Effect of intense exercise on inflammatory cytokines and growth mediators in adolescent boys

The Role of Secreted Frizzled-Related Protein 5 (Sfrp5) in Overweight and Obesity in Childhood and Adolescence

Background/Objective: Secreted frizzled-related protein 5 (Sfrp5) is an anti-inflammatory adipokine that has been implicated in the pathophysiology of obesity and its metabolic complications. Despite the fact that numerous studies have been carried out in adults, limited data on Sfrp5 exist for youth, especially in relation to overweight and obesity. Methods: In our study, we assessed the concentrations of Sfrp5, total oxidative (TOS) and antioxidative (TAS) status, high-sensitivity C-reactive protein (hs-CRP), and several cytokines (IL-1α, IL-1β, IL-2, IL-6, IL-8, IL-12, TNF-α) in 120 children and adolescents (mean age ± SE: 11.48 ± 0.25 years; 48 prepubertal, 72 pubertal; 74 males and 46 females) before and 1 year after the implementation of a personalized, structured, lifestyle intervention program of healthy diet, sleep, and physical exercise. Results: Based on the body mass index (BMI), participants were categorized as having morbid obesity (n = 63, 52.5%), obesity (n = 21, 17.5%), overweight (n = 22, 18.33%), or normal BMIs (n = 14, 11.67%), based on the International Obesity Task Force (IOTF) cut-off points. Following the 1-year lifestyle intervention program, a significant improvement in anthropometric measurements (BMI, BMI-z score, diastolic blood pressure, WHR, and WHtR), body-composition parameters, hepatic enzymes, lipid profile, inflammation markers, and the insulin-sensitivity profile (HbA1C, HOMA index) was observed in all subjects. Sfrp5 decreased in subjects with obesity (p < 0.01); however, it increased significantly (p < 0.05) in patients with morbid obesity. Linear regression analysis indicates that TNF-α and systolic blood pressure were the best positive predictors and hs-CRP was the best negative predictor for Sfpr5 concentration at initial assessment and glucose concentration for ΔSfrp5, while TNF-α and TAS were the best positive predictors for Sfpr5 concentration at annual assessment. Conclusions: These results indicate that Sfrp5 is associated with severe obesity and is increased following weight loss in children and adolescents with morbid obesity. It is also related to metabolic homeostasis, as well as inflammation and oxidative status.

Hormonal and inflammatory responses in prepubertal vs. pubertal male children following an acute free-weight resistance training session

PURPOSE

Examine the acute hormonal and cytokine responses to free-weight resistance training in trained prepubertal and pubertal male children.

METHODS

Prepubertal (n = 21; age 11.4 ± 1.1 years; Tanner I-II) and pubertal male children (n = 20; age 15.8 ± 0.7 years; Tanner III-V) conducted a moderate-intensity free-weight resistance training program to failure with venous blood sampling before (pre), immediately after (post) and during the recovery phase of the program (post-15,-30 min). Growth hormone (GH), insulin-like growth factor-I (IGF-I), cortisol, testosterone, IL-6, and TNF-α were analyzed in serum samples. Biological maturation was assessed according to the stages of the Tanner scale.

RESULTS

There was a significant time-by-group interaction in IGF-I response (p = 0.044; η2 = 0.209) and testosterone (p < 0.001; η2 = 0.508), indicating a greater change in the pubertal group compared to the prepubertal group. Both groups significantly increased post-exercise GH levels (p < 0.05). Only the prepuberal group significantly increased levels of IL-6 at all post-exercise time points (p < 0.05). Both groups showed a significant (p < 0.05) increase in TNF-α levels compared to resting levels.

CONCLUSION

These data suggest that acute testosterone and IGF-I response following resistance training differ between trained prepubertal and pubertal male children. Moderate-intensity resistance training performed to failure may thus have different effects in trained prepubertal and pubertal male children, which should be considered when giving training advice.

TRIAL REGISTRATION

Clinical trials number: NCT05022992.

Mechanisms of exercise for diabetic neuropathic pain

Diabetic neuropathic pain (DNP) is a common disease that affects the daily lives of diabetic patients, and its incidence rate is very high worldwide. At present, drug and exercise therapies are common treatments for DNP. Drug therapy has various side effects. In recent years, exercise therapy has received frequent research and increasing attention by many researchers. Currently, the treatment of DNP is generally symptomatic. We can better select the appropriate exercise prescription for DNP only by clarifying the exercise mechanism for its therapy. The unique pathological mechanism of DNP is still unclear and may be related to the pathological mechanism of diabetic neuropathy. In this study, the mechanisms of exercise therapy for DNP were reviewed to understand better the role of exercise therapy in treating DNP.

Effects of Resistance and Endurance Training Alone or Combined on Hormonal Adaptations and Cytokines in Healthy Children and Adolescents: A Systematic Review and Meta-analysis

BACKGROUND

No previous systematic review has quantitatively compared the effects of resistance training, endurance training, or concurrent training on hormonal adaptations in children and adolescents. Objective was to examine the effects of exercise training and training type on hormonal adaptations in children and adolescents.

METHODS

A systematic literature search was conducted in the following databases: PubMed, Web of Science, and EBSCO. Eligibility criteria were: population: healthy youth population sample (mean age < 18 years); intervention: resistance training, endurance training, or concurrent training (> 4 weeks duration); comparison: control group; outcome: pre- and post-levels of hormones and cytokines; and study design: randomized and non-randomized controlled trials. We used a random-effect model for the meta-analysis. The raw mean difference in hormones from baseline to post-intervention was presented alongside 95% confidence intervals (CI). Further, the certainty of evidence quality and the risk of bias were assessed.

RESULTS

A total of 3689 records were identified, of which 14 studies were eligible for inclusion. Most studies examined adolescents with fewer studies on children (age < 12 years, N = 5 studies) and females (N = 2 studies). Nine exercise training programs used endurance training, five studies used resistance training, and no eligible study used concurrent training. The meta-analysis showed no significant effect of exercise training on testosterone (MD = 0.84 nmol/L), cortisol (MD = - 17.4 nmol/L), or SHBG (MD = - 5.58 nmol/L). Subgroup analysis showed that resistance training significantly increased testosterone levels after training (MD = 3.42 nmol/L) which was not observed after endurance training (MD = - 0.01 nmol/L). No other outcome differed between training types. Exercise training resulted in small and non-significant changes in GH (MD = 0.48 ng/mL, p = 0.06) and IGF-I (MD = - 22.90 ng/mL, p = 0.07). GH response to endurance training may be age-dependent and evident in adolescents (MD = 0.59 ng/mL, p = 0.04) but not when children and adolescents are pooled (MD = 0.48 ng/mL, p = 0.06). Limited evidence exists to conclude on IL-6 and TNF-α effects of exercise training. Assessments of GRADE domains (risk of bias, consistency, directness, or precision of the findings) revealed serious weaknesses with most of the included outcomes (hormones and cytokines).

CONCLUSIONS

This systematic review suggests that exercise training has small effects on hormonal concentrations in children and adolescents. Changes in testosterone concentrations with training are evident after resistance training but not endurance training. GH's response to training may be affected by maturation and evident in adolescents but not children. Further high-quality, robust training studies on the effect of resistance training, endurance training, and concurrent training are warranted to compare their training-specific effects.

REGISTRATION

PROSPERO: CRD42021241130.

Physical activity and adipokine levels in individuals with type 2 diabetes: A literature review and practical applications

We review the effects of acute and long-term physical activity on adipokine levels in individuals with type 2 diabetes (T2D). Three electronic databases were searched. Studies made in animal models were excluded, while studies based on participants with and without T2D, and also studies with type 1 diabetes were included. Of the 2,450 citations, 63 trials, including randomised control trials, cross-sectional and longitudinal studies, met our inclusion criteria. Seventy and five percent of studies reported the effects of physical activity on tumor necrosis factor-alpha (TNFα), interleukin 6 (IL-6), adiponectin, visfatin, omentin-1, and leptin levels. There are no robust results due to variations in exercise modality, intensity, duration, and also differences in cohort characteristics in the literature. Only four studies described the effects of an acute session of physical activity on adipokine levels. Overall, physical activity improves diabetes status by regulating adipokine levels. However, long-term aerobic + resistance training combined with dietary modifications is likely to be a more effective strategy for improving adipokines profiles in patients with type 2 diabetes.

Cytokine concentrations in saliva vs. plasma at rest and in response to intense exercise in adolescent athletes

BACKGROUND

Salivary measures are advantageous in conducting large paediatric studies involving repeated measures. However, research measuring salivary cytokines in youth is limited.

