Author Interviews, Exercise - Fitness, Rheumatology / 06.10.2015

Anja Bye, PhD, Senior Researcher Cardiac Exercise Research Group (CERG) K.G. Jebsen Center of Exercise in Medicine National Council of Cardiovascular Disease Department of Circulation and Medical Imaging Medical Faculty Norwegian University of Science and TechnologyMedicalResearch.com Interview with: Anja Bye, PhD, Senior Researcher Cardiac Exercise Research Group (CERG) K.G. Jebsen Center of Exercise in Medicine National Council of Cardiovascular Disease Department of Circulation and Medical Imaging Medical Faculty Norwegian University of Science and Technology Medical Research: What is the background for this study? What are the main findings? Dr. Bye: The background was that we know that this type of training is superior to exercise at lower intensities in cardiovascular risk reduction in several patients groups. As it was not tested in patients with rheumatic disease, we set out to determine if this type of exercise would be tolerated in these patients, and of they would experience the same benefits on the cardiovascular system as other patients groups, and healthy young and elderly individuals. Hence the main goal was not to treat the rheumatic disease, but to study whether the exercise training would be tolerated, as we assumed they would have equal benefits from this type of exercise as everyone else. I think the most interesting findings were that all of the participants were capable of participating in this type of high-intensity exercise program, without reporting any negative side-effects. Of course the great increase in VO2max, and  the trend towards a reduction in the inflammation after the exercise intervention was very interesting. (more…)
Author Interviews, Exercise - Fitness / 04.10.2015

Prof. Ismail Laher Department of Anesthesiology Department of Pharmacology and Therapeutics Faculty of Medicine University of British Columbia Vancouver, CanadaMedicalResearch.com Interview with: Prof. Ismail Laher Department of Anesthesiology Department of Pharmacology and Therapeutics Faculty of Medicine University of British Columbia Vancouver, Canada  Medical Research: What is the background for this study? What are the main findings? Dr. Laher: There are several groups based in various parts of the world looking to create an exercise pill. We examined the proposed candidates and summarized how these agents work at the cellular level. The main finding is that each of these agents each acts on a select aspect of physical exercise does in humans —these agents seem to interact with only some of the molecular signals activated by regular physical exercise, for example in skeletal muscle. What they fail to do is to provide all the other benefits of exercise such as improved bone strength, better blood supply to many areas of the body, improved activity of insulin and other glucose lowering drugs. Basically these exercise pills will help some athletes reach their goal of faster and stronger muscles even faster—of course this opens the door to doping in human and animal sporting competitions. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness, Nutrition / 21.09.2015

Beetroot juice WikipediaMedicalResearch.com Interview with: Chris Thompson BSc MSc ANutr AFHEA University of Exeter St. Luke's Campus Exeter Devon Medical Research: What is the background for this study? Response: Dietary nitrate has been shown to favourably alter the contractility of type II muscle fibres and enhance blood flow to working muscles that are predominantly type II. Dietary nitrate may also improve perfusion to areas of the brain responsible for cognitive function. It is therefore possible that through these mechanisms, nitrate-rich beetroot juice supplementation may improve both physical and cognitive performance during exercise which reflects the high intensity intermittent nature of team sport play. Medical Research: What are the main findings? Response: Participants were able to complete greater total work during an intermittent sprint test following nitrate-rich beetroot juice supplementation. We also found that dietary nitrate enabled a reduction in response time to decision making during the cognitive tasks performed throughout the exercise test. (more…)
Author Interviews, BMJ, Exercise - Fitness / 21.09.2015

