Eva-Maria Strasser

The effect of six months of elastic band resistance training, nutritional supplementation or cognitive training on chromosomal damage in institutionalized elderly

Increased DNA and chromosomal damage are linked to aging and age-related diseases like cardiovascular diseases, diabetes or cancer. Physical activity and an optimal status of micro- and macronutrients are known to reduce the incidence of MN, a marker for chromosomal instability and mutagenicity. Once older people reach a certain age they change from a home-living situation to an institutionalized situation, which is often accompanied by malnutrition, depression and inactivity. We conducted the current study to investigate the effect of a six month progressive resistance training (RT), with or without protein and vitamin supplementation (RTS) or cognitive training (CT) only, on chromosomal damage measured by the cytokinesis block micronucleus cytome assay in 97 Austrian institutionalized women and men (65-98years). All three intervention groups demonstrated a tendency of a reduced frequency of cells with MN (-15%) as well as for the total number of MN (-20%), however no significant time-effect was observed. Besides a significant increase in plasma B12 and red blood cell folate status, the six month change of B12 was negatively correlated with the six month change of the MN frequency in the RTS group (r=-0.584, p=0.009). Our results suggest that in this age group either physical or cognitive training may result in similar biochemical changes and therefore enhance resistance against genomic instability. Supplementation with the vitamins B12 and folic acid could contribute to reduced chromosomal damage in institutionalized elderly.

Effects of elastic band resistance training and nutritional supplementation on physical performance of institutionalised elderly--A randomized controlled trial.

OBJECTIVES To evaluate the effects of elastic band resistance training in combination with nutrient supplementation on muscular strength and the ability to perform mobility-related activities of daily living in older adults living in retirement care facilities. DESIGN Randomized controlled trial, with a 6-month intervention period. SETTING A retirement care facility, Vienna, Austria. PARTICIPANTS One hundred and seventeen older adults (14 males (12%) and 103 females (88%)), aged 65 to 97 years (mean age: 82.8 ± 6.0), having a mini-mental state examination score ≥ 23 and no chronic diseases posing a medical contraindication to training therapy. INTERVENTION Participants were randomly assigned, but stratified by sex, to one of three intervention groups: supervised resistance exercise training (RT), RT in combination with nutrient supplementation (RTS), or cognitive training group (CT). All interventions were performed two times a week for 6 months. RT was designed to train all major muscle groups using elastic bands. The nutrient supplement (rich in proteins, vitamin D, B2, B12) was distributed every morning as well as after each RT session. MEASUREMENTS A battery of motor ability tests and functional test were performed prior to as well as following 3 months and finally after 6 months of intervention. These tests included isokinetic torque measurements of the knee extensors and flexors in concentric mode at 60 and 120°/s, isometric handgrip strength, senior arm-lifting test, chair stand test, maximum walking speed and a 6-minute walking test (6 MWT). RESULTS A repeated-measures ANOVA analysis revealed significant improvements in physical function of lower (p=0.002) and upper extremities (p=0.006) for RT and/or RTS in comparison to CT. For isokinetic measurements, 6 MWT, and gait speed time effects (p<0.05) were detected without any group × time interaction effects. Dropouts showed lower performance in chair stand test (p=0.012), 6 MWT (p=0.003), and gait speed (p=0.013) at baseline than that of the finishers of the study. CONCLUSION Six months of a low intensity resistance exercise using elastic bands and own body weight is safe and beneficial in improving functional performance of institutionalised older people. Multinutrient supplementation did not offer additional benefits to the effects of RT in improving muscular performance.

