The effects of acute interval exercise and strawberry intake on postprandial lipemia

YesPurpose: Raised postprandial triglycerides (TAG) and related oxidative stresses are strongly associated with increased cardiovascular disease (CVD) risk. Acute exercise and strawberry ingestion independently ameliorate postprandial lipid excursions and oxidative stress. However, the combined effects of these lifestyle interventions is unknown. We investigated whether acute exercise and strawberry consumption improved postprandial responses to an oral fat tolerance test (OFTT) in overweight/obese males. Methods: Overweight/obese adult males underwent four separate OFTT (73g fat, 33g carbohydrate) with blood sampled at baseline and hourly for 4 h after OFTT. Two OFTT contained 25g freeze-dried strawberries and two contained strawberry flavouring (placebo). Participants performed 40 minutes of submaximal high intensity interval cycling exercise (HIIE) 16 h before one strawberry and one placebo OFTT, and rested before the remaining two OFTT. Serum TAG was analysed and TAG area under curve (AUC) and incremental AUC (iAUC) were calculated. Oxidative stress markers were measured at baseline and 4 h. Differences between conditions (strawberry/placebo and exercise/rest) were assessed using repeated measures ANOVA. Results: Ten males (Age, 31.5 IQR 17.8 years; BMI, 29.9 ±1.8 kg.m-2) completed the study. TAG AUC was 1.5 mmol.4h-1.L-1 lower for the exercise conditions compared to the rest conditions (95% confidence interval [CI]= -2.3 to 0.8, p= 0.001). TAG AUC was not different between the strawberry and placebo conditions (CI= -1.3 to 0.6, p= 0.475). TAG iAUC was 0.5 mmol.4h-1.L-1 greater for the strawberry compared to the placebo conditions (CI= 0.1 to 1.0, p= 0.021). There were no changes in markers of lipid related oxidative stress (P> 0.05). Conclusion: Acute submaximal HIIE appears effective in reducing postprandial lipaemia in overweight/obese adult males. However, strawberry ingestion did not improve postprandial TAG

Serum transthyretin and aminotransferases are associated with lean mass in people with coronary heart disease: further insights from the CARE-CR study

Background: Low muscle mass disproportionately affects people with coronary heart disease compared to healthy controls but is under-researched and insufficiently treated. Inflammation, poor nutrition, and neural decline might contribute to low muscle mass. This study aimed to assess circulatory biomarkers related to these mechanisms [albumin, transthyretin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and C-terminal agrin fragment] and their relationship with muscle mass in people with coronary heart disease. Our findings could be beneficial to indicate mechanisms of sarcopenia, detect sarcopenia, and evaluate treatment. Methods: Serum blood samples from people with coronary heart disease were analysed for biomarker concentrations using enzyme-linked immunosorbent assays. Skeletal muscle mass was estimated using dual X-ray absorptiometry derived appendicular lean mass and reported as skeletal muscle index (SMI; kg m−2), and as a proportion of total body mass [appendicular skeletal mass (ASM%)]. Low muscle mass was defined as a SMI <7.0 and <6.0 kg m−2, or ASM% <25.72 and <19.43% for men and women, respectively. Associations between biomarkers and lean mass were adjusted for age and inflammation. Results: Sixty-four people were assessed; 14 (21.9%) had low muscle mass. People with low muscle mass had lower transthyretin (effect size 0.34, p = 0.007), ALT (effect size 0.34, p = 0.008), and AST (effect size 0.26, p = 0.037) concentrations, compared to those with normal muscle mass. SMI was associated with inflammation-corrected ALT (r = 0.261, p = 0.039) and with inflammation- and age-adjusted AST/ALT ratio (r = −0.257, p = 0.044). Albumin and C-terminal agrin fragment were not associated with muscle mass indices. Conclusion: Circulatory transthyretin, ALT and AST were associated with low muscle mass in people with coronary heart disease. Low concentrations of these biomarkers might indicate that low muscle mass is partially explained by poor nutrition and high inflammation in this cohort. Targeted treatments to address these factors could be considered for people with coronary heart disease

The effectiveness of the Healthworks Staying Steady community-based falls prevention exercise programme to improve physical function in older adults: a 6-year service evaluation

Abstract: Background: Falls prevention exercise programmes are evidence-based and recommended for improving physical function in older adults. However, few service evaluations exist to assess the effectiveness of community-delivered interventions in practice. Methods: We conducted a six-year, retrospective evaluation of the community-delivered Staying Steady programme (Healthworks, United Kingdom). Staying Steady is a 27-week, tailored strength and balance programme delivered in a group setting (1-h, once/week) and at home (30–40 min, 2–3 times/week). Participants were referred by healthcare professionals, or self-referred, due to a history or risk of falling. Routinely collected outcome measures (30-s chair stand, Timed Up and Go, four-stage balance test, and patient reported outcomes; including ‘fear of falling’ and ‘ability to manage health’) were analysed. Factors associated with programme completion were reported. The intervention effect on physical function was analysed in subgroups: participants used arms to chair-stand or a walking-aid at both (‘aided’), neither (‘unaided’), or one assessment timepoint (‘aided at baseline only’ or ‘aided at follow-up only’). Results: There were 1,426 referrals; 835 (67.3%) participants enrolled on to the Staying Steady programme, 406 (32.7%) declined, 185 (13.0%) were inappropriately referred and excluded from analysis. After enrolling, 451 (54.0%) participants completed, and 384 (46.0%) dropped out. Chair stand performance improved in participants who were unaided (n = 264; median 2.0 [1.0, 4.0] repetitions; P < 0.001), or aided at baseline, follow-up or both (n = 170, P < 0.05). Timed Up and Go performance improved in the unaided (n = 387; median ˗3.1 [˗5.4, ˗1.4] s, P < 0.001), and aided at baseline only (n = 32; median ˗4.9 [˗10.8, ˗3.4] s, P < 0.001) groups. Four-stage balance performance improved (n = 295; median 1.0 [0.0, 1.0] points, P < 0.001). After programme completion, participants self-reported an improved ability to manage their health and daily activities, improved confidence, and a reduced fear of falling. Presence of chronic obstructive pulmonary disease, fear of falling, prescribed nutritional support, disability and social deprivation influenced non-completion of Staying Steady. Conclusions: Completing Staying Steady improved physical function in older adults. Methods to encourage retention of participants from groups associated with low uptake and adherence should be investigated