Pilot Randomized Controlled Trial of Lymfit: A Theory-Guided Exercise Intervention for Young Adults with Lymphoma.

Despite the rapidly emerging evidence on the contributions of physical activity to improving cancer-related health outcomes, adherence to physical activity among young adults with lymphoma remains suboptimal. Guided by self-determination theory (SDT), the Lymfit intervention (a 12-week individualized exercise program with bi-weekly kinesiologist support and an activity tracker) aimed to foster autonomous motivation toward physical activity. This pilot randomized controlled trial aimed to evaluate the feasibility, acceptability, and preliminary effects of Lymfit. Young adults (N = 26; mean age of 32.1 years) with lymphoma who were newly diagnosed and those up to six months after completing treatment were recruited and randomly assigned one-to-one to either the intervention group (n = 13) or a wait-list control group (n = 13). All a priori feasibility benchmarks were met, confirming the feasibility of the study in terms of recruitment uptake, retention, questionnaire completion, intervention fidelity, missing data, Fitbit wear adherence, and control group design. The intervention acceptability assessment showed high ratings, with eight out of ten items receiving >80% high ratings. At post-intervention, an analysis of covariance models showed a clinically significant increase in self-reported physical activity levels, psychological need satisfaction, and exercise motivation in the intervention group compared to controls. Lymfit also led to meaningful changes in six quality-of-life domains in the intervention group, including anxiety, depression, fatigue, sleep disturbance, social roles and activities, and pain interference. The findings support Lymfit as a promising means to meet psychological needs and increase the autonomous motivation for physical activity in this group. A fully powered efficacy trial is warranted to assess the validity of these findings.

A single-armed proof-of-concept study of Lymfit: A personalized, virtual exercise intervention to improve health outcomes in lymphoma survivors in the pandemic.

BACKGROUND AND OBJECTIVE: Treatments of lymphoma can lead to reduced physical functioning, cancer-related fatigue, depression, anxiety, and insomnia. These side effects can negatively impact the cancer survivor's quality of life. Mounting evidence indicates that physical activities are highly therapeutic in mitigating the short- and long-term side effects of cancer treatments. Yet, lymphoma survivors' participation in physical activities remains suboptimal, which has been further exacerbated by the deleterious effects of isolation during the COVID-19 pandemic. The Lymfit intervention aims to offer motivational support, expert guidance, and a personalized exercise prescription to optimize physical activities among lymphoma survivors. This proof-of-concept study explores implementation feasibility (retention, technical and safety), and the preliminary effects of Lymfit on various health outcomes. METHOD: This was a single-armed trial with a pre-and post-test design. Twenty lymphoma survivors were recruited to participate in the 12-week Lymfit intervention. Wearable activity trackers (Fitbit) were given to participants as a motivational tool and for data collection purposes. Participants received a personalized exercise prescription designed by a kinesiologist. Physiologic metrics were collected by the Fitbit monitors and were stored in the Lymfit database. Self-reported questionnaires measuring health outcomes were collected at baseline and post-intervention. RESULTS: The retention rate of this trial was 70%. Minimal technical issues and no adverse effects were reported. Lymfit led to significant improvements in sleep disturbances and the ability to participate in social activities and decreased fear of cancer recurrence. It also increased daily steps and decreased sedentary time in participants who did not meet the recommended physical activity guidelines. SIGNIFICANCE: With access to resources and fitness centers being limited during the pandemic, the Lymfit intervention filled an immediate need to provide physical activity guidance to lymphoma survivors. Findings provide preliminary support that implementing the Lymfit intervention is feasible and demonstrated promising results.

Interactions between a polygenic risk score for plasma docosahexaenoic fatty acid concentration, eating behaviour, and body composition in children.

