THE GSTP1 c.313A>G POLYMORPHISM MODULATES THE CARDIORESPIRATORY RESPONSE TO AEROBIC TRAINING

The GSTP1 c.313A>G polymorphism is a candidate to explain some of the individual differences in cardiorespiratory fitness phenotypes’ responses to aerobic exercise training. We aim to explore the association between the GSTP1 c.313A>G polymorphism and the response to low-high impact aerobic exercise training. Sixty-six Polish Caucasian women were genotyped for the GSTP1 c.313A>G polymorphism; 62 of them completed 12-week aerobic (50-75% HR_max) exercise training and were measured for selected somatic features (body mass and BMI) and cardiorespiratory fitness indices – maximal oxygen uptake (VO_2max, maximum heart rate (HR_max), maximum ventilation (V_Emax) and anaerobic threshold (AT) – before and after the training period. Two-factor analysis of variance revealed a main training effect for body mass reduction (p=0.007) and BMI reduction (p=0.013), improvements of absolute and relative VO_2max (both p<0.001), and increased V_Emax (p=0.005), but not for changes in fat-free mass (FFM) (p=0.162). However, a significant training x GSTP1 c.313A>G interaction was found only for FFM (p=0.042), absolute and relative VO_2max (p=0.029 and p=0.026), and V_Emax (p=0.005). As the result of training, significantly greater improvements in VO_2max, V_Emax and FFM were gained by the GG+GA group compared to the AA genotype group. The results support the hypothesis that heterogeneity in individual response to training stimuli is at least in part determined by genetics, and GSTP1 c.313A>G may be considered as one (of what appear to be many) target polymorphisms to influence these changes.     

Circulating MicroRNAs and Aerobic Fitness – The HUNT-Study

Aerobic fitness, measured as maximal oxygen uptake (VO_2max), is a good indicator of cardiovascular health, and a strong predictor of cardiovascular mortality. Biomarkers associated with low VO_2max may therefore represent potential early markers of future cardiovascular disease (CVD). The aim of this study was to assess whether circulating microRNAs (miRs) are associated with VO_2max-level in healthy individuals. In a screening study, 720 miRs were measured in serum samples from healthy individuals (40–45 yrs) with high (n = 12) or low (n = 12) VO_2max matched for gender, age and physical activity. Candiate miRs were validated in a second cohort of subjects with high (n = 38) or low (n = 38) VO_2max. miR-210 and miR-222 were found to be higher in the low VO_2max-group (p<0.05). In addition, miR-21 was increased in male participants with low VO_2max (p<0.05). There were no correlations between traditional risk factors for CVD (blood pressure, cholesterol, smoking habit, or obesity) and miR-21, miR-210 and miR-222. DIANA-mirPath identified 611 potential gene-targets of miR-21, miR-210 and miR-222, and pathway analysis indicated alterations in several important signaling systems in subjects with low VO_2max. Potential bias involve that blood was collected from non-fasting individuals, and that 8 performed exercise within 24 h before sampling. In conclusion, we found that miR-210, miR-21, and miR-222 were increased in healthy subjects with low VO_2max. The lack of association between these three miRs, and other fitness related variables as well as traditional CVD risk factors, suggests that these miRs may have a potential as new independent biomarkers of fitness level and future CVD.     

Aerobic Fitness in Children and Young Adults with Primary Ciliary Dyskinesia

Background

Although aerobic fitness is regarded as an overall prognostic measure of morbidity and mortality, its evaluation in the chronic progressive sinopulmonary disease primary ciliary dyskinesia (PCD) has been infrequently and inconsistently reported. Here we assessed peak oxygen uptake (VO_2peak) in a large well-characterized cohort of PCD patients, and explored whether VO_2peak was associated with parameters of pulmonary function, self-reported physical limitations, and physical activity level.

Methods

VO_2peak, spirometry, diffusing capacity, whole-body plethysmography, and nitrogen multiple breath inert gas washout (N₂ MBW) were assessed in a cross-sectional, single-occasion study of clinically stable children and young adults with PCD. We used a questionnaire including self-reported physical limitations in everyday life or in vigorous activities, and estimation of weekly hours of strenuous physical activity. VO_2peak in PCD patients was compared with that in matched, healthy control subjects and a national reference.

