scholarly journals Aberrant Mechanical Efficiency during Exercise Relates to Metabolic Health and Exercise Intolerance in Adolescents with Obesity

2021 ◽  
Vol 18 (20) ◽  
pp. 10578
Author(s):  
Wouter M. A. Franssen ◽  
Guy Massa ◽  
Bert O. O. Eijnde ◽  
Paul Dendale ◽  
Dominique Hansen ◽  
...  
Keyword(s):  
Exercise Tolerance ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Mechanical Efficiency ◽  
Cardiopulmonary Exercise Test ◽  
Metabolic Health ◽  
Exercise Intolerance ◽  
Peak Performance ◽  
Cardiometabolic Health ◽  
Physical Activity Interventions

Background. Mechanical efficiency (ME) might be an important parameter evaluating cardiometabolic health and the effectiveness of physical activity interventions in individuals with obesity. However, whether these cardiometabolic risk factors may relate to ME in adolescents with obesity is not known yet. Therefore, this study aims to compare the mechanical efficiency during maximal exercise testing between adolescents with obesity and lean adolescents, and to examine associations with exercise tolerance and metabolic health. Methods. Twenty-nine adolescents with obesity (BMI SDS: 2.11 ± 0.32, age: 13.4 ± 1.1 years, male/female: 15/14) and 29 lean (BMI SDS: −0.16 ± 0.84, age: 14.0 ± 1.5 years, male/female: 16/13) adolescents performed a maximal cardiopulmonary exercise test from which the net mechanical efficiency (MEnet) and substrate oxidation (carbohydrates and lipids) were calculated. Indicators for peak performance were collected. Biochemistry (lipid profile, glycaemic control, inflammation, leptin) was studied in fasted blood samples. Regression analyses were applied to examine relations between MEnet and exercise tolerance or blood variables in the total group. Results. Peak work rate (WRpeak), oxygen uptake (V̇O2peak)/WRpeak, ME, and MEnet were significantly lower (p < 0.05) in adolescents with obesity compared to their lean counterparts (p < 0.05). Furthermore, a reduced MEnet was independently related to a lower WRpeak (SC β = 2.447; p < 0.001) and elevated carbohydrate oxidation during exercise (SC β = −0.497; p < 0.001), as well as to elevated blood low-density lipoprotein cholesterol (SC β = −0.275; p = 0.034) and fasting glucose (SC β = −0.256; p = 0.049) concentration. Conclusion. In adolescents with obesity, the mechanical efficiency is lowered during exercise and this relates to exercise intolerance and a worse metabolic health.

scholarly journals Modelling the Reallocation of Time Spent Sitting into Physical Activity: Isotemporal Substitution vs. Compositional Isotemporal Substitution

2021 ◽  
Vol 18 (12) ◽  
pp. 6210
Author(s):  
Gregory J. H. Biddle ◽  
Joseph Henson ◽  
Stuart J. H. Biddle ◽  
Melanie J. Davies ◽  
Kamlesh Khunti ◽  
...  
Keyword(s):  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Future Research ◽  
Cardiometabolic Health ◽  
Low Density Lipoprotein Cholesterol ◽  
Cross Sectional ◽  
Randomised Control Trials ◽  
Data Driven Decisions

Isotemporal substitution modelling (ISM) and compositional isotemporal modelling (CISM) are statistical approaches used in epidemiology to model the associations of replacing time in one physical behaviour with time in another. This study’s aim was to use both ISM and CISM to examine and compare associations of reallocating 60 min of sitting into standing or stepping with markers of cardiometabolic health. Cross-sectional data collected during three randomised control trials (RCTs) were utilised. All participants (n = 1554) were identified as being at high risk of developing type 2 diabetes. Reallocating 60 min from sitting to standing and to stepping was associated with a lower BMI, waist circumference, and triglycerides and higher high-density lipoprotein cholesterol using both ISM and CISM (p < 0.05). The direction and magnitude of significant associations were consistent across methods. No associations were observed for hemoglobin A1c, total cholesterol, or low-density lipoprotein cholesterol for either method. Results of both ISM and CISM were broadly similar, allowing for the interpretation of previous research, and should enable future research in order to make informed methodological, data-driven decisions.

