Body-size phenotypes and cardiometabolic risk in Rheumatoid Arthritis

Objectives: Obesity is a significant contributor to metabolic complications. However, such complications are not uniform in people with similar body-size. The existence of normal-weight individuals with and obese individuals without metabolic complications has been described in the general population and is important in the context of cardiovascular disease (CVD). This has not been investigated in rheumatoid arthritis (RA), a condition associated with increased cardiometabolic risk. This study aims to identify the prevalence and predictors of body-size phenotypes in RA and investigate their associations with CVD risk. Methods: Body mass index (BMI: kg/m2), body fat (BF) and fat free mass (FFM), RA characteristics and CVD risk factors were assessed in 363 (262 females) volunteers with RA. Abnormal cardiometabolic status was defined as the presence of >1 of the following: hypertension, increased triglycerides or increased Low or reduced High Density Lipoprotein, high glucose, insulin resistance. Results: Among normal-weight, overweight, and obese participants 25%, 45.8%, 57.1% respectively were metabolically abnormal. Old age (B= 1.032, err=0.011; p= 0.005), waist circumference (B= 1.057, err= 0.011; p= 0.000), and smoking cessation (B= 1.425, err= 0.169; p=0.036) were significant predictors for metabolic abnormality. Conclusions: A significant number of RA patients present with different body-size and metabolic phenotypes. BMI alone is not a sufficient indicator of cardiometabolic risk in RA; this may have significant implications in their CVD risk evaluation. Body fat distribution seems to be a significant contributor to such abnormalities. Further research is needed, focusing on the metabolic properties of specific adipose depots of RA patient

Fitness in contemporary dance: a systematic review.

It has been suggested that dancers are less fit compared to other athletes. However, the majority of studies make their arguments based on data deriving mainly from ballet. Therefore, the aim of the current review was to investigate: a) aerobic and anaerobic fitness, muscular strength and body composition characteristics in contemporary dancers of different levels, and b) whether supplementary exercise interventions, in addition to normal dance training, further improves contemporary dance performance. Three databases (Medline, Cochrane and the Cumulative Index to Nursing & Allied Health research database) were searched to identify publications regarding the main fitness components of contemporary professional and student dancers. At a professional level, it appears that contemporary dancers demonstrate higher maximal oxygen uptake and higher scores in muscular endurance than ballet dancers. However, contemporary dance students are equally fit compared to their ballet counterparts and their body composition is also very similar. Only two studies have investigated the effects of supplementary exercise training on aspects of dance performance. Further research is needed in order to confirm preliminary data, which suggest that the implementation of additional fitness training is beneficial for contemporary dance students to achieve a better performance outcome

Stretch Intensity vs. Inflammation: A Dose-dependent Association?

The intensity of stretching is rarely reported in scientific literature. In this study, we examined the effects of stretching intensities at 30%, 60%, and 90% of maximum range of movement (mROM) on the inflammatory response of the right hamstring muscle. Methods: A randomised within-subject trial was conducted with 11 healthy recreationally active males over a three week period. Participants were strapped into an isokinetic dynamometer in the supine position, with the right knee fastened in a knee immobilizer. After randomising the ROM percentages, the hamstring muscle was moved to one of the three chosen ROM percentages for that week and held there for 5 x 60 seconds followed by a 10 second rest between repetitions. A 5ml blood sample was collected pre-, immediately post, and at 24 hours post intervention for high sensitivity C-reactive protein (hsCRP) assessments. Results: Significant increases in hsCRP levels were observed between 30% mROM and 90% mROM (p=0.004) and 60% mROM and 90% mROM (p=0.034), but not between 30% and 60% (p>0.05). Conclusions: Muscle stretching at submaximal levels does not elicit a significant systemic inflammatory responses

Acute effects of Vitamin D3 supplementation on muscle strength in Judoka athletes: a randomized placebo-controlled, double-blind trial

Objective: Indoor athletes have been shown to be prone to vitamin D3 deficiency. The aim of the study was to examine the acute effects of vitamin D supplementation on muscle function using isokinetic dynamometry. Design: Randomized placebo-controlled, double-blind study. Setting: Institutional. Participants: Adult male white national level judoka athletes (n = 22) who were involved in full-time training. Exclusion criteria were vitamin supplementation, overseas travel to sunny climes, and/or an injury incurred during the last 3 months before testing. Interventions: Subjects were randomly allocated to the treatment (150 000IU vitamin D3) or placebo and given blinded supplements by an independent researcher. Participants were tested twice, 8 days apart, on a Monday morning before the start of judo training and after 2 days of rest. A 5 to 7 mL of blood sample was collected followed by isokinetic concentric quadriceps and hamstring muscle function assessments on the right leg at 30 and 200°·s. Main outcome measures: Repeated-measures analysis of variance was used to analyze isokinetic muscle force and serum 25(OH)D3. Regression to the mean was used to examine changes in 25(OH)D3 levels over the study period. Results: The treatment group demonstrated a significant increase in serum 25(OH)D levels (34%, P ≤ 0.001) and muscle strength (13%, P = 0.01) between days 1 and 8. No significant differences were found for the placebo group for the same period. Conclusions: A single bolus of 150 000IU vitamin D3 had a significant positive effect on serum 25(OH)D levels and muscle function in vitamin D insufficient elite indoor athletes. Clinical relevance: Serum 25(OH)D3 levels of indoor athletes should be monitored throughout the year and especially during winter months. Beneficial responses, in muscle strength and serum 25(OH)D3, to 1 dose of vitamin D3 supplementation can be observed within 1 week of ingestion. Muscle strength is linked to serum 25(OH)D levels. Acute Effects of Vitamin D3 Supplementation on Muscle Strength in Judoka Athletes: A Randomized Placebo-Controlled, Double-Blind Trial (PDF Download Available). Available from: https://www.researchgate.net/publication/283499805_Acute_Effects_of_Vitamin_D3_Supplementation_on_Muscle_Strength_in_Judoka_Athletes_A_Randomized_Placebo-Controlled_Double-Blind_Trial [accessed May 10, 2016]

