The Impact of Aerobic Exercise and Badminton on HDL Cholesterol Levels in Taiwanese Adults

Lifestyle Medicine: An Antidote to Cardiovascular Diseases

Despite numerous advances in basic understanding of cardiovascular disease pathophysiology, pharmacology, therapeutic procedures, and systems improvement, there hasn't been much decline in heart disease related mortality in the US since 2010. Hypertension and diet induced risk continue to be the leading causes of cardiovascular morbidity. Even with the excessive mortality associated with the COVID-19 pandemic, in 2020, heart disease remained the leading cause of death. Given the degree of disease burden, morbidity, and mortality, there is an urgent need to redirect medical professionals' focus towards prevention through simple and cost effective lifestyle strategies. However, current practice paradigm and financial compensation systems are mainly centered disease management and not health promotion. For example, the financial value placed on 3-10 min smoking cessation counseling (.24RVUs) is 47-fold lower than an elective PCI (11.21 RVUs). The medical community seems to be enamored with the latest and greatest technology, new devices, and surgical procedures. What if the greatest technology of all was simply the way we live every day? Perhaps when this notion is known by enough, we will switch to this lifestyle medicine technology to prevent disease in the first place.

Aerobic, muscle-strengthening, and flexibility physical activity and risks of all-cause and cause-specific mortality: a population-based prospective cohort of Korean adults

BACKGROUND

Studies have shown that aerobic and muscle-strengthening physical activities reduce mortality risk. However, little is known about the joint associations of the two activity types and whether other type of physical activity, such as flexibility activity, can provide similar mortality risk reduction.

OBJECTIVES

We examined the independent associations of aerobic, muscle-strengthening, and flexibility physical activities with all-cause and cause-specific mortality in a population-based prospective cohort of Korean men and women. We also examined the joint associations of aerobic and muscle-strengthening activities, the two physical activity types that are recommended by the current World Health Organization physical activity guidelines.

DESIGN

This analysis included 34,379 Korea National Health and Nutrition Examination Survey 2007-2013 participants (aged 20-79 years) with mortality data linkage through December 31, 2019. Engagement in walking, aerobic, muscle-strengthening, and flexibility physical activities was self-reported at baseline. Cox proportional hazards model was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), adjusting for potential confounders.

RESULTS

Flexibility physical activity (≥ 5 vs. 0 d/wk) was inversely associated with all-cause (HR [95% CI] = 0.80 [0.70-0.92]; P-trend < 0.001) and cardiovascular mortality (0.75 [0.55-1.03], P-trend = 0.02). Moderate- to vigorous-intensity aerobic physical activity (≥ 50.0 vs. 0 MET-h/wk) was also associated with lower all-cause (HR [95% CI] = 0.82 [0.70-0.95]; P-trend < 0.001) and cardiovascular mortality (0.55 [0.37-0.80]; P-trend < 0.001). Similar inverse associations were observed with total aerobic physical activity, including walking. Muscle-strengthening activity (≥ 5 vs. 0 d/wk) was inversely associated with all-cause mortality (HR [95% CI] = 0.83 [0.68-1.02]; P-trend = 0.01) but was not associated with cancer or cardiovascular mortality. Compared to participants meeting the highest guidelines for both moderate- to vigorous-intensity aerobic and muscle-strengthening physical activities, those not meeting in any guideline were associated with higher all-cause (1.34 [1.09-1.64]) and cardiovascular mortality (1.68 [1.00-2.82]).

CONCLUSIONS

Our data suggest that aerobic, muscle-strengthening, and flexibility activities are associated with lower risk of mortality.

Jogging and weight training associated with increased high-density lipoprotein cholesterol levels in Taiwanese adults

BACKGROUND

Although previous studies have shown that aerobic and resistance exercise increase high-density lipoprotein cholesterol (HDL-C) levels, the optimal type of exercise has not been determined. Therefore, the purpose of this study was to investigate the association of jogging (a type of aerobic exercise) and weight training (a type of resistance exercise) with HDL-C levels in Taiwanese adults.

