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Objective. We examined the influence of missense polymorphism, endothelial nitric oxide synthase (NOS3) + 894 G>T (rs1799983), on habitual physical activity (PA) and the muscle strength response to resistance training (RT). Methods. Men (n = 354) and women (n = 424; 24.3 ± 8.0 yr) were genotyped. Subjects reported hr/wk in vigorous and light intensity PA and sitting on the Paffenbarger PA questionnaire. One repetitionmaximum assessedmuscle strength. Multivariable and repeated measures ANCOVA tested differences among NOS3 +894 G>T and PA and RT phenotypes by gender. Results. hr/wk in vigorous intensity PA (5.4 ± 1.2 versus 8.3 ± 0.4; P = 0.019), more hr/wk in light intensity PA (42.1 ± 2.4 versus 35.8 ± 0.7; P = 0.011), and less hr/wk sitting (37.6 ± 2.8 versus 45.8 ± 0.9; P = 0.006) than those with the G allele. Women with NOS3 +894 TT gained more absolute (4.4 ± 0.3 versus 3.7 ± 0.8 kg; P = 0.013) and relative (78.3 ± 5.8 versus 61.9 ± 1.8%; P = 0.007) strength than those with the G allele. Conclusions. NOS3 +894 G>T associated with PA among men and women and the muscle strength response to RT among women only. Our findings indicate the need for prospective studies examining the influence of NOS3 variants on PA and the muscle response to RT as well as elucidating underlying mechanistic pathways for the associations observed. [ABSTRACT FROM AUTHOR]

Background: Strategies that may increase compliance to reduced energy intakes are needed to reduce the health burden of obesity. Conflicting evidence exists regarding the effects of snacking on satiety and energy intake. Methods: This study compared short-term satiety from two common snack foods, low fat popcorn or potato chips. Using a counterbalanced within-subject design, 35 normal weight non-smoking participants (17 men, 18 women) ages 20–50 years (mean age 33 ± 11, BMI 23 ± 2 kg/m2) consumed four conditions each: 200 mL of water (control), one cup (4 g, 15 kcal) popcorn, 6 cups (27 g, 100 kcal) popcorn, and one cup (28 g, 150 kcal) potato chips, each with 200 mL water. Participants rated their hunger, satisfaction, prospective consumption, and thirst on 100 mm visual analogue scales 30 minutes after commencement of snack consumption. In addition, post-snack energy intake from an ad libitum meal (amount served less amount remaining) was measured, and the test food and meal combined energy intake and energy compensation were calculated. Results: Participants expressed less hunger, more satisfaction, and lower estimates of prospective food consumption after six cups of popcorn compared to all other treatments (P < 0.05). Energy compensation was 220% ± 967%, 76% ± 143% and 42% ± 75% after one cup popcorn, six cups popcorn and one cup potato chips, respectively. Combined energy intake was significantly greater (P < 0.01) during the potato chips condition (803 ± 277 kcal) compared to control (716 ± 279 kcal) or popcorn conditions (698 ± 286 kcal for one cup and 739 ± 294 kcal for six cups). Combined energy intakes from both popcorn conditions were not significantly different than control (p > 0.05). Conclusion: Popcorn exerted a stronger effect on short-term satiety than did potato chips as measured by subjective ratings and energy intake at a subsequent meal. This, combined with its relatively low calorie load, suggests that whole grain popcorn is a prudent choice for those wanting to reduce feelings of hunger while managing energy intake and ultimately, body weight. [ABSTRACT FROM AUTHOR]

Hepatic lipase (HL) and lipoprotein lipase (LPL) activities (HLA, LPLA) modify lipoproteins and facilitate their binding to hepatic receptors. Apolipoprotein E (APOE) physically interacts with the lipases, and the three common haplotypes of the APOE gene (ε2, ε3, and ε4) yield protein isoforms (E2, E3, and E4, respectively) that are functionally different. Lipase activities themselves differ by sex and exercise training status. The interaction of APOE genotype, exercise training, and sex effects on lipase activities has not been studied. We measured postheparin plasma lipase activities in normolipidemic men and women with the three most common APOE genotypes, which are the haplotype combinations ε2/ε3 (n = 53 ), ε3/ε3 (n = 62), and ε4/ε3 (n = 52), enrolled in 6 mo of aerobic exercise training. These haplotype combinations comprise an estimated 11.6, 62.3, and 21.3% of the population, respectively. Baseline HLA was 35% lower in women than in men (P < 0.0001). In men but not women, HLA was higher in ε2/ε3 group compared with E4/~3 (P = 0.01) and ~3/~3 (P = 0.05). Neither sex nor APOE genotype affected baseline LPLA. Training decreased HLA by 5.2% (P = 0.018) with no APOE effect. The apparent increase in LPLA following exercise was significant and APOE dependent only when corrected for baseline insulin (P < 0.05). Exercise decreased LPLA by 0.8 µmol free fatty acid (FFA)⋅ml-1⋅h-1 (-6%) in ε3/ε3 compared with the combined increases of 6.6% in ε2/ε3 and 12% in ε4/ε3 (P = 0.018 vs. ε3/ε3). However, these differences were statistically significant only after correcting for baseline insulin. We conclude that common APOE genotypes interact with 1) sex to modulate HLA regardless of training status, with ε2/ε3 men demonstrating higher HLA than ε3/ε3 or ε4/ε3 men, and 2) aerobic training to modulate LPLA, regardless of sex, with ε3/ε3 subjects showing a significant decrease compared with an increase in ε2/ε3 and ε3/ε4 after controlling for baseline insulin. [ABSTRACT FROM AUTHOR]

