Twelve Weeks of Daily Lentil Consumption Improves Fasting Cholesterol and Postprandial Glucose and Inflammatory Responses-A Randomized Clinical Trial.

Lentils have potential to improve metabolic health but there are limited randomized clinical trials evaluating their comprehensive impact on metabolism. The aim of this study was to assess the impact of lentil-based vs. meat-based meals on fasting and postprandial measures of glucose and lipid metabolism and inflammation. Thirty-eight adults with an increased waist circumference (male ≥ 40 inches and female ≥ 35 inches) participated in a 12-week dietary intervention that included seven prepared midday meals totaling either 980 g (LEN) or 0 g (CON) of cooked green lentils per week. Linear models were used to assess changes in fasting and postprandial markers from pre- to post-intervention by meal group. Gastrointestinal (GI) symptoms were assessed through a survey randomly delivered once per week during the intervention. We found that regular consumption of lentils lowered fasting LDL (F = 5.53, p = 0.02) and total cholesterol levels (F = 8.64, p < 0.01) as well as postprandial glucose (ß = -0.99, p = 0.01), IL-17 (ß = -0.68, p = 0.04), and IL-1ß (ß = -0.70, p = 0.03) responses. GI symptoms were not different by meal group and all symptoms were reported as "none" or "mild" for the duration of the intervention. Our results suggest that daily lentil consumption may be helpful in lowering cholesterol and postprandial glycemic and inflammatory responses without causing GI stress. This information further informs the development of pulse-based dietary strategies to lower disease risk and to slow or reverse metabolic disease progression in at-risk populations.

Metabolic impact of polyphenol-rich aronia fruit juice mediated by inflammation status of gut microbiome donors in humanized mouse model.

Background: The Aronia melanocarpa fruit is emerging as a health food owing to its high polyphenolic content and associated antioxidant activity. Antioxidant-rich foods, such as Aronia fruit, may counter inflammatory stimuli and positively modulate the gut microbiome. However, a comprehensive study characterizing the impact of Aronia fruit supplementation has not been completed. Therefore, we completed analyses measuring the metabolic, microbial, and inflammatory effects of a diet supplemented with Aronia fruit juice. Method: Humanized mice were generated by colonizing gnotobiotic mice with microbiomes from human donors presenting disparate inflammation levels. Blood and fecal samples were collected throughout the course of an 8-week dietary intervention with either Aronia juice or a carbohydrate-matched beverage alone (2 weeks) or in combination with a high-fat diet to induce inflammation (6 weeks). Samples were analyzed using 16S rRNA gene sequencing (stool) and liquid chromatography-mass spectrometry (serum). Results: We demonstrated transfer of microbiome composition and diversity and metabolic characteristics from humans with low and high inflammation levels to second-generation humanized mice. Aronia supplementation provided robust protection against high-fat diet induced metabolic and microbiome changes that were dependent in part on microbiome donor. Aronia induced increases in bacteria of the Eggerthellaceae genus (7-fold) which aligns with its known ability to metabolize (poly)phenols and in phosphatidylcholine metabolites which are consistent with improved gut barrier function. The gut microbiome from a low inflammation phenotype donor provided protection against high-fat diet induced loss of microbiome ß-diversity and global metabolomic shifts compared to that from the high inflammation donor. Conclusion: These metabolic changes elucidate pathway-specific drivers of reduced inflammation stemming from both Aronia and the gut microbiota.

Eight weeks of lentil consumption attenuates insulin resistance progression without increased gastrointestinal symptom severity: A randomized clinical trial.

