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Heiston EM, Ballantyne A, La Salvia S, Musante L, Erdbrügger U, Malin SK. Acute exercise decreases insulin-stimulated extracellular vesicles in conjunction with augmentation index in adults with obesity. J Physiol 2023; 601:5033-5050. [PMID: 35081660 PMCID: PMC9314457 DOI: 10.1113/jp282274] [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] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 01/04/2022] [Indexed: 11/08/2022] Open
Abstract
Extracellular vesicles (EVs) are often elevated in obesity and may modulate disease risk. Although acute exercise reduces fasting EVs in adults with obesity, no data exist on insulin-mediated EV responses. This study evaluated the effects of exercise on EV responses to insulin in relation to vascular function. Ten (5M/5F) sedentary adults with obesity (34.3 ± 3.7 kg/m2 ) completed an evening control and acute exercise condition (70%V ̇ O 2 max ${\dot{V}_{{{\rm{O}}_{\rm{2}}}{\rm{max}}}}$ to expend 400 kcal). Following an overnight fast, participants underwent a 2 h euglycaemic-hyperinsulinaemic clamp (90 mg/dl; 40 mU/m2 /min) to determine metabolic insulin sensitivity (M-value), phenotypes of medium- to large-sized EVs, and aortic waveform measures. Endothelial (CD105+ , CD41- /CD31+ )-, leukocyte (CD45+ )-, platelet (CD41+ , CD41+ /31+ )- and tetraspanin (TX+ )-derived EVs, as well as platelet endothelial cell adhesion molecule (CD31+ ), were determined before and after the clamp using high resolution spectral flow cytometry. Although exercise did not alter fasting haemodynamics, it lowered the augmentation index (AIx75, P = 0.024) and increased the M-value (P = 0.042). Further, exercise decreased all fasting EVs (P < 0.01) and decreased insulin-stimulated TX+ (P = 0.060), CD31+ (P = 0.060) and CD41- /31+ (P = 0.045) compared to rest. Interestingly, greater insulin-stimulated decreases in CD41- /31+ were associated with reduced AIx75 during the clamp (r = 0.62, P = 0.059), while insulin-stimulated decreases in CD41+ (r = -0.68, P = 0.031), CD41+ /31+ (r = -0.69, P = 0.262), TX+ (r = -0.66, P = 0.037) and CD31+ (r = -0.69, P = 0.028) correlated with M-value following exercise. Thus, acute exercise may decrease fasting and insulin-stimulated medium- to large-size EVs in conjunction with improved M-value and AIx75. More research is needed to understand effects of exercise on EVs in the regulation of glucose homeostasis and vascular function. KEY POINTS: Extracellular vesicles (EVs) are increased in states of obesity and may play a role in altered insulin sensitivity and blood pressure; aerobic exercise decreases fasting EV concentrations the following day in adults with obesity. This study directly tested the effects of insulin on EVs and how a single bout of exercise impacts these responses. Together, these data highlight the positive effects of a single bout of exercise on fasting and insulin-stimulated EVs, with the latter relating to increased insulin sensitivity and decreased augmentation index. These results support future research identifying EVs as mechanistic factors in glucose regulation and vascular function as well as clinical use of exercise to reduce cardiovascular disease risk.
