Author Interviews, Exercise - Fitness, Orthopedics, Rheumatology / 14.09.2015

Dr. Kristi Elisabeth Heiberg PhD Post.doc Department of Medical Research Baerum Hospital Vestre Viken Hospital TrustMedicalResearch.com Interview with: Dr. Kristi Elisabeth Heiberg PhD Post.doc Department of Medical Research Baerum Hospital Vestre Viken Hospital Trust Medical Research: What is the background for this study? Dr. Heiberg: This study is a long term follow-up of 60 patients who suffered from hip osteoarthritis and were treated with total hip arthroplasty (THA) approximately 5 years earlier. In a prior study, the patients participated in a RCT study, examining the effects of a supervised walking skill training program on physical functioning, pain and self-efficacy (1). The training program was performed between three and five months after surgery, and it was compared to a control group without supervised physiotherapy in the same time span. The results showed that immediately after the walking skill training intervention was completed, several outcome variables were statistically significant more improved in the training group than in the control group, and at one year after surgery the statistically significant effect on walking capacity (measured by the 6-min walk test) still sustained. Few long-term follow-up of RCTs regarding physical functioning in patients after total hip arthroplasty are previously published. Furthermore in another prior study, we examined the recovery of the total group of the same patients from preoperatively to one year after surgery (2). The results showed that the patients were statistically significant improved in all outcomes of physical functioning, pain and self-efficacy during the first year, but they still did not quite reach the level of healthy peers in walking capacity. In line with this, they also reported one year after surgery that they wanted to further improve their ability to walk and to participate in recreational activities (3). However, it seems that patients’ desires regarding physical activity are poorly understood and have received relatively little evaluation, although regular physical activity is considered to be one of the most important lifestyle behaviors affecting health. Only few prior studies have examined the long term recovery of physical functioning and the impact on physical activity. Therefore, in this present 5-year follow-up study after total hip arthroplasty the aims were threefold.
  • First, to examine the long-term effect from the supervised walking skill training program on physical functioning, pain and self-efficacy;
  • Second, to examine the long-term recovery of physical functioning from one to five years; and
  • Third, to identify predictors of physical activity outcome five years after THA among personal and preoperative variables (4).
(more…)
Author Interviews, Exercise - Fitness, Heart Disease / 09.09.2015

Carl "Chip" Lavie MD, FACC FACP, FCCP Medical Director, Cardiac Rehabilitation and Prevention Director, Exercise Laboratories John Ochsner Heart and Vascular Institute Professor of Medicine Ochsner Clinical School-UQ School of Medicine Editor-in-Chief, Progress in Cardiovascular DiseasesMedicalResearch.com Interview with: Carl "Chip"  Lavie MD, FACC FACP, FCCP Medical  Director, Cardiac  Rehabilitation and Prevention Director, Exercise Laboratories John Ochsner Heart and Vascular Institute Professor of Medicine Ochsner Clinical  School-UQ School of Medicine Jefferson, LA Editor-in-Chief, Progress in Cardiovascular Diseases  Medical Research: What is the background for this study? What are the main findings? Dr. Lavie: My co-authors and I reviewed the published literature on the impact of running on chronic diseases and cardiovascular disease and all-cause mortality. Although we reviewed substantial running literature, the major 4 studies were from Dr. Paul Williams and 18 of his papers from the National Runners' and Walkers' Study, The National Aging Runners Study, 2 papers from the Copenhagen City Heart Study, and 2 reports from DC Lee and Steven Blair and one from the Aerobics Center Longitudinal Study. Medical Research: What should clinicians and patients take away from your report? Dr. Lavie: This data showed tremendous impact of running to  lower weight and prevent obesity, dyslipidemia,  hypertension, and type 2 diabetes mellitus. Runners also had less osteoarthritis, need for hip replacement, lower disability with aging, less benign prostatic hypertrophy, lower mortality from several cancers and lower stroke, but the most impressive impact was the large reductions in cardiovascular disease and all-cause mortality, particularly the dramatic impacts of quite low running doses. (more…)
Author Interviews, Exercise - Fitness, Mental Health Research / 07.09.2015

MedicalResearch.com Interview with: Eric A.F. Herbst MSc Ph.D. student Human Health and Nutritional Sciences University of Guelph Guelph, ONEric A.F. Herbst MSc Ph.D. student Human Health and Nutritional Sciences University of Guelph Guelph, ON Medical Research: What is the background for this study? What are the main findings? Response: Many neurological diseases result in declines in mitochondrial content and function in the brain. Therefore, the purpose for this study was to determine if mitochondrial content could be enhanced in the brain through exercise, as previously demonstrated in skeletal muscle, and also to determine if similar exercise-signaling pathways are activated between the two tissues in the process. This study found that despite reproducing similar findings in skeletal muscle, acute and chronic exercise did not activate traditional signaling mechanisms (AMPK, ERK1/2, CAMKII, P38) in either the cortex or striatum of the brain, nor did it result in sustained increases in mitochondrial respiration, DNA copy number, or protein content. (more…)
Aging, Author Interviews, Cognitive Issues, Exercise - Fitness / 22.08.2015

Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of CopenhagenMedicalResearch.com Interview with: Rikke Hodal Meincke PhD student Center for Healthy Aging and the Department of Public Health University of Copenhagen Medical Research: What is the background for this study? Response: A sufficient level of physical capability is a precondition for maintaining independence and quality of life. Physical capability can be assessed objectively by tests of physical performance, for instance handgrip strength, chair-rising and postural balance. Physical performance is associated with mortality and disability in late life, so gaining insights into the variance in physical performance is important to promote sustained physical capability and prevent disability. Research has previously found physical activity, health status and socioeconomic position to be associated with physical performance. In addition, early life factors, such as childhood SEP, have been found to be associated with measures of physical performance later in life. The objective of our study was to examine the association between intelligence in early adulthood and midlife physical performance in Danish men. If an association between intelligence in early life and midlife physical performance exists it may indicate that cognitive abilities and physical performance share some of the same neurodevelopmental processes, but may also indicate that intelligence has an independent effect on later physical performance through various pathways. Medical Research: What are the main findings? Response: In our study of more than 2800 Danish men, we found positive associations between intelligence in early adulthood and five objective measures of physical performance in midlife independent of other early life factors. A one standard deviation increase in intelligence score resulted in 1.1 more chair-rises in 30 seconds, a 1 cm higher jump, a 3.7% smaller balance area, a 0.7 kg increase in handgrip-strength, and a 0.5 kg increase in lower back force. (more…)
Author Interviews, Exercise - Fitness, Lifestyle & Health / 11.08.2015

Lucas J. Carr, PhD Department of Health and Human Physiology University of Iowa Iowa City IA 52242MedicalResearch.com Interview with: Lucas J. Carr, PhD Department of Health and Human Physiology University of Iowa Iowa City IA 52242 Medical Research: What is the background for this study? What are the main findings? Dr. Carr: Office employees are exposed to hazardous levels of sedentary work which is now known to contribute negatively to both physical and mental health. This study tested the effect of retrofitting standard office desks with portable elliptical machines for the purpose of increasing the physical activity levels of sedentary office workers while they are at work. This approach is slightly different that traditional approaches which ask employees to be more active during non-working hours.  We found employees provided the pedal devices became more active while at work and pedaled an average of 50 minutes per day over four months. These findings suggest this approach was successful at increasing physical activity levels of employees while at work and over a fairly long period of time. (more…)
Aging, Author Interviews, BMJ, Exercise - Fitness / 05.08.2015

Dr David Hupin CHU Saint-Etienne, Hôpital Nord Service de Physiologie Clinique et de l'Exercice, Centre VISAS Cedex 2, FranceMedicalResearch.com Interview with: Dr David Hupin CHU Saint-Etienne, Hôpital Nord Service de Physiologie Clinique et de l'Exercice, Centre VISAS Cedex 2, France Medical Research: What is the background for this study? Dr. Hupin: Today, over 95% of the world’s population has health problems, according to the Global Burden of Disease Study published recently in The Lancet. The proportion of healthy years lost due to disease rapidly increased with age. There is no medical treatment that can influence as many diseases in a positive manner as can physical activity. It is well established that regular physical activity is an efficient strategy for successful aging. The 2008 Physical Activity guidelines for Americans recommend a minimum of 150 min of moderate-intensity (>3 MET) or 75 min of vigorous-intensity (≥6 MET) physical activity per week or an equivalent combination of moderate and vigorous physical activity (MVPA). A Metabolic Equivalent or MET is a unit useful for describing the energy expenditure of a specific physical activity. However, less than 50% of older adults are able to achieve the current recommendations of physical activity. Thus, the prescription of physical activity for older adults needs to be clarified, i.e., what "dose" of physical activity is required. Medical Research: What is the design of your study? Dr. Hupin: Within the dynamic Department of Clinical and Exercise Physiology of University Hospital of St-Etienne, we conducted a systematic review and meta-analysis. Out of at total of 835 relevant studies, nine were suitable for analysis. These involved a total of 122, 417 participants, monitored for an average of around 10 years, during which time 18,122 died. (more…)
Aging, Author Interviews, Exercise - Fitness / 30.06.2015

MedicalResearch.com Interview with: Andreas Vigelsø PhD, research assistant University of Copenhagen Faculty of Health Sciences Center for Healthy Aging Dept. of Biomedical Sciences Copenhagen Denmark Medical Research: What is the background for this study? Response: According to the UN, the number of individuals more than 60 years old is expected to more than double, from 841 million worldwide today to more than 2 billion in 2050. Furthermore, the aging process is associated with a reduction in muscle mass, strength and fitness level. Collectively, this may contribute to frailty and may limit independent living. In addition, disease or injuries that can cause short-term immobilization are a further threat to independent living for older individuals. Despite its clinical importance for an increasing population of older individuals, few studies have examined older individuals after immobilization. Thus, our aim was to determine the effect of aerobic retraining as rehabilitation after short-term leg immobilization on leg strength, leg work capacity, and leg muscle mass in young and older men. Medical Research: What are the main findings? Response: Interestingly, our study reveals that inactivity affects the muscular strength in young and older men equally. Having had one leg immobilized for two weeks, young people lose up to a third of their muscular strength, while older people lose approx. one fourth. A young man who is immobilized for two weeks loses muscular strength in his leg equivalent to ageing by 40 or 50 years. Moreover, short-term leg immobilization had marked effects on leg strength, and work capacity and 6 weeks’ retraining was sufficient to increase, but not completely rehabilitate, muscle strength, and to rehabilitate aerobic work capacity and leg muscle mass. (more…)
Author Interviews, Exercise - Fitness, Parkinson's / 03.06.2015

