Effects of Omega-3 fatty acids supplementation and resistance training on skeletal muscle.

BACKGROUND & AIMS: The aim of this study was to investigate the omega-3 fatty acids supplementation, and resistance training on muscle strength and mass. METHODS: A review was conducted by searching relevant randomized controlled trials investigating the effects of omega-3 fatty acids supplementation and resistance training on skeletal muscle strength and mass. Three experts independently performed a thorough examination of the literature database and conducted the systematic review and meta-analysis. RESULTS: Four studies were ultimately included in the systematic review after screening. The results of the meta-analysis revealed that the supplementation of omega-3 fatty acids and resistance training significantly improved muscle strength compared to the placebo-controlled group. However, no significant effects were observed in the effect for muscle mass. CONCLUSIONS: The interventions of omega-3 fatty acids supplementation and resistance training show promise as a countermeasure against muscular dysfunction. While further research is warranted to investigate its effects on skeletal muscle mass, the findings of this study hold implications for maintaining and/or improving the quality of life to elderly people.

Oxygen uptake during the last bouts of exercise incorporated into high-intensity intermittent cross-exercise exceeds the V˙ O2max of the same exercise mode.

Oxygen uptake (V˙ O2) was measured during a non-exhaustive high-intensity intermittent cross-exercise (HIICE) protocol consisting of four alternating bouts of 20 â€‹s running (R) and three bouts of bicycle exercise (BE) at ∼160% and ∼170% maximal oxygen uptake (V˙ O2max), respectively, with 10 â€‹s between-bout rests (sequence R-BE-R-BE-R-BE-R). The V˙ O2 during the last BE ([52.2 â€‹± â€‹5.0] mL·kg-1·min-1) was significantly higher than the V˙ O2max of the BE ([48.0 â€‹± â€‹5.4] mL·kg-1·min-1, n â€‹= â€‹30) and similar to that of running. For clarifying the underlying mechanisms, a corresponding HIICE-protocol with BE and arm cranking ergometer exercise (AC) was used (sequence AC-AC-BE-AC-BE-AC-AC-BE). In some experiments, thigh blood flow was occluded by a cuff around the upper thigh. Without occlusion, the V˙ O2 during the AC ([39.2 â€‹± â€‹7.1] mL·kg-1·min-1 [6th bout]) was significantly higher than the V˙ O2max of AC ([30.2 â€‹± â€‹4.4] mL·kg-1·min-1, n â€‹= â€‹7). With occlusion, the corresponding V˙ O2 ([29.8 â€‹± â€‹3.9] mL·kg-1·min-1) was reduced to that of the V˙ O2max of AC and significantly less than the V˙ O2 without occlusion. These findings suggest that during the last bouts of HIICE may exceed the of the specific exercise, probably because it is a summation of the V˙ O2 for the ongoing exercise plus excess post-oxygen consumption (EPOC) produced by the previous exercise with a higher V˙ O2max.

Home-based high-intensity interval training improves cardiorespiratory fitness: a systematic review and meta-analysis.

BACKGROUND: High-intensity interval training (HIIT) is an effective methods to improve maximal oxygen uptake. However, there is no definitive conclusion about the specific effectiveness of home-based HIIT. This review investigated the effects of home-based HIIT on cardiorespiratory fitness in a systematic review and meta-analysis. METHODS: Four electronic databases were searched (PubMed, Cochran database, Web of Science, Igaku Chuo Zasshi) for studies through March 25, 2023. Eligibility criteria include randomized controlled trials of home-based HIIT in adult people regardless disease or handicaped. Comparisons were made between non-exercise controls, laboratory-based HIIT, and moderate-intensity continuous training (MICT). The primary outcome was defined as cardiorespiratory fitness and the secondary outcome was defined as patient-reported outcomes. The standardized mean difference (SMD) with 95% confidence intervals (CIs) was calculated for quantitative indices. The random-effect model was used as the pooling method. RESULTS: Two hundred seven studies were identified, and 15 satisfied the inclusion criteria. The meta-analysis for cardiorespiratory fitness showed superiority of home-based HIIT to non-exercise controls (SMD 0.61, 95% CI: 0.21, 1.02). However, no significant difference in cardiorespiratory fitness was observed between home-based HIIT and lab-based HIIT (SMD: -0.35, 95%CI: -0.73, 0.03). Also, no significant difference was observed between the home-based HIIT and MICT (SMD 0.34, 95% CI: -0.05, 0.73). CONCLUSION: These results indicated that home-based HIIT was an effective intervention for improving cardiorespiratory fitness in healthy adults and patients. Importantly, this review found no significant differences in cardiorespiratory fitness between home-based HIIT and the group of laboratory HIIT and MICT, highlighting its comparable effectiveness and potential as a practical and valuable exercise intervention.

