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The British Journal of Nutrition Aug 2023The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as... (Review)
Review
The identification of somatic growth, through reference curves, can be used to create strategies and public policies to reduce public health problems such as malnutrition and obesity and to identify underweight, overweight and obesity. The purpose of this systematic review was to identify studies providing reference growth curves for weight status in children and adolescents. A systematic search was conducted in eight databases and in gray literature (Google scholar). To assess the risk of bias/methodological quality of studies, the National Institutes of Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-sectional Studies (NHLBI) was used. Overall, 86 studies that met the inclusion criteria were included. Through the values of reference growth curves for the identification of underweight, overweight and obesity, it was possible to verify that there is great variability among percentiles for the identification of underweight, overweight and obesity. The most prevalent percentiles for underweight were P3 and P5; for overweight, the most prevalent was P85 and the most prevalent percentiles for obesity were P95 and P97. The most prevalent anthropometric indicators were Body Mass Index (BMI), Waist Circumference (WC), Body Mass (BM) for age and height for age. Conclusion: Such data can demonstrate that the optimal growth must be reached, through the standard growth curves, but that the reference curves demonstrate a cut of the population growth, raising possible variables that can influence the optimal growth, such as an increase in the practice of physical activities and an awareness of proper nutrition.
Topics: Humans; Child; Adolescent; Overweight; Thinness; Growth Charts; Cross-Sectional Studies; Obesity; Body Mass Index; Reference Values
PubMed: 36695353
DOI: 10.1017/S0007114522003786 -
Musculoskeletal Care Sep 2023It is unclear how much physical activity (PA) people with fibromyalgia (PwF) engage in. We conducted a meta-analysis to examine PA levels in PwF and compared levels with... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
It is unclear how much physical activity (PA) people with fibromyalgia (PwF) engage in. We conducted a meta-analysis to examine PA levels in PwF and compared levels with age- and gender-matched controls and between objective and subjective assessments.
METHODS
Embase, PubMed and CINAHL Plus were searched by two independent reviewers from inception till 3 January 2023 using the keywords: 'fibromyalgia' OR 'fibrositis' AND 'physical activity' OR 'exercise' OR 'sports'. A random effects meta-analysis adjusting for publication bias was conducted.
RESULTS
Across 22 studies, there were 5997 (5956 women) PwF (median age = 44 years). After trim and fill adjustment, PwF spent a mean of 4.0 (95% CI = 2.3-5.8) min/day in vigorous PA, 67.5 (95% CI = 35.4-99.6) min/day in moderate intensity PA and 270.5 (95% CI = 99.6-441.4) min/day in light PA. Only 37.7% (95% CI = 18.7-61.5) of PwF achieved the public PA recommendation of 150 min of moderate to vigorous PA per week. PwF walked 5663.7 (95% CI = 4493.5-6833.9) steps per day, which is below the 6000 steps per day recommendation. PwF spent 39.0 min/day (95% CI = 22.8-55.1, p < 0.001) less in PA than healthy controls, while MET-minutes per week is 1324.7 (95 % CI = 237.6-2411.7, p = 0.017) lower. There were no significant differences between subjective and objective PA assessments (p = 0.69).
CONCLUSION
Our data demonstrate that the majority of PwF are still insufficiently physically active to obtain significant health benefits. Future clinical PA interventions specifically targeting the prevention of physical inactivity in PwF and engaging physically inactive PwF to become physically active are warranted.
Topics: Humans; Female; Adult; Fibromyalgia; Sedentary Behavior; Walking
PubMed: 37186016
DOI: 10.1002/msc.1771 -
The Cochrane Database of Systematic... Oct 2021Cardiovascular disease (CVD) is a leading cause of death globally. Recently, dipeptidyl peptidase-4 inhibitors (DPP4i), glucagon-like peptide-1 receptor agonists... (Meta-Analysis)
Meta-Analysis
Dipeptidyl peptidase-4 inhibitors, glucagon-like peptide 1 receptor agonists and sodium-glucose co-transporter-2 inhibitors for people with cardiovascular disease: a network meta-analysis.
