The Effects of Protein and Carbohydrate Supplementation, with and without Creatine, on Occupational Performance in Firefighters.

BACKGROUND: The purpose of this study was to assess the effects of protein and carbohydrate supplementation, with and without creatine, on occupational performance in firefighters. METHODS: Using a randomized, double-blind approach, thirty male firefighters (age: 34.4 ± 8.4 yrs., height: 1.82 ± 0.07 m; weight: 88.6 ± 12.5 kg; BF%: 17.2 ± 5.8%) were randomized to receive either (A.) 25 g of whey protein isolate + 25 g of carbohydrate powder (ProCarb group); or (B.) ProCarb + 5 g of creatine (Creatine group) in a double-blind fashion over a period of 21-26 days (depending on shift rotations) to evaluate the impact of supplementation on occupation-specific performance. At baseline and following supplementation, firefighters completed a battery of tests. These tests included an aerobic speed test on an air-braked cycle ergometer followed by the hose carry, body drag, stair climb, and Keiser sled hammer for time. RESULTS: No significant differences in measures of performance were observed at baseline (p > 0.05). There was a significant main effect for time observed for rescue, stair climb, total time to completion, and time trial performance (p < 0.05). There was a significant group × time (p < 0.05) interaction for rescue and forcible entry. Independent sample t-tests indicated that the Creatine group experienced a greater reduction (from baseline) in completion time for the rescue (1.78 ± 0.57 s, 95% CI: 0.61, 2.95 s, p = 0.004) and forcible entry (2.66 ± 0.97 s, 95% CI: 0.68, 4.65 s, p = 0.01) tests compared to the ProCarb group. No significant group × time interactions were observed for the hose line advance, stair climb, total time to completion, and time trial performance (p > 0.05). CONCLUSIONS: The addition of supplemental creatine to a protein and carbohydrate supplement to the diet of career firefighters throughout a three week period improves occupational performance in firefighters in specific areas of high-intensity, repetitive actions.

Are Women with Normal-Weight Obesity at Higher Risk for Cardiometabolic Disorders?

OBJECTIVES: This study aimed to evaluate the cardiometabolic abnormalities in women with normal-weight obesity (NWO) in comparison with lean, overweight, and obese women. METHODS: This cross-sectional study evaluated the assessment of cardiometabolic abnormalities of women with NWO compared to lean, overweight, and obese women. NWO was defined as a BMI < 25 kg.m-2 and a BFP higher than 30%. Anthropometric variables, cardiometabolic abnormality markers (fasting blood glucose (FBG), blood pressure (BP), lipid profile, insulin resistance, and high-sensitivity C-reactive protein (hs-CRP)), and liver enzymes were also examined. RESULTS: Significant differences were observed in HDL concentrations between NWO, lean, and obese participants (p < 0.05). There were no significant differences in FBG, insulin resistance, liver enzymes, or cholesterol between groups (p > 0.05). The prevalence of the abnormal metabolic phenotype was higher in NWO compared to the lean group (4.0% and 24.1%, respectively; p < 0.05). Women with type 2 and 3 obesity had abnormal metabolic profiles (60.9% and 73.9%, respectively) compared to NWO participants (p < 0.01). The NWO group had a significantly higher incidence of cardiometabolic abnormalities compared to the lean participants (p < 0.05), while the type 2 and 3 obese individuals had significantly higher incidences compared to the NWO group (p < 0.001 and p < 0.001, respectively). CONCLUSIONS: Individuals with NWO had a significantly higher incidence of cardiometabolic abnormalities when compared to lean participants. These abnormalities strongly relate to BFP and waist circumferences.

Branched-Chain Amino Acids Supplementation Does Not Accelerate Recovery after a Change of Direction Sprinting Exercise Protocol.

