The human body best performs when it is physically active. The consequences of inactivity can bring about many health risks. The purpose of this study was to investigate the relationship between physical activity, waist circumference and medication use among South African men. Men between ages 30 and 65 years (N = 5000, ͞x = 43.2; ± 8.55) were included in this study. With the use of medication, distinction was drawn between various ethnic groups. Subjects selected for this study are members of the same medical aid. The respondents that formed part of a non-random availability population and participated voluntarily were used in this study. According to the results, it appears that out of a total of 4 954 respondents, 58.3% had the lowest incidence of physical activity, 21% were moderately active and 20.7% highly active. WC appears much higher among those that fall within the lowest incidence of physical activity group. No significant difference was observed between moderately and highly active people. There are 11 members in the high Physically Active (PA) category that has the highest WC (X =131.5). When scrutinising the different ethnic groups it is obvious that moderate to high PA is associated with a lower WC. Chronic medication (CM) use is determined on the basis of the registry for chronic medication use of the relevant medical aid. Those who participated in the assessment of waist circumference, CM and PA consisted of 4 964 respondents. In this study distinction was drawn between three medical condition influenced by exercise, namely diabetes, cholesterol and depression and hypertension. The results indicate that CM use is associated with higher WC and reduced kCal consumption. The majority of respondents (78%) do not use medication and 21.9% do. Those that do not use medication showed to have the lowest WC. However, respondents that are highly active and also use CM showed a lower MO than those that are low and moderately active. It can thus be deduced that regular physical activity is directly related to one’s health. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

The human body best performs when it is physically active. The consequences of inactivity can bring about many health risks. The purpose of this study was to investigate the relationship between physical activity, waist circumference and medication use among South African men. Men between ages 30 and 65 years (N = 5000, ͞x = 43.2; ± 8.55) were included in this study. With the use of medication, distinction was drawn between various ethnic groups. Subjects selected for this study are members of the same medical aid. The respondents that formed part of a non-random availability population and participated voluntarily were used in this study. According to the results, it appears that out of a total of 4 954 respondents, 58.3% had the lowest incidence of physical activity, 21% were moderately active and 20.7% highly active. WC appears much higher among those that fall within the lowest incidence of physical activity group. No significant difference was observed between moderately and highly active people. There are 11 members in the high Physically Active (PA) category that has the highest WC (X =131.5). When scrutinising the different ethnic groups it is obvious that moderate to high PA is associated with a lower WC. Chronic medication (CM) use is determined on the basis of the registry for chronic medication use of the relevant medical aid. Those who participated in the assessment of waist circumference, CM and PA consisted of 4 964 respondents. In this study distinction was drawn between three medical condition influenced by exercise, namely diabetes, cholesterol and depression and hypertension. The results indicate that CM use is associated with higher WC and reduced kCal consumption. The majority of respondents (78%) do not use medication and 21.9% do. Those that do not use medication showed to have the lowest WC. However, respondents that are highly active and also use CM showed a lower MO than those that are low and moderately active. It can thus be deduced that regular physical activity is directly related to one’s health. / Thesis (MSc (Biokinetics))--North-West University, Potchefstroom Campus, 2013.