AIM

Compare salivary with plasma concentrations of inflammatory cytokines at rest and following exercise in adolescent swimmers (21 male, 22 female).

METHODS

Following collection of resting saliva and blood samples, participants performed a bout of high-intensity interval swimming, with samples taken again ∼15 min post-swimming and analysed for interleukin-6 (IL-6), interleukin 10 (IL-10), and tumour necrosis factor-alpha (TNF-α).

RESULTS

Resting IL-10 was significantly lower, while IL-6 and TNF-α were significantly higher in saliva compared with plasma. IL-10 increased from pre- to post-swimming in plasma, but less so in saliva (51% vs. 29%; p = 0.02). TNF-α decreased post-swimming in saliva, but not in plasma (-27% vs -1%; p = 0.01). IL-6 decreased post-swimming in saliva compared with plasma (-21% vs. -3%; p = 0.06). Intraclass correlation coefficients (ICC) revealed no association between salivary and plasma IL-6 and TNF-α, while IL-10 showed a weak correlation only at rest (ICC = 0.39; p = 0.05).

CONCLUSIONS

Differences in concentrations and exercise responses, along with weak correlations, suggest that salivary cytokine levels are not an accurate representation of blood cytokine levels, and should not be used as a surrogate measure in paediatric studies.

Effect of propolis supplementation on athletic performance, body composition, inflammation, and oxidative stress following intense exercise: A triple-blind randomized clinical trial

BACKGROUND

Emerging evidence indicates that propolis as a novel potential antioxidant has unique benefits. This study aimed to evaluate the effect of propolis on oxidative stress, inflammation, body composition, and athletic performance in healthy active subjects.

METHODS

This clinical trial was conducted on 54 male military cadets. Eligible subjects were randomly allocated to receive a single dose of 450 mg propolis twice daily for four weeks or a matching placebo containing microcrystalline cellulose. Cooper 12-min run test and running-based anaerobic sprint test were performed to measure aerobic and anaerobic performance. Blood samples were obtained immediately after Cooper's test to evaluate oxidative stress and inflammation status. Fat mass and fat-free mass were analyzed using bioelectrical impedance.

RESULTS

Mean changes in fat mass, fat-free mass, anaerobic powers, fatigue index, and VO2 max did not differ significantly between the two groups after the adjustment for baseline values (P-value>0.05). A significant change was observed in plasma levels of IL-6 (-1.43 ± 0.11pg/mL), total oxidant status (-3.9 ± 0.2µmol/L), total antioxidant capacity (164 ± 12 µmol/L), malondialdehyde (-0.52 ± 0.03µmol/L), oxidative stress index (-0.45 ± 0.04), and glutathione (48.72±2µmol/L) in the propolis group compared with the placebo group after the adjustment for baseline values and weight changes (P-value<0.05). Although IL-10 concentrations had no significant changes in both groups, the ratio of IL-6/IL-10 significantly reduced in the propolis group compared with the placebo group (-0.174 ± 0.015 versus. 0.051 ± 0.014; P-value: 0.041).

CONCLUSIONS

Our results indicated that propolis might have beneficial effects on oxidative stress and inflammation following intense activities in healthy male subjects.

The Impact of Professional Sports Activity on GH-IGF-I Axis in Relation to Testosterone Level

The study was designed to investigate whether sports-induced elevation of testosterone level impacts on the growth hormone/insulin-like growth factor-I (GH-IGF-I) axis and body composition, especially skeletal muscle mass. The study included 12 male wrestlers aged 21.1 ± 1.7 years and 10 male nonathletes aged 21.1 ± 1.2 years. Anthropometric and biochemical measurements in the group of nonathlete men were carried out once, while for wrestlers they were carried out twice, that is, on the 1st and 14th days of the training camp.

The levels of resting free testosterone (fT), cortisol (C), and human growth hormone (hGH) were significantly higher in the athletes than in nonathletes. A 2-week sports training induced a significant reduction in fT, IGF-I, and IGF binding protein-3 (IGFBP-3) levels and a rise in C level. Increased C level and reduced fT level in the athletes’ blood caused a rise in C/fT from the level of 39.95 ± 4.97 nmol/L to 59.73 ± 10.09 nmol/L (p < .05). A negative correlation was demonstrated between C/fT ratio and IGF-I level (r = −0.474, p < .05), which may indicate an inhibitory impact of high C level and low fT concentration on IGF-I release in response to sports training.

Sports activity induces significant changes in the C/fT ratio that can impact on the secretion of GH and IGF-I from the liver and finally on the fat-free body mass. The quantification of GH-IGF-I axis in relation to testosterone level could be a useful diagnostic tool in biochemical assessment of the regenerative ability of skeletal muscle or provide evidence of the early stages of muscle functional overload.

Changes in Inflammatory Cytokines and Irisin in Response to High Intensity Swimming in Adolescent versus Adult Male Swimmers

Swimming is a popular youth sport that is considered beneficial for cardiovascular fitness. However, the potential inflammatory outcomes of high intensity swimming in younger swimmers are unclear, as is the response of irisin, a myokine released during exercise with anti-inflammatory properties. This study compared the plasma concentrations of interleukins 1-beta (IL-1β), 6 (IL-6), 10 (IL-10), tumor necrosis factor alpha (TNF-α) and irisin in response to intense swimming between adolescent and adult male swimmers. Thirty-two swimmers (16 adolescents, 14 ± 1 years; 16 adults, 21.5 ± 3.1 years) completed a high intensity interval swimming trial. At rest, only TNF-α was higher (33%, p < 0.05) in adolescents compared with adults. There was an overall significant increase in IL-1β from pre- to post-swimming (3% in adolescents, 24% in adults), but no significant interaction. IL-10 significantly increased in both groups (+34% in adolescents, +56% in adults). IL-6 and TNF-α increased significantly (+32% and +26%, respectively) in adults, but not in adolescents (+2% and -9%, respectively). Adults showed a small, but significant decrease in irisin (-5%), with no change in adolescents. The lack of an IL-6, TNF-α and irisin response to intense swimming in adolescent swimmers may suggest a blunted inflammatory and myokine response following high intensity exercise in trained youth.

Redox Homeostasis and Inflammation Responses to Training in Adolescent Athletes: a Systematic Review and Meta-analysis

Background

Several studies have highlighted the substantial role of the athlete’s redox and inflammation status during the training process. However, many factors such as differences in testing protocols, assays, sample sizes, and fitness levels of the population are affecting findings and the understanding regarding how exercise affects related biomarkers in adolescent athletes.

Objectives

To search redox homeostasis variables’ and inflammatory mediators’ responses in juvenile athletes following short- or long-term training periods and examine the effect size of those variations to training paradigms.

Methods

A PRISMA-compliant systematic review and meta-analysis were conducted. The entire content of PubMed (MEDLINE), Scopus, and Science Direct were systematically searched until December 2019. Studies with outcomes including (1) a group of adolescent athletes from any individual or team sport, (2) the assessment of redox and/or inflammatory markers after a short- (training session or performance testing) or longer training period, and (3) variables measured in blood were retained. The literature search initially identified 346 potentially relevant records, of which 36 studies met the inclusion criteria for the qualitative synthesis. From those articles, 27 were included in the quantitative analysis (meta-analysis) as their results could be converted into common units.

Results

Following a short training session or performance test, an extremely large increase in protein carbonyls (PC) (ES 4.164; 95% CI 1.716 to 6.613; Z = 3.333, p = 0.001), a large increase in thiobarbituric acid reactive substances (TBARS) (ES 1.317; 95% CI 0.522 to 2.112; Z = 3.247, p = 0.001), a large decrease in glutathione (GSH) (ES − 1.701; 95% CI − 2.698 to − 0.705; Z = − 3.347, p = 0.001), and a moderate increase of total antioxidant capacity (TAC) level (ES 1.057; 95% CI − 0.044 to 2.158; Z = 1.882, p = 0.060) were observed. Following more extended training periods, GSH showed moderate increases (ES 1.131; 95% CI 0.350 to 1.913; Z = 2.839, p = 0.005) while TBARS displayed a small decrease (ES 0.568; 95% CI − 0.062 to 1.197; Z = 1.768, p = 0.077). Regarding cytokines, a very large and large increase were observed in IL-6 (ES 2.291; 95% CI 1.082 to 3.501; Z = 3.713, p = 0.000) and IL-1 receptor antagonist (ra) (ES 1.599; 95% CI 0.347 to 2.851; Z = 2.503, p = 0.012), respectively, following short-duration training modalities in juvenile athletes.