Eicosapentaenoic Acid and Medium-Chain Triacylglycerol Structured Lipids Improve Endurance Performance.

PURPOSE: The effects of intake of STGs containing esterified eicosapentaenoic acid (EPA) and medium-chain triglycerides (MCTs) on cardiorespiratory endurance have not yet been reported. This study aimed to examine the efficacy of interesterified structured lipids EPA and MCTs on cardiorespiratory endurance. METHODS: This 8-week randomized double-blind placebo-controlled parallel-group study involved 19 healthy men. The participants were randomly assigned to a group that received interesterified structured lipids EPA and MCTs (STG group, 9 participants) or a group receiving a PM of EPA and MCTs (PM group, 10 participants). The outcome measures were time to exhaustion (TTE) and time to reach the anaerobic threshold in the peak oxygen uptake (VO2peak) test, VO2peak, and anaerobic threshold. RESULTS: The increase in TTE in the VO2peak test after the intervention period compared with before the intervention period was significantly greater in the STG group (53 ± 53 s) than in the PM group (-10 ± 63 s; p < 0.05). Similarly, the increase in time to reach the anaerobic threshold was significantly greater in the STG group (82 ± 55 s) than in the PM group (-26 ± 52 s; p < 0.001). CONCLUSION: This study demonstrated that the consumption of interesterified structured lipids EPA and MCTs improved endurance in humans.

Omega-3 fatty acids enhance the beneficial effect of BCAA supplementation on muscle function following eccentric contractions.

Background: This study investigated the combined effect of branched-chain amino acids (BCAA) and fish oil (FO) on muscle damage caused by eccentric contractions (ECCs) of the elbow flexors, with a special focus on muscular function. Methods: Twenty-nine untrained male participants were enrolled in this double-blind, placebo-controlled, parallel study. The participants were randomly assigned to the placebo (PL) group (n = 9), BCAA supplement group (n = 10), and BCAA+FO supplement group (n = 10). The BCAA+FO group consumed eicosapentaenoic acid (EPA) 600 mg and docosahexaenoic acid (DHA) 260 mg per day for 8 weeks, while the BCAA and BCAA+FO groups consumed 9.6 g per day for 3 days prior to and until 5 days after ECCs. Participants performed six sets of 10 ECCs at 100% maximal voluntary contraction (MVC) using dumbbells. Changes in MVC torque, range of motion (ROM), muscle soreness using visual analog scales, upper circumference, muscle thickness, echo intensity, and serum creatine kinase (CK) were assessed before, immediately after, and 1, 2, 3, and 5 days after ECCs. Results: The MVC torque was significantly higher in the BCAA+FO group than in the PL group immediately after ECCs (p < 0.05) but not in the BCAA group. Both BCAA and BCAA+FO groups showed greater ROM and lower muscle soreness than the PL group (p < 0.05). CK was significantly lower in the BCAA group than in the PL group at 5 days after ECCs (p < 0.05). Conclusions: This study reveals that supplementation with BCAA and FO may favorably impact immediate recovery of peak torque production. Alternatively, in comparison to PL group, BCAA supplementation favorably reduces creatine kinase.

