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Zhang T, Yang S, Liu W, Bai Q, Gao S. Tai Chi training as a primary care plan for the prevention and management of hypertension: an opinion and positioning article. Ann Med 2024; 56:2320863. [PMID: 38373214 PMCID: PMC10878327 DOI: 10.1080/07853890.2024.2320863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/14/2024] [Indexed: 02/21/2024] Open
Abstract
Hypertension is a prevalent chronic condition worldwide that can impact patients' quality of life. Oral antihypertensive drugs are widely used to manage high blood pressure, primarily by regulating the renin-angiotensin-aldosterone system. Nevertheless, limited efficacy and low compliance represent significant obstacles, arising primarily from dose, duration, and medication type restrictions. Furthermore, the prolonged use of antihypertensive medication may result in dependence and adverse effects, without any substantial improvement in achieving targeted blood pressure leves. As a result, research has focused on using exercise therapy to treat hypertension. Tai Chi, a widely-practiced Chinese health exercise, has evolved into a form of exercise therapy that might help alleviate the risk associated with hypertension. Therefore, this article aims to outline the role of Tai Chi in preventing and managing hypertension.
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Affiliation(s)
- Ting Zhang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
- University Hospital, Zhejiang Normal University, Jinhua, China
| | - Shuman Yang
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
| | - Wei Liu
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Qingping Bai
- Physical Education College, Guangxi University of Science and Technology, Liuzhou, China
| | - Song Gao
- College of Physical Education and Health Sciences, Zhejiang Normal University, Jinhua, China
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Darvish S, Mahoney SA, Venkatasubramanian R, Rossman MJ, Clayton ZS, Murray KO. Socioeconomic status as a potential mediator of arterial aging in marginalized ethnic and racial groups: current understandings and future directions. J Appl Physiol (1985) 2024; 137:194-222. [PMID: 38813611 DOI: 10.1152/japplphysiol.00188.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/28/2024] [Accepted: 05/28/2024] [Indexed: 05/31/2024] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death in the United States. However, disparities in CVD-related morbidity and mortality exist as marginalized racial and ethnic groups are generally at higher risk for CVDs (Black Americans, Indigenous People, South and Southeast Asians, Native Hawaiians, and Pacific Islanders) and/or development of traditional CVD risk factors (groups above plus Hispanics/Latinos) relative to non-Hispanic Whites (NHW). In this comprehensive review, we outline emerging evidence suggesting these groups experience accelerated arterial dysfunction, including vascular endothelial dysfunction and large elastic artery stiffening, a nontraditional CVD risk factor that may predict risk of CVDs in these groups with advancing age. Adverse exposures to social determinants of health (SDOH), specifically lower socioeconomic status (SES), are exacerbated in most of these groups (except South Asians-higher SES) and may be a potential mediator of accelerated arterial aging. SES negatively influences the ability of marginalized racial and ethnic groups to meet aerobic exercise guidelines, the first-line strategy to improve arterial function, due to increased barriers, such as time and financial constraints, lack of motivation, facility access, and health education, to performing conventional aerobic exercise. Thus, identifying alternative interventions to conventional aerobic exercise that 1) overcome these common barriers and 2) target the biological mechanisms of aging to improve arterial function may be an effective, alternative method to aerobic exercise to ameliorate accelerated arterial aging and reduce CVD risk. Importantly, dedicated efforts are needed to assess these strategies in randomized-controlled clinical trials in these marginalized racial and ethnic groups.
