Nordic Walking Training Causes a Decrease in Blood Cholesterol in Elderly Women Supplemented with Vitamin D

The effect of physical activity on vitamin D: A systematic review and meta-analysis of intervention studies in humans

Objectives

Cross-sectional studies demonstrate a positive association between higher physical activity and serum 25-hydroxyvitamin D (25(OH)D) concentration. However, whether this association is causal is unclear. We conducted a systematic review to identify intervention studies that examined the effect of physical activity on serum 25(OH)D concentration in humans.

Study design

Systematic review and meta-analysis.

Methods

We searched PubMed, Scopus and Web of Science to identify full-text peer-reviewed articles published in English from inception until January 2023. Eligible studies were randomised controlled trials or quasi-experimental studies. We used random effects meta-analysis to calculate the weighted mean difference (WMD) in the change in 25(OH)D concentration between physical activity and control groups. We used the revised Cochrane risk-of-bias tool for randomized trials (RoB 2) to assess the methodological quality of included studies.

Results

We included 32 articles in the systematic review and 24 in the meta-analysis. The intervention varied from resistance and weight-bearing exercises (n = 13) to aerobic exercises (n = 10), moderate and moderate-to-vigorous exercises (n = 5), aquatic exercise (n = 2), and multicomponent traditional exercises (n = 2) (Tai Chi and Yijinjing). The WMD in 25(OH)D in the physical activity and control groups was 9.51 and 4.87, respectively (between-group mean difference 4.64, p = 0.002). However, the difference was only evident in studies that implemented the intervention outdoors (n = 3; between-group mean difference 17.33, p < 0.0001); when the intervention was indoors there was no significant effect of physical activity on 25(OH)D (n = 16; between-group mean difference 1.80, p = 0.113).

Conclusions

This meta-analysis of physical activity interventions in humans showed that physical activity does not lead to increased 25(OH)D independently of time outdoors. However, most studies were under-powered, in many the exercise was low intensity, and vitamin D was not the primary outcome.

The Impact of a 6-Week Nordic Walking Training Cycle and a 14-Hour Intermittent Fasting on Disease Activity Markers and Serum Levels of Wnt Pathway-Associated Proteins in Patients with Multiple Myeloma

Background: Multiple myeloma (MM) accounts for about 10-15% of all diagnosed hematologic malignancies and about 1-2% of all cancer cases. Approximately 80-90% of MM patients develop bone disease and the changes rarely regress. It is only possible to stop or slow their progression. A major role in bone destruction in MM is attributed to the Wnt signaling pathway, and its action can be modified by various types of interventions including training and diet. Therefore, the aim of this project was to evaluate the effects of a Nordic Walking (NW) training cycle and intermittent fasting (IF) on the levels of selected bone turnover markers associated with the Wnt pathway in patients with MM. Materials and methods: Results from 35 patients divided into training (NW and IF NW) and non-training (IF and control) groups were included in the analysis. A 6-week training cycle involving 60 min workouts 3 times a week was conducted. Body mass and composition as well as the levels of vitamin D, calcium and phosphorus, beta2-microglobulin, and albumin were examined before and after the completion of the training cycle. Markers of bone turnover were also determined: sclerostin (SOST), Dickkopf-related protein 1 (DKK-1), osteoprotegrin (OPG), osteopontin (OPN), and Tartrate-resistant acid phosphatase 5b (TRACP 5b). Results: There was no negative effect of IF or combined training and fasting on the nutritional status of the patients (the level of albumins was unchanged). Both training groups showed an increase in serum concentrations of the active metabolite of vitamin D (IF NW and NW: p = 0.001 and p = 0.022, respectively). The change in the concentration of this vitamin negatively correlated with the concentration of TRACP 5b (r = -0.413, p = 0.014). Evaluating the concentrations of markers related to bone turnover, a reduction in the concentrations of SOST (time: p = 0.026, time vs. group: p = 0.033) and TRACP 5b (time: p < 0.001, time vs. group p < 0.001) was indicated. Conclusions: The obtained results allow one to indicate the training with the poles as a safe and beneficial form of physical activity that should be recommended to patients suffering from MM. However, the results obtained in the present study are not sufficient to show the beneficial effect of IF applied without trainings.

