Waging war on physical inactivity: using modern molecular ammunition against an ancient enemy

Setting the stage: possible mechanisms by which acute contraction restores insulin sensitivity in muscle

It has long been known that acute exercise can dramatically improve insulin sensitivity in previously insulin-resistant muscle; however, the precise mechanisms underlying this clinically significant interaction remain unknown. Using hindlimb perfusions in obese Zucker rats, our group found that acute muscle contraction synergistically improved insulin-stimulated glucose transport in skeletal muscle, but contrary to our hypothesis, these findings were not associated with either improved insulin signaling or decreased intramuscular lipid metabolites. A further analysis revealed that the improved insulin sensitivity was associated with a robust increase in mitochondrial energy flux. These findings and reports from other labs suggest that mitochondrial energy flux and mitochondrial oxidative capacity may govern insulin sensitivity and override insulin signaling defects associated with obesity. This review will discuss the effects of acute exercise to enhance insulin sensitivity in previously insulin-resistant muscle and present possible novel mechanisms by which alterations in mitochondrial energy metabolism may play a regulatory role.

Susruta of India, an unrecognized contributor to the history of exercise physiology

When considering the history of exercise physiology, authors begin with Hippocrates and the "Golden Age" of Greece before mentioning Galen and the contributions from Rome. However, this approach has omitted the information from the ancient civilizations of India which flourished before and during the emergence of Mycenaen cultures. Specifically ignored have been 1) the tridosa doctrine (humoral theory), which as early as 1500 B.C., emphasized that disease occurred because of a displacement of one or more of the three humors, with health being achieved when the humors were in equilibrium and 2) the perspective of Susruta (Sushruta) who was a 600 B.C. physician who included exercise in his prescriptions to prevent and treat diseases. Susruta not only advocated exercise to maintain equilibrium among the humors, notably kapha, he promoted exercise to minimize the consequences of obesity and diabetes. To be effective, exercise had to be daily and moderate in intensity and never excessive or to exceed the half-maximum limit for exhaustion, because disease or even death could ensue. It is concluded that Susruta's concepts pertaining to chronic exercise and to the health benefits of exercise were "remarkably modern" and that future authors on the history of exercise physiology should include contributions from ancient India.

Neurogenesis and exercise: past and future directions

Research in humans and animals has shown that exercise improves mood and cognition. Physical activity also causes a robust increase in neurogenesis in the dentate gyrus of the hippocampus, a brain area important for learning and memory. The positive correlation between running and neurogenesis has raised the hypothesis that the new hippocampal neurons may mediate, in part, improved learning associated with exercise. The present review gives an overview of research pertaining to exercise-induced cell genesis, its possible relevance to memory function and the cellular mechanisms that may be involved in this process.

The influences of diet and exercise on mental health through hormesis

It is likely that the capacity of the brain to remain healthy during aging depends upon its ability to adapt and nurture in response to environmental challenges. In these terms, main principles involved in hormesis can be also applied to understand relationships at a higher level of complexity such as those existing between the CNS and the environment. This review emphasizes the ability of diet, exercise, and other lifestyle adaptations to modulate brain function. Exercise and diet are discussed in relationship to their aptitude to impact systems that sustain synaptic plasticity and mental health, and are therefore important for combating the effects of aging. Mechanisms that interface energy metabolism and synaptic plasticity are discussed, as these are the frameworks for the actions of cellular stress on cognitive function. In particular, neurotrophins are emerging as main factors in the equation that may connect lifestyle factors and mental health.

Exercise, oxidative stress and hormesis

Physical inactivity leads to increased incidence of a variety of diseases and it can be regarded as one of the end points of the exercise-associated hormesis curve. On the other hand, regular exercise, with moderate intensity and duration, has a wide range of beneficial effects on the body including the fact that it improves cardio-vascular function, partly by a nitric oxide-mediated adaptation, and may reduce the incidence of Alzheimer's disease by enhanced concentration of neurotrophins and by the modulation of redox homeostasis. Mechanical damage-mediated adaptation results in increased muscle mass and increased resistance to stressors. Physical inactivity or strenuous exercise bouts increase the risk of infection, while moderate exercise up-regulates the immune system. Single bouts of exercise increases, and regular exercise decreases the oxidative challenge to the body, whereas excessive exercise and overtraining lead to damaging oxidative stress and thus are an indication of the other end point of the hormetic response. Based upon the genetic setup, regular moderate physical exercise/activity provides systemic beneficial effects, including improved physiological function, decreased incidence of disease and a higher quality of life.

Liver fattening during feast and famine: an evolutionary paradox

Liver disease is one of the features of metabolic syndrome, one of the most occurring diseases of the twenty-first century. During food deprivation and starvation, adipose tissue elsewhere in the body delivers lipid components to the liver where they are stored as triacylglycerols (TG). Continuous and excessive food intake, on the other hand, leads to liver fattening (hepatic steatosis). In the long term this reaction is pathogenic mainly by inflammation reactions. We postulate the hypothesis in the evolutionary context that individuals with genes promoting the efficient deposition of fat during periods between famines (thrifty genes) in combination with a proinflammatory genotype would be favored and be selected during the course of evolution. Furthermore we postulate the hypothesis that the majority of man, living in a world were famine never comes, are physiologically not adapted to modern social behavior with abundance of food.

Analysis of arterial intimal hyperplasia: review and hypothesis

BACKGROUND

Despite a prodigious investment of funds, we cannot treat or prevent arteriosclerosis and restenosis, particularly its major pathology, arterial intimal hyperplasia. A cornerstone question lies behind all approaches to the disease: what causes the pathology?

HYPOTHESIS

I argue that the question itself is misplaced because it implies that intimal hyperplasia is a novel pathological phenomenon caused by new mechanisms. A simple inquiry into arterial morphology shows the opposite is true. The normal multi-layer cellular organization of the tunica intima is identical to that of diseased hyperplasia; it is the standard arterial system design in all placentals at least as large as rabbits, including humans. Formed initially as one-layer endothelium lining, this phenotype can either be maintained or differentiate into a normal multi-layer cellular lining, so striking in its resemblance to diseased hyperplasia that we have to name it "benign intimal hyperplasia". However, normal or "benign" intimal hyperplasia, although microscopically identical to pathology, is a controllable phenotype that rarely compromises blood supply. It is remarkable that each human heart has coronary arteries in which a single-layer endothelium differentiates early in life to form a multi-layer intimal hyperplasia and then continues to self-renew in a controlled manner throughout life, relatively rarely compromising the blood supply to the heart, causing complications requiring intervention only in a small fraction of the population, while all humans are carriers of benign hyperplasia. Unfortunately, this fundamental fact has not been widely appreciated in arteriosclerosis research and medical education, which continue to operate on the assumption that the normal arterial intima is always an "ideal" single-layer endothelium. As a result, the disease is perceived and studied as a new pathological event caused by new mechanisms. The discovery that normal coronary arteries are morphologically indistinguishable from deadly coronary arteriosclerosis continues to elicit surprise.