BCAAs supplementation has been widely used for post-exercise recovery. However, no evidence is currently available to answer the question of whether BCAAs supplementation can attenuate muscle damage and ameliorate recovery after a bout of change of direction (COD) sprinting, which is an exercise motion frequently used during team sport actions. This study aimed to assess the effect of BCAAs supplementation on muscle damage markers, subjective muscle soreness, neuromuscular performance, and the vascular health of collegiate basketball players during a 72 h recovery period after a standardized COD protocol. Participants orally received either BCAAs (0.17 g/kg BCAAs + 0.17 g/kg glucose) or placebo (0.34 g/kg glucose) supplementation before and immediately after a COD exercise protocol in a randomized, crossover, double-blind, and placebo-controlled manner. Creatine kinase increased immediately after exercise and peaked at 24 h, muscle soreness remained elevated until 72 h, whilst arterial stiffness decreased after exercise for both supplemented conditions. A negligibly lower level of interleukin-6 was found in the BCAAs supplemented condition. In conclusion, the results of this study do not support the benefits of BCAAs supplementation on mitigating muscle damage and soreness, neuromuscular performance, and arterial stiffness after COD for basketball players.

L-Citrulline supplementation attenuates aortic pulse pressure and wave reflection responses to cold stress in older adults.

BACKGROUND AND AIMS: Augmented aortic systolic blood pressure (SBP) and wave reflection via sympathetic-mediated vasoconstriction elevates the risk for adverse cardiovascular events in older adults. L-citrulline (L-CIT) supplementation has shown to reduce aortic SBP and pulse pressure (PP) responses to cold pressor test (CPT) induced sympathoactivation in young men. The aim of this study was to elucidate the efficacy of L-CIT supplementation to attenuate aortic hemodynamic responses to CPT in older adults. METHODS AND RESULTS: Sixteen older adults were randomly assigned to placebo or L-CIT (6 g/day) for 14-days in a crossover, double-blind, placebo-controlled design. Brachial SBP and aortic SBP, PP, augmented pressure (AP), augmentation index standardized at 75 bpm (AIx@75), and pressure of the forward (Pf) and reflected (Pb) waves were evaluated at rest and during CPT pre- and post-intervention. Although no hemodynamic changes at rest, brachial SBP (Δ-12 ± 18 vs. Δ4 ± 14 mmHg; P = 0.008) and aortic SBP (Δ-10 ± 14 vs. Δ4 ± 12 mmHg; P = 0.005), PP (Δ-10 ± 12 vs. Δ4 ± 11 mmHg; P = 0.002), AP (Δ-4 ± 4 vs. Δ2 ± 7 mmHg; P = 0.004), AIx@75 (Δ-3.2 ± 7.2 vs. Δ2.2 ± 6.9%; P = 0.038), Pf (Δ-6 ± 10 vs. Δ3 ± 9 mmHg; P = 0.019), and Pb (Δ-4 ± 6 vs. Δ2 ± 6 mmHg; P = 0.008) responses to the CPT were significantly attenuated following L-CIT supplementation vs. placebo. CONCLUSIONS: L-CIT supplementation attenuated aortic pulsatile pressure and pressure wave reflection responses to CPT in older adults, providing possible cardioprotection during cold-induced sympathoactivation in older adults.

The effect of interval training on adipokine plasmatic levels in rats with induced myocardial infarction.

Context: Exercise has been demonstrated to reduce pro-inflammatory while boosting anti-inflammatory adipokines; yet research in relation to Myocardial infarction (MI) is limited.Objective: The aim of this study was to investigate the effect of an interval exercise-training programme on concentrations of Lipocalin-2 and Adiponectin plasmatic levels in rats with induced MI.Materials and methods: The experimental study design comprised of three groups, including: a control group, MI control group and MI training group that participated in an interval training protocol for six weeks.Results: There was a significant increase in Lipocalin-2 levels in the MI interval training group when compared to the other groups.Discussion and conclusion: Although interval training has beneficial effects on adiponectin, it also increases Lipocalin-2 concentrations. Because Lipocalin-2 significantly contributes to the pathogenesis of atherosclerosis and adverse cardiac conditions, our findings suggest that interval training might be a counterproductive strategy to improve MI-related cardiac damage.

