Alan C. Utter

Influence of Obesity on Immune Function

OBJECTIVE To compare immune function in obese and nonobese subjects. DESIGN Obese and nonobese subjects were compared cross-sectionally. To test for the influence of other factors on immunity, aerobic fitness, psychological well-being, and serum levels of glucose, triglycerides, and cholesterol were measured and included in multiple regression models to determine their comparative effects. SUBJECTS/SETTING Community-based subjects included 116 obese women (age = 44.3 +/- 9.7 years, body mass index = 33.2 +/- 6.5) and 41 nonobese women (age = 42.2 +/- 10.9 years, body mass index = 21.2 +/- 1.9). STATISTICAL ANALYSES PERFORMED Independent t tests, Pearson product moment correlations, and stepwise multiple regression procedures. RESULTS Obesity was linked to elevated leukocyte and lymphocyte subset counts (except for natural killer and cytotoxic/suppressor T cells), suppressed mitogen-induced lymphocyte proliferation (an index of T- and B-cell function), higher monocyte and granulocyte phagocytosis and oxidative burst activity, and normal activity of natural killer cells. APPLICATIONS/CONCLUSIONS These data support the contention that obesity is associated with alterations in immune function. Further research is needed to link immunosuppression with the previously reported elevated risk of infection among the obese.

Children's OMNI Scale of Perceived Exertion: walking/running evaluation

PURPOSE The Childrens OMNI-walk/run Scale of Perceived Exertion (category range, 0-10) was evaluated using male and female children (6-13 yr of age) during a treadmill graded exercise test. METHODS A cross-sectional, perceptual estimation paradigm using a walking/running test protocol was administered. Oxygen uptake (VO(2), mL x min(-1)), %VO(2max), ventilation (VE, L x min(-1)), respiratory rate (RR, breaths x min(-1)), respiratory exchange ratio (RER), heart rate (HR, beats x min(-1)), V(E)/VO(2) ratio, and ratings of perceived exertion (RPE) measurements were made every minute throughout the test. RESULTS Significant correlations were found between OMNI-walk/run Scale RPE responses and VO(2), %VO(2max), HR, V(E)/VO(2) ratio, and RR throughout the maximal treadmill exercise test. The strongest correlations were found between RPE and %VO(2max) (r = 0.41-0.60, P < 0.001) and HR (r = 0.26-0.52, P < 0.01). CONCLUSION The psychophysiological responses provide validity evidence for use of the Childrens OMNI-walk/run Scale over a wide range of exercise intensities during both walking and running.

Physical activity among ethnically diverse college students

Abstract The authors compared physical activity patterns among 874 Asian, 332 African, 1,101 White, and 529 Hispanic American college students aged 18 to 25 years. According to self-report responses, 46.7% of the sample did not engage in vigorous physical activity and 16.7% were physically inactive. Among women, ethnic-specific rates of physical inactivity were Asian, 28.1%; African, 23.5%; White, 17.4%; and Hispanic, 20.3%. For men, rates of inactivity were Asian 11.7%; African, 7.7%; White, 12.0%; and Hispanic, 13.8. Weight-training activity, youthful physical activity, and TV viewing accounted for a significant portion of the variance in physical activity levels (13.1% for women and 14.8% for men). The results of this study support the need for physical activity interventions for college students, particularly minorities.

Immune response to exercise training and/or energy restriction in obese women.

PURPOSE The effect of exercise training (five 45-min walking sessions/wk at 60-75% maximum heart rate) and/or moderate energy restriction (4.19-5.44 MJ or 1,200-1,300 kcal x d(-1)) on innate and adaptive immunity (including mitogen-stimulated lymphocyte proliferation (MSLP), natural killer cell activity (NKCA), and monocyte and granulocyte phagocytosis and oxidative burst (MGPOB) was studied in obese women (N = 91, age 45.6 +/- 1.1 yr, body mass index 33.1 +/- 0.6 kg x m(-2)) randomized to one of four groups: control (C), exercise (E), diet (D), exercise, and diet (ED). METHODS Aerobic power, body composition, and immune function were measured in all subjects before and after a 12-wk diet intervention period, with data analyzed using a 4 x 2 repeated measures design. All subjects self-reported symptoms of sickness in health logs using a precoded checklist. Statistical significance was set at P < or = 0.05. RESULTS Data from this study indicate that although exercise training was unrelated to any significant changes in resting immune function, the number of days with symptoms of upper respiratory tract infection (URTI) was reduced relative to subjects in the nonexercise groups (5.6 +/- 0.9 and 9.4 +/- 1.1 sickness days, respectively, P < 0.05). Energy restriction and weight loss (7.9 +/- 0.7 kg) was associated with a significant decrease in MSLP, but no change in NKCA, MGPOB, or URTI. CONCLUSION The data are consistent the viewpoint that weight loss, even at a moderate rate, is associated with a decrease in mitogen-stimulated lymphocyte proliferation without a change in various measures of innate immunity of the blood compartment.