CONCLUSION

Two questions should inform the priorities of our research: (1) what controls switch the single cell-layer intimal phenotype into normal hyperplasia? (2) how is normal (benign) hyperplasia maintained? We would be hard-pressed to gain practical insights without scrutinizing our premises.

Low physical activity and obesity: causes of chronic disease or simply predictors?

BACKGROUND AND PURPOSE

Many studies have shown associations between risk of morbidity and mortality with both obesity and low physical activity (PA), but association does not imply causality. Moreover, there is an inverse relationship between PA and obesity; therefore, controlling for one of these factors when investigating the risk associated with the other is essential. The purpose of this review is to determine whether low PA and obesity actually cause metabolic dysfunction and chronic disease, especially type 2 diabetes (T2D), rather than simply operating as predictors or markers.

METHODS

The case for causality is strengthened if the following two conditions are satisfied: first, that significant associations between obesity or low PA and risk persist after controlling appropriately; and second, that the physiological mechanisms by which obesity or low PA may exert a causal effect are clearly established. The studies examined include those that have used cardiorespiratory (CR) fitness as a surrogate measure for PA, thus also providing evidence for low CR fitness as an independent risk factor in its own right.

RESULTS AND CONCLUSIONS

Low PA and poor CR fitness are independent predictors of mortality related to type 2 diabetes and chronic disease in general. Together with well-demonstrated mechanisms, there is strong evidence that low PA and low CR fitness are direct, independent causes of metabolic dysfunction and type 2 diabetes. Despite some reports to the contrary, there is evidence that both general and visceral obesity are predictors of mortality and morbidity after controlling for PA. However, in the absence of established mechanisms, evidence is insufficient to conclude that either general or visceral obesity is a direct, independent cause of metabolic dysfunction or type 2 diabetes.

Effects of aerobic exercise on lipids and lipoproteins in adults with type 2 diabetes: a meta-analysis of randomized-controlled trials

OBJECTIVE

To conduct a meta-analysis of randomized-controlled trials in order to examine the effects of 8 weeks or more of aerobic exercise on lipids and lipoproteins in adults with Type 2 diabetes.

METHODS

Studies were included if total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), ratio of TC to HDL-C (TC/HDL-C), triglycerides (TG), or all of the above, were assessed. A secondary outcome was glycosylated haemoglobin (HbA1).

RESULTS

Seven studies representing 220 men and women (112 exercise, 108 control) were available for pooling. Using a random-effects model, a statistically significant reduction of about 5% was found for LDL-C, whereas no statistically significant improvements were found for TC, HDL-C, TC/HDL-C or TG. A trend for a statistically significant reduction in HbA1 was also found.

CONCLUSIONS

Although our overall results suggest that aerobic exercise lowers LDL-C in adults with Type 2 diabetes, additional randomized-controlled trials are needed on this topic.

The contribution of physical activity and sedentary behaviours to the growth and development of children and adolescents: implications for overweight and obesity

The obesity epidemic is a global trend and is of particular concern in children. Recent reports have highlighted the severity of obesity in children by suggesting: "today's generation of children will be the first for over a century for whom life expectancy falls." This review assesses the evidence that identifies the important role of physical activity in the growth, development and physical health of young people, owing to its numerous physical and psychological health benefits. Key issues, such as "does a sedentary lifestyle automatically lead to obesity" and "are levels of physical activity in today's children less than physical activity levels in children from previous generations?", are also discussed.Today's environment enforces an inactive lifestyle that is likely to contribute to a positive energy balance and childhood obesity. Whether a child or adolescent, the evidence is conclusive that physical activity is conducive to a healthy lifestyle and prevention of disease. Habitual physical activity established during the early years may provide the greatest likelihood of impact on mortality and longevity. It is evident that environmental factors need to change if physical activity strategies are to have a significant impact on increasing habitual physical activity levels in children and adolescents. There is also a need for more evidence-based physical activity guidelines for children of all ages. Efforts should be concentrated on facilitating an active lifestyle for children in an attempt to put a stop to the increasing prevalence of obese children.

Metabolic inflexibility in skeletal muscle: a prelude to the cardiometabolic syndrome?

Peripheral insulin resistance, which is largely dependent on skeletal muscle, is closely linked to the development of the cardiometabolic syndrome. Metabolic flexibility is the capacity for skeletal muscle to acutely shift its reliance between lipids or glucose during fasting or postprandial conditions. Obese and insulin-resistant individuals display elevated intramuscular lipids, impaired vasculature function, decreased fatty add oxidation during fasting, and reduced postprandial glucose metabolism. Impairments in metabolic flexibility are linked to physical inactivity, excess energy intake and obesity, and genetic predisposition. Each of these factors precludes the development of insulin resistance and the cardiometabolic syndrome by mechanistic links that are not fully understood.

Exercise training and sympathetic nervous system activity: evidence for physical activity dependent neural plasticity

1. It has been generally accepted that regular physical activity is associated with beneficial effects on the cardiovascular system. In fact, the idea that exercise maintains cardiovascular health is evident by the direct links between a sedentary lifestyle and the risk of cardiovascular and other disease states. 2. Cardiovascular diseases, such as hypertension and heart failure, are often associated with sympathetic nervous system (SNS) overactivity. Conversely, exercise has been shown to reduce hypertension and decrease elevated SNS activity. In addition, there is evidence that exercise may reduce resting blood pressure and sympathetic outflow in normal individuals. 3. Although somewhat controversial in humans, evidence from animal studies also indicates that exercise training reduces baroreflex-mediated and other forms of sympathoexcitation in normal individuals. Collectively, these data are consistent with the hypothesis that physical activity may decrease, and physical inactivity may increase, the incidence of cardiovascular disease via alterations in SNS activity. Despite the important clinical implications of this possibility, the mechanisms by which exercise alters control of SNS activity remain to be fully elucidated. 4. Recent evidence suggests that central nervous system (CNS) plasticity occurs under a variety of conditions, including varying levels of physical activity. The purpose of the present brief review is to provide evidence that changes within the CNS contribute importantly to altered regulation of the SNS observed following exercise training. The primary hypothesis is that physical activity versus inactivity produces plasticity within neural networks that regulate SNS activity. This hypothesis is supported by published and preliminary data that suggest that exercise training may reduce sympathoexcitation by reducing activation of neurons within cardiovascular regions of the brain. These mechanisms are likely to be important in disease states of sympathetic overactivity and in normal healthy individuals whose risk of cardiovascular disease is reduced by leading an active versus sedentary lifestyle.