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Affiliation(s)
- Sanna Darvish
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Sophia A Mahoney
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | | | - Matthew J Rossman
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Zachary S Clayton
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
| | - Kevin O Murray
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, United States
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3
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AL-Mhanna SB, Batrakoulis A, Wan Ghazali WS, Mohamed M, Aldayel A, Alhussain MH, Afolabi HA, Wada Y, Gülü M, Elkholi S, Abubakar BD, Rojas-Valverde D. Effects of combined aerobic and resistance training on glycemic control, blood pressure, inflammation, cardiorespiratory fitness and quality of life in patients with type 2 diabetes and overweight/obesity: a systematic review and meta-analysis. PeerJ 2024; 12:e17525. [PMID: 38887616 PMCID: PMC11182026 DOI: 10.7717/peerj.17525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 05/16/2024] [Indexed: 06/20/2024] Open
Abstract
Background Structured aerobic or resistance training alone seems to be a beneficial tool for improving glucose homeostasis, chronic systemic inflammation, resting cardiovascular function, and mental health in people with obesity and type 2 diabetes mellitus (T2DM). The aim of the present study was to synthesize the available data on the effectiveness of combined aerobic and resistance training (CART) on glycemic control, blood pressure, inflammation, cardiorespiratory fitness (CRF), and quality of life (QoL) in overweight and obese individuals with T2DM. Methods A database search was carried out in PubMed, Web of Science, Scopus, Science Direct, Cochrane Library, and Google Scholar from inception up to May 2023. The Cochrane risk of bias tool was used to assess eligible studies, and the GRADE method to evaluate the reliability of evidence. A random-effects model was used, and data were analyzed using standardized mean differences and 95% confidence intervals. The study protocol was registered in the International Prospective Register of Systematic Reviews (ID: CRD42022355612). Results A total of 21,612 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants (mean age: 57 ± 7 years) who met the eligibility criteria. CART demonstrated significant improvements in body mass index, glycated hemoglobin, systolic and diastolic blood pressure, C-reactive protein, tumor necrosis factor-alpha, interleukin-6, CRF, and QoL compared to ST. These findings highlight the significance of exercise interventions such as CART as essential elements within comprehensive diabetes management strategies, ultimately enhancing overall health outcomes in individuals with T2DM and overweight/obesity.No differences were found in resting heart rate between CART and ST. An uncertain risk of bias and poor quality of evidence were found among the eligible studies. Conclusion These outcomes show clear evidence considering the positive role of CART in inducing beneficial changes in various cardiometabolic and mental health-related indicators in patients with T2DM and concurrent overweight/obesity. More studies with robust methodological design are warranted to examine the dose-response relationship, training parameters configuration, and mechanisms behind these positive adaptations.
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Affiliation(s)
- Sameer Badri AL-Mhanna
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | | | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Abdulaziz Aldayel
- Exercise Physiology Department, King Saud University, Riyadh, Saudi Arabia
| | - Maha H. Alhussain
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, Riyadh, Saudi Arabia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Yusuf Wada
- Department of Zoology, Ahmadu Bello University, Zaria, Nigeria
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Safaa Elkholi
- Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Daniel Rojas-Valverde
- Centro de Investigación y Diagnóstico en Salud y Deporte, Escuela Ciencias del Movimiento Humano y Calidad de Vida Universidad Nacional de Costa Rica, Heredia, Costa Rica
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Sprague BN, Tu W, Unverzagt FW, Moser LR, Adams M, Carter A, Dawkins E, Keith NR, Reinoso DR, Clark DO. Food resources and kitchen skills plus aerobic training (FoRKS+) for black adults with hypertension: A pilot trial protocol. Contemp Clin Trials 2024; 141:107533. [PMID: 38621517 PMCID: PMC11221607 DOI: 10.1016/j.cct.2024.107533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 03/21/2024] [Accepted: 04/10/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Midlife hypertension is associated with cognitive decline and Alzheimer's disease and related dementia (ADRD), suggesting that blood pressure control may be a therapeutic target for dementia prevention. Given excess hypertension in non-Hispanic Black (NHB) adults, blood pressure control may also reduce ADRD disparities. We describe a pilot randomized controlled trial (RCT) to evaluate the feasibility and preliminary efficacy of a multicomponent lifestyle-based intervention versus enhanced usual care on cognition among middle-aged NHB adults. METHODS AND STUDY DESIGN The Food Resources and Kitchen Skills plus Aerobic Training (FoRKS+) study is a 2-arm, single-blinded trial that compares those receiving the FoRKS+ program (target N = 64) versus those receiving enhanced usual care (target N = 64) in local federally-qualified health centers. Key eligibility criteria include self-identified NHB adults between ages 35-75 with a mean systolic blood pressure ≥ 130 mm/Hg obtained from 24-h ambulatory blood pressure monitoring. The FoRKS+ program includes 5 weeks of hypertension self-management courses, 11 weeks of nutrition courses, and 12 weeks of aerobic training in dietitian and health coach-led virtual groups. We will collect data on primary cognitive outcomes, feasibility, hypothesized intervention mediators and moderators, and demographic and health covariates at baseline, near intervention weeks 16-, and 28 (primary outcome assessment), and week 52 follow-up. We will use mixed-effects modeling to examine intervention effects on cognition. DISCUSSION This pilot RCT will examine the feasibility and preliminary effects of a multicomponent lifestyle intervention on cognitive function in NHB adults, which may have implications for reducing health disparities in ADRD.
