Nutrient synergy: definition, evidence, and future directions.

Nutrient synergy refers to the concept that the combined effects of two or more nutrients working together have a greater physiological impact on the body than when each nutrient is consumed individually. While nutrition science traditionally focuses on isolating single nutrients to study their effects, it is recognized that nutrients interact in complex ways, and their combined consumption can lead to additive effects. Additionally, the Dietary Reference Intakes (DRIs) provide guidelines to prevent nutrient deficiencies and excessive intake but are not designed to assess the potential synergistic effects of consuming nutrients together. Even the term synergy is often applied in different manners depending on the scientific discipline. Considering these issues, the aim of this narrative review is to investigate the potential health benefits of consuming different nutrients and nutrient supplements in combination, a concept we define as nutrient synergy, which has gained considerable attention for its impact on overall well-being. We will examine how nutrient synergy affects major bodily systems, influencing systemic health. Additionally, we will address the challenges associated with promoting and conducting research on this topic, while proposing potential solutions to enhance the quality and quantity of scientific literature on nutrient synergy.

Supplementation with Nitric Oxide Precursors for Strength Performance: A Review of the Current Literature.

Nitric-oxide-stimulating dietary supplements are widely available and marketed to strength athletes and weightlifters seeking to increase muscle performance and augment training adaptations. These supplements contain ingredients classified as nitric oxide (NO) precursors (i.e., "NO boosters"). Endogenous NO is generated via a nitric oxide synthase (NOS)-dependent pathway and a NOS-independent pathway that rely on precursors including L-arginine and nitrates, with L-citrulline serving as an effective precursor of L-arginine. Nitric oxide plays a critical role in endothelial function, promoting relaxation of vascular smooth muscle and subsequent dilation which may favorably impact blood flow and augment mechanisms contributing to skeletal muscle performance, hypertrophy, and strength adaptations. The aim of this review is to describe the NO production pathways and summarize the current literature on the effects of supplementation with NO precursors for strength and power performance. The information will allow for an informed decision when considering the use of L-arginine, L-citrulline, and nitrates to improve muscular function by increasing NO bioavailability.

Effect of watermelon supplementation on exercise performance, muscle oxygenation, and vessel diameter in resistance-trained men.

INTRODUCTION: Watermelon shows promise as an ergogenic aid due to its high concentration of L-citrulline, vitamins, minerals, and antioxidants. PURPOSE: The purpose of this study was to examine the effect of watermelon supplementation on exercise performance, muscle oxygenation, and vessel diameter. METHODS: In a crossover design fashion, 15 resistance-trained men (22.4 ± 2.9 years; 177.5 ± 7.1 cm; 82.7 ± 11.2 kg) were randomly assigned to supplement with either watermelon juice concentrate (WM; 2.2 g·day-1 L-citrulline) or placebo (PL) for 7 days prior to completing an experimental trial consisting of an isometric mid-thigh pull test and acute bench press protocol. Participants completed two sets of two repetitions at 75% 1 repetition maximum (1-RM) with maximum ballistic intent followed by five repetition-maximum (RM) sets at the same load. Barbell velocity and power were measured via linear position transducer during the first two sets, while volume load and muscle oxygenation were quantified during RM sets. Brachial artery diameter and subjective perception measures were assessed at baseline and immediately pre- and post-exercise. RESULTS: Except for a greater percent change in skeletal muscle oxygenation during WM compared to PL on average and across sets (mean difference = + 4.1%, p = 0.033, BF10 = 2.2-54.5), separate traditional and Bayesian analyses of variance with repeated measures, as well as paired-samples t tests for calculated summary measures, revealed no evidence favoring conditional differences in any measure of performance, perception, or muscle oxygenation. CONCLUSION: Short-term watermelon supplementation does not appear to enhance isometric force production, bench press performance, blood vessel diameter, or muscle oxygenation parameters compared to PL in resistance-trained men.

Influence of Dietary Nitrate Supplementation on Physical Performance and Body Composition Following Offseason Training in Division I Athletes.

