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Day K, Nguo K, A Edwards B, M O'Driscoll D, C Young A, P Haines T, S Hamilton G, Ghazi L, Bristow C, Truby H. Body composition changes and their relationship with obstructive sleep apnoea symptoms, severity: The Sleeping Well Trial. Clin Nutr 2023; 42:1661-1670. [PMID: 37515844 DOI: 10.1016/j.clnu.2023.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 06/12/2023] [Accepted: 07/07/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND & AIMS Obstructive sleep apnoea (OSA) and obesity share a complex bi-directional relationship as location of body fat and changes in regional body composition may be more important for OSA improvement than changes in total body weight only. The aim of this study was to evaluate the impact of a 6-month weight loss intervention for adults newly diagnosed with moderate-severe OSA and obesity on regional body composition. The secondary aims evaluated the relationship between changes in OSA symptoms and severity and anthropometry and regional body composition during the first 12-months after commencing CPAP and explored differences in outcomes between males and females. METHODS Participants (n = 59) received CPAP overnight at home alongside a 6-month modified fasting intervention with 12-months follow up. Regional body composition was measured by Dual X-ray absorptiometry, (DXA) and anthropometry before and after the lifestyle intervention. OSA severity was measured using the apnoea hypopnea index via overnight polysomnography and OSA symptoms were measured using the Epworth Sleepiness scale. RESULTS Forty-seven adults (74% male) had complete measures available with a mean age of 50.0 y (SD 11.0) and BMI 34.1 kg/m2 (SD 5.0). Following the intervention average fat mass changed by -5.27 kg (5.36), p < 0.001) and visceral adipose tissue (-0.63 kg (0.67), p < 0.001) significantly decreased in males only with a maintenance of fat-free mass (mean -0.41 kg (1.80), p = 0.18). Females (n = 12) had significant decreases in waist circumference (mean -3.36 cm (3.18) p < 0.01), android lean (-0.12 kg (0.04), p < 0.05) and android total mass (-0.28 kg (0.39), p < 0.05) only. Regional body composition changes in males were positively associated with improvements in OSA severity (p < 0.01) but not OSA symptoms. CONCLUSION Improvements in regional body composition were seen in males only which were related to improvements in OSA severity but not OSA symptoms. Females may exhibit different OSA pathophysiology and may require different treatment approaches. TRIAL REGISTRATION https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=369975&isReview=trueAACTRN12616000203459 ACTRN12616000203459.
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Affiliation(s)
- Kaitlin Day
- School of Agriculture, Food and Ecosystem Sciences, Faculty of Science, The University of Melbourne, Australia; Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Australia.
| | - Kay Nguo
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Australia
| | - Bradley A Edwards
- Department of Physiology, Biomedicine Discovery Institute, Monash University, Australia; Department of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Australia
| | - Denise M O'Driscoll
- Department of Respiratory and Sleep Medicine, Eastern Health, Australia; Eastern Health Clinical School, Monash University, Australia
| | - Alan C Young
- Department of Respiratory and Sleep Medicine, Eastern Health, Australia; Eastern Health Clinical School, Monash University, Australia
| | - Terry P Haines
- School of Primary and Allied Health Care, Monash University, Australia
| | - Garun S Hamilton
- School of Clinical Sciences, Monash University, Australia; Monash Lung, Sleep, Allergy and Immunology Department, Monash Health, Australia
| | - Ladan Ghazi
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences, Monash University, Australia
| | - Claire Bristow
- School of Public Health and Preventive Medicine, Monash University, Australia
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, University of Queensland, Australia
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Khalafi M, Habibi Maleki A, Sakhaei MH, Rosenkranz SK, Pourvaghar MJ, Ehsanifar M, Bayat H, Korivi M, Liu Y. The effects of exercise training on body composition in postmenopausal women: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1183765. [PMID: 37388207 PMCID: PMC10306117 DOI: 10.3389/fendo.2023.1183765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 05/18/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction We conducted a systematic review and meta-analysis to investigate the effect of exercise training on body composition outcomes in postmenopausal women. Methods PubMed, Web of Science, CINAHL, and Medline were searched to identify the randomized controlled trials which evaluated effect of exercise training versus control in postmenopausal women. Standardized mean differences (SMD), weighted mean differences (WMD) and 95% confidence intervals (95% CIs) were calculated using random effects model. Results One hundred and one studies involving 5,697 postmenopausal women were included in the meta-analysis. Results indicated that exercise training effectively increased muscle mass/ volume, muscle and fiber cross-sectional area and fat-free mass, and decreased fat mass, body fat percentage, waist circumference and visceral fat. Furthermore, subgroup analyses results revealed that aerobic and combined training had greater beneficial effects on fat mass outcomes, whereas resistance and combined training had greater beneficial effects on muscle mass outcomes. Discussion Overall, our results revealed that exercise training is effective for improving body composition in postmenopausal women. To be specific, aerobic training is effective on fat loss, whereas resistance training is effective on muscle gain. However, combination of aerobic and resistance trainings may be considered a viable strategy to improve body composition in postmenopausal women. Systematic review registration https://www.crd.york.ac.uk/prospero/, identifier CRD42021283425.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Aref Habibi Maleki
- Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Rasht, Guilan, Iran
| | - Sara K. Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Mohammad Javad Pourvaghar
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran
| | - Mahsa Ehsanifar
- Department of Exercise Physiology and Corrective Exercises, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Hadis Bayat
- Department of Exercise Physiology, Central Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Mallikarjuna Korivi
- Institute of Human Movement and Sports Engineering, Zhejiang Normal University, Jinhua, Zhejiang, China
| | - Yubo Liu
- Institute of Human Movement and Sports Engineering, Zhejiang Normal University, Jinhua, Zhejiang, China
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Yadav U, Kumar N, Sarvottam K. Role of obesity related inflammation in pathogenesis of peripheral artery disease in patients of type 2 diabetes mellitus. J Diabetes Metab Disord 2023; 22:175-188. [PMID: 37255816 PMCID: PMC10225462 DOI: 10.1007/s40200-023-01221-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 03/29/2023] [Indexed: 06/01/2023]
Abstract
Objective Type 2 diabetes mellitus (T2DM) has emerged as one of the greatest global health challenges of twenty-first century. Visceral obesity is one of the most important determinant of insulin resistance (IR) as well as T2DM complications. Therefore this review focuses on the molecular mechanism of obesity induced inflammation, signaling pathways contributing to diabetes, as well as role of lifestyle interventions and medical therapies in the prevention and management of T2DM. Method Articles were searched on digital data base PubMed, Cochrane Library, and Web of Science. The key words used for search included Type 2 diabetes mellitus, obesity, insulin resistance, vascular inflammation and peripheral arterial disease. Result Visceral obesity is associated with chronic low grade inflammation and activation of immune systems which are involved in pathogenesis of obesity related IR and T2DM. Conclusion Metabolic dysregulation of adipose tissue leads to local hypoxia, misfolded/unfolded protein response and increased circulating free fatty acids, which in turn initiate inflammatory signaling cascades in the population of infiltrating cells. Mechanism that relates the role of adipocytokines with insulin sensitivity and glucose homeostasis might throw a light on the development of therapeutic interventions and subsequently might result in the reduction of vascular complications.
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Affiliation(s)
- Umashree Yadav
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
| | - Nilesh Kumar
- Department of General Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005 India
| | - Kumar Sarvottam
- Department of Physiology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh 221005 India
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Kogon AJ, Roem J, Schneider MF, Mitsnefes MM, Zemel BS, Warady BA, Furth SL, Rodig NM. Associations of body mass index (BMI) and BMI change with progression of chronic kidney disease in children. Pediatr Nephrol 2023; 38:1257-1266. [PMID: 36018433 PMCID: PMC10044533 DOI: 10.1007/s00467-022-05655-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 06/03/2022] [Accepted: 06/03/2022] [Indexed: 10/15/2022]
Abstract
BACKGROUND Obesity is prevalent among children with chronic kidney disease (CKD) and is associated with cardiovascular disease and reduced quality of life. Its relationship with pediatric CKD progression has not been described. METHODS We evaluated relationships between both body mass index (BMI) category (normal, overweight, obese) and BMI z-score (BMIz) change on CKD progression among participants of the Chronic Kidney Disease in Children study. Kaplan-Meier survival curves and multivariable parametric failure time models depict the association of baseline BMI category on time to kidney replacement therapy (KRT). Additionally, the annualized percentage change in estimated glomerular filtration rate (eGFR) was modeled against concurrent change in BMIz using multivariable linear regression with generalized estimating equations which allowed for quantification of the effect of BMIz change on annualized eGFR change. RESULTS Participants had median age of 10.9 years [IQR: 6.5, 14.6], median eGFR of 50 ml/1.73 m2 [IQR: 37, 64] and 63% were male. 160 (27%) of 600 children with non-glomerular and 77 (31%) of 247 children with glomerular CKD progressed to KRT over a median of 5 years [IQR: 2, 8]. Times to KRT were not significantly associated with baseline BMI category. Children with non-glomerular CKD who were obese experienced significant improvement in eGFR (+ 0.62%; 95% CI: + 0.17%, + 1.08%) for every 0.1 standard deviation concurrent decrease in BMI. In participants with glomerular CKD who were obese, BMIz change was not significantly associated with annualized eGFR change. CONCLUSION Obesity may represent a target of intervention to improve kidney function in children with non-glomerular CKD. A higher resolution version of the Graphical abstract is available as Supplementary information.
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Affiliation(s)
- Amy J Kogon
- Pediatrics, Division of Nephrology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania Philadelphia, Philadelphia, PA, USA.
| | - Jennifer Roem
- Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Michael F Schneider
- Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mark M Mitsnefes
- Pediatrics, Division of Nephrology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Babette S Zemel
- Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, USA
| | - Bradley A Warady
- Pediatrics, Division of Nephrology, Children's Mercy Kansas City, Kansas City, MO, USA
| | - Susan L Furth
- Pediatrics, Division of Nephrology, Children's Hospital of Philadelphia, Perelman School of Medicine, University of Pennsylvania Philadelphia, Philadelphia, PA, USA
| | - Nancy M Rodig
- Pediatrics, Division of Nephrology, Boston Children's Hospital, Boston, MA, USA
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Tian Y, Li C, Shilko TA, Sosunovsky VS, Zhang Y. The relationship between physical activity and diabetes in middle-aged and elderly people. Medicine (Baltimore) 2023; 102:e32796. [PMID: 36820542 PMCID: PMC9907994 DOI: 10.1097/md.0000000000032796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
To investigate the association between diabetes symptoms and physical activity (PA) levels among middle-aged and older Chinese adults. Data for this study were obtained from 2018 Charles data. Z test, logistic regression analysis, and linear hierarchical regression analysis were performed in 5352 individuals aged ≥50 years with complete information. In terms of diabetes, 6.8% of the middle-aged and elderly people with diabetes were detected, and 93.2% of the middle-aged and elderly people without diabetes symptoms. The proportion of middle-aged and elderly people with high PA levels was 50.5%, and the proportion of middle-aged and elderly people with low PA was 49.5%. There was a significant positive correlation between low PA and diabetes (P < .05). After adjusting demographic characteristics (gender, registered permanent residence type, education level, age, widowhood) and health status characteristics (poor mood, asthma, hyperlipidemia, disability, memory disease, self-assessment of health status, hypertension, smoking, stroke, depression), there was still a statistical significance between PA level and diabetes (P < .05). The risk of diabetes of middle-aged and elderly people in China increases with age, while the risk of diabetes of middle-aged and elderly people with low level of PA is higher. The risk of diabetes is high among middle-aged and elderly people who are old, have poor self-evaluation health, suffer from hyperlipidemia, memory disease, and asthma. The middle-aged and old people should increase their PA levels to prevent and improve diabetes.
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Affiliation(s)
- Ying Tian
- College of Sports Science, Shenyang Normal University, Shenyang, China
| | - Cheng Li
- Department of Grain Science and Industry, Kansas State University, Manhattan, KS
| | | | | | - Yaqun Zhang
- School of Sports Science, Anshan Normal University, Anshan, China
- * Correspondence: Yaqun Zhang, School of Sports Science, Anshan Normal University, No.43, Pingan Street Tiedong District, Anshan, Liaoning, China (e-mail: )
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Evaluation of a Supervised Adapted Physical Activity Program Associated or Not with Oral Supplementation with Arginine and Leucine in Subjects with Obesity and Metabolic Syndrome: A Randomized Controlled Trial. Nutrients 2022; 14:nu14183708. [PMID: 36145083 PMCID: PMC9501942 DOI: 10.3390/nu14183708] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background: In patients with obesity and metabolic syndrome (MetS), lifestyle interventions combining diet, in particular, and physical exercise are recommended as the first line treatment. Previous studies have suggested that leucine or arginine supplementation may have beneficial effects on the body composition or insulin sensitivity and endothelial function, respectively. We thus conducted a randomized controlled study to evaluate the effects of a supervised adapted physical activity program associated or not with oral supplementation with leucine and arginine in MetS-complicated patients with obesity. Methods: Seventy-nine patients with obesity and MetS were randomized in four groups: patients receiving arginine and leucine supplementation (ALs group, n = 20), patients on a supervised adapted physical activity program (APA group, n = 20), patients combining ALs and APA (ALs+APA group, n = 20), and a control group (n = 19). After the baseline evaluation (m0), patients received ALs and/or followed the APA program for 6 months (m6). Body composition, MetS parameters, lipid and glucose metabolism markers, inflammatory markers, and a cardiopulmonary exercise test (CPET) were assessed at m0, m6, and after a 3-month wash-out period (m9). Results: After 6 months of intervention, we did not observe variable changes in body weight, body composition, lipid and glucose metabolism markers, inflammatory parameters, or quality of life scores between the four groups. However, during the CPET, the maximal power (Pmax and Ppeak), power, and O2 consumption at the ventilatory threshold (P(VT) and O2(VT)) were improved in the APA and ALs+APA groups (p < 0.05), as well as the forced vital capacity (FVC). Between m6 and m9, a gain in fat mass was only observed in patients in the APA and ALs+APA groups. Conclusion: In our randomized controlled trial, arginine and leucine supplementation failed to improve MetS in patients with obesity, as did the supervised adapted physical activity program and the combination of both. Only the cardiorespiratory parameters were improved by exercise training.