BACKGROUND: The relationship between eating behaviour and current body weight has been described. However little is known about the effect of polyunsaturated fatty acids (PUFA) in this relationship. Genetic contribution to a certain condition is derived from a combination of small effects from many genetic variants, and polygenic risk scores (PRS) summarize these effects. A PRS based on a GWAS for plasma docosahexaenoic fatty acid (DHA) has been created, based on SNPs from 9 genes. OBJECTIVE: To analyze the interaction between the PRS for plasma DHA concentration, body composition and eating behaviour (using the Children Eating Behaviour Questionnaire) in childhood. SUBJECTS/METHODS: We analyzed a subsample of children from the Maternal, Adversity, Vulnerability and Neurodevelopment (MAVAN) cohort with PRS and measurements of eating behaviour performed at 4 years of age (n = 210), 6 y (n = 177), and body fat determined by bioelectric impedance at 4 y and 6 y or by air displacement plethysmography and dual-energy X-ray absorptiometry at 8 y (n = 42 and n = 37). PRS was based on the GWAS from Lemaitre et al. 2011 (p threshold = p < 5*10-6), and a median split created low and high PRS groups (high PRS = higher DHA level). RESULTS: In ALSPAC children, we observed an association between PRS and plasma DHA concentration (ß = 0.100, p < 0.01) and proportion (ß = 0.107, p < 0.01). In MAVAN, there were interactions between PRS and body fat on pro-intake scores in childhood, in which low PRS and higher body fat were linked to altered behaviour. There were also interactions between PRS and pro-intake scores early in childhood on body fat later in childhood, suggesting that the genetic profile and eating behaviour influence the development of adiposity at later ages. CONCLUSIONS: A lower PRS (lower plasma PUFA) can be a risk factor for developing higher body fat associated with non-adaptive eating behaviour in childhood; it is possible that the higher PRS (higher plasma PUFA) is a protective feature.

Participation in and outcomes from a 12-month tailored exercise programme for people with multiple sclerosis (MSTEP©): a randomized trial.

OBJECTIVE: To estimate, among people with multiple sclerosis, the extent to which a personally tailored exercise programme (MSTEP©) resulted in greater improvements in exercise capacity and related outcomes over 12 months in comparison with general exercise guidelines. DESIGN: Two-group randomized trial. SUBJECTS: Ambulatory and sedentary. INTERVENTIONS: MSTEP©, a personally adapted exercise regimen done on most days including two days of high intensity exercise; guidelines recommending 30 minutes of moderate intensity aerobic and strength training two times per week. MAIN MEASURES: Primary outcome was peak oxygen consumption (VO2peak) at 12 months; secondary outcomes were composite measures of physical function, fatigue, and health-related quality of life. RESULTS: In total, 137 people were randomized, 66 were lost over 12 months leaving 71 with outcome data, 34 in MSTEP© group, and 37 in the Guideline group. Exercise enjoyment and confidence and exercise-induced fatigue predicted retention. There were no differences between groups on the proportion making a 10% increase in VO2peak (27.1% MSTEP© vs 29.6% Guidelines; OR: 0.83; 95% CI: 0.23-3.08) by the 12 month assessment. The effect on fatigue was larger in the MSTEP© group than the Guideline groups (OR: 1.59; 95% CI: 0.93-2.74), the effect on physical function was more modest (OR: 1.35; 95% CI: 0.80-2.25), and null for health-related quality of life outcomes. CONCLUSIONS: The disappointing exercise retention suggests that people with multiple sclerosis may not consider exercise important to their brain health. Either type of exercise resulted in stable exercise capacity over 1 year in those sticking with the programme.

Sleep Duration and Timing in the Medium- to Long-Term Post-Bariatric Surgery.

