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Background: Growth hormone secretion and muscle mass decline from midpuberty throughout life, culminating in sarcopenia, frailty, decreased function, and loss of independence. The decline of growth hormone in the development of sarcopenia is one of many factors, and its etiologic role needs to be demonstrated.Objective: To determine whether MK-677, an oral ghrelin mimetic, increases growth hormone secretion into the young-adult range without serious adverse effects, prevents the decline of fat-free mass, and decreases abdominal visceral fat in healthy older adults.Design: 2-year, double-blind, randomized, placebo-controlled, modified-crossover clinical trial.Setting: General clinical research center study performed at a university hospital.Participants: 65 healthy adults (men, women receiving hormone replacement therapy, and women not receiving hormone replacement therapy) ranging from 60 to 81 years of age.Intervention: Oral administration of MK-677, 25 mg, or placebo once daily.Measurements: Growth hormone and insulin-like growth factor I levels. Fat-free mass and abdominal visceral fat were the primary end points after 1 year of treatment. Other end points were body weight, fat mass, insulin sensitivity, lipid and cortisol levels, bone mineral density, limb lean and fat mass, isokinetic strength, function, and quality of life. All end points were assessed at baseline and every 6 months.Results: Daily administration of MK-677 significantly increased growth hormone and insulin-like growth factor I levels to those of healthy young adults without serious adverse effects. Mean fat-free mass decreased in the placebo group but increased in the MK-677 group (change, -0.5 kg [95% CI, -1.1 to 0.2 kg] vs. 1.1 kg [CI, 0.7 to 1.5 kg], respectively; P < 0.001), as did body cell mass, as reflected by intracellular water (change, -1.0 kg [CI, -2.1 to 0.2 kg] vs. 0.8 kg [CI, -0.1 to 1.6 kg], respectively; P = 0.021). No significant differences were observed in abdominal visceral fat or total fat mass; however, the average increase in limb fat was greater in the MK-677 group than the placebo group (1.1 kg vs. 0.24 kg; P = 0.001). Body weight increased 0.8 kg (CI, -0.3 to 1.8 kg) in the placebo group and 2.7 kg (CI, 2.0 to 3.5 kg) in the MK-677 group (P = 0.003). Fasting blood glucose level increased an average of 0.3 mmol/L (5 mg/dL) in the MK-677 group (P = 0.015), and insulin sensitivity decreased. The most frequent side effects were an increase in appetite that subsided in a few months and transient, mild lower-extremity edema and muscle pain. Low-density lipoprotein cholesterol levels decreased in the MK-677 group relative to baseline values (change, -0.14 mmol/L [CI, -0.27 to -0.01 mmol/L]; -5.4 mg/dL [CI, -10.4 to -0.4 mg/dL]; P = 0.026); no differences between groups were observed in total or high-density lipoprotein cholesterol levels. Cortisol levels increased 47 nmol/L (CI, 28 to 71 nmol/L (1.7 microg/dL [CI, 1.0 to 2.6 microg/dL]) in MK-677 recipients (P = 0.020). Changes in bone mineral density consistent with increased bone remodeling occurred in MK-677 recipients. Increased fat-free mass did not result in changes in strength or function. Two-year exploratory analyses confirmed the 1-year results.Limitation: Study power (duration and participant number) was insufficient to evaluate functional end points in healthy elderly persons.Conclusion: Over 12 months, the ghrelin mimetic MK-677 enhanced pulsatile growth hormone secretion, significantly increased fat-free mass, and was generally well tolerated. Long-term functional and, ultimately, pharmacoeconomic, studies in elderly persons are indicated. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to examine the sex-specific influence of expected exercise duration on the physiological responses to RPE-clamp exercise anchored to RPE 15 with participants being deceived into believing the RPE-clamp exercise would last for 20-, 30-, or 40-min, but all trials were 30-min., Methods: Twelve males and 12 females completed a graded exercise test followed by randomly ordered RPE-clamp trials at RPE15 on the Borg 6-20 scale where subjects were deceived into expecting exercise to last for either 20-, 30-, or 40-min, but the actual duration for each trial was 30-min. Separate 2 (Sex [Male vs. Female]) × 3 (Deception [20-min, 30-min, 40-min]) × 11 (Time [0, 3, 6, 9, 12, 15, 18, 21, 24, 27, 30 min]) mixed model analyses of variance (ANOVAs) with appropriate follow-up ANOVAs, and Bonferroni-corrected pairwise comparisons, were used to examine changes in volume of oxygen uptake ( V ˙ O 2 ), heart rate (HR), respiration rate (RR), power output, and muscle oxygen saturation (%SmO 2 )., Results: Females, but not males, demonstrated lower power outputs when expected duration was 40-min compared to 20-min after approximately half of the exercise bout. V ˙ O 2 , regardless of Sex, was also lower when expected duration was 40-min (62.47 ± 5.59% V ˙ O 2 max ) compared to 20-min (66.35 ± 5.79% V ˙ O 2 max ). There was no effect of expected duration on HR, RR, or %SmO 2 , but females demonstrated significantly higher HR (86.06 ± 5.93%HR max ) and RR (74.81 ± 7.26%RR max ) compared to males (79.52 ± 4.96%HR max ; 62.31 ± 5.80%RR max )., Conclusions: RPE-clamp exercise performance in females, but not males, may be influenced by the expectation of exercise duration., Competing Interests: Declarations. Conflict of interest: This research was supported by the Arvle and Ellen Turner Thacker Research Fund in addition to the Kinesiology and Health Promotion Department Student Research Fund. MAS is funded by National Institutes of Health (K01-AG073698). The authors have no conflicts of interest to report., (© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Farmers may be at a higher risk of developing hip osteoarthritis (OA) due to the high demands of their occupation. To the authors' knowledge, the gait patterns of farmers that may be associated with hip joint degeneration have yet to be analyzed. Therefore, this study compares gait mechanics between farmers and non-farmers (controls). It is hypothesized that farmers would exhibit altered lower extremity joint mechanics during walking when compared to matched controls. This exploratory study included five farmers and five sex-, age-, and body mass index (BMI)-matched controls. A 3D gait analysis was performed while study participants walked at a self-selected speed on an instrumented treadmill. Sagittal plane hip, knee, and ankle kinetics and kinematics were assessed. Effect sizes and between-group differences in demographics and gait mechanics were assessed. There were no group differences in walking speed, total stance time as well as hip and knee joint kinematics ( p  > 0.05). Farmers exhibited statistical trends ( p  = 0.07-0.08) of lower peak ankle plantarflexion angles, higher plantarflexor moments, higher knee flexion moment impulse, and higher peak vertical ground reaction force during the first and second halves of stance. Additionally, farmers ambulated with a significantly higher knee extensor moment ( p  = 0.04) and moment impulse ( p  = 0.05) during the first half of stance and a higher ankle plantarflexion moment impulse ( p  = 0.04). The results demonstrate a multi-joint gait alteration in farmers compared to non-farmers and may suggest a compensatory gait pattern to optimize hip joint mechanics and mitigate hip joint degeneration. These results provide a preliminary understanding of the impact that agricultural occupations have on joint mechanics that may be associated with the increased prevalence of hip OA in the farming population.

Purpose: This study quantified the metabolic demands (oxygen uptake (V̇O 2 )), power output adjustments, changes in the V̇O 2 /power output ratio, and perceptual responses (rating of perceived exertion (RPE)) during constant heart rate (HR) exercise performed within the vigorous intensity range (77%-95% HR peak )., Methods: Twelve women (mean ± SD age, 22 ± 4 yr) performed a graded exercise test to exhaustion to determine peak parameters, and three randomly ordered, constant HR trials to exhaustion or for 60 min at the lower (HR L = 77% HR peak ), middle (HR M = 86% HR peak ), and higher (HR H = 95% HR peak ) end of the vigorous intensity range. Time course of changes and patterns of responses were examined for V̇O 2 , power output, V̇O 2 /power output, and RPE for the composite and for each subject., Results: Across the HR L (time to exhaustion ( Tlim ) = 56.3 ± 9.9 min), HR M (51.8 ± 13.5 min), and HR H (27.2 ± 17.7 min) trials, V̇O 2 and power output decreased quadratically ( P < 0.05) relative to the initial value from 10% to 100% of Tlim , whereas the V̇O 2 /power output increased quadratically from 20% to 100% Tlim , and RPE increased linearly from 50% to 100% Tlim . The V̇O 2 and RPE, collapsed across time, for HR L (54.3% ± 3.3% V̇O 2peak , 11 ± 1.5 RPE) were lower than HR M (64.9% ± 4.5% V̇O 2peak , 14 ± 1.7 RPE), and both were lower than HR H (80.1% ± 4.1% V̇O 2peak , 17 ± 1.4 RPE). None of the 12 subjects at HR L , 6 at HR M , and 7 at HR H were within the vigorous V̇O 2 range., Conclusions: The HR L was not sufficient to meet the desired metabolic intensity for vigorous exercise, whereas the middle to higher end of the range elicited a V̇O 2 within the prescribed range of only ~50%-60% of the subjects. This study indicated that exercise held constant at a percentage of HR peak cannot consistently be used to prescribe a desired metabolic stimulus., (Copyright © 2024 by the American College of Sports Medicine.)

