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Corres P, Maldonado-Martín S, Gorostegi-Anduaga I, Fryer SM, Jurio-Iriarte B, MartínezAguirre-Betolaza A, Arratibel-Imaz I, Francisco-Terreros S, Pérez-Asenjo J. Is cardiorespiratory fitness independently associated with the biochemical profile in overweight/obese adults with primary hypertension? The EXERDIET-HTA study. Scandinavian Journal of Clinical and Laboratory Investigation 2018; 78:613-620. [PMID: 30474427 DOI: 10.1080/00365513.2018.1531297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Cardiorespiratory fitness (CRF) is positively associated with enhanced cardiovascular health. This cross-sectional study aimed to determine associations between CRF and the biochemical profile of overweight/obese adults diagnosed with primary hypertension (HTN). Does cardiorespiratory fitness (exposure) positively affect the biochemical profile (outcome) in overweight/obese individuals suffering from HTN? Assessment with anthropometric, ambulatory blood pressure monitoring (24 h), CRF (peak oxygen uptake, V̇O2peak) and biochemical analysis was performed on 214 participants (138 men, 76 women). A series of linear and logistic regression analyses were conducted. Participants were divided into CRF tertiles (classified as low, moderate and high CRF). The CRF was independently and inversely associated with aspartate aminotransferase (AST; β = -0.328, p < .05) and alanine aminotransferase (ALT; β = -0.376, p < .01) concentrations. C-reactive protein, AST/ALT ratio, gamma-glutamyl transpeptidase, total cholesterol/high-density lipoprotein cholesterol ratio, glucose, insulin and insulin resistance index (HOMA-IR), were all associated, but not independently, with CRF in linear and/or unadjusted logistic regression models. However, independently, logistic regression revealed that glucose was associated with the moderate CRF group. Findings suggest that a lower CRF is associated with an unhealthy biochemical profile in non-physically active and overweight/obese individuals with HTN. As such, this population should look to increase physical activity in order to improve their CRF and biochemical profile.
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Affiliation(s)
- Pablo Corres
- a Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section , University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz , Spain
| | - Sara Maldonado-Martín
- a Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section , University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz , Spain
| | - Ilargi Gorostegi-Anduaga
- a Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section , University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz , Spain
| | - Simon M Fryer
- b School of Sport and Exercise , University of Gloucestershire , Gloucester , UK
| | - Borja Jurio-Iriarte
- a Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section , University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz , Spain
| | - Aitor MartínezAguirre-Betolaza
- a Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section , University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz , Spain
| | - Iñaki Arratibel-Imaz
- a Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section , University of the Basque Country (UPV/EHU) , Vitoria-Gasteiz , Spain
| | | | - Javier Pérez-Asenjo
- d Cardiology Unit , Igualatorio Médico Quirúrgico (IMQ-Amárica) , Vitoria-Gasteiz , Spain
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252
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Affiliation(s)
- Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School - the University of Queensland School of Medicine, New Orleans, LA, United States of America.
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253
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de Souza de Silva CG, Kokkinos P, Doom R, Loganathan D, Fonda H, Chan K, de Araújo CGS, Myers J. Association between cardiorespiratory fitness, obesity, and health care costs: The Veterans Exercise Testing Study. Int J Obes (Lond) 2018; 43:2225-2232. [PMID: 30459403 DOI: 10.1038/s41366-018-0257-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Accepted: 10/07/2018] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVE Obesity is a chronic disease, a risk factor for other chronic conditions and for early mortality, and is associated with higher health care utilization. Annual spending among obese individuals is at least 30% higher vs. that for normal-weight peers. In contrast, higher cardiorespiratory fitness (CRF) is related to many health benefits. We sought to examine the association between CRF and health care costs across the spectrum of body mass index (BMI). METHODS Data from 3,924 men (58.1 ± 11.1 years, 29.2 ± 5.3 kg.m-2) who completed a maximal exercise test for clinical reasons and to estimate CRF were recorded prospectively at the time of testing. Cost data (USD) from each subject during a 6-year period after the exercise test were merged with the exercise database and compared according to BMI and estimated CRF (CRFe). Subjects were categorized as normal-weight (BMI < 25.0 kg.m-2), overweight (BMI 25.0-29.9 kg.m-2), and obese (BMI ≥ 30.0 kg.m-2). We also formed four CRFe categories based on age-stratified quartiles of metabolic equivalents (METs) achieved: least-fit (5.1 ± 1.5 METs; n = 1,044), moderately-fit (7.6 ± 1.5 METs; n = 938), fit (9.4 ± 1.5 METs; n = 988), and highly-fit (12.4 ± 2.2 METs; n = 954). RESULTS Average annual costs per person adjusted for age and presence of cardiovascular disease were $37,018, $40,572, and $45,683 for normal-weight, overweight, and obese subjects, respectively (p < 0.01). For each 1-MET incremental increase in CRFe, annual cost savings per person were $3,272, $4,252, and $6,103 for normal-weight, overweight, and obese subjects, respectively. Stratified by CRFe categories, annual costs for normal-weight, overweight, and obese subjects in the highest CRFe quartile were $28,028, $31,669, and $32,807 lower, respectively, compared to subjects in the lowest CRFe quartile (p < 0.01). CONCLUSION Higher CRFe is associated with lower health care costs. Cost savings were particularly evident in obese subjects, suggesting that the economic burden of obesity may be reduced through interventions that target improvements in CRF.
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Affiliation(s)
- Christina Grüne de Souza de Silva
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. .,Heart Institute Edson Saad/Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | | | - Rachelle Doom
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Holly Fonda
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Khin Chan
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | | | - Jonathan Myers
- Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.,Division of Cardiovascular Medicine, Stanford University, Palo Alto, CA, USA
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Ozemek C, Laddu DR, Lavie CJ, Claeys H, Kaminsky LA, Ross R, Wisloff U, Arena R, Blair SN. An Update on the Role of Cardiorespiratory Fitness, Structured Exercise and Lifestyle Physical Activity in Preventing Cardiovascular Disease and Health Risk. Prog Cardiovasc Dis 2018; 61:484-490. [PMID: 30445160 DOI: 10.1016/j.pcad.2018.11.005] [Citation(s) in RCA: 125] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
The cardiovascular disease (CVD) pandemic has placed considerable strain on healthcare systems, quality of life, and physical function, while remaining the leading cause of death globally. Decades of scientific investigations have fortified the protective effects of cardiorespiratory fitness (CRF), exercise training, and physical activity (PA) against the development of CVD. This review will summarize recent efforts that have made significant strides in; 1) the application of novel analytic techniques to increase the predictive utility of CRF; 2) understanding the protective effects of long-term compliance to PA recommendations through large cohort studies with multiple points of assessment; 3) and understanding the potential harms associated with extreme volumes of PA.
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Affiliation(s)
- Cemal Ozemek
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Deepika R Laddu
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-University of Queensland School of Medicine, New Orleans, LA, USA
| | - Hannah Claeys
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Leonard A Kaminsky
- Fisher Institute of Health and Well-Being, Ball State University, Muncie, IN, USA
| | - Robert Ross
- Schoold of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada; School of Medicine, Department of Endocrinology and Metabolism, Queen's University, Kingston, Ontario, Canada
| | - Ulrik Wisloff
- K. G. Jebsen Center of Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement & Nutrition Sciences, University of Queensland, St. Lucia, QLD, Australia
| | - Ross Arena
- Department of Physical Therapy and the Integrative Physiology Laboratory, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
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Temporal Trends in the Cardiorespiratory Fitness of 2,525,827 Adults Between 1967 and 2016: A Systematic Review. Sports Med 2018; 49:41-55. [DOI: 10.1007/s40279-018-1017-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
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Abstract
Maximal oxygen consumption (V̇ O2,max) denotes the upper limit of aerobic energy flux through the cascade of oxygen transfer from the environment to tissue mitochondria, essentially to skeletal muscle mitochondria during intense exercise. A high V̇ O2,max is a key component for athletic success in human and animal endurance sports. From a public health perspective, a high V̇ O2,max is a validated negative predictor for cardiovascular disease and all-cause mortality. V̇ O2,max varies by more than twofold between sedentary subjects and shows a heritability value greater than 50%. Likewise, the capacity for an individual's V̇ O2,max to be increased with exercise training (i.e. its trainability) varies massively between subjects, independent of each subject's V̇ O2,max in the absence of training (i.e. their sedentary V̇ O2,max), and with a similarly high heritability. Athletic as well as public health interests have prompted a search for the genetic profile of sedentary V̇ O2,max and of trainability. Candidate-gene studies, gene-expression studies and genome-wide-association studies (GWAS) have not been able to identify a genetic signature that distinguishes subjects or athletes with a favorable V̇ O2,max phenotype or a high trainability from controls. Here, I propose that multigenetic phenotypes such as V̇ O2,max are emergent properties of multiple underlying transcriptomic networks modified by epistasis, the epigenome and the epitranscriptome. The genetic approach is thus considered to be necessary but insufficient for furthering our understanding of multigenetic higher-level functions.
