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France-Ratcliffe M, Hopkins ND, Low DA, Cocks MS, Jones H, Sheen KS, Sprung VS. Perceptions of Antenatal Exercise in Pregnant Females and the Impact of COVID-19. Int J Environ Res Public Health 2022; 19:10635. [PMID: 36078351 PMCID: PMC9518533 DOI: 10.3390/ijerph191710635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/11/2022] [Accepted: 08/23/2022] [Indexed: 06/15/2023]
Abstract
Exercise during pregnancy presents many benefits for the mother and baby. Yet, pregnancy is characterised by a decrease in exercise. Studies have reported barriers to antenatal exercise. The coronavirus (COVID-19) pandemic may have further exacerbated barriers to antenatal exercise as pregnant females faced many challenges. Rich, in-depth exploration into pregnant female's perceived barriers to antenatal exercise during COVID-19 is imperative. Questionnaires reporting physical activity levels were completed by all participants (n = 14). Semi-structured interviews were conducted between November 2020 and May 2021 in the UK. Interviews were analysed using thematic analysis and revealed four main themes: 'Perceptions of being an active person shaping activity levels in pregnancy', 'How do I know what is right? Uncertainty, seeking validation and feeling informed', 'Motivators to antenatal exercise' and 'A process of adaptations and adjustment'. Findings indicate that the COVID-19 pandemic exacerbated barriers to antenatal exercise and highlight the importance of direct psychosocial support and clear, trustworthy information. Findings also support the fundamental need for better education amongst healthcare professionals regarding antenatal exercise.
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Affiliation(s)
- Madeleine France-Ratcliffe
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Nicola D. Hopkins
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - David A. Low
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Matthew S. Cocks
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Helen Jones
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Kayleigh S. Sheen
- Faculty of Health, School of Psychology, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
| | - Victoria S. Sprung
- Research Institute for Sport & Exercise Sciences, Liverpool John Moores University, Tom Reilly Building, Byrom Street, Liverpool L3 3AF, UK
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Maxwell JD, Bannell DJ, Brislane A, Carter SE, Miller GD, Roberts KA, Hopkins ND, Low DA, Carter HH, Thompson A, Claassen JAHR, Thijssen DHJ, Jones H. The impact of age, sex, cardio-respiratory fitness, and cardiovascular disease risk on dynamic cerebral autoregulation and baroreflex sensitivity. Eur J Appl Physiol 2022; 122:1531-1541. [PMID: 35429292 PMCID: PMC9132800 DOI: 10.1007/s00421-022-04933-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 03/08/2022] [Indexed: 11/10/2022]
Abstract
Background Humans display an age-related decline in cerebral blood flow and increase in blood pressure (BP), but changes in the underlying control mechanisms across the lifespan are less well understood. We aimed to; (1) examine the impact of age, sex, cardiovascular disease (CVD) risk, and cardio-respiratory fitness on dynamic cerebral autoregulation and cardiac baroreflex sensitivity, and (2) explore the relationships between dynamic cerebral autoregulation (dCA) and cardiac baroreflex sensitivity (cBRS). Methods 206 participants aged 18–70 years were stratified into age categories. Cerebral blood flow velocity was measured using transcranial Doppler ultrasound. Repeated squat-stand manoeuvres were performed (0.10 Hz), and transfer function analysis was used to assess dCA and cBRS. Multivariable linear regression was used to examine the influence of age, sex, CVD risk, and cardio-respiratory fitness on dCA and cBRS. Linear models determined the relationship between dCA and cBRS. Results Age, sex, CVD risk, and cardio-respiratory fitness did not impact dCA normalised gain, phase, or coherence with minimal change in all models (P > 0.05). cBRS gain was attenuated with age when adjusted for sex and CVD risk (young–older; β = − 2.86 P < 0.001) along with cBRS phase (young–older; β = − 0.44, P < 0.001). There was no correlation between dCA normalised gain and phase with either parameter of cBRS. Conclusion Ageing was associated with a decreased cBRS, but dCA appears to remain unchanged. Additionally, our data suggest that sex, CVD risk, and cardio-respiratory fitness have little effect.
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Carter SE, Draijer R, Stewart CE, Moss AD, Thijssen DHJ, Hopkins ND. Are acute sitting-induced changes in inflammation and cerebrovascular function related to impaired mood and cognition? Sport Sci Health 2021; 17:753-762. [PMID: 34721696 PMCID: PMC8550027 DOI: 10.1007/s11332-021-00753-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 03/27/2021] [Indexed: 11/29/2022]
Abstract
Purpose Sedentary behaviour is negatively associated with mood and cognition, yet how acute sitting contributes to these overall associations is unknown. Since sitting heightens inflammation and impairs cerebrovascular function, this study investigated the hypothesis that these sitting-induced changes are related to impaired mood and cognition. Methods Twenty-five healthy desk workers (18 male, 28.3 ± 7.5 years, BMI: 24.2 ± 3.3 kg∙m-2) were recruited. During laboratory visit one, participants were familiarised with cognitive performance tests measuring executive function, attention and working memory. During laboratory visit two, participants completed 6 h of continuous, uninterrupted sitting. At baseline and after 6 h, serum markers of inflammation, middle cerebral artery blood flow velocity (MCAv), cerebrovascular carbon dioxide reactivity (CVR), dynamic cerebral autoregulation (CA), cognitive performance and mood (positive and negative affect, alert, contented and calm) were assessed. Data were analysed using paired-samples t tests and correlation analyses. Results Following sitting, C-reactive protein (∆-1.0 µg/ml) and tissue plasminogen activator (∆-360.4 pg/ml) decreased (p < 0.05), MCAv reduced (∆-2.9 cm∙s-1, p = 0.012) and normalised gain increased in the very low frequency range, indicating impaired CA (∆ + 0.22%·mmHg-1, p = 0.016). Positive affect (∆-4.6, p < 0.001), and alert (∆-10.6 p = 0.002) and contented (∆-7.4, p = 0.006) mood states also decreased following sitting. No significant changes in interleukin-6, tumour necrosis factor-alpha, von Willebrand factor, CVR or cognitive performance were observed (p > 0.05). The observed changes in inflammation and cerebrovascular function were not related to changes in mood (p > 0.05). Conclusion Alterations in inflammation or cerebrovascular function following six hours of prolonged, uninterrupted sitting are not related to the observed reductions in mood, indicating other mechanisms underlie the relationship between acute sitting and mood disturbances.
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Affiliation(s)
- Sophie E Carter
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,School of Science, Technology and Health, York St John University, Nestlé Rowntree Park Sports Campus, Haxby Road, York, YO31 8TA UK
| | - Richard Draijer
- Unilever Foods Innovation Centre, Wageningen, The Netherlands
| | - Claire E Stewart
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Andy D Moss
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Abstract
A vegan diet is associated with reduced cardiovascular morbidity and mortality, but protein deficiencies may be detrimental to skeletal muscle structure and function. The aim of this study was to compare the vascular and skeletal muscle properties between young, healthy, recreationally active habitual vegan (VEG) and omnivorous (OMN) men. Sixteen OMN and nine VEG underwent ultrasound scans to determine brachial artery flow-mediated dilation (FMD) and carotid artery intima-media thickness (cIMT) and vastus lateralis (VL) muscle thickness and fascicle pennation angle. Knee extension maximal voluntary isometric contraction (MVIC) force was assessed on an isokinetic dynamometer, and V˙O2max on a cycle ergometer and online gas analysis system. A three-day food diary determined habitual dietary behaviour. Bayesian analyses of independent groups provided "moderate" to "very strong" evidence for lower consumption of absolute (63±21 g/d vs. 98 ± 30 g/d; Bayes Factor (BF01) = 0.140) and relative (0.86 ± 0.29 g/kg/d vs.1.36 ± 0.52 g/kg/d; BF01 = 0.259) protein, absolute saturated fat (15.2 ± 7.9 g vs. 30.3 ± 11.8 g; BF01 = 0.089) and cholesterol (5.0 ± 6.0 mg vs. 337.9 ± 232.6 mg; BF01 = 0.019) in VEG compared to OMN, respectively. Further, there was "anecdotal" evidence to support no differences in FMD (3.37 ± 3.31% vs. 4.58 ± 5.82%; BF01 = 2.591), cIMT (0.51 ± 0.07 mm vs. 0.49 ± 0.04 mm; BF01 = 2.510), VL thickness (26.1 ± 3.7 mm vs. 27.8 ± 6.4 mm; BF01 = 2.726), fascicle pennation angle (16.6 ± 4.7° vs. 17.7 ± 3.7°; BF01 = 2.844), MVIC (627 ± 182 N vs. 551 ± 102 N; BF01 = 1.656) or V˙O2max (40.8 ± 9.8 ml/kg/min vs. 35.8 ± 5.2 ml/kg/min; BF01 = 1.218) between VEG and OMN, respectively. Despite marked differences in habitual nutrient intake, healthy, young vegan and omnivorous men did not differ regarding vascular and skeletal muscle structure and function, or cardiovascular fitness.
