Matthew B. Cooke

A Structured Diet and Exercise Program Promotes Favorable Changes in Weight Loss, Body Composition, and Weight Maintenance

BACKGROUNDnA number of diet and exercise programs purport to help promote and maintain weight loss. However, few studies have compared the efficacy of different methods.nnnOBJECTIVEnTo determine whether adherence to a meal-replacement-based diet program (MRP) with encouragement to increase physical activity is as effective as following a more structured meal-plan-based diet and supervised exercise program (SDE) in sedentary obese women.nnnDESIGNnRandomized comparative effectiveness trial.nnnPARTICIPANTS/SETTINGnFrom July 2007 to October 2008, 90 obese and apparently healthy women completed a 10-week university-based weight loss trial while 77 women from this cohort also completed a 24-week weight maintenance phase.nnnINTERVENTIONnParticipants were matched and randomized to participate in an MRP or SDE program.nnnMAIN OUTCOME MEASURESnWeight loss, health, and fitness-related data were assessed at 0 and 10 weeks on all subjects as well as at 14, 22, and 34 weeks on participants who completed the weight maintenance phase.nnnSTATISTICAL ANALYSES PERFORMEDnData were analyzed by multivariate analysis of variance for repeated measures.nnnRESULTSnDuring the 10-week weight loss phase, moderate and vigorous physical activity levels were significantly higher in the SDE group with no differences observed between groups in daily energy intake. The SDE group lost more weight (-3.1 ± 3.7 vs -1.6 ± 2.5 kg; P = 0.03); fat mass (-2.3 ± 3.5 vs -0.9 ± 1.6 kg; P = 0.02); centimeters from the hips (-4.6 ± 7 vs -0.2 ± 6 cm; P = 0.002) and waist (-2.9 ± 6 vs -0.6 ± 5 cm; P = 0.05); and, experienced a greater increase in peak aerobic capacity than participants in the MRP group. During the 24-week maintenance phase, participants in the SDE group maintained greater moderate and vigorous physical activity levels, weight loss, fat loss, and saw greater improvement in maximal aerobic capacity and strength.nnnCONCLUSIONSnIn sedentary and obese women, an SDE-based program appears to be more efficacious in promoting and maintaining weight loss and improvements in markers of health and fitness compared to an MRP type program with encouragement to increase physical activity.

Effects of diet type and supplementation of glucosamine, chondroitin, and MSM on body composition, functional status, and markers of health in women with knee osteoarthritis initiating a resistance-based exercise and weight loss program

BackgroundThe purpose of this study was to determine whether sedentary obese women with knee OA initiating an exercise and weight loss program may experience more beneficial changes in body composition, functional capacity, and/or markers of health following a higher protein diet compared to a higher carbohydrate diet with or without GCM supplementation.MethodsThirty sedentary women (54 ± 9 yrs, 163 ± 6 cm, 88.6 ± 13 kg, 46.1 ± 3% fat, 33.3 ± 5 kg/m2) with clinically diagnosed knee OA participated in a 14-week exercise and weight loss program. Participants followed an isoenergenic low fat higher carbohydrate (HC) or higher protein (HP) diet while participating in a supervised 30-minute circuit resistance-training program three times per week for 14-weeks. In a randomized and double blind manner, participants ingested supplements containing 1,500 mg/d of glucosamine (as d-glucosamine HCL), 1,200 mg/d of chondroitin sulfate (from chondroitin sulfate sodium), and 900 mg/d of methylsulfonylmethane or a placebo. At 0, 10, and 14-weeks, participants completed a battery of assessments. Data were analyzed by MANOVA with repeated measures.ResultsParticipants in both groups experienced significant reductions in body mass (-2.4 ± 3%), fat mass (-6.0 ± 6%), and body fat (-3.5 ± 4%) with no significant changes in fat free mass or resting energy expenditure. Perception of knee pain (-49 ± 39%) and knee stiffness (-42 ± 37%) was decreased while maximal strength (12%), muscular endurance (20%), balance indices (7% to 20%), lipid levels (-8% to -12%), homeostasis model assessment for estimating insulin resistance (-17%), leptin (-30%), and measures of physical functioning (59%), vitality (120%), and social function (66%) were improved in both groups with no differences among groups. Functional aerobic capacity was increased to a greater degree for those in the HP and GCM groups while there were some trends suggesting that supplementation affected perceptions of knee pain (p < 0.08).ConclusionsCircuit style resistance-training and weight loss improved functional capacity in women with knee OA. The type of diet and dietary supplementation of GCM provided marginal additive benefits.Trial RegistrationClinicalTrials.gov: NCT01271218

