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Guo Y, Pan D, Wan H, Yang J. Post-Ischemic Stroke Cardiovascular Risk Prevention and Management. Healthcare (Basel) 2024; 12:1415. [PMID: 39057558 PMCID: PMC11276751 DOI: 10.3390/healthcare12141415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2024] [Revised: 07/12/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Cardiac death is the second most common cause of death among patients with acute ischemic stroke (IS), following neurological death resulting directly from acute IS. Risk prediction models and screening tools including electrocardiograms can assess the risk of adverse cardiovascular events after IS. Prolonged heart rate monitoring and early anticoagulation therapy benefit patients with a higher risk of adverse events, especially stroke patients with atrial fibrillation. IS and cardiovascular diseases have similar risk factors which, if optimally managed, may reduce the incidence of recurrent stroke and other major cardiovascular adverse events. Comprehensive risk management emphasizes a healthy lifestyle and medication therapy, especially lipid-lowering, glucose-lowering, and blood pressure-lowering drugs. Although antiplatelet and anticoagulation therapy are preferred to prevent cardiovascular events after IS, a balance between preventing recurrent stroke and secondary bleeding should be maintained. Optimization of early rehabilitation care comprises continuous care across environments thus improving the prognosis of stroke survivors.
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Affiliation(s)
- Yilei Guo
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China; (Y.G.); (D.P.)
| | - Danping Pan
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China; (Y.G.); (D.P.)
| | - Haitong Wan
- The First Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou 310003, China;
- Institute of Cardio-Cerebrovascular Disease, Zhejiang Chinese Medical University, Hangzhou 310053, China
- Key Laboratory of TCM Encephalopathy of Zhejiang Province, Hangzhou 310053, China
| | - Jiehong Yang
- College of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou 310053, China; (Y.G.); (D.P.)
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Gao K, Su Z, Meng J, Yao Y, Li L, Su Y, Mohammad Rahimi GR. Effect of Exercise Training on Some Anti-Inflammatory Adipokines, High Sensitivity C-Reactive Protein, and Clinical Outcomes in Sedentary Adults With Metabolic Syndrome. Biol Res Nurs 2024; 26:125-138. [PMID: 37579279 DOI: 10.1177/10998004231195541] [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] [Indexed: 08/16/2023]
Abstract
OBJECTIVE This study aimed to investigate the effects of aerobic interval training and resistance training on anti-inflammatory adipokines, high sensitivity C-reactive protein, and clinical outcomes in sedentary men with metabolic syndrome. METHODS A total of 33 sedentary men with metabolic syndrome (age: 46.2 ± 4.6 years; body mass index: 35.4 ± 1.9 kg.m2) were randomly assigned to one of 3 groups: aerobic interval training (n = 12), resistance training (n = 10), or control (n = 11). Participants in the exercise groups completed a 12-week training program, 3 sessions per week, while those in the control group maintained their sedentary lifestyle. The levels of high sensitivity C-reactive protein (hs-CRP), omentin-1, adiponectin, lipid profiles, blood pressure, glucose metabolism, body composition, and peak oxygen uptake (VO2peak) were measured at baseline and after the intervention. RESULTS Both aerobic interval training and resistance training significantly improved the levels of omentin-1 and adiponectin, as well as reduced inflammation, as indicated by a decrease in hs-CRP levels. Exercise training also led to significant improvements in lipid profiles, blood pressure, glucose metabolism, and body composition. Specifically, the aerobic interval training group had significantly greater increases in high-density lipoprotein cholesterol and VO2peak, as well as greater reductions in low-density lipoprotein cholesterol, triglycerides, and total cholesterol compared to the resistance training group. CONCLUSION Exercise training, particularly aerobic interval training and resistance training, can be an effective non-pharmacological intervention for managing inflammation and improving cardiovascular health in metabolic syndrome patients.
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Affiliation(s)
| | - Zhanguo Su
- Faculty of Physical Education, Huainan Normal University, Huainan, China
- International College, Krirk University, Bangkok, Thailand
| | - Junyan Meng
- Faculty of Physical Education, Huainan Normal University, Huainan, China
| | - Yuzhong Yao
- International College, Krirk University, Bangkok, Thailand
| | - LiGuang Li
- International College, Krirk University, Bangkok, Thailand
| | - Yiping Su
- Faculty of Mathematics and Science, Universitity Pendidikan Sultan Idris, Tanjong Malim, Malaysia
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Abstract
Cardiovascular diseases (CVD) remain the leading cause of death globally, and further efforts are being undertaken to understand and modify CVD risk factors, such as dyslipidemia (DLD), hypertension, and diabetes. The sedentary lifestyle of most individuals today contributes to the prevalence of these conditions. Uncontrolled dyslipidemia serves as a fertile ground for atherosclerotic plaque formation, while lipoproteins (Lp) act as cofactors for inflammatory processes that cause plaque destabilization leading to subsequent CVD events. As such, many health experts and institutions continue to emphasize the importance of cardiorespiratory fitness (CRF) and muscular strength (MusS) with the intent to reduce atherogenic lipoproteins and proprotein convertase subtilisin kexin type 9 (PCSK-9) expression. Concordantly, the two modes of exercise training (ET), such as aerobic ET (aET) and resistance ET (rET) have both demonstrated to improve CRF and MusS, respectively. Although both modes of ET were shown to independently reduce mortality, participation in both forms resulted in a more pronounced improvement in cholesterol levels and CVD-related mortality. Though reduction of adiposity is not a pre-requisite to achieve better control of DLD through increased CRF and MusS, the beneficial effects of physical activity on the inflammatory processes linked to atherosclerosis are almost always associated with a simultaneous decrease in overall adiposity. It is therefore essential to promote both aET and rET, including weight loss in order to attenuate the risks stemming from atherosclerosis and its proinflammatory components.
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Kargarfard M, Nobari H, Kamyar K, Zadeh AK, Oliveira R. Effects of 12-week moderate aerobic exercise on ROCK2 activity, hs-CRP and glycemic index in obese patients with impaired glucose tolerance. Physiol Behav 2022; 257:113976. [PMID: 36183850 DOI: 10.1016/j.physbeh.2022.113976] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 08/23/2022] [Accepted: 09/27/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Obesity is a chronic low-grade inflammatory state that is related to prediabetes, increased Rhoassociated kinase 2 (ROCK2) activity and concentration of high-sensitivity C-reactive protein (hs-CRP). Therefore, the study was conducted to investigate the effects of 12-week moderate aerobic exercise on ROCK2 activity, hs-CRP, glycosylated hemoglobin A1C (HbA1c), and glycemic index in obese patients with impaired glucose tolerance. METHODS In a quasi-experimental design with pre and post-test, 42 obese men with prediabetes [mean±SD, age: 44.73 ± 3.30 years, body mass index (BMI): 33.22 ± 2.05 kg/m2, HbA1c: 6.29 % ± 0.75] were allocated into two randomized homogeneous groups: Aerobic training group (AT, n=22) or control group (C, n=20). Exercise group performed a moderate aerobic exercise program three sessions per week, 60 minutes per session for 12 weeks. Body mass, BMI, maximal oxygen consumption (VO2max), serum levels of fasting blood glucose (FBG), insulin, insulin resistance (HOMA-IR), homeostasis model assessment of β-cell function (HOMA-B); HbA1c, hs-CRP, or ROCK2 activity were measured before and after the study period. The data were analyzed using repeated measures ANOVA 2×2 and paired sample t test at a significant level of p < 0.05. RESULTS AT caused a significant reduction in body mass (p≤ 0.001), BMI (p= 0.04), HOMA-B (p=0.003), serum levels of FBG (p= 0.002), HbA1c (p= 0.039), hs-CRP (p≤ 0.0001), and ROCK2 activity (p= 0.001). In contrast, in the same group, a significant increase was observed in VO2max (p= 0.04). CONCLUSION The results of this study showed that moderate aerobic exercise was an effective and safe method to prevent type 2 diabetes and cardiovascular diseases in obese men with prediabetes by improving glucose metabolism, reduction of body mass, ROCK2 activity and serum levels of hs-CRP.
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Affiliation(s)
- Mehdi Kargarfard
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran.
| | - Hadi Nobari
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran; Department of motor performance, Faculty of Physical Education and Mountain Sports, Transilvania, University of Braşov, 500068 Braşov, Romania; Department of Physiology, School of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain.
| | - Kian Kamyar
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran.
| | - Ali Khosravi Zadeh
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran.
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal; Research Center in Sport Sciences, Health Sciences and Human Development, 5001-801 Vila Real, Portugal; Life Quality Research Centre, 2040-413 Rio Maior, Portugal.
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5
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Abstract
Physical activity and its sustained and purposeful performance-exercise-promote a broad and diverse set of metabolic and cardiovascular health benefits. Regular exercise is the most effective way to improve cardiorespiratory fitness, a measure of one's global cardiovascular, pulmonary and metabolic health, and one of the strongest predictors of future health risk. Here, we describe how exercise affects individual organ systems related to cardiometabolic health, including the promotion of insulin and glucose homeostasis through improved efficiency in skeletal muscle glucose utilization and enhanced insulin sensitivity; beneficial changes in body composition and adiposity; and improved cardiac mechanics and vascular health. We subsequently identify knowledge gaps that remain in exercise science, including heterogeneity in exercise responsiveness. While the application of molecular profiling technologies in exercise science has begun to illuminate the biochemical pathways that govern exercise-induced health promotion, much of this work has focused on individual organ systems and applied single platforms. New insights into exercise-induced secreted small molecules and proteins that impart their effects in distant organs ("exerkines") highlight the need for an integrated approach towards the study of exercise and its global effects; efforts that are ongoing.
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Affiliation(s)
| | - Prashant Rao
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Cardiovascular Research Center, Beth Israel Deaconess Medical Center, Boston, MA
| | - Jeremy M. Robbins
- Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center, Boston, MA
- Cardiovascular Research Center, Beth Israel Deaconess Medical Center, Boston, MA
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Abstract
PURPOSE Low dose radiation therapy (LDRT) using doses in the range of 30-150 cGy has been proposed as a means of mitigating the pneumonia associated with COVID-19. However, preliminary results from ongoing clinical trials have been mixed. The aim of this work is to develop a mathematical model of the viral infection and associated systemic inflammation in a patient based on the time evolution of the viral load. The model further proposes an immunomodulatory response to LDRT based on available data. Inflammation kinetics are then explored and compared to clinical results. METHODS The time evolution of a viral infection, inflammatory signaling factors, and inflammatory response are modeled by a set of coupled differential equations. Adjustable parameters are taken from the literature where available and otherwise iteratively adjusted to fit relevant data. Simple functions modeling both the suppression of pro-inflammatory signal factors and the enhancement of anti-inflammatory factors in response to low doses of radiation are developed. The inflammation response is benchmarked against C-reactive protein (CRP) levels measured for cohorts of patients with severe COVID-19. RESULTS The model fit the time-evolution of viral load data, cytokine data, and inflammation (CRP) data. When LDRT was applied early, the model predicted a reduction in peak inflammation consistent with the difference between the non-surviving and surviving cohorts. This reduction of peak inflammation diminished as the application of LDRT was delayed. CONCLUSION The model tracks the available data on viral load, cytokine levels, and inflammatory biomarkers well. An LDRT effect is large enough in principle to provide a life-saving immunomodulatory effect, though patients treated with LDRT already near the peak of their inflammation trajectory are unlikely to see drastic reductions in that peak. This result potentially explains some discrepancies in the preliminary clinical trial data.
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Affiliation(s)
- Charles Kirkby
- Department of Medical Physics, Jack Ady Cancer Centre, Lethbridge, Alberta, Canada.,Department of Oncology, University of Calgary, Calgary, Alberta, Canada.,Department of Physics and Astronomy, University of Calgary, Calgary, Alberta, Canada
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Thyregod M, Løkke A, Skou ST, Larsen J, Bodtger U. Changes in systemic inflammation after pulmonary rehabilitation in patients with COPD and severe physical inactivity - an exploratory study. Chron Respir Dis 2022; 19:14799731221112439. [PMID: 36113167 PMCID: PMC9483968 DOI: 10.1177/14799731221112439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Severe physical inactivity (SPI) in patients with COPD is associated
with a poor prognosis. It is unknown whether there is a link between SPI and
systemic inflammation, and if systemic inflammation in SPI changes following
pulmonary rehabilitation (PR). Methods: A prospective, observational study of patients referred for at least
7 weeks of PR comprising 2 h of exercise therapy and education twice weekly. At
baseline and after PR, daily physical activity level (PAL) was measured with a
validated activity monitor, SenseWear® as well as systemic
inflammation: b-eosinophils, p-fibrinogen, p-CRP, s-IL-6 and s-CD 163. SPI was
defined as PAL <1.4. Results: At baseline, SPI was present in 31 of the 57 patients included, and 23%
(7/31) improved to non-SPI after PR. We observed no differences between patients
with SPI and non-SPI, except baseline plasma fibrinogen level was slightly yet
significantly higher in patients with SPI (median 13.3 [6.2–23.6] vs 11.2
[6.5–16.7] µmol/l) but change in fibrinogen levels differed insignificantly
between patients who improved to non-SPI at follow-up compared to patients with
persistent SPI (−0.6 [−16.9–9.9] vs −0.4 [−11.2–1.2] µmol/l). Conclusion: SPI in COPD appears not to be associated with a distinct inflammatory
profile compared to less sedentary COPD patients attending pulmonary
rehabilitation. Currently biomarkers have no role in the detection of SPI in
COPD.