Optimizing the therapeutic benefits of exercise in Type 2 diabetes

Other than diet and medication, exercise is considered one of the three cornerstones of good diabetes treatment. Nevertheless, current clinical guidelines on Type 2 diabetes provide no detailed information on the modalities of effective exercise intervention in the treatment of Type 2 diabetes. Based on a review of currently available literature, exercise modalities are being identified to maximize the benefits of exercise intervention in the treatment of different Type 2 diabetes subpopulations. Both endurance and resistance types of exercise have equal therapeutic strength to improve metabolic control in patients with Type 2 diabetes. When applying endurance-type exercise, energy expenditure should be equivalent to approximately 1.7-2.1 MJ/exercise bout on 3 but preferably 5 days/wk. In sarcopenic or severely deconditioned patients with Type 2 diabetes, focus should lie on the implementation of resistance-type exercise to attenuate and/or reverse the decline in skeletal muscle mass and strength. Before choosing the most appropriate exercise modalities, the patient's disease stage should be well characterized, and an ECG-stress test should be considered. Based on baseline aerobic fitness, level of co-morbidities, body composition, and muscle strength, patients should be provided with an individually tailored exercise intervention program to optimize therapeutic value. A multidisciplinary individualized approach and continued exercise training under personal supervision is essential to enhance compliance and allow long-term health benefits of an exercise intervention program.

Rat models of caloric intake and activity: relationships to animal physiology and human health

Every rodent experiment is based on important parameters concerning the levels of caloric intake and physical activity. In many cases, these decisions are not made consciously, but are based on traditional models. For experimental models directed at the study of caloric intake and activity, the selection of parameters is usually aimed at modeling human conditions, the ultimate goal of which is to gain insight into the pathophysiology of the disease process in man. In each model, it is important to understand the influence of diet, exercise, and genetic background on physiology and the development of disease states. Along the continuum of energy intake from caloric restriction to high-fat feeding, and of energy output from total inactivity to forced exercise, a number of models are used to study different disease states. In this paper, we will evaluate the influence of the quantity and composition of diet and exercise in several animal models, and will discuss how each model can be applied to various human conditions. This review will be limited to traditional models using the rat as the experimental animal, and although it is not an exhaustive list, the models presented are those most commonly represented in the literature. We will also review the mechanisms by which each affects rat physiology, and will compare these to the analogous mechanisms in the modeled human disease state. We hope that the information presented here will help researchers make choices among the available models and will encourage discussion on the interpretation and extrapolation of results obtained from traditional and novel rodent experiments on diet, exercise, and chronic disease.

Long-Term Low-Calorie Low-Protein Vegan Diet and Endurance Exercise are Associated with Low Cardiometabolic Risk

BACKGROUND

Western diets, which typically contain large amounts of energy-dense processed foods, together with a sedentary lifestyle are associated with increased cardiometabolic risk. We evaluated the long-term effects of consuming a low-calorie low-protein vegan diet or performing regular endurance exercise on cardiometabolic risk factors.

METHODS

In this cross-sectional study, cardiometabolic risk factors were evaluated in 21 sedentary subjects, who had been on a low-calorie low-protein raw vegan diet for 4.4 +/- 2.8 years, (mean age, 53.1 +/- 11 yrs), 21 body mass index (BMI)-matched endurance runners consuming Western diets, and 21 age- and gender-matched sedentary subjects, consuming Western diets.

RESULTS

BMI was lower in the low-calorie low-protein vegan diet (21.3 +/- 3.1 kg/m(2)) and endurance runner (21.1 +/- 1.6 kg/m(2)) groups than in the sedentary Western diet group (26.5 +/- 2.7 kg/m(2)) (p < 0.005). Plasma concentrations of lipids, lipoproteins, glucose, insulin, C-reactive protein, blood pressure (BP), and carotid artery intima-media thickness were lower in the low-calorie low-protein vegan diet and runner groups than in the Western diet group (all p < 0.05). Both systolic and diastolic BP were lower in the low-calorie low-protein vegan diet group (104 +/- 15 and 62 +/- 11 mm Hg) than in BMI-matched endurance runners (122 +/- 13 and 72 +/- 9 mmHg) and Western diet group (132 +/- 14 and 79 +/- 8 mm Hg) (p < 0.001); BP values were directly associated with sodium intake and inversely associated with potassium and fiber intake.

CONCLUSIONS

Long-term consumption of a low-calorie low-protein vegan diet or regular endurance exercise training is associated with low cardiometabolic risk. Moreover, our data suggest that specific components of a low-calorie low-protein vegan diet provide additional beneficial effects on blood pressure.

Quantification of urinary zwitterionic organic acids using weak-anion exchange chromatography with tandem MS detection

A rapid and accurate quantitative method was developed and validated for the analysis of four urinary organic acids with nitrogen containing functional groups, formiminoglutamic acid (FIGLU), pyroglutamic acid (PYRGLU), 5-hydroxyindoleacetic acid (5-HIAA), and 2-methylhippuric acid (2-METHIP) by liquid chromatography tandem mass spectrometry (LC/MS/MS). The chromatography was developed using a weak anion-exchange amino column that provided mixed-mode retention of the analytes. The elution gradient relied on changes in mobile phase pH over a concave gradient, without the use of counter-ions or concentrated salt buffers. A simple sample preparation was used, only requiring the dilution of urine prior to instrumental analysis. The method was validated based on linearity (r2>or=0.995), accuracy (85-115%), precision (C.V.<12%), sample preparation stability (<or=5%, 72 h), and established patient ranges. The method was found to be both efficient and accurate for the analysis of urinary zwitterionic organic acids.

The Effect of Acute Exercise on Serum Brain-Derived Neurotrophic Factor Levels and Cognitive Function

Brain-derived neurotrophic factor (BDNF) is one of a family of neurotrophic factors that participates in neuronal transmission, modulation and plasticity. Previous studies using animals have demonstrated that acute and chronic exercise leads to increases in BDNF in various brain regions.

PURPOSE

To determine the effects of acute exercise on serum BDNF levels in humans, and to determine the relationship between exercise intensity and BDNF responses. Additionally, the relationship between changes in BDNF and cognitive function was examined.

METHODS

Fifteen subjects (25.4 +/- 1.01 yr; 11 male, 4 female) performed a graded exercise test (GXT) for the determination of VO2max and ventilatory threshold (VTh) on a cycle ergometer. On separate days, two subsequent 30-min endurance rides were performed at 20% below the VTh (VTh - 20) and at 10% above the VTh (VTh + 10). Serum BDNF and cognitive function were determined before and after the GXT and endurance rides with an enzyme-linked immunosorbent assay (ELISA) and the Stroop tests, respectively.

RESULTS

The mean VO2max was 2805.8 +/- 164.3 mL x min(-1) (104.2 +/- 7.0% pred). BDNF values (pg x mL(-1)) increased from baseline (P<0.05) after exercise at the VTh + 10 (13%) and the GXT (30%). There was no significant change in BDNF from baseline after the VTh - 20. Changes in BDNF did not correlate with VO2max during the GXT, but they did correlate with changes in lactate (r=0.57; P<0.05). Cognitive function scores improved after all exercise conditions, but they did not correlate with BDNF changes.

CONCLUSION

BDNF levels in humans are significantly elevated in response to exercise, and the magnitude of increase is exercise intensity dependent. Given that BDNF can transit the blood-brain barrier in both directions, the intensity-dependent findings may aid in designing exercise prescriptions for maintaining or improving neurological health.

