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Jin J, Xiong G, Peng F, Zhu F, Wang M, Qin R. The ratio of skeletal muscle mass to body mass index combined with inflammatory immune markers to stratify survival of pancreatic cancer after pancreatoduodenectomy. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2024; 50:108355. [PMID: 38703633 DOI: 10.1016/j.ejso.2024.108355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 03/21/2024] [Accepted: 04/16/2024] [Indexed: 05/06/2024]
Abstract
BACKGROUND We sought to combine skeletal muscle index and inflammatory immune markers to stratify long-term survival in patients with pancreatic cancer after pancreatoduodenectomy (PD). METHODS A total of 581 patients with pancreatic cancer underwent PD were included, and divided into the training and validation cohort. Image analysis of computed tomography scans was used to calculate the ratio of skeletal muscle (SM) area to body mass index (BMI). Naples prognostic score (NPS) was calculated from blood-test inflammatory immune markers. Propensity score matching (PSM) analysis was performed to minimize biases of clinicopathological characteristics. To estimate the overall survival (OS), a nomogram was developed using the training cohort. The predictive accuracy of nomogram was estimated by concordance index (C-index), calibration curve, and receiver operating characteristics (ROC) curve. RESULTS After PSM analysis, SM/BMI ratio, NPS, lymph node metastasis, TNM stage, surgical margin, tumor grade and adjuvant therapy were independent predictors of OS, which were all assembled into nomogram. The SM/BMI ratio was the best single-predictor for 3- and 5-year OS, with an AUC of 0.805 (95% CI: 0.755-0.855) and 0.812 (95% CI: 0.736-0.888), respectively. Harrell's c-index of the nomogram in the training cohort was 0.786 (95% CI: 0.770-0.802), and the area under ROC curve of 1-year, 3- and 5-year OS prediction were 0.869 (95%CI: 0.837-0.901), 0.846 (95%CI: 0.810-0.882) and 0.849 (95%CI: 0.801-0.896). CONCLUSIONS The nomogram based on SM/BMI ratio and NPS had excellent predictive performance, which should be incorporated to conventional risk scores to stratify survival of patients with PDAC after PD.
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Affiliation(s)
- Jikuan Jin
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Guangbing Xiong
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Feng Peng
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Feng Zhu
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China
| | - Min Wang
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China.
| | - Renyi Qin
- Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan, Hubei, 430030, China.
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Campisi M, Cannella L, Pavanello S. Cosmic chronometers: Is spaceflight a catalyst for biological ageing? Ageing Res Rev 2024; 95:102227. [PMID: 38346506 DOI: 10.1016/j.arr.2024.102227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/05/2024] [Accepted: 02/06/2024] [Indexed: 02/22/2024]
Abstract
Astronauts returning from space missions often exhibit health issues mirroring age-related conditions, suggesting spaceflight as a potential driver of biological ageing and age-related diseases. To unravel the underlying mechanisms of these conditions, this comprehensive review explores the impact of the space "exposome" on the twelve hallmarks of ageing. Through a meticulous analysis encompassing both space environments and terrestrial analogs, we aim to decipher how different conditions influence ageing hallmarks. Utilizing PubMed, we identified 189 studies and 60 meet screening criteria. Research on biological ageing in space has focused on genomic instability, chronic inflammation, and deregulated nutrient sensing. Spaceflight consistently induces genomic instability, linked to prolonged exposure to ionizing radiation, triggers pro-inflammatory and immune alterations, resembling conditions in isolated simulations. Nutrient sensing pathways reveal increased systemic insulin-like growth-factor-1. Microbiome studies indicate imbalances favoring opportunistic species during spaceflight. Telomere dynamics present intriguing patterns, with lengthening during missions and rapid shortening upon return. Despite a pro-ageing trend, some protective mechanisms emerge. Countermeasures, encompassing dietary adjustments, prebiotics, postbiotics, symbiotics, tailored exercises, meditation, and anti-inflammatory supplements, exhibit potential. Spaceflight's impact on ageing is intricate, with diverse findings challenging established beliefs. Multidisciplinary studies provide guidance for future research in this field.
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Affiliation(s)
- Manuela Campisi
- Occupational Medicine, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Luana Cannella
- Occupational Medicine, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Sofia Pavanello
- Occupational Medicine, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy.
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Alghannam AF, Alharbi DS, Al-Hazzaa HM. Sarcopenia of Ageing: Does a Healthier Lifestyle Matter in Reversing the Trajectory? A Brief Narrative Review and a Call for Action in Saudi Arabia. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2024; 12:10-16. [PMID: 38362094 PMCID: PMC10866379 DOI: 10.4103/sjmms.sjmms_54_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 08/01/2023] [Accepted: 10/08/2023] [Indexed: 02/17/2024]
Abstract
The concept of health span is an emerging topic in recent years, with a truly palpable relevance to public health. With ageing comes a loss of skeletal muscle mass, strength, and performance, which is termed as sarcopenia. Sarcopenia is a major public health concern and poses a challenge to health-care systems. Modifiable lifestyle factors may be linked to the course of sarcopenia progression. Many countries developed diagnostic tools to accurately detect sarcopenia for its prevention, delay, or treatment. However, to date, there is no sufficient information regarding the status of sarcopenia in Saudi Arabia. The review aims to discuss sarcopenia and relevant updates in research and literature, the association with modifiable lifestyle factors, the implications of sarcopenia in a rapidly developing country such as Saudi Arabia, and the current state and need for research in Saudi Arabia in this domain along with future directions in combating this disease.
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Affiliation(s)
- Abdullah F. Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Dalal S. Alharbi
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hazzaa M. Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
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Mangogna A, Di Girolamo FG, Fiotti N, Vinci P, Landolfo M, Mearelli F, Biolo G. High-protein diet with excess leucine prevents inactivity-induced insulin resistance in women. Clin Nutr 2023; 42:2578-2587. [PMID: 37972527 DOI: 10.1016/j.clnu.2023.10.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/18/2023] [Accepted: 10/29/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND AND AIMS Muscle inactivity leads to muscle atrophy and insulin resistance. The branched-chain amino acid (BCAA) leucine interacts with the insulin signaling pathway to modulate glucose metabolism. We have tested the ability of a high-protein BCAA-enriched diet to prevent insulin resistance during long-term bed rest (BR). METHODS Stable isotopes were infused to determine glucose and protein kinetics in the postabsorptive state and during a hyperinsulinemic-euglycemic clamp in combination with amino acid infusion (Clamp + AA) before and at the end of 60 days of BR in two groups of healthy, young women receiving eucaloric diets containing 1 g of protein/kg per day (n = 8) or 1.45 g of protein/kg per day enriched with 0.15 g/kg per day of BCAAs (leucine/valine/isoleucine = 2/1/1) (n = 8). Body composition was determined by Dual X-ray Absorptiometry. RESULTS BR decreased lean body mass by 7.6 ± 0.3 % and 7.2 ± 0.8 % in the groups receiving conventional or high protein-BCAA diets, respectively. Fat mass was unchanged in both groups. At the end of BR, percent changes of insulin-mediated glucose uptake significantly (p = 0.01) decreased in the conventional diet group from 155 ± 23 % to 84 ± 10 % while did not change significantly in the high protein-BCAA diet group from 126 ± 20 % to 141 ± 27 % (BR effect, p = 0.32; BR/diet interaction, p = 0.01; Repeated Measures ANCOVA). In contrast, there were no BR/diet interactions on proteolysis and protein synthesis Clamp + AA changes in the conventional diet and the high protein-BCAA diet groups. CONCLUSION A high protein-BCAA enriched diet prevented inactivity-induced insulin resistance in healthy women.
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Affiliation(s)
- Alessandro Mangogna
- Institute for Maternal and Child Health, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofolo, Trieste, Italy
| | - Filippo Giorgio Di Girolamo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy; Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Nicola Fiotti
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Pierandrea Vinci
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Matteo Landolfo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Filippo Mearelli
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Gianni Biolo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy.
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Saloň A, Çiftci GM, Zubac D, Šimunič B, Pišot R, Narici M, Fredriksen PM, Nkeh-Chungag BN, Sourij H, Šerý O, Schmid-Zalaudek K, Steuber B, De Boever P, Goswami N. Retinal venular vessel diameters are smaller during ten days of bed rest. Sci Rep 2023; 13:19258. [PMID: 37935771 PMCID: PMC10630473 DOI: 10.1038/s41598-023-46177-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 10/28/2023] [Indexed: 11/09/2023] Open
Abstract
Older individuals experience cardiovascular dysfunction during extended bedridden hospital or care home stays. Bed rest is also used as a model to simulate accelerated vascular deconditioning occurring during spaceflight. This study investigates changes in retinal microcirculation during a ten-day bed rest protocol. Ten healthy young males (22.9 ± 4.7 years; body mass index: 23.6 ± 2.5 kg·m-2) participated in a strictly controlled repeated-measures bed rest study lasting ten days. High-resolution images were obtained using a hand-held fundus camera at baseline, daily during the 10 days of bed rest, and 1 day after re-ambulation. Retinal vessel analysis was performed using a semi-automated software system to obtain metrics for retinal arteriolar and venular diameters, central retinal artery equivalent and central retinal vein equivalent, respectively. Data analysis employed a mixed linear model. At the end of the bed rest period, a significant decrease in retinal venular diameter was observed, indicated by a significantly lower central retinal vein equivalent (from 226.1 µm, CI 8.90, to 211.4 µm, CI 8.28, p = .026), while no significant changes in central retinal artery equivalent were noted. Prolonged bed rest confinement resulted in a significant (up to 6.5%) reduction in retinal venular diameter. These findings suggest that the changes in retinal venular diameter during bedrest may be attributed to plasma volume losses and reflect overall (cardio)-vascular deconditioning.
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Affiliation(s)
- Adam Saloň
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria
| | - Göktuğ Mert Çiftci
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Department of Psychiatry, University Hospital Münster, Münster, Germany
| | - Damir Zubac
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department 1 of Internal Medicine, Centre for Integrated Oncology, Aachen, Bonn, Cologne, Düsseldorf, University Hospital of Cologne, Cologne, Germany
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Marco Narici
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Per Morten Fredriksen
- Faculty of Applied Ecology, Agricultural Sciences and Biotechnology, Inland Norway University of Applied Sciences, Lillehammer, Norway
| | - Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Health Sciences, Walter Sisulu University PBX1, Mthatha, 5117, South Africa
| | - Harald Sourij
- Internal Medicine, Division of Endocrinology and Diabetology, Interdisciplinary Metabolic Medicine Trials Unit, Medical University of Graz, Graz, Austria
| | - Omar Šerý
- Laboratory of Neurobiology and Molecular Psychiatry, Department of Biochemistry, Faculty of Science, Masaryk University, Kamenice 753/5, 625 00, Brno, Czech Republic
- Laboratory of Neurobiology and Pathological Physiology, Institute of Animal Physiology and Genetics, Czech Academy of Sciences, Veveří 97, 602 00, Brno, Czech Republic
| | - Karin Schmid-Zalaudek
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria
| | - Bianca Steuber
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria
| | - Patrick De Boever
- Centre for Environmental Sciences, Hasselt University, Hasselt, Belgium
| | - Nandu Goswami
- Division of Physiology & Pathophysiology, Otto Loewi Research Center for Vascular Biology, Immunology, and Inflammation, Medical University of Graz, Graz, Austria.
- Research Unit "Gravitational Physiology and Medicine", Physiology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstraße 6/D.05, 8010, Graz, Austria.
- Integrative Health, Alma Mater Europaea Maribor, Maribor, Slovenia.
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.
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Fradkin M, Elyashiv M, Brik M, Kait MG, Albukrek D, Singer P, Dankner R. The efficacy of calorimetry-based nutritional support versus recommended dietary intake-based nutritional support in the successful weaning of chronically ventilated patients: A study protocol for a double blind randomized controlled trial. Clin Nutr ESPEN 2023; 54:94-97. [PMID: 36963903 DOI: 10.1016/j.clnesp.2023.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 12/13/2022] [Accepted: 01/03/2023] [Indexed: 01/15/2023]
Abstract
BACKGROUND & AIMS Mechanically ventilated patients are weaned during acute care hospitalization when it is determined that they are ready for withdrawal. If weaning fails, patients are admitted to a rehabilitation medical center for continued supportive care and additional weaning attempts. This study's objective is to increase the success rate of weaning from prolonged mechanical ventilation (PMV), and to shorten the overall weaning period by tailoring the patient's caloric intake according to their individually measured energy needs. METHODS We designed a randomized, controlled, double-blinded trial to be conducted among PMV patients undergoing routine ventilation-weaning attempts. Patients in the intervention arm will be fed according to energy needs determined by calorimetry. Patients in the control arm will be fed according to the standard of care, namely the Recommended Dietary Allowance (RDA) guidelines. Each patient will undergo up to five weaning attempts. Study outcomes will include successful weaning rate, time to successful weaning, and 3-12 months survival rate. DISCUSSION This trial aims to examine the safety and efficacy of a nutritional diet based on an individual's measured caloric needs in terms of weaning rates and weaning time. We hypothesize that calorimetry-based nutrition plan will prove to be superior in both success rate and time to successful weaning compared to the standard nutrition plan based on the resting energy expenditure (REE) formula during the weaning process. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT04825717.
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Affiliation(s)
- Mila Fradkin
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Schoenbrun Academic Nursing School, Sourasky Medical Center, Tel Aviv, Israel.
| | - Maya Elyashiv
- Intubation Unit, Reuth Rehabilitation Medical Center, Tel Aviv, Israel.
| | - Michael Brik
- Reuth Research and Development Institute, Reuth Rehabilitation Medical Center, Tel Aviv, Israel.
| | - Michal G Kait
- Reuth Nutritional Department, Reuth Rehabilitation Medical Center, Tel Aviv, Israel.
| | - Dov Albukrek
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Reuth Rehabilitation Medical Center, Tel Aviv, Israel.
| | - Pierre Singer
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; General Intensive Care Department and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Israel.
| | - Rachel Dankner
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; Reuth Research and Development Institute, Reuth Rehabilitation Medical Center, Tel Aviv, Israel.
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Nutritional Strategies in the Rehabilitation of Musculoskeletal Injuries in Athletes: A Systematic Integrative Review. Nutrients 2023; 15:nu15040819. [PMID: 36839176 PMCID: PMC9965375 DOI: 10.3390/nu15040819] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/08/2023] Open
Abstract
It is estimated that three to five million sports injuries occur worldwide each year. The highest incidence is reported during competition periods with mainly affectation of the musculoskeletal tissue. For appropriate nutritional management and correct use of nutritional supplements, it is important to individualize based on clinical effects and know the adaptive response during the rehabilitation phase after a sports injury in athletes. Therefore, the aim of this PRISMA in Exercise, Rehabilitation, Sport Medicine and Sports Science PERSiST-based systematic integrative review was to perform an update on nutritional strategies during the rehabilitation phase of musculoskeletal injuries in elite athletes. After searching the following databases: PubMed/Medline, Scopus, PEDro, and Google Scholar, a total of 18 studies met the inclusion criteria (Price Index: 66.6%). The risk of bias assessment for randomized controlled trials was performed using the RoB 2.0 tool while review articles were evaluated using the AMSTAR 2.0 items. Based on the main findings of the selected studies, nutritional strategies that benefit the rehabilitation process in injured athletes include balanced energy intake, and a high-protein and carbohydrate-rich diet. Supportive supervision should be provided to avoid low energy availability. The potential of supplementation with collagen, creatine monohydrate, omega-3 (fish oils), and vitamin D requires further research although the effects are quite promising. It is worth noting the lack of clinical research in injured athletes and the higher number of reviews in the last 10 years. After analyzing the current quantitative and non-quantitative evidence, we encourage researchers to conduct further clinical research studies evaluating doses of the discussed nutrients during the rehabilitation process to confirm findings, but also follow international guidelines at the time to review scientific literature.
