Aloys Berg

Weight loss without losing muscle mass in pre-obese and obese subjects induced by a high-soy-protein diet

OBJECTIVE: To determine change of weight, body composition, metabolic and hormonal parameters induced by different intervention protocols.DESIGN: Randomized, controlled study including participants exhibiting a BMI between 27.5 and 35. Three different interventions containing lifestyle education (LE-G), or a substitutional diet containing a high-soy-protein low-fat diet with (SD/PA-G) or without (SD-G) a guided physical activity program.SUBJECTS: A total of 90 subjects (mean weight 89.9 kg; mean BMI 31.5), randomly assigned to one of three treatment groups.MEASUREMENTS: Change in body weight, fat mass and lean body mass measured with the Bod Pod® device at baseline, 6 weeks and 6 months; change in metabolic and hormonal parameters.RESULTS: In all, 83 subjects completed the 6-months study. BMI dropped highly significantly in all groups (LE-G: −2.2±1.43 kg/m2; SD-G: −3.1±1.29 kg/m2; SD/PA-G: −3.0±1.29 kg/m2). Subjects in the SD-G and in the SD/PA-G lost more weight during the 6-months study (−8.9±3.9; −8.9±3.9 kg) than did those in the LE-G (−6.2±4.2 kg), and had a greater decrease in fat mass (−8.8±4.27; −9.4±4.54 kg) than those in the LE-G (−6.6±4.59 kg). In contrast, no significant intraindividual or between-group changes in the fat-free mass were seen. In all groups, metabolic parameters showed an improvement in glycemic control and lipid profile.CONCLUSIONS: Our data suggest that a high-soy-protein and low-fat diet can improve the body composition in overweight and obese people, losing fat but preserving muscle mass.

Influence of training volume and acute physical exercise on the homocysteine levels in endurance-trained men: Interactions with plasma folate and vitamin B12

The interrelation between physical exercise and plasma levels of homocysteine (Hcy), vitamin B12, and folic acid has not been examined. Therefore, we investigated the influence of extensive endurance training and acute intense exercise on plasma concentrations of total Hcy, vitamin B12, and folic acid in 42 well-trained male triathletes. Examinations and blood sampling took place before and after a 30-day endurance training period as well as before and 1 and 24 h after a competitive exercise (sprint triathlon). Following the training period, no significant change in Hcy levels could be detected for the whole group. Subgroup analysis in quartiles of training volume revealed that – as compared with the lowest quartile (low-training group: 9.1 h training/week) – athletes in the highest training quartile (high-training group: 14.9 h training/week) exhibited a significant decrease in Hcy levels (from 12.7 ± 2.3 to 11.7 ± 2.4 µmol/l as compared with levels of 12.5 ± 1.5 and 12.86 ± 1.5 µmol/l in the low-training group; p < 0.05). The plasma folate levels were significantly higher in the high-training group at all points of examination (p < 0.05). 1 h and 24 h after competition, the Hcy concentration increased in all athletes independent of the previous training volume (24 h: 12.3 ± 1.8 vs. 13.5 ± 2.6 µmol/l; p < 0.001), although the increase was decisively stronger in the low-training group. 1 h after competition, the plasma folate concentration increased (7.03 ± 2.1 vs. 8.33 ± 2.1 ng/ml; p < 0.05) in all athletes. Multivariate analysis showed that the exercise-induced increase in the Hcy levels was dependent on baselines levels of folate and training volume, but not on the vitamin B12 levels. In conclusion, although intense exercise acutely increased the Hcy levels, chronic endurance exercise was not associated with higher Hcy concentrations. Moreover, athletes with the highest training volume, exhibiting also the highest plasma folate levels, showed a decrease in Hcy levels following the training period as well as a much lower increase of the Hcy concentration after acute intense exercise. The combined effect of training and higher plasma folate levels to reduce Hcy should be investigated in future studies.

Myocardial stress after competitive exercise in professional road cyclists.

