Effect of regular exercise on homocysteine concentrations: the HERITAGE Family Study

Exploring the neuroprotective role of physical activity in cerebral small vessel disease

Cerebral small vessel disease (cSVD) is a common neurological finding characterized by abnormalities of the small blood vessels in the brain. Previous research has established a strong connection between cSVD and stroke, as well as neurodegenerative disorders, notably Alzheimer's disease (AD) and other dementias. As the search for effective interventions continues, physical activity (PA) has emerged as a potential preventative and therapeutic avenue. This review synthesizes the human and animal literature on the influence of PA on cSVD, highlighting the importance of determining optimal exercise protocols, considering aspects such as intensity, duration, timing, and exercise type. Furthermore, the necessity of widening the age bracket in research samples is discussed, ensuring a holistic understanding of the interventions across varying pathological stages of the disease. The review also suggests the potential of exploring diverse biomarkers and risk profiles associated with clinically significant outcomes. Moreover, we review findings demonstrating the beneficial effects of PA in various rodent models of cSVD, which have uncovered numerous mechanisms of neuroprotection, including increases in neuroplasticity and integrity of the vasculature and white matter; decreases in inflammation, oxidative stress, and mitochondrial dysfunction; and alterations in amyloid processing and neurotransmitter signaling. In conclusion, this review highlights the potential of physical activity as a preventive strategy for addressing cSVD, offering insights into the need for refining exercise parameters, diversifying research populations, and exploring novel biomarkers, while shedding light on the intricate mechanisms through which exercise confers neuroprotection in both humans and animal models.

Nutrition Interactions With Exercise Training on Endothelial Function

Exercise is advised to improve overall cardiovascular health and endothelial function. However, the role of nutrition on this exercise-induced endothelial adaptation is not clear. Here, we hypothesize that nutrients interact with exercise to influence endothelial function and chronic disease risk.

Plasma homocysteine levels and handgrip strength in postmenopausal women

OBJECTIVE

This study evaluated handgrip strength (HGS), circulating homocysteine levels and related factors in postmenopausal women.

METHODS

This study is a sub-analysis of a prospective cohort of 303 postmenopausal women aged 62.7 ± 6.9 years who had HGS measures with a digital dynamometer as the primary outcome, and plasma homocysteine and creatinine levels and glomerular filtration rate (GFR) measures as the secondary outcomes.

RESULTS

The average HGS was 22.5 ± 4.0 kg, 29.4% of women had dynapenia (HGS < 20 kg), adiposity was 40.3 ± 5.4% and 9.57% of women had hyperhomocysteinemia (homocysteine >15 μmol/l). There were no differences between tertiles of homocysteine and HGS (p = 0.641). Plasma homocysteine levels were unrelated to HGS (r = -0.06) and correlated with age (r = 0.17), GFR (r = -0.28) and creatinine (r = 0.23). Hyperhomocysteinemia was not associated with HGS (odds ratio [OR] = 0.98 [95% confidence interval (CI): 0.89; 1.08]) or dynapenia (OR = 1.10 [95% CI: 0.45; 2.47]). The risk of presenting low HGS were not significantly associated with homocysteine (OR = -0.08 [95% CI: -0.21; 0.06]) and were associated with age (OR = -0.23 [95% CI: -0.29; -0.17]), adiposity (OR = -6.52 [95% CI: -9.53; -3.50]) and creatinine (OR = 6.22 [95% CI: 2.48; 9.97]).

CONCLUSIONS

HGS and dynapenia were unrelated to hyperhomocysteinemia. Age, GFR and creatinine were significantly associated with plasma homocysteine levels.