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Affiliation(s)
- Briana N Sprague
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA.
| | - Wanzhu Tu
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Frederick W Unverzagt
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lyndsi R Moser
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mariah Adams
- Department of Kinesiology, Indiana University Bloomington, Bloomington, IN, USA
| | - Amy Carter
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Emily Dawkins
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | - NiCole R Keith
- Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA; Department of Kinesiology, Indiana University Bloomington, Bloomington, IN, USA
| | - Deanna R Reinoso
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Daniel O Clark
- Department of Medicine, Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana University Center for Aging Research, Regenstrief Institute, Inc, Indianapolis, IN, USA
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Al-Mhanna SB, Rocha-Rodriguesc S, Mohamed M, Batrakoulis A, Aldhahi MI, Afolabi HA, Yagin FH, Alhussain MH, Gülü M, Abubakar BD, Ghazali WSW, Alghannam AF, Badicu G. Effects of combined aerobic exercise and diet on cardiometabolic health in patients with obesity and type 2 diabetes: a systematic review and meta-analysis. BMC Sports Sci Med Rehabil 2023; 15:165. [PMID: 38049873 PMCID: PMC10696788 DOI: 10.1186/s13102-023-00766-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 11/06/2023] [Indexed: 12/06/2023]
Abstract
BACKGROUND Lifestyle modifications involving diet and exercise are recommended for patients diagnosed with obesity and type 2 diabetes mellitus (T2DM). The purpose of this review was to systematically evaluate the effects of combined aerobic exercise and diet (AEDT) on various cardiometabolic health-related indicators among individuals with obesity and T2DM. METHODOLOGY A comprehensive search of the PubMed/Medline, Web of Science, Scopus, Science Direct, Cochrane, and Google Scholar databases was conducted for this meta-analysis. The Cochrane risk of bias tool was used to evaluate eligible studies, and the GRADE tool was used to rate the certainty of evidence. A random-effects model for continuous variables was used, and the results were presented as mean differences or standardised mean differences with 95% confidence intervals. RESULTS A total of 16,129 studies were retrieved; 20 studies were included, and data were extracted from 1,192 participants. The findings revealed significant improvements in body mass index, body weight, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides, fasting blood glucose, fasting plasma insulin, glycated hemoglobin, leptin, interleukin-6, C-reactive protein, and adiponectin (p < 0.05) compared to the standard treatment (ST) group. No significant differences were observed between the AEDT and ST groups in fat mass, hip circumference, waist-to-hip ratio, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and tumor necrosis factor-alpha. The present findings are based on low- to moderate-quality evidence. CONCLUSIONS AEDT may be a critical behavior for holistic cardiometabolic health-related benefits as a contemporary anti-obesity medication due to its significant positive impact on patients with obesity and T2DM. Nevertheless, further robust evidence is necessary to determine whether AEDT is an effective intervention for lowering cardiovascular and metabolic risk factors among individuals with obesity and T2DM.
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Affiliation(s)
- Sameer Badri Al-Mhanna
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, New Delhi, India
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Sílvia Rocha-Rodriguesc
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Viana do Castelo, Portugal
- Tumour & Microenvironment Interactions Group, INEB- Institute of Biomedical Engineering, i3S-Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia
| | - Alexios Batrakoulis
- Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Dietetics, University of Thessaly, Trikala, Greece
| | - Monira I Aldhahi
- Department of Rehabilitation, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Hafeez Abiola Afolabi
- Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Fatma Hilal Yagin
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Inonu University, Malatya, Turkey
| | - Maha H Alhussain
- Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, Riyadh, Saudi Arabia
| | - Mehmet Gülü
- Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
| | - Bishir Daku Abubakar
- Department of Human Physiology, Federal University Dutse, Dutse, Jigawa State, Nigeria
| | - Wan Syaheedah Wan Ghazali
- Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, 16150, Malaysia.