Sleep duration improves short-term following bariatric surgery; however, little is known about its association with bodyweight medium- to long-term post-surgery. The purpose of this study was to describe sleep duration and its relationship with BMI and body composition. Forty-nine individuals, with a BMI of 36.6 ± 9.8 kg/m2, regained 26.4 ± 17.8% of their lost weight 9.5 ± 3.3 years post-surgery (range 3-16 years). Sleep logs and ActivPAL3 accelerometers were used to assess sleep duration. Participants averaged 7.9 ± 1.6 h/day and 8.5 ± 1.7 h/day of sleep for weekdays and weekends, respectively (P < 0.01). A positive association between delta weekend-weekday sleep timing midpoint with BMI (ß = 0.03, 95% CI = 0.01, 0.06; P = 0.01) was noted in the multivariable-adjusted model. On average, this sample achieved recommended sleep durations medium- to long-term post-surgery. Having an earlier sleep timing midpoint during the weekend may be associated with lower BMI.

Seasonal Changes in Physiological Responses and Body Composition During a Competitive Season in Male and Female Elite Collegiate Ice Hockey Players.

Delisle-Houde, P, Reid, RER, Insogna, JA, Chiarlitti, NA, and Andersen, RE. Seasonal changes in physiological responses and body composition during a competitive season in male and female elite collegiate ice hockey players. J Strength Cond Res 33(8): 2162-2169, 2019-Ice hockey continually overloads athletes with limited time for recovery, which may affect several physiological responses and alter body composition. The purpose of this study was to identify changes in physiological parameters and body composition profiles over the competitive season in elite collegiate ice hockey players. Forty-four players, 24 males (age = 22.7 ± 1.3 years, height = 1.82 ± 0.6 m, and body mass = 86.87 ± 6.44 kg) and 20 females (age = 19.9 ± 1.8 years, height = 1.66 ± 0.7 m, and body mass = 68.76 ± 5.91 kg) participated in 4-minute submaximal exercise tests and body composition assessments at pre-season, mid-season, and end-season. Changes in physiological parameters and body composition were analyzed using repeated-measures analysis of covariance controlling for age. Males' postexercise blood lactate concentration decreased (p ≤ 0.05) from pre- to mid-season (9.3 vs. 6.2 mmol·L) and increased (p ≤ 0.05) from mid- to end-season (6.2 vs. 8.0 mmol·L). Heart rate increased (p ≤ 0.05) after the third and fourth minute of the submaximal test in both sexes from pre- to end-season and from mid- to end-season. Males' body fat percentage decreased (p ≤ 0.05) from mid-season (17.4 vs. 16.1%), whereas increases were observed (p ≤ 0.05) in both sexes from mid- to end-season. This study produced evidence that male and female collegiate hockey athletes' physiological responses and body composition profiles change over the season. Sport scientists working with collegiate hockey teams, may need to revise annual training programs to attenuate reductions in fitness and hopefully prevent injuries.

Effect of weight loss via bariatric surgery for class III obesity on exertional breathlessness.

We examined the impact of bariatric surgery on cardiometabolic, ventilatory and breathlessness responses to incremental cycle exercise testing in adults with class III obesity (n = 6). O2 consumption, CO2 production, minute ventilation (V̇) and breathing frequency were reduced during submaximal exercise after surgery. Inspiratory capacity (IC) and inspiratory reserve volume were lower at rest and any given V̇E during exercise after surgery. In the transition from rest to peak exercise, dynamic IC decreased by 0.13 L before surgery and increased by 0.21 L after surgery. Breathlessness intensity ratings were lower during exercise at power outputs ≥75-watts after surgery (e.g., by 1.0 and 1.4 Borg 0-10 scale units at 75-watts and the highest equivalent power output of 117-watts, respectively). In contrast, bariatric surgery had no effect on breathlessness-V̇E relationships during exercise. In conclusion, relief of exertional breathlessness following bariatric surgery could not be explained by improved dynamic breathing mechanics, but reflected the awareness of reduced metabolic and ventilatory requirements of exercise.

Week and Weekend Day Cadence Patterns Long-Term Post-Bariatric Surgery.