The HERITAGE Family Study: A Review of the Effects of Exercise Training on Cardiometabolic Health, with Insights into Molecular Transducers

The aim of the HERITAGE Family Study was to investigate individual differences in response to a standardized endurance exercise program, the role of familial aggregation, and the genetics of response levels of cardiorespiratory fitness and cardiovascular disease and diabetes risk factors. Here we summarize the findings and their potential implications for cardiometabolic health and cardiorespiratory fitness. It begins with overviews of background and planning, recruitment, testing and exercise program protocol, quality control measures, and other relevant organizational issues. A summary of findings is then provided on cardiorespiratory fitness, exercise hemodynamics, insulin and glucose metabolism, lipid and lipoprotein profiles, adiposity and abdominal visceral fat, blood levels of steroids and other hormones, markers of oxidative stress, skeletal muscle morphology and metabolic indicators, and resting metabolic rate. These summaries document the extent of the individual differences in response to a standardized and fully monitored endurance exercise program and document the importance of familial aggregation and heritability level for exercise response traits. Findings from genomic markers, muscle gene expression studies, and proteomic and metabolomics explorations are reviewed, along with lessons learned from a bioinformatics-driven analysis pipeline. The new opportunities being pursued in integrative -omics and physiology have extended considerably the expected life of HERITAGE and are being discussed in relation to the original conceptual model of the study.

The association of physical activity on homocysteine in pregnant women

INTRODUCTION

Women with high levels of physical activity have improved pregnancy, labor, and delivery outcomes related to cardiovascular health. Hyperhomocysteinemia, which predicts cardiovascular disease risk, is associated with maternal vascular complications during pregnancy, such as placental abruption and preeclampsia. However, studies are lacking on whether physical activity impacts homocysteine in pregnant women, pointing to a potential mechanism behind the improved cardiovascular health in women who exercise during pregnancy. The purpose of this study was to examine if women with high levels of physical activity have lower levels of homocysteine compared to women with low levels of physical activity.

METHODS

This study was a secondary analysis using data from the 2003 to 2006 National Health and Nutrition Examination Survey. A total of 257 pregnant women were included. Physical activity was assessed objectively over seven days with accelerometers. High and low groups based on moderate-to-vigorous physical activity (MVPA) and steps/day were defined. Homocysteine and related laboratory biomarkers (vitamin B12, folate, pyridoxal 5'-phosphate) were assessed through blood draws. Data assembly was performed using SAS and analysis via SPSS Complex Samples.

RESULTS

Only an estimated 17.7 ± 4.7% of women met guidelines to achieve at least 150 min per week of MVPA. Plasma homocysteine was not different between pregnant women with high and low levels of moderate-to-vigorous physical activity (4.39 ± 0.21 and 4.44 ± 0.17 µmol/L; p > .05) or between those with high and low levels of steps (3.95 ± 0.26 and 4.62 ± 0.27 µmol/L; p > .05) when the data was split into two quantiles by the median. These results were similar when using log-transformed values for homocysteine to normalize the distribution of data. Pregnant women in the group of the high steps tended to have higher vitamin B12, folate, and pyridoxal 5'-phosphate than those in the group of the low steps. Sensitivity analyses revealed that homocysteine was not different between the upper 25% (4.04 ± 0.22 µmol/L) and lower 25% (4.17 ± 0.26 µmol/L) MVPA (p = .716) but that it was statistically higher in the low (<5000 steps/day) (4.99 ± 0.20 µmol/L) steps/day group compared to high (>7500 steps/day) steps/day (3.99 ± 0.23 µmol/L) (p = .003) after excluding individuals with hypertension and thyroid/kidney issues.

CONCLUSION

Maternal steps/day, but not MVPA, appear to be associated with homocysteine (albeit weakly) in the present study after excluding potential factors which impact homocysteine. The volume of physical activity appears to be an important indicator as this difference was not revealed until the physical activity was more distinctly separated.

The effect of physical activity on total homocysteine concentrations and cardiovascular risk in older Brazilian adults with type 2 diabetes