Yi-Wen Chen PhD Candidate, and Darlene Reid, BMR(PT), PhD Professor and Chair Department of Physical Therapy University of Toronto Toronto, OntarioMedicalResearch.com Interview with: Yi-Wen Chen PhD Candidate, and Darlene Reid, BMR(PT), PhD Professor and Chair Department of Physical Therapy University of Toronto Toronto, Ontario Medical Research: What is the background for this study? Response: Tai Chi is a time-honored exercise in China, developed during the Sung Dynasty, which has gained increased popularity in Western society. Most styles of Tai Chi consist of slow rhythmic movements that often emphasize typical attributes of exercise including range of motion, strengthening, balance, and postural alignment. In addition, there are spiritual aspects of Tai Chi that focus on relaxation, breath control, and cultivating internal energy. Several studies have demonstrated its multifaceted benefits in the elderly and in people living with chronic diseases including cancer, cardiovascular diseases, respiratory disorders and arthritis. If you were interested in seeing videos of beginner practices, check out some tai chi online to better clarify the motions previously described. Many individuals that require increased exercise and physical fitness also have one or more comorbidities; 9 out 10 Canadians live with more than one chronic condition and this proportion increases to 98% in adults over the age of 65 years. Increased fitness can increase quality of life and decrease risk of mortality and morbidity in older persons and in many chronic conditions. However, treatment, including exercise is often prescribed within a single specialty. Rarely is information provided to health professionals that integrates therapeutic approaches across several common chronic disorders. Accordingly, we performed a systematic review to determine if Tai Chi is an effective physical activity that improves symptoms, physical function, quality of life and depression in cancer, osteoarthritis (OA), heart failure (HF) and chronic obstructive pulmonary disease (COPD)? We also examined if Tai Chi had similar effects for the same outcome measures across different chronic conditions? (more…)
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…)
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, 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, 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…)
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, 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…)
Author Interviews, Weight Research / 14.03.2015

Harold P. Erickson Ph.D. James B. Duke Professor, Department of Cell Biology Duke Univ. Med. Center Durham, NC 27710MedicalResearch.com Interview with: Harold P. Erickson Ph.D. James B. Duke Professor, Department of Cell Biology Duke Univ. Med. Center Durham, NC  27710 MedicalResearch: What is the background for this study? Dr. Erickson: In Jan 2012 a paper reported the discovery of irisin, a hormone reportedly lopped off a precursor in muscle and sent through the bloodstream to fat tissue, where it turned white fat into brown fat. Brown fat burns calories, and is what hibernating animals – and even human babies -- use to keep warm. Turning on brown fat had exciting promise for obesity, diabetes, etc. Dozens of labs around the world jumped on the discovery and started trials in animals and humans of how irisin levels in blood were altered by exercise and a variety of metabolic challenges. MedicalResearch: What are the main findings? Early reports. Dr. Erickson: The follow-up studies from different labs reported a huge range of values for the level of irisin in blood, so they could not all be right. And most of them failed to find any significant effect of exercise. In 2013 two papers criticized the irisin study. A commentary article by Harold Erickson (Adipocyte 2:289-93) reported two substantial flaws in the original study. A research paper by S. Raschke, J. Eckel and colleagues (PloS one 8:e73680) concluded that humans did not make significant amount of irisin. The human gene for irisin has a deleterious mutation in the start codon, and Raschke et al showed that this reduced irisin expression to only 1% the level with the normal start. These two reports may have slowed new labs entering the field, but many groups already invested continued to publish. (more…)
Author Interviews, Cognitive Issues, Exercise - Fitness / 21.01.2015

Dr. Liana Machado PhD Department of Psychology Brain Health Research Centre University of Otago Dunedin New ZealandMedicalResearch.com Interview with: Dr. Liana Machado PhD Department of Psychology Brain Health Research Centre University of Otago  Dunedin New Zealand Medical Research: What is the background for this study? What are the main findings? Response: A large body of data indicates links between chronic physical activity levels and cognitive performance in healthy populations. Although the bulk of evidence comes from studies in older adults, a number of studies have established links in children and in young adults. However, the mechanisms supporting the exercise-cognition links have remained unclear. Finding from an earlier study of ours, published in the journal Neuropsychology, pointed toward cerebrovascular factors as potentially important. In our new study in Psychophysiology, we found evidence suggesting that higher oxygen availability in the brain is one of the cerebrovascular factors that helps support better cognitive performance in people who exercise more regularly, thus providing important insight toward understanding why cognitive performance improves with regular exercise. (more…)
Exercise - Fitness, Kidney Disease / 20.11.2014

