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Physical activity and CVD in older adults: an expert's perspective.
Orkaby, AR, Forman, DE
Expert review of cardiovascular therapy. 2018;(1):1-10
Abstract
The benefits of physical activity have long been recognized as powerful preventive opportunities for both prevention of cardiovascular disease and aging-related morbidity. However, physical activity remains under-prescribed and under-utilized. Areas covered: In this narrative review, the authors focus on physical activity as a modifiable lifestyle factor that can modify aging processes as well as cardiovascular pathophysiology that is often exacerbated by aging. Specific recommendations are provided for physical activity over the range of typical older individuals, spanning from those who are sedentary and frail to those who are active and robust. Expert commentary: Physical activity is a critically underused preventive strategy that can prevent cardiovascular disease and mitigate some of the physiological changes that occur with aging. Identifying activities that are accessible and enjoyable, while considering issues of safety, are key to developing an individualized exercise prescription for all older adults.
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Sport-based physical activity recommendations and modifications in C-reactive protein and arterial thickness.
Cayres, SU, de Lira, FS, Kemper, HCG, Codogno, JS, Barbosa, MF, Fernandes, RA
European journal of pediatrics. 2018;(4):551-558
Abstract
UNLABELLED We analyzed the effects of 1 year of engagement in ≥ 300 min/week of organized sports on inflammatory levels and vascular structure in adolescents. The sample was composed of 89 adolescents (11.6 ± 0.7 years old [43 boys and 46 girls]), stratified according to engagement in ≥ 300 min/week of sport practice during at least 12 months of follow-up (n = 15, sport practice; n = 74, non-sport practice). Arterial thickness (carotid and femoral) was assessed by ultrasound scan, while high sensitive C-reactive protein levels were used to assess inflammatory status. Trunk fatness (densitometry scanner), biological maturation (age at peak height velocity), blood pressure, and skipping breakfast were treated as covariates. Independently of body fatness and biological maturation, the group engaged in sports presented a higher reduction in C-reactive protein (mean difference -1.559 mg/L [95%CI -2.539 to -0.579]) than the non-sport group (mean difference -0.414 mg/L [95%CI -0.846 to 0.017]) (p = 0.040). There was a significant relationship between changes in C-reactive protein and changes in femoral intima-media thickness in the non-sport group (r = 0.311 [95%CI 0.026 to 0.549]). CONCLUSION Inflammation decreased in adolescents engaged in organized sports, independently of trunk fatness and biological maturation. Moreover, inflammation was related to arterial thickening only in adolescents not engaged in sports. What is Known: • Intima media thickness is a relevant marker of cardiovascular disease in pediatric groups, being affected by obesity and inflammation. • The importance of monitoring inflammatory markers from childhood is enhanced by the fact that alterations in these inflammatory markers in early life predict inflammation and alterations in carotid IMT in adulthood. What is New: • Anti-inflammatory properties related to physical exercise performed at moderate intensity, on inflammation and alterations in IMT are not clear in pediatric groups. • Due to the importance that sport participation has assumed as a promoter of improvements in health and quality of life, it is necessary to understand its potential benefits for cardiovascular health during human growth.
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Exercise Effects on Adipose Tissue Postprandial Lipolysis and Blood Flow in Children.
Yan, H, Pierce, JR, Myers, KB, Dubose, KD, Dubis, GS, Tanner, CJ, Hickner, RC
Medicine and science in sports and exercise. 2018;(6):1249-1257
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Abstract
UNLABELLED Poor suppression of lipolysis and blunted increase in blood flow after meal ingestion in obese adults may indicate resistance to the antilipolytic action of insulin. Exercise may be used to normalize lipolytic responses to food intake by increasing insulin sensitivity. PURPOSE To determine if acute bouts of aerobic exercise and/or excise training alter lipolytic and blood flow responses to food intake in lean (LN) and obese (OB) children. METHODS Sixty-five children (9-11 yr) were randomized into acute exercise (EX: 16 LN and 28 OB) or control (CON: 9 LN and 12 OB) groups that exercised (EX), or rested (CON) between standardized breakfast and lunch. Microdialysis probes were inserted into the subcutaneous abdominal adipose tissue to monitor interstitial glycerol (lipolysis) and blood flow. Changes in interstitial glycerol and nutritive flow were calculated from dialysate samples before and after each meal. A subgroup (OB = 15 and LN = 9) from the acute exercise group underwent 16 wk of aerobic exercise training. RESULTS Poor suppression of lipolysis and a blunted increase in adipose tissue nutritive blood flow in response to breakfast was associated with BMI percentile (r = 0.3, P < 0.05). These responses were normalized at lunch in the OB in the EX (P < 0.05), but not in OB in the CON. Sixteen weeks of exercise training did not improve meal-induced blood flow and marginally altered the antilipolytic response to the two meals (P = 0.06). CONCLUSIONS Daily bouts of acute aerobic exercise should be used to improve the antilipolytic and nutritive blood flow response to a subsequent meal in obese children.