Results

Forty-four PCD patients aged 6–29 years exhibited reduced VO_2peak compared to healthy controls (P<0.001) and the national reference. VO_2peak was abnormal (z-score <–1.96) in 34% of PCD patients. Spirometric values, RV/TLC, and indices of N₂ MBW were significantly abnormal, but VO_2peak only correlated with FEV₁ and DL_CO/V_A. VO_2peak correlated with complaints of moderate or significant limitations in vigorous activities (P = 0.0001), exhibited by 39% of PCD patients.

Conclusion

One-third of PCD patients exhibited substantially lower aerobic fitness than healthy subjects. Aerobic fitness correlated with FEV₁, DL_CO/V_A and self-reported complaints of limitations in vigorous physical activity. These findings are most likely explained by PCD pulmonary disease and its impact on pulmonary function and physical ability. Considering fitness as an important outcome and including regular strenuous physical activity in PCD treatment would probably altogether increase pulmonary clearance, lung function, aerobic fitness, and quality of life, and prevent lifestyle-related diseases.     

Influences of Normobaric Hypoxia Training on Physical Fitness and Metabolic Risk Markers in Overweight to Obese Subjects

Previous studies suggested that hypoxia and exercise may have a synergistic effect on cardiovascular and metabolic risk factors. We conducted a single blind study in overweight to obese subjects to test the hypothesis that training under hypoxia (HG, n = 24, FiO₂ = 15%) results in similar or even greater improvement in body weight and metabolic risk markers compared with exercise under normoxia (NG, n = 21, FiO₂ = 21%). After an initial metabolic evaluation including incremental exercise testing, subjects trained in normoxic or hypoxic conditions thrice weekly over a 4‐week period at a heart rate corresponding to 65% of maximum oxygen uptake (VO_2max). The experimental groups were similar at the start of the investigation and weight stable during the training period. Subjects in the hypoxia group trained at a significantly lower workload (P < 0.05). Yet, both groups showed similar improvements in VO_2max and time to exhaustion. Respiratory quotient and lactate at the anaerobic threshold as well as body composition improved more in the hypoxia group. We conclude that in obese subjects, training in hypoxia elicits a similar or even better response in terms of physical fitness, metabolic risk markers, and body composition at a lower workload. The fact that workload and, therefore, mechanic strain can be reduced in hypoxia could be particularly beneficial in obese patients with orthopedic comorbidities.     

Cardiorespiratory Fitness Is Associated with Hard and Light Intensity Physical Activity but Not Time Spent Sedentary in 10–14 Year Old Schoolchildren: The HAPPY Study

Background

Sedentary behaviour is a major risk factor for developing chronic diseases and is associated with low cardiorespiratory fitness in adults. It remains unclear how sedentary behaviour and different physical activity subcomponents are related to cardiorespiratory fitness in children. The purpose of this study was to assess how sedentary behaviour and different physical activity subcomponents are associated with 10–14 year-old schoolchildren''s cardiorespiratory fitness.

Methods

135 schoolchildren (81 girls, 12±1 year) completed 7-day minute-by-minute habitual physical activity monitoring using triaxial accelerometers and undertook a maximal cardiorespiratory fitness test.

Results

After controlling for sex, age, ethnicity, socioeconomic status and total wear time, light physical activity (1.5–2.9 METs) was negatively associated (β = −.24, p<.01) and hard physical activity (≥9 METs) positively associated (β = .45, p<.001) with cardiorespiratory fitness. Vigorous and hard physical activity were associated with cardiorespiratory fitness for boys (F = 5.64, p<.01) whereas light, moderate and hard physical activity were associated with physical fitness for girls (F = 10.23, p<.001). No association was found between sedentary time and cardiorespiratory fitness (r = −.13, p>.05). Sedentary to active transitions revealed little variability between cardiorespiratory fitness tertiles.