Dr. Lori P. Altmann Department of Speech, Language, and Hearing Sciences Center for Movement Disorders and Neurorestoration University of Florida, Gainesville, FloridaMedicalResearch.com Interview with: Dr. Lori P. Altmann Department of Speech, Language, and Hearing Sciences Center for Movement Disorders and Neurorestoration University of Florida, Gainesville, Florida Medical Research: What is the background for this study? What are the main findings? Dr. Altmann: There are a multitude of studies from our labs and others examining the effects of doing a variety of different cognitive tasks while walking or while maintaining postural control, and the results across studies are consistent—motor performance usually declines.  These “dual task effects” are exaggerated in healthy older adults, and are even more pronounced in people with Parkinson disease (PD).  Our study investigated dual task effects during cycling in healthy older adults and people with Parkinson disease.  In contrast to most studies of this type which typically contrast dual task effects of two cognitive tasks, we used an array of 12 cognitive tasks of graded difficulty, from very very easy to extremely difficult.  One of our primary goals was to establish that the dual task effects were directly related to the difficulty of the cognitive task. Our primary findings were that, instead of cycling slower when doing various cognitive task, both groups of participants sped up, and the amount they sped up was directly related to the difficulty of cognitive tasks.  In the easiest task, cycling speed increased by an average of about 25%, With some participants actually doubling their single task speed. There was no evidence that this increase in cycling speed came as a result of prioritizing cycling over the cognitive tasks, as scores on the cognitive tasks either remained the same or got slightly better.  Interestingly, people with Parkinson disease still showed faster cycling during the easiest tasks, but did not benefit as much from the dual task as the healthy adults. We attribute our findings to arousal that is triggered by both the cycling and the cognitive tasks which increases attentional resources that can be used for both motor and cognitive processing.  We believe the findings haven’t been documented before because most studies use gait or balance as the motor tasks, and these are much more difficult tasks that demand more attentional resources, leading to the typical findings of dual task costs instead of dual task benefits. The decrease in dual task benefits experienced by people with Parkinson disease, we believe, is due to the effects of Parkinson disease on neurotransmitters.  Both cognitive and physiological arousal increase the production of dopamine and norepinephrine in the brain, and disease processes in Parkinson disease interfere with production of these neurotransmitters, thus limiting arousal-based increases in attentional resources. (more…)
Author Interviews, Exercise - Fitness, PLoS, Technology / 15.05.2015

Michael Rebold, PhD, CSCS Assistant Professor Department of Exercise Science Bloomsburg University Bloomsburg, PA 17815MedicalResearch.com Interview with: Michael Rebold, PhD, CSCS Assistant Professor Department of Exercise Science Bloomsburg University Bloomsburg, PA 17815 Medical Research: What is the background for this study? What are the main findings? Dr. Rebold: We assessed how common smartphone uses (texting and talking) interfere with treadmill exercise. We found that when individuals use their smartphones during exercise for texting or talking, it causes a reduction in exercise intensity. (more…)
Author Interviews, BMJ, Exercise - Fitness, Technology / 13.05.2015

Dr. Shang-Ming Zhou Senior Lecturer in Statistical Modelling and Analytics for Epidemiology and Public Health, Public Health Informatics Group, Health Information Research Unit (HIRU), UKCRC DECIPHer (Development and Evaluation of Complex Interventions for Public Health Improvement) Centre, College of Medicine, Swansea University, Swansea, MedicalResearch.com Interview with: Dr. Shang-Ming Zhou Senior Lecturer in Statistical Modelling and Analytics for Epidemiology and Public Health, Public Health Informatics Group, Health Information Research Unit (HIRU), UKCRC DECIPHer (Development and Evaluation of Complex Interventions for Public Health Improvement) Centre, College of Medicine, Swansea University, Swansea, UK Medical Research: What is the background for this study? What are the main findings? Response: In medical and sport science research, body-worn accelerometers are widely used to provide objective measurements of physical activity. However, accelerometers collect data continuously even during periods of nonwear (i.e. periods when participants may not be wearing their monitor, such as during sleeping). It is important to distinguish time of sedentary behaviours (eg. watching television) from time of nonwear. The clinical consequence of misclassification of accelerometer wear and nonwear would overestimate or underestimate physical activity level, and mislead the interpretation of the relationship between physical activity and health outcomes. Automated estimation of accelerometer wear and nonwear time events is particularly desired by large cohort studies, but algorithms for this purpose are not yet standardized and their accuracy needs to be established. This study presents a robust method of classifying wear and nonwear time events under free living conditions for triaxial accelerometers which combines acceleration and surface skin temperature data. The new findings are: Either acceleration data or skin temperature data alone is inadequate to accurately predict wear and nonwear events in some scenarios under a free living condition; This study provides a simple and efficient algorithm on use of short time periods of consecutive data blocks for accurately predicting triaxial accelerometer wear and nonwear events; Combining both types of acceleration and skin temperature data can significantly improve the accuracy of accelerometer wear and nonwear events classification in monitoring physical activity. (more…)
Author Interviews, Diabetes, Diabetes Care, Exercise - Fitness, Weight Research / 13.05.2015

