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Purpose: Overweight individuals are at risk of intermediate hyperglycemia (IHG) [1]. Increasing physical activity (PA) in IHG is one method to reduce the risk of glucometabolic and cardiovascular (CV) complications [2]. This study investigates walking to music as a modality to increase moderate intensity PA and regulate glucometabolic disturbances. Patients and Methods: Participants were randomized to usual care (UC) or intervention group (IG) who completed a 6 month walking to music program. Physiological assessments for a range of variables (DEXA, flow mediated dilatation (FMD) and glucometabolic biomarkers) were completed at baseline, 4, 6 and 9 months (follow-up). Results: For IG group, walking compliance decreased with time however 71.4%, 79.5% and 73% of walking completed was moderate intensity at 4, 6 and 9 months. At 6 months IG FMD was significantly lower than UC and HbA1Cwas 5% lower. Other physiological markers were not altered. Conclusion: Walking to music may be a novel method to encourage moderate intensity PA. However, the majority of results demonstrate that this intervention was not more effective than UC in managing glucometabolic and CV biomarkers in IHG. Future interventions should include additional support for the entire study duration however this has cost implications.

Current evidence suggests that chronic inflammation contributes to the development of coronary artery disease (CAD). Interestingly, exercise may constitute a method of reducing inflammation in this patient population. As such, this systematic review and meta-analysis examined the evidence generated by randomised studies that investigated the effect of exercise on inflammatory biomarkers in CAD. Literature was sought from various sources. Outcomes were pooled in a random-effects model to calculate standardised mean differences (SMD) with 95% confidence intervals (CI). Twenty-five studies were reviewed; post-intervention C-reactive protein (SMD: -0.55 (95% CI: -0.93, -0.16), P = 0.005), fibrinogen (SMD: -0.52 (95% CI: -0.74, -0.29, P = 0.00001)), and von Willebrand factor (SMD: -1.57 (95% CI: -2.23, -0.92), P = 0.00001) values were significantly lower in exercise groups compared to controls. In addition, qualitative analyses identified evidence that supports a beneficial effect of exercise on these acute-phase reactants. However, the impact of exercise on anti-inflammatory cytokines, adhesion molecules, and chemokines is equivocal, which may be attributed to a paucity of research. Nevertheless, the findings of this review suggest that exercise induces an anti-inflammatory effect in CAD patients. Although, the quality of evidence needs to be improved by further randomised studies with high methodological qualities and large sample sizes.

Exercise is widely recognised for its health enhancing benefits. Despite this, an overproduction of reactive oxygen and nitrogen species (RONS), outstripping antioxidant defence mechanisms, can lead to a state of (chronic) oxidative stress. DNA is a vulnerable target of RONS attack and, if left unrepaired, DNA damage may cause genetic instability.This meta-analysis aimed to systematically investigate and assess the overall effect of studies reporting DNA damage following acute aerobic exercise.Web of Science, PubMed, MEDLINE, EMBASE, and Scopus were searched until April 2019. Outcomes included (1) multiple time-points (TPs) of measuring DNA damage post-exercise, (2) two different quantification methods (comet assay and 8-oxo-2'-deoxyguanosine; 8-OHdG), and (3) protocols of high intensity (≥ 75% of maximum rate of oxygen consumption; VOLiterature search identified 4316 non-duplicate records of which 35 studies were included in the meta-analysis. The evidence was strong, showcasing an increase in DNA damage immediately following acute aerobic exercise with a large-effect size at TP 0 (0 h) (SMD = 0.875; 95% CI 0.5, 1.25; p 0.05). When comparing between comet assay and 8-OHdG at TP 0, a significant difference was observed only when using the comet assay. Finally, when isolating protocols of long-distance and high-intensity exercise, increased DNA damage was only observed in the latter. (SMD = 0.48; 95% CI - 0.16, 1.03; p = 0.15 and SMD = 1.18; 95% CI 0.71, 1.65; p 0.05 respectively).A substantial increase in DNA damage occurs immediately following acute aerobic exercise. This increase remains significant between 2 h and 1 day, but not within 5-28 days post-exercise. Such an increase was not observed in protocols of a long-distance. The relationship between exercise and DNA damage may be explained through the hormesis theory, which is somewhat one-dimensional, and thus limited. The hormesis theory describes how exercise modulates any advantageous or harmful effects mediated through RONS, by increasing DNA oxidation between the two end-points of the curve: physical inactivity and overtraining. We propose a more intricate approach to explain this relationship: a multi-dimensional model, to develop a better understanding of the complexity of the relationship between DNA integrity and exercise.

BackgroundExercise is widely recognised for its health enhancing benefits. Despite this, an overproduction of reactive oxygen and nitrogen species (RONS), outstripping antioxidant defence mechanisms, can lead to a state of (chronic) oxidative stress. DNA is a vulnerable target of RONS attack and, if left unrepaired, DNA damage may cause genetic instability.ObjectiveThis meta-analysis aimed to systematically investigate and assess the overall effect of studies reporting DNA damage following acute aerobic exercise.MethodsWeb of Science, PubMed, MEDLINE, EMBASE, and Scopus were searched until April 2019. Outcomes included (1) multiple time-points (TPs) of measuring DNA damage post-exercise, (2) two different quantification methods (comet assay and 8-oxo-2′-deoxyguanosine; 8-OHdG), and (3) protocols of high intensity (≥ 75% of maximum rate of oxygen consumption;VO2-max) and long distance (≥ 42 km).ResultsLiterature search identified 4316 non-duplicate records of which 35 studies were included in the meta-analysis. The evidence was strong, showcasing an increase in DNA damage immediately following acute aerobic exercise with a large-effect size at TP 0 (0 h) (SMD = 0.875; 95% CI 0.5, 1.25;p p = 0.15 and SMD = 1.18; 95% CI 0.71, 1.65;p ConclusionsA substantial increase in DNA damage occurs immediately following acute aerobic exercise. This increase remains significant between 2 h and 1 day, but not within 5–28 days post-exercise. Such an increase was not observed in protocols of a long-distance. The relationship between exercise and DNA damage may be explained through the hormesis theory, which is somewhat one-dimensional, and thus limited. The hormesis theory describes how exercise modulates any advantageous or harmful effects mediated through RONS, by increasing DNA oxidation between the two end-points of the curve: physical inactivity and overtraining. We propose a more intricate approach to explain this relationship: a multi-dimensional model, to develop a better understanding of the complexity of the relationship between DNA integrity and exercise.

Background: Exercise has proved effective in attenuating the unfavourable response normally associated with postprandial hypertriglyceridemia (PHTG) and accompanying oxidative stress. Yet, the acute effects of prior exercise and PHTG on DNA damage remains unknown. The purpose of this study was to examine if walking alters PHTGinduced oxidative damage and the interrelated inflammatory mechanisms.Methods: Twelve apparently healthy, recreationally active, male participants (22.4 ± 4.1 years; 179.2 ± 6 cm; 84.2 ± 14.7 kg; 51.3 ± 8.6 ml·kg− 1·min− 1) completed a randomised, crossover study consisting of two trials: (1) a high-fat mealalone (resting control) or (2) a high-fat meal immediately following 1 h of moderate exercise (65% maximal heartrate). Venous blood samples were collected at baseline, immediately post-exercise or rest, as well as at 2, 4 and 6 hpost-meal. Biomarkers of oxidative damage (DNA single-strand breaks, lipid peroxidation and free radicalmetabolism) and inflammation were determined using conventional biochemistry techniques.Results: DNA damage, lipid peroxidation, free radical metabolism and triglycerides increased postprandially (main effect for time, p < 0.05), regardless of completing 1 h of preceding moderate intensity exercise. Plasma antioxidants(α-tocopherol and γ-tocopherol) also mobilised in response to the high-fat meal (main effect for time, p < 0.05), butno changes were detected for retinol-binding protein-4.Conclusion: The ingestion of a high fat meal induces postprandial oxidative stress, inflammation and a rise in DNA damage that remains unaltered by one hour of preceding exercise.Keywords: Exercise, Postprandial hypertriglyceridemia, Oxidative stress, DNA, Inflammation