Purpose: To determine the effects of dietary nitrate supplementation, in the form of red spinach extract (RSE), on adaptations to offseason training in collegiate athletes.Methods: Sixteen Division I male baseball athletes (20.5 ± 1.7y, 90.4 ± 0.5 kg) enrolled in this study and were randomized into a RSE (n = 8) or placebo (n = 8; PL) group. Athletes completed an 11-week resistance training program during the offseason, which consisted of 2-3 workouts per week of upper and lower-body exercises and baseball-specific training. Athletes consumed a RSE (2 g; 180 mg nitrate) or PL supplement daily for the entire offseason training program. Pre and post-training, all athletes underwent one-repetition maximum (1RM) strength testing for the bench press and completed a Wingate anaerobic cycle test (WAnT). Body composition analysis was completed via a 4-compartment model, as well as muscle thickness (MT) measurement of the rectus femoris (RF) and vastus lateralis (VL) via ultrasonography. Resting heart rate and blood pressure (BP) were also obtained. Separate repeated measures analyses of variance were used to analyze all data.Results: Significant (p ≤ 0.05) main effects for time were observed for improved bench 1RM, fat-free mass, body fat percentage, RF MT, and VL MT. No significant group x time interactions (p > 0.05) were found for any measure of performance, body composition, or cardiovascular health. However, a trend for improved peak power in the WAnT was observed (p = 0.095; η2=0.200).Conclusions: These data suggest that daily RSE supplementation had no effect on performance, body composition, or cardiovascular measures in male Division I baseball players following offseason training.

A Systematic Review of Mindfulness-Based Interventions for Patients with Mild Cognitive Impairment or Dementia and Caregivers.

The aim of this article was to systematically review the quality and efficacy of the current evidence for mindfulness-based interventions (MBIs) in patients with mild cognitive impairment (MCI), patients with dementia (PwD), and their caregivers. We identified 20 randomized controlled trials (RCTs) (11 for patients, 9 for caregivers) published in the last 15 years. Evidence suggested that MBIs are highly acceptable and credible treatments for patients with MCI, PwD and caregivers. Specifically, for PwD, the results indicated that the magnitude of post-treatment effects of MBIs are in the medium to large range for psychosocial outcomes, and in the small to medium range for cognitive functioning; however, treatment effects on dementia biomarkers were mixed, ranging from small to large, depending on the outcome measure. Findings also evidenced salutary effects of MBIs for caregivers of PwD, with post-treatment effects ranging from medium to large for caregiver stress and burden and large effects for quality of life, and mixed outcomes for cognitive functioning, with effects in the small to large range. However, confidence in these findings is relatively limited due to methodological limitations, especially in terms of poor consistency in intervention strategies, outcome measures, and other key criteria across studies. To better assess the value of MBIs for these populations and optimize treatment outcomes, we recommend further research with improved study methodology (e.g., multi-method assessment, universal criterion and outcome measures, use of active control groups, larger sample sizes, long-term follow-up) to replicate current findings and enhance our understanding of underlying treatment mechanisms of MBIs.

Effect of Multi-Ingredient Preworkout Supplementation on Repeated Sprint Performance in Recreationally Active Men and Women.

Gonzalez, AM, Pinzone, AG, Bram, J, Salisbury, JL, Lee, S, and Mangine, GT. Effect of multi-ingredient preworkout supplementation on repeated sprint performance in recreationally active men and women. J Strength Cond Res 34(4): 918-923, 2020-The purpose of this investigation was to examine the effects of acute supplementation of a multi-ingredient preworkout supplement (MIPS), containing a proprietary blend of ancient peat and apple extracts, creatine monohydrate, taurine, ribose, and magnesium, on sprint cycling performance. Seventeen recreationally active men and women (23.2 ± 5.9 years; 172.9 ± 14.3 cm; 82.4 ± 14.5 kg) underwent 2 testing sessions administered in a randomized, counterbalanced, double-blind fashion. Subjects were provided either MIPS or placebo (PL) one hour before performing a sprint cycling protocol, which consisted of ten 5-second "all-out" sprints interspersed by 55 seconds of unloaded pedaling. Average power (PAVG), peak power (PPK), average velocity (VAVG), and distance covered were recorded for each sprint. Separate linear mixed models revealed decrements (p < 0.05) compared to the first sprint in PAVG (75-229 W) and PPK (79-209 W) throughout all consecutive sprints after the initial sprint during PL. Likewise, diminished (p ≤ 0.029) VAVG (3.37-6.36 m·s) and distance covered (7.77-9.00 m) were noted after the third and fifth sprints, respectively, during PL. By contrast, during MIPS, only VAVG decreased (2.34-5.87 m·s, p ≤ 0.002) on consecutive sprints after the first sprint, whereas PAVG and PPK were maintained. In addition, a significant decrease (p = 0.045) in distance covered was only observed on the ninth sprint during MIPS. These data suggest that recreational athletes who consumed the MIPS formulation, one hour before a repeated sprinting session on a cycle ergometer, better maintained performance compared with PL.

