Long-term effect of different physical activity levels on subclinical atherosclerosis in middle-aged men: a 25-year prospective study

Structured Moderate Exercise and Biomarkers of Kidney Health in Sedentary Older Adults: The Lifestyle Interventions and Independence for Elders Randomized Clinical Trial

Rationale & Objective

In the Lifestyle Interventions and Independence for Elders (LIFE) trial, a structured exercise intervention slowed kidney function decline in sedentary older adults. Biomarkers of kidney health could distinguish potential mechanisms for this beneficial effect.

Study Design

Randomized controlled trial.

Setting & Population

A total of 1,381 sedentary adults aged 70-89 years enrolled in the LIFE trial.

Intervention

Structured, 2-year, moderate-intensity exercise intervention versus health education.

Outcomes

Physical activity was measured by step count. Primary outcomes were changes in 14 serum and urine biomarkers of kidney health collected at baseline, year 1, and year 2. We determined the effect of randomization on changes in kidney measures and then evaluated observational associations of achieved activity on each measure.

Results

Participants assigned to exercise walked on average 291 more steps per day than participants assigned to health education. The intervention was not significantly associated with changes in biomarkers of kidney health. In observational analyses, persons in the highest versus lowest quartile of activity (≥3,470 vs <1,568 steps/day) had significant improvement in urine albumin (mean, -0.22 mg albumin/g urine creatinine [interquartile range (IQR), -0.37 to -0.06]), alpha-1-microglobulin (-0.18 mg/L [-0.28 to -0.08]), trefoil factor-3 (-0.24 pg/mL [-0.35 to -0.13]), epidermal growth factor (0.19 pg/mL [0.06-0.32]), uromodulin (0.06 pg/mL [0.00-0.12]), interleukin 18 (-0.09 pg/mL [-0.15 to -0.03]), neutrophil gelatinase-associated lipocalin (-0.16 pg/mL [-0.24 to -0.07]), monocyte chemoattractant protein-1 (-0.25 pg/mL [-0.36 to -0.14]), clusterin (-0.16 pg/mL [-0.30 to -0.02]), serum tumor necrosis factor receptor-1 (-0.25 mg/dL [-0.39 to -0.11]) and tumor necrosis factor receptor-2 (-0.30 mg/dL [-0.44 to -0.16]). In sensitivity analyses, incremental changes in activity were most impactful on urine interleukin 18 and serum tumor necrosis factor-1.

Limitations

The original study was not designed to assess the impact on kidney health. Non-white individuals and patients with advanced chronic kidney disease are underrepresented.

Conclusions

Randomization to structured exercise did not improve kidney health at a group level. However, higher exercise was associated with concurrent improvements in biomarkers of glomerular injury, tubular function/repair, tubular injury, generalized inflammation, and tubulointerstitial repair/fibrosis.

Plain-Language Summary

In the Lifestyle Interventions For Elders (LIFE) study, randomization to an exercise and physical activity intervention improved the slope of estimated glomerular filtration rate over 2 years compared with health education among older adults. In this study, we sought to determine whether there were specific biomarkers of kidney health that were affected by the exercise and physical activity intervention to investigate potential mechanisms for this positive impact on kidney decline. We found that randomization to the intervention did not improve any of the 14 measures of kidney tubule health. However, in observational analyses, higher activity was independently associated with improvements in several domains, especially tubular injury and generalized inflammation. These results help to clarify the impact of physical activity on kidney health.

ERRα Attenuates Vascular Inflammation via Enhanced NFκB Degradation Pathway

We have previously reported that β-aminoisobutyric acid (BAIBA), a muscle-derived exercise mimetic, had anti-inflammatory and reactive oxygen species (ROS) scavenging effects in vascular endothelial cells through the enhanced expression of peroxisome proliferator-activated receptor gamma coactivator-1β (PGC-1β). Although BAIBA also increased the expression of estrogen-related receptor α (ERRα), the roles of ERRα in vascular endothelial cells have yet to be fully elucidated. Here, we found that human aortic endothelial cells (HAECs) infected with ERRα-expressing adenovirus had significantly decreased mRNA levels of tumor necrosis factor α-stimulated proinflammatory molecules. However, ERRα overexpression had little effect on the mRNA levels of PGC-1β, peroxisome proliferator-activated receptors, and almost all ROS scavenging molecules, except for superoxide dismutase 2. ERRα expression significantly decreased NFκB reporter activities in a dose-dependent manner with unaltered IκBα phosphorylation levels but with a significant increase in the mRNA levels of PDZ and LIM domain protein 2 (PDLIM2) and copper metabolism gene MURR1 domain-containing protein (COMMD1), which enhance the ubiquitination and degradation of NFκB. Also, PDLIM2 and COMMD1 mRNA levels were upregulated in BAIBA-treated HAECs. Finally, we identified the ERRα-response element in the COMMD1 promoter region (-283 to -29 bp). These results indicated that ERRα exerted anti-inflammatory effects in vascular endothelial cells through COMMD1-mediated attenuation of NFκB activity, which could be an atheroprotective mechanism of physical exercise.

