Alfons Ramel

A diet rich in long chain omega-3 fatty acids modulates satiety in overweight and obese volunteers during weight loss.

Long chain omega-3 fatty acids (LC n-3 FA) are considered nutritional factors with a potential to modulate food intake. Thus, the aim of the current study was to determine whether appetite could be affected by LC n-3 FA when included in a calorie-restricted diet to treat overweight or obesity. Appetite was explored in volunteers (31+/-5 years; BMI: 28.3+/-1.5 kg/m(2)) during the last 2 weeks of an 8-week energy-restricted balanced diet (weight loss=-5.9+/-3.1%) providing either a low (<260 mg/day; n=112) or a high amount (>1300 mg/day; n=121) of LC n-3 FA. Erythrocyte membrane fatty acids were measured to detect diet-related changes in fatty acids and a validated visual analogue scale (VAS) was used to measure hunger sensations directly after and 2h after a test dinner. The LC n-3 FA content in erythrocyte membrane was lower in the low LC n-3 FA group (10.5+/-2.5% vs. 12.5+/-2.6%; p<0.001) after the intervention. The VAS assessment revealed lower hunger sensations in the high LC n-3 FA group immediately after the test dinner (fullness: p=0.045) and after 120 min (fullness: p=0.008; hunger: p=0.039). Correlation analysis showed a positive relation between n-3 FA/n-6 FA ratio in erythrocyte membrane and fullness 2h postprandial (r=0.139; p=0.032). In conclusion, LC n-3 FA intake modulates postprandial satiety in overweight and obese volunteers during weight loss. Further research is needed to investigate whether LC n-3 FA improve compliance to the nutritional treatment of overweight and obesity as well as weight loss maintenance.

Moderate consumption of fatty fish reduces diastolic blood pressure in overweight and obese European young adults during energy restriction

OBJECTIVE Dietary intervention studies suggest that a daily fish meal can improve blood pressure (BP); however, such a dietary regimen might be difficult to sustain. The objective of the present study was to investigate whether salmon consumption three times per week improves BP during energy restriction in young adults. METHODS In this 8-wk intervention, 324 subjects (20-40 y of age, body mass index 27.5-32.5kg/m(2), from Iceland, Spain, and Ireland) were randomized to one of four energy-restricted diets (-30% relative to estimated requirements): salmon (150g three times per week, resulting in a daily consumption of 2.1g of omega-3 long-chain polyunsaturated fatty acids [omega-3 LC-PUFAs]), cod (150g three times per week, 0.3g of omega-3 LC-PUFAs per day), fish oil capsules (1.3g of omega-3 LC-PUFAs per day), or control (sunflower oil capsules, no seafood). Body weight, diastolic BP (DBP), systolic BP (SBP), and docosahexaenoic acid (DHA) in erythrocyte membrane were measured at baseline and endpoint. RESULTS Participants showed weight loss (-5.2+/-3.2kg, P<0.001) and decreases in SBP (-4.4+/-8.6 mmHg, P<0.001) and DBP (-4.1+/-7.4 mmHg, P<0.001) after the intervention. The salmon (B=-2.71, P=0.032) and fish oil (B=-2.48, P=0.044) groups had significantly lower endpoint DPB than the cod group, but not significantly different from control. Lower baseline DHA (percentage) in erythrocytes was associated with greater DBP reductions (B=0.576, P=0.017). CONCLUSION Salmon consumption three times per week can decrease DBP similar to fish oil and significantly more than lean fish during an 8-wk energy restriction in young overweight individuals. A lower DHA content in erythrocyte membrane at baseline, which might indentify infrequent fish eaters, is associated with a greater DBP reduction in the course of an 8-wk dietary intervention providing fatty seafood.

Effects of whey proteins and carbohydrates on the efficacy of resistance training in elderly people: double blind, randomised controlled trial.

