Creatine supplementation and age influence muscle metabolism during exercise

Young [n = 5, 30 +/- 5 (SD) yr] and middle-aged (n = 4, 58 +/- 4 yr) men and women performed single-leg knee-extension exercise inside a whole body magnetic resonance system. Two trials were performed 7 days apart and consisted of two 2-min bouts and a third bout continued to exhaustion, all separated by 3 min of recovery. 31P spectra were used to determine pH and relative concentrations of Pi, phosphocreatine (PCr), and beta-ATP every 10 s. The subjects consumed 0.3 g . kg-1 . day-1 of a placebo (trial 1) or creatine (trial 2) for 5 days before each trial. During the placebo trial, the middle-aged group had a lower resting PCr compared with the young group (35.0 +/- 5.2 vs. 39.5 +/- 5.1 mmol/kg, P < 0.05) and a lower mean initial PCr resynthesis rate (18.1 +/- 3.5 vs. 23.2 +/- 6.0 mmol . kg-1 . min-1, P < 0.05). After creatine supplementation, resting PCr increased 15% (P < 0.05) in the young group and 30% (P < 0.05) in the middle-aged group to 45.7 +/- 7.5 vs. 45.7 +/- 5.5 mmol/kg, respectively. Mean initial PCr resynthesis rate also increased in the middle-aged group (P < 0.05) to a level not different from the young group (24.3 +/- 3.8 vs. 24.2 +/- 3.2 mmol . kg-1 . min-1). Time to exhaustion was increased in both groups combined after creatine supplementation (118 +/- 34 vs. 154 +/- 70 s, P < 0.05). In conclusion, creatine supplementation has a greater effect on PCr availability and resynthesis rate in middle-aged compared with younger persons.

Extracellular-regulated protein kinase cascades are activated in response to injury in human skeletal muscle

The mitogen-activated protein (MAP) kinase signaling pathways are believed to act as critical signal transducers between stress stimuli and transcriptional responses in mammalian cells. However, it is not known whether these signaling cascades also participate in the response to injury in human tissues. To determine whether injury to the vastus lateralis muscle activates MAP kinase signaling in human subjects, two needle biopsies or open muscle biopsies were taken from the same incision site 30-60 min apart. The muscle biopsy procedures resulted in striking increases in dual phosphorylation of the extracellular-regulated kinases (ERK1 and ERK2) and in activity of the downstream substrate, the p90 ribosomal S6 kinase. Raf-1 kinase and MAP kinase kinase, upstream activators of ERK, were also markedly stimulated in all subjects. In addition, c-Jun NH2-terminal kinase and p38 kinase, components of two parallel MAP kinase pathways, were activated following muscle injury. The stimulation of the three MAP kinase cascades was present only in the immediate vicinity of the injury, a finding consistent with a local rather than systemic activation of these signaling cascades in response to injury. These data demonstrate that muscle injury induces the stimulation of the three MAP kinase cascades in human skeletal muscle, suggesting a physiological relevance of these protein kinases in the immediate response to tissue injury and possibly in the initiation of wound healing.

Hyperhydration: tolerance and cardiovascular effects during uncompensable exercise-heat stress

This study examined the efficacy of glycerol and water hyperhydration (1 h before exercise) on tolerance and cardiovascular strain during uncompensable exercise-heat stress. The approach was to determine whether 1-h preexercise hyperhydration (29.1 ml H2O/kg lean body mass with or without 1.2 g/kg lean body mass of glycerol) provided a physiological advantage over euhydration. Eight heat-acclimated men completed three trials (control euhydration before exercise, and glycerol and water hyperhydrations) consisting of treadmill exercise-heat stress (ratio of evaporative heat loss required to maximal capacity of climate = 416). During exercise ( approximately 55% maximal O2 uptake), there was no difference between glycerol and water hyperhydration methods for increasing (P < 0.05) total body water. Glycerol hyperhydration endurance time (33. 8 +/- 3.0 min) was longer (P < 0.05) than for control (29.5 +/- 3.5 min), but was not different (P > 0.05) from that of water hyperhydration (31.3 +/- 3.1 min). Hyperhydration did not alter (P > 0.05) core temperature, whole body sweating rate, cardiac output, blood pressure, total peripheral resistance, or core temperature tolerance. Exhaustion from heat strain occurred at similar core and skin temperatures and heart rates in each trial. Symptoms at exhaustion included syncope and ataxia, fatigue, dyspnea, and muscle cramps (n = 11, 10, 2, and 1 cases, respectively). We conclude that 1-h preexercise glycerol hyperhydration provides no meaningful physiological advantage over water hyperhydration and that hyperhydration per se only provides the advantage (over euhydration) of delaying hypohydration during uncompensble exercise-heat stress.