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Affiliation(s)
- Mimi Thyregod
- Department of Respiratory Medicine, 91907Naestved Hospital, Nastved, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
| | - Anders Løkke
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Medicine, 4321Little Belt Hospital University, Vejle, Denmark
| | - Søren T Skou
- Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, 573169University of Southern Denmark, Odense, Denmark.,The Research Unit PROgrez, Department of Physiotherapy and Occupational Therapy, Næstved-Slagelse-Ringsted Hospitals, Region Zealand, Denmark
| | - Jacob Larsen
- Department of Pathology, 53140Zealand University Hospital, Roskilde, Denmark
| | - Uffe Bodtger
- Department of Respiratory Medicine, 91907Naestved Hospital, Nastved, Denmark.,Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.,Department of Respiratory Medicine, Zealand University Hospital, Roskilde, Denmark
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8
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Drosatos IA, Tsoporis JN, Izhar S, Gupta S, Tsirebolos G, Sakadakis E, Triantafyllis AS, Rigopoulos A, Rigopoulos D, Rallidis LS, Rizos I, Parker TG. Differential Regulation of Circulating Soluble Receptor for Advanced Glycation End Products (sRAGEs) and Its Ligands S100A8/A9 Four Weeks Post an Exercise Intervention in a Cohort of Young Army Recruits. Biomolecules 2021; 11:1354. [PMID: 34572568 PMCID: PMC8469473 DOI: 10.3390/biom11091354] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/08/2021] [Accepted: 09/08/2021] [Indexed: 12/17/2022] Open
Abstract
Apart from its beneficial effects on cardiovascular risk factors, an anti-inflammatory effect of exercise is strongly implicated. Yet, data regarding the effect of an exercise intervention on healthy individuals are limited and contradictory. The present study aimed to investigate the effects of a physical activity intervention on the soluble form of the receptor for advanced glycation end products (sRAGEs) and its ligands S100A8/A9. A total of 332 young army recruits volunteered and 169 completed the study. The participants underwent the standard basic training of Greek army recruits. IL-6, IL-1β, S100A8/A9, and sRAGEs were measured at the beginning and at the end of the training period. Primary rodent adult aortic smooth muscle cells (ASMCs) were analyzed for responsiveness to direct stimulation with S100A8/A9 alone or in combination with sRAGEs. At the end of the training period, we observed a statistically significant reduction in S100A8/A9 (630.98 vs. 472.12 ng/mL, p = 0.001), IL-1β (9.39 [3.8, 44.14] vs. 5.03 [2.44, 27.3] vs. pg/mL, p = 0.001), and sRAGEs (398.38 vs. 220.1 pg/mL, p = 0.001). IL-6 values did not change significantly after exercise. S100A8/A9 reduction was positively correlated with body weight (r = 0.236 [0.095, 0.370], p = 0.002) and BMI (r = 0.221 [0.092, 0.346], p = 0.004). Direct stimulation of ASMCs with S100A8/A9 increased the expression of IL-6, IL-1β, and TNF-α and, in the presence of sRAGEs, demonstrated a dose-dependent inhibition. A 4-week military training resulted in significant reduction in the pro-inflammatory cytokines IL-1β and S100A8/A9 complex. The observed reduction in sRAGEs may possibly reflect diminished RAGE axis activation. Altogether, our findings support the anti-inflammatory properties of physical activity.
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Affiliation(s)
- Ioannis-Alexandros Drosatos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
- Department of Preventive Medicine, 414 Military Hospital, 15236 Athens, Greece;
| | - James N. Tsoporis
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
| | - Shehla Izhar
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
| | - Sahil Gupta
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
| | - George Tsirebolos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
- Department of Cardiology, 401 General Military Hospital of Athens, 11525 Athens, Greece
| | - Eleftherios Sakadakis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Andreas S. Triantafyllis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Angelos Rigopoulos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | | | - Loukianos S. Rallidis
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Ioannis Rizos
- Second Department of Cardiology, Attikon University Hospital, 12462 Athens, Greece; (I.-A.D.); (G.T.); (E.S.); (A.S.T.); (A.R.); (L.S.R.); (I.R.)
| | - Thomas G. Parker
- Keenan Research Centre for Biomedical Science, Li Ka Shing Knowledge Institute, Unity Health Toronto, University of Toronto, Toronto, ON M5B 1W8, Canada; (S.I.); (S.G.); (T.G.P.)
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Sanchis-Gomar F, Lavie CJ, Marín J, Perez-Quilis C, Eijsvogels TMH, O'Keefe JH, Perez MV, Blair SN. Exercise Effects On Cardiovascular Disease: From Basic Aspects To Clinical Evidence. Cardiovasc Res 2021; 118:2253-2266. [PMID: 34478520 DOI: 10.1093/cvr/cvab272] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.
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Affiliation(s)
- Fabian Sanchis-Gomar
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.,Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Carl J Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
| | - Jorge Marín
- Growth, Exercise, Nutrition and Development Group, Faculty of Health and Sport Sciences, University of Zaragoza, Zaragoza, Spain
| | - Carme Perez-Quilis
- Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Science, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - James H O'Keefe
- St. Luke's Mid America Heart Institute, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Marco V Perez
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, USA
| | - Steven N Blair
- Department of Exercise Sciences, University of South Carolina, Columbia, USA
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10
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Abstract
The World Health Organization has declared obesity to be a global epidemic that increases cardiovascular disease (CVD) mortality risk factors, such as hypertension, diabetes, dyslipidemia, and atherosclerosis. The increasing ratio of time spent in sedentary activities to that spent performing physically demanding tasks increases the trends to obesity and susceptibility to these risk factors. Dyslipidemia is the foundation of atherosclerotic buildup and lipoproteins serve as cofactors to the inflammatory processes that destabilize plaques. Increasing cardiorespiratory fitness and muscular strength helps attenuate concentrations of low-density lipoproteins (LDLs), such as LDL cholesterol, and increase levels of high-density lipoprotein cholesterol, as well as reduce proprotein convertase subtilisin kexin type 9 expression. Effects of physical activity on the inflammatory pathways of atherosclerosis, specifically C-reactive protein, are more closely related to reducing the levels of adiposity in tandem with increasing fitness, than with exercise training alone. The purpose of this review is to describe the physiology of dyslipidemia and relate it to CVD and exercise therapies.
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11
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Bitkin EC, Kara C, Yılmaz GC, Mammadova J, Aydın HM. Evaluation of children with type 1 diabetes mellitus in terms of overweight/obesity in tertiary care hospital. J Pediatr Endocrinol Metab 2021; 34:995-1000. [PMID: 34162026 DOI: 10.1515/jpem-2021-0268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 05/10/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Obesity is a growing problem in type 1 diabetes mellitus (T1DM) today. The aim of our study is to determine the frequency of overweight/obesity at the time of diagnosis and during follow-up in children with T1DM as well as review the conditions that may accompany. METHODS A total of 315 patients with T1DM were retrospectively analyzed. The patients were divided into two groups as normal weight and overweight/obese. The two groups were compared in terms of age at diagnosis, birth weight, anthropometric measurements, insulin dose used and blood pressure measurements, and insulin, c-peptide, hemoglobin A1c, triglyceride, and high-density lipoprotein levels at the time of diagnosis and follow-up. RESULTS The height, weight and body mass index standard deviation (BMI SD) scores, and c-peptide levels at the time of diagnosis of the overweight/obese group were higher than those with normal weight (p<0.001 and p = 0.008, respectively). The frequency of dyslipidemia and hypertension was higher in the overweight/obese group than in the normal weight group [18.2 vs. 5% (p = 0.015) and 10 vs. 1.5% (p = 0.003), respectively]. CONCLUSIONS In our study, the fact that the overweight/obese group had higher BMI and c-peptide and lower HDL values at the time of diagnosis can be evaluated as indicators that insulin resistance syndrome can accompany T1DM from the beginning (double diabetes). When determining the treatment and follow-up strategies of patients with T1DM, considering the risk of obesity and taking the necessary precautions is very important in terms of morbidity.
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Affiliation(s)
- Eda Celebi Bitkin
- Department of Pediatrics, Van Yüzüncü Yıl University, Faculty of Medicine, Division of Pediatric Endocrinology, Van, Turkey
| | - Cengiz Kara
- Department of Pediatrics, Istinye University, Faculty of Medicine, Division of Pediatric Endocrinology, Istanbul, Turkey
| | - Gülay Can Yılmaz
- Department of Pediatrics, Muğla Sıtkı Koçman University, Faculty of Medicine, Division of Pediatric Endocrinology, Muğla, Turkey
| | - Jamala Mammadova
- Department of Pediatrics, Istinye University, Faculty of Medicine, Division of Pediatric Endocrinology, Istanbul, Turkey
| | - Hasan Murat Aydın
- Department of Pediatrics, Ondokuz Mayis University, Faculty of Medicine, Division of Pediatric Endocrinology, Samsun, Turkey
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12
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Roddick CM, Christie CD, Madden KM, Chen FS. Social integration after moving to a new city predicts lower systolic blood pressure. Psychophysiology 2021; 58:e13924. [PMID: 34423451 DOI: 10.1111/psyp.13924] [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: 01/28/2021] [Revised: 07/27/2021] [Accepted: 08/04/2021] [Indexed: 11/30/2022]
Abstract
Residential mobility is linked to higher incidence of cardiovascular disease (CVD) and mortality. A mechanism by which residential relocation may impact health is through the disruption of social networks. To examine whether moving to a new city is associated with increased CVD risk and whether the extent to which movers rebuild their social network after relocating predicts improved CVD risk and psychosocial well-being, recent movers (n = 26), and age- and sex-matched nonmovers (n = 20) were followed over 3 months. Blood pressure, C-reactive protein/albumin ratio (CRP/ALB), social network size, and psychosocial well-being were measured at intake (within 6 weeks of residential relocation for movers) and 3 months later. Multiple regression indicated higher systolic blood pressure (SBP) for movers (M = 107.42, SD = 11.39), compared with nonmovers (M = 102.37, SD = 10.03) at intake, though this trend was not statistically significant. As predicted, increases in movers' social network size over 3 months predicted decreases in SBP, even after controlling for age, sex, and waist-to-hip ratio, b = -2.04 mmHg, 95% CI [-3.35, -.73]. Associations between increases in movers' social ties and decreases in depressive symptoms and stress were in the predicted direction but did not meet the traditional cutoff for statistical significance. Residential relocation and movers' social network size were not associated with CRP/ALB in this healthy sample. This study provides preliminary evidence for increased SBP among recent movers; furthermore, it suggests that this elevation in CVD risk may decrease as individuals successfully rebuild their social network.
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Affiliation(s)
- Charlotte M Roddick
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Chelsea D Christie
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kenneth M Madden
- Department of Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Frances S Chen
- Department of Psychology, The University of British Columbia, Vancouver, British Columbia, Canada
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13
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Farley G, Riggs DW, Bhatnagar A, Hellmann J. Omega-3 polyunsaturated fatty acids modify the inverse association between systemic inflammation and cardiovascular fitness. Clin Nutr 2021; 40:4097-4105. [PMID: 33618966 DOI: 10.1016/j.clnu.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/18/2021] [Accepted: 02/02/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND OBJECTIVE Exercise increases quality of life and lowers all-cause mortality, likely by preventing cardiovascular disease. Although the beneficial effects of exercise are linked with reductions in chronic inflammation, individual responses vary and factors that contribute to the anti-inflammatory effects of cardiovascular fitness remain largely undefined. We sought to investigate the role of fatty acids in the inverse relationship between inflammation and cardiovascular fitness. APPROACH AND RESULTS In this cross-sectional study using data from 435 participants in NHANES and linear regression models with CRP as the outcome, we observed significant negative interactions between VO2max and omega-3 polyunsaturated fatty acids (PUFAs) but not saturated, monounsaturated, or omega-6 PUFAs. When stratified by omega-3 PUFA tertiles, participants in the medium tertile, but not low tertile, show an enhanced negative association between VO2max and CRP, with a -32.0% difference (95% CI: -44.95, -15.9%) per 10 mL/kg/min of VO2max. Exploratory factor analysis identified five unique dietary fatty acid (FA) profiles. The FA profile consisting predominantly of omega-3 PUFA had the strongest negative association for VO2max and CRP, with a -28.2% difference in CRP (95% CI: -43.4, -8.9) per 10 mL/kg/min of VO2max. We also found that alpha-linolenic acid (ALA) and docosahexaenoic acid (DHA) enhanced the negative association between VO2max and CRP, suggesting that the anti-inflammatory response to VO2max capacity is associated with ALA and DHA levels. Males, Whites, and individuals with lower BMI were more sensitive to the effects of omega-3 PUFAs, while having high SFA levels attenuated the benefit. CONCLUSIONS This study suggests that omega-3 PUFAs are effect modifiers for VO2max and CRP and that the anti-inflammatory benefits of increasing cardiovascular fitness are associated with omega-3 PUFAs.