MedicalResearch.com Interview with: Edward "Ted" Weiss, Ph.D. Associate Professor Department of Nutrition and Dietetics Saint Louis University Saint Louis MO Medical Research: What is the background for this study? What are the main findings? Dr. Weiss:  Results from one of our previous study yielded a surprising result that diet-induced weight loss improved insulin sensitivity (major diabetes risk factor) by the same amount as exercise induced weight loss. We thought that the exercise-induced weight loss would have yielded benefits from the weight loss itself but also from a weight loss-independent benefit that has been reported in other studies. One explanation for dietary restriction providing the same benefit of exercise was that it also provides benefits besides those that are attributable to weight loss. Our recently completed/published study was designed to evaluate this possibility and the finding do suggest what we hypothesized... i.e. that dietary restriction provides benefits above and beyond that which are attributable to weight loss. (more…)
Author Interviews, Cancer Research, Exercise - Fitness, Lymphoma / 02.05.2015

MedicalResearch.com Interview with: Terry Boyle, PhD CIHR Fellow, MSFHR Trainee, Honorary UBC Killam Fellow Cancer Control Research, BC Cancer Agency School of Population and Public Health, The University of British Columbia Australian NHMRC Early Career Fellow The University of Western Australia Cancer Control Research, BC Cancer Agency Vancouver BC Canada Medical Research: What is the background for this study? What are the main findings? Dr. Boyle : Little is known about what causes non-Hodgkin lymphoma (NHL), so trying to identify risk factors is particularly important for the prevention and control of this cancer. There is really good evidence that people who are physically active have a lower risk of some cancers (such as colon and breast cancers), but not many studies have investigated whether being physical active is associated with the risk of non-Hodgkin lymphoma. The key finding of this case-control study was that study participants who were in the higher (second, third, and fourth) quartiles of vigorously intense physical activity performance in their lifetimes had about 25 percent to 30 percent lower risk for NHL, compared with those who were in the lowest (first) quartile of vigorously intense physical activity. (more…)
Aging, Author Interviews, Exercise - Fitness, Geriatrics, Lifestyle & Health, Nutrition / 01.05.2015

Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South KoreaMedicalResearch.com Interview with: Yunhwan Lee, MD, DrPH Director, Institute on Aging Professor of Preventive Medicine & Public Health Ajou University School of Medicine Suwon, South Korea Dr. Lee wishes to acknowledge Jinhee Kim, PhD, the lead author of the study. Medical Research: What is the background for this study? Dr. Lee: We have known for some time that there is a progressive loss of muscle mass with aging, where older people lose on average about 1% of their skeletal muscle mass per year. A decline in muscle mass is serious in that it increases the person’s risk of falls, frailty, disability, and death. Because there is currently no “cure” for muscle mass loss, prevention is the best strategy. Over the years, researchers have studied various lifestyle factors to identify potentially modifiable behaviors that may prevent or slow the loss of muscle mass. The majority of prior research so far have found that diet, in the form of protein supplementation, and exercise, especially resistance exercise, may confer some benefits. More recently, the scientific community have begun to pay attention to the positive role of vegetables and fruits intake on the muscle. The role of aerobic exercise on muscle mass is, however, less clear. Also, because people tend to adopt various lifestyles, we were interested in finding out whether those engaging in healthier patterns of diet and exercise retained higher muscle mass. This is why bodybuilders pay such close attention to their diet and make sure their muscle mass is at it's peak. They can also take supplements like SARMs (see SARMS.io for more information about that) to improve muscle mass but their diet has a massive effect on it too. This is where some of the inspiration for this research came from as we knew what an effect food had on bodybuilders so we wondered how it could effect the elderly. Using data from a nationally representative sample of older adults, we investigated whether those who had healthier diet and participated in regular exercise, individually and in combination, maintained higher muscle mass. We looked at five healthy lifestyle factors that included dietary intake of three food groups (meat, fish, eggs, legumes; vegetables; and fruits) and participation in two types of exercise (aerobic and resistance). (more…)
Author Interviews, Exercise - Fitness, Salt-Sodium / 14.04.2015

Edward "Ted" Weiss, Ph.D. Associate Professor Department of Nutrition and Dietetics Saint Louis University Saint Louis MO 63104MedicalResearch.com Interview with: Edward "Ted" Weiss, Ph.D. Associate Professor Department of Nutrition and Dietetics Saint Louis University Saint Louis MO 63104 Medical Research: What is the background for this study? What are the main findings? Dr. Weiss: Public health recommendations are to keep sodium consumption below 2300 mg/day to avoid adverse health effects. However, most people in the US consume over 4000 mg/day. Furthermore, endurance athletes are often advised to add sodium to their diets to replace the sodium that is lost in sweat and are often lead to believe that the additional sodium is important for exercise performance. Clearly these recommendations are at odds with each other. In a double-blind placebo-controlled trial, we evaluated the effect of salt capsule consumption (containing a 1800 mg sodium) on exercise performance and on thermoregulation during 2 - 2.5 hours of running or cycling. Exercise performance was not different between the salt and placebo conditions (i.e. it didn't provide benefit or harm for performance) nor did any of the markers of thermoregulation differ, suggesting that the salt didn't help (or hurt) the body's ability to cool itself. (more…)
Author Interviews, Exercise - Fitness, JAMA, NIH / 06.04.2015