Motivation: Abdominal obesity (hereafter referred to as "obesity") is becoming the biggest "global epidemic" of our modern times. It is associated with a range of diseases, including cardiovascular diseases and hypertension. Recent research showed that an increase in sympathetic activity is of central importance in the pathogenesis of obesity-related diseases. Increased leptin levels and impaired baroreflex sensitivity have both been independently associated with abdominal obesity and increased sympathetic activity. A perception of poorer health may also contribute to the physiological characteristics of obesity-related diseases. A lack of data regarding sympathetic activity, leptin levels, baroreflex sensitivity and perception of health in Africans, serves as a motivation for conducting this study. Objective: To investigate the contributions of leptin levels, baroreflex sensitivity and perception of health data to increased sympathetic activity in lean and obese African women from South Africa. Methodology: The manuscript presented in Chapter 2 made use of the data obtained in the POWIRS (Profiles of Obese Women with the Insulin Resistance Syndrome) study. A group of 102 urbanized African women, living in the North-West Province of South Africa, was recruited according to body mass indexes. Only 85 subjects were included for analysis due to incomplete datasets. For this study, subjects were divided into lean and obese groups according to their waist circumferences. Anthropometric measurements were done according to standardized methods. Resting cardiovascular measurements were obtained from Finometer observations. Resting, fasting levels of leptin were calculated after radioimmunoassay analyses. Subjective perception of health was determined by means of the 28-item General Health Questionnaire. Comparisons between the groups were done using analysis of covariance (ANCOVA) whilst adjusting for cardiovascular risk factors (age. smoking, alcohol consumption and physical activity). Correlation coefficients were determined to indicate any associations between leptin, baroreflex sensitivity and perception of health with sympathetic activity (represented by heart rate) and other cardiovascular variables. The study was approved by the Ethics committee of the North-West University and all the subjects gave informed consent in writing. The reader is referred to the Methods section in Chapter 2 for a more detailed description of the subjects, study design and analytical procedures used in this dissertation. Results and conclusion: Results from this study indicate that obese African women, compared to lean African women, were older, reported higher physical activity, and exhibited higher diastolic and mean blood pressure, heart rate, cardiac output, arterial compliance, leptin and hypertension prevalence rate values. In lean African women social dysfunction was positively associated with diastolic and mean blood pressure and arterial resistance, and negatively with arterial compliance. In obese African women baroreflex sensitivity was negatively associated with diastolic blood pressure, which could be an indication of impaired baroreflex sensitivity. In this obese group a perception of social dysfunction was associated with decreased heart rate. Although leptin and heart rate were significantly higher in the obese Africans, no significant correlations existed between these variables to reflect leptin's enhancement of sympathetic activity. However, leptin correlated weakly but positively with cardiac output (p = 0.054, r = 0.32). In conclusion, baroreflex sensitivity (although similar between groups) and leptin seem to contribute to blood pressure and thus hypertension in obese African women, possibly through increased sympathetic activity and volume loading. A perception of poorer health, especially a perception of social dysfunction, could possibly contribute to this image. / Thesis (M.Sc. (Physiology))--North-West University, Potchefstroom Campus, 2007.

60 % of Canadians have suboptimal vitamin D (<75 nmol/L) and 25% are obese. Obesity has been reported to be a risk factor for low vitamin D, but there is uncertainty about the magnitude of the association. Linear regression was performed using data from the nationally representative cross-sectional Canadian Health Measures Survey (2007-2009). Height, weight, waist circumference (WC), and vitamin D levels were directly measured. There were 5298 participants aged 6 to 79 years. Using a conservative p value of 0.001, body mass index (BMI) category obese / obese I was positively associated and WC was inversely associated with vitamin D level in crude analysis. WC was inversely associated with vitamin D level in multivariate analysis. The pattern of relationship is not the same as other studies, yet this was a large study with direct measurements. There may be issues with linearity of relationships or subgroups disturbing the relationship.

Objectives: The aim of this study was to determine the prevalence of MetS among different African populations using the new Joint Statement Criteria. Hereafter we aimed to determine whether waist or neck circumference is the best predictor of MetS risk after ethnic, gender and age-specific cut-points were developed. Lastly, we aimed to determine whether afore-mentioned cut-point can predict albumin:creatinine ratio as a marker of target organ damage. Methods: The study sample (N=409) comprised of urban African (men, N=101; women, N=99) and Caucasian (men, N=101; women, N=108) teachers from the Dr. Kenneth Kaunda Education district in the North-West Province, South Africa. Participants were aged between 25 and 65 years. Anthropometric measurements, albumin:creatinine ratio and other markers of the metabolic syndrome (MetS) (systolic and diastolic blood pressure [SBP and DBP], glucose, triglycerides [TG] and high density lipoprotein [HDL]) were determined. Results: Africans (65 and 63 % for men and women) and Caucasian men (73%) showed high prevalence of MetS; ROC analysis determined neck circumference (NC) cut-points of 39 and 35 cm for young and older African men, 32 and 35 cm for young and older African women, 40 and 41 cm for Caucasian men and 34 and 33 cm for Caucasian women. This NC cut-point can be used to determine metabolic syndrome risk in all groups, except in African women; ROC developed waist circumference (WC) cut-points were 91 cm for all African male groups, 84, 81 and 84 cm for young, older and total group of African women. Suggested WC cut-points for Caucasian men were 93 cm for the young group and 97 cm for older as well as total Caucasian male groups, while cut-points for Caucasian women were 87 cm, 79 cm and 84 cm for young, older and total Caucasian women. These WC cut-points were good measures of metabolic syndrome risk in all groups; neither cut-point of WC nor NC could increase the risk of albumin:creatinine ratio. Conclusion: African women as a group present with few MetS risk factors and glucose is associated with renal function risk in Africans; NC cut-points may be used as an additional anthropometric marker to predict the metabolic syndrome in a South African cohort, but not in African women; WC cutpoints demonstrated to be good predictors of the metabolic syndrome in the same South African cohort, especially among men; WC would seem to be the best measure of MetS risk in all African populations, although NC can also be used for this purpose in all African populations, except in African women. / Thesis (PhD (Human Movement Science))--North-West University, Potchefstroom Campus, 2012