Obesity can negatively influence walking cadence, reducing the overall intensity of daily activities and increasing the risk of weight gain. PURPOSE: Objectively describe the walking cadence of individuals' long-term post-bariatric surgery. METHODS: Fifty-eight participants, 51.2 ± 8.9 years old, with a BMI of 34.6 ± 10.1 kg/m2, 10.0 ± 3.1 years post-surgery wore an activPAL accelerometer for 7 consecutive days. Data was analyzed using participants' current BMI, dichotomized by obesity status, < or ≥ 30 kg/m2. RESULTS: On average, participants walked 5124 ± 2549 steps/day on weekdays and 6097 ± 2786 steps/day on weekend days (p = .003). Participants spent the majority (75%) of their daily steps at a slow-walking average cadence (non-obese: week = 65.3 ± 5.0 steps/min and weekend = 63.8 ± 6.7 steps/min; obese: week = 67.8 ± 8.2 steps/min and weekend = 63.3 ± 6.9 steps/min), with no difference between groups for week or weekend days (p = .153 and .774). The cadence of participants with obesity was significantly lower on weekends compared to weekdays for walking events > 30 s (p = .002) and > 60 s (p = .008) in duration. Weekday cadence of participants without obesity was similar to weekend day cadence across all walking event durations. The majority of walking events occurred below 30 s in duration for all participants. CONCLUSIONS: Long-term post-bariatric surgery, movement occurs in short duration bouts at a slow-walking cadence for the majority of movement. Individuals without obesity had similar movement patterns from week to weekend days while participants with obesity significantly lowered their cadence on weekend days.

Predicting On-Ice Skating Using Laboratory- and Field-Based Assessments in College Ice Hockey Players.

PURPOSE: To determine the predictability of common laboratory/field and novel laboratory tests for skating characteristics in Canadian college ice hockey players. METHODS: A total of 18 male hockey players from the university's varsity hockey team age 20-25 y (height 180.7 [6.4] cm, weight 87.1 [6.7] kg, and body fat 16.2% [4.0%]) completed common laboratory-/field-based testing (ie, standing long jump, vertical jump, off-ice proagility, V˙O2max, Wingate), novel laboratory-based testing (ie, Biodex dynamometer, dual-energy X-ray absorptiometry scan), and on-ice testing (ie, 30-m forward sprint, 30-m backward sprint, on-ice proagility). RESULTS: Pearson correlations and stepwise regression revealed relationships between on-ice forward sprint and 4 off-ice tests (Wingate relative peak power [r = -.62, P < .01], standing long jump [r = -.45, P < .05], off-ice proagility left [r = .51, P < .05], and vertical jump impulse [r = .60, P < .01]). On-ice proagility left was correlated with off-ice proagility left (r = .47, P < .05), Wingate relative peak power (r = -.55, P < .01), and vertical jump impulse (r = -.53, P < .05). The 30-m backward skating test and the on-ice proagility right were not correlated with any off-ice test. CONCLUSION: Commonly used laboratory/field tests are effective in predicting 2 important primary abilities in ice hockey.

Comparing DXA and Air Displacement Plethysmography to Assess Body Composition of Male Collegiate Hockey Players.

Delisle-Houde, P, Reid, RER, Insogna, JA, Prokop, NW, Buchan, TA, Fontaine, SL, and Andersen, RE. Comparing DXA and air-displacement-plethysmography to assess body composition of male collegiate hockey players. J Strength Cond Res 33(2): 474-478, 2019-Accurate assessment of body composition is an important consideration for athletes because it is a health/performance variable. However, little is known about the variability in values obtained across different assessment methods for specific athlete populations. The purpose of this study was to compare 2 common laboratory methods that assess body composition: air displacement plethysmography (BOD POD) and dual energy x-ray absorptiometry (DXA). Twenty-nine male collegiate hockey players, (Age = 24.07 ± 1.49, BMI = 26.5 ± 2.74) participated in this study. All participants underwent back-to-back BOD POD and DXA evaluations. Paired t-tests and Bland-Altman analyses were performed to compare differences in fat mass, fat percentage, and fat-free mass between methods. Average fat percentage reported by the DXA and BOD POD was 15.34 ± 3.53 and 11.66 ± 4.82 respectively, resulting in a bias score of 3.78 ± 2.33 kg (t(28) = 8.71, p ≤ 0.001). Average fat mass reported by the DXA and BOD POD was 13.42 ± 3.59 and 10.15 ± 4.54 kg respectively, resulting in a bias score of 3.27 ± 1.92 kg (t(28) = 9.18, p ≤ 0.001). Average fat-free mass reported by the DXA and BOD POD was 73.31 ± 5.30 and 76.25 ± 5.74 kg respectively, resulting in a bias score of -2.93 ± 2.06 kg (t(28) = -7.66, p ≤ 0.001). Our findings can help make more insightful comparisons between studies that use different body composition methodologies among athletic populations.