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Affiliation(s)
- Gabrielle Farley
- Diabetes and Obesity Center, Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA; School of Public Health and Information Sciences, University of Louisville, Louisville, KY, USA
| | - Daniel W Riggs
- Diabetes and Obesity Center, Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA; Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA
| | - Aruni Bhatnagar
- Diabetes and Obesity Center, Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA
| | - Jason Hellmann
- Diabetes and Obesity Center, Christina Lee Brown Envirome Institute, Division of Environmental Medicine, Department of Medicine, University of Louisville School of Medicine, Louisville, KY, USA.
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14
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Farbod M, Eizadi M, Rashidi M, Mirakhori Z. Effects of Aerobic Training With No Caloric Restriction on Serum Resistin and Lipid Profile in Inactive Overweight Women. INTERNATIONAL JOURNAL OF BASIC SCIENCE IN MEDICINE 2020. [DOI: 10.34172/ijbsm.2020.04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Obesity is a major risk factor for inflammation and cardiovascular diseases. We tried to assess whether 12 weeks of aerobic exercises affect serum resistin level and lipid profile in overweight females or not. Methods: For this purpose, 32 non-trained adult females with the mean age of 38 ± 7 years old and body mass index (BMI) of 32 ± 3 kg/m2 were randomly assigned to aerobic exercise (n=16) and control (n=16) groups. Twelve weeks of aerobic exercise program including 3 sessions weekly at 60-75% of maximum heart rate was considered. Fasting serum resistin level, lipid profile (total cholesterol [TC], low-density lipoprotein [LDL] and high-density lipoprotein [HDL] cholesterol, and triglyceride [TG]), and anthropometric indexes were measured and compared between the two groups before and after training. Results: Serum resistin, lipid profile markers, and anthropometrical indexes were not significantly different at baseline between the two groups (P>0.05). TG, TC, LDL, and serum resistin did not change significantly after the intervention in the exercise group (P>0.05). However, a significant increase in HDL (exercise: 46.3 ± 9.6 vs. 51.4 ± 8.5, P=0.011; control: 45.8 ± 7.9 vs. 46.8 ± 6.9 P=0.326) and a significant decrease in LDL/HDL ratio (exercise: 2.94 ± 0.12 vs. 2.47 ± 0.19, P=0.019; control: 3.14 ± 0.23 vs. 3.18 ± 0.63, P=0.265) were observed after the intervention. Other variables in the control group remained unchanged. Conclusion: Aerobic exercises had no impacts on the inflammatory profile but could improve lipid profile with an emphasis on HDL in adult obese women.
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Affiliation(s)
- Maryam Farbod
- Master of Science, Department of Physical Education and Sports Sciences, Parand Branch, Islamic Azad University, Tehran, Iran
| | - Mojtaba Eizadi
- Assistant Professor, Department of Exercise Physiology, Saveh Branch, Islamic Azad University, Saveh, Iran
| | - Mohammad Rashidi
- Assistant Professor, Department of Exercise Physiology, Semnan Branch, Islamic Azad University, Semnan, Iran
| | - Zahra Mirakhori
- Assistant Professor, Department of Physical Education and Sport Sciences, Amirkabir University of Technology, Tehran, Iran
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15
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Self-Report Tools for Assessing Physical Activity in Community-Living Older Adults with Multiple Chronic Conditions: A Systematic Review of Psychometric Properties and Feasibility. Can J Aging 2019; 39:12-30. [PMID: 31631827 DOI: 10.1017/s0714980819000357] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Identifier l'outil d'autodéclaration de l'activité physique (AP) le plus adapté pour l'évaluation de l'AP chez les personnes âgées vivant dans la communauté qui sont atteintes de multiples maladies chroniques (MMC). L'AP peut avoir une influence positive sur la santé physique et psychologique de cette population. Bien qu'il existe des outils d'auto-évaluation de l'AP, les propriétés psychométriques et la faisabilité de l'utilisation de ces outils chez les personnes âgées avec MMC sont peu connues. Une revue systématique des études publiées entre 2000 et 2018 portant sur les propriétés psychométriques et la faisabilité de 18 outils d'auto-évaluation élaborés pour les personnes âgées vivant en communauté (≥ 65 ans) a été réalisée en vue de déterminer leur pertinence pour les personnes âgées atteintes de MMC. L'évaluation des données disponibles sur les propriétés psychométriques et la faisabilité des 18 outils d'auto-évaluation de l'activité physique a permis d'établir que l'Échelle d'évaluation de l'activité physique chez les personnes âgées (Physical Activity Assessment Scale for the Elderly; PASE) est l'outil d'auto-évaluation le plus adapté, qui devrait être recommandé pour la population de personnes âgées avec MMC. The purpose of this study was to identify the self-report physical activity (PA) tool best suited for assessment of PA in community-dwelling older adults with multiple chronic conditions (MCC). PA can positively influence physical and psychological health in this population. Although self-report PA tools exist, little is known about the psychometric properties and feasibility of using these tools in older adults with MCC. A systematic literature review from 2000 to 2018 was conducted of studies reporting on the psychometric properties and feasibility of 18 self-report PA tools for community-dwelling older adults (≥ 65 years) to determine the suitability of these tools for use in older adults with MCC. Based on an assessment of the available evidence for the psychometric properties and feasibility of 18 different self-report PA tools, the Physical Activity Assessment Scale for the Elderly (PASE) is recommended as the best-suited self-report PA tool for older adults with MCC.
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16
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Siahpush M, Farazi PA, Wang H, Robbins RE, Singh GK, Su D. Muscle-strengthening physical activity is associated with cancer mortality: results from the 1998-2011 National Health Interview Surveys, National Death Index record linkage. Cancer Causes Control 2019; 30:663-670. [PMID: 31004232 DOI: 10.1007/s10552-019-01169-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 04/10/2019] [Indexed: 01/09/2023]
Abstract
PURPOSE To examine the association of muscle-strengthening activities (MSA) and cancer mortality. METHODS We pooled data from the 1998 to 2009 National Health Interview Survey (NHIS), which were linked to records in the National Death Index. Mortality follow-up was through 31 December 2011. Based on U.S. federal guidelines for physical activity, we dichotomized MSA and compared those who performed MSA twice a week or more to others with lower MSA. We also examined dose-response relationship of MSA frequency with cancer mortality. Hazard ratios (HR) from Cox regression were computed to estimate the association of MSA with the risk of cancer mortality. Mean follow-up was 7.9 years and the analysis sample size was 310,282. RESULTS Covariate-adjusted results showed that meeting the MSA guideline was associated with a 19% lower risk of cancer mortality (HR 0.81, 95% CI 0.73, 0.90). We found no evidence of a dose-response relationship between the frequency of performing MSA and cancer mortality. CONCLUSION Adhering to the U.S. federal guideline for MSA is associated with lower cancer mortality. Public health programs and policy for cancer prevention and control should promote MSA to further reduce cancer mortality.
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Affiliation(s)
- Mohamamd Siahpush
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, 984340 Nebraska Medical Center, Omaha, NE, 68198-4340, USA.
| | - Paraskevi A Farazi
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, USA
| | - Hongmei Wang
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, 984395 Nebraska Medical Center, Omaha, USA
| | - Regina E Robbins
- Department of Sociology & Anthropology, University of Nebraska at Omaha, 6001 Dodge Street, Omaha, NE, 68182-0213, USA
| | - Gopal K Singh
- Office of Health Equity, Health Resources and Services Administration, U.S. Department of Health & Human Services, Rockville, MD, 20857, USA
| | - Dejun Su
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, 984340 Nebraska Medical Center, Omaha, NE, 68198-4340, USA
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Mohammadkhani PG, Irandoust K, Taheri M, Mirmoezzi M, Baić M. Effects of eight weeks of aerobic exercise and taking caraway supplement on C-reactive protein and sleep quality in obese women. BIOL RHYTHM RES 2019. [DOI: 10.1080/09291016.2019.1587837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Khadijeh Irandoust
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Morteza Taheri
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Masoud Mirmoezzi
- Faculty of Physical Education and Sports Science, Islamic Azad University, Tehran, Iran
| | - Mario Baić
- Faculty of Kinesiology, University of Zagreb, Zagreb, croatia
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18
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Chowdhury MA, Sholl HK, Sharrett MS, Haller ST, Cooper CC, Gupta R, Liu LC. Exercise and Cardioprotection: A Natural Defense Against Lethal Myocardial Ischemia-Reperfusion Injury and Potential Guide to Cardiovascular Prophylaxis. J Cardiovasc Pharmacol Ther 2019; 24:18-30. [PMID: 30041547 PMCID: PMC7236859 DOI: 10.1177/1074248418788575] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Similar to ischemic preconditioning, high-intensity exercise has been shown to decrease infarct size following myocardial infarction. In this article, we review the literature on beneficial effects of exercise, exercise requirements for cardioprotection, common methods utilized in laboratories to study this phenomenon, and discuss possible mechanisms for exercise-mediated cardioprotection.
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Affiliation(s)
- Mohammed Andaleeb Chowdhury
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
- * Mohammed Andaleeb Chowdhury, Haden K. Sholl, and Megan S. Sharrett contributed equally to this work
| | - Haden K Sholl
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
- * Mohammed Andaleeb Chowdhury, Haden K. Sholl, and Megan S. Sharrett contributed equally to this work
| | - Megan S Sharrett
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Steven T Haller
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Christopher C Cooper
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Rajesh Gupta
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
| | - Lijun C Liu
- 1 Department of Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, USA
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19
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Sung KD, Pekas EJ, Scott SD, Son WM, Park SY. The effects of a 12-week jump rope exercise program on abdominal adiposity, vasoactive substances, inflammation, and vascular function in adolescent girls with prehypertension. Eur J Appl Physiol 2018; 119:577-585. [PMID: 30554386 DOI: 10.1007/s00421-018-4051-4] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 12/06/2018] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Childhood obesity is strongly associated with cardiovascular disease (CVD) development. It is necessary to combat unfavorable outcomes of obesity at a young age by utilizing effective interventions, such as exercise. PURPOSE We sought to examine the effects of a jump rope exercise program on CVD risk factors, including body composition, vasoactive substances, inflammation, and vascular function in prehypertensive adolescent girls. METHODS Forty girls (age 14-16) were recruited and randomly assigned to a jump rope exercise group (EX, n = 20) or control group (CON, n = 20). Body composition, nitrate and nitrite levels, endothelin-1 (ET-1), C-reactive protein (CRP), systolic blood pressure and diastolic blood pressure (SBP, DBP), and arterial stiffness were measured before and after 12 weeks. RESULTS There were significant group by time interactions following the 12-week program for body composition (from 33.8 ± 3.6 to 30.2 ± 3.1%), central adiposity (from 86.4 ± 4 to 83.3 ± 5 cm), SBP (from 126 ± 3.3 to 120 ± 2.1 mmHg), and brachial-to-ankle pulse wave velocity (from 8.2 ± 1.0 to 7.4 ± 0.2 m/s). Nitrate/nitrite levels increased (from 54.5 ± 5.1 to 57.2 ± 5.2 µmol) along a reduction in CRP levels (from 0.5 ± 0.4 to 0.2 ± 0.1 mg/L). There were no significant changes in ET-1 (P = 0.22). CONCLUSIONS These findings indicate that jump rope exercise may be an effective intervention to improve these CVD risk factors in prehypertensive adolescent girls. Jumping rope is an easily accessible exercise modality that may have important health implications for CVD prevention in younger populations.