Vibration in the vehicle environment has long been investigated considering the driver&#039 / s exposure. However not only drivers but also the front seat car passengers are exposed to considerable amount of vibration. In order to investigate the phenomenon, this research consisted of three stages. In the first stage of the study, model analysis has been carried out. Based on the results it has been suggested that increased damping in the lumbar area in contact with the backrest can decrease the vibration transmission. The second stage comprised of the laboratory studies. Based on the results attained from the model, waist belts filled with different fluids having different coefficients of viscosity were prepared and tested. The inclination of the backrest angle was chosen as the second parameter. The cushions having ready-made gel mediums were seen to be effective in reducing low frequency vibrations where the angle of inclination affected the response of the cushions. In the third part of the thesis, field measurements were carried out in order to confirm the results attained in the laboratory. It was observed that the inclination of backrest angle played a major role in the exposure of the passenger in fore and aft direction. The cushions proved to be effective at certain frequencies in the field, differing due to the design and the medium.

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado. / Background & aims: Several studies have examined the effect of vegetarian diets (VD) on metabolic syndrome (MetS) or its components, but findings have been inconsistent. The aim of this study was to perform a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies to assess the association between VD and MetS or its components (systolic blood pressure [SBP], diastolic blood pressure [DBP], fasting glucose triglycerides, waist circumference [WC], HDL-cholesterol (HDL-C)) in adults. Methods: The Cochrane Library, EMBASE, PubMed, Web of Science, and Scopus were searched. RCTs, cohort studies and cross-sectional studies evaluating the effects of VD on MetS or its components in adults, with omnivore diet as control group, were included. Random effects meta-analyses stratified by study design were employed to calculate pooled estimates. Results: A total of 71 studies (n = 103 008) met the inclusion criteria (6 RCTs, 2 cohorts, 63 cross-sectional). VD were not associated with MetS in comparison to omnivorous diet (OR 0.96, 95% CI 0.50–1.85, p = 0.9) according to meta-analysis of five cross-sectional studies. Likewise, meta-analysis of RCTs and cohort studies indicated that consumption of VD were not associated with MetS components. Meta-analysis of cross-sectional studies demonstrated that VD were significantly associated with lower levels of SBP (mean difference [MD] −4.18 mmHg, 95%CI −5.57 to −2.80, p < 0.00001), DBP (MD −3.03 mmHg, 95% CI −4.93 to −1.13, p = 0.002), fasting glucose (MD −0.26 mmol/L, 95% CI −0.35to −0.17, p < 0.00001), WC (MD −1.63 cm, 95% CI −3.13 to −0.13, p = 0.03), and HDL-C (MD −0.05 mmol/L, 95% CI −0.07 to −0.03, p < 0.0001) in comparison to omnivorous diet. Heterogeneity of effects among cross-sectional studies was high. About, one-half of the included studies had high risk of bias. Conclusions: VD in comparison with omnivorous diet is not associated with a lower risk of MetS based on results of meta-analysis of cross-sectional studies. The association between VD and lower levels of SBP, DBP, HDL-C, and fasting glucose is uncertain due to high heterogeneity across the cross-sectional studies. Larger and controlled studies are needed to evaluate the association between VD and MetS and its components. / Revisión por pares

