THE ACUTE EFFECTS OF A HIGH GLYCEMIC INDEX MEAL COMBINED WITH PROLONGED SITTING ON VASCULAR FUNCTION: A RANDOMIZED CROSSOVER TRIAL

Chronic prolonged sitting and consumption of high glycemic index (GI) meals are known to increase the risk of cardiovascular diseases. However, it is currently unknown whether prolonged sitting and consumption of a high GI meal have a combined negative acute effect on local and central arterial stiffness (AS). Therefore, 18 young, healthy participants (21.7±2.5 y, 70% F, 25.5±6.1 kg/m2) were randomized to: 3h sitting with a high GI beverage (HGI) or a low GI beverage (LGI). Prolonged sitting (3 hours) and consumption of a HGI beverage increased central (brachial-femoral) AS, in the LGI (0.27 m/s) and the HGI (0.45 m/s) condition (p=0.027). Peripheral (femoral-ankle) PWV increased (0.211 m/s) regardless of the level of GI consumed. Carotid-femoral PWV was not influenced by prolonged sitting or HGI meal consumption. Sitting increases central and peripheral AS in young, healthy individuals. Consuming a HGI meal has a moderate detrimental effect on central (brachial-femoral) PWV.Master of Art

Acute changes in carotid-femoral pulse-wave velocity are tracked by heart-femoral-pulse-wave velocity

Background: Carotid-femoral pulse-wave velocity (cfPWV) is the reference standard measure of central arterial stiffness. However, it requires assessment of the carotid artery, which is technically challenging, and subject-level factors, including carotid artery plaque, may confound measurements. A promising alternative that overcomes these limitations is heart-femoral PWV (hfPWV), but it is not known to what extent changes in cfPWV and hfPWV are associated. Objectives: To determine, (1) the strength of the association between hfPWV and cfPWV; and (2) whether change in hfPWV is associated with change in cfPWV when central arterial stiffness is perturbed. Methods: Twenty young, healthy adults (24.0 [SD: 3.1] years, 45% female) were recruited. hfPWV and cfPWV were determined using Doppler ultrasound at baseline and following a mechanical perturbation in arterial stiffness (120mmHg thigh occlusion). Agreement between the two measurements was determined using mixed-effects regression models and Bland-Altman analysis. Results: There was, (1) strong (ICC >0.7) agreement between hfPWV and cfPWV (ICC= 0.82, 95%CI: 0.69,0.90), and, (2) very strong (ICC >0.9) agreement between change in hfPWV and cfPWV (ICC = 0.92, 95%CI: 0.86,0.96). cfPWV was significantly greater than hfPWV at baseline and during thigh occlusion (both P <0.001). Inspection of the Bland-Altman plot, comparing cfPWV and corrected hfPWV, revealed no measurement magnitude bias. Discussion: The current findings indicate that hfPWV and cfPWV are strongly associated, and that change in cfPWV is very strongly associated with change in hfPWV. hfPWV may be a simple alternative to cfPWV in the identification of cardiovascular risk in clinical and epidemiological settings

New Patient Telephonic Visits

PMG Oregon currently schedules approximately 60,000 New Patient visits each year. New patients are often seen at their first visit, with very little, and/or, without most up-to-date medical information transferred to their new clinical care team. The delay or lack of information results in challenges to our clinic teams to provide the best care for our new patients. It also results in providers/care teams spending additional time entering clinical data either during the new patient appointment, after the appointment, and often additional appointments are needed to address patient problems that could be completed in the initial visit

Validity and reliability of lower-limb pulse-wave velocity assessments using an oscillometric technique

There is a growing interest in the deleterious effects of sedentary behaviour on lower-limb arterial health. To permit further investigation, including in larger epidemiological studies, there is a need to identify lower-limb arterial health assessment tools that are valid and reliable, yet simple to administer. Purpose: This study sought to determine the validity and between-day reliability of femoral-ankle pulse-wave velocity (faPWV) measures obtained using an oscillometric-based device (SphygmocCor XCEL) in supine and seated positions. Doppler ultrasound (US) was used as the criterion. Methods: A total of 47 healthy adults were recruited for validity (n=32) and reliability (n=15) analyses. Validity was determined by measuring faPWV in seated and supine positions using the XCEL and US devices, in a randomised order. Between-day reliability was determined by measuring seated and supine faPWV using the XCEL on 3 different mornings, separated by a maximum of 7 days. Results: The validity criteria (absolute standard error of estimate [aSEE] <1.0 m/s) was met in the supine (aSEE = 0.8 m/s, 95% CI: 0.4-1.0), but not the seated (aSEE = 1.2 m/s, 95 % CI: 1.1, 1.2) position. Intras-class correlation coefficient estimates revealed the XCEL demonstrated good reliability in the supine position (ICC=0.83, 95% CI: 0.65, 0.93), but poor reliability in the seated position (ICC = 0.29, 95% CI: 0.23, 0.63). Conclusions: The oscillometric XCEL device can be used to determine lower-limb PWV with acceptable validity and reliability in the conventionally recommended supine position, but not the seated position

Local Exercise Does Not Prevent the Aortic Stiffening Response to Acute Prolonged Sitting: A Randomized Crossover Trial