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Maintenance of Serum Ionized Calcium During Exercise Attenuates Parathyroid Hormone and Bone Resorption Responses.
Kohrt, WM, Wherry, SJ, Wolfe, P, Sherk, VD, Wellington, T, Swanson, CM, Weaver, CM, Boxer, RS
Journal of bone and mineral research : the official journal of the American Society for Bone and Mineral Research. 2018;(7):1326-1334
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Abstract
Exercise can cause a decrease in serum ionized calcium (iCa) and increases in parathyroid hormone (PTH) and bone resorption. We used a novel intravenous iCa clamp technique to determine whether preventing a decline in serum iCa during exercise prevents increases in PTH and carboxy-terminal collagen crosslinks (CTX). Eleven cycling-trained men (aged 18 to 45 years) underwent two identical 60-min cycling bouts with infusion of Ca gluconate or saline. Blood sampling for iCa, total calcium (tCa), PTH, CTX, and procollagen type 1 amino-terminal propeptide (P1NP) occurred before, during, and for 4 hours after exercise; results are presented as unadjusted and adjusted for plasma volume shifts (denoted with subscript ADJ). iCa decreased during exercise with saline infusion (p = 0.01 at 60 min) and this was prevented by Ca infusion (interaction, p < 0.007); there were abrupt decreases in Ca content (iCaADJ and tCaADJ ) in the first 15 min of exercise under both conditions. PTH and CTX were increased at the end of exercise (both p < 0.01) on the saline day, and markedly attenuated (-65% and -71%; both p < 0.001) by Ca. CTX remained elevated for 4 hours after exercise on the saline day (p < 0.001), despite the return of PTH to baseline by 1 hour after exercise. P1NP increased in response to exercise (p < 0.001), with no difference between conditions, but the increase in P1NPADJ was not significant. Results for PTHADJ and CTXADJ were similar to unadjusted results. These findings demonstrate that bone resorption is stimulated early in exercise to defend serum iCa. Vascular Ca content decreased early in exercise, but neither the reason why this occurred, nor the fate of Ca, are known. The results suggest that the exercise-induced increase in PTH had an acute catabolic effect on bone. Future research should determine whether the increase in PTH generates an anabolic response that occurs more than 4 hours after exercise. © 2018 American Society for Bone and Mineral Research.
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Physical activity and inactivity trajectories associated with body composition in pre-schoolers.
Meredith-Jones, K, Haszard, J, Moir, C, Heath, AL, Lawrence, J, Galland, B, Taylor, B, Gray, A, Sayers, R, Taylor, R
International journal of obesity (2005). 2018;(9):1621-1630
Abstract
BACKGROUND/OBJECTIVES Early childhood is characterised by rapid development and is a critical period for the establishment of activity behaviours. We aim to examine how physical activity (PA) and sedentary behaviour (SB) track during the first 5 years of life, and to investigate associations between trajectories and body composition at 5 years of age. SUBJECTS/METHODS A total of 438 participants (50% male) wore an Actical accelerometer for 5 days at at least two of 1, 2, 3.5 and 5 years of age. Spearman correlation coefficients examined PA tracking from age 1 to 5 and trajectories of PA and SB were estimated using discrete mixture modelling. Regression models tested associations between both PA and SB trajectories and body composition measures. RESULTS Tracking coefficients for PA ranged from r = 0.31-0.51 across the ages, with similar tracking observed for sedentary behaviour (r = 0.21-0.39). Four distinct trajectory patterns were identified separately for PA and SB: consistently low, consistently high, increasing and decreasing. BMI and waist circumference were not significantly associated with PA trajectories, but those in the consistently high activity group had significantly lower % body fat (95% CI) at age 5 (14.3%; 13.5, 15.2) than those in the consistently low (16.8%; 15.6, 18.2) or increasing (15.7%; 14.7, 16.7) groups (P = 0.017). Sedentary behaviour trajectories were not associated with any of the anthropometric measures at age 5 (P > 0.05). CONCLUSIONS Physical activity and sedentary behaviour tracking is broadly similar from infancy to early childhood. Children with consistently higher levels of physical activity have reduced body fat at 5 years of age, although differences are relatively small.