Conclusions

The results showed significant alterations in oxidative stress and cytokine levels after acute exercise, ranging from moderate to extremely large. In contrast, the variations after chronic exercise ranged from trivial to moderate. However, the observed publication bias and high heterogeneity in specific meta-analysis advocate the need for further exploration and consistency when we deal with the assessed variables to ascertain the implications of structured training regimes on measured variables in order to develop guidelines for training, nutritional advice, and wellbeing in young athletes.

Trial Registration

PROSPERO CRD42020152105

The Systemic Effects of Exercise on Regulators of Muscle and Bone in Girls and Women

PURPOSE

To assess the systemic effects of an acute bout of moderate-intensity exercise on factors that are known to regulate muscle and bone growth in prepubertal girls and women.

METHODS

A total of 12 prepubertal girls (8-10 y) and 12 women (20-30 y) cycled at 60% maximal oxygen uptake for 1 hour followed by 1 hour recovery. Blood samples were collected at rest, mid-exercise, end of exercise, mid-recovery, and end of recovery. Plasma was analyzed for interleukin-6, chemokine ligand 1, fibroblast growth factor-2, total insulin growth factor-1 (IGF-1), and free IGF-1 using enzyme-linked immunosorbent assays assays.

RESULTS

Both groups had similar concentrations of systemic factors at baseline with the exception of free IGF-1, which was higher in girls (P = .001). Interleukin-6 response was lower in girls versus women (P = .04), with a difference of +105.1% at end of exercise (P < .001), +113.5% at mid-recovery (P = .001), and +93.2% at end of recovery (P = .02). Girls and women exhibited significant declines in chemokine ligand 1, fibroblast growth factor-2, and total IGF-1 during recovery.

CONCLUSION

Compared with women, an acute bout of moderate-intensity exercise in girls elicits a lower inflammatory response, suggesting that other mechanisms may be more important for driving the anabolic effects of exercise on muscle and bone in girls.

Bone accrual over 18 months of participation in different loading sports during adolescence

This study investigated the impact and non-impact sports on bone mineral density accrual in adolescents over 18 months. The impact sports were beneficial for bone health (accrual of bone density). In contrast, swimmers had similar or lower bone mineral density compared with the control group depending on the skeletal site.

PURPOSE

To investigate the impact and non-impact sports on bone mineral density (BMD) accrual in adolescents over a period of 18 months METHODS: The sample was composed of 71 adolescents, avarage age of 12.7 (± 1.7) years old at baseline. Bone outcomes were compared according to the loading of the sports practiced (impact sports, n = 33 [basketball, karate, and judo], non-impact sport, n = 18 [swimming], and control group, n = 20). Areal bone mineral density (aBMD) was measured by dual-energy X-ray absorptiometry (DXA) and bone mineral apparent density (BMAD) estimated through equation. The results were compared between the groups using analysis of variance and analysis of covariance.

RESULTS

Adjusted aBMD at lower limbs, whole body less head (WBLH), and adjusted WBLH BMAD were significantly greater in the impact sport group than the non-impact sport group at all time points. Adjusted upper limbs aBMD was significantly higher at the impact sports group compared to the non-impact sport group at 9 months and 18 months, besides compared to the control group at baseline and 18 months. Non-impact sport group presented a significant lower adjusted aBMD compared with control group at lower limbs and WBLH at 9 months, and at 9 months and 18 months in WBLH BMAD. There was a significant interaction (time × sport group) at upper limbs (p = 0.042) and WBLH aBMD (p = 0.006), and WBLH BMAD (p < 0.001).

CONCLUSION

Impact sports were more beneficial on accumulating aBMD and BMAD over a period of 18 months, while non-impact group (swimmers) had similar and lower aBMD and BMAD compared with the control group.

Exercise Science and Child Health: A Tale of Many Journeys

Children are the most naturally physically active human beings; reduced physical activity is a cardinal sign of childhood disease, and exercise testing provides mechanistic insights into health and disease that are often hidden when the child is at rest. The physical inactivity epidemic is leading to increased disease risk in children and, eventually, in adults in unprecedented ways. Cardiopulmonary exercise testing (CPET) biomarkers are used to assess disease severity, progress, and response to therapy across an expanding range of childhood diseases and conditions. There is mounting data that fitness in children tracks across the life span and may prove to be an early, modifiable indicator of cardiovascular disease risk later in life. Despite these factors, CPET has failed to fulfill its promise in child health research and clinical practice. A major barrier to more accurate and effective clinical use of CPET in children is that data analytics and testing protocols have failed to keep pace with enabling technologies and computing capacity. As a consequence, biomarkers of fitness and physical activity have yet to be widely incorporated into translational research and clinical practice in child health. In this review, the author re-examines some of the long-held assumptions that mold CPET in children. In particular, the author suggests that current testing strategies that rely predominantly on maximal exercise may, inadvertently, obfuscate novel and clinically useful insights that can be gleaned from more comprehensive data analytics. New pathways to discovery may emanate from the simple recognition that the physiological journey that human beings undertake in response to the challenge of exercise may be far more important than the elusive destination of maximal or peak effort.

Cytokine, glycemic, and insulinemic responses to an acute bout of games-based activity in adolescents

An acute bout of endurance exercise in adults stimulates a same‐day anti‐inflammatory response which may affect low‐grade chronic inflammation and insulin resistance and benefit cardio‐metabolic health. The anti‐inflammatory responses to intermittent games‐based exercise and to exercise in young people beyond 2 hours post‐exercise are unknown. Thus, the purpose of the present study is to examine the anti‐inflammatory, glycemic and insulinemic response to games‐based activity in adolescents. Following ethical approval and familiarization, 39 adolescents (12.3 ± 0.7 years) completed an exercise (E) and rested (R) trial in a counterbalanced, randomized crossover design. Following a standardized breakfast, participants completed 1‐hour games‐based activity. Capillary blood samples were taken at baseline, immediately and 1 hour post‐exercise, and 30, 60 and 120 minutes following a standardized lunch. A final blood sample was taken the next morning. Data were analyzed using repeated measures ANOVA. IL‐6 concentration was higher on day one of the exercise trial (E:3.4 ± 0.4, R:2.7 ± 0.4 pg/mL; P = 0.006), as was the anti‐inflammatory IL‐6:TNF‐α ratio (E:5.53 ± 0.93, R:3.75 ± 0.45; P = 0.027). Levels of the anti‐inflammatory cytokine IL‐10 increased on day two of the exercise trial (E:2.11 ± 0.23, R:1.66 ± 0.16 pg/mL; P = 0.032). Insulin sensitivity was enhanced on the exercise trial with a reduction in iAUC following the standardized lunch (E:2310 ± 834, R:3122 ± 1443 mU/L × 120 minutes; P < 0.001). Games‐based activity stimulated an anti‐inflammatory response up to 24 hours post‐exercise and improved insulin sensitivity in response to a standardized meal in healthy adolescents. These novel findings suggest that games‐based activity is an ecologically valid mode of exercise to elicit beneficial effects on cardio‐metabolic risk factors in young people.

The Impact of Training Load on Bone Mineral Density of Adolescent Swimmers: A Structural Equation Modeling Approach

PURPOSE

To investigate the mediating effect of muscle mass on the relationship between training load and bone density in adolescent swimmers.

METHODS

A cross-sectional study involving 87 control and 22 swimmers aged 10-19 years (overall sample: n = 109). Swimmers had a minimum of 1 year of competition in regional and national championships, and control adolescents reported 1 year without any organized sport. Bone density was the main outcome (dual-energy X-ray absorptiometry), which was measured in upper limbs, lower limbs, spine, and whole body. Monthly training load was the independent variable, while the mediation effect of lean soft tissue was assessed. Maturity offset, age, inflammation, and vitamin D intake were treated as covariates.

RESULTS

Swimmers had lower bone density than controls; there was a significant and positive relationship between training load and muscle mass. In boys, training load presented a negative correlation with bone density in lower limbs [r = -.293; 95% confidence interval (CI), -.553 to -.034]. In girls, training load was negatively related to bone mineral density in lower limbs (r = .563; 95% CI, -.770 to -.356) and whole body (r = -.409; 95% CI, -.609 to -.209).

CONCLUSION

Training load had a negative relationship on bone density of swimmers of both sexes, independently of the positive effect of lean soft tissue on bone density.