Aerobic exercise capacity remains normal despite impaired endothelial function in the micro- and macrocirculation of physically active IDDM patients

The aim of the present study was to examine if diabetes in the absence of neuropathy affects the exercising capacity of IDDM patients, and whether regular, intense training has a beneficial effect on endothelial function. Five groups of subjects were studied: 23 healthy control subjects who exercised regularly (age 33 +/- 6 years), 23 nonneuropathic type 1 diabetic patients who exercised regularly (age 33 +/- 6 years, IDDM duration 11 +/- 8 years), 7 neuropathic type 1 diabetic patients who exercised regularly (age 36 +/- 7 years, IDDM duration 22 +/- 8 years), 18 healthy subjects who did not exercise regularly (age 34 +/- 7 years), and 5 nonneuropathic type 1 diabetic patients who did not exercise regularly (age 31 +/- 4 years, IDDM duration 20 +/- 3 years). All groups were matched for age, sex, and body weight. No differences existed in the energy expenditure per week in physical activity among the three exercising groups or between the two nonexercising groups. The maximal oxygen uptake was similar between control and diabetic nonneuropathic exercisers, and among diabetic neuropathic exercisers, control nonexercisers, and diabetic nonexercisers; however, a significant difference existed between the first two and the last three groups (P < 0.0001). A stepwise increase was found in the resting heart rate among the groups, ranging from the lowest in control exercisers to the highest in diabetic nonexercisers, but the maximal heart rate was lower only in diabetic neuropathic exercisers compared with all other groups (P < 0.05). Assessments of endothelial function in both macro- and microcirculation were performed in 12 control exercisers, 10 diabetic nonneuropathic exercisers, 5 diabetic neuropathic exercisers, 17 control nonexercisers, and 4 diabetic nonexercisers. When all diabetic patients were considered as one group and all control subjects as another, the microcirculation endothelial function in the diabetic group was reduced compared with the control subjects (91 +/- 49 vs. 122 +/- 41% flux increase over baseline; P < 0.05). In contrast, no differences existed among the three diabetic groups or between the two control groups. Similarly, in macrocirculation, a reduced response during reactive hyperemia was observed in the diabetic patients compared with control subjects (7.0 +/- 4.5 vs. 11.2 +/- 6.6% diameter increase; P < 0.05), whereas again no difference existed among the three diabetic groups or between the two control groups. These data suggest that diabetes per se does not affect aerobic exercise capacity (VO2max) in physically active individuals, but is reduced in the presence of neuropathy. In addition, regular exercise training involving the lower extremities does not improve the endothelial function in the micro- and macrocirculation of the nonexercised upper extremity in type 1 diabetic patients.

Hyperhydration: thermoregulatory effects during compensable exercise-heat stress

This study examined the effects of hyperhydration on thermoregulatory responses during compensable exercise-heat stress. The general approach was to determine whether 1-h preexercise hyperhydration [29. 1 ml/kg lean body mass; with or without glycerol (1.2 g/kg lean body mass)] would improve sweating responses and reduce core temperature during exercise. During these experiments, the evaporative heat loss required (Ereq = 293 W/m2) to maintain steady-state core temperature was less than the maximal capacity (Emax = 462 W/m2) of the climate for evaporative heat loss (Ereq/Emax = 63%). Eight heat-acclimated men completed five trials: euhydration, glycerol hyperhydration, and water hyperhydration both with and without rehydration (replace sweat loss during exercise). During exercise in the heat (35 degrees C, 45% relative humidity), there was no difference between hyperhydration methods for increasing total body water (approximately 1.5 liters). Compared with euhydration, hyperhydration did not alter core temperature, skin temperature, whole body sweating rate, local sweating rate, sweating threshold temperature, sweating sensitivity, or heart rate responses. Similarly, no difference was found between water and glycerol hyperhydration for these physiological responses. These data demonstrate that hyperhydration provides no thermoregulatory advantage over the maintenance of euhydration during compensable exercise-heat stress.

