Brain-Periphery Interactions in Huntington's Disease: Mediators and Lifestyle Interventions.

Prominent pathological features of Huntington's disease (HD) are aggregations of mutated Huntingtin protein (mHtt) in the brain and neurodegeneration, which causes characteristic motor (such as chorea and dystonia) and non-motor symptoms. However, the numerous systemic and peripheral deficits in HD have gained increasing attention recently, since those factors likely modulate disease progression, including brain pathology. While whole-body metabolic abnormalities and organ-specific pathologies in HD have been relatively well described, the potential mediators of compromised inter-organ communication in HD have been insufficiently characterized. Therefore, we applied an exploratory literature search to identify such mediators. Unsurprisingly, dysregulation of inflammatory factors, circulating mHtt, and many other messenger molecules (hormones, lipids, RNAs) were found that suggest impaired inter-organ communication, including of the gut-brain and muscle-brain axis. Based on these findings, we aimed to assess the risks and potentials of lifestyle interventions that are thought to improve communication across these axes: dietary strategies and exercise. We conclude that appropriate lifestyle interventions have great potential to reduce symptoms and potentially modify disease progression (possibly via improving inter-organ signaling) in HD. However, impaired systemic metabolism and peripheral symptoms warrant particular care in the design of dietary and exercise programs for people with HD.

Health Patterns across Adulthood: An Age-Based Investigation of the Nutritional Status, Homocysteine, and CoQ10 of Bank Staff.

BACKGROUND: This study aimed to evaluate age-specific variations in the blood levels of micronutrients, homocysteine, and CoQ10, along with physical activity (PA) patterns, among 123 Austrian adult bankers in operational and frontline roles (mean age: 43 years; 50% female). METHODS: Blood analysis was conducted to assess micronutrients and the serum concentrations of homocysteine and CoQ10. The micronutrient values in whole blood were compared to sex-specific reference ranges and categorized as below, within, or above them. The Global Physical Activity Questionnaire was utilized to assess PA patterns. Participants were classified as young adults (18-34 years), middle-aged adults (35-49 years), and older adults (50-64 years). RESULTS: Significant age-based differences were found in participants' mean homocysteine levels (p = 0.039) and homocysteine categories (p = 0.034), indicating an increasing prevalence of hyperhomocysteinemia with age. No significant difference between age categories was observed for sex, BMI, diet types, PA levels, sedentary behavior, and CoQ10 (p > 0.05). There was no significant age-based difference in the blood concentrations of most minerals and vitamins (p > 0.05), except for magnesium among females (p = 0.008) and copper among males (p = 0.042). CONCLUSION: The findings offer initial evidence of the age-related differences in the health status of adult bankers, providing insights for customized approaches to occupational health that support the importance of metabolic health and overall well-being across adulthood.

Gender Disparities in Health Biomarkers, Lifestyle Patterns, and Nutritional Status among Bank Staff: A Cross-Sectional Study.

Background and Objectives: Despite the importance of nutritional status and a healthy lifestyle in shaping overall well-being, little is known about examining gender-specific differences and trends in health, lifestyle, and nutritional status. The present study aimed to evaluate blood levels of micronutrients, homocysteine, and CoQ10, as well as physical activity (PA) levels and sedentary behavior, among a cohort of Austrian bank staff, with a particular focus on identifying gender differences as well as gender-specific nutritional deficiencies compared to the reference ranges. Materials and Methods: Following a cross-sectional study design, 123 Austrian bank staff (mean age: 43 years; 51% females) participated in this study. Blood samples were collected to evaluate participants' micronutrient status and serum levels of homocysteine and CoQ10. Whole-blood values of macronutrients were compared to gender-specific reference ranges and categorized into three groups: below, within, or over the range. The WHO's Global Physical Activity Questionnaire was used to assess PA levels and sedentary behaviors. Results: No significant difference between males and females was found for diet types, PA levels, sedentary time, homocysteine levels, or CoQ10 values (p > 0.05). A high PA level was reported by 64% of males and 58% of females. 71% of females and 56% of males were found to have a vitamin D deficiency. 63-98% of females and 72-97% of males showed normal blood levels for the remaining micronutrients, including potassium, calcium, magnesium, copper, iron, zinc, selenium, manganese, molybdenum, B6, B9, and B12. Conclusions: The findings highlight the necessity of implementing tailored strategies to foster healthy lifestyle behaviors, thereby enhancing the overall state of health, particularly in the context of occupational health.