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Affiliation(s)
- Hans Hoppeler
- Department of Anatomy, University of Bern, Balzerstrasse 2, CH-3000 Bern, Switzerland
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257
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Correlation between DXA and laboratory parameters in normal weight, overweight, and obese patients. Nutrition 2018; 61:143-150. [PMID: 30711863 DOI: 10.1016/j.nut.2018.10.023] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Revised: 09/18/2018] [Accepted: 10/19/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE The aim of this study was to review the existence and types of correlations between body composition densitometric parameters and laboratory values associated to cardiometabolic risk. METHODS We retrospectively analyzed data from 316 individuals in the weight range from normality to super-obesity, submitted to total body dual-energy x-ray absorptiometry (DXA) scans and routine biochemistry at S.Orsola-Malpighi Hospital from June 2010 to March 2014. The study included 182 women, 45.8 ± 13.4 y of age, with a body mass index (BMI) of 31.5 (± 11) kg/m2 (group F) and 134 men, 45.4 ± 13.6 y of age, with a BMI of 27.6 (± 7.8) kg/m2 (group M). All patients underwent whole-body scan (Lunar iDXA, GE Healthcare, Madison, WI, USA) and laboratory analysis (blood fasting glucose, total cholesterol, high-density lipoprotein cholesterol, tricylglycerides [TGs], aspartate aminotransferase, and alanine aminotransferase). Correlation between laboratory values and total body and regional fat mass (including visceral adipose tissue [VAT] and subcutaneous adipose tissue in the android region), and lean mass parameters were analyzed with linear and stepwise regressions analysis (significance limit, P < 0.05). Receiver operating characteristic curves were performed to assess the accuracy of the best-fit DXA parameter (VAT) to identify at least one laboratory risk factor. RESULTS In both groups, BMI and densitometric parameters showed a linear correlation with fasting blood glucose and TG levels and an inverse correlation with high-density lipoprotein cholesterol (P < 0.05), whereas no correlation was observed with total cholesterol levels. The only densitometric parameter retained in the final model of stepwise multiple regression was VAT for fasting blood glucose (group F: β = 0.4627, P < 0.0001; group M: β = 0.6221, P < 0.0001) and TG levels (group F: β = 0.4931, P < 0.0001; group M: β = 0.1990, P < 0.0261) independently of BMI. The optimal cutoff points of VAT to identify the presence of at least one laboratory risk factor were >1395 g and >1479 cm3 for men and >1281 g and >1357 cm3 for women. CONCLUSIONS DXA analysis of VAT is associated with selected laboratory parameters used for the evaluation of cardiometabolic risk and could be per se a helpful parameter in the assessment of clinical risk.
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258
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Fletcher GF, Landolfo C, Niebauer J, Ozemek C, Arena R, Lavie CJ. Promoting Physical Activity and Exercise. J Am Coll Cardiol 2018; 72:1622-1639. [DOI: 10.1016/j.jacc.2018.08.2141] [Citation(s) in RCA: 276] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/21/2018] [Indexed: 01/03/2023]
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259
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Strieter L, Laddu DR, Sainsbury J, Arena R. The Importance of School-based Healthy Living Initiatives: Introducing the Health and Wellness Academy Concept. Prog Cardiovasc Dis 2018; 62:68-73. [PMID: 30236752 DOI: 10.1016/j.pcad.2018.08.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Accepted: 08/19/2018] [Indexed: 11/26/2022]
Abstract
Over the last 15 years, the number of school and community based health-intervention programs in the United States has grown. Many of these programs aim to prevent non-communicable chronic disease diagnoses (e.g., obesity, cardiovascular disease and type-2 diabetes). The Department of Physical Therapy in the College of Applied Health Sciences (CAHS) at the University of Illinois at Chicago (UIC) created a school-based wellness program (SBWP) that focuses on nutrition and physical activity, providing tailored experiences that motivate adolescents to make healthier lifestyle choices. The SBWP began as a camp for children in the surrounding neighborhoods and implemented healthy living practices utilizing students from Departments in the CAHS. From this camp, the Health and Wellness Academy (HWA) evolved. This paper provides a review of school-based initiatives and introduces the UIC HWA, an innovative and reproducible approach that can bring positive environmental change by improving health outcomes for children and their families.
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Affiliation(s)
- Lindsey Strieter
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA.
| | - Deepika R Laddu
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Jenna Sainsbury
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, IL, USA
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261
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Kieffer SK, Zisko N, Coombes JS, Nauman J, Wisløff U. Personal Activity Intelligence and Mortality in Patients with Cardiovascular Disease: The HUNT Study. Mayo Clin Proc 2018; 93:1191-1201. [PMID: 30193673 DOI: 10.1016/j.mayocp.2018.03.029] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/16/2018] [Accepted: 03/28/2018] [Indexed: 01/08/2023]
Abstract
OBJECTIVE To test whether Personal Activity Intelligence (PAI), a personalized metric of physical activity (PA) tracking, is associated with all-cause and cardiovascular disease (CVD) mortality in patients with self-reported CVD and to determine whether these associations change depending on whether contemporary PA recommendations are met. PATIENTS AND METHODS A total of 3133 patients with CVD (mean [SD] age, 67.6 [10.3] years; 64% men) were followed from the date of participation in the Nord-Trøndelag Health Study (between January 1, 1984, and February 28, 1986) until the date of death or the end of follow-up (December 31, 2015). The participants' weekly PAI score was calculated and divided into 4 groups (PAI scores of 0, ≤50, 51-99, and ≥100). We used Cox proportional hazards regression models to estimate hazard ratios for CVD and all-cause mortality rates. RESULTS After mean follow-up of 12.5 years (39,157 person-years), there were 2936 deaths (94%), including 1936 CVD deaths. Participants with weekly PAI scores of 100 or greater had 36% (95% CI, 21%-48%) and 24% (95% CI, 10%-35%) lower risk of mortality from CVD and all causes, respectively, compared with the inactive group. Participants had similar risk reductions associated with their weekly PAI scores regardless of following contemporary PA recommendations or not. CONCLUSION Obtaining a weekly PAI score of at least 100 was associated with lower mortality risk from CVD and all causes in individuals with CVD regardless of whether the current PA recommendations were met.
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Affiliation(s)
- Sophie K Kieffer
- K.G. Jebsen Center for Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nina Zisko
- K.G. Jebsen Center for Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Australia
| | - Javaid Nauman
- K.G. Jebsen Center for Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Ulrik Wisløff
- K.G. Jebsen Center for Exercise in Medicine at the Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Australia.
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262
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Franklin BA, Kaminsky LA, Kokkinos P. Quantitating the Dose of Physical Activity in Secondary Prevention: Relation of Exercise Intensity to Survival. Mayo Clin Proc 2018; 93:1158-1163. [PMID: 30193669 DOI: 10.1016/j.mayocp.2018.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 07/30/2018] [Indexed: 01/09/2023]
Affiliation(s)
- Barry A Franklin
- Preventive Cardiology and Cardiac Rehabilitation, Beaumont Health, Royal Oak, MI; Oakland University William Beaumont School of Medicine, Rochester, MI.
| | - Leonard A Kaminsky
- Clinical Exercise Physiology Laboratory, Fischer Institute of Health and Well-Being, Ball State University, Muncie, IN
| | - Peter Kokkinos
- Veterans Affairs Medical Center, Georgetown University School of Medicine, George Washington University School of Medicine and Health Sciences, Washington, DC
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263
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Gries KJ, Raue U, Perkins RK, Lavin KM, Overstreet BS, D'Acquisto LJ, Graham B, Finch WH, Kaminsky LA, Trappe TA, Trappe S. Cardiovascular and skeletal muscle health with lifelong exercise. J Appl Physiol (1985) 2018; 125:1636-1645. [PMID: 30161005 DOI: 10.1152/japplphysiol.00174.2018] [Citation(s) in RCA: 67] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The purpose of this study was to examine the effects of aerobic lifelong exercise (LLE) on maximum oxygen consumption (V̇o2max) and skeletal muscle metabolic fitness in trained women ( n = 7, 72 ± 2 yr) and men ( n = 21, 74 ± 1 yr) and compare them to old, healthy nonexercisers (OH; women: n = 10, 75 ± 1 yr; men: n = 10, 75 ± 1 yr) and young exercisers (YE; women: n = 10, 25 ± 1 yr; men: n = 10, 25 ± 1 yr). LLE men were further subdivided based on intensity of lifelong exercise and competitive status into performance (LLE-P, n = 14) and fitness (LLE-F, n = 7). On average, LLE exercised 5 day/wk for 7 h/wk over the past 52 ± 1 yr. Each subject performed a maximal cycle test to assess V̇o2max and had a vastus lateralis muscle biopsy to examine capillarization and metabolic enzymes [citrate synthase, β-hydroxyacyl-CoA dehydrogenase (β-HAD), and glycogen phosphorylase]. V̇o2max had a hierarchical pattern (YE > LLE > OH, P < 0.05) for women (44 ± 2 > 26 ± 2 > 18 ± 1 ml·kg-1·min-1) and men (53 ± 3 > 34 ± 1 > 22 ± 1 ml·kg-1·min-1) and was greater ( P < 0.05) in LLE-P (38 ± 1 ml·kg-1·min-1) than LLE-F (27 ± 2 ml·kg-1·min-1). LLE men regardless of intensity and women had similar capillarization and aerobic enzyme activity (citrate synthase and β-HAD) as YE, which were 20%-90% greater ( P < 0.05) than OH. In summary, these data show a substantial V̇o2max benefit with LLE that tracked similarly between the sexes, with further enhancement in performance-trained men. For skeletal muscle, 50+ years of aerobic exercise fully preserved capillarization and aerobic enzymes, regardless of intensity. These data suggest that skeletal muscle metabolic fitness may be easier to maintain with lifelong aerobic exercise than more central aspects of the cardiovascular system. NEW & NOTEWORTHY Lifelong exercise (LLE) is a relatively new and evolving area of study with information especially limited in women and individuals with varying exercise intensity habits. These data show a substantial maximal oxygen consumption benefit with LLE that tracked similarly between the sexes. Our findings contribute to the very limited skeletal muscle biopsy data from LLE women (>70 yr), and similar to men, revealed a preserved metabolic phenotype comparable to young exercisers.
