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The effect of Omega-3 polyunsaturated fatty acid supplementation on exercise-induced muscle damage.
Kyriakidou, Y, Wood, C, Ferrier, C, Dolci, A, Elliott, B
Journal of the International Society of Sports Nutrition. 2021;(1):9
Abstract
BACKGROUND Exercise-induced muscle damage (EIMD) results in transient muscle inflammation, strength loss, muscle soreness and may cause subsequent exercise avoidance. Omega-3 (n-3) supplementation may minimise EIMD via its anti-inflammatory properties, however, its efficacy remains unclear. METHODS Healthy males (n = 14, 25.07 ± 4.05 years) were randomised to 3 g/day n-3 supplementation (N-3, n = 7) or placebo (PLA, n = 7). Following 4 weeks supplementation, a downhill running protocol (60 min, 65% V̇O2max, - 10% gradient) was performed. Creatine kinase (CK), interleukin (IL)-6 and tumour necrosis factor (TNF)-α, perceived muscle soreness, maximal voluntary isometric contraction (MVIC) and peak power were quantified pre, post, and 24, 48 and 72 h post-EIMD. RESULTS Muscle soreness was significantly lower in N-3 vs PLA group at 24 h post-EIMD (p = 0.034). IL-6 was increased in PLA (p = 0.009) but not in N-3 (p = 0.434) following EIMD, however, no significant differences were noted between groups. Peak power was significantly suppressed in PLA relative to pre-EIMD but not in N-3 group at 24 h post-EIMD. However, no significant difference in peak power output was observed between groups. MVIC, CK and TNF-α were altered by EIMD but did not differ between groups. CONCLUSION N-3 supplementation for 4 weeks may successfully attenuate minor aspects of EIMD. Whilst not improving performance, these findings may have relevance to soreness-associated exercise avoidance.
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Relationships between hyperinsulinaemia, magnesium, vitamin D, thrombosis and COVID-19: rationale for clinical management.
Cooper, ID, Crofts, CAP, DiNicolantonio, JJ, Malhotra, A, Elliott, B, Kyriakidou, Y, Brookler, KH
Open heart. 2020;(2)
Abstract
Risk factors for COVID-19 patients with poorer outcomes include pre-existing conditions: obesity, type 2 diabetes mellitus, cardiovascular disease (CVD), heart failure, hypertension, low oxygen saturation capacity, cancer, elevated: ferritin, C reactive protein (CRP) and D-dimer. A common denominator, hyperinsulinaemia, provides a plausible mechanism of action, underlying CVD, hypertension and strokes, all conditions typified with thrombi. The underlying science provides a theoretical management algorithm for the frontline practitioners.Vitamin D activation requires magnesium. Hyperinsulinaemia promotes: magnesium depletion via increased renal excretion, reduced intracellular levels, lowers vitamin D status via sequestration into adipocytes and hydroxylation activation inhibition. Hyperinsulinaemia mediates thrombi development via: fibrinolysis inhibition, anticoagulation production dysregulation, increasing reactive oxygen species, decreased antioxidant capacity via nicotinamide adenine dinucleotide depletion, haem oxidation and catabolism, producing carbon monoxide, increasing deep vein thrombosis risk and pulmonary emboli. Increased haem-synthesis demand upregulates carbon dioxide production, decreasing oxygen saturation capacity. Hyperinsulinaemia decreases cholesterol sulfurylation to cholesterol sulfate, as low vitamin D regulation due to magnesium depletion and/or vitamin D sequestration and/or diminished activation capacity decreases sulfotransferase enzyme SULT2B1b activity, consequently decreasing plasma membrane negative charge between red blood cells, platelets and endothelial cells, thus increasing agglutination and thrombosis.Patients with COVID-19 admitted with hyperglycaemia and/or hyperinsulinaemia should be placed on a restricted refined carbohydrate diet, with limited use of intravenous dextrose solutions. Degree/level of restriction is determined by serial testing of blood glucose, insulin and ketones. Supplemental magnesium, vitamin D and zinc should be administered. By implementing refined carbohydrate restriction, three primary risk factors, hyperinsulinaemia, hyperglycaemia and hypertension, that increase inflammation, coagulation and thrombosis risk are rapidly managed.
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Ileostomy Care: A Guide for Home Care Clinicians.
Berti-Hearn, L, Elliott, B
Home healthcare now. 2019;(3):136-144
Abstract
This article focuses on the care and management of patients living with an ileostomy. Due to shortened hospital stays, patient teaching related to self-care of ostomies has shifted from the hospital to the home setting. It is important for home care clinicians to be knowledgeable about all aspects of ostomy care. Patients with ileostomies are particularly prone to peristomal skin problems, as well as fluid and electrolyte and nutritional imbalances. This article reviews the anatomy and physiology of the gastrointestinal tract, indications for the creation of an ileostomy, and prevention and treatment of early and late complications. Practical advice on ileostomy care and patient teaching is provided.
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4.
Sources of variance within and among young men in concentrations of 17β-estradiol and testosterone in axillary perspiration.