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Affiliation(s)
- Ki-Dong Sung
- Department of Physical Education, Pusan National University, Busan, South Korea
| | - Elizabeth J Pekas
- School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE, 68182, USA
| | - Steven D Scott
- School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE, 68182, USA
| | - Won-Mok Son
- Department of Physical Education, Pusan National University, Busan, South Korea
| | - Song-Young Park
- Department of Physical Education, Pusan National University, Busan, South Korea. .,School of Health and Kinesiology, University of Nebraska at Omaha, 6001 Dodge St., Omaha, NE, 68182, USA.
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20
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Stephens NA, Brouwers B, Eroshkin AM, Yi F, Cornnell HH, Meyer C, Goodpaster BH, Pratley RE, Smith SR, Sparks LM. Exercise Response Variations in Skeletal Muscle PCr Recovery Rate and Insulin Sensitivity Relate to Muscle Epigenomic Profiles in Individuals With Type 2 Diabetes. Diabetes Care 2018; 41:2245-2254. [PMID: 30072402 DOI: 10.2337/dc18-0296] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 07/15/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Some individuals with type 2 diabetes do not reap metabolic benefits from exercise training, yet the underlying mechanisms of training response variation are largely unexplored. We classified individuals with type 2 diabetes (n = 17) as nonresponders (n = 6) or responders (n = 11) based on changes in phosphocreatine (PCr) recovery rate after 10 weeks of aerobic training. We aimed to determine whether the training response variation in PCr recovery rate was marked by distinct epigenomic profiles in muscle prior to training. RESEARCH DESIGN AND METHODS PCr recovery rate as an indicator of in vivo muscle mitochondrial function in vastus lateralis (31P-magnetic resonance spectroscopy), insulin sensitivity (M-value; hyperinsulinemic-euglycemic clamp), aerobic capacity (Vo2peak), and blood profiles were determined pretraining and post-training. Muscle biopsies were performed pretraining in vastus lateralis for the isolation of primary skeletal muscle cells (HSkMCs) and assessments of global DNA methylation and RNA sequencing in muscle tissue and HSkMCs. RESULTS By design, nonresponders decreased and responders increased PCr recovery rate with training. In nonresponders, insulin sensitivity did not improve and glycemic control (HbA1c) worsened. In responders, insulin sensitivity improved. Vo2peak improved by ∼12% in both groups. Nonresponders and responders were distinguished by distinct pretraining molecular (DNA methylation, RNA expression) patterns in muscle tissue, as well as in HSkMCs. Enrichment analyses identified elevations in glutathione regulation, insulin signaling, and mitochondrial metabolism in nonresponders pretraining, which was reflected in vivo by higher pretraining PCr recovery rate and insulin sensitivity in these same individuals. CONCLUSIONS A training response variation for clinical risk factors in individuals with type 2 diabetes is reflected by distinct basal myocellular epigenomic profiles in muscle tissue, some of which are maintained in HSkMCs, suggesting a cell-autonomous underpinning. Our data provide new evidence to potentially shift the diabetes treatment paradigm for individuals who do not benefit from training, such that supplemental treatment can be designed.
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Affiliation(s)
- Natalie A Stephens
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Bram Brouwers
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | | | - Fanchao Yi
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Heather H Cornnell
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Christian Meyer
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL
| | - Bret H Goodpaster
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL.,Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL
| | - Richard E Pratley
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL.,Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL
| | - Steven R Smith
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL.,Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL
| | - Lauren M Sparks
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, Orlando, FL .,Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL
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21
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Sloan RP, Shapiro PA, McKinley PS, Bartels M, Shimbo D, Lauriola V, Karmally W, Pavlicova M, Choi CJ, Choo T, Scodes JM, Flood P, Tracey KJ. Aerobic Exercise Training and Inducible Inflammation: Results of a Randomized Controlled Trial in Healthy, Young Adults. J Am Heart Assoc 2018; 7:e010201. [PMID: 30371169 PMCID: PMC6201415 DOI: 10.1161/jaha.118.010201] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 07/17/2018] [Indexed: 12/31/2022]
Abstract
Background Consensus panels regularly recommend aerobic exercise for its health-promoting properties, due in part to presumed anti-inflammatory effects, but many studies show no such effect, possibly related to study differences in participants, interventions, inflammatory markers, and statistical approaches. This variability makes an unequivocal determination of the anti-inflammatory effects of aerobic training elusive. Methods and Results We conducted a randomized controlled trial of 12 weeks of aerobic exercise training or a wait list control condition followed by 4 weeks of sedentary deconditioning on lipopolysaccharide (0, 0.1, and 1.0 ng/mL)-inducible tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), and on toll-like receptor 4 in 119 healthy, sedentary young adults. Aerobic capacity by cardiopulmonary exercise testing was measured at study entry (T1) and after training (T2) and deconditioning (T3). Despite a 15% increase in maximal oxygen consumption, there were no changes in inflammatory markers. Additional analyses revealed a differential longitudinal aerobic exercise training effect by lipopolysaccharide level in inducible TNF -α ( P=0.08) and IL-6 ( P=0.011), showing T1 to T2 increases rather than decreases in inducible (lipopolysaccharide 0.1, 1.0 versus 0.0 ng/mL) TNF- α (51% increase, P=0.041) and IL-6 (42% increase, P=0.11), and significant T2 to T3 decreases in inducible TNF- α (54% decrease, P=0.007) and IL-6 (55% decrease, P<0.001). There were no significant changes in either group at the 0.0 ng/mL lipopolysaccharide level for TNF- α or IL-6. Conclusions The failure to support the primary hypotheses and the unexpected post hoc findings of an exercise-training-induced proinflammatory response raise questions about whether and under what conditions exercise training has anti-inflammatory effects. Clinical Trial Registration URL : http://www.clinicaltrials.gov . Unique identifier: NCT 01335737.
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Affiliation(s)
- Richard P. Sloan
- Division of Behavioral MedicineDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
- New York State Psychiatric InstituteNew YorkNY
| | - Peter A. Shapiro
- Division of Consultation/Liaison PsychiatryDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
| | - Paula S. McKinley
- Division of Behavioral MedicineDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
| | - Matthew Bartels
- Department of Rehabilitation MedicineColumbia University Medical CenterNew YorkNY
| | - Daichi Shimbo
- Department of MedicineColumbia University Medical CenterNew YorkNY
| | - Vincenzo Lauriola
- Division of Behavioral MedicineDepartment of PsychiatryColumbia University Medical CenterNew YorkNY
| | - Wahida Karmally
- Irving Institute for Clinical and Translational ResearchColumbia University Medical CenterNew YorkNY
| | - Martina Pavlicova
- Department of BiostatisticsMailman School of Public HealthColumbia University Medical CenterNew YorkNY
| | | | | | | | - Pamela Flood
- Department of AnesthesiologyColumbia University Medical CenterNew YorkNY
| | - Kevin J. Tracey
- The Feinstein Institute for Medical ResearchNorthwell HealthManhassettNY
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22
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Tanner A, Vassallo M, Kwan J, Allen SC. The pulmonary rehabilitation regimen: a treatment for frailty and 'inflammaging'? Br J Hosp Med (Lond) 2018; 79:432-437. [PMID: 30070944 DOI: 10.12968/hmed.2018.79.8.432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary rehabilitation is an exercise-based intervention that improves walking endurance, strength, functional independence, wellbeing and the risk of re-admission to hospital. It was developed for patients recovering from acute exacerbations of chronic obstructive pulmonary disease, and sometimes other long-term inflammatory lung diseases. Many other conditions have a chronic inflammatory component, including type 2 diabetes, obesity, osteoarthritis and old age. Such background inflammation is linked to a range of adverse outcomes, including all-cause mortality, sarcopenia and other markers of frailty. Exercise, including pulmonary rehabilitation, has an anti-inflammatory effect on innate immune chemistry, and improves outcomes in a variety of conditions, although for most diagnostic groups there is no consistent structured programme similar to pulmonary rehabilitation. The authors contend that the pulmonary rehabilitation model could be used generically to treat other chronic and post-acute inflammatory states and thereby reduce the risk of frailty and other adverse outcomes.
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Affiliation(s)
- A Tanner
- Foundation Doctor, Department of Medicine, The Royal Bournemouth Hospital, Bournemouth, Dorset
| | - M Vassallo
- Consultant Physician and Visiting Professor, Department of Medicine, The Royal Bournemouth Hospital, Bournemouth, Dorset and Centre for Postgraduate Medical Research and Education, Bournemouth University, Dorset
| | - Jsk Kwan
- Clinical Associate Professor and Honorary Consultant Physician, Faculty of Medicine, University of Hong Kong, Hong Kong SAR, China
| | - S C Allen
- Consultant Physician and Visiting Professor, Department of Medicine, The Royal Bournemouth Hospital, Bournemouth, Dorset BH7 7DW and Centre for Postgraduate Medical Research and Education, Bournemouth University, Dorset
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23
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Wernicke K, Zeissler S, Mooren FC, Frech T, Hellmann S, Stiesch M, Grischke J, Linnenweber S, Schmidt B, Menne J, Melk A, Bauer P, Hillebrecht A, Eberhard J. Probing depth is an independent risk factor for HbA1c levels in diabetic patients under physical training: a cross-sectional pilot-study. BMC Oral Health 2018; 18:46. [PMID: 29548317 PMCID: PMC5857102 DOI: 10.1186/s12903-018-0491-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2017] [Accepted: 02/23/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This cross-sectional study investigates the potential association between active periodontal disease and high HbA1c levels in type-2-diabetes mellitus subjects under physical training. METHODS Women and men with a diagnosis of non-insulin-dependent diabetes mellitus and ongoing physical and an ongoing exercise program were included. Periodontal conditions were assessed according to the CDC-AAP case definitions. Venous blood samples were collected for the quantitative analysis of HbA1c. Associations between the variables were examined with univariate and multivariate regression models. RESULTS Forty-four subjects with a mean age of 63.4 ± 7.0 years were examined. Twenty-nine subjects had no periodontitis, 11 had a moderate and 4 had a severe form of periodontal disease. High fasting serum glucose (p < 0.0001), high BMI scores (p = 0.001), low diastolic blood pressure (p = 0.030) and high probing depth (p = 0.036) were significantly associated with high HbA1c levels. CONCLUSIONS Within the limitations of this study HbA1c levels are positively associated with high probing pocket depth in patients with non-insulin-dependent diabetes mellitus under physical exercise training. Control and management of active periodontal diseases in non-insulin-dependent patients with diabetes mellitus is reasonable in order to maximize therapeutic outcome of lifestyle interventions.
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Affiliation(s)
- Katharina Wernicke
- Department of Prosthetic Dentistry, Hannover Medical School, Hannover, Germany
| | - Sven Zeissler
- Faculty of Physical Education and Sports, Comenius University Bratislava, Bratislava, Slovakia
| | - Frank C Mooren
- Faculty of Sports Medicine, University of Giessen, Giessen, Germany
| | - Torsten Frech
- Faculty of Sports Medicine, University of Giessen, Giessen, Germany
| | | | - Meike Stiesch
- Department of Prosthetic Dentistry, Hannover Medical School, Hannover, Germany
| | - Jasmin Grischke
- Department of Prosthetic Dentistry, Hannover Medical School, Hannover, Germany
| | | | - Bernhard Schmidt
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Jan Menne
- Department of Nephrology, Hannover Medical School, Hannover, Germany
| | - Anette Melk
- Department of Pediatric Nephrology, Hannover Medical School, Hannover, Germany
| | - Pascal Bauer
- Clinic I, Cardiology and Angiology, University Hospital Giessen, Giessen, Germany
| | - Andree Hillebrecht
- Faculty of Sports Medicine, University of Giessen, Giessen, Germany.,Medical Department Volkswagen AG, Baunatal, Germany
| | - Jörg Eberhard
- Department of Prosthetic Dentistry, Hannover Medical School, Hannover, Germany. .,Faculty of Dentistry, Charles Perkins Centre, Westmead Centre for Oral Health, University of Sydney, Sydney, New South Wales, 2145, Australia.
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Brauer SG, Kuys SS, Paratz JD, Ada L. Improving physical activity after stroke via treadmill training and self management (IMPACT): a protocol for a randomised controlled trial. BMC Neurol 2018; 18:13. [PMID: 29382298 PMCID: PMC5791375 DOI: 10.1186/s12883-018-1015-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The level of physical activity undertaken by stroke survivors living in the community is generally low. The main objectives of the IMPACT trial are to determine, in individuals undergoing rehabilitation after stroke, if 8 weeks of high-intensity treadmill training embedded in self-management education (i) results in more physical activity than usual physiotherapy gait training and (ii) is more effective at increasing walking ability, cardiorespiratory fitness, self-efficacy, perception of physical activity, participation, and health-related quality of life as well as decreasing cardiovascular risk, and depression, at 8 and 26 weeks. METHODS A prospective, two-arm, parallel-group, randomised trial with concealed allocation, blinded measurement and intention-to-treat analysis, will be conducted. 128 stroke survivors undergoing rehabilitation who are able to walk independently will be recruited and randomly allocated to either the experimental or control group, who will both undergo gait training for 30 min, three times a week for 8 weeks under the supervision of a physiotherapist. Outcomes will be measured at baseline (Week 0), on completion of the intervention (Week 8) and beyond the intervention (Week 26). This study has obtained ethical approval from the relevant Human Research Ethics Committees. DISCUSSION Improving stroke survivors' walking ability and cardiorespiratory fitness is likely to increase their levels of physical activity. Furthermore, if education in self-management results in sustained high levels of physical activity, this should result in improved participation and quality of life. TRIAL REGISTRATION This trial was registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12613000744752 ) on 4th July, 2013.