Effects of Citrulline Supplementation on Exercise Performance in Humans: A Review of the Current Literature.

Gonzalez, AM and Trexler, ET. Effects of citrulline supplementation on exercise performance in humans: A review of the current literature. J Strength Cond Res 34(5): 1480-1495, 2020-L-citrulline, a nonessential amino acid found primarily in watermelon, has recently garnered much attention for its potential to augment L-arginine bioavailability, nitric oxide production, and exercise performance. Over the past decade, L-citrulline has received considerable scientific attention examining potentially ergogenic properties for both aerobic and anaerobic exercise performance. Thus, the purpose of this article is to summarize the theoretical rationale behind L-citrulline supplementation and to comprehensively review the available scientific evidence assessing the potential ergogenic value of L-citrulline supplementation on vascular function and exercise performance in humans. In addition, research that has investigated the potential synergistic effects of L-citrulline with other dietary ingredients (e.g., arginine, antioxidants, nitrates, and branched-chain amino acids) is reviewed. Oral L-citrulline and citrulline malate supplementation have shown to increase plasma citrulline and arginine concentrations, along with total nitrate and nitrite concentrations. Although blood flow enhancement is a proposed mechanism for the ergogenic potential of L-citrulline, evidence supporting acute improvements in vasodilation and skeletal muscle tissue perfusion after supplementation is scarce and inconsistent. Nevertheless, several studies have reported that L-citrulline supplementation can enhance exercise performance and recovery. Given the positive effects observed from some investigations, future studies should continue to investigate the effects of both acute and chronic supplementation with L-citrulline and citrulline malate on markers of blood flow and exercise performance and should seek to elucidate the mechanism underlying such effects.

The Stony Brook Health Enhancement Program: The development of an active control condition for mind-body interventions.

This article describes the development of a manualized, eight-session multiple health behavior change program which addresses sleep, exercise, nutrition, substance use, and working with one's healthcare team. Our goal was to design a structured, evidence-based program that could be facilitated by a single health professional and could act as an active, credible control for mind-body intervention studies. Psychoeducational content was adapted from the latest government and peer-reviewed guidelines. Preliminary work suggests the program is acceptable and feasible for use in patients of varying ages with heterogeneous mental and physical health problems. It is adaptable for both face-to-face and online delivery.

Effects of a Multi-Ingredient Energy Supplement on Cognitive Performance and Cerebral-Cortical Activation.

This study assessed whether a multi-ingredient energy supplement (MIES) could enhance cerebral-cortical activation and cognitive performance during an attention-switching task. Cerebral-cortical activation was recorded in 24 young adults (12 males, 12 females; 22.8 ± 3.8 yrs) via electroencephalography (EEG) both at rest and during the attention-switching task before (pretest) and 30 min after (posttest) consumption of a single serving of a MIES (MIES-1), two servings of a MIES (MIES-2), or a placebo (PL) in a double-blinded, randomized crossover experimental design. EEG upper-alpha power was assessed at rest and during the task, wherein d' (Z[hit rate]-Z[false alarm rate]) and median reaction time (RT) for correct responses to targets on attention-hold and attention-switch trials were analyzed. For both d' and RT, the Session (MIES-1, MIES-2, PL) × Time (pretest, posttest) interaction approached statistical significance (p = .07, η2p = 0.106). Exploring these interactions with linear contrasts, a significant linear effect of supplement dose on the linear effect of time was observed (ps ≤.034), suggesting the pretest-to-posttest improvement in sensitivity to task target stimuli (d') and RT increased as a function of supplement dose. With respect to upper-alpha power, the Session × Time interaction was significant (p < .001, η2p = 0.422). Exploring this interaction with linear contrasts, a significant linear effect of supplement dose on the linear effect of time was observed (p < .001), suggesting pretest-to-posttest increases in cerebral-cortical activation were a function of supplement dose. In conclusion, our findings suggest that MIES can increase cerebral-cortical activation and RT during task performance while increasing sensitivity to target stimuli in a dose-dependent manner.

