Frailty and Aging in HIV- Status Post 13 Years of National Awareness.

The People aged 50 years and above comprise over 50% of people living with HIV (PLWH) in the US. Despite the advances made with anti-retroviral therapy in increasing their life span, PLWH are plagued with non-AIDS associated conditions which increase their risk for morbidity and mortality. Frailty, a decline in physical and functional reserve, is one of the manifestations of aging, has a prevalence of 5-30%, and occurs up to 2 decades earlier in people aging with HIV (PAWH). The majority of providers for PAWH have minimal experience with the concept of gerontology, frailty, and aging. Hence, there is a gap in clinicians' knowledge on how to address frailty and aging in PAWH. This review will focus on the clinical interventions that mitigate frailty and aging in PAWH as well as highlight areas of investigation towards achieving these mediations. Beyond the identification of the roles of exercise and nutrition, more studies are needed on the pragmatic approach to apply these resources to routine care. There should be continued reinforcement of the proven strategy of combination antiretroviral therapy as well as treatment of co-infections and age-appropriate health and cancer screening in PAWH.

IL-6 and Soluble Receptors in Overweight and Obese African American Women With and Without Breast Cancer.

Interleukin 6 (IL-6) and its receptors are expressed in approximately half of breast cancer (BC) tissues, and high serum IL-6 levels are associated with poor prognosis. African American (AA) patients with BC have higher serum IL-6 levels compared to Caucasians, suggesting additional risk of disease-related complications in AAs. The purpose of this study was to compare IL-6 complex biomarkers in AA women with and without a history of BC. We conducted a secondary analysis of phenotypic data from two studies of weight loss in AA women with and without a history of BC who had similar age and adiposity. Biomarkers analyzed included tumor necrosis factor alpha (TNF-α), IL-6, IL-6 soluble receptor (IL6sr), and soluble glycoprotein 130 (GP130); IL6sr and GP130 were newly analyzed for this study. TNF-α levels were 1.86 times higher in the BC group (N = 7) compared to those without BC (N = 10; p < 0.001) despite similar age, weight, and body mass index. GP130 levels tended to be higher in women with BC; IL-6 and Il-6 sr were not different between groups. There was a strong correlation between GP130 and TNF-α (r = .638; p = .006) in the group overall. High TNF-α levels in the BC group and a strong correlation between GP130 and TNF-α in the overall group suggest the presence of IL-6 complex initiated TNF-α production. Further study is needed to evaluate IL-6 reduction through a variety of approaches, including weight loss and anti-IL-6 therapies, which may ultimately implicate the reduction of IL-6 complex associated BC-specific recurrence and mortality.

Increased Intramuscular Adipose Tissue Is Related to Increased Capillarization in Older Adults.

BACKGROUND: High levels of intramuscular adipose tissue and low levels of capillarization are both predicative of low muscle and mobility function in older adults, however little is known about their relationship. OBJECTIVES: The purpose of this study was to examine the relationship of intramuscular adipose tissue and capillarization in older adults. SETTING: An outpatient medical center. PARTICIPANTS: Forty-seven sedentary adults (age 59.9 ± 1.0 years, BMI 32.0 ± 0.7 kg/m2, VO2max 22.4 ± 0.7 ml/kg/min); Measurements: All participants underwent CT scans to determine intramuscular adipose tissue and muscle biopsies to determine capillarization in the mid-thigh. A step-wise hierarchical linear regression analysis was used to examine the contributions of age, sex, race, body mass index, 2-hour postprandial glucose, VO2max, and muscle capillarization, to the variability in intramuscular adipose tissue. RESULTS: The predictors as a group accounted for 38.1% of the variance in intramuscular adipose tissue, with body mass index and capillarization each significantly contributing to the final model (P<0.001). The part correlation of body mass index with intramuscular adipose tissue was r = 0.47, and the part correlation of capillarization with intramuscular adipose tissue was r = 0.39, indicating that body mass index and capillarization explained 22.1%, and 15.2% of the variance in intramuscular adipose tissue. CONCLUSIONS: While increased muscle capillarization is typically thought of as a positive development, in some clinical conditions, such as tendinopathies, an increase in capillarization is part of the pathological process related to expansion of the extracellular matrix and fibrosis. This may also be an explanation for the surprising finding that high capillarization is related to high levels of intramuscular adipose tissue. Future studies are necessary to determine the relationship of changes in both capillarization and intramuscular adipose tissue after interventions, such as exercise.

