Collegiate male athletes exhibit conditions of the Male Athlete Triad.

The primary purpose of this study was to determine prevalence of the Male Athlete Triad (MAT) conditions: low energy availability (EA), low bone mineral density (BMD), and low testosterone in male collegiate athletes from different sports. Participants included 44 collegiate male athletes (age, 20.4 ± 0.2 years; body mass index, 25.3 ± 1.3 kg/m2) from 7 sports (cross country, soccer, basketball, wrestling, track, golf, and baseball). Resting metabolic rate, 3-day food intake, 7-day exercise energy expenditure, body composition, and reproductive and metabolic hormones were assessed. Of the total participants, 15% had low EA, 0% had low BMD, 28% had low total testosterone (TT), and 80% had low calculated free testosterone (cFT). There were no significant correlations between EA, BMD, TT, and cFT. Insulin and sex hormone binding globulin (SHBG) were below and on the upper end of the reference range for healthy male adults, respectively. Insulin was negatively correlated with total (r = -0.330, p = 0.043) and lumbar spine BMD z-scores (r = -0.413, p = 0.010). Low TT and low cFT were the most prevalent MAT conditions among all athletes. Further research should investigate the relationship between insulin and SHBG and the role of these hormones in the MAT. Novelty: Assessment of energy availability alone is not sufficient to identify physiological disturbances in collegiate male athletes. Low total and/or free testosterone may be present in some collegiate male athletes, regardless of BMD status. Low insulin and high SHBG concentration may portray the presence of conditions of the MAT in male collegiate athletes.

Advancements in AAV-mediated Gene Therapy for Pompe Disease.

Pompe disease (glycogen storage disease type II) is caused by mutations in acid α-glucosidase (GAA) resulting in lysosomal pathology and impairment of the muscular and cardio-pulmonary systems. Enzyme replacement therapy (ERT), the only approved therapy for Pompe disease, improves muscle function by reducing glycogen accumulation but this approach entails several limitations including a short drug half-life and an antibody response that results in reduced efficacy. To address these limitations, new treatments such as gene therapy are under development to increase the intrinsic ability of the affected cells to produce GAA. Key components to gene therapy strategies include the choice of vector, promoter, and the route of administration. The efficacy of gene therapy depends on the ability of the vector to drive gene expression in the target tissue and also on the recipient's immune tolerance to the transgene protein. In this review, we discuss the preclinical and clinical studies that are paving the way for the development of a gene therapy strategy for patients with early and late onset Pompe disease as well as some of the challenges for advancing gene therapy.

Nutrition of the captive western lowland gorilla (Gorilla gorilla gorilla): a dietary survey.

The successful management of captive animals requires attention to multiple interconnected factors. One critical aspect of the daily life of a captive animal is the recommended and/or provisioned diet. This study focuses on the diets of zoo-housed gorillas. A national survey of diets among zoo-housed gorillas was conducted to examine diets being offered to captive gorillas in the United States and Canada. This survey serves as a follow-up to a 1995 dietary survey of zoo-housed gorillas and goes further to quantify nutritional profiles at responding institutions. Results are encouraging, as zoos have made clear improvements in dietary nutrient profiles offered over the past 15 years. However, we suggest that zoological and sanctuary institutions follow Gorilla Species Survival Plan (SSP) recommendations and work to continuously improve diets provided, which could improve gorillas' health and well-being.

Weight management for individuals with intellectual and developmental disabilities: rationale and design for an 18 month randomized trial.

