The Association Between an Addictive Tendency Toward Food and Metabolic Characteristics in the General Newfoundland Population.

Background: Our previous study of 29 obese food addiction (FA) patients found that FA is associated with lipid profiles and hormones which may be a factor in cardiovascular disease (CVD) and insulin resistance (IR). However, there is currently no data available regarding the relationship between FA symptoms and metabolic characteristics of CVD and IR in the general population. We designed this study to investigate the correlation between FA symptoms with lipid profiles and IR in men and women of the general Newfoundland population. Methods: 710 individuals (435 women and 275 men) recruited from the general Newfoundland population were used in analysis. FA symptoms were evaluated using the Yale Food Addiction Scale (YFAS). Glucose, insulin, HDL, LDL, total cholesterol and triglycerides levels were measured. IR was evaluated using the homeostatic model of assessment (HOMA). Participants were grouped by sex and menopausal status. Age, physical activity, calories and total % body fat were controlled. Results: Partial correlation analysis revealed that in men, YFAS symptom counts were significantly correlated with HOMA-ß (r = 0.196, p = 0.021), triglycerides (r = 0.140, p = 0.025) and inversely correlated with HDL (r = -0.133, p = 0.033). After separating by menopausal status, pre-menopausal women exhibited no correlations and post-menopausal women had a significantcorrelation with triglycerides (r = 0.198, p = 0.016). Conclusion: FA is significantly correlated with several markers of metabolic disturbance in men and to a lesser extent, post-menopausal women, in the general population. Further research is required to explain sex specific associations and elucidate any potentially causal mechanisms behind this correlation.

Serum metabolic biomarkers distinguish metabolically healthy peripherally obese from unhealthy centrally obese individuals.

BACKGROUND: Metabolic abnormalities are more associated with central obesity than peripheral obesity, but the underlying mechanisms are largely unknown. The present study was to identify serum metabolic biomarkers which distinguish metabolically unhealthy centrally obese (MUCO) from metabolically healthy peripherally obese (MHPO) individuals. METHODS: A two-stage case-control study design was employed. In the discovery stage, 20 individuals (10 MHPO and 10 MUCO) were included and in the following validation stage, 79 individuals (20 normal weight (NW), 30 MHPO, 29 MUCO) were utilized. Study groups were matched for age, sex, physical activity and total dietary calorie intake with MHPO and MUCO additionally matched for BMI. Metabolic abnormality was defined as: 1) HOMA-IR > 4.27 (90(th) percentile), 2) high-density lipoprotein cholesterol < 1.03 mmol/L in men and < 1.30 mmol/L in women, 3) fasting blood glucose ≥ 5.6 mmol/L, and 4) waist circumference > 102 cm in men and > 88 cm in women. MUCO individuals had all of these abnormalities whereas MHPO and NW individuals had none of them. A targeted metabolomics approach was performed on fasting serum samples, which can simultaneously identify and quantify 186 metabolites. RESULTS: In the discovery stage, serum leucine, isoleucine, tyrosine, valine, phenylalanine, alpha-aminoadipic acid, methioninesulfoxide and propionylcarnitine were found to be significantly higher in MUCO, compared with MHPO group after multiple testing adjustment. Significant changes of five metabolites (leucine, isoleucine, valine, alpha-aminoadipic acid, propionylcarnitine) were confirmed in the validation stage. CONCLUSIONS: Significantly higher levels of serum leucine, isoleucine, valine, alpha-aminoadipic acid, propionylcarnitine are characteristic of metabolically unhealthy centrally obese patients. The finding provides novel insights into the pathogenesis of metabolic abnormalities in obesity.

Effect of FTO Gene and Physical Activity Interaction on Trunk Fat Percentage Among the Newfoundland Population.

