High Body Mass Index Is Associated with the Extent of Muscle Damage after Eccentric Exercise

Psychophysical changes after total sleep deprivation and experimental muscle pain

Sleep disturbances exacerbate chronic pain, increase psychological load, and increase inflammation. Delayed onset muscle soreness (DOMS) mimics aspects of chronic pain, predominantly affecting peripheral pain mechanisms, while experimental sleep provocations have been shown to impact central pain mechanisms. This study aimed to combine a DOMS model with total sleep deprivation (TSD) to create a novel model affecting both peripheral and central pain mechanisms. A total of 30 healthy participants attended two sessions (baseline and follow-up) separated by 24 h of TSD and a home rating after 48 h. Assessments of interleukin 6 (IL-6) levels, sleep quality, pain catastrophising, affect, and symptoms of depression and anxiety were included in the baseline and follow-up sessions. Additionally, pressure pain and tolerance thresholds, temporal summation, and conditioned pain modulation (CPM) were assessed using cuff-pressure algometry in the baseline and follow-up sessions. DOMS was induced with eccentric calf raises during the baseline session followed by 24 h of TSD. At follow-up pain tolerance (p = 0.012) was significantly reduced, and CPM (p = 0.036) was significantly impaired compared to baseline. Psychological changes included decreases in pain catastrophising (p = 0.027), positive affect (p < 0.001), negative affect (p = 0.003), and anxiety (p = 0.012). Explorative regression models predicted 58% and 68% of DOMS pain intensity after 24 and 48 h, respectively, based on baseline body mass index, pain thresholds, psychological measures, and IL-6 (p < 0.01). Combining DOMS with 1 night of TSD induced pain hypersensitivity, impaired CPM, and altered psychological states. A combination of baseline inflammation, psychological measures, and pain sensitivity significantly predicted DOMS pain intensity after 24 and 48 h.

Is moderate-intensity interval training more tolerable than high-intensity interval training in adults with obesity?

Interval training (IT) has been shown to be a time-effective alternative to traditional training programmes in the management of obesity. Nevertheless, studies comparing the effects of different IT intensities on inflammation, muscle and liver damage, and perceptual responses in people with obesity are relatively scarce. This study aimed to compare the acute effects of two different IT protocols matched by the mean load and duration on biochemical and perceptual responses in sedentary adults with obesity. Twenty-two volunteers (age = 33.40 ± 10.01 years, BMI = 38.29 ± 7.09 kg/m²) were randomized to perform two conditions: moderate-intensity IT (MIIT) 5 × 3 min (70% of peak power output (PPO))/2 min (45%PPO) and high-intensity IT (HIIT) 8 × 1 min (90%PPO)/2 min (45%PPO). Blood samples were drawn before and after exercise for biochemical and haematological measurements. Rating of perceived exertion (RPE) was assessed during and after exercise. Perceptual pain was evaluated before, throughout and after exercise. C-reactive protein, white blood cells and neutrophils increased only after HIIT (p < 0.001, for all). Aspartate aminotransferase, alanine aminotransferase, creatine kinase and lactate dehydrogenase increased in both HIIT and MIIT (p < 0.001, for all), without any difference between sessions. HIIT induced a greater increase of blood lactate compared to MIIT (p < 0.05). Pain and RPE scores were higher during HIIT vs. MIIT (p < 0.001 and p < 0.01, respectively). MIIT induced fewer immune system perturbations and less muscle pain and was perceived as more tolerable compared to HIIT session. Therefore, MIIT could be used as a first step to promote body adaptations before starting a HIIT programme in sedentary people with obesity.

Health Impacts of High BMI in China: Terrible Present and Future

Temporal trends and future expectations of health effects due to high body mass index (BMI) remain uncertain in China. The trends of high-BMI-related death in China were evaluated and predicted until 2040 using data and methods from the Global Burden of Disease study. The absolute numbers and age-standardized rates of death and disability-adjusted life years (DALYs) were also calculated by age, gender, and cause. From 1990 to 2019, the high-BMI-related death percent, number and rate were all significantly increased in China, and death rate may exceed that globally in the next 10 years. High BMI caused more deaths and DALYs for men than for women, and the gap appeared to increase over time. In 2019, the burden of high BMI among ages 0−14 and 15−19 for children and adolescents were lower than that among adults (>20 years). The most common cause of death associated with high BMI was stroke, followed by ischemic heart disease and hypertensive heart disease. High BMI burden is a significant public health challenges in China. BMI surveillance and evaluation of evidence-based preventive strategies should be immediately initiated in Chinese residents due to the rapid increase in the burden of high BMI.