Bone tissue, blood lipids and inflammatory profiles in adolescent male athletes from sports contrasting in mechanical load

Exploring the effect of non-impact and impact sports is particular relevant to understand the interaction between skeletal muscle and bone health during growth. The current study aimed to compare total and regional bone and soft-tissue composition, in parallel to measurements of blood lipid and inflammatory profiles between adolescent athletes and non-athletes. Anthropometry, biological maturity, dual energy X-ray absorptiometry (DXA) scans, training load and lipid and inflammatory profiles were assessed in a cross-sectional sample of 53 male adolescents (20 non-athletes, 15 swimmers and 18 basketball players) aged 12–19 years. Multiple comparisons between groups were performed using analysis of variance, covariance and magnitude effects (ES-r and Cohen’s d). The comparisons of controls with other groups were very large for high-sensitivity C-reactive protein (d range: 2.17–2.92). The differences between sports disciplines, regarding tissue outputs obtained from DXA scan were moderate for all variables except fat tissue (d = 0.4). It was possible to determine small differences (ES-r = 0.17) between controls and swimmers for bone area at the lower limbs (13.0%). In parallel, between swimmers and basketball players, the gradient of the differences was small (ES-r range: 0.15–0.23) for bone mineral content (24.6%), bone area (11.3%) and bone mineral density (11.1%) at the lower limbs, favoring the basketball players. These observations highlight that youth male athletes presented better blood and soft tissues profiles with respect to controls. Furthermore, sport-specific differences emerged for the lower limbs, with basketball players presenting higher bone mineral content, area and density than swimmers.

Somatic maturation and the relationship between bone mineral variables and types of sports among adolescents: cross-sectional study

CONTEXT AND OBJECTIVE:

Peak height velocity (PHV) is an important maturational event during adolescence that affects skeleton size. The objective here was to compare bone variables in adolescents who practiced different types of sports, and to identify whether differences in bone variables attributed to sports practice were dependent on somatic maturation status.

DESIGN AND SETTING:

Cross-sectional study, São Paulo State University (UNESP).

METHODS:

The study was composed of 93 adolescents (12 to 16.5 years old), divided into three groups: no-sport group (n = 42), soccer/basketball group (n = 26) and swimming group (n = 25). Bone mineral density and content were measured using dual-energy x-ray absorptiometry and somatic maturation was estimated through using peak height velocity. Data on training load were provided by the coaches.

RESULTS:

Adolescents whose PHV occurred at an older age presented higher bone mineral density in their upper limbs (P = 0.018). After adjustments for confounders, such as somatic maturation, the swimmers presented lower values for bone mineral density in their lower limbs, spine and whole body. Only the bone mineral density in the upper limbs was similar between the groups. There was a negative relationship between whole-body bone mineral content and the weekly training hours (β: -1563.967; 95% confidence interval, CI: -2916.484 to -211.450).

CONCLUSION:

The differences in bone variables attributed to sport practice occurred independently of maturation, while high training load in situations of hypogravity seemed to be related to lower bone mass in swimmers.

PARÂMETROS IMUNOLÓGICOS E INFECÇÕES DO TRATO RESPIRATÓRIO SUPERIOR EM ATLETAS DE ESPORTES COLETIVOS

RESUMO Entre atletas e treinadores, existe uma percepção comum de que altas cargas de treinamento e competições, aplicadas de forma crônica, com controle nutricional e/ou períodos de recuperação inadequados, podem reduzir a resistência imunológica, aumentando a predisposição aos episódios de infecções, principalmente infecções do trato respiratório superior (ITRS). Nesse sentido, o presente estudo está centrado em revisar as interações entre os parâmetros imunológicos com a síndrome do sobretreinamento, especificamente em esportes coletivos, considerando a sua natureza intermitente. Assim, foi realizada uma revisão de periódicos nacionais e internacionais relacionados com o tema. As correlações entre exercício, sistema imunológico e suscetibilidade às ITRS têm sido avaliadas principalmente em esportes individuais e de resistência em comparação aos coletivos. As modulações dos leucócitos ao longo da temporada, frente ao efeito somatório das cargas de treinamento e competições, quando analisadas especificamente quanto aos neutrófilos e monócitos, possivelmente se relacionam com os processos de reparo tecidual e incidência de ITRS. As modulações relacionadas com os linfócitos parecem estar relacionadas mais diretamente com a incidência das ITRS. Ademais, o entendimento de todos os marcadores propostos, incluindo os imunológicos em associação com os indicadores de desempenho e controle do treinamento, parece ser um caminho mais promissor para o diagnóstico clínico do estado imunológico do atleta e da prevenção da síndrome do sobretreinamento do que necessariamente a busca por um marcador exclusivo de excesso de treinamento.

Serum IGF-I, IGFBP-3 and ALS concentrations and physical performance in young swimmers during a training season

INTRODUCTION

The GH/IGF-I axis is a system of growth mediators, receptors, and binding proteins that regulate somatic and tissue growth; and it has been shown that exercise programs are related to the anabolic function of this axis.

OBJECTIVE

The aim of this study was to analyse the changes of serum IGF-I concentration and that of its binding proteins IGFBP-3 and ALS in adolescent swimmers at different stages of a training season, and compare them with physical performance parameters and body composition of the athletes.

MATERIAL AND METHODS

Nine male athletes, aged 16 to 19years and who trained regularly throughout the season, were included in this study. Serum IGF-I, IGFBP-3, and ALS concentrations were recorded before and after (pre×post) standardized training sessions during the different stages of a training season (extensive×intensive×tapering). Endurance in freestyle, anaerobic fitness in tied swimming (Peak Force and Average Force), body mass, fat percentage, and lean body mass were also analysed at the different stages of training in order to compare the changes of the IGF-I/IGFBP/ALS system with the physical performance and body composition of the athletes. Variations in the IGF-I/IGFBP-3-ALS system before and after a standardized training session, and at the different stages of training were analysed by the Wilcoxon and Friedman non-parametric tests, respectively. Significance was considered at 5%.

RESULTS

The results from this study demonstrate that IGF-I is sensitive to the acute and chronic effects of training, exhibiting biphasic behaviour throughout the season. The catabolic phase was characterized by a reduction in serum IGF-I concentrations during the intensive stage (∆_IGF-I: - 43.33±47.32ng/ml; P<0.05) while the anabolic phase was marked by similar basal concentrations at the different stages of training and an increase in post-training serum IGF-I concentrations during the tapering stage (320±40; 298±36 and 359±94ng/ml; P<0.05). IGFBP-3 was only sensitive to the chronic effects of training, with a reduction in post-training serum concentrations during the intensive stage and an increase during the tapering stage (4.7±0.7, 4.6±0.4 and 5.0±0.7mg/l; P<0.05). No significant difference (P>0.05) was observed in pre- or post-training IGFBP-3 concentrations (∆_IGFBP-3) at the different stages. ALS concentrations remained unchanged throughout the season, demonstrating that in adolescent athletes they are unaffected by the acute or chronic effects of swimming. Peak Force (25.0±6.3, 24.2±5.7 and 28.5±6.5N; P<0.05) and Average Force (10.3±3.6, 8.8±1.8 and 14.7±1.8N; P<0.05) followed IGF-I and IGFBP-3 variations, with a decrease during the intensive stage and a significant (P<0.05) increase during the tapering stage. The body composition and cardiorespiratory condition of the swimmers did not vary significantly throughout the season, exhibiting behaviour independent of IGF-I or IGFBP-3.

CONCLUSION

Serum IGF-I and IGFPB-3 concentrations have proven to be sensitive markers of training status and, thus, may be used as guides for coaches and athletes in the challenging task of modulating training intensity in young athletes.

Endurance training-induced changes in the GH-IGF-I axis influence maximal muscle strength in previously untrained men

OBJECTIVE

In this study we have determined the effects of 20weeks of endurance running training on the GH-IGF-I axis changes in the context of the skeletal muscle performance and physical capacity level.

DESIGN

Before and after the endurance training program a maximal incremental exercise tests, a 1500m race and a muscle strength measurements were performed and the blood samples were taken to determine both resting as well as end-exercise serum growth hormone (GH), insulin-like growth hormone-I (IGF-I), insulin-like growth hormone binding protein-3 (IGFBP-3) and plasma interleukin-6 (IL-6) concentrations.