Accuracy of two Generic Prediction Equations and One Population-Specific Equation for Resting Energy Expenditure in Individuals with Spinal Cord Injury.

PURPOSE: The primary aim was to assess the accuracy of common prediction equations, the Harris-Benedict (HB) and the Mifflin St. Jeor (MSJ) equations, for estimating resting energy expenditure (REE) among people with spinal cord injury (SCI) against actual REE measurements. The secondary aim was to cross-validate the Buchholz et al. energy prediction equation created for people with SCI. METHODS: A metabolic cart with canopy was used to measure the actual REE. The HB, MSJ, and the Buchholz et al. equations were used for the prediction of REE. RESULTS: Thirty-nine participants (31 males and 8 females) were enrolled in this cross-sectional study. The REEs significantly differed from one another, F(1.52, 57.68) = 52.04, P < 0.001, where both the HB (M = 1703.06, SD = 265.1) and the MSJ (M = 1628.92, SD = 233.8) energy predictions were significantly higher (P < 0.001) than the measured REE (M = 1394.05, SD = 298.7). In contrast, the Buchholz et al. equation did not differ from the measured REE. CONCLUSIONS: Our data show that the HB and MSJ equations do not accurately predict the energy needs of this community. Using a SCI-specific equation would improve estimates of REE, such as the Buchholz et al. equation. More research into energy equations for this population may help health care professionals better tailor dietary requirements for weight management.

Relationship Between Physiologic Tests, Body Composition Changes, and On-Ice Playing Time in Canadian Collegiate Hockey Players.

Delisle-Houde, P, Chiarlitti, NA, Reid, RER, and Andersen, RE. Relationship between physiologic tests, body composition changes, and on-ice playing time in canadian collegiate hockey players. J Strength Cond Res 32(5): 1297-1302, 2018-Hockey player's body composition and physical fitness are suggested to influence coaching decisions regarding on-ice playing time. The purpose of this study was to explore the relationship between seasonal body composition changes, off-ice preseason testing, and on-ice metrics. Twenty-one Canadian collegiate hockey players (22.70 ± 1.30 years old, 181.0 ± 5.92 cm, 86.52 ± 6.41 kg) underwent off-ice physical testing at the beginning of their season and had one total body dual energy x-ray absorptiometry scan at the beginning and end of the season. The team's statistician tracked all on-ice metrics. Pearson correlations were used to explore relationships between off-ice tests (long jump, vertical jump, beep test, and Wingate test), change in body composition (body fat percentage, visceral adiposity, and total lean tissue mass), and on-ice performance (average time on ice, average shift length, power play time, penalty kill time, and shot differential). Long jump was correlated with shot differential (r = -0.532, p ≤ 0.05) and average shift length (r = -0.491, p ≤ 0.05) while fatigue index was correlated with average ice time (r = -0.476, p ≤ 0.05). Hockey performance is a complex interaction of player's body compositions and skeletal fitness that interact to affect on-ice playing metrics.

Effect of Employment Status on Physical Activity and Sedentary Behavior Long-Term Post-Bariatric Surgery.

