Activité physique durant la grossesse: associations avec le poids de naissance et la composition corporelle du nouveau-né

Plusieurs études se sont penchées sur les effets de l’activité physique maternelle sur le poids du nouveau-né, un paramètre reflétant l’environnement intra-utérin associé au risque ultérieur d’obésité et de problèmes métaboliques. Devant les taux alarmants d’obésité infantile à travers le monde, l’identification d’interventions préventives efficaces devient un enjeu majeur dans la lutte contre l’obésité et ses complications. L’activité physique maternelle pourrait être une avenue intéressante, étant donné ses effets bénéfiques sur le gain de poids et le profil métabolique maternels et son potentiel de diminution du poids de naissance de l’enfant. Cependant, la dose optimale d’activité physique et ses effets sur la composition corporelle du nouveau-né sont encore méconnus. Par ailleurs, la majorité des femmes enceintes ne rencontrent pas les recommandations en matière d’activité physique durant la grossesse et les femmes obèses, chez qui les bienfaits de l’activité physique pourraient possiblement avoir le plus grand impact, présentent souvent les niveaux les plus bas. Curieusement, peu d’études ont évalué les effets d’une intervention d’activité physique durant la grossesse dans cette population. Ainsi, avant d’envisager l’activité physique comme une intervention thérapeutique non-pharmacologique durant la grossesse, il importe d’en évaluer la faisabilité et la sécurité et d’en connaître extensivement les effets. Notamment, il s’avère primordial de vérifier s’il est possible d’augmenter en toute sécurité les niveaux d’activité physique durant la grossesse, particulièrement chez les femmes obèses, et de distinguer les effets spécifiques de différents stimuli d’activité physique (variant en type, volume, intensité et moment de la grossesse) sur la croissance fœtale. Dans ce contexte, nous avons dans un premier temps entrepris une revue systématique de la littérature des études observationnelles portant sur l’association entre l’activité physique maternelle et les paramètres de croissance fœtale mesurés à la naissance. Dans un deuxième temps, 2 études de cohortes évaluant l’impact du type, du volume, de l’intensité et du trimestre de pratique de l’activité physique ont été menées afin de complémenter et d’approfondir les résultats de la revue systématique. Finalement, une étude d’intervention randomisée a été réalisée afin d’évaluer s’il est possible d’améliorer les niveaux d’activité physique durant la grossesse chez les femmes enceintes obèses. Nos travaux ont permis d’illustrer l’influence variable que différents stimuli d’activité physique maternelle peuvent avoir sur l’anthropométrie néonatale. La revue systématique a montré qu’un volume moyen d’activité physique est associé à une augmentation du poids de naissance comparativement à un volume plus faible, alors qu’un volume élevé est associé à une diminution du poids de naissance, comparativement à un volume plus faible. Nos données suggèrent également que l’association entre l’activité physique maternelle et le poids de naissance varie en présence de certaines caractéristiques maternelles. Notamment, nous avons montré pour la première fois que l’activité physique vigoureuse pratiquée en début de grossesse était associée à une diminution importante du poids de naissance chez les femmes qui reçoivent un diagnostic de pré-éclampsie en fin de grossesse. L’importance de l’intensité de l’activité physique dans la relation entre l’activité physique maternelle et la croissance fœtale a également été soulignée pour la première fois dans notre étude de cohorte avec mesure de la composition corporelle néonatale. Contrairement à l’activité physique d’intensité modérée, l’activité physique vigoureuse en début de grossesse est associée à une diminution du poids de naissance, principalement en raison d’une adiposité néonatale réduite. Finalement, les résultats de l’essai randomisé ont permis d’établir la faisabilité d’une intervention d’activité physique supervisée visant à augmenter la pratique d’activité physique chez des femmes enceintes obèses et le potentiel d’une telle intervention à favoriser le maintien de la condition physique et une meilleure gestion du gain de poids chez ces femmes. L’ensemble de ces résultats permet de mieux cerner l’impact de l’activité physique maternelle sur la croissance fœtale, en fonction des caractéristiques spécifiques du stimulus d’activité physique mais également de la population étudiée. La faisabilité d’une intervention d’activité physique prénatale dans une population de femmes obèses laisse entrevoir de nouvelles possibilités dans la prévention de l’obésité infantile et de ses complications. L’identification d’une dose optimale d’activité physique favorisant la santé de l’enfant à court et à long terme dans diverses populations de femmes enceintes et l’identification des facteurs permettant une meilleure adhérence aux recommandations qui en découleront constituent des pistes de recherche essentielles à la lutte contre l’obésité.