RESULTS

20weeks of endurance running training improved power output generated at the end of the maximal incremental test by 24% (P<0.012), 1500m running time by 13% (P<0.012) and maximal muscle strength by 9% (P<0.02). End-exercise IGF-I/IGFBP-3 ratio was decreased by 22% after the training (P<0.04) and the magnitude of IGF-I/IGFBP-3 ratio decrease (ΔIGF-I/IGFBP-3_ex) was 2.3 times higher after the training (P<0.04). The magnitude of the exercise-induced changes in IGFBP-3 concentration was also significantly higher (P<0.04) and there was a trend toward lower end-exercise IGF-I concentration (P=0.08) after the training. These changes were accompanied by a significantly higher (30%) end-exercise IL-6 concentration (P<0.01) as well as by a 3.4 times higher magnitude of IL-6 increase (P<0.02) after the training. Moreover, there were strong positive correlations between changes in resting serum IGF-I concentration (ΔIGF-I_res) and IGF-I/IGFBP-3 ratio (ΔIGF-I/IGFBP-3_res) and changes in muscle strength (ΔMVC) (r=0.95, P=0.0003 and r=0.90, P=0.002, respectively).

CONCLUSIONS

The training-induced changes in the components of the GH-IGF-I axis may have additive effects on skeletal muscle performance and physical capacity improvement.

Exercise-Induced Oxidative Stress Responses in the Pediatric Population

Adults demonstrate an upregulation of their pro- and anti-oxidant mechanisms in response to acute exercise while systematic exercise training enhances their antioxidant capacity, thereby leading to a reduced generation of free radicals both at rest and in response to exercise stress. However, less information exists regarding oxidative stress responses and the underlying mechanisms in the pediatric population. Evidence suggests that exercise-induced redox perturbations may be valuable in order to monitor exercise-induced inflammatory responses and as such training overload in children and adolescents as well as monitor optimal growth and development. The purpose of this review was to provide an update on oxidative stress responses to acute and chronic exercise in youth. It has been documented that acute exercise induces age-specific transient alterations in both oxidant and antioxidant markers in children and adolescents. However, these responses seem to be affected by factors such as training phase, training load, fitness level, mode of exercise etc. In relation to chronic adaptation, the role of training on oxidative stress adaptation has not been adequately investigated. The two studies performed so far indicate that children and adolescents exhibit positive adaptations of their antioxidant system, as adults do. More studies are needed in order to shed light on oxidative stress and antioxidant responses, following acute exercise and training adaptations in youth. Available evidence suggests that small amounts of oxidative stress may be necessary for growth whereas the transition to adolescence from childhood may promote maturation of pro- and anti-oxidant mechanisms. Available evidence also suggests that obesity may negatively affect basal and exercise-related antioxidant responses in the peripubertal period during pre- and early-puberty.

Exercise and Immune Function in Children

Exercise immunology is one of the fastest growing disciplines of the past 2 decades. Unfortunately, the number of investigations devoted to the pediatric population remains low, and our understanding of the interaction between acute and chronic exercise and the immune system in youth is relatively deficient. In general, healthy children experience smaller overall perturbations to the immune system in response to an acute bout of exercise as compared with adults, and they demonstrate a faster recovery of the immune system following exercise. There is only limited evidence to suggest that moderate to high levels of habitual physical activity are associated with a reduction in the incidence of infection and illness in youth. Special consideration should be made for the young athlete training and competing during an illness or infection. Some of the unique exercise responses of the immune system in children may have important clinical relevance, but much more work is required in this area.

Markers of biological stress in response to a single session of high-intensity interval training and high-volume training in young athletes

PURPOSE

The aim of the present study was to compare the effects of high-intensity interval training (HIIT) vs high-volume training (HVT) on salivary stress markers [cortisol (sC), testosterone (sT), alpha-amylase (sAA)], metabolic and cardiorespiratory response in young athletes.

METHODS

Twelve young male cyclists (14 ± 1 years; 57.9 ± 9.4 mL min^-1 kg^-1 peak oxygen uptake) performed one session of HIIT (4 × 4 min intervals at 90-95 % peak power output separated by 3 min of active rest) and one session of HVT (90 min constant load at 60 % peak power output). The levels of sC, sT, their ratio (sT/sC) and sAA were determined before and 0, 30, 60, 180 min after each intervention. Metabolic and cardiorespiratory stress was characterized by blood lactate, blood pH, respiratory exchange ratio (RER) and heart rate (HR), oxygen uptake ([Formula: see text]), ventilation (V _E) and ventilatory equivalent (V _E/[Formula: see text]).

RESULTS

sC increased 30 and 60 min after HIIT. However, 180 min post exercise, sC decreased below baseline levels in both conditions. sT increased 0 and 30 min after HIIT and 0 min after HVT. sAA and sT/sC ratio did not change significantly over time in HIIT nor HVT. Metabolic and cardiorespiratory stress, evidenced by blood lactate, HR, [Formula: see text], V _E, and V _E/[Formula: see text] was higher during HIIT compared to HVT.

CONCLUSION

The metabolic and cardiorespiratory stress during HIIT was higher compared to HVT, but based on salivary analyses (cortisol, testosterone, alpha-amylase), we conclude no strong acute catabolic effects neither by HIIT nor by HVT.

Prolonged Practice of Swimming Is Negatively Related to Bone Mineral Density Gains in Adolescents

BACKGROUND

The practice of swimming in "hypogravity" conditions has potential to decrease bone formation because it decreases the time engaged in weight-bearing activities usually observed in the daily activities of adolescents. Therefore, adolescents competing in national levels would be more exposed to these deleterious effects, because they are engaged in long routines of training during most part of the year. To analyze the effect of swimming on bone mineral density (BMD) gain among adolescents engaged in national level competitions during a 9-month period.

METHODS

Fifty-five adolescents; the control group contained 29 adolescents and the swimming group was composed of 26 athletes. During the cohort study, BMD, body fat (BF) and fat free mass (FFM) were assessed using a dual-energy x-ray absorptiometry scanner. Body weight was measured with an electronic scale, and height was assessed using a stadiometer.

RESULTS

During the follow-up, swimmers presented higher gains in FFM (Control 2.35 kg vs. Swimming 5.14 kg; large effect size [eta-squared (ES-r)=0.168]) and BMD-Spine (Swimming 0.087 g/cm(2) vs. Control 0.049 g/cm(2); large effect size [ES-r=0.167]) compared to control group. Male swimmers gained more FFM (Male 10.63% vs. Female 3.39%) and BMD-Spine (Male 8.47% vs. Female 4.32%) than females. Longer participation in swimming negatively affected gains in upper limbs among males (r=-0.438 [-0.693 to -0.085]), and in spine among females (r=-0.651 [-0.908 to -0.036]).

CONCLUSIONS

Over a 9-month follow-up, BMD and FFM gains were more evident in male swimmers, while longer engagement in swimming negatively affected BMD gains, independently of sex.

Effect of gender on the GH-IGF-I response to anaerobic exercise in young adults

Exercise-associated effects on the growth hormone-insulin-like growth factor-I (GH-IGF-I) axis were studied, mainly after aerobic exercise. We determined the gender effect on the GH-IGF-I axis response to a standard all-out Wingate anaerobic test (WAnT) in healthy active young adult men and women (men = 12 and women = 16; age range: 24-34 years). Blood samples for GH and IGF-I, key elements of the GH-IGF-I axis, were collected before and 20, 30, 40, and 60 minutes after the beginning of exercise. In addition, we collected postexercise blood lactate levels. Postexercise lactate levels were higher among men; however, this difference did not reach statistical significance (13.8 ± 1.3 vs. 11.1 ± 1.0 mmol·L, respectively; p = 0.1). The WAnT was associated with a significant increase in GH in both genders. However, GH peak was greater among women (10.8 ± 1.8 vs. 5.6 ± 1.4 ng·ml, in women and men, respectively; p < 0.01). In addition, postexercise GH peak occurred significantly earlier in female (20 minutes) compared with male participants (40 minutes). Exercise was associated with a significant increase in IGF only among men (from 166.8 ± 8.4 to 186.9 ± 9.3; p < 0.02); however, no significant between-gender effect was found. In summary, supramaximal anaerobic exercise was associated with a greater and earlier postexercise GH peak in women compared with men. All together, the results suggest anaerobic exercise-related anabolic-type hormonal response.