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Affiliation(s)
- Joe Page
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Robert M Erskine
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Institute of Sport, Exercise and Health, University College London, London, UK
| | - Nicola D Hopkins
- School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Holder SM, Bruno RM, Shkredova DA, Dawson EA, Jones H, Hopkins ND, Hopman MTE, Bailey TG, Coombes JS, Askew CD, Naylor L, Maiorana A, Ghiadoni L, Thompson A, Green DJ, Thijssen DHJ. Reference Intervals for Brachial Artery Flow-Mediated Dilation and the Relation With Cardiovascular Risk Factors. Hypertension 2021; 77:1469-1480. [PMID: 33745297 DOI: 10.1161/hypertensionaha.120.15754] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Sophie M Holder
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., L.G.).,INSERM, U970, Paris Cardiovascular Research Center (PARCC), France (R.M.B.).,Paris Descartes University, France (R.M.B.)
| | - Daria A Shkredova
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, the Netherlands (D.A.S., M.T.E.H., D.H.J.T.).,Centre for Heart, Lung, and Vascular Health, School of Health and Exercise Science, University of British Columbia, Kelowna, Canada (D.A.S.)
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.)
| | - Maria T E Hopman
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, the Netherlands (D.A.S., M.T.E.H., D.H.J.T.)
| | - Tom G Bailey
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Australia (T.G.B., J.S.C.)
| | - Jeff S Coombes
- School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, Brisbane, Australia (T.G.B., J.S.C.)
| | - Christopher D Askew
- VasoActive Research Group, School of Health and Sport Sciences, University of the Sunshine Coast, Sippy Downs, QLD, Australia (C.D.A.).,Sunshine Coast Health Institute, Sunshine Coast Hospital and Health Service, Birtinya, QLD, Australia (C.D.A.)
| | - Louise Naylor
- School of Human Sciences (Exercise and Sports Science), The University of Western Australia, Crawley (L.N., D.J.G.)
| | - Andrew Maiorana
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia (A.M.).,Allied Health Department and Advanced Heart Failure and Cardiac Transplant Service, Fiona Stanley Hospital, Perth, Australia (A.M.)
| | - Lorenzo Ghiadoni
- Department of Clinical and Experimental Medicine, University of Pisa, Italy (R.M.B., L.G.)
| | - Andrew Thompson
- Wolfson Centre for Personalised Medicine, University of Liverpool, United Kingdom (A.T.)
| | - Daniel J Green
- School of Human Sciences (Exercise and Sports Science), The University of Western Australia, Crawley (L.N., D.J.G.)
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, United Kingdom (S.M.H., E.A.D., H.J., N.D.H., D.H.J.T.).,Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, the Netherlands (D.A.S., M.T.E.H., D.H.J.T.)
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Roberts KA, Draijer R, Hopkins ND, de Graaf Y, Holder SM, Carter SE, Thijssen DHJ, Low DA. Impact of green tea on the deleterious cardiometabolic effects of 7-days unhealthy lifestyle in young healthy males. Physiol Rep 2021; 9:e14720. [PMID: 33682367 PMCID: PMC7937942 DOI: 10.14814/phy2.14720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/15/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE The aim of this study was to examine if catechin-rich green tea abrogates the negative effects of 7-days of physical inactivity and excessive calorie-intake on insulin homeostasis and peripheral vascular function. METHODS Using a randomized, double-blind, crossover design, twelve healthy men (29 ± 6 yrs) underwent 7-days unhealthy lifestyle (UL), including physical inactivity (-50% steps/day) and overfeeding (+50% kcal/day). This was combined with green tea consumption (UL-tea; 3 doses/day) or placebo (UL-placebo). Before and after each intervention, we examined postprandial blood glucose and insulin (3-h after a 1,202 kcal meal) and upper and lower limb vascular function (flow-mediated dilation (FMD%)) and carotid artery reactivity (CAR%). RESULTS UL-placebo increased postprandial glucose and insulin, while UL-tea decreased postprandial glucose and insulin (Time*Intervention interaction effects: both p < 0.05). UL-placebo decreased CAR% and femoral FMD%, while UL-tea prevented these effects (Time*Intervention interaction effects of p < 0.04 and p < 0.001, respectively). There was no main effect of Time or Time*Intervention interaction (both p > 0.05) for brachial FMD%. CONCLUSION Seven days of physical inactivity and overfeeding impair insulin homeostasis and vascular function. These effects were mitigated by a daily intake of catechin-rich green tea.
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Affiliation(s)
- Kirsty A Roberts
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Richard Draijer
- Unilever Foods Innovation Centre, Wageningen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Young de Graaf
- Unilever Foods Innovation Centre, Wageningen, The Netherlands
| | - Sophie M Holder
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Sophie E Carter
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.,Department of Physiology, Research Institute for Health Science, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - David A Low
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK
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7
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Brislane Á, Jones H, Holder SM, Low DA, Hopkins ND. The Effect of Exercise During Pregnancy on Maternal and Offspring Vascular Outcomes: a Pilot Study. Reprod Sci 2020; 28:510-523. [PMID: 33258064 PMCID: PMC7808996 DOI: 10.1007/s43032-020-00302-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 08/20/2020] [Indexed: 01/28/2023]
Abstract
The aim of this pilot study is to obtain estimates for the change in maternal cerebrovascular (primary) and offspring vascular structure (secondary) during healthy pregnancy that includes structured exercise. Eighteen pregnant women self-assigned to a moderate-intensity aerobic exercise intervention or a control group. Maternal cerebral blood flow (CBF) at the middle cerebral artery, cerebro- and peripheral-vascular function was assessed at the end of each trimester. Offspring carotid artery intima-media thickness (IMT) was measured within 12 weeks of birth. For exploratory purposes, we performed statistical analysis to provide estimates of the change for primary and secondary outcome variables. Maternal CBF reduced (− 8 cm s−1 [− 14 to − 2]) with evidence of change to cerebral autoregulation (normalised gain: 0.12 %cm s−1% mmHg−1mmHg/% [− 0.18 to 0.40]) during pregnancy. Offspring carotid IMT was smaller in the exercise group (− 0.04 mm [− 0.12–0.03]) compared with controls. Based upon this data, a sample size of 33 and 57 in each group is required for low-frequency normalised gain and offspring IMT, respectively. This would provide 90% power to detect statistically significant (P < 0.05) between group differences in a randomised controlled trial. CBF is reduced in pregnancy, possibly due to reduced vascular resistance and altered maternal cerebral autoregulation. Maternal exercise had negligible effects on cerebrovascular adaptation to pregnancy, but we observed lower offspring carotid artery wall thickness following maternal exercise. Our directional findings and sample size estimations should be explored in a fully powered randomised control trial. Clinical trial registration: The trial was registered on March 14th at https://register.clinicaltrials.gov (NCT03079258). Participant enrolment began on 3rd April 2016.
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Affiliation(s)
- Áine Brislane
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK.
- School of Sport, York St. John University, Lord Mayor's Walk, York, YO31 7EX, UK.
| | - Helen Jones
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Sophie M Holder
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - David A Low
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - Nicola D Hopkins
- Research Institute of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
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Carter SE, Draijer R, Maxwell JD, Morris AS, Pedersen SJ, Graves LEF, Thijssen DHJ, Hopkins ND. Using an e-Health Intervention to Reduce Prolonged Sitting in UK Office Workers: A Randomised Acceptability and Feasibility Study. Int J Environ Res Public Health 2020; 17:ijerph17238942. [PMID: 33271884 PMCID: PMC7729470 DOI: 10.3390/ijerph17238942] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 01/03/2023]
Abstract
Low-cost workplace interventions are required to reduce prolonged sitting in office workers as this may improve employees’ health and well-being. This study aimed to assess the acceptability and feasibility of an e-health intervention to reduce prolonged sitting among sedentary UK-based office workers. Secondary aims were to describe preliminary changes in employee health, mood and work productivity after using an e-health intervention. Healthy, university office workers (n = 14) completed this study. An 8 week randomised crossover design was used, consisting of two trials: Intervention (computer-based prompts) and Control. Eligibility and retention rates were recorded to assess the feasibility of the trial and interviews were conducted following the intervention to explore its acceptability. Sitting, standing and stepping were objectively assessed prior to and during week 8 of each trial. Before and after each trial, measurements of vascular function, cerebrovascular function, mood and work productivity were obtained. This study had eligibility and retention rates of 54.5% and 77.8%, respectively. Participants expressed a lack of autonomy and disruption to their workflow when using the e-health intervention, raising concerns over its acceptability and long-term implementation. Preliminary data indicate that the intervention may improve the patterning of activity accrued during work hours, with increases in the number of standing and stepping bouts completed, in addition to improving vascular function. This e-health intervention is feasible to deliver in a cohort of university office workers. However, adaptations to its implementation, such as personalised settings, are needed to increase acceptability before larger trials can be conducted.
