Effects of novel creatine formulation supplementation on muscle strength, muscle volume and biochemical indicators in people older than 65 years

Uvod: Kreatin je dobro poznat suplement koji za poboljšanje performansi koriste sportisti. U poslednje vreme sve je više istraživanja koja ispituju suplementaciju kreatinom kod starijih osoba zbog brojnih pozitivnih efekata na kontrolu šećera u krvi, lipidni status, mišićno-koštani sistem i potencijalnog neuroprotektivnog delovanja. Cilj ovog istražívanja je da se utvrde efekti suplementacije kombinacije kreatina i prekursora kreatina guanidinosirćetne kiseline (GAA) na mišićnu snagu, mišićnu masu, biohemijske i indikatore tkivno ćelijske bioenergetike, funkcionalne sposobnosti, kvalitet života povezan sa zdravljem i kognitivne funkcije starijih osoba. Materijali i metode: U istraživanju je učestvovala 21 osoba treće životne dobi (starost 69.6±4.9 godina, visina 162.7±7.7cm, telesna masa 73.3±12.4kg, 13 žena). Suplementacija je trajala 8 nedelja u režimu dvostruko-slepe, placebo kontrolisane randomizovane krosover studije. Eksperimentalna grupa je konzumirala kombinaciju kreatina (Cr) i guanidinosirćetne kiseline (GAA) (4 grama dnevno), a placebo grupa ekvivalentnu količinu inulina (4 grama dnevno); doza je rastvorena u mlakoj vodi (250 mL) i uzimana jednom dnevno pre doručka. Inicijalno i po završetku suplementacije sprovedena su a ntropometrijska merenja, dinamometrija stiska šake, analiza sastava tela, testovi funkcionalno-motoričkih sposobnosti, biohemijske analize, magnetna spektroskopija mozga i mišića te upitnici za procenu kvaliteta života povezanog sa zdravljem, sarkopenije, nivoa fizičke aktivnosti i kognitivnih sposobnosti. Rezultati: Statistički značajne razlike na kraju režima suplementacije između grupa utvrđene su za testove motoričkih sposobnosti - 5xTest ustajanja sa stolice (pre 14.3±3.0s vs. Cr+GAA grupa 11.8±2.1s, placebo 12.1±2.4sec; p<0.001) i Timed-Up and Go Test (pre 10.4±2.0s vs. Cr+GAA grupa 9.1±0.0s, placebo 9.6±1.9sec; p<0.001), obim desne (pre 30.5±2.9cm vs. Cr+GAA grupa 31.9±2.8cm, placebo 31.6±3.4cm; p<0.001) i leve nadlaktice (pre 30.1±3.0cm vs. Cr+GAA grupa 31.8±3.1cm, placebo 31.9±0.1cm; p<0.001), vrednosti glukoze u krvi (pre 4.7±0.5mmol/L vs. Cr+GAA grupa 5.1±0.7mmol/L, placebo 4.9±0.5mmol/L; p=0.02), ukupne proteine (pre 78.9±5.7g/L vs. Cr+GAA grupa 73.2±3.8 g/L, placebo 76.6±4.4g/L; p=0.002), stopu bubrežne filtracije (pre 84.4±10.5ml/min vs. Cr+GAA grupa 71.9±12.0ml/min, placebo 75.3±12.9ml/min; p<0.001), vrednosti kreatina (pre 12.9±4.5umol/L vs. Cr+GAA grupa 22.9±12.2umol/L, placebo 18.3±4.2umol/L; p=0.01), GAA (pre 1.9±0.8umol/L vs. Cr+GAA grupa 2.8±0.8umol/L, placebo 2.6±1.4umol/L; p=0.002) i kreatinina (pre 68.5±17.4umol/L vs. Cr+GAA grupa 110.1±27.4umol/L, placebo 118.3±24.7umol/L; p<0.001) u serumu, te dijastolni krvni pritisak (pre 78.4±9.3mm/Hg vs. Cr+GAA grupa 86.9±8.6mm/Hg, placebo 89.7±10.3mm/Hg; p<0.001). Protonska magnetna spektroskopija mišića pokazala je statistički značajno povećanje vrednosti kreatina u Cr+GAA grupi (pre 