Weight management for individuals with intellectual and developmental disabilities (IDD) has received limited attention. Studies on weight management in this population have been conducted over short time frames, in small samples with inadequate statistical power, infrequently used a randomized design, and have not evaluated the use of emerging effective dietary strategies such as pre-packaged meals (PMs). Low energy/fat PMs may be useful in individuals with IDD as they simplify meal planning, limit undesirable food choices, teach appropriate portion sizes, are convenient and easy to prepare, and when combined with fruits and vegetables provide a high volume, low energy dense meal. A randomized effectiveness trial will be conducted in 150 overweight/obese adults with mild to moderate IDD, and their study partners to compare weight loss (6 months) and weight maintenance (12 months) between 2 weight management approaches: 1. A Stop Light Diet enhanced with reduced energy/fat PMs (eSLD); and 2. A recommended care reduced energy/fat meal plan diet (RC). The primary aim is to compare weight loss (0-6 months) and weight maintenance (7-18 months) between the eSLD and RC diets. Secondarily, changes in chronic disease risk factors between the eSLD and RC diets including blood pressure, glucose, insulin, LDL-cholesterol, and HDL-cholesterol will be compared during both weight loss and weight maintenance. Finally, potential mediators of weight loss including energy intake, physical activity, data recording, adherence to the diet, study partner self-efficacy and daily stress related to dietary change will be explored.

Effects of growth hormone treatment in adults with Prader-Willi syndrome.

OBJECTIVE: Since limited data exist on adults with Prader-Willi syndrome (PWS) and growth hormone (GH) treatment, we report our experience on the effects of treatment for one year on body composition, physical activity, strength and energy expenditure, diet, general chemistry and endocrine data with quality of life measures. DESIGN: We studied 11 adults with PWS (6F:5M; average age=32 yrs) over a 2 year period with GH treatment during the first year only. Electrolytes, IGF-I, glucose, thyroid, insulin, lipids, body composition, physical activity and strength, diet, energy expenditure and quality of life data were collected and analyzed statistically using linear modeling at baseline, at 12 months following GH therapy and at 24 months after treatment cessation for 12 months. RESULTS: Total lean muscle mass was significantly increased (p<0.05) during GH treatment along with moderate-vigorous physical activity and plasma IGF-I and HDL levels, but returned to near baseline after treatment. Percent body fat decreased during the 12 months of GH treatment but increased after treatment. CONCLUSIONS: Previously reported beneficial effects of GH treatment in children with PWS were found in our adults regarding body composition, physical activity and plasma HDL and IGF-I levels. Several beneficial effects diminished to near baseline after cessation of GH treatment for 12 months supporting the continuation of treatment in PWS into adulthood and possibly adults not previously treated during childhood.

One set resistance training: effect on body composition in overweight young adults.

AIM: This study evaluate the impact of a 6-month, 1-set RT protocol on changes in weight and body composition in overweight young adults. METHODS: Sixty-three overweight young adults were randomized to RT or control; 55 participants (RT: N.=32; C: N.=23; BMI=27.3+2.9; age=20.7+2.7 yrs) competed the 6 month training protocol and all assessments. RT consisted of 1-set, 9 exercises, 3 times/wk., with a resistance of 3-6 repetition maximum (RM). Body composition was assessed using dual energy X-ray absorptiometry, and strength using 1RM. Participants were instructed to maintain their normal ad libitum diet and normal activities of daily living. RESULTS: Body weight and BMI increased significantly (P<0.05) in RT and C, however; the between group difference was not significant. RT induced a mean increase in fat-free mass of 1.5 kg in both males and females with significant between groups differences for change in fat-free mass noted in the total sample, and in both males and females. Between group differences for change in fat mass were not statistically significant in the total sample, or in either gender. Significant between group differences for change in % fat were noted in the total sample (RT=-0.3%, C=+5.8%, P<0.05) and in females (RT=-3.7%, C=+3.0%, P<0.01), but not in males (RT=3.4%, C=9.8%). Significant between group differences (P<0.001) were observed for change in chest (RT=45 %, C=3%) and leg press (RT=57 %, C=9%) maximal strength. CONCLUSION: A 6 month, 1-set RT program in overweight young adults increased fat-free mass and prevented increases in fat mass and % fat.

Total body bone mineral content and density during weight loss and maintenance on a low- or recommended-dairy weight-maintenance diet in obese men and women.