OBJECTIVE: To explore the effect of FTO gene and physical activity interaction on trunk fat percentage. DESIGN AND METHODS: Subjects are 3,004 individuals from Newfoundland and Labrador whose trunk fat percentage and physical activity were recorded, and who were genotyped for 11 single-nucleotide polymorphisms (SNPs) in the FTO gene. Subjects were stratified by gender. Multiple tests and multiple regressions were used to analyze the effects of physical activity, variants of FTO, age, and their interactions on trunk fat percentage. Dietary information and other environmental factors were not considered. RESULTS: Higher levels of physical activity tend to reduce trunk fat percentage in all individuals. Furthermore, in males, rs9939609 and rs1421085 were significant (α = 0.05) in explaining central body fat, but no SNPs were significant in females. For highly active males, trunk fat percentage varied significantly between variants of rs9939609 and rs1421085, but there is no significant effect among individuals with low activity. The other SNPs examined were not significant in explaining trunk fat percentage. CONCLUSIONS: Homozygous male carriers of non-obesity risk alleles at rs9939609 and rs1421085 will have significant reduction in central body fat from physical activity in contrast to homozygous males of the obesity-risk alleles. The additive effect of these SNPs is found in males with high physical activity only.

The effect of a short-term high-intensity circuit training program on work capacity, body composition, and blood profiles in sedentary obese men: a pilot study.

The objective of this study was to determine how a high-intensity circuit-training (HICT) program affects key physiological health markers in sedentary obese men. Eight obese (body fat percentage >26%) males completed a four-week HICT program, consisting of three 30-minute exercise sessions per week, for a total of 6 hours of exercise. Participants' heart rate (HR), blood pressure (BP), rating of perceived exertion, total work (TW), and time to completion were measured each exercise session, body composition was measured before and after HICT, and fasting blood samples were measured before throughout, and after HICT program. Blood sample measurements included total cholesterol, triacylglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, glucose, and insulin. Data were analyzed by paired t-tests and one-way ANOVA with repeated measures. Statistical significance was set to P < 0.05. Data analyses revealed significant (P < 0.05) improvements in resting HR (16% decrease), systolic BP (5.5% decrease), TW (50.7%), fat tissue percentage (3.6%), lean muscle tissue percentage (2%), cholesterol (13%), triacylglycerol (37%), and insulin (18%) levels from before to after HICT program. Overall, sedentary obese males experienced a significant improvement in biochemical, physical, and body composition characteristics from a HICT program that was only 6 hours of the total exercise.

The Association of Serum Total Peptide YY (PYY) with Obesity and Body Fat Measures in the CODING Study.

BACKGROUND: PYY is an appetite suppressing hormone. Low circulating PYY has been linked to greater BMI. However data is controversial and this association has not been verified in large human populations. OBJECTIVE: The purpose of this study was to investigate if fasting serum total PYY is associated with obesity status and/or adiposity at the population level. DESIGN: A total of 2094 subjects (Male-523, Female-1571) participated in this investigation. Total PYY was measured in fasting serum by enzyme-linked immunosorbent assay. Obesity status (NW-normal-weight, OW-overweight and OB-obese) was determined by the Bray Criteria according to body fat percentage measured by dual-energy x-ray absorptiometry and the WHO criteria according to BMI. One-way ANOVA and multiple regression was used to assess the adiposity-specific association between PYY and the following; weight, BMI, waist-circumference, hip-circumference, waist-hip ratio, percent body fat (%BF), trunk fat (%TF), android fat (%AF) and gynoid fat (%GF). RESULTS: PYY was not significantly different among NW, OW and OB groups defined by neither %BF nor BMI for both men and women. However among women, fasting PYY was positively associated with adiposity measures. Women with the highest (Top 33%) waist-circumference, %BF and %TF had significantly higher PYY (10.5%, 8.3% and 9.2% respectively) than women with the lowest (Bottom 33%). Age, smoking, medication use and menopause were all positively associated with PYY levels in women but not in men. CONCLUSION: To our knowledge this is the largest population based study, with the most comprehensive analysis and measures of confounding factors, to explore the relationship of circulating PYY with obesity. Contrary to initial findings in the literature we discovered that PYY was positively associated with body fat measures (waist-circumference, %BF and %TF) in women. Although the effect size of the positive association of PYY with obesity in women is small, and potentially negligible, it may in fact represent a protective response against significant weight gain.

Beneficial association of serum ghrelin and peptide YY with bone mineral density in the Newfoundland population.