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Khalafi M, Symonds M. Impact of exercise training plus caloric restriction on cardiometabolic health in menopausal women who are overweight or obese: A meta-analysis. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Batrakoulis A, Jamurtas AZ, Fatouros IG. Exercise and Type II Diabetes Mellitus: A Brief Guide for Exercise Professionals. Strength Cond J 2022. [DOI: 10.1519/ssc.0000000000000731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Association between physical activity and insulin resistance using the homeostatic model assessment for insulin resistance independent of waist circumference. Sci Rep 2022; 12:6002. [PMID: 35397649 PMCID: PMC8994755 DOI: 10.1038/s41598-022-10032-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 03/31/2022] [Indexed: 11/08/2022] Open
Abstract
Only a few studies have evaluated the relationship between physical activity (PA) and Homeostatic model assessment for insulin resistance (HOMA-IR). Therefore, we aimed to analyze the association between HOMA-IR and PA. We included 280,194 Korean without diabetes who underwent health examinations. The short form of the International Physical Activity Questionnaire was completed. PA level was divided into sedentary, mild PA, and health-enhancing PA (HEPA). The HOMA-IR levels were calculated. Confounding factors including waist circumference were adjusted. The median follow-up duration was 4.13 years. A significant inverse relationship was observed between PA level and HOMA-IR (p < 0.001). Compared with the sedentary group, HOMA-IR was lower in the HEPA group (p < 0.001), even when HEPA group decreased PA level over time (p < 0.001). Mild PA (p < 0.001) or HEPA showed a lower risk of HOMA-IR progression (p < 0.001). Increasing PA or maintaining HEPA was significantly associated with a lower HOMA-IR (p < 0.001), HOMA-IR improvement (p < 0.001), and a lower risk of HOMA-IR progression (p < 0.001). Our findings support the inverse relationship between PA and HOMA-IR in a population without diabetes. PA might improve IR and prevent its progression among populations without diabetes, independent of the waist circumference.
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Khalafi M, Ravasi AA, Malandish A, Rosenkranz SK. The impact of high-intensity interval training on postprandial glucose and insulin: A systematic review and meta-analysis. Diabetes Res Clin Pract 2022; 186:109815. [PMID: 35271876 DOI: 10.1016/j.diabres.2022.109815] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/14/2022]
Abstract
AIMS We performed a systematic review and meta-analysis to investigate the effects of high-intensity interval training (HIIT) on postprandial glucose (PPG) and insulin (PPI) versus non-exercise control and moderate-intensity continuous training (MICT) in participants with both normal and impaired glucose. METHODS The PubMed, Scopus, and Web of Science electronic databases were searched up to October 2021 for randomized trials evaluating HIIT versus control and/or versus MICT on glucose and insulin AUC using oral glucose tolerance testing. Subgroup analyses based on intervention duration (short-duration < 8 weeks, moderate-duration ≥ 8 weeks), baseline glucose levels (normal glucose and impaired glucose) and type of HIIT (L-HIIT and SIT) were also conducted across included studies. RESULTS A total of 25 studies involving 870 participants were included in the current meta-analysis. HIIT effectively reduced glucose [-0.37 (95% CI -0.60 to -0.13), p = 0.002] and insulin [-0.36 (95% CI -0.68 to -0.04), p = 0.02] AUC when compared with a CON group. Reductions in glucose AUC were significant for those with impaired glucose at baseline (p = 0.03), but not for those with normal glucose levels (p = 0.11) and following moderate-duration (p = 0.01), but not short-duration interventions (p = 0.18). However, there were no differences in glucose (p = 0.76) or insulin (p = 0.43) AUC between HIIT and MICT intervention arms. CONCLUSIONS Our results demonstrated that both HIIT and MICT are effective for reducing postprandial glycemia and insulinemia, particularly by moderate-duration interventions, and in those with impaired glucose.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Ali A Ravasi
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran
| | - Abbas Malandish
- Department of Exercise Physiology, Faculty of Sport Sciences, Urmia University, Urmia, Iran
| | - Sara K Rosenkranz
- Department of Food, Nutrition, Dietetics and Health, Kansas State University, Manhattan, KS, USA
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Abe T, Song JS, Bell ZW, Wong V, Spitz RW, Yamada Y, Loenneke JP. Comparisons of calorie restriction and structured exercise on reductions in visceral and abdominal subcutaneous adipose tissue: a systematic review. Eur J Clin Nutr 2022; 76:184-195. [PMID: 34040197 DOI: 10.1038/s41430-021-00942-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 05/02/2021] [Accepted: 05/12/2021] [Indexed: 01/06/2023]
Abstract
Exercise and low-calorie diets are common approaches taken to produce an energy deficit for weight loss in obesity. Changes in visceral and abdominal subcutaneous fat associated with weight loss are important questions but have not yet been concluded. We investigated the relationship between changes in visceral (VAT) and subcutaneous adipose tissue (SAT) areas obtained by abdominal imaging with the change in total body fat. The relevant databases were searched through January 2021 according to the PRISMA guidelines. Sixty-five studies were included. We found that the change in total body fat was associated with changes in both VAT and abdominal SAT areas, but the relationship between total body fat and the abdominal SAT area appeared stronger. Baseline values of VAT and abdominal SAT area were similar in the three treatment groups (calorie restriction, calorie restriction plus exercise, and exercise alone). The reduction in abdominal SAT area for a loss of 1 kg of total body fat was about 10 cm2, which was similar among all the treatments. The change in VAT area (-26.3 cm2) was a similar level as the change in abdominal SAT area (-31.5 cm2) in the exercise, whereas in the calorie restriction with and without exercise, the change in VAT area (-33.6 and -51.6 cm2, respectively) was approximately half of the reduction of SAT area (-65.1 and -87.2 cm2, respectively). Absolute changes in VAT and abdominal SAT areas might differ between interventions for the exercise and calorie restriction with and without exercise.
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Affiliation(s)
- Takashi Abe
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA. .,Graduate School of Health and Sports Science, Juntendo University, Inzai, Chiba, Japan.
| | - Jun Seob Song
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Zachary W Bell
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Vickie Wong
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Robert W Spitz
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Yujiro Yamada
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
| | - Jeremy P Loenneke
- Department of Health, Exercise Science, and Recreation Management, Kevser Ermin Applied Physiology Laboratory, The University of Mississippi, Oxford, MS, USA
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Borer KT. Why We Eat Too Much, Have an Easier Time Gaining Than Losing Weight, and Expend Too Little Energy: Suggestions for Counteracting or Mitigating These Problems. Nutrients 2021; 13:3812. [PMID: 34836068 PMCID: PMC8618649 DOI: 10.3390/nu13113812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/13/2021] [Accepted: 10/19/2021] [Indexed: 12/11/2022] Open
Abstract
The intent of this review is to survey physiological, psychological, and societal obstacles to the control of eating and body weight maintenance and offer some evidence-based solutions. Physiological obstacles are genetic and therefore not amenable to direct abatement. They include an absence of feedback control against gaining weight; a non-homeostatic relationship between motivations to be physically active and weight gain; dependence of hunger and satiation on the volume of food ingested by mouth and processed by the gastrointestinal tract and not on circulating metabolites and putative hunger or satiation hormones. Further, stomach size increases from overeating and binging, and there is difficulty in maintaining weight reductions due to a decline in resting metabolism, increased hunger, and enhanced efficiency of energy storage. Finally, we bear the evolutionary burden of extraordinary human capacity to store body fat. Of the psychological barriers, human craving for palatable food, tendency to overeat in company of others, and gullibility to overeat when offered large portions, can be overcome consciously. The tendency to eat an unnecessary number of meals during the wakeful period can be mitigated by time-restricted feeding to a 6-10 hour period. Social barriers of replacing individual physical work by labor-saving appliances, designing built environments more suitable for car than active transportation; government food macronutrient advice that increases insulin resistance; overabundance of inexpensive food; and profit-driven efforts by the food industry to market energy-dense and nutritionally compromised food are best overcome by informed individual macronutrient choices and appropriate timing of exercise with respect to meals, both of which can decrease insulin resistance. The best defense against overeating, weight gain, and inactivity is the understanding of factors eliciting them and of strategies that can avoid and mitigate them.
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Affiliation(s)
- Katarina T Borer
- School of Kinesiology, The University of Michigan, Ann Arbor, MI 48104, USA
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Norouzpour M, Marandi SM, Ghanbarzadeh M, Zare Maivan A. The effect of combined exercises on the plasma levels of retinol-binding protein 4 and its relationship with insulin resistance and hepatic fat content in postmenopausal women with nonalcoholic fatty liver disease. J Sports Med Phys Fitness 2021; 62:684-690. [PMID: 33871240 DOI: 10.23736/s0022-4707.21.12233-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Evidence suggests increased serum levels of retinol-binding protein 4 (RBP4) in postmenopausal women with nonalcoholic fatty liver disease (NAFLD). This study investigated the effect of combined exercises on the plasma levels of RBP4 and its relationship with insulin resistance and hepatic fat content in these women. METHODS This quasi-experimental study randomly assigned 24 women with fatty liver and a mean age of 56.18±4.58 years to an experimental group and a control group. The experimental group participated in ten-week incremental endurance-resistance training as combined exercises three sessions a week. Fatty liver was diagnosed with ultrasound, RBP4 levels were measured and insulin resistance was determined using the Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Between-group data were analyzed using ANCOVA, within-group data using the dependent t-test and Wilcoxon test and relationships between RBP4 and variables using Spearman and Pearson correlation coefficients. RESULTS Ten weeks of combined exercises significantly decreased RBP4 levels (P=0.000), HOMA-IR (P=0.011) and hepatic fat levels (P=0.000) in the experimental group compared to in the controls. The posttest showed significant correlations between RBP4 levels and hepatic fat levels (P=0.002) and no correlations between RBP4 levels and insulin resistance (P=0.116). CONCLUSIONS Combined exercises significantly reduced serum levels of RBP4 in postmenopausal women with fatty liver. RBP4 was not related to insulin resistance and effects of RBP4 on hepatic fat regulation were independent of the effects of insulin resistance.
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Affiliation(s)
- Masoumeh Norouzpour
- Exercise Physiology Department, Sport Sciences Faculty, University of Isfahan, Isfahan, Iran
| | - Sayed M Marandi
- Exercise Physiology Department, Sport Sciences Faculty, University of Isfahan, Isfahan, Iran -
| | - Mohsen Ghanbarzadeh
- Exercise Physiology Department, Sport Sciences Faculty, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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Saeidi A, Haghighi MM, Kolahdouzi S, Daraei A, Abderrahmane AB, Essop MF, Laher I, Hackney AC, Zouhal H. The effects of physical activity on adipokines in individuals with overweight/obesity across the lifespan: A narrative review. Obes Rev 2021; 22:e13090. [PMID: 32662238 DOI: 10.1111/obr.13090] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 06/05/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
This narrative review summarizes current knowledge on the effects of physical activity (PA) on adipokine levels in individuals with overweight and obesity. Approximately 90 investigations including randomized control, cross-sectional and longitudinal studies that reported on the effects of a single session of PA (acute) or long-term PA (chronic) on adipokine levels in individuals with overweight/obesity were reviewed. The findings support the notion that there is consensus on the benefits of chronic exercise training-regardless of the mode (resistance vs. aerobic), intensity and cohort (healthy vs. diabetes)-on adipokine levels (such as tumour necrosis factor-alpha, interleukin-6, adiponectin, visfatin, omentin-1 and leptin). However, several confounding factors (frequency, intensity, time and type of exercise) can alter the magnitude of the effects of an acute exercise session. Available evidence suggests that PA, as a part of routine lifestyle behaviour, improves obesity complications by modulating adipokine levels. However, additional research is needed to help identify the most effective interventions to elicit the most beneficial changes in adipokine levels in individuals with overweight/obesity.
