Music Tempo: A Tool for Regulating Walking Cadence and Physical Activity Intensity in Overweight Adults?

This study investigated if music tempo can prompt a desired walking cadence, and if music can provide a stimulus to regulate physical activity intensity in a longitudinal physical activity intervention with free-living adults. Overweight adults (n = 37; 94.26 ± 17.11 kg; 49.63 ± 12.37 years) were randomly assigned to an intervention (IG, n = 17) or usual care group (UC, n = 20) as part of a novel nine-month walking intervention. IG participants walked to self-selected music with a predetermined tempo and received a behavioural change support programme. At baseline, four-, six- and nine-months participants were asked to walk around an elliptical track at their habitual pace (0-2 min) and then in time to a predetermined tempo (2-8 min) designed to elicit moderate intensity. Cadence response (steps/min) was assessed and intensity (heart rate (bpm) recorded using wireless telemetry. A repeated measures general linear model (GLM) examined differences between groups over time (p < 0.05). All data is presented as means ± SD. At each assessment point both groups displayed an immediate cadence adjustment in response to music tempo (p < 0.01) i.e., habitual cadence vs. 3 METs target cadence (p < 0.05) and 3 METs target cadence vs. 5 METs target cadence (p < 0.05). Additionally, IG participants displayed an increased habitual cadence (0-2 min) at each assessment point (p < 0.05; 110 ± 9, 121.80 ± 7.5, 121.46 ± 10, 121.93 ± 7 steps/min respectively). UC participant's habitual cadence was unchanged from 0-9 months (p > 0.05; 120 ± 10, 116 ± 13, 119 ± 12 and 119 ± 9 steps/min respectively). Music tempo may be a useful regulatory tool to prompt the free-living individual to reach an appropriate stride rate to achieve a walking pace that is at least moderate intensity. It also appears that results may be trainable as throughout the study an increased habitual walking cadence was observed, in the absence of music.

Lipoprotein subfraction oxidation in acute exercise and ageing.

Exercise and ageing can independently increase free radical production that may enhance the susceptibility of LDL to oxidation and create a more atherogenic LDL particle. This investigation was designed to examine exercise and ageing on the susceptibility of LDL subfractions to oxidation. Eleven aged (55 ± 4 years) and twelve young (21 ± 2 years) participants completed a progressive exercise test to exhaustion and within one week performed a 1 h bout of moderate intensity (65% VO(2max)) exercise. Blood was assayed for metabolites associated with lipid composition (total cholesterol, free cholesterol, triglycerides) and lipoprotein susceptibility to oxidation. Exercise increased small density (sdLDL) oxidation, independently of age (p < 0.05). However, sdLDL oxidation further increased 24 h post exercise in the aged group (p < 0.05). With regards to the changes in lipid components within LDL, free and total cholesterol and triglycerides in large buoyant (lbLDL) were all elevated 24 h post exercise in aged compared with young (p < 0.05 for all comparisons). There was a decrease in triglycerides in medium density (mdLDL) 24 h post exercise in the aged group (p < 0.05). The lipid composition of sdLDL, VLDL, HDL(2), HDL(3) and serum lipid hydroperoxides remained unchanged as a function of exercise and ageing (p > 0.05). Although regular exercise training is known to be protective against cardiovascular disease (CVD) onset, our data demonstrates that acute exercise can increase sdLDL oxidative susceptibility, and this is independent of age and regardless of a change in LDL lipid composition. However, age seems to be a determining factor with regards the susceptibility of sdLDL to oxidation 24 h following exercise.

Exercise training protects the LDL I subfraction from oxidation susceptibility in an aged human population.

BACKGROUND: Exercise training is considered an effective strategy to improve metabolic disease. Despite this, less is known regarding exercise training in the prevention and susceptibility of LDL subfraction oxidation, particularly in an aged population. METHODS: Eleven aged (55 ± 4 yrs) and twelve young (21 ± 2 yrs) participants were randomly separated into an experimental or control group as follows: young exercise (n = 6); young control (n = 6); aged exercise (n = 6) and aged control (n = 5). The participants assigned to the exercise groups performed 12 weeks of moderate intensity (55-65% VO2max) exercise training. Venous blood was extracted at baseline, and 48 h following 12 weeks of exercise and assayed for a range of metabolites associated with lipid composition and lipoprotein susceptibility to oxidation. RESULTS: Although there was no difference in the oxidation potential (time ½ max) of LDL I, II or III between groups at baseline (p > 0.05), there was an increase in time ½ max for LDL I following exercise within the aged exercise group (p < 0.05). Moreover, α-tocopherol concentration was selectively lower in the aged exercise group, compared to the young exercise at baseline. The lipid composition of LDL I, LDL II, LDL III, VLDL, HDL2, HDL3 and serum lipid hydroperoxides remained unchanged as a function of exercise training and ageing (p > 0.05). CONCLUSION: The primary finding of this study demonstrates that adaptations in LDL resistance to oxidation occur following 12 weeks of exercise training in the aged, and this may be of clinical significance, as oxidation of LDL has been implicated in atherosclerosis.

