-
1.
Effect of a multicomponent nutritional supplement on functional outcomes for Duchenne muscular dystrophy: A randomized controlled trial.
Davidson, ZE, Hughes, I, Ryan, MM, Kornberg, AJ, Cairns, AG, Jones, K, Hutchence, M, Sampaio, H, Morrison, M, Truby, H
Clinical nutrition (Edinburgh, Scotland). 2021;(7):4702-4711
Abstract
BACKGROUND & AIMS Duchenne muscular dystrophy (DMD) is an X-linked neuromuscular condition causing progressive muscle weakness and premature death. Whilst effective treatments such as gene therapy are developed, families often seek complementary therapies such as nutrition supplements to help their son maintain function; however, there is limited evidence supporting the use of nutritional supplements in DMD. This study aimed to compare the effect of a Standard nutritional supplement with an Enhanced nutritional supplement combining three nutriceuticals on functional outcomes in ambulatory boys with Duchenne muscular dystrophy (DMD). DESIGN A 50-week double blinded, randomized, controlled crossover trial was conducted in four Australian neuromuscular centres. Primary outcome measures were 6-min walk distance (6MWD) and community ambulation (StepWatch™ Activity Monitoring). Secondary outcome measures included body composition and quality of life. Serum 25-hydroxyvitamin D was measured. RESULTS Twenty-seven boys completed the intervention. Traditional crossover analysis demonstrated the Enhanced supplement compared to the Standard supplement was associated with a difference of +12 (95% CI: -16, 40) metres in 6MWD, +0.5 (95% CI: -53, 54) inactive minutes per day and -95 (95% CI: -887, 696) steps per day. A mixed effect model indicated a potentially clinically important effect of the Enhanced supplement on the 6MWD of +31 (95% CI: -19, 81) metres. Mean serum 25 hydroxyvitamin D levels at week 50 was 94 (95% CI: 84, 104) nmol/L. There was no observable effect of either supplement regime on body composition or quality of life. CONCLUSIONS Whilst a positive effect of the Enhanced supplement on functional outcomes was observed, this finding was inconclusive due to the small sample size. The results do not support the use of combined nutritional supplements to improve body composition or quality of life in DMD. A dose of 2000 IU vitamin D was an adequate dose to raise serum 25-hydroxyvitamin D over 50 weeks. CLINICAL TRIAL REGISTRY Registry #: ACTRN12610000462088, http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12610000462088.
-
2.
Interrupting Prolonged Sitting Reduces Postprandial Glucose Concentration in Young Men With Central Obesity.
Wongpipit, W, Zhang, X, Miyashita, M, Wong, SH
The Journal of clinical endocrinology and metabolism. 2021;(2):e791-e802
Abstract
CONTEXT Prolonged sitting elevates postprandial metabolic markers, resulting in increased risks of cardiovascular diseases and type 2 diabetes. Interrupting prolonged sitting may reduce these risks. However, more information is needed to understand the patterns of interrupting prolonged sitting to obtain metabolic health benefits. OBJECTIVE This study examined the effects of interrupting prolonged sitting with different intensities and durations of walking with an equivalent energy expenditure on postprandial metabolic responses in young Chinese men with central obesity. DESIGN A randomized crossover experimental trial was conducted. SETTING Participants underwent three 6-hour experiments with a 7-day washout period between each experiment: prolonged sitting, 3 min of light-intensity walking every 30 minutes, and 1.5 minutes of moderate-intensity walking every 30 minutes. PARTICIPANTS AND SAMPLES Baseline (fasting) and 6-hour postprandial metabolic glucose and lipid levels were analyzed among 18 young Chinese men with central obesity. MAIN OUTCOME MEASURES Generalized estimating equations (adjusted for the potential confounders explaining residual outcome variance (body mass index) and age), trial order, preprandial values, and lead-in activity) were used, and the incremental areas under the curve (iAUC) of each outcome were compared between prolonged sitting and interrupted prolonged sitting conditions. RESULTS Compared with prolonged sitting, both interrupting prolonged sitting conditions reduced the iAUCs for glucose (P < .05) but not insulin, C-peptide, triglycerides, or nonesterified fatty acids. CONCLUSIONS Both conditions of interrupted prolonged sitting reduced postprandial glucose concentrations in young Chinese men with central obesity when the energy expenditure was equivalent.
