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Raberin A, Burtscher J, Burtscher M, Millet GP. Hypoxia and the Aging Cardiovascular System. Aging Dis 2023; 14:2051-2070. [PMID: 37199587 PMCID: PMC10676797 DOI: 10.14336/ad.2023.0424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 04/24/2023] [Indexed: 05/19/2023] Open
Abstract
Older individuals represent a growing population, in industrialized countries, particularly those with cardiovascular diseases, which remain the leading cause of death in western societies. Aging constitutes one of the largest risks for cardiovascular diseases. On the other hand, oxygen consumption is the foundation of cardiorespiratory fitness, which in turn is linearly related to mortality, quality of life and numerous morbidities. Therefore, hypoxia is a stressor that induces beneficial or harmful adaptations, depending on the dose. While severe hypoxia can exert detrimental effects, such as high-altitude illnesses, moderate and controlled oxygen exposure can potentially be used therapeutically. It can improve numerous pathological conditions, including vascular abnormalities, and potentially slows down the progression of various age-related disorders. Hypoxia can exert beneficial effects on inflammation, oxidative stress, mitochondrial functions, and cell survival, which are all increased with age and have been discussed as main promotors of aging. This narrative review discusses specificities of the aging cardiovascular system in hypoxia. It draws upon an extensive literature search on the effects of hypoxia/altitude interventions (acute, prolonged, or intermittent exposure) on the cardiovascular system in older individuals (over 50 years old). Special attention is directed toward the use of hypoxia exposure to improve cardiovascular health in older individuals.
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Affiliation(s)
- Antoine Raberin
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
| | - Johannes Burtscher
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
| | - Martin Burtscher
- Department of Sport Science, University of Innsbruck, Innsbruck, A-6020, Austria.
| | - Grégoire P. Millet
- Institute of Sport Sciences, University of Lausanne, CH-1015, Lausanne, Switzerland.
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Braybrook PJ, Tohira H, Birnie T, Brink D, Finn J, Buzzacott P. Types and anatomical locations of injuries among mountain bikers and hikers: A systematic review. PLoS One 2023; 18:e0285614. [PMID: 37647303 PMCID: PMC10468092 DOI: 10.1371/journal.pone.0285614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 04/26/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND Mountain biking and hiking continue to grow in popularity. With new participants to these sports, it is likely the number of injuries will increase. To assist medical personnel in the management of these patients we attempted to quantify the types and locations of injuries sustained by mountain bikers and hikers. Objective The objective of this systematic review is to identify the type and anatomical location of injuries for both mountain bikers and hikers. METHODS A systematic search was undertaken using CINAHL, Cochrane, ProQuest, PubMed and Scopus databases. Reviewers assessed the eligibility of articles by a title/abstract review and final full-text review. Studies were included if the types of injuries were reported by medical personnel and contained anatomical locations. Studies were excluded if it did not take place on a trail or if the injuries were self-reported. Risk of bias was assessed utilising the Joanna Briggs Institute (JBI) checklists for study quality. No meta-analysis or comparison between mountain bikers and hikers was possible due to the high heterogeneity of the definition of injury. RESULTS A total of 24 studies met the inclusion criteria, 17 covering mountain biking and 7 hiking. This represented 220,935 injured mountain bikers and 17,757 injured hikers. The most common type of injuries sustained by mountain bikers included contusions, abrasions and minor lacerations, which made up between 45-74% of reported injuries in studies on competitive racing and 8-67% in non-competitive studies. Fractures represented between 1.5-43% of all reported injuries. The most injured region was the upper limbs reported in 10 of 17 studies. For hikers the most common injuries included blisters and ankle sprains with blisters representing 8-33% of all reported injuries. The most common body location to be injured by hikers was a lower limb in all 7 studies. CONCLUSIONS This is the first systematic review to report on the injury epidemiology of the two most common trail users; mountain bikers and hikers. For participants in both activities the majority of injuries were of minor severity. Despite this, the high proportions of upper limb fractures in mountain bikers and ankle sprains in hikers cannot be ignored. TRIAL REGISTRATION Registration: This systematic review was prospectively registered with the University of York PROSPERO database on the 12/4/2021 (CRD42021229623) https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021229623.
