Stuart R. Gray

The effect of a pedometer-based community walking intervention "Walking for Wellbeing in the West" on physical activity levels and health outcomes: a 12-week randomized controlled trial

BackgroundRecent systematic reviews have suggested that pedometers may be effective motivational tools to promote walking. However, studies tend to be of a relatively short duration, with small clinical based samples. Further research is required to demonstrate their effectiveness in adequately powered, community based studies.ObjectiveUsing a randomized controlled trial design, this study assessed the impact of a 12-week graduated pedometer-based walking intervention on daily step-counts, self-reported physical activity and health outcomes in a Scottish community sample not meeting current physical activity recommendations.MethodSixty-three women and 16 men (49.2 years ± 8.8) were randomly assigned to either an intervention (physical activity consultation and 12-week pedometer-based walking program) or control (no action) group. Measures for step-counts, 7-day physical activity recall, affect, quality of life (n = 79), body mass, BMI, % body fat, waist and hip circumference (n = 76), systolic/diastolic blood pressure, total cholesterol and HDL cholesterol (n = 66) were taken at baseline and week 12. Analyses were performed on an intention to treat basis using 2-way mixed factorial analyses of variance for parametric data and Mann Whitney and Wilcoxon tests for non-parametric data.ResultsSignificant increases were found in the intervention group for step-counts (p < .001), time spent in leisure walking (p = .02) and positive affect (p = .027). Significant decreases were found in this group for time spent in weekday (p = .003), weekend (p = .001) and total sitting (p = .001) with no corresponding changes in the control group. No significant changes in any other health outcomes were found in either group. In comparison with the control group at week 12, the intervention group reported a significantly greater number of minutes spent in leisure time (p = .008), occupational (p = .045) and total walking (p = .03), and significantly fewer minutes in time spent in weekend (p = .003) and total sitting (p = .022).ConclusionA pedometer-based walking program, incorporating a physical activity consultation, is effective in promoting walking and improving positive affect over 12 weeks in community based individuals. The discussion examines possible explanations for the lack of significant changes in health outcomes. Continued follow-up of this study will examine adherence to the intervention and possible resulting effects on health outcomes.

The Development of Diet-Induced Obesity and Glucose Intolerance in C57Bl/6 Mice on a High-Fat Diet Consists of Distinct Phases

High–fat (HF) diet-induced obesity and insulin insensitivity are associated with inflammation, particularly in white adipose tissue (WAT). However, insulin insensitivity is apparent within days of HF feeding when gains in adiposity and changes in markers of inflammation are relatively minor. To investigate further the effects of HF diet, C57Bl/6J mice were fed either a low (LF) or HF diet for 3 days to 16 weeks, or fed the HF-diet matched to the caloric intake of the LF diet (PF) for 3 days or 1 week, with the time course of glucose tolerance and inflammatory gene expression measured in liver, muscle and WAT. HF fed mice gained adiposity and liver lipid steadily over 16 weeks, but developed glucose intolerance, assessed by intraperitoneal glucose tolerance tests (IPGTT), in two phases. The first phase, after 3 days, resulted in a 50% increase in area under the curve (AUC) for HF and PF mice, which improved to 30% after 1 week and remained stable until 12 weeks. Between 12 and 16 weeks the difference in AUC increased to 60%, when gene markers of inflammation appeared in WAT and muscle but not in liver. Plasma proteomics were used to reveal an acute phase response at day 3. Data from PF mice reveals that glucose intolerance and the acute phase response are the result of the HF composition of the diet and increased caloric intake respectively. Thus, the initial increase in glucose intolerance due to a HF diet occurs concurrently with an acute phase response but these effects are caused by different properties of the diet. The second increase in glucose intolerance occurs between 12 - 16 weeks of HF diet and is correlated with WAT and muscle inflammation. Between these times glucose tolerance remains stable and markers of inflammation are undetectable.