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Affiliation(s)
- Emily M. Heiston
- Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA
- Department of Kinesiology, University of Virginia, VA
| | | | - Sabrina La Salvia
- Division of Nephrology, Department of Medicine, University of Virginia, VA
| | - Luca Musante
- Division of Nephrology, Department of Medicine, University of Virginia, VA
| | - Uta Erdbrügger
- Division of Nephrology, Department of Medicine, University of Virginia, VA
| | - Steven K. Malin
- Department of Kinesiology, University of Virginia, VA
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ
- Division of Endocrinology, Metabolism & Nutrition, Department of Medicine, New Brunswick, NJ
- The New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ
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Khalafi M, Sakhaei MH, Kazeminasab F, Rosenkranz SK, Symonds ME. Exercise training, dietary intervention, or combined interventions and their effects on lipid profiles in adults with overweight and obesity: A systematic review and meta-analysis of randomized clinical trials. Nutr Metab Cardiovasc Dis 2023; 33:1662-1683. [PMID: 37414662 DOI: 10.1016/j.numecd.2023.05.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 05/09/2023] [Accepted: 05/18/2023] [Indexed: 07/08/2023]
Abstract
AIMS We performed a systematic review and meta-analysis to compare the effects of Ex (exercise training) vs. DI (dietary intervention) vs. combined Ex and DI on total cholesterol (TC), low-density lipoprotein cholesterol (LDL), triglycerides (TG), and high-density lipoprotein cholesterol (HDL) in adults with overweight and obesity. DATA SYNTHESIS PubMed, Web of Science, and Scopus were searched to identify original articles published until March 2022, using keywords for the categories "exercise training," "dietary intervention," "overweight and obesity," and "randomized." Studies that included lipid profiles as outcomes and performed in adults with body mass indexes (BMIs) ≥ 25 kg/m2 were included. A total of 80 studies involving 4804 adult participants were included in the meta-analysis. Ex was not as effective as DI for reducing TC and TG and was less effective for reducing LDL. In addition, Ex increased HDL to a greater extent than DI. Combined interventions decreased TC, TG, and LDL but did not increase HDL more than Ex alone. Combined interventions failed to reduce TC or LDL but decreased TG and increased HDL more than DI alone. CONCLUSIONS Our results suggest that the combination of Ex and DI can be more effective than either Ex or DI alone in improving lipid profiles in adults with overweight and obesity.
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Affiliation(s)
- Mousa Khalafi
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Mohammad Hossein Sakhaei
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Guilan, Guilan, Iran.
| | - Fatemeh Kazeminasab
- Department of Physical Education and Sport Sciences, Faculty of Humanities, University of Kashan, Kashan, Iran.
| | - Sara K Rosenkranz
- Department of Kinesiology and Nutrition Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA.
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, United Kingdom.
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Faiz H, Malin SK. A low-calorie diet raises β-aminoisobutyric acid in relation to glucose regulation and leptin independent of exercise in women with obesity. Front Physiol 2023; 14:1210567. [PMID: 37362426 PMCID: PMC10289796 DOI: 10.3389/fphys.2023.1210567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 05/31/2023] [Indexed: 06/28/2023] Open
Abstract
Introduction: β-aminoisobutyric acid (BAIBA) is a suggested cytokine secreted from skeletal muscles that regulates insulin sensitivity, pancreatic function, and fat oxidation. However, no studies to date have examined if a low-calorie diet (LCD) or LCD + with interval exercise (LCD + INT) differentially raises BAIBA. The purpose was to examine if LCD or LCD + INT raises circulating BAIBA in relation to cardiometabolic health. Methods: For this, twenty-three women with obesity were randomized to either 2-weeks of LCD (n = 12, 48.4 ± 2.5 y, 37.84 ± 1.5 kg/m2; ∼1200 kcal/day) or LCD + INT (n = 11, 47.6 ± 4.3 y, 37.9 ± 2.3 kg/m2; ∼60 min/d of INT alternating 3 min of 90% and 50% HRpeak), with matched energy availability. Fasting BAIBA and adipokines along with glucose, insulin, C-peptide, and FFA after every 30 min up to 120 min were obtained during a 75 g OGTT to estimate total area under the curve (tAUC), insulin sensitivity (SIIS), pancreatic function [disposition index (DI)], and hepatic insulin clearance (HIC). Fuel use (indirect calorimetry) was tested at 0, 60, and 120 min of the OGTT along with fitness (VO2peak) and body composition (BodPod). Results: Both treatments lowered body weight (p < 0.001) and leptin (p < 0.001) but raised BAIBA (p = 0.007) and insulin sensitivity (p = 0.02). LCD + INT increased VO2peak (p = 0.02) and REE tAUC120min (p = 0.02) while LCD and LCD + INT decreased carbohydrate oxidation (CHOox) tAUC120min (p < 0.001). Increased BAIBA associated with reduced weight (r = -0.67, p < 0.001), leptin (r = -0.66, p = 0.001), CHOox tAUC120min (r = -0.44, p = 0.03) and DImuscle120min (r = -0.45, p = 0.03), but elevated HIC120min (r = 0.47, p = 0.02). Discussion: Concluding, LCD and LCD + INT increased BAIBA in relation to reduced body weight and pancreatic function in women with obesity. This suggests energy deficit is a key factor regulating circulating BAIBA.
