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Noone J, Mucinski JM, DeLany JP, Sparks LM, Goodpaster BH. Understanding the variation in exercise responses to guide personalized physical activity prescriptions. Cell Metab 2024; 36:702-724. [PMID: 38262420 DOI: 10.1016/j.cmet.2023.12.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/25/2024]
Abstract
Understanding the factors that contribute to exercise response variation is the first step in achieving the goal of developing personalized exercise prescriptions. This review discusses the key molecular and other mechanistic factors, both extrinsic and intrinsic, that influence exercise responses and health outcomes. Extrinsic characteristics include the timing and dose of exercise, circadian rhythms, sleep habits, dietary interactions, and medication use, whereas intrinsic factors such as sex, age, hormonal status, race/ethnicity, and genetics are also integral. The molecular transducers of exercise (i.e., genomic/epigenomic, proteomic/post-translational, transcriptomic, metabolic/metabolomic, and lipidomic elements) are considered with respect to variability in physiological and health outcomes. Finally, this review highlights the current challenges that impede our ability to develop effective personalized exercise prescriptions. The Molecular Transducers of Physical Activity Consortium (MoTrPAC) aims to fill significant gaps in the understanding of exercise response variability, yet further investigations are needed to address additional health outcomes across all populations.
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Affiliation(s)
- John Noone
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | | | - James P DeLany
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Lauren M Sparks
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA
| | - Bret H Goodpaster
- Translational Research Institute, AdventHealth, Orlando, FL 32804, USA.
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Mangone LA, Kwon OS, Johnson BT, Wu Y, Pescatello LS. The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Mayo Clin Proc Innov Qual Outcomes 2024; 8:131-142. [PMID: 38384718 PMCID: PMC10878792 DOI: 10.1016/j.mayocpiqo.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Objective To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention. Patients and Methods We systematically searched 5 electronic databases for placebo-controlled RCTs through January 31, 2023. We included short-term and long-term exercise interventions that compared the efficacy and safety of exercise+statin vs exercise+placebo in healthy adults and reported SAMS preintervention and postintervention. Publication bias and methodological study quality assessments were performed. Results Five of 454 potentially qualifying RCTs met the inclusion criteria, all short-term exercise RCTs. Participants were predominantly physically inactive young to middle-aged (M=37.2 y) men (57%), 252 (49%) who were on statin therapy, and 271 (53%) on placebo. Of the 3 RCTs providing qualitative SAMS results, 19 (9%) out of 220 participants reported SAMS on exercise+statin and 10 (4%) out of 234 reported SAMS on exercise+placebo. There was no difference between exercise+statin vs exercise+placebo for maximal oxygen consumption (d=-0.18; 95% CI, -0.37 to 0.00; P=.06) or creatine kinase after short-term exercise (d=0.59; 95% CI, -0.06 to 1.25; P=.08). Participants in the exercise+statin group reduced low-density lipoprotein cholesterol vs exercise+placebo (d=-1.84; 95% CI, -2.28 to -1.39; P<.001). Most of the RCTs exhibited low levels of risk of bias (k=4, 80%) and achieved moderate methodological study quality (75.0%±5.2%). Conclusion Self-reported SAMs tended to be 5% greater after short-term exercise in statin users compared with placebo, although this difference did not achieve statistical significance. There remains an important need for placebo-controlled RCTs investigating the prevalence of statin-induced SAMS during exercise training.