| | - Abdullah F Alghannam
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Transilvania University of Brasov, Brasov, Romania
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Bersaoui M, Bisai A, Baldew SM, Toelsie J, Goessler K, Cornelissen VA. Can postexercise hypotension also be observed in African and Asian populations: a systematic review and meta-analysis of randomized controlled trials. J Hum Hypertens 2023; 37:1076-1085. [PMID: 37468543 DOI: 10.1038/s41371-023-00844-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 05/16/2023] [Accepted: 06/19/2023] [Indexed: 07/21/2023]
Abstract
Worldwide, raised blood pressure (BP) or hypertension is the global leading risk factor for the development of cardiovascular diseases and all-cause mortality, with the highest prevalence found in Asian and African origin populations. Post-exercise hypotension (PEH), defined as a sustained reduction in BP after a single bout of exercise is an important physiological phenomenon in BP management. However, little is known about the hypotensive effect of a single bout of exercise in non-Caucasian populations. We systematically summarized the acute effects of a single bout of aerobic exercise on BP in a population of African or Asian origin. We searched the MEDLINE database identifying randomized controlled trials investigating the effect of a single bout of aerobic exercise on BP in African or Asian populations with optimal BP, high normal BP or hypertension published in a peer reviewed journal up to August 2021. A subsequent meta-analysis was performed using random-effect models fitted to estimate effect sizes. We identified 10 aerobic exercise trials performed in individuals of Asian origin (n = 136; mean age: 29.51 (21.2-69) years: 78% male; baseline systolic BP/diastolic BP: 118.9 ± 9.64/68.9 ± 2.69 mmHg) and 11 aerobic exercise trials involving individuals of African origin (n = 157; mean age: 41.05 (29.9-49) years; 59% male; baseline systolic BP/diastolic BP: 134.5 ± 8.65 mmHg/82.2 ± 3.24 mmHg). Non-significant reductions in office systolic BP and diastolic BP at 30 min post exercise (-2.25 [-6.38, 1.88] mmHg, p = 0.28/-1.02 [-2.51, 0.47] mmHg, p = 0.18) and 60 min post exercise (-2.80 [-7.90, 2.28], p = 0.27/-1.95, [-5.66, 1.75], p = 0.3) were observed compared to the control intervention. No statistically significant differences were found between both ethnic groups (p > 0.05). Ambulatory BP was reported only in a few African groups. No effect was found on 24h-systolic BP post exercise, but 24h-diastolic BP was statistically significantly reduced (-1.89 [-3.47, -0.31] mmHg, p < 0.01) after a bout of aerobic exercise compared to the control intervention. The available evidence is insufficient to recommend a single session of aerobic exercise as an efficient tool to lower BP in African and Asian populations. Though, the paucity of data in non-Caucasian populations underscores the need for additional efforts to establish the efficacy of single bouts of exercise, including isometric and dynamic resistance exercise, as a potential non-pharmacological adjunct to help lowering BP in the daily life of descendants of Asian or African origin.
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Affiliation(s)
- M Bersaoui
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname.
- Department of Rehabilitation Sciences, Cardiovascular Exercise Physiology Unit, KU Leuven, Leuven, Belgium.
| | - A Bisai
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - S M Baldew
- Department of Physical Therapy, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - J Toelsie
- Department of Physiology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - K Goessler
- Applied Physiology and Nutrition Research Group - Center of Lifestyle Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - V A Cornelissen
- Department of Rehabilitation Sciences, Cardiovascular Exercise Physiology Unit, KU Leuven, Leuven, Belgium
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Schneider VM, Domingues LB, Umpierre D, Tanaka H, Ferrari R. Exercise characteristics and blood pressure reduction after combined aerobic and resistance training: a systematic review with meta-analysis and meta-regression. J Hypertens 2023; 41:1068-1076. [PMID: 37115856 DOI: 10.1097/hjh.0000000000003455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
OBJECTIVE The purpose of this systematic review with meta-analysis was to determine the efficacy of combined aerobic and strength training in adults with hypertension and the influence of exercise training characteristics on blood pressure (BP) reduction. METHODS Randomized clinical trials of interventions involving combined aerobic and strength training versus nonexercise control groups (Control) in adults with hypertension were included. The literature search was conducted on PubMed, Cochrane Central, EMBASE, Scopus, and LILACS until December 2021. A random effects meta-analysis was performed using the mean difference in BP changes from baseline, comparing combined aerobic and strength training vs. Control as the effective measure. A multivariate meta-regression analysis was also performed to evaluate the relationship between exercise training characteristics and magnitudes of BP reductions. RESULTS Thirty-seven studies with 41 exercise interventions (1942 participants) were analyzed. The pooled mean differences with a 95% confidence interval (95% CI) showed significant reductions in SBP (-6.4 mmHg; 95% CI, -9.1 to -3.6) and DBP (-3.7 mmHg; 95% CI, -4.9 to -2.4). Meta-regression analysis revealed that greater exercise intensity and a greater number of sets in resistance training were associated with greater reductions in SBP. Greater exercise intensity was also associated with greater decreases in DBP. CONCLUSION Combined aerobic and resistance training is an effective intervention in reducing both SBP and DBP in adults with hypertension, with greater hypotensive effects expected with higher intensity and more volume.