METHODS

The data used in this cross-sectional study were obtained from the Taiwan Biobank (TWB), which is a national health resource that contains the genetic information of Taiwanese volunteers aged 30-70 years. A total of 75,635 subjects (47,881 women and 27,754 men) were included in this study. The subjects were divided into four groups: jogging (n = 2,278), weight training (n = 522), mixed exercise (n = 519), and no exercise (n = 72,316). The TWB data were collected through questionnaires (e.g. basic characteristics, lifestyle factors, and disease history), biochemical tests, and anthropometric measurements.

RESULTS

Compared with no exercise, jogging, weight training, and mixed exercise were all associated with higher HDL-C levels (β = 2.5470, 2.6249, and 3.2117, respectively). As seen, the β value was highest for the mixed exercise group, followed by weight training and then jogging (p for trend <0.0001).

CONCLUSIONS

In the current study, jogging and weight training were individually associated with higher levels of HDL-C. Engaging in both activities was associated with much higher levels of HDL-C. Our findings suggest that regular jogging and weight training might play an important role in increasing HDL-C levels.

Monobutyrin and monovalerin improve gut-blood-brain biomarkers and alter gut microbiota composition in high-fat fed apolipoprotein-E-knockout rats

Monobutyrin (MB) and monovalerin (MV), glycerol esters of short-chain fatty acids (SCFAs), have been shown to positively influence lipid profile and biomarkers in the gut and brain. This study examined whether MB and MV in high-fat diets, affected microbiota composition and gut-blood-brain markers in apolipoprotein E deficient (ApoE-/-) rats, a model for studies of lipid-associated disorders, and neurodegenerative processes in Alzheimer's disease (AD). ApoE-/- rats fed MB and MV increased Tenericutes and the brain neurotransmitter γ-aminobutyric acid (GABA), while the blood stress hormone corticosterone decreased compared to control rats. Only rats that received MB showed a significant increase in cholic acid and Adlercreutzia in the caecum. In rats fed MV, the decrease of Proteobacteria was associated with decreased corticosterone levels. Conclusively, dietary supplementation of SCFA glycerol esters can modulate gut-blood-brain markers and alter gut microbiota composition in ApoE-/- rats, suggesting that SCFAs also could counteract lipid disorders-related diseases.

Physical Exercise and Health: A Focus on Its Protective Role in Neurodegenerative Diseases

Scientific evidence has demonstrated the power of physical exercise in the prevention and treatment of numerous chronic and/or age-related diseases, such as musculoskeletal, metabolic, and cardiovascular disorders. In addition, regular exercise is known to play a key role in the context of neurodegenerative diseases, as it helps to reduce the risk of their onset and counteracts their progression. However, the underlying molecular mechanisms have not yet been fully elucidated. In this regard, neurotrophins, such as brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF), glia cell line-derived neurotrophic factor (GDNF), neurotrophin-3 (NT-3), and neurotrophin-4 (NT-4), have been suggested as key mediators of brain health benefits, as they are involved in neurogenesis, neuronal survival, and synaptic plasticity. The production of these neurotrophic factors, known to be increased by physical exercise, is downregulated in neurodegenerative disorders, suggesting their fundamental importance in maintaining brain health. However, the mechanism by which physical exercise promotes the production of neurotrophins remains to be understood, posing limits on their use for the development of potential therapeutic strategies for the treatment of neurodegenerative diseases. In this literature review, we analyzed the most recent evidence regarding the relationship between physical exercise, neurotrophins, and brain health, providing an overview of their involvement in the onset and progression of neurodegeneration.

Physical Exercise: An Overview of Benefits From Psychological Level to Genetics and Beyond

Any form of physical activity, including exercise, is linked with preventing several diseases including metabolic disorders, cancer, and mood disorders. Beyond benefits, its therapeutic activity is inconclusive in terms of types, intensity, and individual training status, and this could be a major research for prescribing exercise as a therapeutic strategy. Exercise and its myriad forms occupy the space on clinical recommendation, which implies that quantifiable benefits of the same have been proven. Further, the benefits of exercise and its impact have also been found to have a genetic underlying interaction, which has created a niche of personal genomics, wherein apart from diet, an exercise regimen also becomes tailorable for every individual. Many subjective well-being reports highlighted daily exercise to keep mental and general health in excellent conditions, and the uncertainties around it. Thus, adopting an exercise behavior and inculcating it as a routine has been recommended. Further, the kind of benefit that can be extracted out of exercise and training is to a great extent influenced by genetic markers around fat, obesity, hunger, as well as satiety. Genetic markers can also impact the body temperature during exercise, making the entire experience of training either comfortable or unpleasant. Thus, there is an overwhelming amount of scientific evidence that has gathered around the benefits of exercise, which has become a pressing need from the 21st century when the belief in the value of exercise started waning, and that spiked up the era of lifestyle and noncommunicable ailments.

