The effect of 12 weeks regular physical activity and vitamin E in the treatment of non-alcoholic steatohepatitis: A pilot study

Background: Despite the prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH), there was no treatment has been proven to be effective in these common diseases. Although many studies have shown that lifestyle modifications such as increasing physical activities and exercise could be effective in the treatment of these common diseases, the optimal strategy was still not determined. According to the beneficial effects of antioxidant agents in the treatment of NASH, vitamin E has been used for this purpose by some clinicians. We designed this study for assessing beneficial effects of regular physical activity on the biochemical and imaging responses in patients with NASH and comparing this with vitamin E as an accepted treatment for NASH. Materials and Methods: This study was Randomized and single-blind clinical trials were carried out in Gonbad-e Kavus through which a total of 30 consecutive patients with the ultra sonographic diagnosis of non-alcoholic steatohepatitis (NASH)were enrolled and randomized to one of the three groups: Vitamin E 800 mg/day, regular physical activity, or both. Results: In all treatment groups improvement in liver transaminases level, serum lipids and ultrasonographic grading of fatty liver occurred after three months of treatment. When these decrement was compared between the treatment groups, there was no statistically significant difference in the value of improvement between the three groups (ANOVA: p>0.5). I.e. all three interventions improved the biochemical and ultrasonographic finding of fatty liver in the same way. Both groups with regular exercise had significant mean weight loss in comparison with the vitamin E group (a mean decrease of 3.0 kg in exercise group, 5.8 kg in subjects on regular exercise plus vitamin E and 0.2 kg in vitamin E group, ANOVA: p=0.04). Conclusion: There were no significant differences between exercise and vitamin E alone or in combination regarding the reduction in the level of liver enzymes and sonographic evidences of fatty liver although both resulted in significant improvements in biochemical endpoints. This implies that physical activity could be considered as effective as vitamin E in the improvement of biochemical and ultrasonographic presentations of NASH and the addition of Vitamin E does not offer any benefits. According to the findings of this pilot study a full-powered study with a control group should be designed. © 2015, Iranian Association of Gastroenterology and Hepatology. All rights reserved

The effect of 12 weeks regular physical activity and vitamin E in the treatment of non-alcoholic steatohepatitis: A pilot study

Background: Despite the prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) and Non-Alcoholic Steatohepatitis (NASH), there was no treatment has been proven to be effective in these common diseases. Although many studies have shown that lifestyle modifications such as increasing physical activities and exercise could be effective in the treatment of these common diseases, the optimal strategy was still not determined. According to the beneficial effects of antioxidant agents in the treatment of NASH, vitamin E has been used for this purpose by some clinicians. We designed this study for assessing beneficial effects of regular physical activity on the biochemical and imaging responses in patients with NASH and comparing this with vitamin E as an accepted treatment for NASH. Materials and Methods: This study was Randomized and single-blind clinical trials were carried out in Gonbad-e Kavus through which a total of 30 consecutive patients with the ultra sonographic diagnosis of non-alcoholic steatohepatitis (NASH)were enrolled and randomized to one of the three groups: Vitamin E 800 mg/day, regular physical activity, or both. Results: In all treatment groups improvement in liver transaminases level, serum lipids and ultrasonographic grading of fatty liver occurred after three months of treatment. When these decrement was compared between the treatment groups, there was no statistically significant difference in the value of improvement between the three groups (ANOVA: p>0.5). I.e. all three interventions improved the biochemical and ultrasonographic finding of fatty liver in the same way. Both groups with regular exercise had significant mean weight loss in comparison with the vitamin E group (a mean decrease of 3.0 kg in exercise group, 5.8 kg in subjects on regular exercise plus vitamin E and 0.2 kg in vitamin E group, ANOVA: p=0.04). Conclusion: There were no significant differences between exercise and vitamin E alone or in combination regarding the reduction in the level of liver enzymes and sonographic evidences of fatty liver although both resulted in significant improvements in biochemical endpoints. This implies that physical activity could be considered as effective as vitamin E in the improvement of biochemical and ultrasonographic presentations of NASH and the addition of Vitamin E does not offer any benefits. According to the findings of this pilot study a full-powered study with a control group should be designed. © 2015, Iranian Association of Gastroenterology and Hepatology. All rights reserved

