Home-Based Indoor Physical Activity Programs for Community-Dwelling Older Adults: A Systematic Review.

CONTEXT: Home-based exercise programs are a good strategy to promote benefits to health for people who cannot visit gyms, clinics, or have limited time for physical activity outside. OBJECTIVE: To synthesize the effect of home-based indoor physical activity on psychosocial outcomes and mobility in community-dwelling older adults. DATA SOURCES: A comprehensive search was conducted in the MEDLINE, PubMed, Embase, SPORTDiscus, Cochrane Library, Scopus, and Google Scholar databases. STUDY SELECTION: A total of 11 studies (13 publications) were included involving a total of 1004 older adults. STUDY DESIGN: A systematic review of randomized controlled trials was conducted using the aforementioned 7 databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. LEVEL OF EVIDENCE: Level 2. DATA EXTRACTION: Two authors independently selected studies, extracted data, and determined the risk of bias and evidence level using the Grading quality of evidence and strength of recommendations (GRADE) guidelines. We conducted a synthesis without meta-analysis (SWiM) to assess the outcome. RESULTS: There is moderately certain evidence that home-based exercise programs reduced the fear of falling. Psychosocial (mental health and quality of life) and mobility outcomes may improve after participating in the intervention inside the home. CONCLUSION: The review found very low to certain evidence that home-based exercises programs improved psychosocial outcomes (mental health and quality of life) and walking speed (mobility). Moderately certain evidence suggests that home-based exercises improved fear of falling. PROTOCOL REGISTER NUMBER: CRD42020182008.

Prevalence of dietary supplement consumption among CrossFit practitioners.

Purpose: We aimed to verify the prevalence of dietary supplements among CrossFit practitioners (CFPs), considering gender and training status. Still, we aimed to determine the type, reasons, and associated factors of dietary supplement utilization among CFPs. Methods: This is a cross-sectional, exploratory, and descriptive study with the snowball sampling method. Data were collected through online questionnaires using the Google Forms® tool. We included CFPs aged 18-64 years, from Aug 1, 2020, to Sept 31, 2020. The questionnaire contained questions to assess the prevalence, type, and reasons for supplement use; also, we assessed information about sociodemographic variables and the prevalence of the main chronic morbidities. To analyze aspects of eating behavior and sleep-related parameters, we applied the three-factor eating questionnaire (TFEQ)-R21 and the Pittsburgh Sleep Quality Index questionnaire (PSQI), respectively. Results: We assessed one hundred twelve (n = 112; 57 men; 55 women) CFPs (28.9 ± 7.64 years old; body mass index (BMI), 25.5 ± 4.83 kg/m2). Eighty-seven (50 men; 37 women; 28.2 ± 6.66 years old; BMI, 25.4 ± 4.55 kg/m2) reported using dietary supplements. Whey protein was the most used supplement (n = 70), followed by creatine (n = 54). Cognitive restraint (a dimension of eating behavior) score was higher in supplement users than in non-users (51.7 ± 18.6 vs. 42.6 ± 20.5; p = 0.040). Sleep-related parameters did not differ between supplement users and non-users. The most associated factors to supplement use were sex (being man; OR, 7.99; p = 0.007), sleep quality (poor; OR, 5.27; p = 0.045), CrossFit level (as prescribed (RX); OR, 4.51; p = 0.031), and cognitive restraint (OR, 1.03; p = 0.029). Conclusion: The CFPs, especially RX and Elite ones, showed a higher prevalence of supplement utilization. Anabolic-related supplements (i.e., whey protein and creatine) were the most used; moreover, several CFPs used supplements not supported by scientific evidence. Cognitive restraint score was higher in supplement users than in non-users. RX level, being men, and poor sleep quality were associated with supplement utilization. These data draw attention to the necessity of nutritional education for CrossFit coaches and athletes. Broader studies are necessary to confirm our findings.