Background/objectives:A few previous studies indicate that protein supplementation increases gains in muscle mass and strength during a resistance exercise program. The purpose of this study was to investigate whether whey protein supplementation results in greater increases in lean body mass, muscle strength and physical function in elderly individuals during 12 weeks of resistance exercise when compared to isocaloric carbohydrate supplementation.Subjects/Methods:A total of 161 men and women, 65–91 years old, participated in a randomized, controlled, double-blind intervention study, involving dietary supplementation and a 12-week resistance exercise program, designed to increase muscle mass and strength of all major muscle groups. Participants exercised three times a week and received either 20 g of whey protein (n=83) or isocaloric carbohydrate (n=78) in liquid form immediately after each workout. Data were obtained at baseline and end point.Results:The primary outcomes, lean body mass, strength and physical function increased significantly during the course of the study. Type of dietary supplementation did not influence gains in lean body mass (P=0.365), quadriceps strength (P=0.776) or performance during a 6-min walk (P=0.726) or a timed up-and-go test (P=0.151). Twenty participants discontinued the intervention.Conclusions:Ingestion of 20 g of whey protein immediately after resistance exercise three times per week, does not lead to greater gains in lean body mass, strength and physical function in elderly people with sufficient energy and protein intakes when compared to isocaloric carbohydrate.

Effect of 12-Week Resistance Exercise Program on Body Composition, Muscle Strength, Physical Function, and Glucose Metabolism in Healthy, Insulin-Resistant, and Diabetic Elderly Icelanders

BACKGROUND Insulin is a stimulator of skeletal muscle protein anabolism and insulin resistance might therefore negatively affect muscle protein metabolism. We investigated muscle mass and physical function before and after a resistance exercise program in participants with prediabetes or type 2 diabetes mellitus (T2DM) in comparison to healthy controls. METHODS This was a secondary analysis of a randomized controlled intervention designed to investigate resistance training among older adults. Glucose metabolism status was not a selection criteria for the trial, and group designation was done retrospectively. Participants (N = 237, 73.7 ± 5.7 y, 58.2% women) participated in a 12-week resistance exercise program (3 times/week; three sets, six to eight repetitions at 75%-80% of the one-repetition maximum), designed to increase strength and muscle mass of major muscle groups. Body composition, muscular strength, timed up and go test, 6-minute walk for distance, and blood chemical variables were measured at baseline and endpoint. RESULTS Participants completing the study (n = 213) experienced significant changes in muscle strength or muscle function, which did not differ significantly between healthy (n = 198), prediabetic (n = 20), and T2DM participants (n = 17). Changes in serum glucose during the intervention differed by group: only glucose improved significantly in the prediabetic group, glucose and triacylglycerol improved significantly in the healthy group, whereas no serum parameter improved significantly in the T2DM group. CONCLUSIONS A 12-week resistance exercise program improves muscle strength and muscle function to a similar extent in healthy, prediabetic, and T2DM elderly people. However, according to our data, T2DM participants do not experience favorable changes in fasting glucose or HbA(1C).

Effects of weight loss and seafood consumption on inflammation parameters in young, overweight and obese European men and women during 8 weeks of energy restriction

Background/Objectives:In vitro studies have shown that long-chain n-3 polyunsaturated fatty acids (LC n-3 PUFAs) can affect inflammation; however, results from intervention studies in overweight or obese individuals are contradicting. The aim of this study was to investigate the effects of weight loss and seafood consumption on inflammation parameters during energy restriction.Subjects/Methods:In this 8-week intervention trial, 324 subjects (aged 20–40 years, body mass index 27.5–32.5 kg/m2 from Iceland, Spain and Ireland) were randomized to one of four energy-restricted diets (−30% relative to estimated requirements): salmon (3 × 150 g/week, 2.1 g LC n-3 PUFA per day); cod (3 × 150 g/week, 0.3 g LC n-3 PUFA per day); fish oil capsules (1.3 g LC n-3 PUFA per day); and control (sunflower oil capsules, no seafood). Body weight, high-sensitivity C-reactive protein (CRP), interleukin-6 (IL-6), glutathione reductase and prostaglandin F2 alpha (PGEF2α) were measured at baseline and end point.Results:Subjects experienced weight loss (−5.2±3.2 kg, P<0.001). Taken together for all subjects, there were significant decreases in all inflammation parameters. On a group level, salmon consumption was most effective, three of the four inflammation parameters decreased in the salmon group (high-sensitivity CRP=−32.0%; IL-6=−18.4%; PGEF2α=−18.5%; all P<0.05). Cod consumption decreased high-sensitivity CRP and IL-6 (−21.5 and −10.8%, respectively, both P<0.05). Changes in the other two groups were not significant, which can be partly explained by the large s.d.Conclusions:The mean concentrations of inflammation parameters decreased during a period of weight loss and dietary intervention. In our study, salmon consumption was most effective, three of the four measured inflammation parameters decreased significantly in the salmon group.