Does Branched-Chain Amino Acids (BCAAs) Supplementation Attenuate Muscle Damage Markers and Soreness after Resistance Exercise in Trained Males? A Meta-Analysis of Randomized Controlled Trials.

Previous studies have reported the positive effects of branched-chain amino acids (BCAAs) supplementation on lowering plasma markers of muscle damage and subjective soreness after resistance exercise. However, a variety of factors can potentially moderate its efficacy. This meta-analysis aimed to summarize the evidence regarding the effect of BCAAs supplementation on plasma muscle damage markers and soreness after resistance exercise in only trained males, by considering the plasma lactate dehydrogenase (LDH) and creatine kinase (CK). Randomized controlled trials were identified through a computerized literature search for the period 2010-2020. The pooled data were analyzed with the random-effects model and heterogeneity using I2. Cochrane Collaboration tools was used for the assessment of risk of bias. Nine studies met the inclusion criteria. A positive effect was found for CK at <24, 24, and 48 h after exercise and for muscle soreness at <24 h only. However, the positive effect was not evident for plasma LDH at any follow-up time. Different outcomes for post-exercise responses may suggest that BCAAs supplementation can attenuate muscle damage and ameliorate muscle soreness after resistance exercise in trained males.

Summated Hazard Score as a Powerful Predictor of Fatigue in Relation to Pacing Strategy.

During competitive events, the pacing strategy depends upon how an athlete feels at a specific moment and the distance remaining. It may be expressed as the Hazard Score (HS) with momentary HS being shown to provide a measure of the likelihood of changing power output (PO) within an event and summated HS as a marker of how difficult an event is likely to be perceived to be. This study aimed to manipulate time trial (TT) starting strategies to establish whether the summated HS, as opposed to momentary HS, will improve understanding of performance during a simulated cycling competition. Seven subjects (peak PO: 286 ± 49.7 W) performed two practice 10-km cycling TTs followed by three 10-km TTs with imposed PO (±5% of mean PO achieved during second practice TT and a self-paced TT). PO, rating of perceived exertion (RPE), lactate, heart rate (HR), HS, summated HS, session RPE (sRPE) were collected. Finishing time and mean PO for self-paced (time: 17.51 ± 1.41 min; PO: 234 ± 62.6 W), fast-start (time: 17.72 ± 1.87 min; PO: 230 ± 62.0 W), and slow-start (time: 17.77 ± 1.74 min; PO: 230 ± 62.7) TT were not different. There was a significant interaction between each secondary outcome variable (PO, RPE, lactate, HR, HS, and summated HS) for starting strategy and distance. The evolution of HS reflected the imposed starting strategy, with a reduction in PO following a fast-start, an increased PO following a slow-start with similar HS during the last part of all TTs. The summated HS was strongly correlated with the sRPE of the TTs (r = 0.88). The summated HS was higher with a fast start, indicating greater effort, with limited time advantage. Thus, the HS appears to regulate both PO within a TT, but also the overall impression of the difficulty of a TT.

Impaired pulse pressure amplification, augmentation index, and arterial stiffness are associated with reduced limb lean mass in overweight and obese postmenopausal women.