This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults (n = 37, 94.26 ± 17.11 kg, 49.63 ± 12.37 years) were randomly assigned to an intervention (IG, n = 17) or usual care group (UC, n = 20) as part of a novel nine-month walking intervention. IG participants walked to self-selected music with a predetermined tempo and received a behavioural change support programme. At baseline, four-, six- and nine-months participants were asked to walk around an elliptical track at their habitual pace (0–2 min) and then in time to a predetermined tempo (2–8 min) designed to elicit moderate intensity. Cadence response (steps/min) was assessed and intensity (heart rate (bpm) recorded using wireless telemetry. A repeated measures general linear model (GLM) examined differences between groups over time (p &lt, 0.05). All data is presented as means ± SD. At each assessment point both groups displayed an immediate cadence adjustment in response to music tempo (p &lt, 0.01) i.e., habitual cadence vs. 3 METs target cadence (p &lt, 0.05) and 3 METs target cadence vs. 5 METs target cadence (p &lt, 0.05). Additionally, IG participants displayed an increased habitual cadence (0–2 min) at each assessment point (p &lt, 0.05, 110 ± 9, 121.80 ± 7.5, 121.46 ± 10, 121.93 ± 7 steps/min respectively). UC participant’s habitual cadence was unchanged from 0–9 months (p &gt, 120 ± 10, 116 ± 13, 119 ± 12 and 119 ± 9 steps/min respectively). Music tempo may be a useful regulatory tool to prompt the free-living individual to reach an appropriate stride rate to achieve a walking pace that is at least moderate intensity. It also appears that results may be trainable as throughout the study an increased habitual walking cadence was observed, in the absence of music.

Sirtuin-1 is a protein that may orchestrate the cardioprotective effect of exercise by controlling cellular processes. This pilot study assessed the feasibility of performing a quasi-experimental study in this area. Patients with postacute myocardial infarction were recruited across four hospital sites in the United Kingdom. The participants were offered one weekly exercise session at Phase-III and Phase-IV cardiac rehabilitation (CR). Measurements were obtained pre-Phase-III CR (Week 1), post-Phase-III CR (Week 8), and post-Phase-IV CR (Week 22). Twenty-eight patients were recruited (79% male, 100% White, 60.2 ± 10.5 years old). The recruitment rate was not fulfilled (d≥ 0.8) was seen after Phase-III and Phase-IV CR. Collectively, a quasi-experimental study is feasible with a revised recruitment strategy.

Despite the clinical benefits, coronary artery disease patient participation rates in cardiac rehabilitation (CR) and long-term exercise are poor. This study explored the factors related to participation in these interventions from the perspectives of post-acute myocardial infarction (AMI) patients and their significant others. Semi-structured interviews were performed with post-AMI patients (number (n) = 10) and their significant others (n = 10) following phase-III and phase-IV CR. Reflexive thematic analysis with an inductive orientation was utilised to identify themes within the dataset (ClinicalTrials.gov identifier: NCT03907293). The overarching theme of the data was a perceived need to improve health, with the participants viewing health benefits as the principal motive for participating in CR and long-term exercise training. Three further themes were identified: motivation, extrinsic influences, and CR experience. These themes captured the underlying elements of the participants’ decision to take part in CR and long-term exercise training for the purpose of health improvements. An AMI collectively impacts the attitudes and beliefs of patients and their significant others in relation to CR participation, long-term exercise, and health. The factors identified in this study may inform strategies to promote patient enrollment in CR and adherence to long-term exercise.IMPLICATIONS FOR REHABILITATIONPost-AMI patients and their significant others reported that health benefits were the primary motive for participating in CR and long-term exercise, with aspects related to motivation, extrinsic influences, and CR experience underpinning the decision.Healthcare professionals should supply information about health benefits during the CR referral process, with insights into the experiences of CR graduates potentially improving the strength of recommendation.CR facilitators may promote long-term exercise adherence by assisting patients with the identification of an enjoyable exercise modality.Healthcare professionals should include significant others in the CR referral process, which may enable these individuals to support the patients’ decisions. Post-AMI patients and their significant others reported that health benefits were the primary motive for participating in CR and long-term exercise, with aspects related to motivation, extrinsic influences, and CR experience underpinning the decision. Healthcare professionals should supply information about health benefits during the CR referral process, with insights into the experiences of CR graduates potentially improving the strength of recommendation. CR facilitators may promote long-term exercise adherence by assisting patients with the identification of an enjoyable exercise modality. Healthcare professionals should include significant others in the CR referral process, which may enable these individuals to support the patients’ decisions.

ObjectivesThere is a lack of public awareness of the importance of engaging in physical activity (PA) in the United Arab Emirates (UAE). Nearly 58% of the UAE adult population self-reports as being physically inactive although little accelerometer data currently exists. The aim of this study was to obtain the first dataset that objectively quantifies PA and sedentary behaviour (SB) in young UAE adults.MethodsThis cross-sectional study recruited 140 university students. Body composition and accelerometry was assessed using a Tanita body composition analyser and ActiGraph accelerometer. Differences (p≤0.05) between gender (male vs female) and body mass index (normal vs overweight/obese) were determined using independent samples t-tests and χ2 tests for nominal variables.ResultsBoth males and females spent high amounts of time in SB, encompassing ~80% of waking hours. PA was primarily light intensity (14.1%), although males spent significantly greater time in moderate-to-vigorous intensity activity. Moreover, 50% of males compared with 76.6% of females were classified as sedentary/low active according to daily step counts.ConclusionOur data provide evidence of high levels of SB among young adults in the UAE with PA being predominantly light intensity, therefore, both PA and SB should be carefully monitored in this country.

Background Measuring the quality of children and young people’s (CYP’s) healthcare services is an essential process for quality assurance, quality improvement and accountability, so that better care can be provided. Past quality measures created without CYP’s input may have been missing ‘what matters’ to CYP themselves. Aims To explore key features of healthcare quality measures most highly regarded by CYP’s and consider factors influencing their priorities; To compare findings with parents and healthcare professionals (HCPs) perceptions of quality measures. Method This qualitative study was undertaken as part of a Modified Delphi consensus study. CYP’s, parents’ and HCPs’ views on 32 widely-used determinates for CYP’s healthcare quality were captured during 3 separate focus group discussions. Measures were classified within General Practice, acute care and long-term care needs. Participants discussed the quality measure statements on which they had voted on during the day. Transcripts were coded by thematic analysis using NVivo12 software. Results Participants included 12 CYP, 6 parents and 12 HCPs from a range of healthcare agencies. CYP value measures that reflect co-production and partnership in decision-making. They desire flexibility and choice regarding their health needs (i.e. ownership of healthcare records and an individualised approach to transition). Measures such as the four-hour A&E wait and annual weight measurements are considered arbitrary. CYP value seamless communication between services and offer digitalization of healthcare as a solution. Ideal measures should reflect a whole systems response with an identifiable patient outcome. In contrast, parents value accessibility and convenience, whereas HCPs value family-centred care practices, timely communication and access to specialist services. CYPs and parents’ priorities are informed by personal or family experience of illness, whereas professionals opinions reflect wider system structures. All groups agreed that understanding and responding to emotional health was of vital importance. CYP want non-judgemental, trusting relationships with HCP enabling open discussion about psychosocial health and wellbeing. Discussion CYP offer a unique alternative perspective on the meaning of quality within quality measures. Service evaluation and improvement led by user-informed service measures will create a healthcare system which truly works with and for CYP in synchrony.

