1,721,115 research outputs found
Critical Reappraisal of the Role and Importance of Exercise Intervention in the Treatment of Obesity in Adults
No full textIn the treatment of obesity in adults, exercise intervention is recommended and some people with obesity even prefer exercise above dietary intervention as a single weight-loss strategy. However, evidence is accumulating that the long-term body weight and adipose tissue mass loss as a result of exercise intervention in these individuals is disappointingly small. Although this could be related to various clinical reasons, more recent evidence reveals that also (patho)physiological abnormalities are involved which cannot be remediated by exercise intervention, especially in metabolically compromised patients. As a result, the role and importance of exercise intervention in the treatment of obesity deserve significant reconsideration to avoid confusion and disappointment amongst clinicians, patients and society. Hence, to reduce adipose tissue mass and body weight, dietary intervention is much more effective than exercise intervention, and is, therefore, of key importance in this endeavour. However, dietary interventions must be supplemented by exercise training to induce clinically relevant changes in specific cardiovascular or metabolic risk factors like blood pressure, blood triglycerides and high-density lipoprotein cholesterol concentrations, as well as visceral adipose tissue mass, physical fitness, muscle mass and strength, quality of life and life expectancy. This allows individuals with obesity to preserve their cardiometabolic health or to shift from a metabolically unhealthy phenotype to a metabolically healthy phenotype. Signifying the true clinical value of exercise interventions might lead to a better understanding and appreciation of the goals and associated effects when implemented in the multidisciplinary treatment of obesity, for which a proper tailoring of exercise prescription is required. Key Points Exercise training allows adults with obesity to shift from a metabolically unhealthy to a metabolically healthy state, regardless of changes in body weight or adipose tissue mass. Targeting metabolic and cardiovascular risk factors, muscle strength, endurance capacity and quality of life should become the main aims of exercise intervention in adults with obesity, instead of focussing on body weight and adipose tissue mass changes. Appropriate tailoring of exercise prescriptions in individuals with obesity is imperative but challenging in this endeavour.This study was supported by an unrestricted grant from Hartcentrum Hasselt, vzw
Editorial: Inter-organ crosstalk during exercise in health and disease: Extracellular vesicles as new kids on the block
No full textKEYWORDS extracellular vesicle (EV), exercise, myokines, exosomes, microRNA (microRNA) Editorial on the Research Topic Inter-organ crosstalk during exercise in health and disease: Extracellular vesicles as new kids on the block Within exercise physiology, the study of factors potentially mediating interorgan crosstalk during and after exercise is a fascinating field of research. As exercise activates a plethora of metabolic pathways in several tissues, organs and systems, examining the underlying biological mechanisms contributing to exercise related metabolic benefits is imperative. Since two decades, the skeletal muscle is known to secrete humoral factors into the circulation in response to exercise, originally described as "myokines" by Pedersen et al. (2003). These myokines are now well known and extensively studied in the field of exercise science (Pedersen and Febbraio, 2012). Interestingly, exercise also triggers other metabolic organs to release similar factors arising from the heart, liver, white and brown adipose tissue, and the nervous system (Chow et al., 2022). These "exerkines" (Safdar et al., 2016) have been recognized to comprise an extensive range of biologically active signalling molecules, including cytokines, lipids, metabolites and (noncoding) nucleic acids, as recently reviewed (Chow et al., 2022). Extracellular vesicles (EVs) and their role as carrier particles for molecular signals became of specific interest in the exerkine field, as EVs are considered (co-)drivers of exercise-induced interorgan crosstalk (Whitham et al., 2018; Vechetti et al., 2021). Differentiated by both their size and nature of vesicular biogenesis, EVs can be primarily classified as exosomes, microvesicles and apoptotic bodies although some overlap does exist between these classifications. EVs may enclose plenty of material, including lipids, proteins and nucleic acids (Théry et al., 2018). Indeed, pioneering EV-related exercise studies have shown an increase in the circulating number of EVs after a single bout of exercise (Brahmer et al., 2019; Frühbeis et al., 2015; Oliveira et al., 2018; Whitham et al., 2018), with recent in vivo research estimating about 5% of circulating, tetraspanin-positive EVs to be muscle-derived (Estrada et al., 2022). However, the frequent lack of rigorous characterization, purification and/or quantification of EVs (which ideally requires a combination of multiple methodologies) makes the understanding of the role of EVs in exercise physiology rather hard (Darragh et al., 2021) and argues for standard approaches and reporting on EV-related exercise science. Nevertheless, many points need to be clarified, but as the interest in EVs research from an exercise and healthWe sincerely thank all authors and reviewers who participated in the Research Topic
Can physical activity reduce the risk of having tinnitus?