28.1±7.0mM vs. Cr+GAA grupa 36.9±9.2mM; p=0.002) te statistički značajne razlike između muškaraca i žena u Cr+GAA grupi (46.3±0.3mM vs. 30.7±4.6mM; p=). Statistički značajno povećanje N acetil aspartata (NAA) u mozgu zabeleženo je samo na jednom vokselu u beloj masi desnog frontalnog režnja (BM2) (pre 7.2±1.9mM vs. Cr+GAA grupa 8.1±0.7mM; p=0.03), kao i značajne razlike između muških i ženskih ispitanika za vrednosti holina u sivoj masi desne središnje parijetalne regije (SM12) (2.1±0.4mM vs. 1.1±0.1mM; p=0.02). Vrednosti kreatina rasle su u gotovo svim posmatranim vokselima u eksperimentalnoj grupi, ali statistički značajno samo u BM2 (pre 5.8±0.5mM vs. Cr+GAA grupa 6.3±0.4mM; p=0.002). U tri su voksela za kreatin utvrđene statistički značajne razlike između muškaraca i žena u Cr+GAA grupi za desni parijetalni režanj (BM10) (5.5±0.3mM vs.6.3±0.5mM; p=0.01), lijevu (SM11) (11.3±0.4mM vs. 8.0±0.9mM; p=0.01) i desnu središnju parijetalnu regiju sive mase (SM12) (11.3±1.7mM vs. 8.2±1.4mM; p=0.03). Procena kvaliteta života pokazala je statistički značajne razlike u zbirnim skalama fizičkog funkcionisanja (PCS) (pre 52.0±4.6 vs. Cr+GAA grupa 55.7±9.1, placebo 54.6±6.7; p=0.001) i mentalnog zdravlja (MCS) (pre 55.0±3.8 vs. Cr+GAA grupa 66.4±7.1, placebo 63.7±9.9; p<0.001). Zaključak: Unos kreatina i GAA tokom 8 nedelja pokazao je pozitivne efekte na poboljšanje funkcionalnih sposobnosti starih osoba, što može da ima korisne posledice u kontekstu unapređenja pojedinih komponenti zdravlja. Poboljšanje biomarkera tkivne bioenergetike mozga i mišića nakon suplementacije može da ima pozitivne efekte na unapređenje metabolizma kod cerebrovaskularnih i kardiovaskularnih bolesti starijih osoba.Background: Creatine is a recognized ergogenic agent used by athletes to improve performance. Recently it has been investigated as beneficial for older people due to positive effects on glycemic control, lipid profile, functioning of the musculoskeletal system, and possible neuroprotective action. In this research, the aim was to determine the effects of supplementation with creatine and guanidinoacetic acid on muscle strength, muscle mass, serum biomarkers, and indicators of tissue bioenergetics, quality of life and cognitive functioning of older people. Materials and Methods: A total of 21 subjects participated in this trial (69.6±4.9 years; 162.7±7.7cm; weight 73.3±12.4kg, 13 women). Supplementation protocol lasted for 8 weeks as a double-blind placebo controlled crossover type of study. Experimental group ingested combination of creatine (Cr) + gunidinoacetate acid (Cr+GAA) (4 gr) once a day before breakfast, diluted in water (250 mL); placebo group consumed equivalent of inulin (4 gr). At baseline and after 8 weeks following measurements were performed: antropometry (upper arm, thigh, waist and hip girth, triceps and abdominal skinfold), body composition using bioimpedance, biochemical analyses, muscle and brain proton magnetic resonance spectroscopy, 5x Sit to Stand test, Timed up and Go Test, 4-m Speed Gait Test, and following questionnaires – The