High-intensity exercise damages mitochondrial DNA (mtDNA) in skeletal muscle. Whether MitoQ - a redox active mitochondrial targeted quinone - can reduce exercise-induced mtDNA damage is unknown. In a double-blind, randomized, placebo-controlled design, twenty-four healthy male participants consisting of two groups (placebo; n = 12, MitoQ; n = 12) performed an exercise trial of 4 x 4-min bouts at 90–95% of heart rate max. Participants completed an acute (20 mg MitoQ or placebo 1-h pre-exercise) and chronic (21 days of supplementation) phase. Blood and skeletal muscle were sampled immediately pre- and post-exercise and analysed for nuclear and mtDNA damage, lipid hydroperoxides, lipid soluble antioxidants, and the ascorbyl free radical. Exercise significantly increased nuclear and mtDNA damage across lymphocytes and muscle (P

Cystic fibrosis (CF) is a genetic disorder associated with vascular endothelial dysfunction. Nitric oxide (NO) plays a major role in maintaining vascular function, and tetrahydrobiopterin (BH4) is a critical determinant of NO bioavailability. Thus the purpose of this study was to investigate the effects of oral administration of BH4 on endothelial function in patients with CF. Twenty-nine patients with CF (18 ± 8 yr old) and 29 healthy matched controls were recruited. Patients with CF participated in a randomized trial where they received a 5 mg/kg dose of oral BH4 (BH4-5; n = 17) or a 20 mg/kg dose of oral BH4 (BH4-20; n = 12). On a separate visit, a subset of patients from each group was retested following a placebo (PLC; n = 9). Brachial artery flow-mediated dilation (FMD) was used to evaluate vascular endothelial function, and a plasma sample was obtained before and 3 h after treatment. Cultured endothelial cells were treated with plasma to assess NO bioavailability. Baseline FMD was lower in patients compared with controls (5.7 ± 3.4 vs. 8.4 ± 3.5%, respectively, P = 0.005). No change in FMD was observed following PLC or BH4-5 (∆FMD: −0.8 ± 1.9% and −0.5 ± 2.5%; P = 0.273 and 0.132, respectively). Treatment with BH4-20, however, resulted in significant improvements in FMD (∆FMD: 1.1 ± 1.4%) compared with BH4-5 ( P = 0.023) and PLC ( P = 0.017). Moreover, BH4-20 significantly decreased endothelial cell superoxide production and increased NO production. These data suggest that a single oral dose of BH4 at 20 mg/kg improves vascular endothelial function in patients with CF, likely via increased endothelial NO synthase coupling. These findings support the hypothesis that loss of BH4 bioactivity contributes, in part, to endothelial dysfunction in patients with CF. NEW & NOTEWORTHY For the first time, the present study documents that a single dose of oral BH4 can improve vascular endothelial function in patients with cystic fibrosis (CF), and our in vitro data suggest this is via decreasing uncoupled nitric oxide. These data provide insight into the important role of BH4 bioactivity in vascular dysfunction and provide the foundation for further investigation into the chronic effects of BH4 treatment in patients with CF.

Purpose Reduced-exertion high-intensity interval training (REHIT) is a genuinely time-efficient exercise intervention that improves aerobic capacity and blood pressure in men with type 2 diabetes. However, the acute effects of REHIT on 24-h glycaemia have not been examined. Methods 11 men with type 2 diabetes (mean ± SD: age, 52 ± 6 years; BMI, 29.7 ± 3.1 kg/m2; HbA1c, 7.0 ± 0.8%) participated in a randomised, four-trial crossover study, with continual interstitial glucose measurements captured during a 24-h dietary-standardised period following either (1) no exercise (CON); (2) 30 min of continuous exercise (MICT); (3) 10 × 1 min at ~ 90 HRmax (HIIT; time commitment, ~ 25 min); and (4) 2 × 20 s ‘all-out’ sprints (REHIT; time commitment, 10 min). Results Compared to CON, mean 24-h glucose was lower following REHIT (mean ± 95%CI: − 0.58 ± 0.41 mmol/L, p = 0.008, d = 0.55) and tended to be lower with MICT (− 0.37 ± 0.41 mmol/L, p = 0.08, d = 0.35), but was not significantly altered following HIIT (− 0.37 ± 0.59 mmol/L, p = 0.31, d = 0.35). This seemed to be largely driven by a lower glycaemic response (area under the curve) to dinner following both REHIT and MICT (− 11%, p 0.9 for both) but not HIIT (− 4%, p = 0.22, d = 0.38). Time in hyperglycaemia appeared to be reduced with all three exercise conditions compared with CON (REHIT: − 112 ± 63 min, p = 0.002, d = 0.50; MICT: -115 ± 127 min, p = 0.08, d = 0.50; HIIT − 125 ± 122 min, p = 0.04, d = 0.54), whilst indices of glycaemic variability were not significantly altered. Conclusion REHIT may offer a genuinely time-efficient exercise option for improving 24-h glycaemia in men with type 2 diabetes and warrants further study.

Background\ud \ud Cardiorespiratory fitness can inform patient care, although to what extent natural variation in CRF influences clinical practice remains to be established. We calculated natural variation for cardiopulmonary exercise test (CPET) metrics, which may have implications for fitness stratification.\ud \ud \ud Methods\ud \ud In a two-armed experiment, critical difference comprising analytical imprecision and biological variation was calculated for cardiorespiratory fitness and thus defined the magnitude of change required to claim a clinically meaningful change. This metric was retrospectively applied to 213 patients scheduled for colorectal surgery. These patients underwent CPET and the potential for misclassification of fitness was calculated. We created a model with boundaries inclusive of natural variation [critical difference applied to oxygen uptake at anaerobic threshold (\ud V˙\ud O2-AT): 11 ml O2 kg−1 min−1, peak oxygen uptake (\ud V˙\ud O2 peak): 16 ml O2 kg−1 min−1, and ventilatory equivalent for carbon dioxide at AT (V̇E/V̇CO2-AT): 36].\ud \ud Results\ud \ud The critical difference for \ud V˙\ud O2-AT, \ud V˙\ud O2 peak, and \ud V˙E\ud /\ud V˙\ud CO2-AT was 19%, 13%, and 10%, respectively, resulting in false negative and false positive rates of up to 28% and 32% for unfit patients. Our model identified boundaries for unfit and fit patients: AT

Background The impact of blood flow regulation and oxidative stress during exercise in cystic fibrosis (CF) has yet to be investigated. Methods A maximal graded exercise test was conducted to determine exercise capacity (VO 2 peak) and peak workload in 14 pediatric patients with mild CF (age 14±3y, FEV 1 93±16 % predicted) and 14 demographically-matched controls. On a separate visit, participants performed submaximal cycling up to 60% of peak workload where brachial artery blood velocity was determined using Doppler ultrasound. Retrograde and antegrade components were further analyzed as indices of blood flow regulation. Results The cumulative AUC for retrograde velocity was lower in patients versus controls (1770±554 vs. 3440±522cm, P =0.038). In addition, an exaggerated oxidative stress response during exercise occurred in patients only ( P =0.004). Conclusion These data suggest that patients with mild CF exhibit impaired blood flow regulation and an exaggerated oxidative stress response to submaximal exercise.