BACKGROUND: The age-related muscle mass loss has been associated with increased arterial stiffness (brachial-ankle pulse wave velocity, baPWV) and wave reflection (augmentation index, AIx). In healthy individuals, pulse pressure (PP) is lower in the aorta compared to the brachial artery (PP amplification, PPA). Postmenopausal women experience elevated aortic stiffness leading to increased AIx and aortic PP causing reduced PPA, an independent predictor of cardiovascular mortality. It is unknown whether appendicular skeletal muscle index (ASMI), arm (ArmLM) or leg lean mass (LegLM) are negatively associated with PPA. The purpose of this study was to investigate the associations between vascular function (PPA, AIx, and baPWV) and lean mass (ASMI, ArmLM, and LegLM) in postmenopausal women. METHODS: The study was performed in 93 postmenopausal women (48-71 years; BMI: 30 ± 7 kg/m2). PPA (brachial/aortic PP), aortic AIx, and baPWV were measured. ArmLM and LegLM were measured by dual-energy X-ray absorptiometry. ASMI was calculated as (ArmLM+LegLM)/Ht2. Associations between vascular and lean mass measures were analyzed by multiple linear regression. RESULTS: PPA was associated with ASMI (ß = 0.29, p = .016) and LegLM (ß = 0.25, p = .028) after adjustment for age, height, systolic pressure, strength, and heart rate. AIx was associated with ASMI (ß = -0.27, p = .011), ArmLM (ß = -0.25, p = .023), and LegLM (ß = -0.22, p = .026), while baPWV was associated with reduced ASMI (ß = -0.23, p = .043) and ArmLM (ß = -0.23, p = .045), but not with LegLM (ß = -0.19, p = .074) after full adjustment. CONCLUSIONS: Our findings indicate that impaired pulsatile hemodynamics (PPA and AIx) are negatively associated with ASMI and LegLM, while arterial stiffness is negatively associated with ASMI and ArmLM. Thus, vascular dysfunction may be implicated in muscle mass loss in overweight and obese postmenopausal women.

Attenuated aortic blood pressure responses to metaboreflex activation in older adults with dynapenia.

BACKGROUND: Low muscle strength (dynapenia) is a primary characteristic of sarcopenia, the age-related loss of muscle mass and strength or low walking speed. New evidence suggests that muscle strength positively affects blood pressure (BP) responses to exercise. As older adults with lowest handgrip strength also have lowest BP at rest, those with dynapenia may experience attenuated BP responses during physical activity. The purpose of this study was to test the hypothesis that dynapenic older adults would exhibit lower BP response to post-exercise muscle ischemia (PEMI). METHODS: Brachial and aortic systolic BP (SBP), diastolic BP (DBP), and mean arterial pressure (MAP) were measured in older adults (age, 80 ± 5 y) with dynapenia (n = 16) and non-dynapenia (n = 9) at rest and during PEMI following 2 min of isometric handgrip exercise at 30% maximal voluntary contraction. Walking speed was assessed by an 8-foot (2.44 m) walk course. RESULTS: Increases in aortic SBP (11 ± 2 vs. 23 ± 6 mm Hg, p = .03), DBP (6 ± 2 vs.14 ± 4 mm Hg, p = .04), and MAP (8 ± 1 vs. 17 ± 5 mm Hg, p = .02) were lower in dynapenic compared to non-dynapenic adults. Aortic MAP (r = 0.52, p < .05) response to PEMI was correlated with MVC in dynapenic adults. Gait speed was correlated with aortic DBP response to PEMI (r = 0.698, p = .05) in non-dynapenic adults. CONCLUSIONS: Our findings indicate that aortic DBP response to muscle metaboreflex activation is attenuated in older adults with dynapenia. Normal aortic DBP response during metaboreflex activation may positively affect walking performance in non-dynapenic older adults.

L-Citrulline Supports Vascular and Muscular Benefits of Exercise Training in Older Adults.

Age-associated reduction in endothelial nitric oxide (NO) synthesis contributes to the development of cardiovascular diseases and sarcopenia. L-Citrulline is a precursor of NO with the ability to improve vascular function and muscle protein synthesis. We hypothesize that vascular and muscular benefits associated with oral L-citrulline supplementation might be augmented by concomitant supplementation with exercise training in older adults.

Effects of Montmorency Tart Cherry Juice Consumption on Cardiometabolic Biomarkers in Adults with Metabolic Syndrome: A Randomized Controlled Pilot Trial.