BACKGROUND
Cardiovascular disease (CVD) is a leading cause of death globally. Recently, dipeptidyl peptidase-4 inhibitors (DPP4i), glucagon-like peptide-1 receptor agonists (GLP-1RA) and sodium-glucose co-transporter-2 inhibitors (SGLT2i) were approved for treating people with type 2 diabetes mellitus. Although metformin remains the first-line pharmacotherapy for people with type 2 diabetes mellitus, a body of evidence has recently emerged indicating that DPP4i, GLP-1RA and SGLT2i may exert positive effects on patients with known CVD.
OBJECTIVES
To systematically review the available evidence on the benefits and harms of DPP4i, GLP-1RA, and SGLT2i in people with established CVD, using network meta-analysis.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, and the Conference Proceedings Citation Index on 16 July 2020. We also searched clinical trials registers on 22 August 2020. We did not restrict by language or publication status.
SELECTION CRITERIA
We searched for randomised controlled trials (RCTs) investigating DPP4i, GLP-1RA, or SGLT2i that included participants with established CVD. Outcome measures of interest were CVD mortality, fatal and non-fatal myocardial infarction, fatal and non-fatal stroke, all-cause mortality, hospitalisation for heart failure (HF), and safety outcomes.
DATA COLLECTION AND ANALYSIS
Three review authors independently screened the results of searches to identify eligible studies and extracted study data. We used the GRADE approach to assess the certainty of the evidence. We conducted standard pairwise meta-analyses and network meta-analyses by pooling studies that we assessed to be of substantial homogeneity; subgroup and sensitivity analyses were also pursued to explore how study characteristics and potential effect modifiers could affect the robustness of our review findings. We analysed study data using the odds ratios (ORs) and log odds ratios (LORs) with their respective 95% confidence intervals (CIs) and credible intervals (Crls), where appropriate. We also performed narrative synthesis for included studies that were of substantial heterogeneity and that did not report quantitative data in a usable format, in order to discuss their individual findings and relevance to our review scope.
MAIN RESULTS
We included 31 studies (287 records), of which we pooled data from 20 studies (129,465 participants) for our meta-analysis. The majority of the included studies were at low risk of bias, using Cochrane's tool for assessing risk of bias. Among the 20 pooled studies, six investigated DPP4i, seven studied GLP-1RA, and the remaining seven trials evaluated SGLT2i. All outcome data described below were reported at the longest follow-up duration. 1. DPP4i versus placebo Our review suggests that DPP4i do not reduce any risk of efficacy outcomes: CVD mortality (OR 1.00, 95% CI 0.91 to 1.09; high-certainty evidence), myocardial infarction (OR 0.97, 95% CI 0.88 to 1.08; high-certainty evidence), stroke (OR 1.00, 95% CI 0.87 to 1.14; high-certainty evidence), and all-cause mortality (OR 1.03, 95% CI 0.96 to 1.11; high-certainty evidence). DPP4i probably do not reduce hospitalisation for HF (OR 0.99, 95% CI 0.80 to 1.23; moderate-certainty evidence). DPP4i may not increase the likelihood of worsening renal function (OR 1.08, 95% CI 0.88 to 1.33; low-certainty evidence) and probably do not increase the risk of bone fracture (OR 1.00, 95% CI 0.83 to 1.19; moderate-certainty evidence) or hypoglycaemia (OR 1.11, 95% CI 0.95 to 1.29; moderate-certainty evidence). They are likely to increase the risk of pancreatitis (OR 1.63, 95% CI 1.12 to 2.37; moderate-certainty evidence). 