A comparison of Diamond Forrester and coronary calcium scores as gatekeepers for investigations of stable chest pain.

To determine if calcium scores (CS) could act as a more effective gatekeeper than Diamond Forrester (DF) in the assessment of patients with suspected coronary artery disease (CAD). A sub-study of the Cardiac CT for the Assessment of Chest Pain and Plaque (CAPP) study, a randomised control trial evaluating the cost-effectiveness of cardiac CT in symptomatic patients with stable chest pain. Stable pain was defined as troponin negative pain without symptoms of unstable angina. 250 patients undergoing cardiac CT had both DF scores and CS calculated, with the accuracy of both evaluated against CT coronary angiogram. Criteria given in UK national guidelines were compared. Of the 250 patients, 4 withdrew. 140 (57 %) patients were male. The mean DF was 47.8 and mean CS 172.5. Of the 144 patients with non-anginal pain 19.4 % had significant disease (>50 % stenosis). In general the DF over estimated the presence of CAD whereas the CS reclassified patients to lower risk groups, with 91 in the high risk DF category compared to 26 in the CS. Both receiver operating curve and McNemar Bowker test analysis suggested the DF was less accurate in the prediction of CAD compared to CS [Formula: see text] Projected downstream investigations were also calculated, with the cost per number of significant stenoses identified cheaper with the CS criteria. Patients with suspected stable CAD are more accurately risk stratified by CS compared to the traditional DF. CS was more successful in the prediction of significant stenosis and appears to be more effective at targeting clinical resources to those patients that are in need of them.

Exercise training and impaired glucose tolerance in obese humans.

Individuals with impaired glucose tolerance (IGT) are at greater risk of developing diabetes than in normoglycaemia. The aim of this study was to examine the effects of 12-weeks exercise training in obese humans with IGT. Eleven participants (6 males and 5 females; 49±9 years; mean Body Mass Index (BMI) 32.4 kg · m(-2)), completed a 12-week brisk walking intervention (30 min per day, five days a week (d · wk(-1)), at 65% of age-predicted maximal heart rate (HR(max)). Anthropometric measurements, dietary intake, pulse wave velocity (PWV, to determine arterial stiffness) and blood pressure (BP) were examined at baseline and post intervention. Fasting blood glucose, glycosylated haemoglobin, insulin, blood lipids, indices of oxidative stress and inflammation (lipid hydroperoxides; superoxide dismutase; multimeric adiponectin concentration and high-sensitivity C-reactive protein) were also determined. Post intervention, PWV (9.08±1.27 m · s(-1) vs. 8.39±1.21 m · s(-1)), systolic BP (145.4±14.5 vs. 135.8±14.9 mmHg), triglycerides (1.52±0.53 mmol · L(-1) vs. 1.31±0.54 mmol · L(-1)), lipid hydroperoxides (1.20±0.47 µM · L(-1) vs. 0.79±0.32 µM · L(-1)) and anthropometric measures decreased significantly (P < 0.05). Moderate intensity exercise training improves upper limb vascular function in obese humans with IGT, possibly by improving triglyceride metabolism, which may subsequently reduce oxidative stress. These changes were independent of multimeric adiponectin modification and alterations in other blood biomarkers.

Effect of α-lipoic acid and exercise training on cardiovascular disease risk in obesity with impaired glucose tolerance.

