Chronicle of the Institute of Medicine physical activity recommendation: how a physical activity recommendation came to be among dietary recommendations

The association between osteoporosis and quality of life among older adults in Southern Iran: findings from the Bushehr Elderly Health Program

BACKGROUND & OBJECTIVE

Osteoporosis is a growing public health concern, particularly among the aging population. This study aimed to evaluate the association between osteoporosis and quality of life (QoL) in a sample of older adults.

METHODS

This cross-sectional study utilized data from all the participants of Bushehr Elderly Health program (BEHP), phase 2. QoL was assessed using the 12-Item Short Form Survey (SF-12 Questionnaire), and participants were classified as having osteoporosis or not based on the WHO diagnostic criteria. The physical (PCS) and mental (MCS) component summaries of QoL were estimated. The association between osteoporosis and QoL was evaluated separately for men and women, considering various health and lifestyle factors using linear regression analysis.

RESULTS

The study included 2,399 participants (average age 71.27 ± 7.36 years). 1,246 were women and 1,153 were men. Osteoporosis was present in 59% of women and 23% of men. Participants with osteoporosis had significantly lower PCS scores compared to those without osteoporosis (women: 38.1 vs. 40.2, p < 0.001; men: 44.3 vs. 45.8, p: 0.002). However, there was no statistically significant difference in MCS scores. Stratified by sex, osteoporosis was significantly associated with PCS in women [β = -2.14 (-3.13, -1.15)] and men [β = -1.53 (-2.52, -0.54)]. After accounting for relevant variables, the association remained significant in women [β=-0.95 (-1.87, -0.03)], but not in men [β=-0.63 (-1.55,0.28)].

CONCLUSION

This study highlights the significant association between osteoporosis and the physical component of QoL in both older men and women, particularly among women. Further research and interventions focusing on enhancing physical QoL in individuals with osteoporosis are warranted to promote healthier aging.

Calorie restriction-induced leptin reduction and T-lymphocyte activation in blood and adipose tissue in men with overweight and obesity

BACKGROUND

T-Lymphocyte activation is modulated by the adipokine leptin and serum concentrations of this hormone can be reduced with short-term calorie restriction. The aim of this study was to understand whether leptin per se is important in determining levels of T-lymphocyte activation in humans, by investigating whether the reduction in leptin concentration following calorie restriction is associated with a decrease in T-Lymphocyte activation in blood and adipose tissue.

METHODS

Twelve men with overweight and obesity (age 35-55 years, waist circumference 95-115 cm) reduced their calorie intake by 50% for 3 consecutive days. Blood and subcutaneous adipose tissue were obtained for isolation of immune cells and cytokine analysis. CD4+ and CD8 + T-Lymphocytes were identified and characterised according to their expression of activation markers CD25 and CD69 by flow cytometry.

RESULTS

Serum leptin was reduced by (mean ± SEM) 31 ± 16% (p < 0.001) following calorie restriction. The percentage of blood CD4 + CD25 + T-lymphocytes and level of CD25 expression on these lymphocytes were significantly reduced by 8 ± 10% (p = 0.016) and 8 ± 4% (p = 0.058), respectively. After calorie restriction, ex vivo leptin secretion from abdominal subcutaneous adipose tissue explants was not changed, and this corresponded with a lack of change in adipose tissue resident T-Lymphocyte activation.

CONCLUSIONS

Serum leptin was reduced after calorie restriction and this was temporally associated with a reduction in activation of blood CD4 + CD25 + T-Lymphocytes. In abdominal subcutaneous adipose tissue, however, leptin secretion was unaltered, and there were no observed changes in adipose resident T-Lymphocyte activation.

The association of osteoporosis and cardiovascular disease risk score based on the Framingham and ACC/AHA risk prediction models: a cross-sectional analysis of Bushehr Elderly Health Program

Background

The association between osteoporosis and cardiovascular disease, two major health problems, has been reported in some studies. In this study was aimed to investigate the relationship between osteoporosis and the CVD risk score based on Framingham and American College of Cardiology and the American Heart Association (ACC/AHA) prediction models in the population over 60 years old.

Methods

A cross-sectional analysis was conducted on data from 2389 men and women participating in the Bushehr Elderly Health (BEH) program. Osteoporosis was defended as T-score ≤  - 2.5 at any site (total hip, femoral neck and lumbar spine (L1-L4). Based on Framingham and ACC/AHA risk scores, participants were categorized as non-high risk (< 20%) or high-risk (≥ 20%). Logistic regression model, was applied to investigate the relationship between osteoporosis and cardiovascular disease risk scores. All comparisons were stratified by sex.

Results

Considering the cut point of ≥ 20% for CVD risk, 36.7% of women and 66.2% of men were categorized as having high risk of CVD in ACC/AHA model. These values in women and men based on the Framingham model were 30% and 35.7%, respectively. In general, there was a negative significant correlation between BMD in the femoral neck, total hip and TBS except for the spine with the CVD risk score in both models. After adjusting for confounding variables, a significant positive association was observed between osteoporosis only at femoral neck with CVD risk score ≥ 20% based on ACC/AHA in both genders.

Conclusion

The ACC/AHA model is effective in identifying the CVD risk difference between individuals with and without osteoporosis.

Sources and determinants of free sugars intake by 5-year-old Australian children in the SMILE cohort

Reducing free sugars intake is important for the prevention of dental caries and obesity in children. The study aimed to determine the amount and sources of free sugars known to contribute to dental caries, and identify sociodemographic determinants of intake by children aged 5 years in Australia. Cross-sectional analysis of dietary data from a cohort study, collected using a customized food frequency questionnaire were used to calculate free sugars intake as grams/day and percentage contribution to Estimated Energy Requirement (EER). The percent contribution of food sources to free sugars intake was derived. Sociodemographic determinants of achieving intakes within WHO thresholds (i.e., <5% and <10% Energy were explored with multinomial logistic regression. Complete data were available for 641 children (347 boys, 294 girls). Median (IQR) free sugars intake (g/day) was 31.6 (21.3-47.6) in boys and 28.1 (19.6-47.9) in girls. The median (IQR) percentage contribution to EER was 7.9 (5.4-12.7); 21% and 42% of children had intakes <5% EER and between 5% and <10%, respectively. The main sources of free sugars were: (1) Cakes, Biscuits and Cereal Bars; (2) Sweetened Milk Products (predominantly yoghurts) and (3) Desserts. Maternal university education, single-parent household, and maternal place of birth being Australia or New Zealand were associated with free sugars intake <5% EER. In conclusion, less than a quarter of 5-year-old children in the SMILE cohort achieved the WHO recommendations to limit free sugars to <5% EER. Strategies to lower free sugars intake could target priority populations such migrants, populations with lower levels of education or health literacy and identify areas for intervention in the wider food environments that children are exposed to.

The association between quality of life and diabetes: the Bushehr Elderly Health Program

BACKGROUND AND OBJECTIVE

Considering the importance of diabetes and its increased prevalence with aging, this study aimed to evaluate the association between diabetes status and quality of life (QOL) and the determining factors in individuals over 60.

METHODS

Two thousand three hundred seventy-five individuals including 819 (34.5%) with diabetes, aged 69.4 ± 6.4, from Bushehr Elderly Health Program (BEHP) were enrolled. We categorized the participants as non-diabetic, controlled diabetic, and poorly controlled diabetic. The QOL was assessed using the SF-12 questionnaire. The physical (PCS) and mental (MCS) component summaries of QOL were estimated. We compared the SF-12 domains and components between the categories using ANOVA. Further, the association of diabetes status with PCS and MCS was assessed after adjustment for possible confounders including age, sex, depression, cognitive impairment, physical activity, and other relevant factors using linear regression analysis.

RESULTS

Individuals with diabetes had lower PCS (40.9 ± 8.8 vs. 42.7 ± 8.6, p-value < 0.001), and MCS scores (45.0 ± 10.2 vs. 46.4 ± 9.4, p-value < 0.001) compared to participants without diabetes. No significant differences were observed in PCS or MCS scores between controlled or poorly controlled individuals with diabetes. Diabetes status was associated with PCS and MCS scores in univariable analysis. Regarding physical component of QOL, after adjusting for other confounders, poorly controlled diabetes was significantly associated with PCS [beta: -1.27 (-2.02, -0.52)]; some other determinants include depression [-7.66 (-8.51, -6.80)], male sex [3.90 (3.24,4.57)], and good physical activity [1.87 (1.17,2.57)]. As for the mental component, controlled diabetes was significantly associated with MCS [-1.17 (-2.13, -0.22)]; other contributing factors include depression [-14.35 (-15.34, -13.37)], male sex [1.97 (1.20,2.73)], good physical activity [-1.55 (-2.35, -0.75)], and smoking [-1.42 (-2.24, -0.59)]. BMI had an inverse association with PCS [-0.19 (-0.26, -0.13)] and a direct association with MCS [0.14 (0.07,0.21)].

CONCLUSION

Individuals with diabetes exhibited reduced QOL scores. Upon adjusting for other variables, it was found that uncontrolled diabetes correlated with decreased PCS scores, whereas controlled diabetes was linked to lower MCS scores. Factors such as depression and being female were identified as contributors to diminished QOL in both physical and mental aspects. These results have the potential to guide healthcare decision-making, facilitating the creation of tailored interventions aimed at improving the QOL for individuals with diabetes, with a specific focus on women and depression.

Prevalence of osteosarcopenic obesity and related factors among Iranian older people: Bushehr Elderly Health (BEH) program

Osteosarcopenic obesity is a new syndrome that has been recently discussed in the scientific community. It is a condition that affects the elderly and involves the loss of bone, muscle, and fat tissue. The few studies that have been done on this disease showed that it has a high prevalence among the elderly and can cause various complications. This study was the first one to investigate this syndrome in Iran, and found that its prevalence was 19.83%.