Circadian rhythms differ between young adult males and females. For example, males tend to be later chronotypes, preferring later timing of sleep and activity, than females. Likewise, there are sex differences in body composition and cardiorespiratory fitness. Few studies have investigated the association between circadian rhythms, cardiorespiratory fitness, and body composition. We sought to determine whether chronotype and circadian phase were associated with cardiorespiratory fitness, body composition, and anthropometric measures in sedentary males and females. Fifty-nine adults participated in the study. Circadian phase and chronotype were measured using dim light melatonin onset (DLMO) and the Morningness-Eveningness Questionnaire (MEQ) score. We used peak oxygen uptake (VO 2peak ) results from a maximal graded exercise test to assess cardiorespiratory fitness. Body composition, BMI, and circumferences were collected as markers of adiposity. We observed a sex difference in the association between DLMO and VO 2peak . For males, a later DLMO was associated with a lower VO 2peak . VO 2peak did not vary based on DLMO in females. Later circadian phase was also associated with increased body fat percentage, fat mass index, and abdominal circumference in males, but not females. Collectively, these results suggest that males who are later chronotypes may be at risk of obesity and low cardiorespiratory fitness., (© 2024 The Authors. Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Abstract: Succi, PJ, Dinyer-McNeely, TK, Voskuil, CC, Abel, MG, Clasey, JL, and Bergstrom, HC. Responses to exercise at the critical heart rate vs. the power output associated with the critical heart rate. J Strength Cond Res 37(12): 2362-2372, 2023-This study examined the physiological (volume of oxygen consumption [V̇ o2 ], heart rate [HR], power output [PO], respiration rate [RR], muscle oxygen saturation [%SmO 2 ]), neuromuscular (electromyographic and mechanomyographic amplitude [EMG AMP and MMG AMP] and mean power frequency [EMG MPF and MMG MPF]), and perceptual (rating of perceived exertion [RPE]) responses during exercise anchored at the critical heart rate (CHR) vs. the PO associated with CHR (PCHR). Nine subjects (mean ± SD ; age = 26 ± 3 years) performed a graded exercise test and 4 constant PO trials to exhaustion at 85-100% of peak PO (PP) to derive CHR and PCHR on a cycle ergometer. Responses were recorded during trials at CHR (173 ± 9 b·min -1 , time to exhaustion [T Lim ] = 45.5 ± 20.2 minutes) and PCHR (198 ± 58 W, T Lim = 21.0 ± 17.8 minutes) and normalized to their respective values at PP in 10% intervals. There were significant ( p ≤ 0.05) mode (CHR vs. PCHR) × time (10%-100% T Lim ) interactions for all variables ( p < 0.001-0.036) except MMG AMP ( p > 0.05). Post hoc analyses indicated differences across time for CHR V̇ o2 (%change = -22 ± 16%), PCHR V̇ o2 (19 ± 5%), CHR RR (24 ± 23%), PCHR RR (45 ± 14%), CHR PO (-33 ± 11%), PCHR HR (22 ± 5%), CHR RPE (22 ± 14%), PCHR RPE (39 ± 6%), CHR %SmO 2 (41 ± 33%), PCHR %SmO 2 (-18 ± 40%), CHR EMG AMP (-13 ± 15%), PCHR EMG AMP (13 ± 13%), CHR EMG MPF (9 ± 8%), CHR MMG MPF (7 ± 11%), and PCHR MMG MPF (-3 ± 14%). The critical heart rate was more sustainable than PCHR but required adjustments in PO which traversed intensity domains and caused dissociations of the responses previously observed in exercise anchored to PO. These dissociations indicated the demands to exercise varied with anchoring scheme and provides an important consideration for practitioners prescribing endurance exercise., (Copyright © 2023 National Strength and Conditioning Association.)

Background: Identifying at-risk children with optimal specificity and sensitivity to allow for the appropriate intervention strategies to be implemented is crucial to improving the health and well-being of children. We determined relationships of body mass indexes for age and sex percentile (BMI%) classifications to actual body composition using validated and convenient methodologies and compared fat and non-fat mass estimates to normative cut-off reference values to determine guideline reliability. We hypothesized that we would achieve an improved ability to identify at-risk children using simple, non-invasive body composition and index measures., Methods: Cross-sectional study of a volunteer convenience sample of 1,064 (537 boys) young children comparing Body Fat Percentage (BF%), Fat Mass Index (FMI), Fat-Free Mass Index (FFMI), determined via rapid bioimpedance methods vs. BMI% in children. Comparisons determined among weight classifications and boys vs. girls., Results: Amongst all subjects BMI% was generally correlated to body composition measures and indexes but nearly one quarter of children in the low-risk classifications (healthy weight or overweight BMI%) had higher BF% and/or lower FFMI than recommended standards. Substantial evidence of higher than expected fatness and or sarcopenia was found relative to risk status. Inaccuracies were more common in girls than boys and girls were found to have consistently higher BF% at any BMI%., Conclusions: The population studied raises concerns regarding actual risks for children of healthy or overweight categorized BMI% since many had higher than expected BF% and potential sarcopenia. When body composition and FMI and FFMI are used in conjunction with BMI% improved sensitivity, and accuracy of identifying children who may benefit from appropriate interventions results. These additional measures could help guide clinical decision making in settings of disease-risks stratifications and interventions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Clasey, Easley, Murphy, Kiessling, Stromberg, Schadler, Huang and Bauer.)

Background: Diffusion tensor imaging (DTI) parameters correlate with muscle fiber composition, but it is unclear how these relate to in vivo contractile function., Purpose: To determine the relationship between DTI parameters of the vastus lateralis (VL) and in vivo knee extensor contractile., Methods: Thirteen healthy, premenopausal women underwent magnetic resonance imaging of the mid-thigh to determine patellar tendon moment arm length and quadriceps cross-sectional area. Fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) of the VL were determined using diffusion tensor imaging (DTI). Participants underwent an interpolated twitch (ITT) experiment before and after a fatiguing concentric-eccentric isokinetic knee extension (60°·s -1 ). During the ITT, supramaximal electrical stimuli were delivered to elicit twitch responses from the knee extensors before, during, and after a maximal voluntary isometric contraction (MVIC). Knee extensor-specific tension during twitch and MVIC were calculated from isometric torque data. Pearson's correlations were used to determine the relationship between muscle contractile properties and DTI parameters., Results: MD and RD were moderately correlated with peak twitch force and rate of force development. FA and AD were moderately inversely related to percent change in MVIC following exercise., Conclusion: MD and RD are associated with in vivo quadriceps twitch properties but not voluntary strength, which may reflect the mechanical properties of constituent fiber types. FA and AD appear to relate to MVIC strength following fatiguing exercise., (© 2022 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Cardiorespiratory fitness, typically measured as peak oxygen uptake (VO 2peak ) during maximal graded exercise testing (GXT max ), is a predictor of morbidity, mortality, and cardiovascular disease. However, measuring VO 2peak is costly and inconvenient and thus not widely used in clinical settings. Alternatively, postexercise heart rate recovery (HRRec), which is an index of vagal reactivation, is a valuable assessment of VO 2peak in older adults and athletes. However, the validity of HRRec as a clinical indicator of cardiorespiratory fitness in young, sedentary adults, who are a rapidly growing population at risk for developing obesity and cardiovascular disease, has not been fully elucidated., Methods: We investigated the association between cardiorespiratory fitness, measured by VO 2peak (mL·kg -1 ·min -1 ), and HRRec measures after a GXT max in 61 young (25.2 ± 6.1 years), sedentary adults (40 females) using 3 methods. We examined the relationship between VO 2peak and absolute (b·min -1 ) and relative (%) HRRec measures at 1, 2, and 3 min post GXT max , as well as a measure of the slow component HRRec (HRRec 1 min minus HRR 2 min), using Pearson's correlation analysis., Results: VO 2peak (36.5 ± 7.9 mL·kg -1 ·min -1 ) was not significantly correlated with absolute HRRec at 1 min ( r = 0.18), 2 min ( r = 0.04) or 3 min ( r = 0.01). We also found no significant correlations between VO 2peak and relative HRRec at 1 min ( r = 0.09), 2 min ( r = -0.06) or 3 min ( r = -0.10). Lastly, we found no correlation between the measure of the slow component HRRec and VO 2peak ( r = -0.14)., Conclusions: Our results indicate that HRRec measures are not a valid indicator of cardiorespiratory fitness in young, sedentary adults., Competing Interests: No conflicts of interest

Background: Compare arterial stiffness among law enforcement officers (LEOs) versus general population normative values and identify predictors of arterial stiffness in LEOs., Methods: Seventy male LEOs (age: 24-54 years) completed body composition, blood pressures, physical activity level, and carotid-femoral pulse wave velocity (cfPWV) measurements. T-tests and regression analyses were utilized to compare LEO data to normative data and predict cfPWV, respectively., Results: Compared to similar age strata within the general population, cfPWV was lower among LEO's under 30-years (mean difference = -0.6 m·s -1 ), but higher among LEOs 50-55-years (mean difference = 1.1 m·s -1 ). Utilizing regression, age, relative body fat, and diastolic blood pressure explained the greatest variance in LEO's cfPWV (adj. R 2 = 0.56, p < 0.001)., Conclusion: This investigation demonstrated that arterial stiffness may progress more rapidly in LEOs and LEOs' relative body fat and blood pressure may primarily affect arterial stiffness and risk of CVD.