Emotional eating, binge eating, physical inactivity, and vespertine chronotype are negative predictors of dietary practices during COVID-19 social isolation: A cross-sectional study.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) emerged and rapidly spread worldwide. Several countries have imposed lockdown and isolation in attempt to mitigate viral spread. However, social isolation has a negative effect on psychological aspects, increasing stress, fear, anxiety, anger and emotional disturbance, as well as affecting sleep pattern and the practice of physical activity. Negative emotions and lifestyle changes trigger overeating, consequently affecting dietary practices. The aim of this study was to verify the prevalence of lifestyle factors (i.e., sleep time/quality and practice of physical exercise), eating behavior dimensions, chronotype, and association with dietary practices (planning, domestic organization, food choice, ways of eating) in home confinement during the COVID-19 pandemic in São Paulo, Brazil. METHODS: This cross-sectional study was conducted between April 27 and May 25, 2020. An anonymous online questionnaire (Microsoft Forms) was used for data collection by the snowball method. We verified dietary practices (outcome), eating behavior, physical exercise practice, sleep quality and duration, and chronotype (exposure variables). Sex, age, educational and social status were assessed as covariates and confounders. We evaluated 724 adults (585 women and 139 men). Mean age was 32.6 y (±11.3) for women and 33.5 y (±10.5) for men. RESULTS: Emotional eating (EE) and binge eating (BE) were positively correlated (r = 0.66; P <0.001). Dietary practices were negatively correlated with BE (r = -0.41; P <0.001), EE (r = -0.33; P <0.001) and body mass index (r = -0.24; P <0.001). Linear regression demonstrated that EE (ß = -0.1351; t = -2.841; P = 0.005; ηp2 = 0.013), BE (ß = -0.2580; t = -5.612; P < 0.001; ηp2 = 0.050), no practice of physical exercise at home (ß = -0.4271; t = -5.933; P < 0.001; ηp2 = 0.055), being vespertine (ß = -0.3435; t = 2.076; P = 0.038; ηp2 = 0.019), and age (ß = -0.082; t = -2.210; P = 0.027; ηp2 = 0.008) are negative predictors of dietary practices. Finally, cognitive restraint (ß = 0.1407; t = 3.858; P < 0.001; ηp2 = 0.024), better sleep quality (ß = 0.1768; t = 2.506; P = 0.012; ηp2 = 0.010), receiving 4-10 wages per month (according to a minimum wage in Brazil that corresponds to US $ 183.01) (ß = 0.2568; t = 2.573; P = 0.10; ηp2 = 0.027) and 10 - 20 wages per month (ß = 0.4490; t = 3.726; P < 0.001; ηp2 = 0.027) are positive predictors of dietary practices. CONCLUSION: Eating behavior, physical exercise, sleep, and social factors can be important predictors for dietary practices during COVID-19 social confinement. Longitudinal studies in Brazil are needed to confirm these findings.

Relationship among hypoxia, sleep and cognitive functions / Relación entre hipoxia, sueño y funciones cognitivas

The scientific literature shows that the reduced oxygen supply (O2) induced by acute or chronic exposure to high altitudes stimulates the organism to adapt to new physiological and psychological conditions imposed by hypoxia. Sleep can suffer partial fragmentation due to exposure to high altitudes, and these changes can be responsible for impaired cognitive functions. Therefore, this study aimed to explore the relationship between hypoxia, sleep and cognitive functions. We conducted a literature review in the period from 1978 to 2020. In that way, we concluded that hypoxia can impair sleep patterns and, consequently, cognitive functions, including memory, attention, executive functions, decision making and reaction time.

La literatura científica muestra que el suministro reducido de oxígeno (O2 ) inducido por aumentos agudos o crónicos en la altitud estimula al organismo a adaptarse a las nuevas condiciones fisiológicas y psicológicas impuestas por la hipoxia. El sueño puede sufrir fragmentación parcial debido a la exposición a grandes altitudes, y estos cambios pueden ser responsables de las funciones cognitivas deterioradas. Por lo tanto, este estudio tuvo como objetivo explorar la relación entre la hipoxia, el sueño y las funciones cognitivas. Realizamos una revisión de la literatura en el período de 1978 a 2020. Por lo tanto, se concluye que la hipoxia puede empeorar el patrón de sueño y, en consecuencia, el funcionamiento cognitivo, incluida la memoria, la atención, las funciones ejecutivas, la toma de decisiones y tiempo de reacción.

Influence of curcumin supplementation on metabolic and lipid parameters of people living with HIV/AIDS: a randomized controlled trial.

BACKGROUND: Scientific studies have shown that the potential therapeutic efficacy of curcumin in several diseases is due to its potent antioxidant and anti-inflammatory properties. Consequently, curcumin supplementation seems to be a valuable alternative for HIV-infected individuals. The aim of this study is to evaluate the influence of curcumin supplementation on substrate oxidation at rest, body composition, and the lipid profile of physically active people living with HIV/AIDS under antiretroviral therapy. METHODS: This double-blind, crossover, randomized clinical trial was comprised of 20 subjects divided into experimental (EG) and control (CG) groups, receiving 1000 mg curcumin/day and placebo, respectively, during a 30-day period. Substrate oxidation at rest was assessed by indirect calorimetry, body composition was measured by dual-energy x-ray absorptiometry, and the lipid profile was evaluated by blood tests. Data analysis was performed by independent samples and paired t-tests to compare the differences between groups and times. A p-value < 0.05 was accepted as significant. RESULTS: There were no differences between groups regarding substrate oxidation at rest or body composition. However, serum triglyceride levels were increased after curcumin supplementation (182 vs. 219 mg/dL; p = 0.004). CONCLUSION: Curcumin supplementation promoted the elevation of serum triglyceride levels in HIV-infected subjects. Further studies with a larger sample cohort, different curcumin doses, and longer intervention times are needed to validate current observations. In addition, the influence of physical activity, dietary intake, and genetic polymorphisms must be considered in future studies to better understand the impact of curcumin supplementation on the lipid profile of people living with HIV/AIDS under antiretroviral therapy.