PURPOSE Based on the determination of cardiac troponin (cTnT), brain natriuretic peptide (BNP), and echocardiographic measurements, recent investigations have reported myocardial damage and reversible cardiac dysfunction after prolonged endurance exercise in apparently healthy subjects. In the present study, we investigated the myocardial stress reaction in professional endurance athletes after strenuous competitive physical exercise. METHODS Eleven highly trained male professional road cyclists (age 27 +/- 4 yr; .VO2peak 67 +/- 5 mL.kg-1.min-1; training workload 34,000 +/- 2,500 km.yr-1) were examined. The following parameters were determined before and after one stage of a 5-d professional cycling race: BNP, cTnT (third-generation assay that shows no cross reactivity with skeletal TnT), creatine kinase (CK), creatine kinase MB (CKMB), myoglobin (Myo), and urea. All participants were submitted to a careful cardiac examination including echocardiography and stress ECG. RESULTS None of the athletes showed pathological findings in the cardiac examination. CK (P < 0.01), CKMB (P < 0.05), and Myo (P < 0.01) were increased after the race. Normal postexercise cTnT levels indicate that the increase in CK, CKMB, and Myo was of noncardiac origin. In contrast, BNP rose significantly from 47.5 +/- 37.5 to 75.3 +/- 55.3 pg.mL-1 (P < 0.01). Pre- and postexercise values of BNP as well as the individual exercise-induced increase in BNP were significantly correlated with age (R2 = 0.68, R2 = 0.66, and R2 = 0.58, respectively; P < 0.05). CONCLUSION Strenuous endurance exercise in professional road cyclists does not result in structural myocardial damage. The rise in BNP in older athletes may reflect a reversible, mainly diastolic left ventricular dysfunction. This needs to be confirmed by larger trials including different intensities, sports, and age groups.

Freiburg Intervention Trial for Obese Children (FITOC): results of a clinical observation study.

BACKGROUND:The Freiburg Intervention Trial for Obese Children (FITOC) is an interdisciplinary, outpatient program for obese children consisting of regular physical exercise and comprehensive dietary and behavioral education. Parental involvement is required. The study is designed as a longitudinal, nonrandomized clinical observation study. An 8-month intensive phase preceded a follow-up phase of 1 y or longer.METHODS:Data were collected from 31 groups comprising 496 children (267 girls, 229 boys), with an average age of 10.5 y. Body height and weight, fasting total-cholesterol (CH), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C) and physical performance were measured initially and after 8.5 months. A group of n=35 obese children (16 girls, 19 boys) who did not take part in this intervention program served as controls.RESULTS:After the intensive intervention phase, body mass index (BMI, kg/m2) as well as BMI deviation scores (BMI-SDS) decreased in both sexes (P<0.001). In the controls, BMI increased (P<0.001) and BMI-SDS remained constant. Whereas CH was only significantly lower (P<0.01) in boys after 8.5 months, LDL-C decreased significantly in both sexes. HDL-C tended to increase in both sexes (not significant). The controls showed no significant changes in CH, LDL-C and HDL-C. The fitness levels (W/kg body weight) improved in the intervention group (P<0.001), but not in the control group.CONCLUSIONS:The results indicate that obese children can be successfully treated in such an intervention program. BMI-SDS and risk factors decreased and physical performance improved. To maintain therapeutical success, we highly recommended that these children enroll in community-based exercise programs in order to help them maintain a more active lifestyle after the follow-up phase.