Therapeutic implications of the choroid plexus-cerebrospinal fluid interface in neuropsychiatric disorders

The choroid plexus (CP) comprises an epithelial monolayer that forms an important physical, enzymatic and immunologic barrier, called the blood-cerebrospinal fluid barrier (BCSFB). It is a highly vascularized organ located in the brain ventricles that is key in maintaining brain homeostasis as it produces cerebrospinal fluid (CSF) and has other important secretory functions. Furthermore, the CP-CSF interface plays a putative role in neurogenesis and has been implicated in neuropsychiatric diseases such as the neurodevelopmental disorders schizophrenia and autism. A role for this CNS border was also implicated in sleep disturbances and chronic and/or severe stress, which are risk factors for the development of neuropsychiatric conditions. Understanding the mechanisms by which disturbance of the homeostasis at the CP-CSF interface is involved in these different chronic low-grade inflammatory diseases can give new insights into therapeutic strategies. Hence, this review discusses the different roles that have been suggested so far for the CP in these neuropsychiatric disorders, with special attention to potential therapeutic applications.

Moderate exercise training attenuates inflammatory mediators in DRG of Type 1 diabetic rats

Painful neuropathy is a long-term and difficult to treat complication of diabetes that affects 25% of diabetic patients and interferes with their quality of life. Unfortunately, available medical treatments are relatively ineffective due to dependency and addiction. Emerging research indicates that moderate-to-vigorous physical activity provides health-related benefits. However, adequate data is not available to determine whether regular exercise would prevent or delay the development of painful neuropathy in subjects with Type 1 diabetes. This study demonstrates the significance of moderate exercise in the amelioration of pain in animals with Type 1 diabetes after 6weeks of exercise paradigm. After initial acclimatization, streptozotocin-diabetic animals were placed in motorized running wheels for 60minperday, for five days a week for 6weeks starting at one week after diabetes. A growing body of evidence suggests that the release of proinflammatory cytokines plays an important role in the development and persistence of pain. This study demonstrates that moderate exercise increases the expression of inhibitory neurotransmitter enkephalin and also reduces the presence of a number of proinflammatory cytokines in the dorsal root ganglia (DRG), subsequently impeding the development of neuropathy along with a decrease in the voltage gated ion channels in the DRG. Overall, the study suggests that exercise may provide an alternate route of treatment of painful neuropathy in Type 1 diabetic subjects by decreasing the use of pain medications, thereby providing a more useful and efficient way for pain management.

Metabolic implications when employing heavy pre- and post-exercise rapid-acting insulin reductions to prevent hypoglycaemia in type 1 diabetes patients: a randomised clinical trial

Aim

To examine the metabolic, gluco-regulatory-hormonal and inflammatory cytokine responses to large reductions in rapid-acting insulin dose administered prandially before and after intensive running exercise in male type 1 diabetes patients.

Methods

This was a single centre, randomised, controlled open label study. Following preliminary testing, 8 male patients (24±2 years, HbA1c 7.7±0.4%/61±4 mmol.l⁻¹) treated with insulin's glargine and aspart, or lispro attended the laboratory on two mornings at ∼08:00 h and consumed a standardised breakfast carbohydrate bolus (1 g carbohydrate.kg⁻¹BM; 380±10 kcal) and self-administered a 75% reduced rapid-acting insulin dose 60 minutes before 45 minutes of intensive treadmill running at 73.1±0.9% VO_2peak. At 60 minutes post-exercise, patients ingested a meal (1 g carbohydrate.kg⁻¹BM; 660±21 kcal) and administered either a Full or 50% reduced rapid-acting insulin dose. Blood glucose and lactate, serum insulin, cortisol, non-esterified-fatty-acids, β-Hydroxybutyrate, and plasma glucagon, adrenaline, noradrenaline, IL-6, and TNF-α concentrations were measured for 180 minutes post-meal.

Results

All participants were analysed. All glycaemic, metabolic, hormonal, and cytokine responses were similar between conditions up to 60 minutes following exercise. Following the post-exercise meal, serum insulin concentrations were lower under 50% (p<0.05) resulting in 75% of patients experiencing hyperglycaemia (blood glucose ≥8.0 mmol.l⁻¹; 50% n = 6, Full n = 3). β-Hydroxybutyrate concentrations decreased similarly, such that at 180 minutes post-meal concentrations were lower than rest under Full and 50%. IL-6 and TNF-α concentrations remained similar to fasting levels under 50% but declined under Full. Under 50% IL-6 concentrations were inversely related with serum insulin concentrations (r = −0.484, p = 0.017).

Conclusions

Heavily reducing rapid-acting insulin dose with a carbohydrate bolus before, and a meal after intensive running exercise may cause hyperglycaemia, but does not augment ketonaemia, raise inflammatory cytokines TNF-α and IL-6 above fasting levels, or cause other adverse metabolic or hormonal disturbances.

Trial Registration

ClinicalTrials.gov NCT01531855

Exercise and type 1 diabetes (T1DM)

Physical exercise is firmly incorporated in the management of type 1 diabetes (T1DM), due to multiple recognized beneficial health effects (cardiovascular disease prevention being preeminent). When glycemic values are not excessively low or high at the time of exercise, few absolute contraindications exist; practical guidelines regarding amount, type, and duration of age-appropriate exercise are regularly updated by entities such as the American Diabetes Association and the International Society for Pediatric and Adolescent Diabetes. Practical implementation of exercise regimens, however, may at times be problematic. In the poorly controlled patient, specific structural changes may occur within skeletal muscle fiber, which is considered by some to be a disease-specific myopathy. Further, even in well-controlled patients, several homeostatic mechanisms regulating carbohydrate metabolism often become impaired, causing hypo- or hyperglycemia during and/or after exercise. Some altered responses may be related to inappropriate exogenous insulin administration, but are often also partly caused by the "metabolic memory" of prior glycemic events. In this context, prior hyperglycemia correlates with increased inflammatory and oxidative stress responses, possibly modulating key exercise-associated cardio-protective pathways. Similarly, prior hypoglycemia correlates with impaired glucose counterregulation, resulting in greater likelihood of further hypoglycemia to develop. Additional exercise responses that may be altered in T1DM include growth factor release, which may be especially important in children and adolescents. These multiple alterations in the exercise response should not discourage physical activity in patients with T1DM, but rather should stimulate the quest for the identification of the exercise formats that maximize beneficial health effects.

Protective role of 17-β-estradiol towards IL-6 leukocyte expression induced by intense training in young female athletes

Exercise performed at a competitive level could deeply modify the immune system and the cytokine response of athletes. In this report, we demonstrated that young elite female artistic gymnasts (n = 16; age: 9-15 years) showed an increase of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) mRNA expression in blood mononuclear cells (PBMCs), in comparison to girls performing the same sport at a recreational level (n = 16; age: 10-15 years). The increase of IL-6 and TNF-α mRNAs appeared to be directly linked to the intensity and duration of the training. Moreover, in elite athletes engaged in artistic gymnastics or in synchronised swimming (n =34; age: 9-15 years), IL-6 gene expression appeared to be modulated by the levels of circulating oestrogens: pre-pubertal athletes (n = 20; age: 11 ± 1 years) revealed a higher increase in IL-6 than pubertal athletes (n = 14; age: 14 ± 1.6 years). In pre-pubertal athletes, body mass index (BMI) percentile was inversely correlated with the increase of both IL-6 and TNF-α. The consequence of these events was the shift of the cytokine profile towards a pro-inflammatory status. These modifications, induced by training performed at an elite level, might negatively affect the growth of female children athletes.

The role of cherries in exercise and health

Recently, cherries and cherry products have received growing attention within the literature with regard to their application in both exercise and clinical paradigms. Reported to be high in anti-inflammatory and anti-oxidative capacity, cherries and their constituents are proposed to provide a similar but natural alternative akin to over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) or analgesics. Within exercise paradigms, concern has been raised with regard to the use of products, which inhibit such inflammatory or oxidative actions, because of the possibility of the blunting of physiological training adaptations. Despite this, numerous scenarios exist both within exercise and clinical populations where a goal of optimal recovery time is more important than physiological adaptation. This review critically evaluates and discusses the use of cherries as a supplementation strategy to enhance recovery of muscle function, inhibit exercise-induced inflammation, oxidative stress, and pain primarily; furthermore, the potential application of cherries to clinical populations is discussed.