2. GLP-1RA versus placebo Our findings indicate that GLP-1RA reduce the risk of CV mortality (OR 0.87, 95% CI 0.79 to 0.95; high-certainty evidence), all-cause mortality (OR 0.88, 95% CI 0.82 to 0.95; high-certainty evidence), and stroke (OR 0.87, 95% CI 0.77 to 0.98; high-certainty evidence). GLP-1RA probably do not reduce the risk of myocardial infarction (OR 0.89, 95% CI 0.78 to 1.01; moderate-certainty evidence), and hospitalisation for HF (OR 0.95, 95% CI 0.85 to 1.06; high-certainty evidence). GLP-1RA may reduce the risk of worsening renal function (OR 0.61, 95% CI 0.44 to 0.84; low-certainty evidence), but may have no impact on pancreatitis (OR 0.96, 95% CI 0.68 to 1.35; low-certainty evidence). We are uncertain about the effect of GLP-1RA on hypoglycaemia and bone fractures. 3. SGLT2i versus placebo This review shows that SGLT2i probably reduce the risk of CV mortality (OR 0.82, 95% CI 0.70 to 0.95; moderate-certainty evidence), all-cause mortality (OR 0.84, 95% CI 0.74 to 0.96; moderate-certainty evidence), and reduce the risk of HF hospitalisation (OR 0.65, 95% CI 0.59 to 0.71; high-certainty evidence); they do not reduce the risk of myocardial infarction (OR 0.97, 95% CI 0.84 to 1.12; high-certainty evidence) and probably do not reduce the risk of stroke (OR 1.12, 95% CI 0.92 to 1.36; moderate-certainty evidence). In terms of treatment safety, SGLT2i probably reduce the incidence of worsening renal function (OR 0.59, 95% CI 0.43 to 0.82; moderate-certainty evidence), and probably have no effect on hypoglycaemia (OR 0.90, 95% CI 0.75 to 1.07; moderate-certainty evidence) or bone fracture (OR 1.02, 95% CI 0.88 to 1.18; high-certainty evidence), and may have no impact on pancreatitis (OR 0.85, 95% CI 0.39 to 1.86; low-certainty evidence). 4. Network meta-analysis Because we failed to identify direct comparisons between each class of the agents, findings from our network meta-analysis provided limited novel insights. Almost all findings from our network meta-analysis agree with those from the standard meta-analysis. GLP-1RA may not reduce the risk of stroke compared with placebo (OR 0.87, 95% CrI 0.75 to 1.0; moderate-certainty evidence), which showed similar odds estimates and wider 95% Crl compared with standard pairwise meta-analysis. Indirect estimates also supported comparison across all three classes. SGLT2i was ranked the best for CVD and all-cause mortality.
AUTHORS' CONCLUSIONS
Findings from both standard and network meta-analyses of moderate- to high-certainty evidence suggest that GLP-1RA and SGLT2i are likely to reduce the risk of CVD mortality and all-cause mortality in people with established CVD; high-certainty evidence demonstrates that treatment with SGLT2i reduce the risk of hospitalisation for HF, while moderate-certainty evidence likely supports the use of GLP-1RA to reduce fatal and non-fatal stroke. Future studies conducted in the non-diabetic CVD population will reveal the mechanisms behind how these agents improve clinical outcomes irrespective of their glucose-lowering effects.
Topics: Cardiovascular Diseases; Dipeptidyl-Peptidase IV Inhibitors; Dipeptidyl-Peptidases and Tripeptidyl-Peptidases; Glucagon-Like Peptide 1; Glucose; Humans; Network Meta-Analysis; Sodium; Sodium-Glucose Transporter 2 Inhibitors; Symporters
PubMed: 34693515
DOI: 10.1002/14651858.CD013650.pub2 -
Scandinavian Journal of Medicine &... Apr 2024Although evidence regarding the effects of high-intensity interval training (HIIT) on mental health has increased in recent years, there is still no consensus regarding... (Meta-Analysis)
Meta-Analysis Review
Effects of high-intensity interval training on depressive and anxiety symptoms in healthy individuals: A systematic review and meta-analysis of randomized clinical trials.
