Helping Elders Living with Pain (HELP)

The HELP study, which is a two-year study supported by a R21 grant from National Institute on Aging, is a direct extension of our previous work examining attentional demands of chronic pain in the older population. The HELP study is designed to compare two different exercise programs - simple body exercise and mind-body exercise, in their effects on pain symptoms, cognitive function, dual-task walking ability, and levels of pain-related biomarkers in community-dwelling older adults with multisite pain who are at risk of falling

Resting Energy Expenditure Changes With Weight Loss: Racial Differences

It is controversial whether weight loss reduces resting energy expenditure (REE) to a different magnitude in black and white women. This study was to determine whether changes in REE with weight loss were different between black and white postmenopausal women, and whether changes in body composition (including regional lean and fat mass) were associated with REE changes within each race. Black (n= 26) and white (n= 65) women (age= 58.2±5.4 years, 25\u3c BMI\u3c 40 kg·m−2) completed a 20-week weight loss intervention. Body weight, lean and fat mass (total body, limb and trunk) via dual energy X-ray absorptiometry, and REE via indirect calorimetry were measured before and after the intervention. We found that baseline REE positively correlated with body weight, lean and fat mass (total, limb, and trunk) in white women only (p\u3c 0.05 for all). The intervention decreased absolute REE in both races similarly (1279±162 to 1204±169 kcal·day−1 in blacks; 1315±200 to 1209±185 kcal·day−1 in whites). REE remained decreased after adjusting for changes in total or limb lean mass in black (1302 to 1182 kcal·day−1, p= 0.043; 1298 to 1144 kcal·day−1, p= 0.006, respectively), but not in white, women. Changes in REE correlated with changes in body weight (partial r = 0.277) and fat mass (partial r= 0.295, 0.275, and 0.254 for total, limb, and trunk, respectively; p\u3c 0.05) independent of baseline REE in white women. Therefore, with weight loss, REE decreased in proportion to the amount of fat and lean mass lost in white, but not black, women

Adipose tissue endocannabinoid system gene expression: depot differences and effects of diet and exercise

<p>Abstract</p> <p>Background</p> <p>Alterations of endocannabinoid system in adipose tissue play an important role in lipid regulation and metabolic dysfunction associated with obesity. The purpose of this study was to determine whether gene expression levels of cannabinoid type 1 receptor (CB1) and fatty acid amide hydrolase (FAAH) are different in subcutaneous abdominal and gluteal adipose tissue, and whether hypocaloric diet and aerobic exercise influence subcutaneous adipose tissue CB1 and FAAH gene expression in obese women.</p> <p>Methods</p> <p>Thirty overweight or obese, middle-aged women (BMI = 34.3 ± 0.8 kg/m², age = 59 ± 1 years) underwent one of three 20-week weight loss interventions: caloric restriction only (CR, N = 9), caloric restriction plus moderate-intensity aerobic exercise (CRM, 45-50% HRR, N = 13), or caloric restriction plus vigorous-intensity aerobic exercise (CRV, 70-75% HRR, N = 8). Subcutaneous abdominal and gluteal adipose tissue samples were collected before and after the interventions to measure CB1 and FAAH gene expression.</p> <p>Results</p> <p>At baseline, FAAH gene expression was higher in abdominal, compared to gluteal adipose tissue (2.08 ± 0.11 vs. 1.78 ± 0.10, expressed as target gene/β-actin mRNA ratio × 10^-3, P < 0.05). Compared to pre-intervention, CR did not change abdominal, but decreased gluteal CB1 (Δ = -0.82 ± 0.25, P < 0.05) and FAAH (Δ = -0.49 ± 0.14, P < 0.05) gene expression. CRM or CRV alone did not change adipose tissue CB1 and FAAH gene expression. However, combined CRM and CRV (CRM+CRV) decreased abdominal adipose tissue FAAH gene expression (Δ = -0.37 ± 0.18, P < 0.05). The changes in gluteal CB1 and abdominal FAAH gene expression levels in the CR alone and the CRM+CRV group were different (P < 0.05) or tended to be different (P = 0.10).</p> <p>Conclusions</p> <p>There are depot differences in subcutaneous adipose tissue endocannabinoid system gene expression in obese individuals. Aerobic exercise training may preferentially modulate abdominal adipose tissue endocannabinoid-related gene expression during dietary weight loss.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00664729">NCT00664729</a>.</p

Behavioural treatments for chronic systemic inflammation: effects of dietary weight loss and exercise training