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Oranger A, Storlino G, Dicarlo M, Zerlotin R, Pignataro P, Sanesi L, Narici M, Pišot R, Simunič B, Colaianni G, Grano M, Colucci S. Impact of 10-day bed rest on serum levels of irisin and markers of musculoskeletal metabolism. FASEB J 2023; 37:e22668. [PMID: 36475382 DOI: 10.1096/fj.202201005rr] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 10/17/2022] [Accepted: 11/11/2022] [Indexed: 12/12/2022]
Abstract
The bed rest (BR) is a ground-based model to simulate microgravity mimicking skeletal-muscle alterations as in spaceflight. Molecular coupling between bone and muscle might be involved in physiological and pathological conditions. Thus, the new myokine irisin and bone-muscle turnover markers have been studied during and after 10 days of BR. Ten young male individuals were subjected to 10 days of horizontal BR. Serum concentrations of irisin, myostatin, sclerostin, and haptoglobin were assessed, and muscle tissue gene expression on vastus lateralis biopsies was determined. During 10-days BR, we observed no significant fluctuation levels of irisin, myostatin, and sclerostin. Two days after BR (R+2), irisin serum levels significantly decreased while myostatin, sclerostin, and haptoglobin were significantly increased compared with BR0. Gene expression of myokines, inflammatory molecules, transcription factors, and markers of muscle atrophy and senescence on muscle biopsies were not altered, suggesting that muscle metabolism of young, healthy subjects is able to adapt to the hypomobility condition during 10-day BR. However, when subjects were divided according to irisin serum levels at BR9, muscle ring finger-1 mRNA expression was significantly lower in subjects with higher irisin serum levels, suggesting that this myokine may prevent the triggering of muscle atrophy. Moreover, the negative correlation between p21 mRNA and irisin at BR9 indicated a possible inhibitory effect of the myokine on the senescence marker. In conclusion, irisin could be a prognostic marker of hypomobility-induced muscle atrophy, and its serum levels could protect against muscle deterioration by preventing and/or delaying the expression of atrophy and senescence cellular markers.
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Affiliation(s)
- Angela Oranger
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Giuseppina Storlino
- Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy
| | - Manuela Dicarlo
- Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy
| | - Roberta Zerlotin
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Patrizia Pignataro
- Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy
| | - Lorenzo Sanesi
- Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Rado Pišot
- Institute of Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Bostjan Simunič
- Institute of Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Graziana Colaianni
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Maria Grano
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Bari, Italy
| | - Silvia Colucci
- Department of Translational Biomedicine and Neuroscience, University of Bari, Bari, Italy
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Nutrition in the prevention and management of sarcopenia - A special focus on Asian Indians. Osteoporos Sarcopenia 2022; 8:135-144. [PMID: 36605171 PMCID: PMC9805983 DOI: 10.1016/j.afos.2022.12.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 11/26/2022] [Accepted: 12/01/2022] [Indexed: 12/15/2022] Open
Abstract
Sarcopenia, characterized by loss of muscle mass and strength, is common in advanced old age but can be accelerated by chronic disease, malnutrition and physical inactivity. Early initiation of intervention to achieve and maintain a higher peak muscle mass and strength may allow for prevention or delay of sarcopenia and facilitate independent living even in old age. In this context, malnutrition, a significant contributor to sarcopenia, is often overlooked among the Indian population. Maintenance of an optimal energy and protein balance with adequate physical activity level is essential to preserve physical function in the aging population. However, research on the role of micronutrients in muscle maintenance, is still in its infancy. This narrative review, therefore, aims to explore the current status of International and Indian research on the role of nutrition in sarcopenia mitigation and the way forward.
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10
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Vinci P, Di Girolamo FG, Mangogna A, Mearelli F, Nunnari A, Fiotti N, Giordano M, Bareille MP, Biolo G. Early lean mass sparing effect of high-protein diet with excess leucine during long-term bed rest in women. Front Nutr 2022; 9:976818. [PMID: 36505255 PMCID: PMC9729546 DOI: 10.3389/fnut.2022.976818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/09/2022] [Indexed: 11/25/2022] Open
Abstract
Muscle inactivity leads to muscle atrophy. Leucine is known to inhibit protein degradation and to promote protein synthesis in skeletal muscle. We tested the ability of a high-protein diet enriched with branched-chain amino acids (BCAAs) to prevent muscle atrophy during long-term bed rest (BR). We determined body composition (using dual energy x-ray absorptiometry) at baseline and every 2-weeks during 60 days of BR in 16 healthy young women. Nitrogen (N) balance was assessed daily as the difference between N intake and N urinary excretion. The subjects were randomized into two groups: one received a conventional diet (1.1 ± 0.03 g protein/kg, 4.9 ± 0.3 g leucine per day) and the other a high protein, BCAA-enriched regimen (1.6 ± 0.03 g protein-amino acid/kg, 11.4 ± 0.6 g leucine per day). There were significant BR and BR × diet interaction effects on changes in lean body mass (LBM) and N balance throughout the experimental period (repeated measures ANCOVA). During the first 15 days of BR, lean mass decreased by 4.1 ± 0.9 and 2.4 ± 2.1% (p < 0.05) in the conventional and high protein-BCAA diet groups, respectively, while at the end of the 60-day BR, LBM decreased similarly in the two groups by 7.4 ± 0.7 and 6.8 ± 2.4%. During the first 15 days of BR, mean N balance was 2.5 times greater (p < 0.05) in subjects on the high protein-BCAA diet than in those on the conventional diet, while we did not find significant differences during the following time intervals. In conclusion, during 60 days of BR in females, a high protein-BCAA diet was associated with an early protein-LBM sparing effect, which ceased in the medium and long term.
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Affiliation(s)
- Pierandrea Vinci
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Filippo Giorgio Di Girolamo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy,Hospital Pharmacy, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Alessandro Mangogna
- Institute for Maternal and Child Health, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Burlo Garofolo, Trieste, Italy
| | - Filippo Mearelli
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Alessio Nunnari
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Nicola Fiotti
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Mauro Giordano
- Department of Advanced Medical and Surgical Sciences, University of Campania L. Vanvitelli, Naples, Italy
| | | | - Gianni Biolo
- Department of Medical Surgical and Health Sciences, Medical Clinic, Cattinara Hospital, University of Trieste, Trieste, Italy,*Correspondence: Gianni Biolo,
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11
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Identification of sarcopenic obesity in adults undergoing orthopaedic surgery: Relationship between “a body shape index” (ABSI) and fat-free mass. A cross -sectional study. PLoS One 2022; 17:e0269956. [PMID: 35731798 PMCID: PMC9216617 DOI: 10.1371/journal.pone.0269956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 05/31/2022] [Indexed: 11/19/2022] Open
Abstract
Background Sarcopenic obesity is a condition characterised by the coexistence of low muscle mass and function (sarcopenia) and excessive fat mass (obesity). The aim of this study was to determine the prevalence of this condition in patients undergoing orthopaedic surgery by gender and type of orthopaedic surgery. In addition, this study investigated the suitability of a waist circumference-based anthropometric measure, body shape index (ABSI), for predicting sarcopenic obesity and the predictive power of ABSI for fat-free mass index (FFMI), a surrogate marker of lean body mass. Methods and findings A cross-sectional study of overweight and obese orthopaedic patients undergoing knee or hip and spine surgery was conducted between October 2019 and March 2020 in Orthopaedic Hospital Valdoltra, Slovenia. General anthropometric parameters body mass index (BMI) and ABSI = (WC/(BMI2/3x height½) as well as body composition data (fat mass FM, fat-free mass FFM, FFMI, and the ratio FM/FFM as an index of sarcopenic obesity) were determined in 120 women (aged 66.5 ± 9.6 years) and 89 men (aged 65.5 ± 7.8 years) with overweight (25 kg/m2 ≤ BMI < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2) by bioelectrical impedance analysis (BIA). Sarcopenic obesity phenotypes based on FM/FFM ratio > 0.80 was present in 15.3% of patients, mainly in female patients undergoing knee surgery. ABSI was significantly associated with age in all women and obese men and with waist circumference (WC) in all patients. ABSI did not correlate with BMI in women and men; however, multiple linear regression analysis showed that BMI independently predicted FFMI (R = 0.83 and 0.70, respectively, p < 0.001) in women and men (β-coefficients: 0.801 and 0.686, respectively) and ABSI in women only (β-coefficient: -0.104). Women with a lower ABSI had a significantly higher FFMI than the group with a higher ABSI. Conclusions Sarcopenic obesity was most prevalent in obese women scheduled for knee surgery. In addition, ABSI, independently predicted FFMI in women and represents a significant predictor of sarcopenic obesity.
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12
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Di Girolamo FG, Fiotti N, Sisto UG, Nunnari A, Colla S, Mearelli F, Vinci P, Schincariol P, Biolo G. Skeletal Muscle in Hypoxia and Inflammation: Insights on the COVID-19 Pandemic. Front Nutr 2022; 9:865402. [PMID: 35529457 PMCID: PMC9072827 DOI: 10.3389/fnut.2022.865402] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/09/2022] [Indexed: 12/23/2022] Open
Abstract
SARS-CoV-2 infection is often associated with severe inflammation, oxidative stress, hypoxia and impaired physical activity. These factors all together contribute to muscle wasting and fatigue. In addition, there is evidence of a direct SARS-CoV-2 viral infiltration into skeletal muscle. Aging is often characterized by sarcopenia or sarcopenic obesity These conditions are risk factors for severe acute COVID-19 and long-COVID-19 syndrome. From these observations we may predict a strong association between COVID-19 and decreased muscle mass and functions. While the relationship between physical inactivity, chronic inflammation, oxidative stress and muscle dysfunction is well-known, the effects on muscle mass of COVID-19-related hypoxemia are inadequately investigated. The aim of this review is to highlight metabolic, immunity-related and redox biomarkers potentially affected by reduced oxygen availability and/or muscle fatigue in order to shed light on the negative impact of COVID-19 on muscle mass and function. Possible countermeasures are also reviewed.
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Affiliation(s)
- Filippo G. Di Girolamo
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
- SC Assistenza Farmaceutica, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
- *Correspondence: Filippo G. Di Girolamo
| | - Nicola Fiotti
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Ugo G. Sisto
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Alessio Nunnari
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Stefano Colla
- SC Assistenza Farmaceutica, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Filippo Mearelli
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Pierandrea Vinci
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
| | - Paolo Schincariol
- SC Assistenza Farmaceutica, Cattinara Hospital, Azienda Sanitaria Universitaria Giuliano Isontina, Trieste, Italy
| | - Gianni Biolo
- Department of Medical Surgical ad Health Science, Clinica Medica, Cattinara Hospital, University of Trieste, Trieste, Italy
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13
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Physical inactivity – The human health’s greatest enemy. Zdr Varst 2021; 61:1-5. [PMID: 35111260 PMCID: PMC8776290 DOI: 10.2478/sjph-2022-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/02/2021] [Indexed: 12/03/2022] Open
Abstract
For decades, research has been highlighting the positive impact of physical activity on health. Despite the immense efforts made by many professional and scientific organizations to raise individual and societal awareness about the role of a sufficient quantity and intensity of physical activity in everyday life and to increase the level of adherence, the situation is still very worrying. Even more worrying is the fact that increasingly prolonged periods of physical inactivity are insidiously and aggressively taking over modern people’s lives – at school, at work, at home, even at leisure. It is probably incomprehensible and difficult for many to accept, but physical inactivity is becoming the first and worst enemy of health in today’s society.
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14
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Schuetz P, Seres D, Lobo DN, Gomes F, Kaegi-Braun N, Stanga Z. Management of disease-related malnutrition for patients being treated in hospital. Lancet 2021; 398:1927-1938. [PMID: 34656286 DOI: 10.1016/s0140-6736(21)01451-3] [Citation(s) in RCA: 112] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 06/16/2021] [Accepted: 06/21/2021] [Indexed: 12/16/2022]
Abstract
Disease-related malnutrition in adult patients who have been admitted to hospital is a syndrome associated with substantially increased morbidity, disability, short-term and long-term mortality, impaired recovery from illness, and cost of care. There is uncertainty regarding optimal diagnostic criteria, definitions for malnutrition, and how to identify patients who would benefit from nutritional intervention. Malnutrition has become the focus of research aimed at translating current knowledge of its pathophysiology into improved diagnosis and treatment. Researchers are particularly interested in developing nutritional interventions that reverse the negative effects of disease-related malnutrition in the hospital setting. High-quality randomised trials have provided evidence that nutritional therapy can reduce morbidity and other complications associated with malnutrition in some patients. Screening of patients for risk of malnutrition at hospital admission, followed by nutritional assessment and individualised nutritional interventions for malnourished patients, should become part of routine clinical care and multimodal treatment in hospitals worldwide.
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Affiliation(s)
- Philipp Schuetz
- University Department of Medicine, Division of General Internal and Emergency Medicine, Kantonsspital Aarau, Aarau, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
| | - David Seres
- Department of Medicine, and Institute of Human Nutrition, Columbia University Irving Medical Center, New York, NY, USA
| | - Dileep N Lobo
- Nottingham Digestive Diseases Centre, University of Nottingham, Nottingham, UK; MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Nottingham, UK; National Institute for Health Research, Nottingham Biomedical Research Centre, Nottingham University Hospitals NHS Trust and University of Nottingham, Nottingham, UK
| | - Filomena Gomes
- Nutrition Science Program, New York Academy of Sciences, New York, NY, USA; NOVA Medical School, Universidade NOVA de Lisboa, Lisboa, Portugal
| | - Nina Kaegi-Braun
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Kantonsspital Aarau, Aarau, Switzerland
| | - Zeno Stanga
- Division of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital, University of Bern, Bern, Switzerland
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15
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Zuccarelli L, Baldassarre G, Magnesa B, Degano C, Comelli M, Gasparini M, Manferdelli G, Marzorati M, Mavelli I, Pilotto A, Porcelli S, Rasica L, Šimunič B, Pišot R, Narici M, Grassi B. Peripheral impairments of oxidative metabolism after a 10-day bed rest are upstream of mitochondrial respiration. J Physiol 2021; 599:4813-4829. [PMID: 34505290 PMCID: PMC9293208 DOI: 10.1113/jp281800] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/08/2021] [Indexed: 11/20/2022] Open
Abstract
Abstract In order to identify peripheral biomarkers of impaired oxidative metabolism during exercise following a 10‐day bed rest, 10 males performed an incremental exercise (to determine peak pulmonary V̇O2 (V̇O2p)) and moderate‐intensity exercises, before (PRE) and after (POST) bed rest. Blood flow response was evaluated in the common femoral artery by Eco‐Doppler during 1 min of passive leg movements (PLM). The intramuscular matching between O2 delivery and O2 utilization was evaluated by near‐infrared spectroscopy (NIRS). Mitochondrial respiration was evaluated ex vivo by high‐resolution respirometry in isolated muscle fibres, and in vivo by NIRS by the evaluation of skeletal muscle V̇O2 (V̇O2m) recovery kinetics. Resting V̇O2m was estimated by NIRS. Peak V̇O2p was lower in POST vs. PRE. The area under the blood flow vs. time curve during PLM was smaller (P = 0.03) in POST (274 ± 233 mL) vs. PRE (427 ± 291). An increased (P = 0.03) overshoot of muscle deoxygenation during a metabolic transition was identified in POST. Skeletal muscle citrate synthase activity was not different (P = 0.11) in POST (131 ± 16 nmol min–1 mg–1) vs. PRE (138 ± 19). Maximal ADP‐stimulated mitochondrial respiration (66 ± 18 pmol s–1 mg–1 (POST) vs. 72 ± 14 (PRE), P = 0.41) was not affected by bed rest. Apparent Km for ADP sensitivity of mitochondrial respiration was reduced in POST vs. PRE (P = 0.04). The V̇O2m recovery time constant was not different (P = 0.79) in POST (22 ± 6 s) vs. PRE (22 ± 6). Resting V̇O2m was reduced by 25% in POST vs. PRE (P = 0.006). Microvascular‐endothelial function was impaired following a 10‐day bed rest, whereas mitochondrial mass and function (both in vivo and ex vivo) were unaffected or slightly enhanced. Key points Ten days of horizontal bed rest impaired in vivo oxidative function during exercise. Microvascular impairments were identified by different methods. Mitochondrial mass and mitochondrial function (evaluated both in vivo and ex vivo) were unchanged or even improved (i.e. enhanced mitochondrial sensitivity to submaximal [ADP]). Resting muscle oxygen uptake was significantly lower following bed rest, suggesting that muscle catabolic processes induced by bed rest/inactivity are less energy‐consuming than anabolic ones.