Conclusions

Hard physical activity (≥9 METs) holds greater potential for cardiorespiratory fitness compared to physical activity of lower intensities. There was no relationship between sedentary behaviour and cardiorespiratory fitness. These findings suggest that, for children, advice should focus on higher intensity physical activity and not sedentary behaviour as a means to maintain or improve cardiorespiratory fitness. Future research should explore longitudinal relationships between hard physical activity, cardiorespiratory fitness and health parameters.     

Prediction of Cardiorespiratory Fitness by the Six-Minute Step Test and Its Association with Muscle Strength and Power in Sedentary Obese and Lean Young Women: A Cross-Sectional Study

Impaired cardiorespiratory fitness (CRF) is a hallmark characteristic in obese and lean sedentary young women. Peak oxygen consumption (VO_2peak) prediction from the six-minute step test (6MST) has not been established for sedentary females. It is recognized that lower-limb muscle strength and power play a key role during functional activities. The aim of this study was to investigate cardiorespiratory responses during the 6MST and CPX and to develop a predictive equation to estimate VO_2peak in both lean and obese subjects. Additionally we aim to investigate how muscle function impacts functional performance. Lean (LN = 13) and obese (OB = 18) women, aged 20–45, underwent a CPX, two 6MSTs, and isokinetic and isometric knee extensor strength and power evaluations. Regression analysis assessed the ability to predict VO_2peak from the 6MST, age and body mass index (BMI). CPX and 6MST main outcomes were compared between LN and OB and correlated with strength and power variables. CRF, functional capacity, and muscle strength and power were lower in the OB compared to LN (<0.05). During the 6MST, LN and OB reached ~90% of predicted maximal heart rate and ~80% of the VO_2peak obtained during CPX. BMI, age and number of step cycles (NSC) explained 83% of the total variance in VO_2peak. Moderate to strong correlations between VO_2peak at CPX and VO_2peak at 6MST (r = 0.86), VO_2peak at CPX and NSC (r = 0.80), as well as between VO_2peak, NSC and muscle strength and power variables were found (p<0.05). These findings indicate the 6MST, BMI and age accurately predict VO_2peak in both lean and obese young sedentary women. Muscle strength and power were related to measures of aerobic and functional performance.     

End Criteria for Reaching Maximal Oxygen Uptake Must Be Strict and Adjusted to Sex and Age: A Cross-Sectional Study

Objective

To describe different end criteria for reaching maximal oxygen uptake (VO_2max) during a continuous graded exercise test on the treadmill, and to explore the manner by which different end criteria have an impact on the magnitude of the VO_2max result.

Methods

A sample of 861 individuals (390 women) aged 20–85 years performed an exercise test on a treadmill until exhaustion. Gas exchange, heart rate, blood lactate concentration and Borg Scale_6–20 rating were measured, and the impact of different end criteria on VO_2max was studied;VO₂ leveling off, maximal heart rate (HR_max), different levels of respiratory exchange ratio (RER), and postexercise blood lactate concentration.

Results

Eight hundred and four healthy participants (93%) fulfilled the exercise test until voluntary exhaustion. There were no sex-related differences in HR_max, RER, or Borg Scale rating, whereas blood lactate concentration was 18% lower in women (P<0.001). Forty-two percent of the participants achieved a plateau in VO₂; these individuals had 5% higher ventilation (P = 0.033), 4% higher RER (P<0.001), and 5% higher blood lactate concentration (P = 0.047) compared with participants who did not reach a VO₂ plateau. When using RER ≥1.15 or blood lactate concentration ≥8.0 mmol•L^–1, VO_2max was 4% (P = 0.012) and 10% greater (P<0.001), respectively. A blood lactate concentration ≥8.0 mmol•L^–1 excluded 63% of the participants in the 50–85-year-old cohort.

Conclusions

A range of typical end criteria are presented in a random sample of subjects aged 20–85 years. The choice of end criteria will have an impact on the number of the participants as well as the VO_2max outcome. Suggestions for new recommendations are given.     