The reproducibility of the Bruce protocol exercise test for the determination of aerobic capacity in older women

The reproducibility of the Bruce exercise test protocol for the determination of maximal aerobic activity was evaluated in sedentary older women. Seventeen women between the ages of 51 and 68 yr performed five maximal graded exercise tests to volitional fatigue on a treadmill. VO2max (mL.kg-1.min-1) values averaged 27.5 +/- 1.1; 28.3 +/- 1.3; 28.4 +/- 1.3; 29.6 +/- 1.5; and 28.2 +/- 1.4 for trials 1-5, respectively, and were not significantly different. Criteria for a plateau in VO2 at the point of exhaustion were met in 21 out of 85 tests (25%). The mean coefficient of variation VO2max for the subjects for the 5 tests was 6.5% (range, 2.0-14%). Pearson's correlation coefficients for the study variables were significant, indicating good agreement between repeated tests (r2: between 0.70 to 0.89). Although there were no significant differences among the mean VO2max values in the 5 trials, 11 subjects had a 1.0 ml.kg-1.min-1 or greater increase in the VO2max from test 1 to test 2, and only 6 subjects had no change or a decrease in VO2max. The mean difference between T2 and T3 was lower (T1 vs T2: 0.8 mL.kg-1.min-1, T2 vs T3: 0.1 mL.kg-1.min-1) indicating slightly better agreement between the second and third set. Estimates of the between and within subject variance revealed a low within subject variance (4.2 (mL.kg-1.min-1)2) compared to the between subject variance (22.1 (mL.kg-1.min-1)2). This study demonstrates that a commonly used exercise testing protocol generates highly reproducible measurements of VO2max in women between 51 and 68 yr. The mean differences between tests and the high level of agreement between repeated tests suggests that a single measurement of VO2max can be performed to assess functional aerobic capacity in this population.

Exercise stimulates the mitogen-activated protein kinase pathway in human skeletal muscle

Physical exercise can cause marked alterations in the structure and function of human skeletal muscle. However, little is known about the specific signaling molecules and pathways that enable exercise to modulate cellular processes in skeletal muscle. The mitogen-activated protein kinase (MAPK) cascade is a major signaling system by which cells transduce extracellular signals into intracellular responses. We tested the hypothesis that a single bout of exercise activates the MAPK signaling pathway. Needle biopsies of vastus lateralis muscle were taken from nine subjects at rest and after 60 min of cycle ergometer exercise. In all subjects, exercise increased MAPK phosphorylation, and the activity of its downstream substrate, the p90 ribosomal S6 kinase 2. Furthermore, exercise increased the activities of the upstream regulators of MAPK, MAP kinase kinase, and Raf-1. When two additional subjects were studied using a one-legged exercise protocol, MAPK phosphorylation and p90 ribosomal S6 kinase 2, MAP kinase kinase 1, and Raf-1 activities were increased only in the exercising leg. These studies demonstrate that exercise activates the MAPK cascade in human skeletal muscle and that this stimulation is primarily a local, tissue-specific phenomenon, rather than a systemic response to exercise. These findings suggest that the MAPK pathway may modulate cellular processes that occur in skeletal muscle in response to exercise.

Aging and the acute phase response to exercise: implications for the role of systemic factors on skeletal muscle protein turnover

Declines in exercise capacity throughout an individual's life span can affect function and can ultimately limit the ability to perform activities of daily living. Along with these changes in exercise capacity and function, studies have reported age-associated changes in several parameters of immune status including declines in cell-mediated and humoral immunity. Exercise has been shown repeatedly to activate host-specific defense mechanisms in a series of coordinated metabolic events similar to the acute phase response to infection. This review will focus on the role of the acute phase response on skeletal muscle remodeling after exercise. In particular, we will discuss the physiological role of exercise-induced neutrophilia and monocyte production of the cytokine interleukin-1 on skeletal muscle remodeling in young and older individuals. The implications of these responses in mediating the metabolic adaptations to exercise will be addressed.