Effects of a rhythmic and choreographic program in obese and overweight participants

Introduction: Currently there is a growing trend in the prevalence of overweight and obesity. This increased prevalence trend leads to an increase in the costs of health care. Objective: The aim of the present study was to analyze the effects on physical fitness and bone mineral density through an intervention program of physical activity based on rhythmic and choreographic activities in an overweight and obese population. Method: An 8-month physical activity based on rhythmic and choreographic activities was conducted in overweight and obese people. Thirty-four participants aged 50.43 ± 10.57 with a body mass index (BMI) 38.37 ± 4.82 took part in the physical activity program. This study assesses the effects of fitness, percentage of body fat and bone mineral density (BMD). Results: After an 8-month physical activity intervention program based on rhythmic and choreographic activities, significant differences were found in: percentage of body fat (p = 0.004), aerobic capacity (p = 0.023), flexibility of the lower limbs (flexibility in the right leg p = 0.029 and left leg p = 0.002), balance (p < 0.001), strength in lower limbs (p = 0..003) and strength in upper limbs (p < 0.001). Besides that, significant differences were found in parameters related with BMD such as T-Score (p = 0.025) and Z-Score (p = 0.012), Bone Quality Index (BQI) (p = 0.026) and an increase in Broadband Ultrasound Attenuation (BUA) although not a statistically significant one (p = 0.939). Conclusions: These findings suggest that a physical activity program based on rhythmic and choreographic activities can act as a preventive method of mobility and fragility, as well as preventing bone loss.

Imaginarios sociales de adolescentes y docentes en torno al cuerpo, la corporalidad y la actividad física. Estudio cualitativo en un colegio de Bogotá, 2014-2015.

Problema. Esta investigación se aproxima al entorno escolar con el propósito de avanzar en la comprensión de los imaginarios de los adolescentes y docentes en torno al cuerpo, la corporalidad y la AF, como un elemento relevante en el diseño de programas y planes efectivos para fomento de la práctica de AF. Objetivo. Analizar los imaginarios sociales de docentes y adolescentes en torno a los conceptos de cuerpo, corporalidad y AF. Métodos. Investigación de corte cualitativo, descriptivo e interpretativo. Se realizaron entrevistas semi-estructuradas a docentes y a estudiantes entre los 12 y 18 años de un colegio público de Bogotá. Se realizó análisis de contenido. Se compararon los resultados de estudiantes por grupos de edades y género. Resultados. Docentes y estudiantes definen el cuerpo a partir de las características biológicas, las diferencias sexuales y las funciones vitales. La definición de corporalidad en los estudiantes se encuentra ligada con la imagen y la apariencia física; los docentes la entienden como la posibilidad de interactuar con el entorno y como la materialización de la existencia. La AF en los estudiantes se asocia con la práctica de ejercicio y deporte, en los docentes se comprende como una práctica de autocuidado que permite el mantenimiento de la salud. Conclusiones. Para promover la AF tempranamente como una experiencia vital es necesario intervenir los espacios escolares. Hay que vincular al cuerpo a los procesos formativos con el propósito de desarrollar la autonomía corporal, este aspecto implica cambios en los currículos.

Factores asociados al desplazamiento activo en bicicleta al colegio en el Distrito Bogotá, Colombia. Estudio FUPRECOL