Accuracy of exercise-based tests for estimating cardiorespiratory fitness and muscle strength in early-stage breast cancer survivors in Japan.

PURPOSE: We aimed to examine whether cardiorespiratory fitness and leg strength can be estimated based on their relationship with physical performance tests in Japanese breast cancer survivors. METHODS: Participants were 50 sedentary women aged 20 to 59 years who have received breast surgery in the past 2 to 13 months after diagnosis of invasive breast cancer (stage I-IIa). Cardiorespiratory fitness and leg strength were measured by peak oxygen consumption (VO2peak), and one-repetition maximum for leg press (leg press 1RM). Physical performance tests were performed 6-min walk test, chair stand test, and grip strength. Using multiple regression analysis, we developed prediction equations for VO2peak and leg strength based on their associations with the physical performance tests. The validity of the estimation equations was assessed using Bland-Altman plots. RESULTS: Mean age, VO2peak, and leg press 1RM were 48 ± 6 years, 25.0 ± 3.6 mL/kg/min, and 95 ± 32 kg, respectively. Multiple regression analysis yielded 6-min walk test distance, age, height, and body weight as predictors of VO2peak. Measured VO2peak and predicted VO2peak showed a moderate positive correlation (r = 0.463, p < 0.001). Chair stand test, grip strength, age, height, and body weight were selected as predictors of leg press 1RM. There was a strong positive correlation between predicted and measured leg press 1RM (r = 0.754, p < 0.001). CONCLUSION: The results suggest that leg strength can be predicted using physical performance tests. However, further examination may be needed to determine whether cardiorespiratory fitness can be predicted based on 6-min walk test.

Cardiorespiratory fitness in breast cancer survivors: a randomised controlled trial of home-based smartphone supported high intensity interval training.

BACKGROUND: A strategy for maintaining and/or improving cardiorespiratory fitness (CRF) in the growing population of cancer survivors is of major clinical importance, especially in the COVID-19 era. The effect of unsupervised high-intensity interval training (HIIT) on increasing CRF in breast cancer survivors is unknown. PURPOSE: The purpose of this study was to determine whether the newly developed habit-B programme, which involves home-based smartphone-supported HIIT using body weight exercises, improves CRF in early-stage breast cancer survivors. METHODS: This single-centre, 12-week, parallel-group, single-blind, randomised controlled trial involved 50 women with stage I-IIa breast cancer, aged 20-59 years, who had completed initial treatment except for hormone therapy. Participants were randomised to either the exercise or control group. The primary outcome was the 12-week change in peak oxygen uptake [Formula: see text]. Other outcomes included muscle strength, 6 min walk test, resting heart rate, physical activity, fatigue, safety and quality of life. RESULTS: The change in [Formula: see text] and leg strength increased significantly in the exercise group compared with the control group (p<0.01). Changes in other outcomes were not significantly different between the groups. CONCLUSION: A home-based HIIT intervention can lead to improve CRF and muscle strength in early-stage breast cancer survivors.

Oncology care providers' awareness and practice related to physical activity promotion for breast cancer survivors and barriers and facilitators to such promotion: a nationwide cross-sectional web-based survey.

