Studies of a targeted risk reduction intervention through defined exercise (STRRIDE)

PURPOSE

The Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE) trial is a randomized controlled clinical trial designed to study the effects of exercise training regimens differing in dose (kcal.wk-1) and/or intensity (relative to peak VO2) on established cardiovascular risk factors and to investigate the peripheral biologic mechanisms through which chronic physical activity alters carbohydrate and lipid metabolism to result in improvements in these parameters of cardiovascular risk in humans.

METHODS

We will recruit 384 subjects and randomly assign them to one of three exercise training regimens or to a sedentary control group. The recruiting goal is to attain a subject population that is 50% female and 30% ethnic minority. The overall strategy is to use graded exercise training regimens in moderately overweight subjects with impairments in insulin action and mild to moderate lipid abnormalities to investigate whether there are dose or intensity effects and whether adaptations in skeletal muscle (fiber type, metabolic capacity, and/or capillary surface area) account for improvements in insulin action and parameters of lipoprotein metabolism. We will study these variables before and after exercise training, and over the course of a 2-wk detraining period. The study sample size is chosen to power the study to examine differences in responses between subjects of different gender and ethnicity to exercise training with respect to the least sensitive parameter-skeletal muscle capillary density.

RESULTS

The driving hypothesis is that improvements in cardiovascular risk parameters derived from habitual exercise are primarily mediated through adaptations occurring in skeletal muscle.

CONCLUSION

Identification that amount and intensity of exercise matter for achieving general and specific health benefits and a better understanding of the peripheral mechanisms mediating the responses in carbohydrate and lipid metabolism to chronic physical activity will lead to better informed recommendations for those undertaking an exercise program to improve cardiovascular risk.

Body composition of physically inactive and active 25-month-old female rats

The purpose of this study was to evaluate the effects of physical activity on the body composition of ageing female rats. Female pathogen-free Long-Evans rats were housed either in individual 7 x 14 x 8 inch cages or in cages with attached running wheels to which they had free access. The runners ate significantly more than the sedentary rats. Food intake from month 10 through month 24 of age averaged 14.6 +/- 0.7 g for the sedentary group, and 18.3 +/- 2.2 g for the active group. The body fat content of the sedentary rats was approximately 50% higher, while their lean body mass and protein content were significantly lower than that of the runners at age 25 months. Total body weight was similar in the active and sedentary groups. Percent body fat and protein of the 25-month-old physically active rats were not significantly different from that of 9-month-old rats, while the sedentary 25-month-old rats had a significantly higher body fat content and a lower body protein content than the 9-month-old animals. These results suggest the possibility that the changes in body composition that occur during middle age in sedentary female rats are largely due to physical inactivity, and that the lean tissue wasting that occurs as the result of the aging process is a late event that occurs closer to the end of life.

Iron status of female runners

This study was designed to observe iron status and prevalence of iron deficient conditions in adult female habitual runners (n = 111) and inactive females of comparable age (n = 65). The runners were significantly lower (p < .05) than the reference group in mean serum ferritin (SF), total iron binding capacity, and red blood cell count, but significantly higher (p < .05) in mean corpuscular hemoglobin. The groups did not differ significantly in hemoglobin concentration, hematocrit, serum iron, percent saturation of transferrin, or red cell protoporphyrin. Chi square analysis indicated that iron depletion (SF < 20 ng.ml-1) was significantly more prevalent (p < .005) in the runners than in the controls. Anemia was extremely rare in both groups. A multiple regression analysis revealed significant negative associations between serum ferritin and coffee/tea intake (p < .001) and running activity (p < .05). These results indicate that habitual runners, as compared with inactive women, are at increased risk for iron deficient states but that full-blown anemia is a rare consequence of this deficient iron status.

Glucose transporters and maximal transport are increased in endurance-trained rat soleus

Voluntary wheel running induces an increase in the concentration of the regulatable glucose transporter (GLUT4) in rat plantaris muscle but not in soleus muscle (K. J. Rodnick, J. O. Holloszy, C. E. Mondon, and D. E. James. Diabetes 39: 1425-1429, 1990). Wheel running also causes hypertrophy of the soleus in rats. This study was undertaken to ascertain whether endurance training that induces enzymatic adaptations but no hypertrophy results in an increase in the concentration of GLUT4 protein in rat soleus (slow-twitch red) muscle and, if it does, to determine whether there is a concomitant increase in maximal glucose transport activity. Female rats were trained by treadmill running at 25 m/min up a 15% grade, 90 min/day, 6 days/wk for 3 wk. This training program induced increases of 52% in citrate synthase activity, 66% in hexokinase activity, and 47% in immunoreactive GLUT4 protein concentration in soleus muscles without causing hypertrophy. Glucose transport activity stimulated maximally with insulin plus contractile activity was increased to roughly the same extent (44%) as GLUT4 protein content in soleus muscle by the treadmill exercise training. In a second set of experiments, we examined whether a swim-training program increases glucose transport activity in the soleus in the presence of a maximally effective concentration of insulin. The swimming program induced a 44% increase in immunoreactive GLUT4 protein concentration. Glucose transport activity maximally stimulated with insulin was 62% greater in soleus muscle of the swimmers than in untrained controls. Training did not alter the basal rate of 2-deoxyglucose uptake.(ABSTRACT TRUNCATED AT 250 WORDS)

Coordinate reduction of rat pancreatic islet glucokinase and proinsulin mRNA by exercise training