This study examines the interplay between exercise and hypoxia in relation to the DNA damage-repair response; with specific interest to DNA double strand damage. Following two VO2max tests, 14 healthy, male participants completed two exercise trials (hypoxia; 12% FiO2, normoxia; 20.9% FiO2) consisting of cycling for 30-min at 80–85% of VO2max relative to the environmental condition. Blood was sampled pre-, immediately post-, 2-, and 4-h post-exercise with additional blood cultured in vitro for 24-, 48-, and 72-h following the experimental trial. Samples were analysed for single- and double-strand DNA damage, FPG-sensitive sites, lipid hydroperoxides, lipid soluble antioxidants, and the ascorbyl free radical quantified by EPR. Exercise increased single strand breaks and FPG-sensitive sites (P 0.05), were also observed following exercise in hypoxia. These findings highlight significant single- and double strand DNA damage and oxidative stress as a function of high-intensity exercise, which is substantially exacerbated in hypoxia and may be attributed to multiple mechanisms of ROS generation. In addition, full repair of DNA damage (SSB, DSB, and FPG-sensitive sites) was observed within 24- and 48-h of normoxic and hypoxic exercise, respectively.

Supported by the Health and Social Care Public Health Agency, Northern Ireland (STL/5268/16 to C.H. and J.G.M.). F.E.-L. received funding from the European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant (agreement no. 707404). The funders of the present study did not have any role in the study design, data collection and analyses, decision to publish, or preparation of the manuscript. F.E.-L. is the guarantor of the review., Objectives: To determine the effects of exercise on fatigue and sleep quality in fibromyalgia (primary aim) and to identify which type of exercise is the most effective in achieving these outcomes (secondary aim). Data Sources: PubMed and Web of Science were searched from inception until October 18, 2018. Study Selection: Eligible studies contained information on population (fibromyalgia), intervention (exercise), and outcomes (fatigue or sleep). Randomized controlled trials (RCT) testing the effectiveness of exercise compared with usual care and randomized trials (RT) comparing the effectiveness of 2 different exercise interventions were included for the primary and secondary aims of the present review, respectively. Two independent researchers performed the search, screening, and final eligibility of the articles. Of 696 studies identified, 17 RCTs (n=1003) were included for fatigue and 12 RCTs (n=731) for sleep. Furthermore, 21 RTs compared the effectiveness of different exercise interventions (n=1254). Data Extraction: Two independent researchers extracted the key information from each eligible study. Data Synthesis: Separate random-effect meta-analyses were performed to examine the effects from RCTs and from RTs (primary and secondary aims). Standardized mean differences (SMD) effect sizes were calculated using Hedges' adjusted g. Effect sizes of 0.2, 0.4, and 0.8 were considered small, moderate, and large. Compared with usual care, exercise had moderate effects on fatigue and a small effect on sleep quality (SMD, -0.47; 95% confidence interval [CI], -0.67 to -0.27; P, Health and Social Care Public Health Agency, Northern Ireland STL/5268/16, European Union's Horizon 2020 research and innovation program under the Marie Sklodowska-Curie grant 707404

This study investigated the effects of cow&rsquo, s milk on recovery from repeated simulated team games (STGs) in females. Twenty female team-sport athletes completed an STG circuit (2x ~ 30 min, with 10 min &lsquo, half-time&rsquo, ). Measures of muscle function, soreness and tiredness, symptoms of stress and serum markers of muscle damage and oxidative stress were determined pre- and 24 h, 48 h, 72 h and 96 h following the circuit. At 48 h, a second STG was completed. Sprint performance (5 m, 15 m), lap time, countermovement jump (CMJ), heart rate and RPE were recorded during each STG. Immediately following each STG, participants consumed either 500 mL of cow&rsquo, s milk (MILK) or 500 mL of an energy-matched carbohydrate (CHO) solution. Compared to CHO, MILK had a beneficial effect in attenuating losses in peak torque for knee extension (60&deg, /s) (likely, effect size (ES) = 0.26 to 0.28) knee flexion (60&deg, ES = 0.45 to 0.61). A benefit for MILK was observed for 5 m sprint (possible-likely, ES = 0.40 to 0.58), 10 m sprint (likely, ES = 0.30 to 0.53) and symptoms of stress (likely&ndash, very likely, small). Mostly unclear outcomes for other variables were observed. For STG variables, trivial (HR, CMJ) and unclear (5 m sprint, 15 m sprint, lap-time, RPE) outcomes were recorded. In conclusion, the consumption of 500 mL of milk attenuated losses in muscle function and perceptions of stress following repeated simulated team-sports games. However, further investigation is warranted to determine whether MILK can influence subsequent team-sport performance.

Background Non-pharmacological interventions are the mainstay of treatment for fibromyalgia, however, current evidence-based guidelines report that the only therapy supported by ‘strong for’ evidence is exercise intervention for pain in fibromyalgia [1]. While increased fatigue and poor sleep quality are among the most burdensome symptoms in fibromyalgia, there remains limited evidence for the effectiveness of exercise in the management of these symptoms [2,3] Objectives To determine the effectiveness of exercise in the management of fatigue and sleep quality in fibromyalgia. Methods A systematic search was conducted using PubMed and Web of Science in October 2018 (Prospero Registration No. CRD42018118005). Eligible studies were randomised controlled trials (RCT) including adults with fibromyalgia (population), who received exercise (intervention) compared to usual care (comparator). Outcomes of interest were fatigue and/or sleep quality. No restrictions were applied for language nor for publication date. Random effects meta-analyses were conducted. The Cochrane Collaboration’s tool was used for assessing risk of bias in the included studies. The quality of evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results Twenty RCTs were included, 17 included measures of fatigue (n=1003) and 12 measures of sleep quality (n=731). In comparison to usual care, exercise had beneficial effects on fatigue (Figure 1, P Conclusion According to the GRADE framework, this review provides low-to-moderate quality evidence that exercise is moderately effective for improving fatigue, and moderate evidence of no/meaningless effects of exercise to improve sleep quality. Further high quality RCTs are required to determine the effectiveness of exercise on fatigue, and in particular, sleep quality in fibromyalgia References [1] Macfarlane GJ, et al. Ann Rheum Dis2017;76:318–28. Doi:10.1136/annrheumdis-2016-209724 [2] Bidonde J, et al. Cochrane Database Syst Rev 2017;2017. Jun 21;6:CD012700 doi:10.1002/14651858.CD012700 [3] Busch AJ, et al. Cochrane database Syst Rev 2013;:CD010884. doi:10.1002/14651858.CD010884 Analyses were conducted using a random effects model. CI, Confidence Interval; df, degrees of freedom; Std, Standardised; SD, Standard Deviation; IV, Inverse Variance; Co-, Co-intervention (Photo, phototherapy; edu, education); C, Cardiorespiratory exercise; F, flexibility exercise; S, Strength training; TC, Tai Chi; QG, Quigong; Y, Yoga; L- and W-B, land- and water-based exercise, respectively. Acknowledgement This study was funded by the Health and Social Care Public Health Agency, Northern Ireland (STL/5268/16) and the Spanish Ministry of Economy and Competitiveness (BES-2014-067612) Disclosure of Interests None declared

Exercise simultaneously incites beneficial (e.g., signal) and harming (e.g., damage to macromolecules) effects, likely through the generation of reactive oxygen and nitrogen species (RONS) and downstream changes to redox homeostasis. Given the link between nuclear DNA damage and human longevity/pathology, research attempting to modulate DNA damage and restore redox homeostasis through non-selective pleiotropic antioxidants has yielded mixed results. Furthermore, until recently the role of oxidative modifications to mitochondrial DNA (mtDNA) in the context of exercising humans has largely been ignored. The development of antioxidant compounds which specifically target the mitochondria has unveiled a number of exciting avenues of exploration which allow for more precise discernment of the pathways involved with the generation of RONS and mitochondrial oxidative stress. Thus, the primary function of this review, and indeed its novel feature, is to highlight the potential roles of mitochondria-targeted antioxidants on perturbations to mitochondrial oxidative stress and the implications for exercise, with special focus on mtDNA damage. A brief synopsis of the current literature addressing the sources of mitochondrial superoxide and hydrogen peroxide, and available mitochondria-targeted antioxidants is also discussed.

