1,720,989 research outputs found
Sedentary behaviour and cardiometabolic health: Integrating the potential underlying molecular health aspects
No full textDuring the last decades, sedentary behaviour has been recognised as an interdependent risk factor for cardiometabolic health and premature mortality. Prolonged sedentary behaviour is associated with increased risks for chronic non-communicable diseases (NCDs) such as obesity, chronic respiratory diseases, type 2 diabetes mellitus, cardiovascular diseases and cancer due to disturbances in cardiometabolic health. However, despite the increased evidence supporting these associations, the underlying molecular mechanisms to the development of these NCDs remain largely unknown. In this review, we therefore discuss the existing evidence with regard to the potential underlying molecular mechanisms of sedentary behaviour-induced perturbations in cardiometabolic health. Here, various potential mechanisms related to carbohydrate metabolism, lipid metabolism, oxidative stress, inflammation and micro-and macro vascular function will be outlined. In addition, we summarise the current evidence on various strategies to interrupt sedentary behaviour and their effects on cardiometabolic health outcomes, including insulin sensitivity, blood lipid profiles, and cardiovascular health. Finally, we highlight key research gaps in the field of sedentary behaviour in relation to the underlying molecular mechanisms
Targeting sedentary behaviour:an activity tracker approach to combat physical inactivity and improve cardiometabolic health
Full text linkDuring the last decades, Western societies live in an environment that is characterized by passive forms of transportation, sedentary jobs and modern communication techniques. These changes have contributed to a predominantly physically inactive lifestyle in which a vast majority of our waking hours is spent in a seated position. Insufficient physical activity is a major contributor to a worse cardiometabolic health profile and the development of chronic diseases, such as type 2 diabetes mellitus and cardiovascular diseases. Despite the significant health benefits of physical activity, adherence to these physical activity guidelines is poor. In addition, it appears that even the recommended levels of physical activity do not always fully protect against cardiometabolic risk factors and the development of chronic diseases. As such, next to the time spent in physical activity, an additional factor that also appears to determine cardiometabolic health and chronic disease development is sedentary behaviour. This thesis investigated the effects of high amounts of physical activity to attenuate the detrimental effects of sedentary behaviour on cardiometabolic health. In addition, the effects of consumer wearable activity trackers to improve physical activity, sedentary behaviour and cardiometabolic health were investigated
The energy expenditure of different strategies to break up prolonged sedentary behaviour in office workers
No full textBackground: Since the millennium shift, the number of people who work in an office environment has increased up to 30%. This leads to an increase in sedentary behaviour (SB), which has been associated with numerous chronic diseases such as type 2 diabetes mellitus and cardiovascular disease. The underlying mechanisms are attributed to metabolic processes, including a higher postprandial glucose and lipid concentration, associated with the low energy expenditure of SB. Purpose: As studies now show that interrupting SB can acutely improve metabolic markers such as glucose regulation, this is an emerging field of research. Even more so because interruptions in SB, in terms of intensity, range from standing breaks to high-intensity physical activity breaks. In order to better compare different strategies for interrupting SB in an office environment, it is important to know the energy expenditure associated with these strategies. Therefore, this study was performed to compare the energy expenditure of two different strategies to interrupt prolonged SB that can be implemented in an office environment to enhance cardio-metabolic health. Methods: In this cross-sectional observational study, indirect calorimetry was used to determine the energy expenditure in three different simulated office environments (prolonged SB, 2min walking breaks @ 3km/h, standing breaks) for a duration of 15 minutes. This technique is based on measuring the oxygen uptake and CO2 production to calculate the associated energy expenditure and sub-strate