Improved walking energy efficiency might persist in presence of simulated full weight regain after multidisciplinary weight loss in adolescents with obesity: the POWELL study.

AIM: Weight loss leads to a reduction of the energy cost of walking but the respective implications of the metabolic and mechanic changes remain unknown. The present study compares the post-weight loss energy cost of walking (Cw) with and without a total reload of the induced weight reduction in adolescents with obesity. METHODS: Energy cost of walking and substrate use were evaluated during a graded walking exercise (4×6-min at 0.75, 1, 1.25, 1.5 m.s-1) before (V1) and after a 12-week intervention in 21 adolescents with obesity (11 girls; 13.8 ± 1.4 y). After weight loss, the walking exercise was randomly repeated once without weight reload (V2) and once with a loading corresponding to the total induced weight loss during the program (V2L). Body composition was assessed before and after the intervention. RESULTS: Body weight and fat mass decreased in response to the 12-week intervention (p < 0.001), while FFM did not change. The absolute gross Cw (ml.m-1) was higher on V1 compared with V2 at every speed. The absolute net Cw (ml.m-1) was higher on V1 compared to V2L at 0.75 m.s-1 (p = 0.04) and 1 m.s-1 (p = 0.02) and higher on V2L compared with V2 at 1.5 m.s-1 (p = 0.03). Net Cw (ml.m-1.kg-1) on V1 being higher than V2 (p < 0.001), and V2L higher than V2 (p = 0.006). The absolute CHO oxidation (mg.min-1) did not show any condition effect (p = 0.12) while fat utilization was higher on V1 compared to V2 and V2L (p < 0.001). Relative to body weight CHO oxidation was lower on V1 compared to V2 (p = 0.04) and V2L (p = 0.004) while relative to body weight fat oxidation was higher on V1 than V2 (p = 0.002). CONCLUSION: Adolescents with obesity might not show an entire rise back to pre-weight loss values of their metabolic cost of walking when weight gain is simulated. These new findings suggest metabolic and physiological adaptations to weight loss of the energy metabolism that remain to be clarified.

Soluble Milk Proteins Improve Muscle Mass Recovery after Immobilization-Induced Muscle Atrophy in Old Rats but Do not Improve Muscle Functional Property Restoration.

OBJECTIVES: Effect of 3 different dairy protein sources on the recovery of muscle function after limb immobilization in old rats. DESIGN: Longitudinal animal study. SETTING: Institut National de la Recherche Agronomique (INRA). The study took part in a laboratory setting. INTERVENTION: Old rats were subjected to unilateral hindlimb immobilization for 8 days and then allowed to recover with 3 different dietary proteins: casein, soluble milk proteins or whey proteins for 49 days. MEASUREMENTS: Body weight, muscle mass, muscle fibre size, isometric, isokinetic torque, muscle fatigability and muscle oxidative status were measured before and at the end of the immobilization period and during the recovery period i.e 7, 21, 35 and 49 days post immobilization. RESULTS: In contrast to the casein diet, soluble milk proteins and whey proteins were efficient to favor muscle mass recovery after cast immobilization during aging. By contrast, none of the 3 diary proteins was able to improve muscle strength, power and fatigability showing a discrepancy between the recovery of muscle mass and function. However, the soluble milk proteins allowed a better oxidative capacity in skeletal muscle during the rehabilitation period. CONCLUSION: Whey proteins and soluble milk proteins improve muscle mass recovery after immobilization-induced muscle atrophy in old rats but do not allow muscle functional property restoration.

The bigger, the stronger? Insights from muscle architecture and nervous characteristics in obese adolescent girls.

BACKGROUND: Young obese youth are generally stronger than lean youth. This has been linked to the loading effect of excess body mass, acting as a training stimulus comparable to strength training. Whether this triggers specific adaptations of the muscle architecture (MA) and voluntary activation (VA) that could account for the higher strength of obese subjects remains unknown. METHODS: MA characteristics (that is, pennation angle (PA), fascicle length (FL) and muscle thickness (MT)) and muscle size (that is, anatomical cross-sectional area (ACSA)) of the knee extensor (KE) and plantar flexor (PF) muscles were evaluated in 12 obese and 12 non-obese adolescent girls (12-15 years). Maximal isometric torque and VA of the KE and PF muscles were also assessed. RESULTS: Results revealed higher PA (P<0.05), greater MT (P<0.001), ACSA (P<0.01), segmental lean mass (P<0.001) and VA (P<0.001) for KE and PF muscles in obese girls. Moreover, obese individuals produced a higher absolute torque than their lean counterparts on the KE (224.6±39.5 vs 135.7±32.7 N m, respectively; P<0.001) and PF muscles (73.3±16.5 vs 44.5±6.2 N m; P<0.001). Maximal voluntary contraction (MVC) was correlated to PA for the KE (r=0.46-0.57, P<0.05-0.01) and PF muscles (r=0.45-0.55, P<0.05-0.01). MVC was also correlated with VA (KE: r=0.44, P<0.05; PF: r=0.65, P<0.001) and segmental lean mass (KE: r=0.48, P<0.05; PF: r=0.57, P<0.01). CONCLUSIONS: This study highlighted favorable muscular and nervous adaptations to obesity that account for the higher strength of obese youth. The excess of body mass supported during daily activities could act as a chronic training stimulus responsible for these adaptations.