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Affiliation(s)
- Paul John Braybrook
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
| | - Hideo Tohira
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- Discipline of Emergency Medicine, Medical School, University of Western Australia, Crawley, Western Australia
| | - Tanya Birnie
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
| | - Deon Brink
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
| | - Judith Finn
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
- St John Western Australia, Belmont, Western Australia
- Discipline of Emergency Medicine, Medical School, University of Western Australia, Crawley, Western Australia
| | - Peter Buzzacott
- Prehospital Resuscitation and Emergency Care Research Unit, Curtin School of Nursing, Curtin University, Bentley, Western Australia
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Huber D, Freidl J, Pichler C, Bischof M, Kiem M, Weisböck-Erdheim R, Squarra G, De Nigris V, Resnyak S, Neberich M, Bordin S, Zechner R, Hartl A. Long-Term Effects of Mountain Hiking vs. Forest Therapy on Physical and Mental Health of Couples: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20021469. [PMID: 36674227 PMCID: PMC9859399 DOI: 10.3390/ijerph20021469] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/29/2022] [Accepted: 12/30/2022] [Indexed: 06/02/2023]
Abstract
BACKGROUND Lifelong physical activity is related to longer health span, which is reflected at an individual level, and is of substantial socioeconomic relevance. Sedentary lifestyles, on the other hand, pose an increasingly major public health problem. In addition, the COVID-19 pandemic had a negative impact on activity levels and well-being. Previous research indicates that contact with nature might improve exercise levels as well as well-being. METHODS This randomized, controlled clinical trial (ANKER-study) investigated the effects of two types of nature-based therapies (forest therapy and mountain hiking) in couples (FTG: n = 23; HG: n = 22;) with a sedentary or inactive lifestyle on health-related quality of life, relationship quality and other psychological and physiological parameters. RESULTS The results of this study displayed that healthy and highly functioning women and men with sedentary lifestyles mentally benefit from contact with nature (quality of life, satisfaction with life, mood, internal and external health-related control beliefs). The gender-specific effect on women is most visible in the physiological outcomes (hemopoietic system, aerobic capacity, skeletal muscle mass and hydration) of mountain hiking. Men and women showed small improvements in blood pressure as a result of the interventions. CONCLUSIONS The ANKER-study provides a method for valid comparison of forest therapy interventions for the first time. Regarding the COVID-19 pandemic, the nature-based intervention presented could offer a multimodal contribution to maintaining a more active lifestyle, further contact with nature that affects peoples physical as well as mental health, and an improvement in social interaction.
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Affiliation(s)
- Daniela Huber
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Johanna Freidl
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Christina Pichler
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Michael Bischof
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Martin Kiem
- Certified Nature and Forest Therapy Guide, 39010 Tisens, Italy
| | | | | | - Vincenzo De Nigris
- Institute of Sports Medicine, South Tyrol Health Authority, 39100 Bozen, Italy
| | - Stefan Resnyak
- Institute of Sports Medicine, South Tyrol Health Authority, 39100 Bozen, Italy
| | - Marcel Neberich
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Susanna Bordin
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - René Zechner
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
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4
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Lopez-Pascual A, Trayhurn P, Martínez JA, González-Muniesa P. Oxygen in Metabolic Dysfunction and Its Therapeutic Relevance. Antioxid Redox Signal 2021; 35:642-687. [PMID: 34036800 DOI: 10.1089/ars.2019.7901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Significance: In recent years, a number of studies have shown altered oxygen partial pressure at a tissue level in metabolic disorders, and some researchers have considered oxygen to be a (macro) nutrient. Oxygen availability may be compromised in obesity and several other metabolism-related pathological conditions, including sleep apnea-hypopnea syndrome, the metabolic syndrome (which is a set of conditions), type 2 diabetes, cardiovascular disease, and cancer. Recent Advances: Strategies designed to reduce adiposity and its accompanying disorders have been mainly centered on nutritional interventions and physical activity programs. However, novel therapies are needed since these approaches have not been sufficient to counteract the worldwide increasing rates of metabolic disorders. In this regard, intermittent hypoxia training and hyperoxia could be potential treatments through oxygen-related adaptations. Moreover, living at a high altitude may have a protective effect against the development of abnormal metabolic conditions. In addition, oxygen delivery systems may be of therapeutic value for supplying the tissue-specific oxygen requirements. Critical Issues: Precise in vivo methods to measure oxygenation are vital to disentangle some of the controversies related to this research area. Further, it is evident that there is a growing need for novel in vitro models to study the potential pathways involved in metabolic dysfunction to find appropriate therapeutic targets. Future Directions: Based on the existing evidence, it is suggested that oxygen availability has a key role in obesity and its related comorbidities. Oxygen should be considered in relation to potential therapeutic strategies in the treatment and prevention of metabolic disorders. Antioxid. Redox Signal. 35, 642-687.