BACKGROUND: Ghrelin and peptide YY (PYY) are appetite regulating hormones secreted from the gastrointestinal tract (gut). Aside from their known effect on energy homeostasis, accumulating data indicates that these gut hormones also affect bone metabolism. However, data regarding the influence of ghrelin and PYY on bone density in humans is very limited, and the results are inconclusive. Therefore, this study was designed to investigate the potential association between circulating ghrelin and PYY with bone density indices in the general population. METHODS: A total of 2257 adult subjects from the CODING (Complex Diseases in the Newfoundland Population: Environment and Genetics) study participated in this investigation. Acylated ghrelin and total PYY were measured in serum after a 12-hour fasting, with the Enzyme- Linked Immunosorbent Assay (ELISA) method. Bone mineral density was measured by dual-energy X-ray absorptiometry at the spine, femoral neck, and total hip. Multiple regression analyses adjusting for age, BMI, physical activity, smoking, and alcohol consumption were employed to analyze the association between serum ghrelin and PYY with bone mineral density parameters. RESULTS: Significant positive associations of ghrelin concentration with L2-L4 BMD, L2-L4 Z-score, femoral neck BMD, femoral neck Z-score, total hip BMD, and total hip Z-score were found in women. No significant correlations between ghrelin and bone density indices were present in men. After dividing the female group into pre-menopausal and post-menopausal, ghrelin was positively correlated with femoral neck Z-score, and total hip Z-score in pre-menopausal women and L2-L4 BMD, and Z-score in post-menopausal group. Moreover, no significant association was discovered between serum PYY and bone density at any site. CONCLUSION: Our results suggest a beneficial association of circulating ghrelin concentration with bone density in women at the population level. This association is independent of major confounding factors including BMI, physical activity, age, alcohol consumption, and smoking. Effect of menopause on this association seemed to be site specific. However, PYY does not seem to be associated with bone density parameters.

Food addiction: its prevalence and significant association with obesity in the general population.

BACKGROUND: 'Food addiction' shares a similar neurobiological and behavioral framework with substance addiction. However whether, and to what degree, 'food addiction' contributes to obesity in the general population is unknown. OBJECTIVES: to assess 1) the prevalence of 'food addiction' in the Newfoundland population; 2) if clinical symptom counts of 'food addiction' were significantly correlated with the body composition measurements; 3) if food addicts were significantly more obese than controls, and 4) if macronutrient intakes are associated with 'food addiction'. DESIGN: A total of 652 adults (415 women, 237 men) recruited from the general population participated in this study. Obesity was evaluated by Body Mass Index (BMI) and Body Fat percentage measured by dual-energy X-ray absorptiometry. 'Food addiction' was assessed using the Yale Food Addiction Scale and macronutrient intake was determined from the Willet Food Frequency Questionnaire. RESULTS: The prevalence of 'food addiction' was 5.4% (6.7% in females and 3.0% in males) and increased with obesity status. The clinical symptom counts of 'food addiction' were positively correlated with all body composition measurements across the entire sample (p<0.001). Obesity measurements were significantly higher in food addicts than controls; Food addicts were 11.7 (kg) heavier, 4.6 BMI units higher, and had 8.2% more body fat and 8.5% more trunk fat. Furthermore, food addicts consumed more calories from fat and protein compared with controls. CONCLUSION: Our results demonstrated that 'food addiction' contributes to severity of obesity and body composition measurements from normal weight to obese individuals in the general population with higher rate in women as compared to men.

Short-term overfeeding increases circulating adiponectin independent of obesity status.

BACKGROUND: Adiponectin is an adipose tissue derived hormone which strengthens insulin sensitivity. However, there is little data available regarding the influence of a positive energy challenge (PEC) on circulating adiponectin and the role of obesity status on this response. OBJECTIVE: The purpose of this study was to investigate how circulating adiponectin will respond to a short-term PEC and whether or not this response will differ among normal-weight(NW), overweight(OW) and obese(OB). DESIGN: We examined adiponectin among 64 young men (19-29 yr) before and after a 7-day overfeeding (70% above normal energy requirements). The relationship between adiponectin and obesity related phenotypes including; weight, percent body fat (%BF), percent trunk fat (%TF), percent android fat (%AF), body mass index (BMI), total cholesterol, HDLc, LDLc, glucose, insulin, homeostatic model assessment insulin resistance (HOMA-IR) and ß-cell function (HOMA-ß) were analyzed before and after overfeeding. RESULTS: Analysis of variance (ANOVA) and partial correlations were used to compute the effect of overfeeding on adiponectin and its association with adiposity measurements, respectively. Circulating Adiponectin levels significantly increased after the 7-day overfeeding in all three adiposity groups. Moreover, adiponectin at baseline was not significantly different among NW, OW and OB subjects defined by either %BF or BMI. Baseline adiponectin was negatively correlated with weight and BMI for the entire cohort and %TF, glucose, insulin and HOMA-IR in OB. However, after controlling for insulin resistance the correlation of adiponectin with weight, BMI and %TF were nullified. CONCLUSION: Our study provides evidence that the protective response of adiponectin is preserved during a PEC regardless of adiposity. Baseline adiponectin level is not directly associated with obesity status and weight gain in response to short-term overfeeding. However, the significant increase of adiponectin in response to overfeeding indicates the physiological potential for adiponectin to attenuate insulin resistance during the development of obesity.

