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Background: Physical activity, sedentary time and sleep have been shown to be associated with cardio-metabolic health. However, these associations are typically studied in isolation or without accounting for the effect of all movement behaviours and the constrained nature of data that comprise a finite whole such as a 24 h day. The aim of this study was to examine the associations between the composition of daily movement behaviours (including sleep, sedentary time (ST), light intensity physical activity (LIPA) and moderate-to-vigorous activity (MVPA)) and cardio-metabolic health, in a cross-sectional analysis of adults with pre-diabetes. Further, we quantified the predicted differences following reallocation of time between behaviours. Methods: Accelerometers were used to quantify daily movement behaviours in 1462 adults from eight countries with a body mass index (BMI) ≥25 kg·m − 2 , impaired fasting glucose (IFG; 5.6-6.9 mmol·l − 1 ) and/or impaired glucose tolerance (IGT; 7.8-11.0 mmol•l − 1 2 h following oral glucose tolerance test, OGTT). Compositional isotemporal substitution was used to estimate the association of reallocating time between behaviours. (Continued on next page)Results: Replacing MVPA with any other behaviour around the mean composition was associated with a poorer cardio-metabolic risk profile. Conversely, when MVPA was increased, the relationships with cardiometabolic risk markers was favourable but with smaller predicted changes than when MVPA was replaced. Further, substituting ST with LIPA predicted improvements in cardio-metabolic risk markers, most notably insulin and HOMA-IR.Conclusions: This is the first study to use compositional analysis of the 24 h movement composition in adults with overweight/obesity and pre-diabetes. These findings build on previous literature that suggest replacing ST with LIPA may produce metabolic benefits that contribute to the prevention and management of type 2 diabetes. Furthermore, the asymmetry in the predicted change in risk markers following the reallocation of time to/from MVPA highlights the importance of maintaining existing levels of MVPA.Trial registration: ClinicalTrials.gov (NCT01777893).

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Congenital heart abnormalities are rare and most often occur separately. These structural and functional disorders can cause a range of diseases that vary in severity, from mild or even asymptomatic to severe and life-threatening. Occasionally these conditions could cause no symptoms in which case they are found accidentally when the patient is examined for other reasons or during autopsy. In this article we present the case of a 47-year-old male patient with triple congenital heart anomaly detected in two consecutive tests performed in pre-hospital medical care.

The aim of this study was to assess the nutritional status and extracurricular physical activity of Sofia Municipality pupils depending on school conditions. Methodology: the height and weight were measured of 123 respondents (boys and girls, with mean age 12.4 ± 0.9 years) from three schools, each of whom was later asked to complete questionnaires that contain questions about age, gender, extracurricular physical activity and dietary intake over the last 24 hours. Based on this information, the following factors were assessed: daily nutritional intake, BMI, nutritional status and physical activity. School conditions: School 1 is in a village type district-there is a mess room, however no Fast food places and Physical education lessons are not held on schedule; School 2 is in a central district-there is a Fast food place, no mess room and Physical education lessons are carried out as planned; School 3 is in a central district-there are four Fast food places, no mess room and Physical education lessons are not held on schedule. Results: In School 1 was observed the highest percent of pupils with below normal BMI-15.6%. In School 2 pupils with normal BMI were 70.7%, extracurricular physical activities were performed 2.5 ± 1.9 h/week and it is statistically at a lower rank than the other schools. In School 3 there were 32.4% of pupils with above normal BMI. Discussion: The high percentage of pupils with low BMI in school 1 is in accordance with an earlier national survey. Conclusions: At School 3 which is with various types of Fast food and not realized Physical education lessons was reported the highest percent of pupils with above normal BMI.