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Affiliation(s)
- Vinícius M Schneider
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Lucas B Domingues
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daniel Umpierre
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
| | - Hirofumi Tanaka
- Cardiovascular Aging Research Laboratory, The University of Texas at Austin, Austin, Texas, USA
| | - Rodrigo Ferrari
- Postgraduate Program in Cardiology, School of Medicine, Universidade Federal do Rio Grande do Sul
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Montazeri M, Zarkesh M, Zadeh-Vakili A, Khalili D, Movahedi M, Khalaj A. Association of physical activity with increased PI3K and Akt mRNA levels in adipose tissues of obese and non-obese adults. Sci Rep 2023; 13:9291. [PMID: 37286617 DOI: 10.1038/s41598-023-36365-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 06/02/2023] [Indexed: 06/09/2023] Open
Abstract
Phosphatidylinositol-3-kinase (PI3K)/Akt signaling pathway regulates glucose and lipid metabolism. We examined the association of PI3K and Akt expression in visceral (VAT) and subcutaneous adipose tissue (SAT) with daily physical activity (PA) in non-diabetic obese and non-obese adults. In this cross-sectional study, we included 105 obese (BMI ≥ 30 kg/m2) and 71 non-obese (BMI < 30 kg/m2) subjects (aged/ ≥ 18 years). PA was measured using a valid and reliable International Physical Activity Questionnaire(IPAQ)-long-form, and the metabolic equivalent of task(MET) was calculated. Real-time PCR was performed to analyze the mRNA relative expression. VAT PI3K expression had a lower level in obese compared to non-obese (P = 0.015), while its expression was higher in active individuals than inactive ones (P = 0.029). SAT PI3K expression was increased in active individuals compared to inactive ones (P = 0.031). There was a rise in VAT Akt expression in the actives compared to the inactive participants (P = 0.037) and in non-obese/active compared to non-obese/inactive individuals (P = 0.026). Obese individuals had a decreased expression level of SAT Akt compared to non-obsesses (P = 0.005). VAT PI3K was directly and significantly associated with PA in obsesses (β = 1.457, P = 0.015). Positive association between PI3K and PA suggests beneficial effects of PA for obese individuals that can be partly described by PI3K/Akt pathway acceleration in adipose tissue.
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Affiliation(s)
- Marzieh Montazeri
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Zarkesh
- Cellular and Molecular Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, PO Box: 19395-4763, Tehran, Iran.
| | - Azita Zadeh-Vakili
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, PO Box: 19395-4763, Tehran, Iran.
| | - Davood Khalili
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Monireh Movahedi
- Department of Biochemistry, Faculty of Biological Science, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Alireza Khalaj
- Tehran Obesity Treatment Center, Department of Surgery, Shahed University, Tehran, Iran
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9
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Zhao X, He Q, Zeng Y, Cheng L. Effectiveness of combined exercise in people with type 2 diabetes and concurrent overweight/obesity: a systematic review and meta-analysis. BMJ Open 2021; 11:e046252. [PMID: 34615674 PMCID: PMC8496382 DOI: 10.1136/bmjopen-2020-046252] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVE To synthesise the available scientific evidence on the effects of combined exercise on glycaemic control, weight loss, insulin sensitivity, blood pressure and serum lipids among patients with type 2 diabetes (T2D) and concurrent overweight/obesity. DESIGN AND SAMPLE PubMed, EMBASE, Web of Science, the Cochrane library, WANFANG, CNKI, SinoMed, OpenGrey and ClinicalTrials.gov were searched from inception through April 2020 to identify randomised controlled trials (RCTs) that reported the effects of combined exercise in individuals with T2D and concurrent overweight/obesity. METHODS Quality assessment was performed using the Cochrane Collaboration's risk of bias tool. The mean difference (MD) with its corresponding 95% CI was used to estimate the effect size. Meta-analysis was performed using Review Manager V.5.3. RESULTS A total of 10 RCTs with 978 participants were included in the meta-analysis. Pooled results demonstrated that combined exercise significantly reduced haemoglobin A1c (MD=-0.16%, 95% CI: -0.28 to -0.05, p=0.006); body mass index (MD=-0.98 kg/m2, 95% CI: -1.41 to -0.56, p<0.001); homeostasis model assessment of insulin resistance (MD=-1.19, 95% CI: -1.93 to -0.46, p=0.001); serum insulin (MD=-2.18 μIU/mL, 95% CI: -2.99 to -1.37, p<0.001) and diastolic blood pressure (MD=-3.24 mm Hg, 95% CI: -5.32 to -1.16, p=0.002). CONCLUSIONS Combined exercise exerted significant effects in improving glycaemic control, influencing weight loss and enhancing insulin sensitivity among patients with T2D and concurrent overweight/obesity.