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Affiliation(s)
- Sophie E. Carter
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
- School of Science, Technology and Health, York St John University, York YO31 8TA, UK
- Correspondence: ; Tel.: +44-1904-876207
| | - Richard Draijer
- Unilever Foods Innovation Centre, Wageningen, The Netherlands;
| | - Joseph D. Maxwell
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
| | - Abigail S. Morris
- Department of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
| | - Scott J. Pedersen
- Active Work Laboratory, School of Education, University of Tasmania, Launceston 7250, Australia;
| | - Lee E. F. Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Nicola D. Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
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Bakker EA, Hartman YAW, Hopman MTE, Hopkins ND, Graves LEF, Dunstan DW, Healy GN, Eijsvogels TMH, Thijssen DHJ. Validity and reliability of subjective methods to assess sedentary behaviour in adults: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2020; 17:75. [PMID: 32539720 PMCID: PMC7294635 DOI: 10.1186/s12966-020-00972-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 05/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Subjective measures of sedentary behaviour (SB) (i.e. questionnaires and diaries/logs) are widely implemented, and can be useful for capturing type and context of SBs. However, little is known about comparative validity and reliability. The aim of this systematic review and meta-analysis was to: 1) identify subjective methods to assess overall, domain- and behaviour-specific SB, and 2) examine the validity and reliability of these methods. METHODS The databases MEDLINE, EMBASE and SPORTDiscus were searched up to March 2020. Inclusion criteria were: 1) assessment of SB, 2) evaluation of subjective measurement tools, 3) being performed in healthy adults, 4) manuscript written in English, and 5) paper was peer-reviewed. Data of validity and/or reliability measurements was extracted from included studies and a meta-analysis using random effects was performed to assess the pooled correlation coefficients of the validity. RESULTS The systematic search resulted in 2423 hits. After excluding duplicates and screening on title and abstract, 82 studies were included with 75 self-reported measurement tools. There was wide variability in the measurement properties and quality of the studies. The criterion validity varied between poor-to-excellent (correlation coefficient [R] range - 0.01- 0.90) with logs/diaries (R = 0.63 [95%CI 0.48-0.78]) showing higher criterion validity compared to questionnaires (R = 0.35 [95%CI 0.32-0.39]). Furthermore, correlation coefficients of single- and multiple-item questionnaires were comparable (1-item R = 0.34; 2-to-9-items R = 0.35; ≥10-items R = 0.37). The reliability of SB measures was moderate-to-good, with the quality of these studies being mostly fair-to-good. CONCLUSION Logs and diaries are recommended to validly and reliably assess self-reported SB. However, due to time and resources constraints, 1-item questionnaires may be preferred to subjectively assess SB in large-scale observations when showing similar validity and reliability compared to longer questionnaires. REGISTRATION NUMBER CRD42018105994.
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Affiliation(s)
- Esmée A Bakker
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Yvonne A W Hartman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Maria T E Hopman
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Lee E F Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - David W Dunstan
- Baker Heart & Diabetes Institute, Melbourne, Australia
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Genevieve N Healy
- The University of Queensland, School of Public Health, Brisbane, Australia
| | - Thijs M H Eijsvogels
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands
| | - Dick H J Thijssen
- Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, P.O. Box 9101, 6500, HB, Nijmegen, The Netherlands.
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
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Carter SE, Draijer R, Holder SM, Brown L, Thijssen DHJ, Hopkins ND. Effect of different walking break strategies on superficial femoral artery endothelial function. Physiol Rep 2019; 7:e14190. [PMID: 31423757 PMCID: PMC6698486 DOI: 10.14814/phy2.14190] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 07/09/2019] [Indexed: 12/22/2022] Open
Abstract
Breaking up prolonged sitting with physical activity (PA) breaks prevents conduit artery dysfunction. However, the optimal break strategy to achieve this, in terms of the frequency or duration of PA, is not known. This study assessed the effect of breaking up sitting with different PA break strategies on lower limb peripheral artery endothelial function. Fifteen participants (10 male, 35.8 ± 10.2 years, BMI: 25.5 ± 3.2 kg m-2 ) completed, on separate days, three 4-h conditions in a randomized order: (1) uninterrupted sitting (SIT), (2) sitting with 2-min light-intensity walking breaks every 30 min (2WALK), or (3) sitting with 8-min light-intensity walking breaks every 2 h (8WALK). At baseline and 4 h, superficial femoral artery function (flow-mediated dilation; FMD), blood flow, and shear rate (SR) were assessed using Doppler ultrasound. For each condition, the change in outcome variables was calculated and data were statistically analyzed using a linear mixed model. There was no significant main effect for the change in FMD (P = 0.564). A significant main effect was observed for the change in blood flow (P = 0.022), with post hoc analysis revealing a greater reduction during SIT (-42.7 ± 14.2 mL·min) compared to 8WALK (0.45 ± 17.7 mL·min; P = 0.012). There were no significant main effects for mean, antegrade, or retrograde SR (P > 0.05). Superficial femoral artery blood flow, but not FMD, was reduced following uninterrupted sitting. This decline in blood flow was prevented with longer duration, less frequent walking breaks rather than shorter, more frequent breaks suggesting the dose (duration and frequency) of PA may influence the prevention of sitting-induced decreases in blood flow.
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Affiliation(s)
- Sophie E. Carter
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- School of SportYork St John UniversityYorkUnited Kingdom
| | | | - Sophie M. Holder
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Louise Brown
- Unilever Research and DevelopmentBedfordshireUnited Kingdom
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Nicola D. Hopkins
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
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11
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Holder SM, Brislane Á, Dawson EA, Hopkins ND, Hopman MTE, Cable NT, Jones H, Schreuder THA, Sprung VS, Naylor L, Maiorana A, Thompson A, Thijssen DHJ, Green DJ. Relationship Between Endothelial Function and the Eliciting Shear Stress Stimulus in Women: Changes Across the Lifespan Differ to Men. J Am Heart Assoc 2019; 8:e010994. [PMID: 30764688 PMCID: PMC6405684 DOI: 10.1161/jaha.118.010994] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/18/2018] [Indexed: 01/26/2023]
Abstract
Background Premenopausal women have a lower incidence of cardiovascular disease, which may partly be due to a protective effect of estrogen on endothelial function. Animal studies suggest that estrogen may also improve the relationship between shear rate ( SR ) and endothelial function. We aimed to explore the relationship between endothelial function (ie, flow-mediated dilation [ FMD ]) and SR (ie, SR area under the curve [ SRAUC ]) in women versus men, and between pre- versus postmenopausal women. Methods and Results Brachial artery FMD and SRAUC were measured in accordance with expert-consensus guidelines in 932 healthy participants who were stratified into young adults (18-40 years, 389 men, 144 women) and older adults (>40 years, 260 men, 139 women). Second, we compared premenopausal (n=173) and postmenopausal women (n=110). There was evidence of a weak correlation between SRAUC and FMD in all groups but older men, although there was variation in strength of outcomes. Further exploration using interaction terms (age-sex× SRAUC ) in linear regression revealed differential relationships with FMD (young women versus young men [β=-5.8-4, P=0.017] and older women [β=-5.9-4, P=0.049]). The correlation between SRAUC and FMD in premenopausal women ( r2=0.097) was not statistically different from that in postmenopausal women ( r2=0.025; Fisher P=0.30). Subgroup analysis using stringent inclusion criteria for health markers (n=505) confirmed a stronger FMD - SRAUC correlation in young women compared with young men and older women. Conclusions Evidence for a stronger relationship between endothelial function and the eliciting SR stimulus is present in young women compared with men. Estrogen may contribute to this finding, but larger healthy cohorts are required for conclusive outcomes.
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Affiliation(s)
- Sophie M. Holder
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Áine Brislane
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Ellen A. Dawson
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Nicola D. Hopkins
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Maria T. E. Hopman
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - N. Timothy Cable
- School of Sport, Exercise and Rehabilitation SciencesUniversity of BirminghamUnited Kingdom
| | - Helen Jones
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
| | - Tim H. A. Schreuder
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Victoria S. Sprung
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of Musculoskeletal Biology IIInstitute of Ageing and Chronic DiseaseUniversity of LiverpoolUnited Kingdom
| | - Louise Naylor
- School of Human Sciences (Exercise and Sport Science)The University of Western AustraliaCrawleyWestern AustraliaAustralia
| | - Andrew Maiorana
- School of Physiotherapy and Exercise ScienceCurtin UniversityPerthAustralia
- Allied Health Department & Advanced Heart Failure and Cardiac Transplant ServiceFiona Stanley HospitalPerthAustralia
| | - Andrew Thompson
- Wolfson Centre for Personalised MedicineUniversity of LiverpoolUnited Kingdom
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise SciencesLiverpool John Moores UniversityLiverpoolUnited Kingdom
- Department of PhysiologyRadboud Institute for Health SciencesRadboud University Medical CenterNijmegenThe Netherlands
| | - Daniel J. Green
- School of Human Sciences (Exercise and Sport Science)The University of Western AustraliaCrawleyWestern AustraliaAustralia
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12
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Carter SE, Draijer R, Holder SM, Brown L, Thijssen DHJ, Hopkins ND. Regular walking breaks prevent the decline in cerebral blood flow associated with prolonged sitting. J Appl Physiol (1985) 2018; 125:790-798. [DOI: 10.1152/japplphysiol.00310.2018] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Decreased cerebrovascular blood flow and function are associated with lower cognitive functioning and increased risk of neurodegenerative diseases. Prolonged sitting impairs peripheral blood flow and function, but its effects on the cerebrovasculature are unknown. This study explored the effect of uninterrupted sitting and breaking up sitting time on cerebrovascular blood flow and function of healthy desk workers. Fifteen participants (10 male, 35.8 ± 10.2 yr, body mass index: 25.5 ± 3.2 kg/m2) completed, on separate days, three 4-h conditions in a randomized order: 1) uninterrupted sitting (SIT), 2) sitting with 2-min light-intensity walking breaks every 30 min (2WALK), or 3) sitting with 8-min light-intensity walking breaks every 2 h (8WALK). At baseline and 4 h, middle cerebral artery blood flow velocity (MCAv) and CO2 reactivity (CVR) of the MCA and carotid artery were measured using transcranial Doppler (TCD) and duplex ultrasound, respectively. Cerebral autoregulation (CA) was assessed with TCD using a squat-stand protocol and analyzed to generate values of gain and phase in the very low, low, and high frequencies. There was a significant decline in SIT MCAv (−3.2 ± 1.2 cm/s) compared with 2WALK (0.6 ± 1.5 cm/s, P = 0.02) but not between SIT and 8WALK (−1.2 ± 1.0 cm/s, P = 0.14). For CA, the change in 2WALK very low frequency phase (4.47 ± 4.07 degrees) was significantly greater than SIT (−3.38 ± 2.82 degrees, P = 0.02). There was no significant change in MCA or carotid artery CVR ( P > 0.05). Results indicate that prolonged uninterrupted sitting in healthy desk workers reduces cerebral blood flow; however, this is offset when frequent short-duration walking breaks are incorporated. NEW & NOTEWORTHY Prolonged uninterrupted sitting in healthy desk workers reduces cerebral blood flow. However, this reduction in cerebral blood flow is offset when frequent short-duration walking breaks are incorporated into this sitting period. For those who engage in long periods of sedentary behavior, chronically breaking up these sitting periods with frequent active break strategies may have important implications for cerebrovascular health; however, further research should explore this hypothesis.