BACKGROUND: Diets high in either dairy or calcium during moderate weight reduction both prevent loss of bone mineral density (BMD) and suppress bone turnover. The purpose of this study was to determine whether recommended dairy and calcium intakes during weight maintenance favorably affect total body BMD (TBBMD) and bone mineral content (TBBMC) in obese adults. METHODS: Obese men (n=49) and women (n=64), aged 40.8+/-0.6 years, underwent 12 weeks of moderate energy restriction (approximately 1200 kcal/day) followed by 24 weeks on either a low or recommended dairy weight maintenance diet. The TBBMC and TBBMD values were measured using dual energy X-ray absorptiometry at baseline, 12, 24 and 36 weeks. Concentrations of calcium, intact parathyroid hormone (iPTH), 25OH and 1,25 (OH)(2) vitamin D in plasma were also measured. Data were analyzed using a two-factor repeated measures analysis of variance. RESULTS: After weight loss, women exhibited a small, but statistically significant, increase in TBBMC (1.17+/-0.57%), whereas TBBMD increased in the men (1.34+/-0.28%). The iPTH concentration decreased significantly in all subjects. Despite significantly greater intakes of calcium, vitamin D and protein compared with the recommended dairy diet, there were no treatment-related differences in outcome variables after 24 weeks of weight maintenance. The TBBMC remained unchanged in women during weight stabilization; both TBBMC and TBBMD decreased in men (-1.59+/-0.51% and -0.70+/-0.25%, respectively). CONCLUSIONS: In summary, results of this study do not provide convincing evidence that moderate weight loss through energy restriction and mild exercise reduces TBBMC in obese men and women. Similarly, a weight-maintenance diet providing the recommended daily servings of dairy does not seem to affect changes in BMC after weight loss.

Weight maintenance, behaviors and barriers among previous participants of a university-based weight control program.

OBJECTIVE: To examine weight loss maintenance among previous participants of a university-based behavioral weight management program and to compare behavioral strategies and perceived barriers between successful and unsuccessful maintainers. METHOD: Previous program participants (n=179) completed mailed surveys assessing current weight, weight control behaviors and perceived barriers to weight loss maintenance. RESULTS: At 14.1+/-10.8 months following completion of treatment, survey respondents were on average 12.6+/-12.6 kg, or 11.3+/-10.7%, below baseline weight; 76.5% of respondents had successfully maintained weight, defined as maintaining a weight loss of at least 5% below baseline. Compared to unsuccessful maintainers, successful maintainers reported practicing four dietary and three physical activity weight control strategies more often and experiencing five barriers to healthy eating and exercise less often. After accounting for time since treatment and maximum weight loss while in treatment, the strongest correlates of successful weight loss maintenance were frequent exercise and perceived difficulty of weight management. CONCLUSIONS: Clinically meaningful weight loss maintenance was achieved by the majority of participants. Findings support the literature indicating that physical activity is one of the strongest predictors of successful weight loss maintenance. Findings also suggest that strategies to reduce the level of perceived effort required for long-term weight control may improve maintenance outcomes.

Effects of long-term aerobic exercise on EPOC.

This study sought to determine the influence of 16 months of progressive aerobic exercise on excess postexercise oxygen consumption (EPOC) and the extent EPOC contributed to weight management. Twenty-five overweight/obese women and 16 overweight/obese men participated in a 16-month exercise program (moderate-intensity treadmill walking) that progressed across the first 26 weeks to 5 days.wk(-1), 45 min.session(-1), and 75% HRR. Three-hour EPOC was measured at baseline, 9 months, and 16 months by indirect calorimetry in response to an exercise session (treadmill walking), in which energy expenditure (EE) was estimated from the participant's previous 10 exercise sessions. For women, EPOC was 7.5 +/- 4.9, 9.6 +/- 7.6, and 6.5 +/- 6.5 L at baseline, 9 months, and 16 months, respectively (p > 0.05). For men, EPOC increased from baseline (11.8 +/- 6.8 L) to 9 months (13.5 +/- 8.6 L) (p < 0.05) with no further increase at 16 months (13.5 +/- 11.0 L). Change in EPOC was correlated with change in EE at 9 months (r = 0.65; p < 0.05) and 16 months (r = 0.58; p < 0.05) for men but not women. Progressive long-term exercise significantly influenced EPOC in overweight/obese men but not women. Change in volume of exercise likely explained the increase in energy expenditure during EPOC in men. EPOC contributed modestly to EE compared to the exercise itself.