Effect of the detraining status on high-fat diet induced fat accumulation in the adipose tissue and liver in female rats

The purpose of the present study was to investigate the effects of a high-fat diet (HFD) in previously trained rats that have been detrained for different periods. Two groups of female rats were, first, either treadmill trained for 8 weeks or remained sedentary (Sed). Trained animals, thereafter, remained inactive for 4 weeks (Inact-4 weeks), while fed a standard diet, before being submitted to a high-fat diet (42% kcal of fat) for an additional 2 or 6 weeks. The order was reversed in a 3rd group in which rats were first kept sedentary for 4 weeks before being submitted to the same 8-week training program that ended with the initiation of the HFD (Inact-0 week). Fat accumulation in the mesenteric depot (P<0.05) and in the sum of 3 intra-abdominal (urogenital, retroperitoneal, and mesenteric; P=0.065) tissues in response to the HF feeding was higher in trained rats kept inactive for 4 weeks than in Sed and Inact-0 week animals. Liver triacylglycerol accumulation also showed a tendency to be higher (P<0.07) in Inact-4 weeks than in Inact-0 week rats. These changes were not associated with significant changes in fat cell diameter and number in the mesenteric adipose tissue. When rats in all groups were subdivided into obesity prone (OP) and obesity resistant (OR) on the basis of the change in body weight gain in response to the HFD, liver lipid infiltration was higher (P<0.01) in OP Inact-4 weeks rats than in all other groups. The present results indicate that previously trained rats that have been inactive for a while maintain higher body adiposity in response to a HFD than in freshly inactive and sedentary rats.

The biochemical basis of the health effects of exercise: an integrative view

Physical inactivity–gene interactions result in changes in gene expression, leading to phenotypic changes in the skeletal muscle cell. A subpopulation of those genes that show changes in expression during physical inactivity are candidates for the environment–gene interactions that cross a threshold of biological significance such that overt clinical disease occurs. AMP kinase, GLUT4 and myosin heavy chain IIx are proposed as candidates for physical inactivity-modulated genes that have an altered function that may trigger a crossing of a threshold to disease. Future experiments will be needed to test the validity of the ideas presented.

Association of television viewing with fasting and 2-h postchallenge plasma glucose levels in adults without diagnosed diabetes

OBJECTIVE

We examined the associations of television viewing time with fasting plasma glucose (FPG) and 2-h postchallenge plasma glucose (2-h PG) levels in Australian adults.

RESEARCH DESIGN AND METHODS

A total of 8,357 adults aged > 35 years who were free from diagnosed diabetes and who attended a population-based cross-sectional study (Australian Diabetes, Obesity and Lifestyle Study [AusDiab]) were evaluated. Measures of FPG and 2-h PG were obtained from an oral glucose tolerance test. Self-reported television viewing time (in the previous week) was assessed using an interviewer-administered questionnaire. Homeostasis model assessment (HOMA) of insulin sensitivity (HOMA-%S) and beta-cell function (HOMA-%B) were calculated based on fasting glucose and insulin concentrations.

RESULTS

After adjustment for confounders and physical activity time, time spent watching television in women was positively associated with 2-h PG, log fasting insulin, and log HOMA-%B and inversely associated with log HOMA-%S (P < 0.05) but not with FPG. No significant associations were observed with glycemic measures in men. The beta-coefficients across categories of average hours spent watching television per day (< 1.0, 1.0-1.9, 2.0-2.9, 3.0-3.9, and > or = 4.0) for 2-h PG in women were 0 (reference), 0.009, 0.047, 0.473, and 0.501, respectively (P for trend = 0.02).

CONCLUSIONS

Our findings highlight the unique deleterious relationship of sedentary behavior (indicated by television viewing time) and glycemic measures independent of physical activity time and adiposity status. These relationships differed according to sex and type of glucose measurement, with the 2-h PG measure being more strongly associated with television viewing. The findings suggest an important role for reducing sedentary behavior in the prevention of type 2 diabetes and cardiovascular disease, especially in women.

Exercise, Lipids, and Lipoproteins in Older Adults: A Meta‐Analysis

The authors used the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in adults 50 years of age and older. Twenty-eight outcomes representing 1427 subjects (806 exercise, 621 control) were available for pooling. Random-effects modeling yielded statistically significant improvements of 1.1%, 5.6%, 2.5%, and 7.1%, respectively, for total cholesterol (mean +/- SEM in mg/dL, -3.3+/-1.7; 95% confidence interval [CI], -6.5 to -0.02; p=0.05), high-density lipoprotein cholesterol (2.5+/-1.0; 95% CI, 0.7-4.4; p=0.01), low-density lipoprotein cholesterol (-3.9+/-1.9; 95% CI, -7.7 to -0.08; p=0.05), ratio of total cholesterol to high-density lipoprotein cholesterol (-0.8+/-0.2; 95% CI, -1.2 to -0.4; p<0.001), but not triglycerides (-7.0+/-3.6; 95% CI, -14.0 to 0.1; p=0.06). After conducting sensitivity analyses, only the improvements in high-density lipoprotein cholesterol and the ratio of total cholesterol to high-density lipoprotein cholesterol remained statistically significant (p<0.05 for both). It was concluded that aerobic exercise increases high-density lipoprotein cholesterol and decreases the ratio of total cholesterol to high-density lipoprotein cholesterol in older adults.

Walking and Non‐HDL‐C in Adults: A Meta‐Analysis of Randomized Controlled Trials

An elevated level of non-high-density lipoprotein cholesterol (non-HDL-C) is a major risk factor for cardiovascular disease. The purpose of this study was to use the meta-analytic approach to examine the effects of walking on non-HDL-C in adults. Twenty-two randomized controlled trials representing 30 outcomes from 948 subjects (573 exercise, 375 control) met our inclusion criteria. Across all designs and categories, random effects modeling resulted in a significantly greater decrease in the walking group when compared with the control group of approximately 4% for non-HDL-C (+/- standard error of the mean, -5.6+/-1.8 mg/dL, 95% confidence interval, -8.8 to -2.4 mg/dL). Meta-regression showed a statistically significant association between changes in non-HDL-C and the year of publication, with greater reductions associated with more recent publication year (R2 = 0.23, p = 0.005). The results of this meta-analytic review suggest that walking reduces non-HDL-C in adult humans.

Fundamental questions about genes, inactivity, and chronic diseases

Currently our society is faced with the challenge of understanding the biological basis for the epidemics of obesity and many chronic diseases, including Type 2 diabetes. Physical inactivity increases the relative risk of coronary artery disease by 45%, stroke by 60%, hypertension by 30%, and osteoporosis by 59%. Moreover, physical inactivity is cited as an actual cause of chronic disease by the US Centers of Disease Control. Physical activity was obligatory for survival for the Homo genus for hundreds of thousands of years. This review will present evidence that suggests that metabolic pathways selected during the evolution of the human genome are inevitably linked to physical activity. Furthermore, as with many other environmental interactions, cycles of physical activity and inactivity interact with genes resulting in a functional outcome appropriate for the environment. However, as humans are less physically active, there is a maladaptive response that leads to metabolic dysfunction and many chronic diseases. How and why these interactions occur are fundamental questions in biology. Finally, a perspective to future research in physical inactivity-gene interaction is presented. This information is necessary to provide the molecular evidence required to further promote the primary prevention of chronic diseases through physical activity, identify those molecules that will allow early disease detection, and provide society with the molecular information needed to counter the current strategy of adding physical inactivity into our lives.

