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Vechetti IJ, Peck BD, Wen Y, Walton RG, Valentino TR, Alimov AP, Dungan CM, Van Pelt DW, von Walden F, Alkner B, Peterson CA, McCarthy JJ. Mechanical overload-induced muscle-derived extracellular vesicles promote adipose tissue lipolysis. FASEB J 2021; 35:e21644. [PMID: 34033143 DOI: 10.1096/fj.202100242r] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 04/02/2021] [Accepted: 04/19/2021] [Indexed: 02/06/2023]
Abstract
How regular physical activity is able to improve health remains poorly understood. The release of factors from skeletal muscle following exercise has been proposed as a possible mechanism mediating such systemic benefits. We describe a mechanism wherein skeletal muscle, in response to a hypertrophic stimulus induced by mechanical overload (MOV), released extracellular vesicles (EVs) containing muscle-specific miR-1 that were preferentially taken up by epidydimal white adipose tissue (eWAT). In eWAT, miR-1 promoted adrenergic signaling and lipolysis by targeting Tfap2α, a known repressor of Adrβ3 expression. Inhibiting EV release prevented the MOV-induced increase in eWAT miR-1 abundance and expression of lipolytic genes. Resistance exercise decreased skeletal muscle miR-1 expression with a concomitant increase in plasma EV miR-1 abundance, suggesting a similar mechanism may be operative in humans. Altogether, these findings demonstrate that skeletal muscle promotes metabolic adaptations in adipose tissue in response to MOV via EV-mediated delivery of miR-1.
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Affiliation(s)
- Ivan J Vechetti
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA.,Center for Muscle Biology, University of Kentucky, Lexington, KY, USA
| | - Bailey D Peck
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - Yuan Wen
- Department of Nutrition and Health Sciences, University of Nebraska-Lincoln, Lincoln, NE, USA.,Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - R Grace Walton
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - Taylor R Valentino
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Alexander P Alimov
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
| | - Cory M Dungan
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - Douglas W Van Pelt
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - Ferdinand von Walden
- Division of Neuropediatrics, Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden
| | - Björn Alkner
- Division of Neuropediatrics, Department of Women's and Children's Health, Karolinska Institutet, Solna, Sweden.,Department of Orthopaedics Eksjö, Regional Hospital Eksjö, Region Jönköping County, Sweden.,Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Charlotte A Peterson
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physical Therapy, University of Kentucky, Lexington, KY, USA
| | - John J McCarthy
- Center for Muscle Biology, University of Kentucky, Lexington, KY, USA.,Department of Physiology, University of Kentucky, Lexington, KY, USA
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Shaikh H, Bradhurst P, Ma LX, Tan SYC, Egger SJ, Vardy JL. Body weight management in overweight and obese breast cancer survivors. Cochrane Database Syst Rev 2020; 12:CD012110. [PMID: 33305350 PMCID: PMC8094215 DOI: 10.1002/14651858.cd012110.pub2] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Studies suggest that overweight and obese breast cancer survivors are at increased risk of cancer recurrence and have higher all-cause mortality. Obesity has an impact on breast cancer survivor's quality of life (QOL) and increases the risk of longer-term morbidities such as type 2 diabetes mellitus and cardiovascular disease. Many cancer guidelines recommend survivors maintain a healthy weight but there is a lack of evidence regarding which weight loss method to recommend. OBJECTIVES To assess the effects of different body weight loss approaches in breast cancer survivors who are overweight or obese (body mass index (BMI) ≥ 25 kg/m2). SEARCH METHODS We carried out a search in the Cochrane Breast Cancer Group's (CBCG's) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL, Issue 6), MEDLINE (2012 to June 2019), Embase (2015 to June 2019), the World Health Organisation International Clinical Trials Registry Platform (WHO ICTRP) and Clinicaltrials.gov on 17 June 2019. We also searched Mainland Chinese academic literature databases (CNKI), VIP, Wan Fang Data and SinoMed on 25 June 2019. We screened references in relevant manuscripts. SELECTION CRITERIA We included randomised controlled trials (RCTs), quasi-RCTs and randomised cross-over trials evaluating body weight management for overweight and obese breast cancer survivors (BMI ≥ 25 kg/m2). The aim of the intervention had to be weight loss. DATA COLLECTION AND ANALYSIS Two review authors independently performed data extraction and assessed risk of bias for the included studies, and applied the quality of the evidence using the GRADE approach. Dichotomous outcomes were analysed as proportions using the risk ratio (RR) as the measure of effect. Continuous data were analysed as means with the measure of effect being expressed as the mean differences (MDs) between treatment groups in change from baseline values with 95% confidence intervals (CIs), when all studies reported exactly the same outcomes on the same scale. If similar