No full textObjective
Tinnitus, the perception of sound without an external source, affects many adults, impacting quality of life. While factors like hearing loss and psychological distress are linked to tinnitus, the relationship with physical activity remains unclear. This study aimed to explore the association between physical activity, sedentary behaviour, and the presence of tinnitus.
Design
This study is a cross-sectional study. The participants completed the long form of the International Physical Activity Questionnaire. Adjusted logistic regression models were used to investigate associations between (components of) physical activity and the presence of tinnitus, and odds ratios (ORs) were calculated.
Study Sample
This study involved 3004 participants (2751 tinnitus patients, 253 healthy controls).
Results
Engaging in moderate or vigorous-intensity physical activity during leisure time for more than 2.5 hours per week was associated with a reduced risk of having tinnitus (OR = 0.515, p < 0.001). Conversely, individuals who reported sitting for more than 7 hours per day had a significantly higher risk of having tinnitus (OR = 2.366, p < 0.001).
Conclusions
The study suggests a potential protective effect of leisure-time physical activity against tinnitus and highlights the importance of reducing sedentary behaviour. Further research is needed to confirm these findings and to understand underlying mechanisms.There was no Conflict of Interest for any of the authors in this study. The author(s) received no financial support for the research, authorship, and/or publication of this article. The results of the study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation. The results of the present study do not constitute endorsement by ACSM
Exercise intensity prescription in cardiovascular rehabilitation: bridging the gap between best evidence and clinical practice
No full textOptimizing endurance exercise intensity prescription is crucial to maximize the clinical benefits and minimize complications for individuals at risk for or with cardiovascular disease (CVD). However, standardization remains incomplete due to variations in clinical guidelines. This review provides a practical and updated guide for health professionals on how to prescribe endurance exercise intensity for cardiovascular rehabilitation (CR) populations, addressing international guidelines, practical applicability across diverse clinical settings and resource availabilities. In the context of CR, cardiopulmonary exercise test (CPET) is considered the gold standard assessment, and prescription based on ventilatory thresholds (VTs) is the preferable methodology. In settings where this approach isn't accessible, which is frequently the case in low-resource environments, approximating VTs involves combining objective assessments-ideally, exercise tests without gas exchange analyses, but at least alternative functional tests like the 6-minute walk test-with subjective methods for adjusting prescriptions, such as Borg's ratings of perceived exertion and the Talk Test. Therefore, enhancing exercise intensity prescription and offering personalized physical activity guidance to patients at risk for or with CVD rely on aligning workouts with individual physiological changes. A tailored prescription promotes a consistent and impactful exercise routine for enhancing health outcomes, considering patient preferences and motivations. Consequently, the selection and implementation of the best possible approach should consider available resources, with an ongoing emphasis on strategies to improve the delivery quality of exercise training in the context of FITT-VP prescription model (frequency, intensity, time, type, volume, and progression)
Changes in postural control and their association with pregnancy-related lumbopelvic pain in multiparous pregnant women: a study protocol
No full textChanges in postural control and their association with pregnancy-related lumbopelvic pain in multiparous pregnant women: a study protocol
No full textThe Role of Skeletal Muscle Mitochondria in Colorectal Cancer Related Cachexia: Friends or Foes?
No full textUp to 60% of colorectal cancer (CRC) patients develop cachexia. The presence of CRC related cachexia is associated with more adverse events during systemic therapy, leading to a high mortality rate. The main manifestation in CRC related cachexia is the loss of skeletal muscle mass, resulting from an imbalance between skeletal muscle protein synthesis and protein degradation. In CRC related cachexia, systemic inflammation, oxidative stress, and proteolytic systems lead to mitochondrial dysfunction, resulting in an imbalanced skeletal muscle metabolism. Mitochondria fulfill an important function in muscle maintenance. Thus, preservation of the skeletal muscle mitochondrial homeostasis may contribute to prevent the loss of muscle mass. However, it remains elusive whether mitochondria play a benign or malignant role in the development of cancer cachexia. This review summarizes current (mostly preclinical) evidence about the role of skeletal muscle mitochondria in the development of CRC related cachexia. Future human research is necessary to determine the physiological role of skeletal muscle mitochondria in the development of human CRC related cachexia.This research received no external funding
Response