PERSISTENT LOW-GRADE INFLAMMATION, as indicated by higher circulating levels of inflammatory mediators such as C-reactive protein, interleukin-6 and tumour necrosis factor-α, is a strong risk factor for several chronic diseases. There are data indicating that decreasing energy intake and increasing physical activity may be effective therapies for reducing overall inflammation. Evidence is strong that circulating levels of inflammatory markers are elevated with total and abdominal obesity, possibly owing to a higher secretion rate of cytokines by adipose tissue in obese people. Moreover, very-low-energy dietary weight loss reduces both circulating markers of inflammation and adipose-tissue cytokine production. Data from several large population-based cohorts show an inverse association between markers of systemic inflammation and physical activity or fitness status; small-scale intervention studies support that exercise training diminishes inflammation. Dietary weight loss plus exercise is likely more effective than weight reduction alone in reducing inflammation. To date, data from randomized, controlled trails designed to definitively test the effects of weight loss or exercise training, or both, on inflammation are limited. Future studies are required to define the amount of weight loss needed for clinically meaningful reductions of inflammation; in addition, fully powered and controlled studies are necessary to clarify the effect of exercise training on chronic, systemic inflammation

Effects of hypocaloric diet and exercise training on inflammation and adipocyte lipolysis in obese postmenopausal women

The purpose of this study was to determine whether a hypocaloric diet with and without exercise training is effective in reducing plasma C-reactive protein, IL-6, TNFalpha, and their soluble receptors (sIL-6R, sTNFR1, and sTNFR2), and whether changes in these inflammatory markers are related to changes in regional lipolysis in obese (body mass index, 32.78 +/- 4.73) postmenopausal women (diet alone, n = 17; diet plus exercise, n = 17). All inflammatory markers were measured by an ELISA method. In vitro lipolysis was evaluated by measuring glycerol release using a one-step enzymatic fluorometric technique. Six months of diet and diet plus exercise decreased total and abdominal fat to a similar degree. Diet plus exercise, but not diet alone, decreased plasma levels of C-reactive protein, IL-6, sIL-6R, and sTNFR1 and increased basal and postreceptor stimulated lipolysis in both abdominal and gluteal regions. Changes in abdominal stimulated lipolysis correlated significantly with changes in plasma IL-6 (r = -0.39) and TNFR1 (r = -047). Thus, diet plus exercise training, but not diet alone, is effective in reducing chronic inflammation in obese postmenopausal women. In addition, modification of chronic inflammation is associated with changes in local adipose tissue metabolism in response to diet and exercise

Effect of exercise training intensity on adipose tissue hormone sensitive lipase gene expression in obese women under weight loss

AbstractBackgroundHormone sensitive lipase (HSL) is an enzyme that regulates adipose tissue lipolysis and plays an important role in chronic exercise-induced changes in adipose tissue metabolism. The purpose of this study was to determine whether aerobic exercise intensity influences abdominal adipose tissue HSL gene expression in obese women under weight loss.MethodsThirty women (body mass index (BMI) = 33.0 ± 0.7 kg/m2, age = 58 ± 1 years) completed one of three 20-week interventions: caloric restriction alone (CR only, n = 8), CR plus moderate-intensity exercise (CR + moderate-intensity, 45%–50% heart rate reserve (HRR), 3 day/week, n = 9), or CR plus vigorous-intensity exercise (CR + vigorous-intensity, 70%–75% HRR, 3 day/week, n = 13). Each group had a similar prescribed energy deficit comprised of underfeeding alone (2800 kcal/week for CR only) or underfeeding (2400 kcal/week) plus exercise (400 kcal/week). Body composition and maximal aerobic capacity (VO2max) were measured, and subcutaneous abdominal adipose tissue samples were collected before and after the interventions. Adipose tissue HSL gene expression was measured by real time reverse-transcriptase polymerase chain reaction.ResultsAll three interventions reduced body weight, fat mass, percent fat, and waist to a similar degree (all p < 0.01). In addition, all interventions did not change absolute VO2max, but increased relative VO2max (p < 0.05 to p < 0.01). Compared to pre-intervention, neither CR only nor CR + moderate-intensity changed adipose tissue HSL gene expression, but CR + vigorous-intensity significantly increased adipose tissue HSL gene expression (p < 0.01). The changes of HSL gene expression levels in the CR + vigorous-intensity group were significantly different from those in the CR only (p < 0.05) and CR + moderate-intensity (p < 0.01) groups. In the whole cohort, changes in adipose tissue HSL gene expression correlated positively to changes in absolute (r = 0.55, p < 0.01) and relative (r = 0.32, p = 0.09) VO2max.ConclusionThese results support a potential effect of aerobic exercise training intensity on hormone sensitive lipase pathway in adipose tissue metabolism in obese women under weight loss