Short-form 36 Ouestionnaire, Sarcopenia and Quality of Life, International Physical Activity Questionairre – Short Form and Montreal Cognitive Assesment. Results: Statistically significant differences between groups following supplementation were found for 5x Sit to Stand test (at baseline 14.3±3.0s vs. experimental group 11.8±2.1s, control 12.1±2.4s; p<0.001), Timed-Up and Go Test (at baseline 10.4±2.0s vs. Cr+GAA 9.1±0.0s, control 9.61±1.9s; p<0.001), right (at baseline 30.5±2.9cm vs. Cr+GAA 31.9±2.8cm, control 31.6±3.4cm; p<0.001) and left upperarm girth (at baseline 30.1±3.0cm vs. Cr+GAA 31.8±3.1cm, placebo 31.9±0.01cm; p<0.001), blood glucose level (at baseline 4.7±0.6mmol/L vs. Cr+GAA 5.1±0.7mmol/L, control 4.9±0.5mmol/L; p=0.02), total serum protein (at baseline 78.9±5.7g/L vs. Cr+GAA 73.2±3.8g/L, control 76.6±4.4g/L; p=0.002), glomerular filtration (at baseline 84.4±10.5ml/min vs. Cr+GAA 71.9±12.0ml/min, control 75.3±12.9ml/min; p<0.001), serum creatine level (at baseline 12.9±4.5umol/L vs. Cr+GAA 22.9±12.2umol/L, control 18.3±4.2umol/L; p=0.01), GAA blood concentration (at baseline 1.9±0.8umol/L vs. Cr+GAA 2.8±0.8umol/L; control 2.6±1.4umol/L; p=0.002), serum creatinine level (at baseline 68.5±17.4umol/L vs. Cr+GAA 110.1±27.4umol/L, control 118.3±24.7umol/L; p<0.001) and diastolic blood pressure (at baseline 78.4±9.3mm/Hg vs. Cr+GAA 86.9±8.6mm/Hg, control 89.7±10.3mm/Hg; p<0.001). Proton magnetic resonance spectroscopy of the vastus medialis muscle showed a significant increase in muscle creatine level (at baseline 28.1±7.0mM vs. Cr+GAA 36.9±9.2mM; p=0.002) and significant sex differences (46.3±0.3mM vs. 30.7±4.6mM; p=0.008). N-acetyl aspartate (NAA) brain level significantly increased in right frontal lobe white matter (at baseline 7.2±1.9mM vs. Cr+GAA 8.1±0.7mM; p=0.03), choline showed no significant changes except between men and women in midline right parietal region grey matter (2.1±0.4mM vs. 1.1±0.1mM; p=0.02). Creatine brain level increased in almost all of the voxels but significantly just in the right frontal lobe white matter (at baseline 5.8±0.5mM vs. Cr+GAA 6.3±0.4mM; p=0.002). Significant differences were observed for men and women in the Cr+GAA group in the right parietal lobe white matter (5.5±0.3mM vs. 6.3±0.5mM; p=0.01), left (11.3±0.4mM vs. 8.0±0.9mM; p=0.01) and right midline parietal region grey matter (11.3±1.7mM vs. 8.2±1.4mM; p=0.03). The Short form 36 Quality of Life questionnaire physical component summary (PCS) (at baseline 52.0±4.6 vs. Cr+GAA 55.7±9.1, control 54.6±6.7; p=0.001) and mental component summary (MCS) (at baseline 55.0±3.8 vs. Cr+GAA 66.4±7.1, control 63.7±9.9; p<0.001) showed significant differences post administration in Cr+GAA group. Conclusion: Creatine and GAA 8-week administration demonstrated positive effects on functional abilities of the elderly, having the potential to benefit particular components of health. Improvements in brain and muscle tissue bioenergetics may lead to metabolism promotion preventing cerebrovascular and cardiovascular diseases of older people