Exercise: applications to childhood ADHD

ADHD is the most common neurobehavioral disorder of childhood, presenting with pervasive and impairing symptoms of inattention, hyperactivity, impulsivity, or a combination. The leading hypothesis of the underlying physiology of this disorder of inattention and/or hyperactivity-impulsivity is based on catecholamine dysfunction. Pharmacotherapy research indicates that psychostimulants, which are catecholamine agonists, show the greatest efficacy for treating the core symptoms of ADHD. Exercise affects the same dopaminergic and noradrenergic systems that stimulant medications target and is a stressor, which elicits measurable physiological changes. The magnitude of these peripheral alterations is posited as a potential biomarker of ADHD. The hypothesis that exercise training alters the underlying physiology present in ADHD and other medical conditions as well as conceptual issues behind its potential clinical utility is reviewed.

The relationship between visceral fat thickness and bone mineral density in sedentary obese children and adolescents

Background

Among adults, obesity has been positively related to bone mineral density. However, recent findings have pointed out that abdominal obesity could be negatively related to bone density. The above mentioned relationship is not clear among pediatric populations. Therefore, this cross-sectional study analyzed the relationship between thickness of abdominal adipose tissue and bone mineral variables in sedentary obese children and adolescents.

Methods

One hundred and seventy five obese children and adolescents (83 male and 92 female) with ages ranging from 6 to 16 years-old were analyzed. Bone mineral content and density were estimated by dual-energy X-ray absorptiometry and ultrasound equipment which estimated the thickness of the abdominal adipose tissue. Pubertal stage was self-reported by the participants.

Results

The mean age was 11.1 (SD = 2.6). Thickness of the abdominal adipose tissue was negatively related to bone mineral density (r = −0.17 [r_95%CI: -0.03;-0.32]), independent of gender, pubertal stage and other confounders (β = −0.134 ± 0.042 [β_95%CI: -0.217; -0.050]).

Conclusions

In sedentary obese children and adolescents abdominal obesity is negatively related to bone mineral density, suggesting a potential link between abdominal obesity and osteoporosis.

Swimming exercise prevents fibrogenesis in chronic kidney disease by inhibiting the myofibroblast transdifferentiation

Background

The renal function of chronic kidney disease (CKD) patients may be improved by a number of rehabilitative mechanisms. Swimming exercise training was supposed to be beneficial to its recovery.

Methodology/Principal Findings

Doxorubicin-induced CKD (DRCKD) rat model was performed. Swimming training was programmed three days per week, 30 or 60 min per day for a total period of 11 weeks. Serum biochemical and pathological parameters were examined. In DRCKD, hyperlipidemia was observed. Active mesangial cell activation was evidenced by overexpression of PDGFR, P-PDGFR, MMP-2, MMP-9, α-SMA, and CD34 with a huge amount collagen deposition. Apparent myofibroblast transdifferentiation implicating fibrogenesis in the glomerular mesangium, glomerulonephritis and glomeruloscelorosis was observed with highly elevated proteinuria and urinary BUN excretion. The 60-min swimming exercise but not the 30 min equivalent rescued most of the symptoms. To quantify the effectiveness of exercise training, a physical parameter, i.e. “the strenuosity coefficient” or “the myokine releasing coefficient”, was estimated to be 7.154×10⁻³ pg/mL-J.

Conclusions

The 60-min swimming exercise may ameliorate DRCKD by inhibiting the transdifferentiation of myofibroblasts in the glomerular mesangium. Moreover, rehabilitative exercise training to rescue CKD is a personalized remedy. Benefits depend on the duration and strength of exercise, and more importantly, on the individual physiological condition.

Synergistic effect of obesity and lipid ingestion in suppressing the growth hormone response to exercise in children

Diet plays an important role in modulating exercise responses, including activation of the growth hormone (GH)/insulin-like growth factor-I (IGF-1) axis. Obesity and fat ingestion were separately shown to reduce exercise GH responses, but their combined effect, especially important in children, has not been studied. We therefore measured the GH response to exercise [30-min intermittent cycling, ten 2-min bouts at ~80% maximal aerobic capacity (Vo(2max)), separated by 1-min rest], started 45 min after ingestion of a high-fat meal (HFM) in 16 healthy [controls; body mass index percentile (BMI%ile) 51 ± 7], and 19 obese (Ob, BMI%ile 97 ± 0.4) children. Samples were drawn at baseline (premeal), and at start, peak, and 30 min postexercise. In the Ob group, a marked ~75% suppression of the GH response (ng/ml) to exercise was observed (2.4 ± 0.6 vs. 10.6 ± 2.1, P < 0.001). This level of suppression was also significantly greater compared with age-, fitness-, and BMI-matched historical controls that had performed identical exercise in fasting conditions. Our data indicate that the reduction in the GH response to exercise, already present in obese children vs. healthy controls, is considerably amplified by ingestion of fat nutrients shortly before exercise, implying a potentially downstream negative impact on growth factor homeostasis and long-term modulation of physiological growth.

Effects of exercise on microRNA expression in young males peripheral blood mononuclear cells

MicroRNAs are increasingly seen as targets of drug discovery because they influence gene function acting both to silence and subtly modulate protein translation. Little is known about effects of dynamic physiological states on microRNA regulation in humans. We hypothesized that microRNA expression in peripheral blood mononuclear cells (PBMCs) would be affected by brief exercise. Twelve young men performed brief bouts of heavy exercise. PBMC microRNA was analyzed before and immediately after exercise using the Agilent Human microRNA V2 Microarray. Exercise altered expression level of 34 microRNAs (FDR < 0.05). Many of them play roles in inflammatory processes (e.g., miR-125b[↓], down-regulated by proinflammatory factor LPS; and miR-132[↑], 125b[↓] and let-7e[↓] involved inTLR4 signaling). Using previous exercise data in PBMCs, we linked the microRNA changes to specific gene pathways. This analysis identified 12 pathways including the TGF-β and MAPK signaling. We also compared exercise-associated microRNA changes in PBMCs with the exercise-associated microRNAs previously identified in neutrophils. Nine microRNAs were affected in both PBMCs and neutrophils, but only six changed in the same direction. A commonly occurring physiologic perturbation, brief heavy exercise, changes microRNA profiles in PBMCs, many of which are related to inflammatory processes. The pattern of change suggests that exercise differentially influences microRNAs in leukocyte subtypes.

Hormonal and inflammatory responses to different types of sprint interval training

We evaluated the effect of different types of sprint interval sessions on the balance between anabolic and catabolic hormones and circulating inflammatory cytokines. Twelve healthy elite junior handball players (17-25 years) participated in the study. Exercise consisted of increasing distance (100 m, 200 m, 300 m, 400 m) and decreasing distance (400 m, 300 m, 200 m, 100 m) sprint interval runs on a treadmill (at random order), at a constant work rate of 80% of the personal maximal speed (calculated from the maximal speed of a 100 m run). The total rest period between the runs in the different interval sessions were similar. Blood samples were collected before, after each run, and after 1-hour recovery. Both types of sprint interval trainings led to a significant (p < 0.05) increase in lactate and the anabolic factors growth hormone, insulin-like growth factor-I (IGF-I), IGF binding protein-3 (IGFBP-3), and testosterone levels. Both types of sprint interval sessions led to a significant (p < 0.05) increase in the circulating pro- and anti-inflammatory mediators IL-1, IL-6, and IL1ra. IL-6 remained elevated in both sessions after 1-hour recovery. Area under the curve was significantly greater (p < 0.05) for lactate and growth hormone (GH) in the decreasing distance session. In contrast, rate of perceived exertion was higher in the increasing distance session, but this difference was not statistically significant (p = 0.07). Changes in anabolic-catabolic hormones and inflammatory mediators can be used to gauge the training intensity of anaerobic-type exercise. Changes in the GH-IGF-I axis and testosterone level suggest exercise-related anabolic adaptations. Increases in inflammatory mediators may indicate their important role in muscle tissue repair after anaerobic exercise. The decreasing distance interval was associated with a greater metabolic (lactate) and anabolic (GH) response but not with a higher rate of perceived exertion. Coaches and athletes should be aware of these differences, and as a result, of a need for specific recovery adaptations after different interval training protocols.

Inflammatory cytokine profiles during exercise in obese, diabetic, and healthy children

OBJECTIVE

Modulation of inflammatory status is considered a key component of the overall health effects of exercise. This may be especially relevant in children with obesity (Ob) or type 1 diabetes (T1DM), in which an imbalance between pro- and anti-inflammatory mediators could accelerate onset and progression of cardiovascular complications. To date, exercise-induced alterations in immuno-modulatory mediators in Ob and T1DM children remain largely unknown.