Abstract: Objective: While various weight-management approaches produce weight loss, they may differ in dietary quality. We monitored changes in nutrient intakes in overweight and obese subjects on three different weight-management programs. Design: Randomized clinical trial (pilot study) with two 12-week phases: phase 1, weekly counseling; phase 2, monitoring only. Subjects/setting: One hundred eighty nonsmoking, sedentary overweight and obese adults began this outpatient study; 134 (body mass index [calculated as kg/m2]=30.9±2.4; age=42.3±1.2 years) were used in analyses. Intervention: Twenty-four weeks of exercise only (control group), hypocaloric diet plus exercise, or hypocaloric diet with fiber-rich whole-grain cereals plus exercise. Main Outcome Measures: At weeks 0, 12, and 24, diet quality was assessed by 3-day food records and body weight was measured. Statistical Analyses Performed: Three-way analysis of variance with repeated measures. Results: The hypocaloric diet with fiber-rich whole-grain cereals plus exercise decreased energy intake more than exercise only (P=0.032). By week 12, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise decreased total fat more than exercise only, which was sustained in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise at 24 weeks (P<0.001). At weeks 12 and 24, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise reduced saturated fat intake more than exercise only. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise increased total fiber, insoluble fiber (both P<0.001), magnesium (P=0.004), and vitamin B-6 (P=0.002) intakes more than the hypocaloric diet plus exercise and exercise only. Calcium and vitamin E intakes were inadequate in all groups. Weight loss was similar in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise. Conclusions: Weight-reduction strategies may be associated with reduced intake of micronutrients, such as calcium and vitamin E. However, a hypocaloric diet with fiber-rich whole-grain cereal is effective for improving or maintaining other aspects of dietary quality during weight loss. [Copyright &y& Elsevier]

Few studies have compared cardiac rehabilitation program outcomes between individuals with congestive heart failure (CHF) and post coronary artery bypass graft (CABG), perhaps due to the lack of insurance reimbursement for a CHF diagnosis. Therefore, we examined the exercise tolerance and quality of life outcomes for 56 individuals with CHF (age=73±9 yrs; ejection fraction=34±11%) and 52 individuals post CABG (age=73±7 yrs; ejection fraction=57±10 %) following a 12-week cardiac rehabilitation program, respectively. Both groups exercised a minimum of 24 sessions over 12-weeks while attending up to 12 educational seminars. Pre- and post- exercise tolerance was measured by a graded treadmill test and quality of life was assessed using the SF-36 Health Survey. Following the 12-week cardiac rehabilitation program there were significant improvements in exercise tolerance in individuals with CHF (163±61 to 251±70 s; p<0.01) and CABG (208±62 to 309±90 s; p<0.01). All nine quality of life constructs improved significantly (p<0.01) within both groups. There were no significant differences in exercise tolerance or quality of life between groups (p=0.17). Furthermore, a positive and significant correlation was found between exercise tolerance and patient perceived physical function (R2=0.34,p<0.01). The data presented in this study suggest that patients with CHF can safely benefits from cardiac rehabilitation and that their outcomes are similar to patients post CABG. [ABSTRACT FROM AUTHOR]

A response from Courtney Sprouse and colleagues to a letter to the editor about their article "SLC30A8 Nonsynonymous Variant Is Associated With Recovery Following Exercise and Skeletal Muscle Size and Strength" in the January 2014 issue is presented.

This study examined the dose-response effects of a 1-year hybrid-type, multicomponent interval training programme (DoIT) on various musculoskeletal fitness parameters in inactive overweight and obese adults in a gym setting. Ninety-seven middle-aged (44.8 ± 5.2 years) individuals with overweight/obesity (31.2 ± 5.7 kg/m2) (66% female) were randomly assigned to the following groups: (i) no-intervention control (CON, n = 29), (ii) DoIT performed once weekly (DoIT-1, n = 24), (iii) DoIT performed twice weekly (DoIT-2, n = 23) and (iv) DoIT performed thrice weekly (DoIT-3, n = 21). DoIT was a time-efficient, intermittent-based, multicomponent exercise protocol using progressive loaded fundamental movement patterns with prescribed work-to-rest intervals (1:3–2:1) in a circuit format (2–3 rounds). Muscular strength, muscular endurance, flexibility, passive range of motion (PRoM), static balance and functional movement screen (FMS®) were assessed at baseline, 6 and 12 months following intervention. At post-training, all exercise groups exhibited superior changes than CON in (i) muscular strength (+13%–38%, p < 0.001); (ii) muscular endurance (+42%–159%, p < 0.001); (iii) flexibility (+12%–42%, p < 0.001); (iv) PRoM (+6%–50%, p = 0.001–0.026); (v) static balance (+61%–163%, p < 0.001); and (vi) FMS (+18%–39%, p < 0.001). Although a single exercise session/week improved musculoskeletal fitness, changes demonstrated a step-wise improvement with two and three sessions/week suggesting a dose-dependent response. The response rate to training was 100% for all exercise groups. These findings suggest that a multicomponent exercise approach incorporating bodyweight drills and resistance-based alternative modes performed under real-world conditions may improve several musculoskeletal fitness indicators in a dose-dependent manner in inactive, middle-aged adults with overweight/obesity. Trial registration: ClinicalTrials.gov identifier: NCT03759951. [ABSTRACT FROM AUTHOR]

Dramatic increases in obesity and diabetes have occurred worldwide over the past 30 years. Some investigators have suggested that these increases may be due, in part, to increased added sugars consumption. Several scientific organizations, including the World Health Organization, the Scientific Advisory Council on Nutrition, the Dietary Guidelines Advisory Committee 2015, and the American Heart Association, have recommended significant restrictions on upper limits of sugars consumption. In this review, the scientific evidence related to sugars consumption and its putative link to various chronic conditions such as obesity, diabetes, heart disease, nonalcoholic fatty liver disease, and the metabolic syndrome is examined. While it appears prudent to avoid excessive calories from sugars, the scientific basis for restrictive guidelines is far from settled. [ABSTRACT FROM AUTHOR]

