Effect of an Exercise and Nutrition Program on Quality of Life in Patients With Atrial Fibrillation: The Atrial Fibrillation Lifestyle Project (ALP).

Background: Studies of separate exercise and weight loss interventions have reported improvements in quality of life (QoL) or reduction in atrial fibrillation (AF) burden. We investigated the impact of a structured exercise, nutrition, and risk-factor-modification program on QoL and AF burden. Methods: In this trial, 81 successive patients with body mass index > 27 kg/m2 and nonpermanent AF were randomized to an intervention (n = 41) or control group (n = 40). The intervention consisted of cardiovascular risk management and a 6-month nutrition and exercise program, followed by a 6-month maintenance program. All participants received usual AF care. The primary end-point was QoL at 6 and 12 months. Results: At 6 months, we observed improved QoL among patients in the intervention group, relative to that among control-group patients (intervention (I) n = 34, control (C) n = 38) in the 36-item Short Form Survey Instrument scores on the subscales of vitality (I: 13.2 ± 20.4; C: 1.0 ± 14.9, P < 0.001), social functioning (I: 14.7 ± 24.1; C: 2.4 ± 21.2, P = 0.018), emotional well-being (I: 5.5 ± 14.1 ; C: -1.0 ± 13.3, P = 0.017), and general health perceptions (I: 8.1 ± 12.3; C: 2.7 ± 13.3, P = 0.009). At the 6-month follow-up, improvement in the scores on the subscales of vitality (P = 0.021) and emotional well-being (P = 0.036) remained significant. The burden of AF as measured by Holter monitor and Toronto AF symptom score was not significantly changed. Conclusions: A structured exercise and nutrition program resulted in significant sustained improvements in QoL, without reduction in AF burden. This type of program may provide an additional treatment for people with impaired QoL due to AF.

Introduction: Des études sur des interventions distinctes d'exercice et de perte de poids ont montré des améliorations de la qualité de vie (QdV) ou la réduction du fardeau de la fibrillation auriculaire (FA). Nous avons examiné les répercussions d'un programme structuré d'exercice, d'alimentation et de modification des facteurs de risque sur la QdV et le fardeau de la FA. Méthodes: Dans le présent essai, nous avons réparti de façon aléatoire 81 patients successifs dont l'indice de masse corporelle était > 27 kg/m2 et la FA était non permanente à une intervention (n = 41) ou à un groupe témoin (n = 40). L'intervention a consisté en la prise en charge du risque cardiovasculaire et un programme d'alimentation et d'exercice de six mois, et a été suivie d'un programme de maintien de six mois. Tous les participants ont reçu les soins usuels relatifs à la FA. Le principal critère d'évaluation était la QdV après six mois et 12 mois. Résultats: Après six mois, nous avons observé la QdV chez les patients du groupe d'intervention par rapport à celle des patients du groupe témoin (intervention [I] n = 34, témoin [C] n = 38) selon les scores de la version abrégée du questionnaire de 36 items aux sous-échelles sur la vitalité (I : 13,2 ± 20,4; C : 1,0 ± 14,9, P < 0,001), le fonctionnement social (I : 14,7 ± 24,1; C : 2,4 ± 21,2, P = 0,018), le bien-être émotionnel (I : 5,5 ± 14,1 ; C : ­1,0 ± 13,3, P = 0,017), et les perceptions de la santé générale (I : 8,1 ± 12,3; C : 2,7 ± 13,3, P = 0,009). Au suivi après six mois, l'amélioration des scores aux sous-échelles sur la vitalité (P = 0,021) et le bien-être émotionnel (P = 0,036) demeurait significative. Le fardeau de la FA selon le moniteur Holter et le score selon la Toronto Atrial Fibrillation Severity Scale n'avait pas changé de façon significative. Conclusions: Un programme structuré d'exercice et d'alimentation a donné lieu à des améliorations significatives et soutenues de la QdV, sans réduire le fardeau de la FA. Ce type de programme peut constituer un traitement supplémentaire aux personnes qui connaissent une diminution de leur QdV en raison de la FA.

FT-Raman spectroscopy, fluorescent probe, and solvent accessibility study of egg and milk proteins.

Due to possible contribution of both electrostatic and hydrophobic interactions, use of anionic fluorescent probes such as 1-anilinonaphthalene-8-sulfonic acid (ANS) and cis-parinaric acid (CPA) for the measurement of protein surface hydrophobicity (S0) has been controversial. A neutral probe, 6-propionyl-2-(dimethylamino)-naphthalene (PRODAN), may circumvent this problem. To select the best indicator of S0, in this study, the data for nine model proteins in phosphate buffer, pH 7.5, measured using the above-mentioned probes, was compared to their FT-Raman spectra and calculated solvent accessibility values. Log S0 measured using CPA had the highest correlation (r = 0.874) with the intensities of Raman spectral signals at 760 cm(-1) and 2800-3100 cm(-1), which were combined using a mixture design based on the random-centroid optimization. The order of correlation of Raman spectral parameters with S0 values were CPA > PRODAN > ANS. FT-Raman spectroscopy, therefore, identified CPA, followed by PRODAN, as the fluorescent probe of choice for describing surface hydrophobicity. However, the amino acid surface accessibility calculated using the PredictProtein software was not useful in identifying the best fluorescent probe for the measurement of S0.

Pattern similarity analysis of amino acid sequences for peptide emulsification.

A new computer program for homology similarity search (HSS) was introduced. Application of the HSS to peptide sequences of short peptides with fewer 32 amino acid residues has explained the underlying mechanism of their emulsifying ability. It was found that certain regularity in the frequency of alternate polar/apolar cycle with high hydrophobic similarity density was required to obtain good emulsion. To supplement this required regularity, charge distribution, molecular flexibility, and a structural torsion caused by a proline residue might also play roles.

Principal component similarity analysis of Raman spectra to study the effects of pH, heating, and kappa-carrageenan on whey protein structure.

Raman spectroscopy was used to elucidate structural changes of beta-lactoglobulin (BLG), whey protein isolate (WPI), and bovine serum albumin (BSA), at 15% concentration, as a function of pH (5.0, 7.0, and 9.0), heating (80 degrees C, 30 min), and presence of 0.24% kappa-carrageenan. Three data-processing techniques were used to assist in identifying significant changes in Raman spectral data. Analysis of variance showed that of 12 characteristics examined in the Raman spectra, only a few were significantly affected by pH, heating, kappa-carrageenan, and their interactions. These included amide I (1658 cm(-1)) for WPI and BLG, alpha-helix for BLG and BSA, beta-sheet for BSA, CH stretching (2880 cm(-1)) for BLG and BSA, and CH stretching (2930 cm(-1)) for BSA. Principal component analysis reduced dimensionality of the characteristics. Heating and its interaction with kappa-carrageenan were identified as the most influential in overall structure of the whey proteins, using principal component similarity analysis.