The effects of training on hormonal concentrations in young soccer players

To test the hypothesis that football training would be accompanied by physiological adaptations and hormonal changes, we analyzed the effects of a whole football season on physical fitness and hormonal concentrations in youth football players. Male football players (n = 29, age 16.51 ± 0.7 years) in a regional professional league and male healthy control subjects (n = 30, age 17.1 ± 1 years) participated to the study. Blood cortisol, testosterone, and growth hormone (hGH) concentrations were assayed before the beginning of the training period (T0), just after the training period (T1), at the middle of the season (T2), and at the end of the season (T3). In each period physical tests and anthropometric measurements were also performed. Results showed significant differences in basal values of cortisol, testosterone, and growth hormone (hGH) in the four time points evaluated (P < 0.01). In addition, the concentrations of hGH were higher in the soccer players group than in control subjects (P < 0.001). Between the start of the training period and the end of the football season significant differences were observed in the anthropometric characteristics and in the physical form of the football players. Furthermore, the hormonal status was significantly correlated with the indicators of the lower limb power (squat-jump [SqJ], and counter-movement-jump [CMJ]) and those of aerobic performance (Yo–Yo intermittent recovery test level 1 (YYIRT1) and maximal oxygen consumption (VO_2max)).These data underscore the importance of establishing training protocols that present the potential to promote positive adaptations without, at the same time, provoking overtraining of young players.     

Tennis Play Intensity Distribution and Relation with Aerobic Fitness in Competitive Players

The aims of this study were (i) to describe the relative intensity of simulated tennis play based on the cumulative time spent in three metabolic intensity zones, and (ii) to determine the relationships between this play intensity distribution and the aerobic fitness of a group of competitive players. 20 male players of advanced to elite level (ITN) performed an incremental on-court specific endurance tennis test to exhaustion to determine maximal oxygen uptake (VO_2max) and the first and second ventilatory thresholds (VT₁, VT₂). Ventilatory and gas exchange parameters were monitored using a telemetric portable gas analyser (K4 b², Cosmed, Rome, Italy). Two weeks later the participants played a simulated tennis set against an opponent of similar level. Intensity zones (1: low, 2: moderate, and 3: high) were delimited by the individual VO₂ values corresponding to VT₁ and VT₂, and expressed as percentage of maximum VO₂ and heart rate. When expressed relative to VO_2max, percentage of playing time in zone 1 (77 ± 25%) was significantly higher (p < 0.001) than in zone 2 (20 ± 21%) and zone 3 (3 ± 5%). Moderate to high positive correlations were found between VT₁, VT₂ and VO_2max, and the percentage of playing time spent in zone 1 (r = 0.68–0.75), as well as low to high inverse correlations between the metabolic variables and the percentage of time spent in zone 2 and 3 (r = -0.49–0.75). Players with better aerobic fitness play at relatively lower intensities. We conclude that players spent more than 75% of the time in their low-intensity zone, with less than 25% of the time spent at moderate to high intensities. Aerobic fitness appears to determine the metabolic intensity that players can sustain throughout the game.     

Roles of physical activity and cardiorespiratory fitness on sex difference in insulin resistance in late elementary years

[Purpose]

Little is known about the potential role of lifestyle factors in sex differences in insulin resistance in late elementary school children.

[Methods]

In this cross-sectional study, we compared sex differences in Tanner scales, body fat, physical activity (PA) and fitness, and insulin resistance markers in elementary school children (boys, n = 69 and girls, n = 81) aged 12-13 years. Body composition was assessed with a standardized protocol. Cardiorespiratory fitness was measured as oxygen consumption during an incremental treadmill exercise. Fasting blood samples were collected for blood chemistry assays including lipids, glucose, insulin and homeostasis model assessment for insulin resistance (HOMA-IR), leptin, and adiponectin. Daily PA was measured with an accelerometer for 7 consecutive days, and they were classified as low-, moderate-, and vigorous-PA. Independent t-tests were used to compare mean differences in the measured variables between boys and girls. There were significant sex differences in Tanner scales, body mass index, percent body fat, and waist circumference (WC).