Cardiometabolic Benefits of Intermittent Fasting

2021 ◽  
Vol 41 (1) ◽  
pp. 333-361
Author(s):  
Krista A. Varady ◽  
Sofia Cienfuegos ◽  
Mark Ezpeleta ◽  
Kelsey Gabel
Keyword(s):  
Weight Loss ◽  
Eating Behaviors ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Diet Therapy ◽  
Cardiometabolic Health ◽  
Intermittent Fasting ◽  
Disordered Eating Behaviors ◽  
Alternate Day Fasting ◽  
Clinically Significant

This review aims to summarize the effects of intermittent fasting on markers of cardiometabolic health in humans. All forms of fasting reviewed here—alternate-day fasting (ADF), the 5:2 diet, and time-restricted eating (TRE)—produced mild to moderate weight loss (1–8% from baseline) and consistent reductions in energy intake (10–30% from baseline). These regimens may benefit cardiometabolic health by decreasing blood pressure, insulin resistance, and oxidative stress. Low-density lipoprotein cholesterol and triglyceride levels are also lowered, but findings are variable. Other health benefits, such as improved appetite regulation and favorable changes in the diversity of the gut microbiome, have also been demonstrated, but evidence for these effects is limited. Intermittent fasting is generally safe and does not result in energy level disturbances or increased disordered eating behaviors. In summary, intermittent fasting is a safe diet therapy that can produce clinically significant weight loss (>5%) and improve several markers of metabolic health in individuals with obesity.

scholarly journals Effects of Exercise Training during Christmas on Body Weight and Cardiometabolic Health in Overweight Individuals

2020 ◽  
Vol 17 (13) ◽  
pp. 4732
Author(s):  
Miguel Ramirez-Jimenez ◽  
Felix Morales-Palomo ◽  
Juan Fernando Ortega ◽  
Alfonso Moreno-Cabañas ◽  
Valle Guio de Prada ◽  
...  
Keyword(s):  
Body Weight ◽  
Exercise Training ◽  
Dietary Habits ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Pharmacological Therapy ◽  
Cardiometabolic Health ◽  
Weight Gains ◽  
Before And After ◽  
Maximal Fat Oxidation

Individuals with abdominal obesity and metabolic syndrome (MetS) have augmented risk of all-cause mortality. Lifestyle interventions are effective to treat MetS, however, there are periods during the year in which exercise programs are discontinued and improper dietary habits reappear (e.g., Christmas holidays). We aimed to analyze if exercise-training during Christmas holidays would avoid body-weight gains and cardiometabolic deterioration in MetS individuals, using a randomized control trial. Thirty-eight men with MetS undergoing exercise training were randomly allocated to either continue (TRAIN group, n = 16) or discontinue (HOLID group, n = 22) training, during the three weeks of Christmas. Anthropometrics (body weight, fat, and waist circumference), fasting blood metabolites (glucose, insulin, triglycerides, and cholesterol concentrations) and exercise maximal fat oxidation (FOMAX) and oxygen uptake (VO2PEAK) were determined before and after Christmas. Both groups were similar at baseline in all parameters (p > 0.05). HOLID group increased body weight (91.3 ± 13.0 to 92.0 ± 13.4 kg, p = 0.004), mean arterial pressure (94.0 ± 10.6 to 97.1 ± 8.9 mmHg, p = 0.026), blood insulin (10.2 ± 3.8 to 12.5 ± 5.4 µIU·mL−1, p = 0.003) and HOMA (3.2 ± 1.3 to 4.1 ± 2.3, p = 0.003). In contrast, TRAIN prevented those disarrangements and reduced total (170.6 ± 30.6 to 161.3 ± 31.3 mg·dL−1, p = 0.026) and low-density lipoprotein cholesterol (i.e., LDL-C, 104.8 ± 26.1 to 95.6 ± 21.7 mg·dL−1, p = 0.013). TRAIN also prevented the reductions in exercise FOMAX and VO2PEAK that was observed in the HOLID group (p = 0.002). In conclusion, exercise training during Christmas, prevents body weight gains and the associated cardiovascular (increase in blood pressure and LDL-C) and metabolic (reduced insulin sensitivity) health risks are an optimal non-pharmacological therapy for that period of the year.