BACKGROUND

Osteosarcopenic obesity syndrome (OSO) is a condition that involves osteopenia/osteoporosis, sarcopenia, and obesity. It leads to a reduction in the quality of life of the elderly and an increase in hospitalization which has attracted the attention of physicians. This study aimed to determine the prevalence and risk factors of osteosarcopenic obesity in people over 60 years of age in Bushehr.

MATERIALS AND METHODS

We used data from the Bushehr study, which included 2426 participants aged ≥ 60 years. We assessed osteoporosis/osteopenia based on T-score; sarcopenia based on hand grip strength, skeletal muscle mass index (SMI), and walking speed; and obesity based on fat mass and BMI for diagnosing OSO. We first examined the factors related to OSO in the univariable analysis and then fitted the multiple logistic regression model, separately for women and men. The result was summarized as adjusted odds ratios with a 95% confidence interval.

RESULTS

In total, 2339 elderly were examined in our study, of which 464 elderly were suffering from osteosarcopenic obesity. The standardized prevalence of OSO was 23.66% (95% CI: 21.15-26.16) in women and 18.53% (95% CI 16.35-20.87) in men. Age was positively linked to osteosarcopenic obesity in both genders and so was diabetes in men. However, education, physical activity, and protein intake were negatively linked to osteosarcopenic obesity in both genders, as well as hypertriglyceridemia and hypertension in women.

CONCLUSION

The prevalence of OSO among men and women of Bushehr city is high and is related to increasing age, low levels of education, physical activity, and protein intake among women and men.

Extraordinary claims in the literature on high-intensity interval training (HIIT): III. Critical analysis of four foundational arguments from an interdisciplinary lens

Kinesiology aspires to be an integrated, interdisciplinary field that studies human movement from multiple perspectives. However, the main societal deliverables of the field, namely exercise prescriptions and physical activity recommendations, still reflect fragmentation, placing more emphasis on physiological outcomes than on behavioral and other considerations. Recently, researchers have called for the introduction of High-Intensity Interval Training (HIIT) to the domain of public health, based on the argument that HIIT can maximize fitness and health benefits for a fraction of the time recommended by the prevailing model of physical activity in public-health guidelines. Here, we show that an unintended side-effect of arguments underpinning the implementation of HIIT in the domain of public health might have been the exacerbation of segmentation. To highlight the value of interdisciplinarity, four foundational claims in support of HIIT are critiqued by tapping into cognate literatures: (1) the primary reason people do not exercise is lack of time, (2) HIIT is relevant to public health, (3) HIIT is being proposed as merely another option, so there is no basis for controversy, and (4) HIIT is safe and well tolerated. These claims are contradicted by credible lines of evidence. To improve the accuracy and effectiveness of its public claims, kinesiology should remain committed to the ideals of integration and interdisciplinarity.

Development of nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea

BACKGROUND/OBJECTIVES

In times of disaster, simplified and minimized nutritional standards are necessary for a quick response to provide nutritious relief food. This study aimed to develop nutrient-based nutritional standards for foodservice at shelters during disasters in the Republic of Korea (South Korea).

SUBJECTS/METHODS

The standards were developed in 2 phases. First, nutrients to be included in the standards were selected. Initial candidates were selected considering 3 aspects: preceding standards, insufficient intake during disasters, and inadequate intake among South Koreans. Final selection was made by excluding nutrients for 3 reasons: nutrients for which there is no deficiency concern in South Korea, nutrients whose intake data were not available, or nutrients whose values presented by Dietary Reference Intakes for Koreans are difficult to achieve based on the current diet among South Koreans. Second, the reference values of energy and the selected nutrients were calculated. The reference values for the entire population who were 1-year-old and over were calculated by multiplying the estimated energy requirements or the recommended nutrient intake and the proportion of each age and sex group. Respective reference values were also calculated for 4 different age groups (1-5, 6-11, 12-64, and ≥ 65-year-old).

RESULTS

The standards for the entire population were 2,000 kcal for energy, 55 g for protein, 650 µg retinol activity equivalents for vitamin A, 95 mg for vitamin C, 1.1 mg for thiamin, 1.3 mg for riboflavin, 14 mg niacin equivalents for niacin, 350 µg dietary folate equivalents for folic acid, 750 mg for calcium, and 11 mg for iron. Four additional standards corresponding to each age group were developed.

CONCLUSIONS

The nutritional standards during disasters were developed for South Korea, including energy and 9 nutrients with reference values for the entire population and 4 different age groups. The standards will contribute to maintaining the health of disaster evacuees in South Korea.

Associations between digital gaming behavior and physical activity among Finnish vocational students

Abstract

Digital gaming is considered to be a major sedentary lifestyle among youth. The time spent on digital gaming may also affect the physical behavior of young adults.

Objective

This study aimed to investigate the associations between various characteristics of digital gaming behavior (i.e., gaming time, device, and game type) and participation in physical activity among Finnish vocational students.

Materials and methods

The research employed a cross-sectional survey design. The analyzed sample consisted of 773 students (455 males, 318 females) from eight vocational school units in Northern Finland who regularly played digital games. Data were collected via an online self-reported questionnaire, which included questions concerning average weekly time spent on digital gaming, preferred device, favorite types of games, and physical activity.

Results

The students spent an average of two hours each day playing digital games. Males preferred to play using personal computers (PCs), whereas mobile gaming was more popular among females. Shooter (42.4%) and entertainment (64.2%) games were the most popular game types among males and females, respectively. The results revealed that male gender and PC gaming were both positively related to physical inactivity among vocational school students. A preference toward sport games was inversely related with physical inactivity.

Conclusion

The presented findings can be utilized to develop interventions that target the prevention of sedentary behavior among vocational students. Further longitudinal studies will be required to reliably assess the relationship between digital gaming and physical activity.

Non-exercise activity thermogenesis in the workplace: The office is on fire

From the second half of the previous century, there has been a shift toward occupations largely composed of desk-based behaviors. This, inevitably, has led to a workload reduction and a consequent lower energy expenditure. On this point, small increments of the non-exercise activity thermogenesis (NEAT) could be the rationale to reach health benefits over a prolonged period. Different published researches suggest solutions to reverse sitting time and new alternative workstations have been thought to increase total physical activity. Therefore, the purpose of this narrative review is to summarize the current state of the research regarding the "NEAT approach" to weight-gain prevention in work environments. This review analyzes the main evidence regarding new alternative workstations such as standing, walking workstations, seated pedal, and gymnastic balls to replace a standard office chair.

Determining total energy expenditure in 3–6-year-old Japanese pre-school children using the doubly labeled water method

The doubly labeled water (DLW, 2H218O) method for calculating the total production of CO2 over several days is currently considered to be the most accurate technique for the measurement of total energy expenditure (TEE), and the results obtained using this method have been used to review energy requirements. Presently, there is limited data available on TEE in Japanese children. The objective of this study was to assess the TEE in pre-school Japanese children using the DLW method. We used a cross-sectional population of 140 children (69 boys and 71 girls) aged 3–6 years. TEE was measured using the DLW method over 8 days under free-living conditions. The average weights (kg) of the boys and girls were 15.6 ± 2.5 and 15.0 ± 2.1 for the 3–4 years old and 19.8 ± 3.8 and 19.6 ± 2.7 for the 5–6 years old, respectively. The corresponding TEE (kcal/day) was 1260.9 ± 357.8 and 1265.2 ± 408.0, and 1682.3 ± 489.0 and 1693.1 ± 473.3, respectively, showing a significant difference with respect to age. Furthermore, TEE per body weight (kcal/kg/day) was 83.2 ± 29.2 and 84.9 ± 26.6, and 85.4 ± 23.2 and 86.7 ± 22.6, respectively. However, when TEE was adjusted for body weight or fat-free mass, there were no age or sex differences. We conclude that in Japanese children, TEE in those aged 3–4 years was similar to the current Ministry of Health recommendations. However, TEE in children aged 5–6 years was slightly higher than the recommendations. Based on these findings, the present results obtained from a large number of participants will provide valuable reference data for Japanese children.

Association of amino acid metabolites with osteoporosis, a metabolomic approach: Bushehr elderly health program

INTRODUCTION AND OBJECTIVES

Amino acids are the most frequently reported metabolites associated with low bone mineral density (BMD) in metabolomics studies. We aimed to evaluate the association between amino acid metabolic profile and bone indices in the elderly population.

METHODS

400 individuals were randomly selected from 2384 elderly men and women over 60 years participating in the second stage of the Bushehr elderly health (BEH) program, a population-based prospective cohort study that is being conducted in Bushehr, a southern province of Iran. Frozen plasma samples were used to measure 29 amino acid and derivatives metabolites using the UPLC-MS/MS-based targeted metabolomics platform. We conducted Elastic net regression analysis to detect the metabolites associated with BMD of different sites and lumbar spine trabecular bone score, and also to examine the ability of the measured metabolites to differentiate osteoporosis.

RESULTS

We adjusted the analysis for possible confounders (age, BMI, diabetes, smoking, physical activity, vitamin D level, and sex). Valine, leucine, isoleucine, and alanine in women and tryptophan in men were the most important amino acids inversely associated with osteoporosis (OR range from 0.77 to 0.89). Sarcosine, followed by tyrosine, asparagine, alpha aminobutyric acid, and ADMA in women and glutamine in men and when both women and men were considered together were the most discriminating amino acids detected in individuals with osteoporosis (OR range from 1.15 to 1.31).

CONCLUSION

We found several amino acid metabolites associated with possible bone status in elderly individuals. Further studies are required to evaluate the utility of these metabolites as clinical biomarkers for osteoporosis prediction and their effect on bone health as dietary supplements.