Quantitative measurement of carotid intima-media roughness*/effect of age and manifest coronary artery disease

UNLABELLED Atherosclerotic changes of the common carotid artery (CCA) may appear like irregularities of the intima-media thickness (abbreviated as IM roughness) in B-mode ultrasound. The purposes of the present study were to investigate whether the CCA IM roughness changes with age and differs between individuals presumed to be healthy and patients with coronary artery disease (CAD). METHODS AND RESULTS Based on a new automatic identification (AI) program, the segmental intima-media thickness (IMT) and IM roughness of the CCA far wall were measured in B-mode images of 15 younger and 22 older volunteers presumed to be healthy, and 46 patients with known CAD. The mean and maximum CCA IMT were lowest in the young group (0.55+/-0.05; 0.65+/-0.06 mm), higher in the older group (0.77+/-0.16; 0.87+/-0.18 mm) and highest in CAD patients (0.88+/-0.18; 1.01+/-0.27 mm) (P<0.01 among all groups). The CCA IM roughness was greatest by far in the CAD patients (0.075+/-0.02 mm; P<0.01 vs. both groups) and increased only slightly with age (younger: 0.035+/-0.008 mm; older: 0.040+/-0.014 mm; P<0.05). Areas under the curve (AUC) of receiver-operating characteristic curves (ROC) predicting patients with CAD were higher for the CCA IM roughness (0.80) than for the mean (0.66) and maximum IMT (0.71). CONCLUSIONS It is suggested that the CCA IM roughness increases with age, and helps to discriminate between individuals presumed to be healthy and patients with manifest CAD better than the CCA mean and maximum IMT.

Influence of different types of exercise on the expression of haem oxygenase-1 in leukocytes.

Haem-oxygenase-1 (HO-1) is an antioxidant stress protein that is mainly induced by reactive oxygen species, inflammatory cytokines and hyperthermia. We assessed the influence of different types of exercise on HO-1 expression in leukocytes of the peripheral blood in three groups of male participants: a short exhaustive run above the lactate steady state (n = 15), eccentric exercise (n = 12) and an intensive endurance run (half-marathon, n = 12). Blood samples were taken at rest and up to 24 h after exercise. Blood lactate concentration after exercise was 9.0 ± 2.1, 3.8 ± 1.6 and 5.1 ± 2.2 mmol · l − 1 (mean ± s) for the exhaustive run, eccentric exercise and half-marathon groups, respectively (P < 0.05). Creatine kinase concentration was highest 24 h after exercise: 133 ± 91, 231 ± 139 and 289 ± 221 U · l − 1 for the exhaustive run, eccentric exercise and half-marathon groups, respectively (P < 0.05). The maximal increase in leukocyte counts after exercise was 11.5 ± 19.2, 6.2 ± 1.4 and 14.7 ± 2.1 × 109 · l − 1. There was no change in HO-1 as a result of the short exhaustive run or the eccentric exercise, whereas the half-marathon had a significant stimulatory effect on HO-1-expression in lymphocytes, monocytes and granulocytes (P<0.001) using flow cytometry analyses. In conclusion, eccentric exercise alone or short-term heavy exercise are not sufficient to stimulate the antioxidative stress protein HO-1 in peripheral leukocytes

Glycaemic and insulinaemic properties of some German honey varieties

The glycaemic and insulinaemic response to different German honey varieties have not been studied so far. Eight German honey grades differing in their floral source and carbohydrate composition were tested. Isoglucidic test meals (25 g carbohydrate) and a 25 g glucose reference were given to 10 clinically and metabolically healthy, fasting individuals (31.5±8.1 years of age (mean±s.d.), two women). Glycaemic and insulinaemic index were calculated by the recommended FAO/WHO measure. Five of the eight tested honey varieties show a low glycaemic index below 55; for six of the eight tested varieties, the glycaemic load was lower than 10 (portion size of 20 g honey). Glycaemic index and insulinaemic index correlated significantly with the fructose content of honey varieties. The results show that glycaemic index and insulinaemic response depend on the fructose content of honey. Therefore, specific honey varieties may be recommended for subjects with impaired glucose tolerance instead of saccharose in food preparations.