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Affiliation(s)
- Ayoub Saeidi
- Department of Physical Education, Damghan Branch, Islamic Azad University, Damghan, Iran
| | - Marjan Mosalman Haghighi
- Faculty of Medicine and Health, Cardiology Centre, The University of Sydney, The Children's Hospital at Westmead, Sydney, Australia
| | - Sarkawt Kolahdouzi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran
| | - Ali Daraei
- Department of Biological Sciences in Sport, Faculty of Sports Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | | | - M Faadiel Essop
- Centre for Cardio-metabolic Research in Africa (CARMA), Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Ismail Laher
- Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, Canada
| | - Anthony C Hackney
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA
| | - Hassane Zouhal
- Movement, Sport and Health Sciences Laboratory (M2S), UFR-STAPS, University of Rennes 2-ENS Rennes, Rennes, France
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No Association between 25-Hydroxyvitamin D and Insulin Resistance or Thyroid Hormone Concentrations in a Romanian Observational Study. ACTA ACUST UNITED AC 2020; 57:medicina57010025. [PMID: 33396784 PMCID: PMC7824327 DOI: 10.3390/medicina57010025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 12/24/2020] [Accepted: 12/28/2020] [Indexed: 12/11/2022]
Abstract
Background and objectives: Vitamin D is involved in insulin resistance through genomic and non-genomic mechanisms. Several observational and randomized studies have discrepant results; some of them showed an improved insulin resistance (IR), and others a neutral effect after vitamin D deficiency is corrected. Materials and Methods: We designed a retrospective observational study that included all women who presented for 33 months in an outpatient clinic in Bucharest, Romania. Results: We analyzed 353 patients with a mean age of 58.5 ± 13.7 years, a mean body mass index (BMI) of 27.36 ± 4.87 kg/m-2, and a mean level of 25-hydroxyvitamin D (25OHD) of 39.53 ± 15.73 ng/mL. There were no differences in the calculated Homeostatic Model Assessment of Insulin Resistance variants 1 and 2 (HOMA-IR) and the Quantitative Insulin Sensitivity Check Index (QUICKI) between women with vitamin D deficit versus normal values. In multivariate analysis, there was no significant relation between 25OHD and the response variables considered by us. Conclusions: We observed a small positive correlation between a higher level of 25OHD and increased glycosylated hemolobin (HbA1c) or IR indices without clinical significance. Other modifiable or non-modifiable factors override 25OHD influence on IR in adult women with a normal serum level and may contribute to the remainder of the variability observed.
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16
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Carmichael OT, Neiberg RH, Dutton GR, Hayden KM, Horton E, Pi-Sunyer FX, Johnson KC, Rapp SR, Spira AP, Espeland MA. Long-term Change in Physiological Markers and Cognitive Performance in Type 2 Diabetes: The Look AHEAD Study. J Clin Endocrinol Metab 2020; 105:5897494. [PMID: 32845968 PMCID: PMC7566388 DOI: 10.1210/clinem/dgaa591] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 08/24/2020] [Indexed: 12/20/2022]
Abstract
CONTEXT The effects of physiological improvements on cognitive function among persons with type 2 diabetes mellitus (T2DM) are not fully understood. OBJECTIVE To determine whether improvements in physiological markers (body weight, blood sugar control, and physical activity) during intensive lifestyle intervention (ILI) are associated with enhancements in cognitive function in older adults with T2DM. DESIGN Multisite randomized controlled trial. SETTING Academic research centers. PATIENTS OR OTHER PARTICIPANTS Participants were aged 45-76 years, with T2DM. INTERVENTION The Action for Health in Diabetes (Look AHEAD) study, a randomized, controlled clinical trial of ILI. MAIN OUTCOME MEASURE Two to 3 cognitive assessments were collected from 1089 participants, the first and last occurring a mean (standard deviation) of 8.6 (1.0) and 11.5 (0.7) years after enrollment. RESULTS Greater improvement in blood sugar control was associated with better cognitive scores (fasting glucose and Rey Auditory Verbal Learning Test [AVLT]: P = 0.0148; fasting glucose and Digit Symbol Coding (DSC): P = 0.0360; HbA1C and DSC: P = 0.0477); but weight loss had mixed associations with cognitive scores (greater body mass index [BMI] reduction and worse AVLT overall: P = 0.0053; and greater BMI reduction and better DSC scores among those overweight but not obese at baseline: P = 0.010). Associations were strongest among those who were overweight (not obese) at baseline, and among those with a history of cardiovascular disease (CVD) at baseline. CONCLUSIONS Improvements in glycemic control, but not necessarily weight status, during ILI may be associated with better subsequent cognitive performance. These associations may differ by adiposity and CVD history.
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Affiliation(s)
- Owen T Carmichael
- Biomedical Imaging Center, Pennington Biomedical Research Center, Baton Rouge, Louisiana
- Correspondence and Reprint Requests: Owen T. Carmichael, PhD, Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA 70808, USA. E-mail:
| | - Rebecca H Neiberg
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Gareth R Dutton
- Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Kathleen M Hayden
- Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Edward Horton
- Joslin Diabetes Center, Harvard University, Boston, Massachusetts
| | - F Xavier Pi-Sunyer
- Division of Endocrinology, Obesity/Nutrition Research Center, Columbia University College of Physicians and Surgeons, New York, NY
| | - Karen C Johnson
- Department of Preventive Medicine, The University of Tennessee Health Science Center, Memphis, Tennessee
| | - Stephen R Rapp
- Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Adam P Spira
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Mark A Espeland
- Division of Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Nicolini C, Toepp S, Harasym D, Michalski B, Fahnestock M, Gibala MJ, Nelson AJ. No changes in corticospinal excitability, biochemical markers, and working memory after six weeks of high-intensity interval training in sedentary males. Physiol Rep 2020; 7:e14140. [PMID: 31175708 PMCID: PMC6555846 DOI: 10.14814/phy2.14140] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/14/2022] Open
Abstract
A single bout of aerobic exercise modulates corticospinal excitability, intracortical circuits, and serum biochemical markers such as brain‐derived neurotrophic factor (BDNF) and insulin‐like growth factor 1 (IGF‐1). These effects have important implications for the use of exercise in neurorehabilitation. Here, we aimed to determine whether increases in cardiorespiratory fitness (CRF) induced by 18 sessions of high‐intensity interval training (HIIT) over 6 weeks were accompanied by changes in corticospinal excitability, intracortical excitatory and inhibitory circuits, serum biochemical markers and working memory (WM) capacity in sedentary, healthy, young males. We assessed motor evoked potential (MEP) recruitment curves for the first dorsal interosseous (FDI) both at rest and during tonic contraction, intracortical facilitation (ICF), and short‐interval intracortical inhibition (SICI) using transcranial magnetic stimulation (TMS). We also examined serum levels of BDNF, IGF‐1, total and precursor (pro) cathepsin B (CTSB), as well as WM capacity. Compared to pretraining, CRF was increased and ICF reduced after the HIIT intervention, but there were no changes in corticospinal excitability, SICI, BDNF, IGF‐1, total and pro‐CTSB, and WM capacity. Further, greater CRF gains were associated with larger decreases in total and pro‐CTSB and, only in Val/Val carriers, with larger increases in SICI. Our findings confirm that HIIT is efficacious in promoting CRF and show that corticospinal excitability, biochemical markers, and WM are unchanged after 18 HIIT bouts in sedentary males. Understanding how aerobic exercise modulates M1 excitability is important in order to be able to use exercise protocols as an intervention, especially in rehabilitation following brain injuries.
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Affiliation(s)
- Chiara Nicolini
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Toepp
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Diana Harasym
- School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
| | - Bernadeta Michalski
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Margaret Fahnestock
- Department of Psychiatry & Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Martin J Gibala
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Aimee J Nelson
- Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada.,School of Biomedical Engineering, McMaster University, Hamilton, Ontario, Canada
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Effects of slow- v. fast-digested protein supplementation combined with mixed power training on muscle function and functional capacities in older men. Br J Nutr 2020; 125:1017-1033. [PMID: 32498755 DOI: 10.1017/s0007114520001932] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Ageing leads to a progressive loss of muscle function (MF) and quality (MQ: muscle strength (MS)/lean muscle mass (LM)). Power training and protein (PROT) supplementation have been proposed as efficient interventions to improve MF and MQ. Discrepancies between results appear to be mainly related to the type and/or dose of proteins used. The present study aimed at determining whether or not mixed power training (MPT) combined with fast-digested PROT (F-PROT) leads to greater improvements in MF and MQ in elderly men than MPT combined with slow-digested PROT (S-PROT) or MPT alone. Sixty elderly men (age 69 (sd 7) years; BMI 18-30 kg/m2) were randomised into three groups: (1) placebo + MPT (PLA; n 19); (2) F-PROT + MPT (n 21) and (3) S-PROT + MPT (n 20) completed the intervention. LM, handgrip and knee extensor MS and MQ, functional capacity, serum metabolic markers, skeletal muscle characteristics, dietary intake and total energy expenditure were measured. The interventions consisted in 12 weeks of MPT (3 times/week; 1 h/session) combined with a supplement (30 g:10 g per meal) of F-PROT (whey) or S-PROT (casein) or a placebo. No difference was observed among groups for age, BMI, number of steps and dietary intake pre- and post-intervention. All groups improved significantly their LM, lower limb MS/MQ, functional capacity, muscle characteristics and serum parameters following the MPT. Importantly, no difference between groups was observed following the MPT. Altogether, adding 30 g PROT/d to MPT, regardless of the type, does not provide additional benefits to MPT alone in older men ingesting an adequate (i.e. above RDA) amount of protein per d.
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Simon TG, Kim MN, Luo X, Yang W, Ma Y, Chong DQ, Fuchs CS, Meyerhardt JA, Corey KE, Chung RT, Stampfer M, Zhang X, Giovannucci EL, Chan AT. Physical activity compared to adiposity and risk of liver-related mortality: Results from two prospective, nationwide cohorts. J Hepatol 2020; 72:1062-1069. [PMID: 31954204 PMCID: PMC8162838 DOI: 10.1016/j.jhep.2019.12.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 12/06/2019] [Accepted: 12/16/2019] [Indexed: 01/26/2023]
Abstract
BACKGROUND & AIMS Obesity in adulthood has been associated with increased risk of liver-related mortality. Whether higher levels of physical activity counteract the excess risk conferred by obesity remains unknown. We simultaneously evaluated the long-term impact of physical activity and adiposity on liver-related mortality, within 2 nationwide populations. METHODS We conducted a prospective cohort study of 77,238 women and 48,026 men, with detailed, validated assessments of weekly physical activity (metabolic equivalent task [MET]-hours]), adiposity (body mass index [BMI], waist circumference), and diet, alcohol use and clinical comorbidities, biennially from 1986 through 2012. Using Cox proportional hazards regression models, we calculated multivariable-adjusted hazard ratios (aHRs) and 95% CIs for liver-related mortality, including death from hepatocellular carcinoma (HCC) and other complications of cirrhosis. RESULTS Over 1,856,226 person-years, we recorded 295 liver-related deaths (108 HCC; 187 cirrhosis). Risk of liver-related mortality increased monotonically with higher BMI during adulthood (ptrend<0.0001) and with weight gain during early adulthood (ptrend <0.0001). The risk of liver-related mortality also declined progressively, with increasing physical activity (ptrend = 0.0003); the aHRs across increasing physical activity quintiles were: 1.0, 0.70 (95% CI 0.51-0.96), 0.59 (95% CI 0.42-0.84), 0.52 (95% CI 0.36-0.74) and 0.46 (95% CI 0.31-0.66). Compared to lean-active adults (BMI <25; ≥18 MET-hours/week), the aHRs for obese-active, lean-sedentary, and obese-sedentary adults were: 1.04 (95% CI 0.73-1.37), 2.08 (95% CI 1.21-3.33) and 3.40 (95% CI 2.06-5.56), respectively. Findings were similar for HCC-specific and cirrhosis-specific mortality. Overall, engaging in average-pace walking for >3 hours/week could have prevented 25% of liver-related deaths (95% CI 0.12-0.38). CONCLUSIONS In 2 prospective, nationwide cohorts, both excess adiposity and reduced physical activity were significant predictors of liver-related mortality. Achieving higher physical activity levels counteracted the excess liver-related risks associated with obesity. LAY SUMMARY This is the first large, prospective cohort study to simultaneously evaluate the impact of obesity and physical activity on the long-term risk of liver-related mortality in 2 nationwide populations of American men and women. The study demonstrated that obesity predicted significantly increased risk of liver-related mortality, while physical activity predicted significantly lower risk of liver-related mortality. Importantly, the excess risk of liver-related mortality observed with obesity was no longer statistically significant among adults who engaged in the equivalent of average-pace walking for 3 hours or more, per week.
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Affiliation(s)
- Tracey G Simon
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, MA
| | - Mi Na Kim
- Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, MA; Division of Gastroenterology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Xiao Luo
- Harvard Medical School, Boston, MA; School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Wanshui Yang
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Yanan Ma
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | | | | | | | - Kathleen E Corey
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, MA
| | - Raymond T Chung
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA
| | - Meir Stampfer
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Xuehong Zhang
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA
| | - Edward L Giovannucci
- Harvard Medical School, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrew T Chan
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA; Harvard Medical School, Boston, MA; Clinical and Translational Epidemiology Unit (CTEU), Massachusetts General Hospital, Boston, MA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA; Broad Institute, Boston, MA; Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, MA.