Impact of the COVID-19 pandemic on the physical and psychological health of female college students in Japan

The spread of COVID‐19 has dramatically changed our lives. This study aimed to examine the lifestyles of female college students, focusing on physical activity, sleep status, and anxiety status during the pandemic (a state of emergency) in Japan. 184 female college students completed two questionnaires, anthropometric measurements, and daily activity log and diet record: 115 and 69 participants before and during the pandemic, respectively. Findings showed a significant decrease in physical activity: physical activity levels fell from “normal” to “low” and the daily step counts decreased by half, from 8671 to 4640. In addition, the results from the questionnaires revealed that half of the participants were at risk of having sleep disturbances, and their cycles became more nocturnal, which may have caused higher anxiety states and lower sleep quality during the pandemic. In addition, anxiety states worsened, with 100% of the participants experiencing high anxiety during the pandemic. Monitoring lifestyle disturbances during the pandemic is needed for the development of interventions to improve health among young women.

Factors associated with TBS worse than BMD in non-osteoporotic elderly population: Bushehr elderly health program

BACKGROUND

Bone mineral density (BMD) and trabecular bone score (TBS) are moderately correlated. TBS is sometimes used as an adjuvant to BMD in the fracture risk assessment. Some individuals with normal BMD or osteopenia, have more degraded TBS. We aimed to identify factors associated with TBS worse than BMD in the non-osteoporotic elderly population.

METHODS

The study subjects were selected from 2384 women and men aged ≥60 years participating in the second stage of the Bushehr Elderly Health program, a population-based prospective cohort study in Iran. The BMDs of different sites and the lumbar spine texture were measured using dual-energy X-ray absorptiometry and the TBS algorithm, respectively. Subjects were categorized based on their BMD and TBS status. Logistic regression was performed to identify the factors associated with "TBS worse than BMD" in non-osteoporotic individuals.

RESULTS

Of 1335 participants included in the study, 112 of 457 women, and 54 of 878 men had worse TBS than BMD. In multivariable analysis, TBS worse than BMD in women was statistically significantly associated with years since menopause (OR: 1.04 (1.00-1.07)) and waist circumference (OR: 1.09 (1.05-1.14)). However, in men, the condition was statistically significantly associated with waist circumference (OR: 1.10 (1.03-1.17)), current smoking (OR: 2.54 (1.10-5.84)), and HDL-C (OR: 1.03 (1.00-1.06)).

CONCLUSION

The results of the study show that higher waist circumference is associated with more degraded TBS than BMD in both men and women. Years passed since menopause and current smoking, respectively in women and men, were associated with more degraded TBS. Considering TBS values in older individuals with higher waist circumference, or a history of smoking despite normal BMDs might help more accurate assessment of bone health. However, further studies are required to confirm the benefit.

The effect of different methods to identify, and scenarios used to address energy intake misestimation on dietary patterns derived by cluster analysis

BACKGROUND

All self-reported dietary intake data are characterized by measurement error, and validation studies indicate that the estimation of energy intake (EI) is particularly affected.

METHODS

Using self-reported food frequency and physical activity data from Alberta's Tomorrow Project participants (n = 9847 men 16,241 women), we compared the revised-Goldberg and the predicted total energy expenditure methods in their ability to identify misreporters of EI. We also compared dietary patterns derived by k-means clustering under different scenarios where misreporters are included in the cluster analysis (Inclusion); excluded prior to completing the cluster analysis (ExBefore); excluded after completing the cluster analysis (ExAfter); and finally, excluded before the cluster analysis but added to the ExBefore cluster solution using the nearest neighbor method (InclusionNN).

RESULTS

The predicted total energy expenditure method identified a significantly higher proportion of participants as EI misreporters compared to the revised-Goldberg method (50% vs. 47%, p < 0.0001). k-means cluster analysis identified 3 dietary patterns: Healthy, Meats/Pizza and Sweets/Dairy. Among both men and women, participants assigned to dietary patterns changed substantially between ExBefore and ExAfter and also between the Inclusion and InclusionNN scenarios (Hubert and Arabie's adjusted Rand Index, Kappa and Cramer's V statistics < 0.8).

CONCLUSIONS

Different scenarios used to account for EI misreporters influenced cluster analysis and hence the composition of the dietary patterns. Continued efforts are needed to explore and validate methods and their ability to identify and mitigate the impact of EI misestimation in nutritional epidemiology.

Divergent immunometabolic changes in adipose tissue and skeletal muscle with ageing in healthy humans

KEY POINTS

Ageing is associated with increased systemic inflammation and metabolic dysfunction that contributes to the development of age-associated diseases. The role of adipose tissue in immunometabolic alterations that take place with ageing is unknown in humans. We show, in healthy, active and lean older adults, that adipose tissue, but not skeletal muscle, displays considerable pro-inflammatory transcriptomic, cellular and secretory changes, as well as a reduction in insulin signalling proteins compared to younger adults. These findings indicate that adipose tissue undergoes substantial immunometabolic alterations with ageing, and that these changes are tissue-specific and more profound than those observed in skeletal muscle or in the circulation. These results identify adipose tissue as an important tissue in the biological ageing process in humans, which may exhibit signs of immunometabolic dysfunction prior to systemic manifestation.

ABSTRACT

Ageing and obesity are both characterized by inflammation and a deterioration in metabolic health. It is now clear that adipose tissue plays a major role in inflammation and metabolic control in obesity, although little is known about the role of adipose tissue in human ageing. To understand how ageing impacts adipose tissue, we characterized subcutaneous adipose tissue and skeletal muscle samples from twelve younger (27 ± 4 years [Young]) and twelve older (66 ± 5 years [Old]) active/non-obese males. We performed a wide-range of whole-body and tissue measures, including RNA-sequencing and multicolour flow cytometry. We also measured a range of inflammatory and metabolic proteins in the circulation and their release by adipose tissue, ex vivo. Both adipose tissue and muscle had ∼2-fold more immune cells per gram of tissue with ageing. In adipose tissue, this immune cell infiltration was driven by increased memory/effector T-cells, whereas, in muscle, the accumulation was driven by memory/effector T-cells and macrophages. Transcriptomic analysis revealed that, with ageing, adipose tissue, but not muscle, was enriched for inflammatory transcripts/pathways related to acquired and innate immunity. Ageing also increased the adipose tissue pro-inflammatory secretory profile. Insulin signalling protein content was reduced in adipose tissue, but not muscle. Our findings indicate that adipose tissue undergoes substantial immunometabolic changes with ageing in humans, and that these changes are tissue-specific and more profound than those observed in the circulation and skeletal muscle.

Total energy expenditure among children with motor, intellectual, visual, and hearing disabilities: a doubly labeled water method

OBJECTIVE

Few studies have evaluated the total energy expenditure (TEE) of children with disabilities using the doubly labeled water (DLW) method; however, none have compared it by disability type. Furthermore, no large-scale studies have focused on the severity of motor disability (MD). We aimed to compare TEE in children with disabilities by disability type.

METHODS

In a cross-sectional study design, TEE was measured using the DLW method, anthropometry, and weighted food records. The following comparisons were made: (1) TEEs among four disability types and (2) TEEs of three subgroups classified by MD based on the Gross Motor Function Classification System (GMFCS).

RESULTS

In total, 256 children (138 boys; ages 6-15 years) were studied. The comparison between the four disability types for boys in all age categories revealed that TEE (kJ/d) was lowest in MD, followed by intellectual disability (ID), visual disability, and hearing disability (HD), in that order. TEE/fat-free mass (FFM) (kJ/FFMkg/d) was also lowest in MD and highest in HD. TEE (kJ/d) and TEE/FFM (kJ/FFMkg/d) were also lowest in MD and highest in HD in girls. For both boys and girls, TEE (kJ/d) and TEE/FFM (kJ/FFMkg/d) were higher in the MD subtype GMFCS I-II than in GMFCS III-IV and GMFCS V.

CONCLUSIONS

TEE differed, depending on the disability type, and was the lowest in MD and highest in HD for both boys and girls. Analysis by GMFCS classification revealed that greater severity of motor dysfunction resulted in lower TEE.

Determinants of Peak Fat Oxidation Rates During Cycling in Healthy Men and Women

This study explored lifestyle and biological determinants of peak fat oxidation (PFO) during cycle ergometry, using duplicate measures to account for day-to-day variation. Seventy-three healthy adults (age range: 19-63 years; peak oxygen consumption [V˙O2peak]: 42.4 [10.1] ml·kg BM-1·min-1; n = 32 women]) completed trials 7-28 days apart that assessed resting metabolic rate, a resting venous blood sample, and PFO by indirect calorimetry during an incremental cycling test. Habitual physical activity (combined heart rate accelerometer) and dietary intake (weighed record) were assessed before the first trial. Body composition was assessed 2-7 days after the second identical trial by dual-energy X-ray absorptiometry scan. Multiple linear regressions were performed to identify determinants of PFO (mean of two cycle tests). A total variance of 79% in absolute PFO (g·min-1) was explained with positive coefficients for V˙O2peak (strongest predictor), FATmax (i.e the % of V˙O2peak that PFO occurred at), and resting fat oxidation rate (g·min-1), and negative coefficients for body fat mass (kg) and habitual physical activity level. When expressed relative to fat-free mass, 64% of variance in PFO was explained: positive coefficients for FATmax (strongest predictor), V˙O2peak, and resting fat oxidation rate, and negative coefficients for male sex and fat mass. This duplicate design revealed that biological and lifestyle factors explain a large proportion of variance in PFO during incremental cycling. After accounting for day-to-day variation in PFO, V˙O2peak and FATmax were strong and consistent predictors of PFO.

Energy Balance Dynamics: Exercise, Appetite, Diet, and Weight Control

Individuals seeking to achieve weight loss are encouraged to achieve a negative energy balance, essentially eat less and move more. The complex relationship between energy expenditure and intake is often overlooked, leaving individuals and practitioners underwhelmed by the results of weight loss efforts. Independently, physical activity and diet interventions can yield modest weight loss and when combined have synergistic effects that promote sustained weight loss. Although physical activity benefits appetite suppression, reduces food rewards, and can be considered a gateway to healthy eating, high levels of daily activity are needed to induce weight loss. Diet is an important component to achieving weight loss, and high-protein diets have the potential for supporting weight loss as well. This column will be focused on the benefits of physical activity in reducing body weight, more specifically, the interdependent relationship between dietary intake and physical activity in achieving weight reduction.