The Relaxation Response Resiliency Program (3RP) in Patients with Headache and Musculoskeletal Pain: A Retrospective Analysis of Clinical Data.

BACKGROUND: Headache and musculoskeletal pain are associated with both physical and mental health symptoms, which together are mutually reinforcing. Addressing mental and physical health symptoms (including pain) concomitantly may provide an effective and efficient way to improve outcomes in this population. We tested an evidence-based, eight-session multimodal group program, the Relaxation Response Resiliency Program (3RP), in patients with headache and musculoskeletal pain. A total of 109 adults (30 with headaches, 79 with musculoskeletal pain). METHODS: Participant were 109 adults (30 with headaches, 79 with musculoskeletal pain) referred by their medical doctor, who completed a battery of questionnaires before and after completion of the 3RP. RESULTS: On average, patients with headache and musculoskeletal pain had higher pretreatment scores for anxiety, depression, and somatization symptoms than the nonpatient normative sample for the Symptom Checklist 90-Revised. Significant improvements were identified from pre- to post-treatment in all mental health symptoms (moderate to large effects) and frequency of pain and co-occurring physical health symptoms (small to moderate effects). Patients also reported significant decreases in degree of discomfort and life interference, which were relatively more modest in the musculoskeletal pain group compared with the headache group. CONCLUSIONS: Overall, results of this study suggest that the 3RP may be an effective treatment for reducing pain and psychological symptoms in patients with headaches and musculoskeletal pain. Future work is needed to evaluate the 3RP via a randomized clinical trial in these patient populations.

Effect of Multi-Ingredient Supplement Containing Satiereal, Naringin, and Vitamin D on Body Composition, Mood, and Satiety in Overweight Adults.

The purpose of this investigation was to examine the effects of 28 days of a dietary supplement on body composition, mood, and satiety in overweight adults. Twenty healthy adults (25.5 ± 3.8 years; 87.3 ± 20.7 kg; 169.9 ± 10.6 cm; 29.9 ± 5.1 body mass index) participated in this randomized, double-blind, placebo-controlled investigation. Ten participants were provided with a dietary supplement containing 178 mg satiereal, 100 mg naringin, and 2,000 IU vitamin D3 daily (SUPP), and ten participants were provided a placebo (PL) for 28 days. Baseline (PRE) and post (POST) assessments included body mass, BMI, and waist circumference measures. In addition, participants provided self-reported food records and completed study questionnaires twice weekly. Questionnaires consisted of profile of mood states, visual analog scales, modified trait food-cravings questionnaire, and a modified state food-cravings questionnaire. No significant differences were noted between groups for total calorie or macronutrient intake (p = 0.65-0.92), body mass (p = 0.34), BMI (p = 0.24), or waist circumference measures (p = 0.56-0.94). In addition, no significant differences between groups were observed for mood states, subjective measures of food cravings, or feelings of anxiety, fullness, bloating, hunger, craving, and stress (p >.05). In conclusion, 28 days of a dietary supplement containing satiereal, naringin, and vitamin D3 did not have any detectable beneficial effects on body-weight management.

Acute Effect of Citrulline Malate Supplementation on Upper-Body Resistance Exercise Performance in Recreationally Resistance-Trained Men.