Purpose: An osteopontin (OPN; SPP1) gene promoter polymorphism modifies disease severity in Duchenne muscular dystrophy, and we hypothesized that it might also modify muscle phenotypes in healthy volunteers. Methods: Gene association studies were carried out for OPN (rs28357094) in the FAMuSS cohort (n = 752; mean ± SD age = 23.7 ± 5.7 yr). The phenotypes studied included muscle size (MRI), strength, and response to supervised resistance training. We also studied 147 young adults that had carried out a bout of eccentric elbow exercise (age = 24.0 ± 5.2 yr). Phenotypes analyzed included strength, soreness, and serum muscle enzymes. Results: In the FAMuSS cohort, the G allele was associated with 17% increase in baseline upper arm muscle volume only in women (F = 26.32; P = 5.32 x 10−1), explaining 5% of population variance. In the eccentric damage cohort, weak associations of the G allele were seen in women with both baseline myoglobin and elevated creatine kinase. The sexually dimorphic effects of OPN on muscle were also seen in OPN-null mice. Five of seven muscle groups examined showed smaller size in OPN-null female mice, whereas two were smaller in male mice. The query of OPN gene transcription after experimental muscle damage in mice showed rapid induction within 12 h (100-fold increase from baseline), followed by sustained high-level expression through 16 d of regeneration before falling to back to baseline. Conclusion: OPN is a sexually dimorphic modifier of muscle size in normal humans and mice and responds to muscle damage. The OPN gene is known to be estrogen responsive, and this may explain the female-specific genotype effects in adult volunteers. [ABSTRACT FROM AUTHOR]

Previous studies have reported associations of polymorphisms in the IGF1 gene with phenotypes of body composition (BC). The purpose of this study was to identify phenotypes of BC and physical function that were associated with the IGF1 promoter polymorphism (rs35767, -C1245T). Subjects from the Health, Aging, and Body Composition Study, white males and females (n = 925/836) and black males and females (533/705) aged 70-79 years were genotyped for the polymorphism. Phenotypes of muscle size and function, bone mineral density, and BC were analyzed for associations with this polymorphism. To validate and compare these findings, a cohort of young (mean age = 24.6, SD = 5.9) white men and women (n = 173/296) with similar phenotypic measurements were genotyped. An association with BC was identified in elderly females when significant covariates (physical activity, age, smoking status, body mass index) were included. White women with C/C genotype had 3% more trunk fat and 2% more total fat than those with C/T (P < 0.05). Black women with C/C genotype had 3% less total lean mass and 3% less muscle mass than their T/T counterparts (P < 0.05). Associations were identified with muscle strength in white women (P < 0.01) that were in agreement with the C/C genotype having lower muscle function. Thus, in an elderly population but not a young population, a polymorphism in the IGF1 gene may be predictive of differences in body composition, primarily in black females. [ABSTRACT FROM AUTHOR]

The article reports on research which was conducted in an effort to assess the association of age with muscle mass and strength in a group of young adults before and after 12 weeks of progressive resistance training. Researchers evaluated 826 male and female subjects. They found that age does have a significant positive relationship with muscle size and strength in untrained young adults and that age does not limit response to training in any practical way during early adulthood.

The purposes of this study were to (1) derive and test allometric scaling models of biceps isometric strength using body mass (BM) and muscle cross-sectional area (CSA) as the scaling variables, (2) assess the influence of body mass index (BMI) by separating the cohort by BMI (normal <25 kg/m(2) vs. overweight/obese > or =25 kg/m(2)) and repeating step 1, and (3) assess the effect of BMI on isometric strength allometrically adjusted for differences in CSA by comparing scaled strength between normal weight versus overweight/obese women. The participants were 183 women (18-39 years old) who reported no strength training in the prior year. Isometric strength and CSA of the biceps were assessed on the non-dominant arm. The CSA allometric model met all statistical criteria and produced a scaling exponent of 0.44. The BM model did not meet these criteria until the entire cohort was separated by BMI. The scaling exponents for normal weight and overweight/obese women were 1.48 and 0.35, respectively. These data suggest that BMI exerted an influence on the relationship between BM and allometrically scaled isometric strength and may be explained by previous studies demonstrating greater contribution of fat mass (FM) versus fat-free mass (FFM) to BMI in overweight/obese women. As such, allometric scaling models of isometric strength, especially in populations that are heterogeneous with regard to body composition, must be carefully tested and examined across the range of BMI. Isometric strength relative to CSA was not significantly different between groups. However, allometrically scaled strength, using CSA as the criterion variable, was significantly greater in overweight/obese women compared to those of normal weight. These data suggest that isometric strength in women is not completely determined by CSA and other factors such as intramuscular fat and muscle fiber type may be confounding or contributing factors. [ABSTRACT FROM AUTHOR]

Abstract: The aims of this study were to examine associations between two SNPs in the human IL-15 gene and three SNPs in the IL-15Rα gene with predictors of metabolic syndrome and phenotypes in muscle, strength, and bone at baseline and in response to resistance training (RT). Subjects were Caucasians who had not performed RT in the previous year and consisted of a strength cohort (n =748), volumetric cohort (n =722), and serum cohort (n =544). Subjects completed 12 weeks of unilateral RT of the non-dominant arm, using their dominant arm as an untrained control. ANCOVA analyses revealed gender-specific associations with: (1) IL-15 SNP (rs1589241) and cholesterol (p =0.04), LDL (p =0.02), the homeostasis model assessment (HOMA; p =0.03), and BMI (p =0.002); (2) IL-15 SNP (rs1057972) and the pre- to post-training absolute difference in 1RM strength (p =0.02), BMI (p =0.008), and fasting glucose (p =0.03); (3) IL-15Rα SNP (rs2296135) and baseline total bone volume (p =0.04) and the pre- to post-training absolute difference in isometric strength (p =0.01); and 4) IL-15Rα SNP (rs2228059) and serum triglycerides (p =0.04), baseline whole muscle volume (p =0.04), baseline cortical bone volume (p =0.04), and baseline muscle quality (p =0.04). All associations were consistent in showing a potential involvement of the IL-15 pathway with muscle and bone phenotypes and predictors of metabolic syndrome. [Copyright &y& Elsevier]