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Affiliation(s)
- Habiba Faiz
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ, United States
- University of Virginia, Charlottesville, VA, United States
- Division of Endocrinology, Metabolism and Nutrition, Rutgers University, New Brunswick, NJ, United States
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ, United States
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ, United States
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Sergeeva E, Ruksha T, Fefelova Y. Effects of Obesity and Calorie Restriction on Cancer Development. Int J Mol Sci 2023; 24:ijms24119601. [PMID: 37298551 DOI: 10.3390/ijms24119601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/25/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023] Open
Abstract
The risk of malignant tumor development is increasing in the world. Obesity is an established risk factor for various malignancies. There are many metabolic alterations associated with obesity which promote cancerogenesis. Excessive body weight leads to increased levels of estrogens, chronic inflammation and hypoxia, which can play an important role in the development of malignancies. It is proved that calorie restriction can improve the state of patients with various diseases. Decreased calorie uptake influences lipid, carbohydrate and protein metabolism, hormone levels and cell processes. Many investigations have been devoted to the effects of calorie restriction on cancer development in vitro and in vivo. It was revealed that fasting can regulate the activity of the signal cascades including AMP-activated protein kinase (AMPK), mitogen-activated protein kinase (MAPK), p53, mTOR, insulin/ insulin-like growth factor 1 (IGF1) and JAK-STAT. Up- or down-regulation of the pathways results in the decrease of cancer cell proliferation, migration and survival and the increase of apoptosis and effects of chemotherapy. The aim of this review is to discuss the connection between obesity and cancer development and the mechanisms of calorie restriction influence on cancerogenesis that stress the importance of further research of calorie restriction effects for the inclusion of this approach in clinical practice.
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Affiliation(s)
- Ekaterina Sergeeva
- Department of Pathological Physiology, Krasnoyarsk State Medical University, No. 1 P. Zheleznyaka Str., 660022 Krasnoyarsk, Russia
| | - Tatiana Ruksha
- Department of Pathological Physiology, Krasnoyarsk State Medical University, No. 1 P. Zheleznyaka Str., 660022 Krasnoyarsk, Russia
| | - Yulia Fefelova
- Department of Pathological Physiology, Krasnoyarsk State Medical University, No. 1 P. Zheleznyaka Str., 660022 Krasnoyarsk, Russia
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Lobene AJ, Ragland TJ, Lennon SL, Malin SK. Nutrition Interactions With Exercise Training on Endothelial Function. Exerc Sport Sci Rev 2023; 51:57-64. [PMID: 36700665 PMCID: PMC10033354 DOI: 10.1249/jes.0000000000000312] [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] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Exercise is advised to improve overall cardiovascular health and endothelial function. However, the role of nutrition on this exercise-induced endothelial adaptation is not clear. Here, we hypothesize that nutrients interact with exercise to influence endothelial function and chronic disease risk.