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Affiliation(s)
- Sophie E. Carter
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Richard Draijer
- Unilever Research and Development, Vlaardingen, The Netherlands
| | - Sophie M. Holder
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Louise Brown
- Unilever Research and Development, Colworth Science Park, Bedfordshire, United Kingdom
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicola D. Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
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13
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Boddy LM, Cunningham C, Fairclough SJ, Murphy MH, Breslin G, Foweather L, Dagger RM, Graves LEF, Hopkins ND, Stratton G. Individual calibration of accelerometers in children and their health-related implications. J Sports Sci 2017; 36:1340-1345. [PMID: 28922063 DOI: 10.1080/02640414.2017.1377842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
This study compared children's physical activity (PA) levels, the prevalence of children meeting current guidelines of ≥60 minutes of daily moderate to vigorous PA (MVPA), and PA-health associations using individually calibrated (IC) and empirical accelerometer cutpoints. Data from 75 (n = 32 boys) 10-12 year old children were included in this study. Clustered cardiometabolic (CM) risk, directly measured cardiorespiratory fitness (CRF), anthropometric and 7 day accelerometer data were included within analysis. PA data were classified using Froude anchored IC, Evenson et al. (Evenson, K. R., Catellier, D. J., Gill, K., Ondrak, K. S., & McMurray, R. G. (2008). Calibration of two objective measures of physical activity for children. Journal of Sports Sciences, 26(14), 1557-1565. doi:10.1080/02640410802334196) (Ev) and Mackintosh et al. (Mackintosh, K. A., Fairclough, S. J., Stratton, G., & Ridgers, N. D. (2012). A calibration protocol for population-specific accelerometer cutpoints in children. PLoS One, 7(5), e36919. doi:10.1371/journal.pone.0036919) (Mack) cutpoints. The proportion of the cohort meeting ≥60mins MVPA/day ranged from 37%-56% depending on the cutpoints used. Reported PA differed significantly across the cutpoint sets. IC LPA and MPA were predictors of CRF (LPA: standardised β = 0.32, p = 0.002, MPA: standardised β = 0.27 p = 0.013). IC MPA also predicted BMI Z-score (standardised β = -0.35, p = 0.004). Ev VPA was a predictor of BMI Z-score (standardised β = -0.33, p = 0.012). Cutpoint choice has a substantial impact on reported PA levels though no significant associations with CM risk were observed. Froude IC cutpoints represent a promising approach towards classifying children's PA data.
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Affiliation(s)
- Lynne M Boddy
- a The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Conor Cunningham
- b Sport and Exercise Sciences Research Institute, Ulster Sports Academy , University of Ulster , Newtownabbey , UK
| | - Stuart J Fairclough
- c Department of Sport and Physical Activity , Edge Hill University , Ormskirk , UK.,d Department of Physical Education and Sport Sciences , University of Limerick , Limerick , Ireland
| | - Marie H Murphy
- b Sport and Exercise Sciences Research Institute, Ulster Sports Academy , University of Ulster , Newtownabbey , UK
| | - Gavin Breslin
- b Sport and Exercise Sciences Research Institute, Ulster Sports Academy , University of Ulster , Newtownabbey , UK
| | - Lawrence Foweather
- c Department of Sport and Physical Activity , Edge Hill University , Ormskirk , UK
| | - Rebecca M Dagger
- e Department of Health Sciences , Liverpool Hope University , Liverpool , UK
| | - Lee E F Graves
- a The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Nicola D Hopkins
- a The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences , Liverpool John Moores University , Liverpool , UK
| | - Gareth Stratton
- f Applied Sports Technology, Exercise and Medicine Research Centre, College of Engineering , Swansea University , Swansea , UK.,g School of Sports Science, Exercise and Health , The University of Western Australia , Perth , Australia
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14
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Abstract
Sedentary behavior has a strong association with cardiovascular disease (CVD) risk, which may be independent of physical activity. To date, the mechanism(s) that mediate this relationship are poorly understood. We hypothesize that sedentary behavior modifies key hemodynamic, inflammatory, and metabolic processes resulting in impaired arterial health. Subsequently, these vascular impairments directly and indirectly contribute to the development of CVD.
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Affiliation(s)
- Sophie Carter
- 1Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, United Kingdom; and 2Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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15
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Buchan DS, Boddy LM, Grace FM, Brown E, Sculthorpe N, Cunningham C, Murphy MH, Dagger R, Foweather L, Graves LEF, Hopkins ND, Stratton G, Baker JS. Utility of three anthropometric indices in assessing the cardiometabolic risk profile in children. Am J Hum Biol 2017; 29. [PMID: 27801547 DOI: 10.1002/ajhb.22934] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 08/08/2016] [Accepted: 10/05/2016] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To evaluate the ability of BMI, WC, and WHtR to identify increased cardiometabolic risk in pre-adolescents. METHODS This is a cross-sectional study involving 192 children (10.92 ± 0.58 years, 56% female) from the United Kingdom between 2010 and 2013. Receiver operating characteristic curves determined the discriminatory ability of BMI, WC and WHtR to identify individuals with increased cardiometabolic risk (increased clustered triglycerides, HDL-cholesterol, systolic blood pressure, cardiorespiratory fitness, and glucose). RESULTS A WHtR ≥ 0.5 increased the odds by 5.2 (95% confidence interval 2.6 - 10.3) of having increased cardiometabolic risk. Similar associations were observed for BMI and WC. Both BMI-z and WHtR were fair predictors of increased cardiometabolic risk, although BMI-z demonstrated the best trade-off between sensitivity and specificity, 76.1% and 63.6%, compared with 68.1% and 65.5% for WHtR. Cross-validation analysis revealed that BMI-z and WHtR correctly classified 84% of individuals (kappa score = 0.671, 95% CI 0.55, 0.79). The sensitivity of the cut-points suggests that 89.3% of individuals were correctly classified as being at risk with only 10.7% misdiagnosed whereas the specificity of the cut-points indicated that 77.8% of individuals were correctly identified as being healthy with 22.2% of individuals incorrectly diagnosed as being at risk. CONCLUSIONS Findings suggest that WHtR provides similar cardiometabolic risk estimates to age and sex adjusted BMI.
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Affiliation(s)
- Duncan S Buchan
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom
| | - Lynne M Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom
| | - Fergal M Grace
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom
| | - Elise Brown
- School of Health Sciences, Oakland University, 2200 N. Squirrel Road, Rochester, Michigan, 48309-4401
| | - Nicholas Sculthorpe
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom
| | - Conor Cunningham
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Health Sciences Building, 97 Lisburn Road, Belfast, BT9 7BL, United Kingdom
| | - Marie H Murphy
- Sport and Exercise Sciences Research Institute, Ulster Sports Academy, Ulster University, Jordanstown Campus, Shore Road, Newtownabbey, Co. Antrim, BT37 0QB, United Kingdom
| | - Rebecca Dagger
- Department of Health Sciences, Liverpool Hope University, Hope Park, Liverpool, L16 9JD, United Kingdom
| | - Lawrence Foweather
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom.,Department of Sport and Physical Activity, Edge Hill University, St Helens Road, Ormskirk, L39 4QP
| | - Lee E F Graves
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom
| | - Nicola D Hopkins
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, United Kingdom
| | - Gareth Stratton
- Applied Sports Technology, Exercise and Medicine Research Centre, College of Engineering, Swansea University, Singleton Park, Swansea, SA2 8PP, United Kingdom.,School of Sports Science, Exercise and Health, the University of Western Australia, Perth, Australia
| | - Julien S Baker
- Institute of Clinical Exercise and Health Science, University of the West of Scotland, Lanarkshire, Hamilton, ML3 0JB, United Kingdom
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16
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Roberts KA, van Gent T, Hopkins ND, Jones H, Dawson EA, Draijer R, Carter HH, Atkinson CL, Green DJ, Thijssen DHJ, Low DA. Reproducibility of four frequently used local heating protocols to assess cutaneous microvascular function. Microvasc Res 2017; 112:65-71. [PMID: 28342751 DOI: 10.1016/j.mvr.2017.03.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 03/21/2017] [Accepted: 03/21/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Skin microvascular responses to local heating are frequently used to assess microvascular function. Several local heating protocols have been developed, all varying slightly in execution. The aim of this study was to determine the inter-day reproducibility of the four most commonly used local heating protocols in healthy young subjects. METHODS Fifteen, healthy males (28±5yrs, BMI 25±2kg/m2) attended two experimental trials 2-7days apart. During each trial, baseline and maximal thermally stimulated forearm skin responses were examined simultaneously at four sites on the dominant forearm using laser Doppler flowmetry (LDF). The following heating protocols were adopted: 1. Rapid 39°C (0.5°C/5s), 2. Rapid 42°C (0.5°C/5s) 3. Gradual 42°C (0.5°C/2min 30s) and 4. Slow 42°C (0.5°C/5min). The coefficient of variation (CV) was calculated for absolute flux, cutaneous vascular conductance (CVC; flux/mean arterial pressure, MAP) and CVC expressed as a percentage of maximal CVC at 44°C (%CVCmax) at three different time points; baseline (33°C), plateau (39/42°C) and maximal (44°C). RESULTS Reproducibility of baseline flux, CVC and %CVCmax was 17-29% across all protocols. During the plateau, Rapid, Gradual and Slow 42°C demonstrated a reproducibility of 13-18% for flux and CVC and 5-11% for %CVCmax. However, Rapid 39°C demonstrated a lower reproducibility for flux, CVC and %CVCmax (all 21%). Reproducibility at 44°C was 12-15% for flux and CVC across all protocols. CONCLUSION This is the first study examining inter-day reproducibility across four local heating protocols. The good-to-moderate reproducibility of the Rapid, Gradual and Slow 42°C protocols support their (simultaneous) use to assess microvascular function. Using Rapid 39°C may require a greater number of subjects to detect differences within subjects.