Creatine supplementation and health variables : a retrospective study

PURPOSE Long-term safety of creatine supplementation has been questioned. This retrospective study was performed to examine markers related to health, the incidence of reported side effects and the perceived training benefits in athletes supplementing with creatine monohydrate. METHODS Twenty-six athletes (18 M and 8 F, 24.7 +/- 9.2 y; 82.4 +/- 20.0 kg; 176.5 +/- 8.8 cm) from various sports were used as subjects. Blood was collected between 7:00 and 8:30 a.m. after a 12-h fast. Standard clinical examination was performed for CBC and 27 blood chemistries. Testosterone, cortisol, and growth hormone were analyzed using an ELISA. Subjects answered a questionnaire on dietary habits, creatine supplementation, medical history, training history, and perceived effects of supplementation. Body mass was measured using a medical scale, body composition was estimated using skinfolds, and resting heart rate and blood pressure were recorded. Subjects were grouped by supplementation length or no use: Gp1 (control) = no use (N = 7; 3 F, 4 M); Gp2 = 0.8-1.0 yr (N = 9; 2 F, 7 M); and Gp3 = 1(+) (N = 10; 3 F, 7 M). RESULTS Creatine supplementation ranged from 0.8--4 yr. Mean loading dose for Gp2 and Gp3 was 13.7 +/- 10.0 and the maintenance dose was 9.7 +/- 5.7 g.d(-)1. Group differences were analyzed using one-way ANOVA. CONCLUSIONS Expected gender differences were observed. Of the comparisons made among supplementation groups, only two differences for creatinine and total protein (P < 0.05) were noted. All group means fell within normal clinical ranges. There were no differences in the reported incidence of muscle injury, cramps, or other side effects. These data suggest that long-term creatine supplementation does not result in adverse health effects.

Quercetin ingestion does not alter cytokine changes in athletes competing in the Western States Endurance Run.

The purpose of this study was to measure the influence of quercetin on plasma cytokines, leukocyte cytokine mRNA, and related variables in ultramarathoners competing in the 160-km Western States Endurance Run (WSER). Sixty-three runners were randomized to quercetin and placebo groups and under double-blinded methods ingested 1000 mg/day quercetin for 3 weeks before the WSER. Thirty-nine of the 63 subjects (n = 18 for quercetin, n = 21 for placebo) finished the race and provided blood samples the morning before the race and 15-30 min postrace. Significant prerace to postrace WSER increases were measured for nine proinflammatory and anti-inflammatory plasma cytokines, cortisol (quercetin = 94%, placebo = 96%), serum C-reactive protein (CRP) (mean +/- SE absolute increase, quercetin = 31.8 +/- 4.2, placebo = 38.2 +/- 5.0 mg/L), and creatine kinase (CK) (quercetin = 21,575 +/- 3,977, placebo = 19,455 +/- 3,969 U/L), with no significant group differences. Interleukin-6 (IL-6) mRNA did not change post-WSER, with a significant decrease measured for leukocyte IL-8 mRNA (0.21 +/- 0.03-fold and 0.25 +/- 0.04-fold change from rest, quercetin and placebo, respectively) and significant increases for IL-1Ra mRNA (1.43 +/- 0.18-fold and 1.40 +/- 0.16-fold change, quercetin and placebo, respectively) and IL-10 mRNA (12.9 +/- 3.9-fold and 17.2 +/- 6.1-fold change, quercetin and placebo, respectively), with no significant differences between groups. In conclusion, quercetin ingestion (1 g/day) by ultramarathon athletes for 3 weeks before a competitive 160-km race significantly increased plasma quercetin levels but failed to attenuate muscle damage, inflammation, increases in plasma cytokine and hormone levels, and alterations in leukocyte cytokine mRNA expression.

Reducing diet and/or exercise training decreases the lipid and lipoprotein risk factors of moderately obese women.

Objective: This study was designed to measure the influence of diet, exercise or both on serum lipids and lipoproteins in obese women. Methods: Obese subjects were randomly divided into one of four groups: diet alone (1,200–1,300 kcal/day, NCEP, Step I), exercise alone (five 45 minute sessions per week at 78.4 ± 0.5% maximum heart rate), exercise and diet, and controls. Maximal aerobic power, body composition, diet, serum lipids and lipoproteins were measured in all subjects at baseline and after a 12-week intervention period. Subjects included 91 moderately obese (45.6 ± 1.1 y, body mass index 33.1 ± 0.6 kg/m2) and 30 nonobese (43.2 ± 2.3 y, body mass index 21.4 ± 0.34 kg/m2) women who were recruited from the surrounding community. Independent t tests were used to compare obese and nonobese subjects at baseline. The 12-week intervention data from the obese groups were analyzed using a 4 × 2 repeated measures ANOVA design. Results: Cross-sectional comparisons at baseline showed obese subjects had significantly higher total cholesterol, triacylglycerol, total cholesterol/HDL-C and LDL-C values and lower HDL-C values. Prospective results showed that subjects in diet and exercise and diet lost 7.8 ± 0.7 and 8.1 ± 0.6 kg body mass, with no significant change for exercise relative to control. Serum cholesterol and triacylglycerol improved in both diet and in exercise and diet after 12 weeks of intervention, and was most strongly related to weight loss. Conclusion: Weight loss is the most effective means of reducing lipid and lipoprotein risk factors in obese women.