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Affiliation(s)
- Amaya Lopez-Pascual
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Paul Trayhurn
- Obesity Biology Unit, University of Liverpool, Liverpool, United Kingdom.,Clore Laboratory, The University of Buckingham, Buckingham, United Kingdom
| | - J Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain.,Precision Nutrition and Cardiometabolic Health, IMDEA Food, Madrid Institute for Advanced Studies, Madrid, Spain
| | - Pedro González-Muniesa
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, Centre for Nutrition Research, University of Navarra, Pamplona, Spain.,IdiSNA, Navarra Institute for Health Research, Pamplona, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIII, Madrid, Spain
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5
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Neumayr G, Engler C, Lunger L, Lechleitner P. Effects of a One-week Vacation with Various Activity Programs on Metabolism and Adipokines. Int J Sports Med 2020; 42:703-707. [PMID: 33260249 DOI: 10.1055/a-1297-4669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study was conducted as part of a larger study of East Tyrolean health tourism, and investigates the effects of an active seven-day vacation on metabolic parameters and adipokines. Fifty-two healthy vacationers participated in two types of vacation activities (golf vs. Nordic walking or e-biking [nw&eb]). In the former group, 30 subjects played golf for a mean duration of 33.5 h per week; in the NW&EB group, 22 persons performed Nordic walking or e-biking for a mean duration of 14.2 h per week. Metabolic parameters and adipokines, such as leptin, adiponectin, GF-21, irisin, omentin-1, betatrophin, and resistin, were measured one day before and one day after the stay. After one week, only the NW&EB group experienced a significant decrease of 1.0 kg in body weight. Significant changes in HDL-C, FGF-21, irisin, and omentin-1 were seen in the golf group; and in triglycerides, HbA1c, leptin and adiponectin in the NW&EB group. No significant changes in betatrophin or resistin were registered in either group. A seven-day vacation with an activity program for several hours per week causes favorable changes in metabolic parameters and adipokines known to be involved in the pathophysiology of the metabolic syndrome. The changes differed in their magnitude and significance, depending on the type of activity.
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Affiliation(s)
| | - Clemens Engler
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Lukas Lunger
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
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6
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Pérez EA, González MP, Martínez-Espinosa RM, Vila MDM, Reig García-Galbis M. Practical Guidance for Interventions in Adults with Metabolic Syndrome: Diet and Exercise vs. Changes in Body Composition. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16183481. [PMID: 31540536 PMCID: PMC6765968 DOI: 10.3390/ijerph16183481] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 12/12/2022]
Abstract
(1) Objective: to establish practical guidance for the design of future clinical trials in MS (metabolic syndrome) patients aged 18 and older, based on a systematic review of randomized clinical trials connecting diet, physical exercise and changes in body composition. (2) Method: this systematic review of randomized clinical trials (RCT) is based on the guidelines recommended by PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Criteria of selection: ≥18 years of age; patients diagnosed with MS; intervention programs including diet, physical exercise and/or modifications in the style of life as treatment, as well as the magnitude of changes in body composition (BC); randomized clinical trial published between 2004 and 2018. (3) Results: the multidisciplinary interventions describe major changes in BC, and the recurring pattern in these clinical trials is an energy reduction and control in the percentage of intake of macronutrients along with the performance of regularly structured exercise; the most analyzed parameter was waist circumference (88.9% of the trials), followed by body weight (85.2%), BMI (77.8%) and body fat (55.6%). (4) Conclusions: The analysis of the information here reported sheds light for the design of future clinical trials in adults with MS. The best anthropometric parameters and units of measurement to monitor the interventions are related to dietary and physical exercise interventions. A list of practical advice that is easy to implement in daily practice in consultation is here proposed in order to guarantee the best results in changes of body composition.