Gonzalez, AM, Spitz, RW, Ghigiarelli, JJ, Sell, KM, and Mangine, GT. Acute effect of citrulline malate supplementation on upper-body resistance exercise performance in recreationally resistance-trained men. J Strength Cond Res 32(11): 3088-3094, 2018-To investigate the effect of citrulline malate (CM) supplementation on upper-body resistance exercise performance, 12 recreationally resistance-trained men (21.4 ± 1.6 years; 163.0 ± 46.2 cm; 85.0 ± 12.4 kg) underwent 2 testing sessions administered in a randomized, double-blind fashion. During each visit, participants were provided either 8 g of CM or a placebo (PL) 40 minutes before beginning a standardized warm-up and initiating a barbell bench press resistance exercise protocol consisting of 5 sets of 15 repetitions at 75% 1 repetition maximum with 2-minute rest intervals. Participants were instructed to complete as many repetitions as possible until either reaching 15 repetitions or muscular failure. Total number of repetitions performed and power output were recorded for each set. Subjective measures of energy, focus, fatigue, and perceived exertion, along with muscle thickness of the triceps brachii, were assessed before and after exercise. Significant (p ≤ 0.05) main effects for time were observed for all variables except for subjective feelings of energy (p = 0.085). A group × time interaction (F = 2.86, p = 0.034, n = 0.21) was observed for repetitions performed, where participants performed more (p = 0.015) repetitions on set 3 during PL (5.7 ± 1.2 repetitions) compared with CM (4.6 ± 1.2 repetitions). However, during set 4, participants tended (p = 0.089) to perform more repetitions during CM (4.8 ± 1.8 repetitions) compared with PL (4.3 ± 1.3 repetitions). No other differences were observed between trials. Supplementation with 8 g of CM 40 minutes before the barbell bench press resistance exercise protocol did not increase exercise performance, augment the muscle swelling response to training, or alter subjective measures of focus, energy, and fatigue in recreationally resistance-trained men.

ß-hydroxy-ß-methylbutyrate free acid supplementation may improve recovery and muscle adaptations after resistance training: a systematic review.

ß-Hydroxy-ß-methylbutyrate free acid (HMB-FA) has been suggested to accelerate the regenerative capacity of skeletal muscle after high-intensity exercise and attenuate markers of skeletal muscle damage. Herein a systematic review on the use of HMB-FA supplementation as an ergogenic aid to improve measures of muscle recovery, performance, and hypertrophy after resistance training was conducted. This review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We included randomized, double-blinded, placebo-controlled trials investigating the effects of HMB-FA supplementation in conjunction with resistance exercise in humans. The search was conducted using Medline and Google Scholar databases for the terms beta-hydroxy-beta-methylbutyrate, HMB free acid, exercise, resistance exercise, strength training, and HMB supplementation. Only research articles published from 1996 to 2016 in English language were considered for the analysis. Nine studies met the criteria for inclusion in the analyses. Most studies included resistance-trained men, and the primary intervention strategy involved administration of 3g of HMB-FA per day. In conjunction with resistance training, HMB-FA supplementation may attenuate markers of muscle damage, augment acute immune and endocrine responses, and enhance training-induced muscle mass and strength. HMB-FA supplementation may also improve markers of aerobic fitness when combined with high-intensity interval training. Nevertheless, more studies are needed to determine the overall efficacy of HMB-FA supplementation as an ergogenic aid.

Post-resistance exercise ingestion of milk protein attenuates plasma TNFα and TNFr1 expression on monocyte subpopulations.

Attenuating TNFα/TNFr1 signaling in monocytes has been proposed as a means of mitigating inflammation. The purpose of this study was to examine the effects of a milk protein supplement on TNFα and monocyte TNFr1 expression. Ten resistance-trained men (24.7 ± 3.4 years; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) ingested supplement (SUPP) or placebo (PL) immediately post-exercise in a randomized, cross-over design. Blood samples were obtained at baseline (BL), immediately (IP), 30-min (30P), 1-h (1H), 2-h (2H), and 5-h (5H) post-exercise to assess plasma concentrations of myoglobin; tumor necrosis factor-alpha (TNFα); and expression of tumor necrosis factor receptor 1 (TNFr1) on classical, intermediate, and non-classical monocytes. Magnitude-based inferences were used to provide inferences on the true effects of SUPP compared to PL. Plasma TNFα concentrations were "likely attenuated" (91.6% likelihood effect) from BL to 30P in the SUPP group compared with PL (d = 0.87; mean effect: 2.3 ± 2.4 pg mL-1). TNFr1 expressions on classical (75.9% likelihood effect) and intermediate (93.0% likelihood effect) monocytes were "likely attenuated" from BL to 2H in the SUPP group compared with PL (d = 0.67; mean effect: 510 ± 670 RFU, and d = 1.05; mean effect: 2500 ± 2300 RFU, respectively). TNFr1 expression on non-classical monocytes was "likely attenuated" (77.6% likelihood effect) from BL to 1H in the SUPP group compared with PL (d = 0.69; mean effect: 330 ± 430 RFU). Ingestion of a milk protein supplement immediately post-exercise appears to attenuate both plasma TNFα concentrations and TNFr1 expression on monocyte subpopulations in resistance-trained men.