Prevalence of osteoporosis among the elderly population of Iran

In a large population-based study of Iran, the age-standardized prevalence of osteoporosis was 24.6% in men and 62.7% in women aged ≥ 60 years. Osteoporosis was negatively associated with body mass index in both sexes, and with diabetes in men and hypertriglyceridemia in women.

PURPOSE

Population aging has made osteoporosis and osteoporotic fractures an important health problem, especially in developing countries. This study aimed to explore the prevalence of osteoporosis and associated factors among the elderly population of the south-west of Iran.

METHODS

Baseline data of the second stage of the Bushehr Elderly Health program was used. Spinal, total hip, or femoral neck osteoporosis was described as a BMD that lies 2.5 standard deviations or more, below the average values of a young healthy adult in the lumbar spine, total hip, or femoral neck, respectively. Osteoporosis at either site was defined as total osteoporosis. Age-standardized prevalence of osteoporosis was estimated. We used the modified Poisson regression with a robust variance estimator to identify the factors related to osteoporosis, adjusting for potential confounders.

RESULTS

Overall, 2425 individuals (1166 men) aged over 60 years were included. In all, total osteoporosis was detected in 1006 (41.5%) of the participants. Using the reference value derived from Caucasian women aged 20-29 years, the age-standardized prevalence of total osteoporosis was 24.6 (95% CI: 21.9-27.3) in men, and 62.7 (95% CI: 60.0-65.4) in women. In men, osteoporosis was positively associated with age, smoking, history of fracture, and history of renal/liver diseases and negatively associated with body mass index (BMI) and diabetes. BMI, hypertriglyceridemia, and education were negatively correlated with osteoporosis in women, while years after menopause and history of fracture increased the likelihood of osteoporosis, significantly.

CONCLUSION

Results support the high prevalence of osteoporosis and osteopenia in the elderly population. Considering the importance of severe complications, especially fractures, comprehensive interventions should be expanded.

Trajectories of Body Composition during Advanced Aging in Consideration of Diet and Physical Activity: A 20-Year Longitudinal Study

This prospective study investigates age-dependent changes in anthropometric data and body composition over a period of two decades in consideration of physical activity and diet in community-dwelling subjects ≥60 years. Overall, 401 subjects with median follow-up time of 12 years were examined. Fat-free mass (FFM) and fat mass (FM) were analyzed using bioelectrical impedance analysis. Physical activity was assessed via a self-administered questionnaire. Dietary intake was examined by 3-day dietary records. Linear mixed-effects models were used to analyze the influence of age, sex, physical activity and energy/protein intake on anthropometric data and body composition by considering year of entry, use of diuretics and diagnosis of selected diseases. At baseline, median values for daily energy and protein intakes were 8.5 megajoule and 81 g and physical activity index was 1.7. After adjusting for covariates, advancing age was associated with parabolic changes indicating overall changes from age 60 to 90 years in women and men in body mass: −4.7 kg, −5.0 kg; body mass index: +0.04 kg/m², −0.33 kg/m²; absolute FFM: −2.8 kg, −3.5 kg; absolute FM: −1.8 kg, −1.2 kg and waist circumference: +16 cm, +12 cm, respectively. No age-dependent changes were found for upper arm circumference and relative (%) FFM. Dietary and lifestyle factors were not associated with changes in anthropometric or body composition parameters. In summary, the results indicate non-linear age-dependent changes in anthropometric data and body composition, which are largely unaffected by the degree of habitual physical activity and dietary protein intake in well-nourished community-dwelling subjects.

Effect of Fat Mass Localization on Fat Oxidation During Endurance Exercise in Women

Independent of total body fat mass, predominant upper body fat mass distribution is strongly associated with cardio-metabolic comorbidities. However, the mechanisms underlying fat mass localization are not fully understood. Although a large body of evidence indicates sex-specific fat mass distribution, women are still excluded from many physiological studies and their specific features have been investigated only in few studies. Moreover, endurance exercise is an effective strategy for improving fat oxidation, suggesting that regular endurance exercise could contribute to the management of body composition and metabolic health. However, no firm conclusion has been reached on the effect of fat mass localization on fat oxidation during endurance exercise. By analyzing the available literature, this review wants to determine the effect of fat mass localization on fat oxidation rate during endurance exercise in women, and to identify future research directions to advance our knowledge on this topic. Despite a relatively limited level of evidence, the analyzed studies indicate that fat oxidation during endurance exercise is higher in women with lower upper-to-lower-body fat mass ratio than in women with higher upper-to-lower-body fat mass ratio. Interestingly, obesity may blunt the specific effect of upper and lower body fat mass distribution on fat oxidation observed in women with normal weight during endurance exercise. Studying and understanding the physiological responses of women to exercise are essential to develop appropriate physical activity strategies and ultimately to improve the prevention and treatment of cardio-metabolic diseases.

Modulation of cardiac renin-angiotensin system, redox status and inflammatory profile by different volumes of aerobic exercise training in obese rats

Overactivation of the classical arm of the renin-angiotensin (Ang) system (RAS) occurs during inflammation, oxidative stress and obesity-induced cardiomyopathy. The activation of the protective arm of RAS may act to counterbalance the deleterious effects of the classical RAS. Although aerobic exercise training (AET) shifts the balance of the RAS towards the protective arm, little is known about the molecular adaptations to different volumes of AET. The aim of this study was to evaluate the impact of AET volume on the modulation of RAS, as well as on cardiac biomarkers of oxidative stress and inflammation, in a diet-induced obesity model. Male Wistar rats were fed either control (CON) or high fat (HF) diet for 32 weeks. At week 20, HF group was subdivided into sedentary, low (LEV, 150 min/week) or high (HEV, 300 min/week) exercise volume. After 12 weeks of exercise, body mass gain, systolic blood pressure and heart rate were evaluated, as well as RAS, oxidative stress and inflammation in the heart. Body mass gain, systolic blood pressure and heart rate were higher in HF group when compared with SC group. Both trained groups restored systolic blood pressure and heart rate, but only HEV reduced body mass gain. Regarding the cardiac RAS, the HF group exhibited favoring of the classical arm and both trained groups shifted the balance towards the counterregulatory protective arm. The HF group had higher B1R expression and lower B2R expression than the control group, and B2R expression was reverted in both trained groups. The HF group also presented oxidative stress. The LEV and HEV groups improved the cardiac redox status by reducing Nox 2 and nitrotyrosine expression, but only the LEV group was able to increase the antioxidant defense by increasing Nrf2 signaling. While the HF group presented higher TNF-α, IL-6 and NFκB expression, and lower IL-10 expression, than the SC group, both training protocols improved the inflammatory profile. Although both trained groups improved the deleterious changes related to obesity cardiomyopathy, it is clear that the molecular mechanisms differ between them. Our results suggest that different exercise volumes might reach different molecular targets, and this could be a relevant factor when using exercise to manage obesity.

The Precious Few Grams of Glucose During Exercise

As exercise intensity exceeds 65% of maximal oxygen uptake carbohydrate energy sources predominate. However, relative to the meager 4-5 g blood glucose pool size in a postabsorptive individual (0.9-1.0 g·L^-1 × 5 L blood = 18-20 kcal), carbohydrate (CHO) oxidation rates of 20 kcal·min^-1 can be sustained in a healthy and fit person for one hour, if not longer, all the while euglycemia is maintained. While glucose rate of appearance (i.e., production, Ra) from splanchnic sources in a postabsorptive person can rise 2-3 fold during exercise, working muscle and adipose tissue glucose uptake must be restricted while other energy substrates such as glycogen, lactate, and fatty acids are mobilized and utilized. If not for the use of alternative energy substrates hypoglycemia would occur in less than a minute during hard exercise because blood glucose disposal rate (Rd) could easily exceed glucose production (Ra) from hepatic glycogenolysis and gluconeogenesis. The goal of this paper is to present and discuss the integration of physiological, neuroendocrine, circulatory, and biochemical mechanisms necessary for maintenance of euglycemia during sustained hard physical exercise.

The day-to-day reliability of peak fat oxidation and FATMAX

PURPOSE

Prior studies exploring the reliability of peak fat oxidation (PFO) and the intensity that elicits PFO (FATMAX) are often limited by small samples. This study characterised the reliability of PFO and FATMAX in a large cohort of healthy men and women.

METHODS

Ninety-nine adults [49 women; age: 35 (11) years; [Formula: see text]O2peak: 42.2 (10.3) mL·kg BM-1·min-1; mean (SD)] completed two identical exercise tests (7-28 days apart) to determine PFO (g·min-1) and FATMAX (%[Formula: see text]O2peak) by indirect calorimetry. Systematic bias and the absolute and relative reliability of PFO and FATMAX were explored in the whole sample and sub-categories of: cardiorespiratory fitness, biological sex, objectively measured physical activity levels, fat mass index (derived by dual-energy X-ray absorptiometry) and menstrual cycle status.

RESULTS

No systematic bias in PFO or FATMAX was found between exercise tests in the entire sample (- 0.01 g·min-1 and 0%[Formula: see text]O2peak, respectively; p > 0.05). Absolute reliability was poor [within-subject coefficient of variation: 21% and 26%; typical errors: ± 0.06 g·min-1 and × / ÷ 1.26%[Formula: see text]O2peak; 95% limits of agreement: ± 0.17 g·min-1 and × / ÷ 1.90%[Formula: see text]O2peak, respectively), despite high (r = 0.75) and moderate (r = 0.45) relative reliability for PFO and FATMAX, respectively. These findings were consistent across all sub-groups.