A low level of physical activity has a potential association with high levels of homocysteine, which implies an increased chance of older adults with type 2 diabetes mellitus developing cardiovascular disease (CVD). However, the effects of physical activity on homocysteine levels have been poorly explored in the literature. Therefore, this study compared homocysteine levels and cardiovascular risk among physically active and inactive older women with type 2 diabetes mellitus. Fifty-nine women with type 2 diabetes mellitus, between 60 and 91 years old, were evaluated. The level of physical activity was assessed using the International Physical Activity Questionnaire (IPAQ) long version to identify active and inactive older women. Blood samples were collected and anthropometric, body composition, and blood pressure measurements were performed to determine homocysteine levels and cardiovascular risk. The results demonstrated that active older women with type 2 diabetes mellitus have lower homocysteine values (F = 17.79, p < 0.001, ηp² = 0.238), cardiovascular risk scores (F = 15.84, p = p < 0.001, ηp² = 0.217), and waist circumferences (F = 2.95, p = 0.013, ηp² = 0.049) when compared with inactive older women. It was concluded that there was a difference in the levels of homocysteine, cardiovascular risk, and waist circumference between active and inactive older women with type 2 diabetes. Active older women are less likely to have cardiovascular risk than inactive older women.

Exercise during pregnancy mitigates the adverse effects of maternal obesity on adult male offspring vascular function and alters one-carbon metabolism

Maternal obesity during pregnancy can adversely affect adult offspring vascular endothelial function. This study examined whether maternal exercise during pregnancy and lactation mitigates the adverse effects of maternal obesity on offspring vascular endothelial function. Female (C57BL/6N) mice were fed from weaning a control diet (10% kcal fat) or western diet (45% kcal fat) to induce excess adiposity (maternal obesity). After 13 weeks, the female mice were bred and maintained on the diets, with and without access to a running wheel (exercise), throughout breeding, pregnancy, and lactation. Offspring were weaned onto the control or western diet and fed for 13 weeks; male offspring were studied. Maternal exercise prevented the adverse effects of maternal obesity on offspring vascular endothelial function. However, this was dependent on offspring diet and the positive effect of maternal exercise was only observed in offspring fed the western diet. This was accompanied by alterations in aorta and liver one-carbon metabolism, suggesting a role for these pathways in the improved endothelial function observed in the offspring. Obesity and exercise had no effect on endothelial function in the dams but did affect aorta and liver one-carbon metabolism, suggesting the phenotype observed in the offspring may be due to obesity and exercise-induced changes in one-carbon metabolism in the dams. Our findings demonstrate that maternal exercise prevented vascular dysfunction in male offspring from obese dams and is associated with alterations in one-carbon metabolism.

Rehydration during exercise prevents the increase of homocysteine concentrations

This study aimed to assess the effect of rehydration during and after acute aerobic submaximal exercise on total homocysteine (tHcy) concentrations and related parameters in physically active adult males. Twenty trained males (29.4 ± 7.9 years old) completed four exercise tests: two without rehydration during exercise (NH1 and NH2), one with rehydration during exercise using water (H1) and one with rehydration during exercise using an isotonic sports drink (H2). After finishing the exercise tests, subjects followed a rehydration protocol for 2 h. Serum tHcy, vitamin B12, folate, creatine and creatinine were analysed before, after and at 2, 6 and 24 h after exercise. Data were analysed with and without correcting for haemoconcentration to assess the changes in tHcy related. The methylenetetrahydrofolate reductase (MTHFR) 677TT genotype was also analysed. THcy (uncorrected by haemoconcentration) increased significantly after exercise (P < 0.05) in the NH1 and NH2 tests [mean increase ± SD: 1.55 ± 0.33 (15.18%) and 1.76 ± 0.25 (17.69%) µmol/L, respectively], while no significant differences were found in the H1 and H2 tests [mean increase: 0.65 (6.29%) and 0.90 (8.69%) μmol/L, respectively]. The increase was partly due to haemoconcentration and partly due to the metabolism underlying acute exercise. THcy concentrations recovered to baseline after 24 h in all tests. In conclusion, adequate rehydration during acute aerobic exercise using either water or a sports drink maintains tHcy concentrations at baseline and for up to 2 h after exercise in physically active male adults and prevents further increases when compared to no rehydration.