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Affiliation(s)
- Laura A. Mangone
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Oh Sung Kwon
- Department of Kinesiology, University of Connecticut, Storrs, CT
- UConn Center on Aging and Department of Orthopedic Surgery, University of Connecticut, School of Medicine, Farmington, CT
| | - Blair T. Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Yin Wu
- Department of Research, Hartford Hospital/HealthCare, Hartford, CT
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Long DE, Kosmac K, Dungan CM, Bamman MM, Peterson CA, Kern PA. Potential Benefits of Combined Statin and Metformin Therapy on Resistance Training Response in Older Individuals. Front Physiol 2022; 13:872745. [PMID: 35492586 PMCID: PMC9047873 DOI: 10.3389/fphys.2022.872745] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 03/24/2022] [Indexed: 12/24/2022] Open
Abstract
Metformin and statins are currently the focus of large clinical trials testing their ability to counter age-associated declines in health, but recent reports suggest that both may negatively affect skeletal muscle response to exercise. However, it has also been suggested that metformin may act as a possible protectant of statin-related muscle symptoms. The potential impact of combined drug use on the hypertrophic response to resistance exercise in healthy older adults has not been described. We present secondary statin analyses of data from the MASTERS trial where metformin blunted the hypertrophy response in healthy participants (>65 years) following 14 weeks of progressive resistance training (PRT) when compared to identical placebo treatment (n = 94). Approximately one-third of MASTERS participants were taking prescribed statins. Combined metformin and statin resulted in rescue of the metformin-mediated impaired growth response to PRT but did not significantly affect strength. Improved muscle fiber growth may be associated with medication-induced increased abundance of CD11b+/CD206+ M2-like macrophages. Sarcopenia is a significant problem with aging and this study identifies a potential interaction between these commonly used drugs which may help prevent metformin-related blunting of the beneficial effects of PRT.Trial Registration: ClinicalTrials.gov, NCT02308228, Registered on 25 November 2014.
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Affiliation(s)
- Douglas E. Long
- Department of Physical Therapy and Center for Muscle Biology, College of Health Sciences, University of Kentucky, Lexington, KY, United States
| | - Kate Kosmac
- Department of Physical Therapy and Center for Muscle Biology, College of Health Sciences, University of Kentucky, Lexington, KY, United States
| | - Cory M. Dungan
- Department of Physical Therapy and Center for Muscle Biology, College of Health Sciences, University of Kentucky, Lexington, KY, United States
| | - Marcas M. Bamman
- Florida Institute for Human and Machine Cognition, Pensacola, FL, United States
- Center for Exercise Medicine and Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Charlotte A. Peterson
- Department of Physical Therapy and Center for Muscle Biology, College of Health Sciences, University of Kentucky, Lexington, KY, United States
| | - Philip A. Kern
- Department of Internal Medicine, Division of Endocrinology, Barnstable Brown Diabetes and Obesity Center, University of Kentucky, Lexington, KY, United States
- *Correspondence: Philip A. Kern,
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Leal-Martín J, Muñoz-Muñoz M, Keadle SK, Amaro-Gahete F, Alegre LM, Mañas A, Ara I. Resting Oxygen Uptake Value of 1 Metabolic Equivalent of Task in Older Adults: A Systematic Review and Descriptive Analysis. Sports Med 2022; 52:331-348. [PMID: 34417980 DOI: 10.1007/s40279-021-01539-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND It is important for sport scientists and health professionals to have estimative methods for energy demand during different physical activities. The metabolic equivalent of task (MET) provides a feasible approach for classifying activity intensity as a multiple of the resting metabolic rate (RMR). RMR is generally assumed to be 3.5 mL of oxygen per kilogram of body mass per minute (mL O2 kg-1 min-1), a value that has been criticized and considered to be overestimated in the older adult population. However, there has been no comprehensive effort to review available RMR estimations, equivalent to 1 MET, obtained in the older adult population. OBJECTIVE The aim of this review was to examine the existing evidence reporting measured RMR values in the older adult population and to provide descriptive estimates of 1 MET. METHODS A systematic review was conducted by searching PubMed, Web of Science, Scopus, CINAHL, SPORTDiscus, and Cochrane Library, from database inception to July 2021. To this end, original research studies assessing RMR in adults ≥ 60 years old using indirect calorimetry and reporting results in mL O2 kg-1 min-1 were sought. RESULTS Twenty-three eligible studies were identified, including a total of 1091 participants (426 men). All but two studies reported RMR values lower than the conventional 3.5 mL O2 kg-1 min-1. The overall weighted average 1 MET value obtained from all included studies was 2.7 ± 0.6 mL O2 kg-1 min-1; however, when considering best practice studies, this value was 11% lower (2.4 ± 0.3 mL O2 kg-1 min-1). CONCLUSION Based on the results of this systematic review, we would advise against the application of the standard value of 1 MET (3.5 mL O2 kg-1 min-1) in people ≥ 60 years of age and encourage the direct assessment of RMR using indirect calorimetry while adhering to evidence-based best practice recommendations. When this is not possible, assuming an overall value of 2.7 mL O2 kg-1 min-1 might be reasonable. Systematic review registration: International Prospective Register of Systematic Reviews on 30 September 2020, with registration number CRD42020206440.
