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"tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "121" "paginaFinal" => "122" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "André Moreira" "autores" => array:1 [ 0 => array:4 [ "nombre" => "André" "apellidos" => "Moreira" "email" => array:1 [ 0 => "andremoreira@med.up.pt" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Serviço de Imunoalergologia, Centro Hospitalar de São João, Porto, Portugal" "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Immunology, Faculty of Medicine, and Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal" "etiqueta" => "b" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "Corra pela sua vida!" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Most people are aware of the health benefits of exercise, however quite often physicians themselves forget to stress the importance of adequate levels of physical activity for their own patients. Lots of money and effort are spent targeting bad cholesterol and high blood pressure after a cardiovascular event. National health services pays for bariatric surgery to effectively bypass the stomach in markedly obese subjects and also for their plastic surgery to remove the extra skin after losing the thick layers of fat. Indisputable medical evidence supports these actions, however they all fall into the category of secondary prevention. These people already have the disease and a key factor in all of these conditions is a sedentary lifestyle.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Physical activity is a key determinant of energy expenditure, and thus is fundamental to energy balance and weight control. Regular physical activity contributes to the primary and secondary prevention of cardiovascular disease and several other chronic conditions. For example, it reduces blood pressure, improves the level of the good cholesterol, improves control of blood glucose in overweight people, even without significant weight loss, and reduces the risk for colon cancer and breast cancer among women. Rapidly westernizing societies are particularly helpful for us to understand where we are (not) moving. Following the World Health Organization stepwise approach to chronic disease risk factor surveillance, it was recently shown that adults living in urban areas of Mozambique exercise daily on average for 11<span class="elsevierStyleHsp" style=""></span>min compared with 3<span class="elsevierStyleHsp" style=""></span>h for those living in rural areas.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> A similar trend is observed in Portugal. Results made available by the Eurobarometer Surveys show the country to be number one for the highest percent of citizens who have never performed regular physical activity (36% compared with 14% for EU). Moreover, only 33% of Portuguese exercise at least once a week, compared with the mean value for the EU top-5 of 64%.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In this issue of the <span class="elsevierStyleItalic">Revista Portuguesa de Pneumologia</span>, Rita Santos-Silva and co-workers report their study on asthmatic children where no differences in levels of physical activity were found compared with healthy peers. This is in line with previously reported data from the Portuguese National Asthma Survey that showed that adult asthmatics, independent of asthma control, do not seem to have a more sedentary lifestyle.<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> In fact, more vigorous physical activity was found among controlled men and uncontrolled women asthmatics than among healthy respondents. These are particularly important observations because they challenge the belief that despite the availability of effective anti-asthmatic therapies, a majority of asthmatics experience a restriction in their physical activity due to asthma. Although exercise is a powerful trigger of bronchoconstriction and symptoms in asthmatic patients and may result in avoidance of physical activity, these observations indicate that both children and adults do as much as their healthy peers which, however, do very little! Therefore, physical activity should be encouraged, as, in the case of adults, only about half of them reached recommended activity levels.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">On the basis of the current knowledge, evidence based prescription of physical activity in asthma seems to be restricted to improvements in the physical fitness of the subjects.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> Although there is no sufficient data to draw clear conclusions, it seems that physical training may also have positive effects on health-related quality of life. In the few clinical trials assessing inflammatory outcomes, regular training had an anti-IgE effect, decreasing both total and allergen specific IgE levels in asthmatic children.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Additionally physical training is safe, and if the disease is under control, does not cause exacerbations.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Contrary to what was expected, the extra burden caused by changes in daily routine or anxiety driven by fear of exacerbations due to the engagement in the training program do not have a negative impact on caregiver's quality of life.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> In fact, children and caregiver's quality of life improve side-by-side, supporting the argument that the asthmatic child should be given appropriate guidance and encouragement to exercise particularly when anxiety or depressive symptoms occur in the family.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Recently the European Academy of Allergy and Clinical Immunology (EAACI) published the first chapter of the Evidence Based Clinical Guidelines on Lifestyle and Asthma.