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Affiliation(s)
- Sandra G. Brauer
- Discipline of Physiotherapy, School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, QLD Australia
| | - Suzanne S. Kuys
- School of Physiotherapy, Faculty of Health Sciences, Australian Catholic University, Banyo, QLD Australia
| | - Jennifer D. Paratz
- School of Allied Health Sciences, Griffith University, Southport, QLD Australia
| | - Louise Ada
- Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, Sydney, NSW Australia
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Sparks LM. Exercise training response heterogeneity: physiological and molecular insights. Diabetologia 2017; 60:2329-2336. [PMID: 29032385 DOI: 10.1007/s00125-017-4461-6] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 08/18/2017] [Indexed: 12/17/2022]
Abstract
The overall beneficial effects of exercise are well studied, but why some people do not respond favourably to exercise is less understood. The National Institutes of Health Common Fund has recently launched the large-scale discovery project 'Molecular Transducers of Physical Activity in Humans' to examine the physiological and molecular (i.e. genetic, epigenetic, lipidomic, metabolomic, proteomic, etc.) responses to exercise training. A nationwide, multicentre clinical trial such as this one also provides a unique opportunity to robustly investigate the non-response to exercise in thousands of individuals that have undergone supervised aerobic- and resistance-based exercise training interventions. The term 'non-responder' is used here to address the lack of a response (to an exercise intervention) in an outcome specified a priori. Cardiorespiratory fitness ([Formula: see text]) as an exercise response variable was recently reviewed; thus, this review focuses on metabolic aspects of the non-response to exercise training. Integrated -omics platforms are discussed as an approach to disentangle the complicated relationships between endogenous and exogenous factors that drive the lack of a response to exercise in some individuals. Harnessing the power of combined -omics platforms with deep clinical phenotyping of human study participants will advance the field of exercise metabolism and shift the paradigm, allowing exercise interventions to be targeted at those most likely to benefit and identifying novel approaches to treat those who do not.
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Affiliation(s)
- Lauren M Sparks
- Translational Research Institute for Metabolism and Diabetes, Florida Hospital, 301 E Princeton Street, Orlando, FL, 32804, USA.
- Sanford Burnham Prebys Medical Discovery Institute, Orlando, FL, USA.
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Sarzynski MA, Ghosh S, Bouchard C. Genomic and transcriptomic predictors of response levels to endurance exercise training. J Physiol 2017; 595:2931-2939. [PMID: 27234805 PMCID: PMC5407970 DOI: 10.1113/jp272559] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/24/2016] [Indexed: 01/28/2023] Open
Abstract
Predicting the responsiveness to regular exercise is a topic of great relevance due to its potential role in personalized exercise medicine applications. The present review focuses on cardiorespiratory fitness (commonly measured by maximal oxygen uptake, V̇O2 max ), a trait with wide-ranging impact on health and performance indicators. Gains in V̇O2 max demonstrate large inter-individual variation even in response to standardized exercise training programmes. The estimated ΔVO2 max heritability of 47% suggests that genomic-based predictors alone are insufficient to account for the total trainability variance. Candidate gene and genome-wide linkage studies have not significantly contributed to our understanding of the molecular basis of trainability. A genome-wide association study suggested that V̇O2 max trainability is influenced by multiple genes of small effects, but these findings still await rigorous replication. Valuable evidence, however, has been obtained by combining skeletal muscle transcript abundance profiles with common DNA variants for the prediction of the V̇O2 max response to exercise training. Although the physiological determinants of V̇O2 max measured at a given time are largely enunciated, what is poorly understood are the details of tissue-specific molecular mechanisms that limit V̇O2 max and related signalling pathways in response to exercise training. Bioinformatics explorations based on thousands of variants have been used to interrogate pathways and systems instead of single variants and genes, and the main findings, along with those from exercise experimental studies, have been summarized here in a working model of V̇O2 max trainability.
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Affiliation(s)
- Mark A. Sarzynski
- Department of Exercise Science, Arnold School of Public HealthUniversity of South CarolinaColumbiaSCUSA
| | - Sujoy Ghosh
- Cardiovascular and Metabolic Disorders Program and Centre for Computational BiologyDuke‐NUS Medical SchoolSingapore
| | - Claude Bouchard
- Human Genomics LaboratoryPennington Biomedical Research CentreBaton RougeLAUSA
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Physical Inactivity and the Economic and Health Burdens Due to Cardiovascular Disease: Exercise as Medicine. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 999:3-18. [DOI: 10.1007/978-981-10-4307-9_1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Leon AS. Attenuation of Adverse Effects of Aging on Skeletal Muscle by Regular Exercise and Nutritional Support. Am J Lifestyle Med 2017; 11:4-16. [PMID: 30202306 PMCID: PMC6124840 DOI: 10.1177/1559827615589319] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/06/2015] [Indexed: 12/19/2022] Open
Abstract
Beginning early in midlife, natural/primary aging is inevitably associated with a progressive reduction in muscle mass and function. This process can progress with aging to a substantial loss of strength, particularly in the lower extremities, reducing mobility. This condition, commonly referred to as sarcopenia, can result in frailty, reducing one's ability to live independently. This article reviews the underlying biological process contributing to the development of sarcopenia and the roles of regular exercise and nutritional support for attenuating aging-associated muscle loss as well as risk and management of sarcopenia and associated frailty.
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Abd El-Kader SM, Al-Jiffri OH. Exercise alleviates depression related systemic inflammation in chronic obstructive pulmonary disease patients. Afr Health Sci 2016; 16:1078-1088. [PMID: 28479901 PMCID: PMC5398455 DOI: 10.4314/ahs.v16i4.25] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Depression is a highly prevalent co-morbidity in Chronic Obstructive Pulmonary Disease (COPD) which was shown to be associated with a worse course of disease, including reduced quality of life and increased symptoms burden, healthcare use, and even mortality. It has been speculated that systemic inflammation may play a role in the presence of depression. Currently, physical activity is an important lifestyle factor that has the potential to modify inflammatory cytokines and depression, however our understanding of how to use exercise effectively in COPD patients to alleviate depression related systemic inflammation is incomplete and has prompted our interest to identify the type and intensities of effective exercise. OBJECTIVE The aim of this study was to measure the changes in depression related systemic inflammation of aerobic exercise training in COPD patients in Jeddah area. MATERIAL AND METHODS Eighty patients with moderate severity of COPD participated in this study and were divided into two groups; the first group received aerobic exercise, whereas the second group received no exercise training for 12 weeks. RESULTS The mean values of tumor necrosis factor-alpha (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6), C-reactive protein (CRP) and Beck Depression Inventory (BDI) scores were significantly decreased in in group (A) after treatments, but the changes in group (B) were not significant .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. CONCLUSION Aerobic exercise is an effective treatment policy to improve depression related to systemic inflammation in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Shehab M Abd El-Kader
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University
| | - Osama H Al-Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King AbdulazizUniversity
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Zoeller RF. Physical Activity and Obesity: Their Interaction and Implications for Disease Risk and the Role of Physical Activity in Healthy Weight Management. Am J Lifestyle Med 2016. [DOI: 10.1177/1559827607306889] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The prevalence of overweight and obesity is increasing at an epidemic rate. Increased adiposity, especially central or visceral adiposity, is predictive of cardiovascular disease/coronary heart disease, metabolic syndrome, and type 2 diabetes mellitus. The increased risk for cardiovascular disease/coronary heart disease and metabolic abnormalities associated with abdominal obesity may be mediated, at least in part, by increased systemic inflammation. Greater physical activity and/or fitness may reduce inflammation associated with greater visceral adiposity. Increased adiposity and low levels of physical activity and/or fitness are risk factors for atherosclerotic disease and type 2 diabetes, as well as the increased mortality associated with them. Increased physical activity/fitness reduces disease and mortality risk regardless of body mass index but does not completely abrogate the risks associated with obesity. Both moderate to vigorous physical activity and weight loss independently reduce the risk for type 2 diabetes and improve glucose/insulin metabolism via di ferent mechanisms. Physical activity on the order of 2500 to 2800 kcal/wk may be necessary to prevent weight gain or maintain weight loss. Strength training is recommended as an adjunct to regular aerobic exercise but not as the primary mode of exercise for weight loss. Individuals are strongly encouraged to engage in regular physical activity because of the known health benefits, regardless of whether that activity results in weight loss.
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Affiliation(s)
- Robert F. Zoeller
- Department of Exercise Science & Health Promotion, Florida Atlantic University, Davie, Florida,
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Orio F, Muscogiuri G, Giallauria F, Savastano S, Bottiglieri P, Tafuri D, Predotti P, Colarieti G, Colao A, Palomba S. Oral contraceptives versus physical exercise on cardiovascular and metabolic risk factors in women with polycystic ovary syndrome: a randomized controlled trial. Clin Endocrinol (Oxf) 2016; 85:764-771. [PMID: 27219465 DOI: 10.1111/cen.13112] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/19/2016] [Accepted: 05/20/2016] [Indexed: 01/23/2023]
Abstract
BACKGROUND Although oral contraceptives (OCs) are one the most widespread therapy in young polycystic ovary syndrome (PCOS) women and physical exercise represents a crucial first step in the treatment of overweight and obese PCOS, no studies were performed to compare the effects on cardiovascular risk (CVR) of OCs and physical exercise in PCOS. OBJECTIVE To compare the effects of OCs administration and physical exercise on the CVR, clinical, hormonal and metabolic parameters in PCOS women. METHODS One hundred and fifty PCOS women were enrolled and were randomized to OCs (3 mg drospirenone plus 30 μg ethinyloestradiol), structured exercise training programme (SETP) or polyvitamin tablets. The intervention phase study was of 6 months. Primary outcome was intima-media thickness (IMT) and flow-mediated dilation (FMD). Secondary outcomes were clinical, hormonal and metabolic changes. RESULTS A significant reduction of IMT and a significant increase of FMD were observed in the SETP group after treatment. Compared to baseline, in the SETP group, a significant improvement in anthropometric measures, insulin sensitivity indexes, lipid profile, cardiopulmonary function, inflammatory markers and frequency of menses was observed. Oral contraceptives use was associated with a significant decrease of hyperandrogenism and a significant improvement of frequency of menses. Further, OCs use had a neutral effect on CVR risk factors. CONCLUSION OCs effectively treat hyperandrogenism and menstrual disturbances, while SETP is more effective in improving cardiometabolic profile and cardiopulmonary function in PCOS.
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Affiliation(s)
- F Orio
- Endocrinology, Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy.