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Chait A, den Hartigh LJ. Adipose Tissue Distribution, Inflammation and Its Metabolic Consequences, Including Diabetes and Cardiovascular Disease. Front Cardiovasc Med 2020; 7:22. [PMID: 32158768 PMCID: PMC7052117 DOI: 10.3389/fcvm.2020.00022] [Citation(s) in RCA: 553] [Impact Index Per Article: 138.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 02/10/2020] [Indexed: 12/13/2022] Open
Abstract
Adipose tissue plays essential roles in maintaining lipid and glucose homeostasis. To date several types of adipose tissue have been identified, namely white, brown, and beige, that reside in various specific anatomical locations throughout the body. The cellular composition, secretome, and location of these adipose depots define their function in health and metabolic disease. In obesity, adipose tissue becomes dysfunctional, promoting a pro-inflammatory, hyperlipidemic and insulin resistant environment that contributes to type 2 diabetes mellitus (T2DM). Concurrently, similar features that result from adipose tissue dysfunction also promote cardiovascular disease (CVD) by mechanisms that can be augmented by T2DM. The mechanisms by which dysfunctional adipose tissue simultaneously promote T2DM and CVD, focusing on adipose tissue depot-specific adipokines, inflammatory profiles, and metabolism, will be the focus of this review. The impact that various T2DM and CVD treatment strategies have on adipose tissue function and body weight also will be discussed.
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Affiliation(s)
- Alan Chait
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, United States
| | - Laura J den Hartigh
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, University of Washington, Seattle, WA, United States
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Hari A, Fealy CE, Axelrod CL, Haus JM, Flask CA, McCullough AJ, Kirwan JP. Exercise Training Rapidly Increases Hepatic Insulin Extraction in NAFLD. Med Sci Sports Exerc 2020; 52:1449-1455. [PMID: 32028458 DOI: 10.1249/mss.0000000000002273] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE We aimed to determine the immediacy of exercise intervention on liver-specific metabolic processes in nonalcoholic fatty liver disease. METHODS We undertook a short-term (7-d) exercise training study (60 min·d treadmill walking at 80%-85% of maximal heart rate) in obese adults (N = 13, 58 ± 3 yr, 34.3 ± 1.1 kg·m, >5% hepatic lipid by H-magnetic resonance spectroscopy). Insulin sensitivity index was estimated by oral glucose tolerance test using the Soonthorpun model. Hepatic insulin extraction (HIE) was calculated as the molar difference in area under the curve (AUC) for insulin and C-peptide (HIE = 1 - (AUCInsulin/AUCC-Pep)). RESULTS The increases in HIE, V˙O2max, and insulin sensitivity index after the intervention were 9.8%, 9.8%, and 34%, respectively (all, P < 0.05). Basal fat oxidation increased (pre: 47 ± 6 mg·min vs post: 65 ± 6 mg·min, P < 0.05) and carbohydrate oxidation decreased (pre: 160 ± 20 mg·min vs post: 112 ± 15 mg·min, P < 0.05) with exercise training. After the intervention, HIE correlated positively with adiponectin (r = 0.56, P < 0.05) and negatively with TNF-α (r = -0.78, P < 0.001). CONCLUSIONS By increasing HIE along with peripheral insulin sensitivity, aerobic exercise training rapidly reverses some of the underlying physiological mechanisms associated with nonalcoholic fatty liver disease, in a weight loss-independent manner. This reversal could potentially act through adipokine-related pathways.
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Affiliation(s)
| | - Ciaràn E Fealy
- Nutrition and Movement Sciences, Maastricht University, Maastricht, The NETHERLANDS
| | - Christopher L Axelrod
- Integrated Physiology and Molecular Medicine Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Jacob M Haus
- Human Bioenergetics Laboratory, University of Michigan, Ann Arbor, MI
| | | | - Arthur J McCullough
- Department of Gastroenterology and Hepatology, Cleveland Clinic, Cleveland, OH
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Fowler JR, Tucker LA, Bailey BW, LeCheminant JD. Physical Activity and Insulin Resistance in 6,500 NHANES Adults: The Role of Abdominal Obesity. J Obes 2020; 2020:3848256. [PMID: 33376604 PMCID: PMC7745049 DOI: 10.1155/2020/3848256] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 03/04/2020] [Indexed: 11/17/2022] Open
Abstract
This cross-sectional investigation studied differences in insulin resistance across levels of physical activity in 6,500 US adults who were randomly selected as part of the National Health and Nutrition Examination Survey (NHANES). Another important objective was to determine the influence of abdominal obesity on the physical activity and insulin resistance relationship. MET-minutes were utilized to quantify total activity based on participation in 48 different physical activities. Two strategies were employed to categorize levels of physical activity: one was based on relative MET-minutes (quartiles), and the other approach was based on the US physical activity guidelines. Insulin resistance was indexed using the homeostatic model assessment (HOMA). Abdominal obesity was indexed using waist circumference. Effect modification was tested by dividing waist circumferences into sex-specific quartiles and then evaluating the relationship between physical activity and HOMA-IR within each quartile separately. Results showed that relative physical activity level was associated with HOMA-IR after controlling for demographic and demographic and lifestyle covariates (F = 11.5, P < 0.0001 and F = 6.0, P=0.0012, respectively). Adjusting for demographic and demographic and lifestyle covariates also resulted in significant relationships between guideline-based activity and HOMA-IR (F = 8.0, P < 0.0001 and F = 4.9, P=0.0017, respectively). However, statistically controlling for differences in waist circumference with the other covariates nullified the relationship between total physical activity and HOMA-IR. Effect modification testing showed that when the sample was delimited to adults with abdominal obesity (Quartile 4), relative (F = 5.6, P=0.0019) and guideline-based physical activity (F = 3.7, P=0.0098) and HOMA-IR were significantly associated. Physical activity and HOMA-IR were not related within the other three quartiles. In conclusion, it appears that differences in physical activity may play a meaningful role in insulin resistance in those with abdominal obesity, but total activity does not seem to account for differences in insulin resistance among US adults with smaller waists.
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Affiliation(s)
- James R. Fowler
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Larry A. Tucker
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - Bruce W. Bailey
- Department of Exercise Sciences, Brigham Young University, Provo, Utah 84602, USA
| | - James D. LeCheminant
- Department of Nutrition, Dietetics, and Food Science, Brigham Young University, Provo, Utah 84602, USA
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Whillier S. Exercise and Insulin Resistance. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1228:137-150. [DOI: 10.1007/978-981-15-1792-1_9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Erickson ML, Haus JM, Malin SK, Flask CA, McCullough AJ, Kirwan JP. Non-invasive assessment of hepatic lipid subspecies matched with non-alcoholic fatty liver disease phenotype. Nutr Metab Cardiovasc Dis 2019; 29:1197-1204. [PMID: 31371265 PMCID: PMC7879392 DOI: 10.1016/j.numecd.2019.06.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/06/2019] [Accepted: 06/17/2019] [Indexed: 12/26/2022]
Abstract
BACKGROUND AND AIMS Nonalcoholic fatty liver disease (NAFLD) is characterized by excessive hepatic fat accumulation. Increased hepatic saturated fats and decreased hepatic polyunsaturated fats may be particularly lipotoxic, contributing to metabolic dysfunction. We compared hepatic lipid subspecies in adults with and without NAFLD, and examined links with hallmark metabolic and clinical characteristics of NAFLD. METHODS AND RESULTS Nineteen adults with NAFLD (total hepatic fat:18.8 ± 0.1%) were compared to sixteen adults without NAFLD (total hepatic fat: 2.1 ± 0.01%). 1H-MRS was used to assess hepatic lipid subspecies. Methyl, allylic, methylene, and diallylic proton peaks were measured. Saturation, unsaturation, and polyunsaturation indices were calculated. Whole-body phenotyping in a subset of participants included insulin sensitivity (40 mU/m2 hyperinsulinemic-euglycemic clamps), CT-measured abdominal adipose tissue depots, exercise capacity, and serum lipid profiles. Participants with NAFLD exhibited more saturated and less unsaturated hepatic fat, accompanied by increased insulin resistance, total and visceral adiposity, triglycerides, and reduced exercise capacity compared to controls (all P < 0.05). All proton lipid peaks were related to insulin resistance and hypertriglyceridemia (P < 0.05). CONCLUSION Participants with NAFLD preferentially stored excess hepatic lipids as saturated fat, at the expense of unsaturated fat, compared to controls. This hepatic lipid profile was accompanied by an unhealthy metabolic phenotype.
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Affiliation(s)
- Melissa L Erickson
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Jacob M Haus
- School of Kinesiology, University of Michigan, 1402 Washington Heights, Ann Arbor, MI 48109, USA
| | - Steven K Malin
- Department of Kinesiology, University of Virginia, 405 Emmet St, Charlottesville, VA 22903, USA
| | - Chris A Flask
- Radiology and Biomedical Engineering, Case Western Reserve University School of Medicine, 10900 Euclid Avenue, Cleveland, OH 44106, USA
| | - Arthur J McCullough
- Gastroenterology/Hepatology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - John P Kirwan
- Department of Pathobiology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA; Gastroenterology/Hepatology, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA.
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25
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Pérez-López A, Valadés D, de Cos Blanco AI, García-Honduvilla N, Vázquez Martínez C. Circulating adiponectin expression is elevated and associated with the IL-15/IL-15Rα complex in obese physically active humans. J Sports Med Phys Fitness 2019; 59:1229-1237. [DOI: 10.23736/s0022-4707.18.09030-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Zhang H, Fealy CE, Kirwan JP. Exercise training promotes a GDF15-associated reduction in fat mass in older adults with obesity. Am J Physiol Endocrinol Metab 2019; 316:E829-E836. [PMID: 30860878 PMCID: PMC6580172 DOI: 10.1152/ajpendo.00439.2018] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Obesity is a major risk factor for metabolic disease. Growth differentiation factor 15 (GDF15) has shown promise as a weight loss agent for obesity in animal studies. In healthy lean humans, fasting plasma GDF15 increases after acute exercise. However, the role of GDF15 in human obesity and the response of plasma GDF15 to exercise training in patients with obesity is unknown. Here, 24 sedentary volunteers with obesity [age: 65 ± 1 yr; body mass index (BMI): 35.3 ± 0.9 kg/m2] participated in a supervised 12-wk aerobic exercise intervention: 1 h/day, 5 days/wk at ~85% maximum heart rate with controlled isocaloric diet. As a result, plasma GDF15 was significantly increased (PRE: 644.1 ± 42.6 pg/ml, POST: 704.4 ± 47.2 pg/ml, P < 0.01) after the exercise intervention. Inconsistent with animal models, ΔGDF15 was not correlated with change in weight, BMI, or resting energy expenditure. However, ΔGDF15 was correlated with a reduction in total fat mass (P < 0.05), abdominal fat mass (P < 0.05), and android fat mass (P ≤ 0.05). Participants with a positive GDF15 response to exercise had increased total fat oxidation (PRE: 0.25 ± 0.05 mg·kg-1·min-1, POST: 0.43 ± 0.07 mg·kg-1·min-1, P ≤ 0.05), metabolic flexibility [PRE: -0.01 ± 0.01 delta respiratory quotient (RQ), POST: 0.06 ± 0.01 delta RQ, P < 0.001], and insulin sensitivity (PRE: 0.33 ± 0.01 QUICKI index, POST: 0.34 ± 0.01 QUICKI index, P < 0.01), suggesting a link between GDF15 and fat mass loss as well as exercise-induced metabolic improvement in humans with obesity. We conclude that the exercise-induced increase in plasma GDF15 and the association with reduced fat mass may indicate a role for GDF15 as a therapeutic target for human obesity.