Physical Activity, Muscle Oxidative Capacity, and Coronary Artery Calcium in Smokers with and without COPD

Introduction

Severe chronic obstructive pulmonary disease (COPD) is partly characterized by diminished skeletal muscle oxidative capacity and concurrent dyslipidemia. It is unknown whether such metabolic derangements increase the risk of cardiovascular disease. This study explored associations among physical activity (PA), muscle oxidative capacity, and coronary artery calcium (CAC) in COPDGene participants.

Methods

Data from current and former smokers with COPD (n = 75) and normal spirometry (n = 70) were retrospectively analyzed. Physical activity was measured for seven days using triaxial accelerometry (steps/day and vector magnitude units [VMU]) along with the aggregate of self-reported PA amount and PA difficulty using the PROactive D-PPAC instrument. Muscle oxidative capacity (k) was assessed via near-infrared spectroscopy, and CAC was assessed via chest computerized tomography.

Results

Relative to controls, COPD patients exhibited higher CAC (median [IQR], 31 [0–431] vs 264 [40–799] HU; p = 0.003), lower k (mean ± SD = 1.66 ± 0.48 vs 1.25 ± 0.37 min⁻¹; p < 0.001), and lower D-PPAC total score (65.2 ± 9.9 vs 58.8 ± 13.2; p = 0.003). Multivariate analysis—adjusting for age, sex, race, diabetes, disease severity, hyperlipidemia, smoking status, and hypertension—revealed a significant negative association between CAC and D-PPAC total score (β, −0.05; p = 0.013), driven primarily by D-PPAC difficulty score (β, −0.03; p = 0.026). A 1 unit increase in D-PPAC total score was associated with a 5% lower CAC (p = 0.013). There was no association between CAC and either k, steps/day, VMU, or D-PPAC amount.

Conclusion

Patients with COPD and concomitantly elevated CAC exhibit greater perceptions of difficulty when performing daily activities. This may have implications for exercise adherence and risk of overall physical decline.

Low physical activity is associated with impaired endothelial function in patients with type 2 diabetes and controls after 5 years of follow-up

BACKGROUND

The long-term association between physical activity and endothelial function has not previously been investigated in patients with type 2 diabetes. Therefore, we aimed to evaluate the relationship between physical activity and endothelial function, assessed by peripheral arterial tonometry, in patients with type 2 diabetes and non-diabetic controls after 5 years of follow-up.

METHODS

We included 51 patients with newly diagnosed type 2 diabetes and 53 sex- and age matched controls. Participants underwent baseline clinical characterization including objective measurement of physical activity level using accelerometery. After 5 years of follow-up, participants were re-examined, and endothelial function was assessed as natural logarithm of reactive hyperemia index (lnRHI).

RESULTS

Physical activity at baseline was associated with lnRHI after 5 years of follow-up in both patients with type 2 diabetes and controls. An increase of 1 standard deviation (SD) in daytime physical activity corresponded to a 6.7 % increase in RHI (95 % confidence interval: 1.1;12.5 %, p = 0.02). We found no difference in lnRHI between patients with diabetes and controls (0.67 ± 0.29 vs. 0.73 ± 0.31, p = 0.28).

CONCLUSIONS

Daytime physical activity is associated with endothelial function after 5 years of follow-up in patients with type 2 diabetes and controls.

The Association between Changes in Coronary Artery Calcium Scores, Dietary Intake, Physical Activity, and Depression Symptoms among the Population of Gaza Strip, Palestine

Background

This study aimed to identify the association between macronutrient intake, physical activity, and depressive symptoms and changes in coronary artery calcium score among the population of Gaza Strip.

Method

The study sample consisted of 269 individuals who underwent non-enhanced coronary computed tomography using 64-slice MDCT (Siemens, Germany) at Al-Shifa medical complex between September 2017 and January 2018. The study participants were divided into two groups; group one, consisting of coronary calcium calcification scoring (CAC) of greater than zero (CAC score > 0), and group two, CAC less than or equal to zero (CAC score ≤ 0). Data about macronutrient intake, physical activity, and depressive symptoms were collected using a validated self-administered questionnaire. Additionally, the participants' anthropometric characteristics and blood biochemical markers were measured.