MedicalResearch.com Interview with: Hannah Arem, MHS, PhD Division of Cancer Epidemiology and Genetics National Cancer Institute, Bethesda, MarylandMedicalResearch.com Interview with: Hannah Arem, MHS, PhD Division of Cancer Epidemiology and Genetics National Cancer Institute, Bethesda, Maryland Medical Research: What is the background for this study? Dr. Arem: The 2008 Physical Activity Guidelines for Americans recommend a minimum of 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity activity per week for “substantial” health benefit, and suggest “additional” benefit with more than double the exercise minimum. However, the guidelines note that there is a lack of evidence for an upper limit of health benefit. We set out to define the dose-response relationship between leisure-time physical activity and mortality and to determine the upper limit of benefit associated with higher levels of aerobic exercise. Medical Research: What are the main findings? Dr. Arem: We found that study participants who met the recommended minimum level of leisure-time physical activity derived most of the mortality benefit, with a 31% lower risk of death compared to inactive individuals. Study participants who engaged in three to five times the recommended minimum level of leisure-time physical activity had a marginally increased mortality benefit, with a 39% lower risk of death compared to inactive individuals. Three to five times the recommended minimum is equivalent to a weekly minimum of walking 7 hours or running 2 hours 15 minutes. (more…)
Author Interviews, Exercise - Fitness, JAMA / 06.04.2015

Klaus Gebel GradDipExRehab, MExSc, MAppSc, PhD Senior Research Fellow Centre for Chronic Disease Prevention College of Public Health, Medical & Veterinary Sciences James Cook University Cairns AUSTRALIAMedicalResearch.com Interview with: Klaus Gebel GradDipExRehab, MExSc, MAppSc, PhD Senior Research Fellow Centre for Chronic Disease Prevention College of Public Health, Medical & Veterinary Sciences James Cook University Cairns Australia Medical Research: What is the background for this study? Response: The physical activity guidelines in most countries recommend for adults to accumulate at least 150 minutes of moderate physical activity (e.g. brisk walking) or 75 minutes of vigorous activity (e.g. jogging or cycling) or an equivalent combination of moderate and vigorous activities where 2 minutes of moderate-intensity activity counts the same as 1 minute of vigorous-intensity activity. However, there have only been a few studies that examined the health benefits of different proportions of moderate and vigorous activity in the composition of total activity. The objective of this study was to examine whether the proportion of total moderate-to-vigorous activity that is achieved through vigorous activity is associated with all-cause mortality, independently of the total amount of moderate-to-vigorous activity. Data were used from the 45 and Up study from the state of New South Wales in Australia, the largest cohort study ever conducted in the Southern hemisphere. Medical Research: What are the main findings? Response: During 1,444,927 person-years of follow-up, 7,435 deaths were registered. Compared with those who reported no moderate-to-vigorous activity (crude death rate=8.34%), the adjusted hazard ratios for all-cause mortality were 0.66 (95% CI 0.61-0.71; crude death rate=4.81%), 0.53 (0.48-0.57; 3.17%), and 0.46 (0.43-0.49; 2.64%) for reporting 10-149, 150-299, and for ≥300 minutes of activity per week respectively. Among those participants who reported any moderate-to-vigorous physical activity, the proportion of vigorous activity showed a dose-response relationship with all-cause mortality: compared with those reporting no vigorous activity (crude death rate=3.84%) the fully-adjusted hazard ratio was 0.91 (95% CI=0.84-0.98; crude death rate=2.35%) in those who reported some vigorous activity (but <30% of total activity); and 0.87 (0.81-0.93; 2.08%) among those who reported ≥30% of activity as vigorous. These associations were consistent in men and women, across categories of body mass index and volume of moderate-to-vigorous physical activity, and in those with and without existing cardiovascular disease or diabetes mellitus. (more…)
Aging, Author Interviews, Exercise - Fitness, Frailty, JAMA, Vitamin D / 23.03.2015

MedicalResearch.com Interview with: Kirsti Uusi-Rasi, PhD, Adjunct Professor Senior Researcher UKK Institute for Health Promotion Research Tampere Finland Medical Research: What is the background for this study? What are the main findings? Dr. Kirsti Uusi-Rasi: Falls are the leading cause of unintentional injuries and fractures in older adults, head injuries and fractures being the most severe consequences. Therefore, falls prevention is important when trying to prevent injuries. There is strong high-quality evidence from previous studies that exercise that includes strength and balance training can reduce the risk of falling in older adults. However, there are also studies that have reported no benefit in reducing the actual incidence of falls. Effects of vitamin D have also been studied widely, and vitamin D is known to be vital for bone metabolism and health. However, results regarding effects on falls and fractures are inconsistent. Furthermore, persons with low vitamin D levels (serum 25OHD) have been associated with lower physical performance and greater decline in physical functioning, but clinical trials exploring the role of vitamin D in reducing falls and fractures and in improving physical functioning are inconclusive. Because there is hardly any evidence about exercise and vitamin D together, we investigated the separate and combined effects of multimodal exercise training and vitamin D supplementation in reducing falls and injurious falls among older women at risk for falling. We assigned 409 participants randomly to one of four groups with: 1)vitamin D 800 IU/day and exercise 2) placebo and exercise 3) vitamin D 800 IU/day without exercise 4) placebo without exercise. Exercise consisted of strength, balance, mobility and agility group training. At the end of two years, exercise seemed to be more effective in reducing injurious falls in this age group, with or without vitamin D. Exercise also improved physical functioning (strength, balance and mobility). In general, the training program was well tolerated with no severe adverse effects or injuries. Vitamin D helped maintain femoral neck BMD and increased trabecular bone density at the tibia. Our study also suggests that the current vitamin D recommendation (800 IU/d for older people) is adequate. (more…)
Author Interviews, Exercise - Fitness, Kidney Disease / 20.03.2015