Circulating glucagon-like peptide-1 increases in response to short-term overfeeding in men.

BACKGROUND: Glucagon-like Peptide-1 (GLP-1) is an incretin hormone secreted from the gastrointestinal tract that facilitates the glucose-dependent insulin response. Additionally, GLP-1 is thought to be involved in energy homeostasis. Currently little is known about GLP-1's responsiveness to an energy surplus, a fundamental cause of obesity and diabetes. Our objective was to examine the response of serum GLP-1 to short-term (7 day) overfeeding in young men. METHODS: Seventy-two young men from the Canadian province of Newfoundland were recruited for the study. For 7-days, the subjects consumed 70% more calories than required at baseline.Various measurements including: anthropometrics, body composition, markers of glucose/lipid metabolism and serum total GLP-1, were taken at a fasted state before (day 1) and after (day 8) the challenge. Paired t-test analyses were used to assess the change in variables after the overfeeding period. Additionally, the relationship between serum GLP-1 and the measured variables at baseline and change due to overfeeding were analyzed. RESULTS: Serum GLP-1 was significantly increased in all groups in response to the 7-day energy surplus, indicating the increase was independent of adiposity status. There was no significant difference in fasting GLP-1 at baseline between the normal weight and overweight/obese groups. At baseline, GLP-1 concentration negatively correlated with HDL-cholesterol and positively correlated with triacylglycerols and markers of insulin resistance in the overweight/obese group. Also GLP-1 was negatively correlated with change in percent gynoid fat in the overweight/obese subjects. Percent change in GLP-1 was negatively associated with percent change in gynoid fat in the normal weight group and positively associated with percent change in cholesterol in the overweight/obese group. Percentage change of circulating triacylglycerols was positively associated with percent change in GLP-1 in both adiposity groups. CONCLUSION: Our findings showed that GLP-1 serum concentration is not a significant factor in determining obesity status. The increase of GLP-1 in all subjects regardless of obesity status, suggest GLP-1 serves as a protective role, counteracting energy surplus.

High dietary magnesium intake is associated with low insulin resistance in the Newfoundland population.

BACKGROUND: Magnesium plays a role in glucose and insulin homeostasis and evidence suggests that magnesium intake is associated with insulin resistance (IR). However, data is inconsistent and most studies have not adequately controlled for critical confounding factors. OBJECTIVE: The study investigated the association between magnesium intake and IR in normal-weight (NW), overweight (OW) and obese (OB) along with pre- and post- menopausal women. DESIGN: A total of 2295 subjects (590 men and 1705 women) were recruited from the CODING study. Dietary magnesium intake was computed from the Willett Food Frequency Questionnaire (FFQ). Adiposity (NW, OW and OB) was classified by body fat percentage (%BF) measured by Dual-energy X-ray absorptiometry according to the Bray criteria. Multiple regression analyses were used to test adiposity-specific associations of dietary magnesium intake on insulin resistance adjusting for caloric intake, physical activity, medication use and menopausal status. RESULTS: Subjects with the highest intakes of dietary magnesium had the lowest levels of circulating insulin, HOMA-IR, and HOMA-ß and subjects with the lowest intake of dietary magnesium had the highest levels of these measures, suggesting a dose effect. Multiple regression analysis revealed a strong inverse association between dietary magnesium with IR. In addition, adiposity and menopausal status were found to be critical factors revealing that the association between dietary magnesium and IR was stronger in OW and OB along with Pre-menopausal women. CONCLUSION: The results of this study indicate that higher dietary magnesium intake is strongly associated with the attenuation of insulin resistance and is more beneficial for overweight and obese individuals in the general population and pre-menopausal women. Moreover, the inverse correlation between insulin resistance and dietary magnesium intake is stronger when adjusting for %BF than BMI.