Serum concentrations of insulin-like growth factor-1, members of the TGF-beta superfamily and follistatin do not reflect different stages of dynapenia and sarcopenia in elderly women

There is a high need for blood-based biomarkers detecting age-related changes in muscular performance at an early stage. Therefore, we investigated whether serum levels of growth and differentiation factor-15 (GDF-15), activin A, myostatin, follistatin, and insulin-like growth factor-1 (IGF-1) would reflect age- and physical performance-related differences between young (22-28 years) and elderly (65-92 years) females. Isokinetic peak torque of knee extension (PTE) was measured in young females to obtain reference values for the discrimination of different stages of age-associated muscle weakness. Additionally, elderly women were screened for sarcopenia using the algorithm of the European Working Group on Sarcopenia in Older People (low muscle mass in addition to low PTE and/or low walking speed). IGF-1 levels were higher and GDF-15 levels were lower in young females in comparison to the elderly (p < 0.01), whereas members of the activin A/myostatin/follistatin axis showed similar levels across age groups. In older women, IGF-1 correlated negatively with age (ρ = -0.359, p < 0.01) and positively with muscle mass (ρ = 0.365, p < 0.01). In contrast, GDF-15 correlated positively with age (ρ = 0.388, p < 0.001) and negatively with muscle mass (ρ = -0.320, p < 0.01). However, none of the serum markers differed between women classified as non-, mildly and severely dynapenic/sarcopenic. Multiple linear regression analyses revealed that a combination of all blood-based biomarkers obtained in addition to age and fat mass moderately predicted muscle mass (+2.9%). Neither a single nor a combined set of tested biomarkers reflected the presence of dynapenia or sarcopenia in elderly women. However, due to the associations of IGF-1 and GDF-15 with correlates of muscle mass and function, these parameters remain promising candidates in a potential set of blood-based biomarkers to diagnose sarcopenia and/or dynapenia.

The impact of six months strength training, nutritional supplementation or cognitive training on DNA damage in institutionalised elderly

Aging and its aligned loss of muscle mass are associated with higher levels of DNA damage and deteriorated antioxidant defence. To improve the bodys overall resistance against DNA damage, maintaining a healthy and active lifestyle is desirable, especially in the elderly. As people age, many have to change their residence from home living to an institution, which is often accompanied by malnutrition, depression and inactivity. The current study aimed at investigating the effect of a 6-month progressive resistance training (RT), with or without protein and vitamin supplementation (RTS), or cognitive training (CT), on DNA strand breaks in 105 Austrian institutionalised women and men (65-98 years). DNA damage was detected by performing the single cell gel electrophoresis (comet) assay. Physical fitness was assessed using the chair rise, the 6-min-walking and the handgrip strength test. In addition, antioxidant enzyme activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) were analysed. Basal DNA damage (lysis) increased significantly after 3 months of intervention in the RT group (T1 - T2 + 20%, P = 0.001) and the RTS group (T1 - T2 + 17%, P = 0.002) and showed a similar tendency in the CT group (T1 - T2 + 21%, P = 0.059). %DNA in tail decreased in cells exposed to H2O2 significantly in the RT (T1 - T2 - 24%, P = 0.030; T1 - T3 - 18%, P = 0.019) and CT (T1 - T2 - 21%, P = 0.004; T1 - T3 - 13%, P = 0.038) groups. Only RT and RTS groups showed significant differences overtime in enzyme activity (RT + 22% CAT-activity T1 - T3, P = 0.013; RTS + 6% SOD-activity T2 - T3, P = 0.005). Contrary to the time effects, no difference between groups was detected for any parameter at any time point. Our results suggest that both CT and RT improve resistance against H2O2 induced DNA damage and that a nutritional supplement has no further protective effect in institutionalised elderly.

[Cellular regulation of anabolism and catabolism in skeletal muscle during immobilisation, aging and critical illness].