PURPOSE: A known barrier to getting breast cancer survivors (BCSs) to engage in habitual exercise is a lack of information on recommended physical activity levels provided to them by oncology care providers (OCPs). However, the actual situation in Japan remains unclear. This study sought to clarify OCPs' awareness and practice related to Japan's physical activity recommendation for BCSs and to ascertain barriers to routine information provision. METHODS: We conducted a web-based survey involving members of the Japanese Breast Cancer Society (JBCS) and the Japanese Association of Cancer Rehabilitation between Dec. 2018 and Feb. 2019. RESULTS: Of 10,830 members, 1,029 (9.5%) responded. Only 19.1% were aware of the details of the JBCS physical activity recommendation, and only 21.2% routinely provided physical activity information to BCSs. Factors related to being aware of the recommendation details were 1) availability of the guidelines, 2) experience reading relevant parts of the guidelines, and 3) involvement in multidisciplinary team case meetings. Barriers to routine information provision were 1) absence of perceived work responsibility, 2) underestimation of survivors' needs, 3) lack of resources, 4) lack of self-efficacy about the recommendation, and 5) poor knowledge of the recommendation. CONCLUSIONS: Only one fifth of the OCPs routinely provided physical activity information. Barriers to provision were poor awareness, self-efficacy, and attitudes and unavailable resources. The physical activity recommendation needs to be disseminated to all OCPs and an information delivery system needs to be established for BCSs to receive appropriate information and support to promote their engagement in habitual physical activity.

Comorbid insomnia among breast cancer survivors and its prediction using machine learning: a nationwide study in Japan.

OBJECTIVE: Insomnia is an increasingly recognized major symptom of breast cancer which can seriously disrupt the quality of life during and many years after treatment. Sleep problems have also been linked with survival in women with breast cancer. The aims of this study were to estimate the prevalence of insomnia in breast cancers survivors, clarify the clinical characteristics of their sleep difficulties and use machine learning techniques to explore clinical insights. METHODS: Our analysis of data, obtained in a nationwide questionnaire survey of breast cancer survivors in Japan, revealed a prevalence of suspected insomnia of 37.5%. With the clinical data obtained, we then used machine learning algorithms to develop a classifier that predicts comorbid insomnia. The performance of the prediction model was evaluated using 8-fold cross-validation. RESULTS: When using optimal hyperparameters, the L2 penalized logistic regression model and the XGBoost model provided predictive accuracy of 71.5 and 70.6% for the presence of suspected insomnia, with areas under the curve of 0.76 and 0.75, respectively. Population segments with high risk of insomnia were also extracted using the RuleFit algorithm. We found that cancer-related fatigue is a predictor of insomnia in breast cancer survivors. CONCLUSIONS: The high prevalence of sleep problems and its link with mortality warrants routine screening. Our novel predictive model using a machine learning approach offers clinically important insights for the early detection of comorbid insomnia and intervention in breast cancer survivors.

Polyunsaturated Fatty Acids, Exercise, and Cancer-Related Fatigue in Breast Cancer Survivors.

Cancer-related fatigue (CRF) is one of the most frequently reported and disabling symptoms in cancer survivors. With its negative impact on the activities of daily living, work, social activities, and mood, CRF causes severe impairment of quality of life. A previous study showed that omega-6 polyunsaturated fatty acid (PUFA) supplementation unexpectedly reduced CRF compared with omega-3 PUFA supplementation and that omega-6 PUFA supplementation reduced pro-inflammatory serum markers in fatigued American breast cancer survivors. Meanwhile, a recent meta-analysis of individual patient data revealed significant benefits of exercise interventions on CRF. Recently, we completed our randomized controlled trial among early-stage Japanese breast cancer survivors, in which we examined the effect of baseline blood PUFA characteristics on change in CRF during the 12-week trial by exercise group and confirmed that increased Cancer Fatigue Scale (CFS) was associated with both docosahexaenoic acid (DHA) (p = 0.06) and omega-3 index (p = 0.08) at baseline in all participants (n = 46, omega-6/omega-3 ratio = 6.79, SD = 1.90). On the contrary, DHA at baseline was positively correlated with change in CRF (r = 0.40, p = 0.06) in the control group (n = 24, omega-6/omega-3 ratio = 7.0). Moreover, eicosapentaenoic acid (EPA) at baseline was positively correlated with leg strength (r = 0.39, p = 0.10) in the exercise group. In conclusion, blood PUFA balance might be associated with the effect of exercise on CRF. In addition, higher EPA in individuals who conducted exercise likely has a beneficial effect on muscle strength. Further investigation is needed to clarify the interaction between PUFAs and exercise for alleviating CRF.