Does physical activity counselling enhance the effects of a pedometer-based intervention over the long-term: 12-month findings from the walking for wellbeing in the west study

BackgroundPedometers provide a simple, cost effective means of motivating individuals to increase walking yet few studies have considered if short term changes in walking behaviour can be maintained in the long-term. The role of physical activity consultations in such interventions is unclear. The purpose of this study was to assess the sustainability of pedometer-based interventions and empirically examine the role of physical activity consultations using long-term results of a community-based walking study.Methods79 low active Scottish men and women (63 women and 16 men) from the Walking for Wellbeing in the West intervention study were randomly assigned to receive either: Group 1; pedometer-based walking programme plus physical activity consultations or Group 2; pedometer-based walking programme and minimal advice. Step counts (Omron HJ-109E Step-O-Meter pedometer), 7 day recall of physical activity (IPAQ long), mood (PANAS) and quality of life (EuroQol EQ-5D) were assessed pre-intervention and 12, 24 and 48 weeks after receiving the intervention. Body mass, body mass index and waist and hip circumference were assessed pre-intervention and 12 and 24 weeks after receiving the intervention. Analyses were performed on an intention to treat basis (baseline value carried forward for missing data) using mixed-factorial ANOVAs and follow-up t-tests.ResultsA significant main effect of time (p < 0.001) was found for step-counts attributable to significant increases in steps/day between: pre-intervention (M = 6941, SD = 3047) and 12 weeks (M = 9327, SD = 4136), t(78) = - 6.52, p < 0.001, d = 0.66; pre-intervention and 24 weeks (M = 8804, SD = 4145), t(78) = - 4.82, p < 0.001, d = 0.52; and pre-intervention and 48 weeks (M = 8450, SD = 3855), t(78) = - 4.15, p < 0.001, d = 0.44. Significant effects were found for several variables of self-reported physical activity, mood and quality of life and are discussed. No other significant effects in health related outcomes were found.ConclusionBoth interventions successfully increased and maintained step counts over 12 months. Physical activity consultations may encourage individuals to be active in other ways beyond walking and to reduce sitting time.Trial Registration NumberCurrent Controlled Trials Ltd ISRCTN88907382

The effect of a 12 week walking intervention on markers of insulin resistance and systemic inflammation.

OBJECTIVES The purpose of the present study was to determine whether a community-based walking intervention, using pedometers, is effective in reducing systemic inflammatory markers. METHODS Participants (age=49(8.9)) were recruited in Glasgow, United Kingdom, from August to December 2006 and were randomly assigned to a control (n=24; 6 males, no change in walking) and intervention group (n=24; 5 males gradually increasing walking by 3000 steps/day on 5 days of the week). Blood samples were collected at baseline, and after 12 weeks, and analysed for glucose, insulin, high sensitivity C-reactive protein (hsCRP), interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R), tumour necrosis factor-alpha (TNF-alpha) and soluble TNF receptors I and II (sTNFR1 and sTNFRII). RESULTS In the control group baseline step counts were 6356 (2953) steps/day and did not change (P>0.05) after 12 weeks, 6709 (2918) steps/day. The intervention group increased (P<0.001) step count from 6682 (3761) steps/day at baseline to 10182 (4081) steps/day at 12 weeks. Over the 12 week period there was no change in any other variables measured, in either control or intervention group. CONCLUSION We conclude that the current community-based intervention did not affect systemic markers of inflammation or insulin sensitivity.

Plasma IL‐6, its soluble receptors and F2‐isoprostanes at rest and during exercise in chronic fatigue syndrome

The aim of the current study was to investigate the levels of interleukin‐6 (IL‐6), its soluble receptors (sIL‐6R and sgp130) and F2‐isoprostanes, at rest and during exercise, in patients with chronic fatigue syndrome (CFS). Six male CFS patients and six healthy controls performed an incremental exercise test to exhaustion and a submaximal exercise bout to exhaustion. Blood samples taken in the submaximal test at rest, immediately post‐exercise and 24 h post‐exercise were analyzed for IL‐6, sIL‐6R, sgp130 and F2‐isoprostanes. A further 33 CFS and 33 healthy control participants gave a resting blood sample for IL‐6 and sIL‐6R measurement. During the incremental exercise test only power output at the lactate threshold was lower (P<0.05) in the CFS group. F2‐isoprostanes were higher (P<0.05) in CFS patients at rest and this difference persisted immediately and 24 h post‐exercise. The exercise study found no differences in IL‐6, sIL‐6R or sgp130 at any time point between groups. In the larger resting group, there were no differences in IL‐6 and sIL‐6R between CFS and control groups. This investigation has demonstrated that patients with CFS do not have altered plasma levels of IL‐6, sIL‐6R or sgp130 either at rest or following exercise. F2‐isoprostanes, however, were consistently higher in CFS patients.