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Affiliation(s)
- Xiaoyan Zhao
- Department of Endocrinology and Metabolism, The Eighth Affiliated Hospital of Sun Yat-Sen University, Shenzhen, China
| | - Qianyu He
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yongmei Zeng
- Department of Endocrinology and Metabolism, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Li Cheng
- School of Nursing, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Yu Y, Chang C, Wu Y, Guo C, Xie L. Dose-effect relationship between brisk walking and blood pressure in Chinese occupational population with sedentary lifestyles: Exercise and blood pressure. J Clin Hypertens (Greenwich) 2021; 23:1734-1743. [PMID: 34390121 PMCID: PMC8678794 DOI: 10.1111/jch.14340] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 01/10/2023]
Abstract
The purpose of this study was to explore the effects of brisk walking on blood pressure (BP) in Chinese Han occupational populations to identify the appropriate volume of exercise needed for BP management. Eight-hundred and two office staff with sedentary lifestyles were recruited to receive a prescription pedometer-assisted brisk walking intervention for 3 months. To evaluate exercise intervention efficiency using statistical methods, the effective steps was divided as follows: 4000- < 8000 (Level 1), 8000- < 10 000 (Level 2), 10 000-12 000 (Level 3), and > 12 000 (Level 4) steps/day. The data of 688 participants who completed the study were analyzed. After intervention, Systolic BP (SBP) and Diastolic BP (DBP) at Levels 1-3 were significantly decreased (p < .05). For participants with hypertension at baseline, all four levels demonstrated a significantly reduced SBP and DBP. In addition, there was a significant dose-effect relationship between the effective steps and the SBP. Compared with the maximum effective steps level (Level 4), the average change of SBP between level 1-3 and level 4 were statistically significant, with -3.24 mm Hg (95%CI: -5.74 to -0.74, p = .011), -2.58 mm Hg (95%CI: -4.73 to -0.43, p = .019), and -2.19 mm Hg (95%CI: -4.20 to -0.18, p = .033), respectively. For the hypertensive cohort, only the difference between Level 1 and 4 was statistically significant (Level 1 vs. Level 4: difference in means = -6.22 mm Hg, 95%CI: -12.68 to -0.24, p = .036). No significant dose-effect relationship of DBP was observed. Our findings showed brisk walking can effectively control BP in Chinese populations and a significant dose-effect relationship was found between exercise and SBP.
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Affiliation(s)
- Yingxiang Yu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Cuiqing Chang
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Yifan Wu
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Chengcheng Guo
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
| | - Lan Xie
- Institute of Sports Medicine, Peking University Third Hospital, Beijing, China
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Budhwani H, Bulls M, Naar S. Proof of Concept for the FLEX Intervention: Feasibility of Home Based Coaching to Improve Physical Activity Outcomes and Viral Load Suppression among African American Youth Living with HIV. J Int Assoc Provid AIDS Care 2021; 20:2325958220986264. [PMID: 33406973 PMCID: PMC7797566 DOI: 10.1177/2325958220986264] [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] [Indexed: 12/20/2022] Open
Abstract
FLEX is a Motivational Interviewing, home-based coaching program that
concurrently targets HIV-related and physical activity goals among African
American youth living with HIV in the United States. To create and pilot test
FLEX, we leveraged a 2-step exploratory sequential mixed methods design informed
by the ORBIT model with initial qualitative work followed by pre-post analysis
of quantitative outcomes, concluding with qualitative exit surveys. Data were
evaluated pre- and 3-months post-intervention. Recruitment was 90%. Participants
reported high program satisfaction and program adherence (76% completion rate).