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Affiliation(s)
- Kevin J Gries
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Ulrika Raue
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Ryan K Perkins
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Kaleen M Lavin
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | | | | | - Bruce Graham
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - W Holmes Finch
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | | | - Todd A Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Scott Trappe
- Human Performance Laboratory, Ball State University, Muncie, Indiana
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Mônico-Neto M, Moreira Antunes HK, dos Santos RVT, D'Almeida V, Alves Lino de Souza A, Azeredo Bittencourt LR, Tufik S. Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study. Eur Respir J 2018; 52:13993003.01972-2017. [DOI: 10.1183/13993003.01972-2017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 07/28/2018] [Indexed: 11/05/2022]
Abstract
Obstructive sleep apnoea (OSA) is positively associated with cardiometabolic diseases; however, high levels of physical activity could decrease the incidence of OSA and associated comorbidities.In this study we aimed to examine the incidence of OSA in relation to physical activity, and its role as a protective factor in individuals with OSA on the incidence of cardiometabolic diseases, in an 8–9-year follow-up study. We analysed data of 658 volunteers from the São Paulo Epidemiologic Sleep Study (EPISONO), a cohort study of individuals aged 20–80 years, collected through polysomnography, the International Physical Activity Questionnaire and an assessment of cardiometabolic profile.Active subjects had a lower risk of developing OSA compared with nonactive subjects (relative risk 0.877, 95% CI 0.296–0.855) and there was a reduced risk of developing type 2 diabetes mellitus in active/apnoeic subjects (relative risk 0.493, 95% CI 0.252–0.961) compared with nonactive subjects. Metabolic equivalent was negatively associated to cardiometabolic markers, such as C-reactive protein (exp(B)=0.720; p=0.001), interleukin-6 (exp(B)=0.991; p=0.03), insulin (exp(B)=0.982; p=0.03), triglycerides (exp(B)=0.997; p<0.001), homeostasis model assessment for insulin resistance (exp(B)≤0.946; p<0.024), quantitative insulin sensitivity check index (exp(B)=992.4; p<0.001) and mean arterial pressure (exp(B)=0.987; p=0.001).Physical activity was a protective factor against type 2 diabetes mellitus in apnoeic individuals; moreover, being active reduced the risk of developing OSA and was associated with a better cardiometabolic profile.
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265
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Smirmaul BPC, Arena R. Infographic. Cardiorespiratory fitness and health. Br J Sports Med 2018; 53:614-615. [PMID: 30087122 DOI: 10.1136/bjsports-2018-099636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/23/2018] [Indexed: 11/03/2022]
Affiliation(s)
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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266
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Gathright EC, Goldstein CM, Loucks EB, Busch AM, Stabile L, Wu WC. Examination of clinical and psychosocial determinants of exercise capacity change in cardiac rehabilitation. Heart Lung 2018; 48:13-17. [PMID: 30093163 DOI: 10.1016/j.hrtlng.2018.07.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/06/2018] [Accepted: 07/11/2018] [Indexed: 11/28/2022]
Abstract
PURPOSE Most cardiac rehabilitation (CR) completers improve in multiple functional and psychosocial domains. However, not all demonstrate uniform improvement in functional indicators such as exercise capacity. This study examined baseline predictors and correlates of change in exercise capacity from CR intake to completion. METHODS CR participants (n = 488) completed assessment of metabolic equivalents (METs) via treadmill stress test, depressive symptoms, quality of life, and social support at intake and discharge. Associations between demographic, clinical, and psychosocial factors and MET changes was tested with linear regression. RESULTS METs increased from intake to discharge (1.91 ± 1.48, p < .001). Younger age (p < .001), lower BMI (p < .001), and lower weight (p < .01) were associated with greater MET change. Greater percentage weight loss (p < .05), and self-reported improvements in physical functioning (p < .001) and bodily pain (p < .01) were concurrently related to MET change. CONCLUSIONS Older CR attendees and those with higher baseline BMI may benefit from tailored intervention to ensure maximum benefit in exercise capacity.
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Affiliation(s)
- Emily C Gathright
- Centers for Preventive and Behavioral Medicine, The Miriam Hospital, 1 Hoppin St, Providence, RI 02903, United States; Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02903, United States.
| | - Carly M Goldstein
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, RI 02903, United States; The Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St, Providence, RI 02903, United States; Providence Veterans Affairs Medical Center, Providence, RI 02908, United States
| | - Eric B Loucks
- Department of Behavioral and Social Sciences and Epidemiology, Brown School of Public Health, Providence, RI 02903, United States
| | - Andrew M Busch
- Department of Medicine, Hennepin County Medical Center, Minneapolis, MN 55415, United States; Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States; Minneapolis Medical Research Foundation, Minneapolis, MN 55404, United States
| | - Loren Stabile
- The Miriam Hospital's Center for Cardiac Fitness, 208 Collyer St, Providence RI 02904, United States
| | - Wen-Chih Wu
- Providence Veterans Affairs Medical Center, Providence, RI 02908, United States; The Miriam Hospital's Center for Cardiac Fitness, 208 Collyer St, Providence RI 02904, United States; Department of Medicine, Alpert Medical School, Brown University, Providence, RI 02903, United States
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Swift DL, McGee JE, Earnest CP, Carlisle E, Nygard M, Johannsen NM. The Effects of Exercise and Physical Activity on Weight Loss and Maintenance. Prog Cardiovasc Dis 2018; 61:206-213. [PMID: 30003901 DOI: 10.1016/j.pcad.2018.07.014] [Citation(s) in RCA: 240] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 07/08/2018] [Indexed: 01/12/2023]
Abstract
Obesity represents a major health problem in the United States and is associated with increased prevalence of cardiovascular (CV) disease risk factors. Physical activity (PA) and exercise training (ET) are associated with reduced CV risk, improved cardiometabolic risk factors, and facilitated weight loss through creating a negative energy balance. Clinicians need to counsel overweight and obese patients on how much PA/ET is needed to promote weight loss and weight loss maintenance. This will help establish realistic expectations and maximize improvements in CV risk factors. Although the minimum guidelines for aerobic PA (150 min of moderate or 75 min of vigorous physical activity per week) can improve CV health, these levels are generally inadequate for clinically significant weight loss or weight maintenance without caloric restriction. The purpose of this review is to evaluate the role of ET to promote clinically significant weight loss and promote weight maintenance. In particular, we will evaluate the likelihood of weight loss from ET programs composed of aerobic training only, resistance training only and programs that combine diet and ET. We will also explore the role of PA in promoting short-term and long-term weight maintenance.
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Affiliation(s)
- Damon L Swift
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America.
| | - Joshua E McGee
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Conrad P Earnest
- Department of Kinesiology, Texas A&M University, College Station, TX, United States of America
| | - Erica Carlisle
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Madison Nygard
- Department of Kinesiology, East Carolina University, Greenville, NC, United States of America; Human Performance Laboratory, East Carolina University, Greenville, NC, United States of America
| | - Neil M Johannsen
- Department of Kinesiology, Louisiana State University, Baton Rouge, LA, United States of America
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Impact of obesity following coronary artery bypass grafting. Coron Artery Dis 2018; 29:371-372. [PMID: 29979257 DOI: 10.1097/mca.0000000000000636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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269
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Wang S, Ren J. Obesity Paradox in Aging: From Prevalence to Pathophysiology. Prog Cardiovasc Dis 2018; 61:182-189. [PMID: 29990534 DOI: 10.1016/j.pcad.2018.07.011] [Citation(s) in RCA: 83] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 11/25/2022]
Abstract
Recent advances in medical technology and health care have greatly improved the management for chronic diseases and prolonged human lifespan. Unfortunately, increased lifespan and the aging population impose a major challenge on the ever-rising prevalence of chronic diseases, in particular cardiometabolic stress associated with the pandemic obesity in our modern society. Although overweight and obesity are associated with incident cardiovascular diseases (CVD), including heart failure (HF), it paradoxically leads to a more favorable prognosis in patients with chronic HF, a phenomenon commonly defined as "obesity paradox". Numerous population-based and clinical studies have suggested possible explanations such as better metabolic reserve, smoking and disease-associated weight loss for obesity paradox. Recent evidence noticed a shift in obesity paradox with aging. While some studies have reported a more pronounced "obesity paradox" in the older patients, others have seen diminished cardiac benefits with overweight and obesity in the elderly patients with CVD. These findings suggested that a complex relationship among aging, metabolism, and HF severity/chronicity, which may explain the shift in obesity paradox in the elderly. Aging negatively affects body metabolism and cardiac function although its precise impact on obesity paradox remains elusive. To develop new strategies for cardiovascular health in the elderly, it is imperative to understand the precise role for aging on obesity-related CVD.
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Affiliation(s)
- Shuyi Wang
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai 200032, China; Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA
| | - Jun Ren
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai 200032, China; Center for Cardiovascular Research and Alternative Medicine, University of Wyoming College of Health Sciences, Laramie, WY 82071, USA.