Peter Kokkinos, PhD, FAHA, FACSM Veterans Affairs Medical Center Professor, Georgetown University School of Medicine George Washington University School of Medicine and Health Sciences Director, LIVe ProgramMedicalResearch.com Interview with: Peter Kokkinos, PhD, FAHA, FACSM Veterans Affairs Medical Center Professor, Georgetown University School of Medicine George Washington University School of Medicine and Health Sciences Director, LIVe Program Medical Research: What is the background for this study? Dr. Kokkinos: This is a prospective study and part of a larger cohort, the Veterans Exercise Testing Study (VETS) designed to assess the association between aerobic fitness and the risk of developing Chronic Kidney Disease or CKD. Our cohort included 5,812 middle-aged male Veterans from the Washington, DC Veterans Affairs Medical Center. All participants were CKD-Free prior to entering the study. Exercise capacity was assessed by a graded exercise test and peak Metabolic Equivalents or METs were determined. Accordingly, we established the following four age-adjusted fitness categories based on Quartiles of peak METs achieved: Least-fit (≤25%; 4.8±0.90 METs; n=1258); Low-fit (25.1%-50%; 6.5±0.96 METs; n=1614); Moderate-fit (50.1%-75%; 7.7±0.91 METs; n=1958), and High-fit (>75%; 9.5±1.0 METs; n=1436). Multivariable Cox proportional hazard models were used to assess the exercise capacity-CKD association. The models were adjusted for age, BMI, blood pressure, medications, CVD, Risk factors, race, and history of alcoholism. Medical Research: What are the main findings? Dr. Kokkinos: During a median follow-up period of 7.9 years, 1,000 individuals developed CKD. The CKD-fitness association was independent, inverse and graded. The CKD risk was 22% lower for every 1-MET increase in exercise capacity. When considering fitness categories, CKD risk decreased progressively as fitness status increased. Specifically, when compared to the Least-Fit individuals the risk of developing CKD was 13% 45% and 58% lower for individuals in the Low-Fit; Moderate and High-Fit categories, respectively. These findings support that higher aerobic fitness lowers the risk of developing CKD. The average exercise capacity necessary to realize these health benefits was just over 6.5 METs (Low-fit). This level of fitness is achievable by many middle-aged and older individuals by daily exercises such as brisk walking. Moderate intensity exercises are effective in improving aerobic fitness regardless of age or comorbidities. Thus, exercise interventions for individuals at risk for CKD and those with preclinical CKD may be implemented to prevent or at least attenuate the rate of developing CKD. (more…)
Author Interviews, Exercise - Fitness, Lifestyle & Health, Weight Research / 18.03.2015

MedicalResearch.com Interview with: Sirpa Soini, MHC, researcher Department of General Practice and Primary Health Care University of Helsinki Medical Research: What is the background for this study? Response: Short-term weight loss is often successful, but he obtained results are difficult to maintain. Therefore, a study focusing on obese people who successfully lost weight, with special  emphasis upon methods applied and background factors, is of major importance. Many people are successful in losing weight by themselves without taking part in any organized group activity. The knowledge about their success and the methods applied does not usually reach the health care personnel and is one reason why it is difficult to get reliable information about those who are successful in losing weight. (more…)
Author Interviews, Chocolate, Exercise - Fitness, Heart Disease, JACC, UCLA, UCSD / 17.03.2015

Pam R. Taub, MD, FACC Assistant Professor of Medicine UC San Diego Health System Division of Cardiology Encinitas, CA 92024MedicalResearch.com Interview with: Pam R. Taub, MD, FACC Assistant  Professor of Medicine UC San Diego Health System Division of Cardiology Encinitas, CA 92024 Medical Research: What is the background for this study? Dr. Taub: Epidemiological studies indicate that the consumption of modest amounts of dark chocolate (DC), which contains the natural cacao flavanol (-)-epicatechin (Epi,) is associated with reductions in the incidence of cardiovascular diseases (CVD). The health benefits of dark chocolate have been attributed to Epi. Clinical studies using cocoa and/or DC in normal volunteers or subjects with CVD have reported improvements in peripheral and coronary vascular endothelial function, blood pressure, lipids, insulin resistance, and inflammatory markers. The mechanism underlying these improvements is thought to be due to increased nitric oxide levels and improved endothelial function. We have also shown that capacity of Epi to favorable impact mitochondria under normal and disease states. We previously conducted pilot study in five patients with heart failure and type II diabetes, and showed that in skeletal muscle (SkM) biopsies there is a severe reduction in mitochondrial volume and cristae, as well as, in structural/functional proteins. After treatment with Epi rich dark chocolate , there was a significant recovery of SkM mitochondrial cristae, structural/functional proteins (e.g. mitofilin), as well as in regulators of mitochondrial biogenesis. However, no studies have examined the capacity of Epi rich dark chocolate to enhance exercise capacity in normal subjects and assess its impact on mitochondrial and oxidative control systems. Medical Research: What are the main findings? Dr. Taub: Seventeen subjects were randomized to placebo (n=8) or DC groups (n=9) and consumed 2 squares of chocolate (20 g, provided by Hershey) for 3 months. We showed in the chocolate group subjects had improved levels of HDL cholesterol and enhanced exercise capacity that is linked to the stimulation of SkM metabolic control endpoints which enhance mitochondrial function. (more…)
Author Interviews, Exercise - Fitness, Salt-Sodium / 14.03.2015