INTRODUCTION: Inactivity and weight regain are serious problems post-bariatric surgery. Nearly half of waking time is spent at work, representing an opportunity to accumulate physical activity and help avoid weight regain. PURPOSE: The purpose of this study is to evaluate potential differences in physical activity and sedentary time by employment status post-bariatric surgery. METHODS: A total of 48 adults (employed (n = 19), unemployed (n = 29)) aged 50.7 ± 9.4 years, BMI = 34.4 ± 10.1 kg/m2, and 10 ± 3 years post-surgery participated. ActivPAL accelerometers measured transitions, steps, and sedentary time for 7 days. RESULTS: Participants worked on average 8.7 ± 1.8 h/day. Twenty-one percent of employed met step/day guidelines on work-days compared to 10% of unemployed. Employed persons transitioned from sitting-to-standing more on work-days (58.6 ± 17.8) than unemployed (45.0 ± 15.4). Employment status did not influence activity or sedentarism on weekend/non-working-days. CONCLUSION: Employment status may be associated with meaningful improvements in activity post-bariatric surgery.

Importance of Body Composition in the National Hockey League Combine Physiological Assessments.

Chiarlitti, NA, Delisle-Houde, P, Reid, RER, Kennedy, C, and Andersen, RE. Importance of body composition in the national hockey league combine physiological assessments. J Strength Cond Res 32(11): 3135-3142, 2018-The National Hockey League (NHL) combine was designed to assess draft-eligible players based on body composition, speed, power, and strength. The importance of body composition in the battery of combine physical tests was investigated, and differences in results based on position were explored. Thirty-seven elite male Canadian university hockey players (age = 22.86 ± 1.55 years, mass = 87.21 ± 6.52 kg, and height = 181.69 ± 6.19 cm) participated in the study at the beginning of their hockey season. All participants underwent physical testing (as outlined in the 2016 NHL combine) and 1 total body dual energy x-ray absorptiometry scan to measure body composition. Partial correlations (controlling for body mass) were used to explore the relationship among body composition measures (body fat percentage, visceral fat, body mass index, lower lean tissue mass, upper lean tissue mass, upper fat mass, and lower fat mass) with NHL fitness tests (bench press, pull-ups, grip strength, long jump, proagility, vertical jump, V[Combining Dot Above]O2max, and the Wingate Anaerobic Test). In 4 of the 6 strength/power tests (Wingate Anaerobic Test, long jump, bench press, and both grip strengths), lower and upper lean tissue mass explained significant amounts of variance. Although forwards and defensemen significantly differed in right grip strength and proagility left scores, they did not differ in regard to any body composition variables. Body composition has a significant influence on several combine-specific tests, which may help sport scientists and strength and conditioning coaches to better tailor training programs and to optimize performance in elite hockey players.

Longitudinal Changes in Body Composition Throughout Successive Seasonal Phases Among Canadian University Football Players.

Kim, J, Delisle-Houde, P, Reid, RER, and Andersen, RE. Longitudinal changes in body composition throughout successive seasonal phases among Canadian university football players. J Strength Cond Res 32(8): 2284-2293, 2018-The purpose of this study was to assess changes in body composition during seasonal phases of the training year among Canadian Inter-University Sport (CIS) football players. Forty university football players were assessed for anthropometry, total body composition, regional body composition, and central adiposity over a 7-month period including the summer off-season and the in-season. Baseline testing occurred in April, before the summer off-season, and follow-ups were completed before training camp, at the beginning of August, and following the in-season, at the beginning of November. Linemen had the greatest tissue percent fat (25.98 ± 6.56%) at baseline, significantly (p < 0.01) greater than big skill (18.69 ± 3.97%) and followed by skill (14.35 ± 3.39%) who were significantly (p < 0.01) leaner than both other groups. Skill players significantly increased fat mass (0.98 ± 0.30 kg, p ≤ 0.05) and waist-to-hip ratio (0.02 ± 0.01, p ≤ 0.05) during the in-season, and linemen increased visceral fat mass from April to November (0.20 ± 0.06 kg, p ≤ 0.01). All players significantly (-1.26 ± 0.30 kg, p = 0.001) decreased lean mass during the in-season. All groups significantly increased bone mineral content during the summer off-season (p ≤ 0.05). There was also a significant time × summer training location interaction (p ≤ 0.05) for fat mass with athletes who remained on campus during summer months gaining the least amount of adiposity. Body composition and central adiposity seem to change differentially among positional groups across the annual training season.