Fish oil supplementation reduces markers of oxidative stress but not muscle soreness after eccentric exercise.

Due to the potential anti-inflammatory properties of fish-derived long chain n-3 fatty acids, it has been suggested that athletes should regularly consume fish oils-although evidence in support of this recommendation is not clear. While fish oils can positively modulate immune function, it remains possible that, due to their high number of double bonds, there may be concurrent increases in lipid peroxidation. The current study aims to investigate the effect of fish oil supplementation on exercise-induced markers of oxidative stress and muscle damage. Twenty males underwent a 6-week double-blind randomized placebo-controlled supplementation trial involving two groups (fish oil or placebo). After supplementation, participants undertook 200 repetitions of eccentric knee contractions. Blood samples were taken presupplementation, postsupplementation, immediately, 24, 48, and 72 hr postexercise and muscle soreness/maximal voluntary contraction (MVC) assessed. There were no differences in creatine kinase, protein carbonyls, endogenous DNA damage, muscle soreness or MVC between groups. Plasma thiobarbituric acid reactive substances (TBARS) were lower (p < .05) at 48 and 72 hr post exercise and H2O2 stimulated DNA damage was lower (p < .05) immediately postexercise in the fish oil, compared with the control group. The current study demonstrates that fish oil supplementation reduces selected markers of oxidative stress after a single bout of eccentric exercise.

The effect of eicosapentaenoic and docosahexaenoic acid on protein synthesis and breakdown in murine C2C12 myotubes

Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been found to stimulate protein synthesis with little information regarding their effects on protein breakdown. Furthermore whether there are distinct effects of EPA and DHA remains to be established. The aim of the current study was to determine the distinct effects of EPA and DHA on protein synthesis, protein breakdown and signalling pathways in C2C12 myotubes. Fully differentiated C2C12 cells were incubated for 24h with 0.1% ethanol (control), 50 μM EPA or 50 μM DHA prior to experimentation. After serum (4h) and amino acid (1h) starvation cells were stimulated with 2 mM L-leucine and protein synthesis measured using (3)H-labelled phenylalanine. Protein breakdown was measured using (3)H-labelled phenylalanine and signalling pathways (Akt, mTOR, p70S6k, 4EBP1, rps6 and FOXO3a) via Western blots. Data revealed that after incubation with EPA protein synthesis was 25% greater (P<0.05) compared to control cells, with no effect of DHA. Protein breakdown was 22% (P<0.05) lower, compared to control cells, after incubation with EPA, with no effect of DHA. Analysis of signalling pathways revealed that both EPA and DHA incubation increased (P<0.05) p70s6k phosphorylation, EPA increased (P<0.05) FOXO3a phosphorylation, with no alteration in other signalling proteins. The current study has demonstrated distinct effects of EPA and DHA on protein metabolism with EPA showing a greater ability to result in skeletal muscle protein accretion.

Fish oil supplementation augments post-exercise immune function in young males

PURPOSE Fish oils and related fatty acid components have anti-inflammatory properties, with beneficial effects against various disorders such as cardiovascular disease. A single bout of exercise can alter immune function. However, the effects of fish oil on immune function after a single bout of exercise are currently unknown. This study investigated the effect of supplementation with fish oil on the immune response to an acute bout of endurance exercise. METHODS Sixteen male subjects underwent a six week double blind randomised placebo controlled supplementation trial involving two groups (fish oil or placebo oil, 3g/day). They attended for two visits, the first involving a maximal exercise test and the second involving a 1-h bout of endurance exercise on a cycle ergometer at 70% (V)O(2peak). Blood samples were taken pre-supplementation, pre-exercise (post-supplementation), immediately, 1 and 3h post-exercise. Samples were analysed for plasma IL-6, eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and cortisol; peripheral blood mononuclear cell (PBMC) IL-2, IL-4 and IFN-γ production; neutrophil phagocytosis/oxidative burst; and natural killer (NK) cell cytotoxic activity. RESULTS Post-supplementation EPA concentration was increased (P=0.0127) in the fish oil group. At 3h post-exercise PBMC IL-2 (P=0.0067) and NK cell activity (P=0.0163) was greater in the fish oil compared with the control group. However, PBMC IL-4 and IFN-γ productions, plasma IL-6 and cortisol concentrations, as well as neutrophil activity were unaffected by fish oil supplementation. CONCLUSION The current study demonstrates that fish oil supplementation reduces increases PBMC IL-2 production and NK cell cytotoxic activity in the recovery period after exercise.