Results

Out of 269 participants, 45-recorded CAC score > 0; 72% of them were males with a mean age of 52.6 ± 5.4 years. Significant differences between the two groups in terms of total energy, lipid intake, and carbohydrate were found (P-value of 0.020, 0.012, and 0.034, respectively). No significant differences were recorded in protein intake, physical activity, and depression. Multivariate logistic regression analysis under adjustment for possible confounding factors revealed that macronutrient intake, physical activity, and depressive symptoms were not associated with the development of CAC in two models.

Conclusion

Based on our findings, macronutrient intake, physical activity, and depressive symptoms are not associated with the development of CAC among the population of Gaza.

The Association of Physical Activity With Carotid Intima Media Thickening in a Healthy Older Population: Cooper Center Longitudinal Study

The purpose of this study was to examine the association between self-reported physical activity (PA) and mean common carotid artery intima-media thickness (CCA IMT) among older adults. The data are from 1,811 Cooper Center Longitudinal Study participants, who were aged ≥60 years, with no history of cardiovascular disease. A medical history questionnaire was used to assess PA. Carotid ultrasound was performed to measure CCA IMT and the presence of plaque and stenosis. Logistic regression models were constructed to estimate the association between PA and CCA IMT after adjustment for covariates. The participants were aged 69.2 ± 5.9 years, and the majority were male (73.3%) and White (96.7%). The odds ratio of abnormal thickening of CCA IMT was 0.72 (95% confidence interval [0.54, 0.96]) in physically active participants (≥500 metabolic equivalent·min/week) after adjustment for covariates. In the current study, meeting PA guidelines in older adulthood was associated with lower odds of abnormal thickening of CCA IMT.

Exercise and Coronary Atherosclerosis: Observations, Explanations, Relevance, and Clinical Management

Physical activity and exercise training are effective strategies for reducing the risk of cardiovascular events, but multiple studies have reported an increased prevalence of coronary atherosclerosis, usually measured as coronary artery calcification, among athletes who are middle-aged and older. Our review of the medical literature demonstrates that the prevalence of coronary artery calcification and atherosclerotic plaques, which are strong predictors for future cardiovascular morbidity and mortality, was higher in athletes compared with controls, and was higher in the most active athletes compared with less active athletes. However, analysis of plaque morphology revealed fewer mixed plaques and more often only calcified plaques among athletes, suggesting a more benign composition of atherosclerotic plaques. This review describes the effects of physical activity and exercise training on coronary atherosclerosis in athletes who are middle-aged and older and aims to contribute to the understanding of the potential adverse effects of the highest doses of exercise training on the coronary arteries. For this purpose, we will review the association between exercise and coronary atherosclerosis measured using computed tomography, discuss the potential underlying mechanisms for exercise-induced coronary atherosclerosis, determine the clinical relevance of coronary atherosclerosis in middle-aged athletes and describe strategies for the clinical management of athletes with coronary atherosclerosis to guide physicians in clinical decision making and treatment of athletes with elevated coronary artery calcification scores.

Improved carotid intima-media thickness-induced high-intensity interval training associated with decreased serum levels of Dkk-1 and sclerostin in type 2 diabetes

AIMS

Carotid intima-media thickness (cIMT) is a validated surrogate marker of atherosclerosis. Dickkopf-1 (Dkk-1) and sclerostin modulate wingless signaling, which is involved in atherosclerosis. The purpose of this study was to investigate whether 12 weeks of high-intensity interval training (HIIT) would improve cIMT and serum Dkk-1 and sclerostin levels in patients with type 2 diabetes.

METHODS

Seventy-four sedentary patients with type 2 diabetes were randomly divided into HIIT and control groups. The HIIT group intervention was 6 intervals (4 min) at 85%-90% HR_max separated by 3 min at 45%-50% HR_max in 3 sessions/week for 12 weeks. Before and after the intervention, cIMT, artery diameter and wall/lm ratio were recorded with high-resolution ultrasound. Serum sclerostin and Dkk-1 were measured by enzyme-linked immunosorbent assay (ELISA).

RESULTS

cIMT decreased significantly in the HIIT group (0.83 ± 0.17 baseline, 0.71 ± 0.14 follow-up) compared to the control group (0.84 ± 0.20 baseline, 0.85 ± 0.19 follow-up) (P < .05). Dkk-1 and sclerostin decreased significantly after 12 weeks of HIIT (P < .01). In addition, VO_2peak was increased in the HIIT group than the control group (by 6.2 mL/kg/min) (P < .05). There was a positive correlation between percent changes in cIMT and percent changes in Dkk-1 and sclerostin (both P < .01). Additionally, there were a negative correlation between percent changes VO2peak and cIMT (r = - 0.740, P = .003), Dkk-1 (r = - 0.844, P < .001) and sclerostin (r = - 0.575, P = .001) in HIIT group.