Comparison of a phone vs clinic approach to achieve 10% weight loss.

OBJECTIVE: To compare the efficacy of a phone vs a traditional face-to-face clinic approach to achieve 10% weight loss and weight maintenance. DESIGN: Twenty-six week, randomized, controlled trial. SUBJECTS: Twenty-four men and 72 women, ages 25-68 years, with a body mass index (BMI) of 33.2+/-3.8. MEASUREMENTS: Weight loss at 12 weeks and weight maintenance at 26 weeks were the primary outcomes. Attendance, meal replacements (MRs), fruits/vegetables (F/V), and physical activity (PA) were measured weekly for process evaluation. RESULTS: Median weight loss (range) from baseline at 12 weeks was significantly different for phone at 10.6 kg (16.6) or 10.4% and clinic at 12.7 kg (19.9) or 13.7%, and both were significantly different when compared with the control group with a weight loss of 0.25 kg (5.6) or 0.24%. Median weight loss at 26 weeks was 12.8 kg (23.4) or 13.0% from baseline for the phone group and 12.5 kg (35.2) or 12.6% from baseline for the clinic group (P>0.05). CONCLUSION: The median weight loss for both phone and clinic groups at 12 and 26 weeks exceeded the NHLBI guideline of 10% weight loss from baseline. The phone approach may be a viable option to the traditional weight management clinic for both service providers and participants.

Neural correlates of timbre change in harmonic sounds.

Timbre is a major structuring force in music and one of the most important and ecologically relevant features of auditory events. We used sound stimuli selected on the basis of previous psychophysiological studies to investigate the neural correlates of timbre perception. Our results indicate that both the left and right hemispheres are involved in timbre processing, challenging the conventional notion that the elementary attributes of musical perception are predominantly lateralized to the right hemisphere. Significant timbre-related brain activation was found in well-defined regions of posterior Heschl's gyrus and superior temporal sulcus, extending into the circular insular sulcus. Although the extent of activation was not significantly different between left and right hemispheres, temporal lobe activations were significantly posterior in the left, compared to the right, hemisphere, suggesting a functional asymmetry in their respective contributions to timbre processing. The implications of our findings for music processing in particular and auditory processing in general are discussed.

Simultaneous bilateral breast reconstruction using latissimus dorsi myocutaneous flaps: a retrospective review of an institutional experience.

A single institution's experience in the simultaneous reconstruction of both breasts using bilateral latissimus dorsi myocutaneous flaps is presented. The procedure was performed on 24 patients by the attending staff of the department of plastic surgery at St. Joseph Hospital in Houston, Texas, between 1979 and 1999. Of the 24 patients reviewed, six had immediate reconstructions, 13 had delayed primary reconstructions, and five had secondary reconstructions of failed or unsatisfactory primary procedures. In the group with delayed reconstructions, the average time between mastectomy and reconstruction was 46.4 months, with a range from 7 days to 21 years. The operative method, results, and outcomes of our experience in these patients is presented.

Signal decomposition method of evaluating head movement to measure induced forelimb lameness in horses trotting on a treadmill.

In horses at a trot, the head moves up and down twice in one stride. In horses with unilateral forelimb lameness this movement is asymmetric. Computer-assisted kinematic analysis of vertical head movement can be used to quantify objectively lameness in horses in clinical trials. However, in mild lameness, absolute measurements of vertical head height may not be sensitive enough to detect small differences in lameness, and extraneous head movement by the horse due to curiosity, excitement or nervousness interferes with the accurate measurement of vertical head movement asymmetry. We describe a simple, signal-decompensation method of evaluating vertical head movement using a model of induced mild foot lameness in 9 horses. The technique assumes that the vertical head movement pattern can be broken down into 3 components; the vertical head movement caused by forelimb lameness (A1), the amplitude of the natural biphasic vertical head movement (A2) and extraneous head movement. Extraneous head movement is mathematically removed from the vertical head movement pattern. A1 and A2 are then calculated. After induction of lameness, mean A1 increased by 1.63 cm (range 0.10-3.33 cm, P = 0:005). Mean A2 did not significantly change after lameness induction. Error in reproduction of the original head movement pattern was 0.3-0.5%. We calculated that a hypothetical clinical trial would require 12 subjects for testing to be 80% certain that this difference would be successfully detected using this method of lameness evaluation.

