Exercise intensity, redox homeostasis and inflammation in type 2 diabetes mellitus

Objectives: To compare 12 weeks of exercise training at two intensities on oxidative stress, antioxidants and inflammatory biomarkers in patients with type 2 diabetes (T2D)

Therapeutic hypothermia translates from ancient history in to practice

Acute postasphyxial encephalopathy around the time of birth remains a major cause of death and disability. The possibility that hypothermia may be able to prevent or lessen asphyxial brain injury is a “dream revisited”. In this review, a historical perspective is provided from the first reported use of therapeutic hypothermia for brain injuries in antiquity, to the present day. The first uncontrolled trials of cooling for resuscitation were reported more than 50 y ago. The seminal insight that led to the modern revival of studies of neuroprotection was that after profound asphyxia, many brain cells show initial recovery from the insult during a short “latent” phase, typically lasting ~6 h, only to die hours to days later during a “secondary” deterioration phase characterized by seizures, cytotoxic edema, and progressive failure of cerebral oxidative metabolism. Studies designed around this conceptual framework showed that mild hypothermia initiated as early as possible before the onset of secondary deterioration, and continued for a sufficient duration to allow the secondary deterioration to resolve, is associated with potent, long-lasting neuroprotection. There is now compelling evidence from randomized controlled trials that mild induced hypothermia significantly improves intact survival and neurodevelopmental outcomes to midchildhood

Testofen® (Fenugreek extract) Increases Strength and Muscle Mass Compared to Placebo in Response to Calisthenics: A Randomized Control Trial

This randomised, placebo controlled, double‐blind study aimed to examine changes in muscular strength and endurance, body composition, functional threshold power, and sex hormones in response to an 8‐week calisthenic programme with daily supplementation with Testofen® (Fenugreek extract) or a placebo. A total of 138 male participants (25‐47yrs) were enrolled and randomized to three equal groups: 600 mg Testofen®/day, 300 mg Testofen®/day or placebo. Muscle strength and endurance, functional threshold power, body composition, and sex hormones were measured at baseline, weeks 4 and 8. Participants completed a whole‐body calisthenic programme three times a week. All groups improved their maximal leg press from baseline to 8 weeks, however, both Testofen® treated groups improved more than placebo (P \u3c .05). The 600 mg group showed decreases in body mass of 1.2 kg, −1.4% body fat and an increase in lean mass (1.8%) at 8 weeks. The 600 mg group also demonstrated an increase in testosterone concentration from baseline to 8 weeks. This study indicates that Testofen® may be an effective ergogenic aid for individuals wanting to rapidly improve their exercise performance capabilities and body composition above and beyond that of calisthenic exercise alone

Curcumin improves delayed onset muscle soreness and postexercise lactate accumulation

The efficacy of curcumin supplementation is traditionally limited due to its poor bioavailability. Despite this, curcumin has previously been shown to improve biomarkers of muscle damage. The addition of a novel drug delivery system that improves bioavailability could improve exercise recovery. The purpose of this randomized double-blind placebo-controlled study was to assess the effect of curcumin (combined with LipiSperse) when consumed as a drink on exercise recovery in recreationally trained healthy males aged 18–35 yrs. The study included 28 young healthy males with strength training experience. The participants undertook lower limb resistance exercise to exhaustion. Fourteen participants received curcumin dispersed in water pre and postexercise and 14 received a matched placebo drink. Pain (visual analogue scale), thigh circumference (TC), lactate, creatine kinase, lactate dehydrogenase, high sensitivity C-reactive protein, myoglobin, interleukin-6, interleukin-10, and tumor necrosis factor-alpha were assessed pre, postexercise and 1, 2, 3, 24, 48, and 72 h postexercise. There was less appearance of postexercise capillary lactate in the curcumin group compared to placebo (7.4 vs 8.8 mmol/L). The placebo group rated overall muscle pain as higher compared to the curcumin group at 48- and 72-h postexercise. TC was reduced in the curcumin group compared to the placebo group at 24- and 48-h postexercise. The results suggest curcumin may facilitate a quicker return to exercise training and/or allow a higher training intensity than a placebo by reducing postexercise pain, modulating inflammatory pathways and reducing lactate accumulation in an exercising population