CONCLUSION

Our results indicate that HIIT decreases cIMT, serum levels of Dkk-1 and sclerostin and improves VO_2peak in patients with type 2 diabetes.

Shaping the adult brain with exercise during development: Emerging evidence and knowledge gaps

Exercise is known to produce a myriad of positive effects on the brain, including increased glia, neurons, blood vessels, white matter and dendritic complexity. Such effects are associated with enhanced cognition and stress resilience in humans and animal models. As such, exercise represents a positive experience with tremendous potential to influence brain development and shape an adult brain capable of responding to life's challenges. Although substantial evidence attests to the benefits of exercise for cognition in children and adolescents, the vast majority of existing studies examine acute effects. Nonetheless, there is emerging evidence indicating that exercise during development has positive cognitive and neural effects that last to adulthood. There is, therefore, a compelling need for studies designed to determine the extent to which plasticity driven by developmental exercise translates into enhanced brain health and function in adulthood and the underlying mechanisms. Such studies are particularly important given that modern Western society is increasingly characterized by sedentary behavior, and we know little about how this impacts the brain's developmental trajectory. This review synthesizes current literature and outlines significant knowledge gaps that must be filled in order to elucidate what exercise (or lack of exercise) during development contributes to the health and function of the adult brain.

Oxidative Stress and Inflammation, Key Targets of Atherosclerotic Plaque Progression and Vulnerability: Potential Impact of Physical Activity

Atherosclerosis, a complex cardiovascular disease, is a leading cause of mortality and morbidity worldwide. Oxidative stress and inflammation are both involved in the development of atherosclerotic plaque as they increase the biological processes associated with this pathology, such as endothelial dysfunction and macrophage recruitment and adhesion. Atherosclerotic plaque rupture leading to major ischemic events is the result of vulnerable plaque progression, which is a result of the detrimental effect of oxidative stress and inflammation on risk factors for atherosclerotic plaque rupture, such as intraplaque hemorrhage, neovascularization, and fibrous cap thickness. Thus, both are key targets for primary and secondary interventions. It is well recognized that chronic physical activity attenuates oxidative stress in healthy subjects via the improvement of antioxidant enzyme capacities and inflammation via the enhancement of anti-inflammatory molecules. Moreover, it was recently shown that chronic physical activity could decrease oxidative stress and inflammation in atherosclerotic patients. The aim of this review is to summarize the role of oxidative stress and inflammation in atherosclerosis and the results of therapeutic interventions targeting them in both preclinical and clinical studies. The effects of chronic physical activity on these two key processes are then reviewed in vulnerable atherosclerotic plaques in both coronary and carotid arteries.

Association between physical activity and sedentary behaviour on carotid atherosclerotic plaques: an epidemiological and histological study in 90 asymptomatic patients

OBJECTIVE

Carotid atherosclerotic plaques are a source of emboli for stroke. 'Unstable' carotid atherosclerotic plaques may have intraplaque haemorrhages, neovessels, prevalent macrophages, excessive calcium deposits, a large lipid core and a thin fibrous cap. Regular physical activity (PA) may lower the risk of plaques becoming unstable. We evaluated the association of both PA and sedentary behaviour (SB) with carotid plaque histopathology.

METHODS

90 asymptomatic patients who were undergoing carotid endarterectomy for carotid artery narrowing identified on ultrasound reported their PA and SB by questionnaires. We calculated PA intensity in MET (metabolic equivalent of task)-min/week. For analysis, the population was divided into tertiles according to PA (T1PA: the less PA patients; T2PA: the intermediate PA patients; T3PA: the most physically active patients) (T1PA<T2PA<T3PA) and SB (T1SB: the less sedentary behaviour patients; T2SB: the intermediate sedentary behaviour patients; T3SB: the most sedentary behaviour patients) (T1SB<T2SB<T3SB). PA was categorised as one of four PA intensities (600, 900, 1600 and 3000 MET-min/week). We obtained the carotid artery plaque at surgery and performed histological analysis of intraplaque haemorrhages (present/absent), neovessels, macrophages, lipid core, calcium deposits and the fibrous cap.

RESULTS

Intraplaque haemorrhage was less frequent in the most physically active tertile (T3PA, 48%) versus T1PA (74%) and in the least sedentary tertile T1SB (50%) versus T3SB (71%). The intraplaque haemorrhage was less frequent in those who exercised more than 900 MET-min/week (59% vs 47% for >900 and <900 MET-min/week, respectively). All the other features that associate with plaque instability (eg, neovessels, macrophages, etc) did not differ by level of PA or SB.