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Affiliation(s)
- Andrea J. Lobene
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE
| | - Tristan J. Ragland
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ
| | - Shannon L. Lennon
- Department of Kinesiology & Applied Physiology, University of Delaware, Newark, DE
| | - Steven K. Malin
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ
- Division of Endocrinology, Metabolism & Nutrition, Department of Medicine, New Brunswick, NJ
- The New Jersey Institute for Food, Nutrition &Health, Rutgers University, New Brunswick, NJ
- Institute of Translational Medicine & Science, Rutgers University, New Brunswick, NJ
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Battillo DJ, Malin SK. Impact of Caloric Restriction and Exercise on Trimethylamine N-Oxide Metabolism in Women with Obesity. Nutrients 2023; 15:1455. [PMID: 36986183 PMCID: PMC10058428 DOI: 10.3390/nu15061455] [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: 02/13/2023] [Revised: 03/04/2023] [Accepted: 03/15/2023] [Indexed: 03/19/2023] Open
Abstract
Trimethylamine N-oxide (TMAO) is linked to cardiovascular disease (CVD) through partly altered central hemodynamics. We sought to examine if a low-calorie diet plus interval exercise (LCD+INT) intervention reduces TMAO more than a low-calorie diet (LCD) program alone in relation to hemodynamics, prior to clinically meaningful weight loss. Women with obesity were randomized to 2 weeks of LCD (n = 12, ~1200 kcal/d) or LCD+INT (n = 11; 60 min/d, 3 min at 90% and 50% HRpeak, respectively). A 180 min 75 g OGTT was performed to assess fasting TMAO and precursors (carnitine, choline, betaine, and trimethylamine (TMA)) as well as insulin sensitivity. Pulse wave analysis (applanation tonometry) including augmentation index (AIx75), pulse pressure amplification (PPA), forward (Pf) and backward pressure (Pb) waveforms, and reflection magnitude (RM) at 0, 60, 120, and 180 min was also analyzed. LCD and LCD+INT comparably reduced weight (p < 0.01), fasting glucose (p = 0.05), insulin tAUC180min (p < 0.01), choline (p < 0.01), and Pf (p = 0.04). Only LCD+INT increased VO2peak (p = 0.03). Despite no overall treatment effect, a high baseline TMAO was associated with decreased TMAO (r = -0.45, p = 0.03). Reduced TMAO was related to increased fasting PPA (r = -0.48, p = 0.03). Lowered TMA and carnitine correlated with higher fasting RM (r = -0.64 and r = -0.59, both p < 0.01) and reduced 120 min Pf (both, r = 0.68, p < 0.01). Overall, treatments did not lower TMAO. Yet, people with high TMAO pre-treatment reduced TMAO after LCD, with and without INT, in relation to aortic waveforms.
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Affiliation(s)
- Daniel J. Battillo
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22903, USA
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA
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7
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Battillo DJ, Malin SK. Relation of Aortic Waveforms with Gut Hormones following Continuous and Interval Exercise among Older Adults with Prediabetes. Metabolites 2023; 13:137. [PMID: 36837756 PMCID: PMC9967213 DOI: 10.3390/metabo13020137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Prediabetes raises cardiovascular disease risk, in part through elevated aortic waveforms. While insulin is a vasodilatory hormone, the gut hormone relation to aortic waveforms is less clear. We hypothesized that exercise, independent of intensity, would favor aortic waveforms in relation to gut hormones. Older adults (61.3 ± 1.5 yr; 33.2 ± 1.1 kg/m2) with prediabetes (ADA criteria) were randomized to undertake 60 min of work-matched continuous (CONT, n = 14) or interval (INT, n = 14) exercise for 2 wks. During a 180 min 75-g OGTT, a number of aortic waveforms (applanation tonometry) were assessed: the augmentation pressure (AP) and index (AIx75), brachial (bBP) and central blood pressure (cBP), pulse pressure (bPP and cPP), pulse pressure amplification (PPA), and forward (Pf) and backward pressure (Pb) waveforms. Acylated-ghrelin (AG), des-acylated ghrelin (dAG), GIP, and GLP-1active were measured, and correlations were co-varied for insulin. Independent of intensity, exercise increased VO2peak (p = 0.01) and PPA120min (p = 0.01) and reduced weight (p < 0.01), as well as AP120min (p = 0.02) and AIx75120min (p < 0.01). CONT lowered bSBP (p < 0.02) and bDBP (p < 0.02) tAUC180min more than INT. There were decreases dAG0min related to Pb120min (r = 0.47, p = 0.03), cPP120min (r = 0.48, p = 0.02), and AP120min (r = 0.46, p = 0.02). Declines in AG tAUC60min correlated with lower Pb120min (r = 0.47, p = 0.03) and cPP120min (r = 0.49, p = 0.02) were also found. GLP-1active 0min was reduced associated with lowered AP180min (r = 0.49, p = 0.02). Thus, while CONT exercise favored blood pressure, both intensities of exercise improved aortic waveforms in relation to gut hormones after controlling for insulin.