Abstract: Objective: Fructose has been implicated in obesity, partly due to lack of insulin-mediated leptin stimulation and ghrelin suppression. Most work has examined effects of pure fructose, rather than high-fructose corn syrup (HFCS), the most commonly consumed form of fructose. This study examined effects of beverages sweetened with HFCS or sucrose (Suc), when consumed with mixed meals, on blood glucose, insulin, leptin, ghrelin, and appetite. Methods: Thirty lean women were studied on two randomized 2-d visits during which HFCS- and Suc-sweetened beverages were consumed as 30% of energy on isocaloric diets during day 1 while blood was sampled. On day 2, food was eaten ad libitum. Subjects rated appetite at designated times throughout visits. Results: No significant differences between the two sweeteners were seen in fasting plasma glucose, insulin, leptin, and ghrelin (P > 0.05). The within-day variation in all four items was not different between the two visits (P > 0.05). Net areas under the curve were similar for glucose, insulin, and leptin (P > 0.05). There were no differences in energy or macronutrient intake on day 2. The only appetite variable that differed between sweeteners was desire to eat, which had a higher area under the curve the day after Suc compared with HFCS. Conclusion: These short-term results suggest that, when fructose is consumed in the form of HFCS, the measured metabolic responses do not differ from Suc in lean women. Further research is required to examine appetite responses and to determine if these findings hold true for obese individuals, males, or longer periods. [Copyright &y& Elsevier]

Abstract: Exercise affects lipoprotein metabolism and apolipoprotein E (Apo E) genotype may alter changes in lipoprotein subclasses that occur with exercise. The present study examined the effects of Apo E genotype (APOE) on the response of lipoprotein subclass concentrations to long-term exercise. A prospective longitudinal study, conducted at seven centers, genetically screened 566 individuals to create three cohorts of healthy adults, equal for gender and the most common APOE variants: E2/3 (n =35), E3/3 (n =40), and E3/4 (n =31). Subjects with body mass index (BMI) ≥31 or evidence of dyslipidemia or metabolic disease were excluded. All subjects exercised aerobically at 75% of maximal heart rate for 40min, four times weekly for 6 months. Fasting lipoprotein subpopulations were measured before and after exercise training using proton nuclear magnetic resonance spectroscopy. Serum lipids for the entire cohort did not change with exercise training, but the LDL subpopulation response varied by APOE. Small-sized LDL particles decreased only in the APOE3 homozygotes whereas medium-sized LDL particles increased only in this group. These changes were directionally different from the responses in the E2/3 and E3/4 subjects (p <0.05). Neither exercise nor APOE variant affected overall LDL or HDL size or cholesterol concentration, but exercise decreased VLDL diameter by 3.5nm (p <0.001) attributable to decreases in large VLDL in each APOE group. In conclusion, APOE variants influence the serum LDL subpopulation response to exercise training in normolipidemic subjects. Subjects homozygous for APOE3 experienced the most beneficial lipid effects from exercise training. [Copyright &y& Elsevier]

Abstract: High density lipoprotein cholesterol (HDL-C) is a primary risk factor for cardiovascular disease. Apolipoprotein A-1 (apoA1) is the major HDL-associated apolipoprotein. The −75 G/A single nucleotide polymorphism (SNP) in the apolipoprotein A1 gene (APOA1) promoter has been reported to be associated with HDL-C concentrations as well as HDL-C response to dietary changes in polyunsaturated fat intake. We examined the effect of this APOA1 SNP on exercise-induced changes in HDL subfraction distribution. From a cohort of healthy normolipidemic adults who volunteered for 6 months of supervised aerobic exercise, 75 subjects were genotyped for the −75 G/A SNP. Of these, 53 subjects were G homozygotes (G/G) and 22 were A carriers (A/G and A/A). HDL subfractions were measured by nuclear magnetic resonance (NMR) spectroscopy by adding categories HDL-C 1+2 for the small subfraction, and HDL-C 3+4+5 for the large. The change in total HDL-C after exercise was 0.8±7.2mg/dL (+1.7%), and was not statistically significant. HDL subfraction amounts also did not significantly change with exercise training in the total cohort or in G homozygotes or A carriers. The amount of the large HDL subfraction increased in the G homozygotes and decreased in the A carriers (mean±S.E.M., 1.8±6.6mg/dL versus −6.1±2.3mg/dL, p <0.0005). In contrast, the amount of the small HDL subfraction decreased in G homozygotes and increased in A carriers (−1.3±6.6mg/dL versus 4.7±1.2mg/dL, p <0.005). These results show that genetic variation at the APOA1 gene promoter is associated with HDL subfraction redistribution resulting from exercise training. [Copyright &y& Elsevier]

Introduction: The aim of the present study was to report on the prevalence of disability and its association with sociodemographic factors among welfare benefit applicants in Greece. The study also compared the disability scores between different health conditions using the WHODAS 2.0 (12-item version), a biopsychosocial-model-based measure., Methods: The Greek WHODAS 2.0, 12-item version, was administered by interview. A three-member medical committee assessed the medical records of the applicants and assigned a disability percentage based on the biomedical measure of disability percentage determination (Barema scale)., Results: The majority of the participants were female (56.65%). Certain health conditions were presented more frequently among welfare benefit applicants (mental health disorders and neoplasms). The domains with the highest rate of difficulty were the "participation" and "life activities" domains. Significant differences were found between WHODAS 2.0 and Barema scores for all eight different health condition categories. The factorial ANOVA (8x2) showed a significant interaction effect between health condition category and gender with respect to the WHODAS 2.0 score (F = 19.033, p <.001, η2 = 0.13). The WHODAS 2.0 score was negatively correlated to gender, years of studies, and marital status and positively correlated to age, working status, and the Barema score. The results revealed that male participants with a partner who were younger, had more studies, were actively working, and had a lower Barema score would have lower WHODAS scores., Conclusion: Sociodemographic characteristics of welfare benefit applicants are associated with disability levels based on WHODAS 2.0. Certain health conditions, like mental health or neuromusculoskeletal conditions, are associated with higher disability scores. There are differences between the biopsychosocial and the biomedical approaches to disability assessment. The implementation of WHODAS 2.0 may contribute to a better understanding of the lived experience of patients and is a feasible and efficient tool. Combining biomedical and biopsychosocial approaches may enhance the procedures of disability assessment and help in the development of policies that support people with disabilities., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2024, Theotokatos et al.)

