food advertisements, a higher energy intake by automatic eating and overconsumption caused by distraction. Interventions aimed to reduce time in sedentary behaviours are in children generally positive. However, their benefits on adiposity markers are small. Thus, if global and macro-level obesogenic factors are not changed substantially, the interventions oriented to prevent obesity will produce small benefits.
- Effects of eight months of whole body vibration training on hip bone mass in older women(2015) SANTIN-MEDEIROS, Fernanda; SANTOS-LOZANO, Alejandro; REY-LOPEZ, Juan Pablo; GARATACHEA, NuriaObjective: The aim of this study was to examine the effect of 8 months of whole-body vibration training on bone mass in octogenarian women. Method: Thirty-seven women (aged 82.4 [SD=5.7] years) voluntarily participated in this study. The vibration group (n=19) trained on a vibration platform twice a week (20 Hz and 2 mm) whereas controls (n=18) did not participate in any training program. Bone mass was measured by dual-energy X-ray absorptiometry at the hip region. General linear repeated measures ANOVA (group by time) was used to examine the effect of whole body vibration on bone mass changes. Results: After the intervention, in all the hip regions (total hip, femoral neck, trochanter, intertrochanter, Ward's area), no statistically significant changes in bone mass were found. Conclusion: Eight months of whole body vibration training (twice a week) in elderly women do not produce osteogenic effects.
- Sleep time and cardiovascular risk factors in adolescents: The HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study(2014) REY-LOPEZ, J. P.; CARVALHO, H. B. de; MORAES, A. C. F. de; RUIZ, J. R.; SJOSTROM, M.; MARCOS, A.; POLITO, A.; GOTTRAND, F.; MANIOS, Y.; KAFATOS, A.; MOLNAR, D.; WIDHALM, K.; HENAUW, S. De; MORENO, L. A.Objective: We aimed to examine the association between adolescents' sleep time and a cardiometabolic risk score. A second aim was to examine associations between sleep time and individual cardiometabolic risk factors. Methods: Adolescents (N = 699; ages, 12.5-17.5 years) participating in the HELENA (Healthy Lifestyle in Europe by Nutrition in Adolescence) study were examined. Sleep time was reported by a questionnaire. Physical activity (PA) was assessed by accelerometry (n = 497). Cardiometabolic risk factors measurements included insulin resistance, blood pressure, adiposity markers, cardiorespiratory fitness, and blood lipids. A cardiovascular disease risk score was computed. Associations were examined by a multilevel regression analysis (linear for individual risk factors and Poisson for the clustered risk score). Results: For school days no association was found between sleep time and cardiometabolic risk factors. At weekend days, the prevalence ratio (PR) of having a clustered risk score increased by 15% for each additional hour of sleep controlling for age, sex, and socioeconomic status (SES); however, the prevalence disappeared when adjusting for PA. Conclusions: In European adolescents sleep time is not associated with cardiometabolic risk factors when important confounders are considered. Future research about sleep cardiovascular risk factors should register other sleep dimensions (sleep patterns or disturbances) to provide a better insight in this scientific field.
- EFFECTS OF EIGHT MONTHS OF WHOLE-BODY VIBRATION TRAINING ON THE MUSCLE MASS AND FUNCTIONAL CAPACITY OF ELDERLY WOMEN(2015) SANTIN-MEDEIROS, Fernanda; REY-LOPEZ, Juan P.; SANTOS-LOZANO, Alejandro; CRISTI-MONTERO, Carlos S.; VALLEJO, Nuria GaratacheaSantin-Medeiros, F, Rey-Lopez, JP, Santos-Lozano A, Cristi-Montero, CS, and Garatachea Vallejo, N. Effects of eight months of whole-body vibration training on the muscle mass and functional capacity of elderly women. J Strength Cond Res 29(7): 1863-1869, 2015Few intervention studies have used whole-body vibration (WBV) training in the elderly, and there is inconclusive evidence about its health benefits. We examined the effect of 8 months of WBV training on muscle mass and functional capacity in elderly women. A total of 37 women (aged 82.4 +/- 5.7 years) voluntarily participated in this study. Subjects were randomly assigned to a vibration group (n = 19) or a control group (n = 18). The vibration group trained on a vertical vibration platform twice a week. The control group was requested not to change their habitual lifestyle. The quadriceps femoris muscle cross-sectional area was determined by magnetic resonance imaging. All participants were evaluated by a battery of tests (Senior Fitness Test) to determine their functional capacity, as well as handgrip strength and balance/gait. General linear repeated-measure analysis of variance (group by time) was performed to examine the effect of the intervention on the outcomes variables. After 8 months, nonstatistically significant differences in the quadriceps CSA (pre-training: 8,516.16 +/- 1,271.78 mm(2) and post-training: 8,671.63 +/- 1,389.03 mm(2)) (p > 0.05) were found in the WBV group (Cohen's d: -0.12), whereas the CON group significantly decreased muscle mass (pre-training: 9,756.18 +/- 1,420.07 mm(2) and post-training: 9,326.82 +/- 1,577.53 mm(2)), with moderate effect size evident (Cohen's d: 0.29). In both groups, no changes were observed in the functional capacity, handgrip strength and balance/gait. The WBV training could prevent the loss of quadriceps CSA in elderly women.