Although evidence regarding the effects of high-intensity interval training (HIIT) on mental health has increased in recent years, there is still no consensus regarding the effects of HIIT on the symptoms of depression and anxiety in a healthy population. Therefore, this systematic review aimed to investigate the effects of HIIT on depressive and/or anxiety symptoms in healthy individuals. The following four databases were searched: PubMed, Scopus, Embase, and PsycINFO. Only randomized clinical trials (RCTs) were included. We performed a random-effects meta-analysis based on standardized mean difference (SMD). The risk of bias was assessed using the RoB 2.0 tool, and the certainty of the evidence was evaluated based on recommendations GRADE. Eight RCTs evaluating 471 participants (81% female) were considered eligible for inclusion. The results of the meta-analysis showed that HIIT-based interventions had no significant effect on reducing anxiety (SMD = -0.17; 95% CI: -0.53, 0.19; p = 0.27) and depressive symptoms (SMD = -0.38; 95% CI: -1.06, 0.30; p = 0.17) compared with the passive control group. In conclusion, HIIT does not improve symptoms of depression and anxiety in healthy individuals. This finding is based on evidence of very low certainty. Therefore, the evidence is still not consistent enough to support HIIT as a viable strategy to reduce both outcomes because of the limited number of included studies and the overall quality of evidence.
Topics: Female; Humans; Male; High-Intensity Interval Training; Randomized Controlled Trials as Topic; Anxiety; Health Status; Mental Health; Quality of Life
PubMed: 38566446
DOI: 10.1111/sms.14618 -
International Journal of Environmental... May 2019Physical activity has a beneficial effect on the brain's development process and cognitive function. However, no review to date has evaluated the effects of active... (Meta-Analysis)
Meta-Analysis
Active Commuting to and from School, Cognitive Performance, and Academic Achievement in Children and Adolescents: A Systematic Review and Meta-Analysis of Observational Studies.
BACKGROUND
Physical activity has a beneficial effect on the brain's development process and cognitive function. However, no review to date has evaluated the effects of active commuting to and from school (ACS) on cognitive performance and academic achievement. The aim of this systematic review and meta-analysis was to evaluate the link between ACS and cognitive performance and academic achievement in children and adolescents.
METHODS
We systematically searched MEDLINE, EMBASE, Web of Science and PsycINFO databases for all observational studies published until May 2019 that examined the association between ACS and cognitive performance or academic achievement. Studies were classified into two groups according to their measured outcomes: cognitive performance (nonexecutive cognitive functions, core executive functions, and metacognition) and academic achievement (marks of different areas). A pooled effect size (ES) was estimated using the DerSimonian and Laird random-effects method for cognitive performance and each area of academic achievement.
RESULTS
Twelve studies that evaluated the relationship between ACS and cognitive performance or academic achievement were included in the systematic review: four studies analyzed both cognitive performance and academic achievement, one study provided data regarding cognitive performance and seven provided data on academic achievement. Finally, nine of 12 studies provided enough data for inclusion in the meta-analysis. Our findings suggest that ACS was not significantly associated with cognitive performance (ES= -0.02; 95% CI: -0.06 to 0.03) or academic achievement (ES= -0.33; 95% CI: -0.83 to 0.17 for mathematics-related skills; ES= -0.37; 95% CI: -0.88 to 0.15 for language-related skills).
CONCLUSIONS
There was insufficient evidence regarding the relationship between ACS and cognitive performance and academic achievement. Future studies should include potential confounders in their analyses and consider the use of standardized self-reports or objective measures of ACS.
Topics: Academic Success; Adolescent; Child; Cognition; Exercise; Humans; Observational Studies as Topic; Schools; Transportation
PubMed: 31126148
DOI: 10.3390/ijerph16101839 -
Psychiatry Research Aug 2023Physical activity is associated with better global functioning in the general population and in people with physical conditions. However, there is no meta-analytic... (Meta-Analysis)
Meta-Analysis Review
Physical activity is associated with better global functioning in the general population and in people with physical conditions. However, there is no meta-analytic evidence on the associations between daily physical activity levels and global functioning in people with mental disorders. The objective of the present meta-analysis therefore was to evaluate the associations between daily physical activity levels and global functioning in individuals with mental disorders. Pubmed, Embase, PsycINFO and SPORTdiscus were searched from inception to August 1st, 2022. Risk of bias was assessed using the National Institutes of Health Study Quality Assessment Tools. A random-effects meta-analysis was performed. Ten studies were identified and six were meta-analyzed including 251 adults (39.2 ± 11.9 years, 33.6% of women). The pooled results from six studies found a moderate positive correlation (r = 0.39, 95% CI 0.242 to 0.528, p<0.001, I²=49.3%) between daily physical activity and global functioning. Three out of four studies not included in the meta-analysis also found significant associations between physical activity and global functioning. The current meta-analysis demonstrated a moderate association between daily physical activity and global functioning in individuals with mental disorders. However, the evidence is based on cross-sectional studies and a causal relationship cannot be established. High-quality longitudinal studies aiming to address this relationship should be conducted.