SummarySkeletal muscle atrophy is associated with situations of acute and chronical illness, such as sepsis, surgery, trauma and immobility. Additionally, it is a common problem during the physiological process of aging. The myofibrillar proteins myosin and actin, which are essential for muscle contraction, are the major targets during the process of protein degradation. This leads to a general loss of muscle mass, muscle strength and to increased muscle fatigue. In critically ill or immobile patients skeletal muscle atrophy is accompanied by enhanced inflammation, reduced wound healing, weaning complications and difficulties in mobilisation. During aging it results in falls, fractures, physical injuries and loss of mobility. Relating to the primary stimulators – hormones, muscle lengthening, stress, inflammation, neuronal activity – research is now focusing on the investigation of the signal transduction pathways, which influence protein synthesis and protein degradation during skeletal muscle atrophy.ZusammenfassungDie Atrophie der Skelettmuskulatur ist eine Begleiterscheinung bei einer Vielzahl von akuten und chronischen Erkrankungen, wie Sepsis, chirurgische Interventionen, Trauma oder Immobilität. Auch während des Alterungsprozesses kommt es zu einem massiven allgemeinen Muskelabbau. Davon betroffen sind insbesondere die für die Muskelkontraktion notwendigen myofibrillären Proteine Myosin und Aktin, wodurch ein Verlust an Muskelmasse und Muskelkraft sowie eine beschleunigte Muskelermüdung entsteht. Die Folgen sind beim kritisch Kranken oder immobilen Patienten erhöhte Infektionsraten, verlangsamte Wundheilung, Komplikationen bei der Entwöhnung von der Beatmung und erschwerte Mobilisation. Im Alter führt dies zu Stürzen, Knochenbrüchen, Verletzungen und Mobilitätsverlust. Ausgehend von den primären Stimulatoren – Hormone, Muskeldehnung, Stress, Inflammation, neuronale Aktivität – konzentriert sich die Wissenschaft auf die Erforschung der Signaltransduktionswege, die zu einer Beeinflussung der Proteinsynthese und des Proteinabbaus bei Atrophien des Skelettmuskels führen.

Supply of R-α-lipoic acid and glutamine to casein-fed mice influences the number of B lymphocytes and tissue glutathione levels during endotoxemia