Introducción: El transporte activo (TA) puede ser una oportunidad para incrementar los niveles de actividad física diarios de los niños y adolescentes, además de destacarse como una estrategia práctica, accesible y sostenible a largo plazo. Objetivos: El objetivo del presente estudio es doble: Analizar los patrones de desplazamiento activo en bicicleta al y desde el centro educativo, y b) Identificar los factores asociados al uso de la bicicleta como TA; en una muestra de niños y jóvenes pertenecientes a escuelas oficiales de Bogotá, Colombia. Material y métodos: Se trata de un sub-análisis del estudio FUPRECOL en 8060 niños y adolescentes entre los 9-17 años de edad). El modo de desplazamiento del escolar fue determinado a través de la pregunta: “¿Durante los últimos 7 días, usaste bicicleta para ir al colegio/escuela y volver a la casa?. Dicha respuesta se categorizó en activos “Si” (si se desplazan en bicicleta) y pasivos “No” (si se desplazan en vehículo motorizado). Se midieron parámetros antropométricos de peso, talla y perímetro de cintura. El máximo nivel de estudios alcanzados por la madre/padre (no reporta, primaria o secundaria/técnico o tecnólogo/universitario o postgrado) y la composición del hogar (vive con padre/vive con madre/con ambos padres/con abuelos/otros familiares) se auto-reportó por los padres. Las relaciones entre el TA y los factores anteriormente descritos se analizaron mediante regresión logística binaria. Resultados: El 21,9% del total de la muestra reporta usar la bicicleta como medio de transporte y el 7,9% acumula más de 120 minutos al día. Se observó una mayor probabilidad de usar la bicicleta como medio de desplazamiento activo a la escuela en los varones, en los jóvenes entre 9 y 12 años, y en aquellos cuyo padre/madre reportaron mayor grado académico, es decir, “universitario/postgrado”. 3 Conclusión: Los hallazgos del presente estudio sugieren que es necesario promover el TA desde la niñez, poniendo mayor énfasis en el paso a la adolescencia y en las jóvenes, para así aumentar los niveles diarios de AF de estos.

Effects of an intervention in eating habits and physical activity in Japanese-Brazilian women with a high prevalence of metabolic syndrome in Bauru, São Paulo State, Brazil

We evaluated the impact of a lifestyle intervention on the cardiometabolic risk profile of women participating in the Study on Diabetes and Associated Diseases in the Japanese-Brazilian Population in Bauru. This was a non-controlled experimental study including clinical and laboratory values at baseline and after a 1-year intervention period. 401 Japanese-Brazilian women were examined (age 60.8±11.7 years), and 365 classified for metabolic syndrome (prevalence = 50.6%). Subjects with metabolic syndrome were older than those without (63.0±10.0 vs. 56.7±11.6 years, p < 0.01). After intervention, improvements in variables were found, except for C-reactive protein. Body mass index and waist circumference decreased, but adiposity reduction was more pronounced in the abdominal region (87.0±9.7 to 84.5±11.2cm, p < 0.001). Intervention-induced differences in total cholesterol, LDL, and post-challenge glucose were significant; women who lost more than 5% body weight showed a better profile than those who did not. The lifestyle intervention in Japanese-Brazilian women at high cardiometabolic risk improved anthropometric and laboratory parameters, but it is not known whether such benefits will persist and result in long-term reduction in cardiovascular events.

Effectiveness of a School-Based Intervention on Physical Activity for High School Students in Brazil: The Saude na Boa Project

Background: We evaluated the effectiveness of a school-based intervention on the promotion of physical activity among high school students in Brazil: the Saude no Boa project. Methods: A school-based, randomized trial was carried out in 2 Brazilian cities: Recife (northeast) and Florianopolis (south). Ten schools in each city were matched by size and location, and randomized into intervention or control groups. The intervention included environmental/organizational changes, physical activity education, and personnel training and engagement. Students age 15 to 24 years were evaluated at baseline and 9 months later (end of school year). Results: Although similar at baseline, after the intervention, the control group reported significantly fewer d/wk accumulating 60 minutes+ moderate-to-vigorous physical activity (MVPA) in comparison with the intervention group (2.6 versus 3.3, P < .001). The prevalence of inactivity (0 days per week) rose in the control and decreased in the intervention group. The odds ratio for engaging at least once per week in physical activity associated with the intervention was 1.83 (95% CI = 1.24-2.71) in the unadjusted analysis and 1.88 (95% CI = 1.27-2.79) after controlling for gender. Conclusion: The Saude no Boa intervention was effective at reducing the prevalence of physical inactivity. The possibility of expanding the intervention to other locations should be considered.

Implication of an intervention program for the promotion of physical activity in the quality of life of people with multiple sclerosis

The aims of this study is to examine the interest for quality of life of an implementation of program physical activity, with patients of multiple sclerosis.