CONCLUSION

In this cross-sectional study of asymptomatic patients who underwent endarterectomy (i) higher reported PA, (ii) intensity of PA and (iii) lower reported SB were associated with lower prevalence of intraplaque haemorrhage. This could be a mechanism whereby PA protects against cerebrovascular disease (stroke) and death.

The combined effect of physical activity and sedentary behavior on subclinical atherosclerosis: a cross-sectional study among Mexican Americans

BACKGROUND

Physical activity and sedentary behavior are considered independent risk factors for chronic disease. However, we do not fully understand their interrelation with key health outcomes such as subclinical atherosclerosis. This study examines the combined effects of sedentary behavior and physical activity on carotid intima-media thickness (cIMT) and presence of carotid plaque in a Mexican American population on the Texas-Mexico border.

METHODS

This cross-sectional study was conducted using retrospective data from a sample (n = 612) of participants from the Cameron County Hispanic Cohort. Carotid ultrasound was used to measure cIMT and presence of carotid plaque. Self-reported questionnaires were used to assess leisure time physical activity and sedentary behavior (TV/movie sitting and total sitting). A series of multivariable regression models were used to assess study aims. An interaction term between physical activity and sedentary behavior was included in models for each respective outcome. Models were controlled for demographic and health-related variables.

RESULTS

There were no significant associations found between physical activity, sedentary behavior and mean cIMT, or cIMT thickness ≥ 75th percentile for age and gender. However, there was a significant interaction between physical activity and TV/movie sitting with presence of carotid plaque. Participants who reported moderate levels of physical activity had significantly lower odds for presence of plaque compared to participants with no activity when TV/movie sitting time was ≤3 h per day. However, there was no significant difference in odds for presence of plaque between physical activity groups when TV/movie sitting exceeded 3 h/day. These results were consistent with models examining total sitting time.

CONCLUSIONS

Our results indicate that for Mexican Americans, there is a combined effect of sedentary behavior and physical activity on presence of carotid plaque. Participating in moderate physical activity is optimal for having lower levels of carotid plaque in addition to avoiding excessive levels of TV/movie sitting (≥3 h/day) and/or total sitting (≥8.5 h/day).

Relationships between sedentary behaviour, physical activity levels and red blood cell distribution width in children and adolescents

Background: Red blood cell distribution width (RDW) is a biomarker for cardiovascular disease(CVD). RDW is associated with sedentary behavior (SB) and physical activity (PA) in adults.To date, no study has evaluated this association in children. The purpose of this study was to evaluate the association between RDW and SB and PA levels of children and adolescents.

Methods: This observational study included data from participants aged 12-20 years in the 2003–2006 National Health and Nutrition Examination Survey (NHANES). SB and PA were measured using accelerometers. Activity levels were classified into intensity categories. Sex specific multivariable regression analyses (adjusted for covariates) were used to explore the associations between SB, PA and RDW.

Results: The study included 2143 children and adolescents (1080 boys and 1063 girls). In the fully adjusted regression model for boys, SB was positively associated with RDW (β =0.116,P=0.004) while moderate PA was negatively associated with RDW (β =-0.082, P=0.048). In girls, there were no significant associations between activity levels and RDW.

Conclusion: This study provides preliminary evidence of the association between SB, moderate intensity PA and RDW in boys, but not in girls. Further research to determine the mechanisms associated with this relationship and underlying sex differences is warranted.

Ten-Year Changes in the Prevalence and Socio-Demographic Determinants of Physical Activity among Polish Adults Aged 20 to 74 Years. Results of the National Multicenter Health Surveys WOBASZ (2003-2005) and WOBASZ II (2013-2014)

Introduction

The aim of the study was to estimate ten-year changes in physical activity (PA) patterns and sociodemographic determinants among adult residents of Poland.

Methods

The study comprised two independent samples of randomly selected adults aged 20–74 years participating in the National Multicentre Health Survey WOBASZ (2003–2005; n = 14572) and WOBASZ II (2013–2014; n = 5694). In both surveys the measurements were performed by six academic centers in all 16 voivodships of Poland (108 measurement points in each survey). Sociodemographic data were collected by an interviewer-administered questionnaire in both surveys. Physical activity was assessed in three domains: leisure-time, occupational and commuting physical activity.