Oxidative stress and vascular endothelial dysfunction are established characteristics of cystic fibrosis (CF). Oxidative stress may contribute to vascular dysfunction via inhibition of nitric oxide (NO) bioavailability. Purpose. To determine if ingestion of a single antioxidant cocktail (AOC) improves vascular endothelial function in patients with CF. Methods. In 18 patients with CF (age 8-39 y), brachial artery flow-mediated dilation (FMD) was assessed using a Doppler ultrasound prior to and two hours following either an AOC (n=18; 1,000 mg vitamin C, 600 IU vitamin E, and 600 mg α-lipoic acid) or a placebo (n=9). In a subgroup of patients (n=9), changes in serum concentrations of α-tocopherol and lipid hydroperoxide (LOOH) were assessed following AOC and placebo. Results. A significant (p=0.032) increase in FMD was observed following AOC (Δ1.9±3.3%), compared to no change following placebo (Δ−0.8±1.9%). Moreover, compared with placebo, AOC prevented the decrease in α-tocopherol (Δ0.48±2.91 vs. −1.98±2.32 μM, p=0.024) and tended to decrease LOOH (Δ−0.2±0.1 vs. 0.1±0.1 μM, p=0.063). Conclusions. These data demonstrate that ingestion of an antioxidant cocktail can improve vascular endothelial function and improve oxidative stress in patients with CF, providing evidence that oxidative stress is a key contributor to vascular endothelial dysfunction in CF.

We have previously demonstrated that reduced-exertion high-intensity interval training (REHIT) is a genuinely time-efficient exercise strategy for improving cardiometabolic health. Here, we examined the affective and perceptual responses to REHIT. Eight young men and women (age 21±1 y, BMI 24.9±2.1 m/kg2, V̇ O2max 39±10 ml/kg/min) and 11 men with type 2 diabetes (T2D; age 52±6 y, BMI 29.7±3.1 m/kg2, V̇ O2max 29±5 ml/kg/min) took part in three-arm crossover trials with RPE and affective valence measured during, and enjoyment and exercise preferences measured following either: 1) REHIT (2x20-s sprints in a 10-min exercise session), 2) HIIT (10x1-min efforts) and 3) 30 min MICT. Furthermore, 19 young men and women (age 25±6 y, BMI 24±4 m/kg2, V̇ O2max 34±8 ml/kg/min) completed a 6-week REHIT intervention with affective valence during an acute REHIT session measured before and after training. Affect decreases (briefly) during REHIT, but recovers rapidly, and the decline is not significantly different when compared to MICT or HIIT in either healthy participants or T2D patients. Young sedentary participants reported similar levels of enjoyment for REHIT, MICT and HIIT, but 7 out of 8 had a preference for REHIT. Conversely, T2D patients tended to report lower levels of enjoyment with REHIT compared with MICT. The decrease in affective valence observed during an acute REHIT session was significantly attenuated following training. We conclude that affective and perceptual responses to REHIT are no more negative compared to those associated with MICT or HIIT, refuting claims that supramaximal sprint interval training protocols are associated with inherent negative responses.

Metabolomics is a relatively new “omics” approach used to characterize metabolites in a biological system at baseline and following a diversity of stimuli. However, the metabolomic response to exercise in hypoxia currently remains unknown. To examine this, 24 male participants completed 1 h of exercise at a workload corresponding to 75% of pre-determined O2max in hypoxia (Fio2 = 0.16%), and repeated in normoxia (Fio2 = 0.21%), while pre- and post-exercise and 3 h post-exercise metabolites were analyzed using a LC ESI-qTOF-MS untargeted metabolomics approach in serum samples. Exercise in hypoxia and in normoxia independently increased metabolism as shown by a change in a combination of twenty-two metabolites associated with lipid metabolism (p < 0.05, pre vs. post-exercise), though hypoxia per se did not induce a greater metabolic change when compared with normoxia (p > 0.05). Recovery from exercise in hypoxia independently decreased seventeen metabolites associated with lipid metabolism (p < 0.05, post vs. 3 h post-exercise), compared with twenty-two metabolites in normoxia (p < 0.05, post vs. 3 h post-exercise). Twenty-six metabolites were identified as responders to exercise and recovery (pooled hypoxia and normoxia pre vs. recovery, p < 0.05), including metabolites associated with purine metabolism (adenine, adenosine and hypoxanthine), the amino acid phenylalanine, and several acylcarnitine molecules. Our novel data provides preliminary evidence of subtle metabolic differences to exercise and recovery in hypoxia and normoxia. Specifically, exercise in hypoxia activates metabolic pathways aligned to purine and lipid metabolism, but this effect is not selectively different from exercise in normoxia. We also show that exercise per se can activate pathways associated with lipid, protein and purine nucleotide metabolism.

A variety of strategies exist to modulate the acute physiological responses following resistance exercise aimed at enhancing recovery and/or adaptation processes. To assess the true impact of these strategies, it is important to know the ability of different measures to detect meaningful change. We investigated the sensitivity of measures used to quantify acute physiological responses to resistance exercise and constructed a physiological profile to characterise the magnitude of change and the time course of these responses. Eight males accustomed to regular resistance exercise performed experimental sessions during a “control week”, void of an exercise stimulus. The following week, termed the “exercise week”, participants repeated this sequence of experimental sessions, and they also performed a bout of lower-limb resistance exercise following the baseline assessments. Assessments were conducted at baseline and at 2, 6, 24, 48, 72, and 96 h after the intervention. On the basis of the signal-to-noise ratio, the most sensitive measures were maximal voluntary isometric contraction, 20-m sprint, countermovement jump peak force, rate of force development (100–200 ms), muscle soreness, Daily Analysis Of Life Demands For Athletes part B, limb girth, matrix metalloproteinase-9, interleukin-6, creatine kinase, and high-sensitivity C-reactive protein with ratios >1.5. Clear changes in these measures following resistance exercise were determined via magnitude-based inferences. These findings highlight measures that can detect real changes in acute physiological responses following resistance exercise in trained individuals. Researchers investigating strategies to manipulate acute physiological responses for recovery and/or adaptation can use these measures, as well as the recommended sampling points, to be confident that their interventions are making a worthwhile impact.

This study aimed to compare the effect of high-intensity interval training (HIIT) with additional whole-body vibration (WBV) on body composition and lipid profile in obese/overweight adults on a hypocaloric diet. Forty adults were randomly assigned to (a) HIIT and vibration and hypocaloric diet (HIITWBV, n ¼ 13), (b) HIIT and diet (HIIT, n ¼ 14), and (c) diet only (control [CON], n ¼ 13). High-intensity interval training WBV participants trained 3 times per week for 8 weeks (6 sets 1 minute of HIIT, cycling at 90% heart rate peak followed by 1 minute of interset vibration, at a frequency of 18 Hz increasing until 25 Hz with a peak-to- peak displacement of 4 mm. Training volume increased 1 set every 2 weeks until 10 sets). The HIIT group performed HIIT training followed by 2 minutes of passive recovery, while the CON continued with their daily activities combined with calorie restriction. Body composition (body fat and fat-free mass) and biochemical indices (glucose, total cholesterol, high-density lipoprotein cholesterol, and triglycerides) were determined. Following 8 weeks, body fat was significantly reduced by 7.5% and both tri- glycerides and total cholesterol decreased in the HIITWBV group only ( 16.5% and 11.7% respectively). This study suggests that HIIT in combination with WBV and a hypocaloric diet can improve overall lipid profile in overweight/obese individuals