Concordance of BAI and BMI with DXA in the Newfoundland population.

BACKGROUND: Body adiposity index (BAI), indirect method proposed to predict adiposity, was developed using Mexican Americans and very little data are available regarding its validation in Caucasian populations to date. OBJECTIVE: The study objectives were to validate the BAI with dual-energy X-ray absorptiometry (DXA) body fat percentage (%BF), taking into consideration the gender and adiposity status. DESIGN AND METHODS: A total of 2,601 subjects (Male 662, Female 1939) from our Complex Diseases in the Newfoundland population: Environment and Genetics (CODING) study participated in this investigation. Pearson correlations, with the entire cohort along with men and women separately, were used to compare the correlation of both BAI and BMI with %BF. Additionally, the concordance between BAI and BMI with %BF were also performed among normal-weight (NW), overweight (OW), and obese (OB) groups. Adiposity status was determined by the Bray Criteria according to DXA %BF. RESULTS: BAI performs better than BMI in our Caucasian population by: (1) reflecting the gender difference in total %BF between women and men, (2) correlating better with DXA %BF than BMI when women and men are combined, and (3) performing better in NW and OW subjects for both the sexes. However, BAI performs less effectively than BMI in OB men and women. CONCLUSION: In summary, the BAI method is a better estimate of adiposity than BMI in non-OB subjects in our Caucasian population. A measurement sensitive to the changes in adiposity for both men and women is suggested to be incorporated into the present BAI equation to increase accuracy.

Serum acylated ghrelin is negatively correlated with the insulin resistance in the CODING study.

OBJECTIVE: Ghrelin is a 28-amino acid orexigenic peptide synthesized mainly in the stomach. Acute administration of ghrelin has been found to decrease insulin secretion. However, little data is available regarding whether ghrelin contributes to the long-term regulation of insulin resistance at the population level. The aim of this study is to investigate the association between circulating ghrelin and insulin resistance in a large population based study. DESIGN: A total of 2082 CODING study (Complex Diseases in the Newfoundland population: Environment and Genetics) subjects were assessed. Subjects were of at least third generation Newfoundland descent, between the ages of 20 and 79 years, and had no serious metabolic, cardiovascular, or endocrine diseases. Ghrelin was measured with an Enzyme Immunoassay method. Insulin and fasting glucose were measured by Immulite 2500 autoanalyzer and Lx20 clinical chemistry analyzer, respectively. Homeostatic Model Assessment of ß cell function (HOMA-ß) and Insulin Resistance (HOMA-IR) and Quantitative Insulin-sensitivity Check Index (QUICKI) were used for measurement of insulin resistance. RESULTS: Partial correlation analyses showed a significant negative correlation between circulating ghrelin and insulin level and insulin resistance in the entire cohort and also in men and women separately. The aforementioned correlation was independent of age, percentage of trunk fat and HDL-cholesterol. According to menopausal status, only pre-menopausal women revealed negative correlations. CONCLUSION: Our results suggest that except for postmenopausal women, high circulating ghrelin level is associated with lower insulin resistance in the general population.

Serum acylated ghrelin concentrations in response to short-term overfeeding in normal weight, overweight, and obese men.

