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Original article
Effect of a program of physical activity motivated by lipid parameters of patients with obesity and/or overweight
Efecto de un programa de actividad física motivada en los parámetros lipídicos de pacientes con obesidad o sobrepeso
Fatima Madrona Marcosa, Josefa M. Panisello Royob, M. Loreto Tarraga Marcosc, Nuria Rosichb, Julio A. Carbayo Herenciad, Josep Alinse, Eudald Castellf, Pedro J. Tárraga Lópezg,
Corresponding author
pjtarraga@sescam.jccm.es

Corresponding author.
a EAP Zona 5 A, Albacete, Spain
b Fufosa, Barcelona, Spain
c Unidad Materno Infantil, Hospital Clínico, Zaragoza, Spain
d Universidad Miguel Hernández, Alicante, Spain
e ABS Abrera, Barcelona, Spain
f Hospital Vall d’Hebrón, Barcelona, Spain
g Facultad de Medicina, Universidad Castilla-La Mancha, Albacete, Spain
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The World Health Organization &#40;WHO&#41; has been forced to declare that obesity is one of the great epidemics that will threaten us during the twenty-first century&#44; which has led the governments of different countries and supranational institutions to grant increasingly greater importance to policies that can contribute to mitigate its effects&#46; As with most of the diseases that have their main origin in environmental and social exposures&#44; it is preventive measures&#44; rather than therapeutic ones&#44; that yield the most effective and efficient results&#44; and in this sense most of the actions&#46;<a class="elsevierStyleCrossRef" href="#bib0135"><span class="elsevierStyleSup">1</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Obesity is a major global public health problem and one of the most frequent metabolic alterations associated with this condition is the dyslipidemia that often accompanies it&#58; its characteristic phenotypic pattern is preprandial hypertriglyceridemia&#44; lowering of high density lipoprotein cholesterol &#40;HDL-C&#41;&#44; postprandial non-HDL hyperlipidemia and the real increase in the production of dense and small particles of low density lipoproteins&#46; Comprehensive treatment &#40;tmnt&#41; of dyslipidemia in obese patients should always include an intense approach to addressing obesity and the identification and management of risk factors that interact with the condition&#44; as well as a pharmacological risk-benefit assessment&#46;<a class="elsevierStyleCrossRefs" href="#bib0135"><span class="elsevierStyleSup">1&#8211;3</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">In our environment&#44; obesity and dyslipidemia are frequently linked&#59; therefore&#44; it is very likely that there will be a dyslipidemia phenotype when the body mass index is between 25&#46;2 and 26&#46;6<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#44; as corroborated by numerous studies&#44; among which is the United States National Health and Nutrition Examination Survey &#40;NHANES&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">4&#8211;6</span></a>&#46; The separate reports on dyslipidemia in men and women and in different ethnic groups reflect a common dyslipidemia pattern&#58; the significant increase in the real quantity of triglycerides &#40;TG&#41; &#40;mainly very low density lipoproteins&#44; total cholesterol &#91;TC&#93; and low HDL-C&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">The NHANES data has shown that the levels of TC are greater in young obese men and women than in non-obese people&#46; The NHANES III study has also demonstrated that in patients with metabolic syndrome the rates of obesity&#44; hypertriglyceridaemia and hypercholesterolaemia are greater than 75&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0150"><span class="elsevierStyleSup">4&#8211;9</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">It is well-known that treatment for dyslipidemia&#44; both in overweight and obese patients&#44; must start with weight loss&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9&#44;10</span></a> Accordingly&#44; the interventions that are focused on changing dietary habits and increasing daily physical activity for the purposes of promoting a healthy lifestyle are the best options for tackling this problem&#59; not forgetting that other interventions such as cognitive-behavioral therapy have proven useful when included in overweight and obesity program for the purpose of improving their effectiveness and helping maintain the results obtained&#46;<a class="elsevierStyleCrossRef" href="#bib0180"><span class="elsevierStyleSup">10</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">In 2004&#44; the World Health Assembly approved the Global Strategy on Diet&#44; Physical Activity and Health&#44; with the aim of reducing the risk factors for non-communicable diseases related to unhealthy diets and physical inactivity&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">8</span></a> It urges all international&#44; national and local organizations and institutions to develop actions that allow the creation of environments that promote an improvement in diet and reduce sedentary lifestyle&#46;<a class="elsevierStyleCrossRef" href="#bib0185"><span class="elsevierStyleSup">11</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">The level of physical condition&#44; as well as the cardiovascular risk related to overweight and obesity in adults&#44; is largely conditioned by the level of physical condition in childhood and adolescence&#46;<a class="elsevierStyleCrossRefs" href="#bib0185"><span class="elsevierStyleSup">11&#44;12</span></a> The benefits of low- to moderate-intensity physical activity form the basis of the physically-active lifestyle&#44; which should be incorporated for a minimum of 30<span class="elsevierStyleHsp" style=""></span>min daily&#44; whether in leisure and free time&#44; work&#44; household chores&#44; etc&#46; planned or unplanned&#44; and that they are part of everyday life&#44; replacing hours of TV&#44; computers and sedentary games with others of