-
3.
Effects of interrupting sitting with different activity bouts on postprandial lipemia: A randomized crossover trial.
Ma, SX, Zhu, Z, Cao, ZB
Scandinavian journal of medicine & science in sports. 2021;(3):633-642
Abstract
To determine whether interrupting prolonged sitting with three different activity breaks has both acute and chronic effects on postprandial lipid metabolism immediately after the activity-break period and on the following day, this study is a secondary analysis of an experimental research, which included 16 sedentary healthy adults (7 men, 24 ± 3 years, BMI 22.2 ± 2.3 kg/m2 ) who completed four 26-h laboratory trials. Participants spent 22.5 hours in a whole room calorimeter for testing energy expenditure (EE), including a 9-h activity-break period: (a) 9-h prolonged sitting (SIT); (b) 3 minutes of brisk walking (60% VO2max ) in between every 30-min sitting bout (WALK3), (c) 5 minutes every 45-min (WALK5), and (d) 8 minutes every 60-min (WALK8). Total area under the curve (tAUC) and incremental AUC (iAUC) for 2-h postprandial serum triglyceride (TG) levels and non-esterified fatty acid (NEFA) levels were examined immediately after the 9-h trial (post-dinner) and the next morning (post-breakfast). WALK8 reduced the post-breakfast TG tAUC by 11% (P = .041) relative to SIT, and the effect was attenuated after adjustment for EE. The tAUC and iAUC indicated no significant treatment effects on post-dinner TG and NEFA, and post-breakfast NEFA in any of the activity-break trials. EE was positively associated with the post-breakfast NEFA iAUC (unstandardized β = 0.17 µmol/L/MJ [0.05-0.28], P = .006). There was a chronic effect of interrupting sitting with short bouts (8 minutes) of brisk walking every 60 minutes on postprandial lipemia the following morning after intervention, and higher activity bout-induced EE may be more effective in sedentary, healthy adults.
-
4.
Cardiovascular Rehabilitation Increases Walking Distance in Patients With Intermittent Claudication. Results of the CIPIC Rehab Study: A Randomised Controlled Trial.
Siercke, M, Jørgensen, LP, Missel, M, Thygesen, LC, Møller, SP, Sillesen, H, Berg, SK
European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery. 2021;(5):768-776
Abstract
OBJECTIVE To examine whether a cardiac rehabilitation programme in a community based setting for patients with intermittent claudication (IC) affects walking ability, quality of life, and changes in health behaviour. The trial investigated a cross sector cardiovascular rehabilitation programme compared with usual care for patients having non-operative management. METHODS The trial allocated 118 patients, with 1:1 individual randomisation to either an intervention or control group. Data were collected at a department of vascular surgery and at a healthcare centre in Denmark. The rehabilitation intervention consisted of usual care plus 12 weeks of exercise training, pedometer, health education, and text messages. The primary outcome was maximum walking distance at six months measured by treadmill walking test. The secondary outcomes were maximum walking distance at 12 months and pain free walking distance measured by treadmill walking test, healthy diet, level of physical activity, and quality of life (QoL) at six and 12 months. RESULTS In the intervention group, 46 participants were analysed, with 47 in the control group. Following three months of rehabilitation, a 37% difference (95% CI 1.10 - 1.70; p = .005) was found between groups in maximum walking distance at six and 12 months, in favour of the intervention group. The same positive effect was found in physical activity, QoL, and healthy diet, but was not statistically significant in pain free walking distance and smoking. CONCLUSION A specialised community based cardiac rehabilitation programme for patients with IC showed statistically and clinically significant effects on maximum walking distance, physical activity, quality of life, and healthy diet, but not on pain free walking distance and smoking, compared with usual care without rehabilitation.
