Alba Camacho-Cardenosa

Background: Overweight and obesity are chronic conditions that could be associated with poorer mental health and perceived quality of life across physical, social, and other domains. Lifestyle-related factors such as physical activity (PA) and physical fitness may influence this association. This study aimed to evaluate whether body mass index (BMI), PA level, and physical fitness are associated with perceived quality of life and mental health among adults enrolling in a university extension program. Methods: This cross-sectional study included 149 adults (48.17±8.67 years). BMI was used as an indicator of nutritional status (31.80±7.00 kg/m2). Validated instruments were used to assess quality of life, mental health, and PA level. Physical fitness was measured using motor tests. Statistical analyses included simple and multiple linear regression with bootstrap procedures. Results: In the univariate analysis, PA level was positively associated with perceived quality of life only in the vitality, where individuals with high PA levels had better scores (β = 10.90; [95% CI: 0.54; 20.58]). Regarding BMI, individuals with overweight showed higher scores in physical functioning (11.67 [3.37; 19.69]) and general health (8.80 [2.81; 14.97]) compared with those with obesity. Physical fitness indicators showed consistent associations with several quality of life domains, particularly outcomes related to muscular strength and agility. In multivariate analyses, no interaction was observed between BMI and PA level. However, interactions between BMI and physical fitness indicated that, among individuals with overweight compared with obesity, better chair stand performance was associated with lower risk of depression (−0.87 [−1.69; −0.15)]) and stress (−0.86 [−1.73; −0.14]), while better performance in the 6-minute walk test was associated with lower depression (−0.08 [−0.14; −0.03)] and stress (−0.08 [−0.14; −0.03]). Conclusion: Physical fitness showed more consistent associations with perceived quality of life and mental health than BMI or PA level. Better physical fitness outcomes may have a stronger relationship with perceived well-being, particularly among individuals with overweight. From clinical and public health perspectives, these findings reinforce the importance of integrated strategies that combine improvements in physical fitness with broader lifestyle and weight management approaches. Multidisciplinary interventions may be more effective in promoting quality of life and mental health among individuals with excess body weight.

Aim: To investigate how sleep features influence next‐day diurnal glucose homeostasis and vice versa in free‐living adults at risk of type 2 diabetes. Materials and Methods: This observational repeated‐measures study included 388 adults aged 25–65 years (50% women) with overweight or obesity (BMI ≥ 25.0–< 40.0 kg/m ² ). Sleep and glucose homeostasis were simultaneously assessed over 14 days using wrist‐worn accelerometers and continuous glucose monitors. Linear mixed models evaluated day‐level associations between sleep metrics—wake‐up time, sleep period time (i.e., time from sleep onset to wake‐up) and sleep efficiency ([total sleep time/sleep period time] × 100)—and diurnal glucose metrics, including mean glucose and its standard deviation (glycaemic variability). Results: We analysed 3942 valid person‐days. Each 1% increase in sleep efficiency was associated with lower next‐day mean glucose (B [95% CI] = −0.05 [−0.08, −0.01] mg/dL; p = 0.007). Each 1 h delay in wake‐up time was linked to reduced next‐day glucose variability (−0.24 [−0.38, −0.10] mg/dL; p = 0.001). Conversely, each 1 mg/dL increase in daytime mean glucose was associated with later wake‐up time (0.008 [0.002, 0.014] h; p = 0.008), longer sleep period time (0.006 [0.000, 0.012] h; p = 0.039) and lower sleep efficiency (−0.05% [−0.08%, −0.01%] %; p = 0.005) the subsequent night. Each 1 mg/dL increase in glucose variability was associated with earlier wake‐up time (−0.02 [−0.03, −0.01] h; p < 0.001). Conclusions: This study provides evidence that sleep and glucose dynamics are temporally associated in free‐living adults at risk of type 2 diabetes. These findings underscore the potential of combining sleep and glucose metrics to inform cardiometabolic risk prevention strategies.