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Affiliation(s)
- Hui Zhang
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University , Cleveland, Ohio
- Department of Pathobiology, Lerner Research Institution, Cleveland Clinic , Cleveland, Ohio
- Integrated Physiology and Molecular Medicine, Pennington Biomedical Research Center , Baton Rouge, Louisiana
| | - Ciarán E Fealy
- Department of Pathobiology, Lerner Research Institution, Cleveland Clinic , Cleveland, Ohio
| | - John P Kirwan
- Department of Physiology and Biophysics, School of Medicine, Case Western Reserve University , Cleveland, Ohio
- Department of Pathobiology, Lerner Research Institution, Cleveland Clinic , Cleveland, Ohio
- Integrated Physiology and Molecular Medicine, Pennington Biomedical Research Center , Baton Rouge, Louisiana
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Sah RP, Sharma A, Nagpal S, Patlolla SH, Sharma A, Kandlakunta H, Anani V, Angom RS, Kamboj A, Ahmed N, Mohapatra S, Vivekanandhan S, Philbrick KA, Weston A, Takahashi N, Kirkland J, Javeed N, Matveyenko A, Levy MJ, Mukhopadhyay D, Chari ST. Phases of Metabolic and Soft Tissue Changes in Months Preceding a Diagnosis of Pancreatic Ductal Adenocarcinoma. Gastroenterology 2019; 156:1742-1752. [PMID: 30677401 PMCID: PMC6475474 DOI: 10.1053/j.gastro.2019.01.039] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 12/13/2018] [Accepted: 01/11/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND & AIMS Identifying metabolic abnormalities that occur before pancreatic ductal adenocarcinoma (PDAC) diagnosis could increase chances for early detection. We collected data on changes in metabolic parameters (glucose, serum lipids, triglycerides; total, low-density, and high-density cholesterol; and total body weight) and soft tissues (abdominal subcutaneous fat [SAT], adipose tissue, visceral adipose tissue [VAT], and muscle) from patients 5 years before the received a diagnosis of PDAC. METHODS We collected data from 219 patients with a diagnosis of PDAC (patients) and 657 healthy individuals (controls) from the Rochester Epidemiology Project, from 2000 through 2015. We compared metabolic profiles of patients with those of age- and sex-matched controls, constructing temporal profiles of fasting blood glucose, serum lipids including triglycerides, cholesterol profiles, and body weight and temperature for 60 months before the diagnosis of PDAC (index date). To construct the temporal profile of soft tissue changes, we collected computed tomography scans from 68 patients, comparing baseline (>18 months before diagnosis) areas of SAT, VAT, and muscle at L2/L3 vertebra with those of later scans until time of diagnosis. SAT and VAT, isolated from healthy individuals, were exposed to exosomes isolated from PDAC cell lines and analyzed by RNA sequencing. SAT was collected from KRAS+/LSLG12D P53flox/flox mice with PDACs, C57/BL6 (control) mice, and 5 patients and analyzed by histology and immunohistochemistry. RESULTS There were no significant differences in metabolic or soft tissue features of patients vs controls until 30 months before PDAC diagnosis. In the 30 to 18 months before PDAC diagnosis (phase 1, hyperglycemia), a significant proportion of patients developed hyperglycemia, compared with controls, without soft tissue changes. In the 18 to 6 months before PDAC diagnosis (phase 2, pre-cachexia), patients had significant increases in hyperglycemia and decreases in serum lipids, body weight, and SAT, with preserved VAT and muscle. In the 6 to 0 months before PDAC diagnosis (phase 3, cachexia), a significant proportion of patients had hyperglycemia compared with controls, and patients had significant reductions in all serum lipids, SAT, VAT, and muscle. We believe the patients had browning of SAT, based on increases in body temperature, starting 18 months before PDAC diagnosis. We observed expression of uncoupling protein 1 (UCP1) in SAT exposed to PDAC exosomes, SAT from mice with PDACs, and SAT from all 5 patients but only 1 of 4 controls. CONCLUSIONS We identified 3 phases of metabolic and soft tissue changes that precede a diagnosis of PDAC. Loss of SAT starts 18 months before PDAC identification, and is likely due to browning. Overexpression of UCP1 in SAT might be a biomarker of early-stage PDAC, but further studies are needed.
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Affiliation(s)
- Raghuwansh P. Sah
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Ayush Sharma
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Sajan Nagpal
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Sri Harsha Patlolla
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Anil Sharma
- Department of Biochemistry and Molecular Biology, Mayo
Clinic, Jacksonville, Florida
| | - Harika Kandlakunta
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Vincent Anani
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Ramcharan Singh Angom
- Department of Biochemistry and Molecular Biology, Mayo
Clinic, Jacksonville, Florida
| | - Amrit Kamboj
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Nazir Ahmed
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Sonmoon Mohapatra
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | - Sneha Vivekanandhan
- Department of Biochemistry and Molecular Biology, Mayo
Clinic, Jacksonville, Florida
| | | | - Alexander Weston
- Department of Radiology Informatics, Mayo Clinic,
Rochester, Minnesota
| | | | - James Kirkland
- Robert and Arlene Kogod Center on Aging, Mayo Clinic,
Rochester, Minnesota
| | - Naureen Javeed
- Department of Physiology and Biomedical Engineering, Mayo
Clinic, Rochester, Minnesota
| | - Aleksey Matveyenko
- Department of Physiology and Biomedical Engineering, Mayo
Clinic, Rochester, Minnesota
| | - Michael J. Levy
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
| | | | - Suresh T. Chari
- Division of Gastroenterology and Hepatology, Mayo Clinic,
Rochester, Minnesota
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Koo JH, Kang EB. Effects of treadmill exercise on the regulatory mechanisms of mitochondrial dynamics and oxidative stress in the brains of high-fat diet fed rats. J Exerc Nutrition Biochem 2019; 23:28-35. [PMID: 31010272 PMCID: PMC6477818 DOI: 10.20463/jenb.2019.0005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Accepted: 03/12/2019] [Indexed: 01/22/2023] Open
Abstract
PURPOSE The purpose of this study was to investigate the effects of treadmill exercise on oxidative stress in the hippocampal tissue and mitochondrial dynamic-related proteins in rats fed a long-term high-fat diet (HFD). METHODS Obesity was induced in experimental animals using high fat feed, and the experimental groups were divided into a normal diet-control (ND-CON; n=12), a high fat diet-control (HFD-CON; n=12) and a high fat diet-treadmill exercise (HFD-TE; n=12) group. The rats were subsequently subjected to treadmill exercise (progressively increasing load intensity) for 8 weeks (5 min at 8 m/min, then 5 min at 11 m/min, and finally 20 min at 14 m/min). We assessed weight, triglyceride (TG) concentration, total cholesterol (TC), area under the curve, homeostatic model assessment of insulin resistance, and AVF/body weight. Western blotting was used to examine expression of proteins related to oxidative stress and mitochondrial dynamics, and immunohistochemistry was performed to examine the immunoreactivity of gp91phox. RESULTS Treadmill exercise effectively improved the oxidative stress in the hippocampal tissue, expression of mitochondrial dynamic-related proteins, and activation of NADPH oxidase (gp91phox) and induced weight, blood profile, and abdominal fat loss. CONCLUSION Twenty weeks of high fat diet induced obesity, which was shown to inhibit normal mitochondria fusion and fission functions in hippocampal tissues. However, treadmill exercise was shown to have positive effects on these pathophysiological phenomena. Therefore, treadmill exercise should be considered during prevention and treatment of obesity-induced metabolic diseases.
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Mey JT, Solomon TPJ, Kirwan JP, Haus JM. Skeletal muscle Nur77 and NOR1 insulin responsiveness is blunted in obesity and type 2 diabetes but improved after exercise training. Physiol Rep 2019; 7:e14042. [PMID: 30912283 PMCID: PMC6434071 DOI: 10.14814/phy2.14042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 03/07/2019] [Accepted: 03/07/2019] [Indexed: 02/07/2023] Open
Abstract
Obesity and type 2 diabetes (T2DM) are characterized by a blunted metabolic response to insulin, and strongly manifests in skeletal muscle insulin resistance. The orphan nuclear receptors, Nur77 and NOR1, regulate insulin-stimulated nutrient metabolism where Nur77 and NOR1 gene expression is increased with acute aerobic exercise and acute insulin stimulation. Whether Nur77 or NOR1 are associated with the insulin-sensitizing effects of chronic aerobic exercise training has yet to be elucidated. Fourteen lean healthy controls (LHC), 12 obese (OB), and 10 T2DM individuals (T2DM) underwent hyperinsulinemic-euglycemic clamps with skeletal muscle biopsies. Muscle was analyzed for Nur77 and NOR1 gene and protein expression at basal and insulin-stimulated conditions. Furthermore, a subcohort of 18 participants (OB, n = 12; T2DM, n = 6) underwent a 12-week aerobic exercise intervention (85% HRmax , 60 min/day, 5 days/week). In response to insulin infusion, LHC increased protein expression of Nur77 (8.7 ± 3.2-fold) and NOR1 (3.6 ± 1.1-fold), whereas OB and T2DM remained unaffected. Clamp-derived glucose disposal rates correlated with Nur77 (r2 = 0.14) and NOR1 (r2 = 0.12) protein expression responses to insulin, whereas age (Nur77: r2 = 0.22; NOR1: r2 = 0.25) and BMI (Nur77: r2 = 0.22; NOR1: r2 = 0.42) showed inverse correlations, corroborating preclinical data. In the intervention cohort, exercise improved Nur77 protein expression in response to insulin (PRE: -1.2 ± 0.3%, POST: 6.2 ± 1.5%). Also, insulin treatment of primary human skeletal muscle cells increased Nur77 and NOR1 protein. These findings highlight the multifactorial nature of insulin resistance in human obesity and T2DM. Understanding the regulation of Nur77 and NOR1 in skeletal muscle and other insulin-sensitive tissues will create opportunities to advance therapies for T2DM.
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MESH Headings
- Adult
- Aged
- Case-Control Studies
- Cells, Cultured
- Chicago
- Cross-Sectional Studies
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/diagnosis
- Diabetes Mellitus, Type 2/physiopathology
- Diabetes Mellitus, Type 2/therapy
- Exercise Therapy
- Female
- Humans
- Insulin Resistance
- Longitudinal Studies
- Male
- Membrane Transport Proteins/genetics
- Membrane Transport Proteins/metabolism
- Middle Aged
- Muscle, Skeletal/metabolism
- Muscle, Skeletal/physiopathology
- Myoblasts, Skeletal/metabolism
- Nuclear Receptor Subfamily 4, Group A, Member 1/genetics
- Nuclear Receptor Subfamily 4, Group A, Member 1/metabolism
- Obesity/blood
- Obesity/diagnosis
- Obesity/physiopathology
- Obesity/therapy
- Ohio
- Signal Transduction
- Time Factors
- Treatment Outcome
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Affiliation(s)
- Jacob T. Mey
- Department of Kinesiology and NutritionUniversity of Illinois ChicagoChicagoIllinois
| | - Thomas P. J. Solomon
- School of Sport, Exercise, and Rehabilitation SciencesUniversity of BirminghamBirminghamUnited Kingdom
| | - John P. Kirwan
- Metabolic Translational Research CenterEndocrinology & Metabolism InstituteCleveland ClinicClevelandOhio
- Integrative Physiology and Molecular Medicine LaboratoryPennington Biomedical Research CenterBaton RougeLouisiana
| | - Jacob M. Haus
- Department of Kinesiology and NutritionUniversity of Illinois ChicagoChicagoIllinois
- School of KinesiologyUniversity of MichiganAnn ArborMichigan
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Quintino-Moro A, Zantut-Wittmann DE, Silva Dos Santos PDN, Melhado-Kimura V, da Silva CA, Bahamondes L, Fernandes A. Thyroid function during the first year of use of the injectable contraceptive depot medroxyprogesterone acetate. EUR J CONTRACEP REPR 2019; 24:102-108. [PMID: 30721635 DOI: 10.1080/13625187.2018.1559284] [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: 12/25/2022]
Abstract
PURPOSE The aim of the study was to evaluate thyroid function profile as a possible factor influencing weight and body composition variation in new users of depot medroxyprogesterone acetate (DMPA). MATERIALS AND METHODS A prospective, non-randomised, comparative study was conducted at the University of Campinas, Brazil. Women aged 18-40 years with a body mass index (BMI) less than 30 kg/m2, normal oral glucose tolerance test, no known diseases, and using no medication, who opted to use DMPA were paired by age (±1 year) and BMI (±1 kg/m2) with women initiating copper intrauterine device (IUD) use. The main outcome measures were thyroid function profile, weight, and body composition, as measured by dual-energy X-ray absorptiometry. We used repeated measures ANOVA to perform comparisons between times and groups. RESULTS We evaluated 28 DMPA users and 24 IUD users who completed the 12-month follow-up. We observed that FT4 levels were higher at 12 months (compared to baseline) in the DMPA group (p < .0001) and that FT4/FT3 ratio had increased in both groups. Additionally, at 12 months, total body mass had increased around 2 kg and lean mass increased in the DMPA group compared to the IUD group; there was also an increase in weight, BMI, total body mass, and fat mass when compared to baseline. CONCLUSIONS No changes in thyroid function occurred that could explain the weight increase observed in DMPA users.