K2CO3-Catalyzed Synthesis of 2,5-Dialkyl-4,6,7-tricyano-Decorated Indoles via Carbon-Carbon Bond Cleavage.

We describe a novel method to synthesize 2,5-dialkyl-4,6,7-tricyanoindole derivatives from a base-catalyzed reaction of 1,3-diketones with fumaronitrile. The reaction proceeds by the condensation of two molecules of fumaronitrile and one molecule of 1,3-diketone in a remarkable process that involves the cleavage of one C(sp3)-C(sp2) bond in 1,3-diketones and the formation of one carbon-nitrogen bond and four carbon-carbon bonds to construct both the aryl and pyrrole rings of the indole in one step.

Reduced LPL and subcutaneous lipid storage capacity are associated with metabolic syndrome in postmenopausal women with obesity.

OBJECTIVES: This study examines the hypothesis that lower adipose tissue lipoprotein lipase (LPL) activity and a limited capacity for subcutaneous adipocyte expansion will be associated with metabolic syndrome (MSyn) in postmenopausal women who are overweight and obese. METHODS: Women (N = 150; age 60 ± 1 year; BMI: 31.5 ± 0.3 kg m-2; mean ± standard errors of the means [SEM]) with and without MSyn had dual-energy X-ray absorptiometry scans for total body fat, CT scans for visceral and subcutaneous abdominal adipose tissue areas, lipid and glucose metabolic profiles, and abdominal and gluteal fat aspirations for subcutaneous fat cell weight (FCW; N = 150) and LPL activity (N = 100). RESULTS: Women with MSyn had similar total body fat, but 15% larger abdominal and 11% larger gluteal FCWs and more visceral fat (179 ± 7 vs. 134 ± 6 cm2) than women without MSyn (P's < 0.05). Abdominal LPL activity was 13% (P = 0.18) lower in women with than without MSyn and correlated with abdominal FCW (r = 0.49, P < 0.01) only in those without MSyn. Visceral fat and abdominal and gluteal FCWs correlated with MSyn components, and subcutaneous adipose tissue correlated with abdominal FCW (r = 0.43, P < 0.01) and LPL activity (r = 0.18, P < 0.05), independent of total body fat. CONCLUSIONS: These results show that women with MSyn have lower LPL activity, limited capacity for subcutaneous adipocyte lipid storage and greater ectopic fat accumulation in viscera than women without MSyn of comparable obesity. This suggests that the development of novel therapies that would enhance adipocyte expandability might prevent the accumulation of ectopic fat and reduce the risk for MSyn in postmenopausal women with obesity.

Influence of Vitamin D and Parathyroid Hormone on Bone and Metabolic Risk in Women with Previous Gestational Diabetes.