Exercise, free radical generation, and aging

Advancing age is associated with profound alterations in body composition and exercise capacity. Skeletal muscle mass declines on average of 6% per decade after age thirty and this change impacts both basal energy requirements and maximal aerobic exercise capacity. While skeletal muscle has one of the highest requirements of all tissues for oxygen, exercise increases total oxygen consumption by approximately 10-fold, causing an increased rate of production of reactive oxygen species (ROS). Biological aging is thought to be influenced by ROS generation and older individuals may be more susceptible to exercise-induced oxidative damage. However, aging is also associated with increases in antioxidant enzymes and controversy still exists as to whether exercise training further upregulates the expression of these free radical scavenging enzymes. Older individuals who participate in regular exercise may have higher requirements for antioxidant vitamins to compensate for the deficit of endogenous antioxidants.

Leg power in young women: relationship to body composition, strength, and function

The ability to generate high forces at high velocity (power) is an important component of physiologic reserve for both athletic performance and functional capacity. A comparison was made between different laboratory methods and field tests designed to evaluate leg power. Nineteen young healthy untrained women participated in this study. Maximum power during the double leg press (KP) occurred between 56-78% of the one repetition maximum (1-RM) and averaged (404 +/- 22 W). Rank-ordered correlation showed an association between KP and another measure of leg power measured on the leg extensor power rig (LR) when expressed per kg LBM (Rho = 0.565, P < 0.016). KP was also related to the 1-RM achieved on the double leg press (R2 = 0.584, P < 0.001). The KP test also correlated with the vertical jump (R2 = 0.538, P < 0.004) and maximal power output during the Wingate anaerobic power test (R2 = 0.299, P < 0.015). However, double leg press power was not related to time to run 40 yards (R2 = 0.020, P < 0.573) or maximal gait velocity (R2 = 0.136, P < 0.121). These results suggest that maximal power during the double leg press occurs at a higher percentage of maximal strength than previously reported. Double leg press power was related to vertical jump performance, validating this field test as a measure of leg muscle power in young women.

A 20-yr longitudinal study of Olympic oarsmen

Nine 1972 silver-medalist oarsmen were studied before the Olympic Games and 10 and 20 yr later. Peak power, metabolic responses, and heart rate were recorded during rowing ergometry; blood lactate was measured following exercise. The skinfold equation yielded percent body fat. The average change (multiple analysis of variance) among measurements from 1972 to 1992 was 37.5 +/- 3% (P < 0.01). Average changes between 1972 and 1982 and between 1982 and 1992 were similar, 17 and 18%, respectively (P < 0.01). The most significant change between 1972 and 1992 was decreased peak blood lactate (106%). Decreases in peak power, VE, and VO2 (ml.kg-1.min-1) were all similar, approximately 40%, and were significant. Body fat increased (from 12.3 to 15.6%), and absolute VO2 and relative VO2 (lean body mass) decreased 30% (P < 0.01). Only body weight, heart rate, and O2 pulse showed smaller changes, but these changes were still significant (P < 0.05). Relative peak VO2 decreased from 65.5 to 46.8 ml.kg-1.min-1 from 1972 to 1992 and at a rate of 10%.decade-1. The most significant changes between 1972 and 1982 were increases in percent body fat (from 12.3 to 16.3%) and decreases in VO2 values (P < 0.01). There was less change in body fat between 1982 and 1992, but lactate significantly decreased (P < 0.01), as did peak power and absolute and relative VO2 and VE. Although fitness levels in former elite oarsmen decreased each decade, these declines were somewhat arrested by regular aerobic training. Body fat increased and metabolic capacity decreased rapidly during the first decade, whereas anaerobic capacity decreased more significantly in the second decade. Anaerobic capacity diminished at a significantly greater rate than aerobic capacity, probably as a result of the aging process and emphasis on aerobic training in post-competitive years.