greater energy expenditure&#46; Among the benefits provided&#44; there is a decrease in mortality from all causes&#44; regardless of their effects on weight&#46; The 2016 WHO study &#40;1&#41; warned that more than 1&#46;4 billion adults&#44; just over a quarter of the world&#39;s adult population &#40;27&#46;5&#37;&#41;&#44; did not exercise enough&#46; That year&#44; about one in 3 women &#40;32&#37;&#41; and one in 4 men &#40;23&#37;&#41; worldwide did not reach the recommended levels of physical activity to stay healthy&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">The multiple benefits of weight loss have been evidenced and it is undeniable that physical exercise helps to obtain greater energy expenditure&#46; There are numerous authors who assert that the best option in weight loss for obese subjects is by combining a proper diet with a regular and structured practice of physical activity&#46;<a class="elsevierStyleCrossRefs" href="#bib0175"><span class="elsevierStyleSup">9&#44;10</span></a> The National Heart&#44; Lung and Blood Institute &#40;1998&#41; advocates the combination of exercise and diet&#44; given its evidence as the best allies of weight loss&#44; with physical activity being the best mechanism&#46;<a class="elsevierStyleCrossRefs" href="#bib0195"><span class="elsevierStyleSup">13&#8211;15</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Our group designed a motivational group intervention for obese patients&#44; conducted by a nurse who had previously been trained by psychological experts&#44; combined with their routine treatment and with a 2-year follow-up period&#46; The results were then published&#44; with 36&#37; of patients achieving weight loss &#8805;5&#37;&#46;<a class="elsevierStyleCrossRefs" href="#bib0210"><span class="elsevierStyleSup">16&#8211;18</span></a> This intervention was subsequently replicated in another region of Spain with the same results&#46; As previously published&#44; an hour-long motivational group intervention every two weeks from weeks 1 to 12&#44; following the Lifestyle&#44; Exercise&#44; Attitudes&#44; Relationships&#44; Nutrition &#40;LEARN&#41;<a class="elsevierStyleCrossRefs" href="#bib0225"><span class="elsevierStyleSup">19&#8211;21</span></a> program guidelines&#44; and then monthly from weeks 13 to 32&#44; following the instructions of the Weight Maintenance Survival Guide program was added to routine treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0240"><span class="elsevierStyleSup">22</span></a> Although the results were highly satisfactory&#44; we now consider whether adding a motivated program of physical activity would add better results on the reduction of lipid parameters&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">For this project&#44; the following working hypothesis is proposed&#58; by adding a digital platform intervention to the motivational group intervention&#44; physical activity and weight results improve&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Method</span><p id="par0055" class="elsevierStylePara elsevierViewall">Randomized and controlled clinical trial&#44; with 2 arms&#44; 12 months of follow-up and a 1&#58;1 allocation ratio&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">The data collection was made between July 2017 and July 2018&#46; Patients&#44; women and men&#44; should have been referred from their company doctors with the diagnosis of overweight or obesity and an age between 25 and 70 years&#46; They came from the health areas of Anoia and Barcelona&#46; The exclusion criteria that were considered were&#58; &#40;1&#41; severe diseases &#40;bedridden&#44; affected by neoplasms&#44; cognitive disorders&#44; etc&#46;&#41;&#59; &#40;2&#41; secondary obesity &#40;hypothyroidism&#44; Cushing&#39;s disease&#44; etc&#46;&#41;&#59; &#40;3&#41; severe sensory diseases that interfere with motivational intervention&#44; such as uncorrected visual or auditory impairments&#44; etc&#46;&#59; &#40;4&#41; severe psychiatric diseases&#59; &#40;5&#41; diagnosis of type 1 or type 2 diabetes mellitus with pharmacological tmnt&#59; &#40;6&#41; diagnosis of arterial hypertension with pharmacological tmnt&#44; and &#40;7&#41; diagnosis of dyslipidemia with pharmacological tmnt&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">The patients who were included in the study signed an informed consent form approved by the regional Ethics Committee&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Interventions&#58; patients were randomized into 2 intervention groups&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">-</span><p id="par0075" class="elsevierStylePara elsevierViewall">Group 1 &#40;G1&#41;&#58; motivated obesity intervention &#40;IMOAP&#41;&#44; with trained nurse and small periodic work groups&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">-</span><p id="par0080" class="elsevierStylePara elsevierViewall">Group 2 &#40;G2&#41;&#58; the use of a digital platform that monitors and promoted physical activity &#40;iwopi&#41; was added to the intervention of G1&#46; This platform allows for registering physical activity and donating it for any of the social causes that exist on the platform&#46; In fact&#44; iwopi is a digital health platform with a methodology based on the science of behavior and behavioral activation&#44; whose objective is to generate the necessary motivation in people to boost physical activity and&#44; subsequently&#44; healthy lifestyle habits&#46; The ability to motivate and activate users is realized through elements of social gamification based on the improvement of physical&#44; mental and social well-being&#46; Among these elements of social gamification&#44; iwopi promotes programs and emotional&#44; collective and collaborative challenges&#44; to stimulate physical activity and social relations with a solidary purpose&#46; The user can monitor his or her physical activity through specific physical activity Apps&#44; Devices &#40;wearables&#44; smartwatches&#44; GPS watches&#41;&#44; or through a