BACKGROUND & AIMS - Metabolic syndrome (MetS), characterized by abdominal obesity, atherogenic dyslipidemia, elevated blood pressure, and insulin resistance is a major public health concern in the United States. The effect of Apolipoprotein E (Apo E) polymorphism has been relatively well studied in relation to cardiovascular disease; however, its effects on MetS are not well established. METHODS - We conducted a cross-sectional study consisting of 1,551 participants from the National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study to assess the relation of Apo E polymorphism with the prevalence of MetS. Information on the different Apo E genotypes was extracted from the database and we defined MetS according to the AHA-NHLBI-IDF-WHO Harmonized Criteria. We used generalized estimating equations to estimate adjusted odds ratios for prevalent MetS and the Bonferroni correction to account for multiple testing in the secondary analysis. RESULTS – Our study population had a mean age (SD) of 56.5 (11.0) years and 49.7% had MetS. There was no association between the Apo E genotypes and MetS. The multivariable adjusted ORs (95% CI) were 1.00 (reference), 1.26 (0.31-5.21), 0.89 (0.62- 1.29), 1.13 (0.61-2.10), 1.13 (0.88-1.47) and 1.87 (0.91-3.85) for the *e3/e3, *e2/e2, *e2/e3, *e2/e4, *e3/e4 and *e4/e4 genotype respectively. In a secondary analysis, the *e2/e3 genotype was associated with lower HDL levels, with the multivariable adjusted ORs (95% CI) of 0.59 (0.36-0.95) when compared to the reference *e3/e3 genotype. CONCLUSIONS - Our findings do not support an association between Apo E polymorphism and MetS in a multi-center population based study of predominantly white US men and women. The *e2/e3 genotype was associated with lower HDL levels as compared to the *e3/e3 genotype. KEY WORDS: Apolipoprotein E (Apo E) polymorphism, metabolic syndrome, blood pressure, glucose, waist circumference, triglycerides, high-density lipoprotein cholesterol

Submitted by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2016-06-21T16:51:44Z No. of bitstreams: 1 Roberta Souza Freitas Fatores associados... 2016.pdf: 1075660 bytes, checksum: a789e9068c829f9e0fce4cded6a358e6 (MD5) / Approved for entry into archive by Ana Maria Fiscina Sampaio (fiscina@bahia.fiocruz.br) on 2016-06-21T16:51:58Z (GMT) No. of bitstreams: 1 Roberta Souza Freitas Fatores associados... 2016.pdf: 1075660 bytes, checksum: a789e9068c829f9e0fce4cded6a358e6 (MD5) / Made available in DSpace on 2016-06-21T16:51:58Z (GMT). No. of bitstreams: 1 Roberta Souza Freitas Fatores associados... 2016.pdf: 1075660 bytes, checksum: a789e9068c829f9e0fce4cded6a358e6 (MD5) Previous issue date: 2016 / Made available in DSpace on 2016-07-22T14:09:07Z (GMT). No. of bitstreams: 3 Roberta Souza Freitas Fatores associados2016.pdf.txt: 162291 bytes, checksum: 3b09f9bee896b38be74dad496f96b13a (MD5) Roberta Souza Freitas Fatores associados2016.pdf: 1075660 bytes, checksum: a789e9068c829f9e0fce4cded6a358e6 (MD5) license.txt: 2991 bytes, checksum: 5a560609d32a3863062d77ff32785d58 (MD5) Previous issue date: 2016 / Fundação Gonçalo Moniz, Instituto de Pesquisas Gonçalo Moniz. Salvador, BA, Brasil / Objetivo: Estimar a prevalência de cintura hipertrigliceridêmica (CH) dos participantes do Estudo Longitudinal da Saúde do Adulto (ELSA-Brasil), identificar fatores associados à CH e comparar com outros indicadores de risco cardiovascular e metabólico. Métodos: Dados da linha de base de uma coorte composta por servidores públicos. O fenótipo CH é definido pela presença simultânea de circunferência da cintura (CC) aumentada e hipertrigliceridemia em jejum. O indicador foi construído segundo pontos de corte da CC definidos pelo National Cholesterol Education Program (NCEP) e International Diabetes Federation (IDF). A associação entre as variáveis independentes e CH foi testada por meio de modelos de regressão logística multivariada. A CH foi comparada também com outros indicadores de risco cardiovascular e metabólico por meio de testes de correlação, índice Kappa, sensibilidade e especificidade. Resultados: Foram avaliados 12.811 funcionários, 54,2% do sexo feminino, a prevalência da CH-IDF foi de 24,7% e a da CH-NCEP de 13,3%. CH foi associado a consumir álcool de modo excessivo, ser ex-fumante, ter hipertensão, diabetes, HDL baixo, não-HDL alto e PCR aumentado, independente do sexo ou critério de definição. A CH também foi associada a auto percepção negativa do estado de saúde entre homens e mulheres classificadas por meio do critério NCEP; a prática de atividade física no tempo livre entre homens; a união atual ou passada entre mulheres com classificação de CH-IDF; e a cor/raça branca e ter seguro de saúde com CH-NCEP no sexo masculino. A síndrome metabólica apresentou maior correlação com CH entre os participantes de ambos os sexos. Conclusões: Em decorrência de suas associações e da correlação com síndrome metabólica, o indicador CH pode ser utilizado como ferramenta de triagem para indivíduos com risco cardiometabólico na prática clínica. / Objective: To estimate the prevalence of hypertriglyceridemic waist (HW) of participants in the Longitudinal Study of Adult Health (ELSA-Brasil), identify risk factors and compare with other cardiovascular and metabolic risk indicators. Methods: Baseline data from a cohort of civil servants. The CH phenotype was defined by the simultaneous presence of increased waist circumference (WC) and hypertriglyceridemia fasting. The indicator was built in cut-off points of the WC defined by the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF). The association between the independent variables and HW were tested using hierarchical multivariate logistic regression models. The CH was compared with other cardiovascular and metabolic risk indicators through correlation tests, Kappa, sensitivity and specificity. Results: A total of 12.811 employees, 54,2% female, with a prevalence of HW-IDF was 24,7% and the HW-NCEP 13,3%. CH was associated with consuming alcohol excessively, being a former smoker, have high blood pressure, diabetes, low HDL, non-HDL high and increased CRP, regardless of sex or defining criterion. The CH was also associated with negative self-perception of health status between men and women classified by the NCEP criteria; physical activity during leisure time for males; the marital status in women for the HW-IDF classification; and color / race and health insurance in males for HW-NCEP. Metabolic syndrome was correlated to HW in both sexes. Conclusions: The HW can be used as a screening tool for patients with cardiometabolic risk in clinical practice once it was associated with these risks factors and it was correlated with metabolic syndrome.

