Irma H. Ullrich

Effects of Resistance vs. Aerobic Training Combined With an 800 Calorie Liquid Diet on Lean Body Mass and Resting Metabolic Rate

OBJECTIVE Utilization of very-low-calorie diets (VLCD) for weight loss results in loss of lean body weight (LBW) and a decrease in resting metabolic rate (RMR). The addition of aerobic exercise does not prevent this. The purpose of this study was to examine the effect of intensive, high volume resistance training combined with a VLCD on these parameters. METHODS Twenty subjects (17 women, three men), mean age 38 years, were randomly assigned to either standard treatment control plus diet (C+D), n = 10, or resistance exercise plus diet (R+D), n = 10. Both groups consumed 800 kcal/day liquid formula diets for 12 weeks. The C+D group exercised 1 hour four times/week by walking, biking or stair climbing. The R+D group performed resistance training 3 days/week at 10 stations increasing from two sets of 8 to 15 repetitions to four sets of 8 to 15 repetitions by 12 weeks. Groups were similar at baseline with respect to weight, body composition, aerobic capacity, and resting metabolic rate. RESULTS Maximum oxygen consumption (Max VO2) increased significantly (p<0.05) but equally in both groups. Body weight decreased significantly more (p<0.01) in C+D than R+D. The C+D group lost a significant (p<0.05) amount of LBW (51 to 47 kg). No decrease in LBW was observed in R+D. In addition, R+D had an increase (p<0.05) in RMR O2 ml/kg/min (2.6 to 3.1). The 24 hour RMR decreased (p<0.05) in the C+D group. CONCLUSION The addition of an intensive, high volume resistance training program resulted in preservation of LBW and RMR during weight loss with a VLCD.

The effects of exercise intensity on body composition, weight loss, and dietary composition in women

OBJECTIVE There is controversy over whether exercise and/or exercise intensity has an effect on total caloric intake or diet composition. The purpose of this study was to test the effect of exercise intensity without dietary manipulation on body composition and/or weight loss and to determine whether exercise intensity affected total caloric intake or diet composition in normal weight young women. METHODS Fifteen women aged 18 to 34 years with a maximal oxygen consumption average or below on the Palo Alto norms served as subjects. Subjects were randomly assigned to: 1) low heart rate intensity exercise group (LI, N = 7) which exercised 40 to 45 minutes approximately four times weekly at a mean heart rate of 132 beats per minute (bpm); 2) high heart rate intensity group (HI, N = 8) which exercised 40 to 45 minutes approximately four times weekly at a mean HR of 163 bpm. All subjects were given a maximal exercise test prior to and during weeks eight, 12 and 16. The first 4 weeks served as a control period, followed by approximately 11 weeks of exercise. Each subject recorded her dietary intake for 1 complete week, including a weekend, during weeks 2, 6, 10 and 14 of the study. RESULTS VO2 max increased (p < .05) in HI (29 +/- 6 ml/kg/minute to 38 +/- 7) but did not change in LI (36 +/- 5 to 38 +/- 7). Percent fat decreased in HI (p < .05) (27 +/- 7 to 22 +/- 4) but was unchanged in LI (22 +/- 6 to 21 +/- 6). The weekly intake of total kcal, carbohydrate, protein and fat did change significantly for either group. The weekly intake of saturated fat declined significantly (p < .05) in HI (21.2 +/- 5.8 g to 14.9 +/- 5.5 g); their weekly intake of cholesterol also decreased (p < .05) between months 2 to 3 (249 +/- 109 mg to 159 +/- 58 mg). No other differences in dietary intake between groups were found. CONCLUSION High heart rate intensity exercise training without dietary manipulation resulted in a decrease in body fat, but not weight change, as well as a decrease in the intake of saturated fat and cholesterol in normal weight young women. These changes were not observed after low heart rate intensity training.

Combined effects of aerobic exercise and omega-3 fatty acids in hyperlipidemic persons

Because both aerobic exercise and fish oil ingestion have been shown to decrease plasma lipids, we examined the effects of combining these modalities in hyperlipidemic subjects. Thirty-four subjects were randomly assigned to one of four groups as follows: fish oil and exercise (FE), N = 7, 50 ml of oil daily and 3 d.wk-1 of aerobic exercise; fish oil (F), N = 7, 50 ml of oil daily; corn oil (CN), N = 10, 50 ml of oil daily; and control (C), N = 10. Blood samples were drawn at baseline and at the end of 4, 8, and 12 wk. The FE and F groups showed significantly lower triglycerides with respect to treatment as compared to the CN and C groups. The FE, F, and CN groups exhibited lower total cholesterol values than the control group but were not different from each other. HDL cholesterol was significantly increased after treatment in the FE and F groups as compared to the CN and C groups. Serum apo-B, LDL cholesterol, and LDL protein decreased significantly in the FE group but not the F group from baseline to 12 wk. VO2max increased and percent fat decreased only in the FE group. In conclusion, aerobic exercise improved the effects of fish oil on LDL cholesterol and apo-B and improved fitness and body composition in hyperlipidemic subjects.