Greater than one-third of adults in the United States have metabolic syndrome (MetS), a cluster of risk factors highly associated with the development of cardiovascular diseases. Premature vascular dysfunction in MetS may lead to accelerated age-related atherogenesis and arterial stiffening, thereby increasing cardiovascular risk. Montmorency tart cherries (Prunus cerasus L.) are rich in bioactive compounds, such as anthocyanins, known to exert cardiovascular protective effects. Previous research suggests that tart cherry juice consumption may improve cardiovascular health. The objective of this study was to evaluate the effects of daily consumption of tart cherry juice on hemodynamics, arterial stiffness, and blood biomarkers of cardiovascular and metabolic health in men and women with MetS. In a randomized, single-blind, placebo-controlled, parallel-arm pilot clinical trial, 19 men and women 20 to 60 years of age with MetS consumed 240 mL of tart cherry juice (Tart Cherry; n = 5 males, 4 females) or an isocaloric placebo-control drink (Control; n = 5 males, 5 females) twice daily for 12 weeks. Arterial stiffness (pulse wave velocity), brachial and aortic blood pressures, wave reflection (augmentation index), and blood biomarkers of cardiovascular and metabolic health were assessed at baseline and 6 and 12 weeks. Oxidized low-density lipoprotein and soluble vascular cell adhesion molecule-1 were significantly lower (P = .047 and P = .036, respectively) in Tart Cherry than Control at 12 weeks, but were not significantly lower than baseline values. There was a trend for total cholesterol to be lower (P = .08) in Tart Cherry than Control at 12 weeks. No significant changes were observed in hemodynamics, arterial stiffness, or other blood biomarkers assessed. These results suggest that daily tart cherry consumption may attenuate processes involved in accelerated atherogenesis without affecting hemodynamics or arterial stiffness parameters in this population. The pilot nature of this study warrants interpreting these findings with caution, and future clinical trials with a larger sample size are needed to confirm these findings.

Effect of Progressive Fatigue on Session RPE.

Rating of perceived exertion (RPE) and session RPE (sRPE) are reliable tools for predicting exercise intensity and are alternatives to more technological and physiological measurements, such as blood lactate (HLa) concentration, oxygen consumption and heart rate (HR). As sRPE may also convey some insights into accumulated fatigue, the purpose of this study was to examine the effects of progressive fatigue in response to heavier-than-normal training on sRPE, with absolute training intensity held constant, and determine its validity as marker of fatigue. Twelve young adults performed eight interval workouts over a two-week period. The percentage of maximal HR (%HRmax), HLa, RPE and sRPE were measured for each session. The HLa/RPE ratio was calculated as an index of fatigue. Multilevel regression analysis showed significant differences for %HRmax (p = 0.004), HLa concentration (p = 0.0001), RPE (p < 0.0001), HLa/RPE ratio (p = 0.0002) and sRPE (p < 0.0001) across sessions. Non-linear regression analysis revealed a very large negative relationship between HLa/RPE ratio and sRPE (r = -0.70, p < 0.0001). These results support the hypothesis that sRPE is a sensitive tool that provides information on accumulated fatigue, in addition to training intensity. Exercise scientists without access to HLa measurements may now be able to gain insights into accumulated fatigue during periods of increased training by using sRPE.

Generalized Approach to Translating Exercise Tests and Prescribing Exercise.

Although there is evidence supporting the benefit of regular exercise, and recommendations about exercise and physical activity, the process of individually prescribing exercise following exercise testing is more difficult. Guidelines like % heart rate (HR) reserve (HRR) require an anchoring maximal test and do not always provide a homogenous training experience. When prescribing HR on the basis of % HRR, rating of perceived exertion or Talk Test, cardiovascular/perceptual drift during sustained exercise makes prescription of the actual workload difficult. To overcome this issue, we have demonstrated a strategy for "translating" exercise test responses to steady state exercise training on the basis of % HRR or the Talk Test that appeared adequate for individuals ranging from cardiac patients to athletes. However, these methods depended on the nature of the exercise test details. In this viewpoint, we combine these data with workload expressed as Metabolic Equivalent Task (METs). We demonstrate that there is a regular stepdown between the METs during training to achieve the same degree of homeostatic disturbance during testing. The relationship was linear, was highly-correlated (r = 0.89), and averaged 71.8% (Training METs/Test METs). We conclude that it appears possible to generate a generalized approach to correctly translate exercise test responses to exercise training.