Elliott, B, Muir, C, deCatanzaro, D
Physiology & behavior. 2017;:23-29
Abstract
The most potent estrogen, 17β-estradiol (E2), and its precursor, testosterone (T), play critical roles in mammalian reproductive processes. Evidence indicates that these steroids are present in bioactive form in the excretions of many male mammals. It has been demonstrated that small lipophilic steroids such as E2 can be absorbed by proximate females from male excretions, arriving in the uterus, brain, and other organs where there are estrogen receptors. We took repeated samples of axillary perspiration from men aged 20-30years during vigorous exercise. Both steroids were consistently measurable, with concentrations that ranged from values comparable to those in facial perspiration and urine of both men and women to values that greatly exceeded concentrations observed in any other substrate of men and women. Inter-individual variance in axillary E2 was positively correlated with the extent of intimate experience with women, as assessed by a questionnaire, but unrelated to subjective measures of stress, exercise habits, or phytoestrogen content of diet. In addition, higher levels of axillary E2 were observed in participants when samples were collected by a female (as compared to a male) experimenter. These data are concordant with an hypothesis that male excretion of sex steroids could exert pro-reproductive influences on proximate females.
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The effect of hypoxia and work intensity on insulin resistance in type 2 diabetes.
Mackenzie, R, Elliott, B, Maxwell, N, Brickley, G, Watt, P
The Journal of clinical endocrinology and metabolism. 2012;(1):155-62
Abstract
CONTEXT Hypoxia and muscle contraction stimulate glucose transport in vitro. We have previously demonstrated that exercise and hypoxia have an additive effect on insulin sensitivity in type 2 diabetics. OBJECTIVES Our objective was to examine the effects of three different hypoxic/exercise (Hy Ex) trials on glucose metabolism and insulin resistance in the 48 h after acute hypoxia in type 2 diabetics. DESIGN, PARTICIPANTS, AND INTERVENTIONS Eight male type 2 diabetics completed 60 min of hypoxic [mean (sem) O(2) = ∼14.7 (0.2)%] exercise at 90% of lactate threshold [Hy Ex(60); 49 (1) W]. Patients completed an additional two hypoxic trials of equal work, lasting 40 min [Hy Ex(40); 70 (1) W] and 20 min [Hy Ex(20); 140 (12) W]. MAIN OUTCOME MEASURES Glucose rate of appearance and rate of disappearance were determined using the one-compartment minimal model. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index and β-cell function (HOMA(β-cell)) were calculated at 24 and 48 h after trials. RESULTS Peak glucose rate of appearance was highest during Hy Ex(20) [8.89 (0.56) mg/kg · min, P < 0.05]. HOMA(IR) and fasting insulin resistance index were improved in the 24 and 48 h after Hy Ex(60) and Hy Ex(40) (P < 0.05). HOMA(IR) decreased 24 h after Hy Ex(20) (P < 0.05) and returned to baseline values at 48 h. CONCLUSIONS Moderate-intensity exercise in hypoxia (Hy Ex(60) and Hy Ex(40)) stimulates acute- and moderate-term improvements in insulin sensitivity that were less apparent in Hy Ex(20). Results suggest that exercise duration and not total work completed has a greater influence on acute and moderate-term glucose control in type 2 diabetics.
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6.
Intermittent exercise with and without hypoxia improves insulin sensitivity in individuals with type 2 diabetes.
Mackenzie, R, Maxwell, N, Castle, P, Elliott, B, Brickley, G, Watt, P
The Journal of clinical endocrinology and metabolism. 2012;(4):E546-55
Abstract
CONTEXT Hypoxia and muscle contraction stimulate glucose transport activity in vitro. Exercise and hypoxia have additive effects on insulin sensitivity in type 2 diabetics (T2D). OBJECTIVE The objective of the study was to examine the effectiveness of intermittent exercise with and without hypoxia on acute- and moderate-term glucose kinetics and insulin sensitivity in T2D. SETTING The study was conducted at a university research center. DESIGN, PARTICIPANTS, AND INTERVENTIONS Eight male T2D patients completed the following: 1) 60 min of continuous exercise at 90% lactate threshold in hypoxia (HyEx60); 2) intermittent exercise at 120% lactate threshold, separated by periods of passive recovery (5:5 min) in hypoxia [Hy5:5; O₂ ∼ 14.7 (0.2)%]; and 3) intermittent exercise (5:5 min) at 120% lactate threshold in normoxia (O₂ ∼ 20.93%). MAIN OUTCOME MEASURES Glucose appearance and glucose disappearance, using an adapted non-steady-state one-compartment model were measured. Homeostasis models of insulin resistance (HOMA(IR)), fasting insulin resistance index (FIRI), and β-cell function were calculated 24 and 48 h after exercise conditions. RESULTS Glucose disappearance increased from baseline (1.85 mg/kg · min⁻¹) compared with 24 h (2.01 min/kg · min⁻¹) after HyEx60 (P = 0.031). No difference was noted for both Hy5:5 (P = 0.064) and normoxia (P = 0.385). Hy5:5 demonstrated improvements in HOMA(IR) from baseline [d 1, 6.20 (0.40)] when comparisons were made with d 2 [4.83 (0.41)] (P = 0.0013). HOMA(IR) and FIRI improved in the 24 h (HOMA(IR), P = 0.002; FIRI, P = 0.003), remaining reduced 48 h after HyEx60 (HOMA(IR), P = 0.028; and FIRI, P = 0.034). CONCLUSION HyEx60 offered the greatest improvements in acute and moderate-term glucose control in T2D. Intermittent exercise stimulated glucose disposal and improved post-exercise insulin resistance, which was enhanced when exercise was combined with hypoxia (Hy5:5). The data suggest a use of hypoxic exercise in treatment of T2D.