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Effects of leucine-enriched essential amino acid and whey protein bolus dosing upon skeletal muscle protein synthesis at rest and after exercise in older women.
Wilkinson, DJ, Bukhari, SSI, Phillips, BE, Limb, MC, Cegielski, J, Brook, MS, Rankin, D, Mitchell, WK, Kobayashi, H, Williams, JP, et al
Clinical nutrition (Edinburgh, Scotland). 2018;(6 Pt A):2011-2021
Abstract
BACKGROUND & AIMS Impaired anabolic responses to nutrition and exercise contribute to loss of skeletal muscle mass with ageing (sarcopenia). Here, we tested responses of muscle protein synthesis (MPS), in the under represented group of older women, to leucine-enriched essential amino acids (EAA) in comparison to a large bolus of whey protein (WP). METHODS Twenty-four older women (65 ± 1 y) received (N = 8/group) 1.5 g leucine-enriched EAA supplements (LEAA_1.5), 6 g LEAA (LEAA_6) in comparison to 40 g WP. A primed constant I.V infusion of 13C6-phenylalanine was used to determine MPS at baseline and in response to feeding (FED) and feeding-plus-exercise (FED-EX; 6 × 8 unilateral leg extensions; 75%1-RM). We quantified plasma insulin/AA concentrations, leg femoral blood flow (LBF)/muscle microvascular blood flow (MBF), and anabolic signalling via immunoblotting. RESULTS Plasma insulineamia and EAAemia were greater and more prolonged with WP than LEAA, although LEAA_6 peaked at similar levels to WP. Neither LEAA or WP modified LBF or MBF. FED increased MPS similarly in the LEAA_1.5, LEAA_6 and WP (P < 0.05) groups over 0-2 h, with MPS significantly higher than basal in the LEAA_6 and WP groups only over 0-4 h. However, FED-EX increased MPS similarly across all the groups from 0 to 4 h (P < 0.05). Only p-p70S6K1 increased with WP at 2 h in FED (P < 0.05), and at 2/4 h in FED-EX (P < 0.05). CONCLUSIONS In conclusion, LEAA_1.5, despite only providing 0.6 g of leucine, robustly (perhaps maximally) stimulated MPS, with negligible trophic advantage of greater doses of LEAA or even to 40 g WP. Highlighting that composition of EAA, in particular the presence of leucine rather than amount is most crucial for anabolism.
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The effect of 12 weeks of aerobic training on serum levels high sensitivity C-reactive protein, tumor necrosis factor-alpha, lipid profile and anthropometric characteristics in middle-age women patients with type 2 diabetes.