Exaggerated Aortic Pulse Pressure and Wave Amplitude During Muscle Metaboreflex Activation in Type 2 Diabetes Patients.

BACKGROUND: Peripheral mean arterial pressure (MAP) responses to muscle metaboreflex activation using postexercise muscle ischemia (PEMI) in type 2 diabetes patients (T2D) are contradictory. Given that aortic pulse pressure (PP) and wave reflections are better indicators of cardiac load than peripheral MAP, we evaluated aortic blood pressure (BP) and wave amplitude during PEMI. METHODS: Aortic BP and pressure wave amplitudes were measured at rest and during PEMI following isometric handgrip at 30% maximum voluntary contraction (MVC) in 16 T2D and 15 controls. Resting aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) and fasting blood glucose (FBG) were measured. RESULTS: Increases in aortic MAP (Δ26 ± 2 mmHg vs. Δ17 ± 2 mmHg), PP (Δ15 ± 2 mmHg vs. Δ10 ± 1 mmHg), augmentation index (AIx) (Δ8.2 ± 1.0% vs. Δ4.5 ± 1.3%), augmented pressure (AP) (Δ11 ± 1 mmHg vs. Δ5 ± 1 mmHg), forward (Pf) (Δ9 ± 1 mmHg vs. Δ5 ± 1 mmHg), and backward pressure waves (Pb) (Δ10 ± 1 mmHg vs. Δ5 ± 1 mmHg) responses to PEMI were greater in T2D than controls (P < 0.05). Aortic PP, but not MAP, response to PEMI was correlated to Pf (r = 0.63, P < 0.001) and Pb (r = 0.82, P < 0.001) responses and cfPWV (r = 0.37, P < 0.05). CONCLUSIONS: Aortic BP and pressure wave responses to muscle metaboreflex activation are exaggerated in T2D. Aortic PP during PEMI was related to increased wave reflection, forward wave amplitude, and aortic stiffness in T2D patients.

Impact of low-intensity resistance and whole-body vibration training on aortic hemodynamics and vascular function in postmenopausal women.

To examine the effects of low-intensity resistance exercise training (LIRET) and whole-body vibration training (WBVT) with an external weighted vest on arterial stiffness, wave reflection, brachial flow-mediated dilation (FMD), and physical performance in postmenopausal women. Thirty-three postmenopausal women were stratified by age, body mass index (BMI), and maximal voluntary contraction (MVC) (age, 65 ± 4 years; BMI, 23.3 ± 2.6 kg/m2; MVC, 17.4 ± 2.6 kg) and randomized into LIRET, WBVT, or a nonexercising control group for 12 weeks. Arterial stiffness, augmentation index (AIx), augmented pressure (AP), brachial FMD, gait speed and leg strength were measured at baseline and 12 weeks. WBVT induced improvements in pulse pressure amplification (PPA) (0.04 ± 0.02) compared to control (P = 0.048) and in wave reflection indices [AIx (-4.3 ± 1.4%) and AP (-2.9 ± 1.3 mmHg)] compared to LIRET (P = 0.039 and 0.048, respectively). WBVT (3.8 ± 1.4%) and LIRET (5.0 ± 1.5%) induced similar improvements in FMD compared to control (P = 0.029 and 0.008, respectively). WBVT and LIRET elicited similar increases in leg strength (P = 0.001 and 0.019, respectively), compared to no improvement in the control group. LIRET significantly increased gait speed compared to WBVT (P = 0.043). Although both WBVT and LIRET increased brachial artery FMD (systemic effect), WBVT seemed to be more efficacious in improving wave reflection and cardiac pulsatile load. Interestingly, LIRET elicited a significant improvement in gait speed. Both modalities seem effective in improving systemic endothelial function and muscle strength in postmenopausal women.