Introduction: The International Classification of Functioning, Disability, and Health (ICF) provides a framework for the biopsychosocial model of disability and was developed by the World Health Organization (WHO). The World Health Organization Disability Assessment Schedule (WHODAS 2.0) is an ICF-based tool that measures health and disability at the population level or in clinical practice. The aim of the study was to examine the psychometric properties of the Greek version of the WHODAS 2.0 (12-item) administered to 10,163 adults who had applied for welfare benefits in three regions of Greece., Methods: The WHODAS 2.0, administered by interview was the primary outcome variable. Principal axis factoring (PAF) and confirmatory factor analysis (CFA) assessed the data fit to the model (construct validity). The correlation between Barema disability percentage (assessed by a three-member medical committee) and WHODAS 2.0 score and the correlation between WHODAS 2.0 score and the number of comorbidities were also examined (concurrent validity). Cronbach's alpha was used to assess the internal consistency of the questionnaire. Floor and ceiling effects were also examined., Results: Internal consistency was acceptable (Cronbach's alpha=0.918). A significant association was found between Barema disability percentage and the WHODAS 2.0 score. Factor analysis showed a clear two-factor solution (PAF and CFA), while no floor or ceiling effects were evident., Conclusion: The Greek version of the 12-item WHODAS 2.0 was found to be reliable and valid in a wide sample of applicants for welfare benefits., Competing Interests: The authors have declared financial relationships, which are detailed in the next section., (Copyright © 2023, Theotokatos et al.)

Background: Although regular exercise is recommended for preventing and treating overweight/obesity, the most effective exercise type for improving cardiometabolic health in individuals with overweight/obesity remains largely undecided. This network meta-analysis aimed to evaluate and rank the comparative efficacy of 5 exercise modalities on cardiometabolic health measures in individuals with overweight/obesity., Methods: A database search was conducted in MEDLINE, Embase, Scopus, and Web of Science from inception up to September 2020. The review focused on randomized controlled trials involving exercise interventions consisting of continuous endurance training, interval training, resistance training, combined aerobic and resistance training (combined training), and hybrid-type training. Exercise interventions aimed to improve somatometric variables, body composition, lipid metabolism, glucose control, blood pressure, cardiorespiratory fitness, and muscular strength. The Cochrane risk of bias tool was used to evaluate eligible studies. A random-effects network meta-analysis was performed within a frequentist framework. The intervention ranking was carried out using a Bayesian model where mean and SD were equal to the respective frequentist estimates., Results: A total of 4331 participants (59% female; mean age: 38.7±12.3 years) from 81 studies were included. Combined training was the most effective modality and hybrid-type training the second most effective in improving cardiometabolic health-related outcomes in these populations suggesting a higher efficacy for multicomponent exercise interventions compared to single-component modalities, that is, continuous endurance training, interval training, and resistance training. A subgroup analysis revealed that the effects from different exercise types were mediated by gender., Conclusions: These findings corroborate the latest guidelines on exercise for individuals with overweight/obesity highlighting the importance of a multicomponent exercise approach to improve cardiometabolic health. Physicians and healthcare professionals should consider prescribing multicomponent exercise interventions to adults with overweight/obesity to maximize clinical outcomes., Registration: URL: https://www.crd.york.ac.uk/PROSPERO/; Unique identifier: CRD42020202647.

The relationship between sugar consumption and various health-related sequelas is controversial. Some investigators have argued that excessive sugar consumption is associated with increased risk of obesity, coronary heart disease, diabetes (T2D), metabolic syndrome, non-alcoholic fatty liver disease, and stimulation of reward pathways in the brain potentially causing excessive caloric consumption. These concerns have influenced organizations such as the World Health Organization, the Scientific Advisory Committee on Nutrition in England not to exceed 5 % of total energy and the Dietary Guidelines for Americans Advisory Committee 2015 to recommend upper limits of sugar consumption not to exceed 10 % of calories. Data from many randomized control trials (RCTs) do not support linkages between sugar consumption at normal levels within the human diet and various adverse metabolic and health-related effects. Fructose and glucose are typically consumed together in roughly equal proportions from high-fructose corn syrup (also known as isoglucose in Europe) or sucrose. The purpose of this review is to present data from recent RCTs and findings from recent systematic reviews and meta-analyses related to sugar consumption and its putative health effects. This review evaluates findings from recent randomized controlled trials, systematic reviews and meta-analyses into the relationship of sugar consumption and a range of health-related issues including energy-regulating hormones, obesity, cardiovascular disease, diabetes, and accumulation of liver fat and neurologic responses. Data from these sources do not support linkages between sugar consumption at normal levels within the human diet and various adverse metabolic and health-related effects., Competing Interests: J. M. Rippe’s research laboratory has received unrestricted grants and Dr. Rippe has received consulting fees from ConAgra Foods, Kraft Foods, the Florida Department of Citrus, PepsiCo International, Coca Cola, the Corn Refiners Association, Weight Watchers International and various publishers. TJA declares no competing interests.

Cardiovascular disease (CVD) is the single largest cause of mortality in the United States and worldwide. Numerous risk factors have been identified for CVD, including a number of nutritional factors. Recently, attention has been focused on fructose-containing sugars and their putative link to risk factors for CVD. In this review, we focus on recent studies related to sugar consumption and cardiovascular risk factors including lipids, blood pressure, obesity, insulin resistance, diabetes, and the metabolic syndrome. We then examine the scientific basis for competing recommendations for sugar intake. We conclude that although it appears prudent to avoid excessive consumption of fructose-containing sugars, levels within the normal range of human consumption are not uniquely related to CVD risk factors with the exception of triglycerides, which may rise when simple sugars exceed 20% of energy per day, particularly in hypercaloric settings., (© 2015 American Society for Nutrition.)