Topics: Adult; Humans; Female; Cross-Sectional Studies; Mental Disorders; Exercise
PubMed: 37364506
DOI: 10.1016/j.psychres.2023.115312 -
Heart (British Cardiac Society) Oct 2016Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Atrial fibrillation (AF) is common in hypertrophic cardiomyopathy (HCM) and is associated with a high risk of stroke. The efficacy and safety of catheter ablation in this setting is poorly characterised. We aimed to systematically review the existing literature and to perform a meta-analysis to determine the efficacy and safety of catheter ablation of AF in patients with HCM.
METHODS
Random-effects meta-analysis of studies comparing HCM versus non-HCM controls. The outcomes of freedom from AF/atrial tachycardia, and acute procedure-related complications were assessed. Studies were searched on MEDLINE, EMBASE, COCHRANE and clinicaltrials.gov.
RESULTS
Fourteen studies were considered eligible for the systematic review, of which five were included in the meta-analysis. Freedom from AF/atrial tachycardia relapse was higher in patients without HCM (after a single procedure: 38.7% HCM vs 49.8% controls, OR=2.25, 95% CI 1.09 to 4.64, p=0.03; after ≥1 procedure: 51.8% HCM vs 71.2% controls, OR=2.62, 95% CI 1.52 to 4.51, p=0.0006; I(2)=33% and 26%, respectively). Risk of procedure-related adverse events was low. Repeat procedures (mean difference=0.16, 95% CI 0.0 to 0.32, p=0.05, I(2)=53%) and antiarrhythmic drugs (OR=4.70, 95% CI 2.31 to 9.55, p<0.0001, I(2)=0%) are more frequently needed in patients with HCM to prevent arrhythmia relapse. Sensitivity analyses suggested that the outcome in patients with HCM with less dilated atria and paroxysmal AF may be more comparable to the general population.
CONCLUSIONS
The observed complication rate of catheter ablation of AF in patients with HCM was low. Even though the risk of relapse is twofold higher, catheter ablation can be effective in patients with HCM and AF, particularly in patients with paroxysmal AF and smaller atria.
Topics: Adult; Aged; Anti-Arrhythmia Agents; Atrial Fibrillation; Cardiomyopathy, Hypertrophic; Catheter Ablation; Chi-Square Distribution; Disease-Free Survival; Female; Humans; Male; Middle Aged; Odds Ratio; Recurrence; Reoperation; Risk Factors; Treatment Outcome
PubMed: 27234160
DOI: 10.1136/heartjnl-2016-309406 -
Archives of Physical Medicine and... Mar 2024To meta-analyze the prevalence and predictors of dropout rates among adults with fibromyalgia participating in exercise randomized controlled trials (RCTs). (Meta-Analysis)
Meta-Analysis
OBJECTIVE
To meta-analyze the prevalence and predictors of dropout rates among adults with fibromyalgia participating in exercise randomized controlled trials (RCTs).
DATA SOURCES
Two authors searched Embase, CINAHL, PsycARTICLES, and Medline up to 01/21/2023.
STUDY SELECTION
We included RCTs of exercise interventions in people with fibromyalgia that reported dropout rates.
DATA EXTRACTION
Dropout rates from exercise and control conditions and exerciser/participant, provider, and design/implementation related predictors.