[Results]

Girls had significantly higher values in Tanner scales (p < 0.001) and percent body fat (p < 0.001) than boys. Boys had significantly higher values in body mass index (p = 0.019) and waist circumference (p < 0.001) than girls. Boys also had significantly higher values in VO_2max (p < 0.001) and low (p < 0.001), moderate (p < 0.001), and vigorous (p < 0.001) PAs. With respect to metabolic risk factors, girls had significantly higher serum levels of triglycerides (p = 0.005), insulin (p < 0.001), and HOMA-IR (p < 0.001) and significantly lower high-density lipoprotein cholesterol (p = 0.015) than boys.

[Conclusion]

In summary, the current findings of the study showed that the increased risk for insulin resistance in girls over boys is associated with higher Tanner scale and percent body fat in conjunction with poor cardiorespiratory fitness and physical inactivity, suggesting that exercise intervention to promote physical activity and fitness is imperative for general health promotion of school children, with a special focus on girls.     

Effects of self-paced high-intensity interval training and moderate-intensity continuous training on the physical performance and psychophysiological responses in recreationally active young adults

This study aimed to compare the effects of 8-week self-paced high-intensity interval training (HIIT) vs. self-paced moderate-intensity continuous training (MICT) on the physical performance and psychophysiological responses of young adults. Twenty-eight recreationally active young adults (age: 21.1 ± 1.6 years) were randomly assigned to either the self-paced HIIT (n = 14) or the MICT (n = 14) group training protocol. The HIIT consisted of two 12–24 x 30 seconds of high-intensity runs interspersed by 30 seconds of recovery. The MICT completed 24–48 minutes of continuous running. Before and after the 8-week interventions the following tests were completed: maximum oxygen consumption (V̇O_2max) estimated from the Yo-Yo Intermittent Recovery Test level 1 (YYIRTL-1), repeated sprint ability (RSA), 10–30-m sprint test, change of direction test (T-drill), countermovement jump (CMJ) and squat jump (SJ), and triple hop distance test (THD). Training rating of perceived exertion (RPE) and physical activity enjoyment scale (PACES) were assessed during the training programme. The HIIT resulted in greater improvement in YYIRTL-1, V̇O_2max, RSA and T-drill performances compared to the MICT. Furthermore, RPE and PACES values were higher in the HIIT than the MICT. This study suggested that self-paced HIIT may be a more effective training regime to improve aerobic fitness with greater physical enjoyment in recreationally active young adults.     

Cardiac Autonomic Modulation Is Determined by Gender and Is Independent of Aerobic Physical Capacity in Healthy Subjects

Background

Aerobic physical capacity plays an important role in reducing morbidity and mortality rates in subjects with cardiovascular diseases. This action is often related to an improvement in the autonomic modulation of heart rate variability (HRV). However, controversies remain regarding the effects of physical training on cardiac autonomic control in healthy subjects. Therefore, our objective was to investigate whether aerobic capacity interferes with the autonomic modulation of HRV and whether gender differences exist.

Methods

Healthy men and women (N=96) were divided into groups according to aerobic capacity: low (VO₂: 22-38 ml/kg^-1 min^-1), moderate (VO₂: 38-48 ml/kg^-1 min^-1) and high (VO₂ >48 ml/kg^-1 min^-1.) We evaluated the hemodynamic parameters and body composition. The autonomic modulation of HRV was investigated using spectral analysis. This procedure decomposes the heart rate oscillatory signal into frequency bands: low frequency (LF=0.04-0.15Hz) is mainly related to sympathetic modulation, and high frequency (HF=0.15-0.5Hz) corresponds to vagal modulation.

Results

Aerobic capacity, regardless of gender, determined lower values of body fat percentage, blood pressure and heart rate. In turn, the spectral analysis of HRV showed that this parameter did not differ when aerobic capacity was considered. However, when the genders were compared, women had lower LF values and higher HF values than the respective groups of men.

Conclusion

The results suggest that aerobic physical capacity does not interfere with HRV modulation; however, the cardiac modulatory balance differs between genders and is characterized by a greater influence of the autonomic vagal component in women and by the sympathetic component in men.     