scholarly journals Assessment of Obesity and Cardiometabolic Status by Integrase Inhibitor Use in REPRIEVE: A Propensity-Weighted Analysis of a Multinational Primary Cardiovascular Prevention Cohort of People With Human Immunodeficiency Virus

2021 ◽  
Vol 8 (12) ◽  
Author(s):  
Emma M Kileel ◽  
Janet Lo ◽  
Carlos Malvestutto ◽  
Kathleen V Fitch ◽  
Markella V Zanni ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Waist Circumference ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cardiovascular Prevention ◽  
Integrase Inhibitor ◽  
Cardiometabolic Health ◽  
Full Data ◽  
Immunodeficiency Virus ◽  
Secondary Analyses

Abstract Background Emerging data demonstrate that the use of integrase inhibitor (INSTI)-based antiretroviral treatment (ART) is associated with increased weight, but the cardiometabolic health consequences of increased weight remains poorly understood. Methods This analysis examined INSTI use (&gt;6 months) at entry among REPRIEVE participants enrolled in High Income and Latin America/Caribbean Global Burden of Disease regions. Primary analyses used linear and logistic regression; secondary analyses used quantile regression to examine differences across the full data distribution. Characteristics of those with and without INSTI use were balanced using inverse probability of treatment weighting. Results Among 4500 REPRIEVE participants, 1848 were on an INSTI-based regimen at entry for an average of 2.1 ± 1.8 years. Integrase inhibitor use (vs no INSTI use) was associated with higher odds of obesity (odds ratio [OR], 1.63; 95% confidence interval [CI], 1.4–1.9) and higher mean body mass index ([BMI] +1.5kg/m2; 95% CI, 1.0–1.9) and waist circumference (+3.6cm; 95% CI, 2.6–4.6). Differences in weight related to INSTI use were greater in the upper tails of the distribution (+3.1kg/m2 [95% CI, 1.9–4.4] at the 90th centile vs +0.7kg/m2 [95% CI, 0.2–1.2] at the 50th centile) and among women and nonwhite participants, with sex and race having an additive effect on BMI. Conversely, INSTI use was not associated with differences in glucose, low-density lipoprotein cholesterol, or higher odds of metabolic syndrome or hypertension. Conclusions Differences in weight and waist circumference associated with INSTI use are (1) not uniform across people with human immunodeficiency virus, (2) greatest among women and nonwhites, and (3) concentrated at the upper tails of weight distribution. These data identify at-risk subgroups for whom long-term cardiovascular disease outcomes should be carefully assessed.

Impact of the occupational environment of a submerged submarine on cardiometabolic health of Royal Navy submariners

2020 ◽  
Vol 77 (6) ◽  
pp. 368-373
Author(s):  
Frances Gunner ◽  
Michael Lindsay ◽  
Pieter Brown ◽  
Anneliese Shaw ◽  
Trish Davey ◽  
...  
Keyword(s):  
Body Weight ◽  
Serum Lipids ◽  
Cardiometabolic Risk ◽  
Prolonged Exposure ◽  
Activity Patterns ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cardiometabolic Health ◽  
Royal Navy