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Wang Y, Chen S, Zhang J, Zhang Y, Ernstsen L, Lavie CJ, Hooker SP, Chen Y, Sui X. Nonexercise Estimated Cardiorespiratory Fitness and All-Cancer Mortality: the NHANES III Study. Mayo Clin Proc 2018; 93:848-856. [PMID: 29602418 DOI: 10.1016/j.mayocp.2018.01.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 11/15/2017] [Accepted: 01/03/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To examine the relationship between estimated cardiorespiratory fitness (eCRF) using nonexercise equations and all-cancer mortality in a representative sample of the US population. PARTICIPANTS AND METHODS A total of 8506 study participants were derived from the Third National Health and Nutrition Examination Survey, conducted from October 18, 1988, to October 15, 1994. They were followed for all-cancer mortality. Participants' CRF was estimated from nonexercise models that were determined by age, body mass index, waist circumference, resting heart rate, physical activity status, and smoking status, and further grouped into quintiles. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazards models for the relationship between eCRF and all-cancer mortality. RESULTS During a mean of 19.5 years of follow-up, 455 cancer deaths (263 men and 192 women) were registered. After adjustment for race/ethnicity, age, educational level, current smoking, hypertension, diabetes mellitus, and hypercholesterolemia, each 1-metabolic equivalent increase in eCRF was associated with 30% (95% CI, 24%-35%) and 27% (95% CI, 18%-36%) risk reduction for all-cancer mortality in men and women, respectively. When eCRF was categorized into quintiles, HRs (95% CIs) were 0.47 (0.24-0.95), 0.81 (0.46-1.44), 0.49 (0.26-0.93), and 0.57 (0.31-1.06) across incremental quintiles in women (quintile 1 was the reference group). However, none of the HRs reached statistical significance in men. CONCLUSION The eCRF was inversely associated with all-cancer mortality in quintiles 2 and 4 in women. More research is needed to further understand the association between eCRF and all-cancer mortality in men.
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Affiliation(s)
- Ying Wang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, Norway
| | - Shujie Chen
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, Norway
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, Norway
| | - Yanan Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, Norway
| | - Linda Ernstsen
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School, University of Queensland School of Medicine, New Orleans, LA
| | - Steven P Hooker
- Exercise Science and Health Promotion Program, College of Health Solutions, Arizona State University, Phoenix
| | - Yuhui Chen
- Department of Mathematics, University of Alabama, Tuscaloosa
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, Norway.
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Factors Associated With Cardiorespiratory Fitness at Completion of Cardiac Rehabilitation: Identification of Specific Patient Features Requiring Attention. Can J Cardiol 2018; 34:925-932. [DOI: 10.1016/j.cjca.2018.03.015] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 03/13/2018] [Accepted: 03/26/2018] [Indexed: 12/13/2022] Open
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Association between Resting Heart Rate and Health-Related Physical Fitness in Brazilian Adolescents. BIOMED RESEARCH INTERNATIONAL 2018; 2018:3812197. [PMID: 30050928 PMCID: PMC6046174 DOI: 10.1155/2018/3812197] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/07/2018] [Indexed: 01/16/2023]
Abstract
The aim of this study was to identify the relationship between health-related physical fitness components (aerobic fitness, muscle strength, flexibility, and body fat) and resting heart rate (RHR) in Brazilian adolescents. The study included 695 schoolchildren (14–19 years) from public schools of the city of São José, Brazil. RHR was evaluated using an automated oscillometric sphygmomanometer. Aerobic fitness was assessed by the modified Canadian Aerobic Fitness Test; muscle strength was measured by handgrip dynamometer; flexibility was assessed by the sit-and-reach test; and body fat was assessed indirectly by sum of two skinfold thicknesses (triceps and subscapular). Sociodemographic variables, habitual physical activity, sexual maturation, and body mass index were the covariates. Cardiorespiratory fitness (β = -0.11; 95%CI: -0.14, -0.08) and handgrip strength (β = -0.10; 95%CI: -0.18, -0.01) were inversely associated with RHR in boys. For girls, cardiorespiratory fitness (β = -0.09; 95%CI: -0.12, -0.06) was inversely associated with RHR. In both sexes, body fat (β = 0.50; 95%CI: 0.25, 0.75 for boys; β = 0.17; 95%CI: 0.36, 2.72 for girls) was directly associated with RHR. The RHR is measured more easily than the physical fitness tests, so it is recommended to assess adolescent's heath in large surveillance systems.
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Chakkera HA, Angadi SS, Heilman RL, Kaplan B, Scott RL, Bollempalli H, Cha SS, Khamash HA, Huskey JL, Mour GK, Sukumaran Nair S, Singer AL, Reddy KS, Mathur AK, Moss AA, Hewitt WR, Qaqish I, Behmen S, Keddis MT, Unzek S, Steidley DE. Cardiorespiratory Fitness (Peak Oxygen Uptake): Safe and Effective Measure for Cardiovascular Screening Before Kidney Transplant. J Am Heart Assoc 2018; 7:JAHA.118.008662. [PMID: 29853444 PMCID: PMC6015378 DOI: 10.1161/jaha.118.008662] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Significant heterogeneity exists in practice patterns and algorithms used for cardiac screening before kidney transplant. Cardiorespiratory fitness, as measured by peak oxygen uptake (VO2peak), is an established validated predictor of future cardiovascular morbidity and mortality in both healthy and diseased populations. The literature supports its use among asymptomatic patients in abrogating the need for further cardiac testing. METHODS AND RESULTS We outlined a pre-renal transplant screening algorithm to incorporate VO2peak testing among a population of asymptomatic high-risk patients (with diabetes mellitus and/or >50 years of age). Only those with VO2peak <17 mL/kg per minute (equivalent to <5 metabolic equivalents) underwent further noninvasive cardiac screening tests. We conducted a retrospective study of the a priori dichotomization of the VO2peak <17 versus ≥17 mL/kg per minute to determine negative and positive predictive value of future cardiac events and all-cause mortality. We report a high (>90%) negative predictive value, indicating that VO2peak ≥17 mL/kg per minute is effective to rule out future cardiac events and all-cause mortality. However, lower VO2peak had low positive predictive value and should not be used as a reliable metric to predict future cardiac events and/or mortality. In addition, a simple mathematical calculation documented a cost savings of ≈$272 600 in the cardiac screening among our study cohort of 637 patients undergoing evaluation for kidney and/or pancreas transplant. CONCLUSIONS We conclude that incorporating an objective measure of cardiorespiratory fitness with VO2peak is safe and allows for a cost savings in the cardiovascular screening protocol among higher-risk phenotype (with diabetes mellitus and >50 years of age) being evaluated for kidney transplant.
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276
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Maunder E, Plews DJ, Kilding AE. Contextualising Maximal Fat Oxidation During Exercise: Determinants and Normative Values. Front Physiol 2018; 9:599. [PMID: 29875697 PMCID: PMC5974542 DOI: 10.3389/fphys.2018.00599] [Citation(s) in RCA: 91] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 05/03/2018] [Indexed: 12/30/2022] Open
Abstract
Using a short-duration step protocol and continuous indirect calorimetry, whole-body rates of fat and carbohydrate oxidation can be estimated across a range of exercise workloads, along with the individual maximal rate of fat oxidation (MFO) and the exercise intensity at which MFO occurs (Fatmax). These variables appear to have implications both in sport and health contexts. After discussion of the key determinants of MFO and Fatmax that must be considered during laboratory measurement, the present review sought to synthesize existing data in order to contextualize individually measured fat oxidation values. Data collected in homogenous cohorts on cycle ergometers after an overnight fast was synthesized to produce normative values in given subject populations. These normative values might be used to contextualize individual measurements and define research cohorts according their capacity for fat oxidation during exercise. Pertinent directions for future research were identified.
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Affiliation(s)
- Ed Maunder
- Sports Performance Research Institute New Zealand, Auckland University of Technology, Auckland, New Zealand
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Chesham RA, Booth JN, Sweeney EL, Ryde GC, Gorely T, Brooks NE, Moran CN. The Daily Mile makes primary school children more active, less sedentary and improves their fitness and body composition: a quasi-experimental pilot study. BMC Med 2018; 16:64. [PMID: 29743076 PMCID: PMC5944120 DOI: 10.1186/s12916-018-1049-z] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Accepted: 04/04/2018] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND The Daily Mile is a physical activity programme made popular by a school in Stirling, Scotland. It is promoted by the Scottish Government and is growing in popularity nationally and internationally. The aim is that each day, during class time, pupils run or walk outside for 15 min (~1 mile) at a self-selected pace. It is anecdotally reported to have a number of physiological benefits including increased physical activity, reduced sedentary behaviour, increased fitness and improved body composition. This study aimed to investigate these reports. METHODS We conducted a quasi-experimental repeated measures pilot study in two primary schools in the Stirling Council area: one school with, and one without, intention to introduce the Daily Mile. Pupils at the control school followed their usual curriculum. Of the 504 children attending the schools, 391 children in primary classes 1-7 (age 4-12 years) at the baseline assessment took part. The follow-up assessment was in the same academic year. Outcomes were accelerometer-assessed average daily moderate to vigorous intensity physical activity (MVPA) and average daily sedentary behaviour, 20-m shuttle run fitness test performance and adiposity assessed by the sum of skinfolds at four sites. Valid data at both time points were collected for 118, 118, 357 and 327 children, respectively, for each outcome. RESULTS After correction for age and gender, significant improvements were observed in the intervention school relative to the control school for MVPA, sedentary time, fitness and body composition. For MVPA, a relative increase of 9.1 min per day (95% confidence interval or 95%CI 5.1-13.2 min, standardised mean difference SMD = 0.407, p = 0.027) was observed. For sedentary time, there was a relative decrease of 18.2 min per day (10.7-25.7 min, SMD = 0.437, p = 0.017). For the shuttle run, there was a relative increase of 39.1 m (21.9-56.3, SMD = 0.236, p = 0.037). For the skinfolds, there was a relative decrease of 1.4 mm (0.8-2.0 mm, SMD = 0.246, p = 0.036). Similar results were obtained when a correction for socioeconomic groupings was included. CONCLUSIONS The findings show that in primary school children, the Daily Mile intervention is effective at increasing levels of MVPA, reducing sedentary time, increasing physical fitness and improving body composition. These findings have relevance for teachers, policymakers, public health practitioners, and health researchers.