Effects of Nordic walking in Alzheimer's disease: A single-blind randomized controlled clinical trial

Non-pharmacological approaches, including exercise programs, have been proposed to improve cognitive function and behavioral symptoms, such as depression, agitation, or aggression, in the management of patients with Alzheimer's disease (AD). Indeed, physical inactivity is one of the main modifiable risk factors in patients with AD, as well as in the development of cardiovascular diseases and related pathologies. Although Nordic Walking (NW), a particular type of aerobic exercise, is known to benefit the health of aging populations, there is little evidence that patients with AD may benefit from this non-pharmacological treatment. In this context, we performed a pilot study in 30 patients with mild/moderate AD to evaluate whether NW influences different cognitive domains, including executive functions, visual-spatial abilities, and verbal episodic memory. To this aim, 15 patients (Control group, CG) underwent reality orientation therapy, music therapy, motor, proprioceptive and postural rehabilitation, and 15 patients (experimental group, EG) in addition to the activities performed by the CG also had the NW with a frequency of twice a week. Neuropsychological assessments and evaluations of daily activities and quality of life were performed at baseline and after 24 weeks. Twenty-two patients, including 13 in the CG and nine in the EG completed the activity program after 24 weeks. The EG showed a significant improvement in the Frontal Assessment Battery, Rey's auditory Verbal Learning Test Delayed Recall, Raven's Colored Progressive Matrices, and completion time for the Stroop Word-Color Interference test, compared to the CG. NW was able to improve cognitive domains like visual-spatial reasoning abilities, verbal episodic memory, selective attention, and processing speed in AD patients. These results, if confirmed by further studies with a larger number of patients and a longer training period, may prospect NW as a safe and likely useful strategy to slow down cognitive impairment in mild/moderate AD.

Influence of Nordic walking with poles with an integrated resistance shock absorber on carbohydrate and lipid metabolic indices and white blood cell subpopulations in postmenopausal women

Background

Regular and individualised physical activities have been shown to prevent adverse changes associated with the aging process. The main purpose of this study was to evaluate changes in carbohydrate and lipid metabolism and white blood cell (WBC) subpopulations in postmenopausal women participating in Nordic walking (NW) training and to compare the use of poles with an integrated resistance shock absorber (RSA) with the use of classic poles.

Materials & Methods

A total of 23 postmenopausal women participated in a 8-week programme of systematic physical activity between February and April. Before and after the training programme, somatic features and serum concentrations of 25-hydroxyvitamin D, glucose, and insulin, were assessed, as well as lipid profile and WBC count and its specific subpopulations.

Results

Analysis of differences in somatic features and biochemical indices before and after training in the group of women who used RSA poles showed significant decreases in fat mass content (p < 0.05), insulin (p < 0.05), homeostatic model assessment of insulin resistance (p < 0.05), triglycerides (p < 0.05), total cholesterol (p < 0.05) and monocytes (p ≤ 0.01). In the group of women who used classic poles (NW), there was a significant decrease in WBC (p ≤ 0.01), lymphocytes (p < 0.05), monocytes (p ≤ 0.01) and granulocytes (p < 0.05).

Conclusion

Increasing the training load through the use of RSA poles resulted in greater changes in carbohydrate and lipid metabolic indices compared to the use of classic NW poles. In turn, the more significant effect on WBC and its specific subpopulations count in the NW, compared to the RSA training programme, may indicate that specificity of training load is an important factor in modifying the immune system response.

Exercise: A Possibly Effective Way to Improve Vitamin D Nutritional Status

Vitamin D deficiency has become a widespread public health problem owing to its potential adverse health effects. Generally, the nutritional status of vitamin D depends on sunlight exposure and dietary or supplementary intake. However, recent studies have found that exercise can influence circulating 25(OH)D levels; although, the results have been inconclusive. In this review, we focused on the effect of exercise on circulating vitamin D metabolites and their possible mechanisms. We found that endurance exercise can significantly increase serum 25(OH)D levels in vitamin D-deficient people but has no significant effect on vitamin D-sufficient people. This benefit has not been observed with resistance training. Only chronic endurance exercise training can significantly increase serum 1,25(OH)₂D, and the effect may be sex-dependent. Exercise may influence 25(OH)D levels in the circulation by regulating either the vitamin D metabolites stored in tissues or the utilization by target tissues. The effects of exercise on 25(OH)D levels in the circulation may be dependent on many factors, such as the vitamin D nutritional status, exercise type and intensity, and sex. Therefore, further research on the effects and mechanisms of exercise on vitamin D metabolites is required.

