A Diet and Fitness Program Similarly Affects Weight Reduction in Schizophrenia Patients Treated with Typical or Atypical Medications.

INTRODUCTION: Schizophrenia patients, receiving new generation antipsychotics, many times suffer from obesity sometimes leading to metabolic syndrome. Diet and fitness programs which reduce weight should be combined in the treatment plan of these patients. This study evaluated patients' adherence and the effect of a diet and fitness program in schizophrenia patients treated with typical vs. atypical antipsychotics. METHODS: 106 stabilized schizophrenia patients participated in a 9-months diet and fitness program, receiving their own menu and a personal workout plan. RESULTS: 60 patients (57%), 27.8±4.8y age, participated in the program for at least one month, i. e., adherent participants, with 4.0±2 months participation average. Months of participation were correlated with weight loss (r=-0.417; p=0.002). Throughout the study patients lost 3.34±1.2 kg in average: 85.95±14.66 at baseline and 82.61±13.78 at the end of program (t=4.969; p<0.001). No association was found between specific types or dose of medication and weight loss (F=0.437, p=0.85). DISCUSSION: Patients with schizophrenia are capable of adhering to a diet and fitness program and successfully lose weight, regardless to taking typical or atypical medications.

Effects of a twelve-week randomized intervention of exercise and/or diet on weight loss and weight maintenance, and other metabolic parameters in obese preadolescent children.

AIMS: To compare the short- and long-term effects of intervention programs on body weight and cardiometabolic risk factors. METHODS: 162 obese children (6-11 years) were randomly assigned to three 12-week interventions with a 9-month follow-up period: exercise (E): 90 min moderate exercise 3 days/week (n = 52); diet (D): balanced hypocaloric diet, weekly meetings with dietician (n = 55), and diet + exercise (D+E) (n = 55). Changes in anthropometric variables, cardiometabolic profile and psychological outcome were assessed. RESULTS: At 12 weeks BMI-SDS, cardiometabolic profiles, and psychological score improved in all groups. The decrease in BMI-SDS was greater in D and D+E compared with E (p < 0.001), without a significant difference between the first two groups. Waist circumference and LDL cholesterol decreased more in D+E compared with E (p = 0.026 and p = 0.038, respectively). The increase in adiponectin was greater in D and D+E compared with E (p = 0.004). Anthropometric and cardiometabolic variables regressed without significant differences between groups after 9 months. However, BMI-SDS, body fat percentage and LDL cholesterol were lower compared to baseline. CONCLUSIONS: Diet alone or combined with exercise are the most effective short-term interventions for weight loss and improved cardiometabolic profiles, without a difference between them. In the long term, obese children need the long-term support of maintenance approaches.

Dissociated effects of physical activity and weight loss on fibrinogen concentrations and markers of red blood cell aggregation. Relevance for life style modification in atherothrombosis.

It has been shown that weight loss and physical activity contribute to a better biorheological profile. Yet, the concentrations of fibrinogen are not always reduced following life style modification. We evaluated the inter-relations between fibrinogen's pro red cell aggregation potential and reduced inflammation and improved lipid profile as anti-aggregating forces in a group of 20 apparently healthy obese volunteers following 4 and 8 months of intensive life modification program which included diet and strenuous physical activity. A significant (p=0.005) weight loss (from a mean+/-SD of 121.4+/-20.9 to 98.0+/-21.3 kg) and decrease in body mass index (from 40.8+/-4.3 to 32.9+/-5.3 kg/m(2), p=0.005) was noted in fourteen individuals who completed the 8-month program. The concentrations of clottable fibrinogen rose from 318+/-96 to 387+/-72 mg/dl (p=0.012) while there was a significant reduction in the erythrocyte sedimentation rate (ESR) (from 19.0+/-12.6 to 10.8+/-7.5 mm/h, p=0.018), triglycerides (from 143+/-80 to 80+/-44 mg/dl, p=0.005), LDL cholesterol (from 128+/-34 to 103+/-17 mg/dl, p=0.005) and total cholesterol (from 211+/-40 to 171+/-17 mg/dl, p=0.007), as well as decrease in insulin concentration (from 36.1+/-21.3 to 20.6+/-8.0 microu/ml, p=0.01) and the insulin resistance index (HOMA-R, from 9.1+/-6.4 to 4.9+/-2.1 glu*ins/405, p=0.008). Despite a significant increment in the concentrations of clottable fibrinogen, a significant reduction was noted in the degree of red cell aggregation as measured by using a slide test and direct visualization of the aggregates. Our conclusion is that the pro-aggregating properties of fibrinogen following intense physical activity are probable counterbalanced by the anti-aggregatory properties of an improved lipid profile and an attenuated acute phase response.