Smartphone and systems such as Apple Health or Google Fit&#44; and convert his or her movement into a real social impact&#46; The technical characteristics are&#58; development languages&#58; HTML5&#44; CSS3&#44; Javascript&#59; programming languages &#40;Backend&#41;&#58; Scala&#59; databases&#58; MySQL&#59; servers&#58; ApacheTecnolog&#237;a&#59; desktop application&#58; Play framework-Boostrap&#59; mobile app development technology&#58; Ionic&#59; security certificate&#58; Comodo SSL Premium Wildcard&#46; Its structure as a single-page application allows a fluid interaction and the responsive design allows it to adapt to any modern browser &#40;desktop&#44; tablet or mobile&#41; without changing the design nor the functionalities&#46; This helps the user to interact on any of their devices and simplifies the learning curve&#44; since the interaction is similar&#46; The application is available on Google Play and Apple Store &#40;<a href="http://www.iwopi.org/">www&#46;iwopi&#46;org</a>&#41;&#46;</p></li></ul></p><p id="par0085" class="elsevierStylePara elsevierViewall">In order to avoid possible influences of diet in the participating nurses&#44; they were trained not to modify them as it was a criterion of withdrawal from the study&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">Losses suffered during the study&#58; one was lost in G1 because of a change in employment status and in G2 one left for family reasons&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Statistical analysis</span><p id="par0095" class="elsevierStylePara elsevierViewall">All calculations were performed with the software program SPSS version 25&#46;0 &#40;v&#46;25&#46;0 of SPSS Inc&#46;&#44; Chicago&#44; IL&#44; USA&#41;&#46; Quantitative variables are shown as mean &#40;standard deviation&#41;&#44; qualitative variables as exact quantity and percentage&#46; The ANOVA test was used to verify that the randomisation was performed correctly between the 3 groups compared&#46; If there had been any significant differences between the groups&#44; the Bonferroni method would be applied a posteriori&#46; To compare the averages throughout the follow-up period&#44; a repeated measures analysis of variance was used&#46; When the normality and sphericity criteria were not met&#44; the non-parametric Friedman test was used&#46; When there were 2 groups to be compared&#44; the differences between the means were calculated with the Student&#39;s t&#44; for both independent and paired groups&#46; Comparisons with a <span class="elsevierStyleItalic">p</span> value &#8804;0&#46;05 were considered statistically significant&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Results</span><p id="par0100" class="elsevierStylePara elsevierViewall">A total of 123 obese or overweight patients &#40;62 in the G1 IMOAP and 61 in the G2 with iwopi&#41; participated&#44; of which 121 completed the study &#40;61 in G1 and 60 in G2&#41;&#46; Mean age 45&#46;55<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>12&#46;83 years&#46; Sex&#58; 57&#46;2&#37; female and 42&#46;8&#37; male&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">It can be seen how both weight and BMI and the main lipid parameters are reduced in both groups&#44; the difference being significant in weight as well as BMI and TC&#46; TGs are reduced in both groups&#44; with the difference between both groups not being significant &#40;<a class="elsevierStyleCrossRefs" href="#tbl0005">Tables 1 and 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">The HDL-C increases in both groups&#44; making it more in the motivated exercise group with significant difference&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">The physical activity of the group with motivated physical activity program intervention is 3 times higher than the group without intervention &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0120" class="elsevierStylePara elsevierViewall">There is a significant relationship between the increase in activity and weight loss &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;001&#41;&#44; also between it and decreased cholesterol&#46; The increase in physical activity also produces a significant increase in HDL-C&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Discussion</span><p id="par0125" class="elsevierStylePara elsevierViewall">This study has shown that one year after applying 2 weight-loss methods&#44; both groups were successful&#44; although weight loss was more intense in the moderate physical activity group &#40;G2&#41; than in the control group&#46; Meanwhile&#44; without any other kind of intervention&#44; it was observed that the majority of patients with dyslipidemia linked to obesity progressed positively &#40;decrease in TC and TG and increase in HDL-C&#41;&#44; although the average values decreased significantly&#44; with these values being greatest in the group who experienced the greatest weight loss&#44; which is in line with these results&#46; In other words&#44; weight loss results in a positive change in the lipid parameters linked to obesity and this change is more extreme the more weight is lost&#46; On average&#44; this was based on a population with TC and TG above the optimum cut-off values &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41; and the changes observed were equally greater in the intervention group &#40;G2&#41; than in the recognized control group &#40;G1&#41;&#46; Given that the changes in weight were modest&#44; but still significant&#44; small changes in the lipid parameters may also be expected&#46; In our study we can see how the groups with the greatest weight loss also have the greatest reduction in TC and TG and increase in HDL-C&#44; which are not proportional to the drop in TG&#44; which confirms that the lipid parameters most associated with physical activity are TC and HDL-C&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Physical activity is an effective tool to modify the lipid profile&#44; acting significantly on the HDL-C indices and the reduction