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> It was shown that gaining the required amount of weight to become obese almost doubled the odds of incident asthma. The evidence about disease related outcomes supported by randomized controlled trials showed the benefits of losing weight for asthma control and lung function. The data are conflicting from the several observational studies, which provided limited and low quality evidence of the beneficial effects of losing weight on asthma related outcomes. Nevertheless, taken together, these observations support the recommendation of tackling obesity and weight management as part of asthma treatment, that is to say, increase your overall physical activity levels!</p><p id="par0030" class="elsevierStylePara elsevierViewall">To conclude, it is recommended that children and adolescents participate in at least 60<span class="elsevierStyleHsp" style=""></span>min of moderate intensity physical activity most days of the week and preferably daily.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> Engagement in physical activity promotes the child's normal psychosocial development, neuromuscular coordination and self- confidence. It also increases the chance of greater interplay between the environmental genome and the human microbial genome. Metagenomic and other studies of healthy and diseased individuals reveal that reduced biodiversity and alterations in the composition of the gut and skin microbiota are associated with various inflammatory conditions, including asthma, allergic and inflammatory bowel diseases, type1 diabetes, and obesity in what has been recently called the Biodiversity Hypothesis.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> Urbanization and sedentarism leads to loss of biodiversity (poor macrobiota/microbiota), poor human microbiota (dysbiosis), immune dysfunction (poor tolerance), inappropriate inflammatory responses, and finally symptoms and clinical disease.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> If people with asthma or allergies are able to maintain proper physical activity levels, particularly in a natural biodiverse environment, they will be less likely to suffer adverse health events associated with sedentary lifestyle, such as heart attack, stroke or diabetes and they will improve their asthma. 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Year/Month | Html | Total | |
---|---|---|---|
2024 November | 8 | 8 | 16 |
2024 October | 30 | 46 | 76 |
2024 September | 52 | 27 | 79 |
2024 August | 47 | 43 | 90 |
2024 July | 34 | 35 | 69 |
2024 June | 24 | 25 | 49 |
2024 May | 37 | 33 | 70 |
2024 April | 30 | 26 | 56 |
2024 March | 33 | 32 | 65 |
2024 February | 36 | 26 | 62 |
2024 January | 26 | 28 | 54 |
2023 December | 21 | 24 | 45 |
2023 November | 34 | 27 | 61 |
2023 October | 20 | 26 | 46 |
2023 September | 20 | 28 | 48 |
2023 August | 20 | 15 | 35 |
2023 July | 20 | 22 | 42 |
2023 June | 19 | 12 | 31 |
2023 May | 34 | 23 | 57 |
2023 April | 22 | 22 | 44 |
2023 March | 48 | 16 | 64 |
2023 February | 37 | 21 | 58 |
2023 January | 13 | 19 | 32 |
2022 December | 35 | 12 | 47 |
2022 November | 46 | 22 | 68 |
2022 October | 46 | 31 | 77 |
2022 September | 16 | 31 | 47 |
2022 August | 28 | 33 | 61 |
2022 July | 26 | 35 | 61 |
2022 June | 17 | 27 | 44 |
2022 May | 39 | 53 | 92 |
2022 April | 24 | 31 | 55 |
2022 March | 37 | 43 | 80 |
2022 February | 28 | 38 | 66 |
2022 January | 21 | 30 | 51 |
2021 December | 30 | 36 | 66 |
2021 November | 21 | 27 | 48 |
2021 October | 26 | 29 | 55 |
2021 September | 26 | 37 | 63 |
2021 August | 16 | 15 | 31 |
2021 July | 22 | 29 | 51 |
2021 June | 19 | 23 | 42 |
2021 May | 25 | 20 | 45 |
2021 April | 45 | 57 | 102 |
2021 March | 64 | 11 | 75 |
2021 February | 40 | 17 | 57 |
2021 January | 30 | 17 | 47 |
2020 December | 16 | 6 | 22 |
2020 November | 25 | 18 | 43 |
2020 October | 29 | 20 | 49 |
2020 September | 35 | 21 | 56 |
2020 August | 31 | 26 | 57 |
2020 July | 50 | 23 | 73 |
2020 June | 34 | 17 | 51 |
2020 May | 42 | 22 | 64 |
2020 April | 36 | 11 | 47 |
2020 March | 56 | 12 | 68 |
2020 February | 46 | 15 | 61 |
2020 January | 66 | 19 | 85 |
2019 December | 48 | 17 | 65 |
2019 November | 68 | 9 | 77 |
2019 October | 70 | 13 | 83 |
2019 September | 67 | 19 | 86 |
2019 August | 93 | 11 | 104 |
2019 July | 97 | 17 | 114 |
2019 June | 102 | 11 | 113 |
2019 May | 134 | 18 | 152 |
2019 April | 102 | 26 | 128 |
2019 March | 162 | 9 | 171 |
2019 February | 196 | 15 | 211 |
2019 January | 152 | 18 | 170 |
2018 December | 161 | 8 | 169 |
2018 November | 37 | 3 | 40 |
2018 October | 42 | 9 | 51 |
2018 September | 24 | 7 | 31 |
2018 August | 36 | 29 | 65 |
2018 July | 48 | 18 | 66 |
2018 June | 52 | 12 | 64 |
2018 May | 74 | 21 | 95 |
2018 April | 98 | 20 | 118 |
2018 March | 76 | 16 | 92 |
2018 February | 31 | 10 | 41 |
2018 January | 71 | 12 | 83 |
2017 December | 90 | 19 | 109 |
2017 November | 39 | 19 | 58 |
2017 October | 26 | 21 | 47 |
2017 September | 36 | 16 | 52 |
2017 August | 33 | 13 | 46 |
2017 July | 28 | 13 | 41 |
2017 June | 51 | 19 | 70 |
2017 May | 48 | 35 | 83 |
2017 April | 27 | 11 | 38 |
2017 March | 25 | 16 | 41 |
2017 February | 14 | 10 | 24 |
2017 January | 28 | 9 | 37 |
2016 December | 15 | 7 | 22 |
2016 November | 23 | 8 | 31 |
2016 October | 7 | 6 | 13 |
2016 September | 3 | 5 | 8 |
2016 August | 7 | 3 | 10 |
2016 July | 6 | 7 | 13 |
2016 June | 4 | 0 | 4 |
2016 May | 21 | 0 | 21 |
2016 April | 15 | 3 | 18 |
2016 March | 26 | 11 | 37 |
2016 February | 37 | 12 | 49 |
2016 January | 21 | 18 | 39 |
2015 December | 40 | 15 | 55 |
2015 November | 16 | 9 | 25 |
2015 October | 18 | 10 | 28 |
2015 September | 23 | 13 | 36 |
2015 August | 23 | 12 | 35 |
2015 July | 23 | 4 | 27 |
2015 June | 22 | 9 | 31 |
2015 May | 26 | 11 | 37 |
2015 April | 24 | 11 | 35 |
2015 March | 26 | 5 | 31 |
2015 February | 20 | 8 | 28 |
2015 January | 23 | 6 | 29 |
2014 December | 33 | 19 | 52 |
2014 November | 26 | 11 | 37 |
2014 October | 28 | 19 | 47 |
2014 September | 24 | 15 | 39 |
2014 August | 24 | 17 | 41 |
2014 July | 33 | 18 | 51 |
2014 June | 67 | 33 | 100 |
2014 May | 91 | 47 | 138 |