Background: The prevalence of hypertension is increasing particularly among obese children and adolescents. Obese children and adolescents with hypertension are likely to remain hypertensive as they reach adulthood and hypertension is linked to an increased risk for cardiovascular disease. Twenty-four-hour ambulatory blood pressure monitoring (ABPM) has become one of the most important tools in diagnosing hypertension in children and adolescents and circadian patterns of blood pressure may be important disease-risk predictors. Methods: A retrospective chart review was conducted in patients aged 6-21 years who underwent 24-h ABPM at Kentucky Children's Hospital (KCH) from August 2012 through June 2017. Exclusion criteria included conditions that could affect blood pressure including chronic kidney disease and other renal abnormalities, congenital heart disease, cancer, and thyroid disease. Subjects were categorized by body mass index into normal (below 85th percentile), overweight (85th-95th percentile), stage I obesity (95th-119th percentile), stage II obesity (120th-139th) and stage III obesity (>140th). Non-dipping was defined as a nocturnal BP reduction of <10%. Results: Two hundred and sixty-three patients (156 male patients) were included in the analysis, of whom 70 were normal weight, 33 overweight, 55 stage I obesity, 53 stage II, and 52 stage III obesity. Although there was no significant difference between normal weight and obese groups for prevalence of hypertension, there was a greater prevalence of SBP non-dipping in obese patients as BMI increased ( p = 0.008). Furthermore, non-dippers had a significantly elevated LVMI as well as abnormal lab values for uric acid, blood lipid panel, creatinine, and TSH ( p < 0.05). Conclusions: These findings demonstrate that obese children and adolescents constitute a large proportion of hypertensive children and adolescents and the severity of pediatric obesity is associated with nocturnal BP non-dipping. Additionally, obesity in children is linked to several cardiovascular risk factors including left ventricular hypertrophy, dyslipidemia, and elevated uric acid levels. Further studies utilizing ABPM measures on risk stratification in this very high-risk population are warranted., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Murphy, Huang, Bauer, Schadler, Makhoul, Clasey, Chishti and Kiessling.)

Abstract: Byrd, MT, Wallace, BJ, Clasey, JL, and Bergstrom, HC. Contributions of lower-body strength parameters to critical power and anaerobic work capacity. J Strength Cond Res 35(1): 97-101, 2021-This study examined the contribution of lower-body strength and isokinetic peak torque measures to the prediction of critical power (CP) and anaerobic work capacity (AWC). Fourteen recreationally trained males (mean ± SD age: 22.4 ± 2.5 years; height: 177.9 ± 7.7 cm; body mass: 84.2 ± 12.4 kg) with anaerobic training experience participated in this study. The lower-body strength measures included 1 repetition max bilateral back squat (BSq), isokinetic peak torque at 30°·s-1 [PT30], and isokinetic peak torque at 240°·s-1 [PT240] of the dominant leg. The CP and AWC were determined from the 3-minute all-out CP cycle ergometer test (CP3MT), with the resistance set at 4.5% of the total body mass. The CP was defined as the mean power output over the final 30 seconds of the test, and the AWC was calculated using the equation, AWC = 150 seconds (P150 - CP), where P150 equals the mean power output for the first 150 seconds. Stepwise regression analyses indicated that only BSq contributed significantly to the prediction of AWC (AWC = 0.0527 [BSq] + 8.094 [standard error of estimate = 2.151 kJ; p = 0.012]), with a correlation of r2 = 0.423. None of the strength parameters significantly predicted CP. These findings indicated that BSq strength accounted for 42% of the variance in AWC, but lower-body strength was not related to CP. The current results indirectly support the unique metabolic characteristics of both CP and AWC in providing separate measures of an individual's aerobic and anaerobic capabilities, respectively., (Copyright © 2018 National Strength and Conditioning Association.)

Background: Cardiorespiratory fitness (CRF) is associated with important health risk outcomes, including the development of Type 2 diabetes and cardiovascular disease. Measures of maximal or peak oxygen consumption (VO 2 ) are the typical criterion methods for determining CRF; however, in clinical settings, these measures are impractical., Methods: We validated a clinically derived estimate of CRF against predicted maximal VO 2 in a sample of healthy, midlife and older adult women ( n  = 188). Women completed a clinic evaluation (including treadmill testing), daily diaries about their physical activity, and additional clinical scales. Two models were tested. The first model calculated estimated cardiorespiratory fitness (eCRF) using assigned weights and regressed eCRF on predicted cardiorespiratory fitness (pCRF). The second model used sample-specific, empirical weights. Both models were tested twice, once with retrospective and once with daily diary physical activity reports., Results: The model accounted for 34% of the variance in pCRF when using assigned weights and 41% of the variance in pCRF when using empirical weights. For age, body mass index, and resting heart rate, assigned and estimated weights were similar, but estimates for physical activity differed. There was little improvement in model fit between retrospective and daily diary measurements of physical activity when either assigned ( R 2  = 0.32) or fitted weights ( R 2  = 0.40) were used., Conclusions: Midlife and older women's CRF can be estimated from routinely collected clinical measures, demonstrating their utility., Competing Interests: No competing financial interests exist., (© Jody L. Clasey et al., 2020; Published by Mary Ann Liebert, Inc.)

Lesniak, AY, Bergstrom, HC, Clasey, JL, Stromberg, AJ, and Abel, MG. The effect of personal protective equipment on firefighter occupational performance. J Strength Cond Res 34(8): 2165-2172, 2020-The purpose of this study was to evaluate the effects of load carriage (LC) and LC plus respirator use (LC + self-contained breathing apparatus [SCBA]) on firefighters' work capacity to enhance our understanding of occupational demands. Twenty-one male structural firefighter recruits (age: 28.6 ± 4.3 years; height: 178.6 ± 7.2 cm; body mass: 94.1 ± 15.4 kg; body fat: 22.9 ± 6.1%) participated. Occupational performance was assessed by time to complete a simulated fire ground test (SFGT). After 2 familiarization trials, recruits performed the following SFGT conditions in a randomized order: PT (physical training clothes), LC only, and LC + SCBA. To describe within-group differences between SFGT conditions, relative difference scores were calculated as follows: % difference = ([experimental trial outcome - PT trial outcome]/PT trial outcome) × 100. Statistical differences between conditions were assessed with repeated-measures analysis of variance. The level of significance was set p < 0.01. Time to complete the LC + SCBA trial (345.9 ± 43.7 seconds; p < 0.001) and LC-only trial (331.2 ± 39.3 seconds; p < 0.001) were significantly greater than the PT trial (241.0 ± 33.3 seconds). Post-SFGT rating of perceived exertion was higher in the LC + SCBA trial (6.7 ± 1.7) and LC trial (6.4 ± 1.5) compared with the PT trial (4.7 ± 1.8; p < 0.001). Heart rate and lactate measures were similar across conditions (p = 0.488; p = 0.287). Personal protective equipment (PPE) significantly decreases the work capacity and increases the perceived effort of occupational tasks. Thus, these findings describe the additional physical demands produced by PPE and indicate that performance of firefighting tasks in an unloaded condition does not reflect work capacity in a bona fide condition.