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Affiliation(s)
| | | | - Rosa María Martínez-Espinosa
- Division of Biochemistry and Molecular Biology, Department of Agrochemistry and Biochemistry, Faculty of Sciences. University of Alicante, 03690 Alicante, Spain
| | - Mariola D Molina Vila
- Department of Mathematics, Faculty of Sciences, University of Alicante, 03690 Alicante, Spain
| | - Manuel Reig García-Galbis
- Department of Nutrition and Dietetics, Faculty of Health Sciences, University of Atacama, Avda. Copayapu 2862, III Region, Copiapó 1530000, Chile.
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7
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Nilsson K, Bentsen P, Grahn P, Mygind L. [What is the scientific evidence with regard to the effects of forests, trees on human health and well-being?]. SANTE PUBLIQUE 2019; S1:219-240. [PMID: 31210482 DOI: 10.3917/spub.190.0219] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
In today's modern society, lifestyle-related diseases play an increasingly important role as the cause of bad health. Staying in and access to environments that contain natural elements such as forests, parks and gardens has been featured because of its potential to stimulating people's health and well-being. An independent research area has developed, which addresses issues that try to explain and document the health effects of access to and activities in nature. To bring together European researchers working with different aspects of the relation between nature and health, COST Action E39 "Forests, Trees, and Human Health and Wellbeing" was established in 2004 and terminated in November 2009. The main results of COST E39 was presented in the book "Forests, Trees and Human Health" published in 2011. This article focuses on three central research questions regarding the relationship between nature and health: (1) Nature's restorative and salutogenic effects on human beings, (2) Health effects of outdoor physical activities, and (3) Therapeutic interventions such as therapy gardens and forest bathing. Based on a systematic review of research carried out in the aftermath of the COST Action the following conclusions are made: (1) There is a remarkable amount of research publications showing a statistical correlation between access to nature and green areas and human physical activity and health. However, there are few studies that really prove a causal relationship, i.e. that access to green areas leads to increased physical activity and better health. (2) The existing research on outdoor activities in natural environments describes a number of positive associations and effects on health, and the evidence for some of these are convincing, albeit there must be reservations for the immediate applicability of the conclusions. (3) A lot of studies also show that nature-based therapeutic interventions work and provide clear positive effects, but there is serious criticism about the quality of the studies. Finally, the authors suggest more emphasis on research regarding the economic benefits of nature's health effects, more research on the effects of nature-based therapeutic interventions, and of broadening the theoretical basis. Furthermore, we foresee a better integration with health policies and practical implementation within urban planning and forest management.
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8
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Neumayr G, Lechleitner P. Effects of a one-week vacation with various activity programs on cardiovascular parameters. J Sports Med Phys Fitness 2018; 59:335-339. [PMID: 29498252 DOI: 10.23736/s0022-4707.18.08221-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND A vacation is considered essential to achieve recovery from the stress of work. Knowledge about the potential health effects of holidays is scarce. The East Tyrolean Health Tourism Study is an open comparative study to investigate the cardiovascular effects of a one-week vacation with different activities on healthy vacationers. METHODS Fifty-two healthy vacationers spending one week in East Tyrol participated in two types of vacation activities (golf versus Nordic walking or e-biking [NW&EB]). In the former group 30 subjects played golf for 33.5 h/week, and in the NW&EB group 22 engaged in Nordic walking or e-biking for 14.2 h/week. Cardiovascular parameters such as performance capacity, blood pressure, heart rate profiles and cardiac diastolic function were measured by a cardiopulmonary exercise test, Holter ECG and echocardiography performed one day before and after the stay. RESULTS There was a significant decrease in body weight of 1.0 kg in the NW&EB-group but not in the golf group. In both groups we noted a reduction of blood pressure and heart rate, which was marked and significant only in the golf group. We observed no significant changes in performance capacity but did note an improvement of cardiac diastolic function in both groups; the improvement was more pronounced in the NW&EB group. CONCLUSIONS A one-week vacation with an activity program for several hours per week is well tolerated by healthy vacationers and improves cardiovascular parameters. The cardiovascular benefits were homogeneous but differed in their magnitude, depending on the activity group. The benefits were probably due to the enhanced physical activity rather than purely a holiday effect.