of cholesterol linked to low-density lipoproteins and serum TGs&#46; In a meta-analysis performed by Kelley et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a> it was shown that physical activity in only 8 weeks was able to significantly increase the values of HDL-C in adults over 18 years&#46; Our study presents HDL-C elevations of 0&#46;64 and 1&#46;72&#44; which although they are discrete increases&#44; if this observation were applied to our results&#44; the increase in the level of HDL-C through the exercise determined by this analysis would result in a reduction of the risk of CVD of approximately 5&#46;1&#37; in men and 7&#46;6&#37; in women&#59; this is potentially of importance in cardiovascular prevention&#44; which is reduced by increasing the level of HDL-C&#46; This is in accordance with a meta-analysis performed by Kodama et al&#46;&#44;<a class="elsevierStyleCrossRef" href="#bib0250"><span class="elsevierStyleSup">24</span></a> which indicated that the effect of aerobic training resulted in an increase of 2&#46;53<span class="elsevierStyleHsp" style=""></span>mg&#47;dl of HDL-C&#46; In a prior observational study&#44;<a class="elsevierStyleCrossRef" href="#bib0245"><span class="elsevierStyleSup">23</span></a> each increase of 1<span class="elsevierStyleHsp" style=""></span>mg&#47;dl &#40;0&#46;026<span class="elsevierStyleHsp" style=""></span>mmol&#47;l&#41; in the level of HDL-C&#44; it was reported as associated with a 2 and 3&#37; decrease in the risk of CVD in men and women&#44; respectively&#46; However&#44; the modest elevation in the level of HDL-C showed that this analysis is of clinical importance and was not far from the previous meta-analysis findings in which Kelley et al&#46;<a class="elsevierStyleCrossRef" href="#bib0255"><span class="elsevierStyleSup">25</span></a> and Halbert et al&#46;<a class="elsevierStyleCrossRef" href="#bib0260"><span class="elsevierStyleSup">26</span></a> reported average net elevations in the level of HDL-C of 1&#46;2<span class="elsevierStyleHsp" style=""></span>mg&#47;dl and 1&#46;9<span class="elsevierStyleHsp" style=""></span>mg&#47;dl&#44; respectively&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">The adherence by both groups is high&#44; since there has been only one loss of a patient in each group&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">Our study has several strong points&#46; We use very strict inclusion criteria&#44; which allowed the extraction of effects of physical exercise with minimal effects of confounding factors&#46; For example&#44; there were no significant changes in dietary intake&#46; Therefore&#44; we could more accurately assess the relationship between exercise itself and the increases in the level of HDL-C&#46; This approach is essential and practical because most people have limitations on volume or time to exercise &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">Table 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conclusions</span><p id="par0145" class="elsevierStylePara elsevierViewall">To conclude&#44; we can confirm that G1&#44; with intensive&#44; permanent tmnt&#44; presents good results that improve with the inclusion of a motivated physical activity program and although telemedicine opens up an interesting opportunity&#59; the use of new information technologies in the field of healthcare &#40;already accessible for almost all patients&#41;&#44; that facilitate doctor&#8211;patient communication and improve cost-effectiveness&#44; as well as being an instrument of great help in consultations&#44; especially in Primary Care&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">The average net increase in the level of HDL-C by exercise itself was modest&#44; but highly significant and more when it is related to cardiovascular risk&#46;</p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Conflict of interests</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interests&#46;</p></span></span>"
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            0 => "Obesidad"
            1 => "Actividad f&#237;sica"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Objective</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">To assess the effect of a motivated physical activity program on the lipid parameters most related to excess weight &#40;triglycerides &#91;TG&#93;&#44; and high density lipoprotein cholesterol &#91;HDL&#93;&#41; in a weight-loss intervention in obese and overweight patients&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">A randomised and controlled&#44; 2-arm&#44; clinical trial and a 12-months follow-up was conducted&#46; The patients included in the study were randomised into 2 intervention groups&#58; motivational intervention of obesity with a previously trained nurse &#40;G1&#41;&#44; motivational group&#44; with digital platform support and motivated physical activity program &#40;iwopi &#91;G2&#93;&#41;&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">The anthropometric variables measured were height&#44; weight&#44; body mass index &#40;BMI&#41;&#44; as well as the analytical variables&#44; total cholesterol&#44; TG and HDL-<span class="elsevierStyleSmallCaps">C</span>&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">A total of 123 patients participated in the study&#44; of which 61 were randomised to G1&#44; and 62 to G2&#46; Both groups significantly decreased weight at the end of the study&#44; with the decrease in G1 being 4&#46;898<span class="elsevierStyleHsp" style=""></span>kg&#44; and 6&#46;292<span class="elsevierStyleHsp" style=""></span>kg in G2&#46; In both groups there was also a significantly decrease &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; in total cholesterol and TG&#44; and increase in HDL cholesterol&#44; with these changes being more intense in the G2 group&#44; as well as being the group that lost more weight&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Weight reduction is accompanied by favourable changes in lipid parameters related to overweight and obesity&#44; being more intense the greater the weight loss&#46;</p></span>"