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Affiliation(s)
- Alessandra Quintino-Moro
- a Family Planning Clinic, Department of Obstetrics and Gynecology , University of Campinas Medical School (UNICAMP) , Campinas , Brazil
| | | | | | - Vaneska Melhado-Kimura
- a Family Planning Clinic, Department of Obstetrics and Gynecology , University of Campinas Medical School (UNICAMP) , Campinas , Brazil
| | - Conceição Aparecida da Silva
- b Division of Endocrinology, Department of Internal Medicine , University of Campinas Medical School (UNICAMP) , Campinas , Brazil
| | - Luis Bahamondes
- a Family Planning Clinic, Department of Obstetrics and Gynecology , University of Campinas Medical School (UNICAMP) , Campinas , Brazil
| | - Arlete Fernandes
- a Family Planning Clinic, Department of Obstetrics and Gynecology , University of Campinas Medical School (UNICAMP) , Campinas , Brazil
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Hari A, Fealy C, Solomon TPJ, Haus JM, Kelly KR, Barkoukis H, Kirwan JP. Exercise-induced improvements in glucose effectiveness are blunted by a high glycemic diet in adults with prediabetes. Acta Diabetol 2019; 56:211-217. [PMID: 30612202 PMCID: PMC6530476 DOI: 10.1007/s00592-018-1272-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 12/10/2018] [Indexed: 11/25/2022]
Abstract
AIMS Glucose effectiveness (GE) refers to the ability of glucose to influence its own metabolism through insulin-independent mechanisms. Diminished GE is a predictor of progression to type 2 diabetes. Exercise training improves GE, however, little is known about how dietary interventions, such as manipulating the glycemic index of diets, interact with exercise-induced improvements in GE in at-risk populations. METHODS We enrolled 33 adults with obesity and pre-diabetes (17 males, 65.7 ± 4.3 years, 34.9 ± 4.2 kg m-2) into a 12-week exercise training program (1 h day-1 and 5 day week-1 at ~ 85% of maximum heart rate) while being randomized to concurrently receive either a low (EX-LOG: 40 ± 0.3 au) or high (EX-HIG: 80 ± 0.6 au) glycemic index diet. A 75-g oral-glucose-tolerance test (OGTT) was performed before and after the intervention and GE was calculated using the Nagasaka equation. Insulin resistance was estimated using a hyperinsulinemic-euglycemic clamp and cardiorespiratory fitness using a VO2max test. RESULTS Both EX-LOG and EX-HIG groups had similar improvements in weight (8.6 ± 5.1 kg, P < 0.001), VO2max (6 ± 3.5 mL kg-1 min-1, P < 0.001) and clamp-measured peripheral insulin resistance (1.7 ± 0.9 mg kg-1 min-1, P < 0.001), relative to baseline data. GE in EX-LOG and EX-HIG was similar at baseline (1.9 ± 0.38 vs. 1.85 ± 0.3 mg dL-1 min-1, respectively; P > 0.05) and increased by ~ 20% post-intervention in the EX-LOG arm (∆GE: 0.07-0.57 mg dL-1 min-1, P < 0.05). Plasma free fatty acid (FFA) concentrations also decreased only in the EX-LOG arm (∆FFA: 0.13 ± 0.23 mmol L-1, P < 0.05). CONCLUSIONS Our data suggest that a high glycemic index diet may suppress exercise-induced enhancement of GE, and this may be mediated through plasma FFAs.
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Affiliation(s)
- Adithya Hari
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA
- Case Western Reserve University, Cleveland, OH, USA
| | - Ciaràn Fealy
- Maastricht University, Maastricht, The Netherlands
| | | | | | - Karen R Kelly
- Warfighter Performance Department, Naval Health Research Center, 140 Sylvester Road, San Diego, CA, USA
| | | | - John P Kirwan
- Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
- Case Western Reserve University, Cleveland, OH, USA.
- Pennington Biomedical Research Center, 6400 Perkins Road, Baton Rouge, LA, 70808, USA.
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Flynn MG, Markofski MM, Carrillo AE. Elevated Inflammatory Status and Increased Risk of Chronic Disease in Chronological Aging: Inflamm-aging or Inflamm-inactivity? Aging Dis 2019; 10:147-156. [PMID: 30705775 PMCID: PMC6345337 DOI: 10.14336/ad.2018.0326] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2018] [Accepted: 03/26/2018] [Indexed: 12/12/2022] Open
Abstract
Age-associated hyper-inflammation or "inflamm-aging" has been linked to the development of chronic diseases and characterized as an unavoidable aspect of aging. However, the inflamm-aging model does not adequately address the potential anti-inflammatory effects of exercise training and the potential for exercise to ameliorate several age-related diseases. In this brief review, we introduce a new paradigm-inflamm-inactivity-that describes a potent counter-measure to age-associated inflammatory illness.
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Affiliation(s)
- Michael G. Flynn
- HCA South Atlantic Division, Charleston, SC 29492, USA
- College of Charleston, Charleston, SC 29424, USA
| | - Melissa M. Markofski
- University of Houston, Department of Health and Human Performance, Houston, TX 77204, USA
| | - Andres E. Carrillo
- Department of Exercise Science, Chatham University, Pittsburgh, PA 15232, USA
- FAME Laboratory, Department of Exercise Science, University of Thessaly, Trikala, Greece
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Lin YH, Huang H. Eight-week of low-intensive lifestyle modification does improve insulin resistance in adults with metabolic syndrome. Diabetes Metab Syndr Obes 2019; 12:613-621. [PMID: 31118723 PMCID: PMC6509938 DOI: 10.2147/dmso.s201526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/05/2019] [Indexed: 12/19/2022] Open
Abstract
Purpose: Improvements in insulin resistance have been observed by following lifestyle modification (LM) for adults with metabolic syndrome (MetS). However, these improvements are associated with relatively intensive and long-term duration LM, which is unlikely to be a part of routine practice for most people. This study examined the impact of a short-term (eight-week) low-intensive LM program on anthropomorphic parameters and insulin resistance in a community-based population. Patients and methods: A total of 174 adults (67 with MetS) were enrolled in this retrospective observational study. The effects of the eight-week LM program on anthropomorphic parameters and glucose homeostasis were investigated. Results: After the LM program, most anthropomorphic parameters in both groups were significantly improved (P<0.05). Glucose homeostasis significantly was improved (P<0.001) in the MetS group. A change in the homeostasis model assessment of insulin resistance (HOMA-IR) was positively associated with the baseline HOMA-IR level (R=0.75, P<0.001). Conclusion: A low-intensive eight-week LM program is an effective and efficient way to improve the anthropomorphic parameters and to reduce insulin resistance, especially for adults with MetS.
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Affiliation(s)
- Yi-Hsin Lin
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Hsuan Huang
- Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan
- Correspondence: Hsuan HuangDepartment of Surgery, Mackay Memorial Hospital, No.424, Sec. 2, Bade Rd., Songshan District, Taipei10556, TaiwanTel +886 2 771 8151Email
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Exercise Is Medicine: Primary Care Counseling on Aerobic Fitness and Muscle Strengthening. J Am Board Fam Med 2019; 32:103-107. [PMID: 30610148 PMCID: PMC6450080 DOI: 10.3122/jabfm.2019.01.180209] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/25/2018] [Accepted: 10/03/2018] [Indexed: 11/08/2022] Open
Abstract
Patient counseling on physical fitness remains underutilized in primary care, despite its clinical and cost effectiveness. Most counseling interventions have focused on aerobic activity and neglected another vital component of physical fitness, muscle strengthening, which has recently been shown to be independently protective against cardiometabolic diseases and premature mortality. This article reviews the latest scientific evidence and makes recommendations toward a more comprehensive approach for promoting physical fitness in primary care. Given the high prevalence and wide-ranging health impacts of physical inactivity, counseling on physical fitness should be a standard part of wellness promotion and disease prevention and treatment for all patients. Interventions that include muscle strengthening will have a significantly greater impact on health outcomes than those focused on aerobic fitness alone. Counseling to promote both aerobic fitness and muscle strengthening is indicated for all patients, irrespective of body weight, and should begin early in life and continue across the life course.
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Kavalakatt S, Khadir A, Madhu D, Hammad M, Devarajan S, Abubaker J, Al-Mulla F, Tuomilehto J, Tiss A. Urocortin 3 Levels Are Impaired in Overweight Humans With and Without Type 2 Diabetes and Modulated by Exercise. Front Endocrinol (Lausanne) 2019; 10:762. [PMID: 31781037 PMCID: PMC6851015 DOI: 10.3389/fendo.2019.00762] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 10/21/2019] [Indexed: 12/26/2022] Open
Abstract
Urocortin3 (UCN3) regulates metabolic functions and is involved in cellular stress response. Although UCN3 is expressed in human adipose tissue, the association of UCN3 with obesity and diabetes remains unclear. This study investigated the effects of Type 2 diabetes (T2D) and increased body weight on the circulatory and subcutaneous adipose tissue (SAT) levels of UCN3 and assessed UCN3 modulation by a regular physical exercise. Normal-weight (n = 37) and overweight adults with and without T2D (n = 98 and n = 107, respectively) were enrolled in the study. A subset of the overweight subjects (n = 39 for each group) underwent a supervised 3-month exercise program combining both moderate intensity aerobic exercise and resistance training with treadmill. UCN3 levels in SAT were measured by immunofluorescence and RT-PCR. Circulatory UCN3 in plasma was assessed by ELISA and was correlated with various clinical and metabolic markers. Our data revealed that plasma UCN3 levels decreased in overweight subjects without T2D compared with normal-weight controls [median; 11.99 (0.78-86.07) and 6.27 (0.64-77.04), respectively; p < 0.001], whereas plasma UCN3 levels increased with concomitant T2D [median; 9.03 (0.77-104.92) p < 0.001]. UCN3 plasma levels were independently associated with glycemic index; fasting plasma glucose and hemoglobin A1c (r = 0.16 and r = 0.20, p < 0.05, respectively) and were significantly different between both overweight, with and without T2D, and normal-weight individuals (OR = 2.11 [1.84-4.11, 95% CI] and OR = 2.12 [1.59-3.10, 95% CI], p < 0.01, respectively). Conversely, the UCN3 patterns observed in SAT were opposite to those in circulation; UCN3 levels were significantly increased with body weight and decreased with T2D. After a 3-month supervised exercise protocol, UCN3 expression showed a significant reduction in SAT of both overweight groups (2.3 and 1.6-fold change; p < 0.01, respectively). In conclusion, UCN levels are differentially dysregulated in obesity in a tissue-dependent manner and can be mitigated by regular moderate physical exercise.
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Affiliation(s)
- Sina Kavalakatt
- Research Division, Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Abdelkrim Khadir
- Research Division, Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Dhanya Madhu
- Research Division, Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Maha Hammad
- Research Division, Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | | | - Jehad Abubaker
- Research Division, Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Fahd Al-Mulla
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Jaakko Tuomilehto
- Research Division, Dasman Diabetes Institute, Kuwait City, Kuwait
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
| | - Ali Tiss
- Research Division, Biochemistry and Molecular Biology Department, Dasman Diabetes Institute, Kuwait City, Kuwait
- *Correspondence: Ali Tiss
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Giovannucci E. An Integrative Approach for Deciphering the Causal Associations of Physical Activity and Cancer Risk: The Role of Adiposity. J Natl Cancer Inst 2018; 110:935-941. [DOI: 10.1093/jnci/djy091] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/17/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Edward Giovannucci
- Department of Nutrition and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
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Abstract
The beneficial effects of exercise on skeletal muscle and the cardiovascular system have long been known. Recent studies have focused on investigating the effects of exercise on adipose tissue and the effects that these exercise-induced adaptations have on overall metabolic health. Examination of exercise-induced adaptations in both white adipose tissue (WAT) and brown adipose tissue (BAT) has revealed marked differences in each tissue with exercise. In WAT, there are changes to both subcutaneous WAT (scWAT) and visceral WAT (vWAT), including decreased adipocyte size and lipid content, increased expression of metabolic genes, altered secretion of adipokines and increased mitochondrial activity. Adaptations specific to scWAT include lipidomic remodeling of phospholipids and, in rodents, the beiging of scWAT. The changes to BAT are less clear: studies evaluating the effect of exercise on the BAT of humans and rodents have revealed contradictory data, making this an important area of current investigation. In this Review, we discuss the exercise-induced changes to WAT and BAT that have been reported by different studies and highlight the current questions in this field.
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Affiliation(s)
- Adam C Lehnig
- Department of Physiology and Cell Biology, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
| | - Kristin I Stanford
- Department of Physiology and Cell Biology, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Wexner Medical Center, Columbus, Ohio 43210, USA
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Shih KC, Kwok CF. Exercise reduces body fat and improves insulin sensitivity and pancreatic β-cell function in overweight and obese male Taiwanese adolescents. BMC Pediatr 2018; 18:80. [PMID: 29471797 PMCID: PMC5822673 DOI: 10.1186/s12887-018-1025-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 01/29/2018] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Improvements in insulin resistance and pancreatic β-cell function have been shown following exercise in adults with obesity; however, few adolescent-based studies have been conducted. This study examined the impact of exercise training on body fat and insulin sensitivity and secretion in overweight and obese adolescents. METHODS The effects of a 12-week exercise program on the parameters of adiposity and glucose homeostasis were investigated in 47 overweight and obese male adolescents. RESULTS After the exercise training program, body weight, body mass index, waist circumference, and body fat were significantly decreased (P < 0.001). Improvements in insulin sensitivity (HOMA-IR: 1.40 vs. 0.86, P < 0.001) and the disposition index (5.84 vs. 12.77, P < 0.001) were also observed. Compared to baseline, oral glucose tolerance tests showed reduced glucose and insulin levels at all time points following the exercise training (all P < 0.001). Subgroup analysis of overweight and obese adolescents with abnormal glucose tolerance revealed that there was no difference in plasma glucose levels as compared to the lean group. CONCLUSIONS A 12-week exercise training is effective in reducing body fat and improving insulin sensitivity and secretion. In addition, the benefits of the exercise intervention were even experienced by those with impaired glucose tolerance.
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Affiliation(s)
- Kuang-Chung Shih
- Division of Endocrinology and Metabolism, Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan.,Division of Endocrinology and Metabolism, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ching-Fai Kwok
- Division of Endocrinology and Metabolism, Department of Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan. .,Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan. .,Division of Endocrinology and Metabolism, Department of Medicine, Taipei-Veteran General Hospital, 201, Sec. 2, Shih-Pai Rd, Taipei, 112, Taiwan.