Body Components Differences and Their Impact of Phase Angle Values in Athletes and Non-athletes

Introduction: The aim of this paper was to determine PhA values in athletes and sedentary population. The specific aim was to determine differences between subjects of the same sex and with a different level of physical activity, as well as the factors affecting PhA values. Materials and Methods: Sixty-six athletes and sedentary students participated in the research. They were divided into four groups according to sex and level of physical activity. Routine BIA at 50 kHz was performed and BMI, PBF, FFM, PMM, TBW, ECW, ICV, ECW/ICE ratio, BMR, BM, PhA and impedance were measured. Results: Male athletes had higher PhA values (6.85±0.5°) compared to male non-athletes (6.29±0.67°), female athletes (5.61±0.44) and female non-athletes (5.47±0.58°). Statistically significant differences were found in men (PhA p=0.004; ECW/ICE ratio p=0.002), but not in women. The highest positive correlation was found in ICW (ρ+0.71 p≤0.01), while the highest negative correlation was found in impedance (ρ-0.79 p≤0.01). PhA variance was mostly due to PMM (B=+0.44, p=0.002). Conclusion: Differences found in male athletes and non-athletes may suggest the influence of physical activity, since the variance in PhA values was mostly due to PMM and a positive correlation with ICW

The impact of strength training on the changes in one’s physique and resting energy expenditure

Background and Purpose: The aim of this research is to determine the way in which the strength training affects the changes in one’s physique and resting energy expenditure. Materials and Methods: 16 sedentary subjects completed strength training for seven weeks, 3 training/week. The examinee’s physique has been analyzed through bioelectrical impedance method (BIA) before and after the seven-week cycle. The variables compared are BW (body weight), WHR (waist-hip ratio), PBF (percent of body fat) and BMR (basal metabolic rate). The differences between the initial and final values have been tested by paired t-test. The correlations between those differences have been expressed by the Pearson correlation coefficient. The level of statistical significance is p=0, 05. Results: The results indicate that the strength training, even in relatively restricted time period, influences the changes in person’s physique, as well as the changes in resting energy expenditure. The mean difference for BMR (p=0.0036), WHR (p=0,022), PBF(p=0,0184) and BW (p=0.0275) have been established for the entire sample. For the males differences were found for BMR (p=0,002), PBF (p=0,0417) and BW (p=0.0280), but no significant change in WHR. No statistically significant changes were found in female group. Correlation was found for differences in results for BMR vs BW r=0.698 (p=0.003), BMR vs WHR r=-0.578 (p=0.019), and PBF vs WHR r=0,671 (p=0,004). Conclusions: The overall changes in one’s physique and energy expenditure indicate that the strength training needs to be one of the crucial factors in physical activity, aimed at the improvement of person’s health

CHRONIC TRAUMATIC ENCEPHALOPATHY: DIAGNOSTIC CRITERIA AND THERAPEUTIC MODELS

Kronička traumatska encefalopatija je neurodegenerativna bolest koja se ubraja u skupinu tauopatija. Povezuje se s opetovanim udarcima u glavu i potresom mozga u sportaša, najčešće u kontaktnim sportovima, hokeju na ledu, nogometu i košarci. Pogađa pojedince u srednjim godinama i nekoliko godina nakon prestanka trauma mozga. Za sada ne postoji jedinstveni dijagnostički kriterij za potvrdu bolesti, ali se provode neuropsihološki i neurološki pregled, analizira krv i cerbrospinalni likvor, te rade snimanja mozga magnetnom rezonancijom i pozitronskom emisijskom tomografi jom. Terapijski modeli uključuju inhibitore stvaranja ROS vrsta, koji se još uvijek intenzivno istražuju, te dodatne metode kao što su prehrambene intervencije, kognitivno bihevioralna terapija, imunoterapija, hiperbarična terapija i druge terapije.The aim of the study was to perform systematic review of the existing literature in order to determine new trends regarding diagnostic criteria and therapeutic models of chronic traumatic encephalopathy (CTE). Review of the literature was done during June 2018. PubMed, ScienceDirect and BioMed Central were included in the search. To identify research and review papers dealing with diagnostic criteria and therapy of CTE, the following key words in English were used: chronic traumatic encephalopathy, diagnosis, therapy. The set criteria was met by 23 papers. CTE is a neurodegenerative disease from the group of tauopathies. There is a connection between repeated head trauma and concussion in athletes, most in contact sports, ice hockey, football and basketball. The condition affects middle-aged individuals, as well as athletes several years after repeated trauma to the head and brain. There are no unique diagnostic criteria confi rming CTE, but neuropsychological and neurological exam, blood and cerebrospinal fl uid analysis need to be performed. Magnetic resonance imaging and positron emission tomography scanning is also useful. Therapeutic models include reactive oxygen species inhibitors (ROS; still under investigation), and some additional models such as nutritional interventions, cognitive-behavioral therapy, immunotherapy, hyperbaric therapy, etc