Fatness but Not Fitness Relative to the Fat-Free Mass Is Related to C-Reactive Protein in 18 Year-Old Adolescents

Introduction

The interaction between fatness, fitness, and C-reactive protein (CRP) in adolescents is not well characterized but may be important to prevent low grade inflammation. The purpose of this study was to assess the relationship between adiposity, different expressions of fitness, and CRP in late adolescence using direct measures of fitness and fatness.

Methods

Anthropometric measurements were taken on 245 eighteen-year-old participants (116 girls). Fasting CRP, glucose, and insulin were measured and homeostatic model assessment (HOMA) calculated. Body composition was estimated via dual energy X-ray absorptiometry. Fitness was assessed with maximal oxygen uptake (VO₂max) during a treadmill test and also expressed relative to the fat-free mass (VO₂max_FFM).

Results

Prevalence of overweight/obesity based on body mass index (BMI) was 20.7% and 25.6% among girls and boys, respectively (p = 0.407), but 42.5% and 58.1% when based on body fat percentage (%fat, p = 0.015). Higher proportion of boys (81.3%) than girls (54.5%) were highly fit (p<0.001), but the percentage of girls with high levels of CRP was greater (12.1% vs 6.2%, p = 0.028). Adiposity, indicated with BMI, waist circumference, fat mass, android fat mass (aFM), or %fat, was positively associated with CRP independent of VO₂max (r = 0.13-0.18, p<0.05) and VO₂max_FFM (r = 0.24-0.32, p<0.001). VO₂max, was negatively associated with CRP independent only of BMI and waist circumference (r = -0.21, p = 0.001), but not %fat, fat mass or aFM (r = -0.08 to -0.12, p>0.05). VO₂max_FFM was unrelated to CRP with (r = -0.07 to -0.11, p>0.05) or without (r = -0.10, p = 0.142) adjustment for adiposity. Additional adjustment for HOMA did not change any of the relationships, although the coefficients were attenuated.

Conclusions

Fatness has a greater association with CRP than fitness in late adolescence. However, VO₂max_FFM, which is truly independent of adiposity, is unrelated to CRP, indicating that the effects of fitness might be mediated via the fatness component embedded in fitness expressed relative to body mass.     

PHYSIOLOGICAL DEMANDS OF YOUNG WOMEN'S COMPETITIVE GYMNASTIC ROUTINES

The objective of this study was to investigate the physiological indices of competitive routines in women''s artistic gymnastics by characterizing post-exercise heart rate (HR), oxygen uptake (VO₂) and peak blood lactate concentration (L_max) in a group of eight young elite-oriented female gymnasts. HR was continuously monitored with Polar RS400 monitors during the test event simulating a competition environment. Within 5 s of the end of each routine, the breath-by-breath gas analyser mask was placed on the face to record VO₂. VO₂max was calculated by the backward extrapolation method of the VO₂ recovery curve. L_max was obtained during recovery (min 1, 3, 5, 7 and 10) subsequent to each event. One week later, HR, VO₂ and L_max were measured during an incremental continuous treadmill test. The treadmill test was confirmed as the assessment with the highest physiological demand. The gymnasts reached their highest values of HR (183-199 beats · min^-1), VO₂/Bm (33-44 ml · kg^-1 · min^-1) and L_max (7-9 mmol · l^-1) in the floor and uneven bars exercises. The vault was the event with the lowest HR (154-166 beats · min^-1) and L_max (2.4-2.6 mmol · l^-1), and the balance beam had the lowest VO₂ (27-35 ml · kg^-1 · min^-1). The mean relative peak intensities attained in the different events, which ranged from 65 to 85% of the individual VO₂max and HRmax recorded in the laboratory, suggest that cardiorespiratory and metabolic demands are higher than previously indicated. The high percentage of VO₂ measured, particularly after the floor event, suggests that aerobic power training should not be neglected in women''s artistic gymnastics.     

Prenatal exposure to maternal psychosocial stress and HPA axis regulation in young adults

Epidemiological studies have reported associations between measures of size and weight at birth and disease risk in later life. Alteration in the regulation of the hypothalamic-pituitary-adrenal (HPA) axis in response to prenatal stress has been proposed as one underlying mechanism. The present study investigated in humans the association of prenatal psychosocial stress exposure with subsequent HPA axis regulation in adult life, with a focus on measures of response to challenge and feedback sensitivity. Healthy young adults whose mothers experienced severe stress during their pregnancy in form of major negative life events (e.g. death of someone close; prenatal stress (PS) group, n = 31) and an age-matched comparison group (CG, n = 30) underwent the Trier Social Stress Test (TSST) and a 1 μg ACTH_1-24 stimulation test. In addition, a diurnal cortisol profile was assessed. ACTH concentrations following a standardized behavioural challenge paradigm (TSST) were marginally significantly higher in PS subjects than in CG subjects (p = .06). Pre-TSST adrenocortical (cortisol) levels were lower (p = .007), whereas the increase in cortisol in response to the TSST was higher (p = .03) in PS subjects compared to CG subjects. Cortisol concentrations following a pharmacological stimulation test simulating pituitary activity (ACTH_1-24 test) were significantly lower in PS than in CG subjects (p = .006). No differences emerged between the two groups in basal diurnal cortisol levels. This study provides first evidence in humans of an association between prenatal psychosocial stress exposure and subsequent alterations in the regulation of the HPA axis.     

Adiponectin Levels during Low‐ and High‐Fat Eucaloric Diets in Lean and Obese Women

Objective: Adiponectin influences insulin sensitivity (S_I) and fat oxidation. Little is known about changes in adiponectin with changes in the fat content of eucaloric diets. We hypothesized that dietary fat content may influence adiponectin according to an individual's S_I. Research Methods and Procedures: We measured changes in adiponectin, insulin, glucose, and leptin in response to high‐fat (HF) and low‐fat (LF) eucaloric diets in lean (n = 10) and obese (n = 11) subjects. Obese subjects were further subdivided in relation to a priori S_I. Results: We found significantly higher insulin, glucose, and leptin and lower adiponectin in obese vs. lean subjects during both HF and LF. The mean group values of these measurements, including adiponectin (lean, HF 21.9 ± 9.8; LF, 20.8 ± 6.6; obese, HF 10.0 ± 3.3; LF, 9.5 ± 2.3 ng/mL; mean ± SD), did not significantly change between HF and LF diets. However, within the obese group, the insulin‐sensitive subjects had significantly higher adiponectin during HF than did the insulin‐resistant subjects. Additionally, the change in adiponectin from LF to HF diet correlated positively with the obese subjects’ baseline S_I. Discussion: Although in lean and obese women, group mean values for adiponectin did not change significantly with a change in fat content of a eucaloric diet, a priori measured S_I in obese subjects predicted an increase in adiponectin during the HF diet; this may be a mechanism that preserves S_I in an already obese group.     

Cost-Effectiveness of Physical Activity among Women with Menopause Symptoms: Findings from a Randomised Controlled Trial

Menopause is a period that may predispose one to a decrease in muscle strength, cardiorespiratory fitness, and quality of life. A study was carried out to evaluate the cost-effectiveness of physical activity among women displaying symptoms of menopause. The cost-effectiveness analysis was based on data from a six-month randomised controlled trial (n = 151). The women in the intervention group engaged in an unsupervised session of at least 50 minutes of physical activity four times a week. The control group continued their physical activity as before. An incremental cost-effectiveness ratio (ICER) was calculated in terms of maximal oxygen consumption, lean muscle mass, and quality-adjusted life years (QALYs) gained. A bootstrap technique was utilised to estimate uncertainty around the point estimate for ICER associated with the intervention. The mean total cost in the intervention group was €1,307 (SEM: €311) and in the control group was €1,253 (SEM: €279, p = 0.10) per person. The mean intervention cost was €208 per person. After six months of the behaviour-change intervention, the ICER was €63 for a 1 ml/kg/min improvement in cardiorespiratory fitness, the additional cost per one-gram increase in lean muscle mass was €126, and the cost per QALY gained was €46. According to the findings, physical activity among menopausal women was cost-effective for cardiorespiratory fitness, for lean muscle mass, and for QALYs gained, since the intervention was more effective than the actions within the control group and the additional effects of physical activity were gained at a very low price. From the societal perspective, the intervention used may promote ability to work and thereby save on further costs associated with early retirement or disability pension if the physical-activity level remains at least the same as during the intervention.     

ADRB2 Haplotype Is Associated With Glucose Tolerance and Insulin Sensitivity in Obese Postmenopausal Women

The β₂‐adrenergic receptor (ADRB2) mediates obesity, cardiorespiratory fitness, and insulin resistance. We examined the hypothesis that ADRB2 Arg16Gly‐Gln27Glu haplotype is associated with body composition, glucose tolerance, and insulin sensitivity in obese, postmenopausal women. Obese (>35% body fat), postmenopausal (age 45–75 years) women (n = 123) underwent genotyping, dual‐energy X‐ray absorptiometry, and computed tomography scans, exercise testing (VO_2max), 2‐h oral glucose tolerance tests (OGTTs), and hyperinsulinemic‐euglycemic clamps (80 mU/m²/min). Analysis of covariance (ANCOVA) tested for differences among haplotypes, with race, % body fat, and VO_2max as covariates. We found that ADRB2 haplotype was independently associated with % body fat, abdominal fat distribution, VO_2max, insulin sensitivity (M/ΔInsulin), and glucose tolerance (ANOVA, P < 0.05 for all). Women homozygous for Gly16–Gln27 haplotype had the highest % body fat (52.7 ± 1.9%), high abdominal fat, low M/ΔInsulin (0.49 ± 0.08 mg/kg/min/pmol/l/10²), and impaired glucose tolerance (IGT) during an OGTT (G₁₂₀ = 10.2 ± 0.9 mmol/l). Women homozygous for Gly16–Glu27 haplotype also had low M/ΔInsulin (0.51 ± 0.05 mg/kg/min/pmol/l/10²) and IGT (G₁₂₀ = 8.2 ± 0.7 mmol/l). Subjects with Arg16–Gln27/Gly16–Gln27 haplotype combination had the highest VO_2max (1.84 ± 0.07 l/min) and M/ΔInsulin (0.7 ± 0.04 mg/kg/min/pmol/l/10²), and normal glucose tolerance (G₁₂₀ = 6.4 ± 0.4 mmol/l), despite being obese. These data show associations of the ADRB2 Arg16Gly‐Gln27Glu haplotype with VO_2max and body composition, and an independent association with glucose metabolism, which persists after controlling for body composition and fitness. This suggests that ADRB2 haplotypes may mediate insulin action, glucose tolerance, and potentially risk for type 2 diabetes mellitus (T2DM) in obese, postmenopausal women.     

Validity of Cooper’s 12-minute run test for estimation of maximum oxygen uptake in male university students

The present study was conducted to validate the applicability of Cooper''s 12-minute run test (CRT) for predicting VO₂max in male university students of Kolkata, India, to bypass the exhaustive and complicated protocol of direct estimation of VO₂max. Eighty-eight sedentary male university students recruited by simple random sampling from the University of Calcutta, Kolkata, were randomly assigned to the study group (N = 58) and the confirmatory group (N = 30). VO₂max of each participant was determined by the direct procedure and the indirect CRT method. The mean value of predicted VO₂max (PVO₂max) (42.8±4.0 ml · kg⁻¹ · min⁻¹ with a range of 33.7–50.9) showed a significant difference with VO₂max (39.8±4.0 ml · kg⁻¹ · min⁻¹ with a range of 33.5–47.7) in the study group. Limits of agreement between PVO₂max and VO₂max were large enough (0.10 to 5.94 ml · kg⁻¹ · min⁻¹) with poor confidence intervals indicating inapplicability of the current protocol of CRT in the studied population. The prediction norm [Y = 21.01X – 11.04 (SEE = 0.193 ml · kg⁻¹ · min⁻¹)] was computed from the significant correlation (r = 0.93, P < 0.001) between distance covered in CRT and VO₂max. Application of this norm in the confirmatory group revealed an insignificant difference between PVO₂max and VO₂max. The modified equation is recommended for application of CRT as a valid method to evaluate the cardiorespiratory fitness in terms of VO₂max in sedentary male Indian youth.