Does Obesity Affect the Severity of Exercise-Induced Muscle Injury?

This literature review investigates the effects of obesity on exercise-induced muscle injury and reexamines the potential mechanisms of exercise-induced muscle injury related to obesity. Several studies reported that high body mass index and percent body fat can significantly affect the markers of muscle injury after exercise, including maximal strength, delayed onset muscle soreness, creatinine kinase level, and myoglobin level. The potential mechanisms resulting in these outcomes include structural changes in the cell membrane induced by high fat levels, increased inflammatory responses due to adipose tissues, reduced muscle satellite cell activation and myogenesis due to lipid overload, differences in muscle fiber distributions, and sedentary behaviors. These mechanisms, however, must be verified through more research. As obesity is a potential risk factor increasing the severity of exercise-induced muscle injuries, the exercise intensity and duration for obese patients must be carefully selected, and a preconditioning intervention (e.g., low-intensity eccentric training) may be considered before or during the early stages of the exercise program.

Effect of a 12-week endurance training program on force transfer and membrane integrity proteins in lean, obese, and type 2 diabetic subjects

The mechanisms accounting for the loss of muscle function with obesity and type 2 diabetes are likely the result of a combination of neural and muscular factors. One muscular factor that is important, yet has received little attention, is the protein machinery involved in longitudinal and lateral force transmission. The purpose of this study was to compare the levels of force transfer and membrane integrity proteins before and after a 12‐week endurance training program in lean, obese, and obese type 2 diabetic adults. Nineteen sedentary subjects (male = 8 and female = 11) were divided into three groups: Lean (n = 7; 50.3 ± 4.1 y; 69.1 ± 7.2 kg); Obese (n = 6; 49.8 ± 4.1 y; 92.9 ± 19.5 kg); and Obese with type 2 diabetes (n = 6; 51.5 ± 7.9 years; 88.9 ± 15.1 kg). Participants trained 150 min/week between 55% and 75% of VO_2max for 12 weeks. Skeletal muscle biopsies were taken before and after the training intervention. Baseline dystrophin and muscle LIM protein levels were higher (~50% p < .01) in lean compared to obese and type 2 diabetic adults, while the protein levels of the remaining force transfer and membrane integrity proteins were similar between groups. After training, obese individuals decreased (−53%; p < .01) the levels of the muscle ankyrin repeat protein and lean individuals decreased dystrophin levels (−45%; p = .01), while the levels of the remaining force transfer and membrane integrity proteins were not affected by training. These results suggest that there are modest changes to force transfer and membrane integrity proteins in middle‐aged individuals as a result of 12 weeks of lifestyle and training interventions.

Movement Time of Lower Trunk Muscles during Dynamic Postural Control in Response to a Sudden Visual Stimulus during Walking: A Pilot Study

Postural control during walking is maintained by the combination of various factors. Among these factors, adjustment of trunk movement is essential for maintaining postural control, and the response of muscles to unpredictable stimuli affects postural control. Loss of balance while walking increases the risk of accidents, the frequency of which depends on age and sex. In this study, we investigated whether there was a difference in the movement time of trunk muscles to sudden stimulation while walking according to age and sex. Fourteen healthy individuals aged 20-30 years (6 men, 8 women) and 12 individuals aged 50-70 years (4 men, 8 women) were included in the study. Movement time of bilateral erector spinae and rectus abdominis muscles in response to visual stimulation during walking was examined using surface electromyography. Movement time was calculated as the total muscle activation time excluding the reaction time. This study revealed no significant differences in movement time of the erector spinae muscles according to sex or age. The role of the rectus abdominis muscles in maintaining posture during walking was insignificant. In conclusion, the movement time of trunk muscles in response to sudden visual stimulation during walking did not differ by age or sex, and the difference in accident frequency may be associated with deterioration of other factors required to maintain posture.

Physiological Changes, Activity, and Stress During a 100-km-24-h Walking-March

Background

Long-endurance exercises like ultramarathons are known to elicit various metabolic and physiological changes in the human body. However, little is known about very long-duration exercise at low intensities regarding healthy human subjects.

Aim

The purpose of this study was to evaluate changes in body composition and metabolism in long-endurance but low-intensity events.