Analysis of body-composition techniques and models for detecting change in soft tissue with strength training

The purpose of this study was to compare the ability of various body-composition assessment techniques to detect changes in soft tissue in older, weight-stable women (50-70 y of age) completing a 1-y randomized, controlled trial of progressive resistance training. The intervention group (n = 20) performed high-intensity strength-training 2 d/wk with five different exercises; the control group (n = 19) was untreated. Hydrostatic weighing, 24-h urinary creatinine, computed tomography of thigh sections, total body potassium, and tritium dilution techniques were used to measure increases in total fat-free mass (FFM) and the muscle and water components of FFM. A decrease in fat mass (by hydrostatic weighing) was seen in the strength-trained women compared with the control subjects (P - 0.01-0.0001). Anthropometry, bioelectric impedance, dual-energy X-ray absorptiometry, and total body nitrogen and carbon did not measure any significant change in soft tissue. The choice of a body-composition technique is important when designing a study expected to affect soft tissue, because not all techniques available are precise enough to detect small changes.

The role of progressive resistance training and nutrition in the preservation of lean body mass in the elderly

Human aging is associated with an increased incidence of several chronic diseases including coronary artery disease, non insulin-dependent diabetes mellitus and osteoporosis. Concurrent with the increased prevalence of these diseases in the elderly are well-documented changes in body composition that include an increased fat mass and a progressive decline in skeletal muscle mass and bone mineral density. Together these factors result in age-related decreases in muscle strength and aerobic capacity which contribute to decreases in functional independence. Progressive resistance (strength) training interventions have been proposed as countermeasures to some of these degenerative processes. Recently, several studies have reported on the effects of high intensity resistance training on muscle function and size in both healthy middle-aged men and women (50-75 years) and older frail men and women (80-100 years). In total, the majority of these studies have shown substantial increases (> 100%) in the one repetition maximum muscle strength of the muscle's being exercised in response to 8 to 12 weeks of strength training (3 to 4 times per week at 70 to 90% of the 1 repetition maximum). In addition, a subset of these reports has also reported significant increases in muscle size either by computed tomography (CT) analysis of muscle cross-sectional area (9 to 17%) or by biopsy examination of muscle fiber size changes (20 to 30%). There is now compelling evidence that progressive resistance training in the elderly can positively influence whole body energy expenditure, muscle growth, and function. In addition, strength training interventions may be a powerful tool in the prevention of age-associated sarcopenia (loss of muscle mass).

Effects of exercise training in the elderly: impact of progressive- resistance training on skeletal muscle and whole-body protein metabolism

The declines in functional capacity and muscle function with advancing age are well-documented. In addition, it appears that the age-related changes in body composition have profound effects on functional capacity and nutrient requirements. The overwhelming evidence presented in the present review suggests that the loss of muscle strength and function observed with advancing age is reversible even in the frail elderly. Along with the profound functional improvement in older individuals in response to progressive-resistance training, several studies have reported increases in resting energy expenditure and increased requirements for dietary protein. Exercise programmes designed to improve muscle strength be recommended for older individuals as an effective countermeasure to the sarcopenia of old age.

Long-term effects of a high-carbohydrate diet and exercise on insulin action in older subjects with impaired glucose tolerance

Carbohydrate metabolism was assessed in 20 glucose-intolerant subjects before and after 12 wk on a high-carbohydrate diet (HC) or the diet combined with exercise training (HC-EX). The diet provided 60% of energy as carbohydrate and 20% as fat. Neither treatment altered fasting glucose or insulin concentrations or their response to a meal. During a glucose clamp (216 pmol insulin/L) glucose disposal increased from 13.2 +/- 0.83 to 14.6 +/- 0.83 mumol.kg fat-free mass-1.min-1 (P < 0.05) in both groups. During more pronounced hyperinsulinemia (654 pmol/L) glucose disposal did not change significantly (49.9 +/- 3.8 to 50.7 +/- 3.8 mumol.kg fat-free mass-1.min-1). Muscle glycogen increased in the HC-EX group (78.5 +/- 8.1 to 161.1 +/- 15.7 mmol glucose/kg muscle), with no changes in the HC group. These results do not support the recommendation to increase the dietary carbohydrate content for improving postprandial glucose metabolism or insulin action in glucose-intolerant adults unless combined with exercise training, which promotes muscle glycogen storage.