Lentils lower acute glycemic responses and promote satiety, benefits that may aid in chronic disease prevention. However, perceived gastrointestinal (GI) effects may deter inclusion of dietary pulses in the diet. We hypothesized that 8 weeks of lentil-based vs meat-based meals would improve glycemic control and improve satiety in metabolically at-risk, nondiabetic adults. Because GI symptoms are rarely reported, we also explored the temporal effects of symptom severity. Adults with an increased waist circumference (male > 40 inches, female > 35 inches) participated in an 8-week dietary intervention that included 5 prepared midday meals each week that were isocaloric but varied in cooked green lentil dosage: 0 g (CON), 300 g (MOD), or 600 g (HI). Assessments included glucose and insulin integrated area under the curve measured during a 75-g carbohydrate tolerance test, hepatic Homeostatic Model of Insulin Resistance (HOMA-IR), and peripheral insulin resistance. On 1 randomized day each week, satiety was assessed at 4:00 pm and GI symptoms at 8:00 pm. A linear model assessed changes in glycemic and GI measures by meal group. Thirty adults (mean ± SD; age, 41.6 ± 11.7 years, body mass index, 35.1 ± 6.3) completed the intervention. HOMA-IR increased in CON (+1.2 units) and decreased in a dose-dependent manner in MOD (-0.9 units, P = .03) and HI (-1.5 units, P < .01) relative to CON. Most participants (87.4%) reported no to mild GI symptoms. Of these, flatulence was mild on average with bloating, abdominal discomfort, and cramping severity 0.3, 0.5, and 0.5 units lower (P < .001). We observed a dose-dependent reduction on rising hepatic insulin resistance and low GI symptom severity with long-term lentil consumption in metabolically at-risk adults.

Determinants of the postprandial triglyceride response to a high-fat meal in healthy overweight and obese adults.

BACKGROUND: Dyslipidemia is a feature of impaired metabolic health in conjunction with impaired glucose metabolism and central obesity. However, the contribution of factors to postprandial lipemia in healthy but metabolically at-risk adults is not well understood. We investigated the collective contribution of several physiologic and lifestyle factors to postprandial triglyceride (TG) response to a high-fat meal in healthy, overweight and obese adults. METHODS: Overweight and obese adults (n = 35) underwent a high-fat meal challenge with blood sampled at fasting and hourly in the 4-hour postprandial period after a breakfast containing 50 g fat. Incremental area under the curve (iAUC) and postprandial magnitude for TG were calculated and data analyzed using a linear model with physiologic and lifestyle characteristics as explanatory variables. Model reduction was used to assess which explanatory variables contributed most to the postprandial TG response. RESULTS: TG responses to a high-fat meal were variable between individuals, with approximately 57 % of participants exceeded the nonfasting threshold for hypertriglyceridemia. Visceral adiposity was the strongest predictor of TG iAUC (ß = 0.53, p = 0.01), followed by aerobic exercise frequency (ß = 0.31, p = 0.05), insulin resistance based on HOMA-IR (ß = 0.30, p = 0.04), and relative exercise intensity at which substrate utilization crossover occurred (ß = 0.05, p = 0.04). For postprandial TG magnitude, visceral adiposity was a strong predictor (ß = 0.43, p < 0.001) followed by aerobic exercise frequency (ß = 0.23, p = 0.01), and exercise intensity for substrate utilization crossover (ß = 0.53, p = 0.01). CONCLUSIONS: Postprandial TG responses to a high-fat meal was partially explained by several physiologic and lifestyle characteristics, including visceral adiposity, insulin resistance, aerobic exercise frequency, and relative substrate utilization crossover during exercise. TRIAL REGISTRATION: ClinicalTrials.gov, NCT04128839 , Registered 16 October 2019 - Retrospectively registered.

Temporal metabolic response yields a dynamic biosignature of inflammation.

Chronic low-grade inflammation is a subclinical condition directly and indirectly linked to the development of a wide range of diseases responsible for the vast majority of morbidity. To examine mechanisms coupled to chronic disease, a group of overweight and obese human subjects without known inflammatory diseases participated in a high-fat meal challenge as an acute inflammation stimulus. Analysis of serum metabolites grouped by baseline cytokine levels revealed that single samples had little power in differentiating groups. However, an analysis that incorporated temporal response separated inflammatory response phenotypes and allowed us to create a metabolic signature of inflammation which revealed metabolic components that are crucial to a cytokine-mediated inflammation response. The use of temporal response, rather than a single time point, improved metabolomic prediction of high postprandial inflammation responses and led to the development of a dynamic biosignature as a potential tool for stratifying risk to a wide range of diseases.