ObjectiveTo determine the effect of prolonged exposure to a submarine environment on biomarkers of cardiometabolic risk in Royal Navy (RN) submariners.MethodsSerum lipids (cholesterol (C), triglyceride (TG), low-density lipoprotein cholesterol, high-density lipoprotein cholesterol (HDL-C), non-HDL-C), glucose, insulin and anthropometrics were compared within three RN submarine crews before and after submerged patrols of 12 or 6 weeks, and with a crew that remained ashore (SUB-HOME). Dietary intake and activity patterns were self-reported during each patrol. Differences were assessed in crew characteristics using one-way analysis of variance and in serum lipids using paired t-tests.ResultsPostpatrol, the mean body weight of submerged crews decreased (−1.4±4.2 kg, p=0.0001), but increased in SUB-HOME (1.9±1.8 kg, p=0.0001). Modest improvements in serum lipids (mean individual change (mmol/L); C=−0.3±0.7, p=0.0001; TG=−0.3±0.7, p=0.0001; HDL-C=−0.1±0.3, p=0.0001; non-HDL-C=−0.2±0.6, p=0.012), glucose (−0.2±0.5, p=0.0001) and insulin (−1.5±4.6 mU/L, p=0.001) were observed in submerged crews. Changes in serum lipids were positively associated with changes in body weight within crews combined. Energy intake was maintained during submerged patrols but was lower compared with non-submerged (11 139±2792 vs. 9617±2466 kJ, p=0.001; 11 062±2775 vs. 9632±2682 kJ, p=0.003).ConclusionsThe environment of a submerged submarine produced no adverse effects on serum biomarkers of cardiometabolic risk in crew. Conversely, modest improvements in these biomarkers were associated with a decrease in body weight.

Lipid profiles in users of combustible and electronic cigarettes

2021 ◽  
pp. 1358863X2110093
Author(s):  
Sana Majid ◽  
Rachel J Keith ◽  
Jessica L Fetterman ◽  
Robert M. Weisbrod ◽  
Jessica Nystoriak ◽  
...  
Keyword(s):  
Electronic Cigarettes ◽  
Low Density Lipoprotein ◽  
Fasting Blood Glucose ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Lipid Profiles ◽  
Electronic Cigarette ◽  
Cardiometabolic Health ◽  
Cigarette Use ◽  
Glucose Levels

Electronic cigarette use has especially risen among adolescents and young adults. The aim of this study was to investigate fasting blood glucose and lipid profiles in chronic combustible cigarette and electronic cigarette users. We evaluated participants aged 21 to 45 ( n = 525, mean age 31 ± 7 years, 45% women) without established cardiovascular disease or risk factors who were combustible cigarette users ( n = 290), electronic cigarette users ( n = 131; 65 sole users and 66 dual users), or never users ( n = 104). In the first wave of enrollment (2014–2017), electronic cigarette users reported their products as first, second and third generation devices (e-cig users) and were all largely current (i.e. dual) or former (sole) combustible cigarette users, whereas in the second wave of enrollment (2019–2020), electronic cigarette users all reported pod-based device use (pod users) and included more sole users who were never smokers. In multivariable-adjusted analyses comparing to never users, both sole e-cig users and combustible cigarette users had higher glucose and triglycerides and lower high-density lipoprotein (HDL) cholesterol levels. Dual e-cig users showed higher triglycerides and very-low-density lipoprotein cholesterol, and lower HDL cholesterol compared to never users. In contrast, pod users (both sole and dual) had lipid profiles and glucose levels similar to never users. Overall, users of early generation electronic cigarettes display adverse metabolic profiles. In contrast, pod-based electronic cigarette users have similar lipid profiles to never users. Future studies are needed to understand the cumulative effects of electronic cigarette use on cardiometabolic health.