Background: Pain interferes with people's daily lives and often limits the extent to which they can pursue goals and engage in activities that promote well-being. However, people vary in how much interference they experience at a given level of pain., Purpose: The present study tested how optimism affects and is affected by pain interference and goal-directed activity among older women., Methods: Every 3 months for 2 years, community-dwelling middle- and older-age women (N = 199) completed online daily diaries at home for a 7 day period, in which they reported their daily pain, pain interference, and goal-directed activity. Optimism was measured at the start and end of the study. Multilevel models tested the between- and within-person relationships among pain, optimism, and pain interference or goal-directed activity. Linear regression predicted change in optimism over 2 years from pain interference and goal-directed activity., Results: Pain best predicted pain interference and optimism best predicted goal-directed activity. There were subtle interactions between optimism and pain-predicting interference and goal-directed activity. Accumulated goal-directed activity and pain interference across the study predicted longitudinal changes in optimism, with higher activity and lower pain interference predicting increased optimism over 2 years., Conclusions: Optimism may play a protective role in disruptions caused by pain on a day-to-day basis, leading to increased goal-directed activity and possibly decreased pain interference. In turn, less interference and more goal-directed activity feed forward into increased optimism, resulting in a virtuous cycle that enhances optimism and well-being among older women., (© Society of Behavioral Medicine 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

BACKGROUNDThe circadian system entrains behavioral and physiological rhythms to environmental cycles, and modern lifestyles disrupt this entrainment. We investigated a timed exercise intervention to phase shift the internal circadian rhythm.METHODSIn 52 young, sedentary adults, dim light melatonin onset (DLMO) was measured before and after 5 days of morning (10 hours after DLMO; n = 26) or evening (20 hours after DLMO; n = 26) exercise. Phase shifts were calculated as the difference in DLMO before and after exercise.RESULTSMorning exercise induced phase advance shifts (0.62 ± 0.18 hours) that were significantly greater than phase shifts from evening exercise (-0.02 ± 0.18 hours; P = 0.01). Chronotype also influenced the effect of timed exercise. For later chronotypes, both morning and evening exercise induced phase advances (0.54 ± 0.29 hours and 0.46 ±0.25 hours, respectively). In contrast, earlier chronotypes had phase advances from morning exercise (0.49 ± 0.25 hours) but had phase delays from evening exercise (-0.41 ± 0.29 hours).CONCLUSIONLate chronotypes - those who experience the most severe circadian misalignment - may benefit from phase advances induced by exercise in the morning or evening, but evening exercise may exacerbate circadian misalignment in early chronotypes. Thus, personalized exercise timing prescription, based on chronotype, could alleviate circadian misalignment in young adults.TRIAL REGISTRATIONTrial registration can be found at www.clinicaltrials.gov (NCT04097886).FUNDINGFunding was supplied by NIH grants UL1TR001998 and TL1TR001997, the Barnstable Brown Diabetes and Obesity Center, the Pediatric Exercise Physiology Laboratory Endowment, the Arvle and Ellen Turner Thacker Research Fund, and the University of Kentucky.

Dinyer, TK, Byrd, MT, Garver, MJ, Rickard, AJ, Miller, WM, Burns, S, Clasey, JL, and Bergstrom, HC. Low-load vs. high-load resistance training to failure on one repetition maximum strength and body composition in untrained women. J Strength Cond Res 33(7): 1737-1744, 2019-This study examined the effects of resistance training (RT) to failure at low and high loads on one repetition maximum (1RM) strength and body composition (bone- and fat-free mass [BFFM] and percent body fat [%BF]) in untrained women. Twenty-three untrained women (age: 21.2 ± 2.2 years; height: 167.1 ± 5.7 cm; body mass: 62.3 ± 16.2 kg) completed a 12-week RT to failure intervention at a low (30% 1RM) (n = 11) or high (80% 1RM) (n = 12) load. On weeks 1, 5, and 12, subjects completed 1RM testing for 4 different exercises (leg extension [LE], seated military press [SMP], leg curl [LC], and lat pull down [LPD]) and a dual-energy x-ray absorptiometry scan to assess body composition. During weeks 2-4 and 6-7, the subjects completed 2 sets to failure for each exercise. During weeks 8-11, the subjects completed 3 sets to failure for each exercise. The 1RM strength increased from week 1 to week 5 (LE: 18 ± 16%; SMP: 9 ± 11%; LC: 12 ± 22%; LPD: 13 ± 9%), week 1 to week 12 (LE: 32 ± 24%; SMP: 17 ± 14%; LC: 23 ± 26%; LPD: 25 ± 13%), and week 5 to week 12 (LE: 11 ± 9%; SMP: 7 ± 9%; LC: 10 ± 7%; LPD: 11 ± 11%) in each exercise, with no significant differences between groups. There were no significant changes in BFFM (p = 0.241) or %BF (p = 0.740) for either group. Resistance training to failure at 30% 1RM and 80% 1RM resulted in similar increases in 1RM strength, but no change in BFFM or %BF. Untrained women can increase 1RM strength during RT at low and high loads, if repetitions are taken to failure.

A growing body of evidence indicates that biomarkers of cardiovascular risk may be related to cerebral health. However, little is known about the role that non-fasting lipoproteins play in assessing age-related declines in a cerebral biomarker sensitive to vascular compromise, white matter (WM) microstructure. High-density lipoprotein cholesterol (HDL-C) is atheroprotective and low-density lipoprotein cholesterol (LDL-C) is a major atherogenic lipoprotein. This study explored the relationships between non-fasting levels of cholesterol and WM microstructure in healthy older adults. A voxelwise and region of interest approach was used to determine the relationship between cholesterol and fractional anisotropy (FA). Participants included 87 older adults between the ages of 59 and 77 (mean age = 65.5 years, SD = 3.9). Results indicated that higher HDL-C was associated with higher FA in diffuse regions of the brain when controlling for age, sex, and body mass index (BMI). HDL-C was also positively associated with FA in the corpus callosum and fornix. No relationship was observed between LDL-C and FA. Findings suggest that a modifiable lifestyle variable associated with cardiovascular health may help to preserve cerebral WM.

Objective: Evaluate the effect of aerobic exercise using arm crank ergometry (ACE) in high motor complete (ISNCSCI A/B) spinal cord injury (SCI) as primarily related to cardiovascular disease (CVD) risk factors and functional mobility and secondarily to body composition and metabolic profiles., Design: Longitudinal interventional study at an academic medical center., Methods: Ten previously untrained participants (M8/F2, Age 36.7 y ± 10.1, BMI 24.5 ± 6.0) with high motor complete SCI (C7-T5) underwent ACE exercise training 30 minutes/day × 3 days/week for 10 weeks at 70% VO 2Peak ., Outcome Measures: Primary outcome measures were pre- and post-intervention changes in markers of cardiovascular fitness (graded exercise testing (GXT): VO 2 , VO 2Peak , respiratory quotient [RQ], GXT time, peak power, and energy expenditure [EE]) and community mobility (time to traverse a 100ft-5° ramp, and 12-minute WC propulsion test). Secondary outcome measures were changes in body composition and metabolic profiles (fasting and area under the curve for glucose and insulin, homeostasis model assessment [HOMA] for %β-cell activity [%β], %insulin sensitivity [%S], and insulin resistance [IR], and Matsuda Index [ISI Matsuda ])., Results: Resting VO 2 , relative VO 2Peak , absolute VO 2Peak , peak power, RQ, 12-minute WC propulsion, fasting insulin, fasting G:I ratio, HOMA-%S, and HOMA-IR all significantly improved following intervention (P < 0.05). There were no changes in body composition (P>0.05)., Conclusions: Ten weeks of ACE at 70% VO 2Peak in high motor complete SCI improves aerobic capacity, community mobility, and metabolic profiles independent of changes in body composition.

Bergstrom, HC, Byrd, MT, Wallace, BJ, and Clasey, JL. Examination of a multi-ingredient preworkout supplement on total volume of resistance exercise and subsequent strength and power performance. J Strength Cond Res 32(6): 1479-1490, 2018-This study examined the acute effects of a multi-ingredient preworkout supplement on (a) total-, lower-, and upper-body volume of resistance exercise and (b) the subsequent lower-body strength (isokinetic leg extension and flexion), lower-body power (vertical jump [VJ] height), upper-body power (bench throw velocity [BTv]), and cycle ergometry performance (critical power and anaerobic work capacity). Twelve men completed baseline strength and power measures before 2 experimental visits, supplement (SUP) and placebo (PL). The experimental visits involved a fatiguing cycling protocol 30 minutes after ingestion of the SUP or PL and 15 minutes before the beginning of the resistance exercise protocol, which consisted of 4 upper-body and 4 lower-body resistance exercises performed for 4 sets to failure at 75% 1 repetition maximum. The exercise volume for the total, lower, and upper body was assessed. The VJ height and BTv were measured immediately after the resistance exercise. Postexercise isokinetic leg extension and flexion strength was measured 15 minutes after the completion of a second cycling protocol. There was a 9% increase in the total-body volume of exercise and a 14% increase in lower-body volume of exercise for the SUP compared with the PL, with no effect on exercise volume for the upper body between the SUP and PL. The increased lower-body volume for the SUP did not result in greater lower-body strength and power performance decrements after exhaustive exercise, compared with the PL. These findings suggested the potential for the SUP to increase resistance exercise volume, primarily related to an increased lower-body volume of exercise.