-
5.
White matter plasticity in healthy older adults: The effects of aerobic exercise.
Mendez Colmenares, A, Voss, MW, Fanning, J, Salerno, EA, Gothe, NP, Thomas, ML, McAuley, E, Kramer, AF, Burzynska, AZ
NeuroImage. 2021;:118305
-
-
Free full text
-
Abstract
White matter deterioration is associated with cognitive impairment in healthy aging and Alzheimer's disease. It is critical to identify interventions that can slow down white matter deterioration. So far, clinical trials have failed to demonstrate the benefits of aerobic exercise on the adult white matter using diffusion Magnetic Resonance Imaging. Here, we report the effects of a 6-month aerobic walking and dance interventions (clinical trial NCT01472744) on white matter integrity in healthy older adults (n = 180, 60-79 years) measured by changes in the ratio of calibrated T1- to T2-weighted images (T1w/T2w). Specifically, the aerobic walking and social dance interventions resulted in positive changes in the T1w/T2w signal in late-myelinating regions, as compared to widespread decreases in the T1w/T2w signal in the active control. Notably, in the aerobic walking group, positive change in the T1w/T2w signal correlated with improved episodic memory performance. Lastly, intervention-induced increases in cardiorespiratory fitness did not correlate with change in the T1w/T2w signal. Together, our findings suggest that white matter regions that are vulnerable to aging retain some degree of plasticity that can be induced by aerobic exercise training. In addition, we provided evidence that the T1w/T2w signal may be a useful and broadly accessible measure for studying short-term within-person plasticity and deterioration in the adult human white matter.
-
6.
Effectiveness and cost-effectiveness of The Daily Mile on childhood weight outcomes and wellbeing: a cluster randomised controlled trial.
Breheny, K, Passmore, S, Adab, P, Martin, J, Hemming, K, Lancashire, ER, Frew, E
International journal of obesity (2005). 2020;(4):812-822
-
-
Free full text
-
Abstract
BACKGROUND The Daily Mile is designed to increase physical activity levels with children running or walking around school grounds for 15-min daily. It has been adopted by schools worldwide and endorsed as a solution to tackle obesity, despite no robust evidence of its benefits. We conducted a cluster randomised controlled trial to determine its clinical and cost-effectiveness. METHODS Forty schools were randomly assigned (1:1) to either the Daily Mile intervention or control group in which only the usual school health and wellbeing activities were implemented. The primary outcome was BMI z-score (BMIz) at 12 months follow-up from baseline, with planned subgroup analysis to examine differential effects. Primary economic analysis outcome was incremental cost per Quality-Adjusted-Life-Year (QALY) gained. RESULTS Using a constrained randomisation approach, balanced on school size, baseline BMIz and proportion of pupils eligible for free school meals, 20 schools were allocated to intervention (n = 1,153 participants) and 20 to control (n = 1,127); 3 schools withdrew (2 intervention, 1 control). At 12 months, BMIz data were available for 18 intervention schools (n = 850) and 19 control schools (n = 820 participants). Using intention-to-treat analysis the adjusted mean difference (MD) in BMIz (intervention - control) was -0.036 (95% CI: -0.085 to 0.013, p = 0.146). Pre-specified subgroup analysis showed a significant interaction with sex (p = 0.001) suggesting a moderate size benefit of The Daily Mile in girls (MD -0.097, 95% CI -0.156 to -0.037). This was consistent with the exploratory economic results that showed The Daily Mile to be highly cost-effective in girls (£2,492 per QALY), but not in boys, and overall to have a 76% chance of cost-effectiveness for the whole sample, at the commonly applied UK threshold of £20,000 per QALY. CONCLUSIONS Overall the Daily Mile had a small but non-significant effect on BMIz, however, it had a greater effect in girls suggesting that it might be considered as a cost-effective component of a system-wide approach to childhood obesity prevention.
-
7.
Land-walking vs. water-walking interventions in older adults: Effects on aerobic fitness.