Eccentric Ergometer Training Promotes Locomotor Muscle Strength but Not Mitochondrial Adaptation in Patients with Severe Chronic Obstructive Pulmonary Disease.

Eccentric ergometer training (EET) is increasingly being proposed as a therapeutic strategy to improve skeletal muscle strength in various cardiorespiratory diseases, due to the principle that lengthening muscle actions lead to high force-generating capacity at low cardiopulmonary load. One clinical population that may particularly benefit from this strategy is chronic obstructive pulmonary disease (COPD), as ventilatory constraints and locomotor muscle dysfunction often limit efficacy of conventional exercise rehabilitation in patients with severe disease. While the feasibility of EET for COPD has been established, the nature and extent of adaptation within COPD muscle is unknown. The aim of this study was therefore to characterize the locomotor muscle adaptations to EET in patients with severe COPD, and compare them with adaptations gained through conventional concentric ergometer training (CET). Male patients were randomized to either EET (n = 8) or CET (n = 7) for 10 weeks and matched for heart rate intensity. EET patients trained on average at a workload that was three times that of CET, at a lower perception of leg fatigue and dyspnea. EET led to increases in isometric peak strength and relative thigh mass (p < 0.01) whereas CET had no such effect. However, EET did not result in fiber hypertrophy, as morphometric analysis of muscle biopsies showed no increase in mean fiber cross-sectional area (p = 0.82), with variability in the direction and magnitude of fiber-type responses (20% increase in Type 1, p = 0.18; 4% decrease in Type 2a, p = 0.37) compared to CET (26% increase in Type 1, p = 0.04; 15% increase in Type 2a, p = 0.09). EET had no impact on mitochondrial adaptation, as revealed by lack of change in markers of mitochondrial biogenesis, content and respiration, which contrasted to improvements (p < 0.05) within CET muscle. While future study is needed to more definitively determine the effects of EET on fiber hypertrophy and associated underlying molecular signaling pathways in COPD locomotor muscle, our findings promote the implementation of this strategy to improve muscle strength. Furthermore, contrasting mitochondrial adaptations suggest evaluation of a sequential paradigm of eccentric followed by concentric cycling as a means of augmenting the training response and attenuating skeletal muscle dysfunction in patients with advanced COPD.

Effects of Neighborhood Walkability on Physical Activity and Sedentary Behavior Long-Term Post-Bariatric Surgery.

ᅟ: Chronic inactivity and weight regain are serious health concerns following bariatric surgery. Neighborhood walkability is associated with higher physical activity and lower obesity rates in normal weight populations. PURPOSE: Explore the influence of neighborhood walkability on physical activity and sedentarism among long-term post-bariatric surgery patients. METHODS: Fifty-eight adults aged 50.5 ± 9.1 years, with a BMI of 34.6 ± 9.7 kg/m2 having undergone surgery 9.8 ± 3.15 years earlier participated in this study. Participants were asked to wear an ActivPAL™ tri-axial accelerometer attached to their mid-thigh for 7-consecutive days, 24 hours/day. The sample was separated into those that live in Car-Dependent (n = 23), Somewhat Walkable (n = 14), Very Walkable (n = 16), and Walker's Paradise (n = 5) neighborhoods as defined using Walk Score®. ANCOVA was performed comparing Walk Score® categories on steps and sedentary time controlling for age and sex. RESULTS: Neighborhood walkability did not influence either daily steps (F (3, 54) = 0.921, p = 0.437) or sedentary time (F (3, 54) = 0.465, p = 0.708), Car-Dependent (6359 ± 2712 steps, 9.54 ± 2.46 hrs), Somewhat Walkable (6563 ± 2989 steps, 9.07 ± 2.70 hrs), Very Walkable (5261 ± 2255 steps, 9.97 ± 2.06 hrs), and Walker's Paradise (6901 ± 1877 steps, 10.14 ± 0.815 hrs). CONCLUSION: Walkability does not appear to affect sedentary time or physical activity long-term post-surgery. As the built-environment does not seem to influence activity, sedentarism, or obesity as it does with a normal weight population, work needs to be done to tailor physical activity programming after bariatric surgery.