- Independent and Combined Effects of Physical Activity and Sedentary Behavior on Blood Pressure in Adolescents: Gender Differences in Two Cross-Sectional Studies(2013) MORAES, Augusto Cesar Ferreira de; CARVALHO, Heraclito Barbosa; REY-LOPEZ, Juan Pablo; GRACIA-MARCO, Luis; BEGHIN, Laurent; KAFATOS, Anthony; JIMENEZ-PAVON, David; MOLNAR, Denes; HENAUW, Stefaan De; MANIOS, Yannis; WIDHALM, Kurt; RUIZ, Jonatan R.; ORTEGA, Francisco B.; SJOSTROM, Michael; POLITO, Angela; PEDRERO-CHAMIZO, Raquel; MARCOS, Ascension; GOTTRAND, Frederic; MORENO, Luis A.Objectives: To examine the independent and combined association of physical activity (PA) and sedentary behavior (SB) on both systolic (SBP) and diastolic blood pressure (DBP) in adolescents from two observational studies. Methods: Participants from two cross-sectional studies, one conducted in Europe (n = 3,308; HELENA study) and the other in Brazil (n = 991; BRACAH study), were selected by complex sampling. Systolic and diastolic blood pressure (outcomes), PA and SB, both independently and combined, and potential confounders were analyzed. Associations were examined by multilevel linear regression. Results: Performing the recommended amount of PA (>= 60 min/d) attenuated the effect of SB on DBP in BRACAH study girls and in boys from both studies. In contrast, PA did not attenuate the effects of SB on the SBP of girls in the HELENA study. The combination of less than recommended levels of PA with 2-4 h/d of sedentary behavior was found to be associated with increased SBP in boys from both studies. Conclusions: Meeting current PA recommendations could mediate the association between SB and DBP in both sexes. In boys, the joint effect of low levels of PA and excessive sedentary activity increases SBP levels. Longitudinal studies are required to confirm these findings.
- Case study in prevention(2016) REZENDE, L. F. M. de; REY-LóPEZ, J. P.; LUIZ, O. do Carmo; ELUF-NETO, J.In this chapter, we highlight our specifi c experience in conducting and reporting an overview of systematic reviews about sedentary behavior and health outcomes. In this overview, we aimed to cover all types of sedentary behavior, health outcomes, and age groups, taking into account the methodological quality of the systematic reviews. We hope to contribute to the discussion of methodological aspects of overviews of systematic reviews for prevention and health, especially on emerging determinants of health, where there is little conceptual or methodological uniformity between studies. © Springer International Publishing Switzerland 2016.
- Sedentary behaviours and its association with bone mass in adolescents: the HELENA cross-sectional study(2012) GRACIA-MARCO, Luis; REY-LOPEZ, Juan P.; SANTALIESTRA-PASIAS, Alba M.; JIMENEZ-PAVON, David; DIAZ, Ligia E.; MORENO, Luis A.; VICENTE-RODRIGUEZ, GermanBackground: We aimed to examine whether time spent on different sedentary behaviours is associated with bone mineral content (BMC) in adolescents, after controlling for relevant confounders such as lean mass and objectively measured physical activity (PA), and if so, whether extra-curricular participation in osteogenic sports could have a role in this association. Methods: Participants were 359 Spanish adolescents (12.5-17.5 yr, 178 boys,) from the HELENA-CSS (2006-07). Relationships of sedentary behaviours with bone variables were analysed by linear regression. The prevalence of low BMC (at least 1SD below the mean) and time spent on sedentary behaviours according to extracurricular sport participation was analysed by Chi-square tests. Results: In boys, the use of internet for non-study was negatively associated with whole body BMC after adjustment for lean mass and moderate to vigorous PA (MVPA). In girls, the time spent studying was negatively associated with femoral neck BMC. Additional adjustment for lean mass slightly reduced the negative association between time spent studying and femoral neck BMC. The additional adjustment for MVPA did not change the results at this site. The percentage of girls having low femoral neck BMC was significantly smaller in those participating in osteogenic sports (>= 3 h/week) than in the rest, independently of the cut-off selected for the time spent studying. Conclusions: The use of internet for non-study (in boys) and the time spent studying (in girls) are negatively associated with whole body and femoral neck BMC, respectively. In addition, at least 3 h/week of extra-curricular osteogenic sports may help to counteract the negative association of time spent studying on bone health in girls.