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Affiliation(s)
| | | | | | | | - Marina Comelli
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Giorgio Manferdelli
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Mauro Marzorati
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Irene Mavelli
- Department of Medicine, University of Udine, Udine, Italy
| | - Andrea Pilotto
- Department of Medicine, University of Udine, Udine, Italy.,Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Simone Porcelli
- Institute of Biomedical Technologies, National Research Council, Milan, Italy.,Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Letizia Rasica
- Institute of Biomedical Technologies, National Research Council, Milan, Italy
| | - Boštjan Šimunič
- Institute of Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Rado Pišot
- Institute of Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy
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16
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Di Girolamo FG, Fiotti N, Milanović Z, Situlin R, Mearelli F, Vinci P, Šimunič B, Pišot R, Narici M, Biolo G. The Aging Muscle in Experimental Bed Rest: A Systematic Review and Meta-Analysis. Front Nutr 2021; 8:633987. [PMID: 34422875 PMCID: PMC8371327 DOI: 10.3389/fnut.2021.633987] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 04/07/2021] [Indexed: 12/30/2022] Open
Abstract
Background: Maintaining skeletal muscle mass and function in aging is crucial for preserving the quality of life and health. An experimental bed rest (BR) protocol is a suitable model to explore muscle decline on aging during inactivity. Objective: The purpose of this systematic review and meta-analysis was, therefore, to carry out an up-to-date evaluation of bed rest, with a specific focus on the magnitude of effects on muscle mass, strength, power, and functional capacity changes as well as the mechanisms, molecules, and pathways involved in muscle decay. Design: This was a systematic review and meta-analysis study. Data sources: We used PubMed, Medline; Web of Science, Google Scholar, and the Cochrane library, all of which were searched prior to April 23, 2020. A manual search was performed to cover bed rest experimental protocols using the following key terms, either singly or in combination: "Elderly Bed rest," "Older Bed rest," "Old Bed rest," "Aging Bed rest," "Aging Bed rest," "Bed-rest," and "Bedrest". Eligibility criteria for selecting studies: The inclusion criteria were divided into four sections: type of study, participants, interventions, and outcome measures. The primary outcome measures were: body mass index, fat mass, fat-free mass, leg lean mass, cross-sectional area, knee extension power, cytokine pattern, IGF signaling biomarkers, FOXO signaling biomarkers, mitochondrial modulation biomarkers, and muscle protein kinetics biomarkers. Results: A total of 25 studies were included in the qualitative synthesis, while 17 of them were included in the meta-analysis. In total, 118 healthy elderly volunteers underwent 5-, 7-, 10-, or 14-days of BR and provided a brief sketch on the possible mechanisms involved. In the very early phase of BR, important changes occurred in the skeletal muscle, with significant loss of performance associated with a lesser grade reduction of the total body and muscle mass. Meta-analysis of the effect of bed rest on total body mass was determined to be small but statistically significant (ES = -0.45, 95% CI: -0.72 to -0.19, P < 0.001). Moderate, statistically significant effects were observed for total lean body mass (ES = -0.67, 95% CI: -0.95 to -0.40, P < 0.001) after bed rest intervention. Overall, total lean body mass was decreased by 1.5 kg, while there was no relationship between bed rest duration and outcomes (Z = 0.423, p = 672). The meta-analyzed effect showed that bed rest produced large, statistically significant, effects (ES = -1.06, 95% CI: -1.37 to -0.75, P < 0.001) in terms of the knee extension power. Knee extension power was decreased by 14.65 N/s. In contrast, to other measures, meta-regression showed a significant relationship between bed rest duration and knee extension power (Z = 4.219, p < 0.001). Moderate, statistically significant, effects were observed after bed rest intervention for leg muscle mass in both old (ES = -0.68, 95% CI: -0.96 to -0.40, P < 0.001) and young (ES = -0.51, 95% CI: -0.80 to -0.22, P < 0.001) adults. However, the magnitude of change was higher in older (MD = -0.86 kg) compared to younger (MD = -0.24 kg) adults. Conclusion: Experimental BR is a suitable model to explore the detrimental effects of inactivity in young adults, old adults, and hospitalized people. Changes in muscle mass and function are the two most investigated variables, and they allow for a consistent trend in the BR-induced changes. Mechanisms underlying the greater loss of muscle mass and function in aging, following inactivity, need to be thoroughly investigated.
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Affiliation(s)
- Filippo Giorgio Di Girolamo
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,SC Assistenza Farmaceutica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Fiotti
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Zoran Milanović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.,Faculty of Sports Studies, Incubator of Kinanthropological Research, Masaryk University, Brno, Czechia
| | - Roberta Situlin
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Filippo Mearelli
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Pierandrea Vinci
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Boštjan Šimunič
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia
| | - Marco Narici
- Department of Biomedical Sciences, Neuromuscular Physiology Laboratory, University of Padova, Padova, Italy
| | - Gianni Biolo
- Clinica Medica, Azienda Sanitaria Universitaria Giuliano Isontina, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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17
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Bychkov A, Reshetnikova P, Bychkova E, Podgorbunskikh E, Koptev V. The current state and future trends of space nutrition from a perspective of astronauts' physiology. Int J Gastron Food Sci 2021. [DOI: 10.1016/j.ijgfs.2021.100324] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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18
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Monti E, Reggiani C, Franchi MV, Toniolo L, Sandri M, Armani A, Zampieri S, Giacomello E, Sarto F, Sirago G, Murgia M, Nogara L, Marcucci L, Ciciliot S, Šimunic B, Pišot R, Narici MV. Neuromuscular junction instability and altered intracellular calcium handling as early determinants of force loss during unloading in humans. J Physiol 2021; 599:3037-3061. [PMID: 33881176 PMCID: PMC8359852 DOI: 10.1113/jp281365] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/30/2021] [Indexed: 01/18/2023] Open
Abstract
Key points Few days of unloading are sufficient to induce a decline of skeletal muscle mass and function; notably, contractile force is lost at a faster rate than muscle mass. The reasons behind this disproportionate loss of muscle force are still poorly understood. We provide strong evidence of two mechanisms only hypothesized until now for the rapid muscle force loss in only 10 days of bed rest. Our results show that an initial neuromuscular junction instability, accompanied by alterations in the innervation status and impairment of single fibre sarcoplasmic reticulum function contribute to the loss of contractile force in front of a preserved myofibrillar function and central activation capacity. Early onset of neuromuscular junction instability and impairment in calcium dynamics involved in excitation–contraction coupling are proposed as eligible determinants to the greater decline in muscle force than in muscle size during unloading.
Abstract Unloading induces rapid skeletal muscle atrophy and functional decline. Importantly, force is lost at a much higher rate than muscle mass. We aimed to investigate the early determinants of the disproportionate loss of force compared to that of muscle mass in response to unloading. Ten young participants underwent 10 days of bed rest (BR). At baseline (BR0) and at 10 days (BR10), quadriceps femoris (QF) volume (VOL) and isometric maximum voluntary contraction (MVC) were assessed. At BR0 and BR10 blood samples and biopsies of vastus lateralis (VL) muscle were collected. Neuromuscular junction (NMJ) stability and myofibre innervation status were assessed, together with single fibre mechanical properties and sarcoplasmic reticulum (SR) calcium handling. From BR0 to BR10, QFVOL and MVC decreased by 5.2% (P = 0.003) and 14.3% (P < 0.001), respectively. Initial and partial denervation was detected from increased neural cell adhesion molecule (NCAM)‐positive myofibres at BR10 compared with BR0 (+3.4%, P = 0.016). NMJ instability was further inferred from increased C‐terminal agrin fragment concentration in serum (+19.2% at BR10, P = 0.031). Fast fibre cross‐sectional area (CSA) showed a trend to decrease by 15% (P = 0.055) at BR10, while single fibre maximal tension (force/CSA) was unchanged. However, at BR10 SR Ca2+ release in response to caffeine decreased by 35.1% (P < 0.002) and 30.2% (P < 0.001) in fast and slow fibres, respectively, pointing to an impaired excitation–contraction coupling. These findings support the view that the early onset of NMJ instability and impairment in SR function are eligible mechanisms contributing to the greater decline in muscle force than in muscle size during unloading. Few days of unloading are sufficient to induce a decline of skeletal muscle mass and function; notably, contractile force is lost at a faster rate than muscle mass. The reasons behind this disproportionate loss of muscle force are still poorly understood. We provide strong evidence of two mechanisms only hypothesized until now for the rapid muscle force loss in only 10 days of bed rest. Our results show that an initial neuromuscular junction instability, accompanied by alterations in the innervation status and impairment of single fibre sarcoplasmic reticulum function contribute to the loss of contractile force in front of a preserved myofibrillar function and central activation capacity. Early onset of neuromuscular junction instability and impairment in calcium dynamics involved in excitation–contraction coupling are proposed as eligible determinants to the greater decline in muscle force than in muscle size during unloading.
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Affiliation(s)
- Elena Monti
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia
| | - Martino V Franchi
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Marco Sandri
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Biomedical Sciences, Venetian Institute of Molecular Medicine, University of Padova, Via Orus 2, Padova, 35129, Italy
| | - Andrea Armani
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Biomedical Sciences, Venetian Institute of Molecular Medicine, University of Padova, Via Orus 2, Padova, 35129, Italy
| | - Sandra Zampieri
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Surgery, Oncology, and Gastroenterology, University of Padova, Padova, 35124, Italy
| | - Emiliana Giacomello
- Clinical Department of Medical, Surgical and Health Sciences, Strada di Fiume, 447, Trieste, 34149, Italy
| | - Fabio Sarto
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Giuseppe Sirago
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Marta Murgia
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Proteomics and Signal Transduction, Max-Planck-Institute of Biochemistry Am Klopferspitz 18, Martinsried, 82152, Germany
| | - Leonardo Nogara
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Lorenzo Marcucci
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy
| | - Stefano Ciciliot
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Department of Biomedical Sciences, Venetian Institute of Molecular Medicine, University of Padova, Via Orus 2, Padova, 35129, Italy
| | - Boštjan Šimunic
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia
| | - Rado Pišot
- Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia
| | - Marco V Narici
- Department of Biomedical Sciences, University of Padova, Padova, 35131, Italy.,Science and Research Center Koper, Institute for Kinesiology Research, Koper, 6000, Slovenia.,CIR-MYO Myology Center, University of Padova, Padova, 35131, Italy
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19
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Kirwan R, McCullough D, Butler T, Perez de Heredia F, Davies IG, Stewart C. Sarcopenia during COVID-19 lockdown restrictions: long-term health effects of short-term muscle loss. GeroScience 2020; 42:1547-1578. [PMID: 33001410 PMCID: PMC7528158 DOI: 10.1007/s11357-020-00272-3] [Citation(s) in RCA: 176] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
The COVID-19 pandemic is an extraordinary global emergency that has led to the implementation of unprecedented measures in order to stem the spread of the infection. Internationally, governments are enforcing measures such as travel bans, quarantine, isolation, and social distancing leading to an extended period of time at home. This has resulted in reductions in physical activity and changes in dietary intakes that have the potential to accelerate sarcopenia, a deterioration of muscle mass and function (more likely in older populations), as well as increases in body fat. These changes in body composition are associated with a number of chronic, lifestyle diseases including cardiovascular disease (CVD), diabetes, osteoporosis, frailty, cognitive decline, and depression. Furthermore, CVD, diabetes, and elevated body fat are associated with greater risk of COVID-19 infection and more severe symptomology, underscoring the importance of avoiding the development of such morbidities. Here we review mechanisms of sarcopenia and their relation to the current data on the effects of COVID-19 confinement on physical activity, dietary habits, sleep, and stress as well as extended bed rest due to COVID-19 hospitalization. The potential of these factors to lead to an increased likelihood of muscle loss and chronic disease will be discussed. By offering a number of home-based strategies including resistance exercise, higher protein intakes and supplementation, we can potentially guide public health authorities to avoid a lifestyle disease and rehabilitation crisis post-COVID-19. Such strategies may also serve as useful preventative measures for reducing the likelihood of sarcopenia in general and in the event of future periods of isolation.
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Affiliation(s)
- Richard Kirwan
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK.
| | - Deaglan McCullough
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Tom Butler
- Department of Clinical Sciences and Nutrition, University of Chester, Chester, UK.
| | - Fatima Perez de Heredia
- School of Biological and Environmental Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ian G Davies
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Claire Stewart
- Research Institute of Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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20
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Collins J, Maughan RJ, Gleeson M, Bilsborough J, Jeukendrup A, Morton JP, Phillips SM, Armstrong L, Burke LM, Close GL, Duffield R, Larson-Meyer E, Louis J, Medina D, Meyer F, Rollo I, Sundgot-Borgen J, Wall BT, Boullosa B, Dupont G, Lizarraga A, Res P, Bizzini M, Castagna C, Cowie CM, D'Hooghe M, Geyer H, Meyer T, Papadimitriou N, Vouillamoz M, McCall A. UEFA expert group statement on nutrition in elite football. Current evidence to inform practical recommendations and guide future research. Br J Sports Med 2020; 55:416. [PMID: 33097528 DOI: 10.1136/bjsports-2019-101961] [Citation(s) in RCA: 98] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/18/2020] [Indexed: 01/09/2023]
Abstract
Football is a global game which is constantly evolving, showing substantial increases in physical and technical demands. Nutrition plays a valuable integrated role in optimising performance of elite players during training and match-play, and maintaining their overall health throughout the season. An evidence-based approach to nutrition emphasising, a 'food first' philosophy (ie, food over supplements), is fundamental to ensure effective player support. This requires relevant scientific evidence to be applied according to the constraints of what is practical and feasible in the football setting. The science underpinning sports nutrition is evolving fast, and practitioners must be alert to new developments. In response to these developments, the Union of European Football Associations (UEFA) has gathered experts in applied sports nutrition research as well as practitioners working with elite football clubs and national associations/federations to issue an expert statement on a range of topics relevant to elite football nutrition: (1) match day nutrition, (2) training day nutrition, (3) body composition, (4) stressful environments and travel, (5) cultural diversity and dietary considerations, (6) dietary supplements, (7) rehabilitation, (8) referees and (9) junior high-level players. The expert group provide a narrative synthesis of the scientific background relating to these topics based on their knowledge and experience of the scientific research literature, as well as practical experience of applying knowledge within an elite sports setting. Our intention is to provide readers with content to help drive their own practical recommendations. In addition, to provide guidance to applied researchers where to focus future efforts.