Children have a reduced maximal voluntary activation level of the adductor pollicis muscle compared to adults.

PURPOSE: The role of nervous factors in the muscle strength difference between children and adults is debated, and the level of physical activity may confound this comparison. The purpose of this study was thus to compare, between children and adults, the maximal voluntary activation level (MVA) of the adductor pollicis (AP) muscle, which is weakly influenced by the level of physical activity. METHODS: Thirteen boys (11.6 ± 0.1 years) and eight men (25.6 ± 1.5 years) were involved in this study. Neuromuscular function assessment included the evaluation of maximal voluntary contraction (MVC) force and of the MVA from peripheral magnetic stimulations of the ulnar nerve. The cross-sectional area of the AP muscle was determined with ultrasonography and used to calculate the specific force. A theoretical value of specific force, extrapolated for a full MVA, was finally computed (specific force@100 % MVA). RESULTS: MVC force (66.8 ± 6.2 vs. 111.0 ± 4.5 N, respectively; P < 0.001) and MVA (85.0 ± 2.7 vs. 94.8 ± 1.4 %, respectively; P < 0.05) were significantly lower in children compared to adults. The specific force was lower in children compared to adults (46.8 ± 3.6 vs. 56.9 ± 2.5 N/cm(2), respectively; P < 0.05), but the specific force@100 % MVA did not differ between groups. CONCLUSION: The results suggest that on an untrained muscle such as the AP muscle, the reduced ability of children to voluntarily activate their muscle could partly account for the difference of muscle strength between children and adults.

The impact of eating habits on anthropometric characteristics in French primary school children.

BACKGROUND: Obesity is increasing worldwide, reaching alarming proportions. Eating habits have changed over time and nowadays children and adolescents' environment favours the adoption of unhealthy eating behaviours leading to metabolic impairment. OBJECTIVE: To explore the impact of eating risk factors and their cumulative effect on anthropometric characteristics in French primary school children. METHODS: A total of 278 healthy French children (7.50 ± 0.67 years old) and their legal representatives agreed to take part in this study. Parents were asked to fill in an eating habits clinical questionnaire with questions about skipping breakfast, snacking between meals, eating in front of the TV and sugar-sweetened beverage consumption. On the basis of the answers, children were classified into four categories as a function of the number of eating risk factors they presented. Body mass index (BMI), the sum of four skinfolds (Σ4 skinfolds: tricipital, bicipital, sub-scapular and supra-iliac) and waist circumference (WC) were measured. BMI was transformed into z-BMI for each child. RESULTS: ANOVA and unpaired t-test provided significantly higher z-BMI, Σ4 skinfolds and WC in children who were used to skipping breakfast, snacking, watching TV while eating and consuming sugar-sweetened beverages. The more children accumulated eating risk factors, the higher were their z-BMI, Σ4 skinfolds and WC (MANOVA: P < 0.001). CONCLUSIONS: Eating habits appear to be associated with anthropometric characteristics in French primary school children. Anthropometric values (z-BMI, Σ4 skinfolds and WC) increased with the number of eating risk factors they presented.

Effects of age and recovery duration on performance during multiple treadmill sprints.