Implications of the Intervention Program for Physical Activity (IPPA) in the perception of illness and wellbeing in people with Multiple Sclerosis (MS)

The aim of this study is to examine the implications of the IPPA in the perception of illness and wellbeing in MS patients. Methods - This is a quasi experimental study non-randomized study with 24 MS patients diagnosed at least 1 year before, and with an EDSS score of under 7. We used the IPPA in 3 groups of eight people in 3 Portuguese hospitals (Lisbon, Coimbra, and Porto). The sessions were held once a week for 90 minutes, over a period of 7 weeks. The instruments used were: We asked the subjects the question “Please classify the severity of your disease?” and used the Personal Wellbeing Scale (PWS) at the beginning (time A) and end (time B) of the IPPA. We used the SPSS version 20. A non-parametric statistical hypothesis test (Wilcoxon test) was used for the variable analysis. The intervention followed the recommendations of the Helsinki Declaration. Results – The results suggest that there are differences between time A and B, the perception of illness decreased (p<0.08), while wellbeing increased (p<0.01). Conclusions: The IPPA can play an important role in modifying the perception of disease severity and personal wellbeing.

Importance of program physical activity in quality of life in multiple sclerosis patients, six months after the intervention

Background: Multiple Sclerosis (MS) is a chronic disease of the central nervous system that affects more often young adults in the prime of his career and personal development, with no cure and unknown causes. The most common signs and symptoms are fatigue, muscle weakness, changes in sensation, ataxia, changes in balance, gait difficulties, memory difficulties, cognitive impairment and difficulties in problem solving MS is a relatively common neurological disorder in which various impairments and disabilities impact strongly on function and daily life activities. Purpose: The aim of this study is to examine the implications of an Intervention Program of Physical Activity (IPPA) in quality of life in MS patients, six months after the intervention.

Emancipating and developing learning activity: Systemic intervention and re-instrumentation in higher education.

The central theme of this thesis is the emancipation and further development of learning activity in higher education in the context of the ongoing digital transformation of our societies. It was developed in response to the highly problematic mainstream approach to digital re-instrumentation of teaching and studying practises in contemporary higher education. The mainstream approach is largely based on centralisation, standardisation, commoditisation, and commercialisation, while re-producing the general patterns of control, responsibility, and dependence that are characteristic for activity systems of schooling. Whereas much of educational research and development focuses on the optimisation and fine-tuning of schooling, the overall inquiry that is underlying this thesis has been carried out from an explicitly critical position and within a framework of action science. It thus conceptualises learning activity in higher education not only as an object of inquiry but also as an object to engage with and to intervene into from a perspective of intentional change. The knowledge-constituting interest of this type of inquiry can be tentatively described as a combination of heuristic-instrumental (guidelines for contextualised action and intervention), practical-phronetic (deliberation of value-rational aspects of means and ends), and developmental-emancipatory (deliberation of issues of power, self-determination, and growth) aspects. Its goal is the production of orientation knowledge for educational practise. The thesis provides an analysis, argumentation, and normative claim on why the development of learning activity should be turned into an object of individual|collective inquiry and intentional change in higher education, and why the current state of affairs in higher education actually impedes such a development. It argues for a decisive shift of attention to the intentional emancipation and further development of learning activity as an important cultural instrument for human (self-)production within the digital transformation. The thesis also attempts an in-depth exploration of what type of methodological rationale can actually be applied to an object of inquiry (developing learning activity) that is at the same time conceptualised as an object of intentional change within the ongoing digital transformation. The result of this retrospective reflection is the formulation of “optimally incomplete” guidelines for educational R&D practise that shares the practicalphronetic (value related) and developmental-emancipatory (power related) orientations that had been driving the overall inquiry. In addition, the thesis formulates the instrumental-heuristic knowledge claim that the conceptual instruments that were adapted and validated in the context of a series of intervention studies provide means to effectively intervene into existing practise in higher education to support the necessary development of (increasingly emancipated) networked learning activity. It suggests that digital networked instruments (tools and services) generally should be considered and treated as transient elements within critical systemic intervention research in higher education. It further argues for the predominant use of loosely-coupled, digital networked instruments that allow for individual|collective ownership, control, (co-)production, and re-use in other contexts and for other purposes. Since the range of digital instrumentation options is continuously expanding and currently shows no signs of an imminent slow-down or consolidation, individual and collective exploration and experimentation of this realm needs to be systematically incorporated into higher education practise.