Effects of phosphatidic acid supplementation on muscle thickness and strength in resistance-trained men.

The purpose of this study was to investigate the effects of phosphatidic acid (PA) supplementation on muscle thickness and strength following an 8 week supervised resistance-training program. Fifteen resistance trained men (22.8 ± 3.5 years; 80.6 ± 8.7 kg; 178.1 ± 5.6 cm; 14.6% ± 8.8% body fat) were randomly assigned to a group that either consumed 750 mg of PA or a placebo (PL). Testing was carried out before (PRE) and after (POST) training/supplementation for muscle thickness and strength. Muscle thickness of the rectus femoris (RF), vastus lateralis (VL), biceps brachii (BB), and triceps brachii (TB) muscles were measured via ultrasonography, along with 1 repetition maximum (1RM) of squat, deadlift, and bench press. Analysis of covariance (ANCOVA), using PRE values as the covariate, did not reveal any group differences for measures of muscle thickness in the RF (PA: 3.6% ± 5.2%; PL: 3.2% ± 4.2%, p = 0.97), VL (PA: 23.4% ± 18.1%, PL: 12.5% ± 15.4%, p = 0.37), BB (PA: 3.7% ± 6.4%, PL: 9.6% ± 12.4%, p = 0.86), or TB (PA: 15.1% ± 17.9%, PL: 10.7% ± 19.3%, p = 0.79). Likewise, no group differences were observed in changes in squat (PA: 8.4% ± 4.1%, PL: 8.1% ± 4.2%, p = 0.79), deadlift (PA: 10.1% ± 10.1%, PL: 8.9% ± 9.5%, p = 0.66), or bench press (PA: 5.7% ± 5.5%, PL: 5.1% ± 3.0%, p = 0.76) exercises. Collectively, however, all participants experienced significant (p < 0.05) improvements in each measure of muscle thickness and strength. Results of this study suggest that PA supplementation, in combination with a 3 days·week-1 resistance-training program for 8 weeks, did not have a differential effect compared with PL on changes in muscle thickness or 1RM strength.

The Effect of Post-Resistance Exercise Amino Acids on Plasma MCP-1 and CCR2 Expression.

The recruitment and infiltration of classical monocytes into damaged muscle is critical for optimal tissue remodeling. This study examined the effects of an amino acid supplement on classical monocyte recruitment following an acute bout of lower body resistance exercise. Ten resistance-trained men (24.7 ± 3.4 years; 90.1 ± 11.3 kg; 176.0 ± 4.9 cm) ingested supplement (SUPP) or placebo (PL) immediately post-exercise in a randomized, cross-over design. Blood samples were obtained at baseline (BL), immediately (IP), 30-min (30P), 1-h (1H), 2-h (2H), and 5-h (5H) post-exercise to assess plasma concentrations of monocyte chemoattractant protein 1 (MCP-1), myoglobin, cortisol and insulin concentrations; and expressions of C-C chemokine receptor-2 (CCR2), and macrophage-1 antigen (CD11b) on classical monocytes. Magnitude-based inferences were used to provide inferences on the true effects of SUPP compared to PL. Changes in myoglobin, cortisol, and insulin concentrations were similar between treatments. Compared to PL, plasma MCP-1 was "very likely greater" (98.1% likelihood effect) in SUPP at 2H. CCR2 expression was "likely greater" at IP (84.9% likelihood effect), "likely greater" at 1H (87.7% likelihood effect), "very likely greater" at 2H (97.0% likelihood effect), and "likely greater" at 5H (90.1% likelihood effect) in SUPP, compared to PL. Ingestion of SUPP did not influence CD11b expression. Ingestion of an amino acid supplement immediately post-exercise appears to help maintain plasma MCP-1 concentrations and augment CCR2 expression in resistance trained men.

Internalized HIV Stigma and Mindfulness: Associations With PTSD Symptom Severity in Trauma-Exposed Adults With HIV/AIDS.