Health promotion for women with human immunodeficiency virus or acquired immunodeficiency syndrome

PURPOSE

The purpose of this pilot study was twofold: first, to modify Stuifbergen's health promotion intervention initially developed for women with multiple sclerosis for use among women with human immunodeficiency virus or acquired immunodeficiency syndrome (HIV/AIDS) and to evaluate the feasibility of the newly modified health promotion intervention named "Put Health Into Living" (PHIL). The pilot study was completed in two phases.

DATA SOURCES

In phase I, data were derived from a literature review, a focus group of women with HIV/AIDS (n= 7), a panel of experts who reviewed the intervention for content, and three female community workers who evaluated the intervention for the context of living with HIV/AIDS, cultural relevancy, and literacy. During phase II, a pretest/posttest one-group design was used to determine the feasibility of the study methods, content, and format of the health promotion intervention among 10 women with HIV/AIDS.

CONCLUSIONS

The pilot study demonstrated the importance of a health promotion intervention for a vulnerable population. Participants verbalized the benefits of attending a health promotion program to gain knowledge and skills to promote their health. One woman said, "I have been positive for 20 years now and no one has talked to me just about my overall health." Participants indicated the PHIL intervention offered a supportive group environment, an overall health focus, and an acceptable format.

IMPLICATIONS FOR PRACTICE

Health promotion is a desirable goal for persons living with a chronic disease, and the PHIL intervention has the potential to benefit persons living with HIV/AIDS if subsequent evidence is found in further testing of the intervention.

PGC-1alpha and PGC-1beta have both similar and distinct effects on myofiber switching toward an oxidative phenotype

Peroxisome proliferator-activated receptor-gamma coactivator-1alpha and -1beta (PGC-1alpha and PGC-1beta) were overexpressed by adenovirus-mediated gene transfer in cultures of primary rat skeletal muscle cells derived from neonatal myoblasts. Effects on muscle fiber type transition and metabolism were studied from days 5 to 22 of culture. PGC-1alpha and PGC-1beta overexpression caused a three- to fourfold increase in mRNA level, a doubling of enzymatic activity of citrate synthase, a slight increase in short-chain acyl-CoA dehydrogenase mRNA, a doubling of the mRNA level, and a 30-50% increase in enzymatic activity of glyceraldehyde-3-phosphate dehydrogenase. Lactate dehydrogenase or creatine kinase activity was unchanged. PGC-1alpha enhanced glycogen buildup twofold at 5 or 25 mM glucose, whereas PGC-1beta caused a decrease. Both PGC-1alpha and PGC-1beta overexpression caused a faster maturation of myotubes, as seen by mRNA downregulation of the immature embryonal and perinatal myosin heavy-chain (MHC) isoforms. PGC-1alpha or PGC-1beta overexpression enhanced mRNA of the slow oxidative-associated MHC isoform MHCIb and downregulated mRNA levels of the fast glycolytic-associated MHC isoforms MHCIIX and MHCIIB. Only PGC-1beta overexpression caused an increase in mRNA of the intermediary fast oxidative-associated MHC isoform MHCIIA. PGC-1alpha or PGC-1beta overexpression upregulated GLUT4 mRNA and downregulated myocyte enhancer factor 2C transcription factor mRNA; only PGC-1alpha overexpression caused an increase in the mRNA expression of TRB3, a negative regulator of insulin signaling. These results show that both PGC-1alpha and PGC-1beta are involved in the regulation of skeletal muscle fiber transition and metabolism and that they have both overlapping and differing effects.

Effect of physical inactivity on the oxidation of saturated and monounsaturated dietary Fatty acids: results of a randomized trial

OBJECTIVES

Changes in the way dietary fat is metabolized can be considered causative in obesity. The role of sedentary behavior in this defect has not been determined. We hypothesized that physical inactivity partitions dietary fats toward storage and that a resistance exercise training program mitigates storage.

DESIGN

We used bed rest, with randomization to resistance training, as a model of physical inactivity.

SETTING

The trial took place at the Space Clinic (Toulouse, France).

PARTICIPANTS

A total of 18 healthy male volunteers, of mean age +/- standard deviation 32.6 +/- 4.0 y and body mass index 23.6 +/- 0.7 kg/m(2), were enrolled.

INTERVENTIONS

An initial 15 d of baseline data collection were followed by 3 mo of strict bed-rest alone (control group, n = 9) or with the addition of supine resistance exercise training every 3 d (exercise group, n = 9).

OUTCOME MEASURES

Oxidation of labeled [d(31)]palmitate (the main saturated fatty acid of human diet) and [1-(13)C]oleate (the main monounsaturated fatty acid), body composition, net substrate use, and plasma hormones and metabolites were measured.

RESULTS

Between-group comparisons showed that exercise training did not affect oxidation of both oleate (mean difference 5.6%; 95% confidence interval [95% CI], -3.3% to 14.5%; p = 0.20) and palmitate (mean difference -0.2%; 95% CI, -4.1% to 3.6%; p = 0.89). Within-group comparisons, however, showed that inactivity changed oxidation of palmitate in the control group by -11.0% (95% CI, -19.0% to -2.9%; p = 0.01) and in the exercise group by -11.3% (95% CI, -18.4% to -4.2%; p = 0.008). In contrast, bed rest did not significantly affect oleate oxidation within groups. In the control group, the mean difference in oleate oxidation was 3.2% (95% CI, -4.2% to 10.5%; p = 0.34) and 6.8% (95% CI, -1.2% to 14.7%; p = 0.08) in the exercise group.

CONCLUSIONS

Independent of changes in energy balance (intake and/or output), physical inactivity decreased the oxidation of saturated but not monounsaturated dietary fat. The effect is apparently not compensated by resistance exercise training. These results suggest that Mediterranean diets should be recommended in sedentary subjects and recumbent patients.

Exercise tolerance in children and adolescents with musculoskeletal pain in joint hypermobility and joint hypomobility syndrome

OBJECTIVES

Musculoskeletal pain is a common complaint in a pediatric health care practice, but exercise tolerance has never been described in detail in these children. Our objectives for this study were to evaluate the maximal exercise capacity, including peak heart rate and oxygen consumption, of children with pain-related musculoskeletal problems, particularly in children with (symptomatic) generalized joint hypermobility and hypomobility, during a bicycle ergometry test to exhaustion; to evaluate muscle strength, bone mineral density, and sports activities in these children and to associate these observations with exercise capacity; and to compare these results with reference values.