Natural killer (NK) lymphocyte-mediated cytotoxicity and cytokine secretion control infections and cancers, but these crucial activities decline with age. NK cell development, homeostasis, and function require IL-15 and its chaperone, IL-15 receptor alpha (IL-15Rα). Macrophages and dendritic cells (DC) are major sources of these proteins. We had previously postulated that additional IL-15 and IL-15Rα is made by skeletal muscle and adipose tissue. These sources may be important in aging, when IL-15-producing immune cells decline. NK cells circulate through adipose tissue, where they may be exposed to local IL-15. The objectives of this work were to determine (1) if human muscle, subcutaneous adipose tissue (SAT), and visceral adipose tissue (VAT) are sources of IL-15 and IL-15 Rα, and (2) whether any of these tissues correlate with NK cell activity in elderly humans. We first investigated IL-15 and IL-15Rα RNA expression in paired muscle and SAT biopsies from healthy human subjects. Both tissues expressed these transcripts, but IL-15Rα RNA levels were higher in SAT than in skeletal muscle. We also investigated tissue obtained from surgeries and found that SAT and VAT expressed equivalent amounts of IL-15 and IL-15Rα RNA, respectively. Furthermore, stromal vascular fraction cells expressed more IL-15 RNA than did adipocytes. To test if these findings related to circulating IL-15 protein and NK cell function, we tested 50 healthy adults aged > 70 years old. Plasma IL-15 levels significantly correlated with abdominal VAT mass in the entire cohort and in non-obese subjects. However, plasma IL-15 levels did not correlate with skeletal muscle cross-sectional area and correlated inversely with muscle strength. Plasma IL-15 did correlate with NK cell cytotoxic granule exocytosis and with CCL4 (MIP-1β) production in response to NKp46-crosslinking. Additionally, NK cell responses to K562 leukemia cells correlated inversely with muscle strength. With aging, immune function declines while infections, cancers, and deaths increase. We propose that VAT-derived IL-15 and IL-15Rα is a compensatory NK cell support mechanism in elderly humans.

Purpose: The purpose of this study was to examine differences in heart rate recovery (HRRec) and oxygen consumption recovery (VO 2 recovery) between young healthy-weight children and children with obesity following a maximal volitional graded exercise test (GXTmax)., Method: Twenty healthy-weight children and 13 children with obesity completed body composition testing and performed a GXTmax. Immediately after the GXTmax, HRRec and VO 2 recovery were measured each minute for 5 consecutive minutes., Results: There were no statistically significant group differences in HRRec for the 5 min following maximal exercise, Wilks's Lambda = .885, F(4, 28) = 0.911, p = .471, between the healthy-weight children and children with obesity despite statistically significant differences in body fat percentage (BF%; healthy-weight children, 18.5 ± 6.1%; children with obesity, 41.1 ± 6.9%, p < .001) and aerobic capacity relative to body mass (VO 2 peak; healthy-weight children, 46.8 ± 8.2 mL/kg/min; children with obesity, 31.9 ± 4.7 mL/kg/min, p < .001). There were statistically significant differences in VO 2 recovery for the 5 min following exercise, Wilks's Lambda = .676, F(4, 26) = 3.117, p = .032. There were no statistically significant correlations between HRRec and body mass index (BMI), BF%, VO 2 peak, or physical activity., Conclusions: In a healthy pediatric population, obesity alone does not seem to significantly impact HRRec, and because HRRec was not related to obesity status, BMI, or BF%, it should not be used as the sole indicator of aerobic capacity or health status in children. Using more than one recovery variable (i.e., HRRec and VO 2 recovery) may provide greater insight into cardiorespiratory fitness in this population.

Critical power (CP) and anaerobic work capacity (AWC) from the CP test represent distinct parameters related to metabolic characteristics of the whole body and active muscle tissue, respectively., Purpose: To examine the contribution of whole-body composition characteristics and local lean mass to further elucidate the differences in metabolic characteristics between CP and AWC as they relate to whole body and local factors., Methods: Fifteen anaerobically trained men were assessed for whole-body (% body fat and mineral-free lean mass [LBM]) and local mineral-free thigh lean mass (TLM) composition characteristics. CP and AWC were determined from the 3-min all-out CP test. Statistical analyses included Pearson product-moment correlations and stepwise multiple-regression analyses (P ≤ .05)., Results: Only LBM contributed significantly to the prediction of CP (CP = 2.3 [LBM] + 56.7 [r 2  = .346, standard error of the estimate (SEE) = 31.4 W, P = .021]), and only TLM to AWC (AWC = 0.8 [TLM] + 3.7 [r 2  = .479, SEE = 2.2 kJ, P = .004])., Conclusions: The aerobic component (CP) of the CP test was most closely related to LBM, and the anaerobic component (AWC) was more closely related to the TLM. These findings support the theory that CP and AWC are separate measures of whole-body metabolic capabilities and the energy stores in the activated local muscle groups, respectively. Thus, training programs to improve CP and AWC should be designed to include resistance-training exercises to increase whole-body LBM and local TLM.

There are conflicting suggestions regarding the most valid resistance (3-5% of body weight) to use for the critical power (CP) 3-min all-out (CP 3min ) test to estimate CP and anaerobic work capacity (AWC). The purpose of this study was to determine if the CP and AWC estimates from the CP 3min test were affected by the percentage of body weight used to set the resistance on a Monark cycle ergometer. Ten recreationally trained participants (mean ± SD: Age: 22.2 ± 2.2 yrs.) completed the CP 3min test at resistances of 4.5% (CP 4.5% ) and 3% (CP 3% ) of body weight to determine the CP and AWC. There were no significant differences between the CP 4.5% (167 ± 34 W) and CP 3% (156 ± 36 W) estimates. The AWC 3% (5.6 ± 2.5 kJ) estimates were significantly lower than the AWC 4.5% (9.0 ± 4.0 kJ). The CP and AWC estimates from the CP 4.5% were consistent with values reported in the literature, however, the AWC estimate from the CP 3% was lower than typically reported. These findings suggested that a resistance set at 3% of body weight for the CP 3min test may be too low to accurately estimate AWC, but 3% and 4.5% resulted in the same estimation of CP. Thus, the principal finding of this study was that a resistance of 4.5% of body weight for CP 3-min in recreationally trained participants resulted in more accurate estimates of AWC, compared to a resistance of 3%, and supports the use of 4.5% body weight resistance to measure both CP and AWC.

Age-related declines in endothelial function can lead to cognitive decline. However, little is known about the relationships between endothelial function and specific neurocognitive functions. This study explored the relationship between measures of endothelial function (reactive hyperemia index; RHI), white matter (WM) health (fractional anisotropy, FA, and WM hyperintensity volume, WMH), and executive function (Trail Making Test (TMT); Trail B - Trail A). Participants were 36 older adults between the ages of 59 and 69 (mean age = 63.89 years, SD = 2.94). WMH volume showed no relationship with RHI or executive function. However, there was a positive relationship between RHI and FA in the genu and body of the corpus callosum. In addition, higher RHI and FA were each associated with better executive task performance. Tractography was used to localize the WM tracts associated with RHI to specific portions of cortex. Results indicated that the RHI-FA relationship observed in the corpus callosum primarily involved tracts interconnecting frontal regions, including the superior frontal gyrus (SFG) and frontopolar cortex, linked with executive function. These findings suggest that superior endothelial function may help to attenuate age-related declines in WM microstructure in portions of the corpus callosum that interconnect prefrontal brain regions involved in executive function.

The purpose of this study was to examine associations among bone mineral density, osteopenia/osteoporosis, body mass index (BMI), and body composition in patients with heart failure (HF). A total of 119 patients (age = 61 ± 12 years, 65% male) underwent dual-energy X-ray absorptiometry scans to determine bone mineral density and body composition. In multivariable linear regressions, BMI, relative skeletal muscle index (RSMI), and mineral-free lean mass were positively associated with total body bone mineral density. Mineral-free lean mass was most strongly associated with bone mineral density (β = .398). In multivariable logistic regressions, higher BMI, RSMI, and mineral-free lean mass were associated with lower odds for osteopenia/osteoporosis. Fat mass was not associated with total body bone mineral density or osteopenia/osteoporosis. These results suggest that muscle mass may be the important component of body mass associated with bone mineral density in patients with HF.

Higher body mass index (BMI) is associated with greater cardiovascular disease (CVD) risk, in part due to aortic stiffening assessed by carotid-femoral pulse wave velocity (cfPWV). Importantly, greater cardiorespiratory fitness (CRF; VO 2peak ) decreases CVD risk, and is associated with reductions in aortic stiffness. We tested the hypothesis that young adult overweight (OW, n=17) compared with healthy-weight (HW, n=17) men will have greater resting aortic stiffness, reduced CRF and an impaired post-exercise hemodynamic response. Resting cfPWV was greater in OW versus HW individuals (5.81 ± 0.13 vs 4.81 ± 0.12 m/sec, p<0.05). Relative CRF (VO 2peak ; mL/kg/min) was lower in OW compared with HW individuals (49.4 ± 1.3 vs 57.6 ± 1.0 mL/kg/min, p<0.05), and was inversely related with cfPWV (p<0.05). However, CRF as absolute VO 2peak (L/min) was not different between groups and there was no relation between cfPWV and absolute VO 2peak (L/min), indicating reduced relative CRF in OW men is due to greater body mass. Following the maximal treadmill exercise test, cfPWV was greater in OW compared with HW subjects from rest to 60 minutes post-exercise (p<0.05). Compared with HW, OW individuals had higher systolic blood pressure (main effect, p<0.05) and diastolic blood pressure was selectively increased for up to 60 minutes following exercise (p<0.05). Overweight individuals had an attenuated post-exercise decrease in mean arterial pressure (p<0.05). Collectively, these results indicate that young, apparently healthy, OW men have greater resting aortic stiffening and an impaired post-exercise hemodynamic response., (© The Author(s) 2016.)