Resistance training and HIIT improve cardiometabolic health in high risk older adults

2021 ◽  
Author(s):  
Kelly Ann McLeod ◽  
Matthew D. Jones ◽  
Jeanette M Thom ◽  
Belinda J. Parmenter
Keyword(s):  
Older Adults ◽  
Resistance Training ◽  
Cardiometabolic Risk ◽  
Meta Analysis ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Interval Training ◽  
Mean Difference ◽  
Cardiometabolic Health ◽  
High Intensity Interval

Progressive resistance training (PRT) and high-intensity interval training (HIIT) improve cardiometabolic health in older adults. Whether combination PRT+HIIT (COMB) provides similar or additional benefit is less clear. This systematic review with meta-analysis of controlled trials examined effects of PRT, HIIT and COMB compared to non-exercise control in older adults with high cardiometabolic risk. Databases were searched until January 2021, with study quality assessed using the PEDro scale. Risk factor data was extracted and analysed using RevMan V.5.3. We analysed 422 participants from nine studies (7 PRT, n=149, 1 HIIT, n=10, 1 COMB, n=60; control n=203; mean age 68.1±1.4 years). Compared to control, exercise improved body mass index (mean difference (MD) -0.33 [-0.47, -0.20], p≤0.0001), body fat % (standardised mean difference (SMD) -0.71 [-1.34, -0.08], p=0.03), aerobic capacity (SMD 0.41 [0.05, 0.78], p=0.03), low-density lipoprotein (SMD -0.27 [-0.52, -0.01], p=0.04), and blood glucose (SMD -0.31 [-0.58, -0.05], p=0.02). Therefore, PRT, HIIT and COMB can improve cardiometabolic health in older adults with cardiometabolic risk. Further research is warranted, particularly in HIIT and COMB, to identify the optimal exercise prescription, if any, for improving older adults cardiometabolic health.

scholarly journals Persistent Cardiometabolic Health Gaps: Can Therapeutic Care Gaps Be Precisely Identified from Electronic Health Records

Healthcare ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 70
Author(s):  
Xiaowei Yan ◽  
Walter F. Stewart ◽  
Hannah Husby ◽  
Jake Delatorre-Reimer ◽  
Satish Mudiganti ◽  
...  
Keyword(s):  
Electronic Health Records ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cardiometabolic Health ◽  
Health Records ◽  
Care Gap ◽  
Care Gaps ◽  
Primary Care Patients ◽  
Therapeutic Care ◽  
Electronic Health

The objective of this study was to determine the strengths and limitations of using structured electronic health records (EHR) to identify and manage cardiometabolic (CM) health gaps. We used medication adherence measures derived from dispense data to attribute related therapeutic care gaps (i.e., no action to close health gaps) to patient- (i.e., failure to retrieve medication or low adherence) or clinician-related (i.e., failure to initiate/titrate medication) behavior. We illustrated how such data can be used to manage health and care gaps for blood pressure (BP), low-density lipoprotein cholesterol (LDL-C), and HbA1c for 240,582 Sutter Health primary care patients. Prevalence of health gaps was 44% for patients with hypertension, 33% with hyperlipidemia, and 57% with diabetes. Failure to retrieve medication was common; this patient-related care gap was highly associated with health gaps (odds ratios (OR): 1.23–1.76). Clinician-related therapeutic care gaps were common (16% for hypertension, and 40% and 27% for hyperlipidemia and diabetes, respectively), and strongly related to health gaps for hyperlipidemia (OR = 5.8; 95% CI: 5.6–6.0) and diabetes (OR = 5.7; 95% CI: 5.4–6.0). Additionally, a substantial minority of care gaps (9% to 21%) were uncertain, meaning we lacked evidence to attribute the gap to either patients or clinicians, hindering efforts to close the gaps.

scholarly journals Dietary Inflammatory Index and Biomarkers of Lipoprotein Metabolism, Inflammation and Glucose Homeostasis in Adults

Nutrients ◽  
2018 ◽  
Vol 10 (8) ◽  
pp. 1033 ◽  
Author(s):  
Catherine Phillips ◽  
Nitin Shivappa ◽  
James Hébert ◽  
Ivan Perry
Keyword(s):  
Glucose Homeostasis ◽  
Low Density Lipoprotein ◽  
Lipoprotein Metabolism ◽  
Density Lipoprotein ◽  
Cardiometabolic Health ◽  
Low Density ◽  
Model Assessment ◽  
Dietary Inflammatory Index ◽  
Acute Phase Reactants ◽  
Inflammatory Index

