Adherence to and effects on physical function parameters of a community-based standardised exercise programme for overweight or obese patients carried out by local sports clubs

OBJECTIVES

To evaluate the adherence to a sports-club-based standardised real-life exercise programme for overweight or obese patients. The effects on physical function parameters, anthropometry and quality of life were also assessed.

STUDY DESIGN

Within this prospective cohort study data from patients in Austrian sports-club-based programmes were analysed.

METHODS

Sports-club-based programmes were held twice a week and carried out by local trainers. The target group was overweight or obese patients. Adherence was determined after 2 and 6 months, and physical function parameters were evaluated at baseline and after 2 months.

RESULTS

A total of 71 patients (age: 52.0; standard deviation [SD: 12.1] years; body mass index [BMI]: 37.3 [SD: 8.2] kg/m²) took part in the study. Within the first 2 months the adherence rate was 62%, while 20% (14/71) participated in ≥75% of all offered sessions. After 6 months, 49% (17/35) of the retained sample still participated regularly in an exercise class. At baseline, muscle strength represented only 70% of the age- and sex-specific reference values and could be increased in a range from +4.0% (1.3 [SD: 3.0] kg; muscular endurance for the pectoral muscles) to +22.5% (16.1 [SD: 17.5] kg) (muscular endurance for the lower limb muscles). Concerning endurance capacity, the heart rate for a constant submaximal workload decreased from 126.4 (SD: 21.7) beats per minute at baseline to 120.9 (SD: 21.1) after 2 months (P < 0.001).

CONCLUSIONS

Sports clubs, as a non-clinical setting, can offer attractive standardised exercise programmes for a minority of overweight or obese patients. Long term changes in life-style, that result in sufficient levels of health enhancing physical activity still remain a huge public health challenge.

Cardiac glycosides induce cell death in human cells by inhibiting general protein synthesis

BACKGROUND

Cardiac glycosides are Na(+)/K(+)-pump inhibitors widely used to treat heart failure. They are also highly cytotoxic, and studies have suggested specific anti-tumor activity leading to current clinical trials in cancer patients. However, a definitive demonstration of this putative anti-cancer activity and the underlying molecular mechanism has remained elusive.

METHODOLOGY/PRINCIPAL FINDINGS

Using an unbiased transcriptomics approach, we found that cardiac glycosides inhibit general protein synthesis. Protein synthesis inhibition and cytotoxicity were not specific for cancer cells as they were observed in both primary and cancer cell lines. These effects were dependent on the Na(+)/K(+)-pump as they were rescued by expression of a cardiac glycoside-resistant Na(+)/K(+)-pump. Unlike human cells, rodent cells are largely resistant to cardiac glycosides in vitro and mice were found to tolerate extremely high levels.

CONCLUSIONS/SIGNIFICANCE

The physiological difference between human and mouse explains the previously observed sensitivity of human cancer cells in mouse xenograft experiments. Thus, published mouse xenograft models used to support anti-tumor activity for these drugs require reevaluation. Our finding that cardiac glycosides inhibit protein synthesis provides a mechanism for the cytotoxicity of CGs and raises concerns about ongoing clinical trials to test CGs as anti-cancer agents in humans.