RESISTANCE TRAINING EXERCISE AND CREATINE IN PATIENTS WITH CHARCOT-MARIE-TOOTH DISEASE

Resistance exercise and creatine supplementation independently improve strength and function in patients with certain neuromuscular diseases. The purpose of this study was to examine the effects of resistance training with and without creatine supplementation on muscle, strength, and function in patients with Charcot–Marie–Tooth (CMT) disease. Twenty patients with CMT consumed 5 g/day creatine or placebo while participating in resistance training for 12 weeks. Energy metabolites, muscle fiber type and size, strength, and timed activities of daily living were measured before and after training. There were no differences between creatine or placebo groups for any outcome. For the groups combined, exercise training increased type I muscle fiber diameter (48.2 ± 14.2 μm vs. 55.4 ± 14.8 μm), strength, and activities of daily living (ADL) times. Thus, patients respond to resistance training with muscle fiber adaptations, and improvements in strength and function. Creatine was not beneficial.

Physical activity and condition, dietary habits, and serum lipids in second-year medical students.

Level of physical activity has been found to be an independent risk factor for coronary heart disease. Because lifestyle and dietary habits are frequently established by early adulthood, we examined the physical activity, physical fitness, body composition, plasma lipids, and diets of a group of second-year medical students. Medical students were studied because of the presumption that they were knowledgeable about exercise and appropriate diet and would have future influence on their patients. A questionnaire which assessed physical activity was returned by 69 (89%) of the 80 students. Over 50% reported no hard or very hard physical activity either during the week or on weekends. Three subjects were smokers. Body composition, cardiovascular fitness, and plasma lipids were assessed in 20 subjects selected at random from the 69. Five of the 15 men, but none of the five women, had greater-than-desirable body fat. Cardiovascular fitness was at least average compared to normal values, but three had hypertension at rest and 12 had hypertensive responses to exercise. Seven of the men had LDL cholesterol above 130 mg/dl and three had LDL:HDL ratios greater than 3. There was a positive correlation (r = 0.5, p = 0.02) between hard/very hard activity assessed by questionnaire and VO2max and a negative correlation (r = 0.4, p = 0.05) between VO2max and percent fat. All 20 subjects reported above average to severe amounts of stress. Analysis of a 48-hr diet record of 22 students showed an average consumption of 47% carbohydrates, 17% protein, and 36% fat. The polyunsaturated/saturated ratio was 0.43.(ABSTRACT TRUNCATED AT 250 WORDS)

Pyramidal tract deficits and polyneuropathy in hyperthyroidism. Combination clinically mimicking amyotrophic lateral sclerosis

Generalized weakness, intermittent dysphagia, and a 40-pound weight loss developed in an elderly man over a six-month period. Examination revealed weakness, atrophy and fasciculations of extremity musculature, pseudobulbar speech, hyperactive upper extremity reflexes, and extensor toe signs without sensory loss. Results of electrodiagnostic studies were consistent with an axonal polyneuropathy. Endocrinologic results were compatible with hyperthyroidism. Radioiodine therapy resulted in resolution of clinical neurologic symptoms and signs within seven months. This case illustrates a previously undescribed concurrence of hyperthyroid associated polyneuropathy and pyramidal tract dysfunction that led to an initial clinical diagnosis of amyotrophic lateral sclerosis.

Understanding osteoporosis: Cornerstone of prevention and treatment

Osteoporosis, especially in the elderly, may be preventable. Postmenopausal white women appear to be primarily at risk. Investigations into the etiology have concentrated on calcium metabolism. New noninvasive tests may supplant iliac biopsy, which is currently the definitive test for osteoporosis. The importance of adequate calcium intake and exercise should be stressed, even in childhood. Once the disease is established, estrogen and calcium therapy and exercise may be beneficial.

Amenorrhea and edema.

In a 22 year old woman extensive edema developed during evaluation for amenorrhea. It was learned then that she was consuming escessive amounts of a laxative daily. Balance studies were performed which demonstrated that she excreted large amounts of sodium in her liquid stools while taking the dose of laxative she had been using. The presence of increased plasma renin activity and increased urinary aldosterone suggest that in this patient the occurrence of the edema after she discontinued use of the laxative was due to secondary aldosteronism presumably caused by plasma volume depletion.

The effect of three test meals on exercise tolerance of an individual with McArdle's disease.

This study examined the effect of three test meals on exercise tolerance of an individual with McArdles disease, a myopathy characterized by phosphorylase b deficiency. The subjects exercise tolerance and ability to achieve the second wind, in response to each test meal, was evaluated over a 16-week period using a bicycle ergometer in a double-blind situation. Data were analyzed using one-way analysis of variance. No significant differences were found. It was concluded that a high protein meal, a high polyunsaturated fat meal, and a meal containing MCT oil did not affect the exercise tolerance of this individual compared to the control meal.

Hypertension and exercise: Where do we stand?

Several risk factors have been identified in patients with essential hypertension. The question is whether regular exercise programs can either prevent or alleviate elevated blood pressure. Published studies generally indicate that aerobic exercise of large-muscle groups can be used as an interventional regimen for hypertension. For mild hypertension, moderate-intensity walking is recommended at least three times a week. Improvement may not be evident in less than 6 months. When exercise alone is not effective or when hypertension is more severe, exercise can still be used as an adjunct to pharmacologic therapy.