Hypoxia Sensing and Responses in Parkinson's Disease.

Parkinson's disease (PD) is associated with various deficits in sensing and responding to reductions in oxygen availability (hypoxia). Here we summarize the evidence pointing to a central role of hypoxia in PD, discuss the relation of hypoxia and oxygen dependence with pathological hallmarks of PD, including mitochondrial dysfunction, dopaminergic vulnerability, and alpha-synuclein-related pathology, and highlight the link with cellular and systemic oxygen sensing. We describe cases suggesting that hypoxia may trigger Parkinsonian symptoms but also emphasize that the endogenous systems that protect from hypoxia can be harnessed to protect from PD. Finally, we provide examples of preclinical and clinical research substantiating this potential.

Effects of qigong Training on Muscle Strengths, Flexibility, Cardiopulmonary Fitness, and Antioxidant/Oxidant Responses in Sedentary Middle-Aged and Elderly Type 2 Diabetes Mellitus Women: A Quasi-Experimental Design, Placebo-Controlled Study.

Background: Qigong exercise training has been suggested to elicit beneficial effects on physical functioning, reduction of oxidative stress, and improved antioxidant capacity in women. However, regular exercise training may support the development of antioxidant defense mechanisms and beneficially modulate oxidant/antioxidant responses. Objective: To evaluate the effects of an 8-week qigong exercise training on exercise performance and oxidative stress responses in sedentary middle-aged and elderly women suffering from type 2 diabetic mellitus (T2DM). Method/design: Quasi-experimental design, placebo-controlled study. Setting: The Department of Physical Therapy, Faculty of Allied Health Science, Burapha University, Thailand. Participants: Thirty-six sedentary middle-aged and elderly women with T2DM. Intervention: Participants were allocated to qigong exercise (n = 20) or to the control group (CG, n = 20). Primary outcome measures: Muscle strengths, flexibility, VO2 max predicted, and walking intensity derived from the 6-minute walk test. Secondary outcome measures: Fasting plasma glucose, antioxidant/oxidant stress parameters, and body composition. Results: Leg strength and trunk flexibility were improved after qigong training and changes were significantly different compared with the CG (all p < 0.05). VO2 max predicted, 6-min walking distance, and walking intensity were all increased (p < 0.05), and oxidative stress markers were diminished after qigong training (p < 0.05). The antioxidant/oxidant balance was improved after qigong training (p < 0.05). Conclusion: The presented findings indicate that 8 weeks of qigong training significantly improved leg strength and trunk flexibility in middle-aged and elderly women with T2DM, partly associated with a more favorable antioxidant/oxidant balance. These effects may beneficially impact on health in this specific population. Clinical Trial Number: TCTR20221003001.

Women at Altitude: Sex-Related Physiological Responses to Exercise in Hypoxia.

Sex differences in physiological responses to various stressors, including exercise, have been well documented. However, the specific impact of these differences on exposure to hypoxia, both at rest and during exercise, has remained underexplored. Many studies on the physiological responses to hypoxia have either excluded women or included only a limited number without analyzing sex-related differences. To address this gap, this comprehensive review conducted an extensive literature search to examine changes in physiological functions related to oxygen transport and consumption in hypoxic conditions. The review encompasses various aspects, including ventilatory responses, cardiovascular adjustments, hematological alterations, muscle metabolism shifts, and autonomic function modifications. Furthermore, it delves into the influence of sex hormones, which evolve throughout life, encompassing considerations related to the menstrual cycle and menopause. Among these physiological functions, the ventilatory response to exercise emerges as one of the most sex-sensitive factors that may modify reactions to hypoxia. While no significant sex-based differences were observed in cardiac hemodynamic changes during hypoxia, there is evidence of greater vascular reactivity in women, particularly at rest or when combined with exercise. Consequently, a diffusive mechanism appears to be implicated in sex-related variations in responses to hypoxia. Despite well-established sex disparities in hematological parameters, both acute and chronic hematological responses to hypoxia do not seem to differ significantly between sexes. However, it is important to note that these responses are sensitive to fluctuations in sex hormones, and further investigation is needed to elucidate the impact of the menstrual cycle and menopause on physiological responses to hypoxia.