Methods

Twenty-five male and 18 female healthy recreational athletes (age 34.6 ± 8.8 years; BMI: 22.4 ± 2.0 kg/m²) of the "100 km Mammutmarsch" were recruited for participation during the events in 2014-2016. Other than classical ultramarathons, the "Mammutmarsch" is a hiking event, in which participants were required to walk but not run or jog. It was expected to complete the 100-km distance within 24 h, resulting in a calculated mean speed of 4.17 km/h, which fits to the mean speed observed (4.12 ± 0.76 km/h). As not all participants reached the finish line, comparison of finishers (FIN, n = 11) and non-finishers (NON, n = 21) allowed differential assessment of performance. Body composition measured through bioelectrical impedance analysis (BIA) was determined pre- and post-event, and serum samples were taken pre-event, at 30, 70, and 100 km to determine NT-pro-BNP, troponin T, C-reactive protein (CRP), cortisol, low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides, total cholesterol, total creatine kinase (CK), CK-MB, aminotransferase (AST), ALT, and sodium levels. Nineteen participants wore actimeter armbands (SenseWear^®) to gain information about body activity and exercise intensity [metabolic equivalent of task (MET)]. Sixteen participants wore mobile heart rate monitors to assess mean heart rate during the race. Serum parameter alterations over the course of the race were analyzed with mixed-effects ANOVA and additional t-tests. All serum parameters were analyzed for correlation concerning different MET levels, speed, age, BMI, baseline NT-pro-BNP, mean heart rate during the race, and sex with linear regression analysis.

Results

We found significant elevations for muscle and cardiac stress markers (CRP, CK, CK-MB, AST, ALT, cortisol, and NT-pro-BNP) as well as decreasing markers of lipid metabolism (cholesterol, triglycerides, LDL). Although the intensity level demanded from our participants was low compared with other studies on (ultra-) marathons, the alteration of tested parameters was similar to those of high-intensity exercise, e.g., NT-pro-BNP showed a fourfold increase (p < 0.01) and LDL decreased by 20% (p = 0.05). Besides the duration of exercise, age, BMI, training status, and sex are relevant parameters that influence the elevation of stress factors. Notably, our data indicate that NT-pro-BNP might be a marker for cardiovascular fitness also in healthy adults.

Conclusion

This low-intensity long-endurance walk evoked a strong systemic reaction and large cell stress and shifted to a favorable lipid profile, comparable to higher intensity events. Despite increasing cardiac stress parameters, there were no indications of cardiac cell damage. Remarkably, the duration seems to have a greater influence on stress markers and metabolism than intensity.

Six Weeks of Aerobic Exercise in Untrained Men With Overweight/Obesity Improved Training Adaptations, Performance and Body Composition Independent of Oat/Potato or Milk Based Protein-Carbohydrate Drink Supplementation

Background: Protein availability around aerobic exercise might benefit aerobic capacity and body composition in normal weight adults. However, it is unknown if individuals with overweight/obesity elicit similar adaptations or improve other cardiometabolic/health-related markers in response to different types of protein. Thus, our aim was to study the effect of supplementation of two different protein drinks in conjunction with exercise on aerobic capacity, body composition and blood health markers in untrained subjects with overweight or obesity.

Methods: The present study measured training adaptation and health parameters over a 6 week period in untrained men with overweight/obesity (n = 28; BMI 30.4 ± 2.2 kg/m²) ingesting either plant- (Oat/Potato; n = 8) or animal-based (Milk; n = 10) protein-carbohydrate drinks (10 g of protein/serving), or a control carbohydrate drink (n = 10) acutely before and after each training session (average three sessions/week @ 70% HR_max). Pre-post intervention V˙O2peak, muscle biopsies and blood samples were collected, body composition measured (DXA) and two different exercise tests performed. Body weight was controlled with participants remaining weight stable throughout the intervention.

Results: For the groups combined, the training intervention significantly increased V˙O2peak (8%; P < 0.001), performance in a time-to-exhaustion trial (~ 100%; P < 0.001), mitochondrial protein content and enzyme activity (~20–200%). Lean body mass increased (1%; P < 0.01) and fat mass decreased (3%; P < 0.01). No significant effects on fasting blood glucose, insulin, lipids or markers of immune function were observed. There were no significant interactions between drink conditions for training adaptation or blood measurements. For body composition, the Oat/Potato and carbohydrate group decreased leg fat mass significantly more than the Milk group (interaction P < 0.05).

Conclusions: Aerobic capacity and body composition were improved and a number of mitochondrial, glycolytic and oxidative skeletal muscle proteins and enzyme activities were upregulated by a 6 week training intervention. However, none of the parameters for endurance training adaptation were influenced by protein supplementation before and after each training session.