Background: Meta-analysis of genome-wide association studies identified obesity-related genetic variants. Due to the pleiotropic effects of related phenotypes, we tested six of these obesity-related genetic variants for their association with physical activity: fat mass and obesity-associated ( FTO )(rs9939609)T>A, potassium channel tetramerization domain containing ( KCTD15 ) (rs11084753)G>A, melanocortin receptor4 ( MC4R )(rs17782313)T>C, neuronal growth regulator 1 ( NEGR1 )(rs2815752)A>G, SH2B adapter protein 1 ( SH2B1 )(rs7498665)A>G, and transmembrane protein18 ( TMEM18 )(rs6548238)C>T., Method: European-American women ( n  = 263) and men ( n  = 229) (23.5 ± 0.3 years, 24.6 ± 0.2 kg/m 2 ) were genotyped and completed the Paffenbarger physical activity Questionnaire. Physical activity volume in metabolic energy equivalents [MET]-hour/week was derived from the summed time spent (hour/week) times the given MET value for vigorous, moderate, and light intensity physical activity, and sitting and sleeping, respectively. Multivariable adjusted [(age, sex, and body mass index (BMI)] linear regression tested associations among genotype (dominant/recessive model) and the log of physical activity volume., Result: MC4R (rs17782313)T>C explained 1.1 % ( p  = 0.02), TMEM18 (rs6548238)C>T 1.2 % ( p  = 0.01), and SH2B1 (rs7498665)A>G 0.6 % ( p  = 0.08) of the variability in physical activity volume. Subjects with the MC4R C allele spent 3.5 % less MET-hour/week than those with the TT genotype ( p  = 0.02). Subjects with the TMEM18 T allele spent 4.1 % less MET-hour/week than those with the CC genotype ( p  = 0.01). Finally, subjects with the SH2B1 GG genotype spent 3.6 % less MET-hour/week than A allele carriers ( p  = 0.08)., Conclusion: Our findings suggest a shared genetic influence among some obesity-related gene loci and physical activity phenotypes that should be explored further. Physical activity volume differences by genotype have public health importance equating to 11-13 lb weight difference annually.

Daily lifestyle practices and habits profoundly affect the likelihood of developing cardiovascular disease (CVD). Abundant research and multiple recent consensus documents support the role of regular physical activity, not smoking cigarettes, maintaining a healthy body weight, controlling cholesterol levels, and controlling blood pressure to lower the risk of CVD. These strategies also play important roles in avoiding ever developing risk factors. Despite overwhelming knowledge in this area, adherence to lifestyle strategies remains suboptimal. Challenges remain in helping the public to act upon the current knowledge in this area. Recent guidelines for managing cholesterol and blood pressure provide new guidance in these areas. Controversy, however, exists related to specific recommendations in both of these areas. Similar strategies that are applied to adults for improving lifestyle habits and practices to lower CVD risk also apply to children and adolescents. A clear consensus exists that lifestyle strategies play a critical role in preventing, managing, and reducing cardiovascular disease and its risk factors.

Both controversy and confusion exist concerning fructose, sucrose, and high-fructose corn syrup (HFCS) with respect to their metabolism and health effects. These concerns have often been fueled by speculation based on limited data or animal studies. In retrospect, recent controversies arose when a scientific commentary was published suggesting a possible unique link between HFCS consumption and obesity. Since then, a broad scientific consensus has emerged that there are no metabolic or endocrine response differences between HFCS and sucrose related to obesity or any other adverse health outcome. This equivalence is not surprising given that both of these sugars contain approximately equal amounts of fructose and glucose, contain the same number of calories, possess the same level of sweetness, and are absorbed identically through the gastrointestinal tract. Research comparing pure fructose with pure glucose, although interesting from a scientific point of view, has limited application to human nutrition given that neither is consumed to an appreciable degree in isolation in the human diet. Whether there is a link between fructose, HFCS, or sucrose and increased risk of heart disease, metabolic syndrome, or fatty infiltration of the liver or muscle remains in dispute with different studies using different methodologies arriving at different conclusions. Further randomized clinical trials are needed to resolve many of these issues. The purpose of this review is to summarize current knowledge about the metabolism, endocrine responses, and potential health effects of sucrose, HFCS, and fructose.

Converging lines of evidence suggest that AKT1 is a major mediator of the responses to insulin,insulin-like growth factor 1 (IGF1), and glucose. AKT1 also plays a key role in the regulation of both muscle cell hypertrophy and atrophy. We hypothesized that AKT1 variants may play a role in the endophenotypes that makeup metabolic syndrome. We studied a 12-kb region including the first exon of the AKT1 gene for association with metabolic syndrome-related phenotypes in four study populations [FAMUSS cohort (n = 574; age 23.7 ± 5.7 years), Strong Heart Study (SHS) (n = 2,134; age 55.5 ± 7.9 years), Dynamics of Health, Aging and Body Composition (Health ABC) (n = 3,075; age 73.6 ± 2.9 years), and Studies of a Targeted Risk Reduction Intervention through Defined Exercise (STRRIDE)(n = 175; age 40–65 years)]. We identified a three SNP haplotype that we call H1, which represents the ancestral alleles eles at the three loci and H2, which represents the derived alleles at the three loci. In young adult European Americans (FAMUSS), H1 was associated with higher fasting glucose levels in females. In middle age Native Americans (SHS), H1 carriers showed higher fasting insulin and HOMA in males, and higher BMI in females. Inolder African-American and European American subjects(Health ABC) H1 carriers showed a higher incidence of metabolic syndrome. Homozygotes for the H1 haplotype showed about twice the risk of metabolic syndrome in both males and females (p < 0.001). In middle-aged European Americans with insulin resistance (STRRIDE) studied by intravenous glucose tolerance test (IVGTT), H1 carriers showed increased insulin resistance due to the Sg component (p = 0.021). The 12-kb haplotype is a risk factor for metabolic syndrome and insulin resistance that needs to be explored in further populations.