Haynes, A, Naylor, LH, Carter, HH, Spence, AL, Robey, E, Cox, KL, Maslen, BA, Lautenschlager, NT, Ridgers, ND, Green, DJ
Journal of sport and health science. 2020;(3):274-282
Abstract
BACKGROUND Low cardiorespiratory fitness is an independent predictor of all-cause and cardiovascular mortality, and interventions that increase fitness reduce risk. Water-walking decreases musculoskeletal impact and risk of falls in older individuals, but it is unclear whether water-walking improves aerobic fitness in the same way as weight-dependent land-walking. This randomized controlled trial involved 3 intervention groups-a no-exercise control group (CG), a land-walking (LW) group, and a water-walking (WW) group-to investigate the comparative impacts of LW and WW to CG on fitness. METHODS Both exercise groups attended individually tailored, center-based, intensity-matched 3 × weekly sessions for 24 weeks, which progressed to 150 min of exercise per week. This was followed by a 24-week no-intervention period. Maximal graded exercise tests were performed on a treadmill at Weeks 0, 24, and 48. RESULTS Maximal oxygen uptake increased from Week 0 to Week 24 in both exercise groups (0.57 ± 0.62 mL/kg/min, 0.03 ± 0.04 L/min for LW; 0.93 ± 0.75 mL/kg/min, 0.06 ± 0.06 L/min for WW, mean ± SE) compared to the CG (-1.75 ± 0.78 mL/kg/min, -0.16 ± 0.05 L/min) (group × time, p < 0.05). Time to exhaustion increased significantly following LW only (123.4 ± 25.5 s), which was significantly greater (p = 0.001) than the CG (24.3 ± 18.5 s). By Week 48, the training-induced adaptations in the exercise groups returned to near baseline levels. CONCLUSION Our study supports current physical-activity recommendations that 150 min/week of moderate-intensity exercise produces improvements in fitness in previously sedentary older individuals. Also, LW and WW elicit similar improvements in fitness if conducted at the same relative intensities. Exercise-naïve older individuals can benefit from the lower impact forces and decreased risk of falls associated with WW without compromising improvements in cardiorespiratory fitness.
-
8.
A trajectory analysis of daily step counts during a physician-delivered intervention.
Cooke, AB, Rahme, E, Defo, AK, Chan, D, Daskalopoulou, SS, Dasgupta, K
Journal of science and medicine in sport. 2020;(10):962-967
Abstract
OBJECTIVES Higher steps are associated with lower mortality and cardiovascular event rates. We previously demonstrated that tailored physician-delivered step count prescriptions successfully increased steps/day in adults with type 2 diabetes mellitus (T2DM) and/or hypertension. In the present analysis, we examined patterns of step count change and the factors that influence different responses. DESIGN Longitudinal observational study METHODS Active arm participants (n=118) recorded steps/day. They received a step count prescription from their physician every 3-4 months. We computed mean steps/day and changes from baseline for sequential 30-day periods. Group-based trajectory modeling was applied. RESULTS Four distinct trajectories of mean steps/day emerged, distinguishable by differences in baseline steps/day: sedentary (19%), low active (40%), somewhat active (30%) and active (11%). All four demonstrated similar upward slopes. Three patterns emerged for the change in steps from baseline: gradual decrease (30%), gradual increase with late decline (56%), and rapid increase with midpoint decline (14%); thus 70% had an increase from baseline. T2DM (odd ratios [OR]: 3.7, 95% CI 1.7, 7.7) and age (OR per 10-year increment: 2, 95% CI 1.3, 2.8) were both associated with starting at a lower baseline but participants from these groups were no less likely than others to increase steps/day. CONCLUSIONS T2DM and older age were associated with lower baseline values but were not indicators of likelihood of step count increases. A physician-delivered step count prescription and monitoring strategy has strong potential to be effective in increasing steps irrespective of baseline counts and other clinical and demographic characteristics.
-
9.