Rates of both traumatic event exposure and posttraumatic stress disorder (PTSD; 22%-54%) are disproportionately elevated among people living with HIV/AIDS (PLHA). Trauma and related psychopathology significantly affect quality of life and disease management in this patient population. The current study examined associations between internalized HIV stigma, mindfulness skills, and the severity of PTSD symptoms in trauma-exposed PLHA. Participants included 137 PLHA (14.6% female; Mage = 48.94, SD = 8.89) who reported experiencing on average, five (SD = 2.67) traumatic events; 34% met diagnostic criteria for PTSD. Results indicate that after controlling for sex, age, education, and number of traumatic events, internalized HIV stigma was positively related to overall PTSD symptom severity (ß = .16, p < .05) and severity of re-experiencing (ß = .19, p < .05) and hyper-arousal (ß = .16, p = .05), but not avoidance, PTSD symptom clusters. Among the mindfulness facets measured, acting with awareness was uniquely negatively related to the overall severity of PTSD symptoms (ß = -.25, p < .01) and the severity of re-experiencing (ß = -.25, p < .05), avoidance (ß = -.25, p < .05), and hyper-arousal (ß = -.29, p < .01) PTSD symptom clusters. These effects were observed after accounting for covariates and shared variance with other mindfulness facets. Theoretically, the present findings suggest that internalized HIV stigma may serve as a vulnerability factor for the severity of certain PTSD symptoms, whereas acting with awareness may function as a protective or resiliency factor for the severity of PTSD symptoms. Implications for the treatment of trauma-exposed PLHA are discussed.

Protein supplementation does not alter intramuscular anabolic signaling or endocrine response after resistance exercise in trained men.

The mammalian/mechanistic target of rapamycin complex 1 (mTORC1) signaling pathway appears to be the primary regulator of muscle protein synthesis. A variety of stimuli including resistance exercise, amino acids, and hormonal signals activate mTORC1 signaling. The purpose of this study was to investigate the effect of a protein supplement on mTORC1 signaling following a resistance exercise protocol designed to promote elevations in circulating hormone concentrations. We hypothesized that the protein supplement would augment the intramuscular anabolic signaling response. Ten resistance-trained men (age, 24.7 ± 3.4 years; weight, 90.1 ± 11.3 kg; height, 176.0 ± 4.9 cm) received either a placebo or a supplement containing 20 g protein, 6 g carbohydrates, and 1 g fat after high-volume, short-rest lower-body resistance exercise. Blood samples were obtained at baseline, immediately, 30 minutes, 1 hour, 2 hours, and 5 hours after exercise. Fine-needle muscle biopsies were completed at baseline, 1 hour, and 5 hours after exercise. Myoglobin, lactate dehydrogenase, and lactate concentrations were significantly elevated after resistance exercise (P < .0001); however, no differences were observed between trials. Resistance exercise also elicited a significant insulin, growth hormone, and cortisol response (P < .01); however, no differences were observed between trials for insulin-like growth factor-1, insulin, testosterone, growth hormone, or cortisol. Intramuscular anabolic signaling analysis revealed significant elevations in RPS6 phosphorylation after resistance exercise (P = .001); however, no differences were observed between trials for signaling proteins including Akt, mTOR, p70S6k, and RPS6. The endocrine response and phosphorylation status of signaling proteins within the mTORC1 pathway did not appear to be altered by ingestion of supplement after resistance exercise in resistance-trained men.

Exploring the effectiveness of a modified comprehensive mind-body intervention for medical and psychologic symptom relief.

BACKGROUND: Chronic illnesses are a major current health concern associated with elevated stress and increased health care costs. OBJECTIVE: The objective of this study was to describe the preliminary effectiveness of a modified, multimodal 8 week mind-body intervention on reducing physical and psychological symptoms in patients with chronic physical, mental and comorbid health issues. METHODS: Two hundred and twenty six adults enrolled in a mind-body group program and completed pre and post program assessments (63% completer rate), including the Medical Symptoms Checklist (MSCL), Health Promoting Lifestyle Profile (HPLP-II), and Symptom Checklist 90R (SCL-90R). RESULTS: Significant improvement was found on 9 of 23 medical symptoms (p < .002), all health promoting lifestyle behaviors (p < .001), and all mental health symptoms (p < .001). CONCLUSIONS: These results indicate that a multimodal mind-body intervention might be useful as a complementary or adjunct therapy for treatment of chronic medical symptoms. Future research is needed to test the intervention using a randomized controlled trial.