Nuclear Factor (erythroid-derived 2)-like 2 (Nrf2) and exercise

Chronic metabolic health diseases are increasing worldwide placing strain on healthcare systems and importantly, impacting individuals’ quality of life. It is well established that many chronic diseases are associated with inflammation and oxidative stress. Exercise is a known strategy to manage and treat inflammation in animals and humans. Understanding the mechanisms which cause acute and chronic changes to systems via various exercise protocols may provide insights into how we can better clinically manage patients with inflammatory and oxidative stress associated diseases. Nrf2 is a basic leucine transcription factor which regulates the expression of antioxidant proteins to protect against damage caused by electrophilic or oxidative stress. The aim of this narrative review is to provide an overview of the literature which has investigated the relationship between acute and chronic exercise training and Nrf2 protein, mRNA and Nrf2-ARE binding activity. This narrative review presents analysis of twenty-nine articles presenting studies using animals and humans. Findings from animal models suggest that exercise increases all molecular aspects of the Nrf2-ARE pathway in all tissues studied. It was noted that there seems to be an age-related decline in Nrf2 protein upregulation with exercise training. In humans, however, there is a lack of evidence to support this claim

Protein supplements: Do they alter dietary intakes?

Effects of protein versus mixed macronutrient supplementation on total energy intake (TED and protein intake during an ad libitum diet were examined. Trained males undertook two, 2-week dietary interventions which were randomized, double blinded, and separated by 2 weeks. These were high-protein supplementation (HP: 1034.5 kJ energy, 29.6 g protein, 8.7 g fat and 12.3 g CHO) and standard meal supplementation (SM: 1039 kJ energy, 9.9 g protein, 9.5 g fat, and 29.4 g CHO) consumed daily following a week of baseline measures. Eighteen participants finished both interventions and one only completed HP. TEl (mean SD) was not different between baseline (11148 +/- 3347 kJ) and HP (10705 +/- 3143 kJ) nor between baseline and SM (12381 3877 kJ), however, TEl was greater with SM than HP (923 4015 kJp =.043). Protein intake (%TEI) was greater with HP (22.4 +/- 6.2%) than baseline (19.4 +/- 5.4%; p =.008) but not SM (20.0 5.0%). No differences in absolute daily protein intake were found. Absolute CHO intake was greater with SM than HP (52.0 +/- 89.5 g, p =.006). No differences in fat intake were found. Body mass did not change between baseline (82.7 +/- 11.2 kg) and either HP (83.1 +/- 11.7 kg) or SM (82.9 11.0 kg). Protein supplementation increases the relative proportion of protein in the diet, but doesn't increase the absolute amount of total protein or energy consumed. Thus some compensation by a reduction in other foods occurs. This is in contrast to a mixed nutrient supplement, which does not alter the proportion of protein consumed but does increase TEI

High day-to-day and diurnal variability of oxidative stress and inflammation biomarkers in people with type 2 diabetes mellitus and healthy individuals

Objective: Assess the variability and differences in oxidative stress, antioxidant, and inflammatory biomarkers in people with type 2 diabetes mellitus (T2D) and healthy controls. Methods:: Ten men and women diagnosed with T2D and ten healthy matched controls (CON) were recruited. Participants had venous blood taken at six different time points on different days, three in the morning (after overnight fast) and three in the afternoon. Inflammation (IL-6, 8, 10 and TNF-α), oxidative stress/antioxidant biomarkers (F-isoprostanes, protein carbonyls, total antioxidant capacity (TAC), glutathione peroxidase activity, IL-6, 8 & 10 and TNF-α) were assessed. Results:: Biomarker concentrations were similar between groups. There was large variability in nearly all biomarkers for both groups. For inflammatory measures, intra-individual coefficients of variation (CV) ranged from 64.0–92.1% and 100.9–259.0% for inter-individual differences. CVs for oxidative stress markers were lower (7.4–31.2% for intra-individual and 8.6–43.0% for inter-individual). TAC had the lowest intra-individual CV–7% for T2D and 8% for CON. Protein carbonyls were more variable in the afternoon (34% CV) compared to morning (24% CV) in CON. IL-6 intra-individual CV was different between groups for afternoon measurements (93% T2D, 60% CON). Conclusion:: Oxidative stress and inflammatory biomarkers show considerable variation in both T2D and healthy populations. Trial registration:ClinicalTrials.gov identifier: NCT01206725