What do we know about homocysteine and exercise? A review from the literature

High total homocysteine (tHcy) concentrations contribute to an increased risk of cardiovascular diseases and neurodegenerative disorders. Several investigations have focused on the effect of exercise on tHcy concentrations, but results remain controversial. The differences among the methodologies in the investigations make difficult the interpretation of results. This review differentiates the effects of exercise on tHcy and establishes the relation with the implicated biomarkers on tHcy metabolism related to exercise. The electronic database MEDLINE (http://www.ncbi.nlm.nih.gov) was used for searching studies published between years 2002 and 2015. 'Homocysteine', 'Training ', 'Exercise', 'Physical Activity' as well as combinations out of these terms were entered in the database. Articles were grouped in: 1) Acute effect of exercise on tHcy, 2) chronic exercise and tHcy, 3) relationship of physical activity (PA) level and cardiorespiratory fitness with tHcy, and 4) biomarkers related to tHcy and exercise. From a total of 30 articles, most of the studies analyzing the acute effect of exercise showed an increase on tHcy concentrations. Studies analyzing the chronic effect on tHcy concentrations showed contradictory results and no consensus exists probably due to the differences in the methodology, exercise interventions and participants characteristics. Low cardiorespiratory fitness seems to be associated with high tHcy; in contrast, the relation of PA levels and tHcy needs further research. Regarding biomarkers related to tHcy and exercise, some studies showed an increase of folate, vitamin B12, and creatine after acute exercise that could to be due to requirement of protein turnover and an increased metabolic demand of vitamin-B.

Effect of physical activity on levels of homocysteine, folate, and vitamin B12 in the elderly

OBJECTIVES

Homocysteine (Hcy) has emerged as a risk factor for cardiovascular diseases (CVD). However the relationship of physical activity (PA) with Hcy levels in the elderly is controversial. Accordingly, the current study examined the effect of low and high participation in PA on serum Hcy in young (n = 77; 18-50 years) and old (n = 207; > 65 years) males (n = 141) and females (n = 142).

METHODS

Level of PA was obtained in a 1-to-1 interview and participants divided into low and high groups. Serum Hcy, folate, and vitamin B12 were obtained after 12 hour fast drawn by venipuncture.

RESULTS

Levels of Hcy correlated with folate (r = -0. 5; p = 0.000) and vitamin B12 (r = -0.3; p = 0.000). The ANOVA revealed a main effect of PA for Hcy (p = 0.04) but not for folate (p = 0.2) and vitamin B12 (p = 0.2). Main effects were found also of age for Hcy (p = 0.000) and folate (p = 0.005) as well as of gender for Hcy (p = 0.000) and vitamin B12 (p = 0.000). Subsequent ANCOVA showed lower levels of Hcy in the participants with greater versus lower PA even after controlling for B12 vitamin.

CONCLUSION

These results confirm the importance of the vitamins for regulating Hcy levels. Additionally, the data suggests that PA affects Hcy levels without affecting and independent of B vitamins in the elderly.

The effect of the MTHFR C677T mutation on athletic performance and the homocysteine level of soccer players and sedentary individuals

This study investigated athletic performance and homocysteine (Hcy) levels in relation to the methylenetetrahydrofolate reductase (MTHFR) C677T mutation and explored the relationship between this mutation and other cardiac risk factors in soccer players and sedentary individuals. The study groups consisted of randomly selected soccer players (n=48) from the Turkish Super and Major League and sedentary male students (n=48) aged 18-27. Anthropometric variables, aerobic and anaerobic thresholds were measured, furthermore, biochemical assays were performed. The level of HDL cholesterol, LDL cholesterol, triglyceride, Hcy, folate, vitamin B12, hemogram and MTHFR C677T was investigated. The results showed that there was a statistical difference between the two groups in terms of body mass, body fat, the BMI, the aerobic threshold heart rate (ATHR), aerobic threshold velocity (ATVL) and anaerobic threshold velocity (ANTVL). The soccer players were found to have lower levels of triglyceride, total cholesterol and LDL cholesterol, and higher levels of folate than the sedentary participants. The analysis of the alleles of the MTHFR C677T polymorphism showed that the participants that carried TT genotypes had a lower level of vitamin B12 and folate, and a higher level of Hcy than the participants carrying CC and CT genotypes. In conclusion, the baseline homocysteine and cardiovascular fitness levels of healthy young males with the TT genotypes of the MTHFR C677T genotype were found to strongly correlate with their levels of Hcy.