Anti-inflammatory response to acute exercise is related with intensity and physical fitness.

PURPOSE: The relationship between inflammatory markers and energetic metabolism has been explored. However, the relationship between exercise intensity and fitness status is unclear, and it is necessary to understand this relationship to apply specific exercise guidance. The purpose of the study was to analyze metabolic and inflammatory responses imposed by acute exercise sessions performed at moderate, heavy, and severe intensities and their relationship with the physical fitness status. METHODS: Nineteen healthy male volunteers performed three acute exercise sessions until exhaustion or up to 60 minutes on a cycle ergometer at moderate (90% of first ventilatory threshold [VT1]), heavy (midpoint between VT1 and second ventilatory threshold [VT2]), and severe (midpoint between VT2 and maximal aerobic power) intensities. Blood lactate, glucose, NEFA, endotoxin, and cytokines were determined for each exercise session. Peripheral and lipopolysaccharide (LPS)-stimulated release of tumor necrosis factor alpha (TNF-α), interleukin (IL)-6, and IL-10 was analyzed before, after, and 60 minutes after sessions. RESULTS: In peripheral blood, severe intensity increased lactate, endotoxin, and TNF-α immediately after exercise and glucose at 60 min after exercise. There was a trend for IL-10 increase at 60 minutes after exercise in peripheral blood. Immediately after exercise, LPS-stimulated TNF-α, IL-6, IL-6/IL-10 ratio, and lactate levels were higher in the severe intensity while nonester fatty acid levels decreased at this time. At 60 minute after exercise, higher concentrations of glucose and a trend for increased IL-10 were observed in severe intensity. A positive correlation was observed between maximal aerobic power and IL-10 ( r = 0.513; P = 0.042), and negative correlations between maximal aerobic power and endotoxin ( r = -0.531; P = 0.034) and lactate ( r = -0.538; P = 0.031) in heavy intensity. CONCLUSION: Our data show a novel finding that higher cytokine responses occur at higher intensities, mainly in severe intensity. However, the anti-inflammatory (IL-10) response was physical fitness-dependent.

Performance and altitude: Ways that nutrition can help.

High altitudes are a challenge for human physiology and for sports enthusiasts. Several reasons lead to deterioration in performance at high altitudes. Hypoxia owing to high altitude causes a breakdown of homeostasis with imbalance in several physiological systems, including the immune system. The reduction in mucosal immunity and inflammation and the predominance of the humoral immune response causes a condition of immunosuppression and an increased likelihood of infection. In addition, it is known that worsening of the immune response is associated with reduced performance. On the other hand, immunonutrition plays an important role in modulating the effects of physical exercise on the immune system. However, to our knowledge, few studies have evaluated the effect of nutrition on the immune system after exercise in hypoxia. Although the association between exercise and hypoxia has been shown to be more severe for the body owing to the sum of stressful agents, supplementation with carbohydrates and glutamine seems to play a relevant role in mitigating immunosuppressive effects. These findings, although limited by the fact that they are the result of very few studies, shed light on a relevant theme for sports physiology and nutrition and suggest that both supplements may be useful for athletes, visitors, and workers in high-altitude regions. The aim of this review was to discuss the effects of high-altitude hypoxia on the human body from the point of view of exercise immunology because it is known that transient immunosuppression after strenuous exercise and competition should be followed by reduction in training overload and worse performance.

Maximum effort training performed in hypoxia alters the mood profile / Exercício físico máximo realizado em hipóxia altera o perfil de humor / Ejercicio físico máximo realizado en hipoxia altera el perfil del estado de ánimo

INTRODUCTION: Physical exercise at high altitude has become constant. However, the risks associated with this type of exercise represent a major concern, considering the influence of important stressors such as hypoxia and physical exercise on psychobiological and physiological responses. OBJECTIVE: Analyze the mood state and behavior of physiological variables of volunteers subjected to a progressive loading protocol until they reached maximum volitional exhaustion, both at sea level and at a simulated altitude of 4500 meters. METHOD: For both conditions studied, the volunteers responded to two instruments that assess mood responses: The Brunel Mood Scale and the Visual Analogue Mood Scale. They also underwent blood sampling to measure blood lactate levels and to evaluate oxygen-hemoglobin saturation. These procedures were performed before, immediately after, and 30 and 60 minutes after the end of the protocol. RESULTS: Hypoxia triggered negative effects on mood responses, especially when compared to sea level conditions. An increase in fatigue level (p=0.02) and mental confusion (p=0.04) was observed immediately after the exercise session, and reduction of vigor (p=0.03) was noted at 30 minutes, accompanied by a reduction in oxygen-hemoglobin saturation immediately after the session and at 30 minutes. There was also an increase in blood lactate levels immediately after the session (p=0.006). CONCLUSION: The particularities of the hypoxic environment associated with maximum exercise are able to cause a deterioration of mood and physiological responses, which can negatively modulate physical performance. This is a cross-sectional clinical study.