A growing body of evidence indicates that cardiorespiratory fitness attenuates some age-related cerebral declines. However, little is known about the role that myocardial function plays in this relationship. Brain regions with high resting metabolic rates, such as the default mode network (DMN), may be especially vulnerable to age-related declines in myocardial functions affecting cerebral blood flow (CBF). This study explored the relationship between a measure of myocardial mechanics, global longitudinal strain (GLS), and CBF to the DMN. In addition, we explored how cardiorespiratory affects this relationship. Participants were 30 older adults between the ages of 59 and 69 (mean age=63.73years, SD=2.8). Results indicated that superior cardiorespiratory fitness and myocardial mechanics were positively associated with DMN CBF. Moreover, results of a mediation analysis revealed that the relationship between GLS and DMN CBF was accounted for by individual differences in fitness. Findings suggest that benefits of healthy heart function to brain function are modified by fitness., (Copyright © 2015 Elsevier Inc. All rights reserved.)

Excessive hip adduction has been associated with a number of lower extremity overuse running injuries. The excessive motion has been suggested to be the result of reduced strength of the hip abductor musculature. Hip anatomical alignment has been postulated to influence hip abduction (HABD) strength and thus may impact hip adduction during running. The purpose of this study was to investigate the relationship between hip anatomy, HABD strength, and frontal plane kinematics during running. Peak isometric HABD strength, 3D lower extremity kinematics during running, femoral neck-shaft angle (NSA), and pelvis width-femur length (PW-FL) ratio were recorded for 25 female subjects. Pearson correlations (p<0.05) were performed between variables. A fair relationship was observed between femoral NSA and HABD strength (r=-0.47, p=0.02) where an increased NSA was associated with reduced HABD strength. No relationship was observed between HABD strength and hip adduction during running. None of the anatomical measurements, NSA or PW-FL, were associated with hip adduction during running. Deviations in the femoral NSA have a limited ability to influence peak isometric hip abduction strength or frontal plane hip kinematics during running. Hip abduction strength does also not appear to be linked with changes in hip kinematics. These findings in healthy individuals question whether excessive hip adduction typically seen in female runners with overuse injuries is caused by deviations in hip abduction strength or anatomical structure., (Copyright © 2015 Elsevier B.V. All rights reserved.)

Law enforcement officers (LEOs) on university campuses are required to perform a variety of physical occupational tasks. Identifying which physical fitness characteristics are associated with these occupational tasks will assist in the development of appropriate exercise programs and physical fitness assessments. Therefore, the purpose of this study was to identify physical fitness and demographic characteristics that were correlated with occupational tasks commonly performed by campus LEOs. The occupational assessment was conducted using an Officer Physical Ability Test (OPAT), which simulated a foot chase of a suspect. Sixteen male LEOs (age: 33.1 ± 8.7 years; body mass: 87.2 ± 11.2 kg; height: 179.0 ± 7.9 cm) performed the OPAT. A battery of physical fitness tests were used to assess aerobic capacity, muscular endurance, strength, power, flexibility, agility, and body composition. Bivariate correlations were performed to identify significant (p ≤ 0.05) correlations between physical fitness characteristics and OPAT time. The officers' age was significantly correlated to the majority of OPAT tasks, physical fitness, and anthropometric assessments. Therefore, partial correlations were used to control for the confounding effects of age. After controlling for the officers' age, the overall OPAT time was significantly correlated with agility (r = 0.57) and aerobic endurance (r = -0.65). Furthermore, push-up, curl-up, body mass, waist circumference, and abdominal circumference were significantly correlated to individual OPAT tasks. In conclusion, exercise programs and fitness assessments should be used for campus LEOs that address a variety of physical fitness characteristics associated with occupational performance. In addition, exercise programs should focus on body composition management and fitness for older LEOs.

Structural firefighting is a dangerous and physically demanding profession. Thus, it is critical that firefighters exercise regularly to maintain optimal physical fitness levels. However, little is known about optimal training methods for firefighters, and exercise equipment is often not available to on-duty firefighters. Therefore, the purpose of this study was to determine the effect of a novel supervised on-duty physical training program on the physical fitness and occupational performance of structural firefighters. Twenty professional male firefighters were divided into a supervised exercise group (SEG; n = 11) and a control group (CG; n = 9). The SEG participated in a 12-week circuit training intervention. The SEG exercised for 1 hour on 2 d·wk. At baseline and after the intervention, subjects performed a battery of physical fitness tests and a simulated fire ground test (SFGT). At baseline, there were no significant differences (p = 0.822) in the completion rate of the SFGT in the SEG (82%) vs. the CG (78%). After the intervention, a significantly greater proportion of the firefighters in the SEG completed the SFGT compared with the CG (SEG = 100% vs. CG = 56%; p < 0.013). In addition, the SEG demonstrated significant improvements in body mass, fat mass, and body mass index (p ≤ 0.05). The findings of this study indicate that training with firefighter equipment improved occupational performance and anthropometric outcomes in incumbent firefighters. Furthermore, implementing a supervised exercise program using firefighter equipment can be done so in a safe and feasible manner.

Circadian rhythms are ≈24 h oscillations in physiology and behavior, and disruptions have been shown to have negative effects on health. Wrist skin temperature has been used by several groups as a valid method of assessing circadian rhythms in humans. We tested the hypothesis that circadian temperature amplitude (TempAmp) and stability (TempStab) would significantly differ among groups of healthy young men of varying adiposities, and that we could identify physiological and behavioral measures that were significantly associated with these temperature parameters. Wrist skin temperatures taken at 10 min intervals for 7 consecutive days were determined in 18 optimal (OGroup), 20 fair (FGroup) and 21 poor (PGroup) %Fat grouped young men and subsequently analyzed using available validated software. Body composition, cardiorespiratory fitness, actigraphy, daily nutritional and sleep data, and fasting lipid, insulin and glucose concentration measures were also determined. Significant changes in TempAmp and TempStab parameters in subjects with a single metabolic syndrome (MetS) risk factor compared to those with no MetS factors was observed. In addition, stepwise multivariate regression analyses showed that 50% of the variance in TempAmp was explained by actigraphy (mean steps taken per day; MSTPD), cardiorespiratory fitness, and late night eating per week (#LNE); and 57% in TempStab by MSTPD, time spent in moderate-to-vigorous activity per day, fat mass, and #LNE. Overwhelmingly, physical activity was the most important measure associated with the differences in circadian rhythm parameters. Further research is warranted to determine the effects of increasing the amount and timing of physical activity on the status of the circadian system in a variety of populations.

High cardiorespiratory fitness (CRF) is an important protective factor reducing the risk of cardiac-related disability and mortality. Recent research suggests that high CRF also has protective effects on the brain's macrostructure and functional response. However, little is known about the potential relationship between CRF and the brain's white matter (WM) microstructure. This study explored the relationship between a comprehensive measure of CRF (VO(2) peak, total time on treadmill, and 1-minute heart rate recovery) and multiple diffusion tensor imaging measures of WM integrity. Participants were 26 healthy community dwelling seniors between the ages of 60 and 69 (mean=64.79 years, SD=2.8). Results indicated a positive correlation between comprehensive CRF and fractional anisotropy (FA) in a large portion of the corpus callosum. Both VO(2) peak and total time on treadmill contributed significantly to explaining the variance in mean FA in this region. The CRF-FA relationship observed in the corpus callosum was primarily characterized by a negative correlation between CRF and radial diffusivity in the absence of CRF correlations with either axial diffusivity or mean diffusivity. Tractography results demonstrated that portions of the corpus callosum associated with CRF primarily involved those interconnecting frontal regions associated with high-level motor planning. These results suggest that high CRF may attenuate age-related myelin declines in portions of the corpus callosum that interconnect homologous premotor cortex regions involved in motor planning., (Copyright © 2011 Elsevier Inc. All rights reserved.)

Bioelectric impedance analyses (BIA) provides a valid and reliable measure of body composition in field, clinical, and research settings if standard protocol procedures are followed, and population-specific equations are available and utilized. The objective of this study was to create and cross-validate a new BIA body composition equation with representative healthy weight (HW), overweight (OW), and obese (OB) young children. Participants were 436 children who were 5-11 years of age. Dual-energy absorptiometry fat-free mass (FFM) was used as the criterion measure and a single frequency tetra-polar BIA device was used to create the new BIA equation. The new BIA equation explained 95.2% of the variance in FFM with no statistical shrinkage upon cross-validation. The use of this equation may help to identify effective intervention strategies to prevent or combat childhood obesity, and may assist in additional conditions or treatments where information concerning body composition measures would provide greater accuracy and sensitivity measures for preventing or combating disease.