Purpose: To investigate whether dinner dietary intake is associated with subsequent sleep parameters, and whether sleep parameters are associated with subsequent breakfast dietary intake. Methods: This study used baseline data from the TEMPUS randomized controlled trial. Eligible participants were adults with obesity (30–40 kg/m ² ; 25–65 years). Sleep parameters were objectively assessed via accelerometry over 14 days. During this time, dietary intake at dinner and breakfast was assessed using one to two 24 h recalls. Dinner dietary intake was matched with sleep registries of the corresponding night, and sleep parameters with the following breakfast dietary intake. Spearman correlation analyses and linear mixed models were used to assess these relationships. Results: A total of 146 participants (47% women) with valid data were included in the analysis (178 dinner-sleep, and 180 sleep-breakfast observations). Higher carbohydrate, sugars, blue fish, and olive oil intake at dinner were associated with improved subsequent sleep parameters (all p ≤ 0.042). In contrast, greater energy, fat, cholesterol, protein, alcohol, red meat, and french fries were associated with poorer subsequent sleep parameters (all p ≤ 0.048). Longer sleep duration was associated with enhanced dietary quality at subsequent breakfast (all p ≤ 0.034). Moreover, later sleep offset was independently associated with higher energy intake, and greater wake after sleep onset was independently associated with higher carbohydrate intake at subsequent breakfast in multivariate analyses (all p ≤ 0.008). Conclusion: These findings highlight the complex relationship between sleep and diet in free-living settings that may inform future interventions for obesity management.

Brazo-Sayavera, Javier, Alba Camacho-Cardenosa, Talita Morais Fernandes, Jamille Guedes Malta Argolo, Ana Paula Morais Fernandes, Carlos Arterio Sorgi, Elisângela Aparecida da Silva Lizzi, and Átila Alexandre Trapé. Effects of moderate-intensity cyclic normobaric hypoxic training on cardiovascular disease risk factors of patients recovered from COVID-19: The AEROBICOVID randomized controlled trial. High Alt Med Biol. 26:265-272, 2025. Objectives: The aim was to analyze the effects of a training program under hypoxic conditions compared with a control and normoxia training program on cardiovascular disease risk factors in patients recovered from COVID-19. Methods: A total of 67 patients were randomly assigned to the control group, training and recovery with hypoxia (T_H:R_H), training in normoxia (T_N) and recovery with hypoxia (R_H), and T_N and recovery in normoxia (R_N). Anthropometric, body composition, respiratory, and cardiometabolic risk factors were analyzed before and after intervention. Results: All intervention groups had positive effects on various health outcomes in patients recovered from COVID-19. The reduction in waist, hip, and waist/hip ratio, glycaemia, total cholesterol, and low-density lipoprotein-cholesterol indicates improvements in cardiovascular health. The increase in the forced expiratory volume in 1 second suggests improvements in respiratory health. In addition, the decrease in cardiovascular disease risk score indicates a reduction in overall cardiovascular disease risk. Conclusions: The study provides evidence to support the clinical benefits of moderate-intensity intermittent hypoxic training as a part of the treatment of patients recovered from COVID-19. It may also provide evidence on the efficacy and safety of intermittent hypoxic training in different health conditions. The study was registered at the Brazilian Clinical Trials Registry (RBR-5d7hkv).

Context: Intermuscular adipose tissue (IMAT) at different anatomical locations may exert distinct effects on cardiometabolic risk. Objective: The present study investigated the relationships of abdominal and mid-thigh IMAT with glucose homeostasis and cardiometabolic risk in adults with overweight or obesity. Design: Multicenter cross-sectional study. Setting: Outpatient clinic. Participants: One hundred eighty-nine adults (50% women; age: 46.8 ± 6.3 years) with overweight or obesity (body mass index: 32.9 ± 3.5 kg/m2). Main Outcome Measures: IMAT content in abdominal and mid-thigh regions was measured by magnetic resonance imaging. Mean glucose levels were monitored over 24 hours during 14 days using continuous glucose monitoring devices. We computed a cardiometabolic risk score including fasting high-density lipoprotein cholesterol, triglycerides, glucose, waist circumference, and systolic and diastolic blood pressure. Results: No associations were identified between abdominal IMAT and glucose homeostasis or cardiometabolic risk (all P > .05). In contrast, a positive association of mid-thigh IMAT with 24-hour (β = 0.226; P = .007), diurnal (β = 0.224; P = .008), and nocturnal mean glucose levels (β = 0.233; P = .006) as well as with cardiometabolic risk score (β = 0.324; P < .001) was observed. Participants with greater accumulation of IMAT in the mid-thigh compared to the abdominal region exhibited significantly higher mean glucose levels and cardiometabolic risk (all P < .005). Conclusion: These findings emphasize the importance of distinguishing between adipose tissue depots when evaluating cardiometabolic risk, as specific accumulation patterns—particularly in the mid-thigh region—may significantly influence individual risk profiles.