Aging and stress-induced changes in complement activation and neutrophil mobilization

We measured the extent of complement activation and neutrophil mobilization after eccentric exercise to determine whether these responses were age dependent and whether they were associated with changes in plasma creatine kinase (CK), a marker for muscle membrane integrity. Repeated forced lengthening of a muscle as it develops tension causes immediate ultrastructural damage to sarcomeres, followed by delayed-onset muscle soreness and release of myocellular enzymes. This can be accomplished in quadriceps muscles by running downhill or by resisting bicycle pedals driven backward by a motor. Twelve older (61-72 yr) and 9 younger (20-32 yr) subjects performed one of these activities for 45 min at an intensity of 78 +/- 2% of maximum heart rate. For all subjects, a median increase of 21% in plasma des-Arg-C3a levels occurred immediately after the protocol, circulating neutrophils increased 66 +/- 10% by 4-6 h, and plasma CK increased 135 +/- 25% by 24 h. The peak increases in neutrophils correlated with the peak increases in des-Arg-C3a (rho = 0.662, P = 0.006), and the peak increases in CK correlated with the rise in neutrophils (rho = 0.523, P = 0.027). The increases in neutrophils and plasma CK were significantly smaller in the older subjects (P < 0.05). The results indicate that increased concentrations of circulating CK after muscle injury are associated with a sequential cascade of inflammatory mediators. Furthermore, neutrophil mobilization, but not complement activation, was diminished in older subjects in response to this stress.

Relationships between in vivo and in vitro measurements of metabolism in young and old human calf muscles

This study compared in vivo measurements of muscle metabolism in humans with magnetic resonance spectroscopy (MRS) and in vitro analysis of biopsies. Healthy subjects [4 young males, 28.2 +/- 6.8 (SD) yr, and 6 older subjects (5 males, 1 female), 66 +/- 6.0 yr] performed a maximal cycle ergometer test, and MRS measurements of the calf muscles and needle biopsies of the lateral gastrocnemius were performed. Biopsies were analyzed for fiber type and citrate synthase (CS) activity. MRS measurements of inorganic phosphate (Pi), phosphocreatine (PCr), ATP, and pH were made using a 1.8-T 78-cm clear-bore magnet-and-spectrometer system. Two or three 5-min bouts of plantar flexion were performed against variable resistance to deplete PCr levels to 50% of resting values (mean end pH 6.99). PCr values during recovery were fit to an exponential curve, and the rate constant (PCrrate) was calculated. PCrrate was used as an index of oxidative metabolism. Older subjects had lower peak O2 uptake (VO2 peak) values (19.2 +/- 5.6 vs. 49.5 +/- 8.1 ml O2.min-1 x kg-1), CS activities (16 +/- 2.8 vs. 25 +/- 2.6 mmol.kg wet wt-1 x min-1), and PCrrate values (25.3 +/- 8. vs. 37.5 +/- 5.3 mmol PCr.kg wet wt-1.min-1) than young subjects. PCrrate correlated with CS activity, and both PCrrate and CS activity correlated with VO2 peak (P < 0.05). No correlations were found between percent fiber type and PCrrate, CS activity, and VO2 peak. These results support studies that showed decreases in muscle metabolism with age in healthy humans and show a good correlation between in vivo and in vitro measurements of oxidative metabolism.

Acute phase response in exercise. III. Neutrophil and IL-1 beta accumulation in skeletal muscle