oxidation. Results: Eleven participants completed all simulated office environments. There was a significant increase in energy expenditure in standing breaks compared to prolonged SB (þ0.11 kcal/min, p ¼ 0.02) and walking breaks compared to both prolonged SB (þ0.49 kcal/min, p < 0.001) and standing breaks (þ0.38 kcal/min, p < 0.001). Conclusions: This study suggests that indirect calorimetry can be used to determine the energy expenditure of different strategies to interrupt prolonged sedentary behaviour. Future studies should consider energy expenditure when studying the cardiometabolic health effects of reducing sedentary behaviour by implementing interruptions. Support/Funding Source: This study was funded by Hasselt University
Invasive fractional-flow-reserve prediction by coronary CT angiography using artificial intelligence vs. computational fluid dynamics software in intermediate-grade stenosis
No full textCoronary computed angiography (CCTA) with non-invasive fractional flow reserve (FFR) calculates lesion-specific ischemia when compared with invasive FFR and can be considered for patients with stable chest pain and intermediate-grade stenoses according to recent guidelines. The objective of this study was to compare a new CCTA-based artificial-intelligence deep-learning model for FFR prediction (FFRAI) to computational fluid dynamics CT-derived FFR (FFRCT) in patients with intermediate-grade coronary stenoses with FFR as reference standard. The FFRAI model was trained with curved multiplanar-reconstruction CCTA images of 500 stenotic vessels in 413 patients, using FFR measurements as the ground truth. We included 37 patients with 39 intermediate-grade stenoses on CCTA and invasive coronary angiography, and with FFRCT and FFR measurements in this retrospective proof of concept study. FFRAI was compared with FFRCT regarding the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy for predicting FFR <= 0.80. Sensitivity, specificity, PPV, NPV, and diagnostic accuracy of FFRAI in predicting FFR <= 0.80 were 91% (10/11), 82% (23/28), 67% (10/15), 96% (23/24), and 85% (33/39), respectively. Corresponding values for FFRCT were 82% (9/11), 75% (21/28), 56% (9/16), 91% (21/23), and 77% (30/39), respectively. Diagnostic accuracy did not differ significantly between FFRAI and FFRCT (p = 0.12). FFRAI performed similarly to FFRCT for predicting intermediate-grade coronary stenoses with FFR <= 0.80. These findings suggest FFRAI as a potential non-invasive imaging tool for guiding therapeutic management in these stenoses.This research is part of the Limburg Clinical Research Center (LCRC) Uhasselt-ZOL-Jessa, supported by Hasselt University, Jessa Hospital and Ziekenhuis Oost-Limburg
Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials
Full text linkBackground To date, it is unclear if consumer wearable activity trackers (CWATs), with or without behaviour multi-component strategies, effectively improve adherence to physical activity and health outcomes under free living conditions in populations with chronic diseases. Therefore, we systematically evaluated the efficacy of CWAT-based interventions to promote physical activity levels and cardiometabolic health in populations with chronic diseases. Methods Randomised controlled trials were collected from five bibliographic databases (PubMed, Embase, Web of Science, The Cochrane Central Register of Controlled Trials and CINAHL). Studies were eligible for inclusion if they evaluated a CWAT-based counselling intervention versus control intervention among patients with chronic respiratory diseases, type 2 diabetes mellitus, cardiovascular diseases, overweight/obesity, cognitive disorders, or sedentary older adults. Data were pooled using a random-effects model. Results After deduplication 8147 were identified of which 35 studies met inclusion criteria (chronic respiratory diseases: 7, type 2 diabetes mellitus: 12, cardiovascular diseases: 6, overweight/obesity: 3, cognitive disorders: 1, sedentary older adults: 6). Compared to control groups, CWAT-based interventions significantly increased physical activity by 2123 steps per day (95% confidence interval [CI], [1605-2641]; p <0.001). In addition, CWAT-based interventions in these populations significantly decreased systolic blood pressure (- 3.79 mm Hg; 95% CI: [- 4.53, - 3.04] mm Hg; p <0.001), waist circumference (- 0.99 cm; 95% CI: [- 1.48, - 0.50] cm; p <0.001) and low-density lipoprotein cholesterol concentration (- 5.70 mg/dl; 95% CI: [- 9.24, - 2.15] mg/dl; p = 0.002). Conclusion CWAT-based interventions increase physical activity and have beneficial effects on important health-related outcomes such as systolic blood pressure, waist circumference and LDL cholesterol concentration in patients with chronic diseases.</p