The aim of this study was to investigate the effects of age and recovery duration on performance during multiple treadmill sprints. Twelve boys (11.7 +/- 0.5 y) and thirteen men (22.1 +/- 2.9 y) performed ten consecutive 10-s sprints on a non-motorised treadmill separated by 15-s (R15) and 180-s (R180) passive recovery intervals. Mean power output (MPO), mean force output (MFO), running velocity, step length, and step rate were calculated for each sprint. Capillary blood samples were drawn from the fingertip at rest and 3 min after the tenth sprint to measure the lactate accumulation (Delta [La]). With R15, all mechanical parameters decreased significantly less in the boys than in the men over the ten sprints (MPO: - 28.9 vs. - 47.0 %, MFO: - 13.1 vs. - 25.6 %, running velocity: - 18.8 vs. - 29.4 %, p < 0.001, respectively). With R180, all mechanical values remained unchanged in the boys. In the men, MPO and MFO significantly decreased over the ten sprints (- 7.8 % and - 4.6 %, p < 0.05, respectively). The running velocity, however, did not decrease because the decrease in step rate (p < 0.001) was compensated by an increase in step length. For either recovery interval, Delta [La] values were higher in the men compared to the boys (R15: 12.7 vs. 7.7 mmol . L (-1), p < 0.001, R180: 10.7 vs. 7.7 mmol . L (-1), p < 0.05). To conclude, the boys maintained more easily their running performance than the men during repeated treadmill sprints with R15. Three-minute recovery periods were sufficient in the boys to repeat short running sprints without substantial fatigue. Despite the decrease in power and force outputs with R180, the young men were able to maintain their running velocity during the test.

Gender differences in peak muscle performance during growth.

Gender-related differences in maximal leg muscle power were examined in 496 females and 426 males aged 8 to 20 years. Cycling peak power (CPP, including the force required to accelerate the flywheel of the cycle ergometer) was measured during three sprints. Optimal velocity (Vopt, velocity at CPP) was also determined. No gender-differences were observed in anthropometric characteristics and cycling performance between 8- and 14-year-old. From age 14, however, males showed a higher CPP than females, but also a higher lean leg volume (LLV, assessed by anthropometry). Allometric relationship between CPP and LLV (CPP = a . LLV ( b)) showed a clear gender-differentiation between 14- and 16-year-old: LLV exponent (b) was 1.05 in males vs. 0.74 in females. From 16 years onwards, analysis of covariance (ANCOVA) showed that the slopes of the CPP-LLV relationship were similar in both genders, but the intercepts differed. In other words, for a similar LLV, males showed greater CPP than females. It was suggested that this sex-related difference was due to total body fat increase, and more specifically lower-limb fat increase during puberty in girls, whilst the boys experienced increased lean body mass. Considering that the same gender-related difference was observed for optimal velocity adjusted for leg length, other factors such as fibre type variability or (and) neuromuscular activation might also be partly responsible for the higher peak muscle performance observed in males.

High-intensity intermittent activities at school: controversies and facts.

In comparison to continuous aerobic type activity, little is known about high-intensity intermittent physical activity in children. Repeated short-term high-intensity activities (> maximal aerobic speed and <10 s) are more characteristic of the spontaneous physical activity of children. Recent studies have shown during repetitive bouts of sprints separated by short recovery intervals, that prepubescent children compared with adults are more able to maintain their performance without substantial fatigue. Moreover, repetitive runs at high velocities (near and higher than the maximal aerobic speed) separated by short recovery periods may elicit a high oxygen consumption in children. Several studies using interval training programmes for 7 weeks, twice a week for 30 min in physical education lessons showed that children's aerobic performance (maximal O2 uptake, maximal aerobic speed) could be enhanced. Training based on these repeated short-term high-intensity exercises could also improve children's anaerobic performance (short-term muscle power, strength and speed). Current evidence suggests that recovery from high-intensity exercises is faster in children than in adults and that repeated runs at high velocities separated by short recovery intervals can improve both aerobic and anaerobic performance. Although continuous aerobic type activity is more scientifically established as a training mode, repeated short-term high-intensity exercises in physical education programmes should be considered to enhance aerobic, as well as, anaerobic fitness in children.

Age differences in human skeletal muscle fatigue during high-intensity intermittent exercise.

UNLABELLED: It has been shown at similar relative work rates that children have higher resistance to fatigue than adults during repeated bouts of high-intensity exercise. This age-related difference in fatigue resistance may be explained by factors including muscle mass, muscle morphology, energy metabolism and neuromuscular activation. CONCLUSION: During high-intensity intermittent exercise, recovery periods play an important role in limiting fatigue. Age-related differences in fatigue resistance could also be explained by differences in the rates of resynthesis of some energetic substrates and the rates of removal of various muscle metabolites.

Effects of age and recovery duration on peak power output during repeated cycling sprints.