Correlations between plasma noradrenaline concentrations, antioxidants, and neutrophil counts after submaximal resistance exercise in men

Background: Generation of reactive oxygen species (ROS) during exercise has been linked to increased oxygen consumption. ROS could also be produced by other mechanisms—for example, a respiratory burst of neutrophils or catecholamine auto-oxidation—when oxygen consumption is only moderately increased. Objectives: To investigate noradrenaline concentrations, neutrophil counts, plasma antioxidants, and lipid oxidation products before and after acute resistance exercise. Methods: 17 male participants undertook a submaximal resistance exercise circuit (10 exercises; 75% of the one repetition maximum; mean (SD) exercise time, 18.6 (1.1) minutes). Blood samples were taken before and immediately after exercise and analysed for plasma antioxidants, noradrenaline, neutrophils, and lipid oxidation products. Wilcoxon’s signed-rank test and Pearson’s correlation coefficient were used for calculations. Results: Neutrophils, noradrenaline, fat soluble antioxidants, and lipid oxidation products increased after exercise. Noradrenaline concentrations were associated with higher antioxidant concentrations. Neutrophils were related to higher concentrations of conjugated dienes. Conclusions: Submaximal resistance exercise increases plasma antioxidants. This might reflect enhanced antioxidant defence in response to the oxidative stress of exercise, though this is not efficient for inhibiting lipid oxidation. The correlation between noradrenaline concentrations and plasma antioxidants suggests a modulating role of the stress hormone. Neutrophils are a possible source of oxidative stress after resistance exercise.

Physical function predicts improvement in quality of life in elderly icelanders after 12 weeks of resistance exercise

BackgroundLittle is known about the effects of resistance training on health related quality of life (HRQL) in the elderly.AimThe main purpose of the study was to investigate the effects of resistance training on strength, body composition, functional capacity and HRQL in independent living elderly people. We hypothesised that resistance training would improve lean mass, muscle strength, physical function and HRQL.MethodsSubjects (N = 237, 73.7±5.7yrs, 58.2% female) participated in a 12-week resistance exercise program (3 times/week; 3 sets, 6–8 repetitions at 75–80% of the 1-repetition maximum) designed to increase strength and muscle mass of major muscle groups. Body composition, quadriceps- and grip strength, timed up and go test (TUG), six minute walk for distance (6MW) and HRQL were measured at baseline and endpoint.ResultsTwo hundred-and-four participants completed the study. Although the increase in lean mass was small (+0.8 kg, P<0.01), quadriceps strength (+53.5N), grip strength (+3.0lb), TUG (-0.6sec), 6MW (+33.6m) and HRQL (+1.2 t-score) improved significantly (all P<0.01). Changes in 6MW predicted improvement in HRQL after 12 weeks.ConclusionsOur study shows that a 12-week resistance exercise program significantly improves lean mass, muscle strength, physical function and HRQL in elderly individuals, and that improvements in physical function predict improvements in HRQL. Our study indicates that resistance training should be promoted for the elderly as it has the potential to improve physical performance, thereby prolonging healthy, independent aging.

Acute impact of submaximal resistance exercise on immunological and hormonal parameters in young men.

In this study, we examined the acute effects of submaximal resistance exercise on immunological and hormonal parameters in 7 resistance-trained and 10 non-resistance-trained males. The participants, who were aged 29.5±7.1 years (mean±s), performed submaximal resistance exercise at 75% of their one-repetition maximum. Blood samples were taken before, during, immediately after, and 30, 60 and 120 min after exercise and analysed for leukocyte subpopulations and stress hormones. Total leukocytes, neutrophils and monocytes increased during exercise, reaching their maximum 2 h after exercise. Lymphocytes increased during exercise, T-helper cells returned to resting values after exercise, and natural killer cells and T-suppressor cells decreased below resting values. The CD4/CD8 ratio decreased during exercise but increased during recovery. The resistance-trained participants tended to have lower T-helper cell counts before, during and immediately after exercise and a lower CD4/CD8 ratio during recovery than the non-resistance-trained participants. Plasma cortisol correlated positively with leukocytes during exercise (r = 0.572, P <0.05), but negatively with T-helper cells 30 and 60 min after exercise (r = –0.573, P <0.05; r = –0.642, P <0.01, respectively). Our results indicate that resistance exercise leads to acute changes in leukocyte counts, despite moderate hormonal changes, independent of training status. Regular resistance exercise might lead to decreased T-helper cell counts and a lower CD4/CD8 ratio, which could increase susceptibility to infections.

