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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.

Compelling research has documented how the circadian system is essential for the maintenance of several key biological processes including homeostasis, cardiovascular control, and glucose metabolism. Circadian clock disruptions, or losses of rhythmicity, have been implicated in the development of several diseases, premature ageing, and are regarded as health risks. Redox reactions involving reactive oxygen and nitrogen species (RONS) regulate several physiological functions such as cell signalling and the immune response. However, oxidative stress is associated with the pathological effects of RONS, resulting in a loss of cell signalling and damaging modifications to important molecules such as DNA. Direct connections have been established between circadian rhythms and oxidative stress on the basis that disruptions to circadian rhythms can affect redox biology, and vice versa, in a bi-directional relationship. For instance, the expression and activity of several key antioxidant enzymes (SOD, GPx, and CAT) appear to follow circadian patterns. Consequently, the ability to unravel these interactions has opened an exciting area of redox biology. Exercise exerts numerous benefits to health and, as a potent environmental cue, has the capacity to adjust disrupted circadian systems. In fact, the response to a given exercise stimulus may also exhibit circadian variation. At the same time, the relationship between exercise, RONS, and oxidative stress has also been scrutinised, whereby it is clear that exercise-induced RONS can elicit both helpful and potentially harmful health effects that are dependent on the type, intensity, and duration of exercise. To date, it appears that the emerging interface between circadian rhythmicity and oxidative stress/redox metabolism has not been explored in relation to exercise. This review aims to summarise the evidence supporting the conceptual link between the circadian clock, oxidative stress/redox homeostasis, and exercise stimuli. We believe carefully designed investigations of this nexus are required, which could be harnessed to tackle theories concerned with, for example, the existence of an optimal time to exercise to accrue physiological benefits.

The Editor-in-Chief and Executive Editors of the Journal of Sports Sciences11 The Editorial Board is comprised of the Editor-in-Chief and five Executive Editors. all identify as male and white.22 A...

The majority of papers submitted to the Journal of Sports Sciences are experimental. The data are collected from a sample of the population and then used to test hypotheses and/or make inferences a...

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.

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.

We published a recent editorial on sample size estimation (Abt et al., 2020), which was one in a series of editorials over many years intended to encourage authors to improve the rigour of studies ...

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.

The prevalence of type 2 diabetes mellitus (T2DM) continues to rise globally. Yet the aetiology and pathophysiology of this noncommunicable, polygenic disease, is poorly understood. Lifestyle factors, such as poor dietary intake, lack of exercise, and abnormal glycaemia, are purported to play a role in disease onset and progression, and these environmental factors may disrupt specific epigenetic mechanisms, leading to a reprogramming of gene transcription. The hyperglycaemic cell per se, alters epigenetics through chemical modifications to DNA and histones via metabolic intermediates such as succinate, α-ketoglutarate and O-GlcNAc. To illustrate, α-ketoglutarate is considered a salient co-factor in the activation of the ten-eleven translocation (TET) dioxygenases, which drives DNA demethylation. On the contrary, succinate and other mitochondrial tricarboxylic acid cycle intermediates, inhibit TET activity predisposing to a state of hypermethylation. Hyperglycaemia depletes intracellular ascorbic acid, and damages DNA by enhancing the production of reactive oxygen species (ROS); this compromised cell milieu exacerbates the oxidation of 5-methylcytosine alongside a destabilisation of TET. These metabolic connections may regulate DNA methylation, affecting gene transcription and pancreatic islet β-cell function in T2DM. This complex interrelationship between metabolism and epigenetic alterations may provide a conceptual foundation for understanding how pathologic stimuli modify and control the intricacies of T2DM. As such, this narrative review will comprehensively evaluate and detail the interplay between metabolism and epigenetic modifications in T2DM.

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.