Variability of oxidative stress biomarkers in hemodialysis patients

Oxidative stress biomarkers may have a role in the future to assist clinical decisions regarding the use of antioxidant therapies and their efficacy. The aims of this study were to evaluate the within and between-individual variability of plasma oxidative stress biomarkers and investigate factors affecting their variability. Plasma F2-isoprostanes and protein carbonyls were measured in 14 hemodialysis patients every 2 weeks for 10 weeks. Within-individual coefficients of variation (CVs) were isoprostanes = 30.4% (range = 6.1–66.7%) and protein carbonyls = 16.3% (8.4–29.5%). Between-individual CVs were isoprostanes = 34.4% (28.9–40.2%) and protein carbonyls = 19.5% (15.6–24.5%). There were no significant (p > 0.05) relationships between the oxidative stress biomarkers and dietary antioxidant intake, medications, clinical and demographic parameters

A self-emulsifying Omega-3 ethyl ester formulation (AquaCelle) significantly improves eicosapentaenoic and docosahexaenoic acid bioavailability in healthy adults

Purpose: Application of intelligent formulation design has the ability to address the poor bioavailability and improve the fasted state bioavailability of fish oils. In this study we assessed the ability of a self-emulsifying drug delivery system (SEDDS), AquaCelle (R), as an additive to enhance the oral absorption of Omega-3 ethyl esters (EE) in healthy subjects under low-fat diet conditions. Methods: Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) EE were formulated with AquaCelle (R). A single dose (680 mg dose of oil containing 272 mg of EPA EE and 204 mg of DHA EE), randomized, double-blind, study measured uptake of EPA and DHA over 24 h in healthy adults. Participants were randomized into two groups, receiving either the SEDDS AquaCelle (R) fish oil formulation or the unformulated fish oil EE as control. Results: The AquaCelle (R) fish oil EE formulation demonstrated instant and complete emulsification on addition to water to produce an emulsion with an average diameter of 43 mu m, compared to the oil alone which did not emulsify. The study revealed a significant difference in absorption (C-max and AUC(0-24h)) between the AquaCelle (R) group and the control group. The AquaCelle (R) group was capable of increasing maximum plasma concentrations and absorption (AUC(0-24h)) of total Omega-3 (EPA + DHA) 3.7- and 7.1-fold, respectively, compared to the control. Conclusion: Formulating Omega-3 EE with a SEDSS concentrate (AquaCelle (R)) demonstrated a significant improvement in the oral absorption of Omega-3 fatty acids without requiring a high-fat meal. Graphic abstract

The association between metabolic syndrome severity and oxidative stress induced by maximal exercise testing – A cross-sectional study

Oxidative stress (OS) has been implicated in the pathogenesis of metabolic syndrome (MetS). The acute change in OS biomarkers due to exercise, known as exercise-induced OS (EIOS), is postulated to be a more appropriate marker of OS compared to spot OS measures. These studies objectives were to investigate EIOS in participants with MetS and compare the associations between EIOS, spot OS measures and MetS severity.Sixty-three participants with MetS had MetS severity assessed using the MetS Z-score. Participants undertook a cardiorespiratory fitness test ( Opeak) to volitional exhaustion (∼8-12 minutes). Plasma OS (total F2-isoprostanes (IsoP), protein carbonyls (PCs)) and antioxidant (glutathione peroxidase (GPx), total antioxidant status (TAS)) biomarkers were measured from samples obtained before and five\ua0minutes post- Opeak test. Wilcoxon's signed-rank tests were used to determine changes in OS markers.There were no significant (p > 0.05) changes in OS or antioxidant biomarkers from pre- to post-exercise (median (interquartile range): IsoP -15.5 (-71.8 to 47.8) pg/mL; PC -0.01 (-0.16 to 0.13) nmol/mg protein; GPx 0.76 (-4.94 to 9.82) U/L, TAS 0.03 (0.00-0.05) mmol/L).A Opeak test to exhaustion failed to induce OS in participants with MetS. There were no associations between MetS severity and spot OS or EIOS biomarkers