        "secciones" => array:4 [
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Valorar el efecto de un programa de actividad f&#237;sica motivada sobre los par&#225;metros lip&#237;dicos m&#225;s relacionados con el exceso de peso &#40;triglic&#233;ridos &#91;TG&#93; y colesterol de las lipoprote&#237;nas de alta densidad &#91;cHDL&#93;&#41; en una intervenci&#243;n para reducir peso en pacientes con sobrepeso y obesidad&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">M&#233;todos</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ensayo cl&#237;nico&#44; aleatorizado y controlado&#44; con 2 brazos y un seguimiento de 12 meses&#46;</p><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Los pacientes incluidos en el estudio fueron aleatorizados en 2 grupos de intervenci&#243;n&#58; intervenci&#243;n motivacional de obesidad con enfermera entrenada previamente &#40;G1&#41;&#44; grupo motivacional&#44; con apoyo de plataforma digital y programa de actividad f&#237;sica motivada &#40;iwopi &#91;G2&#93;&#41;&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Las variables antropom&#233;tricas medidas fueron estatura&#44; peso&#44; &#237;ndice masa corporal &#40;IMC&#41; y las anal&#237;ticas&#44; colesterol total&#44; TG y cHDL&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Han participado en el estudio 123 pacientes&#44; de los que 61 fueron aleatorizados al G1 y 62 al G2&#46; Todos los grupos disminuyeron significativamente el peso al final del estudio&#44; siendo la disminuci&#243;n en el G1 &#40;&#8722;4&#44;898<span class="elsevierStyleHsp" style=""></span>kg&#41; y del G2 &#40;&#8722;6&#44;292<span class="elsevierStyleHsp" style=""></span>kg&#41;&#46; Tambi&#233;n todos los grupos disminuyeron significativamente &#40;p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; el colesterol total y los TG&#44; y aumentaron el cHDL&#44; siendo estos cambios m&#225;s intensos en el grupo G2&#44; el grupo que m&#225;s peso perdi&#243;&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">La reducci&#243;n de peso se acompa&#241;a de cambios favorables en los par&#225;metros lip&#237;dicos relacionados con el sobrepeso y la obesidad&#44; siendo m&#225;s intensos cuanto mayor es la p&#233;rdida de peso&#46;</p></span>"
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            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
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      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0010">Please cite this article as&#58; Madrona Marcos F&#44; Panisello Royo JM&#44; Tarraga Marcos ML&#44; Rosich N&#44; Carbayo Herencia JA&#44; Alins J&#44; et al&#46; Efecto de un programa de actividad f&#237;sica motivada en los par&#225;metros lip&#237;dicos de pacientes con obesidad o sobrepeso&#46; Cl&#237;n Investig Arterioscler&#46; 2019&#59;31&#58;245&#8211;250&#46;</p>"
      ]
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      0 => array:8 [
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        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
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        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at1"
            "detalle" => "Table "
            "rol" => "short"
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          "leyenda" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The results are expressed as an average &#40;standard deviation&#41; or absolute &#40;relative&#41; frequencies&#46;</p><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">The averages were compared using path variance analysis and the <span class="elsevierStyleItalic">a posteriori</span> comparison between the groups using the Bonferroni test&#46; The comparison between the proportions with the chi-squared test&#46;</p><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">cm&#58; centimetres&#59; G1&#58; IMOAP &#40;structured motivational intervention&#41; group&#59; G2&#58; IMOAP group to which the physical activity platform is added&#59; HbA1c&#58; glycosylated hemoglobin&#59; HDL&#58; high density lipoproteins&#59; BMI&#58; body mass index&#59; kg&#47;m<span class="elsevierStyleSup">2</span>&#58; kilograms divided by height in square meters&#59; kg&#58; kilograms&#59; mg&#47;dl&#58; milligrams per deciliter&#59; DBP&#58; diastolic blood pressure&#59; SBP&#58; systolic blood pressure&#46;</p>"
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">G1 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>61&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">G2 &#40;<span class="elsevierStyleItalic">n</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>60&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Female&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">35 &#40;57&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">34 &#40;56&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;996&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Male&#44; <span class="elsevierStyleItalic">n</span> &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;42&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26 &#40;43&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Age &#40;years&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&#46;4 &#40;12&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">47&#46;1 &#40;12&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;452&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;8 &#40;14&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;8 &#40;13&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;0 &#40;3&#46;5&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;8 &#40;3&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;885&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Waist circumference &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87&#46;2 &#40;10&#46;1&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90&#46;0 &#40;9&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;236&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline blood glucose &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">93&#46;7 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">94&#46;7 &#40;5&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;433&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HbA1c&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;5 &#40;0&#46;2&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;248&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total cholesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">242&#46;1 &#40;38&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">246&#46;8 &#40;28&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;527&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">HDL cholesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">48&#46;1 &#40;11&#46;6&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&#46;8 &#40;12&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;002<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triglycerides &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172&#46;3 &#40;72&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172&#46;6 &#40;62&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;497&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SBP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">132&#46;5 &#40;6&#46;0&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">132&#46;7 &#40;4&#46;8&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;600&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">DBP&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">75&#46;3 &#40;5&#46;4&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74&#46;3 &#40;5&#46;9&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;494&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Steps&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3369&#46;4 &#40;662&#46;3&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3227&#46;1 &#40;671&#46;7&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;357&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2183619.png"
              ]
            ]
          ]
          "notaPie" => array:1 [
            0 => array:3 [
              "identificador" => "tblfn0005"
              "etiqueta" => "a"
              "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Significant differences between the control group and the rest of the groups&#46;</p>"
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Baseline sample data by group&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0010"
        "etiqueta" => "Table 2"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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          0 => array:3 [
            "identificador" => "at2"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
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          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">G1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">G2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline weight &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88&#46;844&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">86&#46;767&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weight over past year &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83&#46;946&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80&#46;473&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Weight loss &#40;kg&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;4&#46;898&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;6&#46;294&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;042&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline BMI &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">31&#46;020&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#46;813&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI at year &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#46;317&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#46;545&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">BMI decrease &#40;kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;1&#46;703&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;2&#46;475&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;03&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2183617.png"
              ]
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        ]
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          "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">List of baseline and post-intervention anthropometric parameters&#46;</p>"
        ]
      ]
      2 => array:8 [
        "identificador" => "tbl0015"
        "etiqueta" => "Table 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
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        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
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            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">G1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">G2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span> value&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline glycosylated hemoglobin &#40;&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;451&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;488&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Glycosylated hemoglobin at year&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;341&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&#46;300&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Difference&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;110&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;0&#46;188&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline total cholesterol &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">242&#46;05&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">246&#46;78&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total