- Fertility Techniques SSD, University Hospital "S. Giovannni di Dio e Ruggi d'Aragona" Salerno, Salerno, Italy.
| | | | - F Giallauria
- Department of Clinical Medicine, Cardiovascular and Immunological Sciences, Cardiac Rehabilitation Unit, "Federico II" University of Naples, Naples, Italy
| | - S Savastano
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - P Bottiglieri
- Unit of Cardiology, University Hospital "S. Giovanni di Dio e Ruggi d'Aragona" Salerno, Salerno, Italy
| | - D Tafuri
- Department of Sports Science and Wellness, "Parthenope" University Naples, Naples, Italy
| | - P Predotti
- Unit of Cardiology, University Hospital "S. Giovanni di Dio e Ruggi d'Aragona" Salerno, Salerno, Italy
| | - G Colarieti
- Fertility Techniques SSD, University Hospital "S. Giovannni di Dio e Ruggi d'Aragona" Salerno, Salerno, Italy
| | - A Colao
- Department of Clinical Medicine and Surgery, "Federico II" University of Naples, Naples, Italy
| | - S Palomba
- Obstetrics and Gynecology Unit, ASMN- IRCCS of Reggio, Reggio Emilia, Italy
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Chow LS, Odegaard AO, Bosch TA, Bantle AE, Wang Q, Hughes J, Carnethon M, Ingram KH, Durant N, Lewis CE, Ryder J, Shay CM, Kelly AS, Schreiner PJ. Twenty year fitness trends in young adults and incidence of prediabetes and diabetes: the CARDIA study. Diabetologia 2016; 59:1659-65. [PMID: 27181604 PMCID: PMC4930716 DOI: 10.1007/s00125-016-3969-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/11/2016] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS The prospective association between cardiorespiratory fitness (CRF) measured in young adulthood and middle age on development of prediabetes, defined as impaired fasting glucose and/or impaired glucose tolerance, or diabetes by middle age remains unknown. We hypothesised that higher fitness levels would be associated with reduced risk for developing incident prediabetes/diabetes by middle age. METHODS Participants were from the Coronary Artery Risk Development in Young Adults (CARDIA) study who were free from prediabetes/diabetes at baseline (year 0 [Y0]: 1985-1986). CRF was quantified by treadmill duration (converted to metabolic equivalents [METs]) at Y0, Y7 and Y20 and prediabetes/diabetes status was assessed at Y0, Y7, Y10, Y15, Y20 and Y25. We use an extended Cox model with CRF as the primary time-varying exposure. BMI was included as a time-varying covariate. The outcome was development of either prediabetes or diabetes after Y0. Model 1 included age, race, sex, field centre, CRF and BMI. Model 2 additionally included baseline (Y0) smoking, energy intake, alcohol intake, education, systolic BP, BP medication use and lipid profile. RESULTS Higher fitness was associated with lower risk for developing incident prediabetes/diabetes (difference of 1 MET: HR 0.99898 [95% CI 0.99861, 0.99940], p < 0.01), which persisted (difference of 1 MET: HR 0.99872 [95% CI 0.99840, 0.99904], p < 0.01] when adjusting for covariates. CONCLUSIONS/INTERPRETATION Examining participants who had fitness measured from young adulthood to middle age, we found that fitness was associated with lower risk for developing prediabetes/diabetes, even when adjusting for BMI over this time period. These findings emphasise the importance of fitness in reducing the health burden of prediabetes and diabetes.
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Affiliation(s)
- Lisa S Chow
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, MMC 101, 420 Delaware St SE, Minneapolis, MN, 55455, USA.
| | - Andrew O Odegaard
- Department of Epidemiology, University of California Irvine, Irvine, CA, USA
| | - Tyler A Bosch
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, MMC 101, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Anne E Bantle
- Division of Diabetes, Endocrinology and Metabolism, Department of Medicine, University of Minnesota, MMC 101, 420 Delaware St SE, Minneapolis, MN, 55455, USA
| | - Qi Wang
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
| | - John Hughes
- Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA
| | - Mercedes Carnethon
- Department of Preventive Medicine, Northwestern University, Chicago, IL, USA
| | - Katherine H Ingram
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA, USA
| | - Nefertiti Durant
- Department of Pediatrics, University of Alabama, Birmingham, AL, USA
| | - Cora E Lewis
- Department of Preventive Medicine, University of Alabama, Birmingham, AL, USA
| | - Justin Ryder
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
| | - Christina M Shay
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Aaron S Kelly
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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Abd El-Kader SM, Al-Jiffri OH, Al-Shreef FM. Plasma inflammatory biomarkers response to aerobic versus resisted exercise training for chronic obstructive pulmonary disease patients. Afr Health Sci 2016; 16:507-15. [PMID: 27605966 PMCID: PMC4994560 DOI: 10.4314/ahs.v16i2.19] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is a main risk for morbidity, associated with alterations in systemic inflammation. Recent studies proved that morbidity and mortality of COPD is related to systemic inflammation as it contributes to the pathogenesis of atherosclerosis and cardiovascular disease. However, increase of inflammatory cytokines adversely affects quality of life, alteration in ventilatory and skeletal muscles functions. Moreover, exercise training has many beneficial effects in correction of the adverse effects of COPD. OBJECTIVE This study aimed to compare the response of inflammatory cytokines of COPD to aerobic versus resisted exercises. MATERIALS AND METHODS One hundred COPD diseased patients participated in this study and were randomly included in two groups; the first group received aerobic exercise, whereas the second group received resisted exercise training for 12 weeks. RESULTS The mean values of TNF-α, Il-2, IL-4, IL-6 and CRP were significantly decreased in both groups. Also; there was a significant difference between both groups at the end of the study with more reduction in patients who received aerobic exercise training. CONCLUSION Aerobic exercise is more appropriate than resisted exercise training in modulating inflammatory cytokines level in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Shehab M Abd El-Kader
- Department of Physical Therapy, Faculty of Applied Medical Sciences, King Abdulaziz University
| | - Osama H Al-Jiffri
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University
| | - Fadwa M Al-Shreef
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, King Abdulaziz University
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Burzynska AZ, Wong CN, Chaddock-Heyman L, Olson EA, Gothe NP, Knecht A, Voss MW, McAuley E, Kramer AF. White matter integrity, hippocampal volume, and cognitive performance of a world-famous nonagenarian track-and-field athlete. Neurocase 2016; 22:135-44. [PMID: 26237526 PMCID: PMC6029702 DOI: 10.1080/13554794.2015.1074709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical activity (PA) and cardiorespiratory fitness (CRF) are associated with successful brain and cognitive aging. However, little is known about the effects of PA, CRF, and exercise on the brain in the oldest-old. Here we examined white matter (WM) integrity, measured as fractional anisotropy (FA) and WM hyperintensity (WMH) burden, and hippocampal (HIPP) volume of Olga Kotelko (1919-2014). Olga began training for competitions at age of 77 and as of June 2014 held over 30 world records in her age category in track-and-field. We found that Olga's WMH burden was larger and the HIPP was smaller than in the reference sample (58 healthy low-active women 60-78 years old), and her FA was consistently lower in the regions overlapping with WMH. Olga's FA in many normal-appearing WM regions, however, did not differ or was greater than in the reference sample. In particular, FA in her genu corpus callosum was higher than any FA value observed in the reference sample. We speculate that her relatively high FA may be related to both successful aging and the beneficial effects of exercise in old age. In addition, Olga had lower scores on memory, reasoning and speed tasks than the younger reference sample, but outperformed typical adults of age 90-95 on speed and memory. Together, our findings open the possibility of old-age benefits of increasing PA on WM microstructure and cognition despite age-related increase in WMH burden and HIPP shrinkage, and add to the still scarce neuroimaging data of the healthy oldest-old (>90 years) adults.
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Affiliation(s)
- A Z Burzynska
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - C N Wong
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - L Chaddock-Heyman
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - E A Olson
- b Department of Kinesiology and Community Health , University of Illinois , Urbana , IL 61801 , USA
| | - N P Gothe
- b Department of Kinesiology and Community Health , University of Illinois , Urbana , IL 61801 , USA
| | - A Knecht
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - M W Voss
- c Department of Psychological and Brain Sciences , University of Iowa , Iowa City , IA 52242-1407 , USA
| | - E McAuley
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA.,b Department of Kinesiology and Community Health , University of Illinois , Urbana , IL 61801 , USA
| | - A F Kramer
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
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Burzynska AZ, Wong CN, Voss MW, Cooke GE, Gothe NP, Fanning J, McAuley E, Kramer AF. Physical Activity Is Linked to Greater Moment-To-Moment Variability in Spontaneous Brain Activity in Older Adults. PLoS One 2015; 10:e0134819. [PMID: 26244873 PMCID: PMC4526228 DOI: 10.1371/journal.pone.0134819] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Accepted: 07/14/2015] [Indexed: 11/19/2022] Open
Abstract
Higher cardiorespiratory fitness (CRF) and physical activity (PA) in old age are associated with greater brain structural and functional integrity, and higher cognitive functioning. However, it is not known how different aspects of lifestyle such as sedentariness, light PA (LI-PA), or moderate-to-vigorous physical activity (MV-PA) relate to neural activity in aging. In addition, it is not known whether the effects of PA on brain function differ or overlap with those of CRF. Here, we objectively measured CRF as oxygen consumption during a maximal exercise test and measured PA with an accelerometer worn for 7 days in 100 healthy but low active older adults (aged 60-80 years). We modeled the relationships between CRF, PA, and brain functional integrity using multivariate partial least squares analysis. As an index of functional brain integrity we used spontaneous moment-to-moment variability in the blood oxygenation level-dependent signal (SDBOLD), known to be associated with better cognitive functioning in aging. We found that older adults who engaged more in LI-PA and MV-PA had greater SDBOLD in brain regions that play a role in integrating segregated functional domains in the brain and benefit from greater CRF or PA, such as precuneus, hippocampus, medial and lateral prefrontal, and temporal cortices. Our results suggest that engaging in higher intensity PA may have protective effects on neural processing in aging. Finally, we demonstrated that older adults with greater overall WM microstructure were those showing more LI-PA and MV-PA and greater SDBOLD. We conclude that SDBOLD is a promising correlate of functional brain health in aging. Future analyses will evaluate whether SDBOLD is modifiable with interventions aimed to increase PA and CRF in older adults.
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Affiliation(s)
- Agnieszka Z. Burzynska
- The Beckman Institute for Advanced Science and Technology at the University of Illinois, Urbana, IL, United States of America
| | - Chelsea N. Wong
- The Beckman Institute for Advanced Science and Technology at the University of Illinois, Urbana, IL, United States of America
| | - Michelle W. Voss
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, United States of America
| | - Gillian E. Cooke
- The Beckman Institute for Advanced Science and Technology at the University of Illinois, Urbana, IL, United States of America
| | - Neha P. Gothe
- Department of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI, United States of America
| | - Jason Fanning
- Department of Kinesiology and Community Health, University of Illinois, Urbana, IL, United States of America
| | - Edward McAuley
- Department of Kinesiology, Health and Sport Studies, Wayne State University, Detroit, MI, United States of America
| | - Arthur F. Kramer
- The Beckman Institute for Advanced Science and Technology at the University of Illinois, Urbana, IL, United States of America
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Ketabipoor SM, Koushkie Jahromi M. Effect of Aerobic Exercise in Water on Serum Estrogen and C - Reactive Protein and Body Mass Index Level in Obese and Normal Weight Postmenopausal Women. WOMEN’S HEALTH BULLETIN 2015. [DOI: 10.17795/whb-25048] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Metsios GS, Stavropoulos-Kalinoglou A, Kitas GD. The role of exercise in the management of rheumatoid arthritis. Expert Rev Clin Immunol 2015; 11:1121-30. [DOI: 10.1586/1744666x.2015.1067606] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Oliveira NL, Ribeiro F, Silva G, Alves AJ, Silva N, Guimarães JT, Teixeira M, Oliveira J. Effect of exercise-based cardiac rehabilitation on arterial stiffness and inflammatory and endothelial dysfunction biomarkers: a randomized controlled trial of myocardial infarction patients. Atherosclerosis 2015; 239:150-7. [PMID: 25602857 DOI: 10.1016/j.atherosclerosis.2014.12.057] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 12/19/2014] [Accepted: 12/24/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Arterial stiffness have shown an independent predictive value for cardiovascular and all-cause mortality. OBJECTIVE This study sought to evaluate the effects of an 8-week exercise-based cardiac rehabilitation program (ECR) on arterial stiffness, and on inflammatory and endothelial dysfunction biomarkers. Additionally, it was assessed two potential confounding variables, daily physical activity and dietary intake. METHODS In this parallel-group trial, 96 patients (56 ± 10 years) were randomized to either the exercise group (EG) or control group (CG) 4 weeks after suffering acute myocardial infarction (MI). ECR consisted of 8 weeks of aerobic exercise at 70-85% of maximal heart rate during 3 sessions weekly, plus usual care. CG participants received only usual care. Baseline and final assessments included arterial stiffness through carotid-femoral pulse wave velocity (cf-PWV), inflammatory and endothelial dysfunction biomarkers, daily physical activity, and dietary intake. (ClinicalTrials.gov: NCT01432639). RESULTS After 8 weeks, no significant changes were found between groups in cf-PWV, inflammatory and endothelial dysfunction biomarkers, daily physical activity, or dietary intake. Excluding those patients (n = 7) who did not attend, at least 80% of the exercise sessions provided similar results, excepting a significant reduction in cf-PWV in the EG compared to the CG. CONCLUSIONS A short-term ECR does not seem to reduce arterial stiffness and inflammatory and endothelial dysfunction biomarkers of post-MI patients under optimized medication. Nevertheless, the decrease of cf-PWV observed in the EG, when considering only those patients who attended at least 80% of exercise sessions, warrants further investigation.