BACKGROUND: Ghrelin, an orexigenic gut hormone secreted primarily from the stomach, is involved in energy homeostasis. However, little data is available regarding its response to energy surplus and the development of human obesity. OBJECTIVE: The present study investigated the response of circulating acylated ghrelin to a 7-day positive energy challenge. DESIGN: A total of 68 healthy young men were overfed 70% more calories than required, for 1-week. Subjects were classified based on percent body fat (measured by dual-energy X-ray absorptiometry) as normal weight, overweight, and obese. Serum acylated ghrelin concentration was measured before and after the positive energy challenge. Additionally, the relationship between acylated ghrelin and obesity-related phenotypes including weight, body mass index, percent body fat, cholesterol, HDL-c, LDL-c, glucose, insulin and homeostasis model assessment of insulin resistance and ß-cell function at baseline and change due to overfeeding, were assessed. RESULTS: Contrary to our expectations, serum acylated ghrelin was significantly increased in response to overfeeding and the increase was independent of obesity status. There was no significant difference in fasting acylated ghrelin between normal weight, overweight, and obese men at baseline. Acylated ghrelin was negatively correlated with weight and BMI for normal weight and with BMI in overweight men. Also ghrelin was correlated with change in weight and BMI in overweight (negative relationship) and obese (positive relationship) groups. CONCLUSION: Our results showed that circulating acylated ghrelin was increased after a 7-day positive energy challenge regardless of adiposity status. However, acylated ghrelin was correlated with change in weight and BMI in opposing directions, in overweight and obese subjects respectively, thus dependent on obesity status.

Whole-body hypothermia has central and peripheral influences on elbow flexor performance.

The superimposed twitch technique was used to study the effect of whole-body hypothermia on maximal voluntary activation of elbow flexors. Seven subjects [26.4 ± 4 years old (mean ± SD)] were exposed to 60 min of either immersion in 8°C water (hypothermia) or sitting in 22°C air (control). Voluntary activation was assessed during brief (3 s) maximal voluntary contractions (MVCs) and then during a 2 min fatiguing sustained MVC. Hypothermia (core temperature 34.8 ± 0.9°C) decreased maximal voluntary torque from 98.2 ± 1.0 to 82.8 ± 5.8% MVC (P < 0.001) and increased central conduction time from 7.9 ± 0.4 to 9.1 ± 0.7 ms (P < 0.05). Hypothermia also decreased maximal resting twitch amplitude from 17.6 ± 4.0 to 10.0 ± 1.7% MVC (P < 0.005) and increased the time-to-peak twitch tension from 55.4 ± 4.0 to 79.0 ± 11.7 ms (P < 0.001). During the 2 min contraction, hypothermia decreased initial torque (P < 0.01) but attenuated the subsequent rate of torque decline (control from 95.5 ± 4 to 29.4 ± 8% MVC; and hypothermia from 85.3 ± 8 to 37.3 ± 5% MVC; P < 0.01). Cortical superimposed twitches increased as fatigue developed but were always lower in the hypothermic conditions. Cortical superimposed twitches increased from a value of 0.4 ± 0.3% MVC prefatigue to 3.9 ± 1.4% MVC postfatigue (P < 0.001) in the hypothermic conditions and from 1.7 ± 0.9 to 5.5 ± 2.3% MVC in control conditions. Our results suggest that hypothermia decreases MVCs primarily via peripheral mechanisms and attenuates the rate of fatigue development by reducing central fatigue.

Serum peptide YY in response to short-term overfeeding in young men.

BACKGROUND: Peptide YY (PYY), a gut hormone that inhibits appetite, has been linked to the development of obesity. OBJECTIVE: This study investigated the nutritional regulation of PYY after 7 d of overfeeding (70% above normal energy requirements) in normal-weight, overweight, and obese men. DESIGN: Sixty-nine men (aged 19-29 y) participated in the study. We analyzed the relation between fasting serum PYY before and after a 7-d overfeeding challenge in normal-weight, overweight, and obese men. In addition, we analyzed PYY with obesity-related phenotypes including weight, percentage body fat (measured by dual-energy X-ray absorptiometry), body mass index (BMI), total cholesterol, HDL, LDL, glucose, insulin, insulin resistance, and ß cell function evaluated by the homeostasis model assessment of insulin resistance (HOMA-IR) and ß cell function (HOMA-ß) at baseline and in response to the energy surplus. RESULTS: Fasting serum PYY concentrations at baseline were not significantly different between the normal-weight, overweight, and obese subjects on the basis of dual-energy X-ray absorptiometry or BMI. Although the PYY concentration significantly increased due to overfeeding, no differences were observed between adiposity statuses. In addition, basal PYY was negatively correlated with the changes of total cholesterol, HDL, and LDL in normal weight. In addition, the increase in PYY after overfeeding was positively correlated with HDL cholesterol and glucose in normal-weight subjects. CONCLUSIONS: Our findings suggest that fasting PYY concentrations are not associated with adiposity status. Moreover, the 7-d overfeeding challenge significantly increased fasting PYY, which is likely a protective response to the positive energy balance.

