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Muscular Strength and Cardiovascular Disease: AN UPDATED STATE-OF-THE-ART NARRATIVE REVIEW.
Carbone, S, Kirkman, DL, Garten, RS, Rodriguez-Miguelez, P, Artero, EG, Lee, DC, Lavie, CJ
Journal of cardiopulmonary rehabilitation and prevention. 2020;(5):302-309
Abstract
This review discusses the associations of muscular strength (MusS) with cardiovascular disease (CVD), CVD-related death, and all-cause mortality, as well as CVD risk factors, such as metabolic syndrome, diabetes, obesity, and hypertension. We then briefly review the role of resistance exercise training in modulating CVD risk factors and incident CVD.The role of MusS has been investigated over the years, as it relates to the risk to develop CVD and CVD risk factors. Reduced MusS, also known as dynapenia, has been associated with increased risk for CVD, CVD-related mortality, and all-cause mortality. Moreover, reduced MusS is associated with increased cardiometabolic risk. The majority of the studies investigating the role of MusS with cardiometabolic risk, however, are observational studies, not allowing to ultimately determine association versus causation. Importantly, MusS is also essential for the identification of nutritional status and body composition abnormalities, such as frailty and sarcopenia, which are major risk factors for CVD.
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[Diagnosis and therapy of sarcopenia-an update].
Goisser, S, Kob, R, Sieber, CC, Bauer, JM
Der Internist. 2019;(2):141-148
Abstract
Since 2016 sarcopenia, the age-associated loss of muscle mass, strength and function, has the ICD-10-GM code M62.50 (International Statistical Classification of Diseases and Related Health Problems, 10th Revision, German Modification). The diagnosis of sarcopenia requires the combined presence of low muscle strength and low muscle mass. Well-established approaches for the prevention and therapy of sarcopenia are exercise programs-in particular strength, endurance and power training-and nutritional interventions, preferably a combination of both. Adequate protein intake is considered highly relevant, while the role of other nutrients involved in muscle metabolism (e. g. creatine, vitamin D, antioxidants, omega-3 fatty acids) is less clear, being still the subject of controversial discussions. Innovative pharmacological therapies are currently under investigation and their future relevance for this indication is unclear. In general, it has to be stated that there are still only few intervention studies available that focused specifically on sarcopenia in older individuals. More studies in this rapidly increasing population are urgently needed.
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Exercise for the prevention of osteoporosis in postmenopausal women: an evidence-based guide to the optimal prescription.
Daly, RM, Dalla Via, J, Duckham, RL, Fraser, SF, Helge, EW
Brazilian journal of physical therapy. 2019;(2):170-180
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Abstract
BACKGROUND Osteoporosis and related fragility fractures are a global public health problem in which pharmaceutical agents targeting bone mineral density (BMD) are the first line of treatment. However, pharmaceuticals have no effect on improving other key fracture risk factors, including low muscle strength, power and functional capacity, all of which are associated with an increased risk for falls and fracture, independent of BMD. Targeted exercise training is the only strategy that can simultaneously improve multiple skeletal and fall-related risk factors, but it must be appropriately prescribed and tailored to the desired outcome(s) and the specified target group. OBJECTIVES In this review, we provide an overview of the general principles of training and specific loading characteristics underlying current exercise guidelines for the prevention of osteoporosis, and an update on the latest scientific evidence with regard to the type and dose of exercise shown to positively influence bone mass, structure and strength and reduce fracture risk in postmenopausal women.
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Supplements with purported effects on muscle mass and strength.
Valenzuela, PL, Morales, JS, Emanuele, E, Pareja-Galeano, H, Lucia, A
European journal of nutrition. 2019;(8):2983-3008
Abstract
PURPOSE Several supplements are purported to promote muscle hypertrophy and strength gains in healthy subjects, or to prevent muscle wasting in atrophying situations (e.g., ageing or disuse periods). However, their effectiveness remains unclear. METHODS This review summarizes the available evidence on the beneficial impacts of several popular supplements on muscle mass or strength. RESULTS Among the supplements tested, nitrate and caffeine returned sufficient evidence supporting their acute beneficial effects on muscle strength, whereas the long-term consumption of creatine, protein and polyunsaturated fatty acids seems to consistently increase or preserve muscle mass and strength (evidence level A). On the other hand, mixed or unclear evidence was found for several popular supplements including branched-chain amino acids, adenosine triphosphate, citrulline, β-Hydroxy-β-methylbutyrate, minerals, most vitamins, phosphatidic acid or arginine (evidence level B), weak or scarce evidence was found for conjugated linoleic acid, glutamine, resveratrol, tribulus terrestris or ursolic acid (evidence level C), and no evidence was found for other supplements such as ornithine or α-ketoglutarate (evidence D). Of note, although most supplements appear to be safe when consumed at typical doses, some adverse events have been reported for some of them (e.g., caffeine, vitamins, α-ketoglutarate, tribulus terrestris, arginine) after large intakes, and there is insufficient evidence to determine the safety of many frequently used supplements (e.g., ornithine, conjugated linoleic acid, ursolic acid). CONCLUSION In summary, despite their popularity, there is little evidence supporting the use of most supplements, and some of them have been even proven ineffective or potentially associated with adverse effects.