Anemia, nutritional status, and inflammation in hospitalized elderly

OBJECTIVE Anemia (hemoglobin <120 g/L) in elderly patients is a health problem. The aim of this study was to investigate the prevalence of anemia and associations of anemia with nutritional status and inflammation in hospitalized elderly. METHODS Sixty patients from the Department of Geriatrics were randomly assigned to participate. Blood samples were drawn and analyzed at the laboratory of the University Hospital in Reykjavik. Nutritional status was assessed using anthropometric and hematologic parameters. RESULTS The prevalence of anemia was 36.7%. Female participants were more frequently anemic than male participants (47.4% versus 18.2%, P = 0.024). Anemic patients had a lower albumin level (31.3 versus 33.4 g/L, P = 0.019) and a higher erythrocyte sedimentation rate (29.6 versus 16.0 mm/h, P = 0.005) and were more often malnourished (81.8% versus 44.7%, P = 0.005) than non-anemic patients. Hemoglobin correlated with prealbumin (rho = 0.338, P = 0.008) and albumin (rho = 0.250, P = 0.054) levels, but negatively with age (rho = -0.310, P = 0.016) and erythrocyte sedimentation rate (rho = -0.412, P < 0.001). In the multivariate analysis, erythrocyte sedimentation rate and nutritional status were significant predictors of hemoglobin (R(2) = 34.0%). CONCLUSION This cross-sectional analysis provides evidence of anemia in 36.7% of patients hospitalized at the Landspitali-University Hospital in Reykjavik and shows an association among anemia, deteriorated nutritional status, and inflammation. Future prospective studies are needed to assess the efficacy of adjuvant nutritional support to stabilize or improve nutritional status including anemia in hospitalized elderly.

Consumption of cod and weight loss in young overweight and obese adults on an energy reduced diet for 8-weeks☆

BACKGROUND AND AIMS In a cross-European study it was recently shown that consumption of cod increases weight loss in men and also has other positive health effects. The aim of this study was to investigate whether cod consumption increases weight loss and improves cardiovascular risk factors in a dose dependent manner during an 8-week energy restriction diet in young overweight and obese healthy adults. METHODS AND RESULTS In this dietary intervention 126 subjects (20-40 years, BMI 27.5-32.5 kg/m(2)) comprised the group given energy-restricted diets (-30%); they were prescribed an identical macronutrient composition but different amounts of cod: the control group were given no seafood; group 1 were given 150 g cod 3 times a week; and group 2 were given 150 g cod 5 times a week. Anthropometric measurements and cardiovascular risk factors were assessed at baseline and endpoint. Body weight decreased after 8-weeks (5.0+/-2.9 kg, P<0.001), also waist circumference (5.0+/-3.2 cm, P<0.001), BMI (1.65+/-0.95 kg, P<0.001), systolic (3.4+/-8.9 mmHg, P=0.001) and diastolic blood pressure (2.4+/-6.9 mmHg, P<0.001), triglycerides (1.26+/-0.567 mmol/L, P=0.030) and insulin (1.21+/-5.31 mU/L, P=0.025). The prevalence of the metabolic syndrome dropped from 29 to 21%. According to linear models weight loss was 1.7 kg greater among subjects consuming 150 g 5x/week compared to the control group (P<0.015). The trend analysis supported a dose-response relationship between cod consumption and weight loss (P<0.001), but changes of other measured cardiovascular risk factors were similar between the groups. CONCLUSION A dose-response relationship between cod consumption and weight loss during an 8-week energy restriction diet is found and 5 x 150 g cod/week results in 1.7 kg greater weight loss in young overweight or obese adults than a isocaloric diet without seafood.