ZusammenfassungHINTERGRUND: Reaktive Sauerstoffspezies und eine verringerte antioxidative Kapazität spielen eine wichtige Rolle in der Modulierung des Immunsystems kritisch Kranker. Ziel dieser Studie war es, den Einfluss einer gemeinsamen oralen Zufuhr der Antioxidantien R-α-Liponsäure (LA) und Glutamin (GLN) auf das Immunsystem und den Glutathion-Stoffwechsel bei einer Endotoxinämie an der Maus zu untersuchen. METHODIK: Weibliche Balb/c Mäuse erhielten über einen Zeitraum von 10 Tagen Nahrungen, die mit GLN (3 g/100 kcal), LA (0.74 mg/100 kcal) oder einer Kombination aus GLN und LA angereichert waren, wobei eine isokalorische und isonitrogene Kontrolle als Vergleichsnahrung diente. Zweiundsiebzig Stunden nach der intraperitonealen Verabreichung von 25 μg Lipopolysaccharid am Tag 7 wurden Anzahl und Phänotyp der Lymphozyten aus den Peyerschen Plaques und der Milz ermittelt. Zusätzlich wurde der Glutathion-Gehalt im Dünndarm, in der Milz und in der Leber gemessen. RESULTATE: Nur eine kombinierte Zufuhr von GLN und LA war in der Lage, die Gesamtzellzahl in den Peyerschen Plaques (+19%) zu erhöhen, was hauptsächlich auf einen Anstieg der B-Lymphozyten zurückzuführen war. In der Milz steigerten sowohl die LA (+17%) als auch die gemeinsame Gabe von GLN und LA (+22%) die Gesamtzellzahl. Der Glutathion-Gehalt des Dünndarms wurde durch LA erhöht, wohingegen GLN plus LA in der Milz am effektivsten war. SCHLUSSFOLGERUNG: Die gemeinsame Gabe von GLN und LA ist in der Lage bei experimenteller Endotoxinämie die Zahl sowohl systemischer als auch intestinaler Blymphozyten selektiv zu erhöhen. Weiters führte LA im Dünndarm zu einem Anstieg des GSH-Gehaltes, dem mengenmäßig am häufigsten vorkommenden intrazellulären Antioxidans. Auf Grundlage dieser Daten ist die Untersuchung einer gemeinsamen Gabe von LA und GLN in septischen Patienten zu empfehlen.SummaryBACKGROUND: An overwhelming production of reactive oxygen species concomitant with a decrease in antioxidative capacity plays an important role in modulation of the immune system in critically ill patients. The purpose of this study was to assess the influence of a combined oral supply of the antioxidants R-α-lipoic acid (LA) and glutamine (GLN) on the immunity of endotoxemic mice, with a special focus on tissue glutathione levels. METHODS: Female Balb/c mice were fed diets enriched with GLN (3 g/100 kcal), LA (0.74 mg/100 kcal), a combination of GLN and LA, or an isocaloric and isonitrogenous control diet for 10 days. On day 7, the mice were challenged intraperitoneally with 25 μg lipopolysaccharide. Seventy-two hours later, the number and phenotype of lymphocytes in Peyers patches (PP) and spleen of the endotoxemic mice were measured. In addition, glutathione levels were determined in the small intestine, spleen and liver. RESULTS: In PP only the combined supply of GLN and LA significantly increased the total cell yield (+19%), which was predominantly due to an increased number of B cells. In the spleen, both LA (+17%) and the combination of GLN and LA (+22%) were able to enhance total cell yield. The glutathione content of the small intestine was increased by feeding LA alone, whereas in the spleen GLN plus LA was most effective. CONCLUSION: Supplying combined GLN and LA to endotoxemic mice is effective in selectively increasing the number of systemic and intestinal B lymphocytes. Furthermore, LA augmented the level of the main intracellular antioxidant glutathione in the small intestine. On the basis of these data we recommend investigation of the effects of LA and GLN supplementation in patients with sepsis.

Körperliche Aktivität in der Prävention und Rehabilitation von onkologischen Erkrankungen

In zahlreichen epidemiologischen Studien wurde nachgewiesen, dass korperliche Aktivitat einen praventiven Einfluss auf die Entstehung von Tumoren hat. Im ersten Teil dieses Kapitels wird gezeigt, bei welchen Tumoren ein praventiver Einfluss durch korperliche Aktivitat berichtet wurde und welche molekularbiologischen Mechanismen hierbei eine Rolle spielen. Auch wahrend bzw. nach einer Tumorerkrankung haben Studien gezeigt, dass durch korperliche Aktivitat Folgeerkrankungen reduziert und die aerobe Kapazitat sowie die Muskelkraft gesteigert werden. Insgesamt kommt es zu einer Steigerung der Lebensqualitat und einer Verbesserung der Prognose. Im zweiten Teil dieses Kapitels wird daher ein Uberblick uber die internationalen Richtlinien zur Durchfuhrung von korperlicher Aktivitat wahrend bzw. nach einer onkologischen Erkrankung gegeben. Danach wird auf einen wesentlichen limitierenden Faktor fur das Ausuben von korperlicher Aktivitat genauer eingegangen: die Tumorkachexie. Es werden die molekularbiologischen Mechanismen und die Wirkung von korperlicher Aktivitat auf diese Prozesse diskutiert.