Prolonged sitting has been shown to promote endothelial dysfunction in the lower legs. Furthermore, it has been reported that simple sitting-interruption strategies, including calf raises, prevent leg endothelial dysfunction. However, it is unclear whether prolonged sitting affects central cardiovascular health, or whether simple sitting-interruption strategies prevent impaired central cardiovascular health. This study sought to answer two questions: in young, healthy adults 1) does prolonged sitting (3 h) lead to increased aortic stiffness, and 2) do intermittent calf raise exercises to prevent pooling prevent aortic stiffening. Twenty young, healthy participants (21.7 ± 2.5 yr, 70% female, 25.5 ± 6.1 kg/m2) were randomized to 3 h of sitting with (CALF) or without (CON) 10 calf raises every 10 min. Aortic stiffening [carotid-femoral pulse wave velocity (PWV)] was measured in the supine position pre- and post-sitting. Venous pooling during sitting was estimated with total hemoglobin (tHB) concentration using near-infrared spectroscopy. There were no condition × time interactions. Following 3 h of sitting, PWV significantly increased (0.30 ± 0.46 m/s, P \u3c 0.001). There was no condition effect for PWV (P = 0.694), indicating the intermittent calf rises did not preserve central cardiovascular health. tHb was not significantly affected by sitting (P = 0.446) but was 1.9 μM higher for CON versus CALF (P = 0.106). Sitting increases aortic stiffness in young, healthy individuals, a process that may be influenced by lower extremity blood pooling. Calf raises, which have been reported to preserve vascular function in the legs, do not appear to provide sufficient stimulus for maintaining central cardiovascular health

Arterial stiffness responses to prolonged sitting combined with a high-glycemic-index meal: a double-blind, randomized crossover trial

Regular exposure to uninterrupted prolonged sitting and the consumption of high-glycemic-index (HGI) meals is independently associated with increased cardiovascular disease risk. Sitting for as little as 1 h can impair the health of both peripheral and central arteries. However, it is currently unknown whether combined acute exposure to uninterrupted prolonged sitting and an HGI meal is more detrimental to global (peripheral and central) vascular health. The purpose of this study was to investigate the effect of prolonged sitting (3 h), following the consumption of an HGI or a low-glycemic-index (LGI) meal, on global pulse wave velocity (G-PWV). Eighteen healthy participants [70% female, mean (standard deviation, SD) age = 22.6 (3.1) yr, body mass index (BMI) = 25.5 (6.1) kg/m2] sat for 3 h after consuming an HGI or LGI meal. G-PWV was assessed by incorporating three PWV measures (carotid-femoral, brachial-femoral, and femoral-ankle). The effects of time (PRE vs. POST) and condition (LGI vs. HGI) were analyzed using linear mixed models. Following prolonged sitting, G-PWV increased by 0.29 m/s (i.e., PRE vs. POST). However, the condition (P = 0.987) and time × condition (P = 0.954) effects were nonsignificant. The current findings support previous research showing an increase in arterial stiffness with prolonged sitting. However, in young and healthy adults, the arterial stiffness response was not worsened through HGI meal consumption

Arterial Stiffness Responses To Prolonged Sitting Combined With a High-Glycemic-Index Meal: A Double-Blind, Randomized Crossover Trial

Regular exposure to uninterrupted prolonged sitting and the consumption of high-glycemic-index (HGI) meals is independently associated with increased cardiovascular disease risk. Sitting for as little as 1 h can impair the health of both peripheral and central arteries. However, it is currently unknown whether combined acute exposure to uninterrupted prolonged sitting and an HGI meal is more detrimental to global (peripheral and central) vascular health. The purpose of this study was to investigate the effect of prolonged sitting (3 h), following the consumption of an HGI or a low-glycemic-index (LGI) meal, on global pulse wave velocity (G-PWV). Eighteen healthy participants [70% female, mean (standard deviation, SD) age = 22.6 (3.1) yr, body mass index (BMI) = 25.5 (6.1) kg/m2] sat for 3 h after consuming an HGI or LGI meal. G-PWV was assessed by incorporating three PWV measures (carotid-femoral, brachial-femoral, and femoral-ankle). The effects of time (PRE vs. POST) and condition (LGI vs. HGI) were analyzed using linear mixed models. Following prolonged sitting, G-PWV increased by 0.29 m/s (i.e., PRE vs. POST). However, the condition (P = 0.987) and time × condition (P = 0.954) effects were nonsignificant. The current findings support previous research showing an increase in arterial stiffness with prolonged sitting. However, in young and healthy adults, the arterial stiffness response was not worsened through HGI meal consumption

Cerebrovascular function response to prolonged sitting combined with a high‐glycemic index meal: A double‐blind, randomized cross‐over trial

Acute prolonged sitting leads to cerebrovascular disruptions. However, it is unclear how prolonged sitting interacts with other common behaviors, including high-(HGI) and low-glycemic index (LGI) meals. Using a double-blind randomized cross-over design, this study evaluated the effects of prolonged (3 hr) sitting, with a high-(HGI; GI: 100) or low-glycemic index (LGI; GI: 19) meal on total brain blood flow (QBrain) and executive function. Eighteen young, healthy, active participants (22.6 [3.1] y, 33% F, 24.3 [3.7] kg/m2) sat for 3 hr after consuming an HGI or LGI meal. Using Doppler ultrasound to measure internal carotid (ICA) and vertebral (VA) artery blood flow, QBrain was calculated: (ICA blood flow + VA blood flow) × 2. Executive function was assessed using the Stroop Test and Trail Making Test—Part B. Brain fog was measured using a modified Borg Category Scale with Ratio properties (CR10). Following 3 hr of sitting, there was a significant decrease in QBrain with time (p = .001, ES = −0.26), though there were nonsignificant interaction (p = .216) and condition effects (p = .174). Brain fog increased (p = .024, ES = 0.27) and Stroop reaction time worsened with time (p = .001, ES: −0.40), though there were nonsignificant condition effects for brain fog (p = .612) and the Stroop test (p = .445). There was a nonsignificant condition effect (p = .729) for the Trail Making Test—Part B, but completion time improved with time (p = .001, ES = −0.40). In conclusion, 3 hr of prolonged sitting decreases QBrain and executive function independent of glycemic index in young, healthy adults