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Affiliation(s)
- James Collins
- Intra Performance Group, London, UK.,Performance and Research Team, Arsenal Football Club, London, UK
| | | | - Michael Gleeson
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Johann Bilsborough
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,New England Patriots, Foxboro, MA, USA
| | - Asker Jeukendrup
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,MySport Science, Birmingham, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - S M Phillips
- Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Lawrence Armstrong
- Human Performance Laboratory, University of Connecticut, Storrs, CT, USA
| | - Louise M Burke
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Rob Duffield
- Faculty of Health, University of Technology, Sydney, New South Wales, Australia.,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia
| | - Enette Larson-Meyer
- Department of Human Nutrition, Foods, and Exercise, Virginia Tech, Blacksburg, VA, USA
| | - Julien Louis
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel Medina
- Athlete Care and Performance, Monumental Sports & Entertainment, Washington, DC, USA
| | - Flavia Meyer
- Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Ian Rollo
- School of Sports Exercise and Health Sciences, Loughborough University, Loughborough, UK.,PepsiCo Life Sciences, Global R&D, Gatorade Sports Science Institute, Birmingham, UK
| | | | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | | | - Gregory Dupont
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | | | - Peter Res
- Dutch Olympic Team, Amsterdam, Netherlands
| | - Mario Bizzini
- Research and Human Performance Lab, Schulthess Clinic, Zurich, Switzerland
| | - Carlo Castagna
- University of Rome Tor Vergata, Rome, Italy.,Technical Department, Italian Football Federation (FIGC), Florence, Italy.,Italian Football Referees Association, Bologna, Italy
| | - Charlotte M Cowie
- Technical Directorate, Football Association, Burton upon Trent, UK.,Medical Committee, UEFA, Nyon, Switzerland
| | - Michel D'Hooghe
- Medical Committee, UEFA, Nyon, Switzerland.,Medical Centre of Excelence, Schulthess Clinic, Zurich, Switzerland
| | - Hans Geyer
- Center for Preventive Doping Research, German Sport University Cologne, Cologne, Germany
| | - Tim Meyer
- Medical Committee, UEFA, Nyon, Switzerland.,Institute of Sports and Preventive Medicine, Saarland University, Saarbrücken, Germany
| | | | | | - Alan McCall
- Performance and Research Team, Arsenal Football Club, London, UK .,Medical Department, Football Federation Australia, Sydney, New South Wales, Australia.,Sport, Exercise and Health Sciences, School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
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21
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Wall BT, Cruz AM, Otten B, Dunlop MV, Fulford J, Porter C, Abdelrahman DR, Stephens FB, Dirks ML. The Impact of Disuse and High-Fat Overfeeding on Forearm Muscle Amino Acid Metabolism in Humans. J Clin Endocrinol Metab 2020; 105:5821526. [PMID: 32303743 DOI: 10.1210/clinem/dgaa184] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 04/16/2020] [Indexed: 01/08/2023]
Abstract
CONTEXT Anabolic resistance is mechanistically implicated in muscle disuse atrophy. OBJECTIVE The objective of this study is to assess whether anabolic resistance is associated with reduced postprandial amino acid uptake or exacerbated by excess lipid availability. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS Twenty men underwent 7 days of forearm immobilization while consuming a eucaloric (CON; n = 11) or high-fat overfeeding (HFD; n = 9; 50% excess energy as fat) diet (parallel design) within our Nutritional Physiology Research Unit. MAIN OUTCOME MEASURES Preimmobilization and postimmobilization we measured forearm muscle cross-sectional area (aCSA), and postabsorptive and postprandial (3-hour postingestion of a liquid, protein-rich, mixed meal) forearm amino acid metabolism using the arterialized venous-deep venous balance method and infusions of L-[ring-2H5]phenylalanine and L-[1-13C]leucine. RESULTS Immobilization did not affect forearm muscle aCSA in either group, but tended to reduce postabsorptive phenylalanine (P = .07) and leucine (P = .05) net balances equivalently in CON and HFD. Mixed-meal ingestion switched phenylalanine and leucine net balances from negative to positive (P < .05), an effect blunted by immobilization (P < .05) and to a greater extent in HFD than CON (P < .05). Preimmobilization, meal ingestion increased leucine rates of disappearance (Rd; P < .05), with values peaking at 191% (from 87 ± 38 to 254 ± 60 µmol·min-1·100 mL forearm volume-1) and 183% (from 141 ± 24 to 339 ± 51 µmol·min-1·100 mL-1) above postabsorptive rates in CON and HFD, respectively, with meal-induced increases not evident postimmobilization in either group (P > .05). CONCLUSIONS Disuse impairs the ability of a protein-rich meal to promote positive muscle amino acid balance, which is aggravated by dietary lipid oversupply. Moreover, disuse reduced postprandial forearm amino acid uptake; however, this is not worsened under high-fat conditions.
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Affiliation(s)
- Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Ana M Cruz
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
- Exeter Medical School, University of Exeter, UK
| | - Britt Otten
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Mandy V Dunlop
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | | | - Craig Porter
- Department of Surgery, University of Texas Medical Branch & Metabolism Unit, Shriners Hospital for Children, Galveston, USA
| | - Doaa Reda Abdelrahman
- Department of Surgery, University of Texas Medical Branch & Metabolism Unit, Shriners Hospital for Children, Galveston, USA
| | - Francis B Stephens
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Marlou L Dirks
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
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Narici M, Vito GD, Franchi M, Paoli A, Moro T, Marcolin G, Grassi B, Baldassarre G, Zuccarelli L, Biolo G, di Girolamo FG, Fiotti N, Dela F, Greenhaff P, Maganaris C. Impact of sedentarism due to the COVID-19 home confinement on neuromuscular, cardiovascular and metabolic health: Physiological and pathophysiological implications and recommendations for physical and nutritional countermeasures. Eur J Sport Sci 2020; 21:614-635. [PMID: 32394816 DOI: 10.1080/17461391.2020.1761076] [Citation(s) in RCA: 219] [Impact Index Per Article: 54.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
The COVID-19 pandemic is an unprecedented health crisis as entire populations have been asked to self-isolate and live in home-confinement for several weeks to months, which in itself represents a physiological challenge with significant health risks. This paper describes the impact of sedentarism on the human body at the level of the muscular, cardiovascular, metabolic, endocrine and nervous systems and is based on evidence from several models of inactivity, including bed rest, unilateral limb suspension, and step-reduction. Data form these studies show that muscle wasting occurs rapidly, being detectable within two days of inactivity. This loss of muscle mass is associated with fibre denervation, neuromuscular junction damage and upregulation of protein breakdown, but is mostly explained by the suppression of muscle protein synthesis. Inactivity also affects glucose homeostasis as just few days of step reduction or bed rest, reduce insulin sensitivity, principally in muscle. Additionally, aerobic capacity is impaired at all levels of the O2 cascade, from the cardiovascular system, including peripheral circulation, to skeletal muscle oxidative function. Positive energy balance during physical inactivity is associated with fat deposition, associated with systemic inflammation and activation of antioxidant defences, exacerbating muscle loss. Importantly, these deleterious effects of inactivity can be diminished by routine exercise practice, but the exercise dose-response relationship is currently unknown. Nevertheless, low to medium-intensity high volume resistive exercise, easily implementable in home-settings, will have positive effects, particularly if combined with a 15-25% reduction in daily energy intake. This combined regimen seems ideal for preserving neuromuscular, metabolic and cardiovascular health.
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Affiliation(s)
- Marco Narici
- Department of Biomedical Sciences, CIR-MYO Myology Center, Neuromuscular Physiology Laboratory, University of Padova, Padua, Italy
| | - Giuseppe De Vito
- Department of Biomedical Sciences, CIR-MYO Myology Center, Neuromuscular Physiology Laboratory, University of Padova, Padua, Italy
| | - Martino Franchi
- Department of Biomedical Sciences, Neuromuscular Physiology Laboratory, University of Padova, Padua, Italy
| | - Antonio Paoli
- Department of Biomedical Sciences, Nutrition and Exercise Physiology Laboratory, University of Padova, Padua, Italy
| | - Tatiana Moro
- Department of Biomedical Sciences, Nutrition and Exercise Physiology Laboratory, University of Padova, Padua, Italy
| | - Giuseppe Marcolin
- Department of Biomedical Sciences, Nutrition and Exercise Physiology Laboratory, University of Padova, Padua, Italy
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy
| | | | | | - Gianni Biolo
- Department of Internal Medicine, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | | | - Nicola Fiotti
- Department of Internal Medicine, University of Trieste, Ospedale di Cattinara, Trieste, Italy
| | - Flemming Dela
- Xlab, Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Geriatrics, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark
| | - Paul Greenhaff
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, National Institute for Health Research Nottingham Biomedical Research Centre, School of Life Sciences, The Medical School, University of Nottingham, Queen's Medical Centre, Nottingham, UK
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23
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Dirks ML, Wall BT, Otten B, Cruz AM, Dunlop MV, Barker AR, Stephens FB. High-fat Overfeeding Does Not Exacerbate Rapid Changes in Forearm Glucose and Fatty Acid Balance During Immobilization. J Clin Endocrinol Metab 2020; 105:5586896. [PMID: 31609422 DOI: 10.1210/clinem/dgz049] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 09/24/2019] [Indexed: 12/25/2022]
Abstract
CONTEXT Physical inactivity and high-fat overfeeding have been shown to independently induce insulin resistance. OBJECTIVE Establish the contribution of muscle disuse and lipid availability to the development of inactivity-induced insulin resistance. DESIGN, SETTING, PARTICIPANTS, AND INTERVENTIONS 20 healthy males underwent 7 days of forearm cast immobilization combined with a fully controlled eucaloric diet (n = 10, age 23 ± 2 yr, body mass index [BMI] 23.8 ± 1.0 kg·m-2) or a high-fat diet (HFD) providing 50% excess energy from fat (high-fat diet, n = 10, age 23 ± 2 yr, BMI 22.4 ± 0.8 kg·m-2). MAIN OUTCOME MEASURES Prior to casting and following 2 and 7 days of immobilization, forearm glucose uptake (FGU) and nonesterified fatty acid (NEFA) balance were assessed using the arterialized venous-deep venous (AV-V) forearm balance method following ingestion of a mixed macronutrient drink. RESULTS 7 days of HFD increased body weight by 0.9 ± 0.2 kg (P = 0.002), but did not alter fasting, arterialized whole-blood glucose and serum insulin concentrations or the associated homeostatic model assessment of insulin resistance or Matsuda indices. Two and 7 days of forearm immobilization led to a 40 ± 7% and 52 ± 7% decrease in FGU, respectively (P < 0.001), with no difference between day 2 and 7 and no effect of HFD. Forearm NEFA balance tended to increase following 2 and 7 days of immobilization (P = 0.095). CONCLUSIONS Forearm immobilization leads to a rapid and substantial decrease in FGU, which is accompanied by an increase in forearm NEFA balance but is not exacerbated by excess dietary fat intake. Altogether, our data suggest that disuse-induced insulin resistance of glucose metabolism occurs as a physiological adaptation in response to the removal of muscle contraction.
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Affiliation(s)
- Marlou L Dirks
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Benjamin T Wall
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Britt Otten
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Ana M Cruz
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Mandy V Dunlop
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Alan R Barker
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
| | - Francis B Stephens
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, UK
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24
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English KL, Bloomberg JJ, Mulavara AP, Ploutz-Snyder LL. Exercise Countermeasures to Neuromuscular Deconditioning in Spaceflight. Compr Physiol 2019; 10:171-196. [PMID: 31853963 DOI: 10.1002/cphy.c190005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The mechanical unloading of spaceflight elicits a host of physiological adaptations including reductions in muscle mass, muscle strength, and muscle function and alterations in central interpretation of visual, vestibular, and proprioceptive information. Upon return to a terrestrial, gravitational environment, these result in reduced function and performance, the potential consequences of which will be exacerbated during exploration missions to austere and distant destinations such as the moon and Mars. Exercise is a potent countermeasure to unloading-induced physiological maladaptations and has been employed since the early days of spaceflight. In-flight exercise hardware has evolved from rudimentary and largely ineffective devices to the current suite onboard the International Space Station (ISS) comprised of a cycle ergometer, treadmill, and resistance exercise device; these contemporary devices have either fully protected or significantly attenuated neuromuscular degradation in spaceflight. However, unlike current microgravity operations on the ISS, future exploration missions will include surface operations in partial gravity environments, which will require greater physiological capacity and work output of their crews. For these flights, it is critical to identify physiological thresholds below which task performance will be impaired and to develop exercise countermeasures-both pre- and in-flight-to ensure that crewmembers are able to safely and effectively complete physically demanding mission objectives. © 2020 American Physiological Society. Compr Physiol 10:171-196, 2020.
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Affiliation(s)
- Kirk L English
- University of Houston-Clear Lake, Houston, Texas, USA.,Exercise and Nutritional Health Institute, University of Houston-Clear Lake, Houston, Texas, USA
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25
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Braun B, Newman A. Accounting for the Nutritional Context to Correctly Interpret Results from Studies of Exercise and Sedentary Behavior. Nutrients 2019; 11:nu11092230. [PMID: 31527417 PMCID: PMC6769997 DOI: 10.3390/nu11092230] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 09/04/2019] [Accepted: 09/04/2019] [Indexed: 01/16/2023] Open
Abstract
There is a wealth of research lauding the benefits of exercise to oppose cardiometabolic disease such as diabetes, CVD and hypertension. However, in the great majority of these studies, the nutritional context (energy balance, deficit, or surplus) has been ignored, despite its profound effect on responses to both exercise and inactivity. Even a minor energy deficit or surplus can strongly modulate the magnitude and duration of the metabolic responses to an intervention; therefore, failure to account for this important confounding variable obscures clear interpretation of the results from studies of exercise or inactivity. The aim of this review is to highlight key lessons from studies examining the interaction between exercise and sedentary behavior, energy status, and glucose and insulin regulation. In addition to identifying notable problems, we suggest a few potential solutions.