The purpose of this study was to compare plasma 25-hydroxyvitamin D [25(OH)D] and parathyroid hormone (PTH), VO2max, bone (by DXA), and metabolic outcomes across age and race-matched postmenopausal women (54±1 years; mean±SEM): 1) with previous gestational diabetes (GDM) (32±1 kg/m(2); n=17), 2) without previous GDM, but with a similar BMI to GDM (32±1 kg/m(2); n=17), and 3) without previous GDM, but with a higher BMI than GDM (36±1 kg/m(2); n=17; p<0.01). The prevalence of 25(OH)D insufficiency and deficiency was high (~80%), but not different across groups, while PTH tended to be ~30% lower in women with a history of GDM (p=0.09). Women with a history of GDM had lower HDL cholesterol and higher diastolic blood pressure and fasting and 2-h glucose levels (by oral glucose tolerance test) (vs. groups 2 and 3; p<0.05). Bone mineral density (BMD) tended to be slightly higher in women with prior GDM than the BMI matched women with no prior GDM (p=0.09). Overall, higher PTH was associated with lower femoral neck (r=- 0.33) and (r=- 0.38) (p <0.05), while lower 25(OH)D was associated with lower VO2max (r=0.25, p=0.05) and higher fasting glucose (r=- 0.14) and insulin (r=- 0.29 (p <0.05). We observed that the poor metabolic profiles of postmenopausal women with a history of GDM are independent of 25(OH)D and PTH. However, due to associations between 25(OH)D and PTH with bone and metabolic outcomes, maintaining recommended 25(OH)D and PTH concentrations is important regardless of a previous history of GDM.

General Copper-Catalyzed Coupling of Alkyl-, Aryl-, and Alkynylaluminum Reagents with Organohalides.

We report the first example of a very general Cu-catalyzed cross-coupling of organoaluminum reagents with organohalides. The reactions proceed for the couplings of alkyl-, aryl-, and alkynylaluminum reagents with aryl and heteroaryl halides and vinyl bromides, affording the cross-coupled products in good to excellent yields. Both primary and secondary alkylaluminum reagents can be utilized as organometallic coupling partners. These reactions are not complicated by ß-hydride elimination, and as a result rearranged products are not observed with secondary alkylaluminum reagents even for couplings with heteroaryl halides under "ligand-free" conditions. Radical clock experiment with a radical probe and relative reactivity study of Ph3Al with two haloarenes, 1-bromonaphthalene and 4-chlorobenzonitrile, having two different redox potentials indicates that the reaction does not involve free aryl radicals and radical anions as intermediates. These results combined with the result of the Hammett plot obtained by reacting Ph3Al with iodoarenes containing p-H, p-Me, p-F, and p-CF3 substituents, which shows a linear curve (R(2) = 0.99) with a ρ value of +1.06, suggest that the current transformation follows an oxidative addition-reductive elimination pathway.

Dietary prescription adherence and non-structured physical activity following weight loss with and without aerobic exercise.

OBJECTIVES: To compare the effects of weight loss with and without exercise on 1) dietary prescription adherence and 2) non-structured activity in postmenopausal women. DESIGN: Longitudinal study. SETTING: Clinical research setting with facility based exercise and nutrition education. PARTICIPANTS: Overweight and obese women, 45-76 years old. INTERVENTION: 6 months of weight loss alone (WL; N=38) or with aerobic exercise (AEX+WL; N=41). MEASUREMENTS: Cardiorespiratory fitness (VO2max), resting metabolic rate (RMR), seven day food intake, and physical activity (by Actical accelerometers worn in a subset subgroup: WL: N=10; AEX+WL: N=15) were assessed before and after the interventions. RESULTS: Both interventions resulted in similar weight loss (~9%) and no significant changes in RMR, while only the AEX+WL group improved VO2max (~10%). At baseline, the AEX+WL group consumed slightly more protein than the WL group (P<0.01). Macronutrient intake did not change following AEX+WL, but the WL group decreased their fat intake and increased their carbohydrates and protein intakes (Ps<0.05), which resulted in similar macronutrient intakes between groups post-intervention. Weekday total activity counts decreased 22% (P<0.05) following WL. This change tended (P=0.07) to be different than the lack of change in non-structured activity observed following AEX+WL. CONCLUSION: Although similar dietary adherence was observed, these data suggest that postmenopausal women undergoing weight loss may benefit from the addition of exercise to prevent the decline in non-structured activity observed following weight loss alone.

Genetic and acute toxicological evaluation of an algal oil containing eicosapentaenoic acid (EPA) and palmitoleic acid.