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Affiliation(s)
| | - Peter Lechleitner
- Medical Center Symbiomed, Lienz, Austria.,Department of Internal Medicine, Hospital Lienz, Lienz, Austria
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Girard O, Malatesta D, Millet GP. Walking in Hypoxia: An Efficient Treatment to Lessen Mechanical Constraints and Improve Health in Obese Individuals? Front Physiol 2017; 8:73. [PMID: 28232806 PMCID: PMC5298970 DOI: 10.3389/fphys.2017.00073] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 01/26/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Olivier Girard
- Athlete Health and Performance Research Center, Aspetar Orthopaedic and Sports Medicine HospitalDoha, Qatar; Faculty of Biology and Medicine, Institute of Sport Sciences, University of LausanneLausanne, Switzerland
| | - Davide Malatesta
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne Lausanne, Switzerland
| | - Grégoire P Millet
- Faculty of Biology and Medicine, Institute of Sport Sciences, University of Lausanne Lausanne, Switzerland
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10
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Lopez-Pascual A, Bes-Rastrollo M, Sayón-Orea C, Perez-Cornago A, Díaz-Gutiérrez J, Pons JJ, Martínez-González MA, González-Muniesa P, Martínez JA. Living at a Geographically Higher Elevation Is Associated with Lower Risk of Metabolic Syndrome: Prospective Analysis of the SUN Cohort. Front Physiol 2017; 7:658. [PMID: 28101063 PMCID: PMC5209344 DOI: 10.3389/fphys.2016.00658] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/14/2016] [Indexed: 11/13/2022] Open
Abstract
Living in a geographically higher altitude affects oxygen availability. The possible connection between environmental factors and the development of metabolic syndrome (MetS) feature is not fully understood, being the available epidemiological evidence still very limited. The aim of the present study was to evaluate the longitudinal association between altitude and incidence of MetS and each of its components in a prospective Spanish cohort, The Seguimiento Universidad de Navarra (SUN) project. Our study included 6860 highly educated subjects (university graduates) free from any MetS criteria at baseline. The altitude of residence was imputed with the postal code of each individual subject residence according to the data of the Spanish National Cartographic Institute and participants were categorized into tertiles. MetS was defined according to the harmonized definition. Cox proportional hazards models were used to assess the association between the altitude of residence and the risk of MetS during follow-up. After a median follow-up period of 10 years, 462 incident cases of MetS were identified. When adjusting for potential confounders, subjects in the highest category of altitude (>456 m) exhibited a significantly lower risk of developing MetS compared to those in the lowest tertile (<122 m) of altitude of residence [Model 2: Hazard ratio = 0.75 (95% Confidence interval: 0.58–0.97); p for trend = 0.029]. Living at geographically higher altitude was associated with a lower risk of developing MetS in the SUN project. Our findings suggest that geographical elevation may be an important factor linked to metabolic diseases.