Purpose Oxidative stress is associated with tissue cytokine secretion although the precise mechanism(s) underpinning this relationship during high intensity intermittent exercise remains unclear. This study investigates the acute response to a bout of high intensity intermittent walking (HIIW), compared to continuous moderate intensity walking (CMW), on various cytokines and biomarkers of oxidative stress. Methods Seventeen (n = 17) apparently healthy male participants (aged 22.6 ± 4.6 years; \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{2} \max$$\end{document}V˙O2max: 53.7 ± 7.1 ml kg−1 min−1) undertook a randomised crossover study consisting of two exercise trials: (1) HIIW requiring 3 × 5 min bursts at 80% \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{2} \max$$\end{document}V˙O2max (each separated by 5 min of walking at 30% \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{2} \max$$\end{document}V˙O2max) and (2) CMW (60% \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\dot{V}{\text{O}}_{2} \max$$\end{document}V˙O2max for 30 min). Each trial was separated by 7 days. Venous blood samples were obtained pre-exercise, post-exercise and at 2, 4, 24 and 48 h post-exercise for determination of systemic inflammation (IL-6 and TNF-α), lipid soluble antioxidants and oxidative stress (LOOH, H2O2 and the ascorbyl free radical). Results Both IL-6 and TNF-α increased immediately post exercise, regardless of intensity and remained elevated until at least 4 h (main effect for time; p

Plant-based nutraceuticals are categorised as nutritional supplements which contain a high concentration of antioxidants with the intention of minimising the deleterious effect of an oxidative insult. The primary aim of this novel study was to determine the effect of exogenous barley-wheat grass juice (BWJ) on indices of exercise-induced oxidative stress. Ten (n = 10) apparently healthy, recreationally trained (V̇O2max 55.9 ± 6 mL·kg−1·min−1), males (age 22 ± 2 years, height 181 ± 6 cm, weight 87 ± 8 kg, body mass index (BMI) 27 ± 1) volunteered to participant in the study. In a randomised, double-blinded, placebo-controlled crossover design, participants consumed either a placebo, a low dose (70 mL per day) of BWJ, or a high dose (140 mL per day) of BWJ for 7-days. Experimental exercise consisted of a standard maximal oxygen uptake test until volitional fatigue. DNA damage, as assessed by the single cell gel electrophoresis comet assay, increased following high intensity exercise across all groups (time × group; p < 0.05, Effect Size (ES) = 0.7), although there was no selective difference for intervention (p > 0.05). There was a main effect for time in lipid hydroperoxide concentration (pooled-group data, pre- vs. post-exercise, p < 0.05, ES = 0.2) demonstrating that exercise increased lipid peroxidation. Superoxide dismutase activity (SOD) increased by 44.7% following BWJ supplementation (pooled group data, pre- vs. post). The ascorbyl free radical (p < 0.05, ES = 0.26), α-tocopherol (p = 0.007, ES = 0.2), and xanthophyll (p = 0.000, ES = 0.5), increased between the pre- and post-exercise time points indicating a main effect of time. This study illustrates that a 7-day supplementation period of a novel plant-derived nutraceutical product is insufficient at attenuating exercise-induced oxidative damage. It is possible that with a larger sample size, and longer supplementation period, this novel plant-based nutraceutical could potentially offer effective prophylaxis against exercise-induced oxidative stress; as such, this justifies the need for further research.

SUMMARY Exercise capacity, an objective measure of exercise intolerance, is known to predict quality of life and mortality in cystic fibrosis (CF). The mechanisms for exercise intolerance in patients with cystic fibrosis (CF), however, have yet to be fully elucidated. Accordingly, this study sought to investigate oxygen uptake kinetics and the impact of fat-free mass (FFM) on exercise capacity in young patients with CF. 16 young patients with CF (age 13 ± 4 years; 10 female) and 15 matched controls (age 14 ± 3 years; nine female) participated. Pulmonary function and a maximal exercise test on a cycle ergometer using the Godfrey protocol were performed. Exercise capacity (VO2peak), VO2 response time (VO2RT), and functional VO2 gain (ΔVO2/ΔWR) were all determined. Lung function was the only demographic parameter significantly lower (P

The impact of Montmorency tart cherry (Prunus cerasus L.) concentrate (MC) on physiological indices and functional performance was examined following a bout of high-intensity stochastic cycling. Trained cyclists (n = 16) were equally divided into 2 groups (MC or isoenergetic placebo (PLA)) and consumed 30 mL of supplement, twice per day for 8 consecutive days. On the fifth day of supplementation, participants completed a 109-min cycling trial designed to replicate road race demands. Functional performance (maximum voluntary isometric contraction (MVIC), cycling efficiency, 6-s peak cycling power) and delayed onset muscle soreness were assessed at baseline, 24, 48, and 72 h post-trial. Blood samples collected at baseline, immediately pre- and post-trial, and at 1, 3, 5, 24, 48, and 72 h post-trial were analysed for indices of inflammation (interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor alpha, high-sensitivity C-reactive protein (hsCRP)), oxidative stress (lipid hydroperoxides), and muscle damage (creatine kinase). MVIC (P < 0.05) did not decline in the MC group (vs. PLA) across the 72-h post-trial period and economy (P < 0.05) was improved in the MC group at 24 h. IL-6 (P < 0.001) and hsCRP (P < 0.05) responses to the trial were attenuated with MC (vs. PLA). No other blood markers were significantly different between MC and PLA groups. The results of the study suggest that Montmorency cherry concentrate can be an efficacious functional food for accelerating recovery and reducing exercise-induced inflammation following strenuous cycling exercise.

Purpose. To measure endothelial function and oxidative stress immediately, 90 minutes, and three hours after exercise of varying intensities.Methods. Sixteen apparently healthy men completed three exercise bouts of treadmill running for 30 minutes at 55%V˙O2max(mild); 20 minutes at 75%V˙O2max(moderate); or 5 minutes at 100%V˙O2max(maximal) in random order. Brachial artery flow-mediated dilation (FMD) was assessed with venous blood samples drawn for measurement of endothelin-1 (ET-1), lipid hydroperoxides (LOOHs), and lipid soluble antioxidants.Results. LOOH increased immediately following moderate exercise (P<0.05). ET-1 was higher immediately after exercise and 3 hours after exercise in the mild trial compared to maximal one (P<0.05). Transient decreases were detected forΔFMD/ShearAUCfrom baseline following maximal exercise, but it normalised at 3 hours after exercise (P<0.05). Shear rate was higher immediately after exercise in the maximal trial compared to mild exercise (P<0.05). No changes in baseline diameter, peak diameter, absolute change in diameter, or FMD were observed following any of the exercise trials (P>0.05).Conclusions. Acute exercise at different intensities elicits varied effects on oxidative stress, shear rate, and ET-1 that do not appear to mediate changes in endothelial function measured by FMD.

Fibromyalgia syndrome (FMS) is a common and complex chronic pain condition. Exercise is recommended in the management of the FMS; however, people with FMS often find exercise exacerbates their condition and causes overwhelming fatigue. The objective of this study was to explore the perceptions of fatigue and sleep dysfunction, and exercise in people with FMS. Three, 60–90 min focus groups were conducted with people with FMS (n = 14). Participants were recruited from patient support groups who had experienced therapeutic exercise in the management of their condition. Focus groups were video and audio recorded and transcriptions analysed for thematic content by three independent evaluators. Fatigue, sleep dysfunction, and pain were universally reported by participants. The over-arching theme to emerge was a lack of understanding of the condition by others. A huge sense of loss was a major sub-theme and participants felt that they had fundamentally changed since the onset of FMS. Participants reported that they were unable to carry out their normal activities, including physical activity and exercise. The invisibility of FMS was associated with the lack of understanding by others, the sense of loss, and the impact of FMS. People with FMS perceive that there is a lack of understanding of the condition among health care professionals and the wider society. Those with FMS expressed a profound sense of loss of their former ‘self’; part of this loss was the ability to engage in normal physical activity and exercise.