Nine untrained men (22-29 yr) performed 45 min of downhill running (16% incline, 70% of maximum heart rate). Needle biopsies of the vastus lateralis were performed before, 45 min after, and 5 days after exercise. Immunohistochemical staining of muscle cross sections revealed a 135% increase in muscle interleukin-1 beta (IL-1 beta) immediately after and a 250% increase (P < 0.03) 5 days after exercise. Using a rating scale (0-3) for the presence of neutrophils, light microscopic examination showed a significant accumulation of neutrophils in muscle biopsies taken 45 min after and 5 days after exercise [before: 0.5 +/- 0.2, 45 min after: 1.5 +/- 0.3 (P < 0.01), and 5 days after: 1.2 +/- 0.2 (P < 0.04)]. In addition, electron microscopic analysis showed an increase in the percentage of damaged Z-bands relative to total Z-bands [before: 4.8 +/- 3.5%, 45 min after: 32.5 +/- 8.6% (P < 0.05), and 5 days after: 14.1 +/- 3.2%]. Neutrophil accumulation was positively correlated to intracellular Z-band damage (rho = 0.66, P < 0.001). Immunohistochemical staining for IL-1 beta was related to neutrophil accumulation in muscle (rho = 0.38, P < 0.06) and to plasma creatine kinase levels (rho = 0.416, P < 0.04). These data indicate that after eccentric exercise ultrastructural damage to skeletal muscle is associated with neutrophil infiltration and muscle IL-1 beta accumulation.

Exercise increases muscle GLUT-4 levels and insulin action in subjects with impaired glucose tolerance

A decline in insulin sensitivity is associated with aging, inactivity, and obesity. The effects of exercise training on glucose homeostasis independent of weight loss in older glucose-intolerant individuals are not well established. We examined the effects of exercise training on oral glucose tolerance, insulin action, and concentration of the GLUT-4 glucose transporters in skeletal muscle. Exercise training at 50 and 75% of heart rate reserve was performed for 12 wk in 18 individuals (age = 64 +/- 2, body fat = 37.0 +/- 1.5%). Peripheral insulin action was determined 96 h after the last exercise bout using a two-step hyperinsulinemic-euglycemic glucose clamp (insulin = 192 and 708 pmol/l). Percent body fat and fat-free mass (FFM) were unchanged with training. Diet composition, assessed by diet record, did not change over the 12 wk. Improved oral glucose tolerance was observed, as exhibited by lower plasma glucose concentrations after training (P < 0.05), whereas plasma insulin response remained unchanged. The rate of glucose disposal was unchanged during the low insulin concentration but increased 11.0% at the high insulin concentration (P < 0.05) after training (54.4 +/- 4.4 vs. 60.4 +/- 5.5 mumol.kg FFM-1.min-1). Skeletal muscle glycogen and GLUT-4 concentration increased 24 and 60%, respectively, with training. There was no direct relationship between the change in GLUT-4 protein and the change in glucose disposal rate. These findings demonstrate that chronic exercise training without changes in body composition improves peripheral insulin action in subjects with impaired glucose tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)

Protective effect of vitamin E on exercise-induced oxidative damage in young and older adults

The protective effect of vitamin E supplementation on exercise-induced oxidative damage was tested in 21 male volunteers. Nine young (22-29 yr) and 12 older (55-74 yr) sedentary male subjects participated in a double-blind protocol and received either 800 IU dl-alpha-tocopherol or a placebo daily. After 48 days, vitamin E supplementation significantly increased alpha-tocopherol in plasma and skeletal muscle. Subjects then performed a bout of eccentric exercise at 75% of their maximum heart rate by running down an inclined treadmill for 45 min. All vitamin E-supplemented subjects excreted less (P < 0.05) urinary thiobarbituric acid adducts after the exercise bout than placebo subjects at 12 days postexercise (35 and 18% above baseline in young and old supplemented groups, respectively, vs. 60 and 80% in young and old placebo groups, respectively). After exercise, the initial difference in alpha-tocopherol concentration of muscle between young placebo and vitamin E-supplemented groups was diminished and muscle lipid conjugated dienes tended to increase (P = 0.09) in placebo subjects. Placebo subjects had a significant decrease in major fatty acids of muscle biopsy taken immediately after exercise. When normalized for the hemoconcentration effects of exercise, the plasma concentration of vitamins E and C and uric acid showed no significant change. The alterations in fatty acid composition, vitamin E, and lipid conjugated dienes in muscle and in urinary lipid peroxides in controls after eccentric exercise are consistent with the concept that vitamin E provides protection against exercise-induced oxidative injury.