Blood lactate concentration following exercise: effects of heat exposure and of active recovery in heat-acclimatized subjects.

The purpose of this study was to examine the effect of ambient heat on the decrease in blood lactate concentration ([LA]bl) during passive and during active recovery. Ten trained men performed six 1-min bouts of exercise at 100% VO2peak on a cycle ergometer, with 1-min rest between the bouts. Each subject exercised twice in thermoneutral (22 degrees C, 40% RH, TN), and twice in hot (35 degrees C, 30% RH, H) conditions. Exercise was followed by either 40 min of passive recovery (sitting) or by 20 min active recovery (cycling at 35% VO2peak) and 20 min passive recovery, named thereafter, 'active recovery'. Capillary blood lactate was measured before, 1 min after, and every 5 min during recovery. Heart rate (HR), rectal and skin temperatures (Tre, Tsk) were monitored continuously. VO2 was measured prior to exercise, during the last exercise bout, the first 10 min of recovery, and periodically thereafter. Post-exercise [LA]bl was similar in all treatments (13.5 +/- 1.8, 13.0 +/- 1.3, 14.8 +/- 4.1, 13.3 +/- 2.6 mmol.l-1 for TN-active, TN-passive, H-active and H-passive, respectively). [LA]bl was significantly lower during active, compared to passive recovery in both, TN and H conditions. Environmental heart did not independently affect [LA]bl during passive or active recovery. Exercise resulted in an elevation in Tre in all treatments, with a significantly higher Tre during active recovery in H compared to the other sessions. Likewise, no differences in HR and in VO2 were observed between H and TN conditions during active nor during passive recovery.(ABSTRACT TRUNCATED AT 250 WORDS)

Laboratory testing of muscle function in the management of neuromuscular disease.

A laboratory was set up to assess muscle weakness and physical disability in patients with peripheral neuromuscular diseases. Muscle strength was mainly measured with a hand held dynamometer and results were expressed in relationship to a "guideline" range for sex: disability was expressed in terms of ordinal data with a performance score and as interval data with simple timed tests. Of 17 patients with polymyositis on immunosuppressive medication followed for a mean of 2.9 years (range 1.1 - 4.7 years) only eight became stronger one of whom died. Assessment of weakness (the major impairment), disability, body weight, creatine kinase and the patient's subjective view of their state were essential to obtaining a clear view of progress.

Shoulder abduction fatiguability.

Shoulder abduction fatiguability has been measured using a hand held myometer in normal subjects and patients with peripheral neuromuscular diseases. An index of fatiguability was based on the decline in force over a series of ten maximum voluntary contractions performed in under a minute. The technique was repeatable and well tolerated. Patients with myasthenia, mitochondrial myopathy and motor neuron disease tended to show excess fatiguability independent of muscle strength. Serial measurements demonstrated alterations in fatiguability but not necessarily strength, associated with changes in symptoms.

The measurement of muscle strength in patients with peripheral neuromuscular disorders.

The variability of voluntary isometric strength measurements has been assessed in normal subjects and patients with peripheral neuromuscular disorders. Knee extensor strength was measured in a muscle testing chair 13 times over 5 months in each of six normal subjects: coefficients of variation (CV) ranged from 4.5 to 14.0% (mean 8.5%) for individual legs in different subjects. Paired measurements of the strength of several clinically weak muscle groups were made 1-4 days apart in 20 patients using both a handheld dynamometer and the muscle chair technique: the test/retest correlation was high (r = 0.97, p less than 0.001). Visual biofeedback did not affect the strength recorded in most cases. Each of five patients had the strength of six or seven clinically weak muscle groups measured by five examiners within a 24 hour period: the CV for the five examiners ranged from 3.6-27.3% (mean 12.8%). A single examiner measuring the same groups on five occasions in three patients obtained a mean CV of 8.9%. Sources of variation are analysed and it is concluded that, with certain precautions, voluntary strength measurements offer a simple, reliable and acceptable method for monitoring change in patients.