CHRONIC TRAUMATIC ENCEPHALOPATHY: DIAGNOSTIC CRITERIA AND THERAPEUTIC MODELS

Kronička traumatska encefalopatija je neurodegenerativna bolest koja se ubraja u skupinu tauopatija. Povezuje se s opetovanim udarcima u glavu i potresom mozga u sportaša, najčešće u kontaktnim sportovima, hokeju na ledu, nogometu i košarci. Pogađa pojedince u srednjim godinama i nekoliko godina nakon prestanka trauma mozga. Za sada ne postoji jedinstveni dijagnostički kriterij za potvrdu bolesti, ali se provode neuropsihološki i neurološki pregled, analizira krv i cerbrospinalni likvor, te rade snimanja mozga magnetnom rezonancijom i pozitronskom emisijskom tomografi jom. Terapijski modeli uključuju inhibitore stvaranja ROS vrsta, koji se još uvijek intenzivno istražuju, te dodatne metode kao što su prehrambene intervencije, kognitivno bihevioralna terapija, imunoterapija, hiperbarična terapija i druge terapije.The aim of the study was to perform systematic review of the existing literature in order to determine new trends regarding diagnostic criteria and therapeutic models of chronic traumatic encephalopathy (CTE). Review of the literature was done during June 2018. PubMed, ScienceDirect and BioMed Central were included in the search. To identify research and review papers dealing with diagnostic criteria and therapy of CTE, the following key words in English were used: chronic traumatic encephalopathy, diagnosis, therapy. The set criteria was met by 23 papers. CTE is a neurodegenerative disease from the group of tauopathies. There is a connection between repeated head trauma and concussion in athletes, most in contact sports, ice hockey, football and basketball. The condition affects middle-aged individuals, as well as athletes several years after repeated trauma to the head and brain. There are no unique diagnostic criteria confi rming CTE, but neuropsychological and neurological exam, blood and cerebrospinal fl uid analysis need to be performed. Magnetic resonance imaging and positron emission tomography scanning is also useful. Therapeutic models include reactive oxygen species inhibitors (ROS; still under investigation), and some additional models such as nutritional interventions, cognitive-behavioral therapy, immunotherapy, hyperbaric therapy, etc

Nutrition Patterns in Prevention and Treatment of Neurodegenerative Diseases: Alzheimer’s Disease

Background: The population of the elderly is increasing, as is the number of people suffering from neurodegenerative diseases. Since the cause of those diseases is unknown, there is no appropriate medical treatment. The purpose of this systematic review is to present papers on consumption of certain foods, supplements or introduction of dietary restrictions that promote healthy brain aging or possibly delay the onset of disease. Methods: The PubMed, ScienceDirect, and SpringerLink databases were used for the research. 24 studies with a total number of 10 445 participants were selected as satisfying the final criteria. Results: Mediterranean diet, dietary supplements and natural nutrients with recently discovered pharmacological properties are of interest to numerous scientists. Conclusion: Since the results of the studies are inconsistent, we concluded that a large, carefully controlled long-term interventional study would be required in order to investigate the effect of nutrition on prevention of disease and cognitive decline