Accumulating evidence identifies diet and inflammation as potential mechanisms contributing to cardiometabolic risk. However, inconsistent reports regarding dietary inflammatory potential, biomarkers of cardiometabolic health and metabolic syndrome (MetS) risk exist. Our objective was to examine the relationships between a food frequency questionnaire (FFQ)-derived dietary inflammatory index (DII®), biomarkers of lipoprotein metabolism, inflammation and glucose homeostasis and MetS risk in a cross-sectional sample of 1992 adults. Energy-adjusted DII (E-DII) scores derived from an FFQ were calculated. Lipoprotein particle size and subclass concentrations were measured using nuclear magnetic resonance (NMR) spectroscopy. Serum acute-phase reactants, adipocytokines, pro-inflammatory cytokines and white blood cell (WBC) counts were determined. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR). Our data indicate that a more pro-inflammatory diet, reflected by higher E-DII scores, was associated with potentially pro-atherogenic lipoprotein profiles characterised by increased numbers of large very low density lipoprotein (VLDL), small dense low density lipoprotein (LDL) and high density lipoprotein (HDL) particles and less large LDL and HDL particles (all p < 0.001). Inflammatory profiling identified a range of adverse phenotypes among those with higher E-DII scores, including higher complement component C3 (C3), C-reactive protein (CRP), (both p < 0.05), interleukin 6 (IL-6) and tumour necrosis factor (TNF)-α concentrations, higher WBC counts and neutrophil to lymphocyte ratio (NLR) and lower adiponectin levels (all p < 0.001). MetS risk was increased among those with higher E-DII scores (OR 1.37, 95% CI (1.01, 1.88), p < 0.05), after adjusting for potential confounders. In conclusion, habitual intake of a more pro-inflammatory diet is associated with unfavourable lipoprotein and inflammatory profiles and increased MetS risk.

scholarly journals Novel plasma biomarkers improve discrimination of metabolic health independent of weight

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Stephen Ellison ◽  
Jawan W. Abdulrahim ◽  
Lydia Coulter Kwee ◽  
Nathan A. Bihlmeyer ◽  
Neha Pagidipati ◽  
...  
Keyword(s):  
Particle Size ◽  
Proportional Hazards ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cox Proportional Hazards ◽  
Metabolic Health ◽  
Plasma Biomarkers ◽  
Cox Proportional Hazards Models ◽  
Medium Particle ◽  
The Individual

AbstractWe sought to determine if novel plasma biomarkers improve traditionally defined metabolic health (MH) in predicting risk of cardiovascular disease (CVD) events irrespective of weight. Poor MH was defined in CATHGEN biorepository participants (n > 9300), a follow-up cohort (> 5600 days) comprising participants undergoing evaluation for possible ischemic heart disease. Lipoprotein subparticles, lipoprotein-insulin resistance (LP-IR), and GlycA were measured using NMR spectroscopy (n = 8385), while acylcarnitines and amino acids were measured using flow-injection, tandem mass spectrometry (n = 3592). Multivariable Cox proportional hazards models determined association of poor MH and plasma biomarkers with time-to-all-cause mortality or incident myocardial infarction. Low-density lipoprotein particle size and high-density lipoprotein, small and medium particle size (HMSP), GlycA, LP-IR, short-chain dicarboxylacylcarnitines (SCDA), and branched-chain amino acid plasma biomarkers were independently associated with CVD events after adjustment for traditionally defined MH in the overall cohort (p = 3.3 × 10−4–3.6 × 10−123), as well as within most of the individual BMI categories (p = 8.1 × 10−3–1.4 × 10−49). LP-IR, GlycA, HMSP, and SCDA improved metrics of model fit analyses beyond that of traditionally defined MH. We found that LP-IR, GlycA, HMSP, and SCDA improve traditionally defined MH models in prediction of adverse CVD events irrespective of BMI.

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