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The effects of caffeine ingestion on isokinetic muscular strength: A meta-analysis.
Grgic, J, Pickering, C
Journal of science and medicine in sport. 2019;(3):353-360
Abstract
OBJECTIVES The aims of this paper are threefold: (1) to summarize the research examining the effects of caffeine on isokinetic strength, (2) pool the effects using a meta-analysis, and (3) to explore if there is a muscle group or a velocity specific response to caffeine ingestion. DESIGN Meta-analysis. METHODS PubMed/MEDLINE, Scopus, and SPORTDiscus were searched using relevant terms. The PEDro checklist was used for the assessment of study quality. A random-effects meta-analysis of standardized mean differences (SMDs) was done. RESULTS Ten studies of good and excellent methodological quality were included. The SMD for the effects of caffeine on strength was 0.16 (95% CI=0.06, 0.26; p=0.003; +5.3%). The subgroup analysis for knee extensor isokinetic strength showed a significant difference (p=0.004) between the caffeine and placebo conditions with SMD value of 0.19 (95% CI=0.06, 0.32; +6.1%). The subgroup analysis for the effects of caffeine on isokinetic strength of other, smaller muscle groups indicated no significant difference (p=0.092) between the caffeine and placebo conditions. The subgroup analysis for knee extensor isokinetic strength at angular velocities of 60°s-1 and 180°s-1 showed a significant difference between the caffeine and placebo conditions; however, no significant effect (p=0.193) was found at an angular velocity of 30°s-1. CONCLUSIONS This meta-analysis demonstrates that acute caffeine ingestion caffeine may significantly increase isokinetic strength. Additionally, this meta-analysis reports that the effects of caffeine on isokinetic muscular strength are predominantly manifested in knee extensor muscles and at greater angular velocities.
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CORP: Measurement of upper and lower limb muscle strength and voluntary activation.
Nuzzo, JL, Taylor, JL, Gandevia, SC
Journal of applied physiology (Bethesda, Md. : 1985). 2019;(3):513-543
Abstract
Muscle strength, the maximal force-generating capacity of a muscle or group of muscles, is regularly assessed in physiological experiments and clinical trials. An understanding of the expected variation in strength and the factors that contribute to this variation is important when designing experiments, describing methodologies, interpreting results, and attempting to replicate methods of others and reproduce their findings. In this review (Cores of Reproducibility in Physiology), we report on the intra- and inter-rater reliability of tests of upper and lower limb muscle strength and voluntary activation in humans. Isometric, isokinetic, and isoinertial strength exhibit good intra-rater reliability in most samples (correlation coefficients ≥0.90). However, some tests of isoinertial strength exhibit systematic bias that is not resolved by familiarization. With the exception of grip strength, few attempts have been made to examine inter-rater reliability of tests of muscle strength. The acute factors most likely to affect muscle strength and serve as a source of its variation from trial-to-trial or day-to-day include attentional focus, breathing technique, remote muscle contractions, rest periods, temperature (core, muscle), time of day, visual feedback, body and limb posture, body stabilization, acute caffeine consumption, dehydration, pain, fatigue from preceding exercise, and static stretching >60 s. Voluntary activation, the nervous system's ability to drive a muscle to create its maximal force, exhibits good intra-rater reliability when examined with twitch interpolation (correlation coefficients >0.80). However, inter-rater reliability has not been formally examined. The methodological factors most likely to influence voluntary activation are myograph compliance and sensitivity; stimulation location, intensity, and inadvertent stimulation of antagonists; joint angle (muscle length); and the resting twitch.
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Relevance to assess and preserve muscle strength in aging field.
Buckinx, F, Aubertin-Leheudre, M
Progress in neuro-psychopharmacology & biological psychiatry. 2019;:109663
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Abstract
According to the revised European consensus on sarcopenia, muscle strength is the primary parameter of sarcopenia and is associated with adverse outcomes or physical limitation. This literature review aims to clarify how and why to measure and preserve muscle strength in older population. Overall, the relationship between muscle strength and physical function is impacted by level of muscle mass, the degree of obesity (BMI), age and physical activity. Therefore, these factors are to be considered in the evaluation of muscle strength. It is necessary to have objective, reliable and sensitive tools to assess muscle strength, in different populations to detect and quantify weakness, to adapt physical exercises to patients' capacity and to evaluate the effects of treatment. Handgrip strength measurement might be reasonable for clinical practice while the measurement of knee flexors/extensors strength with both 1RM and dynamometers is increasingly important yet restricted by the requirement of special equipment. Physical activity and nutrition are two important behavioral factors to maintain muscle strength. Combined exercise and nutrition interventions improved muscle strength to a more prominent degree than exercise or nutrition alone.