outcomes were reported on different scales the standardised mean difference (SMD) was used as the measure of effect. Quality of life data and relevant biomarkers were extracted where available. MAIN RESULTS We included a total of 20 studies (containing 23 intervention-comparisons) and analysed 2028 randomised women. Participants in the experimental groups received weight loss interventions using the core element of dietary changes, either in isolation or in combination with other core elements such as 'diet and exercise', 'diet and psychosocial support' or 'diet, exercise and psychosocial support'. Participants in the controls groups either received usual care, written materials or placebo, or wait-list controls. The duration of interventions ranged from 0.5 months to 24 months. The duration of follow-up ranged from three months to 36 months. There were no time-to-event data available for overall survival, breast cancer recurrence and disease-free survival. There was a relatively small amount of data available for breast cancer recurrence (281 participants from 4 intervention-comparisons with 14 recurrence events; RR 1.95, 95% CI 0.68 to 5.60; low-quality evidence) and the analysis was likely underpowered. Overall, we found low-quality evidence that weight loss interventions for overweight and obese breast cancer survivors resulted in a reduction in body weight (MD: -2.25 kg, 95% CI: -3.19 to -1.3 kg; 21 intervention-comparisons; 1751 women), body mass index (BMI) (MD: -1.08 kg/m2, 95% CI: -1.61 to -0.56 kg/m2; 17 intervention-comparisons; 1353 women), and waist circumference (MD:-1.73 cm, 95% CI: -3.17 to -0.29 cm; 13 intervention-comparisons; 1193 women), and improved overall quality of life (SMD: 0.74; 95% CI: 0.20 to 1.29; 10 intervention-comparisons; 867 women). No increase was seen in adverse events for women in the intervention groups compared to controls (RR 0.94, 95% CI: 0.76 to 1.17; 4 intervention-comparisons; 394 women; high-quality evidence). Subgroup analyses revealed that decreases in body weight, BMI and waist circumference were present in women regardless of their ethnicity and menopausal status. Multimodal weight loss interventions (which referred to 'diet, exercise and psychosocial support') appeared to result in greater reductions in body weight (MD: -2.88 kg, 95% CI: -3.98 to -1.77 kg; 13 intervention-comparisons; 1526 participants), BMI (MD: -1.44 kg/m2, 95% CI: -2.16 to -0.72 kg/m2; 11 studies; 1187 participants) and waist circumference (MD:-1.66 cm, 95% CI: -3.49 to -0.16 cm; 8 intervention-comparisons; 1021 participants) compared to dietary change alone, however the evidence was low quality. AUTHORS' CONCLUSIONS Weight loss interventions, particularly multimodal interventions (incorporating diet, exercise and psychosocial support), in overweight or obese breast cancer survivors appear to result in decreases in body weight, BMI and waist circumference and improvement in overall quality of life. There was no increase in adverse events. There is a lack of data to determine the impact of weight loss interventions on survival or breast cancer recurrence. This review is based on studies with marked heterogeneity regarding weight loss interventions. Due to the methods used in included studies, there was a high risk of bias regarding blinding of participants and assessors. Further research is required to determine the optimal weight loss intervention and assess the impact of weight loss on survival outcomes. Long-term follow-up in weight loss intervention studies is required to determine if weight changes are sustained beyond the intervention periods.
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Affiliation(s)
- Hassan Shaikh
- Faculty of Medicine, University of New South Wales, Sydney, Australia
| | | | - Li Xin Ma
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
- Nutrition and Food Hygiene Department, Hebei University, Baoding, China
| | - Sim Yee Cindy Tan
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
- Nutrition and Dietetics Department, Concord Repatriation General Hospital, Concord, Australia
- Sydney Medical School, University of Sydney, Sydney, Australia
| | - Sam J Egger
- Cancer Research Division, Cancer Council NSW, Sydney, Australia
| | - Janette L Vardy
- Concord Cancer Centre, Concord Repatriation General Hospital, Sydney, Australia
- Faculty of Medicine and Health, Concord Clinical School, The University of Sydney, Sydney, Australia
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Werneck AO, Oyeyemi AL, Cyrino ES, Ronque ERV, Szwarcwald CL, Coelho-e-Silva MJ, Silva DR. Association between age at menarche and blood pressure in adulthood: is obesity an important mediator? Hypertens Res 2018; 41:856-864. [DOI: 10.1038/s41440-018-0079-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 03/10/2018] [Accepted: 03/13/2018] [Indexed: 11/10/2022]