Field torso-warming modalities: a comparative study using a human model.

OBJECTIVE: To compare four field-appropriate torso-warming modalities that do not require alternating-current (AC) electrical power, using a human model of nonshivering hypothermia. METHODS: Five subjects, serving as their own controls, were cooled four times in 8 degrees C water for 10-30 minutes. Shivering was inhibited by buspirone (30 mg) taken orally prior to cooling and intravenous (IV) meperidine (1.25 mg/kg) at the end of immersion. Subjects were hoisted out of the water, dried, and insulated and then underwent 120 minutes of one of the following: spontaneous warming only; a charcoal heater on the chest; two flexible hot-water bags (total 4 liters of water at 55 degrees C, replenished every 20 minutes) applied to the chest and upper back; or two chemical heating pads applied to the chest and upper back. Supplemental meperidine (maximum cumulative dose of 3.5 mg/kg) was administered as required to inhibit shivering. RESULTS: The postcooling afterdrop (i.e., the continued decrease in body core temperature during the early period of warming), compared with spontaneous warming (2.2 degrees C), was less for the chemical heating pads (1.5 degrees C) and the hot-water bags (1.6 degrees C, p < 0.05) and was 1.8 degrees C for the charcoal heater. Subsequent core rewarming rates for the hot-water bags (0.7 degree C/h) and the charcoal heater (0.6 degree C/h) tended to be higher than that for the chemical heating pads (0.2 degree C/h) and were significantly higher than that for spontaneous warming rate (0.1 degrees C/h, p < 0.05). CONCLUSION: In subjects with shivering suppressed, greater sources of external heat were effective in attenuating core temperature afterdrop, whereas sustained sources of external heat effectively established core rewarming. Depending on the scenario and available resources, we recommend the use of charcoal heaters, chemical heating pads, or hot-water bags as effective means for treating cold patients in the field or during transport to definitive care.

An inverted seated posture decreases elbow flexion force and muscle activation.

The purpose of this study was to determine if discrepancies exist between upright and inverted seated positions in isometric maximal voluntary contraction (MVC) elbow flexor force, MVC force produced in the first 100 ms (F100), MVC rate of force development, electromyographic (EMG) activity of the biceps and triceps as well as heart rate and blood pressure. The results showed significantly (p < 0.01) higher MVC force (543.6 +/- 29.6 vs. 486.5 +/- 23.0 N), F100 (328.3 +/- 94.5 vs. 274.6 +/- 101.8 N), rate of force development (p = 0.003) (1,851.9 +/- 742.2 vs. 1,591.0 +/- 719.6 N s(-1)) and biceps brachii EMG activity (48%, p < 0.01) in the upright versus inverted condition. There were relatively greater co-contractions with the inverted position (p < 0.01) due to the lack of change in triceps' EMG and the substantial decrease in biceps' EMG. There were no significant changes in trunk EMG activity. With inversion, there were significant decreases in heart rate (16.8%), systolic (11.6%) and diastolic (12.1%) blood pressures (p < 0.0001). These results illustrate decrements in neuromuscular performance with an inverted seated posture which may be related to an altered sympathetic response.

Caloric restriction does not offset age-associated changes in the biophysical properties of motoneurons.