Increased flavor preference and lick activity for sucrose and corn oil in SWR/J vs. AKR/J mice.

Nutrient preferences and orosensory responses were characterized in two mouse inbred strains. In two-bottle solution tests (tastant vs. vehicle; ascending concentrations), the effects of strain and chow type (12 or 26% fat) on preference thresholds for sucrose and corn oil were compared in AKR/J and SWR/J mice. SWR/J mice displayed lower preference thresholds and ingested more sucrose than AKR/J mice did. SWR/J mice also showed lower preference thresholds and consumed more corn oil than AKR/J mice did; corn oil preference was suppressed 3.5-fold in AKR/J mice compared with SWR/J mice when fed 26% fat chow. Next, licking was recorded during 30-s access to sucrose or corn oil across a range of concentrations. SWR/J mice licked the tastants more than AKR/J mice did. Analysis of modal interlick intervals during lick training revealed that SWR/J mice licked water faster than AKR/J mice when water deprived, suggesting that motor as well as sensory factors may determine lick responses to tastants in brief-access tests. Finally, in two-bottle tests pitting maximally preferred concentrations of sucrose (8 or 16%) against corn oil (20%), SWR/J mice highly preferred sucrose over corn oil at either sucrose concentration. AKR/J mice preferred corn oil over 8% sucrose but reversed their preference when 16% sucrose was offered. These results support a primary role of flavor in the nutrient preferences of SWR/J mice. In AKR/J mice, the low lick activity for sucrose and corn oil and greater suppression of corn oil preference by the high-fat chow suggest that their preferences depend more on postingestive factors than on flavor.

Capsaicin-treated rats permanently overingest low- but not high-concentration sucrose solutions.

The effect of capsaicin-induced chemical ablation of visceral afferents on 1-h liquid sucrose consumption was investigated in food-deprived rats. We first show that although 10% sucrose is permanently overconsumed by capsaicin-treated (CAPs) compared with vehicle-treated (VEHs) control rats, 40% sucrose is only overconsumed during the first but not subsequent 1-h exposures. Furthermore, one group of CAPs lost the overconsumption response at 20% when exposed to progressively increasing sucrose concentrations of 10-40%, and another group recovered the overconsumption response at 10% when exposed to a series of decreasing concentrations. Control rats ingested relatively constant volumes of sucrose over the range of 10, 15, and 20%, resulting in significantly different energy intakes. In contrast, CAPs generally showed a concentration-dependent decrease in volume intake, resulting in relatively constant energy intake. These results suggest that capsaicin-sensitive visceral afferents, likely from gastric distension and other preabsorptive sensors, provide major control over volume ingested. In the absence of these signals, rats initially overconsume, but rapidly learn to use other signals from capsaicin-resistant preabsorptive or postabsorptive sites, to control future intake. This redundant satiety system appears to be sensitive to the osmotic value or caloric content of the unfamiliar food, but only if this is above a threshold of about 15% sucrose.

Kinematics of the hind limb in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and intra-articular administration of anesthetic.