Right Ventricular Infarction Presenting With Refractory Hypoxia Due to Shunting Across a Patent Foramen Ovale.

Right ventricular infarction is often associated with significant morbidity and mortality. Here, we report a case of right ventricular infarction associated with persistent hypoxia due to acute right-to-left shunting through a patent foramen ovale. (Level of Difficulty: Intermediate.).

Interaction of Beta-Hydroxy-Beta-Methylbutyrate Free Acid and Adenosine Triphosphate on Muscle Mass, Strength, and Power in Resistance Trained Individuals.

Lowery, RP, Joy, JM, Rathmacher, JA, Baier, SM, Fuller, JC Jr, Shelley, MC II, Jäger, R, Purpura, M, Wilson, SMC, and Wilson, JM. Interaction of beta-hydroxy-beta-methylbutyrate free acid and adenosine triphosphate on muscle mass, strength, and power in resistance trained individuals. J Strength Cond Res 30(7): 1843-1854, 2016-Adenosine-5'-triphosphate (ATP) supplementation helps maintain performance under high fatiguing contractions and with greater fatigue recovery demands also increase. Current evidence suggests that the free acid form of ß-hydroxy-ß-methylbutyrate (HMB-FA) acts by speeding regenerative capacity of skeletal muscle after high-intensity or prolonged exercise. Therefore, we investigated the effects of 12 weeks of HMB-FA (3 g) and ATP (400 mg) administration on lean body mass (LBM), strength, and power in trained individuals. A 3-phase double-blind, placebo-, and diet-controlled study was conducted. Phases consisted of an 8-week periodized resistance training program (phase 1), followed by a 2-week overreaching cycle (phase 2), and a 2-week taper (phase 3). Lean body mass was increased by a combination of HMB-FA/ATP by 12.7% (p < 0.001). In a similar fashion, strength gains after training were increased in HMB-FA/ATP-supplemented subjects by 23.5% (p < 0.001). Vertical jump and Wingate power were increased in the HMB-FA/ATP-supplemented group compared with the placebo-supplemented group, and the 12-week increases were 21.5 and 23.7%, respectively. During the overreaching cycle, strength and power declined in the placebo group (4.3-5.7%), whereas supplementation with HMB-FA/ATP resulted in continued strength gains (1.3%). In conclusion, HMB-FA and ATP in combination with resistance exercise training enhanced LBM, power, and strength. In addition, HMB-FA plus ATP blunted the typical response to overreaching, resulting in a further increase in strength during that period. It seems that the combination of HMB-FA/ATP could benefit those who continuously train at high levels such as elite athletes or military personnel.

The effects of 12 weeks of beta-hydroxy-beta-methylbutyrate free acid supplementation on muscle mass, strength, and power in resistance-trained individuals: a randomized, double-blind, placebo-controlled study.

INTRODUCTION: Studies utilizing beta-hydroxy-beta-methylbutyrate (HMB) supplementation in trained populations are limited. No long-term studies utilizing HMB free acid (HMB-FA) have been conducted. Therefore, we investigated the effects of 12 weeks of HMB-FA supplementation on skeletal muscle hypertrophy, body composition, strength, and power in trained individuals. We also determined the effects of HMB-FA on muscle damage and performance during an overreaching cycle. METHODS: A three-phase double-blind, placebo- and diet-controlled randomized intervention study was conducted. Phase 1 was an 8-week-periodized resistance-training program; Phase 2 was a 2-week overreaching cycle; and Phase 3 was a 2-week taper. Muscle mass, strength, and power were examined at weeks 0, 4, 8, and 12 to assess the chronic effects of HMB-FA; and assessment of these, as well as cortisol, testosterone, and creatine kinase (CK) was performed at weeks 9 and 10 of the overreaching cycle. RESULTS: HMB-FA resulted in increased total strength (bench press, squat, and deadlift combined) over the 12-week training (77.1 ± 18.4 vs. 25.3 ± 22.0 kg, p < 0.001); a greater increase in vertical jump power (991 ± 168 vs. 630 ± 167 W, p < 0.001); and increased lean body mass gain (7.4 ± 4.2 vs. 2.1 ± 6.1 kg, p < 0.001) in HMB-FA- and placebo-supplemented groups, respectively. During the overreaching cycle, HMB-FA attenuated increases in CK (-6 ± 91 vs. 277 ± 229 IU/l, p < 0.001) and cortisol (-0.2 ± 2.9 vs. 4.5 ± 1.7 µg/dl, p < 0.003) in the HMB-FA- and placebo-supplemented groups, respectively. CONCLUSIONS: These results suggest that HMB-FA enhances hypertrophy, strength, and power following chronic resistance training, and prevents decrements in performance following the overreaching.