Effect of vitamin D supplementation on cardiac-metabolic risk factors in elderly: a systematic review and meta-analysis of clinical trials

BACKGROUND

There has been a longstanding interest in the potential effect of vitamin D in preventing cardiac-metabolic diseases. However, there are divergent results regarding the impact of vitamin D supplementation (VDS) on managing cardiac-metabolic outcomes in the elderly population.

MATERIAL AND METHOD

We systematically searched electronic databases; Web of Science, PubMed, Scopus, EMBASE, Cochrane, and ProQuest. We included all trials that evaluated the effect of VDS on cardiac-metabolic risk factors in the elderly population, which were published until 30 September 2021. The effects of VDS on cardiac-metabolic outcomes were assessed using standardized mean difference (SMD). A random-effect model was used to pool the SMD and 95% confidence interval (CI).

RESULT

The literature search identified 4409 studies, of which 12 trials met inclusion criteria. Results of random effect meta-analysis indicated a significant reduction in total cholesterol (TC) (SMD: - 0.14 mg/dl; 95% CI: - 0.25, - 0.02) and triglyceride (TG) (SMD: - 0.45 mg/dl; 95% CI: - 0.86, - 0.04) with VDS compared to the placebo. The subgroup analyses revealed that the reduction of TG in patients with diabetes and vitamin D deficiency was significant. Furthermore, short-term intervention (≤ 6 months) induced a significantly lower level of TG and insulin in comparison to longer duration (> 6 months).

CONCLUSION

The study suggests that VDS could improve insulin concentration and dyslipidemia in the elderly population. The systematic review was registered in Alborz university of medical sciences with 2060-01-03-1397 number and the Ethics council IR.ABZUMS.REC.1397.207 number.

Bariatric Surgery Induced Changes in Blood Cholesterol Are Modulated by Vitamin D Status

The effect of metabolically active bariatric surgery treatment on lipid metabolism is inconclusive. The authors of this study presume that initial vitamin D status may play a regulating role in influencing the beneficial post-effects of bariatric surgery, especially the lipid profile. The biochemical data obtained from 24 patients who had undergone laparoscopic one-anastomosis gastric bypass (OAGB) at baseline, 3 months before the surgery, at the time of surgery, and 6 months later, demonstrate that vitamin D status influenced the postoperative lipid profile. The baseline established the partition line which divided patients into two groups according to the stated calcidiol initial concentration level of 32 ng/mL. The data shows that OAGB induces a decrease in TG and hsCRP while increasing HDL. Conversely, in patients whose 25(OH)D₃ was below 32 ng/mL TC significantly increased while those above this concentration remained in the normal physiological range. The changes induced by OAGB in TG, glucose, and hsCRP were similar in both groups. Unexpectedly, the surgery did not affect vitamin D metabolites. In conclusion, the results of the study suggest that a higher concentration of serum 25(OH)D₃ may enhance the protective effects of OAGB.

Multicomponent Exercise Program for Improvement of Functional Capacity and Lipidic Profile of Older Women with High Cholesterol and High Triglycerides

Background: Physical inactivity is a primary cause of most chronic diseases. In addition, the negative effects of aging, physical inactivity and dyslipidemia are risk factors for cardiovascular diseases of older women. Exercise is considered fundamental for the treatment and prevention due to the benefits in the health of this population, but detraining periods after exercise can reverse them. Multicomponent exercise (ME) is a combined method of aerobic and resistance training that can improve the lipidic profile of older women with high cholesterol and triglycerides. Methods: Seventeen older women (EG: 65.3 ± 4.7 years, 1.52 ± 4.12 m) followed a supervised ME program of nine months and three months of detraining (DT), and fifteen older women (CG: 66.4 ± 5.2 years, 1.54 ± 5.58 cm) continued their daily routine, without exercise. Total cholesterol (TC), triglycerides (TG), blood glucose (GL) and functional capacity (FC) were evaluated at the beginning and at the end of the program and after three months of DT. Results: ME program improved (p < 0.05) lipidic profile: GL (−15.6%), TC (−15.3%), TG (−19.3%) and FC: agility (−13.3%), lower body strength (27.78%), upper body strength (26.3%), cardiorespiratory capacity (11.2%), lower body flexibility (66.67%) and upper body flexibility (85.72%). DT declined the lipidic profile and FC (p < 0.05). Conclusion: Lipidic profile and functional capacity can be improved with nine months of ME. Besides the negative effects of DT, three months were not enough to reverse the benefits of exercise in older women with high values of TG and TC.

