R. G. Israel

A new paradigm for type 2 diabetes mellitus: could it be a disease of the foregut?

SUMMARY BACKGROUND DATA We previously reported, in a study of 608 patients, that the gastric bypass operation (GB) controls type 2 diabetes mellitus in the morbidly obese patient more effectively than any medical therapy. Further, we showed for the first time that it was possible to reduce the mortality from diabetes; GB reduced the chance of dying from 4.5% per year to 1% per year. This control of diabetes has been ascribed to the weight loss induced by the operation. These studies, in weight-stable women, were designed to determine whether weight loss was really the important factor. METHODS Fasting plasma insulin, fasting plasma glucose, minimal model-derived insulin sensitivity and leptin levels were measured in carefully matched cohorts: six women who had undergone GB and had been stable at their lowered weight 24 to 30 months after surgery versus a control group of six women who did not undergo surgery and were similarly weight-stable. The two groups were matched in age, percentage of fat, body mass index, waist circumference, and aerobic capacity. RESULTS Even though the two groups of patients were closely matched in weight, age, percentage of fat, and even aerobic capacity, and with both groups maintaining stable weights, the surgical group demonstrated significantly lower levels of serum leptin, fasting plasma insulin, and fasting plasma glucose compared to the control group. Similarly, minimal model-derived insulin sensitivity was significantly higher in the surgical group. Finally, self-reported food intake was significantly lower in the surgical group. CONCLUSIONS Weight loss is not the reason why GB controls diabetes mellitus. Instead, bypassing the foregut and reducing food intake produce the profound long-term alterations in glucose metabolism and insulin action. These findings suggest that our current paradigms of type 2 diabetes mellitus deserve review. The critical lesion may lie in abnormal signals from the gut.

The effects of detraining on power athletes

We investigated the effects of 14 d of resistive exercise detraining on 12 power athletes. In comparing performances pre- to post-detraining, there were no significant (P > 0.05) changes in free weight bench press (-1.7%), parallel squat (-0.9%), isometric (-7%) and isokinetic concentric knee extension force (-2.3%), and vertical jumping (1.2%). In contrast, isokinetic eccentric knee extension force decreased in every subject (-12%, P < 0.05). Post-detraining, the changes in surface EMG activity of the vastus lateralis during isometric, and isokinetic eccentric and concentric knee extension were -8.4%, -10.1%, and -12.7%, respectively (all P > 0.05). No significant changes occurred in knee flexion forces or EMGs (P > 0.05). Percentages of muscle fiber types and the Type I fiber area remained unchanged, but Type II fiber area decreased significantly by -6.4% (P < 0.05). Levels of plasma growth hormone (58.3%), testosterone (19.2%), and the testosterone to cortisol ratio (67.6%) increased, whereas plasma cortisol (-21.5%) and creatine kinase enzyme levels (-82.3%) decreased (all P < 0.05). Short-term resistive exercise detraining may thus specifically affect eccentric strength or the size of the Type II muscle fibers, leaving other aspects of neuromuscular performance uninfluenced. Changes in the hormonal milieu during detraining may be conducive to an enhanced anabolic process, but such changes may not materialize at the tissue level in the absence of the overload training stimulus.

The Effects of Static and Ballistic Stretching on Delayed Onset Muscle Soreness and Creatine Kinase

The purpose of this study was to determine if static and ballistic stretching would induce significant amounts of delayed onset muscle soreness (DOMS) and increases in creatine kinase (CK). Twenty males were randomly assigned to a static (STATIC) or ballistic stretching (BALLISTIC) group. All performed three sets of 17 stretches during a 90-min period, the only group difference being that STATIC remained stationary during each 60-s stretch while BALLISTIC performed bouncing movements. Subjective ratings of DOMS (scale: 1-10) and serum CK levels were assessed before and every 24 hours post stretching, for 5 days. A repeated measures ANOVA revealed a significant main effect due to time (p < 0.05), with peak soreness occurring at 24 hours after (M = 2.8 +/- 1.6). Surprisingly, a group effect (p < .05) demonstrated that DOMS was significantly greater for STATIC than for BALLISTIC. At 24 hours there was a 62% (p < .05) increase in CK for combined groups. These findings indicate that similar bouts of static and ballistic stretching induce significant increases in DOMS and CK in subjects unaccustomed to such exercise. Furthermore, static stretching induced significantly more DOMS than did ballistic.