ß-Hydroxy-ß-methylbutyrate free acid reduces markers of exercise-induced muscle damage and improves recovery in resistance-trained men.

The purpose of the present study was to determine the effects of short-term supplementation with the free acid form of b-hydroxyb-methylbutyrate (HMB-FA) on indices of muscle damage, protein breakdown, recovery and hormone status following a high-volume resistance training session in trained athletes. A total of twenty resistance-trained males were recruited to participate in a high-volume resistance training session centred on full squats, bench presses and dead lifts. Subjects were randomly assigned to receive either 3 g/d of HMB-FA or a placebo. Immediately before the exercise session and 48 h post-exercise, serum creatine kinase (CK), urinary 3-methylhistadine (3-MH), testosterone, cortisol and perceived recovery status (PRS) scale measurements were taken. The results showed that CK increased to a greater extent in the placebo (329%) than in the HMB-FA group (104%) (P»0·004, d » 1·6). There was also a significant change for PRS, which decreased to a greater extent in the placebo (9·1 (SEM 0·4) to 4·6 (SEM 0·5)) than in the HMB-FA group (9·1 (SEM 0·3) to 6·3 (SEM 0·3)) (P»0·005, d » 20·48). Muscle protein breakdown, measured by 3-MH analysis, numerically decreased with HMB-FA supplementation and approached significance (P»0·08, d » 0·12). There were no acute changes in plasma total or free testosterone, cortisol or C-reactive protein. In conclusion, these results suggest that an HMB-FA supplement given to trained athletes before exercise can blunt increases in muscle damage and prevent declines in perceived readiness to train following a high-volume, muscle-damaging resistance-training session.

Changes in perceived recovery status scale following high-volume muscle damaging resistance exercise.

Currently no research has investigated the relationship between muscle damage, hormonal status, and perceived recovery scale (PRS). Therefore, the purpose of this study was to determine the effects of a high-volume training session on PRS and to determine the relationship between levels of testosterone, cortisol, and creatine kinase (CK) and PRS. Thirty-five trained subjects (21.3 ± 1.9 years) were recruited. All subjects participated in a high-volume resistance training session consisting of 3 sets of full squats, bench press, deadlifts, pullups, dips, bent over rows, shoulder press, and barbell curls and extensions. Pre-PRS and post-PRS measurements (0-10), soreness, CK, cortisol, and testosterone were measured before and 48 hours after training. Perceived recovery scale declined from 8.6 ± 2.3 to 4.2 ± 1.85 (p < 0.05). Leg, chest, and arm soreness increased from pre- to postexercise. Creatine kinase significantly increased from pre- to postworkout (189.4 ± 100.2 to 512 ± 222.7 U/L). Cortisol, testosterone, and free testosterone did not change. There was an inverse relationship between CK and PRS (r = 0.58, p < 0.05). When muscle damage was low before training, cortisol and free and total testosterone were not correlated to PRS. However, when damage peaked at 48 hours postexercise, free, but not total, testosterone showed a low direct relationship with PRS (r = 0.2, p < 0.05). High-volume resistance exercise lowers PRS scores. These changes are partly explained by a rise in serum indices of muscle damage. Moreover, free testosterone seems to have a positive relationship with PRS.