No full textWe thank Dote-Montero and Amaro-Gahete [1] for their comments and thoughts regarding the nutritional standardization methodology described in our study [2]. The role of pre-exercise nutrition in modifying substrate oxidation rates during exercise is well known in literature. Yet, in the acute exercise phase, it is mainly exercise intensity that dominates substrate oxidation irrespective of training status or dietary intake [3]. Moreover, and different from healthy individuals, patients with type 2 diabetes mellitus (T2DM) are mostly characterized by a reduced metabolic flexibility, resulting in low variability in respiratory exchange ratio for marked changes in insulin levels [4]. The short-term effect of the pre-exercise evening meal composition or the fasting duration on fasting glycemia/insulinemia might be limited [5], but remains questionable in T2DM patients and thus warrants more research. In our study [2] patients selected their own breakfast (type and amount) on the exercise days, and therefore the meal was not standardized for either energy content or carbohydrate content. These breakfasts were repeated throughout the entire intervention to obtain some degree of standardization on the exercise days. Patients in the fasted exercise group began their training after an overnight fasting period (at least 10 hours of fasting; no upper limit defined). Aside from different fasting durations, standardizing pre-exercise meals (with defined composition and energy content) will definitely alter metabolic responses, as some patients will be undernourished and others will be overfed compared to their habitual diet. Therefore, in terms of external validity and real-life situations, it is hard to generalize a pre-exercise evening meal. With regard to optimal exercise-nutrition interaction, altering meal timing should be actively attempted in exercise intervention studies instead [6]. We agree with Dote-Montero and Amaro-Gahete [1] that standardization of pre-measurement conditions is imperative. In our study [2], two separate laboratory visits were included, each requiring specific preparation guidelines. Patients were asked to abstain from alcoholic and caffeinated drinks for 48 hours, to perform no exercise or any other moderate/vigorous physical activity within the last 72 hours and to have their latest meal (mostly lunch) at least 2 hour
Periodized versus classic exercise therapy in Multiple Sclerosis: a randomized controlled trial
No full textBackground: Periodizing exercise interventions in Multiple Sclerosis (MS) shows good high intensity exercise training adherence. Whether this approach induces comparable training adaptations with respect to exercise capacity, body composition and muscle strength compared to conventional, linear progressive training programs however is not known. Methods: Thirty-one persons with MS (all phenotypes, mean EDSS 2.3?1.3) were randomized into a twelve-week periodized (MSPER, n=17) or a classic endurance (MSCLA, n=14) training program. At baseline (PRE), exercise capacity (maximal exercise test, VO2max), body composition (DEXA) and muscle strength (Biodex?) were assessed. Classic, moderate intensity endurance training (60-80% HRmax, 5 training sessions/2w, 60min/session) was performed on a stationary bicycle. Periodized exercise included 4 recurrent 3-week cycles of alternated endurance training (week 1: endurance training as described above), high intense exercise (week 2: 3 sessions/w, 3 ? 20s all-out sprints, 10min/session) and recovery weeks (week 3: one sprint session as described above). POST measurements were performed similar to baseline. Total exercise volume of both programs was expressed as total peak-effort training minutes. Results: For MSCLA, total exercise volume included 1728 total peak-effort training minutes, whereas MSPER included only 736. Despite this substantially reduced training volume, twelve weeks of periodized training significantly (p<0.05) improved VO2max (+14%, p=0.001), workload (+20%) and time until exhaustion (+25%). Classic training significantly (p<0.05) improved workload (+10%) and time until exhaustion (+17%), but not VO2max (+5%, p=0.131). Pre-post improvements for VO2max were significantly higher in MSPER compared to MSCLA (p=0.046). Conclusion: These data show that despite substantially lower training time (57% less peak-effort training minutes), 12 weeks of periodized exercise training in persons with MS seems to induce larger improvements in parameters of exercise capacity compared to classic endurance training. We therefore recommend to further investigate the effect of training periodization on various functional rehabilitation measures in MS.Keytsman, C (corresponding author), Hasselt Univ, REVAL Rehabil Ctr, Biomed Res Inst BIOMED, Agoralaan Bldg A, B-3590 Diepenbeek, Belgium.
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Sedentary behaviour and cardiometabolic health: Integrating the potential underlying molecular health aspects
No full textDuring the last decades, sedentary behaviour has been recognised as an interdependent risk factor for cardiometabolic health and premature mortality. Prolonged sedentary behaviour is associated with increased risks for chronic non-communicable diseases (NCDs) such as obesity, chronic respiratory diseases, type 2 diabetes mellitus, cardiovascular diseases and cancer due to disturbances in cardiometabolic health. However, despite the increased evidence supporting these associations, the underlying molecular mechanisms to the development of these NCDs remain largely unknown. In this review, we therefore discuss the existing evidence with regard to the potential underlying molecular mechanisms of sedentary behaviour-induced perturbations in cardiometabolic health. Here, various potential mechanisms related to carbohydrate metabolism, lipid metabolism, oxidative stress, inflammation and micro-and macro vascular function will be outlined. In addition, we summarise the current evidence on various strategies to interrupt sedentary behaviour and their effects on cardiometabolic health outcomes, including insulin sensitivity, blood lipid profiles, and cardiovascular health. Finally, we highlight key research gaps in the field of sedentary behaviour in relation to the underlying molecular mechanisms
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