Influence of body mass index and weight lifting on bicep brachii muscle and distal bicep tendon stiffness evaluated using ultrasound elastography

BACKGROUND

This study aimed to investigate the relationship between stiffness of the bicep brachii muscle (BBM) and distal bicep tendon (DBT) and effects of weight lifting (pre- to post-workout changes) among groups with different body mass indexes (BMI).

METHODS

Participants were divided into four groups according to BMI: A, underweight (< 18.5 kg/m²); B, normal (18.5-24.9 kg/m²); C, overweight (25.0-29.9 kg/m²); and D, obese (> 30.0 kg/m²). All participants were males who were untrained and had sedentary lifestyle without involvement in sports activities for the past 12 months. Ultrasonographic measurements to determine muscle and tendon stiffness was performed on the dominant side (i.e., right side) of the upper extremities in all participants.

RESULTS

Twenty-one healthy and untrained males volunteered to participate in this study; 14 were nonsmokers and 7 were smokers. The mean age and BMI were 22.5 ± 1.5 years and 23.8 ± 6.3 kg/m², respectively. Groups A, B, C, and D had four, ten, four, and three participants, respectively. The BBM thickness did not increase with increase in BMI and was not significantly different (P > .05) between groups. The BBM stiffness was significantly different (all P < .05) from pre- to post-workout values in all groups, whereas DBT stiffness did not follow the same trend.

CONCLUSIONS

Our study revealed that the BBM thickness is independent of BMI. After weight lifting, BBM stiffness in groups A and B increased for BBM compared to those in groups C and D. A similar trend was also recorded for DBT. Weight lifting in concentric and eccentric motions affects the stiffness of the BBM and DBT, thus weight lifting plays a role in adjusting the stiffness of the BBM and DBT. Trial registration The study was approved by ethics committee of the College of Applied Medical Sciences (CAMS 080-3839; March 14, 2018).

Prevalence of work-related musculoskeletal disorders among Egyptian printing workers evidenced by using serum biomarkers of inflammation, oxidative stress, muscle injury, and collagen type I turnover

OBJECTIVE

Printing workers experience a high rate of musculoskeletal disorders (MSDs). This study aims to determine the prevalence of MSDs, estimate serum biomarkers denoting musculoskeletal tissue changes, and determine some individual risk factors for MSDs among Egyptian printing workers.

METHODS

Eighty-five male printing workers and 90 male administrative employees (control group) were recruited from a printing press in Giza. A validated version of the standardized Nordic questionnaire was used. Serum biomarkers of inflammation (interleukin (IL)-1α, IL-1β, IL-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP)), cell stress or injury (malondialdehyde (MDA) and creatine kinase skeletal muscle (CK-MM)), and collagen metabolism (collagen-I carboxy-terminal propeptide (PICP) and type-I collagen cross-linked C-telopeptide (CTx)) were measured for all participants.

RESULTS

This study showed a significant (p < 0.001) prevalence of the musculoskeletal symptoms (76.5%) and significant (p < 0.001) elevation in the levels of all measured biomarkers among the printing workers (means ± SD: IL-1α = 1.55 ± 0.9, IL-1β = 1.53 ± 0.87, IL-6 = 1.55 ± 0.85, TNF-α = 4.9 ± 2.25, CRP = 6.78 ± 3.07, MDA = 3.41 ± 1.29, CK-MM = 132.47 ± 69.01, PICP = 103.48 ± 36.44, and CTx = 0.47 ± 0.16) when compared with their controls (prevalence: 34.4%; means ± SD: IL-1α = 0.88 ± 0.61, IL-1β = 0.96 ± 0.72, IL-6 = 1.03 ± 0.75, TNF-α = 2.56 ± 1.99, CRP = 2.36 ± 1.1, MDA = 0.85 ± 0.21, CK-MM = 53.48 ± 33.05, PICP = 56.49 ± 9.05, and CTx = 0.31 ± 0.06). Also, significant (p < 0.001) positive strong associations were observed between age, body mass index (BMI), and the duration of employment with all measured biomarkers, where all correlation coefficients were >0.7.

CONCLUSION

Printing workers suffer a high prevalence of work-related MSDs that might be related to some individual factors (age, BMI, and duration of employment). Consequently, preventive ergonomic interventions should be applied. Further studies should be done to elucidate the link between tissue changes and detected biomarkers to follow the initiation and progression of MSDs and study the effectiveness of curative interventions.

