James M. Smoliga

Resveratrol and health – A comprehensive review of human clinical trials

In the past decade, the small polyphenol resveratrol has received widespread attention as either a potential therapy or as a preventive agent for numerous diseases. Studies using purified enzymes, cultured cells, and laboratory animals have suggested that resveratrol has anti-aging, anti-carcinogenic, anti-inflammatory, and anti-oxidant properties that might be relevant to chronic diseases and/or longevity in humans. Although the supporting research in laboratory models is quite substantial, only recently data has emerged to describe the effects of resveratrol supplementation on physiological responses in humans. The limited number of human clinical trials that are available has largely described various aspects of resveratrols safety and bioavailability, reaching a consensus that it is generally well-tolerated, but have poor bioavailability. Very few published human studies have explored the ability of resveratrol to achieve the physiological benefits that have been observed in laboratory models, although many clinical trials have recently been initiated. This review aims to examine the current state of knowledge on the effects of resveratrol on humans and to utilize this information to develop further guidelines for the implementation of human clinical trials.

The role of upper torso and pelvis rotation in driving performance during the golf swing

Abstract While the role of the upper torso and pelvis in driving performance is anecdotally appreciated by golf instructors, their actual biomechanical role is unclear. The aims of this study were to describe upper torso and pelvis rotation and velocity during the golf swing and determine their role in ball velocity. One hundred recreational golfers underwent a biomechanical golf swing analysis using their own driver. Upper torso and pelvic rotation and velocity, and torso-pelvic separation and velocity, were measured for each swing. Ball velocity was assessed with a golf launch monitor. Group differences (groups based on ball velocity) and moderate relationships (r ≥ 0.50; P < 0.001) were observed between an increase in ball velocity and the following variables: increased torso – pelvic separation at the top of the swing, maximum torso – pelvic separation, maximum upper torso rotation velocity, upper torso rotational velocity at lead arm parallel and last 40 ms before impact, maximum torso – pelvic separation velocity and torso – pelvic separation velocity at both lead arm parallel and at the last 40 ms before impact. Torso – pelvic separation contributes to greater upper torso rotation velocity and torso – pelvic separation velocity during the downswing, ultimately contributing to greater ball velocity. Golf instructors can consider increasing ball velocity by maximizing separation between the upper torso and pelvis at the top of and initiation of the downswing.

Effects of Warming-up on Physical Performance: A Systematic Review With Meta-analysis

Fradkin, AJ, Zazryn, TR, and Smoliga, JM. Effects of warming-up on physical performance: a systematic review with meta-analysis. J Strength Cond Res 24(1): 140-148, 2010-The value of warming-up is a worthy research problem because it is not known whether warming-up benefits, harms, or has no effect on individuals. The purpose of this study was to review the evidence relating to performance improvement using a warm-up. A systematic review and meta-analysis were undertaken. Relevant studies were identified by searching Medline, SPORTDiscus, and PubMed (1966-April 2008). Studies investigating the effects of warming-up on performance improvement in physical activities were included. Studies were included only if the subjects were human and only if the warm-up included activities other than stretching. The quality of included studies was assessed independently by 2 assessors using the Physiotherapy Evidence Database scale. Thirty-two studies, all of high quality (6.5-9 [mean = 7.6] of 10) reported sufficient data (quality score >6) on the effects of warming-up on performance improvement. Warm-up was shown to improve performance in 79% of the criterions examined. This analysis has shown that performance improvements can be demonstrated after completion of adequate warm-up activities, and there is little evidence to suggest that warming-up is detrimental to sports participants. Because there were few well-conducted, randomized, controlled trials undertaken, more of these are needed to further determine the role of warming-up in relation to performance improvement.

An eight-week golf-specific exercise program improves physical characteristics, swing mechanics, and golf performance in recreational golfers