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Affiliation(s)
- Javier Leal-Martín
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Miguel Muñoz-Muñoz
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Sarah Kozey Keadle
- Department of Kinesiology and Public Health, California Polytechnic State University, San Luis Obispo, USA
| | | | - Luis M Alegre
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Asier Mañas
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Avda. Carlos III S/N, 45071, Toledo, Spain.
- CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain.
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Marcos-Pardo PJ, González-Gálvez N, López-Vivancos A, Espeso-García A, Martínez-Aranda LM, Gea-García GM, Orquín-Castrillón FJ, Carbonell-Baeza A, Jiménez-García JD, Velázquez-Díaz D, Cadenas-Sanchez C, Isidori E, Fossati C, Pigozzi F, Rum L, Norton C, Tierney A, Äbelkalns I, Klempere-Sipjagina A, Porozovs J, Hannola H, Niemisalo N, Hokka L, Jiménez-Pavón D, Vaquero-Cristóbal R. Sarcopenia, Diet, Physical Activity and Obesity in European Middle-Aged and Older Adults: The LifeAge Study. Nutrients 2020; 13:E8. [PMID: 33375058 PMCID: PMC7822002 DOI: 10.3390/nu13010008] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/17/2020] [Accepted: 12/18/2020] [Indexed: 02/07/2023] Open
Abstract
The revised European consensus defined sarcopenia as a progressive and generalized skeletal muscle disorder that is associated with an increased likelihood of adverse outcomes including falls, fractures, physical disability and mortality. The aim of this study was to determine the prevalence of sarcopenia and analyse the influence of diet, physical activity (PA) and obesity index as risk factors of each criteria of sarcopenia. A total of 629 European middle-aged and older adults were enrolled in this cross-sectional study. Anthropometrics were assessed. Self-reported PA and adherence to the Mediterranean diet were evaluated with the Global Physical Activity Questionnaire (GPAQ) and Prevention with Mediterranean Diet questionnaire (PREDIMED), respectively. The functional assessment included handgrip strength, lower body muscle strength, gait speed and agility/dynamic balance. Of the participants, 4.84% to 7.33% showed probable sarcopenia. Sarcopenia was confirmed in 1.16% to 2.93% of participants. Severe sarcopenia was shown by 0.86% to 1.49% of participants. Male; age group ≤65 years; lower body mass index (BMI); high levels of vigorous PA; and the consumption of more than one portion per day of red meat, hamburgers, sausages or cold cuts and/or preferential consumption of rabbit, chicken or turkey instead of beef, pork, hamburgers or sausages (OR = 0.126-0.454; all p < 0.013) resulted as protective factors, and more time of sedentary time (OR = 1.608-2.368; p = 0.032-0.041) resulted as a risk factor for some criteria of sarcopenia. In conclusion, age, diet, PA, and obesity can affect the risk of having low muscle strength, low muscle mass or low functional performance, factors connected with sarcopenia.