Replacing sitting with light-intensity physical activity throughout the day versus 1 bout of vigorous-intensity exercise: similar cardiometabolic health effects in multiple sclerosis. A randomised cross-over study
No full textPURPOSE: Persons with Multiple Sclerosis (PwMS) are physically inactive and spend more time in sedentary behaviours than healthy persons, which increases the risk of developing cardiometabolic diseases. In this randomised crossover study, the cardiometabolic health effects of replacing sitting with light-intensity physical activity (LIPA) and exercise (EX) were investigated. MATERIALS AND METHODS: Twenty-eight mildly disabled PwMS performed four 4-day activity regimens in free-living conditions; CONTROL (habitual activity), SIT, LIPA, and EX. Plasma glucose and insulin (oral glucose tolerance test), plasma lipids, inflammation, resting heart rate, blood pressure, body weight, and perceived exertion were measured (clinical-trials.gov: NCT03919058). RESULTS: CONTROL: 9.7 h sitting/day, SIT: 13.3 h sitting/day, LIPA: 8.3 h sitting, 4.7 h standing, and 2.7 h light-intensity walking/day, and EX: 11.6 h sitting/day with 1.3 h vigorous-intensity cycling. Compared to SIT, improvements (p < 0.001) after LIPA and EX were found for insulin total area under the curve (-17 019 ± 5708 and -23 303 ± 7953 pmol/L*min), insulin sensitivity (Matsuda index +1.8 ± 0.3 and +1.9 ± 0.4) and blood lipids (triglycerides: -0.4 ± 0.1 and -0.5 ± 0.1 mmol/L; non-high-density lipoprotein cholesterol: -0.3 ± 0.1 and -0.5 ± 0.1 mmol/L), with no difference between LIPA and EX. Perceived exertion was higher after EX compared to LIPA (Borg score [6-20]: +2.6 ± 3.3, p = 0.002). CONCLUSION: Replacing sitting with LIPA throughout the day exerts similar cardiometabolic health effects as a vigorous-intensity exercise in PwMS.IMPLICATIONS FOR REHABILITATIONIncreasing light-intensity physical activity (LIPA) throughout the day improves cardiometabolic health to the same extent as one vigorous-intensity exercise sessionIncreasing LIPA induces less exertion than performing a vigorous-intensity exercise.sponsorship: This work was supported by the Flemish Fund for Scientific Research (FWO Vlaanderen; 11E9221N). The funding source was not involved in the preparation of the article. (Flemish Fund for Scientific Research (FWO Vlaanderen)|11E9221N)status: Publishe
A scoping review on Chronic Venous Disease and the development of a Venous Leg Ulcer: The role of obesity and mobility
No full textObjective: The risk factors obesity and reduced mobility are not well known in the development of a Venous Leg Ulcer (VLU). The aim of this scoping review is to explore the mechanisms by which obesity and reduced mobility contribute the development of a VLU in patients with Chronic Venous Disease (CVD). Methods: For this scoping review a search was performed in May 2019 in the Cochrane Library and Pubmed to identify studies on the working mechanisms of obesity and mobility in developing a VLU. Hand searches were performed to find additional studies explaining the working mechanisms (indirectly related to the VLU). Two reviewers independently reviewed the abstracts and full-text articles. Results: Twenty-eight studies met our eligibility criteria. Disturbed range of ankle motion and gait can lead to a reduced Calf Muscle Pump (CMP) function which leading to a venous outflow disorder. Increased abdominal pressure due to obesity can lead to a venous outflow obstruction and increased adipose tissue mass results in an increase in adipokine secretion. The venous outflow disorder, outflow obstruction and increased adipokine secretion can all lead to chronic systemic inflammation, increased endothelial permeability and hence microcirculatory dysfunction. This alone can result in a VLU. Conclusion: Obesity and reduced mobility can lead to a reduction of the CMP function, an increase in abdominal pressure and an increase in adipose tissue mass. This can simultaneously lead to haemodynamic changes in the macro- and microcirculation of the lower extremities and eventually in a VLU. In patients with obesity and reduced mobility the microcirculation alone can lead to skin changes and eventually a VLU. Therefore, early recognition of CVD symptoms in patients with obesity and reduced mobility is crucial to diagnose and treat CVD to prevent a VLU
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