CONCLUSION

Repeated assessments are required to more accurately determine PFO and FATMAX.

Effects of head motion on postural stability in healthy young adults with chronic motion sensitivity

Background

Motion sensitivity, or motion sickness, is common in modern vehicular and visually stimulating environments. Several studies have shown a relationship between motion sensitivity and decreased postural stability. We aimed to evaluate the effects of head motion (horizontal and vertical) on postural stability in healthy adults with and without chronic motion sensitivity (CMS).

Methods

Sixty healthy adult men and women (age, 20–40 years) with CMS (CMS group, n = 30) and without CMS (non-CMS group, n = 30) participated in the study. Postural stability was assessed during three conditions (static, horizontal head motion, and vertical head motion) using computerized dynamic posturography. Group and condition-related differences in equilibrium scores were evaluated.

Results

There was no significant group x condition interaction (F_2,114 = 0.9, partial ƞ² = 0.04, p = 0.35). However, significant condition-related differences in equilibrium scores were observed (F_2,114 = 26.4, partial ƞ² = 0.31, p < 0.001). Equilibrium scores were significantly worse in the horizontal and vertical head motion conditions compared to those in the static condition (p < 0.001), but were comparable in vertical and horizontal head motion conditions (p = 0.27).

Conclusions

Postural stability was lower in the horizontal and vertical conditions compared to the static condition. However, horizontal and vertical head motions had comparable effects on postural stability in both CMS and non-CMS groups, contrary to our expectations.

Impact of Recreational Sports Activities on Metabolic Syndrome Components in Adolescents

We investigated the impact of a sports activities program on metabolic syndrome (MetS) components and pre-MetS among adolescents. Blood samples, blood pressure, weight, height, body mass index, waist circumference, body fat percentage, frequency of food consumption, daily time in moderate-to-vigorous physical activity (MVPA), and sedentary behavior (SB) of 92 male adolescents aged 14-18 years (16.07 ± 0.93) were evaluated. From this initial sample, 36 participants (39.1%) were diagnosed with pre-MetS or MetS and were invited to participate in the intervention program. Twelve individuals diagnosed with pre-MetS or MetS agreed to participate in a recreational sports activities program lasting 14 weeks. The pre- and post-sport program comparison showed a reduction in total cholesterol, low-density lipoprotein, and non-high-density lipoprotein (HDL), and an increase in HDL and MVPA time in the intervention group. Sports activities accounted for 42% of the MVPA daily recommendation, and at the end of the intervention period, only seven subjects maintained a positive diagnosis for pre-MetS or MetS. This study showed that recreational sports activities had a significant impact on the lipid profile.

A Mobile-Based Comprehensive Weight Reduction Program for the Workplace (Health-On): Development and Pilot Study

BACKGROUND

There is a growing interest in mobile technology for obesity management. Despite the known effectiveness of workplace-based weight loss programs, there are few studies on mobile phone-delivered interventions.

OBJECTIVE

This study aimed to develop and verify an integrated and personalized mobile technology-based weight control program, named Health-On, optimized for workplaces.

METHODS

A weight reduction algorithm was developed for calorie prescription, continuous monitoring, periodic feedback and reevaluation, goal resetting, and offline intervention with behavior-changing strategies. A total of 30 obese volunteers (body mass index ≥25 kg/m²) participated in the 12-week Health-On pilot program. The primary outcome was weight reduction, and secondary outcomes were improved anthropometric measures, metabolic profiles, and fat computed tomography measures, all assessed pre- and postintervention.

RESULTS

Health-On incorporated proprietary algorithms and several strategies intended to maximize adherence, using compatible online and offline interventions. The mean weight of 30 participants decreased by 5.8%, and median weight also decreased from 81.3 kg (interquartile range [IQR] 77.1-87.8) before intervention to 76.6 kg (IQR 70.8-79.5) after the 12-week intervention period (P<.001). The metabolic profiles and fat measures (blood pressure, glycosylated hemoglobin, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, alanine aminotransferase, and visceral and subcutaneous adipose tissue; P<.05) also improved significantly.

CONCLUSIONS

In this single-group evaluation of 30 participants before and after the Health-On program, body weight decreased and metabolic profiles and fat measures improved. Follow-up studies are needed to assess effectiveness and long-term adherence.

Objectively-measured physical activity patterns and longitudinal weight category status in a rural setting

Objectives

To investigate the relationship between longitudinal weight-change and objectively-measured physical activity (PA) in a rural African setting in 143 adults (≥ 30 years), using data from two cross-sectional surveys, separated by approximately 10 years. Participants were categorised into three weight-change groups (Weight-loss: ≥ 25 kg m⁻²→ < 25 kg m⁻²; Weight-gain: < 25 kg m⁻²→ ≥ 25 kg m⁻²; Weight-stability: remained < 25 kg m⁻² or ≥ 25 kg m⁻²). Daily ambulation and activity energy expenditure (AEE), measured in the 2005–2007 health survey, was examined across the weight-change groups. Using the daily AEE data, the proportion of those in the weight-change groups, meeting or not meeting two PA guidelines (150- and 420 min week⁻¹), was examined.

Results

Weight-change was found in 18.2% of the sample. There was no significant overall body mass change (+ 1.2 kg, p = 0.1616). However, there was significant change in body mass in the weight-gain (+ 15.2 kg) and weight-loss (− 10.8 kg) groups (p ≤ 0.0011). Nearly 90% of those who gained weight met the 150 min week⁻¹ guideline. A significantly greater proportion of the weight-stable group (< 25 kg m⁻²) met the 420 min week⁻¹ guideline (p < 0.05). Ambulatory level was high irrespective of weight group, although the weight-stable group (< 25 kg m⁻²) approached 15,000 steps day⁻¹. There was an inconsistent and weak association between PA and weight-change in this group.

Exercise-induced cardiac opioid system activation attenuates apoptosis pathway in obese rats

AIM

To compare the effect of 150 min vs. 300 min of weekly moderate intensity exercise training on the activation of the opioid system and apoptosis in the hearts of a diet-induced obesity model.

METHODS

Male Wistar rats were fed with either control (CON) or high fat (HF) diet for 32 weeks. At the 20th week, HF group was subdivided into sedentary, low (LEV, 150 min·week^-1) or high (HEV, 300 min·week^-1) exercise volume. After 12 weeks of exercise, body mass gain, adiposity index, systolic blood pressure, cardiac morphometry, apoptosis biomarkers and opioid system expression were evaluated.

RESULTS

Sedentary animals fed with HF presented pathological cardiac hypertrophy and higher body mass gain, systolic blood pressure and adiposity index than control group. Both exercise volumes induced physiological cardiac hypertrophy, restored systolic blood pressure and improved adiposity index, but only 300 min·week^-1 reduced body mass gain. HF group exhibited lower proenkephalin, PI3K, ERK and GSK-3β expression, and greater activated caspase-3 expression than control group. Compared to HF, no changes in the cardiac opioid system were observed in the 150 min·week^-1 of exercise training, while 300 min·week^-1 showed greater proenkephalin, DOR, KOR, MOR, Akt, ERK and GSK-3β expression, and lower activated caspase-3 expression.

CONCLUSION

300 min·week^-1 of exercise training triggered opioid system activation and provided greater cardioprotection against obesity than 150 min·week^-1. Our findings provide translational aspect with clinical relevance about the critical dose of exercise training necessary to reduce cardiovascular risk factors caused by obesity.

Evaluation of lifestyle of female adolescents through latent class analysis approach

BACKGROUND

Lack of regular physical activity, high sedentary behavior and presence of unbalanced alimentary practices are attitudes associated with an inadequate lifestyle among female adolescents.

OBJECTIVE

to assess the lifestyle of female adolescents based on measurements of behavioral variables.

METHODS

Cross-sectional study with 405 female adolescents between 14 and 19 years old, resident and attending public schools in Viçosa (state of Minas Gerais). Their lifestyle was analyzed by the Physical Activity Recall, number of steps, screen time (ST), cellphone time (CT), sitting time, food frequency questionnaire (FFQ), and alcohol and tobacco consumption. With multiple correspondence analysis it was possible to observe dispersion and approximation of the variables' categories. Latent class analysis (LCA) was used for modeling the "lifestyle" variable, having been conducted in the poLCA (Polychromous Variable Latent Class Analysis) package of the R statistical software.

RESULTS

The mean age was 15.92 ± 1.27 years. Most of the adolescents were considered physically inactive (78%) and with low number of steps (82.57%); 41.45% reported not performing Moderate to Vigorous Physical Activities (MVPA) adequately. Sedentary behavior was found high when assessing ST (72.90%) and CT (65.31%). It was found the best fitted latent class model for the lifestyle (p-G2 = 0.055, p-χ2 = 0.066) featured three latent classes and one covariate (alcohol): Class 1, 'Inactive and Sedentary' (γ = 77.5%); Class 2, 'Inactive and Non-sedentary lifestyle (γ=16.31%); and Class 3, 'Active and sedentary' (γ=6.19%). Female adolescents that had 'never consumed alcohol' were 2.26 times as likely (log OR = 0.8174; p = 0.033) to belong to class 3 (Active & Sedentary lifestyle) than to class 1 (Inactive & Sedentary lifestyle).

CONCLUSION

Latent class analysis model with five manifest variable (MVPA, number of steps, ST, sitting time and number of meals) and alcohol consumption like covariate showed itself to be an accurate and objective method in the assessment of female adolescents' lifestyle. Female adolescents that had 'never consumed alcohol' were more as likely to belong to class 'Active & Sedentary lifestyle' than to class Inactive & Sedentary lifestyle. An inactive and sedentary lifestyle is coupled to other unhealthy behaviors during adolescence, possibly carrying over into adult life.