A Family-Based Approach to Preventing Excessive Weight Gain

Objective: Preventing weight gain in adults and excessive weight gain in children is a high priority. We evaluated the ability of a family‐based program aimed at increasing steps and cereal consumption (for breakfast and snacks) to reduce weight gain in children and adults.

Effects of Aerobic Training on Primary Dysmenorrhea Symptomatology in College Females

Abstract “Single-Dose Therapy for Cystitis in Women: A Comparison of Trimethoprim-Sulfamethoxazole, Amoxicillin, and Cyclacillin,” Thomas M. Hooton et al. We evaluated single-dose regimens of trimethoprim-sulfamethoxazole, amoxicillin, and cyclacillin as treatment for acute cystitis in 38 women. The trial was prematurely stopped because of frequent treatment failures. At two days after treatment, all 13 patients given trimethoprim-sulfamethoxazole were cured, while four (31%) of the 13 given amoxicillin and four (33%) of 12 given cyclacillin had persistent bacteriuria. At two weeks, 11 (85%) of 13 patients given trimethoprim-sulfamethoxazole, six (50%) of 12 given amoxicillin, and three (30%) of ten given cyclacillin were cured. One patient with positive results of antibody-coated bacteria testing who was treated with cyclacillin had signs and symptoms of acute pyelonephritis three days after treatment, and two patients treated with amoxicillin and one treated with trimethoprim-sulfamethoxazole converted ...

White blood cell response to uphill walking and downhill jogging at similar metabolic loads

SummaryThe object of this study was to determine whether leukocytosis would occur in response to eccentric exercise, to concentric exercise, and/or to possible increases in serum corticol levels. Eight men performed 2 bouts of exercise at 46%

Relationship between cardiorespiratory fitness and lipoprotein(a) in men and women

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Effects of fitness level and the regional distribution of fat on carbohydrate metabolism and plasma lipids in middle- to older-aged men☆

for 40 min. Subjects initially walked up a 10% grade (UW); 2 weeks later they jogged down a 10% grade (DJ), a form of eccentric exercise known to induce delayed onset muscle soreness (DOMS). Venous blood samples were drawn before and after each exercise bout (0, 0.5, 1, 1.5, 2, 2.5, 3, 3.5, 4, and 5 h). Total and differential WBCc and serum cortisol levels were assessed. Results were analyzed using repeated measures ANOVA (2 × 11). Subjects experienced severe DOMS after DJ. There was a significant difference in TWBCc (p<0.0001) between UW and DJ. Post-hoc testing revealed no significant increase over baseline values for UW; after DJ there was a 46% increase over baseline values (p<0.05) initially seen at 1.0 h. These increases in TWBCc were predominantly a reflection of increases in neutrophils which were significant (p<0.0001) when compared to baseline values at 1.0, 1.5 and 2.0 h (∼60%). No significant neutrophil increases were seen after UW. Cortisol levels were similar for both groups pre-exercise (UW=367.1±38.6, DJ=320.2±44.16 mnol · L−1 x±SE) and decreased similarly for both groups after exercise, and thus were not related to the post-exercise neutrophilia. In conclusion, the neutrophilia seen after the DJ appeared to be a response to differences in the exercise, not plasma cortisol levels. Thus a bout of eccentric exercise appears to induce a significant post-exercise increase in neutrophils seen between 1.0 and 2.0 h after the termination of exercise.