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Affiliation(s)
- Pablo Jorge Marcos-Pardo
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Noelia González-Gálvez
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Abraham López-Vivancos
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Alejandro Espeso-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
| | - Luis Manuel Martínez-Aranda
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
| | - Gemma María Gea-García
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Francisco Javier Orquín-Castrillón
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
| | - Ana Carbonell-Baeza
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - José Daniel Jiménez-García
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Daniel Velázquez-Díaz
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Cristina Cadenas-Sanchez
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Emanuele Isidori
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Chiara Fossati
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Fabio Pigozzi
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Lorenzo Rum
- Department of Movement, Human and Health Sciences University of Rome “Foro Itálico”, 00135 Roma, Italy; (E.I.); (L.R.)
| | - Catherine Norton
- Health Research Institute (HRI), University of Limerick, V94 T9PX Limerick, Ireland; (C.N.); (A.T.)
| | - Audrey Tierney
- Health Research Institute (HRI), University of Limerick, V94 T9PX Limerick, Ireland; (C.N.); (A.T.)
| | - Ilvis Äbelkalns
- Faculty of Pedagogy, Psychology and Art, University of Latvia, 1586 Riga, Latvia; (I.Ä.); (A.K.-S.); (J.P.)
| | - Agita Klempere-Sipjagina
- Faculty of Pedagogy, Psychology and Art, University of Latvia, 1586 Riga, Latvia; (I.Ä.); (A.K.-S.); (J.P.)
| | - Juris Porozovs
- Faculty of Pedagogy, Psychology and Art, University of Latvia, 1586 Riga, Latvia; (I.Ä.); (A.K.-S.); (J.P.)
| | - Heikki Hannola
- Business and Services Department, Sport and Leisure, Lapland University of Applied Sciences, 96300 Rovaniemi, Finland; (H.H.); (N.N.); (L.H.)
| | - Niko Niemisalo
- Business and Services Department, Sport and Leisure, Lapland University of Applied Sciences, 96300 Rovaniemi, Finland; (H.H.); (N.N.); (L.H.)
| | - Leo Hokka
- Business and Services Department, Sport and Leisure, Lapland University of Applied Sciences, 96300 Rovaniemi, Finland; (H.H.); (N.N.); (L.H.)
| | - David Jiménez-Pavón
- MOVE-IT Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain; (J.D.J.-G.); (D.V.-D.); (D.J.-P.)
| | - Raquel Vaquero-Cristóbal
- Research Group on Health, Physical Activity, Fitness and Motor Behaviour (GISAFFCOM) and Physical Activity and Sport Sciences Department, Faculty of Sport, Catholic University San Antonio of Murcia, 30107 Murcia, Spain; (P.J.M.-P.); (A.L.-V.); (A.E.-G.); (L.M.M.-A.); (G.M.G.-G.); (F.J.O.-C.); (R.V.-C.)
- Active Aging, Exercise and Health/HEALTHY-AGE Network, Consejo Superior de Deportes (CSD), Ministry of Culture and Sport of Spain, 28040 Madrid, Spain; (A.C.-B.); (C.C.-S.); (C.F.); (F.P.)
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Sarcopenia: A Contemporary Health Problem among Older Adult Populations. Nutrients 2020; 12:nu12051293. [PMID: 32370051 PMCID: PMC7282252 DOI: 10.3390/nu12051293] [Citation(s) in RCA: 172] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 04/23/2020] [Accepted: 04/26/2020] [Indexed: 12/21/2022] Open
Abstract
Sarcopenia, a geriatric disease characterized by a progressive loss of skeletal muscle mass and loss of muscle function, constitutes a rising, often undiagnosed health problem. Its prevalence in the elderly population is largely considered variable, as it ranges from 5% to 50% depending on gender, age, pathological conditions as well as diagnostic criteria. There is no one unified approach of treatment or assessment, which makes sarcopenia even harder to assess. There is a pressing need to provide better diagnosis, diagnostics, prevention, and individualized health care. Physical activity and nutrition are the main studied ways to prevent sarcopenia, and they also offer better outcomes. This review aims to report the prevalence of sarcopenia in older adults, its etiology, prevention, and treatment techniques.