The purpose of this study was to determine the effects of an 8-week golf-specific exercise program on physical characteristics, swing mechanics, and golf performance. Fifteen trained male golfers (47.2 ± 11.4 years, 178.8 ± 5.8 cm, 86.7 ± 9.0 kg, and 12.1 ± 6.4 U.S. Golf Association handicap) were recruited. Trained golfers was defined operationally as golfers who play a round of golf at least 2–3 times per week and practice at the driving range at least 2–3 times per week during the regular golf season. Subjects performed a golf-specific conditioning program 3–4 times per week for 8 weeks during the off-season in order to enhance physical characteristics. Pre- and posttraining testing of participants included assessments of strength (torso, shoulder, and hip), flexibility, balance, swing mechanics, and golf performance. Following training, torso rotational strength and hip abduction strength were improved significantly (p = 0.05). Torso, shoulder, and hip flexibility improved significantly in all flexibility measurements taken (p = 0.05). Balance was improved significantly in 3 of 12 measurements, with the remainder of the variables demonstrating a nonsignificant trend for improvement. The magnitude of upper-torso axial rotation was decreased at the acceleration (p = 0.015) and impact points (p = 0.043), and the magnitude of pelvis axial rotation was decreased at the top (p = 0.031) and acceleration points (p = 0.036). Upper-torso axial rotational velocity was increased significantly at the acceleration point of the golf swing (p = 0.009). Subjects increased average club velocity (p = 0.001), ball velocity (p = 0.001), carry distance (p = 0.001), and total distance (p = 0.001). These results indicate that a golf-specific exercise program improves strength, flexibility, and balance in golfers. These improvements result in increased upper-torso axial rotational velocity, which results in increased club head velocity, ball velocity, and driving distance.

Strength, Flexibility, and Balance Characteristics of Highly Proficient Golfers

Despite the emergence of golf-specific training programs and training aids, relatively little research has been conducted examining the physical characteristics that are important to golf performance. We studied the strength, flexibility, and balance characteristics of golfers across 3 proficiency levels based on handicap index (HCP) (≤0, 1–9, and 10–20) to determine the physical characteristics unique to highly proficient golfers. A total of 257 (age: 45.5 ± 12.8 years, height: 180.6 ± 6.5 cm, weight: 87.9 ± 12.6 kg) healthy, male golfers participated in the study. Testing included an assessment of strength (torso, shoulder, and hip), flexibility (torso, shoulder, and hip), and single-leg balance. Golfers in the highest proficiency group (HCP = 0) had significantly (p ≤ 0.05) greater hip strength, torso strength, shoulder strength, shoulder flexibility, hip flexibility, torso flexibility, and balance (eyes open) than golfers in the lowest proficiency group (HCP 10–20). The results of this study demonstrate that better golfers possess unique physical characteristics that are important to greater proficiency. These characteristics have also been demonstrated to be modifiable through golf-specific training programs.

Challenges of Translating Basic Research Into Therapeutics: Resveratrol as an Example

Basic science literature abounds with molecules that promise to ameliorate almost any disease, from curing cancer to slowing the aging process itself. However, most of these compounds will never even be evaluated in humans, let alone proven effective. Here, we use resveratrol as an example to highlight the enormous difficulties in understanding pharmacokinetics, determining side effects, and, ultimately, establishing mechanisms of action for a natural compound. Despite extensive interest and effort, and continuing promising results from basic science groups, very little is known even today about the effects of resveratrol in humans. Part of the problem is the unattractiveness of natural compounds to large, well-funded companies that could run clinical trials because developing their own molecules affords much greater protection for their intellectual property. In fact, selling unpatentable material motivates smaller nutraceutical companies to complicate the scientific problem even more--each creates its own proprietary blend, making it extremely difficult to compare their data with those of other companies, or of academic labs using pure compounds. But even beyond these problems lies a deeper one; resveratrol, and almost every natural compound, is likely to have many clinically relevant targets with different dose-response profiles, tissue distributions, and modifiers. Tackling this type of problem efficiently, and even beginning to address the spectrum of other molecules with claimed benefits, is likely to require the development of new paradigms and approaches. Examples include better molecular modeling to predict interactions, large-scale screens for toxic or other common effects, affinity-based methods to identify drug-interacting proteins, and better synthesis of existing data, including legislation to promote the release of trial results, and tracking of voluntary supplement usage. The evidence for benefits of resveratrol in humans remains too sparse to be conclusive; yet, the limited data that are available, combined with a growing list of animal studies, provide a strong justification for further study.