METHODS

Thirty-two children (mean age: 12.1 years; SD: 3.4 years; range: 6.2-20.1 years; 62% male) with musculoskeletal pain-related syndromes (joint hypermobility syndrome [n = 13] and joint hypomobility syndrome [n = 19]) participated. The reference group consisted of 117 healthy primary school prepubertal children, 167 healthy secondary school adolescents, and 98 young adults (249 girls and 133 boys; mean age total reference group: 14.5 +/- 4.0 years; range: 8-20.8 years). Anthropometry, range of joint motion, muscle strength, bone mineral density (speed of sound and broadband ultrasound attenuation), sports activities, and a maximal exercise test using an electronically braked cycle ergometer were performed, and the patient stopped because of volitional exhaustion. Expired gas analysis and heart rate and transcutaneous oxygen saturation by pulse oximetry measurements also were performed.

RESULTS

Children with joint hypomobility syndrome as well as children with joint hypermobility syndrome had a higher mean z score (SD) of weight and BMI compared with the reference group. A significantly decreased absolute peak oxygen consumption and relative peak oxygen consumption in both patient groups was found compared with control subjects. In 14 of 32 children with a z score relative peak oxygen consumption of less than -2, maximal heart rate was significantly decreased compared with 18 children with a z score relative peak oxygen consumption of -2 or more (mean [SD] z score speed of sound: -1.3 [0.8] vs -0.5 [1.0] and mean [SD] heart rate: 175.9 [11.5] vs 187.5 [10.9], respectively). In the total group, a high significant correlation between the z score of relative peak oxygen consumption and the z score of the speed of sound was found as well as with z score of BMI. Sixteen (50%) of 32 participated in sports activities with (mean: 0.9 hours/week; SD: 1.4 hours/week), whereas in the control group, 12% of did not participate in sports activities (mean: 2.8 hours/week; SD: 2.2 hours/week). Children who participated in sports activities had a (borderline) significant increased mean (SD) z score of absolute peak oxygen consumption and mean (SD) z score of broadband ultrasound attenuation compared with children who did not participate in sports activities (-0.3 [1.1] vs -1.2 [1.3] and -0.45 [0.8] vs -0.9 [0.5], respectively).

CONCLUSIONS

In children with musculoskeletal pain-related syndromes, particular in children with (symptomatic) generalized joint hypermobility and hypomobility, maximal exercise capacity is significantly decreased compared with age- and gender-matched control subjects. The most probable explanation for the reduced exercise tolerance in our patients is deconditioning.

Exercise increases SOCS-3 expression in rat skeletal muscle: potential relationship to IL-6 expression

Suppressor of cytokine signalling-3 (SOCS-3) has been implicated in the onset of insulin resistance in non-muscle tissue. Thus, we examined the effects of exercise training on SOCS-3 expression and the potential role of SOCS-3 in muscle. Female Sprague-Dawley rats (5-8 months) were treadmill trained for 12 weeks and the muscles were removed 24 h after the last bout of exercise. Exercise training increased SOCS-3 mRNA expression by 80% and 154% in the plantaris and soleus muscle, respectively. To mimic the effects of increased SOCS-3 expression, SOCS-3 cDNA was cotransfected with a NF-kappa B (NF-kappaB) luciferase construct into cultured C2C12 myotubes. SOCS-3 overexpression increased NF-kappaB transcriptional activity by 27-fold. The proximal region of the IL-6 gene promoter contains a NF-kappaB consensus site, which contributes to increased IL-6 expression in various tissues. SOCS-3 cDNA was cotransfected into cultured C2C12 myotubes with either the IL-6 luciferase construct or a mutated NF-kappaB IL-6 luciferase construct. SOCS-3 overexpression increased IL-6 transcriptional activity by 15-fold, however, when the NF-kappaB site was mutated SOCS-3 failed to increase IL-6 transcriptional activity. We subsequently found that IL-6 mRNA expression was elevated in the plantaris and soleus muscles of the trained animals compared to the sedentary animals. Finally, exercise induced a significant reduction in IkappaBalpha and increased phosphorylation of Ikappakappa suggesting that NF-kappaB activation was elevated after exercise training. These data suggest that training-induced elevations in SOCS-3 expression in skeletal muscle may contribute to the exercise-induced increase in IL-6 expression through alterations in the mechanisms that mediate NF-kappaB activity.

Phenotypic plasticity and experimental evolution

Natural or artificial selection that favors higher values of a particular trait within a given population should engender an evolutionary response that increases the mean value of the trait. For this prediction to hold, the phenotypic variance of the trait must be caused in part by additive effects of alleles segregating in the population, and also the trait must not be too strongly genetically correlated with other traits that are under selection. Another prediction, rarely discussed in the literature, is that directional selection should favor alleles that increase phenotypic plasticity in the direction of selection, where phenotypic plasticity is defined as the ability of one genotype to produce more than one phenotype when exposed to different environments. This prediction has received relatively little empirical attention. Nonetheless, many laboratory experiments impose selection regimes that could allow for the evolution of enhanced plasticity (e.g. desiccation trials with Drosophila that last for several hours or days). We review one example that involved culturing of Drosophila on lemon for multiple generations and then tested for enhanced plasticity of detoxifying enzymes. We also review an example with vertebrates that involves selective breeding for high voluntary activity levels in house mice, targeting wheel-running behavior on days 5+6 of a 6-day wheel exposure. This selection regime allows for the possibility of wheel running itself or subordinate traits that support such running to increase in plasticity over days 1–4 of wheel access. Indeed, some traits, such as the concentration of the glucose transporter GLUT4 in gastrocnemius muscle, do show enhanced plasticity in the selected lines over a 5–6 day period. In several experiments we have housed mice from both the Selected (S) and Control (C) lines with or without wheel access for several weeks to test for differences in plasticity (training effects). A variety of patterns were observed, including no training effects in either S or C mice, similar changes in both the S and C lines, greater changes in the S lines but in the same direction in the C lines, and even opposite directions of change in the S and C lines. For some of the traits that show a greater training effect in the S lines, but in the same direction as in C lines, the greater effect can be explained statistically by the greater wheel running exhibited by S lines (`more pain, more gain'). For others, however, the differences seem to reflect inherently greater plasticity in the S lines (i.e. for a given amount of stimulus, such as wheel running/day, individuals in the S lines show a greater response as compared with individuals in the C lines). We suggest that any selection experiment in which the selective event is more than instantaneous should explore whether plasticity in the appropriate (adaptive) direction has increased as a component of the response to selection.

License to run: exercise impacts functional plasticity in the intact and injured central nervous system by using neurotrophins

Exercise has been found to impact molecular systems important for maintaining neural function and plasticity. A characteristic finding for the effects of exercise in the brain and spinal cord has been the up-regulation of brain-derived neurotrophic factor (BDNF). This review focuses on the ability of exercise to impact brain circuitry by promoting neuronal repair and enhance learning and memory by increasing neurotrophic support. A paragon for the role of activity-dependent neurotrophins in the CNS is the capacity of BDNF to facilitate synaptic function and neuronal excitability. The authors discuss the effects of exercise in the intact and injured brain and spinal cord injury and the implementation of exercise preinjury and postinjury. As the CNS displays a capacity for plasticity throughout one's lifespan, exercise may be a powerful lifestyle implementation that could be used to augment synaptic plasticity, promote behavioral rehabilitation, and counteract the deleterious effects of aging.