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Affiliation(s)
- Daniel J. Battillo
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
| | - Steven K. Malin
- Department of Kinesiology and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Department of Kinesiology, University of Virginia, Charlottesville, VA 22903, USA
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA
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Remchak ME, Heiston EM, Ballantyne A, Dotson B, Malin SK. Aortic waveform responses to insulin in late versus early chronotype with metabolic syndrome. Physiol Rep 2022; 10:e15473. [PMID: 36301720 PMCID: PMC9612142 DOI: 10.14814/phy2.15473] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 08/31/2022] [Indexed: 11/17/2022] Open
Abstract
Late chronotype (LC) correlates with reduced metabolic insulin sensitivity and cardiovascular disease. It is unclear if insulin action on aortic waveforms and inflammation is altered in LC versus early chronotype (EC). Adults with metabolic syndrome (n = 39, MetS) were classified as either EC (Morning-Eveningness Questionnaire [MEQ] = 63.5 ± 1.2) or LC (MEQ = 45.5 ± 1.3). A 120 min euglycemic clamp (40 mU/m<sup>2</sup> /min, 90 mg/dL) with indirect calorimetry was used to determine metabolic insulin sensitivity (glucose infusion rate [GIR]) and nonoxidative glucose disposal (NOGD). Aortic waveforms via applanation tonometry and inflammation by blood biochemistries were assessed at 0 and 120 min of the clamp. LC had higher fat-free mass and lower VO<sub>2</sub> max, GIR, and NOGD (between groups, all p ≤ 0.05) than EC. Despite no difference in 0 min waveforms, both groups had insulin-stimulated elevations in pulse pressure amplification with reduced AIx75 and augmentation pressure (AP; time effect, p ≤ 0.05). However, EC had decreased forward pressure (Pf; interaction effect, p = 0.007) with insulin versus rises in LC. Although LC had higher tumor necrosis factor-α (TNF-α; group effect, p ≤ 0.01) than EC, both LC and EC had insulin-stimulated increases in TNF-α and decreases in hs-CRP (time effect, both p ≤ 0.01). Higher MEQ scores related to greater insulin-stimulated reductions in AP (r = -0.42, p = 0.016) and Pf (r = -0.41, p = 0.02). VO<sub>2</sub> max correlated with insulin-mediated reductions in AIx75 (r = -0.56, p < 0.01) and AP (r = -0.49, p < 0.01). NOGD related to decreased AP (r = -0.44, p = 0.03) and Pf (r = -0.43, p = 0.04) during insulin infusion. LC was depicted by blunted forward pressure waveform responses to insulin and higher TNF-α in MetS. More work is needed to assess endothelial function across chronotypes.
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Affiliation(s)
| | - Emily M. Heiston
- University of VirginiaCharlottesvilleVirginiaUSA,Virginia Commonwealth UniversityRichmondVirginiaUSA
| | | | | | - Steven K. Malin
- Rutgers UniversityNew BrunswickNew JerseyUSA,University of VirginiaCharlottesvilleVirginiaUSA,Division of Endocrinology, Metabolism & NutritionRutgers UniversityNew BrunswickNew JerseyUSA,New Jersey Institute for Food, Nutrition and HealthRutgers UniversityNew BrunswickNew JerseyUSA,Institute of Translational Medicine and ScienceRutgers UniversityNew BrunswickNew JerseyUSA
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Akter S, Akhter H, Chaudhury HS, Rahman MH, Gorski A, Hasan MN, Shin Y, Rahman MA, Nguyen MN, Choi TG, Kim SS. Dietary carbohydrates: Pathogenesis and potential therapeutic targets to obesity-associated metabolic syndrome. Biofactors 2022; 48:1036-1059. [PMID: 36102254 DOI: 10.1002/biof.1886] [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: 05/11/2022] [Accepted: 07/01/2022] [Indexed: 02/06/2023]
Abstract
Metabolic syndrome (MetS) is a common feature in obesity, comprising a cluster of abnormalities including abdominal fat accumulation, hyperglycemia, hyperinsulinemia, dyslipidemia, and hypertension, leading to diabetes and cardiovascular diseases (CVD). Intake of carbohydrates (CHO), particularly a sugary diet that rapidly increases blood glucose, triglycerides, and blood pressure levels is the predominant determining factor of MetS. Complex CHO, on the other hand, are a stable source of energy taking a longer time to digest. In particular, resistant starch (RS) or soluble fiber is an excellent source of prebiotics, which alter the gut microbial composition, which in turn improves metabolic control. Altering maternal CHO intake during pregnancy may result in the child developing MetS. Furthermore, lifestyle factors such as physical inactivity in combination with dietary habits may synergistically influence gene expression by modulating genetic and epigenetic regulators transforming childhood obesity into adolescent metabolic disorders. This review summarizes the common pathophysiology of MetS in connection with the nature of CHO, intrauterine nutrition, genetic predisposition, lifestyle factors, and advanced treatment approaches; it also emphasizes how dietary CHO may act as a key element in the pathogenesis and future therapeutic targets of obesity and MetS.