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Affiliation(s)
- Barry Braun
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA.
| | - Alissa Newman
- Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA
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26
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Winnard A, Scott J, Waters N, Vance M, Caplan N. Effect of Time on Human Muscle Outcomes During Simulated Microgravity Exposure Without Countermeasures-Systematic Review. Front Physiol 2019; 10:1046. [PMID: 31474878 PMCID: PMC6707384 DOI: 10.3389/fphys.2019.01046] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Accepted: 07/30/2019] [Indexed: 12/11/2022] Open
Abstract
Background: Space Agencies are planning human missions beyond Low Earth Orbit. Consideration of how physiological system adaptation with microgravity (μG) will be managed during these mission scenarios is required. Exercise countermeasures (CM) could be used more sparingly to decrease limited resource costs, including periods of no exercise. This study provides a complete overview of the current evidence, making recommendations on the length of time humans exposed to simulated μG might safely perform no exercise considering muscles only. Methods: Electronic databases were searched for astronaut or space simulation bed rest studies, as the most valid terrestrial simulation, from start of records to July 2017. Studies were assessed with the Quality in Prognostic Studies and bed rest analog studies assessed for transferability to astronauts using the Aerospace Medicine Systematic Review Group Tool for Assessing Bed Rest Methods. Effect sizes, based on no CM groups, were used to assess muscle outcomes over time. Outcomes included were contractile work capacity, muscle cross sectional area, muscle activity, muscle thickness, muscle volume, maximal voluntary contraction force during one repetition maximum, peak power, performance based outcomes, power, and torque/strength. Results: Seventy-five bed rest μG simulation studies were included, many with high risk of confounding factors and participation bias. Most muscle outcomes deteriorated over time with no countermeasures. Moderate effects were apparent by 7-15 days and large by 28-56 days. Moderate effects (>0.6) became apparent in the following order, power and MVC during one repetition maximum (7 days), followed by volume, cross sectional area, torques and strengths, contractile work capacity, thickness and endurance (14 days), then muscle activity (15 days). Large effects (>1.2) became apparent in the following order, volume, cross sectional area (28 days) torques and strengths, thickness (35 days) and peak power (56 days). Conclusions: Moderate effects on a range of muscle parameters may occur within 7-14 days of unloading, with large effects within 35 days. Combined with muscle performance requirements for mission tasks, these data, may support the design of CM programmes to maximize efficiency without compromising crew safety and mission success when incorporated with data from additional physiological systems that also need consideration.
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Affiliation(s)
- Andrew Winnard
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Jonathan Scott
- Space Medicine Office, European Astronaut Centre, Cologne, Germany
| | - Nathan Waters
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Martin Vance
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Nick Caplan
- Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, United Kingdom
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27
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Oikawa SY, Holloway TM, Phillips SM. The Impact of Step Reduction on Muscle Health in Aging: Protein and Exercise as Countermeasures. Front Nutr 2019; 6:75. [PMID: 31179284 PMCID: PMC6543894 DOI: 10.3389/fnut.2019.00075] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/03/2019] [Indexed: 12/17/2022] Open
Abstract
Declines in strength and muscle function with age—sarcopenia—contribute to a variety of negative outcomes including an increased risk of: falls, fractures, hospitalization, and reduced mobility in older persons. Population-based estimates of the loss of muscle after age 60 show a loss of ~1% per year while strength loss is more rapid at ~3% per year. These rates are not, however, linear as periodic bouts of reduced physical activity and muscle disuse transiently accelerate loss of muscle and declines in muscle strength and power. Episodic complete muscle disuse can be due to sickness-related bed rest or local muscle disuse as a result of limb immobilization/surgery. Alternatively, relative muscle disuse occurs during inactivity due to illness and the associated convalescence resulting in marked reductions in daily steps, often referred to as step reduction (SR). While it is a “milder” form of disuse, it can have a similar adverse impact on skeletal muscle health. The physiological consequences of even short-term inactivity, modeled by SR, show losses in muscle mass and strength, as well as impaired insulin sensitivity and an increase in systemic inflammation. Though seemingly benign in comparison to bed rest, periodic inactivity likely occurs, we posit, more frequently with advancing age due to illness, declining mental health and declining mobility. Given that recovery from inactivity in older adults is slow or possibly incomplete we hypothesize that accumulated periods of inactivity contribute to sarcopenia. Periodic activity, even in small quantities, and protein supplementation may serve as effective strategies to offset the loss of muscle mass with aging, specifically during periods of inactivity. The aim of this review is to examine the recent literature encompassing SR, as a model of inactivity, and to explore the capacity of nutrition and exercise interventions to mitigate adverse physiological changes as a result of SR.
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Affiliation(s)
- Sara Y Oikawa
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Tanya M Holloway
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Exercise Metabolism Research Group, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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28
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Buso A, Comelli M, Picco R, Isola M, Magnesa B, Pišot R, Rittweger J, Salvadego D, Šimunič B, Grassi B, Mavelli I. Mitochondrial Adaptations in Elderly and Young Men Skeletal Muscle Following 2 Weeks of Bed Rest and Rehabilitation. Front Physiol 2019; 10:474. [PMID: 31118897 PMCID: PMC6504794 DOI: 10.3389/fphys.2019.00474] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/04/2019] [Indexed: 12/21/2022] Open
Abstract
The aim of the study was to evaluate the expression levels of proteins related to mitochondrial biogenesis regulation and bioenergetics in vastus lateralis muscle biopsies from 16 elderly and 7 young people subjected to 14 days of bed-rest, causing atrophy, and subsequent 14 days of exercise training. Based on quantitative immunoblot analyses, in both groups a reduction of two key regulators of mitochondrial biogenesis/remodeling and activity, namely PGC-1α and Sirt3, was revealed during bed-rest, with a subsequent up-regulation after rehabilitation, indicating an involvement of PGC-1α-Sirt3 axis in response to the treatments. A difference was observed comparing the young and elderly subjects as, for both proteins, the abundance in the elderly was more affected by immobility and less responsive to exercise. The expression levels of TOM20 and Citrate Synthase, assayed as markers of outer mitochondrial membrane and mitochondrial mass, showed a noticeable sensitivity in the elderly group, where they were affected by bed-rest and rehabilitation recalling the pattern of PGC-1α. TOM20 and CS remained unchanged in young subjects. Single OXPHOS complexes showed peculiar patterns, which were in some cases dissimilar from PGC-1α, and suggest different influences on protein biogenesis and degradation. Overall, exercise was capable to counteract the effect of immobility, when present, except for complex V, which was markedly downregulated by bed-rest, but remained unaffected after rehabilitation, maybe as result of greater extent of degradation processes over biogenesis. Phosphorylation extent of AMPK, and its upstream activator LKB1, did not change after bed-rest and rehabilitation in either young or elderly subjects, suggesting that the activation of energy-sensing LKB1-AMPK signaling pathway was “missed” due to its transient nature, or was not triggered under our conditions. Our study demonstrates that, as far as the expression of various proteins related to mitochondrial biogenesis/remodeling, adaptations to bed-rest and rehabilitation in the two populations were different. The impact of bed-rest was greater in the elderly subjects, where the pattern (decrease after bed rest and recovery following rehabilitation) was accompanied by changes of mitochondrial mass. Modifications of protein abundance were matched with data obtained from gene expression analyses of four public human datasets focusing on related genes.
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Affiliation(s)
- Alessia Buso
- Department of Medicine, University of Udine, Udine, Italy
| | - Marina Comelli
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Miriam Isola
- Department of Medicine, University of Udine, Udine, Italy
| | | | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Joern Rittweger
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany.,Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Desy Salvadego
- Department of Medicine, University of Udine, Udine, Italy
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre, Koper, Slovenia
| | - Bruno Grassi
- Department of Medicine, University of Udine, Udine, Italy.,Institute of Bioimaging and Molecular Physiology, National Research Council, Milan, Italy
| | - Irene Mavelli
- Department of Medicine, University of Udine, Udine, Italy.,INBB Istituto Nazionale Biostrutture e Biosistemi, Rome, Italy
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29
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Šimunič B, Koren K, Rittweger J, Lazzer S, Reggiani C, Rejc E, Pišot R, Narici M, Degens H. Tensiomyography detects early hallmarks of bed-rest-induced atrophy before changes in muscle architecture. J Appl Physiol (1985) 2019; 126:815-822. [PMID: 30676871 DOI: 10.1152/japplphysiol.00880.2018] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
In young and older people, skeletal muscle mass is reduced after as little as 7 days of disuse. The declines in muscle mass after such short periods are of high clinical relevance, particularly in older people who show a higher atrophy rate and a slower or even a complete lack of muscle mass recovery after disuse. Ten men (24.3 yr; SD 2.6) underwent 35 days of 6° head-down tilt bed rest, followed by 30 days of recovery. During bed rest, a neutral energy balance was maintained, with three weekly passive physiotherapy sessions to minimize muscle soreness and joint stiffness. All measurements were performed in a hospital at days 1-10, 16, 28, and 35 of bed rest (BR1-BR10, BR16, BR28, and BR35, respectively) and days 1, 3, and 30 after reambulation (R + 1, R + 3, and R + 30, respectively). Vastus medialis obliquus (VMO), vastus medialis longus (VML), and biceps femoris (BF) thickness (d) and pennation angle (Θ) were assessed by ultrasonography, whereas twitch muscle belly displacement (Dm) and contraction time (Tc) were assessed with tensiomyography (TMG). After bed rest, d and Θ decreased by 13-17% in all muscles ( P < 0.001) and had recovered at R + 30. Dm was increased by 42.3-84.4% ( P < 0.001) at BR35 and preceded the decrease in d by 7, 5, and 3 days in VMO, VML, and BF, respectively. Tc increased only in BF (32.1%; P < 0.001) and was not recovered at R + 30. TMG can detect early bed-rest-induced changes in muscle with higher sensitivity before overt architectural changes, and atrophy can be detected. NEW & NOTEWORTHY Detection of early atrophic processes and irreversible adaptation to disuse are of high clinical relevance. With the use of tensiomyography (TMG), we detected early atrophic processes before overt architectural changes, and atrophy can be detected using imaging technique. Furthermore, TMG detected irreversible changes of biceps femoris contraction time.
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Affiliation(s)
- Boštjan Šimunič
- University of Primorska , Koper , Slovenia.,Science and Research Centre Koper, Institute for Kinesiology Research , Koper , Slovenia
| | - Katja Koren
- Science and Research Centre Koper, Institute for Kinesiology Research , Koper , Slovenia
| | - Jörn Rittweger
- Institute of Aerospace Medicine, German Aerospace Center , Cologne , Germany.,Department of Pediatrics and Adolescent Medicine, University of Cologne , Cologne , Germany
| | - Stefano Lazzer
- Department of Medicine, University of Udine , Udine , Italy.,School of Sport Sciences, University of Udine , Udine , Italy
| | - Carlo Reggiani
- Science and Research Centre Koper, Institute for Kinesiology Research , Koper , Slovenia.,Department of Biomedical Sciences, University of Padova , Padova , Italy
| | - Enrico Rejc
- Kentucky Spinal Cord Injury Research Center, University of Louisville , Louisville, Kentucky
| | - Rado Pišot
- Science and Research Centre Koper, Institute for Kinesiology Research , Koper , Slovenia
| | - Marco Narici
- Science and Research Centre Koper, Institute for Kinesiology Research , Koper , Slovenia.,Department of Biomedical Sciences, University of Padova , Padova , Italy
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University , Manchester , United Kingdom.,Institute of Sport Science and Innovations, Lithuanian Sports University , Kaunas , Lithuania.,University of Medicine and Pharmacy of Targu Mures , Targu Mures , Romania
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30
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Oikawa SY, McGlory C, D'Souza LK, Morgan AK, Saddler NI, Baker SK, Parise G, Phillips SM. A randomized controlled trial of the impact of protein supplementation on leg lean mass and integrated muscle protein synthesis during inactivity and energy restriction in older persons. Am J Clin Nutr 2018; 108:1060-1068. [PMID: 30289425 DOI: 10.1093/ajcn/nqy193] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Accepted: 07/16/2018] [Indexed: 12/24/2022] Open
Abstract
Background In older persons, muscle loss is accelerated during physical inactivity and hypoenergetic states, both of which are features of hospitalization. Protein supplementation may represent a strategy to offset the loss of muscle during inactivity, and enhance recovery on resumption of activity. Objective We aimed to determine if protein supplementation, with proteins of substantially different quality, would alleviate the loss of lean mass by augmenting muscle protein synthesis (MPS) while inactive during a hypoenergetic state. Design Participants (16 men, mean ± SD age: 69 ± 3 y; 15 women, mean ± SD age: 68 ± 4 y) consumed a diet containing 1.6 g protein · kg-1 · d-1, with 55% ± 9% of protein from foods and 45% ± 9% from supplements, namely, whey protein (WP) or collagen peptides (CP): 30 g each, consumed 2 times/d. Participants were in energy balance (EB) for 1 wk, then began a period of energy restriction (ER; -500 kcal/d) for 1 wk, followed by ER with step reduction (ER + SR; <750 steps/d) for 2 wk, before a return to habitual activity in recovery (RC) for 1 wk. Results There were significant reductions in leg lean mass (LLM) from EB to ER, and from ER to ER + SR in both groups (P < 0.001) with no differences between WP and CP or when comparing the change from phase to phase. During RC, LLM increased from ER + SR, but in the WP group only. Rates of integrated muscle protein synthesis decreased during ER and ER + SR in both groups (P < 0.01), but increased during RC only in the WP group (P = 0.05). Conclusions Protein supplementation did not confer a benefit in protecting LLM, but only supplemental WP augmented LLM and muscle protein synthesis during recovery from inactivity and a hypoenergetic state. This trial was registered at http://www.clinicaltrials.gov as NCT03285737.
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Affiliation(s)
- Sara Y Oikawa
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Chris McGlory
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Lisa K D'Souza
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Adrienne K Morgan
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Nelson I Saddler
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Steven K Baker
- Department of Neurology, Michael G DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada
| | - Gianni Parise
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Stuart M Phillips
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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31
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Biolo G, Di Girolamo FG, McDonnell A, Fiotti N, Mearelli F, Situlin R, Gonelli A, Dapas B, Giordano M, Lainscak M, Grassi G, Zauli G, Secchiero P, Mekjavic I. Effects of Hypoxia and Bed Rest on Markers of Cardiometabolic Risk: Compensatory Changes in Circulating TRAIL and Glutathione Redox Capacity. Front Physiol 2018; 9:1000. [PMID: 30104982 PMCID: PMC6077233 DOI: 10.3389/fphys.2018.01000] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 07/09/2018] [Indexed: 12/18/2022] Open
Abstract
In chronic diseases, hypoxia and physical inactivity are associated with atherosclerosis progression. In contrast, a lower mortality from coronary artery disease and stroke is observed in healthy humans residing at high altitude in hypoxic environments. Eleven young, male volunteers completed the following 10-day campaigns in a randomized order: hypoxic ambulatory, hypoxic bed rest and normoxic bed rest. Before intervention, subjects were evaluated in normoxic ambulatory condition. Normobaric hypoxia was achieved in a hypoxic facility simulating 4000 m of altitude. Following hypoxia, either in bed rest or ambulatory condition, markers of cardiometabolic risk shifted toward a more atherogenic pattern consisting of: (a) lower levels of total HDL cholesterol and HDL2 sub-fraction and decreased hepatic lipase; (b) activation of systemic inflammation, as determined by C-reactive protein and serum amyloid A; (c) increased plasma homocysteine; (d) decreased delta-5 desaturase index in cell membrane fatty acids, a marker of insulin sensitivity. Bed rest and hypoxia additively decreased total HDL and delta-5 desaturase index. In parallel to the pro-atherogenic effects, hypoxia activated selected anti-atherogenic pathways, consisting of increased circulating TNF-related apoptosis-inducing ligand (TRAIL), a protective factor against atherosclerosis, membrane omega-3 index and erythrocyte glutathione availability. Hypoxia mediated changes in TRAIL concentrations and redox glutathione capacity (i.e., GSH/GSSG ratio) were greater in ambulatory conditions (+34 ± 6% and +87 ± 31%, respectively) than in bed rest (+17 ± 7% and +2 ± 27% respectively). Hypoxia-induced cardiometabolic risk is blunted by moderate level of physical activity as compared to bed rest. TRAIL and glutathione redox capacity may contribute to the positive interaction between physical activity and hypoxia. Highlights: – Hypoxia and bed rest activate metabolic and inflammatory markers of atherogenesis. – Hypoxia and physical activity activate selected anti-atherogenic pathways. – Hypoxia and physical activity positive interaction involves TRAIL and glutathione.