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Affiliation(s)
- Ross A Chesham
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, FK9 4LA, UK
| | - Josephine N Booth
- Institute of Education, Community and Society, Moray House School of Education, University of Edinburgh, Scotland, EH8 8AQ, UK
| | - Emma L Sweeney
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, FK9 4LA, UK
| | - Gemma C Ryde
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, FK9 4LA, UK
| | - Trish Gorely
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, FK9 4LA, UK
- Present address: School of Health, Social Care and Life Sciences, University of the Highlands and Islands, Centre for Health Sciences, Old Perth Road, Inverness, IV2 3JH, UK
| | - Naomi E Brooks
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, FK9 4LA, UK
| | - Colin N Moran
- Faculty of Health Sciences and Sport, University of Stirling, Scotland, FK9 4LA, UK.
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Abstract
We critically appraised all available evidence regarding exercise interventions for improving patient survival and reducing hospital admissions in adults with chronic heart failure (HF). We searched 4 databases up to April 2018 and graded the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation working group approach. We reviewed 7 meta-analyses and the publications of 48 randomized controlled trials (RCTs). In HF with reduced ejection fraction, low-quality evidence suggests that exercise prevents all-cause hospitalizations [Relative risk (RR), 0.77; 95% confidence interval (CI), 0.63 to 0.93; 1328 patients in 15 RCTs] and hospitalizations due to HF (RR, 0.57; 95% CI, 0.37 to 0.88; 1073 patients in 13 RCTs) and improves quality of life (standardized mean difference, -0.37; 95% CI, -0.60 to -0.14; 1270 patients in 25 RCTs) but has no effect on mortality. In HF with preserved ejection fraction, low-quality evidence suggests that exercise improves peak oxygen uptake (mean difference, 2.36; 95% CI, 1.16 to 3.57; 171 patients in 3 RCTs) and quality of life (mean difference, -4.65; 95% CI, -8.46 to -0.83; 203 patients in 4 RCTs). In patients after heart transplantation, low-quality evidence suggests that exercise improves peak oxygen uptake (standardized mean difference, 0.68; 95% CI, 0.43 to 0.93; 284 patients in 9 RCTs) but does not improve quality of life. In order to reduce hospitalization and improve quality of life for adults with HF and reduced ejection fraction, clinicians should recommend exercise interventions. For adults with HF and preserved ejection fraction and in those undergoing heart transplantation, clinicians may recommend exercise interventions in order to improve peak oxygen uptake.
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Konopka AR, Wolff CA, Suer MK, Harber MP. Relationship between intermuscular adipose tissue infiltration and myostatin before and after aerobic exercise training. Am J Physiol Regul Integr Comp Physiol 2018; 315:R461-R468. [PMID: 29718700 DOI: 10.1152/ajpregu.00030.2018] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Intermuscular adipose tissue (IMAT) is associated with impaired skeletal muscle contractile and metabolic function. Myostatin and downstream signaling proteins such as cyclin-dependent kinase 2 (CDK2) contribute to the regulation of adipose and skeletal muscle mass in cell culture and animals models, but this relationship remains incompletely understood in humans. The purpose of this study was to determine if the infiltration of IMAT was associated with skeletal muscle myostatin and downstream proteins before and after 12 wk of aerobic exercise training (AET) in healthy older women (OW; 69 ± 2 yr), older men (OM; 74 ± 3 yr), and young men (YM; 20 ± 1 yr). We found that the infiltration of IMAT was correlated with myostatin and phosphorylated CDK2 at tyrosine 15 [P-CDK2(Tyr15)]. IMAT infiltration was greater in the older subjects and was associated with lower skeletal muscle function and exercise capacity. After 12 wk of AET, there was no change in body weight. Myostatin and P-CDK2(Tyr15) were both decreased after AET, and the reduction in myostatin was associated with decreased IMAT infiltration. The decrease in myostatin and IMAT occurred concomitantly with increased exercise capacity, skeletal muscle size, and function after AET. These findings demonstrate that the reduction in IMAT infiltration after AET in weight stable individuals was accompanied by improvements in skeletal muscle function and exercise capacity. Moreover, the association between myostatin and IMAT was present in the untrained state and in response to exercise training, strengthening the potential regulatory role of myostatin on IMAT.
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Affiliation(s)
- Adam R Konopka
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign , Urbana, Illinois
| | | | - Miranda K Suer
- Human Performance Laboratory, Ball State University, Muncie, Indiana
| | - Matthew P Harber
- Human Performance Laboratory, Ball State University, Muncie, Indiana
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Bueno-Antequera J, Oviedo-Caro MÁ, Munguía-Izquierdo D. Sedentary behaviour, physical activity, cardiorespiratory fitness and cardiometabolic risk in psychosis: The PsychiActive project. Schizophr Res 2018; 195:142-148. [PMID: 29033281 DOI: 10.1016/j.schres.2017.10.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Revised: 09/29/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
Abstract
This study aimed to explore the possible independent associations of sedentary behaviour (SB), physical activity (PA), and cardiorespiratory fitness (CRF) with clustered (CCRS) and individual cardiometabolic risk (waist circumference [waist], systolic/diastolic blood pressure, triglycerides, high-density lipoprotein-cholesterol, and fasting blood glucose) in patients with psychosis. In 43 outpatients with psychosis (mean age±SD: 42.3±8.5years, 86% men), SB and light, moderate-to-vigorous, and total PA were measured with the SenseWear Pro3 Armband, and CRF with the 6-minute walking test. Multiple linear regression models adjusted for multiple confounders were applied. High SB, low PA and low CRF levels were associated with an unfavourable cardiometabolic risk profile (increased presence of metabolic syndrome and number of cardiometabolic abnormalities, as well as worse values and elevated presence of abnormalities for all individual cardiometabolic risk factors). SB was associated with CCRS, number of cardiometabolic abnormalities, waist, and fasting blood glucose (all p<0.05). After adjusting for PA and CRF, waist and fasting blood glucose remained significant. Light PA was associated with waist, moderate-to-vigorous PA with CCRS, and total PA with CCRS and waist (all p<0.05). These results became non-significant after adjusting for SB and CRF. CRF was associated with CCRS, waist, and systolic blood pressure (all p<0.05). The associations with CCRS and waist remained significant after adjusting for SB and PA. Together, these results suggest the importance of considering SB and CRF, regardless PA, in the prevention and treatment of cardiometabolic disorders among patients with psychosis.
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Affiliation(s)
- Javier Bueno-Antequera
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Miguel Ángel Oviedo-Caro
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
| | - Diego Munguía-Izquierdo
- Department of Sports and Computer Science, Section of Physical Education and Sports, Faculty of Sports Sciences, Universidad Pablo de Olavide, ES-41013 Seville, Spain.
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282
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Motl RW, Barstow EA, Blaylock S, Richardson E, Learmonth YC, Fifolt M. Promotion of Exercise in Multiple Sclerosis Through Health Care Providers. Exerc Sport Sci Rev 2018; 46:105-111. [DOI: 10.1249/jes.0000000000000140] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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283
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de Souza e Silva CG, Kaminsky LA, Arena R, Christle JW, Araújo CGS, Lima RM, Ashley EA, Myers J. A reference equation for maximal aerobic power for treadmill and cycle ergometer exercise testing: Analysis from the FRIEND registry. Eur J Prev Cardiol 2018. [DOI: 10.1177/2047487318763958] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background Maximal oxygen uptake (VO2max) is a powerful predictor of health outcomes. Valid and portable reference values are integral to interpreting measured VO2max; however, available reference standards lack validation and are specific to exercise mode. This study was undertaken to develop and validate a single equation for normal standards for VO2max for the treadmill or cycle ergometer in men and women. Methods Healthy individuals ( N = 10,881; 67.8% men, 20–85 years) who performed a maximal cardiopulmonary exercise test on either a treadmill or a cycle ergometer were studied. Of these, 7617 and 3264 individuals were randomly selected for development and validation of the equation, respectively. A Brazilian sample (1619 individuals) constituted a second validation cohort. The prediction equation was determined using multiple regression analysis, and comparisons were made with the widely-used Wasserman and European equations. Results Age, sex, weight, height and exercise mode were significant predictors of VO2max. The regression equation was: VO2max (ml kg–1 min–1) = 45.2 – 0.35*Age – 10.9*Sex (male = 1; female = 2) – 0.15*Weight (pounds) + 0.68*Height (inches) – 0.46*Exercise Mode (treadmill = 1; bike = 2) ( R = 0.79, R2 = 0.62, standard error of the estimate = 6.6 ml kg–1 min–1). Percentage predicted VO2max for the US and Brazilian validation cohorts were 102.8% and 95.8%, respectively. The new equation performed better than traditional equations, particularly among women and individuals ≥60 years old. Conclusion A combined equation was developed for normal standards for VO2max for different exercise modes derived from a US national registry. The equation provided a lower average error between measured and predicted VO2max than traditional equations even when applied to an independent cohort. Additional studies are needed to determine its portability.