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Affiliation(s)
- Salima Akter
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Medical Biotechnology, Bangladesh University of Health Sciences, Dhaka 1216, Bangladesh
| | - Hajara Akhter
- Biomedical and Toxicological Research Institute, Bangladesh Council of Scientific and Industrial Research (BCSIR), Dhaka 1205, Bangladesh
| | - Habib Sadat Chaudhury
- Department of Biochemistry, International Medical College Hospital, Tongi 1711, Bangladesh
| | - Md Hasanur Rahman
- Department of Biotechnology and Genetic Engineering, Bangabandhu Sheikh Mujibur Rahman Science and Technology University, Gopalganj 8100, Bangladesh
| | - Andrew Gorski
- Department of Philosophy in Korean Medicine, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
| | | | - Yoonhwa Shin
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Biomedical Science Institute, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Md Ataur Rahman
- Department of Pathology, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Korean Medicine-Based Drug Repositioning Cancer Research Center, College of Korean Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Global Biotechnology & Biomedical Research Network (GBBRN), Department of Biotechnology and Genetic Engineering, Faculty of Biological Sciences, Islamic University, Kushtia 7003, Bangladesh
| | - Minh Nam Nguyen
- Research Center for Genetics and Reproductive Health, School of Medicine, Vietnam National University, Ho Chi Minh City, Vietnam
| | - Tae Gyu Choi
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
| | - Sung-Soo Kim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul 02447, Republic of Korea
- Pristine Pharmaceuticals, Patuakhali 8600, Bangladesh
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul 02447, Republic of Korea
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Starzak M, Stanek A, Jakubiak GK, Cholewka A, Cieślar G. Arterial Stiffness Assessment by Pulse Wave Velocity in Patients with Metabolic Syndrome and Its Components: Is It a Useful Tool in Clinical Practice? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610368. [PMID: 36012003 PMCID: PMC9407885 DOI: 10.3390/ijerph191610368] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/17/2022] [Accepted: 08/18/2022] [Indexed: 05/07/2023]
Abstract
Metabolic syndrome (MS) is not a single disease but a cluster of metabolic disorders associated with increased risk for development of diabetes mellitus and its complications. Currently, the definition of MS published in 2009 is widely used, but there are more versions of the diagnostic criteria, making it difficult to conduct scientific discourse in this area. Increased arterial stiffness (AS) can predict the development of cardiovascular disease both in the general population and in patients with MS. Pulse wave velocity (PWV), as a standard method to assess AS, may point out subclinical organ damage in patients with hypertension. The decrease in PWV level during antihypertensive therapy can identify a group of patients with better outcomes independently of their reduction in blood pressure. The adverse effect of metabolic disturbances on arterial function can be offset by an adequate program of exercises, which includes mainly aerobic physical training. Non-insulin-based insulin resistance index can predict AS due to a strong positive correlation with PWV. The purpose of this paper is to present the results of the review of the literature concerning the relationship between MS and its components, and AS assessed by PWV, including clinical usefulness of PWV measurement in patients with MS and its components.