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Affiliation(s)
- Gianni Biolo
- Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Filippo G Di Girolamo
- Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Adam McDonnell
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | - Nicola Fiotti
- Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Filippo Mearelli
- Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberta Situlin
- Clinica Medica, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Arianna Gonelli
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, University of Ferrara, Ferrara, Italy
| | - Barbara Dapas
- Department of Life Science, University of Trieste, Trieste, Italy
| | - Mauro Giordano
- Ospedale Clinicizzato di Marcianise, Dipartimento di Scienze Mediche, Chirurgiche, Neurologiche, Metaboliche e dell'Invecchiamento, Università degli Studi della Campania Luigi Vanvitelli, Marcianise, Italy
| | - Mitja Lainscak
- Department of Internal Medicine, General Hospital Murska Sobota and Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Gabriele Grassi
- Department of Life Science, University of Trieste, Trieste, Italy
| | - Giorgio Zauli
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, University of Ferrara, Ferrara, Italy
| | - Paola Secchiero
- Dipartimento di Morfologia, Chirurgia e Medicina Sperimentale, University of Ferrara, Ferrara, Italy
| | - Igor Mekjavic
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
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32
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Dirks ML, Stephens FB, Jackman SR, Galera Gordo J, Machin DJ, Pulsford RM, van Loon LJC, Wall BT. A single day of bed rest, irrespective of energy balance, does not affect skeletal muscle gene expression or insulin sensitivity. Exp Physiol 2018; 103:860-875. [DOI: 10.1113/ep086961] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 04/04/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Marlou L. Dirks
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
| | - Francis B. Stephens
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
| | - Sarah R. Jackman
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
| | - Jesús Galera Gordo
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
| | - David J. Machin
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
| | - Richard M. Pulsford
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
| | - Luc J. C. van Loon
- Department of Human Biology; NUTRIM School of Nutrition and Translational Research in Metabolism; Maastricht University Medical Centre; Maastricht The Netherlands
| | - Benjamin T. Wall
- Department of Sport and Health Sciences; College of Life and Environmental Sciences; University of Exeter; Exeter UK
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33
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Biolo G, Di Girolamo FG, Heer M, Sturma M, Mazzucco S, Agostini F, Situlin R, Vinci P, Giordano M, Buehlmeier J, Frings-Meuthen P, Mearelli F, Fiotti N. Alkalinization with potassium bicarbonate improves glutathione status and protein kinetics in young volunteers during 21-day bed rest. Clin Nutr 2018; 38:652-659. [PMID: 29739680 DOI: 10.1016/j.clnu.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 12/22/2017] [Accepted: 04/06/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND & AIMS Physical inactivity is associated with lean body mass wasting, oxidative stress and pro-inflammatory changes of cell membrane lipids. Alkalinization may potentially counteract these alterations. We evaluated the effects of potassium bicarbonate supplementation on protein kinetics, glutathione status and pro- and anti-inflammatory polyunsaturated fatty acids (PUFA) in erythrocyte membranes in humans, during experimental bed rest. METHODS Healthy, young, male volunteers were investigated at the end of two 21-day bed rest periods, one with, and the other without, daily potassium bicarbonate supplementation (90 mmol × d-1), according to a cross-over design. Oxidative stress in erythrocytes was evaluated by determining the ratio between reduced (GSH) and oxidized glutathione (GSSG). Glutathione turnover and phenylalanine kinetics, a marker of whole body protein metabolism, were determined by stable isotope infusions. Erythrocyte membranes PUFA composition was analyzed by gas-chromatography. RESULTS At the end of the two study periods, urinary pH was 10 ± 3% greater in subjects receiving potassium bicarbonate supplementation (7.23 ± 0.15 vs. 6.68 ± 0.11, p < 0.001). Alkalinization increased total glutathione concentrations by 5 ± 2% (p < 0.05) and decreased its rate of clearance by 38 ± 13% (p < 0.05), without significantly changing GSH-to-GSSG ratio. After alkalinization, net protein balance in the postabsorptive state improved significantly by 17 ± 5% (p < 0.05) as well as the sum of n-3 PUFA and the n-3-to-n-6 PUFA ratio in erythrocyte membranes (p < 0.05). CONCLUSIONS Alkalinization during long-term inactivity is associated with improved glutathione status, anti-inflammatory lipid pattern in cell membranes and reduction in protein catabolism at whole body level. This study suggests that, in clinical conditions characterized by inactivity, oxidative stress and inflammation, alkalinization could be a useful adjuvant therapeutic strategy.
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Affiliation(s)
- Gianni Biolo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
| | | | - Martina Heer
- Department of Nutrition and Food Science, Nutrition Physiology, University of Bonn, Bonn, Germany
| | - Mariella Sturma
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Sara Mazzucco
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Francesco Agostini
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Roberta Situlin
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Pierandrea Vinci
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Mauro Giordano
- Department of Medical, Surgical, Neurological, Metabolic and Geriatrics Sciences, Second University of Naples, Naples, Italy
| | - Judith Buehlmeier
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Köln, Germany
| | | | - Filippo Mearelli
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Nicola Fiotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
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34
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Barazzoni R, Bischoff SC, Boirie Y, Busetto L, Cederholm T, Dicker D, Toplak H, Van Gossum A, Yumuk V, Vettor R. Sarcopenic obesity: Time to meet the challenge. Clin Nutr 2018; 37:1787-1793. [PMID: 29857921 DOI: 10.1016/j.clnu.2018.04.018] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 04/26/2018] [Indexed: 01/01/2023]
Abstract
The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social and multi-disciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures and cancer, as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenetic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight-reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term "sarcopenic obesity" has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.
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Affiliation(s)
- Rocco Barazzoni
- Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy; Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy.
| | - Stephan C Bischoff
- University of Hohenheim, Department of Nutritional Medicine, Stuttgart, Germany
| | - Yves Boirie
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, CRNH Auvergne, F-63000 Clermont-Ferrand, France; CHU Clermont-Ferrand, Service Nutrition Clinique, F-63000 Clermont-Ferrand, France
| | - Luca Busetto
- Department of Medicine, University of Padova, Italy; Center for the Study and the Integrated Management of Obesity (EASO COM), Padova University Hospital, Padova, Italy
| | - Tommy Cederholm
- Uppsala University, Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala, Sweden
| | - Dror Dicker
- Internal Medicine Department & Obesity Clinic, Hasharon Hospital-Rabin Medical Center, Petach-Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hermann Toplak
- Department of Medicine, Medical University Graz, Austria
| | - Andre Van Gossum
- Department of Gastroenterology, Clinic of Intestinal Diseases and Nutritional Support, Hopital Erasme, Free University of Brussels, Brussels, Belgium
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Roberto Vettor
- Department of Medicine, University of Padova, Italy; Center for the Study and the Integrated Management of Obesity (EASO COM), Padova University Hospital, Padova, Italy
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35
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Floreani M, Rejc E, Taboga P, Ganzini A, Pišot R, Šimunič B, Biolo G, Reggiani C, Passaro A, Narici M, Rittweger J, di Prampero PE, Lazzer S. Effects of 14 days of bed rest and following physical training on metabolic cost, mechanical work, and efficiency during walking in older and young healthy males. PLoS One 2018. [PMID: 29529070 PMCID: PMC5847238 DOI: 10.1371/journal.pone.0194291] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
In this study, we investigated: i) the effects of bed rest and a subsequent physical training program on metabolic cost (Cw), mechanical work and efficiency during walking in older and young men; ii) the mechanisms underlying the higher Cw observed in older than young men.Twenty-three healthy male subjects (N = 16 older adults, age 59.6±3.4 years; N = 7 young, age: 23.1±2.9 years) participated in this study. The subjects underwent 14 days of bed rest followed by two weeks of physical training (6 sessions). Cw, mechanical work, efficiency, and co-contraction time of proximal muscles (vastus lateralis and biceps femoris) and distal muscles (gastrocnemius medialis and tibialis anterior) were measured during walking at 0.83, 1.11, 1.39, 1.67 m·s-1 before bed rest (pre-BR), after bed rest (post-BR) and after physical training (post-PT).No effects of bed rest and physical training were observed on the analysed parameters in either group. Older men showed higher Cw and lower efficiency at each speed (average +25.1 and -20.5%, P<0.001, respectively) compared to young. Co-contraction time of proximal and distal muscles were higher in older than in young men across the different walking speeds (average +30.0 and +110.3%, P<0.05, respectively).The lack of bed rest and physical training effects on the parameters analyzed in this study may be explained by the healthy status of both young and older men, which could have mitigated the effects of these interventions on walking motor function. On the other hand, the fact that older adults showed greater Cw, overall higher co-contraction time of antagonist lower limb muscles, and lower efficiency compared to the young cohort throughout a wide range of walking speed may suggest that older adults sacrificed economy of walking to improve stability.
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Affiliation(s)
- Mirco Floreani
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Enrico Rejc
- Department of Medical Area, University of Udine, Udine, Italy
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, United States of America
| | - Paolo Taboga
- Department of Medical Area, University of Udine, Udine, Italy
- Department of Kinesiology and Health Science, California State University, Sacramento, CA, United States of America
| | - Alessandro Ganzini
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Bostjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre Koper, Koper, Slovenia
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Angelina Passaro
- Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy
| | - Marco Narici
- MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Derby Royal Hospital, Derby, United Kingdom
| | - Joern Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
- Department of Pediatrics and Adolescent Medicine, University of Cologne, Cologne, Germany
| | - Pietro Enrico di Prampero
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
| | - Stefano Lazzer
- Department of Medical Area, University of Udine, Udine, Italy
- School of Sport Sciences, University of Udine, Udine, Italy
- * E-mail:
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36
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Rejc E, Floreani M, Taboga P, Botter A, Toniolo L, Cancellara L, Narici M, Šimunič B, Pišot R, Biolo G, Passaro A, Rittweger J, Reggiani C, Lazzer S. Loss of maximal explosive power of lower limbs after 2 weeks of disuse and incomplete recovery after retraining in older adults. J Physiol 2018; 596:647-665. [PMID: 29266264 DOI: 10.1113/jp274772] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 12/11/2017] [Indexed: 01/01/2023] Open
Abstract
KEY POINTS Disuse in older adults can critically decrease lower limb muscle power, leading to compromised mobility and overall quality of life. We studied how muscle power and its determinants (muscle mass, single muscle fibre properties and motor control) adapted to 2 weeks of disuse and subsequent 2 weeks of physical training in young and older people. Disuse decreased lower limb muscle power in both groups; however, different adaptations in single muscle fibre properties and co-contraction of leg muscles were observed between young and older individuals. Six physical training sessions performed after disuse promoted the recovery of muscle mass and power. However, they were not sufficient to restore muscle power to pre-disuse values in older individuals, suggesting that further countermeasures are required to counteract the disuse-induced loss of muscle power in older adults. ABSTRACT Disuse-induced loss of muscle power can be detrimental in older individuals, seriously impairing functional capacity. In this study, we examined the changes in maximal explosive power (MEP) of lower limbs induced by a 14-day disuse (bed-rest, BR) and a subsequent 14-day retraining, to assess whether the impact of disuse was greater in older than in young men, and to analyse the causes of such adaptations. Sixteen older adults (Old: 55-65 years) and seven Young (18-30 years) individuals participated in this study. In a subgroup of eight Old subjects, countermeasures based on cognitive training and protein supplementation were applied. MEP was measured with an explosive ergometer, muscle mass was determined by magnetic resonance, motor control was studied by EMG, and single muscle fibres were analysed in vastus lateralis biopsy samples. MEP was ∼33% lower in Old than in Young individuals, and remained significantly lower (-19%) when normalized by muscle volume. BR significantly affected MEP in Old (-15%) but not in Young. Retraining tended to increase MEP; however, this intervention was not sufficient to restore pre-BR values in Old. Ankle co-contraction increased after BR in Old only, and remained elevated after retraining (+30%). Significant atrophy occurred in slow fibres in Old, and in fast fibres in Young. After retraining, the recovery of muscle fibre thickness was partial. The proposed countermeasures were not sufficient to affect muscle mass and power. The greater impact of disuse and smaller retraining-induced recovery observed in Old highlight the importance of designing suitable rehabilitation protocols for older individuals.
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Affiliation(s)
- Enrico Rejc
- Department of Medicine, University of Udine, Udine, Italy.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY, USA
| | - Mirco Floreani
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
| | - Paolo Taboga
- Department of Medicine, University of Udine, Udine, Italy.,Department of Kinesiology and Health Science, California State University, Sacramento, CA, USA
| | - Alberto Botter
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Lina Cancellara
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Marco Narici
- Department of Biomedical Sciences, University of Padova, Padova, Italy.,MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Derby Royal Hospital, Derby, UK
| | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| | - Rado Pišot
- Institute for Kinesiology Research, Science and Research Center of Koper, Koper, Slovenia
| | - Gianni Biolo
- Department of Medical Sciences, Surgical and Health Sciences, Clinica Medica AOUTS, University of Trieste, Italy
| | - Angelina Passaro
- Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy
| | - Joern Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Stefano Lazzer
- Department of Medicine, University of Udine, Udine, Italy.,School of Sport Sciences, University of Udine, Udine, Italy
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Intensive insulin therapy increases glutathione synthesis rate in surgical ICU patients with stress hyperglycemia. PLoS One 2018; 13:e0190291. [PMID: 29300728 PMCID: PMC5754081 DOI: 10.1371/journal.pone.0190291] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Accepted: 12/06/2017] [Indexed: 01/04/2023] Open
Abstract
Objective The glutathione system plays an essential role in antioxidant defense after surgery. We assessed the effects of intensive insulin treatment (IIT) on glutathione synthesis rate and redox balance in cancer patients, who had developed stress hyperglycemia after major surgery. Methods We evaluated 10 non-diabetic cancer patients the day after radical abdominal surgery combined with intra-operative radiation therapy. In each patient, a 24-hr period of IIT, aimed at tight euglycemic control, was preceded, or followed, by a 24-hr period of conventional insulin treatment (CIT) (control regimen). Insulin was administered for 24 hours, during total parenteral nutrition, at a dosage to maintain a moderate hyperglycemia in CIT, and normoglycemic blood glucose levels in IIT (9.3±0.5 vs 6.5±0.3 mmol/L respectively, P<0.001; coefficient of variation, 9.7±1.4 and 10.5±1.1%, P = 0.43). No hypoglycemia (i.e., blood glucose < 3.9 mmol/L) was observed in any of the patients. Insulin treatments were performed on the first and second day after surgery, in randomized order, according to a crossover experimental design. Plasma concentrations of thiobarbituric acid reactive substances (TBARS) and erythrocyte glutathione synthesis rates (EGSR), measured by primed-constant infusion of L-[2H2]cysteine, were assessed at the end of each 24-hr period of either IIT or CIT. Results Compared to CIT, IIT was associated with higher EGSR (2.70±0.51 versus 1.18±0.29 mmol/L/day, p = 0.01) and lower (p = 0.04) plasma TBARS concentrations (2.2±0.2 versus 2.9±0.4 nmol/L). Conclusions In patients developing stress hyperglycemia after major surgery, IIT, in absence of hypoglycemia, stimulates erythrocyte glutathione synthesis, while decreasing oxidative stress.