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Affiliation(s)
- Christina G de Souza e Silva
- Heart Institute Edson Saad, Federal University of Rio de Janeiro, Brazil
- Cardiology Division, Veterans Affairs Palo Alto Health System/Stanford University, USA
| | - Leonard A Kaminsky
- Fisher Institute of Health and Well-Being and Clinical Exercise Physiology, Ball State University, Muncio, USA
| | | | | | | | - Ricardo M Lima
- Faculty of Physical Education, University of Brasília, Brazil
| | - Euan A Ashley
- Stanford Center for Inherited Cardiovascular Disease, Stanford University, USA
| | - Jonathan Myers
- Cardiology Division, Veterans Affairs Palo Alto Health System/Stanford University, USA
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Montalbán-Méndez C, Soriano-Maldonado A, Vargas-Hitos JA, Sáez-Urán LM, Rosales-Castillo A, Morillas-de-Laguno P, Gavilán-Carrera B, Jiménez-Alonso J. Cardiorespiratory fitness and age-related arterial stiffness in women with systemic lupus erythematosus. Eur J Clin Invest 2018; 48. [PMID: 29319879 DOI: 10.1111/eci.12885] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 01/05/2018] [Indexed: 01/21/2023]
Abstract
BACKGROUND The aim of this study was twofold: (i) to examine the association of cardiorespiratory fitness with arterial stiffness in women with systemic lupus erythematosus; (ii) to assess the potential interaction of cardiorespiratory fitness with age on arterial stiffness in this population. MATERIALS AND METHODS A total of 49 women with systemic lupus erythematosus (mean age 41.3 [standard deviation 13.8] years) and clinical stability during the previous 6 months were included in the study. Arterial stiffness was assessed through pulse wave velocity (Mobil-O-Graph® 24 hours pulse wave velocity monitor). Cardiorespiratory fitness was estimated with the Siconolfi step test and the 6-minute walk test. RESULTS Cardiorespiratory fitness was inversely associated with pulse wave velocity in crude analyses (P < .05), although this relationship was attenuated when age and other cardiovascular risk factors were controlled. There was a cardiorespiratory fitness × age interaction effect on pulse wave velocity, regardless of the test used to estimate cardiorespiratory fitness (P < .001 for the Siconolfi step test; P = .005 for the 6-minute walk test), indicating that higher cardiorespiratory fitness was associated with a lower increase in pulse wave velocity per each year increase in age. CONCLUSIONS The results of this study suggest that cardiorespiratory fitness might attenuate the age-related arterial stiffening in women with systemic lupus erythematosus and might thus contribute to the primary prevention of cardiovascular disease in this population. As the cross-sectional design precludes establishing causal relationships, future clinical trials should confirm or contrast these findings.
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Affiliation(s)
- Cristina Montalbán-Méndez
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - José A Vargas-Hitos
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Luis M Sáez-Urán
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Antonio Rosales-Castillo
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
| | - Pablo Morillas-de-Laguno
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Blanca Gavilán-Carrera
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Juan Jiménez-Alonso
- Systemic Autoimmune Diseases Unit, Department of Internal Medicine, "Virgen de las Nieves" University Hospital, Granada, Spain
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285
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Combined Effect of Sauna Bathing and Cardiorespiratory Fitness on the Risk of Sudden Cardiac Deaths in Caucasian Men: A Long-term Prospective Cohort Study. Prog Cardiovasc Dis 2018; 60:635-641. [DOI: 10.1016/j.pcad.2018.03.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 03/09/2018] [Indexed: 02/08/2023]
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286
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Laukkanen JA, Araújo CGS, Kurl S, Khan H, Jae SY, Guazzi M, Kunutsor SK. Relative peak exercise oxygen pulse is related to sudden cardiac death, cardiovascular and all-cause mortality in middle-aged men. Eur J Prev Cardiol 2018; 25:772-782. [DOI: 10.1177/2047487318761679] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Preliminary evidence suggests that peak exercise oxygen pulse – peak oxygen uptake/heart rate-, a variable obtained during maximal cardiopulmonary exercise testing and a surrogate of stroke volume, is a predictor of mortality. We aimed to assess the associations of peak exercise oxygen pulse with sudden cardiac death, fatal coronary heart disease and cardiovascular disease and all-cause mortality. Design A prospective study. Methods Peak exercise oxygen pulse was assessed in a maximal cycling test at baseline in 2227 middle-aged men of the Kuopio Ischaemic Heart Disease cohort study using expired gas variables and electrocardiograms. Relative peak exercise oxygen pulse was obtained by dividing the absolute value by body weight. Results During a median follow-up of 26.1 years 1097 subjects died; there were 220 sudden cardiac deaths, 336 fatal coronary heart diseases and 505 fatal cardiovascular diseases. Relative peak exercise oxygen pulse (mean 19.5 (4.1) mL per beat/kg/102) was approximately linearly associated with each outcome. Comparing extreme quartiles of relative peak exercise oxygen pulse, hazard ratios (95% confidence intervals) for sudden cardiac death, fatal coronary heart disease and cardiovascular disease, and all-cause mortality on adjustment for cardiovascular risk factors were 0.55 (0.36–0.83), 0.58 (0.42–0.81), 0.60 (0.46–0.79) and 0.59 (0.49–0.70), respectively ( P < 0.001 for all). The hazard ratios were unchanged on further adjustment for C-reactive protein and the use of beta-blockers. The addition of relative peak exercise oxygen pulse to a cardiovascular disease mortality risk prediction model significantly improved risk discrimination (C-index change 0.0112; P = 0.030). Conclusion Relative peak exercise oxygen pulse measured during maximal exercise was linearly and inversely associated with fatal cardiovascular and all-cause mortality events in middle-aged men. In addition, relative peak exercise oxygen pulse provided significant improvement in cardiovascular disease mortality risk assessment beyond conventional risk factors.
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Affiliation(s)
- Jari A Laukkanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
- Department of Internal Medicine, Central Finland Health Care District, Finland
- Faculty of Sport and Health Sciences, University of Jyväskylä, Finland
| | | | - Sudhir Kurl
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Finland
| | - Hassan Khan
- Department of Medicine, Emory University, USA
| | - Sae Y Jae
- Department of Sport Science, University of Seoul, Republic of Korea
| | - Marco Guazzi
- Department of Biomedical Sciences, Cardiology Department, IRCCS Policlinico San Donato, San Donato Milanese, Univrsity of Milan, Milan, Italy
| | - Setor K Kunutsor
- School of Clinical Sciences, Translational Health Sciences, Bristol Medical School, University of Bristol, UK
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287
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Lambert K, Hokayem M, Thomas C, Fabre O, Cassan C, Bourret A, Bernex F, Feuillet-Coudray C, Notarnicola C, Mercier J, Avignon A, Bisbal C. Combination of nutritional polyphenols supplementation with exercise training counteracts insulin resistance and improves endurance in high-fat diet-induced obese rats. Sci Rep 2018; 8:2885. [PMID: 29440695 PMCID: PMC5811550 DOI: 10.1038/s41598-018-21287-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/29/2018] [Indexed: 12/22/2022] Open
Abstract
Separately, polyphenols and exercise are known to prevent insulin resistance (IR) but their combined curative effects on established obesity and IR require further investigation. Therefore, we compared the metabolic effects of a combination of exercise and grape polyphenols supplementation in obese IR rats with high-fat diet (EXOPP) to the effect of high-fat diet alone (HF) or with a nutritional supplementation of grape polyphenols (PP) or with endurance exercise (EXO) during 8 wks. We observed an improvement of systemic and skeletal muscle insulin sensitivity in EXO and EXOPP rats. EXOPP rats compared to HF rats presented a lower insulinemia and HOMA-IR with higher liver and muscle glycogen contents. Interestingly, EXOPP rats had a 68% enhanced endurance capacity compared to EXO rats with also a higher activation of AMPK compared to sedentary and EXO rats with increased lipid oxidation. Together, our results suggest that grape polyphenols supplementation combined with exercise has a synergistic effect by increasing muscle lipid oxidation and sparing glycogen utilization which thus enhances endurance capacity. Our data highlight that in cases of established obesity and IR, the combination of nutritional grape polyphenols supplementation and exercise heighten and intensify their individual metabolic effects.
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Affiliation(s)
- Karen Lambert
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France.
| | - Marie Hokayem
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
| | - Claire Thomas
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France.,University d'Evry Val d'Essonne, département STAPS. François Mitterrand Boulevard, 91025, Evry, France
| | - Odile Fabre
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
| | - Cécile Cassan
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
| | - Annick Bourret
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
| | - Florence Bernex
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
| | | | - Cécile Notarnicola
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
| | - Jacques Mercier
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France.,Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295, Montpellier, France
| | - Antoine Avignon
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France.,Centre Hospitalier Régional Universitaire (CHRU) Montpellier, 34295, Montpellier, France
| | - Catherine Bisbal
- PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214. 34295, Montpellier, cedex 5, France
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288
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Evidence-Based Exercise Recommendations to Reduce Hepatic Fat Content in Youth- a Systematic Review and Meta-Analysis. Prog Cardiovasc Dis 2018; 61:222-231. [PMID: 29452135 DOI: 10.1016/j.pcad.2018.01.013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 01/31/2018] [Indexed: 12/18/2022]
Abstract
The main purposes of this study were to elucidate the effects of supervised-exercise training (ET) interventions on hepatic fat content and on non-alcoholic fatty liver disease (NAFLD) prevalence in children and adolescents and to provide information about the optimal ET prescription (type, intensity, volume, and frequency) needed to reduce hepatic fat content in youths. Supervised-ET interventions performed in children and adolescents (6-19 years) that provided results of exercise effects on hepatic fat content or NAFLD prevalence were included. Supervised-exercise significantly reduced hepatic fat content compared to the control groups. Lifestyle interventions that included supervised-ET significantly reduced the prevalence of NAFLD. This systematic review and meta-analysis shows that supervised-ET could be an effective strategy in the management and prevention of NAFLD in children and adolescents. Both aerobic and resistance ET, at vigorous or moderate-to-vigorous intensities, with a volume ≥60 min/session and a frequency ≥3 sessions/week, aiming to improve cardiorespiratory fitness and muscular strength, had benefits on hepatic fat content reduction in youth. These data concur with the international recommendations of physical activity for health promotion in youth and may be useful when designing ET programs to improve and prevent hepatic steatosis in the pediatric population.