The Association of Physical Activity Level with Micronutrient and Health Status of Austrian Bank Employees.

BACKGROUND: Favorable health benefits of an active lifestyle have been clearly documented within the context of occupational health. However, a knowledge gap exists regarding the monitoring and comparison of micronutrient status across varying levels of physical activity (PA). This study aimed to investigate the association of PA level with micronutrient status and the associated health biomarkers among a cohort of Austrian bank employees. METHODS: Using a cross-sectional design, this study involved the participation of bank employees (n = 123; average age: 43 years; 49% males) from the federal state of Tyrol, located in the western part of Austria. To assess PA levels and sedentary behavior, the Global Physical Activity Questionnaire (GPAQ; developed by the WHO) was administered. Accordingly, participants were categorized into three groups: low PA, moderate PA, and high PA. Participants' blood samples were obtained to measure blood levels of micronutrients, homocysteine, and CoQ10. The values of vitamins and minerals in whole-blood were compared to sex-specific reference ranges and grouped into three categories: below, within, or exceeding the reference range. RESULTS: The prevalence of a high PA level was 61%, while 18% of participants had a low PA level. Overweight/obesity was significantly less prevalent among participants with high PA levels (22%) compared to those with moderate (50%) and low (50%) PA levels (p = 0.045). No significant differences between PA levels were found for sex, age, diet type, homocysteine, or CoQ10 markers (p > 0.05). There was no significant PA-based difference in blood concentrations of most vitamins and minerals (p > 0.05), except for vitamin D (p = 0.001) among females, as well as selenium (p = 0.040) and vitamin B12 (p = 0.048) among males. CONCLUSION: The present findings offer initial insights into the link between PA behaviors, micronutrient status, and health, highlighting potential implications in occupational health and lifestyle, specifically in developing tailored approaches based on PA levels.

Recommendations for Women in Mountain Sports and Hypoxia Training/Conditioning.

The (patho-)physiological responses to hypoxia are highly heterogeneous between individuals. In this review, we focused on the roles of sex differences, which emerge as important factors in the regulation of the body's reaction to hypoxia. Several aspects should be considered for future research on hypoxia-related sex differences, particularly altitude training and clinical applications of hypoxia, as these will affect the selection of the optimal dose regarding safety and efficiency. There are several implications, but there are no practical recommendations if/how women should behave differently from men to optimise the benefits or minimise the risks of these hypoxia-related practices. Here, we evaluate the scarce scientific evidence of distinct (patho)physiological responses and adaptations to high altitude/hypoxia, biomechanical/anatomical differences in uphill/downhill locomotion, which is highly relevant for exercising in mountainous environments, and potentially differential effects of altitude training in women. Based on these factors, we derive sex-specific recommendations for mountain sports and intermittent hypoxia conditioning: (1) Although higher vulnerabilities of women to acute mountain sickness have not been unambiguously shown, sex-dependent physiological reactions to hypoxia may contribute to an increased acute mountain sickness vulnerability in some women. Adequate acclimatisation, slow ascent speed and/or preventive medication (e.g. acetazolamide) are solutions. (2) Targeted training of the respiratory musculature could be a valuable preparation for altitude training in women. (3) Sex hormones influence hypoxia responses and hormonal-cycle and/or menstrual-cycle phases therefore may be factors in acclimatisation to altitude and efficiency of altitude training. As many of the recommendations or observations of the present work remain partly speculative, we join previous calls for further quality research on female athletes in sports to be extended to the field of altitude and hypoxia.