Algal strains of Nannochloropsis sp. were developed, optimized, cultivated and harvested to produce a unique composition of algal oil ethyl esters (Algal-EE) that are naturally high in eicosapentaenoic acid (EPA, 23-30%) and palmitoleic acid (20-25%), and contain no docosahexaenoic acid (DHA). Algal-EE was evaluated for mutagenic activity (Ames bacterial reverse mutation, in vitro mammalian chromosome aberration, in vivo micronucleus test) and for acute oral toxicity in Sprague-Dawley rats. In the acute toxicity study, rats received a single oral gavaged dose of Algal-EE (2000 mg/kg body weight). Clinical observations were made for 14 days before sacrifice on Day 15. Macroscopic evaluation involved the examination of all organs in the cranial, thoracic, and abdominal cavities. Algal-EE showed no evidence of mutagenicity, did not produce an increase in the frequency of structural chromosome aberrations, and did not cause an increase in the induction of micronucleated polychromatic erythrocytes. There were no macroscopic abnormalities. Algal-EE up to 2000 mg/kg body weight did not affect body weight, organ appearance or produce any toxic-related signs of morbidity. The acute median lethal dose (LD50) of Algal-EE was >2000 mg/kg body weight. Based on these assays, Algal-EE does not appear to have any genetic or acute oral toxicity.

Plasminogen Activator Inhibitor-1, Body Fat and Insulin Action in Aging Women.

Plasminogen activator inhibitor-1 (PAI-1) over-expression is linked to obesity, insulin resistance, and age. We hypothesized that aerobically trained women athletes would have reduced PAI-1 regardless of age compared to sedentary controls and levels would be associated with hyperinsulinemia. Plasma PAI-1 was measured in women athletes who were young (YA, n=19, VO2max=53.7±1.1ml/kg/min) and older (OA, n=18, VO2max=46.6±1.5ml/kg/min) and compared to 19 sedentary controls (YC, n=6, VO2max=35.9±1.2ml/kg/min; OC, n=13, VO2max=22.1±1.7ml/kg/min). PAI-1 levels did not differ between YA and OA but was 23% higher in OC compared to OA (P<0.05). PAI-1 was inversely associated with VO2max, directly to %body fat, and subcutaneous abdominal fat, fasting leptin, insulin, and first-phase and second-phase insulin response during a hyperglycemic clamp. The current results suggest that older athletes have low PAI-1 levels possibly due to high levels of physical fitness, reduced body fat, and increased insulin action and may contribute to low atherothrombosis and improved cardiovascular health.

Aerobic exercise + weight loss decreases skeletal muscle myostatin expression and improves insulin sensitivity in older adults.

OBJECTIVE: To determine whether aerobic exercise training + weight loss (AEX + WL) would affect the expression of myostatin and its relationship with insulin sensitivity in a longitudinal, clinical intervention study. DESIGN AND METHODS: Thirty-three obese sedentary postmenopausal women and men (n = 17 and 16, age: 61 ± 1 years, body mass index: 31 ± 1 kg/m(2) , VO2 max: 21.9 ± 1.0 mL/kg/min, X ± Standard error of the mean (SEM)) completed 6 months of 3 days/week AEX + WL. During an 80 mU m(-2) min(-1) hyperinsulinemic-euglycemic clamp, we measured glucose utilization (M), myostatin, myogenin, and MyoD gene expression by real-time RT-PCR in vastus lateralis muscle at baseline and 2 h. RESULTS: Body weight (-8%) and fat mass (-17%) decreased after AEX + WL (P < 0.001). Fat-free mass (FFM) and mid-thigh muscle area by computed tomography did not change but muscle attenuation increased (P < 0.05). VO2 max increased 14% (P < 0.001). AEX + WL increased M by 18% (P < 0.01). Myostatin gene expression decreased 19% after AEX + WL (P < 0.05). Basal mRNA myostatin levels were negatively associated with M before the intervention (r = -0.43, P < 0.05). Insulin infusion increased myoD and myogenin expression before and after AEX + WL (both P < 0.001) but basal levels did not change. The insulin effect on myostatin expression was associated with the change in M after AEX + WL (r = 0.56, P < 0.005). CONCLUSIONS: Exercise and weight loss results in a downregulation of myostatin mRNA and an improvement in insulin sensitivity in obese older men and women.