Daily Physical Activity as an Intervention Strategy for Anxious Elementary Students

The focus of this project was twofold: a comprehensive examination of provincially mandated, school-based physical activity programming beyond physical education, as well as an exploration of the potential relationship between school-based physical activity and student anxiety. The data were collected using a descriptive research methodology consisting of a qualitative document analysis of provincial government publications pertaining to school-based physical activity programming and the literature on the relationship between physical activity and student anxiety. The findings revealed inconsistencies between the Canadian provinces and territories in providing mandated school-based physical activity beyond physical education. It was also revealed that regular school-based physical activity has the potential to make a positive impact on students’ lives in many ways. Students are living more sedentary lives, and evidence shows that regular physical activity could prevent and treat student anxiety.

Pedometer: intervention strategy and physical activity promotion

World Health Organization (WHO) has prioritized physical activity (PA) as one of the mostrelevant strategies leading the decreasing prevalence of noncommunicable chronic diseases. Pedometer has emerged as one of the valid intervention programs, reliable and useful to assess,measure and promote the physical activity practice, through counts the number of steps perday. One of the aims is to establish the goals based on steps per day made by a person and thepositive feedback, which can generate behavior changes and adoption of healthy habits, from a regular physical activity practice perspective. This review attends to enhance the current state ofpedometer program, as an intervention one, in all kind of population; its health impact and theapplication methodologies, using the pedometer as a steps quantifier device, with feasible access,use and management. Additionally, the review will be useful as a framework to design futureresearch projects, aim to develop, adapt and apply evidence based pedometer protocols, insideclinical, academic and community context.

Political intervention in economic activity

This paper proposes a political economy explanation of bailouts to declining industries. A model of probabilistic voting is developed, in which two candidates compete for the vote of two groups of the society through tactical redistribution. We allow politicians to have core support groups they understand better, this implies politicians are more or less effective to deliver favors to some groups. This setting is suited to reproduce pork barrels or machine politics and patronage. We use this model to illustrate the case of an economy with both an efficient industry and a declining one, in which workers elect their government. We present the conditions under which the political process ends up with the lagged-behind industry being allowed to survive.

Prebiotic evaluation of a novel galactooligosaccharide mixture produced by the enzymatic activity of Bifidobacterium bifidum NCIMB 41171, in healthy humans: a randomized, double-blind, crossover, placebo-controlled intervention study

Background: Galactooligosaccharides are selectively fermented by the beneficial member of the colonic microflora contributing to the health of the host. Objective: We assessed the prebiotic potential of a novel galactooligosaccharide produced through the action of beta-galactosidases, originating from a probiotic Bifidobacterium bifidum strain, against a galactooligosaccharide produced through the action of an industrial P-galactosidase and a placebo. Design: Fifty-nine healthy human volunteers participated in this study. Initially, the effect of the matrix on the prebiotic properties of a commercially available galactooligosaccharide (7 g/d) was assessed during 7-d treatment periods with a 7-d washout period in between. During the second phase, 30 volunteers were assigned to a sequence of treatments (7 d) differing in the amount of the novel galactooligosaccharide (0, 3.6, or 7 g/d). Stools were recovered before and after each intervention, and bacteria numbers were determined by fluorescent in situ hybridization. Results: Addition of the novel galactooligosaccharide mixture significantly increased the bifidobacterial population ratio compared with the placebo (P < 0.05), whereas 7 g/d of the novel galactooligosaccharide significantly increased the bifidobacterial ratio compared with the commercial galactooligosaccharide (P < 0.05). Moreover, a significant relation (P < 0.001) between the bifidobacteria proportion and the novel galactooligosaccharide dose (0, 3.6, and 7 g/d) was observed. This relation was similar to the effect of the novel galactooligosaccharide on the prebiotic index of each dose. Conclusions: This study showed that galactooligosaccharide mixtures produced with different beta-galactosidases show different prebiotic properties and that, by using enzymes originating from bifidobacterial species, an increase in the bifidogenic properties of the prebiotic product is achievable.