Impact of high- and low-intensity resistance training on arterial stiffness and blood pressure in adults across the lifespan: a review.

Resistance training (RT) is performed for improvements in body composition in young healthy adults and for health benefits in middle-aged and older adults. Traditionally, RT is prescribed at moderate- to high-intensity to promote benefits on skeletal muscle mass and strength in middle-aged and older adults without considering the vascular effects. Recent evidence suggests that muscle strength may be more protective than muscle mass for cardiovascular disease prevention and that muscle strength can be importantly improved with low-intensity RT. The main purpose of this review was to examine the effects of RT intensity on arterial stiffness and blood pressure (peripheral and central) in young and older adults. Although small increases in central arterial stiffness (carotid ß and carotid-femoral pulse wave velocity [PWV]) have been reported in young and middle-aged men, this review suggests that low- and high-intensity RT may not affect arterial stiffness whereas low-intensity RT may decrease systemic arterial stiffness (brachial-ankle PWV) in young healthy adults or not affect arterial stiffness in middle-aged and older adults. Independently of the intensity, RT may be effective to reduce blood pressure (peripheral and central) in middle-aged and older adults with at least elevated blood pressure at baseline. Further studies are needed to examine the impact of RT on arterial stiffness, central blood pressure, and wave reflection in middle-aged and older adults.

Impact of daily strawberry consumption on blood pressure and arterial stiffness in pre- and stage 1-hypertensive postmenopausal women: a randomized controlled trial.

Growing evidence indicates that strawberries are cardioprotective. We conducted an eight-week randomized, double-blind, placebo-controlled, parallel arm clinical trial to investigate the effects of daily consumption of freeze-dried strawberry powder (FDSP) on blood pressure (BP) and arterial stiffness in pre- and stage 1-hypertensive postmenopausal women. Sixty postmenopausal women were randomly assigned to one of three groups: (1) control, (2) 25 g FDSP and (3) 50 g FDSP (n = 20 per group). Assessments of body weight, BP, arterial stiffness as measured by pulse wave velocity (PWV), and collection of blood samples for analyses of vasoactive and antioxidant molecules were performed at baseline, four and eight weeks. After eight weeks, systolic BP, as well as brachial- and femoral-ankle PWV were lower than baseline in the 25 g FDSP group (141 ± 3 to 135 ± 3 mmHg, P = 0.02; 15.5 ± 0.5 to 14.8 ± 0.4 m s-1, P = 0.03, and 11.0 ± 0.2 to 10.4 ± 0.2 m s-1, P = 0.02, respectively), whereas no statistically significant changes were observed in the control or 50 g FDSP groups. Plasma nitric oxide metabolite levels increased at four and eight weeks in the 50 g FDSP group compared to baseline (8.5 ± 1.2 to 13.6 ± 1.3 and 13.3 ± 1.5, respectively, P = 0.01), whereas no significant changes were observed in the control or 25 g FDSP groups. Serum levels of superoxide dismutase increased at four weeks returning to baseline levels at eight weeks in all three groups. Significant differences among groups were not detected for any of the parameters. Although BP and arterial stiffness improved in the 25 g FDSP group over time, a treatment effect was not observed. Thus, it would be premature to affirm that daily consumption of FDSP improves BP or vascular function in pre- and stage 1-hypertensive postmenopausal women. This trial was registered at as NCT02099578.

Benefits of whole-body vibration training on arterial function and muscle strength in young overweight/obese women.