Obese subjects with impaired glucose tolerance (IGT) are more susceptible than healthy individuals to oxidative stress and cardiovascular disease. This randomised controlled investigation was designed to test the hypothesis that α-lipoic acid supplementation and exercise training may elicit favourable clinical changes in obese subjects with IGT. All data were collected from 24 obese (BMI ≥ 30 kg/m2) IGT patients. Following participant randomisation into two groups, fasting venous blood samples were obtained at baseline, and before and following intervention. The first group consisted of 12 participants who completed a 12 week control phase followed by 12 weeks of chronic exercise at 65% HRmax for 30 minutes a day, 5 days per week, while ingesting 1 gram per day of α-lipoic acid for 12 weeks. The second group consisted of 12 participants who completed the same 12 week control phase, but this was followed by 12 weeks of 1 gram per day of α-lipoic acid supplementation only (no exercise). The main findings show a comparatively greater rate of low density lipoprotein (LDL) oxidation in the group consisting of α-lipoic acid only (p < 0.05 vs. pre intervention), although total oxidant status was lower post intervention (p < 0.05 vs. baseline) in this group. However, exercise and α-lipoic acid in combination attenuates LDL oxidation. Furthermore, in the α-lipoic acid supplement plus exercise training group, total antioxidant capacity was significantly increased (p < 0.05 vs. baseline and pre intervention). Body fat percentage and waist and hip circumference decreased following exercise training (p < 0.05 vs. post intervention). There were no selective treatment differences for a range of other clinical outcomes including glycaemic regulation (p > 0.05). These findings report that α-lipoic acid ingestion may increase the atherogenicity of LDL when ingested in isolation of exercise, suggesting that in IGT the use of this antioxidant treatment does not ameliorate metabolic disturbances, but instead may detrimentally contribute to the pathogenesis of atherosclerosis and development of CVD. However, when α-lipoic acid is combined with exercise, this atherogenic effect is abolished.

Effect of cinnamon on gastric emptying, arterial stiffness, postprandial lipemia, glycemia, and appetite responses to high-fat breakfast.

BACKGROUND: Cinnamon has been shown to delay gastric emptying of a high-carbohydrate meal and reduce postprandial glycemia in healthy adults. However, it is dietary fat which is implicated in the etiology and is associated with obesity, type 2 diabetes and cardiovascular disease. We aimed to determine the effect of 3 g cinnamon (Cinnamomum zeylanicum) on GE, postprandial lipemic and glycemic responses, oxidative stress, arterial stiffness, as well as appetite sensations and subsequent food intake following a high-fat meal. METHODS: A single-blind randomized crossover study assessed nine healthy, young subjects. GE rate of a high-fat meal supplemented with 3 g cinnamon or placebo was determined using the 13C octanoic acid breath test. Breath, blood samples and subjective appetite ratings were collected in the fasted and during the 360 min postprandial period, followed by an ad libitum buffet meal. Gastric emptying and 1-day fatty acid intake relationships were also examined. RESULTS: Cinnamon did not change gastric emptying parameters, postprandial triacylglycerol or glucose concentrations, oxidative stress, arterial function or appetite (p < 0.05). Strong relationships were evident (p < 0.05) between GE Thalf and 1-day palmitoleic acid (r = -0.78), eiconsenoic acid (r = -0.84) and total omega-3 intake (r = -0.72). The ingestion of 3 g cinnamon had no effect on GE, arterial stiffness and oxidative stress following a HF meal. CONCLUSIONS: 3 g cinnamon did not alter the postprandial response to a high-fat test meal. We find no evidence to support the use of 3 g cinnamon supplementation for the prevention or treatment of metabolic disease. Dietary fatty acid intake requires consideration in future gastrointestinal studies. TRIAL REGISTRATION NUMBER: at http://www.clinicaltrial.gov: NCT01350284.

The impact of acute moderate intensity exercise on arterial regional stiffness, lipid peroxidation, and antioxidant status in healthy males.

There is a paucity of research examining the influence of acute exercise on pulse wave velocity (PWV) and oxidative stress. The purpose of this study was to examine the effects of acute moderate aerobic exercise on PWV and oxidative stress in healthy males. Eight apparently healthy males (age 23.6 ± 2.8 yrs; stature 181.4 ± 8.1 cm; weight 83.4 ± 16.2 kg; all data mean ±SD) participated in a randomized crossover design consisting of (i) a one hour bout of moderate aerobic exercise and (ii) a control trial of one hour rest. Pre- and post-exercise blood samples were drawn for the determination of lipid hydroperoxides (LOOHs) and lipid-soluble antioxidants (lycopene, retinol, and ß-carotene). Exercise had no effect on stiffness and LOOHs (P > 0.05). Retinol and lycopene were increased following exercise (P < 0.05). These findings suggest that acute moderate exercise has no effect on PWV and LOOHs, but it can increase systemic antioxidants, which may be of benefit to health.

Exercise-induced lipid peroxidation: Implications for deoxyribonucleic acid damage and systemic free radical generation.