The impact of badminton lessons on health and wellness of young adults with intellectual disabilities: a pilot study

Background: Physical activity has been proposed as a context to foster the healthy development of individuals and reduce the risk of many chronic problems. This study evaluates the impact of badminton lessons on health and wellness in young adults with intellectual disabilities (ID). Methods: Eighteen participants with ID (14 males and 4 females, aged 19-26) and with little or no experience in badminton were assigned to an exercise group and a control group. The curriculum selected was Shuttle Time Starter Lessons. The exercise group practiced for 50 min each session, twice a week for 10 lessons with peers, while the control group maintained a regular life schedule. Physiological measures, motor performance, Special Olympics Individual Badminton Skills Assessment; and psychological measures were conducted before and after the program. A Wilcoxon signed-rank test was conducted to compare pre- and post-tests in each group. Results: The significantly reduced resting heart rate, longer walking distances in the 6-minute walk test, and better performance in badminton skills were evident in the exercise group. Further, a significantly increased left frontal alpha asymmetry was seen in the exercise group with participants expressing positive effects after the inclusive badminton program. Finally, resting EEG frontal asymmetry seemed to be reflective of emotion in persons with ID. Conclusions: Shuttle Time Badminton Lessons could be feasible for adults with ID. School teachers and coaches may adapt it to improve health and wellness and acquire badminton skills in adults with ID. In addition, the inclusive environment can motivate their participation.

Transition Patterns of Weight Status and Their Predictive Lipid Markers Among Chinese Adults: A Longitudinal Cohort Study Using the Multistate Markov Model

BACKGROUND

Obesity is well recognized as a risk factor for cardiometabolic diseases. The development of obesity is a dynamic process that can be described as a multistate process with an emphasis on transitions between weight states. However, it is still unclear what convenient biomarkers predict transitions between weight states. The aim of this study was to show the dynamic nature of weight status in adults stratified by age and sex and to explore blood markers of metabolic syndrome (MetS) that predict transitions between weight states.

METHODS

This study involved 9795 individuals aged 18 to 56 at study entry who underwent at least two health check-ups in the eight-year period of study in the health check-up centre of our institution. Weight, height and biochemical indices were measured at each check-up. The participants were divided into four groups based on age and sex (young male, middle-aged male, young female and middle-aged female groups). A multistate Markov model containing 3 states (healthy weight, overweight and obesity) was adopted to study the longitudinal weight data.

RESULTS

Young people were more likely to transit between weight states than middle-aged people, and middle-aged people were more resistant to recover from worse states. The mean sojourn time in obesity was greatest in the middle-aged male group (6.23 years), and the predicted rate of obesity beginning with healthy weight was greatest in the young male group (13.7%). In multivariate models, age group and triglyceride (TG) and high-density lipoprotein cholesterol (HDL) levels were significant for specific transitions in females, whereas age group and HDL levels were significant in males. In females, if HDL levels increased 1 mmol/L, the probability of progression from healthy weight to overweight decreased by 37.0% (HR= 0.63), and the probabilities of recovery (overweight to healthy weight and obesity to overweight) increased by 62.0% (HR= 1.62) and 1.23-fold (HR= 2.23), respectively. In males, if TG levels increased 1 mmol/L, the risk of progression from healthy weight to overweight increased by 24.0% (HR= 1.24). Each unit increase in HDL levels was associated with a 0.99-fold (HR= 1.99) increase in the chance of recovery from overweight to healthy weight and with a 0.37-fold (HR= 0.63) decrease in the risk of progression from healthy weight to overweight.

CONCLUSION

The weight status of young people was less stable than that of middle-aged people. Males were more likely to become overweight and more resistant to recover from worse states than females. Young males with healthy weight were more likely to develop obesity than other healthy weight groups. Blood lipid levels, especially HDL, were predictors of weight transitions in adults. Prevention and intervention measures should be applied early.