Unlabelled: Participation in regular aerobic exercise has been shown to increase arterial size and that exercise-induced vascular remodeling may be regional rather than systemic. However, these issues have been minimally investigated concerning resistance training., Purposes: To determine whether 1) resistance training of the nondominant arm elicits an increase in diameter of the brachial artery and 2) unilateral training induces arterial remodeling in the contralateral arm., Methods: Twenty-four previously untrained participants, consisting of 18 females (aged 22.3 +/- 5.1 yr) and 6 males (aged 21.7 +/- 1.8 yr), participated in unilateral strength training of the biceps and triceps for 12 wk using their nondominant arm. Isotonic (one-repetition maximum, 1RM) and isometric (ISO) strength of the biceps were assessed before and after training on both arms. Brachial artery diameter and biceps muscle cross-sectional area (CSA) of both arms were also measured before and after training using magnetic resonance imaging (MRI)., Results: Brachial artery diameter increased 5.47% (P < 0.05) in the nondominant trained arm with no change observed in the dominant untrained arm. Biceps CSA increased 18.3% (P < 0.05) in the trained arm with no change (P > 0.05) in the untrained limb. Nondominant 1RM and ISO strength increased by 35.1% and 16.8%, respectively (P < 0.05 for both), although there were no significant changes (P > 0.05) in the contralateral arm. A modest correlation was found between the increases in CSA and in brachial artery diameter (r2 = 0.19, P = 0.039)., Conclusions: These results indicate that upper arm vascular remodeling, manifesting as increased brachial artery diameter, can result from resistance training and that these changes are localized to the trained limb and associated with increases in CSA.

The present study examined associations between the ciliary neurotrophic factor (CNTF) 1357 G --> A polymorphism and the muscle strength response to a unilateral, upper arm resistance-training (RT) program among healthy, young adults. Subjects were 754 Caucasian men (40%) and women (60%) who were genotyped and performed a training program of the nondominant (trained) arm with the dominant (untrained) arm as a comparison. Peak elbow flexor strength was measured with one repetition maximum, isometric strength with maximum voluntary contraction, and bicep cross-sectional area with MRI in the trained and untrained arms before and after training. Women with the CNTF GG genotype gained more absolute isometric strength, as measured by MVC (6.5 +/- 0.3 vs. 5.2 +/- 0.5 kg), than carriers of the CNTF A1357 allele in the trained arm pre- to posttraining (P < 0.05). No significant associations were seen in men. Women with the CNTF GG genotype gained more absolute dynamic (1.0 +/- 0.1 vs. 0.6 +/- 0.1 kg) and allometric (0.022 +/- 0.0 vs. 0.015 +/- 0.0 kg/kg(-0.67)) strength, as measured by 1 RM, than carriers of the CNTF A1357 allele in the untrained arm pre- to posttraining (P < 0.05). No significant associations were seen in men. No significant associations, as measured by cross-sectional area, were seen in men or women. The CNTF 1357 G --> A polymorphism explains only a small portion of the variability in the muscle strength response to training in women.

Rates of overweight and obesity have been on a steady rise for decades, and the problems society faces from this and associated metabolic diseases are many. As a result, the need to understand the contributing factors is great. A very compelling case can be made that excess sugar consumption has played a significant role. In addition, fructose, as a component of the vast majority of caloric sweeteners, is seen to be particularly insidious. Evidence shows that fructose bypasses many of the body's satiating signals, thus potentially promoting overconsumption of energy, weight gain, and the development on insulin resistance. It has also been shown to increase uric acid levels, which in turn promotes many of the abnormalities seen in the metabolic syndrome including hypertriglyceridemia. However, the main source of fructose in the diet is high-fructose corn syrup (HFCS), an artificially manufactured disaccharide that is only 55% fructose. This review highlights the fact that limited data are available about the metabolic effects of HFCS compared with other caloric sweeteners. The data suggest that HFCS yields similar metabolic responses to other caloric sweeteners such as sucrose.

Purpose: We examined associations among myostatin (MSTN) 2379 A > G and 163 G > A and follistatin (FST) -5003 A > T and -833 G > T single nucleotide polymorphisms (SNP) on the muscle size and the strength response to resistance training (RT)., Methods: Subjects (n = 645, age = 24.1 +/- 0.2 yr, body mass index [BMI] = 24.2 +/- 0.2 kg x m(-2)) self-disclosed themselves as Caucasian (78.9%), African American (3.6%), Asian (8.4%), Hispanic (5.0%), or Other (4.2%). They were genotyped for MSTN 2379 A > G (n = 645), MSTN 163 G > A (n = 639), FST -5003 A > T (n = 580), and FST -833 G > T (n = 603). We assessed dynamic (one repetition maximum [1RM]) and isometric (maximum voluntary contraction [MVC]) muscle strength and size (cross-sectional area [CSA]) of the elbow flexors before and after 12 wk of unilateral upper-arm RT. Repeated-measures ANCOVA tested associations among genetic variants and muscle phenotypes with age and BMI as covariates., Results: Baseline MVC was greater among African Americans who were carriers of the MSTN G(2379) allele (AG/GG, n = 15) than the A2379A homozygotes (n = 8; 64.2 +/- 6.8 vs 49.8 +/- 8.7 kg). African Americans who were carriers of the FST T(-5003) allele (n = 12) had greater baseline 1RM (11.9 +/- 0.7 vs 8.8 +/- 0.5 kg) and CSA (24.4 +/- 1.3 vs 19.1 +/- 1.2 cm(2)) than African Americans with the A-5003A genotype (n = 14; P < 0.05). No MSTN or FST genotype and muscle phenotype associations were found among the other ethnic groups (P >or= 0.05)., Conclusion: MSTN 2379 A > G and FST -5003 A > T were associated with baseline muscle strength and size among African Americans only. These ethnic-specific associations are hypothesis generating and should be confirmed in a larger sample of African Americans.

High-fructose corn syrup (HFCS) has been implicated in excess weight gain through mechanisms seen in some acute feeding studies and by virtue of its abundance in the food supply during years of increasing obesity. Compared with pure glucose, fructose is thought to be associated with insufficient secretion of insulin and leptin and suppression of ghrelin. However, when HFCS is compared with sucrose, the more commonly consumed sweetener, such differences are not apparent, and appetite and energy intake do not differ in the short-term. Longer-term studies on connections between HFCS, potential mechanisms, and body weight have not been conducted. The main objective of this review was to examine collective data on associations between consumption of HFCS and energy balance, with particular focus on energy intake and its regulation.