Prof. Francesca Mallamaci Professor of Nephrology Head of the Hypertension Unit at the Department of Nephro-Urology, CNR-IBIM Research on Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, ItalyMedicalResearch.com Interview with: Prof. Francesca Mallamaci Professor of Nephrology Head of the Hypertension Unit at the Department of Nephro-Urology, CNR-IBIM Research on Clinical Epidemiology and Pathophysiology of Renal Diseases and Hypertension, Reggio Calabria, Italy Medical Research: What is the background for this study? What are the main findings? Dr. Mallamaci: It is well known that physical activity is beneficial both in normal individuals and in patients with heart failure which represent a high risk category of patients. We have scanty information about physical activity in dialysis patients. So the aim of our study was to test the effectiveness of a low-intensity, easy to implement, home exercise program on physical performance in about 300 dialysis patients in a multicenter, randomized, controlled clinical trial (EXCITE, ClinicalTrials.gov NCT01255969). What we found in our study was that dialysis patients who performed exercise improved their physical performance and this was documented by 2 well known and validated performance tests such as the Six Minute Walking Test and the Sit-to-stand-to sit test. We found also that after 2 year follow-up dialysis patients who were in the active exercise arm had a lower rate of hospitalization and a trend to a better survival, compared to dialysis patients in the control arm of the study. (more…)
Breast Cancer, Exercise - Fitness / 20.11.2014

MedicalResearch.com: Interview Invitation Dr. Wenji Guo University of Oxford Medical Research: What is the background for this study? Response: Previous studies report increased risk for breast cancer in postmenopausal women who have a higher Body Mass Index (BMI) – a measure of body fat based on height and weight. However, BMI is unable to distinguish between excess weight due to fat rather than muscle. More direct measures of fatness, such as body fat percentage, may be better indicators of disease risk. And although probable evidence for the relationship between physical activity and breast cancer now exists, questions still remain over the role of vigorous compared to lower intensity physical activity. (more…)
Author Interviews, JAMA, Pediatrics, Weight Research / 05.11.2014

MedicalResearch.com Interview with: Angela Alberga, PhD Eyes High Postdoctoral Fellow Werklund School of Education University of Calgary Ronald J. Sigal, MD, MPH, FRCPC Professor of Medicine, Kinesiology, Cardiac Sciences and Community Health Sciences Division of Endocrinology and Metabolism, Cumming School of Medicine, University of Calgary Health Senior Scholar, Alberta Innovates-Health Solutions Member, O'Brien Institute of Public Health, Libin Cardiovascular Institute and Julia McFarlane Diabetes Research Centre Medical Research: What are the main findings of the study? Response: The Healthy Eating, Aerobic and Resistance Training in Youth study examined the effects of exercise on body composition and cardiometabolic risk markers in adolescents with obesity. A total of 304 overweight or obese adolescents were randomized to four groups. The first group performed resistance training involving weight machines and some free weights; the second performed only aerobic exercise on treadmills, elliptical machines and stationary bikes; the third underwent combined aerobic and resistance training; and the last group did no exercise training. All four groups received nutritional counseling. In analyses involving all participants regardless of adherence, each exercise program reduced percent body fat, waist circumference and body mass index to a similar extent, while the diet-only control group had no changes in these variables. In participants who exercised at least 2.8 times per week, we found that combined aerobic and resistance training produced greater decreases in percentage body fat, waist circumference, and body mass index than aerobic training alone. Waist circumference decreased close to seven centimeters in adherent participants randomized to combined aerobic plus resistance exercise, versus about four centimeters in those randomized to do just one type of exercise, with no change in those randomized to diet alone. (more…)
Aging, Author Interviews, Exercise - Fitness / 22.10.2014

Professor Emrah Düzel Director, Institute of Cognitive Neuroscience University College LondonMedicalResearch.com Interview with: Professor Emrah Düzel Director, Institute of Cognitive Neurology and Dementia Research, OvG Univ. Magdeburg, Germany Institute of Cognitive Neuroscience University College London Medical Research: What are the main findings of the study? Professor Düzel: We found that even in old age, intensive and long-term (3 months) aerobic exercise can improve blood flow in the hippocampus, a brain structure that is of critical importance for memory.  The increase in blood flow is evident during a resting state and this means that the exercise improves the overall perfusion of the hippocampus. Such effects had previously only been reported in young adults. As previously observed in young adults, the change in blood flow after exercise is related to the improvement of specific memory skills. We found the closest relationship between improved blood flow and recognition memory for complex objects. This is interesting because this type of memory is likely to benefit from “pattern separation”, a process that in animal studies of exercise is tightly associated with hippocampal neurogenesis. However, we also found that the exercise-related improvement in hippocampal blood flow and in recognition memory was absent in the older seniors of our study cohort. Those  who were beyond 70 did not show any improvement. We reasoned that this may have been due to higher levels of stress in the older seniors. Therefore, we investigated whether elevated serum cortisol levels dampened the benefits of exercise in the older seniors. But this was not the case making it unlikely that stress levels can account for these findings. (more…)
AHA Journals, Author Interviews, Heart Disease, Karolinski Institute / 29.09.2014