Exercise-induced deoxyribonucleic acid (DNA) damage is often associated with an increase in free radicals; however, there is a lack of evidence examining the two in parallel. This study tested the hypothesis that high-intensity exercise has the ability to produce free radicals that may be capable of causing DNA damage. Twelve apparently healthy male subjects (age: 23 ± 4 years; stature: 181 ± 8 cm; body mass: 80 ± 9 kg; and VO(2max) : 49 ± 5 ml/kg/min) performed three 5 min consecutive and incremental stages (40, 70, and 100% of VO(2max) ) of aerobic exercise with a 15-min period separating each stage. Blood was drawn after each bout of exercise for the determination of ex vivo free radicals, DNA damage, protein carbonyls, lipid hydroperoxide (LOOH) concentration, and a range of lipid-soluble antioxidants. Lipid-derived oxygen-centered free radicals (hyperfine coupling constants a(Nitrogen) = 13.7 Gauss (G) and aß(Hydrogen) = 1.8 G) increased as a result of acute moderate and high-intensity exercise (P < 0.05), while DNA damage was also increased (P < 0.05). Systemic changes were observed in LOOH and for lipid-soluble antioxidants throughout exercise (P < 0.05); however, there was no observed change in protein carbonyl concentration (P > 0.05). These findings identify lipid-derived free radical species as possible contributors to peripheral mononuclear cell DNA damage in the human exercising model. This damage occurs in the presence of lipid oxidation but in the absence of any change to protein carbonyl concentration. The significance of these findings may have relevance in terms of immune function, the aging process, and the pathology of carcinogenesis.

Acute exercise and impaired glucose tolerance in obese humans.

BACKGROUND: Individuals with impaired glucose tolerance (IGT) have a greater risk of developing diabetes and cardiovascular disease compared with those with normal glycemic control. The aim of this study was to examine the effects of acute aerobic exercise on glycemia, regional arterial stiffness, and oxidative stress in obese subjects with IGT. DESIGN: Twelve obese subjects (7 men and 5 women; 48.0±9.4 years; body mass index 32.4±7.0kg/m(2)) with IGT participated in a 30-minute bout of walking at 65% of maximum predicted heart rate. Pulse wave velocity (PWV, for determination of arterial stiffness) and blood pressure were examined before and after exercise, whereas venous blood samples were drawn for the determination of glucose, blood lipids, and indices of oxidative stress and inflammation (lipid hydroperoxides; superoxide dismutase; high-sensitivity C-reactive protein). RESULTS: After exercise PWV (9.1±1.2m/s vs. 8.6±1.0m/s), glucose (5.7±0.6 mmol·L(-1) vs. 5.4±0.6 mmol·L(-1)), and diastolic blood pressure (94±14mm Hg vs. 86±13mm Hg) decreased, respectively (P < .05). A correlation was observed between PWV and glucose (r=0.544, P < .05). There were no changes in lipid hydroperoxides, superoxide dismutase, high-sensitivity C-reactive protein, or blood lipids (P > .05). CONCLUSIONS: These findings suggest that acute aerobic exercise can reduce regional arterial stiffness in obese subjects with IGT by possibly improving glucose metabolism, independent of changes in oxidative stress.

Acute effects of walking on inflammatory and cardiovascular risk in sedentary post-menopausal women.

Biochemical markers of inflammation are emerging as new predictors of risk of cardiovascular disease (CVD) and may alter acutely with exercise. Few studies have been conducted on the effects of walking on these markers or whether different walking intensities elicit varied effects. As there is growing interest in modifiable lifestyle factors such as walking to reduce CVD risk, these inflammatory responses warrant investigation. The aim of this study was to compare the effects of walking at 50% versus 70% of predicted maximal heart rate on C-reactive protein (CRP), plasma fibrinogen, and triglycerides in sedentary post-menopausal women. Twelve post-menopausal women (mean age 58 years, s +/-6; stature 1.62 m, s+/-0.06; body mass 66.8 kg, s +/-6.2) completed two 30-min treadmill walks in a randomized cross-over design. Fasted blood samples were taken (for the determination of plasma fibrinogen, CRP, and lipids) before, immediately after, and 1 and 24 h after exercise. Triglyceride concentrations decreased from pre-exercise to 24 h post exercise at both walking intensities (time x group interaction, P < 0.05). No significant effects were observed for plasma fibrinogen, CRP, total cholesterol, low-density or high-density lipoprotein cholesterol (time x group interaction, P > 0.05). The results of this study suggest that fasting plasma triglycerides are decreased on the morning after 30 min of brisk walking at either 50% or 70% of maximal heart rate (moderate and vigorous intensity).

Exercise and postprandial lipaemia: effects on peripheral vascular function, oxidative stress and gastrointestinal transit.