Students' motivational processes and their relationship to teacher ratings in school physical education: a self-determination theory approach

In the present study, we used a model of motivation grounded in self-determination theory (Deci & Ryan, 1985, 1991; Ryan & Deci, 2000a, 2000b, 2002) to examine the relationship between physical education (PE) students' motivational processes and ratings of their effort and persistence as provided by their PE teacher. Data were obtained from 394 British secondary school students (204 boys, 189 girls, 1 gender not specified; M age = 11.97 years; SD = .89; range = 11-14 years) who responded to a multisection inventory (tapping autonomy-support, autonomy, competence, relatedness, and self-determined motivation). The students' respective PE teachers subsequently provided ratings reflecting the effort and persistence each student exhibited in their PE classes. The hypothesized relationships among the study variables were examined via structural equation modeling analysis using latent factors. Results of maximum likelihood analysis using the bootstrapping method revealed the proposed model demonstrated a good fit to the data, chi-squared (292) = 632.68, p < .001; comparative fit index = .95; incremental fit index = .95, standardized root mean square residual = .077; root mean square error of approximation (RMSEA) = .054 (90% confidence interval of RMSEA = .049 -.060). Specifically, the model showed that students who perceived an autonomy supportive environment experienced greater levels of autonomy, competence, and relatedness and had higher scores on an index of self-determination. Student-reported levels of self-determined motivation positively predicted teacher ratings of effort and persistence in PE. The findings are discussed with regard to enhancing student motivation in PE settings.

Planning to win: Health and lifestyles associated with physical activity amongst 15,423 adults

STUDY OBJECTIVE

To assess levels of physical activity in the general population and amongst the 'healthy', and to identify factors associated with this important health behaviour.

DESIGN

Population-based cross-sectional study.

SETTING

North-west England.

PARTICIPANTS

Adults (aged at least 18 years) registered with a general practitioner with a residential address within two local administrative districts (local authorities).

MAIN RESULTS

Less than one-third of adults performed adequate amounts of physical activity for health protection, and this differed little when analyses were restricted to 'healthy' people. Lower levels of physical activity were observed amongst women, older people, ethnic groups, those with obesity and in each increased quintile of social deprivation. Current smokers, but not previous smokers, were less likely to be physically active, as were those not eating at least five portions of fruit and vegetables per day. Lack of physical activity was associated with poor general health and a history of, or current, chronic disease.

CONCLUSIONS

Concerted efforts are required by the Government, society and individuals to overturn our predominantly physically inactive adult population. Interventions may be needed which specifically target certain groups, especially the most socially deprived, and that consider individuals and societal barriers to becoming physically active. Evidence of the effectiveness of individual and population-based interventions remains scant and this needs to be addressed urgently.

Neurobiology of exercise

Voluntary physical activity and exercise training can favorably influence brain plasticity by facilitating neurogenerative, neuroadaptive, and neuroprotective processes. At least some of the processes are mediated by neurotrophic factors. Motor skill training and regular exercise enhance executive functions of cognition and some types of learning, including motor learning in the spinal cord. These adaptations in the central nervous system have implications for the prevention and treatment of obesity, cancer, depression, the decline in cognition associated with aging, and neurological disorders such as Parkinson's disease, Alzheimer's dementia, ischemic stroke, and head and spinal cord injury. Chronic voluntary physical activity also attenuates neural responses to stress in brain circuits responsible for regulating peripheral sympathetic activity, suggesting constraint on sympathetic responses to stress that could plausibly contribute to reductions in clinical disorders such as hypertension, heart failure, oxidative stress, and suppression of immunity. Mechanisms explaining these adaptations are not as yet known, but metabolic and neurochemical pathways among skeletal muscle, the spinal cord, and the brain offer plausible, testable mechanisms that might help explain effects of physical activity and exercise on the central nervous system.

Revenge of the “Sit”: How lifestyle impacts neuronal and cognitive health through molecular systems that interface energy metabolism with neuronal plasticity

Exercise, a behavior that is inherently associated with energy metabolism, impacts the molecular systems important for synaptic plasticity and learning and memory. This implies that a close association must exist between these systems to ensure proper neuronal function. This review emphasizes the ability of exercise and other lifestyle implementations that modulate energy metabolism, such as diet, to impact brain function. Mechanisms believed to interface metabolism and cognition seem to play a critical role with the brain derived neurotrophic factor (BDNF) system. Behaviors concerned with activity and metabolism may have developed simultaneously and interdependently during evolution to determine the influence of exercise and diet on cognition. A look into our evolutionary past indicates that our genome remains unchanged from the times of our hunter-gatherer ancestors, whose active lifestyle predominated throughout almost 100% of humankind's existence. Consequently, the sedentary lifestyle and eating behaviors enabled by the comforts of technologic progress may be reaping "revenge" on the health of both our bodies and brains. In the 21st century we are confronted by the ever-increasing incidence of metabolic disorders in both the adult and child population. The ability of exercise and diet to impact systems that promote cell survival and plasticity may be applicable for combating the deleterious effects of disease and ageing on brain health and cognition.

Genetic analysis of physical activity in twins

BACKGROUND

The reduced contribution of physical activity (PA) to daily energy expenditure contributes to the increased prevalence of obesity. A genetic control of activity-induced energy expenditure (AEE) may contribute to a genetic susceptibility to obesity.

OBJECTIVE

Our aim was to investigate the relative contribution of genetic and environmental factors to the variation and covariation in AEE and PA.

DESIGN

Twelve monozygotic and 8 same-sex dizygotic (including 2 same-sex sibling pairs; age differences: 2 and 2.5 y) twin pairs aged between 18 and 39 y participated. AEE was measured in a respiration chamber for 24 h and with doubly labeled water in daily life for 2 wk. PA was recorded simultaneously with a triaxial accelerometer. Structural equation modeling was used to separate and quantify the observed variance into sex-adjusted additive genetic and common and unique environmental contributions.

RESULTS

In the respiration chamber, common and unique environmental factors explained the variance in AEE and PA, and no genetic contribution was found. In daily life, genetic factors explained 72% of the variance in AEE and 78% of the variance in PA. Unique environmental factors explained the remaining variance. The same additive genetic factors explained 67% of the covariance in AEE and PA in daily life.

CONCLUSIONS

In the present exploratory study that used gold standard measurements for AEE and PA but a limited sample size, genetic influence explained a large part of the variation in AEE and PA in daily life, whereas both AEE and PA were influenced by environment only within the confined area of the respiration chamber.