The response of circulating levels of the interleukin-6/interleukin-6 receptor complex to exercise in young men.

The formation of an interleukin-6/IL-6 receptor (IL-6/IL-6R) complex increases the biological activity and half-life of IL-6, with its response to exercise currently unknown. The aim of the present study was to determine the response of circulating levels of the IL-6/IL-6R complex to exercise. Nine healthy male participants performed 1h of cycling exercise at a workload required to elicit 90% lactate threshold. Venous blood samples were taken at rest, immediately post-exercise and after 1.5 h rest. Hemoglobin concentration and hematocrit were measured to estimate changes in plasma volume during exercise. The concentrations of IL-6, sIL-6R and the IL-6/IL-6R complex were measured via ELISA and corrected for changes in plasma volume. A single bout of acute exercise resulted in a 5-fold increase (P<0.05) in IL-6 and a 1.2-fold increase (P<0.05) in sIL-6R immediately after exercise. These returned to baseline at 1.5 h after the cessation of exercise. There was a 2.1-fold increase (P<0.05) in the levels of the IL-6/IL-6R complex post-exercise with levels remaining 1.8 times elevated (P<0.05) after 1.5 h rest. The present study has demonstrated, for the first time, that circulating levels of the IL-6/IL-6R complex are increased in response to acute exercise in young males.

Sex differences in the effect of fish-oil supplementation on the adaptive response to resistance exercise training in older people: a randomized controlled trial

Background: Resistance exercise increases muscle mass and function in older adults, but responses are attenuated compared with younger people. Data suggest that long-chain n–3 polyunsaturated fatty acids (PUFAs) may enhance adaptations to resistance exercise in older women. To our knowledge, this possibility has not been investigated in men. Objective: We sought to determine the effects of long-chain n–3 PUFA supplementation on resistance exercise training–induced increases in muscle mass and function and whether these effects differ between older men and women. Design: Fifty men and women [men: n = 27, mean ± SD age: 70.6 ± 4.5 y, mean ± SD body mass index (BMI; in kg/m2): 25.6 ± 4.2; women: n = 23, mean ± SD age: 70.7 ± 3.3 y, mean ± SD BMI: 25.3 ± 4.7] were randomly assigned to either long-chain n–3 PUFA (n = 23; 3 g fish oil/d) or placebo (n = 27; 3 g safflower oil/d) and participated in lower-limb resistance exercise training twice weekly for 18 wk. Muscle size, strength, and quality (strength per unit muscle area), functional abilities, and circulating metabolic and inflammatory markers were measured before and after the intervention. Results: Maximal isometric torque increased after exercise training to a greater (P < 0.05) extent in the long-chain n–3 PUFA group than in the placebo group in women, with no differences (P > 0.05) between groups in men. In both sexes, the effect of exercise training on maximal isokinetic torque at 30, 90, and 240° s−1, 4-m walk time, chair-rise time, muscle anatomic cross-sectional area, and muscle fat did not differ (P > 0.05) between groups. There was a greater (P < 0.05) increase in muscle quality in women after exercise training in the long-chain n–3 PUFA group than in the placebo group, with no such differences in men (P > 0.05). Long-chain n–3 PUFAs resulted in a greater decrease (P < 0.05) than the placebo in plasma triglyceride concentrations in both sexes, with no differences (P > 0.05) in glucose, insulin, or inflammatory markers. Conclusion: Long-chain n–3 PUFA supplementation augments increases in muscle function and quality in older women but not in older men after resistance exercise training. This trial was registered at clinicaltrials.gov as NCT02843009.