INTRODUÇÃO: Prática de exercícios físicos em elevadas altitudes tem se tornado constante. Entretanto, os riscos associados a esta representam uma grande preocupação, considerando a influência de importantes agentes estressores, como hipóxia e exercício físico, sobre as respostas psicobiológicas e fisiológicas. OBJETIVO: Analisar o perfil do humor e o comportamento de variáveis fisiológicas de voluntários submetidos a um protocolo de cargas progressivas até a Exaustão Voluntária Máxima no nível do mar e em altitude simulada de 4.500 metros. MÉTODOS: Para ambas as condições estudadas, os voluntários responderam a dois instrumentos que avaliam as respostas do humor, Escala de Humor de Brunel e o Visual Analogue Mood Scale, e foram submetidos à coleta de sangue para verificar a concentração de lactato sanguíneo, bem como para avaliar a saturação de oxi-hemoglobina. Esses procedimentos foram realizados antes, imediatamente depois e 30 e 60 minutos após o término do protocolo. RESULTADOS: A hipóxia desencadeou efeitos negativos sobre as respostas de humor, principalmente com relação ao nível do mar. Verificou-se aumento da fadiga (p = 0,02) e da confusão mental (p=0,04) imediatamente após a prática e redução do vigor (p = 0,03) aos 30 minutos; acompanhadas da diminuição da saturação da oxi-hemoglobina imediatamente após e aos 30 minutos; constatou-se ainda, o aumento da concentração de lactato sanguíneo no momento imediatamente após (p = 0,006). CONCLUSÃO: As particularidades do ambiente hipóxico associadas à realização do exercício físico máximo são capazes de piorar o estado de humor e as respostas fisiológicas, o que pode modular negativamente o desempenho físico. Este estudo é do tipo clínico transversal.

INTRODUCCIÓN: La práctica de ejercicios físicos en elevadas altitudes se ha vuelto constante. Entretanto, los riesgos asociados a ésta representan una gran preocupación, considerando la influencia de importantes agentes estresantes, como hipoxia y ejercicio físico, sobre las respuestas psicobiológicas y fisiológicas. OBJETIVO: Analizar el perfil del humor y el comportamiento de variables fisiológicas de los voluntarios sometidos a un protocolo de cargas progresivas hasta el Agotamiento Voluntario Máximo, al nivel del mar y a una altitud simulada de 4500 metros. MÉTODOS: Para ambas condiciones estudiadas, los voluntarios respondieron a dos instrumentos que evalúan las respuestas del humor: la Escala de Humor de Brunel y el Visual Analogue Mood Scale, y fueron sometidos a colecta de sangre para verificar la concentración de lactato sanguíneo, bien como para evaluar la saturación de oxihemoglobina. Estos procedimientos fueron realizados antes, inmediatamente después, y 30 y 60 minutos después de finalizar el protocolo. RESULTADOS: La hipoxia desencadenó efectos negativos sobre las respuestas de humor, principalmente con relación al nivel del mar. Se verificó aumento de fatiga (p = 0,02) y de la confusión mental (p = 0,04) inmediatamente después de la práctica y reducción del vigor (P = 0,03) a los 30 minutos; acompañadas de la disminución de la saturación de la oxihemoglobina inmediatamente después y a los 30 minutos; se constató además el aumento de la concentración de lactato sanguíneo en el momento inmediatamente después (p = 0,006). CONCLUSIÓN: Las particularidades del ambiente hipóxico asociadas a la realización del ejercicio físico máximo, son capaces de empeorar el estado de humor y las respuestas fisiológicas, lo que puede modular negativamente el desempeño físico. Este estudio es del tipo clínico transversal.

Melatonin and sleep responses to normobaric hypoxia and aerobic physical exercise: A randomized controlled trial.