Background: Recent reports suggest that dietary energy density (ED) is associated with diet quality, energy intake, and body weight. Breakfast consumption was also associated with diet quality and body weight; however, little is known about the association of breakfast consumption with dietary ED., Objectives: We examined differences in the ED (in energy content/g of food) of diets between breakfast consumers and nonconsumers, and in breakfast reporters we examined the association of ED of breakfast foods with ED of nonbreakfast foods, diet quality, and body mass index (BMI; in kg/m(2))., Design: We combined dietary data from the 3 continuous National Health and Nutrition Examination Surveys (1999-2004) to determine the ED (in kcal/g) of foods and nutritive beverages and the ED of foods only (n = 12 316; >or=20 y). Linear and logistic regression methods were used to examine the independent associations of breakfast reporting or breakfast ED with 24-h ED, nonbreakfast ED, diet quality, and BMI., Results: The ED of 24-h dietary intake was lower among breakfast reporters than among nonreporters. Women breakfast reporters (but not men) had lower BMI than did nonreporters (27.9 +/- 0.2 compared with 29.4 +/- 0.4; P = 0.001). With increasing breakfast ED, nonbreakfast ED and fat intake increased, but micronutrient intake and the likelihood of mention of all 5 food groups declined. BMI increased with increasing breakfast ED in men but with increasing nonbreakfast ED in women (P

C-reactive protein (CRP) is a marker for systemic inflammation and increased cardiovascular disease risk. Regular exercise may decrease CRP. Apolipoprotein E (apo E) has 3 common genotype variants--E2/3, 3/3, and 3/4--that modulate lipid metabolism and may have other metabolic physiologic roles, including some evidence that the genotype affects CRP levels. We assessed fasting serum CRP in 117 (male = 51, female = 66) healthy adults who volunteered for a 6-month aerobic exercise program. Both pre- and posttraining measurements were available in 71 (male = 31, female = 40) subjects. At baseline and follow-up, the numbers of subjects in the 3 groups were approximately equal: 2/3, n = 33 and 20; 3/3, n = 41 and 26; and 3/4, n = 43 and 25. At baseline, CRP levels differed by apo E genotype: means +/- SD were 2.84 +/- 2.18, 2.59 +/- 2.34, and 1.90 +/- 2.13 mg/L for E2/3, 3/3, and 3/4 subjects, respectively (3/4 vs 2/3, P < .05). In women, CRP was higher than that in men (3.14 +/- 2.49 vs 2.12 +/- 2.13 mg/L, P < .006). Exercise failed to affect CRP in the entire cohort (2.68 +/- 2.38 vs 2.52 +/- 2.48 mg/L) or in any apo E genotype group, and the apo E genotype effect observed at baseline persisted after training. In a largely white study cohort, CRP is higher in apo E3/3 than in 3/4 subjects and in women compared with men, but remains unchanged by 6 months of standard aerobic exercise training of the volume and higher intensity promoted by national organizations to reduce cardiovascular disease risk. How apo E genotype affects CRP is not known.

Apolipoprotein B (apoB) concentration and age are independently associated with an increased risk for cardiovascular disease. Age is also associated with increased apoB concentration. The purpose of this study was to determine the effects of exercise on apoB and examine the association between age and lipoproteins. Forty-one sedentary individuals exercised for 6 months, four times/week for 40 min between 60 and 85% of their maximal heart rate. Lipids were determined three times: before training, 24 and 72 h after the last training session. Exercise did not alter apoB (1.2+/-0.05 g/l vs. 1.2+/-0.05 g/l; P>0.05), or other lipids or lipoproteins. When participants were sequestered by baseline low density lipoprotein cholesterol (LDLc), total cholesterol (TC) was decreased at 24 h post (6.3+/-0.2 mmol/l vs. 6.0+/-0.2 mmol/l, P<0.05) and LDLc after 24 and 48 h post (4.3+/-0.1 mg/dl vs. 3.9+/-0.1 and 4.1+/-0.2 mg/dl, P<0.05) in the high LDLc group. In the low LDLc group both TC (4.4+/-0.2 mmol/l vs. 4.6+/-0.2 and 4.6+/-0.2 mmol/l, P>0.05) and LDLc (2.6+/-0.1 mmol/l vs. 2.8+/-0.1 and 2.8+/-0.2 mmol/l, P<0.05) were elevated at 24 h and remained elevated at 72 h post compared to baseline. Age does not affect apoB or lipoproteins in response to exercise. Individuals with high baseline LDLc experienced acute reduction in TC and LDLc produced by each exercise session.

Objective: While various weight-management approaches produce weight loss, they may differ in dietary quality. We monitored changes in nutrient intakes in overweight and obese subjects on three different weight-management programs., Design: Randomized clinical trial (pilot study) with two 12-week phases: phase 1, weekly counseling; phase 2, monitoring only., Subjects/setting: One hundred eighty nonsmoking, sedentary overweight and obese adults began this outpatient study; 134 (body mass index [calculated as kg/m(2)]=30.9+/-2.4; age=42.3+/-1.2 years) were used in analyses., Intervention: Twenty-four weeks of exercise only (control group), hypocaloric diet plus exercise, or hypocaloric diet with fiber-rich whole-grain cereals plus exercise., Main Outcome Measures: At weeks 0, 12, and 24, diet quality was assessed by 3-day food records and body weight was measured., Statistical Analyses Performed: Three-way analysis of variance with repeated measures., Results: The hypocaloric diet with fiber-rich whole-grain cereals plus exercise decreased energy intake more than exercise only (P=0.032). By week 12, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise decreased total fat more than exercise only, which was sustained in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise at 24 weeks (P<0.001). At weeks 12 and 24, the hypocaloric diet with fiber-rich whole-grain cereals plus exercise reduced saturated fat intake more than exercise only. The hypocaloric diet with fiber-rich whole-grain cereals plus exercise increased total fiber, insoluble fiber (both P<0.001), magnesium (P=0.004), and vitamin B-6 (P=0.002) intakes more than the hypocaloric diet plus exercise and exercise only. Calcium and vitamin E intakes were inadequate in all groups. Weight loss was similar in the hypocaloric diet with fiber-rich whole-grain cereals plus exercise and the hypocaloric diet plus exercise., Conclusions: Weight-reduction strategies may be associated with reduced intake of micronutrients, such as calcium and vitamin E. However, a hypocaloric diet with fiber-rich whole-grain cereal is effective for improving or maintaining other aspects of dietary quality during weight loss.