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Barazzoni R, Bischoff S, Boirie Y, Busetto L, Cederholm T, Dicker D, Toplak H, Van Gossum A, Yumuk V, Vettor R. Sarcopenic Obesity: Time to Meet the Challenge. Obes Facts 2018; 11:294-305. [PMID: 30016792 PMCID: PMC6189532 DOI: 10.1159/000490361] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 05/17/2018] [Indexed: 12/11/2022] Open
Abstract
The prevalence of overweight and obesity has reached epidemic proportions worldwide due to increasingly pervasive obesogenic lifestyle changes. Obesity poses unprecedented individual, social, and multidisciplinary medical challenges by increasing the risk for metabolic diseases, chronic organ failures, and cancer as well as complication rates in the presence of acute disease conditions. Whereas reducing excess adiposity remains the fundamental pathogenic treatment for obese individuals, complex metabolic and lifestyle abnormalities as well as weight reduction therapies per se may also compromise the ability to preserve muscle function and mass, especially when chronic disease co-exists with obesity. Emerging evidence indicates that low muscle mass and quality have a strong negative prognostic impact in obese individuals and may lead to frailty, disability, and increased morbidity and mortality. Awareness of the importance of skeletal muscle maintenance in obesity is however low among clinicians and scientists. The term 'sarcopenic obesity' has been proposed to identify obesity with low skeletal muscle function and mass, but its utilization is largely limited to the aging patient population, and consensus on its definition and diagnostic criteria remains insufficient. Knowledge on prevalence of sarcopenic obesity in various clinical conditions and patient subgroups, on its clinical impacts in patient risk stratification, and on effective prevention and treatment strategies remain therefore dramatically inadequate. In particular, optimal dietary options and medical nutritional support strategies to preserve muscle mass in obese individuals remain largely undefined. The European Society for Clinical Nutrition and Metabolism (ESPEN) and the European Association for the Study of Obesity (EASO) recognize and indicate obesity with altered body composition due to low skeletal muscle function and mass (sarcopenic obesity) as a scientific and clinical priority for researchers and clinicians. ESPEN and EASO therefore call for coordinated action aimed at reaching consensus on its definition, diagnostic criteria, and optimal treatment with particular regard to nutritional therapy. We are convinced that achievement of these goals has a strong potential to reduce the burden of morbidity and mortality in the rapidly increasing obese patient population.
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Affiliation(s)
- Rocco Barazzoni
- Internal Medicine, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
- Azienda Sanitaria Universitaria Integrata di Trieste (ASUITS), Trieste, Italy
- *Rocco Barazzoni, MD, PhD, Department of Medical, Surgical and Health Sciences, University of Trieste, Strada di Fiume 447, 34149 Trieste, Italy,
| | - Stephan Bischoff
- Department of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany
| | - Yves Boirie
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRA, UNH, CRNH Auvergne, Clermont-Ferrand, France
- Service Nutrition Clinique, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Luca Busetto
- Department of Medicine, University of Padova, Italy
- Center for the Study and the Integrated Management of Obesity (EASO COM), Padova University Hospital, Padova, Italy
| | - Tommy Cederholm
- Department of Public Health and Caring Sciences/Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
| | - Dror Dicker
- Internal Medicine Department & Obesity Clinic, Hasharon Hospital-Rabin Medical Center, Petach-Tikva, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hermann Toplak
- Department of Medicine, Medical University Graz, Graz, Austria
| | - Andre Van Gossum
- Department of Gastroenterology, Clinic of Intestinal Diseases and Nutritional Support, Hopital Erasme, Free University of Brussels, Brussels, Belgium
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Roberto Vettor
- Department of Medicine, University of Padova, Italy
- Center for the Study and the Integrated Management of Obesity (EASO COM), Padova University Hospital, Padova, Italy
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Nutritional Considerations in Preventing Muscle Atrophy. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2018; 1088:497-528. [DOI: 10.1007/978-981-13-1435-3_23] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Passaro A, Soavi C, Marusic U, Rejc E, Sanz JM, Morieri ML, Nora ED, Kavcic V, Narici MV, Reggiani C, Biolo G, Zuliani G, Lazzer S, Pišot R. Computerized cognitive training and brain derived neurotrophic factor during bed rest: mechanisms to protect individual during acute stress. Aging (Albany NY) 2017; 9:393-407. [PMID: 28161695 PMCID: PMC5361671 DOI: 10.18632/aging.101166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Accepted: 01/25/2017] [Indexed: 12/19/2022]
Abstract
Acute stress, as bed rest, was shown to increase plasma level of the neurotrophin brain-derived neurotrophic factor (BDNF) in older, but not in young adults. This increase might represent a protective mechanism towards acute insults in aging subjects. Since computerized cognitive training (CCT) is known to protect brain, herein we evaluated the effect of CCT during bed rest on BDNF, muscle mass, neuromuscular function and metabolic parameters. The subjects that underwent CCT did not show an increase of BDNF after bed rest, and showed an anti-insular modification pattern in metabolism. Neuromuscular function parameters, already shown to beneficiate from CCT, negatively correlated with BDNF in research participants undergoing CCT, while positively correlated in the control group. In conclusion, BDNF increase can be interpreted as a standardized protective mechanism taking place whenever an insult occurs; it gives low, but consistent preservation of neuromuscular function. CCT, acting as an external protective mechanism, seems to modify this standardized response, avoiding BDNF increase or possibly modifying its time course. Our results suggest the possibility of differential neuroprotective mechanisms among ill and healthy individuals, and the importance of timing in determining the effects of protective mechanisms.
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Affiliation(s)
- Angelina Passaro
- Medical Science Department, University of Ferrara, Ferrara 44121, Italy.,Co-first authors
| | - Cecilia Soavi
- Medical Science Department, University of Ferrara, Ferrara 44121, Italy.,Co-first authors
| | - Uros Marusic
- Science and Research Centre, University of Primorska, Koper 6000, Slovenia
| | - Enrico Rejc
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, KY 40202, USA
| | - Juana M Sanz
- Medical Science Department, University of Ferrara, Ferrara 44121, Italy
| | - Mario L Morieri
- Medical Science Department, University of Ferrara, Ferrara 44121, Italy
| | | | - Voyko Kavcic
- Institute of Gerontology, Wayne State University, Detroit, MI 48202, USA.,Biomedical Research and Innovative Society, Ljubljana 1000, Slovenia
| | - Marco V Narici
- School of Graduate Entry Medicine and Health, University of Nottingham, Derby DE22 3NE, UK
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padua, Padua 35131 Italy
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Division of Internal Medicine, University of Trieste, Trieste 34149, Italy
| | - Giovanni Zuliani
- Medical Science Department, University of Ferrara, Ferrara 44121, Italy
| | - Stefano Lazzer
- Department of Medical and Biological Sciences, University of Udine, Udine 33100, Italy.,School of Sport Sciences, University of Udine, Udine 33100, Italy
| | - Rado Pišot
- Science and Research Centre, University of Primorska, Koper 6000, Slovenia
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Revel A, Jarzaguet M, Peyron MA, Papet I, Hafnaoui N, Migné C, Mosoni L, Polakof S, Savary-Auzeloux I, Rémond D, Dardevet D. At same leucine intake, a whey/plant protein blend is not as effective as whey to initiate a transient post prandial muscle anabolic response during a catabolic state in mini pigs. PLoS One 2017; 12:e0186204. [PMID: 29045496 PMCID: PMC5646799 DOI: 10.1371/journal.pone.0186204] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 09/27/2017] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Muscle atrophy has been explained by an anabolic resistance following food intake and an increase of dietary protein intake is recommended. To be optimal, a dietary protein has to be effective not only to initiate but also to prolong a muscle anabolic response in a catabolic state. To our knowledge, whether or not a dairy or a dairy/plant protein blend fulfills these criterions is unknown in a muscle wasting situation. OBJECTIVE Our aim was, in a control and a catabolic state, to measure continuously muscle anabolism in term of intensity and duration in response to a meal containing casein (CAS), whey (WHEY) or a whey/ plant protein blend (BLEND) and to evaluate the best protein source to elicit the best post prandial anabolism according to the physio-pathological state. METHODS Adult male Yucatan mini pigs were infused with U-13C-Phenylalanine and fed either CAS, WHEY or BLEND. A catabolic state was induced by a glucocorticoid treatment for 8 days (DEX). Muscle protein synthesis, proteolysis and balance were measured with the hind limb arterio-venous differences technique. Repeated time variance analysis were used to assess significant differences. RESULTS In a catabolic situation, whey proteins were able to initiate muscle anabolism which remained transient in contrast to the stimulated muscle protein accretion with WHEY, CAS or BLEND in healthy conditions. Despite the same leucine intake compared to WHEY, BLEND did not restore a positive protein balance in DEX animals. CONCLUSIONS Even with WHEY, the duration of the anabolic response was not optimal and has to be improved in a catabolic state. The use of BLEND remained of lower efficiency even at same leucine intake than whey.
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Affiliation(s)
- Aurélia Revel
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Marianne Jarzaguet
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Marie-Agnès Peyron
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Isabelle Papet
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Noureddine Hafnaoui
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Carole Migné
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Laurent Mosoni
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Sergio Polakof
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Isabelle Savary-Auzeloux
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Didier Rémond
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
| | - Dominique Dardevet
- Université Clermont Auvergne, INRA, UNH, Unité de Nutrition Humaine, PFEM, MetaboHUB-Clermont, CRNH Auvergne, Clermont-Ferrand, France
- * E-mail:
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Di Girolamo FG, Agostini F, Mazzucco S, Situlin R, Mearelli F, Vinci P, Fiotti N, Biolo G. Baseline deficiency of the anti-inflammatory eicosapentaenoic acid in cell membranes worsens lean body mass wasting induced by inactivity. CLINICAL NUTRITION EXPERIMENTAL 2017. [DOI: 10.1016/j.yclnex.2017.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Kenny HC, Rudwill F, Breen L, Salanova M, Blottner D, Heise T, Heer M, Blanc S, O'Gorman DJ. Bed rest and resistive vibration exercise unveil novel links between skeletal muscle mitochondrial function and insulin resistance. Diabetologia 2017; 60:1491-1501. [PMID: 28500394 DOI: 10.1007/s00125-017-4298-z] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/07/2017] [Indexed: 10/19/2022]
Abstract
AIMS/HYPOTHESIS Physical inactivity has broad implications for human disease including insulin resistance, sarcopenia and obesity. The present study tested the hypothesis that (1) impaired mitochondrial respiration is linked with blunted insulin sensitivity and loss of muscle mass in healthy young men, and (2) resistive vibration exercise (RVE) would mitigate the negative metabolic effects of bed rest. METHODS Participants (n = 9) were maintained in energy balance during 21 days of bed rest with RVE and without (CON) in a crossover study. Mitochondrial respiration was determined by high-resolution respirometry in permeabilised fibre bundles from biopsies of the vastus lateralis. A hyperinsulinaemic-euglycaemic clamp was used to determine insulin sensitivity, and body composition was assessed by dual-energy x-ray absorptiometry (DEXA). RESULTS Body mass (-3.2 ± 0.5 kg vs -2.8 ± 0.4 kg for CON and RVE, respectively, p < 0.05), fat-free mass (-2.9 ± 0.5 kg vs -2.7 ± 0.5 kg, p < 0.05) and peak oxygen consumption ([Formula: see text]) (10-15%, p < 0.05) were all reduced following bed rest. Bed rest decreased insulin sensitivity in the CON group (0.04 ± 0.002 mg kgFFM-1 [pmol l-1] min-1 vs 0.03 ± 0.002 mg kgFFM-1 [pmol l-1] min-1 for baseline vs post-CON), while RVE mitigated this response (0.04 ± 0.003 mg kgFFM-1 [pmol l-1] min-1). Mitochondrial respiration (oxidative phosphorylation and electron transport system capacity) decreased in the CON group but not in the RVE group when expressed relative to tissue weight but not when normalised for citrate synthase activity. LEAK respiration, indicating a decrease in mitochondrial uncoupling, was the only component to remain significantly lower in the CON group after normalisation for citrate synthase. This was accompanied by a significant decrease in adenine nucleotide translocase protein content. CONCLUSIONS/INTERPRETATION Reductions in muscle mitochondrial respiration occur concomitantly with insulin resistance and loss of muscle mass during bed rest and may play a role in the adaptations to physical inactivity. Significantly, we show that RVE is an effective strategy to partially prevent some of the deleterious metabolic effects of bed rest.
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Affiliation(s)
- Helena C Kenny
- 3U Diabetes Consortium, School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, D09 NR58, Ireland
- National Institute for Cellular and Biotechnology, Dublin City University, Dublin, Ireland
| | - Floriane Rudwill
- Université de Strasbourg, Institut Pluridisiplinaire Hubert Curien, Départment d'Ecologie, Physiologie et Ethologie, CNRS, UMR7178, Strasbourg, France
| | - Laura Breen
- National Institute for Cellular and Biotechnology, Dublin City University, Dublin, Ireland
| | | | | | | | - Martina Heer
- Profil, Neuss, Germany
- Institute of Nutrition and Food Sciences, University of Bonn, Bonn, Germany
| | - Stephane Blanc
- Université de Strasbourg, Institut Pluridisiplinaire Hubert Curien, Départment d'Ecologie, Physiologie et Ethologie, CNRS, UMR7178, Strasbourg, France
| | - Donal J O'Gorman
- 3U Diabetes Consortium, School of Health and Human Performance, Dublin City University, Glasnevin, Dublin 9, D09 NR58, Ireland.
- National Institute for Cellular and Biotechnology, Dublin City University, Dublin, Ireland.