The Effects of Different Passive Static Stretching Intensities on Recovery from Unaccustomed Eccentric Exercise - A Randomized Controlled Trial

Effects of passive static stretching intensity on recovery from unaccustomed eccentric exercise of right knee extensors was investigated in 30 recreationally active males randomly allocated into three groups: high-intensity (70-80% maximum perceived stretch), low-intensity (30-40% maximum perceived stretch), and control. Both stretching groups performed 3 sets of passive static stretching exercises of 60s each for hamstrings, hip flexors, and quadriceps, over 3 consecutive days, post-unaccustomed eccentric exercise. Muscle function (eccentric and isometric peak torque) and blood biomarkers (CK and CRP) were measured before (baseline) and after (24, 48, and 72h) unaccustomed eccentric exercise. Perceived muscle soreness scores were collected immediately (time 0), and after 24, 48, and 72h post-exercise. Statistical time x condition interactions observed only for eccentric peak torque (p=.008). Magnitude-based inference analyses revealed low-intensity stretching had most likely, very likely, or likely beneficial effects on perceived muscle soreness (48-72h and 0-72h) and eccentric peak torque (baseline-24h and baseline-72h), compared with high-intensity stretching. Compared with control, low-intensity stretching had very likely or likely beneficial effects on perceived muscle soreness (0-24h and 0-72h), eccentric peak torque (baseline-48h and baseline-72h), and isometric peak torque (baseline-72h). High-intensity stretching had likely beneficial effects on eccentric peak torque (baseline-48h), but likely harmful effects eccentric peak torque (baseline-24h) and CK (baseline-48h and baseline-72h), compared with control. Therefore, low-intensity stretching is likely to result in small-to-moderate beneficial effects on perceived muscle soreness and recovery of muscle function post-unaccustomed eccentric exercise, but not markers of muscle damage and inflammation, compared with high-intensity or no stretching.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Effects of physical activity on the link between PGC-1a and FNDC5 in muscle, circulating Ιrisin and UCP1 of white adipocytes in humans: A systematic review

Background: Exercise may activate a brown adipose-like phenotype in white adipose tissue. The aim of this systematic review was to identify the effects of physical activity on the link between peroxisome proliferator-activated receptor gamma coactivator 1-alpha (PGC-1a) and fibronectin type III domain-containing protein 5 (FNDC5) in muscle, circulating Irisin and uncoupling protein one (UCP1) of white adipocytes in humans. Methods: Two databases (PubMed 1966 to 08/2016 and EMBASE 1974 to 08/2016) were searched using an appropriate algorithm. We included articles that examined physical activity and/or exercise in humans that met the following criteria: a) PGC-1a in conjunction with FNDC5 measurements, and b) FNDC5 and/or circulating Irisin and/or UCP1 levels in white adipocytes. Results: We included 51 studies (12 randomised controlled trials) with 2474 participants. Out of the 51 studies, 16 examined PGC-1a and FNDC5 in response to exercise, and only four found increases in both PGC-1a and FNDC5 mRNA and one showed increased FNDC5 mRNA. In total, 22 out of 45 studies that examined circulating Irisin in response to exercise showed increased concentrations when ELISA techniques were used; two studies also revealed increased Irisin levels measured via mass spectrometry. Three studies showed a positive association of circulating Irisin with physical activity levels. One study found no exercise effects on UCP1 mRNA in white adipocytes. Conclusions: The effects of physical activity on the link between PGC-1a, FNDC5 mRNA in muscle and UCP1 in white human adipocytes has attracted little scientific attention. Current methods for Irisin identification lack precision and, therefore, the existing evidence does not allow for conclusions to be made regarding Irisin responses to physical activity. We found a contrast between standardised review methods and accuracy of the measurements used. This should be considered in future systematic reviews.PCD and ADF were supported by the European Union 7th Framework Programme [FP7-PEOPLE-2012-IRSES (FUEGO grant no. 612547), and FP7-PEOPLE-2013-IRSES (U-GENE grant no. 319010)]. PS was supported by the Swedish Federal Government under the LUA/ALF agreement (grant no. ALFGBG-431481)