Results

Leisure-time PA changed substantially between the surveys (p<0.001). The prevalence of subjects being active on most days of week fell in both genders in the years 2003–2014 (37.4% vs 27.3% in men); 32.7% vs 28.3% in women. None or occasional activity increased from 49.6% to 56.8% in men, while remained stable in women (55.2% vs 54.9%). In both WOBASZ surveys the likelihood of physical inactivity was higher in less educated individuals, smokers and those living in large agglomerations (p<0.01). No significant changes were observed in occupational activity in men between the surveys, while in women percentage of sedentary work increased from 43.4% to % 49.4% (p<0.01). Commuting PA decreased significantly in both genders (p<0.001). About 79.3% of men and 71.3% of women reported no active commuting in the WOBASZ II survey.

Conclusions

The observed unfavourable changes in PA emphasize the need for novel intervention concepts in order to reverse this direction. Further detailed monitoring of PA patterns in Poland is of particular importance.

Body composition, nutritional status, and endothelial function in physically active men without metabolic syndrome--a 25 year cohort study

BACKGROUND

The purpose of this analysis was to investigate the relationship between body composition, metabolic parameters and endothelial function among physically active healthy middle-aged and older men.

METHODS

Out of 101 asymptomatic men prospectively tracked for traditional cardiovascular risk factors (mean observation period 25.1 years), 55 metabolically healthy individuals who maintained stable leisure time physical activity (LTPA) level throughout the observation and agreed to participate in the body composition assessment were recruited (mean age 60.3 ± 9.9 years). Body composition and raw bioelectrical parameters were measured with bioelectrical impedance analysis (BIA). Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system.

RESULTS

Strong correlations were observed between lifetime physical activity (PA), aerobic fitness and most of analyzed body composition parameters. The strongest inverse correlation was found for fat mass (p < 0.01) while positive relationship for fat-free mass (p < 0.01), total body water (p < 0.05 for current aerobic capacity and p < 0.01 for historical PA), body cell mass (p < 0.001), muscle mass (p < 0.001), calcium and potassium (p < 0.01 and p < 0.001 for current aerobic capacity and p < 0.001 and p < 0.01 for historical PA, respectively) and glycogen mass (p < 0.001). Among metabolic parameters, HDL cholesterol (HDL-C) and uric acid were significantly associated with most body composition indicators. Regarding endothelial function, a negative correlation was found for RHI and body mass (p < 0.05) while positive relationship for RHI and body cell mass (p < 0.05), calcium (p < 0.05) and potassium mass (p < 0.05). Impaired endothelial function was observed among 8 subjects. Among bioelectrical parameters, impedance (Z) and resistance (R) normalized for subjects' height were negatively related with body mass, body mass index (BMI) and waist circumference (p < 0.001); while reactance (Xc) normalized for patients' height was negatively related with body mass (p < 0.05). The mean phase angle value was relatively high (8.83 ± 1.22) what reflects a good level of cellularity and cell function. Phase angle was positively related with body mass and BMI (p < 0.05).

CONCLUSIONS

Both fat mass and muscle mass components are important predictors of metabolic profile. Maintaining regular high PA level and metabolically healthy status through young and middle adulthood may have beneficial influence on body composition parameters and may prevent age-related decrease of fat-free mass and endothelial dysfunction.

Regular physical activity and cardiovascular biomarkers in prevention of atherosclerosis in men: a 25-year prospective cohort study

Background

The purpose of the study was to examine the association between leisure-time physical activity (LTPA), cardiovascular biomarkers and atherosclerosis among asymptomatic men with stable LTPA level throughout the 25-year prospective observation.

Methods

Out of 101 asymptomatic men prospectively observed for their lifestyle and cardiovascular risk factors, the cohort of 62 individuals (mean age 59.9 years) maintained a stable LTPA level during the 25-year observation. Regular check-ups with the assessment of traditional risk factors, detailed measurements of LTPA level and aerobic capacity were performed since baseline. At the latest follow-up (2011/12) a set of cardiovascular biomarkers was measured using enzyme-linked immunosorbent assay. Subclinical atherosclerosis was assessed by means of coronary artery calcification score and intima-media thickness (IMT). Endothelial function was evaluated by means of the reactive hyperemia index. The studied biomarkers and indices were analyzed in the three cohorts representing stable low-tomoderate (<2050 kcal/week), high (2050-3840 kcal/week) and very high LTPA (>3840 kcal/week).