The causes of able-bodied gait asymmetries are unclear. Mild (< 3 cm) leg-length inequality (LLI) may be one cause of these asymmetries; however, this idea has not been thoroughly investigated. The purpose of this study was to investigate the nature of the relationship between LLI and able-bodied gait asymmetries. We hypothesized that subjects (n = 26) with relatively large LLI, quantified radiographically, would display less symmetrical gait than subjects with relatively small LLI. Gait asymmetries for joint kinematics and joint kinetics were determined using standard gait analysis procedures. Symmetry coefficients were used to quantify bilateral gait symmetry for sagittal-plane hip, knee, and ankle joint angles, moments, and powers. A Pearson product-moment correlation coefficient (r) was used to evaluate the relationship between LLI and the aforementioned symmetry coefficients. Also, these symmetry coefficients were compared between subjects with relatively small LLI (LLI < 1 cm; n = 19) and relatively large LLI (LLI ≥ 1 cm; n = 7). Statistically significant relationships were observed between LLI and the symmetry coefficient for knee joint moment (r = -0.48) and power (r = -0.51), and ankle joint moment (r = -0.41) and power (r = -0.42). Similarly, subjects with relatively large LLI exhibited significantly lower symmetry coefficients for knee joint moment (p = 0.40) and power (p = 0.35), and ankle joint moment (p = 0.40) and power (p = 0.22) than subjects with relatively small LLI. Degree of bilateral symmetry for knee and ankle joint kinetics appears to be related to LLI in able- bodied gait. This finding supports the idea that LLI is one cause of able-bodied gait asymmetries. Other factors, however, are also likely to contribute to these gait asymmetries; these may include other morphological asymmetries as well as asymmetrical neuromuscular input to the lower limb muscles. Key pointsModerate negative relationships were observed between mild limb-length inequality and gait symmetry for knee and ankle moment and power.Subjects with relatively large mild limb-length inequality (between 1.0 and 2.3 cm) exhibited significantly less symmetrical gait for knee and ankle joint moment and power than subjects with relatively small mild limb-length inequality (< 1 cm).These results indicate that the degree of symmetry for knee and ankle joint kinetics appears to be related to mild limb-length inequality in able-bodied gait.These results further our understanding of normal human walking and provide important background information for future studies on gait pathology associated with mild limb-length inequality.

The purpose of this study was to descriptively compare the physical activity and dietary intake of public school (PSC) versus home schooled children (HSC). Potential parental and home influences were also examined. Thirty six matched pairs of public school-home school children aged 7-11 years participated in this study. Each participant wore an activity monitor and recorded their dietary intake concurrently for seven consecutive days. PSC had significantly more total and weekday steps, and spent more time in moderate-to-vigorous physical activity compared with HSC. There were no differences in dietary intake between the two groups. These results suggest differences in physical activity between PSC and HSC and encourage further study of public and home school environments, in relation to the obesity epidemic.

Background: Glucagon-like peptide 1 (GLP-1) and pancreatic polypeptide (PP) are intestinal hormones that are involved in the post-prandial satiety response. We sought to assess meal-related changes in these hormones in young children and determine whether differences exist between normal weight (NW) and overweight (OW) children., Methods: Seven to 11-year-old healthy NW (n=20) and OW (n=12) volunteers were given a standardized breakfast and lunch following an overnight fast and had measurements of GLP-1 and PP over 9 hours. We characterized whether GLP-1 and PP changed from the pre-prandial to the post-prandial state and whether the serum levels corresponded to reported appetite., Results: GLP-1 did not increase after eating, did not decline prior to the next meal, and did not correspond to satiety ratings in either group. PP increased post-prandially in OW children after both breakfast and lunch, but in the NW group PP only increased after breakfast. PP levels did not decline in either group as the next meal approached., Conclusions: In our study of school-age children, feeding had little effect on GLP-1 secretion and a variable effect on serum PP levels. Observed differences in the GLP-1 and PP responses between the NW and OW groups do not suggest there is an intrinsic abnormality in their secretion that causes weight gain.

Objective: Ghrelin and peptide YY (PYY) are two gut hormones that have effects on appetite. Our objectives were to characterize the patterns of secretion of these hormones in response to feeding in school-age children and determine whether there were differences between normal weight (NW) and overweight (OW) subjects., Methods and Procedures: This was a cross-sectional study at one tertiary care center. Subjects were 7- to 11-year-old healthy NW and OW volunteers recruited from local advertisements. Following an overnight fast, the subjects were given a standardized breakfast and lunch and had nine hourly blood samples for total ghrelin and total PYY. We assessed whether ghrelin and PYY levels changed from the preprandial to postprandial state and corresponded to reported hunger/satiety., Results: Hunger ratings were similar between the two groups throughout the study period. Ghrelin was not suppressed after eating, did not rise prior to the next meal, and did not correspond to hunger ratings in either group. PYY increased postprandially and decreased preprandially in the NW group, but OW children exhibited this pattern for only part of the day. PYY levels incompletely corresponded to reported satiety in the OW group., Discussion: Mixed meal consumption had little effect on ghrelin secretion and a variable effect on PYY secretion in young children in our study. Differences that were observed between the groups do not suggest that an abnormality in their secretion contributes to the development of obesity.

Objectives: To compare (1) total body volume (V(b)) and density (D(b)) measurements obtained by hydrostatic weighing (HW) and air displacement plethysmography (ADP) in adults with spinal cord injury (SCI); (2) measured and predicted thoracic gas volume (V(TG)); and (3) differences in percentage of fat measurements using ADP-obtained D(b) and HW-obtained D(b) measures that were interchanged in a 4-compartment body composition model (4-comp %fat)., Design: Twenty adults with SCI underwent ADP and V(TG), and HW testing. In a subgroup (n=13) of subjects, 4-comp %fat procedures were computed., Setting: Research laboratories in a university setting., Participants: Twenty adults with SCI below the T3 vertebrae and motor complete paraplegia., Interventions: Not applicable., Main Outcome Measures: Statistical analyses, including determination of group mean differences, shared variance, total error, and 95% confidence intervals., Results: The 2 methods yielded small yet significantly different V(b) and D(b). The groups' mean V(TG) did not differ significantly, but the large relative differences indicated an unacceptable amount of individual error. When the 4-comp %fat measurements were compared, there was a trend toward significant differences (P=.08)., Conclusions: ADP is a valid alternative method of determining the V(b) and D(b) in adults with SCI; however, the predicted V(TG) should be used with caution.

The effects of increased muscle temperature via continuous ultrasound prior to a maximal bout of eccentric exercise were investigated on the symptoms of delayed onset muscle soreness (DOMS) of the elbow flexors. Perceived muscle soreness, upper arm circumferences, range of motion (ROM), and isometric and isokinetic strength were measured over 7 days on 14 college-aged men (n = 6) and women (n = 8). Ten minutes of continuous ultrasound (ULT) or sham-ultrasound (CON) were administered. Muscle temperature was measured in the biceps brachii of both arms. Muscle temperature increased by 1.79 degrees +/- 0.49 degrees C (mean +/- SD) in the experimental arm of the ULT group. Muscle soreness was induced by a single bout of 50 maximal eccentric contractions. The ULT group did not differ significantly (p < 0.05) from the CON group with respect to perceived muscle soreness, upper arm circumference, ROM, and isometric and isokinetic strength. In conclusion, increased muscle temperature failed to provide significant prophylactic effects on the symptoms of DOMS.

Objectives: To determine the bone mineral density (BMD) of the legs, arms, and trunk region of a group of adults with spinal cord injury (SCI) and to determine the relationship between regional BMD values and the time since injury., Design: BMD measurements were determined by total-body, dual-energy x-ray absorptiometry scans and percentage values (percentage-matched BMD), based on manufacturer-supplied normative data for age, sex, body weight, and ethnic group. The relationship between percentage-matched BMD values and time since injury was determined by linear regression analyses., Setting: Research laboratories in a university setting., Participants: Twenty-nine subjects (21 men, 8 women; mean age, 38.5 y) who had sustained an SCI a mean of 10.6 years earlier (range, 0.6-35.3 y)., Interventions: Not applicable., Main Outcome Measures: The relationship between percentage-matched BMD values and the time since injury., Results: There was a significant inverse relationship between percentage-matched BMD leg (r2 = -.76), arm (r2 = -.45), and trunk (r2 = -.38) values and the log of time since injury., Conclusion: Despite the varying levels of SCI and other relevant BMD contributing factors, the regional percentage-matched BMD values were significantly inversely related to the log of time since injury.