Cardiorespiratory fitness modifies the association between dietary fat intake and plasma fatty acids

Objectives: To investigate the relation between (1) cardiorespiratory fitness and plasma saturated, monounsaturated and polyunsaturated fatty acids and (2) the interactions between cardiorespiratory fitness, dietary fat intake and plasma fatty acid composition.Design: Cross-sectional analysis.Setting and subjects: The subjects were randomly selected, 127 middle-aged Finnish men participating in the DNASCO exercise intervention study.Interventions: Cardiorespiratory fitness was determined spiroergometrically, dietary intake of macro- and micronutrients by 4-day food records and plasma fatty acids by gas chromatography. The subjects were divided into tertiles of aerobic fitness.Results: Differences between fitness tertiles were not observed for dietary intake of total fat, and saturated, monounsaturated or polyunsaturated fatty acids (percent of total energy). In contrast, plasma saturated fatty acids were significantly lower (P<0.01) and polyunsaturated fatty acids significantly higher (P<0.05) in the highest fitness tertile compared to the lowest tertile. Dietary saturated fat intake was positively associated with plasma saturated fatty acids (r=0.342; P<0.05) and inversely with plasma polyunsaturated fatty acids (r=−0.453; P<0.01) only in the lowest fitness tertile. In addition, a positive correlation between body mass index and plasma saturated fatty acids (r=0.516; P<0.01) as well as a negative correlation between body mass index and plasma polyunsaturated fatty acids (r=−0.516; P<0.01) was observed in the lowest tertile solely.Conclusion: Different levels in cardiorespiratory fitness are associated with different levels in plasma saturated and polyunsaturated fatty acids and lead to modifications in the association between dietary and plasma fatty acids. These findings can perhaps be explained by a reduced hepatic fatty acid and lipoprotein synthesis as well as by an enhanced muscular lipid utilization, which are commonly seen in those who are physically active and who exhibit a higher level of fitness.

Lipoprotein phenotype and adhesion molecules correlate with diurnal triglyceride profiles in patients with coronary artery disease

BACKGROUND AND AIM To assess the relationships between different diurnal triglyceride (TG) profiles (p) and the atherogenicity of the lipoprotein phenotype and adhesion molecule concentrations in patients with coronary artery disease (CAD). METHODS AND RESULTS Repeated measurements of fasting TG and TGp were made in 29 CAD patients; fasting cholesterol levels (total-C, VLDL, LDL, HDL and small dense LDL) and soluble cell adhesion molecules (sCAM) (ICAM-1 and E-selectin) were measured once. Three different TGps were defined: fasting (137.0 +/- 60.7 mg/dL) and all other TG levels <200 mg/dL (LL; n=7); a fasting TG level <200 mg/dL (147.0 +/- 49.9 mg/dL) and maximum TG levels >200 mg/dL (LH; n=13); and both fasting (225.1+/-76.2 mg/dL) and maximum TG levels >200 mg/dL (HH; n=9). We then analysed the associations between the TGp types and the lipoprotein phenotype and CAMs. LL had significantly lower values than LH (p<0.05 for all parameters except sE-selectin) and HH (p<0.05 for all parameters) of VLDL (11.2 +/- 5.8, 18.8 +/- 9.4, 28.1 +/- 8.8 mg/dL), LDL-5 (11.6 +/- 3.3, 16.4 +/- 4.5, 22.1 +/-7.9 mg/dl) and LDL-6 (12.0 +/- 3.2, 17.0 +/- 5.7, 25.7 +/- 9.6 mg/dL), sICAM-1 (209.4 +/- 30.3, 267.5 +/- 60.6, 273.4 +/- 59.1 ng/dL) and sE-selectin (25.1 +/- 17.6, 35.5 +/- 11.5, 48.5 +/- 20.2 ng/dL). CONCLUSION Although the differences in fasting TG levels between the LL and LH groups were not significantly different, LH had a more atherogenic lipoprotein phenotype and higher concentrations of adhesion molecules. TGp measurements seem to be suitable for identifying CAD patients with an unfavourable diurnal TG and atherosclerosis-prone lipoprotein metabolism.