Results

At baseline the three cohorts were comparable in terms of age and clinical characteristics. At follow-up, the cohort with stable high LTPA (2050-3840 kcal/week) had significantly lower concentrations of hs-CRP (2.20 ± 1.0 mg/L), oxidized-LDL (68.35 ± 67.7 ng/mL), leptin (4.71 ± 3.07 ng/mL) and irisin (0.47 ± 0.13 μmol/L), and the most favorable indices of atherosclerosis and endothelial function as compared with other groups (p < 0.05). Regular marathon runners had increased concentrations of hsCRP (3.12 ± 1.4 mg/L), oxidized-LDL (249.8 ± 129 ng/ml), Interleukine-6 (3.74 ± 2.4 pg/ml). A positive correlation was observed between hsCRP and IMT (r = 0.301; p < 0.01), and irisin and IMT (r = 0.223; p < 0.05).

Conclusions

The data suggest that stable high LTPA (2050-3840 kcal/week) is associated with the most favorable profile of key cardiovascular biomarkers and indices of atherosclerosis. Lifetime very high LTPA is associated with increased lowgrade inflammation and may, therefore, exert an atherogenic effect.

Lifestyle including dietary habits and changes in coronary artery calcium score: a retrospective cohort study

Background

General diet and lifestyle are considered to have an effect on levels of atherosclerosis but previous studies have shown inconsistent results. The aim of this study was to investigate whether macronutrient intake, physical activity and depressive symptoms are associated with progression of preclinical atherosclerosis in healthy Korean adults.

Methods

A total of 2623 individuals from Kangbuk Samsung Hospital Health Screening Center in South Korea were enrolled between 2010 and 2012 and had follow-up at 2013. Every participant received a non-enhanced coronary computed tomography (CT) and completed questionnaires for food intake frequency, depression and physical activity levels. The study population was divided into two groups according to CAC progression, namely CAC group (CAC score >0) or non-CAC group (CAC score ≤ 0), and were compared according to macronutrient intake, degree of depressive symptoms and physical activity.

Results

A total of 2175 subjects were eligible for the analysis and among them, 592 subjects had progression of CAC. Total energy, carbohydrate and fat intake showed significant differences between the two groups (p-values of 0.01, 0.021 and 0.016 respectively). However, levels of protein intake did not vary for the two groups (p = 0.286). Depressive symptoms and extent of physical activity were similar between the two groups. Multivariate analysis was conducted with adjustment for possible confounding factors. The hazard ratios for CAC progression were not different according to macronutrient intake, degree of depressive symptoms and physical activity.

Conclusion

In this large relatively healthy population based observational study, CAC progression showed no significant association with total energy intake, proportion of macronutrient intake, depressive symptom and physical activity.

Electronic supplementary material

The online version of this article (doi:10.1186/s40885-016-0038-9) contains supplementary material, which is available to authorized users.

Effects of exercise training on carotid intima-media thickness in patients with type 2 diabetes and coronary artery disease. Influence of carotid plaques

Background

Carotid intima-media thickness (cIMT) holds prognostic information for future cardiovascular disease and is associated with the extent of coronary atherosclerosis. We investigated the effect of exercise on cIMT progression in patients with both type 2 diabetes and coronary artery disease (CAD).

Methods

Patients with type 2 diabetes and CAD (n = 137) were randomized to exercise training or standard follow-up. The 12 month exercise program contained 150 min weekly of combined aerobic and resistance training. High-resolution ultrasonography of the distal part of the common carotid artery (CCA) was performed to measure cIMT before and after the intervention. The CCA and the carotid bulb were scanned for the presence of atherosclerotic plaques. Differences in changes between the randomized groups were calculated by one-way ANCOVA.

Results

In the total population no difference in changes of cIMT from baseline to 12 months was observed between the exercise group and controls [−0.016 mm (95 % CI −0.037 to 0.006) vs. −0.007 mm (95 % CI −0.029 to 0.015), p = 0.57]. However, there was a significant interaction between the effect of exercise training and the presence of carotid plaques (p = 0.013), and significant reduced cIMT was demonstrated in the exercise group compared with controls in patients without identified carotid plaques (n = 65) [−0.034 mm (95 % CI −0.060 to 0.008) vs. 0.013 mm (95 % CI −0.011 to 0.038), p = 0.010].

Conclusion

One year of exercise training in patients with type 2 diabetes and CAD did not significantly change cIMT progression. However, in patients without identified carotid plaques, beneficial effect of exercise training on cIMT progression was demonstrated.

The impact of long-term changes in metabolic status on cardiovascular biomarkers and microvascular endothelial function in middle-aged men: a 25-year prospective study

BACKGROUND

The aim of this analysis was to examine long-term effects of changes in metabolic status on microvascular endothelial function and cardiovascular diseases (CVD) biomarkers among physically active middle-aged men.