The Effects of Fish Oil Supplementation on Markers of Inflammation in Chronic Kidney Disease Patients

OBJECTIVEnOne prevalent characteristic of all stages of chronic kidney disease (CKD) is excessive production of proinflammatory cytokines. Fish oil (FO) supplementation has been reported to lower levels of proinflammatory cytokines. The benefits of FO for an extensive range of populations and a variety of health concerns are apparent, yet the anti-inflammatory benefits for nondialysis CKD patients are not as well documented. Therefore, the purpose of this study was to investigate the effects of the daily consumption of FO (1,400 mg eicosapentaenoic acid + 1,000 mg docosahexaenoic acid) on interleukin 1β (IL-1β), interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) for 8xa0weeks in nondialysis CKD patients.nnnDESIGN, SETTING, AND SUBJECTSnIn this double-blind, randomized, placebo-controlled intervention, the effect of 8xa0weeks of FO administration on IL-1β, IL-6, and TNF-α levels in nondialysis CKD patients were evaluated.nnnINTERVENTIONnThirty-one nondialysis CKD patients (17 = FO; 14 = placebo) randomly received either FO dietary supplementation 2.4 g/day (1,400 mg eicosapentaenoic acid + 1,000 mg docosahexaenoic acid) or placebo (safflower oil) for 8 weeks.nnnMAIN OUTCOME MEASURESnIL-1β, IL-6, and TNF-α were all measured as markers of inflammation.nnnRESULTSnOne-way analysis of variance revealed no significant differences in IL-6 (P = .06), IL-1β (P = .18), and TNF-α (P = .20) between groups in pretest values. Additionally, no pretest differences existed between groups for age (P = .549), weight (P = .324), waist circumference (P = .086), gender (P = .591), and ethnicity (P = .875). Covariance was calculated using compliance, age, gender, ethnicity, body weight, and waist circumference as covariates. No significant differences were discovered between groups after FO supplementation for IL-6 (P = .453) and TNF-α (P = .242). A significant difference was discovered for IL-1β (P = .050) with lower levels in the FO group.nnnCONCLUSIONSnThe results of this study are in agreement with some previous studies that suggest that FO supplementation has no effect on plasma proinflammatory cytokines TNF-α or IL-6, but does have an effect on IL-1β in nondialysis CKD patients.

The use of metabolomics to monitor simultaneous changes in metabolic variables following supramaximal low volume high intensity exercise

AbstractnHigh intensity exercise (HIE) stimulates greater physiological remodeling when compared to workload matched low-moderate intensity exercise. This study utilized an untargeted metabolomics approach to examine the metabolic perturbations that occur following two workload matched supramaximal low volume HIE trials. In a randomized order, 7 untrained males completed two exercise protocols separated by 1xa0week; (1) HIE150xa0%: 30xa0×xa020xa0s cycling at 150xa0% VO2peak, 40xa0s passive rest; (2) HIE300xa0%: 30xa0×xa010xa0s cycling at 300xa0% VO2peak, 50xa0s passive rest. Total exercise duration was 30xa0min for both trials. Blood samples were taken at rest, during and immediately following exercise and at 60xa0min post exercise. Gas chromatography-mass spectrometry analysis of plasma identified 43 known metabolites of which 3 demonstrated significant fold changes (HIE300xa0% compared to the HIE150xa0% value) during exercise, 14 post exercise and 23 at the end of the recovery period. Significant changes in plasma metabolites relating to lipid metabolism [fatty acids: dodecanoate (pxa0=xa00.042), hexadecanoate (pxa0=xa00.001), octadecanoate (pxa0=xa00.001)], total cholesterol (pxa0=xa00.001), and glycolysis [lactate (pxa0=xa00.018)] were observed following exercise and during the recovery period. The HIE300xa0% protocol elicited greater metabolic changes relating to lipid metabolism and glycolysis when compared to HIE150xa0% protocol. These changes were more pronounced throughout the recovery period rather than during the exercise bout itself. Data from the current study demonstrate the use of metabolomics to monitor intensity-dependent changes in multiple metabolic pathways following exercise. The small sample size indicates a need for further studies in a larger sample cohort to validate these findings.