Postprandial lipaemia may lead to an increase in oxidative stress, inducing endothelial dysfunction. Exercise can slow gastric emptying rates, moderating postprandial lipaemia. The purpose of this study was to determine if moderate exercise, prior to fat ingestion, influences gastrointestinal transit, lipaemia, oxidative stress and arterial wall function. Eight apparently healthy males (age 23.6 +/- 2.8 yrs; height 181.4 +/- 8.1 cm; weight 83.4 +/- 16.2 kg; all data mean +/- SD) participated in the randomised, crossover design, where (i) subjects ingested a high-fat meal alone (control), and (ii) ingested a high-fat meal, preceded by 1 h of moderate exercise. Pulse Wave Velocity (PWV) was examined at baseline, post-exercise, and in the postprandial period. Gastric emptying was measured using the 13C-octanoic acid breath test. Measures of venous blood were obtained prior to and following exercise and at 2, 4 and 6 hours post-ingestion. PWV increased (6.5 +/- 1.9 m/sec) at 2 (8.9 +/- 1.7 m/sec) and 4 hrs (9.0 +/- 1.6 m/sec) post-ingestion in the control group (time x group interaction, P < 0.05). PWV was increased at 2 hrs post-ingestion in the control compared to the exercise trial; 8.9 +/- 1.7 vs. 6.2 +/- 1.5 m/sec (time x group interaction, P < 0.05). Lipid hydroperoxides increased over time (pooled exercise and control data, P < 0.05). Serum triacylglycerols were elevated postprandially (pooled exercise and control data, P < 0.05). There were no changes in gastric emptying, cholesterol, or C-reactive protein levels. These data suggest that acute exercise prior to the consumption of a high-fat meal has the potential to reduce vascular impairments.

The effect of acute aerobic exercise on pulse wave velocity and oxidative stress following postprandial hypertriglyceridemia in healthy men.

Oxidative stress is postulated to be responsible for the postprandial impairments in vascular function. The purpose of this study was to measure pulse wave velocity (PWV) and markers of postprandial oxidative stress before and after an acute bout of moderate exercise. Ten trained male subjects (age 21.5 +/- 2.5 years, VO2 max 58.5 +/- 7.1 ml kg(-1) min(-1)) participated in a randomised crossover design: (1) high-fat meal alone (2) high-fat meal followed 2 h later by a bout of 1 h moderate (60% max HR) exercise. PWV was examined at baseline, 1, 2, 3, and 4 h postprandially. Blood Lipid hydroperoxides (LOOHs), Superoxide dismutase (SOD) and other biochemical markers were measured. PWV increased at 1 h (6.49 +/- 2.1 m s(-1)), 2 h (6.94 +/- 2.4 m s(-1)), 3 h (7.25 +/- 2.1 m s(-1)) and 4 h (7.41 +/- 2.5 m s(-1)) respectively, in the control trial (P < 0.05). There was no change in PWV at 3 h (5.36 +/- 1.1 m s(-1)) or 4 h (5.95 +/- 2.3 m s(-1)) post ingestion in the exercise trial (P > 0.05). LOOH levels decreased at 3 h post ingestion in the exercise trial compared to levels at 3 h (P < 0.05) in the control trial. SOD levels were lower at 3 h post ingestion in the control trial compared to 3 h in the exercise trial (0.52 +/- 0.05 vs. 0.41 +/- 0.1 units mul(-1); P < 0.05). These findings suggest that a single session of aerobic exercise can ameliorate the postprandial impairments in arterial function by possibly reducing oxidative stress levels.

The effect of serum creatinine method choice on estimated glomerular filtration rate determined by the abbreviated MDRD formula.

BACKGROUND: The aim of this study was to measure the variability in estimated glomerular filtration rate (eGFR) calculated by laboratories in Northern Ireland where creatinine assays other than the Beckman CX3 assay used to derive the Modification of Diet in Renal Disease (MDRD) are utilized. METHODS: Fifty patient samples were analysed for serum creatinine by kinetic Jaffe assays on the Roche modular P-800 (compensated assay), the Beckman LX20 and the Abbott Aeroset analysers. RESULTS: The median (interquartile range) eGFR calculated by the abbreviated MDRD equation using the creatinine results obtained by each method were 45.4 (31.7-66.6), 49.2 (35.4-78.1) and 50.0 (35.1-71.2) mL/min/1.73 m2 for Beckman, Roche (compensated) and Abbott assays, respectively. Following mathematical alignment of creatinine methods to the Beckman method the median (interquartile range) eGFR for the Roche and Abbott methods were 44.0 (32.0-67.6) and 45.6 (31.2-64.8) mL/min/1.73 m2, respectively. CONCLUSION: The regression equations published in this study can be used to align creatinine methods. However, method-related biases in eGFR of up to 10% are minimal in the context of the magnitude of variance reflected in the 90% confidence intervals.