MedicalResearch.com Interview with: Juan Del Coso Garrigós Profesor CC. de la Act. Física y del Deporte Responsable del Laboratorio de Fisiología del Ejercicio UNIVERSIDAD CAMILO JOSÉ CELA MedicalResearch: What is the background for this study? What are the main findings? Response: From a scientific point of view, it is well known that salt (either in capsules or included in a drink) can improve physical performance and several other physiological factors such as plasma volume maintenance, thermoregulation, etc in endurance activities.  These effects are more evident when the amount of salt ingested during exercise matches the amount of salt lost by sweating.  By using only sports drinks, it is impossible to replace all the salt lost by sweating because they only contain a relatively small amount of salt in their compositions (between ½ and 1/3 of the amount of salt lost by sweating). In fact, some of the investigations that determined the effectiveness of ingesting salt in sports have been financed by most popular sport drinks trademarks.  However, sports drink companies only include a part of the salt lost by sweating because for them, taste is elemental for their markets!  I suppose that, if they include more salt in their commercially available drinks, they would be more effective to prevent dehydration and performance decline, but at the same time, the taste of the drink would diminish the amount of beverage ingested worldwide. In this case, in the sport drinks market there is a well- established balance between taste and physiological effectiveness. As an example, most “salted” sport drinks contain 20-25 mM of sodium while it is well known that sweat sodium concentration ranges from 20 to 60 mM (salty sweater can reach 100 mM!!).  This is not a regulatory limitation, because UE considers sports drinks to carbohydrate-electrolyte solutions that contain sodium between 20 and 50 mM. Our main finding is: To ingest salt capsules, in addition to the habitual rehydration routines with sports drinks, improves performance in a triathlon.  This ergogenic effect was mediated by better maintenance of body water and electrolytes balances. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Weight Research / 05.03.2015

MedicalResearch.com Interview with Christopher C. Imes, PhD, RN Assistant Professor, Acute and Tertiary Care University of Pittsburgh, School of Nursing MedicalResearch: What is the background for this study? Dr. Imes: Increased physical activity (PA) with reduced energy intake is the key strategy to achieve weight loss. However, in research, there are challenges to obtaining accurate PA data. Many studies rely on self-report, which is easily accessible and inexpensive but is known to have numerous limitations. Pedometers are a relatively inexpensive and accessible method to objectively measure certain aspects of physical activity. The purpose of this analysis was to examine the associations between self-reported physical activity, pedometer step count data and weight loss during the first 6-months of the Self-Efficacy Lifestyle Focus (SELF) trial. All participants in this trial were instructed to reduce their calorie and fat intake, were encouraged to engage in at least 150 minutes of moderately intense PA/week or 7500 steps/day, and to self-monitor their diet and physical activity. MedicalResearch: What are the main findings? Dr. Imes: Change in self-reported physical activity from baseline to 6 months was not associated with weight change. However, average daily step count, derived from pedometers given to participants during the same time period, was associated with weight loss. More daily steps results in more weight loss. The participants who averaged over 7500 steps/day lost about 9.5% of their initial body weight; whereas, the participants who averaged less than 5000 steps/day only lost about 5.0%. (more…)
Author Interviews, Exercise - Fitness, Heart Disease / 05.03.2015

Prof. Scott Montgomery Prof. Montgomery is a clinical epidemiologist, conducting research in life-course influences on chronic disease risk Örebro UniveristyMedicalResearch.com Interview with: Prof. Scott Montgomery Prof. Montgomery is a clinical epidemiologist, conducting research in life-course influences on chronic disease risk Örebro Univeristy Medical Research: What is the background for this study? What are the main findings? Prof. Montgomery: Stress is thought to increase the risk of heart disease. However, an experience that is stressful for one person may not be so for another, as stress resilience varies. As we believe that stress resilience is influenced by childhood experiences, we examined whether teenagers with low stress resilience were more likely to have coronary heart disease in subsequent adulthood (they were followed to a maximum age of 58 years). In this study of 237,980 men, we found that low stress resilience in adolescence was associated with a raised risk of heart disease. A surprising result was that although higher levels of fitness in adolescence were associated with lower heart disease risk, the benefit of such fitness, in terms of heart disease risk, was not present in the men with low stress resilience. (more…)
Aging, AHA Journals, Author Interviews, Exercise - Fitness / 20.02.2015

Thomas W. Buford, PhD Assistant Professor, Division of Clinical Research Department of Aging and Geriatric Research, University of Florida College of Medicine Director, Health Promotion Center University of Florida Institute on AgingMedicalResearch.com Interview with: Thomas W. Buford, PhD Assistant Professor, Division of Clinical Research Department of Aging and Geriatric Research, University of Florida College of Medicine Director, Health Promotion Center University of Florida Institute on Aging Medical Research: What is the background for this study? What are the main findings? Dr. Buford: This study was a cross-sectional analysis of data collected from over 1000 older adults upon their entry into the Lifestyle Interventions and Independence for Elders (LIFE) study. Briefly, participants were recruited into the LIFE Study who were over 70 years of age, sedentary, and had mobility limitations. The objective of this study was to examine, at baseline prior to their participation in the study interventions, the association between daily physical activity habits and risk of major cardiovascular events (i.e. heart attack and coronary-related death). The study utilized accelerometers, devices designed to identify and quantify human movement, to measure participant’s daily activity. Predicted risk of cardiovascular events was determined using a risk score established in the Framingham Heart Study. As identified by accelerometry measures, participants spent on average 70% of their waking hours being sedentary. The major finding of the study, however, was that even extremely low-level activity was associated with an improved cardiovascular risk profile. For every 25-30 minutes a participant was sedentary per day, predicted risk was 1 percent higher. Conversely, But activity identified as slightly above sedentary — which could be light housework or slow walking — was associated with higher levels of the more beneficial kind of cholesterol, HDL, in people with no history of heart disease. (more…)
Author Interviews, Diabetes, Exercise - Fitness, Pain Research, Weight Research / 20.02.2015