Age and the effect of exercise, nutrition and cognitive training on oxidative stress – The Vienna Active Aging Study (VAAS), a randomized controlled trial

ABSTRACT The purpose of this study was to investigated the effect of age – over or under life‐expectancy (LE) – on six months resistance training alone or combined with a nutritional supplement, and cognitive training by analyzing markers for oxidative stress and antioxidant defense in institutionalized elderly, living in Vienna. Three groups (n=117, age=83.1±6.1 years) – resistance training (RT), RT combined with protein and vitamin supplementation (RTS) or cognitive training (CT) – performed two guided training sessions per week for six months. Oxidative stress, antioxidant defense and DNA strand breaks were analyzed and transformed into an “antioxidant factor” to compare the total effect of the intervention. Physical fitness was assessed by the 6‐min‐walking, the chair‐rise and the handgrip strength tests. We observed significant negative baseline correlations between 8‐oxo‐7.8‐dihydroguanosine and handgrip strength (r=−0.350, p=0.001), and between high sensitive troponin‐T and the 6‐min‐walking test (r=−0.210, p=0.035). RT and RTS groups, showed significant improvements in physical performance. Over LE, subjects of the RT group demonstrated a significant greater response in the “antioxidant factor” compared to RTS and CT (RT vs. RTS p=0.033, RT vs. CT p=0.028), whereas no difference was observed between the intervention groups under LE. Six months of elastic band resistance training lead to improvements in antioxidant defense, DNA stability and oxidative damage, summarized in the “antioxidant factor”, however mainly in subjects over their statistical LE. Consuming a supplement containing antioxidants might inhibit optimal cellular response to exercise. The study was approved by the ethics committee of the City of Vienna (EK‐11–151–0811) and registered at ClinicalTrials.gov, NCT01775111. HIGHLIGHTSPhysical fitness was linked to lower DNA damage and reduced cardiac risk markers.Strength training improved the redox state, especially in the oldest subjects.Consuming antioxidants seems to blunt optimal response to exercise in the elderly.

Zelluläre Regulation des Anabolismus und Katabolismus der Skelettmuskulatur bei Immobilität, im Alter und bei kritisch Kranken@@@Cellular regulation of anabolism and catabolism in skeletal muscle during immobilisation, aging and critical illness

SummarySkeletal muscle atrophy is associated with situations of acute and chronical illness, such as sepsis, surgery, trauma and immobility. Additionally, it is a common problem during the physiological process of aging. The myofibrillar proteins myosin and actin, which are essential for muscle contraction, are the major targets during the process of protein degradation. This leads to a general loss of muscle mass, muscle strength and to increased muscle fatigue. In critically ill or immobile patients skeletal muscle atrophy is accompanied by enhanced inflammation, reduced wound healing, weaning complications and difficulties in mobilisation. During aging it results in falls, fractures, physical injuries and loss of mobility. Relating to the primary stimulators – hormones, muscle lengthening, stress, inflammation, neuronal activity – research is now focusing on the investigation of the signal transduction pathways, which influence protein synthesis and protein degradation during skeletal muscle atrophy.ZusammenfassungDie Atrophie der Skelettmuskulatur ist eine Begleiterscheinung bei einer Vielzahl von akuten und chronischen Erkrankungen, wie Sepsis, chirurgische Interventionen, Trauma oder Immobilität. Auch während des Alterungsprozesses kommt es zu einem massiven allgemeinen Muskelabbau. Davon betroffen sind insbesondere die für die Muskelkontraktion notwendigen myofibrillären Proteine Myosin und Aktin, wodurch ein Verlust an Muskelmasse und Muskelkraft sowie eine beschleunigte Muskelermüdung entsteht. Die Folgen sind beim kritisch Kranken oder immobilen Patienten erhöhte Infektionsraten, verlangsamte Wundheilung, Komplikationen bei der Entwöhnung von der Beatmung und erschwerte Mobilisation. Im Alter führt dies zu Stürzen, Knochenbrüchen, Verletzungen und Mobilitätsverlust. Ausgehend von den primären Stimulatoren – Hormone, Muskeldehnung, Stress, Inflammation, neuronale Aktivität – konzentriert sich die Wissenschaft auf die Erforschung der Signaltransduktionswege, die zu einer Beeinflussung der Proteinsynthese und des Proteinabbaus bei Atrophien des Skelettmuskels führen.