This work evaluated the effects of moderate physical exercise performed under hypoxic conditions on melatonin and sleep. Forty healthy men were randomized into four groups: Normoxia (N) (n = 10); Hypoxia (H) (n = 10); Exercise under Normoxia (EN) (n = 10); and Exercise under Hypoxia (EH) (n = 10). The observation period for all groups was approximately 36 h, beginning with a first night devoid of any intervention. Aerobic exercise was performed by the EN and EH groups on a treadmill at 50% of the ventilatory threshold intensity for 60 min. Sleep evaluation was performed on the 1st and 2nd nights. Venous blood samples for the melatonin measurement were obtained on the 1st and 2nd days at 7:30 AM as well as on the 1st and 2nd nights at 10:30 PM. On the 2nd night, melatonin was higher in the H group than in the N group, but both were lower than values of the EH group. The nocturnal increase in melatonin was inversely correlated with the oxygen saturation of hemoglobin (SaO2%) on the 2nd night in the H group and on the 2nd day in the EH group. Diurnal remission of nocturnal melatonin appeared to be postponed in the H group and even more so in the EH group. Thus, normobaric hypoxia, which is equivalent to oxygen availability at an altitude of 4500 m, acutely increases melatonin. Moreover, diurnal remission of the nocturnal increase in melatonin seems to be delayed by hypoxia alone but even more so when acting together with exercise.

Physical activity as a moderator for obstructive sleep apnoea and cardiometabolic risk in the EPISONO study.

Obstructive sleep apnoea (OSA) is positively associated with cardiometabolic diseases; however, high levels of physical activity could decrease the incidence of OSA and associated comorbidities.In this study we aimed to examine the incidence of OSA in relation to physical activity, and its role as a protective factor in individuals with OSA on the incidence of cardiometabolic diseases, in an 8-9-year follow-up study. We analysed data of 658 volunteers from the São Paulo Epidemiologic Sleep Study (EPISONO), a cohort study of individuals aged 20-80 years, collected through polysomnography, the International Physical Activity Questionnaire and an assessment of cardiometabolic profile.Active subjects had a lower risk of developing OSA compared with nonactive subjects (relative risk 0.877, 95% CI 0.296-0.855) and there was a reduced risk of developing type 2 diabetes mellitus in active/apnoeic subjects (relative risk 0.493, 95% CI 0.252-0.961) compared with nonactive subjects. Metabolic equivalent was negatively associated to cardiometabolic markers, such as C-reactive protein (exp(B)=0.720; p=0.001), interleukin-6 (exp(B)=0.991; p=0.03), insulin (exp(B)=0.982; p=0.03), triglycerides (exp(B)=0.997; p<0.001), homeostasis model assessment for insulin resistance (exp(B)≤0.946; p<0.024), quantitative insulin sensitivity check index (exp(B)=992.4; p<0.001) and mean arterial pressure (exp(B)=0.987; p=0.001).Physical activity was a protective factor against type 2 diabetes mellitus in apnoeic individuals; moreover, being active reduced the risk of developing OSA and was associated with a better cardiometabolic profile.

The Secretory Leukocyte Protease Inhibitor mRNA expression is involved with inflammatory control after downhill exercise in the triceps brachii intermediary head in Wistar rats.

After severe skeletal muscle damage, communication between inflammatory macrophages, myogenic cells, and modulatory secretion factors is essential to induce re-establishment of skeletal muscle structure. To analyze when characteristic gene expression of macrophages, myogenic cells, and SLPI are modulated after an exercise-induced muscle damage (EIMD) downhill protocol. Twenty-six rats were exposed to an experimental protocol of exercise and euthanized before (CTRL), immediately after (G0), and 24 (G24) and 48 (G48) hours after the exercise. After euthanasia, the Triceps brachii were dissected and analyzed by enzyme-linked immunosorbent assay and real time polymerase chain reaction. The CD68 expression was higher in the G24 when compared with all groups (p value < 0.05), whereas the CD163 was inhibited compared with G0 (p value < 0.05). MyoD and Myogenin were higher in the G24 when compared with G0 and G48 (p value < 0.05). The mRNA Secretory Leukocyte Protease Inhibitor (SLPI) was higher in the G48 when compared with the CTRL and G0 (p value < 0.05). IL-6 and TNF-α cytokines did not significantly change, but IL-10 presented a trend to be lower in the G0 when compared with G24 (p value = 0.054). A significant negative correlation was observed between CD68/CD163 (C.C = -0.71) and positive correlations between CD68/Myogenin (C.C = 0.65); MyoD/Myogenin (C.C = 0.72); IL-10/MyoD (C.C = 0.46), IL-10/MYOGENIN (C.C = 0.59); and IL-6/IL-10 (C.C = 0.64). A higher expression of CD68, concomitant with an elevation in MyoD and Myogenin 24 h after exercise, along with some correlations, suggests macrophage communication with myogenic cells independent of CD163 elevation. Additionally, the reestablishment of IL-10 in 24 h with the SLPI increased until 48 h indicate that these molecules are involved with anti-inflammatory transition after downhill exercise in the TBIH of Wistar rats.

Effects of Carbohydrate and Glutamine Supplementation on Oral Mucosa Immunity after Strenuous Exercise at High Altitude: A Double-Blind Randomized Trial.