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Affiliation(s)
- Nórton Luís Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.
| | - Fernando Ribeiro
- School of Health Sciences, University of Aveiro, Agras do Crasto, Campus Universitário de Santiago, 3810.193 Aveiro, Portugal.
| | - Gustavo Silva
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.
| | - Alberto Jorge Alves
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal; Higher Institute of Educational Sciences, Rua Dr. Luís Gonzaga F. Moreira, 4610.177 Felgueiras, Portugal.
| | - Nuno Silva
- Department of Clinical Pathology, S. João Hospital, Alameda Prof. Hernâni Monteiro, 4200.319 Porto, Portugal.
| | - João Tiago Guimarães
- Department of Clinical Pathology, S. João Hospital, Alameda Prof. Hernâni Monteiro, 4200.319 Porto, Portugal.
| | - Madalena Teixeira
- Cardiology Department, Centro Hospitalar de Vila Nova de Gaia/Espinho, Rua Conceição Fernandes, Vila Nova de Gaia, 4434.502 Espinho, Portugal.
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Rua Dr. Plácido Costa, 91, 4200.450 Porto, Portugal.
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Li YK, Hui CLM, Lee EHM, Chang WC, Chan SKW, Leung CM, Chen EYH. Coupling physical exercise with dietary glucose supplement for treating cognitive impairment in schizophrenia: a theoretical model and future directions. Early Interv Psychiatry 2014; 8:209-20. [PMID: 24224943 DOI: 10.1111/eip.12109] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 10/10/2013] [Indexed: 01/09/2023]
Abstract
AIMS Metabolic dysregulation may disrupt the complex neuroprotective mechanisms essential for brain health. Recent studies have pointed out the possible aetiological role of metabolic dysregulation in the onset of schizophrenia and the associated cognitive impairment. In this paper, we aimed to generate a theoretical model of how a combination of physical exercise and dietary glucose supplement may help to alleviate cognitive impairment in schizophrenia. METHODS Literature on metabolic dysregulation, especially insulin resistance, in relation to the onset of schizophrenia and the associated cognitive impairment is reviewed. The cognitive enhancement effects of physical exercise and dietary glucose supplement are then summarised. Finally, we propose a theoretical model based on the concerted effects of physical exercise and glucose supplement. RESULTS In general, the joint action of physical exercise and dietary glucose supplement could up-regulate glucose and insulin transport into the brain, as well as augmenting the release of insulin growth factor-1 and brain-derived neurotrophic factor. Physical exercise and glucose supplement could enhance energy supply and neuroplasticity in brain, subsequently leading to potential cognitive enhancement in schizophrenia. However, glucose supplement is not suitable for patients with abnormal metabolic profile. CONCLUSIONS The combination of physical exercise and glucose supplement has potential therapeutic values in treating cognitive impairment in schizophrenia. Further research is necessary to investigate the optimal patterns of exercise and doses of glucose for treating cognitive impairment in schizophrenia.
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Affiliation(s)
- Yuet-Keung Li
- Department of Psychiatry, University of Hong Kong, Hong Kong
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Park MY, Kim SH, Cho YJ, Chung RH, Lee KT. Association of Leisure Time Physical Activity and Metabolic Syndrome over 40 Years. Korean J Fam Med 2014; 35:65-73. [PMID: 24724001 PMCID: PMC3978187 DOI: 10.4082/kjfm.2014.35.2.65] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 01/09/2014] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND This study aimed to investigate the relationship between leisure time physical activities (LTPA) and metabolic syndrome (MS). METHODS Five thousand seven hundred and thirty two adults 40 years old or older were enrolled in the study from April 2009 to December 2010. National Cholesterol Education Program's Adult Treatment Panel III was used for the criteria of MS, and Minnesota Leisure Time Physical Activity Questionnaire was used to measure LTPA. After adjusted covariates (age, hypertension, smoking, drinking, education level, household income level, work time physical activities, and menopause for females), the relationship between LTPA and MS was analyzed using logistic regression analysis. RESULTS The prevalence of MS was 22.8% in men, and 14.1% in women. Average LTPA was 1,498 kcal/wk in men, and 1,308 kcal/wk in women. After adjustment for covariates, the odds ratios of middle and low LTPA compared with high LTPA were 1.06 (0.87-1.34), 1.54 (1.08-1.75), for women, this same association was not seen in men. The prevalence of MS was 22.8% in men and 14.1% in women, and their LTPA burned 1,498 and 1,308 kcal/wk, respectively. When the odds ratio of MS for the high LTPA group was set at 1.0, the odds ratio of MS was 1.06 (0.87-1.34) in the middle LTPA group and 1.54 (1.08-1.75) in the low LTPA group in women, which showed that the MS risk increased when the LTPA was lower. This same association was not seen in men. CONCLUSION LTPA was independently associated with metabolic syndrome, but only for women.
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Affiliation(s)
- Mi-Young Park
- Department of Family Medicine, Daegu Catholic University College of Medicine, Daegu, Korea
| | - Sung-Hi Kim
- Department of Family Medicine, Daegu Catholic University College of Medicine, Daegu, Korea
| | - Yoon-Jeong Cho
- Department of Family Medicine, Daegu Catholic University College of Medicine, Daegu, Korea
| | - Rae-Ho Chung
- Department of Family Medicine, Daegu Catholic University College of Medicine, Daegu, Korea
| | - Ki-Tae Lee
- Department of Family Medicine, Daegu Catholic University College of Medicine, Daegu, Korea
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Ryan AS, Ge S, Blumenthal JB, Serra MC, Prior SJ, Goldberg AP. Aerobic exercise and weight loss reduce vascular markers of inflammation and improve insulin sensitivity in obese women. J Am Geriatr Soc 2014; 62:607-14. [PMID: 24635342 DOI: 10.1111/jgs.12749] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To examine the relationships between plasma and tissue markers of systemic and vascular inflammation and obesity and insulin resistance and determine the effects of aerobic exercise training plus weight loss (AEX+WL) and weight loss (WL) alone on these biomarkers. DESIGN Prospective controlled study. SETTING Veterans Affairs Medical Center and University research setting. PARTICIPANTS Overweight and obese sedentary postmenopausal women (N = 77). INTERVENTIONS Six months, 3 d/wk AEX+WL (n = 37) or WL (n = 40). MEASUREMENTS Total-body dual-energy X-ray absorptiometry, abdominal computed tomography, hyperinsulinemic-euglycemic clamps (a criterion standard method of assessing insulin sensitivity), adipose tissue biopsies (n = 28), and blood for homeostasis model assessment-insulin resistance, and soluble forms of intracellular adhesion molecule 1 (sICAM-1) and vascular cell adhesion molecule 1 (sVCAM-1), C-reactive protein (CRP), and serum amyloid A (SAA). RESULTS Body weight (P < .001), percentage of fat (P < .001), visceral fat (P < .005), triglyceride levels (P < .001), and systolic blood pressure decreased comparably after WL and AEX+WL (P = .04). Maximal oxygen consumption increased 16% after AEX+WL (P < .001). Insulin resistance decreased in both groups (P = .005). Glucose utilization according to the clamp increased 10% (P = .04) with AEX+WL and 8% with WL (P = .07). AEX+WL decreased CRP by 29% (P < .001) and WL by 21% (P = .02). SAA levels decreased twice as much after AEX+WL (-19%, P = .02) as after WL (-9%, P = .08). Plasma sICAM-1 and sVCAM-1 levels did not change, but women with the greatest reduction in plasma sICAM-1 levels had the greatest reductions in fasting glucose (P = .02), insulin (P = .02), and insulin resistance (P = .004). Gluteal ICAM messenger ribonucleic acid levels decreased 27% after AEX+WL (P = .02) and did not change after WL. CONCLUSION Obesity and insulin resistance worsen markers of systemic and vascular inflammation. A reduction in plasma sICAM-1 is important to improve insulin sensitivity. CRP, SAA, and tissue ICAM decrease with exercise and weight loss, suggesting that exercise training is a necessary component of lifestyle modification in obese postmenopausal women.
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Affiliation(s)
- Alice S Ryan
- Baltimore Veterans Affairs Medical Center and Research and Development Service, Veterans Affairs Maryland Health Care System, Baltimore, Maryland; Division of Gerontology and Geriatric Medicine, Department of Medicine, School of Medicine, University of Maryland, Baltimore, Maryland; Baltimore Geriatric Research, Education and Clinical Center, Baltimore, Maryland
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Santilli F, Vazzana N, Iodice P, Lattanzio S, Liani R, Bellomo RG, Lessiani G, Perego F, Saggini R, Davì G. Effects of high-amount-high-intensity exercise on in vivo platelet activation: modulation by lipid peroxidation and AGE/RAGE axis. Thromb Haemost 2013; 110:1232-40. [PMID: 24030807 DOI: 10.1160/th13-04-0295] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2013] [Accepted: 08/09/2013] [Indexed: 12/18/2022]
Abstract
Physical activity is associated with cardiovascular risk reduction, but the effects of exercise on platelet activation remain controversial. We investigated the effects of regular high-amount, high intensity aerobic exercise on in vivo thromboxane (TX)-dependent platelet activation and plasma levels of platelet-derived proteins, CD40L and P-selectin, and whether platelet variables changes may be related to changes in high-density lipoprotein (HDL) and in the extent of oxidative stress and oxidative stress-related inflammation, as reflected by urinary isoprostane excretion and endogenous soluble receptor for advanced glycation end-products (esRAGE), respectively. Urinary excretion of 11-dehydro-TXB₂ and 8-iso-prostaglandin (PG)F(2α) and plasma levels of P-selectin, CD40L and esRAGE were measured before and after a eight-week standardised aerobic high-amount-high-intensity training program in 22 sedentary subjects with low-to-intermediate risk. Exercise training had a clear beneficial effect on HDL cholesterol (+10%, p=0.027) and triglyceride (-27%, p=0.008) concentration. In addition, a significant (p<0.0001) decrease in urinary 11-dehydro-TXB₂ (26%), 8-iso-PGF(2α) (21%), plasma P-selectin (27%), CD40L (35%) and a 61% increase in esRAGE were observed. Multiple regression analysis revealed that urinary 8-iso-PGF(2α) [beta=0.33, SEM=0.116, p=0.027] and esRAGE (beta=-0.30, SEM=31.3, p=0.046) were the only significant predictors of urinary 11-dehydro-TXB₂ excretion rate over the training period. In conclusion, regular high-amount-high-intensity exercise training has broad beneficial effects on platelet activation markers, paralleled and possibly associated with changes in the lipoprotein profile and in markers of lipid peroxidation and AGE/RAGE axis. Our findings may help explaining why a similar amount of exercise exerts significant benefits in preventing cardiovascular events.
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Affiliation(s)
- Francesca Santilli
- Giovanni Davì, Center of Excellence on Aging, "G. D'Annunzio" University Foundation, Via Colle dell'Ara, 66013 Chieti, Italy, Tel.: +39 0871 541312, Fax: +39 0871 541261, E-mail:
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Croymans DM, Krell SL, Oh CS, Katiraie M, Lam CY, Harris RA, Roberts CK. Effects of resistance training on central blood pressure in obese young men. J Hum Hypertens 2013; 28:157-64. [PMID: 24005959 DOI: 10.1038/jhh.2013.81] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2013] [Revised: 04/25/2013] [Accepted: 05/07/2013] [Indexed: 11/09/2022]
Abstract
Central blood pressure is a predictor of the risk of cardiovascular disease (CVD), and the effects of resistance training (RT) on central blood pressure are largely unknown. This study explored the effects of high-intensity RT on central blood pressure, indices of arterial stiffness and wave reflection and inflammatory/atherogenic markers in overweight or obese, sedentary young men. Thirty-six participants were randomized to RT (12 weeks of training, 3/wk, n=28) or control groups (C, 12 weeks of no training, n=8) and assessed for changes in central and brachial blood pressures, augmentation index (AIx), carotid-femoral pulse wave velocity (cfPWV), carotid intima-media thickness (cIMT), body composition, lipids and inflammatory/atherogenic markers. High-intensity RT resulted in decreased central and brachial systolic/diastolic blood pressures (all P0.03), despite not altering AIx (P=0.34) or cfPWV (P=0.43). The vascular endothelial growth factor increased (P=0.03) after RT, without any change in cIMT, C-reactive protein, oxidized LDL (oxLDL) or other inflammatory markers (all P0.1). Changes in the central systolic blood pressure (cSBP) were positively correlated with changes in oxLDL (r=0.42, P=0.03) and soluble E-selectin (r=0.41, P=0.04). In overweight/obese young men, high-intensity RT decreases cSBP, independently of weight loss and changes in arterial stiffness. The cardioprotective effects of RT may be related to effects on central blood pressure.