Resveratrol treatment as an adjunct to pharmacological management in type 2 diabetes mellitus—systematic review and meta‐analysis

The red wine polyphenol, resveratrol, is highly effective in treating type 2 diabetes mellitus (T2DM) in animal models, but there is no consensus regarding its efficacy in humans. We conducted a systematic review, which included searches in nine scholarly databases and six clinical trial registries, and identified randomized controlled clinical trials whereby resveratrol was used as an adjunct to pharmaceutical interventions in T2DM. Meta-analysis on clinical parameters was performed for available data. Of 764 articles originally identified, data from six unique datasets, examining a total of 196 T2DM patients (104 resveratrol, 92 control/placebo) ultimately met inclusion criteria. Statistically significant (p < 0.05) positive effects, indicating that resveratrol supplementation was more effective than placebo/control, were identified for systolic blood pressure, hemoglobin A1c, and creatinine, but not for fasting glucose, homeostatic model assessment of insulin resistance, diastolic blood pressure, insulin, triglycerides, LDL, or HDL cholesterol. No major adverse events were reported and side effects of resveratrol were not different than placebo/control. Though limitations in sample size and treatment duration preclude definitive changes in clinical practice, significant improvements in multiple cardiometabolic biomarkers and an excellent safety profile support resveratrol as a leading candidate as an adjunct to pharmacological management of T2DM.

Enhancing the Delivery of Resveratrol in Humans: If Low Bioavailability is the Problem, What is the Solution?

Resveratrol has emerged as a leading candidate for improving healthspan through potentially slowing the aging process and preventing chronic diseases. The poor bioavailability of resveratrol in humans has been a major concern for translating basic science findings into clinical utility. Although a number of positive findings have emerged from human clinical trials, there remain many conflicting results, which may partially be attributed to the dosing protocols used. A number of theoretical solutions have been developed to improve the bioavailability of resveratrol, including consumption with various foods, micronized powders, combining it with additional phytochemicals, controlled release devices, and nanotechnological formulations. While laboratory models indicate these approaches all have potential to improve bioavailability of resveratrol and optimize its clinical utility, there is surprisingly very little data regarding the bioavailability of resveratrol in humans. If bioavailability is indeed a limitation in the clinical utility of resveratrol, there is a need to further explore methods to optimize bioavailability in humans. This review summarizes the current bioavailability data, focusing on data from humans, and provides suggested directions for future research in this realm.

A Comparison of Physical Characteristics and Swing Mechanics Between Golfers With and Without a History of Low Back Pain

STUDY DESIGN Controlled laboratory study using a cross-sectional design. OBJECTIVES To examine the kinematics and kinetics of the trunk and the physical characteristics of trunk and hip in golfers with and without a history of low back pain (LBP). BACKGROUND Modified swing patterns and general exercises have been suggested for golfers with back pain. Yet we do not know what contributes to LBP in golfers. To create and validate a low back-specific exercise program to help prevent and improve back injuries in golfers, it may be valuable to understand the differences in biomechanical and physical characteristics of golfers with and without a history of LBP. METHODS Sixteen male golfers with a history of LBP were matched by age and handicap with 16 male golfers without a history of LBP. All golfers underwent a biomechanical swing analysis, trunk and hip strength and flexibility assessment, spinal proprioception testing, and postural stability testing. RESULTS The group with a history of LBP demonstrated significantly less trunk extension strength at 60 degrees/s and left hip adduction strength, as well as limited trunk rotation angle toward the nonlead side. No significant differences were found in postural stability, trunk kinematics, and maximum spinal moments during the golf swing. CONCLUSION Deficits observed in this study may affect a golfers ability to overcome the spinal loads generated during the golf swing over time. Exercises for improving these physical deficits can be considered, although the cause-effect of LBP in golfers still cannot be determined.

RELATIONSHIP BETWEEN CYCLING MECHANICS AND CORE STABILITY

Core stability has received considerable attention with regards to functional training in sports. Core stability provides the foundation from which power is generated in cycling. No research has described the relationship between core stability and cycling mechanics of the lower extremity. The purpose of this study was to determine the relationship between cycling mechanics and core stability. Hip, knee, and ankle joint kinematic and pedal force data were collected on 15 competitive cyclists while cycling untethered on a high-speed treadmill. The exhaustive cycling protocol consisted of cycling at 25.8 km·h−1 while the grade was increased 1% every 3 minutes. A core fatigue workout was performed before the second treadmill test. Total frontal plane knee motion (test 1: 15.1 ± 6.0°; test 2: 23.3 ± 12.5°), sagittal plane knee motion (test 1: 69.9 ± 4.9°; test 2: 79.3 ± 10.1°), and sagittal plane ankle motion (test 1: 29.0 ± 8.5°; test 2: 43.0 ± 22.9°) increased after the core fatigue protocol. No significant differences were demonstrated for pedaling forces. Core fatigue resulted in altered cycling mechanics that might increase the risk of injury because the knee joint is potentially exposed to greater stress. Improved core stability and endurance could promote greater alignment of the lower extremity when riding for extended durations as the core is more resistant to fatigue.