Jennifer E. Layne

Reduction of Abdominal Obesity in Lipodystrophy Associated with Human Immunodeficiency Virus Infection by Means of Diet and Exercise: Case Report and Proof of Principle

Lipodystrophy associated with human immunodeficiency virus infection causes abdominal fat gain, peripheral subcutaneous fat atrophy, insulin resistance, low levels of high-density lipoprotein cholesterol, and hypertriglyceridemia. An exercise program combined with a moderate-fat, low-glycemic-index, high-fiber diet can reverse several aspects of lipodystrophy, and, until specific treatment is available, should be considered for treatment of lipodystrophy.

Resistance training and timed essential amino acids protect against the loss of muscle mass and strength during 28 days of bed rest and energy deficit

Spaceflight and bed rest (BR) result in losses of muscle mass and strength. Resistance training (RT) and amino acid (AA) supplementation are potential countermeasures to minimize these losses. However, it is unknown if timing of supplementation with exercise can optimize benefits, particularly with energy deficit. We examined the effect of these countermeasures on body composition, strength, and insulin levels in 31 men (ages 31-55 yr) during BR (28 days) followed by active recovery (14 days). Subjects were randomly assigned to essential AA supplementation (AA group, n = 7); RT with AA given 3 h after training (RT group, n = 12); or RT with AA given 5 min before training (AART group, n = 12). Energy intake was reduced by 8 +/- 6%. Midthigh muscle area declined with BR for the AA > RT > AART groups: -11%, -3%, -4% (P = 0.05). Similarly, greatest losses in lower body muscle strength were seen in the AA group (-22%). These were attenuated in the exercising groups [RT (-8%) and AART (-6%; P < 0.05)]. Fat mass and midthigh intramuscular fat increased after BR in the AA group (+3% and +14%, respectively), and decreased in the RT (-5% and -4%) and AART groups (-1 and -5%; P = 0.05). Muscle mass and strength returned toward baseline after recovery, but the AA group showed the lowest regains. Combined resistance training with AA supplementation pre- or postexercise attenuated the losses in muscle mass and strength by approximately two-thirds compared with AA supplement alone during BR and energy deficit. These data support the efficacy of combined AA and RT as a countermeasure against muscle wasting due to low gravity.

A Home-Based Nutrition Intervention to Increase Consumption of Fruits, Vegetables, and Calcium-Rich Foods in Community Dwelling Elders

OBJECTIVE To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. DESIGN Six-month, home-based nutrition intervention study. SUBJECTS Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n = 38) or a control group that received an exercise intervention (n = 32). INTERVENTION Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. MAIN OUTCOME MEASURES Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired t tests were conducted to test within-group changes. RESULTS Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1 +/- 0.2 (mean +/- SEM) servings per day (2.8 to 3.9, P = .01), vegetables 1.1 +/- 0.2 servings per day (2.3 to 3.4, P = .001), and milk/dairy 0.9 +/- 0.2 servings per day (3.0 to 3.9, P = .001). There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene (P < or = .02; r = 0.33 and r = 0.33, respectively). CONCLUSION The results of this study suggest that it is possible to improve the dietary intake of community dwelling elders to include more fruits, vegetables, and calcium-rich foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement.

A comparison of the clinical and cost-effectiveness of 3 intervention strategies for AIDS wasting.

Objective:To compare oxandrolone (OX) or strength training with nutrition alone (NA) for AIDS wasting. Subjects:Fifty patients with AIDS; 47 completing the study. Interventions:Randomization to (1) NA with placebo pills, (2) nutrition with 10 mg of OX administered orally twice a day, or (3) nutrition with progressive resistance training (PRT) for 12 weeks. Main Outcome Measures:Midthigh cross-sectional muscle area (CSMA), physical functioning (PF), costs, and cost-effectiveness in dollars/quality-adjusted life-years (

Resistance training alters cytokine gene expression in skeletal muscle of adults with type 2 diabetes.

/QALYs). Results:The OX and PRT subjects had increases in CSMA (7.0% ± 2.5%, P = 0.01; 5.0% ± 2.0%, P = 0.04, respectively), although these increases did not differ significantly from the NA arm (NA: 1.0% ± 1.0%; OX vs. NA: P = 0.09; PRT vs. NA: P = 0.26). Only PRT caused significant improvements in PF (mean ± SE: 10.4 ± 3.8 points on a 100-point scale) and 7 measures of strength (P values: 0.04 to <0.001). There were no overall differences between groups in PF change. Among patients with impaired baseline PF, however, OX was significantly less effective than NA and PRT was significantly better than NA. All treatments led to increases in protein intake and performance; NA and PRT also increased caloric intake. The institutional costs per subject in this trial were

Community-Based Strength Training Improves Physical Function in Older Women With Arthritis

983 for NA,

A Randomized Controlled Trial of Resistance Exercise Training to Improve Glycemic Control in Older Adults With Type 2 Diabetes

3772 for OX, and

The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial.

3189 for PRT. At a community-based level of intensity, the institutional costs per QALY were

The effects of progressive resistance training on bone density: a review.

45,000 (range:

The Effects of Multidimensional Home-Based Exercise on Functional Performance in Elderly People

42,000-