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The impact of statins on physical activity and exercise capacity: an overview of the evidence, mechanisms, and recommendations. Eur J Appl Physiol 2020; 120:1205-1225. [PMID: 32248287 DOI: 10.1007/s00421-020-04360-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Accepted: 03/24/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Statins are among the most widely prescribed medications worldwide. Considered the 'gold-standard' treatment for cardiovascular disease (CVD), statins inhibit HMG-CoA reductase to ultimately reduce serum LDL-cholesterol levels. Unfortunately, the main adverse event of statin use is the development of muscle-associated problems, referred to as SAMS (statin-associated muscle symptoms). While regular moderate physical activity also decreases CVD risk, there is apprehension that physical activity may induce and/or exacerbate SAMS. While much work has gone into identifying the epidemiology of SAMS, only recent research has focused on the extent to which these muscle symptoms are accompanied by functional declines. The purpose of this review is to provide an overview of possible mechanisms underlying SAMS and summarize current evidence regarding the relationship between statin treatment, physical activity, exercise capacity, and SAMS development. METHODS PubMed and Google Scholar databases were used to search the most relevant and up-to-date peer-reviewed research on the topic. RESULTS The mechanism(s) behind SAMS, including altered mitochondrial metabolism, reduced coenzyme Q10 levels, reduced vitamin D levels, impaired calcium homeostasis, elevated extracellular glutamate, and genetic polymorphisms, still lack consensus and remain up for debate. Our summation of the evidence leads us to suggest that the etiology of SAMS development is likely multifactorial. Our review also demonstrates that there is limited evidence for statins impairing exercise adaptations or reducing exercise capacity for the majority of the investigated populations. CONCLUSION The available evidence indicates that the benefits of engaging in physical activity while on statin medication largely outweigh the risks.
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Henderson RM, Lovato L, Miller ME, Fielding RA, Church TS, Newman AB, Buford TW, Pahor M, McDermott MM, Stafford RS, Lee DSH, Kritchevsky SB. Effect of Statin Use on Mobility Disability and its Prevention in At-risk Older Adults: The LIFE Study. J Gerontol A Biol Sci Med Sci 2016; 71:1519-1524. [PMID: 26988662 PMCID: PMC5055646 DOI: 10.1093/gerona/glw057] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 03/01/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND HMG-CoA reductase inhibitors (statins) are among the most commonly prescribed classes of medications. Although their cardiovascular benefits and myalgia risks are well documented, their effects on older adults initiating an exercise training program are less understood. METHODS 1,635 sedentary men and women aged 70-89 years with Short Physical Performance Battery (SPPB) score of 9 or below and were able to walk 400 m were randomized to a structured, moderate-intensity physical activity (PA) program consisting of both center-based (twice/wk) and home-based (3-4 times/wk) aerobic, resistance, and flexibility training or to a health education (HE) program combined with upper extremity stretching. RESULTS Overall, the PA intervention was associated with lower risk of major mobility disability (hazard ratio [HR] = 0.82; 95% confidence interval [CI] = 0.69-0.98). The effect was similar (p value for interaction = .62) in both statin users (PA n = 415, HE n = 412; HR = 0.86, 95% CI = 0.67-1.1) and nonusers (PA n = 402, HE n = 404; HR = 0.78, 95% CI = 0.61-1.01). Attendance was similar for statin users (65%) and nonusers (63%). SPPB at 12 months was slightly greater for PA (8.35±0.10) than for HE (7.94±0.10) in statin users but not in nonusers (PA 8.25±0.10, HE 8.16±0.10), though the interaction effect was not statistically significant. Self-reported PA levels were not different between statin users and nonusers. CONCLUSIONS Although statins have been associated with adverse effects on muscle, data from the LIFE Study show that statin users and nonusers both benefit from PA interventions. Older adults who require statin medications to manage chronic medical conditions and are sedentary will be able to benefit from interventions to increase PA.