IMPACT OF WEIGHT LOSS AND AEROBIC EXERCISE ON NUTRITION AND BONE MINERAL DENSITY IN AFRICAN AMERICAN AND CAUCASIAN POSTMENOPAUSAL WOMEN.

BACKGROUND: Weight loss is often recommended for obese women to reduce fat mass and the risk of developing chronic diseases, but may result in a reduction of bone mineral density (BMD). African Americans have greater BMD than Caucasians, but differences in the decrease in BMD between these races following weight reduction with and without exercise are unknown. OBJECTIVES: The purpose of this study was to investigate the hypothesis that Caucasian women would lose greater amounts of BMD than African American women after undergoing weight loss, but that the addition of aerobic exercise would attenuate the loss in both races. DESIGN: Longitudinal. PARTICIPANTS: African American (n=34) and Caucasian (n=63), overweight and obese postmenopausal (age 45-80 years). INTERVENTION: Six months of weight loss (250-350 kcal/days deficit) alone (WL) or in combination with aerobic exercise consisting of 3 days/week treadmill training at >85% of heart rate reserve for 45 min (AEX+WL). MEASUREMENTS: Femoral neck, total femur, and lumbar BMD, VO2max, urinary calcium, and dietary intake. RESULTS: African American women had a greater body weight, BMI, and BMD all sites and lower dietary protein and calcium intakes than Caucasian women (all P<0.05). Weight decreased 7.5% in both groups and VO2max increased only after AEX+WL (intervention effect, P<0.001). Both races lost ~1% of their femoral neck and total femur BMD following the interventions (P's<0.01). There were no race by intervention interactions. There was a trend for the women undergoing WL to lose greater femoral neck BMD than those in AEX+WL (P=0.07). There were no associations between changes in BMD and changes in VO2max, urinary calcium, or dietary intake. CONCLUSIONS: Our data indicate that despite beginning the interventions with greater BMD than Caucasian postmenopausal women, African Americans were not spared from losses of femoral neck and total femur BMD following six months of weight loss, but that addition of aerobic exercise to weight loss tends to attenuate the decreases in femoral neck BMD in both races.

Safety evaluation of DHA-rich Algal Oil from Schizochytrium sp.

The safety of DHA-rich Algal Oil from Schizochytrium sp. containing 40-45 wt% DHA and up to 10 wt% EPA was evaluated by testing for gene mutations, clastogenicity and aneugenicity, and in a subchronic 90-day Sprague-Dawley rat dietary study with in utero exposure, followed by a 4-week recovery phase. The results of all genotoxicity tests were negative. In the 90-day study, DHA-rich Algal Oil was administered at dietary levels of 0.5, 1.5, and 5 wt% along with two control diets: a standard low-fat basal diet and a basal diet supplemented with 5 wt% of concentrated Fish Oil. There were no treatment-related effects of DHA-rich Algal Oil on clinical observations, body weight, food consumption, behavior, hematology, clinical chemistry, coagulation, or urinalysis. Increases in absolute and relative weights of the liver, kidney, spleen and adrenals (adrenals and spleen with histological correlates) were observed in both the Fish Oil- and the high-dose of DHA-rich Algal Oil-treated females and were not considered to be adverse. The no observed adverse effect level (NOAEL) for DHA-rich Algal Oil under the conditions of this study was 5 wt% in the diet, equivalent to an overall average DHA-rich Algal Oil intake of 4260 mg/kg bw/day for male and female rats.

Safety evaluation of Algal Oil from Schizochytrium sp.

