Systemic and vascular markers of inflammation in relation to metabolic syndrome and insulin resistance in adults with elevated atherosclerosis risk.

OBJECTIVE: In recent years high sensitive C-reactive protein (hsCRP), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular cell adhesion molecule-1 (sICAM-1), fibrinogen, and plasminogen activator inhibitor-1 (PAI-1) were recognized as risk factors for cardiovascular disease (CVD). The aim of the present study was to investigate the relationship between these vascular and systemic markers of low-grade inflammation and traditional risk factors, the metabolic syndrome (MetS) or insulin resistance (IR). METHODS AND RESULTS: In 137 adults (41-78 years) with at least 2 risk factors for atherosclerosis the following parameters were determined: hsCRP, sVCAM-1, sICAM-1, PAI-1, fibrinogen, waist circumference (WC), blood pressure, Body Mass Index (BMI), fasting serum glucose (FSG), insulin, triglycerides (TG), total cholesterol (TC), LDL, and HDL. The presence or absence of MetS according to the AHA/NHLBI Scientific Statement criteria was assessed. IR was defined using the homeostasis model (HOMA-IR). Subjects with MetS had significantly higher values of hsCRP, sICAM-1, sVCAM-1, PAI-1, fibrinogen (each P<0.05) and lower HDL-levels (P<0.05) compared with subjects without MetS. Similar results were found using HOMA-IR-quartiles. Subjects in the bottom quartile (HOMA-IRor=5.03). HDL was significantly higher (P<0.05) in subjects in the lowest quartile versus those in the highest quartile. Incidentally we found no significant differences in total and LDL cholesterol among MetS, HOMA, and traditional CVD risk factor groups, respectively. CONCLUSION: Systemic and vascular markers of inflammation showed significant associations with IR and the MetS and may be incorporated into traditional CVD risk prediction models. Such models should be established and validated in forthcoming large scale prospective studies on CVD risk.

Nutrition concepts for elite distance runners based on macronutrient and energy expenditure.

CONTEXT: Elite distance runners (EDR) must optimize their nutrition to maintain their demanding training schedules. OBJECTIVE: To develop a nutrition concept for EDR based on energy and macronutrient expenditures. DESIGN: This theoretical study provides calculations for macronutrient and energy expenditures of EDR. Anthropometric and metabolic characteristics of EDR were assumed based on average real EDR. SETTING: University of Kiel. PATIENTS OR OTHER PARTICIPANTS: Three prototypic types of male EDR described in the literature as type I (TI; body mass = 72 kg, respiratory quotient = 0.9 at rest, fast-twitch muscle fibers = 60% to 70%), type II (TII; body mass = 67 kg, respiratory quotient = 0.82 at rest, fast-twitch muscle fibers = 50%), and type III (TIII; body mass = 60 kg, respiratory quotient = 0.75 at rest, fast-twitch muscle fibers = 30% to 40%). MAIN OUTCOME MEASURE(S): We calculated the macronutrient and energy expenditures of the 3 types of EDR according to body mass, respiratory quotient, and percentage of fast-twitch muscle fibers. RESULTS: We found that the average energy expenditure was 3750 kcal . d(-1) for TI runners, 3463 kcal . d(-1) for TII runners, and 3079 kcal . d(-1) for TIII runners. The carbohydrate (CHO) expenditure reached an average value of 10.0 g . kg(-1) . d(-1) for TI runners, 8.0 g . kg(-1) . d(-1) for TII runners, and 4.7 g . kg(-1) . d(-1) for TIII runners. When the EDR accomplished running sessions at a pace >or=100% of maximum oxygen consumption, all types of runners had a CHO demand of about 10 g . kg(-1) . d(-1). The TI and TII runners need a CHO intake of 8 to 10 g . kg(-1) . d(-1). For the TIII runners, a CHO intake >6 g . kg(-1) . d(-1) is necessary during anaerobic training sessions. CONCLUSIONS: Nutrition concepts must be differentiated for EDR according to metabolic and anthropometric characteristics of the runners and their special training emphases.