METHODS

In this study, we monitored the kinetic profiles of 8 pro-and anti-inflammatory cytokines (TNF-a, IL-6, IL-2, IL-8, IL-5, IL-13, IL-10, IL-4) during a standardized exercise challenge (ten 2-min cycling bouts at 80% VO2max, separated by 1-min intervals) in 23 Ob (12 females, 11 males), 23 T1DM (10 females and 13 males) patients and 20 healthy (CL, 10 females and 10 males) children. Blood glucose of T1DM patients was kept in the 4.4-6.1 mM range for at least 90 minute prior to and during exercise. Blood samples were drawn at rest and after every other exercise bout.

RESULTS

In Ob, TNF-a and IL-2 were significantly greater (p<0.0167) as compared to T1DM and CL, both at baseline and throughout exercise. All other variables, while not significant, were quantitatively elevated in Ob vs. CL. In T1DM, IL-4 and IL-8 levels were similar to Ob, IL-2 and TNF-a similar to CL, and IL-6, IL-5, IL-13, IL-4 levels were intermediate between the Ob and CL groups.

CONCLUSIONS

During exercise, therefore, both Ob and T1DM children displayed exaggerated pro-inflammatory responses, although with clearly different magnitude and involved mediators. Our data support the necessity to identify specific exercise formats through which each at-risk pediatric population can draw maximal beneficial health effects.

Altered inflammatory, oxidative, and metabolic responses to exercise in pediatric obesity and type 1 diabetes

Obesity (Ob) and type 1 diabetes (T1DM) are associated with increased inflammation and oxidative stress, which are major pathogenetic pathways toward higher cardiovascular risks. Although long-term exercise protects against systemic inflammation and oxidation, acute exercise actually exerts pro-inflammatory and oxidative effects, prompting the necessity for better defining these molecular processes in at-risk patients; in particular, very little is known regarding obese and T1DM children. We therefore examined key inflammatory and oxidative stress variables during exercise in 138 peripubertal children (47 Ob, 12.7 ± 0.4 yr, 22 F, BMI% 97.6 ± 0.2; 49 T1DM, 13.9 ± 0.2 yr, 20 F, body mass index% [BMI] 63.0 ± 3.6; 42 healthy, CL, 13.5 ± 0.5 yr, 24 F, BMI% 57.0 ± 3.6), who performed 10 bouts of 2-min cycling ~80% VO(2max) , separated by 1-min rest intervals. Blood samples were drawn at baseline and peak exercise. Ob displayed elevated baseline interleukin-6 (IL-6, 2.1 ± 0.2 pg/mL, p < 0.005) vs. CL (1.5 ± 0.3), whereas T1DM displayed the greatest maximum exercise-induced change in IL-6 (1.2 ± 0.3) than in both Ob (0.7 ± 0.1, p < 0.001) and CL (0.6 ± 0.1, p < 0.0167). Myeloperoxidase (MPO) was elevated in T1DM (143 ± 30 ng/mL, p < 0.0167) vs. CL (89 ± 10) and Ob (76 ± 6), whereas increases in exercise only occurred in Ob and CL. Disparate baseline and exercise responses were also observed for 8-hydroxy-2'-deoxyguanosine, glutathione, and F(2) -isoprostane. This data show distinct patterns of dysregulation in baseline and adaptive immunologic and oxidative responses to exercise in Ob and T1DM. A full understanding of these alterations is required so that developing exercise regimens aimed at maximizing health benefits for specific dysmetabolic states can be achieved based on complete scientific characterization rather than empirical implementation.

Nontraditional risk factors and biomarkers for cardiovascular disease: mechanistic, research, and clinical considerations for youth: a scientific statement from the American Heart Association

The rapid increase in the prevalence and severity of obesity in children is likely to lower the age of onset and increase the incidence of cardiovascular disease worldwide. Understanding the pathophysiology and improving the clinical management of cardiovascular disease involve a knowledge of novel risk factors and biomarkers. The clinical and mechanistic roles of these novel biological factors during childhood are currently being investigated. The goals of this scientific statement are to present the existing knowledge and theoretical framework of nontraditional risk factors for cardiovascular disease as they relate to children and adolescents, to describe the relevance and weight of available experimental and clinical evidence and the therapeutic implications pertaining to nontraditional risk factors in the pediatric population, and to stimulate further research with a goal of developing valid and reliable approaches to identify and validate novel risk factors that will aid in the clinical evaluation and perhaps prediction of cardiovascular disease in the pediatric population. Although several biomarkers are promising, substantial research is required before nontraditional risk factors can be used to identify and reduce cardiovascular disease risk in children and adolescents.

Inhaled fluticasone and the hormonal and inflammatory response to brief exercise

PURPOSE

Inhaled corticosteroids (ICS) improve symptoms in lung diseases, such as asthma. Initial data suggest that the effects of ICS remain localized in the lung; however, recent studies demonstrate alteration to the peripheral immune system in patients with asthma. We sought to evaluate the effect of ICS on peripheral immune mediators and hypothalamic-pituitary-adrenal axis and their response to exercise in healthy men.

METHODS

Eleven healthy males (18-30 yr old) were placed on 2 wk of fluticasone proprionate (440 μg) twice daily. A 30-min bout of exercise was performed on a cycle ergometer at approximately 70% of peak work rate before and after the start of ICS. Blood was sampled before and after exercise. Cytokines and hypothalamic-pituitary-adrenal axis mediators were measured by ELISA, and fluticasone was measured by liquid chromatography/tandem mass spectrometry.

RESULTS

After ICS treatment, cortisol and adrenocorticotropin were decreased, and a blunted exercise response was observed for cortisol, adrenocorticotropin, and growth hormone. Peripheral leukocytes and neutrophils were significantly increased in response to exercise in both the untreated and the ICS-treated conditions and at baseline after ICS treatment. Interleukin-6 was elevated with ICS treatment, but the exercise response was blunted. Circulating median fluticasone levels were 0.15 ng·mL(-1) and were increased to 0.20 ng·mL(-1) in response to exercise.

CONCLUSIONS

Exercise revealed deficits in growth hormone production after ICS treatment not identified by static markers. Neutrophils were shown to be surrogate markers of the systemic effect of ICS. Exercise significantly increased circulating levels of fluticasone. Exercise challenge tests can be used to assess the physiological effect of exogenous corticosteroids.

Hormonal response to Taekwondo fighting simulation in elite adolescent athletes

Exercise training efficiency depends on the training load, as well as on the athlete's ability to tolerate it. The aim of the present study was to evaluate the effect of fighting simulation (3 fights, 6 min each, 30 min rest between fights) on anabolic (IGF-I, LH, FSH, estradiol, and testosterone) and catabolic hormones (cortisol) in elite, male (n = 10) and female (n = 10) adolescent (12-17 years) Taekwondo fighters. Blood samples were collected before the first and immediately after the third fight. The fighting simulation practice led to significant (p < 0.05) decreases in IGF-I (males -27.1 ± 25.6, females -22.4 ± 36.3 ng/ml), LH (males -0.7 ± 1.2, females -2.3 ± 3.3 U/L), and FSH (males -0.9 ± 0.5, females -1.5 ± 1.1 U/L), and to a significant increase (p < 0.05) in cortisol (males 141.9 ± 30.1, females 64.1 ± 30.6 mcg/dL) in both genders. Fighting simulation decreases in testosterone (males -1.9 ± 1.6, females -0.02 ± 0.06 ng/mL), and free androgen index (males -20.1 ± 21.5, females -0.3 ± 0.5) were significant (p < 0.05) only in male fighters. Exercise had no significant effect on estradiol, sex-hormone-binding globulins or thyroid function tests. Our data demonstrate that the physiologic and psychologic strain of a Taekwondo fighting simulation day led to a catabolic-type circulating hormonal response.

Effect of acute exercise on the levels of salivary cortisol, tumor necrosis factor-alpha and nitric oxide

The aim of the present study was to assess the levels of salivary cortisol, tumor necrosis factor-alpha (TNF-alpha) and nitric oxide (NO) before, during and after acute exercise. Acute exercise was induced using a standard treadmill test with Bruce protocol in ten physically active male participants. Unstimulated saliva was collected before, during and after exercise. The levels of salivary cortisol and TNF-alpha were assessed by enzyme immunoassays. Salivary NO was determined by the Griess reagent. The results showed that both salivary cortisol and TNF-alpha increased and peaked at 14 min during exercise and then decreased. The levels of NO were increased up to 1 h after exercise and subsequently lowered after 24 h. The results of the present study suggest that acute exercise may induce high levels of salivary cortisol, TNF-alpha and NO.