Effect of carbohydrate ingestion and hormonal responses on ratings of perceived exertion during prolonged cycling and running.

Abstract This randomized, double-blind, placebo-controlled study was designed to determine the influence of exercise mode, and 6% carbohydrate (C) versus placebo (P) beverage ingestion, on ratings of perceived exertion (RPE) and hormonal regulation to 2.5 h of high-intensity running and cycling (≈75% maximum oxygen uptake) by ten triathletes who acted as their own controls. Statistical significance was set at P ≤ 0.05. The pattern of change in RPE over time was significantly different between C and P ingestion (P < 0.001) and between running and cycling modes (P = 0.001). The lowest RPE values were seen in the C-cycling sessions and the highest in the P-running sessions. The pattern of change in the respiratory exchange ratio and fat and carbohydrate oxidation rates were significantly different between the C and P conditions but not between the running and cycling modes. C relative to P ingestion (but not exercise mode) was associated with higher plasma levels of glucose and insulin and lower plasma cortisol and growth hormone levels. The pattern of change in plasma levels of catecholamines and lactate did not differ between the C and P conditions. These data indicate that a lower RPE was associated with a higher level of carbohydrate oxidation, higher plasma glucose and insulin levels, and lower plasma cortisol and growth hormone levels during cycle exercise following C supplementation as compared to P feeding. These findings support a physiological link between RPE and carbohydrate substrate availability as well as selected hormonal regulation during cycle exercise.

Chronic quercetin ingestion and exercise-induced oxidative damage and inflammation

Quercetin is a flavonoid compound that has been demonstrated to be a potent antioxidant in vitro. The objective of this study was to evaluate if quercetin ingestion would increase plasma antioxidant measures and attenuate increases in exercise-induced oxidative damage. Forty athletes were recruited and randomized to quercetin or placebo. Subjects consumed 1000 mg quercetin or placebo each day for 6 weeks before and during 3 d of cycling at 57% work maximum for 3 h. Blood was collected before and immediately after exercise each day, and analyzed for F2-isoprostanes, nitrite, ferric-reducing ability of plasma, trolox equivalent antioxidant capacity, and C-reactive protein. Statistical analyses involved a 2 (treatment) x 6 (times) repeated measures analysis of variance to test main effects. F2-isoprostanes, nitrite, ferric-reducing ability of plasma, trolox equivalent antioxidant capacity, and C-reactive protein were significantly elevated as a result of exercise, but no group effects were found. Despite previous data demonstrating potent antioxidant actions of quercetin in vitro, this study indicates that this effect is absent in vivo and that chronic quercetin ingestion does not exert protection from exercise-induced oxidative stress and inflammation.

Metabolic efficiency during arm and leg exercise at the same relative intensities.

This study was conducted to compare gross efficiency (GE), net efficiency (NE), work efficiency (WE), and delta efficiency (DE) between arm crank and cycle exercise at the same relative intensities. Eight college-aged males underwent two experimental trials presented in a randomized counterbalanced order. During each trial subjects performed three intermittent 7-min exercise bouts separated by 10-min rest intervals on an arm or semirecumbent leg ergometer. The power outputs for the three bouts of arm crank or cycle exercise corresponded to 50, 60, and 70% of the mode-specific VO2peak. GE, NE, and WE were determined as the ratio of Kcal.min-1 equivalent of power output to Kcal.min-1 of total energy expended, energy expended above rest and energy expended above unloaded exercise, respectively. DE was determined as the ratio of the increment of Kcal.min-1 of power output above the previous lower intensity to the increment of kcal.min-1 of total energy expended above the previous lower intensity. GE and NE did not differ between arm crank and cycle exercises. However, WE was lower (P < 0.05) during arm crank than cycle exercise at 50, 60, and 70% VO2peak. DE was also lower (P < 0.05) during arm crank than cycle exercise at delta 50-60 and at delta 60-70% VO2peak. It is concluded metabolic efficiency as determined by work and delta efficiency indices was lower during arm crank compared with cycle exercise at the same relative intensities. These findings add to the understanding of the difference in metabolic efficiency between upper and lower body exercise.