The aim of the present study was to investigate the effects of age and recovery duration on the time course of cycling peak power and blood lactate concentration ([La]) during repeated bouts of short-term high-intensity exercise. Eleven prepubescent boys (9.6 +/- 0.7 yr), nine pubescent boys (15.0 +/- 0.7 yr) and ten men (20.4 +/- 0.8 yr) performed ten consecutive 10 s cycling sprints separated by either 30 s (R30), 1 min (R1), or 5 min (R5) passive recovery intervals against a friction load corresponding to 50 % of their optimal force (50 % Ffopt). Peak power produced at 50 % Ffopt (PP50) was calculated at each sprint including the flywheel inertia of the bicycle. Arterialized capillary blood samples were collected at rest and during the sprint exercises to measure the time course of [La]. In the prepubescent boys, whatever recovery intervals, PP50 remained unchanged during the ten 10 s sprint exercises. In the pubescent boys, PP50 decreased significantly by 18.5 % (p < 0.001) with R30 and by 15.3 % (p < 0.01) with R1 from the first to the tenth sprint but remained unchanged with R5. In the men, PP50 decreased respectively by 28.5 % (p < 0.001) and 11.3 % (p < 0.01) with R30 and R1 and slightly diminished with R5. For each recovery interval, the increase in blood [La] over the ten sprints was significantly lower in the prepubescent boys compared with the pubescent boys and the men. To conclude, the prepubescent boys sustained their PP50 during the ten 10 s sprint exercises with only 30 s recovery intervals. In contrast, the pubescent boys and the men needed 5 min recovery intervals. It was suggested that the faster recovery of PP50 in the prepubescent boys was due to their lower muscle glycolytic activity and their higher muscle oxidative capacity allowing a faster resynthesis in phosphocreatine.

Acid-base balance during repeated cycling sprints in boys and men.

The aim of this study was to investigate the acid-base balance during repeated cycling sprints in children and adults. Eleven boys (9.6 +/- 0.7 yr) and ten men (20.4 +/- 0.8 yr) performed ten 10-s sprints on a cycle ergometer separated by 30-s passive recovery intervals. To measure the time course of lactate ([La]), hydrogen ions ([H(+)]), bicarbonate ions ([HCO(3)(-)]), and base excess concentrations and the arterial partial pressure of CO(2), capillary blood samples were collected at rest and after each sprint. Ventilation and CO(2) output were continuously measured. After the 10th sprint, concentrations of boys vs. men were as follows: [La], 8.5 +/- 2.1 vs. 15.4 +/- 2.0 mmol/l; [H(+)], 43.8 +/- 1.3 vs. 66.9 +/- 9.9 nmol/l (P < 0.001). Significant correlations showed that, for a given [La], [H(+)] was lower in the boys compared with the men (P < 0.001). Significant relationships also indicated that, for a given [La], [HCO(3)(-)] and base excess concentration were similar in the boys compared with the men. Moreover, significant relationships revealed that, for a given [H(+)] or [HCO(3)(-)], arterial partial pressure of CO(2) was lower in the boys compared with the men (P < 0.001). The ventilation-to-CO(2) output ratio was higher in the boys during the first five rest intervals and was then higher in the men during the last five sprints. To conclude, during repeated sprints, the ventilatory regulation related to the change in acid-base balance induced by lactic acidosis was more important during the first rest intervals in the boys compared with the men.

Pathology of arrhythmogenic right ventricular cardiomyopathy/dysplasia--an autopsy study of 20 forensic cases.

Arrhythmogenic right ventricular dysplasia/ cardiomyopathy (ARVC) is characterized histologically by massive infiltration of the right ventricular wall by fat tissue, with surviving strands of cardiomyocytes bordered by or embedded in fibrosis. ARVC has been recognized as a cause of sudden death, especially in the young. The purpose of our autopsy study was to examine the clinical characteristics and the pathological patterns in the hearts of 20 people who died suddenly of ARVC. In view of our findings and the literature, we discussed the possible causes and pathogenesis of ARVC, as well as the mechanisms by which sudden death occurs in this disease. During the 7-year study period, 20 hearts from 9 men and 11 women fulfilled the criteria for ARVC. The mean age was 41 years (range, 17 to 80). The disease was unknown prior to death in all cases. Fourteen persons died at rest, and six on effort. In 9 of the 20 cases, the trigger of sudden death was an acute emotional stress, sometimes associated with a moderate physical activity. The mean heart weight was 380 g (range, 280 to 520). Both ventricles were involved in 40% of the cases. Inflammatory infiltrates consisting of lymphocytes were present in 60% of the cases, but myocyte necrosis was found in only one case. ARVC is more likely to result from a degenerative process than a congenital disorder. Genetic factors, viral or autoimmune inflammation or both, and apoptosis are also involved in the degenerative disorder.