Objective 1) To assess the incidence of cardiovascular disease (CVD) risk factors in a university population, and 2) to investigate the effects of an 8-week exercise intervention on CVD risk factors. Methods Forty-six students participated in this study. Baseline cardiorespiratory fitness was assessed using maximal oxygen uptake (VO2 max). Total cholesterol, high-density lipoprotein (HDL)-cholesterol and triglycerides were measured. Body mass index (BMI), waist-to-hip circumference ratio (WHR), blood pressure (BP) and arterial stiffness were also assessed. Participants performed 8weeks of exercise consisting of 60 min of moderate-high intensity exercise three times a week, and all parameters were repeated following the 8-week program. Results Participants were divided into an apparently healthy control group (BMI 2) and an overweight/obese experimental group (BMI ≥ 25 kg/m2). Both groups had low cardiorespiratory fitness and clear evidence of risk for CVD. Following the 8-week program, participants demonstrated significant improvement in biochemical parameters and in overall fitness (p Conclusion Early detection of CVD risk factors, particularly in a young population, can lead to earlier prevention of disease through lifestyle changes. Moreover, short-term exercise can have important effects on reducing CVD risk factors, improving body composition and overall cardiorespiratory fitness.

Two doses (30 and 60 mL) of Montmorency tart cherry concentrate (MC) were used to investigate their impact on physiological indices of uric acid activity, inflammation and the bioavailability of the major anthocyanin (CYA-3-O-GluRut). Following MC supplementation plasma CYA-3-O-GluRut increased (P

Lycopene can exert antioxidant effects against peripheral and cellular oxidative stress and may be associated with reduced diabetic risk. Conversely, exercise-induced free radicals are thought to underpin many of the desirable whole-body adaptations following training and the use of antioxidants within the exercise model remains debatable. PURPOSE: To investigate the effect of lycopene supplementation on oxidative stress and glucose homeostasis following acute aerobic exercise. METHOD: Twenty-eight (n=28) apparently healthy male volunteers were recruited (age 24 ± 4 years; weight 78 ± 10 kg; height 178 ± 8 cm; 2max 40 ± 7 ml·kg-1 ·min-1 ) in a randomised, single blind, placebo-controlled study. Participants were required to attend the Laboratory on two occasions: prior to and following 6 weeks of supplementation of either 10mg lycopene (LG; n=15) or placebo (PG; n=13) followed by a bout of acute exercise for one hour at 65% 2max. Exogenous glucose oxidation was then measured on a isotope ratio mass spectrometer in a sub-group of participants (n=14) following exercise, by administration of a standard oral glucose tolerance test (OGTT; 75g glucose). Venous blood samples were drawn for measurement of oxidative stress parameters, plasma glucose and insulin. RESULTS: Plasma lycopene increased in LG only (0.01 ± 0.004 vs.0.02 ± 0.007 µmol/L; P 0.05, respectively). A main effect for an increase in insulin was observed two hours post OGTT in the sub-groups (Pooled data, P 0.05) and an 11% decrease for PG (2.17 ± 1.06 vs. 1.94 ± 1.53; P >0.05). No change in plasma glucose was detected at any point, or after the OGTT (P >0.05). CONCLUSION: In healthy males, lycopene supplementation had no effect on post exercise levels of ROS or markers of lipid peroxidation, despite an increase in plasma lycopene. However, lycopene supplementation may affect post exercise insulin sensitivity in response to glucose consumption, but further parallel research is required.

Arterial stiffness is a major contributor to the development of atherosclerosis and consequently cardiovascular disease. This study aimed to examine whether 6 months of accumulated (3 × 10 minutes, 5 days/week) brisk walking was sufficient to reduce arterial stiffness in sedentary, overweight individuals. Seventy-seven individuals (19 men, 58 women; age, 30-55 years) were randomly allocated to one of three groups; two groups completed 30 minutes of accumulated walking with either monthly or weekly telephone support; the third group (control) performed stretching exercises. The walking groups were combined and telephone support included as a covariate. Anthropometry, blood pressure (BP), blood lipids, pulse wave velocity (PWV), and NOx (surrogate marker for nitric oxide) were measured at baseline, post-intervention and 4 months post-intervention. No changes were observed for anthropometry, BP, or lipids. However, at the end of the intervention, there was a decrease in PWV (P < .001) accompanied by an increase in NOx (P < .001), with changes maintained 4 months post-intervention. A strong negative correlation between PWV and NOx was also observed (P < .001; r = -0.65). A lifestyle approach to meeting current physical activity guidelines results in favorable alterations in arterial function in overweight individuals.

Exercise-induced reactive oxygen and nitrogen species are increasingly considered as beneficial health promotion. Astaxanthin (ASX) has been recognized as a potent antioxidant suitable for human ingestion. We investigated whether ASX administration suppressed antioxidant enzyme activity in moderate-intensity exercise. Seven-week-old male C57BL/6 mice (n = 8/group) were treated with ASX (5, 15, and 30 mg/kg BW) combined with 45 min/day moderate-intensity swimming training for four weeks. Results showed that the mice administrated with 15 and 30 mg/kg of ASX decreased glutathione peroxidase, catalase, malondialdehyde, and creatine kinase levels in plasma or muscle, compared with the swimming control group. Beyond that, these two (15 and 30 mg/kg BW) dosages of ASX downregulated gastrocnemius muscle erythroid 2p45 (NF-E2)-related factor 2 (Nrf2). Meanwhile, mRNA of Nrf2 and Nrf2-dependent enzymes in mice heart were also downregulated in the ASX-treated groups. However, the mice treated with 15 or 30 mg/kg ASX had increased constitutive nitric oxidase synthase and superoxide dismutase activity, compared with the swimming and sedentary control groups. Our findings indicate that high-dose administration of astaxanthin can blunt antioxidant enzyme activity and downregulate transcription of Nrf2 and Nrf2-dependent enzymes along with attenuating plasma and muscle MDA.

Introduction: Although pharmacological antioxidants have previously been investigated for a prophylactic effect against exercise oxidative stress, is not known if α-lipoic acid supplementation can protect against DNA damage following high intensity isolated quadriceps exercise. This randomised controlled investigation was designed to test the hypothesis that fourteen days of α-lipoic acid supplementation can attenuate exercise-induced oxidative stress. Methods: Twelve (n=12) apparently healthy male participants (age 28 ± 10 years, stature 177 ± 12 cm and body mass 81 ± 15 kg) were randomly assigned to receive either a daily supplement of 1000mg of α-lipoic acid (2 × 500mg tablets) for fourteen days (n = 6) or receive no supplement (n = 6) in a double blinded experimental approach. Blood and muscle biopsy tissue samples were taken at rest and following the completion of 100 isolated and continuous maximal knee extension (minimum force = 200 N, speed of contraction = 60°/sec). Results: Exercise increased mitochondrial 8-OHdG concentration in both groups (P < 0.05 vs. rest) with a concomitant decrease in total antioxidant capacity (P < 0.05 vs. rest). There was a marked increase in blood total antioxidant capacity following oral α-lipoic acid supplementation (P < 0.05 vs. non-supplemented), while DNA damage (Comet assay and 8-OHdG) lipid peroxidation and hydrogen peroxide increased following exercise in the non-supplemented group only (P < 0.05 vs. supplemented). Exercise increased protein oxidation in both groups (P < 0.05 vs. rest). Conclusion: These findings suggest that short-term α-lipoic acid supplementation can selectively protect DNA (but not in muscle mitochondria) and lipids against exercise-induced oxidative stress.