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Affiliation(s)
- Kirsty A Roberts
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Thijs van Gent
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Ellen A Dawson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Richard Draijer
- Unilever Research & Development, Olivier van Noortlaan 120, 3133 AT Vlaardingen, The Netherlands
| | - Howard H Carter
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia 6009, Australia
| | - Ceri L Atkinson
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia 6009, Australia
| | - Daniel J Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; School of Sport Science, Exercise and Health, The University of Western Australia, Crawley, Western Australia 6009, Australia
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK; Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - David A Low
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.
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Green DJ, Hopkins ND, Jones H, Thijssen DHJ, Eijsvogels TMH, Yeap BB. Sex differences in vascular endothelial function and health in humans: impacts of exercise. Exp Physiol 2016; 101:230-42. [PMID: 26663420 DOI: 10.1113/ep085367] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 12/10/2015] [Indexed: 12/20/2022]
Abstract
NEW FINDINGS What is the topic of this review? This brief review discusses potential sex differences in arterial function across the age span, with special emphasis on the effects of oestrogen and testosterone on the vascular endothelium. What advances does it highlight? We discuss the relationship between the impacts of sex hormones on arterial function and health in the context of epidemiological evidence pertaining to the menopause and ageing. Studies performed in humans are emphasized, alongside insights from animal studies. Findings suggest that the combination of exercise and hormone administration should be potentially synergistic or additive in humans. This brief review presents historical evidence for the purported impacts of male and female sex hormones on the vasculature in humans, including effects on macro- and microvascular function and health. Impacts of ageing on hormonal changes and arterial function are considered in the context of the menopause. Physiological data are presented alongside clinical outcomes from large trials, in an attempt to rationalize disparate findings along the bench-to-bedside continuum. Finally, the theoretical likelihood that exercise and hormone treatment may induce synergistic and/or additive vascular adaptations is developed in the context of recent laboratory studies that have compared male and female responses to training. Differences between men and women in terms of the impact of age and cardiorespiratory fitness on endothelial function are addressed. Ultimately, this review highlights the paucity of high-quality and compelling evidence regarding the fundamental impact, in humans, of sex differences on arterial function and the moderating impacts of exercise on arterial function, adaptation and health at different ages in either sex.
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Affiliation(s)
- Daniel J Green
- School of Sport Science, Exercise and Health, The University of Western Australia, Nedlands, Western Australia, Australia.,Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Thijs M H Eijsvogels
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK.,Radboud Institute for Health Sciences, Department of Physiology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bu B Yeap
- School of Medicine and Pharmacology, University of Western Australia, Crawley, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley and Fremantle Hospitals, Perth, Australia
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18
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Hopkins ND, Green DJ, Dawson EA, Jones H. The Acute Effect Of High Intensity Interval Exercise And Moderate Continuous Exercise On Endothelial Function In Children. Med Sci Sports Exerc 2016. [DOI: 10.1249/01.mss.0000485572.36681.dd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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20
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Füssenich LM, Boddy LM, Green DJ, Graves LEF, Foweather L, Dagger RM, McWhannell N, Henaghan J, Ridgers ND, Stratton G, Hopkins ND. Physical activity guidelines and cardiovascular risk in children: a cross sectional analysis to determine whether 60 minutes is enough. BMC Public Health 2016; 16:67. [PMID: 26801090 PMCID: PMC4724140 DOI: 10.1186/s12889-016-2708-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 01/08/2016] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Physical activity reduces cardiovascular mortality and morbidity. The World Health Organisation (WHO) recommends children engage in 60 min daily moderate-to-vigorous physical activity (MVPA). The effect of compliance with this recommendation on childhood cardiovascular risk has not been empirically tested. To evaluate whether achieving recommendations results in reduced composite-cardiovascular risk score (CCVR) in children, and to examine if vigorous PA (VPA) has independent risk-reduction effects. METHODS PA was measured using accelerometry in 182 children (9-11 years). Subjects were grouped according to achievement of 60 min daily MVPA (active) or not (inactive). CCVR was calculated (sum of z-scores: DXA body fat %, blood pressure, VO2peak, flow mediated dilation, left ventricular diastolic function; CVR score ≥ 1SD indicated 'higher risk'). The cohort was further split into quintiles for VPA and odds ratios (OR) calculated for each quintile. RESULTS Active children (92 (53 boys)) undertook more MVPA (38 ± 11 min, P < 0.001), had greater VO2peak (4.5 ± 0.8 ml/kg/min P < 0.001), and lower fat % (3.9 ± 1.1 %, P < 0.001) than inactive. No difference were observed between active and inactive for CCVR or OR (P > 0.05). CCVR in the lowest VPA quintile was significantly greater than the highest quintile (3.9 ± 0.6, P < 0.05), and the OR was 4.7 times higher. CONCLUSION Achievement of current guidelines has positive effects on body composition and cardiorespiratory fitness, but not CCVR. Vigorous physical activity appears to have beneficial effects on CVD risk, independent of moderate PA, implying a more prescriptive approach may be needed for future VPA guidelines.
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Affiliation(s)
- L M Füssenich
- Department of Physiology, Radboud University Nijmegen Medical Centre, Nijmegen, Netherlands
| | - L M Boddy
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Tom Reilly Building, Byrom Street, Liverpool, L3 2ET, UK
| | - D J Green
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Tom Reilly Building, Byrom Street, Liverpool, L3 2ET, UK.,School of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Perth, WA, 6009, Australia
| | - L E F Graves
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Tom Reilly Building, Byrom Street, Liverpool, L3 2ET, UK
| | - L Foweather
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Tom Reilly Building, Byrom Street, Liverpool, L3 2ET, UK
| | - R M Dagger
- School of Health Sciences, Liverpool Hope University, Liverpool, L16 9JD, UK
| | - N McWhannell
- Department of Sport and Exercise Science, University of Chester, Chester, CH1 4BJ, UK
| | - J Henaghan
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Tom Reilly Building, Byrom Street, Liverpool, L3 2ET, UK
| | - N D Ridgers
- Centre for Physical Activity and Nutrition (C-PAN) Research, Deakin University, 221 Burwood Highway, Burwood, VIC, 3175, Australia
| | - G Stratton
- Applied Sports Technology Exercise and Medicine Research Centre (A-STEM), Swansea University, Swansea, SA2 8PP, UK
| | - N D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Tom Reilly Building, Byrom Street, Liverpool, L3 2ET, UK.