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Krumpolec P, Vallova S, Slobodova L, Tirpakova V, Vajda M, Schon M, Klepochova R, Janakova Z, Straka I, Sutovsky S, Turcani P, Cvecka J, Valkovic L, Tsai CL, Krssak M, Valkovic P, Sedliak M, Ukropcova B, Ukropec J. Aerobic-Strength Exercise Improves Metabolism and Clinical State in Parkinson's Disease Patients. Front Neurol 2017; 8:698. [PMID: 29312123 PMCID: PMC5743754 DOI: 10.3389/fneur.2017.00698] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 12/05/2017] [Indexed: 12/27/2022] Open
Abstract
Regular exercise ameliorates motor symptoms in Parkinson’s disease (PD). Here, we aimed to provide evidence that exercise brings additional benefits to the whole-body metabolism and skeletal muscle molecular and functional characteristics, which might help to explain exercise-induced improvements in the clinical state. 3-months supervised endurance/strength training was performed in early/mid-stage PD patients and age/gender-matched individuals (n = 11/11). The effects of exercise on resting energy expenditure (REE), glucose metabolism, adiposity, and muscle energy metabolism (31P-MRS) were evaluated and compared to non-exercising PD patients. Two muscle biopsies were taken to determine intervention-induced changes in fiber type, mitochondrial content, and expression of genes related to muscle energy metabolism, as well as proliferative and regenerative capacity. Exercise improved the clinical disability score (MDS-UPDRS), bradykinesia, balance, walking speed, REE, and glucose metabolism and increased muscle expression of energy sensors (AMPK). However, the exercise-induced increase in muscle mass/strength, mitochondrial content, type II fiber size, and postexercise phosphocreatine (PCr) recovery (31P-MRS) were found only in controls. Nevertheless, MDS-UPDRS was associated with muscle AMPK and mechano-growth factor (MGF) expression. Improvements in fasting glycemia were positively associated with muscle function and the expression of Sirt1 and Cox7a1, and the parameters of fitness/strength were positively associated with the expression of MyHC2, MyHC7, and MGF. Moreover, reduced bradykinesia was associated with better muscle metabolism (maximal oxidative capacity and postexercise PCr recovery; 31P-MRS). Exercise training improved the clinical state in early/mid-stage Parkinson’s disease patients, including motor functions and whole-body metabolism. Although the adaptive response to exercise in PD was different from that of controls, exercise-induced improvements in the PD clinical state were associated with specific adaptive changes in muscle functional, metabolic, and molecular characteristics.
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Affiliation(s)
- Patrik Krumpolec
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Silvia Vallova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.,Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Lucia Slobodova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.,Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Veronika Tirpakova
- Institute of Sports Medicine and Physical Education, Faculty of Medicine, Slovak Medical University in Bratislava, Bratislava, Slovakia
| | - Matej Vajda
- Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
| | - Martin Schon
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.,Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Radka Klepochova
- High Field MR Centre, Department of Biomedical Imaging and Imaged-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular Imaging, MOLIMA, Medical University of Vienna, Vienna, Austria
| | - Zuzana Janakova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.,Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Igor Straka
- 2nd Neurology Department, Faculty of Medicine, Comenius University & University Hospital Bratislava, Bratislava, Slovakia
| | - Stanislav Sutovsky
- 1st Neurology Department, Faculty of Medicine, Comenius University & University Hospital Bratislava, Bratislava, Slovakia
| | - Peter Turcani
- 1st Neurology Department, Faculty of Medicine, Comenius University & University Hospital Bratislava, Bratislava, Slovakia
| | - Jan Cvecka
- Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
| | - Ladislav Valkovic
- High Field MR Centre, Department of Biomedical Imaging and Imaged-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Oxford Centre for Clinical Magnetic Resonance Research (OCMR), BHF Centre of Research Excellence, University of Oxford, Oxford, United Kingdom
| | | | - Martin Krssak
- High Field MR Centre, Department of Biomedical Imaging and Imaged-Guided Therapy, Medical University of Vienna, Vienna, Austria.,Christian Doppler Laboratory for Clinical Molecular Imaging, MOLIMA, Medical University of Vienna, Vienna, Austria.,Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Peter Valkovic
- 2nd Neurology Department, Faculty of Medicine, Comenius University & University Hospital Bratislava, Bratislava, Slovakia
| | - Milan Sedliak
- Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
| | - Barbara Ukropcova
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia.,Institute of Pathological Physiology, Faculty of Medicine, Comenius University, Bratislava, Slovakia.,Faculty of Physical Education and Sports, Comenius University, Bratislava, Slovakia
| | - Jozef Ukropec
- Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
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Cho DK, Choi DH, Cho JY. Effect of treadmill exercise on skeletal muscle autophagy in rats with obesity induced by a high-fat diet. J Exerc Nutrition Biochem 2017; 21:26-34. [PMID: 29036763 PMCID: PMC5643208 DOI: 10.20463/jenb.2017.0013] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 09/19/2017] [Indexed: 12/20/2022] Open
Abstract
[Purpose] This study aimed to investigate the effects of treadmill exercise on body weight, blood biochemistry, and autophagy. [Methods] Triglyceride, total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, insulin, and glucose levels were measured, the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score was calculated, and the soleus muscle was analyzed for autophagy-related factors (Beclin-1, p62, LC3, Lamp-2) in rats with obesity induced by a high-fat diet. Eight-week-old Sprague Dawley rats were fed a high-fat diet for 35 weeks and then subjected to 10 weeks of treadmill exercise. The experimental group was divided into a Normal Diet-Sedentary (ND-SED, n=8) group, an (High-Fat Diet-Sedentary (HF-SED, n=8) group, and an High-Fat Diet + Treadmill Exercise (HF-TE, n=8) group. The intensity of treadmill exercise was set as 8 m/min for 5 min, 11 m/min for 5 min, 15 m/min for 20 min, and 11 m/min for the last 5 minutes. A glucose tolerance test was performed at the 2nd and 8th week of exercise by sampling of tail blood. [Results] With endurance exercise, the HFTE group showed a significant decrease in body weight, with improved blood biochemical indices and HOMA-IR scores, in comparison with the HF-SED group. However, there was no significant difference in Beclin-1, p62, LC3, and Lamp-2 proteins as measured by autophagic flux in the soleus muscle. [Conclusion] Treadmill exercise induced improvements in body weight, body fat, and biochemical indicators of obesity and Type 2 diabetes, but had no effect on autophagy in soleus muscle.
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Affiliation(s)
- Do Keun Cho
- Laboratory of Exercise Biochemistry, Korea National Sport University, Seoul, Republic of Korea
| | - Dong Hun Choi
- Laboratory of Exercise Biochemistry, Korea National Sport University, Seoul, Republic of Korea
| | - Joon Yong Cho
- Laboratory of Exercise Biochemistry, Korea National Sport University, Seoul, Republic of Korea
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Lesser IA, Singer J, Hoogbruin A, Mackey DC, Katzmarzyk PT, Sohal P, Leipsic J, Lear SA. Effectiveness of Exercise on Visceral Adipose Tissue in Older South Asian Women. Med Sci Sports Exerc 2017; 48:1371-8. [PMID: 26909531 DOI: 10.1249/mss.0000000000000906] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Individuals of South Asian (SA) origin have a greater risk for type 2 diabetes and cardiovascular disease than other ethnic populations. This increased risk is in part explained by the unique obesity phenotype of elevated visceral adipose tissue (VAT) among this population. Aerobic exercise in Europeans is effective at reducing VAT, but this has not been studied in SA, who have some of the lowest levels of physical activity in the world. Therefore, the purpose of this study was to determine whether exercise can reduce VAT given the unique obesity phenotype and associated disease risk in the SA population. METHODS A total of 75 physically inactive, postmenopausal SA women were randomized to either culturally based (Bhangra dance), standard (gym-based), or control (nonexercise) program for 12-wk. The primary outcome was change in VAT. RESULTS The average attendance in the culturally based and standard program was 78% ± 33% and 67% ± 25%, respectively. After an intention-to-treat analysis, VAT was not significantly reduced in culturally based (-60 cm, 95% confidence interval [CI] = -172 to 54, P = 0.300) or standard (-98 cm, 95% CI = -216 to 21, P = 0.106) exercise compared with control after adjustment for baseline physical activity and age. In those participants who attended more than two-thirds of the exercise classes, VAT was significantly reduced compared with control (-109 cm, 95% CI = -204 to -13, P = 0.026). CONCLUSION In intention-to-treat analysis VAT was not significantly reduced after 12 wk of either standard or culturally based exercise. However, attendance in both standard and culturally based exercise was high, and VAT was significantly reduced among SA women who adhered to these programs.
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Affiliation(s)
- Iris A Lesser
- 1Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, BC, CANADA; 2School of Population and Public Health, University of British Columbia and St. Paul's Hospital, Vancouver, BC, CANADA; 3Faculty of Health, Kwantlen Polytechnic University, Surrey, BC, CANADA; 4Center for Hip Health and Mobility, University of British Columbia, Vancouver, BC, CANADA; 5Pennington Biomedical Research Center, Baton Rouge, LA; 6Department of Family Practice, University of British Columbia, Vancouver, BC, CANADA; 7Department of Radiology, St.Paul's Hospital, Vancouver, BC, Canada; 8Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, CANADA; and 9Division of Cardiology, Providence Health Care, Vancouver, BC, CANADA
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Rostás I, Pótó L, Mátrai P, Hegyi P, Tenk J, Garami A, Illés A, Solymár M, Pétervári E, Szűcs Á, Párniczky A, Pécsi D, Rumbus Z, Zsiborás C, Füredi N, Balaskó M. In middle-aged and old obese patients, training intervention reduces leptin level: A meta-analysis. PLoS One 2017; 12:e0182801. [PMID: 28809927 PMCID: PMC5557366 DOI: 10.1371/journal.pone.0182801] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/25/2017] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Leptin is one of the major adipokines in obesity that indicates the severity of fat accumulation. It is also an important etiological factor of consequent cardiometabolic and autoimmune disorders. Aging has been demonstrated to aggravate obesity and to induce leptin resistance and hyperleptinemia. Hyperleptinemia, on the other hand, may promote the development of age-related abnormalities. While major weight loss has been demonstrated to ameliorate hyperleptinemia, obese people show a poor tendency to achieve lasting success in this field. The question arises whether training intervention per se is able to reduce the level of this adipokine. OBJECTIVES We aimed to review the literature on the effects of training intervention on peripheral leptin level in obesity during aging, in order to evaluate the independent efficacy of this method. In the studies that were included in our analysis, changes of adiponectin levels (when present) were also evaluated. DATA SOURCES 3481 records were identified through searching of PubMed, Embase and Cochrane Library Database. Altogether 19 articles were suitable for analyses. STUDY ELIGIBILITY CRITERIA Empirical research papers were eligible provided that they reported data of middle-aged or older (above 45 years of age) overweight or obese (body mass index above 25) individuals and included physical training intervention or at least fitness status of groups together with corresponding blood leptin values. STATISTICAL METHODS We used random effect models in each of the meta-analyses calculating with the DerSimonian and Laird weighting methods. I-squared indicator and Q test were performed to assess heterogeneity. To assess publication bias Egger's test was applied. In case of significant publication bias, the Duval and Tweedie's trim and fill algorithm was used. RESULTS Training intervention leads to a decrease in leptin level of middle-aged or older, overweight or obese male and female groups, even without major weight loss, indicated by unchanged serum adiponectin levels. Resistance training appears to be more efficient in reducing blood leptin level than aerobic training alone. CONCLUSIONS Physical training, especially resistance training successfully reduces hyperleptinemia even without diet or major weight loss.
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Affiliation(s)
- Ildikó Rostás
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - László Pótó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Mátrai
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Institute of Bioanalysis, Medical School, University of Pécs, Pécs, Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
- Hungarian Academy of Sciences - University of Szeged, Momentum Gastroenterology Multidisciplinary Research Group, Szeged, Hungary
- Division of Gastroenterology, First Department of Internal Medicine, University of Pécs, Pécs, Hungary
| | - Judit Tenk
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - András Garami
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Anita Illés
- Division of Gastroenterology, First Department of Internal Medicine, University of Pécs, Pécs, Hungary
| | - Margit Solymár
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Erika Pétervári
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Ákos Szűcs
- First Department of Surgery, Semmelweis University, Budapest, Hungary
| | | | - Dániel Pécsi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Zoltán Rumbus
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Csaba Zsiborás
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Nóra Füredi
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
| | - Márta Balaskó
- Institute for Translational Medicine, Medical School, University of Pécs, Pécs, Hungary
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AminiLari Z, Fararouei M, Amanat S, Sinaei E, Dianatinasab S, AminiLari M, Daneshi N, Dianatinasab M. The Effect of 12 Weeks Aerobic, Resistance, and Combined Exercises on Omentin-1 Levels and Insulin Resistance among Type 2 Diabetic Middle-Aged Women. Diabetes Metab J 2017; 41:205-212. [PMID: 28537059 PMCID: PMC5489501 DOI: 10.4093/dmj.2017.41.3.205] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Accepted: 01/09/2017] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Recent studies have shown that omentin-1 derived from adipokines can affect physiological regulations and some metabolic dis-eases such as type 2 diabetes mellitus (T2DM). METHODS The purpose of this study was to examine the impact of 12 weeks of aerobic (cycle ergometer), resistance, and combined exercises on omentin-1 level, glucose and insulin resistance indices in overweight middle age women with T2DM. In this study, 60 overweight middle age diabetic women were selected using simple random sampling and they were assigned to three groups of aerobic exercise (n=12), resistant exercise (n=12) and combined exercise (n=13), and one control group (n=15). Exercises were done in a three times per week sessions for a total of 12 weeks. Blood samples were collected before each exercise session and 24 hours after of the last session. RESULTS Present study showed that fasting blood sugar decreased significantly in all intervention groups, while homeostasis model assessment of insulin resistance (HOMA-IR) decreased only in the aerobic and combined exercises groups. Furthermore, there was a significant increase in the omentin-1 level only in the combined exercise group. CONCLUSION Compared to aerobic and resistance exercises, 12 weeks of combined exercise was more efficient in improving HOMA-IR and increasing serum omentin-1 among women with T2DM.