The Effects of Nordic Walking Compared to Conventional Walking on Aerobic Capacity and Lipid Profile in Women Over 55 Years of Age

BACKGROUND

The purpose of this study was to investigate the effects of Nordic Walking compared to conventional walking on aerobic capacity, the lipid profile, left ventricular ejection fraction, body mass, and body mass index in women over 55 years old.

METHODS

The study was comprised of 74 women over 55 years of age. Participants were randomized to the Nordic Walking (n = 38) or conventional walking (n = 36) training groups. The echocardiogram, treadmill exercise stress test, lipid profile, and body mass were assessed at baseline (pretest) and after 12 weeks (posttest).

RESULTS

The authors found a significant main effect over time in duration (effect size [ES] = 0.59, P < .0001), distance covered (ES = 0.56, P < .0001), peak oxygen consumption (ES = 0.43, P < .0001), metabolic equivalent (ES = 0.29, P < .0001), peak heart rate (ES = 0.2, P < .0001), peak diastolic blood pressure (ES = 0.11, P = .0045), total cholesterol (ES = 0.26, P < .0001), and low-density lipoprotein cholesterol (ES = 0.16, P = .0005). The authors did not observe a time versus group interaction or the effect between groups. Post hoc tests revealed significant pretraining to posttraining differences in low-density lipoprotein cholesterol after the Nordic Walking training program and in peak diastolic blood pressure after the conventional walking training program. The heart rate, systolic blood pressure, and diastolic blood pressure at rest, peak diastolic blood pressure, somatic parameters (body mass and body mass index), and left ventricular ejection fraction did not change in either group.

CONCLUSIONS

Both training programs resulted in increases in aerobic capacity and decreases in total cholesterol.

Effect of HFE Gene Mutation on Changes in Iron Metabolism Induced by Nordic Walking in Elderly Women

Background

Excess iron accumulation in human tissue is associated with the diet, lack of exercise, or genetic factors. Iron accumulation increases the risk of acute myocardial infarction, diabetes, and cancer. On the other hand, exercise reduces the risk of several morbidities and influences iron metabolism. Here, we evaluated changes in iron metabolism induced by exercise in elderly women bearing the H63A HFE mutation.

Purpose

To identify a factor that modulates the effect of exercise on iron metabolism. We investigated whether regular exercise induces similar changes in iron metabolism, mainly manifested by lowered body iron stores, in individuals bearing the wild-type (WT) and mutated HFE gene.

Subjects and Methods

Seventy-six women (average age 69.2±5.6 years old) were enrolled in the study. Thirty-nine women participated in 12 weeks of Nordic walking (NW) training; the remaining participants were assigned to the control group. Based on the H63A HFE mutation status, the NW group was divided into women bearing the mutation (HET, n=12) and women with the WT gene (WT, n=27).

Results

The training resulted in a statistically significant reduction in the serum iron (p=0.03) and ferritin levels (p=0.001); hepcidin levels remained unchanged. No differences in these parameters were noted between the HET and WT groups.

Conclusion

These observations suggest that a reduction in body iron stores might constitute an important aspect of the health-promoting effect of exercise, regardless of the genetic background.

Iron Status in Elderly Women Impacts Myostatin, Adiponectin and Osteocalcin Levels Induced by Nordic Walking Training