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289
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Affiliation(s)
- Andrew Elagizi
- Department of Internal Medicine, Leonard J Chabert Medical Center, Houma, LA, USA
| | | | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School-The University of Queensland School of Medicine, New Orleans, LA, USA
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290
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Radford NB, DeFina LF, Leonard D, Barlow CE, Willis BL, Gibbons LW, Gilchrist SC, Khera A, Levine BD. Cardiorespiratory Fitness, Coronary Artery Calcium, and Cardiovascular Disease Events in a Cohort of Generally Healthy Middle-Age Men: Results From the Cooper Center Longitudinal Study. Circulation 2018; 137:1888-1895. [PMID: 29343464 DOI: 10.1161/circulationaha.117.032708] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 12/15/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND A robust literature demonstrates that coronary artery calcification (CAC) and cardiorespiratory fitness (CRF) are independent predictors of cardiovascular disease (CVD) events. Much less is known about the joint associations of CRF and CAC with CVD risk. In the setting of high CAC, high versus low CRF has been associated with decreased CVD events. The goal of this study was to assess the effect of continuous levels of CRF on CVD risk in the setting of increasing CAC burden. METHODS We studied 8425 men without clinical CVD who underwent preventive medicine examinations that included an objective measurement of CRF and CAC between 1998 and 2007. There were 383 CVD events during an average follow-up of 8.4 years. Parametric proportional hazards regression models based on a Gompertz mortality rule were used to estimate total CVD incidence rates at 70 years of age as well as hazard ratios for the included covariates. RESULTS CVD events increased with increasing CAC and decreased with increasing CRF. Adjusting for CAC level (scores of 0, 1-99, 100-399, and ≥400), for each additional MET of fitness, there was an 11% lower risk for CVD events (hazard ratio, 0.89; 95% confidence interval, 0.84-0.94). When CAC and CRF were considered together, there was a strong association between continuous CRF and CVD incidence rates in all CAC groups. CONCLUSIONS In a large cohort of generally healthy men, there is an attenuation of CVD risk at all CAC levels with higher CRF.
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Affiliation(s)
| | - Laura F DeFina
- Cooper Institute, Dallas, TX (L.F.D., D.L., C.E.B., B.L.W., L.W.G.)
| | - David Leonard
- Cooper Institute, Dallas, TX (L.F.D., D.L., C.E.B., B.L.W., L.W.G.)
| | - Carolyn E Barlow
- Cooper Institute, Dallas, TX (L.F.D., D.L., C.E.B., B.L.W., L.W.G.)
| | | | - Larry W Gibbons
- Cooper Institute, Dallas, TX (L.F.D., D.L., C.E.B., B.L.W., L.W.G.)
| | - Susan C Gilchrist
- Department of Clinical Cancer Prevention, University of Texas MD Anderson Cancer Center, Houston (S.C.G.)
| | - Amit Khera
- Department of Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (A.K., B.D.L.)
| | - Benjamin D Levine
- Department of Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas (A.K., B.D.L.) .,Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital, Dallas (B.D.L.)
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291
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Quindry JC, Franklin BA. Cardioprotective Exercise and Pharmacologic Interventions as Complementary Antidotes to Cardiovascular Disease. Exerc Sport Sci Rev 2018; 46:5-17. [PMID: 28885265 DOI: 10.1249/jes.0000000000000134] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Exercise and pharmacologic therapies to prevent and treat cardiovascular disease have advanced largely through independent efforts. Understanding of first-line drug therapies, findings from preclinical animal studies, and the need for research initiatives related to complementary cardioprotective exercise-pharma interventions are reviewed from the premise that contemporary cardioprotective therapies must include adjunctive exercise and lifestyle interventions in addition to pharmacologic agents.
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Affiliation(s)
- John C Quindry
- Health and Human Performance, University of Montana, Missoula, MT
| | - Barry A Franklin
- Health and Human Performance, University of Montana, Missoula, MT
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292
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Gorostegi-Anduaga I, Corres P, MartinezAguirre-Betolaza A, Pérez-Asenjo J, Aispuru GR, Fryer SM, Maldonado-Martín S. Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study. Eur J Prev Cardiol 2018; 25:343-353. [DOI: 10.1177/2047487317749956] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Both exercise training and diet are recommended to prevent and control hypertension and overweight/obesity. Purpose The purpose of this study was to determine the effectiveness of different 16-week aerobic exercise programmes with hypocaloric diet on blood pressure, body composition, cardiorespiratory fitness and pharmacological treatment. Methods Overweight/obese, sedentary participants ( n = 175, aged 54.0 ± 8.2 years) with hypertension were randomly assigned into an attention control group (physical activity recommendations) or one of three supervised exercise groups (2 days/week: high-volume with 45 minutes of moderate-intensity continuous training (MICT), high-volume and high-intensity interval training (HIIT), alternating high and moderate intensities, and low-volume HIIT (20 minutes)). All variables were assessed pre- and post-intervention. All participants received the same hypocaloric diet. Results Following the intervention, there was a significant reduction in blood pressure and body mass in all groups with no between-group differences for blood pressure. However, body mass was significantly less reduced in the attention control group compared with all exercise groups (attention control –6.6%, high-volume MICT –8.3%, high-volume HIIT –9.7%, low-volume HIIT –6.9%). HIIT groups had significantly higher cardiorespiratory fitness than high-volume MICT, but there were no significant between-HIIT differences (attention control 16.4%, high-volume MICT 23.6%, high-volume HIIT 36.7%, low-volume HIIT 30.5%). Medication was removed in 7.6% and reduced in 37.7% of the participants. Conclusions The combination of hypocaloric diet with supervised aerobic exercise 2 days/week offers an optimal non-pharmacological tool in the management of blood pressure, cardiorespiratory fitness and body composition in overweight/obese and sedentary individuals with hypertension. High-volume HIIT seems to be better for reducing body mass compared with low-volume HIIT. The exercise-induced improvement in cardiorespiratory fitness is intensity dependent with low-volume HIIT as a time-efficient method in this population. ClinicalTrials.gov Registration: NCT02283047.
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Affiliation(s)
| | - Pablo Corres
- Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Spain
| | | | | | | | - Simon M Fryer
- School of Sport and Exercise, University of Gloucestershire, UK
| | - Sara Maldonado-Martín
- Department of Physical Education and Sport, University of the Basque Country (UPV/EHU), Spain
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293
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Barnes JN, Fu Q. Sex-Specific Ventricular and Vascular Adaptations to Exercise. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1065:329-346. [PMID: 30051394 DOI: 10.1007/978-3-319-77932-4_21] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Increasing data suggest that there are sex differences in ventricular and vascular adaptations to aerobic (endurance) exercise, which may be attributed to different physical and physiological features in men and women. Despite that cardiovascular control during acute exercise at the same relative work rate (e.g., the percentage of peak oxygen uptake) appears to be similar between the sexes, women have blunted responses or adaptations to prolonged (e.g., ≥1 year) exercise training compared with men. Currently, there is little evidence to suggest that exercise-induced vascular adaptations are different between men and women. Furthermore, sex differences in skeletal muscle adaptations to exercise, and how this influences cardiovascular function, remain unclear. Identifying potential differences and the mechanisms behind such exercise-induced adaptations is important for the optimization of exercise interventions between men and women across the life span.
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Affiliation(s)
| | - Qi Fu
- Institute for Exercise and Environmental Medicine, Dallas, TX, USA.,University of Texas Southwestern Medical Center, Dallas, TX, USA
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294
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295
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Keats MR, Cui Y, DeClercq V, Dummer TJB, Forbes C, Grandy SA, Hicks J, Sweeney E, Yu ZM, Parker L. Multimorbidity in Atlantic Canada and association with low levels of physical activity. Prev Med 2017; 105:326-331. [PMID: 28987335 DOI: 10.1016/j.ypmed.2017.10.013] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 09/12/2017] [Accepted: 10/04/2017] [Indexed: 11/27/2022]
Abstract
Owing to an aging population and medical advances, the anticipated growth and prevalence of multimorbidity has been recognized as a significant challenge and priority in health care settings. Although physical activity has been shown to play a vital role in the primary and secondary prevention of chronic disease, much less is known about the relationship between physical activity and multimorbidity. The objective of the present study was to examine the relationship between physical activity levels and multimorbidity in male and female adults after adjusting for key demographic, geographical, and lifestyle factors. The study drew data from a prospective cohort in Atlantic Canada (2009-2015). The sample included 18,709 participants between the ages of 35-69. Eighteen chronic diseases were identified. Physical activity levels were estimated based on the long form of the International Physical Activity Questionnaire. Using logistic regression analysis, we found that multimorbid individuals were significantly more likely to be physically inactive (OR=1.26; 95% CI 1.10, 1.44) after adjusting for key sociodemographic and lifestyle characteristics. Additional stratified analyses suggest that the magnitude of the effect between multimorbidity and physical activity was stronger for men (OR=1.41; 95% CI 1.12, 1.79) than women (OR=1.18; CI 1.00, 1.39) and those living in rural (OR=1.43; CI 1.10, 1.85) versus urban (OR=1.20; CI 1.02, 141) areas. Given the generally low levels of physical activity across populations and a growing prevalence of multimorbidity, there is a need for a prospective study to explore causal associations between physical activity, multimorbidity, and health outcomes.