The safety of Algal Oil from Schizochytrium sp. was evaluated by testing for gene mutations, clastogenicity and aneugenicity, and in a subchronic 90-day Sprague-Dawley rat dietary study. The results of all genotoxicity tests were negative. The 90-day study involved dietary exposure to 0.5, 1.5, and 5 wt.% of Algal Oil and two control diets: a standard low-fat basal diet and a basal diet supplemented with 5 wt.% menhaden oil (the fish oil control). There were no treatment-related effects of Algal Oil on clinical observations, body weight, food consumption, behavior, hematology, clinical chemistry, coagulation, or urinalysis parameters. Increased mean liver weights and alveolar histiocytosis were observed in both the fish oil control and the high-dose Algal Oil-treated animals and were not considered to be adverse. Algal Oil was bioavailable as demonstrated by the dose-related increase of DHA and EPA levels in tissues and plasma. The no observable adverse effect level (NOAEL) for Algal Oil under the conditions of this study was 5 wt.% in the diet, equivalent to an overall average Algal Oil intake of 3250 mg/kg bw/day for male and female rats. Based on the body surface area, the human equivalent dose is about 30 g Algal Oil/day for a 60 kg adult.

Preclinical safety evaluation in rats using a highly purified ethyl ester of algal-docosahexaenoic acid.

Preclinical studies have shown that docosahexaenoic acid (DHA) derived from microalgae (DHASCO) is neither mutagenic nor toxic in acute, subchronic or developmental tests. DHASCO, triglyceride oil from the fermentation of Crypthecodinium cohnii, contains 40-50% (400-500 mg/g) of DHA by weight. Martek Biosciences Corporation has developed a concentrated ethyl ester of DHA (900 mg/g) from DHASCO (MATK-90). A 90-day subchronic safety study with a one-month recovery period using Sprague-Dawley rats included clinical observations, ophthalmic examination, hematology, clinical chemistry, toxicokinetic evaluation, and pathological assessments. Effects of MATK-90 were compared with those produced from DHASCO and control (corn oil). Doses of MATK-90 (1.3, 2.5 and 5.0 g/kg/day) and DHASCO (5.0 g/kg/day=2g of DHA) were administered once-daily by oral gavage at a volume of 10 mL/kg. The corn oil was also administered by oral gavage (10 mL/kg/day). There were no treatment-related adverse effects in any of the parameters measured at doses of

Cardiovascular health and fitness after stroke.

Stroke patients have profound cardiovascular and muscular deconditioning, with metabolic fitness levels that are about half those found in age-matched sedentary controls. Physical deconditioning, along with elevated energy demands of hemiparetic gait, define a detrimental combination termed diminished physiological fitness reserve that can greatly limit that can greatly limit performance of activities of daily living. The physiological features that underlie worsening metabolic fitness in the chronic phase of stroke include gross muscular atrophy, altered muscle molecular phenotype, increased intramuscular area fat, elevated tissue inflammatory markers, and diminished peripheral blood flow dynamics. Epidemiological evidence further suggests that the reduced cardiovascular fitness and secondary biological changes in muscle may propagate components of the metabolic syndrome, conferring added morbidity and mortality risk. This article reviews some of the consequences of poor fitness in chronic stroke and the potential biological underpinnings that support a rationale for more aggressive approaches to exercise therapy in this population.

Adiponectin levels do not change with moderate dietary induced weight loss and exercise in obese postmenopausal women.