This study analyzed the effects of carbohydrate and glutamine supplementation on salivary immunity after exercise at a simulated altitude of 4500 m. Fifteen volunteers performed exercise of 70% of VO2peak until exhaustion and were divided into three groups: hypoxia placebo, hypoxia 8% maltodextrin (200 mL/20 min), and hypoxia after six days glutamine (20 g/day) and 8% maltodextrin (200 mL/20 min). All procedures were randomized and double-blind. Saliva was collected at rest (basal), before exercise (pre-exercise), immediately after exercise (post-exercise), and two hours after exercise. Analysis of Variance (ANOVA) for repeated measures and Tukey post hoc test were performed. Statistical significance was set at p < 0.05. SaO2% reduced when comparing baseline vs. pre-exercise, post-exercise, and after recovery for all three groups. There was also a reduction of SaO2% in pre-exercise vs. post-exercise for the hypoxia group and an increase was observed in pre-exercise vs. recovery for both supplementation groups, and between post-exercise and for the three groups studied. There was an increase of salivary flow in post-exercise vs. recovery in Hypoxia + Carbohydrate group. Immunoglobulin A (IgA) decreased from baseline vs. post-exercise for Hypoxia + Glutamine group. Interleukin 10 (IL-10) increased from post-exercise vs. after recovery in Hypoxia + Carbohydrate group. Reduction of tumor necrosis factor alpha (TNF-α) was observed from baseline vs. post-exercise and after recovery for the Hypoxia + Carbohydrate group; a lower concentration was observed in pre-exercise vs. post-exercise and recovery. TNF-α had a reduction from baseline vs. post-exercise for both supplementation groups, and a lower secretion between baseline vs. recovery, and pre-exercise vs. post-exercise for Hypoxia + Carbohydrate group. Five hours of hypoxia and exercise did not change IgA. Carbohydrates, with greater efficiency than glutamine, induced anti-inflammatory responses.

Carbohydrate Supplementation Influences Serum Cytokines after Exercise under Hypoxic Conditions.

INTRODUCTION: Exercise performed at the hypoxia equivalent of an altitude of 4200 m is associated with elevated inflammatory mediators and changes in the Th1/Th2 response. By contrast, supplementation with carbohydrates has an anti-inflammatory effect when exercise is performed under normoxic conditions. The objective of this study was to evaluate the effect of carbohydrate supplementation on cytokines and cellular damage markers after exercise under hypoxic conditions at a simulated altitude of 4200 m. METHODS: Seven adult male volunteers who exercised for 60 min at an intensity of 50% VO2Peak were randomly evaluated under three distinct conditions; normoxia, hypoxia and hypoxia + carbohydrate supplementation. Blood samples were collected at rest, at the end of exercise and after 60 min of recovery. To evaluate hypoxia + carbohydrate supplementation, volunteers received a solution of 6% carbohydrate (maltodextrin) or a placebo (strawberry-flavored Crystal Light®; Kraft Foods, Northfield, IL, USA) every 20 min during exercise and recovery. Statistical analyses comprised analysis of variance, with a one-way ANOVA followed by the Tukey post hoc test with a significance level of p < 0.05. RESULTS: Under normoxic and hypoxic conditions, there was a significant increase in the concentration of IL-6 after exercise and after recovery compared to at rest (p < 0.05), while in the hypoxia + carbohydrate group, there was a significant increase in the concentration of IL-6 and TNF-α after exercise compared to at rest (p < 0.05). Furthermore, under this condition, TNF-α, IL-2 and the balance of IL-2/IL-4 were increased after recovery compared to at rest (p < 0.05). CONCLUSION: We conclude that carbohydrate supplementation modified the IL-6 and TNF-α serum concentrations and shifted the IL-2/IL-4 balance towards Th1 in response without glycemic, glutaminemia and cell damage effects.

Macrophage Polarization: Implications on Metabolic Diseases and the Role of Exercise.

Macrophages are cells of the innate immune response that trigger inflammation resolution. The phenotype of "classically activated macrophages" (M1) has anti-tumoricidal and anti-bactericidal activities. On the other hand, "alternatively activated macrophages" (M2) are involved in tissue remodeling and immunomodulatory functions. The change in the polarization of macrophages varies according to the diversity of cytokines present in the microenvironment or by the stimuli of an antigen. It involves such factors as interferon-regulatory factors, peroxisome proliferator-activated receptors (PPARs), hypoxia-inducible factors (HIFs), and signal transducers and activators of transcription (STATs). Switching the phenotype of macrophages can help attenuate the development of an inflammatory disease. Exercise can promote alterations in the number of innate immune cells and stimulates phagocytic function. Chronic exercise seems to inhibit macrophage infiltration into adipose tissue by attenuating the expression of F4/80 mRNA. Furthermore, exercise may also increase the expression of M2 markers and reduce TNF-α and TLR4 mRNA expression, which activates the inflammatory pathway of NF-κB. Chronic exercise reduces ß2-adrenergic receptors in monocytes and macrophages by modulating TLR4 signaling as well as suppressing IL-12 production, a stimulator of interferon Y. In this review, we discuss macrophage polarization in metabolic diseases and how exercise can modulate macrophage plasticity.