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Affiliation(s)
- Amaya Lopez-Pascual
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of NavarraPamplona, Spain; Centre for Nutrition Research, School of Pharmacy and Nutrition, University of NavarraPamplona, Spain
| | - Maira Bes-Rastrollo
- IDISNA Navarra's Health Research InstitutePamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIIIMadrid, Spain; Department Preventive Medicine and Public Health, University of NavarraPamplona, Spain
| | - Carmen Sayón-Orea
- Department Preventive Medicine and Public Health, University of Navarra Pamplona, Spain
| | - Aurora Perez-Cornago
- Department Preventive Medicine and Public Health, University of NavarraPamplona, Spain; Cancer Epidemiology Unit, Nuffield Department of Population Health, University of OxfordOxford, UK
| | - Jesús Díaz-Gutiérrez
- Department Preventive Medicine and Public Health, University of Navarra Pamplona, Spain
| | - Juan J Pons
- IDISNA Navarra's Health Research InstitutePamplona, Spain; Department History, Art History, and Geography, University of NavarraPamplona, Spain
| | - Miguel A Martínez-González
- IDISNA Navarra's Health Research InstitutePamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIIIMadrid, Spain; Department Preventive Medicine and Public Health, University of NavarraPamplona, Spain
| | - Pedro González-Muniesa
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of NavarraPamplona, Spain; Centre for Nutrition Research, School of Pharmacy and Nutrition, University of NavarraPamplona, Spain; IDISNA Navarra's Health Research InstitutePamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIIIMadrid, Spain
| | - J Alfredo Martínez
- Department of Nutrition, Food Science and Physiology, School of Pharmacy and Nutrition, University of NavarraPamplona, Spain; Centre for Nutrition Research, School of Pharmacy and Nutrition, University of NavarraPamplona, Spain; IDISNA Navarra's Health Research InstitutePamplona, Spain; CIBERobn Physiopathology of Obesity and Nutrition, Centre of Biomedical Research Network, ISCIIIMadrid, Spain
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11
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Gutwenger I, Hofer G, Gutwenger AK, Sandri M, Wiedermann CJ. Pilot study on the effects of a 2-week hiking vacation at moderate versus low altitude on plasma parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome. BMC Res Notes 2015; 8:103. [PMID: 25885799 PMCID: PMC4383206 DOI: 10.1186/s13104-015-1066-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2014] [Accepted: 03/18/2015] [Indexed: 02/08/2023] Open
Abstract
Background Hypoxic and hypobaric conditions may augment the beneficial influence of training on cardiovascular risk factors. This pilot study aimed to explore for effects of a two-week hiking vacation at moderate versus low altitude on adipokines and parameters of carbohydrate and lipid metabolism in patients with metabolic syndrome. Methods Fourteen subjects (mean age: 55.8 years, range: 39 – 69) with metabolic syndrome participated in a 2-week structured training program (3 hours of guided daily hiking 4 times a week, training intensity at 55-65% of individual maximal heart rate; total training time, 24 hours). Participants were divided for residence and training into two groups, one at moderate altitude (1,900 m; n = 8), and the other at low altitude (300 m; n = 6). Anthropometric, cardiovascular and metabolic parameters were measured before and after the training period. Results In study participants, training overall reduced circulating levels of total cholesterol (p = 0.024), low-density lipoprotein cholesterol (p = 0.025) and adiponectin (p < 0.001). In the group training at moderate altitude (n = 8), lowering effects on circulating levels were significant not only for total cholesterol, low-density-lipoprotein cholesterol and adiponectin (all, p < 0.05) but also for triglycerides (p = 0.025) and leptin (p = 0.015), whereas in the low altitude group (n = 6), none of the lipid parameters was significantly changed (each p > 0.05). Hiking-induced relative changes of triglyceride levels were positively associated with reductions in leptin levels (p = 0.006). As compared to 300 m altitude, training at 1,900 m showed borderline significant differences in the pre-post mean reduction rates of triglyceride (p = 0.050) and leptin levels (p = 0.093). Conclusions Preliminary data on patients with metabolic syndrome suggest that a 2-week hiking vacation at moderate altitude may be more beneficial for adipokines and parameters of lipid metabolism than training at low altitude. In order to draw firm conclusions regarding better corrections of dyslipidemia and metabolic syndrome by physical exercise under mild hypobaric and hypoxic conditions, a sufficiently powered randomized clinical trial appears warranted. Trial registration ClinicalTrials.gov ID NCT02013947 (first received November 6, 2013).
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Affiliation(s)
- Ivana Gutwenger
- Department of Anesthesiology, Hospital of Bressanone
- Brixen, Bressanone
- Brixen (BZ), Italy.
| | - Georg Hofer
- Department of Anesthesiology, Hospital of Silandro, Schlanders (BZ), Italy.
| | - Anna K Gutwenger
- Department of Internal Medicine, Hospital of Silandro
- Schlanders, Silandro
- Schlanders (BZ), Italy.
| | - Marco Sandri
- Data, Methods and Systems Statistical Laboratory, University of Brescia, Brescia (BS), Italy.
| | - Christian J Wiedermann
- Department of Internal Medicine, Central Hospital of Bolzano
- Bozen, Bolzano
- Bozen (BZ), Italy. .,Interdisciplinary Medical Research Center South Tyrol (IMREST), Bolzano
- Bozen (BZ), Italy.
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