High-intensity interval training in breast cancer survivors: a systematic review.

BACKGROUND: To review the settings and outcomes of high-intensity interval training (HIIT) interventions for breast cancer survivors, and to explore the feasibility of prescribing exercise for breast cancer survivors. METHODS: A systematic search of electronic databases was conducted for studies published up to May 31, 2020. Eligibility criteria included randomized controlled trials of HIIT intervention in breast cancer survivors. Studies were grouped by whether the intervention was conducted during or after breast cancer treatment, and intervention methods and outcomes were reviewed within each group. RESULTS: Twenty-six studies were identified, and 13 satisfied the inclusion criteria. Intervention was conducted during treatment in 8 studies, and after treatment in 5. Intervention duration ranged from 3 to 16 weeks, with 2 or 3 sessions per week, for a total of 9 to 36 sessions. All interventions were supervised; 12 were lab-based, and 1 was community-based. One of most promising outcomes was improvement of cardiorespiratory fitness by HIIT. CONCLUSION: This review found that all studies on HIIT for breast cancer survivors investigated lab-based, supervised interventions, but not home-based or unsupervised. HIIT is a time-efficient method for increasing cardiovascular function in breast cancer survivors, but further research is necessary to determine its effects on other outcomes.

Conduction Velocity of Muscle Action Potential of Knee Extensor Muscle During Evoked and Voluntary Contractions After Exhaustive Leg Pedaling Exercise.

PURPOSE: Muscle fiber conduction velocity (CV) has been developed to estimate neuromuscular fatigue and measured during voluntary (VC) and electrically evoked (EC) contractions. Since CV during VC and EC reflect different physiological phenomena, the two parameters would show inconsistent changes under the conditions of neuromuscular fatigue. We investigated the time-course changes of CV during EC and VC after fatiguing exercise. METHODS: In 14 young males, maximal voluntary contraction (MVC) of knee extensor muscles, CV during electrical stimulation (CV-EC) and MVC (CV-VC) were measured before and immediately, 30 min, 60 min, 120 min, and 24 h after exhaustive leg pedaling exercise. RESULTS: CV-EC significantly increased immediately after the fatiguing exercise (p < 0.05) and had a significant negative correlation with MVC in merged data from all time-periods (r = -0.511, p < 0.001). CV-VC significantly decreased 30, 60, and 120 min after the fatiguing exercise (p < 0.05) and did not show any correlations with MVC (p > 0.05). CONCLUSION: These results suggest that CV during EC and VC exhibits different time-course changes, and that CV during EC may be appropriate to estimate the degree of neuromuscular fatigue after fatiguing pedaling exercise.

Sitting-induced Endothelial Dysfunction Is Prevented in Endurance-trained Individuals.

PURPOSE: Prolonged sitting impairs leg endothelial function, which seems to be mediated by a sustained reduction in blood flow-induced shear stress. However, whether regular endurance training is effective in preventing sitting-induced leg endothelial dysfunction remains largely unknown. Herein, we tested the hypothesis that sitting-induced leg endothelial dysfunction is prevented in high endurance-trained individuals. METHODS: The endurance-trained group comprised 10 male collegiate cyclists, and the untrained group comprised nine men with no regular endurance training. Peak oxygen uptake (V˙O2peak) was initially determined in all participants using incremental exercise test (37.9 ± 4.7 mL·min·kg in the untrained group versus 60.8 ± 3.6 mL·min·kg in the endurance-trained group). At second visit, the popliteal artery flow-mediated dilation (%FMD) was assessed before and after a 3-h sitting period. During the sitting period, the popliteal artery diameter and blood velocity were measured every hour. RESULTS: The popliteal artery blood flow and shear rate were significantly and similarly reduced during the sitting period in both groups (P < 0.001). In a 3-h sitting, a significant impairment in popliteal artery %FMD was observed in the untrained group (P = 0.003), but it was prevented in the endurance-trained group (P < 0.196). CONCLUSIONS: In conclusion, the present study revealed that sitting-induced leg endothelial dysfunction is preventable in endurance-trained individuals.