The Role of Energy Intake on Fitness-Adjusted Racial/Ethnic Differences in Central Adiposity Using Quantile Regression

BACKGROUND

Energy intake (EI) is suggested to be associated with adiposity and may explain previously observed fitness-adjusted racial disparities in waist circumference (WC).

OBJECTIVE

The purpose of this study was to comprehensively evaluate the role of EI on the fitness-adjusted racial/ethnic disparities in WC in a nationally representative sample of females using quantile regression.

METHODS

Our sample consisted of 3874 female participants (aged 12 to 49 years) from the 1999-2004 National Health and Nutrition Examination Survey. The role of EI was assessed in separate analyses via estimation using a 24-hour dietary recall (DR) and the Institute of Medicine total daily energy expenditure equations. Age-stratified quantile regression models were used to estimate the differences in WC between minority groups and non-Hispanic (NH) white, adjusting for EI, CRF, age, and height.

RESULTS

Results from the quantile regression analyses adjusting for EI via DR showed significant differences in WC between NH black and NH white at the 25th-90th WC percentiles (5.9-11.1 cm) for females 20-49 and at the 90th WC percentile (10.1 cm) for females 16-19. For females 12-15, no significant differences were observed between NH black and NH white. Analyses adjusting for EI via IOM showed significant differences in WC between NH black and NH white only for females aged 20-49 years, at the 50th and 75th percentile (1.7-3.6 cm). Compared to NH White, Mexican American females, in all age groups, tended to have significantly greater WC.

CONCLUSIONS

These results highlight the importance of rigor in energy intake assessments, suggesting that EI, if adequately assessed, may explain a substantial part of the racial/ethnic differences in WC between NH black and NH white females. Additionally, the observed persistence of estimated differences in WC with advancing age suggests other factors (e.g., hormones) may play a role.

Why are women slimmer than men in developed countries?

Women have a lower BMI than men in developed countries, yet the opposite is true in developing countries. We call this the gender BMI puzzle and investigate its underlying cause. We begin by studying time trends in Japan, where, consistent with the cross-country puzzle, the BMI of adult women has steadily decreased since the 1950s, whereas the BMI of adult men has steadily increased. We study how changes in energy intake and energy expenditure account for the over-time gender BMI puzzle using the Japanese National Nutrition Survey from 1975 to 2010, which provides nurse-measured height and weight and nutritionist-assisted food records. Because long-term data on energy expenditure do not exist, we calculate energy expenditure using a steady-state body weight model. We then conduct cross-country regression analysis to corroborate what we learn from the Japanese data. We find that both energy intake and energy expenditure have significantly decreased for Japanese adult men and women and that a larger reduction in energy expenditure among men than women accounts for the increasing male-to-female BMI gap. Trends in BMI and energy expenditure vary greatly by occupation, suggesting that a relatively large decrease in physical activity in the workplace among men underlies the gender BMI puzzle. The cross-country analysis supports the generalizability of the findings beyond the Japanese data. Furthermore, the analysis suggests the increasing male-to-female BMI gap is driven not only by a reduction in the energy requirements of physically demanding work but also by weakening occupational gender segregation. No support is found for other explanations, such as increasing female labor force participation, greater female susceptibility to malnutrition in utero, and gender inequality in nutrition in early life.

Habitual physical activity levels do not predict leg strength and power in healthy, active older adults

Physical activity is considered crucial in attenuating losses in strength and power associated with ageing. However, in well-functioning, active older adults the relationship between habitual physical activity and muscle function is surprisingly unclear. Leg press velocity, force, and power, were compared between 50 older and 30 younger healthy individuals, and associations with habitual physical activity explored. An incremental power test was performed on a pneumatic leg press, with theoretical maximum velocity, force, and power calculated. Vastus lateralis muscle thickness was measured by ultrasound, and participants wore a combined accelerometer and heart rate monitor for 6-days of free-living. Older individuals produced lower absolute maximum velocity, force, and power, than younger individuals. When accounting for smaller muscle size, older individual's maximum force and power remained markedly lower. Both groups were active, however using age specific thresholds for classifying physical activity, the older individuals engaged in twice the amount of moderate-to-vigorous physical activity in comparison to the younger individuals. There were no associations between any characteristics of muscle function and physical activity. These data support that the ability to generate force and power deteriorates with age, however habitual physical activity levels do not explain inter-individual differences in muscle function in active older individuals.

BODY DISSATISFACTION, PHYSICAL ACTIVITY, AND SEDENTARY BEHAVIOR IN FEMALE ADOLESCENTS

Objective:

To evaluate the association of body image with physical activity level, body composition, and sedentary behavior (SB) of female adolescents.

Methods:

Exploratory cross-sectional study conducted with 120 female adolescents aged between 14-19 years, from the city of Viçosa, Minas Gerais, Southeast Brazil. Body image was evaluated with a Body Silhouette Scale (BSS) and a Body Shape Questionnaire (BSQ). Weight, height, and waist circumference values were analyzed, as well as the waist-to-height ratio and body fat percentage. The physical activity level (PAL) was assessed by 24-hour Physical Activity Recall and SB by screen time, that is, time spent in front of a TV, playing video game, on the computer and using tablets, and, separately, the cell phone time.

Results:

Mean age was 16.5±1.5 years, and most adolescents were eutrophic (77.6%), sedentary/low PAL (84.2%), with high screen time (85.2%) and cell phone time (58.7%). Body dissatisfaction was stated in 40.6% of BSQ and 45.8% of BSS evaluations. Body distortion was identified in 52.9% of participants. All body composition measures, along with cell phone time and PAL, were associated with body dissatisfaction, the more active adolescents presenting higher levels of dissatisfaction.

Conclusions:

This study concluded that female adolescents with higher cell phone time also present higher body dissatisfaction, as well as the most physically active ones. All body composition measurements were associated with body dissatisfaction, mainly body mass index, waist circumference, and waist-to-height ratio.

High orange juice consumption with or in-between three meals a day differently affects energy balance in healthy subjects

Sugar-containing beverages like orange juice can be a risk factor for obesity and type 2 diabetes although the underlying mechanisms are less clear. We aimed to investigate if intake of orange juice with or in-between meals differently affects energy balance or metabolic risk. Twenty-six healthy adults (24.7 ± 3.2 y; BMI 23.2 ± 3.2 kg/m²) participated in a 4-week cross-over intervention and consumed orange juice (20% of energy requirement) either together with 3 meals/d (WM) or in-between 3 meals/d (BM) at ad libitum energy intake. Basal and postprandial insulin sensitivity (primary outcome), daylong glycaemia, glucose variability and insulin secretion were assessed. Body fat mass was measured by air-displacement plethysmography. After BM-intervention, fat mass increased (+1.0 ± 1.8 kg; p < 0.05) and postprandial insulin sensitivity tended to decrease (ΔMatsuda_ISI: −0.89 ± 2.3; p = 0.06). By contrast, after WM-intervention fat mass and gamma-glutamyl transferase (GGT) decreased (−0.30 ± 0.65 kg; −2.50 ± 3.94; both p < 0.05), whereas glucose variability was higher (ΔMAGE: +0.45 ± 0.59, p < 0.05). Daylong glycaemia, insulin secretion, changes in basal insulin sensitivity, and triglycerides did not differ between WM- and BM-interventions (all p > 0.05). In young healthy adults, a conventional 3-meal structure with orange juice consumed together with meals had a favorable impact on energy balance, whereas juice consumption in-between meals may contribute to a gain in body fat and adverse metabolic effects.

High intake of orange juice and cola differently affects metabolic risk in healthy subjects

BACKGROUND

Higher consumption of sugar-containing beverages has been associated with an elevated risk of type 2 diabetes and gout. Whether this equally applies to cola with an unhealthy image and orange juice (OJ) having a healthy image remains unknown.

METHODS

In order to investigate whether OJ and cola differently affect metabolic risk 26 healthy adults (24.7 ± 3.2 y; BMI 23.2 ± 3.3 kg/m²) participated in a 2 × 2-wk intervention and consumed either OJ or caffeine-free cola (20% Ereq as sugar from beverages) in-between 3 meals/d at ad libitum energy intake. Glycemic control, uric acid metabolism and gut microbiota were assessed as outcome parameters.

RESULTS

Fecal microbiota, body weight, basal and OGTT-derived insulin sensitivity remained unchanged in both intervention periods. Levels of uric acid were normal at baseline and did not change with 2-wk cola consumption (-0.03 ± 0.67 mg/dL; p > 0.05), whereas they decreased with OJ intervention (-0.43 ± 0.56 mg/dL; p < 0.01) due to increased uric acid excretion (+130.2 ± 130.0 mg/d; p < 0.001). Compared to OJ, consumption of cola led to a higher daylong glycemia (ΔiAUC: 36.9 ± 83.2; p < 0.05), an increase in glucose variability (ΔMAGE-Index: 0.29 ± 0.44; p < 0.05), and a lower 24 h-insulin secretion (ΔC-peptide excretion: -31.76 ± 38.61 μg/d; p < 0.001), which may be explained by a decrease in serum potassium levels (-0.11 ± 0.24 mmol/L; p < 0.05).

CONCLUSION

Despite its sugar content, regular consumption of large amounts of OJ do not increase the risk of gout but may even contribute to lower uric acid levels. The etiology of impaired insulin secretion with cola consumption needs to be further investigated.

Greenhouse gas emissions of self-selected diets in the UK and their association with diet quality: is energy under-reporting a problem?

BACKGROUND

While the admittedly limited number of epidemiological findings on the association between diet-related greenhouse gas emissions (GHGE) and diet quality are not always consistent, potential influence of bias in the estimation of diet-related GHGE caused by misreporting of energy intake (EI) has not been investigated. This cross-sectional study evaluated diet-related GHGE in the UK and their association with diet quality, taking account of EI under-reporting.