Weight Status and Body Composition in Freshman Students at the College of Applied Sciences “Lavoslav Ruzicka” in Vukovar, from 2008 to 2016

Aim: The aim of the study is to analyze the common occurrence of different weight categories among first-year students at Lavoslav Ruzicka College for Applied Sciences in the city of Vukovar, as well as to make an assessment of their body composition. Methods: During the period from 2008 to 2016 there were 710 first-year students (461 women and 249 men) whose height and weight were measured, and body composition assessed, by bio-electric impedance analysis. Results: Most of the subjects were of normal weight (74.5%), while the ratio between the weight status categories of men has proven to be significantly different from that of women. It was established that 8.9% of women as opposed to 2% of men were below normal weight, while there were more obese individuals among men (25.7%) than there were among women (15.4%). However, the percentage of obesity was similar in both sexes, being 5.4% in women and 5.2% in men. There was no significant difference in the ratio between the weight categories during the measurement period. Conclusion: Most of the students at the College for Applied Sciences fall in the normal weight category. There are more obese individuals among men, while among women there are more of those with lower average body weight. The dominance of obesity and the overall ratio between the weight categories and the body composition in the category of first-year students have not changed significantly during the period between 2008 and 2016

Određivanje adhezije između pletene podloge i naslojenog poliuretana

Cilj ovog rada je ispitati jačinu adheziije između poliuretanskog nanosa i podloge više naslojenih pletiva, te usto opisati svojstva poliuretana, te tehnološki proces nanošenja poluretana na pletivo. Ispitivana je adhezija četiri uzorka naslojenog pletiva. To su poliuretanom naslojeno glatko desno-lijevo pletivo, poliuretanom naslojeno kulirno interlok pletivo, poliuretanom naslojeno osnovino pletivo power – net, te poliuretanom naslojeno osnovino pletivo voile. Svaki uzorak podvrgnt je ispitivanju adhezije po propisanoj normi. Uzorak sa power-net pletenom podlogom pokazuje najjaču adheziju između nanosa i podloge, najviše istezanje, te najmanju anizotropiju izmjerenih sila i istezanja po redu i nizu pletiva, te ga se može preporučiti za izradu odjevnih predmeta

Određivanje adhezije između pletene podloge i naslojenog poliuretana

Cilj ovog rada je ispitati jačinu adheziije između poliuretanskog nanosa i podloge više naslojenih pletiva, te usto opisati svojstva poliuretana, te tehnološki proces nanošenja poluretana na pletivo. Ispitivana je adhezija četiri uzorka naslojenog pletiva. To su poliuretanom naslojeno glatko desno-lijevo pletivo, poliuretanom naslojeno kulirno interlok pletivo, poliuretanom naslojeno osnovino pletivo power – net, te poliuretanom naslojeno osnovino pletivo voile. Svaki uzorak podvrgnt je ispitivanju adhezije po propisanoj normi. Uzorak sa power-net pletenom podlogom pokazuje najjaču adheziju između nanosa i podloge, najviše istezanje, te najmanju anizotropiju izmjerenih sila i istezanja po redu i nizu pletiva, te ga se može preporučiti za izradu odjevnih predmeta

Optimizing the Function of Upstanding Activities in Adult Patients with Acquired Lesions of the Central Nervous System by Using the Bobath Concept Approach – A Case Report

Nonspecific medical gymnastic therapy may help patients after stroke achieve certain results in terms of efficiency but not in terms of quality of movement. The goal of treatment by Bobath concept is development of movement (effectiveness) and optimization of movement (efficiency). This article presents the case of a 62-year old patient who had experienced a stroke and has difficulties with standing up activities. It underscores the importance of not only recovery of function but also optimization of the function in such patients