Transcriptional profiling in mouse skeletal muscle following a single bout of voluntary running: evidence of increased cell proliferation

Skeletal muscle undergoes adaptation following repetitive bouts of exercise. We hypothesize that transcriptional reprogramming and cellular remodeling start in the early phase of long-term training and play an important role in skeletal muscle adaptation. The aim of this study was to define the global mRNA expression in mouse plantaris muscle during (run for 3 and 12 h) and after (3, 6, 12, and 24 h postexercise) a single bout of voluntary running and compare it with that after long-term training (4 wk of running). Among 15,832 gene elements surveyed in a high-density cDNA microarray analysis, 900 showed more than twofold changes at one or more time points. K-means clustering and cumulative hypergeometric probability distribution analyses revealed a significant enrichment of genes involved in defense, cell cycle, cell adhesion and motility, signal transduction, and apoptosis, with induced expression patterns sharing similar patterns with that of peroxisome proliferator activator receptor-gamma coactivator-1alpha and vascular endothelial growth factor A. We focused on the finding of a delayed (at 24 h postexercise) induction of mRNA expression of cell cycle genes origin recognition complex 1, cyclin A2, and cell division 2 homolog A (Schizoccharomyces pombe) and confirmed increased cell proliferation by in vivo 5-bromo-2'-deoxyuridine labeling following voluntary running. X-ray irradiation of the hindlimb significantly diminished exercise-induced 5-bromo-2'-deoxyuridine incorporation. These findings suggest that a single bout of voluntary running activates the transcriptional network and promotes adaptive processes in skeletal muscle, including cell proliferation.

Variation and homogeneity in affective responses to physical activity of varying intensities: an alternative perspective on dose-response based on evolutionary considerations

A model for systematic changes in patterns of inter-individual variation in affective responses to physical activity of varying intensities is presented, as a conceptual alternative to the search for a global dose-response curve. It is theorized that trends towards universality will emerge in response to activities that are either generally adaptive, such as moderate walking, or generally maladaptive, such as strenuous running that requires anaerobic metabolism and precludes the maintenance of a physiological steady state. At the former intensity the dominant response will be pleasure, whereas at the latter intensity the dominant response will be displeasure. In contrast, affective responses will be highly variable, involving pleasure or displeasure, when the intensity of physical activity approximates the transition from aerobic to anaerobic metabolism, since activity performed at this intensity entails a trade-off between benefits and risks. Preliminary evidence in support of this model is presented, based on a reanalysis of data from a series of studies.

Aerobic exercise, lipids and lipoproteins in overweight and obese adults: a meta-analysis of randomized controlled trials

OBJECTIVE

Use the meta-analytic approach to examine the effects of aerobic exercise on lipids and lipoproteins in overweight and obese adults.

DATA SOURCES

(1) Computerized literature searches, (2) cross-referencing from review and original articles, (3) hand searching, and (4) expert review of reference list.

STUDY SELECTION

(1) randomized controlled trials, (2) aerobic exercise > or =8 weeks, (3) adult humans > or =18 y of age, (4) all subjects overweight or obese (BMI > or =25 kg/m(2)), (5) studies published in journal, dissertation, or master's thesis format, (6) studies published in the English-language, (7) studies published between 1 January 1955 and 1 January 2003, (8) assessment of one or more of the following lipid and/or lipoprotein variables: total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), and triglycerides (TG).

DATA ABSTRACTION

Dual-coding by the first two authors (inter-rater agreement=0.96).

RESULTS

In total, 13 studies representing 31 groups (17 exercise, 14 control), 613 subjects (348 exercise, 265 control), and up to 17 outcomes were available for pooling. Across all categories, random-effects modeling resulted in statistically significant improvements for TC (X +/- s.e.m., - 3.4+/-1.7 mg/dl, 95% CI, - 6.7 to - 0.2 mg/dl) and TG (X +/-s.e.m., - 16.1+/-7.3 mg/dl, 95% CI, - 30.2 to - 2.1 mg/dl) but not HDL (X +/- s.e.m., 1.6+/-0.8 mg/dl, 95% CI, - 0.02 to 3.2 mg/dl) or LDL (X +/-s.e.m., - 0.5+/-1.3 mg/dl, 95% CI, - 3.0 to 2.0 mg/dl). Changes were equivalent to improvements of 2% (TC), 11% (TG), 3% (HDL), and 0.3% (LDL). After conducting sensitivity analyses (each study deleted from the model once), only decreases in TG remained statistically significant. Increases in HDL were associated with increases in maximum oxygen consumption (VO(2 max) in ml/kg/min, r=0.75, P=0.002) and decreases in body weight (r=0.77, P<0.001), while decreases in LDL were associated with decreases in body weight (r=0.75, P=0.009).

CONCLUSIONS

Aerobic exercise decreases TG in overweight and obese adults. However, a need exists for additional randomized controlled trials in various overweight and/or obese populations above and beyond those included in our analysis.

Melanocortin-4 receptor gene and physical activity in the Québec Family Study

Physical inactivity is a risk factor for numerous chronic diseases. Low compliance with interventions to increase activity suggests involvement of biological systems.

OBJECTIVE

To examine whether sequence variants in genes encoding neuropeptides and receptors in the arcuate and paraventricular nucleus of the hypothalamus contribute to variations in physical activity level in the Québec Family Study.

METHODS

We genotyped polymorphisms in the melanocortin-4 receptor (MC4R), melanocortin-3 receptor (MC3R), neuropeptide-Y (NPY), neuropeptide-Y Y1 receptor (NPY Y1R), cocaine- and amphetamine-regulated transcript (CART), agouti-related protein (AGRP), and pro-opiomelanocortin (POMC) genes in 669 subjects (age (X+/-s.d.): parents: 52+/-3.4 y; offspring: 28+/-8.7 y). Total physical activity, moderate-to-strenuous activity, and inactivity phenotypes were estimated from a three-day record. The past year's physical activity level was assessed from a questionnaire. Associations between the physical activity phenotypes and the polymorphisms were analyzed using the MIXED model (SAS).

RESULTS

The MC4R-C-2745T variant showed significant associations with physical activity phenotypes. The lowest moderate-to-strenuous activity scores (P = 0.005) and the highest inactivity scores (P = 0.01) emerged in the T/T genotype. Exclusion of obese subjects increased the association. For inactivity, the association of the MC4R-C-2745T variant was strongest in the offspring (P = 0.002). The T/T offspring had both the highest inactivity score and the lowest body mass index. The CART-A1475G variant modified the associations with MC4R-C-2745T; T/T homozygotes had the lowest activity scores when they also had the A/A CART-A1475G genotype. No significant associations were observed with polymorphisms in the other neuropeptides.

CONCLUSION

These findings suggest that DNA sequence variation at the MC4R gene locus may contribute to the propensity to be sedentary.

Effects of exercise and diet on chronic disease

Currently, modern chronic diseases, including cardiovascular diseases, Type 2 diabetes, metabolic syndrome, and cancer, are the leading killers in Westernized society and are increasing rampantly in developing nations. In fact, obesity, diabetes, and hypertension are now even commonplace in children. Clearly, however, there is a solution to this epidemic of metabolic disease that is inundating today's societies worldwide: exercise and diet. Overwhelming evidence from a variety of sources, including epidemiological, prospective cohort, and intervention studies, links most chronic diseases seen in the world today to physical inactivity and inappropriate diet consumption. The purpose of this review is to 1) discuss the effects of exercise and diet in the prevention of chronic disease, 2) highlight the effects of lifestyle modification for both mitigating disease progression and reversing existing disease, and 3) suggest potential mechanisms for beneficial effects.