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Rueegg CS, Kriemler S, Zuercher SJ, Schindera C, Renner A, Hebestreit H, Meier C, Eser P, von der Weid NX. A partially supervised physical activity program for adult and adolescent survivors of childhood cancer (SURfit): study design of a randomized controlled trial [NCT02730767]. BMC Cancer 2017; 17:822. [PMID: 29207962 PMCID: PMC5717834 DOI: 10.1186/s12885-017-3801-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 11/20/2017] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Beyond survival of nowadays >80%, modern childhood cancer treatment strives to preserve long-term health and quality of life. However, the majority of today's survivors suffer from short- and long-term adverse effects such as cardiovascular and pulmonary diseases, obesity, osteoporosis, fatigue, depression, and reduced physical fitness and quality of life. Regular exercise can play a major role to mitigate or prevent such late-effects. Despite this, there are no data on the effects of regular exercise in childhood cancer survivors from randomized controlled trials (RCTs). Primary outcome of the current RCT is therefore the effect of a 12-months exercise program on a composite cardiovascular disease risk score in childhood cancer survivors. Secondary outcomes are single cardiovascular disease risk factors, glycaemic control, bone health, body composition, physical fitness, physical activity, quality of life, mental health, fatigue and adverse events (safety). METHODS A total of 150 childhood cancer survivors aged ≥16 years and diagnosed ≥5 years prior to the study are recruited from Swiss paediatric oncology clinics. Following the baseline assessments patients are randomized 1:1 into an intervention and control group. Thereafter, they are seen at month 3, 6 and 12 for follow-up assessments. The intervention group is asked to add ≥2.5 h of intense physical activity/week, including 30 min of strength building and 2 h of aerobic exercises. In addition, they are told to reduce screen time by 25%. Regular consulting by physiotherapists, individual web-based activity diaries, and pedometer devices are used as motivational tools for the intervention group. The control group is asked to keep their physical activity levels constant. DISCUSSION The results of this study will show whether a partially supervised exercise intervention can improve cardiovascular disease risk factors, bone health, body composition, physical activity and fitness, fatigue, mental health and quality of life in childhood cancer survivors. If the program will be effective, all relevant information of the SURfit physical activity intervention will be made available to interested clinics that treat and follow-up childhood cancer patients to promote exercise in their patients. TRIAL REGISTRATION Prospectively registered in clinicaltrials.gov [ NCT02730767 ], registration date: 10.12.2015.
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Affiliation(s)
- Corina S. Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
- Department of Health Sciences and Health Policy, University of Lucerne, Frohburgstrasse 3, 6002 Lucerne, Switzerland
| | - Susi Kriemler
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Simeon J. Zuercher
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Hirschengraben 84, 8001 Zürich, Switzerland
| | - Christina Schindera
- Department of Pediatric Oncology and Hematology, University Children’s Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012 Bern, Switzerland
| | - Andrea Renner
- Paediatric Endocrinology, Pediatric Endocrinology Centre Zurich AG (PEZZ), Möhrlistrasse 69, 8006 Zürich, Switzerland
| | - Helge Hebestreit
- Children’s Hospital, University Hospital Würzburg, Josef-Schneider-Str. 2, 97080 Würzburg, Germany
| | - Christian Meier
- Division of Endocrinology, Diabetes, Metabolism and Bone Research, University Hospital Basel, Missionsstrasse 24, 4055 Basel, Switzerland
| | - Prisca Eser
- University Clinic of Cardiology, Preventive Cardiology and Sports Medicine, Inselspital, University Hospital Bern, 3010 Bern, Switzerland
| | - Nicolas X. von der Weid
- Department of Pediatric Oncology and Hematology, University Children’s Hospital Basel (UKBB), University of Basel, Spitalstrasse 33, 4056 Basel, Switzerland
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Ma LX, Bulsara MK, Tan SY, Vardy J. Body weight management in overweight and obese breast cancer survivors. THE COCHRANE DATABASE OF SYSTEMATIC REVIEWS 2016. [DOI: 10.1002/14651858.cd012110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Li Xin Ma
- Concord Repatriation General Hospital; Concord Cancer Centre; Hospital Rd, Concord, Sydney New South Wales Australia 2139
- Hebei University; Nutrition and Food Hygiene Department; No. 342 East Yuhua Rd Baoding Hebei Province China 071000
| | - Max K Bulsara
- The University of Notre Dame Australia; Institute for Health Research; 19 Mouat Street PO Box 1125 Fremantle WA Australia 6959
| | - Sim Yee Tan
- Concord Repatriation General Hospital; Concord Cancer Centre; Hospital Rd, Concord, Sydney New South Wales Australia 2139
- Concord Repatriation General Hospital; Nutrition and Dietetics Department; Building 38 Hospital Road Concord NSW Australia 2139
- University of Sydney; Sydney Medical School; Sydney Australia
| | - Janette Vardy
- Concord Repatriation General Hospital; Concord Cancer Centre; Hospital Rd, Concord, Sydney New South Wales Australia 2139
- University of Sydney; Sydney Medical School; Sydney Australia