Optimizing the Benefits of Exercise on Physical Function in Older Adults

As the number of older adults continues to rise worldwide, the prevention of physical disability among seniors is an increasingly important public health priority. Physical exercise is among the best known methods of preventing disability, but accumulating evidence indicates that considerable variability exists in the responsiveness of older adults to standard training regimens. Accordingly, a need exists to develop tailored interventions to optimize the beneficial effects of exercise on the physical function of older adults at risk for becoming disabled. The present review summarizes the available literature related to the use of adjuvant or alternative strategies intended to enhance the efficacy of exercise in improving the physical function of older adults. Within this work, we also discuss potential future research directions in this area.

Bioactive properties and clinical safety of a novel milk protein peptide

BackgroundMilk protein fractions and peptides have been shown to have bioactive properties. This preliminary study examined the potential mechanisms of action and clinical safety of novel milk protein peptide (MP).FindingsA novel MP mixture inhibits the tyrosine kinase activity of epidermal growth factor receptor (EGFR), vascular endothelial growth factor receptor 2 (VEGFR2), and insulin receptor (IR) with IC50 of 9.85 μM, 7.7 μM, and 6.18 μM respectively. In vitro, this multi-kinase inhibitor causes apoptosis in HT-29 colon cancer cells, and in a C. elegans worm study, showed a weak but significant increase in lifespan. A six week double-blind, placebo-controlled study involving 73 healthy volunteers demonstrated that the MP mixture is safe to consume orally. All clinical blood markers remained within normal levels and no clinically significant side effects were reported. There was some evidence of improved insulin sensitivity, neutrophil-to-lymphocyte ratio (NLR), and quality of life assessment of role of physical function.ConclusionsThese data in combination with the observed in vitro anti-cancer properties warrant further clinical studies to investigate this MP mixture as a potential clinical nutrition intervention for improving the quality of life and clinical outcomes in cancer patients.Trial RegistrationNCT01412658

Metabogenic and Nutriceutical Approaches to Address Energy Dysregulation and Skeletal Muscle Wasting in Duchenne Muscular Dystrophy

Duchenne Muscular Dystrophy (DMD) is a fatal genetic muscle wasting disease with no current cure. A prominent, yet poorly treated feature of dystrophic muscle is the dysregulation of energy homeostasis which may be associated with intrinsic defects in key energy systems and promote muscle wasting. As such, supplementative nutriceuticals that target and augment the bioenergetical expansion of the metabolic pathways involved in cellular energy production have been widely investigated for their therapeutic efficacy in the treatment of DMD. We describe the metabolic nuances of dystrophin-deficient skeletal muscle and review the potential of various metabogenic and nutriceutical compounds to ameliorate the pathological and clinical progression of the disease.

Periexercise coingestion of branched-chain amino acids and carbohydrate in men does not preferentially augment resistance exercise-induced increases in phosphatidylinositol 3 kinase/protein kinase B-mammalian target of rapamycin pathway markers indicative of muscle protein synthesis