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Affiliation(s)
- Zeinab AminiLari
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Mohammad Fararouei
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sasan Amanat
- Department of Nutrition, Shiraz University of Medical Sciences School of Nutrition and Food Sciences, Shiraz, Iran
| | - Ehsan Sinaei
- Department of Physical Therapy, Shiraz University of Medical Sciences School of Rehabilitation Sciences, Shiraz, Iran
| | - Safa Dianatinasab
- Department of Nutrition, Shiraz University of Medical Sciences School of Nutrition and Food Sciences, Shiraz, Iran
| | - Mahmood AminiLari
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada
| | - Nima Daneshi
- Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences School of Health, Shiraz, Iran
| | - Mostafa Dianatinasab
- Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Epidemiology, Student Research Committee, Shiraz University of Medical Sciences School of Health, Shiraz, Iran.
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24th European Congress on Obesity (ECO2017), Porto, Portugal, May 17-20, 2017: Abstracts. Obes Facts 2017; 10 Suppl 1:1-274. [PMID: 28528328 PMCID: PMC5661480 DOI: 10.1159/000468958] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
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Merlotti C, Ceriani V, Morabito A, Pontiroli AE. Subcutaneous fat loss is greater than visceral fat loss with diet and exercise, weight-loss promoting drugs and bariatric surgery: a critical review and meta-analysis. Int J Obes (Lond) 2017; 41:672-682. [DOI: 10.1038/ijo.2017.31] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/30/2016] [Accepted: 01/20/2017] [Indexed: 02/07/2023]
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Gaffney CJ, Mansell P, Stephens FB, Macdonald IA, Tsintzas K. Exercise Metabolism in Nonobese Patients with Type 2 Diabetes Following the Acute Restoration of Normoglycaemia. J Diabetes Res 2017; 2017:8248725. [PMID: 28634587 PMCID: PMC5467393 DOI: 10.1155/2017/8248725] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
This study investigated how acute restoration of normoglycaemia affected energy metabolism during exercise in nonobese patients with type 2 diabetes. Six subjects (mean ± SEM) aged 56.2 ± 2.7 years, with a BMI of 24.5 ± 1.5 kg/m2 and a VO2 peak of 28.7 ml/kg/min, attended the lab on two randomised occasions for a four-hour resting infusion of insulin or saline, followed by 30 minutes cycling at 50% VO2 peak. During the 4 h resting infusion, there was a greater (P < 0.0001) reduction in blood glucose in insulin treatment (INS) (from 11.2 ± 0.6 to 5.6 ± 0.1 mmol/l) than in saline treatment/control (CON) (from 11.5 ± 0.7 to 8.5 ± 0.6 mmol/l). This was associated with a lower (P < 0.05) resting metabolic rate in INS (3.87 ± 0.17) than in CON (4.39 ± 0.30 kJ/min). During subsequent exercise, blood glucose increased significantly in INS from 5.6 ± 0.1 at 0 min to 6.3 ± 0.3 mmol/l at 30 min (P < 0.01), which was accompanied by a lower blood lactate response (P < 0.05). Oxygen uptake, rates of substrate utilization, heart rate, and ratings of perceived exertion were not different between trials. Insulin-induced normoglycaemia increased blood glucose during subsequent exercise without altering overall substrate utilization.
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Affiliation(s)
- Christopher J. Gaffney
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK
- School of Sport and Health Sciences, University of Exeter, St Luke's Campus, Exeter EX1 2LU, UK
| | - Peter Mansell
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Francis B. Stephens
- School of Sport and Health Sciences, University of Exeter, St Luke's Campus, Exeter EX1 2LU, UK
| | - Ian A. Macdonald
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK
| | - Kostas Tsintzas
- Medical Research Council/Arthritis Research UK Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham NG7 2UH, UK
- *Kostas Tsintzas:
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Abdominal Adiposity, Not Cardiorespiratory Fitness, Mediates the Exercise-Induced Change in Insulin Sensitivity in Older Adults. PLoS One 2016; 11:e0167734. [PMID: 27936206 PMCID: PMC5147957 DOI: 10.1371/journal.pone.0167734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 11/18/2016] [Indexed: 11/19/2022] Open
Abstract
Abdominal obesity and low cardiorespiratory fitness (CRF) are associated with insulin resistance in older adults. Exercise is associated with improvement in insulin sensitivity. Whether this association is mediated by change in CRF and/or abdominal obesity is unclear. The current study is a secondary analysis of data from a randomized controlled trial in Kingston, Ontario. Sedentary older adults (60–80 years) (N = 80) who completed the exercise (N = 59) or control (N = 21) conditions for 6 months were included. CRF was measured using a treadmill test, adipose tissue (AT) by magnetic resonance imaging, and insulin sensitivity by hyperinsulinemic-euglycemic clamp. Waist circumference (WC) was measured at the iliac crest. Mediation analyses were used to assess whether abdominal AT and/or CRF mediated the exercise-induced change in insulin sensitivity. By comparison to controls, reduction (mean ± SD) was observed for visceral (-0.4 ± 0.4 kg) and abdominal subcutaneous (-0.4 ± 0.4) AT depots, WC (-4.1 ± 3.2 cm) and BMI (-0.9 ± 0.8 kg/m2) (p < 0.05). Insulin sensitivity (4.2 ± 5.2 M/I) and CRF (0.2 ± 0.3 L/min) improved in the exercise group (p < 0.05). All AT variables, BMI and WC were mediators of the change in insulin sensitivity (p < 0.05). After adjustment for change in total AT, abdominal AT remained a mediator with an effect ratio of 0.79 (p < 0.05), whereas total AT was not significant when adjusted for abdominal AT (p > 0.05). The effect ratio for change in WC and BMI combined (0.63, p<0.05) was greater than either alone. In conclusion, CRF did not mediate the exercise-induced change in insulin sensitivity in older adults. Abdominal adiposity was a strong mediator independent of change in total adiposity.
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Lesser IA, Guenette JA, Hoogbruin A, Mackey DC, Singer J, Gasevic D, Lear SA. Association between exercise-induced change in body composition and change in cardiometabolic risk factors in postmenopausal South Asian women. Appl Physiol Nutr Metab 2016; 41:931-7. [DOI: 10.1139/apnm-2016-0082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The South Asian population suffers from a high prevalence of type 2 diabetes and cardiovascular disease (CVD). A unique obesity phenotype of elevated visceral adipose tissue (VAT) is associated with CVD risk among South Asians. Exercise-induced reduction in VAT and body fat is an effective mechanism to improve cardiometabolic risk factors but this has not been shown in South Asians. Whether exercise-induced changes in measurements such as waist circumference (WC) are independently related to changes in cardiometabolic risk factors in South Asians is unknown. Multi-slice computed tomography scanning was used to assess VAT, cardiometabolic risk factors through a fasting blood sample, and body fat using dual-energy X-ray absorptiometry. Forty- nine postmenopausal South Asian women who participated in two 12-week aerobic exercise programs were included. Bivariate correlations were used to assess associations between change in cardiometabolic risk factors and change in body composition. Regression analyses were conducted with change in glucose, insulin, and homeostatic model assessment of insulin resistance (HOMA-IR) as dependent variables and change in body composition as independent variables of interest. There were significant associations between changes in fasting insulin, glucose, and HOMA-IR with change in VAT. The association between change in VAT and these cardiometabolic risk factors was independent of change in other body composition variables of interest. South Asian women should be encouraged to engage in aerobic activity to reduce their risk of type 2 diabetes and CVD, and physicians should be aware of improvements in glucose regulation with exercise training not observed through reductions in WC.
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Affiliation(s)
- Iris A. Lesser
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
| | - Jordan A. Guenette
- Department of Physical Therapy and Centre for Heart Lung Innovation, University of British Columbia and St Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Amandah Hoogbruin
- Faculty of Health, Kwantlen Polytechnic University, Surrey, BC V3W 2M8, Canada
| | - Dawn C. Mackey
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
- Centre for Hip Health and Mobility, University of British Columbia, Vancouver, BC V5Z 1M9, Canada
| | - Joel Singer
- School of Population and Public Health, University of British Columbia and St. Paul’s Hospital, Vancouver, BC V6Z 1Y6, Canada
| | - Danijela Gasevic
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AD, UK
| | - Scott A. Lear
- Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Vancouver, BC V6B 5K3, Canada
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada
- Division of Cardiology, Providence Health Care, Vancouver, BC V6Z 1Y6, Canada
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Verheggen RJHM, Maessen MFH, Green DJ, Hermus ARMM, Hopman MTE, Thijssen DHT. A systematic review and meta-analysis on the effects of exercise training versus hypocaloric diet: distinct effects on body weight and visceral adipose tissue. Obes Rev 2016; 17:664-90. [PMID: 27213481 DOI: 10.1111/obr.12406] [Citation(s) in RCA: 188] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/25/2016] [Accepted: 02/12/2016] [Indexed: 12/12/2022]
Abstract
Exercise training ('exercise') and hypocaloric diet ('diet') are frequently prescribed for weight loss in obesity. Whilst body weight changes are commonly used to evaluate lifestyle interventions, visceral adiposity (VAT) is a more relevant and stronger predictor for morbidity and mortality. A meta-analysis was performed to assess the effects of exercise or diet on VAT (quantified by radiographic imaging). Relevant databases were searched through May 2014. One hundred seventeen studies (n = 4,815) were included. We found that both exercise and diet cause VAT loss (P < 0.0001). When comparing diet versus training, diet caused a larger weight loss (P = 0.04). In contrast, a trend was observed towards a larger VAT decrease in exercise (P = 0.08). Changes in weight and VAT showed a strong correlation after diet (R(2) = 0.737, P < 0.001), and a modest correlation after exercise (R(2) = 0.451, P < 0.001). In the absence of weight loss, exercise is related to 6.1% decrease in VAT, whilst diet showed virtually no change (1.1%). In conclusion, both exercise and diet reduce VAT. Despite a larger effect of diet on total body weight loss, exercise tends to have superior effects in reducing VAT. Finally, total body weight loss does not necessarily reflect changes in VAT and may represent a poor marker when evaluating benefits of lifestyle-interventions.
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Affiliation(s)
- R J H M Verheggen
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M F H Maessen
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - D J Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,School of Sport Science, Exercise and Health, the University of Western Australia, Crawley, Western Australia, Australia
| | - A R M M Hermus
- Department of Internal Medicine, Division of Endocrinology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - M T E Hopman
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - D H T Thijssen
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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McClatchey PM, Schafer M, Hunter KS, Reusch JEB. The endothelial glycocalyx promotes homogenous blood flow distribution within the microvasculature. Am J Physiol Heart Circ Physiol 2016; 311:H168-76. [PMID: 27199117 DOI: 10.1152/ajpheart.00132.2016] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 05/03/2016] [Indexed: 02/02/2023]
Abstract
Many common diseases involve impaired tissue perfusion, and heterogeneous distribution of blood flow in the microvasculature contributes to this pathology. The physiological mechanisms regulating homogeneity/heterogeneity of microvascular perfusion are presently unknown. Using established empirical formulations for blood viscosity modeling in vivo (blood vessels) and in vitro (glass tubes), we showed that the in vivo formulation predicts more homogenous perfusion of microvascular networks at the arteriolar and capillary levels. Next, we showed that the more homogeneous blood flow under simulated in vivo conditions can be explained by changes in red blood cell interactions with the vessel wall. Finally, we demonstrated that the presence of a space-filling, semipermeable layer (such as the endothelial glycocalyx) at the vessel wall can account for the changes of red blood cell interactions with the vessel wall that promote homogenous microvascular perfusion. Collectively, our results indicate that the mechanical properties of the endothelial glycocalyx promote homogeneous microvascular perfusion. Preservation or restoration of normal glycocalyx properties may be a viable strategy for improving tissue perfusion in a variety of diseases.
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Affiliation(s)
- P Mason McClatchey
- Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Medicine, Denver Veterans Affairs Medical Center, Denver, Colorado; Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michal Schafer
- Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado; and
| | - Kendall S Hunter
- Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Division of Cardiology, Department of Pediatrics, Children's Hospital Colorado, Aurora, Colorado; and
| | - Jane E B Reusch
- Division of Endocrinology, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Department of Medicine, Denver Veterans Affairs Medical Center, Denver, Colorado; Department of Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Center for Women's Health Research, University of Colorado School of Medicine, Aurora, Colorado
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