Plasma creatine kinase activity and exercise-induced muscle damage in older men

Plasma creatine kinase (CK) activity has often been used as a marker of exercise-induced skeletal muscle damage. While the pattern of muscle damage following eccentric exercise has been established in young adults, there is little data available on eccentric exercise-induced muscle damage in older individuals. The purpose of this study was to compare ultrastructural changes in skeletal muscle following high intensity eccentric exercise of young and older men and to determine whether CK activity is a reliable predictor of muscle damage. Five young (20-30 yr) and five older untrained men (59-63 yr) performed three 15-min bouts of eccentric exercise at 90, 80, and 70% of maximal concentric power output. There was a prolonged increase in CK up to 10 d following exercise that was not significantly different between groups. Light and electron microscopic examination of needle biopsies obtained from the vastus lateralis showed evidence of focal damage in greater than 90% of the post-exercise fibers examined in the older subjects, compared with values ranging from 5 to 50% reported previously in young subjects. Quantitative analysis using light microscopy showed greater damage in the older subjects than reported previously in young subjects. These data suggest that older adults experience greater muscle damage following eccentric exercise than young subjects, which may be due in part to the smaller muscle mass and lower VO2max seen in older men. In addition, there was no relationship between CK activity and the corresponding amount of muscle damage observed in each subject, suggesting that CK activity may be a poor predictor of exercise-induced muscle damage.

Enhanced protein breakdown after eccentric exercise in young and older men

The effects of eccentric exercise on whole body protein metabolism were compared in five young untrained [age 24 +/- 1 yr, maximal O2 uptake (VO2max) = 49 +/- 6 ml.kg-1.min-1] and five older untrained men (age 61 +/- 1 yr, VO2max = 34 +/- 2 ml.kg-1.min-1). They performed 45 min of eccentric exercise on a cycle ergometer at a power output equivalent to 80% VO2max (182 +/- 18 W). Beginning 5 days before exercise and continuing for at least 10 days after exercise, they consumed a eucaloric diet providing 1.5 g.kg-1.day-1 of protein. Leucine metabolism in the fed state was measured before, immediately after, and 10 days after exercise, with intravenous L-[1-13C]leucine as a tracer (0.115 mumol.kg-1.min-1). Leucine flux increased 9% immediately after exercise (P less than 0.011) and remained elevated 10 days later, with no effect of age. Leucine oxidation increased 19% immediately after exercise and remained 15% above baseline 10 days after exercise (P less than 0.0001), with no effect of age. In the young men, urinary excretion of 3-methylhistidine per gram of creatinine did not increase until 10 days postexercise (P less than 0.05), but in the older men, it increased 5 days after exercise and remained high through 10 days postexercise (P less than 0.05), averaging 37% higher than in the young men. These data suggest that eccentric exercise produces a similar increase in whole body protein breakdown in older and young men, but myofibrillar proteolysis may contribute more to whole body protein breakdown in the older group.

Acute phase response in exercise. II. Associations between vitamin E, cytokines, and muscle proteolysis

Cytokines such as interleukin 1 (IL-1), tumor necrosis factor-alpha (TNF-alpha), and interleukin 6 (IL-6) mediate a variety of host responses to trauma and infection, including skeletal muscle proteolysis. This investigation assesses the influence of damaging eccentric exercise on in vitro production and plasma concentrations of cytokines and their relationship to muscle protein breakdown. In a double-blind placebo-controlled protocol, 21 male subjects took vitamin E supplements (800 IU/day) for 48 days, then ran downhill on an inclined treadmill. Twenty-four hours after this single session of eccentric exercise, endotoxin-induced secretion of IL-1 beta was augmented 154% (P less than 0.01) in cells obtained from the placebo subjects, but no significant exercise-related changes were observed in cells from the vitamin E-supplemented subjects. TNF-alpha secretion was also significantly increased 24 h after exercise, but the response was not inhibited by vitamin E. In contrast, IL-6 secretion did not change after exercise, but dietary vitamin E supplementation significantly reduced IL-6 secretion throughout the 12-day period of observation (P = 0.023). Urinary 3-methylhistidine excretion correlated with mononuclear cell secretion of both IL-1 beta (P less than 0.05) and prostaglandin E2 (P less than 0.05), supporting the concept that these mononuclear cell products contribute to the regulation of muscle proteolysis.