Effect of Body Fat Percentage on Muscle Damage Induced by High-Intensity Eccentric Exercise

This study aimed to investigate the impact of percent body fat (%BF) on muscle damage after high-intensity eccentric exercise. Thirty healthy male undergraduates (mean age: 22.0 ± 2 years, height: 176.9 ± 5 cm, weight: 75.8 ± 11.6 kg) participated in this study, and they were classified according to their %BF into a high %fat group (HFG, ≥20%, n = 15) and a low %fat group (LFG, ≤15%, n = 15). For eccentric exercise, two sets of 25 reps were performed on a modified preacher curl machine using the elbow flexor muscle. Maximal isometric strength, muscle soreness (passive and active), creatine kinase (CK), and myoglobin (Mb) were measured as indices of muscle damage. The data were analyzed with repeated measures ANOVA. The results show that there is a significant group–time interaction for both CK and Mb after eccentric exercise (p = 0.007, p = 0.015, respectively), with a greater increase in the HFG than in the LFG. However, there was no significant group–time interaction for maximal isometric strength and muscle soreness (passive and active) (p > 0.05). These results suggest that %BF is a factor that alters the muscle damage indices CK and Mb, which indicate membrane disruption, after eccentric exercise.

Loss of CD36 protects against diet-induced obesity but results in impaired muscle stem cell function, delayed muscle regeneration and hepatic steatosis

AIM

The prevalence of obesity is a major risk factor for cardiovascular and metabolic diseases including impaired skeletal muscle regeneration. Since skeletal muscle regenerative capacity is regulated by satellite cells, we aimed to investigate whether a high-fat diet impairs satellite cell function and whether this is linked to fatty acid uptake via CD36. We also aimed to determine whether loss of CD36 impacts on muscle redox homeostasis and skeletal muscle regenerative capacity.

METHODS

We studied the impact of a high-fat diet and CD36 deficiency on murine skeletal muscle morphology, redox homeostasis, satellite cell function, bioenergetics and lipid accumulation in the liver. We also determined the effect of CD36 deficiency on skeletal muscle regeneration.

RESULTS

High-fat diet increased body weight, intramuscular lipid accumulation and oxidative stress in wild-type mice that were significantly mitigated in CD36-deficient mice. High-fat diet and CD36 deficiency independently attenuated satellite cell function on single fibres and myogenic capacity on primary satellite cells. CD36 deficiency resulted in delayed skeletal muscle regeneration following acute injury with cardiotoxin. CD36-deficient and wild-type primary satellite cells had distinct bioenergetic profiles in response to palmitate. High-fat diet induced hepatic steatosis in both genotypes that was more pronounced in the CD36-deficient mice.

CONCLUSION

This study demonstrates that CD36 deficiency protects against diet-induced obesity, intramuscular lipid deposition and oxidative stress but results in impaired muscle satellite cell function, delayed muscle regeneration and hepatic steatosis. CD36 is a key mediator of fatty acid uptake in skeletal muscle, linking obesity with satellite cell function and muscle regeneration.

Elevated serum creatine kinase in the early stage of sporadic amyotrophic lateral sclerosis

OBJECTIVE

To assess the changes of muscle-related biomarkers at the early stage of amyotrophic lateral sclerosis, and to confirm these findings in an experimental animal model.

METHODS

Thirty-nine subjects with sporadic amyotrophic lateral sclerosis and 20 healthy controls were enrolled and longitudinally evaluated. We evaluated serum creatine kinase and creatinine levels and appendicular lean soft-tissue mass using dual X-ray absorptiometry. The levels of biomarkers at early ALS stages were estimated using linear mixed models with unstructured correlation and random intercepts. We also analyzed the longitudinal changes of serum creatine kinase and creatinine, together with the mRNA levels of acetylcholine receptor subunit γ (Chrng) and muscle-associated receptor tyrosine kinase, markers of denervation, in the gastrocnemius muscle of superoxide dismutase 1 (SOD1)^G93A transgenic mice, an animal model of amyotrophic lateral sclerosis.

RESULTS

The estimated levels of creatine kinase were higher in subjects with amyotrophic lateral sclerosis at the early stage than in healthy controls, although the estimated appendicular lean soft-tissue mass and creatinine levels were equivalent between both groups, suggesting that the elevation of creatine kinase precedes both muscular atrophy and subjective motor symptoms in sporadic amyotrophic lateral sclerosis. In SOD1^G93A mice, the serum levels of creatine kinase were elevated at 9 weeks of age (peri-onset) when Chrng started to be up-regulated, and were then down-regulated at 15 weeks of age, consistent with the clinical data from patients with sporadic amyotrophic lateral sclerosis.

INTERPRETATION

Creatine kinase elevation precedes muscular atrophy and reflects muscle denervation at the early stage.