Mechanisms underlying the health benefits of intermittent hypoxia conditioning.

Intermittent hypoxia (IH) is commonly associated with pathological conditions, particularly obstructive sleep apnoea. However, IH is also increasingly used to enhance health and performance and is emerging as a potent non-pharmacological intervention against numerous diseases. Whether IH is detrimental or beneficial for health is largely determined by the intensity, duration, number and frequency of the hypoxic exposures and by the specific responses they engender. Adaptive responses to hypoxia protect from future hypoxic or ischaemic insults, improve cellular resilience and functions, and boost mental and physical performance. The cellular and systemic mechanisms producing these benefits are highly complex, and the failure of different components can shift long-term adaptation to maladaptation and the development of pathologies. Rather than discussing in detail the well-characterized individual responses and adaptations to IH, we here aim to summarize and integrate hypoxia-activated mechanisms into a holistic picture of the body's adaptive responses to hypoxia and specifically IH, and demonstrate how these mechanisms might be mobilized for their health benefits while minimizing the risks of hypoxia exposure.

The V˙O2max Legacy of Hill and Lupton (1923)-100 Years On.

PURPOSE: One hundred years ago, Hill and Lupton introduced the concept of maximal oxygen uptake (V˙O2max), which is regarded as "the principal progenitor of sports physiology." We provide a succinct overview of the evolvement of research on V˙O2max, from Hill and Lupton's initial findings to current debates on limiting factors for V˙O2max and the associated role of convective and diffusive components. Furthermore, we update the current use of V˙O2max in elite endurance sport and clinical settings. Practical Applications and Conclusions: V˙O2max is a healthy and active centenarian that remains a very important measure in elite endurance sports and additionally contributes as an important vital sign of cardiovascular function and fitness in clinical settings. Over the past 100 years, guidelines for the test protocols and exhaustion criteria, as well as the understanding of limiting factors for V˙O2max, have improved dramatically. Presently, possibilities of accurate and noninvasive determination of the convective versus diffusive components of V˙O2max by wearable sensors represent an important future application. V˙O2max is not only an indicator of cardiorespiratory function, fitness, and endurance performance but also represents an important biomarker of cardiovascular function and health to be included in routine assessment in clinical practice.

Immune consequences of exercise in hypoxia: A narrative review.

Immune outcomes are key mediators of many health benefits of exercise and are determined by exercise type, dose (frequency/duration, intensity), and individual characteristics. Similarly, reduced availability of ambient oxygen (hypoxia) modulates immune functions depending on the hypoxic dose and the individual capacity to respond to hypoxia. How combined exercise and hypoxia (e.g., high-altitude training) sculpts immune responses is not well understood, although such combinations are becoming increasingly popular. Therefore, in this paper, we summarize the impact on immune responses of exercise and of hypoxia, both independently and together, with a focus on specialized cells in the innate and adaptive immune system. We review the regulation of the immune system by tissue oxygen levels and the overlapping and distinct immune responses related to exercise and hypoxia, then we discuss how they may be modulated by nutritional strategies. Mitochondrial, antioxidant, and anti-inflammatory mechanisms underlie many of the adaptations that can lead to improved cellular metabolism, resilience, and overall immune functions by regulating the survival, differentiation, activation, and migration of immune cells. This review shows that exercise and hypoxia can impair or complement/synergize with each other while regulating immune system functions. Appropriate acclimatization, training, and nutritional strategies can be used to avoid risks and tap into the synergistic potentials of the poorly studied immune consequences of exercising in a hypoxic state.

Impact of Environmental Factors on the ACL Injury Risk in Recreational Alpine Skiing.