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Affiliation(s)
- D M Croymans
- 1] David Geffen School of Medicine, University of California, Los Angeles, CA, USA [2] Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - S L Krell
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - C S Oh
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - M Katiraie
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - C Y Lam
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
| | - R A Harris
- Georgia Prevention Institute, Georgia Health Sciences University, Augusta, GA, USA
| | - C K Roberts
- Exercise and Metabolic Disease Research Laboratory, Translational Sciences Section, School of Nursing, University of California, Los Angeles, CA, USA
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Buffart LM, Galvão DA, Brug J, Chinapaw MJM, Newton RU. Evidence-based physical activity guidelines for cancer survivors: current guidelines, knowledge gaps and future research directions. Cancer Treat Rev 2013; 40:327-40. [PMID: 23871124 DOI: 10.1016/j.ctrv.2013.06.007] [Citation(s) in RCA: 170] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Revised: 06/20/2013] [Accepted: 06/25/2013] [Indexed: 01/22/2023]
Abstract
Physical activity during and after cancer treatment has beneficial effects on a number of physical and psychosocial outcomes. This paper aims to discuss the existing physical activity guidelines for cancer survivors and to describe future research directions to optimize prescriptions. Studies on physical activity during and after cancer treatment were searched in PubMed, Clinicaltrials.gov, Australian New Zealand Clinical Trials Registry, and Dutch Trial registry. Physical activity guidelines for cancer survivors suggest that physical activity should be an integral and continuous part of care for all cancer survivors. However, the development of these guidelines has been limited by the research conducted. To be able to develop more specific guidelines, future studies should focus on identifying clinical, personal, physical, psychosocial, and intervention moderators explaining 'for whom' or 'under what circumstances' interventions work. Further, more insight into the working mechanisms of exercise interventions on health outcomes in cancer survivors is needed to improve the efficacy and efficiency of interventions. Finally, existing programs should embrace interests and preferences of patients to facilitate optimal uptake of interventions. In conclusion, current physical activity guidelines for cancer survivors are generic, and research is needed to develop more personalized physical activity guidelines.
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Affiliation(s)
- L M Buffart
- EMGO Institute for Health and Care Research and the VU University Medical Center, Department of Epidemiology and Biostatistics, Van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands.
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Donges CE, Duffield R, Guelfi KJ, Smith GC, Adams DR, Edge JA. Comparative effects of single-mode vs. duration-matched concurrent exercise training on body composition, low-grade inflammation, and glucose regulation in sedentary, overweight, middle-aged men. Appl Physiol Nutr Metab 2013; 38:779-88. [DOI: 10.1139/apnm-2012-0443] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- Cheyne E. Donges
- School of Human Movement Studies, Charles Sturt University, Panorama Avenue, Bathurst, Australia, 2795
| | - Rob Duffield
- School of Human Movement Studies, Charles Sturt University, Panorama Avenue, Bathurst, Australia, 2795
| | - Kym J. Guelfi
- School of Sport Science, Exercise and Health, The University of Western Australia, Perth, Australia
| | - Greg C. Smith
- Department of Molecular Medicine and Pathology, The University of Auckland, New Zealand
| | - David R. Adams
- School of Human Movement Studies, Charles Sturt University, Panorama Avenue, Bathurst, Australia, 2795
| | - Johann A. Edge
- Department of Exercise and Sports Science, The University of Auckland, New Zealand
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A consideration of biomarkers to be used for evaluation of inflammation in human nutritional studies. Br J Nutr 2013; 109 Suppl 1:S1-34. [PMID: 23343744 DOI: 10.1017/s0007114512005119] [Citation(s) in RCA: 257] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
To monitor inflammation in a meaningful way, the markers used must be valid: they must reflect the inflammatory process under study and they must be predictive of future health status. In 2009, the Nutrition and Immunity Task Force of the International Life Sciences Institute, European Branch, organized an expert group to attempt to identify robust and predictive markers, or patterns or clusters of markers, which can be used to assess inflammation in human nutrition studies in the general population. Inflammation is a normal process and there are a number of cells and mediators involved. These markers are involved in, or are produced as a result of, the inflammatory process irrespective of its trigger and its location and are common to all inflammatory situations. Currently, there is no consensus as to which markers of inflammation best represent low-grade inflammation or differentiate between acute and chronic inflammation or between the various phases of inflammatory responses. There are a number of modifying factors that affect the concentration of an inflammatory marker at a given time, including age, diet and body fatness, among others. Measuring the concentration of inflammatory markers in the bloodstream under basal conditions is probably less informative compared with data related to the concentration change in response to a challenge. A number of inflammatory challenges have been described. However, many of these challenges are poorly standardised. Patterns and clusters may be important as robust biomarkers of inflammation. Therefore, it is likely that a combination of multiple inflammatory markers and integrated readouts based upon kinetic analysis following defined challenges will be the most informative biomarker of inflammation.
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Abstract
The reality of regression of atherosclerotic plaques was established as long ago as 1987 by aggressive cholesterol reduction even before the era of statin therapy. Nevertheless, the most important aspect of patient benefit to prevent cardiovascular (CV) disease events is stabilization of these plaques so they will not rupture. Lowering of low-density lipoproteins is critical to this goal and can be considered the gold standard of preventive CV medicine. The major goal for the high-risk patient and the diabetic patient is lowering these harmful lipoproteins to less than 70 mg/dL. No discussion of CV disease prevention is complete without considering tobacco abuse and its elimination. Even secondhand smoke has been established as harmful. Control of hypertension is another major aspect of CV disease prevention, and a blood pressure less than 120/80 mm Hg is ideal. With obesity a major problem in the developed world, its role in the metabolic syndrome is of major significance as is the high prevalence of this so-called syndrome versus collection of specific risk factors in a population with poor health habits. Control of diabetes mellitus has established benefit from the standpoint of CV disease prevention except that some problems have been reported with extremely tight blood sugar control. Exercise was long considered good but now there are evidence-based reasons to recommend it as essential in CV disease prevention. There are many unforeseen frontiers in CV disease prevention but, for now, everything points to elevation of high-density lipoproteins as the next focus of this prevention.
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Affiliation(s)
- Thomas F Whayne
- Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky, Lexington, Kentucky
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Aspects of inflammation and oxidative stress in pediatric obesity and type 1 diabetes: an overview of ten years of studies. EXPERIMENTAL DIABETES RESEARCH 2012; 2012:683680. [PMID: 23093953 PMCID: PMC3475317 DOI: 10.1155/2012/683680] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2012] [Accepted: 08/16/2012] [Indexed: 01/04/2023]
Abstract
Obesity and type 1 diabetes (T1DM) are the two most common conditions of altered metabolism in children and adolescents. In both, similar long-term cardiovascular complications are known to occur, mediated in large part by underlying inflammatory and oxidative processes whose biochemical details remain relatively unclear. Through a series of experiments in these patient populations, over the last decade our laboratory has clarified a number of key issues in this field. Interestingly, while obese and type 1 diabetic children often differed in the specific type and magnitude of molecular alterations, in both groups a clear exaggeration of inflammatory and oxidative activation was detected when compared to healthy, age-matched controls. Our main findings include definition of resting and exercise-induced cytokine patterns and leukocyte profiles, patterns of activation of immune cells in vitro, and correlation of the magnitude of observed alterations with severity of obesity and quality of glycemic control. Further, we have identified a series of alterations in growth factor profiles during exercise that parallel inflammatory changes in obese children. This paper offers a concise overview of the salient results from this decade-long research effort.
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Barbosa CMG, Terra-Filho M, de Albuquerque ALP, Di Giorgi D, Grupi C, Negrão CE, Rondon MUPB, Martinez DG, Marcourakis T, dos Santos FA, Braga ALF, Zanetta DMT, Santos UDP. Burnt sugarcane harvesting - cardiovascular effects on a group of healthy workers, Brazil. PLoS One 2012; 7:e46142. [PMID: 23029413 PMCID: PMC3459900 DOI: 10.1371/journal.pone.0046142] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 08/29/2012] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Brazil is the world's largest producer of sugarcane. Harvest is predominantly manual, exposing workers to health risks: intense physical exertion, heat, pollutants from sugarcane burning. DESIGN Panel study to evaluate the effects of burnt sugarcane harvesting on blood markers and on cardiovascular system. METHODS Twenty-eight healthy male workers, living in the countryside of Brazil were submitted to blood markers, blood pressure, heart rate variability, cardiopulmonary exercise testing, sympathetic nerve activity evaluation and forearm blood flow measures (venous occlusion plethysmography) during burnt sugarcane harvesting and four months later while they performed other activities in sugar cane culture. RESULTS Mean participant age was 31 ± 6.3 years, and had worked for 9.8 ± 8.4 years on sugarcane work. Work during the harvest period was associated with higher serum levels of Creatine Kinase - 136.5 U/L (IQR: 108.5-216.0) vs. 104.5 U/L (IQR: 77.5-170.5), (p = 0.001); plasma Malondialdehyde-7.5 ± 1.4 µM/dl vs. 6.9 ± 1.0 µM/dl, (p = 0.058); Glutathione Peroxidase - 55.1 ± 11.8 Ug/Hb vs. 39.5 ± 9.5 Ug/Hb, (p<0.001); Glutathione Transferase- 3.4±1.3 Ug/Hb vs. 3.0 ± 1.3 Ug/Hb, (p = 0.001); and 24-hour systolic blood pressure - 120.1 ± 10.3 mmHg vs. 117.0 ± 10.0 mmHg, (p = 0.034). In cardiopulmonary exercise testing, rest-to-peak diastolic blood pressure increased by 11.12 mmHg and 5.13 mmHg in the harvest and non-harvest period, respectively. A 10 miliseconds reduction in rMSSD and a 10 burst/min increase in sympathetic nerve activity were associated to 2.2 and 1.8 mmHg rises in systolic arterial pressure, respectively. CONCLUSION Work in burnt sugarcane harvesting was associated with changes in blood markers and higher blood pressure, which may be related to autonomic imbalance.
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Affiliation(s)
- Cristiane Maria Galvão Barbosa
- Pulmonary Division - Heart Institute(InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- FUNDACENTRO, São Paulo, São Paulo, Brazil
| | - Mário Terra-Filho
- Pulmonary Division - Heart Institute(InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - André Luis Pereira de Albuquerque
- Pulmonary Division - Heart Institute(InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Dante Di Giorgi
- Hypertension Unit, Heart Institute(InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Cesar Grupi
- Electrocardiology Unit, Heart Institute(InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Carlos Eduardo Negrão
- Unit of Cardiovascular Rehabilitation and Exercise Physiology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Maria Urbana Pinto Brandão Rondon
- Unit of Cardiovascular Rehabilitation and Exercise Physiology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Daniel Godoy Martinez
- Unit of Cardiovascular Rehabilitation and Exercise Physiology, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Tânia Marcourakis
- Department of Clinical and Toxicological Analyses, University of São Paulo Pharmacological Sciences School, São Paulo, Brazil
| | - Fabiana Almeida dos Santos
- Department of Clinical and Toxicological Analyses, University of São Paulo Pharmacological Sciences School, São Paulo, Brazil
| | - Alfésio Luís Ferreira Braga
- Environmental Epidemiology Study Group, Laboratory of Experimental Air Pollution, Department of Pathology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Environmental Exposure and Risk Assessment Group, Catholic University of Santos, Santos, São Paulo, Brazil
| | | | - Ubiratan de Paula Santos
- Pulmonary Division - Heart Institute(InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, São Paulo, Brazil
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Whayne TF, Maulik N. Nutrition and the healthy heart with an exercise boost. Can J Physiol Pharmacol 2012; 90:967-76. [DOI: 10.1139/y2012-074] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In this era of potent medications and major cardiovascular (CV) procedures, the value of nutrition can be forgotten. A healthy diet is essential, regardless of CV risk. Caloric balance is inherent to a good diet. Despite patients who say they eat little, ideal weight can be maintained if calories are burned. Composition is another component of a healthy diet. The Dietary Approaches to Stop Hypertension (DASH) and Mediterranean diets provide proof of CV benefit from their specific content. Metabolic syndrome (MS) is associated with poor diet and obesity. A healthy diet with good nutrition benefits the MS patient and associated conditions such as obesity and diabetes. Exercise, in conjunction with a healthy diet and good nutrition, helps maintain optimal weight and provides CV benefit such as decreased inflammation and increased vasodilatation. Whether vitamins or other nutritional supplements are important in a healthy diet is unproven. Nevertheless, the most promising data of added benefit to a healthy diet is with vitamin D. Some dietary supplements also have promise. Alcohol, in moderation, especially red wine, has nutritional and heart protective benefits. Antioxidants, endogenous or exogenous, have received increased interest and appear to play a favorable nutritional role. CV health starts with good nutrition.
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Affiliation(s)
- Thomas F. Whayne
- Gill Heart Institute, University of Kentucky, 326 Wethington Building, 900 South Limestone Street, Lexington, KY 40536-0200, USA
| | - Nilanjana Maulik
- Molecular Cardiology and Angiogenesis Laboratory, University of Connecticut School of Medicine, 263 Farmington Avenue, Farmington, CT 06030-1110, USA
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