DATA SYNTHESIS
A random effects meta-analysis and meta-regression were conducted. In total, 89 RCTs involving 122 exercise arms in 3.702 people with fibromyalgia were included. The trim-and-fill-adjusted prevalence of dropout across all RCTs was 19.2% (95% CI=16.9%-21.8%), which is comparable with the dropout observed in control conditions with the trim-and-fill-adjusted odds ratio being 0.31 (95% CI=0.92-1.86, P=.44). Body mass index (R=0.16, P=.03) and higher effect of illness (R=0.20, P=.02) predicted higher dropout. The lowest dropout was observed in exergaming, compared with other exercise types (P=.014), and in lower-intensity exercises, compared with high intensity exercise (P=.03). No differences in dropout were observed for the frequency or duration of the exercise intervention. Continuous supervision by an exercise expert (eg, physiotherapist) resulted in the lowest dropout rates (P<.001).
CONCLUSIONS
Exercise dropout in RCTs is comparable with control conditions, suggesting that exercise is a feasible and accepted treatment modality; however, interventions are ideally supervised by an expert (eg, physiotherapist) to minimize the risk of dropout. Experts should consider a high BMI and the effect of the illness as risk factors for dropout.
Topics: Adult; Humans; Body Mass Index; Exercise Therapy; Fibromyalgia; Odds Ratio; Patient Dropouts
PubMed: 37331421
DOI: 10.1016/j.apmr.2023.06.002 -
Neuroscience and Biobehavioral Reviews Mar 2024A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the... (Review)
Review
A growing body of research has demonstrated the potential role for physical activity as an intervention across mental and other medical disorders. However, the association between physical activity and suicidal ideation, attempts, and deaths has not been systematically appraised in clinical samples. We conducted a PRISMA 2020-compliant systematic review searching MEDLINE, EMBASE, and PsycINFO for observational studies investigating the influence of physical activity on suicidal behavior up to December 6, 2023. Of 116 eligible full-text studies, seven (n = 141691) were included. Depression was the most frequently studied mental condition (43%, k = 3), followed by chronic pain as the most common other medical condition (29%, k = 2). Two case-control studies examined suicide attempts and found an association between physical activity and a reduced frequency of such attempts. However, in studies examining suicidal ideation (k = 3) or suicide deaths (k = 2), no consistent associations with physical activity were observed. Overall, our systematic review found that physical activity may be linked to a lower frequency of suicide attempts in non-prospective studies involving individuals with mental disorders.
Topics: Humans; Suicide, Attempted; Suicidal Ideation; Risk Factors; Mental Disorders; Exercise
PubMed: 38246231
DOI: 10.1016/j.neubiorev.2024.105547 -
Sao Paulo Medical Journal = Revista... 2022The relationship with body image, which is the way the body presents itself to each subject, can be aggravated in children and adolescents diagnosed with an human...
CONTEXT
The relationship with body image, which is the way the body presents itself to each subject, can be aggravated in children and adolescents diagnosed with an human immunodeficiency virus (HIV) infection, since these patients use antiretroviral therapy and may suffer from the adverse effects of the treatment due to continuous use of medication.
OBJECTIVE
To estimate the prevalence of body image dissatisfaction, to describe the assessment methods, and to identify associated factors in children and adolescents diagnosed with HIV.
DESIGN AND SETTING
This is a systematic review. Department of Physical Education, Florianópolis - Brazil.
METHODS
We followed the procedures of the Preferred Reporting Items for Systematic Reviews (PRISMA) and the Cochrane recommendations in the selection of articles through a search performed in eight databases.
RESULTS
Prevalence of body image dissatisfaction due to thinness was between 36.7-52.0% in males and 28.1-36.4% in females, and body image dissatisfaction due to overweight was between 8.0-31.2% in males and 21.9-50.0% in females. Factors associated with body image dissatisfaction were as follows: female sex, older age, low levels of physical activity, low self-esteem, higher body fat, higher body weight, greater arm muscle area, triceps skinfold thickness, and higher body mass index.
CONCLUSION
Children and adolescents of both sexes diagnosed with HIV infection are dissatisfied by thinness and overweight of their body image.
REGISTRATION
https://www.crd.york.ac.uk/prospero/ (CRD42021257676).
Topics: Male; Humans; Child; Adolescent; Female; Body Image; Overweight; Thinness; HIV; HIV Infections; Body Mass Index; Body Weight
PubMed: 36417660
DOI: 10.1590/1516-3180.2022.0154.R2.19082022