In recreational alpine skiing, an ACL injury represents the most common injury. Skiing is a complex activity where the skier interacts with the environment, such as weather, snow conditions, temperature, etc. Thus, the aim of this study was to evaluate the potential impact of environmental factors on ACL injury risk in recreational alpine skiers. Among a cohort of 392 ACL-injured skiers and 392 uninjured controls matched for sex and skiing skill, environmental factors were collected by questionnaire. Factors included weather conditions, snow conditions, perceived temperature, and slope difficulty at the time-point of the accident (ACL-injured skiers) or of questioning during the ski day (uninjured controls).Multiple logistic regression revealed that in addition to age, five environmental factors were significantly predictive of an ACL injury: fresh snow (OR 10.5), grippy snow (OR 7.8), icy slope condition (OR 12.4), very cold/cold perceived temperature (OR 1.6), and skiing on easy slopes (OR 6.9). In conclusion, besides age, environmental factors such as fresh and grippy snow, icy slope conditions, low temperatures, and flat slopes are associated with an increased ACL injury risk in recreational alpine skiing. Those factors are at least partly modifiable and should be taken into consideration for preventive strategies.

Exploiting moderate hypoxia to benefit patients with brain disease: Molecular mechanisms and translational research in progress.

Hypoxia is increasingly recognized as an important physiological driving force. A specific transcriptional program, induced by a decrease in oxygen (O2) availability, for example, inspiratory hypoxia at high altitude, allows cells to adapt to lower O2 and limited energy metabolism. This transcriptional program is partly controlled by and partly independent of hypoxia-inducible factors. Remarkably, this same transcriptional program is stimulated in the brain by extensive motor-cognitive exercise, leading to a relative decrease in O2 supply, compared to the acutely augmented O2 requirement. We have coined the term "functional hypoxia" for this important demand-responsive, relative reduction in O2 availability. Functional hypoxia seems to be critical for enduring adaptation to higher physiological challenge that includes substantial "brain hardware upgrade," underlying advanced performance. Hypoxia-induced erythropoietin expression in the brain likely plays a decisive role in these processes, which can be imitated by recombinant human erythropoietin treatment. This article review presents hints of how inspiratory O2 manipulations can potentially contribute to enhanced brain function. It thereby provides the ground for exploiting moderate inspiratory plus functional hypoxia to treat individuals with brain disease. Finally, it sketches a planned multistep pilot study in healthy volunteers and first patients, about to start, aiming at improved performance upon motor-cognitive training under inspiratory hypoxia.

Association of personal and equipment-related factors on ACL injury risk in alpine skiers with cautious or risk-taking behaviour: A case-control study.

Background: In recreational alpine skiing ACL injury risk depends on the interaction of individual characteristics and behaviours as well as on equipment-related factors. Aim: to evaluate if and to what extent personal characteristics and equipment-related parameters are associated with ACL injury risk in cautious and risk-taking recreational alpine skiers. Methods: A retrospective questionnaire-based, case-control study of ACL-injured and uninjured in a cohort of cautious as well as risk-taking recreational skiers was conducted. Participants self-reported their demographics, skiing skill level, and risk-taking behaviour. Ski length, side-cut radius, widths of the tip, waist, and tail were recorded from each participant's skis. Standing heights at the front and rear components of the ski binding were measured with a digital sliding caliper, and a standing height ratio between the front and rear components was calculated. Ski boot sole abrasion at the toe and heel pieces was also measured with the digital sliding caliper. Results: In total, 1068 recreational skiers (50.8% females) with a mean age of 37.8 ± 12.3 years participated, of whom 193 (22.0%) sustained an ACL injury, and 330 (30.9%) participants reported a risk-taking behaviour. Results of the multiple logistic regression analyses revealed that a higher age, a lower skill level, a higher standing height ratio, and greater ski boot sole abrasion at the toe as well as heel pieces were independently associated with an increased ACL injury risk in both the cautious and the risk-taking group. Among cautious skiers, a longer ski length was an additional significant risk factor for sustaining an ACL injury. In conclusion, the same personal and equipment related characteristics contribute to an increase in the ACL injury risk regardless of risk-taking behaviour, with the only difference that longer skis represent an additional risk factor in cautious skiers.