Study protocol for a nationwide questionnaire survey of physical activity among breast cancer survivors in Japan.

INTRODUCTION: A major concern is that few cancer survivors meet the guidelines for recommended levels of physical activity. No studies have investigated physical activity among breast cancer survivors nationwide in Japan. Therefore, the aims of this study are to identify the levels of physical activity among breast cancer survivors, to examine factors-related physical activity among breast cancer survivors and to identify breast cancer survivors' preferences for and interest in exercise programmes in order to inform the future programme development. METHODS AND ANALYSIS: We will administer a cross-sectional survey using a self-report questionnaire to breast cancer survivors. At each of 50 facilities selected to include a variety of institutional backgrounds according to the population distribution of different regions throughout Japan, we will consecutively distribute the questionnaire to 30 outpatients who have completed initial treatments, except for hormone therapy. The target sample size is 1500 survivors. We will calculate descriptive statistics for each measurement item and perform univariate and multivariate analyses using outcome measures (eg, physical activity and quality of life) related to physical, psychological, social and environmental factors. DISCUSSION: This is the first nationwide survey of physical activity levels among breast cancer survivors in Japan. Identifying the factors associated with physical activity will help us to develop, disseminate and implement programmes that encourage more survivors to adhere to physical activity guidelines. ETHICS AND DISSEMINATION: The protocol was approved by the Institutional Review Board (IRB) of the National Cancer Center on 11 January 2019 (ID: 2018-295). In addition, many of the participating facilities required ethical approval from their local IRBs, while others did not. Accordingly, approval from the local IRBs of individual facilities was obtained when required. The findings will be disseminated through peer-reviewed publications and conference presentations.

Developing the structure of Japan's cancer survivorship guidelines using an expert panel and modified Delphi method.

PURPOSE: To develop consensus-based components used in the first evidence-based cancer survivorship guidelines in Japan. METHODS: Purposive sampling was used to recruit a panel of experts in oncology clinical practice, nursing, health science, epidemiology, and patient advocacy. The panel engaged in a modified Delphi process to (1) generate consensus related to the definition of survivorship, (2) determine the aim and target users of the guideline, and (3) identify clinical issues for inclusion. A Web-based survey and panel meeting were conducted to obtain the panelists' feedback on the initial draft proposed by the secretariat. Multiple online votes were then completed until all elements of the proposed guidelines reached an approval rate of 80% or higher. Following each round, iterative refinements were made based on all panelists' feedback. RESULTS: Twenty-two experts were enrolled in the panel and participated in four rounds of online voting and two face-to-face meetings. Ultimately, the panel reached consensus on the definition of survivorship, the aim of the guidelines, and target users. Moreover, 11 of the original 17 clinical issues were retained. Finally, the panel selected two priority areas to implement immediately. CONCLUSION: The panel's consensus on the definition of survivorship, aim and target users of the guideline, and 11 clinical issues will serve as a compass for the development of comprehensive cancer survivorship guidelines in Japan. IMPLICATIONS FOR CANCER SURVIVORS: A culturally sensitive consensus approach was developed to improve the long term health and well- being of cancer survivors in Japan.

Effect of home-based high-intensity interval training and behavioural modification using information and communication technology on cardiorespiratory fitness and exercise habits among sedentary breast cancer survivors: habit-B study protocol for a randomised controlled trial.