Objetivo: Verificar o efeito em longo prazo do tratamento da apneia do sono com CPAP na circunferência da cintura em pacientes com apneia do sono. Métodos: Foram incluídos indivíduos com apneia do sono de ambos os sexos, idade superior a 18 anos, com indicação de uso de CPAP que aderiram ou não ao tratamento. Todos foram submetidos à polissonografia de noite inteira pelo método convencional em laboratório do sono afiliado a universidade entre 01/01/2007 e 01/06/2012. O grupo com CPAP realizou pelo menos três polissonografias. O grupo controle foi composto por pacientes que repetiram a polissonografia após pelo menos seis meses, que relataram não receber qualquer tipo de tratamento e que mantinham o IAH na segunda polissonografia. Resultados: No grupo CPAP foram incluídos 77 pacientes e no grupo controle, 43 pacientes. O tempo de acompanhamento foi respectivamente de 2,5 e 2,3 anos. Foi observada uma redução significativa na circunferência abdominal no grupo CPAP, comparando com controles através do teste t de Student (P= 0,024). O modelo logístico binário para prever redução da circunferência abdominal após o período de acompanhamento foi significativo (P <0,001), utilizando-se como regressores: uso do CPAP, sexo, idade> 45 anos, IMC≥ 30 kg/m2 e IAH≥ 30. O R2 de Nagelkerke foi de 0,36, indicando que essas variáveis explicam 36% da variação da redução da circunferência abdominal. Conclusão: O uso de CPAP se associa à redução da circunferência abdominal, independentemente de sexo, idade e índice de apneia-hipopneia basais, bem como da diferença de índice de massa corporal. Este achado justifica pesquisas futura sobre o papel da apneia do sono no volume de gordura visceral. / Objective: Verify the long term effect of sleep apnea treatment with CPAP on waist circumference in patients with sleep apnea. Methods: Individuals of both genders, older than 18 years that adhered to CPAP use or not were included. All underwent a full-night polysomnography by the conventional method in a university-affiliated sleep laboratory between 01/01/2007 to 01/06/2012. The group using CPAP underwent at least three polysomnographies. The control group consisted of patients with moderate to severe OSA who repeated a polysomnography after at least six months. Only individuals who reported not receiving any treatment and in which the AHI continued in the same OSA categories at the second polysomnography were included. Results: The CPAP group included 77 and the control group, 43 patients. Follow up time was, respectively, 2.5 and 2.3 years. A significant reduction in waist circumference was observed in the CPAP group, comparing with controls by Student’s t test (P= 0.024). The binary logistic model to predict decreased waist circumference after follow up period was significant (P<0.001), using as regressors: CPAP use, gender, age>45 years, BMI≥30 Kg/m2, and AHI≥30. The Nagelkerke R Square was 0.36, indicating that these variable explain 36% of the variance of waist circumference reduction. Conclusion: Long-term CPAP therapy is associated with a reduction in waist circumference, regardless of sex, age and basal apnea-hypopnea as well as the difference in body mass index.