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Affiliation(s)
- Rebecca M Henderson
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina.
| | - Laura Lovato
- Department of Biostatistical Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Michael E Miller
- Department of Biostatistical Sciences, Wake Forest University Health Sciences, Winston-Salem, North Carolina
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, Massachusetts
| | - Tim S Church
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge
| | - Anne B Newman
- Department of Epidemiology, University of Pittsburgh, Pennsylvania
| | - Thomas W Buford
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Marco Pahor
- Department of Medicine, Northwestern University, Feinberg School of Medicine, Chicago, Illinois
| | - Mary M McDermott
- Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville
| | - Randall S Stafford
- Stanford Prevention Research Center, Stanford School of Medicine, Palo Alto, California
| | - David S H Lee
- College of Pharmacy, Oregon State University and Oregon Health and Science University, Portland
| | - Stephen B Kritchevsky
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Sticht Center on Aging, Wake Forest School of Medicine, Winston-Salem, North Carolina
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9
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Margaritelis NV, Theodorou AA, Baltzopoulos V, Maganaris CN, Paschalis V, Kyparos A, Nikolaidis MG. Muscle damage and inflammation after eccentric exercise: can the repeated bout effect be removed? Physiol Rep 2015; 3:3/12/e12648. [PMID: 26660557 PMCID: PMC4760450 DOI: 10.14814/phy2.12648] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
The current consensus in exercise physiology is that the repeated bout effect always appears after few eccentric exercise sessions. This is the first attempt to challenge this tenet, by exploiting specificity in muscle plasticity. More specifically, we examined whether the opposing adaptations in muscle induced after concentric and eccentric exercise can attenuate and/or remove the repeated bout effect. Seventeen young men were randomly assigned into one of the following groups: (1) the alternating eccentric‐concentric exercise group; and (2) the eccentric‐only exercise group. Both groups performed 8 weeks of resistance exercise using the knee extensors of both legs on an isokinetic dynamometer. The alternating eccentric‐concentric exercise group performed an alternating exercise protocol, switching between eccentric‐only and concentric‐only exercise every 4 weeks, while the eccentric‐only group performed eccentric exercise. Evaluation of muscle damage using physiological (isometric torque, delayed onset muscle soreness, and range of movement) and biochemical (creatine kinase) markers and inflammation (C‐reactive protein) was performed at weeks 1, 5, and 10. Baseline isometric peak torque was also evaluated at week 14 after another cycle (4 weeks) of alternating or eccentric‐only exercise training. In the alternating eccentric‐concentric exercise group, the concentric exercise training performed prior to eccentric exercise reduced dramatically the repeated bout effect by reversing muscle back to its unaccustomed state. On the contrary, the eccentric‐only exercise group exhibited a typical manifestation of the repeated bout effect. Interestingly, muscle strength was elevated similarly for both alternating and eccentric‐only exercise groups after 13 weeks of training. The alternating eccentric‐concentric exercise scheme, implemented in the present study, has for the first time successfully overcame the repeated bout effect. The similarity in muscle strength measurements following the two protocols is against the notion that inflammation plays an important role in exercise‐induced adaptations in muscle.
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Affiliation(s)
- Nikos V Margaritelis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | | | | | - Constantinos N Maganaris
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Vassilis Paschalis
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus School of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
| | - Antonios Kyparos
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Michalis G Nikolaidis
- School of Physical Education and Sports Science at Serres, Aristotle University of Thessaloniki, Serres, Greece
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10
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Bonfim MR, Oliveira ASB, do Amaral SL, Monteiro HL. Treatment of dyslipidemia with statins and physical exercises: recent findings of skeletal muscle responses. Arq Bras Cardiol 2015; 104:324-31. [PMID: 25993596 PMCID: PMC4415869 DOI: 10.5935/abc.20150005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 10/10/2014] [Accepted: 10/13/2014] [Indexed: 12/31/2022] Open
Abstract
Statin treatment in association with physical exercise practice can substantially reduce cardiovascular mortality risk of dyslipidemic individuals, but this practice is associated with myopathic event exacerbation. This study aimed to present the most recent results of specific literature about the effects of statins and its association with physical exercise on skeletal musculature. Thus, a literature review was performed using PubMed and SciELO databases, through the combination of the keywords "statin" AND "exercise" AND "muscle", restricting the selection to original studies published between January 1990 and November 2013. Sixteen studies evaluating the effects of statins in association with acute or chronic exercises on skeletal muscle were analyzed. Study results indicate that athletes using statins can experience deleterious effects on skeletal muscle, as the exacerbation of skeletal muscle injuries are more frequent with intense training or acute eccentric and strenuous exercises. Moderate physical training, in turn, when associated to statins does not increase creatine kinase levels or pain reports, but improves muscle and metabolic functions as a consequence of training. Therefore, it is suggested that dyslipidemic patients undergoing statin treatment should be exposed to moderate aerobic training in combination to resistance exercises three times a week, and the provision of physical training prior to drug administration is desirable, whenever possible.