INTRODUCTION: Maintaining high levels of physical activity helps to maintain and improve physical health and quality of life, and plays a role in reducing adverse effects due to cancer treatments. Moreover, a greater degree of cardiorespiratory fitness is associated with reduced risk of all-cause mortality. However, there are no home-based programme for improving cardiorespiratory fitness using body weight exercises for breast cancer survivors. This study will assess the efficacy of the newly developed habit-B programme on maximum oxygen uptake compared with treatment as usual with wearable device. The effects of this programme on exercise habits, level of physical activity, physical fitness and subjective indices will also be investigated. METHODS AND ANALYSIS: This is a 12-week, parallel-group, single-blind, randomised controlled trial. Allocation will be managed by a central server using a computer-generated random allocation sequence provided by an independent data centre. Participants will be assigned to the habit-B programme (high-intensity interval training, exercise counselling + guidance, home-based exercise support using information and communication technology, and a wearable device) or treatment as usual with a wearable device. Subjects will be sedentary women aged 20-59 years who have received breast surgery in the past 2-13 months after the diagnosis of invasive breast cancer (stages I-IIa) and have never received chemotherapy except for hormone therapy. The primary endpoint is the change in peak oxygen uptake (VO2peak; mL/kg/min) between the groups after 12 weeks of intervention. ETHICS AND DISSEMINATION: The study protocol was approved by the Institutional Review Board of the National Cancer Center Japan on 28 February 2019 (ID: 2018-347). The findings will be disseminated through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER: UMIN000036400.

Expectations of and recommendations for a cancer survivorship guideline in Japan: a literature review of guidelines for cancer survivorship.

BACKGROUND: Optimal cancer survivorship care needs its comprehensive guidelines. We aimed to identify English and Japanese guidelines that include cancer survivorship in their title, the issues highlighted in such guidelines, and any existing oncology practice guidelines in Japan that address these issues. METHODS: This literature review was performed in three stages. First, guidelines published in English or Japanese that included cancer survivorship in the title were identified. Then, the issues that each cancer survivorship guideline addressed were defined. Lastly, Japanese guidelines that include survivorship issues were sought. RESULTS: Six guidelines published in English addressed 31 cancer survivorship issues. No specific cancer survivorship guideline was available in Japanese. Thirty-four Japanese guidelines mentioned cancer survivorship issues. These guidelines addressed screening/surveillance for detecting recurrence or secondary cancer but did not address coordination of care, implications for practice, or inclusion of family. At present, Japanese guidelines poorly address the issue of promotion of a healthy lifestyle in cancer survivors. Also, poorly addressed were long-term and late effects such as pain, psychological distress, fatigue, cognitive dysfunction, cardiovascular effects (including anthracycline-induced cardiac toxicity), sleep disorders, and sexual dysfunction in cancer survivors. CONCLUSION: There is a need for guidelines on optimal coordination of care between oncologists and other health care providers to support patients along the cancer care continuum and specifically to encourage a healthy lifestyle as part of cancer survivorship. The development of a comprehensive Japanese guideline that addresses these issues would help to improve the clinical outcome for cancer survivors in Japan.

Gene expression profile of muscle adaptation to high-intensity intermittent exercise training in young men.

High-intensity intermittent exercise training (HIIT) has been proposed as an effective approach for improving both, the aerobic and anaerobic exercise capacity. However, the detailed molecular response of the skeletal muscle to HIIT remains unknown. We examined the effects of the HIIT on the global gene expression in the human skeletal muscle. Eleven young healthy men participated in the study and completed a 6-week HIIT program involving exhaustive 6-7 sets of 20-s cycling periods with 10-s rests. In addition to determining the maximal oxygen uptake ([Formula: see text]), maximal accumulated oxygen deficit, and thigh muscle cross-sectional area (CSA), muscle biopsy samples were obtained from the vastus lateralis before and after the training to analyse the skeletal muscle transcriptome. The HIIT program significantly increased the [Formula: see text], maximal accumulated oxygen deficit, and thigh muscle CSA. The expression of 79 genes was significantly elevated (fold-change >1.2), and that of 73 genes was significantly reduced (fold-change <0.8) after HIIT. Gene ontology analysis of the up-regulated genes revealed that the significantly enriched categories were "glucose metabolism", "extracellular matrix", "angiogenesis", and "mitochondrial membrane". By providing information about a set of genes in the human skeletal muscle that responds to the HIIT, the study provided insight into the mechanism of skeletal muscle adaptation to HIIT.