cholesterol at year &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">237&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">236&#46;72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Reduction&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;4&#46;67&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8722;10&#46;06&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#60;0&#46;032&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline triglycerides &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172&#46;26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">172&#46;58&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Triglycerides at year &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">152&#46;60&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">153&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Reduction&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;19&#46;66&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8722;19&#46;43&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;0&#46;12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Baseline HDL-C &#40;mg&#47;dl&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">48&#46;08&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">49&#46;83&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#60;0&#46;042&nbsp;\t\t\t\t\t\t\n
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        0 => array:2 [
          "identificador" => "bibs0015"
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                    0 => array:2 [
                      "titulo" => "The relationship between serum triglycerides and skinfold thickness in obese subjects"
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                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "M&#46;J&#46; Albrink"
                            1 => "J&#46;W&#46; Meigs"
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                      "doi" => "10.1111/j.1749-6632.1965.tb34830.x"
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                        "tituloSerie" => "Ann NY Acad Sci"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/5217001"
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                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Anthropometric indexes in the prediction of type 2 diabetes mellitus&#44; hypertension and dyslipidaemia in a Mexican population"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "A&#46; Berber"
                            1 => "R&#46; G&#243;mez-Santos"
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                      "doi" => "10.1038/sj.ijo.0801827"
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                        "tituloSerie" => "Int J Obes Relat Metab Disord"
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                        "volumen" => "25"
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "Prevalence of the metabolic syndrome among US adults&#58; findings from the Third National Health and Nutrition Examination Survey"
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                0 => array:2 [
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                          "etal" => true
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                            0 => "I&#46; Ponce-Garcia"
                            1 => "M&#46; Simarro-Rueda"
                            2 => "J&#46;A&#46; Carbayo-Herencia"
                            3 => "J&#46;A&#46; Divis&#243;n-Garrote"
                            4 => "L&#46;M&#46; Artigao-R&#243;denas"
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                  "host" => array:1 [
                    0 => array:2 [
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                0 => array:1 [
                  "referenciaCompleta" => "AESAN&#44; Agencia Espa&#241;ola de Seguridad Alimentaria y Nutrici&#243;n&#46; Encuesta Nacional de Ingesta Diet&#233;tica Espa&#241;ola&#59; 2011&#46; Available at&#58; <a target="_blank" href="http://www.aesan.msc.es/AESANweb/notas%20prensa/nutricion%20estudio%20obesidad.shtml">http&#58;&#47;&#47;www&#46;aesan&#46;msc&#46;es&#47;AESANweb&#47;notas prensa&#47;nutricion estudio obesidad&#46;shtml</a> &#91;accessed 27&#46;06&#46;16&#93;&#46;"
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                    0 => array:2 [
                      "titulo" => "Variables predictive of adherence to diet and physical activity recommendations in the treatment of obesity and overweight&#44; in a group of Spanish subjects"
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                          "etal" => false
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                      "titulo" => "Primary prevention of cardiovascular disease with a Mediterranean diet"
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                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Estruch"
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                            3 => "M&#46;I&#46; Covas"
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                      "titulo" => "Psychological interventions for overweight or obesity &#91;review&#93;"
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                          "etal" => false
                          "autores" => array:4 [
                            0 => "K&#46;A&#46; Shaw"
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                            2 => "C&#46; del Mar"
                            3 => "J&#46; Kenardy"
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                    ]
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                    0 => array:2 [
                      "doi" => "10.1002/14651858.CD004158.pub3"
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                      "titulo" => "Major factors for facilitating change in behavioral strategies to reduce obesity"
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos