The relationship of creatine kinase variability with body composition and muscle damage markers following eccentric muscle contractions

[Purpose]

The purpose of the study was to investigate the relationship between CK variability and body composition and muscle damage markers following eccentric exercise.

[Methods]

Total 119 healthy male subjects were recruited to perform 50 eccentric contractions consisted of 2 sets of 25 contractions. Then, blood creatine kinase (CK) activity was analyzed to divide into three groups based on their CK activity levels. Maximum isometric strength (MIS), muscle soreness (SOR) and body composition data were obtained before and after exercise.

[Results]

The results showed that high CK responders had a significant decrease in MIS (p<0.001) and greater SOR (p<0.01) following eccentric exercise compared to low CK responders. Percent body fat was also higher in high responders compared to low responders (p=0.014). Peak CK activity was significantly correlated with MIS and SOR but no correlation with % body fat, muscle mass, and body mass index.

[Conclusion]

CK variability following eccentric exercise is closely related to MIS and SOR and % body fat may be a potent factor for CK variability.     

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.     

Effect of walking exercise on abdominal fat,insulin resistance and serum cytokines in obese women

[Purpose]

The purpose of the study was to investigate the effect of 12-week walking exercise on abdominal fat, insulin resistance and serum cytokines in obese women.

[Methods]

Following baseline measurements, obese women (N = 20) who met obesity criterion of BMI at 25 kg/m² or greater were randomly assigned to the control (n = 10) or exercise groups (n = 10). Women assigned to the exercise group participated in a walking exercise (with an intensity of 50-60% of predetermined VO²max, a frequency of 3 days per week and duration of 50-70 minutes targeting 400 kcal of energy expenditure per session) for 12 weeks, while women assigned to the control group maintained their sedentary lifestyle. After the 12-week walking intervention, post-test measurements were conducted using the same procedure as the baseline measurement. Analyses of variance with repeated measures were used to evaluate any significant time by group interactions for the measured variables.

[Results]

With respect to body fat parameters, significant time-by-group interactions were found in the abdominal subcutaneous (p = < 0.001) and visceral adipose tissues (p = 0.011). The exercise group had significant reductions in both subcutaneous and visceral adiposity, and the control group had no significant changes in those parameters. Similarly, there were significant time by group interactions in fasting glucose (p = 0.008), HOMA-IR (p = 0.029), serum TNF-α (p = 0.027), and IL-6 (p = 0.048) such that the exercise group had significant reductions in those parameters, with no such significant changes found in the control group. The exercise group also had a significant increase in serum adiponectin (p = 0.002), whereas the control group had no significant change in the parameter.

[Conclusion]

In summary, the current findings suggest that walking exercise can provide a safe and effective lifestyle strategy against abdominal obesity and serum insulin resistance markers in obese women.     

Effect of intake of gardenia fruits and combined exercise of middle-aged obese women on hormones regulating energy metabolism

[Purpose]

This study is aimed at analyzing how exercise and gardenia affect hormones that regulate energy metabolism by having middle aged, obese women exercise and take gardenia simultaneously.

[Methods]

This study assigned a total of 35 middle-aged obese women with body fat percentage of more than 35 percent into 9 people of the complex treatment group of intake of gardenia and exercise, 9 people of the exercise group, 9 people of the gardenia group and 8 people of the control group in order to find out the effect of the intake of gardenia fruits and Combined exercise of 8 weeks on the body composition, hormones regulating energy metabolism. This study arranged .08 g per weight of 1 kg of the gardenia fruits to be taken twice a day for 8 weeks after breakfast and dinner through the numerical method of roasting the gardenia fruits on fire. And the exercise program was set to be five times a week for 8 weeks, whereas the aerobic exercise of 60 to 70 minutes was 50 to 60 percent for HRmax; thus, the resistance exercise was set to be 1-RM 50 percent. As for the data analysis, the two-way repeated measures ANOVA was utilized for the analysis of interactive effect between groups and times.

[Results]

Thus, the obtained conclusion is as follows: The %fat and WHR has decreased further in the gardenia+exercise group and the exercise group as compared with the control group. And the visceral fat area has decreased further in the gardenia and exercise group and the gardenia group as compared with the control group (p<.05). In addition, the gardenia+exercise group and the exercise group were found to have a significant improvement effect in all the items of body composition, and the gardenia group has reduced the fat percentage and BMI after the treatment (p<.05). Leptin has decreased further in the gardenia+exercise group and the exercise group as compared with the control group, and the insulin resistance and GLP-1 have decreased in all the treatment groups (p<.05).

[Conclusion]

As a result of this study, all the treatment groups were found to have an improvement effect of research variables in general; therefore, the single treatment and complex treatment for the middle-aged obese women were found to have a positive impact on body composition, adjusting factors for energy metabolism. Also, the complex treatment was found to be more positive in terms of change amount. In particular, in the case of visceral fat area that is the major risk factor for metabolic disease of middle-aged obese women, it was found to have decreased further in the complex treatment group than the gardenia group; therefore, the complex treatment was found to be more advantageous.     

The Relationship between Endogenous Androgens and Body Fat Distribution in Early and Late Postmenopausal Women

Objectives

To investigate the relationship between endogenous androgens and body fat distribution in early and late postmenopausal women.

Materials and Methods

We enrolled postmenopausal women consisting of an early group (≤5 years since menopause, n = 105) and a late group (≥10 years since menopause, n = 107). Each group was subdivided into normal weight (BMI <24 kg/m²) group, overweight and obese (BMI ≥24 kg/m²) group. Fasting total testosterone (T), dehydroepiandrosterone-sulfate (DHEA-S) and sex hormone-binding globulin (SHBG) levels were measured. Body fat distribution was evaluated by dual-energy X-ray absorptiometry (DEXA).

Results

Late postmenopausal women had a higher proportion of body fat than early postmenopausal women. The body fat of the overweight and obese women had a greater tendency to accumulate in the abdomen compared with the normal weight women both in early and late postmenopausal groups. The overweight and obese women had a higher free testosterone (FT) than the normal weight women in early postmenopausal women (P<0.05). In late postmenopausal women, the overweight and obese women had higher DHEA-S levels than normal weight women (P<0.05). No direct relationship was observed between the T levels and body fat distribution both in early and late postmenopausal groups (P>0.05).The FT in early postmenopausal women and the DHEA-S levels in late postmenopausal women correlated positively with the trunk/leg fat ratio (T/L) and the proportion of android fat whereas correlated negatively with the proportion of gynoid fat in the partial correlation and multiple linear regression analyses (all P<0.05).

Conclusions

Serum T levels do not correlate directly with body fat distribution, the FT in early postmenopausal women and DHEA-S levels in late postmenopausal women correlate positively with abdominal fat accumulation.     

A pilot crossover study: effects of an intervention using an activity monitor with computerized game functions on physical activity and body composition

Background

Wearing an activity monitor as a motivational tool and incorporating a behavior-based reward system or a computerized game element might have a synergistic effect on an increase in daily physical activity, thereby inducing body fat reduction. This pilot crossover study aimed to examine the effects of a short-term lifestyle intervention using an activity monitor with computerized game functions on physical activity and body composition.

Methods

Twenty healthy volunteers (31 ± 3 years) participated in a 12-week crossover study. The participants were randomly assigned to either Group A (a 6-week game intervention followed by a 6-week normal intervention) or Group B (a 6-week normal intervention followed by a 6-week game intervention). The participants wore both a normal activity monitor (Lifecorder EX) and an activity monitor with computerized game functions (Yuuhokei) during the game intervention, whereas they only wore a normal activity monitor during the normal intervention. Before, during, and after the intervention, body composition was assessed.

Results

Significantly more daily steps were recorded for the game intervention than for the normal intervention (10,520 ± 562 versus 8,711 ± 523 steps/day, P < 0.01). The participants performed significantly more physical activity at an intensity of ≥ 3 metabolic equivalents (METs) in the game intervention than in the normal intervention (3.1 ± 0.2 versus 2.4 ± 0.2 METs · hour/day, P < 0.01). Although body mass and fat were significantly reduced in both periods (P < 0.01), the difference in body fat reduction was significantly greater in the game intervention than in the normal intervention (P < 0.05).

Conclusions

A short-term intervention using an activity monitor with computerized game functions increases physical activity and reduces body fat more effectively than an intervention using a standard activity monitor.     

A comparison of hydration effect on body fluid and temperature regulation between Malaysian and Japanese males exercising at mild dehydration in humid heat

Background

This study investigated the effect of hydration differences on body fluid and temperature regulation between tropical and temperate indigenes exercising in the heat.

Methods

Ten Japanese and ten Malaysian males with matched physical characteristics (height, body weight, and peak oxygen consumption) participated in this study. Participants performed exercise for 60 min at 55% peak oxygen uptake followed by a 30-min recovery at 32°C and 70% relative air humidity with hydration (4 times each, 3 mL per kg body weight, 37°C) or without hydration. Rectal temperature, skin temperature, heart rate, skin blood flow, and blood pressure were measured continuously. The percentage of body weight loss and total sweat loss were calculated from body weight measurements. The percentage change in plasma volume was estimated from hemoglobin concentration and hematocrit.

Results

Malaysian participants had a significantly lower rectal temperature, a smaller reduction in plasma volume, and a lower heart rate in the hydrated condition than in the non-hydrated condition at the end of exercise (P <0.05), whereas Japanese participants showed no difference between the two hydration conditions. Hydration induced a greater total sweat loss in both groups (P <0.05), and the percentage of body weight loss in hydrated Malaysians was significantly less than in hydrated Japanese (P <0.05). A significant interaction between groups and hydration conditions was observed for the percentage of mean cutaneous vascular conductance during exercise relative to baseline (P <0.05).

Conclusions

The smaller reduction in plasma volume and percentage body weight loss in hydrated Malaysians indicated an advantage in body fluid regulation. This may enable Malaysians to reserve more blood for circulation and heat dissipation and thereby maintain lower rectal temperatures in a hydrated condition.     

Neighborhood Street Scale Elements,Sedentary Time and Cardiometabolic Risk Factors in Inactive Ethnic Minority Women

Background

Cardiometabolic risk factors such as obesity, excess percent body fat, high blood pressure, elevated resting heart rate and sedentary behavior have increased in recent decades due to changes in the environment and lifestyle. Neighborhood micro-environmental, street scale elements may contribute to health above and beyond individual characteristics of residents.

Purpose

To investigate the relationship between neighborhood street scale elements and cardiometabolic risk factors among inactive ethnic minority women.

Method

Women (N = 410) completed measures of BMI, percent body fat, blood pressure, resting heart rate, sedentary behavior and demographics. Trained field assessors completed the Pedestrian Environment Data Scan in participants’ neighborhoods. Data were collected from 2006–2008. Multiple regression models were conducted in 2011 to estimate the effect of environmental factors on cardiometabolic risk factors.

Results

Adjusted regression models found an inverse association between sidewalk buffers and blood pressure, between traffic control devices and resting heart rate, and a positive association between presence of pedestrian crossing aids and BMI (ps<.05). Neighborhood attractiveness and safety for walking and cycling were related to more time spent in a motor vehicle (ps<.05).

Conclusions

Findings suggest complex relationships among micro-environmental, street scale elements that may confer important cardiometabolic benefits and risks for residents. Living in the most attractive and safe neighborhoods for physical activity may be associated with longer times spent sitting in the car.     

Exercise training is more effective than resveratrol supplementation on alleviation of inflammation in peritoneal macrophages of high fat diet mice

[Purpose]

This study investigated the effect of exercise training and resveratrol supplementation with low fat diet on proinflammatory profiles by Lipopolysaccharide (LPS)-stimulation in peritoneal macrophage of high fat diet mice.

[Methods]

To accomplish the purpose of this study, C57BL/6 male mice were fed high fat diet (45% fat diet) for 8 weeks. Then these mice were divided into 3 groups; HLC (high fat diet and low fat diet for 8 weeks as the control, n=10), HLR (high fat diet and low fat diet for 8 weeks with resveratrol supplementation, n=10). HLE (high fat diet and low fat diet for 8 weeks with moderate exercise training, n=10). Resveratrol (10 mg/kg) was administrated once a day, 5 days/week for 8 weeks. Exercise training was performed for 8 weeks on a treadmill running for 30-60 min/day at 10-22 m/min, 0% grade, 5 days/week. After exercise training, all the peritoneal macrophage was collected and LPS (0, 0.5, 1.0 μg/ml) were used to stimulate the cells. Then peritoneal macrophage TNF-α, IL-6, MCP-1, IL12p70, IFN-γ, IL-10 were measured by BD cytometric bead array mouse inflammation kit.

[Results]

As a result, body weight and total cholesterol were significantly reduced in HLE compared with HLC (p<.05). Also, TNF-α and MCP-1 were decreased in HLE compared with HLC (p<.05) by LPS-stimulation (0, 0.5, 1.0 μg/ml) and IL-6, IL-12p70 and IFN-r were decreased in HLE compared with HLC (p<.05) by LPS-stimulation (1.0 μg/ml). But resveratrol supplementation did not affect the result.

[Conclusion]

These findings suggest that exercise training has beneficial effects on body weight, total cholesterol, peritoneal macrophage and proinflammatory cytokine in high fat diet mice.     

Effect of high-intensity exercise and high-fat diet on lipid metabolism in the liver of rats

[Purpose]

This study investigated the effects of high-intensity exercise (Ex) and high dietary fat intake on lipid metabolism in the liver of rats.

[Methods]

Male Sprague-Dawley rats were randomly assigned to one of the four groups (n=10 per group) that were maintained on a normal diet (ND) or high-fat diet (HFD) consisting of 30% fat (w/w), with or without exercise on a treadmill at 30 m/min and 8% grade) for 4 weeks (i.e., ND, ND+Ex, HFD, and HFD+Ex groups).

[Results]

Body weight (p<.001), total plasma cholesterol (TC) (p<.001), triglyceride (TG) (p<.05), and liver TG levels (p<.05) were increased in the HFD group relative to the ND groups, and serum glucose (p<.05), insulin (p<.05), homeostatic model assessment of insulin resistance (HOMA-IR) (p<.01), and liver TG levels (p<.01) were also higher in the HFD group compared to the ND+Ex group. Plasma free fatty acid was elevated in the HFD+Ex group compared to the HFD group (p<.01). With the exception of acetyl coenzyme A carboxylase, the expression of lipid metabolism-related genes in the liver was altered in the Ex groups compared to the control group (p<.05), with genes involved in lipolysis specifically up regulated in the HFD+Ex group compared to the other groups.

[Conclusion]

Vigorous exercise may increase glucose utilization and fat oxidation by activating genes in the liver that are associated with lipid metabolism compared to that in animals consuming a HFD without exercise. Therefore, high intensity exercise can be considered to counter the adverse effects of high dietary fat intake.     

Serum Glycated Albumin Is Inversely Influenced by Fat Mass and Visceral Adipose Tissue in Chinese with Normal Glucose Tolerance

Background

Recent studies have revealed that body mass index (BMI) inversely influenced serum glycated albumin (GA), which may cause an underestimation of GA-monitored short-term hyperglycemic control.

Objective

This study was to investigate the association between anthropometric variables (BMI and waist circumference (W)) and accurate adiposity variables (percentage of body fat (%fat), fat mass, free fat mass (FFM), subcutaneous fat area (SFA), and visceral fat area (VFA)) with serum GA.

Design

A total of 2563 subjects (1037 men, 593 premenopausal women, and 933 postmenopausal women) with normal glucose tolerance underwent bioelectrical impedance body fat content measurement and magnetic resonance imaging. Serum GA and absolute value of GA (aGA) were measured by enzymatic assay.

Results

Compared to the BMI <25.0 kg/m² group, the BMI ≥25.0 kg/m² group had significantly higher fasting plasma glucose, glycated hemoglobin A1c, and body fat parameters including W, %fat, fat mass, FFM, SFA, and VFA, but significantly lower aGA, and GA in all the three sex- and menopause-stratified groups (all P<0.05). GA decreased with the increment of fat mass for all three groups (all P for trend <0.001). In the same BMI category, men and postmenopausal women with elevated %fat (men, ≥25%; women, ≥35%) still had significantly lower GA than those with normal %fat (men, <25%; women, <35%) (all P<0.05). Multiple stepwise regression showed that %fat, fat mass, and VFA were independently associated with GA.

Conclusions

Serum GA was inversely influenced by fat mass and visceral adipose tissue in Chinese with normal glucose tolerance.     

Does the Method of Weight Loss Effect Long-Term Changes in Weight,Body Composition or Chronic Disease Risk Factors in Overweight or Obese Adults? A Systematic Review

Background

Differences in biological changes from weight loss by energy restriction and/or exercise may be associated with differences in long-term weight loss/regain.

Objective

To assess the effect of weight loss method on long-term changes in weight, body composition and chronic disease risk factors.

Data Sources

PubMed and Embase were searched (January 1990-October 2013) for studies with data on the effect of energy restriction, exercise (aerobic and resistance) on long-term weight loss. Twenty articles were included in this review.

Study Eligibility Criteria

Primary source, peer reviewed randomized trials published in English with an active weight loss period of >6 months, or active weight loss with a follow-up period of any duration, conducted in overweight or obese adults were included.

Study Appraisal and Synthesis Methods

Considerable heterogeneity across trials existed for important study parameters, therefore a meta-analysis was considered inappropriate. Results were synthesized and grouped by comparisons (e.g. diet vs. aerobic exercise, diet vs. diet + aerobic exercise etc.) and study design (long-term or weight loss/follow-up).

Results

Forty percent of trials reported significantly greater long-term weight loss with diet compared with aerobic exercise, while results for differences in weight regain were inconclusive. Diet+aerobic exercise resulted in significantly greater weight loss than diet alone in 50% of trials. However, weight regain (∼55% of loss) was similar in diet and diet+aerobic exercise groups. Fat-free mass tended to be preserved when interventions included exercise.     

Effects of potato and lotus leaf extract intake on body composition and blood lipid concentration

[Purpose]

The purpose of this study was to investigate the effects of potato and lotus leaf extract intake on body composition, abdominal fat, and blood lipid concentration in female university students.

[Methods]

A total of 19 female university students participated in this 8-week study, and they were randomly assigned into 2 groups; potato and lotus leaf extract (skinny-line) administered group (SKG, n =9) and placebo group (PG, n = 10). The main results of the present study are presented below.

[Results]

1) Body mass index, and percent body fat and abdominal fat in students of the SKG showed a decreasing tendency without significant interaction, 2) total cholesterol (TC), triglyceride (TG), and low density lipoprotein (LDL-C) in students of the SKG showed an averagely decreasing tendency and there was a significant interaction of TC only, 3) high density lipoprotein (HDL-C) in students of the SKG showed an increasing tendency without significant interaction, and 4) Z-score of fatness testing interaction in group × repetition did not show a significant interaction; however, there was a significant interaction of TC in group × repetition. Based on these results, 8-week intake of potato and lotus leaf extract had a positive effect of lowering TC. On the other hand, it had no significant effect on other types of lipids and percent body fat changes.

[Conclusion]

There was a positive tendency of blood lipids in students of the SKG and it seems that potato and lotus leaf extract intake might prevent obesity and improve obesity related syndromes.     

Measurement of body composition in response to a short period of overfeeding

Background

Obesity and overweight are increasing in prevalence in developed countries as a result of changing dietary habits and a lack of physical activity. The purpose of the present study was to evaluate the changes in body composition during short-term overfeeding using the three-component model, which is composed of fat mass (FM), total body water (TBW), and fat-free dry solids (FFDS).

Methods

Ten healthy men completed 3 days of overfeeding during which they consumed 1,500 kcal/day more energy than consumed in their normal diets. Body composition was evaluated at three time points: the day before and after their normal diets and the day after the 3-day overfeeding diet.

Results

Before and after their normal diets, there were no significant differences in body weight and composition, but after 3 days of overfeeding, body weight, TBW, and FFDS increased 0.7, 0.7, and 0.2 kg, respectively (P <0.0001). There was no significant difference in FM between the normal and overfeeding diets.

Conclusion

This study suggests that TBW gain contributes to weight gain following a short-term overfeeding.     

Lifelong Obesity in a Polygenic Mouse Model Prevents Age- and Diet-Induced Glucose Intolerance– Obesity Is No Road to Late-Onset Diabetes in Mice

Aims/Hypothesis

Visceral obesity holds a central position in the concept of the metabolic syndrome characterized by glucose intolerance in humans. However, until now it is unclear if obesity by itself is responsible for the development of glucose intolerance.

Methods

We have used a novel polygenic mouse model characterized by genetically fixed obesity (DU6) and addressed age- and high fat diet-dependent glucose tolerance.

Results

Phenotype selection over 146 generations increased body weight by about 2.7-fold in male 12-week DU6 mice (P<0.0001) if compared to unselected controls (Fzt:DU). Absolute epididymal fat mass was particularly responsive to weight selection and increased by more than 5-fold (P<0.0001) in male DU6 mice. At an age of 6 weeks DU6 mice consumed about twice as much food if compared to unselected controls (P<0.001). Absolute food consumption was higher at all time points measured in DU6 mice than in Fzt:DU mice. Between 6 and 12 weeks of age, absolute food intake was reduced by 15% in DU6 mice (P<0.001) but not in Fzt:DU mice. In both mouse lines feeding of the high fat diet elevated body mass if compared to the control diet (P<0.05). In contrast to controls, DU6 mice did not display high fat diet-induced increases of epididymal and renal fat. Control mice progressively developed glucose intolerance with advancing age and even more in response to the high fat diet. In contrast, obese DU6 mice did neither develop a glucose intolerant phenotype with progressive age nor when challenged with a high fat diet.

Conclusions/Interpretation

Our results from a polygenic mouse model demonstrate that genetically pre-determined and life-long obesity is no precondition of glucose intolerance later in life.     

Dietary Restriction and Exercise for Diabetic Patients with Chronic Kidney Disease: A Systematic Review

Background

Obesity and sedentary lifestyle are major health problems and key features to develop cardiovascular disease. Data on the effects of lifestyle interventions in diabetics with chronic kidney disease (CKD) have been conflicting.

Study Design

Systematic review.

Population

Diabetes patients with CKD stage 3 to 5.

Search Strategy and Sources

Medline, Embase and Central were searched to identify papers.

Intervention

Effect of a negative energy balance on hard outcomes in diabetics with CKD.

Outcomes

Death, cardiovascular events, glycaemic control, kidney function, metabolic parameters and body composition.

Results

We retained 11 studies. There are insufficient data to evaluate the effect on mortality to promote negative energy balance. None of the studies reported a difference in incidence of Major Adverse Cardiovascular Events. Reduction of energy intake does not alter creatinine clearance but significantly reduces proteinuria (mean difference from −0.66 to −1.77 g/24 h). Interventions with combined exercise and diet resulted in a slower decline of eGFR (−9.2 vs. −20.7 mL/min over two year observation; p<0.001). Aerobic and resistance exercise reduced HbA1c (−0.51 (−0.87 to −0.14); p = 0.007 and −0.38 (−0.72 to −0.22); p = 0.038, respectively). Exercise interventions improve the overall functional status and quality of life in this subgroup. Aerobic exercise reduces BMI (−0.74% (−1.29 to −0.18); p = 0.009) and body weight (−2.2 kg (−3.9 to −0.6); p = 0.008). Resistance exercise reduces trunk fat mass (−0,7±0,1 vs. +0,8 kg ±0,1 kg; p = 0,001−0,005). In none of the studies did the intervention cause an increase in adverse events.

Limitations

All studies used a different intervention type and mixed patient groups.

Conclusions

There is insufficient evidence to evaluate the effect of negative energy balance interventions on mortality in diabetic patients with advanced CKD. Overall, these interventions have beneficial effects on glycaemic control, BMI and body composition, functional status and quality of life, and no harmful effects were observed.     

Using Mid-Upper Arm Circumference to End Treatment of Severe Acute Malnutrition Leads to Higher Weight Gains in the Most Malnourished Children

Objective

The World Health Organization recommends discharging children admitted to nutrition programs treating severe acute malnutrition, with a low mid-upper arm circumference (MUAC <115 mm) when weight gain is >15%. When this recommendation is followed, the most severely malnourished children receive a shorter treatment compared to children that are less severely malnourished. This study assesses whether using MUAC >125 mm as discharge criteria eliminates this effect.

Methods and Findings

Data from 753 children cured from a Médecins Sans Frontières outpatient nutrition program in Gedaref, North Sudan were analyzed. MUAC >125 mm was used as discharge criteria. Length of stay and percent weight gain of children were compared in relation to nutritional status on admission. Children with low MUAC on admission had a longer duration of treatment (p = 0.000) and also a higher percent weight gain (p = 0.000) than children with higher MUAC. Similar results with weight-for-height z-scores categories were shown with both duration of treatment (p = 0.000) and percent weight gain (p = 0.000).

Conclusion

This study shows that using MUAC as the discharge criteria eliminates the effect of shorter treatment in most severely malnourished children compared to least severely malnourished, as is observed with percent weight gain. The findings directly address the main concern that has been identified with the current WHO recommendation of using percent weight gain. MUAC could be used as discharge criteria, instead of percent weight gain, as having a longer duration of treatment and a higher percent weight gain for the most malnourished is highly desirable.     

The effects of either resveratrol or exercise on macrophage infiltration and switching from M1 to M2 in high fat diet mice

[Purpose]

The aim of this study was to compare the effectiveness of either resveratrol supplementation or exercise training on macrophage infiltration and switching from M1 to M2 kupffer cells in high fat diet mice.

[Methods]

C57BL/6 mice were separated into 5 groups: normal diet (ND; n = 6), high-fat diet (HD; n = 6), high-fat diet with resveratrol (HR; n = 6), high-fat diet with exercise (HE; n = 6) or high-fat diet with resveratrol and exercise (HRE; n = 6). Resveratrol supplementation mice were orally gavaged with resveratrol (25mg/kg of body weight) dissolved in 50% propylene glycol. Exercise mice ran on a treadmill at 12-20 m/min for 30-60 min/day, 5 times/week for 12 weeks.

[Results]

After 12 weeks of intervention, the liver was analyzed. F4/80 expression was evaluated by western blot while CD11c and CD163 mRNA expressions were evaluated by RT-PCR. The weights of the body and liver were significantly increased in the HD and HR group compared to the ND group (p < 0.01). However, the weights were most effectively reduced in the HE and HRE groups compared to the HD group (p < 0.05). The macrophage marker, F4/80 expression was significantly lower in the HE and HRE groups compared to the HD group (p < 0.05). mRNA expression of the M1 macrophage marker, CD11c, in the HD group was significantly increased compared to the ND group (p < 0.01). mRNA expression of the M2 macrophage specific marker, CD163, in the HE and HRE groups were significantly increased compared to the HD group (p < 0.05). The mRNA expressions of TLR4, ICAM-1 and VCAM-1, which induce pro-inflammatory cytokine production, were strongly decreased in the HR, HE, and HRE groups compared to the HD group.

[Conclusion]

These results suggest that moderate exercise training inhibits macrophage infiltration and up regulation of CD163 expression. However, resveratrol supplementation is not enough to ameliorate obesity-induced macrophage infiltration and switching.     

Determinants of Childhood Adiposity: Evidence from the Australian LOOK Study

Background

To contribute to the current debate as to the relative influences of dietary intake and physical activity on the development of adiposity in community-based children.

Methods

Participants were 734 boys and girls measured at age 8, 10 and 12 years for percent body fat (dual emission x-ray absorptiometry), physical activity (pedometers, accelerometers); and dietary intake (1 and 2-day records), with assessments of pubertal development and socioeconomic status.

Results

Cross-sectional relationships revealed that boys and girls with higher percent body fat were less physically active, both in terms of steps per day and moderate and vigorous physical activity (both sexes p<0.001 for both measures). However, fatter children did not consume more energy, fat, carbohydrate or sugar; boys with higher percent body fat actually consumed less carbohydrate (p = 0.01) and energy (p = 0.05). Longitudinal analysis (combined data from both sexes) was weaker, but supported the cross-sectional findings, showing that children who reduced their PA over the four years increased their percent body fat (p = 0.04). Relationships in the 8 year-olds and also in the leanest quartile of all children, where adiposity-related underreporting was unlikely, were consistent with those of the whole group, indicating that underreporting did not influence our findings.

Conclusions

These data provide support for the premise that physical activity is the main source of variation in the percent body fat of healthy community-based Australian children. General community strategies involving dietary intake and physical activity to combat childhood obesity may benefit by making physical activity the foremost focus of attention.