Effects of Different Exercise Modes on Arterial Stiffness and Nitric Oxide Synthesis.

PURPOSE: Aerobic training (AT) and high-intensity intermittent training (HIIT) reduce arterial stiffness, whereas resistance training (RT) induces deterioration of or no change in arterial stiffness. However, the molecular mechanism of these effects of different exercise modes remains unclear. This study aimed to clarify the difference of different exercise effects on endothelial nitric oxide synthase (eNOS) signaling pathway and arterial stiffness in rats and humans. METHODS: In the animal study, forty 10-wk-old male Sprague-Dawley rats were randomly divided into four groups: sedentary control (CON), AT (treadmill running, 60 min at 30 m·min, 5 d·wk for 8 wk), RT (ladder climbing, 8-10 sets per day, 3 d·wk for 8 wk), and HIIT (14 repeats of 20-s swimming session with 10-s pause between sessions, 4 d·wk for 6 wk from 12-wk-old) groups (n = 10 in each group). In the human study, we confirmed the effects of 6-wk HIIT and 8-wk AT interventions on central arterial stiffness and plasma nitrite/nitrate level in untrained healthy young men in randomized controlled trial (HIIT, AT, and CON; n = 7 in each group). RESULTS: In the animal study, the effect on aortic pulse wave velocity (PWV), as an index of central arterial stiffness, after HIIT was the same as the decrease in aortic PWV and increase in arterial eNOS/Akt phosphorylation after AT, which was not changed by RT. A negative correlation between aortic PWV and eNOS phosphorylation was observed (r = -0.38, P < 0.05). In the human study, HIIT- and AT-induced changes in carotid-femoral PWV (HIIT -115.3 ± 63.4 and AT -157.7 ± 45.7 vs CON 71.3 ± 61.1 m·s, each P < 0.05) decreased, and plasma nitrite/nitrate level increased compared with those in CON. CONCLUSIONS: HIIT may reduce central arterial stiffness via the increase in aortic nitric oxide bioavailability despite it being done in a short time and short term and has the same effects as AT.

Effects of short-lasting supramaximal-intensity exercise on diet-induced increase in oxygen uptake.

This study was undertaken to quantify the additional increase in diet-induced oxygen uptake after exhaustive high-intensity intermittent exercise (HIIE), consisting of 6-7 bouts of 20-sec bicycle exercise (intensity: 170% V˙O2max) with a 10-sec rest between bouts. Using a metabolic chamber, the oxygen uptake of ten men was measured from 10:30 am to 07:00 am the next day on two separate days with or without HIIE, with lunch (12:00) and supper (18:00) (Diet experiment). On two other days, the oxygen uptake of six different subjects was measured from 10:30 to 16:00 with or without HIIE, but without meals (Fasting experiment). Ten minutes of exercise at 50% V˙O2maxpreceded the HIIE in both experiments; EPOC (excess postexercise oxygen consumption) after HIIE was found to wear off before 12:00 in both experiments. In the Diet experiment, oxygen uptake during HIIE and EPOC were 123.4 ± 12.0 and 115.3 ± 32.3 mL·kg-1, respectively. Meals elevated resting oxygen uptake on both days, but those on the HIIE day were significantly higher than on the control day. This enhanced diet-induced oxygen uptake (difference in resting oxygen uptake from 12:00-23:00 between HIIE and control day: ΔDIT) was 146.1 ± 90.9 mL·kg-1, comparable to the oxygen uptake during the HIIE and EPOC The ΔDIT was correlated with subjects' V˙O2max(52.1 ± 6.6 mL·kg-1·min-1) (r = 0.76, n = 10, P < 0.05). We concluded that HIIE enhances diet-induced oxygen uptake significantly, and that it is related to the cardiorespiratory fitness.