Validity and reliability of Fitbit activity monitors compared to ActiGraph GT3X+ with female adults in a free-living environment.

OBJECTIVES: Inexpensive activity monitors have recently gained popularity with the general public. Researchers have evaluated these consumer-based monitors in laboratory-conditions. Given the current wide-spread consumer use of these devices, it is important to ensure users are attaining accurate information compared to previously validated measures. This study investigates the accuracy of Fitbit One and Flex activity monitors in measuring steps, sedentary time, and time spent in light, moderate, and vigorous intensity activities with ActiGraph GT3X+ with female adults in free-living conditions. DESIGN: Cross-sectional study. METHODS: Twenty-two women, 21.23±1.63 years, BMI: 22.35±2.34kg/m2 wore two Fitbit Ones (bra and waist), one Fitbit Flex on the wrist, and one ActiGraph GT3X+ on the waist for seven-consecutive days. Repeated measures ANOVA was used to explore differences in steps, sedentary time, and time spent in light, moderate and vigorous intensity activities among the four devices. RESULTS: No differences were found in number of steps recorded across the four devices. Fitbit One, waist and bra, overestimated time spent in light intensity activities. Fitbit One (waist) and Fitbit Flex overestimated time spent in moderate intensity activities. Fitbit One, waist and bra, and Fitbit Flex overestimated time spent in vigorous intensity activities. All Fitbit activity monitors overestimated MVPA and underestimated sedentary time compared to the ActiGraph. CONCLUSIONS: Regardless of wear-location all Fitbit devices provide similar activity monitoring and users can wear the devices wherever best accommodates their lifestyle or needs. Users should not rely solely on these monitors when tracking vigorous and MVPA activities.

Energy Intake and Food Habits between Weight Maintainers and Regainers, Five Years after Roux-en-Y Gastric Bypass.

We explored differences in dietary behaviours, energy, and macronutrient intake among individuals who had regained or maintained weight loss 5 or more years after Roux-en-Y gastric bypass (RYGB). This study assessed 27 adults who underwent RYGB an average of 12.1 ± 3.7 years before this study was conducted. Dietary assessment was performed using 3-day food records. Daily energy intake (kcal), protein (g), carbohydrate (g), fat (g), and alcohol intake (g) were computed using the ESHA's Food Processor®. Participants were classified by percent weight loss, maintainers (≥38 %), and regainers (≤30 %). Daily carbohydrate consumption was greater in regainers (222 ± 84.3 g) compared with maintainers (162 ± 67.5 g), (P < 0.05). Thirty-seven percent of participants were not consuming the recommended amount of protein and 26% reported never taking vitamin supplements after surgery. Alcohol consumption was higher among regainers (18.5 ± 30.9 g) compared with maintainers (2.6 ± 6.5 g), (P < 0.05). Finally, 74% of the participants reported no contact with a Registered Dietitian, whereas 78 % were in contact with a health care professional once a year post-surgery. Differences were seen in carbohydrate intake and alcohol consumption between weight maintainers and regainers. These data suggest dietitians need to play a more active role in the long-term care of this medically complex population.