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

Concomitant aerobic- and hypertrophy-related skeletal muscle cell signaling following blood flow-restricted walking

International audienceObjectiveThis study is aimed to examine the acute responses to a blood flow restriction (BFR) low-intensity aerobic exercise, compared with a similar exercise without BFR, on several aerobic- and hypertrophy-related proteins expression and hormonal responses.MethodsOn two different occasions, five healthy untrained male subjects were required to perform (i) a BFR low-intensity aerobic exercise consisting of 5 sets of 2-min bouts of walking at an exercise intensity of 63–65% HRmax (equivalent to 40% of VO2max), interspersed by 1-min rest; and (ii) similar exercise bouts without BFR (Ctrl). For each condition, venous blood samples were collected at pre- (baseline), immediately and 2-h post-exercise. Baseline and 3-h post-exercise muscle biopsy samples (vastus lateralis) were also performed for protein expression analysis.ResultsHIF-1α, PGC-1α, and VEGF proteins content were significantly higher (P ConclusionThe addition of blood flow restriction during walking exercise initiate a concomitant cell signaling pathways regulating mitochondrial biogenesis, angiogenesis, and skeletal muscle protein expression

Effect of Intermittent Training on Oxidative and Glycolytic Capacity in Rat Skeletal Muscles

Introduction: Any type of exercise protocol has specific effects on the physiology of the body. Thus, according to the purpose of the training program and conditions of the subjects, a specific exercise protocol is needed to be considered. Therefore, the purpose of this study was to assess the effect of intermittent training on oxidative and glycolytic capacity in rat skeletal muscles. Methods: Forty male rats were divided into two old (27 mon, 389±31 g) and young groups (3 ± 4 mon, 224±14 g), each of which were randomly divided into control and experimental groups (n = 10). Training group performed intermittent exercise on a treadmill 6 times /week for 8weeks. It consisted of 10 bouts of 4 min running interspersed by 2 min of active rest. All rats were anesthetized, 24 hours after the last session exercise, and Soleus (SOL) and extensor digitorumlongus (EDL) muscles were removed rapidly. In fact, the tissues were analyzed in regard with CS and LDH enzymes activities. In order to analyze the study data, one way-ANOVA and Tukey's post-hoc tests were applied. Results: The results demonstrated that CS enzyme activity in EDL and SOL muscles increased significantly in both, old (OT) and young groups (YT) (p 0.05). Conclusion: The results suggested that the training method described in the present study can be quite beneficial to the young and old, when a simultaneous increase in oxidative and glycolytic capacity is aimed

Does aerobic exercises induce mtDNA mutation in human blood leucocytes?

The aim of this study was to determine the effect of eight weeks aerobic training on mitochondrial DNA (mtDNA) mutation in human blood leucocytes. Twenty untrained healthy students (training group: n =10, age = 20.7±1.5 yrs, weight = 67.7±10 kg, BF% = 17.5±7.35 & control group: n =10, age = 21±1.3 yrs, weight = 78.5±18.5 kg, BF% = 18.2±6.4) were randomly assigned to two groups and participated in an eight weeks aerobic training program. Blood samples were collected before and after the eight weeks aerobic training. mtDNA mutation were analyzed using a multiplex polymerase chain reaction (PCR) method. Although, all subjects were fairly young and the possibility of mtDNA mutation at normal condition was unlikely, just to be certain, all blood samples were also analyzed for possible mutation. Those subjects who had mutant mtDNA prior to the study, were excluded. The findings show that there were no changes in mtDNA mutation in human leucocytes in both groups before and after eight weeks aerobic training (P>0.05). These results demonstrate that eight week aerobic training dose not causes mtDNA mutation in human blood leucocytes.Key words: mtDNA; Oxidative stress; Common deletion; Aerobic training