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Affiliation(s)
- Monika Starzak
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Specialistic Hospital No. 2 in Bytom, Batorego 15 St., 41-902 Bytom, Poland
| | - Agata Stanek
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
- Correspondence: or
| | - Grzegorz K. Jakubiak
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
| | - Armand Cholewka
- Faculty of Science and Technology, University of Silesia, Bankowa 12 St., 40-007 Katowice, Poland
| | - Grzegorz Cieślar
- Department and Clinic of Internal Medicine, Angiology, and Physical Medicine, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Batorego 15 St., 41-902 Bytom, Poland
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Effect of High-Intensity Interval Training Combined with Fasting in the Treatment of Overweight and Obese Adults: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084638. [PMID: 35457507 PMCID: PMC9030367 DOI: 10.3390/ijerph19084638] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 04/05/2022] [Accepted: 04/06/2022] [Indexed: 02/06/2023]
Abstract
Objectives: A systematic review and meta-analysis is conducted to compare the effects of high-intensity interval training (HIIT) combined with fasting (HIIT + fasting) and other interventions (HIIT alone, fasting alone, or normal intervention) in adults with overweight and obesity on body composition (body mass, body mass index (BMI), waist circumference (WC), percent fat mass (PFM), fat mass (FM), fat-free mass (FFM)), maximal oxygen uptake (VO2peak), and glucose metabolism (fasting plasma glucose (FPG)), fasting plasma insulin (FPI)). Methods: The databases of PubMed, the Cochrane Library, Embace, Web of Science, CNKI, Wangfang Data, and CBM were searched from their inception to February 2022. Randomized controlled trials comparing the effects of HIIT + fasting and other interventions on adults with overweight and obesity were included in this meta-analysis. The risk of bias was assessed by the Cochrane risk of bias tool. The effect size was completed by using mean difference (MD) and standard deviation. If there were varying units or large differences among the included studies, the standardized mean difference (SMD) would be used. The certainty of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Results: Nine randomized controlled trials with 230 overweight and obese adults were conducted in accordance with our inclusion criteria. The results of the meta-analysis revealed that compared to the control group HIIT + fasting had better effects on the body mass, WC, FM, and VO2peak, while there were no significant differences in PFM, FFM, FPG, and FPI. Conclusions: Despite the number of included trials being small and the GRADE of all outcomes being very low, HIIT + fasting has a positive effect on the body composition of overweight and obese adults, and significantly improves VO2peak. For adults with overweight and obesity who have long-term comorbidity, HIIT + fasting was a better way to improve FPG than HIIT alone or fasting alone. More studies are required to investigate different combinations of HIIT + fasting; and the safety of HIIT + fasting intervention on overweight and obese adults.
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Remchak MME, Piersol KL, Bhatti S, Spaeth AM, Buckman JF, Malin SK. Considerations for Maximizing the Exercise "Drug" to Combat Insulin Resistance: Role of Nutrition, Sleep, and Alcohol. Nutrients 2021; 13:1708. [PMID: 34069950 PMCID: PMC8157556 DOI: 10.3390/nu13051708] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/24/2021] [Accepted: 05/13/2021] [Indexed: 01/12/2023] Open
Abstract
Insulin resistance is a key etiological factor in promoting not only type 2 diabetes mellitus but also cardiovascular disease (CVD). Exercise is a first-line therapy for combating chronic disease by improving insulin action through, in part, reducing hepatic glucose production and lipolysis as well as increasing skeletal muscle glucose uptake and vasodilation. Just like a pharmaceutical agent, exercise can be viewed as a "drug" such that identifying an optimal prescription requires a determination of mode, intensity, and timing as well as consideration of how much exercise is done relative to sitting for prolonged periods (e.g., desk job at work). Furthermore, proximal nutrition (nutrient timing, carbohydrate intake, etc.), sleep (or lack thereof), as well as alcohol consumption are likely important considerations for enhancing adaptations to exercise. Thus, identifying the maximal exercise "drug" for reducing insulin resistance will require a multi-health behavior approach to optimize type 2 diabetes and CVD care.