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E F Graves L, C Murphy R, Shepherd SO, Cabot J, Hopkins ND. Evaluation of sit-stand workstations in an office setting: a randomised controlled trial. BMC Public Health 2015; 15:1145. [PMID: 26584856 PMCID: PMC4653846 DOI: 10.1186/s12889-015-2469-8] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 11/03/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Excessive sitting time is a risk factor for cardiovascular disease mortality and morbidity independent of physical activity. This aim of this study was to evaluate the impact of a sit-stand workstation on sitting time, and vascular, metabolic and musculoskeletal outcomes in office workers, and to investigate workstation acceptability and feasibility. METHODS A two-arm, parallel-group, individually randomised controlled trial was conducted in one organisation. Participants were asymptomatic full-time office workers aged ≥18 years. Each participant in the intervention arm had a sit-stand workstation installed on their workplace desk for 8 weeks. Participants in the control arm received no intervention. The primary outcome was workplace sitting time, assessed at 0, 4 and 8 weeks by an ecological momentary assessment diary. Secondary behavioural, cardiometabolic and musculoskeletal outcomes were assessed. Acceptability and feasibility were assessed via questionnaire and interview. ANCOVA and magnitude-based inferences examined intervention effects relative to controls at 4 and 8 weeks. Participants and researchers were not blind to group allocation. RESULTS Forty-seven participants were randomised (intervention n = 26; control n = 21). Relative to the control group at 8 weeks, the intervention group had a beneficial decrease in sitting time (-80.2 min/8-h workday (95 % CI = -129.0, -31.4); p = 0.002), increase in standing time (72.9 min/8-h workday (21.2, 124.6); p = 0.007) and decrease in total cholesterol (-0.40 mmol/L (-0.79, -0.003); p = 0.049). No harmful changes in musculoskeletal discomfort/pain were observed relative to controls, and beneficial changes in flow-mediated dilation and diastolic blood pressure were observed. Most participants self-reported that the workstation was easy to use and their work-related productivity did not decrease when using the device. Factors that negatively influenced workstation use were workstation design, the social environment, work tasks and habits. CONCLUSION Short-term use of a feasible sit-stand workstation reduced daily sitting time and led to beneficial improvements in cardiometabolic risk parameters in asymptomatic office workers. These findings imply that if the observed use of the sit-stand workstations continued over a longer duration, sit-stand workstations may have important ramifications for the prevention and reduction of cardiometabolic risk in a large proportion of the working population. TRIAL REGISTRATION ClinicalTrials.gov NCT02496507 .
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Affiliation(s)
- Lee E F Graves
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK. .,Research Institute for Sport and Exercise Science, Physical Activity Exchange, Liverpool John Moores University, 62 Great Crosshall Street, Liverpool, L3 2AT, UK.
| | - Rebecca C Murphy
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
| | - Sam O Shepherd
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
| | - Josephine Cabot
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, UK.
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Abstract
CONTEXT Kinesiology tape (KT) has become popular among athletes for both injury prevention and rehabilitation due to its reported therapeutic effects, including facilitation of lymphatic flow and enhanced peripheral blood flow. However, evidence to support such claims is insufficient. OBJECTIVE To determine whether KT improves skin blood flow (SkBF) responses in young, elite soccer players. DESIGN Randomized crossover study. SETTING Research laboratory. PATIENTS OR OTHER PARTICIPANTS Thirteen healthy, elite, adolescent male soccer players (age = 14.7 ± 0.6 years). INTERVENTION(S) Participants completed 2 experimental trials; during trial 1, the volar aspect of the dominant forearm was taped. Forearm SkBF was measured within the taped area and 3 cm lateral to the taped area. During trial 2, no tape was applied to either site. Both trials were performed within 7 days. MAIN OUTCOME MEASURE(S) Baseline and maximal thermally (42°C) stimulated SkBF responses were assessed using laser Doppler flowmetry. Continuously measured SkBF and derived mean arterial pressure obtained at 5-minute intervals were used to calculate cutaneous vascular conductance (CVC), the primary outcome measure. RESULTS No differences were observed for baseline SkBF or CVC between trials or measurement sites. After local heating, no differences were evident for SkBF or CVC between trials or measurement sites. CONCLUSIONS Our findings suggest that, in healthy, trained adolescent males, KT was not associated with increased forearm SkBF.
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Hopkins ND, Dengel DR, Stratton G, Kelly AS, Steinberger J, Zavala H, Marlatt K, Perry D, Naylor LH, Green DJ. Age and sex relationship with flow-mediated dilation in healthy children and adolescents. J Appl Physiol (1985) 2015; 119:926-33. [PMID: 26251515 DOI: 10.1152/japplphysiol.01113.2014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 07/28/2015] [Indexed: 11/22/2022] Open
Abstract
Flow-mediated dilation (FMD) is a noninvasive technique used to measure conduit artery vascular function. Limited information is available on normative FMD values in healthy children and adolescents. The objective of this study was to assess relationships between age and sex with FMD across childhood and adolescence. Nine hundred and seventy-eight asymptomatic children (12 ± 3 yr, range 6-18 yr, 530 male) underwent ultrasonic brachial artery assessment before and after 5 min of forearm ischemia. Sex differences in FMD and baseline artery diameter were assessed using mixed linear models. Baseline artery diameter was smaller in females than males [2.96 mm (95% CI: 2.92-3.00) vs. 3.24 mm (3.19-3.28), P < 0.001] and increased with age across the cohort (P < 0.001). Diameter increased between ages 6 and 17 yr in males [from 2.81 mm (2.63, 3.00) to 3.91 mm (3.68, 4.14)] but plateaued at age 12 yr in females. Males had a lower FMD [7.62% (7.33-7.91) vs. 8.31% (7.95-8.66), P = 0.024], specifically at ages 17 and 18 yr. There was a significant effect of age on FMD (P = 0.023), with a reduction in FMD apparent postpuberty in males. In conclusion, the brachial artery increases structurally with age in both sexes; however, there are sex differences in the timing and rate of growth, in line with typical sex-specific adolescent growth patterns. Males have a lower FMD than females, and FMD appears to decline with age; however, these findings are driven by reductions in FMD as males near maturity. The use of age- and sex-specific FMD data may therefore not be pertinent in childhood and adolescence.
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Affiliation(s)
- Nicola D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom;
| | - Donald R Dengel
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota; Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Gareth Stratton
- Applied Sports Technology Exercise and Medicine Research Centre, Swansea University, Swansea, United Kingdom
| | - Aaron S Kelly
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota; Department of Medicine, University of Minnesota, Minneapolis, Minnesota
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Hanan Zavala
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Kara Marlatt
- School of Kinesiology, University of Minnesota, Minneapolis, Minnesota
| | - Daniel Perry
- Institute of Child Health, University of Liverpool, Alder Hey Children's NHS Foundation Trust, Liverpool, United Kingdom; and
| | - Louise H Naylor
- School of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Australia
| | - Daniel J Green
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom; School of Sports Science, Exercise and Health, The University of Western Australia, Crawley, Australia
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Jones H, Nyakayiru J, Bailey TG, Green DJ, Cable NT, Sprung VS, Hopkins ND, Thijssen DHJ. Impact of eight weeks of repeated ischaemic preconditioning on brachial artery and cutaneous microcirculatory function in healthy males. Eur J Prev Cardiol 2014; 22:1083-7. [PMID: 25147345 DOI: 10.1177/2047487314547657] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Accepted: 07/27/2014] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ischaemic preconditioning has well-established cardiac and vascular protective effects. Short interventions (one week) of daily ischaemic preconditioning episodes improve conduit and microcirculatory function. This study examined whether a longer (eight weeks) and less frequent (three per week) protocol of repeated ischaemic preconditioning improves vascular function. METHODS Eighteen males were randomly allocated to either ischaemic preconditioning (22.4 ± 2.3 years, 23.7 ± 3.1 kg/m(2)) or a control intervention (26.0 ± 4.8 years, 26.4 ± 1.9 kg/m(2)). Brachial artery endothelial-dependent (FMD), forearm cutaneous microvascular function and cardiorespiratory fitness were assessed at zero, two and eight weeks. RESULTS A greater improvement in FMD was evident following ischaemic preconditioning training compared with control at weeks 2 (2.24% (0.40, 4.08); p=0.02) and 8 (1.11% (0.13, 2.10); p=0.03). Repeated ischaemic preconditioning did not change cutaneous microcirculatory function or fitness. CONCLUSIONS These data indicate that a feasible and practical protocol of regular ischaemic preconditioning episodes improves endothelial function in healthy individuals within two weeks, and these effects persist following repeated ischaemic preconditioning for eight weeks.
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Affiliation(s)
- Helen Jones
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Jean Nyakayiru
- Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Tom G Bailey
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Daniel J Green
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK School of Sports Science, Exercise and Health, The University of Western Australia, Perth, Australia
| | - N Timothy Cable
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK Department of Sports Science, Aspire Academy, Doha, Qatar
| | - Victoria S Sprung
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Nicola D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
| | - Dick H J Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK Department of Physiology, Radboud University Medical Centre, Nijmegen, The Netherlands
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Graves LEF, Batterham AM, Foweather L, McWhannell N, Hopkins ND, Boddy LM, Gobbi R, Stratton G. Scaling of peak oxygen uptake in children: a comparison of three body size index models. Med Sci Sports Exerc 2014; 45:2341-5. [PMID: 23698249 DOI: 10.1249/mss.0b013e31829bfa79] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE We aimed to compare three candidate body size index models for the scaling of aerobic fitness (V(˙)O(2peak)) in children: whole body mass, total lean body mass, and the lean mass of both legs. METHODS V(˙)O(2peak) and total lean mass of the body and both legs (via dual-energy x-ray absorptiometry) were assessed in 126 girls and 87 boys aged 9-11 yr. We applied nonlinear allometric models of the form V(˙)O(2peak) = a×body size, adjusted for biological sex and maturity offset (years from peak height velocity). We assessed goodness of fit using the Akaike information criterion. RESULTS The Akaike weights (Akaike differences) were as follows: lean mass of both legs = 0.69 (0), total lean body mass = 0.31 (1.6), and whole body mass = <1e-8 (36.6). The size exponent (90% confidence interval) for the lean mass of both legs was 0.55 (0.46-0.64). V(˙)O(2peak) was 17% (13%-21%) lower in girls after controlling for the lean mass of both legs and maturity offset. After controlling for body size and sex, a 1-yr increase in maturity offset (closer to peak height velocity) was associated with a 6% (4%-9%) higher V(˙)O(2peak). CONCLUSIONS Allometric scaling of V(˙)O(2peak) by the lean mass of both legs provides the best model for quantifying growth-related changes in aerobic fitness in pediatric populations, although this model is only marginally superior to the total lean body mass model. There is no support for the total body mass model. Maturity and sex are also important covariates exerting a size-independent influence on peak aerobic fitness.