Effects of active commuting to work for 12 months on cardiovascular risk factors and body composition.
Sareban, M, Fernandez La Puente de Battre, MD, Reich, B, Schmied, C, Loidl, M, Niederseer, D, Niebauer, J
Scandinavian journal of medicine & science in sports. 2020;(Suppl 1):24-30
-
-
Free full text
-
Abstract
Active commuting has the potential to decrease cardiovascular risk by increasing physical activity. We aimed to investigate the effects of active commuting to work for 12 months on body composition and cardiovascular risk factors. Therefore, 73 hospital employees (age: 46 ± 9 years, 36% males), with a predominantly passive way of commuting, were randomly assigned to an intervention group (IG) and a control group (CG) in a 2:1 fashion. The IG was further divided into a public transportation plus active commuting group (IG-PT) and a cycling group (IG-C). Both IGs were prompted to reach 150 min/wk of moderate intensity exercise. Daily self-reported commuting details were verified by GPS tracking. All subjects underwent assessment of body composition, resting blood pressure, glycemic control, and lipid profile at the beginning and end of the study. Data for final analyses were available in 62 subjects. Commuting details indicated that the subjects randomized to IG changed their commuting habits. HbA1c decreased by 0.2% [95%CI: -0.3, -0.2] in IG-PT but was not statistically different between groups (P = .06). LDL cholesterol decreased in IG-C by 0.8 mmol/L [-1.1, -0.4] and by 0.6 mmol/L [-1.2, 0.1] in IG-PT which can be considered biologically relevant but did not yield statistical significance. Body composition and blood pressure did not differ between groups. Active commuting to work for 12 months did not change body composition but yielded relevant changes in lipid profile and glycemic control. Health benefits of active commuting should be addressed by healthcare professionals when counseling individuals that seek to improve their cardiovascular risk profile.
-
10.
Metabolic Effects of Breaking Prolonged Sitting With Standing or Light Walking in Older South Asians and White Europeans: A Randomized Acute Study.
Yates, T, Edwardson, CL, Celis-Morales, C, Biddle, SJH, Bodicoat, D, Davies, MJ, Esliger, D, Henson, J, Kazi, A, Khunti, K, et al
The journals of gerontology. Series A, Biological sciences and medical sciences. 2020;(1):139-146
-
-
Free full text
-
Abstract
BACKGROUND Prolonged sitting is common in older adults and is associated with insulin resistance and poor cardiometabolic health. We investigate whether breaking prolonged sitting with regular short bouts of standing or light walking improves postprandial metabolism in older white European and South Asian adults and whether effects are modified by ethnic group. METHODS Thirty South Asian (15 women) and 30 white European (14 women) older adults (aged 65-79 years) undertook three experimental conditions in random order. (a) Prolonged sitting: continuous sitting during an observation period if 7.5 hours consuming two standardized mixed meals. (b) Standing breaks: sitting interrupted with 5 minutes of standing every 30 minutes (accumulating 60 minutes of standing over the observation period). (c) Walking breaks: sitting interrupted with 5 minutes of self-paced light walking every 30 minutes (accumulating 60 minutes of walking). Blood samples (glucose, insulin, triglycerides) and blood pressure were sampled regularly throughout each condition. RESULTS Compared with prolonged sitting, walking breaks lowered postprandial insulin by 16.3 mU/L, (95% CI: 19.7, 22.0) with greater reductions (p = .029) seen in South Asians (22.4 mU/L; 12.4, 32.4) than white Europeans (10.3 mU/L; 5.9, 14.7). Glucose (0.3 mmol/L; 0.1, 0.5) and blood pressure (4 mm Hg; 2, 6), but not triglycerides, were lower with walking breaks, with no ethnic differences. Standing breaks did not improve any outcome. CONCLUSIONS Breaking prolonged sitting with short bouts of light walking, but not standing, resulted in clinically meaningful improvements in markers of metabolic health in older adults, with South Asians gaining a greater reduction in postprandial insulin. TRIAL REGISTRATION NCT02453204.