METHODS

Dietary data used were from the National Diet and Nutrition Survey rolling programme 2008/2009-2013/2014, in which 4-day food diaries were collected from 3502 adults aged ≥19 years. Diet-related GHGE were estimated based on 133 food groups, using GHGE values from various secondary sources. Diet quality was assessed by the healthy diet indicator (HDI), Mediterranean diet score (MDS) and Dietary Approaches to Stop Hypertension (DASH) score. EI misreporting was assessed as reported EI divided by estimated energy requirement (EI:EER).

RESULTS

Mean value of daily GHGE was 5.7 kg carbon dioxide equivalents (CO₂eq), which is consistent with those reported from a number of national representative samples in other European countries. Mean EI:EER was 0.74. Assuming that all the dietary variables were misreported in proportion to the misreporting of EI, the mean value of the misreporting-adjusted diet-related GHGE was 8.2 kg CO₂eq/d. In the entire population, after adjustment for potential confounders (i.e., age, sex, ethnicity, socioeconomic classification, smoking status and physical activity), diet-related GHGE were inversely associated with HDI and DASH score but not with MDS. However, with further adjustment for EI:EER, diet-related GHGE showed inverse associations with all three measures of diet quality. Similar associations were observed when only under-reporters (EI:EER < 0.70; n = 1578) were analysed. Conversely, in the analysis including only plausible reporters (EI:EER 0.70-1.43; n = 1895), diet-related GHGE showed inverse associations with all diet quality measures irrespective of adjustment.

CONCLUSIONS

With taking account of EI under-reporting, this study showed inverse associations between diet-related GHGE and diet quality not only in the entire sample but also in the separate analyses of plausible reporters and under-reporters, as well as potential underreporting of diet-related GHGE.

Plant-Based Diet, Serum Fatty Acid Profile, and Free Radicals in Postmenopausal Women: The Diet and Androgens (DIANA) Randomized Trial

High calorie and fat consumption and the production of free radicals are two major mechanistic pathways between diet and disease. In this study we evaluated the effect of a plant-based diet poor in animal fat and rich in (n-3) fatty acids on fatty acids of serum phospholipids and on the production of reactive oxygen metabolites (ROMs). One hundred and four healthy female postmenopausal volunteers were recruited and randomized to a dietary intervention or a control group. Dietary intervention included a program of food education and biweekly common meals for 18 weeks. When the intervention and control groups were compared, it was seen that dietary intervention resulted in a significant reduction of saturated fatty acids (-1.5%) and a significant increase in (n-3) fatty acids (+20.6%), in particular docosahexaenoic acid (+24.8%). We observed that arachidonic acid decreased (–7.7%), while (n-6) fatty acids did not, and the (n-3)/(n-6) polyunsaturated ratio increased significantly (+24.1%). As expected, ROMs decreased significantly in the intervention group (-6%). The results indicated that a plant-based diet can improve the serum fatty acid profile and decrease ROMs production. These results suggest that a plant-based diet may reduce the body's exposure to oxidative stress.

Exercise training dose differentially alters muscle and heart capillary density and metabolic functions in an obese rat with metabolic syndrome

NEW FINDINGS

What is the central question of this study? Regular exercise is recommended as a non-pharmacological approach for the prevention and treatment of metabolic syndrome. However, the impact of different combinations of intensity, duration and frequency of exercise on metabolic syndrome and microvascular density has not been reported. What is the main finding and its importance? We provide evidence on the impact of aerobic exercise dose on metabolic and microvascular alterations in an experimental model of metabolic syndrome induced by high-fat diet. We found that the exercise frequency and duration were the main factors affecting anthropometric and metabolic parameters and microvascular density in the skeletal muscle. Exercise intensity was related only to microvascular density in the heart. We evaluated the effect of the frequency, duration and intensity of exercise training on metabolic parameters and structural capillary density in obese rats with metabolic syndrome. Wistar-Kyoto rats were fed either a standard commercial diet (CON) or a high-fat diet (HFD). Animals that received the HFD were randomly separated into either a sedentary (SED) group or eight different exercise groups that varied according to the frequency, duration and intensity of training. After 12 weeks of aerobic exercise training, the body composition, aerobic capacity, haemodynamic variables, metabolic parameters and capillary density in the heart and skeletal muscle were evaluated. All the exercise training groups showed reduced resting systolic blood pressure and heart rate and normalized fasting glucose. The minimal amount of exercise (90 min per week) produced little effect on metabolic syndrome parameters. A moderate amount of exercise (150 min per week) was required to reduce body weight and improve capillary density. However, only the high amount of exercise (300 min per week) significantly reduced the amount of body fat depots. The three-way ANOVA showed a main effect of exercise frequency and duration for the improvement of metabolic syndrome and capillary density in skeletal muscle. Exercise intensity was a main factor in reversing microvascular rarefaction in the heart.

High, but not low, exercise volume shifts the balance of renin-angiotensin system toward ACE2/Mas receptor axis in skeletal muscle in obese rats

Metabolic syndrome is a cluster of metabolic risk factors that is linked to central obesity, elevated blood pressure, insulin resistance (IR), and dyslipidemia, where the renin-angiotensin system (RAS) may provide a link among them. This study aimed to evaluate volume exercise effects comparing low vs. high volume of chronic aerobic exercise on RAS axes in skeletal muscle in a diet-induced obesity (DIO) rat model. For this, male Wistar-Kyoto rats were fed a standard chow (SC) diet or a high-fat (HF) diet for 32 wk. Animals receiving the HF diet were randomly divided into low exercise volume (LEV, 150 min/wk) and high exercise volume (HEV, 300 min/wk) at the 20th week. After 12 wk of aerobic treadmill training, the body mass and composition, blood pressure, glucose and lipid metabolism, RAS axes, insulin signaling, and inflammatory pathway were performed. HEV slowed the body mass gain, reduced intra-abdominal fat pad and leptin levels, improved total and peripheral body composition and inflammatory cytokine, reduced angiotensin II type 1 receptor expression, and increased Mas receptor protein expression compared with the HF animals. Sedentary groups (SC and HF) presented lower time to exhaustion and maximal velocity compared with the LEV and HEV groups. Both exercise training groups showed reduced resting systolic blood pressure and heart rate, improved glucose tolerance, IR, insulin signaling, and lipid profile. We conclude that the HEV, but not LEV, shifted the balance of RAS toward the ACE2/Mas receptor axis in skeletal muscle, presenting protective effects against the DIO model.

Dietary intake is independently associated with the maximal capacity for fat oxidation during exercise

Background: Substantial interindividual variability exists in the maximal rate of fat oxidation (MFO) during exercise with potential implications for metabolic health. Although the diet can affect the metabolic response to exercise, the contribution of a self-selected diet to the interindividual variability in the MFO requires further clarification.Objective: We sought to identify whether recent, self-selected dietary intake independently predicts the MFO in healthy men and women.Design: The MFO and maximal oxygen uptake ([Formula: see text]O₂ max) were determined with the use of indirect calorimetry in 305 healthy volunteers [150 men and 155 women; mean ± SD age: 25 ± 6 y; body mass index (BMI; in kg/m²): 23 ± 2]. Dual-energy X-ray absorptiometry was used to assess body composition with the self-reported physical activity level (SRPAL) and dietary intake determined in the 4 d before exercise testing. To minimize potential confounding with typically observed sex-related differences (e.g., body composition), predictor variables were mean-centered by sex. In the analyses, hierarchical multiple linear regressions were used to quantify each variable's influence on the MFO.Results: The mean absolute MFO was 0.55 ± 0.19 g/min (range: 0.19-1.13 g/min). A total of 44.4% of the interindividual variability in the MFO was explained by the [Formula: see text]O₂ max, sex, and SRPAL with dietary carbohydrate (carbohydrate; negative association with the MFO) and fat intake (positive association) associated with an additional 3.2% of the variance. When expressed relative to fat-free mass (FFM), the MFO was 10.8 ± 3.2 mg · kg FFM^-1 · min^-1 (range: 3.5-20.7 mg · kg FFM^-1 · min^-1) with 16.6% of the variability explained by the [Formula: see text]O₂ max, sex, and SRPAL; dietary carbohydrate and fat intakes together explained an additional 2.6% of the variability. Biological sex was an independent determinant of the MFO with women showing a higher MFO [men: 10.3 ± 3.1 mg · kg FFM^-1 · min^-1 (3.5-19.9 mg · kg FFM^-1 · min^-1); women: 11.2 ± 3.3 mg · kg FFM^-1 · min^-1 (4.6-20.7 mg · kg FFM^-1 · min^-1); P < 0.05].Conclusion: Considered alongside other robust determinants, dietary carbohydrate and fat intake make modest but independent contributions to the interindividual variability in the capacity to oxidize fat during exercise. This trial was registered at clinicaltrials.gov as NCT02070055.

Effects of colostrum serum on the serotonergic system in the dorsal raphe nuclei of exercised rats

[Purpose]

The central fatigue hypothesis suggests that exhaustion, or the maximum level of exercise, induces excessive stress and increases serotonin concentrations in the brain, which in turn decreases central nervous system (CNS) function and induces fatigue. Our aim was to determine the effects of colostrum serum on the serotonergic system in the dorsal raphe nuclei during exhaustive exercise.

[Methods]

Animals were randomly divided into five groups: control, exercise, exercise and treatment with 50, 100, and 200 mg/kg of colostrum serum. The rats in the colostrum serum treatment groups were fed colostrum serum at three different doses of 50, 100, and 200 mg/kg per day for seven days. The rats in the control and exercise groups received water by oral gavage once per day for seven days.

[Results]

The time to exhaustion in response to treadmill running increased after treatment with colostrum serum. These results show that exhaustive exercise led to over activation of the serotonergic system in the dorsal raphe nuclei, and that treatment with colostrum serum suppressed of the exercise-induced expression of tryptophan hydroxylase (TPH) and serotonin (5-HT). The results also indicated that exhaustive exercise induced 5-HT_1A autoreceptor and serotonin transporter (5-HTT) overexpression in the dorsal raphe nuclei, and that colostrum serum treatment suppressed exhaustive exercise-induced 5-HT_1A and 5-HTT expression in the dorsal raphe nuclei. The most effective dose of colostrum serum was 100 mg/kg.