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Mache S, Jensen S, Jahn R, Steudtner M, Ochsmann E, Preuß G. Worksite Health Program Promoting Changes in Eating Behavior and Health Attitudes. Health Promot Pract 2015; 16:826-36. [DOI: 10.1177/1524839915596310] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background. The aim of the present study was to evaluate the effectiveness of a worksite multicomponent health promotion intervention on eating behavior and attitudes, changes in body weight, and readiness to make eating behavior changes among workers over a 12-month intervention period. Method. A total of 3,095 workers of a logistic company participated in a quasi-experimental comparison group study design. The intervention group received a multicomponent health training. Two of the main elements of the multicomponent intervention were physical exercise training and nutrition counseling/training. During the pilot year, participants completed a survey at baseline and again after 12 months to assess physical activity–, health-, and diet-related factors. Results. Results showed that participants’ body weight did not significantly decrease in the intervention group. Mean weight loss in the intervention groups was 0.5 kg (body mass index = 0.1 kg/m2). Eating behaviors in the intervention group improved more than in the comparison group. Some positive intervention effects were observed for the cognitive factors (e.g., changes in eating attitudes). Baseline readiness to change eating behavior was significantly improved over time. Conclusions. We demonstrated initial results of a long-term multicomponent worksite health promotion program with regard to changes in body weight, eating behavior, and attitudes. This evaluation of a 12-month pilot study suggests that a worksite health promotion program may lead to improvements in nutritional health behaviors for a number of workers. An investigation of long-term effects of this multicomponent intervention is strongly recommended.
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Affiliation(s)
- Stefanie Mache
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Jensen
- Bremen International Graduate School of Social Sciences, Bremen, Germany
| | - Reimo Jahn
- Helmut Schmidt University, Hamburg, Germany
| | | | - Elke Ochsmann
- University of Applied Sciences Zwickau, Zwickau, Germany
| | - Geraldine Preuß
- Charité Universitätsmedizin Berlin–Humboldt University of Berlin–Free University of Berlin, Germany
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Meeting Contemporary Expectations for Physical Therapists: Imperatives, Challenges, and Proposed Solutions for Professional Education. ACTA ACUST UNITED AC 2014. [DOI: 10.1097/00001416-201400001-00010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Alberga AS, Medd ER, Adamo KB, Goldfield GS, Prud'homme D, Kenny GP, Sigal RJ. Top 10 practical lessons learned from physical activity interventions in overweight and obese children and adolescents. Appl Physiol Nutr Metab 2013; 38:249-58. [PMID: 23537015 DOI: 10.1139/apnm-2012-0227] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Physical activity (PA) interventions targeting overweight and obese children and adolescents have shown only modest success, and dropout is an area of concern. Proper design and implementation of a PA intervention is critical for maximizing adherence and thus increasing the overall health benefits from PA participation. We propose practical advice based on our collective clinical trial experience with support from the literature on best practices related to PA interventions in overweight and obese children and adolescents. The top 10 lessons learned are (i) PA setting–context is important; (ii) choice of fitness trainer matters; (iii) physical activities should be varied and fun; (iv) the role of the parent–guardian should be considered; (v) individual physical and psychosocial characteristics should be accounted for; (vi) realistic goals should be set; (vii) regular reminders should be offered; (viii) a multidisciplinary approach should be taken; (ix) barriers should be identified early and a plan to overcome them developed; and (x) the right message should be communicated: specifically, what's in it for them? The recommendations in this paper can be used in other pediatric PA programs, physical education settings, and public health programs, with the hope of decreasing attrition and increasing the benefits of PA participation to promote health in children and adolescents.
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Affiliation(s)
- Angela S. Alberga
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Montpetit Hall, Ottawa, ON K1N 6N5, Canada
| | - Emily R. Medd
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Montpetit Hall, Ottawa, ON K1N 6N5, Canada
| | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Montpetit Hall, Ottawa, ON K1N 6N5, Canada; Healthy Active Living and Obesity Research Group (HALO), Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Gary S. Goldfield
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Montpetit Hall, Ottawa, ON K1N 6N5, Canada; Healthy Active Living and Obesity Research Group (HALO), Children's Hospital of Eastern Ontario Research Institute, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
| | - Denis Prud'homme
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Montpetit Hall, Ottawa, ON K1N 6N5, Canada
| | - Glen P. Kenny
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 125 University Private, Montpetit Hall, Ottawa, ON K1N 6N5, Canada
| | - Ronald J. Sigal
- Faculties of Medicine and Kinesiology, University of Calgary, 1820 Richmond Road SW, Room 1898, Calgary, AB T2T 5C7, Canada
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