Saghebjoo, M, Nezamdoost, Z, Ahmadabadi, F, Saffari, I, Hamidi, A
Diabetes & metabolic syndrome. 2018;(2):163-168
Abstract
AIMS: The aim of this study was to investigate the effect of 12 weeks of aerobic training on serum levels of high sensitivity C- reactive protein (hs-CRP), tumor necrosis factor-alpha (TNF-α), lipid profile and anthropometric characteristics in middle-aged women patients with type-2 diabetes. METHODS A quasi-experimental study, 20 women patients with type-2 diabetes (mean age, 50.25 ± 4.36 years, Body mass index, 25.51 ± 2.91 kg/m2, and body fat percentage 23.67 ± 3.05%) were randomly categorized into two experimental and control groups. The protocol aerobic training included eight-minute jogging and eight-minute running with 75-85 percent maximum heart rate reserve in the first session. Per both sessions, one minute added to running time and it increased up to 32 min after 12 weeks. Blood sampling and anthropometric measurements, 24 h before and 48 h after the last training session were conducted. RESULT The result showed a significant reduction in hs-CRP and TNF-α in the experimental than control group (P = 0.01). Exercise training-treated patients showed a significant decrease in TG, LDL and increase HDL in comparison with baseline and the control group (P < .05). The results also showed a significant decrease in weight, body mass index, body fat percentage, and waist-hip ratio (P values 0.02, 0.03, 001, 0.04 respectively) following the 12 weeks aerobic training. CONCLUSION It seems that long-term aerobic training, improved some important anthropometric and biochemical parameters in patients with type-2 diabetes. These observations give a new insight into the mechanisms by which aerobic training can reduce the cardiovascular risk in diabetes.
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Strategies and challenges associated with recruiting retirement village communities and residents into a group exercise intervention.
Duckham, RL, Tait, JL, Nowson, CA, Sanders, KM, Taaffe, DR, Hill, KD, Daly, RM
BMC medical research methodology. 2018;(1):173
Abstract
BACKGROUND Randomized controlled trials (RCTs) provide the highest level of scientific evidence, but successful participant recruitment is critical to ensure the external and internal validity of results. This study describes the strategies associated with recruiting older adults at increased falls risk residing in retirement villages into an 18-month cluster RCT designed to evaluate the effects of a dual-task exercise program on falls and physical and cognitive function. METHODS Recruitment of adults aged ≥65 at increased falls risk residing within retirement villages (size 60-350 residents) was initially designed to occur over 12 months using two distinct cohorts (C). Recruitment occurred via a three-stage approach that included liaising with: 1) village operators, 2) independent village managers, and 3) residents. To recruit residents, a variety of different approaches were used, including distribution of information pack, on-site presentations, free muscle and functional testing, and posters displayed in common areas. RESULTS Due to challenges with recruitment, three cohorts were established between February 2014 and April 2015 (14 months). Sixty retirement villages were initially invited, of which 32 declined or did not respond, leaving 28 villages that expressed interest. A total of 3947 individual letters of invitation were subsequently distributed to residents of these villages, from which 517 (13.1%) expressions of interest (EOI) were received. Across three cohorts with different recruitment strategies adopted there were only modest differences in the number of EOI received (10.5 to 15.3%), which suggests that no particular recruitment approach was most effective. Following the initial screening of these residents, 398 (77.0%) participants were deemed eligible to participate, but a final sample of 300 (58.0% of the 517 EOI) consented and was randomized; 7.6% of the 3947 residents invited. Principal reasons for not participating, despite being eligible, were poor health, lack of time and no GP approval. CONCLUSION This study highlights that there are significant challenges associated with recruiting sufficient numbers of older adults from independent living retirement villages into an exercise intervention designed to improve health and well-being. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12613001 161718 . Date registered 23rd October 2013.
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Postprandial Metabolic Responses Differ by Age Group and Physical Activity Level.