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Affiliation(s)
- Lee Edwin Fisher Graves
- 1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UNITED KINGDOM; 2Health and Social Care Institute, Teesside University, Middlesbrough, UNITED KINGDOM; 3Department of Sports and Exercise Sciences, Chester University, Chester, UNITED KINGDOM; 4Department of Health Sciences, Liverpool Hope University, Liverpool, UNITED KINGDOM; 5College of Engineering, Swansea University, Swansea, UNITED KINGDOM; and 6School of Sport Science, Exercise and Health, University of Western Australia, Perth, AUSTRALIA
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Konidari A, Auth MKH, Murphy MH, Cunningham C, Foweather L, Gobbi R, Graves LEF, Hopkins ND, Stratton G, Boddy LM. Assessment of biochemical liver markers, physical activity, fitness and body mass index for a cardiometabolic risk model in childhood. Acta Paediatr 2014; 103:e194-8. [PMID: 24512112 DOI: 10.1111/apa.12591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Revised: 01/29/2014] [Accepted: 02/04/2014] [Indexed: 11/28/2022]
Abstract
AIM The aim of this study was to investigate clustered cardiometabolic risk scores in healthy 10- to 12-year-olds using anthropometric characteristics, measurements of cardiorespiratory fitness (CRF) and physical activity and blood markers of metabolic disease. We also evaluated how including markers of liver cell injury would affect the clustered cardiometabolic risk assessment model. METHODS This cross-sectional study focused on 99 children aged 10-12 years. The main outcome included assessing participants with increased and low cardiometabolic risk factors using a clustered risk score model that incorporated markers implicated in metabolic syndrome pathogenesis. Two clustered risk scores were calculated, one incorporating markers of liver cell injury. RESULTS Children classified as 'increased risk' exhibited significantly lower CRF and higher body mass index Z-scores than their 'low-risk' peers. No significant differences in physical activity were observed. This trend remained unchanged when markers of liver injury were included in the clustered risk assessment model. CONCLUSION The clustered risk score model is a scientifically robust method of cardiometabolic risk assessment, which reiterates the importance of weight reduction and CRF promotion in childhood. Our study did not show a significant contribution of liver injury markers, and further research is needed to evaluate their effect on cardiometabolic risk stratification in childhood.
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Affiliation(s)
- A Konidari
- Department of Paediatric Gastroenterology, Hepatology and Nutrition; Alder Hey Children's NHS Foundation Trust; Liverpool UK
| | - MKH Auth
- Department of Paediatric Gastroenterology, Hepatology and Nutrition; Alder Hey Children's NHS Foundation Trust; Liverpool UK
| | - MH Murphy
- Sport and Exercise Sciences Research Institute; Ulster Sports Academy; University of Ulster; Jordanstown Campus; Newtownabbey Co. Antrim UK
| | - C Cunningham
- Sport and Exercise Sciences Research Institute; Ulster Sports Academy; University of Ulster; Jordanstown Campus; Newtownabbey Co. Antrim UK
| | - L Foweather
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - R Gobbi
- Department of Health Sciences; Liverpool Hope University; Hope Park; Liverpool UK
| | - LEF Graves
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - ND Hopkins
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
| | - G Stratton
- Applied Sports Technology, Exercise and Medicine Research Centre; College of Engineering; Swansea University; Swansea UK
- School of Sports Science, Exercise and Health; The University of Western Australia; Perth WA Australia
| | - LM Boddy
- The Physical Activity Exchange; Research Institute for Sport and Exercise Sciences; Liverpool John Moores University; Liverpool UK
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Boddy LM, Murphy MH, Cunningham C, Breslin G, Foweather L, Gobbi R, Graves LEF, Hopkins ND, Auth MKH, Stratton G. Physical activity, cardiorespiratory fitness, and clustered cardiometabolic risk in 10- to 12-year-old school children: the REACH Y6 study. Am J Hum Biol 2014; 26:446-51. [PMID: 24599609 DOI: 10.1002/ajhb.22537] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2013] [Revised: 02/07/2013] [Accepted: 02/14/2014] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES (1) Investigate whether clustered cardiometabolic risk score, cardiorespiratory fitness (CRF), sedentary time (ST), and body mass index Z-scores (BMI Z-scores), differed between participants that met and did not achieve ≥60 min of daily moderate to vigorous intensity physical activity (MVPA). (2) Compare clustered cardiometabolic risk score, BMI Z-score, ST, and MVPA by CRF status. METHODS One hundred and one (n = 45 boys) 10- to 12-year-old participants took part in this cross-sectional study, conducted in Liverpool (Summer 2010) and Ulster (Spring 2011) UK. Assessments of blood markers, stature, sitting stature, body mass, waist circumference, flow mediated dilation (FMD), and resting blood pressure (BP) were completed. CRF (VO2 peak) was estimated using an individually calibrated treadmill protocol. Habitual MVPA and ST were assessed using an individually calibrated accelerometer protocol. Clustered cardiometabolic risk scores were calculated using blood markers, FMD (%), BP and anthropometric measures. Participants were classified as active (≥60 min MVPA) or inactive and as fit or unfit. Multivariate analysis of covariance (MANCOVA) was used to investigate differences in cardiometabolic risk, BMI Z-score, CRF, and ST by activity status. MANCOVA was also completed to assess differences in cardiometabolic risk, MVPA, ST, and BMI Z-score by fitness status. RESULTS Inactive children exhibited significantly higher clustered cardiometabolic risk scores and ST, and lower CRF than active children. Unfit participants exhibited significantly higher clustered cardiometabolic risk scores, BMI Z-scores and ST and lower MVPA in comparison to fit participants. CONCLUSIONS This study highlights the importance of children achieving 60 min MVPA daily and provides further evidence surrounding the importance of CRF for health.
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Affiliation(s)
- Lynne M Boddy
- The Physical Activity Exchange, Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, L3 2AT, United Kingdom
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Hopkins ND, Cuthbertson DJ, Kemp GJ, Pugh C, Green DJ, Cable NT, Jones H. Effects of 6 months glucagon-like peptide-1 receptor agonist treatment on endothelial function in type 2 diabetes mellitus patients. Diabetes Obes Metab 2013; 15:770-3. [PMID: 23451821 DOI: 10.1111/dom.12089] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Revised: 12/17/2012] [Accepted: 02/14/2013] [Indexed: 12/15/2022]
Abstract
Glucagon-like peptide-1 receptor agonists (GLP-1 RA) are used for treatment in type 2 diabetes mellitus (T2DM). Little is known about their cardiovascular (CV) impact. We sought to determine the effects of chronic treatment on vascular function in T2DM. Brachial artery endothelial-dependent flow-mediated dilation (FMD) and endothelial-independent glyceryl trinitrate (GTN) function and carotid intima-medial thickness (cIMT) were assessed in 11 severely obese T2DMs (4 females, 7 males: 55 ± 8 years, diabetes duration 8.3 ± 4.7 years mean ± s.d.) before and after 6 months GLP-1 RA. Body weight (5.3 ± 1.2 kg; p < 0.05) and magnetic resonance imaging determined total and subcutaneous fat, but not visceral fat, decreased. Glycaemic control improved. There were no significant changes in FMD, GTN and cIMT (-1.1 ± 0.4%, 0.3 ± 3.0% and 0.00 ± 0.04 mm, respectively). Despite significant improvements in body composition and glycaemic control, 6 months GLP-1 RA treatment did not modulate vascular function. Alternative strategies may therefore be needed to reduce the burden of CV risk in severely obese patients with long-standing T2DM.
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Affiliation(s)
- N D Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
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Hopkins ND, Green DJ, Tinken TM, Sutton L, McWhannell N, Cable NT, Stratton G, George K. Does brachial artery flow-mediated dilation scale to anthropometric characteristics? Eur J Appl Physiol 2010; 110:171-6. [PMID: 20440622 DOI: 10.1007/s00421-010-1490-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2010] [Indexed: 12/20/2022]
Abstract
Flow-mediated dilation (FMD) assesses the health of the vascular endothelium. Despite widespread adoption of scaling practices in cardiac research, scaling for body size or composition has not been used for FMD. The present study investigated the relationships between brachial FMD and body composition in 129 children aged 9-10 (75 female symbol, 54 male symbol), and 50 men aged 16-49. Body composition variables (total, lean, fat mass in the whole body, arm, forearm) were assessed by dual-energy X-ray absorptiometry, FMD was measured in the brachial artery using high-resolution ultrasound. FMD was scaled using simple ratios (y/x) and allometric approaches (y/x ( b )) after log-log least squares linear regression produced allometric exponents (b). Size independence was confirmed via bivariate correlations (x:y/x; x:y/x ( b )). No relationships were evident between FMD and body composition variables in adults. Small correlations existed between FMD and measures of segmental fat mass in children (r = -0.18 to -0.19, p < 0.05), there were no significant relationships between FMD and measures of lean or total mass in children. For all significant relationships, b-exponents were different from 1 (CIs -0.36 to 0.07), suggesting ratio scaling approaches were flawed. This was confirmed when ratio scaling produced negative residual size correlations, whereas allometric scaling produced size-independent indices. Correlations between FMD and body composition were weak in children and insignificant in adults. As the results of this study are limited to the populations examined, our findings do not support the adoption of scaling procedures to correct FMD.