OBJECTIVE: The purpose of this study was to determine changes in adiponectin levels with moderate weight loss, weight loss plus aerobic exercise, or weight loss plus resistive exercise in overweight and obese, sedentary postmenopausal women. DESIGN: Longitudinal, clinical intervention study of 6-month (3 x /week) program of either weight loss (WL, n=15), weight loss + aerobic exercise (WL+AEX, n=16), or weight loss + resistive exercise (WL+RT, n=9) SUBJECTS: We studied 40 sedentary, overweight and obese (body mass index, BMI=32+/-1 kg/m(2), X+/-s.e.m.) postmenopausal (57+/-1y) women. MEASUREMENTS: Fat mass and fat-free mass (FFM) by dual-energy X-ray absorptiometry, plasma insulin, leptin, and adiponectin by radioimmunoassay. RESULTS: Age, body weight, BMI, waist and hip circumferences, waist-to-hip ratio, VO(2)max, percent fat, total body fat mass, FFM, and fasting plasma glucose, insulin, leptin, and adiponectin concentrations were similar among WL, WL+AEX, and WL+RT groups before the interventions. In all women combined, body weight, BMI, and waist and hip circumferences decreased (P < 0.001). There was a significant absolute decrease in percent body fat from 47 to 44%, representing a 13% decrease in total fat mass and a -1.6% change in FFM. Fasting concentrations of plasma adiponectin did not change (40+/-16%, P=NS), whereas fasting plasma glucose, insulin, and leptin all decreased (P<0.001). CONCLUSIONS: Plasma adiponectin levels do not change with a 6-month moderate weight reduction program even when accompanied by aerobic or resistive exercise training in overweight and obese postmenopausal women.

Body fat distribution and flow-mediated endothelium-dependent vasodilation in older men.

OBJECTIVE: Recent studies indicate that abdominal fat accumulation, in particular intra-abdominal fat, is related to impaired endothelial function in young healthy volunteers. The aim of this study was to examine whether the distribution of body fat depots is related to impaired endothelial function in older men. METHODS: Cross-sectional sample of 38 older (68+/-1 y) sedentary (VO(2max)=2.4+/-0.1 l/min) men. Flow-mediated endothelial dependent vasodilation (EDD) was assessed in the brachial artery in response to reactive hyperemia using high-resolution ultrasound. Abdominal subcutaneous and visceral fat depots were assessed by computed tomography scan (CT-scan) at the L(4)-L(5) region in the supine position. Percentage body fat was assessed via dual-energy X-ray absorptiometry (DEXA). RESULTS: Flow-mediated percentage change in brachial artery was 7.6+/-0.7%, suggesting an impaired flow-mediated EDD. Using simple linear regression analysis, there were no statistically significant relationship observed between flow-mediated EDD and the indices of total and abdominal adiposity (percentage body fat=29.3+/-0.9%, r=-0.11; total abdominal fat area=465+/-23 cm(2), r=-0.1; intra-abdominal fat area=200+/-14 cm(2), r=-0.14; subcutaneous fat area=265+/-13 cm(2), r=-0.05; BMI=29.3+/-0.9 kg/m(2), r=-0.07; and waist to hip ratio=0.98+/-0.01, r=-0.20). CONCLUSION: These findings suggest that in older sedentary men there is no clear correlation between adiposity and body fat distribution and impairment of flow-mediated endothelium dependent vasodilation.

Does age, sex, or ACE genotype affect glucose and insulin responses to strength training?

The purpose of the present study was to determine whether age, sex, or angiotensin I-converting enzyme (ACE) genotype influences the effects of strength training (ST) on glucose homeostasis. Nineteen sedentary young (age = 20-30 yr) men (n = 10) and women (n = 9) were studied and compared with 21 sedentary older (age = 65-75 yr) men (n = 12) and women (n = 9) before and after a 6-mo total body ST program. Fasting insulin concentrations were reduced in young men and in older men with ST (P < 0.05 in both). In addition, total insulin area under the curve decreased by 21% in young men (P < 0.05), and there was a trend for a decrease (11%) in older men (P = 0.06). No improvements in insulin responses were observed in young or older women. The ACE deletion/deletion genotype group had the lowest fasting insulin and insulin areas under the oral glucose tolerance test (OGTT) curve before training (all P < 0.05), but those with at least one insertion allele had a trend for a greater reduction in total insulin area than deletion homozygotes (P = 0.07). These results indicate that ST has a more favorable effect on insulin response to an OGTT in men than in women and offer some support for the hypothesis that ACE genotype may influence insulin responses to ST.