The effects of a home-based physical activity intervention on cardiorespiratory fitness in breast cancer survivors; a randomised controlled trial

The aim of this current randomised controlled trial was to evaluate the effects of a home-based physical activity (PA) intervention on cardiorespiratory fitness in breast cancer survivors. Thirty-two post-adjuvant therapy breast cancer survivors (age = 52 ± 10 years; BMI = 27.2 ± 4.4 kg∙m2) were randomised to a six-month home-based PA intervention with face-to-face and telephone PA counselling or usual care. Cardiorespiratory fitness and self-reported PA were assessed at baseline and at six-months. Participants had a mean relative V̇O2max of 25.3 ± 4.7 ml∙kg−1∙min−1, which is categorised as “poor” according to age and gender matched normative values. Magnitude-based inference analyses revealed likely at least small beneficial effects (effect sizes ≥.20) on absolute and relative V̇O2 max (d = .44 and .40, respectively), and total and moderate PA (d = .73 and .59, respectively) in the intervention compared to the usual care group. We found no likely beneficial improvements in any other outcome. Our home-based PA intervention led to likely beneficial, albeit modest, increases in cardiorespiratory fitness and self-reported PA in breast cancer survivors. This intervention has the potential for widespread implementation and adoption, which could considerably impact on post-treatment recovery in this population

Role of UCP1 gene variants in interethnic differences in the development of cardio-metabolic diseases

Cardio-metabolic diseases (CMDs) comprise a cluster of risk factors that contribute to chronic pathological conditions with adverse consequences for cardiovascular function and metabolic processes. A wide range of CMD prevalence rates among different ethnic groups has been documented. In view of accumulated evidence, there is a trend toward increasing CMD prevalence rates in Eastern Europe and Western Asia. Numerous studies have revealed an association between uncoupling protein 1 (UCP1) gene variants and CMDs. UCP1 activity is essential for brown adipose tissue (BAT)-mediated thermogenesis. Experimental animal studies and epidemiological studies in humans highlight the significance of BAT-mediated thermogenesis in protecting against obesity and maintaining a lean phenotype. We hypothesize that the genetic variation in UCP1 gene expression observed among different ethnic groups could contribute to the ethnic-specific predisposition to CMD development. Constructing such prevalence maps of UCP1 gene variants could contribute significantly into identifying high-risk ethnic groups predisposed to the development of CMDs, and further shaping public health policies by the improvement of existing preventive and management strategies

Sedentary behaviour in rheumatoid arthritis: definition, measurement and implications for health

This is an accepted manuscript of an article published by Oxford Academic in Rheumatology on 07/04/2017, available online: https://doi.org/10.1093/rheumatology/kex053 The accepted version of the publication may differ from the final published version.RA is a chronic autoimmune disease characterized by high grade-inflammation, and associated with elevated cardiovascular risk, rheumatoid-cachexia and functional impairment. Sedentary behaviour (SB) is linked to heightened inflammation, and is highly pervasive in RA, likely as a result of compromised physical function and persistent fatigue. This high sedentarity may exacerbate the inflammatory process in RA, and hold relevance for disease-related outcomes. The aim of this narrative review is to provide an overview of the definition, measurement and health relevance of SB in the context of RA. Contradictions are highlighted with regard to the manner in which SB is operationalized, and the significance of SB for disease outcomes in RA is outlined. The advantages and disadvantages of SB measurement approaches are also discussed. Against this background, we summarize studies that have reported SB and its health correlates in RA, and propose directions for future research

Association of fat mass profile with natriuretic peptide receptor alpha in subcutaneous adipose tissue of medication-free healthy men: A cross-sectional study

Background: Atrial natriuretic peptide increases lipolysis in human adipocytes by binding to natriuretic peptide receptor-A (NPRA). The aim of the current study was to examine the associations of NPRA mRNA of subcutaneous adipose tissue with fat mass, fat-free mass, body mass index (BMI) and arterial blood pressure in medication-free healthy men. Method: Thirty-two volunteers [age (years): 36.06±7.36, BMI: 27.60±4.63 (kg/m2)] underwent assessments of body height/weight, % fat mass, fat-free mass (kg), blood pressure, and a subcutaneous adipose tissue biopsy via a surgical technique. Results: We found that NPRA mRNA was negatively associated with % fat mass (r=-0.40, R2=0.16, p=0.03) and BMI (r=-0.45, R2=0.20, p=0.01). Cohen’s f2 effect size analyses showed a small effect size between NPRA mRNA and BMI (f2=0.25). One-way analysis of variance with Bonferroni post-hoc tests showed a tendency for mean differences of NPRA mRNA across BMI categories (p=0.06). This was confirmed by Cohen’s d effect size analyses revealing a large effect size of NPRA mRNA between obese individuals (BMI≥30 kg/m2) and either normal weight (BMI=19-25 kg/m2; d=0.94) or overweight (BMI=25-30 kg/m2; d=1.12) individuals. Conclusions: NPRA mRNA is negatively associated with % fat mass and BMI in medication-free healthy men, suggesting a possible role of NPRA in the control of fat mass accumulatio