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Dietary Patterns, Skeletal Muscle Health, and Sarcopenia in Older Adults.
Granic, A, Sayer, AA, Robinson, SM
Nutrients. 2019;(4)
Abstract
In recent decades, the significance of diet and dietary patterns (DPs) for skeletal muscle health has been gaining attention in ageing and nutritional research. Sarcopenia, a muscle disease characterised by low muscle strength, mass, and function is associated with an increased risk of functional decline, frailty, hospitalization, and death. The prevalence of sarcopenia increases with age and leads to high personal, social, and economic costs. Finding adequate nutritional measures to maintain muscle health, preserve function, and independence for the growing population of older adults would have important scientific and societal implications. Two main approaches have been employed to study the role of diet/DPs as a modifiable lifestyle factor in sarcopenia. An a priori or hypothesis-driven approach examines the adherence to pre-defined dietary indices such as the Mediterranean diet (MED) and Healthy Eating Index (HEI)-measures of diet quality-in relation to muscle health outcomes. A posteriori or data-driven approaches have used statistical tools-dimension reduction methods or clustering-to study DP-muscle health relationships. Both approaches recognise the importance of the whole diet and potential cumulative, synergistic, and antagonistic effects of foods and nutrients on ageing muscle. In this review, we have aimed to (i) summarise nutritional epidemiology evidence from four recent systematic reviews with updates from new primary studies about the role of DPs in muscle health, sarcopenia, and its components; (ii) hypothesise about the potential mechanisms of 'myoprotective' diets, with the MED as an example, and (iii) discuss the challenges facing nutritional epidemiology to produce the higher level evidence needed to understand the relationships between whole diets and healthy muscle ageing.
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[Protein supplementation to prevent loss in muscle mass and strength in frail older patients: a review].
Bonnefoy, M, Gilbert, T, Bruyère, O, Paillaud, E, Raynaud-Simon, A, Guérin, O, Jeandel, C, Le Sourd, B, Haine, M, Ferry, M, et al
Geriatrie et psychologie neuropsychiatrie du vieillissement. 2019;(2):137-143
Abstract
Minimum levels of protein intake are essential for the preservation of muscle mass and function, which is a major preventive issue of successful aging. Epidemiological studies suggest strong associations between protein intake and the different elements of sarcopenia, namely maintenance of lean mass and muscle strength. Most often, protein intakes among older patients are below requirements, independently from situations of under nutrition. This opens the path for nutritional interventions to prevent the consequences of sarcopenia in older patients. Isolated amino-acids such as leucine have shown positive effects in the short term only. The positive effects of protein supplementations on muscle strength and function are currently not established in the absence of concomitant exercise training. The highest level of evidence supports interventions combining exercise and nutrition.
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Effect of Cocoa Products and Its Polyphenolic Constituents on Exercise Performance and Exercise-Induced Muscle Damage and Inflammation: A Review of Clinical Trials.
Massaro, M, Scoditti, E, Carluccio, MA, Kaltsatou, A, Cicchella, A
Nutrients. 2019;(7)
Abstract
In recent years, the consumption of chocolate and, in particular, dark chocolate has been "rehabilitated" due to its high content of cocoa antioxidant polyphenols. Although it is recognized that regular exercise improves energy metabolism and muscle performance, excessive or unaccustomed exercise may induce cell damage and impair muscle function by triggering oxidative stress and tissue inflammation. The aim of this review was to revise the available data from literature on the effects of cocoa polyphenols on exercise-associated tissue damage and impairment of exercise performance. To this aim, PubMed and Web of Science databases were searched with the following keywords: "intervention studies", "cocoa polyphenols", "exercise training", "inflammation", "oxidative stress", and "exercise performance". We selected thirteen randomized clinical trials on cocoa ingestion that involved a total of 200 well-trained athletes. The retrieved data indicate that acute, sub-chronic, and chronic cocoa polyphenol intake may reduce exercise-induced oxidative stress but not inflammation, while mixed results are observed in terms of exercise performance and recovery. The interpretation of available results on the anti-oxidative and anti-inflammatory activities of cocoa polyphenols remains questionable, likely due to the variety of physiological networks involved. Further experimental studies are mandatory to clarify the role of cocoa polyphenol supplementation in exercise-mediated inflammation.