Emerson, SR, Kurti, SP, Emerson, EM, Cull, BJ, Casey, K, Haub, MD, Rosenkranz, SK
The journal of nutrition, health & aging. 2018;(1):145-153
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OBJECTIVES To compare the postprandial metabolic responses to a high-fat meal in healthy adults who differ by age and physical activity level. DESIGN Cross-sectional, quasi-experimental design. SETTING Physical Activity and Nutrition Clinical Research Consortium (PAN-CRC) at Kansas State University (Manhattan, KS, USA). PARTICIPANTS Twenty-two healthy adults: 8 younger active (YA) adults (4M/4W; 25 ± 5 yr), 8 older active (OA) adults (4M/4W; 67 ± 5 yr), and 6 older inactive (OI) adults (3M/3W; 68 ± 7 yr). INTERVENTION Following an overnight (10-hour) fast and having abstained from exercise for 2 days, participants consumed a high-fat meal (63% fat, 34% CHO; 12 kcal/kg body mass; 927 ± 154 kcal). To assess the metabolic response, blood draws were performed at baseline and each hour following the meal for 6 hours. MEASUREMENTS Fasting and postprandial triglycerides (TG), glucose, Total-C, and HDL-C were measured. Metabolic load index (MLI) and LDL-C were calculated. RESULTS There were significant group x time interactions for TG (p < 0.0001) and MLI (p = 0.004). The TG total area-under-the-curve (tAUC) response was significantly lower in YA (407.9 ± 115.1 mg/dL 6 hr) compared to OA (625.6 ± 169.0 mg/dL 6 hr; p = 0.02) and OI (961.2 ± 363.6 mg/dL 6 hr; p = 0.0002), while the OA group TG tAUC was lower than the OI group (p = 0.02). The TG peak was significantly lower in YA (90.5 ± 27.0 mg/dL) than OA (144.0 ± 42.2 mg/dL; p = 0.03) and OI (228.2 ± 96.1 mg/dL; p = 0.0003), and was lower in the OA group compared to the OI group (p = 0.03). Glucose was significantly lower 1 hour after the meal in YA (89.4 ± 10.1 mg/dL; p = 0.01) and OA (87.3 ± 22.3 mg/dL; p = 0.005) versus OI (110.7 ± 26.9 mg/dL). MLI tAUC was significantly lower in YA (936.8 ± 137.7 mg/dL 6 hr; p = 0.0007) and OA (1133.0 ± 207.4 mg/dL; p = 0.01) versus OI (1553.8 ± 394.3 mg/dL), with no difference (p = 0.14) between YA and OA groups. Total-C and LDL-C were generally lower in younger compared to older participants at baseline and throughout the postprandial period, while no group or time effects were evident in HDL-C. CONCLUSION Both physical activity status and aging appear to affect the postprandial metabolic, namely TG, response to a high-fat meal. These findings point to an inherently diminished metabolic capacity with aging, but suggest that physical activity may help minimize this decrement.
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Effects of hydrogen rich water on prolonged intermittent exercise.
Da Ponte, A, Giovanelli, N, Nigris, D, Lazzer, S
The Journal of sports medicine and physical fitness. 2018;(5):612-621
Abstract
BACKGROUND Recent studies showed a positive effect of hydrogen rich water (HRW) intake on acid-base homeostasis at rest. We investigated 2-weeks of HRW intake on repeated sprint performance and acid-base status during prolonged intermittent cycling exercise. METHODS In a cross over single-blind protocol, 8 trained male cyclists (age [mean±SD] 41±7 years, body mass 72.3±4.4 kg, height 1.77±0.04 m, maximal oxygen uptake [V̇O2max] 52.6±4.4 mL·kg-1·min-1) were provided daily with 2 liters of placebo normal water (PLA, pH 7.6, oxidation/reduction potential [ORP] +230 mV, free hydrogen content 0 ppb) or HRW (pH 9.8, ORP -180 mV, free Hydrogen 450 ppb). Tests were performed at baseline and after each period of 2 weeks of treatment. The treatments were counter-balanced and the sequence randomized. The 30-minute intermittent cycling trial consisted in 10 3-minute blocks, each one composed by 90 seconds at 40% V̇O2max, 60 seconds at 60% V̇O2max, 16 seconds all out sprint, and 14 seconds active recovery. Oxygen uptake (V̇O2), heart rate and power output were measured during the whole test, while mean and peak power output (PPO), time to peak power and Fatigue Index (FI) were determined during all the 16 seconds sprints. Lactate, pH and bicarbonate (HCO3-) concentrations were determined at rest and after each sprint on blood obtained by an antecubital vein indwelling catheter. RESULTS In the PLA group, PPO in absolute values decreased significantly at the 8th and 9th of 10 sprints and in relative values, ΔPPO, decreased significantly at 6th, 8th and 9th of 10 sprints (by mean: -12±5%, P<0.006), while it remained unchanged in HRW group. Mean power, FI, time to peak power and total work showed no differences between groups. In both conditions lactate levels increased while pH and HCO3- decreased progressively as a function of the number of sprints. CONCLUSIONS Two weeks of HRW intake may help to maintain PPO in repetitive sprints to exhaustion over 30 minutes.