Age-associated changes in neuromuscular function may be due to a loss of motor neurons as well as changes in their biophysical properties. Neuronal damage imposed by reactive oxygen species may contribute to age-related deficits in CNS function. Thus we hypothesized that aging would alter the functional properties of motoneurons and that caloric-restriction would offset these changes. Intracellular recordings were made from lumbar motoneurons of old Fisher Brown Norway (FBN) fed ad libitum (oldAL, 30.8+/-1.3 mo) or on a fortified calorie-restricted diet from 14 wk of age (oldCR, 31.0+/-1.8 mo). Basic and rhythmic firing properties recorded from these aged motoneurons (MNs) were compared with properties recorded from young FBN controls (young, 8.4+/-4.6 mo). Compared with young MNs, old MNs had a 104% greater (P<0.001) afterhyperpolarization potential (AHP), a 21.1% longer AHP half-decay time (P<0.05), 28.7% lower rheobase (P<0.001), 49.7% greater (P<0.001) input resistance, 21.1% (P<0.0001) less spike frequency adaptation, lower minimal (30.2%, P<0.0001) and maximal (16.7%, P<0.0001) steady-state firing frequencies, a lower (35.5%, P<0.0001) frequency-current slope, and an increased incidence of persistent inward current. Because basic properties became more diverse in old MNs and the slope of the frequency-current relationship, which is normally similar for high- and low-threshold MNs, was lower in the old group, we conclude that aging alters the biophysical properties of MNs in a fashion that cannot be simply attributed to a loss of high-threshold MNs. Surprisingly, caloric restriction, which is known to attenuate aging-associated changes in hindlimb muscles, had no effect on the progress of aging in the innervating MNs.

Shivering heat production and core cooling during head-in and head-out immersion in 17 degrees C water.

INTRODUCTION: Many cold-water scenarios cause the head to be partially or fully immersed (e.g., ship wreck survival, scuba diving, cold-water adventure swim racing, cold-water drowning, etc.). However, the specific effects of head cold exposure are minimally understood. This study isolated the effect of whole-head submersion in cold water on surface heat loss and body core cooling when the protective shivering mechanism was intact. METHODS: Eight healthy men were studied in 17 degrees C water under four conditions: the body was either insulated or exposed, with the head either out of the water or completely submersed under the water within each insulated/exposed subcondition. RESULTS: Submersion of the head (7% of the body surface area) in the body-exposed condition increased total heat loss by 11% (P < 0.05). After 45 min, head-submersion increased core cooling by 343% in the body-insulated subcondition (head-out: 0.13 +/- 0.2 degree C, head-in: 0.47 +/- 0.3 degree C; P < 0.05) and by 56% in the body-exposed subcondition (head-out: 0.40 +/- 0.3 degree C and head-in: 0.73 +/- 0.6 degree C; P < 0.05). DISCUSSION: In both body-exposed and body-insulated subconditions, head submersion increased the rate of core cooling disproportionally more than the relative increase in total heat loss. This exaggerated core-cooling effect is consistent with a head cooling induced reduction of the thermal core, which could be stimulated by cooling of thermosensitive and/or trigeminal receptors in the scalp, neck, and face. These cooling effects of head submersion are not prevented by shivering heat production.

Cooling hyperthermic firefighters by immersing forearms and hands in 10 degrees C and 20 degrees C water.

INTRODUCTION: Firefighters experience significant heat stress while working with heavy gear in a hot, humid environment. This study compared the cooling effectiveness of immersing the forearms and hands in 10 and 20 degrees C water. METHODS: Six men (33 +/- 10 yr; 180 +/- 4 cm; 78 +/- 9 kg; 19 +/- 5% body fat) wore firefighter 'turn-out gear' (heavy clothing and breathing apparatus weighing 27 kg) in a protocol including three 20-min exercise bouts (step test, 78 W, 40 degrees C air, 40% RH) each followed by a 20-min rest/cooling (21 degrees C air); i.e., 60 min of exercise, 60 min of cooling. Turn-out gear was removed during rest/cooling periods and subjects either rested (Control), immersed their hands in 10 or 20 degrees C water (H-10, H-20), or immersed their hands and forearms in 10 or 20 degrees C water (HF-10, HF-20). RESULTS: In 20 degrees C water, hand immersion did not reduce core temperature compared with Control; however, including forearm immersion decreased core temperature below Control values after both the second and final exercise periods (p < 0.001). In 10 degrees C water, adding forearm with hand immersion produced a lower core temperature (0.8 degrees C above baseline) than all other conditions (1.1 to 1.4 degrees C above baseline) after the final exercise period (p < 0.001). Sweat loss during Control (1458 g) was greater than all active cooling protocols (1146 g) (p < 0.001), which were not different from each other. DISCUSSION: Hand and forearm immersion in cool water is simple, reduces heat strain, and may increase work performance in a hot, humid environment. With 20 degrees C water, forearms should be immersed with the hands to be effective. At lower water temperatures, forearm and/or hand immersion will be effective, although forearm immersion will decrease core temperature further.