Exercise deprivation increases negative mood in exercise-addicted subjects and modifies their biochemical markers.

The aim of this study was to identify the possible association between biochemical markers of exercise addiction and affective parameters in a sample of athletes during 2weeks of withdrawal exercise. Eighteen male runners were distributed into a control group (n=10) composed of runners without exercise addiction symptoms and an exercise addiction group (n=8) composed of runners with exercise addiction symptoms. The volunteers performed a baseline evaluation that included affective questionnaires, blood samples, body composition and an aerobic test performed at ventilatory threshold I. After the baseline evaluation, the groups started an exercise withdrawal period that was sustained for 2weeks. During exercise withdrawal, an actigraph accelerometer was used to monitor the movement index, and CK and LDH were measured in blood samples to validate the non-exercise practice. At the end of the exercise withdrawal period, a blood collection, aerobic test and mood scale was performed in the re-test. The results showed that at the end of the experimental protocol, when compared with the control group, the exercise addiction group showed an increase in depression, confusion, anger, fatigue and decreased vigor mood that improved post-exercise, along with low levels of anandamide at all time-points evaluated and a modest increase in ß-endorphin post-exercise. Moreover, the exercise addiction group showed a decrease in oxygen consumption and respiratory exchange ratio after the exercise withdrawal period, which characterized a detraining phenomenon. Our data suggest that a 2-week withdrawal exercise period resulted in an increase of negative mood in exercise addiction; additionally, exercise addiction showed low levels of anandamide.

The impact of sleep on age-related sarcopenia: Possible connections and clinical implications.

Sarcopenia is a geriatric condition that comprises declined skeletal muscle mass, strength and function, leading to the risk of multiple adverse outcomes, including death. Its pathophysiology involves neuroendocrine and inflammatory factors, unfavorable nutritional habits and low physical activity. Sleep may play a role in muscle protein metabolism, although this hypothesis has not been studied extensively. Reductions in duration and quality of sleep and increases in prevalence of circadian rhythm and sleep disorders with age favor proteolysis, modify body composition and increase the risk of insulin resistance, all of which have been associated with sarcopenia. Data on the effects of age-related slow-wave sleep decline, circadian rhythm disruptions and obstructive sleep apnea (OSA) on hypothalamic-pituitary-adrenal (HPA), hypothalamic-pituitary-gonadal (HPG), somatotropic axes, and glucose metabolism indicate that sleep disorder interventions may affect muscle loss. Recent research associating OSA with the risk of conditions closely related to the sarcopenia process, such as frailty and sleep quality impairment, indirectly suggest that sleep can influence skeletal muscle decline in the elderly. Several protein synthesis and degradation pathways are mediated by growth hormone (GH), insulin-like growth factor-1 (IGF-1), testosterone, cortisol and insulin, which act on the cellular and molecular levels to increase or reestablish muscle fiber, strength and function. Age-related sleep problems potentially interfere intracellularly by inhibiting anabolic hormone cascades and enhancing catabolic pathways in the skeletal muscle. Specific physical exercises combined or not with nutritional recommendations are the current treatment options for sarcopenia. Clinical studies testing exogenous administration of anabolic hormones have not yielded adequate safety profiles. Therapeutic approaches targeting sleep disturbances to normalize circadian rhythms and sleep homeostasis may represent a novel strategy to preserve or recover muscle health in older adults. Promising research results regarding the associations between sleep variables and sarcopenia biomarkers and clinical parameters are required to confirm this hypothesis.

Exercise performed at hypoxia influences mood state and anxiety symptoms / Exercício realizado em hipóxia influencia o estado de humor e sintomas de ansiedade / El ejercicio realizado en la hipoxia influencias estado de ánimo y síntomas de ansiedad

During hypoxia conditions, psychological states can be worsened. However, little information is available regarding the effect of physical exercise performed in hypoxia conditions on mood state and anxiety symptoms. The aim of the present study was to elucidate the acute effect of moderate physical exercise performed at hypoxia on mood states and anxiety symptoms in healthy young subjects. Ten volunteers were subjected to the following conditions: a normoxic condition (NC) and a hypoxic condition (HC). They performed 45 min of physical exercise. Their anxiety symptoms and mood states were evaluated at the initial time point as well as immediately following and 30 and 60 min after the exercise session. Our results showed a significant increase in post-exercise anxiety symptoms and a significant decrease in mood scores immediately after and 30 min after exercise performed in the HC. Moderate physical activity performed at hypoxia condition increased post-exercise anxiety and worsened mood state.