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Affiliation(s)
- Melanie R Keats
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada.
| | - Yunsong Cui
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Vanessa DeClercq
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Trevor J B Dummer
- Centre of Excellence in Cancer Prevention, School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Cynthia Forbes
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Scott A Grandy
- School of Health and Human Performance, Dalhousie University, Halifax, NS, Canada
| | - Jason Hicks
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Ellen Sweeney
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Zhijie Michael Yu
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
| | - Louise Parker
- Atlantic PATH, Population Cancer Research Program, Dalhousie University, Halifax, NS, Canada
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296
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Lahoud R, Chongthammakun V, Wu Y, Hawwa N, Brennan DM, Cho L. Comparing SF-36® scores versus biomarkers to predict mortality in primary cardiac prevention patients. Eur J Intern Med 2017. [PMID: 28625611 DOI: 10.1016/j.ejim.2017.05.026] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Risk stratification plays an important role in evaluating patients with no known cardiovascular disease (CVD). Few studies have investigated health-related quality of life questionnaires such as the Medical Outcomes Study Short Form-36 (SF-36®) as predictive tools for mortality, particularly in direct comparison with biomarkers. Our objective is to measure the relative effectiveness of SF-36® scores in predicting mortality when compared to traditional and novel biomarkers in a primary prevention population. METHODS 7056 patients evaluated for primary cardiac prevention between January 1996 and April 2011 were included in this study. Patient characteristics included medical history, SF-36® questionnaire and a laboratory panel (total cholesterol, triglycerides, HDL, LDL, ApoA, ApoB, ApoA1/ApoB ratio, homocysteine, lipoprotein (a), fibrinogen, hsCRP, uric acid and urine ACR). The primary outcome was all-cause mortality. RESULTS A low SF-36® physical score independently predicted a 6-fold increase in death at 8years (above vs. below median Hazard Ratio [95% confidence interval] 5.99 [3.86-9.35], p<0.001). In a univariate analysis, SF-36® physical score had a c-index of 0.75, which was superior to that of all the biomarkers. It also carried incremental predictive ability when added to non-laboratory risk factors (Net Reclassification Index=59.9%), as well as Framingham risk score components (Net Reclassification Index=61.1%). Biomarkers added no incremental predictive value to a non-laboratory risk factor model when combined to SF-36 physical score. CONCLUSION The SF-36® physical score is a reliable predictor of mortality in patients without CVD, and outperformed most studied traditional and novel biomarkers. In an era of rising healthcare costs, the SF-36® questionnaire could be used as an adjunct simple and cost-effective predictor of mortality to current predictors.
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Affiliation(s)
- Rony Lahoud
- Cleveland Clinic Foundation, Heart Vascular Institute, Department of Cardiology, Cleveland, OH, United States
| | | | - Yuping Wu
- Cleveland Clinic Foundation, Heart Vascular Institute, Department of Cardiology, Cleveland, OH, United States
| | - Nael Hawwa
- Cleveland Clinic Foundation, Heart Vascular Institute, Department of Cardiology, Cleveland, OH, United States
| | - Danielle M Brennan
- C5Research, Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, United States
| | - Leslie Cho
- Cleveland Clinic Foundation, Heart Vascular Institute, Department of Cardiology, Cleveland, OH, United States.
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297
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Kontro TK, Sarna S, Kaprio J, Kujala UM. Mortality and health-related habits in 900 Finnish former elite athletes and their brothers. Br J Sports Med 2017; 52:89-95. [PMID: 29127265 DOI: 10.1136/bjsports-2017-098206] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is conflicting evidence on the associations between participation in vigorous sports, health habits, familial factors and subsequent mortality. We investigated all-cause mortality and health-related behaviour among former elite athletes and their brothers. METHODS The mortality of Finnish male former elite athletes, who had represented Finland between 1920 and 1965 (n=900) and their age-matched brothers (n=900), was followed from the time when athlete started an elite athlete career until 31 December 2015. The age-adjusted HRs were calculated by a paired Cox proportional hazards model. In 2001, surviving participants (n=199 athletes and n=199 age-matched brothers) reported their self-rated health (SRH), physical activity, alcohol consumption and smoking habits in the questionnaire. RESULTS During the total follow-up period, 1296 deaths (72% of the cohort) occurred. The age-adjusted HRs for all-cause mortality in former athletes was 0.75 (95% CI 0.65 to 0.87, P<0.001) compared with their age-matched brothers. Median age at death was 79.9 years for endurance, 75.9 years for mixed sports and 72.2 years for power sports athletes, and 77.5, 73.7 and 72.2 years for their age-matched brothers, respectively. In 2001, compared with their brothers, former athletes smoked less (P<0.001), were more physically active (P<0.05) and rated their health more often as very good (P<0.05). CONCLUSIONS Former elite athletes are more physically active, smoke less, have better self-rated health and live longer than their brothers. Genetic differences between athletes and brothers, aerobic training for endurance elite sports and a healthier lifestyle may all contribute to reduced mortality.
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Affiliation(s)
| | - Seppo Sarna
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Jaakko Kaprio
- Department of Public Health, University of Helsinki, Helsinki, Finland.,Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
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Development of a New ICT-Based Multisensor Blood Pressure Monitoring System for Use in Hemodynamic Biomarker-Initiated Anticipation Medicine for Cardiovascular Disease: The National IMPACT Program Project. Prog Cardiovasc Dis 2017; 60:435-449. [DOI: 10.1016/j.pcad.2017.10.002] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2017] [Accepted: 10/29/2017] [Indexed: 11/25/2022]
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299
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Poole DC, Richardson RS, Haykowsky MJ, Hirai DM, Musch TI. Exercise limitations in heart failure with reduced and preserved ejection fraction. J Appl Physiol (1985) 2017; 124:208-224. [PMID: 29051336 DOI: 10.1152/japplphysiol.00747.2017] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
The hallmark symptom of chronic heart failure (HF) is severe exercise intolerance. Impaired perfusive and diffusive O2 transport are two of the major determinants of reduced physical capacity and lowered maximal O2 uptake in patients with HF. It has now become evident that this syndrome manifests at least two different phenotypic variations: heart failure with preserved or reduced ejection fraction (HFpEF and HFrEF, respectively). Unlike HFrEF, however, there is currently limited understanding of HFpEF pathophysiology, leading to a lack of effective pharmacological treatments for this subpopulation. This brief review focuses on the disturbances within the O2 transport pathway resulting in limited exercise capacity in both HFpEF and HFrEF. Evidence from human and animal research reveals HF-induced impairments in both perfusive and diffusive O2 conductances identifying potential targets for clinical intervention. Specifically, utilization of different experimental approaches in humans (e.g., small vs. large muscle mass exercise) and animals (e.g., intravital microscopy and phosphorescence quenching) has provided important clues to elucidating these pathophysiological mechanisms. Adaptations within the skeletal muscle O2 delivery-utilization system following established and emerging therapies (e.g., exercise training and inorganic nitrate supplementation, respectively) are discussed. Resolution of the underlying mechanisms of skeletal muscle dysfunction and exercise intolerance is essential for the development and refinement of the most effective treatments for patients with HF.
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300
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Herman ME, O'Keefe JH, Bell DSH, Schwartz SS. Insulin Therapy Increases Cardiovascular Risk in Type 2 Diabetes. Prog Cardiovasc Dis 2017; 60:422-434. [PMID: 28958751 DOI: 10.1016/j.pcad.2017.09.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 12/11/2022]
Abstract
Insulin therapy increased cardiovascular (CV) risk and mortality among type 2 diabetes (T2D) patients in several recently reported clinical outcomes trials. To assess whether this association is causative or coincidental, PubMed searches were used to query the effects of insulin therapy for T2D on CV health and longevity from large-scale outcomes trials, meta-analyses, and patient registry studies, as well as basic research on insulin's direct and pleiotropic actions. Although several old studies provided conflicting results, the majority of large observational studies show strong dose-dependent associations for injected insulin with increased CV risk and worsened mortality. Insulin clearly causes weight gain, recurrent hypoglycemia, and, other potential adverse effects, including iatrogenic hyperinsulinemia. This over-insulinization with use of injected insulin predisposes to inflammation, atherosclerosis, hypertension, dyslipidemia, heart failure (HF), and arrhythmias. These associations support the findings of large-scale evaluations that strongly suggest that insulin therapy has a poorer short- and long-term safety profile than that found to many other anti-T2D therapies. The potential adverse effects of insulin therapy should be weighed against proven CV benefits noted for select other therapies for T2D as reported in recent large randomized controlled trials.
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Affiliation(s)
- Mary E Herman
- Montclair State University, New Jersey, United States; Social Alchemy Ltd. Building Global Research Competency, United States
| | - James H O'Keefe
- University of Missouri-Kansas City, School of Medicine, Kansas City, MO, United States; Saint Luke's Mid America Heart Institute, United States.
| | | | - Stanley S Schwartz
- Main Line Health System, Wynnewood, PA, United States; University of Pennsylvania, Philadelphia, PA, United States
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