We examined the relationship between abdominal visceral fat (AVF) and plasma concentrations of lipids and lipoproteins in 19 females (F) (not on estrogen) and 31 males (M) over the age of 60 (age = 66.8 years). In addition, the effects of growth hormone (GH) release, fitness (Vo(2) peak), insulin, and glucose concentrations (both fasting and in response to an oral glucose tolerance test) on lipids were examined. Subjects were categorized by low (L) and high (H) AVF (L < 130 cm(2), H > 130 cm(2)), fat mass (FM) (above or below median value), and AVF corrected for fat mass. Factorial analysis of variance (ANOVA) showed that when subjects were divided by AVF and FM, similar results were observed with H > L (P <.05) for very-low-density lipoprotein-cholesterol (VLDL-C), triglycerides (TG), VLDL-TG, apolipoprotein (apo)-B, apo-B VLDL, cholesterol (Chol)/high-density lipoprotein (HDL), LDL/HDL, apoB/A1 and L > H for HDL, HDL(2), HDL(3), apo A1, and LDL/apo-B LDL. Gender differences were also observed with F > M for Chol, LDL, HDL, and HDL(2). When AVF was corrected for FM, these gender differences were still present. After correcting for FM, differences remained between H and L AVF groups for VLDL, TG, VLDL-TG, apo-B, apo-B LDL, apo-B VLDL, apoB/A1 (P <.05). Twenty-four hour integrated GH concentration (IGHC) was inversely related to VLDL, TG, VLDL TG, LDL TG, apoB, apoB VLDL, apoB LDL, Chol/HDL, LDL/HDL, and apoB/A1 in F, but not M (P <.05). Vo(2) peak was directly related to Chol, LDL, HDL(3), and apoB LDL with stronger relationships observed in F. Fasting insulin was related to lipids and lipoproteins in both men and women. These data suggest that, in older adults, elevated levels of AVF, FM, and AVF corrected for FM are associated with unfavorable lipid-lipoprotein profiles and extend similar findings reported in younger males and females with elevated AVF. These data also support previous findings indicating that AVF is a primary determinant of GH release., (Copyright 2003, Elsevier Science (USA). All rights reserved.)

Numerous physiological factors modulate GH secretion, but these variables are not independent of one another. We studied 40 younger (20-29 yr.; 21 men and 19 women) and 62 older (57-80 yr.; 35 men and 27 women) adults to determine the contributions of several demographic and physiological factors to the variability in integrated 24-h GH concentrations. Serum GH was measured every 10 min for 24 h in an enhanced sensitivity chemiluminescence assay. The predictor variables included: age group (young or old), gender, abdominal visceral fat (by computed tomography), total body fat mass and percentage body fat by dual-energy x-ray absorptiometry, serum IGF-I, fasting serum insulin, 24-h mean estradiol and testosterone, and peak oxygen uptake by graded exercise (treadmill) testing. Multiple ordinary least squares regression analysis was used to quantitatively assess the individual contribution that each predictive measure made to explain the variability among values of integrated 24-h GH concentrations while in the presence of the remaining predictors. The model explained 65% of the variance in integrated 24-h GH concentrations. Abdominal visceral fat (P < 0.002) and fasting insulin (P < 0.008) were consistently important predictors of integrated 24-h GH concentrations independent of age group, gender, and all other predictor variables. Although serum IGF-I was an important overall predictor of integrated 24-h GH concentrations (P = 0.002), this relationship was present only in the young subjects and was modulated by gender. The remaining variables failed to contribute significantly to the model. We conclude that abdominal visceral fat and fasting insulin are important predictors of integrated 24-h GH concentrations in healthy adults, independent of age and gender. Serum IGF-I is an important predictor of integrated 24-h GH concentrations in young but not older subjects. Bidirectional feedback between each of these three factors and GH secretion may account for the strong relationships observed.

Objective: A single-slice computed tomography (CT) scan provides a criterion measure of total abdominal fat (TAF) and abdominal visceral fat (AVF), but this procedure is often prohibitive due to radiation exposure, cost, and accessibility. In the present study, the utility of anthropometric measures and estimates of trunk and abdominal fat mass by dual-energy X-ray absorptiometry (DXA) to predict CT measures of TAF and AVF (cross-sectional area, cm2) was assessed., Research Methods and Procedures: CT measures of abdominal fat (at the level of the L4-L5 inter-vertebral space), DXA scans, and anthropometric measures were obtained in 76 Caucasian adults ages 20-80 years., Results: Results demonstrated that abdominal sagittal diameter measured by anthropometry is an excellent predictor of sagittal diameter measured from a CT image (r=0.88 and 0.94; Total Error [TE]=4.1 and 3.1 cm, for men and women, respectively). In both men and women, waist circumference and abdominal sagittal diameter were the anthropometric measures most strongly associated with TAF (r=0.87 to 0.93; Standard Error of Estimate (SEE)=60.7 to 75.4 cm2) and AVF (r=0.84 to 0.93; SEE=0.7 to 30.0 cm2). The least predictive anthropometric measure of TAF or AVF was the commonly used waist-to-hip ratio (WHR). DXA estimates of trunk and abdominal fat mass were strongly associated with TAF (r=.94 to 0.97; SEE=36.9 to 50.9 cm2) and AVF (r=0.86 to 0.90; SEE=4.9 to 27.7 cm2)., Discussion: The present results suggest that waist circumference and/or abdominal sagittal diameter are better predictors of TAF and AVF than the more commonly used WHR. DXA trunk fat and abdominal fat appear to be slightly better predictors of TAF but not AVF compared to these anthropometric measures. Thus DXA does not offer a significant advantage over anthropometry for estimation of AVF.

We examined the validity of percent body fat (%Fat) estimation by two-compartment (2-Comp) hydrostatic weighing (Siri 2-Comp), 3-Comp dual-energy X-ray absorptiometry (DEXA 3-Comp), 3-Comp hydrostatic weighing corrected for the total body water (Siri 3-Comp), and anthropometric methods in young and older individuals (n = 78). A 4-Comp model of body composition served as the criterion measure of %Fat (Heymsfield 4-Comp; S. B. Heymsfield, S. Lichtman, R. N. Baumgartner, J. Wang, Y. Kamen, A. Aliprantis, and R. N. Pierson Jr., Am. J. Clin. Nutr. 52: 52-58, 1990.). Comparison of the Siri 3-Comp with the Heymsfield 4-Comp model revealed mean differences of /= r = 0.997, total error values

Single-slice abdominal computed tomography (CT) scanning has been used extensively for the measurement of abdominal visceral fat (AVF). Optimal anatomical scan location and pixel density ranges have been proposed and are specifically reported to allow for the replication and standardization of AVF measurements. Standardization of the anatomical boundaries for CT measurement of AVF and the influence of age and gender on results obtained with different boundary locations have received much less attention. To determine the influence of three boundary analysis methods (AVF-1, AVF-2, and AVF-3) on the measurement of AVF by CT, 54 older (60 years to 79 years) and 37 younger (20 years to 29 years) healthy men and women were examined. The measurement boundary for AVF-1 was the internal most aspect of the abdominal and oblique muscle walls, and the posterior aspect of the vertebral body. AVF-2 used fat measurements enclosed in a boundary formed by the midpoint of the abdominal and oblique muscle walls, and the most posterior aspect of the spinous process. AVF-3 used fat measurements enclosed in a boundary formed by the external border of the abdominal and oblique muscle walls, and the external border of the erector spinae. Greater AVF measures were obtained with AVF-2 and AVF-3 compared with AVF-1 (p < 0.0001). These differences were greater in older compared with younger subjects (p < 0.0001) and greater in women compared with men (p < 0.02). The significantly greater AVF measurements obtained with AVF-2 and AVF-3 resulted from the inclusion of larger amounts of fat that are not drained by the portal circulation. This included retroperitoneal, intermuscular, and intramuscular lipid droplets, which increase with aging. On the basis of these results, we recommend the AVF-1 anatomical boundaries for the measurement of AVF in clinical investigations, particularly with older subjects. These data demonstrate the importance of precise and reproducible anatomical boundaries for the measurement of AVF, particularly in longitudinal studies.

To determine if the mode of 17 beta-estradiol (E2) administration affects growth hormone (GH) concentrations, eight postmenopausal women were studied under the following conditions: (1) control (no E2), (2) oral E2 (Estrace, 1 mg every 12 h for 2 weeks) and (3) transdermal E2 (Estraderm patch, 0.1 mg, two patches changed daily for 2 weeks). Blood was collected every 5 min for 24 h and assayed for serum GH concentrations using a sensitive chemiluminescence assay. Serum E2 levels were comparable during both E2 treatment regimens when measured with a specific chemiluminescence assay. The 24-h integrated GH concentrations (IGHC, min . micrograms/L) increased in all eight subjects from (mean +/- SE) 494 +/- 102 during control to 860 +/- 111 (P < 0.05) and 832 +/- 149 (P < 0.05) during oral and transdermal E2, respectively. Both E2 treatments significantly increased GH pulse height, individual pulse area, incremental pulse amplitude, interpeak valley concentration, and interpeak valley nadir (as measured by Cluster algorithm) when compared with control. No significant differences were observed in the number of GH pulses per 24 h. Insulin-like growth factor-I (IGF-I, micrograms/L) concentrations decreased from 165 +/- 19 (control) to 109 +/- 11 (oral E2, P < 0.05) and 122 +/- 15 (transdermal E2, P < 0.05). No statistically significant differences in attributes of pulsatile GH release or IGF-I concentrations were observed between the oral and transdermal E2 treatments. We conclude that both oral and transdermal E2 treatment increase serum GH concentrations in postmenopausal women. This increase is manifested by larger GH pulses and higher basal (interpulse) GH levels, not by changes in pulse frequency. Both routes of E2 administration decrease serum IGF-I concentrations, which may attenuate IGF-I negative feedback on pituitary somatotrophs and hypothalamic somatostatin secretion, resulting in enhanced pulsatile GH release.