The effects of a single bout of resistance exercise (RE) in conjunction with periexercise branched-chain amino acid (BCAA) and carbohydrate (CHO) ingestion on skeletal muscle signaling markers indicative of muscle protein synthesis were determined. It was hypothesized that CHO + BCAA would elicit a more profound effect on these signaling markers compared with CHO. Twenty-seven males were randomly assigned to CHO, CHO + BCAA, or placebo (PLC) groups. Four sets of leg presses and leg extensions were performed at 80% 1 repetition maximum. Supplements were ingested 30 minutes and immediately before and after RE. Venous blood and muscle biopsy samples were obtained immediately before supplement ingestion and 0.5, 2, and 6 hours after RE. Serum insulin and glucose and phosphorylated levels of muscle insulin receptor substrate 1 (IRS-1), protein kinase B, mammalian target of rapamycin, phosphorylated 70S6 kinase, and 4E binding protein 1 were assessed. Data were analyzed by 2-way repeated-measures analysis of variance. Significant group × time interactions were observed for glucose and insulin (P < .05) showing that CHO and CHO + BCAA were significantly greater than PLC. Significant time main effects were observed for IRS-1 (P = .001), protein kinase B (P = .031), mammalian target of rapamycin (P = .003), and phosphorylated 70S6 kinase (P = .001). Carbohydrate and CHO + BCAA supplementation significantly increased IRS-1 compared with PLC (P = .002). However, periexercise coingestion of CHO and BCAA did not augment RE-induced increases in skeletal muscle signaling markers indicative of muscle protein synthesis when compared with CHO.

High fat diet and associated changes in the expression of micro-RNAs in tissue: Lessons learned from animal studies

Environment and genetic factors play an important role in the development of obesity, and diet is one of the main contributing factors to this disease. High fat intake is associated with body weight gain, leading to obesity and other metabolic diseases. MicroRNAs (miRNAs) are a group of small, noncoding RNAs that are important regulators of gene expression at posttranscriptional level. Studies have shown that high fat intake, independent of body weight status, can significantly impact both negatively and positively the expression of miRNAs and thus the biological function of tissues such as adipose, skeletal, and cardiac muscle, liver, neuronal, and endothelial. This review will summarize the effects of high calorie diet in the form of high fat intake on miRNA expression in various tissues of animal models and of high fat fed offspring. We will also briefly review the impact of different dietary lipids on miRNA expression. Given changes in miRNA expression have been associated with the development of many diseases including obesity, understanding their biological role could have important clinical implications and offer tangible therapeutic targets for the prevention, management, and/or treatment of obesity and other lifestyle-related disorders.

Co‑ingestion of carbohydrate with branched‑chain amino acids or l‑leucine does not preferentially increase serum IGF‑1 and expression of myogenic‑related genes in response to a single bout of resistance exercise

The purpose of this study was to determine if the co-ingestion of carbohydrate (CHO) with branched-chain amino acids (BCAA) or l-leucine (LEU) preferentially affected serum IGF-1 and the expression of myogenic-related genes in response to resistance exercise (RE). Forty-one college-age males were randomly assigned to 1 of 4 groups: CHO, CHO-BCAA, CHO-LEU, or placebo (PLC). Resistance exercise consisted of 4 sets of 10 repetitions of leg press and leg extension at 80xa0% 1RM. Supplements were ingested peri-exercise, and venous blood and muscle biopsies were obtained pre-exercise (PRE), and at 30, 120, and 360xa0min post-exercise. Serum IGF-1 was determined with ELISA, and skeletal muscle mRNA expression of myostatin, ACTRIIB, p21kip, p27kip, CDK2, cyclin B1, cyclin D1, Myo-D, myogenin, MRF-4, and myf5 was determined using real-time PCR. Results were analyzed by two-way ANOVA for serum IGF-1 and two-way MANOVA for mRNA expression. Serum IGF-1 in CHOxa0+xa0BCAA was greater than PLC (pxa0<xa00.05) but was not affected by RE (pxa0>xa00.05). A significant groupxa0×xa0time interaction was located for cylin D1 (pxa0<xa00.05), but not for any other genes. However, significant time effects were noted for cyclin B1 and p21cip (pxa0<xa00.05). At 30, 120 and 360xa0min post-exercise, p21cip was significantly less than PRE. Cyclin D1 was greater than PRE and 30xa0min post-exercise at 120 and 360xa0min post-exercise, whereas cyclin B1 was significantly greater than PRE at 120xa0min post-exercise (pxa0<xa00.05). Unlike the co-ingestion of CHO with either BCAA or l-leucine in conjunction with RE, the expression of various myogenically related genes were up-regulated with RE.