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Affiliation(s)
- N D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, L3 2ET, UK
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Hopkins ND, Green DJ, Tinken TM, Sutton L, McWhannell N, Thijssen DHJ, Cable NT, Stratton G, George K. Does conduit artery diameter vary according to the anthropometric characteristics of children or men? Am J Physiol Heart Circ Physiol 2009; 297:H2182-7. [PMID: 19837946 DOI: 10.1152/ajpheart.00228.2009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Arterial measurements are commonly undertaken to assess acute and chronic adaptations to exercise. Despite the widespread adoption of scaling practices in cardiac research, the relevance of scaling for body size and/or composition has not been addressed for arterial measures. We therefore investigated the relationships between brachial artery diameter and body composition in 129 children aged 9 to 10 yr (75 girls and 54 boys), and 50 men aged 16-49 yr. Body composition variables (total, lean, and fat mass in the whole body, arm, and forearm) were assessed by dual-energy X-ray absorptiometry, and brachial artery diameter was measured using high-resolution ultrasound. Bivariate correlations were performed, and arterial diameter was then scaled using simple ratios (y/x) and allometric approaches after log-log least squares linear regression and production of allometric exponents (b) and construction of power function ratios (y/xb). Size independence was checked via bivariate correlations (x:y/x; x:y/xb). As a result, significant correlations existed between brachial artery diameter and measures of body mass and lean mass in both cohorts (r=0.21-0.48, P<0.05). There were no significant relationships between diameter and fat mass. All b exponents were significantly different from 1 (0.08-0.50), suggesting that simple ratio scaling approaches were likely to be flawed. This was confirmed when ratio scaling produced negative residual size correlations, whereas allometric scaling produced size-independent indexes (r=0.00 to 0.03, P>0.05). In conclusion, when between- or within-group comparisons are performed under circumstances where it is important to control for differences in body size or composition, allometric scaling of artery diameter should be adopted rather than ratio scaling. Our data also suggest that scaling for lean or total mass may be more appropriate than scaling for indexes of fat mass.
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Affiliation(s)
- N D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, 15-21 Webster St., Liverpool, L3 2ET, UK
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Atkinson G, Batterham AM, Black MA, Cable NT, Hopkins ND, Dawson EA, Thijssen DHJ, Jones H, Tinken TM, Green DJ. Is the ratio of flow-mediated dilation and shear rate a statistically sound approach to normalization in cross-sectional studies on endothelial function? J Appl Physiol (1985) 2009; 107:1893-9. [PMID: 19833808 DOI: 10.1152/japplphysiol.00779.2009] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
It has been deemed important to normalize flow-mediated dilation (FMD), a marker of endothelial function, for between-subject differences in the eliciting shear rate (SR) stimulus. Conventionally, FMD is divided by the area under the curve of the SR stimulus. In the context of a cross-sectional comparison across different age cohorts, we examined whether this ratio approach adhered to established statistical assumptions necessary for reliable normalization. To quantify brachial artery FMD and area under the curve of SR, forearm cuff inflation to suprasystolic pressure was administered for 5 min to 16 boys aged 10.9 yr (SD 0.3), 48 young men aged 25.3 yr (SD 4.2), and 15 older men aged 57.5 yr (SD 4.3). Mean differences between age groups were statistically significant (P < 0.001) for nonnormalized FMD [children: 10.4% (SD 5.4), young adults: 7.5% (SD 2.9), older adults: 5.6% (SD 2.0)] but not for ratio-normalized FMD (P = 0.10). Moreover, all assumptions necessary for reliable use of ratio-normalization were violated, including regression slopes between SR and FMD that had y-intercepts greater than zero (P < 0.05), nonlinear and unstable relations between the normalized ratios and SR, skewed data distributions, and heteroscedastic variance. Logarithmic transformation of SR and FMD before ratio calculation improved adherence to these assumptions and resulted in age differences similar to the nonnormalized data (P = 0.03). In conclusion, although ratio normalization of FMD altered findings about age differences in endothelial function, this could be explained by violation of statistical assumptions. We recommend that exploration of these assumptions should be routine in future research. If the relationship between SR and FMD is generally found to be weak or nonlinear or variable between samples, then ratio normalization should not be applied.
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Affiliation(s)
- Greg Atkinson
- 1Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
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Hopkins ND, Thijssen DHJ, Tinken TM, Sutton L, McWhannell N, George K, Cable TN, Stratton G, Green DJ. Influence Of Measures Of Body Composition On Vascular Function In Children. Med Sci Sports Exerc 2009. [DOI: 10.1249/01.mss.0000354756.02315.3e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Hopkins ND, Stratton G, Tinken TM, McWhannell N, Ridgers ND, Graves LEF, George K, Cable NT, Green DJ. Relationships between measures of fitness, physical activity, body composition and vascular function in children. Atherosclerosis 2008; 204:244-9. [PMID: 18930229 DOI: 10.1016/j.atherosclerosis.2008.09.004] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2008] [Revised: 09/02/2008] [Accepted: 09/03/2008] [Indexed: 11/17/2022]
Abstract
BACKGROUND The prevalence of obesity and physical inactivity in Western countries has increased rapidly. Both are modifiable risk factors for cardiovascular disease. Atherosclerosis begins in childhood and endothelial dysfunction is its earliest detectable manifestation. METHODS We assessed flow-mediated dilation (FMD) in 129 children (75 female; 10.3+0.3 yrs; 54 male; 10.4; 0.3 yrs). FMD was normalised for differences in the eliciting shear rate stimulus between subjects (SR(AUC)). Fitness was assessed as peak oxygen uptake during an incremental treadmill exercise test (V O(2)peak). Body composition was measured using a dual-energy X-ray absorptiometry (DEXA) scan. Physical activity (PA) was assessed using Actigraph accelerometers. The cohort was split into tertiles according to FMD% and also FMD% corrected for SR(AUC) to gain insight into the determinants of vascular function. RESULTS Across the cohort, significant correlations were observed between FMD%/SR(AUC) and DEXA percentage fat (r=-0.23, p=0.009) and percentage lean mass (r=0.21, p=0.008), and also with PA performed at moderate-to-high intensity (r=0.363, p=0.001). For children in the lowest FMD%/SR(AUC) tertile, a stronger relationship with all PA measures was observed, particularly with high intensity PA (r=0.572, P=0.003). Regression analysis revealed that high intensity PA was the only predictor of impaired FMD%/SR(AUC). CONCLUSIONS These data suggest that traditional risk factors for CHD in adult populations impact upon vascular function in young people. Furthermore, it appears that individuals with impaired FMD may benefit from performing high intensity PA, whereas no relationships exist between FMD and lower intensities of PA or between PA and FMD in those subjects who possess preserved vascular function a priori.
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Affiliation(s)
- N D Hopkins
- Research Institute for Sport and Exercise Science, Liverpool John Moore's University, Liverpool, United Kingdom
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Thijssen DHJ, van Bemmel MM, Bullens LM, Dawson EA, Hopkins ND, Tinken TM, Black MA, Hopman MTE, Cable NT, Green DJ. The impact of baseline diameter on flow-mediated dilation differs in young and older humans. Am J Physiol Heart Circ Physiol 2008; 295:H1594-8. [PMID: 18708443 DOI: 10.1152/ajpheart.00669.2008] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Flow-mediated dilation (FMD) has become a commonly applied approach for the assessment of vascular function and health, but methods used to calculate FMD differ between studies. For example, the baseline diameter used as a benchmark is sometimes assessed before cuff inflation, whereas others use the diameter during cuff inflation. Therefore, we compared the brachial artery diameter before and during cuff inflation and calculated the resulting FMD in healthy children (n=45; 10+/-1 yr), adults (n=31; 28+/-6 yr), and older subjects (n=22; 58+/-5 yr). Brachial artery FMD was examined after 5 min of distal ischemia. Diameter was determined from either 30 s before cuff inflation or from the last 30 s during cuff inflation. Edge detection and wall tracking of high resolution B-mode arterial ultrasound images was used to calculate conduit artery diameter. Brachial artery diameter during cuff inflation was significantly larger than before inflation in children (P=0.02) and adults (P<0.001) but not in older subjects (P=0.59). Accordingly, FMD values significantly differed in children (11.2+/-5.1% vs. 9.4+/-5.2%; P=0.02) and adults (7.3+/-3.2% vs. 4.6+/-3.3%; P<0.001) but not in older subjects (6.3+/-3.4% vs. 6.0+/-4.2%; P=0.77). When the diameter before cuff inflation was used, an age-dependent decline was evident in FMD, whereas FMD calculated using the diameter during inflation was associated with higher FMD values in older than younger adults. In summary, the inflation of the cuff significantly increases brachial artery diameter, which results in a lower FMD response. This effect was found to be age dependent, which emphasizes the importance of using appropriate methodology to calculate the FMD.
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Affiliation(s)
- Dick H J Thijssen
- Research Institute for Sport and Exercise Science, Liverpool John Moores University, Liverpool, United Kingdom.
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