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Anabolic resistance assessed by oral stable isotope ingestion following bed rest in young and older adult volunteers: Relationships with changes in muscle mass. Clin Nutr 2016; 36:1420-1426. [PMID: 27742138 DOI: 10.1016/j.clnu.2016.09.019] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/12/2016] [Accepted: 09/22/2016] [Indexed: 11/22/2022]
Abstract
BACKGROUND & AIMS Aging and experimental bed rest are associated with muscle atrophy and resistance to post-prandial stimulation of protein synthesis or anabolic resistance (AR). We have used in young and older adult volunteers, during short-term bed rest, a quick and non-invasive method, based on a single oral bolus of the stable isotope L[ring-2H5]phenylalanine (D5Phe), to determine post-prandial AR, defined as ratio between irreversible hydroxylation and incorporation into body protein of ingested phenylalanine. METHODS We compared in older (O, 59 ± 1 y) and young (Y, 23 ± 1 y) healthy male volunteers the effects of two-week bed rest on post-prandial protein kinetics, assessed during absorption of a standard ready-to-use oral nutritional supplement, through stable-labeled isotope amino acid D5Phe, diluted in water, given as single oral load. The metabolic fate of D5Phe is either utilization for protein synthesis or irreversible hydroxylation to L[ring-2H4]tyrosine (D4Tyr). AR was defined as ratio between the areas under the curves of D4Tyr-to-D5Phe plasma concentrations over 6 h meal absorption. To determine the relationships between AR and muscle changes following bed rest, quadriceps muscle volume (QMV) was determined by magnetic resonance imaging (MRI). RESULTS At baseline, in pooled Y and O subjects, values of AR were inversely correlated with QMV (R = -0.75; p < 0.03). Following 2-weeks of inactivity, there were significant bed rest effects on AR (p < 0.01) and QMV (p < 0.03), as well as significant bed rest × group interaction for AR (p < 0.03; +9.2% in Y; +21.9% in O) and QMV (p < 0.05; -5.7% in Y; -%7.3 in O). In pooled subjects, the percentage delta changes in AR and QMV, induced by bed rest, were inversely correlated (R = -0.57; p < 0.05). CONCLUSION Bed rest-induced AR is much greater in the older than in younger adults. We have developed a new, simple, non-invasive method for the assessment of AR. The results indicate that this metabolic abnormality is a key mechanism for sarcopenia of aging and inactivity.
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Abstract
Nutrition is one method to counter the negative impact of an exercise-induced injury. Deficiencies of energy, protein and other nutrients should be avoided. Claims for the effectiveness of many other nutrients following injuries are rampant, but the evidence is equivocal. The results of an exercise-induced injury may vary widely depending on the nature of the injury and severity. Injuries typically result in cessation, or at least a reduction, in participation in sport and decreased physical activity. Limb immobility may be necessary with some injuries, contributing to reduced activity and training. Following an injury, an inflammatory response is initiated and while excess inflammation may be harmful, given the importance of the inflammatory process for wound healing, attempting to drastically reduce inflammation may not be ideal for optimal recovery. Injuries severe enough for immobilization of a limb result in loss of muscle mass and reduced muscle strength and function. Loss of muscle results from reductions in basal muscle protein synthesis and the resistance of muscle to anabolic stimulation. Energy balance is critical. Higher protein intakes (2-2.5 g/kg/day) seem to be warranted during immobilization. At the very least, care should be taken not to reduce the absolute amount of protein intake when energy intake is reduced. There is promising, albeit preliminary, evidence for the use of omega-3 fatty acids and creatine to counter muscle loss and enhance hypertrophy, respectively. The overriding nutritional recommendation for injured exercisers should be to consume a well-balanced diet based on whole, minimally processed foods or ingredients made from whole foods. The diet composition should be carefully assessed and changes considered as the injury heals and activity patterns change.
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Affiliation(s)
- Kevin D Tipton
- Health and Exercise Sciences Research Group, University of Stirling, Cottrell Building, Stirling, FK9 4LA, Scotland, UK.
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46
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Soavi C, Marušič U, Sanz JM, Morieri ML, Dalla Nora E, Šimunič B, Pišot R, Zuliani G, Passaro A. Age-related differences in plasma BDNF levels after prolonged bed rest. J Appl Physiol (1985) 2016; 120:1118-23. [DOI: 10.1152/japplphysiol.01111.2015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/01/2016] [Indexed: 01/22/2023] Open
Abstract
Brain-derived neurotrophic factor (BDNF) is a member of the family of neurotrophins and has been implicated in brain resistance to insults. Murine studies have demonstrated increased hippocampal concentration after acute immobilization and decreased concentration after chronic immobilization. In humans, chronic stress and sedentary lifestyle result in decreased plasma BDNF levels, but there no data exist regarding acute immobilization. The aim of our study was to evaluate age-related responses [comparing 7 younger subjects (age 23 ± 3 yr) and 8 older subjects (age 60 ± 4 yr)] of plasma BDNF before (baseline data collection, BDC) and after 14 days (BR14) of horizontal bed rest (BR). At BDC, BDNF levels were not different between the two groups ( P = 0.101), although at BR14, BDNF levels were higher in older subjects (62.02 ± 18.31) than in younger subjects (34.36 ± 15.24 pg/ml) ( P = 0.002). A general linear model for repeated measures showed a significant effect of BR on BDNF ( P = 0.002). The BDC BDNF levels correlated with fat-free mass in both populations (ALL) ( R = 0.628, P = 0.012), (older, R = 0.753, P = 0.031; younger, R = 0.772, P = 0.042), and with total cholesterol in ALL ( R = 0.647, P = 0.009) and older study subjects ( R = 0.805, P = 0.016). At BR14, BDNF correlated with total cholesterol ( R = 0.579, P = 0.024) and age ( R = 0.647, P = 0.009) in ALL. With an increase in age, the brain could become naturally less resistant to acute stressors, including the detrimental effects of prolonged bed rest, and thus the increase in BDNF in the older study group might reflect a protective overshooting of the brain to counteract the negative effects in such conditions.
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Affiliation(s)
- Cecilia Soavi
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
| | - Uroš Marušič
- Science and Research Centre, University of Primorska, Capodistria, Slovenia
| | - Juana Maria Sanz
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
| | | | | | - Bostjan Šimunič
- Science and Research Centre, University of Primorska, Capodistria, Slovenia
| | - Rado Pišot
- Science and Research Centre, University of Primorska, Capodistria, Slovenia
| | - Giovanni Zuliani
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
| | - Angelina Passaro
- Medical Science Department, University of Ferrara, Ferrara, Italy; and
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Low Muscularity and Myosteatosis Is Related to the Host Systemic Inflammatory Response in Patients Undergoing Surgery for Colorectal Cancer. Ann Surg 2016; 263:320-5. [PMID: 25643288 DOI: 10.1097/sla.0000000000001113] [Citation(s) in RCA: 148] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE We examined the relationships between computed tomography (CT)-defined skeletal muscle parameters and the systemic inflammatory response (SIR) in patients with operable primary colorectal cancer (CRC). BACKGROUND Muscle depletion is characterized by a reduced muscle mass (myopenia) and increased infiltration by inter- and intramuscular fat (myosteatosis). It is recognized as a poor prognostic indicator in patients with cancer, but the underlying factors remain unclear. METHODS A total of 763 patients diagnosed with CRC undergoing elective surgical resection between 2006 and 2013 were included. Image analysis of CT scans was used to calculate Lumbar skeletal muscle index (LSMI), and mean muscle attenuation (MA). The SIR was quantified by the preoperative neutrophil to lymphocyte ratio (NLR) and albumin levels. Correlation and multivariate regression analysis was performed to identify independent relationships between patient SIR and muscle characteristics. RESULTS Patients with NLR > 3 had significantly lower LSMI and lower MA than those with NLR < 3 [LSMI = 42.07 cmm vs 44.27 cmm (P = 0.002) and MA = 30.04 Hounsfield unit (HU) vs 28.36 HU (P = 0.016)]. Multivariate logistic regression analysis showed that high NLR [odds ratio (OR) = 1.78 (95% confidence interval [CI]: 1.29-2.45), P < 0.001] and low albumin [OR = 1.80 (95% CI: 1.17-2.74), P = 0.007] were independent predictors of reduced muscle mass. High NLR was significantly related with a low mean MA and hence myosteatosis [OR = 1.60 (95% CI: 1.03-2.49), P = 0.038]. CONCLUSIONS These results highlight a direct association between myopenia, myosteatosis, and the host SIR in patients with operable CRC. A better understanding of factors that regulate muscle changes such as myopenia and myosteatosis may lead to the development of novel therapies that influence a more metabolically "healthy" skeletal muscle and potentially alter cancer outcomes.
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48
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Ryan BJ, Goodrich JA, Schmidt WF, Stothard ER, Wright KP, Byrnes WC. Haemoglobin mass alterations in healthy humans following four-day head-down tilt bed rest. Exp Physiol 2016; 101:628-40. [PMID: 26914389 PMCID: PMC4851582 DOI: 10.1113/ep085665] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 02/19/2016] [Indexed: 02/01/2023]
Abstract
NEW FINDINGS What is the central question of this study? Is haemoglobin mass (Hbmass) decreased following 4 days of head-down tilt bed rest (HDTBR), and does increased red blood cell (RBC) destruction mediate this adaptation? What is the main finding and its importance? Haemoglobin mass was increased immediately following HDTBR, before decreasing below baseline 5 days after return to normal living conditions. The transient increase in Hbmass might be the result of decreased RBC destruction, but it is also possible that spleen contraction after HDTBR contributed to this adaptation. Our data suggest that the decreased Hbmass 5 days following HDTBR resulted from decreased RBC production, not increased RBC destruction. Rapid decreases in haemoglobin mass (Hbmass) have been reported in healthy humans following spaceflight and descent from high altitude. It has been proposed that a selective increase in the destruction of young red blood cells (RBCs) mediates these decreases, but conclusive evidence demonstrating neocytolysis in humans is lacking. Based on the proposed triggers and time course of adaptation during spaceflight, we hypothesized that Hbmass would be reduced after 4 days of -6 deg head-down tilt bed rest (HDTBR) and that this would be associated with evidence for increased RBC destruction. We assessed Hbmass in seven healthy, recreationally active men before (PRE), 5 h after (POST) and 5 days after (POST5) 4 days of HDTBR. The concentration of erythropoietin decreased from 7.1 ± 1.8 mIU ml(-1) at PRE to 5.2 ± 2.8 mIU ml(-1) at POST (mean ± SD; P = 0.028). Contrary to our hypothesis, Hbmass was increased from 817 ± 135 g at PRE to 849 ± 141 g at POST (P = 0.014) before decreasing below PRE to 789 ± 139 g at POST5 (P = 0.027). From PRE to POST, the concentration of haptoglobin increased from 0.54 ± 0.32 to 0.68 ± 0.28 g l(-1) (P = 0.013) and the concentration of bilirubin decreased from 0.50 ± 0.24 to 0.32 ± 0.11 mg dl(-1) (P = 0.054), suggesting that decreased RBC destruction might have contributed to the increased Hbmass. However, it is possible that spleen contraction following HDTBR also played a role in the increase in Hbmass at POST, but as the transient increase in Hbmass was unexpected, we did not collect data that would provide direct evidence for or against spleen contraction. From PRE to POST5, the concentration of soluble transferrin receptor decreased from 20.7 ± 3.9 to 17.1 ± 3.3 nmol l(-1) (P = 0.018) but the concentrations of ferritin, haptoglobin and bilirubin were not significantly altered, suggesting that the decrease in Hbmass was mediated by decreased RBC production rather than increased RBC destruction. Peak oxygen uptake decreased by 0.31 ± 0.16 l min(-1) from PRE to POST (P = 2 × 10(-4) ) but was not significantly altered at POST5 compared with PRE. Overall, these findings indicate that 4 days of HDTBR does not increase RBC destruction and that re-examination of the time course and mechanisms of Hbmass alterations following short-term spaceflight and simulated microgravity is warranted.
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Affiliation(s)
- Benjamin J. Ryan
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Jesse A. Goodrich
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Walter F. Schmidt
- Department of Sports Medicine/Sports Physiology, University of Bayreuth, Bayreuth, Germany
| | - Ellen R. Stothard
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Kenneth P. Wright
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - William C. Byrnes
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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Pišot R, Marusic U, Biolo G, Mazzucco S, Lazzer S, Grassi B, Reggiani C, Toniolo L, di Prampero PE, Passaro A, Narici M, Mohammed S, Rittweger J, Gasparini M, Gabrijelčič Blenkuš M, Šimunič B. Greater loss in muscle mass and function but smaller metabolic alterations in older compared with younger men following 2 wk of bed rest and recovery. J Appl Physiol (1985) 2016; 120:922-9. [PMID: 26823343 DOI: 10.1152/japplphysiol.00858.2015] [Citation(s) in RCA: 83] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 01/24/2016] [Indexed: 11/22/2022] Open
Abstract
This investigation aimed to compare the response of young and older adult men to bed rest (BR) and subsequent rehabilitation (R). Sixteen older (OM, age 55-65 yr) and seven young (YM, age 18-30 yr) men were exposed to a 14-day period of BR followed by 14 days of R. Quadriceps muscle volume (QVOL), force (QF), and explosive power (QP) of leg extensors; single-fiber isometric force (Fo); peak aerobic power (V̇o2peak); gait stride length; and three metabolic parameters, Matsuda index of insulin sensitivity, postprandial lipid curve, and homocysteine plasma level, were measured before and after BR and after R. Following BR, QVOL was smaller in OM (-8.3%) than in YM (-5.7%,P= 0.031); QF (-13.2%,P= 0.001), QP (-12.3%,P= 0.001), and gait stride length (-9.9%,P= 0.002) were smaller only in OM. Fo was significantly smaller in both YM (-32.0%) and OM (-16.4%) without significant differences between groups. V̇o2peakdecreased more in OM (-15.3%) than in YM (-7.6%,P< 0.001). Instead, the Matsuda index fell to a greater extent in YM than in OM (-46.0% vs. -19.8%, respectively,P= 0.003), whereas increases in postprandial lipid curve (+47.2%,P= 0.013) and homocysteine concentration (+26.3%,P= 0.027) were observed only in YM. Importantly, after R, the recovery of several parameters, among them QVOL, QP, and V̇o2peak, was not complete in OM, whereas Fo did not recover in either age group. The results show that the effect of inactivity on muscle mass and function is greater in OM, whereas metabolic alterations are greater in YM. Furthermore, these findings show that the recovery of preinactivity conditions is slower in OM.
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Affiliation(s)
- Rado Pišot
- Institute for Kinesiology Research, Science and Research Centre, University of Primorska, Koper, Slovenia
| | - Uros Marusic
- Institute for Kinesiology Research, Science and Research Centre, University of Primorska, Koper, Slovenia
| | - Gianni Biolo
- Department of Medical, Surgical and Health Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy
| | - Sara Mazzucco
- Department of Medical, Surgical and Health Sciences, Division of Internal Medicine, University of Trieste, Trieste, Italy
| | - Stefano Lazzer
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy
| | - Bruno Grassi
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy;
| | - Carlo Reggiani
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Luana Toniolo
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | | | - Angelina Passaro
- Department of Medical Sciences, Section of Internal and Cardiorespiratory Medicine, University of Ferrara, Ferrara, Italy
| | - Marco Narici
- MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Derby Royal Hospital, Derby, United Kingdom
| | - Shahid Mohammed
- MRC/ARUK Centre for Musculoskeletal Ageing Research, University of Nottingham, Derby Royal Hospital, Derby, United Kingdom
| | - Joern Rittweger
- Institute of Aerospace Medicine, German Aerospace Center (DLR), Cologne, Germany
| | - Mladen Gasparini
- Department of Vascular Surgery, General Hospital Izola, Izola, Slovenia; and
| | | | - Boštjan Šimunič
- Institute for Kinesiology Research, Science and Research Centre, University of Primorska, Koper, Slovenia
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50
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Cucca A, Mazzucco S, Bursomanno A, Antonutti L, Di Girolamo F, Pizzolato G, Koscica N, Gigli G, Catalan M, Biolo G. Amino acid supplementation in l-dopa treated Parkinson's disease patients. Clin Nutr 2015; 34:1189-94. [DOI: 10.1016/j.clnu.2014.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Revised: 11/21/2014] [Accepted: 12/13/2014] [Indexed: 12/19/2022]
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