The early arterial dysfunction linked with obesity and a sedentary lifestyle heightens the likelihood of suffering from future cardiovascular events. Whole-body vibration training (WBVT) may improve systemic arterial stiffness (brachial-ankle pulse wave velocity (baPWV)) and muscle strength in pre- and post-menopausal women. However, the effectiveness of WBVT to impact the arterial segments included in baPWV is unknown. The aim of this study was to investigate the effects of WBVT on aortic and leg arterial stiffness in young sedentary overweight/obese women. Thirty-eight young (21 years) overweight/obese women were randomized to WBVT (n=25) or a nonexercising control (CON, n=13) groups for 6 weeks. PWV, brachial and aortic blood pressures (BP), wave reflection (augmentation index (AIx)) and leg muscle strength measurements were acquired before and after 6 weeks. WBVT significantly reduced carotid-femoral PWV (aortic stiffness, P<0.05), femoral-ankle (leg arterial stiffness, P<0.01) and baPWV (systemic arterial stiffness, P<0.01) compared with CON. The reduction in brachial systolic BP (SBP), heart rate, aortic SBP, aortic diastolic BP, AIx normalized to a heart rate of 75 beats per min (AIx@75; P<0.01) and AIx (P<0.05) following WBVT was significant compared with CON (P<0.05). WBVT increased leg muscle strength compared with CON (P<0.001). There was a significant negative correlation between changes in relative muscle strength and aortic stiffness (r=-0.41, P<0.05). WBVT led to reductions in arterial stiffness, central BP and wave reflection in young obese women. WBVT may be an effective intervention toward vascular health promotion and prevention in young overweight/obese women (ClinicalTrials.gov identifier: NCT02679898).

Influence of L-citrulline and watermelon supplementation on vascular function and exercise performance.

PURPOSE OF REVIEW: L-Citrulline, either synthetic or in watermelon, may improve vascular function through increased L-arginine bioavailability and nitric oxide synthesis. This article analyses potential vascular benefits of L-citrulline and watermelon supplementation at rest and during exercise. RECENT FINDINGS: There is clear evidence that acute L-citrulline ingestion increases plasma L-arginine, the substrate for endothelial nitric oxide synthesis. However, the subsequent acute improvement in nitric oxide production and mediated vasodilation is inconsistent, which likely explains the inability of acute L-citrulline or watermelon to improve exercise tolerance. Recent studies have shown that chronic L-citrulline supplementation increases nitric oxide synthesis, decreases blood pressure, and may increase peripheral blood flow. These changes are paralleled by improvements in skeletal muscle oxygenation and performance during endurance exercise. The antihypertensive effect of L-citrulline/watermelon supplementation is evident in adults with prehypertension or hypertension, but not in normotensives. However, L-citrulline supplementation may attenuate the blood pressure response to exercise in normotensive men. SUMMARY: The beneficial vascular effects of L-citrulline/watermelon supplementation may stem from improvements in the L-arginine/nitric oxide pathway. Reductions in resting blood pressure with L-citrulline/watermelon supplementation may have major implications for individuals with prehypertension and hypertension. L-Citrulline supplementation, but not acute ingestion, have shown to improve exercise performance in young healthy adults.

Influence of low and normal appendicular lean mass on central blood pressure and wave reflection responses to muscle metaboreflex activation in postmenopausal women.

Sarcopenia, defined by reduced appendicular skeletal muscle mass (ASM)/height2 (ASMI), is associated with increased arterial stiffness (brachial-ankle pulse wave velocity, baPWV) and wave reflection (augmentation index, AIx). Blood pressure (BP) responses to metaboreflex activation (post-exercise muscle ischemia, PEMI) are exaggerated in older prehypertensives and hypertensives. We examined peripheral and aortic haemodynamics at rest and during PEMI in postmenopausal women with low-ASMI and normal-ASMI. Resting radial AIx and baPWV as well as brachial and aortic systolic BP, pulse pressure, systolic time index, and subendocardial viability ratio (SEVR) responses to PEMI were greater in women with low-ASMI than normal-ASMI. Increased baPWV associated with low-ASMI may play a major role in the exaggerated pulse pressure and SEVR responses to PEMI in postmenopausal women.