Meta-analysis of postactivation potentiation and power: effects of conditioning activity, volume, gender, rest periods, and training status.

There is no clear agreement regarding the ideal combination of factors needed to optimize postactivation potentiation (PAP) after a conditioning activity. Therefore, a meta-analysis was conducted to evaluate the effects of training status, volume, rest period length, conditioning activity, and gender on power augmentation due to PAP. A total of 141 effect sizes (ESs) for muscular power were obtained from a total of 32 primary studies, which met our criteria of investigating the effects of a heavy preconditioning activity on power in randomized human trials. The mean overall ES for muscle power was 0.38 after a conditioning activity (p < 0.05). Significant differences were found between moderate intensity (60-84%) 1.06 and heavy intensity (>85%) 0.31 (p < 0.05). There were overall significant differences found between single sets 0.24 and multiple sets 0.66 (p < 0.05). Rest periods of 7-10 minutes (0.7) after a conditioning activity resulted in greater ES than 3-7 minutes (0.54), which was greater than rest periods of >10 minutes (0.02) (p < 0.05). Significant differences were found between untrained 0.14 and athletes 0.81 and between trained 0.29 and athletes. The primary findings of this study were that a conditioning activity augmented power output, and these effects increased with training experience, but did not differ significantly between genders. Moreover, potentiation was optimal after multiple (vs. single) sets, performed at moderate intensities, and using moderate rest periods lengths (7-10 minutes).

Concurrent training: a meta-analysis examining interference of aerobic and resistance exercises.

The primary objective of this investigation was to identify which components of endurance training (e.g., modality, duration, frequency) are detrimental to resistance training outcomes. A meta-analysis of 21 studies was performed with a total of 422 effect sizes (ESs). Criteria for the study included were (a) compare strength training alone to strength plus endurance training (concurrent) or to compare combinations of concurrent training; (b) the outcome measures include at least one measure of strength, power, or hypertrophy; and (c) the data necessary to calculate ESs must be included or available. The mean ES for hypertrophy for strength training was 1.23; for endurance training, it was 0.27; and for concurrent training, it was 0.85, with strength and concurrent training being significantly greater than endurance training only. The mean ES for strength development for strength training was 1.76; for endurance training, it was 0.78; and for concurrent training, it was 1.44. Strength and concurrent training was significantly greater than endurance training. The mean ES for power development for strength training only was 0.91; for endurance training, it was 0.11; and for concurrent training, it was 0.55. Significant differences were found between all the 3 groups. For moderator variables, resistance training concurrently with running, but not cycling, resulted in significant decrements in both hypertrophy and strength. Correlational analysis identified significant negative relationships between frequency (-0.26 to -0.35) and duration (-0.29 to -0.75) of endurance training for hypertrophy, strength, and power. Significant relationships (p < 0.05) between ES for decreased body fat and % maximal heart rate (r = -0.60) were also found. Our results indicate that interference effects of endurance training are a factor of the modality, frequency, and duration of the endurance training selected.

Oral contraceptive use: impact on folate, vitamin B6, and vitamin B12 status.

Since many unplanned pregnancies occur while women are using oral contraceptives (OCs), it is important to understand the potential impact of these drugs on folate, vitamin B6 , and vitamin B12 status. Although a number of early studies concluded that OCs negatively impact folate status, the majority of these studies were conducted when the estrogen content of OCs was much higher. In addition, the interpretation of findings from many of these studies is problematic since no controls were included for potentially confounding factors. The presently available data do not support a conclusion that currently used OCs negatively impact folate status. In regard to vitamin B6 , however, existing population-based data do provide evidence that current low-dose OCs may negatively impact vitamin B6 status. The observed depression in plasma pyridoxal 5'-phosphate concentrations in OC users may reflect decreased body reserves of the vitamin, which could put women who discontinue OCs and become pregnant at risk for vitamin B6 inadequacy during pregnancy. Functional indicators of vitamin B12 status are not significantly impacted by OC use. Definitive conclusions, however, await further investigations.