Preliminary findings indicate reductions in participants’ viral loads and
improvements across 4 measures of physical activity.
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Affiliation(s)
- Henna Budhwani
- Department of Health Care Organization and Policy, 9968University of Alabama at Birmingham (UAB) School of Public Health, Birmingham, AL, USA
| | - Maurice Bulls
- Behavior Change Consulting (BCC), Kansas City, KS, USA
| | - Sylvie Naar
- Center for Translational Behavioral Science, 12236Florida State University (FSU) College of Medicine, Tallahassee, FL, USA
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Nascimento LCGD, Eustaquio JMJ, Mendes LP, Santos ROD, Barbosa Neto O. SWIM TRAINING REVERSES SOME EFFECTS OF NANDROLONE DECANOATE IN WISTAR RATS. REV BRAS MED ESPORTE 2021. [DOI: 10.1590/1517-8692202127022020_0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Introduction: The indiscriminate use of androgenic steroids may have deleterious effects on human tissue. Objectives: Evaluate the effects of chronic administration of the steroid nandrolone decanoate (DECA) on autonomic cardiovascular modulation, kidney morphometry and the association between these variables in Wistar rats subjected to physical training with swimming. Methods: Thirty-two male Wistar rats aged 20 weeks were distributed among four experimental groups according to the training received: sedentary control (SC), sedentary treated with DECA (SD), trained control (TC) and trained treated with DECA (TD). The hemodynamic parameters, including blood pressure and variations in systolic blood pressure (SBPV) and diastolic blood pressure (DBPV), and kidney morphometry were evaluated. The level of significance adopted was 5%. Results: The SD group had higher baseline SBP and DBP values when compared to the SC, TC and TD groups, which were similar to each other. The rats in the SD group had higher systolic blood pressure (SBPV) and diastolic blood pressure (DBPV) variation values and higher absolute and normalized values in the LF band of the DBPV when compared to the animals in the SC, TC and TD groups. The animals in the SD group had a significantly higher rate of kidney fibrosis compared to the SC, TC and TD groups. There were no significant differences between the sympathetic modulation of SBPV through the LF component and kidney fibrosis. Conclusions: Physical training with swimming was effective in preventing the increase in blood pressure levels and lowering the occurrence of kidney fibrosis in animals treated with anabolic steroids. Level of Evidence IV; Series of cases .
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Xiang K, Qin Z, Zhang H, Liu X. Energy Metabolism in Exercise-Induced Physiologic Cardiac Hypertrophy. Front Pharmacol 2020; 11:1133. [PMID: 32848751 PMCID: PMC7403221 DOI: 10.3389/fphar.2020.01133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/13/2020] [Indexed: 12/17/2022] Open
Abstract
Physiologic hypertrophy of the heart preserves or enhances systolic function without interstitial fibrosis or cell death. As a unique form of physiological stress, regular exercise training can trigger the adaptation of cardiac muscle to cause physiological hypertrophy, partly due to its ability to improve cardiac metabolism. In heart failure (HF), cardiac dysfunction is closely associated with early initiation of maladaptive metabolic remodeling. A large amount of clinical and experimental evidence shows that metabolic homeostasis plays an important role in exercise training, which is conducive to the treatment and recovery of cardiovascular diseases. Potential mechanistic targets for modulation of cardiac metabolism have become a hot topic at present. Thus, exploring the energy metabolism mechanism in exercise-induced physiologic cardiac hypertrophy may produce new therapeutic targets, which will be helpful to design novel effective strategies. In this review, we summarize the changes of myocardial metabolism (fatty acid metabolism, carbohydrate metabolism, and mitochondrial adaptation), metabolically-related signaling molecules, and probable regulatory mechanism of energy metabolism during exercise-induced physiological cardiac hypertrophy.
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Affiliation(s)
- Kefa Xiang
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Zhen Qin
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Huimin Zhang
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
| | - Xia Liu
- Department of Clinical Pharmacy, School of Pharmacy, Second Military Medical University, Shanghai, China
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Goessler KF, Peçanha T. A call for attention: Is it time to revise the exercise guidelines for hypertension in African and Asian populations? Eur J Prev Cardiol 2019; 27:455-456. [PMID: 31490088 DOI: 10.1177/2047487319874896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Karla F Goessler
- Department of Physical Education, Filadelfia University Center, Brazil
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