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Affiliation(s)
- Mariana Rotta Bonfim
- Programa de Pós-Graduação em Ciências da
Motricidade, Instituto de Biociências, Universidade Estadual Paulista
“Júlio de Mesquita Filho” (UNESP), Rio Claro, SP – Brazil
| | - Acary Souza Bulle Oliveira
- Setor de Doenças Neuromusculares, Escola Paulista de Medicina,
Universidade Federal de São Paulo (UNIFESP), São Paulo, SP - Brazil
| | - Sandra Lia do Amaral
- Departamento de Educação Física, Faculdade de
Ciências, UNESP, Bauru, SP – Brazil
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11
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Paschalis V, Theodorou AA, Panayiotou G, Kyparos A, Patikas D, Grivas GV, Nikolaidis MG, Vrabas IS. Stair descending exercise using a novel automatic escalator: effects on muscle performance and health-related parameters. PLoS One 2013; 8:e56218. [PMID: 23437093 PMCID: PMC3578864 DOI: 10.1371/journal.pone.0056218] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2012] [Accepted: 01/08/2013] [Indexed: 01/09/2023] Open
Abstract
A novel automatic escalator was designed, constructed and used in the present investigation. The aim of the present investigation was to compare the effect of two repeated sessions of stair descending versus stair ascending exercise on muscle performance and health-related parameters in young healthy men. Twenty males participated and were randomly divided into two equal-sized groups: a stair descending group (muscle-damaging group) and a stair ascending group (non-muscle-damaging group). Each group performed two sessions of stair descending or stair ascending exercise on the automatic escalator while a three week period was elapsed between the two exercise sessions. Indices of muscle function, insulin sensitivity, blood lipid profile and redox status were assessed before and immediately after, as well as at day 2 and day 4 after both exercise sessions. It was found that the first bout of stair descending exercise caused muscle damage, induced insulin resistance and oxidative stress as well as affected positively blood lipid profile. However, after the second bout of stair descending exercise the alterations in all parameters were diminished or abolished. On the other hand, the stair ascending exercise induced only minor effects on muscle function and health-related parameters after both exercise bouts. The results of the present investigation indicate that stair descending exercise seems to be a promising way of exercise that can provoke positive effects on blood lipid profile and antioxidant status.
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Affiliation(s)
- Vassilis Paschalis
- Department of Physical Education and Sport Science, University of Thessaly, Trikala, Greece
- Institute of Human Performance and Rehabilitation, Center for Research and Technology – Thessaly, Trikala, Greece
- Laboratory of Exercise, Health and Human Performance, Research Center European University of Cyprus, Nicosia, Cyprus
| | - Anastasios A. Theodorou
- Laboratory of Exercise, Health and Human Performance, Research Center European University of Cyprus, Nicosia, Cyprus
| | - George Panayiotou
- Laboratory of Exercise, Health and Human Performance, Research Center European University of Cyprus, Nicosia, Cyprus
| | - Antonios Kyparos
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Dimitrios Patikas
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Gerasimos V. Grivas
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Michalis G. Nikolaidis
- Institute of Human Performance and Rehabilitation, Center for Research and Technology – Thessaly, Trikala, Greece
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
| | - Ioannis S. Vrabas
- Exercise Physiology and Biochemistry Laboratory, Department of Physical Education and Sport Sciences at Serres, Aristotle University of Thessaloniki, Serres, Greece
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