Single and combined associations of accelerometer-assessed physical activity and muscle-strengthening activities on plasma homocysteine in a national sample

BACKGROUND

Aerobic exercise and resistance training (RT) are individually associated with positive health outcomes. It has been shown that combining both aerobic and RT exercise may produce greater outcomes than each type alone. Homocysteine has been shown to decrease with aerobic and RT exercise. However, no study has examined the combined effects of both types on homocysteine, which was the purpose of this study.

METHODS

Data from the 2003-2006 NHANES were used. Homocysteine values were obtained from a blood sample. Accelerometer-derived physical activity (PA) was measured using accelerometry, and MSA was measured via a questionnaire.

RESULTS

Meeting the recommendations for accelerometer-derived PA was associated with lower homocysteine (β_adjusted  = -0·29; P = 0·04), as was meeting the recommendations for MSA (β_adjusted  = -0·30; P = 0·028). Compared to those meeting zero recommendations, there was no difference between those meeting 1 and those meeting both (P = 0·08). Further, higher homocysteine was linked with increased all-cause mortality (HR = 1·47; 95% CI: 1·29-1·69) and CVD-specific mortality (HR = 1·48; 95% CI: 1·20-1·81).

CONCLUSION

These results suggest that PA and MSA are associated with lower homocysteine and that there may be a dose-response relationship when combining both forms of exercise, which is an important finding as higher homocysteine is predictive of increased all-cause and CVD-specific mortality.

Independent beneficial effects of aged garlic extract intake with regular exercise on cardiovascular risk in postmenopausal women

The purpose of the study was to assess the effects of a 12 weeks aged garlic extract (AGE) regimen with regular exercise on cardiovascular disease (CVD) risk in postmenopausal women. A total of 30 postmenopausal women (54.4 ± 5.4 years) were randomly divided into the following four groups: Placebo (Placebo; n = 6), AGE intake (AGEI; n = 8), exercise and placebo (Ex + Placebo; n = 8), exercise and AGE (Ex + AGE; n = 8) groups. The AGE group consume 80 mg per day, and exercise groups performed moderate exercise (aerobic and resistance) three times per week. After 12 weeks of treatment, body composition, lipid profile, and CVD risk factors were analyzed. Body weight was significantly decreased in AGEI, Ex + Placebo, and Ex + AGE groups compared to baseline. Body fat % was significantly decreased in the AGEI and Ex + Placebo groups. Body mass index (BMI) was significantly decreased in the AGEI, Ex + Placebo, and Ex + AGE groups. Fat-free mass was significantly decreased in the AGEI group. Total cholesterol (TC) was significantly lower in the Ex + Placebo compared to the Placebo group. AGE supplementation or exercise effectively reduced low-density lipoprotein (LDL-C). Triglyceride (TG) was significantly increased in the AGEI group. Malondialdehyde (MDA) levels were significantly decreased in the AGEI, Ex + Placebo, and Ex + AGE compared to the placebo group. AGE supplementation reduced homocysteine levels regardless of whether the women also exercised. The present results suggest that AGE supplementation reduces cardiovascular risk factors independently of exercise in postmenopausal women.

Association of recreational physical activity with homocysteine, folate and lipid markers in young women

We assessed the influence of recreational physical activity in young healthy women on homocysteine, a potential risk factor for cardiovascular disease (CVD). Participants were 124 23-year-old normal-weight Italian recreational athletes (performing 8.7 +/- 2.46 h week(-1) exercise) and 116 controls. Median blood homocysteine, folate and lipid markers did not differ between athletes and controls. Elevated homocysteine levels at CVD risk > or =12.0 and > or =15.0 micromol l(-1) were not different between groups. Continuous homocysteine was inversely related to folate (P < 0.001), positively associated with age (P = 0.009) and creatinine (P = 0.033), but not associated with hours of exercise, body mass index, and lipid markers. Women with folate depletion (<3.0 microg l(-1)) were 4.5-fold more likely to have homocysteine > or =15.0 micromol l(-1). Recreational physical exercise does not adversely impact homocysteine levels among young women. Only low folate significantly increases the risk for hyperhomocysteinemia in young women.