OBJECTIVE: To identify hind limb and pelvic kinematic variables that change in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and after subsequent intra-articular administration of anesthetic. ANIMALS: 8 clinically normal adult horses. PROCEDURE: Kinematic measurements were made before and after transient endotoxin-induced lameness of the distal intertarsal and tarsometatarsal joints and after intra-articular administration of anesthetic. Fourteen displacement and joint angle (metatarsophalangeal [fetlock] and tarsal joints) measurements were made on the right hind limb, sacrum, and the right and left tubera coxae. Kinematic measurements were compared by general linear models, using a repeated measures ANOVA. Post hoc multiple comparisons between treatments were evaluated with a Fisher least squared difference test at alpha = 0.05. RESULTS: After lameness induction, fetlock and tarsal joint extension during stance decreased, fetlock joint flexion and hoof height during swing increased, limb protraction decreased, and vertical excursion of the tubera coxae became more asymmetric. After intra-articular administration of anesthetic, limb protraction returned to the degree seen before lameness, and vertical excursion of the tubera coxae became more symmetric. CONCLUSIONS AND CLINICAL RELEVANCE: Increased length of hind limb protraction and symmetry of tubera coxae vertical excursion are sensitive indicators of improvement in tarsal joint lameness. When evaluating changes in tarsal joint lameness, evaluating the horse from the side (to assess limb protraction) is as important as evaluating from the rear (to assess pelvic symmetry).

Changes in kinematic variables observed during pressure-induced forelimb lameness in adult horses trotting on a treadmill.

OBJECTIVE: To determine whether kinematic changes induced by heel pressure in horses differ from those induced by toe pressure. ANIMALS: 10 adult Quarter Horses. PROCEDURE: A shoe that applied pressure on the cuneus ungulae (frog) or on the toe was used. Kinematic analyses were performed before and after 2 levels of frog pressure and after 1 level of toe pressure. Values for stride displacement and time and joint angles were determined from horses trotting on a treadmill. RESULTS: The first level of frog pressure caused decreases in metacarpophalangeal (fetlock) joint extension during stance and increases in head vertical movement and asymmetry. The second level of frog pressure caused these changes but also caused decreases in stride duration and carpal joint extension during stance as well as increases in relative stance duration. Toe pressure caused changes in these same variables but also caused maximum extension of the fetlock joint to occur before midstance, maximum hoof height to be closer to midswing, and forelimb protraction to increase. CONCLUSION AND CLINICAL RELEVANCE: Decreased fetlock joint extension during stance and increased head vertical movement and asymmetry are sensitive indicators of forelimb lameness. Decreased stride duration, increased relative stance duration, and decreased carpal joint extension during stance are general but insensitive indicators of forelimb lameness. Increased forelimb protraction, hoof flight pattern with maximum hoof height near midswing, and maximum fetlock joint extension in cranial stance may be specific indicators of lameness in the toe region. Observation of forelimb movement may enable clinicians to differentiate lameness of the heel from lameness of the toe.

Macronutrient diet selection in thirteen mouse strains.

The strain distribution for macronutrient diet selection was described in 13 mouse strains (AKR/J, NZB/B1NJ, C57BL/6J, C57BL/6ByJ, DBA/2J, SPRET/Ei, CD-1, SJL/J, SWR/J, 129/J, BALB/cByJ, CAST/Ei, and A/J) with the use of a self-selection protocol in which separate carbohydrate, fat, and protein diets were simultaneously available for 26-30 days. Relative to carbohydrate, nine strains consumed significantly more calories from the fat diet; two strains consumed more calories from carbohydrate than from fat (BALB/cByJ, CAST/Ei). Diet selection by SWR/J mice was variable over time, resulting in a lack of preference. One strain (A/J) failed to adapt to the diet paradigm due to inadequate protein intake. Comparisons of proportional fat intake across strains revealed that fat selection/consumption ranged from 26 to 83% of total energy. AKR/J, NZB/B1NJ, and C67BL/6J mice self-selected the highest proportion of dietary fat, whereas the CAST/Ei and BALB/cByJ strains chose the lowest. Finally, epididymal fat depot weight was correlated with fat consumption. There were significant positive correlations in AKR/J and C57BL/6J mice, which are highly sensitive to dietary obesity. However, absolute fat intake was inversely correlated with epididymal fat in two of the lean strains: SWR/J and CAST/Ei. We hypothesize that the SWR/J and CAST/Ei strains are highly sensitive to a negative feedback signal generated by increasing body fat, but the AKR/J and C67BL/6J mice are not. The variation in dietary fat selection across inbred strains provides a tool for dissecting the complex genetics of this trait.