[Conclusion]

Overall, our study suggests that colostrum serum has positive effects on exercise performance and recovery by increasing the resistance to fatigue.

The Validity of US Nutritional Surveillance: USDA's Loss-Adjusted Food Availability Data Series 1971-2010

The purpose of this study was to examine the validity of the 1971-2010 United States Department of Agriculture's (USDA's) loss-adjusted food availability (LAFA) per capita caloric consumption estimates. Estimated total daily energy expenditure (TEE) was calculated for nationally representative samples of US adults, 20-74 years, using the Institute of Medicine's predictive equations with "low-active" (TEE L-ACT) and "sedentary" (TEE SED) physical activity values. TEE estimates were subtracted from LAFA estimates to create disparity values (kcal/d). A validated mathematical model was applied to calculate expected weight change in reference individuals resulting from the disparity. From 1971-2010, the disparity between LAFA and TEE L-ACT varied by 394kcal/d-(P < 0.001), from -205kcal/d (95% CI: -214, -196) to +189kcal/d (95% CI: 168, 209). The disparity between LAFA and TEE SED varied by 412kcal/d (P < 0.001), from -84kcal/d (95% CI: -93, -76) to +328kcal/d (95% CI: 309, 348). Our model suggests that if LAFA estimates were actually consumed, reference individuals would have lost ~1-4kg/y from 1971-1980 (an accumulated loss of ~12 to ~36kg), and gained ~3-7kg/y from 1988-2010 (an accumulated gain of ~42 to ~98kg). These estimates differed from the actual measured increments of 10kg and 9kg in reference men and women, respectively, over the 39-year period. The USDA LAFA data provided inconsistent, divergent estimates of per capita caloric consumption over its 39-year history. The large, variable misestimation suggests that the USDA LAFA per capita caloric intake estimates lack validity and should not be used to inform public policy.

Total Energy Expenditure in Obese Kuwaiti Primary School Children Assessed by the Doubly-Labeled Water Technique

The aim of this pilot study was to assess body composition and total energy expenditure (TEE) in 35 obese 7–9 years old Kuwaiti children (18 girls and 17 boys). Total body water (TBW) and TEE were assessed by doubly-labeled water technique. TBW was derived from the intercept of the elimination rate of deuterium and TEE from the difference in elimination rates of ¹⁸O and deuterium. TBW was used to estimate fat-free mass (FFM), using hydration factors for different ages and gender. Fat mass (FM) was calculated as the difference between body weight and FFM. Body weight was not statistically different but TBW was significantly higher (p = 0.018) in boys (44.9% ± 3.3%) than girls (42.4% ± 3.0%), while girls had significantly higher estimated FM (45.2 ± 3.9 weight % versus 41.6% ± 4.3%; p = 0.014). TEE was significantly higher in boys (2395 ± 349 kcal/day) compared with girls (1978 ± 169 kcal/day); p = 0.001. Estimated physical activity level (PAL) was significantly higher in boys; 1.61 ± 0.167 versus 1.51 ± 0.870; p = 0.034. Our results provide the first dataset of TEE in 7–9 years old obese Kuwaiti children and highlight important gender differences to be considered during the development of school based interventions targeted to combat childhood obesity.

Diet misreporting can be corrected: confirmation of the association between energy intake and fat-free mass in adolescents

Subjective energy intake (sEI) is often misreported, providing unreliable estimates of energy consumed. Therefore, relating sEI data to health outcomes is difficult. Recently, Börnhorst et al. compared various methods to correct sEI-based energy intake estimates. They criticised approaches that categorise participants as under-reporters, plausible reporters and over-reporters based on the sEI:total energy expenditure (TEE) ratio, and thereafter use these categories as statistical covariates or exclusion criteria. Instead, they recommended using external predictors of sEI misreporting as statistical covariates. We sought to confirm and extend these findings. Using a sample of 190 adolescent boys (mean age=14), we demonstrated that dual-energy X-ray absorptiometry-measured fat-free mass is strongly associated with objective energy intake data (onsite weighted breakfast), but the association with sEI (previous 3-d dietary interview) is weak. Comparing sEI with TEE revealed that sEI was mostly under-reported (74 %). Interestingly, statistically controlling for dietary reporting groups or restricting samples to plausible reporters created a stronger-than-expected association between fat-free mass and sEI. However, the association was an artifact caused by selection bias – that is, data re-sampling and simulations showed that these methods overestimated the effect size because fat-free mass was related to sEI both directly and indirectly via TEE. A more realistic association between sEI and fat-free mass was obtained when the model included common predictors of misreporting (e.g. BMI, restraint). To conclude, restricting sEI data only to plausible reporters can cause selection bias and inflated associations in later analyses. Therefore, we further support statistically correcting sEI data in nutritional analyses. The script for running simulations is provided.

Feedback from physical activity monitors is not compatible with current recommendations: A recalibration study

Wearable devices to self-monitor physical activity have become popular with individuals and healthcare practitioners as a route to the prevention of chronic disease. It is not currently possible to reconcile feedback from these devices with activity recommendations because the guidelines refer to the amount of activity required on top of normal lifestyle activities (e.g., 150 minutes of moderate-to-vigorous intensity activity per week over-and-above normal moderate-to-vigorous lifestyle activities). The aim of this study was to recalibrate the feedback from self-monitoring. We pooled data from four studies conducted between 2006 and 2014 in patients and volunteers from the community that included both sophisticated measures of physical activity and 10-year risk for cardiovascular disease and type 2 diabetes (n=305). We determined the amount of moderate-to-vigorous intensity activity that corresponded to FAO/WHO/UNU guidance for a required PAL of 1.75 (Total Energy Expenditure/Basal Metabolic Rate). Our results show that, at the UK median PAL, total moderate-to-vigorous intensity physical activity will be around 735 minutes per week (~11% of waking time). We estimate that a 4% increase in moderate-to-vigorous intensity activity will achieve standardised guidance from FAO/WHO/UNU and will require ~1000 minutes of moderate-to-vigorous intensity activity per week. This study demonstrates that feedback from sophisticated wearable devices is incompatible with current physical activity recommendations. Without adjustment, people will erroneously form the view that they are exceeding recommendations by several fold. A more appropriate target from self-monitoring that accounts for normal moderate-to-vigorous lifestyle activities is ~1000 minutes per week, which represents ~15% of waking time.

Pregnancy physical activity questionnaire (PPAQ): reliability and validity of Turkish version

[Purpose] The aim of this study was to translate the Pregnancy Physical Activity Questionnaire into Turkish and test its reliability and validity among Turkish pregnant women. [Subjects and Methods] The subjects were 204 healthy, single pregnant women between the ages 18 and 40 who volunteered to participate in this study. Reliability was evaluated by measuring the one-week test-retest reliability with the intraclass correlation coefficient and Pearson's correlation analysis. Concurrent validity was examined by comparing the Pregnancy Physical Activity Questionnaire with the long form of the International Physical Activity Questionnaire and step counts with pedometer. [Results] The mean age of the participants was 28.23±4.94 years, and the mean for BMI was 26.09±4.40. For test-retest reliability, r values were respectively 0.961, 0.934, 0.957 and 0.981 for self-reported sedentary, light, moderate, and vigorous activity, respectively. Intraclass correlation coefficient scores ranged from 0.924 to 0.993. For validity, the Pearson's correlation coefficients between the Pregnancy Physical Activity Questionnaire and long form of the International Physical Activity Questionnaire ranged from moderate (r = 0.329) to high (r = 0.672). The correlation value between the total score of the Pregnancy Physical Activity Questionnaire and the step counts was 0.70. [Conclusion] The Turkish version of the Pregnancy Physical Activity Questionnaire is a valid and reliable tool for measurement of the physical activity level of pregnant women.

Resistance Exercise Attenuates High-Fructose, High-Fat-Induced Postprandial Lipemia

INTRODUCTION

Meals rich in both fructose and fat are commonly consumed by many Americans, especially young men, which can produce a significant postprandial lipemic response. Increasing evidence suggests that aerobic exercise can attenuate the postprandial increase in plasma triacylglycerols (TAGs) in response to a high-fat or a high-fructose meal. However, it is unknown if resistance exercise can dampen the postprandial lipemic response to a meal rich in both fructose and fat.

METHODS

Eight apparently healthy men (Mean ± SEM; age = 27 ± 2 years) participated in a crossover study to examine the effects of acute resistance exercise on next-day postprandial lipemia resulting from a high-fructose, high-fat meal. Participants completed three separate two-day conditions in a random order: (1) EX-COMP: a full-body weightlifting workout with the provision of additional kilocalories to compensate for the estimated net energy cost of exercise on day 1, followed by the consumption of a high-fructose, high-fat liquid test meal the next morning (day 2) (~600 kcal) and the determination of the plasma glucose, lactate, insulin, and TAG responses during a six-hour postprandial period; (2) EX-DEF: same condition as EX-COMP but without exercise energy compensation on day 1; and (3) CON: no exercise control.

RESULTS

The six-hour postprandial plasma insulin and lactate responses did not differ between conditions. However, the postprandial plasma TAG concentrations were 16.5% and 24.4% lower for EX-COMP (551.0 ± 80.5 mg/dL × 360 minutes) and EX-DEF (499.4 ± 73.5 mg/dL × 360 minutes), respectively, compared to CON (660.2 ± 95.0 mg/dL × 360 minutes) (P < 0.05).

CONCLUSIONS

A single resistance exercise bout, performed ~15 hours prior to a high-fructose, high-fat meal, attenuated the postprandial TAG response, as compared to a no-exercise control condition, in healthy, resistance-trained men.