Exercise training results not only in enhanced insulin sensitivity but also in a reduction in insulin secretion. In this study, we examined the effects of exercise training on the expression of genes potentially related to insulin synthesis and glucose-stimulated insulin release by measuring pancreatic islet proinsulin, glucose-transporter (GLUT2), and glucokinase mRNAs. Female Wistar rats were subjected to 100 min of running at 25 m.min-1 up a 15% incline for 90 min/day for 6 days/wk for 3 wk. Pancreatic mRNA was evaluated by Northern- and dot-blot analysis with [32P]cRNA probes. We found no change in the pancreatic content of GLUT2 mRNA but found marked decreases in the content of proinsulin mRNA (78%, P less than 0.005) and glucokinase mRNA (65%, P less than 0.001). These results suggest that exercise modulates both islet glucose metabolism and insulin synthesis at the level of gene expression. Furthermore, there was a significant correlation between the decreases in glucokinase and proinsulin mRNA concentrations (r = 0.95, P less than 0.001), suggesting that expression of these genes is regulated in parallel.

Glucose feedings and exercise in rats: glycogen use, hormone responses, and performance

This study compared the effects of glucose feeding and water on endurance performance, glycogen utilization, and endocrine responses to exhaustive running in rats. Forty-eight trained rats ran at approximately 70% peak O2 consumption (VO2) while receiving, via gavage, 1 ml of an 18% glucose solution or water every 30 min. Glucose- (GF) and water-fed rats (WF) were pair matched and killed at rest, at 25 or 50% of their previously determined run time to exhaustion, or at exhaustion. Run times to exhaustion were 4.6 +/- 1.0 and 3.0 +/- 0.9 h in GF and WF rats, respectively. In WF rats, plasma glucose declined continuously from a resting value of 7.4 +/- 0.5 to 1.8 +/- 0.5 mM at exhaustion and was lower than in GF rats at all exercise time points. In GF rats, glucose was maintained at 7.4 +/- 0.5 mM for 3 h before dropping to 3.9 +/- 0.6 mM at exhaustion. In both groups, liver and muscle glycogen decreased dramatically during the 1st h and changed only slightly thereafter. During the 3rd h, glycogen levels were maintained in GF rats but continued to decrease in WF rats (P less than 0.05). Insulin decreased during exercise and was not significantly different between groups. Glucagon, epinephrine, norepinephrine, and corticosterone increased to a greater extent in WF than in GF rats during the first 3 h of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)

Fluid availability of sports drinks differing in carbohydrate type and concentration

Plasma D2O-accumulation profiles (qualitative indices of fluid-absorption rates) were determined in eight subjects after ingestion of 275 mL of five D2O-labeled beverages: a water placebo (W), 6% maltodextrin (6% M), and three solutions containing a 6%, 8%, and 10% glucose-fructose mix (6% GF, 8% GF, and 10% GF). Except for W all beverages contained 20 mmol sodium/L and 3 mmol potassium/L. No differences in plasma D2O accumulation were found. Plasma glucose increased at 20 and 30 min after ingestion of the carbohydrate drinks and returned to baseline (6% GF and 6% M) or below (8% GF and 10% GF) by 60 min. Insulin responded similarly and, except for a slightly lower value at 30 min for 6% GF, no differences were detected. It appears that fluids in drinks containing less than or equal to 8-10% carbohydrate (simple sugars or maltodextrins) are made available for dilution in body fluids at similar rates and should be similar in replenishing body fluids lost in sweat during exercise.

Carbohydrate-electrolyte drinks: effects on endurance cycling in the heat

On three occasions cyclists completed, as fast as possible, two exercise tasks (T1 and T2) separated by 30 min rest. T1 and T2 were equivalent to the work performed during 2 h cycling at 75% VO2max and 30 min at 75% VO2max, respectively. Every 20 min subjects drank 275 mL of a 6% (MC) or 2.5% (LC) carbohydrate-electrolyte beverage or a water placebo (P). The initial drink during both T1 and the rest period contained 20 g D2O as a marker for entry of ingested fluid into blood. No differences in drink effects were found for heart rate, sweat rate, change in plasma volume, rectal temperature, or D2O accumulation in blood. Blood glucose and respiratory exchange ratios were higher and T2 was performed faster with MC than with P. Ingestion of MC can help maintain blood glucose and enhance performance of prolonged cycling exercise without compromising fluid replenishment.

Effects of ingesting 6% and 12% glucose/electrolyte beverages during prolonged intermittent cycling in the heat

This study compared the effects of ingesting 6% (MC) and 12% (HC) glucose/electrolyte beverages, and a flavored water placebo (P) on markers of fluid absorption, palatability, and physiological function during prolonged intermittent cycling in the heat. On three occasions, 15 trained male cyclists performed two 60 min cycling bouts at 65% VO2max (E1 and E2). A brief exhaustive performance ride (approximately 3 min) was completed after E1 and E2, and after 20 min recovery (P1, P2, P3). Every 20 min, subjects consumed 275 mL of P, MC or HC. The first drink contained 20 mL of D2O, a tracer of fluid entry into blood plasma. Plasma D2O accumulation was slower for HC than for P and MC (P less than 0.001). HC caused more nausea (P less than 0.01) and fullness (P less than 0.05) than MC or P, and subjects said they would be less likely to consume HC during training or competition (P less than 0.10). Sweat rates, HR, Tre, Tsk, VO2, and PV were similar for all drinks. Performance of P1, P2, P3 were not different among drinks. However, four cyclists failed to maintain the prescribed work rate during E2 for HC but only one failed for MC and P. These data suggest that the slow absorption of a 12% glucose/electrolyte beverage during prolonged intermittent exercise in the heat may increase the risk of gastrointestinal distress and thereby limit performance.