Dan White PT , ScD, Msc University of DelawareMedicalResearch.com Interview with: Dan White PT , ScD, Msc University of Delaware Medical Research: What is the background for this study? What are the main findings? Dr. White: We know that diet and exercise are beneficial to reduce knee pain, however it is not known whether diet and exercise can actually prevent the development of knee pain in people at high risk.  We found that an intensive program of diet and exercise had a small but statistically significant protective effect with preventing the development of knee pain in overweight and obese people with diabetes. (more…)
Author Interviews, Exercise - Fitness, Geriatrics, PLoS / 19.02.2015

Tess Harris St George’s University of LondonMedicalResearch.com Interview with: Tess Harris St George’s University of London   MedicalResearch: What is the background for this study? Response: Physical activity is vital for both physical and mental health in older people, preventing at least 20 common health problems. Yet the majority of older people do not achieve the World Health Organisation physical activity guidelines for health of at least 150 minutes every week of at least moderate-to-vigorous intensity physical activity in bouts that each last at least 10 minutes. Brisk walking is a good way to achieve moderate intensity physical activity, with a low risk of harm. Pedometers can give you direct feedback on your step-count and accelerometers record both step-counts and the intensity of physical activity achieved. The PACE-Lift trial assessed whether an intervention to increase walking, comprising pedometer and accelerometer feedback, combined with physical activity consultations provided by practice nurses over a 3 month period, based on simple behaviour change techniques, could lead to sustained increases in physical activity in 60-75 year olds. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease / 17.02.2015

Dr. Miranda ArmstrongMedicalResearch.com Interview with: Dr Miranda Armstrong M.Phil. Physical Activity Epidemiologist Cancer Epidemiology Unit University of Oxford Oxford, UK Medical Research: What is the background for this study? What are the main findings? Dr. Armstrong: Physical activity has generally been associated with reduced risk of heart disease. However, there is limited evidence on the associations between the frequency and durations of various activities with stroke and blood clots, especially in middle-aged women. This is a very large study of 1.1 million middle-aged women, which confirms the benefits of moderate activity for reducing the risk of heart disease and stroke. Further to this, it shows that benefits may be more wide ranging than previously thought as the risk of blood clots was also lower in women reporting moderate activity when compared to inactive women. We found little evidence to suggest that activity more frequent than a few times per week provided further benefits in relation to these diseases. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Primary Care / 10.02.2015

Molly B. Conroy MD, MPH Assistant Professor of Medicine, Epidemiology, and Clinical and Translational Science University of Pittsburgh, Pittsburgh, PA,MedicalResearch.com Interview with: Molly B. Conroy MD, MPH Assistant Professor of Medicine, Epidemiology, and Clinical and Translational Science University of Pittsburgh, Pittsburgh, PA, Medical Research: What is the background for this study? What are the main findings? Response: The background for the study is the fact that middle-aged women are at high risk for being physically inactive, which puts them at higher risk for heart disease, cancer, and other chronic health problems. We compared an interventionist-led physical activity and weight loss program delivered in coordination with primary care to a booklet that women were asked to use to exercise by themselves at home. We found that women who received the interventionist-led program had significantly greater increases in physical activity at 3 months, compared to women who received booklet. At 12 months, women who received the interventionist-led program were still more active than they were before starting the program, although the difference between the 2 groups was no longer significant. (more…)
Alzheimer's - Dementia, Author Interviews, Exercise - Fitness / 06.02.2015

MedicalResearch.com Interview with: Paula Iso-Markku, MD, Department of Clinical Physiology and Nuclear Medicine,  HUS Medical Imaging Center,  Helsinki University Central Hospital and University of Helsinki Helsinki , Finland MedicalResearch: What is the background for this study? What are the main findings? Dr. Iso-Markku : The social, financial and humane burden of the dementia is extensive as the worldwide prevalence of dementia is estimated around 35.6 million. Finding efficient prevention strategies for dementia is crucial. Within the past decade vascular risk factors have been recognized as very potential risk factors of dementia. As physical activity is known to affect vascular risk factors, it might also be a potential preventive tool against dementia. Few comprehensive epidemiological studies on physical activity in middle age and dementia occurrence later in life have been conducted. The comprehensive Finnish Twin Study offers a unique approach to the subjects as the shared growing up environment and genes can be taken into account. The study population is extensive and a good representation of the Finnish population. In this study the association of physical activity in adulthood and dementia mortality was investigated in a 29-year follow-up. The main finding in this study was that persistent vigorous (i.e. more strenuous than walking) physical activity was significantly associated with lower dementia mortality. The results in the paired analysis, comparing twins to co-twins, were similar but remained non-significant. The analyses of the volume of physical activity were, however, controversial. (more…)