Impaired iron metabolism is associated with increased risk of many morbidities. Exercise was shown to have a beneficial role; however, the mechanism is not well understood. The purpose of this study was to assess the relationship between exerkines and iron metabolism in elderly women before and after 12 weeks of Nordic Walking (NW) training. Exerkines like myostatin, adiponectin, and osteocalcin have been shown to have several positive effects on metabolism. Thirty-six post-menopausal women (66 ± 5 years old, mean ± SD) were randomly assigned to a NW intervention group (n = 18; body mass, 68.8 ± 11.37 kg; fat, 23.43 ± 7.5 kg; free fat mass, 45.37 ± 5.92 kg) or a control group (n = 18; body mass, 68.34 ± 11.81 kg; fat, 23.61 ± 10.03 kg; free fat mass, 44.73 ± 3.9 kg). The training was performed three times a week for 12 weeks, with the intensity adjusted to 70% of the individual maximum ability. Before and one day after the 12-weeks intervention, performance indices were assessed using a senior fitness test. Blood samples (5 mL) were obtained from the participants between 7 and 8 AM, following an overnight fast, at baseline and one day immediately after the 12-week training program. A significant and large time × group interaction was observed for iron (NW: 98.6 ± 26.68 to 76.1 ± 15.31; CON: 100.6 ± 25.37 to 99.1 ± 27.2; p = 0.01; ηp2 = 0.21), myostatin (NW: 4.42 ± 1.97 to 3.83 ± 1.52; CON: 4.11 ± 0.95 to 4.84 ± 1.19; p = 0.00; ηp2 = 0.62), adiponectin (NW: 12.0 ± 9.46 to 14.6 ± 10.64; CON: 12.8 ± 8.99 to 11.9 ± 8.53; p = 0.00; ηp2 = 0.58), and osteocalcin (NW: 38.9 ± 26.04 to 41.6 ± 25.09; CON: 37.1 ± 33.2 to 37.2 ± 32.29; p = 0.03; ηp2 = 0.13). Furthermore, we have observed the correlations: basal ferritin levels were inversely correlated with changes in myostatin (r = −0.51, p = 0.05), change in adiponectin, and change in serum iron (r = −0.45, p = 0.05), basal iron, and osteocalcin after training (r = -0.55, p = 0.04). These findings indicate that iron modulates NW training-induced changes in exerkine levels.

The effect of overtraining on serum leptin levels in women national wrestlers

Purpose: Weight control and weight loss during the periods of wrestling competitions are attached great importance -in order to be successful in wrestling. Leptin hormone level is known to play an important role in the control of body weight. For this reason, the purpose of this study was to investigate the effect of substantial weight loss on serum leptin levels of women wrestlers during competition periods. Material and Methods: Twenty-five women wrestlers who trained for 2015 European Championship from Turkish National Wrestling Team and 26 sedentary women were recruited voluntarily for this study. Serum leptin levels of wrestlers in the experimental group and sedentary women in the control group were measured after overnight fasting before and after 21 days training camp of 2015 European Championship. Results. Statistically significant difference was found in the direction of decrease in body weight, body mass index (BMI), glucose, insulin, cholesterol, triglyceride, LD, VLDL and leptin parameters and increase in HDL parameters before and after training camp in the experimental group ( p < .05 ). There was a statistically significant difference in leptin levels between the control group and women wrestlers ( p < .05 ). There was also a statistically significant difference in leptin levels of wrestlers before and after training camp ( p < .05 ). Conclusion. As a result, the data obtained in the study indicate that intense wrestling trainings in camping period brought about weight loss and decreased leptin levels.

The Effect of Nordic Walking Training Combined with Vitamin D Supplementation on Postural Control and Muscle Strength in Elderly People-A Randomized Controlled Trial

Nordic Walking (NW) and Vitamin D concentration (Vit D) alone have been shown to contribute to the health and performance of elderly people. However, the interaction between these two factors has yet to be explored. In this study 42 women over 60 years of age (69.02 ± 5.56 years) were recruited and divided in two NW groups: a high-intensity interval training group (HI-NW) and a moderate-intensity continuous training group (MI-NW). Individuals from each group completed a 12-week NW training program (3 times a week/2 hours) combined with randomized Vitamin D supplementation (HD = high dose: 4000 IU/day or LD = low dose: 800 IU/day). Body composition, postural control, muscle strength and Vitamin D serum concentration were measured twice; before and after the intervention. To investigate the interaction between supplementation and training a mixed-design analysis of variance (ANOVA) was performed. The HI-NW group, regardless of supplementation dose, increased their Vit D and elbow torque performance. On the other hand, in the MI-NW group the same Vit D outcome was seen only with HD supplementation and was also associated with increased leg muscle mass. In conclusion, beneficial effects of both HI-NW and MI-NW training regimes were seen. The impact of the dose supplementation on Vit D and body composition was related to the type of NW training.