dr_iffat_rahmanMedicalResearch.com Interview Invitation with: Dr. Iffat Rahman Ph.D. Unit of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, 17177 Stockholm, Sweden Medical Research: What are the main findings of the study? Dr. Rahman: Our study suggests that moderate to high level of physical activity could protect against heart failure in women. (more…)
Author Interviews, Exercise - Fitness, Kidney Disease / 27.09.2014

Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome ItalyMedicalResearch.com Interview with: Pietro Manuel Ferraro, MD PhD Candidate Division of Nephrology Catholic University of the Sacred Heart Rome Italy Medical Research: What are the main findings of the study? Dr. Ferraro: We analyzed the association between physical activity and energy intake and the risk of developing kidney stones in three large cohorts of U.S. health professionals. The 215,133 participants included did not have any history of kidney stones when follow-up began. During 20 years of follow-up, 5,355 of them developed a kidney stone. Initially, we found that participants with higher physical activity levels had a reduced risk of developing stones in two of the three cohorts. However, after accounting for a number of factors that could potentially confound the association such as age, body mass index and dietary intake, the association was no longer significant. Similarly, energy intake was not associated with a reduced risk of developing kidney stones. (more…)
Author Interviews, Exercise - Fitness, General Medicine, Occupational Health / 10.09.2014

Saurabh S. Thosar, Ph.D., Postdoctoral Researcher Oregon Institute for Occupational Health Sciences, Oregon Health & Science UniversiMedicalResearch.com Interview with: Saurabh S. Thosar, Ph.D., Postdoctoral Researcher Oregon Institute for Occupational Health Sciences, Oregon Health & Science University Medical Research: What are the main findings of the study? Dr. Thosar: We discovered that 3 hours of sitting leads to an impairment in shear rate and an impairment in femoral artery endothelial function. When systematic breaks are added in the sitting time the shear rate and the endothelial function are preserved. (more…)
AHA Journals, Author Interviews, Exercise - Fitness, Gender Differences, Heart Disease, Stanford / 21.08.2014

Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233MedicalResearch.com Interview with Marco Perez, MD Instructor in Cardiovascular Medicine Director, Inherited Cardiac Arrhythmia Clinic Stanford University Medical Center Cardiac Electrophysiology & Arrhythmia Service Stanford, CA 94305-5233 Medical Research: What are the main findings of the study? Dr. Perez: It was already known that obesity is an important risk factor for atrial fibrillation.  We studied over 80,000 postmenopausal women enrolled in the Women’s Health Initiative who were followed for the onset of atrial fibrillation, an irregular heart rhythm associated with stroke and death.  We found that those who exercised more than 9 MET-hours/week (equivalent to a brisk walk of 30 minutes six days a week) were 10% less likely to get atrial fibrillation than those who were sedentary.  Importantly, the more obese the women were, the more they benefited from the exercise in terms of atrial fibrillation risk reduction. (more…)
Author Interviews, BMJ, Exercise - Fitness, Weight Research / 20.08.2014

MedicalResearch.com Interview with: Dr Ellen Flint, BA MSc PhD, Research Fellow Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine Tavistock Place, LondonMedicalResearch.com Interview with: Dr Ellen Flint, BA MSc PhD, Research Fellow Department of Social & Environmental Health Research London School of Hygiene & Tropical Medicine Tavistock Place, London Medical Research: What are the main findings of the study? Dr. Flint: Men and women who commuted to work by cycling, walking or public transport had significantly lower BMI and percentage body fat than their car-using counterparts. This was the case despite adjustment for a range of factors which may affect both body weight and commuting mode preference (e.g. limiting illness, age, socioeconomic position, sports participation and diet). The differences were of a clinically meaningful magnitude. For example, compared to car users, men who commuted via active or public transportation modes were on average 1 BMI point lighter. For the average man in the sample this would equate to a difference in weight of almost half a stone (3kg). (more…)