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Affiliation(s)
- Mary-Margaret E. Remchak
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Kelsey L. Piersol
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Sabha Bhatti
- Division of Cardiovascular Medicine, Rutgers University, New Brunswick, NJ 08901, USA;
| | - Andrea M. Spaeth
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
| | - Jennifer F. Buckman
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
- Center of Alcohol Studies, Rutgers University, Piscataway, NJ 08854, USA
| | - Steven K. Malin
- Department of Kinesiology & Health, Rutgers University, New Brunswick, NJ 08901, USA; (M.-M.E.R.); (K.L.P.); (A.M.S.); (J.F.B.)
- Division of Endocrinology, Metabolism & Nutrition, Rutgers University, New Brunswick, NJ 08901, USA
- New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, NJ 08901, USA
- Institute of Translational Medicine and Science, Rutgers University, New Brunswick, NJ 08901, USA
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Dotson BL, Heiston EM, Miller SL, Malin SK. Insulin stimulation reduces aortic wave reflection in adults with metabolic syndrome. Am J Physiol Heart Circ Physiol 2021; 320:H2305-H2312. [PMID: 33861146 DOI: 10.1152/ajpheart.00975.2020] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Adults with metabolic syndrome (MetS) have increased fasting arterial stiffness and altered central hemodynamics that contribute, partly, to increased cardiovascular disease (CVD) risk. Although insulin affects aortic wave reflections in healthy adults, the effects in individuals with MetS are unclear. We hypothesized that insulin stimulation would reduce measures of pressure waveforms and hemodynamics in people with MetS. Thirty-five adults with obesity (27 women; 54.2 ± 6.0 yr; 37.1 ± 4.8 kg/m2) were selected for MetS (ATP III criteria) following an overnight fast. Pulse wave analysis was assessed using applanation tonometry before and after a 2-h euglycemic-hyperinsulinemic clamp (90 mg/dL, 40 mU/m2/min). Deconvolution analysis was used to decompose the aortic waveform [augmentation index corrected to heart rate of 75 beats/min (AIx@75); augmentation pressure (AP)] into backward and forward pressure components. Aerobic fitness (V̇o2max), body composition (DXA), and blood biochemistries were also assessed. Insulin significantly reduced augmentation index (AIx@75, 28.0 ± 9.6 vs. 23.0 ± 9.9%, P < 0.01), augmentation pressure (14.8 ± 6.4 vs. 12.0 ± 5.7 mmHg, P < 0.01), pulse pressure amplification (1.26 ± 0.01 vs. 0.03 ± 0.01, P = 0.01), and inflammation [high-sensitivity C-reactive protein (hsCRP): P = 0.02; matrix metallopeptidase 7 (MMP-7): P = 0.03] compared to fasting. In subgroup analyses to understand HTN influence, there were no insulin stimulation differences on any outcome. V̇o2max, visceral fat, and blood potassium correlated with fasting AIx@75 (r = -0.39, P = 0.02; r = 0.41, P = 0.03; r = -0.53, P = 0.002). Potassium levels were also associated with insulin-mediated reductions in AP (r = 0.52, P = 0.002). Our results suggest insulin stimulation improves indices of aortic reflection in adults with MetS.NEW & NOTEWORTHY This study is one of the first to investigate the effects of insulin on central and peripheral hemodynamics in adults with metabolic syndrome. We provide evidence that insulin infusion reduces aortic wave reflection, potentially through a reduction in inflammation and/or via a potassium-mediated vascular response.
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Affiliation(s)
- Brielle L Dotson
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Emily M Heiston
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia.,Division of Cardiology, Pauley Heart Center, Virginia Commonwealth University, Richmond, Virginia
| | - Stephanie L Miller
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia
| | - Steven K Malin
- Department of Kinesiology, University of Virginia, Charlottesville, Virginia.,Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey.,Division of Endocrinology, Metabolism and Nutrition; Rutgers University, New Brunswick, New Jersey.,New Jersey Institute for Food, Nutrition and Health, Rutgers University, New Brunswick, New Jersey.,Institute of Translational Medicine and Science, Rutgers University, New Brunswick, New Jersey
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