The timing and duration of menopause is important when evaluating the risk for cardiovascular disease in postmenopausal women, likely related in part to nitric oxide (NO) bioavailability. The flow-mediated dilation (FMD) test is a noninvasive assessment of NO bioavailability in humans, and tetrahydrobiopterin (BH4) is essential for NO synthesis. A high-fat meal (HFM) has been used to increase lipemia and reduce NO bioavailability. Thus, this study sought to determine if menopausal transition has any impact on the postprandial endothelial function response to a HFM, and evaluate the effect of BH4 on postprandial endothelial function in postmenopausal women and men.Utilizing a randomized, double-blind, placebo-controlled design, sex-steroid hormones and FMD were determined in 30 older adults (10 postmenopausal women aged below 3 y [W 3], 10 postmenopausal women aged above 10 y [W 10], and 10 men) at baseline and 4 hours after the ingestion of a HFM alone or a HFM with BH4 (HFM + BH4; 5 mg/kg).Data are presented as mean ± SEM. Independent of treatment, postprandial testosterone was significantly (P 0.05) decreased in men (-64 ± 11 ng/dL), whereas no changes were observed in W 3 or W 10 group. In addition, concentrations of progesterone were higher (P = 0.019) and the testosterone/estradiol ratio was lower (P = 0.026) in all groups after the ingestion of HFM + BH4 compared with the ingestion of HFM alone. Overall, an increase in FMD was observed after the ingestion of HFM + BH4 (Δ1.9% ± 0.6%), whereas no change in FMD was observed after the ingestion of HFM alone (Δ-0.7% ± 0.6%).Co-ingestion of BH4 with a HFM not only alters the sex-steroid hormone ratio, it improves postprandial FMD after a HFM regardless of postmenopause status or sex.

This study examined the effects of beetroot juice (BTJ) on recovery between two repeated-sprint tests. In an independent groups design, 20 male, team-sports players were randomized to receive either BTJ or a placebo (PLA) (2 × 250 mL) for 3 days after an initial repeated sprint test (20 × 30 m; RST1) and after a second repeated sprint test (RST2), performed 72 h later. Maximal isometric voluntary contractions (MIVC), countermovement jumps (CMJ), reactive strength index (RI), pressure-pain threshold (PPT), creatine kinase (CK), C-reactive protein (hs-CRP), protein carbonyls (PC), lipid hydroperoxides (LOOH) and the ascorbyl free radical (A•−) were measured before, after, and at set times between RST1 and RST2. CMJ and RI recovered quicker in BTJ compared to PLA after RST1: at 72 h post, CMJ and RI were 7.6% and 13.8% higher in BTJ vs. PLA, respectively (p < 0.05). PPT was 10.4% higher in BTJ compared to PLA 24 h post RST2 (p = 0.012) but similar at other time points. No group differences were detected for mean and fastest sprint time or fatigue index. MIVC, or the biochemical markers measured (p > 0.05). BTJ reduced the decrement in CMJ and RI following and RST but had no effect on sprint performance or oxidative stress.

This study investigated Montmorency tart cherry concentrate (MC) supplementation on markers of recovery following prolonged, intermittent sprint activity. Sixteen semi-professional, male soccer players, who had dietary restrictions imposed for the duration of the study, were divided into two equal groups and consumed either MC or placebo (PLA) supplementation for eight consecutive days (30 mL twice per day). On day 5, participants completed an adapted version of the Loughborough Intermittent Shuttle Test (LISTADAPT). Maximal voluntary isometric contraction (MVIC), 20 m Sprint, counter movement jump (CMJ), agility and muscle soreness (DOMS) were assessed at baseline, and 24, 48 and 72 h post-exercise. Measures of inflammation (IL-1-β, IL-6, IL-8, TNF-α, hsCRP), muscle damage (CK) and oxidative stress (LOOH) were analysed at baseline and 1, 3, 5, 24, 48 and 72 h post-exercise. Performance indices (MVIC, CMJ and agility) recovered faster and muscle soreness (DOMS) ratings were lower in the MC group (p < 0.05). Additionally, the acute inflammatory response (IL-6) was attenuated in the MC group. There were no effects for LOOH and CK. These findings suggest MC is efficacious in accelerating recovery following prolonged, repeat sprint activity, such as soccer and rugby, and lends further evidence that polyphenol-rich foods like MC are effective in accelerating recovery following various types of strenuous exercise.

The aim of this study was to assess the reliability and feasibility of cycle ergometer tests in young children with cystic fibrosis (CF). Children with CF aged 6-11 years and with stable lung disease performed two cycle ergometry tests (intermittent sprint and continuous incremental) on two occasions 1 week apart. Reliability was assessed using repeated-measures ANOVA. Bias was considered to be significant at P < 0.05 level and a coefficient of variation (CV) below 10% was considered acceptable. Feasibility and acceptability data were also collected. Sixteen children with CF completed the study: (9M:7F), 8.7(1.8) years, FEV(1) %predicted: 88.1(17.4). Power measurements recorded during the intermittent sprint test demonstrated significant bias over days (P < 0.05) and CVs were between 10% and 15%. Peak work capacity recorded during the continuous incremental test was reliable (bias P < 0.05, CV < 10%), as was heart rate and SpO(2) recorded during both tests (bias P < 0.05, CV < 10%). No problems were experienced in administering the tests and all children completed both tests on two separate occasions. There was a mixed response to questions on acceptability of tests. This is the first study to provide information on the reliability of performance measures recorded during an intermittent sprint protocol (peak power) and a continuous incremental cycle ergometry (peak work capacity) in children with CF.

Pharmacological antioxidant vitamins have previously been investigated for a prophylactic effect against exercise-induced oxidative stress. However, large doses are often required and may lead to a state of pro-oxidation and oxidative damage. Watercress contains an array of nutritional compounds such as β-carotene and α-tocopherol which may increase protection against exercise-induced oxidative stress. The present randomised controlled investigation was designed to test the hypothesis that acute (consumption 2 h before exercise) and chronic (8 weeks consumption) watercress supplementation can attenuate exercise-induced oxidative stress. A total of ten apparently healthy male subjects (age 23 (sd4) years, stature 179 (sd10) cm and body mass 74 (sd15) kg) were recruited to complete the 8-week chronic watercress intervention period (and then 8 weeks of control, with no ingestion) of the experiment before crossing over in order to compete the single-dose acute phase (with control, no ingestion). Blood samples were taken at baseline (pre-supplementation), at rest (pre-exercise) and following exercise. Each subject completed an incremental exercise test to volitional exhaustion following chronic and acute watercress supplementation or control. The main findings show an exercise-induced increase in DNA damage and lipid peroxidation over both acute and chronic control supplementation phases (Pv.supplementation), while acute and chronic watercress attenuated DNA damage and lipid peroxidation and decreased H2O2accumulation following exhaustive exercise (Pv.control). A marked increase in the main lipid-soluble antioxidants (α-tocopherol, γ-tocopherol and xanthophyll) was observed following watercress supplementation (Pv.control) in both experimental phases. These findings suggest that short- and long-term watercress ingestion has potential antioxidant effects against exercise-induced DNA damage and lipid peroxidation.

The combined effects of 42 days of chronic sleep disruption and repeated hourly bouts of physical exertion have not been described. This case study reports the physiological and psychological demands placed on one individual who walked 1 mile in each consecutive hour for a period of 1,000 h (42 days), covering a total distance of 1,000 miles. The participant walked at a mean speed of 1.75 m/s completing each mile in approximately 15 min. Over the course of the challenge, the individual lost 1.6 kg in body weight. Markers of skeletal muscle damage, increased gradually whilst free testosterone levels decreased over the course of the challenge. Stress hormones increased whilst inflammatory markers (CRP) initially rose but then returned towards baseline over the course of the study. Cognitive motor performance measured via reaction time was maintained throughout the 42 days. The participant also displayed mood states typical of an elite athlete at baseline and throughout the challenge. Participation in this novel '1,000 mile 1,000 h' walking challenge evoked considerable physiological stress in a fit, healthy middle-aged participant but did not markedly alter cognitive performance or mood over the 42-day period.