METHODS

Metabolically healthy men (n = 101, mean age 59.7 years), free of symptoms and treatment, have been prospectively observed for their lifestyle and CVD risk factors (observation period 24.7 years). At the latest follow-up (2011/2012) a set of CVD biomarkers was measured using enzyme-linked immunosorbent assay. Microvascular endothelial function was evaluated by means of the reactive hyperemia index (RHI) using Endo-PAT2000 system. At follow-up the participants were divided into metabolically healthy (0-1 metabolic parameters) and metabolically unhealthy (≥2 metabolic parameters) groups. Metabolic syndrome was defined according to the NCEP ATP III definition.

RESULTS

Traditional metabolic risk factors were significantly associated with hsCRP, ox-LDL, Il-6, leptin and adiponectin/leptin ratio. Reactive hyperemia index was negatively related to body mass (p < 0.01), waist circumference (p < 0.05), triglycerides (p < 0.01), TG/HDL ratio (p < 0.01), uric acid (p < 0.05), sICAM-1 (p < 0.05) and Il-6 (p < 0.05), and positively to HDL-C (p < 0.01) and leisure-time physical activity (p < 0.01). Men who maintained metabolically healthy status (n = 47) through the observation had significantly lower hsCRP and uric acid (p < 0.05), higher adiponectin/leptin ratio (p < 0.05), higher mean RHI and lower prevalence of endothelial dysfunction (p < 0.05) as compared to the metabolically unhealthy group (n = 54). Regular physical activity level was significantly higher among metabolically healthy individuals during the whole observation.

CONCLUSIONS

Even subtle changes in metabolic profile influence inflammatory biomarkers and microvascular endothelial function. Leptin, adiponectin/leptin ratio and hsCRP are significant predictors of metabolic profile. Interleukine-6 and sICAM-1 may be used as indicators of early endothelial dysfunction in asymptomatic men. High leisure-time physical activity level is an important contributor of metabolically healthy profile through middle adulthood.

Sedentary work--associations between five-year changes in occupational sitting time and body mass index

OBJECTIVE

The aim of this study is to investigate the association between five-year changes in occupational sitting and body mass index (BMI) in working adults.

METHODS

We analyzed data from The Danish Work Environment Cohort Study (2005 and 2010, n=3.482). Data on occupational sitting, weight, height and several potential confounders were self-reported. The association between change in occupational sitting (hours) (categorized as large decrease <-7.5, moderate decrease -7.5 to <-2.5, no change -2.5 to 2.5, moderate increase >2.5 to 7.5 and large increase >7.5) and change in BMI was explored by multiple linear regression analyses.

RESULTS

43.0% men and 36.1% women had high occupational sitting time (≥25h per week) at baseline. 31.8% men and 27.2% women decreased while 30.0% men and 33.0% women increased occupational sitting. The proportion of obese (BMI≥30) increased almost 3% for both genders. BMI changed 0.13 (CI: 0.06; 0.20, p=0.0003), per category of change in occupational sitting in women, but no association was found in men.

CONCLUSION

In women, there is a positive association between five-year changes in occupational sitting and BMI.

Physical and immunological aspects of exercise in chronic diseases

Physical inactivity and sedentary lifestyles are believed to be independent risk factors for the occurrence of numerous diseases, including, obesity, Type 2 diabetes, metabolic syndrome, cardiovascular disease, cancer and mental health, all leading to substantial morbidity and/or premature death. It has been found that regular exercise, is associated with better quality of life and health outcomes, and reduces the risk of cardiovascular disease and cancer. Here, we review the effects regular exercise has on mental health and well-being, on the immune system and in cancer, cardiovascular disease, autoimmunity and metabolic syndrome. Is exercise the new immunotherapy to treat diseases?

Physical activity in chronic kidney disease: a plausible approach to vascular calcification?

Vascular calcification (VC) is a prominent feature that affects up to 40 to 80% of Chronic Kidney Disease (CKD) patients depending on the degree of renal impairment. Though etiology and pathogenesis of the different types of VC are far from being elucidated, it is conceivable that an imbalance between promoters and inhibitors represents the condition that triggers VC deposition and progression. In addition to traditional cardiovascular risk factors, several lines of evidence suggest that specific factors may affect the arterial system and prognosis in CKD. Over the last decade, a few pharmacological strategies aimed at controlling different selected risk factors for VC have been investigated yielding conflicting results. In light of the complicated interplay between inhibitors and promoters as well as the fact that VC represents the result of cumulative and prolonged exposure to multiple risk factors, a more comprehensive risk modification approach such as lifestyle modification or physical activity (PA) may represent a valid strategy to attenuate VC deposition and progression.We herein aim at reviewing the rationale and current evidence on the potential for lifestyle modification with a specific focus on PA as a cost-effective strategy for VC treatment.