Em condição de hipóxia o aspecto psicológico pode piorar, porém, ainda há pouca informação sobre a resposta do exercício físico realizado nestas condições sobre o estado de humor e os sintomas de ansiedade. O objetivo deste estudo foi investigar o efeito agudo do exercício físico moderado realizado em condição de hipóxia sobre o estado de humor e sintomas de ansiedade de jovens saudáveis. Dez voluntários foram submetidos a duas condições: Condição Normóxia (CN) e Condição Hipóxia (CH) e realizaram 45' de exercício físico. Os sintomas de ansiedade e humor foram avaliados no momento basal, imediatamente após, 30 e 60 minutos. Observou-se um aumento significativo dos sintomas de ansiedade pós-exercício físico e uma redução significativa dos escores de humor em condição de hipóxia imediatamente e após 30 minutos de exercício. O exercício físico moderado realizado em condição de hipóxia promove uma resposta ansiogênica pós-exercício físico e piora do estado de humor.

En condiciones de hipoxia , los estados psicológicos pueden empeorar . Sin embargo, hay poca información disponible sobre el efecto del ejercicio físico realizado en condiciones de hipoxia en los síntomas del estado de ánimo y de ansiedad. El objetivo del presente estudio fue determinar el efecto agudo del ejercicio físico moderado realizado en hipoxia en los estados de ánimo y los síntomas de ansiedad en los sujetos jóvenes sanos. Diez voluntarios se sometieron a las siguientes condiciones : una condición de normoxia ( NC ) y una condición hipóxica ( HC ). Realizaron 45 min de ejercicio físico. Sus síntomas de ansiedad y los estados de ánimo fueron evaluados en el momento inicial , así como inmediatamente después y 30 y 60 minutos después de la sesión de ejercicio. Nuestros resultados mostraron un aumento significativo en los síntomas de ansiedad después del ejercicio y una disminución significativa en las puntuaciones del estado de ánimo inmediatamente después y 30 minutos después del ejercicio realizado en la HC. El ejercicio físico moderado realizado en condicines de hipóxia aumentó después del ejercicio ansiedad y empeoró el estado de ánimo.

Downhill exercise-induced changes in gene expression related with macrophage polarization and myogenic cells in the triceps long head of rats.

Macrophages are one of the most heterogenic immune cells involved in skeletal muscle regeneration. After skeletal muscle damage, M1 phenotypes exhibit pro-inflammatory reaction. In a later stage, they are converted to M2 phenotypes with anti-inflammatory properties. To study when gene expressions of macrophage polarization are changed after damage induced by downhill exercise to exhaustion is the objective of this paper. Before (CTRL) and 0 h (G0), 24 h (G24), 48 h (G48) and 72 h (G72) after 18 bouts of downhill exercise, the animals were euthanised, and the triceps were dissected. We measured gene expression of macrophages (CD68 and CD163), myogenic cells (MyoD and myogenin) and quantified cytokine secretion (interleukin (IL)-6, IL-10 and tumour necrosis factor alpha (TNF-α)). The CD68 expression was lower in G72 compared with G24 (P = 0.005) while CD163 was higher in G48 compared with G24 (P = 0.04). The MyoD expression was higher in G72 compared with G0 (P = 0.04). The myogenin expression was lower in G24 compared with CTRL (P = 0.01) and restored in G72 compared with G24 (P = 0.007). The TNF-α was significantly higher at all times after 24 h (all compared with CTRL, with P = 0.03). The CD68 and CD163 expressions behaved distinctly after exercise, which indicates macrophage polarization between 24 and 48 h. The distinct expression of myogenin, concomitantly with MyoD elevation in G72, indicates that myogenic cell differentiation and the significant change of TNF-α level show an important role of this cytokine in these processes.

Exercise improves immune function, antidepressive response, and sleep quality in patients with chronic primary insomnia.

The aim of this study was to evaluate the effects of moderate aerobic exercise training on sleep, depression, cortisol, and markers of immune function in patients with chronic primary insomnia. Twenty-one sedentary participants (16 women aged 44.7 ± 9 years) with chronic primary insomnia completed a 4-month intervention of moderate aerobic exercise. Compared with baseline, polysomnographic data showed improvements following exercise training. Also observed were reductions in depression symptoms and plasma cortisol. Immunologic assays revealed a significant increase in plasma apolipoprotein A (140.9 ± 22 to 151.2 ± 22 mg/dL) and decreases in CD4 (915.6 ± 361 to 789.6 ± 310 mm(3)) and CD8 (532.4 ± 259 to 435.7 ± 204 mm(3)). Decreases in cortisol were significantly correlated with increases in total sleep time (r = -0.51) and REM sleep (r = -0.52). In summary, long-term moderate aerobic exercise training improved sleep, reduced depression and cortisol, and promoted significant changes in immunologic variables.